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8 août 2010 7 08 /08 /août /2010 16:31

I am currently in Taiwan doing field research for my upcoming granule book, so I?m going to do a series of blogs on various local trends in Chinese medicine. Today?s blog will look at some of the trends in Chinese medical devices in Taiwan. A variety of interesting things fit into this category, such as customized granule packaging machines and decoction-steam delivery devices, which direct steam from a decoction to an affected site on the body     (Dell XPS M1210 Battery)       .

Follow up:

Over the next several days, I will be blogging about other local Chinese medical trends, such as the influence of herbal medicine in Taiwanese cuisine, the integration of Chinese medicine into the Taiwanese healthcare system, Taiwanese research trends in Chinese medicine, and other prominent local herbal trends like the consumption of tea and bing lang (betel nut)        (Dell Latitude X200 Battery)          .

When I go to Hong Kong and mainland China over the next few weeks, I will make similar posts about trends in their herbal marketplaces and other regional features.

Acupuncture Needles

In terms of acupuncture needles, Taiwanese doctors tend to use the traditional Chinese needles that most of us are familiar with. The needles are generally average to slightly thick by American standards; 32 and 30 gauge needles are the most common and gauges 34 and thinner are very rarely seen        (Dell Latitude XT2 Tablet PC Battery)       .

Clean needle technique (i.e., no handling of the shaft) and swabbing of points with alcohol is the norm. Acupuncture needles in Taiwan are nearly exclusively disposable, single-use needles. I have only ever seen autoclaved reusable needles used by one doctor in Taiwan; this particular doctor was a specialist in eye diseases and used specially blunted needles to reduce the risk of bleeding when needling into the orbital cavity          (Dell Precision M70 Battery)         .

Unlike in mainland China, where guide tubes are almost never seen, some Taiwanese acupuncturists do use guide tubes. In my experience, the majority of Taiwanese doctors still use freehand needling rather than guide tubes, but there is not a strong bias against the use of guide tubes            (Dell XPS M1330 Battery)          .

To a certain extent, the acceptance of guide tubes in Taiwan likely reflects the fact that Taiwan is typically more pro-Japanese than mainland China, so the Japanese influence of guide tubes has become more readily integrated into the local practice of acupuncture. (Some of my previous blog posts discuss how Japanese Kampo has influenced the Taiwanese granule world           (Dell TT485 Battery)         .

Another difference in acupuncture technology between Taiwan and the mainland is the lack of zhen dao (acutomic needles or ?knife needles?) in Taiwan. A zhen dao is a new type of needle that has created a lot of buzz in modern China; zhen dao are a cross between a needle and a scalpel, a bit like a very thick needle that has a tip like a sharpened tiny flat-headed screwdriver         (Dell XT832 Battery)           .

These new devices are used to treat stubborn musculoskeletal disorders that do not respond to normal acupuncture and tui na, and have recently been researched for internal medicine conditions as well. Typically, anesthetic is administered and the ?knife needles? are used to cut adhesions within the muscle fibers, with the theory being that the micro-trauma promotes a strong healing response. This new acupuncture device has spawned hundreds of research papers in mainland China, but hasn?t reached Taiwan in any prominent way yet      (Dell 451-10528 Battery)            .

Moxa

Moxa use is fairly straightforward in Taiwan. I have seen a variety of different handheld applicators, but not nearly as many different applicator styles as one can see in mainland China. Pole moxa and warm needling remain the most common types of moxa delivery, and infrared lamps are used as well    (Dell 312-0660 Battery)        .

While Taiwan does not appear to have quite as many different devices for shaping moxa cakes and applying moxa as we see in the mainland, there is a very unique type of ?heavenly moxibustion? that is used seasonally in Taiwan. Heavenly moxibustion refers to using medicinals to stimulate the skin without the use of mugwort and fire. Typically heavenly moxibustion uses irritating substances such as garlic or white mustard seed (bai jie zi) to cause the skin to blister       (Hp 520 battery)        .

The type of heavenly moxa that is particularly distinct to Taiwan is applied once per year, during one specific period of several weeks in a particular season. A large bolus of a special herbal paste is applied to the skin on the back of the hand, towards the wrist over the first and second metacarpal bones. The bolus is held in place with gauze, and it is removed after the irritating sensation becomes too much to bear          (IBM ThinkPad X41 Tablet battery)     .

Apparently the resulting blister lasts for nearly a month and is quite painful. This technique is supposed to provide good health throughout the year. Some of the young resident doctors at the hospital introduced me to it, since it is an interesting traditional thing. I must admit that I removed the bolus nearly as soon as the irritating sensation started becoming intense, so I didn?t go for the whole blister experience (I could tell within minutes that it would REALLY hurt to leave that thing on my hand)        (Acer Extensa 500 battery)         .

A bit off topic from moxa but still in the realm of warm things? Taiwan also has hundreds of hot springs, which are often attributed various healing properties. Typically the signs promoting the various health benefits of the water composition at any given spring are somewhat exaggerated, but nonetheless soaking in warm mineral-rich water is a part of the holistic approach in Taiwan        (Dell Studio 1737 battery )       .

The hot springs are typically in beautiful locations and there is tremendous variety in mineral composition from one region to the next. Massage and various hydrotherapy techniques are commonly seen in hot springs as well     (Dell RM791 battery)         .

Granule Delivery Systems

As I?ve written about in previous blogs, there are major differences in the manufacturing process and clinical application of granules between Taiwan and China. As far as medical devices go, one of the most prominent trends in Taiwan revolves around the use of dispensing machines that package granules for patients in clinics and hospitals          (Dell Latitude E6400 battery)         .

In Taiwan, granules are weighed and mixed together as a loose powder, often with small electric mixing machines. They are then put into a machine that dispenses them in individual plastic sachets, one sachet per dose. One can program in the amount of powder to be dispensed in each sachet, and the machine divides the whole powder batch into convenient little pouches (Dell inspiron 1501 battery)         .

The plastic packaging is often customized for each hospital and clinic. These machines have recently started to appear in the U.S. as well, but I?ve never seen them in use in an American clinic       .

Beyond granules, Korean extraction machines are found in Taiwan as well. However, these extractors are not nearly as prominent in Taiwan as they are in Korea and China            (Dell Vostro 1000 battery)          .

The hospital that I studied at had about 15 extractors and my former teacher Feng Ye has a few in his clinic, but ultimately they are not that commonly seen. Granules are by far the most common method of using herbal medicine in Taiwan when convenience is desired. As I?ve mentioned before in prior blog articles, granules in Taiwan are nearly always used as whole formulas with single herb additions         (Dell Inspiron E1505 battery)         .

Pai Sha

Pai Sha is a method of rhythmically striking the body with a special instrument. The object used is often a long bundle of thin pieces of wood (think of a narrow broom end with thin pieces of wood instead of straw). The instrument hits the body with strength but the blow is rapidly diffused by the natural give of the bundle of wood. For smaller parts of the body, the pai sha tool can be a simple stick or other blunt device with a handle            (Acer Aspire One battery)          .

Pai sha is similar to gua sha and cupping in that it promotes bruising in a measured way. Pai sha can be a bit uncomfortable, and it is similar to gua sha in the sense that it is a folk practice rather than a formal medical practice. In other words, gua sha and pai sha are never really given by doctors or seen in hospitals, but they are very common methods of self-healing among the general population. The basic theory is that raising bruises in a consistent and modest way encourages blood circulation and clears up old static blood          (ACER Aspire 5020 Battery)         .

Herbal Steamers

Steam-directing machines are another common Chinese medical device seen in Taiwan. These steamers are essentially self-contained glass machines that decoct herbs and funnel the steam at a local area via a firm hose. They are particularly common in clinics that treat a lot of impediment patterns (bi syndrome) and other joint diseases         (Acer AS07B72 battery)      .

When the medicinals cook, the steam that issues forth warms the affected joints and directs the effect of the medicinals to the local area. This technique is referred to as steam-washing (zheng xi) in Chinese medicine. The fragrance and essential oils that disperse with the steam are thought to help to treat skin diseases and impediment patterns          (Dell XPS M2010 battery)         .

This is just a short survey of some of the unique Chinese medical devices that are prevalent in Taiwan. Come back to our blog again to read the continuation in the series, when we discuss medicinal cookery in Taiwan, as well as local herbs, Chinese medical healthcare, and research trends. From there, we?ll go on to trends in Hong Kong and Guangzhou, then up north to Beijing            (Dell Latitude C400 Battery)              .

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