No, I said Si Shen Cong. Next
question: You want to stick the needles where? Or,
patients will stop me in my tracks with a firm "I don't want
needles in my head." What's happening here? No big deal, I'm just
trying to utilize the Four Spirit Alarm extra point set on the top
of your head.
Does it sound alarming? Painful? I can understand that. Needles
in the head doesn't soundfunto most people, but rest assured it
usually doesn't hurt. The scalp is a shallow place, not too full of
fleshy, innervated muscles.
Right up there on the top, slightly to the back, you'll find a
special set of four points calledSi Shen Cong. Chinese
pronunciation sounds something like "Shee Shen Chong." English
pronunciation sounds more like "Cheech and Chong." It's ok, just
keep working on it.
One translation calls this extra point "God's Cleverness." We
use it for improving concentration, memory, focus, or other related
indications. In TCM treatment strategies, it helps to "calm the
Shen," or "relax the mind and settle the spirit." In adults, this
4-point combination could be indicated in cases of wind stroke,
headaches, epilepsy, and dizziness. In children, traditionally this
point combination was used for slow development, mental
retardation, and recently for ADHD.
In clinic today I polled my fellow
interns to see how often they add the point "Governing Vessel (GV)
20" into the mix when using Si Shen Cong. Why would someone do
this? Well, as I argued, it just seems like the right thing to do.
GV20 is a masterful point, located smack in the center of the four
needles used in Si Shen Cong. Its indications are similar, not
shocking, considering they are all within a couple of inches of one
GV20, also called the "Hundred Convergences" in English and "Bai
Hui" in Chinese, you can find this point on the midline of the
head, five cun back from the anterior hairline. GV20 is generally
used for two indications--pulling things up or pulling things down.
How can it do both, you ask? Well, Chinese medicine is magical,
don't you know.
GV20 is indicated for prolapse, thus it can pull things up.
Whether it's your uterus, rectum, bladder, or vagina that's
prolapsed, GV20 can help put it back up where it belongs. Same goes
for hemorrhoids--other items that should not be hanging down.
GV20 is indicated for yang rising in
the top of the body. Think headaches, hypertension, dizziness, red
eyes, irritability, tinnitus, seizures, and more! Interestingly, in
these cases, GV20 at the top of the head is paired with anchoring
points found at the extreme lower end of the body. For the horrible
conditions mentioned here, Liver 2 would be an effective paired
Whether you're rectum has prolapsed, you've been dealt a massive
vertex headache, or you just want to improve your concentration and
focus for the upcoming test, you might want to give needles in the
head a chance. When your acupuncturist suggests "Si Shen Cong," now
you'll know it's not Cheech and Chong she's referring to. But
they're fun, too.
I think not. Yet, there are around
50,000 homeless veterans in the U.S. on any given night -- despite
a 33% drop since 2010! "The U.S. Department of Veterans Affairs
(VA) states that the nation's homeless veterans are predominantly
male, with roughly 8% being female. The majority are single; live
in urban areas; and suffer from mental illness, alcohol and/or
substance abuse, or co-occurring disorders."
This is where acupuncture comes in,
friends. The National Acupuncture Detoxification Association
(NADA) protocol, specifically, is helping veterans with PTSD manage
stress, addictions, difficulty sleeping, and other behavioral and
mental health conditions. NADA uses a standard set of ear points --
Sympathetic, Shen Men, Kidney, Liver, and Lung -- stimulated either
with needles or with ear seeds.
Since it was established in the Bronx in 1974, the NADA protocol
has brought relief not only to veterans, but also others in need of
assistance with addictions, from food to illegal drugs. How does it
work? The acupuncturist -- or one of over 10,000 health care
professionals trained specifically in NADA protocol -- inserts the
five sterile, stainless steel, one-time use needles into the ear
and lets them remain for up to 45 minutes. Then, we take them out.
It's simple. It's fast. It's cheap. It's effective.
What are patients saying about the NADA
protocol? "...improved program retention, a more optimistic and
cooperative attitude toward the process of recovery, as well as
reductions in cravings, anxiety, sleep disturbance and need for
On Friday, June 26, NUHS Chief AOM Clinician Dr. Hyundo
Kim and a group of acupuncture and oriental medicine interns
headed downtown to the Chicago National Guard Armory to offer free PTSD ear
seed treatments to homeless veterans. That's right -- NADA can
get even easier! When needles aren't appropriate or convenient, we
can still stimulate the ear points of the NADA protocol with
stick-on ear seeds. The added bonus is that the patient can
essentially take the treatment "to go," and can squeeze the seeds,
reactivating the points, for the next few days.
At that Chicago Stand-Down event, held in June, homeless
veterans are brought together in a single location to access
community resources and supplies needed to begin addressing their
individual problems and rebuilding their lives. Our group of
volunteers provided ear seed treatments while other groups provided
everything from a hot meal to a bag of clothing to an eye exam. I
saw booths for flu shots, HIV tests, dental services, and Reiki.
That day -- that one day -- those homeless veterans had a
Representatives were on-site to match them with shelters, jobs,
and the benefits they earned for their service to the United States
of America. They were welcomed, they were appreciated, and they
This weekend I saw an article about the word "eggcorn" being
added to the dictionary. Perfect, I thought. Someone has finally
justified my mispronunciation of the word "acorn." After all these
years, I've been vindicated.
No. That's not what happened. Apparently, a word has been
created, tested, and formalized for these types of circumstances.
When enough people say a word incorrectly enough times, it can
become a legitimized word. You can't just be totally crazy and
wrong, though, mind you. You have to misuse a word and
have it be somewhat close to making sense. Then you can be
"For all intensive purposes," "a mute
point," "an averse reaction," "old timer's disease," and "soup
chef." All wrong. Look again -- it should read "for all intents and
purposes," "a moot point," "an adverse reaction," Alzheimer's
disease," and "sous chef." Notice how the words commonly used are
technically wrong, but still actually kind of correct? Now there's
a word for that, and that word is, appropriately, an "eggcorn."
What do eggcorns have to do with TCM? Well, thanks for asking.
Some of my favorite intentional misspeaks just happen to be related
to auricular acupuncture, or, as I call it, "earcupuncture."
Closely related is the way that I call the ear apex the "earpex."
Sometimes, I just can't help myself. It's like the words are out
there just calling me to stick them together. Maybe I'm not even
misspeaking; I'm just making new contractions. You're welcome.
Today, on this new day, just one week after Merriam-Webster
added "eggcorn" to the dictionary, I feel confident in using my
slightly off the beaten Daoist path terminology. I'm using
earcupuncture, or earicular acupuncture, I'm bleeding the earpex
point to lower blood pressure, and I'm not apologizing. Words that
are wrong but self-explanatory enough to be right are OK in my
Also, ear acupuncture is important. It's powerful, it's fast,
it's easy, and it's cheap to perform. People need to become more
familiar with this modality of Traditional Chinese Medicine, but
the sterile statement, "I'm going to insert needles into your ear
now," doesn't always go over well with patients. Can an eggcorn or
two lighten the mood? Can a spoonful of humor make the needle slide
in more smoothly?
Why does auricular acupuncture work so well that I'm willing to
mispronounce it to help new patients accept it? The theory of
auricular acupuncture is that the ear is a microsystem, where every
body part is represented and connected to a particular point on the
ear. Red spot on the antihelix? Maybe it's revealing your knee
pain. Really sore when I squeeze your lobe? Could be your tooth
infection screaming for help.
Say it how you like. Whether it's ear acupuncture, ear-icular
acupuncture, or earcupuncture, just try it out. I won't judge you
on your pronunciation. Will it hurt? Maybe. Here's a secret tip.
Sometimes we don't even use needles on the ear points. We have
these things called "ear seeds," and they definitely don't hurt. If
you could handle the feel of a Band-Aid with a piece of dirt stuck
to it, then you'd be fine with ear seeds. Just squeeze and enjoy
the pain relieving benefits. It's easier than sticking an acorn to
No one likes to be wrong. No one likes to admit that his or her
medicine is not the best. When a patient walks into the room
seeking treatment, we each want to be the one to say, "Yes, we can
help you." While acupuncture has successfully treated the masses
for thousands of years, and has been recommended by the World
Health Organization for dozens of conditions and diseases, it's not
the only tool in the shed in 2015.
On Thursday at Cook County Hospital, I sat at the computer in a
treatment room entering the subjective information from an existing
patient presenting with a new chief complaint -- left calf pain.
We'd treated her in the acupuncture wing of the outpatient pain
clinic before, but her chief complaint was usually lower back pain.
Initially, I thought "another case of sciatica," as I worked
through her SOAP note and mentally scanned the best acupuncture
points for the job.
"Sharp pain in the back of my leg," she said, gingerly touching
her left calf. I asked, "When did it start, and have you had this
pain before?" "Yesterday, and NO," she snapped back at me. "It's so
swollen and the pain is sharp right here," she added. She confirmed
that there had been no trauma to the area, and I released my grip
and let the pack of needles slide deeper down into my lab coat
I'm kind of new here, and I readily admit that my weakness as an
acupuncture intern is ruling out contraindications and sorting out
red flags before I start sticking needles into the patient. Can I
still needle you if your blood pressure is 150/90? Some books say
yes, some sources say no. Acupuncture lowers blood pressure, so
shouldn't we go ahead and do it? Refer out! Confusion. "It's
normal," everyone assures me. "You'll gain that confidence through
clinical experience over time." Well, as a third year acupuncture
student, I don't feel like it's been enough time. I walk into the
head clinician's office and start presenting the case. Something
just feels...off...with this patient.
The beauty of my internship at Stroger Hospital is that although
it's not set up to be an integrative treatment experience for each
patient, it can transform into one in under 60 seconds. Our calf
pain patient came into the acupuncture wing of the pain clinic, but
upon suspicion of an emergency situation (yes, we were all thinking
"Deep Vein Thrombosis" or "DVT" at this point in the show), we went
two doors down the hall and snagged an MD intern to evaluate her
presentation from a western perspective, too.
He quickly assessed her signs and symptoms and agreed that we
needed to rule out a DVT before moving ahead with her regularly
scheduled acupuncture treatment at that time. Within seconds, our
integrated team had changed course, explained the testing process
to the patient, called over to the ER, and had a nurse transport
For thousands of years the expansive Chinese empire developed
what we now call "Traditional Chinese Medicine," or "Oriental
Medicine," of which acupuncture and herbs form the foundation. A
complete and effective medical system, the doctors not only placed
needles, administered herbal formulas, gave hands-on manipulations,
moxibustion, and cupping treatments, but also did bone-setting and
any other emergency medicine that was required. Today, in the
United States, our scope of practice is generally not so extensive
as to include bone-setting, but we respect the completeness of the
TCM system in its entirety.
This does not mean, though, that we ignore the
advancements of other medical systems or technologies. It means
that instead of blindly accepting the often too-invasive and
side-effect ridden treatment plans of the mainstream western
medical system, we utilize only the elements that we see as truly
necessary or complementary to a holistic treatment plan. In short,
I LOVE DIAGNOSTIC IMAGING. Sure, it's wrong sometimes, giving false
positives and false negatives alike, but overall it gives us a
somewhat clearer look inside the human body than what we can piece
together by looking at a patient's tongue and feeling her
I'm not saying that modern diagnostic imaging is necessary for
an acupuncturist to be effective in treating modern patients, but
it is another tool in the shed nowadays. The shed has grown larger
in the past 50 years, but it's also full of a lot of junk. Often
the expert walks in, picks up the best tool for the job -- the one
he's trained to use most confidently -- and steps over the rest.
The skill is being adept in choosing those tools that are best
suited for the situation, even if they aren't from the same
"The doctor of the future will give no medication, but will
interest his patients in the care of the human frame, diet and in
the cause and prevention of disease." Thanks, Thomas A.
Edison. I like that quote. Doctors of Oriental Medicine,
herbalists, and acupuncturists generally give herbs as part of a
complete treatment plan, but giving a pill to pop -- whether
pharmaceutical, peppermint, or deer antler-- is not the only way to
The doctor of the future will be truly integrative. He will
skillfully diagnose the patient's whole body, mind, and spiritual
condition, drawing from both hands-on examination findings and
high-tech imaging of internal structures. In the future, when the
patient presents with the new chief complaint of acute calf pain
and swelling, we can use modern imaging to quickly rule out the DVT
and then use acupuncture to treat her condition and balance her
body. We can give her qi gong exercises and dietary changes to
support her long-term health and wellness. Thomas Edison will be
Further Reading: The Patient Will See You Now: The Future of
Medicine is in Your Hands by Eric Topol
"Give her a Brazilian in Room 1!" This is the new catchphrase
around Stroger. That's right, we're giving Brazilians at the pain
clinic in Cook County Hospital. I occasionally worry that a passing
doctor thinks I'm waxing ladies in the treatment room, but the
concern quickly fades as I get down to business. This Brazilian is
all in the ears, and the only intimate part is the bleeding. I
always think bleeding is sort of a personal interaction.
According to a successful acupuncturist in Brazil, the best
treatment for relieving joint pain with heat signs is to tonify the
energy of the major internal organs, direct it towards the affected
joints, and then bleed it out of the body. How do we do this
exactly? Here's a sample case: inflammatory knee pain, let's say on
the left knee. It's painful, the area is red, swollen, and warm to
the touch. The patient often reports feeling warm, the pulse is
slightly rapid, and the tongue is often red.
The Brazilian technique is essentially a three-step process.
First, we needle the following points on the ear of the
non-affected side: Shen Men, Sympathetic, Liver, Kidney, Heart, and
Lung. Six needles so far, if you're counting. Then, we needle the
corresponding painful body parts on the ear of the affected side of
the body: Knee. OK, we're up to 7 needles so far. Totally doable.
Now we let those needles rest for a while while we enter the SOAP
note in the lovely electronic medical records system at
After about 10 or 15 minutes, we take those needles all out.
Next step, we get intimate. It's time to bleed the Ear Apex on the
affected side. I like to give it a few hard squeezes to ensure I'm
stealing as much hot blood out of this person's body as possible.
Don't worry -- it's usually just a drop or two.
What happens next? Well, it varies. Often times, though, it goes
like this. The patient stands up, wiggles around to "test" for any
perceptible changes in pain level and range of motion, and starts
to smile. "I feel better!" Pain levels are dropping from 10/10's to
4/10's in that 15-minute treatment time. Is it unorthodox?
Somewhat. Is it effective? Seems to be. Will we keep giving
Brazilians at Stroger? You bet.
• So What Is Chinese Medicine?
• Jabbing Nerves with Needles
• Mission in Nicaragua
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