Migraine Headache and traditional Chinese medicine

Back in the year 2001 I started a site:

Migraine/Headache at http://www.lews.info/headache/".

This site aims to give a perspective of how traditional Chinese medicine (TCM) sees the problems of headache/migraine. You'll see what 'syndromes' mean to the diagnosis of proper causes, how 'symptoms' help in reaching the right conclusion, what 'channels' are responsible for a specific parts of headache, how migraine is classified in terms of TCM diagnostic methods, some of the case studies that illustrate real cases of headache/migraine, what specific herbs are for various types of headache/migraine. Further readings are provided if you're interested in some of the deep theories of TCM.

Below are the categories I started with:

Headache (general):
Headache: Causes and Mechanisms
Discussion on Endopathic/Internal Headache
Differentiative Diagnosis
Channels of Headache
Locations/Characteristics of Headache
Conclusion

Headache (Syndromes):
Hyperactivity of the Liver-yang
Deficiency of the Kidney-yin
Insufficiency of Kidney-yang
Deficiency of both Blood and Qi
Retention of Phlegm and Dampness
Blood Stasis

Headache (Symptoms):
High Blood Pressure (Hypertension) (Liver-Jue) Headache
Low Blood Pressure (Hypo-tension) Headache
Headache due to Premenstrual Syndrome (PMS) or Premenstrual Tension (PMT)
Headache due to Menopause (Climacteric Syndrome)

Migraine:
Migraine (Neuro-headache)
Modern understanding of the causes of migraine
Modern interpretation of the manifestations

Treatments According to Syndromes
S1: Wind-Heat type
S2: Wind-Phlegm type
S3: Qi Stagnation due to Liver-Fire type
S4: Jueyin Inner Cold type
S5: Blood deficiency
S6: Insufficiency of Qi

Migraine differentiation in accordance with symptoms
Type 1: Mono Type (Accumulation of Cold in the Liver Channel and Qi Stagnancy)
Type 2: Blinking Dim Spots Type (Three syndromes in TCM)
Type 3: Complex Light Spots Type (Accumulation of Cold in the Liver Channel and Qi Stagnancy)
Type 4: Cluster Type (Stagnancy of the Liver-Qi and Exterior Wind)

Case Study:
Headache due to Blood Stasis
Headache due to High Blood Pressure (Hyperactivity of the Liver-Yang)
Headache due to Loss of Blood
Headache due to Low Blood Pressure Type (Deficiency of both Qi and Blood)

Migraine: Mono Type (Accumulation of Cold in the Liver channel and Qi Stagnancy)
Migraine: Bush Type (Stagnancy of the Liver-Qi)
Migraine: Complex Light Spots Type (Stagnancy of the Liver-Qi)
Migraine (Wind-Cold Type due to Insufficiency of Kidney-Yang)

Specific Herbs:
藁本，GaoBen, Gao Ben, Ligusticum Sinense (Ligusticum Sinense Oliv.)
川芎，ChuanXiong, Chuan Xiong, Chuanxiong Rhizome (Rhizoma Ligustici Chuanxiong)
白芷，BaiZhi, Bai Zhi, Dahurian Angelica Root (Radix Angelicae Dahuricae)
吴茱萸，WuZhuYu, Wu Zhu Yu, Evodia Fruit (Fructus Evodiae)
柴胡，ChaiHu, Chai Hu, Bupleurum Root (Radix Bupleuri)
细辛，Xixin, Xi Xin, Wild Genger (Herba Asari)
苍术，CangZhu, Cang Zhu, Atractylodes Rhizome (Rhizoma Atractylodis)
羌活，QiangHuo, Qiang Huo, Notopterygium Root (Rhizoma seu Radix Notopterygii)
防风，FangFeng, Fang Feng, Ledebouriella Root (Radix Ledebouriellae)

Resources:
"Zhang's Medical Comprehension", by Zhang Jing-Yue
"The Heart Law of Dan Xi", by Zhu Dan-Xi
"Medicine Narration", by Wang Ren-Yen
Manifestations of Headache, various contributors
The Causes of Migraine, various contributors
Links to other Migraine Headache sites

For more details please visit "http://www.lews.info/headache/"

Premature Ovarian Failure (POF) vs. Menopause, from the perspective of traditional Chinese medicine

[POF vs. Menopause] To begin with, traditional Chinese medicine (TCM) looks at Premature Ovarian Failure (POF) from the point of view of amenorrhea, infertility and its related symptoms. Many symptoms of POF are like premature menopause, amid an abnormal one. These symptoms are hot flashes, night sweats, energy loss, vaginal dryness, low sex drive, sleeping problems, loose bladder control and etc.

[The role of Kidney-Qi] From TCM theories, kidney system is the one responsible most for POF. If the kidney-qi (energy) is strong, the Chong and Ren channels (of which acupuncture is based on) will be full of energy and menstruation will come on time every month. POF, with its absence of menstruation, therefore falls into the category. According to modern research, Chinese herbs that boost kidney-qi, by regulating kidney system, remarkably raise estrogen level, and doing so without the side effects of HRT (Hormone Replacement Therapy). Modern research and traditional efficacy seem to blend in well in this case. (Pic: Visualization of qi of internal organs & systems)

[Other syndromes] Warming the kidney-qi is suitable for those who are (1) lacking of kidney-qi or warming energy. There are other syndromes manifested by patients of POF. Among them are: (2) Deficiency of kidney-yin, (3) Blood stagnation due to qi-exhaustion, (4) Stagnated liver-qi and deficiency of kidneys, (5) Accumulation of phlegm and wetness, and (6) Deficiency of blood and kidneys.

So there are at least 6 syndromes of POF. The question is: which one does a particular patient belong to?

[What type am I?] Sometimes it can be a combination of two or three syndromes in one body. It depends on which syndrome is more prominent than the others. In fact, every individual is unique. And therefore manifestation of diseases on different bodies can have different symptoms. This is a very important concept of TCM. Another woman may have POF but display quite different signs and symptoms; because of different body types and syndromes.

It's therefore important to have the correct diagnosis, both from conventional medicine and TCM diagnosis.

[TCM diagnosis of syndrome] Traditional Chinese medicine (TCM), nonetheless, doesn't work by just knowing diagnosis (the name of the disease) of conventional medicine. She will need to go to a TCM physician for a complete TCM diagnosis based on methods of, among them, pulse taking, tongue reading, symptoms profile, and histology and so on. By combining all these information then only can a TCM physician diagnose your SYNDROME, a phrase describing your body and constituent and its relationship with the illnesses. After knowing the syndrome of her illness, an herbal or acupuncture (choice of acupoints and manipulation methods) prescription can then be formulated. An herbal prescription can have from 8 to 16 herbs (or more or less, depending on individual needs), ranging in different amounts. Prescription of Chinese herbs can hardly be one or two herbs. It’s the interoperability of these many herbs that works in a more complete care for the body.

[Acupuncture treatment in accordance with syndrome] The above are herbal treatments. Another treatment method worth considering is acupuncture. The kidney essence is everything before an ovulation is possible. Deficiency of kidney and its essence is thus one of the most prominent syndromes of POF. By tracking both of DU channel and kidney channel, a few acupoints such as Guan Yuan, Zhong Ji, Da He, and Zi Gong, Shen Shu, Yong Quan can be taken for acupuncture treatment. All these have been proven to be effective for symptoms related to POF. (Pic: Ren channel)

Consultation with a qualified TCM physician is for sure necessary for proper diagnosis of syndrome and the subsequent herbal or acupuncture treatment methods.

Bali trip day 1

Been back home for 3 days. Busy working with follow-up patients and some paper works. And it's the end-beginning of the month; it's time to analyze the whole month's works.

My wife, Louise, and I enjoyed the Bali, Indonesia trip very much in many ways: It's well-paced and we had time to relax and did something we've never done before. The air ticket package had the hotel covered and all that we needed to do was to take our time to check out places of interest.

Day 1:

On the first day we landed at Denpasar (Bali International Airport) at noon time and took a cab to head to Novotel Tanjung Benoa. The resort is great with nice landscaping and as I should know right now it's Balinese architecture. In fact, more I'd like to learn about the arts and philosophy of the architecture. But for now let's talk about the trip. We checked in and were greeted by friendly customer service and the Guava drinks were refreshing. Should have asked for second glass! Louise and I sheepishly asked for the availability of SEA-VIEW room and were told yes there are 8 bungalows on the beach side and only two have sea views. Eventually our hotel room is located across the street but not on the beach side! Ala… just a momentary upset as we knew we were on budgetary trip. The good thing is there are pools both across the street and on the beach side. So it's after all a 4-star hotel resort. After a light unpacking at the hotel room we were both a little hungry and decided to check the place out for some restaurants. Initial checking left us the impression that the place is quite remote from main town and therefore we went to the hotel beach club for lunch.

And this was where the food poisoning issue took place! We ordered fish and chips (Louise and I have been half vegetarians for a year), mixed fruit juice and pineapple juice. Thinking about it, we should have known it coming as Louise commented the fish (or the combination with pineapple juice) tasted funny and tingling. I took one piece of fish and realized it wasn't very fresh but was ok. 15 minutes into it Louise started to have itchy rashes on her neck, upper arms and feeling very hot. While we were having lunch, we bumped into a Malaysian couple who were on honeymoon. They saw us having dinner and we invited them to sit down for a chat. While we enjoyed exchange remarks on this beautiful island Louise was getting more and more uneasy. And she even felt facial numbness. All those symptoms told me it's more than allergic reaction; it can be a combination of food poisoning and allergic reaction.

It was only later that we recalled seafood (especially shrimps) contains high amount of arsenic which is believed to harmless for most conditions. When a large amount of vitamin C (as in some fruit juices) is taken together with seafood, however, this arsenic can prove to be very poisonous and fatal, the mechanism of which is still not very much known.

Quickly we went back to the hotel room and put a cold pack on her forehead. Nausea started to come in and I was thinking it's better to vomit all those food in the stomach than have them decompose to more toxic reaction. A few induced vomiting caused violent vomiting. It was harsh and it had to be done. After the stomach was empty I handed her half glass of warm water. The idea is to clear the digestion tract and dilute the toxins. I also applied acupressure technique on acupuncture points Hegu, Quchi to reduce the heat and stomach toxins. Half and hour later, with all the combined techniques she got better. With facial numbness and body temperature subsiding, we knew the situation was under control and were much relieved.

We decided to just rest for the evening.

Then again human beings can't be tamed easily. 3 hours later when the temperature is cool, rashes gone and numbness disappeared, she wanted to go out and explore. Well, knowing she's much better, I was eager to walk around the neighborhood too. We decided we wanted to walk south to the Nusa Dua direction. Along the way there are plenty of restaurants and small travel agencies. And to my surprise, Polo Ralph Laurent seems to be everywhere and so much cheaper (Then later we also saw plenty of just "Polo", so there are two Polos?) than it is in Malaysia. Souvenirs shops are everywhere too and the arts of bargaining came in readily. Ha. Louise and I are not so much shoppers (For sure I'm not) but we were ready to get something simple for a few friends and colleagues.

Before that was the necessity to take dinner. With the shadow of food poisoning Louise wanted to eat porridge to replenish fluid in stomach. Porridge? Steamed white rice is everywhere but not porridge. We walked further to the south and to our pleasant surprise there was indeed a Chinese restaurant! And it's pretty exclusive too! Being half vegetarians and in the need of porridge it came handy with the Chinese lady boss who can speak Mandarin pretty well. She patiently listened to our need of fluid and vegetarian menu and recommended exactly what we needed. While waiting for the dinner, we came to understand she was originally from East Jawa and just moved to Bali not long ago. She doesn't write the Chinese much but communication in Mandarin is splendid. She also briefly told us when President Suharto was around, things were hard for the Chinese culture to be kept. And guess what, Suharto passed away during noon time on the first day we landed on Indonesia. The man who was there for 32 years, probably the longest ever premier of anywhere in the world, was gone and dead…

I only got to know in the evening when we got back to hotel room and switched on the TV for some local news (My habit or checking out local newspapers, news, magazines). And then Berry, my Indonesian friend who lives in Jakarta, smsed me about the news later. My question as that time was: "How is he going to be remembered in the history of Indonesia and Asia?" Probably I'd compile a story on this later. It helps too in understanding Indonesian history for the past three decades.

By the way, food at this Chopstick Restaurant (at Club Bali Mirage, Jalan Pramata 72, Tanjung Benoa, Nusa Dua, Bali) was very authentic indeed. The taste and the way the food are prepared and cooked were just so typical of Chinese style. I say this because many Chinese restaurants in the USA and Europe have their foods heavily modified to suit local needs and tongue of favours. While it's understandable to do so to blend in, the authentic taste of the food is no longer Chinese.

When we are hungry there is not much we can and want to do in life. Now that Louise and I are full and spirit rising high, we went back from the way we came to book 2 daily tours for the next day. (Pic: Garuda, Half-man-half-eagle)

What is acupuncture? What can it do?

Q: What’s acupuncture & how does it work to treat diseases?
A: Acupuncture is a natural holistic approach of healing. With insertion of sterilized disposable needles into the acupuncture points to balance the qi (energy). If qi is too much, stagnant or too little, it will cause diseases. The right manipulation techniques adjust the qi to its appropriate conditions and enhance our body‘s immune system.

Q: What diseases can be treated with acupuncture?
A: Acupuncture has been proved - through controlled trials - to be effective for(*1): •Adverse reactions to radio and/or chemotherapy•Dysmenorrhoea•Headache•Hypertension(HBP)•
Hypotension(LBP)•Stroke•Luekopenia •Sciatica•Rheumatoid Arthritis(RA)•Low back pain•Allergic rhinitis•Depression•Biliary colic•Periarthritis of shoulder•Neck pain•Nausea & Vomiting•Knee pain•Neck pain•Tennis elbow•Renal colic•Facial pain and etc.

Diseases for which therapeutic effect has been shown(*1): •Abdominal pain•Bronchial asthma•Cancer pain•Diabetes mellitus(NID)•Cholelithiasis•Facial spasm•Insomnia•Female infertility•Obesity•Herpes zoster•Hyperlipaemia•Chronic cholecystitis•Male sexual dysfunction•Meniere disease•Osteoarthritis•Polycystic ovary syndrome•Premenstrual syndrome•Neurodermatitis•Chronic ulcerative colitis•Alcohol, tobacco, opium, cocaine & heroine dependence•Sore throat•Tonsillitis•Raynaud syndrome•Female urethral syndrome•Schizophrenia•Gouty arthritis•Chronic prostatitis and etc.

Q: Is acupuncture safe?
A: Acupuncture has no side effects. There is minimal risk of organ penetration. The locations, angles as well as depth of insertions are closely observed to avoid injuries. Proper sterilization and disposable needles are used.

(*1): “Acupuncture: review and analysis of reports on controlled clinical trials”, WHO (World Health Organization) research paper. Geneva 2002. ISBN 92 4 154543 7 (NLM classification: WB 369)