Helpful hints for the novice five element acupuncturist: 3 Keep it simple

One of the mantras I can still hear my master JR Worsley telling us was: "Even a little child can understand this", and by "this", he meant the underlying principles of five element acupuncture.  One of my own mantras, following on from this, is:  "Find the element and the element will do the work".  A person's element is the imprint which nature gives each of us as the stamp of our unique individuality. By supporting this element through treatment directed at it we are helping nature do its work, with each treatment strengthening the element and allowing it to return our patients to a state of balance and harmony within themselves.

There is never any need to reach for complex point combinations.  We should rely instead on the simplest treatments, and the least number of them to help the elements.  We should also avoid over-treating our patients.  We should wait until we have proof that the element we have chosen confirms our diagnosis, before gradually spacing treatments out from one to two weeks, then to a month and eventually longer.  

It is good to understand that each time we insert a needle into an acupuncture point this can be seen as an interference with a patient's energy, and to some extent as disempowering the elements.  We should therefore interfere in the most gentle way and as least often as possible to allow the elements to regain the control over patients' energy which nature intends for them.  Unnecessary treatment encourages the elements to continue to hand over control to us rather than empowering them to do their own work.

 

And finally, always remember when in doubt choose a command point.  Unlike other points, you can use and re-use them as often as you like.

73. Continuing teaching during lockdown

Being unable to give any person-to-person seminars during this year of COVID has meant that I have had to come up with other ideas for continuing to help my many hundreds of Chinese five element practitioners and students from a distance.  Like many of us, I have been driven to think of ways of using social media to do this, and it was while watching one of the many online programmes which helped me while away some of the lockdown time that I realised that here was another excellent way of passing on my knowledge.  So for many months now, but only after many hours of tuition from a media-savvy son, I would sit down each day in front of my iPad and record myself for up to 10 minutes talking about whatever five element topic came into my mind as being of interest to my students.  

 

These recordings started off without much of a plan, but I soon realised that they had developed into an excellent accompaniment to my Handbook of Five Element Practice, the text which all Chinese five element students base their studies upon.  I was very pleased to hear recently that over 50,000 copies have been sold worldwide over the past 10 years, making it the most successful book on acupuncture my Chinese publisher has sold.  I thought it that was very likely, therefore, that there would be many aspiring five element practitioners who would welcome the kind of personal teaching my video recordings offer in my absence.  I arranged these video recordings around the different topics covered in the Handbook so that the complete set of more than 30 videos adds something to the text.  I sent each video over to China as I recorded it; they were then edited, Mandarin subtitles added and put online to be downloaded on subscription.  These subscriptions have proved very popular, with more than 1500 people so far enrolled.  And Guy Caplan has now added a further series of videos on ways of helping students with their CSOE (colour, sound, odour and emotion) sensory skills.

 

After completing the Handbook videos, I moved on to recording a more advanced set for practising five element acupuncturists, and followed that with a kind of online autobiography, describing my journey from my first encounter with five element acupuncture as a patient more than 30 years ago to my arrival in China.  Finally I am also now working with Guy Caplan on a series of videos about treating long-term patients, which will list the kinds of treatment we give patients who have been coming to us for many years.  

 

Novice practitioners often find the move from the well-defined early stages of treatment to the more spaced-out treatments at later stages difficult to deal with.  For these long-standing patients there is no longer any need to worry ourselves about finding the right element, since the fact that they are still coming to us after so many years of treatment is proof that they are doing well and just need some top-up treatment.  Practitioners, though, often feel that they have to ring the changes and each time should be searching around for different points to use.  This is not what is needed, and we list for each element the kind of simple treatments we continue to give our long-term patients, showing that, apart from interspersing basic element treatment with the occasional clearing of a block, the points we choose are often much the same year in year out, with the simple aim of reinforcing the patient's element.  

 

In fact, long-term treatment is in a way the easiest treatment of all.  By this time, we know all about our patients' lives, and have developed very easy, warm relationships with them.  Patients' eagerness to continue coming for treatment year after year is satisfying proof of how effective five element treatment can be.  This can provide a welcome relief from the much more complex work involved in attempting to manoeuvre a path through the undergrowth of the different elements until we find our way to the right element at the start of a patient's treatment.  So we have asked long-standing patients of each element if they are happy for us to record them talking about themselves, and tell us how their treatment has helped them in the past and is continuing to help them now.  We also list the one or two years' treatments they have recently received as further encouragement for our fellow practitioners. 

 

 

70. Updating the procedures for clearing Possession and Aggressive Energy

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. 

69. Five element acupuncture treatment of Long Covid symptoms

I am pre-occupied at the moment with thinking of ways in which five element acupuncture can help all those many, many people who have emerged from their bouts of COVID 19 still suffering the side-effects lumped together under the name of Long Covid.  I was prompted to think more about this by an article I have just read in the Guardian newspaper entitled "Don't be fooled.  Covid won't be cured by a wonder drug".  After looking at some traditional herbal remedies, including some from China, it comments very wisely: "It doesn't pay to rule out (remedies) just because there's no clear rationale for how they would do the job."  We could include acupuncture in the list of remedies to be considered when looking at ways of treating Long Covid.  

So how does five element acupuncture approach the treatment of the many Long Covid symptoms?  We know that these range from extreme tiredness, chest pain, heart palpitations to joint pain, nausea and high fever.  One of the things my years as five element acupuncturist has taught me is how effective we can be in treating conditions, such as these, which are described as being non-specific ailments with no obvious aetiology.  In five element terms a variety of symptoms affecting different organs must be caused by some severe attack upon the elements controlling these organs, to the extent that their ability to retain balance has been overwhelmed.  

It is likely that the elements will also have become sufficiently weakened to cause Aggressive Energy to appear, making this obviously the first treatment we should carry out.  We must also consider the possibility of having first to clear IDs, a condition that that might appear when a patient is facing a life-threatening illness.  And then we should look for any of the other major blocks to treatment, such as Husband/Wife, moving on to consider Entry/Exit blocks, starting with the major CV/GV block.  This may occur when severe illness has weakened the elements' connection to their main sources of energy the two great pathways of Conception and Governor Vessels (Ren Mai and Du Mai).  Other Entry/Exit blocks may also need to be cleared, before we move on to treat the patient's element.   I would also always think it advisable to re-check for AE at intervals after this if some of the COVID symptoms persist, because severe illness may have weakened the elements' ability to withstand stress and allow AE to creep in again.

 

I would love us to be able to offer this treatment to as many sufferers of Long Covid as we can, if only the conventional medical world would learn to accept the fundamental validity of what five element acupuncture can do.  But until this happens, all we can do is treat those patients who find their way to us, and hope that these people will spread the word to their fellow sufferers.

  

33. Unravelling the puzzle of point locations a little

For many years I was completely unaware of the fact that different branches of acupuncture used anatomical locations for some of their points which differed from the ones I had been taught.  The first five or more years of my practice were spent in a complete five element bubble, since at that time JR Worsley’s college at Leamington was the largest college, and many of us who trained there were completely unaware of the existence of other schools of acupuncture.  I know I certainly was, until rumours started to spread around the acupuncture community that acupuncturists who had visited China were bringing back with them another form of acupuncture which appeared not so much to complement what we had learned, but to cast doubt in the minds of some five element acupuncturists about the validity of what they were practising.  This was first brought home to me when standing in a lunch queue at an acupuncture event and being told by a fellow acupuncturist, with some disdain in her voice, “JR has a very odd way with moxibustion”, followed by, “You don’t still only do five element acupuncture, do you?”

I always find it interesting when I observe how often people are only too happy to grab hold of anything which might seem to undermine some practice or concept which holds a dominant position, almost as though they cannot wait to mock what before they expressed admiration for, or indeed, as in the case of many five element acupuncturists, actually used for years in their practice.  This happens all too often, particularly where somebody has been pre-eminent in one discipline.  Perhaps it is then only natural that those sheltering in the shadow of such a person may start to feel increasingly disempowered, and look for ways of asserting their own independence of thought.  This happened most famously with Carl Jung’s abandonment of his admiration for his mentor, Sigmund Freud, and the same thing happened in this country when JR Worsley’s legacy to acupuncture started being mocked in the way I encountered.

In a very short space of time this was followed by a growing onslaught by the acupuncture world in general on the right of five element acupuncture to be considered as a stand-alone discipline.  I have written a lot about the difficulties I, as a devoted five element acupuncturist, have encountered in defence of my practice over the years, but in this blog I want to look at how influences from China have apparently changed this country’s approach to the location of certain points, and how far this is still something five element acupuncture needs to take into account.

The subtle undermining of an accepted five element tradition extended also to the area of point location, where people started discussing whether the five element locations used, based on a long-established tradition going back through to JR Worsley’s teachers, Jacques Lavier and We Wei Ping, came up against the locations modern Chinese acupuncture was now deciding for us, and which have come to replace those in many British acupuncture colleges.  I am certain no historian of acupuncture, nor have I, any way of knowing whether the point locations which have gradually superseded some of those used in five element acupuncture have clinical validity or not.  And this is the only factor in the debate about different point locations which I feel needs to be taken into account.  If I needle a point in my well-practised five element location will a point at a slightly different location used in modern Chinese acupuncture, and following hard on its heels, modern British acupuncture, have the same clinical effect?

We sometimes think that acupuncture does not lend itself to “evidence-based research” in quite the same way as scientifically-based therapies, because it does not seem possible in a holistic discipline such as ours, and similarly in any of the different forms of psychotherapy, to obtain sufficient objective evidence of the efficacy of any clinical procedure which cannot be measured by some physical instrument.  But I think my many years of practice have provided me with just as much evidence that the points I use in treatment have actually brought about material changes in my patients, and ones which are perceptible to others, provided that their senses are sufficiently honed to perceive sensory and emotional changes.

When a patient says, as one of my patients did, that “the treatment you gave me a few days ago really made me feel I could face life again,” is that not evidence of the efficacy of the particular treatment, made possible by needling specific acupuncture points?  The problem is that a reader of this blog only has my word for this, and if I were to invite observers into my practice room during the treatment, might the presence of unfamiliar faces affect the patient’s response to the treatment, and perhaps nullify it?  I do, though, have what I like to call one objective proof of the location of one of the disputed locations of an acupuncture point as a result of a moving encounter I had when consulting JR Worsley about one of my patients.

This point is the one on the Kidney meridian which in the five element point numbering is IV (Ki) 7.  As any five element acupuncturist knows, this is one of the first points in the combination of six points, needled bilaterally, used to clear one of the most serious energy blocks recognized in five element acupuncture, that of a Husband/Wife imbalance.  IV 7 is a tonification point, drawing energy from Water’s mother element, Metal, and in the five element location is at 3 ACI (cun) from the prominence of the medial malleolus.  We were taught to needle all six points before taking the pulses to see whether we had cleared the block, in effect checking whether the patient’s Heart energy - (I (Ht)7 is the last point in the procedure - was recovering sufficiently to combat the spiritual despair which is one of the main indicators of this block. 

 had taken a patient to see JR Worsley, and he had diagnosed a H/W block, leaving me to carry out the treatment.  As this was early on in my acupuncture career, it took me some time to mark up the points, particularly those on the Kidney meridian which require much careful measuring of the leg, so when JR returned I had only had time to needle the first two points, III (Bl) 67 and IV (Ki) 7.  Before I had told him that I had not completed the whole procedure, he took the pulses, nodded at me, and said, “That’s cleared.  Good.”  It was then that I realised that the re-establishment of a strong connection between the Metal and Water elements through the tonification points must have been sufficient to clear the block.  From then on I have always checked the pulses at this early stage in the procedure just to see if this often happens, which I find it does.  Each time, though, I go on to carry out the full procedure because I recognize that needling the remaining points strengthens the connection between the elements which a H/W imbalance shows has been weakened.

From this, and from my own experiences, corroborated by my years of clearing many H/W blocks, I know that the tonification point on the Kidney meridian is where we locate it in five element acupuncture, at 3 ACI (cun) from the level of the medial malleolus.  The Kidney source point, IV (Ki) 3, too, which also forms part of the H/W procedure, is at a different location from the more recently accepted location.  I therefore recommend any practitioner trying to clear a H/W block to adopt the five element anatomical location of these two points. I like to think that I am stepping in the footsteps of an acupuncture master in using the points exactly where he told us they were, and feel that something of the energy I felt passing from him through to the patients I brought to him for consultation is transferring itself a little to me as I needle the points where he told us to find them.

 

 

 

5. Two further incidents confirming my belief in the forces we can draw upon in treatment

Both of these two cases concerned two very ill patients of mine, each, because of the severity of their condition, unable to talk easily to me to help me make my initial diagnosis.  The first was a friend’s mother, who was in a very advanced stage of bone cancer, in great pain and with a body with many tumours.  I really didn’t know how I could help her, but was determined to do something.  She was lying in bed, and severe back pain prevented much movement.  This was obviously not the time to carry out even the most cursory diagnosis, and I had prepared myself for this by asking my friend beforehand to describe her mother to me in as much detail as she could.  From this I gained the impression that she might be Earth, something reinforced by the yellow colour I thought I could see on her skin, although I did wonder how far this rather unhealthy yellow was not so much an accurate pointer to Earth but the result of her illness. 

She could hardly move, but her daughter and I managed to prop her up sufficiently for me to put needles in the three upper series of points for the AE drain (Lung, Heart Protector and Heart), where a great deal of Aggressive Energy appeared as angry red circles around all six needles.  I could only hope that there was no further AE on points lower down the back which I could not reach.  As the AE drained, I was amazed to see that the patient’s initially very burnt-looking back caused by so much radiotherapy treatment gradually lots its angry red and returned to a good, clear skin colour.  After this, I cleared a Husband/Wife block, and ended with Earth source points.

When I had finished the treatment, the patient looked much more peaceful and less distressed.  I tucked her up with a kiss, and went downstairs, leaving her daughter to sit with her.  About half-an-hour later, to my surprise, my friend walked into the kitchen where I was sitting with the rest of the family, saying, “Mum is coming downstairs behind me.”  She told me that her mother had not been able to stand on her own for the past few weeks, but now felt strong enough to join us.  My friend said that this was also the first time that she had seen her mother smile for a long time.  And there was her mother slowly walking towards us.

I continued to treat the patient, and from that point onwards until her death six months later her spirit never faltered, even though it was obvious to all that she had not many more months to live.  This was a very moving experience for me, because it showed me so clearly that my acupuncture treatment could help a patient cope so much better even with a life-threatening disease and even in the last few months of life.  

The second instance of what I learnt from treating a very ill patient occurred at much the same time, when I was asked to go to hospital to treat a man who had just suffered a very severe stroke.  Again the patient was too ill to talk, but I did the best I could to make a diagnosis with all my senses on full alert.  He had been propped up in a wheelchair, so I was able to take his pulses, but he could not be moved sufficiently for me to do an AE drain.  Those were the days when the thorough early training I had received had inculcated into me a rigid adherence to taking all the preliminary steps we had to take before the first treatment.  Even in such a serious case, I thought that I should do the Akabane test, particularly as I thought this might show some significant readings because there had been such a severe left-sided stroke.

Carrying out the Akabane test was not easy, although easier on the hands than on the feet which were on the footrest of his wheelchair.  By dint of kneeling on the floor I managed to do the reading on all the meridians, but when correcting the block had to be careful to make sure that the lighted moxa stick did not burn my patient, because he only nodded slightly or blinked an eye to show me when he felt the heat.  To my surprise every single Akabane reading was out, with excess readings all on one side and almost no reaction at all on the other side.  I assumed that this was the effect of the stroke.  So I set about correcting them as best as I could, remembering that we were told that often correcting just one meridian’s imbalance would be likely to correct any others that were out of balance.  And this is what happened.  By this time I  thought that he might well be Metal (from the strong Metal smell and his colour), so decided to correct the Lung and Large Intestine Akabanes first, to offer immediate help to his Metal element in this way.  After having done this, I re-checked the other Akabane readings, and found that they had indeed returned almost to normal, with much less discrepancy between the two sides.  I also corrected a Husband/Wife imbalance I found, something I imagine may often be the result of a severe stroke (the Heart under attack), and I completed the treatment with the Metal source points.  When I had finished I was delighted when my patient suddenly said, “I feel better now”.  When I had first seen him, I had thought he was very close to death.  Now I no longer felt this.

The treatments of these two patients confirmed for me the simplicity of the five element protocols I had been taught.  It was good see how the elements responded so powerfully to the simplest of treatments, and confirmed for me what JR Worsley had often emphasized, that to treat an element it would be enough to needle its source points again and again, and we would achieve the same results “only perhaps it would take just a little longer” than if we moved on to more complex element points.

What I learned from these two treatments also convinced me that the urgency of helping a very sick patient feeds some power with us, which can raise what we do to another level.  I did not think it was a coincidence that I had somehow been led to home in on the right elements and choose the right treatments.  The words, a practitioner’s intention, are bandied about rather too blithely, but I do think that if we are focussing all our attention upon trying to help somebody, our heightened senses may well be guiding us to select the right treatment.  At least this is what I have learned.

This also reminds me of the time when a young practitioner friend of mine told me sadly, “I use the same points as you do, but I don’t seem to get the same results.”  I puzzled about this for a time, but eventually realised that he and I had a very different approach to our practice.  I was totally convinced of the power of what five element acupuncture could achieve.  He doubted it, and eventually moved on to practising another kind of more physically based acupuncture.  His doubts must have conveyed themselves to the treatment he was giving, whereas I came to realise my absolute conviction added power to the treatments I gave.  This was another of those profound lessons my practice taught me which have have stayed with me to support me over the years.