When Antiobiotics No Longer Work

Today’s New York Times has an interesting article about how western medicine is turning to ancient remedies to counter the looming “superbug” crisis.



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Post Cupping Care


Michael Phelps displays cupping marks at the 2016 Rio Olympics

The Post Cupping Prime Directive:

Keep the area warm, covered and dry. Avoid showering until the next day. Do NOT apply ICE!!

In all the recent media flurry over cupping, instigated by cupping marks on Olympian Michael Phelps, I’ve seen no instructions on what to do – and what not to do – after cupping. This is unfortunate, because if you’re not careful, you can undo the benefits of cupping (and its companion scraping modality gua sha) and even end up feeling worse than you did before.

Those marks left after cupping and gua sha are actual bruises, the result of broken capillaries in the tissues under the skin. In Chinese medical terminology, these marks represent the release of some combination of heat, wind and dampness. Indeed, after cupping or gua sha the skin feels very hot, both to the touch, and as a subjective sensation by the patient. Sometimes so much dampness is pulled out that the cups actually steam up inside while they’re attached.

In Western treatments, the response is often to treat a symptom with its opposite. For example, if an area of the body is hot, the treatment is to cool it down, often to the extreme, with ice. However, with cupping and gua sha, this is absolutely the wrong thing to do.

Those cupping bruises allow a release of pathologies, but once the area is opened up, Chinese medical theory asserts that the energy can also go the other direction. Cold and dampness can be drawn into the area, causing a relapse and even worsening of the condition, and possibly leading to chronic problems.

I’ve seen this in my own practice. Last year I treated a woman in her seventies suffering from sciatica. I determined that she had a wind/damp obstruction and that she could benefit from acupuncture as well as one cup over a point on her hip (Gall Bladder 30 – “Jumping Round”).  Initially, after the treatment she felt much better. She had a dark, round cupping mark that felt warm to the touch. As I always do, I told her that she must let that heat release and do nothing to allow cold or dampness to be drawn into that point. These are important instructions that I always repeat.

However, when she got home and showed her family her cup mark, they freaked out. They overruled my instructions and applied ice to her cup mark throughout the evening. While of course they meant well, this was just about the worst thing they could have done. The next morning she woke up with sharp pain, her sciatica far worse than before her initial treatment. It was a difficult situation, as her family blamed my treatment rather than their response. Thankfully she did return, with one of her family members, and we were able to get everyone on the same page. For me it was a learning experience; oral instructions are not enough because proper post-cupping care can be counter-intuitive.

Yes, Michael Phelps and his colleagues jump right into the pool after cupping. It’s probably not the best thing, but these are world-class athletes with efficient metabolisms that recover quickly. They also constantly insult their bodies for the sake of performance. For the rest of us mere mortals, we need to be safe and careful.  These techniques can be very effective as long as we take all proper precautions and don’t short-circuit the process.

Happy cupping!



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Cupping Precautions


The attention to cupping marks on Olympic swimmers has produced a recent flurry of press reports and a surge of interest in cupping. While I’m happy that more people are being introduced to this technique, I’m concerned that it’s being seen as more of a spa-type treatment than as serious therapy used in conjunction with Chinese medicine.None of the articles I’ve read addresses the contraindications for cupping, nor do they note that in the wrong hands and/or on the wrong people, cupping can be harmful and can make conditions worse. Also, specific protocols must be followed after cupping (or its companion scraping technique, gua sha) in order to avoid potentially harmful side effects. I’ll write about these post-cupping protocols in my next post.

Here are the main contraindications to cupping:

  • Pregnancy. One article I read said to “use caution” when cupping someone who’s pregnant. I go beyond that. I would never cup a pregnant woman, unless I was trying to induce labor. Cupping strongly moves blood. Cupping the sacrum is a great way to get a delayed menstrual period to begin, but it can also induce a miscarriage. If you are pregnant, do not allow anyone to cup you!
  • Fatigue/Exhaustion. Cupping is taxing. It will make you more tired and deplete your resources.
  • Blood Deficiency/Anemia. Actually, I sometimes do use gentle gua sha or cupping for blood deficiency. The Chinese Medical protocol is called “move blood to build blood.” But I know what I’m doing and I know when enough is enough. The cupping person at your spa does not (unless he/she is also an acupuncturist). Some signs of blood deficiency are light-headedness or postural dizziness (as you rise to standing from sitting or lying down), pale complexion, dry eyes and insomnia.
  • Skin Conditions. Cupping should never been done on skin that is sunburned or has any sort of rash. Ditto for sensitive skin or any sort of acne breakout.
  • Post-Surgery. Delicate, surgery-traumatized tissue needs time to heal. Cupping violently breaks apart the tissues. Cupping and gua sha can be very helpful in relieving the congestion after the area has healed (depending on the site), but healing takes time – months not weeks.
  • Nausea/Queasiness. Cupping stirs things up. Sometimes people are a little queasy afterwards, but it usually settles quickly. But don’t do it if you’re feeling queasy beforehand.
  • Too Young or Too Old. I would never cup a child, and I rarely cup seniors. I’ve learned through experience that older people respond better to gentler treatments of all types. If a treatment is too strong, the treatment can backfire, and the pain you were trying to treat can become worse, not better.

Trust your instincts. Cupping is not licensed or regulated.Anyone can legally do it. Many types of therapists are riding the wave of publicity and adding cupping to their offerings. (A cupping set can cost as little as $15.) Some know what they’re doing but many do not. Some truly want to help you and others just want your money. Please stay informed and stay safe!


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An Acupuncturist’s Take on Cupping in the News

Every few years cupping is in the news, generally when a celebrity is photographed displaying cup marks. A few years ago it was Gwyneth Paltrow at the Oscars. This time it’s Olympic swimmer Michael Phelps, parading large cupping marks on his beautifully developed shoulders and back. (Probably also his legs, but I didn’t see those photos.)

In Michael Phelps’ case, suction cups are used as adjunctive therapy to western sports medicine. News reports stress that, although some athletes swear by the technique, the effects of cupping are “unproven” and possibly rely on a “placebo effect.” At the end of the recent NY Times article, it’s mentioned that cupping sets are cheap, and some people just cup themselves.

Cupping has been around for thousands of years. Originating in China, the technique began with the use of clay and bamboo cups, eventually evolving into today’s use of glass and plastic cups. The recent publicity begs clarification of the two distinct and divergent paths that the technique of cupping has taken over the millennia – that of folk medicine vs sophisticated scholarly Chinese medicine.

The current application of cupping of athletes is more suggestive of folk medicine – a broad-stroke approach. Where does it hurt? Let’s slap a cup there. This is very similar to the approach of the NFL’s acupuncturists, who, post-game, insert lots of needles into football players wherever they say it hurts. This is a very unsophisticated form of acupuncture which I would argue works more via a placebo effect (not to be discounted!) than with standard acupuncture energetics.

Thus it is with cupping. Yes, it can certainly relieve pain and pull out knots in muscles. But it can also do so much more.

Cupping and its companion scraping technique, gua sha, are used alone or in combination with many acupuncture protocols. Both techniques strongly move qi and blood, and they are to be used after consideration of many factors and with utmost respect.  Because Western medicine does not recognize their effectiveness, they remain under the radar and unregulated. But they are not benign! They are extremely powerful in the right (or I’m afraid wrong) hands.

I believe Michael Phelps was cupped by an acupuncturist. The cupping mark on his anterior shoulder is dead-on the point Large Intestine 15 – “Shoulder Bone.” This is an important point for freeing all shoulder ailments, and it is also an important point for transforming “dampness.” It is often used in assisting its elementally paired meridian, Lung, in releasing pathologies. I frequently use this point in allergy treatments.

Cupping such an important point indiscriminately can have unintended consequences, especially if the patient is an allergy sufferer or has other lung issues. But presumably Michael Phelps’s practitioner is aware of this and has proceeded accordingly. However, it’s unlikely that the untrained, unlicensed entrepreneur operating one of the many new “cupping clinics” opening up will know this.

My next post will be about contra-indications and potential dangers of cupping. Please stay tuned.


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Cupping Makes the News!

The New York Times published a piece on cupping, thanks to Michael Phelps’s cup marks he’s displaying at the Olympics.

I use cupping in my practice almost every day. My comments will follow shortly!

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Where does the time go?

It’s been a year – yes a YEAR – since I last posted on my blog. How can that be?

Actually I know the reason. Last summer I experienced what I’m now calling “digital collapse.” I was living much of my life online, spending hours a day on my computer. I became so overwhelmed with the constant stream of information – emails, Facebook posts, YouTube, news streams and everything else internet – that it paralyzed me.  I stopped responding, and the emails piled up until my “to respond” list became impossibly long.

I’m back online now, finally answering emails some of which are months old. It’s going to take me a while. But it’s different now. I limit my time on the computer, especially on beautiful days. I take at least one long walk every day. It’s a much better way to live.

The internet is miraculous, but it sucks away your time. And since this moment is all we really have, it can also suck away your life.

That’s enough internet for me today. I’m off to Blue Mountain Reservation for a real life hike! Come join me on the trail.


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Nihao! Greetings from China


(Note: I wrote this on May 24th but was unable to access WordPress. Big Red prevented my “Jumping the Wall” after all. I’m just back and am posting this from home.)

I’m in Changhsa – the capitol of Hunan Province – in the home stretch of my three-week tour. I’m “Jumping the Wall” – as the locals put it – evading the Great Firewall. Otherwise, no Google, Facebook, YouTube, Twitter, New York Times or blogging. What people can see or know is tightly controlled in China. But as a foreign visitor, I won’t get in trouble for Jumping the Wall.

Many assume I’m here studying Chinese medicine. But no. I’m touring with a children’s magic show, experiencing China in a way few foreigners ever could. Our ten-person company includes seven Chinese people in their twenties – all of them good-natured and extremely hard-working. Only one speaks English. All our crew are “China One” – products of China’s one-child policy. China’s traditional family-oriented culture has been completely altered – no siblings, aunts, uncles or cousins. It’s hard for us to even imagine. These young people’s knowledge of the world is limited, and they know it. But they don’t know what they don’t know. They were astonished to learn that Americans adopt Chinese babies. In the ancient city of Chenzhou a huge statue of Quan Yin – the Buddhist goddess of compassion – drew blank stares from our crew when I remarked on it.

China’s complete break with its past – The Cultural Revolution of the 20th Century – included its sophisticated ancient medicine as well. Acupuncture in China was completely restructured in the 1950s and given a new name – TCM – Traditional Chinese Medicine. It was greatly simplified into about 80 patterns of illness and reformulated into a more western approach. Acupuncturists in China are all also western medical doctors – highly-trained and respected, but unfortunately also occasionally somewhat arrogant.

TCM remains the standard acupuncture modality practiced throughout the world. All my licensing exams were TCM-based. TCM is a good modality, effective for a wide range of ailments. But it’s only a tiny remnant of what existed before the Cultural Revolution – before it was stripped of its spiritual, mystical and shamanistic elements. Thankfully the old knowledge survived through a small number of Chinese doctors who escaped – including the grandfather of my teacher, Jeffrey C. Yuen – who now are educating acupuncturists throughout the world who are eager for this information.

The old medicine no longer exists here in China. In fact, it’s illegal to practice Classical Acupuncture here, just as it’s illegal to practice Qigong. I’m sure I could learn a great deal from the Chinese TCM acupuncturists, but instead my practice will be greatly enriched by my immersion in Chinese culture and language. There are still remnants of Old China, glimpsed through the windows of the world’s fastest trains – rice paddies still plowed by water buffalo, gracefully terraced hillside fields, a magnificent white crane swooping down for a landing – counterbalanced by a decaying ancient monastery sharing its mountaintop aerie with a cell phone tower.

China’s medical classics state, “All healing is rooted in Spirit.” China has repudiated its spirituality, yet there’s a great hunger for it here. Buddha statues adorn car dashboards and incense burns at the remaining temples and shrines. A growing number of medical practitioners throughout the world are learning the comprehensive systems of Classical Chinese Medicine. We will lovingly preserve it until China is ready to take it back.

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