Best Ways to Eliminate Terrible Breath by Nova Klawinski

Amongst the primary explanation why people look for dental care is due to stinky breath. Bad breath or medically generally known as halitosis is an evident obnoxious odor noticed when an individual breathes or exhales. Foul breath is definitely caused by various reasons such as smoking or eating unhealthy foods. Improper oral hygiene also can lead to halitosis which might produce uneasiness and frustration whenever an individual speaks or breathes. Feel fortunate though for that can now be treated conveniently.

Cleaning the teeth using fluoride toothpaste for about twice a day is likely the main and the commonest mean in eliminating bad breath. This could remove stains, bacteria and food debris stuck in the teeth. Based upon studies, foul breath mostly occurs as a result of bacteria exist in your tongue.Hence experts advocate that it will likely's wise to use soft-bristled toothbrushes for they are often ideally applied within your tongue.

Flossing your teeth once daily can remove halitosis or halitosis. They originated from plastic nylons or silks which are greatly inserted in between your teeth. The foods debris stuck in your teeth is among the many main cause why bad breath exist hence utilizing such mean helps. Another way and eliminate halitosis is through utilizing a mouthwash. A mouthwash this is usually a liquid form solution that's composed of anti-plaque agents that kills bacteria in no time. However, only a few mouthwashes are applicable simpler for you thus it pays to go to first your hygienist or dentist before applying one. If you would like sign up for bad breath with natural cures you might use baking soda. A lot of experts affirmed that this natural method can vastly treat foul breath together with salt and water twice a day. When using this method, it is important that you have a quarter teaspoon of baking soda and salt before mixing letting it to water. Then, mixed it in a cup of water. Following that, now you can leverage your natural method in removing halitosis. Based on research, tobacco or whatever forms of pipes can cause bad breath. Smoking irritates your gums and results in stains within your teeth which makes your teeth on yellowish state. Therefore, most experts advised that the best way to eliminate such terrible condition is to stay clear of and begin quitting smoking. This will includeg cancer, heart diseases, gum diseases and etc. When living life to the fullest, you have to engage you to ultimately well balanced meals however there are actually harmless foods that could cause halitosis including onions are garlic. However, when you are very into this type of foods, better use a mouthwash following them or maybe, try utilize a glass of water after consuming them. Factually, water washes all the bacteria surrounding in the teeth.

Factually, halitosis exists in many terms which impede you from talking. Fortunately, they are curable. All you need to do is to seek first assistance from your unique hygienist and start thinking about the aforementioned tips displayed above.

About the Author

You can find a lot more amazing info on this great website. emergency dentistry.

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All About the Residential Yoga Courses in Rishikesh by rickyz marioz

One of the oldest and the most powerful remedies, Yoga has been treating mankind with various health problems since time immemorial. The science of yoga actually originated in India thousands of years ago and since then it has been practiced by humans to get relived from their diseases and lead a healthy life. Nothing compares to this deep form of physical exercise that encompasses several aspects and helps people to stay fit emotionally, mentally and physically for long period of time. There are millions of people from all age group who wish to learn different techniques of yoga and bring in new dimensions to their lives. This clearly states that Yoga Instructor is a promising career prospect through which one can serve humanity apart from making massive amount of earning.

If you are one of those who are eager to step in the yoga industry and become successful yoga instructor then it is highly recommended to take Yoga Teacher Training Rishikesh into consideration. There are a certain number of highly renowned yoga institutes in Rishikesh, Uttarakhand, India. Rishikesh is one of the ancient cities in the world and is likely referred to as the Yoga capital of India and the world. The yoga institutes of Rishikesh are registered with the Yoga Alliance India and the USA. The yoga training course is specifically designed by experts that are intended to give students the deep insight of the different Yoga techniques that they can practice themselves to attain their peace of mind as well as spread the knowledge to the outer world.

The Yoga Courses In Rishikesh include both practical and theory classes that cover everything related to traditional hatha yoga practice that begins from the basic level and then proceeds to the advance level with the progressing time. As the courses are comprised of basic to advance level yogic techniques, the courses are ideal for beginners and experienced alike. Accomplishing the yoga training course successfully will help you to be fit physically, emotionally and mentally apart from making you a certified yoga teacher with a completion certificate from Yoga Alliance, the USA.

If your goal is to become a certified yoga instructor and give new dimensions to your life then it is highly advised to undertake Residential hatha Yoga TTC In Rishikesh, India. You can surf internet and learn more about the institutes and according to your interest and preference, you can choose the best one for yourself.

About the Author

If you are one of those who are eager to step in the yoga industry and become successful yoga instructor then it is highly recommended to take Yoga Teacher Training Rishikesh into consideration. For more information visit us:http://www.yoga-vedanta.in/ 

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Sinusitis and Hoarseness Natural Health Q&A by Brian B. Carter, MS, LAc

Q: I had my spleen removed because of Hodgkins Disease. What should I use for stuffy sinus and constant hoarseness?
- Patrick

A: In my opinion, you shouldn't "use" anything, but go see a Chinese medicine (CM) practitioner (acupuncturist/herbalist) for the appropriate herbs for your condition, which I cannot diagnose over the internet. I wonder if you are hoarse because of over the counter decongestants?
- B

Q: I went to the Doctor because I was hoarse. With the sinus drainage and him thinking that it could be stomach acid, I did try things like Nexium and Nasonex spray, without any luck. In reading some of your website I thought that I read something about a sinus and spleen connection. I think it was something about wet or dry spleen that herbs could help. If you don't have a spleen, it seems that you would be prone to constant sinus problems, which I think I have. It seems like I always have some mucous at the back of my throat. Any ideas? I would appreciate any info you can offer. I will try to locate a Chinese medicine practitioner.
Thanks,
- Patrick

The Spleen in Western and Chinese Medicine
Well, first please note that the Spleen of CM is different than the anatomical spleen of western medicine. The western spleen organ is mostly involved with blood, whereas the Chinese medicine Spleen organ-system is about digestion, assimilation, getting energy to the four limbs. In western terms, Spleen qi is probably something like enzymes (though not limited to that), which work with the stomach acid (part of the Stomach qi or yang) to digest the food.

Causes of Sinus Congestion
There is a connection with the sinuses: In CM, Spleen deficiency leads to dampness and phlegm (this is probably the "wet spleen" you were trying to remember), which can show up in sinus congestion. The Spleen is said to "raise the clear yang and descend the turbid yin." But there are other causes and factors in sinus congestion: inflammation (heat), stress, qi stagnation, and Liver/Gallbladder damp-heat.

Treat the Causes and the Symptoms
To treat it well, you need not only a sinus draining formula like Cang Er Zi Tang (CEZT) as the basis, but also herbs that address the root and related patterns. Only taking CEZT would not fix the cause of the problem, so by itself it would be only a temporary fix. We would add all or parts of formulas like:

Liu Jun Zi Tang for Spleen deficient dampness
Er Chen Tang for phlegm
Long Dan Xie Gan Tang for Liver Gallbladder damp-heat
Shu Kan Wan or Xiao Yao San for Liver qi stagnation.
Huang Lian Wen Dan Tang for phlegm and Stomach heat

But you can't take them all! And, taking the wrong ones could make you worse. So, get thee to an herbalist - that is, an acupuncturist who knows their herbs. We have an acupuncturist-finding resource which also has some tips for evaluating several acupuncturists before deciding which one to see.

For more on sinus problems, read these three articles:
http://www.pulsemed.org/sinusitis.htm
http://www.pulsemed.org/sinusphlegmetc2.htm
http://www.pulsemed.org/jkcfs.htm

Hoarseness and the Lung-system
In Chinese medicine, we generally attribute hoarseness and loss of voice to dryness. The Lung-system, which includes the throat, is said to "hate dryness." The Lung likes to be moist - so the Lung yin is very important, and dryness is the enemy.

In fact, the autumn season (when this question was asked and article was written), is associated with both the Lung and with dryness. So this would be the time of the year that the most people would get hoarse.

There are good herbs for this- e.g. the formula Ophiopogonis Plus (O+)from Far East Summit. But again, the complexity of the whole condition may make just one formula problematic - this one increase Lung yin, and if you also have sinus congestion, it might even worsen that. So, you'd need some combination like CEZT and O+.

A simple kitchen remedy for Lung dryness would be to drink some pear juice.

B

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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How to Treat Your Migraines Yourself with Acupressure by Brian B. Carter, MS, LAc

Acupuncture and Migraine is a sophisticated medicine for a complicated disease.

Acupuncture is good not only for the headache, but for the various types of migraine auras, AND for preventing migraines. Also, you can use the points I'll suggest below to give yourself acupressure at home for free!

Acupuncture and migraine treatment, like all acupuncture, is based on the principles and theories of Chinese medicine. From a Chinese Medicine perspective, the causes are emotional excesses (stress, long-term emotional disturbance, even just long-term frustration!), dietary imbalance (too much of the wrong foods and too little of the right ones), and the deficiencies inherent in the aging process can lead to the symptoms of migraine.

Acupuncture points may be different for acute attacks, and for prevention. There is acupuncture to treat, for example, a one-sided headache, and then a slightly different acupuncture to treat the susceptibility to stress that causes it.

Acupuncture - The Pain "Reset Button"
A neurologist told us in a guest lecture at my alma mater, the Pacific College of Oriental Medicine, that acupuncture is the best therapy for chronic pain. He said that chronic pain signals can get 'grooved in' to the brain. That means that even after the real problem has been totally eliminated, the brain may still be "echoing" pain signals to us. This fits with Oliver Sach's observation that migraine is like a neurological configuration or 'frame of mind' or arrangement that the migraineur keeps falling into.

Acupuncture can act as a 'reset button' to end these echoes of pain. The sooner you get acupuncture, the better, because the longer the pain is there, the more difficult it is to change.

In Chinese Medicine, we diagnose each patient according to what is called a pattern of imbalance, a group of symptoms. There are 5 basic patterns involved in migraines, but real people are complex and may have several patterns going on at the same time.

Let's take a look at acupuncture and migraine in terms of the 5 patterns mentioned by Bob Flaws and Philippe Sionneau in their "Treatment of Modern Western Medical Diseases in TCM." Acupuncture is much more effective than acupressure, but in case you want to try out some of these points on yourself, you can massage them. Check out this link for the locations of these acupuncture and migraine points.

Migraine pattern #1 - Liver depression, qi and blood deficiency
This is basically stress and frustration with bodily depletion. Common symptoms of this type of migraine include one sided headache, blurred vision, numbness and tingling of the fingers, emotional depression, stress, fatigue, and menstrual irregularities. Acupuncture and migraine for this type might include points like Liv3, LI4 or linggu, P6, GB20, GB39, and GB43.

Migraine pattern #2 - Ascendant Liver yang
This migraine includes dizziness, sudden anger, light sensitivity, and ringing ears. Liver yang rises when the liver yin is deficient - and that happens over time from kidney yin deficiency, which can be due to overwork, too much sex, or too many warm herbs like ginseng and other sexual tonics. Too much coffee over a long period of time could contribute to this pattern, too (many people insist that coffee helps their migraines, and it can, but only temporarily. It may make underlying problems worse at the same time). Acupuncture and migraine for this type might include Liv2, K3, K6, GB39, and GB43.

Migraine pattern #3 - Cold reversal pattern
This migraine features pain at the top of the head, feeling of chill during attack, vomiting clear liquids, and a sensitivity to wind. This is a sudden attack of migraine only. It happens when the influences of stress (liver) attack the digestion (spleen). Acupuncture and migraine here might include moxa on ST36, Ren6, Du20, K7, and needling P6 and Ren13.

Migraine pattern #4 - Phlegm reversal pattern
This headache comes with dizziness, heavy-headedness, the feeling like there's a tight band wrapped around the head, vomiting of phlegm, stuffiness in the chest, and a lack of appetite. It's a severe complication of digestive deficiency. Phlegm comes from dampness, which is a diseased fluid problem due to poor digestion. Acupuncture and migraine to remedy this would be points like ST40, Sp9, L5, and ST36.

Migraine pattern #5 - Blood stasis obstructing the network vessels
This is a stubborn, stabbing headache that doesn't change locations. It may be due to injury to the head, or blood may have stagnated due to qi stagnation. Points that fix this one are LI4, Sp6, SP10, and Liv3.

Acupressure resources- you can check out a free acupressure chart on my website at http://pulsemed.org/free-acupressure-chart.htm. For more help with acupressure, you should buy my book, Powerful Body, Peaceful Mind.

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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Truth and Lies about Menopause Herbs by Brian B. Carter, MS, LAc

Menopause Herbs Don't Work?
by Brian Benjamin Carter

A couple years ago, a study of herbs and other natural remedies for menopause got a lot of press. Particularly of note were its assertions that black cohosh is the only herb shown to help in menopause.

We could incorrectly assume then that no herbs help for menopause. However, there are some problems with that conclusion. Let's take a look at them:

1. Most herbs have not been subjected to RCT's (Randomized Controlled Trials, medical science's most advanced study design).
2. RCT's are not the only kind of study that provides reliable information.
3. Herbs are hardly ever prescribed alone. Research should be conducted on time-tested herbal formulas for menopause - not single herbs.
4. American researchers tend to ignore or discount research done outside the U.S.
5. Researchers' own biases affect their conclusions... no study is perfect. Researchers may have little trouble finding reasons to throw out a study whose conclusions threaten their beliefs.

Ok, then...

1. Which herbs have been subjected to RCT's?
A quick search of MedLine for "herb randomized controlled trial" yields only 13 results for 11 herbs and herb formulas (note that searching for just herbs alone yields more than 2300 studies):

St John's Wort, Black Cohosh
Bing gan tang, Yi zhu tang, Yi Er Gan Tang (Hep C)
Phyllanthus, 'Jianpi Wenshen recipe', Fuzheng Jiedu Tang (Hep B)
Polyporus umbellatus polysaccharide
Echinacea (Common cold)
Ginger (Nausea)
'AM' a Ugandan herb remedy (Malaria)
I know this is not the full list of well-studied herbs. The groundbreaking 1998 Journal of the American Medical Association issue on alternative medicine included the first RCT faithful to the principles of chinese herbal medicine, a study of herbs for IBS.

In the November 2002 review of menopause treatments, only 10 of the 29 studies (RCT's) they reviewed studied herbs. Of those, only two - black cohosh (sheng ma) and dang gui - are chinese herbs. There are many chinese herbs and herbal formulas for menopause that have not been studied in RCT's.

2. RCT's aren't the only kind of study.
Without a doubt, they are the best, the gold standard… they eliminate the placebo effect as much as possible, etc. They're good. But most herbs haven't had their RCT day in the sun. Why not? Because it costs a lot of money!

Drug companies spend hundreds of thousands of dollars on each drug to prove its safety (not necessarily its effectiveness) in RCT's. No single company has a motivation to study an herb which they cannot patent, own, and have the exclusive right to sell. They may take the course of isolating one part of an herb and patenting that, but then we've taken the herb out of its traditional framework. Applying it like a drug puts it in the biomedical treatment framework- the same one that assumes side effects are unavoidable. We'd like to avoid that!

There are plenty of other kinds of studies- from smaller scale clinical retrospectives (analyzing the data from treatment records) to in-vitro (in a glass tube) lab studies of herbs' effects on micro-organisms. In-vitro studies can show how a substance works, but don't tell us how it works in humans.

A search of MedLine for "Chinese Herb" yields 879 results. We get everything from the effect of herbs on rats in space (yes, really) to drug-herb interactions. And we find a lot of studies from outside the U.S. I don't have time right now to survey all 626 - sorry!

But the point is that there are a lot of studies out there that tell us positive things about herbs even though they haven't yet been awarded adequate funding for an RCT.

3. Herbs are hardly ever prescribed alone. Research should be conducted on time-tested herbal formulas for menopause - not just single herbs.
Most people know little to nothing about the most comprehensive and effective traditional system of herbal prescription - Chinese Herbal Medicine.

Clinical experience and research studies have shown that herbs work better in groups (formulas) than alone. Just as certain drug combinations have positive or negative effects, certain combinations of herbs have special additive functions or may need to be avoided.

The first systematic herbal text was written in 200AD, the Shang Han Lun (Cold Damage Classic). For at least 1800 years, chinese herbs have been prescribed primarily in formulas - groups of 4-12 herbs.

New research on chinese herbs should verify, refine, and build on the last 1800 years. The idea to research single herbs comes from the pharmaceutical drug paradigm, not the tradition to which chinese herbs belong. It makes sense that since most American researchers are biomedical that they would use a biomedical approach... but it's still wrong.

4. American researchers tend to ignore or discount research done outside the U.S.
I wasn't able to find anything to back this up, so I'll just say that it seems as if American researchers don't acknowledge research from other countries. Or perhaps they simply are more skeptical of it? In any case, I notice that many of the topics I investigate (alternative and complementary treatments) are studied in Europe, but not in the U.S. I admit I don't have all the info on the general level of quality of studies from different countries, or how much and why American researchers disregard such studies.

5. Researchers' own biases affect their conclusions. No study is perfect. Researchers can easily find a reasons to be skeptical about any study that opposes their own beliefs.
This is backed up by a meta-study I found… the psychology researchers found that those who reviewed studies were more likely to criticize its methodology if its conclusions disagreed with their bias, and more likely to approve of its methodology if its conclusions agreed with their bias.

There is no such thing as a perfect study. Good research tries to keep problems affecting the results and interpretation at a minimum, but imperfections are unavoidable. That means that if someone doesn't like the results of your study, they can find a reason to discredit the study.

This reminds me of the joke: "97% of all statistics are false." This implies, of course, that it could itself be false. Statistics, like anything else, can be deceiving. Inaccuracies of commission or omission (conscious or unconscious) can "spin" the truth toward the reader's bias.

Traditional Chinese Medicine (Herbs and Acupuncture) for Menopause
The review of RCT's on herbs for menopause shows that many herbs still need to be investigated. However, RCT's are not the only reliable proof that medicines are effective and safe.

At least 1000 years of tradition indicate that chinese herbal medicine helps balance women in menopause. Acupuncture has been used for somewhere between 2,000-30,000 years.

Acupuncture and herbs for menopause help alleviate many symptoms; most commonly responsive are hot flashes, depression, and vaginal dryness. Salivary hormone tests in clinical settings often show changes in testosterone and progesterone.

Another interesting point about the November 2002 study is that neither black cohosh nor dang gui are used alone in chinese herbal remedies for menopause. Black Cohosh can cause headaches and dizziness, but might be safely used in an herbal formula for menopause. Dang gui is similar- it is a warming herb, so by itself it could even increase the heat in hot flashes!

The moral of the story: See a chinese medical practitioner and use formulas, not single herbs.

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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Memory Herbs: Why Gingko Doesn't Always Work by Brian B. Carter, MS, LAc

Q: When reading, I can't seem to focus or retain information as I once did. I was wondering if you had any suggestions, herbal remedies, or insight to offer. I appreciate your assistance.

A: Memory function is a complex issue that an overly simplistic herbal approach cannot solve.

Why Gingko Doesn't Always Work For Memory
Popular magazines said that gingko was the herbal memory cure, but people's experience and science have not borne this out. I'm not surprised. In Chinese medicine, we recognize that one symptom can be have multiple causes. We have to look for the root, and look at the surrounding symptoms and signs to find the appropriate cure.

Your memory loss/concentration could be due to something that gingko can address, or to something else. If you give it to a bunch of people without first differentiating the cause of their problem, you won't know who will get better and who won't. Although gingko is a Chinese herb, we generally don't use it for memory or concentration problems. It does "move the blood," though, so problems due to "blood stagnation" might improve with it.

The Root Causes of Memory and Concentration
So what are the causes of memory loss and concentration problems? The disease of Impaired Memory (Jian Wang) is subdivided into:*

Heart/Spleen vacuity: Caused by overthinking, overwork, insufficient nutrition. Symptoms of palpitations, insomnia, fatigue, poor appetite, loose stool.

Kidney jing vacuity: Caused by overwork, disease, ageing, too much sex. Symptoms of loose teeth, loss of or early greying of hair, low back and knee weakness and soreness, weak bones.
Non-interaction of Heart and Kidneys: Caused by constitutional (genetic) weakness, disease, too much sex, or extreme emotional disturbances. Symptoms of dizziness, ear tinging, palpitations, low back and knee soreness and weakness, feel hot in afternoon and evening, sweat while sleeping, insomnia.
Phlegm: Caused by excess emotions, anger, frustration, digestive deficiency. Symptoms of sleepiness, dizziness, nausea, reduced appetite, phlegm in throat.
Blood stasis: Caused by stagnation, stress, emotions, trauma. (This is the most likely of the five that might respond to gingko) Symptoms of sudden and enduring impaired memory, abdominal fullness and pain, easy defecation of dark stool.
Concentration is very similar, and the above patterns more or less fit. For more information along the lines of attention deficit disorder, see this vast bunch of info.

For herbal remedies, see an acupuncturist/herbalist. They can make sure which type you have, and help you get better.

Chinese herbal remedies are personalized, synergistic, balanced... the best way to go in my opinion - much better than a number of single herbs from the health food store.

Difficulty Reading
Although not as likely in your case, since you used to do better with reading, many people learned to read wrong. They learned to visualize the entire word as a picture (using the wrong part of the brain), instead of sounding it out (phonics - using the correct part of the brain). If you use the visual part, it takes more mental effort, and makes you sleepy. So it is possible that as you age, or if you get worn out, using the visual part of the brain for reading would be more and more impossible.

If this is your problem, you may want to see a specialist, or look into various phonics products - they say you can re-learn reading even as an adult. But this isn't my area of expertise. It's just a supplemental idea for you to think about, and pursue with others.

*Source of the Pattern Differentiation: The Treatment of Disease in Chinese Medicine, Vol 1 by Philippe Sionneau and Lu Gang.

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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What is Qi? (How to Get More Energy) by Brian B. Carter, MS, LAc

This is one of the most common questions Americans ask about Chinese Medicine, and not an easy one to answer. Qi (pronounced "chee" and sometimes spelled 'chi') is possibly the most essential and the most controversial aspect of Traditional Chinese Medicine (TCM). Biomedicine often feels it can quite easily dismiss parts or all of TCM by maintaining that modern science cannot verify the existence of qi. The false idea that qi is an 'energy' like electricity has worsened this controversy.

Is Qi Energy?

Some TCM practitioners say qi is 'energy.' This is not too bad of an explanation. But don't go away thinking we believe there are electrical circuits running through your body! Some scholars (D.E. Kendall, and Paul Unschuld) maintain that the idea of qi as 'energy' was a mistranslation from the Chinese.

Then What is It?

In terms of basic TCM ontology ("what exists"), Qi is one of the four basic constituents of the body:

Yin Blood Qi Yang
< --- Substance Function --- >
< --- Cold Hot --- >

(Yin and Blood are substantial, yin is cold; qi and yang are functional, yang is hot)

Consider this convenient car-engine analogy: Yin is water from the radiator to cool the engine, blood is oil, qi is the force that moves the pistons, and the engine can be said to be in a yang state when operating. Perhaps the explosion itself is yang, while the force of the explosion is qi. We can also say that the gas contains a qi that has yet to be utilized.

(In the actual chinese character for the word, qi is the steam rising from a cooking pot of rice. I hope that explanation made sense to ancient Chinese, because it doesn't make much to me! To be fair to the ancient chinese, we can think of the steam coming from the rice as being less substantial, more yang than the rice itself, but still...)

What Happens Without Qi?

Another way to understand things is by their absence (darkness is defined as the absence of light). Without sufficient qi,

* your digestive system cannot break down food or transport nutrients to the rest of your body
* you become easily fatigued and are always tired
* you lose your appetite
* your limbs are heavy
* you might wake up frequently at night because you need to urinate
* academic/organizing thought is difficult or impossible
* everything is overwhelming (you cannot 'digest' what is going on)
* you tend to worry (the emotional component - TCM is a holistic medicine that does not separate body and mind)

How Do I Get More Qi?

The proper diet goes a long way. TCM dietary principles are too complex to cover here (I must say though that it is surprising to many patients, perhaps because vegetarianism is thought to be synonymous with alternative medicine, that TCM advocates eating meat and mostly cooked foods).

Herbs that increase the qi include ginseng, and codonopsis.

Avoid activities that drain the qi - Be sensible about your energy expenditure by living a balanced life; don't be too sedentary or too active. If you are a couch potato, your qi can't flow without exercise. If you are a type-A personality, relax and don't use yourself up too early in life - you may live to regret it!

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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The Yin and Yang of Social Phobia by Brian B. Carter, MS, LAc

Q:I feel that I am experiencing social phobia symptoms (red face, racing heart, sweating) and don't want to take a prescription drug with a bunch of bad side effects that will only mask these symptoms. I'm very interested in Chinese medicine but feel that I may be the person it has no effect on. I'd like some more information on overcoming anxiety and social phobia so I may live again. I'm probably yang deficient but no one would expect me to say that nor would they think I'd even be the one asking for info about overcoming anxiety.
- Ryan

A: Ryan, did you read our social phobia article yet? ([http://pulsemed.org/Socialphobia.htm])

Are you looking for more detailed lifestyle-type solutions? Are you suspicious that Chinese Medicine won't work for you because you've tried Chinese Medicine before, or are you just afraid of the disappointment? What makes you say you think you are yang deficient? Help me target my response to you with answers to these questions. All the best, B

Q: Hi Brian, I don't exactly know why I feel I'm yang deficient, I know very little about chinese medicine. But from my extensive readings on the internet about the symptoms I've been experiencing (red face, racing heart, constant heat, sometimes with uncontrollable sweating, nervousness--social phobia). I feel I'm exerting many of what I understand to be yang deficiency symptoms.

I'm not really shy but feel I'm really under a lot of pressure especially when around strangers or making a first impression. I'm hoping to overcome this without Western meds. that have too many terrible side effects. As far as lifestyle changes, I've been doing practically the same things I've always done, but now everything is just much harder in general, and the social phobia of whatever kind may be to blame. If you have any recommendations about changing this naturally, I'm all ears.

I've never tried a chinese medicine before, I just am skeptical about the true intentions of a lot of on-line doctors/therapists that are quick to perscribe something for someone they do not know or really care about.

Not to sound like a Mr. Know-it-all, but I'm a graduating with a Marketing minor soon and know a lot about advertising and marketing schemes. This being a problem many Americans face makes it all the more enticing for someone attempting make a quick buck from desperate people. But I do not feel this way about your organization and as I said, I know very little about Chinese medicine. I'd like to find something that works for me and hope you'll talk with me some more.

Thank you very very much for your time and understanding
Sincerely, Ryan

A: Ryan, thanks for your clarification, and your feedback.

I keep hearing about online doctors... I haven't looked into this, so I can't speak to that. But yes, the internet and my email inbox are full of marketing messages.

The Pulse's major goal is to raise public awareness about Chinese Medicine. We take part in a few affiliate programs (Amazon.com, The Diet Forum) but these are peripheral, and do not influence our writings. We are committed to the highest ethical standards- which I have discussed in this article. (10 guidelines article)

Yin and Yang Deficiency
So, let's talk about yin and yang deficiency. Yin is passive and cool. Yang is active and hot. Thus, a yin deficiency is a lack of coolness and passivity which leads to "hot" symptoms... feelings of heat, restlessness, etc. Yang deficiency is a lack of heat and activity, so it appear "cold"... feelings of cold, diminished function, tiredness, etc.

However, diagnosis is not so simple. Yin or yang symptoms can be due to deficiency or excess. The ones above are just the deficiency kind. A yang excess would be hot and overactive. A yin excess would be cold and sluggish.

Diagnosis in Chinese Medicine
I'm going to run you through a hypothetical Chinese Medicine diagnosis- just for your information- you should find a Chinese Medicine physician in your area and consult them for treatment. I don't know all the facts of your case, so I can't substitute for a one-on-one consultation. To find a Chinese Medicine physician, go to this page.

Your symptoms are "red face, racing heart, constant heat, sometimes with uncontrollable sweating, nervousness--social phobia"

The red face, racing heart, constant heat, and uncontrollable sweating are all heat symptoms. So are they yin deficiency, or yang excess? In yin deficiency, sweating is usually at night and correlates with a feeling of heat in the palms and feet. In yin deficiency, usually only the cheeks are red... whereas in yang excess the whole face is red. In yin deficiency, feelings of heat are in the afternoon or evening.

It appears to me you more likely have a yang excess.

The 8 Principles of Chinese Medicine
Up to now, we've only talked about 6 of the 8 principles. The 8 principles are a general categorizing system for diagnosis... They are

internal/external
cold/hot
deficient/excess
yin/yang

One Chinese physician proposed adding downward/ upward direction to this, for a total of 10 principles.

So for you - so far - we have: yang, hot and excess.

Is the Disease Internal or External?
Causes of external heat are usually viruses, flu's etc. And external diseases are usually recent, not chronic. Nor do they often have severe emotional effects... unless they've been around for a while and caused other internal problems. Usually emotional issues are due to internal causes. Sources of emotional trauma may be external, but the disease processes are still considered to be internal. I'm going to assume your disease is internal, but if your symptoms are only a recent development, then an external pathogen is a possibility.

Zang Fu Syndromes of Social Phobia
Now, if we take our 8 principle diagnosis of internal, hot, excess, and yang over to the article on Social Phobia... in particular the section on Zang Fu syndromes (opens another window for reference)

We see 5 Zang Fu syndromes listed. The first two are deficiency. The last three are excess. So, we can further differentiate by seeing which symptoms of your fit those syndromes. Here is where Tongue and Pulse diagnosis become key, and where a one-on-one with a Chinese Medicine practitioner is indispensable. Also, I don't have enough information from you to make this further differentiation.

Just for your information, the 5 Social Phobia Zang Fu patterns in terms of the 8 principles are:

Heart and Kidney Yin Deficiency = internal, hot, yang, deficient
Spleen and Heart Qi and Blood Deficiency = internal, no temp, yin, deficient
Heart Fire or Excess Heart Yang = internal, hot, yang, deficient and excess
Phlegm Fire Disturbing the Heart = internal, hot, yang, excess
Liver Heat and Blood Deficiency = internal, hot, yang, deficient and excess

Diagnosis by Zang Fu vs. Diagnosis by Type
Now, these 5 Zang Fu syndromes are not the end-all-be-all... this is what is called "diagnosis by type." It is not exactly the same as "pattern differentiation." It's a process by which we start with a disease (in this case Anxiety), and look at what Chinese Medical scholars believe to be the differential diagnosis. This style of diagnosis is fairly new... so it is in development. But it's a good place to start.

Once we have a type, we can take the representative herbal formula and modify it more specifically to you. This part is based on pattern differentiation and a knowledge of the actions of various chinese herbs. There are hundreds of herbs to choose from. We can fine-tune your formula over a few visits to eliminate side effects. For more about how herbal medicine can be effective without side effects, read the article, "Healing Without Side Effects?"

One on One Help
Probably the best thing for anxiety would be to see a Chinese Medicine physician who can get you the right herbal formula, and give you acupuncture to regulate your nervous system.

Other Helpful Therapies for Social Phobia
Along with this, it would be good to see a counselor who can guide you through some self-reflection about your social phobia... especially if it's been a recurrent part of your history.

It may take all three of those things- and in addition to the counseling, prayer and meditation can be powerfully transformative. It's not easy to confront deeply held fears, and mistaken ideas about ourselves and the world, but it's well worth it. You can't really run from them- not in any constructive way. They'll just hang around and wait for you to deal with them... and you won't be happy until you do.

In fact, wasn't it Eleanor Roosevelt who said that the best way to destroy fear is to do the thing you are most afraid of? Try toastmasters - most people are more afraid of public speaking than death! Toastmasters is a support and learning group for public speaking, and the first lesson is how to use the fear to your advantage!

BEST WISHES in your healing... and if I can help further, please let me know.

All the best,
B

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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Recovering From Stroke with Acupuncture by Brian B. Carter, MS, LAc

Q: I had a stroke 7 years ago. It was due to a blood clot in the brain. I am making a good recovery, but I am curious to know if acupuncture would benefit me.
Tim

A: Tim, the best time to get acupuncture for stroke is immediately afterwards - ideally while still in the hospital, if the docs will allow it. Seven years is a long time to wait for acupuncture. But it still may help you… You won't know unless you try it.

Scalp Acupuncture
Usually scalp style acupuncture is used for stroke. Needles are "threaded" along the scalp underneath the skin. There are at least three different scalp systems (Dr. Jiao Shun Fa's original style from the 1970s, Dr. Zhu's, and Dr. Yamamoto's styles). Call local acupuncturists and find out if they have experience with scalp acupuncture.

How Many Treatments?
It may take 10-20 treatments to get results. In China, they treat patients every day. That's not financially realistic here, but 2 or 3 times per week is good. In your case - after 7 years - it may take sustained and intense stimulus to make a change.

Complementary Therapies
You can also take herbal formulas to balance out the constitutional issues that led to the stroke, and help repair the damage. Acupuncture can be combined with physical rehab. It can improve both motor function (ability to move muscles) and sensory (ability to feel). You may recover function to some degree, but in more serious strokes there may be no response.

Will it Work for Me?
It's hard to say whether an individual will respond and how much- partner with the acupuncturist - they will get to know you case thoroughly, integrate what they're doing with your other medical providers. See the acupuncturist until you hit a plateau. Then your acupuncturist may try another system or strategy.

Stroke and Acupuncture Research
What's clear from several studies is that very severe stroke patients may be less likely to respond to acupuncture. This issue has not been thoroughly researched. Typically, American researchers have used inadequate acupuncture (style, points, and frequency of treatments). They conduct and review studies using points that Chinese acupuncturists would not use, and then conclude that acupuncture doesn't work. I say, "No, it's your brain that doesn't work, because you don't do a thorough literature review before designing your studies!"

As James Rotchford, MD, (a medical doctor and acupuncturist who has reviewed hundreds of acupuncture research studies and reviews on his website, [http://www.acubriefs.com]) mentions below, there are many approaches within acupuncture. Scalp styles (there are 3 - who knows which is most effective when - a good research topic) appear to be best for neurological conditions like stroke, MS, and post-concussion syndrome. To study body acupuncture points for stroke demonstrates unfamiliarity with the work that has been done thus far.

Is the acupuncture (style, points, and frequency of treatments) studied in most research considered the most effective kind by acupuncture experts?

It is not.

Why study acupuncture points and styles that clinicians themselves don't think work?

Three possibilities come to mind:

Arrogance: "Even though Chinese have been doing acupuncture for thousands of years, they don't know anything about it." This isn't so implausible - mainstream American docs and researchers already ignore European research - why not Chinese, too? If their methodology differs from the drug-model, it's because they aren't as advanced as us. And if we disagree with the results, the methodology is criticized. Otherwise, it's fine. Psychological studies of the research review process have proven this bias.
Idiocy: It's hard to imagine that someone smart enough to do research isn't smart enough to read the literature, but I suppose it's possible, or
Conspiracy: "Let's do the wrong acupuncture on purpose so we have proof that acupuncture doesn't work." This would be fool's work, since there is already incontrovertible evidence that it does.
If the studies suck, then why review them?

Because a review of multiple studies carries more weight than just one study. It's easier to convince people with a review.

The major issue with research reviews is that if the studies were inadequate in the first place, then the review's conclusions will be wrong. Until the methodology and study designs are improved, what's the point?

Again, we suggest researchers review the Chinese medicine literature. Rotchford advocates outcome studies rather than drug-style RCT's. In outcome studies, no placebo is used, but there is no satisfactory placebo for acupuncture research.

When acupuncture studies are done well, why aren't the results always positive?

Rotchford says, "Dr. Naeser has shown that the extent of CT demonstrated destruction does make a distinct difference in response to acupuncture. Why are Western studies equivocal when those from China and Japan so heavily support a role for acupuncture treatment in thousands of cases?

"First, the acupuncture approach is different. In the Orient, acupuncture is done daily to twice daily for maximum stimulation of the nervous system. Various experts recommend treating 3 times weekly as a minimum; more would be better.
"Second, Western studies use standard major Yang Ming and Shao Yang points. Chinese studies indicate that using scalp points alone or in addition to provide a stronger input. A newer approach, Xingnao Kaiqiao (A consciousness awakening), generated by Dr. Shi Xuemen and co workers, appears extremely attractive. They treat PC 6, GV 26, SP 6, BL 40, HT 1 (a bit distal to the usually designated point), LU 5, and LI 4 in sequence each to the point of tears (GV 26) and muscle jerking. In a series of 3200 patients, an essential cure is claimed in 58% and 90% effective improvement to the point of reasonable self sufficiency. Other points are added for pseudobulbar palsy, where good results are reported in over 300 patients. Comparing this technique to traditional Yang points and to scalp acupuncture, they denote excellent results in 76% versus 36%.
"I suggest a study such as done by Johansson's group, using Xingnao Kaiqiao, and with treatment given at least 5 days a week. Third, we must consider Qi transmission from healer to patient in any therapy, especially in acupuncture. I believe intent is essential; and the intensity of interest and empathy might create a much improved healing. Considering this, the background and training of the involved acupuncturists in a study should be noted." - from his review of "Acupuncture For Dysphagia Following Stroke." (see link below)

So, the people doing acupuncture research don't study Chinese medical acupuncture, but rather their own strange version of it - who knows where it comes from. I have no idea who's teaching them (are they teaching themselves?), or what books they are reading, if any. I'm not usually so bluntly critical of people's work, but as a body of work, I'd say that American acupuncture research has earned the distinction of being mostly useless.

About the Author

Acupuncturist, herbalist, and medical professor Brian B. Carter founded the alternative health megasite The Pulse of Oriental Medicine (http://www.PulseMed.org/). He is the author of the book "Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure" (November, 2004). Brian speaks on radio across the country, and has been quoted and interviewed by Real Simple, Glamour, and ESPN magazines.

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The Dying Breed - Healthcare in Eastern Europe by Sam Vaknin

Transition has trimmed Russian life expectancy by well over a decade. People lead brutish and nasty lives only to expire in their prime, often inebriated. In the republics of former Yugoslavia, respiratory and digestive tract diseases run amok. Stress and pollution conspire to reap a grim harvest throughout the wastelands of eastern Europe. The rate of Tuberculosis in Romania exceeds that of sub-Saharan Africa.

As income deteriorated, plunging people into abject poverty, they found it increasingly difficult to maintain a healthy lifestyle. Crumbling healthcare systems, ridden by corruption and cronyism, ceased to provide even the appearance of rudimentary health services. The number of women who die at - ever rarer - childbirth skyrocketed.

Healthcare under communism was a public good, equitably provided by benevolent governments. At least in theory. Reality was drearier and drabber. Doctors often extorted bribes from hapless patients in return for accelerated or better medical treatment.

Country folk were forced to travel hundreds of miles to the nearest city to receive the most basic care. Medical degrees were - and still are - up for sale to the highest, or most well-connected, bidder. Management was venal and amateurish, as it has remained to this very day.

Hospital beds were abundant - not so preventive medicine and ambulatory care. One notable exception is Estonia where the law requires scheduled prophylactic exams and environmental assessment of health measures in the workplace.

Even before the demise of central healthcare provision, some countries in east Europe experimented with medical insurance schemes, or with universal healthcare insurance. Others provided healthcare only through and at the workplace. But as national output and government budgets imploded, even this ceased abruptly.

Hospitals and other facilities are left to rot for lack of maintenance or shut down altogether. The much slashed government paid remuneration of over-worked medical staff was devoured by hyperinflation and stagnated ever since. Equipment falls into disrepair. Libraries stock on tattered archaic tomes.

Medicines and other substances - from cultures to vaccines to immunological markers - are no longer affordable and thus permanently in short supply. The rich monopolize the little that is left, or travel abroad in search of cure. The poor languish and die.

Healthcare provision in east Europe is irrational. In the healthcare chapter of a report prepared by IRIS Center in the University of Maryland for USAID, it says:

"In view of the fall in income and government revenue, there is a need for more accurate targeting of health care (for instance, more emphasis on preventive and primary care, rather than tertiary care), and generally more efficient use of benefits (e.g., financing spa attendance by Russian workers can be cut in favor of more widespread vaccination and public education). As the formal privatization (much is already informally privatized) of health care proceeds, and health insurance systems are developed, health care access for poverty-stricken groups and individuals needs to be provided in a more reliable and systematic way."

But this is hard to achieve when even the token salaries of healthcare workers go unpaid for months. Interfax reported on March 9 that 41 of Russia's 89 regions owe their healthcare force back wages. Unions are bereft of resources and singularly inefficacious.

The outcomes of a mere 6 percent of national level consultations in Lithuania were influenced by the health unions. Their membership fell to 20 percent of eligible workers, the same as in Poland and only a shade less than the Czech Republic (with 32 percent).

No wonder that "under the table" "facilitation fees" are common and constitute between 40 and 50 percent of the total income of medical professionals. In countries like the Czech Republic, Croatia, and chaotic Belarus, the income of doctors has diverged upwards compared to other curative vocations. It is not possible to obtain any kind of free medical care in the central Asian republics.

This officially tolerated mixture of quasi-free services and for-pay care is labeled "state-regulated corruption" by Maxim Rybakov from Central European University in his article "Shadow Cost-sharing in Russian Healthcare".

As though to defy this label, the Russian Ministry of Health is conducting - together with the Audit Chamber and the Ministry of the Interior - a criminal investigation against healthcare professionals. The Russian "Rossiiskaya Gazeta" quoted in Radio Liberty/Radio Free Europe:

"According to Shevchenko (the Russian minister of health), there are some 600,000 doctors and 3 million nurses working in Russia today; of this total around 500 medical workers are currently being investigated on suspicion of a variety of offenses such as taking bribes, using fake medical certificates, and reselling medicine at a profit. Shevchenko also stated that the State Duma will soon adopt a law on state regulation of private medical activities, which he said will put the process of commercializing medical establishments on a more legal footing."

The UN's ILO (International Labour Organization) warned, in a December 2001 press release, of a "crisis in care". According to a new survey by the ILO and Public Services International (PSI):

"The economic and social situation in several East European countries has resulted in the near collapse of some health care systems and afflicted health sector workers with high stress, poor working conditions and salaries at or below minimum wage - if and when they are paid."

Guy Standing, the ILO Director of the Socio-Economic Security Program and coordinator of the studies added:

"Rapidly increasing rates of sexually-transmitted diseases, HIV/AIDS, tuberculosis and numerous chronic diseases have created a crisis of care made all the more dramatic by diminishing public health structures, lack of training of health care professionals and general de-skilling of the workforce. All of this has surely contributed to the catastrophic fall in life expectancy rates in Russia, Ukraine and some other countries in the region."

The situation is dismal even in the more prosperous and peaceful countries of central Europe. In another survey, also conducted by the ILO ("People's Security Survey"), 82 percent of families in Hungary claimed to be unable to afford even basic care.

This is not much better than Ukraine where 88 percent of all families share this predicament. Agreements signed in the last two years between Hungarian hospitals and cash-plan insurers further removed health care from the financial reach of most Hungarians.

Healthcare workers in all surveyed countries - from the Czech Republic to Moldova - complained of earning less than the national average and of crippling wage arrears. In some countries - Armenia, Moldova, Kyrgyzstan - few bother to clock in anymore. In others - Poland and Latvia, for instance - a much abbreviated working week and temporary labor contracts are imposed on the reluctant and restive healthcare workers.

One in twenty hospitals in Poland had to close between 1998-2001. In an impolitic spat of fiscal devolution, ill-prepared local authorities throughout the region were left to administer and finance the shambolic health services within their jurisdictions.

The governments of east Europe tried to cope with this unfolding calamity in a variety of ways.

Consider Romania. Half the population claim to be "very satisfied" with its health services.

In Romania, the 1997 Health Insurance Law shifted revenue collection and provider payments to a maze-like coalition of 41 district health insurance houses (HIH) headed by a National Health Insurance House. Romanian citizens are forced to foot one third of their health bills in a country which spends a mere 3 percent of GDP on the salubrity of its citizens - the equivalent of $100 per year per capita. Only a small part of this coerced co-financing is formal and legal.

About 70 percent of the meager state budget is derived from erratic payroll health insurance fund contributions, now set at 14 percent of wages. The national budget supplements the rest. Some of the contributions are distributed among the poorest regions to narrow the inequality between urban and rural areas.

The HIH's pay health care providers, such as hospitals based on capitation, or a projected global budget. They are experimenting now with fee-for-service reimbursement methods. All these payment systems, inevitably, are open to abuse. Monitoring and auditing are poor and relations are incestuous.

The Ministry of Health still makes all major procurement decisions. Many government organs - the Ministry of the Interior, the transport system, the Army - all maintain their wastefully parallel care provision networks. Donor funds, multilateral financing, and government money have all vanished into this insatiable sink of venality.

The only rays of light are private dental and medical clinics, laboratories, and polyclinics working side by side with private pharmacies and apothecaries. These cater to the well-to-do. But the government emulated them and "privatized" the institution of the family physician (general practitioner).

GP's now receive, on a contractual basis, payment per socially-insured patient treated. They make rent-free use of clinics and equipment in their workplace. Many of these doctors now borrow small amounts from willing banks - a scarcity in Romania - to open their own practice.

In an article published on March 2000 in "Central Europe Review" and titled "Trying our Patients", Professor Pavel Pafko, Head of the Third Surgery Department, Charles University Faculty Hospital, Prague, lamented the state of Czech medicine:

"After the 1989 Velvet Revolution, there were fundamental changes in the health service: the market was opened to manufacturers of medical equipment, aids and medicines, and Parliament announced the right for everyone to choose their own doctor. In my opinion, the health service was not sufficiently prepared for these fundamental changes.

In the public's mind the idea of 'free health care' survived and continues to survive from the Communist period, as does the idea that all of us are equal as long as we are healthy. The sick man in many cases loses this equality and cannot himself pay by legal means for what the state, or rather the insurance companies, have no resources to provide."

Expenditure on health amounted in the 1990's to c. 7 percent of GDP per year (compared to 14 percent of a much larger GDP in OECD countries). But medical insurance firms cannot cope with vertiginous prices of imported medicines. Hospitals now receive insufficient lump-sum payments rather than getting reimbursed for procedures and treatments carried out. Naturally, most of these go towards staff wages. Little is left for medical care.

Poland is in no better shape. Its embattled minister of health, Mariusz Lapinski, stumbles from crisis to criticism in his doomed effort to reform a ramshackle system. The two current scandals involve heavily and unsustainably subsidized drugs and a new health bill, fiercely opposed by progressive interests, such as medical doctors and nurses. The Polish weekly, Wprost, went as far as comparing Poland's healthcare to Egypt's, Turkey's, and Mexico's.

The World Bank discovered in 1998 that 78 percent of Poles had to pay illicitly to obtain basic care. Lapinski intends to dissolve the regional state health funds and resurrect them in the form of a national edition. But state-run hospitals in Poland are insolvent. Naturally, healthcare workers have little faith in the management skills of the state.

They are calling for open competition among teams of commercial health insurance funds and health care providers. They would also like to increase health insurance contributions to allow Poland to spend on health more than the current 5.5 percent of GDP.

UPI reported recently ("Shock Therapy in Macedonian Healthcare") about a strike of medics in Macedonia as typical of the problems facing the healthcare systems of all countries in transition: privatization, the involvement of the state, and Western influence of the reform process. The transition to the western General Practitioner (GP) model is hotly debated. As far as doctors are concerned, it is a lucrative proposition. But it could exclude poorer patients from medical care altogether.

Still, the main problem is the gap between grandiose expectations and self-image - and shabby reality. East European medicine harbors fantastic pretensions to west European standards of quality and service. But it is encumbered with African financing and Vietnamese infrastructure. Someone must bridge this abyss with loads of cash. Either the government, or the consumer must cough up the funds. The sooner everyone come to terms with this stressful truth - the healthier.

About the Author

Sam Vaknin ( http://samvak.tripod.com ) is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He served as a columnist for Central Europe Review, PopMatters, and eBookWeb, and Bellaonline, and as a United Press International (UPI) Senior Business Correspondent. He is the the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

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