Medical Acupuncture
A Journal For Physicians By Physicians

Spring / Summer 1999 - Volume 11 / Number 1
"Aurum Nostrum Non Est Aurum Vulgi"

     
     
     
     

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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