We should never rely too much on our pulse-taking

An Israeli practitioner, Anton, who is making every effort to deepen his understanding of five element acupuncture, has recently sent me the following interesting question:

I have a question about the husband/wife block. Today I treated a patient and found this block on her. And this is the third time in four months that I make this treatment for her. Well, maybe I am missing something, am I? Does it seem ok to you to have this block back almost every month?

 

This patient delivered a baby four months ago, and the baby has a heart problem from birth. He needs to undergo a surgery on the next week. I explain to myself that all the worry about new born baby makes the block to come back every time, but is it really so? Do you think it is possible, or maybe I need to pay attention to something else?

 

This was my reply to him:

It is very rare for blocks to come back more than once in a short time.  It is most likely that this patient’s pulses are always a little stronger on the right hand than the left hand, so that it isn’t a H/W block.  Just assume that that is what is the case, and don’t treat the block again.

I mulled over his question and my reply for a time afterwards, and realised that I should have added something important.  I myself never rely only on my pulse-taking to help me diagnose a block of any kind. As I have said on many occasions, pulse-taking is a very complex art, much more complex than I think we like to admit to ourselves.  In effect we are attempting to read the state of the five different elements and their 12 officials with what I always like to think of as the rather blunt instruments of our finger-tips.  Of course we get more adept at doing this as the years pass, but I have never forgotten the lessons I learned comparing JR Worsley’s pulse-readings with my own, even after I had been more than 3 years in practice (plus 3 years training myself to read pulses). 

He would tell me one of my patients had an Entry/Exit block or a Husband/Wife block when I simply could not feel this.  Conversely, what I rather simplistically thought to be some kind of a block would turn out not to be that.  In other words the delicate art of accurate pulse-reading was something I realised would take me many years to learn.  And in the meantime I realised, too, that I had to look for other indications in patients which should be helping me suspect the presence of a block.  In the case of a Husband/Wife block, we must never forget that this is the indication of a deep attack on the Heart, and a patient must be showing signs of some desperation, of almost wanting to give up.  They may not articulate this in words, and some may like to hide their despair, but as good five element acupuncturists we should always be looking below the surface to see what is really going on deep inside a patient.

Anton’s patient is dealing with the serious condition of her baby, but not everybody facing something like this would necessarily feel like giving up.  It may not be causing a Husband/Wife block, though it is always worth considering this, and carrying out the treatment procedure for a block even if we are not sure of the pulse picture.  Remember that it never matters if we try to clear a block of any kind, from Possession to a simple Entry/Exit block, if the block is not there.  It is then only like trying to open a door which is already open.  So it is better to err on the side of treating for a block even if we are unsure of its presence, rather than ignoring what might be a block.  On the other hand, once you have treated a block, you don’t need to repeat this treatment if you are sure you got the points the first time.

 

 

 

 

 

 

 

 

 

Perhaps we are alone in the universe after all

The more I encountered the concept of the elements early on in my acupuncture studies, the more I became fascinated by the idea that the same energies which create the universe also created me and will continue to go on giving me life until the day I die.  As acupuncturists we are not always aware in our everyday work with the elements as we treat our patients that these elements are symbols for universal aspects of cosmic life.  I have therefore always been intrigued to realise how much this understanding of the work I do forces me to confront the deepest of life’s mysteries.  This has led me to the belief that each of us can be seen as a tiny thought in the mind of whatever god or universal force we believe ultimately created the universe.

I am therefore always thrilled when a little more light is shed into the deepest of life’s mysteries, where science tries to make sense of how human life appeared and, even more mysteriously, why it appeared in the form it has done.  So here is a further offering to my curiosity from the Guardian a few days ago with the headline: “Perhaps we are alone in the universe after all”.  The article describes a paper written by three Oxford University philosophers in which they surmise that “the probability (is) that we are alone in our galaxy, and perhaps in the universe…. There is quite probably no one out there to rescue or to care about us.  What happens to our species is in our hands alone.  We had better get on with it.”

This has prompted me to look up some other quotations I had collected over the years on much the same subject.  Some are by Martin Rees, the Astronomer Royal, in which he says, in lovely poetic language:

 

“We are composed of the language of the universe”
“I think it’s only life which gives the universe any meaning.”

 

And, most memorably:

 

“Perhaps it could be said that the universe was made for Man”.

 

Finally, in an article about Leonardo da Vinci, the writer, an art historian, said the following:

 “I once heard a scientist remark that perhaps the principal function of mankind was to bear witness to the universe, to be here precisely to see in the night sky the light of long dead stars, and in so doing to give completion and meaning.”

 

All these are profound thoughts for us all to ponder on.  But I don’t think we can understand the potential power of what we do as we harness the energies of the elements through our needles to help our patients if we ignore the deeper implications of our practice.

 

Western Medicine confirms the existence of the Chinese Clock

I love it when Western medicine shows its surprise at discovering something we acupuncturists (and the ancient Chinese more than 2000 years ago) have known about all along.  In today’s Guardian newspaper there is an article entitled, “Night shifts throw brain and gut out of sync, research finds”. 

Here are some quotes from it:

“The finding highlights the dramatic impact that night shifts can have on the different processes that govern the natural rhythms of organs and systems throughout the human body”.

and:

“We have a central master clock in the brain that draws on changes in ambient light to control when we wake up and when we fall asleep.  But many other organs in the body have their own biological clocks, including the digestive system.”

and:

“..nowadays we can do anything we like at any time of day, so we are giving our body clock very confusing time cues.”

 

The Chinese, of course, extended their understanding of the 24-hour body clock to cover the longer period of the 12 months of the year, linking all these daily and seasonal variations to the waxing and waning of the influences of the five elements.    

 

Guy and I needle our own horary points as we pass through the different time zones on our flights to and from China.  We both feel that this certainly helps to mitigate the effects of jet-lag.

 

Some early mistakes in my practice

Looking back at the early years of my practice, I sometimes cringe with shame at some of the mistakes I made.  These were not, as some people might assume, to do with my very basic understanding of the elements, or my choice of treatments, although they, too, were with hindsight often rather naïve or even somewhat inappropriate.  Instead they were nearly all to do with my relationship to my patients.  Based on something which JR Worsley had impressed upon us, I somehow thought that I had to make myself available to my patients at all times, even interpreting what he said as meaning that a patient should be able to contact me at any time they wanted to.  Those were the days well before emails and mobile phones when patient-practitioner contact was nearly 100% by good old-fashioned landline.  Since I worked from home, I soon realised that I needed to install a dedicated practice line so as not to confuse my private with my professional phone calls.  This meant also having two answering machines, making quite an impressive array of phone equipment lining my kitchen shelf.

I still remember the excitement of coming back home and seeing the “message received” light blinking on my practice phone.  I would always hope that this meant that a new patient was making contact, for each new patient was then a highly exciting event.  There was, however, one definite advantage of patients having to get in touch with me by phone, and not, as usually happens nowadays, by email or text message.  This meant that when I answered them our first contact was always person-to-person, and not the much more impersonal contact of the written word through emails.  It is now often overlooked how important this initial contact can be, not only because it offers both patient and practitioner a bridge to that key aspect of five element treatment, which is the setting up of a good relationship with our patients, but it also gives us the luxury of trying to diagnose two key components of an element’s presence, the tone of voice and the emotion the patient is showing.  On the patient’s side, it helps get them past the often challenging situation of a first meeting in the practice room.  I felt that this first phone call shaped the nature of my future relationship to my patients.

But the flipside of these personal phone calls was that it gave my patients the impression that they could phone me whenever they wanted to, and this was where I started to make things difficult for myself.  I didn’t then have enough confidence to lay down careful guidelines as to when they could phone and what they could phone me about.  And I soon found this led to a further mistake.  Patients got used to phoning me at odd hours of the day, either early in the morning or, most often, rather late in the evening.  And I would find myself engaged in long conversations with them, all of which, I should have told them, were best suited to being continued at their next treatment.  It took me quite some time, and many interrupted evenings of phone calls, before I realised that what the patients and I were talking about belonged much more appropriately to the practice room, where it would help me determine the kind of treatment the patient needed.  As five element acupuncturists it is the treatment we offer our patient which helps solve their problems, and although five element acupuncture is partly a talking therapy, because of course our patients need to talk to us and we to them, it is good to remember that it is the needle, not our words, which eventually helps them.

This open-door, or rather open-telephone, policy of mine also opened the door to the thorny question of discussing the element I was treating them on.  I learnt to my cost that it is never a good idea to talk this through with a patient, because often one of the reasons for doing this can be our unconscious desire for reassurance from the patient that we are on the right track, and it is surely not their task to help us.  We are often hoping that they will confirm that we have made the right choice.  And I have come to realise that nobody, even the most experienced five element practitioner, is good at diagnosing their own element, though practitioners often like to feel that they are the best judge of this.  Unfortunately this is rarely the case, since we all tend to be rather blind to our own faults and like to think we have a special relationship to an element whose qualities we admire.  And if you mistakenly start to discuss a patient’s element with them, what do you do when you change your mind and change element, or change it several times?    Do you tell your patient this or leave them with the mistaken idea that they are of the Earth element when you have perhaps moved through Fire before finally landing on Wood?   We all know how often we find ourselves trawling through the elements before finally finding the correct one.  Thankfully, though, this happens less and less for me now.  So take heart all you novice five element acupuncturists out there.

So now I always advise practitioners to lay down firm guidelines for their patients on when and how to get in touch with them between treatments.   If we don’t do this, we are laying ourselves open to the possibility of patients controlling treatment.  For further discussion about this see my two blogs of 14 June 2018: Never let a patient take control in the practice room, and A lesson from JR Worsley: the importance of keeping control in the practice room.

Finally, it is not a good idea to tell patients what points you are using except very occasionally.  It is difficult enough for us to put into words why we are choosing a particular point or set of points, let alone explain this to a lay person.  If they ask, I have learnt to say, “I am not here to teach you to be an acupuncturist.  If you are interested in learning more, I suggest you read my Simple Guide to Five Element Acupuncture which explains my approach to treating you”.  The following are some of the few exceptions to this rule:  telling patients about horary and seasonal treatments (because we have to book our patients in at specific times for these), and correcting an Akabane imbalance, because patients are often fascinated to find that the readings change after treatment.  I have found that this is a very good way of convincing rather sceptical patients, particularly hard-headed businessmen, at the very start of treatment that there is something in what I do.

It is also useful to explain to patients that some of their symptoms may be the result of an entry/exit block, and obviously we need to explain in a little detail why we think a CV/GV (Ren Mai/Du Mai) block needs to be cleared.  In the case of this block I always first ask if the patient feels very exhausted all the time, a very good sign of a CV/GV block, and I tell them that this is because the main pathways of energy running up and down the body are blocked, draining them of energy.  Sometimes I add the fact that JR Worsley told us that if only these points were on the wrist we would do them on every patient!

On the other hand for obvious reasons I never tell a patient that I am about to clear a Husband/Wife block or do Possession treatment, because the last thing you want to do is worry the patient by giving them the idea that there is something seriously wrong with them.  With Possession, however, I tell the patient that I am doing some lovely connecting treatment, and that I need their help to make sure that they feel each of the seven points properly.  I have noticed that patients needing this treatment really understand what I mean when I say this, as though I am reassuring them that I know that they feel disconnected.  This is also a good way of describing Possession, which is in effect a level of disconnection of the spirit.

I am passing on some of my tips for what to tell patients because I wish I had been told much of what I learnt by hit and miss through my own practice.  It would have avoided some of the problems I created for myself.

Daring to think our own thoughts

However much we owe to those from whom we have learnt the most, it is one of the fundamental qualities of being a human being that each of us has the right, and I like to think also the duty, to develop our own understanding, and in so doing perhaps move what we have learnt in new directions.  This prevents us from simply repeating robot-like what we have been taught, and gives us space to develop fresh approaches.  It is natural that we will all feel daunted by the expertise of others, particularly those with many more years’ experience than we have, and this may make us believe that we have nothing original to add to what has gone before, but we each have our own particular perspective on our work.

I am thinking about this today, because of an email I received this morning.  It always amazes me how things occur very unexpectedly to move my thoughts in a new direction, this email being one of them.  It was from my lovely young Indian friend, Sujata, who lives in Bangalore.  Sujata is a keen reader of my blogs, and is herself a serious yoga practitioner, always looking for an inspiring yoga teacher to replace the one who unfortunately moved to another town and has left her somewhat bereft.

She told me about an interesting book she had just read in which the author described developments in his yoga practice.  This is what she said about his book:  

“(The writer) outlined his frustrated attempts, what the teachers had said, what he could implement or learn, what he refused to do, and how all this shaped his philosophy and knowledge.  It came at a time (a few weeks ago) when I (Sujata, that is) felt there were no more teachers here whom I could contact (after meeting a highly unsuitable teacher!) and I would just have to proceed by myself, by re-reading the old texts and practising.  It motivated me to think about things I had not thought of for a long time.”   

 

Sujata finished by writing:  “….It was the book about an apprentice that gave me the final push to go ahead, not the books written by masters.”

As I read this, a light went on suddenly in my mind.  I am very preoccupied at the moment in describing the many lessons I have learned over the years which have contributed to help me develop my five element practice.  What I had not until now thought of doing was to include in this writing more about the often difficult personal obstacles I have had to overcome in my practice to reach the point where I am today.  Sujata’s email has provided me with another slant on how I should pass on my experiences.  This should not just describe the valuable lessons I have learnt from others, but also the difficulties I made for myself.  In past writings I have tended to omit these, or have only briefly mentioned problems I encountered in my practice.  Perhaps the time has come, stimulated by what Sujata has written, to describe the five element journey to where I am now in more candid, honest terms than I have done so far.

 

This may well be a help to any reader now struggling with the inevitable confusions and puzzling situations confronting anyone starting out on the hard, but ultimately supremely satisfying road to becoming a competent five element acupuncturist.

The significance of a Husband/Wife imbalance

I remember asking JR Worsley how he would describe the onset of death in five element terms, and he gave me this very simple reply:  “A person dies when Aggressive Energy appears again and again, and a Husband/Wife imbalance can no longer be corrected.”

If we think through the H/W treatment procedure, his reply makes perfect sense.  It is always good to look at the five element chart when doing this, and trace the points we use to clear H/W on the chart itself.  When I teach the procedure I always draw a vertical line down the middle of the five element circle, separating the two sides in half.  When looking at the chart in front of us, and starting from the Fire element on the right side at the top, there are the two Outer Fire officials, the Three Heater and Heart Protector, the Earth element and the Metal element.  On the left side, there are the two Inner Fire officials, Small Intestine and Heart, the Wood element and the Water element.  Energy passes along the Shen cycle from Inner Fire, through Earth, Metal, Water, Wood to Outer Fire and on again in its endless circling.  The vertical line I draw to separate these two sides should be a broken not a straight line.  During life, the two sides must always be joined energetically, but when there is a H/W imbalance this connection weakens and threatens to break.  The point of complete separation represents death.

The Husband/Wife imbalance is diagnosed by a pulse reading which reflects a weakening of the cycle of energy, with the pulses on the right-hand side, which we call the Wife’s side, becoming excessively strong at the expense of those on the left, the Husband’s side.  (We need not be politically correct here.  The term is taken from an ancient Chinese view of the world.)  The following is the sequence of the points we use: III (Bl) 67, IV (Ki) 7, IV (Ki) 3, VIII (Li) 4, II (SI) 4, I (Ht) 7.  The sequence is important, because the first two points, Water tonification points, immediately act to strengthen the connection between the Metal and Water elements, in effect reinforcing the link between left and right sides.  They are followed by two energy transfers across the Ke cycle.  Energy is transferred from the excess energy of the Spleen on the right across the Ke cycle to the Water element on the left by needling IV (Ki) 3, and from the Metal element on the left to the Wood element on the right by needling VIII (Wo) 4.  The sequence is completed by the source points of the Small Intestine and Heart, further strengthening all the officials on the left side, and, significantly, finally including the Heart.

JR told me one day to clear a Husband/Wife imbalance on one of my patients. He returned to the room to check on what I was doing when I had only begun the procedure, and had just needled the Water tonification points.  He took the patient’s pulses, and told me that the block had already cleared.  I completed the procedure after he left the room, as I did not think it appropriate to leave it half-way through.  This made me understand for the first time exactly how important it was to re-establish a strong connection between Metal and Water.  It is when the flow of energy between them starts to weaken that we must be alert to the strain it is putting on the Heart which is now being deprived of the good energy it needs to function properly.  When a person is dangerously ill, it is this link between the officials which starts to weaken and eventually breaks completely at the point of death.  In five element terms, the weakened Kidney (the Water element no longer receiving energy from the Metal element) passes Aggressive Energy across the Ke cycle to the Heart.  Looked at in terms of orthodox medicine, this represents kidney failure inevitably leading to cardiac failure. 

We are not going against nature if we try to correct a H/W imbalance in a severely ill patient whenever we find it.  We are just doing all we can to strengthen the Heart and make the patient as comfortable as possible.  Eventually, the imbalance will not correct itself if the patient is too ill.  This is when death takes over. The Heart will be telling us when it has had enough of life.

I always find it comforting to find the explanation for the onset of death in such clear five element terms, and I am grateful that we have such simple and powerful means in our hands to treat a potentially life-threatening condition in its early stages.