The American Journal of Chinese Medicine

Chinese patients display an unsually high incidience of hepatocellular carcinoma, as expressed in autopsy statistics, in hepatic biopsy specimens, in terms of ratios per 100,000 population, and with regard to standarized mortality rates. As in other ethnic groups, Chinese hepatoma patients show a pronounced numerical preponderance of male over female persons. Whether this sex difference is due to the existnece of cross-reactivity between HBsAg and a male-associated antigen remains to be confirmed. Of the Chinese patients residing abroad, those that were born in China (Idai) are at considerably higher risk of developing hepatic cancer than those born in their countries of residence (Erdai). This observation, per se, strongly argues in favor of an environmental, rather than racial, factor in the causation of such tumors. Among environmental factors suspected of contributing towards the observed inter-ethnic differences in hepatoma incidence rates, parasitic infestations appear to play no role in hepatocarcinogenesis, with the possible exception of clonorchiasis which has been implicated in cholangiocellular carcinomas. Dietary factors, hepatotoxins and alcoholism at beast are of only secondary etiological significance. Cirrhosis has been considered the most important etiological factor in the development of hepatocellular neoplasms. In Chinese patients the proportion of hepatomas arising in cirrhotic livers in many times higher than in Caucasian persons. Surveys have shown that the hepatitis-associated antigen has a high incidence of occurrence in persons of Chinese ancestry, especially those that were born in China, as well as in patients with hepatomas. It has been established that Chinese-Americans are at a very high risk for both hepatitis B virus infection and liver cell carcinoma. In addition, it has been hypothesized that in some families children will be infected with the virus by their mothers during the perinatal period, and that in some cases the infected person swill proceed through several stages (carrier state with retentions of antigen; development of chronic hepatitis; elaboration of cirrhosisis) to the development of hepatocellular carcinoma. It appears, then, that infection with the hepatitis B virus, during the earlier phases of life, is the single most important event in the eventual elaboration of hepatocellular carcinoma. The available epidemioligcal data on Chinese patients constitute a significant body of evidence in support of these conclusions.

Through the Chinese drugs appearing in prescriptions for hormonal diseases which were recorded in standard medical collections in Chinese historical texts, we book for the Chinese conception of the empirical cures.

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.

This paper analyzes doctor-patient relations in Japan from an interactionist perspective, based on interviews of medical personnel and patients and on participant-observation in a number of medical institutions. After describing Japanese categories of social relationships, the author shows how, by utlizing symbolic behavior, both doctors and patients attempt to manipulate the relationship to provide a desired degree of mutual reliance.

Elementary form of nitrogen (protein), phosphorus, potassium and magnesium contained in 180 different kinds of Chinese medicines are analyzed by means of 14-MeV neutron activation technique. The percent contents of these elements in the Chinese medicines range from 0 to 34.41% (average: 11.73%) for protein, from 0.03 to 37.42% (average: 1.72%) for phosphorus, from 0.12 to 33.22% (average 2.94%) for potassium and 0.03 to 5.62% (average: 0.43%) for magnesium. Comparison of the percent results with the previous measurements for another 66 kinds of Chinese medicines is made.

This article reviews the state of research for a number of plants traditionally related to treatment of cardiovascular diseases. It stresses the importance of both anthropological surveys and historical studies for the proper understanding of this ancient and still very popular medicine.

The effects of the Chinese herb Shan-dou-gen, Euchestra formosana, on metabolic, respiratory and vasomotor activities as well as body temperature were assessed in conscious rats at various ambient temperatures. Systemic administration of Shan-dou-gen produced a dose-dependent hypothermia in rats at room temperature (22°C) and below. The hypothermia in response to Shan-dou-gen was brought about by both cutaneous vasodilatation and decreased metabolic heat production. There were no changes in respiratory evaporative heat loss. However, in the heat (30°C), administration of Shan-dou-gen produced no changes in rectal temperature or other thermoregulatory variables. Furthermore, the hyppothermia induced by Shan-dou-gen was greatly antagonized by pretreatment of animals with 5,6-dihydroxytryptamine (predominantly a depletor of central serotonin nerve fiber), but not with 6-hydroxydopamine (a relative depletor of central catecholamine nerve fiber). It appears that the hypothermic effects of Shan-gou-gen may be mediated through serotonin release within the brain.

The object of this study is to answer the question: Is acupuncture of any use in ophthalmology? Ophthalmology today can boast of 95% accuracy in diagnosis, but modern therapeutics has not caught up with diagnosis. Despite an inability to explain in modern scientific terms the healing power of acupuncture, documentation of over 500 cases treated shows that this modality can be successful in the treatment of eye diseases, especially in cases of retinitis pigmentosa, high myopia, cataracts, surgical aphakia, controlled glaucoma and re-attached ablation retinae. We notice in these cases that improvement occurs in the central acuity, and no improvement in the visual field, color-vision and nightblindness. Apparently acupuncture acts on the macula alone and not on the entire retina. Acupuncture is not intended to substitute for established medication or surgery in ophthalmology. It cannot restore a tissue or organ damaged beyond regeneration, "incurable" eye diseases per se are not cured by acupuncture. Only symptoms are relieved and dimness of vision is a symptom which can be alleviated in many cases with periodic treatment.

The present study was undertaken to evaluate if plasma or CSF β-endorphin level can be induced to rise during the treatment of heroin addiction by electroacupuncture. Based on the examination of 30 addicts, we obtained no evidence indicating an increase of β-endorphin level in either the plasma or the CSF after 30 min of acupuncture. In spite of this, the majority of the addicts experienced a reduction of withdrawal symptoms during treatment. Since electroacupuncture may only induce a highly localized secretion of β-endorphin in the brain, our results cannot unequivocally exclude the possibility that this peptide is involved in mediating the action of acupuncture.

There was increase production of adrenocortical hormones (cortisol and corticosterone) in the adrenal during three different types of stress: immobilization, exposure to heat, and exposure to cold. Such a state of hypersecretion of adrenocortical hormones was inhibited by electroacupuncture at the Tsu-San-Li (St-36) locus.

Acupuncture with electrical stimulation effectively suppresses naloxone-induced morphine withdrawal in rats and reduces the plasma levels of adrenocorticotropin and thyroid stimulating hormone.

A number of investigators have noted the presence of neural structures beneath acupuncture loci either in superficial or deep structures only, or else in both superficial and deep structures. The fact the acupuncture loci correspond to motor points and trigger points is also now well recognized. However, the presence of venous structures beneath acupuncture loci is not so well documented. The presence of a "communicating" or "perforating" vein beneath many points, and the apparent correspondence of known common sites of such veins in the lower limbs with acupuncture points in reported. It is proposed that the failure of acupuncture analgesia and acupuncture therapy in a proportion of cases may be due to the irregularity of the sites of the perforating veins, although their sites may be somewhat more fixed than sometimes thought. The absence of acupuncture points in areas where there is also known absence of perforating veins, e.g. bony areas such as the medial subcutaneous surface of the tibia, is also put forward as "negative" supporting evidence for the relationship between acupuncture loci and perforating veins. Moreover the more recent "discovery" of so many new or "strange" acupuncture loci may be due to the irregularity of the sites of these veins in many people. It is proposed that the nature of acupuncture loci is actually two holes, one in the dermis due to a neurovascular bundle or nerve piercing it, and one (or even more) directly beneath it (although separated by subcutaneous tissue) in the deep fascia due to a perforating vein, neurovascular bundle or nerve piercing it. The correspondence of these holes may allow relatively greater passage of biological electrical current from deeper tissues to the surface of the body, and autonomic nerves at these points may thus be involved in monitoring this current for purposes of homeostasis.

The acupuncture treatment situation was beneficial to the majority of people with how back pain. This was shown by the use of the short-term controls and long-term controls, although the later were not intended in the study design. After acupuncture, there was a 51% pain reduction in the average pain score in the Immediate Treatment Group. This short-term controls, the Delayed Treatment Group, had no reduction whatsoever in their pain scores at the comparable followup period. Later, the Delayed Treatment Group were also treated by acupuncturists, and reported 62% less pain. When these two treatment groups were compared at 40 weeks with long-term controls (Inadequate Treatment Group), the Inadequate Treatment Group still had the same pain scores, on the average, as when they were enrolled in the study. Both treatment groups, on the average, had 30% lower pain scores. Furthermore, 58% of the treatment groups felt that they were definitely improved at 40 weeks, while only 11% of the Inadequate Treatment Group felt definitely improved at 40 weeks.

In prospective, random assignment of 2 groups of 15 patients, relief of postoperative pain with narcotic medications was evaluated and compared with transcutaneous electrical nerve stimulation (TENS) for 2 days immediately following surgery. Presence of ileus and hospital stay were identifical in both groups. Patients on TENS demonstrated a marked significant decrease in the amount of narcotics administered. There was favorable nursing, physician and patient acceptance to these devices. Further clinical evaluation is, therefore, in progress.