ATMS Journal Autumn 2015

Journal of the

Australian Traditional Medicine Society

A New Homoeopathic Tool: The Candegabe Algorithm social media comments

Australian Wheat

Its Role in Food Security, Politics and Diet-related Disease

Volume 21 | Number 1 | Autumn 2015

The Art of Traditional Medicine: Implications for Education More Research on Homoeopathy

Endometriosis and the Herbal Medicine approach to Treatment

ISSN 1326-3390

Health Fund News | New Research | Book Reviews

科 學 濃 縮 中 藥

02 9634 1800

info@yeschinaherb.com

www.yeschinaherb.com

科 學 濃 縮 中 藥

Journal of the

Australian Traditional Medicine Society Volume 21 | Number 1

Contents AUTUMN 2015

47

MEDICAL QIGONG WORKSHOP IN HOBART B. PEARSON

05

PRESIDENT’S MESSAGE | B. TANNOUS

26

06

UNANI TIBB J. WOLLUMBIN

08

30

48

PRACTITIONER PROFILE T. ACHESON

CEO’S REPORT | T. LE BRETON

LETTER TO THE EDITOR

REPORTS

THE ART OF TRADITIONAL MEDICINE PART 1: IMPLICATIONS FOR EDUCATION J. SLEEMAN

ARTICLES

10

ENDOMETRIOSIS AND THE HERBAL MEDICINE APPROACH TO TREATMENT T. HARRIS & A.M.VLASS.

50

LAW REPORT

52

34

AUSTRALIAN WHEAT: ITS ROLE IN FOOD SECURITY, POLITICS AND DIET-RELATED DISEASE D. FERREIRA

16

NECK PAIN AND TREATMENT STRATEGIES G. P. KOUSALEOS

22

MORE RESEARCH ON HOMOEOPATHY R. MEDHURST

38

RECENT RESEARCH

56

BOOK REVIEWS

NEWS

58

HEALTH FUND UPDATE

A NEW HOMOEOPATHIC TOOL: THE CANDEGABE ALGORITHM R. CAMPBELL

HEALTH FUND NEWS

44

PRODUCTS & SERVICES GUIDE

UNDERSTANDING KINESIOLOGY J. BEASLEY

59 65 70

CONTINUING EDUCATION

JATMS | Autumn 2015 | 3

The Australian Traditional-Medicine Society Limited (ATMS) was incorporated in 1984 as a company limited by guarantee ABN 46 002 844 233.

ATMS HAS THREE CATEGORIES OF MEMBERSHIP

Accredited member Associate member Student membership is free MEMBERSHIP AND GENERAL ENQUIRIES

ATMS, PO Box 1027 Meadowbank NSW 2114 Tel: 1800 456 855 Fax: (02) 9809 7570 info@atms.com.au www.atms.com.au PRESIDENT

Betty Tannous | betty.tannous@atms.com.au VICE PRESIDENTS

Stephen Eddey | stephen.eddey@atms.com.au Greg Morling | greg.morling@atms.com.au CEO

Trevor Le Breton | trevor@atms.com.au TREASURER

Antoinette Balnave | antoinette.balnave@atms.com.au DIRECTORS

Peter Berryman | peter.berryman@atms.com.au Daniel Zhang | daniel.zhang@atms.com.au Maggie Sands | maggie.sands@atms.com.au Sandra Grace | sandra.grace@atms.com.au Robert Medhurst | robert.medhurst@atms.com.au Jesse Sleeman | jesse.sleeman@atms.com.au Brad McEwen | brad.mcewen@atms.com.au Christine Pope | christine.pope@atms.com.au

LIFE MEMBERS

Dorothy Hall* - bestowed 11/08/1989 Simon Schot* - bestowed 11/08/1989 Alan Jones* - bestowed 21/09/1990 Catherine McEwan - bestowed 09/12/1994 Garnet Skinner - bestowed 09/12/1994 Phillip Turner - bestowed 16/06/1995 Nancy Evelyn - bestowed 20/09/1997 Leonie Cains - bestowed 20/09/1997 Peter Derig* - bestowed 09/04/1999 Sandi Rogers - bestowed 09/04/1999 Maggie Sands - bestowed 09/04/1999 Freida Bielik - bestowed 09/04/1999 Marie Fawcett - bestowed 09/04/1999 Roma Turner - bestowed 18/09/1999 Bill Pearson - bestowed 07/08/2009 * deceased HALL OF FAME

Dorothy Hall - inducted 17/09/2011 Marcus Blackmore - inducted 17/09/2011 Peter Derig - inducted 17/09/2011 Denis Stewart - inducted 23/09/2012 Garnet Skinner - inducted 22/09/2013 Copyright 2015. All rights reserved. The opinions expressed in this journal are those of each author.

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President’s Message Betty Tannous | ATMS President

I

t is my distinct honour and pleasure to write my first President’s report for the Australian Traditional Medicine Society’s Journal.

My vision is to see ATMS retain its place as the leader in the complementary health industry. ATMS represents the professionals, and it is important that I and the rest of the Board represent you, the members, and promote a sense of professional esteem and an identity that the public will feel confident and eager to consult with.

As President, I wish to acknowledge the new Board and the work that the previous Board has done. The 2015 ATMS Board of Directors has a rich, talented and skilled membership.

With the talent that is available and the desire to work collaboratively, my role will be to guide and support the committees and their various ideas, while providing a strong ground for those ideas to grow in.

In the next two years I hope to create a culture where employees and members are happy and proud to be part of the ATMS family. This will be accomplished by continued communication and transparency with members.

“With the talent that is available and the desire to work collaboratively, my role will be to guide and support the committees and their various ideas, while providing a strong ground for those ideas to grow in.”

ATMS continues to flourish and we will be continuing the wonderful work already undertaken, with media campaigns and an increase of our on-line presence through social media and blogs to raise the profile of the association.

The new website looks amazing, is very professional and will offer members a wide range of opportunities.

In the next few years we also face many challenges, including changes in the education sector, the ongoing relationships with health funds and attacks by sceptics on natural therapies.

I am confident that through the new Board, the CEO Trevor Le Breton, the wonderful staff in the office and you the members these challenges will be overcome.

In closing I would like to pay tribute to the outgoing President, Maggie Sands, who has diligently given her time for the good of the association. I am pleased that Maggie will remain on the board and we will benefit from her years of experience.

As we head toward this new chapter of the Association, may the wind be at our back and may we have a smooth ride ahead.

Betty Tannous President

“With the new Board and its roles now established, I look forward to getting down to work for our members and advancing the professions of ATMS and the Association as the leader of Natural Medicine in Australia.”

CEO’s Report Trevor Le Breton | Chief Executive Officer

W

elcome to the Autumn 2015 Edition of JATMS. Much has been going on at ATMS and within our industry since the last Journal.

New Office Bearers Following the meeting of the Board of Directors, on Sunday 1 March, it is my great pleasure to announce the positions of Chairperson (President), Vice-Chairpersons (Vice-Presidents), Treasurer and Company Secretary. After careful deliberation, a ballot was undertaken by the new Board of Directors which resulted in the election of Betty Tannous as Chairperson as of 28 February 2015. Please join us in welcoming Betty to this integral role.

With extensive experience as a successful business consultant and remedial massage and homoeopathic practitioner, Betty’s advanced IT, project management and small business expertise, coupled with a diverse understanding of the natural medicine industry, will be an invaluable asset to ATMS and its members.

Stephen Eddey and Greg Morling were elected Vice -Chairpersons, Antoinette Balnave Treasurer, and I will continue in the role of Company Secretary.

The Board also resolved for stability purposes that these appointments be for a period of two years, until the first meeting of the directors after the 2016 AGM. ATMS

6 | vol21 no1 | JATMS

would like to extend our sincerest thanks to former Chairperson Maggie Sands for her contributions to the Association in this role since May 2013. Maggie has been a vocal and passionate advocate for ATMS and the industry. Her dedication is greatly appreciated.

With the new Board and its roles now established, I look forward to getting down to work for our members and advancing the professions of ATMS and the Association as the leader of Natural Medicine in Australia.

Are your details correct?

If you are not receiving copies of our emails or the Journal perhaps you have changed your email address or have moved and forgotten to tell us. As I get around from group to group I am amazed at the number of times members say they never know what is going on – but when asked if they have moved or opted out of our newsletter the answer nine times out of ten is yes.

So, keep in touch and contact the support office team on 1800 456 855 and stay up to date!

Happy Year of the Goat A very belated but heartfelt Happy New Year to our members of Asian backgrounds. Thank you to those who attended our New Year celebration training

event held on February 8 in Sydney, where over 160 members were present. Thanks to speakers Fiona Liu and Daniel Deng and to Director Daniel Zhang for his passionate commitment to ensuring the success of this event.

Member Forums During the past weeks we have been undertaking Member Forums to ask members their opinions on ATMS - how are we going, how can we improve and what they are looking for going forward? The key outcomes of these forums were shared with the Board at its last meeting. The next step will be to undertake a broader quantitative study of members to ensure the results are representative before they are adopted into our Strategic Plan.

NTRAC REVIEW As reported previously, the final report of the Natural Therapies Review into the efficacy, cost effectiveness and safety of 17 modalities was submitted to former Minister for Health, Peter Dutton, on 3 November 2014. As part of the review, The Office of the National Health and Medical Research Council (ONHMRC) conducted a comprehensive literature review of natural therapies between May 2008 and May 2013, and assessed evidence provided by 46 organisations and individuals such as ATMS.

The purpose of the review was to ensure that those natural therapies that are paid through the Rebate on Health Insurance are underpinned by a credible evidence-base that demonstrates their clinical efficacy, cost effectiveness, safety and quality to support consideration of whether they should be supported by the rebate.

The one key conclusion from the review came from the Chief Medical Officer, who stated that the absence of evidence does not mean that the therapies evaluated do or do not work. It means that there is simply no high quality research available for these therapies.

Since the report was tabled there has been a change in Minister, with the Prime Minister announcing his cabinet reshuffle last Christmas. Ms Sussan Ley has been appointed Minister and has made no further progress with the report. Her announcement on Friday 27 February that Health Fund premiums would increase by approximately 6.2% or $200 per annum was a further sign that no definitive decision on rebates for natural therapies is imminent.

Despite calls to run petitions to lobby the government or make representations the Board and Management of ATMS are not in favour of this approach. As one of the privileged associations to represent the industry on the review we are bound by a confidentiality agreement as to its outcomes. One aspect which was abundantly clear throughout the review was the methodology adopted and the apparent dearth of research in key modalities provide the ATMS Research Committee with a clear agenda for the future. As a starting point the Board of ATMS resolved at its recent meeting to use the funds set aside annually for the Simon Schot awards to fund ongoing research in the industry.

EDUCATION UPDATE It has been a busy time on the education front. Since the last Journal ATMS has endorsed the revised training packages in Massage, Ayurveda Medicine, Aromatherapy and Kinesiology. These

changes will be endorsed shortly, before RTOs are advised to commence teaching the new package.

Despite the decision by other associations and the Community Services and Health Industry Skills Council to remove Advanced Diplomas as an entry pathway into the industry for homoeopathy, naturopathy, western herbal medicine and nutritional medicine, the Board of ATMS recently resolved that it will continue to recognise the qualification for admission to ATMS as a member.

However, ATMS cannot guarantee these members the ongoing recognition of their qualifications by Health Funds and reaffirms our commitment to work with industry to retain this recognition while working with other associations for the development of degree level qualifications which meet the entire requirements of industry.

Accredited Membership - what does it mean for me?

I thought it timely to once again remind all Accredited Members of the four simple steps they need to take in order to ensure that their status as Accredited Members is maintained.

Step 1 – Ensure you are a financial member of ATMS – payment is due annually on 1 July Step 2 – Agree to and ensure compliance to undertake 20 hours (equivalent to 20 points) of Continuing Education Step 3 – Have a Certificate of Currency with adequate cover for Personal Indemnity and Public Liability Insurance Step 4 – Have a current First Aid Certificate (not just CPR but the entire course) renewed every three years.

If you have the above in place you will ensure continuity with Health Funds and maintain your status as an Accredited Member. Remember, if you have a qualification that does not satisfy the Health Training Package and you do lose

your status, ATMS cannot guarantee your ongoing recognition by the Health Funds.

At the recent Board meeting several new membership categories were discussed and these will be refined with a view to their launch before the new membership renewal cycle in June 2015.

GST The office is regularly asked about GST, and what ATMS is going to do to influence the government to change its current position.

The answer is both complex and at the same time simple. The present government (and I suspect governments of the immediate future) will remain essentially ‘broke’, that is, they have limited income for their huge outgoings.

Currently the following natural therapies listed under the GST Act are: • Acupuncture • Chiropractic • Herbal medicine including Chinese herbal medicine and Ayurvedic Medicine • Naturopathy • Osteopathy

Is massage therapy GST-free?

Massage therapy is not GST-free because it is not listed in the GST Act. However, massage therapy is GST-free where it is: • Supplied as part of a GST-free listed complementary health service • Supplied by a recognised professional in that listed complementary health service who is trained in massage therapy • Considered by the listed complementary health service profession to be a standard technique or component of that listed complementary health service, and • Accepted by the listed complementary health service profession as being necessary for the appropriate treatment of the recipient In recent times the present Coalition Government has speculated about actually increasing the GST as it applies to Goods and Services, so the notion of removing the GST on massage, or of increasing the

JATMS | Autumn 2015 | 7

CEO’S REPORT

GST-free threshold from $75,000pa, as it presently stands, is extremely unlikely, as several Ministers have intimated.

LETTERS

If you need more information about when natural medicine services are GST-free visit the ATO website at www.ato.gov.au

Health Funds We were audited for all modalities by Medibank in mid-February and await the outcome of this. We have also recently been in discussions with BUPA regarding criteria for Remedial Massage and accreditation for an expansion of modalities covered by this insurer.

ATMS reviewing its policies One of the first steps of the new Board and Management is working together to ensure that our policies for members are relevant and up to date. A review has been undertaken and, with the assistance of Frequently Asked Questions from members, development of a set of policies which can be clearly understood and implemented by members of all modalities has commenced.

As a feature of the development of these policies small work groups of members will be called upon to review each policy to ensure it is clearly understood, and most importantly, be able to be implemented.

Once developed the policies will be sent to members and uploaded to the website under the MEMBERS ONLY section.

Easter office closing: the support office at Meadowbank will be closed from 5pm on Thursday 2 April and reopen at 9am on Tuesday 7 April 2015. The staff will be taking a well-earned break as it has been a rather hectic start to the New Year.

As always I welcome your views and comments on any issue. You can call me on 1800 456 855 or send an email to trevor@atms.com.au Take care …

Trevor Le Breton Chief Executive Officer MBA, BBus (Marketing), GAICD, Dip OHS

8 | vol21 no1 | JATMS

Dear Editor, JATMS Summer 2014 contains a fascinating insight into the challenges we confront regarding the appropriate use of practitioner-only products (POPs). This well-written article contains some amazing concerns about the future of our POP prescribing and support.

I share the concerns expressed as to the inappropriate and unprofessional supply of these products, but unless our industry agrees to a uniform approach, the dollar will always rule, and the interests of the patient will be pushed aside. POPs have different labelling requirements, and that must mean that a label should be attached with specific instructions. That in turn might mean a “mini-consultation” with appropriate recording of patient details and a professional fee which could be included in the cost of the product sought.

The ready supply of POPs, especially in a community or “retail” pharmacy setting, defies logic, especially from a group of so-called health professionals who have trouble managing their own “pharmacist-only medicines” within their pharmacy. This group of overthe-counter medicines require specific and meaningful intervention by the pharmacist, and in many cases, this requirement is not met appropriately.

Indeed, many of these products might also need the short consultation, labelling and recording similar to POPs. The relegation of POPs to general items of commerce alongside the everexpanding complementary medicine

products is a disgrace. The industry can’t be all things to all men. Either self-regulation and professionalism are regained, along with an agreement as to a structured supply arrangement (mini-consult, record, label) or we open the gates to destroy POPs. POPs are a precious opportunity to satisfy the expectations of our patients. Being challenged by a patient to justify a difference in perceived price is not a pleasant experience, but pharmacists seem to be going out of their way to deliberately grab the retail opportunity. Most pharmacists have no training in POPs or even complementary medicines to any extent, yet freely sell them.

Perhaps the companies with a strict POP policy can be regarded as trail blazers at this time, whilst others can continue to supply every outlet without restriction as to their competence.

More importantly, as various academic groups seek to “medicalise” our herbs and nutrients, the industry must offer a united voice every time an aggressive statement is released to the media, as is happening with homoeopathy currently. In most cases, the response from our industry seems to be complete silence.

POPs give us the unique opportunity to be taken seriously.

For goodness sake, let’s be proud of our heritage, our training, our integrity and more especially our results.

Gerald Quigley ATMS Member 10368 Malvern, VIC

February - March 2015 Fe 5 WHAT YOU WILL LEARN FROM ATTENDING THIS SEMINAR: • Understand the types of interactions which can occur and learn how to assess the safety of prescribing natural medicines for your patients on conventional medications.

• Discover natural remedies with proven clinical evidence of safety and efficacy which can improve your clinical outcomes.

• Identify the real and significant risks all natural medicine Practitioners must be aware of to ensure safe prescribing.

• Recognise how poor nutritional status may actually contribute to adverse drug reactions, and how you can protect your patients.

• Learn how to counter side effects and address ethical and practical concerns around drug weaning with clear guidelines and implications for your practice.

• Discuss how to communicate effectively with medical Practitioners, focussing on patient-centred care, collective decision making, minimising risk and increasing benefits to your patients.

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METAGENICS UPDATE | FEBRUARY / MARCH 2015

1

MET4013 - 01/15

PROUDLY PRESENTED BY

ARTICLE

Endometriosis

and the Herbal Medicine Approach to Treatment Thomas Harris | BSc (Hons) Ph.D Ann Monica Vlass | BSc (Hons); BHSc (Nat); Adv. Dip Herbal Medicine; Adv. Dip Nutrition

Pathophysiology of endometriosis Abstract Endometriosis is a heterogeneous and oestrogendependent inflammatory disease characterised by morphological and biologically active endometrium (composed of endometrial-type glandular tissue and stroma) that is present in sites outside the uterine cavity. The disease is complex, with tissue implantation occurring as a result of a phenomenon known as retrograde menstruation. Although this is considered central to the pathogenesis of endometriosis, 90% of women who experience this event do not have endometriosis. However, the remaining 10% of this population do. Alterations in the immune system (increased TNF-Îą, PGE2 and reduced NK cells), excess inflammation and high oestrogen levels play a role in establishing endometrial implants. Given the multifactorial nature of the condition a range of herbal medicines has been identified to treat the different clinical symptoms and underlying cause of endometriosis. The following review will examine the pathophysiology of endometriosis and the herbal medicine approach to treatment.

10 | vol21 no1 | JATMS

Endometriosis is a heterogeneous and oestrogen-dependent inflammatory disease characterised by morphological and biologically active endometrium (composed of endometrialtype glandular tissue and stroma), that is present in sites outside the uterine cavity.1 The condition occurs in women during the reproductive years.2 The most common locations for endometriotic deposits are the ovaries and pelvic peritoneum.

Sites to which this type of tissue attaches include the uterosacral ligaments (63%), ovaries superficial (56%) and deep (20%), ovarian fossa (33%), anterior vesical pouch (22%), Pouch of Douglas (19%) and intestines (9%).3 The location of, and inflammatory response to, these lesions are believed to play a key role in the manifestation of the signs and symptoms of endometriosis.

Tissue implantation occurs as a result of a phenomenon known as retrograde menstruation, first described by Sampson in 1927.4 Although this is considered central to the pathogenesis of endometriosis, 90% of women who experience this event do not have endometriosis, but the remaining 10% do.2, 5 Immune system responses may explain why some women develop endometriosis and why others do not. It has been proposed that alterations in immune function, particularly cellular immunity, play a critical role in establishing endometrial implants and their sustained growth and development.6 There is a number of theories that purport to explain the aetiology of endometriosis: 1. Sampson’s theory of transplantation and implantation through the fallopian tubes and into the peritoneum during menstruation.

2. Meyer’s theory, suggesting that metaplasia of the coelomic epithelium is the origin of endometriosis.

3. Halban’s theory, suggesting that distant lesions are established by the haematogenous or lymphogenous spread of active endometrial cells.

Clinically, there are three distinct forms of endometriosis: 1. Peritoneal endometriosis, where the endometrial implants are on the surface of the pelvic peritoneum and ovaries.

2. Endometriomas, where ovarian cysts are lined by endometrioid mucosa.

3. Retrovaginal endometriotic nodule, comprising a solid mass that is composed of adipose and fibromuscular tissue, that is commonly found between the rectum and vagina.6 Endometriosis can be classified in four levels of severity: Stage 1 minimal, Stage 2 mild, Stage 3 moderate and Stage 4 severe disease, as defined by the American Fertility Society’s classification system.7 However, these stages do not directly correlate with clinical symptoms like pain, dyspareunia or fecundity rate.8 Endometriosis has been reported to occur in association with other medical conditions, including headaches, arthralgia, allergies, atopic reactions, hypothyroidism, fibromyalgia, chronic fatigue syndrome and vaginal candidiasis.9 The common histological features of endometriosis are endometrial stromal or epithelial cells, chronic bleeding and signs of inflammation. It is important to note that endometriosis has a number of features common to neoplasms including uncontrolled growth, angiogenesis, invasion of adjacent tissues, defective apoptosis and sustained local inflammatory responses.10 Although a number of body systems and organs can be involved in the signs and symptoms of endometriosis, the reproductive ones are most typical and include cyclic or non-cyclic chronic pelvic pain, dysmenorrhoea, mittleschemertz, dyspareunia, metrorrhagia, post-coital and premenstrual spotting, menorrhagia, menstrual clotting and infertility. Vaginal, urinary and gastrointestinal symptoms closely associated with reproductive symptoms include vaginal thrush prior to menses, catemenial diarrhoea, rectal discomfort, dyschezia, and rectal bleeding. Endometriosis may be asymptomatic, especially if the disease is isolated to the peritoneum. The severity of symptoms and probability of diagnosis increase with age.11 The dysmenorrhoea associated with endometriosis can commonly be accompanied by other symptoms, including fever, nausea, vomiting, tachycardia, headaches, fatigue or lightheadedness, and diarrhoea. Affected women experience sharp, intermittent spasms centred in the suprapubic area during menstrual bleeds.

The pain can radiate to the back of the legs or the lower back, and has been reported to occur in 76% of adult women12 and 94% of adolescent women diagnosed with endometriosis.13

“ALTHOUGH A NUMBER OF BODY SYSTEMS AND ORGANS CAN BE INVOLVED IN THE SIGNS AND SYMPTOMS OF ENDOMETRIOSIS, THE REPRODUCTIVE ONES ARE MOST TYPICAL AND INCLUDE CYCLIC OR NON-CYCLIC CHRONIC PELVIC PAIN, DYSMENORRHOEA, MITTLESCHEMERTZ, DYSPAREUNIA, METRORRHAGIA, POST-COITAL AND PREMENSTRUAL SPOTTING, MENORRHAGIA, MENSTRUAL CLOTTING AND INFERTILITY”.

The dysmenorrhoea associated with endometriosis or during menses is attributed to alteration in cellular immunity. This is evident in excess production of prostaglandins (Class PGE2 and PGF2-α) that are secreted into the endometrium, which increase uterine contractility and cause uterine hypoxia and the subsequent pelvic pain.9 It has been proposed that direct invasion of the retrograde endometrial cells to the pelvic nerve activates the innate immune system and the release of humoral factors that play a role in inflammatory oedema, including the recruitment of phagocytic cells, macrophages, cytokines and prostaglandins. These cells and their mediators stimulate the afferent nerve fibres that carry signals to the brain, where they are interpreted as pain.

Oestrogen plays a critical role in endometriosis. Although endometriosis is a multifactorial disease much research points towards oestrogen being involved in its establishment and maintenance.10, 14, 15, 16 Oestrogen promotes a feedback mechanism that induces key steroidogenic genes, most notably aromatase (which catalyses the conversion of testosterone to oestrogen) and the over-expression of cyclo-oxygenase 2 (which produces the prostaglandin E2) that promotes local inflammation.

Inflammation is a doubled-edged sword, as it triggers the regulated destruction of tissues, but also initiates and guides endometrial repair.(10) Oestrogens in particular have recently been shown to act on signalling pathways of macrophages that sustain the underlying inflammation, causing the release of a range of cytokines, most notably tumour necrosis factor –α (TNF–α), that perpetuate the inflammatory response.10 It has been reported that women with endometriosis have increased numbers of macrophages in the peritoneal fluid, indicating altered function.9, 10 Macrophages produce excess quantities of cytokines (TNF-α, IL-1 and IL-6) that create the inflammatory drive in endometriosis, contributing to its pathology. Endometriosis has recently been considered a disease

JATMS | Autumn 2015 | 11

ARTICLE

of the macrophages.10 Macrophages also produce other products such as matrix metalloproteinases, which are responsible for degrading extracellular matrix, thus directly contributing to the growth and development of ectopic implants.10 Other immune cells shown to be altered in this disease include the natural killer cells. Their activity is significantly reduced in endometriosis, and with this reduced activity comes the inability of these cells to be able to undertake immunological surveillance, accounting for the inability to clear and remove the retrograde endometrial cells.6, 9

Herbal medicines used in the treatment of endometriosis There is a range of therapeutic goals that can be addressed by using herbal medicines for women with endometriosis. In order to treat aspects of cellular immunity effects, it is important to improve relative oestrogen excess, which triggers a pro-inflammatory cascade, and to overcome immune system irregularities. When oestrogens are continuously unopposed, the immune system will not regulate, so opposing them must be a primary treatment aim.

Prostaglandin synthesis must be regulated to ensure normal uterine function and healthy flow of menstruation.

found herbs such as soy, red clover, hops and licorice contain large amounts of measurable oestrogen that is bioactive.22 On the other hand, herbs like dong quai, chase tree berry and black cohosh did not contain any bioactive forms of oestrogen.22 Herbal medicines have been used to promote a hypooestrogenic peritoneal environment, which is an important treatment consideration to prevent the ongoing growth and advance of the disease. This is most effectively achieved by reducing the expression and or activity of the aromatase enzyme. The activity of this enzyme is increased in endometriosis and causes a marked increase in the locally bioavailable E2 concentration, and consequently the production of PGE2.17 It should be noted that this is a positive feedback mechanisms, greater concentrations of E2 leading to higher concentrations of PGE2.17 The use of aromatase inhibitors for the systemic and local inhibition of oestrogen biosynthesis has shown promising results in the treatment of endometriosis.23

For many women with endometriosis, pain is the single most debilitating factor of their condition.17 Since inflammation plays an important role in the pathophysiology of endometriosis in relation to pain, herbs with anti-inflammatory actions are critical considerations.18, 19, 20 Although not as fast-acting as conventional medications, repeated acute dosing (e.g. hourly doses) often leads to temporary alleviation of pain.21 Other associated and complex symptoms that can be treated with herbal medicines include general fatigue, anxiety, depression, genito-urinary infections, irritable bowel syndrome and chronic fertility problems.21

Endometriotic lesions contain oestrogen, progesterone, and androgen receptors. Oestrogen receptor (ER) β levels in endometriosis are >100 times higher than those in endometrial tissue. Elevated ERβ suppresses ERα expression.

A severely high ERβ-to-ERα ratio in endometriotic stromal cells is associated with suppressed progesterone receptors and increased cyclo-oxygenase-2 levels. This biological phenomenon contributes to progesterone resistance and inflammation 24. Therefore, herbs that counteract progesterone resistance and inflammation would be of benefit in the treatment of endometriosis (see Table 1).

Therapeutic Aims

Improving liver metabolism and bile flow

Reducing unopposed oestrogen growth-promoting effects

Conjugating oestrogen from the body should be considered.

Treatment approaches should include a detoxification therapy that uses drainage remedies for the pelvic system and the liver, employing cholagogues, choleretics, hepatics, diuretics, and lymphatic cleansers.

Hormone modulation is an important treatment consideration for endometriosis, given that local production of oestrogen in ectopic endometrium and the systemic availability of oestrogen promote the growth and development of this abnormal tissue. A relative oestrogen to progesterone ratio imbalance causes PMS-type symptoms and is associated with the abnormal production of the endometrium.

A number of herbal medicines have been shown to modulate or ‘competitively inhibit’ oestrogen response, although care needs to be taken here as there is limited evidence for the use of herbal medicines and changes that occur in the endocrine system in patients with endometriosis.17 According to Bone and Mills21 those herbs that have estrogenic effects should be avoided in endometriosis, as excess oestrogen intake would aggravate the condition (this argument would extend to plantbased phyto-oestrogens consumed in the diet). One research study that classified herbs based on their oestrogen activity

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Improving uterine tone to promote healthy menstrual flow

Prostaglandin balance affects uterine tone and is responsible for healthy menstruation. Imbalance in prostaglandin production can lead to problems with retrograde flow and the intensity and type of menstrual pain associated with endometriosis. Consequently, it is important to rectify this imbalance as a causative factor.

Uterine tonics regulate uterine contractions and tone.

Spasmolytics reduce excessive and abnormal spasms of the uterus, thereby relieving pain and ensuring orderly uterine evacuation. Emmenagogues or uterine stimulants encourage an expulsive uterine contraction and are useful

in endometriosis when menstrual flow is sluggish (thick, tarry, black) and when congestive symptoms are apparent (e.g. heavy dragging pain with late onset menstruation).

Emmenagogues are always prescribed with uterine tonics to reduce the likelihood of retrograde menstruation, ease pain and regulate menstruation.7

Table 1.

HERBAL ACTION

HERBS AND DOSAGE

Aromatase inhibitors

Urtica dioca (15-40 ml/week) Camellia sinensis (1 cup per day, 50mg EGCG) Serenoa serrulata (15-30 ml/week)

Progesterone support

Vitex angus castus ( 6-18 ml/week) Rehmannia glutinosa (30-60 ml/week) Bupleurum falcatum (25-60 ml/week) Coleus forskohlii (40-90 ml/week)

Anti-proliferative

Corydalis (20-40 ml/week) Salvia miltiorrhiza (40-60 ml/week)* Cinnamon (20-40 ml/week) Chinese angelica (40-60 ml/week) Glycyrrhiza Glabra (15-40 ml/week) Myrrh (10-30 ml/week) White peony (30-60 ml/week)

Herbal medicines can be used to decrease cytokines and increase NK cell function, increase phagocytosis, provide antioxidant support, and inhibit both growth factors and angiogenesis.

Uterine tonic

Angelica sinensis (30-60 ml/week) Cimicfuga racemosa (10-20 ml/week) Chamaelirium luteum (15-50ml/week)

Emmenagogue

Artemesia vulgaris (5-20 ml/week)

Traditionally lymphatic drainage herbs, prescribed for lymphatic congestion, have immune-stimulating effects.

Symptoms of lymphatic congestion include lower pelvic discomfort, heaviness and dragging-down type pain.

Spasmolytic

Viburnums (15-30 ml/week) Paeonia lactiflora (30-60 ml/week) Corydalis ambigua (20-40 ml/week)

Immune regulation (includes increased phagocytosis, anti-inflammatory, increased NK cell function)

Zingiber officinale (5-15 ml/week) Boswellia (200 to 400mg per day)* Echinacea species (20-40 ml/week) Astragalus (30-60 ml/week) Withania somnifera (35-90 ml/week) Paeonia lactiflora (30-60 ml/week) Rehmannia glutinosa (30-60 ml/week) Curcumin Longa (35-100 ml/week)

Anti-oxidants

Angelica sinensis (30-60 ml/week) Camellia sinensis (1 cup per day, 50mg EGCG) Curcumin Longa (35-100 ml/week)

Anti-angiogenesis

Camellia sinensis (1 cup per day, 50mg EGCG) Curcumin Longa (35-100 ml/week)

Lymphatic drainage

Calendula offinalis (10-30 ml/week) Phytolacca decandra (1-7 ml/week) *

Anti-adhesive

Calendula officinale (10-30 ml/week) Curcuma longa (40-100 ml/week) Echinacea species (20-40 ml/week) Gotu Cola (20-40 ml/week) Salvia miltiorrhiza (40-60 ml/week)*

Regulate immune function

There is a number of aims in regulating immunity with herbal medicines, since the immunological aetiology of endometriosis seems to involve a complex interplay of hyperimmune, autoimmune, and hypoimmune factors.17, 19 Individual variations of presentation and constitution (e.g. depletion, susceptibility to colds and flu, repeated vaginal infections, atopic conditions, rheumatoid arthritis tendencies prior to menstruation) will need to be evaluated as they will provide an overall picture of the clinical conditions and the degree of immune dysregulation.

Alleviate inflammation

Inflammation is a major presentation of endometriosis, and as pro-inflammatory mediators such as NF-Kappa B play a key role in promoting and maintaining abnormal growth of the endometrial tissue, herbal treatment approaches will consider anti-inflammatory and antioxidant actions to down-regulate growth factors and inflammatory mediator signalling, and further disable downstream signalling of other chemical/ chemotaxis involvement. Anti-inflammatory effects will provide symptomatic pain relief and aid improved uterine tone and healthy menstrual flow.

Soften adhesions

Adhesion formation, commonly associated with endometriosis, is related to the production of the prostaglandin series 2 inflammatory mediators and a build-up of white blood cell debris in the pelvis. Herbal treatments aim to reduce and soften adhesion formation with anti-adhesive, antiinflammatory, vulnerary and lymphatic drainage herbs.

Some Principal Herbs to Consider Table 1 below shows the actions of herbs with their recommended dosages used in the treatment of endometriosis.

Dosage obtained from Bone27; * Dosage obtained from Bone and Mills21

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Herbal considerations for acute and chronic pain relief Providing pain relief for women undergoing endometriosis treatment for underlying cellular disruptions is imperative, as pain can be the single most debilitating aspect of this condition after infertility. The pain experienced during endometriosis is probably caused by abnormalities in cyclooxygenase 2 enzyme, and high levels of inflammatory mediators, including TNF-Îą, IL-1, PGF-alpha and PGE2. Changes in prostaglandin production can explain major symptoms of primary dysmenorrhoea as well as increased uterine muscle contraction, lack of blood flow to the uterus (causing ischemia) and the lowering of the pain threshold.

Pain may be increased during menstruation as the inflammatory mediators are at their highest point in the reproductive cycle.

Herbs with analgesic, anti-spasmodic, general warming and sedative actions are used for generalised or local pain of aching or sharp quality.

These underlying issues play a role in the pain and discomfort commonly reported in endometriosis.

References 1. Darrow SL, Vena JE, Batt RE, Zielezny MA, Michalek AM, Selman S. Menstrual cycle characteristics and the risk of endometriosis.

Epidemiology. 1993;4(2):135-42.

2. Olive DL, Schwartz LB. Endometriosis. The New England journal of medicine. 1993;328(24):1759-69.

3. Young, V.J., Brown, J.K., Saunders, P.T. and Horne, A.W. (2013). The role of the peritoneum in the pathogenesis of endometriosis. Human Reproduction Update. 2013;19(5): 558-569.

4. Sampson, J.A. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol. 1927; 4:422-469.

Herbs with these benefits include black cohosh, corydalis, pulsatilla, dong quai, ginger and Jamaican dogwood. Herbs such as corydalis, Jamaican dogwood and pulsatilla are generally prescribed for moderate to severe pain.17 Jamaican dogwood is a herb that has reliable spasmolytic, analgesic and mild sedative properties.17 This herb is particularly beneficial for the pelvic pain and dysmenorrhea associated with endometriosis. Pulsatilla is prescribed specifically when the patient presents with ovarian pain. Dong Quai has analgesic, antispasmodic and anti inflammatory actions and may be useful for dull and aching pain.17 Dosages for these herbs to counteract mild to severe pain have been described elsewhere by Romm.17

5. Ulukus M, Arici A. Immunology of endometriosis. Minerva ginecologica.

2005;57(3):237-48.

Other herbal choices for pain used by eclectics for endometriosis are: Helonias or False Unicorn root (Chamaelirium luteum), useful for pelvic engorgement, aching, propulsive pain and a bearing down feeling; Blue Cohosh (caulophyllum thallictroides) for constant, cramp-like endometrial pain; and Wild Yam (Dioscorea villosa) for endometriosis of the fallopian tubes with painful cramping and ovarian colic.17 Dioscorea contains steroidal saponins, phytosterols, alkaloids and tannins and displays antispasmodic and anti-inflammatory properties that may be of use in endometriosis to help relieve disabling cramps in the pelvic area as well as aches around the rest of the body, such as the back.26 A dosage of 20-30 mls per week has been outline by Bone and Mills21, p293.

9. Eisenberg VH, Zolti M, Soriano D. Is there an association between autoimmunity and endometriosis? Autoimmunity reviews.

2012;11(11):806-14.

This review has highlighted the range of treatment approaches necessary to treat/support endometriosis and its surrounding symptoms. It is clear that there are multiple systems operating in this disease, which support its establishment, growth and development. The link between the endocrine and immune system cannot be underestimated in endometriosis and herbs that help restore unopposed oestrogen, reduce inflammation and enhance immune cells of the first line of defence (including natural killer cells) should be central considerations for treatment.

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6. Bulun SE. Endometriosis. The New England journal of medicine.

2009;360(3):268-79.

7. Canavan TP, Radosh L. Managing endometriosis. Strategies to minimize pain and damage. Postgraduate medicine. 2000;107(3):213-6, 22-4.

8. Sterility Fa. Endometriosis and infertility: a committee opinion. The Practice Committee of the American Society for Reproductive Medicine.

September 2012; 98.

10. Capobianco A, Rovere-Querini P. Endometriosis, a disease of the macrophage. Frontiers in immunology. 2013;4:9.

11. Vessey MP, Villard-Mackintosh L, Painter R. Epidemiology of endometriosis in women attending family planning clinics. BMJ. 1993;306(6871):182-4.

12. Kuohung W, Jones GL, Vitonis AF, Cramer DW, Kennedy SH, Thomas D, et al. Characteristics of patients with endometriosis in the United States and the United Kingdom. Fertility and sterility. 2002;78(4):767-72.

13. Reese KA, Reddy S, Rock JA. Endometriosis in an adolescent population: the Emory experience. Journal of pediatric and adolescent gynecology.

1996;9(3):125-8.

14. Giretti MS, Fu XD, De Rosa G, Sarotto I, Baldacci C, Garibaldi S, et al. Extra-nuclear signalling of estrogen receptor to breast cancer cytoskeletal remodelling, migration and invasion. PloS one.

2008;3(5):e2238.

15. Ito K, Utsunomiya H, Yaegashi N, Sasano H. Biological roles of estrogen and progesterone in human endometrial carcinoma--new developments in potential endocrine therapy for endometrial cancer. Endocrine journal.

2007;54(5):667-79.

16. Podgaec S, Abrao MS, Dias JA, Jr., Rizzo LV, de Oliveira RM, Baracat EC. Endometriosis: an inflammatory disease with a Th2 immune response component. Human reproduction. 2007;22(5):1373-9.

17. Romm A. Botanical Medicine For Women Health United States: Churchill Livingstone; 2010.

18. Ricci AG, Olivares CN, Bilotas MA, Baston JI, Singla JJ, Meresman GF, et al.

Natural therapies assessment for the treatment of endometriosis. Human reproduction. 2013;28(1):178-88.

19. Wieser F, Cohen M, Gaeddert A, Yu J, Burks-Wicks C, Berga SL, et al. Evolution of medical treatment for endometriosis: back to the roots? Human reproduction update. 2007;13(5):487-99.

20. Selcuk I, Bozdag G. Recurrence of endometriosis; risk factors, mechanisms and biomarkers; review of the literature. Journal of the Turkish German Gynecological Association. 2013;14(2):98-103.

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3:55 PM

21. Bone K, Mills, S. Principles and Practice of Phytotherapy, UK: Churchill Livingstone; 2013.

22. Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs and spices. Society for Experiemtnal Biology and Medicine. 1998, 217:1-8.

23. Wieser F, Yu J, Park J, Gaeddert A, Cohen M, Vigne JL, et al. A botanical extract from channel flow inhibits cell proliferation, induces apoptosis, and suppresses CCL5 in human endometriotic stromal cells. Biology of reproduction.

2009;81(2):371-7.

24. Burney RO, LCG. Pathogenesis and pathophysiology of endometriosis. Fertility and sterility. 2012;98, 511–519 25. Trickey R. Women, Hormones & the Menstrual Cycle: Herbal & Medical Solutions from Adolescence to Menopause. 2rd Edition ed. Crows Nest NSW: Allen and Unwin; 2004.

26. Hechtman L. Clinical Naturopathic Medicine Revised. Chatswood, NSW: Elsevier, Australia; 2012.

27. Bone K. A Clinical Guide to Blending Liquid Herbs. UK: Churchill Livingsone; 2003.

ARTICLE

Neck Pain

and Treatment Strategies George P. Kousaleos | LMT

Introduction The neck is one of the most important and distinctive regions of the human body. It has a number of functions, including support for the head and face and coordination of movement between the cranium and thorax. It houses the cervical portion of the spinal cord, seven delicate vertebrae, major arteries and veins, lymphatic vessels and nodes, many muscles, and connective tissue that wraps, envelops and interconnects all of the above.

Data from a recent global study indicated that low back and neck pain are the most common musculosksletal disorders.1 Indeed, neck and back pain are the two most common complaints experienced by those who suffer soft-tissue injuries and seek massage therapy as a primary treatment.

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“The present upsurge in the use of smart phones and tablets that require users to flex their heads forward to work on them creates more problems for the neck. Most participants in a recent study experienced hand and neck pain during texting.�

Neck pain is a common condition in many parts of the world and is increasing both among the general population and within specific occupations (such as construction workers and office workers).

It affects between 26% and 71% of the population at some point in their lives.2 Neck pain can be caused by overuse, athletic injuries, postural distortions, or automobile accidents (e.g. whiplash). It is also associated with tension headaches.

The present upsurge in the use of smart phones and tablets that require users to flex their heads forward to work on them creates more problems for the neck. Most participants in a recent study experienced hand and neck pain during texting, and held their breath and experienced emotional arousal when receiving text messages. Moreover, most participants were unaware of these physiological changes.3 Therapeutic massage is an effective way of reducing pain and other symptoms related to sub-acute and chronic mechanical neck disorders.2 This article examines the anatomy of the neck and treatment strategies that include relaxation techniques, clinical procedures, and exercise options for some of the most common client complaints.

The Anatomy The bony structure of the neck comprises seven cervical vertebrae. The atlas, or C1, is where the head attaches to the neck.

It is different from the other six cervical vertebrae in that it lacks a vertebral body.

The atlas has two arches, anterior and posterior, which allows it to sit on top of the axis, or C2. The axis allows for the atlas and head to rotate on its unique structure, a tooth-like projection known as the odontoid process. The odontoid process sits upright, allowing it to be surrounded by the foramen of the atlas. The other five cervical vertebrae (C3-7) have a more traditional formation, with vertebral bodies and transverse and spinous processes. All the cervical vertebrae support and protect the spinal cord within the vertebral foramen, an opening that is posterior to the vertebral bodies. Between each vertebra (except between C1 and C2) there is an intervertebral disc, which consists of a dense outer annulus fibrosus and a soft, jelly-like nucleus pulposus.

Because the intervertebral discs act like shock absorbers, there are many injuries that affect the condition of the disc. Some compression injuries tear the annulus fibrosus, while more serious injuries force the jelly-like nucleus into the vertebral foramen. These injuries can endanger the spinal cord, individual spinal roots or spinal nerves.

The muscles of the neck can be divided into three regions – posterior, lateral (see Figure 1), and anterior (see Figure 2). The deepest muscles in the posterior region include the erector spinae, which has lateral and medial components.

The longissimus and splenius portions form the superficial and deep muscles respectively. The longissimi are responsible for erect posture and the splenii are responsible for rotation.

There are also spinalis muscles which attach spinous processes of the upper thoracic and lower cervical vertebrae to the spinous processes of the upper cervical vertebrae. The semispinalis capitis is one of the strongest muscles of the neck, attaching from thoracic and cervical transverse processes to the occipital bone of the skull. Some of the

important shorter muscles of the posterior neck include the rectus capitis, posterior minor and posterior major, which attach the atlas and the atlas, respectively, to the occipital bone. Other important muscles of the posterior neck include trapezius and levator scapulae, which are often considered to be head and shoulder muscles, as they attach to the clavicle and scapula, respectively, from the occiput.

The most important lateral muscles of the neck include the sternocleidomastoid (SCM) and the scalene group (anterior, medius, and posterior). These muscles either turn the head (primarily the SCM) or tilt it to the side (primarily the scalenes). The scalenes are also muscles of quiet inspiration, as they lift the first two pairs of ribs at the superior part of the thorax. Between the anterior and medial scalene is the scalene opening, which allows for passage of the brachial plexus and the subclavian artery.

The anterior muscles of the neck are also called prevertebral muscles. Most anatomy books include the scalenes in this group, but for our treatment strategies we will view them as lateral muscles. The prevertebral muscles also include the longus capitis, longus colli, and the rectus capitis anterior. These muscles combine to bend the neck and head forward (bilaterally) or tilt the head and neck to the side (unilaterally).

The final important soft tissues of the neck consist of two investing layers of cervical fascia and the epimysium of each muscle.

The superficial cervical fascia is a thin layer that consists mainly of loose areolar connective tissue and adipose tissue that extends from the head to the thorax and the shoulders to the axilla. The deep cervical fascia or fascia colli is subdivided into superficial, middle and deep layers, which surround the vertebral column4.

The epimysium of each muscle will often be the site of adhesions and thickening following injury. These layers of fascia are richly innervated with sensory neurons and are often the primary site of strained or injured soft tissues.4

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• Muscle stiffness and decreased range of motion • Delayed pain in neck (24 to 48 hours) following accident • Headache associated with neck pain Massage therapy treatments can be safely administered once an osteopath, chiropractor, physiotherapist or medical practitioner has evaluated the injury and ruled out more serious damage to the vertebra, intervertebral discs, and spinal cord.

Whiplash occurs when there is forceful impact from behind, causing the neck and head to move violently forward and back in an abrupt motion.

Figure 1. Muscles of the neck, lateral view (from Gray’s Anatomy).

While many whiplash injuries are caused by rear-end automobile accidents, there are also lateral

whiplash injuries that occur from violent side impact.6 Common symptoms are: • • • • • •

Neck pain and stiffness Headaches Pain in the shoulders or upper back Difficulty concentrating Blurred vision or ringing in the ears Irritability and fatigue

As with neck sprain/strain, whiplash injury should be evaluated by an osteopath, chiropractor, physiotherapist or medical practitioner. Based on the severity of the symptoms, MRI or CAT scans may be useful in determining the severity of the injury.

Once structural damage has been ruled out, any massage therapy treatment can be enhanced with the use of ice (for acute stage), or contrast therapies (alternating hot and cold therapy) for chronic stage).

Common Neck Injuries A global study of the epidemiology of neck pain published in 2010 indicated that the estimated one-year incidence of neck pain is between 10% to 20%, with a higher incidence in office and computer workers5. While some studies report that between 33% and 65% of people have recovered from an episode of neck pain at one year, most cases run an episodic course over a person’s lifetime, so relapses are common.5 As explained earlier, there are many factors that cause neck pain, including occupational, sport-related and non-specific ones, and whiplash-associated disorders.6 Neck sprain or strain is a common cervical injury that massage therapists treat. These injuries are often caused by impact or contact with another person, object, or surface. Neck sprain or strain is most frequently associated with sports accidents, but can easily occur in falls or automobile accidents. Neck sprain usually refers to ligament damage and neck strain to muscle damage. Common symptoms of neck sprain/strain are: • Pain in the neck that increases with movement

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Figure 2. The anterior vertebral muscles (from Gray’s Anatomy).

Overuse and Postural Distortions Overuse injuries to the neck are often caused by daily activities that are repetitive in nature, or create undue strain for extended periods of time.

These can include carrying heavy backpacks or shoulder bags, workrelated repetitive motion with the arms and shoulders, or sitting at a desk in a strained position that holds the head and neck forward of the body. These days, ‘text neck’, or ‘iSlouching’, is becoming a problem as a result of slumping over phones and tablets reading messages or playing games. Common symptoms of this type of muscle strain are: • Neck pain and stiffness • Pain that radiates from neck to shoulder • Tenderness at the base of the skull • Chronic dull pain throughout the neck and upper back • Tension headaches Massage therapy treatments are even more beneficial if the client can change the repetitive pattern that may have caused the injury. Carrying a lighter backpack or shoulder bag in a more balanced position, or changing the workstation to allow for better body mechanics are necessary for an optimal outcome. While forward head position is common in the computer age, postural distortions of the neck may also be caused by distortions in the back, pelvis, or legs. Chronic tightness of the fascia and muscles of the upper neck is one of the primary causes of tension headaches.

Treatment Strategies When red flags for serious underlying conditions have been eliminated, various massage therapy modalities can have a positive effect in diminishing neck pain.8 Therapeutic massage can decrease pain and tenderness, and improve range of motion for sub-acute and chronic neck pain.2 A treatment plan that incorporates the following components should improve the soft tissue dysfunction found in common neck injuries. The following criteria apply:

• Test range of motion of the neck before and after treatment.

• Treat the whole body – all soft tissue is connected through the multiple layers of fascia that surround and support the body.

• Spend considerable time warming the soft tissues of the neck before applying deeper pressure.

• Balance the treatment of the neck by working with posterior, lateral and anterior regions of the neck.

• Address any corresponding issues in the paraspinal tissues of the thoracic and lumbar regions.

• Teach safe stretches for the neck and back and encourage the client to practice alignment exercises that improve posture.9 • Perform massage therapy in a progressive series of sessions that gradually work deeper as clients tolerance increases.

• Go slow, improving the parasympathetic reflexes of the autonomic nervous system.10

Test range of motion Testing the range of motion of the neck before treatment will give the therapist and the client a starting point to measure the effectiveness of the treatment. Use forward flexion and hyperextension, lateral flexion to both sides, and rotation in either direction. Have the client attempt each movement with light to moderate effort, as neck pain can increase during movement. Test the same range of motion following the session, again with minimal pressure. Hopefully, the client will have increased their range of motion and have experienced a decrease of any painful sensation caused by movement.

Treat the whole body The best strategy for a therapeutic massage session is one that incorporates a thorough treatment of legs, pelvis, back, abdomen, chest, and arms, as well as the neck, head, and face. Some massage therapists prefer to start the session with treatment for the extremities and trunk before moving into the neck, shoulders, and skull. Others prefer to start with

more general work on the neck, then move to other regions of the body, followed by deeper work for the neck, shoulders, and skull. If time is limited and a full-body treatment isn’t possible, at least work on the paraspinal, chest, and shoulder tissues that attach below the neck, and the cranial tissues that attach from the skull.

Warm the tissues Tight, contracted, or shortened tissues do not allow for full circulatory response of blood, lymph, or interstitial fluid.

Warming the tissues prior to specific work assists in the body’s ability to nourish and cleanse the affected area.

This increases the solubility of the ground substance, or matrix, of the dense fibrous connective tissues, which starts the process of diminishing adhesions and reducing spasm.

Balance the neck treatment No matter where the neck injury is, plan a balanced treatment that works with posterior, lateral, and anterior tissues.

The older the injury is, the more likely that compensation has occurred on the opposite side. Work with the client in prone, supine, and side-lying positions to achieve maximum benefit for each area.

Address paraspinal tissues Because the neck is a part of the spinal column, spend quality time during the session reducing hypertonicity that is common in the superficial and deep muscles of the back. If obvious kyphosis or lordosis is apparent use methods that improve the alignment and support of the chest and pelvis.9 Remember that the thoracolumbar aponeurosis is the densest tissue in the back and can restrict the release of tissues in the mid and lower back.

Teach stretches Along with the cervical range of movement used prior to the treatment, it is also beneficial to instruct the client to stretch the full spinal column through a series of flexibility exercises (providing that no other spinal problems exist that could be aggravated by stretching).

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Like the neck, the back and trunk should steadily become more pliable. The most common series of stretches include forward flexion (from standing or sitting), side bending (from standing or kneeling), moderate hyperextension (from prone position), and spinal twists (from standing or supine position). Important aspects to consider when teaching flexibility exercises are teaching the client to use light to moderate effort, to use a full and even breathing cycle, and to use slow and thoughtful movements.

Progressive series Whether treating neck injuries or injuries to any part of the body, the best results often happen with a progressive series of sessions that engage increasingly deeper layers of soft tissue. Many clients who are experiencing neck pain can initially handle only light pressure. Progressive sessions also allow the client to practise

self-help exercises or other home treatments (ice or hot/cold contrast) that will expedite recovery. Still other clients have either time or financial restraints that limit the amount of massage therapy that is affordable or practical. In my experience, establishing a progressive series of three to six treatments will support recovery from most common neck injuries.

New research shows that massage can relieve neck pain effectively if it’s done for the correct length of time. This study, on chronic non-specific neck pain, showed that one-hour sessions two or three times a week appear to be the most effective, whereas 30-minute treatments were not significantly more effective than the waiting-list control condition in terms of achieving a clinically meaningful improvement in neck dysfunction or pain.7

Table 1. Grades of Neck Pain8

DESCRIPTION

S YM P TO M S / S I G N S

Grade I No signs of major pathology and no or little interference with daily activities.

Stiffness, tenderness, but no significant neurological complaints.

No signs and symptoms of major structural pathology (e.g. fracture, dislocation, infection).

Grade II No signs of major pathology, but interference with daily activities.

Interference with daily activities.

No signs and symptoms of major structural pathology or root compression.

Grade III Neck pain with neurological signs or symptoms

Complaints of neck pain associated with significant neurological signs (e.g. decreased deep tendon reflexes, weakness, sensory deficits).

These complaints suggest malfunction of spinal nerves or the spinal cord.

Grade IV Neck pain with signs of major pathology

Complaints of neck pain and/or its associated disorders along with signs or symptoms of major structural pathology, detected by clinician.

Be aware of red flags for fractures, myelopathy, infection, neoplasm, other destructive lesions or systemic diseases.

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Go slow Many disciplines of massage therapy teach, “To go deeper, go slower.” Since most neck injuries include strain or spasm of both extrinsic and intrinsic layers of fascia and muscles, the need to manipulate multiple layers of tissue is apparent. Whether it is the first treatment session or the sixth of a progressive series, it is important to remember that by applying pressure too quickly sympathetic responses can easily be stimulated. Most people in pain experience heightened levels of fear and anxiety. Controlling the application of pressure through slower stroke speed is critical to successful outcomes.10

Summary Neck pain is common and can have a considerable effect on a person’s quality of life. Many factors contribute to an individual’s neck pain, including overall physical and mental health, work and daily activities. There are various environmental and personal factors that cause neck pain, and most neck pain is not the result of serious injury or disease.6 Effective massage treatment for neck pain can help return your client to a more active, pain free lifestyle. However if clients present with neurological signs or symptoms (Grade II & IV, see Table 1), refer to an osteopath, chiropractor, physiotherapist or medical practitioner.

Enjoy the challenge!

References 1. Storheim K, Zwart J-A. Musculoskeletal disorders and the Global Burden of Disease study. Annals of the rheumatic diseases.

2014;73(6):949-50.

2. Brosseau L, Wells GA, Tugwell P, Casimiro L, Novikov M, Loew L, et al. Ottawa panel evidence-based clinical practice guidelines on therapeutic massage for neck pain. Journal of bodywork and movement therapies.

2012;16(3):300-25.

3. Lin I-M, Peper E. Psychophysiological patterns during cell phone text messaging: A preliminary study. Applied psychophysiology and biofeedback. 2009;34(1):53-7.

4. Warshafsky D, Goldenberg D, Kanekar SG. Imaging anatomy of deep neck spaces.

Otolaryngologic Clinics of North America.

2012;45(6):1203-21.

5. Hoy D, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Practice & Research Clinical Rheumatology.

2010;24(6):783-92.

6. Guzman J, Hurwitz EL, Carroll LJ, Haldeman S, Côté P, Carragee EJ, et al. A new conceptual model of neck pain: linking onset, course, and care: the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics. 2009;32(2):S17-S28.

7. Sherman KJ, Cook AJ, Wellman RD, Hawkes RJ, Kahn JR, Deyo RA, et al. Five-week outcomes from a dosing trial of therapeutic massage

for chronic neck pain. The Annals of Family Medicine. 2014;12(2):112-20.

8. Guzman J, Haldeman S, Carroll LJ, Carragee EJ, Hurwitz EL, Peloso P, et al. Clinical practice implications of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendations. Journal of manipulative and physiological therapeutics.

2009;32(2):S227-S43.

9. Muscolino JE. Advanced Treatment Techniques for the Manual Therapist: Neck. Lippincott Williams & Wilkins, Philadelphia 2012.

10. Schleip, Robert. “Fascial plasticity–a new neurobiological explanation: Part 1.” Journal of Bodywork and movement therapies 7, no. 1 (2003): 11-19.

George Kousaleos, LMT, is the founder and director of the Core Institute, a school of massage therapy and structural bodywork in Tallahassee, FL. He is a graduate of Harvard University, and has been a leader in the massage therapy field over his 30-year career.

He was the General Manager of the 1996 British Olympic Preparation Camp Sports Massage Team and Co-Director of the 2004 Athens Health Services Sports Massage Team.

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More Research on

Homoeopathy Robert Medhurst | BNat ND DHom

For those of us who accept the fundamental premise of homoeopathy, Similia Similibus Curentur, do we need to have this validated by research? To many, the principle is so well accepted that it’s become common sense and therefore doesn’t require any validation. A lot of what we do in our clinics is based on that same common sense, what we have learnt from others in training, from texts or journals or what we have learnt through personal experience or observation.

But what about those for whom this isn’t common sense - clients, potential clients, healthcare practitioners from other disciplines and people who can potentially influence our capacity to practise our craft or the way in which we practise it, such as those working in or on behalf of various levels of government? For these people, some sort of objective and credible evidence can be helpful if not essential, and it’s with this need in mind that I’ve summarised some of the more recent and notable pieces of research into homoeopathy.

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Journal, 2001, 90, 4, 180-2. In a study involving 230 children with acute otitis media, homoeopathic treatment was compared with placebo to determine whether homoeopathic treatment provided a faster resolution of symptoms than placebo. After 12 hours, 72% of those using homoeopathy experienced significant relief of symptoms, which was 2.4 times faster than the response to placebo.

Human Research 1. Colin P. Homeopathy and respiratory allergies: a series of 147 cases. Homeopathy, 2006, 95, 2, 68-72. In this case series, 147 consecutive patients suffering from respiratory allergy who attended a private homoeopathic clinic were assessed for their response to constitutional homoeopathic treatment.

Of these patients, 105 were sufferers of ear, nose and throat allergies. Only two of these patients failed to respond to treatment and none experienced an exacerbation of symptoms. The other 42 patients were sufferers of pulmonary allergies, all except five of whom experienced relief, with two of these experiencing an exacerbation of symptoms.

2. Frass M, et al. Influence of potassium dichromate on tracheal secretions in critically ill patients.

Chest. 2005, 127, 3, 936-41. Stringy tracheal secretions often complicate or even prevent extubation of people

breathing with continuous positive airway pressure. This issue provoked the development of a study involving 50 people breathing spontaneously with continuous positive airway pressure who were randomly assigned to receive either five globules twice daily of Kali bic 30C or the same dose and frequency of placebo globules. The study results were assessed using the amount of tracheal secretions from Day 2 of the study, the amount of time spent by the subjects in the ICU in which they were staying and the time until successful extubation.

After the results were assessed, it was found that those who’d been given the Kali bic produced fewer tracheal secretions than those on placebo and their stay in the ICU was shorter than those on placebo, as was their time to successful extubation.

3. Frei H, Thurneysen A. Homeopathy in Acute Otitis Media in Children: Treatment Effect or Spontaneous Resolution? British Homeopathic

4. Friese KH, Zabalotnyi DI. Homeopathy in acute rhinosinusitis : A double-blind, placebo controlled study shows the efficiency and tolerability of a homeopathic combination remedy. HNO (Organ of the Deutsche Gesellschaft der Hals-, Nasen- und Ohrenärzte) 2007, 55, 4, 271-7. Using a randomized, double-blind study method, 144 people with acute rhinosinusitis were treated with either a combination of homoeopathic remedies (Group A) or placebo (Group B) and assessed at days 0, 7, 14 and 21 of treatment using a five point sinusitis symptom score (the worst score being 20). After analysing the results it was found that those in Group A experienced a drop in symptom scores from 12.1+/-1.6 to five.9+/-2.0 points after seven days. Those in Group B experienced a decrease from 11.7+/-1.6 to 11.0+/-2.9 points (p<0.0001). The final results showed that the homoeopathic combination resulted in freedom from complaints in 90.3% of the patients and improvement in a further 8.3%, whereas in the placebo group the complaints remained unchanged or became worse in 88.9% of the patients.

Animal Research 1. Chaudhuri S, Varshney JP. Clinical management of babesiosis in dogs with homeopathic Crotalus horridus 200C. Homeopathy, 2007, 96, 2, 90-4. Babesiosis is a protozoal disease suffered by dogs. It’s associated with infestation by Babesia gibsoni and is normally transmitted by ticks.

In this clinical case comparison the effects of Crotalus horridus 200C on dogs suffering from this condition were compared with the effects of the

JATMS | Autumn 2015 | 23

ARTICLE

standard pharmaceutical treatment, diminazine aceturate. At 18 days after the medications were given results were assessed, and on the clinical scores for the various symptoms produced by the dogs in response to the protozoa it was found that Crotalus horridus 200C provided the same level of clinical recovery from the illness as did diminazine aceturate.

2. de Paula Coelho C, et al.

Therapeutic and pathogenetic animal models for Dolichos pruriens. Homeopathy, 2006, 95, 3, 136-43. This study was designed to determine the effect of various homoeopathic potencies of Dolichos pruriens on artificially induced itch in laboratory rats, and also to determine if these potencies could elicit a proving effect in normal rats. In the first part of this study (performed blind) the rats with the induced itch were given ascending potencies of the remedy over a 30 day period and the results were compared to placebo controls. It was found that all potencies of the remedy provided a therapeutic effect against the induced itch. In the second part of the study, also performed blind, no proving effects were seen.

3. Falkowski GJS, et al, Causticum hahnemanni, Conium maculatum and Lycopodium clavatum highly diluted medications decreases parasitemia in mice infected

by Trypanosoma cruzi. Int J High Dilution Res, 2012, 11, 40, 198199. Proceedings of the XXVI GIRI Symposium; 2012,Sep, 20-22; Florence (Italy). This Brazilian research looked into the effect of homoeopathically prepared Causticum 13C, Conium maculatum 13C and Lycopodium clavatum 13C on mice infected with T. cruzi, the organism associated with Chagasâ&#x20AC;&#x2122; disease in humans. In a blind randomized controlled trial design, mice were given one of the three medicines being tested, or a placebo, to test the preventative capacity of these substances. Parasitaemia and clinical parameters were assessed daily.

When compared to the control, all of the

24 | vol21 no1 | JATMS

medicines tested provided a significant level of protection, with the best results seen in the mice given Lycopodium.

4. Chakraborty I, Sukul A, Sukul NC. Nux Vomica 200 CH reduced acute hypnotic effect of alcohol in young toads. Int J High Dilution Res, 2012, 11, 40, 208-208. Proceedings of the XXVI GIRI Symposium; 2012, Sep, 20-22; Florence (Italy). Previous research has shown that homoeopathically prepared Nux vomica has the capacity to correct ailments produced by alcohol. In this Indian study, a replication of this work was performed. Using 10 repetitions of the same experiment, young toads given either Nux vomica 200C or a control substance, and then exposed to sufficient quantities of ethanol to cause them to become unbalanced. They were then assessed for their capacity to regain that balance and it was shown that, compared to the control, Nux vomica 200C was associated with a significant reduction in ethanol related imbalance.

Plant Research 1. Trebbi G, et al. Phytopathological and nutraceutical evaluation of cauliflower plants treated with high dilutions of arsenic trioxide.

Int J High Dilution Res, 2012, 11, 40, 161-162. Proceedings of the XXVI GIRI Symposium; 2012, Sep, 20-22; Florence (Italy). The fungus, Alternaria brassicicola, is a common cause of dark leaf spot disease in cauliflower (Brassica oleracea L.). In this study, researchers from the University of Bologna tested the antifungal capacity of homoeopathically prepared Arsenic trioxide 35X and Cuprum metallicum 5X and compared to controls. Two experiments were performed. In the first, spore suspensions were prepared in the test substances and their inhibiting effect on germination was recorded microscopically after incubation at 25°C for five hours. In the second experiment, the same treatments were tested on plants artificially inoculated with the fungus. To do this the test field in which the plants were to be grown was divided into plots according to a completely randomized block design.

In the first trial, plants were artificially inoculated and treated every week; the infection level was evaluated on cauliflower heads. The second trial was performed on the same field with the aim of inducing a natural infection, mediated by infected crop residues. Measurement endpoints concerned the evaluation of some physiological parameters along with the glucosinolate content on cauliflower heads. On analysis, the team found that Arsenic 35X and Cuprum 5X induced a significant decrease of mean infection level (-50%). In addition, physiological and nutraceutical analyses of healthy heads demonstrated that Arsenicum induced a significant increase of both head size and glucosinolate content.

In-Vitro Research 1. Huh YH, Kim MJ, Yeo MG. Homeopathic Rhus toxicodendron treatment increased the expression of cyclooxygenase-2 in primary cultured mouse chondrocytes. Homeopathy, 2013, 102, 4, 248-53. In this in-vitro research, cultures of mouse chondrocytes were exposed to 4X, 30X, 30C and 200C homoeopathic potencies of Rhus toxicodendron. Assessments were then made of the expression of collagen type II, a marker protein of chondrocytes, and cyclooxygenase-2 (COX-2), which is responsible for the biosynthesis of prostaglandin E2 (PGE2) and the regulation of the inflammatory response, using biochemical and immunological methods such as reverse transcription polymerase chain reaction (RT-PCR), quantitative (or real-time) RT-PCR (qRT-PCR) and immunoblot assays.

The anti-inflammatory effects of the remedies were significant. All of the Rhus tox potencies, most notably the 30X, increased the mRNA expression of COX-2, and mRNA expression in both RT-PCR and qRT-PCR analyses. The 4X, 30X and 30C potencies inhibited collagen type II expression, suggesting that Rhus tox induced the dedifferentiation of chondrocytes. In addition, treatment with 30X Rhus tox significantly increased PGE2 release compared with other homoeopathic dilutions of Rhus tox.

ARTICLE

Unani Tibb Jimi Wollumbin | CEO, One Health Organisation

A Brief History Unani Tibb literally means ‘Ionian Medicine’ and refers to Traditional Greek/Galenic Medicine. Like everything in Western medicine, it seems, it began with Hippocrates. However it is important to note that Hippocrates’ medicine was not really like any of the schools of medicine that claimed him as their founder: he was not as vitalistic as the Galenists, nor as noninterventionist as the Nature Cure doctors, and he certainly was not as hyper-rationalist and reductionist as modern medicine – despite his clear respect for empiricism. Be that as it may, it was Hippocrates who first took the cosmogenic model of the preSocratic philosopher Empedocles and moulded it into a useable medical model by marrying the four elements (fire, air, earth and water) with four fundamental biological processes, the four humours (blood, bile, phlegm and black bile).

Over 500 years later this humoral model was taken by Galen, Rome’s most famous physician, and used to formalise a vitalistic system of medicine that informed medical thought in Europe for a millennium and a half. During the dark days of the middle ages, classical Greco-Roman knowledge and culture was either lost or put on the back burner, but was eagerly taken up and developed by the blossoming Islamic cultures of the Middle East. Here, in the 10th century, many commentators feel that Galen’s work was ‘completed’ by the Persian polymath Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā. Referred to as Avicenna in the west for obvious reasons, he was also dubbed ‘The Prince

26 | vol21 no1 | JATMS

Image Credit: Wellcome Library, London. Wellcome Images

The following information was collated in India while conducting interviews at the Central Council for Research in Unani Medicine (CCRUM) and their affiliated institutes.

According to CCRUM statistics from 2012, across the subcontinent of India there are currently 40 accredited Unani institutions, each with inpatient units between 50 - 200 beds, 50000 accredited practitioners and 2000 new graduates per year.

of Physicians’, with his Canon of Medicine used as a standard reference right up until the early 19th century, arguably coming to eclipse Galen himself.

The final instalment in this chain-of-knowledge saga is the introduction of Galenic medicine to India with the Muslim conquests that took place up until the 16th century. Due to the perceived Hindu religious associations of Ayurvedic medicine, Muslim communities in India have reportedly largely preferred to consult a Unani/Galenic physician, as those physicians are also of the Muslim faith. During the 1950’s and ’60’s, in the nationalist wake of Ghandi’s independence movement, all indigenous systems of medicine were formally granted the government patronage and support they were denied under the British Raj. It is because of this support that India is currently the widely acknowledged centre of learning in Galenic medicine, and the reason why I travelled to the east to study the medicine of my western ancestors.

The Four Degrees While the more famous Galenic humoral model outlined in my earlier articles (JATMS, 19(4): 222-225 and JATMS 20(1): 20-23) focused on the realm of human beings and how best to understand them in sickness and in health, it has an indispensable, though less well known, model that is used primarily to understand medicines. The process of determining an appropriate prescription in Galenic Medicine, therefore,

“Unani Tibb literally means ‘Ionian Medicine’ and refers to Traditional Greek/Galenic Medicine. Like everything in Western medicine, it seems, it began with Hippocrates.” commences with categorising the condition and or individual, depending on whether the condition is chronic or acute, and then uses this to find the complementary medicine according to the law of contraries. The law of contraries is the foundation of all major traditional systems and simply dictates that conditions and individuals should be treated with medicines of an opposite nature, that is, hot conditions are treated with cool medicines, and moist individuals are treated with dry medicines. It is here that we encounter the primary qualities that underpin both the humours and the temperaments of the Galenic system in their unadorned fashion: hot, cold, dry and moist. While Traditional Chinese Medicine, Ayurveda and Tibetan Medicine all use this foundational model of the vitalistic approach in some form, Galen was unique in introducing a system for classifying the relative differences between medicines of the same quality, hence Galenic texts describe thyme as hot and dry in the 3rd degree, while classifying nettle as hot and dry in the 1st degree.

Hippocratic plaque at entrance to Hamdard Laboratory in Delhi

My research in India suggests that modern Unani practitioners use the degrees in a straightforward linear fashion, so that the higher the number of the degree the stronger the intensity of the remedy. This is understandable, as not even Galen managed to finish defining the degrees for all the herbs in his materia medica. However a concise summary of the full system is provided by that incredible English renegade Nicholas Culpeper.

After boldly and controversially translating the Royal College of Physicians’ Pharmacopoeia from Latin into English in 1649, in 1652 he went on to publish Galen’s Art of Physic1 in the common tongue.

It is here that we find an accessible description of the original model with all its subtleties.

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Of Medicines Hot Hot in the 1 Degree: Cools the body by inducing sweating and reduces pain by ‘making the offending humours thin’ (e.g. warming diaphoretics such as mint) st

Hot in the 2nd Degree: Increases digestion and ‘by a gentle heat concocts and expels the humours’ - especially phlegma (e.g. stomachics such as angelica) Hot in the 3rd Degree: Strongly digests and resolves ‘tough and compacted humours’. These are our obviously warming medicines that assist in bronchial catarrh, chronic mucosal congestion, poor circulation and parasites (e.g. spices such as ginger, cayenne and clove; pectorals such as blood root and thyme, and hot vermifuges such as oregano).

Hot in the 4th Degree: These medicines are little used in modern western practice as they are ‘so hot that they burn the body of man being outwardly applied to it’ (e.g. mustard plasters).

Of Medicines Dry Drying medicines ‘consume moisture and stop fluxes’ (discharges).

Purely dry medicines are found in the class of astringents and antihaemorrhagics used in modern practice, but an astringing quality is often found in either hot or cool medicines. For simplicity’s sake it is easier and more practical not to divide this class into the four degrees. A secondary tonifying action is attributed to drying medicines as they ‘make the body and members firm that are weakened by moisture so that they may perform their proper function’. The use of astringents to tonify is attested by a range of herbs in current use, including raspberry and lady’s mantle in obstetrics, rose and sage in gynaecology and, perhaps the best known astringent in the western canon, oak, used by herbalists and Bach flower therapists alike to strengthen clients broken down by a long history of abuse or addiction. Lest they be applied injudiciously however, Culpeper warns that if the body’s primal moisture be consumed by excess use of astringents then ‘the members can neither be nourished, nor yet perform their proper functions’.

Matthew Wood2 further attests to this, stating that large doses of astringents can bind so thoroughly that they cause dryness and tension, suggesting they are best employed for ‘relaxed’ tissue states.

The most common example in modern practice of dry medicines creating tension (especially in Melancholic or Vata constitutions which are congenitally cold and dry) is that of black tea which is often implicated in tight muscles, arthritis and ‘tea drinkers stomach’.

Of Medicines Cooling ‘I beseech you take notice of this’ are the words with which Culpeper opens the section on cooling medicines, going on to urge us to use cooling medicines (particularly of the 3rd and 4th degrees) with caution and to heed the patient’s general constitution. For, as ‘our bodies are nourished by heat, and we live by heat’, excessive cooling and draining can further weaken an already depleted individual. Whether or not Samuel Thompson3 was familiar with the works of Culpeper we find these sentiments strongly echoed in

28 | vol21 no1 | JATMS

the Physico-Botanical system that arose from the former’s teachings almost 200 years later.

Cool in the 1st Degree: ‘Their use is first in nourishment’ to create a balanced meal/diet, but they can also be ‘outwardly applied if the inflammation be not great’ (e.g. salad greens or small amounts of slightly bitter herbs used in salads).

Cool in the 2nd Degree: This class of medicines are herbs for those ‘whose stomachs are strong, and livers hot’ and that have an obviously cooling and relaxing quality internally and externally - soothing irritation, calming excitation or hyper-function and comforting the heart-mind (e.g. calming stomachics such as spearmint; cooling hepatics like chrysanthemum; demulcents such as slippery elm; and simple nervines such as melissa).

Cool in the 3rd Degree: ‘The unbridled heat of choler is assuaged’ through medicines cool in the 3rd degree, which refers to bitter detoxicants, anti-infectives and draining herbs that reduce heat and inflammation. In addition, this class of medicines can be used for mania and other mental and emotional conditions as ‘sometimes the spirits are moved inordinately through heat’ (e.g. anti-infectives such as barberry; cholagogues such as gentian; laxatives like rhubarb; septicaemics such as echinacea; and detoxicants such as wormwood).

Cool in the 4th Degree: These medicines are increasingly difficult to obtain by modern herbalists as they ‘mitigate desperate and vehement pains’ and ‘stupefy the senses’ (e.g. narcotics and anodynes such as henbane or opium). Modern examples could possibly include very high doses of kava, wild lettuce and Jamaican dogwood.

Of Medicines Moist In the section on moist medicines Culpeper states that there is no separation of degrees for moist medicines, explaining that, as all medicines are either hot or cold, moisture is not given any room to vary a great degree, for ‘the one dries it up, the other condenses it’. Moist demulcent and emollient medicines therefore consistently ‘make slippery, ease the cough, and help the roughness of the throat’. To this we might add that moistening mucilages soothe irritation in the GIT, and by reflex, the lungs, assisting in the protection of delicate mucous membranes and consequently aiding nutrition. This nutritive action is what I interpret their systemic effect to be when Culpeper states they ‘make both blood and spirits thicker’ (e.g. slippery elm, linseed, comfrey (root), marshmallow, wild yam (fresh), plantain, and aloe (gel)).

Closing Remarks As Thomas Kuhn4 observed when he introduced the world to the very notion of a paradigm, when we shift from one perspective to another we do not so much climb closer to the truth as shift along the medicine wheel to view the matter from a different angle.

For at the same time as new perceptions are made possible, old perceptions are lost, with this phenomenon having since come to

be referred to as ‘Kuhnian loss’. The relevance of this notion to a re-evaluation of the medicine of our ancestors is clearly apt, but two brief closing examples that Culpeper ‘beseeched’ us to mind will suffice to provide modern examples of the clinical relevance of applying a Galenic lens to the practice of western herbalism in the 21st century: Example 1: The herbs categorised as ‘cold in the 3rd degree’ include many of phytomedicine’s most treasured anti-microbials: hydrastis, andrographis, pau d’arco, coptis. That they contain a very real potential for further weakening an immunologicallydepleted individual by excessively draining the body’s vital heat or by dampening the digestive fire, as Culpeper suggests, is attested to by modern Unani, Ayurvedic and Chinese physicians alike. Modern naturopaths and herbalists may avoid such unintended iatrogenesis by incorporating vitalistic tools like the four degrees.

Example 2: It is interesting to note that an enormous array of modern pharmaceuticals would be classified as cooling in either the 3rd or 4th degree, with analgesics, anti-depressants and anti-psychotics generally being cold in the 4th degree (like wild lettuce) and antibiotics generally being cold in the 3rd degree (like

andrographis). This observation alone suggests an invaluable key to further combat their many side effects using a vitalistic approach to herbal medicine, by attempting to mitigate them with the use of medicines warm in the 2nd degree to kindle the digestive fire and protect gut-based immunity (e.g. angelica, astragalus, elecampaign, fennel) and those warm in the 3rd degree to keep the blood and humours circulating freely while recovering from an extended course of anti-depressants or analgesics (e.g. bayberry, rosemary, camphor, damiana, cinnamon).

References 1. Galen’s Art of Physick. Translated by N. Culpepper. London: Peter Cole, 1952.

2. Wood M. The Practice of Traditional Western Herbalism. Berkeley, CA: North Atlantic Books, 2004.

3. Thompson - Llyod JC. Life and Discoveries of Samuel Johnson, Bulletin 11. Bulletin of the Llyod Library of Botany, Pharmacy and Materia Medica 1900; (Reproduction Series Seven).

4. Kuhn TS. The Structure of Scientific revolutions. Chicago: University of Chicago Press, 1996.

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DISCUSSION PAPER

The Art of Traditional Medicine Part 1: Implications for Education Jesse Sleeman | BA, MA; ATMS Director

Abstract Traditional medicine is an ancient art that has always been central to the health of all peoples. Any art is identifiable by four criteria: it arises from the creative spirit; it is unique; it arises from the artistâ&#x20AC;&#x2122;s acquired and innate skills and abilities, and at best, with the addition of inspiration; and ultimately it arises directly from our philosophy about life and the world, and indirectly from our cultural, family and physical environment. Any education system that fails to recognise and incorporate these criteria into its teaching, and especially to incorporate traditional philosophies of health and healing into the clinical situation, fails to nurture the artist and extinguishes the tradition. Because of this failure, increasingly the philosophy of biomedicine is infiltrating traditional medicine.

During the twentieth century the disciplines of Science, Medicine and Law became dominated by academic positivism, professionalisation and the influence of corporate and political vested interests, resulting in todayâ&#x20AC;&#x2122;s system of indoctrination, not education. The impact of this on these professions is plain to see. The Arts, however, remained focussed on creativity and education in its original meaning. Since Traditional Medicine nowadays is viewed as a science, rather than an art, it too is losing its artistic origins.

30 | vol21 no1 | JATMS

What is art?

It is the premise of this article that herbal medicine in particular, and traditional medicine in general, are arts. And though there is scant evidence of prehistoric human use of plant material—the first being from a Neanderthal burial site in Shanidar, Iraq, dating back 60,000 to 80,000 years, which contained eight genera of medicinal plants, seven of which are still used by herbalists today— undoubtedly the art of medicine, like the arts of hunting, food preparation, and tool making, and all the other arts, dates back to our first ancestors, homo habilis (‘handy man’), 2.5 million years ago.1,2 Defining art, however, is as problematic as defining beauty, mind, or life itself.

As central as all these things are to our own existence, and to our cultures, it is the eye and mind of the beholder that ultimately identifies what art—or beauty, or mind, or life—is. Thus, during the socially turbulent 1960s, when wild, young, Elizabethan energy was whirling through many Western populations with the blossoming of the flower-power counterculture’s artistic creations, the ageing German philosopher and sociologist Theodor Adorno, clearly perplexed by what he was witnessing among the young generation of baby boomers and their fellow travellers, wrote in his book Aesthetic Theory: ‘It is self-evident that nothing concerning art is self-evident any more …’.3 However difficult identifying art may be, and however much we may be emotionally, morally or intellectually repulsed by some expressions of it, there are nevertheless major features of it that we can all readily identify.

The primary criterion is that art is the process and product of our creative spirit. To the ancient Greeks, the source of this was the Muses, the nine daughters of Zeus and Mnemosyne, who inspired poets, writers, musicians, orators, dancers and natural philosophers.

The second is that art is unique, not a standardised process or product. The third is that art arises from an artist’s

skills acquired through observation and experience at the very least, and by the addition of the artist’s natural abilities and inspiration at its best. Because the third criterion leads to and arises from an artist’s philosophy about life and the world, the fourth criterion is that art arises from our philosophy; and, since our philosophy springs from our cultural, family and physical environment, particularly during our formative years, art also emerges from our environment.

Let’s take a brief look at the implications of these criteria for education. The first two criteria are interwoven aspects of the unconscious mind, of a universal muse. Hence, the creative spirit cannot be taught; it can be encouraged, nurtured and nourished, but it cannot be taught because it arises from the wild, intuitive, unconscious mind—the realm of the muse, of inspiration—not the conscious, daytime-thinking mind. Therefore, any teaching system that imposes standardisation in any endeavour of learning undermines the creative spirit of the learner. In essence, there is never a ‘right way’ of doing anything; the artist alone determines the techniques and tools employed for his or her art in every instance. Therefore, in art there are no experts, only good and bad artists, as defined by their functional output, whether in aesthetics, stimulation of the senses, mood, or intellect; or, in the domain of medicine, permanent improvement in people’s psychological and physiological functions and a restoration of wholeness.

In the realm of traditional therapies, this means that the art is to be found in the clinical situation. Practice in clinic work is therefore central to honing the skills of the practitioner. The same applies to musicians who hone their skills by practising on musical instruments, and for writers who hone skills through the practice of writing. Hence, any examination system that demands ‘right’ answers to written questions is not assessing that student’s art. It is simply a lazy bureaucratic method of ticking off a checklist to eventually give someone

a piece of paper to say that they passed the exams. Written examinations should address the foundational philosophy and the principles underpinning clinical practice, the rationale for choice of therapies or remedies and the treatment protocol.

The third and fourth criteria—art arises from our skills and philosophies acquired through observation and experience in our environment at the very least, and through natural abilities and inspiration at best—are interwoven aspects of the conscious and unconscious mind. The fabric of such interwoven energies is beliefs, and beliefs arise from observation and experience. And, as the years pass, beliefs give rise to an individual’s perspective, to a person’s or, collectively, a culture’s, philosophy. This is the leavening process of education on the mind.

Therefore, teaching that avoids teaching a new perspective, a new philosophy, different to that of the learner’s current culture, will result in the culture’s philosophy being the default setting for that learner. In essence, he or she will be a good little enculturated soul with the same old beliefs as the collective beliefs of the dominant elders of that culture.

Such indoctrination and stagnation is perfect for armies, for oligopolies, for unimaginative, same-old-same-old corporations and institutionalised social structures, but deadly for the creative growth of an individual and the culture.

Liken this to being taught a foreign language by learning only the vocabulary but not the grammar; the default setting for grammar will be that of the learner’s first language.

Thus, in the education of traditional therapists, if traditional ideas and philosophies about health and healing are not the fundamental and continuing focus of the curriculum and professional development, then biomedicine becomes the default setting. The reason is that biomedical philosophy pervades our culture, our media, our conversations.

We hear that people ‘battle’ disease,

JATMS | Autumn 2015 | 31

DISCUSSION PAPER

‘fight’ cancer, and seek ‘wellness’. In our culture, anti-inflammatories, antibacterials, anti-tussives, anti-tissuefunction therapies, or contraries, or opposites, are deemed to be appropriate treatment for tissues that ‘have gone wrong’. The result of such warped ‘education’ is graduates who are pseudomedical practitioners using traditional remedies in non-traditional ways.

Examples of this are the use of St John’s Wort (Hypericum perforatum), a herb from the European herbal tradition, for the treatment of depression, and Echinacea (Echinacea angustifolia or E. purpurea), a herb from the native American, Great Plains tradition, for the blanket treatment of infections— traditionally, St John’s Wort was used for nerve and menstrual pain, and Echinacea was used for surface heat conditions (visible redness and swelling, tangible heat, and patient reports of irritation or pain).

Indeed, the art of herbal medicine has been rapidly eroded since I began learning it 40 years ago. I remember attending the 112th Annual Conference of the National Institute of Medical Herbalists in England, in 1976, where Mrs Nalda Gosling, then President of the Institute, presented a talk on what then constituted a herbalist. Her suggestion was that the modern British herbalist then consisted of: ‘20 parts ancient healer, 20 parts traditional English herbalist, 20 parts American physiomedicalist, 20 parts diagnostician, 10 parts pharmacist, and 10 parts intuition.’4 Today, thanks to modern education, a herbalist is, from my observations, increasingly this: 20 parts biochemical herbalist, 20 parts novice biomedical practitioner, 15 parts business manager, 10 parts novice biomedical dietitian and nutritionist, 10 parts novice biochemist, 10 parts novice biomedical diagnostician, 10 parts marketer, and 5 parts accountant.

The Arts

“TODAY, THANKS TO MODERN EDUCATION, A HERBALIST IS, FROM MY OBSERVATIONS, INCREASINGLY THIS: 20 PARTS BIOCHEMICAL HERBALIST, 20 PARTS NOVICE BIOMEDICAL PRACTITIONER, 15 PARTS BUSINESS MANAGER, 10 PARTS NOVICE BIOMEDICAL DIETITIAN AND NUTRITIONIST, 10 PARTS NOVICE BIOCHEMIST, 10 PARTS NOVICE BIOMEDICAL DIAGNOSTICIAN, 10 PARTS MARKETER, AND 5 PARTS ACCOUNTANT. ”

32 | vol21 no1 | JATMS

Many human endeavours are subsumed under the title, ‘the Arts’—their cultural importance is identified by the capital ‘A’. This includes not only the visual arts, performing arts, and literary arts—all of which are sometimes subsumed under the banner of ‘fine art’—but also academic disciplines in the humanities, social sciences and languages. Many of us have acquired Arts degrees that incorporate such subjects as architecture, archaeology, anthropology, philosophy, psychology, mathematics, sociology, politics, history, religion, geography, economics, music, linguistics and, of course, languages. Since the time of the ancient Greeks, mathematics has been considered to be one of the Arts, and was known as the bridge between natural philosophy (Science) and the Arts.

And what distinguishes the Arts from Medicine, Law, or Science? If we had asked this question during the nineteenth century and earlier centuries the answer would have been, they are just different domains of human endeavour

and knowledge about ourselves and our surrounding world, based upon observation and experience, questioning and defining, from both the present perspective and from preserving and studying the past. Naturally, all were driven by human curiosity. Indeed Science was known as natural philosophy and natural history, the former being the study of the nature of the world and the universe (physics), the latter the study of life (biology). And Medicine was once looked upon as an art.

But during the twentieth century, dominated as it came to be by academic positivism and professionalisation, and corporate power, the answer, particularly for the Life Sciences, and Medicine in particular, and for Law, has become radically different. During the 1960s, the flower-power generation readily knew the answer to this … creativity.

Arts students were at university to become free thinkers, to go on into any human endeavour and develop and use their creative and enquiring spirit. Hence, the primary aim of any university’s faculty of Arts is, or at least should be, to ensure that students develop their critical and creative thinking. Indoctrination, dogma and standardisation are anathema to this domain of learning. Students in the Arts are, or should be, learning to use what is known in popular psychology as both ‘right-brain’ lateral thinking alongside ‘left-brain’ reasoning (mathematics and logic), and empiricism (observation and experience), together with their intuitive, unconscious minds, to become creators, innovators and discoverers. Central to their disciplines is imaginative reasoning, experience and insight. This arena of knowledge encapsulates gnosis (the Greek word for ‘knowledge’); this is our intuitive and experiential understanding. From this type of knowledge a culture derives wisdom.

Nowadays, creativity often blossoms in ‘blue skies research’ in Science (pure science without any commercial agenda).

But though innovation in the Applied

Sciences arises from the creative spirit, it often lacks wisdom. Instead, such science is focussed on gathering information (bits of information about a subject, not an holistic overview) and then discovering ways of manipulating the subject matter.

Because researchers fail to adopt an holistic perspective, fail to connect the dots to the ethical, ecological and health impacts of such tunnel-vision creativity, their creations can be very destructive.

Wisdom is the heart of education. The Latin origin of the word ‘education’ reveals its importance: e (from/out), ducere (to lead), meaning to ‘lead out’, to connect with and expand into the world at large. That’s what education is all about: expanding the mind.

The Business of Medicine, Law and Science Unlike the Arts, a university’s faculties of Medicine, Law and Life Sciences during the twentieth century, and continuing on into the twenty-first century, abandoned any idea of creativity and instead have been training students to become competent medical practitioners, life scientists or lawyers as defined by the medical, scientific or legal establishments; and as dictated by the corporate and political vested interests of these professions. From the 1960s onwards the disciplines of Psychology and Sociology were also hijacked by academic positivists who strove to quantify the human psyche and human society. Since then, the human psyche and society have primarily been studied and then measured through mathematical quantification.

Admittedly, Law was traditionally classified within the domain of the Humanities, but because students learn the theories, principles and practice of a system of rules and guidelines for orchestrating the behaviour of individuals and groups within today’s very complex society this discipline is the very antithesis of creativity. Those lawyers with the greatest creative vision work to find ways of circumventing the rules of law, invariably for corporate psychopaths, or identifying where certain rules break

other rules. Those lawyers with the least creative vision invariably become members of political parties and, once in power, become visionless legislators.

If we dig down into the common theme of Medicine, Applied Science and Law, we discover that all are based upon manipulation. Thus, medical students are learning how to manipulate sick people’s bodies with drugs, or surgery, and, more lucratively, to manipulate the bodies of healthy people (for example, via vaccinations purportedly to reduce infections, statin drugs to reduce cholesterol, corticosteroids to reduce inflammation, contraceptives to prevent pregnancy, psychotropic drugs such as benzodiazepine tranquilisers to reduce psychological stress, and so on). Some scientists learn how to manipulate the physical world and pass the patented ideas on to crafty technologists to make their fortunes: through the genetic manipulation of foods, for example, or the atomic manipulation of materials in nanotechnology, or plundering oil, mineral or biochemical wealth from nature’s repository, or manipulating matter to create atomic energy or weapons, or manipulating our biosphere with various frequencies of electromagnetic radiation for telecommunications, and so on. Law manipulates people’s social structures to control people, and money, particularly through politics. And in Psychology, cognitive behavioural therapists learn to manipulate people’s thinking and behaviour. Its widespread application is evident in the fields of the media, politics and advertising.

At the core of learning in Medicine, Life Sciences and Law is induction. And the sum and substance of induction is indoctrination. The Latin origin of the word reveals its essence: in (in/inwards), ducere (to lead), meaning to ‘lead in’, and by implication, to lead into a job, to recruit. Induction is the process of narrowing down a trainee’s creativity and natural instincts. Thus, the armed forces induct young people into their ranks so that in the heat of battle, recruits obey

orders from their superiors, rather than follow their instincts to scream, panic, or flee. At worst, they must be resigned to dying in battle. That’s what induction is all about: narrowing the mind, if not shutting it down. And doing what you’re told.

Today, behind the academic positivism and professionalisation of much of what is termed ‘education’ lies corporate greed for money and power. We have an ‘education’ system—more correctly, an induction system— that blocks creativity and instead breeds student clones for the workforce. During the 1960s, the flowerpower generation knew that students studying anything other than the Arts were in training to become well-paid, ‘nine-to-five-schmoes’. Thus, medical, scientific, or legal indoctrination, dogma and standardisation are central to the modern training and subsequent employment of students in these domains of learning. These disciplines demand ‘left-brain’ thinking only, and impose conventional thinking about medical, scientific or legal issues. In each of these disciplines, established theories must be followed. Those who veer from the established path are sidelined, shunned and unemployed.

References 1. Leroi-Gourhan A. “The flowers found with Shanidar IV, a Neanderthal burial in Iraq.”

Science, 1975; 190 (4214): 562–564.

2. Solecki RS. “Shanidar IV, a Neanderthal flower burial in northern Iraq.” Science, 1975; 190 (4217): 880–881.

3. Adorno T. Aesthetic Theory, translated by Athlone Press Ltd, London, 1997, published

by Bloomsbury Academic, London, 2013, p. 1.

Original publication in German: Aesthetische Theorie, Suhrkamp Verlag, Frankfurt am Main, Germany, 1970.

4. Gosling N. “Presidential Address 1976”, March 1977, New Herbal Practitioner, 1977; 3 (1): 3.

Editor’s note: The views expressed in this article are those of the author and may not be shared by the Editor or the Association.

JATMS | Autumn 2015 | 33

STUDENT RESEARCH

Australian Wheat:

Its Role in Food Security, Politics and Diet-related Disease Dora Ferreira | 1st Year Student, ACNT BHSc Nutritional Medicine Student

34 | vol21 no1 | JATMS

I

nternational food security is an issue facing the entire world with the predicted global population expected to reach 9 billion by 2050.1 Organisations such as the International Maize and Wheat Improvement Centre (CIMMYT) and the Food and Agriculture Organisation of the Untied Nations (FAO) see wheat as a potential solution to the global issue.2 Australia is a food-secure wealthy nation producing 20 million tonnes of wheat a year, 80% of which is exported to 40 countries, generating over $4 billion dollars in export revenue each year. This makes wheat one of the country’s most valuable exports.3,4 This article examines the environmental, productivity and policy implications arising from the increased production of wheat, explores the historical role wheat has played in Australia’s food supply and safety, and examines the evidence and research indicating links between diabetes, cardiovascular disease and the consumption of wheat, exploring the potential benefits and challenges Australians face by decreasing wheat consumption and increasing fruit and vegetable intake.

Wheat is a valuable commodity and an important source of plant protein for many countries in the developing world.2 It is predicted that the demand for wheat by 2050 will increase by 70%; however the challenges facing wheat production are also accumulating.2 Issues such as increasingly aggressive pests and diseases, diminishing water resources, limited available land and unpredictable weather conditions - due to climate change - create insurmountable obstacles for both global and Australian production.1,2 CIMMYT is a not-for-profit organisation that researches sustainable development of wheat and maize farming.5 Its founder, Norman Borlaug, received the 1970 Nobel Peace Prize for his contributions to the green revolution, an era spanning the 1940’s and 1960’s, characterised by the introduction of chemical fertilisers, synthetic herbicides and pesticides, which resulted in higher agricultural

productivity.6 Borlaug is also credited with developing disease resistant highyielding high-protein (gluten) strains of wheat, thereby increasing food production in developing countries and aiding in the reduction of global food insecurity.6 His successor, Sanjaya Rajaram, expanded on his achievements and was awarded the 2014 World Food Prize Laureate for CIMMYT’s wheat-breeding program. The program developed 480 wheat varieties released in 51 countries, increasing the world’s wheat production by more than 200 million tons.7 Unfortunately, these successes have also come at a cost to the environment, polluting the water systems, reducing soil quality ( leading to erosion), increasing energy consumption and straining already scarce water recourses, thus proving themselves to be unsustainable.6,8 The issues facing the world and influencing policy weigh heavily on these facts as countries, including Australia, try to address issues of food insecurity by producing and exporting greater amounts of wheat sustainably with minimal damage to the environment.9 Wheat has been a part of the Australian diet since 1788, when the first fleet arrived. It was initially cultivated in NSW.3,4 Since then consumption and cultivation of the crop has grown steadily, with yields over the past 20 years growing by 2.3% per year and 5 million tonnes of wheat being consumed domestically by humans and livestock.3,4 It is currently the largest grain crop grown in Australia, occupying 14 million hectares of land in 2010. Eighty percent of this crop is exported and it enjoys 15% of the world wheat trade annually.3,10 Australian wheat is known internationally for its high protein/gluten content, ranging from 9.5% to 13%, which also implicates it in dietrelated disease, sensitivities and allergies.11 Between 2003-2004 in the Australian domestic market, 994,000 tonnes of wheat flour were used to make bread, 73,000 tonnes to make pastries and 110,000 tonnes to make biscuits.3 Such figures illustrate the importance wheat has played in Australia’s food security and its economic

growth, often being an industry enjoying government protection.3 They also set the scene for potential health issues arising from the over-consumption of wheat.

It is widely known and accepted that the protein gluten found in wheat is the cause of coeliac disease, but research now also links diabetes and cardiovascular disease to the consumption of wheat products.

Diabetes and cardiovascular disease weigh heavily on the burden of healthcare in Australia, with data indicating the rates of diagnosis increasing.12-14 There are 1 million people living with type 1 and type 2 diabetes in Australia, and over 3 million people above the age of 25 years are expected to have diabetes by 2025 if current rates continue.13 The total annual cost of type 2 diabetes for Australians is up to $6 billion dollars, leading the government to declare it a national health priority in 1997.13 Type 1 diabetes (T1D) is an organ-specific autoimmune disease directed against the pancreatic beta cells that produce the endocrine hormone insulin.15 A study conducted on mice in 2013 investigated the possible causal link between glutenaltering healthy microbial gastrointestinal bacteria and T1D, stating ‘epidemiological data suggest that early exposure of infants to cereals containing gluten may increase the risk of T1D.’15 Their study found that ‘gluten free diets significantly delay the onset as well as reduce the overall incidence of spontaneous T1D in nonobese diabetic mice. Therefore gluten may play a part in the pathogenesis of T1D by modulating the gut microflora.’15 Type 2 diabetes has also been linked to the consumption of a grain based diet,16 with the ABC’s Catalyst program ‘Low carb diet fat or fiction’ which aired on 13 November 2014 contributing to this debate.

Cardiovascular disease is the leading cause of death in Australia, responsible for over 43,900 deaths in 2012, averaging one Australian death every 12 minutes.12,14 Interestingly, 65% of all deaths from cardiovascular disease in Australia occur in people with diabetes.13 New evidence now points to the ‘cardiotoxicity of wheat’17 and

JATMS | Autumn 2015 | 35

STUDENT RESEARCH

the role that dietary lectins (carbohydratebinding proteins found in wheat, also known as Wheat Germ Agglutinin or WGA), may promote ‘the formation of fatty streaks and mature atherosclerotic plaque in the arteries.’17 Both Lundell18 and Ji17 argue that highly processed carbohydrates such as flour made from wheat cause chronic inflammation of the arteries that leads to cardiovascular disease. This opinion was also expressed in the ABC’s Catalyst program.19 Given the compounding body of evidence it would appear that Australians would benefit greatly by reducing the consumption of wheat products and increasing fruit and vegetable consumption, but this transition is fraught with difficulties. The Australian economy relies heavily on the revenue generated by wheat farming. It is possible that, due to economic issues, both the government and industry may oppose these types of messages in the media. The Australian Bureau of Statistics in 2003-043 stipulated that at least 30,000 farms in Australia grew wheat, demonstrating the number of families relying on this crop for income.

The Australian Dietary Guidelines releases up-to-date advice based on scientific evidence surrounding the amounts and types of foods Australians need to consume for optimum health and to avoid diet-related disease.20 These guidelines advise that men between the ages of 19 and 50 should consume six serves of vegetables and six serves of grains a day and women in the same age group, five serves of vegetable and six serves of grains a day - advice directly conflicting with new evidence emerging and discussed in this paper.20 Adding to this argument, figures show that 60-70% of Australians currently meet the recommended cereal intake requirements, mostly in the form of energy dense foods such as cakes and biscuits, but only 8.2% meet the recommended fruit and vegetable requirements. This is an alarming figure, showing the extent to which Australians over-consume wheatbased foods.12,21

36 | vol21 no1 | JATMS

The benefits of eating fruit and vegetables are widely reported, including the reduction of type 1 and type 2 diabetes, cardiovascular disease and obesity, as well as the added bonus of increasing vitamin and mineral levels. Studies have shown that seven serves of vegetables a day can lower the risk of dying from diet-related disease by 42% when compared eating less than one portion a day.22 Wheat has long been regarded as a solution to the issues of food security globally, with organisations such as CIMMYT pouring valuable resources, manpower and financial support into developing disease-resistant, high-yielding varieties containing a higher protein level and being environmentally hardy. Australia as a food-secure nation and large exporter of wheat is expected to play a part in this process, but it has come at a cost to the land and health of the Australian people.

Wheat has always been a part of the Australian diet, but consumption of wheatbased products in recent years has been increasing steadily, accompanied by an increase in diet-related diseases such as type 1 and type 2 diabetes, cardiovascular disease, coeliac disease and obesity. The challenge Australia now faces is how to turn this around, given that wheat is such a valuable commodity, and the literature on the recommended dietary guidelines for wheat tells a different story.

References 1. The Prime Minister’s Science Engineering and Innovation Council. Australia and food security in a changing world. Canberra (Australia): The Prime Minister’s Science and Engineering and Innovation Council; 2010.

2. CIMMYT International Maize and Wheat Improvement Center. Wheat improvement - The mandate of CIMMYT’s global wheat program, 2014 [cited on 11 November 2014] http://www.cimmyt.org/en/what-we-do/ wheat-research/item/wheat-improvementthe-mandate-of-cimmyt-s-global-wheatprogram.

3. Australian Bureau of Statistics. Year book Australia:the Australian wheat industry.

Canberra (Australia): ABS; 2006. ABS publication 1301.0.

4. Australian Wheat Board. Australian wheat. [cited on 29 October 2014] http://www. muehlenchemie.de/downloads-future-offlour/FoF_Kap_07.pdf 5. CIMMYT International maize and wheat improvement center. Our history, 2014 [cited on 11 November 2014] http://www.cimmyt. org/en/who-we-are/our-history 6. Educational portal. What is the green revolution? Definition, benefits and issues, 2014 [cited on 11 November 2014] http:// education-portal.com/academy/lesson/whatis-the-green-revolution-definition-benefitsand-issues.html#lesson 7. The world food prize Borlaug centennial laureate. Dr Sanjaya Rajaram, 2014 [cited on 14 November 2014] http://www.cimmyt.org/ en/component/docman/doc_view/40-2014laureate-story 8. Australian Institute of Health and Welfare.

Australia’s food and nutrition 2012. Canberra (Australia): Australian Institute of Health and Welfare; 2012.

9. Australian Bureau of Agriculture and Recourse Economics and Sciences. Agriculture and food, global food security: Facts issues and implications Issue 1-2011. Canberra (Australia): Australian Bureau of Agriculture and Recourse Economics and Sciences; 2011.

10. Price Waterhouse Coopers. Australian grains industry, the basics. [cited on 11 November 2014] http://www.pwc.com.au/industry/ agribusiness/assets/Australian-GrainsIndustry-Nov11.pdf 11. Australian Export Grains and Innovation Centre. Australian wheat. South Perth (Western Australia); Department of Agriculture and Food; 2012.

12. Australian Bureau of Statistics. Daily intake of fruit and vegetables. Canberra (Australia): ABS; 2013. ABS publication 4338.0.

13. Baker IDI Heart and Diabetes Institute.

Diabetes the silent pandemic and it’s impact on australia. [cited on 14 November 2014] https://www.diabetesaustralia.com.au/ Documents/DA/What’s%20New/12.03.14%20 Diabetes%20management%20booklet%20 FINAL.pdf 14. National Heart Foundation. Cardiovascular disease fact sheet. [cited on 12 November 2014] http://www.heartfoundation.org. au/SiteCollectionDocuments/FactsheetCardiovascular-disease.pdf 15. Marietta, E., Gomez, A., Yeoman, C., Tilahun, A., Clark, C., Luckey, D., Murray, J., White, B., Kudva, Y., & Rajagopalan, G. Low incidence of spontaneous type 1 diabetes in non-obese diabetic mice raised on gluten-free diets is associated with changes in the Intestinal Microbiome. 2013. PLOS ONE. 8(11). doi: 10.

1371/journal.pone.00786887. [cited on 11 November 2014] http://www.ncbi.nlm.nih. gov/pmc/articles/PMC3827256/.

16. Ji, S. (2012). The Dark Side of Wheat - New Perspectives On Celiac Disease and Wheat Intolerance. Retrieved on 12 November 2014 http://www.greenmedinfo.com/page/darkside-wheat-new-perspectives-celiac-diseasewheat-intolerance-sayer-ji 17. Ji, S. Wheat’s cardiotoxicity: as serious as a heart attack. 2012. [cited on 12 November 2014] http://www.greenmedinfo.com/blog/ wheats-cardiotoxicity-serious-heart-attack 18. Lundell, D. Heart surgeon speaks out on what really causes heart disease. 2012. [cited on 12 November 2014] http://www.sott.net/ article/242516-Heart-surgeon-speaks-out-onwhat-really-causes-heart-disease

19. Catalyst (2014, November 13). [Television Program]. Sydney, Australia: ABC Television.

20. National Health and Medical Research Council. Eat for health Australian dietary guidelines summary. Canberra (Australia): National Health and Medical Research Council; 2013.

21. National Health and Medical Research Council. Eat for health Australian dietary guidelines. Canberra (Australia): National Health and Medical Research Council; 2013.

22. Oyebode, O., Gordon-Dseagu, V., Walker, A., & Mindell, J.S. Fruit and vegetable consumption and all-cause, cancer and cvd mortality analysis of health survey for england. J Epidemiol Community Health. 2014;68(9), 856862. doi: 10.1136/jech-2013-203500.

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JATMS | Autumn 2015 | 37

ARTICLE

A New Homoeopathic Tool: The Candegabe Algorithm Rhonda Campbell | DipHom, DBM, Natural Fertility Cert, Reiki teacher and the author of ‘Luke’s Rescue by the Bach Flowers’

Could there be codes other than Hahneman’s Law of Similars?

Classic homoeopathy uses symptoms but there is another standard (or similar), The Huma Method (Candegabe’s Algorithm).1 The Huma method proposes a mathematical paradigm, using a numerical code as a new standard. It bypasses most of the problems inherent in our repertories. Recently proven remedy rubrics are not always present in the repertories and the size of rubrics is increasing as new remedy provings are published. However, this algorithm uses a different approach in finding similarity between substance and people and does not make reference to sign and symptoms. This algorithm is not philosophy but a new and exciting tool for homoeopaths. The case still needs to be taken with the same amount of care and then the algorithm chart can be studied to help find the best remedy.

After a period of experimentation with this innovative tool I have found a way to use it in my practice. The aim of this article is to explain how to find the simillimum from the algorithm result, and to demonstrate how it works, with two examples. In an article published in May 2014 in Homeopathy for Everyone,2 I have described three cases using the algorithm result and demonstrated how a remedy can be selected. The algorithm works by translating the personal information of a client (name, nickname, initials, date of birth, country of birth,) into a phonetic numeric code or pattern, using the international phonetic alphabet. It then compares the numero-phonetic code of the Latin name of homoeopathic remedies: “Like cures like”, and gives a readout chart demonstrating the remedies that correspond to the patient’s personal information. The chart is produced from a normal distribution curve3 and a curve of asymmetric distribution.4 The algorithm is a new mathematical approach to a paradigm of homoeopathy, created by Dr Marcello Candegabe5 and his team. Dr Candegabe is a homoeopath from the Argentina School of Homoeopathy6 and Director of the Universidad Candegabe

38 | vol21 no1 | JATMS

de Homeopatica.7 The code was calculated using a baseline of cured cases. It is simply a mathematical probability algorithm.

The chart contains thirty to forty remedies graded according to their correspondence to your client’s details. They are graded according to the kingdom, and now a combined analysis has been added to the chart with grading for consonant, vowel and key remedy parameters. The remedies obtained from the algorithm result are ranked from nine to two and indicate the rank or level of mathematical similarity between the substance and case under analysis. The algorithm also represents a graph, called the pregnancy, which indicates the most likely substance of the homoeopathic remedy (animal, plant, mineral, imponderable).

The new method came into being when Dr Candegabe met Hans Peter Durr, a physicist from the Max Planck Institute.

Durr reasoned that there must be many codes that relate medicines to patients. After the meeting Candegabe put together a development team6 including 20 homoeopaths, two mathematicians, a statistics engineer, an epistemologist, a linguist, a quantum physicist, a Latin expert and a programming expert at the University of Buenos Aires. They studied the most stable parameters which could be as far from human subjectivity as possible.It took three years before they were satisfied with the results and in 2008 the Algorithm was made available online for the first time. The Huma method was proven in over 900 cases,6 using more than 1000 remedies. Over 400 cases cured with classical homoeopathy were analysed as control cases. To date there are 2000 cases analysed.6 Homoeopaths from 25 countries, including Italy, USA, UK, Ecuador, Mexico, Brazil, Japan and Argentina are using this method.

The experimental method was evaluated by the team using two different methods: • studying the results of already homoeopathically cured cases and observing whether they appeared in the algorithm study, and

• Studying the remedies found in the Algorithm study of an untreated patient or unsuccessfully treated patient and observing whether a remedy that cured the patient was displayed.

I used my repertorisation results and then compared it with the algorithm result to help find the medicine for the case.

Many new remedies or little known remedies came up in the algorithm result and readers may find the simillimum is not necessarily in the repertorisation. A study of the new remedies is needed. Readers can draw on information from different well-known homoeopaths to help them see the remedy in the result. I have had amazing results with remedies that came up in the algorithm analysis. Without the algorithm, I would never have thought of these remedies. Bannan published an article in Homeopathic Links in 20137. He emphasises how important it is to use the correct spelling with the correct vowels and to use nicknames as well as birth names. It is more difficult to get a result with Slavic and Chinese names because there are incompatibilities with the Latin Base. Bannan has found that it is unusual for a person to need a remedy that scores less than 6. I have not necessarily found that. The higher the remedy’s top score the closer is the correspondence between it and the name.

In Spring 2014 Bannan gave the first training on the algorithm in New York to help homoeopaths come to grips with the subtleties of the system. I hope that this article encourages homoeopaths to give this exciting new Candegabe algorithm method a trial. It has opened my eyes to many new remedies and given me a new inspiration for homoeopathic practice.

The following cases show how the algorithm can help with the case.

Case 1 - Algorithm Chart 1 (see Figure 1) Female (Janet) First Consultation: 19/3/2014 Janet had put her much loved house on the market because there was a large development being built around the corner.

She was sad because the development was going to disturb her peace and quiet. Her house sold very quickly. She felt flat and couldn’t stop crying from grief, and was anxious about the future. She was psychic and felt spirits around her. She had a fear of aliens (Mancinella) and evil, and heard voices. She wasn’t sleeping well and she told me that when she was a teenager she often woke with electric shocks going through her body.

The rubrics used were: MIND - WEEPING: MIND - ANXIETY - future, about Mind - FEARS, phobias, general - aliens, of

SLEEP - WAKING - shocks, from - electric-like shocks in head MIND - DELUSIONS, - voices, hears MIND - DELUSIONS - voices - hearing MIND - FEAR - evil; fear of

Remedy: Asterias rubens 200 She rang in a week for a progress report and said that before she got back to the car after the consultation she was feeling a lot better and had stopped crying. I had given her a dose of Asterias rubens 200 in the consultation. The next day she developed severe diarrhoea and deep pain in her body (she remembered she had experienced the same pain 18 months ago).

Second consultation: 9/4/14 She said she was in a much better place, no weeping and she said that the severe diarrhoea felt like a clean-out of a lifetime, a clean-out of fear, sadness and losing things. She was starting to feel a bit sad again because she was trying to find another house to live in. She was sleeping better and had not been angry at all since she last saw me (she hadn’t mentioned that in the first consultation).

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JATMS | Autumn 2015 | 39

ARTICLE

Algorithm Chart 1

Algorithm Chart 2

Janet

Samantha

Impregnancy Symmetry

Impregnancy Animal 20% Vegetable 40% Mineral 40%

5 MSR (Matematical Similarity Range 8

Kingdom

Remedy

Mineral

Causticum Hahnemanni

Vegetable

8

Vegetable Mineral

Cinnamomum ceylanicum Coffea cruda Aceticum acidum

Mineral

Ferrum sulphuricum

7

Vegetable

Tilia Europea

7

Vegetable

Pyrus Americanus

7

Mineral

6

Vegetable

Arsenicum sulphuratum flavum Rhus toxicodendron

Mineral

Curprum sulphuricum

4

Mineral

Kalium arsenicosum

Mineral Mineral

Magnesium carbonicum Uranium nitricum

Vegetable Vegetable

4 3

Vegetable Mineral Vegetable

Cannabis indica Aesculus hippocastanum Hypericum perforatum Natrium arsenicosum Paeonia officinalis

Mineral

Ammonium causticum

Mineral Vegetable Vegetable

8 7

5

Consonants

• • • • •

Key Remedies

• • • •

4

• • •

•

4 4

•

•

• •

•

2

Ammonium muriaticum Opium Sabadilla officinalis

2 2 2

•

Vegetable Vegetable Mineral

Staphysagria Tabacum Zincum metallicum

2 2 2

Mineral

Zincum muriaticum

2

Animal Animal Mineral

Asterias rubens Lac delphinum Iridium metalicum

2 2 2

Mineral

Succinicum acidum

2

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3 3 3

•

•

• •

•

Kingdom

Remedy

Mineral Vegetable Vegetable Mineral Vegetable Vegetable Vegetable Mineral Animal Mineral Vegetable Animal Animal Mineral Mineral Vegetable Vegetable Vegetable Vegetable Animal Mineral Mineral Vegetable Vegetable Vegetable Mineral Vegetable Mineral Mineral Mineral Mineral Animal Vegetable Min/Ani Vegetable

Ferrum metallicum Lycopodium clavatum Cannabis indica Cuprum sulpuricum Helonias dioica Prunus spinosa Rhododendron chrysanthum Ammonium muriaticum Onchorynchus tschawytscha Iridium metallicum Veratrum album Lac delphinum Dendroaspis polylepsis Alumina Aqua petra Cactus grandiflorus Guajacum officinale Penicillinum Rhus toxicodendron Ambra grisea Ammonium bromatum Antimonium sulphuratum auratum Arum dracontium Boletus laricis Camphora officinalis Causticum Hahnemanni Cedron Cocainum hydrochloricum Kalium carbonicum Magnesium muriaticum Manganum Medorrhinum Cistis Canadensis Cortisonum Myrica cerifera

MSR (Matematical Similarity Range 8 8 6 6 6 6 6 6 6 6 5 4 4 3 3 3 3 3 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Remedy: None, but I gave her Aterias rubens M to be taken if she felt worse for more than two days and only to take one dose (6 drops in 250mls of water and then to take 1 teaspoon of the mix). She rang four weeks later and had taken the diluted dose of Asteria rubens M when she moved out of her house. She said it worked immediately, with no physical discomfort. She felt strong and positive.

Samanthaâ&#x20AC;&#x2122;s algorithm report (see below) indicated she would equally respond to a plant remedy (40%) or a mineral (40%) as shown in the Impregnancy. I was thinking of selecting the mineral Cuprum as her remedy but chose Cuprum sulph because it was number 4 in her algorithm report with a symmetry of 6.

Seventh Consultation: 23rd March 2011

Janetâ&#x20AC;&#x2122;s algorithm report (Chart 1) indicated she was most likely going to respond to an animal remedy (50% Impregnancy Symmetry). There are only two animals in her report: Asterias rubens and Lac delphinium. Asterius rubens was chosen after reading the materia medica. I had never prescribed the remedy before.

Case 2 - Algorithm Chart 2 (see Figure 2) Female (Samantha) First Consultation: March 2009

Since the last visit she had used Cuprum sulph 200 successfully when she got the reflux and spasm symptoms. She still occasionally burped. She had thrush a number of times with burning pain, dryness and itching in her vagina and vulva and an itching discharge. She used anti-fungal creams on each occasion. She was very anxious about her health and would seek advice from doctors and specialists for any small symptom.

She was having trouble falling asleep and was worrying about small things. Although the Cuprum sulph helped her reflux, the remedy did not seem to be helping her anxiety about her health.

I studied the algorithm again looking for a remedy that included hypochondriasis.

Samantha came to see me with polycystic ovary syndrome.

She hadnâ&#x20AC;&#x2122;t had periods for 10 months. Her periods returned to normal on Belladonna 200 and M, and with a herbal mix.

Fifth Consultation: 3rd August 2010 Samantha came to see me with reflux - a burning sensation after eating and better for cold drinks. She felt a backward pulling sensation, which felt like a spasm in her chest. She felt like she was choking. She felt better for stretching and it was difficult to burp to release trapped gas. She had bloating. She felt anxious and a little depressed, and seemed overly concerned about her health.

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The rubrics used were: Stomach - ACID, reflux, esophagus Stomach - DISTENSION, stomach Throat - CHOKING, general STOMACH - ERUCTATIONS - difficult CHEST - SPASMS of MIND - ANXIETY MIND â&#x20AC;&#x201C; Hypochondriasis

Remedy: Cuprum Sulph 200 daily for 5 days.

Sixth Consultation: 27 October 2010 th

Her spasms reduced immediately and the burning and reflux were gone. The burping comes back occasionally. She said she was taking control of things on her own and felt stronger in herself.

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Remedy: Cuprum sulph 200 when needed

JATMS | Autumn 2015 | 41

ARTICLE

The rubrics used were: MIND – Hypochondriasis FEMALE GENITALIA/SEX - PAIN - burning FEMALE GENITALIA/SEX - ITCHING FEMALE GENITALIA/SEX - ITCHING - Vulva - leukorrhea; from Stomach - BELCHING, eructations SLEEP - SLEEPLESSNESS

Remedy: Helonius M for 4 days.

Eighth Consultation: 31st March 2011 The itching and burning in her vagina stopped after 2-3 days.

She said she felt her system was being cleansed because she saw white ropy strands in her stool. She occasionally gets a dry vagina but it only lasts for half an hour. She gets bloating sometimes. She lost 8 kgs in weight. She said her restlessness had reduced but she was constantly fighting the fear that she might not stay that way. She wasn’t as worried about money.

Remedy: Helonius 10M for 3 days. I told her to repeat 1 dose after every period if she felt anxious.

Ninth Consultation: 10th August 2011 She had thrush symptoms only very occasionally. She was reading a lot and was definitely more relaxed and less anxious, trusting life a bit more. She got the occasional fear of getting sick again but it didn’t overtake her. She felt more light-hearted and more focused.

This new tool can be used for prescribing and in the development of clinical materia medica for the little known and rarely used remedies. It makes it easier for homeopaths to make a better remedy choice and will suggest remedies which would not be normally considered.

References 1. Candegabe Algorithm. About the Algorithm [Internet]. The Huma Method. [cited 2015 Feb 2] Available from: http://www.algoritmocandegabe.com/ index.php?option=com_content&view=article&id=48&Itemid=55 2. Campbell R. Using the Candegabe Algorithm to Fine Tune Homeopathic Repertorisation. Homeopathy For Everyone [Internet]. 2014 [cited 2014 May]. Available from: http://hpathy.com/homeopathy-papers/usingcandegabe-algorithm-fine-tunehomeopathic-repertorisation/ 3. Gauss CF. Normal Distribution [Internet]. [cited 2015 January]. Available from: http://en.wikipedia.org/wiki/Normal_distribution 4. Gumbel EJ. Curve of Asymmetric Distribution [Internet]. [cited 2015 January]. Available from: http://en.wikipedia.org/wiki/Gumbel_ distribution 5. Candegabe M, Cataldi G. Homeopathy in the year 2005. Presented at the 64° LMHI Warsaw Congress 2009. Timeless Quality Homeopathy. [cited 2015 January]. Available from: http://www.universidadcandegabe.org/ files/Trabajos/m_candegabe/Homeopathy_2050.pdf 6. Candegabe Research Team. Escuela Médica Homeopática Argentina.

[Internet]. 2005. [cited 2015 January]. Available from: http:// escuelapaschero.com.ar/?cat=70

Remedy: Helonius 10M when needed.

7. Bannan R. 21st Century Homeopathy. Homeopathic Links 2013;28:1-8

July 2014 Report Samantha has had a baby and has remained healthy and relaxed.

She takes Helonius 10M occasionally when she feels she needs another dose. Samantha’s algorithm report had suggested she would respond to a plant or mineral remedy, as both were 40% probability in the Impregnancy. Helonius is a plant and number 5 on the Algorithm report with a symmetry of 6. Helonius has hypochondriasis. Sankaran 8 suggests that in Helonius we have an attention-seeking behaviour by her hypochondriasis. In this way she keeps from being excluded.

8. Sankaran R. Rajan Sankaran [Internet]. [cited 2015 January]. Available from: www.Rajansankaran.com

She had initially responded to Belladonna before I knew about the algorithm. It is interesting to see how she responded to different remedies. I feel that if I had given Helonius in the beginning of her treatment the journey to her balanced mental emotional and physical wellbeing would have been faster.

The Candegabe Community is hoping to develop and realise the potential of this new tool. The algorithm can be used with other tools and systems including Sankaran8 Scholten,9 Liz Lalor,10 Vermuelen,11 Alistair Gray12 etc.

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9. Scolten J. Jan Scholten [Internet]. [cited 2015 January]. Available from: http://www.janscholten.com/janscholten/Welcome.html 10. Lalor L. Facebook [Internet]. [Cited 2015 January]. Available from: https:// www.facebook.com/liz.lalor.9 11. School of Homeopathy. Frans Vermuelen [Internet].[cited 2015 January].

Available from:http://www.homeopathyschool.com/the-school/patrons/ frans-vermeulen/ 12. Whole Health Now. Alastair Gray [Internet]. [cited 2015 January]. Available from: http://www.wholehealthnow.com/bios/alastair-gray.html

European Remedial Massage Techniques “Learn the successful European techniques to solve problems.”

This is course 1 of a series of courses to learn European remedial massage techniques with a strong focus in learning the successful European techniques to solve problems. In Europe massage therapy is fully integrated in the medicine and outcome orientated.

In ERMT 1 you will learn new result based techniques for the upper part of the body including positional vertigo, headache and migraine, and interpreting of X-rays and MRI.

When and where: 23rd and 24th May 2015 Mosman Presented by Richard Rohrhofer Price for a 2 days course: $295.00 Contact: info@marcaurel.com.au Ph: 0435 153 212 www.marcaurel.com.au

AXIAL IMBALANCES & CORRECTIONS: Assess & treat spinal conditions Perth (Rossmoyne)—28th & 29th Mar Yallingup, WA‐2nd & 3rd May APPENDICULAR IMBALANCES & CORREC‐ TIONS: Assess & treat sports injuries & limbs Brisbane—7th & 8th Mar Melbourne—14th & 15th Mar Central Coast NSW— Same dates as Melb.

Adelaide—21st & 22nd Mar, Sydney—Same dates as Adelaide Perth (Rossmoyne) ‐ 6th & 7th June Yallingup, WA‐4th & 5th July HEAD & SELECTED ORGANS: TMJ, breathing problems & other organ conditions–1 day plus the Skill Refining Brisbane 9th & 10th May Melbourne, 16th & 17th May Central Coast NSW— Same dates as Melb.

Adelaide—23rd & 24th May Sydney—Same dates as Adelaide

More workshops available in our website

P.O. Box 2065 Chermside Centre Qld 4032 info@aoit.com.au www.aoit.com.au Ph 07 3172 7761

JATMS | Autumn 2015 | 43

ARTICLE

Understanding Kinesiology Jennifer Beasley | Neuro-Trainer, Naturopath, Kinesiologist, Dip Early Childhood, Adv Dip in Special Education. Director of Neuro-Intelligence.

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â&#x20AC;&#x153;Kinesiology involves the use of muscle testing, muscle monitoring or muscle checking as a verification tool for monitoring feedback from your nervous system. It is a tool, not a technique, for monitoring a subconscious neurological response.â&#x20AC;?

S

ince the development of Applied Kinesiology from the physiotherapy and chiropractic fields in the 1960’s, kinesiology has grown into a therapy that encompasses many variations and different approaches.

Its aim is to empower people to achieve wellness and all kinesiology practitioners use the same neurological feedback in their treatment. As with many alternative and mainstream practices, people who consult a number of practitioners in the same field will have a different experience from each one. The kinesiology experience is no exception to this.

The Basics: How neurological feedback works Your nervous system monitors and coordinates all your body interactions. A qualified kinesiology practitioner uses a change of muscle response to assess feedback from your nervous system. This change of muscle response is detected when light pressure is applied to an extended arm or leg.

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Definitions Kinesiology is the study of muscle movement.

The term is also used to refer to the practice of assessing how an individual adapts to a particular stress or challenge. Failure to adapt appropriately to accumulated stress can manifest as symptoms in our physical bodies and in our psychological and emotional lives, through the body’s electrical and energetic systems.

Kinesiology involves the use of muscle testing, muscle monitoring or muscle checking as a verification tool for monitoring feedback from your nervous system. It is a tool, not a technique, for monitoring a subconscious neurological response. According to the Australian Institute for Kinesiologists, kinesiology is used to evaluate stress levels in a person’s nervous and energy systems. The Australian Kinesiology Association defines kinesiology as a modality that ‘encompasses holistic health disciplines which use the gentle art of muscle monitoring to access information about a person’s wellbeing’.

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What a kinesiologist does and does not do A kinesiologist does not diagnose or treat any disease. A kinesiologist uses a change of a muscle response as an assessment tool to verify whether the body can adapt to challenges. Understanding the body’s defence response is crucial to understanding why there is a change of muscle response. We have a nervous system that helps us adapt to change in the most efficient way. To understand this better, let us look at what happens in the brain that maintains this defence response via stress reactions. The word stress is not really an accurate description of what is happening in the brain or to us. We are designed to function under stress as a way of challenging ourselves.

This helps us grow and develop. If we are unable to adapt appropriately to stress the body can become ‘distressed’.

Geared up and bracing for more stress Many of us have lives that are full of incongruities and pressures. When we experience these pressures we gear ourselves up to protect ourselves from them. Always on alert for these pressures, we start to defend against them, whether they are real or imagined. In this defence reaction we go into a distress response. It

is this change in the brain that becomes our greatest neurological and hence, functional, enemy.

The habit of distress The body can fall into the subconscious habit of being in defence most of the time. This means that some other function of the brain, like thinking, learning or even making basic life choices, can be impeded. We find it difficult to concentrate, remember, or to co-ordinate simple tasks. We can engage in distress reactions over anything, perceived or real. The day can become a battle for survival.

More importantly, we may not even be aware we are in this distressed state.

This habitual defence pattern slows recovery and makes life an effort. Posttraumatic stress syndrome is an example of the body sustaining a defence pattern against trauma. However, we can sustain our responses to less brutal events than trauma in the same way. Being in constant distress uses an enormous amount of energy. It can develop over time, with challenge after challenge, that can cause weakened immunity, body dysfunctions, deficiencies, emotional reactions, and an inability to make the best choices for ourselves.

How to break the distress habit Kinesiologists help the body break the distress habit in two ways. The first is to retrain the brain to not go into defence reaction mode (distress) habitually; the second is to bring the blood back to the areas that are starved of it, and its nutrients, by stimulating points on the forehead that activate this.

How kinesiology assists A Kinesiologist will use various methods to re-train a person’s habitual patterns.

These methods are tailored to individual clients’ needs. All of the techniques are designed to develop a supportive habit of integrated functioning. This has an effect on their physical symptoms, their emotions and their patterns of thinking.

Depending on the context, neuroreflex points, emotional stress release points and reframing of past experiences through changing perceptions may be used to help regulate and recondition the brain patterns. Practitioners may also use lymphatic drainage, circulation flow reflexes and other body reflexes to encourage physical changes throughout the nervous system.

When we are at our optimum health, we are best able to adapt to any challenge. Kinesiologists use a change of muscle response try to clarify the source of the challenge and the best treatment approach. Each individual will experience something different in their kinesiology session due to their own life experiences. Kinesiology encourages symptoms to fade and a better functioning pattern to emerge. A new sense of integration, adaptability and change can become evident as each person is able to meet the challenges that come their way.

Jenni has been in practice for the past 27 years, operating private clinics in Melbourne, the Gold Coast and Northern NSW.

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WORKSHOP

One of the important aspects of the day’s work centered on the knowledge that the work can be used for both self-healing and working with patients.

Medical Qigong Workshop in Hobart

The photo shows some of the students who attended the workshop.

Bill Pearson is a former President of ATMS, a Life Member and an accredited TCM Practitioner who runs the Jian Shen School of Tai Chi and Qigong in Hobart.

Bill Pearson | Former Vice President and President. Life member.

In February I presented a Medical Qigong Workshop in Hobart, which attracted practitioners from the north and south of the state. The day concentrated on the work by Professor Hongtao Xu who created, teaches and practises Medical Qigong at the Xiyuan Hospital in Beijing. He refers to the style as Guigen Qigong or “returning to the source or root”.

The sections of Guigen Qigong learned on the day help regulate the meridian system, clear stagnation (physical and emotional), embracing the ancient Taoist understanding of restoring natural harmony by using the three Treasures of TCM which are qi, jing and shen.

Practice of this form of Medical Qigong brings harmony to the mind, body and spirit and is used extensively (if not exclusively) in the Xiyuan Hospital in Beijing, which I was privileged to observe in 2012 as part of an extensive period of training under Professor Xu. Professor Xu and his work attract people from all around the world, including doctors, students of Tai Chi and Qigong and practitioners from many forms of practice.

JATMS | Autumn 2015 | 47

PRACTITIONER PROFILE

“Set your goals high, reach for the stars ... carpe diem! If an opportunity, even a scary one, comes your way, grab it!

Wonderful things can happen if you open yourself up for all possibilities.”

ATMS Member Interview Tracie Acheson ND

The modalities I practise include naturopathy, herbal medicine, homoeopathy, nutrition, lifestyle enhancement, flower remedies, iridology and counselling. I offered hypnotherapy, remedial and aromatherapy massage in my early years of practice.

I have been in practice since the late 80’s when very little was known of natural therapies. In the early years there were very few natural therapy clinics around and massage “parlours” outnumbered us at a ratio of 10:1. I had to screen many less than desirable inquirers. I am pleased that times have changed in this regard.

What have been the major influences on your career?

The major influence on my career has been my teacher and herbal guru, Dennis Stewart, who inspired me, supported me and passed on his passion for herbal medicine by truly giving me a feel for the remedies he spoke so passionately about.

I feel blessed to have gained my herbal foundation from Dennis. Secondly, I

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acknowledge my mentor, Marelle Burnum Burnum ND, who gave generously of her time to share with me her wealth of knowledge over the years. I observed her in the final stages of my studies and after I had graduated and was building my own practice. She is passionate and inspiring and has a true gift for holistic natural medicine.

What do you most like about being a naturopathic practitioner?

I feel so blessed to be able to help people get well and stay well. During my 27 years in practice I have seen a lot of patients and I never tire of seeing people come back to me with a smile on their face, so grateful that their condition, that has often led them all the way through the medical realms and finally to me, is improving daily. I really don’t think there is a more rewarding feeling. With the fast pace that our world asks of us, our patients are too often not only physically unwell but also emotionally and spiritually unwell. I love the fact that our medicines, along with genuinely

listening to patients, understanding them and validating their stories also help to bring their mental imbalances back towards wellness. Having been in practice a long time I have seen people who were in their teens and are now in their 40’s bringing their children in to see me. A few years back I was chuffed to discover a file in my cabinets of a six yearold girl brought to me by her mother for tonsillitis and to discover that this same six-year-old girl was now the naturopath I had just hired to help me at the clinic.

What advice would I give to a practitioner starting out?

I would let them know that they need to have an excellent work ethic and understand that building a successful practice includes having clinic hours that make them available to patients and committed to seeing through their new clinic’s quieter times. Any well established practitioner will confirm that there were tough times. I would advise getting a part time job if they need to supplement their income, continuing clinical observation with experienced

practitioners, and accepting that it is natural to feel that there is so much more to learn. Just keep learning. They should use their skills to prioritise where they need to start with each patient and communicate their strategy with their patients about their roads to recovery.

Leading patients to fully understand their health and working together with them to return them to wellness can be the most rewarding relationship that a patient and practitioner can have.

Set your goals high, reach for the stars ... carpe diem! If an opportunity, even a scary one, comes your way, grab it!

Wonderful things can happen if you open yourself up for all possibilities. I was thrilled to have been recognised by the Sydney Morning Herald as one of the best clinics in Sydney, and was honoured to

be voted “Most Outstanding Specialised Business” by the Small Business Awards in Sydney in recent times. These things are possible. Just aspire to be the best that you can be. *Smile*

What are your future ambitions?

Healing and helping people get well is in my veins. I see myself continuing to do this even if it takes on a different form in the future. After helping a family from Oman recently with their health while they were in Australia visiting their son who was working here, I was asked for a prospectus to take back to the UAE with a view to my consulting in Oman, regularly visiting Oman part-time to educate and help the staff of a large company over there. It is early days, but I see more of these opportunities opening up. I will always continue to gain knowledge with

the aim of helping my patients with my clinical skills.

These are interesting times for the natural medicine industry. I would love to see naturopathy and nutritional guidance in our hospitals! I think it is important that we don’t lose our identity and “the art” of healing while we strive for a more mainstream path.

It is wonderful that we are taking on and understanding the science of our bodies but feel I it is important that while we are doing this, we don’t lose our art form. If we end up having registration, I would like to see more health fund rebates and an ability to get back some of the herbs that have been taken from us over the last 30 years. There are so many nutrients not yet approved for Australia that will be really helpful to our patients in the future.

JATMS | Autumn 2015 | 49

LAW REPORT

Workplace Bullying Ingrid Pagura | BA, LLB

O

n 1 January 2014 the Fair Work Act 2009 (Cth), which covers about 85% of Australian workers, was amended to included jurisdiction to deal with workplace bullying. Section 789FD was added and provides that a worker is ‘bullied at work’ if ‘an individual or group repeatedly behaves unreasonably towards that worker’ and that ‘behaviour creates a risk to health and safety’. This is consistent with the draft model code prepared by Safe Work Australia. These new provisions cover both employees and independent contractors. For definition of each please see article in ATMS Journal Vol 17(2), 36-37 (June, 2011).

This amendment will allow a person who believes that they have been bullied to apply to the Fair Work Commission (FWC) for an order to stop the bullying.

So where does this leave businesses? Each business must: • Understand the scope of the FWC’s new bullying power and orders it can make; • Understand the definition of ‘bullied at work’ and appreciate the difference between bullying and reasonable management action; • Have a policy stating that bullying is unacceptable and conduct training; • Have procedures in place for addressing allegations of bullying in the workplace in a prompt and fair manner; and • Manage the risk of bullying (e.g., monitor patterns of behaviour).

The difficulty here is distinguishing between bullying and reasonable management action.

• Threatening behaviour. This could include threats or actual violence or abuse. It could also include threats to make a person’s work or home life difficult.

• Abusing management or supervisory power. This could include threats to dismiss a worker or unfair rostering, or even unfair monitoring of their work.

• Belittling or humiliating comments. This could include offering belittling opinions or constant criticism or dismissing a worker’s opinion or contribution without good reason, spreading malicious rumours, and teasing, practical jokes or initiation ceremonies.

• Exclusion from work-related events. This could include isolating workers from normal working direction, training or developments, and not inviting them to meetings, not including them in emails, or deliberately giving them wrong information.

• Unreasonable work expectations, including too much or too little work, or work below or beyond a worker’s skill level. This could include subjecting a person to unexplained job changes, meaningless tasks or tasks beyond their skills, subjecting a person to over-work and placing them under impossible deadlines or unnecessary pressure.

Some examples of bullying are: • Aggressive or intimidating conduct. This could include swearing, shouting and inappropriate comments about appearance and lifestyle.

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• Unnecessary administrative delays. This could include delays in processing pay or leave applications.

• Displaying offensive material.

• Pressure to behave in an inappropriate manner. This could include having to participate in jokes, initiation ceremonies or illegal activities.

Note that this all behaviour must be repeated and must create a risk to health and safety to qualify as bullying.

Some examples of reasonable management action are: • Performance management processes. These could include giving a worker a warning about their performance, and setting reasonable workplace goals, standards and deadlines.

• Disciplinary action for misconduct. This could include warnings, suspension or dismissal provided they were legally carried out, informing a worker about unsatisfactory work performance or inappropriate work behaviour, and directing a worker to perform duties in keeping with their job.

• Maintaining reasonable workplace goals and standards. This could include management encouraging or urging workers to do their best, and avoiding occasional one-off incidents such a losing your temper or shouting.

Note that all this conduct must be carried out in a reasonable manner.

To determine whether the behaviour has been reasonable the FWC will objectively assess it within the context of circumstances and knowledge. This means that all aspects of behaviour, particular incidents and a particular workplace’s culture will be taken into account.

So what should you do if there is a bullying issue in your workplace? First try and resolve the issue in the workplace.

It is always easier to do this than having to go to the FWC for an order. Create a culture where workers feel comfortable raising issues with their supervisors or health and safety representatives. Train all staff in appropriate workplace behaviour and lead by example. It is hard to stamp out bullying if you are seen to be a bully yourself! Remind workers of what is expected of them. Have procedures in place that enable workers to know what to do if they are bullied. Respond to complaints quickly and be seen to be taking a complaint seriously. Show that you are ‘walking the walk’, not just ‘talking the talk’ when it comes to not tolerating workplace bullying.

JATMS | Autumn 2015 | 51

RECENT RESEARCH

Acupuncture and TCM Zhu Y, Wu Z, Ma X, Liu H, Bao C, Yang L, Cui Y, Zhou C, Wang X, Wang Y, Zhang Z, Zhang H, Jia H, Wu H. Brain regions involved in moxibustioninduced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study. BMC Complementary and Alternative Medicine 2014, 14:500 doi:10.1186/1472-6882-14-500.

Background: Moxibustion is one of the most commonly used therapies in acupuncture practice, and is demonstrated to be beneficial for patients with diarrhea from irritable bowel syndrome (D-IBS). But its mechanism remains unclear. Because visceral hypersensitivity in IBS patients has been documented by evaluation of perceived stimulations through functional magnetic resonance imaging (fMRI) studies, we focused on observing brain imaging changes in D-IBS patients during rectal balloon distention before and after moxibustion in order to reveal its possible central mechanism and further evaluate its effect.

Methods: This clinical trial is registered under the number: ChiCTR-TRC-10000887.

Eighty D-IBS patients were randomly divided into a moxibustion and sham moxibustion group (control group) for a 4-week treatment. Fifteen patients in moxibustion group and thirteen patients in control group completed two fMRI scans during a 50 and 100 ml rectal balloon distention before and after treatment.

Rectal pain were obtained with a scan test.

Birmingham IBS Symptom Scale and IBS Quality of Life (QOL) Scale were used to evaluate therapeutic effect.

Results: After treatment, the decrease in Birmingham IBS Symptom Scale and IBS QOL Scale scores in moxibustion group was significantly greater than that of control group (P < 0.01). The defecation urge threshold and the pain perception threshold of moxibustion group was also significantly higher after treatment than that of control group (P < 0.01). The decrease in pain score during the 100 ml

52 | vol21 no1 | JATMS

rectal balloon distention in moxibustion group was significantly greater than that of control group (P < 0.05). There was no definite activated center during the 50 ml rectal distention in either group before treatment. After treatment, the prefrontal cortex (PFC) was affected in moxibustion group, while the PFC and the anterior cingulated cortex (ACC) were affected in control group. During the 100 ml distention before treatment in both groups, the PFC and ACC were activated. After treatment, they disappeared in moxibustion group but remained in control group.

Conclusions: Moxibustion can improve symptoms and quality of life in D-IBS patients. It can also decrease rectal sensitivity. The activation of PFC and ACC during a 100 ml rectal distention disappeared after moxibustion treatment.

Aromatherapy Rabelo AS, Serafini MR, Rabelo TK, de Melo MC, da Silva Prado D, Gelain DP et al.

Chemical composition, antinociceptive, antiinflammatory and redox properties in vitro of the essential oil from Remirea maritima Aubl. (Cyperaceae) BMC Complementary and Alternative Medicine 2014, 14:514 doi:10.1186/1472-6882-14-514.

Background: The present study was carried out to evaluate antioxidant, antinociceptive and anti-inflammatory activities of essential oil from R. maritima (RMO) in experimental protocols.

Methods: The essential oil from the roots and rhizomes of RMO were obtained by hydrodistillation using a Clevenger apparatus, and analyzed by gas chromatography/mass spectrometry (GC/MS). Here, we evaluated free radical scavenging activities and antioxidant potential of RMO using in vitro assays for scavenging activity against hydroxyl radicals, hydrogen peroxide, superoxide radicals, and nitric oxide. The total reactive antioxidant potential (TRAP) and total antioxidant reactivity (TAR) indexes and in vitro lipoperoxidation were also

evaluated. The ability of RMO to prevent lipid peroxidation was measured by quantifying thiobarbituric acid-reactive substances (TBARS). NO radical generated at physiological pH was found to be inhibited by RMO, that showed scavenging effect upon SNP-induced NO production at all concentrations. Antinociceptive and anti-inflammatory properties were evaluated by acetic acid writhing reflex, Formalin-induced nociception and Carrageenan-induced edema test.

Results: The majors compounds identified was remirol (43.2%), cyperene (13.8%), iso-evodionol (5.8%), cyperotundone (5.7%), caryophyllene oxide (4.9%), and rotundene (4.6%). At the TRAP assay, RMO concentration of 1 mg.mL-1 showed anti-oxidant effects and at concentration of 1 and 10 ng.mL-1 RMO showed pro-oxidant effect. RMO at 1 mg.mL-1 also showed significant antioxidant capacity in TAR measurement.

Concentrations of RMO from 1 ng.mL-1 to 100 mug.mL-1 enhanced the AAPHinduced lipoperoxidation. RMO reduced deoxyribose oxidative damage, induced by the Fenton reaction induction system, at concentrations from 1 ng.mL-1 to 100 mug.mL-1. We observed that RMO caused a significant increase in rate of adrenaline auto-oxidation. On the other hand RMO did not present any scavenging effect in H2O2 formation in vitro. The results of this study revealed that RMO has both peripheral and central analgesic properties. The RMO, all doses, orally (p.o.) administered significantly inhibited (p < 0.05, p < 0.01 and p < 0.001) the acetic acid-induced writhings and two phases of formalininduced nociception in mice.

Conclusions: The RMO demonstrated antioxidant and analgesic profile which may be related to the composition of the oil.

Gostner JM, Ganzera M, Becker K, Geisler S, Schroecksnadel S, Überall F, Schennach H, Fuchs D. Lavender oil suppresses indoleamine 2,3-dioxygenase activity in human PBMC.

BMC Complementary and Alternative Medicine 2014, 14:503 doi:10.1186/1472-6882-14-503

Background: Lavender remedies have been used in traditional medicine because of antimicrobial, anti-inflammatory and mood alleviating effects, but underlying molecular mechanisms are not yet fully elucidated. Recently, studies investigating the effects of lavender oil in the context of psychiatric disorders have indicated potent pharmacological properties.

Metabolism of tryptophan by indoleamine 2,3-dioxygenase (IDO) was found to provide a biochemical link between immunology and neuroendocrinology and to be a frequent target of natural products.

Methods: In this in vitro study, interferences of lavender oil and constituents (-)-linalool, (+)-α-pinene and (+)-limonene with tryptophan catabolism

by IDO and formation of neopterin via guanosine triphosphate (GTP)cyclohydrolase-I and of interferon-γ have been investigated using unstimulated and phytohemagglutinin (PHA)-stimulated human peripheral blood mononuclear cells (PBMC).

Results: Treatment with lavender oil dose-dependently suppressed PHAinduced tryptophan breakdown and kynurenine formation. Similar effects were observed for the three constituents.

In parallel, formation of neopterin and interferon-γ was diminished upon lavender oil treatment. In unstimulated PBMC, effect of lavender oil treatment was similar, but less pronounced.

Conclusion: Data from this in vitro study suggest that lavender oil treatment might contribute to the modulation of the immune and neuroendocrine system by interfering with activation-induced tryptophan breakdown and IDO activity.

Herbal Medicine Aeentz S, Abbott JA, Smith CA and Bensoussan A. Herbal medicine for the management

of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism: a review of the laboratory evidence for effects with corroborative clinical findings. BMC Complementary and Alternative Medicine 2014, 14:511 doi:10.1186/1472-688214-511

Background: Polycystic ovary syndrome (PCOS) is a prevalent, complex endocrine disorder characterised by polycystic ovaries, chronic anovulation and hyperandrogenism leading to symptoms of irregular menstrual cycles, hirsutism, acne and infertility. Evidence based medical management emphasises a multidisciplinary approach for PCOS, as conventional pharmaceutical treatment addresses single symptoms, may be contraindicated, is often associated with side effects and not effective in some cases. In addition women with PCOS have expressed a strong desire for alternative treatments.

This review examines the reproductive endocrine effects in PCOS for an alternative treatment, herbal medicine.

The aim of this review was to identify consistent evidence from both preclinical and clinical research, to add to the evidence base for herbal medicine in PCOS (and associated oligo/amenorrhoea and hyperandrogenism) and to inform herbal selection in the provision clinical care for these common conditions.

Methods: We undertook two searches of the scientific literature. The first search sought pre-clinical studies which explained the reproductive endocrine effects of whole herbal extracts in oligo/ amenorrhoea, hyperandrogenism and PCOS. Herbal medicines from the first search informed key words for the second search. The second search sought clinical studies, which corroborated laboratory findings. Subjects included women with PCOS, menstrual irregularities and hyperandrogenism.

Results: A total of 33 studies were included in this review. Eighteen preclinical studies reported mechanisms of effect and fifteen clinical studies corroborated pre-clinical findings,

including eight randomised controlled trials, and 762 women with menstrual irregularities, hyperandrogenism and/ or PCOS. Interventions included herbal extracts of Vitex agnus-castus, Cimicifuga racemosa, Tribulus terrestris, Glycyrrhiza spp., Paeonia lactiflora and Cinnamomum cassia. Endocrine outcomes included reduced luteinising hormone (LH), prolactin, fasting insulin and testosterone.

There was evidence for the regulation of ovulation, improved metabolic hormone profile and improved fertility outcomes in PCOS. There was evidence for an equivalent effect of two herbal medicines and the pharmaceutical agents bromocriptine (and Vitex agnus-castus) and clomiphene citrate (and Cimicifuga racemosa). There was less robust evidence for the complementary combination of spirinolactone and Glycyrrhiza spp. for hyperandrogenism.

Conclusions: Preclinical and clinical studies provide evidence that six herbal medicines may have beneficial effects for women with oligo/amenorrhea, hyperandrogenism and PCOS. However the quantity of pre-clinical data was limited, and the quality of clinical evidence was variable. Further pre-clinical studies are needed to explain the effects of herbal medicines not included in this review with current clinical evidence but an absence of pre-clinical data.

Yamani H, Mantri N, Morrison PO, Pang E. Analysis of the volatile organic compounds from leaves, flower spikes, and nectar of Australian grown Agastache rugose. BMC Complementary and Alternative Medicine 2014, 14:495 doi:10.1186/1472-6882-14-495.

Background: The foraging choices of honey bees are influenced by many factors, such as floral aroma. The composition of volatile compounds influences the bioactivity of the aromatic plants and honey produced from them. In this study, Agastache rugosa was evaluated as part of a project to select the most promising medicinal plant species for production of bioactive honey.

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RECENT RESEARCH

Methods: Headspace solid-phase microextraction HS-SPME /GC-MS was optimized to identify the volatile bioactive compounds in the leaves, flower spikes, and for the first time, the flower nectar of Australian grown A. rugosa.

Results: Methyl chavicol (= estragole) was the predominant headspace volatile compound in the flowers with nectar, flower spikes, and leaves, with a total of 97.16%, 96.74% and 94.35%, respectively.

Current results indicate that HS–SPME/ GC–MS could be a useful tool for screening estragole concentration in herbal products.

Conclusion: Recently, estragole was suspected to be carcinogenic and genotoxic, according to the European Union Committee on Herbal Medicinal Products. Further studies are needed on safe daily intake of Agastache as herbal tea or honey, as well as for topical uses.

Integrative Medicine Johnson JR, Crespin DJ, Griffin KH, Finch MD, Rivard RL, Baechler CJ, Dusek JA. The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation. BMC Complementary and Alternative Medicine 2014, 14:486 doi:10.1186/1472-6882-14-486

Background: Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited.

The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population.

Methods: Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted

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to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10).

Results: Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value < 0.001) decrease in pain and a 54.8% (p-value < 0.001) decrease in anxiety. There was no difference between treatment modalities on pain reduction; however, mind-body and energy therapies (p-value < 0.01), traditional Chinese medicine (p-value < 0.05), and combination therapies (p-value < 0.01) were more effective at reducing anxiety than bodywork therapies.

Each additional year of age reduced the odds of receiving any IM therapy by two percent (OR: 0.98, p-value < 0.01) and females had 96% (OR: 1.96, p-value < 0.01) higher odds of receiving any IM therapy compared to males.

Conclusions: Cardiovascular inpatients reported statistically significant decreases in pain and anxiety following care with adjunctive IM interventions. This study underscores the potential for future practice-based research to investigate the best approach for incorporating these therapies into an acute care setting such that IM therapies are most appropriately provided to patient populations..

Massage

greater quantities of exposed patient skin more often than most other healthcare professionals. The purpose of this study therefore was to ascertain the ability of manual therapists to detect, screen and refer suspicious skin lesions.

Method: A web-based questionnaire and quiz was used in a sample of UK chiropractic student clinicians and registered chiropractors to gather data during 2011 concerning skin screening and referral behaviors for suspicious skin lesions.

Results: A total of 120 questionnaires were included. Eighty one percent of participants agreed that screening for suspicious skin lesions was part of their clinical role, with nearly all (94%) assessing their patients for lesions during examination. Over 90% of the participants reported regularly having the opportunity for skin examination; with nearly all (98%) agreeing they would refer patients with suspicious skin lesions to a medical practitioner. A third of respondents had referred a total of 80 suspicious lesions within the last 12 months with 67% warranting further investigation.

Conclusion: Nearly all respondents agreed that screening patients for suspicious skin lesions was part of their clinical role, with a significant number already referring patients with lesions.

Gomes CAFP, El Hage Y, Amaral AP, Politti F and Biasotto-Gonzalez DA.

Detection of suspicious skin lesions, screening and referral behaviour of UK based chiropractors. Chiropractic and Manual Therapies 2015, 23:5 doi:10.1186/s12998-014-0047-2

Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial. Chiropractic & Manual Therapies 2014 22:43 doi:10.1186/ s12998-014-0043-6

Background: UK morbidity and mortality rates from skin cancer are increasing despite existing preventative strategies involving education and early detection. Manual therapists are ideally placed to support these goals as they see

Introduction: Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in

Glithro S, Newell D, Burrows L, Hunnisett A & Cunliffe C. 2015.

the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism.

Methods: Sixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD. Results: The inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups.

Conclusion: Massage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles.

However, the combination of therapies led to a reduction in the intensity of signs and symptoms among individuals with severe TMD and sleep bruxism.

Nutrition Jeong JH, Kim HJ, Park SK, Jin DE, Kwon O-J, Kim H-J, Heo HJ. An investigation into the ameliorating effect of black soybean extract on learning and memory impairment with assessment of neuroprotective effects. BMC Complementary and Alternative Medicine 2014, 14:482 doi:10.1186/1472-6882-14-482

Background: The physiological effects of the non-anthocyanin fraction (NAF) in a black soybean seed coat extract on Aβ-induced oxidative stress were investigated to confirm neuroprotection.

In addition, we examined the preventive effect of NAF on cognitive defects induced by the intracerebroventricular (ICV) injection of Aβ.

Methods: Levels of cellular oxidative stress were measured using 2’,7’-dichlorofluorescein diacetate (DCF-DA). Neuronal cell viability was investigated by 3-(4,5-dimethylthiazol2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assay. To investigate in vivo anti-amnesic effects of NAF by using Y-maze and passive avoidance tests, the learning and memory impairment in mice was induced by Aβ. After in vivo assays, acetylcholinesterase (AChE) activity and level of malondialdehyde (MDA) in the mouse brain were determined to confirm the cognitive effect. Individual phenolics of NAF were qualitatively analyzed by using an ultraperformance liquid chromatography (UPLC) Accurate-Mass Quadrupole Time of-Flight (Q-TOF) UPLC/MS. Results: A NAF showed cell protective effects against oxidative stressinduced cytotoxicity. Intracellular ROS accumulated through Aβ1–40 treatment was significantly reduced in comparison to cells only treated with Aβ1–40. In MTT and LDH assay, the NAF also presented neuroprotective effects on Aβ1–40-treated cytotoxicity.

Finally, the administration of this NAF in mice significantly reversed the

Aβ1–40-induced cognitive defects in in vivo behavioral tests. After behavioral tests, the mice brains were collected in order to examine lipid peroxidation and AChE activity. AChE, preparation was inhibited by NAF in a dosedependent manner. MDA generation in the brain homogenate of mice treated with the NAF was decreased.

Q-TOF UPLC/MS analyses revealed three major phenolics from the nonanthocyanin fraction; epicatechin, procyanidin B1, and procyanidin B2.

Conclusions: The results suggest that the NAF in black soybean seed coat extracts may improve the cytotoxicity of Aβ in PC12 cells, possibly by reducing oxidative stress, and also have an anti-amnesic effect on the in vivo learning and memory deficits caused by Aβ. Q-TOF UPLC/ MS analyses showed three major phenolics; (-)-epicatechin, procyanidin B1, and procyanidin B2. Above results suggest that (-)-epicatechins are the major components, and contributors to the anti-amnesic effect of the NAF from black soybean seed coat.

Public health Muramoto ML, Howerter A, Matthews E, Floden L, Gordon J, Nichter M, Cunningham J, Ritenbaugh C. Tobacco brief intervention training for chiropractic, acupuncture, and massage practitioners: protocol for the CAM reach study. BMC Complementary and Alternative Medicine 2014, 14:510 doi:10.1186/1472-688214-5102

Background: Tobacco use remains the leading cause of morbidity and mortality in the US. Effective tobacco cessation aids are widely available, yet underutilized.

Tobacco cessation brief interventions (BIs) increase quit rates. However, BI training has focused on conventional medical providers, overlooking other health practitioners with regular contact with tobacco users. The 2007 National Health Interview Survey found that

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BOOK REVIEWS

approximately 20% of those who use provider-based complementary and alternative medicine (CAM) are tobacco users. Thus, CAM practitioners potentially represent a large, untapped community resource for promoting tobacco cessation and use of effective cessation aids.

Existing BI training is not well suited for CAM practitioners’ background and practice patterns, because it assumes a conventional biomedical foundation of knowledge and philosophical approaches to health, healing and the patient-practitioner relationship. There is a pressing need to develop and test the effectiveness of BI training that is both grounded in Public Health Service (PHS) Guidelines for tobacco dependence treatment and that is relevant and appropriate for CAM practitioners.

Methods/Design: The CAM Reach (CAMR) intervention is a tobacco cessation BI training and office system intervention tailored specifically for chiropractors, acupuncturists and massage therapists. The CAMR study utilizes a single group one-way crossover design to examine the CAMR intervention’s impact on CAM practitioners’ tobaccorelated practice behaviors.

Results: Primary outcomes included CAM practitioners’ self-reported conduct of tobacco use screening and BIs. Secondary outcomes include tobacco using patients’ readiness to quit, quit attempts, use of guidelinebased treatments, and quit rates and also non-tobacco-using patients’ actions to help someone else quit.

Discussion: CAM practitioners provide care to significant numbers of tobacco users. Their practice patterns and philosophical approaches to health and healing are well suited for providing BIs. The CAMR study is examining the impact of the CAMR intervention on practitioners’ tobacco-related practice behaviors, CAM patient behaviors, and documenting factors important to the conduct of practice-based research in real-world CAM practices.

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Heal with Food.

Food Farmacopoeia Reviewed by Stephen Clarke.

Debbie Pannowoitz. Publisher. Place of publication. 2011. ISBN 978-0-646-55973-5 Available at author’s website www.healwithfood.com.au and as an ebook at www.smashwords.com $35 including postage and handling for shipment within Australia

The author has set out to produce a reference book to guide readers through the therapeutic use of food to aid in the management of 107 health conditions, set out alphabetically, including such emotional and behavioural conditions as depression and hyperactivity. It is intended to be read by both health professionals and the general public: the author describes it as ‘a quick desk or kitchen reference.’

Debbie’s knowledge of the chemistry of foods reflects her background in scientific research, and she presents the reasons for both eating and avoiding foods by striking the right balance between technical detail and

straightforward description of the chemical actions of particular foods.

For each condition she specifies foods to be eaten and to be avoided in clear bullet point format. She has no ideologically derived dietary barrow to push beyond a general caveat about avoiding processed food. Happily the lists of foods to be eaten are generally much longer than those to be avoided, so practitioners and their patients following these guidelines will enjoy plenty of variety in their diets.

There are fourteen appendices which alone would justify buying this book. They are too numerous to list separately but include an excellent listing of the vitamin, mineral and amino acid contents of foods, grouped into signs of their deficiency, remedial and biochemical actions, and sources in foods; nutrient interactions; and preparing vegetarian meals so as to achieve a balanced nutritional profile.

There is also a four-page glossary of terms. This will be a valuable reference for general readers and for practitioners who may wish to recommend to their patients a thorough and well-presented guide to therapeutic foods.

Acupuncture for IVF and Assisted Reproduction Reviewed by Stephen Clarke.

Irina Szmelskyj and Lianne Aquilina. Churchill Livingstone Elsevier. Edinburgh, 2015. ISBN 9780-7020-5010-7. Available at http://www.elsevierhealth. com.au/au/searchResults. jsp?queryTerm=Acupuncture%20for%20 IVF&_requestid=777830 AUD 66.37

Limitations of space prevent this review from doing full justice to this remarkable book. Nor does the book’s title tell the whole story of the depth and breadth of the information it contains. As the writer of the foreword (Giovanni Maciocia, himself a renowned writer on TCM and gynaecology) points out, it deals not only with the role of TCM in Assistive

Reproduction Therapy (ART), but also comprehensively with the TCM view of reproductive anatomy and subfertility. It is a deeply scholarly exercise in holism; its integrated approach superbly balances western ART and the therapeutic role of TCM, not in terms merely of assessment and treatment but of their conceptions of physiology and function as well.

The book contains many case studies and red flags. Each chapter is summarised at its ending, which is also where the exhaustive references also appear – a very practical practice in this reviewer’s opinion. Clinical tips appear throughout.

Among the appendices are twentyfive pages of case history templates for practitioner use that in themselves reflect the book’s exceptionally wide scope, information on commonly used medications in ART, and medications known to adversely affect fertility.

Readers of this book will deepen their knowledge of TCM perspectives on reproductive anatomy and physiology, the pathology and aetiology of TCM syndromes presented by subfertile patients and how to diagnose them, and how to adapt acupuncture treatment to ART protocols, all in the wider context of contemporary ART. Practitioners of all levels of experience and TCM students should find it compelling reading and an invaluable companion to their learning.

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HEALTH FUND UPDATE

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HEALTH FUND NEWS

Health Funds ATMS is a ‘professional organisation’ within the meaning of section 10 of the Private Health Insurance Accreditation Rules 2008. This potentially allows ATMS accredited members to be recognised as approved providers by the various private health funds. Approved health fund provider status is, however, subject to each individual health fund’s requirements.

Consequently, membership of ATMS does not automatically guarantee provider status with all health funds.

Please also note that several health funds do not recognise courses done substantially by distance education, or qualifications obtained overseas.

Additional requirements for recognition as a provider by health funds include: • Clinic Address (Full Street Address must be provided – Please note that some health funds may list your clinic address on their public websites) • Current Senior First Aid • Current Professional Indemnity Insurance (some health funds require specific minimum cover amounts) • Compliance with the ATMS Continuing Education Policy • Compliance with the Terms and Conditions of Provider Status with the individual health funds.

ATMS must have current evidence of your first aid and insurance on file at all times.

When you join or rejoin ATMS, or when you upgrade your qualifications, you will need to fill out the ATMS Health Fund Application and Declaration Form available on the ATMS website.

Once this is received, along with any other required information for health fund eligibility assessment, details of eligible members are sent to the applicable health funds on their next

available listing. The ATMS office will also forward your change of details, including clinic address details to your approved health funds on their next available list. Please note that the health funds can take up to one month to process new providers and change of details as we are only one of many health professions that they deal with.

constitutes health fund fraud.

Health fund fraud is a criminal offence which may involve a police investigation and expulsion from the ATMS Register of Members.

Lapsed membership, insurance or first aid will result in a member being removed from the health funds list.

As health funds change their provider eligibility requirements from time to time, upgrading qualifications may be necessary to be re-instated with some health funds.

It is of note that the health funds require practitioners to be in private practice.

Some health funds will not recognise claims where accommodation, facilities or services are provided or subsidised by another party such as a public hospital or publicly funded facility. Rebates are only claimable for the consultation (not the medicines or remedies); however this does not extend to mobile work including markets, corporate or hotels.

Home visits are eligible for rebates.

TERMS AND CONDITIONS OF PROVIDER STATUS Many of the Terms and Conditions of Provider Status for the individual health funds are located on the ATMS website.

For the Terms and Conditions for the other health funds, it will be necessary to contact the health fund directly.

Please be aware that whilst a health fund may indicate that they provide a rebate for specific modalities, this rebate may only be claimable if the client has the appropriate level of health cover with that fund and has not exceeded any limits on how much they are eligible to claim back over a certain period of time.

Please note that whilst there is no law or regulation requiring patient clinical notes to be taken in English, many of the major health funds do require patient clinical notes to be taken in English.

Failure to do this will be a breach of the Health Funds Terms and Conditions and may result in the practitioner being removed as a provider for that health fund.

Australian Health Management (AHM)

For health funds to rebate on the services of Accredited members, it is important that a proper invoice be issued to patients.

The information which must be included on an invoice is also listed on the ATMS website. It is ATMS policy that only Accredited members issue their own invoice.

An Accredited member must never allow another practitioner, student or staff member to use their provider details, as this constitutes health fund fraud.

Misrepresenting the service(s) provided on the invoice also

Names of eligible ATMS members will be sent to AHM each month. AHM’s eligibility requirements are listed on the ATMS website www.atms.com. au. ATMS members can check their eligibility by checking the ATMS website or by contacting the ATMS Office on 1800 456 855. Your ATMS Number will be your provider number, unless you wish to have online claiming. You will then need to contact AHM directly for the new provider number.

Australian Regional Health Group (ARHG) This group consists of the following health funds: • ACA Health Benefits Fund Ltd • Cessnock District Health Benefits Fund • CUA Health Limited • Defence Health • GMHBA (Including Frank Health Fund) • GMF Health • Health.com.au

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HEALTH FUND NEWS

• Health Care Insurance Limited • HIF WA • Latrobe Health Services (Federation Health) • Mildura District Hospital Fund • Navy Health Fund • Onemedifund • Peoplecare Health Insurance • Phoenix Health Fund • Police Health Fund • Queensland Country Health Fund Ltd • Railway and Transport Fund Ltd • Reserve Bank Health Society Limited • St Luke’s Health • Teachers Federation Health • Teachers Union Health • Transport Health • Westfund

If ATMS member 123 is accredited in Western herbal medicine, the ARHG provider number will be AT00123W.

Details of eligible members, including member updates are sent to ARHG by ATMS monthly. The details sent to ARHG are your name, address, telephone and accredited discipline(s). These details will appear on the ARHG websites. If you do not wish your details to be sent to ARHG, please advise the ATMS office on 1800 456 855.

Members who are accredited for Remedial Massage or Chinese Massage, will need to use the following letters.

The ARHG provider number is based on your ATMS number with additional lettering. To work out your ARHG provider number please follow these steps: 1 Add the letters AT to the front of your ATMS member number 2 If your ATMS number has five digits go to step 3. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

3 Add the letter that corresponds to your accredited modality at the end of the provider number; A ACUPUNCTURE, C CHINESE HERBAL MEDICINE, H HOMOEOPATHY, N NATUROPATHY, O AROMATHERAPY, W WESTERN HERBAL MEDICINE.

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4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Western Herbal Medicine and Aromatherapy, the ARHG provider numbers are AT00123W and AT00123O. ARHG - REMEDIAL MASSAGE AND CHINESE MASSAGE Remedial Massage and Chinese Massage therapists who graduated after March 2002 must hold a Certificate IV or higher from a registered training organisation.

M MASSAGE THERAPY R REMEDIAL THERAPY The letter at the end of your provider number will depend on your qualification, not the modality in which you hold accreditation*. All members who meet the ARHG eligibility requirements, who hold a Diploma of Remedial HLT50302 or HLT50307 or a Diploma of Chinese Remedial Massage HLT50102, HLT50107 or HLT50112 will be able to use both the ‘M’ and ‘R’ letters. It is recommended to use the ‘R’ as often as possible, but as not all health funds under ARHG cover ‘Remedial Therapy’, it will be necessary to use the ‘M’ at the end of the provider number for those funds only. All other eligible Remedial Massage Therapists who do not hold the Diploma of Remedial HLT50302 or HLT50307 or a Diploma of Chinese Remedial Massage HLT50102, HLT50107 or HLT50112 are required to use the ‘M’ at the end of their provider number. *Members accredited for Remedial Therapies and approved for ARHG for this modality under their previous criteria will continue to be recognised under Remedial Therapy and will be

fine to use the ‘R’ in their provider number. Should members in this situation lapse membership, first aid or insurance etc they will then be required to meet the current ARHG criteria.

Australian Unity Names and details of eligible ATMS members will be sent to Australian Unity each month. ATMS members will need to contact Australian Unity on 1800 035 360 to register as a provider, after filling out the Australian Unity Application Form located on the ATMS website to activate their provider status. This only needs to happen the first time. The provider eligibility requirements for Australian Unity are located on the ATMS website www. atms.com.au. Your ATMS number can be used as your Provider Number, or you can contact Australian Unity for your Australian Unity generated Provider Number. Please note that Australian Unity requires Professional Indemnity Insurance (to at least $2 million) and Public Liability Insurance (to at least $10 million).

BUPA (including MBF, HBA, Health Cover Direct, AXA, NRMA, SGIO, SGIC, St Georges Health, ANZ Health and Mutual Community)

Names and details of eligible ATMS members will be sent to BUPA on a weekly basis. The provider eligibility requirements for BUPA are located on the ATMS website www.atms. com.au. The Provider eligibility requirements include an IELTS test result of an overall Band 6 or higher for TCM qualifications completed in a language other than English. BUPA will generate a Provider Number after receiving the list of eligible practitioners. BUPA advises ATMS of your Provider Number and ATMS will then advise those members directly.

CBHS Health Fund Limited Names and details of eligible ATMS members will be sent to CBHS each month. The details sent to CBHS are your name, address, telephone and accredited

discipline(s). These details will appear on the CBHS website. If you do not want your details to be sent to CBHS, please advise the ATMS office on 1800 456 855.

The provider eligibility requirements for CBHS are located on the ATMS website www.atms.com.au. Your ATMS number will be your Provider Number.

The provider number is based on your ATMS number with additional lettering.

To work out your Health Partners provider number please follow these steps:

Doctors Health Fund

2 If your ATMS number has five digits go to step 3. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

Names and details of eligible ATMS members will be sent to Doctors Health Fund each month. Please note that Doctors Health Fund only covers Remedial Massage. The provider eligibility requirements for Doctors Health Fund are located on the ATMS website www.atms.com.au. Your ATMS number will be your Provider Number.

Grand United Corporate To register with Grand United Corporate, please apply directly to Grand United on 1800 249 966.

HBF Names and details of eligible ATMS members will be sent to HBF each month. The provider eligibility requirements for HBF are located on the ATMS website www.atms.com.au.

HBF generates provider numbers after they receive the first claim from first HBF client.

1 Add the letters AT to the front of your ATMS member number

3 Add the letter that corresponds to your accredited modality at the end of the provider number; A ACUPUNCTURE, C CHINESE HERBAL MEDICINE, H HOMOEOPATHY, M REMEDIAL MASSAGE N NATUROPATHY, W WESTERN HERBAL MEDICINE. If ATMS member 123 is accredited in Western Herbal Medicine, the provider number will be AT00123W.

HCF

4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Western Herbal Medicine and Aromatherapy, the provider numbers are AT00123W and AT00123O.

Names and details of eligible ATMS members will be sent to HCF on a weekly basis. The provider eligibility requirements for HCF are located on the ATMS website www.atms.com. au. Your ATMS number will be your Provider Number.

For all other modalities that Health Partners cover that are not listed above including Alexander Technique, Bowen Therapy, Kinesiology and Reflexology, eligible providers will need to use their ATMS number.

Health Partners

Medibank Private

Names and details of eligible ATMS members will be sent to Health Partners each month. The provider eligibility requirements for Health Partners are located on the ATMS website www. atms.com.au. Health Partners uses the same Provider number system as ARHG for certain modalities and the ATMS number or other modalities.

Names and details of eligible ATMS members will be sent to Medibank Private on a monthly basis. The provider eligibility requirements for Medibank Private are located on the ATMS website www.atms.com.au. Medibank Private requires Clinical Records to be taken in English. Medibank Private generates Provider Numbers after receiving the

list of eligible practitioners from ATMS. Medibank Private sends these provider numbers directly to your clinic address/ es. Please note that Medibank has placed a restriction of up to a maximum 3 clinic addresses that will be recognised for Remedial Massage. There are no restrictions on the number of recognised clinics for other modalities.

NIB Names and details of eligible ATMS members will be sent to NIB on a weekly basis. The provider eligibility requirements for NIB are located on the ATMS website www.atms.com.au.

NIB does accept overseas Acupuncture and Chinese Herbal Medicine qualifications which have been assessed as equivalent to the required Australian qualification by Vetassess. Your ATMS Number will be your provider number, unless your client wishes to claim online. Your client will need to contact NIB directly or search by your surname and postcode on the NIB website www. nib.com.au for your provider number for online claiming purposes.

HICAPS ATMS members who wish to activate these facilities need to register directly with HICAPS. HICAPS do not cover all health funds and modalities. Please go to www.hicaps.com.au or call 1800 805 780 for further information.

JATMS | Autumn 2015 | 61

ADVERTORIAL

Copper Toxicity Jon Gamble | BA ND Adv Dip Hom (ATMS member 1190)

Practitioners need to be aware of copper levels in their patients, as deficiency and excess cause clinical problems.

Deficiency symptoms include anaemia, bone abnormalities, hypo-pigmentation, impaired growth, increased infections, hyperthyroidism, and affect glucose and cholesterol metabolism.

Adults with excess copper

Excess copper also causes symptoms.

Children on the autistic spectrum have high copper and low zinc levels, known as kryptopyrroluria. It is crucial to identify copper levels in unresponsive conditions. When copper levels normalise, many symptoms reduce or disappear.

Case example

Children with excess copper

The Oligoscan reading (see table below) showed clear copper toxicity, with compromised zinc metabolism.

Many children diagnosed with OCD and ADHD show high copper levels which cause the neurological symptoms of difficulty in concentration, restlessness, twitching, tics, headaches, nausea, anxiety and oppositional behaviour.

Adults can display all the neurological symptoms of excess copper that children do. They can also irritable bowel syndrome, particularly women on the Oral Contraceptive Pill. Symptoms are nausea, constipation and diarrhoea plus hormonal headaches.

A 52-year-old woman presented with tremors, dizziness and balance problems of an unknown cause. She had also suffered from anxiety and depression for many years. She had had headaches since she was a teenager. She often had constipation and occasional nausea.

Treatment

Zinc - 80mg elemental zinc per day Greater Celandine herbal extract - 15 drops 3 times daily before meals.

Homeopathic Agaricus 200c on alternate days to reduce tremor and dizziness.

Repeat Oligoscans monitored mineral levels. Copper chelate and the zinc supplement were continued for one year, until mineral levels became normal. The treatment was successful in removing all symptoms.

Previous articles: • Mercury Toxicity: Volume 20 Issue #2 • Nutritional Deficiency: Volume 20 Issue #3 • Cadmium Toxicity: Volume 20 Issue #4

Copper chelate 5 drops every 2nd day.

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

62 | vol21 no1 | JATMS

ADVERTORIAL

Prescribing Garlic: Clinical considerations from constituents to potential drug interactions healing

By Rebecca Hopkins | BAppSc (Nat), GradDip (Nat) High-quality garlic extracts provide an efficacious prescribing option for a range of regularly presenting conditions.

As a suitable option for the majority of patients, like with all medicinal herbal extracts, prescribing garlic requires careful consideration in certain subsets of patients, particularly those patients taking pharmaceutical medications, undergoing surgery or those who are pregnant or breastfeeding. 1, 2 Another equally important consideration, which maximises clinical efficacy, is the selection of a consistent highquality standardised garlic extract, with enhanced stability of active constituents.

Selecting supplemental forms Garlic contains a variety of organosulphur compounds thought to be responsible for its pharmacological effect; however to date much of the focus and research has been on one compound in particular, allicin, also known as diallyl thiosulphinate.2 Allicin has been shown to have antibacterial, antifungal, and antiprotozoal properties.2-5 Whilst highly effective as an antipathogenic agent, unfortunately allicin is an extremely volatile compound and rapidly degrades to form other sulphur derivatives soon after being formed.6 The challenges of allicin production has led to advancements in processing and the development of a resultant stabilised allicin garlic extract. The volatile nature of allicin, highlights the need for

selecting and prescribing a high-quality, stabilised supplemental form.6

Garlic supplementation and surgery To ensure their safety, patients should be encouraged to disclose all the nutrient and herbal supplements they are taking to the relevant healthcare professionals.

At moderate doses, garlic is generally considered safe for those undergoing elective surgery.7 However, due to the potential anti-platelet activity of garlic as shown in in vitro studies, it may be advised to temporarily cease garlic supplementation 10 days prior to surgery, depending on the presenting clinical case.1,8

Garlicâ&#x20AC;&#x2122;s safety in pregnancy & lactation Garlic supplementation is not recommended during pregnancy due to insufficient data supporting is safe use.1,2 According to some herbal texts, garlic is considered safe and compatible with breastfeeding, although the safety of supplemental doses of garlic has not been well established.1,4 Maternal garlic supplementation has been thought to cause colic in breastfed infants, however evidence is conflicting.8

Garlicâ&#x20AC;&#x2122;s drug interactions and considerations Pharmacokinetic studies have shown that garlic has the potential to interact with drugs metabolised by various CYP enzymes in healthy individuals,

particularly CYP1A2, CYP2D6, and CYP3A4, and may inhibit or increase the expression of intestinal P-glycoprotein.9 Care, consideration and close observation is advised when prescribing garlic alongside any pharmaceutical medication.9 As a general rule, it is advised to prescribe supplements at least two hours away from medications.

Clinical prescribing implications Caution Advised: If prescribing garlic alongside warfarin and other anticoagulant and antithrombotic medication, it is important to carefully monitor the patient assessing INR and watching for signs of bleeding.9 Potentially Beneficial: Evidence suggests that co-administration of garlic with hypolipidaemic drugs such as statins, may be beneficial in the reduction of coronary artery atherosclerosis plaque development.9 Whilst combined treatment of statins and garlic is potentially beneficial, when used concomitantly it is advised to monitor the patient closely regardless.9 For further information on garlic drug interactions including unlikely interactions, along with guidelines for dosing in specific conditions, please contact BioMedica for our garlic technical sheet.

Full reference list available on request

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

JATMS | Autumn 2015 | 63

ADVERTORIAL

KO DA Pharmaceutical is Taiwan’s Most Trusted TCM Brand

By Lydia Lee KO DA Pharmaceutical have been concerned over pesticides found in Chinese herbs since many years ago, even before Greenpeace. We prioritise safety first above all else; as the most trusted brand in Taiwan, KO DA is the only manufacturer to provide full transparency of our manufacturing and quality control processes from start to finish. In Taiwan, KO DA is the first company to establish their Herbal Sourcing Project and also award-winning Cloud Herbal Tracing Platform via QR Code which details the agricultural base, planting methods, harvesting, safety inspections, testing methodologies and test results. This allows complete transparency and to give users the full picture on safety, reliability and ethical conduct of KO DA’s processes.

manufactured in Good Manufacturing Practice (GMP) and ISO 9001:2008 certified fully automated facilities which prevents any possibility of contamination or human discrepancy.

KO DA also utilises professional CleanIn-Place (CIP) cleaning systems to rinse the internal part of machines and pipes without contamination by human hands or other external factors. This ensures that KO DA’s manufacturing equipment is always kept clean, aseptic and safe.

1. When sourcing raw materials, KO DA implements a very strict Source Management System (Herbal Sourcing Project) where the agricultural environments in China are carefully assessed and formal contracts are enforced with farmers after the assessments. The contracted farmers are required to create detailed production records in accordance to Good Agricultural Practice (GAP).

Additional requirements are to inspect and record water and soil conditions before and after harvest, confirm origin of herb by testing samples of species and its properties, and adhere to all other planting specifications required

by KO DA.

3. The purchased raw materials, semifinished products to finished products are also consistently and heavily screened for pesticides using the most advanced testing equipment such as Gas Chromatography-Mass Spectrometry-Mass Spectrometry (GCMS/MS) and Liquid Chromatography– Mass Spectrometry-Mass Spectrometry (LC-MS/MS). In addition to pesticides, KO DA invests in Thin Layer Chromatography (TLC), Coupled Plasma-Optical Emission Spectrometer (ICP-OES) for numerous heavy metals, High Performance Liquid Chromatography with Postcolumn Fluorescenc (HPLC-FL) for Aflaxotins, and LC-MS/MS again for Aristolochic Acid. All testing are conducted by KO DA’s onsite laboratory which is both Taiwan Accreditation Foundation (TAF) ISO 17025:2005 AND certified by Taiwan Food and Drug Administration (TFDA).

2. At the start of production, the raw materials that qualify are thoroughly soaked, rinsed and cleaned for each and every batch of production and

4. And of course, each and every batch of KO DA’s finished product is again tested and accompanied with the Certificate of Analysis (COA) that

accurately reflects test results to the nearest parts-per-million (ppm).

5. KO DA Pharmaceutical also seeks independent and reputable third party laboratories to ensure that their own testing standards remain accurate, relevant and up-to-date. We have a selection of herbal products that have passed 252 pesticide items too, such as Bai He, Gou Qi Zi, Qian Shi and Yi Yi Ren which are herbs that are most likely to be contaminated with pesticides based on various studies and experience.

KO DA Pharmaceutical proactively references essential guidelines from governments around the world (Europe and the US in particular); consolidates and integrates the strictest specifications as part of KO DA’s comprehensive manufacturing and quality control processes. Pesticides is just one of the numerous quality measures that is continuously and closely monitored at KO DA. For more information about KO DA Pharmaceutical, please call Yes Chinaherb on 02 9634 1800, visit www.yeschinaherb.com or email info@yeschinaherb.com

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

64 | vol21 no1 | JATMS

ATMS Products & Services Guide

JATMS | Autumn 2015 | 65

PRODUCTS & SERVICES GUIDE

10 knots Uniforms

Cathay Herbal

sales@10knots.com.au | www.10knots.com.au | 0487 101 001

orders@cathayherbal.com | www.cathayherbal.com | 1800 622 042

Imagine if your uniforms were designed by a fellow Practitioner, someone who knows what the uniform should perform like in an active job... Introducing 10 knots uniforms, designed by Practitioners for Practitioners.

• Style and Comfort – freedom to move, adjustable fit and superb cut.

• Durable and breathable quality fabrics. Natural Linen or Functional (Poly/Viscose).

• Ethically designed and manufactured in Australia, stock held on site, no minimum order.

Feel the difference, from AM to PM appointments you will look and feel fresh. … I designed your uniforms with a genuine desire to make a difference, aesthetically and practically.

Established in 1986, Cathay Herbal is a company that is run by practitioners who constantly work to ensure they understand and meet the needs of you, the practitioner.

All products sold by Cathay Herbal undergo rigorous development and investigation before being offered as part of their range.

With one of the largest ranges of Chinese Classical formulas outside of China, they don’t just stock the popular ones.

Cathay’s range is large and comprehensive.

As well as the classical Black Pill range they also have many formulas available in tablet and capsules and a range of herbal granules, liquids and plasters.

Academy of Integrated Therapies (AOIT)

Chi-Chinese Healing College

admin@chihealing.com.au | www.chihealing.com.au | 0416 286 899

info@aoit.com.au | www.aoit.com.au | 07 3359 8523 About 15 years ago Neil Skilbeck, a Chiropractor and Osteopath made a valuable discovery integrating soft tissue and bones together. This has led to our course of Musculoskeletal Therapy (MST).

We believe in integrating knowledge as it leads to very powerful solutions such as we have demonstrated through our courses. We also provide CE workshops to fill in gaps in basic training of most body therapy courses.

These consist of foot corrections, nerve dynamics, limb neurology, axial and appendicular assessment and treatment and our specialty of pelvic mechanics.

BioMedica Nutraceuticals

info@biomedica.com.au | www.biomedica.com.au | 1300 884 702 BioMedica is an Australian owned company dedicated to the research, development and production of high quality, low excipient and efficacious practitioner formulations. Our products are developed by practitioners for practitioners. As a ‘Strictly Practitioner Only’ company, BioMedica is strongly dedicated to preserving and enhancing the role of the holistic practitioner.

Our products are only sold to practitioners in a clinical setting, this has been our long standing policy since our inception in 1998, and remains firmly in place to this day. We also aim to provide highly relevant technical education materials and seminars, with practical research and insights that can be immediately integrated into clinical practice.

66 | vol21 no1 | JATMS

Established since 1990 in Australia founded and directed by Master Zhang Hao, offering quality courses in nationally accredited qualifications of Diploma of Traditional Chinese Medicine Remedial Massage (An Mo Tui Na) and Diploma of Remedial Massage. The College is also conducting the short CE skill update courses and workshops throughout the year specially for professional massage therapists and health care workers.

The College now also trading under the name - Australian School of Remedial Therapies to specialize in delivering Vocational Training Programs.

If you still like the caring, practical and personalised traditional study model and environment - Try us!

Eagle Natural Health

clinicalsupport@eaglenaturalhealth.com.au www.eaglenaturalhealth.com.au | 1300 265 662 Eagle is rightly regarded as a pioneer in the Australian ‘practitioner’ natural health sector. Established in 1966, our reputation is based on the passion and dedication of Eagle’s founder, Dr Townsend Hopkins. Maintaining his wholehearted adherence to naturopathic principles, Eagle has created a range of advanced and effective naturopathic products.

Leading Eagle formulas such as Tresos-B®, Beta A-C® Powder, Haemo-Red® Plus and Digestaid have set a standard of high quality and effectiveness that are now a part of the Australian healthcare practitioners’ vernacular.

Today, Eagle continues Dr Townsend Hopkins’ traditions by producing formulas containing vitamins, minerals, amino acids, nutrients, herbs and homoeopathics that are trusted, reliable and efficacious.

Health World Limited

Marleen Herbs of Tasmania

www.healthworld.com.au | 07 3117 3300

ronald.winckel@bigpond.com | www.marleenherbs.com | 03 6492 3129

Health World Limited is recognised as a Leading Natural Health Science Company and the innovators in Natural Health products and Healthcare professional education. Health World Limited and Metagenics have invested in cutting edge manufacturing technology and equipment in order to expand production of the highest quality Natural Medicines. This level of commitment ensures that Health World Limited produces products that you and your patient can trust for quality and effectiveness.

Looking for Fresh Plant Tinctures?

For instance: Fresh Hawthorn, Oats, St johnswort, Coneflower, Sage, Golden rod.

Ask us for free samples of our 150+ fresh plant tinctures!

Marleen Herbs of Tasmania specialises in the organic certified cultivation and processing of medicinal plants since 1987.

Fresh Plant Tinctures, especially “mother tinctures” made from fresh plants according to the German Homeop. Pharmacopee (GHP) are our main product line but we also produce other liquids with plant based oil, glycerin or even vinegar.

“FreshPlant Tinctures - Minimal processing for maximum effect “.

Helio Supply Co

tcm@heliosupply.com.au | www.heliomed.com | 02 9698 5555 Helio Supply Co is a wholesaler of Acupuncture and TCM supplies. We distribute nationally as well as internationally and pride ourselves on our service to customers. Established in 2000, we are committed to providing educational opportunities, a practitioner support line and sourcing the best domestic and international equipment and materials.

Herbs of Gold Pty Ltd

info@herbsofgold.com.au | www.herbsofgold.com.au | 02 9545 2633 Herbs of Gold has been dedicated to health since 1989, providing premium and practitioner strength herbal and nutritional supplements. Formulated by qualified, clinical and industry experienced naturopaths, herbalists and nutritionists, our formulations are based on current scientific research and traditional evidence. We take great care in all aspects of our business; right from the selection of raw materials through to the finished product, reviewing our environmental impact and sustainability of ingredients. All Herbs of Gold products meet stringent regulations for safety, quality and efficacy.

HESTA

hesta@hesta.com.au | hesta.com.au | 1800 813 327 For more than 25 years, HESTA has focused on helping those in the health and community services sector reach their retirement goals. We now have more than 785,000 members, 155,000 employers and more than $28 billion in assets.

HESTA’s size means we can offer many benefits to members and employers. These include: low fees, a fully portable account, easy administration, access to low-cost income protection and death insurance, limited financial advice (at no extra cost), super education sessions and transition to retirement options. We also provide access to great value health insurance, banking and financial planning.

For more information visit hesta.com.au or call 1800 813 327.

Oligoscan Australasia

jon@karunahealthcare.com.au | www.oligoscan.net.au | 02 4228 0977 For practitioners of CAM to adequately treat patients with chronic diseases, it is essential to have at your fingertips to investigative tools to give the answers you need to create a viable treatment plan. Using the Oligoscan we can detect in only a few minutes the patient’s heavy metal load in addition to the bio-availability of their nutritive minerals. We can show patients why they have their symptoms, and help them to see a way out and back to health. Oligoscan is non-invasive, requires no tissue biopsy, and uses state of the art technology called Spectrophotometry.

Next practitioner training day: Sydney : 23rd August at 1.30.

Oncology Massage Training

info@oncologymassagetraining.com.au www.oncologymassagetraining.com.au | 0410 486 767 Are you turning away clients with cancer? Oncology Massage Limited provide internationally recognised training for therapists who want to work safely with clients with cancer, in treatment for cancer or a history of cancer.

Courses are held nationally around Australia, and we will schedule courses in regional areas where there is enough interest. We also maintain a national listing of therapists, trained by OM Ltd, which is accessed by cancer support organisations and hospitals nationally.

Don’t turn clients with cancer away, or refer them on. Improve your skills and get the confidence you need to improve client wellbeing.

Contact us at info@oncologymassagetraining.com.au for more information or check out the website.

Issued by H.E.S.T. Australia Limited ABN 66 006 818 695 AFSL No. 235249,Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. For more information about HESTA, call 1800 813 327 or visit hesta.com.au for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA products.

JATMS | Autumn 2015 | 67

PRODUCTS & SERVICES GUIDE

Quest for Life Foundation

info@questforlife.com.au www.questforlife.com.au | 1300 941 488 Founded by Petrea King in 1989, the Quest for Life Foundation provides retreats and community based workshops that encourage, educate and empower people with the tools to create emotional resilience and peace of mind.

Our retreats support people living with: • Depression • Anxiety • Grief • Loss • Trauma • Cancer • Chronic illness • Eating disorders • Chronic pain Assisting people from all walks of life we provide a proven, effective and holistic approach to physical, mental, emotional and spiritual wellbeing.

Sun Herbal

info@sunherbal.com.au | www.sunherbal.com | 1300 797 668 The No. 1 supplier of prepared Chinese herbal medicine in Australia and New Zealand. Your clinical success is our bottom line.

BLACK PEARL® pills • ChinaMed® capsules • Red Peony® granules for KIDS 192 herbal formulas effective for both common and difficult to treat conditions.

Sun Herbal supports you with: • A comprehensive website • Telephone support • Detailed reference manuals • Seminars & webinars • Regular Sun Herbal ‘Extracts’ (research and case studies) • Patient brochures & posters • Samples & bonus offers • Practitioner dispensing only

Terindah Travel

hello@terindahtravel.com.au | www.terindahtravel.com.au | 03 5294 0929

RemStone

hello@remstone.com.au | www.remstone.com.au | 0407 565 980 RemStone advances results and treatment outcomes by assisting prevention, rehabilitation + maintenance - allowing the good things in life to be enjoyed.

Desk bound jobs, home life activities or athletic adventures; RemStone is the universal helping hand. Developed in Australia, RemStone is a unique manual therapy offering a less invasive + more efficient treatment for pain and discomfort. RemStone accelerates remedial treatment, enhanced by unique safe + efficient fascial release stone techniques.

Whilst helping the client, RemStone assists the manual therapist gain more efficient results, prevents their own potential injury and extends their longevity in the industry.

If you’re a professional therapist - become a Licensed RemStone Therapist in 2014! Earn CE’s, advance your skill level, learn safe + efficient deep tissue/ fascial stone release techniques and share in RemStone’s business model.

We supply and support you to integrate stone massage into your business with training + career pathways, stones + equipment, marketing material RemStone is your ready-made and hands-on solution.

Courses starts soon! JUNE 2014

Terindah Travel is a leading travel agency for health and wellness holidays.

Founded in 2010, we are fully a licensed business located in Geelong, Victoria, but servicing students and practitioners throughout Australia. We have a range of natural medicine study tours for a range of modalities through which CPE and/or clinic hours can be obtained. Upcoming departures include Nepal in July and India in September with an ACNT lecturer. Please see our website and contact us to book. We’d be happy to also arrange your travel to seminars, conferences, retreats and personal holidays.

Terra Rosa

Terra Rosa www.terrarosa.com.au

Your Source for Massage Information

terrarosa@gmail.com | www.terrarosa.com.au | 0402 059 570 Terra Rosa specialised in educational massage DVDs and books. It has the largest collection of massage DVDs in Australia and the world, covering all modalities from Anatomy, Swedish Massage, Reflexology, Sports Massage to Myofascial Release and Structural Integration. We also provide the best in continuing education with workshops by international presenters including Orthopaedic Massage, Taping, Fascial Fitness and Myofascial Therapy.

The ATMS Products & Services Guide will appear in every issue of JATMS If you wish to list your company, practice, products, services or training course to appear in the June issue’s ATMS Products & Services Guide, please contact Yuri Mamistvalov on 0419 339 865.

Cost is $150 for one issue or $500 for 4 consecutive issues. Listing comprises of – Logo, 100 word profile and contact information.

68 | vol21 no1 | JATMS

SYDNEY INSTITUTE OF   TRADITIONAL CHINESE MEDICINE CRICOS 01768k | NTIS 5143 

  Nowadays alternate medicine practitioners are all learning  Acupuncture and Chinese Herbal Medicine

Open Day: 18 July, 2015 from 10am to 2pm 



Enrol into Sydney Institute of     Traditional Chinese Medicine (SITCM)   

   F E E H E L P AVA I L A B L E   

Bachelor Degree of Traditional Chinese Medicine   (double modalities of acupuncture and Chinese   herbal medicine)    C O U R S E C O M M E N C E S : 15 F E B 2 016 

Aproved

by AUSTUDY  Recognized by major Health Funds  •



31 years since establishment with graduates successfully  practicing nationally and abroad

• National TCM registration • Limited seat for international students   • 4 years visa for overseas students    Flexible Time and Practical Course

We are in the city: Level 5, 545 Kent St, Sydney NSW 2000 02 9261 2289

administration@sitcm.edu.au

www.sitcm.edu.au

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EDUCATION AND TRAINING

Continuing Education Continuing education (CE) is a structured program of further education for practitioners in their professional occupations.

The ATMS CE policy is designed to ensure its practitioners regularly update their clinical skills and professional knowledge. One of the main aims of CE is to keep members abreast of current research and new developments which inform contemporary clinical practice.

The ATMS CE policy is based on the following principles: • Easily accessible to all members, regardless of geographic location • Members should not be given broad latitude in the selection and design of their individual learning programs • Applicable to not only the disciplines in which a member has ATMS accreditation, but also to other practices that are relevant to clinical practice which ATMS does not accredit (e.g. Ayurveda, yoga) • Applicable to not only clinical practice, but also to all activities associated with managing a small business (e.g. bookkeeping, advertising) • Seminars, workshops and conferences that qualify for CE points must be of a high standard and encompass both broad based topics as well as discipline-specific topics • Financially viable, so that costs will not inhibit participation by members, especially those in remote areas • Relevant to the learning needs of practitioners, taking into account different learning styles and needs

70 | vol21 no1 | JATMS

• Collaborative processes between professional complementary medicine associations, teaching institutions, suppliers of therapeutic goods and devices and government agencies to offer members the widest possible choice in CE activities • Emphasis on consultation and cooperation with ATMS members in the development and implementation of the CE program ATMS members can gain CE points through a wide range of professional activities in accordance with the ATMS CE policy. CE activities are described in the CE policy document as well as the CE Record. These documents can be obtained from the ATMS office (telephone 1800 456 855, fax (02) 9809 7570, or email info@atms.com.au) or downloaded from the ATMS website at www.atms.com.au.

It is a mandatory requirement of ATMS membership that members accumulate 20 CE points per financial year. Five (5) CE points can be gained from each issue of this journal. To gain five CE points from this issue, select any three of the following articles, read them carefully and critically reflect how the information in the article may influence your own practice and/or understanding of complementary medicine practice: • Harris T , Vlass A. Endometriosis and the herbal medicine approach to treatment • Kousaleos G. Neck pain and treatment strategies • Medhurst R. More research on homoeopathy

IT IS A MANDATORY REQUIREMENT OF ATMS MEMBERSHIP THAT MEMBERS ACCUMULATE 20 CE POINTS PER FINANCIAL YEAR. FIVE (5) CE POINTS CAN BE GAINED FROM EACH ISSUE OF THIS JOURNAL

• Wollumbin J. Unani Tibb • Ferreira D. Australian Wheat: its Role in Food Security, Politics and Dietrelated Disease • Pagura I. Workplace bullyingAs part of your critical reflection and analysis, answer in approximately 100 words the following questions for each of the three articles: 1 What new information did I learn from this article?

2 In what ways will this information affect my clinical prescribing/ techniques and/or my understanding of complementary medicine practice?

3 In what ways has my attitude to this topic changed?

Record your answers clearly on paper for each article. Date and sign the sheets and attach to your ATMS CE Record.

As a condition of membership, the CE Record must be kept in a safe place, and be produced on request from ATMS.

EDUCATION AND TRAINING

Continuing Education - Calendar 2015 DATE

EVENT

PRESENTER

LOCATION

7th & 8th March

Seminar: Myofascial Trigger Points - The Upper Body

Raymond Smith

Bankstown, NSW

8th March

Seminar: The Nutritional Medicine Management of Chronic Diseases

Brad McEwen

Bankstown, NSW

14th & 15th March

Seminar: Acupressure for the Head, Neck and Shoulders

John Kirkwood

Glenelg North, SA

15th March

Seminar for Bodywork Practitioners: Client Care

Maggie Sands

Coffs Harbour, NSW

18th March

Webinar: Clinical Applications of Amino Acids

Brad McEwen

N/A

21st & 22nd March

Seminar: Massage techniques for immobility syndromes

Bill Pearson

Hobart, Tas

26th March

Webinar: Living in tune with your Ayurvedic body-type

Shaun Matthews

N/A

28th & 29th March

Seminar: Trigger Point Release for the Upper Body

Raymond Smith

Gladesville, NSW

18th & 19th April

Seminar: Trigger Point Release for the Upper Body

Raymond Smith

Canberra, ACT

15th April

Webinar: Eating disorders

Stephen Eddey

N/A

18th May

Webinar: Body Signs

Ann Vlass

N/A

24th May

Seminar: Fertility

Ann Vlass

Melbourne, Vic

24th May

Seminar: Ayurvedic psychology

Shaun Matthews

Gosford, NSW

March 2015

April 2015

May 2015

The proposed seminar and webinar topics, dates and locations (for seminars) are subject to change.

Please keep an eye on the ATMS website www.atms.com.au for the latest information and to book online.

JATMS | Autumn 2015 | 71

E DNEY BRISBPEANRTSY H ELAIDE SADEYLADIDNE EYNB DISBPERTH A R E A N UAIRDE E O B EL L AD E M M OURNE E L B O URNE H MELB PEdR T y e sy n ADELAIDE ADELAIDE

SEMINarS 2015

Y E N SYD

Booking is essential, and not to be missed. Seminar notes, gift pack or gift voucher included.

Supporting you to achieve 1P5D cents outStanding reSultS for ev your patientS.

March 2015

JULY 2015

BrISBaNE Sunday, 15th March 2015

9:00am - 2:00pm Better IVF Outcomes with chinese Medicine by Peter Kington To book: Carol Anderson 07 3852 2288 or admin@chineseherbalsupplies.com.au

MELBOUrNE Sunday, 29th March 2015

9:00am – 1:00pm Better IVF Outcomes with chinese Medicine by Peter Kington To book: China Books 1800 448 855 / 03 9663 8822 or info@chinabooks.com.au

SYDNEY Sunday, 26th July 2015

9:00am – 1:00pm Better IVF Outcomes with chinese Medicine by Peter Kington To book: China Books Sydney 1300 661 484 / 02 9280 1885 or info@chinabookssydney.com.au

aUGUST 2015 BrISBaNE Wednesday, 5th august 2015

aPrIL 2015 SYDNEY Tuesday, 28th april 2015

6:30pm – 9:00pm Dementia & cognitive Impairment – how to approach Patients with Early Signs of Dementia using TcM by Tony reid To book: China Books Sydney 1300 661 484 / 02 9280 1885 or info@chinabookssydney.com.au

BrISBaNE Thursday, 30th april 2015

6:30pm – 9:30pm Dementia & cognitive Impairment – how to approach Patients with Early Signs of Dementia using TcM

by Tony reid To book: Acupuncture Australia 1800 886 916 / 07 3808 4568 or amy@acupa.com.au

MaY 2015 PErTh Sunday, 3rd May 2015

9:00am – 4:30pm IVF Support for Men and Women by Peter Kington To book: Julie Fergusson 08 9311 6800 or JulieF@renerhealth.com

BrISBaNE Sunday, 10th May 2015

9:00am – 1:00pm Better IVF Outcomes with chinese Medicine by Peter Kington To book: NRG 1300 138 815 or beckyc@nrgaust.com

MELBOUrNE Sunday, 17th May 2015

9:00am – 1:00pm Winter ailments with chinese Medicine by Peter Kington To book: China Books 1800 448 855 / 03 9663 8822 or info@chinabooks.com.au

SYDNEY Sunday, 24th May 2015

9:00am – 1:00pm Winter ailments with chinese Medicine by Peter Kington To book: Acuneeds Australia 1800 678 789 / 03 9562 8198 or info@acuneeds.com

6:30pm – 9:30pm 1. DISOrDErS DUE TO DaMP- hEaT, TcM approach to Difficult clinical Scenarios 2. MOOD DISOrDErS IN TcM – Focus on Depression

by Tony reid To book: Acupuncture Australia 1800 886 916 / 07 3808 4568 or amy@acupa.com.au

aDELaIDE Sunday, 23rd august 2015

9:00am – 4:30pm IVF Support for Men and Women by Peter Kington To book: Acuneeds Australia 1800 678 789 / 03 9562 8198 or info@acuneeds.com

SEPTEMBEr 2015 SYDNEY Sunday, 6th September 2015

9:00am – 1:00pm Menstrual Disorders & Gynaecology With chinese Medicine

by Peter Kington To book: China Books Sydney 1300 661 484 / 02 9280 1885 or info@chinabookssydney.com.au

BrISBaNE Sunday, 13th September 2015

9:00am – 2:00pm Menstrual Disorders & Gynaecology with chinese Medicine by Peter Kington To book: Carol Anderson 07 3852 2288 or admin@chineseherbalsupplies.com.au

OcTOBEr 2015 MELBOUrNE Sunday, 18th October 2015

9:00am – 1:00pm Menstrual Disorders & Gynaecology with chinese Medicine by Peter Kington To book: China Books 1800 448 855 / 03 9663 8822 or info@chinabooks.com.au

BrISBaNE Sunday, 25th October 2015

9:00am – 1:00pm healthy ageing for the 21st century Male by Peter Kington To book: Acuneeds Australia 1800 678 789 / 03 9562 8198 or info@acuneeds.com

FOR mORe inFORmatiOn ViSit

www.sunherbal.com

all information correct at time of printing. However, due to events beyond our control, changes may be required.

INNOV_15009

ThESE EVENTS arE PrOUDLY ParTNErED BY: