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Principles and practice of chiropractic. 2nd ed.
108 ComplementaryThempies in Medicine: Review section
Qi Gong techniques. There am now several fine books available on Chinese medical theory, medical history, diagnosis and point location but the practical skills have been previously poorly represented. This book amply fills that gap. What makes this book such a valuable addition to the literature is the combination of excellent illustrations and lucid text The illustrations in particular are models of clarity. The whole work is so clearly laid out that practitioners who have not undertaken any clinical training for some time could make significant improvements in their technique with careful study of its contents. The book also where possible draws upon classical references to support its techniques. It is, for example, particularly interesting on the topic of whether the needle should be left in or withdrawn, when the practitioner intends to reinforce the Qi of the patient. Many Western practitioners favour leaving the needle in but this work comes down strongly on the side of withdrawing the needle almost immediately, citing Ling Shu (approx 200 BC) chapter 1 ‘OnceQi has arrivedthere is no further need to retain the needle in the patient’s body as the aim of the manipulation has now been achieved’. Ling Shu chapter 3 states ‘A good physician will wait for the arrivalof Qi. Onlythen will he practisereinforcing and reducing techniques to balance the patient’s energy.’ Acupuncturistswho practice what the Chinese sometimes call ‘New Acupuncture’, in which there is no place for Yin/YangFive Element theory or even the existence of Qi itself, will of course rarely discern this instant. Most patients cannot be relied upon to differentiatebetween the awarenessof Da Qi and other physical sensations. Inevitably this means that, unless the practitioner’spoint location is absolutely impeccable, the therapeutic effect of a point will be only a fraction of that point’s potential. The practitioner’s ability to feel this moment is one of the hallmarks of the Master and the study of any amount of books, however excellent, can never replace the development of the practitioner’s sensitivity in this respect It must be borne in mind while reading this book that the techniques it favours are all drawn from those most in favour in China today. Japanese,Korean and many Westem patients, accustomed to far more gentle techniques than those practised in China, would be horrified by the vigour of some of the manipulations demonstrated in this text, such as ‘Lighting the fue on the mountain ‘Green dragon swings his tail’ and ‘Whitetiger shakes his head’. Theremust be few Westernpractitioners,however, whose technical proficiency would not improve if they are prepared to devote some time to practising the techniques described in this excellent book. Peter Mole BA, MAC, MTAS
Dean of Studies, College of Integrated Chinese Medicine Immediate Past President Traditional Acupuncture Society Practitioner at Oxford Acupuncture Centre
Principles and Practice of Chiropractic. 2nd ed. by Scott Haldemann Norwalk,CL Appleton & Lange, 1992. 641~~.
$69.95 (fi5) ISBN: 0 8385 6360 0 The initial edition of Scott Haldemann’s Principies and Practiceof Chiropracticwasa much praised collection of ‘stand alone’ conference papers, becoming outdated because of the rapid evolution of both chiropractic and back-pain research. The second edition has attempted a significantdegree of unification aud forms a more coherent document. The information has been apportioned into four sections: History, Philosophy and Sociology of Chiropractic; Physiological and Biomechanical Principles; Spinal Analysis and DiagnosticMethods; and fmally Chiropractic Care. For the non-chiropractor,the initial section contains five interesting,revealing and informative chapters. This section bares all, starting from ‘pre-chiropractic’manipulation. It opens in a very readablestyle, however, the reader is soon aware,as with many compilations, that the text has been written by various authors, e.g. repetition is occasionally noticeable. The changes in style are not as obvious in the physiological and biomechanical principles section, which would be better titled ‘The Scientific Basis’ as it appears mainly anatomical and pathophysiological. The initial chapters are excellent, the only distractions being the labelling of some figures. A poor degree of co-ordination by the editor is also apparent, resulting in three similarly titled chapters (on pathophysiology of spinal structures) each have a different emphasis. The final chapter in this section forms a good, albeit textbook level, grounding in physiological biomechanics. This occasionally loses track of its remit, however, such as ending in 5 pages of hypotheses. Although in line with the book’s theme, this was perhaps not appropriatein a section giving the ‘scientific angle’. The remaining sections form the ‘back-bone’ of the book. Those chapters dealing with spinal analysis and diagnosticmethods are variable,however, the history and physical/manual examination chapters show, in reasonable detail, procedures used to test for neurological and vascularproblems as well as to determine pain. However, the photographs appear inadequate in this context and would only be of use to someone familiar with such techniques. Attempts at dealing with the subjectivity within chiropractic are covered in the instrumentation chapter. This leads into more interesting chapters covering descriptionsof the use of X-raysin diagnosis and study of vertebral motion. These chapters are both useml and informative. In any medical field, a major concern always lies with the quality and effectiveness of its patient cam. This is
Review!aecth
discussed in the final section, where the treatment (manipulative/adjustive elements at least) is questioned in a reasonablyhonest way. A variety of techniques are illustrated, each being introduced with a brief history of development. The section becomes less well-defined towards the end, covering excessive trauma, rehabilitation and complications of manipulation thus forming unfortunate associations. I found this book a relatively easy read, informative and a potentially useful reference text, giving an insight into the minds of chiropractors,especially the American ones. Although occasionally disjointed, and at times repetitive, this edition is mom unified than the first. It does suffer the fate of many compilations, in that some chapters are written by certain self-styled authorities who do not always do justice to the subject. Maybe editorial control should be stronger next time. Peter McCarthy PhD
Senior Lecturer in Basic Sciences Anglo-EuropeanCollege of Chiropractic Bournemouth,UK
Adverse Effects of Herbal Drugs edited by P.A.G.M. de Smet et al. Berlin: Springer-Verlag, 1992. xiv + 275~~. DM 98 (approx M5) (paper) ISBN: 3 540 53100 9 At a time when the controversy between alternativedisciplines, in particular herbalism, and orthodox medicine is still a highly emotive issue, the publication of this book is bound to raise some guarded suspicion from the side of the herbalists (phytotherapists). The authors am wellknown and respected authorities in the pharmacology of botanical drugs, and may be expected to be objective in their statements. From personal experience, I know how minimal is the general practitioners’andmedical establishments’knowledge of herbal drugs; hence the reason for the many telephone calls from hospital pharmacy departments requesting information about their safety. Through the now well-established Poisons Unit a wealth of information about side effects or toxicity of orthodox drugs - common commodities such as volatile oils, peppermint, ammonia and the ever-growing array of products in the health food shops - is now becoming available to GPs and the hospital pharmacists. The authors of this book are to be congratulated in providing information about the adverse effects of herbal preparations. The book is well laid out and, in spite of contributions from 13 different authors, all experts in their scientific fields, the book has not become fragmented. A wealth of
109
information is available and it deserves a place in the libraryof practisingphytotherapists. It is, therefore, a pity that a few weaknesses have occurred, which could have been avoided. For instance, the frostpart of the book is devoted to the contamination of herbalproducts, due to its cultural environment, harvesting and processing techniques, sterilisation, radio-activity, etc. Although valid points, these have nothing to do with the possible side effects of the constituents of the herbs themselves and it is a pity that the herbs are getting bogged down in these issues. These factors am alike for all natural products, whether they are potatoes, carrots, oranges, apples, nuts, meat or milk. In this day and age everything we consume is subjected to the ‘blessings’ of modem techniques and chemicals, and so are herbs. The fact that it is human intervention which may turn totally safe products into potentially hazardous substances should have been pointed out and not attributedto herbs. Another point that struck me was the sometimesrather weak scientific arguments. The chapter about Foeniculum (fennel) seems mom to be promoting the use of fennel than to indicate any adverse reactions. The adversereactionprofilementioning animal data states that the LDsodose for rats is between 3.12 and 4.5 ml/kg of fennel oil, an enormously high dose which rather indicates an absence of toxicity. However, on the whole the book contains much useful information and, for the phytotherapists, the general human data are very valuable. All practitioners of phytotherapyhave come acrossthose rare instancesof adverse reactions against herbs which we think to be totally safe and without side effects, and it is very helpful to have some infonnation availablein these situations. Apart from this, it offers us a considerableamount of information conceming active constituentsand the pharmacology of a number of herbs which am much in use in herbal medicine. Hein H. Zeylstra FNIMH School
Principal of Phytotherapy(Herbal Medicine) Sussex, UK
The Controlled Clinical Trial: An Analysis by Harris L. Coulter Washington:Center for Empirical Research, 1991. 165pp. $12.00 ISBN: 0 916386 04 x 1422145thStreet North West, Washington DC 100016, USA] This is an excellent critique of the controlled clinical trial from a historical perspective. Dr Coulter analyses the clinical trial as a cultural, snuctmal, historical and scientific phenomenon. His conclusions, though occasionally extreme, am certainly devastating for conventional me-
Qi Gong techniques. There am now several fine books available on Chinese medical theory, medical history, diagnosis and point location but the practical skills have been previously poorly represented. This book amply fills that gap. What makes this book such a valuable addition to the literature is the combination of excellent illustrations and lucid text The illustrations in particular are models of clarity. The whole work is so clearly laid out that practitioners who have not undertaken any clinical training for some time could make significant improvements in their technique with careful study of its contents. The book also where possible draws upon classical references to support its techniques. It is, for example, particularly interesting on the topic of whether the needle should be left in or withdrawn, when the practitioner intends to reinforce the Qi of the patient. Many Western practitioners favour leaving the needle in but this work comes down strongly on the side of withdrawing the needle almost immediately, citing Ling Shu (approx 200 BC) chapter 1 ‘OnceQi has arrivedthere is no further need to retain the needle in the patient’s body as the aim of the manipulation has now been achieved’. Ling Shu chapter 3 states ‘A good physician will wait for the arrivalof Qi. Onlythen will he practisereinforcing and reducing techniques to balance the patient’s energy.’ Acupuncturistswho practice what the Chinese sometimes call ‘New Acupuncture’, in which there is no place for Yin/YangFive Element theory or even the existence of Qi itself, will of course rarely discern this instant. Most patients cannot be relied upon to differentiatebetween the awarenessof Da Qi and other physical sensations. Inevitably this means that, unless the practitioner’spoint location is absolutely impeccable, the therapeutic effect of a point will be only a fraction of that point’s potential. The practitioner’s ability to feel this moment is one of the hallmarks of the Master and the study of any amount of books, however excellent, can never replace the development of the practitioner’s sensitivity in this respect It must be borne in mind while reading this book that the techniques it favours are all drawn from those most in favour in China today. Japanese,Korean and many Westem patients, accustomed to far more gentle techniques than those practised in China, would be horrified by the vigour of some of the manipulations demonstrated in this text, such as ‘Lighting the fue on the mountain ‘Green dragon swings his tail’ and ‘Whitetiger shakes his head’. Theremust be few Westernpractitioners,however, whose technical proficiency would not improve if they are prepared to devote some time to practising the techniques described in this excellent book. Peter Mole BA, MAC, MTAS
Dean of Studies, College of Integrated Chinese Medicine Immediate Past President Traditional Acupuncture Society Practitioner at Oxford Acupuncture Centre
Principles and Practice of Chiropractic. 2nd ed. by Scott Haldemann Norwalk,CL Appleton & Lange, 1992. 641~~.
$69.95 (fi5) ISBN: 0 8385 6360 0 The initial edition of Scott Haldemann’s Principies and Practiceof Chiropracticwasa much praised collection of ‘stand alone’ conference papers, becoming outdated because of the rapid evolution of both chiropractic and back-pain research. The second edition has attempted a significantdegree of unification aud forms a more coherent document. The information has been apportioned into four sections: History, Philosophy and Sociology of Chiropractic; Physiological and Biomechanical Principles; Spinal Analysis and DiagnosticMethods; and fmally Chiropractic Care. For the non-chiropractor,the initial section contains five interesting,revealing and informative chapters. This section bares all, starting from ‘pre-chiropractic’manipulation. It opens in a very readablestyle, however, the reader is soon aware,as with many compilations, that the text has been written by various authors, e.g. repetition is occasionally noticeable. The changes in style are not as obvious in the physiological and biomechanical principles section, which would be better titled ‘The Scientific Basis’ as it appears mainly anatomical and pathophysiological. The initial chapters are excellent, the only distractions being the labelling of some figures. A poor degree of co-ordination by the editor is also apparent, resulting in three similarly titled chapters (on pathophysiology of spinal structures) each have a different emphasis. The final chapter in this section forms a good, albeit textbook level, grounding in physiological biomechanics. This occasionally loses track of its remit, however, such as ending in 5 pages of hypotheses. Although in line with the book’s theme, this was perhaps not appropriatein a section giving the ‘scientific angle’. The remaining sections form the ‘back-bone’ of the book. Those chapters dealing with spinal analysis and diagnosticmethods are variable,however, the history and physical/manual examination chapters show, in reasonable detail, procedures used to test for neurological and vascularproblems as well as to determine pain. However, the photographs appear inadequate in this context and would only be of use to someone familiar with such techniques. Attempts at dealing with the subjectivity within chiropractic are covered in the instrumentation chapter. This leads into more interesting chapters covering descriptionsof the use of X-raysin diagnosis and study of vertebral motion. These chapters are both useml and informative. In any medical field, a major concern always lies with the quality and effectiveness of its patient cam. This is
Review!aecth
discussed in the final section, where the treatment (manipulative/adjustive elements at least) is questioned in a reasonablyhonest way. A variety of techniques are illustrated, each being introduced with a brief history of development. The section becomes less well-defined towards the end, covering excessive trauma, rehabilitation and complications of manipulation thus forming unfortunate associations. I found this book a relatively easy read, informative and a potentially useful reference text, giving an insight into the minds of chiropractors,especially the American ones. Although occasionally disjointed, and at times repetitive, this edition is mom unified than the first. It does suffer the fate of many compilations, in that some chapters are written by certain self-styled authorities who do not always do justice to the subject. Maybe editorial control should be stronger next time. Peter McCarthy PhD
Senior Lecturer in Basic Sciences Anglo-EuropeanCollege of Chiropractic Bournemouth,UK
Adverse Effects of Herbal Drugs edited by P.A.G.M. de Smet et al. Berlin: Springer-Verlag, 1992. xiv + 275~~. DM 98 (approx M5) (paper) ISBN: 3 540 53100 9 At a time when the controversy between alternativedisciplines, in particular herbalism, and orthodox medicine is still a highly emotive issue, the publication of this book is bound to raise some guarded suspicion from the side of the herbalists (phytotherapists). The authors am wellknown and respected authorities in the pharmacology of botanical drugs, and may be expected to be objective in their statements. From personal experience, I know how minimal is the general practitioners’andmedical establishments’knowledge of herbal drugs; hence the reason for the many telephone calls from hospital pharmacy departments requesting information about their safety. Through the now well-established Poisons Unit a wealth of information about side effects or toxicity of orthodox drugs - common commodities such as volatile oils, peppermint, ammonia and the ever-growing array of products in the health food shops - is now becoming available to GPs and the hospital pharmacists. The authors of this book are to be congratulated in providing information about the adverse effects of herbal preparations. The book is well laid out and, in spite of contributions from 13 different authors, all experts in their scientific fields, the book has not become fragmented. A wealth of
109
information is available and it deserves a place in the libraryof practisingphytotherapists. It is, therefore, a pity that a few weaknesses have occurred, which could have been avoided. For instance, the frostpart of the book is devoted to the contamination of herbalproducts, due to its cultural environment, harvesting and processing techniques, sterilisation, radio-activity, etc. Although valid points, these have nothing to do with the possible side effects of the constituents of the herbs themselves and it is a pity that the herbs are getting bogged down in these issues. These factors am alike for all natural products, whether they are potatoes, carrots, oranges, apples, nuts, meat or milk. In this day and age everything we consume is subjected to the ‘blessings’ of modem techniques and chemicals, and so are herbs. The fact that it is human intervention which may turn totally safe products into potentially hazardous substances should have been pointed out and not attributedto herbs. Another point that struck me was the sometimesrather weak scientific arguments. The chapter about Foeniculum (fennel) seems mom to be promoting the use of fennel than to indicate any adverse reactions. The adversereactionprofilementioning animal data states that the LDsodose for rats is between 3.12 and 4.5 ml/kg of fennel oil, an enormously high dose which rather indicates an absence of toxicity. However, on the whole the book contains much useful information and, for the phytotherapists, the general human data are very valuable. All practitioners of phytotherapyhave come acrossthose rare instancesof adverse reactions against herbs which we think to be totally safe and without side effects, and it is very helpful to have some infonnation availablein these situations. Apart from this, it offers us a considerableamount of information conceming active constituentsand the pharmacology of a number of herbs which am much in use in herbal medicine. Hein H. Zeylstra FNIMH School
Principal of Phytotherapy(Herbal Medicine) Sussex, UK
The Controlled Clinical Trial: An Analysis by Harris L. Coulter Washington:Center for Empirical Research, 1991. 165pp. $12.00 ISBN: 0 916386 04 x 1422145thStreet North West, Washington DC 100016, USA] This is an excellent critique of the controlled clinical trial from a historical perspective. Dr Coulter analyses the clinical trial as a cultural, snuctmal, historical and scientific phenomenon. His conclusions, though occasionally extreme, am certainly devastating for conventional me-