This paper entitled “Ma Huang (Herbae Ephedra): Setting the Record Straight” appeared in the Journal of Chinese Medicine, February 2016 issue. The article presents the Western biochemistry of ephedrine and pseudoephedrine (the pharmacologically active ingredients in Ephedra), and the Chinese medicine application of the whole herb, Ephedra. The paper reviews the proper uses of the Chinese herb in anti-asthmatic formulas, and the improper applications of the herb in combination with caffeine for weight loss. Ephedra was banned in the United States in 2004 and it is important to understand what went wrong when it was combined with caffeine, a combination never used in Chinese medicine. It is also very important to understand how it is being safely used in China and Japan today. The question posed is, should the abuse of an herb weigh against its right or proper use?
My second case report was published in the September 2012 Journal of Chiropractic Medicine. The title is “Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine.”
It documents the complete resolution of daily headaches with superimposed migraines after five treatments. This is noteworthy because this patient had suffered from episodic migraines since she was a teenager.
The neurological mechanisms of acupuncture and spinal manipulative therapy involved are also described in great detail.
I would like to thank Dr. Yihyun Kwon, DC, MSOM, PhD; my faculty advisor, Dr. Jerrilyn Cambron, DC, MPH, PhD; and Robert Hansen, Graphic Designer, for their contributions to this case report.
JCM September 2012, Volume 11, Number 3, pages 192-201
The World Health Organization has reported that acupuncture therapy; tested in controlled clinical trials and reported in recent literature, is considered effective for1:
- Adverse reactions to radiotherapy and/or chemotherapy
- Allergic rhinitis (including hay fever)
- Biliary colic
- Depression (including depressive neurosis and depression following stroke)
- Dysentery, acute bacillary
- Dysmenorrhoea, primary
- Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)
- Facial pain (including craniomandibular disorders)
- Hypertension, essential
- Hypotension, primary
- Induction of labour
- Knee pain
- Low back pain
- Malposition of fetus, correction of
- Morning sickness
- Nausea and vomiting
- Neck pain
- Pain in dentistry (including dental pain and temporomandibular dysfunction)
- Periarthritis of shoulder
- Postoperative pain
- Renal colic
- Rheumatoid arthritis
- Tennis elbow
Acupuncture is a therapeutic modality that has been used for about 2,000 years. It likely started in a more rudimentary form, perhaps stimulating specific points on the body with rocks. Like modern science, the practice of acupuncture has evolved as our understanding of anatomy and physiology has advanced. Acupuncture is a practice that is ahead of the research. We know it works for example to relieve pain, and we’re in the process of understanding the mechanisms.
Acupuncture cannot be a placebo because its effects are observed in anesthetized animals. The natural endorphin effect that Dr. Pomeranz is credited with discovering was demonstrated in anesthetized lab mice.
The late Professor Bruce Pomeranz described himself as a Popperian scientist, meaning he would develop a hypothesis and attempt to disprove it. He spent 20 years attempting to disprove acupuncture analgesia and was unable to do so. In the process, he proved through several lines of hypotheses that acupuncture did indeed work.
Dr. Pomeranz graduated from McGill University, earned his Ph.D. from Harvard University in 1967, and conducted research at Massachusetts Institute of Technology before becoming a professor of physiology at the University of Toronto in 1979.
The story I’ve read is that Dr. Pomeranz had a Chinese student who told him about the analgesic effects of acupuncture. True to his Popperian scientific mind, Dr. Pomeranz set out to disprove acupuncture analgesia. The results of the experiments, however, demonstrated that acupuncture created analgesia that could not be explained by any of the science known at the time. As a result, Dr. Pomeranz didn’t publish his findings; instead, he shelved them.
In 1975, at the University of Aberdeen in the United Kingdom, Dr. Hans Kosterlitz and his colleague John Hughes discovered neuropeptides, which they named enkephalins and endorphins. These pain-relieving chemicals are produced naturally in the brain in response to things like exercise and meditation.
The pain-relieving effect of acupuncture has been known for several millennia, yet the analgesia that Dr. Pomeranz demonstrated repeatedly in his lab experiments could not begin to be explained until 1975 with the discovery of the new neuropeptides. This is the perfect example of what I mean by the practice is ahead of the research. We know acupuncture works, and we are now beginning to understand how.
We now know that the endorphin, enkephalin, and dynorphin release during acupuncture is only one piece of the puzzle. Acupuncture has many other positive and dynamic effects. Locally, where the needle is placed, acupuncture stimulates the release of adenosine, which increases microcirculation. Low blood flow, or ischemia, is associated with myofascial pain and joint pain; therefore, increasing blood flow through acupuncture can provide great relief. Acupuncture also increases acetylcholine esterase levels. This enzyme breaks down acetylcholine at the neuromuscular junction, thereby relieving unrelenting painful muscle contraction and loosening those knots and boulders in the shoulders that remain after we’ve relaxed.
This is by no means an exhaustive list of the therapeutic effects of acupuncture. It is just a sampling, just the beginning.