Tag Archives: Pediatric Treatment Protocols

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What to do about Seasonal Allergies!

 

 

I would like to talk about seasonal allergies and some of you may have heard me talk about it, but I think it is because of this time of year, it is the time to talk about it and see how we can help people with this condition.

Click here to download the transcript.  Click here to download the slides.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, my name is Moshe Heller, and I would first like to think the American Acupuncture Council for having this, having me on this show. So great privilege and it’s a great show and helping us acupuncturists talk about different stuff. And I’m the first today I would like to talk about seasonal allergies and some of you may have heard me talk about it, but I think it is because of this time of year, it is the time to talk about it and see how we can help people with this condition.

So I will start with.

The weather’s getting warmer. The trees are starting to bloom and we are starting to feel that. Or our patients are starting to feel the effect of of this season. And I don’t know about you, but I’ve been getting a lot of calls to my office to try to help with these seasonal allergies.

So I wa I thought the best way to discuss how to help people with it is to bring a case. I’m going to talk about this young boy has, he was nine years old when he came to see me. And he’s been, he has been suffering from allergies for the past, about five years. So since he was about four and it’s interesting cause I’ve been seeing more and more children with allergies because I think it is actually a condition that is growing in numbers and we see more and more children and.

And adults would that matter who are suffering from allergies and we can see the numbers are growing. Even the CDC has published information about that too. So you are going to see more and more of these cases in your office to them. Sure. So he’s a nine year old. He is a chief complaint is nasal congestion, sneezing.

These are all and watery, itchy eyes. These are all very common symptoms of the seasonal allergies. Occasionally you will experience a lung congestion. So it goes down to his lung and he’ll have cough with a clear. And sometimes yellow sputum and this user does sputum is difficult for him to expect rate.

So it sounded it’s a sign of some congestion. The patient mother says that he’s more susceptible to catching colds than his peers. And family members. And she’s also reports that he’s allergy testing a reveal that he’s allergic to soy and tree nuts, which indicated to me, so other than the environmental allergies, he also has some food allergies.

He had a difficulty falling asleep and it was very hard for him to wake up because he would go to sleep late. And then only have six hours of sleep for a nine-year-old. As far as I’m concerned, this is not really a sufficient amount of hours. He also suffered from nasal clear nasal congestion.

He would have headaches when he was tired. And interestingly enough, he also had called sores one or two times per year. That cold sores for me are signs that there’s some kind of immune disorder. And also there’s a lingering pathogenic factor as involved with. He’s very sensitive to smells and his tends to have eczema behind the knees and elbows or in the elbow bends.

And the rash is usually red and itchy and raised in bumpy, but not Uzi. Eczema as usually another common disease that is Como co coincide with children who are very allergic. And also we see that with adults. He would have chest tightness and shortness of breath, especially when he’s exposed to cold.

So cold will make it the condition worse.

So his tongue is pale and puffy, which points towards some deficiency and slight center crack, and a red tip with particular in the upper jaw. And the coding is slightly thick and white meaning that there’s some More on the cold side and that the particular showing some underlying heat.

As we can see, it’s already pulling, pointing towards a complex. Condition, the pulse was slippery in the turn, but otherwise weak and his lymph LAN glands were congested and positive. This is something I do on a regular basis when I see children I palpated for the lymph glands under the jaw.

And along the anterior aspect of the SCM. So if they feel that if I feel that there are marble sized protrusions, then definitely that’s a positive lift Glen and a, usually those are the, when the lymph glands are positive, it points to. Maybe the condition involves a lingering pathogenic factors.

They have to see other factors also, but it’s a, quite a a strong, positive although he was nine, I was still looking at the finger vein and finger vein observation is something that we do a lot in pediatrics. It’s mostly done for children around to. Two years old, from from newborns to, to two or three afterwards traditionally it wasn’t used so much, but I’ve found it very helpful to look at that to look at the finger vein, even at older kids, because they’re radically.

At that age, it should not be president if it is it’s indicative of something. The finger Bain was very dark usually indicates heat. That was another indication that there was some underlying heat disorder in his case we, I observed his face and his cheeks seemed to be a bit red.

And the mother reports that they are a lot of times are red. And she said always red and there were also dark circles under the eyes and they were puffy. I have actually included a picture. You, it’s hard to see the redness in the cheeks and with the lighting. Case, but believe me, this area, this whole area, you could see it’s a little discard colored.

And you, and in real life, this was red. You could definitely see the dark area under his eye and you can absolutely see the puffiness of.

So I diagnose this, a guy with lingering passion, pathogenic factors and LPF with phlegm accumulation and underlying lung chief acuity. So there is definitely some lung T vacuity in the sense that that the tendency to get sick. And the lung congestion that happens as a result of that are all indicating that the lingering pathogenic factor included the large lymph gloat and the lymph gland and the history of having frequent colds and the phlegm accumulation could be seen in his tongue.

And and post. And the symptoms. I chose to use a combination of points, large intestine, 11 to help clear the heat, the underlying heat lung seven, to regulate the lung and strengthened the lung. Gallbladder 40 as a point to help clear the sinuses. It’s a point. Frequently when I see rhinitis or allergic rhinitis, a lot of times I would use that with moxa, especially if there’s pure cold in this case I didn’t, but frequently I will use marks on go about at 40, I use spleen nine to.

To the spleen transform dampness and and so screen nine is a point I use a lot when I see that the spleen needs to trends to help in the evacuation of damp and phlegm. And then I also have added liver five is I know that some of you may have not don’t remember, but Oliver five is the master point of plump.

It for me, that trans translation of that, or understanding of that is that liver five helps to work. The liver work through phlegm. No. We know that Fleming damp does hinder the flow of Liberty. And therefore I look at liver five as a point that helps deliver, move through phlegm and help the transformation and movement to a phlegm and resolution.

So I used that a lot of times when phlegm is involved live. I sent the, I sent him home with magnets and I do that frequently with children to support the treatment or continue the treatment to have a more significant effect. And so magnets are an amazing tool. Both were adults and kids.

I find them very helpful if you understand how they work. Then it’s really easy to use. And I’ve used it for, I use it a lot with children and also adults, as I said before, the advantage of the magnets is that you have. Of the polarity. You have the ability to either disperse or tonify. So depending on what magnets you use the magnets I use come with a dispersing aspects.

Facing the skin. So if I use, if I stick the magnet to buy lab, as I received it, then this would be a dispersing function on by Lao. If I flip it over, it will be tonifying therefore you be 13 and you be 20. I flip them over and help to To tonify both the lung and the spleen. And then I use this point below stomach 44.

It’s on the other side, on the the sole side of the foot behind opposite to stomach 44. That’s a point that’s used by Kiko Matsumoto for Allergies in general and specifically allergic rhinitis. The use of below stomach 44 the opposite side of stomach 44 with a magnet and dispersion is a great take home for kids and also adults as a.

I recommended them to avoid dairy and wheat. And the reason is of course we I do believe that they are very allergy forming foods. But also they are if you remember, they are the major phlegm producing foods in, in Chinese medicine dietary theory. Avoiding dairy and wheat will help with resolving damp and phlegm, as well as avoiding soy and nuts.

Those, we also see that he’s allergic to, and it will be good to avoid them until the body is able to ex you know we clear some of the heat and the phlegm, and there’ll be an improved. And we also talked a lot about trying to increase the sleep to at least seven hours so that he starts going back to trying to sleep early.

We talked about different things like either yoga moves or chicken moves to help him move into. Sleep. And I taught him some of those and that also helped him to fall asleep a little faster in. I gave him some herbs as part of the treatment. I combined shout child who tongue with a variation of Wu may one.

You may ask yourself why why did he use womanly one? We’ll talk about that in a few minutes, but I use that frequently for patients who are trying to address allergic or atopic tendencies the treatment was continued once a week. The acupuncture treatment for six treatments. And at that time, the patient reported.

He felt less congested and the skin rash was almost completely gone in general. His, he had quite a significant improvement. The treatment continued for another six treatment, but every two weeks and after which the patient skin has cleared completely. And at the time the patient was, I gave another formula.

I changed the formula. We took him off of the shell child who tongue and gave him every Haitian of Jade windscreen for continued treatment and every changing of the season, he comes for our a tune up to prevent the recurrence of the allergies. And this has been very successful.

I put here the formulas in ingredients. So you have it, I’m going to send or post the PDF version of these slides. So you can have. But this is a variation of G of a jar. The will, may one. And this is the shower chow Yukon tongue, the classical shower champ, shallow child who tongue I use in his case.

And this is the variation of the Jade windscreen. I added some Jean one and a Jaguar to the combo to support his condition. I wanted to just Talk a few minutes, a few seconds about why I chose we’ll may one as my formula. This comes from the studies that Dr. Lee did for the treatment of food allergies and also allergies in general.

And she based her and you can actually see, read this article if you have a moment. I think it’s very interesting. The reason she chose the idea behind it, it comes from diet. The concept that actually. The exposure to per Siddiq two parasites in patients who have allergies will reduce their allergies or in air in areas where parasites are very common allergies are much.

Present. She thought that an antiparasitic formula will create similar effects. And indeed she did some studies that were very favorable and therefore I decided to this formula and right here you’ll have the exact base formula, which he star, she based her. Her research on, she called this formula F a H F one.

And it is basically the classical rule may wand. And one, one more second about this in her original formula, he she. The form of the, she took she food, the foods and the shisha were eliminated in her test form nine. And I guess they had some issues with both of these herbs and as a, as part of the formula, I later on created a similar format and I’ll talk to her about that in a few minutes.

I added it back. I also wanted to mention that allergies always equals diets for me. I have never treated an allergy person without discussing whether it’s food, whatever, the allergic reaction where it’s allergic asthma or allergic eczema or any atopic disorder. When we suspect there’s an allergy at the root of your patient’s disorder always discussed die.

It’s really important to eliminate phlegm producing foods. It’s a live and just look at the diet and see if it is a contributing factor. I want to remind you that there is at day two logical factors for allergy there’s. One of them is actually. Pesticide and GMO foods that irritate the gut and cause what we call a leaky gut syndrome.

So that’s also something that we need to look at and And so it’s really important to make a real important discussion, to have a really important discussion about food. So I always start by asking them, what do they eat? How’s their schedule and what’s happening. And I asked them to keep a three week journal food, John journal of what they’re eating and how it is affecting them in here.

You have. The chart that I have them fill out for each day. So that keeps me, keeps the record and helps me see if there’s any patterns or any foods that are being consumed that could be contributing to the factor. And as I said here, pesticides and GMO can be irritating to the gut and cause me one of the causes for the allergy allergic reaction.

I also strongly believe that vaccinations can definitely contribute to To the allergic reaction and because of their effect on or how we see the effect on the body and the FA the fact that the pathogen that is being injected can actually become a latent and cause hyper activity in the immune system.

So I actually developed a formula called guard in my company that’s called motion herbs. And you’ll see the link at the end of the slideshow a formula that’s called guard, and it is a formula that you will Give to your patients before and about two weeks before and keep it on two weeks after each vaccination.

So it helps to eliminate that causative factor. I also, as I mentioned before, leaky gut syndrome is another theory that we have about why a children have or adults also in that case have allergies. As you can see here, there’s an irritation of the gut and the relationship of.

The gut to the immune system will or could create allergies. I one of the Part of another syndrome that we should probably discuss, just because we are talking about allergies is mass cell activation syndrome. I have a few slides in here that are, that talk a little bit about what is mass cell activation and also.

What are the diagnostic criteria is here? There’s a, an article because this is a really important factor when we talk about allergies. Here’s the definition of mass cell activation disorders and And one of the sentence I wanted to point out is dermatographic ism, which means that when you scratch the skin, it leaves a mark, a stronger than most people.

And that’s a really good sign to an indicator for muscle activation disorder. I am going to leave you. To read the signs and symptoms and this really going all over many Systems in our body affecting many systems around a body, but I wanted to also talk to you, just point you to this three herbs Chinese Arbel three Chinese herbs that are, that there were some lists research done on how they can affect.

The the reduce mass cell activation. So it’s called the three or formula Shuang one Leons and it stabilizes mass cells through the activation of the ma mitochondrial calcium on a uni. These are really, this is, I thought very interesting. And you’ll have, this is the summary of the Arctic of the, this article.

And and so it will, I think it’s really helpful to read about that and know that this syndrome actually exists and we can help it a lot with Chinese herbs and acupuncture Points that I consider to to work on when I when I see that there’s mass cell or for that matter allergic or a topic disorder.

So I always look at this kind of area of between large intestine, 10 and 11, and even towards the the triple burner channel this whole area is an area that regulates the immune system. And if it’s tender, I usually will need it needle it We also think of triple warmer, 16 is our lymph regulator because a lot of times we will have liver congestion as part of the syndrome.

So that’s really important to think about it. Do 12. Is helps with lung T regulation and we call it the thymus Glen reflex. And we know that the thymus gland is something is an, a Glen that deteriorates as we age, but is takes an important part in regulating the immune system at younger ages. So do 12 is a point.

I always pop it to see if there’s any sensitivity. I already mentioned behind stomach 44, which I used with case studies that we discussed and that I will. Popping along the spine to look for tight spots around, do two or three around L four L five L three and also around T 11, which is two six.

I also want to quickly mention this formula called Santiam 12. I used. Formula a lot for it’s a formula that is that is you can order it. It’s a patent and it is great for allergic rhinitis. And I look at these herbs as herbs that are very help with allergy symptoms.

So I always look at this formula and take herbs that pertain to the patient I’m working with to to reduce allergic reaction. I also created my own version of the of the variation of well may one. And I called it react with motion at motion herbs and react is a great support for children and adults who are having either food or environmental allergies.

And you have all the ingredients here. To to look at, and also I added this kind of idea of what are the indications and some of the specific dosage suggestion and cautions of this form. And a little bit of how I formed it. And finally additional support, like what I would do to help support it.

I just want to mention that core sit-in is an amazing supplement that you can Dispense to your patients to support to your treatment with seasonal allergies and allergies in general, it’s a natural bioflavonoid that downgrades, the histamine response. So it’s a sort of like a natural anti-histamine and it works really great.

Yeah. Strongly recommend that you explore that. And I use usually a product called de hissed by so the highest is a combination, of course, certain nettles. And I think bromelain is there too. It is fantastic. And if you suspect any gut Irritation or leaky gut. I always think of glutathione as a supplement to, to support my treat.

Thank you very much for listening. I hope that what I’ve talk to you about today, you can actually take to your clinic and use it to help many children or even adults in this transition time so that they can also enjoy the spring. And so thank you very much.

I also would, again, to thank the American Acupuncture Council for doing this show. It’s a, it’s really great. And hopefully you’ll join the continuing sessions of this this program. Thank you very much.

 

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GB-16 Eye Window to oculomotor dysfunction

 

 

The topic of my presentation for to you today is window to the soul. My personal MRI research application of gallbladder 16

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, welcome to this week’s American Acupuncture Council’s Live Facebook podcast show I’m your host for today. Poney Chiang of neuro-meridian.net coming to you from Toronto Canada. The topic of my presentation for to you today is window to the soul. My personal MRI research application of gallbladder 16 in Chinese name is I window and its application for oculomotor dysfunctions.

Let’s jump to the slides.

So I want to preface by give me a little bit of information about what we do know currently about the indications of points on the scalp. They’re the most common indications of points on the scalp. And I’m talking about your co your common traditional acupuncture points from the gallbladder gardening vessel, bladder Meridian, as such, I’m not talking about microsystem line style of scalp acupuncture.

If you look at some of the indication of the points on the scale, they all seem to have some application to headaches, dizziness, perhaps convulsion, perhaps something indicative of epilepsy. But if you look at these points a little bit more kosher detail, we’ll start, begin to notice that the points that say over the occipital region benefit vision, for example, points, governors versus 18 butter, nine gallbladder 19, for example, have visual reads.

Functions and it’s long been thought that one possible mechanism for this is that there must be some kind of transcranial effect of stimulation. The points on the scalp that is able to send a message to the visual cortex that happens to also be located hospital area of the head. And perhaps that is the mechanism by which these points such as due 18 bladder nine and so forth are able to have a visual related effect.

Certainly if we were to look at points in the temporary region, it’s been said to benefit deafness, for example, points like all about our 10 GABA, 11 Sandra 18 and 19 and so forth. These points are very close to around the year area, but the resolve of the temporal region. And that’s also precisely where the auditory cortex corresponds to.

So another example that perhaps the mechanism has a transcranial effect. If you want to take this concept before. And apply that the the knowledge of the homonculus among this is the representation proportional representation. Of of the surface of brain and as a corresponds to the body.

So you might be familiar of the, these lit there’s little figures. I call them California reason type of cartoon characters, where they have very big hands and very big mouth. And that’s because the hands and feet have the most densest nerve endings. And therefore they receive proportionally greater representation on our, on the cortex or surface of our brain.

And that’s the idea of a homonculus. So if you apply that to the way that the functions of do 20 has been passed down, which is one of them has many functions. The ability to treat Energen are the problems in Chinese medicine. We always say that it’s the idea of treating opposites of do 20 country problems and do one or rent one.

But if you think about the homonculus it’s represented It’s a way such that the midline is exactly what the foot and genitals are located, then followed by Sally laterally, Diablo shrimp, and even more Laddy the face. So by stealing the midline, you are stimulating the anal genital portion of the homonculus.

And so that’s another way we can understand how a point like do 20 said to have the effect, the tree enter general problems on the other end of the pole might actually be again, functioning, fine transcranial effect, but specifically to the somatosensory cortex region of the energetic whole representation of homonculus.

Now the other points that suggest that might have points that we able to treat conscious. Such as the gallbladder 15, there are some points that able to treat persistent vomiting, such as gallbladder eight. Now, could that be because of some kind of vestibulocochlear problems so that if your sense of balance is off, then you feel basically emotions stationary, and also want to always want to vomit all the time.

And so the list goes on. And so there’s definitely a lot of traditional indication that suggest that the results are getting must be a result that can be explained to the central nervous system. For example, if your eyes are staring upwards, okay. Or for example, you have hemiplegia such that say, for example, you have a stroke, for example, and there are certain number of points.

So I should do 21 do 24 and so forth that treat these kinds of problems. So th the fact that we can put needles on the scalp and be able to treat paralysis of parathas is on the bottom. Below the neck. We mean that somehow we’re able to obviously not put any needles in the extremities. The fact that we can have that effect must be through some kind of central effect on the peripheral nervous system, central nervous system effect on the peripheral nervous system.

So there’s a lot of these indications to be passed on to us. And it’s always me implied that the mechanism must be some kind of transcranial effect. And and so what I decided to do as part of the research I’ve done in the last two and a half years is to take a very systematic MRI based approach to look at which points on the scalp corresponds to which part of the surface of the cortex of the brain, so that we can add more insight as to what some of these points are doing, but also perhaps add more information that has yet to be passed down, to look at what other application we have of these.

So in order to do this we designed a MRI’s research project using six males, six female, they’re all right-handed. They all happened to be acupuncturists, and then we scan them all. And then we use a software to then image analysis software to label the acupuncture points on the scalp.

And the name of the software is called brain site. The report at 40 IQ points on the scalp. There’s 34, regular points, six extra points. And it’s because system’s home is is symmetrical left and right. So it’s actually only just three unique points. The front end boxes are unique, left, and right.

Are not unique because they just mirror images of each other. And how to income tie on Diana, et cetera. So in total tally 40 acupoints per person, whereas product subsequent to the scanning process. And then we’ll use this, the Mr. And the analytical software to tell us which part of the surface corresponds at the scalp correspond to which part of the surface of the brain.

Then we average this cordon is in all 12 subjects. And then we can then use existing research about what we know about these areas on the surface of the brain. And these areas of the brain are called Bryman areas, named Abby neurologist by the name of Broadman. And then from that information, we can then go on to interpret.

The functions of these points, and that allows us to compare to existing scale acupuncture systems. It allows us to look into the names of these points, a traditional nature of the points. If the points give us a hint of what these points are supposed to doing and how that match the modern research, that’s already been established from the Brahma air research.

We can compare to traditional functions at these points. And most importantly, can we broaden the application? Because as I said, initially, a lot of these point just say they treat headaches and convulsion and dizziness that there’s gotta be more to it than that. So hopefully this research will help us ha add more ammunition to our tool belt.

This is a example of a research subject that we were preparing prior to the scanning process. We put these little sticky pads on the hairline. These are actually vitamin E oil capsules. And the reason why we do that on the hairline is that as a lot of acupoints actually, in fact, all the acupuncture points on this job are located by using the hairline and either interior, lateral, posterior hairline, as a reference point.

So it’s important that we define the hairline because what happens in the MRI, the hair actually doesn’t show up so we can not go back and reconstruct the hair if we didn’t prepare this in advance. But fortunately these vitamin E capsules do show up in MRI so that we can figure out what the hairline once was.

And from there, it’s just as good as having the actual hairline and with the software go in and actually plot the points on the scalp. This is an example of a MRI software I’m RS facility at the York university, where I’m an adjunct professor where the research was conducted. And yet. As the subject is being Stan, we get this little blister bumps things.

That’s the vitamin E capsules that are, that is defining hairline. And you can see, you don’t see any hair in the MRI. Okay. But instantaneously, we get a read out and we start able to take section on images of the brain prior to actually defining which part is service or brand correspond, to which points on the scalp.

We have to let the Mr software know the XYZ boundaries of the brain. So that when we did, we used, when you talk about, which part of the surface of brain, which coordinate XYZ so that we can cross references for do they exist in prime, in research. For example, before we do that, we have to define what, how wide and tall and deep as XYZ these are.

So this is there’s a software. We can see here where we’re defining that with these green boxes and to ask they pursue aspect, latter aspect, for example, and it should appear in a few aspects, so on and so forth. Okay. And then once we do find that information and we tell this image Mr. Software, where is the space that they are permitted to work within, then we label, I keep on your points on the scalp, as you can see over here, but we didn’t have enable any points that are below the skull.

Okay. So for example, do 16 or do a gallbladder 12 is actually below the mastery process. So that’s technically off the scalp off the skull. Points points a submersible line like gallbladder 20 and bladder 10. For example, if you feel that they’re below the occipital bone. So again, if you’re off the bone, that means you’re too far away from the brain.

And so the assumption is that then is far less likely that a needle can have an effect on the brain if the needle is not actually even on the region of the cranium or the skull. So this is for that reason, these points are excluded. Okay. And then as you can see, once we plot that down, the computer, the Mr and ethical software can start immediately giving us information.

And so this is a bit too small for you to see, but you can start to see some of the points have been labeled and that we can correspond to different regions of the brain. And and then we can. Very cool image like this, where if you imagine that the scalp and the cranium is no longer there, then all you have is just the needle as the vis directory penetrating into the servers that are brain.

So these are the exact same points you saw earlier labeled on the scalp, but the software allows us to determine where that is in a coordinate system. It’s called stereotactic coordinate. That was the XYZ I mentioned on the SCUP. And this process is called registration. When you correspond the location on the scalp to the surface of brain there’s process in neuroscience on your imaging studies is called registration.

So essentially we registered 40 points, combination of regular and extra points on the scalp. For 12 individuals. And then from there we retained the coordinates and we averaged the coordinates of all 12 people to arrive at the average coordinate on the scalp or on the surface of the brain corresponding to the 40 points as being passed down.

So the reason we’re doing this is so that we can confidently say that I say the point bladder nine, for example, on the average human being is effecting coordinates XYZ, and therefore affecting this specificity functional. This is an example of a pretty little picture that we can get from the MRI analysis software.

In this case, we’re only showing you the bladder points on the scalp and these different colorful areas that are brain correspond to different Brotman areas that I mentioned. So there’s already been over 50 years probably like over 60 years of research on the ramen areas and what they do and that knowledge is always being updated as we speak.

So once we figured out what the coordinates are on the scalp, not only are we able to learn what functions they have as we are today, as more research are being added to these functional areas we will be able to add to the indication that we’ve learned for these traditional 40 points on the scalp.

So for the purpose of today’s. Presentation. I’m going to only focus on one or two points. Obviously this is a work that took me more than three and a half years to conduct. I wanted to focus on just two points. And as you saw on the title of the presentation to today, I’m gonna focus on a points gallbladder 16, and how we can apply that for ocular motor dysfunctions.

Before I go there, I need to give you a little bit of brief introduction about the surface anatomy in the brain. Okay. So while you’re looking at here is the interior, the frontal lobe, occipital lobe, temporal lobe, and parietal lobe, and the frontal lobe is further divided into different gyrus. This one here is a superior frontal gyrus.

This one here is called the middle frontal gyrus, but they can further divide that into rostrum, his head or Caro tail portion. So that’s where they put different color. And finally are. If there’s a superior and the middle funder gyrus, then there must be an inferior frontal gyrus, but that is further divided in three different regions.

They’re called pars or

and so forth. Don’t worry about so much. I just want to help you appreciate which part gobbler 16 falls into. So it’s going to be falling into this superior frontal gyrus portion. So it’s an F so it’s in the frontal lobe. Here’s a central sulcus, so that have the motor and premotor regions. And as a matter of sensory regions on either side, but even more interior to that, we have what’s called the prefrontal cortex, which is divided into three different viruses.

Okay. So what we’re going to be focusing our attention to is specifically in a superior frontal gyrus region or the prefrontal cortex. And if you now overlay the prominent information on top of that, This line division here between one prime area, 1, 2, 3, and four. How there’s different colors, that’s the demarcation of those central sulcus.

That’s the motor in, and there’s a matter of century you’re there. And if you go forward, we have brought from area four, which is the motor cortex. Six is the premotor 8, 9, 10, so on and so forth. And so as far as prime and correspondence goes, if you remember the image from before the superior frontal gyrus is processing over here, then we’re looking at maybe GABA, prominent area, six province, area eight.

That’s going to be approximately where the point GABA is 16 is located. This is just a quick, low reference a slide for everyone, because I know that unless people are using traditional points system to do the points, scalp acupuncture head, it’s been a while since they learned these tune measurement and we’re testing on these in school.

Sometimes we don’t remember exactly where they are. If you look at the, to measure over here, this black line here is supposed to represent the hairline. And then so gallbladder 16 is if you look at this two measurement here, right here is 0.5. Green is a 1.1 0.5. So that means that in total God, our 16 green gobbler 16 would be to turn from the interior and tear hairline.

Approximately I want to just mention that the the point location. And air land and not to scale. Okay. It there, they’re only, the color is only meant to tell you the relative measurements that the arrows themselves are not to scale to one another. Okay. So the make any case, gallbladder 16 is over here and later on, you’ll find me mentioning the point bladder six, notice that they’re quite close to each other.

And and they were roughly fall on that. Definitely call out, fall on the front of the frontal lobe, for sure. Cause there’s a front half of the head, but because they’re on either side of the midline, they’re going to be corresponding to superior frontal gyrus, and then the middle of front of the gyrus, we’ll be here and then finding inferior, energize to be even more lateral as we come from a middle center out.

Okay. So that’s talk a little bit about part of the scalp functional area. That’s really that critical is functioning area. Something called a frontal eye field frontal. I feel a previous FEF for short in non-human primates is in progress area number eight and but when I was conducting this research in the beginning I was a little bit disappointed because the point gallbladder is 16 which had a Chinese name for the point.

You can see here, the point is I window mood, trunk. Okay. It suggests that there may be some kind of, I really to function to this point. So I thought, oh, wouldn’t it be pretty cool if this is a point to do with irony function correspondent to the frontal eye field, because it’s not the first time it’s never it’s.

We have seen a lot of examples in the past where the name of the point doing this project is function. So wouldn’t it be cool if the point name I window matched frontal eye field, but unfortunately I was a little bit disappointed because all the research literature showed on a nonhuman primates that the frontal eye field was located in area.

We’re in fact that point gallbladder 16, I window, was actually located in Bravo six. So it was, close they’re right beside each other, but wasn’t really reading on. So I thought, oh, maybe there is had to do with the way that the needles angle a direction maybe, or maybe just coincidence.

There’s actually no correlation whatsoever between name, the function and the point. But fortunately as more research came out about the front of IPO in humans, as opposed to non human primates, it turned out that in humans, the front that I feel was indeed I’m prime and . So I was very excited when I found out about that, because that means that gallbladder 16 falling up brother area six is a perfect match.

It’s the frontal eye field, which I’ll explain it as functions for matches the Chinese name of the point for I window. That’s pretty pretty cool. And it’s in of itself. So what does the front. I find the I field is involved in movement of the eyes, but specifically horizontal darting, quick glancing movements, not slow tracking movement at a cold pursuit.

These quick lateral or inferior superior starting movements are costs the cards. Okay. And and so the front door, I feel plays a role in this quick psychotic movements of the eyes. If you had lesions on your, I’d say frontal eye field on the right side, then what’s going to happen is that both eyes are going to deviate towards the side of the lesion.

So it may say her lesion on the right front, the, I feel both eyes are going to deviate. Towards the right to the right. If you have lesions in the left frontal eye field, both eyes are going to deviate to the left. And what that means is that they are unable to track to the opposite side.

So in other words, you’ve had lesions on the right from the infield IDV to the right then I’m unable to do psychotic mood. To the left. Okay. So there are a lot of quick neurological tests that that you can learn that to be able to assess. And you’re not neurological patients as to if they have any ocular motor dysfunctions, you need a psychotic test.

The ocular motor functions belong to the midbrain. So cranial Creo nurse three and four primarily are located or have their nucleus in the midbrain cranial nerves. Cranial nerve six is also involved in in the eye movement. But that’s more located in the Pines, but for the most part, a frontal eye field test gives us an appreciation of the integrity of the midbrain, because if the migraine was compromised in some way, perhaps by degeneration, there is nucleus, which includes the nucleus of.

Three and four, you said ocular motor and and and trochlear nerves then you’re going to have eye motor movement issues. So these are called ocular motor dysfunctions. So here’s a graphical representation of what I just mentioned, suppose that you have a damage on your right motor cortex.

So in this case it would damage your right frontal ICU as well. Then what’s going to happen is that your eyes are only are going to deviate towards the silent region. So if say delusional deviation, and that is because the the right brain controls as, movements on the left. If there does the dementia, the right brain, then the dotted line.

That control movements to the left are not functioning. Therefore they are unable to oppose to the move of movements to the right. Therefore that’s why all your movements are going to end up to the right. Okay. So don’t worry so much if this is a more deeper neurology that you’re ready to dive into, but it’s very powerful tool because acupuncture is able to treat central nervous system problem.

It’s great. It’s been proven to be able to treat great peripheral nervous system problems. Now what’s next. Now we need to actually show the acupuncture had benefits well beyond just the peripheral nervous system working as you use as a treat central and peripheral nervous system problems. So here’s the image acquired for the goblin Meridian region.

And as you can see, I’ve labeled GABA point 16, 17, 18. And this is the lateral view, and this is the bird’s-eye view. And what I’ve done is I’ve drawn in yellow dotted lines, to the extent you, the Sockeye in that region, because it’s a bit, this is because zig-zaggy, it takes a bit of training to visualize this.

What we’re seeing here. This, the superior inferior Sockeye here is called the superior frontal circus. So the superior funder soccer separates a superior from the Gera and the middle front of the jaw, right? And this thought, and over here is the precentral. Soccer’s this darker more notice?

My here is the central sulcus. Therefore the line that’s in front of it is the precentral circus. And it’s been reasonably established that the frontal IPO in humans are located. It’s located at the cross section of these two soccer. Where did this line meets? This line is where the P where we’re the frontal I feel is thought to be located in this general region over here and now look at where the point GABA R 16 is located.

GABA 16 is very close to this intersection area. And if you were to follow them, varied direction and Meridian and needle from 16 to 17 or intuitive, posterior, why as indicative as air dashing over here, that needle is covered this entire frontal IFL region. And gallbladder 16, as I mentioned is Chinese name is I window.

So perhaps it’s not a coincidence that the ancient acupuncturist named this point I window, because they realized, find empirical observation experience. These points have something to do with eyes and vision. Similarly, at another point that’s located very nearby to this area. And a prostitute over here on the bladder Meridian called bladder six it’s Chinese thing is called light guard, meaning it guards or protects light and light to suggest that optics when the eye light enters your eyes, how you pee, you’re able to see it may not be a coincidence either.

That another point that is very close to the frontal IFU approximately over here also has in its name, something suggest stiff a vision or site.

Okay. So this is a side-by-side comparison, butter six over here. . Over here and there. So if I were to supra, bring gallbladder 16 over to help you visualize go by 16 would be where my cursor is pointed. See how those two points are very close to each other. So if you were trying to in intersect that area, you would need on call bar 16 posteriorly and viruses laterally, and in a intersection kind of way here.

And that will allow you to cover the frontal eye field as much as possible.

Now I’m going to segue a little bit to talk about something else that’s in this area. We’ve been talking about Brahmin numbers, area six. What is, what else do we know about ? Other than that as free dated frontal eye field, as you can see from this bird side, We have probably here four and six, probably the air force actually motor cortex.

So corresponds to movement at execution, but problem area six is in a premotor cortex. And the difference between six and four is that four has more to do with the planning of the movement. Whereas, sorry, six, as much as the planning, because as you get closer to the frontal loads, more reasoning decision-making so six is the coaches that are fun to look.

It has some more to do the thinking aspect and movement. Whereas for itself, the motor itself is the actual movement portion. Now, if you looked at this picture more closely, you’ll see that number six actually has two colors. The darker one is the central portion. And the light, the lighter ones are flanking it.

So the lighter ones is actually the true premotor cortex that’s involved in preparation, the movement. That’s more medial portion as. As a different name, it’s called a supplemental motor area. It’s still a , it’s a supplemental motor area and it is important in initiating complex sequence of movement. So it’s very specific for initiates it is.

So it’s the middle part over here. Brought me a six, the supplement area initiates it. And then the regions flanking it, prepares it. And then finally the motor area itself executes the movement. Okay. This is important because these points are mentioned GABA 16 and I’m better butter six. They fall in the, in addition to being part of the funder, I feel they also fall in this supplement and more area that initiates complex sequence of movements.

Okay. In addition to the funding, I feel being known to be important for control eye movement. We actually know the reason that it does it is bad. There’s direct connection between the cortex where these Fanta IFA regions are located to the ocular motor system in the midbrain, the track technology, or the study of the connections between different regions that are bringing it has asked me to be established.

That is a direct correlation to the mid-brain area. So even though maybe areas of what’s called subcortical structures are too deep for us to affect funds of scalp acupuncture, we might be able to indirectly reach it by stimulating the surface of the cortex. If we know which part of the more deeper structures it connects to.

Now, just as a interesting little trivia if. Not only do we think that is how to do the movement, you remember how it had in the supplement Moria motor area. It has to do with initiation something. And I mentioned how it was closer to the frontal lobe. So I had to move to do a thinking.

There’s actually a lot of interesting research that shows that the frontal I feel is involved in thinking as well. If you ask somebody a question and they don’t have the answer right away, watch the way they think a lot of times people will point their eyes upwards or point their eye to the left, or right.

As they’re thinking as if the answer is somewhere in space to the left or to the right or to the above, really people are not looking down when they thinking, but that’s actually engagement of your front frontal. I feel you’re fun to, I feel part of the brain is helping you to retrieve memory information.

So the eye movement control. My ashy be indicative of memory, recall functions as well. Very interesting. So just because, oh, I’m not interested in neurological eye movement problems as the bit to neurological for me, don’t think of it that way. It’s actually a way for you to assess somebody’s memory and, or or a memory degeneration.

And as these movements improve, it’s actually indirect way for you to to assess whether the patient’s memory and pay and information recall. And the speed and accuracy of that recall is improving or not now. So that’s a little bit, that’s a lot of background, but now I’m going to jump into how I applied these points for two very interesting cases that are very different.

The first case is a case of what’s called Havana syndrome. Have you ever syndrome is something that made the cover of time magazine in the year approximately in the year 2017. And it was happening to diplomats of Canadian, us diplomats, R B station in Havana and and the SIM, for some reason, there was a concerted presentation of neurological symptoms, very similar to concussion symptoms that was happening all across Havana, but only in the embassies of the committee Canadian and the U S diplomat star station there.

So there is, there was white speculation that perhaps there’s, this is some kind of political. Motivated attack some kind of weapon that is unknown, that is perhaps some kind of energy, pulse, electromagnetic energy of some store. Nobody could explain it, but it was undeniable that there was this was happening to not just Americans, but the Canadians and only seeing, not seeing the tourists are visiting there, but only seeing this in the staff that was working there.

So this is being recognized as a real thing and so much so that the journal of American acupuncture association, Gemma actually published a report of the symptoms and the title of the paper is neurological manifestations among us government personnel reporting, direct directional, audible, and sensory phenomenon.

Yeah. Cuba. The the symptoms for these patients are very much like concussion symptoms. They might have dizziness or nausea, headaches, sensitivity to light. They have balancing problems. They have some eye movement disorders. Some of them find that they have the sight difficulty or language, memory loss.

And so these, this, these symptoms are symptoms that the patient never had before. So it was considered a type of acquired injury, but it just that in this case, there was no known trauma physical trauma to the head that could explain this concussion. And there’s suspected that this was perhaps some kind of secret weapon, energy propo projection that was affecting those people.

But these people get tested and Realogy cause second opinions and undeniably have these symptoms. For some reason, I got an American who his mom is the Canadian and they were visiting Canada and and for six or eight weeks or so. And so the mom did the research for the son and mom listen, Canada.

So found me and sent his son here to see if I could help him. And so it was, it’s pretty interesting never in a million years, but I think that I get to treat like the Havana syndrome up in Canada. And so these are the symptoms that the patient presented with 35 year old male civil servant had an acquired brain injury in April, 2017.

Imaging results show that they’re scattered white matter of the brain and S as a focus in the cerebellum area. So it doesn’t make sense. The Serbian has to do the movement, coordination of movement. So if the patient presented with some kind of movements of balance, where it’s about has a balance as well, problems, that would make sense because there’s some kind of scattered white matter.

That’s visible for imagings person who has SIBO, headaches who have tinnitus, but that tends to abate after two weeks later. But the subro headache continued. There’s some challenges, balance issues, patients that reports that there some difficulty retaining information. And also they’re very easy to have ice strains and one of the triggers, bright lights, and also when he was rotating head while tracking with his eyes.

So that’s a, you’re looking at something, but you had to rotate your head, fix your gaze on that, something that kind of eye fixation combined with neck movement. We’re bringing line headaches or sense of dizziness, imbalance and so forth. And also he found that he’s not as precise with his use of language.

And that for example, he would say things like I put the feet on top of the stairs, what he meant was he put the slippers or shoot on top of the stairs, but, footage slip an issue I’ve raised similar ideas, but just to represent what, one of the represent that my part of the body or pods represents something that you wear, but in his brain, they, you could see his brain.

Wasn’t able to retrieve that information as effectively. So given the limited amount of time who was going to be in Canada, we were only able to do eight sessions. And so at first it’s, his headaches would be averaged every two average twice a week, but you started having about two hours and this is much, much better than, when when this order just started.

And then the tongue is thick white coat from root to tip or suggested. There’s not a damn a system that he does. He are redness in the root of the town. There’s hate in a liberal region and heart, mild heat in the heart region. Definitely. More suggested lower jaw heat and liver fire, and a lot of dampness.

Okay. And he had this injury in about June, so April, 2017, but didn’t come and see me until December of 2018. And and so it’s closest to six months after the incident. So I treated points. As it relates to the LA dentist, I see on the tongue, but points high stakes PCs, six, these are points that are known to have the ability to calm the autonomic nervous system.

So I was using that to help them reduce some of that stress and anxiety from dealing with an unknown ETL disease and disorders uncertain as to, whether am I ever going to get better, especially when this solar information know about this kind of problems. So it was necessary to calm and relax the patient.

And I also did the F the scalp for sensory motor area. And so if those of you have studies, scalp acupuncture, there’s these two lines around the vertex or the brain, and these points also have a global because it’s shadow, there’s the Corpus callosum, either hemispheres, they have a global level, right hemisphere, so a balancing effect.

So I tend to just start more conservative and more general without focusing in too much. I did do a speech area too, because it has on war retrieval issues. And then in terms of your acupuncture, I did points in the vestibular point because he had some business issues that will occur when he has fixing his diaper, moving his head and hypothalamus because there’s a point that also regulates oughta nervous system.

The next session I continued to treat the scalp acupuncture areas. Now I added the balance area, which is located in the hospital region. Still have the speech area and for the. I still have thalamus then now at a singular gyrus, which is a point that is just about the course proper skill OPSM.

And so there’s a little bit deeper down at the surface of the brain. And then I added some points in the body at different points in the body. Gallbladder 39, as is a point of if there’s a point of marrow, which should release the idea of brain and Chinese medicine. I thought it too. Now, Ching now changes the point.

That’s relative to the horizontal crease of the ankle is what is two, two up and once in lateral from from a stomach 41, it’s now changed, literally means clarity to the brain. So it has some kind of neurological symptoms as well. So I. Cognitive significance. So I thread it all by three 19 arching.

So I’m at 40, as you know is for phlegm. And Sandra has five, there’s some studies that shows that it helps communication between left brain, right brain. So I had this kind of idea. I’m starting, I’m putting on to treat this patient. And then it wasn’t until the third treatment that I decided to add GABA R 16 I window.

Because at that point I was learning to make sense of the research that was presented to you earlier. I thought, I wouldn’t have to ocular motor movement. It can’t hurt if I try to add that point as well to see what happens. By the beginning of the fourth treatment, a patient hasn’t had any headache for three weeks.

Whereas previously he was ha he would have headaches at least twice a week. So I, what I suspect is that some of that headache is actually due to the brain, trying to. Makes sense of balance. And I related information between the eye movement and the cerebellum areas of the head. And when I cannot make sense of that information, your your point of reference, your point of balance is off and makes you feel dizzy.

And that can then, bring out a sense of nausea or may bring a sense of headache and so forth. Even though I wasn’t directly treating headache by calming down the sympathetic nervous system by working on the balance and ocular motor area, or the fungi, a few areas that made him have better balance and in, so doing may his brain able to not have to divert his resources to other types of problems.

And so unfortunately men, he has no disease. He has no disease. Okay. And then and then the, one of the main thing that you constantly need new will be what are the kinds of things that you’re constantly new were given business problems is that when he was driving, he would have to shift this case between his eyes and the GPS, and was driving, looking at the row, looking at the GPS and that change of eye movement and depth movement will cause them to become busy.

And that was coming that habit every single time. So that was a very good tool for us to use, to gauge our progress. If he was able to have, if that is the getting better, then we know our team is working. So the fifth treatment, he no longer would get cheap headaches or dizziness. When he, when you was doing the GPS looking at GPS, looking on the road.

Okay. And so we continue to do the similar type of thing. Continue to come the cemetery nurses using points as is Vegas point, the reticular formation points a year, shaman points in a year. And and and he, on his last visit, he came back he was starting to have a little bit of headache, but it didn’t cause nausea like I normally would do, but that, that dizziness or headache that brings some for changing eye movement was still not there.

So it seemed like that was very stable improvement. So I like to think that the GABA are 16 point that I use in combination with cerebellum points or vertical points played a big role in helping him be able to have more confidence in both independence to be able to drive on his own and go about on his own.

The next case is a pediatric cerebral palsy case. The child was born in 2020. And and has history of taking prednisone to limit seizures that has only seen on EEG is not seen clinically like by the parents or, day to day. And then the the patient is Delvin, developmentally delayed.

He’s born on may 20, 20, but only began rolling more than a year later in June, 2021. Normally you expect that, maybe like seven, eight months maybe. And so there was definitely some delay And there’s a child has tendency to lower the head and gaze to the bottom, right?

So the head is lower case the bottom, and there’s an inability to control the eye movement. And and there’s also some spasticity of the fingers at difficulty opened them to grasp objects.

And there’s a tendency for the eyes to want to, rest towards the bottom. So the I is better to, as able to there’s more awareness spatial awareness of the things that are alive and less awareness of space on the right side. At almost 22 months, almost two years old was still unable to crawl.

So this is a child who was very delayed and neurologist believed that what he, mostly, I, he has his say we were policy was maybe some kind of brain damage or something to show that in happening in utero. And he was born this way and had difficulty lifting his body up from the stomach.

Usually you should be able to crawl and go on all fours, there’s Encore and I’m moving. There’s no precision grassing object brain to the mouth to chew or, to bite on that the kids are supposed to have. And and then. And so does the general tissue, we gave him this child.

So patient didn’t want to see what we can do at scalp without scalp acupuncture or with with acupuncture. And I mentioned the best thing to do would actually be scalp acupuncture because because this is undeniably a central nervous system problems. Scalp acupuncture is a system that was designed for this.

And I explained to the risk and possible risks and so forth. And because of the concern that the fontanelle might not be closed, this child is too, they are developmentally delayed. So we cannot confidently say that if fontanelle is fully closed, right? So for that reason, they didn’t feel comfortable doing active scalp acupuncture point closer to the vertex of the head.

But I explained to them that, hospital region, those fundamentals those bony plates would have fuse already. And so it would be safe to near that area. And I, we might be able to do the balance minds for, to help with balance related issues. So we, for the fourth three sessions, We did the balance point and the scalp and all we just did with just plain six pericardium six and sand gel five, Sandra five.

I mentioned I’m insured for using, I mentioned before research shows that it helps to stimulate left-brain right-brain communication , and its main states are specific points to affect the tibial nerve in the median nerve to help create sensation into the fingers. And oftentimes that’s been helpful to help open up spasticity of clenched fingers and toes.

And so after three sessions, parents report that the right hand that was previously the most close is now able to open a much more. And then both hands are now open about 75% of the time. Whereas before there were closed a hundred percent of the time and I’m there and requested if I could do something about this passage in your bicep, which I basically just do a local Twitch response, muscle twitching cabins.

And I said very forth. This is now the fifth treatment, hands up, fully open, and now is able to actually grab toys to this mouth, but it’s not doing it with any type of purpose or desire to read something and grab it and bring it themselves. If they happen to swing their hand and grab something, then I’ll bring it to them out to divide it.

Okay. And then we also did some nutrition recommendations such as Alliance, Maine. It was just been shown to help re regeneration of nervous system tissue. And then we continued to help them with treating spasticity in the calf and by surgery. This is just local muscle needling is very similar to.

A technique that a surgical intervention that that they have created in Western medicine is called social surgical myofascial, lengthening where basically they are making tiny decisions in the ligament to help the extension. So they have less contraction of muscles. So we were doing acupuncture.

Needles was essentially the same thing, just a little bit less invasive and less surgical. I added copper scholars point in a year. That’s the point that the cruise stimulation communicates to me left and right brain. And then the patient stopped coming for a month because of scheduling reasons with me.

But despite not having any treatment for a month, fingers are remains open. And now the child is able to start sitting up and lean four on the high chair. Whereas before, if there was four on the high shirt, there’s just totally fall over on their face, on the high chair. So that means that there’s some core control that this child didn’t have before

we treat it local Twitch response on mussels hamstrings and gastrocs and soldiers to help with the spasticity that this child is presenting. And and then and then the parents, Charles the P the, this boy had a brother. And so because of a busy being, having a newborn in the family, he they stopped bringing him for awhile.

And then. And then I want to the reason why I show this slide is that there’s a point here called master sensorial point over here. And and what it corresponds to is actually the junction of all the different lobes of the brain. So the frontal parietal occipital temporary, so and so forth.

So this point of the brain is it’s called the masters and Sora point because essentially because the junction or the lobe stimulates all the brain at the same time. Patient, the parent came with a new imaging results showing that there was diffuse Y white matter patterns across the brain.

So I needed to have a way to, to treat. Across the whole brain and it has been in and they’ve and they also found that there was extra amount of degeneration in the course of Corpus callosum, which is why I needed to focus on points. I sent out five and the regular course crevasse and point to try to focus on th delivery, more stimulation to the regions.

So they came back in January 15th and they had a seizure in late 20, 21. On top of, having a younger brother, they were just too busy and didn’t come for awhile. So because of that, they put the doctors put them on an anti-seizure medication. Just to repeat what I say, or their CT shows us there’s reduced white matter and and thinning of the all across the brain and thinning of the Corpus callosum.

So this is why the treatment needed to have the masters in short point to stimulate the whole brain, but also to specifically focus on the Corpus callosum, because there was thinning of the Corpus callosum. Now the patients feel that they’re seeing a lot of progress and it’s been awhile. Now this, they feel that is pretty safe with their son.

So there’s now they requested me to do scopic Highlands in other areas that are approved, that they were previously worried about. The fontanelle is being closing. So the air would be the first sensory motor on the midline. And now I think, can you do to balance the area and Knoxville region? And then so after we did that one treatment with including the the Prada lobes and the frontal lobe for the first time, Patient came back and noticed that there was market improvement in the core strength.

The kid was starting to lean over in a high chair, but now actually it’s able to complete sit up in the high chair on his own. And actually when they’re lying down on the stomach and a bag trying to change the diaper is starting to want to do sit-ups to come back up. So this is very interesting because the only thing that was done differently was areas that are known to affect the core and immediately that got, that, got that, that improve.

So we can see if it’s working, don’t change it. We keep on doing that. And and we can understand why we do that because the area, of course, the first sensory motor area and the mid line, as you re very close to the supplementary motor you’re right. I mentioned to beginning, which helped initiate movement.

And then in February, on February 2nd, February, I decided that since this kid has this preference of the eyes going down to the bottom and has difficulty seeing things on the left side, there’s obviously some kind of ocular motor issues. What do I have to lose by trying to put the gallbladder 16 there and also put governing vessel 17, which corresponds to the primary visual cortex is back.

So what is both of the sensory aspect division wide for the movement as a vague vision? And can you do the rest of the point? And at the end of that session for the very first time the child was hugging the mom’s face. Okay. And so according to the mom has never, the child’s never done that before. And then that was pretty promising, but two days later I received an email from the mom and this is a video I’m going to show you.

After only adding the gallbladder 16 point, which is really the eye movement that at the child biweekly or weekly physiotherapy session, when they’re playing with toys and learning to move their hands and eyes for coordination purposes, that there was for the very first time a intense, intentional grabbing of objects, fixing it, seeing, grabbing it and being able to bring it back with purpose, not just randomly.

Okay. So this is a video that I’m going to show you to finish today’s presentation. And and so let’s have the video please,

so you can see very well. He is reaching for the. This is it, you have been using the special how many times he never did. And then the mom is commenting that they always use this for all the time, but this person

Okay. So that means that as they move the toy away, he’s aware of it and is changes, naked eyes to continue to track that toy. So this is, I just thought it was very interesting to be able to share that outcome, that research with you, that scholars 16 call I window, has in his name, something to his vision and based on our MRI research.

Safe to say that is probably the frontal eye field, which is involved in ocular, motor hyperbole, and specifically for six psychotic movements. So I hope you appreciate the excitement that I get when I do this kind of research, but as obviously the reward is to be able to help, we are conditions like Havana syndrome and the two little boy who, is so severely developmentally delayed.

Now we actually can help them in their physical therapy or occupational therapy so that they have a better chance of having a a a a higher quality of life. Thank you very much for your attention. And next week for our our show, our guests are going to be Brian Lai and Matt Callison

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Treating Children with Anxiety – Moshe Heller

 

We’re going to talk in the next 30 minutes about treating children with anxiety and it’s definitely a growing issue that I see more and more in my office especially lately and since the pandemic.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, my name is Moshe Heller and I’ve been practicing and teaching Chinese medicine for the past. 28 years. And I wanted to first think the American Acupuncture Council for organizing the show and giving me an opportunity to speak about this really important subject matter treating children with anxiety.

If you can start the slide. We’re going to talk in the next 30 minutes about treating children with anxiety and it’s definitely a growing issue that I see more and more in my office especially lately and since the pandemic. And I think the pandemic definitely has a strong influence on children’s.

Tendency to be anxious. And and we can see this very clearly in even in the CDC report from March through October, the PR the proportion of mental health related emergency department visits increased 24% in children aged five to 11, and 31% among teenagers age 12 to 17 compared to 2019.

So there’s a huge increase. And but I wanted to present how we can really help with with Chinese medicine, with our medicine. Very Much. So I wanted to I’m going to start by just going over a case study that will present some of the common issues that I see in my office. So I want to talk about Sally, which is not a, it’s a not her real name is a 17 year old female that.

Came to see me in the office. And she was brought in by her. She gave me with her mother. And then as you walked in the room, I noticed that her, she had a really pale complexion and. With that her eyes were very bright. Although she didn’t, we didn’t, she didn’t have a direct gaze.

At the beginning there was a lot of shyness. Her body was very thin, but looked very tense and her main complaints were having anxiety. Digestive disorders like indigestion. She felt a lot of gas and bloating and very uncomfortable with her in her digestive system. As he said, she came with her mother and she was at first very shy.

And her mother would actually answer her questions, but after a while she opened up and we even I asked the mother to wait outside. So we had some time together to talk about her issues. So she reported that the anxiety really started a little over a year ago and that was about a year into the pandemic and she thought it was related to the changes due to the pandemic.

The pandemic created a lot of change in children’s lifestyle. The way that they had to learn and that caused of course, a lot of stress and therefore anxiety. In the past three months though, her symptoms became much more severe. And they included things like. Difficulty falling asleep, palpitations nightmares difficulty focusing on schoolwork and being easily distracted racing thoughts and then loss of appetite.

And then also a tingling and loss of sensation in the fingers, fingertips and toes which is a very typical of some of the panic disorder. And and also had some diarrhea like on and off diarrhea and a pasty feeling in their mouth and nausea, frequent nausea. So that’s, these are all the symptoms.

She reported. So she also experienced on the background, some seasonal allergies. So she had that tendency to have some damn port phlegm frequent headaches. Mostly occipital and frontal and tension in the neck and shoulders was very, as a co, she experienced that frequently. She also complained of having a weak digestive system even before meaning.

She would be very gassy and experiencing soft stools and diarrhea frequently. She craved sugar and was taking an iron supplement because of low iron count in. Her misses were regular. They came every 28 to 30 days. But there was a lot of heavy bleeding and it lasted four to five days and had some low back pain prior to the arrival of the bleeding and her pulse was really thin and tight.

And the tongue very swollen and puffy, and there were teeth marks and a thick white coat on the all over the tongue. But the tip was a very rare. So I diagnosed her with having a spleen and heart by acuity which is a common pattern that I see in in, in adolescents. And the blood acuity and liver G w also having some blood vacuity and liver cheek constraint with a slight damp accumulation or pretend to have some Dem.

So I chose to include points like heart seven rent, 17 rent, 12 rent, six stomach, 25, stomach 36 and spleen six. So I would choose anywhere between four, four to six points. And you do that by laterally and would see her once a week. So we talked about changing her diet, eliminating Dan producing foods, meaning that reducing her dairy cheese intake and simple carbs white flour products and and.

And adding, eating more foods that strengthened spleen, QI and blood things like beets and yams and butternut squash to include it in her guide. So that there’ll be some nourishment as well as maintaining a warm dive, meeting, eating more soups and And cooked foods rather than raw food.

So we could see here that there’s a, that I arranged all the symptomology and how each with each of the which each of the patterns the loss of appetite and the gas Ines and the sugar cravings and weak digestion and tendency for soft stools, all indicated a spleen. Vacuity the.

Back by acuity was manifested with the palpitations, the nightmares, the difficulty focusing on schoolwork and being easily distracted. And the blood vacuity with difficulty falling asleep which is something I differentiate, Difficulty falling asleep as more of a blood vacuity, as opposed to falling asleep easily and waking up at in the middle of the night, which is a more of a yin vacuity.

Then the heavy menses may also contribute to the blood vacuity. So we are seeing these heavy menses. It may also indicate. The Liberty constraint and we see with the the frequent headaches she will also the tense look, the tense neck and shoulder, and this kind of tendency to be easily stressed.

And this combination of having Liberty stagnation with blood vacuity which points towards the liver blood vacuity would explain this kind of tendency to have loss and tingling sensation in the toes. And. And the seasonal allergies, of course may lead may point to a bit of a lung deficiency, as well as maybe some tendency to have dampness, as we say.

And also the tendency to have nausea and this kind of pasty feeling in the mouth all point towards dampness. I think I skipped the. Okay. So I actually prescribed a F herbal formula and I prescribed a formula called calm plus, this is a formula that I’ve I created in my herbal company called motion herbs.

And then I have a link down at the end of the slideshow to our website motion or. Dot com. And this complex is a combination of herbs that move liver cheese com the heart and and strengthen the blood and yen and therefore, I used that I like to use this formula for anxiety and it’s really fit very well into this picture.

And after 10 days of this formula she reported feeling much calmer. She did not have any anxiety episodes in the last few days and she felt much better and sleep pattern was also. Much better. And she was able to do schoolwork with less effort. So she showed marked in poor improvement with taking this formula.

After three months of this formula, most of her symptoms were resolved and including her digestive issues, and we decided to stop taking the formula. So after three months of this formula, she reported that the. Our symptoms has, we’re almost, we’re completely resolved. So I wanted to to go over I’m actually just going to skim quickly about the definition of anxiety in biomedicine, in the sense that we want.

Understand how, when people say that they ha they’re anxious, what does that mean? Usually anxiety falls under what we call generalized anxiety disorder. And we can you can read this hopefully this th. PowerPoint would be available for you to go back. And there are under this the anxiety section, we also see panic disorders as part of that, as well as things that are associated with D with with anxiety is phobias and specific D different specific phobias included in.

And also social anxiety disorders and separation anxiety disorders, and post-traumatic stress disorder is a very common diagnosis nowadays. And very important that we understand that when somebody complains of having anxiety, it could be related to post-traumatic PTA.

In terms of Chinese medicine. On the other hand, it’s interesting that anxiety is not really a classical category that is used in classical Chinese medicine, but it’s more modern term. And since we see palpitations. As being one of the very common symptoms with anxiety, it is a lot of times included in it.

So fear and palpitation Gingy or panics robbing that’s Chang Chong or junk chow, which is agitation. It’s this kind of feeling of being overwhelmed.

I’m sorry. I think. Okay. But in children, that is really a we have to remember a few things that are very important. I think when we’re treating children with anxiety, because children have unique characteristics that make them more prone to having anxiety. First of all there’s this famous saying that says that all children disease are caused by fear, fright and indigestion, and that starts from an early age.

Most of the pathologies that we see in children stem from having some kind of a fright or fear or being anxious, and then also in combination with

These are the two important aspects. So we also have to remember that it is the characteristics of children to be excess in wood and fire and deficient in earth, metal, and water. So that means that this kind of excess in wood and fire will create a higher. Tendency to be very anxious and very stressed or they would pick up stress more easily.

Whereas the metal where’s the earth being deficient is causing a spleen vacuity which was. Although we think a lot of times as as a spleen vacuum being not necessarily associating with anxiety in reality, I see that a lot of times this kind of earth vacuity is the cause for anxiety because of its relationship with the heart in particular.

It also is important to see that in each developmental stage is each age. We see different pathologies common pathologies. And I wanted to put point out that this. From seven to puberty is the age where we are becoming more aware of our emotions and being challenged, especially by society too.

Control those emotions and in that period of time that is very very time where we need to pay attention because children can easily develop anxiousness around different issues. Because of that. Necessity to be in, in control or have this transformation where suddenly they have to be in control of their emotions.

So a very, as we say, a very livery time, and that is it at that period of time. So we have to remember the children are susceptible to emotional stress, and I’m talking about little kids two years old, a year old, a few months old, four or less, or even later, even the stress doesn’t necessarily need to come from.

Themselves, but rather from the environments of the pickup stress and what’s happening from their mother or from their caregiver or from their family or their surrounding. And I always believe that children are this, like this emotional antenna. So they pick up whatever is in the environment and it affects their their own.

So in that case I always remember that when children come in with anxiety, I always check in with the caregiver in, from this idea of treating the child, treating the mother to treat the child. So especially with anxiety, that is very important to, to consider.

I in the R coursing gene chin pediatrics we tend to we also teach this whole idea that there is this kind of spiral of development, and we revisit different issues at each period of time. And I, we really believe that this developmental Mandela will tell you how to approach children at different ages, according to where they are in this cycle of growth.

And so we see here that each cycle of growth is related to to an element and that and since it is controlled by a certain element, it has the same kind of nature that we would expect from that element in in, in, in that period of time. So attention. Alienation and anxiety are a modern pandemic.

We see that very quick, very commonly. And we see that because I think we are giving children too little, too late of these things and things like too little connection, too little exercise, too little darkness, too little quiet. To the BOR being bored. So children don’t know or don’t want to be bored.

And I think that’s actually an important aspect of growth growing up, but we also give them too much, too fast too much food additives and an energy rich, nutrient poor diet too much pollution too much artificial light and screen time. All these things create an excess of young, whereas not enough of a balance.

And so it and so the so that it creates this kind of. Imbalance of having too much of the fire and the T then scatters and therefore eventually will cause or is it gives a tendency to form a anxious. So there are, I wanted to also point out that there are two there are a few common patterns of illness that I see very frequently that you can pick it, pick up and they, a lot of times.

We’ll be we’ll cause development in, or be part of it. It will be that the child will be anxious. So the first one has to do with it, what we call an accumulation disorder and we see that frequently in younger children. Although, I think we can see a lot of times the remanence of that later on in age, but it’s one of the advantages of treating children, treating pediatrics is that you can catch these things very early on and really prevent.

Years of suffering later on emotional suffering or physical suffering. If you catch that on, when a child is young and that they have a lot of red cheek and a lot of irritability and insomnia, but also have this kind of indigestion or difficulty digesting foods and you might suspect an accumulation disorder in, and by the way, accumulation disorder is something, a term that was coined by Julian, Scott which he has great ideas and I found it to be very true ineffective, but we go very deeply into assessing and diagnosing accumulation disorders in children.

In our course at pediatrics. And that this accumulation disorder also points to this kind of very important triangle or three aspects that we that are connected and interrelated. And that is the new Europe, neuro gastro immune triad. Or a trial. So there’s a relationship between our nervous system through the Vegas nerve that affects our gastrointestinal.

Function. And that affects our immune function. And there is feedback in both directions that that we need to understand that it’s all connected. So when we have an issue with our nervous system, like having anxiety, we definitely need to be in tune with what’s going with the gastro immune function.

Accumulation disorder disorders are a gastric dis disturbance that we need to look at. And we’ll talk about the immune aspect in a second. So I just put in some main points that we use for treatment seafaring is the main points when the child is young up to probably two years of age later on, we might use more body.

For a treating that, that accumulation. Hyperactive spleen sheet deficiency is another diagnosis that we commonly see. This is a child that has all the signs of spleen vacuity, but behaviorly is really having a lot intends to be very anxious, has a lot of sleep disturbances little. Asleep difficulty falling asleep enjoying being the center of attention and w and wants to be very manipulative all these symptoms and usually the child looks very thin and and weak, but the energy is bursting.

So hyperactive splintery deficiency. Another pattern that we commonly diagnosed. And or see frequently especially associated with anxiety later on in life. The interesting thing is that when we have when we have hyperactive spleen Xi deficiency, our treatment is based on strengthening the spleen and not necessarily calming all that excess.

It will come from this. The seemingly a false excess comes from a deficiency and we need to strengthen rather than disperse. There’s another pattern that we usually see, which is called hyperactive kidney cheat deficiency. This this also will have a lot of spleen Xi deficiency, signs and symptoms, but they’ll have very specific other symptoms like dark pools around the eyes.

The page would be a very thin but long a face would be really pale, bright. Wow. And be very fearful and anxious in this case, the fear is very strong and having a lot of anxiety about different things. Being very hypersensitive and also has a lot of issues around sleep and takes very long to go get into bed.

These are very difficult children to treat because they are so afraid from any thing that is done to them, that they can become very hysterical. In any case? The important thing is that the treatment is again mostly use points that strengthen both kidney and spleen and not necessarily any dispersing treatment.

And the last one, which is the other arm of the tr triple the triangle which is the immune part is the lingering pathogenic factor. And I think this is a very important thing to remember because when we look at pathogenic factors that enter into the body, Child as young as they become, they can become lingering.

And there’s a lot of signs and symptoms that will, you will help you diagnose them. And once they are lingering, they can affect our emotional gr the level of the, our nervous system. And therefore, Can cause anxiety later on or tendency to be very anxious. We’re running out of time.

So I’m going to run through the rest of the slides the treatment for the lingering pathogenic factor as we have this really. Amazing. Treatment protocol, which is bylaw. You be 13, 18 and 20. And I use a combination of shout child tongue or some kind of variation of shout child, your tongue to treat that lingering pathogenic factor aspect of the patient.

So in pediatrics I just wanted to point out we have different treatment modalities. We’ll out, tend to use a lot of TuiNa shown Ishan technique is an amazing technique, which we teach again at the Jim Shang pediatrics course. I think that it’s an amazing technique that we can apply to children and get very good results without inserting needles.

And that the gates, the fear factor, especially for anxious kids. And I also use another. Technique, which is cutaneous electricity stimulation, meaning using electrical stimulation to stimulate certain points as opposed to using needles, all that is taught in our course. We also connect we use magnets and we use, we teach how to use them for Paid for pediatric patients.

And they’re an amazing tool that you can actually send patients with it and shows the show them how to massage it and and participate in the treatment. And it creates great results. So I’ve concluded some of the points that I use for anxiety, as well as common patterns in terms of using both both points and herbs.

And I’m actually running out of time. So I will end with this With thank you for being here and listening. And if you want to hear more, there’s many avenues to to hear more and learn more about treating children and and with anxiety or treating children in general through either My herbal company, which is called motion herbs which I have sometimes free webinars on, on, through that venue, I’m going to be treating teaching a course through global branches, which is called the first cycle of life and focusing on the first years, 7, 7, 8 years of children.

So you can Look at the global branches, look it up online and you can register on that their page. And through our Jing Shen pediatrics sent course, which will be distributed through net of knowledge and loss, OMS which, and you can pick it up. So I want to thank the ACA again for this wonderful opportunity to speak.

It’s been a pleasure and I want to remind you that next Wednesday log on here, Sam Collins. Thank you very much.

 

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TCM Infertility, Pain and Overall Wellness Geek-Out Session

 

 

However, the focus really is going to be on clinical and why it’s important to just keep learning and how neuroanatomy can advance your practice.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Again, thanks to the AAC, um, for inviting me to be part of their, uh, To The Point show. And my name is Lorne Brown. I’m a CPA, a charter accountant. I’m also a doctor of traditional Chinese medicine in Vancouver, BC, Canada, and I’m also trained in laser therapy and, uh, I run healthy seminars and today we’re going to have a special guest. Um, my colleague and friend Poney Chiang, um, Poney is an acupuncturist as well. Um, he’s a neuro Meridian and neuro anatomy expert. And so he’s been teaching on healthy seminars so we can understand the neuroanatomy and neuroscience of acupuncture, both the classical and mainstream. And we had a geek-out session. So Poney and I had a Geekout session a couple of weeks ago, and we decided to share this with you, and I’m going to tie this into practice management. However, the focus really is going to be on clinical and why it’s important to just keep learning and how neuroanatomy can advance your practice.

And so again, I want to thank Poney for joining me today. Um, and there he is great to have you here and we’re going to, we’re going to geek out again. What I want to share with you is low-level laser therapy for fertility, and I’m going to give you a very short version story, but this has been my focus. I think I’m one of their early adopters outside of Japan using laser for fertility. And I do combine it with acupuncture. Um, and the reason, um, I started doing this was I came across a paper, um, where a medical doctor, Dr sure. Out of Japan, um, he, he he’s a pain specialist and he would treat people for pain. And he had this technique, which is later, um, been dubbed the Oshiro technique or the proximal priority technique. And he did a lot of work around the neck area.

And, um, he would always treat this first, before he treated the local area where there was pain. And in the story, the true story that happened here is he was treating a woman who was 55 years of age with menopause for back pain. And so he would do this proximal treatment. Um, the purpose is to create blood flow everywhere because if you increase blood flow everywhere, it would go to the toe and you’d go to the back and this would help with the healing. And so he did this technique with her and lo and behold, not only did he resolve her vaccine, but her cycle returned, uh, she wasn’t happy about that. And he thought it was a, one-off go see your OB GYN, cause it could be something serious. Well, within the calendar year, he was treated another woman in menopause for back pain.

Her period came back. So what they decided to do in his, at the hospital is they did a very small pilot of about 74 women that were translating to English as severe infertility average age, 39, several years of infertility, um, many cycles of art assisted reproductive techniques. And about 23% of them became pregnant. And over 60% had a live birth rate. And this is from a very poor prognosis group. And then they expanded that study to 701 women and 23% got pregnant, 50% got it, had a live birth. And his thinking was the reason these women had an improvement in their fertility is when doing this technique around the neck. Um, it created a parasympathetic response, which they were able to measure using thermal photography and other lab tests. Um, it would increase blood flow everywhere, including blood flow to the ovaries and more blood and circulation to the ovaries, better follicular Genesis, and lo and behold.

This was the reasoning why they thought the improve the fertility in these women. So I had been working on my protocol and I’ve spoken to practitioners around the world that are experts in laser therapy and treating fertility. Some that are treating the endometriosis and they’re doing stuff around the neck. They’re doing stuff locally on the abdomen. There’s doing stuff on the sacrum as do I. And I wanted to know why for a couple of reasons, one is it’s important to communicate to the patients how this will benefit them. And also the, the, uh, IVF doctors I work with. They want to understand this from a Western perspective, it’s, they’re not going to learn Chinese medicine. And so it’s important for them to understand that from a Western perspective, here’s the small little practice management tip and then pointing is going to come in and I got some questions for him and we’re going to geek out.

The practice management to appear is because I became well known as an early adopter for laser, for fertility. And because I invested in these machines, just so you know, um, I have several machines machines, each one’s, um, about $25,000 or more. Um, and I invested in these and women before COVID, uh, were flying to my clinic to be treated by this. So it wasn’t something I was expecting, or it would happen, but because I separated or separate myself from the pack, in a sense, I was doing something different. I was doing acupuncture for fertility, but I was bringing in laser for fertility. And I was able to explain from a Western perspective, how this can benefit and become familiar with the papers and share this, this attracted both, um, Western doctors and the public to seek my clinic for these treatments. So here’s the Geeko part because it’s important to know you can’t just buy laser, start doing this.

You want to understand how to use it so you can keep using it better and patients have questions. And so we have doctors, you got to explain it. So if pony can come back on here, pony, I got some questions for you. They talk about this parasympathetic response and, um, for acupuncture. So I’m going share with you. They talk about the anatomical features, but what they did is they did points in the nuclear, the also pity area. So do 15 bladder, 10 gallbladder, 20 area. They did stuff to, to reach the vertebral artery. So gel 17, um, they did the carotid stomach nine, 10, and they wanted to hit a feature called this Dalai ganglia, stomach 11. And can you explain to us in pony, how is this? Cause this is something we could use on all of our patients. If it’s going to bring chief flow everywhere, um, specifically also for fertility, can you explain then why these points stomach 11, 9, 10 do 15. How is this going to engage a parasympathetic response and increased blood flow everywhere, including the reproductive system?

Sure. Uh, if we can have the slides, please would make it easier for us to explain. So when you’re doing points, um, on the occipital area, um, or looking at points at gallbladder 20 blurred, 10 points in this area are actually where, as you know, the cervical portion of the trapezius muscle goes there, you might not know about cervicogenic headache. Ty traps can give you headaches, right? But the attribute this muscle is interesting is that as the muscle innovated by a cranial nerve 11 spinal accessory nerve. And so when you put a needle in trapezius muscle, including points that Goldberg 20 bladder, 10, even Goldberg 21, um, you are stimulating the spinal accessory nerve. We used to think that spinal accessory nerve is truly a motor nerve, but now we know that it’s actually sensory and motor. So what that means is that as an African bring information back to the brainstem, back to the nucleus of this cranial nerve 11, and what’s interesting is that quite another 11th nucleus is right adjacent to the cranial nerve 10 nucleus, which is a Vegas nerve.

So it is known that there’s new Peters have interactions with each other. So this is why simply needing points that GABA are $20 21. Anything that is supplied by the spinal accessory nerve will have effect from the cranial 11 nerve nucleus to the or 10 biggest nucleus. And as you know, Vegas, 90% of the body’s parasympathetic response. So we can easily explain how points in the back of the neck can achieve this increase in parasympathetic state and therefore more profusion to all the glands and organs of the body. Now ask for points in the front. Um, uh, while you’re looking at here in the dissection picture, uh, it’s got the throw in the south big is all removed and D these long, um, cell tissues that the, um, the probes are supporting or raising, it’s called a, it’s called a cervical sympathetic ganglion. So, um, uh, if you look at the diagram on the, on the bottom, you’ll see there’s actually three cervical sympathetic ganglia superior, cervical, middle cervical, and thoracic also know as the Stella, as an a star.

So, interesting thing is that every single one is Ganga are actually an acupuncture point. That’s already been passed down to it by ancient acupuncture or ancient acupuncture anonymous. And when we stimulate these points, if we can look at the Sutton, the next slide, please, there are correspondence like given to us in terms of the point. And the exact ganglion does involve without going into way too much detail. Okay. But you should want to gangs are actually supplied nerves to the heart, the cardiac. So they each one of these gangs individually and collectively supply the cardiac nerve that controls the contraction. So if you are modulating this, you are improving cardiac output. Therefore it’s an increased blood flow to everywhere in the body. So this is likely how the Ashira protocol was able to, to, you know, inadvertently increased fertility, you know, even though the focus in our neck, but because it’s affecting the civic center Ganga, which is known to control the, the, um, the heart rate, it’s increasing cardiac output, which gives you blood everywhere, including reproductive organs.

Brilliant. And thank you for that. And this is, so this is why I think, because it’s on the parasympathetic, I think of cheapo like liver cheese stagnation would become tight and constricted and that’s authentic. And when you’re in parasympathetic that she’s flowing freely, which is probably why most of the research, the women 38 and under seem to be benefiting most from laser fertility, because they’re the cheese stagnation type. And once you get into the 38, plus we’re probably getting more into the kidney in, in young deficiency. And, um, maybe we’re not able to, um, with the laser therapy do enough for them. And so this is my working theory. I think a lot of the women we’re seeing that we’re helping have a form of stagnation in Stacy’s. The laser therapy has other benefits, too. It helps regulate inflammation. Doesn’t Al not only just increased blood flow and it does help improve the mitochondria functions.

So there’s all these benefits back to our neuroanatomy. So myself included, a lot of people started wanting to put the lasers closer to the ovaries, but in the laser world, um, red and infrared light, it’s really difficult to get that kind of light to the ovaries in the Oshiro group. They did the neck and they also did a point near when 12, they didn’t say why I was thinking, they’re trying to hit the ovarian artery because it kind of comes off the aortic arch near there. But you’re telling me from a neuro anatomy perspective, there’s a different level. And, um, can you tell me why there might’ve been benefit from then doing the, the red 12? Is there any reflex points or anything happening in the abdomen that we’d want to target and before you go, they’re pointing. I just want to share that where we’re at today is we want to do the approximal points.

We want to get the blood flow. We want to hit some lymph nodes that are feeding the abdominal area. And I want to talk about the lotto gene, a lot of non Chinese medicine, trained, um, laser therapists, um, always treat the nerve roots coming out that are innovating the area they want to effect. So this is kind of what I want to cover with you today from a neuro anatomy, neuro Murray and acupuncture specialty, what are we doing from a Chinese medicine and Western perspective? So is there any benefit doing something locally that’s going to help, um, with the ovarian function and uterine receptivity, keeping in mind when we talk about the needle or the laser, the laser is not going to reach therapeutic level. It’s unlikely. It’s going to reach the ovaries and you’re not going to put a needle in the ovaries, right? You don’t want to do that. So, so what is happening here? What are we doing when we do these lower abdominal points that can be impacting the reproductive system, or were they just having happy thoughts? And there is no real benefit from the run 12

Area. Uh, if we can have this slide with the sympathetic and parasympathetic, uh, innovations of the spine. Um, so while we get that ready, let me just explain that. Um, in Chinese medicine, we’re talking about ying and yang, visual, Oregon in Western medicine to have a similar and how we try to achieve healthy balance in Western medicine has similar notion of homeostasis where you’re trying to balance the parasympathetic and sympathetic nervous system. Yes, that’s the mind. And so it’s, to me, they’re very analogous concepts in Eastern medicine, and we’re trying to balance any, obviously Oregon in Western medicine, we’re trying to achieve sympathetic comparison, like balancing short and, and, and the other student is that each organ has both sympathetic and Paris, the next innovation. And they both do their job to encourage ensure optimal function of each Oregon. So if I can draw your attention to the left side of this diagram, what you’re seeing here is the spinal cord. And those little dots are horizontal lines that are coming out from the blue dots. And the blue lines represent parts of the sympathetic chain, which is, as you may recall from square thoracic or lumbar. So it’s [inaudible].

And so when you look at where those nerves go to, they go to various types of, of, uh, uh, plexus in gangland then, which then subsequently control the blood flow to various organs. So, um, as you know, a lot of the, the, um, uh, fertility related points, um, um, uh, they took on shirt for on the actual point, um, stomach 29, which was supposed to mean gray line is returning the period, right? So these points are located in the lower pelvic area. So where, um, so how can we account for this based on this, um, understanding of the sympathetic person and never system, if I can draw your attention. And if we really hone in to the very, very bottom blue nerve on the left side, it’s called a lumbar spine secondary. And, and, uh, so if you have a laser there, right there, perfect.

And you can see that, uh, from there there’s one more pink, red color that comes out, it’s called a hypogastric plexus, right? And then if you look at the very, very bottom word in the gray box, it says reproductive organs. So that means that if we can trace the report organs, blood flow to the hypogastric plexus, which by tracing one level up to the lumbar spine CIC nerve, and then back to level L one L two. So if we look at the points that are in that area, it’s going to share in stomach 29th. And, and it’s only Tanya that if you look at the indication though, I have to do with, with fertility, with men seas, with reproduction. So we can explain that because those points in that area are exactly Lyn 12 region of the, of the, of the dermatome. So by, by putting nerves there, we are having what’s called reflexive effect.

The needle stimulate T 12 L one nerves, which travels back to the spine. Does these nerves wrap around from the spine around to the interior as aspect of the body, does the Afrin sensation and back to the spine and reaches is corresponding T 12 L one segment. Now each second, each second response has sensory motor, as well as sympathetic, um, uh, types of innovation. So we call this reflex effect. Once the Afrin reaches a segment, it was sent information to the corresponding autonomic levels, which in this case are digs, precise, autonomic levels of the, of the body that controls the, uh, cemetery output or the blood flow to these reproductive organs. So it is by, it seems that we’re affecting and locally, we are, we are in tenders that were needing over the ovaries for example, but the information is going back to the spine and then the spine, um, passes it through the sympathy, Oregon, which then sends it back into the Oregon. It’s effecting it’s instantaneous, but it has undergone a complete full stroke. It, but it happens so fast that it’s, it seems as if there’s an immediate effect. And

So, um, when you’re the, whether this spinal segment segments that are innervating the ovaries and cause, um, I’ve heard also in some of the literature I looked at, they were talking about like T nine T 10 and T 11 innovate, the old reason, S one S two more for the uterus. When you mentioned stomach 29 and Z gong, you’re saying that’s more like T 12 L one. And we, when we did get go, you did say there’s like a Christmas tree effect. So when you’re needing below, you’re still getting a lot of these or lasering. You’re getting those above, but can you just clarify what you’re seeing there? What’s from this diagram, what’s innovating the old reason what’s innovating the uterus from the spinal second.

Okay. So if you were to, to, uh, look at the Y to Jaggi points or the, uh, the back shoe points along the spine, um, re recall what we were about the sympathetic chain is [inaudible] right. So all two of bring us to 2023 level and our be 20, 22 levels. I say bladder 2023 level is two. And then bladder 22 is our one. So, um, now we’re talking about what’s called the dorsal Ramiah of the spinal nerve, as opposed to the veterinary. And I, when we were talking about needing the pelvic area, those are the parts of the spine of that came forward. They call the interior Mr. Ventura, but there are ones that go back to integrate the muscles around the spine. And those fellow doors are in mind. So if you needle L one L two, which happens to be bladder bladder 22, 20 23, and these are the points that we would use anyway, because there can use reproduction in Chinese medicine, right? Actually, probably that you need to read it by KMS, but if you need, at that level, you are still at L one and L two. So the same simplest reflux applies. It’s just that now it’s happening through the posterior branch as opposed to the ventral branch, but at the same permission will ultimately go back to the same segment, L one L two and then cross into the sympathetic, uh, aspect of the, of our body. So

Again, beautiful Chinese medicine that we have, the front middle and the back shoes. If somebody is facing, we can treat anterior, we can do the Z gong and stomach 28 are still make 29 points and have that reproductive effect at the point say, or if we’re treating them face down, we can do the back Shu point, like we know for a kidney for reproduction. Um, and again, same segments so we can dress it, both sides. So the Chinese medicine approach understood this 2000 years ago. And now with neuroanatomy, we can explain why you can do it face up or face down, and you’re still having that effect. Am I, if I’m understanding

You correctly? Absolutely. And there’s this one tiny, tiny bit I can add to that is that we’ve been talking a lot about what’s going on to lifestyle as a slide today. Let’s take a look at the right side of the slide, which is a parasympathetic. So it, um, ultimately when we need all yes. If, if we can just focus on the sacrum area on the, on the bottom where the black two black lines coming out. Yeah. Or that area right there. So oftentimes I get asked, um, you know, if you’re stimulating a SIM and say, isn’t it that gonna reduce blood flow and, um, and, uh, uh, we only want to stimulate the parasympathetic that that is correct. But what we do know from a lot of studies in acupuncture is that, um, uh, the ultimate net gain effect that acupuncture is parasympathetic. It, even though it’s limit points are supposed to more sympathetic is a very short transient effect.

It’s almost like the body knows that, oh, I’m feeling more sympathetic. Now I can activate my own homeostatic mechanism to go towards parasympathetic. So the end result will always be parasympathetic. So you can think of it as using the young, to treat a year in Chinese medicine kind of concept. Okay. Obviously they are obviously see within each other. So inseparable concepts. Now let’s take a look about a, the Paris Stemmet idea. We would need a formula that directly. So those are your, your, your, um, your secret for MRR points, but our 31 32 33. So if you look at the bottom, uh, of the right side of the, this fixture, um, you’ll, you’ll see that these, um, these nerves also supply the reproductive organs, right? You see that there’s college coming up from there, from the black lines on there, right? It’s not just a red lines on the left.

That would mean that we put our origin as well. So just, if you want to be super finicky, theoretically speaking, or anatomically speaking, it’s only as two and three and onwards would have the effect. So that means [inaudible] or bladder 31 is not as important here. So if you have the ability to palpate the real for a minute and try to put the needle into that for, to affect those points, you want to target as to it onwards. So if we can have the very first slide, we can jump to the very beginning, we get it, we get a sort of inside out view. There it is. The inside our view of what happens in the sacred and the inside. And you see all those nerves and all the blood vessels over there, they actually communicate with each other. So when you put a needle into [inaudible], we are increasing the parasympathetic control of the pelvic organs and blood flow directly.

Now you may look at this and realize that, oh, this is kind of like the Sonic nerve, right? These nerves become the side nerve NSI. And it goes all the way down to the back of the thigh, into the lower leg, even down to the foot area. And what’s the point that’s most commonly associated gynecology in all the Chinese medicine, spleen six, right? As many as six lies exactly on the site, Agner trajectory. So even though you may not be needing the second directly by noodling spinning six, you are liking kneeling in the sacrum indirectly. What’s the message comes back to you because the sciatic nerve is, um, as, um, uh, alpha syn two segments. So crosses these these segments so that you will have a direct impact on the blood flow to of the, of the pelvic organs, reproductive organs, your genital organs, and so on and so forth.

So these things that we learned from, from traditional indications that passed down, there’s absolutely no reason to doubt they do what they say they do. It’s just that we don’t have the understanding to catch up with these information. But, but, uh, another thing is that if you understand this new anatomy, then you can actually create more points. So points like, can you four, can you, five are all derivatives the Stagner and, and, and you can see why they will also potentially be very effective for treating fertility issues and you can create your own protocol. So once you understand the new UNM, I remember

When we had our offline geek-out session, you’re sharing how spleen six, the nerves, a little bit deeper, but easier to reach it, like kidney three or kidney six, because of this reflex point. That’s what you’re talking about now.

Yes. So the, the, the, the part that say that reaches that immediate aspect, the ankle is called the posterior tibial nerve. So if you go through Spain stage, they actually got to pass through a muscle called the Fetzer digitorum muscle, you know, to get to the dinner. But if you go a little more distant with when the nerve becomes more superficial about, at the level of CUNY 3, 4, 5, 6, those points you can think of it as, like, can you say X four or more for year and aspect, right. Can you three for CI aspect, those points are still derivatives of the sagging there. So the message was still go back to the, to the S two S level two to improve circulation of that pelvic pelvic organs. So there’s no re ne no reason why you can, it cannot add another level of TCM on top of that heel. How do you decide within Spain six or seven spins three? You know, they are all Threadless. I never anatomic issue at work, but, you know, six might have more yin indications or is three might have other indications, you know, or you want to use a more of a, a low point. Like, can you afford, for example, so you can, how they’re actually not mutually exclusive. You can actually refine it further with, with a TCM lens on top of it.

And this is why, um, I like studying with pony and why I recommend pony. Um, I remember one of your course on healthy seminars, you’re talking about these nerve roots and having this discussion about the sympathetic and parasympathetic and how you mentioned you’re reaching the sympathetic, but it has this parasympathetic effect, because I think you were mentioning, there’s like three that were coming out from the dorsal root. Um, you reached the more superficial one, but when you reach that superficial one, they’re like their siblings, they’re all affected. And therefore you’re getting that parasympathetic as well. That’s right. And so, um, tying this together then, um, I just want to share with you that, uh, the Chinese medicine aspect of it, it just blows my mind still how brilliant it is because we’re choosing points based on a different paradigm. However, in modern times with this incredible technology, it is explaining it is validating these points.

And I know some of my colleagues are purists and they don’t want to know anything about the west. And I like to know as much as I can about both. Um, because as you’ve shared, it can help direct your treatment in choosing your points. And what’s really valuable in clinical practice is my patients and the doctors. I work with the medical doctors. Um, they’re not going to understand the back Shu point for the kidney, but they want to understand how this nerve root is going to innovate the old reason. If I do this, we know there’s a parasympathetic response, which brings more blood flow there or activates this organ. That’s important to them. And so this is why I highly recommend the integrative approach. It does not mean forget about what you’ve learned and forget it, what acupuncture. It really is going deep into the classical and going deep into neuroanatomy, but with a trained acupuncturist, like pony Chung, because you pay tribute to both medicines, you don’t dismiss one or the other, and you’re constantly the two which helps with clinic, you know, myself.

Um, I’ve invested, it’s almost embarrassing. I was looking, I have over $260,000 in lasers in my clinic now we’re, we have many practitioners, so patients want it. So we need to have these lasers. And I don’t know how many thousands of hours I’ve invested so I can keep, um, modifying how I do it. So I can be individualized and improve our, our approach. And as you can see, I’m talking to people like pony. We did this conversation, a version of this offline. And then I just said, you know what? This was so fantastic for me. I want to share this with everybody. And so this is why we came on and did a mini version of what we did already, because I think this is really beneficial. And so my message here is not to be scared of other things like laser therapy. It’s incredible how it’s transforming my practice.

I use both the acupuncture and the laser in my practice for fertility. Um, and so that’s been valuable. It’s made patients, um, want to, um, come to my practice for these treatments. And I keep learning and talking to people like pony, um, cause it gives you the confidence and the key is to be able to communicate why you’re doing what you’re doing. And so I’m not suggesting that you just violate her and start to do it. Um, just like you wouldn’t want somebody just to do a weekend acupuncture course and start doing acupuncture on people. You do want to under, you want to get good quality lasers and you really want to understand what you’re doing so you can play with your protocol. I have to give another big, thank you to pony again, for the cadaver work you’ve been doing. And just the deep dive you’re doing in neuro Meridian acupuncture. Um, and, and bringing this to the masses again, you can study with pony on healthy seminars.com, um, and a big thank you to the American acupuncture council for inviting me to host this show. I want to let you know that your speaker next week will be Poney, Poney Chiang also hosts a show on the AAC. So tune into the ACC and you can listen to Poney Chiang and hear what he’s going to talk about on his show. Uh, thank you all very much and Poney, Thank You. Have PTT anytime. All right, till next time

Michelle Gellis Thumb

AAC – Treating Cosmetic and Neuromuscular Facial Conditions with Facial Motor Points

Click here to download the transcript.

Click here to download the slides.

Hi, everyone. Welcome this afternoon. I want to thank the American Acupuncture Council for this opportunity to present on treating the face with facial motor points, and I appreciate everyone coming out in the middle of their afternoon or evening or early morning, depending on where you are. If we can go to the slides, little bit about myself, my name’s Michelle Gellis, and I teach cosmetic and neuromuscular facial classes, facial acupuncture classes, internationally. This is a picture of me teaching a class about a year ago in Maryland. What I wanted to talk about today were a couple of things that work with both cosmetic and neuromuscular facial conditions, but before I did that, I did want to talk a little bit about facial acupuncture in general.

When we use the term facial acupuncture, we are talking about a very large topic, so it encompasses anything having to do with a person’s appearance and/or a function of their face so things like wrinkles and sagging skin, and also neuromuscular facial conditions like Bell’s palsy, TMJ, trigeminal neuralgia, stroke, ptosis, and many other facial conditions. Facial acupuncture is actually the largest growing subspecialty in acupuncture right now and so getting trained is something I’m going to talk about in a moment, but it is very important if you are going to specialize.

Facial hair acupuncture can include everything from just needling to using facial cups, gua sha, or doing microneedling on the face, and facial acupuncture is not some new and trendy thing that the Kardashians are doing on social media. Yes, they are and it is really something that has been around a very long time. When they found the emperor and the empresses in their tombs, they had jade gua sha tools and there are records dating back to the Sung Dynasty and even before that of people talking about facial acupuncture throughout history. I have written two publications for the Journal of Chinese Medicine. I’ve written many publications, but to specifically of interest, one is on treating neuromuscular facial conditions with more of a multifaceted approach.

Today we’re going to be speaking about facial motor points, and this is part of a multifaceted approach to treating the face. I’m a classically trained 5-element acupuncturist. I have been teaching at the Maryland University of Integrative Health, formerly the Tai Sophia Institute since 2003, and my second publication was on the importance of clearing energetic blocks prior to doing any facial acupuncture, and links to both of these can be found on my website facialacupunctureclasses.com. As I mentioned, there have been quite a few studies on facial acupuncture. I’ve listed a few here, and some of them are pertaining to the cosmetic effects and some of these are pertaining to more of the functionality of the face.

These slides will be available on the AAC site and when I teach my classes, I go over these in a little more detail, but I just wanted to let you see that there actually has been researched done on facial acupuncture. When you’re thinking about your practice and how facial acupuncture can fit in, if you’re just looking at the cosmetic aspects, it’s great because you’re not dealing with insurance. It’s a very reliable stream of cash income. Again, you’re not dealing with insurance. You don’t have to bill the insurance companies, and one thing that we’ve learned during this pandemic is just how much people depend on having other people take care of them for their appearance, and people will spend money on vanity before they will spend money on their health.

If you think about some of the signs, the protest signs for things to open up, they were, “I want to get my haircut. I want to get my nails done.” No one was saying, “I want to go see my doctor or my dentist.” People do spend money on vanity and also, if you learn the neuromuscular foundations of a lot of this, it can open your scope of practice. You can see patients or patients will seek you out because you have this subspecialty or someone who will be known for being able to work on the face. A lot of us, we go to acupuncture school where we don’t spend a lot of time needling the face. We’re not comfortable with it. We didn’t really focus on learning those points.

It opened your scope of practice, will give you a very unique skillset. These are some pictures of me doing some microneedling in a class and some facial gua sha. That’s the benefits for you, for your patients done correctly. A facial acupuncture treatment should include body points and should bring chi and blood to the face, to the muscles, to the skin. Facial acupuncture because it is a full body treatment helps with digestion, immunity, circulation, and all of these things. Everything shows up right here, and it will carry nutrients to your cells and by doing that, it helps to stimulate collagen and elastin production.

Also if you’re using intradermal needles, which are very small needles which require some specialized training to be very effective, it will actually stimulate collagen and elastin production. Again, for your patients, if your patients is having any sort of… This patient of mine had ptosis where one eyelid was lower than the other. You could see her eyelid on our right, but her left was lower than her other eyelid, and she was getting married. She was very self-conscious about it and through treatment, I was able to get the levator muscle to function better and help so that her eyelids were even. On a more cosmetic level, people that have rosacea, facial acupuncture treats the hormones.

We do hormonal points if that’s an issue, and it can help with different skin conditions. This was a student of mine in one of my classes and just during the course of class, I worked on one side of her face and she had a rosacea, and you can see how the rosacea cleared after I had done the facial cupping. People asked me all the time, does facial acupuncture work, and these are just a few of my before and after photos. This person up in the center and the top, she had a scar right in her nasolabial fold and through treatment, the scar softened and ultimately, dissipated.

This person down here in the center, had some dark spots and again, through treatment and some intradermal needles through microneedling and I also work a bit in my classes with skincare, with skincare, I was able to really help her to get some of those dark spots to disappear. This other patient here had a tremendous amount of modeling in her chin, a lot of wrinkling and the corners of her mouth were very much turned down. As you can see in the bottom picture here on her left on our right, that the corners of her mouth, instead of being turned down, they were starting to lift up. With her, I definitely used some motor points, which is the topic of today’s conversation.

Again, another patient. This was actually someone who’d been coming to me for years with wrist pain, elbow pain, shoulder pain on and off. She saw that I specialize in cosmetic acupuncture and she was concerned because she was having some asymmetry where her one brow and lid was coming down a little more than the other. I said, “Just get on the table,” and I treated the left side, and the difference was remarkable just from one treatment. Again, I used motor points in that treatment. Getting trained is important. The American Acupuncture Council does require that if you are doing cosmetic acupuncture, that you get trained by one of their certified providers, and I am one of the few people on their list of people who do training.

The reason for that is because there is special documentation, there are precautions, there are red flags and you really need to prescreen your patients for different contraindications. If someone hasn’t been screened properly and you are doing cosmetic acupuncture, you can bring on things like headaches. If they are prone to high blood pressure, it can raise their blood pressure, and many other things. The other part about training is, as you can see, there are 43 muscles in the face. Many of them are very small and when you’re working with the musculature of the face, you really need to know what you’re doing so that you don’t cause asymmetry, overstimulate a muscle or the nerves and the blood vessels, the capillaries on the face.

Some of them are very close to the surface, and really knowing where they are and how to prevent bruising is important. I’ve made a list of some of the neuromuscular facial conditions that I see most often in my practice. When someone within a 20- to 30-mile radius of where I live is looking up acupuncture for one of these conditions, I’m going to come up because this is something I specialize in. Again, specializing in facial acupuncture can be very beneficial for your practice and when I’m treating any of these conditions, of course, I will treat the underlying condition and I do use a multifaceted approach. Meaning, I use some submuscular needling and facial cupping, some gua sha, some scalp acupuncture, but motor points are a big part of treating neuromuscular facial conditions.

Also when we’re working strictly with cosmetic conditions, if you think about our emotions and how they manifest on the face, really understanding each one of the emotions, either from a 5-element perspective or just from a TCM perspective, how these organs being out of balance, what kind of wrinkles that might cause on the face. Using some of the motor points to really as reset switches, and we’ll talk about that in a second, can really help with things like hooded eyelids, the frown lines, crow’s feet and Bell’s palsy. I found these pictures in a book for artists or sculptors. They are artists, but I love them because they show a face at rest and then four different emotions, which of the facial muscles are used.

As we age, these muscles become not as functional as when we get older. Now some of them get overused, some of them don’t work as well. Some of the muscles that we overuse are going to end up causing lines and sometimes early sagginess on our face. You can see here when someone is showing rage, just how many different muscles are involved, and the same thing with joy. Motor points are something that were discovered actually quite a long time ago. Medical doctors have used them. I found an old medical text, and they were using motor points with hypodermic needles and stimulating them. I’ve listed some of the researchers, some of the people that have done a lot of work in the motor point world and what a motor point is, it’s the most electrically excitable part of the muscle.

When you find the motor point, you can stimulate it, and it is where the motor nerve bundle is… The nerve is actually attached into the muscle. Fortunately for us, many of them are acupuncture points. We don’t have to have a deep knowledge of anatomy in order to find them because we have the acupuncture points as reference points. If a muscle is too flacid, it’s not firing properly and if it’s too tense, it’s not firing properly. By stimulating the motor point, you are helping the muscle to function properly, whether it’s to relax or to get back to doing its job that it should be doing. As I mentioned, many motor points are also acupuncture points, but they are not trigger points or ashi points.

A trigger point is really a sore spot and you press on it or you needle it, and it feels good. It could be like a knot, but motor points are different, and there are motor points on the face. All of them are innervated by the seventh cranial nerve, except for the temporalis and the masseter, and those are innervated by the trigeminal nerve. In order to figure out which motor point you should use, if you looked at those other drawings, there’s arrows going in every direction. You have to understand what the functions of the different 43 facial muscles are.

When I teach my neuromuscular class or I have an advanced cosmetic class, I go through every single one of the emotions or every single one of the issues that might come up with a particular, if someone had Bell’s palsy and which motor point to use, but we are going to talk about a couple of them today. Normally, you just needle straight in or slightly at a slight oblique angle, and you want a needle into the muscle, but not through the muscle. I think I just did this slide this morning. I think this is all of the facial motor points. I’ve got one dot for each. I got a little crowded on one side, so I put some on the other side.

As you can see, there are quite a few facial motor points, and then there are others for the platysma and for the temporalis and also for the SCM, but I don’t have those marked out on here. Let’s talk about a couple, and the first two would be the procerus and the corrugator, and they give you the angry eyes or the frown lines. Here’s the corrugator muscle and the motor point. This brings your eyebrows together. It works in conjunction with the procerus, which is right here, but for the corrugator, the motor point is just lateral to bladder two. For the procerus the motor point is actually Yintang, so it’s easy to find. Again, these two muscles work together to bring the eyebrows together.

Another muscle group is the frontalis, which helps to raise your eyebrows, like if you’re surprised or inquisitive. For each wrinkle just about, there is an underlying emotion and it’s a topic for a whole nother conversation, but I just wanted to bring that up. I could talk about this for six hours so I’m trying to squeeze everything in in a half an hour as much as I can so. The frontalis again causes these horizontal wrinkles. The frontalis is two muscles right here and the motor point is gallbladder 14, and I have a little video. I had needle this on a patient and just stimulated it. You could see that her issue was a drooping eyelid on one side, and the frontalis is connected to your eyebrows so I had needled that.

As you can see, it really woke the muscle up. The orbicularis oculi is something that can be affected if a person has Bell’s palsy or a stroke, and the way you would test for it, can the person close their eyes and open their eyes. From a strictly cosmetic point of view, it is involved and these are called crow’s feet. Here is where the orbicularis oculi is, and there’s two motor points. One is between Qiuhou 23 and gallbladder one, and the other one is the extra point right here, which is more or less between stomach two and gallbladder one. Another motor point and this is something that is important for pursing your lips, bringing your top lip up.

If someone had some sort of paralysis around their mouth, if they put their lips together and they blew out, air would come out. If you or I did it, it would come out evenly, or it wouldn’t come out at all, but if someone had paralysis on one side, the air would only come out on the weak side, and it can also cause lip wrinkles. You can see a picture right here of how all of this works, and the name of the muscle is the mentalis. It makes your lip go down. There’s actually three different muscles that are involved in getting your bottom lip up to your top lip, but it can cause wrinkles on your lower chin and wrinkles all around the lips, and here is a video.

I had a student in class who had had Bell’s palsy years ago, and she said she still could not close her lips completely. I went ahead and needled the mentalis, and I noticed immediately that the muscle started twitching. I stimulated it, and you can see what happens. This was a muscle that wasn’t functioning at all. One of the things that comes up right now during this time, we’re in the middle of a pandemic, and our patients should be wearing masks in our treatment room. There was a lot of questions that have come up. I teach my classes now via livestream webinar, and my students have asked, “Well, how am I going to do my job?” Well, I just started back to work last week, and I gave a lot of thought to I can certainly protect myself, but I want to keep my treatment space protected as well.

The first thing I did was I took a box of surgical masks, and I did a little video. If you go to my Facebook group, I have a Facebook group. It’s called facial acupuncture, or my Instagram is also facial acupuncture. If you go to either one of these, you will see I have hundreds of short demonstration videos, articles and this was I think last week. I just took a surgical mask and so anyway, I have a demo video of how I made this, but I just took a regular surgical mask, cut the elastic, folded it. I use some hemming tape, like seamstress might use, or you might use if you wanted to hem your pants without the needle and thread. I just use the tape on the inside, and then I just reattached the elastic.

You can see the front and the back, and this wasn’t the best version. This was a version that I did. I hadn’t tucked the sides in, but other than LI20 and right around the top and bottom of my lip, if someone is wearing this mask, you can get to their entire face and neck. If they were to cough or sneeze or whatever, it’s still contained under a mask which works. I used one six times last week and I just give it to my patients, and then throw it out. Surgical masks are easy enough to get on Amazon right now. They’re inexpensive too. The next level that I’m working on, I saw this idea on the right, which was designed for aestheticians, and it’s a lucite box. I actually ordered one, but for my purposes, it was too open.

I was concerned that it was just too open, so I’ve actually been working with the manufacturer. I have designed this box on the left. I don’t have a photo of it, until I let them know how many I want. I’m not going to be selling these for profit. I’m going to probably order five or 10 or a hundred, and then just have them shipped to acupuncturists, so they can safely treat their patient’s face. Your patient’s head would go here. There’s holes for your arm. It’s very high up. It’s 15 inches, so your patient doesn’t feel claustrophobic, and I angled this part. When you’re sitting and working on their face, you can lean over and get a little closer. The little dots here, these boxes are actually collapsible.

When it comes in the mail, it’s whatever five pieces, and then you just put it together, and that way you can take it apart if you’re traveling or if you just want to store it, you don’t need it, but it was my extra level of sneeze guarding because a large part of my practice is treating people’s faces. That is my very quick talk on facial motor points, and I am going to open it up for questions. Alan, if you’re there, I don’t know what to do with my slides while we’re doing questions though. I see. Something in the chat box, leave the slides. Okay. I left the slides. No questions. Yeah. If you have questions, you can put them in the comments, and I will answer them later.

If you have questions afterwards, you can just put them in the comments and I can answer them. Okay. Thank you again for tuning in, and you can visit my website, facialacupunctureclasses.com. There’s information about my livestream and my recorded webinars, and I want to thank the American Acupuncture Council again for giving me this opportunity. Thank you so much.

Please subscribe to our YouTube Channel (http://www.youtube.com/c/Acupuncturecouncil ) Follow us on Instagram (https://www.instagram.com/acupuncturecouncil/), LinkedIn (https://www.linkedin.com/company/american-acupuncture-council-information-network/) Periscope (https://www.pscp.tv/TopAcupuncture). Twitter (https://twitter.com/TopAcupuncture) If you have any questions about today’s show or want to know why the American Acupuncture Council is your best choice for malpractice insurance, call us at (800) 838-0383. or find out just how much you can save with AAC by visiting: https://acupuncturecouncil.com/acupuncture-malpractice-quick-quote/.

Moshe Heller & Stephen Cowan

Phlegm – Etiology pathology and treatment Moshe Heller

Hi, my name is Moshe Heller. First I’d like to thank the American Acupuncture Council for hosting this show, and providing this really wonderful platform for writing information.

I’d like to start talking today, and today’s lecture would be, I will talk a little bit about pediatric phlegm, or phlegm in general. I want to just have a short discussion about etiological factors, pathology, and also the treatment. Since phlegm is actually a very, very common thing nowadays because of, as we know, a lot of … The flu is very common and upon us. As disease progresses, I see many children presenting with phlegm presentations in the past few weeks.

Let’s start. I think the slides are on, and you’re seeing it. The first thing I’d like to just talk about is that … Why do children actually have phlegm, or tend to have phlegm? There’s a famous saying that children produce phlegm very easily, and there’s a few reasons for that.

It all starts with the fact that, actually, children are born with very weak spleens. We assume that, at the beginning of their life, they will always have spleen vacuity. That presents with their tendency to have difficulty digesting, also having very soft stools. That’s a normal thing for them, and that’s a very clear sign their spleen is deficient. Therefore, when you have a spleen deficiency, dampness can easily accumulate and therefore transform into phlegm.

Also there’s another saying that the exterior of children is not secure, and they contract pathogens very easily. WHen the child contracts a pathogen, it influences the way that the lung functions, and the spleen. Therefore, also, the end result could be an accumulation of phlegm, or dampness and then phlegm.

There are a few other supportive factors to the production of phlegm, and one of them has to do with … What I see very commonly now is that the feeding schedule is not as … Parents tend to feed babies on what we call “on demand”. Therefore their scheduling of feedings are random, and sometimes cause this eating on various times, and end up a lot of times overeating. That in itself can also cause an issue with or become a burden on the spleen, and therefore produce more phlegm.

Also, as the children grow, and we start to introduce new foods, a lot of times wrong foods can be presented to them. Meaning either they’re too cold or difficult on the digestive system, and that could be because one of the most common thing is introducing fruits earlier on, or too early. As we believe in Chinese medicine, that fruits are cold and therefore can really burden the spleen, also.

There’s also the issue of formula. I think that sometimes the formula is very heavy and is actually over rich, and therefore not so easy to digest. A lot of children, once they’re put on formulas, actually start developing phlegm. It’s a very interesting thing to watch, because we have then the issue of, what to we do if there’s no other sources of food, and we have to look at different formulas as solutions?

I also want to mention one other thing that’s really commonly seen in my office is that a lot of times antibiotics are given inappropriately, meaning that … Antibiotics definitely have a place and a time to be used, and they are very important. Nonetheless, if they’re used inappropriately, they can produce a dampness very easily because of their nature. As we know, from a Chinese medical perspective, antibiotics are cold and bitter, and therefore they are hard on the spleen. If we have a cold condition, and it’s a cold exterior condition, and we give out antibiotics, the end result will be that there will be some phlegm developing, or damp and then phlegm.

How do we diagnose? How do we know that there is phlegm in the body? Sometimes in children the easiest way is that we see it. As we saw in the first picture of the slides, sometimes it’s very visible, but sometimes it isn’t. If there’s no discharge, there are other telling signs that are important to realize.

One thing ends up as a result of this, especially if the phlegm is stuck in the sinuses, the child becomes a mouth breather. A lot of times we’ll see that their lower lip is a little saggy. Especially if they’re trying to concentrate, you’ll see that their lower lip opens and falls down, and it doesn’t shut down. A lot of times it will also result with some more drooling, or a tendency to drool, heavier if they’re at the teething age.

We have this drooped lower lip, and then mouth breathing. Then we can hear them breathing a lot of times. Another telling sign is snoring at night. Snoring at night usually indicates there’s something that’s blocking, and that phlegm is one of the causes of snoring in kids. Mouth breathing, heavy breathing, or snoring at night, those are all really strong signs.

Of course, palpating the lymph glands is a very important diagnostic procedure in children, because if the lymph glands are swollen, that’s a really strong sign that there is some phlegm accumulating, and a very particular type of phlegm, which we’ll talk in a second. Then, also, the actual history itself of the disease. If there’s chronic sinusitis, or chronic ear infection, or tonsillitis, all these are signs that maybe there’s this phlegm that’s lingering, and is a part of the pathology of the disease.

Another thing that’s really important to use as a tool is listening to the lung sounds. That’s something that, if you’re seeing children, you should probably have a stethoscope with you, because listening to the lung sounds can help in your diagnosis, another sign that can help you in the diagnosis of the patient.

For example, if you hear wheezing when you listen to the lung, you know that that is a constriction of the bronchials. That means that there’s Chi stagnation. But, if you hear crackles, crackles are the sounds like little balloons popping, that is a sound that there is phlegm in the lung. I use it as a diagnostic technique. I listen to the lung. If I hear those crackles, I know that I’m going to need to clear phlegm from the lung.

I want to go over two patterns, this is diagnostic patterns, that are very common in children. The first one I want to discuss is accumulation disorders. We discussed this many times before, but I’m just want to remind you that a lot of times accumulation disorders are the reason that children are presenting with phlegm.

What it is is that … It’s like food stagnation in adults, but its difference is that this could be just from either overeating or eating things that are very difficult for them to digest, and then that accumulates in the stomach and creates this heat and phlegm. The heat symptoms manifest with these red cheeks that are there all the time. This is heat rising from the stomach, and you’ll see these little, almost like stop lights, with the two red cheeks. They’re very distinct. It’s a sign that the digestion is a little overheating and stagnant.

Of course, that will also affect their … They’ll be a little more cranky and irritable, and maybe have difficulty falling, or staying, or waking up frequently. These children don’t sleep as well because something’s not digesting well.

Of course, once these fluids go up and stagnate, they can cause phlegm to accumulate. Then you’ll see this green nasal discharge, exactly like you saw in the first picture. Then you’ll probably see cough involved with it that is very rattly, and maybe some slippery coughs. These are all phlegm signs that come from the accumulation disorder.

When we recognize or diagnose accumulation disorder as the source, we always need to think of Si Feng as the treatment points. Of course, Stomach 36, Stomach 25, and CV-12 are also really important to help, and San Jiao 6, which really helps to move the Chi and resolve the blockage in the digestive system. These are all really important points, but the main treatment point will be Si Feng.

Then the formula that you might be considering has to do with helping the digestion. I have a great formula that’s based on Bao He Wan in my new motion line. I have a website that will be at the end of the slideshow. You can log on and look at digest. It’s a really fantastic formula for supporting the digestive system in situations just like that.

The other aspect is lingering pathogenic factors. Lingering pathogenic factor, a lot of times either cause phlegm or are the phlegm itself. When we diagnose lingering pathogenic factors, we usually have three types or three syndromes under that. One is more of a deficient kind that’s a little more rare, and it involves spleen Chi deficiency. The other one is called retention of phlegm, and retention of very thick phlegm.

We’ll go over the last two just to remind you how we diagnose them. When we only have retention of phlegm, usually you’ll see that there’s this recurring infection, and it can be anywhere from the sinuses, to the throat, to the chest, to the ears. There’ll be a lot of phlegm or discharge from the nose, or cough with a gurgling or rattling sound. There’ll be mouth breathing, like we discussed earlier. There’s emotional state where they want things, but they don’t really want them. They’ll say, “I want this,” but when you give it to them, they’ll throw it away. That’s a very typical sign of that. Then, also very choosy, and wanting only sweet or white foods.

Sometimes you’ll see a manifestation of that phlegm on the stool itself. That’s question we have to ask parents. How does the stool look? Does it change color? Have you noticed any changes in … If there’s this glistening, or it’s a little bit shiny, that’s a sign that there’s phlegm in the stool. Then, of course, enlarged lymph glands, which is really a very important sign for the lingering pathogenic factor.

When it becomes thick phlegm, there’s a lot of the same symptoms. A lot of times the thing that triggers me is that, when I ask, when we discuss the illness history with the parents, they’ll always say a sentence like, “Since their illness, they haven’t been really the same.” The underlying mechanism is that the child’s character is altered or really changed. There’s something either subtly or really more significant change in their character.

Then, that’s very typical of that, when we think that phlegm is becoming so distinct that it actually changes the spirit, or changes … With an adult, we’ll say that there’s phlegm blocking the heart orifices, and then the Shen is not as clear. That’s when we start seeing that in children.

A lot of times there’ll be two other signs that I want to say. They’ll have these energy crashes. They’ll suddenly have periods where they just are really cranky, and they only want to really rest. Also it is sometimes associated with intermittent abdominal pain. These are all signs of the lingering pathogenic factor with very thick phlegm.

The treatment, when you recognize that, is combination of four points, Bai Lao, which is an extra point in the back, UB13, 18, and 20. This is the basic protocol. Sometimes I combine it with the Shao Yang combination of Gallbladder 41 and Triple Warmer 5. Also I will palpate UB43. If it feels very full and excess, I might needle that also.

The main form that I use for that is a combination of Xiao Chai Hu Tang. We’ll talk a little bit about Xiao Chai Hu Tang, because it’s not the first formula that you would think for phlegm, but I found it really helpful with many children, especially with children, to resolve phlegm. I guess because [Ban Xia 00:21:00] is in that formula, but it really is a mild way to resolve phlegm. Helps the children resolve it. I’ve used it many times. You can see that, once Xiao Chai Hu Tang is used in its correct formula, you will see a slow drying of that phlegm, and the symptoms are reduced. I really want you to remember Xiao Chai Hu Tang, especially with kids when they have phlegm.

I want to give a case example that I was treating, actually, a few days ago, last week. There’s this two-year-old boy that came to my office that the parents were saying that was experiencing back-to-back ear infections. Again and again, the ear infections would repeat. Also it always comes with fever and pain. The child really is two years, but still is talking already, and expressing pain in the ear. He mostly tugs and pulls on the left ear, but both ears is something that he’s experienced.

His mother says that everything was normal during pregnancy. The delivery was fine. At the end he needed to be vacuumed, but he was healthy otherwise. Around nine months of age, something around then, she had to stop breastfeeding, go back to work. Although she was giving him formula beforehand as a supplement, at around nine months, around that time, formula was a the only thing she was giving, of course and the introduction of solids.

At that time, there was a lot of dairy products that were introduced. That created a lot of wheezing, or he started to have these episodes of wheezing, almost like asthma. Went to the doctor, the doctor gave steroids in a nebulizer, an inhaler. That really calmed the wheezing, as the mother was reporting.

Then, a few months later, he got another really bad cold. Then that developed into an ear infection, and he was given antibiotics. Since then, it’s been repeated ear infections and rounds of antibiotics. Last round of antibiotics was about three weeks ago. He was given Amaxicillin, and he is currently still complaining of ear infection, although there’s no fevers, which the mother was relieved. She took her to the pediatrician a few days before the appointment, and there was still accumulation of fluids behind the ear drum. The doctor was saying that they may need to consider doing ear plug operation. That’s why they were looking for an alternative way to treat him.

The mother was saying that the baby is a very picky eater, and in the last month they were trying to get him off of dairy, because they thought that that could be a problem, and that’s why he’s having the ear infections, which I agreed. We also agreed that, from now on, they should probably stop wheat.

Bowel movements are two to three times a day. The mother thinks it’s pretty normal, and they don’t seem to be too soft or hard. He doesn’t complain of stomach aches. But, his sleep is not good. He wakes very frequently. He drinks a lot of water throughout the night, and also the mother reports that he’s addicted to the pacifier throughout the day. She’s wanting him to stop, or trying to wean him off of that.

On examination, I found submandibular lymph nodes that were positive or enlarged. His finger vein, which is something that I observed, was very dark, which means heat, and wide. That means that the pathogen is strong, and it’s reached the wind gate. It hasn’t really penetrated extremely deep. Therefore we could address it by resolving it on the [Yan 00:26:43] layers. I’ll explain in a second. Also, when I was examining him, it was clearly that his breathing was heavy and he sounded very congested.

Out of that, I was very clear that his diagnosis was that he had what we call thick phlegm LPF. I believe that it had developed from what we might call a food accumulation, or an accumulation disorder prior to that. I needled the points San Jiao 5 and Gallbladder 41. That is a combination I use for ear infections, because when we address the Shao Yang, it opens up the flow of Chi around the ear. That could be, in itself, the treatment for the ear part of the disorder.

I also added Bai Lao UB13, 18, and 20, as we know, because of the lingering pathogenic factor. I also prescribed Xiao Chai Hu Tang. The first days after the treatment, I got a report that the child was sleeping much better, which was I think a very important sign to see.

I’m running out of time, but I wanted to just mention a few formulas that we usually use for phlegm. Including Er Chen Tang, is an important basic formula for phlegm that we know. Sometimes you can combine that with Xiao Chai Hu Tang. I usually think of Er Chen Tang when I see a spleen deficient at the background of the phlegm accumulation. If there’s spleen deficiency at the background, Er Chen Tang is what I would think for.

Ban Xia Hou Po Tang, another really important formula for phlegm. The difference between that and Er Chen Tang is that Er Chen Tang is more spleen-y, and whereas Ban Xia Hou Po Tang is more liver-y. If the spleen is really deficient and is the cause of the phlegm accumulation, then we can use Shen Ling Bai Zhu San. Or, if there’s an accumulation disorder at the background, Bao He Wan is the choice. As I mentioned, you can check my variation of Bao He Wan in the motion herbs website.

There’s other two formulas I just want to mention that is related to cough. Qing Qi Hua Tan Wan is the famous phlegm heat, or sometimes called Pinellia Expectorant. That clears phlegm heat from the lung. That’s when you have a lot of this cough, which is productive with yellow phlegm. But, if there’s more phlegm dryness, we think of Bei Mu Gua Lou San as the formula for resolving phlegm and dryness.

I think that’s about the time that I have for this presentation. Thank you very much for joining me, and I hope we will meet again in our next session.

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