Procedure for diagnosing 130 budding five element acupuncturists in one day

I am often asked how on earth we have attempted to offer a five element diagnosis to the many hundreds of acupuncturists in China who have come to our seminars over the past eight years.  I am just returning from another week’s seminar in Beijing where we have tried yet again to do just that, so I would like to describe the procedure we have worked on over the years to do this.

Of the 300 or so practitioners who attended, some 130 were new to us.  All these had previously attended one of the many preliminary five element courses in many towns all over China organized by the more experienced of our five element group of practitioners, now promoted to the role of five element teachers.  By the time Mei, Guy and I arrive at a seminar all those attending will have been given a provisional diagnosis of their element as a starting point from which we work.

In China, nobody seems to worry at all when I explain that all diagnoses we make are only a first attempt at finding their element.  They are very unconcerned when we change these preliminary diagnoses, and may change them again during the week of our seminar.  This is probably because I always emphasize that none of us can ever truly “know” the guardian element until treatment has confirmed that we are on the right track.   

As encouragement for myself, and for others, I always like to remember JR Worsley telling us when we were students that we would all be able to diagnose as quickly as he did when we had as much experience as he had after his 45 years of practice.  I have now had 30 or more years of five element practice to help me, and if I add these years to those of Guy and Mei, I like to think that together we reach JR’s total of years.  Certainly to my surprise, every time to we return to China  the three of us are getting better and better at our diagnoses, and quicker and quicker at making them, too.  And we work together very well as a team.

So here I will describe the procedure for carrying out these multiple diagnoses which we have developed to cope with the ever-increasing number of those attending our seminars who wish to have some idea of their own element.  As we know, all five element acupuncturists should as far as possible be sure of their own element as an essential pre-requisite for their practice, for without this we do not know what shadow our own element unconsciously casts over our patients.  And all those attending quite rightly crave a diagnosis from the most experienced five element practitioners they can find.  I therefore think we have a duty to offer them our expertise in diagnosing the elements, with the proviso that we make these diagnoses in a rather idiosyncratic way to take account of the sheer numbers involved.  The Chinese, bless their hearts, willingly accept this without complaint.

This is what we do:  To help us, we are given photographs of the new practitioners grouped together according to the element to which they have been assigned in the introductory seminars.  We then count the total number for each element.  This seminar (April 2019) the numbers were:

Wood: 17,  Fire: 10,  Earth: 32,  Metal: 21, Water: 42, plus 11 still left undiagnosed.   

From experience we know that if we work quickly, we can get through this large number in a day, divided into a morning section from 8.30 – 12, a long lunch-break of 2 ½ hours from 12 to 2.30 (the Chinese always take a nap after lunch), and an afternoon session from 1.30 – 5.30.  Five chairs are placed on the raised platform at the front of the large seminar room, and Mei, Guy and I sit in the front row of the audience group, with many people sitting on the floor all around us, and everybody else seated behind us.  There is always a scramble for people to get as close to us as possible, because they want to hear the discussions we carry on between us. 

This time we started with one of the larger groups (when our minds were fresh!), choosing Earth first, because starting with the largest group, Water, was likely to give the room a more uneasy feel (Water’s fear showing itself as it is asked to talk in front of such a large group of people).  An Earth group is much more at ease, and this helps to settle the room down nicely at the start.

Five of the each group sit down in turn on the platform in front of us, and we look at this small group as a whole to see how far they seem at ease with each other (or not), and whether any particular person stands out from the group in some way.  Then each of the five is asked to talk a little about anything they want, as we listen to their voices (the audience group is told to do this with closed eyes for part of the time), and observe them closely.  Over the years everybody coming to our seminars has got much better at spotting the odd person who doesn’t seem to fit in with the rest of the group.  This may be the one who sits forward whilst the others sit back, the one who turns to look at the person talking, whilst the others look straight ahead, or is constantly moving whilst the others remain still.  We have found that the audience as a whole has become surprisingly good at pointing out any significant differences.

Mei, Guy and I then put our heads together and decide whether or not we agree with the provisional diagnoses.  We discuss quite openly where we have doubts and why this is so and which element group we think a person should be re-allocated to. 

When we have gone through an element group as a whole, we ask all those we still think are that element to stand together on the platform for us to take a look at the group as a whole.  And here we may change our diagnosis again, because in the large element group, one or two will now stand out as feeling different.  These we then re-allocate to join another element grouping during the day.

At previous seminars Guy had the bright idea of providing coloured stickers in the five element colours, which we would put on those we had diagnosed so that everybody could see from a distance which element we had provisionally allocated to those attending.  This time, instead of a coloured sticker, each person was given a much more visible ribbon to wear around their neck, the colour of which could be spotted a long way away to help us if we decided to change a diagnosis.

After this seminar I totted up how many changes we made for each element. For Wood it was 5 out of 17, for Fire it was only 1 out of 10, for Earth it was 17 out of 32, for Metal 8 out of 21 and for Water 8 out of 42.  From this random survey we could conclude that the Chinese five element acupuncturists running the preliminary seminars are better at diagnosing Fire (nearly 100% right), than Earth (only about 50% right)!  For some reason there are always a large number of Water people at our seminars, and practitioners over there therefore have a lot of practice in diagnosing this element.

This may seem a rather complicated procedure, but it works surprisingly well, and is an excellent way of helping a large group of practitioners learn more about diagnosing the elements in one day than they will learn from seeing only a few patients at a time.  We do the diagnoses at the start of a five-day seminar, which leaves us nearly four days in which to change our minds.  When you are sitting in front of a roomful of people, all wearing very visible coloured ribbons around their necks, it becomes surprisingly easy to see those who respond to what is going on in an expected way and those who don’t.  I was delighted that the last thing I did as I left the platform on our last afternoon was ceremonially to remove the red ribbon around a young man’s neck and replace it with a yellow ribbon to great applause in the room.  I had been talking about the Fire element, and in my usual Fire way had stoked up a lot of laughter in the room, except in this young man who only looked puzzled.  “He looks worried as though trying to process something, and isn’t his colour yellow?” I asked myself.  “He must surely be Earth, not Fire”.  He himself was delighted at the change, as he had felt that he didn’t really fit in amongst his fellow Fire practitioners.

We have also added another simple diagnostic technique to our teaching, which is to ask the group whether they feel a patient coming before the class makes the room feel “up” or “down” (i.e., yang or yin).  If “up”, then it is likely to be either Wood or Fire, if “down” then Metal or Water, with Earth “neither up nor down”, or “both up and down”.  This is again a surprisingly simple way of helping those new to five element acupuncture start examining the feelings different elements evoke in them.