Module 3 ~ Traditional Medicine:

1
Module 3 Traditional Medicine Ancient Systems

• Ayurvedic and Traditional Chinese Medicine

2
Ayuvedic Medicine

• ayurvedic means the science of life longevity
• Comprehensive system combines natural therapies
  herbs, diet, ex with a prof approach to
  treatment

3
The Template for Forms of CAM Analysis (last
pg in outline)

• In general, what is practice of ____?
• What supports this belief/practice ?
• What can be learned fr history and variations of
  this form of CAM ?
• Examples of diagn, use treatm ?
• What evidence and how to explore it both/either
  quantit qualitatively ?
• What prof prep/certific needed to do ?

4
Derivatives

• 8 derivative branches p. 221 in text chapter
  10 in modern med pediatrics, ob/gyn,
  opthamalogy, geriatrics, otolaryngology,
  toxicology, surgery and general medicine
• Modern healing modalities s/a massage, diet,
  herbal, acupuncture etc have roots in Ayurv
  philosophy

5
Ayurvedic Questions

• Ayurv physician asks
• NOT, What disease does my client have ?
  BUT. . .
• Who is my client ?
• Holistic then, not reductionistic

6
Balance in Ayurvedic
3 doshas energies Vata or thin Pitta or muscul Kapha large
Body Thin, delicate Medium Hvyset
Mind Hyperact Orderly Perfecist relaxed
Soul Intuitive Loving passion8 forgiving
7
The Energies bodily functions
Doshas Vata ( Ecto ) Pitta ( Meso ) Kapha ( Endo )
Bodily Function Eats sleeps Constip Cramps Loves food Ulcers, hrtburn, Eats slowly Allergies Hi chol
see effects of tastes on the 3 doshas p. 223
8
Conception of individual

• Vata, pitta kapha factors from parents combine
  with season, time, quality of emotional
  relationship with self and others/universe
• constellates the qualities of the individual
• our indiv constitution is made and does not
  vary, according to Ayurvedic
• Note pages 227-229 re characteristics of each
  dosha where you see yourself

9
The Five Elements

• Space, Air, Fire, Water Earth are the most
  fundamental to Ayur science/art
• Dosha energy comprised of the 5 blue elements
  where Air Space is energy of movement (vata)
  fire water constitute pitta with the principle
  of digestion water earth make up kapha, the
  energy of structure lubrication

10
The Elements doshas where rep in the body
K
P
V
11
Ayurvedic Tongue Diagnosis Areas
12
Ayur Treatment

• 4 step process of cleansing
  de-toxifying palliation
  rejuvenation mental spiritual healing
• Instead of going thru each step in class, have
  posted these steps as slides on web site for this
  Module

13
(No Transcript)
14
(No Transcript)
15
Ayur Treatment

• 4 step process of cleansing
  de-toxifying palliation
  rejuvenation mental spiritual healing
• Instead of going thru each step in class, have
  posted these steps as slides on web site for this
  Module

16
Ayur Treatment Step 1

• Cleansing and Detox involves anything from
  induced vomiting, bowel enema, blood cleansing
• Use herbal steam saunas for skin detox
• After this, preparations of yogurt herbs used
  to replenish intestinal bacteria

17
Ayur Treatment Step 2

• Palliation used to balance the doshas
• Combo of herbs, yoga stretches, breathing
  exercises, meditation
• Palliation is treatment as well as daily practice
  for healthy folk
• Want daily discipline and good assimilation of
  food

18
Ayur Treatment Step 3

• Rejuvenation is basically body/mind/spirit
  tune-up thru
• Herbal treatments
• Mineral preparations suited to affected dosha
• Yoga exercises

19
Ayur Treatment Step 4

• Mental hygiene spiritual healing attempts to
  improve mind to hier level of spiritual
  functioning thru
• Sound therapy or use of mantras
• Meditation yoga
• Pharmaceutics or remedies

20
Cdn Aids Treatment Info Exchange
Ayurvedic-based treatments
A public Health Agency of Canada web site
21
Conclusions re Ayurvedic System

• Sophisticated and ancient system from India (
  Tibet )
• Focuses on whole organism reln to external
  world
• Seeks to estab/maintain harmonious balance
  within/outside the body
• Texts are in Sanskrit but Columbia Univ in NY
  devoted to inquiry educ about ancient Indian
  medicine/healing

22
Module 3 Ancient Systems Traditional Chinese
Medicine

• In China, TCM is under the administration of
  State Administration of TCM and Pharmacology
• TCM is defined as a medical science governing the
  theory and practice of traditional Chinese
  medicine
• it includes Chinese medication,
  pharmacology/herbology, acupuncture, massage, and
  Qigong

23
We need to pick a weekFeb 6 or Feb 13
http//www.mokshayogalondon.com/
24
(No Transcript)
25
(No Transcript)
26
multiple levels of disease multiple
levels of interventionS
27
Asian Culture The Great Wall of China
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
Cdn Medical Acupuncture Society
32
(No Transcript)
33
Trad Ch Medicine - Acupuncture

• Origins of TCM shrouded in mystery perhaps BCE
  origins
• Best trace is to origins at start of CE with
  rudiments of acupuncture and herbal medicine
• TCM stymied in devel by political ravages not
  until mid 20th C ( Ch Mao ) did TCM become
  systematized into colleges/univ tr

34
TCM Fundamental Concepts

• Philosophy of TCM tied to yin yang
• YY as paired opposites w equilibrium the quest
• Male/Female Heaven/Earth lite/dark all as
  energies in human system and in our environment

35
(No Transcript)
36
(No Transcript)
37
HEADACHES
LI 4
Half way along the second metacarpal
38
DISAPPEARING TENSION (Small Intestine 12)
SI 12
39
INSOMNIA
SPLEEN 6
just above tip of medial malleolus, behind the
tibia.
40
SORE THROAT
Lung 11
41
EXAM ANXIETY
Heart 7
Thumb side of tendon at crease.
First skin crease
42
What does Acupuncture treat

• what is treated is daily life, chronic kinds of
  irritants, illnesses
• Balance restoration is key

43
Most common Acu-treatable conditions

• Nausea vomiting
• Tendinitis
• Insomnia
• Dysmenorrhea Fibromyalgia
• Headache, neck pain TMJ pain post surgical
  pain back pain osteoarthritis
• Strokes arthritis dental procedures

44
Whats the Evidence ?

• WHO lists 40 conditions for which qualitative
  claims have been made for effectiveness
• By gold standard science, ev is inconclusive
  whether acupuncture is effective

45
(No Transcript)
46
Bodys energy meridians centers
47
(No Transcript)
48
(No Transcript)
49
Major Meridians

• Lung LU
• Large intestine LI
• Stomach ST
• Spleen SP
• Heart HT
• Small Intestine SI
• Bladder BL-UB

• Kidney KI
• Pericardium CX P HC
• Tri-heater TH
• Gall Bladder GB
• Liver LIV
• Conception Vessel
• Governing vessel

50
(No Transcript)
51
Sham, single-blind

• In these studies, ac practitioner puts needles in
  fake location
• Problems ?
• Consider too, standardized point when acu treats
  indivs differently
• Are now trying to used trained acup actors to
  deliver the sham treatment

52
The Literature re Ac Effectiveness

• Many of the studies done in China
• Systematic bias in that literature bec meta
  analyses show very hi eval of effectiveness in
  Chinese med lit, 99 effective vs 80-85 in
  western countries med lit
• Many of the Chinese studies used no placebo, no
  control group at all
• Thus, great skepticism

53
(No Transcript)
54
What has Acupunc shown ?

• Most positive results in studies re nausea and
  vomiting
• Use P6, about 2 inches above wrist crease using
  wrist band w pearl-sized bead thus can
  standardize treatment self-stim P6
• Effectiveness of P6 stim for anesthesia-induced
  nausea using double and single blind studies

55
What has Acupunc shown ?

• Tendinitis treated well in single-blind, placebo
  control studies where treatm shown to be slightly
  more effective than placebo group
• Tennis elbow double-blind study using sham
  acupuncture showed greater tolerance of pain
  elbow use for treatment group

56
Others

• Success re treating insomnia but imagine
  practical problems here
• Some success in DB study treating dysmenorrhea
  with a 41 reduction in use of pain medication by
  treatm group
• Being used more now to alleviate pain of chronic
  fatigue ( fibromyalgia )
• Mixed results re treating headaches asthma
  widespread use in treating TMJ

57
Back Pain Acupuncture

• Western society fascinated by possible use of acu
  in LBP treatm
• All kinds of studies comparing acu with physical
  therapy, massage, chiro treatments
• In most studies, hier rate of effectiveness in
  PT, mass, chiro

58
Conclusions re Evidence ?

• Now working to standardize and do well
  administered studies
• Ex in US, acu needles now classed by FDA as
  legit medical device rather than experimental
  device
• Greater funding for res now in the West which
  should help
• Also, better acceptance of case studies vs DB
  controlled ones

59
(No Transcript)
60
(No Transcript)
61
(No Transcript)
62
Acupuncture in Canada

• Variety of institutes and colleges
• Most well known is Academy of Clinical Chinese
  Medicine of Toronto
• Also, Grant MacEwan College in Edmonton offers
  Prov government-sanctioned diploma program
• And, on West Coast

63
(No Transcript)
64
Standardization of Training

• 3 years to become certified acupuncturist
• 4 years to become TCM Practitioner
• 5 years to become Doctor of TCM
• Still up to cities to license and regulate TCM
  most provinces are pending but fully regulated in
  Alberta, BC and Quebec
• And, right here in London Ont is ..

65
(No Transcript)
66
Final Thoughts

• Typical CAM area
• Will never meet DB standards
• Need more longitudinal studies to mount evidence
• Viable alternative
• Tough to form decision basis for health consumer
  but note the commonization of acupuncture and
  herbs via web sites

67
Thursday Feb 2/06

• No Class !!!
• However Tues Feb 7 Dr Robert Dronyk, ND
• Instead of class, read
• Links Naturopathy Therapies
• Links Naturo Res Article
• Text chapter 12 re Homeopathy
• Links 1997 Meta Analysis re Homeopathic
  Effectiveness
• See main page of web site for link re yoga
  sessions starting Feb 6th