The Meaning of Autumn from a Chinese Medical Perspective

Autumn is the beginning of the yin cycle when daylight begins to fade within twelve hours. It's a time of harvest when we gather colourful fruits and vegetables for winter storage. Pumpkins and squashes are our symbols of plenty. We also gather stores of wood for the fire and get out our warm clothes for the colder, darker days of winter.

In Chinese medicine Autumn is associated with the element of metal and organs of large intestine and the lungs; one eliminates waste, the other receives heavenly Qi.

This need to eliminate is clearly seen in nature. Autumn is known for the falling of leaves. Farmers know how important it is for this year's debris to be recycled, turned into rich nutrients like minerals for next year's new crops. We eat nourishing food, extract what is of quality, and remove what is not needed.

Any inappropriate retention would be seen as prematurely eliminating or holding on too long. This could manifest physically as either diarrhoea or constipation. At the emotional and spiritual level, holding onto old outgrown beliefs, judgements and negative thoughts can pollute our speech, relationships and our basic sense of self worth. If we don't let go of what is now ripe, mature and complete, we will be unable to move on to the next phase.

Inspiration: A divine influence directly and immediately exerted upon the mind or soul.

Exhaling and inhaling are necessary functions. We can get by by without food and even water for some time, but cannot last more than minutes without breath. Many ancient cultures, in addition to the Chinese, equate inhalation with inspiration. Life without this divine connection feels empty and dull. The time of day associated with the lungs is 3-5a.m. In many cultures this is the time of early morning meditation, with deep breathing practices. Starting our day with inspiration allows us to better appreciate the glory of nature which abounds all around us.

The lungs govern our body's protective qi energy, helping us to ward off the wind and cold that are ushered in with the seasonal change. When this energy is weak, a body may succumb to colds and flu. The lungs fill with phlegm, coughs occur, the nasal passages become congested. The increased wind can cause dryness e.g. a dry cough. Dry skin, known in Chinese medicine as the "third lung", can lose it’s ability to eliminate, causing acne, psoriasis or eczema.

Autumn is generally a good time to consider cleansing the gastro intestinal tract (GIT). Look at your diet and eliminate unsupportive foods. Perhaps follow a simple detox cleanse or go for a colonic cleanse to further help with elimination.

Steps you can take every day:-

1. Increase your exercise or any activity that increases breath.

2. Hydrate. Drink lots of water and wean yourself from dehydrating fluids such as coffee, black tea and alcohol.

3. Eat foods that are contracting and astringent, to match the seasonal change to draw inwards, eventually leading to winter. Such foods are often sour: pickles, sauerkraut, vinegar, lemons, limes and grapefruit. Others are aduki beans, yogurt, some plums and apples, even rose hip tea. To COMBAT THE DRYNESS ADD WHOLE OATS, MILLET, BARLEY, SWEET POTATOES AND YAMS, SEAWEEEDS, almonds, pine nuts, eggs, crab, oyster, mussels and autumn fruits such as apples, persimmons, pears and loquats.

4. Set aside time to meditate or pray, and connect with the spiritual world.

In general, try to think “less is best". Let the beauty and simplicity of autumn feed the soul whilst appreciating the divine wisdom of nature all around us!

Timing of Acupuncture

When acupuncture is used to supplement and enhance the process of conventional treatment it is vital to consider the correct timing of the therapy in order to maximise the benefit and efficacy. This is where the value of a truly experienced practitioner cannot be underestimated.

Recent research has demonstrated how effective acupuncture can be in reducing the side effects (like nausea, vomiting and fatigue) of radio and chemotherapy in cancer patients. Knowing exactly when (before or after but not during) the treatment process is vital to the process. Therefore a specific treatment plan would be devised after discussions between all the parties involved.

Women having acupuncture while undergoing IVF have, according to new research, increased their chances of becoming pregnant by 65 per cent when having treatment within one day of embryo transfer. The timing of the acupuncture sessions in relation to embryo transfer differed somewhat among trials. However, all the women received acupuncture immediately before or immediately after the embryo transfer. Understanding how the timing of this part of the process (taking in aspects such as whether the patient has previously used oral contraception or other methods) should be applied to each individual patient is almost as important as knowledge of acupuncture treatment itself.

Cancer Treatment Effects - Can Acupuncture Help?

Does acupuncture help cancer patients?

The article ‘Acupuncture for Cancer-Related Fatigue in Patients with Breast Cancer: a pragmatic randomized controlled trail’ was published in the ‘Journal of Clinical Oncology’ in Dec, 2012. The trial was conducted at the University of Manchester under Professor Alexander Molassiotis, a specialist in cancer and supportive care at the University of Manchester, This was the most recent of several similar undertakings which have been conducted in the last twenty years.

This trial was a pragmatic, randomized controlled trial comparing acupuncture with enhanced usual care. The study involved 302 patients who had all received chemotherapy for breast cancer in the five years before the study. Most reported feeling chronically tired for a year or more. 75 women were randomly assigned to receive a booklet (being part of ‘usual care’ procedure) about managing fatigue, while 227 received acupuncture once a week for six weeks as well as a usual care. Treatment was delivered by acupuncturists once a week for 6 weeks through needling three pairs of acupoints.

After six weeks, both groups were asked to rate their levels of fatigue, anxiety, depression and other quality-of-life measures. Among the acupuncture group, general fatigue had dropped by almost four points on a 0-20 scale, compared with a less than a one-point decline in the booklet /usual care only group.

Anxiety and depression scores dropped by even more post-acupuncture, compared with the scores from women in the booklet/usual care only group. Emotional and physical well-being got a greater boost with acupuncture therapy as well, the researchers found.

Amit Sood, M.D., of the Mayo Clinic in Rochester, Minnosota., who was not part of the study, told Reuters that the four-point drop should be considered enough to make acupuncture ”well worth a try” for some people.

Julienne Bower of UCLA’s Jonsson Comprehensive Cancer Center noted, in response to the study results, that “there is a critical need” for more studies like this to help patients cope with the effects of cancer treatment.

I was invited to the Whittington Hospital’s London Clinic to give acupuncture to some of their cancer patients and also performed similar treatments at the Harley Street Medical Centre.

Here I was introduced to several patients including those suffering from cancer of the breast, kidney, lung, bowel and varying kinds of pelvic cancers. These patients were all undergoing treatment by chemotherapy and/or radiotherapy. After acupuncture treatment, there was general reporting by these patients of noticeable reductions in nausea and vomiting. Levels of fatigue were also reduced with recovery times shortened so that more patients were able to return to some normal living between hospital cancer treatments. It was also seen that patients were more able to release some of the anxiety and depression typically experienced so that their emotional wellbeing was significantly enhanced.

There is widespread general agreement between all types of health professionals, patients and support groups that the value of a more enhanced and positive state of mind is of inestimable value in supporting the healing process.


What Can We Do For You in 2014?

This period after the traditional New Year Celebrations (and before the beginning of the Chinese New Year?) with the exciting prospect of moving to our new larger premises in 22, Harley Street, London has been a time for reflection as well as looking forward. Like all caring practitioners, we take pride in our achievements but also realistically ask; ‘What more can we do for our patients in 2014? How can we improve upon our achievements to date?’

It has been three years since we established the current Dapeng Clinic in Harley Street. Things have, I realise, changed astonishingly quickly since the clinic’s patients now are very different from those I saw at the outset.

I recall that most of the patients treated when I first began there in 2011 presented with skin conditions like acne, eczema, psoriasis etc. This emphasis has shifted considerably reflecting the prevailing realisations (via media and internet reporting) of the time in which we live and an intelligent self-awareness and education among patients. Now there are more people presenting with long standing conditions such as chronic fatigue, cancer, fertility issues, stroke and other unexplained syndromes (being none the less worrying for that!). People have realized that dietary considerations, exercise and lifestyle changing protocols can have a profoundly positive impact upon their health. However, prolonged excessive stress, negative emotions such as anger or anxiety, trauma and over work are serious factors which help to undermine people’s health. The increasing incidence of these, when not addressed, is now contributing to more serious, even potentially fatal, diseases.

In 2014, we will be providing a one stop holistic service for our clients which will be of the highest standard.

Our clients will be offered consultations which provide personalised advice on nutrition, exercises and approach to lifestyle matters in addition to individually tailored healing treatment. This may, when appropriate, also include giving patients referrals to other specialists such as private GPs, chiropractors, osteopaths, personal trainers and meditation instructors. We are also delighted to contemplate how the move to our newly refurbished clinic in the heart of London’s busy Harley Street will facilitate the creation of a calm, benign and restorative oasis for our clients so that they can experience the best kind of healing environment.

Please note our web page blogs on various topics will continue. We hope this helps more people understand holistic or complementary medicine in greater depth gaining insight into how it’s very different approach to achieving wellness has already benefited many and will continue to do so.

Dapeng Zhang will be at 22, Harley Street, W1G 9PL from Tuesday 18th February 2014

Infertility: There is Another Way

Infertility, which now affects more couples than ever, appears to have reached epidemic proportions as one in six now have difficulty in conceiving. Awareness of IVF treatment within the consciousness of the public makes it seem to be the first and most obvious choice since the term IVF seems to be almost synonymous with infertility. However, there are good reasons held by many practitioners both mainstream and holistic (myself included) to question whether this should always be the case. We are also all aware that would be parents are often demoralized by enduring repeated invasive medical procedures especially if the long hoped for result is not achieved.

Happily, a quiet revolution in thinking about conception is taking place. Certain Holistic approaches have been used to such good effect that the media and wise couples are looking increasingly at (or even being medically referred to) experts (i.e. those having substantial experience and post graduate training) in areas such as TCM and acupuncture only to be surprised by the established reputation, success rate and waiting lists which already exist amongst these particular professionals.

It is the case that, while IVF can sometimes create new life, its limitations lie within the fact that it does nothing to address the actual causes of an inability to conceive. Much infertility is 'unexplained' which means that, without addressing or resolving the issues that lie beneath, IVF is less likely to be successful. These underlying factors include: nutritional deficiencies, unidentified health conditions, toxin exposure, stress, food intolerances, allergies and immune deficiencies. They may subtly, but critically, interact unhelpfully with a kind of negative synergy to impact the quality of a woman's eggs and man's sperm, thereby affecting your ability to conceive and maintain the health of your embryo.

For example, in my own practice, I have found that miscarriages and apparent infertility are frequently concomitant with sub clinical hypothyroidism. In other words, women may not necessarily show the most obvious symptoms of this condition or they have been tested by standard laboratory tests which fail to identify people who are at the low end of normal. TCM has other ways of revealing this by using differential diagnosis which identifies and distinguishes conditions by identifying various signs and symptoms. Often, there is simply a need to clear the system by enhancing the flow of Qi (body energy) so increasing blood supply to the ovaries, and restoring levels of general health in order to make pregnancy more possible. It is also helpful to treat the man as well as the women to ensure that optimum conception health exists for both of them. Sperm counts are usually relatively easy to improve.

Not long ago I treated Katie* whose unsuccessful attempts to have a child using IVF had left her feeling almost hopeless. However she had, rather than reconcile herself to childlessness, decided to be open minded about trying different approaches to her predicament. I had treated her for four months before she rang me one day almost breathless with excitement to say that she was, at last, pregnant. To ensure the safe continuity of the pregnancy I continued to treat her for another two months. Recently, she sent me a picture of her lovely baby girl with heartfelt thanks. These are the moments which make all our hopes and endeavours feel so very worthwhile.

Adult Acne


Traditional Chinese Medicine Insights into Adult Acne

From the perspective of Traditional Chinese Medicine (TCM), effective treatment for adult acne is undertaken by looking to specific diagnostic patterns and finding the one which is appropriate for the individual presenting patient. The chosen acupuncture points, application techniques and herbal medicines used will be focused around this pattern instead of being based solely on the directly manifest condition as is usual in western medicine.

With proper application of TCM, the practitioner will treat the root cause of not only the immediately obvious health issue, but often several others including those which the person may not yet have experienced. One or more of the TCM diagnostic patterns described below are likely to be involved when an adult is experiencing acne. However, some cases may require other causes and complaints to be addressed and may require multiple pattern use and/or complex relationships between the patterns.

TCM describes different diseases as having their origins in both the internal and external environment of the patient with internal imbalances being often affected by the external environment. One or more of the following TCM diagnostic patterns are likely to be involved when an adult is experiencing acne.

Part 1.

Traditional Chinese Medicine classifies adult acne into three different types

1.Conditions that may arises from the Heat in the Blood

Main Symptoms & Signs
Papules -- inflamed lesions that appear as small, pink bumps on the skin often hot to the touch.

Pattern related conditions:- Anaemia, Dermatitis, Eczema, Furuncles, Haemorrhoids, Psoriasis and toothache.

2.General signs and symptoms of Liver Fire

Headache, irritability, explosive anger, dizziness, tinnitus, bitter taste in the mouth, reddish face, red eyes, dream disturbed sleep, constipation.

This type of acne changes with the menstrual cycle. It is usually worse before menstruation, which is accompanied by irregular period or period pain.

Pattern related conditions

Asthma, Gallstones, Chronic Cholescystitis, Cystitis, Convulsion, Coma, Depression, Vertigo, Hypertation, Insomnia, Leucorrhoea, Rheumatoid Arthritis, Thyroiditis, Tinnitus, Trigeminal Neuralgia.

3.General signs and symptoms of the spleen and stomach damp heat

Epigastric and/or abdominal discomfort, lack of appetite, heavy body, thirst with little/no desire to drink, abdominal pain, loose stools, nausea, headache, intermittent acne and cystic acne which are mainly characterised by skin lesions.

Pattern related conditions

Appendicitis, Behcet’s disease, Crohn’s disease, Epigastric pain, Gingivitis, Jaundice, Glomerulonephritis, Obesity, Pancreatitis Sinusitis, Ulcerative Colitis, Uroschesis.

Part 2.

Traditional Chinese Medicine Also Uses Facial Map Reading To Analyze Individual Conditions

Acne affects different facial areas which may be related to different health issues.

Acne around the forehead is related to intestinal problems

The patient would need to eat less processed or junk food and reduce dietary fat.

Acne between the eye brows is related to stomach problems

The patient should increase their dietary fibre intake, reduce their toxin overload and drink herbal teas to help digestion while cutting down sugar and caffeine.

Acne around the left cheek is related to liver issues

The patient would need to avoid alcohol, greasy food and dairy products. Food allergies would be particularly suspect. Adequate sleep should be sought so the liver can rest and regenerate properly.

Acne around right cheek is related to lung issues

The patient needs to begin boosting their immune system. Regular exercise, stopping smoking and consuming more green vegetables with recommended wheatgrass juice would be advised.

Acne around the lips is related with kidney function issues

This is indicative of general dehydration. An urgent need to increase fluid consumption would be advised and the avoidance of acid forming foods.

Acne around the chin is related to hormonal imbalance

Stress and distress need to be given attention. Drinking more water and fluids will help to rebalance the hormonal system together with adequate sleep

Part 3.

TCM treatments for adult acne.

1.Cosmetic acupuncture

This therapeutic protocol would be used with particular emphasis on it’s DEEP ANTI INFLAMMATORY TREATMENT aspects to rebalance the PH levels in the body through use of facial acupuncture points, improving circulation and purifying internal environment.

2.Herbal tea

Certain herbs will do much to detoxify the body, rebalance the hormonal system, and improve digestive function

3.Facial cupping

Detoxification and stimulation of the micro- circulation would be aided by this.

4.Facial reflexology and lymph system massage.

These types of massage enhances the immune system assisting with circulatory function, nutrient flow, tissue fluid retention and toxic drainage.

Depression and Grief: new thinking or old thinking?

Depression and Grief

The outward signs of depression and grief can at first appear quite similar but in Traditional Chinese Medicine, (as in life) when properly observed, they are different in both cause and manifestation.

TCM holds that the forces of the spirit and qi (body energy flow) dominate all matter including the human body and spirit. Thus If the spirit is at peace, the heart is in harmony. When the heart is in harmony, the body is whole. If one seeks to cure the physical body one must first heal the spirit.’

While the effects of various emotional states (whether grief, depression, PND or SAD) may gravitate to different organs and disrupt their normal functions, the psychic aspects of the heart and liver are always held to be the primary source of all facets of our emotional life, whether positive or negative. Therefore, in the diagnosis and treatment of depression, the focus is on primarily on the heart and liver. However, there is awareness that the Gastro Intestinal Tract can also either affect, or be affected by, disturbances to the mental and spiritual well being of an individual i.e. psychosocial stressors can lead to altered brain-gut interactions and vice versa.

For example, Long periods of pensiveness, melancholy, hopelessness and excessive mental activities might be symptomatic of grief and require a different approach and application of acupuncture and other TCM modalities to Long standing bottled-up emotions such as anger, hatred, resentment and stress alternating with hopelessness. These stagnate the liver Qi (energy). The liver’s free flowing function is especially important in harmonizing the emotions and digestion since stagnancy will then invade the spleen causing various symptoms of abdominal distress and fatigue.

Other therapeutic modalities may provide a supporting role, e.g. cognitive psychotherapy, adoption of a healthy lifestyle. The initial aims of this combined approach would be improvement of mood, detection and correction of contributing factors (through psychotherapy, counselling, nutrition, physical fitness, stress management) and balancing the physiology (with acupuncture and Chinese herbal medicine). The goals of such an approach would be to encourage responsibility in the patient for implementing and maintaining healthy lifestyle practices. TCM treatment would continue until physiological balance has been established.’

Suggestions for Additional Activities to be undertaken by the patient.

1. Begin to think about and seek ways to train your mind.

2. Develop calmness of the mind to subdue unhelpful thoughts and emotions.

3. Build upon positive thoughts and states of mind.

4. Cultivate good, useful, positive, healthy habits every day.

5. Welcome change as positive, beneficially challenging and life enhancing.

6. Develop a long term perspective.

7. Know and the meaning of suffering.

8. Develop and invest in deep relationships and friendships.

9. Develop a sense of compassion for yourself and others.

10. Release your Buddha (!)

11. Talk to friends and share your emotions.

12. Exercise to refresh positive energy

13. See food as positive energy and life giving/enhancing.

Rehabilitation Exercises After Injury

Dapeng Zhang's Shoulder Exercises
1. This is a resistance exercise to build muscle; Have one arm bent at the side of the body and try to lift it against gentle resistance (such as another person) preventing this by using counter pressure. A strip of latex sheeting (or a long bungee) held securely under the foot (don't let it snap back!) will also provide this.

2. Stand at arms length from a wall and move the hand up and down as though you were using a paint brush.

3. Push off the wall gently with both hands as though you were doing vertical 'press ups'. Start these with only what feels comfortable and try to build up the repetitions every few days.

4. Imagine you are striving to reach a ripe apple high on a tree - just out of reach. Stand on tiptoe trying to make every bit of yourself higher and taller to reach it. Relax and repeat.

Do remember that whilst exercises are very necessary, it's important to listen to our bodies and gauge how they feel in regard to how much physical stress is needed to be beneficial rather than overly taxing to the recovering shoulder.

Ankle Rehabilitation Exercises
Use these exercises to increase the range of motion ankle after injury. All exercises (except the ‘Alphabet’ exercises) should be performed while sitting on the floor with your legs full extended, knees straight, out in front of you (this is the ‘neutral position’). Each one should be performed 10 times in row.


1. Moving only your ankle, point your foot back toward your nose (while keeping knee straight). Continue until you feel discomfort or can't tilt it back any further.

2. Hold the position for 15 seconds then return to the neutral position.

Plantar flexion
1. Moving only your ankle point your foot forward (while keeping knees straight). Continue until you feel discomfort or can't move it any further.

2. Hold for 15 seconds then return to the neutral position.


1. Moving only your ankle and keeping your toes pointed up, turn your foot inward, so the sole is facing your other leg. Continue until either discomfort is felt or you can no longer turn your foot inward.

2. Hold this position for 15 seconds then return to the neutral position.


1. Moving only your ankle and keeping your toes pointed up, turn your foot outward, away from your other leg. Continue until either discomfort is felt or you can no longer turn your foot.

2. Hold for 15 seconds then return to the neutral position.

The Alphabet
1. Sit on a chair with your foot dangling in the air or on a bed with your foot hanging off edge.

2. Draw the alphabet one letter at a time by moving the injured ankle and using your big toe as your 'pencil'.

Knee Injury Rehabilitation Exercises
1. Heel slide

Sit on the floor with legs outstretched. Slowly bend the knee of your injured leg while sliding your heel/foot across the floor toward you. Slide back into the starting position and repeat 10 times.

2. Isometric Contraction of the Quadriceps

Sit on the floor with your injured leg straight and your other leg bent. Contract the quadricep of the injured knee without moving the leg. Hold for 10 seconds, Relax, then repeat 10 times

3. Prone knee flexion:

Lie on your stomach with your leg straight. Bend your knee and bring your heel toward your buttocks. Hold 5 seconds. Relax. Repeat 10 times.

Add the following exercises once knee swelling decreases and you can stand evenly on both legs without favoring the injured knee.

4. Passive Knee extension

Sit in a chair and place your heel on another chair of equal height. Relax your leg and allow your knee to straighten. Rest in this position 1-2 minutes several times a day to stretch out the hamstrings.

5. Heel Raise

While standing, place your hand on a chair for balance. Raise up onto your toes and hold it for 5 seconds. Slowly lower your heel to the floor and repeat 10 times.

6. Half Squat

Stand holding a table with both hands. With feet shoulder's width apart, slowly bend your knees and squat, lowering your hips into a half squat. Hold 10 seconds and slowly return to a standing position. Repeat 10 times.

7. Knee extension

Loop one end of a theraband around a table leg and the other around the knee of your injured leg and face the table. Bend your knee about 45 degrees against the resistance of the tubing and return.

8. One legged standing

As tolerated, try to stand unassisted on the injured leg for 10 seconds. Work up to this exercise over several weeks.

Wrist strengthening - Basic exercises

To begin with, the following basic wrist strengthening exercises should be performed 3 times daily doing 10 repetitions each time.

1. Spread your fingers apart and close them

2. Imitate a typing action and do this as fast as you can

3. Place your hand palm down a table and lift each finger in turn

4. Squeeze a tennis ball, hold for 5 seconds, 10 times and release the grip.

Repeat these exercises regularly during the day as long as there is no pain or discomfort.

Advanced Exercises

Throw a ball against a wall and build up to throwing a ball with a partner gradually using more distance in between.

Use a racquet, golf club or other equipment to practice typical movements alone before returning fully to your chosen sport or activity.

Clinical Depression

Clinical Depression and TCM: (Part One)

Before the 1980’s the national publication of the Traditional Chinese Medicine textbook contained very little information on common psychological problems such as depression and anxiety. When modern Western psychiatry was introduced into China during that decade, there was no equivalent entity in Chinese medicine to correspond to a diagnosis of Clinical Depression. Chinese psychiatrists defined ‘Depression’ by borrowing traditional pathogenic term yu (see below) and qualifying it with ‘suppress’.

In contemporary TCM, the term ‘yu’ is reserved to describe the stagnation of the qi that is associated with emotional strain and centres on liver dysfunction. In most contexts this signifies an inability to express one’s emotional responses, marked by irritability and a sense of frustration. The alternative, relatively newer term: zhi, is used in reference to qi to denote stagnation or sluggish movement in a general sense without necessarily implying emotional causes.

In modern transmissions of TCM theory, the precise nature of the relationships between an individual’s psychic life and organs are generally described with lists of correspondences between an organ and various emotions and mental faculties.

According to the Ling Shu, Scroll 2 Chapter 8:* “When the liver is deficient, fear will occur; when there is excess, one will become angry. When the heart is deficient, sorrow will occur; when there is excess, unceasing laughter will occur.” This is the only reference in the entire Nei Jing (the oldest typical TCM book) to emotions ’coming from’ organs. Thus, according to the major classical source of Chinese medicine, only the liver and, more specifically, the heart are capable of generating and affecting emotions.

While the effects of various emotional states may gravitate to different organs and disrupt their normal functions, the psychic aspects of the heart and liver alone are always held to be the primary source of all facets of our emotional life, whether positive or negative. Therefore, in the diagnosis and treatment of depression, we need to focus primarily on the heart and the liver.

The original classics of TCM have a spiritual orientation manifest in the belief that the forces of the spirit and qi dominate all matter including the human body and spirit. Thus If the spirit is at peace, the heart is in harmony. When the heart is in harmony, the body is whole. If one seeks to cure the physical body one must first heal the spirit.’ This is diametrically opposed to the orientation of Chinese medicine text from contemporary China, which places physical causes in the leading role.

Part two The Five Phases or Five Elements theory provides a useful framework for understanding depression. Viewed in simple terms, depression may be best defined by what is absent from the psyche of the depressed individual, compared with what is present in the normal healthy individual, namely:

· A sense of joy

· The ability to respond emotionally and express emotions

· The ability to give significance or meaning to things

The first related to fire; the second to wood; the third to earth. Thus we have failure in these three aspects of the Five Elements, implicating the involvement of heart-pericardium, liver and spleen in the pathogenesis of depression. In light of the above discussion, the liver and heart disorder are primary, while spleen deficiency is secondary.

The main contributing factors may be categorized as:

The experience of prolonged or intense emotional strain

· Lack of emotional self-control

· Imbalance between work and leisure

· Excessive mental work

· Lack of clearly defined value system

· Lack of harmonious interpersonal relationship

· Failure to cultivate harmony with nature

· Lack of personal integrity

· Neglect of self-cultivation

· Inaccurate self-knowledge

Any, or a combination of, the above may weaken the spirit and lead to the development of specific organ system imbalances. For the purposes of clinical diagnosis and treatment, four major syndrome-patterns may be described for patients presenting with a depressed mood, signifying the core pathodynamics of this condition:

· Liver qi constraint

· Instability of the heart qi

· Heart-blood and spleen-qi deficiency

· Phlegm clouding the mind and senses

It should be noted that patients mostly present with varying combinations of the above.

A 2004 review of clinical studies concluded that ‘there is insufficient evidence to determine the efficacy of acupuncture compared to medication, or waiting list control or sham acupuncture, in the management of depression. Scientific study design was poor and the number of people studied was small.’ However, the authors noted, rather promisingly, that ‘there was no evidence that medication was better than acupuncture in reducing the severity of depression, or improving depression’ defined as remission. A 2007 systematic review of randomized controlled trials of acupuncture in the treatment of depression concluded that ‘Despite the findings that the odds ratios of existing literature suggest a role for acupuncture in the treatment of depression, the evidence thus far is inconclusive’. A recent randomized controlled trial to assess the efficacy of acupuncture as an intervention for patients with DSM-IV Major Depressive Disorder(MDD), involving 151 subjects, concluded that’ results fail to support its efficacy as a monotherapy for’ MDD’.

Both animal and human studies have shown that acupuncture is able to modulate central neurotransmitters, which may be the key to its’ observed effect on mood regulation.

Based on the European Journal of Oriental Medicine, p32-47 Vol6. No.5.2010-11

‘Based on the material discussed above, I propose that patients with a clear diagnosis of clinical depression should be referred to a qualified psychiatrist for assessment and only receive antidepressant medication under this level of professional guidance. Other therapeutic modalities may provide a supporting role, e.g. cognitive psychotherapy, adoption of a healthy lifestyle together with TCM treatment. The initial aims of this combined approach would be improvement of mood, detection and correction of contributing factors (through psychotherapy, counselling, nutrition, physical fitness, stress management) and balancing the physiology (with acupuncture and Chinese herbal medicine). The goals of such an approach would be to discontinue the medication as soon as possible, while shifting the responsibility to the patient for implementing and maintaining healthy lifestyle practices. TCM treatment would continue until physiological balance has been established.’

Can Acupuncture Help IBS?

Irritable Bowel Syndromes (IBS) is a chronic functional gastrointestinal disorder characterized by episodic abdominal pain or discomfort in association with altered bowel habits being diarrhoea and/or constipation). Other gastrointestinal symptoms (such as bloating and flatulence) are also very common. A variety of factors are believed to play a role in the development of IBS symptoms. These include; altered bowel motility, visceral hypersensitivity, psychosocial stressors, altered brain-gut interactions, immune activation/low grade inflammation, alterations in the gut microbiome, and genetic factors.

In the absence of the pathophysiological biomarkers which can distinguish between the differing IBS subgroups, treatment of this condition is predicated upon a patient’s most bothersome symptoms. According to Traditional Chinese Medicine, IBS is caused by a combination of the following:-

Longstanding bottled-up emotions such as anger, hatred, resentment, stress, and depression. These will stagnate the liver Qi (energy) The livers’ free flowing function is especially important in harmonizing the emotions and digestion. Stagnant liver Qi will then invade the spleen causing abdominal distension and pain, constipation and /or diarrhoea, flatulence, sour belching, nausea, vomiting and tiredness.

Long periods of pensiveness, melancholy, excessive mental activities will knot the Qi and weaken the spleen giving rise to tiredness, loss of appetite, and loose stools. There may also be lack of concentration and poor memory.

Irregular eating habits, eating too little, following a strict diet, or overeating, will impair the function of spleen. This can result in bad digestion, poor appetite, lethargy and loose stools.

Overuse of antibiotics in the treatment of various respiratory and infectious disease. Most antibiotic are cold and damp in nature and will injure the spleen and stomach resulting in diarrhoea, candida (yeast) infections and dyspepsia as well as tiredness, weakness and poor weight gain.

How Can Acupuncture Help IBS?

Acupuncture offers a positive optional solution for IBS sufferers. Often the term ‘Irritable Bowel Syndrome’ is used as a catch-all phrase for all cases of abdominal distress which do not have other explanations. In Chinese medicine, various cases of IBS are not viewed as falling into one broad disease category, but are broken down into many different disorders because the causes can be so varied. The individual symptoms vary greatly from person to person because the underlying problem is usually very different for each person. In TCM terms, IBS may be classified as a type of abdominal/intestinal pain, epigastrial/stomach pain, or as a type of diarrhoea, depending on the individual symptoms experienced.

For IBS with abdominal/intestinal pain, the cause is usually due to liver-energy becoming blocked, which may cause further problems with the spleen’s digestive functions. The blocked liver energy causes symptoms of bloating, constipation, and belching, as well as moodiness and irritability. These are symptoms which may well be aggravated by emotional disturbances or upset. When the spleen is also involved, there will additionally be fatigue and alternating constipation and diarrhoea. Acupuncture treatment helps mobilise liver energy to resolve the over long retention of food, relieve pain and improve digestion while correcting spleen function to resolve diarrhoea and improve energy levels.

For IBS with epigastric/stomach pain,the cause can be due to a variety of different imbalances within the stomach leading to improper or incomplete digestion of food. This can cause a variety of symptoms ranging from pain, nausea and vomiting to belching, headaches, diarrhoea or constipation. Each and every symptom experienced by the sufferer will depend on the specific problem occurring within the stomach. These may be due to heat or cold damaging the stomach, or because the stomach energy is blocked. In all these cases, acupuncture is helpful in restoring the stomach to its’ proper function so that digestion problems and symptoms are resolved.

Research has shown that physical activity improves symptoms in patients with IBS and is protective against symptom deterioration. A recent demonstration of this has been provided by a study from the University of Gothenburg, Sweden. Also, an experiment in the use of electro-acupuncture (in which a small electrical shock is delivered via the acupuncture needle) was conducted on dogs causing their stomachs to empty faster. This is the first clear evidence that acupuncture is actually able to directly affect the function of the bowel and suggests that it may very well be useful in treating IBS.
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