Scalp Acupuncture for the Treatment of Marfan Syndrome: A Case Study
Joanne Johnson

EJOM Vol. 8 No. 5 (2017)

This case reports the treatment of Marfan syndrome (MFS) using scalp acupuncture. There are challenges in diagnosing genetic conditions in traditional Chinese medicine (TCM). Furthermore, in this case it is difficult to know whether it was the Marfan syndrome or multiple sclerosis that reacted positively to the acupuncture intervention. The patient was diagnosed with both in 2015. Some symptoms of Marfan syndrome and multiple sclerosis appeared to be overlapping (ie muscle stiffness and spasm), symptoms of which may present in both diseases.

The Role of the 24-Hour Cycle of Qi in the Diagnosis
and Treatment of Insomnia
Peter Mole

EJOM Vol. 8 No. 4 (2016)

Chronic insomnia is extremely common. Many of our patients suffer from it and report it as their main complaint or as a secondary complaint. The 24-Hour Cycle of Qi is no longer to be found in contemporary Chinese medical literature but it can provide useful information to help with the diagnosis and treatment of insomnia. The main TCM books also make no distinction between patterns that commonly cause insomnia and those that are extremely rare.

How is Rising Obesity Tackled in China and Europe?
Jane Wills and Tingting Liu
EJOM Vol. 8 No. 3 (2016)

Overweight and obesity are a growing problem in China but their causes may be differently viewed as a consequence of globalisation and the development of an obesogenic environment or as a consequence of an individual’s wellbeing. This paper explores these different explanations and the ways that the problem is addressed in Sino and European policy and TCM practice. Obesity can be linked to an unhealthy diet and eating practices and a lack of activity, and behavioural changes as well as TCM treatments that address the gastrointestinal digestive function may be effective in altering this. Obesity is, however, also a complex and global issue that needs to be recognised as a social problem.

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Attilio D'Alberto
EJOM Vol. 8 No. 1 (2015)

Introduction: Cocaine is the most commonly used illicit stimulant drug in Europe. Auricular acupuncture has been used as a form of treatment for drug addiction since the early 1970s.

Discussion: Cocaine addiction affects all the solid (zang, yin) organs: Lung, Liver, Heart, Spleen and Kidney, causing a complete zang fu disharmony. Within cocaine addiction theory, these five patterns can be grouped into two cycles: the first cycle involves the Lung, Heart and Spleen. The second cycle involves the Lung, Kidney and Liver.

Spirit aspect: Cocaine addiction is rooted in artificially inflating the po for it to dominate over the Heart. This creates a false generation in the Lung, which temporary increases the mother- son relationship between the Lung and Kidney. An addict is reminded of the empty high by the zhi and relayed across the mind by the yi.

Treatment strategies: The NADA protocol is a 'cookbook' strategy and acupuncture points located on the body should be used as well. Conclusions: The use of Chinese medicine therapy can decrease the number of patients being admitted to hospital with drug related illnesses, benefit society in reduced crime rates and benefit the addicts themselves.

Yubin Lu, Qin Chu and Li Lu

EJOM Vol. 7 No. 6 (2014)

The pharynx and the larynx are two important structures of the human body with totally different natures and significances to human life. Due to the translators' lack of knowledge about Chinese medical theories, many important symptoms involving these two structures are simply translated as a pathology of the 'throat'. For example, when there is an invasion of Wind Heat, 'sore throat' is a common symptom. Yin deficiency also presents 'dry throat' as a result of loss of nourishment. These kinds of terms ignore the differences between 'pharynx' and 'larynx' and thus do not correctly express or carry the information behind these terms in Chinese medicine.

Jonathan Pledger
EJOM Vol. 7 No. 5 (2014)

Autistic Spectrum Disorder (ASD) impacts on every aspect of a child’s life and the number
diagnosed with this lifelong condition is growing. Few studies have researched acupuncture and ASD. This study uses an integrated Traditional Chinese Medicine (TCM) and Five Element style of acupuncture and differential diagnosis with individualised treatments.

Julia Bletcher
EJOM Vol. 7 No. 5 (2014)

Depression is a debilitating condition and patients suffering with depression are prevalent in UK primary care. However, suitability for current treatments leaves up to 30% of patients lacking appropriate care. If proven effective, acupuncture may be a suitable intervention to expand current NHS treatment options. Recent critical literature reviews of studies prior to 2010 highlight a need for more robust studies. The aim of this research is to explore the latest evidence of acupuncture efficacy for depression. An electronic database search was conducted of randomised control trials since 2010 exploring the efficacy of acupuncture. The results showed 19 of 22 studies supported acupuncture for depression. However, a number of methodological limitations were identified and there was limited data concerning long-term benefits. Although outcomes suggest acupuncture could be considered as a treatment for depression in UK primary care, more robust research is still needed. In addition, the majority of existing research does not reflect current clinical practice. Therefore, further investigation using a more pragmatic approach is recommended.

Sarah Attwell-Griffiths and Mark Bovey
EJOM Vol. 7 No. 5 (2014)

Self-injury is prolific, often chronic and linked to suicide risk. Conventional medical research into self-injury is extensive, but CAM research is limited to a single study (Bell et al, 2011) that demonstrates that self-acupuncture reduces self-injury.
This paper uses literature research to derive a TCM interpretation of how self-injury works, and then explores clinical implications.

Beverley de Valois
EJOM Vol. 7 No. 4 (2013)

This paper presents case studies of three patients with non-cancer-related lymphoedema of the lower extremities, who participated in a project to assess the potential for using acupuncture and moxibustion as an adjunct to usual lymphoedema care. They illustrate how people with lymphoedema and complex co-morbidities (including morbid obesity) can benefit from treatment, and how reducing the symptom burden increases their ability to self-manage their chronic, incurable condition. They also demonstrate that acupuncture treatment can be effective even when large areas of the body are contraindicated to needling. Also shown are some of the practical challenges of dealing with morbidly obese patients. These case studies may influence existing perceptions of clinicians, patients, and acupuncturists about acupuncture’s potential role in the management of lymphoedema, and they suggest that research into this area is warranted.

Cornelia Davies
EJOM Vol. 7 No. 4 (2013)

A daily home-use moxibustion (moxa) protocol for nourishing the immune system during chemotherapy, first described by Dr Friedrich Staebler (Staebler, 2006), allows a patient to participate positively in his or her immune support during the entire period. The protocol requires the patient to have a helper to apply moxa daily on back shu points. This paper discusses a variation on the existing protocol, which allows a patient without available help to be self-supporting on this.

Venanzio D’Agostino and Diurka Torres
EJOM Vol. 7 No. 4 (2013)

For two years the authors worked in a specialised centre at Pistoia in Tuscany, under the scientific direction of Dr Giampaolo La Malfa, psychiatrist and neurologist, head of the Psychiatry Unit in the Careggi University Hospital (Florence), professor at the School of Specialization in Psychiatry, Florence University, founding member and president of the Società Italiana per lo Studio del Ritardo Mentale (SIRM), and board member of the European Association of Mental Health in Mental Retardation. This collaboration is ongoing. A number of indications can be drawn from this experience. Practical results: prompt diagnosis, regular therapy (at least once a week), parental involvement. Implications for research: verification of the therapy’s incidence on general metabolic equilibrium and on the metabolism of minerals; testing of hormonal release in states of anxiety from stress not dominated by the adaptive phase.

Yasemin Cayir, Turan Set and Zekeriya Akturk
EJOM Vol. 7 No. 4 (2013)

Bell’s palsy is an acute facial paralysis due to inflammation of the facial nerve. Corticosteroids, antiviral agents, and physical therapy can be used to treat Bell’s palsy. However these treatments cannot be said to provide a cure. Acupuncture may be an alternative option for Bell’s palsy and, as evidence of its effectiveness, we present a case report on a patient with Bell’s palsy who was treated with acupuncture.

Dr Hongchun Yin
EJOM Vol. 7 No. 3 (2013)

Tui na massage, one of the main forms of therapy in traditional Chinese medicine, has been widely used in the treatment of paediatric diseases. In this article, the author presents three cases of common paediatric diseases: eczema, insomnia and facial paralysis which responded well to tui na massage. In case 2 the insomnia was treated using a unique tui na technique passed down from Mr Zhang Xizhen, i.e. massaging with egg white on the three yang channels. As tui na massage is safe and promising, it is worthy of further study.

Shen Pi'an
EJOM Vol. 7 No. 2 (2012)

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease with a complex and highly variable range of symptoms that can affect any part of the body. Based on Professor Shen’s 50 years’ clinical experience in treating SLE patients with Chinese medicine, this article summarises the main aspects of TCM aetiology and pathology as well as offering a practical insight into the main treatment principles he employs on a regular basis.
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Wanzhu Hou
EJOM Vol. 7 No. 2 (2012)

The author discusses the Chinese medical understanding of the causes and treatment of Multiple Sclerosis and presents a case which illustrates how treatment with Chinese medicine mediates the body's internal environment and benefits the recovery of damaged tissues during the treatment.

Mazin Al-Khafaji
EJOM Vol. 7 No. 2 (2012)

The author presents a typical case of ulcerative colitis from his practice to outline some of the fundamental principles required for treatment of both the acute and chronic phases of the disease.

Hamid Montakab
EJOM Vol. 7 No. 1 (2012)

In this article, the author presents a case study of a 45-year-old woman who has suffered with insomnia for four years. He first presents an analysis of this case from the perspectives of TCM pattern differentiation, Blood and shen, and wei qi, and then provides a fascinating analysis based on the Extraordinary Vessels, in particular the yin wei mai and yin qiao mai which, he suggests, act as inner synchronizers, controlling the length and depth of sleep time. The successful treatment of this patient with acupuncture is then detailed with explanatory comments.

Naava Carman
EJOM Vol. 7 No. 1 (2012)

Pruritic urticarial papules & plaques of pregnancy (PUPP) presents with intensely itchy, hive-like papules, which typically begin on the abdomen, and spread to thighs, buttocks and occasionally to the arms. The diagnosis in traditional Chinese medicine is a combination of Damp Heat and Blood xu leading to Dryness and therefore Wind. In this case, this condition can be seen as a direct consequence of an underlying imbalance for which the original treatment had not been completed.

Rachel Peckham and Jacqueline Mangold
EJOM Vol. 7 No. 1 (2012)

This paper is written in two parts. Rachel Peckham and Jacqueline Mangold both worked as clinicians/clinical supervisors at the Core Trust over a collective period of fourteen years. The Core Trust is a community based rehabilitation programme for people with substance misuse problems. The model used is innovative, interesting and successful; offering acupuncture and counselling / psychotherapy as the main treatments. The paper is written in two parts, reflecting both author’s experience and observations as clinicians at the Core Trust. Rachel ran a study on the role and the impact of the NADA auricular acupuncture group treatment given daily at the project. Twelve participants, at different stages of the programme were interviewed once as a means of data source, and a qualitative analysis was carried out using grounded theory. Jacqueline collected data via MYMOP2 questionnaires from clients that were receiving one-to-one body acupuncture at the onset and end of their treatment.Results from both studies raise interesting questions about the nature of addiction and the positive role acupuncture can play in the recovery of the addicted person.

Rebecca Avern
EJOM Vol. 6 No. 6 (2011)

There have been times in my practice when a patient with cancer has walked through my door and I have had a heart sink moment. Can I realistically make a difference to them? Are they secretly hoping that acupuncture will ‘cure’ their cancer? Are their expectations of what I can do for them too high? Will I feel inadequate if their cancer progresses? Should I be referring them to a herbalist too? My experience of treating J has provided a strong antidote to these feelings. It has taught me that, without doubt, I can as an acupuncturist make a positive difference to the health and wellbeing of someone with cancer, and that the experience can be an uplifting one.

Simon Becker
EJOM Vol. 6 No. 6 (2011)

Chinese herbal medicine (CHM) is gaining popularity in chemo- and radiotherapy support treatments. However, the potential risk of interactions seems high. Does clinical experience provide any evidence about the risks involved? Does it make sense to prescribe CHM to patients on chemo- and radiotherapy? Or are patients put at risk? In this article, these two factors – interaction potentials and clinical experience – are evaluated via a review of the current literature on these topics. The author points out that, in investigating interactions, a pharmacological approach focused on single medicinals and their compounds and relying primarily on in vitro and animal studies as well as on theoretical assumptions, does not accurately reflect standard CHM practice and is therefore of limited use in providing clinical guidance. Bothe the pharmacological and the clinical approaches must, he argues, be combined to come up with a valid conclusion. While acknowledging that currently available evidence is far from sufficient for final conclusions, the author's review finds that although there is a potential for interaction between chemotherapy and Chinese medicinals, the cautious and traditional use of CHM for chemo-and radiotherapy patients seems supported by the current literature. Preliminary clinical studies suggest that Chinese herbal medicine benefits chemo- and radiotherapy patients. Besides improving quality of life, the concurrent intake of CHM seems to reduce side-effects due to the toxicity of chemo- or radiotherapy.

Beverley de Valois & Rachel Peckham
EJOM Vol. 6 No. 6 (2011)

Using acupuncture in lymphoedema management is controversial, as it is feared that it may introduce infection or exacerbate lymphoedema. This paper presents case studies of four cancer survivors who participated in an exploratory study investigating the use of acupuncture and moxibustion as an adjunct to usual care for lymphoedema to promote wellbeing and improve quality of life. They illustrate how individualised treatment plans meet the diverse and changing needs of patients with a complex, chronic side effect of cancer treatment for which there is currently no cure. They also demonstrate that acupuncture treatment can be effective even when large areas of the body are contraindicated to needling. The stories of these four participants may help influence existing perceptions on the parts of clinicians, patients, and acupuncturists about acupuncture’s potential role in the management of lymphoedema.

Patricia Ronan, Dominic Harbinson, Douglas MacInnes, Wendy Lewis, Nicola Robinson
EJOM Vol. 6 No. 5 (2010-11)

This article reports on a small pre-clinical pilot study to explore the acceptability and effects of acupuncture in the treatment of schizophrenia. It outlines the research question and methods used and presents preliminary results of the qualitative and quantitative data gathered. Eleven participants who had been diagnosed with schizophrenia were recruited to the study. They had not had complete remission of symptoms despite treatment, and/or they suffered from the side-effects of antipsychotic medication. In addition to standard care, participants received individual assessment and treatment with acupuncture using a traditional Chinese medicine approach. Treatments were given twice a week for 10 weeks. The preliminary results from this study are very positive, indicating that acupuncture treatment yielded a wide range of benefits in terms of improved quality of life, as well as reductions in the symptoms of schizophrenia and the side effects of anti-psychotic medication. Of particular note are motivational and physical health improvements, especially relating to sleep, energy levels and social engagement.
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Dr Helen Rogers (edited and abridged by Dominic Harbinson)
EJOM Vol. 6 No. 5 (2010-11)

This article is an edited and abridged version of a report, based on a study conducted in Walsall in 2008-2009, evaluating the effectiveness of acupuncture for people with psychosis. The study’s methodology utilised validated quantitative research tools and semi-structured interviews conducted with participants and their carers, relatives or partners. Strong evidence emerges from both the quantitative and qualitative data that there were significant improvements in service users’ mental health and general wellbeing following a course of acupuncture. These included: significantly improved sleep patterns; reduced anxiety and stress levels; better physical health; better eating habits; and increased self confidence and self esteem.
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Tony Reid
EJOM Vol. 6 No. 5 (2010-11)

With the dramatic increase in the number of prescriptions for the selective serotonin reuptake inhibitor (SSRI) class of antidepressant drugs over the last two decades, it seems as if we are in the midst of a ‘depression epidemic’. Without denying the reality of the extreme suffering experienced by patients with a depressive disorder, the author argues that in many instances the diagnosis of depression is not a valid one. Pointing to the weaknesses in both the contemporary psychiatric paradigm and in contemporary TCM perspectives, he argues for a complete overhaul of the way in which depression is diagnosed and treated as well as the ways in which clinical outcomes are assessed. He calls for a restriction in the use of SSRIs because of their dubious risk-to-benefit ratio and for TCM treatment he proposes four major syndrome-patterns for patients with depressed mood, based on the core pathodynamics of this condition.

Yair Maimon
EJOM Vol. 6 No. 5 (2010-11)

According to Western medicine stress is a response to danger. This response creates numerous changes in the body as a result of the activation of the hypothalamic-pituitaryadrenal (HPA) system. There is a release of hormones such as gluco-corticoids, primarily cortisol, and of neurotransmitters, such as catecholamines (dopamine, nor-epinephrine and epinephrine). These changes manifest themselves in the form of different symptoms. These symptoms will be discussed in relation to their pathology and analyzed according to the emotional response to stressors, as understood in Chinese medicine.

Neil Quinton
EJOM Vol. 6 No. 5 (2010-11)

In this article, the acupuncturist who delivered the service evaluated by Dr Helen Rogers, (see “The Effectiveness of Acupuncture in the Management of Psychosis – An Evaluation” in EJOM Vol 6 No 5) sketches the background to the Walsall project and the approach and diagnostic framework he adopted. Patterns and pathomechanisms which are commonly seen in presentations of schizophrenia and bipolar illness are outlined, with particular emphasis on the significance of liver depression qi stagnation and spleen qi vacuity which, the author suggests, are often at the root of the condition and which can be treated effectively with acupuncture. The issues of treatment duration and frequency are also discussed as are point combinations. The author argues that there should be no reason why traditional acupuncturists cannot function as an integrated part of an already existing mental health team, significantly contributing to the management of psychotic illness by reducing anxiety and improving sleep, as well as proving a successful way of engaging both difficult to engage and younger patients, making it of particular use to Assertive Outreach and Early intervention teams.

Joyce K. Anastasi, Bernadette Capili, Ann M. Chung, Richard Hammerschlag
EJOM Vol. 6 No. 4

Distal sensory peripheral neuropathy is a common neurological complication experienced by people living with the human immunodeficiency virus (HIV). Traditional Chinese medicine (TCM) may offer effective interventions in the management of its symptoms. To improve the quality and transparency of reporting acupuncture clinical trials, the Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed in 1996 and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) recommendations were introduced in 2001. Incorporating international guidelines, this paper describes the development of a RCT including rationale, design, methods, procedures and logistics for a pilot study aimed at evaluating acupuncture and moxibustion for neuropathy associated with HIV. Using STRICTA guidelines as a template, aspects of clinical research design are explored to further optimise future studies of TCM.

Tony Reid
EJOM Vol. 6 No. 4

The potential benefits of an integrated Western and traditional Chinese medical system, while enormous, are likely to be hampered unless a critical evidence-based approach is taken to the evaluation of the strengths and weaknesses of both systems. The best available evidence in many instances is quite poor – on both sides. The evidence of traditional usage (particularly in TCM) is an undervalued resource that, for better or worse, will remain our best guide for many years to come. This paper discusses several key issues centred on how to make best use of this resource and develop a more sharply focused clinical arm of TCM.

Giovanni Maciocia
EJOM Vol. 6 No. 3 (2009) 

The ‘Four Levels’ term refers to the four levels of depth in the development of fevers from acute infectious diseases. It is a brilliant theory of Chinese medicine that was developed during the early Qing dynasty by Ye Tian Shi in his book ‘A Study of Warm Diseases’ (Wen Bing Xue, 1746). In my opinion, the theory of the Four Levels provides the key to an understanding of acute, febrile, infectious diseases. This article will highlight the application of the theory of the Four Levels to the diagnosis and treatment of H1N1 influenza (‘swine flu’).
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Friedrich Staebler
EJOM Vol. 6 No. 3 (2009)

This article begins with a summary of government guidelines on swine flu for the benefit of acupuncturists and Chinese medicine practitioners. It then gives an overview of the TCM diagnosis, treatment and prevention of swine flu, with particular reference to possible acupuncture treatments, the leading herbal formulas given in the Chinese literature and the appropriate use of patent medicines according to the depth and stage of the pathogen. It concludes with thoughts on the prevention of complications of swine flu for patients at risk and a few practical considerations from the practitioner's perspective.

Dominic Harbinson
EJOM Vol. 6 No. 3 (2009)

This short article looks at the anti-viral drug Tamiflu which, along with Relenza, is being used as front-line medication in the treatment of swine flu. The article outlines Tamiflu's actions and history, its connection with Chinese herbal medicine, and the controversies surrounding government policies - at both national and international level - that promote its deployment.

Zara Melyan
EJOM Vol. 6 No. 2 (2009)

This article describes the author's treatment of a 50-year-old male patient who had suffered from a severe form of asthma for 12 years. She suggests that in normal medical practice, case studies are based on a correct diagnosis which is then followed by a successful treatment. In this case, her initial diagnosis was not entirely spot on, and it took her a few treatments to come to the right conclusion. However, the case is, she argues, still of interest, not only because of its successful outcome, but also because it clearly illustrates how Five Element treatment works.

Katie Scampton
EJOM Vol. 6 No. 1 (2008)

Hardly a week goes by these days without an article appearing in the press about acupuncture and IVF. Practitioners certainly report an increase in the number of patients seeking thier help to conceive. Here the author demonstrates the ethical dilemmas and emotional rollercoaster that accompanied one particularly difficult dase - for both patient and practitioner - and asks when, if ever, should one admit defeat and stop treatment?
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Paul Hougham
EJOM Vol. 6 No. 1 (2008)

This case study is an exploration of some of the emotional issues surrounding fertility and conception as well as the wider questions of conception and destiny. The study outlines a patient's presentation for treatment and how the issue of conception arose as part of the ongoing narrative of her health and her wellbeing. The telling of the case progresses according to the tradition of Five Element Acupuncture, and an understanding of the elements as a textured presentation of qi, strongly influenced by qi gong teachings. The discussion acknowledges some of our contemporary professional approaches to fertility and explores how we as practitioners might cultivate, perhaps even facilitate, the impossible dialogue of destiny surrounding childbirth.
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Christine Grabowska and and Anne Manyande
EJOM Vol. 6 No. 1 (2008)

Expectant mothers with a third trimester breech presentation were offered moxibustion treatment to turn the foetus into a cephalic presentation. In the 76 women who were enrolled in the study, the acupoint BI 67 was stimulated for seven days morning and evening by rolls of moxa (Artemisia vulgaris). The women were instructed in how to use the moxibustion at home and to involve their partners if they could not reach their little toes. In this preliminary study, it was shown that moxibustion treatment can bring about spontaneous version from a breech presentation for a cephalic presentation; this occurred in 45% of the women treated. The results indicate that moxibustion was more successful when administered in the afternoon than in the morning (x2 = 27.86, DF = 14, p < .01) 6 (20.5%) vs 23 (79.5%) respectively. This is in line with the Chinese clock where bladder time rises to a maximum in the afternoon. Most of the versions occurred during the 36th week of pregnancy (r = 0.27, n = 47, p < .05).

Beverley de Valois
EJOM Vol. 5 No. 6

In a research study to investigate the use of acupuncture to manage hot flushes and night sweats in women taking tamoxifen for early breast cancer, the author explored the use of clearing blocks to treatment. Blocks to treatment are phenomena in the Five Elements theoretical framework of acupuncture practice, and are not often explored in research studies. The author presents five case studies, discussing the application of treatment protocols for blocks to treatment and showing how they precipitated significant ‘turning points’ in the patients’ progress. She also discusses how these cases shaped and developed her own interpretation of the significance of clearing blocks to treatment, contributing to a ‘turning point’ in her understanding of Five Elements Constitutional Acupuncture to encompass these approaches in her research and in clinical practice.

Stephen Lee
EJOM Vol. 5 No. 6

In this article, the author introduces the reader to the treatment of musculoskeletal problems using electroacupuncture (EA) using techniques which he has developed over the last 20 years and which he finds indispensable to the treatment of intractable, chronic musculoskeletal problems. He discusses the treatment of the following conditions: lower back pain, sciatica, osteoarthritis of the hip, hip pain, knee pain, frozen shoulder, tennis elbow, carpal tunnel syndrome, arthritic finger joints, arthritic knuckles, plantar fasciitis and scar tissue.

Andrew Flower
EJOM Vol. 5 No. 6

There seems to be a general consensus within the acupuncture and Chinese herbal community that research is a necessary process to establish our professional status. It may be regarded as a ‘good’ thing, a bold venture to bring Chinese medicine into the cosy confines of evidence based medicine; or perhaps more cynically ‘a necessary twenty-first century evil’ that we need to grit our teeth and get on with. This is an account of the author's foray into the research world to explore the role of Chinese herbal medicine (CHM) in the treatment of endometriosis. He set off on his journey dressed in a shiny suit of optimistic positivist fervour. Now several years down the line he feels more like Don Quixote lining up his intellectual lance and charging heroically towards the next windmill on the horizon. This then is the story of how a naive would-be knight lost his armour, encountered the dark forces of bureaucracy, and depending upon your point of view either grew up or went quietly nuts.
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Hugh MacPherson and Kate Thomas
EJOM Vol. 5 No. 4

This article reports on a highly significant, high-quality randomised controlled trial to determine whether GP referral to a short course (up to 10 individualised sessions) of traditional acupuncture might improve longer term outcomes for patients with chronic low back pain in primary care, and at a cost that would be affordable by the NHS. 241 patients were recruited to the trial with 160 being randomised to the acupuncture group and 81 to the control group which received usual GP care alone. The results indicate that when patients in primary care with low back pain are referred to a BAcC acupuncturist for a short course of treatment, they will, on average, improve over time and show greater improvement than if they had received usual GP care alone. Although the course of acupuncture only lasted around 3 months, their situation improved over time, and continued to improve between 12 and 24 months. The authors' recommendation from this study is that GPs should consider referring patients with low back pain to a qualified acupuncturist.
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Rebecca Avern
EJOM Vol. 5 No. 3

This article describes the case histories of three women diagnosed with various blood clotting disorders. The blood clotting disorders had impaired the ability of each of them to carry a baby to full term. The article looks at the similarities and differences between the women in terms of TCM patterns, and Five Element Constitutional Factor (CF). It describes how the medication they were prescribed affected the choice of treatment principles and also their response to acupuncture treatment. It ends with the author’s reflections on the experience of treating them.
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Roisin Golding
EJOM Vol. 5 No. 3

Much archaic acupuncture theory is considered ‘superstitious’ by modern practitioners. The author wanted to find out if the application of some of the older principles of treatment as outlined in the Nei Jing made any difference to treatment. The article reports on the treatment of a 29-year old woman who sought treatment for infertility associated with polycystic ovaries and anovulation. Using tonfication and sedation techniques according to the phases of the lunar cycle, the patient’s periods were restored and eventually a pregnancy was successfully taken to term.

Beverley de Valois
EJOM Vol. 5 No. 3

Following encouraging results from research investigating the use of individualised, traditional acupuncture to manage treatment side effects in women with early breast cancer, the author conducted a follow-up study to explore the use of the NADA protocol in the same clinical context. This article charts her discoveries in applying the NADA protocol as a standardised treatment in a group setting. She discusses its flexibility and potential, and considers its limitations. Case studies present a range of different experiences and perceived benefits for three women who received this treatment, including their reactions to being treated in a group setting.

Angel Wang Hanbing with Dominic Harbinson
EJOM Vol. 5 No. 3

The term pre-menstrual syndrome (PMS) refers to a range of physiological and psychological symptoms which women commonly experience some 7-10 days before their period. The symptoms tend to increase in severity as the period approaches and then disappear once it begins, although in severe cases they may arise or persist outside the pre-menstrual phase. This article gives a brief outline of how traditional Chinese medicine (TCM) understands PMS and presents five Chinese herbal medicine formulae (plus clinically relevant modifications) devised by well-known TCM gynaecologist doctors from China for the treatment of some of the various manifestations of PMS. The formulae are presented according to the main presenting condition and the TCM pattern being treated, namely: breast distension due to liver qi depression, abdominal distension and pain due to qi stagnation and blood stasis, emotional problems due to liver and kidney yin deficiency, and headache due to liver qi depression and liver and kidney yin deficiency.

Richard Graham
EJOM Vol. 5 No. 3

The catalyst for this article was a Problem Back Masterclass for physiotherapists held at Highgrove under the auspices of the Prince of Wales. The article describes the author’s personal experience of chronic back pain and the inspirational influence of the maverick Australian physio, Sarah Keys. The ability of the spine, given the right condition, to heal itself of even the most recalcitrant problems is highlighted. Pointing to acupuncture’s ability to provide simple, safe and highly effective treatment for back pain, the author concludes by affirming that: ‘We have much to learn from western medicine, but western medicine has much to learn from us. This is what real integration is all about.’

Qu Lifang and Mary Garvey
EJOM Vol. 5 No. 2

The Huangdi Neijing (Yellow Emperor’s Inner Canon) contains numerous references to ‘spirits’ that are said to reside within the body. The term ‘shen-zhi’ means ‘spirit-mind’ and telescopes the five spirits (shen, hun, po, yi, zhi) of early Chinese medical theorising. Shen-zhi theory explains the principles for understanding Chinese medicine’s perspective on human consciousness. The theory describes how each of the wu shen (five spirits) govern certain aspects of mentality and are closely related to sensory faculties, body tissues, visceral systems, and physiological substances according to the wu xing (five phase) framework of correspondence and relationship. Spirit activities thereby provide the human organism with its distinctive array of mental and sensory abilities including intelligence, insight, focused attention and memory. Shen-zhi theory is derived from key sections of the Neijing that define the nature of the wu shen, their physiological activities and relationships. When these resources and relationships are disrupted a variety of common or more serious disorders may result. We discuss some of these, and a number of specific disorders that have a particular connection with the five spirits and shen-zhi theory. Broadly speaking, they are ‘mind’ or ‘mental’ disorders. Analysis of their signs and symptoms illustrates the theory and clarifies its diagnostic relevance for modern clinicians. 
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Neil Quinton
EJOM Vol. 5 No. 2

This article gives the practitioner’s perspective of acupuncture treatment delivered in a group setting within a mental health day service at the Broadway North Resource Centre in Walsall. The clients all had enduring mental health problems, most having been diagnosed with anxiety and/or depression, along with a number of people suffering from bi-polar disorder and schizophrenia. The practicalities of running the project are clearly outlined and common disease pathomechanisms are identified – highlighting the centrality of liver/spleen disharmony – along with typical treatment principles and points. Although there is still considerable resistance to acupuncture from some quarters and a frustratingly prevalent perception that the benefits of acupuncture are confined to ‘relaxation’, the author’s experience shows that acupuncture has a huge amount to contribute to mainstream mental health services and to the quality of life of service users.

Dr Friedrich Staebler
EJOM Vol. 5 No. 2

This paper, which complements part 1, published in EJOM Vol. 5 No. 1, 2005, discusses the general principles of treating cancer with traditional Chinese medicine (TCM), especially the contribution which acupuncture and moxibustion can make, both in slowing down the spread of tumours and in counteracting the side effects of radio- and chemotherapy. The latter is given particular prominence, since the paper argues that acupuncture and moxibustion should be used primarily as a back-up, and concomitant to conventional cancer treatment. This is followed by the introduction of a simple and effective treatment protocol the author has developed, using moxa to combat bone marrow depression (the drop in red and white blood cells) during chemotherapy. The paper concludes with two case histories chosen to give practical examples, and to show the strengths and limitations of acupuncture and moxibustion in the treatment of cancer.

Doreen Till
EJOM Vol. 5 No. 2

This paper, based on research conducted as part of an MA in Community Mental Health, explores service users’ experiences of acupuncture delivered in a group setting within a mental health day service at the Broadway North Resource Centre in Walsall. The majority of service users felt that acupuncture had improved their health both mentally and physically. Whilst some individuals found a group setting slightly intimidating at first, they also found benefits in the peer support that such a setting facilitated. All participants in the study thought that acupuncture should be more widely available within mental health services, and that a greater range of therapies should also be provided. Acupuncture within a group setting can be a cost-effective way of delivering a popular treatment that service users perceive as helpful to their health.

Dominic Harbinson and Patricia Ronan
EJOM Vol. 5 No. 2

The medical treatment of psychosis continues to be limited, often with severe side effects. This paper sets out to examine the literature available on the treatment of psychosis and schizophrenia with acupuncture, to outline the evidence already available and to highlight the case for research into this treatment approach in the UK.  A literature search was carried out using Ovid, Medline, Psych-info, Yahoo, Google and author contact to discover what research has taken place to date. This yielded evidence that acupuncture is effective in the treatment of psychosis. Although most of the research is from China and is somewhat dated, a number of studies have also been conducted in the West with promising outcomes. Given the poor prognosis for schizophrenic patients and the side effects implicit in the chronic use of conventional medication, there would appear to be good grounds for further research into acupuncture as a potential treatment modality. Carrying this out under modern scientific research conditions would help clarify whether and how this treatment might work.  However obstacles such as ethics, funding and how such a study might be controlled will have to be overcome.

Dr Friedrich Staebler
EJOM Vol. 5 No. 1

This paper is written for acupuncturists to examine the challenges we are faced with when treating patients with cancer. It looks at what cancer is, both in the western and TCM paradigm, and examines the role of the emotions in the development of cancer. Questions are asked: What happens to patients when they are diagnosed with cancer? What are the treatment options? When are we, as acupuncturists, called upon and what is our role as carers and as acupuncturists? What can acupuncture and Chinese medicine contribute in the treatment of cancer, and where are the limitations? The aim of this paper is to encourage acupuncturists to participate in the fight against cancer without being unrealistic and over-confident about the treatment outcome.

Dr Sanjeev Rastogi and Dr Atul Rastogi
EJOM Vol. 4 No. 6

This case study, based upon the trial of acupuncture in a patient with lumbar canal stenosis, opens up a new vista in conservative management protocol to deal with this condition. Spinal canal stenosis, being a multi-level disorder and an associate of age-related co-morbidities, poses a considerable difficulty in selection of the right approach of management. Surgical decompression does not always result in reversal of neurological deficits and can lead to reluctance in choosing this option. Conservative management, on the contrary, often results in good patient compliance and substantial improvements. The addition of acupuncture to conventional conservative management makes it more likely to lead to a measurable and positive outcome, as is evident in the case study presented here.

Ruth Young
EJOM Vol. 4 No. 6

This case study concerns a boy of 12 who had become school phobic after being severely bullied on moving to secondary school. The author initially trained in Five Element acupuncture at Leamington followed by a TCM course at Reading which aimed to integrate the two styles of acupuncture. The study, which includes information on the patient’s background, diagnosis, treatment plan, diet and lifestyle advice and treatment outcome, is presented as an illustration of how successful very simple Five Element acupuncture can be in the treatment of quite severe mental health and emotional problems.

Elisa Rossi
EJOM Vol. 4 No. 6

This article – drawn from the book Shen – Psychological Aspects of Chinese Medicine: the Classics & Contemporary Practice (currently in translation) – examines the various pathologies associated with emotional illness, paying particular attention to their links to fire. The concepts of constraint (yu) and stagnation (zhi) of qi, fire (huo), phlegm (tan), blood stasis (xueyu), empty fire and ‘restlessness and agitation’ (fanzao) are discussed with reference to classical Chinese texts by authorities such as Liu Wansu, Li Dongyuan and Zhu Danxi.

Inga Heese
EJOM Vol. 4 No. 5

A case study dealing with the treatment of acute capsulitis of the shoulder, often referred to as frozen shoulder, a common complaint in an acupuncture clinic, occurring most frequently in middle age and more commonly in women. Symptoms include reduced mobility and pain. The author covers the examination and diagnosis of the patient and the relevant treatment principles, treatment protocol and outcome. The main treatment aim was to restore the function of the shoulder and to stop the pain. She chose to needle the local channels and collaterals to stimulate the flow of qi and blood. In addition she used some general points to increase qi and blood production and circulation. She concludes that acupuncture can be a powerful tool when treating dysfunction of the muscular system. In frozen shoulder the acute inflammatory phase can be recovered easily and progression to the adhesive stage can be prevented through successful treatment.

Beverley A Lawton
EJOM Vol. 4 No. 4

This case study describes the treatment of a patient who suffered from increasing anxiety, depression and panic since the birth of her only child two years previously. She also experienced no desire for social interaction not for sexual contact with her partner, the child’s father, despite what appeared to be a long-term loving and supportive relationship. The diagnosis, pathology and aetiology are discussed, treatment principles are listed in a chart, and the treatment plan is described step by step. The author also deals with lifestyle guidance. By the end of a course of 10 treatments, the patient no longer suffered from postnatal depression, and no longer required Seroxat medication. She continues to have regular acupuncture in order to maintain the benefits of treatment.

April Joslin
EJOM Vol. 4 No. 3

The author uses a short case study to demonstrate how, by a careful examination both of a patient's own condition and of the symptoms induced by chemotherapy, acupuncture treatment may result in significant improvements leading to the beginning of a process of self-healing.

Nick Johnson, Dominique Joire, James Tomkinson, Sammy Reid, Lola Boix, Alex Murray and Paloma Sparrow
EJOM Vol. 4 No. 2

This study observes and monitors the effect of 6 months of traditional Chinese medicine on a group of NHS patients with essential hypertension. The management was in both terms of symptomatology and blood pressure levels. It provides a background, treatment protocol and results, along with specific reports on 8 patients.

Julian Scott
EJOM Vol. 4 No. 1

In the treatment of children, symptoms which relate to kidney deficiency, such as poor memory, difficulty in concentrating, enuresis or thin or weak bones are often seen. The author has differentiated three main types of kidney deficiency which are kidney jing deficiency, kidney organ weak and kidney qi xu. Signs and symptoms of the three patterns and their different treatment and outcomes are explored.

Warren M Cochran
EJOM Vol. 4 No. 1

Much has been written on the socio-economic and religio-philosophical impact of epidemic disease on the apparent frailty of human existence. However, medical historiography has not always addressed the issue of how changing disease patterns may have influenced therapeutic strategies. The theme of this article focuses on this aspect of medical history by considering how disease manifestations as perceived by physicians of Chinese medicine, have helped shape medical notions and determine therapeutic response.

Ann Bradford
EJOM Vol. 3 No. 6

This case study shows how simple techniques such as acupuncture, acupressure and tui na were used successfully in the treatment of a child diagnosed with congenital nephrotic syndrome. The author explains how parents who are taught simple acupressure and massage techniques were able to participate in their child's treatment. The case shows how simple techniques given frequently can have very beneficial effects, even in such complex cases as this, and how such beneficial effects also extended to the family, who felt included and necessary in the treatment of their son.

Julian Scott
EJOM Vol. 3 No. 6

This is a case history outlining the deep changes that can occur when a sick child receives acupuncture. The patient is a 13 months old boy seriously ill with asthma, who was already on heavy doses of steroids and who had had seven 10-day courses of antibiotics in the previous 5 months. The case history covers his road to recovery through a healing crisis which led to no further attacks of asthma.

Margaret Pinnington
EJOM Vol. 3 No. 5

This article explains the development of AcuDetox (Acupuncture Detoxification) to treat the growing drug addiction problem. The Lincoln Hospital model is outlined, as are the roots of NADA (National Acupuncture Detoxification Association) NADA US, NADA UK and NADA UK training. Research published in The Lancet and the Archives of Internal Medicine is mentioned, proving the effectiveness of acupuncture in treating chronic addiction.

Avi Magidoff
EJOM Vol. 3 No. 3

In this article the reader is introduced to other forms of diagnosis and treatment of male uro-genital problems. The standard TCM concepts of kidney deficiency, yin fire, and damp heat, while often useful, do not always provide the best treatment strategies for all patients. With the ability to utilise other points of view, readers may be able to benefit patients with problems that have not responded to the standard TCM approaches.
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Yu Lehua
EJOM Vol. 3 No. 3

This article reports on the effects of modern silver acupuncture (MSA) on chronic soft tissue lesions in the lower back. A study involving the treatment of 89 patients suffering from severe lower back pain is described. The techniques involved in carrying out the treatment are detailed. The results of the study are analysed. It is concluded that MSA is an effective treatment, especially for soft tissue lesions from conversion of acute injuries and chronic overuse injuries in the lower back.

Pang Jun, Huang Bo-ling, Li Yu-shun, Zhou Yu-yan, Han Zhi-yong and Faye Richardson
EJOM Vol. 3 No. 3

Gout is a systemic disease which involves the impediment of protein metabolism. Abnormal protein metabolism results in hyperuricemia with acute clinical manifestations of redness, swelling and hot pain of affected joints. Repeated bouts form gouty calculae in joints. Western medical treatment concentrates on managing symptoms. Traditional Chinese medicine, with its theory of differentiating diagnosis and treatment based on syndrome analysis, holds that gout is caused by the inability of the kidney to transform fluids and failure of the spleen to conduct normal transporting functions, and to distinguish between clearness and turbidness thus leading to the generation of internal heat and dampness. Principles of clinical treatment aim to clear heat and remove dampness, dredge collaterals to stop pain and regulate functions of the spleen and kidney. By utilising the main acupoints, St 36 zu san li, St 40 feng long, Sp 6 san yin jiao, the researchers achieved a 90% efficacy rate in treating patients with gout (improved visceral functions manifested by normal uric acid and ESR levels) and its symptoms (joint swelling and pain alleviated) without side effects, increasing their acceptance and satisfaction with acupuncture.

Dr Zhang Jia Sheng
EJOM Vol. 3 No. 3

This article (translated from Chinese Acupuncture and Moxibustion 1987 Vol. 7 No. 1) reports on the treatment with acupuncture and moxibustion of 248 cases of male infertility over the period 1981-1985. Treatment was deemed effective in 166 cases. Patients with impotence and ejaculatory dysfunction responded better than cases with sperm abnormalities. Translated by Xiao Y Zhang.

Qing Zhang
EJOM Vol. 3 No. 3

Acute prostatitis is inflammation of the prostate gland, usually affecting men between the ages of 30 and 50. Traditional Chinese medical theory sees prostatitis as Lin Syndrome, with the urinary tract symptoms being due to dampness and heat accumulating in the lower jiao, causing disturbance to water circulation and distribution. Acupuncture and Chinese herbal medicine treatment for this condition are outlined and a case study is presented in which successful resolution of acute protatitis was achieved in three treatments.

Jane Lyttleton
EJOM Vol. 3 No. 1

This article presents a case study of a woman in her 30s suffering from a number of chronic disorders including headaches, back pain and depression as well as erratic ovulation and possible early menopause. Treatment involved both acupuncture and Chinese herbal medicine and focussed initially on her general health and on regulating her menstrual cycle with specific fertility treatments commencing two years later. The case study highlights many of the sorts of questions which practitioners have to deal with in trying to help women seeking treatment to aid fertility, and provides a good example of how useful the information from basal body temperature (BBT) charts can be and how it can influence the course of treatment. 
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Felicity Moir
EJOM Vol. 3 No. 1

The beginning of the menstrual cycle, puberty, and the end of the menstrual cycle, menopause or the climacteric are extremely important events in a woman’s life, both personally and in relation to their role in society. While most girls move smoothly into puberty and establish regular pain-free cycles, there are some who never establish a pattern and the resultant imbalances lead to pain, pre-menstrual tension and irregularity which daunts them physically and emotionally for many years and leads to problems later such as infertility and fibroids. Similarly, most women in the climacteric also move into the next phase of their lives with few symptoms, but for 20-30% there can be major problems, and for a further number the fear and dread around the menopause generates low self image and subsequent illness and loss of power. This article examines these issues through the prism of 2 case studies, one involving a teenage girl suffering from irregular painful periods accompanied by nose bleeds, and the other involving a woman in her mid-50s who had recently started to experience hot flushes and night sweats, along with a number of other symptoms.

David Mayor
EJOM Vol. 2 No. 5

In this second article on chronic pain and its measurement (the first was published in EJOM Vol 2, No 4), Mayor provides a thorough literature analysis about the complex inter-relationships between pain, anxiety and depression. He discusses which comes first - pain or anxiety. He also explores how the emotional state of a patient relates to the task of pain prevention, particularly in regard to chronic pain sufferers.

David Mayor
EJOM Vol. 2 No. 4

When treating patients with pain, it is important to at least try to understand what pain is. This first article in a series on chronic pain covers some general aspects of pain and its taxonomy, in particular the differences between acute and chronic pain, and between nociceptive and neurogenic pain. The next article will explore the psychology of pain, and in particular the relationships between pain, anxiety and depression. A follow-up article will be devoted to some of the thorny issues of pain measurement. The references given should be useful as a starting point for anyone embarking on their own exploration of the literature on chronic pain.
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Karen Simporis
EJOM Vol. 2 No. 4

From 1985-1988, the author worked at the Rocky Mountain Regional Pain Management Centre in Colorado. This article is about the role of acupuncture within the holistic framework of a pain management centre. The treatment of pain by acupuncture is seen as symptomatic by many and therefore less subtle than other 'holistic' approaches. Western acupuncture prescriptions are symptomatic, simplistic and undifferentiated. They treat the biao only which may work well for some acute problems, but the ben must be tackled in chronic disorders. Additionally untreated pain can lead to further problems; spiritual, emotional and physical. As western medicine comes to realise that the piecemeal treatment of pain is rarely effective, the comprehensive approach of traditional Chinese medicine becomes increasingly relevant.

Adrian Lyster
EJOM Vol. 2 No. 4

Pain relief is the most widely practised application of acupuncture. Research evidence suggests that acupuncture is credible but conceals a number of unanswered questions that are of relevance to practitioners of TCM. What is the nature of the relief provided, is it palliative or therapeutic and is acupuncture a clinical match to different pain conditions? What method of acupuncture is used in research trials and does it correspond with clinical practice? What are the different descriptive and explanatory models for chronic pain? This article critically reviews the current models and examines some of the implications for both our understanding of pain and our application of acupuncture.

Pamela Boxx
EJOM Vol. 2 No. 4

As a consultant obstetrician and TMC acupuncturist, Boxx conducted a trial into the use of acupuncture analgesia during labour. The results were generally very favourable with patients expected to need pethidine or entonox getting by without either. Babies born to mothers using only acupuncture as an intrapartum analgesia mostly emerged 'howling lustily and in the pink'. The 'pros' and 'cons' of acupuncture during labour are discussed as are practical issues of justifying the acupuncturists presence in the delivery room.

Yi Zhen Jia
EJOM Vol. 2 No. 4

This article discusses the treatment of Bi Syndrome. Traditional herbal methods follow the principal of expelling the pathogenic factor. However in modern times the addition of herbs to invigorate blood and move qi has made these formulae much more effective. The herbs to invigorate blood are discussed and modern pharmacological research showing the reason for their success is considered. Translated by X Y Zhang

Tony Brewer
EJOM Vol. 2 No. 4

Brewer presents his personal view of changes in patterns of lower back pain presented over the last 25 years. It appears that the causes of lower back pain vary with the type of patient seen, for example Chinese in China may match the 'text book' models, however when working in western society this is clearly not the case. In fact much of the lower back pain presented is caused by retardation in the flow of qi rather than pathogenic factors. This leads to stiffness with the result that the muscle is more prone to spasm. Brewer presents a very clear list of signs and symptoms and discusses them from TCM and western physiology perspective. He describes thorough examination by palpation, the use of distal and local points and methods of needling.

Geoff Wadlow
EJOM Vol. 2 No. 2

Three cases of migraine are presented where the presenting conditions and the treatment approach of Chinese medicine are similar, but where the details surrounding a patient’s life can often explain why a treatment may not work rather than the prescription of points chosen.