Acupuncture In Practice

A collage of theory, thought, approach and technique that is useful in clinical practice. The diversity of cases presented illustrates the rich tradition of oriental medicine styles and techniques. Both a reference text as well as a clinically useful book that will be a source of both inspiration as well as introspection into the processes of oriental medicine. The style of the book makes both appealing reading as well as personal—— as opposed to the usual format employed in case history texts to date.

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Until recently, most of the Chinese medicine case history literature that I have encountered has been Chinese in origin. Much of this presents fairly straightforward textbook cases and almost inevitably the patient is 'cured'. More interestingly, Chinese journals often include more complex cases which illustrate some of the idiosyncrasies of individual patients and especially the individualised approach of the practitioner, usually an old and experienced doctor. Over the last couple of years, however, the London School of Acupuncture has pioneered a new Western style of case presentation in this journal.

These cases have been characterised by their extremely detailed presentation, by the attention paid to the life history and emotional responses of the patient, and by the daring fact that the clinical outcome is not always an unqualified success. The synthesis of such attention to the uniqueness of the individual being treated with an equally meticulous consideration of the Chinese medicine diagnosis, represents an exciting development in Chinese medicine practice, a mature synthesis of East and West. Now Acupuncture in Practice presents a whole textbook of such cases, reflecting the work of different acupuncture practitioners throughout the Western world.

Inevitably there are differences in approach, and yet the similarities shine forth. Each case is characterised by a detailed presentation of case history and present symptoms, diagnosis and analysis, discussion of treatment principles and approach, point selection and explanation, and treatment outcome. In each case moreover, we are presented with a real person whom we get to know by reading the case. Equally, in most cases we learn a lot about the practitioner, since most have chosen to be quite self-revealing. Of course many of the patients are cured but in a significant number of cases, although the interaction between practitioner and patient brings great benefit to the patient, some of their discomfort remains. As we know, this is what really happens in practice, and the openness of some practitioners writing here is truly moving, none more so than Nicholas Haines: Sometimes I hate my work. I hate seeing or experiencing things that I really don't want to, having to face up to situations in other people's lives that would be my worst nightmare, and getting to know and care about people who are already suffering or who are going to suffer horribly. I would sometimes, in my selfish, blinkered way, rather not see these things. To hell with the idea of my work being 'rewarding', 'fulfilling' and of my 'helping people to die with dignity'. Alice is such a person and I feel so guilty saying it. Alice came to see Nicholas Haines with motor neurone disease. As well as describing in detail her symptoms and his Chinese medicine diagnosis, treatment principle, point selection etc. Nicholas charts his feelings of helplessness and sorrow as he sees this young woman with young children slowly deteriorate and approach her inevitable death. I have to admit that, at times, I felt pretty useless as an acupuncturist, always wondering whether Alice would have been in better health, happier, or even cured had someone else been treating her. Perhaps a better acupuncturist than I knew all the answers... With the help of acupuncture I think Alice has lived a little longer and that her time has been a little easier. But she will still die and I will still feel that I have failed her. I loved meeting Alice and being with her but, if I'm really honest, I would rather not have seen her suffering.

Many of the cases are inspiring and exciting. Jane Lyttleton describes the triumphant outcome of her treatment of Maria, a woman desperate to become pregnant who was left after surgery with just one quarter of one ovary which on her first acupuncture visit was failing to produce any follicles despite the highest doses of ovulation stimulating drugs. She had failed to conceive over 18 months of medication and IVF treatment, and yet after three acupuncture treatments was pregnant. When her first baby was six months old, unbelievably she became pregnant again and now has two children.

This book evokes a feeling of great respect in me for the work done by the many practitioners involved. Even allowing for the greater focus that inevitably comes into play when one's case notes are going to be published, what we see here is the work of a serious mature profession, whose practitioners are experienced, knowledgeable, skilled, sensitive and compassionate.

Finally, just because I was so struck by it, I would like to quote from Ted Kaptchuk's absorbing Preface on the tradition of case history presentation in classical Chinese medicine: Yet even further, for me, the deepest communication in this book is never quite verbalised. It touches on what Sun Si-miao (581-682 CE), the great physician, healer and alchemist of the Tang dynasty, wrote in the last year of his life when he was supposedly 99 years old. In his final statement on healing, Sun Simiao made what for China was an icono-clastic and radical declaration: people have illness 'because they do not have love in their life and are not cherished'.

Reviewed by Peter Deadman

Contents

Foreword Giovanni Maciocia

Preface Ted J. Kaptchuk

Acknowledgements

Introduction Hugh MacPherson

1. The cruel virus: a case of HIV and AIDS Nguyen Tinh Thong

2. Harry Sandra Hill

3. Diabetic neuropathy in the lower extremities Kiiko Matsumoto and David Euler

4. Ockham's razor and a case of ankylosing spondylitis Volker Scheid

5. Africa, malaria and a 'virus' Friedrich Stoebler

6. A heartsink patient Charles Buck

7. Treating the untreatable Nicholas Haines

8. Maria's children Jane Lyttleton

9. Pregnancy, nausea and multiple sclerosis Bob Flaws

10. Depression and fatigue after giving birth Arne Kausland

11. A case of postpartum complications? Stephen Birch

12. Elinor in the dance Dianne Connelly

13. A case of tropical acne Shmuel Halevi

14. Palpitations, periods and purpose Peter Valaskalgis

15. Shouting for sympathy Ken Shifrin

16. The tip of the volcano David A. Bray

17. Hysterectomy: is it necessary? Feli"city" Moir

18. The young woman who could only crawl Peter Delaney

19. Early damage Alan Papier

20. Judy, a left-handed Caucasian Miki Shima

21. California dreaming Richard Gold

22. Challenges that take their toll Bernard Cote

23. Out of my head and into my heart Leon Hammer

24. Like mother, like daughter Yves Requena

25. Undescended testicles Julian Scott

26. A case of a gastric ulcer Eric Marie

27. Unwinding a volvulus to cure a migraine Satya Ambrose

28. Epigastric pain Lucio Sotte

29. Irritable bowel syndrome and a painful shoulder Bert Zandbergen

30. An Achilles heel Daniel Bensky

31. Coffee, marijuana and back pain Arya Nielsen

32. A crushing pain the chest Mark Seem

33. Unresolved shock Holly Guzma'n

34. Surrender or control? Jurgen Mucher

35. Managing pharmaceutical drug withdrawal Dan Kenner

36. Solidity and fragility Zoe Brenner

37. Anxiety, agitation and angry determination Richard Blackwell

38. A clear case of possession Angela Hicks

39. Fleas, ponies, doctors, angels Harriet Beinfield

40. Headaches, angels and guiding spirits Jacqueline Young

Index