More on Entry/Exit blocks

I do not myself 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 undergraduate years training myself to read thousands of 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 that I had to look for other indications in patients which would help me suspect the presence of a block.  It is always good to remember, too, 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 unsure of its presence, rather than ignoring what might be a block.   

Since I am always somewhat suspicious of the accuracy of my pulse readings, I like to supplement what I think they are telling me with what I see as corroborating physical or other evidence of a block’s presence.  If energy is blocked, such blocks can occur at any level of body, mind or spirit.  In the case of a Husband/Wife block, for example, we must never forget that this represents an attack upon 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.  Unexpected outbursts of anger or irritation, too, are therefore as much pointers to a block involving the Wood element, as feeling that there is excess or lack of energy in the Wood pulses.  Over the years I have observed many physical and emotional indicators which may suggest the presence of an Entry/Exit block to help me supplement what the pulses tell me.  You can read more fully about these in my Handbook of Five Element Practice.

It is very rare to find an Entry/Exit block between the two paired officials within an element.  In all the many years in which I observed JR Worsley taking pulses, I never once heard him say that he had found such a block.  In fact, I remember quite clearly his telling us that the yin and yang officials try as hard as possible to share their energy in order to bring harmony to their element.  This is why he said we should always start by treating both yin and yang officials equally within any treatment.  Even when he diagnosed a patient as having the Gall Bladder rather than the Liver as their Guardian Official, we should not neglect the Liver.  And as I am still not sure of my ability to diagnose which official is the dominant one, I therefore continue to treat both yin and yang officials.

The only exception is when I diagnose Inner Fire, and specifically therefore the Small Intestine, where I try as far as possible to concentrate treatment upon the many Small Intestine points, having been told early on in my training that the Heart is considered a sacred meridian, and therefore should always be approached with care.

 

The significance of a CV/GV (Ren Mai/Du Mai) block

A CV/GV block is the deepest block of all Entry-Exit blocks, indicating that there has been some disturbance to the central line of energy passing up and down the back and front of the body.  The two pathways of Conception and Governor Vessels link together to create a great circle of energy within which we are enclosed, body and soul.  These central meridians provide the source of all the energies of the other 12 meridians which branch off from them.  They together form two great streams in the ocean of life which feed 12 subsidiary tributaries, each of which then has its own function in maintaining the cohesion and health of the whole.  Any impediment to the smooth flow around this central circle of energy must then necessarily have a great effect upon the ability of all the 12 officials to function as they should.  

I remember JR Worsley telling us that when there is a CV/GV block, a patient “lingers miserably”, whilst with a Husband/Wife imbalance they feel as though they can’t go on and just want to give up.  I think the idea of “lingering miserably” expresses well the debilitating loss of energy this block causes in a person.  From the point of view of our pulse readings, we know that all the pulses should be indicating great weakness, revealing an overall lack of energy in all the elements.  When I think the block is there, I therefore always ask my patients whether they feel exhausted most of the time, reflecting this general depletion in their energy, and inevitably they always do.  This is another guide to help me  with my diagnosis.

Since all the elements are under stress, the symptoms shown can vary greatly, depending upon which element or elements are most affected.  The elements will show that they are suffering in different ways, and a patient will often talk about all kinds of niggling symptoms which indicate an attack upon one or more elements.  In particular, the block can often appear after a Caesarian birth, where a large incision will have been made right across the CV line.  I have found it is worth needling the points to clear this block in any patient who has had this surgery, as well as in women trying to conceive, where one of the impediments to conception is often a weakness in the flow of energy along the CV meridian.  The same can also be true for men as well as woman.  The health and nature of the sperm can be affected by blocked energy along the CV meridian or between CV and GV.

Persistent problems which treatment of the elements seems unable to shift may also be caused by a CV/GV block.  For example, this may be one of the reasons why a person cannot lose weight despite being very careful with their diet, since the sluggishness of the overall level of energy throughout the meridian system slows down their elements’ ability to process food and eliminate waste material, leading to its being hoarded as fat in the body.  It is always worth considering this block, even if your fingers cannot detect an overall picture of empty pulses, whenever a symptom persists unchanged despite all the elemental treatment you give your patient. 

The importance of ensuring an interrupted flow of energy through CV and GV was brought home to me when JR Worsley told us that if the points used to clear this block were on the hand, we would do them on all our patients.  Because of their position and practitioners’ reluctance to use them routinely, the block is sadly much under-diagnosed, to the detriment of patients’ health.

 

More on Entry-Exit blocks

In my last blog (25 July) I said that I am never happy simply relying on my pulse readings to detect the appearance of blocks.  To supplement what I think the pulses are telling me, over the years I have therefore drawn up my own list of signs, both physical and emotional, which alert me to the possibility that they may be there.   

Entry-Exit blocks form the largest group of blocks.  I have always thought that they should really be called Exit-Entry blocks, because they occur between the exit points of one meridian on the Wei cycle of energy and the entry point of its adjacent meridian, for example between X (LI) 20 and XI (St) 1.  They are a sign of an over-accumulation of energy at the exit point of the first meridian leading to depletion of energy at the entry point of the following meridian, with the pulses of the Exit point having relatively excess energy compared with the pulse on the next Entry point.  In the example of a X- XI block, for some reason the Large Intestine has become unable to pass some of its energy on to the Stomach, or the Stomach has become too weak to accept it.

One of the advantages of the five element numbering of meridians i that the numerical order we use makes it easy to list the blocks.  These consist of the following blocks: II – III (SI – Bl), IV – V (Ki – HP), VI – VII (TH – GB), VIII – IX (Liv – Lu), X – XI (LI – St) and XII – I (Sp – Ht).  The remaining Entry-Exit block is that between CV and GV (Du Mai and Ren Mai), which stands somewhat apart, as being the most significant block of all.  I will write about this in another blog.

A frequently found block is a II – III (SI - Bl) block between Inner Fire and the Water element, treated by needling II 19 and III 1. Here physical symptoms can sometimes be very obvious, with patients pinching the corners of their eyes to get rid of some irritation, or rubbing itchy ears.  At the deeper level, the block can be found at a time when a person is struggling to sort out their life, often appearing as treatment progresses, and patients are aware that changes need to be made, which put a strain on the Small Intestine, the official most involved with working out such changes.

This is a block often found in children.  Their frequent ear-aches and hearing troubles can be seen in five element terms as signs of the stress life places upon a child’s Small Intestine, as it tries to make sense of all the confusing signals pouring into its ears from the world outside.  Western medicine treats these ear problems by inserting grommets.  We do it, much less drastically, by needling II 19 and III 1.  In a similar fashion, much of the disturbing increase in the prescription of steroid inhalers for young children affected by asthma could well be reduced by treating their X – XI (LI – St) blocks to counter the increasing levels of environmental and emotional pollution they are exposed to which is being inhaled by a child’s Lung official. 

All these blocks are at the exit point of one element and the entry point of the next element.  I have wondered how often there may also be blocks within an element, in other words between its yin and yang officials, which are more difficult to detect from a pulse reading.  I remember JR Worsley saying that after a little treatment an element’s yin and yang officials become strong enough to share their energy, and at no time during the many hours I spent observing him with patients do I recall him diagnosing a block of this kind within an element.  I have however myself once found a IX – X block between the Lung and the Large Intestine within the Metal element in a patient who had just had colostomy surgery. There was a very marked discrepancy between the two pulses, and I successfully cleared this block by needling IX 7, the exit point on the Lung, and X 4, the entry point on the Large Intestine.  But this was the only time in my many years of practice where I found a sufficiently noticeable block within an element. 

When trying to diagnose an Entry-Exit block, I always like to have in mind the physical area of the body where the entry and exit points are located, and, at a deeper level, look to see whether the patient is showing any emotional signs indicating some disturbance of the officials concerned.  In the case of a X - XI block, for example, the position of X 20 at the side of the nose and of XI 1 just below the eye indicates a blockage of energy running up the nose towards the eye.  It is easy to see that this may well cause, and does often cause, symptoms such as hay fever, sinusitis or conjunctivitis.  At a deeper level, this block can also be seen as a manifestation of the difficulty the Metal element’s LI official may be experiencing in letting go for some reason, and the resultant difficulty of the Earth element’s Stomach official to process what is coming to it.  This imbalance between the two linked elements may also reveal itself in changes in some of the sensory signals they show, such as a very marked change of colour or emotion.  For example, I have detected an VIII – IX (Liv – Lu) block in patients well before taking a pulse reading, because a patient who has previously been very mild and gentle suddenly turns up for treatment telling me how angry he feels with the world. 

It is important to remember, too, that Entry-Exit blocks are not related to a particular element, and can appear in people of any element.  They can therefore not be used to help us diagnose a person’s element.

Finally, I have noticed that people have what I call their “favourite” blocks, ones that recur at intervals.  Mine happens to be a II – III (SI - Bl) block, other people’s might be a XII – 1 (Sp - Ht) block or a VIII – IX  (Li - Lu) block.  These blocks recur only very infrequently, perhaps once in 6 months or a year, and are a sign of some individual weakness in the balance of the elements within us.

My next blog will be about the deepest block all, that between CV and GV (Ren Mai and Du Mai).

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.

 

 

 

 

 

 

 

 

 

Not yet finding the right element does not mean that the treatment you give is wrong

I was walking along thinking about the blog I have just posted Nobody likes getting things wrong (13 July), when I realised that I needed to add something to it.  If we are treating a “wrong” element, we may assume that we are doing something wrong.  But that is not what I believe.  We should not condemn any treatment we give as being wrong provided that we follow one of the basic rules of five element practice, and that is to ensure that we are not going against nature by taking more energy away from an already depleted element, or adding energy to an element already with an excess of energy. 

Our pulse-readings should tell us what to do, for they will help us assess the relative level of energy in the different pulses.  Any treatment we then give on whatever element we choose will not only not harm, but will be beneficial, because it will help balance out the different levels of energy between the five elements.  And anything which brings greater balance is to be recommended.

To all five element acupuncturists out there reading this I would therefore say “take heart”.  You can never harm a patient if you let the pulses guide you in this way even if you are unsure which element you should be concentrating your treatment upon.  Pulses alone are unlikely to pinpoint the patient’s element for you, (but you may like to take note here of Peter Eckman’s comments on my blog on Facebook about this). Using your reading of the pulses to help balance the relative strengths of the different elements one to another can help you lose some of your worry about whether the element you have chosen to treat is the “right” one or not.

Finally, in all my years of practice, no patient of mine has ever, I repeat ever, told me that any treatment I had given them had made them feel worse, except when it has temporarily exposed an underlying block, such as Husband/Wife or Entry/Exit, which the appropriate follow-up treatment successfully clears. 

I think nature is very kind.  The elements help themselves by disliking the states of imbalance which lead one element to have too much energy and another too little.  It seems that they try everything to even out any discrepancy in energy between them, which is why the treatment using energy transfers between elements is greeted with such a huge sigh of relief by all the elements.

The effect of clearing a CV/GV (Ren Mai/Du Mai) block

I love hearing patients’ descriptions of how specific treatments make them feel.  Here is a lovely testimonial to the power of clearing a CV/GV block:

“I feel that this experience has allowed the real essence of who I am to emerge.  For the first time in my life I feel that the real me has arrived.”

I don’t think you can have a more powerful statement explaining the effect of removing this major block to the healthy flow of the elements.

 

Treatment of alopecia - another satisfactory use of a CV/GV block

A fellow practitioner, Jo Banthorpe, invited me to her practice for a day in mid-May to help with the treatment of some of her patients.  Before I arrived she warned me that she looked somewhat different from when we had last seen each other because she had developed alopecia, and now had large bare patches on her head.  She had therefore shaved her hair close to the skull to make these patches less noticeable.  I have Jo's permission to write about this.

During the day with her I asked her whether she had had treatment for a CV/GV (Ren Mai/DuMai) block, or had even considered this as being the cause of the alopecia.  I told her that over the years I had successfully treated several patients with alopecia, each having been told that there was little Western medicine could do to restore hair growth.  In each case clearing a CV/GV block led within a few weeks to the gradual re-growth of the hair.  I had been encouraged to select this treatment because I felt that such a drastic depletion of energy causing severe hair loss of this kind could only be the result of some serious energy block.  This obviously pointed to a CV/GV block.

I cleared this blockage on Jo during my day with her and awaited the result.  You can imagine how happy I was a few days ago to receive an email from her telling me that she was “delighted to report that my hair seems to be growing back! ” And “I don't think it was growing back before we did CV/GV, in fact I think I was still losing it but more from the hair line at the sides.”   She enclosed some photos of the back and side of her head, clearly showing the re-growth of hair.

This is yet another example of the drastic improvement in all kinds of conditions that clearing a CV/GV block can lead to.  It isn’t always at all clear from our often inadequate pulse readings that there is sufficiently severe depletion of energy to point immediately to a CV/GV block.  But if in doubt, and there is a persistent deep-seated condition which your treatment cannot seem to shift, then always think of this block. 

I remember quite clearly JR Worsley telling us that if the points for clearing a CV/GV block were on the wrist we would do it on every patient!  Those words have stayed with me for 30 years, and encouraged me to think often of this block and clear it, perhaps receiving confirmation only afterwards, when the patient’s symptoms change dramatically, that there was indeed such a block there.  So all of you out there who hesitate to diagnose this block because you are uncertain of your pulse-taking or feel reluctant to needle some of these points, just do this treatment. The block is surprisingly often there, and if it isn’t, it never hurts to do it.  It’s only like opening a door which is already open.