Medical acupuncture in pregnancy: a textbook

239 Pages·2005·4.68 MB·English

by  Ansgar T. Roemer

III
Medical Acupuncture
in Pregnancy
A Textbook
Ansgar T. Roemer, M.D.
University Gynecological
Hospital
Mannheim, Germany
With contributions by:
Thomas Kempfle, Ingrid Reuther
147 illustrations
Thieme
Stuttgart · New York
I
h
II
IV
Library of Congress Cataloging-in-Publication Data Important note: Medicine is an ever-changing science under-
going continual development. Research and clinical experience
Roemer, Ansgar T. are continually expanding our knowledge, in particular our
[Akupunktur für Hebammen, Geburtshelfer und knowledge of proper treatment and drug therapy. Insofar as
Gynäkologen. English] this book mentions any dosage or application, readers may rest
Medical acupuncture in pregnancy : a textbook/ assured that the authors, editors, and publishers have made
Ansgar T. Roemer ; with contributions by Thomas Kempfle, every effort to ensure that such references are in accordance
Ingrid Reuther ; [translator, Ruth Gutberlet ; illustrator, with the state of knowledge at the time of production of the
Enbe-Design Baasner]. book.
p. ; cm. Nevertheless, this does not involve, imply, or express any guar-
Includes bibliographical references and index. antee or responsibility on the part of the publishers in respect
ISBN 3-13-135831-9 (alk. paper) -- ISBN 1-58890-255-2 to any dosage instructions and forms of applications stated in
(alk. paper) the book. Every user is requested to examine carefully the
1. Acupuncture. 2. Pregnancy--Alternative treatment. manufacturers’ leaflets accompanying each drug and to check,
3. Medicine, Chinese. if necessary in consultation with a physician or specialist,
[DNLM: 1. Acupuncture Therapy--methods--Pregnancy. whether the dosage schedules mentioned therein or the con-
2. Pregnancy Complications--prevention & control. traindications stated by the manufacturers differ from the
3. Medicine, Chinese Traditional--methods. 4. Prenatal statements made in the present book. Such examination is par-
Care--methods. WB 369 R715a 2005a] I. Kempfle, ticularly important with drugs that are either rarely used or
Thomas. II. Reuther, Ingrid. III. Title. have been newly released on the market. Every dosage sched-
RG129.A25R64 2005 ule or every form of application used is entirely at the user’s
618.2'4--dc22 own risk and responsibility. The authors and publishers request
every user to report to the publishers any discrepancies or in-
1st German edition 1999 accuracies noticed. If errors in this work are found after publi-
2nd German edition 2000 cation, errata will be posted at www.thieme.com on the
product description page.
This book is an authorized and revised translation of Some of the product names, patents, and registered designs re-
the 3rd German edition published and copyrighted 2002 ferred to in this book are in fact registered trademarks or pro-
by Hippokrates Verlag, Stuttgart, Germany. Title of the prietary names even though specific reference to this fact is not
German edition: Akupunktur für Hebammen, always made in the text. Therefore, the appearance of a name
Geburtshelfer und Gynäkologen without designation as proprietary is not to be construed as a
representation by the publisher that it is in the public domain.
This book, including all parts thereof, is legally protected by
Contributors: copyright. Any use, exploitation, or commercialization outside
Thomas Kempfle, Private Practice, Gevelsberg, Germany the narrow limits set by copyright legislation, without the pub-
Ingrid Reuther, M.D., Private Practice, lisher’s consent, is illegal and liable to prosecution. This applies
Grafschaft Karweiler, Germany in particular to photostat reproduction, copying, mimeograph-
ing, preparation of microfilms, and electronic data processing
and storage.
Translator: Ruth Gutberlet, M.A., CHom, Fulda, Germany
Illustrator: Enbe-Design Baasner
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V
About this book
Literature is not intended to replace classroom edu- with a lot of inspiration and advice, particularly
cation. This text aims to help midwives, obstetri- Dr. C. Gabriel, Dr. D. Klein, Dr. F. Ramakers, P. Ru-
cians, and gynecologists who are studying acu- dolph, B. Seybold, Dr. K. Zähres, and all the associ-
puncture in selecting the correct acupuncture ation's midwifery advisors
points. A crucial aspect of this healing art is the — Dr. C. Gabriel, for her knowledgeable critique of
proper stimulation of the specific acupuncture the manuscript; B. Seybold for her many inspira-
point. Only practice and experience will provide the tions and her outstanding courses
practitioner with this skill. Textbook theory and — Hippokrates, for agreeing to various special re-
hands-on experience in the classroom are the ideal quests and effectively implementing them in this
combination for the student. book
This textbook gives a concise overview of the the- — Dr. U. Novotny, the editor whose knowledge and
ory of Traditional Chinese Medicine (TCM) for mid- patience greatly contributed to the creation of
wives, gynecologists, and obstetricians who want to this book
go beyond the results of treatments that are based on — D. Seiz (†) of Hippokrates; she was open to all re-
common formulas. The book serves as a guideline to quests and suggestions and made all the means of
applying the voluminous theories of TCM in daily the publishing house available to the successful
practice. The list of points and point categories as production of this book
well as references to the TCM basics are part of the — Angelika-M. Findgott of Thieme International for
special focus that was placed on combining theoreti- her effective handling of the translation project
cal and practical aspects. Usually, the complicated and Ruth Gutberlet for rendering a fine translation
concepts have to be compiled from various sources. — Prof. F. Melchert (Director of the Gynecological
Here, these concepts are clearly and concisely ar- University Hospital Mannheim), Prof. M. Weigel,
ranged, which makes this text valuable both for en- and Prof. W. Zieger, for their advice and support in
try-level training and as a reference book. It is establishing acupuncture as part of medical
recommended for beginners of obstetric/gynecologi- training at the university level, as well as their
cal acupuncture as well as experienced practitioners. support for various research projects and con-
With increased knowledge comes a greater un- ventions.
derstanding of the importance of experience in daily
practice. The practice of acupuncture is a never-end- I am most grateful to my family, particularly my
ing learning process. Through this book, years of ac- wife, whose support and inspiration accompanied
upuncture practice and teaching experience are all my ventures into acupuncture. Over the past
made available to the reader. An author still gains years, only her patience and support have made it
insights through the process of exchanging experi- possible for me to integrate family, medical practice,
ence and thoughts with colleagues. The publication community service, teaching, presentations, con-
of this textbook gives me the opportunity to express ventions, and the work on this book.
my gratitude to the people who made a special con- Finally, thanks to everyone who was not men-
tribution to my knowledge and experience. tioned here by name but helped my journey into ac-
upuncture.
I would like to express special thanks to: Once again, I would like to mention the particular
— My acupuncture teachers, particularly Prof. J. Bis- significance of the late D. Seiz. Over the course of the
chko (†), Prof. G. Kubiena, Dr. G. Stux, and the past decade, we owe the publication of outstanding
teachers I met during my studies in China TCM teaching material in large parts to her. She had a
— Colleagues who passed on their vast experience unique way of joining opposites to help along the rel-
to me, particularly Dr. M. Adam (Geburtshaus evant matters. This book was written in her memory.
Wien-Nußdorf)
— My colleagues at the medical continuing educa-
tion association Pro Medico who provided me Ansgar T. Roemer
VI
Contents VII
Contents
1 Introduction to Acupuncture and Traditional Chinese Medicine (TCM)
What is Acupuncture? . . . . . . . . . . . . . . . . . . . . . . . . 2 (cid:2) The Theory of Yin and Yang . . . . . . . . . . . . . . . . . . 5
(cid:2) Acupuncture Arrives in Europe . . . . . . . . . . . . . 2 (cid:2) The Five Fundamental Substances . . . . . . . . . . . 8
(cid:2) Acupuncture as a Regulatory Therapy . . . . . . . 3 (cid:2) The Five Phase Theory . . . . . . . . . . . . . . . . . . . . . 10
(cid:2) The Internal Organ Theory (Zang Fu) . . . . . . . . . 13
The Basics of TCM . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 (cid:2) The Disease Concept of TCM . . . . . . . . . . . . . . . . 14
(cid:2) Tao . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 (cid:2) TCM Diagnostics . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Life Force Qi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Tongue Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Five Phases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Pulse Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

(cid:2) Concepts of TCM . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Disease Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
2 Systematics
(cid:2) “Access To The Depth”—Xue: The Point . . . . . . 24 (cid:2) Extraordinary Channels . . . . . . . . . . . . . . . . . . . . 40
(cid:2) Acupuncture Points . . . . . . . . . . . . . . . . . . . . . . . 24 (cid:2) The Significance of the Channels for TCM . . . . 40
(cid:2) Channel Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Four Main Categories . . . . . . . . . . . . . . . . . . . . . . 26 The 12 Regular Channels . . . . . . . . . . . . . . . . . . . . . . 42
The Five Transport Points . . . . . . . . . . . . . . . . . . . 27
Tonification and Sedation Points. . . . . . . . . . . . . 29 The Yin Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Acute (Xi) Cleft Points . . . . . . . . . . . . . . . . . . . . . . 29 (cid:2) Kidney Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Intersection (Group) Points . . . . . . . . . . . . . . . . . 30 (cid:2) Liver Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Confluence Jiao Hui Points . . . . . . . . . . . . . . . . . . 30 (cid:2) Heart Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
The Eight Meeting Points (cid:2) Pericardium Channel . . . . . . . . . . . . . . . . . . . . . . 46
(Influential, Master Points) . . . . . . . . . . . . . . . . . . 30 (cid:2) Spleen Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
The European Master Points . . . . . . . . . . . . . . . . 32 (cid:2) Lung Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Extraordinary Points (Extra Channel Points) . . . 34
A-Shi Points (Ouch Points) . . . . . . . . . . . . . . . . . . 34 The Yang Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Somatotopic Areas . . . . . . . . . . . . . . . . . . . . . . . . 34 (cid:2) Large Intestine Channel . . . . . . . . . . . . . . . . . . . . 49
Ear Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . 34 (cid:2) Stomach Channel . . . . . . . . . . . . . . . . . . . . . . . . . 50
Symptomatic Points . . . . . . . . . . . . . . . . . . . . . . . 35 (cid:2) Small Intestine Channel . . . . . . . . . . . . . . . . . . . . 51
(cid:2) Triple Burner Channel . . . . . . . . . . . . . . . . . . . . . . 52
The Channel System of Acupuncture . . . . . . . . . . . 36 (cid:2) Bladder Channel . . . . . . . . . . . . . . . . . . . . . . . . . . 53
(cid:2) System Overview . . . . . . . . . . . . . . . . . . . . . . . . . 36 (cid:2) Gallbladder Channel . . . . . . . . . . . . . . . . . . . . . . . 54
Three Channel Circulations . . . . . . . . . . . . . . . . . 36
(cid:2) Channel Partnerships . . . . . . . . . . . . . . . . . . . . . . 38 The Extraordinary Channels . . . . . . . . . . . . . . . . . . . 55
Coupled Channels . . . . . . . . . . . . . . . . . . . . . . . . . 38 (cid:2) Ren Mai Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Corresponding Channels . . . . . . . . . . . . . . . . . . . 38 (cid:2) Du Mai Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
VIII Contents
3 Criteria and Rules
Methods of Locating Points. . . . . . . . . . . . . . . . . . . . 58 Treatment Technique . . . . . . . . . . . . . . . . . . . . . . . . . 74
(cid:2) Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Prerequisites For Acupuncture Therapy . . . . . . . . 60 (cid:2) Moxibustion Therapy . . . . . . . . . . . . . . . . . . . . . . 79
(cid:2) Electrostimulation . . . . . . . . . . . . . . . . . . . . . . . . . 80
Effects and Reactions . . . . . . . . . . . . . . . . . . . . . . . . . 61 (cid:2) Laser Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . 80
(cid:2) Scientific Background . . . . . . . . . . . . . . . . . . . . . . 61 (cid:2) PuTENS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
The Effects of Acupuncture on Pain . . . . . . . . . . . 61 (cid:2) Injection Acupuncture . . . . . . . . . . . . . . . . . . . . . 81
(cid:2) Acupressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Integrating Acupuncture Into a Treatment Plan . . 64 (cid:2) Qi Gong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Characteristics of Acupuncture During Organizational Model . . . . . . . . . . . . . . . . . . . . . . . . . 83
Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 (cid:2) Therapy Categories . . . . . . . . . . . . . . . . . . . . . . . . 83
(cid:2) Point Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 (cid:2) Ear Acupuncture . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
(cid:2) General Recommendations . . . . . . . . . . . . . . . . . 69
Prerequisites For Acupuncture Therapy
Treatment Rules and Therapeutic Guidelines . . . . 70 in a Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
4 The Practice of Acupuncture in Obstetrics and Gynecology
Obstetrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Puerperium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
(cid:2) List of Indications . . . . . . . . . . . . . . . . . . . . . . . . . . 88 (cid:2) Involution Disorders . . . . . . . . . . . . . . . . . . . . . . . 106
(cid:2) Functional Disorders of The Breast . . . . . . . . . . 106
Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 (cid:2) Mental/Emotional Disorders During
(cid:2) General Regulation Based on Mental/ Confinement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Emotional Balance . . . . . . . . . . . . . . . . . . . . . . . . . 89 (cid:2) Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
(cid:2) Hyperemesis Gravidarum . . . . . . . . . . . . . . . . . . 90 (cid:2) Urinary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . 109
(cid:2) Heartburn and Vomiting . . . . . . . . . . . . . . . . . . . 90 (cid:2) Emergency Points . . . . . . . . . . . . . . . . . . . . . . . . . 110
(cid:2) Early Labor and Impending Premature
Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Acupuncture and Gynecology . . . . . . . . . . . . . . . . . . 111
(cid:2) Infections During Pregnancy . . . . . . . . . . . . . . . . 92 Significance of Acupuncture . . . . . . . . . . . . . . . . . 111
(cid:2) Treatment of Addictions During Pregnancy . . 92 Acupuncture Indications For
(cid:2) Breech Presentation . . . . . . . . . . . . . . . . . . . . . . . 93 Gynecological Disorders . . . . . . . . . . . . . . . . . . . . 114
(cid:2) Gestosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 General Therapy Rules . . . . . . . . . . . . . . . . . . . . . . 115
(cid:2) Pain Conditions During Pregnancy . . . . . . . . . . 95 (cid:2) Premenstrual Syndrome (PMS) . . . . . . . . . . . . . . 115
(cid:2) Childbirth Preparation using (cid:2) Dysmenorrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Römer’s Scheme (Mannheim Model) . . . . . . . . 97 (cid:2) Functional Disorders of the Menstrual Cycle . . 116
(cid:2) Amenorrhea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Peripartal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 (cid:2) Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
(cid:2) Induction of Labor . . . . . . . . . . . . . . . . . . . . . . . . . 100 (cid:2) Menopausal Syndrome . . . . . . . . . . . . . . . . . . . . . 117
(cid:2) Acupuncture During Delivery . . . . . . . . . . . . . . . 100 (cid:2) Vaginal Discharge . . . . . . . . . . . . . . . . . . . . . . . . . 118
(cid:2) Analgesia During Delivery . . . . . . . . . . . . . . . . . . 101 (cid:2) Pruritus Vulvae . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
(cid:2) Dysfunctional Labor and Insufficiently (cid:2) Adnexitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Coordinated Uterine Contractions . . . . . . . . . . 102 (cid:2) Chronic Pelvic Pain . . . . . . . . . . . . . . . . . . . . . . . . . 119
(cid:2) Cervical Dystocia . . . . . . . . . . . . . . . . . . . . . . . . . . 103 (cid:2) Low-Back Pain in Women . . . . . . . . . . . . . . . . . . . 119
(cid:2) Placental Detachment Disorders . . . . . . . . . . . . 104 (cid:2) Headache Syndrome—Hormone-Related
Migraine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
(cid:2) Urethritis and Cystitis . . . . . . . . . . . . . . . . . . . . . . 121
Contents IX
(cid:2) Chronic Recurring Infections . . . . . . . . . . . . . . . 121 (cid:2) Chronic Recurring Nonpuerperal
(cid:2) Emesis and Chemotherapy . . . . . . . . . . . . . . . . . 122 Mastitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
(cid:2) Mastopathy and Mastodynia . . . . . . . . . . . . . . . 122 (cid:2) Pain Following Mastectomy . . . . . . . . . . . . . . . . 123

(cid:2) Outlook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
5 Point Atlas
LU = Lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 GB = Gallbladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
LI = Large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 LR = Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
ST = Stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 GV = Governing vessel . . . . . . . . . . . . . . . . . . . . . . . . 172
SP = Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 CV = Conception vessel . . . . . . . . . . . . . . . . . . . . . . . 177
HT = Heart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 EX-HN = Head and neck . . . . . . . . . . . . . . . . . . . . . . . 185
SI = Small intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 EX-CA = Chest and abdomen. . . . . . . . . . . . . . . . . . . 188
BL = Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 EX-B = Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
KI = Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 EX = “Breast point in front of the axilla”. . . . . . . . . 190

PC = Pericardium . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 EX-LE = Lower extremity . . . . . . . . . . . . . . . . . . . . . . 191
6 Chinese Nutrition Therapy and Qi Gong
Chinese Nutrition Therapy . . . . . . . . . . . . . . . . . . . . 196 Qi Gong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
(cid:2) Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 (cid:2) The History of Qi Gong . . . . . . . . . . . . . . . . . . . . . 213
(cid:2) Points of Practical Importance . . . . . . . . . . . . . 197 (cid:2) Qi Gong in Traditional Chinese Medicine . . . . . 214
The Five Flavors . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 (cid:2) Perceivable Phenomena . . . . . . . . . . . . . . . . . . . 215
The Five Thermal Food Natures . . . . . . . . . . . . . . 198 (cid:2) Learning Qi Gong . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Basic Recipes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 (cid:2) Indications for Qi Gong Exercises . . . . . . . . . . . . 218
(cid:2) Gynecological Aspect . . . . . . . . . . . . . . . . . . . . . . 199 (cid:2) Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . 220

(cid:2) Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 (cid:2) Side Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
Appendix
American and International Tai Ji and Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Qi Gong Associations . . . . . . . . . . . . . . . . . . . . . . . . . 223
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225