KYUNGHEE UNIVERSITY KOREAN MEDICAL CENTER
> Oriental Medicine > Department
 
  This clinics educational aim is to train medical specialists in acupuncture & moxibustion.  This departmentconsists of a facial disorder clinic, paralysis clinic, spine-joint clinic, arthritis clinic, and bee venom clinic, we stand as a major clinical department taking charge of about 40% of total outpatients. Clinical aspects dealt in the hospital of Oriental Medicine are described below.
 
 
 
Facial Disorder Clinic
  This clinic has been dealing with patients with facial disorders such as facial palsy, hemifacial spasm, blephalospasm, trigeminal neuralgia, idiopathic facial neuralgia, and ptosis.  These disorders come from intensive stress, fatigue, decrease in immunity, etc. Using DITI and brain MRI, differentiation and diagnosis of central type facial nerve palsy and mass lesion is achieved.  With guidelines for everyday life accompanied by an explanation for prognosis, acupuncture & moxibustion therapy, dermal needle therapy, taping therapy, aroma therapy and medication therapy are also widely used.
 
 
Peripheral facial nerve palsy
  Peripheral facial nerve palsy results from palsy of facial nerve in which the palsied side of the face is distorted and contracted so that it will not move voluntarily.  If it becomes severe, the eye on the palsied side will not close, and when eating, food might be spilled.  Other symptoms include loss of taste on the palsied side, inability toshed tears or saliva, and being hypersensitive to sound.
   
  Causing factors
 Most of the time, facial nerve palsy is accompanied by  various causing factors such as, coldness, viral infection, trauma, brain tumor, CVA(cerebrovascular attack), MS (multiple sclerosis), etc.  But it may also occur abruptly in a person just as a facial palsy.  This kind of case, called "Bell's palsy" is assumed to be induced by  viral infection.
   
  Differential diagnosis
 Differential diagnosis has to be undertaken very carefully since symptoms might be of oncological diseases such as acoustic neuroblastoma.  Differentiation of the central- type facial palsy from the peripheral-type facial palsy also has to be judged with caution: the central type palsy may be one of the symptoms coming from CVA, where it has to be treated upon taking caring of CVA at the same time, which demands a totally different approach from the peripheral type palsy.  In peripheral type, Ramsay-Hunt Syndrome calls for different prognosis and treatment which needs special inspection as well.
   
  Examination
 Brain MRI is widely used for the differentiation of the central-type facial palsy and for tumors.  Temporal MRI is recommended for Bell's palsy to check for contrast-enhancing of the facial nerve.  Also widely used is DITI and after 2 weeks of the attack of a disease, the degree of damage on the facial nerve should be checked by EMG and another EMG in 2 to 3 months.
   
  Treatments
 The perpetual goal of treatments are to leave no sequela and at the same time to make clear any possible sequelae to the patients.  In Oriental medicine, it is a disease called "Goo-an-wa-sa(Ϣ?), or "Wa-sa-poong(?), known to be caused by external causes like Wind()Coldness()Heat() and internal causes like Deficiency of Qi(Ѩ) or Blood().  Therefore, when it is acute, deficiency in the Meridians(թ) and symptoms caused by Wind() should be treated with methods that disperse the Wind and smooth Meridian passages(ߤթ) while treatments for benign cases should be concentrated on methods of activating the Qi and invigorating the Blood(Ѩ), or removing the Wind and easing the Meridian passages(թ).  Widely used meridians are the ones passing through the facial part such as TE17, GB14, ST2, ST6, and LI20.  Aroma therapies and other new methods are being introduced these days.  Prescriptions are those that control the Qi such as Kamisoyosan(ʥګѨߤ: HH149), Kamiseungkitang(ʥګ: HH267), and Kamikwakhyangjungkisan(ʥګΫѨߤ: HK040). Prescriptions like Paedoksan(Ըߤ: HH031) and Kamiboiktang(ʥګ: HK008) may be prescribed according to the recovering conditions of the patient.
   
 
Hemifacial spasm and blephalospasm
  Clinical development
Hemifacial spasms, including blephalospasms are known to be caused by hypersensitive reflection of the facial nerve itself, which can be divided into two types: secondary which occurs after Bell's palsy, and idiopathic.  It is insidious for persons in their forties and fifties, and more occurrences are observed in women than in men.
   
  Diagnosis
Temporal MRI is processed to rule out mass lesions or arterial malformation of the brainstem, from where the 7th cranial nerve originates.  Most of the cases are from blood vessels of brainstems like the AICA(anterior inferior cerebellar artery) compressing the 7th cranial nerve which induces hypersensitivity.  Findings from MRI with considerations of clinical symptoms, microvasular decompression may be recommended after co-diagnosis with Western Medicine.
   
  Treatments
Common causes can be categorized into Wind-Heat(), deficiency of Qi and Blood(Ѩ), or stagnation of damp phlegm().  Treatments with acupuncture and moxibustion are likely to include acupoints such as BL2, ST1, ST2, Taiyamg(Ex-HN), GB20, ST4, ST6, ST36, BL60, BL64, and TE23.  For the recovery of general condition, treatments are to follow facial nerve palsy and the causes should be treatedas more important than the symptoms.
   
 
Facial pain
  Diseases that might cause facial pain include pains from dental diseases, defects of temporomandibular joints, and trigeminal neuralgia.
   
  Trigeminal neuralgia

- Clinical development
Superficial senses of the face are mainly controlled by the 5th cranial nerve, the trigeminal nerve.  Not all facial pain is from trigeminal neuralgia since the sympathetic nervous system and other nerves are also related, although trigemial neuralgia ranks first.  Pains that come from trigeminal neuralgia are severe, sharp, stabbing, and paroxysmal, which spasmodically lasts for a short period of time.  It is likely to be induced by little stimulations such as being out in the wind, chewing food, washing the face with water, or brushing the teeth.

- Causes and treatments
Causing factors have not yet been clearly recognized, but it tends to occur more in women over the age of 50.  As it has been proven recently, trigeminal neuralgia is also mostly from arterial malformation of originating division from the trigeminal nerve close to the brain stem.  MRI is recommended for clear identification.

- Differentiation and diagnosis
 Diseases that cause facial pain such as dental diseases and TMD(temporomandibular joint disorder) should generally be differentiated.

- Treatments
Acupuncture and moxibustion treatments with medication treatments are given as conservative therapy.  Migraine and orofacial pain are induced by Wind and Coldness(), Phlegm-Fire(), and burning of the Yangmyung Stomach(٥) and are treated by methods of dispersion of Wind and cooling the heat(ߤ), and invigorating Blood and smoothing the passage of Meridians(թ) on acupoints like LI4, ST44, KI1, GB14, Eoyo(Ex-HN), LI4, ST6, LR3, ST36, BL12, and GB20.  The buccal point, maxilarry point, mandibular point, Shenmen point, and occipital point are widely treated acupoints when auricular acupuncture is used.
   
  Temporomandibular disorder

- Clinical phases and causing factors
 TMD is likely to accompany pain in the mandibular joint, crepitant, or difficulty in opening and closing the mouth.  It had been treated in dental clinics since it has been considered as a disorder of the joints around the teeth. But, many cases of temporomandibular pains show that continued hypernervousness of muscles that take part in the movements of temporomandibular joints affects the functions of joints.

- Treatments
Acupuncture and moxibustion treatments, physical treatments, medication treatments, and stabilizing splintare given with counseling for managing everyday activity and stresses.  Since TMD is within the range of migraine and orofacial pain, and that the LI, ST, SI, TB, GB acupoints pass through the temporomandibular joints and facial part, treatments should be given by distal/proximal acupuncture from the according acupoints.

Acupoints for treatment may differ according to patients, but trigger points of masseater muscles should be under special caution when acupoints are being chosen.  LI4 and ST36 are usually acupunctured on both sides, while ST7, TE17, Taiyang(Ex-HN), and ST6 are acupunctured on the affected side.
 
 
SpineJoint Clinic
  This clinic specializes in pains of the neck, low back, limbs, hands and feet which come from problems in bones, muscles, and ligaments of the neck, back, low back, and various joints.

Herniation of cervical?lumbar disc, cervical?lumbar spondylosis, ankylosing spondylitis, spinal stenosis, osteoporosis, frozen shoulder, and sprains are commonly treated diseases in the specialized clinic.  Myalgia, MPS(myofascial pain syndrome), and carpal tunnel syndrome are also effectively treated in this clinic.  Systemic diagnosis is processed, followed by co-diagnosisboth in Oriental and Western medical clinics, which is then treated with acupuncture, moxibustion, cupping therapy, taping therapy, and medication therapy for the smooth cycle of Qi and Blood within the musculoskeletal system.  This, in turn, helps the recovery of muscles, tendons, and ligaments, and at the same time, reduces pain and increases the range of movements by strengthening muscular power and attenuating the stress on muscles.  Described is how neck pain, shoulder pain, and low back pain are treated clinically.
 
 
Neck pain
  Peripheral facial nerve palsy results from palsy of facial nerve in which the palsied side of the face is distorted and contracted so that it will not move voluntarily.  If it becomes severe, the eye on the palsied side will not close, and when eating, food might be spilled.  Other symptoms include loss of taste on the palsied side, inability toshed tears or saliva, and being hypersensitive to sound.
   
  Causes and differential diagnosis
 Herniation of cervical disc, spinal stenosis, traumatic cervical spondylosis, RSD(reflex sympathetic dystrophy), MPS(myofascial pain syndrome), tumor in the cervical region, OPLL(ossification of posterior longitudinal ligament), torticolis, TOS(thoracic outlet syndrome), and cervical instability are widely known causes of neck pain.  If the patient complains of numb hands, symptoms may be from problems in the shoulder or carpal tunnel, but not the neck although symptoms may appear similar.

 CT(computer tomography) and MRI(magnetic resonance imaging) are commonly used for diagnosis and the results are speculated through DITI(digital infrared thermal imaging system).
   
  Treatments
Acute cases are treated by acupuncture and moxibustion to attenuate the stiffness of the neck and compression of the nerve muscles. Based on theory SI3, BL62, TE3, GB34, PC7, and CV24 are commonly used acupoints.  LU7, and LI4 may be added if the neck shows stiffness. TE3, and BL40 may be added for those who have a stiff spine.
   
 
Shoulder Pain
  Shoulder pain includes the pain around the shoulder joints as well as in circumferential muscles and upper limbs from the shoulders to the wrists.  The number of patients complaining for shoulder pain is increasing these days from increase in office lifestyles and uses of computers. 
   
  Causing factors
 Major causes are adhesive capsulitis, TOS(thoracic outlet syndrome), tendinitis of supraspinatus, subacromial bursitis, biceps tendinitis, and levator scapulae bursitis.
   
  Differentiations of symptoms Patients with acute cases within a period of 2 weeks have a history of damage such as dislocation, fracture or rupture of the rotator cuff. In these cases, the common symptoms are deformity or swelling.

Patients with chronic cases of more than 2 weeks should especially be examined with their ages and symptoms taken into consideration.

Pain coming from the rotator cuff induces pain at night, which prevents the patients from sleeping on the painful side. If the pain is limited only to the top of the shoulder, dislocation of joint is suspected. Pain from bursitis or rupture of the rotator should radiate from the deltoid part to the outer portion of the brachium.  Sometimes, patients with rotator cuff complain for numbness on forearms and hands, for which the symptoms may be misdiagnosed as carpal tunnel syndrome.  Pains coming from rotator cuff are more severe when the patient stretches his or her arms up to the sky, and also when the patient is trying to throw something.  However, shoulder pain from stimulation on the cervical nerve root is lessened when the forearms and hands are placed on the head.
   
  Treatments
 In Oriental medicine, shoulder pains are closely related to the Heart, Lung, Spleen and Stomach. It is said to be caused by the deficiency of Qi and Blood, which enables Wind, Cold, and Dampness to penetrate into the body easily.  phlegm-Dampness() comes from Yang-deficiency of the Spleen and Kidney(ޡ), which causes the watery phlegm() to be stagnated and cause the transportation of Qi and Blood to slow down.  Stagnated Blood is caused by contusions.

Moxibustion is more widely used for those who have suffered for a long period of time with symptoms of numbness, heaviness and soreness whereas acupuncture is preferred for acute cases with severe pain.  If the ill portion is swollen without fever, moxibustion is recommended, but if the ill portion with both swelling, fever, and pain, acupuncture is more effective.  Commonly used acupoints for treatments include LI15, LI4, LI16, TE5, TE3, TE10, and TE14.

Prescriptions may differ according to the causing factors and below are lists of frequently prescribed herbal medicine.

 Sodamjeseoptang(: HM363)
 Banhagumchultang(: HK070)
 Gumchuldodamtang(Գ: HH058)
 Seokyungtang(: HH148)
 Keopoongseokyungtang(: HK032)
 Kamikalguntang(ʥګ: HM372).
   
 
Low Back Pain
  Diagnosis
CT (computed tomography) and MRI (magnetic resonance imaging) are commonly used, and the clinical results from these are examined through DITI (digital infrared thermal imaging system).
   
  Treatments
Acupuncture and moxibustion are applied to the ill portion of the low back and acupoints related to the low back to make smooth the cycle of Qi and Blood.  classical acupuncture is usually given, and Sa-am acupuncture therapy, and Constitution acupuncture therapy are also in use.

For treatments with aqua-acupuncture, acupoints are chosen according to the nervous level of the sciatica, and acupoints of BL23, BL24, BL25, BL26 are treated on both sides.

Of eight acupoints on the sacrum(bilateral B31, B32, B33, and B34), GB30, BL40, BL57, BL60 are acupunctured on the affected side. If it appears as BL Meridian Type, BL36, BL37, B56 or tonification of the Urinary Bladder Meridian are also acupunctured on the ill side.  If it is GB Meridian Type, GB31, GB34, GB39, or tonification of the Gall Bladder Meridian are acupunctured.  In Central Type, BL36, BL37, GB31, GB34 are acupunctured on the affected side while Mixed Type is used on the affected side on BL36, BL56, GB31, GB34, and GB39.

Electro-acupuncture and bee-venom acupuncture are also used, and negative therapy and Chuna therapy are used with physically treating machines of Western Medicine. Medications are dependent upon the causing factors, symptoms and the Constitutions of each patients, and may vary based on Pattern Identification.
   
  Clinical practice for low back pain

- Wind-Dampness Type
The back is heavy and in pain and it may also characteristically be a cramp all the way through the legs. If it is rainy or cloudy, the pain becomes more severe and may be attenuated by warming it or doing some activities. The patients' tongue coating is thin and white and the pulse is weak which is felt as gentle. Treatments should be based on elimination of Wind with dispersion of Cold and Smoothing Dampness with penetrating the numbness. Commonly used prescriptions are  Ohjucksan(ߤ: HK159), Dokhualkisaengtangkagam(Լʥ: HM381), and Ohyaksoonkisankagam(Ѩߤʥ: HK157).

Ohjucksan(ߤ: HK159) is a prescription widely used for low back pain with Palmihwan(ګ: HK161), Dokhualkisaengtang(Լ: HM381), and Boeuntang(: HM380).

Prescriptions for removin stagnated Blood() may be added according to the patients' condition. Powder for five kinds of accumulation in the abdomen is especially added with Yeoshintang(:, , : HM378) in cases of sprains.  For pain in the lower limbs, powder of semen arecae and folium perillae is added. Sopoongboshimdodamtang(: HM304), which is used in outpatient clinics of Kyunghee University Medical Center, may be applied to patients of Wind-Dampness Type.

 Taking the lateral position lightens the burden of the patient when treating with acupuncture and moxibustion. Commonly used acupoints are BL23, BL24, BL26, and BL25 which should be inserted on both sides, and BL32, GB31, GB40, GB57, and G B60 for parts of the lower limbs with sciatica.

- Cold-Dampness Type
 Pains include freezing pain in the low back with heaviness and stickiness, which gets severe in rainy or cold/freezing weather.  When it happens to be under Heat, the pain lessens and the painful part is relatively fixed with feelings of sinking and heaviness.

 The patients' tongue coating is either white or sticky, and the pulse is felt as sunken and slow. Treatments should be based on elimination of Cold with moving of phlegm-Dampness() warming and opening the passages for Meridians. Widely prescribed medicines are Samseuptang(?) with additions, and  Younggaechoolgamtang(ֽ: HK153). KHU Oriental Medical Hospital widely uses medications like Sopoongboshimdodamtang(: HM304), and GV4, GB3, and GB34 are acupoints commonly treated in addition to moxibustion therapy.

- Dampness-Heat Type
 Pains characteristically accompany fever on the painful part, and feelings of heaviness also come with the pain as if sitting in water. Physical activities may lessen pain, and if exposed to too much dampness, the pain will worsen.  Symptoms such as scanty dark urine, thirst, fever with dysphoria and spontaneous sweating may occur. Tongue coating is yellow and greasy, and the pulse is slippery and frequent. Treatments should be based on clearing Heat with transforming Dampness and easing the branches of the Meridians. Chilmichangbaekhwan(ګߤ) and Sammyohwan(߲) are fundamental prescriptions, and Yongdamsagantang(ף)may also be prescribed for its' cold nature with an effect of clearing Heat and detoxifying. ST36 and GB34 are commonly treated with acupuncture and moxibustion.

- Blood Stagnation Type
The affected part has stabbing pain which is felt to be fixed in one place and the pain gets worse when pressed.  The pain tends to lessen during the day, but worsen during the night.  Bodily symptoms include solid and blackish bowels, blackish tongue coating, and a choppy pulse.  Treatments are basically ones that promote blood flow to remove blood stasis, and govern Qito stop pain.  Common prescriptions include Kamihwalheoltang(ʥګ: HH141), Dangguibinsan(ߤ) and Yeoshintang(: HM378). Therapy for removal of stagnated blood can be applied to the ill part of the body. Acupoints like GV26, GV1, and SI3 may also be used in addition.

- Kidney-Deficiency Type
 Low back is prone to muscular atrophy and becomes feeble, and the pain in the region may not be strong but steady. It may get worse with overworking and improve by taking bed rest, or getting massages. Bodily symptoms include dizziness, tinnitus, nocturnal emission, and an increase in the amount of leukorrhea. If there is a deficiency of Kidney-Yang, symptoms such as clear urine, loss of thirst, a pale tongue, and a sunken and slow pulse is likely to accompany. In cases where  Kidney-Eum is deficient, dryness of the mouth and throat, flushing sensation over the palms and soles, restlessness, insomnia, a reddened tongue with little coating, and tiny and frequent pulse occurs. For deficiency of Kidney-Yang, Kidney-Yang should be warmed and supplemented and the low back should be supported with strength.  Prescriptions should be made for the vital gate such as Palmihwan(ګ: HK161).  For deficiency of Kidney-Eum, Eum(vital essence) should be replenished with the clearance of Heat, and the Blood should be nourished. A commonly used prescription is Yookmijihwangtang(ګ: HM306). For acupuncture therapy, GV4, BL52, and KI3 may be additionally treated according to the conditions of the patient. Moxibustion may be applied on BL23 and GV4 for times.
 
 
Arthritis Clinic
  Numbness() refers to conditions caused from the muscles or Meridians receiving pathogens either externally or internally, the symptoms of which include pain, numbness, dyskinesia, and edema on joints or the whole body. Corresponding diseases in Western Medicine include rheumatic arthritis, osteoarthritis, and ankylosing spondylosis.

  Rheumatic arthritis is different from other arthritic diseases in that the pain is not limited to certain joints but migrates through out all limbs. It is an autoimmune disease in which swollen joints hurt and joint destruction occur with pain, which then induces joint deformity.   Osteoarthritis, occurring usually on the knee joints of over middle-aged people, is a disease where joint cartilage wears out to cause local degenerative changes. 

  The arthritis clinic provides both oriental medical and western medical methods for accurate speculations. X-ray, bone scan, BDM (bone density meter) and MRI (magnetic resonance imaging) for western medical examinations, and DITI(digital infrared thermal imaging system) followed by medication,aqua-acupuncture, bee- venom acupuncture, and physical therapy for Oriental medical examinations.

  In Oriental Medicine, it responds to Yeokjeolpoong()", "Seolanpoong()", and "Chuckkang(˭)", and is categorized into Wind, Cold, Heat, and Dampness for treatment. It can also be categorized into skin impediment, pulse impediment, muscle impediment, tendon impediment, and bone impediment according to where the illness started.

  Commonly used prescriptions are,  Daejinkitang(Ѩ), Gaejijakyakjimotang(ٽ), Samyosan(ߤ), and Tongpoongbang(۰). Waisulan(), Naisulan(Ү), and acupoints of ST34, SP10, ST36, GB34, GB39, LR3, LI4, LI11, LI10, KI3, and BL60 are widely used for treatment.  Bee-venom acupuncture may be applied for treating joints.

  Common prescriptions for pain of the shoulder and arm are Kamiseokyungtang(ʥګ: HM360), Huisoosan(ߤ: HH147), and Kumchooldodamtang(: HH058). Kamidaekanghualtang(ʥګ˶: HH143) and Kamisamkieum(ʥګ߲Ѩ: HM358) are prescribed for rheumatic diseases, and Kamisopoonghualheoltang(ʥګ: HH144) and Kamiyoungsunkeotongeum(ʥګ: HH145) are prescribed for acute arthritis and polyarthritis. Patients should receive treatments for several months, and follow-up treatments may also be continued.
 
 
Rheumatoid Arthritis
  Definitions  
 Chronic and systemic inflammatory disease, where noninfectious chronic inflammatory responses occur in joints or synovial membrane for a long period of time. Synovial membranes may swell over and may also accompany destructions of structures around cartilage, which then induce swollen joints and pains.
   
  Causing factors
 Causing factors have not been clearly determined. Immunological problems are the most persuasive cause so far, but direct the factor that act as a stimulant for immunological response has not been proven. Possibility of infectious triggers is being researched.
   
  Treatment
 The primary goals for treatments are complete relief of symptoms, control of immunological and inflammatory processes of diseases, and avoidance of complications of diseases. Secondary goals are preservation of the functions of joints, and recovery to engage in normal everyday life activities. 
   
  Bee-venom therapy
 Bee venom is used for managing rheumatoid arthritis. It is one of the newly-introduced herbal-acupuncture therapies, which combines the effects of normal acupuncture and the medical effects of the unique biochemical substance of bee-venom. Bee venom from honeybees are extracted and processed to be used in acupuncture therapy on related acupoints. A little amount gives off strong within a short period of time, and lasts a long time. It is considered a relatively safe therapy with no severe side-effects like other hormone medications. Enzymes, peptide components, and non-peptide components are three big components that comprise about 40 primary components that make up bee-venom. The effects of bee-venom acupuncture reaches through the whole body.

- Clinical use of bee -venom acupuncture
  Disorders where bee-venom acupuncture may be clinically applied include rheumatoid arthritis, acute/chronic arthritis including osteoarthritis, herniation of lumbar disc, pains from MPS, frozen shoulder, sequelae from sprains, lateral epicondylitis, facet joint syndrome, and others that are difficult to be treated with medication therapy only.

- Applying methods
 It should be applied only after an allergy test is administered, and the response should be examined for about 3 points with 0.3 cc (dilution ratio of 3000:1) for each try. After the third try, application may be normally given. subcutaneous injectionis recommended.

- Side effects
 The most common abnormal response to bee-venom acupuncture is a rash. Face, two hands, and feet will swell over and redden with itching. When the bee-venom liquid spreads into the body, an antibody forms within the body, which fights against the antigen (the bee-venom liquid). Abnormal responses lessen as the body adapts to the bee-venom.  This is why people who had been treated with bee venom acupuncture 34 times complain the most as side-effects. 

- Addiction to bee-venom
 This occurs when an excessive amount of bee-venom, has been put into the body. Skins all over the body swells and it may also cause difficulty in breathing, vomiting, chills, and shock.
   
 
Osteoarthritis
  It is also called degenerative arthritis or degenerative joint disease. It is a noninfectious disease of the joint, which frequently occurs in middle-aged and elderly people. Structural breakdown of cartilage and osteophytes on joints occur characteristically on cartilages like knee joints. 
   
  Causing Factors
 Various factors combine to cause osteoarthritis.  It is caused either as idiopathic or secondary.  Causing factors for secondary cases are previous trauma, infection, crystal deposition, previous rheumatoid arthritis, metabolic causes, underlying orthopedic disorders, or disorders of the bones.
   
  Treatments
 Whole body treatments(adequate amount of rest, joint movement, weight monitoring) is accompanied by medication therapy.
 
 
Facial clinic
  This clinic mainly deals with patients who has persistent facial palsy for a long period of time (longer than six months) and also esthetic problems such as wrinkles(crows-feet wrinkles, forehead wrinkles, nasolabial folds), dark circles under the eyes, ptosis, asymmetry of the face, etc.

  The arthritis clinic provides both oriental medical and western medical methods for accurate speculations. X-ray, bone scan, BDM (bone density meter) and MRI (magnetic resonance imaging) for western medical examinations, and DITI(digital infrared thermal imaging system) followed by medication,aqua-acupuncture, bee- venom acupuncture, and physical therapy for Oriental medical examinations.

  In Oriental Medicine, it responds to Yeokjeolpoong()", "Seolanpoong()", and "Chuckkang(˭)", and is categorized into Wind, Cold, Heat, and Dampness for treatment. It can also be categorized into skin impediment, pulse impediment, muscle impediment, tendon impediment, and bone impediment according to where the illness started.

  Commonly used prescriptions are,  Daejinkitang(Ѩ), Gaejijakyakjimotang(ٽ), Samyosan(ߤ), and Tongpoongbang(۰). Waisulan(), Naisulan(Ү), and acupoints of ST34, SP10, ST36, GB34, GB39, LR3, LI4, LI11, LI10, KI3, and BL60 are widely used for treatment.  Bee-venom acupuncture may be applied for treating joints.

  Common prescriptions for pain of the shoulder and arm are Kamiseokyungtang(ʥګ: HM360), Huisoosan(ߤ: HH147), and Kumchooldodamtang(: HH058). Kamidaekanghualtang(ʥګ˶: HH143) and Kamisamkieum(ʥګ߲Ѩ: HM358) are prescribed for rheumatic diseases, and Kamisopoonghualheoltang(ʥګ: HH144) and Kamiyoungsunkeotongeum(ʥګ: HH145) are prescribed for acute arthritis and polyarthritis. Patients should receive treatments for several months, and follow-up treatments may also be continued.
 
 
Persistent facial palsy
  Causing factors
Patients with persistent facial palsy not only have external awkwardness but difficulty in everyday life as well. The cause may be from great damage on the facial nerve in the beginning, inadequate treatment, recurrence of facial palsy, unstable blood pressure or glucose level, continued stress, etc.
   
  Treatments
The main aim is to restore the muscles normal function of the muscles. The muscles on the head and neck region are stimulated with specially designed acupuncture needles(much thinner and shorter than the ones used for limbs). Acupuncture needle function to control the volume of each muscle. Muscles like the temporalis and the SCM are administered first for overall management of the face. The palsied side is treated for a longer period of time with more acupuncture needles than the healthy side.

One session takes about an hour and two sessions are recommended for a week. The total amount of sessions needed differs according to the patients' age and how severe the facial palsy is.
   
 
Esthetic facial acupuncture
  Background
As we age, the facial tone looks darker and the muscles tend to move downward due to gravity. As the facial muscles lose strength, the folds they make appear as wrinkles on the skin covering those muscles. This is why facial muscles should be treated for esthetic purposes.
   
  Treatment
Since every person looks different the esthetic facial acupuncture should differ in every

cases. When a patient comes in, the doctor examines through the face for

asymmetry, tone, strong and weak points, etc. indeed to figure out what muscles

should be managed and how.

Treatment is given with facial acupuncture needles since minor bleeding may lead to bruising, vitamin K cream is used especially around the eyes. The effect of the treatment lasts longer than a botox treatment and has no side effects.

Herbal medicine in addition to acupuncture treatment may enhance the overall condition of the body and help the flow of Qi through the face region as well. Moxibustion treatment is included for correction of facial tone.
 
 
 
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