During my years studying with my teacher, he'd communicate the importance of honoring each modality within Chinese medicine in its core essence. Modern acupuncture is highly influenced by the thinking of herbal medicine, based on the zang fu organ theories that have been adopted by TCM. This is arguably a reason he has spent so much time communicating essential acupuncture thinking from the classical era based on the Ling Shu, the core acupuncture textbook.
However, my classically based acupuncture practice has benefited greatly from the understanding of strategies rooted in herbal medicine, especially those coming from the Imperial Medical Academy. I practice acupuncture from a classical Ling Shu-style approach, yet I've adopted many IMA-based treatment principles and strategies.
The IMA was a committee comprised of some of the most respected doctors and scholars from China who agreed on strategies and treatment criteria for treating various conditions. Several of the Great Masters were members.
Nourishing the Blood
The treatment of mental health (shen disturbance) emphasizes the sheng hua principle, focusing on blood. The first three criteria for treating mental health require "nourishing" and "invigorating" the blood. The emphasis should obviously be placed on either nourishing or moving blood accordingly, depending on the prevalence of the patient's excess or deficiency. Sheng hua teaches that in order to successfully nourish blood, it must also be moved and vice versa.
Blood carries the shen and nourishes the mind; therefore, it is considered primary to mental health treatment.
Calming the Shen
The next two criteria in the mental health strategy require "calming the shen" and "strengthening the spleen," both of which work on the mind. Calming the shen can involve many different methods: clearing heat, stabilizing, nourishing or quieting. It can also involve working with "wind" (the neurological system) through the process of "extinguishing" or "coursing," especially when the liver is involved in the shen disturbance.
Strengthening the Spleen
Strengthening the spleen comes from Confucian thinking about mental health. Shen disturbance, they believe, is rooted in a "weak mind," which must be strengthened via the yi, which is housed in the spleen. This addresses issues such as obsessiveness, compulsion, addictions, eating disorders and confusion that can be associated with shen disturbance. This may also involve transforming or draining dampness and phlegm, which are the results of a weak spleen.
Nourishing the Yin
The final set of criteria for treating the shen involves "nourishing the yin," which may also require the clearing of heat. Yet again, the specific strategy for working with the yin depends on the person. There may be "full heat" that needs to be cleared, "blood heat" that needs to be cooled, or "empty heat."
Nourishing the yin also depends on what level of yin deficiency the patient is experiencing. Is it rooted in the thin (jin) fluids, which are more associated with the lungs and stomach: the endocrine aspect of the body; or related to the thick (ye) fluids more associated with the hormonal endocrine, relating to the kidneys and liver?
The "Gift" of Herbal Medicine & Acupuncture
Throughout Chinese medical history, most clinicians, including the Great Masters like Li Dong Yuan, communicated their ideas through their herbal writings. Acupuncture wasn't discussed as frequently. Therefore, most of the strategies from these great clinicians comes in the form of herbal language and theory we as acupuncturists must understand and translate into acupuncture thinking.
In herbal medicine, there are obviously several herbs to satisfy the strategies for treating mental health. The task (and fun), however, in being an acupuncturist is in applying these strategies to our medicine.
Acupuncture is arguably a very personal modality. We are working with points located on the bodies of our patients; we essentially work with the patient him/herself, without any outside substance. An acupuncture point, in addition to having various physiological functions, is also a portal into a person's consciousness. Therefore, we can get very detailed and personal with our treatments, focusing closely on the individual we are treating.
For example, there are many points that invigorate the blood, clear heat, etc. However, getting to know the patient, creating a deep, therapeutic resonance, allows us to know which specific points would best address their particular experience in life. The names of the points and significance of the channels help us focus closely, allowing us to touch the patient in a deeply personal, even spiritual way.
I recall when I first began receiving acupuncture, it would often feel as if my practitioner would "give me" the points, as if they were a gift during our treatments. She'd "gift me" not only the physiological effect of the point, but also the consciousness of the point, which would have widespread effects in my body, mind and life. It always felt like a sacred experience, and certainly showcased her deep understanding and reverence for the points.
Spiritual Significance of the Therapeutic Strategies
Each therapeutic strategy has a spiritual significance to it. There is a philosophy to "nourishing the yin" for example that goes beyond merely generating body fluids. Philosophically, yin provides a sense of containment, contentment and stability. To use a point like KI 3 (Tai Xi), "The Grand Ravine," to achieve this has a different effect than using KI 6 (Zhao Hai), "The Shining Sea," for example.
KI 3 makes reference to a "ravine," which resonates with the xi cleft idea relating to having the fortitude, faith and resources to weather emergencies in our lives. KI 6 as the "Illuminating Sea," and the starting point of the yin qiao vessel, relates more to the ability to look into ourselves and see worthiness and inner richness. This type of reflective ability can help us to feel the positive qualities of yin. Each point is both a therapeutic cultivation and a spiritual lesson.
A Transformative Process
Confucian philosophy emphasizes the importance of cultivating the virtues. They consider mental illness to be a disorder of the mind, rooted in weakness of the yi (mindfulness capacity). Acupuncture as seen in this way becomes a process by which a person is able to transform their emotions ("the seven injuries") into virtues such as compassion, benevolence and wisdom. The strategies provided by the IMA help guide this process.
Structured water (H3O2) can be considered a fourth state of water between liquid and solid. It has the hexagonal structure of ice; however, missing a critical bond, it behaves more like a gel than a solid, but retains some of its crystalline structure.
In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD. It is not uncommon to encounter patients taking these prescriptions for five-plus years.
Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
