I once stumbled upon an ancient Chinese curse: “I wish you to live at the times of great changes”. Right now, we definitely live in times of rapidly changing acupuncture world terrain. Is it a curse or a blessing? It seems that new requirements, advancements, or regulations for our profession surface every time I turn around. That can be a blessing, to gain greater acceptance by mainstream medicine. Or it can be a curse, if we do not adapt to necessary changes and are left in the “acupuncture parlor”.

A few major steps were made nationally and internationally to bring us to the blessed future. Some of them are in the area of legislation, others are in the arena of standardization. The biggest terra incognita remaining to unravel is – the DOSAGE OF ACUPUNCTURE.

More and more insurance companies are extrapolating on payment for acupuncture services. It is no longer a question whether acupuncture is effective or not. The questions that are being asked now are things like: how many sessions are needed? how frequently? what are the expectations?

There are not many research papers evaluating real clinical practice which include the diversity of acupuncture styles and pattern presentations. One of the most prominent, which used realistic dosage of acupuncture, and served as a ground for the VA (Veterans Administration) to start employment for acupuncturists, was “The Effectiveness of Individualized Acupuncture Protocols in the Treatment of Gulf War Illness: A Pragmatic Randomized Clinical Trial”. It was published by Lisa Conboy, Travis Gerke, Kai-Yin Hsu, Meredith St John, Marc Goldstein, and Rosa Schnyer, and can be found here: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149161

So, this is YOUR chance to share what you’ve experienced, is an appropriate dose for acupuncture. Please look at the studies below, and share your expertise based on your style of acupuncture – be it 5 elements, Japanese, one of the famous masters, etc.

To start, lets understand the standard language of Traditional Medicine that I used for TCM diagnosis pattern and treatment principle. You can find the exact definition in the WHO (World Health Organization) manual entitled “WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region”. This manual can be downloaded here: http://www.wpro.who.int/publications/who_istrm_file.pdf

This manual provided terminology for the future ICD-11, Chapter 26 (Traditional Medicine1) diagnostic codes to be active in 2023. The beta version can be found here: https://icd.who.int/en/.

Case studies below use current billable ICD-10 diagnostic codes of western medicine, with the addition of non-billable ICD-11 (TM1) codes. This is how our billing will be in the future.

Please recall your clinical experience and email your comments and thoughts, being as specific as possible, to suzy@fsoma.org

1. Do you agree with the goal’s time frames? If no, why not?

2. If you practice a different style (Five Element, Japanese, Korean, etc.), would your goals differ because of the differences? If yes, how so? If no, please let us know that too.

3. Would you request different frequency of visits?

4. Do different medications (please specify) used in the past or present change the goal’s time frames, frequency and length of the treatment?

5. Comment on anything else you think is relevant.

Case Study #1:

30 years old male presenting with a chief complaint of “pulling” constant low back pain radiating to right buttock that started after camping trip 4 months ago to the lake and is worse with rainy weather. Severity of pain is 4/10. As well has frequent dull frontal headache and sensation of heaviness in the body. Has a frequent loose stool.

Objectively: No pathology was found on X-Ray

TCM Tongue: pink, with thicker white coat

TCM Pulse: soggy

Western medicine billable diagnosis: M54.5 Low back pain with right side sciatica

Non-billable ICD-11 (TM1) Diagnosis: SC61Lumbago disorder (TM1) due to SE82 Dampness factor pattern (TM1)

TCM treatment principle: relieve pain, expel wind-damp

Acupuncture Tx: position prone

TCM points – GB20, UB12, SP9, K7. UB23,25, Yaoyan, Right buttock Ashi.

Adjacent techniques: TDP lamp on lumbar region

Recommended acupuncture tx frequency:

• 2-3 times a week for 3 weeks,

• after that 1-2 times a week for 2-3 more weeks

Treatment Goal:

in 3 weeks pain reduction by ~ 50%

in 6 weeks pain reduction by ~ 75%

Take home recommendations:

TCM Herbal Rx: Qian Huo Sheng Shi Tang

Topical: Zheng Gu Shui Spray 3-6 times a day

Treatment Goal with addition of herbs:

• in 3 weeks pain reduction by ~ 75%

• in 6 weeks pain reduction by ~ 90-100%

Case Study #2

32 years old female presenting with chief complaint of dull low back pain with occasional sharp electric sensation radiating down to the knee on the lateral side of her right leg that started after lifting her 2 years old child 6 months ago. Severity of pain is 3-5/10. As well she has mild dysmenorrhea, PMS and alternating bowels. She is prone to depression.

Objectively: No pathology was found on X-Ray

TCM Tongue: pink, with thin white coat

TCM Pulse: string-like (wiry)

Western medicine billable diagnosis: M54.5 Low back pain with right side sciatica

Non-billable ICD-11 (TM1) Diagnosis: SC61Lumbago disorder (TM1) due to SE91 Qi stagnation pattern (TM1), SG2A Gallbladder meridian pattern (TM1).

TCM treatment principle: relieve pain, promote smooth movement of Qi, open Gall Bladder Meridian

Acupuncture Tx: prone

Points Auricular – LV, Shenmen

Points TCM: LI4, LV3, UB19,24,25, Yaoyan, R-GB29,30,31,34,41, R-SJ5

Adjacent techniques: Tuina on lumbar region

Recommended acupuncture tx frequency:

• 2 times a week for 4 weeks,

• after that 1 times a week for 4 more weeks

Treatment Goal:

in 4 weeks pain reduction by ~ 40%

in 8 weeks pain reduction by ~ 75%

Take home recommendations:

TCM Herbal Tx: Chai Hu Shu Gan San modified – (herbs expected to be taken for 3-6 months at therapeutic dose for low back pain, after that are tempered to maintenance dose for management of dysmenorrhea, PMS and mood)

Topical: Po Sum On Oil 3-6 times a day

Treatment Goal with addition of herbs:

• in 4 weeks pain reduction by ~ 75%

• in 8 weeks pain reduction by ~ 90-100%

Case Study #3

Example: 55 years old male presenting with chief complaint of “stiff “ low back pain with occasional “cramping” pain radiating down on the back of right leg all the way to the lateral side of the foot that started gradually 3 years ago and is worse with cold weather. Severity of pain is 5-7/10.

As well he has cold pale extremities, high triglycerides and decrease in libido

Objectively: MRI showed L5 bulging disk

TCM Tongue: pale, with moderate white coat

TCM Pulse: slow, deficient on right chi position

Western medicine billable diagnosis: M54.5 Low back pain with right side sciatica

Non-billable ICD-11 (TM1) Diagnosis added in comments window current EMR systems: SC61Lumbago disorder (TM1) due to SF97 Kidney yang deficiency pattern (TM1), SG26 Bladder meridian pattern (TM1)

TCM treatment principle: relieve pain, move Qi, warm Kidney Yang, open Bladder Meridian

Acupuncture Rx: prone

Points TCM: LI4, LV3, UB23, 25, K3, Yaoyan, R-GB30, R-UB36,37,39,40,56,62, R-SI3; Points Auricular: K

Adjacent techniques: TDP lamp on lumbar region, Moxa

Recommended acupuncture tx frequency:

• 2 times a week for 6 weeks,

• after that 1 times a week for 6 more weeks

• give one month of break and repeat if necessary.

• every year in the summer repeat course of acupuncture treatment for 6 weeks 1 time a week preventatively

Treatment Goal:

in 6 weeks pain reduction by ~ 25%

in 12 weeks pain reduction by ~ 50%

Take home recommendations:

TCM Herbal Tx: Du Huo Ji Sheng Tang – expected to be taken for 6 – 12 months. Possibly may need to be taken at maintenance dose long term.

Topical: Capsaicin cram 3 times a day or patch at skin tolerance

Treatment Goal with addition of herbs:

• in 4 weeks pain reduction by ~ 50%

• in 8 weeks pain reduction by ~ 75%

Case Study #4

75 years old female presenting with chief complaint of constant “burning, aching” low back pain, accompanied with “stabbing” pain extends to right glut. Pain started 15 years ago and becomes progressively severe and is worse on standing and walking. She cannot walk or stand longer than 15 minutes. Severity of pain is 6-8/10

As well has insomnia with difficulty to stay a sleep, reduction in memory, tinnitus, thinning hair, dry mouth, stiff aching knees, varicose veins and cyanotic feet.

Objectively: MRI showed degeneration of L3,4,5 discs, Spinal stenosis

TCM Tongue: red, moist, no coat

TCM Pulse: string-like and deficient on both chi positions

Western medicine billable diagnosis: M54.5 Low back pain with right side sciatica

Non-billable ICD-11 (TM1) Diagnosis added in comments window of current EMR systems: SC61Lumbago disorder (TM1) due to SF01Blood stasis pattern (TM1),

SF94 Kidney yin and yang deficiency pattern (TM1)

TCM treatment principle: relieve pain, break Qi, activate Blood, warm Kidney Yang, nourish Kidney Yin

Acupuncture Rx: prone

Points TCM: Li4, Liv3, HuaTuoJiaJi-L4,5, UB23, Yaoyan, K3, R-GB29,30, UB60, R-SI3, L-UB62, R-GB41, L-SJ5

Points Auricular: K

Adjacent techniques: TDP lamp on lumbar region, Gua Sha, Cupping, E-steam

Recommended acupuncture tx frequency:

• 2 times a week for 6 weeks,

• after that 1 times a week for 6 more weeks

• after that every second to every fourth week dependent on severity of pain

Treatment Goal:

• in 6 weeks pain reduction by ~ 10-15%

• in 12 weeks pain reduction by ~ 30%

Take home recommendations:

TCM Herbal Tx: Shen Tong Zhu Yu Tang + Liu Wei Di Huang Tang modified – indefinitely

Topical: Tiger balm 3-6 times a day + Wu Yang Plaster – at skin tolerance

Treatment Goal with addition of herbs:

• in 6 weeks pain reduction by ~ 30%

• in 12 weeks pain reduction by ~ 50%

Comment: These are just four possible scenarios. There are a many more combinations of TM1 patterns for WM billable diagnostic code of low back pain.

We look forward to hearing from you!

Telemedicine involves the use of electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine technology is frequently used for follow-up visits, management of chronic conditions, medication management, specialist consultation and a host of other clinical services that can be provided remotely via secure video and audio connections.

Benefits: Using telemedicine as an alternative to in-person visits has a host of benefits for patients

•Less time away from work

•No travel expenses or time

•Less interference with child or elder care responsibilities

•Privacy

•No exposure to other potentially contagious patients

Privacy and Security

Because patient data will be transmitted when telemedicine is used, it is subject to HIPAA regulations. Consumer video services like Skype and Facetime do not meet this standard. In order to maintain compliance, providers must choose technology solutions that use data encryption to protect patient data.

How common is telemedicine?

Telemedicine is an important and quickly growing component of healthcare delievery in the United States. There are currently about 200 telemedicine networks, with 3,500 service sites in the US. In 2011 alone the Veterans Health Administration delivered over 300,000 remote consultations using telemedicine. More than half of all U.S. hospitals now use some form of telemedicine.

Is telemedicine safe?

Yes. When used under the right conditions and for appropriate cases, telemedicine has been shown to be as safe and effective as in-person care. Of course, not every condition is conducive to treatment via video visits, so providers must use good judgement when leveraging this channel for healthcare delivery.

Does Medicare or Medicaid pay for telemedicine?

For Medicare patients, national telehealth policy sets many restrictions on patient location, services provided over telemedicine and facilities at which patients receive these services. However, the Medicare Chronic Care Management Program is a national policy that set no such restrictions on telemedicine practiced by Medical Doctors (MD). Medicaid reimbursement varies from state to state, resulting in a patchwork of different policies and reimbursement requirements. Insurance companies do NOT pay for Oriental medicine telemedicine consult.

How difficult is telemedicine technology to use?

In order to be effective, telemedicine technologies must be easy to use for both patients and providers. The best solutions are easy for medical offices to set up and deploy and as easy for patients as the mobile device applications they use every day.

Controlling the Metabolic Rates: Iodine is required by the body for the synthesis of the thyroid hormones, thyroxine (T4 – containing 4 iodone atoms) and triiodothyronine (T3 – containing 3 iodine atoms). These hormones play an important part in the controlling of the basic metabolic rate (BMR). Also, these hormones help regulate the heart rate, blood pressure, temperature and body weight.

Maintaining the Energy Levels: Iodine aids in the proper utilization of calories and this way it ensures optimum levels of energy in the body. This mechanism also prevents the storage of excess amounts of calories as fats in the body.

Maintaining the Health of the Reproductive System: Iodine supports the growth and the maturity of the genital organs. Pregnant women need adequate amounts of iodine to lower down the possibilities of stillbirths. Iodine is also important in preventing neurocognitive conditions like cretinism in babies. Iodine is also known for promoting abilities like speech, hearing, motion and growth in babies.

Treating Fibrocystic Diseases Effectively: Fibrocystic breast disease is caused due to increased estrogen production and is known to most women simply as having “lumpy breasts”. Iodine may decrease breast tissue sensitivity to estrogen. It has been found that patients who are treated for low thyroid hormone have decreased breast pain and breast nodules. This suggests that low thyroid hormone or iodine deficiency may be a factor in fibrocystic breast disease.

Assisting in Programmed Cell Death: Iodine assists in the process of programmed cell death or apoptosis. This process allows the development of new organs apart from ensuring the elimination of cancer cells or diseased cells which might cause harm to the individual. In a study it was found that human lung cells (with genes spliced into them that enhance iodine uptake and utilization) implanted in mice undergo apoptosis and shrink when given iodine. Researchers believe that this anti-cancer function of iodine may well prove to be it’s most important benefit apart from thyroidal influence.

What are the Deficiency Symptoms of Iodine?

Development of Goitre, or enlargement of the thyroid gland, is usually the earliest visible symptom of iodine deficiency. The enlargement of the thyroid results from overstimulation of the thyroid gland by thyroid stimulating hormone (TSH), as the body attempts to produce increased amounts of thyroid hormone. Goiter can occur for many other reasons as well, but iodine deficiency is among the most common causes worldwide.

Iodine deficiency can lead to hypothyroidism, which in turn, can cause an abnormal gain in the body weight due to deposition of excess calories as fats. Conventional medicine’s response to hypothyroidism typically ignores causes and prescribes synthetic thyroxine hormone in an attempt to balance out the health equation with another unnatural substance; this is nothing new. But hypothyroidism is a national epidemic, affecting roughly 10% of the female population in the US and in no way sparing men. It has created a stable, ever-expanding market for these cash cow thyroid drugs (the leading thyroid drug was #7 on JAMA’s list of ‘most commonly prescribed’ in 2006; one year later it was #4).

Iodine deficiency can also cause depression, frustration and poor levels of perception.

Constipation and fatigue are the other conditions brought about by iodine deficiency.

Iodine deficiency raises the risk of infertility, misscarrige and stillbirth in pregnant women. In some serious cases, mental retardation often gets associated with cretinism characterized by physical malformation.

Children with IDD can grow up stunted, apathetic, mentally retarded, and incapable of normal movements, speech, or hearing. Globally, 2.2 billion people (38% of the world’s population) live in areas with iodine deficiency and risks its complications.

Breast Cancer: The Iodine and Thyroid Connection

Fibrocystic disease of the breast consists of small or large, sometimes painful lumps in women’s breasts. It varies in the way it shows—not only in different women, but also because it changes from month to month in the same women.

Since the number of cells increases in the breast during the cycle, some of the cells have to be removed to restore the normal state each month. Iodine is the trigger mechanism that causes excess cells to disappear to complete this normal process of cell death. Without enough iodine, the extra cells that develop during the menstrual cycle due to the hormonal stimulation do not resolve back to the normal breast architecture. These leftover cells build up over repeated cycles and cause the lumps, soreness, and larger lesions of fibrocystic disease.

However, while about 90 percent of North American women have fibrocystic disease, about 40 percent of these women experience no symptoms. Their breasts may be normal to examination, but the disease may be only microscopically detectable with a biopsy.

Fibrocystic disease over decades of hormonal stimulation eventually tends to cause some cells to change to cancer cells. Lack of iodine contributes to appearance of fibrocystic disease, so women who have fibrocystic disease may be more susceptible to breast cancer. Although breast scars from fluid leakage out of the cysts are often permanent, iodine given therapeutically in the correct doses gradually may help to get rid of all fibrocystic disease except for the scars.

How much of Iodine is enough?

The thyroid gland needs approximately 6mg/day of iodine for sufficiency. The breasts need at least 5mg of iodine; that leaves 2mg (13mg-llmg) of iodine for the rest of the body. This 2mg is still well above the RDA (14x the RDA) of 150mcg/day of iodine. Either way, this would explain why the RDA for iodine is inadequate and why it is necessary not only to get your iodine levels evaluated but, more importantly, to supplement with the correct amount and form of iodine.

Also Iodine remains the perfect antiseptic with the least side effects of all time. As a perfect antiseptic killing all single-celled organisms, there has to be a common mechanism of a single element like iodine. In fact, the reaction of iodine with tyrosine destroys the protein and consequently the cell itself. If, in vertebrates and multicellular organisms, the tyrosine molecule is hidden from the surface when it is normally functioning, the iodine will not trigger any apoptosis. However, during abnormal development, it could be that tyrosine or histidine molecules are slowly exposed to the surface. Extracellular iodine bathing the cells could then trigger the apoptotic mechanisms. The second phase of cancer spread involves thyroid hormone indirectly. The connective tissue barrier and function is controlled and strengthened by adequate levels of connective tissue thyroid hormone. Thus thyroid hormone controls the connective tissue barrier, and prevents the spread of cancer cells.

When you should not supplement Iodine?

If you have Thyroid cancer

If you are on thyroid medication: do not take Iodine without testing.

Iodine allergy. Mostly, it occurs after a person is given an injection containing contrast dyes, in which iodine is added for improving X-ray images. This is why doctors must first perform iodine allergy test and then go for dye tests. Whenever iodine allergy occurs, either there is some external reason (like injections etc.) or there is over dose of iodine in the body.

Iodine Overdose: mostly caused by procedures. Effects of iodine overdose are far more severe in small children than in adults. Some common signs and symptoms of overdose of iodine that are noticed in both adults and children are given below. Abdominal pain which can vary from mild to moderate, Metallic taste can be felt in the mouth, quite frequently. Pain in throat and mouth. Low or no urine output. Shortness of breath. Shock and seizures. Mental confusion. Excessive feeling of thirst. Diarrhea. Fever. Vomiting. Coughing

How much is too much?

The amount of naturally occurring iodine present in these food substances is not so high that it can cause iodine overdose. It mainly occurs due to medicines which contain iodine as an ingredient. It includes Pima syrup, Lugol’s solution, tincture of iodine, etc. Those who are undergoing radioactive iodine therapy for treatment of thyroid disease by can also get iodine overdose.

Iodine Testing

1st Option: ZRT Lab’s Iodine Test in Dried Urine. That is one of the easiest ways to take control of your health and wellness while understanding the importance of underlying symptoms and your potential risk for iodine deficiency. It now only requires a few minutes to collect urine on a filter strip 2 times a day as opposed to the inconvenience of a 24 hour collection that requires a bulky container for collection. Cost is just $75. Insurance unfortunatelly will not pay for it as for many innovations.

2nd option: ZRT’s Comprehensive Iodine Thyroid Test in Dried Urine and Blood Spot. While measurement of urinary iodine levels may provide useful information on one’s iodine nutritional status, iodine sufficiency does not always guarantee that adequate amounts of thyroid hormones will be synthesized by the thyroid gland. ZRT has combined the advanced technology of iodine determination in dried urine (DU), with that of thyroid hormone measurements in finger prick dried blood spots (DBS) to create the Comprehensive Iodine Thyroid Test. The Iodine-Thyroid Profile is designed to evaluate not only the availability of iodine, but also its capacity to be utilized for thyroid hormone synthesis. The thyroid glands capacity to utilize iodine for thyroid hormone synthesis is determined by measuring thyroglobulin, TSH, total T4, free T4, free T3, and TPO antibodies in finger-prick whole blood dried on filter paper. Cost is just $315. Insurance unfortunatelly will not pay.

We all are different! The best way to determine is TEST it!

To prevent a Flu or Common cold:

·         Guna-Flu Homeopathic remedy

·         Acupuncture

·         Chinese Herbs To Treat:

Guna-Flu Homeopathic remedy Acupuncture Chinese Herbal Formulas that have antiviral and antibacterial properties, and relieve symptoms (fever, cough or headache)To restore immune system after a disease:

Acupuncture Herbal tonics Proper dietary recommendations Nutritional supplements

How homeopathic Guna-Flu works?

The principle of homeopathy is that like shall be cured by like. In other words, a substance produces symptoms of illness in a well person when administered in large doses; if we administer the same substance in minute quantities, it will cure the disease in a sick person. The dose is small so that there is no danger of any long term side effects. Homeopathic remedies never have an issue with resistance.  This is because the remedies do not have any direct effect on the virus.  They just modify our body’s response to it by enabling our defense mechanism to a better recognition of what needs to be fought off.

Guna-Flu is a new generation remedy combining classic homeopathy with discoveries of modern medicine. It addresses not only symptoms of a disease but also introduces a proper immunologic response of the body.

According to Clinical research on 291 children between 3 and 6 years old on prevention of Flu, compare Guna-Flu versus standard Western Drugs: only 38% of the children included in the Guna-Flu (Omeogriphi®) Group fell ill with URI compared with 50% of those included in the Control Group. These percentages certainly illustrate that Guna-Flu has better preventive efficacy than Bacterial Lysates (conventional reference medicines).

Guna-Flu is effective for prevention and treatment.  How Acupuncture and Chinese herbs work?

Chinese medicine has successfully treated the cold and flu for thousands of years with Chinese herbs and acupuncture treatment. Acupuncture and Herbs helps to prevent the flu by simply strengthening the body’s immune system. Traditionally to decrease a susceptibility to a common cold or flu patients are seen four times a year, at the change of seasons, to increase immunity to the ever changing environment.

Prevention is the key to everything and Oriental Medicine is no different. You will benefit much more from being treated prior to the onset of flu symptoms. However, if symptoms due being to arise, then immediate treatment is imperative. The sooner treatment is received for flu-like symptoms the faster and more effective treatment is. Our treatment either stops the cold and flu within one to two days or significantly reduces symptoms and duration. Chinese medicine also helps resolve sinus congestion, sore throat and coughs. Studies have shown that certain blood counts and immune enhancing chemicals stay elevated for at least 3 days following an acupuncture treatment.

What Western Allopathic Medicine has to offer? 

To prevent a Flu or Common cold:

Hand WashFlu Vaccine- shot or oralTo Treat:

No medicine to kill a virusChemical drugs effects to suppress symptoms (fever, cough or headache)Antibiotics to treat bacterial complications such as Bronchitis, Pneumonia or Pleurisy.To restore immune system after a disease:

·         None

Is a Flu vaccine safe and effective?

Common thought: “Flu shots are like a religion. Questioning the efficacy of flu shots to ‘believers’ is seen as unreasonable and foolish.”

It takes about 9 months to make a vaccine!

Each winter scientists and researchers from the World Health Organization try to predict which strains of flu will circulate the following year. After officials select the three strains of flu virus that they think are most likely to be circulating during the next winter season (they picked the wrong ones last year), vaccine makers grow the viruses in fertilized chicken eggs, with 500,000 eggs per day (each examined by hand) for up to eight months.

Formaldehyde is used to inactivate the virus. It is a known cancer-causing agent. Aluminum is added to promote an antibody response. It is a neurotoxin that may play a role in Alzheimer’s disease. Other additives and adjuvants in the flu vaccine include Triton X-100 (a detergent), Polysorbate 80, carbolic acid, ethylene glycol (antifreeze), gelatin, and various antibiotics – neomycin, streptomycin, and gentamicin – that can cause allergic reactions in some people.

Two-thirds of the vaccines made for the 2008–09 flu season, 100 million of them, contain full-dose thimerosal, an organomercury compound, which is 49% mercury by weight. It is used to disinfect the vaccine. Each one of these 100 million flu shots contain 25 micrograms of mercury, 250 times more than the Environmental Protection Agency’s safety limit. Mercury is a neurotoxin, which has a toxicity level 1,000 times that of lead.

Mercury in vaccines has also been implicated as a cause of autism. Vaccine makers have now removed thimerosal from all childhood vaccines, except flu shots.

Three serious, acknowledged adverse reactions to the flu vaccine are joint inflammation and arthritis, anaphylactic shock (and other life-threatening allergic reactions), and Guillain-Barré syndrome. Guillain-Barré syndrome (GBS) is a paralytic autoimmune disease that fells people several weeks after their flu shot.

Last year was not a good year. A good rate of protection would be 70 percent. A CDC report says the efficacy rate of the 2009 vaccine was 44 percent.

The history of honey is extremely rich in ancient Russia. In the 12th century a manuscript titled “About Honey” with hundreds of medicinal recipes was published by Duchess Evlampia, the grand-daughter of the famous Russian King Vladimir Monomah.  Until the early 20th century honey was considered an official medical remedy, and was actively prescribed by family physicians.  Even as recently as World War I, doctors treated wounds with honey. With the advent of antibiotics honey fell out of use for its healing properties, but scientific research is now rediscovering honey’s natural healing power. Definition: According to the Codex Alimentarius (1989): Honey is the natural sweet substance produced by honeybees (Apis Mellifera) from the nectar of blossoms or from the secretion of living parts of plants or excretions of plant sucking insects on the living parts of plants, which honeybees collect, transform, and combine with specific substances of their own, store and leave in the honey comb to ripen and mature.

Honey is a thick, viscous, syrupy, yellowish or yellow-brown fluid, clear when fresh, but losing its translucence with age and depositing crystals. It has an intensely sweet, feebly acrid taste, and a distinctive odor. There are more than 300 types of honey, varying in flavor and color (from pale yellow to dark amber), depending on the type of blossoms visited by the honeybee. Some of the most commonly produced types of honey in the United States are alfalfa, orange blossom, clover, buckwheat, and tupelo.

Principal Constituents: Laevulose (fruit sugar) 36%, dextrose (grape sugar or glucose) 32%, and sucrose (cane sugar) 2%, maltose (malt sugar) 8%, mineral salts 2%, hydrogen peroxide, phenolics, flavonoids, terpenes, vitamins, microelements, and anti-bacterial substances.  Properties: Antimicrobial and anti-inflammatory. Honey works due to its sugar content, low protein composition, and by osmosis. Honey acts as a natural antibiotic that limits the growth of bacteria. Honey promotes tissue regeneration due to its high vitamin and microelement content.The value of honey differs by diastase number (quantity of enzymes per unit of volume). This allows measuring the effectiveness of biological activity of honey. The highest diastase number is found in honey manufactured at northern latitudes with harsh climates. For example: southern honey has a diastase number of 5 to 9, while northern honey has a diastase number of 30 to 50. In this diastase number range, northern honey is not just a food but a drug. The only type of honey shown to be effective in treatment is crude unprocessed honey. Properties of Feng Mi in Chinese medicine: sweet in flavor, neutral in nature, enters the Lung, Spleen and Large Intestine channels. Actions: strengthens middle-jiao, relieves spasm, alleviates pain, moistens Lung to arrest cough, moistening dryness and relaxing the bowel to relieve constipation. Indicated for gastric pain, consumptive diseases, lingering cough, dryness in the bowels and constipation, and for the elderly and those patients with weakened body resistance due to chronic diseases. According to “Compendium of Materia Medica,” by Li Shi Zhen, honey can help dispel pathogenic heat, clear away toxins, nourish yin and strengthen the spleen.

Contraindications: Allergies to bee products!!!  Open form of TB, lung cancer, congestive heart failure, kidney failure, general high fever, fragile capillaries, hemorrhages, advance osteoporosis, and all contraindications that apply to circulatory massage. Indications of Honey TuiNa: To relieve cough, facilitate expectoration, moisten lung, clear toxins, reduce edema, and strengthen immune function in the treatment respiratory system diseases characterized by cough and wheezing.

Chinese Differential Diagnosis according to Zang Fu Syndromes:

a. Cough and wheezing with hard to expectorate mucus d/t Wind-Cold with internal Heat, Wind-Heat, Lung-Heat, Phlegm-Heat, Liver Qi Stagnation damaging the Lungs, Liver Fire invading Lung, Lung and Kidney Yin Deficiency are treated with combination of Honey TuiNa and Inhalation.

b. Cough and wheezing with easy to expectorate profuse mucus d/t Wind-Cold with Phlegm Fluids, Phlegm-Damp, Lung and Spleen Yang Deficiency are treated with Honey TuiNa without Inhalation.

c. Cough and wheezing without mucus or with red blood expectoration d/t Warm-Dryness, Cool-Dryness, Lung Qi, and Blood Stasis are contraindicated for treatment with Honey TuiNa.  Technique of Honey TuiNa: due to breathing difficulties perform while patient is seated.

1st step – prepare inhalation using a steam inhaler, with a solution consisting of 1 table spoon of honey, 1 teaspoon of baking soda and 20 drops of eucalyptus essential oil in distilled or mineral water. Allow the patient to inhale the steam for 20 minutes.

2nd step – using Ca (rubbing) method massage abdominal, intercostals, SCM and scalene muscles and entire back with no lubricant for 3-4 minutes.

3rd step – warm up 1 table spoon of solid variety of honey in your palms, distribute on the patient’s back using palm An (pressing), follow with Pai (patting) and continue with palm Ji (beating), repeat the sequence with alternating rhythm on entire back focusing on lungs region.

4th step – wipe the residue from the back with a moist, hot towel.

5th step – cover patient with a blanket. Offer a cup of warm herbal tea appropriate to Chinese differential diagnosis with a teaspoon of honey. Let the patient rest for at least 10 minutes before letting them leave.

Because honey is extremely potent, honey TuiNa should not be administered more than five times every other day. A patient should perform inhalation at home every evening up to ten times.  Summary: Tested for millennia folk therapy shouldn’t be forgotten in our modern age of synthetic drugs and quick fix strategies. Recent research underlines the scientific basis for honey therapy utilizing its antibacterial properties working even for the most antibiotic resistant strains of microbes. Honey can be successfully used to treat many disorders and for enhancement of well-being.   Resources:  P.I. Filippov, V.P. Filippova, 2003, “Honey and other bee products in diet and medicine”

V.I. Vasichkin, Leningrad, 1991, “Textbook on massage”

L.M. Kliachkin, M.N. Vinogradova, Moscow, 1988, “Physiotherapy”

V.I. Dubrovskij, Moscow, 1992, “All kinds of massage”

D.N. Stojanovskij, Stalker, 1999, “Encyclopedia of folk medicine”

Textbook, Kiev, 1978, “Internal diseases”

Textbook, Neva, 1983, “Anatomy and physiology”

R. Werner, Lippincott Williams, “A Massage Therapist’s Guide to Pathology” 2nd edition

W B Saunders, 2002, “Mosby’s Medical, Nursing & Allied Health Dictionary” 6th edition

John K. Chen & Tina T. Chen, 2004, Art of Medicine Press, “Chinese Medical Herbology & Pharmacology”

Will Maclean  Jane Lyttleton, 2000, Redwing Book Co, “Clinical Handbook of Internal Medicine: The Treatment of Disease With Traditional Chinese Medicine, vol. 1”

The English-Chinese Encyclopedia of Practical Traditional Chinese Medicine, Higher Education Press, Beijing,  China, “Tuina Therapeutics”

The report found that over a 12-month period, headache patients who received regular acupuncture sessions reported fewer headaches, had a higher quality of life, missed fewer days from work, used less medication, and made fewer visits to a general practitioner than patients given standard treatment for headaches. The research was conducted at a series of single acupuncture practices and general practices in Wales and Great Britain. In the study, the authors recruited 401 patients who suffered from chronic headaches, predominantly migraine headaches. The patients were randomized to receive either acupuncture or “usual care” from a general practitioner. In the acupuncture group, subjects standard care for headaches, and were also treated with acupuncture up to 12 times over a three-month period. Treatment patterns were individualized to each patient, and different points were used based on the discretion of the acupuncturist providing care. In the usual care group, patients received standard headache care from their general practitioner, but were not referred out for acupuncture.

At various times throughout the study, patients used a daily diary to track the frequency and severity of headache pain, and any related medication use. Headache severity was measured four times a day on a six-point scale, with the total summed to give a headache score. In addition, the patients completed the SF 36 Health Status Questionnaire at the start of the study, and at three months and 12 months after treatment. Patients also completed a series of questionnaires every three months that monitored use of different headache treatments, days missed from work due to illness, and other usual activities.

Initially, there was not much difference between patients in either group. By the 12-month interval, however, striking differences were noted in terms of frequency of headache, doctor visits and medication use:

Patients given acupuncture had an average of 1.8 less days with headaches over the first four weeks of the study compared to the control group. When projected over 52 weeks, the authors estimated that acupuncture would result in an average 22 fewer days of headaches per year.

The effects of acupuncture appeared to be long-lasting. At the start of treatment, the average weekly headache score among acupuncture patients was 24.6. Three months after the start of the study, the average score had dropped to 18.0; at 12 months, it had dropped by more than 34 percent, to 16.2. In the standard care patients, weekly headaches scores dropped only 16 percent over the course of the year.

Results from the SF-36 questionnaire showed significant benefits for acupuncture patients in terms of physical role functioning, energy levels and changes in health. Over the course of a year, physical role functioning, energy and health change scores increased an average of 9.6, 7.4 and 10.3 points, respectively, for those in the acupuncture group. These scores also increased in usual care patients, but at much lower levels.

Acupuncture patients used an average of 15 percent less medication to treat headaches than patients receiving only usual care. They also made 26 percent fewer visits to a general practitioner, and missed fewer days from work due to sickness.

“Acupuncture in addition to standard care results in persisting, clinically relevant benefits for primary care patients with chronic headache, particularly migraine, compared with controls,” the researchers commented. “We also found improvements in quality of life, decreases in use of medication and visits to general practitioners, and reductions in days off sick.”

In their conclusion, the researchers admitted they could not rule out the occurrence of a placebo effect, as the study did not include a sham acupuncture group. In addition, since the patients knew which treatment group they were assigned to, there remained the possibility that patients could give somewhat biased assessments of their treatments. However, the authors noted that the results of their study were similar to results seen in blinded, placebo-controlled trials, which “provides further evidence that bias does not completely explain the apparent effects of acupuncture.”

The authors recommended that their findings should be taken into account by policymakers when assessing the most cost-effective ways of treating patients. They also called for an expansion of acupuncture services for the treatment of chronic headaches in the National Health Service, which provides health care to millions of Britons each year.

In an interview with the BBC, Dr. Mike Cummings, the medical director for the British Medical Acupuncture Society, called the study “innovative” and agreed with the authors’ assertions.2

“It is very positive for us,” he said of the research. “This should help to lift acupuncture out of what is seen to be alternative to mainstream medicine … It should be made available in primary care to treat pain and to prevent costly referrals to hospitals.”

By Michael Devitt.