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communications
Letters
to the Editor
To
the Editor: Re: "Acupuncture Treatment of Bell's Palsy: A
Case Report," by Dr David Sniezek, Medical Acupuncture, Fall/Winter,
1998-99 (Vol. I O/No. 2).
I do congratulate you on the quality
improvements on the journal. I also commend you for your desire
to improve the quality of the published articles. In this regard,
I wish to point out the above-mentioned article probably should
not have seen the light of day. In the first place, it is only
one case of Bell's palsy that was treated with acupuncture. In
the second place, Bell's palsy is a self-limited disease and the
majority of the cases, particularly in young people, always improve.
The difficult cases are those in elderly individuals and those
with diabetes. Therefore, I do not feel it worthy of the journal
to publish case reports like this. One should know the natural
course of the disease before attributing improvement from a certain
treatment.
- Atremio G. Pagdan, MD
La Jolla, California
The
Author's Reply: I want to thank Dr Pagdan for recounting the
importance of understanding the natural progression of Bell's
palsy. 1 felt this was already well known by your readership and,
therefore, only tangentially discussed this in my article. What
made this particular case unique was that this was a severe case
of Bell's palsy that did not improve at a time when we would expect
to see improvement, followed by quick and dramatic improvement
after acupuncture treatment. Studies and experience in neurological
recovery also favor a less optimistic outcome when there is no
improvement during the first 3 months. When the facial nerve undergoes
substantial degeneration, as in this case, the ultimate recovery
may take up to several years, resulting almost always in aberrant
reinnervation.
Previous acupuncture studies observed
progress when treatment was initiated immediately, or before 2
months after the onset of symptoms. We expect to see significant
recovery during these initial stages without any treatment. I
believe these studies failed to adequately consider the natural
progression of this condition. What made our case interesting
was the severity, completeness of the degeneration, and the chronicity,
followed by dramatic improvement with only a brief course of acupuncture.
Given what we now know about this condition and nerve regeneration,
we would have expected a long and protracted recovery with incomplete
reinnervation. What happened instead was a relatively quick and
complete recovery. I felt this response was remarkable and worthy
of reporting and publication.
Of course, the result could be completely
coincidental, and the result does not prove that acupuncture altered
the natural progression of the disease. However, knowing what
we do about the slow and incomplete recovery of severe facial
nerve palsy, there is sufficient circumstantial evidence in this
case to evoke interest to consider further study.
-David P. Sniezek, MD
Washington,
DC
1. Kimura
J, Rodnitzky RL, Okawara S.
Electrophysiologic analysis of aberrant regeneration after facial
nerve paralysis. Neurology. 1975;25:989-993.
To
the Editor: The recent article by Dr Richard Niemtzow, "A
High Protein Regimen and Auriculomedicine for the Treatment of
Obesity: A Second Clinical Observation," published in Medical
Acupuncture (Vol. 10/ No. 2) was very interesting. However, I
want to alert the readers that what was described in the article
as "auriculomedicine" is, in fact, "auriculotherapy."
While auriculotherapy is a "physical
reflex technique" in which instruments such as a point finder
are used to identify active points like those mentioned in the
article, auriculomedicine is an "energetic reflex technique" that
identifies points using filters, as well as the change in the
radial pulse, known as the Vascular Autonomic Signal (VAS). Additionally,
while auriculotherapy deals with the inverted fetus representation
of Dr Paul Nogier, auriculomedicine deals with additional and
more complex presentations, namely Phases 1, 2, 3, and 4. The
author obviously used the basic inverted fetus representation,
with no use of filters or VAS. Hence, the distinction should be
clear that he used auriculotherapy and not auriculomedicine.
-Nader Soliman, MD
Rockville, Maryland
From
the Editor: Thanks for your kind enlightenment on the subject.
- Dr Richard Niemtzow
To
The Editor: Congratulations on your great work on the latest
issue of Medical Acupuncture (Fall/Winter, 1998/1999, Vol. I O/No
2).
I have a distinct impression that Medical
Acupuncture has become of age, and it is on the right track to
accomplish its mission.
Effectiveness of acupuncture has been
witnessed over the centuries, and there are many Western physicians
who have had personal experiences to testify to this. It is now
incumbent upon our medical community to demonstrate scientifically
the underlying explanation of its efficacy.
To that end, Medical Acupuncture is a
very logical vehicle. Your qualifications and enthusiasm, along
with the capable help from your assistant editor, Ms Roz Royal,
will be a great contribution to accomplish this goal. You have
my heartfelt good wishes, trust, and respect.
-William C. Lee, MD, MS
Minneapolis, Minnesota
From
the Editor: Thanks, Dr Lee, for your kind words. It is really
the membership that you have to thank for cooperating and sending
in their material.
- Dr Richard Niemtzow
To
the Editor: It was great to meet you in Chicago. Again, compliments
for the wonderful job you have done with our journal. It is a
quantum leap. I enjoyed the poems written by Christine Deigan.
I also wrote two poems on the occasion of the friendly roasting
of our mentor, Dr Joseph Helms, at the conclusion of our Pain
and Primary Care module. I am sending them for your review for
publication in our journal.
- Tapan K. Chaudhuri, MD, FRCP(C)
Kansas City, Missouri
"The
Origin of Acupuncture and How It Was Propagated To USA"
Little
by little, year by year,
He spread the word of acupuncture.
Women and men of every race,
Came running to be face to face,
With a man they called their savior,
Joseph Helms, the King, the Emperor.
"A
Prayer"
As another
meeting is about to convene in heaven,
This is a prayer
from the class of 1997.
Dr Helms, forever may he live,
So that he may continue to forgive
The poor students, who did not understand N+ 1,
Or did not know the application of distinct meridian.
Million more students, may he teach
In times of despair, which points to reach.
Stomach 7 or GV 20,
(To some of the preceptors, both are pretty),
How to piqure the manubrium,
In a pathetic design of triangular equilibrium.
May his kingdom keep on growing
With the chants of Mantras - Ting, Shu and Jing.
Oh God, please be certain,
That he continues to treat the students,
As if they were in a kindergarten.
This is our sincere desire
That forever lasts The Helms' empire.
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