When teaching students I have always had to draw an imagery line between what I have learnt to do in my practice as an experienced five element practitioner and what it is advisable to tell students to do. I am sure that many of my fellow five element acupuncturists have over the years also developed their own approaches to their practice.
I had to consider this when writing my Handbook of Five Element Practice, which is intended for budding five element acupuncturists, and now, in its latest edition, has the addition of a Teach Yourself Manual for all those who are not able to join a college course or train with a five element acupuncturist. In the original edition, published first more than 15 years ago, I rather blindly copied what I had been taught in my original training at JR Worsley’s Leamington College. It was only when my own students started pointing out to me some years later that what I was teaching them in class differed in some respects from what I had written that I realised how far in my own practice I must have adapted what I had been taught without realising it.
This has been brought home to me very strongly recently by questions from practitioners on two different and important aspects of five element practice, both relating to clinical procedures. The first is about the procedure for clearing possession and the second about that for an AE drain. Both questions have made me think carefully about why I have adapted what I was taught in the way I have, and whether it is appropriate to incorporate these changes into any future teaching that I do. Alternatively I ask myself whether there will always be some discrepancy of this kind between what an experienced practitioner does compared with what it is advisable for novice practitioners to do.
First, to the procedure for clearing possession. I have been troubled for some time by the fact that in all the years during which I saw JR Worsley with patients, and he diagnosed many cases of possession, not once did he suggest that we should start treatment with EDs (External Dragons), nor, on the only occasion when he thought IDs (Internal Dragons) had not been successful, did he immediately suggest that I should move on to EDs. And yet in his Points Book not only are the points for EDs listed, but also two sets of points for IDs, making a total of three sets of possible points. This has always puzzled me, but I sadly never took the opportunity of my many hours following JR to ask him when we should be thinking of using EDs, nor how we should choose between the two sets of ID points. We were told to use one set of the ID points listed, those for patients “with depression”. Like so many things I now wish I had asked him, I wasted that opportunity, and will now never know why all three sets of points were listed.
Of course, other practitioners may have had different experiences when consulting JR, but I have had to base my thoughts on what I personally observed. So why did we learn in class that if IDs did not clear possession, we should straightaway move on to EDs, when I never saw this happening in practice?
In fact, what I did learn from treating my patients with IDs diagnosed by JR was how quickly possession cleared with ID treatment. Certainly it never took the 20 minutes’ wait that we had all been told might be necessary, and which I dutifully copied into my Handbook as part of the procedure.
Having over the years therefore observed how quickly possession clears if the needles are inserted correctly, I now tell students to leave them in for a much shorter time, about 5 minutes, if there is no effect, before tonifying the points strongly and removing them. I find the strong tonification usually does the trick which the initial sedation may not have done, and there is rarely need to repeat the procedure. Even if I feel that sedation has cleared the block I still tonify the needles before removing them, as a fall-back procedure just in case possession is still there. Better safe than sorry, I think to myself.
So when a practitioner recently pointed out that what I said about possession treatment in a video lesson I gave was different from what I had written in my Handbook, this gave me pause for thought, and made me realise that since my clinical experience had modified the procedure I had been taught as a student, it was sensible to reflect this change to my thinking in future editions of my Handbook, which I am now doing.
The second example of a change in clinical procedure which has been pointed out to me by a student concerns the procedure for an Aggressive Energy drain, and specifically the order in which the needles are inserted. What I have written in my Handbook is based on what I learnt as a student. We were told not to insert the needles in the AEPs (back shu points) of the Heart unless there is first erythema around the needles of the two points immediately above them, those of the AEPs of the Heart Protector. Like the good student I was, I continued to do this until one day, after I had been in practice for quite a while, I thought I would speed the procedure up a little by inserting all six sets of needles including those in the Heart AEPs, which I did very carefully. Since I noticed no ill-effects from this, I have continued to do this as a matter of course, making sure that I am particularly careful not to insert the needles too deeply into III (Bl) 15.
To my surprise one day I found that erythema appeared around the Heart AEPs in one patient but not around those of the Heart Protector AEPs, something which seemed at odds with what we had been told. This was that Aggressive Energy could only reach the Heart AEPs if it was passed through from the Heart Protector. This made me all the more determined to needle all six sets of points. I also found that it was only after the AE appeared on the Heart AEPs that erythema gradually emerged around the two Heart Protector needles, almost as though I had summoned Aggressive Energy to emerge by stimulating the Heart AEPs.
The discovery of Aggressive Energy on the Heart but not on the Heart Protector still puzzles me, but I have only found this to happen in very few cases in my many years of practice. I therefore assume that these were very rare examples of something slightly inexplicable, or perhaps I did not position the needles correctly on the Heart Protector AEPs, and missed detecting the AE that was there.
I still feel it is a safer procedure to defer putting needles into the Heart AEPs until the Heart Protector is given time to reveal whether it has Aggressive Energy or not. This is particularly the case for novice practitioners whose needling skills may not be sufficiently good to avoid inserting the needles too deeply. After waiting a little while, it would then be perfectly safe to insert needles very shallowly in the Heart AEPs just to make sure you drain any Aggressive Energy which might happen to be there.
All medical traditions change and develop with time, as they benefit from the experiences of all the many practitioners who have passed through over the years and the centuries. This is right and proper, otherwise practices would atrophy. I myself observed the changes JR Worsley made to clinical protocols he developed during my years observing him. It is therefore always good for practitioners to be prepared to incorporate changes in their practice if they wish to learn from those with greater experience. The important thing here is that we should make such changes only if we are sure that any new protocols suggested to us are based on the experiences of those with clear clinical expertise.
I am sure that five element acupuncture will continue to benefit from the adaptations future generations of acupuncturists may feel they should make to today’s practice.
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