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LETTERS
TO THE EDITOR
To
the Editor: I read Michael Buffington's article, "The Five
Phases Paradigm and The Myers Briggs Type Indicator: Correspondence
and Therapeutic Applicability," with interest. Based on my previous
knowledge of Myers-Briggs typing and my clinical observations,
I find this a useful correlation that can be applied to treatment
planning as well as patient education regarding health maintenance
from both a physical and emotional standpoint. I appreciate Dr.
Buffington's attempt to bring each Yin and Yang element type to
life with a real or fictional character example. However, he uses
male figures in nine of ten types.
In the alternative and complementary
medicine report in JAMA, it was stated that the majority of patients
seeking such modalities (doctors like us) are women, not to mention
that at least 50% of the population is female. I look forward
to more from Dr.. Buffington on this topic, and expansion of his
examples to include a female representative for each type.
--Alison Lee, M.D.
Ann Arbor, Michigan
The
Author's Reply:
To the Editor: Thank you, Dr.
Lee, for your comments regarding the Myers-Briggs article. I couldn't
agree more with your ideas. Women do indeed make up a majority
of patients in the doctor's office. (The result of a more complex
spleen meridian and therefore, iGm system, I suppose.)
How about presenting some good female
types from your perspective? We could have fun with Goldie Hawn
or Lily Tomlin, for example.
-- Mike Buffington, M.D.
De Queen, Arkansas
To
the Editor: The recent article by Dr. Amelia Dolson entitled,
"Acupuncture From A Pathologist's Perspective: Linking Physical
to Energetic," was both interesting and curious. It was interesting
from the standpoint that a pathophysiological and embryological
hypothesis for an "energy based physiology" was being outlined.
Curious from the standpoint that not one reference was made to
the concept of Matrix Regulation Theory, proposed by the late
professor Alfred Pischinger. Pischinger, a professor of Histology
and Embryology at the University of Vienna, and the "father" of
modern Histo-chemistry, spent his entire professional career studying
cellular communication. The first edition of his sentinel work,
"Matrix and Matrix Regulation," published in German in 1975 and
English in 1991 ( 1 ), should be required reading in all U.S.
medical schools. It clearly and scientifically establishes the
ground (Matrix) regulation system as the final common pathway
for all "information ('energetic') based" clinical regulation
therapies. It is now required reading at most European medical
universities. Acupuncture, of course, is a fundamental information
('energetic') based regulatory therapy. Apparently, Dr. Dolson
is either unaware of or does not subscribe to Pischinger's concepts.
Hopefully, it is the former. We believe a review of these concepts
would certainly have enhanced Dr. Dolson's otherwise interesting
paper. The persistent bias of the American academic medical community's
lack of knowledge and/or interest in European medical scientific
work has resulted in a serious information gap in the American
scientific community's lack of understanding regarding information-based
"regulation therapies." Such lack of information is unfortunate
for those clinicians trying to put their clinical experience with
patient responses into a framework they can accept and understand.
We suggest any clinician using acupuncture will be well served
by carefully reading Pischinger's sentinel work and the included
references.
-- David A. Edwards, M.D., FACP, FBIH
Corazon lbarra-llarina,
M.D., FBII I
Reno, Nevada
1. Pischinger A. Matrix and matrix regulation basis, for a holistic
theory in medicine (English edition). Haug International. Brussels,
Belgium, 1991.
The
Author's Reply:
To the Editor: I thank Dr.'s Edwards
and Ibarra-llarina for their interest and comments. In my article,
I attempted to link embryologic, biochemical, structural, and
mechanical models of the physical body with the energetic. Dr.
Pischinger's book, "Matrix and Matrix Regulation, Basis for a
Holistic Theory in Medicine,' explores the largely biochemical
aspects of extracellular matrix. I particularly appreciate the
book's discussion of the pathogenesis of chronicity in the connective
tissue and arteriovenous anastomoses. I fully agree that the extra
cellular matrix is essential to biologic regulation. As I explained
in my paper, many of the extracellular matrix proteglycans also
interact electrically with collagen, a property which I believe
is an important link from the physical to the energetic.
Your main concern seems to be a lack
of understanding about information-based "regulation therapies."
I can assure you that this is a goal that you, Dr. Pischinger,
and I share. 1 suspect availability of appropriate literature
is only a small part of what is needed; the larger measure is
a paradigm shift, which I believe is underway.
-- A. Lynn Dolson, M.D.
Tallahassee, Florida
To
the Editor: I was very excited when I received my copy of
the Medical Acupuncture journal. It's like watching the birth
of a baby! As a family physician and acupuncturist in solo practice,
it was great to have my colleague's approaches to problems. I
would like to see all case reports given in the same format as
Dn Jordorkovsky's, with the actual points and electrical connections
given. Keep up the good work and thank you to all the people who
worked hard to make this a reality.
-- Marie Steinmetz, M.D.
Alexandria, Virginia
To
the Editor: As a recently trained disciple of Dr. Helms, who
is boning up for the Proficiency Exam in April, I was momentarily
frazzled to read on the inside cover page in the section on standard
nomenclature, of Vol. 10/Number 1 in our journal, Medical Acupuncture,
that "Zang" refers to "Hollow organs," and "Fu" to "Solid organs."
Darn, would I ever get these strange words straight?
Once again, I went back to our Bible,
Acupuncture Energetics, where I was relieved to see that I had
actually remembered these alien terms correctly. The simple mnemonic
that I use is: Fu... sounds soft and airy; therefore, Fu goes
with hollow. I have other acupuncture mnemonics that are unprintable.
-- Allen Fein, M.D.
Westhampton Beach,
New York
From
the Editor: Thank you for your astute observations. "Fu-eey"
on us! Changes made.
-- Dr. Richard Niemtzow
To
the Editor: Dr. Steven Braverman's abstract concerning infected
total knee arthroplasty after acupuncture is of great concern.
l want to point out that Dr. Braverman is in error when he says
the overall risk of infection after total joint replacement is
8%. In recent large studies, the risk of infection after total
hip and total knee replacement is in the area of 1% (1,2).
While there is most likely no way
of knowing if this acupuncture treatment caused his post-operative
knee infection, I think it is probably not appropriate to perform
acupuncture in the early post-operative period.
-- Jonathan L. Kates, M.D.
Somerset, Pennsylvania
1. Infection as a complication of total knee replacement arthroplasty:
risk factors and treatment in 67 cases. J Bone and Joint Surgery,
Inc. Vol. 72-A, No. 6, July 1990;878-883.
2. Current concepts review: infection after total hip arthroplasty.
J Bone and Joint Surgery, Inc. Vol. 77-A~ No. 10, October 1995;1576-1588.
The
Author's Reply:
To the Editor: I would like to
respond to Dr. Kates' comment regarding the abstract entitled,
"Infected Total Knee Arthroplasty: Potential Acupuncture Complication?".
Dr. Kates is correct when he identifies
the risk of deep joint infection following total joint replacement
at 1%. The risk of surgical wound infection following such surgery
is 8% (1). Ten to fifteen percent of these wound infections progress
to deep joint infections requiring surgical debridgement or removal
of the prosthesis. The patient in this case report had a superficial
wound infection that was reported in the poster presentation,
but not the published abstract.
Dr. Kates' comment, "it is probably not
appropriate to perform acupuncture in the early post-operative
period," is an opinion base on conjecture only, and one that is
not supported by the literature. The survey presented in this
abstract suggests that acupuncture may be safe and appropriate.
One case report does not suggest causality, but should be considered
carefully when entering into treatments that may be deemed as
risky by some. Treatments, such as this, place the acupuncturist
in direct line of fire for blame if a coincidental infection does
occur. This case points out the necessity for prospective trials
regarding the risk of acupuncture complications.
-- Major Steven E. Braverman, M.D.
Washington, D.C.
l. Gordon SM, Culver DH, Simmons B P, Jarvis WR. Risk factors
for wound infections after total knee arthroplasty. Am J Epidemiol
1990; 131 (5):905-16.
To the Editor: We have read
with interest the article, "Acupuncture Treatment of Migraine,
Clinical Observation," by Dr. William Lee, in the last issue of
Medical Acupuncture.
We are concerned, however, about using
the Chinese localizations of "organs," as these points are derived
from a functional observation and are not anatomically correct.
In failing to recognize the actual organs involved in an ailment,
the patient may lose more beneficial treatment through auricular
or body acupuncture, homeopathy, or herbal intervention. Further,
this leads to treatment of the symptoms rather than of the cause.
We are also interested in discussing
the use of the points Shen Men, Kidney, and "Sun." We are addressing
the use of Shen Men in a separate article in this issue. The author
refers to using the Kidney point that he places in the superior
concha. While this is commonly found on Chinese-style auricular
charts, this is anatomically incorrect. The proper localization
for the Kidney in Phase 1 is on the ascending helix, while the
Kidney of Phase 2 is in the lower concha rather than in the superior
concha. We may direct the reader's attention to the fact that
what the Chinese charts usually refer to as the "kidney" is, in
fact, the cerebral cortex in Phase 3, according to Dr. Paul Nogier,
"the father of both auricular therapy and auricular medicine."
There is no doubt that this point may have some control over kidney
function, but it is not a proper kidney organ localization. Finally,
the author also referred to "Sun" point, which we confess we never
have heard of before, and it is clearly not an organ.
The French Nogier auricular tradition
has steadf'astly maintained consistency in their point locations
as a function of anatomical and embryological development. This
offers the physician the opportunity to be far more precise in
knowing the true nature of a dysfunctional auricular zone and
its organ association in one of the 3 Phases. This precision will
lend not only further understanding of the pathophysiology of
a condition but also, yield more enduring clinical results when
treated.
Finally, we would like to note that the
French Auricular tradition has recognized that treatment of the
anterior auricular surface is better indicated when needing muscle
relaxation, and the mastoid surface is better indicated to give
muscle contraction. As such, the migraine patient will often respond
better with treatment on the mastoid surface, since the vasodilatation
causing the pain will be better ameliorated.
-- Nader E. Soliman, M.D.
Rockville, Maryland
Bryan L. Frank, M.D.
Richardson, Texas
To
the Editor: Upon completing the UCLA Acupuncture Clinical
in Bethesda, I wrote some songs for the class party. Dr. Helms
and Dr. Wendy Page-Echols suggested they might be fun to see in
Medical Acupuncture. After you review them, I hope you agree.
-- Christine Deignan, M.D.
Bettendorf, Iowa
To
the tune o f"My Bonnie Lies Over the Ocean"
My De Chi lies over the Dan Tien,
My De Chi lies over Heart 3,
My De Chi lies over the Dan Tien,
Oh, bring back my De Chi to me!
Bring
back, bring back
Bring back my De Chi to me, to me
Bring back, bring back
Bring back my De Chi to me.
Oh!
Blow the wind o'er the Feng Fu,
And blow the wind o'er the Feng Chi,
Oh! Blow the wind o'er the Feng Fu,
And bring back my De Chi to me!
Bring
back, Bring back
Bring back my De Chi to me, to me
Bring back, bring back
Bring back my De Chi to me.
Electrons
ran over my Ming Men
Electrons ran over Heart 3,
Electrons ran over my Ming Men
And brought back my De Chi to me.
Bring
back, bring back
Bring back my De Chi to me, to me
Bring back, bring back
Bring back my De Chi to me.
To
the tune of "I've Been Working on the Railroad"
I've been working on the Rong Chi
All the Jing long day
I' ve been working on the Rong Chi
Just to pass the time away
Don't have hear the kori calling?
Rising up so early in the morn
Don't you hear the liver shouting?
"L
1 blow your horn!'
L 1 won't you blow,
L 1 won't you blow,
L 1 won't you blow your horn ? (Repeat)
To
the tune of "Knick-Knack Paddy-Whack"
This "Old Joe" he played one
He played Moxa-knack on my thumb.
With a Moxa-knack. ITO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played two
He played Moxa-knack on my Sbu.
With a Moxa-knack, ITO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played three
He played Moxa-knack on my Zu San Li.
With a Moxa-knack, lTO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played four
He played Moxa-knack on my pelvic floor.
With a Moxa-knack, lTO-whack,
Push it through the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played five
He played Moxa-knack on my sex drive.
With a Moxa-knack, lTO-whack,
Got to find a bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played six
He played Moxa-knack on my "UCLA Helms-approved" sticks.
With a Moxa-knack, lTO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played seven
He played Moxa-knack on my Anterior Heaven,
With Moxa-knack, ITO-whack,
Push it to the bone
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played eight
He played Moxa-knack on my Wind Gate.
With a Moxa-knack, ITO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played nine
He played Moxa-knack on my spine,
With a Moxa-knack, ITO-whack,
Push it to the bone,
Then "Old Joe" comes Fu Xi home.
This
"Old Joe" he played ten
He played Moxa-knack once again,
With a Moxa-knack, ITO-whack,
Push it to the bone,
Then " Old Joe" comes Fu Xi home.
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