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DR. STEMMLER’S MONTHLY TEACHING ROUNDS

NOVEMBER, 1998

As the Emperor Said

(Copyright Stemmler, 1999)

Huang Di ( the legendary emperor known as the Yellow Emperor, who is said to have reigned from 2696 to 2598 BC) said to Qi Bo (one of his closest advisors), "I, the emperor of the people, receive revenues of rents and taxes to nourish the Hundred Families, but I am grieved by not being able to provide for those afflicted with disease. I wish they did not have to endure the poison of medicines and the use of stone probes. I prefer to use those fine needles which penetrate the channels, harmonize the blood and qi energy, manage the current and countercurrents, and assemble the exits and entrances. Please unravel this for future generations and enlighten them in the proper methods so this therapy will not be destroyed or severed for aeons. See that it is easy to use, difficult to forget, a classical record. Delineate the process, clarify the extrinsic and the intrinsic, define an end and a beginning. Please formalize the reality of each item. Begin with the fundamentals of classical acupuncture. I wish to hear of these essentials."

Qi Bo answered saying, "In accordance with your imperial request, I relate the following: You wish to have the principles and records. To begin with the first, there a total of nine needles and the principles of their way. The principle of using these fine needles are easy to say but difficult to master."

…"Ordinary skills of acupuncture maintain the physical body; high skills maintain the spirit…"

…"Without careful observation of the disease, how can there be an understanding of its origin…?"

…"Ordinary doctors are in the dark; wondrous are the few who possess the unique skills…"

…"When inserting the needle, it is necessary to harmonize the yang and control the yin and the yang…"

…"Qi is located in the channels…" and "…In acupuncture, when the qi is reached, do not ask the measure, but needle until the qi is reached…" and "…Only when the qi is reached, will acupuncture be effective…"

…"Look at the patient’s color. Observe the eyes. Know how the qi disperses and returns. Each has its own form. Listen to the patient’s movement or stillness. Know his balance. The right hand is used to hold and push the needle while the left hand assists and controls. When the qi is reached, then withdraw…" and "…All can be governed or controlled by acupuncture…"

…"When man’s five viscera are diseased, they might be compared to conditions of thorns, stains, knots, or obstructions. Thorns, although embebbed for a long time, still can be pulled out. Stains, although filthy for a long time, still can be washed away. Knots, although tied for a long time, still can be untied. Obstructions, although blocked for a long time, still can be opened up. Some people say chronic disease cannot be cured. This is speaking incorrectly. The skillful acupuncturist can take hold of the disease in the same way he pulls out thorns, washes out stains, unties knots, or breaches obstructions. Disease, although chronic, still can be ended. Those who say diseases are incurable have not mastered the technique of acupuncture…"

(Excerpt from the Ling Shu or the Canon of Acupuncture, which is the second part of the Huang Di Nei Jing, The Yellow Emperor’s Classic of Internal Medicine, compiled around 220 BC)

COMMENTS:

It is interesting to read about the worries of the emperor several thousand years ago, and realize that these same concerns continue to worry many of us today. The kind of health care we provide and receive, to what extent we will tolerate suffering and unpleasant side effects, and the search for a kinder, safer and more effective form of medicine. Back then, the emperor was not happy with subjecting his people to "the poison of medicines and the use of probe stones". Now, a growing number of physicians are reevaluating the cost/benefit ratio of the drugs dispensed and the procedures patients routinely undergo. Is this drug really safe and effective for the condition diagnosed? Is the diagnosis absolutely correct or just presumptive? Will the patient benefit from it so greatly that he or she should be advised to take the risk of potential serious side effects? Is this x-ray, that lab test or that MRI going to change the course of action? Or is there a simpler, less invasive way to confirm one’s clinical diagnosis?

"The principle of using these fine needles are easy to say but difficult to master", announced Qi Bo then, still an appropriate answer to today’s often-asked question: "Dr, why don’t more doctors practice Chinese medicine?" Acupuncture, which is just one aspect of Chinese medicine, appears to be just a simple needle-sticking method not worth studying or, perhaps, easy to learn if one decided to do so. Far from true, many doctors quickly become confused with the theoretical complexity, frustrated with poor results, and ready to return to the more familiar and safer haven of Western medicine. That may explain why only a few study it, and even fewer practice it. So "they stay in the dark". Yet, if they persevered and became really dedicated, "they would become wondrous"…

"Needle until the qi is reached…only when the qi is reached will acupuncture be effective", is an important concept in clinical acupuncture. Some acupuncturists advertise "painless acupuncture", which sounds attractive but may be no more than an enticement to attract scared American patients. There is no such thing as "not feeling the needles" when acupuncture is practiced seriously. The arrival of qi is usually felt by both the patient and the practitioner. And it is not a distressing pain either; just a momentary sensation of fullness, electricity, burning or minor ache, that quickly dissipates. None of the needles should hurt once they are all in place. If any of them do, they need to be slightly moved, so that the acupuncture session can proceed in the most relaxed manner.

And finally, a comment about what the Chinese call "knotty diseases". Qi Bo talked about "thorns, stains, knots, or obstructions". These terms apply to difficult to treat chronic diseases, which are usually treated ineffectively with Western methods. Symptoms may be temporarily controlled, but the diseases prevail and progress over time. Such conditions include lupus, cirrhosis of the liver, migraine headaches, kidney stones, strokes and paralysis, enlarged or inflammed prostates, and uterine fibroids, among others. With proper knowledge of Chinese medicine, many of these diseases can be effectively treated with acupuncture and herbs, a topic I will discuss in greater detail in one of my forthcoming books: The Prognosis has Changed.

Christina Stemmler, MD


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