02 August 2009

Mental-Emotional Aspects of Acupuncture

These are raw notes from a lead translator, Dr. Tran. 
He encouraged us to distribute notes and records of his lectures freely. 
These may be of interest to acupuncture students, and demonstrate very different notions from what is commonly taught and understood.
Note that calling the 'psycho-spiritual' or 'mental-emotional' aspects the Essence-Spirit (Jing-Shen) is a big and welcome change. 'Psycho' and 'emotional' have negative connotations in English, unfortunately. 'Spiritual' and 'mental' can be removed from the body and lived experience in our conventions. But if we call these Essence-Spirit, they become deeper, integral and essential. 


Mental Emotional Aspects of Classical Chinese Medicine
by Dr. Tran, Viet Dzung
Lecture at Bastyr University
Seattle WA
March 26, 2004 


“Everything is mental”
Su Wen Chapter 13- ancients were unaffected by passions. Actions were free, unaffected by external actions. By the writing of this text, people were seen as consumed by worry & overwork.
Ch. 14- When jing-shen of organ is affected, it loses its ability to nourish jing-wei.

PHSYSIOLOGY / Ideal
Mental oft called Shen. But ancients always called it Jing-shen.
Shen = mental. Jing = quintessence, the purest energy.

ST fundus/bolus;Sp, grain qi/earthy>Hand Taiyin/LU/heavenly respiratory qi; the mixing of earth & heavenly qi makes Ying/nutritive qi.

Jing circulates in all organs. There is such a thing as Lung Jing. 3 types of Jing: using SP as example:
  1. anatomical [flesh],
  2. sensory lips [taste],
  3. Shen/Jing-shen [Yi/thought].
So the part of the organs which rule these relationships is the Jing.

Rigor in terminology is key. 5 ‘elements’ is incorrect; it is the 5 Movements instead.

Each organ ‘conserves’ a jing-shen or mental activity.

[LR=neuro-muscular, but via its Jing aspect.]
Jing-shen Hun = vegetative soul; creativity; exteriorization.
Shen=mental
Yi=thought
Po=sensitive soul; interiorization 
Zhi=will

These jing shen always are referred to in pairs.
Hun-Po = exteriorization-interiorization.
Yi-Zhi = Acquired-innate.

Acquired= sp/st, like sun.
v. Innate = Kidney; what was there before sun.

2 types of Jing:
Ming men
Tong [Zong] qi= thoracic / ancestral; movement of diaphragm.

‘Think or not, but if you must think, make a decision and take action.’
Think/Yi is a fluid movement that goes all the way thru the Heart to the Kidney. Blockage here is very serious. We no longer live with thought, but preoccupation /obsession.
              Abdominal bloating = sp xu; epidemic.
Earth qi is form, tumor. Hence the epidemic of tumors.

Jing shen when harmonized form consciousness, perception, understanding, differentiation of internal/external & self/non-self. 

PATHOLOGY-
Negative emotions- Ht=anxiety, anguish; unmotivated laughter. Lu = sad, anxiety. Etc.
LingShu- these emotions destabilize activities of organs via these ‘pathways’:
  1. organ- on itself. Ex: LR anger depletes yin, leading to yang exc.
  2. inhibition- 5 movement Ke cycle. Ex: LU disturbance unable to inhibit LR.
  3. son>mother- 5 movt. Reverse Sheng cycle. Ex: fire>wood.

Ex: “Jing-shen Shen”- HT, KI/fear, SP/preoccupation.
When shen is disturbed: self-mastery is lost; fear/panic occurs.
Shen disturbances worse in winter.
HT = sovereign.

TREATMENT
Entry-exit passage points of Shen Qi: Below-
C3 = LU
C4 = PC
C5 = HT
------
C7 = LR
T4 = SP
T7 = KI

Back-shu points helpful b/c work on yang aspect of organs, their functionality, which helps transform ying>jing>shen. UB 44 is concentration of jing-shen shen.
Don’t needle back shu points much! Use heat/moxa on back-shu and entry exit pts.
Think, use head in all treatment actions. Technique depends upon reasoning.

Pts of concentration of Zong/Tong qi, the
Sea of Qi: Upper = RN 17; mid = 12; low = 4; all = 6.
Ex: tx HT w/ RN 17, 6.

[Fear = stress.]             

Sheng cycle = inhibition.

Ex: tx HT-
Reduce anguish using sheng cycle, HT 3.
Help mother-son by limiting earth SP 1.
Limit fear/KI with KI 3.

[LingShu- sp disturbance = thoracic oppression, etc.]

jing shen Yi problems worse in Spring [Sheng cycle].
Zong/Sea pts: mid jiao RN 12, & 6 for overall.
Entry exit below T4 w/ moxa or tonifying needle to increase jing-shen/mental aspect.
Back shu UB 20 moxa to increase jing>ying-wei.
Outer back shu to increase yi.
Preoccupation SP 1; LR 4 for anger, LU 10 limit sadness.
We can’t act on innate pre-natal qi, which gradually diminishes. KI xu always there, never full. We can maintain innate qi only, by increasing acquired qi.
Thought must go towards action or blockage occurs. To move thought, use wind: SP 1.
Indecision tonify GB 40. “I will move your thoughts to help you be decisive. You might make the wrong decisions, but you need to move.”
KI 3 with Ear-Kidney for Zhi. So SP 1, GB 40, KI 3 help sp xu, move thought.
SP/ST is most important. However when treating it, or Damp, the Wei is necessary to address: this is via the LR. Wei is like water, a protective moat. DU-14 is anti microbial, parasitical, inflammatory; also entry/exit of Hun; reunion of all yang mai. Yang channels carry water. LR is last step of Wei formation. Brazilian docs measured lymphocytes.

Moxa- moderation key. Get slight erythema/redness only. Too much will sedate.
12-15 tx., 2-3x/wk, 20 min retention.

The Brain is just a jar, a can to store jing. It is secondary. Jing [anatomic, sensory, etc.] carried via extraordinary channels to brain. Jing created elsewhere.

Treatment 1- Psoriasis.
Extra pt #13 at mastoid tip “caring for vision” –wood, Anmian 2, Ex pt betw DU 15 + GB 20, UB 4>7 [2 Dragons], Ear Shenmen, KI, LU; REN 17, 14 [both angled up], 12, 4, 7, HT 7, PC 6, LU 7 [>LI4], GB 34, ST 36, SP 6, KI 7>8 to bone for yin, UB 62 [below bone], LR 2>3, SP 1.
Dermatology = heat, HT, blood.
Extra points are concentrations of Jing, so good for jing shen.
Ear is concentration of Jing, so good for jing associations [lung with skin, for ex.]
REN 17 regulates fire & water: Fire of PC, water of SJ. Thread 17>22 for best effect on SOB, chest oppression, etc. PC = master of HT; always treat heart with it.

Tx 2- systemic pain. Xu pulse.
Ex #13, GB-20>Ex 13 for sleep, Ear SM, KI, RN 17, 14, 12, 4 directions 45 degrees from Rn 12 very superficial [‘4 Flowers’], RN 4, 6, LU 9, HT 7>6, PC 6, ST 36, SP 6, LR 3, SP 4, 1, UB 62 [below bone].
“Water escaping” =KI unconsolidated= clammy cold hands, feet= ‘de-nutrition’; moxa good.
Extra channels carry jing, a fire  --the yin ones especially. Chong for ex is at surface, linking the deep KI ch pts., which are at the peritoneum.
Phlegm has many types; fire is the worst.
Most all meds = yang.
In extreme deficiency, use 3-4 needles. Moxa in great weakness not good since mingmen blocked: fire signs with insomnia, anxiety present.
To calm mind, tonify KI yin: marrow points UB 7, 23, 52, KI 7>8, RN 4, LI 16, UB 11, GB 39, DU 20 , 15.
Women are more yang due to loss of yin blood from menses, childbirth.

Tx 3- Obsessive-compulsive.
No ST-42 pulse = cold feet. Breathing appears oppressed.
Ex #13, GB 8>SJ 20 to calm, Ear Shenmen, KI, HT; ST 13 angled down, RN 17, 14, 12, 10, 7 [lo jiao/LR/KI], 3 [for UB/water/yin]; HT 7, PC 6, LU 9; GB 34, SP 6, LR 3, SP 1.
Shaoyang is gentle spring rain.
Points to clear yang from thorax: CV 22, KI 27, ST 13—very impt pt where all yang ch except UB enter thorax. Anxiety diminshed when breathing better.
Massage less effective when working at the level of these points. A patient who is really sick will allow any method which might help.
Fractures often lead to onset of mental disturbance from ‘brutal diminuition’ of water leading to excess fire.
The sovereign should never leave the home. Wandering alzheimer’s a disturbance of this.

Channel pathway of Ren, the Sea of Yin. Internal pathways of principal channels are essential to understand symptomatology.
Why Ren 10 above? SP 12>RN 2,3>13, 15>RN 10>ST>SP>HT [connects earth to fire]. ST>SP 16.

Case 4- firefighter. Fatigue after prostate removal. Parkinson’s prior to that. No meds. Shakes in right limbs. All parkinson’s have internal agitation, ready to explode.
Tremulous tongue. Internal Wind comes from intense fire.
Prostate=uterus. Removal of these organs damage yin.
Yesterday’s tx tonified. Unable to tx his parkinson’s until now.
Scalp ac- tremor zone 2 needles towards each other [‘cross needle’]; contralat.
LU 7>LI 4, LI 4, 11, SI 3, SJ 2>3, 3, 5; RN 17, 14; EAR SM, KI, LR, which is on right side only (SP is on right instead); GB 34 to smother but not kill fire using earth, LR 2>3 using earth again, SP 6, KI 7, GB 39 ant of bone, deeply [max of 1 cun needle] [midpt of 2 bones]. 
Differentiates between organic natural fire and perverse. The former is best treated with earth, the latter with water.