Acupuncture & TCM Articles
Neil R. Gumenick is the founder and Director of The Institute of Classical Five-Element Acupuncture. Neil is a Worsley certified advanced teacher of Classical Five-Element Acupuncture and a practitioner with over 27 years of private practice experience. Neil holds three degrees from the College of Traditional Acupuncture (U.K.), and he participated for 10 years in the Master Apprentice Program™, led by Profs. J.R. & J.B. Worsley. Neil has taught at the USC and UCLA Schools of Medicine, the Worsley Institute of Classical Acupuncture, the Traditional Acupuncture Foundation, California Acupuncture College, Santa Barbara College of Oriental Medicine, and Pacific College of Oriental Medicine. He has been a Professor at Emperor's College of Traditional Oriental Medicine and SAMRA University of Oriental Medicine. Neil is co-author of The Art of Practice Management for Acupuncture Health Care Practices
The Spirits of the Points: The Bladder Official Part One
By Neil Gumenick, MAc (UK), LAc, Dipl. Ac
In Classical Five-Element Acupuncture, the Bladder Official is described as "The Official Who Controls the Storage of Water." Our bodies are approximately 60 percent water, with water being the primary component of blood, cells, and the means by which anything can move or flow in the body.
The Bladder is both a reservoir of water and is responsible for discharging the contained waste. Our survival is threatened equally by lack of reserves and overflow. The ancient Chinese taught that we are microcosms, and the recent tsunami tragedy in Indonesia is illustrative of the catastrophic damage that can be caused by excess water, as well as the deadly water pollution following the event.
Within human beings, perhaps more devastating than the physical expressions of imbalance are the mind and spirit when they are deprived, flooded, or polluted by the Water Element in imbalance. Feeling internally empty of reserves, everything seems to be too much to handle, uncertain, and frightening. Like having no money in the bank, we may live in a state of terror of an unknown future, cringing with every ring of the phone or knock at the door. Fear is the emotion associated with the Water Element. Awash in an internal torrent, drowning, out of control - people are similarly driven to desperation. The total denial or lack of fear, simply the flip-side of this emotion, is just as dangerous, blinding us to real threats and preventing us from taking appropriate action.
This article will discuss specific points on the Bladder Meridian and how they are used for their spiritual connotation. I emphasize that there are many causes of fear. The emotion can come from any element, as each contains the emotions of all five. Thus, we cannot conclude that simply because a patient is expressing fear, it necessarily means we would treat the Water Element. Furthermore, an imbalance in any element can and must affect the Water and its associated Officials, the Bladder and Kidney, and can cause them to manifest symptoms on any level.
The Causative Factor
Central to the practice of Classical Five-Element Acupuncture is determining - by odor, color, sound, and emotion - which element is the underlying Causative Factor in a patient. That is the element upon which we focus treatment. Because all elements are related as members of an intimate family, once having balanced and harmonized the Causative Factor, all other Elements and Officials, which had been disturbed as a result, will benefit. Unless the disease has progressed beyond Nature's reach to reverse, all will resolve naturally.
How do we know Water is the Causative Factor? The patient will smell putrid, will show the color blue lateral to the eyes, will speak in a groaning voice, and will repeatedly and inappropriately express the emotion of fear or lack of fear. While it is relatively easy to memorize these associations, developing the sensory skills to truly perceive these diagnostic pillars in real patients takes persistent practice and skilled guidance.
There are as many manifestations of Water in an individual as there are individuals. Thus, there is no such thing as a "Water type." What is Water in nature? Is it a roaring ocean, a peaceful lake, a meandering stream, a thunderous rainstorm, a gentle drizzle, a tidal wave? Are they not all expressions of Water? No two putrid odors are the same, nor are two shades of blue, groaning voices, nor expressions of fear; yet these indicators, unique to each person, will clearly express the underlying cause of disease.
A patient is born with a particular Causative Factor, which does not change to another Element over the course of his/her life. The intensity of the odor, color, sound, and emotion will vary according to the degree and severity of the imbalance, but the underlying cause does not shift among the elements with the passing of time or changing of circumstances. However, having identified it accurately, we have a most powerful means to effect healing of body, mind, and spirit at whatever stage a patient seeks our aid - before symptoms have manifested (as odor, color, sound, and emotion may express long before symptoms materialize), in acute distress, or in chronic debilitation.
The Doors of Perception
In Classical Five-Element Acupuncture, we would only choose from the following points (as well as from many other possible choices) in response to the need of a patient who is primarily imbalanced in the Water Element. We determine the need of the patient by means of rapport, being "at one" with him or her. From a state of oneness, we can perceive the need of the patient. My teacher, Professor J.R. Worsley, taught that there is no such thing as "diagnosing" another person. We can only diagnose ourselves, for we only experience the exterior world and "others" only via our own senses. It is a basic operating principle in our work that perception = projection. Once our doors of perception are open, we can accurately smell, see, hear, and feel. We become conscious of what we feel in the presence of the patient. Thus, we know the cause of the imbalance and, having embodied the spirits of the points, we translate the need into the exact points being called for.
From the above, it should be clear that in this system, we do not arrive at diagnostic conclusions by analysis. In the West, we have been intensely conditioned to rely on the mind. We "think" our way through life and have been rewarded since childhood for so doing. Medicine, too, has increasingly become a matter of analyzing, compartmentalizing, diagnosing and treating labels, rather than unique individuals. Classical Five-Element Acupuncture, on the other hand, draws no conclusions based on any categorization: not body type or shape, facial characteristics, behavior, gestures, spoken words, symptoms, attitudes, nor personal history.
Awakening our senses and achieving a state of "presence," empty of mental chatter (e.g. expectations, associations, desires, and beliefs about the patient or ourselves), is a central focus of Classical Five-Element training and the only way to perceive the whole of a patient - with the whole of us. Professor Worsley taught us, "Practicing this system of medicine from your senses is very easy. Coming from your head, it is impossible."
UB 67: Extremity of Yin
As the Metal point of the meridian, UB 67 is often used as a tonification point. As such, it can be used when the Large Intestine (the "mother" of the Bladder) has a relative excess amount of energy in relation to the Bladder. This is determined by pulse diagnosis and, if found, tonifying UB 67 will move the excess from the "mother" to her hungry "child." This is a simple transfer of energy and one of the most elegant treatments we can administer - connecting a hungry child to the breast if its mother.
Used for its spiritual connotation, Extremity of Yin can be used on Water imbalanced patients who have reached their limit (or extremity) of endurance and are ready to "throw in the towel." They may be exhausted, fearful, anxious, depressed, ready to give up, feeling they have no more to give. This point can re-energize and deeply replenish this Official when the storage tank has nearly run out.
UB 66: Penetrating Valley
As the Water point of the meridian, this point can be used as a horary point between the hours of 3 p.m. and 5 p.m. We use horary points to clear away accumulated debris and obstructions, allowing us to see the true state of an Official. Like a pond covered over with scum and dead leaves, we need to see the state of the water underneath. Is it clear, murky, polluted? We need to know in order to assess how to treat it. This point, used as an horary, provides us with the means to know. It cleans the water, as well as clearing the path for the water to flow freely.
In nature, water traverses all sorts of terrain (hills, mountains, valleys) on its way to the sea. When it flows unobstructed, it finds its way over, under, or around any barrier. In our lives, we too encounter varied terrain and sometimes seemingly insurmountable barriers. Our path may seem blocked. We can get stuck in a valley and perceive no way out. We may become frozen with fear. This point, used for its spiritual connotation (at any time of day), can penetrate into the depths of the valley and clear the way, lifting us beyond the obstacles, liberating us from the fear of an unknown future.
UB 58: Fly and Scatter
As the Junction (Luo Connecting) point of the meridian, UB 58 can be used to create balance and harmony between the two Water Officials if we find, by pulse diagnosis, that the Kidney has a relative excess of energy while the Bladder has a relative deficiency. These Officials must share the available energy equally in order to function optimally. Tonifying UB 58 will draw the excess from Kidney to Bladder, bringing brother and sister Officials together in perfect harmony.
Used for its spiritual connotation, this point brings peace, order, and harmony to scattered components, especially thoughts and feelings. It creates order from chaos. To some Water-imbalanced patients, even a slight disturbance can be perceived as a major catastrophe, viewed far out of proportion. The mind can fly off in a million directions, imagining all sorts of alarming scenarios. In Nature, water effortlessly takes the exact shape of whatever contains it. In a state of balance, the same happens within us. Harmony in the Bladder Official means using only the appropriate amount of reserve for the task at hand - neither over nor underdoing. However, when the water is not contained or without boundaries, it scatters and flows everywhere, randomly and uncontrolled. It is easy to see how the mind can "freak out" and lose its stability and peace. As the natural flow of the mind is disrupted, we may babble uncontrollably or, in the opposite extreme, become frozen and rigid. The spirit will similarly be disturbed as our will and determination diminish with the scattering and depletion of our reserves. This point, used appropriately, can restore the calm and containment vital to our sense of security and instinct of survival.
Bladder Meridian (BL, UB)
The Foot Greater Yang (Tai Yang) of the Bladder 67 points
The urinary bladder channel of the Foot-Taiyang originates from the inner canthus of the eye. Passing through the forehead, it flows up to the vertex. It bifurcates above the posterior hairline into two lines. One line runs from the posterior aspect of the neck downward along the medial border of the scapula (3 cun lateral to the back mid-line). Passing through the gluteal region. Another line runs straight downward (1.5 cun lateral to the mid-line of the back) to the lumbar region. From there it descends along the posterior aspect of the thigh to the popliteal fossa. Descending to the posterior aspect of the gastrocnemius muscle and further to the posterior inferior aspect of the lateral malleolus. Ending at lateral posterior side of the tip of the little toe.
View Bladder Meridian Point Locations.
The Art of Practice Management for Acupuncture Health Care Practices
What you will find in this book is a specific, comprehensive approach that gets to the root cause of success in practice.
This new book presents acupuncture practice as art from the standpoint of centering, qi, and wholeness. It builds on the premise that practices succeed from bridging inner and outer aspects of the self. It is an inquiry into the self and addresses clear understandings and approaches to reputable patient care and practice qi. It brings in the five elements and work with the seasons of practice from training and start-up to growth, stability, expansion and transformation. The authors artfully bridges the essence of both patient and practitioner well-being without excluding the practicalities of financial well-being. This book very specifically and extensively shows how the different parts of practice nourish and feed one another and are interdependent on one another for the qi to flow synchronistically.
It explores the dual nature of procedures that work and those which do not in acupuncture health care practice, returning again and again to the delicate balance of practicality and spirituality.
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