Use of Cams in Pediatrics

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TCM:

Reading

Accupuncture: who uses it?, why? A menopausal women seeking an alternative to hormone replacement therapy, an asthmatic child reacting poorly to prescribed drugs.

-Find alternative to a practice that failed or complement an existing one.

Huang Di Nei Jing Su (Yellow Emperor’s Classic of Internal Medicine: TCM basis codified in 2nd century BC Han Dynasty. Focus on prevention rather than treatment after onset Acupuncture became mainstream in USA after China- America relations normalized in 1971.

Confucianism: Respect, Ritual and Custom, Honor, Learning, ‘Ren’ compassion and humane action, filial piet, moderation

Taoist practices- Alchemy, physical and sexual practices, body and spirit , recitation, talismans

Tui Na: Acupuncture, herbs, food, massage Tai Chi: exercise

Diagnosis identifies imbalance in Ying and Yang, treatment seeks to restore harmony.

Person embodies fusion of Shen (psyche,mind) and Essence (soma); Landscape made up of: Qi- life force, Moisture, Blood, Jing (semen)

Types of Qi: inherited, nutritive, respiratory and defence

Qi travels through Jing Luo channels or meridians

Five Primal powers (Wu-xing):

Supplementing Moisture will relieve Dryness, just as e l i m i n ating Moisture will c o u n t e ract Dampness. The principle of complementarity applies: for Cold, warm; for Heat, cool; for congested Qi, Moisture, or Blood, enc o u rage movement; for depletion, nourish; for internal Wind, subdue; for external Wind, relieve surf a c e congestion; and for Phlegm, dissolve.

Pulse diagnosis involves palpation along the radial artery at six positions and two depths. Rapid pulse-Hyperactivity, heat and Yang; Low pulse: hypoactivity, cold, or yin

Tongue inspection (size,shape, texture and qua;ity of fur): Pal tongue with white fur indicates presence of Cold. Red tongue with yellow fur indicates Heat. Flabby or thin tongue indicates deficiency of Qi or Blood. Tense or swollen tongue suggests congestion of these constituents. Quivering or rigid tongue indicates the presence of Wind.

Liver-blood,tendons, nerves, Qi and blood circulation, temperament and judgement. damaged by anger and frustration

Heart- arteries, perception, propulsion and perfusion of blood, joy. Damaged by overstimulation

Spleen-Moisture, flesh, muscles, assimilation of nutrients, thinking and remembering. Damaged by worry and inertia

Lungs- Qi, skin, body hair, rhythm and tempo of breath and circulation, suboncious drives. Damaged by excessive grief and longing.

Kidneys: Jing, bones, marrow, brain and instincts. Damages by overwork and pessimism.

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Homeopathy:

Samuel Hahnemann- recognized similarity between quinine poisoning and symptoms of malaria, the disease it was meant to cure.

Tenets of Homeopathy: -Remedies are selected according to the ‘law of similar’(that which ills a man, also cures him), only one remedy given at a time, holistic approach (mental, emotional, physical), only enough medicine to stimulate healing.

2 people with similar clinical diagnosis may need different remedies, dilutions are stronger-potenization,

Hallucinogens and Psychedelics:

Spirituality-Way of life-including perspectives, values, habits and goals oriented around transcendent concerns. (eg: submission to Allah)

Psychedelics given bad rep due to hippy culture, subsequently called : Deliriant, Entheogen, Imaginant, Oneirogen, Phanarothyme, Psychotomimetic

Sub-grouping:

Indoles: LSD- d-lysergic acid, DMT- dimethyltryptamine, psilocybin, ibogaine, harmaline

Phenethylamines: Mescaline, 2-CB, DOM, MDA, MDMA

Dissociative Anesthetics- ketamine, PCP

Others: Nitrous oxide, salvia divinorum, THC

Classical vs non-classical (habit forming): LSD, mescaline DMT and psilocybin are classical entheogens.

Psychoactive mechanisms (neurobiological activity): classical compounds all activate serotonin receptor (agonist)(5HT2A). MDMA-NMDA(N-methyl-D-asparate) receptor antagonism, Salvia-kappa receptor agonism, serotonin release, Ketamine-glutamatergic modulation, cannabinoid receptor activation,

NOT associated with dopamine release from reward pathways

Read Complete Effects’ Adverse effects include: dysphoria, anxiety, loss of behavioral control. rarely-psychosis or flashbacks in vulnerable individuals.

Ketamine uses: anti-depressant, treatment for opioid, cocaine and alcohol dependence

Caused by: promotion of prefrontal neural plasticity, glutamate homeostasis, modulation of prefrontal activity, attenuation of resting-state connectivity and activity, other psychological mechanisms

Historical Use: Set and setting

Treatment: Negative association, psycholytic therapy, psychedelic therapy, hallucinogen-facilitated therapy, Neurobiological Approaches

Physical Exercise:

Effects on the brain: increased growth factors resulting in neurogenesis, metabolism, vascular function and neurodegeneration, alleviation of depressed mood

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Hippocampus: Dentate gyrus, location of neurogenesis. Important for pattern separation (distinguishing faces, streets, etc). Basis for memory, new cells become neurons. Depression sign of smaller hippocampus.

BDNF (Brain derived neurotrophic factor): exercise (or antidepressants) promotes synthesis, member

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