Relief

REDUCTION OF SYMPTOMS SUCH AS PAIN, INFLAMMATION, AND LIMITED MOTION.

• The importance of the relief phase is to have you feel better as quickly as possible.

Relief Care: A minimal program of treatment that gets your body to a point where you don’t have symptoms for 3-4 weeks.

Correction

RESTORATION OF NORMAL HEALTHFUL BODY FUNCTION.

• The goal of this stage of care is to facilitate the body’s natural abilities to heal and stabilize itself.

A large percentage of healing takes place during this phase.

Corrective Care: A program of treatment that eliminates the cause of a problem by restoring as much function and health to the body as possible.  It usually takes place over a period of months or even years.  In acupuncture, that means the circulation of qi and blood are restored and the organs are as strong and balanced as possible.

Maintenance

MAINTENANCE AND EXPANSION OF THE PROGRESS AND HEALTH ACHIEVED

• The value of this phase is to maintain the progress you have achieved to support ongoing healing and to help prevent future health problems.

Maintenance care: A course of treatment which takes place once a patient’s circulation and imbalances have already been corrected.  At this stage a patient may only need treatment once a month or even once every 6 months.  The goal of Maintenance Care is to keep the patient at the level of health achieved in Corrective Care and prevent problems despite the stresses of life.

An Analogy: A Leaky Roof

The function of your roof is to prevent water from leaking into your house.  If the roof is not functioning properly, every time it rains water will leak through.   However, you don’t usually know this is going on while the shingles and the wood beneath rot.  The process can go on for a long time before a stain develops in your ceiling or water begins to drip through.  Eventually, every time it rains it will leak into your house.

To deal with the problem, you could put a bucket under the leak and mop up the floor, but the damage to your house will continue to get worse.   To correct the problem, you must fix the cause of the leak by fixing the roof so that it functions properly again.

It takes more time and money up front to fix the roof than to mop the floor, but in the long run it saves you time, energy, money and your house.

In people, there can be malfunction and disease processes that go on for a long time before any symptoms show up.  Only after the function has degenerated to a certain point do symptoms appear and you start to suffer.

To relieve the symptoms, you can take drugs or apply ice, but when you stop them the symptoms return.  When you treat the underlying cause of disease and improve the overall function of the body, symptoms will naturally disappear.  As function improves and the disease pattern is breaking down, symptoms will fluctuate as the body tries to heal.  The more function you have, the fewer symptoms there will be.  It is only when the cause is corrected will symptoms go away and stay away.

Relief care is like putting a bucket underneath the leak.  Corrective care is like repairing the roof.   Maintenance care is like tending to the roof as it wears from unavoidable environmental stress.

Corrective Care

Corrective Care is the care necessary not only to relieve or reduce a person’s pain or symptoms, but also to remove the actual cause of the problem.

For example, a person might have headaches, which resulted from a breakdown in organ function, blood stagnation, or energy stagnation.  These can cause an effect—a reduction in blood supply to the head—which in turn results in headaches.

Relief Care focuses on the symptoms: the headaches.   Relief Care would be similar to taking Aspirin, which, although it may temporarily alleviate headaches, does nothing to correct the underlying cause.

Corrective Care focuses on making certain the underlying stagnation and organ imbalance—the cause—are corrected and therefore the headaches—the result—are gone.

How long does corrective care take?

Not everyone can reach complete correction.  Sometimes a person’s problem has reached a point that complete correction not is possible.  Your acupuncturist will inform you of the severity of your problem and if correction is possible.

Correcting a person’s function is similar to pouring cement into a mold.  If you remove the mold before the cement hardens, you lose the object you wanted to create.

Continue your care:

Research shows that the body takes longer to heal than the pain or symptoms last.  Continued care encourages your body to heal faster and more completely than on-again / off-again treatments.

Health is vital in order to be happy

The current American lifestyle causes a large amount of concern among people who care about health.  There has been a dramatic increase in noncommunicable diseases within the last decade, and that number is still rising.  According to the Center for Disease Control and Prevention (CDC), seven out of every ten deaths are attributed to chonic diseases such as cancer, diabetes, and cardiovascular disease (e.g. heart attack and stroke).

Right now at least two paradigms of healing exist in our society.  One paradigm, which centers around diagnosing and treating disease, takes a mechanistic approach to illness in which the patient’s symptoms are combated with pharmaceuticals and/or surgery.  This approach assumes that if the patient’s symptoms improve via painkillers, antibiotics, steroids, or other suppressive treatments, then the patient is cured.

A second paradigm, the one that has always been embraced by Chinese medicine, looks at a person as a whole and acts to stimulate his or her healing, even before disease is apparent.  This paradigm strives to maintain homeostasis within the body, allowing it to function optimally and thereby promoting improved health.  Disease symptoms function as messengers to tell us what is going on in the body and can direct the practitioner to treat certain systems to bring better health.  Symptoms merely indicate the existence of a “dis-ease” in the body–that is, an imbalance.  When symptoms appear, they are only the tip of the proverbial iceberg that for some time has been developing beneath the surface.  This paradigm approaches symptoms as indicators of something going on deeper in the body; rather than merely suppressing the symptom, it strives to find and remove its true cause.

Qi Stagnation, Blood Stagnation and Organ Imbalances

How imbalance affects your health

1.) Qi: Energy or Vital force.

Meridians: pathways of Qi that travel along the exterior and through the interior of the body, connecting the organs to every part of the body.

Qi Stagnation:

a.) An interruption in the flow of Qi through the meridians. Like a kink in a garden hose.

b.) An interruption of communication from the organs to any cell or tissue in the body, often causing functional organ imbalances.

2.) Blood: The fluid that circulates through your body and brings your cells what they need to function correctly, including: water, oxygen, nutrients, minerals, salts, hormones and enzymes.  The Blood also takes away those things that interfere with the function of the cells including carbon dioxide and waste.

Blood stagnation: An interruption of the flow of Blood through the smallest vessels, called capillaries, which supply all the cells, organs, joints, etc.

3.) Organs: bodily structures that perform the physiologic functions necessary for the body to survive.  For example: the lungs oxygenate the Blood and take out carbon dioxide, the stomach and intestines break down food into nutrients and supply them to the body via the Blood.  The organs are the lungs, large intestine, stomach, spleen, liver, gall bladder, pericardium, heart, small intestine, kidneys and bladder.

Organ Imbalance: a state of abnormal organ function due to deficiency or excess.  Every organ interacts with every other. Imbalances in the liver, for example, can negatively affect the digestion of the stomach.

Working together, the Qi, Blood, and Body Organs

determine the dynamic health of the body.

Organ imbalance, Qi and Blood stagnation are caused by any physical, emotional or chemical stress a person cannot adapt to.  At first, stress only affects us on a more energetic level.  However, as stress persists over time the effects become more material and manifest in the body in various ways: from tension and pain to arthritis, tumors and disability.

The longer a condition is allowed to go untreated, the less chance there is for recovery.  What began as a minor problem or discomfort may lead to irreversible damage.

The purpose of Acupuncture and Chinese medicine is to return the flow of Qi and Blood back to normal and to have the organs working at their peak.  This will in turn restore function to the affected area.  If detected early, Qi/Blood stagnation and organ imbalances respond well to Chinese medicine with an excellent chance for a complete and painless recovery.

Mechanisms of Acupuncture

By Donald Kendall, L.Ac., O.M.D.

In TCM theory, disease, pain, or dysfunction was considered to be the result of energy being out of balance by being blocked, stagnated, deficient, or excessive. If the bodys energy was harmonious and uninterrupted, then the person should be in a fine state of health. It was observed that energy distributions could be manipulated by needling or heating (moxibustion) specific points along the channels that were particularly sensitive to stimulation, and that energy could also be strengthened through nutrition or the use of herbal remedies.

It can be shown that acupuncture works primarily because of its interaction with the afferent nociceptive (pain) and proprioceptive (muscle length and position) sensory and other nerves that in turn provoke local, spinal, and centrally mediated control.

Points and channels have unique tissue and anatomical properties and functional responses that can be shown to be related to defensive mechanisms. Activation of the spinal afferent processing system by stimulation of the superficial nociceptive and peripheral proprioceptive fibers appears to be most important in bringing about spinal and central control in the mediation of acupuncture.

No matter how minor the assault, the skin and subcutaneous tissue will provide efficient defense in the form of immune and repair processes. Stimulating the skin with an acupuncture needle is no exception, especially when inserted at acupoints, which, due to their unique histological features, will stimulate the body to react strongly. Overall, the bodys defense system will seek to expel, destroy, or neutralize the foreign object by mounting an immune reaction, initially increasing the blood flow and reducing residual muscular or tissue tension to aid in working the object out of the body. This process brings about a complex integrated immune, visceral, and somatic response that causes activation the spinal afferent processing system, which in turn initiates descending control. Analgesia is also produced by spinal segmental processes and central mediated inhibition of the nociceptive fibers, probably to allow an animal to still respond to a life threatening stress episode without being hampered by the presence of a painful thorn or sticker.

It has been found through both human and animal research studies that acupoints contain a significantly higher concentration of mast cells, fine lymphatics, blood capillaries, venules, and converging arterioles, along with sympathetic nerves supplying the vessels, nerve bundles, nerve plexuses, and free nerve endings. This makes acupoints extremely reactive to the micro-damage of needle insertion.

When the endothelium of small blood vessels and capillaries, and the surrounding connective tissue of points are injured (such as by needle insertion), numerous damaging products, including fragments of collagen, microfibrils, and basement membrane, are generated. Mast cells concentrated at the acupuncture points help to increase the initial vasodilation phase by releasing histamine, heparin, and kinin protease. This delays the blood clotting aspects of the repair phase and has a positive anticoagulation effect.

The reaction to needle insertion is controlled by an energy and calcium dependent cascading process which is modulated by the cAMP-cGMP balance in the cytoplasm of the primary target cells (mast cells and basophils). The initial effect causes arterioles to vasodilate and increase the permeability of the capillaries. Venules and veins are induced to constrict and lymphatic vessels dilate. This enhances the flow of blood borne immune cells and damage and repair substances into the surrounding tissue area where the needle has been inserted. The reaction has several time dependent features that include (1) vasodilation, (2) nociceptive excitation, (3) chemotaxis, (4) solubilization, (5) tissue repair, and (6) inactivation of the reaction. Many of these substances have very short lifetimes and only act in localized areas, while others can continue to be active after the acupuncture needles have been removed.

When a needle is inserted into an acupuncture point and manipulated, usually by rotating the needle back and forth while at the same time lifting and thrusting up and down slightly, a reaction occurs that is called deqi. It refers to the arrival of response. The sensation to the reaction has been described as a feeling of distention, heaviness, cramping, numbness and soreness, and sometimes pain. A local redness, wheal formation (local edema), and spreading of the redness to form a flare response are typically observed surrounding the needle sometime after insertion. It is thought that histamine, substance P, leukotrienes (LT) and platelet activating factor (PAF) participate in this reaction. If nerve function to the area of needle insertion is interrupted, or if substance P is depleted in the nociceptive fiber by application of capsaicin, the flare response is absent.

Histamine, prostaglandins, serotonin (5HT) and leukotrienes are also important initial mediators of the acupuncture effect. Plasma levels of prostaglandin E have been observed to increase when excellent acupuncture analgesia is achieved for surgery with histamine, 5HT, dopamine beta hydroxylase (DBH), and cAMP levels showing a corresponding decrease. In cases of poor effect for acupuncture analgesia, plasma levels of histamine, 5HT, DBH, and cAMP show an increase. The effect of acupuncture on plasma 5HT seems to be related to increasing its re-uptake in platelets, thereby causing a decrease in levels.

The channels were mapped out in ancient times by carefully recording the superficial pathways of subjective reports of peripheral nerve reaction in response to stimulating points on the skin, and the resulting traditional acupuncture charts were diagrammatic representations of the propagation of sensation (PS) lines. PS can be stimulated either by needle insertion, moxibustion, pressure manipulation, vibration, acoustic stimulation, massage, chemical application, or electro-stimulation. Vital to the propagation of PS along the channels are nociceptive (A-delta, group III, C and group IV fibers) and proprioceptive (group II) fibers, sending branches that synapse on neurons several segmental levels above and below their point of entry in the dorsal horn, these interconnections can give rise to the propagation of signals up and down the cord from the point that needling sensation is stimulated.

Propagated sensation has a latent characteristic as well as a prompt or conspicuous nature. In the case of latent PS needling sensation may be experienced without any propagation of a sensation along the channel. It can be induced after needle insertion by percussing the channel with a small hammer, demonstrating the involvement of intrafusal fibers.

The unique physiological features at acupuncture points, channels, and spinal axial pathways account for the higher probability that signals will propagate along these pathways as opposed to non-points or non-channel areas. Propagated sensation is not subjectively experienced unless a sufficient number of proprioceptive and nociceptive (FRA) fibers participate in the reaction.

This article was taken from Kendall, D.E. (1989). A Scientific Model for Acupuncture. American Journal of Acupuncture, 17(3), 251-268.

About the Author

Dr. Donald Kendall, author of Dao of Chinese Medicine, first became involved with Chinese medicine after graduating from the University of Illinois with a degree in engineering, when he adopted the use of Chinese herbs as his primary health care strategy. This led to the study of physiology and Chinese medicine, culminating in a degree from the California Acupuncture College as Doctor of Oriental Medicine. Dr. Kendall has more than twenty years of private clinical experience, including acupuncture research at the UCLA dental school and as a staff member at UCLAs Center for East-West Medicine. Dr. Kendall has also served on the boards of several state and national professional organizations for acupuncture and Oriental medicine. He has developed and taught acupuncture orthopedics and dental acupuncture certification courses, and has participated in veterinary medical acupuncture training programs. He lectures extensively around the United States, as well as internationally, and has published a number of articles on various aspects of Chinese medicine, with an emphasis on how acupuncture works.

Chinese medicine enhances the recuperative power, immunity, and state of well-being. With fewer side effects and easy assimilation, Chinese herbs are safe, effective, and gently nurturing.

Traditional Chinese Medicine

With over 23 centuries of continuous use, traditional Chinese medicine approaches disharmonies from within a framework that addresses the patient’s constitution. Both the disharmony and the essential or underlying physical makeup of the individual are taken into account for diagnosis and treatment.

Western drugs often control symptoms but do not alter the disease process, whereas Chinese herbal therapy treats the imbalance underlying a condition’s symptoms. Each treatment is tailored to the individual and based upon a traditional diagnosis.

How Herbs Work

“Since fatigue results from a lack of Qi, herbs that nourish the Qi have an energizing effect. Since blurry vision, restless sleep, and irritability result from depleted Blood, Blood-enriching herbs improve vision, sleep, and equanimity. Since dry skin and dehydration arise from insufficient Moisture, herbs that replenish it soften the skin and relieve an otherwise unquenchable thirst.

Herbs assist the Organ Networks in the performance of their tasks. Particular herbs enhance the capacity of the Heart to propel the blood and soothe the mind, the Spleen to manage digestion and fluid equilibrium, the Lung to handle respiration and the body’s defenses, the Liver to maintain resilient emotions and supple limbs, and the Kidney to sustain sexual and regenerative power. Some herbal formulas address ailments such as colds, allergies, inflammations, or cramps with dramatic and immediate results, wh ile others fortify body reserves over time.

Chinese herbs are usually combined in formulas to enhance their individual properties and actions. Symptoms and signs are matched with therapeutic effects, reflecting the particular conditions and needs of each patient. Tonic formulas restore eroded body resources; regulating formulas decongest the Qi, Moisture, and Blood, relieving discomfort; and purging formulas eliminate pathogenic influences.

Herbs, more like foods than drugs, can supplement the diet and fortify your constitution as well as prevent or remedy ailments. Formulas fall into three principal categories and have specific energetic actions:

Tonifying or supplementing formulas are used for conditions of weakness or deficiency. Deficiency patterns may be seen in any of the organ systems especially; Spleen, Lung, Kidney, Liver (Blood and Qi) with symptoms such as fatigue, poor digestion, low immunity, and incontinence.

Purging or eliminating formulas eradicate a pathogen such as a virus or bacteria. These are very specific types of formulas that are mainly used for conditions such as Wind Heat invasion (common cold or flu), Heat and Toxins (growths or infections), or pain conditions such as Blood stasis, or excess Dampness (arthritis).

Harmonizing formulas restore balance and equanimity to an organ system – usually the Liver/Gall Bladder (Digestive system) that may manifest as manic behavior, constipation or diarrhea.

Patterns can be complex and manifest in many different ailments and behaviors.”

Chinese Medicine – How it Works
Harriet Beinfield & Efrem Korngold