Tag Archives: acupuncture

Pathogens and Pathology

The search for a vaccine to the corona virus while a worthy endeavour may take a long time, and may even turn out to be chasing the impossible. The guardian newspaper published an article on the 22nd of April implying that the vaccine if it arrives could indeed take a lot longer than we would like. The fastest developed vaccine was the mumps vaccine that took 4 years. In the meanwhile as I write this lockdown is easing off, schools are beginning to open, later this month we will also re open our clinic as everyone else, albeit with some extra precautions, will go back to work.

In the face of still high numbers of infections what can we do besides the sensible precautions of hand washing, wearing masks and [where possible] social distancing? This is good public health policy when considering the problem in terms of a pathogen i.e. the virus. When it comes to Traditional East Asian medicine the emphasis generally shifts from pathogen to pathology.

Although traditional medicine in many ways evolved as a response to epidemics, its approach to treatment focusses not on a causal pathogen such as a virus or bacteria, rather on how that pathology manifests in the patient. In this way we don’t think of treating an illness so much as a person who is ill. So in the case of Covid 19 there is no set formula or combination of points to needle, the treatment is determined by the collection of symptoms that the person is showing. Different combinations of fever, sweating, thirst, cough, sore throat, body aches, digestive issues, chest pain etc. together with specific pulse presentations, will determine what kind of herbal formula or acupuncture treatment will guide the body back to a healthy state. This approach takes the whole body’s systems into account to bring about a recovery irrespective of what has created the problem in the first place. As such it is applicable to Covid 19 or regular seasonal flu or any kind of deviation from a healthy state.

When the normal life promoting processes within us lose their way they can give rise to distressing symptoms, sometimes minor sometimes major. The aim of traditional medicine is to rectify pathology and reinstate physiology; actually this can be done at any time and ideally before pathology sets in. This is where traditional medicine has a role to play in prevention of illness, or at least minimising its risk. Because the focus of treatment is to optimise healthy functioning it can almost always be given as none of us are 100 % healthy. Herbal and acupuncture treatments are given based on pattern differentiation but there is a great deal of latitude in terms of severity of the pattern. Thus the same formula could be given to someone with almost no symptoms, just minor lack of appetite and some congestion under the ribs [not something they would remotely consider a medical problem] or to someone else with a severe sore throat and alternating fevers or migraines. The possibility of treating when things are mild or almost non existent is an opportunity to prevent or reduce the chance of  more serious health crisis.

At the beginning of the lockdown I read a translated blog from a county level hospital in Henan province in China written by traditional Chinese medical doctors describing the herbal medicine regime used at their hospital. In addition to the different formulas used for patients experiencing symptoms of Covid 19 they also had a regime of formulas for the admin staff and doctors and anyone who was healthy but might come into contact with infected people. At the time of writing none of the staff had become infected and this was seen in part due to the preventative treatment they were advocating. Although there is no Chinese medical magic bullet that will stop you getting ill, herbs and / or acupuncture treatments can help to keep your body functioning as well as it can and so minimise getting ill.

Some treatments like the application of direct moxa to an acupuncture point on the leg were specifically designed for the maintenance of health and immunity in later life. This is being utilised today in the treatment of drug resistant TB by the efforts of the group Moxafrica. It’s this approach of strengthening health that is a unique aspect of Chinese medicine and should be utilised as much as possible before we go into autumn and a possible second wave of the virus.

Skin deep

One of the key features of my treatment style nowadays is the adoption of contact needling which forms a key part of the Toyohari style of acupuncture training. This a technique where the point is needled at the surface of the skin and the skin itself is not broken. It is carried out through slowly approaching the surface with a [usually] silver needle then after waiting for a short while the needle is removed. This seems counterintuitive to the commonly held image of acupuncture where one assumes [or at least I did at first] that a needle needs to penetrate the skin to have effect. Most of my treatments begin with this technique and in a few cases it is all I do; though I was sceptical my self in the beginning, after having used it for a number of years my confidence in the technique has grown through the results I’ve seen and also through feeling the body’s response as I use it.

It’s only relatively recently that I’ve come across the work of Dr. Denda a Japanese skin scientist through the journal of North American Oriental medicine [Nov 2013, Vol 20, #59, March 2013 Vol. 20 # 57]. Dr. Denda has discovered that the epidermis or outermost layer [0.06mm-0.2mm] of the skin doesn’t just act as a barrier to protect the interior, rather it is able to monitor the external environment, acting like a giant sense organ and processing this information much like an independent brain. He dubs it the “third brain” [I believe elsewhere people have dubbed the gastro intestinal system as a second brain]. According to Dr. Denda the skin cells can act like sensors picking up more detailed information that could be possible using just nerve receptors, rather the keratinocytes in every cells are able to pick up environmental information, process it and transmit it to the nervous system.

According to Dr Denda stimulating the skin can have a positive effect on the mind in times of stress. This is not really news to most of us, massage and touch have a calming effect in a general way but the emphasis on skin over muscle [as in a deep massage or deep needling] perhaps goes some way to explain the growth of skin level acupuncture techniques in japan such as contact needling. Both epidermis and the brain have a common developmental origin in the ectoderm, and it is known that the hormone oxytocin which promotes positive physical and mental states, is released from stimulation of the skin. But it doesn’t end with oxytocin, the epidermis has receptor also for dopamine, acetylcholine, adrenaline, melatonin, glucocorticoids and more. It is believed that the epidermis has a close relationship to the autonomic nervous system, research has shown stress levels of the pituitary gland showing as changes in the skin barrier function, and the adjustment of circadian rhythms can be achieved by shining light on the skin to affect the sleep centre in the hypothalamus. This relationship between the skin surface and the inner centres of the brain can explain the importance of palpation in diagnosing patterns in traditional acupuncture. It’s as if we can locate internal patterns of stress by feeling disturbances on the surface of the skin.

When it comes to needling, inserting a needle to a depth of around 4 mm will be detected by the brain as the local stimulation is transmitted to the somatosensory areas via unmyelinated and myelinated fibers. This way brain can identify the location of the stimulus, this is an effective means of relieving local pain, improving peripheral and therefore whole body circulation. With contact needling however there is no direct transmission through these nerve fibers, its as if the autonomic system is affected directly via the sensory organ aspect of the hypothalamus, namely the skin surface. This is not registered as a local stimulus but a skin initiated whole body effect. The autonomic system is the body’s autopilot, it governs the moment to moment functioning of the the organs either stimulating or dampening their function. It should ideally maintain optimum functioning of the body in differing situations of physical and emotional stress, when this becomes suboptimal it can begin to the the origin of illness and poor health. If this is not corrected then any symptomatic treatment whether western or Chinese will have limited effect so treating this level of imbalance is seen as a key to maintaining good health in traditional East Asian healthcare. This is what acupuncturists call a root treatment, something to create an overall global balance independent of any particular symptom. It manifests during treatment as a deeper sense of relaxation, changes in breathing and in the pulse. The nature of contact needling as a means of stimulation that does not register as coming from any one particular location makes it especially suitable for this aspect of treatment.

Stress and Self Harm

I recently read a headline that shocked me. According to the guardian newspaper [https://www.theguardian.com/society/2018/aug/06/hospital-admissions-for-teenage-girls-who-self-harm-nearly-double ] the number of under 17s reported to GPs for self harm has increased by 68% in 3 years. My eldest daughter is now nearly 12 and  about to go through puberty and adolescence, the prospect of which makes me uneasy not least when I think of the pressures our kids are under these days. Of course the stresses that build up and culminate in the need to self harm can be complex and multi factored and there is probably no one solution to fit everyone. That said because of the nature of my job I can’t help but see a headline like this and ruminate on the way stress is described and treated in Chinese medicine. 

One of the key differences in Asian thought is the lack of separation between mind and body. The mind is literally seen as being embedded in the body, specifically in the blood and by extension in the muscles [muscles are basically blood in East Asian thought].This is not so unusual an idea, if you stop to think about it. As soon as you get stressed, or irritated, or excited or scared somewhere some part of your muscular system will tighten up; maybe skeletal muscles of the shoulder and neck or, you diaphragm or stomach muscles [‘butterflies’] even smooth muscles around the organs eg your breathing and digestion can be affected. 

Treatment is effectively to try to put the body/mind into a more relaxed state, to soften congestion and let the blood and the mind flow more easily. Needles are used to trigger this through light painless [often largely non inserted] stimulation, though also heat therapy, herbs and even occasionally controlled microbleeding can play a part. I’m not suggesting that acupuncture is necessarily always the only solution to the stresses that our teenagers face today. These will often require multifaceted approaches, East Asian medicine can’t remove many of the external causes, however it can provide a less destructive means of relieving the stresses that build up in the body whatever your age and situation.

example case for the treatment of eczema

Case example: allergic skin reactions

The patient was a female in her 20s presenting with the following complaints:

  • Allergic reactions triggered by foods, environmental factors, etc. leading to:
    • Red inflamed skin, itchy, dry, bumpy
    • Swollen face, breathing problems
  • Abdominal pain, bloating, intolerance to many kinds of foods
  • Fatigue
  • Headaches, neck and shoulder pain and stiffness
  • Occasional difficulty urinating, irregular or loose bowels

Prior to treatment the skin flares were frequent and could lead to steroids being used to calm the outbreak.

Treatment began January 2017 with beginning of improvement after about a month and continued improvement so that by 2-3 months skin was much clearer and by the summer skin was much better and use of steroids only rarely if at all needed. The following images represent a change in the condition of the skin over this period of treatment.

Before treatment
















After treatment


In addition to improvements in the skin there have been  improvements in digestion, less bloating and pain, improved ability to tolerate a much wider range of foods. There is less fatigue, sleep is better, headaches and neck pain is better.

Treatment began with acupuncture and then herbal formulas were added, sometimes as granules and sometimes as ground bulk herbs to be boiled up.

At the time of writing we still treat periodically and there have been some minor relapses but overall improvements have held.