Today was the third day of our acupuncture course. We are starting to get the hang of the bus system and getting to class on time. The buses run fairly frequently, so as long as we leave early enough to pass up the buses that are too full, we are able to get to campus comfortably and fast.
The topics we discussed in class today were etiology for disease in traditional Chinese medicine, how to diagnose disease in traditional Chinese medicine, the various types of instruments used in acupuncture, and the various methods used in acupuncture.
The etiology of disease in traditional Chinese medicine is based mainly on the six exogenous factors (wind, cold, summer heat, damp, dryness, and fire) and seven emotions (joy, anger, melancholy, worry, grief, fear, and fright). These factors are thought to cause non-infectious disease while infectious pathogens are another category. Each of these factors fall under the yin or yang category, which determine where in the body becomes invaded as well as causing yin and yang imbalance. Yin qi will invade the yin side of the body and yang qi will invade the yang side of the body. Additionally, the natural characteristics of each factor describe how the disease spreads. For example, wind will cause disease that has rapid onset, migratory symptoms, and rapid changes. Multiple factors may invade the body together, though certain opposing factors will never be found in combination (ex. fire and cold). Wind is the only primary exogenous factor that can lead other factors into the body. The seven emotions will usually not cause disease unless they become overwhelming or uncontrollable. Five of the seven emotions are tied to a zang fu organ and will show symptoms in the associated organ when there is emotional imbalance.
Diagnosing disease in traditional Chinese medicine involves observation of the patient, auscultation, olfaction, history from the owner, and palpation. This approach actually has many parallels to the way we are taught to approach a case in our conventional veterinary curriculum. Dr. Liu mentioned that history from the owner is one of the most important parts of diagnosing disease, which is also emphasized by our clinicians back in the States. In TCVM, two other important observations include the color, shape, and coating of the tongue as well as the characteristics of the patient’s pulse.
We also learned that an important aspect of treating disease with acupuncture is deciding on the type of needle to use and the method you will apply. The most commonly used needles in the US are filiform needles, or dry needles, and the most common methods used are white needling (or dry needling) and electro-acupuncture. In China, along with filiform needles there are many other types of needles, such as round-sharp needles, 3-edged needles, chuan huang needles, fire needles, eyebrow-shaped needles, gas-releasing needles, etc. used for other acupuncture methods such as hemo-acupuncture, fire acupuncture, and moxibustion. Unfortunately for us, not only are these needles difficult to acquire, the methods are not commonly accepted in the United States.
Dr. Liu explained that there are various techniques for inserting acupuncture needles, manipulating them after insertion, and removal of the needles. Needles are commonly held in one hand while the other hand holds the skin in place. Since animals have such flexible skin, there are several ways to stabilize the skin for needle insertion, such as pinching, stretching, and thumbing. It is important to prevent the skin from moving during needle insertion as otherwise the needle may be distorted after insertion and will miss penetrating the acupuncture point. Once the needle is inserted, varying levels of stimulation can be applied to the acupuncture point by either extending the time that the needle is left in the point or by manipulating the needle such as twirling, thrusting, or rotating. Needle removal usually involves holding the skin stable with one hand and twirling and pulling gently with the other hand until the needle comes out.
After this class, we were all excited to practice these methods next week. While it is a lot of information to be learning, everything is all so interesting. It seems amazing that ancient Chinese doctors were able to do so much just based on what they saw through gross observation.
Once we were dismissed from class, a few of us, along with Dr. Hoenig, Dr. Clark-Price and three of the host students (Hu, Wang and Fan), went across the city to a silk shop and pearl market. It took us quite a while to get to the silk shop and upon arrival, we were informed that it was closed! Amazingly, the owner of the shop was there and offered to keep the shop open just to let us look around. The shop was so beautiful. They even had real silk worms in a basket to show how the silk is made! The shop had multiple floors and all of us went home with some gifts for friends and family. Our next stop was the pearl market where our student hosts had a blast bargaining with the shop owners for us. Within the market, there are many different vendors trying to sell their products. Since there is so much competition there among vendors, bargaining is expected. It was a great experience and we had a lot of fun with our student hosts. After leaving the pearl market, we all had dinner at a lovely restaurant where the student hosts suggested different dishes for us to try. One was a pear and white fungus dessert. It was delicious and quite a few of the students enjoyed it. We parted ways with our student host s on the subway and headed back to the hotel late in the evening. What an eventful day!