June 2009
Episodic or chronic tension headaches - to the layperson headaches which are either frequently recurring or ongoing and are often stress-related - can seriously affect someone's quality of life. I'm not sure whether Western medicine has a satisfactory answer to this problem, but reassuringly a recent paper has indicated that acupuncture may well be of benefit.
The Cochrane library (home to a large catalogue of medical meta-review papers) has just published a paper updating a review carried out in 2001. The authors of this update conclude that 'acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches'. Knowing the terminology that is usually employed in such reports, I take this to be a very positive endorsement of the powers of acupuncture in relation to such headaches. It is particularly significant that the studies concerned looked at acupuncture as a prophylactic, i.e. using acupuncture in the prevention of such headaches, rather than just as a means of treating a current headache.
As I have mentioned previously in these postings, I think that high quality research is essential in developing acceptance of acupuncture, particularly in the West. This recent meta-review update is another a step towards that goal.
May 2009
There was an interesting article in this week's New Scientist about what is termed 'nocebo' which they described as 'placebo's evil twin brother'. The nocebo effect describes the phenomenon where, if we believe something is harming us, we will be harmed.
An example cited was of a man diagnosed with severe liver cancer and given only months to live. A few months later he died as had been expected. His autopsy however revealed that, far from being advanced, the tumour was actually still quite small and would not ordinarily have killed him. The inference drawn from this was that it was his belief that he was dying that actually killed him.
The article gives many other examples of the nocebo effect, including situations where alerting people to the potential side effects of drugs has led to them experiencing those side effects, even where they were taking a placebo!
This nocebo concept raises many very interesting questions about how medical professionals should communicate and interact with their patients in order to minimise the nocebo effect.
We should be aware of the power our beliefs and expectations can have over our health, whether for better or worse. Really placebo and nocebo are two sides of the same coin; they both represent the same power which is named 'placebo' or 'nocebo' depending on how desirable or otherwise the outcome is to us.
April 2009
To gain recognition and acceptance in the West (where the western medicine paradigm is the prevailing one), Chinese herbal medicine needs to prove itself through well conducted laboratory research and clinical trials. This is still limited outside of China mainly because there is little funding for it. The majority of medical research in the West is funded by pharmaceutical companies, and as Chinese medicines cannot realistically be patented in the form they are used, there is understandably little in it for them.
However there is still good quality research being conducted. For example, a team of researchers recently carried out a review into the effects of Japanese herbal medicine on gastrointestinal (digestive system) problems. Japanese herbal medicine is derived from Chinese herbal medicine and most of the herbal formulas used in Japanese herbal medicine are based on traditional Chinese formulas.
The reviewers found that a herbal formula called rikkunshi-to (known as liu jun zi tang in Chinese medicine) was effective in reducing the discomfort associated with functional dyspepsia (non-ulcer digestive problems) and dai-kenchu-to (da jian zhong tang in Chinese medicine) was effective at relieving constipation and post-operative ileus (disruption to the normal propelling function of the bowel.
Although in this case the findings relate to some fairly broad categories of illness - constipation and functional dyspepsia - often research examines specific conditions e.g. in this case functional dyspepsia, constipation and post-operative ileus. This is generally because it is easier to study a very narrow condition where the cause is known i.e. post operative ileus. However, in my opinion these type of findings are still helpful, not only because they may have broader implications for similar problems; but also because they add to the growing body of evidence in favour of herbal medicine.
March 2009
Another piece of research caught my eye this month, not simply for itself but also because it reminded me of a connected piece of research from 2007. Both studies were related to garlic and its health benefits.
It has countless health benefits from helping protect the heart, to preventing the common cold. It truly is a wonder food. But the research I saw this month suggests that its main health giving properties may actually derive from an acid that is produced by the decomposition of allicin, the main active ingredient.
In my mind this ties in with the 2007 piece of research which suggested that, while most of the health benefits of garlic are tested used raw garlic, cooking can reduce the levels of the health promoting compounds. But crushing the garlic (ideally ten minutes before cooking) can protect against the detrimental effects of cooking. Crushing or chopping garlic releases an enzyme, alliinase, that catalyzes the formation of allicin which subsequently breaks down into the beneficial compounds.
So there we have it. Eat garlic - loads of it if possible - but crush it ten minutes before cooking. Bish bosh.
February 2009
You may have noticed the lack of journal entries over the last couple of months. Technical problems made them virtually impossible, but hopefully that is all behind me now and I can start afresh!
Talking of fresh starts, I've noticed that there are lots of people out and about exercising at the moment. This tends to happen at this time of year - people have made it their new year's resolution to start a new exercise regime and they are still fired up by their initial resolve.
Unfortunately it seems that all too often people's expectations and the demands they put on themselves are unrealistically high. If they find they cannot keep up with the demanding scheule they've set themselves or if they injured as a result of pushing themselves too hard before they're ready - they give up completely.
My qi gong teacher always used to say that it is better to do a little every day rather than to over-extend ourselves and have periods of excessive over-activity followed by nothing. It seems to me that the real problem is often that we want to see instant results from our efforts and believe that if we push ourselves as hard as we can, those results will come more quickly. This tendency can also be exacerbated as our increased focus on our health/fitness/appearance makes us even more fixated on making improvements and we can easily lose a broader perspective.
So my advice for 2009 is to go easy on yourself. Don't let self-improvements take over to the detriment of the rest of your life. If you genuinely want to build a new routine into your life for the long term - start small and build up. Once something has the power of habit behind it, will be much easier to build on it and any improvements are more likely to stay for the long-term.
November 2008
An interesting piece of research caught my eye this month. It was a complicated study but was essentially using brain imaging to investigate the ways in which the human brain's response to emotional stimuli changes when we label those emotional stimuli.
In the study, researchers showed the participants pictures of people expressing strong emotions such as fear, anger etc. Without going into too much detail, the researchers found that brain activity diminished in the amygdala (a part of the brain most associated with the experience of strong internal emotions such as panic and fear, and the triggering of the biological aspects of these states) when the participant chose a word to describe the emotion depicted such as "angry" or "fearful". This reduction in activity did not happen when the participants simply chose a name for the people in the pictures, such as "Harry". Also when the participant chose a word to describe the emotion depicted, there was increased activity in right ventrolateral prefrontal cortex, an area of the brain associated with thinking in words about emotional experiences.
I found this study especially interesting because it suggests that we can reduce the effect of our emotions by naming them, and in Chinese medicine, emotional factors are seen as being one of the principal causes of ill-health. So can we reduce ill-health by becoming aware of and naming our emotions?
What struck me in particular about this study, was that it seemed to echo the Buddhist practice of mindfulness. Mindfulness practice involves noticing and paying attention to our emotional states often by simply naming them, rather than actively trying to change them. This research seems to indicate the neurological mechanism that could lie behind mindfulness practice, as well as suggesting that such practice can have a scientifically measurable effect.
October 2008
The change of season, with us again, heralds the time for coughs and colds. People seem to be becoming increasingly aware not only that antibiotics have no effect on these viral pathogens, but that it's the overuse of antibiotics that has helped produce the drug resistant superbugs (like MRSA and C. Difficile) we are currently battling with in our hospitals.
So if antibiotics and Western medicine have nothing to offer us against colds, what can help? Well, as usual, I usually opt for herbal medicine, but I don't restrict myself to Chinese herbal medicine. A large scale analysis project carried out last year to evaluate the evidence for echinacea in the prevention and treatment of the common cold found that the published evidence supports the premise that echinacea is beneficial in decreasing the incidence and duration of the common cold. In other words it has a positive effect on whether you actually catch a cold in the first place and if you do, how long that cold lasts.
So in my view taking echinacea has got to be better than badgering a GP to prescribe powerful medicines that not only have no real effect on the problem but can contribute to some extremely serious problems affecting our country.
September 2008
'Holistic' is a term that seems to have become quite fashionable of late. Even in business-speak, a 'holistic approach' appears to be flavour of the month. What do we actually mean by holistic, so often associated with new age therapies and derided as wishy-washy, and why is it so important?
From my own point of view, in terms of the human being, a holistic view is one that regards all aspects of a person as a unity. No differentiation between mind, body and emotions. And this does not just mean a close relationship between mind and body, as that phrase still maintains the distinction at its heart.
Talk of this unity of mind and body can jar with some people, who might experience themselves as being their mind and having a body. Unfortunately a thorough examination of the historical and philosophical twists and turns that have brought us to this state of affairs is beyond the scope of these few paragraphs, but suffice it to say that common sense of today is often derived from the philosophy of yesterday. However even a fairly cursory investigation into the nature of our emotions and the ways in which they affect us 'mentally' and 'physically' reveals that finding a line at which so-called 'mind' ends and so-called 'body' starts is not easy. When one digs deeper into this issue, the basis for a divided mind-body view is difficult to find and in fact such a view becomes hard to sustain
Fortunately, advances in modern science and medicine are actually bringing us closer to a view of unity of the body and mind. As to why in Chinese medicine we hold the holistic principle so highly, it is because if the mind and body are one undifferentiated whole, to attempt to treat one without reference to the other ignores the full picture. The more complete and accurate our understanding of health and ill-health, the more accurately and effectively we can influence it.
And if anyone is still tempted to think that this sounds a bit strange, it is as nothing when compared to the strangeness of our universe currently suggested by quantum theory.
August 2008
Rather depressingly, we've not seen much of the sun this summer, and now autumn seems to be approaching fast. Many of us will be looking for ways to boost our energy levels through the next few months. And a simple morning routine could be all that's needed.
In China, people often prepare themselves for the day ahead by doing some form of traditional exercise such as tai chi or qi gong. Even those who don't do this will often have some form of short routine to wake up the body and mind at the start of the day, to get the energy and blood flowing. This can be as simple as a five minute head or body massage, and often involves rapping the body with the knuckles along the energy channels (or meridians) which are used in acupuncture.
So even if it seems overwhelming to find the time for a tai chi session every day, you might want to try the following to perk yourself up in the mornings.
Rap your knuckles gently along each arm, first going down the inside towards your hand and then back up the outside. On both the inside and the outside, think of there being three equally spaced channels running from your shoulder to your hand and rap your knuckles along each of these in turn - down the inside then back up the outside each time. Then do the same for the legs, but this time go down the outside on each of the three channels and up the inside on each of the three channels. Finish off by massaging your face and head paying particular attention to your forehead, temples and the two depressions on either side of your spine at the base of your skull. Shake out your arms and legs and you're ready for the day ahead.
July 2008
I've recently taken up Aikido, the Japanese martial art. One of the main principles behind it is similar to the Chinese concept of "wu wei" which can be translated along the lines of "effortless action" or "not forcing". The movements used in Aikido should be gentle, but the effects of those movements can be dramatic. Aikido is similar to Tai Chi in that respect.
These principles come from Daoist (or Taoist as it is more commonly written) roots, the same roots which underpin Chinese medicine. Indeed, the "do" in "Aikido" is the Japanese version of the Chinese "Dao" (or "Tao"); the Japanese and Chinese characters are identical.
One of the keys to success in both Aikido and Chinese medicine is a sensitivity to the situation - sensitivity to the movements and intentions of the adversary in Aikido, and to the subtle manifestations of ill-health in Chinese medicine. It is essential to understand and work with the forces and influences present in the situation you are faced with, rather than imposing your will upon it. With the judicious use of gentle power, carefully timed and precisely aimed, you can have a much greater effect than might normally be thought possible.
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