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).

The challenge of treating very young children

In the early days of my practice I was very reluctant to treat young children.  I knew that they could not themselves tell me what was wrong, and without talking to them I was not sure how I was going to diagnose their element.  Everything I learnt about them would therefore have to be filtered through what their parent told me. (For simplicity’s sake I will call the mother the parent, although the same holds true for the father.)  Before seeing the child, therefore, we need to arrange to talk to the mother quietly on her own, and not in the child’s hearing.  Ideally this should be done face to face, rather than on the phone, and certainly not by email.  A private talk will also yield crucial information about the mother’s relationship to the child, and here we have to use our diagnostic skills to discover what exactly is going on between mother and child.

Most, if not all, problems in young children (and in later life!) originate in family life.  The difficulty for us here is that most parents are often unaware of the part they play in this, for, like most of us when faced with unpleasant facts, we are reluctant to admit to our own responsibility.  A parent of a distressed child often has unresolved issues around being a parent which may well be, and usually is, the prime reason for disturbance in the child.  I have some very good examples of this from my own practice which have reinforced my conviction that if only I could treat the mother, the young child would probably not need treatment.  This conviction, and often my experiences of failing to help the child, have reinforced my increasing reluctance over the years to treat young children.    

I was fortunate that I was able to take the first two children I was asked to treat to see JR Worsley.  This was at a very early stage in my practice, when I did not know how I should approach treating them.  The first child was a young boy of about 3, who was said by his mother to be completely out of control.  He would only let his mother touch him, refused to relate to anybody else and had been given a provisional diagnosis of autism.  His mother and I had to drag him kicking and screaming from the car to the practice room, where JR, after looking at him quickly, told me to carry out the AE drain, despite his loud protests, with his mother and me holding him firmly on my lap.  As I recall there was no AE, although I have since often found a surprising amount of AE in even the youngest child. 

JR diagnosed the element as Wood, and told me to follow the AE drain with the source points on Wood on the left side only.   To my surprise, shortly after the treatment, the young boy suddenly fell quiet, turned his head to look at me and kept eye contact as I walked away, something he had not done with any of us before.  I interpreted this as the Wood element diffusing his terrible sense of anger.   From then on, for the few treatments he continued to come to me once a fortnight for the simple five element command point treatment JR had recommended, he would run happily to greet me as though he enjoyed his treatments.  Nobody would then have diagnosed him as other than a normal little boy.

Sadly, however, I was only allowed to treat him a few more times. JR had pointed out that I should do possession treatment on the mother, luckily a patient of mine, something I had not yet noted, but very shortly afterwards, the mother abruptly stopped treatment for both herself and her child. The child’s father, who was very happy with my continuing to treat his son, explained his wife’s decision to stop treatment by the fact that she was very disturbed to think that I might think that she was the cause of the child’s problems, something she denied totally.  He himself could see that she was much too possessive of the child, but could do little to persuade her to allow me to continue treating their child.

I had similar experiences with two other mothers, both of whom, though ostensibly wanting help for their young children, refused to acknowledge that there was anything in their own attitudes to their children which might be contributing to the problem, and both quickly discontinued the child’s treatment very early on despite quite clear evidence that it was helping.

Of course, other practitioners may have had happier experiences of treating children than I have had, and their experiences may well be with less complex mother-child relationships than mine have been.  I’m sure, too, that much can be done to help young children deal with whatever problems, psychological or physical, they come to you with simply by trying hard to diagnose the element by means of any information you can glean, then doing an AE drain and basic five element treatment. 

 

I am happy, though, that I can finish this blog with a rather lovely story of the successful treatment of a young child, though I never saw the child or inserted a single needle.  A patient of mine had an 18 month-old daughter who had suddenly started to suffer from asthma.  Could I do something to help, she asked me.  With some of the unhappy experiences I had had in mind, I was at first reluctant to do so, but then I put on my five element hat, and asked myself.  “Why would a little baby develop asthma?  Why would its Metal element be in such distress?”  Metal, being the element of our relationship to our father, I asked whether anything had recently changed at home, particularly in relation to the child’s father.  She told me that he had joined a golf club, and was now away from home for much of the weekend.  Before this, the whole family had had happy weekends doing things together.  I talked through the needs of the Metal element with both father and mother, and suggested that the father should make every effort to be with the child as much as he could, perhaps sacrificing some golf for his child’s sake. This was rather a long shot on my behalf, and I wasn’t very optimistic that this would help.

 

To the father’s credit he did this, and even I was surprised when the mother told me that, after a few weeks of increased attention from the father, the child’s asthma started to improve, and eventually disappeared altogether.  And this without the need for any medication, or any needles.  Here both parents had enough insight into family relationships and were open to listening to advice, something which is unfortunately rather rare, as we know.  

Treating children with five element acupuncture

I love passing on heartening news about the results of simple five element treatments.  And this latest anecdote, from the practice of a friend of mine, encouraged me to think a little more about our approach to treating children.

An 11-year old girl suffering from severe migraine came for treatment.  The practitioner felt that her element was Fire, and this is the first treatment she was given:

AE drain (great deal of AE on Lung, Heart Protector and Heart)
Source points of Outer Fire, VI (TH) 4 and V (HP) 7

The migraines stopped completely the day after treatment, and have not recurred since.  She will be given one more treatment in a few weeks’ time (summer seasonal:  VI 6 (TH 6) and V 8 (HP 8)), and will come back for occasional top-up treatment if necessary.

The migraines started after she moved school, leaving many of her close friends behind.  She was also now being bullied by another child.  All this meant that her Fire element was suddenly placed under a great deal of stress with which it could not cope.  Hence the migraines and hence, too, the Aggressive Energy.

This made me think about the treatment I have given children, and why I have always, without exception, found Aggressive Energy to be there, and often a surprising amount of it for such young children.  This then set me thinking about AE in general, and what its presence signifies.  So why so much AE in children, when very sick adults may not have any?

I like to think that this may be because in children the imbalances are usually still at a fairly superficial stage, and have not had time to infiltrate deep within the elements.  We were always told that AE was the result of one element under stress flinging the negative energy which is weakening it across the K’o (Ke) cycle to its grandchild element in an attempt to avoid harming its own child element.  If the element under stress (which does not need to be the guardian element) has sufficient energy to get rid of negative energy in this way, it is still strong enough to maintain a good level of energy.  An AE drain may therefore help to deal with the first attack on the elements, and it may be that it is only when elements are deeply weakened that more sustained treatment at a deeper level is required.

When we treat children, we use exactly the same five element protocols as for adults, but we use less of them and treat far less often.  We don’t need to treat children more frequently than once in two weeks, even at the start of treatment, and then only for a few treatments, spreading treatments out more quickly than for adults.  We also use less moxa on the points (though children will be fascinated by moxa if you show a cone being heated on yourself first to calm them).  We also needle on one side of the body only, to reduce the stress for a child, except in the case of the AE drain and Entry/Exit blocks.

We also have to get used to needling a struggling child!  I use short needles, and always hold the needles carefully covered by my hand so that the child doesn’t see them.  It is important to needle quickly, and not delay things by trying to talk a child through its fear, as you would with an adult.  With the AE drain, if the child is young enough I ask the parent to take the child on their lap, and hold the child very firmly as I insert the needles.  The needles often fall out when the child struggles, so have a good supply to hand. 

And pulse-taking in these circumstances is also quite difficult!  So we do our best with whatever information we have.  Obviously, too, we have to learn about the child not only by observing it ourselves for as long as we can, but by talking to the parent(s)/guardian.  Again, obviously, this should if possible be done when the child is not present.  A phone call or meeting before the first treatment, in which we ask the parent/guardian the kind of questions we would ask an adult at the TD (Traditional Diagnosis) is essential to give us a picture of what is going on with the child and the family’s approach to this.

What is interesting, though, is that children themselves respond very quickly to the effects of treatment.  Though they may shriek or struggle a bit, the little child who makes a terrible fuss about the actual needling will often be the one who rushes into the practice room and greets me with a kiss, as though it knows I have helped them. 

The important thing is always to bear in mind that the reason why a child needs treatment is, as we know, not simply because of something physical, but, as with any patient we treat, inevitably has a deeper emotional cause.  All those terrible cortisone inhalers now lined up on primary school shelves which the young children are told to take for their asthmas could be thrown away if only people realized the stress their children’s Metal elements are placed under in this modern world.  When we are asked to treat children, therefore, we must always look beyond the child first to the parent(s), and then beyond the parent to the world in which the child lives. 

Usually, unfortunately, we are not asked to treat the parent, although we can clearly see that this is where the trouble lies.  In the case of this young girl, it seems that her parents may not appreciate how much the change of school and the bullying is affecting their child, and are not acting to support the child’s Heart Protector in a way that will help it protect itself from the bullying.  As we know, bullies always pick on a child which shows weakness, so the stronger her Heart Protector becomes, the more it will be able to stand up for itself.