Category Archives: Uncategorized

CHI GONG FOR HEALTH

Tuesday lunch time from 1-2 is now the new time for the chigong class. Beginners welcome, these are simple stretches and breathing exercises, and static postures to develop internal strength and restore vitality. Classes are £45 for 6 first class is free. Why not try it out!

The kika Facebook page had an interesting article uploaded about the history of chi gong within the medical community in China during the 50s and 60s where it was initially first introduced into hospitals. The article deals also with the problems they had in terms of the conflict of having to package it in terms that  were politically acceptable for the the ruling regime whilst still making it clinically effective. Though no doubt some of the claims at the time could be seen as questionable it is still a part of the medical establishment and can be offered to patients, with research continuing to this day in its appellation for specific illnesses.

Click here to get to the Facebook page which also has a post relating to taichi and heart disease.

kika

Why call it “kika”?  – kika is formed from two Chinese characters, or Kanji as they are known in Japanese. The ‘ki’  [ 喜 ] character means joy or happiness, the ‘ka’ [ 花 ] character means flower. Besides being taken from each of our daughters names the combination reflects a way of treatment. Traditional Chinese medicine is based on a “root and branch” approach. In order to get happy healthy flowers on your branches you need strong and balanced roots. The treatments on offer are to help strengthen your “roots” in order to maintain blossom on your branches!

So typically in acupuncture, treatment is structured in this way. Part is to strengthen the root or constitution and part is to address the symptom. Sometimes these parts of the treatment overlap.

The chi gong exercises can be seen as a kind of home therapy to strengthen one’s vital energy and improve health. Moving exercises co-ordinate the body’s muscle and nervous system and the standing exercises mimic the idea of a tree with strong roots, increasing stamina, circulation and lower body strength while relaxing the mind and lifting the spirit

Some reflections on studying Kampo

Some reflections on my studies in Kampo

Tony Todd

I got interested in Kampo around three years ago and decided to study it after having had treatment for a cough which hadn’t responded to other treatments. The formula prescribed to me was Polyporus combination for three days followed by min. Cinnamon and Peony for one week. The cough cleared before I’d finished the first packet and by the time I’d finished the second one I’d decided to sign up for the course. My reason for studying Kampo wasn’t simply that I thought it effective. I’d also had TCM herbs in the past with good results, though in the intervening period I’d moved away from TCM-style syndromes in favour of Japanese meridian therapy in my acupuncture practice. This approach to acupuncture is characterised by an emphasis on palpatory findings over other diagnostic information as well as forming diagnostic patterns around a Sho. Having come to acupuncture originally from Shiatsu, the twin aspects of palpation and Sho within Kampo made it seem like the most obvious choice for herbal study.

An overview of Kampo and its working methods

Much as in the case of acupuncture, traditional herbal medicine was in serious decline throughout the Meiji period (1868-1911) and modern Kampo owes much to figures like Otsuka Keisetsu who, with Yakuzu Domei in 1938, formed the East Asia Society for Medicine in order to unite traditional Doctors in Japan, China and Korea. If the Meiji era is seen as Kampo’s lowest point then its highest could be thought of as the Edo period (1600-1868) when the practice of fukushin abdominal palpation was developed as well as the emergence of the Koho-ha [Classical Medicine faction] school, founded by Geni Nagoya (1628-1696) and Yoshimisu Todo (1702-1773). Yoshimisu’s motto “Do not mention what is invisible” epitomised the contrast with the Gosei-ha [Later Generation faction] school by rejecting the more abstract and esoteric theories and promoting a return to the more simple and practical approach of early Chinese medicine as seen in the writings of Zhang Zhong Jing. Todo discarded the theories of Qi and flavour as well as the theory of channel affinities. His indications for herbs would be in terms of characteristic signs and symptoms derived from cross referencing the patterns they appeared in e.g. Gypsum would be indicated for severe thirst [1] rather than seen in terms as either its Qi or flavour. Though Gosei-ha did not entirely disappear (and in fact later objections to Koho-ha gave rise to an eclectic school, the Secchu-ha in the late Edo period), Kampo today has been influenced by this Koho-ha tendency to a simpler theoretical model grounded in more ‘tangible’ and tactile signs and less inclined to speculate on processes and pathophysiological mechanisms that are not directly experienced. Perhaps this is best expressed in the method of diagnosis by Sho.

Sho [sign/symptom package over syndrome]

The Sho or Akashi [証] is the constellation of signs and symptoms that point to a treatment method or formula. Whereas in other herbal styles one may move from:

signs/symptoms >> syndrome>> treatment

where the syndrome describes some kind of pathophysiological state of the body, and there maybe several treatments possibilities for a given syndrome (different herbs added to or subtracted from a formula, different formulas, different combinations of acupuncture points etc). The method of Sho on the other hand is simply:

signs/symptoms >> treatment

where a given formula (or acupuncture point protocol) will resolve a given a particular combination of signs and symptoms. Nigel Dawes has described this as “formula matching”:

..the practice of composing a formula based on the perceived individual actions of each herb was not discussed in the early classical texts. [2] Prescribing was done on the basis of ‘matching’ an existing formula to a patient conformation, called a SHO in Japanese. The SHO differs from the modern TCM concept of a pathological syndrome in that it includes not only a collection of identifiable signs and symptoms but also pays attention to the patient’s subjective complaints, the constitution, the state of the digestive function and diagnostic specialities such as Fukushin. In Kampo terms each formula is therefore said to have its own unique SHO and the practitioners job is to match the SHO with the patient. [3]

Rather than taking a formula and trying to bend it round to cover all the presenting symptoms, a practitioner will be looking for characteristic patterns within the patients symptoms that point to the use of a particular formula. The use of the formula may resolve the case entirely or in the case of a partial resolution will give rise to a new Sho that is treated with a new formula or possibly combination of formulas. The skill of the practitioner will be seeing the most appropriate Sho in an often confusing set of symptoms, and in knowing how long to prescribe for and what kind of combinations might be needed. In some respects there are similarities with homeopathy, both have a ‘key and lock approach’, matching the remedy to the person/condition. Arnaud Versluys has talked about a ‘Shen Nong’ lineage of practitioners, more concerned with the practicalities of medicine in the field rather than philosophical and theoretical speculation and though Zhang Zhong Jing was clearly a master of Nei Jing theory his book could be used by practitioners as a practical manual. The method of treatment by Sho fits this model; one may of course enquire into the pathophysiology that a Sho represents but it is not the primary object, that of course being to see the Sho and successfully treat the patient. This sensibility runs through Japanese meridian style acupuncture and Shiatsu too, giving rise to the motto ‘the diagnosis is the treatment’.

In practice one can organise Shos into groupings usually around the substances (qi, blood,water), around Shang Han Lun confirmations (tai yang, jue yin etc), or around weak digestion (ichokyojaku). Key signs/symptoms will lead one towards one group or another such as abdominal confirmations for some water or blood formulas, pulse and symptoms for tai yang or jue yin formulas etc. One then matches signs and symptoms with constitution eg a blood formula indication (such as pressure pain in the lower left quarter of the abdomen) could lead to a Persica and Rhubarb Sho for a more full type or Cinnamon and Hoelen for a more medium type constitution. Shos can also be grouped in terms of Outside/Inside [Hyo/Ri], Empty/Full [Kyo/Jitsu], Hot/Cold [Netsu/Kyo] where typically Outside/Surface Shos are treated by Shang Han Lun Yang confirmations and Inside Shos are treated by Shang Han Lun Yin confirmations or formulas from the Jing Gui Yao Lue or later texts, and are themselves typically grouped into qi, blood [Oketsu], water [Suidoku] types. Full and empty includes here the overall state of the patient as well as the nature of presenting symptoms and Hot and Cold to distinguish formulas that have a more heating or cooling effect.

Abdominal palpation

I don’t want to say much about abdominal palpation as it was covered in some detail in the last issue other than to point out that this too is largely derived from Zhang Zhong Jing [4] and exemplifies a sense of immediacy and practicality that runs through Japanese medicine. [5]

Formulas over ingredients

As formulas are seen as the basic building blocks of Kampo, in practice this means that addition or subtraction of ingredients is not common. A formula is given as a unit and then changed to another formula as the presenting pattern changes, similar to peeling layers of an onion. Sometimes more than one formula would be used simultaneously but again in general the formula would be seen as the basic unit. Of course this is not a black and white situation. Even when I first studied Kampo in the UK, modification was not seen as never occurring but simply bottom of the list of things to try, and after considerable experience of using the formula in its original form.[6] While I was in Japan I did see some modification but it was not often and tended to be more combinations of formulas or the addition or increasing of the amount of aconite to boost the warming properties of a formula.

Dosages and preference for classical formulas

The term Kampo could also be used to signify a preference for classical (Han dynasty) formulas. Though this is not exclusive, and there are examples of formulas from the fever schools and from Li Dong Yuan, as well as a few examples of more recent Japanese formulas, one can clearly say that there is a bias towards Zhang Zhong Jing formulas. Another feature is that dosages are smaller than are commonly used in modern Chinese formulas, typically 1/3 of the Chinese dose.

Formulas and the Japanese Health Service

In 1976 the Japanese Ministry of Health and Welfare listed 43 granulated extracts as being covered by the health insurance system. Today there are over 150 formulas, produced by pharmaceutical companies such as Sun Ten and Tsumura for the health system and available from any doctor or pharmacist. Formulas outside of these can also used but cost approximately three times as much for the patient.

My experience of two clinics

I spent time at two clinics in Tokyo in 2008 and 2007, with Dr Tarashi at the Genwado clinic in Ginza and with Dr Watanabe at Keio University. Both practice Kampo in the tradition of Dr Otsuka who’s material the UK course is based on, and this quickly became evident in the formulas they used and in the method of abdominal palpation which was more or less identical with what I studied at home. In both cases I was not the only student present, which in itself helped to shine light on the experience of studying in Japan. In both clinics students (mostly other doctors) would sit in with the doctor and simply observe the consultations and formulas given. Whenever doctors felt there was something especially interesting to point out they would do so in terms of symptom patterns or formulas, or sometimes taking the student over to feel the patient’s abdomen. Other than that there would be little if any formal teaching in the clinic. At Keio there were weekly discussions of new patients amongst the doctors, each discussing what they had prescribed and their assessment of the case. The time I was there this was followed by reading from one of Otsuka’s memoirs, on that occasion it was from a chapter on the action of Hoelen 5 combination and Tang Gui and Peony combination. The students would take it in turns to read and the senior doctors would comment on the text in the light of their experience.

The two clinics I visited were quite different in some ways. Tarashi’s clinic is a ‘family’ clinic that mostly specialises in fertility (though patients once having been

treated tend to also come back for other reasons too), while the Keio clinic is at a prestigious university hospital outpatients department which treats a wide variety of problems. Many of the patients are also simultaneously visiting other university departments, and patient information is kept on a database where formulas are noted alongside blood tests and other findings from other departments. It appears as a very modern integrated health system, with patients either self- referring or coming via other departments. In other ways what actually happens is similar in both clinics, both are very busy seeing around 50 patients in a morning. The importance of a large breakfast quickly became apparent as it could end up being a while before lunch.

The volume of patients is I believe an important factor as to how the art is learned. Unlike more modern western approaches to interactive learning the student is more of a sponge, seeing the patients come in, listening to their symptoms and (if the clinics not too busy) feeling their abdomen/pulse, and seeing the results of the prescription. It is an approach that cuts through intellectual analysis and gradually one begins to associate certain patterns with certain formulas.[7] The key of course is to see a sufficient volume of patients, in the absence of which it is helpful to have other methods of study to rely on.

Doctors in both clinics treated a lot of long term chronic problems, sometimes prescribing for a month or 6 weeks at a time, before checking the patient to either modify or continue with the prescription. At Keio especially, patients were often taking more than one prescription concurrently, in some cases alongside western pharmaceuticals. At Genwado I noted that formulas tended not to be changed according to the different stages of the menstrual cycle as is often taught in the UK (such as supplementing blood and yin before ovulation and warming and boosting yang post ovulation)[8] When I asked Tarashi about this he replied that this idea was introduced into Kampo circles some time ago but never really took root; he believed that formulas treating underlying imbalances take time to adjust the body’s core misalignments and that changing the formula at such regular intervals did not significantly improve results. At Keio, similarly, the changing of formulas though sometimes used is not popular. It would seem to highlight an interesting area of divergence between the use of Kampo and TCM formulas.

Another interesting comment that I heard was that though interest in Kampo amongst doctors has grown dramatically in recent years, actual understanding of Kampo is very poor. Many doctors prescribe quite symptomatically without an appreciation of traditional theory and working methods. The Doctors who were observing with me at Genwado seemed not to know very much traditional theory, though to their credit they were interested in learning Kampo as an alternative approach for their patients that was less likely to produce side effects. At Keio Dr. Nishimura told me that when he began to study Kampo there were very few departments in medical schools. Now over 80 medical schools teach Kampo as part of their core curriculum and there are three post graduate courses in Kampo at Keio, Chiba and Toyama Universities. The Keio course is a three-year course and he feels it is important for doctors interested in Kampo to study to this level.

At Genwado Terashi finds that a high percentage of his patients can be grouped according to the following (approximate) scheme:
FLOW CHARTS

Constitution

strong?

No

See below

Excess water type:

Stephania & Astragalus comb.

Yes

Yes

Yes

No

No

No

Yes

Average / normal constitution?

Large frame?

Kyokyokuman type

Maj. Buplerurum comb. with Cinnamon & Hoelen comb.

Condition worse before a period ?

Average build Oketsu type

Cinnamon & Hoelen comb.

Average build Gassy type:

Abdomen type

Cinnamon & Persica comb.

Constitution strong?

Yes

See above

No

Digestion strong ?

Weak digestion type [ichokyojaku]

Maj. Six comb.

Min. Cinnamon & Peony comb.

No Yes

No

Dizzy? Light headed on standing

Cold type Abdominal pain Dang Gui & Jujube comb.

Yes

Kyo type Blood type

Dang Gui & Peony comb.

These formulas don’t of course account for all the prescriptions though they would seem to form the base from which he would work. In some cases for example he might make use of Rehmannia 8 combination if in addition to the above there was also vacuity below the navel, or combine warming elements of the formula to Tang Gui and Peony for a Dang Gui and Peony Sho with more cold. In an addition to the abdominal patterns I’d previously learned he also saw tightness along both sides of the lower abdomen (superior to the anterior superior iliac spine) as relating to cold and an indication for Dang Gui & Jujube. Another feature of Genwado was the use of raw ingredients for most of the patients, though Keio made use of Tsumura produced granules which is typical of herbal medicine in Japan. The time I spent at the clinics was extremely interesting, it confirmed much of what I’d been taught about the Kampo approach and put it into a wider context, though it left me feeling that there are still too many formulas that I don’t know well enough!

After thoughts

Kampo in the UK is a small part of the Chinese herbal medicine sector. The Kampo society periodically runs introductory courses on a small group basis, with mornings covering theory and afternoons seeing patients. Despite a current lack of study/courses for practitioners who have completed the basic course, there is supervision available from existing practitioners and in some ways this is perhaps closer in spirit to how Kampo is often learned. Studying in Japan is always an option but does require a reasonable level of Japanese. Material is however increasingly becoming available in English. Otsuka’s book is soon to be published in English and there are books by Hong Yen Hsu, Robert Rister, Takahide Kuwaki, Yoshiharu Shibata, as well as several articles and cases published in the North American Journal of Oriental Medicine. Moving beyond what is ‘officially Kampo’, the recent series of lectures by Arnaud Versluys on the Shang Han Lun has for me been an inspiring and useful resource. The Shang Han Lun based working methods not surprisingly share a lot of common ground with Kampo, and though discussion of flavours may not be to Yoshimasu Todo’s liking, the presentation of family formulas I think would get a nod of approval. Of course books and lectures are no substitute for patients. My brief look at the clinics in Japan highlighted some differences in learning and teaching methods as well as clinical reality, since the situation in Japan is much more integrated with conventional healthcare, and driven by doctors with a full pharmacopoeia at their disposal and huge patient volumes. While at Keio I went to a presentation by a representative of Tsumura, the pharmaceutical company that manufacture the formulas used in the Japanese healthcare system. There I was told that the Japanese pharmacopoeia does not contain any aristolochic acid as they use varieties of Asarum and Stephania that are free of it. Perhaps this could be an answer to the restrictions faced by both TCM and Kampo practitioners in the UK?

NOTES

[1] ‘Stroll through Kampo History’, North American Journal of Oriental Medicine, November 2003 #20
[2] Though it has been shown that the architecture of Shang Han Lun formulas is founded on the flavour model of five phase therapeutics [Arnaud Versluys, ‘Shang Han Lun Seminars’, London, Spring 2008], applications of Kampo formulas are not discussed at this level but in terms of objective signs/symptoms (as they are described in Shang Han Lun)

[3] http://www.pacificcollege.edu/alumni/newsletters/summer2003/kampo [4] See The Lantern Vol 3 #2, Vol 3 #3 (articles by Michael Max and Steve Clavey)

[5] Though this trend is rooted in Classical Chinese medicine: see Elizabeth Hsu – Tactility and the Body in early Chinese Medicine. Science in Context 18 (1) 7-34 2005
[6] This was echoed in a recent lecture by Arnaud Versluys (November 2008) who stressed the importance of allowing classical formulas to demonstrate their efficacy before modifying and altering their effects. By not allowing this to happen one is never in a position to understand the effects of these formulas in their normal state and thus is in a even weaker position to be able to make decisions about how to modify

[7] Arnaud Versluys has painted similar descriptions of traditional study methods in the Chinese Shang Han Lun tradition
[8] Jane Littleton, The Treatment of Infertility with Chinese Medicine. Churchill Livingstone 2004

Treating back pain

Treatment of back pain with acupuncture

Effectiveness in treating back pain

“Affecting around 1 in 3 adults in the UK each year, low back pain is a very common According to NICE [National institute for clinical excellence] Lower back pain is a condition with an estimated 2.5 million people seeking help from their GP about their condition” 1. Recent recommendations from the guideline for health professionals include “ offering a course of acupuncture needling, up to a maximum of 10 sessions over a period of up to 12 weeks”2 While it is gratifying to have support from bodies such as NICE acupuncturists and their patients have long been aware of the benefits of acupuncture for back pain, which probably ranks as one of the more common complaints that people come to see us with.

So what can you expect if you come to see an acupuncturist for back pain. To some extent it depends who you go and see, what kind of training they’ve had, what style of acupuncture they practise etc. Part of the problem of trying to research acupuncture for a given condition is that there are a number of different approaches to treatment, and even within a given style practitioners adapt and evolve their own techniques. Thus research protocols that are based on standardized treatments actually tell us little about the efficacy of acupuncture in a realistic clinical setting.

From the perspective of a patient the most obvious differences will be whether they needle the area that hurts or whether they needle somewhere away from the pain, whether you feel the needles strongly or not at all, whether they leave the needles in or not, whether they use other techniques such as massage or cupping or moxa for example, how much importance they put on other aspects of your health/life, whether they rely on just asking you about the problem or whether they use traditional diagnostics such as pulse taking, inspection of the tongue, abdomen palpation etc.

Root and Branch

In traditional acupuncture there is the idea of ‘root’ and ‘branch’. Broadly speaking from a any problem such as a back ache has an aspect that is visible and tangible such as the pain it self and a more hidden aspect or origin out of which it has arisen and or to which it is still connected. In the same way as a tree has an aspect that is above ground and another that is below, the yang aspect is the branch or symptom and the yin aspect is the root which could be seen as the relative functioning of the body as a whole. This greater disharmony could have been what lead to the pain or in the case of a sudden acute trauma it could just be the way the body is responding to the pain; maybe with other muscles groups tightening, referred pain to other joints, affects on posture etc. Any treatment in traditional acupuncture consists of bringing a greater balance within yin and yang aspects of the person, that generally requires attending to the root and branch of the problem.

Often the difference in approach is characterised by the degree to which the acupuncturist focuses on the root or branch and the methods they use to treat one or the other. In this context the sort of ‘acupuncture’ [here on referred to as dry needling] that is done by GPs, physiotherapists, chiropractors etc can be thought of as one approach to treat the branch without consideration for

1 http://www.nice.org.uk/media/7D0/4D/2009031LowBackPainGuidelineRelease.pdf 2 http://www.nice.org.uk/media/7D0/4D/2009031LowBackPainGuidelineRelease.pdf

the root. Unless the pain is acute to the point that one has to control it before doing anything else, most traditionally trained acupuncturists will focus part of the treatment in resolving the symptom and part in resolving the root pattern. A smaller proportion of acupuncturists may focus simply on one or the other. This in turn leads to a broad diagnostic approach that goes beyond the specifics of the back pain and rather looks to see if there are any underlying patterns of disharmony whether in digestion, menstruation, sleep etc and is ascertained by questions as well as through traditional techniques such as palpation of the abdomen and pulse, and inspection of the tongue. These findings are in turn considered with reference to the main symptom eg back pain. Sometimes there is a clear connection, sometimes not. In either case traditional acupuncturists see balancing the big picture as a necessary step in treating any symptom, rather like laying firm foundations before building a house. Root treatment tends to relax the body’s nervous system which in turn helps in the release of spasm and improved postural alignment. Usually this is achieved through 2 or 3 points in the arms or legs which may or may not be left inserted [or in the case of some styles such as Toyohari which I practise, may not even be inserted at all].

Variation in Needling

In treating the main symptom some practitioners will tend to needle the place where you are feeling the pain, where as some will tend to needle away from the area, and of course a lot of us will do both to varying degrees. Alongside location differences exist between number of needles used (from just one or two to twenty or thirty), degree of stimulation (from none to very strong/painful) and also whether they use adjunct therapy like moxibustion, cupping, massage etc.

For me personally though I do often treat the affected directly I prefer to treat away from it as much as possible; the body is connected up in many interesting and mysterious ways that over many centuries have been documented in texts that became the basis for traditional East Asian medicine. [More on this in future article]. Often one has to release blocks in one part of the body which is stopping another part from repairing. Practically it means that stimulating a point on the outside of your wrist can help your lower back to get better! This is useful as sometimes when the back is in spasm trying to insert needles at that location can be quite uncomfortable and in some people can actually aggravate the condition. When this is suspected having a plan B or a selection of distal points can be very handy. So next time someone such as myself starts needling your foot for your headache, don’t assume that you have totally wasted your money on someone who doesn’t know his arse from his elbow, as there is in fact a point below the elbow that work rather well for haemorrhoids!

An extension of the use of distal points is the use of micro systems. You may have come across this idea in Reflexology treatments where the whole body is treated from the feet. This is also the case with ear acupuncture or Korean hand acupuncture, both of which use similar idea of treating the whole body from just a small part. In affect taking the body to be like a hologram. So sometimes one or two points in a specific part of the body can relieve your back pain or shoulder pain.

Another difference between approaches to treatment is the degree of stimulation and depth of insertion. Broadly speaking modern Chinese styles tend to needle more deeply and with more stimulation [including electric stimulation similar to TENS], needles are left in place for 20-30 mins or periodically stimulated. At the other end of the spectrum is shallow and contact needling used by

Japanese acupuncturists which is characterised by mild or no stimulation and without needles left in place [or for much shorter periods]. Both systems work well when practised correctly; personally I use a mix of the two but mostly rely on shallow insertions [often non insertions] and mild or no stimulation. Whatever the approach the final goal is for the nervous system and soft tissue to relax, alleviating spasm and allowing repair and re-alignment to take place.

What to expect from treatment

First a general consultation takes place to try to better understand the background to what may have caused the back pain as well as its nature and location. Then together with information about general health further diagnostic checks are made such as palpating the abdomen and the radial pulse, a few points will be chosen to either needle, or stimulate using heat or pressure, on the arms, legs and abdomen [not necessarily all at the same time]. This helps to relax the body as a whole and correct the big picture imbalances. As the body’s tissues are all interconnected this will begin the process of relaxing the area in pain. Then if you are able to turn over the back is now treated. Usually points are used in the lower legs and often the local area too is needled or treated with moxibustion [heat].

Traditional acupuncture is more than just insertion of needles. Originally acupuncturists used 9 kinds of needle; around half of these were not meant to be inserted, with rounded tips they were used to massage and press muscle tissue and joints. In addition moxibustion [heat from burning a herb] is used to warm the area or to dispel spasm and inflammation. There are many techniques for moxibustion that all revolve around the application of heat over a large or small area, either with a heat lamp or the pure dried herb. Other techniques include cupping and massage to move stuck blood and relax spasm.

Receiving treatment should feel relatively pleasant and relaxing. If it’s causing discomfort then its counter productive and alternative techniques need to be used. After treatment where possible try to relax and have an easy day, try to avoid vigorous exercise and alcohol. How many treatments are needed will depend on how long you have had the problem and you general state of health. Most muscular problems that present with reasonable healthy individuals respond fairly soon, with some noticeable improvement usually in the first two or three treatments. In some cases only one or two treatments are necessary, in more chronic cases it might take longer with the frequency of treatment decreasing as the condition improves. Usually I treat once a week though it sometimes it is better in the beginning to treat twice a week if the condition is severe. Acupuncture and moxibustion [as well as Chinese herbal medicine] often offer good cost effective solutions to back pain, joint pain and many muscular skeletal problems. If you are suffering from anything of this kind and would like to discuss it further please email me at info@croydonandpurleyacupuncture.co.uk or call me on 0781 585 1476.

Tony Todd

Welcome to kika clinic

kika is a Croydon based acupuncture and Chinese medicine clinic located in Addiscombe; convenient for Croydon, Shirley, Norwood, Beckenham, Bromley and West Wickham. It is situated on Bywood avenue, Addiscombe and is walking distance from the tram [nearest stop Arena]. There is plenty of parking.

 The clinic has been set up by Tony Todd who has been practising in the Croydon and Purley area since 2000. We offer a range of treatments specialising in acupuncture, Chinese herbal medicine, and bodywork such as shiatsu and massage. Please see relevant pages for more details on treatments and costs. We also have small classes for therapeutic exercises such as yoga, chigong and taichi.

Please get in touch to find out more

Why call it “kika”?  – kika is formed from two Chinese characters, or Kanji as they are known in Japanese. The ‘ki’  [ 喜 ] character means joy or happiness, the ‘ka’ [ 花 ] character means flower. Besides being taken from each of our daughters names the combination reflects our approach to treatment. Traditional Chinese medicine is based on a “root and branch” approach. In order to get happy healthy flowers on your branches you need strong and balanced roots. The treatments on offer are to help strengthen your “roots” in order to maintain blossom on your branches!

IMG_6665