The Art and Practice of Diagnosis in Chinese Medicine: Extract

To celebrate the release of The Art and Practice of Diagnosis in Chinese Medicine by Nigel Ching, we have released an extract from the book.

Click here to read the extract.

This textbook is a complete diagnostic manual for students of Chinese medicine. It covers how to collect and collate the relevant information needed to make a diagnosis and clearly describes the various diagnostic models in Chinese medicine.

Click here to read more about the book or to purchase a copy.

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Other Titles by Nigel Ching

The Fundamentals of Acupuncture 

A fantastically readable guide to Chinese Medicine, this illustrated textbook covers the basic foundations and principles of acupuncture and TCM. Nigel Ching covers everything from the theories of yin and yang to point functions and needling techniques.

Click here to read more about The Fundamentals of Acupuncture.

Clare Stephenson on Eastern and Western Medicine, Acupuncture and Complementary Therapies in Practice

Clare Stephenson, author of The Acupuncturist’s Guide to Conventional Medicine, discusses how knowledge of Eastern medicine can improve conventional medicine practitioners response to patients, if complementary therapies should be incorporated into routine medical practice and her background in Eastern and Western medicine. 

Clare, you trained as a doctor in conventional medicine. What led you to discover Eastern medicine, and Acupuncture in particular?

I initially had close contact with Eastern medicine over 20 years ago through attending an evening class in Tai Chi. Tai Chi is based on Qi Gong, the ancient system of movements for health. Qi Gong is considered one of the five pillars of Chinese medicine – both share the understanding that the physical body is a manifestation of an energetic foundation which can be manipulated by subtle and not-so-subtle means in order to promote health. The exposure to the practice of Tai Chi sparked my interest in learning more about Chinese medicine.

The more I understood about Chinese medical health philosophy and its integrity, the more I wanted to learn. I travelled to China where I saw acupuncture being practised as a front line medical treatment alongside western medicine. This then inspired me to undertake a three year formal training course in the practice of acupuncture at the College of Integrated Chinese Medicine in Reading.  All this was whilst I was also working in UK general practice and public health medicine, so I was continually being challenged to understand how these two approaches to describing health and disease might overlap!

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Behind the Scenes of: ‘The Yellow Monkey Emperor’s Classic of Chinese Medicine’ with Spencer Hill

In this blog post, Spencer Hill recalls the process of drawing the cartoons for The Yellow Monkey Emperor’s Classic of Chinese Medicine and how he met and came to work with Damo Mitchell.

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Gateways to Greater Health

Available 21st November 2015

Available 21st November 2015

In The Way of the Five Elements, John Kirkwood references a category of acupoints known as entry and exit points. Here, he elaborates on these points, the timely use of which can make big differences to treatment outcomes.

Qi flows through the 12 organ meridians in a continuous circuit. It flows out of the exit point of one meridian and into the entry point of the next meridian in the Wei Qi cycle. For most of the meridians the entry point is the first point of the meridian. The exit point is either the last point or one close to the end of the meridian.

 

Entry-Exit Blocks

If work with a client is not holding, there may be a block to treatment and it is worth looking for a possible entry-exit block since these are the most frequently encountered blocks and the most easily treated. Acupressure is well suited to working with these blocks.

An entry-exit block arises when Qi is not flowing freely from one meridian to the next. The blockage of Qi flow between exit and entry point may be partial or complete.

Sometimes a block becomes evident early in treatment, but more commonly, the block occurs during the course of treatment and needs to be addressed in order for the treatment to proceed successfully.

Diagnosing Blocks

The most reliable way to detect blocks is on the pulse where there is a relatively full pulse on one meridian and a relatively deficient pulse on the following meridian. If the pulse is not used, signs and symptoms such as skin eruptions, swelling, pain, constriction, feelings of congestion, fullness or emptiness at the entry-exit points are all suggestive of a block.

In addition, if treatment suddenly becomes less effective or stops working altogether, an entry-exit block may be suspected. An unexpectedly strong reaction during the course of treatment can also indicate a block. This kind of block is caused when an existing block manifests itself as a result of the extra Qi that is made available.

Treating Blocks

When a block is suspected, palpation of the points can confirm the diagnosis. Holding the points, the practitioner may sense a numbness, deadness, emptiness and/or lack of movement either at the entry point, the exit point, or both.

Blocks may be bi-lateral or unilateral. To focus your intention, it is best to work on one side at a time. Begin by holding both the entry and the exit point. Stay with both if both are blocked. If only one is blocked, then hold the one blocked point.

Some points can take a long time to open, and even then reluctantly. When both practitioner and client visualise pulling Qi through, this can aid the process.

More than one treatment may by necessary to resolve a block. Even when the block appears to be resolved, it may reappear later in treatment.

Two Kinds of Blocks

Since there are 12 organ meridians, there are 12 possible blocks. Six of these flow from a meridian into its partner meridian (e.g. Gall Bladder to Liver). The other six flow from a meridian of one Element to a meridian of another Element (e.g. Triple Heater to Gall Bladder).

It is this second kind of block that I want to focus on here since it occurs more frequently, is the greater block to treatment and tends to produce the more serious symptoms.

Large Intestine to Stomach

LI 20 is slightly lateral and superior to the outside base of the nose. Qi flows to ST 1 which lies below the pupil at the orbital ridge. Signs and symptoms can include spots or rashes at LI 20, nasal congestion, sinusitis, difficulty smelling, spots or rashes below the eye, eye spasms, pain or congestion at the eye.

Spleen to Heart

This is one of the more common entry-exit blocks. SP 21 lies on the side of the body, below the armpit in the 7th intercostal space and roughly at the level of the xiphoid process. Qi flows from there to HT 1 which is in the depression at the centre of the armpit. Symptoms can include fullness of the chest, palpitations, pain in the ribcage, depression, fatigue, pain in the armpit, appetite disorders, and spots or rashes at the site of the points.

Small Intestine to Bladder

SI 19 is at the tragus of the ear, in a depression that appears with the mouth open. Qi flows from there to BL 1 which is located at the inner corner of the eye, just above the tear duct. Symptoms can include jaw tension, eye problems, tear duct issues, eye pain and headaches.

Kidney to Heart Protector

K 22 lies in the 5th intercostal space, 2 cun lateral to the midline, flowing to HP 1 which is 1 cun lateral and slightly superior to the nipple in the 4th intercostal space. On women, use HP 2 which is between the heads of the biceps 2 cun below the fold of the armpit. Symptoms can include tension or pain at the side of the sternum or in the breast; rashes, spots or lumps at site of points or in the intervening space; depression, fear and lack of joy for life.

Triple Heater to Gall Bladder

TH 22 is 0.5 cun anterior to the upper border of the root of the ear, on the posterior border of the hairline of the temple, flowing to GB 1 in a depression 0.5 cun lateral to outer canthus of the eye. Symptoms of this block may be frontal and temporal headaches, vision problems, tics and an inability to see the way forward or take action.

Liver to Lung

LV 14 is on the nipple line, in the 6th intercostal space, usually slightly above the level of the xiphoid process. Qi moves from there to LU 1 which is 6 cun lateral to the midline in the 1st intercostal space. Symptoms can be breathing difficulty or constriction, fullness of the ribcage, emotions of grief and anger (often suppressed) and a feeling of being tired and wired.

By becoming aware of the potential for these blocks and clearing them as they arise, practitioners can greatly support their clients’ treatment processes and promote swifter healing.

Learn more about John Kirkwood’s new book The Way of the Five Elements HERE.

Request a copy of the new US Acupuncture & Chinese Medicine Catalog

Our brand new US Acupuncture & Chinese Medicine Catalog is about to mail. If you’d like to receive a free copy, please sign-up for our mailing list and we’ll send a copy ASAP.

Take advantage of this opportunity to see Singing Dragon’s ever expanding list of authoritative books and resources. Acupuncture 2015 catalog 2Guohui Liu, M.Med., L.Ac.’s major new translation of the classic Shang Han Lun, Discussion of Cold Damage (Shang Han Lun): Commentaries and Clinical Applications, makes the foundational text fully accessible to English speaking clinicians for the first time. Rainy Hutchinson, an acupuncturist who runs her own clinic in Sheffield, UK, invites students to color and doodle their way through the sequence of images on each channel in her new book, The Acupuncture Points Functions Colouring Book. Longtime Singing Dragon author, Dr. David Twicken DOM, LAc provides a complete exploration of the theories and clinical applications of the Luo Collaterals, and the Shen and the five Shen in his newest book, The Luo Collaterals: A Handbook for Clinical Practice and Treating Emotions and the Shen and The Six Healing Sounds.

Click this link to sign-up to our mailing list and receive a catalog which features the above books and more.

For more information on Singing Dragon or to see our complete list of books and resources, please visit: www.singingdragon.com.

 

A revolution in understanding pain – interview with the author of ‘Pain is Really Strange’

Haines-PainIsReallyStrange

 

 

 

In this interview Steve Haines, author of Pain is Really Strange, discusses the topic of pain, he explains the reasons behind his choice to write a book about it using the graphic medium and tells us what people can do to manage pain.

Read the edited interview here:

Why do a book on pain?

There’s an awful lot of pain around. There was a huge survey done in Europe: 1 in 5 people experience chronic pain. They have persistent or severe pain for more than six months. For many of them, the median time was a number of years.

People manage large amounts of pain. Pain is a universal human experience; everybody knows what pain is.

The really exciting news is that there is a revolution in how we understand pain. The goal of the book is to try and explain that. How pain works is actually a little bit counterintuitive, a little bit strange. Some of the things that people think cause pain actually turn out to be not quite as central as folklore would have it.

Why do a graphic book on pain?

Education is a central tool in changing pain. The goal of using images it to make it light and really accessible. A good image can communicate an argument and idea very quickly. The book emerged from lots of lectures and talks I’ve given over the years. I have been endlessly trying to find creative ways of explaining how pain works to my clients and students.

I was incredibly lucky to meet Sophie Standing. I have really enjoyed how she’s visualized the work. She surprised me sometimes about how she took an idea that I’d been familiar with for a number of years and just showed it in a very different way.

I think that graphic novels can be very powerful tools. Pain Is Really Strange is short and sweet, 36 pages, but there’s an awful lot of information packed into the book. The images try and really crystallize ideas into something simple.

 Who is the book aimed at?

The book is for everybody. Everybody experiences pain, and I think everybody can learn from the new science. The current research can really help us change our idea and experience of what pain is, even really difficult chronic pain.

I would offer that everybody should be able to stand, walk, sit, and sleep, without issues. You might not be able to run a marathon anymore, and you might not have the best tennis serve that you had when you were in your 20s, but ordinary movements of sitting, standing, walking, lifting your shopping; it’s actually often possible to get people to a place where they can do those everyday functions with ease reasonably quickly. That makes a huge change in happiness and vitality

What is the central message of the book?

There is something that you can do to change your pain experience. There’s always a change in behaviour, a change in how you think, feel, move that can be used to creatively stimulate your brain to do something different.

The really central message is: think of pain as a bad habit or an alarm system that has gone wrong. Short-term it was very useful, but long-term chronic pain serves very little purpose. We can unlearn the pain habit. We can train our nervous system to respond differently to the information that’s coming in.

What is the hardest thing to explain about pain?

By saying: “Pain involves the brain,” people often feel that you’re saying that it’s their fault. That’s really not what I am saying. I like to talk about the mind, the brain, and the body. The mind is our consciousness, our awareness, our sense of self. The brain is in between the mind and the body. Pain is an output from the nervous system, not an input.

The brain can make mistakes. It gets into habits or reflexes. Evolution has taught us to respond to the threat of danger very, very quickly, and sometimes in those quick responses, we go down fixed, hard-wired, old patterns that are hard to break out of. But, and this is the important bit, reflexes and habits are responsive to new learning; we can learn to respond differently.

There’s no one answer to pain. For me that’s very exciting, but it can feel overwhelming and confusing. It implies that creativity, learning to do things differently, is possible. A complex nervous system will benefit from a multitude of responses. Culture, society, family, stress, how we eat, emotion and metabolic activity in our body are all deeply relevant to the pain experience.

What can people do to manage pain?

Mostly, it’s about being creative. Do something different. Whatever you’ve been doing, if you’re still in pain, it’s not working. Try a new approach. We can move differently, understand differently, feel differently, describe ourselves differently. The book explores some simple hints about how we might do those things, but the essence is change and creativity in response to the danger signal, and not going down fixed, hard-wired responses.

Understand that reflexes that were useful when you really needed to protect the tissues as they repaired are no longer useful after the tissues have repaired. Tissue repair takes no more than a few months. In chronic pain the nervous system needs recalibrating.

For me, the book is a very hopeful book; there is something you can do to change your pain experience. Pain isn’t about tissues. It’s about an alarm system in the nervous system that’s exaggerated and is no longer accurate about the state of the tissues.

Steve Haines, June 2015

Or listen to the full interview here. Linda from Singing Dragon asked Steve Haines some questions…

Steve Haines has been working in healthcare for over 25 years and as a bodyworker since 1998. He is the co-author of ‘Cranial Intelligence’ and author of the short graphic books ‘Pain Is Really Strange’ and ‘Trauma Is Really Strange’. Understanding the science of pain and trauma has transformed his approach to healing. He has studied Yoga, Shiatsu, Biodynamic Craniosacral Therapy, and Trauma Releasing Exercises (TRE). He is a UK registered Chiropractor and teaches TRE and Cranial work all over the world. His treatments now use education, embodied awareness and light touch to help people move more freely and be more present. Steve lives and works between London and Geneva. 

Treatments: www.stevehaines.net Teaching TRE: www.trecollege.com Teaching Cranial: www.bodyintelligence.com Graphic Books: www.painisreallystrange.com

 

 

 

Shōnishin – The Art of Japanese Acupuncture Without Needles

What is ShōniOppenheimer-Wer_Shonishin_978-1-84819-160-0_colourjpg-webshin?

Shōnishin (from Japanese shōni = little child, shin = needling) is a non-invasive method of acupuncture which was developed in Japan for pediatric treatment around 100 years ago. Instead of using needles there are different tools and instruments. They are used for rubbing and tapping on certain reflex zones and meridian areas, as well as on acupuncture points for gentle stimulation along the torso and the extremities.

The therapeutic effect of Shōnishin is to regulate and support the specific development of children, especially the central and autonomous nervous systems. Therefore the treatment is very effective, especially for children with different disharmonies or illnesses from birth to school age. As Shōnishin has no side effects and is absolutely painless, this kind of treatment is made-to-measure for the needs, complaints, and illnesses of babies and children.

Other client groups who can benefit from Shōnishin

Shōnishin is being used as an alternative to acupuncture in women’s shelters, mother-child facilities and nurseries. This aids women and children, who are in difficult social or monetary situations, abandoned and without any obvious way out. This includes traumatized women and children (e.g. survivors of rape), who are only able to permit touching via the “interposed” Shōnishin instrument where no skin-to-skin contact happens.

Another field of application for Shōnishin will be in the treatment of older adults. Particular parameters like skin conditions and mental conditions seem to show retrogression into childhood. First experiences with Shōnishin in homes for the aged show promising treatment approaches. Even here it becomes obvious, that treatment with a Shōnishin instrument is advantageous as older adults often suffer from a shortage of caring touch. With Shōnishin the contact doesn’t take place directly, but indirectly with an instrument. Thus, older adults have no fear of contact and are willing to allow the treatment. Yet another advantage of treating elderly people with Shōnishin is that as many of them have to take blood-thinning medicines, with the non-invasive and gentle treatment technique with Shōnishin, there is no contraindication.

Training in Shōnishin

Training in Shōnishin varies a lot in the way it is done outside Japan. In Germany there are trainers who offer one-day courses. This, of course, entails the risk that therapists with minimal training could bring Shōnishin into public disrepute if they treat children outside their own household.

As a member of the Japanese Scientific Association of Acupuncture for Children (Nihon Shōni Hari Gakkai), my main aim in running courses is to set a high quality standard in the interest of both small and older children. My courses are based on current traditional Japanese medicine research and on Western health sciences on the other.

Knowledge on child development from both Western and Eastern points of view are an essential lesson of the course. Shōnishin training is best acquired after a basic training in a meridian therapy (e.g. acupuncture, Tuina or Shiatsu) and a minimum six days course. Since, ultimately, children are going to be treated, the motor and sensory aspects of child development in the first 12 months of life are taught, as is energetic development. The most important thing is to understand how the meridians develop, and their influence on child development and development in later life.

Theoretical Basics of Shōnishin

I have based my training of Shonishin upon my nearly 30 years’ experience of working with children. My wife, Karin, initially trained as a physiotherapist and and went on to study shiatsu in Japan. In 1985, she and I founded an institute for Complementary and Alternative Medicine just outside Frankfurt, Germany. Karin teaches baby and child shiatsu internationally and is a Founder of the German Shiatsu Society. She has written a number of books on the subject, including Children at Their Best and Baby Shiatsu.

Together, we have developed a modShonishin2el of energetic development that can serve as the theoretical foundation for Shōnishin. It is the basis for understanding child development in its energetic aspect, and ultimately for diagnostic and therapeutic processes that depends on the stages of development.

The model of energetic development is an attempt to bring the knowledge of modern neuroscience, developmental psychology and developmental physiology into harmony with the knowledge and experience of oriental medicine.

The model states that each energetic stage of motor and sensory development builds on the previous developmental stage. The meridians play a primary role in this and represent a communications network connecting the child with her external world. They are then also responsible for the child’s development of posture, movement, patterns of behavior and personality.

Knowing about the ways motor, sensory and energetic functioning are interwoven, opens up new perspectives on child development, resulting in specific treatment approaches. Ultimately, it is the knowledge of meridians in developmental stages forms the foundation for treatment of children of all ages with Shōnishin.

 

Shonishin Training with Thomas Wernicke in the UK:
3 day course as part of the 6 day Shonishin Training with Thomas Wernicke:
When: Saturday 30th May to Monday 1st June 2015
Where: Edinburgh
Cost: Early Bird booking by 31st March 2015 £235, full cost thereafter £260
For more information and to book your place (places limited to 12 people) contact:
Svenja Schaper, Shiatsu Practitioner, Dip. BSS, MRSS, PGCE
svenjashiatsu@movingtouch.co.uk mobile: 07842 563 298

~~~

Thomas Wernicke is a licensed General Practitioner with qualifications in complementary medicine, Chinese and Japanese acupuncture, as well as manual therapies including craniosacral therapy and osteopathy for adults, children and babies, psychosomatic therapy and homeopathy. He is a member of the Japanese Scientific Society for Shonishin, and since 2004, he has been the Training Manager for Daishi Hari Shonishin in Europe. Thomas is also Founding Member and President of the International Society for Traditional Japanese Medicine. He lives in Hochheim, Germany. He has written Shonishin: The Art of Non-Invasive Paediatric Acupuncture publishing by Singing Dragon.

 

Developing internal energy for enhancing your healing practice

Solos_Developing-Inte_978-1-84819-183-9_colourjpg-webIt is a common theory in all the Chinese internal styles that the qi of the dantian must reach the tips of the fingers, although, how this is accomplished may differ majorly among different arts. The purpose is to make the strikes felt deep within the opponent’s body without damaging your hands. The training of such a skill, besides the internal cultivation practices, usually involves some form of punching or hitting to strengthen the ligaments of the hands, and also to make the hits (and touch) soft, powerful and precise, able to reach deep inside.

Crossing over to healing, such a skill is also very important, because in your tuina you need to protect the health of your hands from harm, and in acupuncture also ensure that you have the correct kind of energy that reaches deep inside the patient’s body to activate the points and channels.

The best tuina manuals usually offer some Neigong exercises designed to cultivate the right skill. Most of them include rigorous meditation while the hands work on a sand bag or a variety of other equipment. However, even such important skills become quite rare these days, because it may take some time to acquire them.

 

But let’s see some old exercises:

Exercise example 1: A traditional old Beijing Tuina method for teaching the hand method for the character for grasping (拿) was as follows:

“A small bucket of water was immersed inside a bigger bucket of water. The handle of the smaller bucket was attached through a leather cord to the outstretched hand of the practitioner, palm facing down. During this exercise the student had to sink the Qi to the Dantian, and then by using the round force (浑圆劲) of the whole body pull the bucket out of the water and then insert it back into the bigger bucket, without any spillage. After achieving the comfort force and the ability to assume a balanced and energy conserving posture, they would have to start meditating upon the character for grasping (拿) for the hands and rise and sink (沉-浮) for the body. Most of this exercise is happening first mentally and then physically. Movement should be soft and focused.”

Exercise example 2: This is an exercise used for the method of hitting (打) the back of the patient by using a split bamboo stick. For this skill, if the amount and type of force is not correct, it can result to damaging the muscles, skin and ligaments of the patient. An old Beijing exercise for this was as follows:

“The doctor assumes the Hun Yuan position, holding a split bamboo stick, or a Taiji long ruler, or just merely visualizing holding one. The Qi sinks to the Dan Tian, and the doctor relaxes every part of his body, until achieving a feeling of being suspended up from strings attached to the body, much like a puppet. The doctor should visualize being inside a Great Balloon that has its center in the Dantian. The outer walls of this “Great Balloon” have many hooks and barbed wire, which prevents it from moving towards any direction. The doctor however, should try to mentally move it by using his intention (意) but not any physical force, while working out all the related energetic contradictory forces (矛盾力) within his body frame. While moving the sphere with the power of the Dantian, the stick always follows the movement of the whole body, but never leads or dictates the direction. At the point (点) where the movement of the whole body stops and changes direction, the doctor should be meditating on developing the correct snapping force that is needed in hitting the back of the patient with the split bamboo stick. Most of this exercise is happening mentally, rather than physically. Movement should be soft and slight.”

 

In a similar way, internal cultivation for acupuncture needling should have a specific healing purpose, direct effect and an exact training methodology, based on appropriate understanding and application of Chinese energetic theories and correct body mechanics. This training should be primarily and directly applied towards treatment, exclusively in the clinic, as an unambiguous and solid therapeutic skill, where rational theory can be coupled with reasonable and consistent benefits, for both the healer and the patient.

In my latest book, Developing Internal Energy for Effective Acupuncture Practice I have included a complete training regime for assisting the energy aware practitioners to enhance their needling skills and transform their medicine into an extraordinary experience. With time and effort, perhaps one can discover the fine subtleties of the system at the energetic level.

Disclaimer: This article provides only simplified instruction for the above exercises, and purely for the sake of theoretical discussion. You should not attempt any of these without professional guidance from a certified teacher. The author of this article and the owner of this blog are not responsible for any harm that may be inflicted through the erroneous application of the information provided in this article.

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Ioannis Solos studied Traditional Chinese Medicine at Middlesex University and the Beijing University of Chinese Medicine. He enjoys researching, teaching, practicing and critically interpreting the ancient philosophy and culture of China, internal martial arts, health preservation practices, classic medical texts and lesser-known Chinese esoteric traditions.