A call for more five element teachers

It is one of my sadnesses that so few good five element practitioners want to pass on their experiences to a new generation of student acupuncturists.  What I have learnt from teaching in China (see my blog of 31 January 2020) has helped me understand some of the reasons for this, and helped me try to devise ways of persuading my fellow five element acupuncturists to have the courage to follow in my footsteps and in those of other five element teachers.  There appear to be very few people now who are prepared to face what they may think is the daunting prospect of diagnosing patients’ elements in front of a group of people.  People are often afraid of committing themselves to diagnosing an element publicly in case they have to change their opinion later on.   

In all the years during which I have been helping practitioners develop their five element skills, I have tried to emphasize the fact that they should not be obsessed with finding the right element immediately, because this is an impossibility, particularly for novice practitioners with little experience to draw upon.  The speed at which we eventually home in on this element is directly related to how long we have been practising, how many patients we have treated, and with what humility we approach our practice.  JR Worsley always said that we learnt more from not getting the element right than from finding the right element often almost by chance, because we might otherwise assume that our diagnostic skills are more highly developed than they are, and this might lead us to become a bit too complacent.

I can confirm from my own experience that he was right.  I am reminded here of a very humbling incident which took place a few years after I qualified when  I returned to the Leamington college to start my postgraduate studies under JR.  Our class of about 25 was asked to diagnose a patient, and to my horror everybody but me raised their hands for Earth, whilst I was the only one who thought the patient was Fire.  What the others had observed, but I had not, was that the patient was circling round the same point again and again in what she was talking about.  To everybody this apparently pointed to Earth’s need to process its thoughts in a repetitive way, which they all saw as being typical for Earth, something I did not. So why had this bit of learning passed me by during my undergraduate training?  Had I perhaps been daydreaming when this was being discussed, a habit I still have, where I find my thoughts veering off sideways from the main topic under discussion?

I naturally felt foolish to find myself unaware of something so typical of the Earth element after two years in practice.  And yet I have never forgotten this incident.  It taught me to overcome the natural feelings of incompetence which a wrong diagnosis will arouse in us all, particularly as I felt I was so publicly exposed.  I realise, though, that this had the long-term effect of making me less worried than some other practitioners are at accepting as quite normal that sense of utter blankness after first meeting a patient, rather than expecting to experience a blinding flash of recognition of an element’s signature.  And the sooner all us five element practitioners learn not to beat ourselves up if we do not recognize a patient’s element as quickly as we think our years of experience warrant, the better a practitioner we will each become.

I believe that the reason why so many five element practitioners hesitate to put themselves forward as teachers comes from the speed at which JR diagnosed patients, which they either observed themselves as I did over many years, or heard about from those he taught.  He would always insist that we would all have reached the same level of diagnostic skill that he had once we had gained the 40 years’ experience he had.  I’m not sure that this is strictly true, but certainly there was an element of truth in what he told us.  The problem is that his example appears to have cast a shadow over the teaching of five element acupuncture which he himself would have been very sad to note.  When I told him one day that I felt that I did not have enough experience to teach others, he said very simply, “You know more than they do, Nora.”  And I remind myself of these words whenever I lose trust in my own ability to teach others.

I started my own teaching life by giving evening classes before I had fully qualified, and I learnt so much from teaching the little I knew then.  One of my acupuncture tutors who encouraged my teaching told me that as a teacher one should never claim we know something that we don’t.  Again this is something which has stood me in good stead, and I always judge those I want to learn from if they are happy to admit that they don’t know the answer to somebody’s question.  It is the teachers who give the impression that they are all-knowing who I am suspicious of, and I have known quite a few of these.

It is interesting that the Chinese five element acupuncturists I teach are quite happy to change their diagnoses, because I have emphasized from the start that it always takes time to home in on a patient’s element. This has meant that many of them are already quite happy to take on the role of teaching others the fundamentals of five element practice, without the fear I often encounter in acupuncturists in this country.

So this blog is a plea for anybody wishing to spread an understanding of five element acupuncture to as many people as possible to overcome their natural fear and just pass on their own delight in their practice.  They should remember that anybody who has been in practice for even as short a time as only a year knows more than those who have never practised five element acupuncture at all.

 

 

My review of Professor Liu Lihong's book: Classical Chinese Medicine

Published by The Chinese University Press
The Chinese University of Hong Kong 2019

 

I would like to start my review of Liu Lihong’s book with the words with which he ends it:

"Why is this book titled “Contemplating Chinese Medicine” in Chinese? What is it that we are contemplating? It is nothing other than these underlying principles, nothing other than the mysteries of nature and life as deciphered through the orientations of time.”  

Liu Lihong was the person who invited me eight years ago to come to China to give an introductory seminar on five element acupuncture, and has since then steadfastly promoted five element acupuncture as a valid discipline of traditional Chinese medicine.  It was therefore a lovely moment of recognition for these years of my work in China since then to read the following in Heiner Fruehauf’s introduction:

 

…”Liu Lihong has developed the Institute (for the Clinical Research of Classical Chinese Medicine) into an influential platform that has reintroduced multiple classical lineages to contemporary scholarly discourse, most notably the Fire Spirit School of Sichuan herbalism (huoshen pai), the traditional system of emotional healing synthesized by the Confucian educator Wang Fengyi (1864-1937), and classical five-element-style acupuncture. Each one of these efforts has had a considerable impact on the grassroots momentum of Chinese Medicine education in China.”

 

Joyful at thus seeing evidence of the importance of my work in China, I was delighted at last to be able to read the book which was the catalyst those eight years ago for Mei Long to write to Liu Lihong, urging him to acquaint himself with this discipline of traditional Chinese medicine, one which she recognized was very close to his own approach.  It has been with much surprise and delight now to receive confirmation that all that I was taught by the great master of five element acupuncture, JR Worsley himself, all that I have since learnt for myself and from my readings of the classics through translations by Father Larre and Elisabeth Rochat, all of this finds strong, almost eerie echoes in what Liu Lihong writes.

Though the book includes much detailed discussion of herbal remedies, since Liu Lihong is a herbalist, I have come to regard it much more as a profound philosophical exposition of Chinese thought, and it could well have been entitled Classical Chinese Philosophy.  Certainly the profound insights about Dao, yin yang and the five elements, which are the main emphasis of the book, also form the bedrock of my five element practice.  In particular, he emphasizes, as JR Worsley always did, the importance of regarding ourselves as embedded in nature.  As he says:

“When discussing Chinese Medicine, the backdrop of the natural world cannot be forgotten. If you have a thorough understanding of the natural world, your foundation in Chinese Medicine will be sound and your understanding can progress.”(p. 375)

Of the many insights I gained from my reading of this book, none impressed me more than the clarity with which he compares traditional Chinese medicine and modern Western medicine, clearly seeing that they spring from different approaches which cannot be melded together into one system as so many people now attempt to do.  Instead he regards them as complementing each other, provided that their fundamental differences are acknowledged.  For instance he writes:

“Western Medicine is clearly biased towards objectivity rather than subjectivity…..Chinese Medicine is vastly different in this respect and places great emphasis on the subjective experience.” (p.262)

I also find the humility he shows in relation to his own understanding of his discipline quite startling and very impressive, such is his respect for his masters whose influence on his development he acknowledges.  I always feel that teachers who are not afraid to know that they have more to learn are the ones I can truly learn from.

And here I encounter a slight problem, for though, quite rightly, he claims that the best, if not the only true way of learning is to sit at the feet of an acknowledged master of whatever discipline we wish to practice (and did I not do exactly that when I was fortunate enough to find my way to JR Worsley?), how are we to find such masters in a world, as he says, where institutionalized classroom learning is valued more highly than the kind of personal transmission from master to pupil?  And even more pertinently, where are the great clinical teachers without which there can be no transmission of such profound age-old disciplines?  Liu Lihong, too, is also deeply concerned about the increasing depletion in the number of those who have sufficient clinical experience to warrant being given the name of masters of their discipline, whilst there are ever-increasing numbers of those eager to learn from such masters.

This is something I have had to struggle with during my time in China, for I often ask myself how can I and my small cohort of two other five element teachers, Guy Caplan and Mei Long, alone pass on as much as we can in the form of personal transmission through our seminars to as many people as we can.  It is with great relief, therefore, that, thanks to Liu Lihong’s efforts and that of those working at his Tong You San He foundation, I can at last be reassured that there is an ever-larger group of Chinese five element teachers who can now pass on their understanding of five element practice to others.

The world needs people of vision, such as Liu Lihong, and I am honoured to have been able to work with and for him.  I am profoundly grateful that my efforts to re-introduce five element acupuncture to the country of its birth have been recognized by him as making a significant contribution to his work in so firmly and courageously ensuring that classical Chinese medicine, including five element acupuncture, now takes its rightful place at the forefront of modern medicine as a profound medical discipline in its own right.

Finally, I want to express my admiration for the team of translators, led by the book’s editor, Heiner Fruehauf, who have made such a tremendous job of creating an English version which reads so beautifully and eloquently.  As a former translator in another life, and still a translator from French into English of Elisabeth Rochat’s work, I appreciate from a very personal point of view the many hours, days and weeks of hard work such an excellent translation would have demanded.

 

 

A reminder to myself about treating Metal and Earth patients

This week a practitioner asked my help with a patient of his, whom I diagnosed as Metal.  I thought she was more likely to be the Lung official (not able to take in) rather than the Large Intestine (not able to let go).   As usual, seeing this patient added something to my thoughts about the elements.

After I left the practice room I realised that I was in danger of forgetting something JR Worsley told us about treating Metal patients, and which I had not pointed out at the time to the practitioner.  This is something which also applies to treating Earth patients.  He told us that we need to be aware that, for different reasons, both elements might find the start of treatment difficult.  Both might find that the first few treatments could have the somewhat disturbing effect of making them feel rather empty.  I see this as confirming that these first treatments have such a profound effect by addressing the element so directly that they often strip away some of the defences we put up to cope with life.  Metal may therefore experience, perhaps for the first time, a profound emptiness of the spirit, that spiritual disconnection which is the burden Metal has to bear when it is out of balance.  Earth, by contrast, may experience a more physically-based emptiness, that of not being nourished, literally the gnawing feeling we have when we are hungry.

We should therefore always warn our Metal and Earth patients that this might happen, reassuring them it this is a good sign that treatment is clearing things away, so that their energy can be replenished with the good things of life.  After all, that is why we often add that prime clearer-away-of-rubbish, the point IX (Lu) 8, Meridian Gutter, to the normal command point treatment at the very early stages of Metal treatment.  And similarly with Earth, we may add XII (Sp) 8, Earth Motivator, or XI (St) 24, Lubrication Food Gate, early on.  In their different ways, these points all have the effect of helping the element we are directing our attention at to reveal its true needs.

I felt that this Metal patient had so profound an emptiness of spirit that after the initial Metal treatments with which we should always start treatment (see my Handbook of Five Element Practice here for advice on what these points are), I felt she might need more to replenish her.  The obvious point which comes to mind here is IV (Ki) 24, Spirit Burial Ground, but I also felt that she might benefit from another point one or two treatments later, a point which JR Worsley told us is “like IV 24, only deeper”, and that is III (Bl) 42, Spiritual Soul Gate.  And somewhere I feel the lovely point, I (Ht) 1, Utmost Source, beckoning at some time in the future.  JR told us that this was the supreme connecting point, re-establishing a direct connection between Heaven and Man (and Woman of course).  It can be used for patients of any element, and what better point for a Metal patient who, in my eyes, so obviously has lost a sense of this connection.

 

My 2018 year-end summary

As the year nears its end, it leaves me with many mixed feelings.  Everybody knows how unhappy I have been about this country’s suicidal plunge into its Brexit nightmare.  I am a European through and through, half my family being Austrian, and I love my multi-national heritage which led me into a delight for languages.  I will finish this blog with something on this topic, but I like to include some more heart-warming and life-enhancing moments which have occurred.  These are the times which convince me that there is indeed a pattern to my life into which all those things which I consider important insert themselves, as though into some pre-ordained shape.  There have been many such moments during the past year, and I list a few of those I consider the most significant.

I have just come across something in a book I happened to pick up from a shelf of unread books, one that I had bought many, many months ago and often put aside as being something I did not at the moment feel I wanted to read.  And yet today there it was, and I found myself taking it with me to my favourite breakfast cafe for my last end-of-year favourite breakfast (a single espresso and a croissant), only to find an illuminating passage which spoke to me.

"Just as when, as we read some books, an almost confusing feeling… can take hold of us, we hand ourselves over to the flow of the words, to their sound, and trust that the text will somehow help us, that it will do something to us, this is much like what happens when he (the main protagonist of this book) is writing.  Forgetting all his plans and ideas, most of his notes thrown away  -  and whilst he hands himself over to the rhythm and poetic logic of the sentences, the smell of his pencils, their quiet scratch on the paper, he fills page after page with a story of which he had not before thought of one word.” (Ralf Rothman: Fire doesn’t burn)"

This exactly reflects what I often feel when reading - that a writer’s words mean something to me , although I don’t know exactly what, as though they reveal a truth hidden behind the actual words.  Certainly this is often how I feel about that most elusive of all forms of writing, poetry.  This I realise, too, is how I view five element acupuncture.  I know that there is a truth hidden behind my practice which I have tried in my own way to put into words in my books, but behind the words I have found to describe what I do lies a profounder truth about human existence, and its glories and its tragedies, which is beyond words, or perhaps only accessible to the most gifted of writers.  I cannot prove that the elements create life in all its varied forms as I describe their actions, and yet I know, at a level beyond words, that they do.

A profound confirmation of this thought occurred during one of my visits to Beijing this year.  My time there happened to coincide with a seminar given by Peter Eckman.  Those who recognise his name will know that he has written the only book, In the Footsteps of the Yellow Emperor, which covers in detail the history of five element acupuncture’s journey to the West,.  Peter and I have known each other for many years, and I was delighted that it so happened  that Professor Liu Lihong, the host of all our many five element seminars, also happened to be in Beijing at the same time.  Peter, Professor Liu, Professor Hor Ting of Yunnan University and Guy and I, plus Lynn who does absolutely everything that needs doing to ensure our stay runs smoothly, therefore found ourselves one evening seated together round a table in a Beijing restaurant.

Peter, I think rather with tongue in cheek, and much to my surprise, since it contradicts what he says in his book, came out with the controversial statement that he didn’t think that JR Worsley had followed any particular acupuncture master in devising his approach to acupuncture.   Whereupon Professor Liu said firmly, “There are three routes of transmission for any discipline.  There is the direct transmission from master to pupil, the indirect transmission through texts, and then", he said, pointing above his head, "there is direct transmission from above."  And this is how he felt JR Worsley had come to his understanding of five element acupuncture.  I loved the fact that somehow something of the truth about human beings embedded in our knowledge of the elements was transmitted directly from above into JR’s heart, to be handed on, often in the same way, to others.

And something that has just happened rounds off my year with a smile, and makes this very sad year which seems to be heading inexorably towards the tragedy of Brexit end on a slightly happier note for me.

In September I wrote to JK Rowling of Harry Potter fame suggesting that it was time that an ardent anti-Brexiteer like her should stand up more and be counted to help fight the cause of us Remainers.  For those of you who didn’t know I had done this, here is my September email to her, via her Press Secretary (email drafted with help from a PR expert (Gill):

"Dear JK Rowling,
For years I have not only admired your literary genius but also your strong political voice on many of the big issues of our time. So I have an ask. The anti-Brexit campaign is well meaning but failing. I know you have already spoken out about the stupidity of this decision, but as we draw closer to this political madness becoming a reality, could you maybe go even further? I am no publicist but could we get Harry Potter yelling from the rooftops to protest? Or a series of powerful tweets from you to help galvanise the country to halt this impending gloom?

Yours, in hope,
Nora Franglen"

I heard nothing back, and assumed that my email never reached her ….. except that, a day ago in the Guardian, I read the following:

“Harry Potter and the Cursed Leader: Author Rowling mocks Corbyn on Twitter:  JK Rowling, a longtime critic of Jeremy Corbyn, has mocked the Labour leader’s position on Brexit in a series of 16 biblical-style tweets. Entitled “The Visitation of the Corbynites: A Festive Thread”, the Harry Potter author includes the claim that the possibility of “Saint Jeremy” bringing a “Jobs First Brexit” is “bollocks”. 

Do you think she did, after all, get my email, and heard my plea?  I’ll never know, but I like to think it may not just have been coincidence that she wrote this series of tweets.

I sent this email to many of my family and friends, finishing it with the words, with which I am rounding off my blogs for the year:

A Happy Christmas, and now a Happy New Year, to you all from a smiling Nora!  Let us hope the world becomes a happier place in 2019.

 

Unravelling the puzzle of point locations a little

For many years I was completely unaware of the fact that different branches of acupuncture used anatomical locations for some of their points which differed from the ones I had been taught.  The first five or more years of my practice were spent in a complete five element bubble, since at that time JR Worsley’s college at Leamington was the largest college, and many of us who trained there were completely unaware of the existence of other schools of acupuncture.  I know I certainly was, until rumours started to spread around the acupuncture community that acupuncturists who had visited China were bringing back with them another form of acupuncture which appeared not so much to complement what we had learned, but to cast doubt in the minds of some five element acupuncturists about the validity of what they were practising.  This was first brought home to me when standing in a lunch queue at an acupuncture event and being told by a fellow acupuncturist, with some disdain in her voice, “JR has a very odd way with moxibustion”, followed by, “You don’t still only do five element acupuncture, do you?”.

I always find it interesting when I observe how often people are only too happy to grab hold of anything which might seem to undermine some practice or concept which holds a dominant position, almost as though they cannot wait to mock what before they expressed admiration for, or indeed, as in the case of many five element acupuncturists, actually used for years in their practice.  This happens all too often, particularly where somebody has been pre-eminent in one discipline.  Perhaps it is then only natural that those sheltering in the shadow of such a person may start to feel increasingly disempowered, and look for ways of asserting their own independence of thought.  This happened most famously with Carl Jung’s abandonment of his admiration for his mentor, Sigmund Freud, and the same thing happened in this country when JR Worsley’s legacy to acupuncture started being mocked in the way I encountered.

In a very short space of time this was followed by a growing onslaught by the acupuncture world in general, led unfortunately by the British Acupuncture Council, on the right of five element acupuncture to be considered as a stand-alone discipline.  I have written a lot about the difficulties I, as a devoted five element acupuncturist, have encountered in defence of my practice over the years, but in this blog I want to look at how influences from China have apparently changed this country’s approach to the location of certain points, and how far this is still something five element acupuncture needs to take into account.

The subtle undermining of an accepted five element tradition extended also to the area of point location, where people started discussing whether the five element locations used, based on a long-established tradition going back through to JR Worsley’s teachers, Jacques Lavier and Wu Wei Ping, came up against the locations modern Chinese acupuncture was now deciding for us, and which have come to be replaced by many British acupuncture colleges.  I am certainly no historian of acupuncture, nor have I any way of knowing whether the point locations which have gradually superseded some of those used in five element acupuncture have clinical validity or not.  And this is the only factor in the debate about different point locations which I feel needs to be taken into account.  If I needle a point in my well-practised five element location will a point at a slightly different location used in modern Chinese acupuncture, and following hard on its heels, modern British acupuncture, have the same clinical effect?

We sometimes think that acupuncture does not lend itself to “evidence-based research” in quite the same way as scientifically-based therapies, because it does not seem possible in a holistic discipline such as ours, and similarly in any of the different forms of psychotherapy, to obtain sufficient objective evidence of the efficacy of any clinical procedure which cannot be measured by some physical instrument.  But I think my many years of practice have provided me with just as much evidence that the points I use in treatment have actually effected material changes in my patients, and ones which are perceptible to others, provided that their senses are sufficiently honed to perceive sensory and emotional changes.

When a patient says, as one of my patients did yesterday, that “the treatment you gave me a few days ago really made me feel I could face life again,” is that not evidence of the efficacy of the particular treatment, made possible by needling specific acupuncture points?  The problem is that a reader of this blog only has my word for this, and if I were to invite observers into my practice room during the treatment, might the presence of unfamiliar faces affect the patient’s response to the treatment, and perhaps nullify it?  I do, though, have what I like to call one objective proof of the location of one of the disputed locations of an acupuncture point as a result of a moving encounter I had when consulting JR Worsley about one of my patients.

This point is the one on the Kidney meridian which in the five element point numbering is IV (Ki) 7.  As any five element acupuncturist knows, this is one of the first points in the combination of six points, needled bilaterally, used to clear one of the most serious energy blocks recognized in five element acupuncture, that of a Husband/Wife imbalance.  IV 7 is a tonification point, drawing energy from Water’s mother element, Metal, and in the five element location is at 3 ACI (cun) from the prominence of the medial malleolus.  We were taught to needle all six points before taking the pulses to see whether we had cleared the block, in effect checking whether the patient’s Heart energy - (I (Ht) 7 is the last point in the procedure - was recovering sufficiently to combat the spiritual despair which is one of the main indicators of this block.

I had taken a patient to see JR Worsley, and he had diagnosed this block, leaving me to carry out the treatment.  As this was early on in my acupuncture career, it took me some time to mark up the points, particularly those on the Kidney meridian which require much careful measuring of the leg, so when JR returned I had only had time to needle the first two points, III (Bl) 67 and IV (Ki) 7.  Before I had told him that I had not completed the whole procedure, he took the pulses, nodded at me, and said, “That’s cleared.  Good.”  It was then that I realised that the re-establishment of a strong connection between the Metal and Water elements through the tonification points must have been sufficient to clear the block.  From then on I have always checked the pulses at this early stage in the procedure just to see if this often happens, which I find it does.  Each time, though, I go on to carry out the full procedure because I recognize that needling the remaining points strengthens the connection between the elements which a H/W imbalance shows has been weakened.

From this, and from my own later experiences, corroborated by my years of clearing many H/W blocks, I know that the tonification point on the Kidney meridian is definitely where we locate it in five element acupuncture, at 3 ACI from the level of the medial malleolus.  The Kidney source point, IV (Ki) 3, too, which also forms part of the H/W procedure, is at a different location from the more recently accepted location.  I therefore recommend any practitioner trying to clear a H/W block to adopt the five element anatomical location of these two points.  I like to think that I am stepping in the footsteps of an acupuncture master in using the points exactly where he told us they were, and feel that something of the energy I felt passing from him through to the patients I brought to him for consultation is transferring itself a little to me as I needle the points where he told us to find them.

Thoughts on the 12 guardian officials in preparation for our coming seminar in Beijing

Guy Caplan, Mei Long (from the Netherlands) and I are off in a few days for our next seminar in Beijing (from 17 – 26 October).  I have lost count, but I think this will be the 14^th seminar we have given there.  As usual, each time I go, I like to think of something new I would like to concentrate our teaching upon.  This time, it has been prompted by an email sent to me by Caroline, a dedicated five element acupuncturist and the lovely translator of my books.  She wondered whether I could talk more about the functions of the 12 officials, because the people she teaches at the five element introductory seminars held before we come seem only to think of them in terms of physical organs, and not as having the deeper meanings associated with their individual elements. 

That made me realise that I, too, concentrate much more upon the elements as a whole, rather than trying to distinguish which of the yin or yang officials holds a dominant position.  I have always thought that it was difficult enough homing in on the correct element, and that I would only confuse myself by trying too hard to see which of its two officials is the most important.  JR Worsley would diagnose somebody as being a “Metal CF”, and then write next to this “IX” or “X” in brackets, meaning that either the Lung or the Colon was the dominant aspect of the Metal element for this particular patient.  I have now rather cheekily coined the phrase “guardian official” to describe this official.  In all the time that I observed patients with him, I never heard him explain what it was in the patient which made him select one or other official, except in the case of the Small Intestine (II).  Here he would always specify, not that this patient’s CF was a I/II as we say in five element acupuncture, but simply a II CF.  I remember very clearly him saying one day as he watched a video of himself asking a patient a question, “Only a II CF would answer like that”.  This taught me a lot about the Small Intestine and the way it looks as it tries to find the correct answer to a question.

Thinking about this carefully in preparation for my Beijing seminar has also brought to my mind the question which has remained a slight puzzle for me throughout my acupuncture life.  In all the hundreds of patients JR diagnosed in front of me, I never once heard him say that a person was a “I CF” (in other words had the Heart as his/her guardian official).  Somebody told me that he had indeed diagnosed an acquaintance of mine as a “I CF”, but that was only hearsay, and never corroborated by JR himself.  And my doubts about the Heart official being the primary cause of an imbalance (that’s what “CF” means) always seemed to me something that a tutor of mine at Leamington put well into words for me.  He said that he himself felt that the Heart, the Supreme Controller of body, mind and spirit, would never allow itself to be so much weakened as to be the ultimate “causative factor of disease”.  Unfortunately I never thought to ask JR himself why I had never seen him diagnose a person as being a Heart CF, so this has always remained an unanswered question for me.  Somehow, though, I have always felt that what my tutor told us rings true. 

There has always been a slight niggle in my mind about this diagnosis, because I felt very strongly when I was with this person, that she was very like me, and that our two Small Intestines were engaged in a slight tussle for supremacy, as each tried to sort the other person out.  Surely the Heart, such a yin official, would just be residing quietly rather than battling with me, as my own yang Small Intestine quite likes to do when it is under some sort of stress.  The niggle was also strengthened by the fact that this person liked to feel that she was a rather rare person by reason of her guardian official being the most important official of the twelve.  I did wonder whether she had herself spread this rumour, rather than that JR had actually diagnosed her as such, but I will never know, whatever my slight suspicions.

 

So I am now thinking carefully about the different qualities of the officials so as to help the 300 or so practitioners gathering next week to hear us in Beijing.  They, of course, are brought up on rote learning of the Neijing Suwen, and I have told them to prepare for what we will be talking about by re-reading Suwen Chapter 8, which is all about the officials, and gives each of them their distinctive name.  Now I have to ask myself, “Do I really understand how the Liver differs from the Gall Bladder in a person with Wood as their guardian element, or the Stomach from the Spleen for Earth?”  These are all very important questions to which I am ashamed not to have paid sufficient attention over the years.  So, as usual, my visits to China and all the other seminars I have held over the years offer fresh stimulation to my thoughts.

 

 

A draft introduction to another book

I am just drafting the introduction to some more of my writings about the elements, and am posting this below as a blog.

"I am drawing together in this book some of the writings about my practice as five element acupuncturist which I feel will be helpful for any of my colleagues, particularly now those in China, who want to benefit from what I have gradually learnt over the years.  I am especially keen to pass on the lessons from my own acupuncture master, JR Worsley, with whom I studied closely for several years as part of my postgraduate training.  One of the many things I remember him telling us was that we would always learn more from what we didn’t get right to start with, especially our diagnosis of guardian element, than when we got things right.  I know that the mistakes I made in my early practice were always valuable lessons for me, and I therefore hope that what I write here will give five element practitioners a little more confidence and enjoyment in their five element practice.

 

We can never be neutral observers of life.  As all scientists now acknowledge, the observer is always part of what is observed, so there is no such thing as being objective.  Our judgements are always subjective.  The important thing is to be aware of this and to try and understand ourselves as deeply as possible so that we can understand the nature of our involvement in any human interaction.  In five element acupuncture terms, this means understanding how our own guardian element colours how we perceive all the people we meet, and in particular how this fact colours our interactions with our patients, and our diagnosis of their particular element.

 

All I write about the elements is always therefore to some extent coloured by what I perceive through the filter of my own element, Fire, and in particular its inner core, the Small Intestine and the Heart deep within.  Anybody reading what I write must therefore take this into account, and accept my particular slant on the elements which a lifetime of being Fire gives to it.  Of course I have many, many years of observing how people of other elements interact with other people, and learning from these observations so that I hope I have  also much to say about the world as seen through the filters of elements which are not my own.  

 

The subjective nature of all our interactions with the world around us is undoubtedly why I notice that my writings about the elements which I present here are not evenly spread over the five, but tend to be focussed more on Wood and Fire, with Earth a slightly more distant third.  Throughout my writing life, I appear to have written far less about Metal and Water.  I rationalize this a little by thinking of the order in which the elements are placed around the great five element circle.  Fire’s relationship to its fellow elements is closest to its mother element, Wood, and its child element, Earth, whilst it has a more distant relationship to the following two yin elements, Metal and Water.  I wonder also whether this helps explain my yang Fire’s deeper understanding of totally yang Wood and half-yang Earth, than of the two more mysterious and more hidden yin elements.  Despite myself, then, this book is tilted slightly more towards the yang, the sunny side of the mountain and daylight, than towards the yin, the shady side of the mountain and the darkening light.

 

As I draw together the observations of all the elements and their interactions with each other which I present here, it is useful for those reading this to understand that, unique as each human being is, everybody will have their own individual take on the elements which will lead to their own often quite different perceptions, but ones which are as valid as mine are for me.  The important thing is that we should constantly test our understanding against what we learn from our interactions with one patient after another, so that we remain honest enough to modify our thoughts to take account of any new insights we gain."

 

 

It's never a good idea to try to persuade a patient to continue treatment

I never think it is right for me to answer questions from practitioners who ask me for help in trying to diagnose a patient’s element or what specific treatment to give.  I can only do this when I am actually there with the patient in the practice room.  On the other hand, there are general questions about five element practice which I find useful to answer, and which often stimulate me into writing a blog.  Into this category falls something which a practitioner, Caline Chew from Singapore, has just emailed me about.  I cannot help her with specific questions about the treatment of her patients, but she finished her email as follows:  “…..I don’t know how I can convince (my patient) to stay on the treatment.”

I always say that treatment can only be successful when both patient and practitioner are equally involved, 50% the patient and 50% the practitioner.  It is therefore good to remember that we can never help a patient who is reluctant to receive treatment.  As soon as we sense this, we need to stop what we are doing and address the issue.  Dealing with a patient who openly doubts the effectiveness of our treatment is always disturbing for any practitioner, nor can we do good work if we are not sure what is going on in the practice room.

One of the tips I learnt many years ago from JR Worsley, which I have followed successfully ever since in all cases where my relationship to my patient is under some strain, is always to be honest with the patient, and tell them as soon as I sense that there is a problem.  You need to be brave enough to ask them whether they, too, feel that this is so.  I always preface what I say with the words, “I feel that ….”  Saying this removes any risk of the patient feeling that we are blaming them for what is not right, and gives them the courage to be open with us.  I am then often surprised by my patients’ answers, which may be quite different from what I have imagined.  This frankness between us goes a long way to solve some of the tricky patient/practitioner issues which complicate our work.

So this is the advice I am going to give Caline, with the hope that it will help restore a good relationship with her patient.  I hope, too, that this will clear up some of her own doubts about what she is doing.

 

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.

 

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.