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Acupuncture Malpractice Insurance – Using Touch and Moxa to Change the Pulses

 

 

As that’s pulse diagnosis. Now, with my system, it’s very important that we feel a flow in the pulse. So when we have our fingers on the patient’s pulses, both left and right, we want to be able to feel a flow of sine waves.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, this is Dr. Martha Lucas, and I am here to talk to you a little bit about pulse diagnosis today. I want to thank the American Acupuncture Council for this opportunity to talk to you to speak with you because if you know me at all or have watched any of my presentations here, you know that I think the most important skill that we have in Chinese medicine is the correct diagnosis.

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And for me, As that’s pulse diagnosis. Now, with my system, it’s very important that we feel a flow in the pulse. So when we have our fingers on the patient’s pulses, both left and right, we want to be able to feel a flow of sine waves. So for example, here, we would want to be able to see a flow of sine waves.

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Going from this way, and then on the left side, we want it to go this way. And as a sine wave is up and down, right? Yang rising to the peak, and then the yin down. And between these, so between our left and right pulses, we will see the sine waves connect in what looks like the infinity symbol.

These connect this way. around and over and up. So we get the infinity symbol from these wrists. Infinity coming over like this. Sine wave. That’s how we know that all of the organ systems are connected. connected and flowing with each other because good health is the flow of energy, the flow of yin and yang from organ system to organ system.

Now, if you’re not paying attention to the flow, let’s say you never heard of that before, things, yin and yang do the tai chi symbol, they flow with each other, but you’ve never thought about that in the pulses. Do what? You take what you think is slippery away, or you take what you think is wiry away, and then you say, Oh, good.

It doesn’t feel wiry anymore. That’s not really a sufficient goal for treatment. Sure, the acupuncture needles did something. They, theoretically, what they did, if it doesn’t feel wiry anymore, was, They opened up the channel to more energy flow, which is always a good thing. Or if you feel like you felt slippery and that went away.

Then again it opened up the channels for flow. I always pick on slippery and wiry because the name of my book is Pulse Diagnosis. One of my books, pulse Diagnosis Beyond Slippery and Wiry, because I feel like in a lot of schools, especially the school I went to. We all knew how to feel slippery and wiry, but there’s so much more than that, and so many depths of pulses than superficial, middle, deep.

We can feel the depth of even pre birth emotional issues in the pulses, so we know that We can feel the person’s whole life from the very beginning to up to the end when yin and yang start to separate, which looks like this, right? The yin is going, the organ systems are getting empty. They can’t hold the energy anymore.

And so that allows the yang to just rise up uncontrollably. So the pulses literally start to separate like this. And it’s interesting that students sometimes in my. Intern courses will bring, I always tell them, bring in their toughest cases. Oftentimes it’s somebody who’s a little bit older, maybe they’ve got some cancer going on, and they’ll say, feel how this person’s 84 years old and feel how strong their pulses are.

And I will point out to them that isn’t a good thing. That’s not a healthy, strong pulse. It’s yin and yang starting to separate like that so that the yang is hitting your fingertips very hard because it doesn’t have any control. Core down there. So there are many beautiful things to learn about the pulses.

These are what has kept me interested in Chinese medicine for 25 years. In fact, I recently took a little trip to the town where my mentor lived and took it. It’s now a barber shop, but I took a picture of the little building and I’m going to write a little newsletter about how that What is now a barbershop was really my beginning in Chinese medicine with my pulse diagnosis mentor Jim Ramholz more than 25 years ago and how that has just kept pulse has kept Chinese medicine alive for me.

So I wanted to tell you a little bit today also about a recent situation where I Balance the pulses, but I did not use acupuncture because, I like to tell people Chinese medicine is a complete system of medicine, right? Acupuncture is just one of the therapies that we use. It’s probably the most well known therapy, the most very much.

well studied in terms of research studies therapy, but it’s not the only therapy we can use when someone comes in and we need to give them some treatment. And you all know Gua Sha, Tui Na, all that, but with this particular case, I used a combination of just touching the person while I had my hand on certain points.

on either the left or the right wrist, depending on what I was trying to change. And some moxa. So just stick moxa. I didn’t use a moxa bong. In this case, I wanted to be able to move the moxa around to different places with my hand on the pulse. And so I use stick moxa. So this person someone I’ve treated for a long time.

She initially came to me many years ago, probably. 20 years ago because she wanted to get pregnant, she ended up adopting a child, but that child is now in college. So I know it was a long time ago and she’s gluten intolerant. So she was, she, I’ll never forget, told me that if she goes to a restaurant and a piece of wheat has touched the plate on which she ate, she would have some sort of a gluten intolerant reaction.

So in her case The diagnosis of gluten intolerance and her experience with it was intermingled with fear, right? And fear we see in a scattered kidney pulse. The kidneys look, I draw them like little dots on the piece of paper, which means there’s no form to it. It’s just, little pieces of energy that are just scattered in and among the kidney position.

So in this case, we had a few things to deal with, but for example, this patient never traveled because she was so afraid of gluten. We, I, she ended up being able to travel. She got I think a scuba diving certificate. So she was able to travel and do that. And her life, she still. She doesn’t eat anything with gluten in it, but you can tell that her life was more robust.

She had less fear, et cetera, et cetera. Of course, adopting a child added a good deal of joy to her life. So I would see her on and off after that. But she recently came in just, she looked, she almost looked like a ragdoll. Her spirit was, Not really even there. I thought she looked a little gray.

She was very thin. She’d lost 15 pounds very quickly. She was just basically an emotional wreck, which is why her spirit looked so dull and just almost not there. She looked, she might have, you might say, like an empty vessel. She had a number of emotional. Her daughter went away to college, but that was about a year and a half ago.

She claimed that it all went well, but she had gotten a divorce prior to that. There was divorce, there was the daughter going away to college, which again, she claimed she was totally well adjusted to, but I have my misgivings about that. But she had most recently had a very Separating interaction with her parents and her sister, and her parents are aging and need some care, and so there was the burden of the guilt of feeling like, oh, I’m going to need to take care of my parents.

And now I’ve broken up with the more or less. Plus, she also had a relationship breakup. And because of all this emotional burden, and, she was not able to eat. So that was where the weight loss came in. Everything she ate, even the things she knew were quote unquote safe to eat, she couldn’t eat, lots of vomiting, and panic attacks.

The day she came to see me was in the afternoon. She told me she’d had five panic attacks that day. So I thought, alright, just looking at her, I, and I’m a good and gentle needler. And she is one of my less is more needle patients. I’m sure we all have some of those where you’re, you take the pulses and you study the, I study the pulses to think, what are the four to six needles I can use with this person that’s actually going to change the pulses back to normal and back to balance.

So she’s one of those. But I just said to myself that day, I’m not going to do any needles. So I said, look, let’s get you up on the table and see what’s happening. One of the things that was happening was that her heart was completely blocked. So the liver came up toward the heart, but there was just a big block there.

No movement in the heart pulse at all, which made sense to me because she had just separated herself from some people. It didn’t really go well. She had a breakup, et cetera, et cetera. So the heart doesn’t want to, feel any of that kind of energy. Remember, all of the organ systems are set up to protect the spirit.

So the I, so I had my hand, that’s the left side, right? The left pulses. So I had one hand there, my pulse taking hand. And all I did was put my right hand over her heart. I didn’t put it on any acupuncture points. I just thought, I’m just going to put my hand here as a comforting, comforting.

Motion and lo and behold, it was just unbelievable, the heart pulse opened up. So I thought, alright, so the heart is feeling, it needs to be open, right? How are, how is this energy going to get over to these kidneys, like I told you in the figure 8, if this isn’t open, if the heart isn’t open, the heart’s small intestine position.

I was very thrilled about that. So I just kept that position for a few minutes, just, letting her calm down, letting her breathe, letting her spirit be open, feeling the liver calm down, feeling it get much more smooth, then the kidneys can come in, right? Because the kidneys want to protect themselves against getting stolen away by perverse liver energy.

So I thought, all right, once I get that open, I went over to her. took her right pulses, right side, because of course, she’s got that gluten intolerance, digestive issues. And so in this particular case, her spleen and stomach pulse was empty. So it went down like this. It was, I draw it like a down arrow. So from childhood, she had issues around nurturing.

And and that ended up as gluten intolerance. So in this case, I kept my pulse taking hand on that, those fingers on that pulse and put my hand just on her abdomen. So I spread it out between REN8 and REN12 because I wanted to get as much of her abdomen as I could. And I let that fill up.

I let that particular, the earth pulse, the spleen stomach pulse start to fill up a little bit. So she had some energy to live, right? That’s our nurturing part of our pulses, the earth. So we needed to build that up so she had some energy for actual living. So I got that going, spent a few minutes with my hand right there and then I went back to the left side, tested out, made sure that the kidney, liver, heart positions were still open and flowing.

So I knew I could get some cross pulse flow going. And then I decided I was going to use some Moxa because I thought let’s get some heat back into the system, rebuild the digestion. I think that’s one of the things Moxa is really good for. And I love doing it over REN8, of course, because then we’re really building up the, her basic core, which I think had been damaged by all of this emotional stuff.

So I did Moxa. There for a few minutes again, constantly checking the pulses to see how they were changing. Then I went down to Kidney 1, excuse me, I did it on Kidney 1. And and just generally around the kidney, Kidney 1, Kidney 2, Kidney 3. Again, I wanted to build that energy up, getting it going.

Forced up through the system because remember in the pulses, the kidneys fund everything. In the, in pulse diagnosis, we know that the kidneys Sorry, the kidneys fund everything. So all the energy to all of the other organ systems is coming from the kidneys. So I knew I needed to get those built back up.

So the getting the heart built up, getting the earth rebuilt is going to start from the kidneys. So I worked on the kidneys. I went back up to the abdomen again, did more moxa around. Ren8, Ren12 to rebuild that up. And then I finished the whole treatment by once again putting my hand on her heart area to get the kidneys and the heart flowing together.

And, oh my goodness, after the treatment, she looked So much brighter. Her spirit was alive again. Of course, she felt better. She felt calm. I was a little nervous about the panic attack part. For one thing, I didn’t want to put needles in, leave her in a room when the patient had just told me that she was possibly gonna have a panic attack.

I felt really good about that treatment. And the reason I wanted to share that story was because it goes to show we don’t always have to do acupuncture. The pulses will respond to other kinds of energy. So use all of your skills. If you’re thinking, Oh, today we don’t want to do any I don’t want to do any needles today.

Always take the pulses. Make notes about what the pulses are doing, draw a pulse picture, and then you will have that to compare with at the end of whatever it is, the treatment that you give. In one of my internships, we just did, I did gua sha and some spinal work on a man that one of the students brought in, who came in super crooked and a lot of pain.

He could barely walk. And at that time, again, I felt like, all right, let’s take his pulses because it’s a pulse diagnosis internship. But we just worked on his body using physical medicine from Chinese medicine, instead of using acupuncture needles. And again, we saw a great change in not only his physicality and pain and ability to walk, but in his pulses.

So I just want to encourage you that no matter what. Whatever therapy you use, your pulse diagnosis is your way to get down to what is the cause of going on with the person and how is your treatment working or not. Because remember, if the pulse doesn’t change, then you need to change your treatment plan because the pulses will always respond when you are on the right track.

with your treatment plan. So that’s just one story that I thought just really struck me as let’s use all of our skills. We don’t have to just use that one therapy acupuncture, but we always have pulse diagnosis as our best. basic line of treatment. It tells us what’s going on with the person and their body gives us that feedback of what worked, what didn’t work.

And then we just keep going until we get those nice sine wave, very smooth, balanced, yang and yin connecting each other. So if it’s Martha, again, this is Martha Lucas. If you would like more information about my courses or my post diagnosis internships, you can go to my website, lucasteachings. com. My private practice site is acupuncturewoman.

com and you can email me with questions at drmlucas at acupuncturewoman. com. I am always happy to help someone become the best doctor Chinese medicine practitioner that you can become. And so once again, I want to thank the American Acupuncture Council for letting me talk with you about pulse diagnosis and good luck in your practice.

 

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Acupuncture Malpractice Insurance – Stomach Channel and Lumbar/Abdominopelvic Dysfunction

 

So today we’re going to be looking at the stomach and spleen and kidney channel, primarily the stomach channel.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, I’m Brian Lau. I’m an instructor with AccuSport Education with the Sports Medicine Acupuncture Certification Program. I’m also help lead the dissection classes. We do a lot of dissection within the program, which is something that’s very relevant to my discussion today. And I’ve been also working on a lot of functional movement patterns organized through the channel sinews which is through Jing Jin movement training.

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So I’m going to present on some of this information today. I want to thank American Acupuncture Council for having me back. I always appreciate this opportunity. So today we’re going to be looking at the stomach and spleen and kidney channel, primarily the stomach channel. We’ll have a part two of this webinar, which will go more into the spleen and kidney channels.

But specifically the abdominal points, a little bit of the anatomy, the depth of the fascial layer that we’re reaching with the needle or manual techniques. Or really your exercise or whatever intervention we’re doing. We want to understand a little bit about the depth, the layer, the target tissue, all of those things.

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So let’s look today at the stomach channel primarily. I have an image up here from Netter’s Atlas of Human Anatomy. So this image doesn’t have these acupuncture points on. It doesn’t have the stomach 27, stomach 25, etc. I put those in manually. Let’s play. But the netter image is really good anatomical illustrations that can give us a little bit of a understanding of the anatomy.

So first thing to notice that the primary aspect of the stomach channel is going right into the midline of the rectus abdominis until I get down lower, we’ll talk about those lower aspects. It also changes as I get up to stomach 18 and goes more to the edge of the rectus abdominis, but by and large.

They’re running up and down the rectus abdominis right along the midline. Another thing to note, looking at the anatomy, is that the rectus abdominis is our six pack ab muscle. For a very lean and muscular, you can see those six pack abs. You can take note that it’s actually eight packs.

There’s a pack up here that’s not very visible, even when people are very muscular and lean. It’s a very flat sort of pack, so there’s actually four on each side, but people see these three. That would give that appearance of the six pack ab muscles. And with that, you can notice these tendinous inscriptions.

So we’ll talk about some of these points that lie right on these tendinous inscriptions. Much more fascial it has a little stronger connection with the surrounding fascial structures. And sometimes I think there’s a little bit more bang for the buck on these points stomach 25, obviously a very big point.

So we can feel and palpate for these tendinous inscriptions. They’re not super obvious in palpation, but you can sense them, you can feel them. You can fall into a slight little valley. off the muscle and that can help guide your palpation and guide your needle angle, needle technique, et cetera.

So we can just initially take note of that, that the points are either in the belly of the rectus abdominis or in these tendinous inscriptions. There’s some variation on the themes lower, And some variation on the themes higher, but by and large, that’s where the territory that we’re going to be in today.

Next webinar, we’ll jump over to the spleen channel and the kidney channel on the abdomen and look at some of the variations of that theme there. So where are we needling? What are we affecting? Multiple things. One is that we have these branches of the thoraco abdominal nerves that wrap around.

They actually travel between the internal and external obliques. They pierce the semilunar line the fascial seam that’s right at the lateral edge of the rectus abdominis. We’ll come back and talk a little more about that next time. And then they, from there, they innervate the rectus abdominis muscle.

They also come back superficial and have cutaneous branches pretty much along right where the stomach channel is. So these would be for T7, T8, T9, 10, 11, and all the way down to 12. Important to note that the, those levels are also the levels where there are innervations for the celiac plexus, for the stomach organ, for multiple organs in our digestive tract, the intestines, et cetera.

So there’s going to be a lot of communication through the nervous system between this innervation of the rectus abdominis and the innervation of things like the stomach organ. So that’s going to be helpful to understand that there can be various visceral, somatic, and somato visceral type reflexes.

Organs are cranky, the muscle is going to get cranky. If the muscles are cranky, the organs are going to get cranky. There’s communication between the two. So that’s going to be part of our effectiveness of needling. These abdominal points is their relationship to the organs. It’s also worth taking note that some of these branches of nerves, like the subcostal nerve has a a bondage.

cutaneous branch that travels in the front through kind of ASIS region, anterior hip, GB29, that kind of area. There’s other nerves from the ilioinguinal and hypogastric that also become cutaneous. So abdominal muscles and the back muscles that are innervated in this area can often refer along these cutaneous branches.

There’s just a lot of communication through the nervous system that’s relevant to the pain patterns. and the dysfunction that we see that would lead us to using these points. So that’s something to notice. These nerves travel between the internal and external obliques. Let’s look at another image and talk about the fascia layer.

All right, so this is an image, both of these are images that I made, so it has a little bit more channel specific language in here. This would be the territory that those nerves are running between the internal and external obliques. If we follow this fascia layer, let’s look at what happens. This fascia, external oblique, all of it goes above the rectus abdominis.

Internal oblique, the fascia actually bifurcates. Some of it goes on top, some of it goes underneath, deep to the rectus abdominis. So for the stomach channel, we’re following this fascia that goes on top of the rectus abdominis. It becomes the anterior rectus sheath. And this is the territory, in my opinion, of the stomach channel is that needle penetrates or as I’m palpating or if I’m doing manual techniques.

I want the target to be that anterior rectus sheath, possibly the muscle itself. So this portion right here. So that’s the territory very frequently. I’ll just bring the needle to that first density on that anterior rectus sheath and try to stimulate a sensation, see if I can get a traveling sensation.

We’ll talk about where we want those to travel to, what we might be looking for those points here in just a moment. But that’s it. That territory of the anterior rectus sheath. Consistent with the external obliques, somewhat the internal obliques also. If I look at that image on the right here.

You can see that would travel through this external oblique fascia. That external oblique muscle does not fascially connect with the spine. As we get into the deeper points in the spleen and kidney, we’ll look at how that really has a much stronger connection into the lumbar region and into the spine through the fascia.

We’ll come back to this next time. But we’re on that target tissue just on top of the rectus All right, so if I follow that anterior rectus sheath and the rectus abdominis up through this channel sinew, if I wanted to look at it that way, the stomach sinew channel, that’s going to travel on top of the ribcage.

So that continuous fascial plane that’s coming up the thigh meets at the abdominal muscles with the rectus abdominis and that anterior rectus sheath will then travel on that uppermost end eight pack muscle, so to speak that goes on top of the ribcage and that’ll follow up into the sternalis and pectoral fascia and then up into the neck.

So it’s superficial to the ribcage, anterior to the ribcage. That’s the full plane. I will bring our focus back here. There is a nice connection to the lumbar spine through the stomach channel, especially the sinew channel that travels up the vastus muscles and into the thoracolumbar fascia here. So this is nice territory.

To consider for lumbar pain, especially when the pain is at the sort of lateral raffae, lateral edge of the the erector to go back to the image just before, when the pain is at the seam right here, that’s a very commonly, you’ll find tension and restriction at the lateral quadricep, that could be a nice distal point to work with that thoracolumbar fascia up here.

But in terms of rectus abdominis, we’re going to put our focus here. That’s going to be consistent with that superficial plane up into the chest as we look at a corrective exercise for abdominal restrictions for the stomach channel. We’ll come back to that idea in a second. All right. So let’s look at some trigger point referral patterns that would give us some indications of when we would consider these points.

Thanks. Locally, at least, we could also add distal points, but we’re going to keep the conversation on the local needling. So let’s start with the upper portion of the rectus abdominis muscle. This is from Travell and Simmons, Myofascial Pain and Dysfunction, Trigger Point Manual, excellent book.

I’m sure many people are familiar with that. This is an older edition image. The newer third edition, they don’t have the X’s on here anymore. This was common areas. where trigger for trigger point formation might form. They weren’t exactly like target tissues, measurable type things. They could, had quite a variability from person to person.

But it was through primarily Janet Trevelle’s experience. Dr. Trevelle would find common areas where trigger points formed and she put the X to somewhat signify that. They’ve taken the Xs out because trigger points can form anywhere in the muscle. I the old version to be honest.

Because there are norms, I guess you can make an argument that if you’re looking for something that you think should be there and it’s not, it can lead you astray. I think that was some of the argument for taking them out. But but I do think that there’s some value in having the kind of go to areas that are fairly consistent.

And this is the case for this upper abdominis muscle. It can have, first of all, a bilateral referral to the mid thorax region, pain that travels horizontally across both sides, pretty common pain pattern that people would obviously think, they would want massage on the back or acupuncture on the back and oftentimes those erector spinae might get a little cranky in response to that because of that noxious kind of irritating signal from the referral of the erector subdominus.

But as you’re working in this region manually with acupuncture, whatever, people frequently feel it refer back to that site of complaint. So first thing is to find it with palpation. The other thing is this area can be common for epigastric type pain, especially in that region locally. Nausea even just irritation of fullness, abdominal fullness difficulty taking a deep breath.

This area can really lock the breath down. Those are all symptoms that I would be considering that would lead me to palpate up in this area. And generally stomach 20, which is one of the points right on this tendinous inscription would be a very powerful point for that. She has the X a little higher up.

Those can be along the rib attachments can also be. Trigger point formation, but I find stomach 20 is the most common sort of go to for that region. So back to Netter, stomach 20, can’t really see that tendinous inscription here. It’s hidden under the fascia in this illustration, but it’d be in this general region as I go.

get into that even with pressure, it feels like it pulls all that tissue down. Almost feels like you’re pulling the diaphragm down. It helps the diaphragm descend a little bit. So this is really useful point needling also with manual therapy, but again, the target tissue would be into that tendinous inscription for stomach 20.

But also I do a lot of manual work here and you can look at the fiber direction that I would want to be able to free the fascia up at this connection of the external obliques and the rectus sheath. So this area can get very congested, narrowed, pulled in, looks like the chest sinks in that region, and I often want to broaden that area by doing a nice deep myofascial stroke away from the midline.

Whoops, sorry, I didn’t mean to click there. But also working on the stomach 20, I’ll show you some variations of some manual techniques I do here in just a moment that I can just do seated on myself. All right, next region is we have this peri umbilical region. This to be honest will be a bigger player when I get into the next webinar it covers the spleen channel because very frequently these will be on the edge of the muscle, but it’s not uncommon to be on the stomach channel stomach 25 in particular can be a really big source of what we’re about to describe.

This can give a very gassy, internal bloated type sensation when there’s trigger points there. And pressure on it will refer all throughout the abdomen, sometimes even into the hip, deep into the pelvis, wrapping around to the back. It can be a pretty broad pain referral. Stomach 25, very useful.

Stomach 27 region is another one that, that’s quite frequently again along that tendinous inscription can be a big component of that type of pain, but we’ll come back and talk about it. Along this lateral edge in the spleen channel and look at the difference in the anatomy next time, right?

So just again back to Netter so we can see the territory for today. Stomach 25 into that tendinous inscription. We’ll look at palpating that. 26, 27, that’s another one that tends to be in that tendinous inscription. So those 27, 25 are the ones that I most frequently find in the stomach channel that gives that kind of gassy, bloated, distended area can be involved with things like constipation working on that area can make it easier for people to have bowel movements.

So there’s just a lot of reflexes between these areas and the internal organs, right? Another kind of region of common trigger point formation we’ll come back to when we look at the kidney channel, these tend to be more medial along the kidney distribution. We’ll talk about the difference in anatomy next time.

So final one, final region is the lower portion of the muscles. And this could be anywhere from stomach 30, which now, because the rectus abdominis is narrowing, now we’re going to be at the edge of the rectus abdominis. The spleen channel travels along that edge, but when the muscle gets closer to the pubic bone attachment, it narrows quite a bit.

The line of the stomach channel falls on the edge of the rectus abdominis there. So it’d be more of a lateral kind of edge of the muscle very frequent area of trigger point formation for low back pain. So that’s going to create this sort of horizontal band of pain into the sacrum and along the iliac crest, oftentimes bilateral, just like this.

It can be a very similar pain to lumbar facet joint pain. And sometimes those two go hand in hand, that it could be a little bit of both. contributing to that horizontal band. But easy to think about the lumbar facets for that and do tests for the lumbar facets. Maybe not quite as apparent to consider the rectus abdominis muscle.

So definitely when you have this type of pain distribution in including palpation and orthopedic evaluation for the lumbar spine, I would encourage you to look at the rectus abdominis if you’re not already. All right, and here’s just an image. You can see what I’m talking about. Spleen channel follows along that lateral edge, stomach channel right in the middle.

But as the muscle becomes narrower and I get down to stomach 30, then I’m on the lateral edge. So trigger points form on that lateral edge, sometimes in the belly of the muscle. It’s a little trickier to distinguish. between the kidney channel and the stomach channel there. But to be honest, I think it’s more often the kidney channel.

So this is another one we’ll come back to in just a bit. All right. So last thing I’m going to come back up to the stomach region up to that upper part of the erectus abdominis and notice underneath that the stomach organ is there. In this area, if there’s a lot of restriction in the rectus abdominis it can impair just normal, good, healthy stomach motility.

So as you take a deep breath in, that stomach has a various ranges of motion. It does rotation in the transverse plane. It kind of moves in the sagittal plane, rolling forward. And it creates sort of a rotation in a diagonal aspect also. So I don’t know if you need to memorize all of the different ranges of motion unless you do visceral based osteopathic type techniques or Tui Na techniques that work with the organ motility, but just having an appreciation for that motility is really very important because as we open up the organ.

The rectus abdominis create more space, create more potential for movement here. That’s going to encourage a little better stomach movement with the breath. It’s going to allow for a deeper breath and really help that healthy motion that kind of massages and mobilizes the stomach organ. So let’s take the PowerPoint away.

We’ll look at a couple manual techniques. And then we’ll look at an exercise to work with this anatomy, especially that upper part of the channel for this class. All right, so we’ll look at an exercise, but let’s first talk about a manual technique. Obviously, this would be done with a patient prone, but it’s easy enough to do on yourself, even standing or seated.

Xiphoid, I need to be careful of the xiphoid process, not putting a lot of pressure on the xiphoid. I’m actually over the rib cage. So just lateral to the xiphoid process, I want to hook into that fascia and mobilize and move that fascia like I’m pulling open the ribcage, moving it lateral, spreading along that lower portion of the ribcage, pretty sensitive area on a lot of people, but I’m not putting a ton of pressure, just sinking to the level of depth to the ribcage, angling, spreading, opening.

So really nice technique that I teach. Very simple to create more space and more openness there. I could also find that tendinous inscription. I can feel the muscle. If I’m careful, I can notice a little dip into that tendinous inscription at stomach 20. Same thing at stomach 25 would be the same technique.

And I just want to press Soften that tissue. It almost feels like I’m pulling that tissue away from the costal margin, creating space. So just some holding pressure there or I could also spread laterally in that same way if I wanted to. Very easy techniques that you can follow up with after needling, and they can give a lot of assistance with creating space, more movement, freeing the tissue after the needling.

So the last thing, we’ll look at a corrective exercise to move and stretch the rectus abdominis, but especially this upper portion. This is from eight pieces of brocade. It’s called Separate Heaven and Earth. I want to start. With my rectus abdominis slightly contracted, pulling up on the pubic bone attachment, that’ll take me into a slight posterior tilt.

Rib cage is slightly pulled down, so I’m bringing my upper and lower attachments closer together. Bottom hand facing up, top hand facing down. My hands change, but think that the hands are moving because I’m opening the front of the body up. Pelvis goes to neutral. Rib cage lifts. and push. My hands are on the midline.

Hands come together because I engage the rectus abdominis. That’s going to start to tuck the pelvis under slightly, bring the ribcage down. Hands separate because my ribcage is lifting away from my pelvis.

Exhale, everything comes together. Inside, inhale, everything comes apart. So the main thing with this exercise is I don’t want my hands to get too much to the side. I want them to be on the midline so that I can encourage that movement in the stomach region, mobilize the stomach organ, stretch the rectus abdominis upper fibers.

So I displace that to the side, I lose that stretch in that midsection. I need to also lift the chest so that everything separates. Everything comes together,

inhale, separate, exhale. Ten times would be a nice nice amount for patients just to open that structure up. Last one is the first move of eight pieces of brocade. Two hands hold up the heavens. I’m going to clasp my fingers, turn my palms up, reach the hands, lift the chest, same thing. Opening of the front of the body helps lift the hands.

If somebody has decent enough balance, they can follow it up on their toes.

Hands come in, spines coming together, lift, press, lift,

and back down. Easy exercises. Patients usually are able to do those quite well. They can really supplement the treatment. Fun to, to go into the abdominal fibers, like I said, we’ll look at a little bit more on that lateral edge and medial edge, looking at the kidney channel and spleen channel.

Difference in the anatomy, we’ll look at that in the next webinar. So thanks again for American Acupuncture Council, and I look forward to the next time.

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Acupuncture Malpractice Insurance – Lumbar Pain: Supplementing Acupuncture with Therapeutic Exercise

 

 

Today I would like to show a side bending exercise I give with patients frequently in the context of treatment of low back pain, especially when the facet joints and the QL is involved.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, this is Brian Lau. I’m with Jingjin Movement Training, also an instructor with Sports Medicine Acupuncture Certification Program. So thanks to American Acupuncture Council. I always appreciate doing these webinars. A lot of fun to get together and share some information with you. Today we’re going to be referring back to the last presentation I did.

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We talked about the internal pattern, talked about the Zhui Yin and Xiao Yang channels in general. We looked at it in relationship to rotation. We even looked at a rotation exercise. Today I would like to show a side bending exercise I give with patients frequently in the context of treatment of low back pain, especially when the facet joints and the QL is involved.

It’s a great exercise, great to add to your repertoire when treating patients. It’s actually a great exercise to do for your own health. You get a twofer, you get something you can practice for yourself if you don’t have a good side bending exercise, but then something you can use to, to, as part of the treatment.

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So it’s an exercise that patients can do at home, yes, but as much as anything, I use some equipment for this. is it’s an exercise that I do after treatment to supplement the treatment to help open the tissue that I worked on with acupuncture manual therapy. So let’s go to the presentation.

We’ll start going over some some introductory information, a little bit of anatomy, and then we’ll look at the movement. Let’s talk about the quadratus lumborum, not the only muscle in the low back that causes low back pain by any means, but it’ll be a little bit of the star of the show for today.

And this exercise can work for a lot of different things, but when the QL is involved, it’s a really great exercise specifically for QL. Type pain. So this is the trigger point referral pattern of the quadratus lumborum. You can see some of the trigger point referrals can be out to the gallbladder channel, along the side, even to the greater trochanter.

They can wrap around to the liver channel. Sometimes the deeper fibers can go towards the SI joint or glute area. But by and large, it’s gallbladder and liver distribution. Now it’s interesting to me because I see, and we’ll look at a brief picture in a moment with the anatomy, I see that the liver, I somborum is part of the liver sinew channel which is a little higher up than the channel is classically described.

We’ll talk about that briefly. But interestingly also is liver V as a distal point, I do treat it locally local treatment is extremely important when you’re working with low back pain when the QL is involved. But as a distal point, liver V, the low connecting point, is a very useful point that becomes very reactive with QL pain.

And it’s interesting that this low connecting point treats this muscle that has a referral both to its its Xiao Yang partner, the gallbladder channel refers to the gallbladder channel, but it also refers to the liver channel. So its referral seems to be between those two those two related channels and the low connecting point would make sense that it would become reactive in that case.

So let’s look briefly at the QL anatomy. This is from Matt Callison’s Motor Point Index. He also has it in his Sports Medicine Acupuncture text. A great book if you don’t have it. This shows the iliac crest attachment, the 12th rib attachment, but also fibers that are going to transverse processes.

It’s a very complex muscle, multi layers. There’s actually three layers of the quadratus lumborum. We did a class on this that’s available on Net of Knowledge, and we talked about all these layers and different fascicles. It’s an interesting muscle. to spend a little more time on that we don’t have time today, but just to highlight that it does have attachments on those transverse processes and the 12th rib and the iliac crest.

It communicates with the multifidi muscles that also attach to the transverse processes and those muscles then go to the spinous processes. So this exercise we’ll be looking at would work those muscles too, but what really I want to highlight in this image in addition to the QL is the facet joints.

We’ll come back and talk about those in a second, but you can see them really well on this illustration. This is where the main movement happens from vertebra to vertebra. Facet joints are also called zygopaphyseal joints and these can be pain generators themselves. When there’s pain associated with a QL, multifidi, and or, and it’s often a and the facet joints this will be a really good exercise to complement it.

So the facet joints of the spine have a coupled relationship between side bending and rotation meaning that they both they, when they do one or the other, they do both. So when you’re side bending, there’s also a rotation component when you’re rotating the individual vertebrae can side bend.

And in particular, the lumbar region has limited rotation just by design. The facet orientation has limited rotation. So we’re going to be doing side bending to really exercise and move those facet joints. So if there is facet joint pain, moving the facets will help open that tissue up and help desensitize that tissue.

But when you’re moving the facets and sidebending, you’re also stretching and contracting, depending on which side you’re sidebending to. Stretching and contracting the quadratus lumborum, and you’re somewhat activating the multifidi also. So nice to know that these coupled relationships exist because really a good comprehensive program will include both sidebending and rotation.

We’re going to look at sidebending today. Here’s the liver sinew channel, so classically it ends at the groin, following up the adductors, adductor longus, pectineus, adductor brevis, gracilis, adductor magnus in my mind is part of the liver sinew channel, it’s more posterior, has a different fascial plane that it lives in, but we’re going to be looking more at those anterior adductors.

I also have in the list the lower portions of the channel, including the flexor digitorum longus, which is what you’d be needling into if you need a liver 5. So that would be affecting that fascial plane. And classically that ends at the groin, but if you follow that fascial plane up, it goes into the psoas, the iliacus, and the QL, all part of that plane, even though we access the QL from the back, it’s much more of a central muscle.

It’s on the fascial plane of the adductors. That would follow really all the way up to the diaphragm. So you can take that channel, in my opinion, up to the diaphragm. But QL is a big player in that and common cause of low back pain. So it’s important to understand these pathways. So liver organ itself has a particular movement that’s going to play into this.

So we looked at rotation at the last webinar I did with the American Acupuncture Council. So in the transverse plane, there’s a rotational movement of the liver in relationship to the diaphragm and the organs around it, like the stomach in particular, kidneys too. There’s a movement in the sagittal plane where it’s tilting forward, tilting back.

Those are going to be exercised much more with rotational type exercises. I want to look at this frontal plane movement. So the frontal plane movement, the liver moves in relationship to the left ligament that holds it up to the diaphragm. And as you side bend to the left and that liver flares up, you want it to be able to move in relationship to the tissues around it, like the transverse colon, the stomach, et cetera.

Then it can also rotate down so it can have a movement in that frontal plane that we’re going to be really highlighting in the rotation exercise. So you’re going to be stretching and contracting the QL, you’re going to be mobilizing liver, you’re going to be opening and closing the facet joints.

It’s important to do sidebending activities because they are underutilized and they’re extremely important for low back health and liver health. Alright, real brief, I’m not going to go into a lot of needle technique for the QL, it takes a little bit more time than I have here today, but I just wanted to highlight a couple directions that you could look at if you’ve had some training with the liver I mean with the liver sinew channel with the QL.

I can needle through this fibrous part of the thoracolumbar fascia where all the abdominal muscles meet, at least all their fascial compartments meet. And then it separates into fascial compartments that wrap around various aspects around the erector spinae and between QL. This is called the lateral raffae.

It’s the lateral seam of the abdominal muscles before they separate into various layers of the thoracolumbar fascia. So I can angle a needle into that. Sometimes that tissue is pretty reactive in and of itself. And that’s my target tissue. Or I could go through that and touch the QL. If I’m trying to needle the QL, I usually just go straight lateral, parallel with the table of the person was lying prone.

If they’re lying sideline, it would go straight towards the table, perpendicular to the table. So there’s some instructions here. If you go back and watch this, you can freeze here and look at those. I, again, this isn’t an instructional webinar on needling that. I just want to give some highlights real quickly here.

I’m palpating into that lateral raffae. So you can see I have about a 30 degree angle or so towards the table. So I’m at the edge of the iliocastalis lumborum advancing the needle into that lateral raffae. Maybe I touch the iliocastalis lumborum. Maybe I touched the quadratus lumborum. Maybe I’m in that fascial seam, which is my target.

And I think what happens is when I hit that fascial seam and engage that, it’s gonna pull on whatever structures it needs to. But it’s just a very reactive place and I needle the lateral raphe quite frequently based on palpation. If my goal is to needle the QL, I’m going to go more parallel to the table, directly cross fiber to the QL or needle it sideline.

I’ll have the leg extended to help depress the ileum on that side and then go straight down towards the table. This is my preferred way of needling the QL if I want to cross fiber the QL, but I might do it prone if I want to combine it with other points, for instance. All right I have some of these types of exercises, including this exercise, but I want to redo the video.

I have it on my YouTube channel, JingJin Movement Training, there’s a QR code there. I haven’t put short samples of those on my Instagram page too, so you can follow that if you’re interested in more information. But I want to now go and show some instruction for this particular exercise that you can use in your treatments.

So I’m going to exit out, and I’m going to back up, so give me just a moment.

Alright, so let’s initially, minimize something, sorry. Let’s talk about equipment first of all. So I’m going to show you two things that I use for this. This is a product called, from a company called StickMobility. StickMobility. StickMobility. com So I like the, I really think this is a solid product. I have them.

I, it comes in a set of two of these. This is a six foot one. I’m not super tall. If you’re taller, I’d get the seven foot one. So I’m about five eight. This one’s going to work for the exercise I’m going to show you quite well. But if you’re six foot tall or something like that, I would go ahead and get the seven foot tall one.

It marks them pretty well on the webpage. So it comes with two of these and it comes with a shorter one. I will say they’re a little pricey. So if you’re not going to use them a lot, I paid 180 for them. That was before greenflation or whatever we want to call it. So they’re probably, I haven’t, I meant to check before the webinar.

They’re probably 200 or 220 or something like that. Now it’s worth it. If you’re going to use them a lot, they’re very solid. They’re not going to break on you. For this particular exercise though especially if you’re going to give it to patients, I think it works just fine with PVC pipe. So with this PVC pipe, I put a little chair stand, whatever these are called that goes on the ends of the legs of the chair.

So I put those on the end because I wanted to be able to grip the floor so that this works out pretty well. These are just little rubber stoppers but the PVC pipe’s pretty strong. So this would be, I don’t know, 10, 15 or something like that. It takes you a little time. You have to go get it and find the appropriate stoppers for it, but it works out just fine.

So I’m going to use the stick mobility one since I have it, but this would be perfectly fine. I’ve never had a problem. PVC pipe’s pretty strong. I’ve never had a problem with that breaking. But I guess that is a consideration if you have a professional product, maybe from a liability standpoint. So maybe in your own office it’s worth having these, but if you’re going to give it to patients and they’re not willing to buy something that’s 200 and they’re only going to do this one exercise, I think the BBC pipe would be a really adequate way of doing it.

But you can also just give this in your office as a complement to the treatment, even if they don’t do it at home, at least they’re engaging that tissue that you just addressed with the acupuncture. So let’s get this set up. I want this to be somewhere about a foot away from my side of my foot. I don’t know, maybe with the metatarsals, doesn’t really matter.

It’s somewhere along the side of the foot, about a foot away. This exercise is easier the farther I move it away. But you’ll see as I go into side bending, if I have it too far away, it’s going to slip. So I need to have it close enough to where it grips. So that’s going to be a little bit of a challenge.

If it’s too hard, you need to move it away. But if you move it away too far, it’s not going to work so well. So about a foot is a good happy medium. So I’m going to put the Stick down. I’m gonna get my arm about at a 90 degree angle at the elbow. I’m gonna reach up, palm facing forward. So if I open my palm up, it’s facing forward.

Grab around. This is where if I was too tall, I’m gonna be like this. I’m not gonna be able to get my head under when I go to do side bending. So it needs to be high enough up to where I’m comfortable. Okay, so I want my chest to turn slightly Towards the bar, and what I’m going to do is I’m going to push out with the lower arm.

I’m going to let the top arm straighten, and I’m going to turn my chest forward. So that’s the position. I need to turn. So I’m pulling with the top arm, but I’m not pulling with the elbow. I’m pulling with the shoulder blade. And then I’m pushing out and extending out. So you can see it gives a really nice stretch all the way through the spine.

For Especially the lumbar spine, very complimentary for working with facet type pain and QL type pain. Come out of it slowly, I can turn my chest back, forward, and relax. So it does take a certain amount of strength for this. This one’s not overly, requires a lot of strength. It’s somewhat also positioning and learning how to use your whole body.

People mostly are trying to use the arms and it’s very difficult for them to push. I’ll show you how I assist them and help them in a second, but part of it is learning how to turn the chest and side bend into the, how to pull with the shoulder girdle without pulling with the arm. That’s going to shorten everything.

I need to pull my scapula back on that side, push the arm out on the bottom one, and then just lean and let it start to bend through the torso. Okay, I’ll show it on the other side and then I’ll show you how I help patients with it. So again, set up about a foot away, arm down, out about hip level, we’ll say about a 90 degree angle thereabouts, maybe slightly lower.

You can adjust it as you go for comfort, palm facing forward. Behind the bar, behind the stick, grab a hold, face my chest towards the bar, or at least in that direction. So I’m rotated in this case to my right, I don’t know if that’s going to show up because sometimes things get a little weird imaged on the webinars, but I’m facing to my right.

This is my right hand at the lower portion, and then I need to turn my chest forward. So I’m turning slightly to the left. Project, pull

the shoulder blade back, my left arm on my top arm, push out with my bottom arm, let everything side bend,

and slowly turn back when I’m ready, and there you go. So how I help. So let’s say I’m back on this side.

Patient can’t really do, first of all, the most often what they’re doing is they’re going to bend the top arm because they’re trying to pull. They need to learn how to let the lats lengthen, let that arm straighten, turn the chest. So it’s a little bit of a difficulty. So imagine I have a patient who’s struggling with this activity here.

I could be on the other side. I usually brace this with my foot and I help them. I’m not just pulling them through it. But I’m giving them some assistance and guiding them, let your top arm straighten, okay there you go, and then I’m helping pull them. Now, once they get into the stretch as far as they can get, I don’t want to just let go when they come out of it.

So I’m pulling, guiding them through it. Their chest is facing forward. Okay, so let’s come out of it. I’m slowly letting up as they turn their chest forward, especially if they have back pain. I don’t want it to be a very jarring activity where they’re in a somewhat compromised position and they just let go.

So I’m helping guide them through it. They don’t have to go as far as I went. Maybe they just go a little bit. Maybe they just get to here. But if I can help pull enough to where Pulls on this top arm, they’re going to start to get that stretch down through the lats, and then also into the QL. Highlight the movement.

I would definitely do it on both sides. So if it’s a lot of pain, maybe they only get this far, but usually this feels good for them. So if it is causing a lot of undue pain, I might come back to it in another treatment, but usually it feels good, feels therapeutic, it feels helpful. It feels like it supplements the treatment.

Same thing. I’d get them set up on this side, chest angled slightly towards the direction of the pole, turn the chest forward, push out, and that same thing. I might be over on this other side, guiding them, giving them some help, making sure they feel stable, guiding their positioning, let that top arm straighten.

Let everything stretch, giving them, coaching them through it, and giving them some guidance, helping them find the maneuver. So using the stick makes it really much more effective. Some people do a side stretch, which is great, nothing wrong with it. Or they might do something with the hands overhead, no problem.

Really nice, You can do a lot of the same types of things. There’s a windmill exercise I do, reaches through nice mobilization. I don’t like this one as much for back pain because of the rotation until they get a little bit more farther along the treatment and they can comfortably go in rotation without causing pain.

So there’s other ways of doing it, but the stick is a really guided way that you can work with patients. You can give them that assistance. You can take them through the process. In a little bit more controlled way. And to be honest, having that arm pulled and stretched from the stick really makes the stretch much more easy to access and takes them into it in a much stronger way.

So it’s a simple bit of equipment, even especially if you just got the PVC pipe. We’d recommend at some point, splurging and getting the stick mobility. I think they’re a really good product, but they are a little pricey. But it’s nice to have maybe the PVC pipe one also in your office so you can show patients and give them some recommendations for what to do in their at their own house when they’re practicing that.

But it, like I said, even just doing it that one time after treatment is part of the treatment. That’s how I view it. So I think you can take that same approach. All right. I think that covers the main information that I wanted to cover for this. Give it a go. Like I said, I have some videos on my YouTube channel, JingJin Movement Training.

I’ll make a point to get a new video up with this from different angles so you can see it and review it. But you can also review it from the webinar. That is on American Acupuncture Council’s Facebook page. It’ll also be on my YouTube channel. And if you wanted to go back and look at the rotation exercise I did, those will be at both of those places also, and it’ll give you a complimentary exercise for rotation that’ll also work.

The internal pathways quite nice. So thanks again for American Acupuncture Council. Look forward to seeing you guys at another time.

 

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Acupuncture Malpractice Insurance – Improving Vitality: Treating the Liver Channel and Organ

 

 

Today, we’re going to be looking a little bit at the liver channel. In particular, we’re going to look at the internal pathway, talk a little bit about some of the anatomy, and we’re going to then look at a therapeutic exercise that’ll help work rotation, liver channel primarily,

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Thanks for tuning in today. I’m Brian Lau. I’m with Jingjin Movement Training. I also teach with Sports Medicine Acupuncture certification program. I want to thank American Acupuncture Council for having me back. Today, we’re going to be looking a little bit at the liver channel. In particular, we’re going to look at the internal pathway, talk a little bit about some of the anatomy, and we’re going to then look at a therapeutic exercise that’ll help work rotation, liver channel primarily, but really all of the Jueyin channels and the Xiaoyang channels.

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That would also include, obviously, gallbladder, Sanjiao, pericardium, and liver, but we’ll highlight the liver channel, that’ll be the focus of the webinar. So let’s go ahead and go to the PowerPoint, and we’ll jump into some anatomy, and then we’ll look at a movement that will work some of this anatomy.

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So this image right here is showing my interpretation of the liver sinew channel. We’ll maybe talk a little bit about the sinews, but I want to go into the next slide, and we’ll go right into the liver channel itself. So many of you are familiar with this image from Dedman’s Manual of Acupuncture, or you’re familiar with other images possibly.

So just to highlight the internal pathway here we have the external pathway, acupuncturists are all very familiar with that, probably familiar with the internal pathway, but the external pathway, we have points. So we have a little better sense of the anatomy. Liver 13 would be actually a motor point, motor innervation for the external obliques.

Liver 14 would also be on the region of the external obliques, more at the attachment site. But let’s look at this little internal pathway. and discuss some of the potential anatomy for that. These internal pathways can be a little bit more vague. So I’m going to go to an image, a couple images actually from Netter’s Atlas of Anatomy, fantastic anatomy atlas.

So in Netter’s Atlas, here we have inside the abdominal cavity. So peritoneum’s removed. What we’re seeing is the liver reflected back. So you can see the little hook here, grabbing the liver, pulling the liver back. And what they’re trying to highlight. What Nutter is highlighting in this image is the lesser omentum between the liver and the stomach.

It’s a ligament that holds the liver to the stomach, allows for a particular amount of movement, but keeps some positioning of those organs intact. So I see that this lesser omentum is part of that internal pathway of the liver. Topography wise, it makes sense. It matches the topography fine, but if you open up in dissection and go inside of that Lesser Omentum, then I think it really gives a clear indication or at least a hint at what Deliver Channel is all about.

And that’s what we’re looking at here. We have the contents of the Lesser Omentum. We have the Hepatic vein, we have the portal vein, and then we also have what I think is really important to understanding the liver pathway and the liver channel itself, is we have a branch of the vagus nerve. In my view, and probably others the liver, Being a general, directing where the blood goes, is really about autonomic nervous system functioning.

Particularly, you could argue that it’s about the parasympathetic rest and digest portion of the autonomic nervous system. Very active at night, the blood returns to the liver at night, it returns to all these vessels inside the liver, these capacitance vessels that holds and stores a whole lot of blood.

Blood moves very slowly through that, they’re more full. At night, when we’re not moving, it’s more under the control of the parasympathetic nervous system. But it’s also really autonomic nervous system regulation, telling the body to give blood to the digestive organs, or do I want to give blood to the skeletal muscles because I’m out playing football or doing martial arts or something like that?

It’s where am I in my phase of activity? So it’s really about regulation between those. Now, we think of the liver oftentimes from pathology, which is more sympathetic overload, but in its health and most obvious function, it’s really more about that rest and digest, the most yin, the quietest portion of the nervous system.

And lo and behold, inside this lesser omentum, we have the branch of the vagus nerve. I would posit that this gives us a hint that internal pathway is following the vagus nerve or has something to do with the vagus nerve. I’m not saying it’s necessarily the entirety of the pathway, but it has something to do with that pathway.

So we’re going to look at a movement in a little bit, and I want to be able to move this region, or at least over time of practice of this movement. I want that to move the liver. and move the liver in relationship to the stomach to be able to exercise the contents in the lesser omentum. So just a real brief summary of movement of the liver.

The liver itself has movement in context of these ligamentous structures like the lesser omentum, in context with the diaphragm, of course, also. So the liver moves in the frontal plane. It moves up and down, follow, I’m gonna turn it over to Jim to talk about the the BAPT program.

The original BAPT program was designed in response to the COVID 19 pandemic to provide a way for the medical population to provide the needs of their bystanders to provide the necessary medical care. back and forth. We’ll look at that when I’m standing in a bit. And then it kind of moves in the sagittal plane, a tucking under type motion and a tilting motion.

So those are the motions we’re going to be really highlighting in this rotation exercise. So if you’re doing rotation and you’re letting that rotation wind through the body, it’s going to start to mobilize the liver, mobilize structures like the lesser momentum, and it’ll really complement Both for your own health, but if you’re treating patients and giving them exercises, it’ll really complement any treatments you’re doing for the liver channel, whether it’s musculoskeletal or internal type work, it’s good to have them be able to exercise these internal portions of the channels.

All right. So when we’re doing these rotations, like I mentioned, it’s sometimes you have movements that work a channel, but by and large, functional movements. We’re looking at networks, and when we’re looking at side bending and rotation, we’re looking at the Zhui Yin, Xiao Yang network. So all of these channels have something to do with rotation, and if that rotation is going through the pelvis, through the spine, through the shoulder girdle then we’re having both the arm channels and the leg channels of these Zhui Yin and Xiao Yang channels exercised.

So it’s really more of a functional network that we’re going to be exercising, but I’m highlighting the internal pathway of the liver channel. So just a couple images here, all of these are showing some aspect of either rotation or side bending with the exception of the middle image, which is really more about extension.

I put this one in here for a particular reason, because even when we’re doing activities like Tai Chi, like this is showing push hands or Tai Chi movement we’re stabilizing the lateral side of the body and the medial sides of the body. So to be able to have this nice posture and express the strength that would come from engaging the back and pushing forward we need to be stable, as the weight drops into the front leg, we don’t want that front, in this case, the left hip to rock up, or we don’t want the other hip to rock down.

We want to have a certain amount of stability from side to side. So this one is using the stabilizers and it is using this Joanne Xiaoyang Network. But to do it, it’s not an active movement that you see like you do in this gymnastics ring movement where you can see an obvious side bending or any of these rotational type movements.

So that’s why I put that one in there, but all of them feature some aspect of rotation or side bending, all featuring that Zhui Yin Shao Yong network. So we’re going to be looking at some pelvic movement, so using the liver channel, at least the sinews, pectineus would be one of those muscles, using the Shao Yong channels, piriformis and the lateral hip rotators.

To create and guide rotation of the pelvis, we’re going to be using the external obliques on the liver channel to help with torso rotation. Internal pathway of the, or at least internal portions of the liver sinew channel, QL, and the psoas will be active. Pericardium channel creates a sling around the body, that’s going to be active.

So really gallbladder channel is going to be active. We’re using those channels primarily, but I want to come back to that idea of exercising the internal pathway to complement treatments or to complement and help our own health. So this is showing some of the complex movements that happen between the two sides of the innominate bone, the pelvic bones.

Those also, when you’re walking, they’re going through a rotational type movement. And this is from a study that kind of highlighted those movements. We don’t need to get in the weeds with that. That’s very complex. That could be its own 20 minutes. Might not even be enough time, but its own its own webinar.

But just to highlight that when we’re doing types of movements like walking or turning, that there’s a discrepancy from side to side as one side does something, the other side does something different, we’ll look at that when I’m standing. All right, and that’s an image highlighting some of the, not just the pelvic movement, but how what happens in the pelvis relates to what happens in the ribcage.

So you can see in this boy running, the pelvis has a rotational and twisting type motion. The rib cage in this case has an opposing opposite action. So what’s happening on the right side of the pelvis is mirrored on the left side of the rib cage, but sometimes you can do rotation and have it mirrored on the same side.

The important thing to highlight is that lower rib cage and where the liver is, where the diaphragm is going to relate. It’s going to respond to what’s happening in the pelvis. So when we’re doing this rotation exercise. I want to look at how that winds from the pelvis up into the lower rib cage out into the shoulder girdle.

If you want to learn more about this, you can check out my YouTube channel. I have a lot of movement from a channel perspective movement exercises on there, Tai Chi, Qi Gong, some other types of calisthenic exercises, all from the lens of the channel perspectives, looking at it from the channel movements.

It’s called Jing Jin Movement Training. You can also check out my Instagram page. There’s a link or at least a QR code for each of those. All right, so I’m going to step back and we’re going to start looking at some of the exercises now. So I’ll get a little more back so you can see me more fully.

Let me just get something else out of the way. All right, so this is one exercise that I use a lot for myself. I give to patients also. It’s going to highlight that rotation in the pelvic girdle. It’s going to highlight that rotation In the lower rib cage, it’s going to highlight that rotation in the shoulder girdle, almost like a towel that’s being wrung out.

I want to have a wringing type motion that works throughout the whole body, so I can exercise that entire channel. I want to start with my stance about shoulder width. Maybe almost pelvis would be a really, a good marker. Maybe the outside of my pelvis could almost fit to the inside of my feet. So about a pelvic width stance would be good.

You can make it a little narrower, you can make it a little wider, but somewhere, I don’t want it to be super wide in this particular exercise. So somewhere about pelvis width, right? So I’m going to start with just a pelvis, so you can highlight that. I’m going to put my hands on my ASIS. This is not the motion, I just want to set the stage for it.

And I want to turn. Just to about 45, turn. As I turn, the pelvis is going to pull on the thighs, so there might be a little rotation, but I don’t want to lose form in my thighs. I don’t want my knees to cave in. I want to keep a certain amount of architecture in the knees. It’s okay if the legs move, it’s okay if the knees move a little bit, but I want to keep somewhat of an openness between the two knees.

I’m just turning, almost as if I’m a playing card at this point. So my ASIS facing 45, my shoulders are facing 45. So I’m not really moving yet in the torso, I’m just moving the pelvis. So even from the get go, there’s a little bit of movement in the pelvis. One side pulls back into a posterior tilt. One side moves into an anterior tilt.

You don’t have to do that. Should just happen once the pelvis loosens up. If you’re working with patients, sometimes they’re stiff and that has to take some time to manifest. But if they’re just getting a genital turn, they’re starting to exercise that movement from side to side, that contralateral movement of the pelvis.

All right, next phase, once I turn 45, I want to continue to turn, pulling through with the rib cage. So pelvis goes, Ribcage continues, as if I’m bringing my chest towards the side wall. Okay, so now let’s look at the full movement with that in mind. One arm up, one hand down, turn,

open the chest. So this hand pulls back to the tailbone.

Relax the torso, turn, open the chest. Relax the torso, turn, open the chest. Real briefly, I’m going to turn to the side so you can see from a different angle. So as I turn This hand, I want to let it pull back, turn my chest. So my chest is almost facing forward now. That’s going to depend on flexibility. I don’t want to torque myself past where I can comfortably move, but that’s the idea is I want to turn past where my pelvis can turn, open the chest, shoulder girdle moves,

soft, gentle. It’s not a real big deal with this exercise, but it can be very useful to do on a regular basis.

Okay. So facing forward again. I want to highlight a couple more things, and then maybe show it, and then I think we’ll be good. So as I turn, opening the chest, it’s as if somebody’s reaching through, pulling, So I want to turn fully to where this area moves. When I come to the other side, turn, move. So I want that whole lower ribcage to pull through so somebody’s reaching through.

See if you can see that as I’m doing the motion.

Might help with it is it might seem like there’s a little bit of a stand up at the end. Chest is bowed and soft. As I turn through, I get taller. Turn, move. Get taller, turn, get taller. So that getting taller is where you start working the lower rib cage and start working the internal pathway of the liver channel.

So that’s it. It’s a simple exercise. I want to get a full turn, but I don’t want to tense my body up and make a big to do with it. I’m just turning the hips, turning and opening the chest. That’s going to help my shoulder girdle open and just the gentle Once I get comfortable with it, then I can speed it up a little bit if I want to go faster.

But I would start small and start slow and get the pathway. Down, get the feeling down before trying to add speed.

I will get a video up on my channel for this. I might go from different angles, you can see it a little bit more. But I think from just that, it’s something to get started with. This is an easy exercise, easy for patients to do. It’s a little bit of coordination with it. It can take a little practice for people a little guidance.

You just want to watch them and see that they’re doing it in a very balanced way. But it offers a lot without too much difficulty, so I think it’s very applicable for a lot of people. You can do it seated also. Just keep in mind when you’re seated that you wouldn’t have access to as much turning of the pelvis.

So if I, if this area was fixed, I wouldn’t want to pull myself around. I wouldn’t want to pull my shoulder girdle around. You get the movement. I would still want it to be small ribcage turning in relationship to the pelvis so you don’t have as far to go in a chair, but it is applicable, it is something you can modify into a seated position.

It’s a good chance to work the liver channel, and it’s helpful for a lot of musculoskeletal, back pain, that kind of stuff, but really anything that’s involving that channel. Yeah. Thanks to American Acupuncture Council. It’s really enjoyable for me to come out and show some of these exercises, look at the pathways, to get a chance for us to feel movement in those channels.

And maybe we’ll check out side bending next time in the next webinar, and we’ll go over some some applications for patient exercises there for your own therapeutic benefit. So thanks again, and I look forward to seeing you guys next time.

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Acupuncture Malpractice Insurance – The Concept of Yin Fire in Pediatrics

 

 

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello. I am, , Moshe Heller. , and I am from Moshen Herbs on one hand and also representing Jingshen Pediatrics, which is a, , , organization that, , teaches, , , classes on. Pediatric treatments in, , in ACU with acupuncture. , and I’d like to thank the American Acupuncture Council for having me today and, , helping me host this.

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, very interesting talk about the concept of yin fire in pediatrics. So, , let’s start, , can we. Turn on the slides. Okay. So, , , I’m gonna be talking about this idea of yin fire. , and before I actually, , would like to discuss that, I wanted to, , bring your attention to the idea. That, , comes from, , pediatric acupuncture.

And, and I’m going to, , talk about, , this for a second before we go into yin fire. And that is, , an , , , , a concept that actually comes from Julian Scott, , from his book of the treatment of, , pediatrics in with acupuncture, , that there are five. Common patterns of disharmony in children. , and the reason I’m pointing, , to this idea is that there’s some, , , correlation or there’s some,

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Similarities between the ideas that he kind of presented, , presents, , in his book and the concept of yin fire. And we’ll see how that correlates in a little bit. But, , I want to remind to kind of discuss these five patterns as, , as, , as sort of like a a, an introduction. So these five patterns include, , a regular spleen G deficiency, , type.

, and that’s the, , , usually, , seen in a deficient type. . , patient, , pediatric patient. , usually they’ll have digestive issues similar to the same concept of having a spleen cheat deficiency in, , your adult, , patients. And that, that I don’t, I. I think I don’t need to, , explain too much. , hopefully everybody knows that.

, the other pattern, the next pattern is a lingering pathogenic factor, and that comes from the idea that children are more susceptible to pathogenic factors and. More so they are more susceptible to having these pathogenic factors linger and continue to influence them, , further than just, than, , the initial invasion.

The other three. The next one is called hyperactive kidney deficiency, hyperactive spleen, G deficiency and accumulation disorders. So these three are the ones I want to kind of point out because there are, , similar in, in that there, there is this kind of. The similar idea of yin fire, where you have a doll, , or a a, a rooted deficiencies condition that creates, , excess like symptoms.

And that’s at the root of yin fire. And that’s why I wanted to point out these, , three, , patterns. Also the hyperactive. Kidney deficiency and the hyperactive spleen deficiency both. At the root, , you will see signs of spleen deficiency are classical signs of spleen deficiency, coupled with a lot of behavioral excess meaning, , difficulty falling asleep.

Being hyperactive in their, in their behavior. , , kids that seem very, , , excessive and sometimes difficult to control. Although, , at the, at the core, they are presenting with a spleen deficiency, signs and symptoms, the accumulation disorder. Is classically according to, , Julian Scott, more of an belongs to an excess type.

But really I’ve seen a lot of accumulation disorder in my office that are deficient. Patients with the accumulation or these, these kind of accumulation of dampness and in particular, , that, , manifests as. , excess signs and symptoms. So I just wanted to, , give that as a, as a introduction, , to the, the idea of, , of yin fire because I think it’s not totally foreign or it’s not completely new, , in that type of thinking.

But, . Let’s talk about yin fire and, , just wanted to point out that, , the concept of yin fire was, , , discussed first by, , li Don Yan, , who wrote the book, , the P Lung in 1249. . In there. You know, we all know that, , li Donan was this, , , famous Chinese doctor who, , developed the idea of the spleen and stomach stu , school, meaning that he believed that a lot of, .

, disorders or most disorders were created or stem from this, , spleen, chief acuity. , and, , and , and in his discussions he discussed the idea of yin fire, which is, , again, , this idea of spleen vacuity at the core and then having. Which we’ll discuss, , what that means in a little bit. , and this idea of Li Donan was discussed, , and debated in many, I import by many important Chinese doctors throughout the years.

. And actually has gained more attention in today. I hear a lot of practitioners talking about Ian Fire. , not, , you know, recently and a lot of, , lectures and, and discussions, which is, , very interesting. And, , the reason I think it’s becoming very popular is because it’s actually. Can be an explanation for many chronic diseases, , or disease that are a mixture of a mixed pattern of excess and deficiency, , in combination.

And we’ll see how that works. , well in, in, in a, in a little bit. , but it’s, it’s, it’s actually, , although you see all these. Excess signs in, in the forefront because the, those are more, , clear. , the right treatment principle is a principle of strengthening and resolving the, the, the main, core idea of this deficiency that’s causing the excess like symptoms that are not really excess.

So, , I’m going to, I, I brought this excerpt from, , from the p , which is the opening, , , con, , , paragraph, , sort of defining what Yin fire is, and it’s, , translated by Lorraine Wilcox, , , which, , provides a very. Good translation in this. You can find, , her article about this, , translation very easily.

, , so let me, , read this, , because I think it’s really important to understand what is said here. So, . , and it starts by talking of, , saying this, if eating and drinking becomes irregular or cold and worth, warmth are inappropriate, the spleen and stomach becomes damaged. So the first sentence we see that the causes of this imbalance, the causes of this balance of, of, of, of the damage of spleen and stomach come from.

, diet basically says it’s either diet, , or inappropriate exposures to, , warmth and cold. , and the diet is, is, is really a very important, , aspect of that. And we have to, . , to, , you know, I, I wanna point out, , before moving on, that, that is, , at the core of, , the treatment pri principles.

When I see, when I recognize infire diet is one thing, I have a very long discussion with my patients, with the parents and the, the children, depending who I’m treating. , about regulating diet and not so much. Not as much as, , I put as, as much as emphasis on. The scheduling and how you eat and, , enough, , chewing and not swallowing, , your food, but chewing it and giving it time and having, , and eating in regular schedule, , as part of this kind of healing of the spleen and stomach.

So this is a very important aspect that, , that we need to pay attention to. Then he goes on on saying, or joy, anger, anxiety, and fear can also consume original qi, or it’s called, he names it as Yuan qe. And here we have to be. And , Lorraine also, , . , points out that when he, , when he call what he calls Yuan Chi, we have to be careful not to, , confuse that with what we call yuan kidney Yuan or Yuan Source.

It’s a different, this Yuan Chi is very much associated with what we might call the chin chi or the clear chi that comes out of. Digestion, right. So, , after, , Gucci is derived from the, the, the, the food and drink it is. Trans and it is connected with the, the, the, , the, the chio, the chi of the air. , it becomes this kind of, , yuan qi and it actually, , is associated with the lower Jiao.

So it’s, , it comes, it’s connected also with some, , of the kidney. , . Kidney. So, , it stems from the lower jaw and goes up to the upper. So, . That’s the Yuan Chi that we’re, we’re, we’re talking about in this case. Once spleen and stomach chi has declined and original Q has become insufficient, the only thing that is abundant is the pathological fire in of the heart.

So in a sense, this, , clear q, , allows the balance or allows the, the, the balance between. , that and heart fire. So once they are declining, , the fire in the heart becomes, , pathological. And this is, this heart fire is yin fire, which arises in the lower J and connects with the heart through its system.

So, , this whole system has to do with the relationship of the pericardium and the Tial fire and, , and it is associated with this kind of movement of qi. And so I. Of, of movement, of qi up and down and, , in our body. And therefore, , a lot of this yin fire is associated with stagnation, stagnation of qi.

So we’ll see that also in a little bit. So Minister Fire Min, minister Fire is the fire of the Lower JAO and the bau. There’s a whole discussion what BAU means, , which we won’t go, go into. , . And once that Tal fire is this, it is the thief of original Qi fire cannot coexist with the original qi. One of them will become victorious and the other will be defeated.

So we see this kind of mechanism that’s, , that’s described, which is . Which I want to sort of, , , in the next slide, I’ve sort of created this, , visual, , , presentation of it. , if we have the lower, middle and upper levels here, , this TAL fire should be, , coming down from the heart and placed.

, under the, , under the pot, if you say, of the spleen and stomach. , So the yanchi, , is also arises from here and, , and is in part of the process. But if the menstrual fire, , is misplaced, it creates, , more heat. If you can imagine this kind of menstrual fire as being the fire under the pot, if the fire is sitting aside from the pot, it brings up, , heat that harass, that can harass the heart.

And so, you know, as the spleen and stomach, , supposed to, , raise the spleen is supposed to bring up the chi to the chest and the stomach riping and rotting and, . It is supposed to connect with the lung chi to create Gucci. And then this is sort of the source of our postnatal chi and also the source of having a very strong and balanced ying chi and way chi.

, so as we can see here, this is all, , once this, there’s an imbalance here. It affects our ability to. , have a balanced immune system. It has, , a, a, a a very, it will affect the mechanisms of our own energy so that it will be very imbalanced and, , and, , if we understand this path of mechanism, we can understand and, , and see it in our patients much clearer.

So I want to just, , also point out that throughout these discussions and development, there’s actually a lot of, . Different. So, yin fire is not one thing. It’s actually a concept. And, , and, and in an article in the JCM, the Journal of Chinese Medicine, , called, , an Introduction to Chinese Medicine Concept of Yin Fire by Sean Randen.

, he writes this, , it’s a, it’s a great article and I, , would recommend reading it. , but he talks about this. The concept of Yen Fire has been discussed and debated through the history of Chinese medicine, and he brings this, , modern auth author from 2007, Leo Tu, who classified Yen Fire, according to four different categories.

. One. , the one of them is the, , what we, he calls occlusive exclusively Q deficiency, , yin fire as described by Lee Donan, you know, in his, in his book. That’s. Currently discussed, but he brings three more aspects of that. One is more, , , issue of XY and mostly this kind of XY cold, xin cold that, , actually the cold creating fire.

So he, , talks about the sea and fire created. From kidney cold. So this, again, this, we, you know, we can see this concept of dull , patterns. So a mixed pattern, cold and heat or deficiency, and what seems like excess. Also, , the other one he discussed is called Kidney in Deficiency, creating Fire. That’s a more classical part of that, but as it as this, if this fire is harassing the heart, that’s when we see yin fire in this case.

And the third one has to do with liver, gallbladder cheese stagnation causing depressive. Heat or fire, , also harassing the heart. So again, I just wanna point out in by this, , is that there’s a broader concept of yen fire other than just, , what we’ve just discussed.

So this is the end of part one of, , the concept of yin fire in pediatrics in part two. I’m going to be speaking about how does yin fire manifest in pediatrics more specifically.

 

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Acupuncture Malpractice Insurance – Pulse Diagnosis: Beyond Slippery and Wiry Part 2

 

 

Lovingly call a slippery and wiry school where all the patients we saw in clinic had slippery and wiry pulses, or thin and wiry.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, I am Dr. Martha Lucas, and I am here with part two of Pulse diagnosis Beyond Slippery and Wiry. I am located, my practices are in Denver and then in Littleton, Colorado. I. Work at a regular internal medicine, modern medicine practice. They asked me to come there many years ago to what they said was help them with their diagnoses, which I thought was pretty cool.

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I also, I. Teach Chinese medicine classes. I’ve been in practice for more than 20 years. The name of the course is, or the name of these webinars in my book is Post-Diagnosis Beyond Slippery and Wiry, because I always say that I went to what I call a slippery. Lovingly call a slippery and wiry school where all the patients we saw in clinic had slippery and wiry pulses, or thin and wiry.

Occasionally we could say thin and wiry, but that was pretty much all we learned, and my school did not have any courses on pulse diagnosis. I was very lucky and. In my very first semester of school, my mentor, Jim Ramal, offered a full semester long course in pulse diagnosis, which I was so excited to be there that I took the class because I had previously been, or still working in Western medicine as a research psychologist, but was very curious about what else is going on besides my patients were cardiovascular.

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Patients who had just had bypass surgery and researchers are curious and I just wanted to know, hey, your engine just got fixed, but what else is working to keep that engine working well? So that’s why I started to study various energy medicines and ended up in Chinese medicine school. Just because I had, as a regular person, taken a color puncture course, but needed to know why certain colors, why on certain points, which I knew nothing about ’cause I was just a regular person, but.

My mentor made me fall in love with his method of pulse diagnosis, and and I never looked back. I continued in school, became a, obviously became a practitioner, and my specialty is the diagnosis. People come to me for. An in-depth diagnosis because guess what? Your treatment is going to be more effective if you actually give a correct diagnosis, and I would like to take that sentence.

I had acupuncture and it didn’t work out of the English language because either the patient didn’t work at it. They expect you to cure their five year long back pain and two treatments or. The diagnosis wasn’t right and then the treatment just didn’t work right? So I want to very much thank the American Acupuncture Council for allowing me this opportunity to go on and on about Pulse diagnosis, because as you can tell, I’m super excited about it.

And you can always look me up@lucasteachings.com or my private practice site is acupuncture women.com, and I am always happy to answer. Any questions that you might have. So let’s go to the slides. As I said, this is part two. So I asked this question, what is this thing called the normal pulse? Because in part one I talked about how even historically, and not only in Chinese medicine, I.

Doctors talked about this thing, taking the pulse during healthy times, and they talked about what a normal pulse is that practitioners need to know how to feel a normal, balanced pulse as well as morbid pulses or imbalance or the pulses of a person who has an illness. And we are going to talk about the normal pulse.

Jin we said it is imperative to know the normal pulse or the pulse in the healthy person before the morbid pulses are to be learned because a morbid pulse is in fact. The abnormal change of a normal pulse? My school never told me what normal was. They talked about I think my school might have been a stomach cheese school that they said, oh, a normal healthy pulse is slightly slippery and somewhat wiry.

Oh my goodness. Could that be more ambiguous? What? What do you mean slightly wiry or slight, somewhat slippery. That’s wrong. That is not what a normal pulse feels like. What a normal pulse is a sine wave yang and yin. So yang rises, yin falls, and then they connect each other. So it’s a series of sign waves, yang and yin yang and yin.

And it’s symmetrical. So the yang isn’t founding up, and the yin is this little tiny thing. It’s symmetrical, it feels smooth, it’s connected. The yang and the yin are mixing, which is what they do, right? They mix with each other to create a wave that they’re each supporting each other. So that’s what normal feels and that’s the goal of every treatment.

The person comes in, you feel they’re outta balance pulse. You determine what you need to do with whatever you’re going to do. Acupuncture gua, una, herbs moa, and then you do your treatment. I recommend a little bit of treatment, refill the pulses to see what happened or what didn’t happen. A little bit of treatment.

Refill the pulses, so it’s a kind of a little puzzle that you’re trying to fix. So any break in symmetry from that normal sine wave yang and yin yang and yin is pathological. If the body isn’t able to self-regulate itself anymore. I. Without help in a perfectly healthy world, the body would self-regulate.

You’d have some outta balance. Let’s say there’s a cold or something and your pulse gets a little bit outta balance, but then your body regulates itself and it goes back into balance. If that. Doesn’t happen. If it can’t return to the normal sine wave, then we need to see people, which is why I recommend what I call maintenance treatments, which is, okay, we got you back into a healthy state.

I’ll see you in a month. And I always tell people, don’t go back to square one. Don’t not go back to square one and call me and say, oh my goodness. Because that would be. Your body is going back into the old pattern of imbalance, instead of staying in a more balanced state.

And believe me, we can retrain a person’s body to learn how to reregulate itself and get more balanced. Are we all ever gonna be perfectly balanced like we were in utero? And sometimes, not even then, frankly, depending on our parents’ health, depending on our parents’ relationship, et cetera. But we can get closer to it.

We can go out of a sickness state into a wellness state more quickly or out of an emotional state, into a calmer state more regularly when we, as the practitioners retrain the person’s body to remember what normal feels like. Because when all of our energies are substantial in communicating with each other, then there is not what we call a pathological pulse.

So we can deal, we can literally watch the health issue go from healthy to unhealthy to back to healthy, as I said, the front of the position. The uprising part is young. That’s the functional aspect of the organ and the back or the downward flow is the yin, which is more the physicality of the organ. So again, using this idea, we can see is this person’s problem more a function or more of a physical?

Problem the large intestine and constipation, we would maybe be able to determine whether the constipation or change in bowel habits is due to a weakness in the large intestine function handling a typical food load, or whether or not it’s over that physical organ is overburdened or both. Other interesting qualities are the co-sign.

So in my way of my system, we have the sine wave, which is normal. We have the co-sign wave, which is the opposite of a sine wave. So it starts more in the yin part and goes up. So that’s, and you, when we, when I teach this in classes and you get to see it like depression is a co-sign in the liver.

Position. Once you see a co-sign, then you are able to recognize it more and more. As I say, it’s often seen in the liver, but it’s seen in other positions as well, and we need to know what level it starts at. If the co-sign starts at the deep level, it’s an older issue with the person, an older emotional issue, or an older.

Physical issue, maybe even they’ve adapted to it. If it starts at the top level, it’s more current, something that they’re dealing with right now. For example, taking that depth idea, sinking or emptiness or you don’t feel anything, it’s empty in the spleen, stomach, the earth position. That can mean early childhood trauma.

It can mean what? What is called the relinquishment wound by psychologists, which means. The person was separated from their mother right at birth. For example, my oldest grandson was a preemie, and so he was, had to be taken out by emergency c-section, and he was taken away from my daughter at that moment.

All right? So he would have a tendency to have what is called the relinquishment wound, and sure enough, because. Spleen, stomach, lung, large intestine, rr immune system. What did he have as an early young one? Immune system issues. What did he have as an early, young one? Skin issues. So these were predictable according to his, preemie experience leading to immune problems may be seen. And he recently got diagnosed with asthma. So all of that, and he’s, thank God, and I also thank Chinese medicine. He is what I would call a very healthy 17-year-old, despite the fact that he went through some early life problems with strider and with rashes, and now has asthma.

But he’s a track runner in cross country. So Chinese medicine, I. Really as you if you couldn’t tell. Really love it. And then other interesting qualities are nodding. This movement is a three dimensional movement, so it comes up in the pulse. You can feel it, touch your finger, and it stays there. You probably heard about it in school as called the spinning bean pulse.

What you would feel in the beginning as you’re learning how to feel an knotted pulse is just it hitting your finger and no flow. It’s not going anywhere. That’s what a tumor feels like. That’s what a cyst feels like. That’s what a fibroid feels like, because what is that diagnosis? It is stagnation.

Stagnation in one spot, right? That cyst is in one spot. That fibroid is in the uterus, the nodding movement is eventually you’ll, if it’s growing, especially, you can feel the spinning at the top. You can feel the movement at the top, but that knotted movement is you feeling a localized stagnation.

Sometimes you feel it after people have a surgery because they just had localized. Trauma, localized damage in their body. You might feel it in the lung pulse because the person has some sort of mucus blocks in there. So that’s what nodding is. And it might seem like a pause because it’s not flowing.

It seems like a pause because it’s rising up. And you feel it before you feel the movement on. Some people think of this as an intermittent pulse, but sometimes you need to be a little more discerning to see whether it’s an actual or not, and. I’m talking to my patients while I’m taking their pulses because when I feel something, as I just said, it can be more than one thing.

So to asking the patient, how’s this, how’s that? Have you ever had this? Is this happening? Is that happening? Then we, I. Are getting down to the nitty gritty of what’s going on. Like the person says, oh yes, I’ve just been diagnosed with colon cancer. That’s why I’m here to see you. Then we might feel that in the right distal position because that’s the lung large intestine.

But we also might feel it in the proximal position because we are feeling the physical organ, the pulses can be a model for the whole body. What’s deep inside and what’s more on the surface, and where it is not only located in what we learned as the traditional pulse positions, but also where is that organ in the actual body.

So we are doing a lot of observation along with what we might call clinical findings, what their doctor has told them they have. So we we might think we’re looking at energetic qualities, but actually we are looking at impulse diagnosis at the physical body, the emotional bodies, and the spiritual bodies.

For example, we don’t ever wanna see a scattered pulse, right? That’s someone who’s living in fear, right? And fear and anxiety are almost the same thing. Fear is a little more dramatic than anxiety, but this person is in constant vigilance. Their kidneys get overloaded, get what we call scattered.

We don’t ever wanna feel, scattered kidney position. And then everything gets more tight after that because the kidneys aren’t flowing, they’re scattered. The sympathetic nervous system is showing up in the pulses because their muscles are getting tight. They’re. Central nervous system is overloaded, so it feels scattered little points of light under your finger instead of a nice kind of flow.

So this patient might think of everything as threatening, and that’s because they’re not centered, right? Their pulse. Can’t moderate itself back to calming the nervous system down and regulating and centering them anymore, they’ve become in that pattern of fear, anxiety, nervousness, and what we do is help that get regulated back to normal, back to balance, back to flowing back to the kidneys, being not scattered and supporting all the other organ systems.

So we talk a little bit about the pulses in cancer development, since we’re talking about nodding in tumors. In a healthy person, we know about the microcosmic orbit, right? Think about it. It’s a sine wave, and what happens when you do a sine wave? The other wave. So sine wave. Sine wave, which is how we communicate left and right, is the infinity symbol, right?

Sine wave this way, sine wave that way. And so we want to support the lower Dante N. We want to facilitate that connection. Some people call it the Tai G connection between yang and Yin and. There’s this story about how monks used to click their teeth actually pumping the salivary glands to catch and contain the fire element Ming Mu, to generate the saliva and swallow it, guiding it down.

The Ren Ma, back to the Dante. And so this idea of preserving your Ming Man fire has been around for a long time. And there are various ways that people in the past have done it. Now a blockage in the diaphragm, what we would call a dmai block, may prevent that saliva from getting down to the Dante.

And it’s the same way energetically, if the dmai is blocked, the vertical flowing channels are not communicating with each other anymore. So if you are, for example, treating a fertility patient and men and women, and you’re. Tonifying, the lower, their reproductive system in the lower J and also trying to help their digestion, but their dimmi is blocked and you don’t know it, you’re not helping them because where’s that energy gonna go?

How are, how is digestion going to communicate with the reproductive area? How is the middle or the upper going to connect with the lower? It’s not because those organ systems are dissociated when there’s a DI block, we need, that’s an example, a simple example of something that we need to be able to feel in the pulses so that we can reorganize those systems so that they’re flowing into each other.

So I recommend taking the pulses with your non-dominant hand for one thing with your right hand, I mean with your dominant hand. It happens to be my right hand. I might take, be taking notes. I might be writing down something that the patient says, and I’m also going deep to superficial. So feeling the Ming man feeling the kidneys.

Feeling what’s going on in their core and then moving up to what’s more current. And for example, a short kidney pulse that can be a blocked dite. Usually a blocked dite feels a little stronger than just a weak kidney. But if the, if there’s a short kidney pulse, a short proximal position, pulse, the kidneys aren’t flowing, that’s the bottom line.

If it’s short, they’re not flowing. They’re not supporting the other organ systems. A short heart pulse. Liver attacking the heart, maybe liver attacking the heart, and the heart is. Stopping that because it’s trying to protect the spirit. Is it old trauma that’s causing that? It could be. These are all things it could mean, and this is partly why we need to communicate with the patient.

I said in part one that like the great sociologist, Andrew Greeley said people will say anything and he was talking about surveys, how you can’t believe surveys. Because people will say anything. Same thing with po with the person’s body. They, I’ve had so many patients that I have felt some sort of old unresolved emotional issue or trauma.

I don’t use the word trauma in the first treatment, of course. And they’ll, I’ll ask them, oh, do you have anything unresolved? Something from the, and they’ll say no, I don’t think so. And then the second or third visit, they’ll say, I was thinking about what you said, and you’re right, I had blah, blah, blah.

So it’s. I just helped that patient know themselves better. I just helped that patient understand the cause of their fibromyalgia or their stomach, their digestive issues. So we are helping the patient know themselves better and understand why. Understand why they are having this particular illness or symptom.

Knotted left kidney pulse in the system I’m using in teach, the left kidney position can be the uterus and the prostate. So if it’s knotted in there, maybe it’s uterine fibroid, maybe there’s some prostate inflammation. A knot at the top of the stomach and or large intestine position is thyroid. In Chinese medicine, we don’t have a thyroid organ, right?

We don’t talk about it. We don’t have, certainly don’t have a thyroid channel per se, but where is the thyroid? It’s near some channels where it’s blockage it’s having little nodules or it’s inability to function well, can be felt in the pulses, and then the gallbladder and San Jal positions, especially at the sensory level.

Can show brain or central nervous system activity. In fact, gall bladder and Sanja channels are very good channels to treat the brain. So let’s talk for a minute about a couple of case studies. So a large gel pulse, right proximal. Remember, we’re gonna look at the positions in some unique ways. This can be, as I said, something going on with the brain.

Or. Something going on physically, right? A patient who has IBS, you might see that big movement in either the middle or the lower gel, but sometimes it’s nervous tension going to the brain. It might have some heat and dampness in it. So we’re looking at things in a unique, more detailed way. A young woman after a C-section, and she has a very stiff and painful neck.

All the tests come back normal, right? She doesn’t have any spine issues. If her pulse in the small intestine position is. Empty. Okay. Of course, her neck is full of muscle tension and knots and inflamed trigger points because there’s no oxygen and blood flow in the small intestine channel. So you know, you might be thinking, oh, wait a minute.

I should be feeling a choppy pulse. No. Remember, sometimes back problems, neck problems, muscle problems are hidden. Because it’s severely depleted, cheat, in her case from childbirth. It’s the hardest thing a woman’s body is ever going to do. Build. Then deliver another human being. So we, this is what I’m saying, we need to be open to what’s going on in all of the channels near where the person’s symptom is.

Or they may have a short wry movement going from the stomach backward. That’s what worry feels like. And we never wanna have worry in the pulses because not only is it not going forward to. Help the lung, large intestine and the immune system be strong, but it’s going backward and attacking the kidneys.

So case study examples, block dite, like I said, fertility example. The person has fallen, they’ve been rear-ended. They’ve been in some sort of accident. And by the way, falls include things like ski falls and sports falls where the person falls and gets right back up. They look down, nothing’s broken, they’re not bleeding.

The Dai still gets blocked. So again, it’s important to know what the person’s history is, what their activities are, if we’re feeling the Dai block, because our treatment is not going to be as effective as we want it to be. If there’s a Dai block. I mentioned a little bit about earth and metal connection.

That’s the immune system, right? So the spleen, stomach, lung, large intestine, they all need to be flowing with each other. So that would mean the kidney position, earth position, metal position, all Y and yin yang and yin. So we can have a strong immune system. Let’s say the person comes in with acne, maybe that is liver stress shooting out.

To the skin, especially on the forehead. Stress, acne especially shows up on the forehead. So again, with acne, we can’t just look at hormones, we can’t just look at heat. We have to look at other possibilities. Of what’s causing this person’s acne. And then the separation of yin and yang, they call that the end of life, right?

That looks like you. What it looks like in the pulses is you only feel yang. And when you go down into the deep portion, it’s pretty, pretty empty. That’s ’cause the organ systems are getting weaker. They’re not able to hold energy anymore. And so what happens? There’s no root. So the pulses just go up y yang, young.

So you know, that’s I treat internal medicine, that’s my specialty. So I always say practitioners who only treat pain are fairly lucky ’cause they’re probably never gonna have to go through the death of a patient. But I went through the death of a patient my very first year out of school. I just had one pass away last year.

It’s when you treat internal medicine, you are going to eventually, as your patients get older and older. Feel that separation of yin and yang, and I don’t like it, but I, it’s a hint of what I need to do. Try to get some of that connection back so they have more of a flow in their pulses. And I’m always optimistic.

I am really, no matter what the person comes with, I at least. I am optimistic that I’m going to be able to maybe slow down the progression of the disease, slow, slow down their symptoms, take their symptoms away, make them feel better quality of life. Always super, super because I get a smile out of the pulses every day.

I. I’m one of those people who’s really lucky that as a woman of a certain age, as I like to say, I still love my work. It still makes me smile every day. It makes my patients smile every day. They’re always interested when they’re like, oh, you’re feeling something, aren’t you? I appreciate your listening to this part two of Pulse diagnosis beyond Slippery and wiry, and I will hopefully see you for part three.

Again, I want to thank the American Acupuncture Council for allowing me to express my excitement to you about Pulse diagnosis, and hopefully I’ll see you next time.

 

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