Module 3 ~ Traditional Medicine: ‘Ancient

Systems’Ayurvedic and Traditional

Chinese Medicine

Ayuvedic Medicine

• ‘ayurvedic’ means the science of life & longevity

• Comprehensive system combines natural therapies [ herbs, diet, ex ] with a prof approach to treatment

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

?

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

Ayurvedic Questions

• Ayurv physician asks• NOT, ‘What disease does my

client have’ ? BUT. . .

• ‘Who is my client ’ ?• Holistic then, not reductionistic

Balance in Ayurvedic

3 doshas energies

Vata or thin

Pitta or muscul

Kaphalarge

Body Thin, delicate

Medium Hvyset

Mind Hyperact

OrderlyPerfecist

relaxed

Soul Intuitive

Loving & passion8

forgiving

The Energies & bodily functions :

Doshas Vata ( Ecto )

Pitta ( Meso )

Kapha ( Endo )

Bodily Function

Eats & sleeps ConstipCramps

Loves foodUlcers, hrtburn,

Eats slowly

AllergiesHi chol

** see effects of tastes on the 3 doshas p. 223

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

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

The Elements& doshas& whererep in the body

K

P

V

Ayurvedic

Tongue

Diagnosis

Areas

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

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

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

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

Ayur Treatment : Step 3

• Rejuvenation is basically body/mind/spirit tune-up thru

• Herbal treatments• Mineral preparations suited to

affected dosha• Yoga exercises

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

Cdn AidsTreatmentInfo Exchange

[ A public Health Agency of Canada web site ]

Ayurvedic-based treatments

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

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

http://www.mokshayogalondon.com/

We need to pick aweek…Feb 6 or Feb 13

multiple levels of disease ~ multiple levels of interventionS

Asian Culture

The Great Wall of China

Cdn MedicalAcupunctureSociety

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

TCM – Fundamental Concepts

• Philosophy of TCM tied to yin & yang• Y&Y as paired opposites w equilibrium

the quest• Male/Female; Heaven/Earth; lite/dark all

as ‘energies’ in human system and in our environment

HEADACHES

LI 4Half way along the second metacarpal

DISAPPEARING TENSION

(Small Intestine 12)

SI 12

INSOMNIA

SPLEEN 6

just above tip of medial malleolus, behind the tibia.

SORE THROAT

Lung 11

EXAM ANXIETY

Heart 7

First skin crease

Thumb side of tendon at crease.

What does Acupuncture treat

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

• Balance restoration is key

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

What’s 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

Body’s energy meridians & centers

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

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

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

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

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

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

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

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

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…

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 ..

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

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 ***