Points for Profit

The Essential Guide to Practice Success for Acupuncturists
by Honora Lee Wolfe

Coming in Fall Allergies Season

This is an article that was published by Blue Poppy some years back…but in case you forgot about this formula, it can be very helpful for your allergy patients in the Spring or Autumn. I don’t do it often, but this is a small shameless marketing moment.

Ease for your Patients with Allergies NOW!

By Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM

A few years ago, Blue Poppy introduced a version of Li Dong-yuan’s Astragalus & Ginseng formula for the prevention of seasonal allergic rhinitis. Then, when numerous customers asked us to also create a formula for the remedial treatment of allergic rhinitis we combed the Chinese medical literature to find the best formula for Westerners for acute stage allergic rhinitis. After reading scores of Chinese research reports on various formulas, I kept coming back to a formula that I personally have used in my own practice for a number of years. This formula is a modification of Bi Qiu Tang (Sniveling Nose Decoction) created by Dr. Wei Zi-zhang of the First Affiliated Hospital of the Guangxi College of Chinese Medicine. Our version, AllerEase is a 9:1 extract and is available in bottles of 60 500mg capsules. We also have a children’s version, AllerEase Jr., in a glycerin base dispensed by dropper. AllerEase has been very popular and well received by practitioners and their patients. We expect the same response for AllerEase Jr., the newest addition to our ever expanding pediatric line.

This formula is based on the concepts that everyone who has allergic rhinitis has a defensive qi vacuity and everyone who has allergic rhinitis has deep-lying or hidden phlegm in their lungs. Although there are different opinions about the creation of defensive qi, after many years of practicing Chinese medicine, I agree with the authors of the Nei Jing (Inner Classic) that the defensive qi exists or issues from the middle burner. In my experience, it is the spleen qi’s upbearing of the clear that supplements the lung qi, and the lungs control the defensive qi. In addition, it is said, “The spleen is the root of phlegm engenderment; the lungs are the place where phlegm is stored.” If the spleen is or becomes vacuous and weak, it will lose control over the movement and transformation of water fluids in the body. These will collect and transform into dampness. If dampness lingers and is retained, it tends to congeal into phlegm over time.

In terms of Chinese medical theory, pollen, animal dander, airborne molds, and microscopic dust are all species of wind evils. Wind evils refer to invisible pathogens, which tend to be airborne (although they do not absolutely have to be). If a person’s defensive qi is vacuous and fails to secure the exterior, wind evils may take advantage of this vacuity and enter the body. The lungs are the florid canopy as well as the tender viscus. Therefore, the lungs are typically the first viscus to be affected by invading wind evils. If these evils hinder and obstruct the diffusion and downbearing of the lung qi, then the lungs lose their control over the water passageways. Instead of fluids being downborne, these back up, if there is already phlegm rheum deep-lying in the lungs, this phlegm counterflows upward along with the lung qi. Thus there is sneezing, nasal congestion, and runny nose. Because the lungs open into the orifices of the nose, wind evils cause itching of the nose.

Although it is wind evils which cause the paroxysmal or acute stage of allergic rhinitis, the pattern that patients with allergic rhinitis present is one of wind cold. Wind describes the disease cause and cold describes the kind of phlegm rheum that is evident. The runny nose that is pathognomonic of allergic rhinitis is a clear, thin, copious watery phlegm. This is cold phlegm as opposed to phlegm heat, which is thick, opaque, and tends to be yellow. While allergic rhinitis may transform into sinusitis, if there is yellow or green phlegm, then this is both a different disease and a different pattern. Simple allergic rhinitis always presents a wind cold pattern. Further, because the defensive exterior is, ipso facto, vacuous and insecure and because there is typically a continuous, unceasing runny nose, the lung qi is insecure and failing to astringe.

This means that the treatment principles for wind cold allergic rhinitis are to fortify the spleen and boost the qi, diffuse the lungs and dispel wind, transform phlegm and warm rheum, and open the orifices of the nose at the same time as astringing and securing the lung qi, and this is exactly what Wei Zi-zhang’s formula does. Within it, Dang Shen, Huang Qi, Bai Zhu, Yi Yi Ren, and Shan Yao supplement the lungs, spleen, and kidneys, the three viscera that govern water metabolism in the body. He Zi and Wu Wei Zi secure the lungs and specifically stop runny nose. Fang Feng and Jing Jie Sui gently dispel wind evils from the exterior while not damaging the defensive qi. Xin Yi Hua and Bo He open the orifices and free the flow of the nose, thus relieving nasal congestion. Chan Tui dispels wind and stops itching. Jie Geng guides the other medicinals to the lungs and also transforms phlegm. Gan Jiang warms the lungs and transforms phlegm. The combination of Yi Yi Ren and Ze Xie seeps dampness via urination and, therefore, helps Bai Zhu eliminate dampness. Gan Cao harmonizes all the other medicinals in the formula at the same time as helping fortify the spleen and supplement the qi. Thus this formula exactly fits the disease mechanisms of this condition.

This formula is not meant for long-term administration. Once the allergic attack has been brought under control, the practitioner should consider switching the patient to Astragalus & Ginseng in order to address the underlying disease mechanisms during the remission stage. However, during acute allergic attacks, one should consider taking more AllerEase than the recommended dose on the bottle. This dosage is only for FDA purposes. It is a minimum daily dose. For larger persons and for quicker effect, this dose may typically be doubled or tripled without harm. During acute attacks, one should suspend Astragalus & Ginseng. It is not necessary or particularly beneficial to take both formulas at the same time. AllerEase itself treats both the root and branches (or tips) simultaneously.

Of course, patients with allergic rhinitis will typically also have to modify their diet. One cannot expect huge results if they continue eating a lot of dairy products, sugars and sweets, and oily, greasy, fatty foods. Nevertheless, research in China has shown this formula to be extremely effective for the remedial treatment of acute allergic rhinitis. Thirty-three patients with wind cold allergic rhinitis and an underlying lung-spleen vacuity were given a single course of treatment with this formula and then followed for six months. In six cases, their symptoms disappeared and did not recur for the full six months of the study. In 23 cases, their symptoms recurred after more than three months but less than six months. However, repeat treatment was able to immediately eliminate their symptoms. Only four cases got no effect. Thus the total effectiveness of this formula was 87.8%. When combined with proper diet and Astragalus & Ginseng, one should be able to dramatically decrease any tendency to relapse. With the late summer and early fall allergy season soon upon us, order a supply of AllerEase® and AllerEase Jr.® today. You won’t be sorry you did.

Copyright © Blue Poppy Press, 2006. All rights reserved.

A favorite recipe for a hot compress

Not all pain patients like heat on their areas of pain, but many do. For those who don’t you can use liniments and patches. For those who crave heat, you can use liniments with a heat lamp, OR use this hot compress in your clinic, OR send people home with bags of these herbs to cook up and use as a soak or compress in between treatments.It’s simple but effective. I learned this one at the Shanghai #1 Teaching Hospital when I was a student there in the tuina ward. They kept a crockpot of this decoction hot and at the ready with clean towels for application on many patients.

Recipe for a Hot Compress

Hong Hua
Chi Shao
Tao Ren
Zi Ran Tong
Dang Gui Wei
Chuan Xiong
Su Mu

15 grams of each in one gallon of water. Place the Hong Hua in a cotton bag or tie into a piece of cheese cloth to make your straining process at the end easier. Simmer for 45-60 minutes. Strain out the dregs and keep this on warm in a slow cooker in your clinic. You can reuse this liquid for 4-5 days if kept warm.

Use flannel cloth or old kitchen towels that you don’t care if they are dyed red by the Hong Hua. Use the compress as hot as you can stand to wring out and as hot as the patient can stand. Place on the skin and pat once or twice….place on the skin and pat once or twice. Repeat this until the skin is red and warm without burning the patient.

The patient could also do this at home for ongoing care of muscle, tendon, soft tissue injuries.

The Power of Fire

At West China Medical University in Sichuan, there is an acupuncture professor who is over 90 years of age and still in practice. He has never had any serious disease in his life, his hearing and vision are still acute, his steps are still nimble, and his viscera and bowels still function regularly. This professor ascribes his good health and long life to moxaing Zu San Li (St 36) incessantly for many years. In an article written by his son, it is said that he has been moxaing this point with wheat grain-sized cones from the first to the eighth day every month for over 60 years.

This story is not unusual in the annals of Chinese medicine. However, in the United States, moxibustion is one of the most under-taught, under-used, and under-appreciated therapies in the world of Asian medicine. Moxibustion encompasses several therapies, but mainly pertains to the burning of the moxa plant, Artemisiae Argyii, on, over, under, or near specific acupoints or areas of the body. More generically, moxibustion can be described as using heat therapy of several kinds to warm the channels and scatter cold, to open the channels and stop pain, to clear heat and disinhibit dampness, to boost the qi and supplement the blood to open the channels. This broad range of application gives moxibustion many uses and can improve the effectiveness of acupuncture or Oriental body work.

Even without choosing points based on pattern diagnosis, it is possible to use moxa for longevity purposes alone, as described in the example above. This type of treatment is appropriate for inclusion when treating anyone over 40, and especially over 50 years old. There are several points from which one might choose, depending upon what is most convenient during your body work treatment. Also, this type of therapy lends itself especially well to “homework” taught to the patient and done between office visits.

Guan Yuan (CV 4) is one of the most common points used for “longevity therapy”. Moxa 3-11 ½ rice grain or sesame seed sized cones/threads once per day.
Shi Dou (Sp 17) is for any and all symptoms which are due to spleen vacuity….fatigue, digestive complaints, or blood vacuity symptoms. Use only the tiniest thread moxa on this point and 3-5 threads per day. If appropriate, this point will be tender to light pressure.
Zu San Li (St 36) for everyone over 40 even if healthy or in patients with poor resistence who often catch colds or flus. Moxa 3-7 ½ rice grain sized or sesame seed sized threads each day for the first week of every month or every day for a month at each equinox.
Qi Hai (CV 6) As the sea of the original qi, this acupoint connects with the five viscera, providing them with supplies of qi. Therefore, moxa on Qi Hai nourishes life and promotes health. Moxa the same as Guan Yuan, listed above.

These are just a few of the simple treatment ideas that you can easily add to a treatment session, helping your patients to increased health and longevity.

Honora Lee Wolfe She has been involved in professional health care education since 1976. Director at the Boulder School of Massage Therapy for five years between 1976-1981, Ms. Wolfe went on to study tuina massage at the Shanghai College of TCM and completed her acupuncture training in 1988. She has taught at many national and regional bodywork and acupuncture colleges and conferences in North America and Europe and is the author or co-author of several books, including Prince Wen Hui’s Cook: Chinese Dietary Therapy, How to Have a Healthy Pregnancy Healthy Birth with Chinese Medicine, Managing Menopause Naturally with Chinese Medicine, Better Breast Health Naturally with Chinese Medicine, Points for Profit: The Essential Guide to Practice Success for Acupuncturists, The Successful Chinese Herbalist with Bob Flaws, and Western Physical Exam Skills for Practitioners of Asian Medicine with Bruce Robinson, MD.

How to Really Work a Health Fair

Where I live in Colorado, during the Spring season there are tons of “Health Fairs” co-sponsored by a large local TV station along with one of the big hospital chains and other health-related companies. There are free and low-cost screenings for all types of things like blood sugar, cholesterol, pap smears, body mass index, blood pressure, and how-to workshops for all kinds of things to help folks stay healthier. These screenings are very low cost compared with standard lab fees. Can’t say for certain, but I expect these events happen all over the US.

Our state association has developed a relationship with the folks who plan these fairs and encourages participation by members all over the state to help build their practices as well as for gaining general public awareness of acupuncture. Still, I am sure that many acupuncturists would ask, “What would I do at one of these events? What screening or service would I offer?”

Here’s a description of what I would do at one of these events.

1. Focus on the visual. Take an acupuncture mannequin. If you cannot beg or borrow one, get a stiff foam-core board from a hobby store and tape a good acupuncture chart to it. Prop this up on a book-stand or tape a triangular “hinge” on the back to make it stand up.
a. Small plexiglass sign-holders that say things like “Chinese herbs are everywhere.” Put this in front of a dish of ginger snaps with tongs for people to take one. (I used to suggest black licorice pieces but for people with high blood pressure this is a no-no.)
b. Consider making an herbal trail mix with goji, walnuts, chopped red dates, and almonds. Write up a little sign stating what each of these does according to Chinese medicine.
c. Some companies will sell you herbal samples to give away or you could make some small liniment samples of your own with one-oz bottles and lids from a packaging supply company.
2. Invite your patients. Offer a free treatment in exchange for them coming for an hour. These events usually run 7AM-12Noon, so if you could get 4-5 patients to be guinea pigs for one hour each, you’d have most of this covered. Put needles in points that are visible to people. I guarantee this will prompt folks to come over and ask, “does it hurt?” at which point the patient says “No! it’s great! You should come!”
3. Have a large sign that says, “Can acupuncture help you? Get a FREE consultation here today!” For this you create a simple 1/2-page sheet for them to fill out with name, major complaint, what they’ve done to treat it so far, would you like my e-newsletter (and if so put your email here, which I never sell, rent, or share), and a short disclaimer that you are not an MD and are not attempting to replace anyone’s MD. These should be only 10 minutes, during which time you ask 2-3 questions, perhaps look at the tongue and take the pulse for one minute. Then tell them whether you think acupuncture could be helpful in their case and how many treatments you’d need to start. Something like, “Acupuncture therapy certainly has a history of success with this condition. Although you may see immediate change with one treatment, you need 4-5 treatments to see if we could consolidate some improvement in your case.”
4. Take lots of cards, brochures, research articles, anything that helps build credibility and gives you something to hand people who visit your booth. Have a clipboard sign-up sheet for your newsletter. Consider another plexiglass sign-holder that says “Ask me about speaking to your group or association about the benefits of acupuncture.” This could get you some speaking engagements.
5. Stay up front! You need to be on the front side of the table in order to engage people. Don’t sit in a chair in the back!! Make your body language say, “I’m here for you. I want to engage you.”
6. Video could be good. This is more complicated, but a video about acupuncture that plays in the background could offer some people a way to engage without having to speak to you first if that’s too scary. You can get good videos about the benefits of acupuncture from Acupuncture Media Works.
7. Two or more practitioners for your booth will be useful so that you can speak to everyone who stops by and not leave people waiting too long.
8. A coupon for a discount? This is optional of course (as are all these ideas) and there is always a case to be made for not giving any discounts, but a “10% off an initial appointment” coupon might get you some appointments right on the spot. I’d try one fair with a coupon and one fair without and see what happens. If you only get “tourists” from the coupons, ding the idea.
9. Work with a local non-profit. Another piece of info on your table might say, “Make an appointment today and we’ll donate ½ the proceeds (or whatever percentage is comfortable) of your first appointment fee to XYZ Local Non-Profit.”
10. A Fish Bowl. “Enter with your Biz Card to win A Complete Diagnostic Session, a $100 Value!” Change the words or numbers as you like, but you get the idea.
11. Have a sign-up sheet. Offer to send people specific research or a free monthly newsletter or a link to a free ebook if they sign up to receive further information from you.
12. Take Time to go and meet all the rest of the people at the other booths and tables. Offer them your card, be friendly, ask about their work, ask where they work, invite them over for a free OM assessment (or whatever you are offering), thank them for participating in the fair.
13. Follow up. After the fair, get in touch with anyone who left contact information. Thank them for coming by. Include a biz card even if you think they took one. Encourage them to visit your website. Tell them to feel free to call if they have other questions about acupuncture/Chinese medical care. Anyone who wanted your eNewsletter, send the most recent issue along with a personalized email. Remember that many people may not be ready to become a patient now, but everyone becomes someone’s patient eventually, so stay in touch with those who’ve given you permission.

So this is work, but not more work than other marketing methods that get you out into a community of people. It may not cost you anything for the table at the fair, or perhaps a very small fee. However, the people who stop by your booth are self-selected and are, by the fact that they are there in the first place, interested in their own health. You will learn a ton about what people think and wonder about acupuncture, and you can get new patients this way.

Good luck and thanks for reading!

Honora Wolfe has been writing, teaching, lecturing, and blogging about business and marketing for a decade or more. Her book, Points for Profit: The Essential Guide to Practice Success for Acupuncturists, is the biz book to own.