Traditional Chinese Medicine Theory

Classical Five Element Acupuncture Treatment - Case Study - TCM Theory

Our patient is a 45-year-old woman, "Mary." She has presented because she has heard this type of acupuncture can make her "feel better."

As mentioned earlier an Earth CF carries a deep sense of emptiness. The emotion of Earth is sympathy, which is best explained as understanding. This they either completely take on or reject. They want someone to hear them and what a struggle life is for them. The skill in the diagnosis is in your behavior to present the patient with a little of each of the Five Elements and see which one they most relate to.

I have chosen Mary as my example because most of her signs indicate an Earth type patient. She is a fairly rounded body type. The quality of her flesh is poor. The colour on her face is a gray/yellow. Her voice sings quite profoundly.

She has not worked full time for many years as she feels she has some type of Chronic Fatigue Syndrome, this is not a typical Earth type symptom as it can manifest in any element.

Physical Questioning

She reports fairly regular stomach upsets. What are they like? "When I feel "down" I usually have a sense of nausea." Do you often feel full? "Yes I go through stages of only eating because I have not eaten all day" and "I quite often binge on food, mostly when I am feeling upset." This emotional connection to the stomach can point toward an Earth CF.

The 7am to 9am period was her low point of the day, and she feels best after 11am. She worries constantly. "I even worry when I have nothing to worry about." No real intake of alcohol or recreational drugs. The bowels are OK sometimes veering toward constipation. No real problem with perspiration. Feels cold especially on the extremities. Had one period on anti-depressants about five years ago, for three months.

Emotional Questioning

Mary reported that she often feels quite empty. She has had a lot of trouble with relationships. She continually seems to find men who "use" her. Even thought they treat her badly she would rather stay with them than be by herself. She feels very good that she has not been in an abusive relationship for about 18 months now. Eventually she mentioned that she has a "little problem with promiscuity." She worries about her weight. When she is lonely she will tend to eat; only once has this lead to a period of self induced vomiting, many years ago. Her mother relied on her a lot when she was young. She felt that she was supposed to be her mothers friend and she would often have to listen to her mum complain about her father. Her father was angry but distant. She felt her mother needed her on one hand and was impossible to please on the other. When she was 10 months old her mother had to go to hospital for 6 months and left Mary with a friend to look after.

Rapport

She really felt like she wanted to be heard. Her life had been a struggle and she wanted me to know about it. If I went into the assertion of Wood with a little of shout in my voice she would quieten. She would come up to the laughter of fire for a while but tired of that. Any time I was giving her sympathy or understanding she seemed to be relaxed and present.

First Treatment

  • Aggressive energy drain
    Spleen (SP) & Heart (HT) Entry/Exit Block - Tonify SP 21 and HT 1
  • Tonify Yuan/Source Points for Stomach (ST 42) and Spleen (SP 3)
  • A pushy pair of Earth pulses and a nearly missing Heart/Small Intestine pulse indicated the SP & HT Entry/Exit block. After this was cleared the twelve pulses evened and dropped in volume.
  • The Source points were chosen as a safe way of introducing the CF energy into her system.

Second Treatment

The patient reported that she a lot more relaxed after the treatment, felt better in her self for a day or so, then back to much the same as before. With no real adverse affects from the first treatment I felt I could pick up the energy and add a Conception Vessl (CV) point safely. I chose CV 12 as it has a direct correlation to the stomach and I wanted to start to get some energy into the Middle Jiao, as this is where this feeling of emptiness resides. The SP/HT Entry/Exit block was back. I choose the Junction (Luo) Points on the ST & SP meridians as their spirit is quite filling (ST 40 Abundant Splendor and SP 4 Princess Grandson).

  • Spleen (SP) & Heart (HT) Entry/Exit Block - Tonify SP 21 & HT 1
  • CV 12 5 x Moxa and Tonify
  • Junction (Luo) Points on Stomach and Spleen meridians - ST 40 and SP 4 3 x Moxa and Tonify

Third Treatment

Mary reported a bit of anger coming up during the week. This is to be expected as the patient starts to feel more embodied through the Earth CF treatments. Earth people are often quite ungrounded and can live in their head. Earth has a lot to do with lack of mothering and some patients will start to feel some old repressed anger coming to the surface. The patient needed to be reassured around this, as she was not used to having this feeling so clearly and was "scared of becoming an angry person."

As the main spirit point I used CV 8 Spirit Deficiency. This is a very powerful way of helping the person feel safe and full. It is described as the feeling a baby has when it has a stomach full of mothers' milk - everything is all right. Useful for when a patient has been worn down over a long period of time.

As command points I chose ST 36 (Leg Three Miles) and SP 8 (Earth Motivator) as they both have the spirit of helping the person feel supported in and encouraged to move forward- whether spiritually, physically or mentally.

Fourth Treatment

The patient reported feeling much better. When asked how she said she was not worrying as much and was not feeling as angry with her family members anymore. When asked what other feeling were present she said that she was feeling quite lonely and wondered if that was to do with the treatment. By doing CV 8 for its spirit you sometimes expect a "Law of Cure" result. Some of the old feelings around feeling satisfied will surface and clear.

I chose the Associated Affect Points (Back Shu) on her CF meridians as these points will touch the Body, Mind and Spirit in one point. The Yang quality of these points will usually help the person feel a sense of their own strength. I added GV 12 Body Pillar as the spirit is to strengthen the feel of the backbone and help them feel that they "can stand up for his/her self."

  • Kidney (KD) & Pericardium (PC) Entry/Exit Block - Tonify KD 23 & PC 1
  • Associated Affect Points (back shu) for Stomach (UB 21) and Spleen (UB 20) Moxa x 7 and Tonify
  • GV 12 Moxa x 3 and Tonify
  • Source Points for Stomach and Spleen - ST 41 & SP 3 Moxa x 3 and Tonify

Fifth Treatment

Quite angry again this week, reported that she felt more like her old self and did not want people to treat her the same way anymore. She had always felt it was important to be "nice" and now wanted to be more than this. Earth CF's quite often have issues around boundaries. The infant quite often experiences some type of enmeshing or smothering from the mother. As the patient comes back into health you may hear stories around this issue.

As Spirit Points I chose ST 20 (Receive Fullness) and SP 16 (Abdomen Sorrow). Again concentrating on the Middle Jiao with spirit points and moxa will help her to feel supported and more full or satisfied in herself. ST 20 helps the person feel they can process and receive energy from outside, whether that is love or simply attention. It supports them in braking the cycle of having to give to others constantly - hoping to get. Abdomen Sorrow has the spirit of letting the person get in touch with the sadness around his or her own emptiness. When they have felt that sadness, they then are more able to let it go and move on.

Further Treatments

Mary continued to see me fortnightly for the next few months. Other points such as ST 9 (People Welcome)-(Window), ST 11 (Storehouse), ST 12 (Broken Bowl) were featured. She reported that she continued to feel stronger and less dependant on other things. She was not worrying as much and felt it was probably time to try some part time work again. She continued to go through bouts of loneliness and anger thought she reported that these felt better and thought she was "probably releasing a lot of old stuff that she could never feel before." Eventually Mary went to see a counselor and through our work and other support is now maintaining a relationship.

Sources and More Information

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were used within this section:

  • Focht, Linda: Desert Institute of Healing Arts, Five Element Theory Lecture Notes
  • Glass, Jonathan & Nancy Lipman: New England School of Acupuncture, Five Element Acupuncture Lecture Notes
  • LaBruzzo, Cynthia: New England School of Acupuncture, TCM Theory Lecture Notes

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