The Art of Chinese Medicine

1. The Art of Chinese Medicine Liming Zhao, L.Ac. Garden City Acupuncture PC

2. The Timeline of Traditional Chinese Medicine 4000 BC- Fu Hsu come up with a concept of Yin Yang 2000 BC- Huang Di and Shen-nong were credited with making instruments for medicinal practice by implement first usages of herbs and theories 1100-220 BC- Huan Di Nei Jing (Yellow Emperor's Internal Classic) was written to summarize previous practices and case involving TCM 220BC-221AD- Shen-nong compiled the First Reference of Chinese Pharmacopoeia titled Shen-nong’s classic of Herbal Medicine

3. The Timeline of Traditional Chinese Medicine 221-580AD- Huang Fumi wrote the first reference guide to treat ailments. The book, titled Systematic Classic of Acupuncture and Moxibustion 1671- TCM spread to Western Society via France 1881- The first medical college was established in Tianjing 1950- The First National Conference on Health promoted the integration between Western and Chinese Health 1972- President Richard Nixon visited China and he advocates for usage of TCM in the US

4. The Timeline of Traditional Chinese Medicine 1982- The National Council for Certification the Acupuncture and Oriental Medicine (NCCAOM) and the American Association of Oriental Medicine (AAOM) were established 2017- American College of Physician released new evidence-based clinical practice guidelines recommending Acupuncture as first-line therapy for pain

5. The Theory of Traditional Chinese Medicine Qi Yi-Yang: Organic Structure: Yin and Yang organs Physiological Function: Function and Matter Pathological Changes Diagnosis Treatment Five Elements: Wood, Fire, Earth, Metal and Water

6. Differences Between Chinese and Western Medicine

7. What is Acupuncture? Acupuncture is the insertion of fine needles into the body at specific points shown as effective in the treatment of specific health problems. These points have been mapped by the Chinese over a period of two thousand years. Recently, electromagnetic research has confirmed their locations.

8. Characteristics of Acupuncture Points Acupuncture points are situated in surface depressions located along the cleavage between muscles and they are hypersensitive. They have an area of 1 to 5 square mm and lowered electrical resistance (5 to 50 kilo-ohms at acupuncture points vs. 0.5 to 3 mega-ohms at non-acupuncture points). They contain rich nerve fibers and have dense gap junctions.

9. How does acupuncture work? • Acupuncture can stimulate neurotransmitter and endogenous opioid peptide production. This has been well demonstrated in a variety of animal studies. • Spinal cord interneuron activation: spinal cord interneurons release dynorphin and enkephalin • Brainstem activation: activation of the raphe magnus nucleus stimulates serotonergic inhibitory fibers and activation of the reticular magnocellular nucleus stimulates norepinephrinergic inhibitory fibers. They thus affect presynaptic and postsynaptic inhibitory control over the incoming primary pain fibers.

10. How does acupuncture work? • Hypothalamic stimulation: endorphinergic, serotonergic and norepiephrinergic fibers are activated in the raphe nucleus by endorphin released in the arcuate nucleus of the hypothalamus. The endorphin also activates a mesolimbic loop of analgesia. • High-frequency electrical input activates dynorphin A synapses mediated by GABA in the spinal cord. • Electrical acupuncture can provoke the diffuse noxious inhibitory control system.

11. How does acupuncture work? • Acupuncture can stimulate the adrenal glands to release cortisol into the blood by the release of endorphin and ACTH in the pituitary gland. • Acupuncture appears to promote vasodilation and to increase blood flow locally by activating the central sympathetic inhibitory system. • Acupuncture can regulate the immune system and endocrine system of the body.

12. The Acupuncture Channel Systems

13. The Acupuncture Channel Systems

14. The Acupuncture Channel Systems

15. The Acupuncture Channel Systems

16. The Acupuncture Channel Systems

17. The Acupuncture Channel Systems

18. The Acupuncture Channel Systems

19. The Acupuncture Channel Systems

20. What problems can be treated by acupuncture? • Ear, Nose and Throat Disorders Toothaches, pain after tooth extraction, gingivitis, acute or chronic ear aches, acute sinusitis, acute rhinitis, hay fever, runny nose, and acute tonsillitis. • Respiratory Disorders Colds and flus, acute and chronic bronchitis, bronchial asthma, pneumonia, acute and chronic laryngitis. • Gastrointestinal Disorders Spasm of the throat and diaphragm, hiccup, gastroptosis, acute or chronic gastritis, sour stomach or heartburn, chronic duodenal ulcuers, acute or chronic colitis, acute and chronic diarrhea, acute bacillary dysentery, nausuea and vomiting, constipation, IBS and iloececal valve problems.

21. What problems can be treated by acupuncture? • Eye Disorders Acute conjunctivitis, central retinitis, nearsightedness, cataracts, macular degeneration disease, retinopathy, glaucoma and strabisma. • Neurological and Muscular Disorders Headaches, migraines, trigeminal neuralgia, facial paralysis, post-stroke numbness and paralysis, peripheral neuritis, neurological bladder dysfunction, bed-wetting, intercosal neuralgia, neck pain, frozen shoulder, tennis elbow, carpal tunnel syndrome, sciatica, lower back pain, osteoarthritis, rheumatoid arthritis, bursitis, clenched jaws, and TMJ.

22. What problems can be treated by acupuncture? • Gynecological Disorders Painful periods, PMS, infertility, menopausal complaints, excessive uterine bleeding, amenorrhea, morning sickness, delayed labor, prolonged labor, painful labor, mastitis, acute and chronic vaginitis, uterine fibroids, fibrocystic breasts. • Stress Disorders Insomnia, anxiety,depression, palpitations, hypertension and treatment of substance abuse. • Immune System disorders Auto Immune diseases and fibromyalgia.

23. Styles of Acupuncture • Traditional Chinese Acupuncture : 14 channels and about 400 acupuncture points can be used to treat wide ranges of disorders.

24. Styles of Acupuncture • Auricular Acupuncture: Very good for pain management and substance abuse treatment.

25. Styles of Acupuncture • Skull Acupuncture: Effective for pain management and acute cerebral infarction treatment.

26. Styles of Acupuncture • Five Elements Acupuncture: The Five Element method gives constant attention to the root causes and spirit-level of imbalances and disease. This treatment method extends Yin/Yang and Five Element laws to channel diagnosis for immediate improvement anywhere in the body using easy-to-access points.

27. Styles of Acupuncture • Japanese Acupuncture: This treatment technique is often directed at using the minimal amount of stimulation to attain the greatest results.

28. What One Can Expect After Treatment The patient may notice a spot of blood at one of more of the needle sites and/or a small bruise could develop. These should not be harmful, but the patient should talk to his practitioner if he is concerned. Patients often experience the most dramatic results in the first treatment. Some patients experience an immediate total or partial relief of their pain or other symptoms. This relief may last or some symptoms may return. In some cases, there may be no immediate relief only to notice the symptoms diminish over the next few treatments. Generally, patients should expect to feel better.

29. References 1.Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians. Medical Acupuncture Publishers 1944 2.Berman BM, Langevin HH, Witt CM, Dubner R. Acupuncture for chronic low back pain. N Engl J Med. 2010 Jul 29;363(5):454-61. 3. Chiang PJ, Liou SY. Acupuncture for chronic low back pain. N Engl J Med. 2010 Oct 28;363(18):1775-6. 4. Ruth M, Weber M, Zenz M. Laser acupuncture for chronic back pain: A doublé-blind clinical study. Schmerz. 2010 Sep;24(5):485-93. 5. Witt CM, Schützler L, Lüdtke R, Wegscheider K, Willich SN. Patient characteristics and variation in treatment outcomes: which patients benefit most from acupuncture for chronic pain? Clin J Pain. 2011 Jul-Aug;27(6):550-5. 6. Maiers MJ, Westrom KK, Legendre CG, Bronfort G. Integrative care for the management of low back pain: use of a clinical care pathway. BMC Health Serv Res. 2010 Oct 29;10:298. 7. Kaptchuk TJ, Chen KJ, Song J. Recent clinical trials of acupuncture in the West: responses from the practitioners. Chin J Integr Med. 2010 Jun;16(3):197-203. Epub 2010 Aug 8.

30. References 8. Trigkilidas D. Acupuncture therapy for chronic lower back pain: a systematic review. Ann R CollSurg Engl. 2010 Oct;92(7):595-8. Epub 2010 Jun 7. Review. 9. Mao JJ, Kapur R. Acupuncture in primary care. Prim Care. 2010 Mar;37(1):105-17. 10. Zhou F, Guo J, Cheng J, Wu G, Xia Y. Electroacupuncture increased cerebral blood flow and reduced ischemic brain injury: Dependence on stimulation intensity and frequency. J Appl Physiol. 2011 Aug 11. 11. Meng X, Zhang YXin J, Lao, Li A, L, Ren K, Berman BM, Tan M, Zhang RX. The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy. Brain Res. 2011 Aug 7. 12. Zhang Y, Meng X, Li A, Xin J, Berman BM, Lao L, Tan M, Ren K, Zhang RX. Electroacupuncture alleviates affective pain in an inflammatory pain rat model. Eur J Pain. 2011 Aug 3 13. Li A, Zhang Y, Lao L, Xin J, Ren K, Berman BM, Zhang RX. Serotonin Receptor 2A/C Is Involved in Electroacupuncture Inhibition of Pain in an Osteoarthritis Rat Model. Evid Based Complement Alternat Med. 2011;2011:619650. Epub 2011 Jan 9.

31. References 14. Zhang Y, Meng X, Li A, Xin J, Berman BM, Lao L, Tan M, Ren K, Zhang RX. Acupuncture Alleviates the Affective Dimension of Pain in a Rat Model of Inflammatory Hyperalgesia. Neurochem Res. 2011 Jun 22. 15. Zhang Y, Li A, Lao L, Xin J, Ren K, Berman BM, Zhang RX. Rostral ventromedial medulla μ, but not κ, opioid receptors are involved in electroacupuncture anti-hyperalgesia in an inflammatory pain rat model. Brain Res. 2011 Jun 13;1395:38-45. Epub 2011 Apr 28. 16. Zhang Y, Li A, Xin J, Lao L, Ren K, Berman BM, Tan M, Zhang RX. Involvement of spinal serotonin receptors in electroacupuncture anti-hyperalgesia in an inflammatory pain rat model. Neurochem Res. 2011 Oct;36(10):1785-92. Epub 2011 May 10. 17. Li A, Lao L, Wang Y, Xin J, Ren K, Berman BM, Tan M, Zhang R. Electroacupuncture activates corticotrophin-releasing hormone-containing neurons in the paraventricular nucleus of the hypothalammus to alleviate edema in a rat model of inflammation. BMC Complement Altern Med. 2008 May 12;8:20. 18. Li A, Zhang RX, Wang Y, Zhang H, Ren K, Berman BM, Tan M, Lao L. Corticosterone mediates electroacupuncture-produced anti-edema in a rat model of inflammation. BMC Complement Altern Med. 2007 Aug 14;7:27.