Tuesday, March 11, 2008

Acupuncture Chronicles I: Do We Have the Ki?

Western doctors can be such arrogant, contemptuous, condescending, judgmental snobs about medical practices in other cultures. It must be the Cartesian mindset. We worship empirical evidence and scoff at concepts that don't rely on observable, measurable phenomena.

I guess I can't really blame us. Reliance on evidence gives us security, a means of holding practitioners accountable for their work, and a solid foundation for our expectations of efficacy and safety. But it also deprives us of millennia of the rich lessons offered by non-Cartesian ways of thinking about the body and the world.

I get annoyed when I see rationalists speak or write in superior, sometimes fundamentalist tones in their polemics against "alternative medicine." Don't get me wrong - I am very much anti-quackery and very much for being educated, careful, and thoughtful about choosing therapies - but I think being categorically dismissive about ancient or foreign healing traditions is both short-sighted and disrespectful. (Of course, I also particpate in liturgy and see value in reading and talking about poetry, so what do I know, right?)

When the anesthesia literature had to start recognizing significant benefits from certain acupuncture techniques, I have to confess I fantasized about standing in front of a roomful of grey-haired white men in white coats and saying "Ha! How d'ya like THEM apples, hm?!"

I used an acupressure technique just yesterday, for a woman whose nausea persisted despite the administration of several different medicines. One of the recovery room nurses called me and asked about trying yet another drug, but it was one I wouldn't have recommended in that particular situation, so after ascertaining what she had already tried, I said, "Give her another five milligrams of drug A and a dose of drug B and I'll be right over to do some P6 acupressure."

When I arrived at the bedside I attached an EKG pad with the little metal nubbin against a spot on the forearm close to the patient's wrist and secured it with a pressure dressing. Half an hour later I was going to call the recovery room to see how the patient was doing when the nurses wheeled her right by me as they were bringing her up to her room. Was it the additional IV meds (which hadn't done a thing for her previously) or the P6 pressure, or a combination of the two? Hard to say, but the nurses were pleased, I was pleased, and most importantly, the patient was relieved and happy. I have other stories about the use of acupuncture/acupressure in anesthetic practice but they will have to wait for another "edition" of Acupuncture Chronicles.

Anesthesiologists are interested in acupuncture and acupressure because of their recognized potential for efficacy against certain pain states and against nausea. The conference I attended in Vermont over the weekend offered a special workshop on acupuncture which was attended to capacity. I was struck by how, in the various discussions on the mechanisms by which acupuncture provides relief, people kept trying to find Western explanations: neurochemical transmission, embryologic connections, cell signalling / second messengers, and microscopic connective tissue changes. I had a nagging thought throughout all the lectures and conversations: could we be "missing the boat" trying to force neurophysiology and biochemistry, very matter-oriented mechanisms, on something that has for thousands of years been explained as an energy-oriented healing method? Will our understanding always be incomplete because we just cannot, will not believe in Chi (or Qi, or, in Japan, Ki), the "life-force" coursing through the meridians along which acupuncture needles are placed?

The National Council Against Health Fraud articulates a fairly commonplace attitude to the concept of Chi, and to acupuncture in general, in its position paper, revealing not only skepticism but also some real disdain for any understanding that departs from the wisdom of modern medicine: "The life force, Ch'i, has no basis in human physiology. The meridians are imaginary; their locations do not relate to internal organs, and therefore do not relate to human anatomy. Acupuncture points are also imaginary. (Various acupuncture charts give different locations for the points.) These fanciful concepts continue to form the basis of modern acupuncture therapy even though extremely sophisticated methods are used to measure its reputed biochemical effects." (Emphasis mine.)

I believe it's possible that not all healing mechanisms rely entirely on matter: molecules, receptors, ion channels, and the like. Even "modern" physics supports the interchangeability of matter and energy: light is a wave as well as a particle. For all we know Chi not only exists but also can be crucial to our health. We can't see it, touch it, or run it on a gel, so of course it must be a load of superstitious hogwash, right? One of the key speakers at the Vermont seminar did concede that even if we could really grasp and accept the concept of Chi, there had to be some interface with the physiology we know and understand that would satisfy our hunger for tangible mechanisms. I agree, I think the truth may lie in both worlds together (yin and yang in balance, anyone?). I don't think medical doctors should cling so obstinately to their mental models of health and pathology as the absolute truth, and I for one am happy to see my field opening up to possibilities that just might do our patients some significant good.


Anonymous said...

A number of years ago, while in Paris, I started to get daily splitting headaches. I went to a doctor—easy and cheap in the French system, even for a foreigner—who checked me out for things like brain tumors, then advised aspirin for the pain. Back in Boston, my Harvard physician did the same tests, then advised Tylenol for the pain. Neither had done anything to address the source of the pain. A Chinese/Japanese friend then brought me down to an acupuncturist in Boston's Chinatown. After about four treatments, my headaches had disappeared, never to return. Anyone want to draw conclusions about the superiority of Western medicine?

Elaine Fine said...

Boy, do I wish there were more doctors like you!

Unknown said...

Ayurvedic Treatment for Heart Diseases
Till early eighties, it was widely believed that heart disease was virtually irreversible. This meant that once developed, the disease ran a progressive course until the coronary arteries were completely blocked. But recent studies have proven beyond doubt that not only it is possible to stall the process of artery blockage but also the blockage can be really reversed. This implies that through measures other than angioplasty (ballooning) or bypass surgery, it is quite possible to increase the blood flow to the areas of theheart that receive less than adequate blood supply due to clogging of the coronary arteries.
It is quite disheartening that the highly technological approach of the modern medicine literally bypasses the underlying causes of the heart disease. Ayurveda, on the other hand, aims at striking at the very root of the disease. A real cure for this disease is only possible if we adopt a holistic approach as the one advocated in Ayurveda and address the problem at its very root. Shunning the age-old principles of healing described in the Vedas- the great Indian heritage, as unscientific only just because they are old, is most unfortunate. However, due to the intensive research work of some doctors in the west, people now have come to believe that Heart Disease can be reversed.
There are some very effective natural treatments for regulating and strengthening the heart. Here are some of the recommendations that Ayurveda makes:
Nourishment : Use of Amla fruit as an excellent anti-oxidant that can help to prevent arterial damage from free radicals as well as nourishing the heart tissue. Amla can help boost the immune system and nourish the heart. Chywanaprash is a delicious nutritive herbal jam that contains Amla and is a real boost to the strength of the heart.
Increase circulation: A major cause of heart problems is due to hardening, inflammation or congestion of the arteries which can restrict blood flow as well as putting pressure on the heart muscle and tissue. Arjuna is one of Ayurveda's wonder herbs for strengthening the cardiac muscle, reducing arterial congestion and lowering blood pressure.
Reduce Blood fats and high cholesterol: If you suffer from high cholesterol try Triphala Guggul which combines a range of herbs known to tackle the causative problems of high cholesterol as well as reduce high levels of blood fats. Relaxation: If you suffer from excess tension try using Ashwagandha . It is a wonder herb for helping reduce tension in the body and mind as well as strengthen the heart muscle.
Dietary suggestions: Eat a nourishing diet that removes all processed foods, poor quality dairy, poor quality oils, hydrogenated oils. Increase foods that are excellent for the heart. Use garlic, turmeric, ginger and saffron. Include whole grains, pulses and foods high in essential fatty acids such as hemp seed oil. EFAs are renowned for helping to keep arteries clean and the heart strong.
Avoid over-eating and eating frequently. Eat a light breakfast and dinner. Lunch should be the main meal. Milk products, fried foods, cold foods and acidic foods should be taken in small quantities. White flour products and foods that contain chemical preservatives and additives should be avoided. Animal products, especially red meat, are not good as they take a long time to be digested, and create a lot of toxins in the stomach.
Seasonal fruits and fresh vegetables (steamed or cooked), Brown bread or Chapatti, salad, sprouts, vegetable soup, buttermilk, cottage cheese (paneer), a little quantity of fresh milk and ghee (clarified butter) prepared from cow's milk, make up an ideal list of food items to choose from. Anything sweet should be taken in moderation. Honey and jaggery are healthier than purified sugar.
Fried things, pulses and their preparations, and groundnut oil are prohibited. Ayurvedic physicians allow butter or ghee, and not groundnut oil. Cow's ghee, cow's milk and cows' butter are useful for the patient. Buffalo ghee and buffalo milk are not recommended. Stimulants like tea, coffee and alcoholic drinks are very harmful for such patients. In addition to maintaining a healthy eating pattern, specific foods are often recognized as particularly heart-healthy. One of the most popular of these healthful foods is fatty fish with its high omega-3 fatty acid content. A recent study determined that women who consumed more omega-3 fatty acid laden fish (two servings weekly) had a reduced rate of death due to heart disease. These researchers found that this was independent of cardiovascular risk factors or other dietary sources that may influence the development of heart disease. Good sources of omega-3's besides fish are: flaxseeds, flaxseed oil, canola oil, olive oil, sesame oil, peanut butter and oil, sunflower seeds and oil, avocado, soybean oil, and safflower oil. Additionally, flavonoids found in tea and cocoa have been recognized for their antioxidant benefit. By blocking oxidative damage to LDL cholesterol and reducing platelet clumping, flavonoids may help to reduce the risk of cardiovascular disease. An inverse association between dietary fiber intake and cardiovascular disease risk has also been proposed. This underscores the recommendation for increased consumption of fiber-rich whole grains, legumes, fruits and vegetables.
Lifestyle: Your heart needs a regular supply of oxygen and it also must not be overstressed. Practice light aerobic exercise and regular relaxation. Ayurveda would recommend some nourishing yoga practices, such as the dynamic 'Sun Salutation' as well as daily breathing practices (Pranayama). Ayurveda suggests exercising within your own limitations and does not encourage excessive exercise that leaves you tired. Yoga is exercise that leaves you energised and fitter.
A very common cause of heart diseases is mental stress. Regular practice of yoga and Pranayama (breathing exercises) reduces stress levels. Also, meditation has been scientifically proven to prevent as well as cure heart diseases.
Ayurveda considers the functions of heart and mind inter-linked. Disturbance in one affects the other. Therefore, patients having heart disease are advised to refrain from anxiety, worry, excessive sexual intercourse and wrathful disposition. All efforts should be made for the patient to have good sleep at night. Even rest during the day is essential. He should never be permitted to remain awake at night for long.
The patient's bowels should move regularly. If there is constipation, he is advised to take a glass of water early morning and go for a walk every day. A gentle laxative like Triphala choorna may be used if required Panchakarma: A gentle head massage with or without oil several times a week is very beneficial. A full-body self-massage with oil once a week is also good.
The Author: Dr.Shashikant Patwardhan
Pondicherry / India

Anonymous said...

The paper from the National Council Against Health Fraud seems to confuse imaginary and invisible. Lots of important things and forces are invisible, or invisible at least until we find a tool to see or measure them (atoms, forces within atoms, air, gravity, sound, patterns). Their invisibility doesn't make them imaginary or less powerful.

Thanks for your thoughtful, interesting blog, Julie.

Anonymous said...

Your writing is poetry. I thoroughly enjoy your blog, and this post in particular. The thing about yin and yang, is they can't stay apart--one always engenders the other. Such is what's happening as East meets West in the world of medicine. You're right about the many closed minds out there, but there are also many open ones--your's is a delightful case in point. Thank you! My name is Julie and I blog about acupuncture at www.fiveminds.wordpress.com

T. said...

Thanks, everyone, for your supportive comments!

And Julie - I'm so glad you let me know about your lovely blog. I've enjoyed the acupuncture AND cooking posts! Thank you for those, and for your kind words.

Lisa Johnson said...

Hi T! Your timing could not get any better! I have my first acupuncture treatment in two hours! : )

T. said...

Ooooooooh!!!! Anali! Please tell us how it goes!

Lisa Johnson said...

I did it! I don't know how many needles were in me, but I really only felt three of them. My acupuncturist, I'll call her C, is wonderful and I feel like we are very much on the same wavelength. C moved two of the needles slightly and then I didn't feel them anymore. The third she took out, because the area was too tender.

It was more relaxing than anything. I felt that same buzz of energy circling in my body that I feel after I do yoga. Something was definitely happening. I'll probably write a post about it in the next few weeks. I'll be going for weekly treatments for the next 3-4 weeks.

T. said...

Anali, that's great! I've heard that from so many people - that acupuncture is really RELAAAAAAAAXING. I'm glad for you and am looking forward to reading your post!

Anonymous said...

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