Name of the Book: Clinical Acupuncture Dr Hu Jinsheng

Name of the Book: Clinical Acupuncture Dr Hu Jinsheng Brief Introduction to Author Hu Jinsheng, male, born on June 21, a M.A. in medicine. He ...
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Name of the Book: Clinical Acupuncture Dr Hu Jinsheng Brief Introduction to Author Hu Jinsheng, male, born on June 21, a M.A. in medicine. He currently hosts the post of Director Physician at Acupuncture Institute, China Academy of Chinese Medical Sciences, and concurrently the Professor at China Beijing International Acupuncture Training Center. Work Experience : From April 1991 to April 1992, he worked one year “Belladonna” Acupuncture Training Center in Sarajevo, Yugoslavia. During the time, he had treated more than one thousand patients with ten thousands of treatments. In the meantime, he had provided acupuncture training to local doctors and had achieved a great success. From October 1995 to April 1996, he had worked together with German Johanniter Hospital to establish the first Sino-German Cooperation Hospital in Bramsche, Germany. He worked there 7 months, during which time he treated more than 400 patients with 4,300 successions of treatment in total. A great success had also been obtained. His excellent treatment was highly evaluated by the local government, hospital and the patients. From March 3, 1997 to March 21, 1997, he had been at Acupunkturhogskole School in Norway three weeks. He lectured courses in English totaling 60 hours to students of the second and third year of the school. From July 1997 to May 1998, he was invited again by the German partner to open up a new cooperation clinic and then he worked 10 months at Hannover. From January 16 to February 18, 2001, he participated in the planning and preparation of another center on traditional Chinese medicine in Germany and was invited to supervise the preparation work. From May 15, 2001 to June 26, 2001, he lectured courses 6 weeks in Norway, which totaled more than 200 hours, to students of six different grades. And he also chaired the graduation examination and the graduation ceremony. From October 26, 2001 to November 2, 2001, I worked in the Korea for International Acupuncture Examinations. From March 2002 to September 2002 , I build up the first ChinaBangladesh International Traditional Chinese Medicine Hospital in Dhaka, Bangladesh and worked in for six months had very effective result, and was highly rated by local government and patients. From the 25th of November 2003 till the 8th of December 2003.I worked in the Nordic Acupuncture Training Centre(NATC) in Oslo and Bergen, Norway, to exchange experience in TCM and to teach and give clinical seminars From the 5th of May 2005 till the 8th of June 2005.I worked in the Nordic Acupuncture Training Centre(NATC) in Oslo, Norway, to exchange experience in TCM and to teach and give clinical seminars From 9th of Oct. 2005 to 6th of Nov.2005, I worked in Belladonna Acupun-cture Centre in Rijeka, Croatia, treated more than 1,80 patients with10,00 sessions by acupuncture, carriedon the training courses for local doctors at the same time, and had a great success. From 24th 0f April 2006 till 5th of June 2006. I worked in the Nordic Acupuncture Training Centre (NATC) in Oslo, Norway, to exchange experience in TCM and to teach and give clinical seminars 1

CONTENTS 0F THE BOOK Ⅰ.Questions and Answers:1—18. Ⅱ.Teaching Round:1—21. Ⅲ.Clinical Observation: 1—4. Example of the Questions & Answers How to Distinguish the Reinforcing Methods from the Reducing Methods in Moxibustion Treatment? As stated in the ancient medical book Miraculous Pivot(灵枢经 published in 2,000 years ago), the reinforcement means that the ignited moxa-cone should be mildly burnt without blowing up the fire with mouth and let it spontaneously go out; and the fire for reduction should be blown up until it is extinguished. In short, the fire for reinforcement is relatively slow, while it should be vigorous when reduction is adopted. However, in clinical practice, the moxibustion methods used vary in different situations. Sometimes, the indirect moxibustion methods are employed. In this case, the classification depends on the material placed between the acupoint and the smouldering moxa-cone. For instance, garlic moxibustion pertains to reducing method for its actions of clearing away the heat and removing the toxic substances, which is used for treating boils and pyogenic infections; while ginger moxibustion as a reinforcing method, exerting the effects of warming the body and expelling the cold, is effective for cold syndrome of the deficiency type. Also, the mild moxibustion with moxa-stick belongs to reinforcement; but the bird-pecking moxibustion (moving the ignited moxa-stick in a range of 1-3 cm apart from the skin surface) is classified as a reducing method. Journal of Traditional Chinese Medicine 307


Example of the Teaching Round Acupuncture Treatment of Allergic Rhinitis Case History Name:Wiest;Sex:female;Age:46 years; Occupation: teacher; Date of first visit:April,1996 Chief complaint Allergic rhinitis for five years.The patient stated that five years before,she got the sensation of weakness and lassitude after undergoing a uterectomy,which was followed by the occurrence of anaphylaxis several months later.The attack was chiefly characterized by morning sneezing and lacrimation,which usually appeared in spring and summer and went worse in the rainy days.The disorder was once diagnosed by western medicine as the syndrome of pollen hypersensitivity. Examination The patient was of medium height and in good mental state.She presented with a pale complexion and slight swelling of the eyelids.The blood pressure was 140/90mmHg,and heart rate 85bpm.No abnormal signs were found by auscultation in the chest and heart.The tongue was pale with thin-white coating,and the pulse weak. Discussion 2

Prof.Hu:Please make a diagnosis for this case based on TCM syndrome differentiation. Dr.Li:I think that this is a case with disorders of the zang-fu organs.In view of the clinical manifestations,morning sneezing,rhinorrhea and lacrimation are all symptoms of the lung disorders.As to the nature of the disease, I think, qi-dificiency dominates because the patient presents such clinical manifestations as listlessness,lassitude,pale tongue proper and feeble pulse,which are all indications of qi-deficiency. Furthermore,as far as the causative factors are concerned,the disease occurred five years after she underwent surgical operation,leading to qi-deficiency that has somewhat injured the human body.Besides,it may also be related with improper postoperative nursing. Qi-deficiency mainly denotes insufficiency of lung-qi,which leads to failure of the superficial-qi to protect the body against invasion by exogenous pathogenic factors.The lung is easily to be affected in the rainy days when the pathogenic factors of wind,cold and dampness prevail,hence the appearance of the above-mentioned symptonms and signs. Dr.Zhang:I agree to Dr.Li's analysis.But,I've got two questions to ask.One is how to explain in TCM the hypersensitivity induced by pollen or other powders;and the other is what qi-deficiency mentioned in clinical practice refers to. Prof.Hu:First,I'd like to say that Dr.Li has given us a very good analysis for the case.He can seek the causative factors by combining the clinical manifestations with the case history,and apply well the TCM theory for making diagnosis based on an overall analysis of the symtoms and signs,without being restricted by modern medical diagnosis. This is exactly the question put forward by Dr.Zhang, to comprehend the sydrome in TCM,which is diagnosed as pollen hypersensitivity by modern medicine.In my view,a good modern TCM doctor should possess the knowledge of modern medicine,such as certain means and ways of diagnosing and the knowledge about common diseases,which we often encounter in our clinical practice.Being a TCM doctor,one should be provided with the knowledge of western medicine,but cannot be restrited by it;otherwise he won't be handy in TCM clinical practice.For quite a few foreign friends,when they begin to learn traditional Chinese medicine,they tend to ask all sorts of questions,such as“What are the points and herbs for hypertension?”and “What are the points for allergic syndromes?” The most important thing is that they have neglected a very important point,i.e.TCM diagnosis and treatment are based on an overall analysis of the symptoms and signs.As has been analysed by Dr.Li,although the knowledge of pollen hypersensitivity is important,a differential diagnosis in TCM treatment should be made on the basis of the four diagnostic methods before giving an appropriate treatment.Only by doing so can the treatment be shooting the arrow at the target,and a satisfactory result be expected. Be sure that in TCM clinical practice,whatever the disease you encounter,give the differential diagnosis and treatment based on the TCM diagnostic methods,though you may refer to the modern medical diagnosis,yet not restricted by it. The question of “qi-deficiency”raised by Dr.Zhang is of great significance. As a matter of fact,qi-deficiency is one type of the disorders of internal injury often seen in the disorders of the five zang-organs.Clinically,insufficiency of the heart-qi,of the lung-qi,of the spleen-qi,and of the kidney-qi are commonly 3

seen.Deficiency of the liver-qi is seldom encountered. There may also be concurrent symptoms of the disorders of both the zang and fu organs,such as insufficiency of both the heart-and lung-qi,of both the heart-and spleen-qi,of both the spleen-and lung-qi,of both the spleen-and kidney-qi,of both the lung-and kidney-qi,and of both the spleen-and stomach-qi.To sum up in a word,qi-deficiency refers to hypofunction,i.e.hypofunction of the zang-fu organs. This case belongs to the type of qi-deficiency,mainly insufficiency of the lung- qi accompanied with insufficiency of the spleen-qi.Hypofunction of the lung due to its qi-deficiency may lead to failure of the superficial-qi to protect the body against invasion by exogenous pathogenic factors which enter the body from the skin and hair,and from the mouth and nose,leading to obstruction of the lung-qi characterized by continuous sneezing,and dysfunction of the lung in distributing vital essence to all parts of the body,manifested by rhinorrhea and lacrimation.In rainy days,the weather tends to be cold and damp,the coldness may attack the defensive system which is closely related with the lung,and the wind may attack the skin and hair,leading to various symptoms of insufficiency of the lung-qi.Meanwhile,the excessive dampness in rainy days may attack the spleen,leading to dysfunction of the spleen in transporting the essence of water and grain to the lung,which,in turn,fails to distribute the essence to all parts of the body.As a result,the skin fails to be nourished,hence the symptom of lassitude. From the above analysis,a conclusion can be drawn that this case is dominated by insufficiency of both the lung-and spleen-qi. One thing should be mentioned here that the commonly mentioned qi-deficiency in clinical practice generally refers to insufficiency of the lung-and spleen-qi.The lung,dominating qi of the whole body,and the spleen(earth),the mother of the lung(metal),are closely related.The injury or flourishing of one of the two organs will surdly involve the other.That's why in clinical practice,if no definite organ is mentioned,qi-deficiency generally denotes insufficiency of both the lung-and spleen-qi.Well,if you don't have any more questions,please give your principle of treatment and prescription of points. Dr.Wang:Prof.Hu's analyses have solved two problems,which I have been confused about for a long time.In my clinical practice,I often come across many patients with a definite modern medical diasgnosis,which may sometimes interfere with the making of TCM differential diagnosis.Now,I've a nice feeling that a talk with a scholar is better than ten years'reading.Thank you ,Prof.Hu. Since TCM differential diagnosis for this case is now clear,the principle of treatment should be regulating and reinforcing the lung-and spleen-qi combined with elimination of the pathogenic factors of wind,cold and dampness. The prescription:Baihui (GV 20),Fengchi (GB 20),Shangxing (GV 23),Yintang (Extra 1),Yingxiang (LI 20),Lieque (LU 7),Hegu (LI 4),Zusanli (ST 36),and Sanyinjiao (SP 6),in which the reducing method is used at the points Fengchi (GB 20),Lieque (LU 7),and Hegu (LI 4)for eliminating the pathogenic factors;the reinforcing method is used at Zusanli (ST 36) and Sanyinjiao (SP 6) for strengthening the earth to produce metal;and the uniform reinforcing-reducing method at the other points. Dr.Li:I agree with Dr.Wang's principle of treatment and prescription of points.I'd like to propose some Back-Shu points,such as Feishu (BL 13)and Pishu(BL 20),be 4

added,and some auricular points be used in combination (such as Fengxi,Ear- Shenmen,Endocrine,Lung,Spleen,Internal Nose,and External Nose),with acupuncture applied at the body points,while seed-embedding on the auricular points. Dr.Wang:I've got one more question that in Europe,there are many children suffering from this disease.How can we give them the treatment? Prof Hu:This is an actual problem.Since children are afraid of being needled because of the pain,auricular seed-embedding and/or cupping method are generally used for them. The embedding method can be applied on one side of the ear for about 3-4 days,and the child patient is asked to press each point 20 times each time,which should be repeated 3 times daily to strengthen the stimulating effect. Cupping method can be applied twice a week,mainly at the points of Feishu (BL 13),Pishu (BL 20),Fengmen (BL 12),and Dazhui (GV 14).Flash cupping is first applied ten times for each point,followed by retaining the cup for 5 min.During the stage of attack,the points of Dazhui (GV 14),Fengmen (BL 12)and Feishu (BL 13) are selected, while Feishu (BL 13)and Pishu (BL 20) selected during the intermission.I've applied this method in many children with quite good effect. Now,you have already given the right principle of treatment and prescription of points,I'd like to emphasize the following two things. 1 Since the patients with pollen hypersensitivity usually have an obvious stage of the attack in spring and summer when flowers are in full bloom,treatment should be given at this stage 3 times per week for eliminating the pathogenic factors.After the stage of attack,the stage of intermission follows,during which treatment shoud be given for regulation,and the Back-Shu points can then be added.The treatment is given twice a week,altogether ten sessions. 2 In order to consolidate the therapeutic effect,the patients should be asked to receive ten treatments every year(one month prior to the stge of attack,twice a week)so as to prevent the recurrence.Such treatment for prevention can be kept on for 1-2 years. Treatment and Result The patient presented herself in April,1996 at the stage of attack,so she was treated with the above-mentioned method conibined with auricular seed- embedding.Acupuncture treatment was given three times a week,which was kept on for two weeks.Thereafter,all the symptoms were obviously alleviated.From the third week on,moxibustion at Dazhui (GV 14)was added for 10 minutes each time.As a result,all the symptoms disappeared.Another 5 treatments were given for consolidation.In the following year,ten treatments were given once again.The follow -up survey showed no recurrence. Note:Many foreign friends have written to us,inquiring who Prof.Ren in the article is.In fact,Prof.Ren is the assumed name of Prof.Hu Jinsheng,the author of the present paper.So,from now on,we'll use Prof.Hu instead of his assumed name. Journal of Traditional Chinese Medicine 74-77,1999


Example of the Clinical Observation Acupuncture Treatment of Migraine in Germany From October 1995 to April 1996, the author worked in Johanniter Hospital of Bramsche in the middle-west of Germany. During the period of time, he treated 89 cases of migraine, and found that migraine in Germany had its unique characteristics which differed from that in other countries and areas, so it was called “German Migraine". Initial study suggested that in Germany, about 25% of the population suffered from headache, and 90% of them suffered from migraine. However, the commonly-used method of treatment was just medication of analgesics inspite of such a high morbidity. Quite a lot patients with the illness were cured by means of Chinese acupuncture. The following is a report of it. Characteristics of German Migraine Headche may be caused by various factors. Based on observation, the characteristics of German migraine are summarized as follows. 1 Relating to improper sleeping posture: In the course of treatment, it was found that many patients with migraine had disorders of the neck. Of course, cervical disorders may be caused by various factors, yet the sleeping posture is a factor that can not be ignored. It was learnt that about 10 -15% of the people took a prone sleeping position with the head deviated to one side. Many infants kept on this sleeping position for years while some adults took it for the whole of their lives. As time went on, there might appear imbalance between the flexors and extensors, leading to impairment of joints, muscles and ligaments, malcirculation of the blood, and dysfunction of the nerves in the neck region, hence the occurrence of headache and its like. 2 Relating to the weather: In Germany, in late autumn, winter and early spring, there used to be snowy and rainy days lacking of sunshine. Therefore, insufficient sunshine and excessive wetness constituted the characteristics of cold-dampness which, once invading the human body, might cause or induce headache. 3 Relating to menstruation: Some female patients got headache before or during the menstrual period, accompanied with dysmenorrhea. This was mostly due to stagnation of qi and blood. 4 Relating to psychic factors: Since Germany is a developed country with sharp competition, various pressures from the society as well as family might be another factor contributing to headache. 5 Relating to long-term administration of contraceptives. General Data 89 cases of migraine received acupuncture treatment, ranging in age from 7 to 90 years; the duration of the illness was from 2 weeks to 40 years; the ratio between males and females was 3 7; the episodes varied from several times daily to once per month. Method of Treatment 1 Differentiation and classification of the illness: 1) The cold-damp type: It is characterized by attack occurring upon variance of weather or in rainy days, pain in one side or both sides of the head, heaviness of the head, white-sticky tongue coating, and deep-wiry pulse. 2) The type of stagnation of qi and blood: It is characterized by a fixed sharp pain in the head. In females, the attack usually start before or during the menstrual period, 6

accompanied by distending pain in the breasts and lower abdomen, dark-grey tongue proper sometimes with ecchymosis, and wiry pulse. 3) The type of hyperactivity of the liver-yang: It is characterized by headache mostly located on both sides of the head, irritability and peevishness, the attack occurring due to psychological problem, red tongue proper with yellow coating, and wiry-rapid pulse. 4) The cervical tetanic type: It is characterized by pain starting from the neck region and going up to one side of the head, stiffness of muscles of the neck with obvious tenderness, and wiry pulse. 2 Selection of points: The points selected for the disease were Fengchi(GB 20), Shuaigu(GB 8), Xuanzhong(GB 39), Tianzhu(BL 10), Geshu(BL 17), Ganshu(BL 18), Danshu(BL 19), Taiyang(Extra 2), Waiguan(TE 5), Hegu(LI 4), Taichong(LR 3), and local Ashi points. Explanation:Migraine belongs to the headache related to the Shaoyang Meridian, therefore, points of Shaoyang Meridian were mainly selected. Fengchi(GB 20) and Shuaigu(GB 8) are the points of the Gallbladder Meridian of Shaoyang. Xuanzhong(GB 39) is an empirical point effective for neck disorder. Tianzhu(BL 10) is a local point used for promoting local circulation of qi and blood. Geshu(BL 17) is used for removing obstruction from the meridians to promote blood circulation and stop pain. Since migraine is closely related to the liver and gallbladder, Ganshu(BL 18) and Danshu(BL 19) are selected to regulate the functions of the liver and gallbladder. Waiguan(TE 5), a point of the Meridian of Hand-Shaoyang, is selected for promoting qi circulation in the Shaoyang Meridian. The combined use of bilateral Hegu(LI 4) and Taichong(liv 3) is to regulate circulation of qi and blood, and open the “four gates”(四关)to stop pain. Taiyang(Extra 2) is used as a local point; and 1 or 2 Ashi points can be selected in combination. 3 Modification of the prescription: Taixi(KI 3) was added for those with headache of the cold-damp type. Guanyuan(CV 4), Xuehai(SP 10) and Sanyinjiao(SP 6) were added for those with headache of the type of stagnation of qi and blood accompanied with dysmenorrhea. Shenmen(HT 7) and Neiguan(PC 6) were added for those with headache of the type of hyperactivity of the liver-yang. Jiaji points on the neck region were added for those with cervical disorders. 4 Manipulation: 1) The reducing method was used for point Fengchi(GB 20) with the needling sensation radiating to the head, and also for Ashi points located mostly on the lateral aspects of the head, in the neck region or along the course of Liver Meridian on the medial aspects of the lower extremities; while the uniform reinforcing-reducing method was used for the rest points upon arrival of qi, followed by retention of the needles for 20 minutes. 2) Strong stimulation was given at the beginning of the treatment or during the seizure of headache. 5-10 more treatments should be given after the headache was checked to regulate the dysfunctioned zang-fu organs and to avoid recurrence. 5 Points for attention: 1) Attention should be paid to the sleeping posture that the lateral and supine positions are preferred and the height of the pillow should be properly adjusted. 2)Attention should be paid to the menstrual hygiene that invasion of cold should be avoided before and during the menstrual period, cold water be kept away from the 7

limbs and abdomen, and cold drink and alcohol forbidden. 3) In the course of treatment, the occurrence of one or two seizures of headache is normal and therefore, treatment should be kept on. Therapeutic Results The 89 cases of migraine were averagely given 14 acupuncture treatments. The therapeutic effects were evaluated as follows. 1 Markedly effective: 55 cases(61 8%) had a quick cure with relief of headache and disappearance of the accompanying symptoms. 2 Effective: 16 cases (18%) had alleviation of the headache, decrease of seizures, and withdrawal of medication. 3 Ineffective: 3 cases (3 4%) had no obvious improvement of the headache. 4 15 cases terminated treatment for various reason, making up 16 9% of the total. The results show that the total effective rate amounts nearly to 80% (61 8% markedly effective and 18% effective). Summary 1 The fact that 25% of the German population have the problem of headache, or migraine is uniquely characteristic of Germany. The administration of analgesics which used to be their local treatment for the problem can neither give a radical cure nor avoid certain side effects. 2 It can be seen from the therapeutic result of a 80% effective rate in 89 cases of migraine that acupuncture treatment is an effective therapy for “German migraine" without any side effects. 3 Since 10% of the migraine cases were related to the improper sleeping posture, due attention should be paid and appropriate measures be taken to prevent occurrence of headache. 4 While receiving acupuncture treatment, the cases of migraine related to menstruation should also try to regulate their emmeniopathy. 5 It seems somewhat difficult for acupuncture treatment to give good effects in those with migraine related to psychological pressures and in those given long-term administration of contraceptives. This needs to be further studied. Journal of Traditional Chinese Medicine 99-101,1998.