Emergency Treatment for a Stroke

I was very sad to hear that one of my friends in Vancouver recently had a stroke. He has been in a coma in the hospital for the past month. Strokes happen suddenly and can cause serious complications and repercussions, so someone at risk of having a stroke – as well as their family members – should know its warning signs and symptoms and how to treat it in an emergency. Risk factors include hypertension, diabetes, high cholesterol, and senile infirmity.

According to the Eastern medicine, there are some warning signs and symptoms before a real wind stroke hits: paralysis of one side of the body, altered consciousness, awkward speech; a stiff neck; facial flushing and the feeling of heat rising upward; numbness or weakness in the hands and feet, especially in the thumb and index finger; dizziness and nausea; strange sounds in the ear; frequent twitching of the eyelids; a heavy-headed feeling and more frequent headaches, especially in the morning; double or blurry vision; deviated tongue to one side; and eye congestion or bloodshot eyes.

The most important emergency response for a stroke is to call 911 immediately, or “scoop and run” to the hospital. It is difficult to heal if not treated within 3 hours after the first symptoms appear as brain cells may die. Next, the victim him/ herself, or anyone in the vicinity, should do the following while waiting for the 911 responders to arrive: calm the victim down mentally and physically; raise the head higher than the heart to lower blood pressure in the brain; turn the head to one side to prevent food from going into the windpipe if vomiting occurs; and if the body is very hot, apply cold compresses to the forehead and/or chest.

I would also like to recommend another emergency procedure that can be done. It is very simple and effective. It improves circulation so that the lighter symptoms disappear. Even if the symptoms are very severe, this could prevent them from getting worse.

The procedure: prick the tip of each of the ten fingers (we call this acu-point Shixuan Xue) and toes (Qiduan Xue). Use a sterilized needle or lancet, pricking to a depth of approximately 2mm right in the centre of the convex area at the tip of the fingers (see picture below), starting with the thumb of one hand and working your way to the little finger one by one. Squeeze each fingertip to draw 3-5 drops of blood. Stop doing it if the stroke symptoms disappear. If not, continue pricking each subsequent finger of another hand, then move on to the toes.

This technique is especially useful when you are somewhere where emergency responders may have difficulty reaching you, such as when camping in the mountains. It is also good for other emergency situations such as sudden unconsciousness (by any cause), severe headaches, and stomachaches. However, do not forget that this treatment should be temporary, just until 911 responders arrive to help.

Stroke1

Eastern Medicine’s Treatment for Hiatal Hernia

Many patients come to see me complaining about abdominal pain, and I use palpation to check their entire abdomen in order to make a diagnosis. Many cry out in pain or even scream when I press a specific point just below the sternum. And many have already received a doctor’s diagnosis of hiatal hernia and are taking pills for this disease.

A hiatal hernia is that the upper part of the stomach bulges up through the esophageal hiatus – the opening in the diaphragm – into the chest cavity. It’s a very common condition and many people with a hiatal hernia don’t realize it because they have few symptoms. But a large hiatal hernia can cause food and stomach acid to back up into the esophagus (acid reflux), leading to heartburn, nausea, belching, and chest pain. In the worst cases, chronic hiatal hernia can injure esophagus and even lead to severe esophageal stenosis or cancer.

Eastern medicine doesn’t categorize this disease in the same way as Western medicine. Instead, it recognizes two conditions which overlap somewhat with hiatal hernia. One is “Pain below the Heart Syndrome”, a specific type of upper abdominal pain, and the other is “Ye Ge”, a late and serious stage of dysphagia (difficulty swallowing).

The causes of hiatal hernia symptoms are mostly considered to be 2 kinds, which are dietary, emotional; Dietary causes are related to overeating, lying down after a large meal, eating rich fatty foods, and excessive alcohol consumption. These can produce lots of phlegm and Qi stagnation which turn to heat. This heat tends to come up and push stomach upward. On emotional factor, Stress causes diaphragm weakness, which can allow the stomach to move upward and to release more stomach acid. Eastern Medicine clearly explains how emotional stress can lead to stomach damage. Using its Five Element Theory, The wood element can become excessive when the patient represses anger. Anger causes them to tighten up and suck their breath upwards leading to pressure on the stomach and cause a hernia.

Hiatal hernia is not regarded by Eastern medicine as merely a local phenomenon, but as one symptom of an unbalance of internal organ system leading to functional or/and structural deformation. For example, aging or sexual indulgence may consume yin-fluids and cause Kidney Yin deficiency and dryness in the esophagus and stomach. And many who have a hiatal hernia also have an inflamed ileocecal valve lower down in their digestive tract causing gas to build up and creating pressure higher up in the digestive system. So though it presents with apparently excessive symptoms, such as heartburn, heat rising to redden the face, and vomiting, belching with gas, it is also a condition of basic deficiency at the same time.

Acupuncture can treat both root cause and symptoms of hiatal hernia, and herb formulas can also support the liver, clear out heat and inflammation from the GI tract, promote healthy digestive function, and relieve emotional anxiety. This requires treatment once a week for 2 to 6 months

Eastern Medicine & Western Medicine

About 15 years ago, I attended an exhibit called ‘Body World’, which displayed human bodies that had been prepared into various forms, positions and stances. Some had been bodies sliced into thin, transparent sections transversely or vertically, and some special parts were cut out from the body like opened drawer, allowing visitors to actually see inside the body. What impressed me the most was not the anatomical features but rather the techniques used to prepare the bodies and their parts for this exhibit.

When I think about it now, the anatomy simply is one way of understanding the human body system, which, of course, does not explain everything there is to know about our bodies. Despite the advancements in modern medicine and its painstaking scrutiny of human anatomy, there are still a lot of unknowns.  One might believe that with further research the gap between the known and unknown may lessen, but by then new diseases and health issues will probably have arisen. The creation of new pathogens is caused by our society and the times.

Eastern medicine is also one interpretation of the human body. It is not focus on individual “mechanical” parts, but instead considers the body to be part of nature, an organic and holistic entity, and so treatment follows these principles. We cannot find qi and meridians, yin yang and five elements in dead bodies, which lead to the belief that anatomy is not of primary importance. There are many aspects of eastern medicine that cannot be proven with physical evidence and may seem somewhat philosophical. But when it comes time to the actual treatment of disease, eastern medicine can cover as many kinds of diseases as Western medicine does.  Of course, each may have their own strong points.

Today, organs can be transplanted or synthetically made. I think that this may be an extension of western medicine’s way of understanding the body through cutting, splitting, opening. I am still standing by patients with needles in my hand, murmuring therapeutic issues; ‘water helps wood, metal restrains wood, so I have to tonify kidney and sedate lung meridian for my patient who has emotional depression.’

 

 

Disease Without Cause and Tan Yin Syndrome

These days, as the temperature drops, many people start to suffer from a variety of aches and pains. Symptoms like severe vertigo, headaches, nausea, and indigestion accompanied by water sounds in the abdomen may appear, and a person may find themselves visiting several different clinics or trying many different treatments. If they have gastrointestinal disturbances they might be merely diagnosed with reflux esophagitis, or lack of nutrition, poor blood circulation, or general neurogenic problems. Yet the patient’s ailments may continue to increase. This is what we call disease without cause.

In Eastern medicine we refer to this as “Tan Yin syndrome”, which can be translated as “phlegm fluid retention” in English. This illness involves an accumulation of bodily fluid mixed with various waste products resulting from an abnormality of water metabolism. Our bodies need to take in about 2L of water per day. After being involved in various metabolic processes in the body, this water normally gets discharged through excretions. But for certain reasons, sometimes this water is retained with other waste products as a thin liquid (fluid), or gets “boiled down” by our body heat into a sticky state (phlegm).

Nasal discharge is an example of visible phlegm. But while phlegm circulates throughout our body along with the qi circulation, it can easily become stuck or stagnant, giving rise to many types of disease (invisible phlegm). Thus there’s a saying that “9 out of 10 illnesses are due to phlegm”. For example, we may experience coughing when phlegm is in the lungs, nausea when it’s in the stomach, fluttering in the chest when it’s in the heart, vertigo and dizziness when it’s in the head, a cold sensation when it’s in the back, congestion when it’s in the chest, fullness when it’s in the upper abdomen, diarrhea when it’s in the intestines, swelling when it’s in the meridians, and numbness when it’s in the limbs.

The typical symptoms of Tan Yin syndrome include: dizziness, fluttering in the chest, shortness of breath, water sounds in the stomach area, aching or numbness in the limbs, expectorated phlegm, nausea, dark circles under the eyes, difficulty losing weight even with fewer meals, etc. These may be accompanied by other symptoms such as sight disturbances, feeling of paralysis in any part of the body, abnormality of sensation, the feeling of something stuck in the throat, acid reflux, an icy cold feeling in the back, nodules in the wrist or neck, chronic fatigue, obesity, schizophrenia, depression, dementia, and fainting.

Causes of the generation of Tan Yin include: weakness of the spleen and stomach, improper dietary habits (e.g. drinking alcohol, overeating, irregular meals, too many cold drinks and/or raw vegetables), overuse of medication, lack of exercise, and more. The treatment for Tan Yin is acupuncture, moxibustion and herbal medicine. But first of all, limit your intake of cold and raw foods, and get more exercise. Then you need to be treated by a medical professional.

 

 

Cold Syndrome

January has now passed, and it feels mild in Merritt this winter (I was living in Merritt when I wrote this). The low mountains to the north protect us from the cold wind, and the wide open space to the south lets in lots of sunshine, helping it to feel cozier here than it otherwise might. In ancient times, people didn’t have the wonderful home heating systems we have today or all the best clothing to protect their bodies from the cold. Cold has always caused humans much trouble.

1,800 years ago, a physician named Zhang ZhongJing wrote a masterpiece on this topic titled Shang Han Lun. It describes diseases generated when cold attacks the body from outside and complicated illnesses which can arise when cold disorders progress and transform. It provides herbal cures for each one – approximately 260 formulas in total. Zhang’s theory accounts for environmental influences and individual response types, and explains how disease tends to progress in stages from “exterior” to “interior” in the body, an enlightened theory foundational to Eastern medicine. He created a system for identifying and treating disease which has endured ever since.

Stage 1: coldness first attacks the exterior of the body: skin, muscles, joints, etc. Typical symptoms are fever and chills, neck stiffness/pain, headaches, body aches, coughing, phlegm – the initial stages of common colds. Eastern medicine uses a light perspiration treatment method during this phase.

Stage 2 involves coldness attacking the body more deeply, in the chest or abdominal cavity. We call this “half exterior, half interior”. Typical symptoms are different than in the first stage and require different treatment. Likewise in Stage 3, when coldness enters the interior of the body: the stomach, the bowels. There are six stages overall.

Zhang specified that coldness doesn’t only come from outside the body. It may be generated by circulation disorders within the body, such as poor digestion, blood stasis and phlegm fluid. Clinically, I mainly see two types. The first is coldness caused by low energy and is usually due to a weak digestive system. The body may easily feel cold, particularly in the hands, feet, and lower abdomen. I recommend taking medications and ingesting foods which, according to Eastern principles, have a warm or hot nature.

The second is coldness caused by imbalance, and is known as “hot in upper, cold in lower” – hot in the chest and head, cold in the hands, feet, and lower abdomen. Affected individuals tend to always feel cold and prefer warmth, and they may notice the upper/lower imbalance when they eat something with a hot nature. It is treated by drawing the heat from the chest and head down to the Dantien (root of energy in the body) so the lower region gets warm naturally.

The theory and formulas left to us by Zhang ZhongJing are indispensable to Eastern medicine today. In the future, if a strong flu befalls us, we may need Zhang’s knowledge to help ourselves. Recent reports on SARS have shown that taking Tamiflu and using Eastern medicine at the same time proves extremely effective.

Chronic Pain Syndrome and Dampness

One day, a woman in her mid-forties came to see me complaining of various pains, especially in her right knee and hip. She said that her doctor had diagnosed her with fibromyalgia, or possibly degenerative arthritis, but she was having difficulty fully recovering from it. She looked slightly overweight and had been suffering from digestive problems for a long time – bloating after meals, loose bowel movements, lowered energy, excessive sleeping, and a heavy feeling in the body. I noticed that the cause of her pain was dampness and gave her 10 acupuncture treatments (once or twice a week) and prescribed herbs for 4 weeks. After2 months of treatment she was very happy because her body felt lighter, her energy was higher, and the pains were gone as well. She was especially thankful to have lost some weight.

In Eastern medicine, the elements of wind, cold, damp (and sometimes heat) within the body are regarded as the main cause of pain in the musculoskeletal system. Those elements work individually or cooperatively to provoke pain. However, dampness is so heavy and turbid that it easily combines with wind, cold and heat which otherwise are easy to eliminate on their own. Dampness has the tendency to be chronic once it settles in the shoulders, lower back, knees or feet, making it similar in nature to chronic pain. Both are persistent and difficult to remove. Dampness causes the cervical or lumbar vertebrae to swell and disintegrate once it settles into them, and makes joints like the knees heavy and achy.

How can we know if our body is being attacked by dampness? The first symptom is a persistent tired, heavy feeling especially in the morning, which may be easier to understand if we imagine the body as a sponge which is full of water. The second symptom is edema, which initially causes swelling around the eyes, in the hands, and/or in the painful area. The third is weight gain, and people may find this happens easily even without any increase or decrease in food consumption. And the fourth is abnormality in the digestive and eliminative system. This symptom may occur often in people who overeat or whose constitutions are less capable of dealing with dampness in the digestive system. It may be experienced as frequent bloating, lack of appetite, frequent urination with little output, and loose stools. Other symptoms of excessive dampness include susceptibility to weather (such as feeling heavier and achier in cloudy or cold weather), and increased heat generation in the afternoon.

So what causes dampness? Lack of exercise, overeating, and stress. Proper flexion and extension during exercise can dispel dampness from the joints and muscles. A rolling stone gathers no moss. Eating more than the body can easily digest and absorb creates dampness. And stress makes the flow of energy in the body stagnant. So we need to increase ventilation by opening windows in our mind. Mold doesn’t grow in a well-ventilated room.

Characteristics of Treatment in Eastern Medicine

A few years ago, I treated a woman who came to see me for severe lower back pain. However, she had been suffering from many other ailments as well, such as diabetes, hypotension, hypothyroidism, fibromyalgia, sciatica, anemia, and insomnia, for between 10 and 40 years. She had had her gall bladder and uterus removed 20 years prior. She also had occasional headaches and indigestion.  Because of all of this, she had to take more than 20 kinds of medications daily, including antibiotics, hormone drugs, multivitamins, etc. I asked her how she was able to take so many medications for such a long period of time, and I still remember her wry smile as she replied, “How can I not take them?”

Treatment is the process of helping the body to gradually need less medication, with complete freedom from medication or any artificial substitutes as the final goal. If a person has to continue taking medication for the duration of his or her life, that is not actually treatment but rather management. Of course, that is important and necessary as well.

The first characteristic of treatment in Eastern medicine is its well-developed and holistic approach to disease/symptom interpretation and treatment. Its focus on treatment (as opposed to management) is supported by a deep understanding of the complex interrelationships between many different diseases/symptoms and their root causes, as well as amongst the various systems of the body. In Western medicine, diseases are dealt with individually, so if a new disease appears then a new medication is added.  This approach tends to miss the big picture perspective which could explain all presenting diseases and symptoms together with one interpretation and involve a singular course of treatment.  For example, if someone suffers from both rhinitis and constipation, they may be prescribed two different drugs under Western medical care. Yet in such a case, Eastern medicine would be aware of the relationship between the lungs and the large intestines, and would focus on treating one underlying and dominant cause.

Secondly, Eastern medicine focuses more on the state of the patient’s own energy which is allowing the illness to attack, rather than focusing exclusively on getting rid of the apparent physical cause. The idea of restoring the “right qi” (right and essential energy) is actually a broader concept than Western Medicine’s idea of “boosting the immune system”, and it is the most important consideration throughout the whole course of treatment. Therefore, we don’t use drugs which could overpower a person’s own “right qi”.  For example, when using acupuncture, we don’t use needles merely to address the related symptoms, but add a few extra needles to strengthen the person’s original qi (energy). Consequently, there are far fewer side effects occurring in Eastern medicine.

We can see from even these few examples that Eastern medicine has the characteristics of being both organic and holistic.

 

 

 

 

ADHD and Eastern Medicine

We can see the number of children who suffer from Attention Deficit and Hyperactivity Disorder (ADHD) increasing significantly around us. According to the Centre for ADHD Awareness, Canada (2010), the most conservative estimates indicate that ADHD affects over 1 million Canadians (including adults), or an average of 1-3 children in every classroom. ADHD is a developmental disorder characterized by a lack of consistent attentiveness, impulsivity, and distractibility. Criteria for diagnosing a person with ADHD may include, for example (from the DSM-VI): often does not seem to listen when spoken to directly; is often easily distracted by extraneous stimuli; often fidgets with hands or feet, or squirms in seat; often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities; and often leaves seat in the classroom or in other situations in which remaining seated is expected.

If left without treatment, the afflicted person may encounter many difficulties during childhood. Research shows learning difficulties in at least 20% of children with ADHD, and inappropriate behaviour in about 30%. Although the main symptoms diminish or may even disappear once they move into adolescence and adulthood, some are still reported as having poor communication with other people, severe depression, a low participation rate in school activities, and difficulty with relationships. Personality disorders, antisocial behaviour, drug use, and low self-esteem are some of the problems which may also be encountered.

Considerations regarding the cause of ADHD may include: birth and childhood environment, first life experiences, premature birth, drug use or stress during pregnancy, as well as brain damage, abnormal secretion of neurotransmitters in the brain, and side-effects from other drugs. Genetic factors are also regarded as a cause of ADHD, since boys are 8 times more likely than girls to experience it.

Methylphenidate, a stimulant to the central nervous system, is generally used as a treatment by Western medicine, but side-effects such as nervousness, agitation, anxiety, and insomnia may occur. It is a long-term treatment, requiring 2-3 years for full effect. Once the condition is stable for more than a year, the possibility of recurrence will be low.

In Eastern medicine, the underlying cause of ADHD is regarded as an imbalance of Yin and Yang. Children usually have a lot of Yang energy, for example heat for growth. If this heat is excessive, they have a tendency to be impulsive or to be easily distracted. On the other hand, if they have a lot of Yin energy, for example cold or fluid, then they have a tendency to be sluggish and lack attention. The children who suffer from ADHD usually have excessive heat in the internal organs originating from a deficiency especially in relation to the heart, liver and gall bladder. Thus ADHD treatment should involve clearing this heat and strengthening the heart and liver. Furthermore, restoration of the function of all internal organs and regulation of Yin & Yang should also be involved for successful treatment without recurrence. Additional supports for basic treatment include psychological treatment to help stabilize emotions, changes in the home environment, dietary adjustments, and home education.

 

Food Accumulation: The Source of All Disease

People often spend 2-3 hours a day eating food. Many of the body’s internal organs participate in this job, such as the spleen, stomach, small and large intestines, liver, and gall bladder. In my clinic I see more people than expected suffering both directly and indirectly from problems relating to this digestive system.

 

In the case of food accumulation (direct translation of a Korean term), according to Eastern medicine, when food is ingested, instead of being properly transformed into good energy, wastes and gas are generated which harm digestive system function.

 

Eating irregularly or too quickly or too much at once, eating after satiation or without hunger, eating too much raw, cold or processed food, or doing something stressful right after meals…Over time such habits can cause an internal accumulation of food waste.

 

Food accumulation cannot easily be diagnosed with a gastroscopy or colonoscopy because there are no polyps or inflammation to be seen. It is mainly recognized by a bloated feeling, bad breath, and/or a feeling of poor digestion and much gas. It can also be diagnosed through abdominal palpation by a healthcare practitioner. The belly may feel hard or have balloon-like lumps, and palpation may feel very uncomfortable or even painful.

 

Food accumulation is classified into three categories according to where it occurs. The symptoms of each are different. If it occurs in the stomach, there may be belching, a sour taste in the mouth, halitosis, heartburn, stomachache, and a sense of food remaining undigested; if in the small intestine,  abdominal distention, a bloating sensation and/or drowsiness after meals; and if in the colon, constipation, diarrhea, copious flatulence, etc.

 

If someone has an internal accumulation of food, we might assume that they would eat less. However, that isn’t what usually happens. Since peristaltic action in the intestinal tract is slowed down by the accumulated waste, and energy is diminished due to compromised digestion, the body asks for more food in order to increase energy, which then increases stagnation and creates a vicious cycle.

 

The reason we call food accumulation the source of all diseases is because it creates many complications. If food is less than fully digested it may easily transform into toxic waste and harm the digestive system directly. It also creates fluid phlegm easily which then circulates with the blood and causes other diseases: frequent sensations of heat, skin problems, rhinitis, allergies, coughs, asthma, headaches, low back pain, etc. It can also lead to obesity and edema due to poor digestion, causing a person to gain weight easily in spite of reduced intake. In these cases, we have to treat the food accumulation first. Otherwise, the other symptoms won’t improve.

 

Preventing food accumulation is simple, like the basic knowledge needed for all of life which we learned back in kindergarten. Eat healthy food (such as seasonal, organic food) regularly. Eat a little less and chew well.

 

For long-term problems, treatment takes 2-3 months with acupuncture and herb medicine.

 

 

4 Constitutional Types: SA Sang Medicine in Korea

Through history, there seems to have been a common trend across various cultures for experienced healers to observe over time a difference in basic bodily constitutions amongst their patients, despite all having the same internal organs. The Ancient Greek physician Hippocrates categorized humans into 4 temperaments: sanguine, choleric, melancholic, and phlegmatic, named for four bodily fluids which were believed to affect human personality, behaviour, and health. Early on, Eastern societies also developed comparable philosophical theories and concepts about nature, also applicable to both human society and the human body, with Yin and Yang being the most familiar to westerners. Such ideas became central to their cultures.

About 120 years ago in Korea, a doctor named Dr. Lee Jhe Ma began to categorize people into 4 medical types of temperaments, and he used this as an approach to diagnosis and medical treatment. Prior to this, Dr. Lee had prescribed the same medicine to two patients who showed the same symptoms, yet one patient lived while the other one died. He was so frustrated with this shocking incident that he started doing research on human body constitutions, and developed his own theory called Sa Sang medicine. According to this theory, from birth people differ in the size and strength of their internal organs, most notably the lungs, liver, spleen, and kidneys. This causes differences in disposition and character, and leads to more individualized diseases, and thus treatment should be individually tailored also. Dr. Lee’s approach has now become very popular and useful.

To give one example, the Tai Yin type has a large liver and small lungs and so is well developed around the waist; they are usually tall, fatty, big (especially in hands and feet), and their skeletal structure appears strong. Their character is dignified but inscrutable. This type of person has a good appetite, eats well and a lot, and may even hurt their stomach due to irregular or excessive eating. They also have a weak lung system so are susceptible to diseases like asthma and bronchitis. Sweating is good for this type.

In the book The Edge Effect, author Eric R. Braverman, M.D. categorizes brain constitution into four types which are governed by four types of hormones. He analyzes each type’s features, merits and weaknesses, their challenges from a medical viewpoint, and treatment solutions through lifestyle changes and food therapy. His approach is very similar to that of Sa Sang medicine.

Sa Sang medicine has defects also, such as ambiguity in distinguishing the constitutions and use of a stereotyping approach. Yet it is still very helpful in disease treatment and prevention. I can say that Sa Sang is one of the best methods in modern world medicine to have the “3P” benefits; it is preventive, predictive, and personalized. A small example: beef is good for the Tai Yin type, while pork is good for the Shao Yang type.