There Are No Secrets: Treating Complicated Conditions with TCM
By Kenton Sefcik, RAc, DiplAc, DiplTCM
Before I learned the art, a punch was just a punch, and a kick just a kick.
After I learned the art, a punch was no longer a punch, a kick no longer a kick.
Now that I understand the art, a punch is just a punch and a kick is just a kick.
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Not negating some family styles, Traditional Chinese Medicine's approach is one for all. Some may argue that it has a cookie-cutter flavor or that Chinese medicine is meant to be passed on from master to disciple like the days of old, however we can't argue the effectiveness of the transmission nor the results in the clinic.
Unfortunately in the field it's very hard to talk shop with my peers. Practitioners don't want to share information. Perhaps it's because they feel that they have to keep their knowledge to themselves – as if the acu-points themselves are what keeps a person in business; this couldn't be further from the truth. I think the opposite in that I find it very comforting that someone else is using a TW6 and KD6 combination to symptomatically treat constipation. It's also very satisfying as a Chinese medicine instructor to be able to give a student that information, they get the results they want, they gain clientele and, finally, they gain the confidence needed to build a practice.
Along with groupings of symptomatic points, which I will discuss in the near future, there are a lot of basic heavy-hitters present within the healing system. To me, there's no such thing as an advanced treatment protocol. Advanced, whether it be in the martial arts, acupuncture or some other discipline means that the basics are soundly mastered. Malcolm Gladwell, author of The Outliers and Blink, was largely behind the 10,000 hours meme.
In a nutshell, what Malcolm discovered was that it takes a person about 10,000 hours of them doing their job/hobby/passion until they are functioning at a subconscious level. This means that a practitioner of Chinese medicine will master the basics in five years if they are actively working on their craft for 40 hours a week and 52 weeks per year.
Bruce Lee said it best with the above quote and I feel that there is still a sense of unhealthy mysticism when it comes to the practice of acupuncture – especially when it comes to how we visualize how healers who have been in practice for years operate.
Unfortunately, not everyone who goes to school to learn Chinese medicine is able to go to Asia for their internship. However, we have the power of video and I would like to use the movie 9,000 Needles for a case in point. By now, I assume most Traditional East Asian Medicine practitioners have seen the movie. For those who haven't, it's a must-see because it emphasizes how a complex condition, in this case a brain-stem bleed causing major stroke-like sequelae, is treated with the usual TCM theory.
Simply, we can ask, "Where's the problem?" At the base of the skull is where the brain-stem bleed occurred. "What are some of the symptoms?" A lack of Shen in the eyes and a basic inability to move – especially on the right hand side. Without a tongue or pulse diagnosis available, we can still see why the points picked worked so well on the movie subject Devin Dearth.
The very first point that was inserted was DU26. Known to help with back pain, coma, fainting and deviation of facial muscles, it was a great point to "wake up" the patient who looked as if he had lost the zest for life after everything was taken from him. Post-stroke, this would be a great point that we would all go for. LI4 and SP6 were next. LI4, Key/Command point for head and face, Source point and general all-around tonification point to again bring the patient to life again. SP6, three Yin meridians meet here, and if it takes up a few pages in Deadman's book while treating all types of signs and symptoms from digestion to sleep problems, it's probably good for just about everything - again, a very effective tonification point.
Fengchi, GB20 was also a powerful point. It's at the source of the problem - plus, it overlaps the scalp-acupuncture "balance area," good for headache and increases the efficacy of any eye, ear or nose treatment. Of course it is a primary point to rid the body of Wind, which Devin's condition mimicked, while promoting blood and qi circulation between the brain and the body.
One of the main concerns the doctors had with Devin, echoing his own, was his lack of mobility: he wanted to be able to walk. Before walking, the right leg needed to function a lot better than it was. The doctors asked Devin to raise his right leg followed by his left leg to compare. After this test was completed, the doctors inserted a needle into UB40 on the right side and strongly manipulated it for what looked to be less than a minute. The needle was removed and the leg was tested again with an immediate response. UB40, Key/Command point for the lower back, relaxes the back of the leg and gives me the sense of how it controls the posterior side as how GB31 controls the lateral side.
Other points were used on a need basis, such as ST2, 3, 4, 5, 6, etc. for facial concerns, and LI15, 14, 11, etc. for arm concerns; Devin couldn't shake the doctor's hand. What I found interesting was that because Devin was receiving treatment every day, neighboring points were alternately used between sessions. For example, one session might include ST2, 4 and 6, while the next time we see the doctors use ST3, 4 and 7. Movement of the tongue was improved by bleeding Ex-HN12 (Jinjin) and Ex-HN13 (Yuye), something that we rarely get to neither see nor do. Being able to use some of these more obscure points in the West needs to be sold to the patient. Benefit has to outweigh preconceived notions in regards to what needling sensation could be or what bleeding technique includes.
Repeat sessions always started with DU26, LI4, and SP6 as the core, reinforcing their clinical importance. When not receiving full-body acupuncture, scalp acupuncture, cupping, Tui Na and herbal (oral inferred and washes seen) treatment ensued. The scalp acupuncture again followed the usual patterns and included "leg and sensory motor area," "motor area," and "speech area" amongst others. The needles were connected to an electro-stimulation machine. Cupping wasn't done just as a "spot treatment" such as just over the Lungs; instead, the cups covered the entire back and were left for 20 minutes each time.
I found it reassuring that even when treating such a tough case, 20 minute acupuncture and 20 minute cupping worked just fine. Giovanni Maciocia has previously written that he interviewed many patients in his clinic and asked them every five minutes or so what they were feeling. Their experiences seemed to peak and he found that the 20 minute mark yielded the best clinical results.
The last key, in my opinion, had to do with consistency as Devin received around-the-clock care for three months. Many times a patient will ask me for advice, "Should I see physio, chiro, massage or you?" First off, they're looking at the modality instead of the practitioner. Healing arts are practitioner-driven, not modality-dependent. Second, practitioner aside, it doesn't really matter. What matters moreover is consistency. In China, a course of treatment is still 10 sessions - however it's completed within a span of 10 consecutive days in a row - while in the West it's completed on a weekly basis. Regardless of the ability to treat with such intensity is irrelevant because we're proving to ourselves in the clinic that once a week is fine for most things. The take-away here is that Lao Tzu was right: a journey of a thousand miles begins with one step.
Even after only a few sessions, we're able to see a magical transformation occur in not only Devin's ability to move and control his body in ways he couldn't before, but in his spirit as well. The difference between the dull appearance of his eyes and skin when he first begins the program to the end where he's following the movements of the fish are exactly like night and day.
Unfortunately, according to Devin's Facebook, the second trip didn't yield the same gains as the first. The treatments seemed to plateau for him. However, it is clear to see that the quality of life drastically improved with the most basic and fundamental protocols of Traditional Chinese medicine. This inspires hope and confidence in me and is something that must be shared with the rest of the practicing world. Our diagnostics work. Our treatment approaches and protocols work:
Where in the body does the problem stem from? Choose acupuncture points that are there. What is the root problem? Treat the systemic condition.
What are the symptoms? Choose acupuncture points that are at these places and be sure to include groupings of symptomatic points. How do you treat a complex problem? By sticking to the basics and staying the course.
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