Notes for the following treatments:


Abbreviations used: CV/GV = Ren/Du, HP (Heart Protector) = Pericardium (P), Aggressive Energy (AE).
All points needled using tonification technique except for certain recognised protocols, such as AE drain.
Moxa cones applied before treatment except where contraindicated.
Number of cones and needle depth taken from JR Worsley's Point Reference Guide.

Wednesday, August 3, 2011

Patient 31: Description of an emergency treatment

This blog discusses whether and when it is appropriate to give what can be called emergency treatment to somebody who you will only be able to treat once or twice.  A Japanese woman, now living in Thailand and a friend of a patient of mine, was in London for 5 days, and wanted very much to have some treatment.  There would be time to give her only two treatments.  I always have to think carefully about whether such little treatment does more harm than good, and each case will be different.  I would have to condense into the three or so hours I could give her what normally is spread over many weeks.  And then there is the added question-mark about the patient’s guardian element.  In the short space of time available to me how likely is it that I will be able to home in on the right element and understand her needs enough to be able to help her?

I decided that I would accept the challenge in this patient’s case for several reasons.  She is herself an acupuncturist and has been very interested in learning about five element acupuncture.  She therefore understood without my telling her that what I would be offering her would be different from the normal slow unfolding of treatment, and was prepared to accept that.  She was also desperately unhappy at the moment, having lost a beloved father recently, and just uprooted herself and her family to move to a new country.  I could hear on the telephone from the despair in her voice that at the very least she would benefit from those simple but profound treatments, the AE drain and possibly clearing a H/W imbalance.  Having decided to see her, I resolved to do the best I could in terms of finding her element. 

The two treatments I was able to give her are a very good example of how I approach emergency treatment of this kind.  I started the first treatment by carrying out a short diagnosis of about half-an-hour.  The more experienced I have become, the more quickly I find I can pinpoint the important aspects of a patient’s life. 

She is a woman of 35, married, with two children, and has just moved to Thailand from Japan where her husband has been relocated.  After this initial half-hour, I knew a great deal about her present life, the difficulties of having a much older husband, of living in a different culture, her relationship with her children, her feelings of inadequacy at not having her own career, her very close relationship with her father, her grief at his unexpected death and her hopes for the future.  I also had details of any medical conditions (none, except high BP, for which she was on medication).  I also did a brief physical diagnosis (Centre Pulse, Akabanes, BP, which was high, so no moxa). 

I basically now knew a lot about her and in particular about how she approached each of the different aspects of her life, which would help me in trying to decide upon an element with which to start her treatment.  The only sensory pointers I could get related to her emotion, which was a mixture of fear and joy, and her colour which seemed to have a bluish-black tinge.  I opted first for Water, although I kept the possibility of Fire at the back of my mind.

Treatment 1 (2 hours):
1                    AE:  none.  I was surprised to find there was none in view of her obvious desperation, but this only goes to confirm that the presence or absence of AE can never be predicted.  A person apparently surprisingly well can have lots of AE, whilst, as here, a desperate patient can have none.
2                    H/W:  As I had suspected from the start, the desperation had led to a H/W imbalance.  She looked much better after this cleared.
3                    CV 14:  I could also have chosen Ki 24 to resuscitate her spirit, but felt that treatment directed at the Heart (CV 14 is the Alarm Point of the Heart) was what she needed more.
4                    Bl 64, Ki 3:  Source points of Water.  There was no change in her colour, and by then something about Water did not satisfy me.  Instead, I was seeing increasing signs of joy/lack of joy lurking below the surface, particularly after the H/W cleared and her cheeks flushed.  I therefore decided to change to Fire.  This is not what I would do in normal treatment.  Chopping and changing elements in the same treatment only serves to confuse both the practitioner and the patients’ elements themselves.  It is always much better to stick to one element at a time in any one treatment, wait to see what its effect is (don’t expect major changes from one treatment on an element, in any case), and give yourself the chance to see exactly which element is responding over time.  There is never a hurry.  The elements will tell us what they need if we give them time.
5                    TH 4, HP 7: Source points of Outer Fire.  After this there was at last some observable change, that of her colour, which became pinker, and she looked more relaxed and much happier as she left. 

She phoned me two days later and told me she felt much better.  Her voice now definitely had an excited, laughing tone, reinforcing my feeling that she was Fire. She said, “I can’t wait to have my next treatment”.

When she came back a few days later for her second treatment, she told me that when she got home after her treatment, “I felt as if I had many tubes in me and they kind of moved around and drained.  I cried and cried for my father.  Now I feel good.”  She was pressing her hand to her heart as she described where these “tubes” were.  I think this is a very graphic description of a H/W imbalance clearing, and the effect on her heart of treatment on the Heart Protector.

Treatment 2 (1 hour):
1        Bl 38
2        TH 6, HP 8 (summer seasonal treatment)

She left looking very happy and cheerful, and I felt happy and cheerful, too. The always risky business of giving such short-term treatment had, in this case, proved successful.  Luckily this patient will be coming back to London in the next 6 months, and will be able to continue her treatment then.

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