About Clinic
The Inner Gate Clinic Mission is to deliver the best quality health care in traditional Oriental Medicine and to educate public about its benefits and ways of integrating it into personal care.
The Inner Gate Clinic is based in New York City, to serve Manhattan (office hours), Bronx and South Westchester (home visits) with their health care needs.
Manhattan office is located three blocks north from
Union Sq at
900 Broadway, #404, New York, NY 10003
(between 19th and 20th street)
Tel: 646-546-9910
Open: Wednesday and Friday.
Angela N. Gabriel, M.S., Licensed Acupuncturist and Certified Herbologist, provides a full range of Oriental Medicine treatments: traditional Chinese and Japanese style acupuncture and moxibustion, Chinese herbal formulas, Chinese therapeutic massage, and nutritional counseling.
Angela studied Traditional Acupuncture, Chinese Herbology, Chinese physical arts and biomedicine in NY College in Syosset, NY. Before studying Oriental medicine she worked in molecular biology research. Great interest in health and illness, in mind, body and sprit connection, Eastern culture and integration of best medicines for patients benefit had inspired her to study Oriental Medicine. Currently Angela has private practice in New York City and participates in clinical study of acupuncture at Columbia University. Angela has been trained in Traditional Chinese Medicine (TCM), microsystem acupuncture, Japanese Meridian Therapy, Chinese meridian massage, and has clinical experience in treating numerous illnesses. Angela’¡Çs background in biochemistry allows her to integrate principles of Eastern and Western nutrition and make customized dietary recommendation for a variety of imbalances and constitutional types. Her special interest is in gynecological, digestive, immune, respiratory, psychosomatic and sleeping disorders, stress-related ilnesses and pediatrics.
Oriental Medicine
is the world’s oldest continuously practiced and documented professional medical system. It has been successfully integrated into modern health care all over the world. Oriental medicine is based on a concept of vital force, or qi, that is believed to flow throughout the body. Disease is proposed to result from the flow of qi being disrupted and yin and yang becoming imbalanced. Oriental medicine aims to regulate a person's spiritual, emotional, mental, and physical balance with acupuncture, moxibustiom, Chinese herbs, nutritional therapy, physical exercises, therapeutic massage and various auxiliary techniques.
Oriental vs. Western medicine:
Both Western and Oriental Medicine have their respective strengths and weaknesses. When they are appropriately combined, the patient is well served. Generally speaking, acute life-threatening conditions are best handled by Western medicine. Routine health problems and chronic conditions often benefit from Oriental Medicine. Oriental medicine is especially good for promoting the body’s ability to heal and recuperate.
Oriental medicine treats the full range of human diseases:
- Stress-related Illnesses
- Digestive Disorders
- Autoimmune Disorders, Respiratory
- Gynecological and Reproductive Disorders
- Disorders of Muscles, Joints, Nervous System
- Circulatory Disorders, Post-stroke sequelae
- Addictions, Endocrine Disorders
- Ear, Nose and Throat disorders
- Emotional and Psychological Disorders
- Aging and degenerative diseases
For the complete list of conditions see: http://www.alpineacupuncture.com/WHO.htm
What is acupuncture and its place in Chinese medicine?
Acupuncture is a unique healing practice used to regulate a flow of Qi in the body. It consists of inserting hair-width thin needles to stimulate specific points situated along the meridians - schematic pathways of Qi which transverse the body from a top of a head and fingertips to the toe tips. Acupuncture is most popular modality of Chinese Medicine in the West and often used as synonym of Chinese medicine. In fact, acupuncture is only one of many modalities used within Chinese medicine. There are simple conditions where acupuncture can be successfully applied alone but majority cases call for a combination of various techniques such as
- Moxibustion
- Chinese herbs
- Food therapy
- Life-style adjustments
- Therapeutic massage
- Cupping
- Ear seeds
- Liniments, plasters, medicinal oils and balms
- Qi gong
- Relaxation techniques
What does it mean to practice acupuncture?
Success of acupuncture is not assured by knowledge of secret powerful points but by experience of practitioner who is trained to do a comprehensive assessment, recognize a pattern of major and secondary imbalances, and then apply the correct technique in a specific place and at right time. As any existing medical system, Chinese medicine is a combination of science and art, knowledge and empirical intuition.
As an exception, there are several well-known points that can be used by everybody in emergency situations:
- LI4 for pain in upper body
- PC6 for nausea and motion sickness points at the fingertips for heart insufficiency
- GV26 for resuscitation when other means are unavailable yet.
All you want to know about acupuncture needles.
- very thin (some are as fine as human hair)
- solid and durable
- disposable
* often geared with guide tubes to make the insertion quick and painless.
Is acupuncture painful?
Is acupuncture uniform technique and always should feel the same?
Here is brief description of several prominent styles of acupuncture/Chinese medicine:
Traditional Chinese Medicine (TCM):
TCM
is the standard school of acupuncture in modern China, which is
thought in most acupuncture colleges worldwide, and the style most
widely practiced. It is based on principles of classical Chinese
medicine and has been developed in modern China. Since it is biggest
school, most recent clinical studies acupuncture used treatment
protocols based on TCM. Main feature of TCM is important role of
Chinese herbal medicine.
Japanese Acupuncture:
Japanese Acupuncture Japanese Acupuncture is a style of acupuncture, which is based on classical Chinese medicine and has being influenced by modern research. It started in Japan several hundreds years ago where traditionally acupuncture schools were assigned by the government to train blind people. Fine needles are used, and more shallow painless insertions are developed. Another emphasis has been made on palpatory techniques. Search for active, responsive points, significance of pulse and abdominal diagnosis (compare to less valued tongue assessment) are distinguishing features of Japanese acupuncture. Unique thread- or rice-grain style moxibustion is another signature of Japanese-style treatment. Japanese acupuncture requires additional training beyond general TCM practice, and traditionally achieved through apprenticeship with one of the accomplished practitioners or a school of practitioners. Because of its gentleness, Japanese acupuncture is often preferred treatment of children and weak, sensitive or fearful patients.
Korean Acupuncture:
Korean Acupuncture has its roots in both classical Chinese medicine and Japanese acupuncture and includes some unique techniques with an emphasis on constitutional body. Korean Hand Acupuncture is a popular system of Korean Acupuncture where the hands are considered a microsystem of the entire body. This is similar in theory to Auricular Acupuncture.
Five Element Acupuncture:
Five Element Acupuncture is a specialty practice, which can be as delicate in needling technique as Japanese acupuncture but tends to focus more on the psycho-spiritual nature of a person as a diagnostic model. This style of medicine was popularized by the late J.R. Worsley and requires significant training outside of general TCM theory. There are several colleges in US that specialize in Five Element acupuncture.
Auricular Acupuncture:
Auricular (Ear) Acupuncture is a both an adjunctive and specialty technique which uses points on the outer ear. Use of ear points is based on the idea of correspondences. The ears can be treated as a microcosm, or representation, of the entire body where each ear point corresponds to the organ and body part. One area where Auricular acupuncture is used extensively is in drug, tobacco and alcohol detoxification centers where the NADA Protocol is used to help people deal with addictions.
Who can practice acupuncture?
The second type of practitioners in US are medical acupuncturists medical doctors (MD) who are certified after 300-hour training in basic TCM knowledge. Unfortunately, 300 hours are generally not enough for understanding of theory and practice of Chinese medicine in its full unless deeper study is underwent subsequently.
Who can receive acupuncture? What if I am afraid of needles?
It is important to know that many parameters of acupuncture can be adjusted according to your needs.
- thickness of needles
- number of points used
- intensity of stimulation
- length of session
What can acupuncture treat? How many sessions are necessary?
Acupuncture can be used for wide range of acute and chronic problems from sport trauma and headache to stroke complications and infertility. One or two session are often enough to take care of acute strain, food poisoning or common cold. Chronic illnesses may require longer (up to several months) and more complex treatments. Standard procedure is a course of 6-10 sessions after which another full reassessment is performed.
According to AAOM the World Health organization Interregional Seminar drew up the following provisional list of diseases that lend themselves to acupuncture treatment. The list is based on clinical experience, and not necessarily on controlled clinical research : furthermore, the inclusion of specific diseases are not meant to indicate the extent of acupuncture's efficacy in treating them.
- Upper Respiratory Tract
- Acute sinusitis
- Acute rhinitis
- Common Cold
- Acute tonsillitis
- Respiratory System
- Acute bronchitis
- Bronchial asthma (most effective in children and in patience without complicating diseases)
- Disorders of the Eye
- Acute conjunctivitis
- Central retinitis
- Myopia (in children)
- Cataract (without complications)
- Disorders of the Mouth
- Toothache, post-extraction pain
- Gingivitis
- Acute and chronic pharyogitis
- Gastro-intestinal Disorders
- Spasms of esophagus and cardia
- Hiccough
- Gastroptosis
- Acute and chronic gastritis
- Gastric hyperacidity
- Chronic duodenal ulcer (pain relief)
- Acute duodenal ulcer (without complications)
- Acute and chronic colitis
- Acute bacillary dysentery
- Constipation
- Diarrhea
- Paralytic ileus
- Neurological and Musculo-skeletal Disorders
- Headache and migraine
- Trigeminal neuralgia
- Facial palsy (early stage, i.e., within three to six months)
- Pareses following a stroke
- Peripheral neuropathies
- Sequelae of poliomyelitis (early stage, i.e., within six months)
- Meniere's disease
- Neurogenic bladder dysfunction
- Nocturnal enuresis
- Intercosral neuralgia
- Cervicobrachial syndrome
- "Frozen shoulder","tennis elbow"
- Sciatica
- Low back pain
- Osteoarthritis
- Acute and chronic pain control
- Muscle spasms, tremors, tics, contractures
- Paresthesias
- Anxiety, fright, panic
- Drug detoxification
- Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
- Sequelae of stroke syndrome (aphasia, hemiplegia)
- Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel)
- Headache, vertigo (Meniere disease), tinnitus
- Phantom pain
- Frozen shoulder
- Cervical and lumbar spine syndromes
- Plantar fasciitis
- Arthritis/arthrosis
- Bursitis, tendonitis, carpal tunnel syndrome
- Sprains and contusions
- In fractures, assisting in pain control, edema, and enhancing healing process
- Temporo-mandibular joint derangement, bruxism
- Dysmenorrhea, pelvic pain
- Anorexia
- Atypical chest pain (negative workup)
- Idiopathic palpitations, sinus tachycardia
- Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
- Constipation, diarrhea
- Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)
- Abdominal distention/flatulence
- Severe hyperthermia
- Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
Acupuncture for health maintenance.
Acupuncture in pregnancy?
Moxibustion is a traditional Chinese medicine technique that involves the burning of dried spongy mugwort (Artemisia vulgaris) to facilitate healing. Moxibustion has been used throughout Asia for thousands of years; in fact, the actual Chinese character for acupuncture, translated literally, means "acupuncture-moxibustion." The purpose of moxibustion, as with most forms of traditional Chinese medicine, is to warm specific areas of the body, strengthen the blood, stimulate the flow of qi, and maintain general health.
How does moxibustion work? Does it hurt?
There are two types of moxibustion: direct and indirect. In direct moxibustion, a small, cone-shaped amount of moxa is placed on top of an acupuncture point and burned. The patient will experience a pleasant heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring.
In indirect moxibustion, a practitioner lights one end of a moxa stick, roughly the shape and size of a cigar, and holds it close to the area being treated for several minutes until the area turns red. Another form of indirect moxibustion uses both acupuncture needles and moxa. A needle is inserted into an acupoint and retained. The tip of the needle is then wrapped in moxa and ignited, generating heat to the point and the surrounding area. After the desired effect is achieved, the moxa is extinguished and the needle(s) removed.
What is moxibustion used for and how it works?
The burning of moxa is believed to expel cold and warm the meridians, which leads to smoother flow of blood and qi. It can help with muscle and joint pain, gynecological pain and cramps, insomnia, cold feeling of hands and feet, and many other problems.
Multiple studies of direct method of moxibustion carried out in Japan have shown that it can affect the healing process in many ways:
- It increases the production of white blood cells.
- It increases the produciton of red blood cells and haemoglobin.
- It improves the overall blood and lymph circulations.
- It helps relaxation of the entire body and improve sleep quality.
- It can more effective for internal chronic ailments than acupuncture due to its unique properties.
Moxibustion has successfully been used to turn breech babies into a normal head-down position prior to childbirth. A landmark study published in the Journal of the American Medical Association in 1998 found that up to 75% of women suffering from breech presentations before childbirth had fetuses that rotated to the normal position after receiving moxibustion at an acupuncture point on the Bladder meridian. Other studies have shown that moxibustion increases the movement of the fetus in pregnant women, and may reduce the symptoms of menstrual cramps when used in conjunction with traditional acupuncture.
Are there any precautions I should be aware of?
Some methods of moxibustion can produce smoke and a pungent odor. Although smoke itself has therapeutic values and aids treatment, patients with respiratory problems may request that their practitioner use smokeless moxa sticks as an alternative.
How do I find an acupuncturist who practices moxibustion in my area?
Moxibustion is usually taught as part of a qualified acupuncture or traditional Chinese medicine degree program. Although there are no licensing or accreditation requirements associated with the practice of moxibustion, in the United States, a practitioner must have an acupuncture license to be allowed to perform moxibustion. Your acupuncturist may suggest applying simple and safe type of self-moxibustion (smokeless indirect moxibustion, for example) at home to prolong benefits of the office treatments. He or she will provide all necessary training and equipment.
Sources:
http://www.acupuncturetoday.com/abc/moxibustion.html
http://www.acupropress.com/japanese_moxibustion.shtml
Chinese Herbal Medicine
Have you ever been to Chinatown? Have you ever walked (or just passed by) into one of those strong-smelling and weird-looking herb shops? Then you have probably wondered about thin slices of dried roots, ugly shaped rootlets, unfamiliar fruits and berries, unimaginable nature of most stuff in the trays and bags. You may have seen ancient scales in use and modern electronic devices in the same store. Hundreds of boxes in herbal cabinets stretched through the walls. Is it possible for us, westerners, to learn about Chinese herbs? Can we use them to help our health?
Chinese Herbology is one of the more important modalities of Chinese medicine along with acupuncture, dietary therapy, massage and exercise. The first Chinese manual on pharmacology, the Shennong Emperor's Classic of Materia Medica, dates back somewhere in the 1st century C.E.
Today Chinese herbal therapy remains a form of primary medical care and practiced hand to hand with western medicine in many hospitals in China, Korea, Japan, Vietnam and other Asian countries.
Much like acupuncture, Chinese herbs are not limited to Asian culture. Many herbs from Chinese pharmacopoeia are actually identical or similar to Western and Aurvedic (Indian) herbs and can be used equally in the West and the East. There is a growing interest in Chinese herbs in the West due to unique and very sophisticated way of prescribing based on principles of Chinese medicine.
Chinese herbal therapy may use substances such as plants, minerals, and animal parts. Every substance's properties, therapeutic effects, time of harvest, preparations, dosage, compatibility, and contraindications are thoroughly characterized within paradigm of Chinese medicine. When Chinese herbs are used in raw form they need to be decocted. Other forms such as concentrated extracts and tinctures do not require any cooking and become more and more popular.
Chinese herbs are usually prescribed in formulations consisting of 3 or more herbs. Herbs and their combinations are chosen based on principles of Chinese medicine. Final prescription (formula) is precisely tailored not only to patient's illness, but to a patient as an individual. Each herb in formula performs its own function: some target major illness (pattern), others address minor symptoms, patient's constitution, counteract possible side-effects, or balance the whole formula. Traditionally all or most of herbs in prescription are cooked (boiled) together.
Formulation is slightly or significantly modified during follow up visits depending on the progress in patient's condition. This is why only properly trained qualified herbalists should prescribe Chinese herbs.
Here you can read in detail how Chinese herbs are prescribed.
A qualified herbalist will assess your condition and constitution by several methods. You will be asked a number of comprehensive questions about your present and past illnesses, subjective feelings, lifestyle, diet, emotions, current medications, vitamins, etc. Your pulse on both wrists and your tongue will be examined. Then your herbalist will design a formula for your condition. Formula is usually based on ancient prescription that had been developed and tested through ages for your pattern. It will be further modified by adding few herbs and tailored precisely to your present condition. Your herbalist will instruct you how to prepare and take formula, what foods you should not eat while on formula, and what side effects you may experience. Your formula is so carefully customized that it has to be modified again as soon as you see any changes in your condition, usually in a week or two in the beginning of treatment. If there are no changes in your condition, your pattern will be re-evaluated. Results are usually seen in few hours or days in acute conditions and days or weeks in chronic conditions. However, chronic or complicated conditions may require long-term compliance (several months or more) and additional therapies and/or life style adjustments in order to achieve stable improvement. These processes comprise holistic healing. When slow but steady improvements are achieved, herbal formula can be modified less frequently, and eventually stopped.
Who is qualified to prescribe Chinese Herbs ("a qualified TCM herbalist")?
Please note that not all licensed and certified acupuncturists in USA are certified herbalists (C.H.)
The requirements in the USA:- Licensure: L.Ac. (in most states), DOM (Doctor of Oriental Medicine), D.A. (Doctor of Acupuncture), C. Ac. (Certified Acupuncturist)
- NCCAOM certification in Chinese Herbology (additional certification, different from Acupuncture) - Dipl. C.H. (Diplomate in Chinese Herbology)
- NCCAOM certification in Oriental Medicine (combined certification in Acupuncture and Chinese Herbology) - Dipl. OM
Food and Ritual
by Angela N. Gabriel, LAc
Many rituals evolve from spiritual traditions. Since the food sustains our bodies, and our bodies house our souls, people throughout the ages have developed love and respect for their food in recognition of this law of Nature. As a result, all cultures have created their own unique eating habits, and the history of these habits is as old as humanity itself.
The most important ingredient of the meal is the consciousness surrounding the food. Celebrations organized around food have often been a central theme of every cultural experience, be they religious or spiritual. Prayers and songs often express gratitude and blessing for the food received, and ideas of love, compassion and sharing. Many also incorporate the acknowledgement of natural laws, and appreciation of the environment. Sometimes special occasions involve the naming of meals, such as Thanksgiving or the Feast of Ramadan, which may include specific table arrangement or setting and the precise preparation of food that coincide with the annual and often seasonal festivities.
The exposure to, and experience of various rituals related to preparation and consumption of food can also influence one's own personal eating habits, as with me. A former roommate of mine was a devotee of Krishna Consciousness. She taught me that Krishna devotees believed that food should be prepared as an offering for the Lord. It was always prepared with concentration on the beauty and kindness of Krishna, his beauty and kindness, assisted by a lots chanting and singing. During kitchen time, no other thoughts were allowed to enter the mind in the kitchen, as the way of ensuring the purity of food. She said when offering the food to the Lord first, it becomes spiritually charged and sanctified. All food is placed before a picture of Lord Krishna asked to be accepted as an offering prior to consumption, while a mantra is recited three times, and a small bell is rung. When Lord Krishna has accepted the food, Prasad, everyone can eat. It is believed that a ritual such as this elevates any meal, even as simple as rice and vegetables to that of the sacred feast. The piece and joy that fill the temple help to cultivate Krishna Consciousness, as well as, aid digestion of food and increase its ability to nourish.
The food rituals of the Sufi community in Upstate New York also fascinate me. What happens there is very similar to what occurs in the Krishna temple. It begins with the members of community gathering together to collectively cook a meal, and it concludes with the collective working again as a unit, clearing away and cleaning the dishes. The head cook gets very focused when she or he, with help of several other people, commences cooking. First, all those present form a circle to do attunements freeing themselves from all the daily distractions and worries while cooking. The kitchen resembles a stage where creative dance is performed.
The members of the community then form another circle prior to eating to say a simple prayer: "The sustainer of our bodies, hearts and souls, bless all that we receive thankfully…" Eating in silence is often a part of the spiritual practices observed in the Sufi community. Meals are never eaten in haste because life is relatively slow-paced there. If I could just say a word about food… It is simple but creative, wholesome, mostly vegetarian and it tastes so good that it make you dream of next visit.
In the Jewish tradition, diet is a way of being in harmony with the Universe. Judaism has a tradition of mitzvah which is God's commandment to do good deeds. Sharing your food in a community meal is a mitzvah - inviting guests, showing hospitality, feeding the hungry are all mitzvah. Both Christian and Islamic countries have similar ideas related to the sacred sharing of food.
Finally, the rituals in Zen Buddhism are as complicated in meaning as they are simple in composition. It is important not overlook or underestimate the significance of any small detail when participating in a monastery trapeze. The posture, order, bowl washing between servings, and even the drinking of the water used for washing, all have meaning. The study of these practices can be so intricate and interesting, I believe they could be the subject for a PhD thesis. From Oriental Medicine perspective, ritual is a spiritual setting that provides the axis or circle between body, mind and spirit" through which Qi, the vital life force, is conveyed. Some of the simple tenets related to spirituality and food are "Fire is the mother of Earth", "Heart qi engenders Spleen Qi". Spleen qi function is the transformation and transportation of Gu Qi, also known as Qi of grain and water, and the origin of the Post-Natal essence which sustains our bodies after birth. Shen is the spirit of Heart. Shen can be understood as state of mind that even transcends the mind itself. Rituals reset the Shen, calming it so it is free to focus on the specific tasks, such as, in this case, eating. In Western Science, we could say the central nervous system is switched from the sympathetic to the parasympathetic mode which is known to be responsible for rest and digestion.
The statements, "we are what we eat", and "we eat according to what we are", are accurate and indispensable to healthy living. When we are attuned to its sacred nature, we can make better choices and derive more benefits from the food we choose to eat.
Services
In clinic
- Initial session
-
$90 (90-120 min)
- Acupuncture session / herbal consultation
-
$70 (60-90 min)
- Herbal consultation without acupuncture
-
$70 (initial visit)
$30 (follow up visit)
- Ear acupuncture (smoking cessation, other conditions)
-
$40 (30 min)/once a
week
$30 (30 min)/twice a week
Home visits:
$100 plus travel expensesCost of Herbs:
Varies from $15/month (Chinese patents) to $15-30/week (powdered and raw herbs)
Links and Resources
Organizations regulating practice of Chinese Medicine in U.S.
- National Certification Commission for Acupuncture and Oriental Medicine
- Accreditation Commission for Acupuncture and Oriental Medicine
- Council of Colleges of Acupuncture and oriental Medicine Read: know your acupuncturist
General Information on Chinese Medicine
- National Center for Complementary and Alternative Medicine Acupuncture
- Chinese Herbal Academy
- Acupuncture Information, Applications and Resources - excellent site
- Sacred Lotus - excellent resource
- History: famous Chinese doctors
Acupuncture Research
- Stroke Patients Benefit from Acupuncture
- Acupuncture Is as Good as Drugs for Migraine
- Acupuncture Relieves Pain and Improves Function in Knee Osteoarthritis
- Acupuncture for depression
Recommended books on Chinese Medicine for layperson reader
- Chinese medicine theory: Web That Has No Weaver (by Ted J. Kaptchuk)
- Chinese and Western Nutrition Healing With Whole Foods: Asian Traditions and Modern Nutrition (by Paul Pitchford)
- Pediatric Chinese Medicine: Keeping Your Child Healthy With Chinese Medicine: A Parent's Guide to the Care & Prevention of Common Childhood Diseases (by Bob Flaws)
Contact
You should feel free to contact Angela with any questions you may have about the clinic or acupuncture in general.
Angela N. Gabriel, L.Ac.
Phone: 646.564.9910
Email: innergate@gmail.com
900 Broadway, #404, New York, NY 10003
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