Ethics in Fertility Medicine? Ross Campbell An increasing number of women undergoing in vitro fertilisation (IVF) are seeking to use acupuncture as a result of its growing reputation for increasing the chances of conception when used as an adjunctive therapy. Those of us involved in this work may feel a sense of joy and satisfaction at being able to assist someone through such a fundamentally life changing experience. At the same time, many practitioners express discomfort with the nature of the medicine involved and feel their role is mostly limited to one of supporting the patient’s health through a physically and emotionally sapping drug regime. Acupuncturists can feel torn between the desire to help the person become pregnant and the desire to distance themselves from a medical practice they see as harmful. This article aims to examine and expose some of the ways in which our humanity is undermined by over reliance on IVF technology to correct infertility. It is hoped that by confronting the difficult ethical problems created by IVF medicine, our profession may recognise its unique capacity to provide a comprehensive fertility treatment for women and will seek to do this at a greater distance from today’s IVF clinics.
Treating Infertility in Traditional Chinese Medicine Song Xuan Ke This article presents the aetiology and pathology of infertility from a TCM point of view, and outlines how it can be treated with Chinese herbal medicine and acupuncture. The final section focuses on the use of TCM to support biomedical assisted reproduction techniques and gives the author's recommended strategies for treatment before, during and after IVF.
How Long is Too Long? Katie Scampton 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? Read the whole article
Huang Di – Medical Sage or Time Lord? Roisin Golding During the Han and Jin dynasty just about every scientific endeavour - from human sciences like politics, to subjects such as astronomy, geography and mathematics, as well as medicine - paid homage to the mythical emperor Huang Di, Yellow Lord of the Earth. This article asserts that by incorporating his name into the title of Huang Di Nei Jing (by 200 AD) he, and whatever it was he stood for, was placed as a cornerstone for acupuncture theory. Without the cornerstone, the architecture of Chinese medical theory so easily comes tumbling down. Are acupuncturists simply making half-built structures out of the rubble? There are so many different styles of acupuncture, all of them interesting but incomplete. So many architectural pieces are left lying, discarded because they simply don’t fit. Is it possible that a fully reconstructed acupuncture theory, one where all the main pieces: yin and yang; five elements; heaven, earth and man; the effect of climates etc, could converge on the corner stone of Huang Di? It is to this end that the meaning of Huang Di will be explored in this article.
Epistemological Orientations to Acupuncture Practice: Implications for Acupuncture Knowledge, Practice and Research Barry Nester This paper explores some ‘epistemological orientations to practice’ that can be drawn upon by academics and practitioners involved in Chinese medicine to understand acupuncture knowledge and professional practice. Using the theoretical framework of Anne Mosey (1992) that she used to examine the health professions, it is argued that the four epistemological orientations to practice identified by Mosey can be reflected upon to better understand acupuncture practice and the acupuncture profession. This analysis helps to understand the reasons for some of the developments of the acupuncture profession, and helps to clarify the underlying assumptions and premises for the diverse opinions on the best way forward for the development of acupuncture knowledge, practice and research.
Cells, Fibres and Fluid: An Explanation for the Homeostatic Effects of Acupuncture Channels and Qi? Darren Chandler This article proposes that acupuncture points and channels correlate to collagen fibres in fascia (Stecco, 2004, Ho, 1997). Fascia is one continuous structure that envelopes and invests all the structures in the body. If you were to dissolve all other tissues and organs leaving just the fascia you would see a ghostly outline of the individual. The author reports on the intracellular and extracellular effects of the stretching of collagen fibres induced by acupuncture needling. He suggests that these neurophysiological effects provide insight into the mechanisms behind not only acupuncture but also tui na and qi gong.
A Time To Be Born Paul Hougham 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. Read the whole article
Management of Breech Presentation with the use of Moxibustion in Women in the UK: A Preliminary Study Christine Grabowska and and Anne Manyande 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).
Intention: Embodying the Moment, Transforming Disease Lee Moden Sun Simiao once said: ‘Medicine is yi. Those who are proficient at using yi are good doctors.’ Zhao Xuemin said: ‘Medicine is yi. It is not as good to use medicinals as it is to use yi…’ (Scheid and Bensky, 1998). This article grew out of a passion to explore the root of statements such as these, from an interest in the inner orientation of the practitioner and from the subtle, dynamic interactions between patient and practitioner. It also arose from a belief that from understanding the wisdom of the ancient guiding principles contained within the Chinese medical classics, we may find significant relevance of that wisdom in contemporary practice. It is only by exploring (both cognitively and experientially) these concepts for ourselves that we might avoid dismissing potentially rich information that offers the possibility of deepening our understanding and informing and transforming our practice.
Respecting Patient Confidentiality Alan Rouse This brief piece clarifies the position on patient confidentiality raised by a reader in response to the author's article ‘Build Up Your Practice With New Patients’ which was published in EJOM Vol 5 No 6.
The Emotion of the Earth Phase: An Examination of English Translations, and the Classic Texts Andrew Prescott An examination of the emotions in Chinese medicine, their Chinese characters and a discussion of the differences between the normative terms for the emotions as found in various texts, especially the use of the term ‘sympathy’ for the emotion of earth (soil) by some European writers as compared with the more common term ‘(over)-thinking’.