Clinical Placement Reflection: Bell’s Palsy and TCM Perspective

Kit Li

During my first day of clinical placement, I shadowed Prof Yang Lu at the Acupuncture Department of Nanfang Hospital (1). His specialised areas include bloodletting therapy, auricular acupuncture, and embedding needle therapy for the treatment of neck, shoulder, lower back, and leg pain, Bell’s palsy, stroke rehabilitation, neurological disorders, and internal conditions such as asthma, vertigo, stomach pain, constipation, and obesity. Although the time was limited, the knowledge I gained from him was extremely valuable.

The Acupuncture Clinic was always fully packed and busy. I remember one morning when around 20 patients were queuing outside the treatment room waiting to be seen. The room contained 10 treatment beds, six electroacupuncture devices, TDP lamps, and three fully equipped trolleys containing various TCM tools. It was a simple medical setting, yet it consistently delivered effective care, as each professor had unique techniques and approaches to treating patients efficiently and successfully.

During my clinical practice, I encountered a wide range of conditions, including Cervical Spondylosis, Sciatica, Bell’s Palsy (BP), post-stroke symptoms, Parkinson’s Disease, cataracts, and emotional disorders. However, the most unforgettable case was a four year-old girl suffering from Bell’s Palsy. She was not the only patient with this condition; even among the adults, around six out of fifteen patients that morning were receiving treatment for Bell’s Palsy.

Honestly, I had never imagined that Bell’s Palsy could occur at such a young age. During the case discussion, Professor Yang explained that in younger patients, the condition is often associated with flu-like infections affecting the ear region.

From a TCM perspective, Bell’s Palsy is often categorised under 'Wind-Stroke' or 'Deviation of the Mouth and Eye'. When it appears after a viral illness, such as herpes simplex, shingles/Ramsay Hunt syndrome, flu-like infections, or an immune flare-up, TCM does not describe the virus in biomedical terms. Instead, it interprets the condition as an external pathogenic factor disrupting the body’s internal balance.

How Does TCM View Virus-Associated Bell’s Palsy?

1. Wind-Heat Toxin

Signs and symptoms: Cold or flu symptoms, sore throat, fever, swollen glands, ear pain, and facial inflammation.

Treatment principle: Expel Wind, clear Heat, resolve toxicity, and open the channels.

TCM interpretation: External Wind combined with Heat or Toxic Heat invades the channels, causing inflammation and obstructing the flow of Qi and Blood within the facial meridians.

2. Damp-Heat or Toxic Heat

Signs and symptoms: Heaviness, swelling, redness, ear vesicles (such as shingles), yellow phlegm, and digestive sluggishness.

Treatment principle: Clear Damp-Heat, detoxify, and transform Phlegm.

TCM interpretation: Dampness and Heat combine with toxin, obstructing circulation within the channels and collaterals.

3. Zheng-Qi Deficiency

Signs and symptoms: Stress, exhaustion, poor sleep, and overwork.

Treatment principle: Strengthen Wei-Qi (defensive Qi), support Spleen and Lung function, and prevent recurrence.

TCM interpretation: Wei-Qi becomes weakened, leaving the body more vulnerable to external pathogenic invasion.

4. Blood Deficiency with Channel Malnourishment

Signs and symptoms: Fatigue, pale complexion, dizziness, dry skin, numbness, muscle weakness, poor circulation, pale tongue, and thready pulse.

Treatment principle: Nourish Blood, regulate Qi and Blood circulation, and nourish the channels and sinews.

TCM interpretation:
When Blood is deficient, the channels and facial muscles become undernourished, weakening the body’s ability to support normal movement and tissue recovery. As a result, residual pathogenic factors may remain within the meridians, delaying healing and prolonging facial weakness or stiffness.

Once the patient’s condition has stabilised, acupuncture treatment (2, 3) should be considered as early as possible. The first seven days are especially crucial for recovery. Shallow needling is generally preferred, particularly on the affected side of the face. Daily treatment is considered ideal, although treatment three to four times per week may still be effective.

However, electroacupuncture is usually avoided during the first seven days, as the facial nerves are already inflamed and damaged, and excessive stimulation is not recommended during the acute stage.

I spoke with the little girl’s mother to better understand the onset of her condition. The child had suffered from a fever for three days in April, and on the fourth day, the left side of her face became paralysed. She was unable to blink her left eye, and the muscles around her mouth became difficult to control.

The recovery process may take approximately 20 days if daily treatment is provided, although outcomes vary depending on the patient’s condition and constitution. During my placement, I witnessed encouraging improvement by her sixth treatment on the fifteenth day. The facial muscles on the affected side had become more relaxed, especially around her left eye and mouth, which were beginning to move more naturally.

According to her mother, the only remaining noticeable issue was that her mouth would still deviate slightly when smiling or crying. She had initially started treatment twice a week from the end of April until mid-May.

On my last day of placement, I saw the little girl again. She was noticeably more cheerful, talkative, and relaxed than when I first met her at the Acupuncture Department.

Seven Key Lifestyle Suggestions for Patients

1. Consume more vegetables and fibre-rich foods in your diet, including tofu, bean products, sweetcorn, lean meat, onions, seaweed, red dates, hawthorn (Shanzha), bitter melon, winter melon, bananas, aubergines, pumpkins, and blackberries.
2. Avoid spicy and overly sour foods, hot-natured foods, strong tea, alcoholic drinks, lamb, and animal organs such as liver and kidneys.
3. Soak your feet in warm water before bedtime for 10–20 minutes to promote circulation and relaxation.
4. Minimise overstimulation from activities such as excessive phone use, television, and laptop screen time.
5. Moderate exercise is beneficial for recovery. Listening to calming music, maintaining a regular sleeping pattern, and keeping emotions stable may also support healing.
6. Perform gentle facial muscle exercises regularly, such as raising the eyebrows, tightly closing the eyes, puffing the cheeks, opening the mouth, wrinkling the nose, and smiling gently. Applying a warm damp towel to the neck and facial area may help relax the muscles. Avoid washing the face with icy cold water, as cold stimulation may aggravate the condition. During windy or cold weather, keep the face and neck well protected.
7. When facial muscles feel weak or difficult to control, practise gently closing the eyes and mouth tightly to improve muscle coordination and awareness.

This placement experience deepened my understanding not only of Bell’s Palsy from both biomedical and TCM perspectives, but also of the importance of early intervention, patient reassurance, and consistent treatment. Most importantly, it reminded me that healing is not only about restoring physical movement, but also about rebuilding confidence, comfort, and hope in the patient’s daily life.

References: 

1) Nanfang Hospital: https://www.smu.edu.cn/english/info/1026/1068.htm

2) Cochrane Review: 'Acupuncture for Bell’s Palsy': 

https://www.cochrane.org/evidence/CD002914_acupuncture-bells-palsy

3) Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs: https://pubmed.ncbi.nlm.nih.gov/31083225/

More Than Acupuncture: A Journey of Growth and Connection

Kit Li

May is a month of connection, connection with family, with learning, and with the path I continue to walk. Once again, I returned to Guangzhou, continuing a journey that first began last year.

My deepest gratitude goes to Professor Tang and Director Huang, Head of the Acupuncture Department, whose thoughtful arrangements gave me the invaluable opportunity to continue shadowing the masters at the Acupuncture Department of Nanfang Hospital (1). During this visit, I had the privilege of learning directly from Director Huang, Professor Wang, Director Yang, Professor Li, and Professor Zhao throughout their clinical sessions. Each of these remarkable teachers guided me with patience and generosity, sharing not only their techniques, but also the wisdom and spirit behind their practice.

Although I am already a qualified Chinese Medicine practitioner, this experience reminded me that true learning has no end. The deeper one enters this field, the more one realises how much there still is to understand.

What moved me most profoundly was not only the exquisite needling techniques I observed, but the essence that animated them. In every consultation and every gesture, there was calmness, precision, compassion, and quiet confidence. These masters transformed each clinic day into something far beyond technical instruction, it became a living lesson in humanity, presence, and healing. Their way of practicing wove together rigour and gentleness, discipline and warmth, inspiring not only the mind, but also the heart.

I am equally grateful to Director Huang for trusting me with the opportunity to share my own knowledge and experience with a group of bright young interns. Teaching them became a meaningful reminder that learning is never one-sided. In guiding others, I found myself learning again, with renewed humility, reflection, and joy. That exchange of knowledge, and the passing forward of experience, became a gift for all of us.

This journey was never solely about acupuncture. It was also about humility, connection, and becoming a little wiser, not only as a practitioner, but as a person.

To everyone who guided, supported, and inspired me during this time, thank you from the bottom of my heart.

Reference:

1) Nanfang Hospital: 

https://www.blogger.com/blog/post/edit/625877704656314609/7543424818091866262?hl=en-GB#

A Return to Guangzhou: Clinical Placement and Anatomical Exploration at Nanfang Hospital

Kit Li

Last autumn, I completed my first clinical placement at the Integrated Hospital of Traditional Chinese and Western Medicine of Southern Medical University in Guangzhou. Seven months later, I returned to Guangzhou for my second clinical placement, this time in the Acupuncture Department at Nanfang Hospital (NH) (1).

On my first day at Nanfang Hospital, I was honoured to be given a one-hour tour by Professor Huang, the Head of the Acupuncture Department, before beginning my clinical practice under the supervision of Professor Yang Lu. The tour provided a valuable introduction to the department and offered insight into the hospital's clinical services, teaching facilities, and research activities.

Nanfeng Hospital was founded in 1941 as the Rear Hospital of the Third Division of the New Fourth Army, NH has a long and distinguished history. In 2018, it was selected as a national pilot hospital for multidisciplinary tumour treatment. In 2004, the hospital transitioned from military to provincial management, aligning with its university, formerly the First Military Medical University, now known as Southern Medical University. Today, NH is recognised as one of the leading general hospitals in South China, with a strong emphasis on both medical service and education.

NH directly hosts, manages, and trains more than 2,500 full-time undergraduate students and over 1,000 full-time postgraduate students each year. The university also welcomes approximately 1,000 to 1,200 international students from more than 90 countries. Student accommodation is provided on campus, with over 8,000 students living in shared dormitories, typically with two or three students per room. Academic studies at NH and Southern Medical University focus primarily on medical and clinical disciplines, including Clinical Medicine, Advanced Clinical Technologies, Traditional Chinese Medicine (TCM), and postgraduate research fields.

During this trip, I also visited the anatomical museum affiliated with NH, officially known as the Southern Medical University Human Science Museum (2), located on the main university campus. The museum is particularly renowned for its world-class corrosion casting specimens, created by injecting coloured polymers into blood vessels to produce intricate, coral-like three-dimensional displays. One of its most treasured exhibits is a cardiovascular cast created in 1978, recognised as the first successful specimen of its kind in China.

The museum houses more than 2,200 specimens and also features a “Digital Human” dissection table, allowing virtual three-dimensional exploration of human anatomy, alongside a memorial area honouring body donors. Observing the real three-dimensional structures of nerves and blood vessels deepened my understanding of acupuncture points and needle insertion techniques.

As a scalp acupuncturist, I have always been fascinated by the structure of the spinal cord and its relationship with brain function. Exploring the intricate connections between the brain and the gut, and understanding how neurological pathways influence the body, continues to inspire my curiosity. These reflections remind me how extraordinary the human body truly is and how much there is still to discover through both modern medicine and TCM.

References:

1) Nanfang Hospital: https://www.smu.edu.cn/english/info/1026/1068.htm

2) Human Science Museum: 

https://www.smu.edu.cn/english/Campus_Life/Human_Science_Museum.htm

The Beginning of Summer (Lixia)

Kit Li

The beginning of the Summer (LiXia 立夏) has quietly arrived, starting on Monday, 5th of May, according to the 24 Solar Terms in the Chinese Lunar Calendar.

In Traditional Chinese Medicine (TCM), Summer is the season when Yang energy reaches its peak, a time of expression, warmth, growth and activity.  The Heart becomes especially active and also more vulnerable.  Emotional excess, such as over-excitement, stress, or restlessness can disturb the Shen (Spirit), leading to insomnia, anxiety or palpitations.  

Additionally, dampness and heat can burden the Spleen, often leading to loss of appetite, bloating, fatigue, and even eczema.  To support digestion and balance internal damp-heat, dietary adjustments are crucial.

Here are some practical and inspired tips for the Beginning of Summer to help you transition smoothly into the warmer months, both physically and emotionally:

- Sleep early, wake early.  Rise with the sun to align with the surge in Yang energy.

- Take a nap (20 mins) after lunch to nourish the heart and counter Summer fatigue.

- Avoid staying up late, which depletes Heart-yang and disrupts sleep quality.

- Keep your emotions balanced, avoid over-excitement, anger or sadness.

- Gentle activities like meditation, calligraphy, nature walks, journaling, or gently breathing exercises help calming the mind and regulate emotions.

- Strengthen the Spleen and dispel dampness with: Soups made with winter melon, barley, and lentils; a daily "ChenPi FuLing tea" (Dried tangerine peels and poria); "Four Gentlemen’s Porridge" which replenishes qi, and support weak digestion.

- If experiencing insomnia, dry mouth, irritability, or blood pressure fluctuations, try massaging the Neiguan  (PC-6) or ShenMen (HT-7), it  helps to calm the Shen and relieve palpitations.

- Make a porridge with Tai Zi Shen 15g (Pseudostellaria root), Lian Zi 15g (Lotus Seeds) and Suanzao Ren 10g (Wild Jujube Kernel) to nourish Heart and promote Qi and Yin.

- Exercise during cooler times (early morning or evening).  Choose gentle movements such as  Taichi, yogo, or brisk walking.

- Avoid excessive sweating, which can weaken Heart-Yang.  Rehydrate with lightly salted water or cooling herbal teas like chrysanthemum or honeysuckle.

-After sweating, avoid chilly breeze.  Carry a light scarf or shawl to cover your neck when entering air-conditioned spaces.

- Reconnect with nature.  Spend time under trees, near rivers, or in gardens, tune in to the seasonal rhythms.

Living in harmony with the seasons is a fundamental principle of TCM.  By aligning your lifestyle with nature's shifts, you can cultivate inner balance, resilience, and well-being, not just through Summer, but all year round.

Link:

Lunar Chinese Calendar:

https://www.yourchineseastrology.com/calendar/24-solar-terms.htm