Articles (scroll down the page):

  • Understanding our emotions and how they manifest in the body

  • Depression and effect of the emotions on the body and soul

  • Stress manifestation and relation to the gallbladder organ

  • Cupping

  • Treating headache and migraine with acupuncture, TCM massage and food adjustments

Understanding our emotions and how they manifest in the body


 

Emotions are mental stimuli that influence our everyday lives. Under normal circumstances, they are not a cause of an illness but if they go 'wrong' they're considered as one of the major internal causes of disease in Traditional Chinese Medicine (TCM).

While Western Medicine tends to stress the psychological aspects of psychosomatic ailments, the pathological damage to the internal organs is very real indeed and is of a very primary concern, when a client enters the treatment room of a TCM therapist with such a complaint. It's well known and experienced that excess emotional activity causes severe energy imbalances, blockages and organ impairments.

Hardly any human being can avoid being angry, sad, worried or afraid sometimes. It is important to realize that one should not fully identify one’s mental and spiritual life with that of the emotional life, as the latter can be so transient. It is also worth mentioning that it is perfectly possible to be alive and lively without being overburdened by excessive emotions.

Emotions only become a cause of disease when they're excessive, prolonged or both as mentioned above. Although they're a definite cause of it, they also have a healthy counterpart. The same mental energy that produces and 'nurtures' excessive emotions can be used and directed towards creative and fulfilling aims. Each emotion as a cause of a disease is only one side of the coin. The other side is a mental energy that pertains to the relevant organ, be it the liver, gallbladder, spleen, stomach, pancreas, kidney, bladder, heart, small intestine, large intestine and lungs. For example the same mental and affective qualities of the liver, which may give rise to anger and resentment over many years, can be harnessed and used for very creative mental development, because a healthy liver/gallbladder network’s functions manifest in a good balance of firmness and flexibility, assertiveness, decisiveness, creativity and commitment to growth and development.

In TCM, excessive emotions act as stimuli, which disturb the Mind and Soul, alter the balance of the internal organs and the harmony of Qi (energy) and Blood, which can be a cause of disease. For this reason, emotional stress is an internal cause of the illness that injures the organs directly. On the other hand, and this is very important, the state of the internal organs can affect our emotional state.

Furthermore, all emotions, besides affecting the relevant organ directly, affect the heart indirectly because the heart houses the Mind. Our hearts can recognize and feel the effect of emotional tension.


 

Let's discuss the effects of each emotion individually:
 

  • GRIEF + DEPRESSION/SADNESS

Grief is the emotion of the lungs and the large intestine, organs associated with the metal element. Loss of any kind will often trigger a feeling of being energetically drained and of having difficult bowel function. Grief can stay with us for a while, and can go unresolved until we decide to release it. When grief is unresolved and becomes chronic, depression and an inability to ‘let go’ of things can arise from this lung energy deficiency. This could eventually interfere with lung function and oxygen circulation. Since our lungs control the flow of energy in our bodies, it’s important that we give ourselves space to deal with painful events rather than stifling them.


 

  • FEAR + FRIGHT

Fear is the emotion of the kidneys and the bladder, organs associated with the water element. It is a normal adaptive emotion, but can become chronic when ignored. Kidney issues often arise when we are dealing with fear, such as a change in life direction or unstable living conditions. When we experience extreme fright, our kidneys struggle to hold the energy and we can quite literally pee our pants.


 

  • WORRY/PENSIVENESS + OVERTHINKING

Worry is the emotion of the spleen/stomach/pancreas network, organs associated with the earth element. Too much pensiveness, worrying and insecurity can weaken our ability to digest – simply knot the energy. When we are worried to a state of anxiety, we find it hard to digest and accept a situation or life event. Lack of trust and ease towards the experiences and the foods we take in to our lives will make it impossible for us to digest them. This can make us feel tired, lethargic, and unable to concentrate. Also here's a bit of a paradox - too much mental stimulation can actually cause mental heaviness, the same as overwork. A week spleen can also be the cause of stubborn weight problems.


 

  • ANGER/FRUSTRATION + DEPRESSION (MANIC)

Anger is the emotion of the liver and the gallbladder, organs associated with the wood element. Emotions like rage, fury or aggravation can indicate that this energy is in excess, and when we experience these emotions consistently, our liver can get damaged. At this point, headaches or dizziness can be common. An imbalanced liver and gallbladder can be caused by longstanding feelings of repressed anger, such as resentment, frustration, and irritability. Also, as the same with other organs, imbalance can be caused by a poor diet, body pollutants such as chemicals, drugs and moulds etc.

Avoiding outbursts of anger will protect liver and gallbladder health. There's also an interesting pattern related to stagnation of liver energy which manifests in mood swings or manic-depressive states. When the energy doesn't move, one can feel low and when under certain circumstances the energy moves or releases, it can turn into a manic state.


 

  • HAPPINESS/JOY + MANIA

Joy is the emotion of the heart and the small intestine, organs associated with the fire element. When we experience true joy and happiness, we are nourishing our heart and small intestine energy. We feel mentally clear and able to process experiences. When we are lacking joy in our lives, the heart suffers and we can feel stuck, mentally chaotic, and have difficulty sleeping. Mania or obsessive joy can indicate an excess of scattered heart energy, and can be the cause of severe mental emotional disorders. Over stimulated heart energy could also cause agitation, insomnia and palpitations. In other words, even the pleasurable emotions can be out of balance.


 

  • ANXIETY

There are 4 origins of anxiety according to TCM:

1: If related to the lungs and large intestine, energy blockage can provoke shallow and irregular breathing or even holding of breath. The large intestine can be detrimentally affected by anxiety, making one more prone to issues like ulcerative colitis and IBS.

2: Kidney and bladder issues could also be at the root of this emotion. Our adrenals regulate our stress response and when adrenal problems become chronic, they can cause anxiety. TCM recognizes the adrenal glands in the same way as the kidneys as they are within the kidney yang aspect. Anxiety can also be caused by disharmony between the kidneys and a blazing heart fire, in this case rapid heart palpitations are experienced.

3: Anxiety can stem from liver imbalance too, when longstanding anger and irritation goes unresolved. In this case anxiety manifests as nervous tension, irritability, and insomnia.

4: Anxiety from excess worry and pensiveness stems from spleen and stomach imbalance. This can cause stomach swelling and bloating after eating.


 

It is very important to know what actually happens inside the body and which issues are affecting our nervous system and vice versa. We can help ourselves by understanding our own mind/body connection, so as to clearly recognize the purpose and reality of our life and our own placement in the world. This knowledge should be given the highest priority, so that we are able to maintain a place or path where we are destined and determined, thus being able to fulfil our own potential and not struggle in life.

Appropriate consultation, correct diagnosis, reasonable attitude towards ones issues and then acupuncture treatment and dietary suggestions may help us to understand, balance and/or adjust the emotions that we are dealing with in our lives.

References:

Depression and effect of the emotions on the body and soul

 

 

My experience of treating depressed patients is that initially the client rarely recognizes the feelings of hopeless despair or hidden resentment and anger that underlie their symptoms, and that at some point in the treatment it is necessary to acknowledge and express these feelings.

 

Biological and social constraints work against the emotional interests; one may withhold their feelings from health practitioners for fear of appearing needy. Attentive and prudent consultation with a tailored acupuncture treatment and nutritional advice allow the patient the tranquility needed to properly process and transform these 'pathogenic' influences. The connection felt with the practitioner enables the patient to feel supported during the process, and if necessary seek additional help from other health professionals.

 

In general, women are twice as likely as men to seek help for depression, but men are four times as likely to kill themselves, whilst male psychiatric patients outnumber women. The violent crime rate is soaring (for most of this violence men are both the perpetrators and the victims), and men are much more likely to experience addiction disorders, especially substance abuse. There is also a hidden cost to society in terms of lost productivity, divorce, one parent families and violence. This makes depression a public health issue.

 

Recent research has revealed that men are more likely to recognize feelings of stress rather than depression, are likely to avoid people when stressed and are less likely to seek help from doctors. However, the problem may be as well compounded by the clinician’s failure to respond to the cries for help, because of cultural or social expectations.

 

The nature of a depressive episode depends to some extent on the era during which one experienced its original or greatest life-defeat. Depression is largely a self-help manouevre, an expression of 'being' alternative to the one that failed in the normal course of the growth at some stage in the life. At the same time, it is a form of mourning throughout the life cycle for part of the 'self' which is spiritually and/or physically struggling from a repression. Chronic depression is one response to the persistent failure of any personality organisation to fulfill its own expectations.

 

Life, on the other hand, has another agenda. It is perforce a growth process which, despite periodic strategic retreats, is basically expansive. Depressions therefore tend to be short lived.

 

Apart from developmental considerations, depression may result at any time there is a profound loss of energy (after illness, labour, severe blood loss or even just a seasonal exposure to the cold when the body is not able to cope with it), inappropriate diet or drug abuse. It is often (but not always) accompanied with severe fatigue, apathy, inability to concentrate and/or perform everyday tasks, aversion to cold, physical weakness, insomnia, anxiety or anger.

 

When faced with something exasperating, one should calmly consider which is more important, inappropriate state of mind or health. This comparison will enable one to gradually eliminate it. Either seeking for help or advice or the ability to adjust one's own physical functions and/or emotions.

 

Emotions are mental stimuli that influence our affective life. Under normal circumstances, they are not a cause of a disease. Hardly any human being can avoid being sad, worried, angry, afraid or angry sometimes. Emotions become causes of a problem only when they are excessive, prolonged or both. Although emotions are a definite cause of disease, they also have a healthy counterpart. The same mental energy that produces and 'nurtures' excessive emotions, can be used and directed towards creative and fulfilling aims. The answer usually lies in an appropriate balance of body and mind which work in such a conjunction.

 

Depression is not simply a shopping list of items (loss of appetite, poor sleep, etc.) which make up the clinical definition but usually a complex problem which spreads across all areas of someone's life, and probably means that they are going to need more than one form of support.

 

The advantage that acupuncture has is that Chinese medicine is very clear about the interaction of body mind and spirit, and sees the functions of the organs as operating on all levels. When a patient visits a practitioner, therefore, and describes a complex array of symptoms, physical, mental and emotional, from a Chinese medicine perspective these can often make sense and offer treatment possibilities as a whole, rather than requiring a tablet for x, another tablet for y, and perhaps counselling and psychotherapy.

 

References:

  • JOURNAL OF CHINESE MEDICINE NUMBER 71 FEBRUARY 2003

  • JOURNAL OF CHINESE MEDICINE NUMBER 43 SEPTEMBER 1993

  • Leon Hammer – Dragon Rises, Red Bird Flies (Psychology and TCM); Station Hill Press New York; 1990

  • David J. Kuoch – Acupuncture Desk Reference; Acumedwes Inc. San Francisco; 2009

  • Joerg Kastner – Dietetics in TCM (Chinese Nutrition Therapy) 2nd edition; Thieme New York; 2009

Stress manifestation and relation to the gallbladder organ 

n modern society, intense competition, time-pressure, difficult relationships and unharmonious family life have become the main causative factors for the high incidence of stress syndromes. This “stress” is a psychological problem which causes also physical response manifesting as muscle tension along the sinew channel and primary Gall Bladder channel. The reason for this lies in the functions of the Gall Bladder as seen from a TCM perspective.

 

The Gall Bladder is seen to have an important role in mental activities and is the main organ involved in stress syndromes. If a state of mental stress goes unrelieved for a long time, increased muscle tension can cause headache and stiffness and pain of the neck-shoulder, which in turn

aggravates stress. This vicious circle has also been observed in western medicine, where psychological factors are viewed as the main causes of muscle tension causing headache and neck pain. When Gall Bladder energy is strong, the Gall Bladder will have a strong power over decision-making. Without this strength, people are unable to adjust to the pressures of modern life and overcome the effects of the unexpected traumas or stressors in their lives.

 

 

Symptoms:

 

• mental stress

• fatigue

• attention deficit disorders

• irritability

• shallow breathing

• gastro-intestinal disorders

• anxiety, fear and insomnia

• chronic facial pain

• migraine headache

• pain of the neck and shoulder, sometimes pain over the whole left or right side of the body.

• muscle tension or sometimes even strip-like muscular nodules can be felt, usually around points such as Qubin GB-7, Fengchi GB-20, Wangu GB-12, Jianjing GB-21 (head and shoulder area).

• patients sometimes complain of a suffocating sensation during the night because of the persistent muscle tension in the neck.

 

The purpose of the treatment is to remove energy stagnation from the organs (liver and gallbladder) and channels to relax tendons, relieve muscle tension and alleviate mental stress and depression.

 

Main acupuncture point used for stress: Yanglingquan GB-34

GB-34 is needled first as a distal point in order to direct the energy down from the upper part of the body where the main symptoms are located. Generally speaking, this point has a strong effect in regulating the Gall Bladder, relaxing muscle tension and relieving stress. Modern scientific research shows that needling GB-34 can not only cause the contraction of the gallbladder organ and promote the secretion of the bile, but can also increase the concentration of gamma-aminobutyric acid (GABA) in the cerebrospinal fluid, thereby relieving spasm. This finding coincides with western medical protocols where “stress” is treated by administration of GABA. GABA is an amino acid which acts as a neurotransmitter in the central nervous system. It is essential for brain metabolism, aiding in proper brain function and prevents anxiety- and stress-related messages from reaching the motor centres of the brain by occupying their receptor sites. GABA is also effective in treating attention deficit disorders. While needling GB-34 is similar in function to the administration of GABA, acupuncture therapy could be viewed as a safer alternative as it stimulates the body’s own natural production of the amino acid.

Cupping

 

There is no idea when cupping first began. It is mentioned in the writing of Hippocrates and was practiced by the Greeks in the fourth century B.C. It was probably known and used by other nations as well. The earliest instrument used was a gourd. In the primitive regions of the world cupping has been practised for thousands of years, and it can still be seen in these parts in its earliest form. The American Indians use the upper end of a buffalo horn about two and a half inches in length with a hole at the tip, through which a vacuum can be produced by suction and which can afterwards be plugged. The medicine men can make a very successful job of cupping for extracting the poison from snake bites and for relieving pain and cramp in the abdomen.

 

Cupping was widely used by most of the best physicians. Hippocrates seems to have used both, dry (cup drawn to the skin) and wet cupping (letting blood out with a cup put on the small cut in the skin), in the main to treat menstrual disorders. Avicenna preferred wet cupping, reserving dry cupping for cold swellings, and whenever cups were to be moved about in various places. He advised cupping as follows: to the nape of the neck in heaviness of the eyelids, itch of the eyes, tremor of the head and lesions of the teeth, ears, nose, throat and face;....under the chin for toothache, sore throat and to cleanse the head and jaws;....between the shoulder-blades for pains in the upper arms and throat and to relax the cardiac orifice of the stomach;....over the loins for scabies, pustules, gout, piles, bladder, kidney and uterine lesions and for inflammatory masses in the upper part of the thigh etc.

 

Cupping may be used by massage and other tactile therapists - integrated to suit their particular technique. It can be used independently or in conjunction with acupuncture (while the needles are in position or following their removal), although cups are most frequently used on their own.

 

During cupping, a therapist is putting a flammable substance such as alcohol, herbs, or paper in a cup and set it on fire. Or simply just a cotton ball locked by surgical forceps and soaked in surgical spirit. As the fire goes out, he puts the cup upside down on your skin – the vacuum is already created by burning of the oxygen. This causes your skin to rise and redden as your blood vessels expand.

Where cupping is done for the first time, there will be nearly always be a bruise mark at the site of application, the degree of bruising depending on the strength of cupping. In any case it will fade away in a week or less. Summer holiday months are not the best time for cupping, as patients will not be pleased when having to explain unsightly bruises on exposed skin. When cupping is applied to the same area for a second time, bruises are much reduced, and are even lighter at the third and subsequent applications until they disappear totally as the stagnation in the affected area disappears and the flow of blood and energy is regulated.

 

It is very safe for children over three years of age. The reason for this age limit is the fact that the skin of a child under three years old is very susceptible to blisters and bruises. Children generally prefer cupping to acupuncture, although some children are petrified of fire, so extra care to relax them before treatment is needed.

 

Strong cupping is avoided on the abdomen and stomach. Cups are not applied over scaly or burned skin. During pregnancy are cups restricted to the abdominal or stomach regions, back points, especially the lower back. Otherwise cupping can be used with safety up to the seventh month of pregnancy.

 

 

The Eight Methods of Cupping 

 

There are eight different methods of cupping: Weak, Medium, Strong, Moving, Needle Cupping, Moxa Cupping, Empty cupping, and Full (Wet) cupping.

 

  • Weak Cupping: this is done with minimum suction, just enough to hold the cup in place. Cups are normally left for 10-20 minutes in adults and 2-5 minutes in children, but in weak cupping they can be kept in place for a longer period if needed. Weak cupping should not induce bruising or any sensation of pulling.

 

  • Medium Cupping: the suction is firmer, and the skin rises just a little inside the cup. This method is suitable for children between seven and fourteen years of age. Medium cupping can also be applied to adults on the stomach and abdomen. Very little bruising will appear even if the cups are left for a long time.

 

  • Strong Cupping: it is used on people who have experienced medium strength cupping previously, so that they know what to expect. Whenever strong cupping is used for the first time, it is advised not to leave the cups in place for more than 3-5 minutes, It is not suitable for children and weak or elderly patients. It causes bruising very rapidly and drains the energy if the cups are left for a long time. It is mainly applied on the back, shoulders and knees.

 

  • Moving Cupping: the most painful method of cupping. It is done by moving the cups while they are in place on the skin. It is mostly used in excess heat conditions, and only on strong adults. Whether the suction applied is medium or strong, movement of the cups while in place will be uncomfortable to say the least. Before attempting the moving method, it is essential to make sure that enough oil has been used on the desired area. Rest is allowed between the sliding movements. The most common area of application is the back. The purpose of moving cupping is to draw out pathogenic heat and regulate the flow of blood. This will cause bruising very rapidly, which is the desired effect, indicating heat coming to the surface. It will be noticed that, as treatment progresses, less bruising will appear in subsequent sessions.

 

  • Needle Cupping: cups can be applied over needles,whilst the needles are in the desired position. This method is used in excess conditions, e.g. red, painful and swollen knees and shoulders.

 

  • Moxa Cupping: moxa (smoking dried mugwort herb) is placed on the needle in the normal way for warm-needle technique, and lit. As soon as the moxa has stopped smoking, and while it is still very hot, cup is placed over the needle. This method is used for tonifying and moving the energy.

 

  • Empty Cupping: this is actually a strong cupping method, but the duration of the suction is very short, i.e. less than one minute. This method is very effective when the effect of “drawing out cold” is desired, especially on weak patients, since it does not drain the energy excessively.

 

  • Full (Wet) Cupping: In the 1830’s when antibiotics were unknown in England, this was the method used to draw out and eliminate poisons and infections from the body. The bleeding method is only used when excess 'Blood-Heat' is involved. A small cut is made - usually in the upper part of the body - and the cup is placed over the cut. The vacuum created will draw blood into the cup which will fill rapidly. In Turkish folk medicine this bleeding method was used when a sudden rise in blood pressure endangered life. The bleeding method should be used with caution and not more than once a month. Not applied on children or patients with weak constitution. Careful sterile technique is essential both during and after the treatment.

 

 

 

Cupping regulates the flow of energy and blood, and can add strength and effectiveness to many therapeutic applications. It is particularly beneficial in the following situations:

 

  • Respiratory system diseases

Sliding cupping over the upper back can treat influenza, fever and cough etc.

 

  • Digestive system diseases

Due to its regulating function on the energy of the Spleen, Stomach, Liver and Gall Bladder, this method can treat such disorders as chronic gastritis, gastrointestinal diseases, indigestion in children, infantile malnutrition or for weakness of the digestive system (poor appetite, diarrhoea and dull ache in the lower abdomen)

 

  • Diseases of the five sense organs

This method can treat facial acne, congestion, swelling and pain of the eyes, sore throat, deafness and tinnitus etc. Fire is an excess pathogenic factor characterized by upward movement,

and five-sense organ diseases are mainly due to excess fire of the body, moving and burning upwards to disturb the upper orifices.

 

  • Lumbar and back pain

Lumbar pain is mostly caused by invasion of wind-cold, damp or strain. This therapy can be used to eliminate pathogens and regulate the channels. Treatment should mostly focus on the local area.

 

  • To draw out pathogenic dampness, especially from arthritic joints

  • Tendonitis

  • Asthmatic conditions

  • Energy and blood stagnation

  • Poor circulation

  • Infertility

  • Insomnia

 

References:

  • Jarrett, L. S. (2003). The Clinical Practice of Chinese Medicine. Stockbridge, MA, USA: Spirit Path Press.

  • Maciocia, G. (2005). The Foundantions of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Second Edition (2nd ed.). USA: Churchill Livingstone.

  • JOURNAL OF CHINESE MEDICINE NUMBER 67 OCTOBER 2001: CLINICAL APPLICATION SLIDING CUPPING by Zhang Hong

  • JOURNAL OF CHINESE MEDICINE NUMBER 37 SEPTEMBER 1991: PRACTICAL GUIDE T0 CUPPING THERAPY by Ilkay Chirali

  • JOURNAL OF CHINESE MEDICINE NUMBER 21 MAY 1986: THE ANCIENT ART OF CUPPING By William Brockbank MA MD FRCP

Treating headache and migraine with acupuncture, TCM massage and food adjustments

 

Headaches are one of the commonest afflictions of mankind, and there are few people who have not suffered from one at some time in their life. Many have such continuous headaches and migraines and they still do not tell the health practitioner that they have one or/and they're stuffing themselves with painkillers or/and anti-depressants.

 

The main concern is a classification and diagnosis of headaches according to:

  • location

  • type of sensation

  • differentiation of syndromes

  • aggravations

1. Classification according to location:

This is perhaps the most important classification for an acupuncture practitioner, for the different parts of the head are nourished by different channels. At the most basic level, diagnosis of the affected channel is sufficient for prescribing a treatment. Points along the meridian should be selected.

 

  • Vertex (top of the head)

This area relates to the liver, via an internal channel. Other conditions which may affect this area are conditions Du channel (going through the spine) blood deficiency.

 

  • Whole head (cranium)

Headaches affecting the whole of the cranium are usually of a 'empty' (deficiency) type, and are correspondingly weak in nature. The causes of this type are the same as those for the vertex – blood deficiency plus it could be qi (energy) or heart deficiency. There is another weak headache which affects the whole cranium, and this is due to insufficiency of kidney essence as it nourishes the brain. Less common whole head headaches are full nature and also affecting the whole cranium. These are due to external wind (flu, infections) which primarily attacks the upper, and of course the most exposed parts of the body. These headaches will be very strong and painful.

 

  • Both sides

These are usually temporal headaches, but occasionally involve bilateral pain along the gallbladder channel. Bilateral headaches are related to the liver (closely related to a gallbladder). Usually these headaches are due to liver yang rising', they're 'full' (excess) type, and are often accompanied by high blood pressure and stress.

 

  • One side (hemicranial)

Usually located at points of the gallbladder channel or along the whole channel in the head (mostly sides). This is perhaps one of the commonest types of headache, and of course is due to a disturbance of the gallbladder channel. It is more true of pains that appear on one side of the forehead. Common factors are liver yang rising, wind, stagnation of liver qi due to nervousness, and stomach heat but it could be also stomach, spleen or blood deficiency.

 

  • Front (forehead)

Frontal headaches are related to the stomach organ. This is truly weak stomach condition but also applies to full heat in the stomach. The front of the head can easily be attacked by wind, giving rise to full type headaches and it may also be affected by problems of the nose and sinus.

 

  • Back (occiput)

This usually relates to the bladder channel, or the Du channel which both pass over this area. The commonest cause is attack of external wind and cold. It can also be due to pain referred up from the neck

 

2. Classification according to sensation:

Generally speaking there are only two causes of pain in TCM. A strong pain is due to obstruction of qi (energy) and a weak pain to malnourishment of an area of the body by qi, blood or the essence. Of course the reasons for obstruction of qi and lack of nourishment are as varied as life itself, but this simple principle should always be borne in mind. It is one of the reasons why acupuncture is so successful in controlling pain -the main function of the needle is to move the qi in the channel, thus clearing any blockage or bringing qi to an undernourished part.

 

  • Dull and heavy

This sensation is usually due to a deficiency condition – blood, qi or essence even though some people are describing it as dull, heavy and full. The dull pain

arises because there is not enough qi to nourish the affected part. The dull, heavy sensation can also come from dampness in which case it really is a full condition.

The dampness does not obstruct the qi, but retards it and so prevents proper nourishment of the head. The heaviness is because damp is a heavy and sinking pathogenic factor. A person suffering from attack of pathogenic damp may describe the sensation as like "having a towel round the head" or "being surrounded by cotton wool".

 

  • Full and bursting

This comes from a full syndrome and is usually due to liver yang rising, or full heat in a high fever.

 

  • Tight, boring

This is due to obstruction or stagnation of energy, usually liver - the organ having failed in its function of ensuring the free-flow of energy. It may also be due to wind, especially wind-cold, which causes obstruction. Usually migraines are of this type.

 

  • Variable

A variable pain is due to local stagnation of energy. When the qi is strong, it flows freely. When weak, the qi slows down and the area is not properly nourished, giving rise to pain. The causes of retardation of energy include trauma, and incomplete cure of attack of external pathogenic wind (flu, cold etc.)

 

  • Continuous

A continuous unvarying pain is usually associated with blood stasis.

 

  • Needle-like pain

Due to long term qi obstruction, or prolonged pain. Prolonged pain anywhere in the body can lead to obstruction of blood in the channels.

 

3. Classification by internal condition:

Proper analysis and arriving of accurate diagnosis is the most important for those using TCM tools (acupuncture, tuina massage, cupping, herbs or nutrition advice). The symptoms and signs are of course not exhaustive, but are provided to give a thumbnail sketch of the syndrome.

 

 

 

CLINICAL MANIFESTATIONS ACCORDING TO DIFFERENTIATION OF SYNDROMES (not all of the accompanied symptoms are appearing + tongue and pulse is also examined to determine the correct diagnosis):

 

Internal 'full' conditions:

 

  • Liver yang:

Headache on either side, dizziness, visual disturbance, seeing stars, bright light sensitivity, nausea, restlessness, insomnia.

 

  • Stomach heat:

Bad breath, mouth ulcers, constipation, dark urine.

 

  • Cold obstruction:

Headache on top or forehead and feeling cool there. Wind sensitivity, desire to cover head to sleep, often vomiting clear sticky fluid, four limbs cold.

 

  • Phlegm:

Dizzy sensation in head, chest and abdomen full and stuffy, vomiting.

 

  • Blood stasis:

Headache like needle stabbing, area of pain fixed, pain not relieved by heat or cold, pain stronger at night.

 

Internal 'empty' (deficient) conditions:

 

  • Qi (energy) deficiency:

Headache persistent and mild, aggravated by work, fatigue or letargy, no strength, body tired, lazy speech, poor appetite.

 

  • Blood deficiency:

Headache with dizziness and vertigo, being easily frightened, bright white colour of the face, pale lips.

 

  • Kidney deficiency:

Headache with feeling of emptiness in head, vertigo, tinnitus; loins, back and knees sore and weak, body without strength, nocturnal emission.

 

External conditions:

 

  • Wind cold:

At first person looks cold and has distending sensation in head; gradually ache appears making back of neck stiff like a board; aversion to wind, and often likes to wear a scarf on the head.

 

  • Wind heat and summer heat:

Distending pain of whole skull, person feels hot and as though skull will burst, face red, thirst with desire to drink, fever.

 

 

Analysis of liver yang type of headache:

 

-Aetiology:

Liver yin (yin is simply understood as coolness or moisture) is insufficient so it cannot balance yang (understood as heat or moving energy) so liver yang rises strongly. Pain appears in the head because liver energy rises to the head causing fullness and obstruction - usually one or both sides because the liver and gallbladder have an internal-external relation and the gallbladder channel goes to the temples. One can possibly see stars and has other visual disturbances because liver yin is insufficient to nourish the eyes. Rebellious liver energy rises impairing the descending function of the stomach, resulting in nausea.

Liver heat also gives rise to the heart fire resulting in restlessness and insomnia.

 

-Aggravation and amelioration

What makes pains worse is at the core of TCM, and is closely related to the differentiation of syndromes according to the organs. In all diagnostic work, this is an important step. Headaches are no exception. Most of this section could apply to pain in any part of the body.

a) Time of day:

 

-Worse in the morning

 

  • Empty type:

This may be due to energy or blood deficiency. Usually of a dull nature, the energy deficiency type is all right while the person lies in bed, but appears when gets up. When moves around and gets the circulation going, it may be relieved, but quickly gets worse when one tries to work. The blood deficiency type is worse while the person lies in bed, as the blood returns to the liver.

  • Full type:

This is due to retardation of liver energy or due to damp. First one arises because the qi slows down while the person is at rest. As one moves around, the headache gradually subsides as the qi circulation gets going. If due to damp the headache arises because the damp flows more easily to the head when lying down. As the person sits up, dizziness can appear but after an hour or so some of the damp will have drained away from the head and one feels better.

 

-Worse in the afternoon

  • Empty type:

It is usually thought of as yin deficiency - especially if the headache gradually gets worse into the evening. If the headache gets worse when the person does physical work, but is relieved when sits down after work, this is a clear indication of energy deficiency.

 

  • Full type

This is usually due to stagnation (retardation) of liver energy and is usually to be found with tense and nervous people. As the day progresses they become more and more tense, and the headache becomes more severe. At night time they relax and the headache subsides. In severe cases there may be liver yin deficiency and liver yang rising.

 

 

b) Weather:

Many conditions are aggravated by certain kinds of weather. Usually the internal condition is named after the kind of weather that aggravates it:

 

  • Worse in Damp

 

  • Worse in Heat

Hot condition - internal or external heat or yin deficiency empty heat.

 

  • Worse in Cold

Cold condition - internal or external cold or yang deficiency cold.

 

  • Worse in Damp

Internal damp, or attack of pathogenic damp. May also be due to spleen deficiency (spleen too weak to transform the dampness or too overhelmed by 'dampening' food).

 

  • Worse in change of weather

TCM abounds in discussion of conditions which are aggravated by change of weather, which to those accustomed to an English climate is mystifying. In many parts of the world, the climate will often stay set for days or weeks at a time and when the weather changes, many people experience discomfort. However, the English weather is very changeable actually and people are not adapting according to it. This condition is then also an indication of stagnation of liver energy, can be aggravated by the weather characteristic of storms, and when a meteorological front is passing over. It is also aggravated in any condition where there is an abundance of positive ions – in large cities, centrally heated buildings, smoke-filled rooms etc.

 

 

c) Life conditions:

 

  • Worse with movement and physical activity

Usually qi or blood deficiency - the weak condition is made weaker by the activity.

 

  • Better with movement and physical activity

Stagnation of qi - may be due to stagnation of liver energy, or due to some trauma causing local stagnation. The physical activity encourages the circulation of qi and so reduces the pain.

 

  • Worse with tension and emotional strain

Stagnation of liver energy - repression of emotions is one of the main causes for stagnation of liver.

 

  • Better with tension and stressful conditions

Energy deficiency – the person is normally deficient but in an exciting or demanding situation can summon up reserves of energy. While the stimulation is there the energy flows but when the stimulation is removed, the person could collapse.

 

  • Worse after eating

One would expect conditions worse after eating to be due to a stomach full condition. In reality a stomach 'full' heat condition is not usually aggravated by eating in general, but only by eating heating foods (spices, red meat etc.). Aggravation after eating is more commonly a sign of spleen deficiency.

 

  • Worse after eating heating foods

An indication of a hot condition. This may be stomach or liver heat, or liver fire.

 

 

d) Menstrual cycle

 

  • Worse before the menstrual cycle

It's a full condition - usually stagnation of liver energy, or liver yang rising.

 

  • Worse during the menstrual cycle

Stagnation of blood and energy

 

  • Worse after the menstrual cycle

Empty condition - usually blood or kidney deficiency.

 

 

Other types of headaches:

  • due to eye disorders

  • due to rhinitis, sinusitis etc

  • too much sunlight

  • histamine-rich foods (fermented alcoholic beverages, especially wine, champagne and beer; fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc.; vinegar-containing foods: pickles, mayonnaise, olives; cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs; soured foods: sour cream, sour milk, buttermilk, soured bread, etc.; dried fruit: apricots, prunes, dates, figs, raisins; most citrus fruits; aged cheese including goat cheese; nuts: walnuts, cashews, and peanuts; vegetables: avocados, eggplant, spinach, and tomatoes; smoked and canned fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines)

  • histamine releasing foods (alcohol, bananas, chocolate, cow’s milk, nuts, papaya, pineapple, shellfish, strawberries, tomatoes, wheatgerm, many artificial preservatives and dyes)

 

 

Effect of a massage and acupuncture:

Empty types of headache are improved by pressure and by a massage, which summons energy and blood to the area. Full headaches are more painful for pressure and therefore massage does hurt in these cases. However, despite the extra pain at the beginning, the massage will then have a dispersing effect on the excess and ultimately will help to ease the headache. If too severe, acupuncture can be used or combination of both

 

Effect of a diet:

 

  • Alcohol generates damp heat. It particularly has a heating effect on the liver, whilst its damp qualities may weaken the spleen or generate phlegm-damp. It has a dispersing effect on the energy, directing it upward and outward, and this upward movement will easily trigger liver fire or yang rising. Red wine is especially sour and therefore has a particularly strong effect on the liver plus it's high on histamines.

 

  • Chocolate also generates damp heat which affects the liver and stomach, the damp affects the spleen.

 

  • Dairy products generate damp and phlegm and they should be avoided or consumed in small amounts by any person with phlegm-damp involvement in their headaches.

 

Above mentioned foods will sometimes trigger the liver types of headache, because the extra damp they generate further obstructing the energy and aggravating the liver energy stagnation.

 

  • Citrus fruits are generally cold and weaken the spleen, and thus can generate damp-phlegm. The extra dampness may then aggravate any liver energy stagnation. Some doctors also believe that citrus fruits can aggravate liver qi stagnation directly, and others that oranges deplete liver yin.

 

  • Tea and coffee have a dispersing effect on the qi, like alcohol, and can trigger liver fire or yang rising.

 

  • Coffee also depletes yin and blood.

 

  • Red meats and fried foods are hot and damp and can aggravate liver fire or yang rising.

 

  • Spices are hot and aggravate liver or stomach fire. They move stagnant qi and can induce stagnant qi to rebel upwards, triggering headache. Spices also tend to deplete yin and blood.

 

  • Sugar depletes the spleen and generates damp and should be avoided in cases with phlegm-damp.

 

In terms of Western medicine, the vast majority of headaches are due to functional disorders without any major pathology. Many of these cases will be amenable to treatmentcby acupuncture, massage or an adjustment in a diet and lifestyle. However, when a person presents with a recent history of persistent headaches but has no history of similar headaches, a Western medicine diagnosis should be sought because of the possibility of serious pathology (especially brain tumour). This is unusual but important to recognise because it will require Western medicine intervention or a combined approach utilising Western and Chinese medicine.

 

References:

 

  • THE TREATMENT OF HEADACHE AND MIGRAINE BY ACUPUNCTURE RICHARD BLACKWELL - JOURNAL OF CHINESE MEDICINE NUMBER 35 JANUARY 1991

  • SOME ACUPUNCTURE POINTS WHICH TREAT HEADACHE by Peter Deadman and Mazin Al-Khafaji with Kevin Baker - JOURNAL OF CHINESE MEDICINE NUMBER 56 JANUARY 1998

  • THE DIAGNOSIS AND TREATMENT OF HEADACHES BY ACUPUNCTURE by Julian Scott - JOURNAL OF CHINESE MEDICINE NUMBER 15 MAY 1984

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