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A: >There are no specific points for raising body temperature. There are a number of reasons in Chinese medicine why the body as a whole might be cold or why specific parts of the body may be cold, but the nature of Chinese medicine is that the practitioner treats the person, not necessarily the symptom in itself. Although the practitioner might describe a patient as Yang Deficient, often manifesting in coldness, there are many different ways in which a Yang Deficiency can both manifest and be created. The choice of points would reflect the specific nature of the unique balance of the individual.

There are plentiful lists of 'cookbook' or formula acupuncture on the internet, and there are often generic points which might appear in many of the possible treatments for Yang Deficiency. We always have a concern, however, that used out of specific context these points may have no effect or no lasting effect, and although they are unlikely to cause any harm, our experience is that people tend to walk away from treatments which cause them transient adverse effects, and we believe that point recommendations without specific diagnosis are not to be trusted.

The best advice, if you are experiencing coldness, is to visit a BAcC member local to you and seek their advice from a brief face to face assessment. This will give you a much clearer idea of what may be possible than that which we can give you here.

Q:  Can you tell me how acupuncture can help with my neurological condition charcot marie tooth, otherwise kown as peripheral neuropathy

A:  The short answer, if we are truthful, is that we are not sure. Charcot Marie Tooth (CMT) is a herditary genetic disorder, and while acupuncture treatment may mitigate some of the symptoms which CMT sufferers experience, there is obviously a limit to what a treatment like acupuncture can achieve, unless one took the extraordinary and unsustainable position that as an energy treatment anything was possible.

From a Chinese medicine perspective the kinds of problems which a CMT sufferer experiences would be defined as weaknesses in the flow of energy, called 'qi', and their effects on the muscles and nerves in terms of conductivity and movement. In stroke treatment, for example, in China acupuncture is used as soon as possible after the CVA to reinstate flow where the qi is said to have been blocked, causing paralysis and loss of sensation. A similar principle would apply in looking at some of the manifestations of CMT, without the same rapid onset. The practitioner would be interested in establishing whether the problems were entirely local or whether they were indicative of woder problems in the system. However, with a genetic problem it may well be that the best to be achieved is getting worse slower, so one has to be realistic. That said, it is always important to bear in mind that when someone has a major disorder there is often a tendency to attribute every symptom to it, and we have come across cases where a symptom which may be generated by a condition has arisen contingently alongside it and been much more amenable to treatment than expected.

If you want to find examples of research into the use of acupuncture and peripheral neuropathy, the google search 'ncbi acupuncture peripheral neuropathy' will generate a number of hits for research studies which show encouraging results. However, peripheral neuropathy can have many different causes, and how universalisable these studies are is not that clear.

The best advice, if you are at all unsure about the best way to proceed, is to see if a BAcC member local to you is happy to give up al little time without charge to offer a face to face assessment of what acupuncture treatment may be able to do. Each patient is unique and different, and there may be evidence which on a brief examination may point you more clearly towards, or away from (!)), treatment.

Q: I have macular degeneration and I would like your opinion on the work of Dr. Lundgren and his Santa Fe protocol. Has no one followed this up in the U.K.? If I can obtain any reassurance I would certainly go to the States for treatment.

A: We have been asked about the treatment of macular degeneration before, and our most recent answer was:

We conducted a search and the best we could come up with

a study in Chinese which appears to demonstrate that acupuncture out-performs conventional medical treatment. Otherwise the only direct reference is a Cochrane Review summary which identifies the fact that there is a systematic review or similar on their files as pending

With conditions like this there are a number of difficulties involved in answering the 'does acupuncture work?' question. From a Chinese medicine perspective, although twenty patients may have the same named western condition there could be twenty different treatments. The symptom from this perspective is merely the weak link where an overall imbalance tips something into poor or degenerating function, and although local treatment could achieve some useful short term gains, helping to improve the underlying balance is the key to getting well and staying well. This involves treating the person as much as treating the disease.

Conditions like this can often become unintentional money pits, and it is easy to build up a treatment habit based more on hope than experience. Practitioners are often inclined to fall into the same trap in pursuit of better health for their patients. The best positive result one might achieve could be a decrease in the extent of deterioration, or as one patient put it once, 'do you know, I think I'm getting worse slower'. Of course, this is unverifiable and largely unmeasurable, but there is no doubt that many patients have reported anecdotally that they have exceeded the expectations of their clinicians in maintaining reasonable function longer than anticipated. Naturally there are a great many other factors which make this possible, not least of which is that seeking complementary treatment is itself evidence of a determination to do something which is probably reflected in someone's overall health.

From a Chinese medicine perspective the eyes as a functional unit have close relationships with two or three major Organs (capitalised to differentiate them from the western concept of an organ) and if there is evidence of a generalised weakness in relevant related Organic functions, a practitioner might think that there is some hope that treatment may be of value. There is also plenty of discussion in Chinese texts about local needling and its potential to halt or even slightly reverse decline.

We have to be realistic, though. The kind of deterioration which this condition causes is well-documented as likely to continue, and it would be a foolish practitioner who tried to instil too much optimism in a prospective patient about the chances of major improvement. However, it is always worth while talking to a BAcC member local to you, and we are sure that our members will be only to happy to give you advice on the basis of a brief face to face assessment.

We are aware of the work of the clinic you mention, as well as two or three similar clinics in India. However, we do not have enough independent corroboration of the results claimed to offer a view, although we have to say that the techniques in the Santa Fe Protocol are not traditional acupuncture. The use of ear acupuncture, electroacupuncture and scalp acupuncture are used by an increasing number of BAcC members, but are not within the mainstream traditional acupuncture training.

We are sorry not to be able to give you more positive advice, but it would be remiss of us to support something whose provenance we cannot check. The best we can offer by way of advice is that you try to find someone who has undergone the treatment with whom you can discuss their experience. In our experience American blog sites abound, and if someone has had a very good, or indeed very bad, experience, you are certain to be able to read about it and make contact.

Q:  My coctor told me I have tennis elbow. He offered no medication  but told me to apply Ibugel  which I have continued to do.  I am still in a lot of pain could acupuncture cure this and roughly how many sessions would it take.

A:Somewhat astonishingly we have realised that no-one has asked this question in the three years during which we have been providing this service. This runs counter to our clinical experience, where this is one of the more established reasons for seeking acupuncture treatment.

We do have a factsheet

which makes encouraging noises about the small number of studies which appear to demonstrate that acupuncture may be an effective way to treat the condition.The problem which bedevils some of the studies, and not just in studies of tennis elbow, is that many are Chinese and start from the premise that acupuncture works and are intended to establish what works best. This means that from a western medical point of view the studies are flawed as evidence on which one could base a recommendation.

However, our clinical experience is that this is a condition which responds quickly if it is going to respond. This particular expert tends to draw a line at three or occasionally four sessionbs if there has been no sustained improvement. There can sometimes be a few good days followed by a reversion to roughly status quo, and unless the point of return starts to creep upwards, it may be better to look at alternatives. That's about as far as we would commit on the number of treatments necessary, and it is best practice for many conditions to review progress after four or five sessions to see whether there has been sustained improvement. For this extremely clear outcome measures are necessary.

The best advice we can offer, and we do for many problems, is to visit a BAcC member local to you for a brief face to face assessment. This will give you a really clear idea of what might be possible, and will enable the practitioner to have a quick look at the wider picture to see what else, if anything, may be hindering the natural process of healing.

There may be one or two activities you will be asked to avoid while the elboe recovers, though. Especially tennis!

Q:  Can acupuncture help relieve symptoms of painful bladder syndrome / interstitial cystitis?

A: Rather surprisingly, there is very little research into this problem. This came as something of a surprise to us because we have colleagues who have made this an area of special interest for a number of years, and we had assumed that this would have been evidence of a more general interest in researching this problem. The most recent study we could find

is typical of many areas of research, where what is available is an extended case report which is suggestive of benefit but a long way short of the standards of proof accepted in the West for claims of efficacy.

However, this does not mean that Chinese medicine has nothing to offer. Problems like this are not modern inventions, and there are a number of recognised syndromes within one of the prevailing styles of Chinese acupuncture which address the problem directly. However, it has to be said that the underlying premise of traditional Chinese medicine is that it treats the person, not the disease, and the practitioner will be interested in seeing the overall pictuire, the backdrop against which the problem developed. This is why, to much puzzlement in the West, the same named condition in twenty people might be treated in twenty entirely different ways. Symptoms are not necessarily the same as the disease, but usually regarded only as evidence that the system as a whole is out of balance.

The main issue with problems such as interstitial cystitis is that they can have good and bad patches, and if someone does decide to have treatment it can be difficult on occasion to work out whether a good run is just simply a good run or whether the treatment is working. Outcome measures are important, but so is regular review of progress and also careful consideration of whether a good patch is down to treatment or not. We have seen a number of case over the years where progress has been written off as 'just a random good run' where practitioners have been less careful about agreeing reliable outcome measures, and this is an opportunity missed.

The best advice we can give, though, is to visit a BAcC member local to you to see whether in their view there is something to be done for you. We are confident that in many cases there will be some positive change but the unknown factor is how much and how sustainable the change is.

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