TCM Basic Substances: Body Fluids (Jin Ye)

This is the fifth and last post on the series on basic body substances in Traditional Chinese Medicine. The basic substances are Qi, Blood (Xue), Essence (Jing), Spirit (Shen), and Body Fluids (Jin Ye). I will be sharing some ideas about the Body fluids or Jin Ye, what they are, their functions, symptoms of imbalance and tips on how to maintain their health.

 

The TCM basic substances are those which are essential for health and for life itself as life cannot be sustained if one of them is missing. These substances are not only the building blocks of the physical body but also encompass the human dimensions of the mind, emotions and spirit.

Body fluids are more than just water

Body fluids are pure Yin energy: They are the juice that enables every bodily process to occur and every organ to function. These fluids can be thin and light or thick and nourishing and their composition is much more than just water: Depending on the specific functions of the fluid and its location in the body, it may contain different minerals and nutrients. Body fluids moisten and lubricate every tissue, and provide nourishment to all our cells as well as facilitating the flow of substances throughout the body.

Every single organ, sense organ and tissue of the body needs Body fluids to be able to perform their functions. Without fluids, everything becomes dry and brittle and the body crumbles. Besides this, Jing Ye conform everything in the body that has liquid form such as gastric juices, tears, saliva, semen, vaginal fluids, synovial fluid, cerebrospinal fluid and of course the Blood. Just think of any part of the body, it will inevitably need some form of fluid to be healthy or do its job. In addition, Body fluids enable the excretion of waste and toxic products out of the body.

 

FUNCTIONS OF JIN YE

Body fluids are generally separated into Jin – the thinner fluids, and Ye – the thicker and richer fluids. These are two expressions of Yin energy, the difference between them being that Ye fluids are comparatively more Yin and Jin fluids comparatively more Yang. This means that Ye fluids are thicker and more nourishing, work at deeper levels of the body, and if they are insufficient our health will be affected more severely.

The main functions of Body fluids are:

• To moisten and lubricate- These two functions are slightly different from each other. On the one hand, providing moisture prevents dryness and brittleness, on the other hand lubrication is like a coating that prevents friction, provides protection, and facilitates the smooth passage of substances and food. Thus, the skin, muscles, tendons, ligaments and sensory orifices are mostly moistened while the internal organs, hollow tracts, joints, the spine and brain are mostly lubricated. Moistening is mostly done by Jin – the lighter more Yang fluids, while lubricating is done by Ye- the richer more Yin fluids.
• To nourish- Body fluids provide the deep nourishment that organ tissues need to be healthy and perform their functions. This includes the brain and the sense organs. Severe deficiency of Body fluids can result in poor organ function, cognitive impairment, and decline in our ability to see, hear, smell. This doesn’t mean all of these things will happen at once. The affected areas will depend on different factors such as our constitutional make up, our lifestyle, environment, and the level of the deficiency of Body fluids.
• To transport- Body fluids provide the transporting platform for many substances from nutrients, neurochemicals and hormones to waste products.
• To conform the Blood- Body fluids conform the liquid part of the Blood, which could be likened to Plasma.

 

BODY FLUID PRODUCTION

Body fluids depend on a healthy diet

Body fluids originate in the digestive system. A healthy digestive system will break down everything that we eat and drink and convert it into Qi, Blood, and more Body Fluids. Body Fluids are the substances least spoken about but they are actually the most essential. The reason for this is that without plentiful Body fluids the digestive system cannot perform its functions of transforming food and drink into Qi, Blood and Body fluids and transporting these substances throughout the body. Qi and Blood are the resources that we use up every single day when we perform our daily activities. These substances depend to a large extent on a healthy digestive system which in turn depends on plentiful Body fluids – which are also produced by the digestive system.

While the digestive system can continue working relatively well when we are Blood deficient, and can still somewhat function when we are Qi deficient, without enough Body fluids its ability to process food and drink will be impaired. As a result, there will be a decline in Qi, Blood and Body fluid production. This vicious cycle can rapidly spiral down and create systemic dysfunction. 

In relation to Qi and Blood, Body fluids are the most Yin substance. For this reason, Qi deficiency is much easier to treat than Body Fluid deficiency, and the latter implies a more severe level of depletion.

 

BODY FLUID DISHARMONIES

Not having enough body fluids results in dryness and poor organ function anywhere in the body. Just think of what happens when things dry out: eyes become sore and unable to be used without their natural moisture, a dry mouth is unable to facilitate the passage of food down the upper digestive tract, a dry throat is unable to swallow and doesn’t allow us to speak fluidly, a dry stomach can become painful and acidic, dry intestines cannot move the stools, dry joints become painful and stiff.

Everything starts in the Stomach and Spleen. When the Body fluids of the Stomach reach a level of deficiency, the impact of this deficiency can be transferred to different parts of the digestive system- the mouth, oesophagus, intestines. If the deficiency is not corrected and becomes more severe, it can start to impact other internal organs to eventually reach the Kidneys, the Heart and the Brain. The increasing lack of Qi, Blood and Body fluids resulting from a deficient Stomach will eventually manifest at a systemic level with symptoms such as low immunity, low energy, hormonal imbalances, poor organ function or organ failure, and neurological symptoms. Having worked for decades with people with immune and neurological conditions, I have very often seen how the severe systemic issues were rooted in a severe Body fluid deficiency of the digestive system.

As Body fluids conform the liquid part of the Blood, the two substances have a strong influence on each other. Generally speaking, the Blood has to do with nourishing the substance of the body such as the muscles, the heart muscle, the brain mass itself, etc; while Body fluids have more influence on the actual function of the organs and systems. However, because of the close relationship between the two substances, a severely deficient Blood will quickly create Body fluid deficiency and vice-versa.

The table below, shows symptoms that may appear in different parts of the body as a result of Body fluid deficiency based on how Body fluids are regarded in Jing Fang Classical Chinese Medicine. The treatment for all of these will invariably involve a nourishing diet consisting of easy to digest foods (such as soups and stews), plenty of rest and sleep and an adjustment of the level of daily activity to the level of available energy. Beside this, specific herbs to nourish the Stomach and the specific area of the body that is affected can be used:

 

ORGAN	BODY FLUID DEFICIENCY SYMPTOMS
BRAIN	Low cognitive function: Difficulty learning, inability to focus or concentrate. Bleak mood, no motivation. Feeling as if the brain is empty Note: The Blood nourishes the brain mass and has an effect on memory and sleep
SENSORY ORIFICES	Dryness/malfunction: Severe dryness of the eyes, mouth, ears, nose. Loss of smell, taste, hearing, eyesight Note: The Blood nourishes the eyes but not so much the other orifices
LUNG	Dryness and low function: Severe dryness, inability to breathe, shortness of breath, weak voice, dry tight chest, organ failure
HEART	Low function: Irregular heartbeat, weakness, organ failure Note: Blood disharmony will affect the strength of the heartbeat and can cause pain
STOMACH	Low function: Low or no appetite, inability to digest with pain/bloating after eating, poor absorption, organ collapse Dryness: low gastric juice production, tightness in epigastrium, acid reflux/nausea/pain on an empty stomach
INTESTINES	Low function: Forceless stools, multiple stools per day, severe constipation, diarrhoea with indigested food, watery stools, waking at night to pass stools, organ failure  Note: The Blood has some effect on moistening the stools
KIDNEY BLADDER	Low function: Easily getting UTIs from not drinking enough, not able to pass urine due to weakness, need to press abdomen to empty bladder, nocturia several times per night, organ failure
GENITALS	Milder effect on quantity of Blood and Sperm quality.  Blood disharmonies have a strong effect on menstruation, reproduction, and sperm quality and quantity
EXTERIOR	JOINTS: pain worse for movement, dry joints, loss of cartilage LIGAMENTS: shrinking, tightness, hyperextension, weak and easily injured/inflamed  Note: The Blood impacts the muscle mass, muscle strength, and bone density

Excess of Body fluids is often mentioned as a type of disharmony. However, given that the fluids that we refer to as basic substance are only the pure, refined, nutritious type of fluids, I would argue that what is normally seen as excess Body fluids is nothing but Damp. Dampness refers to an accumulation of turbid fluids of varied consistency which are a result of either poor metabolism – i.e. an inability of the digestive system to transform food and drink into usable substances which results in an accumulation of unprocessed matter- or poor diet- the consumption of foods that are considered damp forming such as processed foods, excessive dairy, gluten, refined sugar, etc. Damp is therefore what may result from a digestive system that is deficient in Qi and/or Body fluids. Having an abundance of the healthy Body fluids in our body would translate as more health and vitality rather than constitute a disharmony causing ill health.

 

HOW BODY FLUIDS BECOME DEFICIENT

Body fluids can become deficient when the body doesn't produce enough, we use up more than we have, or when there is excessive leakage. The main sources of deficiency are:

• Not enough Body fluids being created by the digestive system: This can happen for various reasons including:

-        Not consuming enough food and drink for our needs – this can happen because there isn’t enough food available, there is an eating disorder, or our level of activity is very high and our consumption of food and drink is not high enough to cover our needs.

-        Consuming food and drink that are not nutritious, have a high level of toxicity, or are difficult to digest: this includes poor quality food, processed foods, food that is too rich, high in sugar, high on harmful chemicals, excessive dairy and wheat, excessive alcohol consumption.

-        Constitutional weakness in the digestive system. Qi or Yang deficiency of the Spleen/Stomach

• Excessive physical activity:  This means doing more physical activity than our body’s resources can afford to do- i.e. an optimum amount of rest and nutrition cannot restore the internal resources needed for long-term health. An example of this is the activity performed by professional athletes: Studies such as this one from Poland and this one from Harvard University, have shown that their increased expenditure of energy leads to accelerating aging which is a manifestation of Body fluid deficiency.
•  

  

  Over sweating depletes the Body fluids

  Leakage of fluids: When the normal and necessary excretion and secretion of fluids become uncontrolled and large amounts of fluids continuously leave the body, the internal production cannot keep up and the result will be a depletion of internal Body fluids. There are “five leakages” that affect the Body fluids. To these we can add excessive bleeding as this can cause severe Blood depletion which will in turn deplete the Body fluids. The five leakages are:

           Excessive sweating: When we frequently sweat profusely

           Excessive crying: Crying often and profusely

           Excessive urination: Copious urination over 8 x day and 2 x night

           Excessive drooling: Constant drooling, excess salivation

           Excessive runny nose: Constantly losing water through the nose

When there is excessive leakage of any fluids, the treatment priority becomes to stop the leakage. This can be done by the intake of specific herbs as well as acupuncture and moxibustion on specific points depending on the particular leakage. Once the leakage is under control, treatment will focus on restoring the lost Body fluids and addressing the internal imbalances that led to the leakage in the first place.

 

HOW TO PREVENT BODY FLUID DEFICIENCY

 In order to have plentiful Body fluids we need to:

•  Look after our Body fluid production, which means taking care of our digestive system, keeping it strong through the regular intake of appropriate food and drink and as free from toxic burdens as we possibly can. More information on how to do this can be found in my previous post about diet and nutrition according to TCM and the post about the main organ of digestion in TCM.
• Make sure we don’t over spend our Body fluid resources by resting and sleeping enough in relation to our energy expenditure. Generally speaking, we will know that we need more rest when we feel exhausted or weak as a result of our normal activities.
• Take time to recover after illness before increasing physical activity. This has become more obvious since the Covid 19 pandemic as many people have become chronically ill after returning to normal activities and exercise too soon following an infection with this virus. We need to be vigilant of our strength and energy levels before returning to normality.

 Once the Body fluid deficiency becomes severe, changes in the diet and lifestyle will not be enough to restore health. Although changes will be necessary to avoid worsening the situation, only treatment that strengthens organ function and nourishes the Body fluids will be able to reverse the situation. Moxibustion and Chinese herbal medicine are often important parts of this process.

Our Body fluids are the most essential substances for our vitality, health and longevity. In addition, they are the juice behind our creativity, our ability to be in the world with full perception and our capacity to learn and be productive. Looking after them is the best way to ensure we can enjoy life and good health into the last stage of our lives.

Sixth visit to Lesvos to give acupuncture at the refugee camp

I’ve just come back from my sixth trip to Lesvos where I spent three weeks offering acupuncture at the Earth Medicine container clinics inside the Mavrovouni refugee camp.

The camp looked pretty much the same as usual with its heat, strong winds blowing dust around, and the blinding effect of the sun reflected on the bright white ground. We are not allowed to take pictures of the actual camp but I would have loved to take one of the disabled toilets that have several steps at their entrance instead of a ramp. I had the impression that there were more tents where new arrivals are accommodated and also more containers where people who have been there longer are moved to. Containers usually host an average of 10 people each.

Me, Judith Curnew and Fabiola Velasquez

Each of my three weeks there had a different quality. The first week was gentle as a colleague from Canada was finishing her stay and we had the chance to do a hand over and discuss some cases. I started treating 6-7 people and by the end of the week I was treating 8-9.   

From the second week onwards, I was the only volunteer offering treatments. I was very busy and the heat was intense. I had the use of three beds so I did my best to accommodate new-comers who were in acute pain as well as those who already had appointments. I treated 10-13 people each day.

Last day's diary

On my last week the weather got hotter and windier. I had many appointments each day and tried to finish off the treatment process with as many people as I could as well as doing some one-off treatments for some people with acute pain (a pic of the last day's schedule gives an idea of what it was like!!). I treated up to 15 people each day.

The dozens of people I treated came mostly from Afghanistan and Syria and there were also some from Iran, Kurdistan (Syrian), Tajikistan, Yemen, Ghana, and Sierra Leone. The men ranged from 12 to 65 years old, with several teenagers who were experiencing pain. The women’s ages ranged between 22 and 60. Most people had severe pain in different parts of their bodies caused by injuries and chronic damage resulting from war, violence and their difficult journeys through several countries. The younger women were often very thin, pale, and some of them had excessive menstrual bleeding which was successfully treated with acupuncture and moxa. Many of the people I saw also had nightmares, heightened stress levels and a very poor appetite and digestion - which in the system of Chinese Medicine I practise would all be directly linked to traumatic experiences and physical strain.

Many of the young men in their 20s from Syria and Afghanistan had severe physical and psychological trauma, extreme levels of pain, very thin bodies and a kind of despair that it's very difficult to witness in such young people. Their stories contained loss, a lot of violence both in their home country and during their journeys– especially in Turkey-, torture, the responsibility of coming here as the only person who may be able to help their families afford food back home, and dreams of having their own job, their own home, their own family that seem totally unlikely from the refugee camp. Most of us will have a young man of this age in our lives: a son, grandson, brother, nephew, student… Just imagine them having to risk their lives in order to not get killed, help their family, or have a future only to get stuck without being able to do any of the things they dreamed of, in a continent where they are demonised for being male, young, and for practising their religion, and where compassion for them is in short supply.  While treating the back pain in these young men, I noticed that every time I used the lighter to light the moxa, the clicking sound made all of them jump out of their skin. This didn’t happen with any of the women. This made me wonder… 

By the end of my stay, almost everyone I treated reported great improvements in their physical condition, their sleep, and their mental health. Some of them are now receiving further treatment in the form of physical therapy which is made possible by the decreased pain levels.

There were no translators some of the time so I had to make do with a translating app that proved extremely useful especially for Arabic language as the app translates and speaks out what you need to say. In contrast, Persian and Kurdish – both of which were very common- have no sound on the apps so I tried hard to read the phonetic writing when the person I was talking to couldn’t read. This caused a variety of reactions, laughter when I got it completely wrong and amazement when I got it right and people thought I knew what I was saying. There are always moments like this of softness and laughter despite the heaviness of the situation and I have never found any victim or poor me mentality in the camp. On the contrary, people show so much strength, resilience, and a lot of hope despite everything they have been through.

A FEW PICS OF THE TREATMENTS I GAVE

As in previous trips, moxibustion featured in most treatments as it is often the most effective way to treat severe pain in people who are depleted

   

          

                                                           

SOME STORIES

I feel that part of my work in Lesvos consists of putting a human face to the word “refugee”. I do this by sharing stories about some of the people I meet there to give a reference of a real person next time we are tempted to give our opinion about “them”. Here are some of the stories I heard and experienced in this trip:

I treated a Syrian lady in her 50s with pain all over her body. She had the sweetest smile and at the end of each treatment filled me with hugs and blessings because her pain seemed so much better. In one of our last sessions, she asked me if her emotions could affect her body and cause pain. When I said that I think that is possible, she told me she used to have five children and now she only has one left and that she felt that this was making her body worse. I didn't dare ask her how that happened to her children, I just hugged her and we both shed a few tears.

I met a family from Afghanistan who arrived in Lesvos in March 2025, composed of a husband and wife in their thirties with their children (four, I think) and the wife's father. I treated the husband and wife, her father and two of their children, all of whom had some form of physical pain and a lot of weakness in their bodies. On their way here, their boat was pushed back by the border patrol and they capsized. Eighteen people drowned in front of their eyes, including the wife's mum. They are still in total shock and their bodies full of grief. Unfortunately, pushbacks are a common practice here even though they are illegal and are often reported by human rights organisations.

Something I noticed this time that wasn't so evident to me in previous trips was that many of the men from Afghanistan had been victims of torture and of violent attacks by the Taliban. One of these men, a man in his 30s, was tortured and brutally beaten and this triggered a stroke that affected the left side of his body, his mental acuity and his speech. Another man in his 60s, saw his brother getting killed and when he tried to recover his body was brutally beaten and thrown into a large fire, he was left with scars and damage to his body that affects the mobility of his hands. Another man in his 20s, was tortured and as a result experiences excruciating body pains from the lower back down to his feet. His emotional trauma is evident by his demeanour and nervousness about being touched. These three men, and many others have had a lot of pain relief from our treatments and found in our treatment rooms a place where they could feel safe, respected, and looked after. Most of the men I have met here, were also beaten up and shot at by the police and armed forces in Iran and Turkey. When we see men who have come a long way to try to reach safety, we have no idea what they may have experienced before arriving here.

 

A VISIT TO THE MEMORIAL TO HUMANITY

During my first trip to Lesvos in the summer of 2021, I was shown a burial ground where people deceased at sea and in the refugee camps of the island had been buried since 2015. It was a place that stirred your soul because you could see the mounds of earth of varying sizes, some of them tiny, many with no names or dates, covered in overgrown grass, containing the bodies of people whose only crime had been to dream of a better future. You could imagine that somewhere in the world, somebody was probably waiting for their news, and praying for their safety. Some of the people who had been buried there actually had family on the island who had not been told about the site of their burial. I made a video of this at the time which you can see here 

Last year, Earth Medicine transformed this place into a memorial site and gave a dignified burial to all those who had been buried there without any dignity or respect. Many of the bodies could not be identified as the authorities had no records but many others now have the name and a place where any loved ones can go and pay their respects. This is also a place for all of us to remember that, under our watch, thousands upon thousands of lives have been senselessly lost while seeking safety.

Memorial to Humanity

The grave of an unknown person 

 

Grave of three children who drowned on the same day 

Similar to previous trips, there were many contrasting experiences and emotions. Most of the people I treated benefited a lot and many became pain free. Seeing faces change from the frown of pain to a relaxed smile, sometimes immediately after the first treatment, felt wonderful and filled my heart with joy. I received so much gratitude, love, blessings, wishes for a blessed life for me and my family. This sounds like words but they weren’t just words, they mean the world coming from people who have lived through so much but are still able to be grateful, appreciative and, above all, to trust someone they have never met before. This work if not only about giving treatments and relieving pain but about reconnecting our hearts with each other. At the same time, I feel the sadness of the ongoing situation of displacement that people here and in so many other countries in the world have to experience. The unstable political climate is creating increasing uncertainty for people here and in many countries in the Middle East and Asia. War will only bring more death and displacement and the consequences will be felt in Lesvos and in the whole of Europe.

 My deepest hope is that one day we will realise that we are all the same, that the people we so strongly judge and even despise are just like us, doing what we would probably do in the same circumstances. I pray that, if one day we have to flee our homes into uncertainty, we will have at least a fraction of the hope, strength, and fortitude that I always see in the refugee camp. I pray that those who have suffered so much will find a place where they can feel safe, welcome, and have an opportunity to thrive and experience peace, abundance and happiness.

As always, deep gratitude to all those who contributed to make this trip happen. Without your help, I couldn’t do this work. 

If you would like to contribute to the wonderful work the organisation does throughout the year you can do so here.

With love, gratitude, and hope,

Sandra

The Use of Acupuncture and Scalp Acupuncture in a Humanitarian Setting- A Case Study

Scalp acupuncture is a system of acupuncture developed in the 20^th Century which – in the case of the Chinese scalp acupuncture illustrated here- integrates traditional acupuncture needling techniques with Western medical knowledge of the functions of the different areas of the cerebral cortex. This system is widely used in China alongside conventional Western treatment for neurological conditions causing motor and sensory dysfunction. In neurology wards in integrative health hospitals in China, patients can be seen performing physiotherapy exercises with needles inserted into the scalp. Many studies show the efficacy of scalp acupuncture in the treatment of mobility issues from diverse causes. (i) (ii) (iii)   

Jiao Scalp acupuncture treatment areas

Acupuncture has been used for a few decades in humanitarian settings and there are several projects initiated by organisations based in the US, UK, and Europe that offer treatments in different areas of the world affected by poverty, war, and natural disasters. It is common to see protocols such as the NADA protocol in these settings. A protocol consists of a fixed ear or body acupuncture point prescription which is repeatedly given to every person without modification, usually in group sessions. This requires a minimum of verbal exchange which can prove a difficulty due to language barriers as well as being suitable for limited levels of time and space and to maximise the amount of people that can be offered treatment at the same time. There is no record of scalp acupuncture being used in this context.

Earth Medicine is an organisation which differs from others that offer humanitarian acupuncture primarily because it is based in the same location as the people they are serving. Currently, this is the only organisation allowed by the Greek government to offer rehabilitation therapies inside the Mavrovouni refugee camp in the island of Lesvos. This organisation has been operating on the island since 2018, four years after the beginning of the so-called “refugee crisis”, when it became obvious that apart from the basic needs of food, water, clothing, and shelter, there were also issues with mobility and long-term injuries amongst the population of the refugee camps. The organisation was born to meet these needs and over the years has been offering physiotherapy, massage, and acupuncture focussing on individual physical needs including rehabilitation.

Because the model of this organisation does not consist of offering treatments temporarily but permanently, it is possible to bring long-term assistance to asylum seekers who stay on the island for several months/years. This article presents a case study of a person treated by Earth Medicine, within a multidisciplinary context and where the use of scalp acupuncture in combination with body acupuncture was crucial. 

CASE STUDY

The patient, who will be referred to as Mr A, male asylum seeker from Somalia in his early 20s, who arrived on the island of Lesvos at the beginning of 2021. After his arrival, he was diagnosed with Pulmonary Tuberculosis (TB) and started treatment for this condition in the Autumn, with an NGO providing medical support. A few weeks later, he was additionally diagnosed with pleural puncture and a month later, he developed Peripheral Neuropathy (PN). At this point, his TB treatment was temporarily stopped. Mr A was admitted to hospital three times in 2021 for the conditions mentioned above. He also had a history of gastritis.

At the time of his initial contact with Earth Medicine, his medication was: Ethambutol 500g, Pyrazinamide 500mg, and Rifinah 300mg and Omeprazole 20mg. 

Mr A’s initial visit to the Earth Medicine’s office was in February 2022. This is a summary of his symptoms at the initial consultation:

Loss of appetite, inability to eat, abdominal pain, severe weight loss: Mr A didn’t feel hungry and if he did eat, he had acid reflux and severe epigastric pain. He also experienced nausea on a daily basis. As a result of this, he had lost a lot of weight and was extremely thin (See Photo 1)

                                     

Photo 1- Mr A in 2021 Hospitalised with lung puncture and showing signs of emaciation

 

Peripheral Neuropathy and loss of mobility of the lower limbs: he presented with total loss of sensation in the lower limbs, burning pain in the legs, inability to stand up and inability to lift or move both feet. At this time, Mr A was spending most of his time lying on his bed as he was too weak to move or get up. He was unable to transfer to a wheelchair or to a chair without a lot of help. Every time he put any weight on his feet, he experienced severe burning pain on the soles of the feet.

Breathing issues: Mr A had scarring on his left lung as a result of the TB (See Photo 2) and experienced tightness in the chest with difficulty breathing. His breathing was agitated when indoors as he felt there was not enough air. He felt calmer outdoors, where he still experienced shortness of breath.

 

Photo 2: An Xray of Mr A’s chest showing lung scarring

 

Constipation: He only passed stools twice per week. Stools were hard, dry, and painful to pass.

Fatigue: Along with physical weakness, Mr A experienced constant physical and mental fatigue.

Mr A Had emotional stress due to his situation which was exacerbated by his having received two asylum rejections. He experienced insomnia as a result of this.

As he had been unable to eat very much for several months, and lack of nourishment was deemed to be exacerbating his extreme weakness and muscle atrophy, the initial stage of his rehabilitation was focussed solely on strengthening his ability to eat and digest with the aim to help him gain the strength necessary for his physical recovery.

INITIAL STAGE OF TREATMENT

At the initial stage of Mr A’s treatment, a diet based on the principles of Chinese medicine was followed. For the first two weeks, he had a simple soup made with bone broth and a few vegetables prepared daily for him at Earth Medicine’s kitchen.  As he had not eaten a proper meal for months, he initially experienced epigastric pain, discomfort, and fullness after eating a small amount of soup. On the third day, the pain started to diminish and it gradually subsided completely over the next days. After two weeks of this diet, Mr A reported having more energy.

As his ability to eat increased, other foods were gradually introduced including rice, a variety of cooked vegetables, and small portions of different types of meat. Everything was very well cooked. As his digestion stabilised, he had more appetite and the nausea subsided, his strength increased and he started to put on weight. At this time, the physical rehabilitation sessions were started.

PHYSICAL REHABILITATION BEGINS

The initial physical therapy aimed to gradually recondition Mr A’s lower limbs and spine. When he started his physical therapy, Mr A was wheel-chair bound, not able to stand without aid and could not lift his feet off the ground. He received daily physiotherapy sessions that integrated games and graded exercises which he performed with aid.

He then started to practise standing from the wheelchair holding on to the parallel physio bars, with a helper holding him up followed by sitting back on the chair. This simple movement was very difficult for him at the beginning because he had severe pain on his feet and ankles on standing and because his legs were not strong enough to hold his weight. With exercises and nutrition, the pain became less severe and his muscles started to feel stronger. After about three weeks, when standing became easier and he was able to stand by himself, a physiotherapist and a helper started to work on aiding him to move along the length of the parallel bars, one moving each foot forward and the other bringing the chair behind him in case he needed to sit down. The lifting of his body, standing and sliding the feet forward were very difficult at the beginning and made the feet and ankle pain return. As he persevered with this work, within two months he was able to move along the length of the bars four times with one helper.  After a lot of practice, he was able to move along the bars by himself, pushing himself from the arms and sliding each foot forward.

At this point, Mr A was able to start using a rollator walker. He was still unable to lift the feet off the ground or move his ankle joints.

 

ACUPUNCTURE ADDED TO REHABILITATION

Mr A received some acupuncture treatments at the beginning of June 2022.

He had six body acupuncture treatments with a practitioner from France. During these sessions, Mr A started to feel some sensation coming back to the toes.

He had no acupuncture treatments for a few weeks and then re-started at the beginning of July, 2022, when I came to the camp for three weeks. We started daily treatments of scalp and body acupuncture. It was stressed that physiotherapy would need to be done after the acupuncture and that the scalp needles- which are threaded under the scalp and therefore do not fall out- would be kept during the physiotherapy sessions. At this time, Mr A was still unable to lift his feet off the ground, the numbness of the toes had returned and he had no feeling from the knees down, he had severe insomnia and he was passing stools every 2 to 3 days. These symptoms were treated with scalp and body acupuncture. The scalp acupuncture lines used were from the Jiao and Lin systems of SA: Du 20, Foot sensory and motor lines, upper parts of Sensory and Motor lines to treat the lower limbs, Anxiety lines (See Photo 3). The body acupuncture was aimed to strengthen his system and help the work of the scalp acupuncture on the lower limbs. Treatments included points on the abdomen to encourage digestion and on the legs to promote circulation and muscle function and reduce pain.

Each day, the physiotherapist from Portugal reported big improvements in his lower limb movement and strength during Mr A’s sessions with the scalp needles. By the fourth treatment, given on July 7^th, Mr A was able to lift his feet off the ground and move the feet from the ankles. After the fifth treatment, he was able to move his toes and managed to give some steps by himself without aid or support. There was a break for the weekend, after which Mr A reported that he had slept very well for three nights and that on the Sunday he had been able to walk around his container without any aid and without experiencing breathing difficulties or shortness of breath.

Photo 3: Mr A having scalp and body acupuncture in July 2022

 

By the 9^th and last treatment of scalp and body acupuncture, Mr A was able to run after a basketball, walked around the city for an appointment and climbed the stairs without help for his acupuncture treatment. Initially his treatments had been given on the courtyard due to his difficulty climbing stairs, then they moved to the ground floor of Earth Medicine’s office as he was able to climb the few steps to get in and for his last treatment, he insisted on being treated on the first floor, which required him to climb up the entrance stairs and then two flights of stairs inside the building. His constipation was not much improved but his sleep was steadily better. He was experiencing pain in his ankles but this was due to excessive exercise. He was so ecstatic about being able to walk that he had been playing basketball in the refugee camp and walking around excessively without much rest.

Mr A had no treatments during August 2022. The next time Mr A had acupuncture and physiotherapy treatments at the beginning of September 2022, his ability to walk was still there and his breathing was normal but he was still experiencing ankle pain which was occasionally severe and stopped him from running, a sport he had started to practice, he was passing stools every other day, had insomnia related to stress and felt tired.

He had eight sessions of body acupuncture with another practitioner from the UK. His pain subsided and he was able to run again, he could sleep better and had more energy.

 

OUTCOME

This is a video compilation of the process of Mr A’s rehabilitation. During July 2022, at the beginning of our treatments, he had poor balance and leg weakness. It can be seen there was rapid change and improvement in mobility during this month as he was having a combination of scalp and body acupuncture plus physiotherapy. These improvements in mobility were sustained  https://www.youtube.com/watch?v=YpbUrDBOroY.

Mr A’s physical rehabilitation ended in October 2022 when he was transferred to another camp in mainland Greece. He was fully able to walk when he left the island, as seen in the video. He eventually was granted asylum and lives in safety with no mobility issues and no breathing difficulties which means he is able to be a productive member of the community he lives in.

This case illustrates how a multidisciplinary approach can produce outstanding results even in severe cases seen in humanitarian settings and how scalp acupuncture can be an effective addition to treatment for mobility issues in this setting. It must be emphasised, that without Mr A’s hard work, perseverance, and faith in the future, none of the treatments provided would have achieved these remarkable effects.

The practitioners involved in the treatment of Mr A were volunteer practitioners fully qualified in their fields of Physiotherapy, Acupuncture and Chinese Medicine. Given the severity of the conditions that can be seen in the refugee camp, the organisation only accepts practitioners with a minimum of 5 years of experience in their field.

I was involved as Acupuncturist and Chinese Medicine practitioner throughout the treatments offered to Mr A with input consisting on the dietary advice based in Chinese medicine theory that was followed and the scalp and body acupuncture treatments during July 2022.

I feel privileged to be able to give treatments with this amazing organisation, if you would like to help Earth Medicine continue their important work, you can donate here.

With gratitude and hope for humanity,

Sandra Arbelaez

 

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REFERENCES

(i) Wang, Shen, Wang, Fu et al. Scalp Acupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine (2012) https://doi.org/10.1155/2012/480950

(ii) Lan-ya LI, Zhen-huan LIU, Qiao-ling XIE, Meta-Analysis on scalp acupuncture based therapy in treating children cerebral palsy. World Journal of Acupuncture - Moxibustion, Volume 24, Issue 3, 49-53 (2014). https://doi.org/10.1016/S1003-5257(15)60012-5

 (iii) Lee, HS., Park, HL., Lee, SJ. et al. Scalp acupuncture for Parkinson’s disease: A systematic review of randomized controlled trials. Chin. J. Integr. Med. 19, 297–306 (2013). https://doi.org/10.1007/s11655-013-1431-9