Reflection Two: The Spirit Uprooted—Classical Chinese

Reflection Two: The Spirit
Uprooted—Classical Chinese
Medicine Loses its Humanity
The Problem:
shenming or spirit clarity (spirit light): “If the
xueqi, the heart and the lungs are functioning
well, and all the meridians and the zangfu are
in harmony with this functioning, there is a
kind of concentration of xueqi at this place,
and there is a good impregnation of the
layers of the skin. The eyes and vision are
good, and the brain is alert. The bones are
solid. All that is called shenming (ibid, p.
118).”
As Part II will reveal, not only have the
Ordinary Skills of Classical jing-luo
Acupuncture suffered at the hands of this
radical reshaping of Classical Chinese
Medicine (in its new, communist, TCM
version, taught in a simplified language with
simplified theory accessible to new students
at TCM Colleges with no grounding in the
Classical concepts).
Larre and de la Vallee paraphrase the oftquoted concept that the practitioner of
ordinary skills observes the body, while the
practitioner of high skills observes the spirits:
“This means that he observes the blood and
qi of man, tonifying or dispersing, following
excess or deficiency (ibid, p. 120).”
This decidedly physical depiction of spirit is
echoed in Maciocia’s study on the subject.
In addition, Confucian and Daoist
foundational knowledge, which informed
mainland Chinese concepts of humanity, was
stripped from Chinese medical texts as
religious and feudal remnants of a past to be
outlawed, forgotten and left behind, along
with life nourishing and self-cultivation
practices (Dao-Yin, Qi Gong) thought to be
essential, in the Classics and up until the late
1950’s in the PRC, in order to aspire to
become a practitioner of High Skills.
Whereas the Western view of body and spirit
depicts the spirit as that which animates the
body, according to Maciocia, the spirit and
body in Chinese medicine “are nothing but
two different states of condensation and
aggregation of Qi […] with the Qi being the
most rarified form (The Psyche in Chinese
Medicine, Churchill Livingston, 2009, pp.45).” He goes on to paraphrase the ancient
concept that the body is able to stand erect
due to the spirit within, and that the spirit
requires the body for its existence and dies
with the body (ibid). He translates from
chapter 66 of the SuWen in a similar, and
again decidedly embodied way, thus: “What is
called shen? Qi and Blood are harmonious;
Nutritive and Defense Qi circulate freely; the
5 Yin organs have been formed; the mind
resides in the heart; the ethereal and
corporeal souls have been formed. Where
there is no shen, there is death. Where there
is shen, there is life (ibid, p. 9).”
Rooted in Spirit: shen and xueqi
Sinologists Claude Larre and Elizabeth
Rochat de la Vallee stress the near identical
nature between the spirits (wushen), and
blood (xue) and qi. “Blood and qi are one of
the best ways through which the spirits
express themselves in a perceptible way. It is
perceptible because it is always through the
balance of xueqi that we have the indication
for treatment. You know that there is excess
or deficiency, so you tonify or disperse […]
The blood and qi are the spirits of man, one
cannot but pay great attention to their
maintenance (Essence, Spirit, Blood and Qi,
Monkey Press, London, 1999, pp. 121-123).
This equation between xueqi-blood and qi--,
and shen-spirit taken as a whole, also define
1 Elisa Rossi comes to the same conclusion in
her study of the classical and modern
Chinese medical concept of Shen. In her
text, Shen: Psycho-Emotional Aspects of Chinese
Medicine, she stresses from the outset that the
classics of Chinese medicine view the
emotions, which can lead to a disturbance of
shen when overly strong or in a person of
weak constitution, as physiological events, a
response of the Shen to stimuli of the outside
world (p. 23).”
of constraint and heat; fullness; and
emptiness in Rossi; Lilium syndrome
depression; emotional stagnation; plum-stone
syndrome; visceral agitation; and excess and
deficiency variants of palpitation and anxiety
syndromes in Maciocia). The focus of each
author, and Larre and de la Vallee is clear: a
practitioner who aspires to practicing High
Skills must learn to recognize, and regulate,
excess, deficiency and stagnation of Qi and
Blood, to treat the shen level with needles
and moxa.
She goes on to clarify that mind and body in
Chinese medicine are perceived as an
indivisible and dynamic unit: “Emotions can
give rise to somatic disorders as well as
psychic illnesses; organic illness can, in turn
give rise to emotional alterations and psychic
pathologies […] This implies that psychic
disorders should be treated starting from the
energetic system of channels and organs,
utilizing the usual diagnostic process, the
same principles, and the same therapeutic
tools (ibid, p.24).”
The first chapter of the Ling Shu goes on for a
few pages detailing the methods, ‘slow, then
quick’ for tonification, and ‘quick, then
slow’ for dispersion. As the text clarifies, this
“is the manipulation and the way of the
needles. Firmness is precious. The primary
fingers make a vertical insertion; do not
needle to the left or right. The spirit seems to
be at the tip of the needle. Focus awareness
on the patient. Investigate the blood pulses
and the needle will not be dangerous. When
inserting the needle, it is necessary to
harmonize the yang and control both the yin
and the yang. The spirit will follow. Do not
go away […] The blood pulses are widely
distributed at the shu points. They are clear
to see and strong to touch (ibid, p. 2).”
She stresses that emotions, when excessive or
in a susceptible individual, alter the
movement of Qi, leading to stagnation of Qi
and functional disturbances of the viscera. If
prolonged, this can lead to actual organ
disorders and even death, as underscored in
the oft-quoted Chapter 8 of the Lingshu:
Benshen, often translated as “rooted in spirit”.
In such serious disorders rooted in the spirit
from emotional stagnation, as this chapter
outlines, death will come in the season that
dominates the organ in question: in Spring,
for the Spleen for example (ibid, pp 26-27).
In this description, which I will return to in a
later Reflection on Needling Technique, the
Ling Shu stresses that only “when the qi is
reached, will acupuncture be effective. This
effect, it is said, is as if the winds blow away
the clouds and clear the azure sky. These are
all the Dao of acupuncture (ibid, p. 3).”
She concludes in like fashion to Larre and de
la Vallee, that to recognize and treat
disorders rooted in spirit, one must recognize
the disorders of qi that have arisen, and treat
them with regular meridian strategies of
point combinations and needling techniques
to tonify or disperse.
So how does a practitioner know if the Qi
(and hence the shen) has been reached? The
Ling Shu provides a clear method of
inspection of the patient’s ‘vital signs’ near
the end of the first scroll thus: “Look at the
patient’s color. Observe the eyes. Know how
the qi disperses and returns. Each has its own
form. Listen to the patient’s movement or
stillness. Know his imbalance and his balance
(ibid, p. 4).”
Rossi and Maciocia each lay out classical and
modern categories of shen disorders (patterns
2 Thus far, the Classical Chinese notion of
shen or spirit sounds very embodied, and
Wang Ju-Yi would seem to concur in his
modern interpretation: “Remember that, to
me, the character shen (character included in
the original text) refers to the intelligence of
existence. It is an innate intelligence that,
when the heart is healthy, any person or
animal might have. This intelligence is also
present in the world at large ( Applied Channel
Theory in Chinese Medicine, Wang Ju-Yi and
Jason D. Robertson, Eastland Press, Seattle,
2008, p. 148).” He is speaking here, of
course, of the shen of the Heart-Mind.
•
In the Chart on the next page, I will list the
main signs and symptoms of disordered shen
in the five Zang as depicted in Rossi, pp. 2627 as suggested by Bruce Park, a former
Korean Buddhist monk and now teacher of
Buddhism, during his presentation of a class
on Chapter 8 of the Ling Shu known as
BenShen (Roots of Spirit). I feel that Rossi gives
a good feel for the effect of the emotions
without getting overly bogged down in details
of the five spirits which have little to do with
Western patients and their emotional
stresses.
These various definitions of spirit are in
keeping with Wiseman and Ye’s definition of
shen in their text, A Practical Dictionary of
CHINESE MEDICINE (second edition,
Paradigm Publications, Brookline, MA, 2008,
pp 550-551): “ 1. (In the narrow sense, that
which is said to be stored by the heart […] 2.
(In a wider sense) that which is said to
present in individuals with healthy
complexion, bright eyes, erect bearing,
physical agility, and clear and coherent
speech. It is said, ‘If the patient is spirited, he
is fundamentally healthy; if he is spiritless, he
is doomed.’ Thus, the spirit sheds useful light
on the severity of a given complaint (ibid).”
The authors of this dictionary go on to
elaborate that there are three fundamental
“conditions of the spirit”:
•
•
inquiry (ibid).” These signs indicate a
relatively serious condition where
extreme caution is necessary;
False Spiritedness: The most classic
sign is that of a fatally ill patient,
who suddenly and briefly exhibits a
rosy complexion, talkativeness, and
an animated spirit not in keeping
with the seriousness of the patient’s
condition. “It is a sign that the
patient’s condition will soon
deteriorate…(ibid).”
Spiritedness: If the patient exhibits
signs of being spirited as above,
indicating that the complaint is
relatively minor, and that although
“certain aspects of the patient’s
health may be seriously affected,
swift improvement may be expected
(ibid, p. 551);”
Spiritlessness: Lack of mental
energy, abnormal breathing, apathy,
“torpid expression, dark complexion
and dull eyes, low voice, slow, halting
speech, and incoherent response to
3 ZANG /Spirit
EMOTION
S&S
DEFICIENCY
EXCESS
Fear, terror, lost
control, the
muscles are
consumed
Sadness
Heart/shen
Anxiety, worry,
thoughts and
apprehension
injure shen
Uncontrollable
laughter
Spleen/yi
Oppression and
anguish that do
not dissolve
injure yi
Restlessness and
disorder, the
four limbs do
not lift up
The four limbs
do not function,
the five organs
are not in
harmony
Abdomen
swollen, difficult
menstruation
and urination
Mania and
oblivion,
abnormal
behavior, genitals
retract, muscles
contract, ribs do
not lift up
Fear
Anger
Nose obstructed,
passage of air
difficult, breath
short
Laboured and
hoarse breathing,
Fullness in the
chest, lifts the
head to breath
Reversal-jue
Swelling, the five
zang are not calm
Liver/hun
Sadness and
sorrow convulse
the center and
injure hun
Lung/po
Euphoria and joy
without limits
injure po
Mania, the mind
does not see
others, the skin
dries out
Intense and
incessant anger
injure zhi
Forgetfulness,
flanks and spinal
column painful,
Cannot bend
forward or
backward
Kidney zhi
Kidney jing
Fear and
apprehension
injure jing
4 (Tu Wei-ming, Humanity and Self-Cultivation:
Essays on Confucian Thought, Cheng & Tsui
Co., Boston, 1978, pp 6-7).
The Spirit by Any Other Name
In a discussion on Shen in Chinese medicine
with senior interns at the college, I was at
first struck by the fact that each person who
spoke up seemed to have a different take on
what spirit meant in the practice of
acupuncture. Reflecting back, I realized two
things: the college had not done a sufficient
job in explaining what shen and spirit mean
in classical Chinese medicine; North
American students are not a homogeneous
cohort, with the same moral and ethicoreligious codes, such as would have existed in
mainland China in Confucian, and perhaps
even Daoist forms, until the PRC communist
regime’s ruthless annihilation of the Chinese
people’s philosophical and even religious
heritage which endured for 4,500 years.
This issue of self-cultivation will be returned
to in a later reflection on reflective practice.
As a ‘religiophilosophy’, which is the way
Confucian scholar Tu Wei-ming frames his
argument, Confucianism seeks to “establish
the ultimacy of man” and to study his unique
“morality, sociality and religiosity” (ibid, pp
84-85). The focus here is on becoming the
most authentic man or sage possible, which
in Chinese Medicine would entail one who
practices High Skills, the Superior Physician.
Sagehood, in this Confucian sense, “rests on
the belief that man is perfectible through his
own effort. To know oneself as a form of selfcultivation is therefore deemed
simultaneously an act of internal selftransformation (ibid, p. 85).”
In the Confucian and Neo-Confucian
traditions, the latter incorporating elements
of Buddhism and Daoism, the mainland
Chinese people had a philosophical and even
religious tradition, depending on the
interpretation, that laid out basic codes of
conduct and upright bearing that were
especially applicable to doctors who sought to
practice High Skills.
Leaving aside the questions raised by some
scholars of Chinese thought regarding the
legitimacy of claims by the Neo-Confucian
masters to be “in the mainstream of
Confucian thinking”, which revolve around
the Neo-Confucian appropriation of many
Daoist and Buddhist beliefs and values, Tu
Wei-ming nonetheless concludes that,
“despite its efforts to absorb inspiration from
other spiritual systems, Neo-Confucianism is
a creative adaptation of classical Confucian
insights, rather than a syncretic culmination
of the ‘Three Teachings’ (ibid)” that spanned
the 11th to the 17th centuries.
In these traditions, which Confucian scholar
Tu Wei-ming refers to as “humanity and selfcultivation” in a text by the same name, the
relationship and tension between jen
(goodness, humanity) and li (propriety)
bespeak a creative tension between an
internal focus on “self-cultivation” and an
external focus on realizing ones self in
society, for the common good.
In his detailed study of the Neo-Confucian
Master Wang-Yang-ming (1472-1529), TuWei-ming focuses on the development of the
innate knowledge of the sage, only possible
through a committed and never-ending effort
of will entailing “a hundred deaths and a
thousand hardships (ibid, p. 105)”, as a selfeffort and a teaching which must be
“embodied”—a “learning of the body and the
A man, in our case a physician, who achieves
the highest “human achievement ever
reached through moral self-cultivation”, is a
chun-zhu or gentleman, a superior person, a
superior physician of high skills
5 mind”, to “think with ones whole being”.
This is portrayed, relative to Yang-ming’s
teachings, as an active and ongoing “decision
to focus on the problem of how rather than
the cognitive issues of what and why”, thereby
refraining “from converting issues of
profound human existence into mere issues
of speculation.” This is a way of
understanding experientially, “as if one has
‘encountered’ or ‘met’ […] that which is to be
understood by “deepening ones selfknowledge (ibid).”
shown great reluctance to submit her
teachings based on the sum total of her inner
experience to rigid formulas. As Wang Yangming puts it, “I strongly fear that the student
might easily grasp [this simple formulation
of] it, treat it as a circumstantial notion, and
play with it, without solidly dwelling in it and
strenuously working at it (ibid p. 105).”
After reviving myself from the exhaustive
study of Maciocia’s The Psyche in Chinese
Medicine, whose voluminous nature
reproduces hundreds of pages from his
‘Foundations’ and ‘Practice of Chinese
Medicine’ texts, and critically reflecting on
his attempt to share his knowledge of the role
of shen in Chinese Medicine in the way that
he did, I realized I was distrustful of such a
wordy, intellectual and academic discourse
on a subject that is so foreign to his, and my,
Western experiences of the psyche and the
body process.
I have learned, from my long-time colleague
Master Kiiko Matsumoto, how the question
“why” during Grand Rounds where we each
treat community patients in a clinical theater
classroom setting, is inappropriate, jarring to
the teaching-learning experience, and
irrelevant. I once watched and listened as
Sensei Matsumoto responded to a student’s
question about why she just did what she did
to the patient thus: “can you not see well,
come up here in the front so you see better”.
A little later in the same Grand Rounds day,
another student asked what the diagnosis was
for the treatment Sensei just completed and
Sensei responded: “When she comes back
next week, if she is better, the diagnosis is
what I did today!”
Having struggled 28 years ago with the
incongruity of Western notions of the inner
Self and the issue of the Western Body-Mind
split, as compared to the Chinese classical
notion of self, I already came to the decision
that I could not apply Chinese spiritual,
philosophical or medical concepts to my
Western patients’ experiences of illness,
especially where matters of the spirit and the
emotions are concerned. While I was able to
liberate myself, in writing this book, from an
infatuation with (often quite brilliant)
Western psycho-somatic concepts, as
derivative of the Body-Mind split of Western
psychology, in order to attempt to practice
acupuncture as a bodymind practice like EastAsian martial arts, or meditation, or Sumi-E
Japanese brush painting, it was through a
constant struggle that I changed my own
teachings at the college.
What I took to be a decidedly Japanese way
of teaching in such clinical environments
appears to have been quite consistent with
this Neo-Confucian teaching which “points
to a kind of ‘confirmation’ in which the
truthfulness of an idea cannot be
demonstrated by logical argument but must
be lived by concrete experience” and whose
“meaning can be readily acknowledged only
by those who have tuned their minds and
bodies to appreciate it (ibid, p. 104).”
And like Wang Yang-ming, who stated that
his process of ‘digging’ and ‘drilling’ as a
“way of examining, tasting, comprehending,
understanding, confirming, and verifying the
quality of [his] life” made such knowing an
“experienced reality”, Master Matsumoto has
In year-end faculty meetings, we often return
to the fact that students are getting better
and better at practicing what they are taught,
but are still not necessarily able to clearly
articulate what it is they are seeing, hearing,
6 feeling and doing when they practice in
clinic. And I inevitably come down on the
side of better practice.
It is with that sense that I was struck by Tu
Wei-ming’s elucidation of the view that “to
‘conquer oneself and return to propriety is
humanity.’ Indeed, the ego has to be
transcended and sometimes even denied for
the sake of realizing the genuine self. For selfcontrol, overcoming the ego, is the authentic
way to gain inner experience. This path is
universally open to every human being, but it
ought to be traveled concretely by each
person (ibid, pp 106-7).” This sort of process
does not alienate one from society, Tu Weiming clarifies, but rather “impels one to
enter into what may be called ‘the
community of the like-minded’ or even ‘ the
community of selfhood.’ In such a
community one not only befriends one’s
contemporaries, but one also establishes an
immediate relationship with the ancients
(ibid, p. 107).”
Having taught Judo as a teenager, for the
children’s class while Sensei Takahiko
Ishikawa, an 8th degree black belt and the
most advanced practitioner of Judo on the
East coast, and twice world champion (sent
from Tokyo by the Kodokan to bring judo to
this part of the country) played GO (in which
he was a highly ranked international expert),
I was always in awe of this powerful man,
whose ability to concentrate on GO and then
move fluidly across the dojo as he taught us
the way of judo, and totally appreciated the
strict discipline he instilled by his example,
and not by words. One could ask how he just
did something, and he would pain-stakingly
take you up and demonstrate the move on
you. But if you asked ‘why’ he did something
the way he did, you would be sent hurling
through the air without knowing what hit
you. Experience with your whole being, I
realized, was the message here, and do not
ask questions which takes you into a
cognitive realm.
I believe that this is how I come to “know”
what Nigel Dawes, or David Kailen were
saying in their Blog responses last month, or
how I know what Kiiko Matsumoto means
when I see, hear, watch and sense what she is
doing. We have all been doing this
acupuncture thing for three decades, and
when things ring true, very few words of
explanation are necessary.
For some reason, this way of learning was a
relief from overly heady French intellectual
studies I was pursuing. And it came naturally,
as did the practice of acupuncture as I shared
in the first month’s Blog. I realized when I
started treating patients in the South Bronx
with acupuncture that this was a similar way
of knowing/learning, and that to teach this
would be a great struggle.
This way of knowing and achieving
professional know-how through the doing of
it is referred to by Polanyi as “the tacit
dimension” which I will explore in my Blog
next week.
This feeling of community is exactly what I
am seeking with this OTHER
ACUPUNCTURE project, which has already
led to connections with colleagues in such a
way as to foster communication about each
of our inner experiences with the classics and
with our practice, in the form of Nigel
Dawes’ and David Kailen’s responses to my
Blog last month, and when I had a sit-down
discussion with Linda Barnes, who steered
me to Tu-Wei-ming ( her former Religious
I have come to finally appreciate looking at
the classic texts, even though I recognize the
impossibility of knowing the reliability of
their translation, while in fact sharing a deep
affinity with many things I am reading, based
on a whole bodymind felt-sense or tacit
knowledge of how what I am reading
resonates with my own inner experiences and
tacit knowing of acupuncture, akin to the
process elaborated by Tu-Wei-ming’s study of
Neo-Confucian self-cultivation and learning.
7 Studies PhD mentor at Harvard) and his
work.
Complete Translation of the Yellow
Emperor’s Classics of Internal Medicine
and the Difficult Classic(Nei-Jing and
Nan-Jing, International College of
Traditional Chinese Medicine,
Vancouver, 2004, p. 65).
What we can learn from Rossi and Maciocia
is that we should not inject our Western
notions of self, the sacred, and spirituality
into the Chinese medical concepts, but
rather attempt to understand these Classical
Chinese concepts on their own terms. But we
must struggle with these notions each in our
own way, and especially when we take
responsibility for teaching others.
After over a year interning with the
celebrated late Chinese Doctor John Shen in
Manhattan’s Chinatown, most Sundays, it
became evident that this was a living example
of the Superior physician of High Skills.
Over two thirds of his patients, who came for
his unique herbal remedies, would be denied
the “poison of medicines” as the Ling Shu
advises, because their problem, as he told
each one in turn, was no problem, their
disease was no disease; their problem was
their Life.
Life Nourishing Practices
Texts examining the main forms of daoyin
and yangsheng as the proper way to live, to
nourish life, existed at the same time as, or
even before the Su Wen, according to Rossi
and Lu. It is for this reason that the first
scroll of the Su Wen already refers to the
ways the people in olden times conducted
themselves in order to live out their proper
life span of 120 years. The patients in those
days were at the center of their own life
nourishing and Daoyin self-development, on
the basis of which the Chinese doctor would
address issues of disordered emotions and
the Five Shen.
He would then proceed to tell them to
regulate their eating times, the time they
went to bed and arose, and to simplify their
life to reduce stressors. He would tell them to
get Chinese rice wine, and Chinese celery on
the way to the subway from his office, and
infuse the celery in the wine, drinking this at
night to help with sleep. He would inevitably
conclude with a new patient suffering such
issues of lifestyle and stress: You take care of
your car better than you take care of yourself.
The patient, previously to the Su Wen, was, to
sound very modern, an active participant in
his own care where spiritual health and the
moderation of emotions and lifestyle were
concerned:
He would then give them a simple
acupuncture treatment to calm the nervous
system, and not suggest a return. He would
not give herbal medicine because he did not
consider them to have a disease, but rather a
stress disorder that they could and should
learn to manage on their own.
1. “One should take an easy-going
attitude toward life and have few
desires;
2. One should form good eating habits;
3. One should lead a regular living
pattern;
4. One should work adequately and
avoid excessive fatigue;
5. One should control sexual desires;
6. One should live in harmony with the
climate of the four seasons ( Su Wen,
Chapter 1, in Henry C. Lu, A
In his later years, he would have tui na
practitioners recently over from PRC, who
became licensed in acupuncture, treat such
patients with massage and acupuncture and
again never prescribe herbal remedies. When
I asked him if I would have to learn how to
master the pulse and tongue as he did, he
stated that since it was clear I wanted to
specialize in acupuncture, there was no need
8 to master these skills, which he relegated to
the treatment of serious internal diseases
with Chinese medicinals.
This clarification between what acupuncture
could best treat (the two thirds of what he
saw where he did not prescribe herbal
remedies)—chronic pain, stress disorders,
functional disorders of the various organ
systems without signs of disease-- are what I
have come to specialize in, and it is here that
mainstream medicine holds out the most
hope for complementary and alternative
medicine and healthcare. In such chronic
musculoskeletal and internal functional and
stress disorders, I have found acupuncture to
be extremely beneficial with very few
treatments at a time. In these disorders, the
shen is always at issue, and when there is a
central adrenal syndrome at the heart of what
I term four patters of visceral
agitation/fatigue, I resort to the extraordinary
vessels as outlined in chapters VII and VIII
of Acupuncture Physical Medicine.
These four templates serve as exemplars for
any stress disorders of the Zang organs.
Where a central internal functional disorder,
or emotionally driven disorder has no
involvement of the adrenals, I simply use the
normal treatment strategies of the regular
meridian circuits, adding the outside line of
the Bladder meridian for the shen aspect of
the Zang involved as well as reactive chong
mai points on the front (Kid 11-27; St 30-13)
to regulate prenatal and postnatal qi, thereby
restoring more normal function of the organs
and the channels, and Qi and Blood. It is in
this way that I address shen disorders when
there is no actual, or serious, mental illness.
I will present the chart for these four patterns
in chart form on the next page:
9 APM Acupuncture – 4 patterns of fatigue/stress
Spinal
Irritation
__________________
Du Mai Excess
Kidney
Yang/Heart
Protector
Dysfunction
Water/Fire
Imbalance
Precipitating
factors may be
trauma of a
physical or
emotional
nature (car
accident,
attack by dog,
abuse)
Signs &
Symptoms
Point
strategies
AOM
Lifestyle
Coaching
________________ ________________ _______________
running on empty,
type-A, adrenal
exhaustion (drops-dead
in bed at night)
YinYang Regulation
works and plays hard,
lives world muscularly,
reacts to world
somatically
very productive, very
active at work, sports,
socially
Ever-Ready Bunny
Superman,
Superwoman,
Supermom or Dad
Patient Complaints:
o
o
o
Ying: Kid 2(Fire) and
3(source)/ying and
shu;
Bl 58 (luo); BL 23
(tonify or disperse
carefully if lower back
muscles are rigid) on
right especially, and
BL 14-43 on left
(Kidney Yang/Heart
Protector dysfunction
Neck & back
pain in stress
muscles
Lowback
syndrome
with adrenal
exhaustionback goes out
under stress
Fibromyalgia
Insomnia and
agitated sleep
To above add BL 18,
20/triple heater
regulatory; SP 6 and
Ht 7 for insomnia;
Local multifidi if spine
is irritated from stress
Can turn over at end
and do yintang for 10
more minutes.
Wei level shallow
oblique needling to
most tender points in
fibromyalgia or highly
sensitive or reactive
patients, leave needles
only 5 minutes
Release most
symptomatic TrPs per
patient’s de Qi
tolerance in stress
muscles (traps,
paraspinals, gluteals,
piriformis)
Take hot bath with
sleep inducing bath
salts, sleepy time tea
or other soporific
while meditating or
listening to soothing
music last hour before
bedtime
Stress importance of
solid sleep to restore
adrenals
Patient Complaint
End result—Adrenal
collapse and CFS
o
Jing: SI3/BL 62 for du
and yangwei Mai
Counsel patient to
start stress
reduction/relaxation
response activity for
overall agitation
10 Engage in physical
activities that distress
muscles per exercise
tolerance level (do
not exercise at night
if suffering from
insomnia)
Do stretching for
tight neck, back,
lumbosacral muscles
Get pillow-top
mattress or egg-crate
mattress cover; side
lying pillow, or
cervical pillow if
sleeping face up
Suggest
hypnotherapy,
EMDR,
psychotherapy to deal
with behavioral and
post-traumatic issues
Diaphragmatic
Constriction/
GI Distress/
chong mai
middle heater
dysfunction
Signs &
Symptoms
AOM
Lifestyle
Coaching
________________ ________________ _______________
___________________
Constrained
Liver Qi
Up-regulated
SNS overacts
on PNS
Taiyin/YAngming
Circuit
dysfunction
Liver/Spleen
dysfunction
Spinal
Irritation and
up-regulated
SNS may be
precipitating
factors for
this pattern of
visceral
agitation
Point
strategies
YinYang Regulation
tight rectus & oblique
muscles- viscerosomatic
tight chest (pectoralis
level with ST 18-Liv 14)
Tight SCM (plum pit
Qi)
Patient Complaints:
o
o
o
IBS, bloating,
undigested
food, diarrhea
and/or
constipation,
abdominal
pain, gas
Reflux or
GERD
Relief in
Crohn’s
Disease or
colitis
Jing:
SP 4(R)/Per 6(L) for
chong and yinwei mai
Ying:
LI 4/Liv 3
Liv 14 (and GB 22 or
Per 1), SP 6
Patient Complaint
ST 36-39 &
ST 25; CV 10, 12, 13;
ST 24-18 on left
ST 25 (Bil) all where
tight and constricted
(dispersal, not TrP
needling)
For Xu-Li, add CV 12,
ST 14-16(left), ST 18
(L); ST 44-43 where
tender either or both
sides
For heartburn to chest,
add CV 18to 17 and
lateral Kid points; or
Kid 22 and Per I if left
sided heartburn
11 Counsel patients that
“their problem is their
Life”
Dr. Shen advice- eat
regularly 3 x day,
never late at night,
never while working
at desk or standing,
slowly, quietly
Do not indulge in
fatty foods or alcohol
Check out if they are
wheat, lactose, or
corn intolerant or
have celiac disease
Do not drink ice-cold
drinks
In reflux and GERD,
raise back of bed 6” to
prevent acid reflux
Above all, teach
abdominal breathing
as AM and PM stress
reduction activity
before arising and
falling asleep, while in
bed face up with
knees bolstered with
pillows, or whenever
hyperventilating (5
minutes)
Pelvic
collapse/
chong, dai, ren
dysfunction
Lower heater
dysfunction
__________________
Spleen Qi
Sinking with or
without
Constrained
Liver Qi in
Middle heater
as possible
precipitating
factors for
this pattern
of visceral
agitation
Signs &
Symptoms
Point
strategies
________________
________________
Flaccidity in middle
heater abdominal
muscles, tightness and
constriction below navel,
pressure and pain at Kid
15.5 to Kid 11 and ST
26-30, and CV 7-2
(chong mai lower heater
branch), tight lower
external obliques (dai
mai); tight linea alba (ren
mai)
YinYang Regulation
Patient Complaints:
o
o
o
o
Prolapsed
organs: postbirthing;
uterus, bladder,
right kidney,
hemorrhoids,
hernias (Shan)
PMS,
amenorrhea,
disrupted
menses,
infertility and
impotence
prostatitis,
vaginitis,
cystitis, pelvic
floor
syndrome;
sexual
dysfunctions
such as erectile
dysfunction or
frigidity
12 Jing:
Chong-Dai Infinity
Treatment: SP
4(R)/Per 6(L) for
chong mai; GB
41(L)/TH 5 (R) for dai
mai
Ying:
Three leg yin source
points SP 3, Kid 3, Liv
3; Sp 6 and 9; Liv 9 for
constrained Liver Qi in
lower heater;
Patient Complaint
Local chong, dai and
ren mai points in lower
heater; local Liv, Sp,
Kid meridian points in
lower heater; local
points over visceral
irritation (ST 30 for
ovaries, CV 4-6 for
uterus etcetera);
CV 2 down, to right
and left to propagate Qi
for lower heater-it is.
AOM
Lifestyle
Coaching
_______________
Coach patients to
develop core
strengthening routine
for middle heater;
stretches for lumbar
region;
Yoga or Qi gong for
lower heater
strengthening
counseling/therapy for
sexual dysfunction
counsel women with
vulvadynea to seek PT
specializing in manual
therapy who specialize
in this
Cardiac
Alarm/ UpperLower heater
dysfunction
__________________
Kidney
Yang/Heart
Protector
Dysfunction
Kidney/Lung Qi
Dysfunction
Pelvic
collapse
and/or
diaphragmatic
constriction
may be
precipitating
factors for
this pattern
of visceral
agitation
Signs &
Symptoms
Point
strategies
________________
________________
Free-floating anxiety,
dread, fear of impending
doom
YinYang Regulation
Shallow breathing,
hyperventilation, heart
palpitations induced by
stress
Chong-Dai Treatment:
SP 4(R)/Per 6(L) for
panic attack, anxiety,
palpitations in patients
with Kidney Yang &
Heart Protector
dysfunction
Suggest stress
reduction or relaxation
response programs for
coping with stress
Ren & Yinchiao mai:
Lu 7/Kid 6 for shallow
breathing and
hyperventilation
syndrome in patients
with Kid/Lu Qi
dysfunction
Suggest mindfulness
training for practicing
anytime/ anywhere
Non-cardiac chest
tightness and discomfort
from diaphragm to
under armpits and
sternum (3 yin muscle
channel referral
patterns) with tightness
in rhomboids and
paraspinals in upper
back
Jing:
Ying/Patient
Complaint:
Patient Complaints:
o Anxiety, panic
Kid 15.5 for adrenals;
o
Per 4 &5 with CV 18-17
for chest constriction
o
attack, heart
palpitations;
cardiac
neurosis;
costrochondritis
Kid 22 and Per 1(L) for
chest pain on left
(cardiac neurosis)
Xu-Li treatment for
chest pain from reflux or
GERD (see second
pattern of fatigue above)
SP 20 & LU 1, Kid 27,
BL 13 and 42 for
hyperventilation
syndrome
13 AOM
Lifestyle
Coaching
_______________
Coach patients to do
abdominal breathing as
above
Suggest meditation,
yoga, Qi gong
Suggest biofeedback,
hypnotherapy, EMDR,
Psychotherapy for
behavioral and posttraumatic issues
medicine, but more specific, perhaps, to the
diverse needs of the North American student
or patient of Acupuncture & Oriental
Medicine (Institute for Functional Medicine,
WA, 2006, pp. 669-685).
The Western Spirit Recovered
What I have realized in researching this topic
and in reflecting at length on my senior
students’ various approaches to and
interpretations of spirit, is that unlike the
Confucian Chinese, who had a centuries-old
set of beliefs and practices based on an ideal
social person who possessed the 5 virtues -benevolence (ren), propriety (li), integrity
(xin), decisiveness (zhi), and right action (yi),
our North American students come from
varied cultural backgrounds that might derive
from Judeo-Christian, Moslem, and African
roots to name but a few. It is therefore
unrealistic to assume that North American
students, or patients, of AOM would share
the same notions of the self, the sacred, and
what spirit means in their lives.
In this 21st century approach to care, the
relevance to the healthcare practitioner of
Mind and Spirit, and the impact of a
patient’s “spirituality” (“search for the sacred,
the sense of being connected to something
greater than self”) and/or organized or
institutionalized religious beliefs, is pivotal.
Evidence on the beneficial effects to health of
a patient’s spirituality and/or religion was
gathered in a systematic review of the
literature over the entire 20th century
(Koenig HG. Religion and medicine IV:
religion, physical health, and clinical
implications. Int J Psychiatry Med. 2001;
31(3): 321-336): “While more research and
better designed studies are needed, the vast
majority of research completed to date
indicates that religious beliefs and practices
are associated with better mental and
physical health (Textbook of FUNCTIONAL
MEDICINE, p. 677).
The notions of the self, the sacred,
spirituality and the relationship between
humans and nature were heavily influenced
by East-Asian traditions and practices at the
height of the New Age Movement, which
gave way to holistic medicine, and then to
complementary and alternative medicine,
and now integrative or functional medicine.
These decidedly North American traditions
yielded a rich array of approaches to the
sacred and spirituality and went on to greatly
influence the way mind-body medicine
approached the role of the spirit in health
and disease.
In another review of the evidence which
looked at the religious/spiritual as compared
to meditation/relaxation practices, Seeman
et al concluded that:
“1. Meditation/relaxation is associated with
better health outcomes in clinical patient
populations (…);
2. Meditation/relaxation is associated with
lower blood pressure (…);
3. Religion/spirituality is associated with
lower blood pressure, less hypertension,
better immune function (…);
4. Meditation/relaxation is associated with
lower cholesterol, lower stress hormone
levels, and differential patterns of brain
activity (…);
5. Meditation is associated with less oxidative
stress, and less blood pressure and stress
hormone reactivity under challenge (…)
21st Century North American Search for the
Sacred
In their primer, Textbook of FUNCTIONAL
MEDICINE, the Institute of Functional
Medicine lays out its approach to the
relevance of the role and impact of
spirituality and the “search for the sacred, the
sense of being connected to something
greater than self” on healthcare practitioners
that is consistent with classical Chinese
14 (ibid).” Other studies cited find that regular
church attendance in healthy individuals
reduces mortality by some 25%, and that
regular church attendance can reduce cardiovascular disease, which may be related to the
“healthier lifestyles adopted by churchgoers
(ibid, p. 678).”
Alternative Medicine show that an enormous
number of people avail themselves of these
practices for their health, wellness and
disease prevention, which I will return to in a
later reflection.
Such practices are consistent with, and
complementary to Acupuncture and Oriental
Medicine life nourishing practices, and AOM
practitioners trained in such approaches will
be in a better position to engage in wellness
and health prevention lifestyle counseling
with their patients in a way that is best suited
to their patients needs. Such a combination
of East Asian and Western approaches might
well become a more and more practical way
of bringing life-nurturing practices back into
a Chinese medicine that would restore the
soul and spirit of Western AOM
practitioners and their patients, through
creative conjunctions and collaborations for
best care.
Citing the conclusions of a study by Hawks et
al on three peer-reviewed spiritually based
health intervention programs (Stress
Reduction Clinic of Jon Kabat-Zinn at the
University of Massachusetts Medical Center,
The Lifestyle Heart Trial, and the Stamford
University School of Medicine complex
psycho-social intervention with metastatic
breast cancer patients) the effects of
“improved spiritual health may be associated
with improved behavioral and emotional
health in such areas as diet, activity levels,
communication skills, treatment compliance,
reduced anxiety and depression, and
improved mood states. These positive
behavioral and emotional improvements in
turn may be associated with heart disease
reversal, reduced cancer mortality, enhanced
immune function, and reductions in pain
and other medical symptoms (ibid, p. 680).”
While it is possible for North American
AOM practitioners to develop Lifestyle and
Life Nurturing programs for their patients,
including Dao-Yin, Qi Gong and herbal
practices, it may be more pragmatic and
appealing to their Western patients to refer
them to neighborhood programs in mindbody and spiritual practice, tailored to their
desires and needs, as well as specialists in the
psyche (psychotherapy, cognitive-behavioral
therapy, body-centered psychotherapy) and
the body (physical and occupational therapy,
athletic training, Rolfing, massage,
Feldenkrais Method, the Alexander
Technique, Gyrotonics, Pilates) and
programs in mind-body health (Yoga, Qi
Gong, T’ai-Qi, Meditation etcetera).
Recent studies on the use of mind-body
practices as one form of Complementary and
15