TCM in Healthcare: We have arrived, but what now?
Nils von Below
This article is a translation of a speech given by the author at the 2013 Rothenburg Congress in Germany. He suggests that, following the establishment of TCM in the health market, the resulting new orientation and strategic direction for our profession are still in the making. Most of us, however, seem to be unaware that we have to deal with a new political situation and that we have to work on our strategic outlook. Our present political situation is much more complicated and difficult than that of the last 30 years. This is a heartfelt rallying call to TCM practitioners across Europe to stand up for our positions and defend them.
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Acupuncture and Moxibustion in the Management of Non-Cancer-Related Lower Limb Lymphoedema: Three Case Studies
Beverley de Valois
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.

Conceptualisation of External Pathogens in Chinese Medicine
Amber Moore
Questions often arise concerning our understanding of disease and in particular, the terminology we use. Indeed, in relation to the body, we may consider that there is no true external or internal state. In this article, the author will look at how Chinese medicine (CM) conceptualises pathogens, how this might contrast with concepts from Western thinking, and what this might mean for CM as a whole, and perhaps other ways of thinking. Finally, she will begin to explore the question of whether this inquiry might support the CM view of the body and health, or vice versa, and what the implications of this might be – for how we view the world, how we live, and how we practise.

Is Acupuncture Research Reflecting Practice? Do Outcome Measures Adequately Capture What Patients Value in the Process of Treatment?
Jackie Shaw, Penelope Bidgood and Nasrollah Saebi
Acupuncture patients’ presentation is often complex,longterm and multifaceted. Many have wide expectations of what treatment can offer and value generalised changes in factors such as energy and stress levels, which may not be related to the original presentation. The objectives of this study are to investigate whether research processes and outcome measures used in current acupuncture studies adequately reflect both the treatment process and the factors that patients experience. The data were collected from an observational study at a student acupuncture clinic at the College of Integrated Chinese Medicine (CICM) in Reading, UK. There were 12 clinics, attended by 495 patients, who completed 3 types of questionnaire. The outcome measures were SF-36, CICM, MYMOP, 9-point VAS scale. The majority of responding patients reported major or moderate changes in wellbeing, energy levels, emotions, stress and confidence/self-esteem. Patients could distinguish between the wider factors assessed and their main complaint apart from wellbeing and general health. Most health seekers reported full or major improvement in their main complaint compared to about half of health improvers. Patients’ priorities in treatment change over time; some adjust the focus of their treatment and long-term patients hope for different benefits.

Using a Daily Home-Support Moxibustion Protocol on St 36 Zu San Li During Chemotherapy: A Case History
Cornelia Davies
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.

Shiatsu and Autism: An Experience in Tuscany
Venanzio D’Agostino and Diurka Torres
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.

The Effect of Acupuncture in a Patient with Bell’s Palsy: A Case Report
Yasemin Cayir, Turan Set and Zekeriya Akturk
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.