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Posts Tagged ‘弗吉尼亚’

Cervical dystonia case

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Today, a friend told me she had acupuncture in our center for two and half weeks, lost weight 6 pounds.

Acupuncture adjusted her appetite and mood.

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Yesterday, a 44 years old lady came and hugged me very tightly for three minutes. And then told me she got pregnant naturally after my acupuncture treatment.

She said she should be my no.76 clients got pregnant–because she had seen there was a notes on the office board-75 pregnancy since 2007.

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J Sex Med. 2010 Feb;7(2 Pt 2):981-95. Epub 2009 Nov 12.

The ACTIV study: acupuncture treatment in provoked vestibulodynia.

Source

Elements of Health Centre, Victoria, Canada.

Abstract

INTRODUCTION:

Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain.

AIM:

To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD.

METHODS:

Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman’s individual TCM diagnosis. TCM practitioners made qualitative notes on participants’ feedback after each session. Main Outcome Measures. Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant.

RESULTS:

A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants.

CONCLUSIONS:

Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.

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My patients and many others sometime want to know what is the difference between IVF and acupuncture in infertility treatments.

Actually, the difference is significant.

1. IVF, using artificial procedure to help the infertility couple to get baby(s). It is a procedure with the external help(doctors) and get “pregnancy”, like a game.  And, sometime, using donor’s egg or sperm. The result could know in one month. If you see the patient has bleeding after some days post the procedure(embryo transferring), the IVF is failed.

2. Acupuncture, adjusts the hormones and improving the function, which makes patient become a normal people. And then she could get pregnancy in any cycle.

Yesterday, one patient told me she got pregnancy after our acupuncture treatments.

 

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Fertil Steril. 2012 Mar;97(3):599-611. Epub 2012 Jan 11.

Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.

Source

Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China.

Abstract

OBJECTIVE:

To evaluate the effect of acupuncture on in vitro fertilization (IVF) outcomes.

DESIGN:

Systematic review and meta-analysis.

PATIENT(S):

Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects ofacupuncture on IVF outcomes.

SETTING:

Not applicable.

INTERVENTION(S):

The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture.

MAIN OUTCOME MEASURE(S):

The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.

RESULT(S):

Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation.

CONCLUSION(S):

Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.

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Dear colleagues & Friends,

A Spring seminar will be hold by Virginia Institute of Traditional Chinese Medicine (VITCM) on April 1, 2012, Sunday. Hope everyone will arrange time to attend, and share your knowledge and experience.

Topics: The Western Diagnosis, TCM Treatments and Research Updates of Common Skin Diseases; Yellow Emperor’s Classics of Internal Medicine.

Location:Potomac Community Center, 11315 Falls Road,Potomac, Maryland 20854;Tel: 240-777-6960.

Skin problems, which affect more than 10 million Americans, can be one of the most frustrating and stubborn group of symptoms to successfully treat. Many pharmaceutical solutions offer quick relief but do not provide a lasting solution, and come with risks such as toxic build-up in the body and weakening of other organ systems. Therefore, more and more people are choosing alternative solutions such as Chinese Medicine, which can be safer and which intends to address the root cause of the symptom instead of covering it up each time it appears. In fact, dermatology is a recognized specialty in traditional Chinese Medicine. Treatments for skin disorders have been described as early as 1100-221 BC in China.  Acupuncture and Chinese herbs offer a natural solution to improving skin conditions with its sophisticated system, both external and internal administration. There are hundreds of herbal formulas available for skin disorders such as herpes, eczema, and psoriasis.

Fee: $208. (Mail check before March 15, 2012, discount rate at $188).

Contact Person: Dr. Arthur Fan,Tel:(703)499-4428, e-mail: ChineseMedicineInstitute@gmail.com. Address: VITCM,8214 Old Courthouse Rd,Vienna, VA 22182.

Lecture Details (included in lecture and discussion):

8:00AM-9:30AM: Tai Chi and Medical Applications. By Drs. Eugene Zhang, Arthur Fan (Outside, in Parking lot; if rain or snow, cancel). 

9:30AM-1:30PM: Western Diagnosis & TCM Management for Common Skin Diseases. By Dr. Yongming Li (this special lecture outline is available in the Blog part)

1:30 PM- 3:00PM:  TCM and Skin Disorder: An Update on Clinical Research. By Dr. Lixing Lao.

3:00PM-5:30PM: Yellow Emperor’s Classics of Internal Medicine: Four Seasons, Five Organs, Yin Yang and Related Experiments. By Dr. Quansheng Lu

Instructors

Dr.Lixing Lao,  CMD, PhD, LAc, Professor of Family Medicine, Director of Traditional Chinese Medicine Research, Center for Integrative Medicine,University of Maryland School of Medicine, Baltimore,MD.

Dr. Lao graduated from Shanghai University of TCM (MD in Chinese medicine) and completed his PhD in physiology at the University of Maryland at Baltimore. He has practiced acupuncture and Chinese medicine for more than 20 years, and has been awarded numerous grants from the NIH and the U.S. Department of Defense to conduct research on acupuncture and alternative medicine. He presents frequently at national and international conferences, including the seminal 1997 NIH Consensus Development Conference on Acupuncture and the White House Commission on Complementary and Alternative Medicine Policy. He was board cochair of the Society for Acupuncture Research, chief editor of American Acupuncturist, the official journal of American Association of Acupuncture and Oriental Medicine.

Dr.Lao was one of funders and professor of former Maryland Institute of Traditional Chinese Medicine (MITCM), which was a well-known school in TCM education during 1990s to 2000s. Currently, he is the honor president and main lecturer of VITCM.

Dr. Eugene Zhang, CMD, PhD, LAc. has been practicing acupuncture for over 15 years, and is a graduate of famous oriental medical school in the world: the Beijing University of TCM.

In China, Eugene Zhang was a Medical Doctor (MD in Chinese Medicine); here in  US he is one of the top Licensed Acupuncturists inVirginia,Maryland and Washington DC. area. He was a well-respected professor and Clinical Supervisor for the prestigious Maryland Institute of Traditional Chinese Medicine (MITCM). Because of his years of experience, he serves as a consultant for the council of Colleges of Acupuncture and Oriental Medicine (CCAOM).

Dr. Zhang is also a senior Taiji (Tai Chi) and Qigong Instructor, both in the United Statesand in China. He has written a detailed book, “The Ultimate Exercise for Mind and Body” that explains the benefits of Qigong and shows pictorially the different body postures.

Dr. Yongming Li, MD, PhD, LAc (in New York and New Jersey). Our guest speaker.

Dr.Li is a leading doctor in both Chinese medicine and Western medicine. He graduated from Liao-ning college of TCM in 1983, and got PhD, MD in USA.

He is a well-known doctor in dermatology, doctor and scholar in the field of acupuncture and Oriental medicine with more 20 years’ clinical experience. Currently, he also serves as a NIH grant reviewer. He was the president of American Traditional Chinese Medicine Society, which has more than 700 members in New York area.

He has published many academic papers and books,included in “Acupuncture Journey to America”, a new published book in acupuncture history.

Dr. Quansheng Lu, CMD, PhD, L. Ac. Dr.Lu is a licensed acupuncturist in Maryland. He graduated from Henan University of TCM in China and subsequently worked as a resident and attending physician of TCM at a general hospital in China for 8 years. During this period, thousands of patients recovered under his treatment.  Given his outstanding contribution in TCM, Dr. Lu was awarded the Outstanding Doctor Award from the Local government. Dr. Lu pursued his master degree in TCM at Beijing University of TCM.

He continued to expand his education and later received a  PhD in cardiology in Chinese and western integrated medicine  at the China Academy of Chinese medical science. He focused on exploring hypertension molecular mechanisms and looked for new anti-hypertensive natural herbs. His supervisor is Professor Keji Chen; president of The Chinese Association of Integrated Medicine, and academician of the Chinese Academy of Sciences. Dr. Lu was a postdoctoral fellow at Georgetown University Medical Center and Children’s National Medical Center.

Dr. Arthur Yin Fan (Fan Ying),PhD, CMD, LAc, a leading specialist in Acupuncture and Chinese herbology, has more than two decades of clinical experience in both Traditional Chinese Medicine (TCM) and Western medicine. In China, he was awarded an M.D. degree in TCM and a Ph.D. in Chinese internal medicine from famous Nanjing University of TCM. He completed additional one year’s training in the Western medicine diagnosis and treatment of neurological disorders as well as a six-year medical residency combining TCM and Western internal medicine. He was a medical doctor in both TCM and coventional medicine when he worked in a University hospital in China. He was the funder of  Nanjing Stroke Center which is now a China national key center in Stroke rescuing and rehabilitation.

An evaluator of medical science research grant applications for many countries, Dr. Fan is currently a consultant for the Complementary and Alternative Medicine program at the University of Maryland medical school. He has also conducted CAM research for the Georgetown University medical school’s programs in nutrition and herbology.

Dr. Fan holds the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certificate in Oriental Medicine, which comprises Acupuncture, Chinese Herbology and Asian Bodywork. Dr.Fan was awarded the third place prize in Taiji-quan (Tai Chi) in China first national health-sport congress (1985,Shenyang,China). Dr.Fan is the funder of VITCM.

Ron Elkayam, MSTCM, graduated from the Academy of Chinese Culture and Health Sciences in Oakland,California in 2004 where he studied acupuncture and Chinese medicine. While still in school studying Chinese Medicine,  Ron studied with Robert Levine, L.Ac., in Berkeley, where he furthered his understanding of acupuncture, herbal formulas, diagnosis, and pulse taking. Inspired to take his learning to a new level, he moved to Taiwan in 2005 to learn Mandarin as a way of deepening his studies in Chinese medicine.Over the course of almost five years, Ron studied Mandarin in universities in Taipei, Shanghai, and Beijing, received advanced Mandarin language certification, and worked in hospitals (Guanganmen,Tonren hospitals) as interns, where he was able to communicate with doctors and patients in their native language and gain useful clinical experience.

Ron has a background in mind-body disciplines and has a 2nd kyu (brown belt) in aikido. He has also studied qigong (Wild Goose style), taiji (Wu and Chen styles), and Kripalu yoga. He also believes in the importance of diet and exercise in helping patients reach optimum health and happiness.

In late 2010, Ron finally returned to theU.S.to bring his clinical experience to American patients.  He has NCCAOM certification in acupuncture and herbal medicine, in addition to being licensed inVirginia,California, and Rhode Island. Ron is originally from Baltimore,MD.At present time, he works part-time to assist VITCM’s daily work.

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“Incredible, my daughter could sleep well and did not have hives again after first-time drinking of the herbal tea you prescribed. Just very slight in the second and the third day’s night. In one word, she has significant improvement, and will get cured.” the patient’s mom said in an e-mail to Dr.Arthur Fan.

This kid has hives several months, esp. during the night- time. Patient had a lot of hives all over the body, affecting her sleeping. Every interesting, the hives disappeared in morning automatically. During the day-time, patient had hives very occasionally.

 “难以置信,您开的药吃的第一夜我女儿就安睡,没有起荨麻疹。第二天下午有一些,但白天好办,玩儿一会儿引开注意力就没事了。第二夜有一点儿。第三夜好好的,一夜无话。总之明显好转,痊愈在即。

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Dr.Arthur Fan has been rated as one of  “top acupuncturists” in Washington DC and northern Virginia area in the Website: www.RateMDs.com.

http://www.ratemds.com/filecache/topTen.jsp?city=WASHINGTON&sid=8

Best Rated Acupuncturists in WASHINGTON, DC
1 Tetsuhiro Ueno – Arlington
2 Yong Chen – Bethesda
3 ARTHUR FAN – VIENNA
4 SUZZANNE LOHR – WASHINGTON
5 ROCCO MANZIANO – SILVER SPRING
6 BK Mudahar – Washington
7 KERRI WESTHAUSER – BETHESDA
8 Wei Peng – BETHESDA

Best Rated Acupuncturists in herndon, VA
1 Tetsuhiro Ueno – Arlington
2 ARTHUR FAN – VIENNA
3 James Larmour – FAIRFAX
4 Rachal Lohr-Dean – Chantilly
5 SATORI POCH – RICHMOND
6 EUGENE ZHANG – FAIRFAX

Best Rated Acupuncturists in mclean, VA
1 Tetsuhiro Ueno – Arlington
2 ARTHUR FAN – VIENNA
3 James Larmour – FAIRFAX
4 SUZZANNE LOHR – WASHINGTON
5 BK Mudahar – Washington
6 SATORI POCH – RICHMOND
7 EUGENE ZHANG – FAIRFAX

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Acupuncture and Chinese herbal medicine is very effective in Guillain-Barre Syndrome’s recovery in some cases.

Here we have a case record in video, I hope patients with Guillain-Barre Syndrome don’t get frustrated, use acupuncture or/and Chinese herbal medicine as early as possible, in most of cases, very good.http://www.youtube.com/watch?v=6Ngu5WrPDcE&feature=youtu.be

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One patient asked Dr.Fan: “Do you think acupuncture could stop my vaginal bleeding during my early stage of pregnancy? ”

My reply is: “Yes. In most of the cases, acupuncture does  help the patients to stop mild vaginal bleeding during their early stage of the pregnancy.”

We had at least 8 successful cases since 2007.

Stopping the vaginal bleeding means stabilizing the condition which may induce the miscarriage.

One patient.Ms.T.M. came today, she had brown color-like bleeding in her vaginal discharge 4 days during her pregnancy week 6.  After one time acupuncture, the brown color disappeared.

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Original Article from http://chinesemedicinetopics.wordpress.com/2010/05/11/opening-through-two/(May 11, 2010 by sharon weizenbaum)
 
[This re-post was got kind permission from Ms.Weizenbaum.]

加减通瘀煎 Jia Jian Tong Yu Jian Modified Opening Through Stasis Decoction

“it is very important that the lack of free flow is paired with fullness, pain or up-bearing symptoms”


By way of introduction to this first chapter, I’d like to write a bit about women’s physiology and the tubular quality of the Ren vessel and the Bao Tai.  Though I have not heard of these pathways written or spoken of as “tubular” per se, thinking of them in this way has helped me to visualize and understand women’s physiology, patho-physiology and the use of herbs in formulas.  So, please bear with me…If we think of the Ren vessel/Bao Tai as a tubular pathway extending from the upper body (Heart and chest) to the womb, physiologically, this tube provides the route for the Heart fire to descend to warm the womb and for the Kidney water to ascend to control, moisten and cool the Heart.  This pathway allows the communication and interaction of fire and water between the upper Jiao and womb.  We can also see that what travels within this tube is the interaction of fire and water which is the red blood.  The scenario that requires the use of formulas like Jia Jian Tong Yu Tang (Modified Open Through Stasis Decoction), is characterized by blood in this tube becoming congealed and blocking the tube.  If we think about the Qi mechanism and the necessity for there to be a constant free flow of Qi up and down, we can see that a plug in this tube could cause a disruption in this free flow.  The Heart Qi and fire may be unable to move down to the womb.  This can cause a myriad of upward rebellion symptoms along with the primary pathology of the uterine contents, whether blood, lochia or fetus, failing to move out freely.

Dr. Xia’s Jia Jian Tong Yu Tang (Modified Open Through Stasis Decoction) is his foundational formula to, for lack of a better analogy, sort of blow the plug out like a spit ball out of a straw.

What we want to know how to do in the clinic is to recognize when there is this kind of plug in the tube – i.e. how to diagnose this.  Additionally we want to know which herbs discharge this manifestation of blood stasis and how to modify a formula for the various presentations we will see clinically.  The presentation may vary in terms of aspects such as excess/deficiency or heat/cold and it can also vary in terms of presenting symptoms such as headaches, insomnia or, as I mentioned in the last post, difficulty swallowing.  Main complaints can vary from PMS, dysmenorrhea, PCOS, endometriosis and infertility to amenorrhea.  We also want to know how to administer the purgative therapy safely – this has to do with careful diagnosis and timing of the treatment.

The main signs I use clinically to diagnose the presence of this “plug” is the combination of lack of free flow of the uterine contents with lower abdominal discomfort and fullness.  Lack of free flow by itself can be due to pathologies such deficiency of blood or Yin fluids or cold etc. in which case blowing out the plug would be unsuitable if not detrimental.  Lower abdominal fullness and discomfort could also be due to many pathologies such as uterine infection, simple blood stasis that does not block the menstrual flow or other stasis in the lower abdomen.

Lack of free flow of the uterine contents manifests as amenorrhea, scanty menstruation, menstruation the stops and starts, failure of the lochia to discharge or non progression of labor.  All of these pathologies can come form other disease factors besides this one and so it is very important that the lack of free flow is paired with fullness, pain or up-bearing symptoms.

The primary herbs that Dr. Xia uses for opening through menstruation here are:

Shan Zha

Qing Pi

Chuan Niu Xi

Ze Lan

Hong Hua

Tao Ren

We will see others in future posts.  It is important to notice that these herbs do have this kind of special indication.

Below is Dr. Xia’s writing on the 1st formula in the 7th chapter of his text.

Translated by Sharon Weizenbaum

Jia Jian Tong Yu Jian 加减通瘀煎 Modified Opening Through Stasis Decoction

Formula Name:

Tong 通 means to open the flow and Yu 瘀 is stasis and refers to blood stasis.  Jian refers to the method of cooking which is to boil.  Opening stasis refers to a strong method of transforming stasis.  One should use stronger vitalizing blood herbs when the intention is to open the passageways, free the flow of blood stasis, scatter and transform blood stasis.  Based on the pathological condition of the patients, I have modified Zhang Jing-yue’s Tong Yu Jian (Open Through Stasis Decoction) into my own experiential formula.

Formula Constituents:

Chao Dang Gui Wei     12 gm

Shan Zha                      10 gm

Xiang Fu                       9 gm

Hong Hua                    6-9 gm

Wu Yao                        6 gm

Qing Pi                        5 gm

Chuan Mu Xiang          9 gm

Ze Lan Ye                    10 gm

Chi Shao                      10 gm

Chuan Niu Xi               10 gm

Tao Ren                        6-10 gm

Method of Application

One package is for one day, divided into two doses.

Formula Function:

Regulates Qi and vitalizes the blood, opens through stasis and synchronizes the menstruation.

Formula Application

This formula treats blood stasis type late menstruation, scanty menstruation, prolonged menstruation and dysmenorrhea.

Formula explanation:

This formula treats blood stasis type irregular menstrual pathology.  This includes blood stasis type dysmenorrhea and amenorrhea presentations.  It places Dang Gui Wei in an important position for vitalizing blood and transforming stasis.  However, these days pharmacies do not discriminate between Dang Gui Wei, Dang Gui Tou and Dang Gui Shen.  Consequently we assist the function of Dang Gui to open stasis with Tao Ren and Hong Hua making this a stronger blood vitalizing formula. Zhang Jing-yue’s original formula contains Hong Hua but is without Tao Ren.  Tao Ren must be added.  Generally, because of the demands of opening through stasis, I base my formula on Tong Yu Jian (Open Through Stasis Decoction), though, according to the clinical presentation I also add Ze Lan Ye and Chuan Niu Xi to open the pathways of the menstruation.  The goal is to vitalize the blood while guiding its flow and opening through the menses. Therefore, in addition to using herbs to vitalize blood and transform stasis, one should also assist with herbs to synchronize and regulate Qi and move stasis.  The point is to first give herbs to move the menstrual Qi.  It is said that “When menstrual blood does not move, first move the Qi because when the Qi moves, the blood will move.  When there is Qi stasis, there is blood stasis and when there is blood stasis, the blood obstructs the Qi movement”.  Because of this, I add Xiang Fu, Wu Yao and Mu Xiang.  These 3 herb flavors regulate the Qi and synchronize the Qi of the Liver, Kidney and Spleen Zang.  When regulating Qi and moving stasis it helps to vitalize blood and open the menstruation and so you can add Qing Pi.  This herb helps promote easy flow and discharge and strengthens the regulating and synchronizing of the Liver Qi.  Because the Liver stores the blood and governs free flow and discharge, when you want to help the flow and discharge of the menstrual blood and this will regulate Qi and synchronize the menstruation.  Therefore when regulating the Qi and synchronizing the menstruation, one should lay stress on the Liver.  One can add Shan Zha.  Master Zhang uses this not only to vitalize blood and open the menstruation, but also to synchronize and regulate the Qi mechanism.  Because of all this, Jia Jian Tong Yu Tang (Modified Open Through Stasis Decoction) is frequently used in the clinic.

Clinical Application

According to Jing Yue Quan Shu: Fu Ren Gui (The Complete Works of Jing Yue: Women’s patterns), Tong Yu Jian (Open Through Stasis Decoction) treats Qi stasis, congealed blood, inhibited menstruation and vessels and extreme abdominal pain.  In addition to treating late menstruation, lack of smooth flow of menses and painful menstruation, Jia Jian Tong Yu Jian (Modified Open Through Stasis Decoction) can also treat post partum congealed blood excess pain as well as blood reversal or blood rebellion.

1.Late Menstruation, scanty menstruation and painful menstruation:
This formula can be used when there is scanty menstruate that does not flow smoothly.  This presents with abdominal pain that resists pressure, purple blood with dark with clots, pain and distention in the abdomen, chest oppression and vexation.  The pulse is thin and wiry and the tongue is purple and dark.  In this circumstance you can add herbs such as Rou Gui and Ze Lan Ye.

2.Post partum blood stasis abdominal pain:
During the post partum time, if the lochia stops too soon or does not flow out smoothly and this is accompanied by purple dark blood with clots, lower abdominal distention and pain, low back soreness and weakness with chest oppression, abdominal distention, purple dark tongue and a thin rough pulse, one should add Ze Lan Ye, Yi Mu Cao and Yan Hu Suo to this formula.

3.Blood stasis blood fainting: 
This presentation can be due to trauma from an accident, or it can simply manifest when there is scanty menstruation with abdominal pain.  The patient suffers from dizziness, fainting, cold limbs, nausea and vomiting, abdominal distention, a thin pulse and a purple dark tongue.  In this circumstance you can add herbs such as Shi Chang Pu, Guang Yu Jin, Zhi Mo Yao or Zhi Ru Xiang.

Modifications:

This formula is from the Jing Yue Quan Shu: Fu Ren Gui (The Complete Works of Jing Yue: Women’s patterns and it can be modified as below:

1.If there is cold stasis add Rou Gui and Wu Zhu Yu

2.If there is full fire with inner heat with blood that does not move due to dry blood add Chao Shan Zhi, Dan Pi.

3.With slight heat and blood deficiency add Bai Shao and Gui Shen.

4.With blood stasis with very scanty blood add Su Mu and Chong Wei Zi

5.With dry knotted stool add Da Huang and E Zhu or add Mang Xiao and Tao Ren.

Clinical Experience

Tong Yu Jian(Open Through the Menses Decoction) is really 3 formulas. 

1.Tong Yu Jian (Open Through the Menses Decoction) comes from the (Jing Yue Quan Shu: Fu Ren Gui (The Complete Works of Jing Yue: Women’s patterns).  MyJia Jian Tong Yu Tang (Modified Open through the Menses Decoction) was developed based on this formula and my own clinical experience.

2.The second formula is from the Xian Nian Ji (Immortal Collections): Vol. 4. This formula uses Gui Wei, Da Huang, Hong Hua, Su Mu.  These are strong herbs for dispelling stasis but in this formula the dosages are light.  It is for moving evil blood and is used primarily for dispelling when there is post partum congealed blood and stasis leading to poor flow of the menstruation.  This is considered evil blood.

3.The third formula is from Guang Lue Liu Shu: chapter 25It uses Pu Huang, Wu Ling Zhi, Chuan Yu Jin, Xiao Zhi Shi, Bai Zhu Tang, Jian Ze Xie, Xi Chi Shao, Tao Ren Ni, Ming Hu Bo.  This formula is used to treat blood stasis in which the abdomen becomes filled with fluid.  The pulse is rough and not smooth.  In theFang Lun Xuan Lu (Selected Writings on Formula Theory) it is written: “When blood stasis is not dispersed, the Spleen and Stomach loose their ability to be fortified and to transform and transport the minute essences.  The turbid Yin gets stopped up and this leads to abdominal distention and fullness.  This is called Blood Tympanites (Gu 臌).  Pu Huang cracks congealed blood, it opens the channels and collaterals.  Wu Ling Zhi cracks congealed blood and also descends the turbid Yin.  Tao Ren cracks the congealed and also moistens dryness.  Chi Shao cracks the congealed and also discharges fire.  Zhi Shi disperses distention and fullness. [Bai] Zhu Tan fortifies the Spleen Qi.  Yu Jin synchronizes the Qi and opens depressive knotting.  Ze Xie separates the clear Yang.  Hu Bo disperses congealed blood and allows open permeability, allowing the congealed to be transformed and for the Qi to be synchronized.  The result is that the Chong vessel is clear and harmonized, the Spleen and Liver Qi transform and the blockage is immediately opened.  How could abdominal distention not recede”?

What these formulas treat is not the same.  However, the meaning of the formulas is identical.  They can be used together in the clinic and adjusted according to the presentation.  When I use Tong Yu Jian (Open Through Stasis Decoction) in the clinic, I often add Shi Xiao San (Powder for Loss of Smile), Tao Ren, Ze Lan and Chuan Niu Xi.  This strengthens the force of transforming stasis and opening the menstruation.  This is because, when the menstruation is blocked and not flowing smoothly, this is usually related to congealed blood and Qi stasis.  So we can say that if we want to open the menstruation we must transform stasis.  If we want to transform stasis we must assist this by moving the Qi.  Qi and blood movement complement each other.  Therefore, in relation to illnesses of menstruation, the meaning of opening through stasis is to open through the menses and transform stasis.

In my own clinical practice I see patients who have serious endometritis.  This may develop after dilation and curettage surgery and it can give rise to adhesions of the uterine cavity.  The degree of adhesions can vary as can the extent to which it influences the menstruation.  It may give rise to scanty menstruation or even amenorrhea.  In general though, this is due to stasis and obstruction in the uterus with lack of free movement of the blood. Tong Yu Jian (Open Through Stasis Decoction) can treat this but the effect is only good in relatively light cases.  For more serious cases surgery must be used to sever the adhesions and this formula can be used after that.

Detailed analysis of the principle herbs in this formula: Hong Hua and Shan Zha.

There are three principle herbs in this formula: Dang Gui Wei, Hong Hua and Shan Zha.  Dang Gui Wei is represented by Dang Gui and has been discussed in previous chapters so here I will discuss Hong Hua and Shan Zha.

Hong Hua

Hong Hua is also called Hong Lan Hua.  It is pungent and its nature is warm.  It enters the Heart and Liver.  Its function is to vitalize blood and open through menses.  It dispels stasis and stops pain and can be used for congealed blood type amenorrhea and post partum congealed static blood abdominal pain.   TheBen Cao Guang Mu (The Grand Compendium of Materia Medica) considers Hong Hua an herb to “vitalize blood, moisten dryness, stop pain, disperse swelling and open through the menses”.  It also says “Blood is generated in the heart wrapper, stored in the Liver and belongs to the Chong and Ren vessels.  Hong Hua is the likeness of blood and therefore, in men it is able to move the blood vessels and in women it opens through the menstrual water.  In large amounts it moves the blood and in small amounts it nourishes the blood.  The Ben Cao Hui Yan (Treasury of Words on the Materia Medica) says “Hong Hua cracks the blood, moves the blood, vitalizes the blood and synchronizes the blood.  Primarily it is used to treat the 100 diseases of pregnancy and birth in which the blood is damaged.  It is also used to treat blood vexation, blood dizziness, unconsciousness with an inability to speak, the lochia striking the Heart, gripping pain around the umbilicus, difficult birth, uterine lining failing to discharge or expired fetus in the abdomen.  All of these are presentations of birthing which Hong Hua can treat.  If there is post partum blood dizziness, lock jaw with clenched fists or an evil enters the blood chamber with incessant talking to the point of craziness or blood oppression with interior distention and the patient falls over stiffly as if dead.  These are all post partum presentations for which Hong Hua cannot help but calm.  If there is amenorrhea with no opening through with cold and heat mixed together or late menstruation with abdominal pain and dark purple dripping or traumatic injury with Qi and blood congealed and accumulating – these are all due to a lack of harmony of Qi and blood.  How can Hong Hua fail to synchronize”?

Shan Zha

Shan Zha is sweet and sour and its nature is slightly warm.  It enters the Spleen, Stomach and Liver channels.  Its function is to disperse food and fortify the Stomach.  When we analyze the pharmo-dynamics of Shan Zha we see that it increases the secretion of the digestive enzymes and is also able to promote the digestion of fats.  This is accompanied by an ability to strengthen Heart function and lower the blood fat. This can be used for presentations that include indigestion, post partum congealed obstructed abdominal pain, hernia and chest obstruction heart pain. The Shen Nong Ben Cao Jing Shu (Commentary on ‘Shen Nong’s Classic of the Materia Medica) says “Shan Zha enters the foot Yang Ming and Tai Yin channels.  The Ben Jing Classic of Materia Medica says that the flavor is sour and the Qi is cold.  That this is able to disperse the digestion and move congealed blood indicates that it is not cold.  Shan Zha is able to enter the Spleen and Stomach, scatter abiding accumulated stasis and water dysentery with post partum blocked pain in the abdomen. Generally Shan Zha is thought to transform food and fluids, fortify the Spleen and Stomach, move knotted Qi and disperse congealed blood.  Because of this it is a suitable food for children and birthing women.  The Ben Jing Classic of Materia Medicaalso says that this is cold and so it has a function as a wash for scabies.  We can see that fundamentally Shan Zha fortifies the Spleen and disperses food stasis.  It also functions to vitalize the blood, transform stasis and disperse accumulated stasis.

Practical Experience

Tong Yu Jian (Open Through the Menses Decoction) is a formula I use frequently in the clinic for lack of free flow of the menstruation.  I often use it with Yue Ju Wanor Wu Wei Tiao Jing San (Tang).  The results are quite good.  For acute abdominal pain use Hong Hua Jiu and the pain will stop.  The Jin Gui (Essentials From The Golden Cabinet) discussed early on that the single flavor Dang Gui in Dang Gui Wan (San) is used for painful menstruation.  The Xian Dai Zhong Yao Xue Da Ci Dian (The Modern Great Dictionary of Chinese Herbs) says that as a principle herb, Shan Zha treats functional dysmenorrhea.  Use 30 gm without the pit, Sunflower seed with the husk 15 gm.  After roasting, grind these into a powder and add 60 gm of brown sugar.  Take one package a day divided into 2 doses or decoct.  Every time before the menses take two packages and do this for 2 cycles.  I treated 105 patients: 30 had a cure, 50 improved and 25 were without effect.  The effect was good for those with blood stasis and deficiency cold.

I treated one case of long cycle.  Ms. Zhang was 35 and her menstruation was scanty and did not flow smoothly.  The color was purple red with small clots and there was lower abdominal acute pain.  When she bled this pain lasted for 12-15 days.  She had an IUD.  Her gynecology and bi-manual check-up revealed no abnormalities and the position of the IUD was normal.  It had been there for 5 years.  Her menstruation had lengthened for the last 5 months.  Her pulse was thin and wiry and her tongue body was dark red with a yellow sticky moss.  On the first day of her menstruation, I gave her 7 packages of Jia Jian Tong Yu Jian(Modified Open Through the Menses Decoction). She stopped bleeding after 8 days.  At the next menstruation I again gave her 7 packages of Jia Jian Tong Yu Jian (Modified Open Through the Menses Decoction).  She bled for 7 days and on day 2 and 3 the amount of blood increased.  She then resumed a normal menstrual cycle.

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针灸在美国

From: http://www.wfas.org.cn/en/show.asp?liststate=0&action=&men=3&Position=&id=1616&pageshow=1#

World Federation of Acupuncture-Moxibustion Societies.

(Author: Liu Jin;   source:information center, Published in 2009)


一、 历史的回顾

    据文献载中医药、针灸早在17世纪便由中国传入欧洲,再由欧洲传入美国。最早在美国出版英文版本针灸专书的是一位名叫F.Bache 的美国医师翻译由S.Morant所著的法文针灸 书,该书于1825年在费城出版( S. Morant: Memair on Acupuncturation)。次年即 1826年 F.Bache。进一步又在北美内科与外科杂志发表 他本人用针灸所治疗的病例报告(F.Bache: North American Medical and Surgical jourrnal l:311-321,1826)。此后便陆续有一些有关针 灸论文在美国发表。经过一百余年后,1942年 E.A.Brav与H.Sigmond曾在美国军医杂志上 报告针灸的疗效,特别强调针刺止痛的疗效 (E.A.Brav:Military Surgeon,9):545-549, 1942),可见在当时已将针灸疗法逐渐介绍到军医中采用。

    华人先侨随着美国自1848年开始的淘金热、铁路热及采矿热之后而大量涌入美国。不久之后,在旧金山及纽约等地随着华埠的出现便开始有一些老中医及针灸医师悬壶济世治病救人,真正的中医药/针灸医术亦随之在美国出现。但在美国掀起“中医针灸热”的要归功于著名报人赖斯顿(James Reston)。赖氏曾任纽约时报副总编,著作颇丰,蜚声国际。1971年赖氏随尼克松总统访问北京后(Arthur Fan Notes: it is before President Nixon’s visit),因患急性阑尾炎而入住协和医院进行手术。手术时及手术后曾用 针麻止痛,疗效甚佳。他于7月康复出院后详细着文介绍了亲身经用针刺止痛的经历及中国中医药的发展和中西医结合的情况,加上电视的播放,霎时间中国针灸针麻的奇迹便展现于美国的千家万户,针灸诊所的患者络绎不绝,对中医针灸医师之需要亦随之大增,不久针灸学校应运而生,歧黄医术随之渐盛于美国。

    由于受到美国“中医针灸热”的影响,美国国立卫生研究院(NIH)于1972年7月成立了“针刺疗法特别委员会”,由麻醉学者、神经病学 者及生理学者等人组成。其主要任务是:复习中国有关文献;组织调查研究有关针灸情况以 及举行针灸学术研讨会等。该委员会于1973 年3月在马里兰州比塞大召开了第一次学术会 议。会上有40余项有关针灸方面的初步研究 成果进行了交流。该会主席J.Bonica教授(华盛顿大学医学院麻醉科主任)在总结发言中指出:“现有资料证明针刺疗法是有效的,这对医 学是重要的。针刺作为某些外科手术中的一种 麻醉方法和一些急性和慢性疼痛的治疗手段是 有希望的。但要在美国广泛开展临床针刺治疗 之前,必须进行妥善精密的设计和严加管理的 科学研究(Proceeding NIH Acupuncture Res each Conference,VI,1973)。

      同一时期美国出版了两份国际有名的中医 针灸杂志。一为美洲中国医学杂志(The Americanl ournal of Chinese Medicine ),于 1973年1月出版,为季刊。另一为美国针灸杂 志(Americann Journal of Acupuncture), 于1973 年3月发行,办为季刊。

    这一时期有些学者还 相继在美国各地成立了有关中医针灸的学术性团体,如美国中国医学会、美国全国针灸研究学会等,都对推动中医药/针灸事业在美国的发展 起了积极的推动作用。

                                    二、美国中医药/针灸的现状

2.1中医药/ 针灸人员的情况

    目前全美国已有34(Arthur Fan notes: currently 44 States,pus DC)个州有针灸立法,颁发针灸执照,全美已有约一万(Arthur Fan notes:At least 3o,000) 名执照针灸医师。 其中约40%分布在加州,约10%分布在纽约州,其余分布在其它各州。另外,约有5000名西医师和3000名脊椎正骨师持有针灸执照,因而可以兼做针灸治疗工作。执照针灸医师由于所在各州立法的不同,职称和行医范围差异很大。例如,在新墨西哥州,州立法规定:凡取得该州针灸执照者,便可 称之为 Doctor of Oriental Medicine(DOM),并 有权写一般西医范围之内的化验单、X线检查 单等等,并可独立诊断疾病,进行医疗鉴定、穴 位注射、激光穴位治疗、指压推拿、开写中药处 方、美国草药、顺势疗法(homeopathic)、物理治 疗,以及给病人开维生素、矿物质、各种脢、氨基 酸等。加州则较特殊,中医与针灸合为一体,两种业务可以兼做。即凡取得针灸执照者,可同 时开写中药处方或给病人中药。对取得针灸执照并有相当医学背景者(即医学学历较高)可称为 Chinese Medicine Doctor(C. M.D)或 Oriental Medicine Doctor(O.M.D.)。佛罗里达州对有针灸执照者,可称为针灸医师(Acupuncture Physician),并允许针灸医师做穴位注射。纽约州针灸立法则规定,除非在中国已获得中医博士学位,广告上不得称自己为Doctor,若有足够的医学背景者亦只能写明: Physician in China, but not in N. Y. S。

    各州之所以有如此大的差异,除了各州情 况有所不同外,主要在于当权者对中医针灸的 理解程度和各州中医针灸工作者的力量,尤其是团结的力量情况而定。也有些州至今针灸执 照是附属于西医委员会之下颁发,如密执安州、 密苏里州及肯萨斯州等。 与针灸日益发展的同时,中医药界的队伍 也在日益壮大。中医诊所和中药店也如雨后春 笋般不断增加,其中不乏有国手及高明的中医 界老前辈。现在中医师及中药店不仅集中在华埠,而且已经不断的逐步深入到主流社会活动与居住地区并受到更多人士的欢迎。现在像在旧金山、洛杉矶、纽约、费城、波士顿、西雅图、亚特兰大等城市的中医诊所和中药店均已达上百家或数百家之多。但是,除加州等少数州中医师已取得合法地位之外,其它各州中医至今尚未立法。中医药到底要不要立法?以及如何立 法?看来需要全美国的中医师首先团结内部达成共识,再进行争取才会有力量。

 2.2中医药/针灸的教育与考试

    目前全美国已有约70所中医针灸学校,其中已被审批合格者有32(不止, 樊蓥注)所,其余正在申请审批中。大部分学校是培养针灸医师的,其学制一般为3年。也有一部份学校是培养针灸与中医师的,其学制多为4年。入学资格一般要求需具有2年大学(College)学历。在校内修完一定学分后可参加全美(N.C.C.A.O.M.)针灸或中医师(或两者全考)资格考试。毕业后也可参加加州针灸(中医)师执照考试,获得执照者可在加州独立开业行医。

    近年有部分中医针灸学校开设针灸或中医学硕士学位课程,也有的正在筹划开设博士(Ph D.)课程。 美国N.C.C.A.O.M.自1985年开始举行美国联邦针灸医师资格考试。每年4月在加州举行,10月在纽约州举行,到目前为止已有6000(现在过万,樊蓥注) 多位针灸医师通过考试。

参加考试的资格限于:

(1)美国国内经3年制或以上针灸(或中医)学历并完成一定学分者;

(2)在美国国外,如中国大陆5年制或以上中医学院毕业各科及格者;

(3)西学中学历要求在5年以上者(中、西医务科相加);

(4)跟师带徒式学习者,老师资格及学习内容需要公证。

    考试分3天进行(现在可以在各地网上考试,樊蓥注),1天为中医针灸理论 与临床知识笔试。限5个小时内答完200个选 择题;1天为点穴考试;1天为C.N.T.(洁针技 术)考试,包括笔试和操作。考试可用英、中、 日、韩文。自1995年开始N.C.C.A.又增加了中药考试,因此N.C.C.A.亦随之改名为N.C.C.A.O.M。中药考试为1天,在5个小时内要 求用笔答完200个有关中药和方剂的选择题, 其中包括中医基础理论。中药考试条件大体和针灸要求相似。到目前为止大约已有800多位中药师通过考试。 考试通过者由N.C.C.A.O.M.发给合格 证书及考试分数通知。持此合格证书者,说明 具有该科之资格,因此亦可称为资格证书。有 的州对有此证书者即颁发针灸执照证明,有的州对用中、日、韩文考试者,另外要求要有英语托福500分以上的成绩(或在大学修完3个学分的英文课)、毕业证明与所学各科成绩单及绿卡等。

 2.3中医药/针灸学术地位改变情况

    中医药/针灸在美国的学术地位是逐步改变和提高的。每提高一步,便说明国家主流社 会的认可程度亦提高一步。美国国立卫生研究院(NIH)对中医药/针灸一直抱着审慎的客观态度,即对中医药/针灸通过不断的考察研究,不断的提高认识水平。

    NIH于1992年起成立了另类医学办公室(O.A.M.),对包括中医药/针灸在内的所谓另类医学,每年拨款一千万美 元(逐年增加)进行研究。因而像哈佛、耶鲁、斯 坦福及霍普金斯等着名大学均承担了研究任务。通过多年的研究NIH终于在1997年11 月初召开了关于针灸的听证会。

其四点结论是:

Ⅰ针灸在美国已广泛应用并有应用价值;

Ⅱ 需探索更多的适应症;

Ⅲ原理研究已明确了能 释放神经及对内分泌的影响等;

Ⅳ尚需进一步解决的问题有:针灸医师的培训、颁发针灸执 照的标准及医疗保险费的支付等。

    美国国家药品和食品管理总局(FDA)在经过多年肯定针灸疗效的基础上,已于1994年正式通过针灸用针由第三类(实验性)医疗用品器械晋升为第二类(医疗用)器械类并宣布其安 全性。1996年9月第四届世界针灸大会在纽约召开,与会者为来自46个国家和地区的专家学 者,1200余人聚首一堂进行学术交流。克林顿总统曾发来专函向大会祝贺,这是美国中医药/ 计灸史上的一件空前大事。

 2.4 中医药/针灸业界的经济地位

    一个行业在一个国家的社会政治地位是由 经济地位决定的。中医药/针灸事业如要纳入美国主流社会的关键,除了其疗效及科学性被 主流社会认可之外,主要是保险业是否支付中 医药/针灸的医疗费用。直至1995年为止美国医学会负责主编的 通用医疗程序编码》(CPT code)一直拒绝将 针灸列入其中。其所持理由是:针灸在美国还 处于试验阶段。正是这种立场严重阻碍了中医药/针灸纳入美国主流社会的历史进程,使美国 保险业系统一直拒付针灸医师的医疗服务支付。

现在代表美国广大西医利益的美国医学会 终于承认针灸是一种正式的有效的医疗程序。 自1998年 1月起全美国中医/针灸医师终于可 以使用该程序,向保险公司申请医疗服务。 自1998年1月起牛津保险公司开始承认 并受理中医/针灸保险之后,同年6月蓝十字蓝盾公司也正式宣布接受针灸保险。现在中医药/ 针灸界的最大愿望是,争取国会在本世纪最后 l-2年之内通过中医药/针灸立法,从而促使 医疗补助(Medicaid)和医疗照顾(Medicare)两项全美国最重要的保险项目,开始对中医药/针灸医疗的全部支付。只有这样才能使更多的美 国民众接受中医/针灸医师的医疗服务,而中医 针灸医师社会地位亦会真正的纳入主流社会。

 三、中医药/针灸在美国的今后 展望

                                                                                                                                                          3.1时代的召唤,历史的使命     

    美国是一个年轻的多民族多文化融合的国家,它欢迎一切对其国家和人民有利的事物。 近20多年来中医药/针灸等所谓的另类疗法,得到越来越多的美国人的欢迎,并且正在发展 成为一个富有生命力的确有其存在和发展价值 的医学学科。 当今由于化学疗法对人体的各种副作用和 后遗症的不利影响越来越明显,加上环境污染 导致人类面临严重的生存危机。有证据显示人类由于这些公害的结果,现在生殖能力每况愈下。

    在此人类历史的大潮流之下,有越来越多 的人要求回归大自然。特别是要求回归自然疗法的呼声已经响起。因此,中医药渐灸推拿按摩以及医疗气功等自然疗法正好符合时代的召唤、肩负这一历史的使命。有人经过统计发现, 现在每3个美国人中,就有一个曾经求助过另类疗法。从医治感冒到绝症求医,各种各样的 病人都有。

    另有一项调查显示,有超过半数的 西医医生在使用其专业医疗方法之后没有疗效 时,曾暗示病人可以尝试另类疗法。一些素有 盛名的医科大学,也已经开设了针灸或中西医 结合的诊室、诊所或研究构等。总之,中医药 /针灸现在美国正是发展的大好良机。

3.2提高素质,加强组织建设

    当前中医药/针灸医师队伍的素质显然已经不断得到提高。但是从1996年纽约州中医药界所出现的那一场严峻的六月风暴来看,由 于个别的人违法乱纪(向病人卖假药等),几乎使得整个中医药界蒙受不白之冤。如果当时没 有纽约州针灸委员会出面调停和各方善心人士 的共同支持,尤其纽约中医药学会及各针灸学 会等的努力,后果不堪设想。可见中医药/针灸 业界人士的素质是极端重要的,为此应当首先 加强一的组织建设。 当前中医药/针灸界的学会性组织仍停留 在有如雨后春笋般的状态。这些组织都分别起 过巨大的有益的推动和团结提高的作用,它是 特定历史条件下所必然的产物。

    历史在前进, 时代在变化,现在应该将这些组织联合起来,再 统一组织全国性的中医药/针灸学术组织。西医师之所以力量强大,这与他们具有统一的全 国性或全州(市)性组织有很大关系。只有统一 的组织或组织健全之后,才能及时发现并纠正害群之马一类的事件,也才能更好的提高中医药/针灸业界人士的素质,并使之达到时代所要 求的医术和医德水平,更好地为广大民众服务。

 

3.3 争取与美国传统医学(西医)并驾齐驱

    在美国的主流社会中所认为的传统医学是 西医,他们认为只有西医才是正规的医疗体系。 中医药/针灸、推拿、按摩等只是另类疗法。这是 由于国情和历史条件所造成的。但是,事物总是遵照事实、真理和科学的规律在起变化和发展。相信只要中医药/针灸业同道们的业务水 平进一步提高,医疗水平和医疗效果进一步被 主流社会所认同,在科研、教学、医疗等方面均 能向科学化、客观化、标准化、规范化不断迈进, 医德和个人素质被广大患者所称颂和欢迎,最后必能与美国传统医学各科并驾齐驱。

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Someone wrote an article online, mentioned the first state had acupuncture legislation was California, actually this is a wrong information. The first state should be Nevada.  Maryland and Oregon were in the same year (1973) immediate after Nevada. Washington DC was in 1989. Virginia in 1993.

网上有人写文章,谈到美国第一个州通过针灸立法的是加利福尼亚,实际上有误。第一个通过针灸立法的应该是内华达,而马里兰和俄勒冈是同一年(1973年)通过立法的。华盛顿DC 是1989年,维吉尼亚则是1993年。

Below is a list from American Association of Acupuncture and Oriental medicine(AAAOM).

State Legislative Initiatives: The first practice act legislation was enacted in 1973 in Nevada Maryland and Oregon. Today, 44 States (PDF), plus the District of Columbia have enacted practice acts.

1973-Maryland, Nevada & Oregon
1974-Hawaii, Montana, South Carolina
1975-Louisiana, New York(I think), and California
1978-Rhode Island
1981-Florida & New Mexico
1983-New Jersey & Utah
1985-Vermont, Washington
1986-Massachusetts, Pennsylvania
1987-Maine
1989-Colorado, District of Columbia, Wisconsin
1990-Alaska
1991-New York(I think this should be the year for re-publishing the sate law)
1993-Iowa, North Carolina, Texas, Virginia
1995-Connecticut, Minnesota
1996-West Virginia
1997-Arkansas, Illinois, New Hampshire
1998-Arizona, Missouri
1999-Idaho, Indiana
2000-Georgia, Ohio, Tennessee
2001-Nebraska
2005-South Carolina
2006-Kentucky, Michigan

2009 -Alabama

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[Dr.Fan notes]: I graduated from Nanjing University of Chinese Medicine in 1986. During my study in that period (1981 to 1986), Dr.Xia Guicheng was my teacher in the class of Chinese Gynecology (Gynecology in Traditional Chinese Medicine), I also had internship under another TCM gynecologist Dr.Sun Ningquan.
Some colleagues asked my if I have Dr.Xia’s book or article, actually, there are several books written by him or his students, available at http://www.amazon.com:
1. Xia Guicheng Practical Chinese Gynecology (Paperback) by 2009 Chinese Medicine Press; 1 edition (October 1 (Paperback – Oct 1, 2009);
Dr.Xia Guicheng also published many academic papers, in Chinese language, some of them already available in English. Here are his papers online.
homepage.mac.com/sweiz/files/article/67-30.pdf
File Format: PDF/Adobe Acrobat – Quick View
by X Guicheng
Xia Guicheng is one the most eminent gynaecology specialists in China today. In my own practice, I find that adapting the treatment principle to the menstrual 
books.google.com/books?isbn=0936185481Bob Flaws – 1993 – Health & Fitness – 267 pages
Xia Guicheng gives the following account of such correlation in the Shanghai Journal of TCM, October 1992. 10 Xia identifies six types or categories of BBT 

Xia GuiCheng (1932 -) is a professor of gynaecology at Nanjing TCM College, and has been involved in teaching, research and clinical treatment for over 30 

Xia Guicheng « Topics in Chinese Medicine

chinesemedicinetopics.wordpress.com/category/famous…/xiaguiche

May 11, 2010 – Posted in Famous Doctors, Xia Guicheng on May 11, 2010 | Leave a Comment ». Dr. Xia is the director of the Gynecology Department at the 

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