The following is an excerpt from my newly published book: "Meridian Circuit Systems: A Channel Based Approach to Pattern Identification."
A meridian based approach to acupuncture therapy seems like a standard necessity; however, the most common forms of pattern identification are not based on methods that emphasize the associations between the channels. While selecting meridians and points are part of any treatment strategy, emphasis is first placed on syndrome differentiation, and secondly on determining appropriate channels and points. This is a core foundation of Chinese medicine that allows acupuncturists to address root imbalances that underlie symptomatic expressions.
If we examine the most popular methods of syndrome differentiation we will find that they are based on symptoms that are grouped according to exogenous factors, the 5-elements, or the zang-fu organs. Although it is common to identify symptoms along meridians, it is less common to actually base pattern identification on a method that works almost exclusively with the relationships that exist between the channels. For instance, if a patient suffers from a headache in the temples one may conclude that the GB meridian is involved. After this it is common for the clinician to think in terms of zang-fu or 5-element imbalances; the headache may be identified as a liver yang pattern, or an excess of fire or wind, and this depends on what other symptoms are present. It is less common for the clinician to think in terms of the temple headache as being a symptomatic expression in the foot shao yang channel, and then arriving at a treatment strategy that is based on the GB meridians connection to the SJ, LV, and HT channels.
Though a clinician that uses zang-fu or 5-element methods of differentiation may ultimately use some of the same channels, their process of determining these meridians is different than someone that uses a channel based approach to pattern identification. The meridian based approaches that I speak of have been cited by several sources including the Nei Jing, the Shang Han Lun, Dr. Richard Tan, Master Tung, and Dr. Wei-Chei Young.
A channel based approach to acupuncture takes as its starting point the relationships that exist between the meridians according to their classical Chinese names, such as the connection between the hand and foot tai yang channels. Meridian based approaches also utilize the horary cycle, and recognize not only the time designations, but also the way in which qi moves sequentially through the circuit of the twelve regular meridians.
As we progress through the pages of this book we shall learn how a meridian based approach to syndrome differentiation coincides with conventional methods of pattern identification, and is grounded in the same theory that applies to the whole of Chinese medicine. We shall also find in this analysis that meridian systems theory is able to account for many of the enigmas in Chinese medicine, as well as offer solutions to some of the most challenging cases we encounter in clinic.
One such challenge is the frequency of patients with complex patterns. Unraveling the all too common cases that simultaneously have three or more patterns presents the clinician with many technical difficulties; namely, getting the client results before they give up on the treatments. With cases that present with multiple patterns it can be extremely difficult to determine the best course of action to take. Do we treat the root, the branch, or both, and how do we get the patient the quickest and most long lasting results?
After using a meridian based approach to syndrome differentiation and treatment for many years, I have found that this method helps to clearly define the most pertinent patterns of disharmony that are present.
As clinicians our primary responsibility is getting the patient results. As we progress through our diagnostic procedures we should remember that our client did not come in to be treated for liver qi stagnation overacting on the spleen and causing dampness and blood deficiency. They came in to be treated for their condition. Though it is vitally important to do proper pattern identification, the clinician must be careful not to be overly subjective in their analysis and questioning of the patient. For it is all too common for doctors to fall into their own subjective patterns, and arrive at a conclusion of `liver qi stagnation,' without adequately understanding what is really going on.
The clinician's inherent subjectivity often first reveals itself during the intake, and this often occurs by the way in which patients are questioned. As a result the clinician may actually unconsciously end up leading the patient into the doctor's personal favorite box of pattern identification. I don't know how many knees have been identified and treated as a kidney deficiency, yet left the patient still hobbling off with knee pain, but I can assure you this is all too common.
To assist the clinician in overcoming their own subjective tendencies I have found it crucial to ask the patient to prioritize their symptoms. A precise method for this has been developed and elaborated upon in chapter four, and it fits perfectly with the meridian based approach to pattern identification and treatment we will be discussing. When this system is employed it greatly assist in identifying patterns and developing precise treatment strategies.
Lastly, the techniques presented here are easily incorporated into all the common methods of syndrome differentiation that are used throughout the large body of Oriental medicine. Meridian systems theory integrates precisely with zang-fu, 5-elements, 8 principles, and all the other conventional methods of pattern identification. In addition, and more importantly, these methods will help any clinician to achieve greater clinical results and efficiency with fewer needles.
With Healing Qi,
Director, Integrative Healing Society
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