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Hysterical aphonia & electroacupuncture - Acupuncture and Moxibustion

Townsend Letter for Doctors and Patients, April, 2003 by Honora Lee Wolfe

Keywords: Conversion disorders, hysterical aphonia, Chinese medicine, Chinese medical psychiatry, electroacupuncture

In Western psychiatry, so-called hysterical aphonia is classified as a conversion reaction. In Chinese medicine, it is one of the psychiatric disorders which is routinely treated with acupuncture instead of internally administered Chinese medicinals. Recently Dr. Yang Yong published an article titled, "The Treatment of 35 Cases of Hysterical Aphonia by Electroacupuncture," in Si Chuan Zhong Yi (Sichuan Chinese Medicine), #6, 2001, on page 76. A summary of that report appears below.

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There were 33 females and two males in this study of 35 patients altogether. The youngest patient was 16 and the oldest was 55 years old. The shortest course of disease was one day, and the longest was three months. Twenty-six cases had already been treated with unspecified medications without result. Nine cases had not received any treatment at the time they came for acupuncture. Twelve cases had a previous history of hysterical disease.

Treatment method:

The points chosen for treatment were Ya Men (GV 15), Lian Quan (CV 23), and Tong Li (Ht 5), bilateral. Ya Men and Lian Quan were needled with 30 gauge 1.5 cun fine needles. Ya Men was needled perpendicularly or with the tip angled down to a depth of 0.8-1.2 cun. Lian Quan was also needled 0.8-1.2 cun deep under the base of the tongue. Then twisting hand technique was used to drain the points. After the needles had been in these two points for one minute, Tong Li was needled with a 30 gauge one cun fine needle perpendicularly to a depth of 0.3-0.5 cun. Twisting technique was applied to administer even supplementing-even draining. Then Ya Men and Lian Quan were stimulated electrically with a G6805 machine with continuous waves and 120-150 cycles per minute with strong stimulation. The needles were retained for 30 minutes. When the needles were withdrawn, pressure was applied to the needle holes to prevent bleeding.

Treatment outcomes:

All 35 cases were judged cured by the above treatment method. This meant that, after treatment, their speech was clear and uninhibited. Nineteen cases were cured in a single treatment, while the remaining 16 required 2-3 treatments.

Representative case history:

The patient was a 37 year-old female who was initially seen on June 9, 1999. According to her family, the woman had stopped talking and had become uncommunicative two weeks before. On examination, there was no hyperemia or edema of the throat, no nodules on the vocal cords, and the movement of the cords was normal. Nevertheless, the woman could not utter a word. Her tongue was pale red with a red tip and slightly yellow fur. Because the physical examination was negative, she was diagnosed as suffering from hysterical aphonia and treated one time with the above electroacupuncture protocol, after which she recovered her voice. She was given one more treatment to consolidate and secure the treatment effects. There was no recurrence, and the woman was judged cured.

Discussion:

According to Dr. Yang, Lian Quan is located in the region of the tongue and throat and is a transport point on the conception vessel. Its effects are that it frees the flow of the tongue and disinhibits the throat and voice. The tongue is the sprout of the heart and the heart opens into the orifice of the tongue. Tong Li is a transport point on the hand shao yin heart channel and soothes and regulates the heat qi. It is also able to free the flow of the orifices and network vessels associated with the heart, specifically treats aphonia, and settles, stills, and quiets the spirit. Ya Men is a transport point on the governing vessel. It is located in the region of the occiput. Its vessel flows or connects freely with the brain. It is also connected to the root of the tongue. This point is able to free the flow of the channels and network vessels, open the spirit orifices, clear the spirit mind, and disinhibit speech. When these three points are used together, front and back, above and below, they free the flow and regulate the conception and governing vessels, balance yin and yang, free the flow of the orifice of the mouth and increase speech.

That being said, this is another example of a fairly intense, even painful or at least uncomfortable, acupuncture treatment being used to treat this disease. Like other such intense acupuncture treatments for conversion disorders, it typically gets a good effect in one treatment, and, personally, I do not find it hard to see why. I do not believe the theoretical rationalizations given by Dr. Yang have anything much to do with the efficacy of this treatment!

For more information on the Chinese medical treatment of conversion disorders, please see Bob Flaws & James Lake's Chinese Medical Psychiatry available from Blue Poppy Press or Blue Poppy Institute's Treating Mental-emotional Complaints with Chinese Medicine.

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Hysterical aphonia & electroacupuncture - Acupuncture and Moxibustion

Townsend Letter for Doctors and Patients, April, 2003 by Honora Lee Wolfe

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