Handouts for October 3rd 2013 Webinar on Treating Pain

 

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Get Better Results When Treating Pain

with Honora Lee Wolfe

Copyright, 2013

THE Basic Statement About Pain

Where there is free flow, there is no pain;

 where there is pain, there is no free flow.

Most Common Patterns Associated with Pain

1.Qi stagnation in the local area

2. Blood stasis in the local area

3. Qi & blood vacuity leading to the lack of nourishment of the sinews & vessels

4. Damp or damp heat inhibiting the flow of qi & blood to and through the sinews and vessels

5. Yang vacuity leading to cold congelation and    blood stasis in the channels & sinews

When treating pain/disease with acupuncture and herbal formulas together one should...

Combine root tx with branch tx for the best results.

• Root tx are based on viscera & bowel; qi & blood; fluids & humors; yin & yang pattern discrimination. (often herbal)

• Branch tx are channel-based, based on channel & network vessel pattern discr. and on palpation. (often acu-moxa)

In Chinese medicine in general,

…all treatment methods can be divided into Bu fa and Xie fa

Bu fa means supplementing methods

Xie fa means draining methods

Best General Acupoints for Pain

LI 11 for all upper body pain (with LI 4 for more power.)

UB 60 & GB 34 for all lower body pain

Add Xi (Cleft) points for more power; add electricity, as strong as the person can handle, on these.

Four Bars for head, neck, torso pain.

Related specific ear points.

Bodywork & Pain

In cases of blood stasis or recent trauma, deep tissue work at the site of the pain is often counter-productive.

Bodywork distal to the injury can be helpful to open the channels and free the flow of qi and blood.

Lighter bodywork on an injury after major healing has occurred is useful.

Bodywork in conjunction with moxa on old injuries may be quite helpful.

Use liniments with these treatments for best results!

Acupoint selection

§For moxibustion, use mostly ah-shi points in trauma conditions

§When using moxa as your local or branch treatment, you might choose tender points on related channels as your root treatment

§E.g., for right side shoulder pain on the yang ming channel, moxa ah-shi points in the area of LI 15, needle the same points on the opposite side, and use thread moxa or gold needles on relevant points foot yang ming and foot tai yin as a root treatment.

Bleeding in pain cases

1. Fever (replete yang, not yin vacuity type) (i.e., full, fast pulse, red tongue, full/replete heat symptoms)

2. Sore throat  (replete yang, wind heat common cold or flu, not vacuity symptoms)

3. Musculoskeletal pain which is stabbing or biting, site specific, and recurrent

4. Musculoskeletal pain which is dull and constant but worse with movement

5. Headaches or eye pain of a replete yang nature

6. Itching

7. To reduce swelling caused by stasis of blood and stagnation of qi

8. Numbness or pain with numbness

9. Vomiting caused by stomach heat

10. Emergency resuscitation

11. When there are clear signs of blood stasis such as varicosities or spider nevi veins, especially for pain conditions on the same channel

External therapies

§Pastes & plasters (gao)

§Wines (jiu) or tinctures (ding ji)

§Powders (fen)

§Oils (you)

§Washes (shui fen)

§Compresses (shi fu)

§Medicinal baths (yao yu)

§Fumigation (yan xun liao fa)

External therapies for pain from Blue Poppy

Shao Lin Dee Dat Jow

§Radix Angelicae Sinensis (Dang Gui)

§Radix Ligustici Wallichii (Chuan Xiong)

§Radix Cyathulae (Chuan Niu Xi)

§Lignum Sappanis (Su Mu)

§Flos Carthami Tinctorii (Hong Hua)

§Flos Caryophylli (Ding Xiang)

§Radix Auklandiae Lappae (Mu Xiang)

§Resina Olibani (Ru Xiang)

§Lignum Santali Albi (Bai Tan Xiang)

§Fructus Foeniculi Vulgaris (Xiao Hui Xiang)

§Alcohol

Functions:

§Moves the qi & quickens the blood

§Disperses swelling & stops pain

Indications: Recent closed injuries with swelling and pain     

      

External Therapies: Dragon’s Blood

§Sanguis Draconis (Xue Jie)

§Lignum Pini Nodi (Song Jie)

§Resina Olibani (Ru Xiang)

§Resina Myrrhae (Mo Yao)

§Radix Et Rhizoma Rhei (Da Huang)

§Flos Carthami Tinctorii (Hong Hua)

§Lignum Sappanis (Su Mu)

§Radix Pseudoginseng (San Qi)

§Camphora (Zhang Nao)

§Borneolum (Bing Pian)

§Alcohol

Functions:

§Quickens the blood & dispels stasis

§Disperses swelling & stops pain

Indications: Recent closed injuries with marked ecchymosis

External therapies: Green Willow Liniment

§Flos Carthami Tinctorii (Hong Hua)

§Radix Aconiti Carmichaeli (Chuan Wu)

§Radix Aconiti Kusnezoffii (Cao Wu)

§Radix Angelicae Sinensis (Dang Gui)

§Semen Pruni Persicae (Tao Ren)

§Herba Ephedrae (Ma Huang)

§Pyritum (Zi Ran Tong)

§Semen Strychnotis (Ma Qian Zi)

§Ramulus Cinnamomi Cassiae (Gui Zi)

§Radix Auklandiae Lappae (Mu Xiang)

§Resina Myrrhae (Mo Yao)

§uncooked Rhizoma Zingiberis (Sheng Jiang)

§Alcohol

Functions:

§Moves the qi & quickens the blood

§Warms the channels & frees the flow of impediment

Indications: Wind cold damp impediment

External therapies: Three Angels Liniment

§Cortex Phellodendri (Huang Bai)

§Rhizoma Atractylodis (Cang Zhu)

§Radix Achyranthis Bidentatae (Niu Xi)

§Caulis Trachelospermi (Luo Shi Teng)

§Caulis Lonicerae Japonicae (Ren Dong Teng)

§Radix Angelicae Dahuricae (Bai Zhi)

§Radix Angelicae Pubescentis (Du Huo)

§Radix Angelicae Sinensis (Dang Gui)

§Radix Et Rhizoma Rhei (Da Huang)

§Camphora (Zhang Nao)

§Borneolum (Bing Pian)

§Alcohol 

Functions:

§Clears heat & eliminates dampness

§Frees the flow of impediment & stops pain

Indications: Wind damp heat impediment

External therapies: Sprain Ointment

§Radix Et Rhizoma Rhei (Da Huang)

§Herba Lycopi Lucidi (Ze Lan)

§Lumbricus (Di Long)

§Fructus Gardeniae Jasminoidis (Zhi Zi)

§Pasta Acaciae Catechu (Er Cha)

§Resina Olibani (Ru Xiang)

§Borneolum (Bing Pian)

§Sesame oil

§Beeswax

Functions:

§Quickens the blood and dispels stasis

§Clears heat, disperses swelling & stops pain

Indications: Recent sprain or closed injury characterized by redness, heat, swelling, and pain

External therapies: Stop Pain Tincture

§Flos Carthami Tinctorii (Hong Hua)

§Rhizoma Nardostachydis (Gan Song Xiang)

§Alcohol

Functions: Moves the qi, quickens the blood, stops pain

Indications: For the symptomatic relief of any pain

External Therapy:

1. Herbal Sports Massage Oil

Moves qi and quickens the blood to stop pain in sports injuries

2. Dr. Bob’s Oil and Pain Stick

Same formula as Po Sum On with peppermint and cinnamon essential oils, for temporary relief of muscle pain

Internal Formulas: Kidney Mansion Formula

Shu Di, Shan Zhu Yu, Gou Qi Zi, Tu Si Zi, Du Zhong, Xu Duan, Bu Gu Zhi, Ba Ji Tian, Niu Xi, Gu Sui Bu, Wu Jia Pi, Dang Gui, Chi Shao, Chuan Xiong, Ren Shen

Tx Patterns: liver-kidney vacuity with  blood stasis and wind damp evils.

Tx Conditions: Chronic low back pain, post-menopausal osteoporosis

For mostly aging patients with chronic low back pain.

Internal Formulas: Impediment Magic Formula

Yi yi ren, Qiang huo, Niu xi, Cang zhu, Mu gua, Xiang fu, Wu yao, Fang ji, Qin jiao, Dang gui, Ru xiang, Mo yao, Tao ren, Hong hua, Di long, Gui zhi, Su gen, Gan cao

Tx Principles: Dispels wind, scatters cold, and eliminates dampness, quickens the blood, frees the flow of the network vessels, and stops pain

Tx Conditions: For chronic, enduring bi due to wind, cold, damp and blood stasis in the network vessels.

For long term use, you may need to add something more to help the formula be more easily digested

Internal Formulas: Dang Gui & Anemarrhena Formula

Dan gui, Dang shen, Bai zhi, Cang zhu, Zhu ling, Ze xie, Zhi mu, Huang qin, Yin chen hao, Ku shen, Ge gen, Qiang huo, Fang feng, Sheng ma, Gan cao.

Tx Patterns: For wind damp heat bi with spleen qi vacuity and liver qi

Tx Conditions: This pattern combination is often seen in rheumatoid arthritis, lupus eryth., fibromylagia, and chronic fatigue (CFIDS)

The dampness here is internally engendered due to spleen deficiency

Experiential Tidbits:           

1. With scar therapy, check which direction of applied pressure on the scar makes the related pain worse or better and insert needles in the direction that makes the pain better. Then go over the scar with a Tiger warmer.

2. Bleed an ear point for immediate pain relief. Any related ear point can be used; find one that is sore.

3. Acute Ankle Sprain - bleed point of worst pain; needle same spot on opposite side with deep, Chinese style needling.

4. Check for vascular spiders around the tail bone and sacrum if there is chronic sciatica, piriformis syndrome, neck tension, or back pain.  If you find them, bleed them.

5. For chronic chest pain where blood stasis plays a role, use Ion Pumping cords with black clip on Per 6 and red clip on GB 34 or Sp 4, whichever is more tender.

6. For chronic one-side low back pain, use Black clip on Bl 23 and Red clip on GB 29 or 34, whichever is more tender. Try the same side first and recheck painful spots. Switch to unaffected side if the painful spots do not improve.

7. Chronic Sciatica - Black Clip on GB 30, Red clip on Ki 1 or Bl 60, Green clip on a point 1 cun lateral to Bl 40. On GB 30 use a long needle Chinese style inserted in the direction that the pain shoots. Must insert needle at the same angle that the pressure elicits pain. Spark the black needle every five minutes...leave all needles for 20 minutes. Add moxa at the end of the treatment.

What to try if treatments are unsuccessful

1. Akabane testing/stimulation

2. Ear needles

3. If there are any purple/black veins, if there has been surgery, or if the pain is fixed and stabbing, consider bleeding one or two points

4. Pay more attention to treating the root.

5. Reexamine the patient’s pulse and tongue and go back over what questions you asked to see if you overlooked any factors that may contribute to the condition.

6. Go over self-care techniques with the patient if you have not already done so.

7. Find out if their work habits have changed or if their work-related stress levels have worsened.

8. Suggest dietary changes to support your root treatment.

And finally….

Combining root therapies with branch therapies always gets better results.

Using external and internal herbals together with your acu-moxa treatments is usually more effective than either one alone in pain conditions.

Good Luck and Best Wishes for Success!

Notes for My Webinar on Skin Diseases

Thanks for attending my Webinar on September 26th. I hope you got a few useful pieces of information from the presentation.
Here's the notes from the presentation.

 

Skin Conditions: Internal and External Formulas plus Acupuncture work Best

with Honora Lee Wolfe

Copyright 2013 • All rights reserved.

What is easy about skin conditions is…

•You can see them! Which makes them easier to pattern discriminate, and…

•You can tell how you are doing immediately as a clinician!

•The patterns and treatments are logical based on the morphology of the lesions.

Wai Ke and Nei Ke

•Dermatology is classified as a group of diseases in the “wai ke” or category of diseases occurring in or on the exterior or outside of the body.

Skin Disease Mechanisms

•Heat

•Toxins

•Wind

•Dampness

•Dryness

•“Chong” or insects/parasites

•Blood stasis

Pattern Discrimination of  Dermatological Conditions

•Redness = heat

•Purple red = heat toxins &/or stasis heat

•Dark red = depressive or stasis heat

•Blisters &/or suppuration = dampness

•Purulence = heat toxins

•Scaling = dryness

•Pigmentation & lichenification = stasis

•Itching = wind

•Heat = heat

•Pain = stasis

Therapies that can be helpful

•Macerated wet herbs

•Herbal pastes

•Resolvant powders

•Ointments

•Tinctures

•Medicated oils

•Compresses

•Washes

•Medicinal baths

•Fumigation

•Moxibustion

•Cupping

•Body and ear needles

Acu-Moxa Therapy

To clear heat from whole body: Da Zhui (GV 14), Qu Chi (LI 11)

To course the liver & resolve depression: Tai Chong (Liv 3), He Gu (LI 4)

To clear heat & resolve depression: Xing Jian (Liv 2)

To clear heat from the blood aspect: Xue Hai (Sp 10), Wei Zhong (Bl 40)

To fortify the spleen & supplement the qi: Zu San Li (St 36), San Yin Jiao (Sp 6)

To seep dampness: Yin Ling Quan (Sp 9)

To nourish the blood: Ge Shu (Bl 17), Gan Shu (Bl 18)

To quicken the blood: Xue Hai (Sp 10)

To quiet the spirit: Shen Men (Ht 7)

To stop itching: Shao Fu (Ht 8)

Treat once per day or at least 2X per week for one month. Then treat once per week as needed.

“Eczema” the most common skin condition

Strictly speaking, Eczema is not one disease, but a group of diseases

1. Atopic eczema

2. Contact dermatitis

            A. Allergic contact dermatitis

            B. Irritant contact dermatitis

3. Seborrheic eczema

4. Varicose eczema

5. Discoid eczema

In U.S., 15 million have some form of eczema

10-20% of world population affected by eczema in childhood

Not contagious • No known WM cure

Atopic Dermatitis

•Most common in infants and young adults

•In U.S., 10% of infants have AD

•3% of total population

•50% of patients affected throughout life

•Hereditary

•Increased genetic sensitivity to allergens, & excessive immune reactions

•Atopic describes a tendency to excess inflammation of the skin, linings of the nose & lungs

•Closely linked to allergic rhinitis & asthma

Nutritional Supplementation

•B complex for dry, itchy skin

•Beta-carotene to promote moisture retention

•Vitamin C as natural antihistamine

•GLA (gamma-linoleic acid) as anti-inflammatory

•Quercetin (bioflavonoid) to prevent allergic response

•Zinc often deficient in people with E, especially if taking longterm steroids

The Main CM Disease Mechanisms of AD

•Spleen vacuity (leads to dampness)

•Liver depression (leads to heat)

•Wind heat, blood heat

•Yin-blood-fluid vacuity malnourishment

•Blood stasis

Simplified, the most commonly seen are:

•Wind heat type: Erythema, no suppuration

•Damp heat type: Suppuration

•Wind dryness type: Lichenification, dryness, scaling  

About Psoriasis

•A non-contagious, chronic skin disease of unknown etiology

•Most researchers agree it is an immune-mediated disorder with a strong genetic component.

•An estimated 4% of the U.S. population or more than seven million Americans suffer from psoriasis.

•Incidence of psoriasis rises to 28% if one parent has this condition and to 68% if both parents suffer from psoriasis.

•May occur at any age, but most patients do not show signs till their 20s, with an average age at diagnosis of 28.

•Somewhere between 150,000-260,000 new cases of psoriasis are diagnosed per year in the U.S.

CM and Psoriasis

•In Chinese medicine, psoriasis is thought to be due to heat toxins in the blood damaging the blood and body fluids and, therefore, secondarily causing dryness and stasis.

•The Tx Principles are, therefore, to nourish and quicken the blood, moisten dryness, clear heat, and resolve toxins

•There are many possible internal formulas to use for this condition depending upon the specific pattern combination the patient present

Formulas & Diet for Psoriasis

•Huo Xue San Yu Tang, Bai Bi Tang, Gui Zhi Tang Jia Jian, Bei Xie Shen Shi Tang Jia Jian, Huang Lian Jie Due Tang Jia Jian, Sheng Xuan Yin, Long Dan Xie Gan Tang jia Jian, Mai Wei Di Huang Tang, Er Xian Tang Jia Jian

•Low-fat low-calorie diet reduces inflammation; avoid alcohol to clear heat from the liver.

•Include Fish oil as an anti-inflammatory and as many anti-oxidants as possible.

Basic Principles for Using External Remedies in CM Dermatology

1. Primarily treat the tips or branches with external remedies

2. Do not use oil-based remedies for wet, suppurating lesions

3. Use water or alcohol based remedies or powders for wet, suppurating lesions

4. Use oil-based remedies for dry, nonsuppurating lesions

5. Determine the relative proportions of the disease mechanisms at work & then choose 2-3 medicines for each mechanism

6. Use medicinals known to be empirically effective when applied externally

7. Feel freer to use inferior grade medicinals when treating externally

Blue Poppy External Remedies

•Acne Tincture clears heat, dispels wind and resolves toxins

•Antifungal Ointment clears heat, resolves toxins, disperses inflammation and stops itching

•Clear Heat Ointment (Si Huang Gao) clears heat, resolves toxins, disperses swelling and stops pain (infected lesions that are hot to the touch)

•Cut & Sore Ointment, clears heat, resolves toxins, moves the blood and stops pain, engenders new flesh

•Eczema Ointment clears heat eliminates dampness, dispels wind and stops itching in wind damp heat eczema

•Herpes Zoster Ointment clears heat and eliminates dampness, courses wind and resolves toxins

•Jade Dew clears heat and cools the blood, disperses swelling and resolves toxins in herpes simplex

•Psoriaquell Ointment nourishes and quickens the blood, moistens dryness and clears heat

•Psoriasis Tincture dispels wind and clears heat, eliminates dampness and resolves toxins, kills parasites, and stops itching.

Anti-fungal Ointment

•Oil and beeswax plus Shi Gao, Hua She, Qing Dai, and Huang Bai

•For chronic dry eczema or dry fungal skin conditions such as ringworm.

•Clears heat, resolves toxins, disperses inflammation and stops itching

Eczema Ointment

•Oil and beeswax plus Da Huang, Huang Bai, Cang Zhu, She Chuang Zi, Bai Zhi, Ku Fan, and Tian Hua Fen

•For wind damp heat eczema

•This formula moistens dryness sufficiently to keep the other ingredients fro damaging fluids.

Psoriaquell Ointment

•Dang Gui, Zi Cao, Da Huang, Lu Hui Zhi, Bing Pian in a veg oil, beeswax and vitamin A, D, & E base.

•For blood heat psoriasis with dry, red lesions and silvery scaling

•Do not use in cases of wet, suppurating psoriasis.

White Pearl

•Mu Li, Huang qi, Dang Shen, Fu Ling, Shan Yao, Pei Lan, Bai Xian Po, She Chuang Zi, Bai Zhu, Fang Geng, Dan Pi, Zi Cao, Jing Jie, Jiang Can, and zhi Gan Cao

•Treats spleen qi xu resulting in a defensive qi insecurity with easy invasion of wind complicated by dampness, heat, toxin, and blood stasis manifesting as chronic hives, eczema, or psoriasis

•Can be used for any skin conditions that presents with these patterns

Little Pearl

•Ren Dong Teng, Shan Zha, Shen Qu, Mai Ya, Fu Ling, Bai Zhu, Bai Bian Dow, Yi Yi Ren, Chen Pi, Ma Chi Xian, Bai Mai Gen, Dan Pi

•Specifically for pediatric eczema due to spleen qi xu with damp heat and possible food stagnation. This eczema will be damp, itchy, and possibly weep

Final Advice for Tx Skin Conditions

1. Check your pattern discrimination

2. Check that your medicinals are appropriate for the pattern

3. Check the dosage

4. Add an external remedy if not using one

5. Check that external remedy is correct if using one

6. Be sure patient is adherent to diet & lifestyle modifications

7. Check for other aggravating factors possibly overlooked before

8. Consider adding acupuncture

Get publicity (and more patients) for doing good in your community

by Honora Lee Wolfe, Dipl.Ac.

One of the best ways to call attention to yourself and your services is to either organize or participate in activities that contribute to your community in a positive way. You don’t need to spend a great deal of time or money on a project that will make the news.  For most of these, it would have an even greater impact to get more than one practitioner involved. That way, “acupuncture” and not just you, get a boost from the activity. So ask your colleagues to get involved and make sure the media knows about what you’re doing. Here are some ideas.

Get every acupuncturist in your community to collect in their clinic:
    1. toys for the local family shelter at Holiday time
    2. food for the community food share
    3. $$ for a local charity drive

Make sure your patients are involved in this effort. Create signs for your treatment rooms and your waiting area. Once you have collected everything, make sure you send out a Press Release to all the local media with a headline such as “Local Acupuncturists Donate 500 New Toys to Local Battered Women & Family Shelter” or whatever. Make sure that every acupuncturist involved gets their name in the Press Release.

Need more patients? Offer free or greatly reduced fee acupuncture one day per week for people who have lost their jobs (up to three treatments maximum). Do this on your least busy day of the week or during your least busy hours. That helps insure that no one scams you because working people probably cannot come on Wednesdays from 11 AM- 3 PM. Do you think these people might become paying customers once they get a new job?? Do you think they will tell their friends? You bet they will. (You can take this idea and do the same thing for the annual “Great American Smoke Out”... i.e., free stop-smoking treatments.)

Join together with some other businesses to sponsor a trash pickup or a graffiti cleanup campaign.  Get a local paint store to donate some paints that were “mis-tints” and get some high school students to help with the painting. Everyone gets good publicity and who knows how many people at the paint store or at the high school (parents, teachers, counselors, administration) will become your patients!

Got old inventory of herbs and vitamins or other products? Get a tax write-off by donating them to the Guatemala Acupuncture Project, Bobbi Aqua’s free clinic in Banda Ache www.gentlebirthsbali.org, or to a free clinic on a Native-American reservation.

Sponsor a little-league team or girls soccer team.  You get to put your name on the back of the t-shirts and all the parents know who you are.

Work with a local nursery to create a tree-planting or flower planting weekend at a local park, along a specific street, around a school playground, or to reclaim a vacant lot. Get as many other businesses (especially acupuncturists) involved as you can.  This is also a great photo opportunity and you may make the 5 o’clock news!

Organize a neighborhood crime watch with other businesses in your area. Get help from the local police department.

Whenever you create any community activities such as these, make sure the local media knows about it as far in advance as possible. This qualifies as “good news”, which is something we could all use more of in our lives. Even the media people may become your patients.

If you cannot find the juice to create your own community event, join in on ones that someone else is creating.  This at least gives you the opportunity to meet new people and tell them about the wonderful benefits of our medicine.  Either way, make sure to send a thank you card to anyone you work with on such projects and be sure to include your business card. Remember, everyone is someone’s patient at some point.  Why shouldn’t they be yours?

Random Practice Building and Clinical Notes

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Here are a few recent items I've collected from here and there.

Advice for living longer, and happier lives!

1. Nurture more friendships. Studies show that people with numerous close relationships have a lower rate of serious illness following personal crises and are likely to live longer than those who remain isolated.
2. Don’t be a couch potato. The sooner you start exercising regularly the healthier you are likely to remain. You will lower your risk for all the major killers in our society…heart disease, high blood pressure, diabetes, obesity, even cancer. Combine #1 & 2…. walk with a friend whenever you can.
3. Build strength. Studies suggest that people over 40 lose 1% per year of muscle strength unless they actively avoid it through strength training. Weight training maintains healthy muscles and bones, and is also important for women who are prone to osteoporosis.
4. Eat naturally. Fruits, vegetables and whole grains are low in fat and calories and help everyone avoid heart disease, diabetes, and inflammatory diseases such as arthritis.
5. Get regular medical screenings for diseases that your age group and sex are prone to develop or for which you have any genetic tendency. The chance for successful treatment is most likely when diseases are detected at the earliest stages.
6. Pursue pleasures such as art, music, flower arranging, team sports, a social life, volunteer opportunities, or even a regular sauna.
7. Laugh as often as possible. Laughing improves blood circulation, increases mental alertness, frees up your qi mechanism, relaxes the liver, and calms the spirit.

Why do most Americans visit their doctor’s office?

According to a report in American Health Magazine, the overwhelming reason why most of us visit our doctor’s office is upper respiratory infections such as colds, flu, and bronchitis… over 190 million office visits per year!  Another 150+ million visits area for heart disease and hypertension. Next come migraines and other headaches. In fourth place is arthritis and back pain.

Chinese medicine can help people with all these conditions! It's easy to inform your patients about all that can be benefited through acupuncture care and Chinese herbal medicine. (Blue Poppy and Acupuncture Media Works have lots of brochures to help you do this with very little effort. See the Brochures and Office Products Link on the left side of the home page.) Also, Blue Poppy Originals include formulas to help your patients with these conditions! Sign up today for access to the herbal section of our site to check out Cold Quell, Clear Vessel, Celestial Mansion, Kidney Mansion, and Impediment Magic today.

Help your patients to a slimmer waistline with these tips.

Feel free to make this list into a handout for your dieting patients. Put your clinic info at the top of the handout.

1. Eat breakfast. Regular meals and occasional low-calorie snacks help prevent binging episodes. Don’t like too much food in the morning? Try some fresh fruit, a small bowl of whole grain high-fiber cereal, or whole grain toast with a sugar-free fruit-only spread.
2. Take your time when eating. Your brain receives “full” signals slowly, about 20 minutes after you eat. So set your fork down between bites, carry on a conversation with family, play soothing music during meals, chew each bit thoroughly.
3. Bite into a slice of lemon of pickle when hunger strikes. The sour take will curb your appetite.
4. Brush your teeth if you get hungry between meals. This sends a subtle message to your brain that the time for food is just finished.
5. Post a list of small household projects on your refrigerator door. Then if you visit the refrigerator out of boredom, you may think to tackle a small chore instead of snacking. When you are busy, your mind will not be on food.
6. Use smaller plates. This makes less food look like more and you will serve yourself less.
7. Exercise in the morning. After fasting through the night, more of the calories you burn will be from stored fat. If you exercise after eating in the afternoon, most of the calories burned are from carbs you just consumed.
8. Remember that after aerobic exercise you will continue to burn calories for several hours after finishing your workout.

Also, herbs that fortify the spleen and boost the qi or that dry dampness and transform phlegm can support your dieting patients. Sign up today for access to the herbal section of our site to check out the Blue Poppy Original formula, Black Dragon.