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Hi all,

I've been thinking about certain questions for a while now

and would like to see how others have been practicing and with what kind of

effects.

 

1. *Laterality of needles* - What decides a bilateral needle treatment

from contralateral or unilateral placement?

 

I usually go contralateral for channel / external pain tx from site of pain

(Master Tung/ Young Wei-Chieh)

and bilateral for organic (zang/fu) d.o., however, I know that Master Nagano

(Kiiko M.) often does unilateral, as well as contralateral, depending on the

issue. Aside from that, are there other perspectives?

In TCM school it is almost always bilateral for a single point, no matter

what.

Any ideas?

 

2. *Length of needle treatment* - What makes you decide between a 20 min.

tx, 30 min and a 40 min tx?

 

3. *Number of herbs in a single formula* - What are your thoughts on the

limit of how many herbs should be in any formula?

Even / odd #?

Tonifying / Dispersing?

 

4. *Dosages of each herb in a single formula* - Besides Bensky doses, some

practitioners I've seen use 1.5 qian as the average single herb dose, others

greater than 5 qian. Is there a classical or historical trend in dosage

amounts?

What kind of considerations would one have in giving small vs. larger doses.

ie. LV metabolism issues, SP qi def. size of patient, etc.

 

It seems as though everyone has their own idea concerning these questions.

I'm wondering if there is rhyme and reason that has worked for you. Thank

you.

 

--

'Freedom from the desire for an answer is essential to the understanding of

a problem.'

 

Jiddu Krishnamurti

 

 

 

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see below, KB

 

On 1/19/07, <johnkokko wrote:

>

> Hi all,

> I've been thinking about certain questions for a while now

> and would like to see how others have been practicing and with what kind

> of

> effects.

>

> 1. *Laterality of needles* - What decides a bilateral needle treatment

> from contralateral or unilateral placement?

>

> I usually go contralateral for channel / external pain tx from site of

> pain

> (Master Tung/ Young Wei-Chieh)

> and bilateral for organic (zang/fu) d.o., however, I know that Master

> Nagano

> (Kiiko M.) often does unilateral, as well as contralateral, depending on

> the

> issue. Aside from that, are there other perspectives?

> In TCM school it is almost always bilateral for a single point, no matter

> what.

> Any ideas?

>

 

I use ipsi lateral local/distal for pain, contralat needle combo in xu

patients to reduce number of needles (eg: sp6/st36 contra lat) and bilat for

zangfu. occ. i use contra lat for pain in a stubborn/diff. case when i'm

trying outside the box tech. to get results.

 

 

 

2. *Length of needle treatment* - What makes you decide between a 20 min.

> tx, 30 min and a 40 min tx?

>

 

this is done according to shi/xu condition/patient. shi=40min, xu=20min.

shorter tx lengths are used for elderly, peds, and xu patients who have neg

reactions (eg: fatigue, lightheaded) post-tx.

 

 

 

3. *Number of herbs in a single formula* - What are your thoughts on the

> limit of how many herbs should be in any formula?

> Even / odd #?

> Tonifying / Dispersing?

>

 

every herbalist has a different answer. begining herbalist are taught 12-15

herb/px, smaller for shan han lun style tx. i write large px (20+) and

get effective results for my patients without s/e. this is an ususual,

perhaps even renegade style, but i works for my patients. i tx many

complicated conditions presenting with multiple sx/patterns. patient base

demogr. is babyboom women. i find younger patients with less complicated

symptomology/patterns tend to get smaller px. peds get smaller px. they

has simple conditions and respond quickly.

 

never heard about focusing on even or odd# of herb in px.

 

tonic/dispersing: as per TP to tx pattern, tonics for xu conditions, etc.

 

 

 

4. *Dosages of each herb in a single formula* - Besides Bensky doses,

> some

> practitioners I've seen use 1.5 qian as the average single herb dose,

> others

> greater than 5 qian. Is there a classical or historical trend in dosage

> amounts?

> What kind of considerations would one have in giving small vs. larger

> doses.

> ie. LV metabolism issues, SP qi def. size of patient, etc.

>

 

herbs have basic dosage ranges, see bensky. its best to stay in the rec

ranges. however, these ranges are for daily doses, as is practiced in

china: 1 bag/day. in the US, most practitioners use 1bag/2days, partly due

to expense, partly because patients often to acu in addition (in china its

usually either/or), and mostly because that's the way its taught.

 

it's ok to stray outside the est. ranges if: the herbalist is experienced,

the herb is known to be safely prescribed in higher doses: eg. huang qi can

go 30-60g or higher. you must have a reason to do this, and know what

you're doing to go this high.

 

actually, px should be dosed by the patients weight. if i recall correctly

its 140g/70 kilos. therefore smaller patients/elderly/peds get lower doses,

and larger, more robust adults get higher doses. liv metab, sp qi xu could

also be taken into consideration when dosing herbs.

 

hope this helps,

 

kb

 

Kath Bartlett, LAc, MS, BA UCLA

Oriental Medicine

Experienced, Dedicated, Effective

 

Asheville Center For

70 Woodfin Place, Suite West Wing Two

Asheville, NC 28801 828.258.2777

kbartlett

www.AcupunctureAsheville.com

 

 

 

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