The Power of Innate Acupuncture Point Selection
By John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)In the early days of my career, I treated a young lady who had suffered extensive neurologic injuries to her face after slipping while cleaning the side of the bathtub. She'd experienced agonizing nose and facial pain, 24 hours a day, seven days a week, for over four years. She complained of multiple paraesthesias, and that her teeth felt like "mush" against her tongue. Virtually every medical doctor in every specialty she consulted ultimately suggested psychiatric care, simply out of total frustration in their failure to eliminate (or even reduce) her horrific pain.
The DCs my patient saw were some of the best, including technique experts in cerebral manipulation; endonasal technique; kinesiology; and various adjustive procedures from the atlas to the coccyx. She consulted me for the possibility of acupuncture, even though it was quite new in the U.S. in 1973. In those early days of acupuncture, only the most desperate patients sought it.
Although I was young in my practice, I possessed incredible confidence, albeit backed by minimal clinical experience. After numerous acupuncture treatments; chiropractic adjustments to the spine; manipulation of the hard and soft palates; and "pulling" her uvula, I came to the hard realization that I, too, had failed her. I suggested she see a psychiatrist. Why, when a patient fails to respond, are we so eager to put the blame on the patient's mentality?
One evening, I felt a sudden urge to find a newspaper article I had saved in a large box in the back of my closet. After dragging out the box and extracting papers, photos, etc., I found a small steno notebook. I threw it over my shoulder to join the rest of the heap, but instead, it struck me right between the eyes, scratching my forehead with the sharp edge of the projecting spiral binding.
The notebook landed in my lap, with a page staring up at me that said, "For nasal pain - point #17." There was also a small, barely legible sketch I had drawn of a hand with the acupoint illustrated. This was the notebook I used on my first visit to China in 1973, when I visited the Tai Chung Medical School in Taipei. It was at the school that I was first presented with the concept of Chinese hand acupuncture.
Talk about something hitting you right between the eyes! I immediately thought of my patient, and wondered if this point could do something for her. Up to that point, I had used every method I knew, and had accepted that I was going to have to relieve her from care.
On her next visit, I stimulated the point I had discovered, quite by accident, the night before. She was irritated with me, because the only procedure I performed during that visit was to tap with a noninvasive needle (teishein) on a point on her wrist. She felt the simplicity of this treatment was inadequate to help her raging pain, and wanted me to do more. Frankly, at that point, there was nothing else I knew to do.
As she walked through the reception room on her way to the door following her treatment, the patient slumped into a dead faint in the middle of the floor. Upon reviving, she explained that she had been overwhelmed because, as she moved across the room, her pain and paraesthesia, which had been of the highest magnitude, were suddenly and instantly relieved.
I can't explain it, and it makes no sense to my physiologic (or just plain logical) mind, but it happened. I shall never forget that acupuncture point, located two fingerbreadths distal to the dorsal wrist crease, in line with an imaginary line drawn down the middle of the index finger.
The patient was released from over four years of devastating, unexplained pain and paraesthesia in a matter of seconds - an incredible testimony to acupuncture. However, it is imperative to understand the whole message, not just the specific point used. The real message is to always act upon those glimmers of innate intuitive insight, and to truly listen to that small voice whispering in your ear throughout the day. Anyone who has been in the health care field long enough to be called a "veteran" knows exactly what I am talking about. Sometimes, the answer to a troubling case may come to you in the most unusual way. Always be receptive to innate, intuitive thoughts regarding patient care.
Years ago, I attended what may have been one of the first graduate school programs in acupuncture in the United States. The principle speaker, from Kowloon, China, stated, "When you don't know what to do any more with a patient, or didn't know what to do in the first place - always consider tsing (jing-well) points, because they're magic. "My initial thought was that this was an extremely exaggerated, simplistic statement, barely worthy of note. However, I scribbled the thought down, which as we know, unfortunately often ends up buried in a myriad of words and paper, never to be seen again.
Months passed, and my practice became increasingly filled with fewer and fewer open appointments. Acupuncture was at a fever pitch, as the general public was inundated with positive reports of its effectiveness from the media.
As I was closing the office one evening in late spring, the front door opened. Standing before me were a mother and father carrying their daughter, who was in obvious severe neurologic insult. Gazing upon this twisted child, I wondered how, because of her advanced condition, the parents could care for her. I then noticed the hospital band on her wrist. The parents explained to me that they were in the process of returning the child to ChildrenÕs Mercy Hospital, as they had been out on a rare day pass. Apparently, it was the child's seventh birthday, and she had been taken home to celebrate with friends and family. This was to be her last birthday. The prognosis was grave.
The diagnosis from the Mayo Clinic was Òidiopathic neurogenic syndrome. Since she suffered from an unusual, unexplained neurologic condition, there was treatment to save her life, only to prolong it Ð and that was failing. She presented rigid neurologic opisthotonis; death imminent.
On the way back to the hospital following the party, which was literally a living funeral, family and friends gathered to be with the child one last time. The child's parents passed my office and decided to stop. Having heard of the benefits of acupuncture, they wondered if perhaps it could help.
As the parents explained the gravity of the situation, including the diagnosis and prognosis, I was frankly overwhelmed. With tears streaming down their faces, they asked if I could treat their baby. Looking at this pitifully rigid child and the parents, I reluctantly told them, "I'm sorry, this is really out of my league, I wouldn't even know where to begin." When they asked if I would just try, as they had literally nowhere else to go, or even if I would work on her as a research project, I again responded with apologies and sorrow that I wouldn't even know where to begin.
At that point, it became as if someone was sitting on my shoulder, whispering, "When you don't know what to do anymore, or didn't know what to do in the first place, always use the tsing points, because they're magic." Was it a thought in my head, or were these words being whispered to me? In any event, the feeling was too strong to ignore. I took a nonpenetrating teishein (one of the original nine acupuncture needles first described) and stimulated each and every one of the 12 meridian tsing points next to the nail bed, for approximately 15 to 20 strokes apiece. I then took a green marking pen and marked each point I had just stimulated, instructing the parents to repeat this procedure every day in the morning and evening, using a ballpoint pen.
Even though they realized they were now on the way back to the hospital to watch their daughter's eventual demise, the parents left the office with a glimmer of hope and the words of a master. (I am embarrassed to say I never even got his name.)
That event happened on a spring evening. One morning that fall, this child began school with her regular class. I only officially saw her once; however, the parents stimulated the tsing points of that child with love, compassion and expectation twice a day. I was invited to her eighth birthday party! To this day, I still use a green felt-tip pen to mark points for follow-up stimulation.
From where did this point selection arise? It had absolutely nothing to do with my academic excellence or highly evolved intellect; it came directly from innate intuition, and listening to what was being said. How many times do we hear, but not listen? Sometimes, we are afraid to act, because the thought may be contrary to what we felt was proper academia. Be alert and aware of the many clues and fleeting thoughts received throughout the day. Acting on some of these innate intuitions can be extremely rewarding.
My last celebrated case of innate intuition bordered on the eerie. I recently saw a middle-aged woman complaining of multiple visceral symptomatologies. It appeared as though every system of her body was pathologically involved, from respiration to the cardiovascular, digestion, musculoskeletal, lymphatic and endocrine systems. She had seen a variety of specialists and was taking 14 different medications. She presented an extremely complicated case history that, when the primary doctors she was seeing came in, needed to be filed in two folders because of the sheer mass of the paperwork.
I began treatment on her using the "electro-meridian imaging" (EMI) method of diagnosis; it showed extreme involvement of 10 of her 12 meridians. She had been to a TCM practitioner I know has a stellar reputation, but even with his years of practice, he could not commit to a TCM diagnosis. To say this was a complicated case would be an understatement.
One afternoon, while driving my car, I was stopped in traffic and found myself wandering mentally. I thought of this patient, what her underlying problem might be, and what I could do for her. As I sat gazing out the passenger window, another vehicle pulled up beside me and rolled just past my window as its rear bumper came into my direct view. I couldn't help but notice its license number: LU6-TW4.
I tried my best to talk myself out of using these two acupuncture points on this patient; however, having been in similar situations before, I had no choice. Following the first treatment, the patient's condition worsened, which I did not think was possible. However, by the next morning, she reported feeling considerably improved. I treated her two times a week for four weeks, at which time she stated she felt like an entirely new person. I also balanced her meridians using EMI.
A recent examination by her primary medical physician revealed major improvements in her blood chemistry. Her symptoms are a fraction of what she previously experienced. Her EMI exam is close to being balanced. She is energetic, sleeps all night and has regained her appetite. She came into the office recently stating she had just signed up for a yoga class. She is excited about the future, as her extreme depression is now just a memory. She has received a total of 12 treatments.
LU6 is the hsi point and TW4 is the yuan point. They have to have a rational explanation. However, how they worked together in this case is a mystery to me. I guess the biggest mystery is, whose car was that?
Of course, this is just a freaky coincidence... or a script from a "Twilight Zone" episode... or a total fabrication - a dream after too many Shitake mushrooms. Our rational mind will not allow for any other explanation. However, these events are around us daily. Take advantage of them.
We are often presented with the answer to our patients' problems (or our own) in unusual ways. We may see a sentence in a book or a billboard that triggers a thought, hear a statement on TV. Act upon it. Don't be afraid to let intuition enter your thoughts. These thoughts, coupled with sound academic principles, are extremely powerful. Keep yourself mentally attuned by constant reading and study, but also allow the sixth sense to become a part of your being.
One of the most significant masters I have had the good fortune to study with said it best: "When the student is ready, the teacher shall appear."
Best wishes for a healthy, happy, productive 2003.
John Amaro, DC, FIAMA, Dipl. Ac, LAc
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