Class Notes 5

POINT COMBINATIONS CLASS

CLASS NOTES 5

FIVE ELEMENTS TREATMENT

Five elements is a theoretical model, and not a completely consistent treatment strategy. There are many times when Five Elements treatments might look good in theory, but in actual execution (when taking other factors into consideration) doesn’t really make sense.

For example, the FOUR NEEDLE TECHNIQUE that is taught as the basic Five-Element-for-Dummies model can be useful sometimes, but not always.

FOUR NEEDLE TECHNIQUE is based on a simple strategy. First, determine if the problem is PRIMARILY one of EXCESS or DEFICIENCY (this can be difficult if you have a mix of excess and deficiency). If EXCESS:

SEDATE SON on the affected channel. So, for Liver Excess, sedate the son (or Fire), i.e. Liver 2.
SEDATE SON on HORARY channel. Son element is Fire, so sedate horary point: Heart 8.
TONIFY GRANDMOTHER (controlling element) on affected channel. So, for Liver Excess, tonify metal (i.e. Liver 4).
TONIFY GRANDMOTHER (controlling element) on HORARY channel. Metal. So, Lung 8.

For DEFICIENCY:

TONIFY MOTHER on affected channel. So, for Spleen Deficiency, tonify Spleen 2 (mother of earth is fire).
TONIFY MOTHER on HORARY channel. Heart 8.
SEDATE GRANDMOTHER (controlling element) on affected channel. Metal. So Spleen 5.
SEDATE GRANDMOTHER (controlling element) on HORARY channel. So Lung 8.

Notice a contradiction? A common pattern is Liver Excess with Spleen Deficiency. And yet, in both of these prescriptions, we are needling Heart 8 and Lung 8, BUT WITH OPPOSITE techniques. Problematic.

Remember that much of Five Element “style” acupuncture is determined not only be the manner of point selection, but also on how a diagnosis is reached. Some styles of Five Element acupuncture, for example, are more psycho-spiritual in nature, and rely upon a CSOE (Color-Sound-Odor-Emotion) that only arises during a relatively freeform (i.e. psychoanalytical) interview. Other styles rely upon pulse to determine the most deficient channel.

WHEN WOULD WE CONSIDER FIVE ELEMENTS?

We could consider Five Elements if we determine an imbalance occupies or influences channels that are not otherwise related. For example, the Lung and Kidneys do not have any other relationship with each other (channel-speaking) other than through their Five Element connections. If there is a problem involving both of these channels, then it is probably worth your while to consider using a Five-Element style treatment.

METAL - WATER PAIRINGS

Think of METAL-WATER pairings when there is a problem of a lack of WATER (Yin) nourishing the tissues of the Lungs (especially the throat).

Lung 7 - Kidney 6: extraordinary vessel pairing: often used clinically for problems affecting the throat (sore throat) because both Ren mai and Yinqiao mai go to the throat. This pair is also effective for problems with urination, and some types of lung-kidney type edema.

Lung 5 (water on metal) - Kidney 7 (metal on water): This pair is used to foster yin and regulate the lung. Used for chronic issues due to lung dysfunction with associated lack of kidney nourishment. For patients with chronic allergies and asthma. Effective for treating seasonal allergies.

Lung 5 (water on metal) - Kidney 6: used for acute conditions where lung is not receiving enough fluids, often due to accumulation of heat. Examples: loss of voice following external wind-heat, wind-dry, or fatigue.

WATER - WOOD PAIRINGS

Think of WATER - WOOD pairings when a lack of WATER (Kidney Yin) leads to “dry flammable WOOD” (i.e. variations of Liver Excess and Liver Fire).

Kidney 7 (metal on water) - Liver 2 (fire on wood): For Kidney Yin Deficiency with concurrent Liver Yang Rising leading to symptoms such as dizziness, tinnitus, red face, dry mouth, and red tongue.

Kidney 3 (earth on water) - Liver 3 (earth on wood): Similar to above, but tends to be used when symptom pattern is more of Kidney Deficiency than Liver Excess (Kidney Deficiency is PRIMARY). Used to “secure the source”, calm the Liver, extinguish wind. Symptoms: high blood pressure, dizziness, insomnia, tinnitus, seminal emission, vomiting, and other excess above deficiency below symptoms.

FIRE - EARTH PAIRINGS

Think of FIRE - EARTH pairings when there is a failure of nourishment and circulation of BLOOD leading to insomnia, low energy, shen disturbances, etc.

Heart 7 (earth on fire) - Spleen 6 (3 leg yin meeting): These two points have a beneficial effect on production and movement of blood. Used to tonify heart and spleen, foster blood, and calm spirit. Dual deficiency of heart and spleen leading to lack of blood nourishment to heart. Symptoms: palpitations caused by emotional stress, insomnia... GUI PI TANG, anyone?

WOOD - EARTH PAIRINGS

We of course think of WOOD - EARTH when there is an excess-deficiency problem centered on the digestive system; i.e. STRESS (Liver) related to digestive issues like IBS, diarrhea, nausea (Spleen).

Liver 2 (fire on wood) - Spleen 2 (fire on earth)

Liver 3 (earth on wood) - Spleen 3 (earth on earth)

EARTH - METAL PAIRINGS

(this happens to coincide with TAIYIN pairings, so will not be discussed separately)

WOOD - METAL

We think of WOOD - METAL whenever there is an insult along the controlling relationship, that is the Wood is rebelling against its overcontrolling grandmother Metal.  Think of Lung symptoms tied to stress.

Liver 4 - Lung 5 - This is a combination from Kiiko Matsumoto style, which may best be understood through Five Elements.  Liver 4 is metal on wood (controlling element).  Lung 5 is water on metal (this is a mother-son relationship).  The combination is used for (o)ketsu, or Blood Stagnation, and may best be understood as a form of Liver Qi and Blood Stagnation.  By needling Liver 4, we are controlling wood.  By needling Lung 5, we are draining metal and indirectly nourishing wood (through water).  This seems paradoxical, but it can be seen as a way to "flush out" the liver.

Aside from the Kiiko Matsumoto understanding, we might use this pairing to treat coughing due to Liver insulting Metal (stress-related coughing).

Liver 4 - Lung 9 - This combo can be used when there is Liver Qi stagnation combined with Lung Qi deficiency (phlegm cough, low energy, etc.).

WOOD - FIRE

WOOD and FIRE are mother and son.  Think of pathologies caused by Liver Qi stagnation/heat transferring over to the Heart.  NOTE: You can address several of these issues via Liver - Pericardium (i.e. JUEYIN pairings) outlined in last class.

Liver 2 - Heart 8 - Liver Fire (due to Yin Deficiency) causing or related to associated Heart Fire (due to Yin Deficiency) symptoms: insomnia, palpitations, anxiety.

METAL - FIRE

METAL and FIRE share a controlling relationship.  We rarely see this played out in practice, however.  Points on Lung and Heart may be used together when there is a general Upper Jiao issue (i.e. simultaneous Lung and Heart heat/fire, or simultaneous Lung and Heart Qi Deficiency).

FIRE - WATER (This is identical to Shaoyin).