Avoiding stagnation is a vital concept to convey to patients during the winter months. This idea of stagnation applies to both physical movement and mental stimulation, and the numerous ways the two cross-pollinate. As the colder weather arrives, physical activity often declines and the circulatory system can slow down as a result.
In the clinical setting, I always discuss the important TCM concept of blood stasis with patients and how this can be affected by lack of physical movement. Some patients do remain extremely active during the winter; however, I have found that many others tend to spend considerably more time indoors.
With this idea of inactivity and consequent blood stasis in mind, clinicians should encourage their patients to stay as active as possible; and emphasize how healthy circulation affects function of the immune system, aging and mental state.
It is common to use the formula "The Four Gates" to move qi and blood. While there is nothing inherently wrong with this approach, I encourage you to consider the impact of the seasons on the body and the meridians. In the winter, moving qi and blood can be extremely important. However it can often be even more important to directly move both with acupuncture.
SP 10: Sea of Blood
When lack of activity manifests as blood stasis during the colder months, I frequently use Sp 10: "Sea of Blood." Sp 10 is commonly used for a wide array of gynecological issues; however, its application spreads much further. Sp 10 is also commonly used for heat in the blood and dermatological issues, both of which can manifest more commonly in the winter months.
Chronic stress during the holiday months also can cause depressive heat in the liver; and patients often eat more heating foods and drink excess alcohol during the winter, which can contribute to heat in the blood. In all of these cases, Sp 10 is extremely clinically effective.
Combining Sp 10 With Ren 6
I often use the combination of Ren 6 and Sp 10 as a substitute for The Four Gates in patients who show patterns of blood stasis and heat in the blood during the cold winter months. Two of the key signs that signal the use of this acupuncture point combination are 1) symptoms that dramatically improve with movement or activity; and 2) engorged, purple-blue sublingual veins.
I also frequently use Sp 10 and Ren 6 in cases of dry skin and cold hands / feet, which are aggravated during the colder months and not generally improved by physical activity. In such cases, the dry skin is not improved with the use of moisturizers and often includes itching and thickening of the skin.
It is not uncommon for individuals to suffer from cold hands and feet during the winter months, but when blood stasis is present, the symptoms are extremely severe and often not improved by warmth or movement. In such cases, Sp 10 can be extremely important.
If patients show a majority of cold signs and also have engorged, purple-blue sublingual veins, I frequently use moxa on Sp 10 and Ren 6. I encourage patients to use acupuncture and moxa therapy twice a week for four weeks in combination with the use of gentle movement therapy such as tai chi and slow yoga classes. Dramatic and lasting improvements can often be seen if frequent sessions are administered for a short period of time.
Adding The Four Gates
If patients are suffering from chronic issues that are severely exacerbated during the winter months and/or suffer from depression or malaise during the winter, I suggest using The Four Gates formula along with Sp 10 and Ren 6. Although exquisitely simple, The Four Gates can be extremely effective in resolving chronic, recalcitrant cases of blood stasis manifesting as both physical and psychological issues.
Help Inspire Your Patients
Along with providing acupuncture, also encourage patients to stay mentally and physically active and motivated during the winter months. This recommendation can have significant clinical implications. We must always assist patients to find tools which keep them mentally and physical inspired.
Sp 10 can move the blood and improve both mental and physical symptoms, but helping patients cultivate and create tools for inspiration and intrinsic motivation is just as important. When this occurs in tandem with intelligently administered acupuncture, you can help patients' lives flow with the seasons, and inspire them to achieve their dreams and goals. This is truly powerful medicine.
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