Professional Documents
Culture Documents
Instructor: Kazuto Miyawaki Lic.Ac. (Japan) T. Koei Kuwahara Lic.Ac Ehrland Truitt DOM.
Subject of study Contents of Lecture Hari Practice # of Handouts, Fundamentals, Keyword and Resources
Miyawaki Kazuto, Lic.Ac. Japan T. Koei Kuwahara, Lic.Ac. Japan President of the Hari Society (617) 926-6986(w): E-mail: takamaharanayasa@gmail.com www.culia.net Organizer/ Instructor: Ehrland Truitt DOM. (505) 820-8786 President of the High Desert Hari Society Translation: Stephen Brown Lic. Ac. Location: Santa Fe Womans club, 1616 Pecos, NM
9:15 am 10:35 pm
HARI PROGRAM (1)
10:40 am 12:00 pm
* Pulse diagnosis Pulse quality and Six comparative DX,. Finding the middle/stomach Ki pulse and determining yin/yang pulses. * Hara DX. Posture for Pulse and Hara Dx: Lunch Break *SHO/Pattern and Sho determination *Point selection (Nanjing Ch. 69,68) and Location Supplementation and Draining of the points Significance of points which are "presently alive"
Tea Break and Breathing EX.
0:10 * How do you start 1.Pulse & Hara Dx. 2.Basic needling:
Lecture Practice
***Hari Demonstration 1. Pulse Dx. and Hara Dx. 2. Basic Hari style needle tech.: Tonification
(H8)(H9)
Practice :
(H4) (H9)
Lecture : Miyawaki
0:10
2:45 pm 5:15 pm
Tea Break 0:10
Practice :
Hari Tx. Demonstration (M. therapy and EV. Treatment) How to Hara EV-Dx. EV Sho determination and Treatment Q&A
Essences of Acupuncture
5:15 pm 5:30 pm
Ki breathing
11:00 am 12:00 pm
3:45 pm 5:00 pm
Practice :
Advanced Whole Tx. practice: EV and M. Therapy (Root and Local treatments.) and Tx. that move the blood. Q&A
Essences of Acupuncture
5:00 pm 5:30 pm
Assignments
Read TJA: Fundamentals Review your notebook and handouts. Read Assignment was indicated in next month schedule.
Practice: Hara and pulse reading, basic technique on your body or friends and floating apple, Live point location
Step3 TonifyDefi.Luoor SourcePt.ofYang meridian. Samesideofbody aspulse. Ifallyangare Deficient. Toni.ST36or TW4bilaterally FindDeficientPt
LU9+SP3
LR3
SP3+PC7
KD3orLR3
#ofOkyu
KD7 + LU8orLU5
SP3
Pxw/softand silky(smooth)skin Pxw/verysensitive toheat Pxw/averageskin Deficient, sticky, and/or flaccid Pt Rough, tight and deficient (corn caved) with indurations Pt
x3
x5
x7
LR8+KD10
SP3orLU9
Acupuncture is an art whose goal is to heal diseases by moving and balancing Ki through the use of needles. In order to reach that goal, one needs various types of practice and training. When it comes to the needling, the first step is perhaps learning a correct posture. The needling stance can be discussed from two dimensions. First, you might consider needling posture in the physical sense, such as stance, breathing technique, and the position of the center of gravity. Second, there is a certain frame of mind or consciousness the practitioner should have when needling. For instance, the practitioner's consciousness must be clearly different when applying tonification and dispersion techniques. To move, Ki, the practitioner's frame of mind and physical posture are very important. Though mind and body cannot be separated, in this article, let us begin by discussing physical posture first. If acupuncture works only because of the stimulation generated by the penetration of the patient's skin by the metallic needle, there should be no need for the discussion of the proper needling posture. Yet, based on the collective experimentations by the Hari Association using the Ki feedback methods by pulse, the inner workings of acupuncture is not so simple. We have discovered that at the moment the practitioner changes his/her posture, even though the practitioner is only placing his/her Oshide/Protecting hand on the patient's acupuncture point without needle, the patient's pulse, skin condition, and breathing change without fail. Sometimes, the observer can detect those changes even if the practitioner's hand is out of contact with the patient. This phenomenon suggests that there is something already at work even before the needle, as the primary acupuncture instrument, contacts a point and Ki starts moving. Why does this occur, and what is at work? With our commonsense, we can easily understand that there are postures that would lead the acupuncturist to health and there are also postures that would make him/her unhealthy. For instance, if you are in the habit of working in a slouching posture or always working at the desk in a stooped over position, it will oppress your internal organs over a long period of time. Moreover, It can be easily understood that this kind of habitual bad posture will eventually result in disorders either in the form of pain, or abnormal curvature of the spine. The relationship between posture and health has been studied since ancient times, and we have no trouble finding various ways to study it. For example, you can take courses on Ki Ko exercise, Aikido, Yoga, Tai Chi Chuan, Alexander Therapy, etc. These specific examples are the ones that I, myself, have studied, and there are many more. However, the point is that in both Asian and European traditions, there are many disciplines whose teachings are designed to benefit health and longevity, and essentially their teachings have to do with learning the correct posture for each stance or technique. To put it differently, by changing posture, the acupuncturist's Ki can change to the type of Ki that can heal or the Ki that causes illness, and this change will be directly transmitted to the patient. I don't meant to rub it in, but I'd like to stress that this change in Ki occurs within the acupuncturist. The acupuncturist's hand may or may not be in contact with the patient's body, so we have to assume that it
is the Ki that's being emitted by the acupuncturist that influences the success or failure of the patient's healing process. It is easy to understand the reason why the good needling posture is important, and it is also easy to understand how to make a good posture in-concept. However, to actually master the proper needling posture and incorporate it in your everyday practice can often take a long time. In order to address this problem, we use the Ki feedback methods by pulse, which makes it possible to learn the correct "Ki-generating needling stance" in a very short time. We have developed our training method for mastering the correct needling posture from our experiences as Hari instructors. So, in the following section, let us review each step and the criteria involved. For actual practice of the needling stance, you should check your performance of each step by using Ki feedback methods by pulse.
slightly upward, so that your Dan Den is pointing at the ground at about 20 degrees, so that you can naturally withhold Ki energy (as if you are pumping air into a balloon situated in Dan Den) not from muscular strength, but from the natural consequence of your posture itself. Memorize this position. Your abdomen must not be tense. It should be relaxed and supple. Place your finger on CV-4 and confirm the concentration of the energy. *Make an energetic triangle with your UNA and Dan Den in the lower half of your body *For your upper body, at first correct your stoop, then your mouth should be closed, and be conscious of GV-20. Connect the healing universal Ki (healing type of Tian Qi) to your GV-20 as if you are connecting a rope brought down from heaven to your GV-20. As the rope is connected to GV-20, then pull the rope up. Then, lower your upper body that's now suspended by the rope from heaven on to your lower body, which is forming a triangle with your Dan Den and UNA s. *At this point, this posture should feel quite natural and comfortable to you. *Check to confirm if you are relaxed. Relax your face. Your eyebrows should be relaxed and loose, and the outer corners of your eyes should be slightly pointing downward, and the corners of your mouth curled a little upward with I (sounds I; e as in easy, the teeth remain closed they are always made by biting the teeth very lightly.). Smile as if you are Buddha. The shape of your lips is such that if you exaggerate it more, you'll almost start drooling. *Let's try and practice sitting, standing, and walking with this posture.
stronger, or if you are nervous and tense, your breathing is being stopped and withheld within your chest, and so on--these are a few examples of the mind/breathing interaction. First, you need to realize the nature of the relationship between the mind and the breathing, and correct your mind, or if you notice the unnatural or undesirable frame of mind within you, by breathing in the manner that is the opposite state of mind, try to control your emotions and desires. Of course it is easier said than done. If you overanalyze the relation between the breathing and the mind, before you are able to control it, you might get suffocated. To prevent that, the easiest way to control your emotion through breathing is if you realize that you are being emotional, first of all start breathings slowly and deeply with nothing else in mind. Compared to just waiting for your mind to calm down without doing anything, with this method, your mind will be regulated and regain calmness much faster, along with a good posture. In my clinic, usually I am not much concerned about the breathing, but concentrate more on the state of the consciousness as I treat my patients. However, I practice the following method of building a good hara (abdomen) regularly everyday. First, inhale deeply through my nose as I inflate my lower abdomen. As I finish inhaling, inject the breath with an imaginary pump into the Dan Den. It spread in every direction to the front, back, and sides as if I were pumping air into a soccer ball situated in the area around CV-4. As I feel that I have pumped enough air into the Dan Den, hold it there for a long time as you can with relaxed body and Buddha smile. Then, after a while, exhale slowly through my mouth. While I am exhaling, if I am aware that I have some Jaki (evil Ki) in my mind, put them together and exhale them strongly with my breath. As a result of your everyday training, if you reach the point in which you feel the existence of the soccer ball in your lower abdomen without conscious effort to breathe, that means you have become an expert oriental medical physician. Most likely, your mind is clear too, and you must be in the good posture all the time, and you are able to make good judgment in any situation. At this time, you will begin using a needle, You will start needling from the posture I finished describing above. Hold the needle at the tip of the round ring you have formed with your arms, and bring down the needle naturally and softly to the acupuncture point of the patient as if you are lending your whole arms gently to the patient. Please experiment with this technique and fine-tune it in your own way.
Prognosis
Looking
Touching DX
Root Treatment
Local Treatment
Selection of point
Checking pulse & evaluation of treatment The Hari Society 06/01/03 Finish Treatment
Step 0 [A] Thoracoabdominal Region and Supplementary points [B] Affected Area [C] Harmony points Step 1 Root Treatment Primary pattern Step 2 Root Treatment Secondary Pattern Step 3 Root Treatment Yang Meridian Step 4 [A] Back and Supplementary points [B] Affected Area [C] Harmony points Step 5 [A] Finish needling [B] Moxibustion [C] Home treatment
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Step 0
[A] 1.
Treating the Thoracoabdominal Region and Supplementary (Alarm) points Sometimes a light sanshin or scatter needling technique is used on the abdomen at towards the
beginning of the examination. This is done when the pulse is difficult to read, and is more a part of the examination than the treatment. 2. 3. Use a tonifying scatter needling technique on the thoracoabdominal region when there is an If the circulation of ki and blood is judged to be poor due to water stagnation or blood stasis in insufficiency of yang ki the thoracoabdominal region, retained needles or a single needle technique can be used, aiming at indurations and areas of resistance or pain on pressure. The standard length of time to retain these needles is 15 to 30 minutes. [B] Treating the Affected Area Treatment given on the affected area is performed while the patient is in a relaxed position. Retained needles are often used, but a single needle technique can be used afterward. When using retained needles on an affected area on the anterior aspect of the body, they are often inserted at the same time that the abdomen is being treated while the patient is in a supine position. In the case of severe symptoms, treatment can begin with the affected area in order to ease the patient's condition as soon as possible. [C] Harmony points: See the handout of the Harmony points
Step 1
Treatment should begin with the root treatment on the yin channels. Tonification should be used on the meridians to which essential ki is deficient. The order to follow is given below. A. Start by tonifying Essential Ki Deficiency that is the primary pattern of imbalance and the
underlying cause of the illness. If both deficiency and excess are involved, start by tonifying the
deficiency and then disperse the excess at the step 2. Sometimes tonification will be sufficient and it will not be necessary to use dispersion. B. then tonifying the "Mother" Meridian and Point
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"The mother" refers to the generating cycle of the five phases and the relationship between each pair of phases. Next, within each meridian there are points that are divided according to the five phases.
Step 2
Treatment for Effects on the yin meridians from Essential Ki deficient it is showing as heat and cold. Tonification and/or dispersion should be used on the meridians to which cold and heat are spreading.
Step 3
Tonification and/or dispersion should be used for effects on the yang meridians to which cold and heat are spreading.
Step 4
[A]
Areas of the back transport points reflect deficiency or excess according to the cold and heat symptomology of each pattern of imbalance. After verifying the deficiency and excess of the meridians and acupuncture points on the back, use retained needles or a single needle technique from the upper to the lower back. However, depending on the pattern of imbalance, there are times when only a single needle technique is used, just as with the thoracoabdominal region. The standard length of time to retain these needles is 15 to 30 minutes. [B] Treating the Affected Area Treatment given on the affected area is performed while the patient is in a relaxed position. Retained needles are often used, but a single needle technique can be used afterward. When using retained needles on an affected area. If they are being used on the posterior aspect of the body, they are often inserted at the same time that the back is being treated while the patient is in a prone position. [C] Harmony points: See the handout of the Harmony points Sanshin, Moxibustion and other
Step 5
[A] 1.
Finish Needling A Sanshin, tonifying or dispersing scatter needling technique can be used over the whole back
and dorsolateral of the lower limb after the retained needles have been removed. The purpose of this
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is to tonify or disperse the external yang ki that flows through the greater yang channel. This will mend any mistakes that were made during the treatment. [B] 1. 2. Moxibustion Direct moxibustion and cone moxibustion can be applied at the same time as the abdomen or Some acupuncture points will develop depressions or indurations due to a deficiency of
back is being treated or after. nutritive ki (blood) and fixed pressure pain from blood stasis. Acute disorders that are accompanied by heat and that suppurate are also caused by nutritive ki (blood) deficiency. Moxibustion is appropriate in any of these cases to deliver result. [C] Other Intradermal needle, Press tug, Press boll Give them homework and suggestions for improvement of living
General Rules for Treatment 1. As a general rule, the above-mentioned treatments begin and focus with the root treatment that is a treatment of the greatest importance, but that is not a rigid rule. The necessary steps must be taken according to the situation. That is, all parts and kinds of treatment have equal value. Moreover, while there is in actuality a temporal sequence to treatment, to the practitioner it feels as if everything is being done at the same time. That is why it is said that the root and local treatments are two faces of the same coin, a harmonious whole. 2. The order of local treatment is given while thinking about yin and yang. For instance, treatment starts on the lower limbs if the affected area is in the upper body, and begins in the upper body is the affected area is in the lower limbs. Treatment begins on the back if the affected area is in the abdomen and beings on the abdomen if the affected area is in the back.
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The determination of a Sho Examination determines the Sho in Meridian Therapy. To decide which Sho is present, consider pathogenesis, symptomology, and the four examinations (Looking, Listening, Asking, and Touching). In this way, by finding the principal Sho, you can start treatment immediately. This form of examination and treatment is called Zui-Sho therapy, and it is the hallmark of Japanese medicine. (Diagnosis followed by treatment) A Sho is not a name attached to neither a specific syndrome nor the enumeration of mere symptoms. Based on meridian theory, we can analyze the condition of a patient with a variety of diseases. The Sho allows us to simplify myriad symptoms into four principal patterns of disharmony. In this way, the principal Sho determined at the end is denoted by the form of a LR Deficiency Sho, a LU Deficiency Yang Excess Sho or a SP Deficiency LR Excess Sho, etc. With a LR deficiency Sho, one can tonify a Liver meridian immediately -- etc. --the Sho encompasses the treatment principle. Furthermore, it determines what kind of treatment you perform, what point of which channel should be used, and needling technique. However, clinically, it is important to determine prognosis initially before beginning treatment. In the case of symptoms which indicate an incurable illness or a condition which is beyond your ability, it is important to warn the patient before starting a treatment. Then, you can proceed with examination and Diagnosis.
JAS: Advanced Treatment Strategies: Meridian Therapy with Cold and Heat
Constitutional Factors
Essential ki deficiency of the five zang organs Zang-Fu Basic Patterns LR Deficiency SP Deficiency LU Deficiency KD Deficiency
Pathological deficiency
Deficiency, Excess, Cold, Meridian Generation of Cold and Heat LR, GB HT, SI PC, TW SP, ST LU, LI KD, BL Chief Complaints Deficiency or Excess of Ki,
cold or heat symptomology due to deficiency or excess of yin or yang
Heat
Occurrence of
Blood Fluid
[1] The Difference in the Generation Mechanism of Cold and Heat Liver Deficiency Heat Pattern, Spleen Deficiency Heat Pattern, and Kidney Deficiency Heat Pattern
Liver Deficiency Heat Pattern Spleen Deficiency Heat Pattern Kidney Deficiency Heat Pattern
The condition becomes chronic the heat will go down, making it mistakable with a cold pattern.
Cold
Heat
The differentiation of cold patterns and heat patterns is not all that difficult if you conduct the questioning examination of the disease process and symptomology by following the pathology, and tie this in with the diagnosis based on the pulse picture and abdominal pattern.
Japanese Meridian Therapy Spleen Deficiency Heat Pattern and Lung Deficiency Heat Pattern
Lung Deficiency Heat Pattern Spleen Deficiency Heat Pattern
Cold pattern
Cold
Cold is generated due to an insufficiency of yang ki, which was caused by an insufficiency of blood and fluids
Japanese Meridian Therapy Spleen Deficiency Cold Pattern and Lung Deficiency Cold Pattern Cold
Weak production, circulation, and release of yang ki. An increase in symptoms of cold due to little production of yang ki caused by a chilling of the Stomach and Intestines Patients who by nature have a Stomach and Intestines that easily become chilled and who have a low production of ki and blood tend to develop these patterns of imbalance.
Lung
deficiency
cold pattern
SHO/Pattern and Pathology Yang Excess Pathology: External excess heat acute heat disease with chill Pulse: Floating, Fast, Excess Yang Deficient Pathology: External deficiency cold pain due to cold Pulse: insertion. SHO: Cold sho *This condition changes to Internal cold, because of the Yin nature of cold. Yin Excess Pathology: Internal excess heat Yin Deficient Pathology: Internal deficiency heat Sinking, Thin, Deficient
Symptom: External (surface) Excess heat; fever, Symptom: Cold on the exterior (surface), lower limbs,
Treatment: After tonifying yin, disperse yang by Treatment: After tonifying yin, tonify yang by shallow shallow insertion. SHO: Heat sho (Yang excess heat sho)
Symptom: Excess heat symptom inside of body. Symptom: Deficiency heat symptom inside of body, Heat invades and stagnates, causing blood stasis stiffness of neck and shoulder, dizziness, headache, and internal organ symptoms. Pulse: Sinking, Excess insomnia, head, neck and shoulder pain due to heat Pulse: Floating, Big, Deficient
Treatment: After tonifying yin, disperse by deep Treatment: After tonifying yin, when heat remains on insertion the yin meridian that has excess. SHO: Heat sho (Yin excess heat sho/pattern) the yang meridian, disperse it by shallow insertion. SHO: Heat sho (Deficient heat sho/pattern)
Japanese Meridian Therapy Establishing Deficiency and Excess through point, pulse and symptoms This method is for judging whether tonification or dispersion would be the better treatment in the case of a systemic disorder, such as an acute febrile disease, in which it has been determined to which meridian(s) cold or heat is spreading. As a rule, dispersion is chosen if the pulse quality is excess, and tonification is chosen if the pulse quality is deficient. However, the decision is often made in connection with the symptomology. If the decision still cannot be made, make the determination based on the state of the palpated acupuncture point(s).
1-4
Deficiency, Excess, Cold, and Heat of the Meridians and Acupuncture Points on which the Local Treatment is Performed The meridians and acupuncture points are flaccid, depressed, or slightly Cold tense. out. There is dulled perception. Pressing feels good. The body is frigid both inside and The pulse is Applying heat feels good.
sinking and deficient. Deficiency The meridians and acupuncture points have protuberances that become depressions when pressed. Heat abnormal. Pressing feels good. If pressing an The pulse is induration feels good, it indicates deficiency. floating and deficient. The surface of the body is frigid, but there are internal indurations and Cold Excess Heat resistance. Pressing causes an increase in pain. There is constant spontaneous pain and constipation. The pulse is sinking and excess. Pressing causes an There is The perception is
The surfaces of the body feel hot to the touch. increase in pain. little urination. The pulse is floating and excess.
Applications Few Many for females Few Somewhat many Many Few, dispersion Very few but
LU Def. Pat. SP Def. Pat. LR Def. Pat. KI Def. Pat. LR Exs. Pat.
Photograph 1
Fig. 4
index and ring finger to either side of the middle finger to perform Pulse Diagnosis. (Photograph 2 and 3) The index finger touches the distal position, the middle finger touches the middle position, and the ring finger touches the proximal position, in Japanese they are called Sun, Kan, and Shaku. In each pulse position (Fig. 4) the five phases, each Zang-Fu and a meridian are linked. (Fig. 5) When you perform Pulse Diagnosis, use your finger pads to feel. Also let the thumb location be near TW4. Let the patient's wrists curve slightly, and place the patient's arms lightly on the abdominal region.
Photograph 2
Photograph 3
Fig. 5
4Shape of pulse
Floating-sinking, slow-fast, and deficient-excess are the Six Basic pulse qualities. Floating pulse floats and is felt on a superficial level. Therefore, the pulse will be felt shortly after applying a finger. A Sinking pulse is felt on a deep level. This pulse cannot be felt unless deeper pressure is applied. However, the standard of the depth of a pulse is a middle pulse. The depth of the pulse corresponds to the depth of needling; it is shallow with a Floating pulse, and deeper with a Sinking pulse. A Slow pulse indicates cold at three or less beats per breath. A fast pulse indicates heat at five or more beats per breath. (Fig. 6 Zang-Fu, Meridian relation in pulse position) The number of beats in a normal pulse is four per breath. As a general rule for needle technique, with a slow pulse, insert the needles slowly, for a fast pulse, quickly. Deficiency is indicated by a soft pulse, and a hard pulse shows excess. Use a Tonification method for deficiency and use a Dispersion method for excess. Distal Middle Left hand Superficial Small intestine Gallbladder Bladder Deep Heart Liver Kidney Right hand Superficial Large intestine Stomach
Triple warmer
Proximal
Right-hand-Distal-Deep level LU, Superficial level, is large intestineProximal are Ming men and TWLeft-hand Distal are HT and SI, Middle is LR and GB, Proximal are KD and BL. (Fig. 6)
The PC is connected in the original book with the life gate. However, clinically, PC is treated as vicarious execution of HT. The right Proximal is the ministerial fire and it is considered the life gate and the Yang Ki of KD. 7. Pulse of HanKan There are patients whose pulse can't be felt in the normal position, but deviates toward Large Intestine meridian where a pulsation exists. In the classic, this is called pulse of HanKan. In addition, similarly, the radial artery can be deviated in some pulse positions, or sees various teratisms rarely, either. When you find such a patient, whose pulse you cannot feel, it can be deficient or it could be diagnosed as a hidden excess. However, take the other methods of examination into consideration, and perform the Sho determination. While advancing treatment, you may feel [right] pulsation. As a special case similar to this, a patient's wrist may also come upon one of the two, or if there is both nothing, the patient's wrist may be covered with a cast.
LR sho Cold
KD sho Heat
KD sho Cold
SP sho Cold
SP sho LR Excess
LU sho LR Excess