Multiple Chemical Sensitivities Successfully
Treated With Classical Five-Element Acupuncture
Kim Smith, MD
Background Multiple chemical sensitivities (MCS) is a poorly understood complex of diverse symptoms occurring in susceptible people after contact with airborne pollutants, often of the type found in modern buildings. It has been called "sick building syndrome." Some individuals have very low thresholds of sensitivity to the point of being disabled by many indoor environments. This condition has both physical and psychological symptoms. No treatment is consistently effective.
Objective To report the successful treatment of MCS in a patient using Classical Five-Element Acupuncture.
Design, Setting, and Patient A case report of a 55-year-old woman with a history of disabling MCS for the previous 5 years.
Intervention The patient was treated weekly for 10 months with appropriate points selected for their mental and spiritual connotations, and points on her causative factor meridian. Co-interventions were counseling and minimal lifestyle changes.
Main Outcome Measure Resolution of symptoms attributed by the patient to building and household airborne inhalants.
Results The patient's symptoms resolved after the first 6 weeks of treatment and did not reoccur throughout the remaining 8 months of therapy.
Conclusion This case suggests Classical Five-Element Acupuncture, having both physical and emotional effects, may be an appropriate therapy for MCS, and perhaps for other conditions with both physical and emotional components.
Multiple Chemical Sensitivity, "Sick-Building Syndrome," Psychophysiologic Illness, Acupuncture, Classical Five-Element Acupuncture, Allergy
The term multiple chemical sensitivity (MCS) refers to an acquired condition of reported recurrent symptoms involving multiple organ systems that occurs upon exposure to many chemically unrelated compounds at doses far below those established in the general population to cause symptoms. The most common complaints are fatigue, headache, nausea, malaise, pain, mucosal irritation, disorientation, dizziness, depression, irritability, poor concentration, and mood instability. The exposures reported to trigger these symptoms are legion. They include1 foods, any synthetic product, formaldehyde, phenol, ammonia, hydrocarbons, petrochemicals, cleaning solvents, paints, smoke, gasoline, vehicle exhaust fumes, pesticides, perfumes, structural plastics, building materials, new carpeting, fungi, viruses, yeast, wood dust, and even endogenous hormones such as progesterone. Physical findings are usually absent in these cases. Studies examining patients' levels of circulating immunoglobulins, complement components, and lymphocyte subsets generally find that most fall within the normal expected ranges, with some exceptions, and do not always correlate with severity of reported illness or length of reported exposure to the presumed causative agent.
Individuals who develop chronic disabling symptoms after known exposure to substances have a significantly higher prevalence of pre-existing anxiety, depression, somatization, and medically unexplained symptoms compared to others who were exposed and had only mild transient symptoms. Although many patients and some physicians regard MCS as a genuine physiologic phenomenon,2 mainstream allergists and immunologists regard it as primarily a somatiform disorder.3 There are no standard diagnostic tests for MCS and diagnosis is by history only. There is no standard treatment other than avoidance, which can lead to social isolation. This is, therefore, not a condition that most physicians find easy to treat.
A 55-year-old woman presented with a 12-year history of becom-ing depressed, lethargic, confused, and anxious whenever she was ex-posed to any household or industrial vapors including all cleaning
products, carpet and paint odors, and perfumes. She was under treatment from an internist and a psychiatrist who diagnosed bipolar disorder, depression, and anxiety disorder. She was placed on lithium, clonazepam, buspirone, triagabine, amlodipine besylate, and zolpidem tartrate, without improvement. Her other medical problems included irritable bowel syndrome, hypothyroidism, hypercholesterolemia, and osteoporosis, all being medically treated. Her surgical history included hysterectomy for ovarian cysts and endometriosis, and hammertoe surgeries.
The patient had worked many years as an administrative assistant first for a police department and then for a large corporation until December 2002 when her symptoms became too prominent. She reported confusion to the extent that she was unable to follow co-workers' conversation, headaches from any fragrance, insomnia, poor coordination, word-finding difficulties, irritability, agitation, and lethargy. Her symptoms improved somewhat upon retirement but would reoccur if she inhaled any scent of laundry or dish soap or other household products.
Physical examination revealed a mildly obese middle-aged woman in no obvious distress. She had a careful steady gait, a mild kyphosis without scoliosis, normal range of motion of limbs, normal muscularity for her age, clear skin and nails, and good hygiene. She had normal temperature of the 3 Jiao and no tenderness over the Hara points. Her umbilical pulse was centered. The patient's blood pressure was 116/80 mm Hg, pulse 62/min and regular. She was oriented; however, speech was rambling and occasionally confused, with some loose associations. Her affect was moderately labile. Her eyes showed evidence of the energetic block known as "possession." Her odor was scorched, her skin color at the temples was ashen, she was laughing, and her emotion alternated between inappropriate expression of joy and lack of joy.
Multiple chemical sensitivity (MCS) is a disease with both physical symptoms and emotional components. Therefore, it seems reasonable to treat it with a modality that affects both of these aspects of the patient. Classical Five Element Acupuncture (CFEA), as taught by the late professor J.R. Worsley and currently by his successor Dr. J.B. Worsley, diagnoses each patient not by symptoms but by evidence of the most fundamental underlying imbalance in the person.4 Chinese cosmology views the universe and the human being as comprising 5 elements: Earth, Fire, Wood, Metal, and Water. Each of the 12 paired acupuncture meridians is associated with one of the elements. Some degree of imbalance among the elements is an inevitable part of human life. Also, for each person, there will be 1 element that is the weak link and will give way first when we are stressed in some way. That element is the person's Causative Factor (CF) because once that element begins to fail in its functions, then all the other elements are forced to attempt to compensate. At that point, any symptom may arise. Consequently, in CFEA, symptoms can never reveal the underlying imbalance. The CF is revealed by the odor of the patient as smelled in the room, the color beside the eyes, the quality of the voice, and the patient's predominant inappropriate emotion. (It is the inappropriate emotion we are looking for because we are identifying imbalance.)
CFEA also includes several formulaic treatments for specific conditions. The first is the Seven Internal Dragons and Seven External Dragons. This group of points activates the healing powers of the individual to remove a particular energetic block known as "possession." Possession is a deep disturbance that interferes with one's control of one's own energy. The need for this treatment is revealed in the patient's gaze, which will appear veiled, making it difficult for the practitioner to sense a connection to the patient through eye contact. This patient was treated with the Dragons and had an immediate change in her demeanor, becoming much calmer and more present.
Next, CFEA employs a formula for clearing toxic and polluted Qi, referred to as Aggressive Energy. This is accomplished by placing needles superficially in the Associated Effect Points (Shu points) of the predominantly Yin organs. This produced redness around the Wood (BL 18), Earth (BL 20), and Water (BL 23) points, exceeding that of the control needles placed in nearby non-meridian locations, indicating the presence of Aggressive Energy. This required 1 hour and 45 minutes to clear.
Finally, the patient was treated with GV 14, HT 1, HT 7, and SI 4 to complete her initial treatment. These points were chosen because her CF was Fire, specifically Small Intestine, so the left hand Fire meridians of HT and S 1 constituted the main meridians of treatment for her regardless of the specific symptoms with which she presented.
The patient was treated every 1-3 weeks. Each treatment consisted 1st of 2 or 3 points selected from either her CF meridian or from the General Spirit points for their effect on her spirit. (Spirit is that intangible combination of will to live, emotional presence, fluidity of interaction, clarity of expression, vibrancy, and shine in the eyes.)
Secondly, Command points, always on the CF meridians, were used. Each point was warmed with direct moxibustion 3-7 times, piqured bilaterally 3-6 fen at an angle of 15° in the direction of Qi flow; De Qi was obtained, the needle was rotated 180° clockwise, and immediately rapidly withdrawn producing tonification. Used were Pang Bong 40 mm 0.025-inch diameter spring handle needles (Lhasa Supply Co).
Regarding lifestyle requirements, the patient was asked to refrain from coffee, and to drink 1 oz of water for every 2 lb of body weight daily. This patient was already employing these measures in her lifestyle. She was also already exercising regularly as we would usually recommend to anyone in search of well-being. This patient, with the consent of her other physicians as well, gradually decreased andstopped clonazepam, zolpidem tartrate, and triagabine.
Improvement was rapid in this patient. Within 5 days, sleep had improved, energy increased, and her depression decreased. By the 3rd treatment at 5 weeks, she reported less irritability, increasing tolerance to odors, and greater relaxation. Within 2 months, she reported resolution of her chemical sensitivities. As treatment progressed, the patient's mood varied and became increasingly positive and stable. At 10 months, she was sleeping well, feeling stable and happy, no longer affected by inhalants, and in the process of gradually decreasing buspirone and amlodipine besylate (taken as a mood stabilizer).
This patient had been treated by a psychiatrist for 12 years and was on multiple medicines – yet was still symptomatic and desperate. It is unclear which, if any, of her symptoms were truly inhalant chemical induced and which were due to her pre-existing psychiatric issues. Her diagnosis of bipolar disorder, made so late in life, is not certain.
From the perspective of ancient Chinese CFEA, the distinction of mental vs physical origin is less important because all disease is seen as a malfunction of the subtle energetic workings of nature in the individual. All treatment is directed at discerning and correcting the fundamental imbalance of the elements in the person. It is the person we are treating, not their symptoms. Restoring balance allows the body to resume normal functioning and heals the symptoms, as this case demonstrates. When we piqure points in CFEA, we recognize that we are not the ones personally healing the body, mind, or spirit of that patient. We are merely invoking the inherent healing potential that was dormant in the patient, and balance then begins to be restored. It is for this reason that there are usually no particular points for particular symptoms. Two patients with similar symptoms may have quite different underlying imbalances. This makes control groups difficult, and makes every case unique. Generally, most patients may not receive identical treatments.
There are many conditions where the cause of the disease and the conventional treatment is unclear, with MCS being only one example. CFEA can be used to discern and correct the underlying imbalance in the person and thereby help relieve symptoms. This is a reasonable approach to use in many diseases, and was extremely effective in this case. Acupuncture may be a successful adjunct in this condition.
- Ford M, Delaney KA, Ling L, Erickson T. Clinical Toxicology. Philadelphia, PA: WB Saunders Co; 2001.
- Rakel D. Integrative Medicine. Philadelphia, PA: WB Saunders Co; 2003.
- Adkinson NF, Yunginger JW, Busse WW, et al. Middleton's Allergy: Principles and Practice, 6th ed. St. Louis, MO: Mosby; 2003.
- Worsley JR. Classical Five-Element Acupuncture. In 3 vols. Charlottesville, VA: Worsley Institute of Classical Five-Element Acupuncture.
Dr Kim Smith practices Emergency Medicine at Ocean Beach Hospital in Ilwaco, Washington, and CFEA in Seattle, WA. Dr Smith is currently in the ongoing Master Apprentice Program under Dr J.B. Worsley.
Kim Smith, MD, DABMA*
1529 Queen Anne Ave N, Ste 100
Seattle, WA 98109
*Correspondence and reprint requests