Wednesday, September 30, 2009

Following the lead

It strikes me how modern Chinese medicine has lost touch with many basics concepts. A major departure is in the way it deals with qi stagnation and it's resultant heat. Modern CM looks to move qi and clear heat. However, if one looks to the body's ecological response as a clue, a different treatment option becomes apparent. The issue is in the confusion of the response as the pathology. Here, heat resulting from the stagnation is not the pathogen. It is the body's attempt to rid the stagnation. It does this by mobilizing it's yang/wei qi to break open stagnant areas/blockages. When the stagnation is too great, or the yang/wei qi insufficient, heat becomes trapped and manifests. From this explanation, it should become clear that when one moves the qi and clears the heat, what is really being cleared is the body's yang qi. Instead, if one looks to assist the bodymind in rectifying the qi stagnation and heat, one should add some more yang/wei qi to disperse the stagnation. Once the stagnation is cleared, the heat resolves through its movement.

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Tuesday, September 29, 2009

Yang, where does it come from?

The idea of ming men life gate fire is not found in the early classics. What many attribute to Kidney yang as being the source of all yang, some argue is really the Heart fire, Imperial fire. Both, of course, are shaoyin, but Heart is fire and Kidney is water. An interesting correlation to this is that the Heart acts through its proxy, the Small Intestine, which can be seen to be the outer manifestation of that fire as it guards the surface, ie wei qi and its tai yang association. The source of all yang comes from the Du mai (Governor vessel), which many attribute to the Kidneys, but in actuality has the opening point of Small Intestine 3 (also the wood point and can be seen as the acupuncture analogue to guizhi cinnamon twig -- see post below). Similarly, the lower dantian/cinnabar field is thought to be the root of yang and deriving from the Kidneys, but the main source of the lower dantian, Ren 4 (Conception vessel) is the front mu point of the Small Intestine.

So, today when a patient came in with significant yang deficiency of the Heart, needling Small Intestine 3 brought about a major change in her pulse.

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Monday, September 28, 2009

Multiple Systems

One of the great strengths of Chinese medicine is the ability to utilize multiple systems of diagnostics and treatments seamlessly in any given patient. Today is a small example:

90 year old female patient:
pulse examination utilized 3 different pulse methods:
1. Dong Han Korean: reveals Knotted pulse in Right distal position. (Here Knotted is akin to the Spinning Bean)
2. CCPD: Right Special Lung position shows a mildly Restricted pulse in the distal aspect of the position
3. Directional Pulse: reveals a Floating pulse in the San Jiao position suggesting a significant loss of latency.

I questioned patient about chest and breast symptoms which she then reported as tightness around chest and breasts. The concern, of course, here is with an obstruction in the chest, most likely due to a tumor with loss of latency (possible metastasis). These findings need to be confirmed on subsequent treatments.

What is interesting is how each pulse method confirmed and added information to the other to provide a clearer picture of the pathology.

The patient was treated with a San Jiao Divergent meridian treatment, SJ 16, Ren 12 with a Deep-Superficial-Deep needling technique, as well as ST 12 and LI 4. The Knotted pulse decreased by 50% as a result of this one treatment.


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COM, CCM: bridging the gaps

One of my goals as a practitioner of Chinese medicine and, in particular, Contemporary Oriental Medicine and Classical Chinese Medicine is to see the links between these two lineages. One that I have pondered lately is the notion of waking with a feeling of not being rested, or early morning fatigue.

My training in COM with Dr. Leon Hammer looks at this symptom very differently from Traditional Chinese Medicine (TCM), as does most of my training differ from TCM (a simplified westernized practice of the medicine). But Dr. Hammer was unique in attributing this symptom to the Heart. A deficiency of the qi of the Heart would create a weakness in the circulatory system which would be most sluggish in the early morning due to the extended hours of sleep and yin influences of the night time.

My training in CCM looks at this symptom as a shao yang pathology. In this sense, as we see the transformation of yin and yang within a 24 hour cycle, it is the early morning that is associated with the shao yang or little yang as it emerges from the yin (jue yin). It is this lesser yang energies that propel the yang in its upward movement. Shao yang is wood and associated with the east and the rising sun.

The link of course is that each of these explanations, while slightly different in terminology and description, are both linking this phenomenon of waking tired with a deficiency in fire or yang. Wood is necessary to fan the wind to stir fire, and shao yang shares both a wood and fire association. A typical herb for treating this can be guizhi cinnamon twig, the wood herb of the wood class, and also a wonderful herb for treating the Heart.


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Contemporary Chinese Pulse Diagnosis seminar

Please join us for a weekend seminar on the Shen-Hammer Contemporary Chinese Pulse Diagnosis (CCPD) pulse diagnostic system. The class will be held Sat-Sun November 21-22, 2009. As always, these classes are limited in size to ensure significant one-on-one attention and instruction.

The class details:
Dates: November 21 and 22
Times: 9am - 5pm
Location: Center for Acupuncture and Herbal Medicine, 166 Mountain Ave, Westfield, NJ 07090
Cost: $300
CEUs/PDAs: 16
Registration: email centerforacupuncture@gmail.com and/or call (908) 654-4333 and send check made payable to 'Ross Rosen' to the above address.
Instructor: Ross Rosen, JD, MSOTM, LAc, CA, Dipl OM (NCCAOM)

Ross Rosen is one of a small group of close students of Dr. Leon Hammer and a certified teacher in Contemporary Chinese Pulse Diagnosis. He works closely with Dr. Hammer on a regular ongoing basis.

Ross Rosen...is a valued instructor of and a direct inheritor of my work and teaching. He is extremely observant and creative in his work, adding to our accumulated knowledge more than any other associate. Of great value is his ability to formulate the essence of Chinese medicine in simple terms accessible to the average person. Chinese medicine at its best, as practiced by Ross Rosen, is capable of discerning the disease process at a very early stage before it manifests an illness, therefore preventing disease, and above all capable of delineating and treating the individual who has the disease.
--Dr. Leon Hammer

Ross has published numerous articles on CCPD, which can be accessed at: http://chinesepulsediagnosis.blogspot.com/

The class will introduce the major concepts of CCPD, the Principle and 22 Complementary pulse positions and the most commonly encountered pulse qualities, clinical significance and some interpretation and much more. 70% of class will be dedicated to hands-on pulse instruction and training. Those attending will leave the weekend with a body of knowledge and skills readily and immediately transferable into one's clinical practice.

Contemporary Chinese Pulse Diagnosis™ (hereinafter "CCPD") is a sophisticated system of diagnostics which relies on the subtleties of the sensations, qualities and structure of the radial artery at both wrists. Heavily steeped in ancient wisdom and classical pulse diagnosis dating back thousands of years, CCPD breaks out of the dogma of pulse systems that in many respects are not relevant to the present day and age. CCPD provides insight into the modern diseases and constitutional imbalances that affect modern man in an industrial world.

CCPD, while having its roots in classical pulse systems, was significantly adapted by Dr. John H.F. Shen over the course of his long and well renowned career having seen hundreds of thousands of patients. After an intensive apprenticeship with Dr. Shen over a period of 28 years, Dr. Leon Hammer took on the arduous task of codifying and continuing the evolution of this pulse system.

The intricacies of CCPD are complex and require significant amounts of hands on training with a certified teacher to fully learn. Essentially, however, information is synthesized from the combinations of various qualities felt at the six principle pulse positions and the twenty two complementary positions, as well as the qualities perceived uniformly over the entire pulse and at each of the requisite depths. Integrating the information from these seemingly disparate parts, one is able to arrive at a complex diagnosis which prioritizes levels of imbalances of not just the symptomatic representations, but more importantly the root causes of disease.

Incorporating concepts and clinical realities that have not been diagnosed by any diagnostic methods in Chinese medicine, CCPD is truly a treasure which can change the lives of patients. By incorporating a precise measure of a healthy balanced pulse, even the subtlest deviations from this norm can be detected, thus establishing its importance not only in treating disease, but also as a preventative medicine.

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