Chinese Medicine notes 04-05

From DmesWiki

TCM04-05 Oct 8, 2005

General treatment protocol on ourselves.

Palpation Hara palpation (the whole abdomen, not just the hara, (which is technically the moving chi between the kidneys). The abdomen reflects the balance of the chi in the body. Last week we were just holding the areas of the different elements and noticing the temperature differences, but now there are ten things that we are thinking of when we palpate the hara.

• 1. Temperature--checking for temp. difference between areas. When you're palpating the lines, you are still feeling for a temperature difference, in the sense of comparing the different areas. At this point we're just noticing it.
• 2. Tension--tight vs. loose, like a guitar string, or no tension at all. You get a sense of how the tension should be when you palpate different abdomens.
• 3. Pressure pain--primarily what we're looking for – the point where they say ouch. Sharp pain with pressure is different from a pain that feels better with pressure. You'll be able to tell if it's a pain that's excessive.
• 4. Fluid sounds--as you poke, are you eliciting a gurgling sound. If it's constant or accompanying breath.
• 5. Travelling sensation--when you press the abdomen on one spot do you get a feeling in another distant spot. This could be significant, esp. if it connects to the area of complaint. Three levels: reactivity under fingers only, reactivity somewhere else in the body, reactivity in the area of complaint. You should mark that one so you can work on that area first. If you fix that part of the belly first, it will address the area of complaint. The other area that you work on next is the reactivity that was not in the area of complaint. This is still more significant than just having reactivity at the point where you are pushing.
• 6. Strength/weakness—a sense of the firmness of the tissue, feels like strength of a muscle, but felt in any tissue. Nice healthy quality, not too hard or too flaccid. Normal strength is a nice resilient feeling that doesn't push back – not like weight lifters. If your hand sinks into the abdomen, it's deficient chi – no tension.
• 7. Tight, hard, loose, soft, lump:

tight=tension, like a too-tight guitar string. Ropey, like a pregnant belly. hard=no resiliency at all, no spring. Usually indicates an excess, maybe a relative excess. (normal=comfortable resiliency). soft=hand goes in more easily than you would expect. loose=even more so--sink hole in the tissue. Mark that.

If you find a sink hole, mark it. You're likely to find a hard spot somewhere else, like a dam somewhere holding the chi. When you find a belly with sink hole and hardness, treat the hardness first (excess). Usually it will go away by itself, but if not, treat the deficiency next. Keep comparing symmetrically – if the hardness or softness is on one side only, it's more significant.

lumps--guidelines: the less well-defined, stationary, and hard the lump is, the easier it will be to disperse. A lump is stuck energy – the longer it stays, it becomes stuck tissue and then a tumor. If you find a change in sensation that feels like a lump, don't push directly on it, but feel around it. if you can get your fingers around the edge of it and can't wiggle it, it's something that's been around for a while and more than you can deal with. If you can't find the edges of it and it feels soft, you can probably easily disperse it. If it's discrete and feels hard, let them know about it and send them to their doctor.

• 8. Pulsations--like the heartbeat on a pulse point; you should only feel it on the sides of the navel and just below, if you palpate deeply (moving chi between the kidneys=aorta in western system). If it's a thin person, you're likely to feel the pulsation. TCM says it's a sign of an imbalanced chi. If it's strong, send them for help. Don't push on it on CV and K lines, and don't push hard on it. If you feel a pulse anywhere else, it's a chi energy pulsation and we want to address that.
• 9. Skin quality/texture--skin itself is too loose or too tight. Too loose is if you pinch it, it stays tented. That signifies dehydration or lack of chi. If you can't even pinch the skin, it's too tight, a sign of too-tight chi, which is excess, or tension. Also check for dry/moist.
• 10. Swelling, indentation--visual and also tactile; hand will go in deeper in one place and not in another.

Five depths of Hara Palpation Assessment--first hold element areas, and then CV line, then pressing with curved fingers, light (skin), deeper (muscle), deeper (organ).

• 1. Touch skin
• 2. Press into muscle
• 3. Press to just touch organ and watch to see if it hurts.
• 4. Press into organ--don't go to this level.
• 5. Press as if into spine--this shouldn't hurt with a normal hara, but we don't go to that level.

(we use only levels 1-3). So it's different levels at different parts of the abdomen.

When you have a hara with a tense quality, you won't be able to get to the third level. This indicates excessive--check if it's one area or the entire abdomen. Likely it's one or more areas but not the whole abdomen.

A fat person could also be very deficient, and a person with strong abs could be excessive. You could be palpating that and find a sink hole, depending on if they're sick or healthy. The abdomen reflects the balance of the chi.

Places that warrent special attention – if you find reactivity here, it's telling something specific that you should treat whenever you find it:

• tenderness or reactivity at K16 (at belly button) or S25 or S14 (also at bb). The actual hara is right around the belly button so these are important points. They reflect past trauma, adrenal problems, a deep underlying impact on flow of chi, probably from a long time ago. It's so deep that if it isn't loosened, no other treatment will hold. For adrenal and trauma, you can use K6 and K27 to release.

• S25--particularly on the left, is related to stagnation. Use Left Li4, Lu5, & immune point combination to release stagnation.
• CV12 (betw. navel and xyphoid) and CV6 (1 cun below navel, which is CV8) . Release with K3 first.
• Tension under ribcage, if you can't get your fingers under the ribcage or if it's flaccid and your fingers go all the way up. There are no specific points for this so you have to treat the rest of the abdomen first according to what you find, and then go back to make sure it's released.
• Iliac crest (when you do the assessment step #10), start in front of the anterior superior iliac spine (in front of the hip bone), go along the hip bones, across the top of the pubic bone and across the other side. Then step #11 and 12, from the top of the hip bone push in and down into the muscle and the insertion of the muscle into the bone, comparing tenderness from left to right. Then palpate the mu points with all the same information in mind, and marking where you find reactivity.)

Write down the points, first on their belly and then on the picture, so you can remember for next time.

Take a history of your partner. Look at their tongue, palpate their abdomen and share it with them.