PAIN 

Understanding Chronic Pain and its Consequences
David Mayor
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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Chronic Low Back Pain
Tony Brewer
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.

Acupuncture and the Raison D'Etre for Alternative Medicine: Interview with Bruce Pomeranz
Bonnie Horrigan
This insightful interview with Dr Pomeranz examines his view of alternative medicine and particularly acupuncture. He discusses how he came to the acupuncture endorphin theory and he explains the scientific methodology using 'lines of evidence' to prove or disprove an hypotheses. We find that Dr Pomeranz has meditated for 30 years and is fascinated with 'borderline stuff' i.e. parapsychology. He says rather than discredit TMC he wants to find out how it works. His research follows the protocol of a skeptical yet open mind. This is a brilliant man.

The Function of Invigorating Blood and Transforming Blood Stasis in the Treatment of Bi Syndrome
Yi Zhen Jia
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

What is the Meridian System Encoding? (Part 2)
Phillip Beach
This is the second paper on the issues of 'what is the meridian system encoding?' and 'how does needling a distal point affect the visceral and neural life of an organism?' It also discusses the significance of the 12 'regular' and  8 'extraordinary' channels, internally and externally related channels, the six channel axes and so on. The author's first paper on this subject was published in EJOM Vol. 2 No. 3.

Acupuncture for Pain Relief in Labour
Pamela Boxx
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.

Formula and Experience - Acupuncture and Chronic Pain: A Critical Reflection
Adrian Lyster
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.

Acupuncture and the Management of Chronic Pain
Karen Simporis
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.

Eye Acupuncture in 108 Cases of Acute Pain in the Biliary System
Chang Jin Yang, Ma Qin and Yue Ling
This article was first published in Chinese Acupuncture and Moxibustion Vol. 16, No. 1. Good therapeutic effects can be achieved when using eye acupuncture to treat brain diseases and a variety of pain syndromes. In recent years acupuncturists have used eye acupuncture to treat 108 cases of acute pain in the biliary system and received satisfactory results. Translated by Xiao Y Zhang.