When they ask you why you
came in for an appointment today, go ahead and let them know that
your urine is coming out in long, clear streams, and that your
dreams have been creepily vivid this week. Tell them that your
bowel movements are light brown, formed, and coming with ease twice
per day in forearm lengths that would make Dr. Yurasek proud.
Mention that you've been feeling kind of cold and that you can't
stand being out in the wind. That heaviness in your arms? Mention
Dive straight into the rest of Oriental Medicine's famed "Ten
Questions," noting whether you've been extra hungry, not so
thirsty, frigidly anti-sexual, exhausted from periods with
quarter-sized black clots, or muzzy-headed in the afternoons. It
all matters. If you're in an AOM clinic, these are the types of
things you can expect to be asked by your acupuncturist or
herbalist. No one here bats an eye when patients share the color
and consistency of their bowel movements. In fact, if you withhold
that information, we can't really help you very well.
Here they are, in detail but translated by me:
The Ten Questions
Your acupuncturist or herbalist not only wants to know these
things, but also actuallyneedsto know many of these things in order
to properly diagnose your condition and begin a treatment plan. If
you have long, clear streams of urine, loose stool, weak knees, a
sore lower back, and feel cold all the time...well, we know what's
going on. No, I'm not going to tell you here. Look it up. Better
yet, visit an acupuncturist!
So, if you're in an AOM clinic, have your thoughts on these
vital topics prepared beforehand. Otherwise, you might be so thrown
off guard by some of the Ten Questions that you can't formulate
sentences. That's actually fine, because none of the 10 questions
directly correlate to grammar skill level. Thank goodness, right?
However, if you find yourself in the office of an MD, keep in mind
that you might not want to just jump right in with details about
where you are in your menstrual cycle and how gassy you've been, if
your chief complaint is seasonal allergies. Just a tip, from me to
Think it's too difficult for you? I think you're wrong. File
this post away under the "if I can do it, you can do it" series.
Unfortunately, this practical how-to post is the result of someone
actually needing to use raw Chinese herbs to feel better--and that
someone is me.
Remember that whole "damp-heat
in the gall bladder" thing from a couple of weeks ago? Yep, me
too. Turns out, I still have that going on. Yes, I self-diagnosed
and self-treated in near silence. Did I say I was good at this? I'm
sorry. No. I'm a student. I know close to nothing. In my defense,
upon an actual visit to the NUHS AOM clinic to exercise my
student-access-to-free-care privilege, I learned that I nailed my
diagnosis and was only one off in my acupoints selection plan.
Ingredients for Treatment
I was indeed on my way towards getting back to normal, but not
quite there yet. No. What I needed was a boost -- a big powerful
boost in the health direction. I needed herbs from Dr. Cai. After
showing my tongue and displaying my pulsating wrists to the masses
of interns, I left the clinic with my trusty sack of Chinese herbs.
At Dr. Cai's request, I also needed to add in a slice of fresh
ginger and three red dates with each batch, which I happened to
have on hand.
Many people would peer into this bag thinking, "What the heck do
I do with this pile of roots, bark, mushrooms, berries, and other
unidentifiables? Technically, there could be geckos and cicada
shells in there...shudder. In fact I refuse to look up everything
in the formula shown on my receipt just in case therearegeckos and
cicada shells in there.... So, here it is--your pictorial
step-by-step guide to using raw Chinese herbs in a decoction. This
is the instruction sheet that goes home with the patient.
Instructions for Cooking Chinese Herbal Formula
What this is trying to say is dump one batch of the herbs into a
pot, soak it, bring it to a boil, then simmer to reduce the liquid
to a drinkable amount. Now, you'll want to find the perfect balance
between "disgusting taste" and "effective dose," and that
isnoteasy. You know you want to concentrate the liquid for potency,
but you also know that you're increasing the taste by the same
Before Cooking and After Cooking
Most herbal decoctions do not taste good. Face it. Most of us
are damp. We eat dairy and fried foods (mmmm...fried dairy), and we
end up with damp-heat. Thus, we need bitter herbs much of the time.
Who's the lucky fella who gets a simple Spleen Qi deficiency
diagnosis that results in a sweet licorice and berries formula to
take home? Not this guy!
So, I soak my bitter herbs, I boil my bitter herbs, I simmer my
bitter herbs. I drink my powerful decoction, and I go to sleep to
let my body do its thing. I wake up a little better, and I know I
have five more nights of chugging down my "bedtime tea" before my
tongue can register just how gross it really tastes.
I could avoid much of the "hard work" in this process by
requesting my herbs in granule form (like a dusty powder that you
stir in warm water to dissolve). But then I'd lose a little
potency. I could avoid all the work and the taste
by requesting a patent pill formula, but then I'd lose even more
potency. No thanks, weak sauce. I need the most full-strength
option known to man -- ancient Chinese man, specifically. I need to
decoct my raw herbs!
I get really annoyed when I'm reading the results of a
scientific study about the effectiveness of acupuncture, and the
author concludes that actual acupuncture was "not significantly
more effective than sham acupuncture." What they seem to be saying
is that acupuncture is not effective at treating X condition. What
they are actual discovering is that needle insertion almost
anywhere in the body will have an effect on the body's condition,
often providing relief from X condition.
I like this part. As Dr. Kwon always told us in
Point Location class, you can still help the patient even if you
don't stick the needle in the exact acupoint. This realization
saved my sanity on more than one occasion when trying to palpate
and count thoracic vertebrae to locate the oh-so-important points
of the Governing Vessel running up the spinal column. It's supposed
to be located at T6, but T7 will be good enough? Awesome. Thank you
for your flexibility, ancient wisdom.
So, back to the studies that drive me nuts. Here's how they
commonly shake out:
Exactly 100 patients were studied for chronic knee pain, with 25
receiving no treatment, 50 receiving actual acupuncture (inserting
needles at specifically proscribed points), and 25 receiving sham
acupuncture (inserting needles randomly in the body). Guess what?
The patients receiving no treatment did not experience improvement.
The patients receiving actual acupuncture reported a 50%
improvement, and those receiving sham acupuncture reported a 45%
I call that good news. The study concludes, instead, that actual
acupuncture is not significantly more effective than sham
acupuncture at treating knee pain. Wrong. What they actually did is
prove Dr. Kwon right -- not that he needs any additional
validation, seriously -- that even when needles are inserted at the
"incorrect" location, acupuncture still has therapeutic benefits
for the patient. Is the goal of an acupuncture treatment for knee
pain simply to eliminate the knee pain? Not exactly.
Any time acupuncture happens, that patient's body experiences a
shift in energy. We can usually feel a difference in the person's
pulse after treatment, compared to before. The qi (energy) has
moved, and in western terms, circulation usually improves. Sure,
the knee pain is improved, but the patient might also sleep better
than usual that night, awake with more energy than usual the next
day, or even notice that a new head cold has resolved
Were these other effects coincidental?
Maybe, but probably not. Any acupuncture is better than no
acupuncture, and the results of studies comparing no treatment,
sham acupuncture, and actual acupuncture will often reveal this
truth. In fact, this little "secret" is why I'm not against other
practitioners doing acupuncture on patients. We've all heard the
buzzword "dry needling," which is when say, your physical therapist
needles your arm when your elbow isn't healing as nicely as you'd
like. I know several chiropractors who have completed the 100-hour
certification in acupuncture, and they can often be seen sticking
some needles into a sore back muscle.
Some acupuncturists are completely against this concept of
non-acupuncturists needling patients, but I'm pretty much OK with
it. I know the patient is probably receiving some benefit
regardless of whether or not the needle goes in at an exact
acupoints. What's important to me is that the patient is aware that
dry needling or someone sticking some needles in where it hurts is
not all that acupuncture has to offer. Those techniques have
benefits, but not the full array of benefits that needling specific
acupoints on specific meridians can produce.
So, if you know someone who's been needled before and didn't
experience a great symptom reduction, it's still worth their time
to try acupuncture from an acupuncturist. Crazy, I know. It's not
that other providers are doing anything wrong; it's just that they
aren't receiving the more complete system of treatment via
acupuncture that we acupuncture students use.
"I hope the points aren't just nerves being shocked by needles,"
I said to AOM classmate Irene. As one of the few AOM students who
originally came into the program to focus on herbal preparations
and dietetics, I felt particularly uninformed about this whole
acupuncture thing. So, there in one of the first courses on the
theory of point energetics -- what the acupoints do and how they do
it -- I finally vocalized, albeit in a whisper-like fashion, my
growing fear: Maybe there's no meridian or point energetics beyond
just sticking a needle into a nerve and hoping it stimulates
something productive in the patient's body. Sure, that might still
help, but it certainly doesn't have the mystique that interested me
in the first place.
"Moving blood and qi," "balancing
energy," and "harmonizing yin and yang"...these concepts are
intriguing, promising, and yes, darn near magical in my opinion. If
we're just jabbing people with needles and shocking them wildly,
then I'm not sure I have the buy-in that a 3-year master of science
in oriental medicine degree requires. So there I sat, giving power
to my secret fear by speaking it aloud, not knowing what Dr. Yihyun
Kwon was going to say to pull me back over to his side of the
fence, and hoping that there was something more -- more ancient,
more Daoist, more qi-related in any way. (Spoiler Alert. Dr. Kwon
Irene surprised me with her response, which I recall as being
something along the lines of, "So what if acupuncture is
just stimulating nerves with needles?" How could she be so callous
to this deep fear that I'd been subconsciously fostering for the
first three months of our program? Didn't she understand that I was
sitting there, suffering in silence, desperate for some oriental
What Dr. Kwon went on to explain in that first Energetics class,
and even more so the following year in Neurophysiology of
Acupuncture class, was a concept that bridged the gap between the
mysticism and the mundane. He simultaneously satisfied my cravings
for evidence-based medicine as well as ancient tradition. Dr. Kwon
= 2. Juli's irrational fears = 0.
Yes, he explained, some points are located right
beside or above a nerve -- grazing it ever so slightly and
eliciting that loved or hated sensation we call "de qi," when
energy arrives along that meridian. Further research and
dissections have confirmed that many of those points not located at
a nerve are actually located exceptionally close to an artery or
vein. Here's where he blows my mind in 3...2...1....
Next, he tells us that these vessels and other structures
harboring acupoints are essentially wrapped up in nerve fibers
themselves. Yes, readers, we've come full circle in Juli's
understanding of neurophysiology (which doesn't take long). Many
acupoints are on a nerve; those that aren't, still kind of are.
And now to process this information.... Do I hate this answer?
Does it ruin the grandeur of ancient energy meridian theory? Nah. I
took the news fairly well, all ignorance and expectations
considered. In today's health care climate, I like that modern
science keeps proving acupuncture theory to be true. Time and time
again, I see modern western research pointing to the validity of
traditional medicine. At the end of the day, or the century, who
doesn't like being told, "You're right"?
• Jabbing Nerves with Needles
• Mission in Nicaragua
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