Clinical Acupuncture and Oriental Medicine最新文献

Over its history, Chinese medicine has developed elaborate conceptual structures based on yin-yang theory to observe, diagnose and treat ‘infectious’ diseases. By observing environmental changes, symptom patterns, and immunological responses to diseases, a number of crucial theories have become cornerstones of Chinese medical treatment and diagnosis. The author's purpose in the first part of this article is to explain how these theoretical structures, which he calls ‘immunological maps’ are relevant to modern clinical practice, and how they can be understood as unique contributions of Chinese medicine to world medicine.

One way in which mainstream and alternative medicine can be integrated is documented in this case study of health care in Iceland, based on 5 months of anthropological field work. The situation is one of plural medicine, in which patients must decide for themselves how they will utilize some combination of conventional and alternative medicine, the latter being excluded from the national insurance system. To the extent that medical research demonstrates that certain alternative therapies are clinically efficacious for some diseases, the medical response in Iceland, as in many parts of the world, has been to perpetuate pluralism and to continue to marginalize alternative practitioners. This has been achieved because biomedical clinicians have appropriated for their own use the techniques that demonstrate efficacy. In Iceland this is true for acupuncture, which is now practiced by some physicians. It is recommended that dialogue be initiated to discuss ways in which exclusion and expropriation might be replaced by collaboration and synergism.

Objectives: To explore further the incidence of local adverse reactions to acupuncture in individual patients.

Design: Reanalysis of our prospective survey.

Setting: Tsukuba College of Technology Clinic in Japan.

Outcome measures: Incidence of adverse reactions which were commonly seen in Japanese-style standard acupuncture practice.

Results: Minor bleeding was less than 15% (of insertions) in 96% of the patients (pt), and 20% or more in 1.5% of pt. Pain on insertion was less than 15% in 98% of pt, and more than 30% in 0.5% of pt. Subcutaneous bleeding was less than 10% in 97% of pt, and more than 30% in 0.3% of pt. Patients under 20 and female patients tended to express pain on insertion more frequently. Minor bleeding on the head region and the lateral forearm, pain on insertion to the back of the hand and the lower back, and subcutaneous bleeding on the front upper arm and the abdomen were more than twice as frequent as the average incidence.

Conclusion: A few patients had remarkable tendencies for bleeding or hyperalgesia. Each school which has its own model of practice should survey the type and incidence of adverse reactions.

This paper suggests a systematic method for combining the ideas of traditional Chinese medicine (TCM) and Western medicine into an integrated body of medical knowledge. Based on an analysis of the medical models in both systems, this essay proposes a definition of Ôthe integrated approachÕ, which is the black-box testing process of TCM augmented by white-box testing methods of Western medicine or the white-box testing method guided by overall functional testing. A mathematical model has also been proposed to quantify the method, and can be used as a framework for software development. We then outline an actual application of the integrated approach in the treatment of a severe case of kidney disease. It is demonstrated in this instance that either the white-box or black-box testing process is insufficient, and only by using the integrated approach of conventional Western medicine and TCM was the condition of the patient improved. Several possible extensions to this research have also been suggested in the paper.

The increasing discussion over recent years about how Chinese medical terms should be translated into English only rarely touches on the names of acupuncture points. While largely standardized alphanumeric codes used in the literature are undoubtedly the most efficient for students striving to master acupuncture, English translations of the point names are nevertheless useful for students wishing to gain a deeper knowledge of the acupuncture tradition. This paper explains the utility of English acupuncture names, describes their semantic features, and discusses the problems of their translation.