Chinese Medicine

Research on Sexual Function Validates TCM Approach

A study published in the Annals of Neurology on December 5th describes the discovery of a group of neurons in the spinal cord that relate to male ejaculation.  The researchers have coined the term SEG, spinal ejaculation generator, to describe this neurological mechanism.  Men with spinal cord injuries who suffer from anejaculation, an inability to discharge semen during intercourse, have been the focus of the studies.  The authors state "The hope is now we have identified this specialized area of the spinal cord, we can use other ways of stimulating these neurons - maybe with electrical, magnetic, or pharmacological methods - to enable ejaculation to occur."

Although it is unlikely that patients with spinal cord damage would be able to experience a sensory climax, treatment might allow for procreation.  Other benefits include an observed but poorly understood post-ejaculatory relaxation of the striated muscles of the limbs that provides relief to patients who suffer from spasticity.  According to the Medscape article by Sue Hughes published December 13th, care might not only aid those with spinal cord trauma but also might help patients without a history of injury who struggle with premature, delayed, or absent ejaculation for other reasons.

This is yet another example of how new research confirms and validates the Chinese medical perspective.  In Chinese medicine, semen is considered to be jing or essence.  The term essence describes more than just male semen, but semen is a visible manifestation of this resource.  Essence is stored in the kidney (we use the singular to differentiate from the Western anatomical concept of the organ).  The kidney resides in the lower back and, in Chinese medicine, is ascribed the function of governing the bone and the bone marrow.  Ergo, the fact that the discharge of semen is controlled by a neurological mechanism nestled in the lower back, specifically at the center of the spine, is no surprise to the traditional Chinese doctor.

In those with spinal trauma, there is, ipso facto, blood stasis and qi stagnation that affects the kidney organ and its related channels and network vessels.  In the short term, blockage of the conduits that allow the organ to interface with the rest of the body inhibits kidney function, while, over the course of time, the lack of nourishment results in the kidney essence being weakened and depleted.  The end result is the inability to ejaculate normally.

In contrast to conventional medicine and science, Chinese medicine also offers a cogent explanation for why ejaculation tends to relax the striated muscles in the limbs and alleviate spasticity.  Spasticity in Chinese medicine is considered a form of internal, bodily wind, and wind is directly linked to the liver.  Moreover, it is stated in Chinese medical classics that the "liver and kidney have the same source."  Trauma to the lower back primarily damages the kidney yin-essence, but liver yin-blood, which is transformed out of essence, is affected secondarily.  When ancient doctors proclaimed that "the liver is yin in form, but yang in function" they were referencing the fact that, although the liver is the main control mechanism for the movement of qi throughout the body, it ultimately depends on nourishment and moistening from the yin, blood, and essence to function well.  Physical trauma to channels and network vessels leads to blood stasis, and blood stasis, in turn, results in blood vacuity or deficiency.  This leaves the liver high and dry, so to speak, and causes it to fail in its main task of ensuring that qi and blood move smoothly and completely throughout the body.

When qi, like the electricity in a wire, cannot flow freely, it backs up and flares and expands outward, causing the limbs to jerk and twitch. Ejaculation is a sudden, strong discharge of qi.  This relaxes the liver and allows qi to naturally dissipate in the limbs, easing tension and resolving spasticity.  Of course, without sufficient lubrication by yin, blood, and essence, the liver will soon become bound again and will be unable to properly course qi in the body.

When the authors hypothesize that electrical, magnetic, or pharmacological stimulation of the SEG neurons might assist in restoring ejaculatory function, they are proposing what Chinese medicine has been doing for centuries.  The specific area where galaninergic neuron density is the greatest, between the L3 and L4 segments, is the location of Yao Yang Guan, the DU-3 point which is indicated for sexual dysfunction, while the Ming Men Du-4 point lies between L1 and L2.  The latter point is especially renowned in Chinese acupuncture for boosting the kidney and assisting with libido and reproduction. 

Seeing research like this study that so closely parallels the Chinese medical model leaves those of us steeped in the Chinese medical perspective feeling a quixotic combination of satisfaction and frustration.  On the one hand, validation of our analysis and methods from another medical model confirms what we already know and puts us in a position to say "I told you so".  On the other hand, it is vexing to watch as humanity reinvents the wheel over and over again.  Giving credit where credit is due, the authors findings have advanced human understanding of the anatomical specifics, but it is impossible to assume that any therapeutic value generated from their work will be an improvement.  It is not likely that the development of surgical implants, drugs with adverse effects, or expensive clinical procedures will be preferable over non-invasive acupuncture or complex herbal formulations that offer the advantages of low cost, centuries of empirical usage, and a low risk of side effects.


Cupping at the Olympics

Chinese medicine is in the news again with cupping of Michael Phelps and other Olympic athletes.  Judging from the online images, cupping is being performed by trainers with cups using a detachable pump.  The telltale marks suggest that the cupping is being done in the anatomical areas that are generally sore or stressed, unfortunately without specific regard to the course of acupuncture channels. 

While this is great publicity for us, this sort of use of Chinese medical treatments by individuals who are not trained in Chinese medicine, in concert with the musings of journalists, can mislead the public about our medicine.  In the NY Times article, the author offers several comments about the intended effects of cupping—not exactly congruent with the thinking in professional Chinese medicine—and offers up a few studies to explore the issue of whether or not cupping therapy is a placebo treatment. 

This example is typical of how Chinese medicine is handled in the popular press.  It is understandable that journalists want to appeal to a broad audience, both the believers and the skeptics.  As a practitioner, it is, of course, frustrating to be reminded how biased the media is in regards to Chinese medicine.  Even indisputable evidence of the direct effects of acupuncture, with functional MRI demonstrating how acupuncture can modulate brain activity as one example, does not seem to be adequate to earn us the benefit of the doubt.  To be fair, there is some media coverage about the shortcomings of Western medicine, but even the biggest cautionary stories seem to be a flash in the pan.  A recent story, for example, described adverse events in hospitals as a leading cause of mortality in the United States.  No matter how alarming the news, once the clamor dies down, it is back to the business of showcasing the latest achievements in medicine and marveling at the bright future of cures, while Chinese medicine is presented with many caveats.

Coverage of Olympic cupping and the quality of the treatment aside, it is still good to have a Chinese medical treatment in the news.  As the old saying goes, there is no such thing as bad publicity, and the tempest in a teapot of Olympic cupping has at least piqued some interest.  People are talking about the use of cupping, and our patients have been asking questions and wanting to know more.  If more Americans realize that there are options available to them, our healthcare system can move forward to a more effective future.

We use cupping frequently here at White Pine.  Cupping is one of those modalities that seem to occur more frequently in clinics run by Chinese practitioners, but we pride ourselves on offering our patients the kind of care you would find in a good clinic in China.  For our patients, we primarily like to use cupping for back and hip pain and for treating stiffness of the neck and shoulders.  We favor the traditional technique of fire cup, where several balls of alcohol-soaked cotton are ignited and used to create a vacuum inside of a glass cup.  This method requires training and experience, so please do not try this at home!

In the coverage of the Olympic cupping, hematomas or bruises are attributed to the breaking of tiny capillaries.  While this may be true structurally, the Chinese understand that bruising is in direct proportion to the amount of blood stasis presenting in the area treated.  In other words, the more chronic, fixed, and severe the pain (all characteristic of blood stasis patterns), the darker the bruise after cupping.  Most of the time, bruising starts out heavy and grows lighter as the condition improves and the pain diminishes.  Of course, with traditional fire cupping, there is a limit to the amount of suction that can be achieved.  Having a ceiling on the force of the suction has an important benefit:  it is unlikely to cause damage to tissues.  The type of cupping featured in the story on the Olympic athletes, however, may involve a powerful suction that could even potentially even dislocate bones, such as spinal vertebra.  Traditional fire cupping is not only more entertaining to watch than pump cupping, it is also safer for the patient. For some of our patients, cupping is their favorite form of Chinese medical care.