selection of points on the channel distribution and not the dermatomes. However, in the case of
disc prolapse, it is also useful to take the dermatome distribution into account and use points on
the Governing Vessel and their corresponding Huatuojiaji points at the level of the disc lesion
and one space below this level. This is because the symptoms and signs arise from the
compression of the nerve root of the spinal nerve below the disc. For example, herniation of the
disc between L5 and S1 causes symptoms of nerve-root irritation of the S1 spinal nerve.
In acute cases, the back pain is severe and no position is comfortable. The patient instinctively
adopts a posture of scoliosis curving towards the side of the prolapse and movements of the
spine are extremely restricted (Figure 24.19(503)). Straight leg raising is limited on the side of
the root irritation and produces intense pain. This test is carried out with the patient supine (face
up). Holding the knee straight, lift each leg in turn flexing at the hip. Marked impairment of the
leg movement and pain when lifted over 30 degrees indicates lumbo-sacral nerve-root
compression. This is further confirmed if more pain is elicited by dorsiflexion of the foot.
Numbness of the leg will appear in a dermatome distribution.
The pain deriving from a prolapsed disc is not due to the disc itself but to compression of the
nerve root and dura mater. The torn annulus fibrosus can heal and the herniated nucleus pulposus
can be reabsorbed.
Disc herniation may persist for months or even years, becoming chronic. The area of pain and
other signs may be summarized in Figure 24.20(504).
From a Western medical perspective, myalgic encephalomyelitis (ME) is a relatively "new"
disease. It is not clear what the causative agent might be; indeed, there is no general agreement
that it is a separate "disease" at all. Even its name is not generally agreed upon. In fact it is
variously called also "Royal-Free disease", "post-viral syndrome", "epidemic neuromyasthenia",
"chronic mono", "chronic Epstein-Barr virus disease" and "chronic fatigue syndrome".
"Myalgic" means "pain in the muscles" while "encephalomyelitis" means inflammation of the
brain and nerves. The reason that there is no general agreement on the nature and causative agent
of this disease is that there is no conclusive test which is specific to ME. Current research,