Treating a patient with terminal lung cancer

Today I received this very moving email from a practitioner who has come to my seminars.  She is happy for me to pass on what she has written because, she told me, “like yourself, I am keen to share experiences so that others may glean a little knowledge which may help them in future treatments.”  So here is what she has told me:

“I am writing to share with you my experience so far of treating my patient with terminal cancer, where, without your guidance and influence, and your mantra of 'the simpler, the better' I feel I would not have been able to do my best.

(When I saw this patient for the first time) he was complaining of severe abdominal pain, had lost a huge amount of weight and was now having difficulty breathing. A&E had been pumping him full of morphine and then discharging him within hours of admission.  In the first two treatments I was able to carry out IDs, AE drain and source points for Wood, after which he said he felt energised and went out for his first walk in months. He cancelled his third treatment as he was admitted into hospital for chest x-rays and investigations (finally), whereupon it emerged that he has a very aggressive form of lung cancer (secondary), with the primary suspected in the large intestine. He started chemotherapy there and then, but expressed a wish to carry on with his acupuncture treatments as soon as he was able.

Just after I saw you last at Guy's Clinical Skills Day earlier this month, I was reading your book 'The Pattern of Things' on the train on the journey home, and came upon the very moving chapter describing your treatment of Martine just before she died. This was a very poignant moment for me as it was whilst I was reading this that I received a text message telling me of my patient's diagnosis and asking whether I would be willing to treat him in hospital, to which I agreed, thankful for the strength and insight I had gained from reading your piece.

.. I was finally able to see him in the hospice today. I had mentally planned my treatment - AE again, possibly H/W, possibly Rich for the Vitals (Bl 38 (43)) or Kidney chest points - only to be told that I wasn't to put needles in his chest or back, and to be honest, he is now so emaciated that I would have been a tad fearful to do so (even the muscles either side of his spine had disappeared to nothing). He was barely able to talk because of the breathlessness, and his pulses were non-existent except in the LU/LI position. I contemplated H/W but thought him to be too weak to tolerate that many needles, so in the end I did source points in one foot only, which sent him off to sleep for half an hour or so.

As an ex-asthmatic myself, I know how incredibly tense my back used to get during an attack and so I offered to gently massage his back, which he was very grateful for, and proceeded to massage neck, shoulders, arms, hands and feet for about an hour. He was visibly more relaxed afterwards and his breathing had become much less laboured, and so at this point I took my leave.

My apologies for the lengthy prose here, but I will finish now by thanking you, Nora, for instilling in me the courage to do less in order to do more, and to carry out my treatments with utmost humility.”

I think this is a good summary of an excellent approach to helping the terminally ill.  (The only thing I suggested was that there would have been no need to worry about clearing a H/W, because clearing it reduces the stress on the Heart, which can only be helpful.)  Thank you, Jo, for sending me this. 

I have just received the following after the patient's next treatment:

When I saw my patient again today I just couldn't believe my eyes - what a transformation! He was sitting up in bed and was able to chat lucidly and freely. He said that the last treatment was amazing and he felt as though something had definitely shifted. His visitors later that evening all commented that they could see his old self was back again, something they hadn't seen for a very long time.

… He said he feels very strong, in fact he used the words 'normal again' and knows absolutely that this is not his time to go.

 

It's always heartening to receive such welcome confirmation of the effectiveness of what we do - with the simplest means.

 

 

 

Acupuncture and herbs: a five element approach

In my first year at acupuncture college JR Worsley explained to us his decision not to incorporate a study of herbs into the curriculum.  This was because “herbology”, as he called it, was such a profound discipline that it required as many years of study as acupuncture, and, like the food we should be eating, the herbs prescribed should come from the country in which we are living.

I have since thought a lot about this, and added my own understanding as to why I think acupuncture, or five element acupuncture in particular, needs to stand alone as a discipline.  In acupuncture we work from the inside out, stimulating a patient’s own energy back to health and relying only on this energy to do the work.  Herbs, on the other hand, are foreign substances entering the body from the outside, and have a different action.  To offer both herbs and acupuncture is therefore, to me, a bit like a Pushmi-pullyu approach (a two-headed animal familiar to me from my childhood reading of Doctor Doolittle), as though we may be tugging a patient’s energies in different directions.  And, even if I considered it necessary, which I don’t, I certainly haven’t had available to me the years of study required to reach a competent level equivalent to that of my study of acupuncture.

Interestingly, Liu Lihong, my host in China, and an outstandingly skilled herbalist of many years’ standing, has told my students, all of them originally also herbalists, not to practise both, but to concentrate entirely on acupuncture.

This blog has been prompted by questions from a fellow practitioner who had heard a herbalist “who also does acupuncture” talking about the need always to add herbs to acupuncture for infertility treatment.  Many herbalists do a bit of acupuncture, as many acupuncturists feel they should add a few herbs, but in my view you can’t add little snippets of other disciplines into your practice without confusing the elements and, as a five element acupuncturist, that is the last thing you want to do.

The results of two simple treatments

I am always happy to receive confirmation of how effective five element acupuncture can be, and particularly so if this comes from my own treatment.  Yesterday I had the simplest of treatments, the clearing of an entry-exit block (Spleen–Heart), finishing with the source points of the Small Intestine and Heart.  I slept better and woke this morning with a clear head, leaping out of bed without for once thinking I needed to stretch my poor old knees to get them working, as I usually have to.  I interpret the clarity of my thoughts and the increased mobility of my body to the release of the blocked energy in the Earth element, particularly the Spleen, the transporter of energy round the body.

The second happy result from treatment comes from the practice of a fellow acupuncturist.  A patient of his came for her first treatment for a distressing skin condition covering the whole of one arm with a large red rash, which not even prolonged steroid treatment had managed to control.  He diagnosed her as being Fire, and did the usual Aggressive Energy drain plus the source points of Outer Fire.  She rang to tell him that her skin had reacted quite strongly the next day, but by the morning of the second day the rash had disappeared completely, leaving both her and her acupuncturist amazed at the speed of change.

Long live simple five element treatment!  Who dares still say that you can’t treat physical symptoms with it?

Four masterpieces

I’ve recently set myself some difficult reading tasks to achieve this year, and have accomplished three out of four.  Some of these books make for easier reading than others, but all are masterpieces.  So here’s my list:
   Will Self: Umbrella (2012)
   James Joyce: Ulysses (1922)
   Thomas Bernhard: Extinction (1986)
   James Joyce: Finnegan’s Wake (1939)

I started with what I have since found the easiest to read, Will Self’s book, a direct descendant of the lineage of James Joyce, and that sent me back again to Ulysses.  I embarked on this with a gulp, knowing from my previous reading that I was about to plunge into deep waters and then, increasingly, finding myself swimming around in a maelstrom of words, all ultimately somehow flowing together into a current I could understand.  Then thanks to a friend I was introduced to the German writer, Thomas Bernhard, and found myself choosing his last book.  Here I faced 600 pages (in German) without a paragraph or a chapter, but thankfully with the occasional full stop.  This represented a greater challenge, requiring of me short immersions of about 25 pages a time, or at the most a daring 50, but a masterpiece without doubt.

And now here I am, swimming even further out into the moily depths of Finnegan’s wake (see how Joyce’s language is already affecting me), determined as I am at last to reach the distant shore of its final cryptic words:  …”A way a lone a lost a last a loved a long the…”, which will bring me back to its beginning again.  I understand very little of it so far, and am at page 100!  But I am getting some help from the synopsis in Wikipedia, and I take to heart the editors’ advice, beautifully written in itself, “Gentle reader, were you to ask How should I read this book? we would answer: passively, like any good book, neither too fast nor too slow.  Do not pause because you cannot understand a word or words:  you are not expected to understand it all….You are learning a language:  a night language.  Morning will come and the clouds of unknowing will begin to dissipate.”

I leave you with a quote from what I regard as a book of supreme poetry rather than prose: “From goddawn glory to glowworm gleam.”  And I trust that morning will soon come!

 

 

“Let’s control technology”

Heard on the BBC Today programme this morning, music to my ears. 

I feel at the moment that I am doing the reverse, as if I am held in the clutches of all different kinds of technology whose secret machinations I do not understand.  I have spent many, many hours trying to untangle the intricacies of how to get my books into ebook format (the comparatively easier part) and then on to Kindle (fairly easy) and Apple i-bookstore (incredibly complex – still unresolved and requiring even more work at deciphering what is needed.  Thank Heavens for Guy!).  And then at the same time as all this, incomprehensibly from my present viewpoint, I have added my names to LinkedIn and Facebook, and have streams of emails pouring in apparently asking me to do all sorts of things I don’t understand.

So today I am taking the day off from all this technology, and instead am off to play piano duets for a blissful hour of Schubert and Mozart, before wandering on to Tate Britain to look at an exhibition there, or just sit in their café with a lovely book I am reading.  And since everybody knows I never look at my mobile phone unless in an emergency, for the time I am away from home I will be beautifully free from any contact with anybody demanding anything of me. 

As the lovely man on the Today programme said, “We should be managing technology rather than it managing us”.  Amen to that!

(Though, of course, I am using technology to post this blog!)

Taster from my Teach Yourself Five Element Acupuncture Manual

I am working on completing the English version of Teach Yourself Five Element Acupuncture for Acupuncturists, and Mei is busy translating the Mandarin version.  We hope to send this to Nanning in time to have enough copies ready for those attending our April seminar there.  I have also asked our book designer, Sarah Harmer, to design a format for the English version to match that of the Handbook of Five Element Practice which the Teach Yourself book will be based upon.  So there are a lot of things going on at the moment.

As a taster, and to whet the appetite of anybody who wants to take a quick glance at what the manual will be offering, I reprint below something from it which introduces my approach to point selection.  In the manual itself I will be following this with a list of the points I like to use.  This makes a total of about 60 points, apart from command points and points to clear blocks.  Other practitioners will, of course, choose different points and perhaps include many more, but each practitioner has to develop their own approach to point selection.  This manual will offer mine.

 

The extract below describes the different point groupings I think about at different stages of treatment:

“Group 1: Points to be used at any stage of treatment:

a) Command points on the Guardian Element’s two officials plus the two AEPS (back shu points) relating to these officials.  The command points are:  source, tonification, horary/seasonal, junction, points used for energy transfers, (plus sedation points – infrequently used in five element acupuncture).

b) Points to be used to clear the following blocks:  Possession, Husband-Wife, Entry-Exit blocks

Group 2:  Points not on an element’s officials which can be used for all elements early on in treatment: 
These points are: CV 8 (and/or CV 14), IV (Ki) 24, III (Bl 37-39) (42-44) 

Group 3:  Points not on an element’s officials which can be used for all elements at later stages of treatment:

These points are on the CV and GV meridians, Kidney chest points, Outer Bladder Points, plus one other point, Heart 1.  The alarm points should also be considered.  They relate to specific officials and therefore have a particular relevance for their respective officials. 

Group 4: Non-command points on an element's officials to be used later on in treatment:
This group includes the additional points which I use most frequently in practice, and forms a group of just under 60 points.  The list of points for each official is given below.  The group of points called Windows of the Sky should be added to this list.”

I’m afraid those reading this blog will have to wait a little longer until the Teach Yourself manual is printed before you can see the list of these 60 points.

 

 

 

 

 

 

 

Further thoughts about the Water element

I pass on some further insights into the Water element which have come to me this morning all the way from India from a Water friend of mine who is very perceptive about her own element.

 

”Water can be aggressive. It's more a wearing-down kind of persistent aggression rather than periodic pushes (as Wood might do) but it's always easier to analyze in retrospect.  Aggression generally brings out reactions in the observer, which throw him/her off balance and make it harder to figure out what is happening.  

I have put up on my fridge door a reminder of the three fearlessnesses (from Lao Tzu), which are:
     The fearlessness of taking pain
     The fearlessness to suffer loss
     The fearlessness towards ferocity”

Thank you for these thoughts, Sujata!

A present from China!

The first email I opened this morning made my heart sing.  It is from one of my students in Chengdu, and I am passing it on in full exactly as she wrote it.  It delights me that this practitioner has gained such deep insights into five element acupuncture in such a short time (about 3 weeks during our seminars, plus a lot of learning in a small group with her fellow practitioners).  It is very heartening to get such positive feedback confirming that we are sowing the seeds for five element acupuncture's revival in China on such fertile ground.

"Recently I have some new understandings of water, and I’m eager to write to you to see if it’s right or not.

There was a patient of mine (I treated him with common acupuncture, not five element acupuncture), who I thought was a wood person for the first few times I saw him. I used to be quite sure of that because he argued a lot, and he liked to direct me what to do. And most of my friends of our Chengdu group considered him to be wood too. As he had read your book, one day when I told him about my diagnosis, he denied it, and he insisted that he is water but wood. So that day I had a longer talk with him, and I found that when he was talking with me, his eyes wandered, and his color was not green but bluish black. He kept telling me about this or that with a fast and droning tone and sometimes I had to stop him to ask another question. I started to think that maybe he was water, but I still thought that there was a lot of wood under water. And except for his casual back pain, he also told me about his main problem, excessive sexual desire, which obsessed him for years and I really didn’t know how to deal with it with common acupuncture. So I decided to treat him with five element acupuncture.

Because of the following two things, now I can be sure of his element, which is water. The first is of course the effect. He was very sensitive to the treatment, he would report his change to me every time after he was treated, and it was going to a very good direction. He found that he was becoming more and more calm, more optimistic to the future and more energetic. He now knew what direction he'd like to go to. The symptoms on his back and leg were almost gone, and his problem of excessive sexual excitement was much better too. The second reason was that one day we had a little argument, he kept saying things to let me know that he was right, which made me become very impatient and even a little angry, but instead of being irritated by me, he started to apologize to me. I thought if he was wood, he would become angrier than me, right?
      Now that I can be certain of his element, I have even more doubts. There are a lot of water people around me, but none of them are like him. They never speak out what they really think of. Even if they do not agree with my opinion, they hide their true feelings. But he seems to be much more overwhelming than other water people, he always pushes me to do things or accept things that he wants me to. Is it because he is a water person with a lot of wood or is this another characteristic of water?
      I was very confused about this until one day I remembered that I had read on Mei's blog that you described Mo Yan (the Chinese Nobel Prize winner) into "quiet flame", and I suddenly realized that since there were different kinds of fire, and there would definitely be different kinds of water, too! Most water people I knew may like small streams glide through the meadow, they skirt obstacles silently, but this patient is more like flood, he is so powerful and if there is a dam, he'll just rise until the dam is broken over. Am I right to comprehend it this way? And since he is becoming more and more calm after treatment, it represents that if a water person is so overwhelming like he used to be, it shows that this person is not in balance, right?

PS: After writing this letter, I read your descriptions of water again, and I found that what I need to know was already on the book! But this time I had much deeper understanding of what you’d written. And I realized that when you were not by our side, patients were our best teachers. We would never make progress if we don’t respect what patients teach us."

 

Watching the elements whilst I watch tennis on TV

I have just watched Andy Murray beating Roger Federer at the Australian Open, and whilst I was watching I was also looking carefully to see whether I still agreed with my previous diagnosis of their elements.  And I still do!   

 

So here are what I think are the elements of a few of the leading tennis players at the moment:

Roger Federer            Water

Novak Djokovic           Fire
Rafael Nadal               Wood
Jo-Wilfried Tsonga      Fire
Maria Sharapova        Metal
Li Na                           Fire
Kim Clijsters               Earth
Andy Murray               Water

Listen to Andy Murray’s voice.  It is a pure groan.  And his coach, Ivan Lendl, must be Metal.

Have fun trying to see whether you agree with me!

 

 

 

 

 

Teach Yourself Five Element Acupuncture for Acupuncturists - a proposal for a new book

The ideal introduction to a healing discipline such as five element acupuncture is in the form of a personal transmission from master to pupil. This was the only way people learned in the past, where the handing down of experience from one generation of a family to the next was common practice and the only type of learning available.  Modern forms of education, though, have increasingly emphasized the need to gather students together into classrooms, there to follow rigidly standardized courses with a ratio of one tutor to a roomful of students.  It is little wonder, then, that against this backdrop of formalized learning, the transmission of many years of deeply personal experiences from a practitioner to a student is a luxury denied to all but the very lucky few, those ones who have been able to find a teacher whose teachings they admire and who lives close enough to them to be available at sufficiently regular intervals to pass on his/her knowledge.

This being so sadly the case now, and the situation being made even harder by the lack of good five element clinicians prepared to teach, I have decided to do what I can to fill a glaring gap by writing this manual based upon my Handbook of Five Element Practice.  Since I cannot single-handedly (or with just a few other five element teachers) satisfy the growing need for this kind of personal transmission of what I have learnt, then I hope this manual will provide something which I cannot offer in any other way.  The purist will complain that long-distance learning of this kind is not only far from ideal but perhaps should not even be undertaken, because the student can be given so little feedback.  But the purist is not confronted, as I am, with many hundreds of Chinese acupuncturists from all over their vast country longing to learn about five element acupuncture, and many more spread all over the world, eagerly learning whatever they can through this blog.

For Chinese and other non-English-speaking students there are the additional problems of language barriers which complicate communication, both written and verbal.  Hence the eventual appearance of these lessons in both a Mandarin version for my Chinese students and an English version for all those other people of different nationalities, equally keen to learn, if the numbers reading my blog are anything to go by, and for whom English must be their lingua franca.

The Mandarin version of this self-tuition course is being translated by Mei Long as I write, so that it will be available for our next seminar in Nanning in April 2013.  I am just completing the English version, which I am planning to issue in book form.  I have yet to decide whether I will also include a kind of addendum listing the (very few) points I use and my reasoning for using them.  This is something I am working on at the moment.