Acupuncture
By Tom Williams
George is a 67 year old pensioner. For about 5 years or
so he had been experiencing problems with increased frequent
urination – especially at night time. He experienced
no pain or discomfort during urination, but once he had
finished he invariably felt that he needed to go again.
Over time he found it increasingly difficult to urinate
and the stream of urine became very thin and minimal. He
began to experience nocturnal enuresis and a few days before
he came to the Chinese medicine clinic he was totally unable
to pass water at all and he experienced lower abdominal
distension and severe discomfort in this area.
He went to his GP who diagnosed an enlarged prostate and
he has been referred to a consultant urologist. The immediate
problem was relieved by the GP performing a catheterization.
However, the retention problem recurred and not wishing
to go through the catheterization process again he came
to the clinic seeking help.
George complained of being tired and lethargic and he would
regularly perspire with minimal exertion. He was somewhat
overweight and his abdomen was distended. He complained
of aching low back and sore knee joints – so painful
at times that he could not walk properly. George lived on
his own, and tended to be erratic with his eating patterns.
He said that he never really felt hungry. His breathing
was weak & shallow and he had a real aversion to the
cold. He also reported bouts of tinnitus from time to time.
George had previously worked as a painter & decorator
until he retired 3 years previously. Until his problems
worsened he had continued to do the odd bit of work for
friends and neighbours, both indoors & outdoors.
George’s tongue was pale & wet with scalloped
edges and his pulse was rather weak and quite soggy to the
touch.
Analysis of George from the Perspective of Chinese
Medicine
In Chinese Medicine the source of all energy in
the body lies in the Kidneys. Chinese medicine differentiates
between the organ systems in terms of process rather than
structure and there are a range of processes that are associated
with the Kidneys and their partner organ system, the Bladder.
This analysis requires a detailed understanding of Chinese
medicine, but the interested reader will be able to follow
the general line of thought.
The Bladder function of storing and releasing urine is
facilitated by the Kidneys – Kidney Qi to be exact.
The following factors are pertinent here:
1. George is 67 years old and there tends to be a natural
decline in Kidney Qi (or energy) with age.
2. There are various presenting features and symptoms that
suggest that the weak or deficient Kidney energy is Kidney
Yang Qi. These include:
• Aversion to cold
• Weakness/lethargy
• Aching/stiff low back & knees
• Wet and pale tongue
• Characteristics of the pulse
3. In the early stages of the problem the Kidneys had ceased
exercising control over the Bladder resulting in increased
frequency. However, as the Kidney Yang energy diminishes
the Kidneys were no longer able to move the body fluids
with any efficiency and this resulted in an increased sluggishness
and the associated symptoms.
4. The type of work that George did until recently was likely
to lead to his Kidney energy becoming depleted. Regular
outdoor work will result in cold and damp invading the lower
back and becoming lodged in the channels of the body –
a pattern described in Chinese medicine as Cold Damp Bi
(or Cold Damp Obstruction Syndrome). This pattern would
also lead to depletion of the Kidney energy.
5. George’s poor & erratic diet will not help.
It is likely that this will have the effect of depleting
the energy of the Spleen, which would lead to the accumulation
of damp in the lower part of the body, which would further
exacerbate the urinary retention problems.
In summary, from the perspective of Chinese medicine, George
presents with the following syndromes:
1. Kidney Yang deficient.
2. Bladder retaining Damp
3. Spleen Qi and/or Yang deficient.
4. Retention of Damp in the lower part of the abdomen (lower
Jiao)
5. Cold Damp Bi in the joints – especially the knees
& lower back.
Treatment Principle for George
When considering treatment from the perspective of Chinese
medicine there is an apparent simple logic based on the
notion of reversing the identified patterns of disharmony.
Thus, in George’s case there is a predominance of
deficiency problems, but also what would be termed excess
problems – mainly where things get ‘stuck’.
In this instance the Kidney & Spleen energy is deficient
while the retained damp and the Bi syndrome can be classified
as excess patterns.
There is also a preponderance of Cold in George’s
condition; therefore we are likely to want to introduce
Heat to counteract that.
Thus, the treatment principles could be summarised as follows:
1. Clear the Damp & warm the Cold (excess conditions)
2. Tonify the Kidney Yang and the Spleen Yang.
Treatment
It was decided to tackle George’s problems with acupuncture,
moxabustion and the use of Chinese Herbs.
Firstly George was given a well known herbal formula which
is commonly used to help clear Cold & Damp from channels
& joints – Du Huo Ji Sheng Tang. This herbal prescription
was given as a powder which required to be made up as a
drink and taken 2/3 daily.
In addition, George commenced on a programme of acupuncture
and moxabustion, which sought to address the identified
problems. A range of empirical acupuncture points were chosen
and moxa burned on needles and over the lower back.
The needling technique was generally reinforcing when tonifying
and reducing in the cases of the excess patterns. It would
not be especially helpful to the general reader to have
detailed point prescriptions, suffice to say, George attended
weekly for 10 weeks and during this time his urinary problems
improved markedly.
His joint problems were still there but were not as severe
as before.
George was very happy with the help he received from Chinese
medicine and while it was likely that he may find some future
recurrence of his difficulties, the combination of lifestyle
advice and his knowing that Chinese medicine help was readily
at hand, was very reassuring for him.
To date, George has not been to see the consultant urologist
and feels much more able to manage the problems himself.
Case Study – Treatment Details
1. Treating Cold/Damp Bi in knees/lower back Sp9; Sp10;
Xixian: St36; St34 (knees) moxa applied on ‘eye of
knee’
Points; Bl23 + moxa box over
low back area
Note: Points and moxa used will also tonify Spleen (St36)
and Kidneys (Bl23)
Moxa will also help to tonify the Yang qi
2. Kidney & Spleen Tonification:
In addition to points mentioned above, acupuncture was
also given to Kid 7; Sp 3; Sp 6: Ren 4; Ren 6; Ren 12; Du
4 (moxa was used on the needles)
The patient was initially treated on the back points with
moxa box on low back area over Bl 23 and Du 4. After 15
minutes the treatment was given on the front points for
another 15 minutes.
Not all points were used every treatment, but the point
selection varied from the one’s noted. The back points
and moxa was used on each occasion.
George made slow progress initially, but after 8/10 treatments
his urinary problems were much better and his general aches
and pains had improved markedly. Treatment continued weekly
until week 15 after which George decided that he had improved
enough. He continued taking the herbal preparation for another
month or so by which time the summer had arrived and he
was generally feeling much better.
George has not returned for treatment since.
About the Author
Tom Williams is a member of the British Acupuncture Council
(BAcC) and of the Register of Chinese Herbal Medicine (RTCM).
He runs a busy practice in Glasgow and lectures at the Northern
College of Acupuncture in York. He has written various easily
accessible books on Chinese medicine including the Complete
Illustrated Guide to Chinese Medicine originally publishes
by Element Books and now published by Harper Collins.
Tom can be contacted at the Kun Chen Clinic in Glasgow:
Tel: 0141 638 8801
Email: twilljan48@aol.com
