Dr. Deborah Genrick. Why Would You Need This? 3/28/2016. Deborah Genrick, DC, LAc, MAc

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1 Deborah Genrick, DC, LAc, MAc Dr. Deborah Genrick Graduate of NWHSU 1997 Owner of multi-disciplinary practice since 2001 Masters in Acupuncture in 2012 from NWHSU Lecturer and Teaching Assistant for Chiropractic Acupuncture seminars since 2009 Liaison Faculty: NWHSU CBI Program (since 2013) Lectures include: Commonly used Points and Functions (8-15 hours), Digestive Complaints (2 hours), Quick Pain Relief with Acupuncture (2 hours), Excess and Deficiency (2 hours) Why Would You Need This? Become more proficient at systemic issues Improve your rapport with you patients Help patients with more than pain Make acupuncture more fun with problem solving Mixing Eastern and Western in some cases for even better results Point selections for the major issues discussed with a Chinese approach. 1

2 Agenda 1. Parts of the Diagnostic Methods 2. Palpation, Pulse and Tongue 3. Traditional Acupuncture History Questions 4. Eastern and Western approaches to Issues Uncovered: Common Issues in the General Public Eastern Diagnostic Methods Inspection. Auscultation and Olfaction Inquiring Palpation Put together a picture! 2

3 Function of Yin Organs 5 Element Theory Basic Eastern Philosophies Yin and Yang Hot or cold Dry or Wet Energy or Substance Excess or Deficiency Pressure Good? 3

4 Inspection Vitality Color Appearance Body Shape: strong, weak, heavy, or skinny Look at Belly button: Pulled tight? Belt channel (TW5, GB41) Observation of the Five Sense Organs Eye, Nose, Ear, Gums, Lips and Mouth, Throat, and Tongue (We will discuss tongue in more detail.) Inspection: Tongue Used to help identify the root cause of the problem Pulse can give false readings Start feeling for excess or deficiency Strong, weak, fast, slow We will look at the tongue findings likely to be present when we look at individual symptoms Tongue Small, thin, narrow Blood and Qi deficiency Swollen, scallops Qi deficiency 4

5 Inspection: Tongue Tongue: Size, Coat, Color Look at the basics, but start looking. Take away the big picture: But LOOK! Spleen Qi Deficiency 5

6 Inspection: Pulse Inspection: Pulse Used to help identify the root cause of the problem Pulse can give false readings Start feeling for excess or deficiency Strong, weak, fast, slow Blood side: Left Qi side: Right 10,000 pulses 6

7 Auscultation and Olfaction Listen to the way people talk and breathe Demanding and short tempered: Need to smooth the liver Breathy and sighing: Qi deficiency and Support the lungs Basics of Smell: Very smelly is heat or toxicity. No smell is deficiency Inquiring (Basic 10) 1. Hot / Cold 2. Sweat 3. Pain 4. Vision / Hearing 5. Sleep 6. Mood / Emotions 7. Stool / Urine 8. Appetite 9. Thirst 10. Women (Period) 7

8 1. Inquiring: Hot or Cold Chills and Fever: External Wind condition LI-11, GB-20, TW-5, Yin tang (sinus involvement), LI-4 Hot Full Body, Hot or Cold: Hands and Feet Move energy through the middle Bagua Pull energy to the hands/feet-baxie/ Bafung Heat the body with moxa 2. Inquiring: Sweat Sweating without moving or exercising. Qi deficiency Sweating only at night? Yin deficiency: K6, LI11, Sweating where? Hands and Feet only? Upper body? Lower body? Move the middle, pull energy to the ends Open up the Belt Channel: TW5, GB41 3. Inquiring: Pain This is what we are really good at! Actually should be broken up in to two areas (upper and lower), but going to leave this together. Type of pain: Burning Stabbing Moving Pain Numbness/ Empty Radiating Pain 8

9 3. Inquiring: Pain Pain in the head or chest Chest: P6, LV14, SP-21 (all over body pain) Head: Front of head: ST44 or 45, LI4, Tai yang Sides of head: GB34, GB44, Tai yang Pain in the back, sides, or limbs Fingers and toes: Baxie or Bafung BL40, BL58, BL62, SI3 Stomach pain: St34 3. Types of Pain Burning Pain Fire, sore, red, swollen, drying of body fluids Stagnation can transform to fire Fever, and can be frenetic movement of blood Can invade from outside or build from within Cold pain External (acute)/ Internal (chronic) Responds poorly to ice Goes against Western philosophy of if in doubt: ice. With Wind and Damp: Causes Bi, musculoskeletal pain 3. Bleeding According to Chinese Acupuncture and Moxibustion (CAM) is an ancient technique Reaves uses this technique: Sterile lancets (three sided) Get 10 drops of blood to drain If having trouble getting blood lower the limb- drop it. Looking for immediate change 9

10 4. Inquiring: Vision or Hearing Flowering vision Dry eyes? Watery eyes? Ringing in the ears? Plugged ears? Blood deficiency Better digestion, Release heat High pitch? Ki Qi deficiency Low pitch (droan)? LV Yang Upraising SI-19: Deep Needling 5. Inquiring: Sleep Vivid dreams? Fall asleep Stay asleep Chest palpitations Never reaching deep sleep because mind continually running HT7, P6, LI11 (if fire) K1 or K2 to ground Yin tang, Amnion, Grounding LI-4, LV3: (4 Gates) P6, Ren17 Grounding KI1, 4-Gates 6. Inquiring: Mood and Emotions Overall Mood? Do emotions go up and down? (May need to ask significant others or family.) Spirit points All emotions start in the heart Stagnation due to the Liver 10

11 6a. Adrenal Fatigue (Western) Waking up in the middle of the night Moods up and down Crave salt or sugar Feels better wearing sunglasses outside Thinker, worrier, planner Pupil check Use your solution to this issue! Biotics ADB5 in my clinic. 6b. Eastern: Ki deficiency Right kidney is the Ming Men Fire Moxa Ki3 Bagua 7. Stool: Very Important!! 11

12 7. Inquiring: Stool Every day? Easy to expell? Loose? Smelly? Size? Consistency? Constipation? Heat? Blood Def? Spleen Qi deficient or dampness: SP6, SP9, St36 Heat-Move and release heat Toxic: LI11, Bleeding, Fire points Small pebbles: Blood deficient Build the Blood: SP6, ST36 Bagua and work on the underlying condition 7. Inquiring: Urination Does input equal output? Burning? Fire in the body? Minimal? Heat signs? Processing issues? Excessive urination? Really looking at whether the digestive system is doing its job to process fluids. Fire descending Remove the heat Yang deficiency, Get heat in the Pot! 8+9. Inquiring: Appetite and Thirst 12

13 8. Inquiring: Appetite Questions: Hunger? Points: Normal and necessary to get hungry Bored with food? Spleen Def: SP6, SP3 Cravings? Discuss Adrenal Fatigue later Excessive hunger Stomach Fire: LI-11, Bleed St-45, St-34 if pain in the stomach as well. 9. Inquiring: Thirst Questions? Not Thirsty? Dampness? Excessive thirst Not Thirsty and very cold Slimy and Thick Tongue Pattern or Points Spleen Qi deficiency: SP9 Fire Yang Deficiency Damp heat or Excess conditions: Candida? Gluten? 10. Inquiring: Menstruation and Leukorrhea Heavy periods extra long periods Heat or Spleen Qi deficiency: LI11, Sp 3 or 6, Moxa LV1 or SP1 Light periods Blood deficiency: St 36 and Sp6: Bagua Delayed onset, Never felt the same after having a baby, Period never the same Leukorrhea: Phlegm or Dampness Blood deficiency or Stagnation Blood deficiency St40, SP9 13

14 Abdomen Palpation See if tender. Which areas? There is actually a whole system in Japanese medicine for Abdominal treatments. Legs Fluid retention or edema Sock lines Dryness, clammy, hot, cold, boggy, tight, hard, soft, ect. Spleen Qi Deficiency Major Patterns Spleen Qi Deficiency with Dampness Candidae Issues Liver Qi Stagnation Liver Qi Stagnation with Fire Liver and Kidney Yin Deficiency Migraines Food Stagnation 14

15 Treatment Strategies Qi stagnation: Move Qi Blood Stasis: Move Blood Burning/ Fire: Cool Dampness: Resolve damp (very difficult) Points: St36, SP3 (or 6), Bl20 Spleen Qi Deficiency With dampness (will discuss later) Dampness Dampness- Caused internally by Spleen Qi deficiency Dull, swollen (distention), heavy pain and discomfort Other symptoms of Spleen Qi deficiency Indigestion Poor appetite Abdominal distention Loose stools or diarrhea Can make muscles weak; declining strength 15

16 SP9 Resolve Dampness Bagua treatments (Moxa) These are more chronic problems and will take longer to resolve than quick treatments. Will see water retention in the lower legs and bloating in the abdomen. Can have loose stool and no appetite. Blood Deficiency St36, Sp6, Bl20 Four Flowers (BL17, Bl19) 4 Gentlemen, Gui pi wan Moxa over above points Blood Deficiency Flowery vision Dry eyes Pale complexion Headache Dizziness Dr 16

17 Main treatment points: Constipation Back shu and front mu of Large Intestine (Bl-25, St-25, TW-6, KI-6) BL-25: used to promote the flow of qi in the large intestines TW-6: Used to promote the flow of qi in the three burners; lifting and thrusting technique KI-6 with TW-6: pair of principle points for constipation (twisting tonification) SP-15 St-44 if increased heat in the system (reduce) Constipation (cont.) Qi and Blood Deficiency (small pebbles, very difficult to expel even with force) BL-20 (Spleen Back shu), BL-21 (Stomach), ST-36 Stagnation Cold: Moxibustion to CV-8 and CV-6 Qi: CV-12 (Front mu of Stomach), LR-3 (Yuan source point of Liver) Heat binding: LI-11 and LI-4 (for any heat in the body) Systemic Yeast Western Treatment/ Damp Heat LV3 LV14 LI-4 Liver Qi Stagnation Free and Easy Wanderer Need to look at why there is stagnation Blood deficiency: Boat on a low river? Food Stagnation? Over whelming Acute Stress Chronic Stress 17

18 KI6 LV3 Liver Kidney Yin Deficiency Remove heat if and issue Pull energy out of the head Headache protocol Rheumania 6 Food Stagnation Move the middle: Bagua, ST36 (always with middle) Release heat: LI11 Counter flow Qi must be sent down: Ren12, 17 Digestive Enzymes: Western approach Release dampness: SP9, Pain in the stomach: ST34 How to Learn Major Patterns Start drawing over and over! 18

19 How to Learn Major Patterns (cell) References Deadman, P. Mazin Al-Khafaji Kevin Baker A Manual of Acupuncture, Journal of Chinese Medicine Publications; 2000 Hecker et al. Color Atlas of Acupuncture, 2 nd Edition, Thieme; 2008 Liu, Wei. Needling Techniques: The Manipulation of Qi with Acupuncture,2002 Nei Jing Reaves, Whitfield. The Acupuncture Handbook of Sports Injuries & Pain. Hidden Needle Press; 2009 Chinese Acupuncture and Moxibustion, Foreign Language Press;2010 Wiseman, Nigel. Practical Dictionary of Chinese Medicine, 2 nd edition, Paradigm Publications;