One of the reasons I love my job is the sheer variety of conditions that I see. And these past few weeks, I've been working with a patient with Parkinson's disease (PD).

This progressive neurological disease - characterised by tremor, muscle rigidity, slowness of movement, and impaired balance and co-ordination (think about Muhammad Ali's last public appearances) - has no cure. Medications used to control the symptoms (dopaminergic drugs that mimic the action of dopamine) stop working after a while and have severe long-term effects on the nervous system such as nausea, confusion and hallucinations.

Enter scalp acupuncture, which I learned at the Heilongjiang University of Chinese Medicine when I was doing my hospital placement in 2014. Up to that point, I had been learning traditional acupuncture, whose origins can be traced back to ancient China more than 2,500 years ago. Scalp acupuncture is a relatively new kid on the block, developed in China in the 1950s. It integrates traditional Chinese needling methods with Western medical knowledge of the areas on the scalp that correspond with the central nervous system's functions (such as motor activity, sensory input, vision, speech, hearing and balance).*

It just so happened that in that part of northern China where Heilongjiang is located, the incidence of strokes is the highest in China. The explanation I heard over and over was this was due to the high rates of smoking and alcohol consumption, and the high-fat diet (think foods that are mostly fried). As a result of the high number of stroke patients, the Chinese medicine hospitals became very good at rehabilitating post-stroke patients. Doctors used a combination of Western medicine drugs, Chinese medicine herbs, physical therapy, Chinese medical massage, body acupuncture, and scalp acupuncture.

(As an aside, a 2010 documentary called 9,000 Needles by an American filmmaker, Doug Dearth, chronicles his brother Devin's journey after Devin suffered a massive stroke. When he couldn't get the care he needed in the US, he travelled to a hospital in Tianjin in China, where he is treated with acupuncture.) 

There is evidence that scalp acupuncture is effective for the treatment of Parkinson's disease, although larger-scale trials are needed. However, I can say that after five acupuncture sessions, my PD patient shows better movement, less tremor, and improved energy levels and mood. PD is a cruel degenerative disease, but I believe that with scalp and body acupuncture, the quality of life of someone with PD can be greatly enhanced.


* Hao, J.J. and Hao, L.L. (2011) Chinese scalp acupuncture. Boulder, Colorado: Blue Poppy Press.

One of the great things about my placement at this hospital in Harbin is the opportunity to observe the rehabilitation of post-stroke patients. I observed in the clinic of Dr Cheng Wei Ping for two weeks and marveled at his skill in scalp acupuncture, helping people move and speak again after a stroke. But the doctor and his students are often too busy to explain the points used on the head, and my limited language skills don't help.

So it was a wonderful opportunity to hear Professor Lu Jin Rong (second from the right in the photo) talk about the basics of scalp acupuncture last week. Compared with classical acupuncture, which has been around for at least 2,000 years, scalp acupuncture is a new development, having been developed in China only over the past 40 years. It is a combination of acupuncture needling techniques and modern knowledge of the brain and its functions.

As a student, I learned the 360 classical acupuncture points -- although only about 100 are commonly used in clinic. However, scalp acupuncture does not use acupuncture points per se, but rather areas on the head that are related to different functions. Professor Lu taught us how to find the motor zone (used for paralysis of the body and face, including speech problems), sensory zone (for numbness like in neuropathy), tremor zone (to reduce symptoms of Parkinson's), and visual and balance zone on the scalp. Professor Lu showed us the techniques for needling and manipulation. It was an amazing afternoon, and was exactly one of the reasons I came to China.

This is not to say that we can be experts with stroke and facial paralysis anytime soon, but it gives us a good grounding to be able to go away and do our own research and try these techniques in clinic when we go home.

On Heping Road in the Xiangfang District of Harbin stands a wonderful new hospital complex devoted to Chinese medicine. Or more accurately, the integration of traditional Chinese medicine and Western medicine. This is my home for the next three months.

My first few weeks will be spent observing Dr Cheng Wei Ping, a famous specialist in neurological conditions such as stroke and facial paralysis, so common in this northeastern corner of China. Dr Cheng holds consultation every morning and might see 30-40 outpatients a morning, aided by about a dozen student assistants. Twice a week he makes the round of wards in the hospital to check on patients with the most serious and acute conditions.

While strokes require immediate life-saving treatment by western medicine, the chronic long-term effects such as loss of speech or movement are not dealt with as well by western medicine. However, scalp acupuncture has been developed over the past 40 years in China, marrying Chinese needling techniques with Western medical knowledge of the cerebral cortex. Many studies show positive results in treating disorders of the nervous system.

Last week my classmates and I observed inpatients and outpatients receiving acupuncture or herbs, more often in combination. Most of the scalp points were unfamiliar -- we were certainly not taught those points at London South Bank! After some reading we realised that these were not actually acupuncture points but were actually areas of the scalp, and mapped directly over parts of the brain controlling areas like speech, motor, sensory, vertigo and hearing, or tremor control. So needles were inserted into patients' scalps depending on what part of the brain needs to be stimulated. Post-stroke patients who have paralysis or weakness of legs will have their foot motor areas needled and stimulated vigorously. 

Lots of research to do this weekend then, so I can understand more of what I will see in Dr Cheng's clinic next week.