Respect News Acubites Practice NICE on osteoarthritis Multibeds: Wellpoint Acupuncture DBS checks: yes or no? Scalp acupuncture as treatment for the brain Moxa production in Japan The autumn leaves Inspiration Just my point Review: More Donkey Business Talking sense about our ancient art & science My treatment room Opinion Learning by being a patient Community PSA: the mark of quality 50 but still yang By members, for members Acupuncture Quarterly from the BAcC | Autumn 2022
Created to better address the patterns displayed by patients in modern practice. • Made in The Netherlands to HACCP+ standards under strict quality controls. • Made in a manufacturingstate-of-the-artsiteusinga strict raw material selection process. • No mineral or animal ingredients. No alcohol and no banned herbs • Suitable for Vegans. ‘Ancient Supplements for the Modern Child’ suwenpress.co.uk Order online at: These products are food supplements, as directed by a qualified practitioner. They are not intended to diagnose, treat, cure or prevent any disease. Not to replace a varied diet. Composed of 12 supplements, dedicated to paediatric patterns seen in a Western clinic. Created by Giovanni Maciocia ® – World renowned author, practitioner and herbalist based on his over 39 years clinical experience The Little Treaures® is a line of supplements dedicated to paediatric issues, that are formulated to reflect Western clinical reality and are balanced to take into account children’s distinctive aetiology and pathology. Hydrophilic Concentrates l 1:5 concentration ratio l Palatable for small children • Breathe Easy • Chest Release • Clear Radiance • Dry Sleep • Ear Release • Little Sentinel • Lucid Mind • Resolve Phlegm • Sino Relief • Silent Night • Throat Soothe • Tummy Soothe
Editorial HouriMember:AlaviEastSussex
Acu. is a BAcC publication, written by members, for members. It combines content relevant to the clinical practice of acupuncture with communications from the BAcC office and Governing Board.
Accuracy and fairness: we strive to be accurate and fair in what we print. We will be open in admitting our mistakes and do our best to rectify them. Contribute We encourage all members to contribute to Acu. via editor@acupuncture.org.uk For full details of submissions and advertising see Contributions page.
December
Design Whirligig Creative Cover Tim Brown Copy & publishing dates 2022 Issue Copy deadline Published Spring 14 January 11 March Summer 14 April 13 June Autumn 14 July 9 September Winter 14 October
When it comes to respect in our medical traditions, I feel that nothing shows my reverence more than returning to the classical texts, paying homage to their depth and the richness of the translators’ work: ‘Huang Di asked: “The application of the needle, it must be based on laws and rules.” Now, what are the laws and what are the rules?
Finally, there’s no time more appropriate than autumn for me to bid farewell – after five years – to my creative colleagues on the editorial team. Acu. will continue to unfold in their deft hands, joined by returning and new members respectively, Rev Deb Connor and Gillian Nicol. I wish them, and you all, the best as we navigate the sea of change, evolution and growth.
‘Qi Bo responded: (In piercing one should take) heaven as law and the earth as rule. Combine them with “the luminaries of heaven” ‘Huang Di: I should like to hear of this ‘QicomprehensivelyBo:Alllawsof piercing require an observation of the qi of sun and moon and stars, and of the eight cardinal (turning points) of the four seasons. When the qi is determined, one (can) pierce the Correspondences(patient).’are not an intellectual exercise or a construct of the mind, but a resonance between you and me, the seasons, stars, winds, tides and the ocean. The relationship between the individual body and the social body, the family, the body of the practitioner and patient and the cosmic body – they resonate at physical and spiritual levels. Suwen 26 above is the perfect expression of that vision. Equally, the practical aspects of resonance – not just woo-woo stuff, but also important practical concerns – strongly influence the efficacy of our treatments. The practice of time and timing – giving the right treatment or formula at the right time, in terms of the progression of symptoms, the season and time of day. All these heavenly configurations come into play in clinical practice. In these pages, John Hamwee’s piece, Learning by Being a Patient, brings many of these configurations to life. And Oran Kivity’s Unity of Purpose honours the practice of time and timing during the production of moxa. How do we deal with the permutations of phase energetic phenomena that are currently occurring? Ian Appleyard’s precis of the situation with the NICE osteoarthritis guidelines is an excellent demonstration of the most respectful of engagements with NICE, other stakeholders, and beyond with the sceptics. The NICE decision in October will have ramifications for acupuncture. As Ian says, the open discussion sessions on ‘Internet Wars’ and ‘Integrated Projects’ will offer some of us a chance to explore the best ways to engage online with sceptics, and how to establish respectful collaborations with mainstream healthcare services. Elsewhere, Charlie Buck offers valuable food for thought as he revisits our ‘rational’ medicine, exploring strategic ways we can demonstrate this rationality whilst embodying a culture of criticality and respect. Also, do look out for Hannah Bowie-Carlin’s review of the BAcC’s recent Boundaries and Consent campaign, with details of many new resources. Our traditional texts and practices offer many tools to understand and deal with what we’re experiencing in the world right now, from Covid, to new chronic illnesses, infectious conditions, and social and environmental unrest. Veneration of ancient wisdom is important and we hope you find many and varied examples of this in these pages.
Editorial policy Community: we aim to facilitate debate and the sharing of news and information for all members of our acupuncture community.
Editorial team Houri Alavi (member) Scott Bridges (member) Tim Brown (member) Rev Deb Connor (member) Sally Crowther (member) Ann Gordon (staff) Joan Maynard (copy editor) Gillian Nicol (student member) Jonquil Westwood Pinto (member, chair) 9
Support: we aim to support members in their professional practice by publishing articles that have genuine practical use. Diversity: we seek to represent all traditions and strands of practice present in the membership. We also welcome content covering other health matters relevant to acupuncture. Freedom and debate: we respect the right of all members to air their views and to challenge the views of other individuals and/ or organisations where appropriate.
Of course, we will not always agree with everything someone else believes or does, but a relationship built on respect allows both sides to feel listened to, understood and accepted in theirOverdiversity.thelast three years, since I joined the BAcC, my focus has been very much on achieving our common goals – nurturing mutual trust and lasting relationships with members, colleagues and our wider stakeholders. The restructuring of our internal processes ensured that the BAcC as a whole remained strong enough to help individual members survive the Covid crisis. But now, of course, this work needs to continue and evolve. At its core, respect is a continuous process of paying attention to those around us. We all of us feel valued when we are heard and understood. Actively listening to what someone is saying – listening to understand as well as to reply – can promote a mutual wellbeing that will ripple throughout our wider community. Our annual survey of members always provides the BAcC with a golden opportunity to listen to understand, and we thank all of you who managed to take part. We’ll be sharing the full results later this year but suffice to say at this point, your feedback is already helping us to develop our plans and priorities for 2023.
A acceptedunderstoodlistenedsidesallowsbuiltrelationshiponrespectbothtofeelto,and
Keynotes
Respect means different things to different people. To me, it means treating everybody with care and recognition; showing courtesy and politeness; accepting a person’s styles, methods, and thinking. In my opinion, respect should be a common value running through every membership organisation – in our treatment of members, our staff team and amongst members themselves. But what exactly does it mean in practice? How do we promote a culture of respect in a way that everyone associated with the BAcC can understand and feel part of it?
Our wider community of acupuncturists can demonstrate mutual respect in multiple ways, often influenced by individual culture, tradition, peers and social setting, and those who support us locally. Many of our differences are really a matter of opinion.
I like to think that all of us in this organisation consider ourselves dutybound to respect those with views different from our own. Opinions offered in a respectful manner serve to oil the wheels of communication and encourage contributions across the board, from members and staff alike. Valuing differences and embracing freedom of expression helps all of us to work together toward our common goal of making the BAcC stronger. To quote the Olympian, Scott Hamilton: ‘The high road is always respected. Honesty and integrity are always rewarded’. He makes a valuable point. Membership organisations such as ours must be based on honesty and integrity. For our part, we will continue to do our best to earn your respect by: • listening to your concerns, recognising your perspective as a member, using your ideas to improve our work • treating you with courtesy, politeness, and kindness • being open with you about our work and how we support you • letting you know our decisionmaking processes and how you can get involved • taking your concerns seriously and offering our apologies if we get it wrong • treating everyone – staff, members and stakeholders – fairly and equally So let’s be good to our fellow members, our colleagues, and of course, ourselves. The opportunities that lie ahead are exciting, with plans for a bigger emphasis on promoting the BAcC, raising the profile of members and, of course, increasing awareness of acupuncture itself. With respect, let’s work together to make them happen. Jennifer Norton 〉 020 8735 1206 〉 j.norton@acupuncture.org.uk
Jennifer NortonChiefExecutive
By members, for members Issue Autumn#362022 Opinion 26 Acupuncture diagnosis: learning by being a patient John Hamwee 27 Lemon roasted sprout hummus Recipe from Rev Deb Connor Community 28 On reflection Pia Huber 29 PSA: the mark of quality Karen Smith 30 50 but still yang College news from Elio Basagni Regional round-up Let’s talk about… our latest campaign Hannah Bowie-Carlin Tribute: Gordon Parfett Office Classifiedscontacts&call for contributions News 4 Acubites Practice 6 NICE guidelines on osteoarthritis Ian Appleyard 7 WebWatch 8 Multibeds: hard work but enjoyable Tess Lugos 10 Evidence base Abstracts from Lisa Sherman 11 DBS checks: yes or no? Caroline Jones & Hannah Bowie-Carlin 12 Scalp acupuncture as treatment for the brain Jasmin Reif 14 Unity of purpose: moxa production in Japan Oran Kivity 16 The autumn leaves… Carole Parker 17 Inner Pass notes: terms & conditions As reported by Ama Zbarcea Inspiration 18 Just my point: LU 9 Peter Firebrace 20 Acupuncture Pulse Diagnosis and the Constitutional Conditional Paradigm by Peter Eckman Book review from Olga Fedina 21 Talking sense about our ancient art & science Charles Buck 24 My treatment room Fiona Swinburne 25 The classic of difficulties Mark Popplewell 26 24 30 12 20 16 21 18
Monkeypox latest
Jonquil Westwood Pinto Deb Connor Gillian Nicol Sally Crowther Scott Bridges Tim Brown editorial
It would seem that differences in fat/ contributorslevelsandmetaboliccomposition,muscle/bodyrate,hormonearealllikelytothe
Heatwaves worsen mental health Research shows that areas of the brain responsible for whichbytaskscomplexsolvingcognitiveareimpairedheatstress,canleadto
Is that liver yang I see rising in your eyes?
Wild-InspiredHarvest,Viljoen’sbookmoxaacupuncturistsallasbutanewfromMarie–Forage,Feast:A
prepared with members in mind
The majority of the UK’s confirmed2,137 cases of monkeypox have been discovered in London numbersandhave led to a push in the NHS vaccination campaign. While anyone can contract the virus, the risk to the public is low and experts do not believe we are on the verge of a national outbreak 〉 tinyurl.com/bdfbndd7
Health comingcampaignsup
30SEP World's Biggest Coffee Morning 〉 30 September 〉 host a coffee morning to raise awareness and money for Macmillan Cancer Support and their help for people living with cancer 〉 coffee.macmillan.org.uk
OCT18 World Menopause Day 〉 18 October 〉 raising awareness of the menopause and the support options available for improving health and wellbeing with this year’s theme of Cognition and Mood 〉 tinyurl.com/kvz6mkdn
National and local awareness days give great hooks for marketing or promoting your practice, plus you’ll be supporting everyone in the BAcC. Here’s a few for autumn.
NOV6 National Stress Awareness Day 〉 6 November 〉 highlighting stress and its impact, and reducing stigma while promoting the importance of wellbeing and stress reduction for individuals and organisations 〉 tinyurl.com/8rbj5538
Cold hands, warm heart… but why?
19SEP National Eye Health Week 〉 19-25 September 〉 promoting the importance of good eye health and the need for regular eye tests for all 〉 visionmatters.org.uk
Fancy a cocktail?moxa
NOV14 National Self Care Week 〉 14-20 November 〉 seeking to embed support for self care across communities, families and generations with this year’s theme Exercise Self Care for Life 〉
Your
AAcubitesteamsmörgåsbordofplant-basednewsbits
OCT1 Stoptober 〉 October 〉 government campaign encouraging the nation’s smokers to stop smoking for the month of October… and beyond 〉 tinyurl.com/39dc37wv
Cuisine – suggests some other culinary uses for this common, wild herb. Anyone care for a mugwort martini made from your very own homemade vermouth? 〉 tinyurl.com/yc6v6n39
Mugwort Vulgaris is familiar to
The eyes may be one of the first parts of the body to show signs of high pressureblood– often before most people are aware they have it. Small blood vessels are very sensitive to change and any damage resulting from high blood pressure can lead to blurry vision. Look out for red areas of haemorrhaging in the eyes 〉 tinyurl.com/y2z9rv5f T cells linked to hair regrowth Scientists at the Salk Institute systemandbetweensurprisinguncoveredhavealinkhairgrowththeimmune 〉 com/5n84rbf8tinyurl.
consistent finding that women really do feel the cold more than men 〉 tinyurl. com/4p2axa7c
affected individuals becoming frustrated or aggressive. And for every one-degree increase in monthly average temperature, mental health-related deaths increase by 2.2 per cent 〉 tinyurl. com/2mjecu3m
tinyurl.com/3xjmfrj4 4 News Acu. | Issue #36 | Autumn 2022
New route to US certification
Hurrah for Houri!
Abnormalising grief
And remember, if you ever spot some morsel of news you'd like to share in Acubites, just send it our way 〉 editor@acupuncture.org.uk
Moxi finder shows her skill
Sometimes search silence within buzzing is good exercise. where not very city,with under million inhabitants.However,the density is high, people live apartment blocks rather than houses,and walls are paper There always neighbour who getting flat renovated, someone who learning to play guitar, someone discussing through an window the neighbour acrossDevelopingthe‘patio’.resilience to noise one the conditions of happy living in city.What helps develop this resilience learning to tune silence. curious to how sometimes, through cacophony city,one tune into perfect silence that one might moment imagine being on top mountain. Yin within the yang yang within yin.The within white semicircle,and the dot within dark semicircle of the map. Stillness movement,movement stillness.Not this one the fundamental principles taichi quan), is reminder nothing absolute,and that every situation state of there is seed of transformation opposite. Within emotional prevails any given moment, seeds transformation into states. the factors internal climate worry and fear, know how look we can seed of And the practice of taichi teaches us look for from the studies of how ‘negative’ ‘positive’ emotions influence our recent research has been exploring how complexity emotions relates andHershfieldlongevity.et ten-year longitudinalstudy whichresearchers conduct observations samesubjectsover extendedperiod time concludedthat‘not were frequentexperiences mixedemotions (co-occurrences positive negative emotions)stronglyassociatedwithrelativelygoodphysicalhealth,butthatincreasesmixedemotionsoveryearsattenuatedtypicalage-relateddeclines.’feelinggood:mixedemotionsphysicalacross2012Theterm‘emodiversity’appearedinpsychologytohowcapacityfeelrangeofemotionsreflectsaandbroaderawarenessinteractionswiththedeeperconnectionwithOngetalexaminewhat‘theandabundanceemotionsindividualsexperience’systemicinflammation.findthat‘greaterdiversityday-to-dayemotionswasassociatedwithlowercirculatinglevelsinflammation(indicatedbyCRP,fibrinogen),independentofmeanofpositivenegativeemotions.’Emodiversityandbiomarkersmation,theorientalisideatransformation,includingtransformationemotions.Perhapsemotionalcomplexity,theabilityappreciatebenefitit,liesabletotheseedtransformationanysituation,eventhedifficult,havingfaithtransformationAstransforming‘partinghorse’sisspreadinghiswings’taichi the ofsimplymovingand feelingmore alivecombineswith creative initiatingtransformation, quiet confidenceinthepossibilityofchange. ‘Howare feeling weouraskclients,inourheartshoping answerrevealsthat was initiated thelasttreatment, arefeelingbetter.The share withpatientswhen saythat arefeelingbetter confluence ofour energies described hexagram oftheYi Ching), The ofChanges.Thishexagram calledJoy andisformed twoof the trigrams, called the Joyous,or Lake.Asexpressedby WilhelmandBayens theirtranslation (1950),‘a evaporatesupwardand thusgradually butwhen lakesare they dryupso readily,foronereplenishestheother.’ ‘Lakes water who bathe, their simply cavort and cooled on leisure. joy like linked does stand alone, accepts the sources of feeding it,stores them and them to to the and sends waters on to lake ultimately, leading the sea’,according to Pearson (2011),another translator classic of interaction,Movementchanges.istransformation,confluenceandexchange,andhealing.theworldconstantlytransformingandourselvesaspartprocesstransformation,seeingasaprocessmovement,transformationinteractionaninvaluable,ongoinglegacythatancientChineseusthatuscopethechallengesoftoday.OlgaFedinagraduatedtheLondonCollegeofTraditionalAcupuncture(LCTA)inandhaslivingpractisingacupunctureinValenciasincededicatedpractitionerandqualifiedteacheroftaichiqigong.
The joy of movement OlgaFedinaAcupuncturist: #35 2022 2022.indd Journey to the West...
... is a ground-breaking documentary, directed by Zoe Coldham and written and produced by Sibyl Coldham. Tracing CM's journey to the UK it explores the challenges of recognition where the dominant culture is against you. The story is told by leading members of the profession including Jasmine Uddin, Felicity Moir and Volker Scheid.
Premiered at Screen on the Green, Islington on the 7 July 2022, the film is being showcased on the UK festival circuit before being optioned for distribution. An edited version will be shown on the Friday night of this year's BAcC conference or watch the preview here 〉 vimeo.com/714351424
know
In Houri’s words: ‘We'll be giving free acupuncture treatments to people who are fleeing their mother countries from war, terrorism, torture and abuse in order to survive. Earth Medicine has been running projects in Lesbos since 2018 and their efforts focus not only on attending to the often chronic physical symptoms of migrants, but also to their mental and emotional needs. Teams of therapists, including physiotherapists and acupuncturists work in rota to ensure that patients receive continual care.’
Pressed info later? Here’s where to start New NICE guideline on arthritis Ian Appleyard calls
for time? Want to grab the essential
now and read the rest
us to action 〉 p6 Wondering about DBS checks? here's the nuts and bolts 〉 p11 Do you need terms & conditions? advice and free consultation on offer 〉 p17
Looking
EFT… withoutacupunctureneedles?
for a little respect for CM? Charlie Buck tells us how to find it 〉 p21 Let's talk about... new resources catch up on the latest campaign 〉 p33 5NewsAcu. | Issue #36 | Autumn 2022
Need to
have on our mental health 〉 tinyurl. com/42jmjjuc
Since the the BAcC office slimmed down in 2020 some us have been lucky enough to be hosted in Houri’s kitchen for the Acu. meetings which are always delightful and accompanied by plates of (Iranian?) food, mint tea and good company. And although we know she will be taking all this generosity and compassion to Lesbos and her future ventures… we’ll miss you Houri! Thank you so very much. You can read more about Earth Medicine’s ethos, projects and fundraising here 〉 justgiving.com/crowdfunding/houri-alavi
Gut-brain connection to mental health
Attentive reader Anita Linskill found Moxi perfectly balanced on Olga Fedina's knee on page 9 of the summer Acu. Find autumn Moxi by 30 September and tell us where 〉 editor@acupuncture.org.uk
We are saying a warm goodbye to Acu. team member Houri Alavi who has been editing the magazine since autumn 2017. Houri recentauthorsbroughthassomanytoAcu.–favourites including Ann Cecil-Sterman and Louis Komjathy. She has worked patiently supporting writers and editing articles and has always offered intelligent insight and vision for the magazine. Recently, she has been inspired by Sarah Budd's article in our spring 2022 issue and will be joining her at a rehabilitation project in Lesbos, Greece this autumn.
Marie itmightneedreckonwhymagazineClaireexplainsexpertsanyoneinofstressreliefwanttogiveago 〉 com/y885us3ztinyurl.
For those wanting to practise in the US, the BAcC is delighted to announce a new streamlined process for eligibility for National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certification for BAcC Members. Our thanks go to Harriet Lansdown of the British Acupuncture Accreditation Board (BAAB) for spearheading the development of this benefit. You can get started here 〉 tinyurl.com/2ds3j35x
A controversial new term for grief lasting longer than six months – Prolonged Grief Disorder – has now been officially recognised in the US. But how long should grief really go on for? 〉 tinyurl.com/3ftu9nm6
A new Chinese study has upped the ante continuingin to effectinsightextraordinaryprovideintothemicrobes
IanAppleyardMember&Policy&ResearchManager
NICE [National Institute for Health and Care Excellence] guidelines on osteoarthritis are currently in development and the new guidance is due to be published on 19 October 2022. A consultation period on the draft guidance has just ended. You can find the draft guidance and other information here 〉 tinyurl. com/2d6pvrvaAcupuncture is not recommended in the draft guidance. The BAcC is a registered stakeholder for these guidelines. Therefore, I prepared a response which I sent to a number of members who are involved in research for feedback. I also got in touch with BMAS [British Medical Acupuncture Society] and AACP [Acupuncture Association of Chartered Physiotherapists], these organisations are also registered stakeholders. We submitted a joint response from all threeFromorganisations.thefeedback I have received, I believe the response we've submitted is good. In addition, because it is a joint response it should have more weight. I have toyed with the idea of publishing our response for all members. I decided against, for the following reasons. Firstly, as a registered stakeholder we do commit not to engage with the press or media in the development process. This mostly refers to the documentation that NICE publishes. However, out of an abundance of caution, I feel it's best we do not put our response in the wider public domain until NICE has had an opportunity to reply. Secondly, our response will be published on NICE’s website in the coming months, although NICE retains the right to edit the responses. As we are registered stakeholders NICE is committed to replying to our feedback. The fundamental reason why acupuncture has been excluded is because of NICE’s interpretation of the sham/placebo comparison. NICE has set a hurdle for acupuncture to jump before it can be included in the economic analysis. Acupuncture needs to be shown not only to be more effective than sham but more effective by a margin of 0.5 SMD [standardised mean difference]. Come October, either the arguments that we've made are accepted and the economic analysis of acupuncture is carried out –which should lead to the inclusion of acupuncture in the guidance; or NICE persists in willdecisionThisshambasedacupunctureexcludingonthecomparison.isacriticalthathaveramifications for acupuncture and beyond. It is important to understand the significance of the evidence for acupuncture in the treatment of chronic pain. In particular, the individual patient data meta-analysis by Vickers et al, first published in 2012 then updated in 2018 〉 tinyurl.com/msebjvav I believe this analysis is, in effect, the final word. Neither those who support acupuncture nor those who are sceptical can change the result. Nor can either side hope any subsequent clinical research is going to change the result.
Neither those who thecanarenoracupuncturesupportthosewhoscepticalchangeresult
So why is that the case? It is predominantly about numbers. Imagine that you are a student and you have completed nine out of ten of your assignments, all of which carry equal weight. Your average mark is 65 per cent. You hope, by pulling all the stops out, to get a really good mark in your final assignment to lift your average up to 70 per cent and get a first. Is this possible? If you get a mark of 75 per cent you will raise your average to 66 per cent: 85 raises it to 67; 95 to 68. Even if you get 100 per cent you'll still fall short of the 70 per cent mark. In my wildest dreams I can imagine getting enough funding for a clinical trial of 200 participants. This would cost hundreds of thousands of pounds. But the
NICE guidelines on osteoarthritis
Ian Appleyard explains why now is the moment for BAcC acupuncturists to collectively engage in setting the record straight about sham procedures and the quality of the real acupuncture
theproceduredesignedandacupuncturedeliversifoutitbeingassignmentsnineSoparticipants.overstudyVickersincludes20,000ratherthanoutoftencompletedismorelike99of100.Evenmytrial,whichbetterhasabettershamthanothers,comes out with the result that is 10 per cent better than the current average this would only lead to a 0.1 per cent change in the current finding. Moreover, if the trial shows a benefit that is 20-30 per cent greater, researchers might decide to exclude it because it is an outlier. Just like examiners might suspect a student of cheating if they suddenly got a mark around 90 per cent when they typically got 65 per cent. The numbers aren't going to change. The results show the acupuncture is beneficial and that it is not purely due to placebo. Sceptics used to say, ‘If you show me the evidence I will change my mind’. Since the publication of the individual patient data metaanalysis a new line can be seen on the various sceptic blogs: ‘The results of acupuncture are interesting but when further research is done this will probably be shown to be the placebo effect’. But just as the student is not going to get a first, they are also not going to fail because of the poor result in the last exam. Similarly, the clear difference in the sham acupuncture comparison is not going to disappear. The interpretation is what matters. The sham procedures are not inert. This fact needs to be acknowledged within any interpretation. I am certainly not the first person to say this: people have been banging on about it for decades.
6 Practice Acu. | Issue #36 | Autumn 2022
WebWatch
drawingacupuncture 〉 tinyurl.com/47v86dsx André mixes art and acupuncture on Instagram. He also teaches acupuncture in Brazil. His pictures speak louder than these words… Alan Watts: the I Ching 〉 youtu.be/cwSYbZoa4mk
The rich tones of Alan Watts are always a soothing joy. Try this classic recording of him discussing the I Ching... or maybe first cast the I Ching to find out when's the best time for you to listen!
7PracticeAcu. | Issue #36 | Autumn 2022
If NICE reverses its decision and removes the placebo comparison hurdle, an economic analysis will then take place. Whilst I believe acupuncture should pass this latter test, there are clearly challenges in it becoming a reality. There are absolutely millions of people with osteoarthritis. Those in charge of the purse strings will be concerned about the potential cost of all these people seeking acupuncture. This is a legitimate concern. We need to show that acupuncture can be delivered in a cost-effective manner. To do so we must establish collaborations with the mainstream healthcare services. These on-the-ground examples can be used to encourage and develop other projects. At the conference we will have another open discussion session (Integrated Projects) to talk about how we can develop such projects. Ultimately, I believe the evidence will prevail: acupuncture will be increasingly accepted as an effective treatment modality. The sceptics are digging themselves into a hole and not following their own scientific processes. If there was something wrong with the methods or analysis of the Vickers at al study, the sceptics are free to put these issues in a peer reviewed journal. NICE might not reverse its decision this year, but it will eventually.
Net of Knowledge Bytes 〉 tinyurl.com/msv2evfd Did you know that the Net of Knowledge has added some free tasty Knowledge Bytes to its already sumptuous offering? From Occam’s Razor to Yogic Breathing For Better Listening… with just about everything and everybody in between. Dip in regularly for a quick hit of inspired teaching.
NICE might not reverse its decision this year, but it will eventually.
Ms Aretha Franklin 〉 tinyurl.com/yttknuej Well really, she had to be in here, didn’t she? And we all know that singing is good for the lungs. So just click on the link, take a deep breath and sing along with the Queen of Soul… R E S P E C T…
With the greatest respect, we offer you some online riches to ease you into the mellow season of autumn Ologies
Why not share your online favourite resources with other members by sending a link to WebWatch via editor@acupuncture.org.uk
The concept of placebo and its importance is deep-rooted within our society and in healthcare research. It is linked to a complex nexus of vested interests of both power and finance. A change in this thinking is effectively a change in the zeitgeist. This is clearly something that is not going to happen overnight. However, if NICE reverses its decision and includes acupuncture it will be a significant moment. Whatever the decision there is going to be discussion on blogs, in social media and most likely mainstream media. I believe it is important that we as acupuncturists engage in this debate. That is why we have organised an open discussion session at this year’s conference: Internet Wars. It is a chance for us to discuss the best ways to engage online: how should we counter sceptic arguments? How can we work with other acupuncture organisations? It is our chance to pool our knowledge and experience to be more effective. It is unlikely that we will have such a large-scale meta-analysis for any other condition. Generally speaking, the funding is not available. I also believe other conditions such as insomnia or depression do not lend themselves so well to the semi-fixed acupuncture protocols typically used in RCTs (randomised control trials). Therefore, we need to win the argument with regards to sham procedures and then following that the quality of the real acupuncture, first. That will allow better designed clinical research to take place.
NeedNICEtoknow
Acupuncture is not recommended in NICE’s draft guidance on osteoarthritis. Joint response from BAcC, BMAS and AACP – all registered stakeholders – has been submitted. Decision will be made in October –with ramifications for acupuncture and beyond. If NICE reverses its decision and removes the placebo comparison hurdle, an economic analysis will then take place. We need to show that acupuncture can be delivered in a cost-effective manner. To do so we must establish collaborations with the mainstream healthcare services.
〉 alieward.com/ologies
A weekly comedic science podcast hosted by award-winning science correspondent Alie Ward. Each week Ward talks with a different ‘ologist’ from a particular scientific field. Themes are wide-ranging, including the human body, marine and wildlife, plants and history. Find your favourite 'ology' in the collection or pick something new to expand your knowledge.
ZOE 〉 tinyurl.com/mv29cscb You've probably heard of the Zoe studies, but did you know they have a collection of podcasts with the world's top scientists explaining the latest health, nutrition, and gut health research in an accessible way?
hindsight, you need to have done your research – look at what’s available in the area, what is a reasonable rent, how much you want to earn, what is a legal structure that works, and how many people you wantOccupyinginvolved.’the old LCTA clinic premises had other benefits – although Wellpoint has since moved to its new space –because many former LCTA patients came. One of them is Gill Rose, who used to come to LCTA to help manage an autoimmune condition. ‘After LCTA, Gill Hack [one of the clinic supervisors] treated me at her multibed in Highgate. And when Gill sold her business, she referred me to Wellpoint and I’ve been coming here ever since.’ Over the past decade Wellpoint has welcomed more than 2,100 patients through its doors. It treats on average 42 patients a week, sometimes up to 60 when busy. About half its patients come via word of mouth and the other half from internet searches. ‘We hardly spend on marketing,’ explains Ghila. ‘A multibed doesn’t require a big [promotional] investment. You don’t need to be on the high street. Our service speaks for itself and people find you on the internet or come via referrals.’
‘When you’re younger you can see three to four people an hour, but as you get older it might only be two,’ Ghila explains. In the beginning the partners were driven and worked very hard, seeing 12 to 13 patients a day. But that is not sustainable in the long run and the danger of burn-out is very real.
TessLugosMember:London
Ghila Banin, the driving force behind Wellpoint more than 11 years ago, says, ‘The project worked even from the beginning. We never had to borrow money, we never had problems paying bills.’ The clinic pays its practitioners a modest but regular salary and continuously reinvests in the business. Happy coincidence Ghila always wanted to set up a multibed clinic after visiting a working men’s hospital in Nanjing in 1995. She tried to set one up in Hereford, then tried again in Israel, but it never worked out.
After moving back to North London from Hereford, she placed an ad in the BAcC members’ magazine in November 2010 for potential partners in a multibed project. In the end four partners – Ghila plus Annetta Apol, Monica Daswani and Dev Shukla –set up Wellpoint in some of the old clinic rooms of the London College of Traditional Acupuncture (LCTA), which closed in October 2010. ‘That was sheer coincidence,’ explains Ghila. ‘I was passing by and saw a For Let sign, so went in and had a look.’ It was a happy coincidence because it meant getting equipment like
reopenedWhenmostalongpandemic,toto2020,inhealthcareclosedfollow-upforsessions.WhenCovidfirstdownalliedclinicsMarchtoMayWellpointhadfigureouthowoperateduringalearningthewaylikebusinesses.theclinicinJune
A community resource Patients are drawn by the twin attractions of a clinic that is open six days a week and affordability. Wellpoint charges £40 for an initial consultation and treatment, and £30
Setting up and running a multibed clinic is hard, but the project can succeed with the right team. It’s possible to deliver high standards of care while keeping costs low. The rewards? An enjoyable way of working and the satisfaction of making acupuncture accessible to more people. My colleagues and I know this because last June we celebrated the 10th anniversary of Wellpoint, our threebed clinic in Finchley Central in North London. Wellpoint is set in Stephens House & Gardens, a Grade II-listed house with extensive landscaped gardens. We operate Monday to Saturday and open late on three weekday evenings. We can offer this because the work is shared by four acupuncturists, with one practitioner in clinic at any one time, seeing one to three patients an hour.
Multibeds: hard work but enjoyable
8 Practice Acu. | Issue #36 | Autumn 2022
Tess Lugos explains how and why Wellpoint Acupuncture survives and thrives while offering low-cost acupuncture in the community
saysdiscussions,’webeforehandthinkwasclinic.openthanlowfurniturelampscouches,treatmentheatandofficeatornocost.Ittookmoreayeartothenew‘TherealottoaboutandhadsomanyAnnetta.‘In
2020, the partners ditched the multibed model and treated on a one-to-one basis to keep safe during that deeply uncertain period. What about pricing? Wellpoint could have raised prices but in the end decided not to because its ethos has always been about making acupuncture accessible. It kept the same charges but asked patients to pay more if they could. The result was a nice surprise. ‘About 65 per cent of patients paid the same,’ says Annetta, ‘but the other 35 per cent paid more such that we earned about the same as if we had raisedPatientsprices.’understood the reasons why they were being asked to pay more and were happy to do so. Many said they wanted to help us stay open, recognising the importance of having a community resource like Wellpoint. We went back to a multibed model in October 2021, once we felt safe enough with more widespread vaccine takeup in the country. We stuck with social distancing guidelines so use only two of the three cubicles, the ones that are farthest apart. The clinic is less busy than before Covid, but in some ways that is not a bad thing.
Wellpoint is expanding and looking for another acupuncturist to work two shifts a week. Please send your CV to info@wellpointacupuncture.co.uk
Wellpoint is located in Stephens House, above (photo: Russ Jackson Photography); Wellpoint partners, left to right: Tess Lugos, Ghila Banin and Annetta Apol (photo: Duane Matthews)
Hard work Some multibeds are set up to have two or more practitioners working at the same time. Because of Wellpoint’s limited space – an office for consultations plus one large treatment room – only one practitioner can be in clinic. It is hard work. The acupuncturist on shift not only juggles consultations while treating multiple patients but also answers the phone, responds to emails, manages the diary, takes payment, and sets up at the start or cleans up after shifts. It is very different to treating on a one-to-one basis and too much for one person to do every day. It is no surprise that most members of the Association of Community and Multibed Acupuncture Clinics (ACMAC), which lists 55 clinics in the UK, offer affordable acupuncture only once or twice a week. In London, ACMAC lists 11 multibeds. Wellpoint is unique that it can offer low-cost acupuncture on a full-time basis, with practitioners that work as a team to offer continuity of care. Longtime patient Gill Rose says, ‘I come to Wellpoint because when one practitioner is away, someone else can pick up. With my autoimmune condition, it would be detrimental to stop treatment, especially if I catch a cold or virus.’ Patients going through IVF particularly need affordable regular treatments. Christine (not her real name) came to Wellpoint while undergoing IVF. ‘I had tragically lost my first baby, Joshua, to a genetic condition, so my husband and I decided to have IVF with preimplantation genetic diagnosis (PGD) to prevent passing on the condition to any children. A family member recommended acupuncture, I did a bit of research, and chose Wellpoint because it’s local, had good reviews, is set in beautiful surroundings and affordable.’ The treatments were a success and Christine now has two healthy children – a three-year-old girl and a six-monthold baby boy! Not easier, but different The business is viable because its team of four works well together. After Dev and Monica left, two others joined Ghila and Annetta. I joined in January 2017 as a maternity cover for Monica and stayed on after she decided not to come back. I qualified in 2015, so I saw working at Wellpoint as a chance to ‘speed learn’ by treating many more patients than I would as a sole practitioner. The same holds true for Debbie Sheldon, who joined as a trainee when she qualified three years ago. The team regularly consults with one another, particularly for complicated or unusual cases. This engenders confidence and helps the new practitioner build their business. (Most of us combine multibed work with private practice.)
Wellpoint’s model is not necessarily easier, but it’s different.’ Everyone brings a strength to the project, whether that is in procurement, admin, marketing or social media. We also have a mix of specialties like nutrition, scalp acupuncture, cosmetic acupuncture, tuina and shiatsu, which we offer in our private practices. ‘We have a very good team, everyone is supportive of each other,’ says Ghila. ‘We cover for each other when it comes to holidays and sick days.’
Wellpoint encourages practitioners to set up multibeds in their communities. ‘It’s very demanding to set up, so you need a good group of practitioners with different skills. You need to know your limits. But the most important thing in our work is to enjoy it.’ The Wellpoint team has had an enjoyable ten years and looks forward to the next ten.
Annetta had been a sole practitioner for four years when she saw Ghila’s ad in 2011. ‘My reason for joining had more to do with wanting to work with others,’ Annetta explains. ‘It’s nice not to have to do everything on your own.
Opposite: Wellpoint treatment room (photo: Duane Matthews)
Want to work in a multibed?
9PracticeAcu. | Issue #36 | Autumn 2022
Wellpoint top tips for starting a multibed • Build a team of practitioners with complementary skills • Decide on your legal structure • If partnership, work out how much capital you need to cover your first year or two • You don't need to be on the high street – look for a low-cost location, for example church or community centre • Open on a full-time basis • Offer evening and weekend hours • Don't mix practiceacupunctureaffordablewithprivateinthesamevenue –patients get confused • Enjoy the work!
Combining acupuncture with simultaneous cognitive training boosts post-stroke cognition Performing scalp acupuncture at the same time as computer-based cognitive training (CBCT) leads to better improvements in cognitive functioning for stroke patients than either acupuncture alone, or acupuncture delivered separately from cognitive training. Chinese researchers randomised 660 patients with poststroke cognitive impairment to interactive dynamic scalp acupuncture (IDSA), simple combination therapy (SCT), or traditional scalp acupuncture (TSA). Scalp acupuncture and CBCT were performed simultaneously in the IDSA group, but separately in the morning and afternoon in the SCT group. Patients in the TSA group underwent scalp acupuncture only. All patients received conventional drug therapy for stroke, along with exercise rehabilitation training. The treatment course was eight weeks. Cognitive function was assessed before treatment, at one (M1) and two months (M2) after treatment initiation, and at one (M3) and two months (M4) post-treatment follow-up. Changes in cognitive scores in the IDSA group were found to be significantly higher than those in the SCT and TSA groups, for all timepoints from M2 to M4, while depression, anxiety and sleep scores all demonstrated significant reduction compared with the other groups.
Overseas member and recovering scientist Lisa Sherman selects top abstracts of the season from the Journal of Chinese Medicine's news section to keep you up to date with the latest in acupuncture research
LisaShermanOverseasMember:NorthCarolina
Electrical acupoint stimulation helpful in IVF Transcutaneous electrical acupoint stimulation (TEAS) can be helpful for improving endometrial receptivity and egg retrieval in patients undergoing in vitro fertilisation and embryo transfer (IVF-ET), conclude Chinese researchers. Two hundred infertility patients undergoing IVF-ET were divided randomly into four experimental groups and a control group. Patients in the experimental groups received TEAS treatment at 20, 30, 40 and 50 mA (E-I, E-II, E-III and E-IV groups, respectively). The control group received treatment TEAS treatment at 5 mA. TEAS was applied at REN 4 guan yuan, REN 3 zhong ji, SP 6 san yin jiao, M-CA18 zi gong, and KID 13 tai xi, for 30 minutes, once a day for 10-13 days. Endometrial thickness in the experimental groups on the day of chorionic gonadotropin administration was significantly better than that in the control group after TEAS stimulation. TEAS also exhibited a greater impact measured by the number of eggs retrieved. No significant effect of TEAS stimulation was observed on either embryo quality or clinical pregnancy rate. Effects of Transcutaneous Electrical Acupoint Stimulation on Ovarian Responses and Pregnancy Outcomes in Patients Undergoing IVF-ET: A Randomised Controlled Trial. Chin J Integr Med. 2022 May;28(5):434-39 〉 pubmed.ncbi.nlm.nih. gov/34762233/ Placebo response varies between different types of sham acupuncture Placebo responses to sham controls used in experimental studies of neck pain differ significantly depending on the type of sham procedure employed, and also depending on the outcome measure used. Chinese investigators randomly assigned 175 patients with neck pain to receive ten sessions of either electroacupuncture, shallow acupuncture, non-acupoint deep acupuncture, non-acupoint shallow acupuncture, or non-penetrating acupuncture. They used the Northwick Park Neck Pain Questionnaire (NPQ) as their primary outcome measure, and the Short-form McGill Pain Questionnaire, visual analog scale (VAS), and Pain Threshold as secondary outcomes to measure the changes from baseline to a three-month follow up. All groups, except nonacupoint shallow acupuncture, showed significant improvement in all outcome measurements. Electroacupuncture only showed improvements that were superior to shallow acupuncture, non-acupoint shallow acupuncture, and non-penetration groups when compared using the NPQ and VAS scale. Interestingly, the non-acupoint shallow acupuncture procedure produced even less placebo response than nonpenetrating acupuncture.
Placebo response varies between different types of sham acupuncture: A randomised double-blind trial in neck pain patients. Eur J Pain. 2022 May;26(5):100620 〉 pubmed.ncbi.nlm.nih.gov/35129852/ Sham acupuncture is not inert Sham acupuncture techniques have similar effects on biomarkers to real acupuncture techniques, suggesting that the use of sham acupuncture as an inert intervention needs to be reconsidered. An international group of researchers based in Korea and Norway evaluated differences in serum biomarker changes between sham acupuncture and verum acupuncture in data from 51 sham acupuncture trials. They found that most of the 36 serum biomarkers measured did not suggest a significant difference between sham acupuncture and verum acupuncture needling. Among the evaluated inflammation and immune-modulatory biomarkers, only seven (VEGF, IG-E, TNF-a, NGF, GABA, NPY, and VIP) were identified as being different between the groups.
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Evidence base
Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety: A Multicenter, Randomised, Controlled Trial. Chin J Integr Med. 2022 Feb;28(2):106-15 〉 pubmed. ncbi.nlm.nih.gov/34874523/
Plausible Mechanism of Sham Acupuncture Based on Biomarkers: A Systematic Review of Randomized Controlled Trials. Front Neurosci. 2022 Feb 3;16:834112 〉 pubmed.ncbi.nlm.nih.gov/35185461/
With thanks to the Journal of Chinese Medicine
‘If a self-employed acupuncture practitioner is responsible for caring for or supervising children, or providing advice or guidance wholly or mainly for children about their physical, emotional, or educational wellbeing and they do this on more than three days in a 30-day period, then they are in regulated activity with children. Ordinarily, this gives eligibility for an Enhanced DBS check with a check of the Children’s Barred List however, self-employed people can’t apply for this level of check themselves; there needs to be someone making a suitability decision on them who can request the check.
Please remember that if you are treating a child under the age of 16: • you must gain the consent of the parent or legally authorised guardian • a parent or legally authorised guardian must be present for the whole treatment Please also bear in mind the relevant sections of the Code of Professional Conduct which are as follows:
We are sometimes approached by members for advice regarding Disclosure and Barring Service (DBS) checks and whether practitioners are required by law to have one. Given the sensitivity around this issue, we thought that all members might find it useful to read here about the information we recently received from the Disclosure and Barring Service (DBS) regarding who needs a DBS check.
Reminder of BAcC rules
Section 33 If you do treat a child under the age of 16, a parent or legally authorised guardian must be present in the treatment room throughout the whole of the examination and treatment. No other person may perform this role without the explicit written consent of the parent or legally authorised guardian.
If the other parent does not wish their child to have treatment, then legally they would need to obtain a Prohibited Steps Order from the court to prevent it fromHowever,happening.inpractice, continuing with a treatment that is expressly against the wishes of one of the parents is likely to create friction within the family and distress to the child. In such cases, you may wish to consider delaying treatment until the dispute has been Carolineresolved.Jones 〉 c.jones@acupuncture.org.ukHannahBowie-Carlin h.bowie-carlin@acupuncture.org.uk
DBS check: yes or no?
a
on
behalf
‘This requirement is set out in the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 which states in several places “any question asked by or on behalf of any person, in the course of the duties of his office or employment, in order to assess the suitability of…” and then lists the professions, offices, employments & work that are eligible to receive unspent criminal record information.’
The information above from the DBS suggests that a self-employed practitioner not only does not need a DBS check but would not be able to obtain one for themselves. If you are employed, you can ask your employer to obtain one for you.
Worried about whether you need DBS check? Hannah Bowie-Carlin and Caroline Jones have been asking questions your
Clarification from the DBS Following some extensive correspondence with the DBS, Hannah has received the following useful response.
On the back of this latest update from the DBS, Caroline thought it seemed like a good opportunity to remind members about the BAcC rules relating to the treatment of children under 16.
Section 32 You must also be aware that the refusal of treatment by a child under the age of 16 may carry legal force and override the consent, even though properly given, of a legally authorised adult. If you are in any doubt, you must contact the Council or seek legal advice before you perform any treatment.
Separated parents & parental responsibility
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‘As far as DBS is concerned there is no legal requirement for someone to get a DBS check – the legislation and our guidance sets out when there is eligibility for the different levels of checks, but doesn’t state that they must be obtained. It’s down to the organisation making the suitability decision to decide whether a DBS check is required.
Section 31 You must seek the consent of a parent or guardian if the patient is under the age of 16. In the absence of such consent, you must not offer treatment.
CarolineJonesProfessionalConductOfficer HannahBowie-CarlinMember&SafePracticeOfficer
If separated parents do not agree on the issue of their child’s treatment, this can sometimes cause problems. Any parent whose name appears on the birth certificate of a child born in England, Wales or Northern Ireland has 'Parental Responsibility'. This means they can give consent for treatment. It is not necessary to obtain the consent of the other parent. (This only applies in Scotland for births from 4 May 2006, but there are other ways of obtaining parental responsibility.)
12 Practice Acu. | Issue #36 | Autumn 2022
of the brain matter determined the point location from then onwards.
Jiao Shunfa, regarded as the founder of SA in China, developed a needling technique which combined TCA with western medical knowledge of the brain and was published in 1971. Shunfa treated areas of the cerebral cortex which correspond to motor and sensory functions as well as balance areas and sight. Also notable amongst other SA founders active in China during 1960s and ‘70s were Tang Songyan, whose head acupuncture is based on the location of the function of the cerebral cortex in combination with the TCM theory of zang fu organs, and Fang Yunpeng, who developed a style by superimposing pictures of the spine and the human body in a prone position on the scalp.
A form of acupuncture performed directly on the scalp was first described in the Huang Di Nei Jing Ling Shu (100-300 BCE). But the actual term scalp acupuncture refers to a different technique – a relatively recent development initiated by the rise of neurological and psychological diseases from the 1950s onward. Scalp acupuncture (SA) is a method in which needles are inserted in the scalp only, as opposed to traditional Chinese acupuncture (TCA) which as we know, works on the whole body and its channels by using local as well as distal points to regulate disorders of a respective organsystem or to connect to other channels.
It was through my work as a contemporary artist and through personal experience of neurological disease that my attention was first brought to the disabilities and limitations and the feeling of powerlessness which arise when the body and brain malfunction.
In order to treat conditions of the brain, needling the scalp has been mentioned since the beginning of TCM. It was said that during the fifth century BCE, Bian Que cured a patient from suffering shī jué 尸厥 (false death or false consciousness) simply by needling the acupuncture point DU 20 bai hui.
acupunctureScalp as treatment for the brain
JasminReifStudentMember:Essex
A curiosity for the science behind autoimmune disease drew me into a self-directed exploration of medicine, neurology and TCM, which I incorporated in my artistic work.
According to the Huang Di Nei Jing Ling Shu the brain’s transport (opening) is in the upper region at the top of the skull and below DU 16 feng fu. Because the du mai is the only vessel that runs through the brain, it is involved in most SA treatment protocols. Otherwise, all scalp points are located on yang channels. They have been mentioned in the Huang Di Nei Jing Su Wen as part of the fifty-nine piercings located on five lines on the head.
Over time, my desire to explore and understand human health in the real world grew until it led me to the City College of Acupuncture London in 2019. My focus has remained on the treatment of neurological diseases. This encouraged me to research into the history of scalp acupuncture, a technique that focuses especially on treating disorders of the nervous system and the brain. Now at the end of my degree, I would like to share a little of what I’ve discovered along the way.
Although shī jué is not a common expression in modern Chinese the literal (modern) translations of the characters are shi: corpse/remains, and jue: lose consciousness/fall into a coma/faint.
Around the same time, Toshikatsu Yamamoto established a different form of SA in Japan by inventing a microsystem of points located on the forehead. He presented his system at Ryodoraku Congress in Osaka, Japan in
A fascination with the brain-body response to chronic stress took recent graduate Jasmin Reif beyond her first profession and deep into the history of scalp acupuncture
In TCM the brain is seen as an extraordinary organ, the sea of marrow. It is not part of the zang fu, all of which have their respective channels – the brain has no such specific channel.
Defining terms
13PracticeAcu. | Issue #36 | Autumn 2022
More recent developments
In 1991 the World Health Organization (WHO) published A Proposed Standard International Acupuncture Nomenclature which included 14 official scalp acupuncture lines. Then in 2011 Jason Jinshun Hao and Linda Lingzhi Hao published their book Chinese Scalp Acupuncture in which they adopt Shunfa Jiao’s style.
Some functions of TCM points are not included in SA, such as the transport points, apart from DU 16 feng fu. Distal points and shu, mu and element points are also not part of SA. Needles are inserted locally, over the corresponding motor and sensory region of the brain, to stimulate its structureTraditionalunderneath.channeltheory cannot be applied to SA, which leaves the impression of a reduction in functionality regarding TCM-concepts.
In Acupuncture for Brain, Tianjun Wang defines lines, zones and areas on the scalp which can be needled.
The use of points on the head in TA is explicitly mentioned in the Huang Di Nei Jing Ling Shu as an alternative location to treat severe acute headache, if the condition cannot be cured via transport openings. It suggests that in such cases it is possible to apply a local piercing. The only other mention in the traditional literature of the sole use of head points is in the treatment of malaria described in the Su Wen.
Influenced by neuroanatomy and western medical approaches, Chinese SA offers a method to directly influence the brain and is widely used for neurological diseases, psychological disorders and pain related conditions such as headache, dizziness, dimness of vision, hemiplegia, epilepsy, loss of speech, mania, spasm, MS, Parkinson’s, ischaemic stroke, and mental problems such as depression and anxiety. Similarly, the indications for Japanese YNSA include all acute pain conditions and neurological diseases.
1973 when he introduced it as Yamamoto New Scalp Acupuncture (YNSA) – a microsystem which uses somatotopebased acupuncture points. These basic points and ypsilon points represent the whole body and correspond ipsilaterally to regions of the body and to internal organs, just as in traditional acupuncture (TA).
SA is therefore not strictly a classic acupuncture. It is the amalgamation of TA and western medical knowledge which proves to be an effective technique to treat neurological and psychological disorders of the brain.
In 1972, the SA technique Xing Nao Kai Qiao (XNKQ) – translated as Awakening the Brain and Opening the Orifices – was invented by Xuemin Shi and has mainly been used for the treatment of ischaemic stroke. Also developed in the 1970s, in America, was a new style by Zhu Minqing. A book on his methods was published in 1992 in which he describes DU 20 bai hui as the basis for all SA points.
Ten years later in 2021, Xuemin Shi’s former student Tianjun Wang published his book on a new concept of SA in which he includes new protocols and new disease patterns such as deficiency of brain marrow, brain yang qi and disorder of brain shen.
In a nutshell
A line is further divided into portions which correspond to the anatomic brain area underneath. He describes the lines running laterally from the midline of the scalp (du mai) to the temporal region where the superciliooccipital line meets the hairline. With DU 20 bai hui used as the midpoint, the motor area runs 0.5 cm posterior to the midpoint. (Other than in TCM, SA measures in cm instead of cun.)
Yamamoto developed new point categories on the forehead, along the hairline and at the temples, by palpating the most tender points on the head as well as diagnostic points on the neck.
Practical applications
Scalp acupuncture aims to reinvent the TCM concept of the brain in order to provide treatment for brain related diseases. In modern SA, the du mai is used to treat conditions called dredging governor meridian, regulating shen, duregulating, cerebrovascular-unblocking, etc.
A collective of farms in the region harvests their mugwort leaves from May to August. After removing the stems and roots, they dry the leaves under the sun. Yamasho collects the dried leaves in late August and stores them until processing starts, usually around December. What we saw in the car park must have been some early arrivals.
I’ve always been curious about how moxa is made, and the relationship between the manufacturing process and the processes of applying it, as described by Stephen Birch above. In August 2018, together with my long-suffering assistant Ryo Izawa I took an overnight bus from Tokyo to Nagahama, in Shiga Prefecture. We were on our way to visit the Yamasho moxa factory, something I’d long wanted to do. The bus was unlike anything I’ve seen in the UK, equipped with seats that extended into long couches for comfortable overnight journeys, pillows and blankets included. As the bus pulled into Nagahama in the morning, I awoke from deep sleep to find my deshi looking tired and more than one curious glance from the other passengers. Apparently, Oran Sensei snored.
Nagahama scene two: Oran, in the taxi to Yamasho, saying ‘I’m on the way to Yamasho!’ Nagahama scene fourteen: Ryo, in the taxi, long face, no idea why, not sure we’ll use that scene. By the end of the day, there were many gigabytes of suchSadly,material.orperhaps, happily, I never got around to editing these clips into anything coherent. The project was forgotten until this year, when I visited a moxa showroom in Taiwan, and I was reminded of the Yamasho trip. I decided to review that visit in this article instead.
Stephen Birch (Japanese Acupuncture and Moxibustion – What's So Unique? Oran Kivity, EJOM, 9:2)
‘The Japanese are very good at taking somebody's idea and kind of playing with it to make it better and more functional, so instead of making a round ball of moxa, you make your moxa shape like a grain of rice, so that the contact point on the skin is much smaller… and you don't roll it hard, you roll it softly, so it burns slowly, it's moulded softly to shape, so when it burns down – yes there's a pinch of heat, but it's not the same kind of burning sensation or really, really hot sensations.’
In a high state of excitement, I filmed every step of the day. Nagahama scene one: Oran, getting into the taxi.
Unity of purpose: moxa production in Japan… … or how does moxa get like
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Drying We were greeted at the factory by Miki-san, the floor manager. With Ryo translating, I learned that the factory is not where the moxa is grown or harvested. It looks pretty much like any other industrial building, except that parts of the car park were covered in plastic sheets on which lay heaps of mugwort leaves, drying in the sun.
Oranthat?KivityAcupuncturist&Author:Kaohsiung, Taiwan
• The floss contains impurities and many small particles of powdered leaves.
In fact, all this sifting produces a lot of waste products. Previously these were discarded, but Yamasho is researching how to recycle some of the waste in various goods such as pet products, insect repellent and as fibre for various industries.
The base of the moxa cone is narrow, reducing its surface area to deliver less heat. As we have seen, the moxa wool is super-refined so that it burns at a lower temperature. Thus, minimal stimulation is emphasised at all stages, starting even at the manufacturing process, and continuing to the rolling technique and even the shape of the cone. Visiting Yamasho opened my eyes to this wonderful unity of purpose.
Oranyoutu.be/D44d9AS_LtkKivitytrainedinEurope, China, and Japan. He has been in continuous practice since 1987, specialising in Japanese acupuncture and moxibustion methods and teaching internationally.
He has written four books about Ontake Warm Bamboo, a new moxibustion tool from Japan. Oran now practises, writes, coaches and teaches from the southern port town of Kaohsiung in Taiwan, where he lives happily by a river, near a lake and close to the sea.
Oran Kivity 〉 orankivity.com
Sifting Fascinating fact: almost none of the leaf that you see at the beginning of the process ends up in the final superpure moxa wool. What Yamasho want for that refined product is the tiny hairs at the bottom of the leaves. The stems and the spongy bits of the leaf are discarded. To do this, they use a rotary sifting machine called the nagadoshi. This is like a giant sieve.
Acknowledgments
• It can also be used for large cone moxibustion (chinetsukyu) or Ontake warm bamboo moxibustion.
• It burns at a relatively high temperature, so it is used with indirect moxa procedures such as on garlic, or in a moxa box. This is also what is used in Yamasho’s platform moxa cones.
Finest grade
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• In the UK, the most well-known of these is Yamasho’s wakukusa medium grade moxa.
Medium grade • This is a slightly lighter, green colour. Although there are still some impurities and leafy particulate matter, it comprises much more of the downy hairs on the underside of the leaves.
Unity of purpose: minimal stimulation at all stages It’s always a fascinating experience to see the steps in the production of something you love. Moxibustion is so much part of our professional lives, but I had no idea how it is made or how it ends up looking the way it does. As with so many Japanese processes, much thought and refinement has gone into all its stages. Dosage is a key component of Japanese acupuncture and moxibustion. Dr Manaka, the renowned 20th century Japanese acupuncturist, described this as getting maximum results with minimum intervention. Japanese okyu encapsulates this. The rolling method is very light, so that the moxa wool is not compressed, resulting in less heat.
December is the winter in Japan, and quite dry. Even after baking in the sun, the leaves are not yet dry enough, so they are processed further in a custommade drying room. Imagine a room with many metal shelves stacked with wire trays of leaves. Now add an industrial fan heater at one end blowing hot air at 100°F, and you get the picture.
This article was based on our interviews, and also used English language material from the Yamasho website at www.moxa.net I’m very grateful to Hiroshi Enomoto at Sankei acupuncture suppliers in Tokyo, who arranged our tour with a single phone call to Yamasho, and to Miki san, who took time out from his work to show us around and indulge my YouTube aspirations. And, of course to Ryo, who organised the transport, led me there and translated. Writing this article gave me the motivation to complete the video project. You can join me on a virtual tour of Yamasho here 〉
• It’s so refined that there’s no part of the leaf left in there. It is composed solely of the hairs on the underside of the leaves.
• It burns at a relatively low temperature, particularly if you roll your tiny cones very loosely. It’s a rookie mistake to roll them tightly.
• This moxa wool is easy to shape and thus can be used on the handle of the needle (kyutoshin). It still burns at a relatively high temperature, though cooler than the Chinese equivalent technique, which used segments of a moxa stick (wenzhen). This radiant heat is useful when used on the end of the needle.
Grades of moxa Yamasho is a traditional manufacturer of moxa. They’ve been around since 1895 and make three general grades of moxa: Relatively coarse • The colour is a darker green.
To make Yamasho’s superpure moxa, suitable for direct moxibustion with rice grain sized cones, this floss needs to be refined even further with another machine called the tomi. After several hours of this, the sifted floss turns from green to yellow. Miki san told us that it takes 100 kg of moxa leaf to make 4 kg of pure moxa wool. That’s a lot of refinement!
• The more yellow the moxa, the more refined it is. My little 100 g box of the best quality wool cost me nearly £100, but to give you some perspective, I’m still rolling tiny half-rice grain sized cones from it, four years on.
Milling Although Yamasho has modernised since 1895, you can see their methods are definitely traditional. All the milling machines are electric, but they still use giant millstones. The leaves are put through a series of three mills, grinding them coarsely at first, and then progressively to the required quality. Each millstone has different patterns of grooves.
16 Practice Acu. | Issue #36 | Autumn 2022
When my mentor/supervisor, the inimitable Sally Blades, said in a session that it sounded like I was transitioning, I had to laugh. ‘Into retirement’, she added. She was right. Looking back, I could see that the process had already begun. I had started to think about… stopping. I suspect that for many of us, the very idea of not practising acupuncture – of not being an acupuncturist – can seem almost shocking. After all, the process of becoming one has probably been quite a struggle: we may have juggled work, family, finances, logistics. We’ve familiarised ourselves with, in many cases, a way of thinking about health, medicine, the body, and the world, to which we were not originally accustomed.Forsomeof us, the job of acupuncturist is a second career, possibly hard won, and therefore all the more precious. I remember, on receiving my licentiate, saying that it meant more to me than my first degree. I was probably a little over-excited at the time! But the practice of East Asian medicine has been fascinating and deeply satisfying emotionally, spiritually, intellectually, even financially. My deep dive into its concepts, and the process of meeting and treating a huge gamut of people, have changed me in a most profound way. But it has not all been a bed of roses. I burned out several time in my career, which I’ve written about in Acu. Each time, I took a break, got support, and reframed my practice. I came to recognise the warning signs. I knew I had started to lose perspective (a classic indicator of stress) if I marched out of the treatment room saying ‘I wish they’d turn up, give me the money, then go away and leave me alone’. Reaching my 60th birthday would in other times have potentially provided a moment to review my working life, but for so many of us this moment came and went with the change in the pension age. Subconsciously, some internal clock was counting down to that date, and I realised that I had always planned to do something different when I reached the big 6-0. Reduce my working hours? Study herbs? Travel more? (For the record, I do appreciate that the whole idea of expecting something like a state pension may be laughable to younger members. Anyway, I plodded on, and was thinking about a sabbatical when the pandemic struck. During the six months in which we were unable to work, I helped run a local foodbank and wrote 20,000 words of a memoir. Another positive effect of the lockdown – as well as giving me a break from treating – was that when it lifted, I finally left the clinic that I had worked at and complained about for 20 years and began working exclusively from my treatment room at home. I was glad to get back to treating, in spite of all the restrictions. But the six months away from practising acupuncture allowed me to see that there might be another way of being. Prior to that I could never envisage life as anything else.
CaroleParkerMember:IsleofWight
beThestoptoOnes:wordsstatethenrequiredconcentrationtodiagnoseandtreathasleftmeinabestexpressedintheofNeilinTheYoung‘Mybrainhurts’.Butitstillwasn’tclearmethatIwantedtoworkcompletely.answerseemedtoarealsabbatical.I decided that I would take a break for six months in six months’ time. Then I started to panic. And it wasn’t about money. What would I do if I wasn’t practising acupuncture? Who would I be? I found myself having moments of anxiety, then depression. I don’t think it’s unusual for those facing retirement to have an identity crisis. I’m sure it’s especially difficult if you have been working full time for the standard 40 years then stop abruptly. My own father had a heart attack as a result. We know what shock can do to the qi of the heart. When he stopped work, I remember my mother saying that he couldn’t cope with having no-one to boss around anymore. But I was different from my dad. So why was I getting so bent out of shape at the thought of not being an acupuncturist, especially as it seemed that I was sick and tired of it? It’s true that I had been very bound up in my work. Apart from carrying out acupuncture, shiatsu and massage treatments, I had been to Beijing to gain clinical experience in a Chinese hospital. I had run a regional support group for ten years. I had taught at an acupuncture college. I had sat on an ethics panel for the BAcC. I remember telling friends that being a traditional acupuncturist suited me: it seemed to be a very full expression of my personality. But would there be any of me left when I stopped? On reflection, I began to suspect that when I ceased to focus on other people and their issues, my own would come swiftly to the fore. Yet after 30 years as a complementary therapist I was tired of hearing about other people’s problems. However, when I contemplated a future without acupuncture it started to look empty, and I began to wonder why. If treating was leaving me so drained that I barely had any energy left for my very absorbing leisure activities, what was so difficult about stopping? I referenced
I continued working, reaching my 66th birthday safely without the government moving the pension goalposts again, which allowed me to reduce my working days to two a week. But something had changed. One day I found myself dealing with an exceptionally demanding patient, and unlike other times when this had happened, I felt I simply couldn’t cope. We’ve all had patients, or days like that: the ones that leave you craving a stiff drink. However, this time the negative effects had not abated when I went back to work the following week. Put simply, I felt that I’d had enough. In a mentoring session, I found myself saying ‘I want to be free’. Oddly, I didn’t want to stop doing courses, or reading about East Asian medicine, I just wanted to stop seeing patients. To use the vernacular, I was ‘peopled out’. I suspect that this may be a more common occurrence for some practitioners than others, reflecting the kind of training they’ve received. For me, hearing about patients’ complaints has left me empty of empathy. The intense
The autumn leaves…
I'm over here building a wonderful relationship with my client, and you want me to put some ugly legal wording in front of them? I might as well throw my wine all over my date! It's not the sexiest conversation. But it doesn't have to be quite that bad. Just build it into your client intake process. Share your terms with your client when they book – (a website link or an email attachment). And make sure you have a record of their agreement - – a tick box, an email reply, or a signature on paper. No tech sorcery needed. But my clients are lovely people. Surely, I don't need all that mean legal stuff. I'm sure they are. However, in any given year, 32 per cent of UK small businesses will have a serious legal issue (significant enough to distract from the day to day). And the average cost? It's £3,410!
Please don’t tell me this is some new BAcC regulation! Absolutely not! Just some friendly advice from a lawyer who likes to work with small businesses.
Terms & conditions
But isn't that stuff for boring corporate people in stuffy suits? Nope. Every business needs terms & conditions. They set out how ‘you’ do business, your expectations, and what your clients can expect from you! You're more than an acupuncturist. You are an entrepreneur. And as a business owner, you need to protect your profit and your peace of mind, so you can focus on what you love.
But I'm an acupuncturist, not a plastic surgeon. I don't have a bazillion £££ to spend on those humongous hourly rates! Listen, if someone is charging in bazillions, they clearly have no understanding of small businesses – so run away! You can absolutely get good legal help at an affordable price.
Ok, so I need terms & conditions. Do I need a refund policy too? As much as you might hate the idea of people asking for refunds, how many times have you checked the refund policy before buying something? Your customers are doing that too. By the way, you're not legally bound to offer a refund – the 14-day ‘cooling off period’ doesn't apply to in-person acupuncture services. However, there are business benefits to offering refunds – and there are many different types of refund policies. Whatever you choose, communicate it clearly. Say my client bought my special offer of ten sessions for the price of eight. He's already had three and now wants to cancel because he's moving to Barbados. Do I refund him? How much?
Well, what do your terms & conditions say? This is exactly why we have legal terms in writing! Much easier to point to a written record and say ‘this is what we agreed’ than negotiate later – even if they didn't read it, they know how it works. Choose whatever approach you want, just make sure you state it clearly up front! If you do find yourself in a situation like this without prior terms, make a fair offer – and if needed, negotiate. And next time, put those terms in place before you sell! Can I charge for no-shows or late cancellations? Absolutely! And saying so in your terms & conditions gives you a legal basis to enforce this. Even so, chasing money is time-consuming, annoying, and expensive. You're far better off taking an up-front deposit (or full payment) and offering a refund for acceptable reasons. But can I say it again –whatever your policy is, make sure you communicate it clearly and get clients to agree to your terms!
You seem to know what you’re talking about. Can I get in touch with you? Sure! I’m happy to offer a free 15-minute consultation to any BAcC member who wants to have a chat about any business related legal stuff.
Just take a look at my website below and/or drop me an email.
Inner Pass Notes as reported by Ama Zbarcea
Ama Zbarcea 〉 onyourownterms.net 〉 team@onyourownterms.net the Karpman Drama Triangle in my article about burnout, and the idea of being a ‘rescuer’ came up in supervision. If you are committed to rescuing people, something that we are at risk of in our line of work, then work can be to some degree a displacement activity. Worse still, it can be a habit or even take on the form of an addiction. So maybe I needed to look more deeply into what scares me about the word ‘retirement’. Was it more than the loss of professional status? It is probably obvious by now that I was going back and forth, if not round in circles. Admitting I was confused was a step in the right direction. And it is a big deal – a life event if ever there was one - because I was not talking about taking a break then resuming normal service. This was ultimately going to be an entire reset, but hopefully a step forward, notOverbackward.aperiod of months and in discussions with mentors, colleagues and family, I think I have managed to get some clarity about what needs to happen. Since acupuncture is all about regulating the system and creating balance – and before you ask, yes, I am having treatment and yes, I do think there’s some phlegm misting my orifices – I am going to take a break and see how I feel. I’m doing a qigong workshop. I’ve bought a kayak. I’ve found two new singing outlets. I’m going to start learning to play a brass instrument. I’m reading How to Retire Happy, Wild and Free by Ernie Zelinski… But I’m pretty sure I’ll be working again, because I love it. Watch this space. The thoughts and ideas contained in this article are a result of the reflective practice training I received as part of my acupuncture, mentoring and supervision trainings. I have a particular interest in supporting newly qualified practitioners and those approaching retirement. For details please contact 〉 carole.acupuncture@hotmail.co.uk
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Preventive action is far more effective than firefighting – and a whole lot less stressful. Be kind to your future self.
Ok, so can I just find some terms & conditions online and use those? Tell me, did you watch a YouTube video and then start sticking needles in people? That might work out… or go disastrously wrong. It takes time to learn what's legally ok. And it's a skill to apply it practically in business – just because someone passed some exams doesn't make them qualified to touch your precious business. Look for real life experience and a proven track record. Just do yourself a favour, save some time and don't try to piece it together all by yourself.
PeterFirebraceBAcCFellow:Denmark
Just my point LU 9
LU 9’s name tai yuan 太 淵is rich in meaning and helpful for us to understand the nature of the point. Tai 太 is great and is applied to many of the yin yuan 原source points, for example KID 3 tai xi 太 溪Great Stream, LIV 3 tai chong 太 衝Great Rushing and SP 3 tai bai 太 白Great White. These are all important deep-acting points. Yuan 淵 shows three drops of water on the left side, indicating the presence of fluids, important for the lung as upper source of water in the body and for the essential nourishment of lung yin. Note that we find further water images in LU 2 yun men 雲 門Cloud Gate, LU 5 chi ze 尺 澤Cubit Marsh and LU 8 經 渠jing qu Meridian Gutter. The lungs cannot function without being properly hydrated. The right side of yuan 淵 shows water swirling between two steep banks. The meaning of yuan 淵 is an abyss or a whirlpool. The philosopher Guanzi says that yuan 淵, the abyss, is one of the five forms of water on
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The traditional view of the lungs was that, as the prime minister beside the sovereign power of the heart, it receives the one hundred mai 脈 vessels in morning audience, both gathering and regulating them. We remember here the lungs as the first meridian in the 12-fold cycle, active at the start of the day, 3 to 5 am, a time when the qi is pure and fresh. I remember once, nearly 40 years ago now, getting up very early in Xian to go and watch people do their qigong exercises. I arrived just before 5 am, in time to see most people, including some particularly sprightly elderly practitioners with swords, packing up and leaving. Initially disappointed, it made me realise the importance
LU 9 works effectively on both heart and lungs. It tonifies the lung qi, frees the lung from oppression and helps the qi to circulate, which helps the blood to move again, thereby refreshing the heart and allowing a reconnection to the brightness and positivity of the shen 神 spirit. Its title of hui 會 reunion point of the mai 脈 vessels points to its power to invigorate circulation and get things moving again. As such it is a point for all circulatory disorders, cold hands, cold feet, varicose veins. It is useful particularly in xu 虛deficient conditions, therefore where there is ongoing weakness and tiredness. It is definitely a point to use for those who do not recover well from respiratory disorders, including influenza or Covid-19, for example with BL 43 gao huang shu 膏 肓 兪, Sun Simiao’s deepacting pick-me-up point in exhaustion.
I don’t know a better point to help a patient cry than LU 9 tai yuan. It seems somehow able to open up a path to a deep pool of unresolved sadness and allow that sadness to be expressed. That is a fantastic quality. Those tears can save many wasted years and even save a life.
LU 9 is a point to remember where grief is the central aspect of the case, whether that is long buried or recent, whether from loss of a loved one through separation or death, whether from loss of personal iden¬¬¬tity through being fired or resigning from work, whether from loss of a home or from financial instability, whether from the spectre of abuse that has haunted and blighted a life. Grief has many causes and many faces, some known and acknowledged, some hidden and locked away. LU 9 gives breath to the breathless, restores qi in those tired, weakened and exhausted, empowers the disempowered. I think in restoring the proper functioning of the lungs, it restores the functioning of the po 魄that are responsible for the automatic, homeostatic, regulatory functioning of the body, seen primarily in deep and uninterrupted breathing, a regular heartbeat and a harmonious digestive system.
LU 9 is in an interesting and important location at the wrist. The area on the radial artery at the cun 寸 inch position, just beside where Lu 9 is located, is known as qi kou 氣 口 , the mouth of the qi. It is here that the qi ‘speaks’ through the pulse where the mai 脈 vessels come to the surface from the depths of the body, allowing the qi to be accessed and assessed in the subtle art of pulse diagnosis. Lu 9 itself gives a link to these depths. The wrist is encircled here by a bracelet of six powerful points, the three yin heavyweight yuan 原source points LU 9 tai yuan 太 淵 Great Abyss, P 7 da ling 大 陵 Big Mound and HT 7 shen men 神 門 Spirit Gate and the three yang points of TH 4 yang chi 陽 池 Yang Pool, LI 5 yang xi 陽 溪 Yang Stream and SI 5 yang gu 陽 谷 Yang Valley. The yang trio are key local points for the strength and flexibility of the wrists, while the three yin points are very effective in emotional disturbance. I often combine LU 9 on one side with P 7 on the other in those going through the difficulties of separation or divorce.
they attached to precise timekeeping as I trudged back to my hotel, a little chastened, a would-be surfer who’d missed the wave.
In Hokusai’s woodblock print, three men prepare a picnic while the Amida waterfall plunges into the abyss below earth and that it never dries up. It is impenetrable, unfathomable, and the precious pearl of knowledge is hidden at the bottom. For the alchemist Ge Hong writing in the Baopuzi, tai yuan 太 淵is the abyss of the north, the hidden origin of life. Daoist texts used tai yuan 太 淵 to express the ascent to the sources of life. ‘To drink at the great abyss, tai yuan 太 淵’ is to swallow the saliva again, to recuperate the refined and essence-laden body fluids in order to regenerate and restore one’s authentic nature. All of these uses of the term tai yuan 太 淵 indicate its profoundly regenerative qualities, something it is important to understand, especially when for us the name Great Abyss may evoke only feelings of danger and uncertainty. LU 9 is the yuan 原source point and the character yuan 淵abyss can be used for yuan 元 source. As a source point it is used when the organ of the lungs is diseased (Lingshu chapter 1). It is the tu 土 earth point and therefore the tonification point, a quality helpful in exhaustion and tiredness, for which it is excellent. Interestingly the fourth century acupuncture points text the Jiayijing lists it as a water point, rather than earth. This is taken to be a scribe’s error, but with all the links with water that we have seen above, it is an interesting one! LU 9 is also called tai quan 太 泉Great Spring, again emphasising its refreshing, restorative, fluid-filled quality. Finally it is also called gui xin鬼 心 Demons or Ghosts in the Heart (in common with P 7 and LU 11). Although not one of Sunsimiao’s 13 gui 鬼 ghost points, LU 9 can also be used for those haunting states of mental and emotional instability, such as a potent mix of deep sadness, fear and fury. Profoundly revitalising to both body and mind, this point heals on several levels, reaching into the depths to restore health.
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Dr Eckman has developed his own method of pulse diagnosis based on Neijing, Nanjing and Maijing (The Pulse Classic). Most of the material contained in this 460-page book will be new to a TCM or five element practitioner. Whether this is exciting or daunting depends on the individual.
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The Compleat Acupuncturist (2014) narrates how the CCA method was developed, while Grasping the Donkey’s Tail (2017) explores the meaning and clinical application of passages from the classical Chinese medical texts.
A whole chapter is devoted to Dr Eckman’s main current interest: diagnosing and treating cancer. It covers, among other topics, the ‘metastatic signal’ detectable in the pulse, and cancer treatment protocol. There are 58 case histories of patients Dr Eckman has treated in San Francisco and in China, where he has been invited to teach several times.
Olga Fedina Acupuncturist: Valencia, Spain If you've been inspired lately – by a book, film, course, podcast, whatever –why not spread your enthusiasm with a review in Acu? Just drop us a line 〉 editor@acupuncture.org.uk
After explaining the concepts of constitution and condition and the mechanisms of qi in the first and second chapter, Dr Eckman lays down the topics for discussion in the rest of the book: What are the natural standards for locating the radial pulses of the 12 organs/officials? (Not what you learned in school.) Does the laterality of treatment points matter, and how can the optimal choice be made? Practically speaking, how does the pulse indicate whether the hand or foot branch of one of the six great meridians is imbalanced? How can one best distinguish an excess from a deficient pulse? Can one detect Akabane imbalances from the pulse?
Summing up the pulse diagnosis, Dr Eckman concludes that ‘at any moment, each person experiences the biggest threat as the target of its innate homeostatic response mechanisms… that we are able to perceive in the pulse patterns that reflect the struggle going on, whether between organism and environment, organism and pathogen, or simply malfunctions of the organism within itself.’ (p 345) This book should inspire acupuncturists seeking to refine their diagnostic and treatment methods and expand their understanding of mechanisms of health and disease.
REVIEW Dr Eckman summarises and shares 50 years’ worth of clinical experience in acupuncture and research into classical Chinese medical texts, distilled into his unique method of diagnosis and treatment: constitutional conditional acupuncture (CCA). His initiation into the world of acupuncture was with Korean practitioners. From the beginning he was exposed to the idea of constitution, fundamental to Korean healing methods. Though he has studied and worked with many teachers, Dr Eckman has remained faithful to and developed further the idea of healing as a return to one’s individual constitutional state of harmony – our original nature. In his words, ‘Ultimately all acupuncture treatment should be based on the Spirit (神 shén), as this aspect of our existence is a fundamental and unchanging part of our original or true nature (Constitution). Remaining in touch with or returning to our true nature is thus the basis for maintaining health and curing disease.’ (p 41) CCA diagnosis involves determining the individual’s constitution. There are 20 constitutions, each corresponding to one of ten zang fu that have a tendency to excess or deficiency. The constitution is the person’s original and lifelong make-up. The next step is to diagnose the present condition, which can be an unbalanced relationship of the constitutional organ with a connected organ through the control cycle or a blockage, perhaps involving an extraordinary vessel. Then the treatment is formulated, mostly using Korean four-needle formulas. In CCA the prime method for diagnosing the patient’s constitution and present condition is the pulse.
Just what is ministerial fire (in the classics), and why is fire included as one of the six climatic factors? How can one clearly distinguish problems due to malfunctions of the extraordinary meridians from those of the regular Meridians? (p 70)
The book does require concentration and perseverance – however, it is fluid, clear and entertaining (as the ‘donkey business’ subtitle playfully suggests). Ideally, the reader should be familiar with the CCA basics. Dr Eckman explains his method in the June 2018 issue of the JCM and his previous books.
Here are some examples of CM pathology study.
Ever stumbled across one of those quackbuster diatribes and noticed a little misinformation and medico-scientific bigotry?
Talking remind us of some nicely relevant arguments he first laid down in a series of four articles in The Acupuncturist. So tell us now, Charlie, what do we need to do to get some
In 326 CE Ge Hong described many diseases. About smallpox, he wrote: ‘The lesions look like burns covered with a white starchy material and whose surface reforms as soon as it is broken. If not treated immediately most people will die, those who survive will be left with purple-black scars.’ Later, Qian Yi (1023-1108) published a detailed account of the symptoms, diagnosis and treatment of chicken pox, measles, scarlet fever and smallpox. Similar discussions of pathology exist for most illnesses. Chao Yuanfang (581-618 CE) wrote a 52-volume text on pathology – On the Causes and Symptoms of Illness – which gave accurate descriptions of 1,732 diseases. On diabetes he wrote: ‘Wasting-thirsting involves unremitting thirst with polyuria, sufferers often have carbuncles and gangrene…. This is a disease with sweet urine that often starts in those who become obese having overindulged in sweet and rich food.’ This description could safely be copied into a modern biomedical text. Centuries after its publication, Chao’s pathology text was translated into Arabic and became part of Avicenna’s medical works which spread to the west and helped found biomedical pathology. Yes! Modern medical pathology is rooted in the work of China’s ancient physicians. So we can challenge the assertion that CM lacks any basis in medical fact and the rational study of pathology. We can drop the naturopaths’ we don’t treat diseases thing. CM pioneered the pathology science and has a long tradition of scholarly study of disease and pathology to partner our energetic Despite decades of work we still have some way to go before we are perceived by many as serious and effective medical professionals. For many we are the wacky brigade. ‘Everyone at work thinks I’m mad coming for acupuncture!’ Ironically, acupuncture can seem more plausible to the medically literate than it does to the Clapham Omnibus Person. But while most doctors know its value for some conditions, fewer seem to like actual acupuncturists – an issue we should ponder on perhaps. We should reflect on ways to improve our act and facilitate the acceptance of traditional acupuncture.
Like you, I’ve asked, Why don’t we DOOO something? The lazy response is to demand that others be more proactive in fighting back, even when the responsibility to explain things might also be embodied through our profession as a whole.
sense about invited&ancientourartscienceCharlesBucktorevisit,reviseand
Sometimes holistic doctrines derived from naturopathy are grafted onto CM. The pitch ‘we don’t treat diseases…’ misrepresents China’s healing traditions. We DO treat diseases and the way we do this is by recognising and treating underlying patterns. The study of symptoms, pathology and disease has always been an integral part of CM. Besides the qi-based explanatory models of health and disease that form one pillar of our practice, China’s physicians also studied the material nature of disease. This work stands up well to modern biomedical scrutiny, even though some was written long ago.
Backward looking Critics say we use oriental nonsense theories and that Chinese medicine (CM) offers no rational concept of disease and pathology. Biomedicine is more ‘real’ as it offers detailed descriptions of pathology. We know this is untrue – but our responses rarely appear robust or connected to a real understanding of the tradition. We maybe need to reflect on the narratives we present.
With this in mind I offer some thoughts on ways that we might have advocacy that presents a compelling picture of our profession, its history, doctrines, efficacy and practices.
Charlesrespect?BuckMember:Cheshire
21InspirationAcu. | Issue #36 | Autumn 2022
22 Inspiration Acu. | Issue #36 | Autumn 2022
enshrined in medical lore. Today your Waitrose lettuce is unlikely to give you dysentery. Ignore critical investigation and we are indeed simply custodians of a fossilised, complacent and sometimes mistaken medical system. A critical outlook surely has greater integrity, it shows that we care about the validity of what we provide to our patients. Politically, a critical mindset makes us less vulnerable to accusations of delusion or backwardness. It might lead to a subtle change in our collective voice, away from ‘the human body has energy channels and a balance of yin and yang…’ to a more tentative ‘healthcare can be modelled in this time-served way and we research this system for the modern world…’. Personally, I believe that what we do is primarily a rational medicine, not a mystical belief system, and that we should seek ways to demonstrate this and, as a profession, to embody this through a culture of criticality.
True Chinese medicine is pragmatic, rational and investigational in spirit. Throughout history it was those who andcontaminationduegotChinainspleenslightlyfoodthoseitconclusionspleenrawthatpublishMedicineresearchshouldobsoletepointthatbranchwasforcriticalitytheydynastychallengesomedevastatingcontributions.someclinicalitestablishedchallengeddoctrinewhenfailedtomatchupwithrealitywhomadeofthegreatestDuringepidemicshadtheaudacitytoclassicalHantheorieswhendidnotwork,puttingaboveblindrespectancientdoctrine;theresultthefoundingofanewofmedicaltheory.Ideaswereimportantatoneinhistorycanbecomeinanother.Weopenlydebateandsuchquestions.TheJournalofChinese(JCM)didonearticleaimedtotestthefoodweakensqiidea.Thewasthatdidn’t;indeed,eatingrawendeduphavingstrongerqi!ProbablyHandynastyuncookedfoodabadreputationto‘nightsoil’thisbecame
Important though it is, characterising what we do in terms of our qi-based models too easily downplays the fact that the tradition included pragmatic study of disease states. We become vulnerable to suggestions that CM is unreal, that we are living in an oriental cloud cuckoo land that provides no rational understanding of disease. But we are not mad acuflakes! In truth, China had plenty of dysentery, smallpox, boils and haemorrhoids and treated things sensibly and seriously. Medical pathology is just as much a part of the historical tradition as all the energetic stuff. Do we also need to reflect on the level of criticality we apply to the tradition we espouse? Grasping a nettle here… could it be that critics have a point when they suggest we have an overly credulous acceptance of ancient ideas? How often do we ask ourselves, is this fact actually true? For all its sins, science accepts that its truths are tentative, always open to challenge and change. In theory at least, biomedicine faces up to the fact that some of its medical teachings are wrong. As the famed Edwardian medical grandee Sir William Osler used to say to his students, ‘By the time you get into practice a half of what you have learned will be proved wrong – we just don’t yet know which half’. How often do we cast a critical eye over our theories? Are the teachings all correct, all of the time? I once conducted a search and failed to find a single formal critical appraisal of acupuncture doctrine in our CM literature in the west! This lays us open to criticism and goes against the spirit of the greatest architects of CM.
It is a well-known and amusing fact in sceptic-world that acupuncture is silly because the ancient Chinese didn’t have a clue about anatomy. But is this true? And even if it were true, how much does it really matter in actual day-to-day medical practice? We really do have to straighten the record on anatomy. It was in the 1840s that anatomy became the main area that western physicians chose to use as evidence of the superiority of their medicine over China’s version. In turn, China’s physicians pointed out that biomedicine’s weakness lay in the scant attention it paid to understanding and regulating function. But the westerners couldn’t see what on earth the Chinese were on about so they assumed it was nonsense. China had a understandingreasonableofanatomy for over 2,000 years but to classical physicians much of that knowledge did not seem crucial. Butchers knew anatomy, also medical tradespeople such as midwives, bonesetters, haemorrhoid experts and battlefield trauma specialists. Aside from Hua Tuo’s alleged surgical exploits circa CE 200, the messy giblet stuff was not the domain of the silkclad classical physician. You could always call on the haemorrhoid specialists, or midwives, and if you needed wounds drained of pus you could see a specialist sores doctor. Unfortunately, their knowledge has mostly been lost, having been entrusted to the less literate professions. will struggle to evidencereferencedebaterationalpeopleinfluenceviaandbytothe
We
Questions of anatomy
Portrait of Ge Hong: woodcut attributed to a Tang dynasty (618-907) creator, Gan Bozong
The reason this issue became the chosen battleground in the 1840s was because at that moment in history anatomy was perhaps the single area where biomedicine was demonstrably superior. But while admittedly the Chinese texts lacked the precision of the later European anatomists, anatomy is not everything; the most crucial measures of a medicine are clinical safety and efficacy. Ironically, in terms of therapeutics, at that time Chinese medicine was superior to its western counterpart and its treatments hold up well in contrast to those of western medicine, most of which would be considered ineffective or dangerous today. Western anatomy may have been obsessively detailed but it was not If CM advocacy is to succeed we need to understand how beliefs are formed. We need to learn how to influence beliefs. We need to recognise that our pre-existing gut-level beliefs are much stronger than facts in determining how we process information.
Beliefs can trigger emotional responses in milliseconds, they can kick in so quickly that we have responded before we are even aware of it. OK, we might weigh things up analytically too, but this comes later, works slower, and even then, our emotions colour things. Reflex emotional responses set us on a course of thinking that's highly biased, especially on topics we feel strongly about. You may have noticed that some people actually get cross when they hear what we do!
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Beliefs are often revealed when people say things like A means B, or X is Y. We mostly learn these beliefs without noticing but we then have a deep sense that they are true: such beliefs profoundly bias even what we consider our most rational conclusions and our ability to interpret facts. People often have strong beliefs about acupuncture, views that are rarely altered by the supply of facts! We imagine people will be convinced by facts – but in reality, supplying facts seems to make people even more entrenched in their existing views. Understanding this particular fact is crucial in smoothing our progress into mainstream healthcare in the West. Even intelligent people in positions of influence suffer from belief bias.
All this means that we will struggle to influence people via rational debate and by reference to the evidence. Simply doing more and better research doesn't change things as much as we might expect. Modern medicine is a belief system, firmly wedded to its own ingrained mythologies and is not especially amenable to change.
Pitching to those who value hierarchies, we can use authorities. For those who value science we have to invoke influencers whose science credentials count for something. For those who dislike the otherness of CM we should adjust our use of language to prevent prejudicial belief hackles being too easily Conservativeraised.thinkers and policymakers will embrace CM more easily if information comes via credible or charismatic authorities who can set things in the context of different values from those normally espoused by alternative therapists. Politicians need to hear messages from those they give social proof to, such as bigger politicians or economists.
Our unconscious beliefs set links to our sense of self, alien ideas can feel like they threaten our very identity so our first instinct is to reject. We resist belief change even when the facts say otherwise. And so our advocacy must do more than just tell people stuff.
Anyway, for much of history the biggest concerns were lifethreatening epidemics; having names for all the body’s bits of gristle doesn’t help much there. Still, it is reasonable to say that for two millennia China’s understanding of anatomy has exceeded that of the West. The Mawangdui manuscripts (168 BCE) named some neck muscles: muscle translation probably heng yang enduring yang sacrospinalis ce yang slanted-lateral yang trapezius ce yin slanted yin scalenes qian yin front yin sternocleidomastoid
To succeed in our moves toward fuller recognition, and respect, I suggest we need to reconsider our approach, both collective and individual. We have to make a strong coherent and persuasive case to our patients, on our websites and also at a national level. We must also box clever in understanding the way belief change happens. Only then can we communicate the true extent of the tradition more accurately, have proper criticality, and convey effectively the profound wisdom to be found in the traditional explanatory model.
So what’s our strategy?
It dawned on me a while ago that the ultimate function of research is to alter beliefs. If we do research and beliefs remain unchanged then the research has failed – we have wasted our time and money. Our profession has literally billions of euros worth of research in print but the impact has been lacking. If we want evidence to be influential it has to be presented in ways that don't trigger contrarian emotional reactions and should be framed to resonate with the recipient’s mindset, outlook and beliefs.
I’m not talking here about religious faiths but cognitive science of belief, the way that our minds create simple rules to help us function in the world.
Challenge beliefs and associations come to mind – instantly we recall ideas that match our existing beliefs and we formulate arguments to challenge the threatening idea. We imagine we are thinking objectively, whereas actually we are just solidifying our existing prejudices, perhaps by giving greater weight to evidence that supports our beliefs and debunking arguments that challenge these beliefs.
In science, peer review tries to tackle this problem by subjecting new ideas to a quality control process so the best ideas can prevail through consensus. Unfortunately, peer reviewers are just as prone to belief biases as anybody else. Experts and the public alike are unduly influenced by those perceived as having status, gravitas, charisma and fame. Even scientific truth is not really truth but a current consensus arrived at through belief processes that we have only a vague awareness of. Scientific truth is not really truth but rather a special form of mythology, the outcome of a Darwinian struggle between the beliefs of individual scientists. Long-time CAM critic Edzard Ernst showed us this. He wrote two versions of a clinical trial of a slimming treatment. The text was identical except that in one paper the treatment was a chemical and in the other it was described as a herb extract. Submitting the two versions for peer review to journals worldwide he found that the herb version was five times more likely to be rejected by the peer reviewers. Judgement of the quality of the science was strongly influenced by subconscious belief-based biases, in this case that a chemical product is inherently more scientifically valid than a herb product. The reader too brings personal belief biases to the reading process. So, the ‘scientific consensus’ is fatally flawed by human nature.
There are also records of formal human dissection in the Han dynasty and the Neijing often mentions the internal organs. This extract from Wang Mang’s biography may have been a source of the Neijing descriptions of the digestive tract and of blood circulation: ‘[in 206 BCE] After Wang Sunjing was captured in battle the Emperor ordered that his body be dissected by a butcher and a court physician. His internal organs were measured and the course of the blood vessels traced using a strip of bamboo. This was done to improve the treatment of Anatomicaldisease.’knowledge advanced in Song dynasty works – the Chart of Mr Ou Xifan’s Organs was published in 1045, then the Collected Truths Chart based on the dissections of 55 cadavers. Another more accurate text based on new dissections was published by Yang Jie in 1113 and gave a reasonable account of internal human anatomy.
Our new home was chosen mostly for its beautiful 100-year-old greenhouse in the garden, with a grapevine just as old. I immediately dreamt of converting it to a treatment space – everyone looked sideways when I suggested it and thought I was mad! How much would it cost? How would I regulate the temperature? How would I restore and maintain the integrity of the structure without ruining it? Also, silly niggles like how will I keep the bugs at bay? And was it a shame not to keep this beautiful space as a place to continue growing plants…? After my maternity leave I had no funds to renovate the garden space. I began working in a clinic for the first time since starting to practice. Everything about renting and sharing space was not for me. Regardless, I did my time, got my head down and worked seven long days a week, until eventually I raised the funds – in large helped by a Crowdfunder supported by my patients – to make the garden space a reality! I used to sit in the greenhouse drinking tea imagining that I would one day welcome patients here. They too would experience the magic of sitting under the grapevine and vibrate with the energy of the most well-thoughtout garden that the previous owners invested with so much love – a garden designed not only to look beautiful but also to support the community of wildlife who depend on it and flourish here. When I dreamed of this space becoming a clinic, my mind wondered around what I would want most when visiting a place to recover my health or seek refuge and support from the stress of my burdens and responsibilities – and I aimed to create that. I wanted my patients to see and feel the consideration, thought and love I poured into this space. I wanted them to feel like this was their soft place to land so they could claim this space as theirs, to deepen a sense of presence andFromvalidation.themoment they arrive it’s zero hassle. Parking their car and accessing the space is never an issue. A switchedon business mind notices everything a patient might and attends to each detail. When they arrive at the gate they can see the well-cared-for plants and feel that care will be extended to them.
I wondered if, when lying with the needles in looking up at the sky, following clouds with their eyes, it would help to lift them out of their
My roomtreatmentFionaSwinburneMember:Tyne&Wear 24 Inspiration Acu. | Issue #36 | Autumn 2022
I also deliberately invested in things some people may not notice but they will feel, such as an elegant, solidly crafted door handle to open the large gate. There is an element of creating an experience for my patients at different levels so they can feel this is going to be something for them. This comes from a genuine desire to create a sanctuary, it’s not just a business strategy.
I began my acupuncture practice from home ten years ago and enjoyed everything working from home afforded me – lifestyle, balance and getting to work in a space I could completely relax in. Fast forward a few years to increasing my clan whilst simultaneously moving to a smaller home, and the reality of working from inside my home was no longer appealing.
On arrival, the path is lined with such tall Yew trees that they encourage you to look up, automatically causing you to inhale. The path then opens up to an expansive view of the garden and what I now call the garden sanctuary. No longer a greenhouse growing plants but a garden sanctuary supporting growth in other ways. When planning this space I wondered if just arriving for treatment at this space could begin the process of downregulating the jangled nervous systems of my busy, stressed patients – even before any needles get administered. I wondered if people would look up and out at the garden and breathe with the plants around them, feel their spirit and connect with the elements to help them connect with themselves.
classicThe difficultiesof Guiltiest pleasure
The Big Cowboy Day (starring my son)
Actually this might be my fantasy parliamentary cabinet
medicine as the garden is always right there as the ultimate guide. And I have no doubt working in nature has inspired me as a practitioner to deepen my own connection with some universal wisdom and truths.
He who laughs last has only just seen the joke
Favourite limerick –There was a young man from Japan Whose limericks didn't quite span When told this was so, He said ‘yes, I know, But I like to fit as many words in the last line as I can’ Mark Popplewell Member: West Yorkshire
One bed or multibed? One's enough these days What’s your animal? Cats, cats and more cats What has life taught you? Tai chi really pays off in the long run –still agile at 65 Tell us a joke I regret rubbing ketchup in my eyes, but that’s Heinz sight What question do you wish you had been asked?
25InspirationAcu. | Issue #36 | Autumn 2022
A game of chess on the computer when I'm supposed to be working Desert island disc Aladdin Sane by David Bowie Desert island film
tobecomespatients.myIteasyreachformetaphorstoguideonthewisdomandphilosophyofChinese
Of course, it’s not all been sunshine, rainbows and flowers. This project took me to my limits and getting here has been at times relentless. No builder or craftsman was willing to give me a finished price on this project, so I had to find the faith and courage to begin regardless. But I always believed in my vision, even when returning to the space – in bitter winter temperatures after a long week of twelve-hour days in clinic – to find it two feet underwater!Evenwhile wondering why I took the hard path I could still see that it had to happen. It went way over budget – and there were lots of tears – but it was all worth it. Every single day I am thankful to share this space with my patients.
What’s your diagnosis? Tea deficiency (best treated with herbs, especially Camellia Sinensis)
Russell Brand, Dale Vince, Jeremy Corbyn, Colin Turner (Let's make everything FREE!)
soothingwouldIfbreathingtheirmindsthinking-doingandintoliving,bodies.onlybriefly,thatbeenough.Iwonderedifthesoundofthe
I wondered if walking barefoot in the garden, feeling Mother Earth beneath their feet would remind them that they are always supported, always have been and always will be.
Favourite proverb
I wondered if they would notice that even when the sky is rather unremarkable, grey or stormy, that it’s always changing and moving. And although everything in this space was well thought out and planned meticulously, the true calling and magic of working here comes from Mother Nature herself. Over anything else, that’s what I draw most on when in clinic. It’s what speaks the deepest to my most disconnected of patients. They may love the building but many are moved to just look at the garden. So aside from the aesthetic beauty of this structure with all of its original features and decor, it’s more of a sensual experience to work here, for me as well as
rain sliding down the glass would feel like a warm embrace and if they would connect with the spirit of water for its ability to cleanse and begin again.
If you weren’t an acupuncturist what would you be doing? I would be a writer – I've managed to write two books so far Superpower of choice ‘It is said a Shaolin priest can walk through walls. Looked for, he cannot be seen’ Sounds ok to me A one-way ticket to… There's no place like home! Which word/phrase do you overuse?
youtu.be/cXD92MmgUew Hero/heroine Jackie Chan and Zhang Ziyi
Both have made lots of movies but they meet in Rush Hour 2
Put t' kettle on What do you see when you turn out the light? You don't want to know, but I wrote about it in my novel Fantasy dinner party guests
Learning Towards the end of my training my supervisor sat with me when I saw a patient for the first time. He then made a diagnosis and wrote down
A great deal of what I know as a practitioner comes from my experience as a patient. Over a period of almost forty years I have had the enormously good fortune to have been treated by wonderful practitioners so I have paid close attention to how they work and to the effects of their treatments. Practically every aspect of acupuncture has been illuminated, but here I will restrict myself to diagnosis and in particular to a few aspects of diagnosis which are often overlooked or misunderstood.Onepractitioner only ever used one kind of diagnosis, which was to discover the patient's 'causative factor'. According to this theory every patient's causative factor was one of the five elements, wood, fire, earth, metal or water, and any treatment should be largely, if not exclusively, confined to that element. That is, an earth person should be treated using points on the stomach and spleen channels, a wood person using points on liver and gall bladder, and so on. If the practitioner did so, the theory continued, then the patient would get better; and if not then they wouldn't.
I was treated for some years as an earth causative factor. It was terrific. My chronic bronchitis disappeared, I became more robust, and I started to make all kinds of important changes in my life. Then one day my practitioner said that she wanted me to have a consultation with JR Worsley in order to get his diagnosis. I did so, and he came to the conclusion that I was fire instead. So instead of stomach and spleen points she started to use fire points – and my treatments were never as effective from then on. I could only think of two possible conclusions to draw. Either he was wrong, which both he and she stoutly denied, or the theory was inadequate. Speaking as a practitioner that was hugely liberating. It helped me to regard all theories and all methods of diagnosis as only partially true. Time after time that has stopped me from doing a treatment suggested by a textbook diagnosis when the clear evidence from the patient pointed to something else. I applied this insight to TCM diagnoses as well. For example, in one week I had two new patients with severe headaches. According to Giovanni Maciocia's magisterial book there are nine causes of headaches, nine possible diagnoses. I tried to fit these patients into one of the nine categories – and I really did try because it would have been so reassuring to have been able to rely on his wisdom and experience – but neither of them would fit however hard I pushed and shoved. Thanks to my experience as a patient I had the confidence to be flexible as a practitioner and trust my own diagnoses.
the points I should use for each of the first five treatments, including the order in which I was to do them, the needle technique and the number of moxa I was to use. Even then I thought it showed the most extraordinary confidence in his diagnosis. Would it really be wise to continue if the patient had a bad response to the second treatment? And if the patient reported no change at all after three treatments was it not an indication that the diagnosis needed to be reviewed? This experience made me pay close attention to what another practitioner was doing when she treated me, and the difference was startling. For one thing she took my pulses after practically every point. Clearly she was using them to get feedback. If the pulses improved then she would work quickly, but sometimes, I noticed, she paused and reconsidered; typically going back to her desk, muttering and scribbling, as she tried to work out what was going on. In other words she was checking her diagnosis during the course of each treatment. I was stunned. Not only because of the contrast with my supervisor's approach but also by the contrast with my previous job, which had involved the management of long term projects when it would often take four of five years before I knew if I was doing the right thing or not. Here was a practitioner finding out if she was on the right track in moments rather than years. There was a deeper learning too. The
beinglearningdiagnosis:AcupuncturebyapatientJohnHamweeMember:Cumbria 26 Opinion Acu. | Issue #36 | Autumn 2022
Reliability and accuracy It is easy to think that a treatment which adheres closely to one or more of the textbook diagnoses will be more reliable and more accurate than one which the acupuncturist arrives at in this way, but I don't believe it is true. For one thing, there is plenty of room for error in applying the textbook categories to the individual patient –Is it heart or liver blood deficiency? Is the excess real or is it masking an underlying deficiency? What weight should be given to the message of tongue, as opposed to that of the pulses, when they are inconsistent? My practitioner clearly acknowledged that her diagnosis was always going to be provisional. Which leads to the question – how did she know when she needed to change or modify her initial diagnosis? A question which I have been exploring ever since. The answer, I think, is that she paid the closest attention to my responses to the needles, in the moment, in the treatment room. When I have tried to apply this principle myself I have used the following signs. First comes the feeling of the needle in my hands. Sometimes, even as soon as I place it above the point, there is a message which says, ‘Yes please’; or the opposite, ‘No, not here’ – messages to which I have learned to pay the closest attention. Pretty frequently too I get the feeling that the needle, once inserted, is doing nothing at all. I check the location and if it still seems right I conclude that the diagnosis which suggested that point is either inadequate or mistaken. Next comes the response. If the patient relaxes or smiles as the point is touched that is surely a good sign, as is improvement in the pulses. Finally, there is the common experience that the atmosphere in the room seems to breathe out and soften, which I take as a sign of benign energetic change. By contrast, there are plenty of signs of an incorrect diagnosis. The skin, as pickyou up pulses,handpatient’sthetotaketheseemscolder
implicit assumption made by my supervisor was that he knew what the patient needed. It is the basic model of western medicine too. The doctor investigates, diagnoses and then prescribes. My experience of acupuncture treatment, on the other hand, was that my practitioner was responding to me. She was taking the changes in my pulses as helpful instructions. Instead of believing she knew what I needed she was investigating, exploring, and discovering what I might need, open to being wrong at any stage of the session. She started with an idea and then tested it continuously throughout the treatment, developing, refining and even changing it as she went. In fact you could say that the treatment itself was a key part of her diagnosis.
Large pinch of sea salt 2 heaped tsp of ground cumin
Ingredients 6 lemon roasted Brussels sprouts – see below 240 g cooked chickpeas
For a batch of lemon roasted sprouts 100 g whole fresh Brussels sprouts
and clammier than it did.
To make the lemon roasted sprouts: Cut the sprouts in half and place them in a bowl. Add the remaining ingredients and stir everything together ensuring the sprouts are well coated. Pour onto a baking sheet and place in the oven for approximately 15 minutes or until golden.
The patient’s pink face goes pale or blotchy, or a strong voice becomes weak. Or you feel somehow uneasy yourself, less comfortable in your own treatment room. In other words, the secret of arriving at a reliable and accurate diagnosis is knowing when you’ve got it wrong. And then being willing to admit it to yourself.
1 Tbsp of nutritional yeast
1 Tbsp lemon juice
How did she know when she needed to change or modify her initial diagnosis?
To make the hummus: Place all ingredients in a bowl and blend together using a hand blender, food processor or your preferred kitchen magic. Serve topped with a dash of paprika and a finely chopped lemon roasted sprout.
27OpinionAcu. | Issue #36 | Autumn 2022
Conclusion If your treatments are based on an incorrect diagnosis the patient will have to live with an energy system disturbed and distorted by what you have done – an alarming prospect. You can reduce the risk if you think of diagnosis as flexible and provisional, as a hypothesis rather than a truth. In short, the standard diagnostic categories are immensely helpful but they are neither infallible nor watertight. Think of diagnosis not as an activity done before treatment and only reconsidered much later, if at all, but as a process of learning and discovery throughout your time with the patient. Finally, see it as reassuring rather than depressing that, if you pay attention in the moment, you will get plenty of indications that your diagnosis is wrong.
A floating pulse becomes fuller and harder, or a wiry pulse become tighter.
flavourroastedYes,Member:RevhummusSproutDebConnorMerseysideyoureadthatcorrectly!Lemonsprouthummus,infact.TheofBrusselssproutspeaksin the cold months when the frost helps them develop a sweet taste. In TCM terms Brussels sprouts are warm with sweet and pungent flavours – they enter the large intestine and stomach channels and expel cold. Chickpeas tonify qi and resolve dampness – they enter the stomach, spleen, and heart channels and are sweet with a neutral temperature.
Use more or fewer sprouts, depending on your preferred hummus texture and level of sproutiness. And if really runny hummus is your thing, add a tablespoon of lemon juice, a dash of avocado oil or a delicious dollop of tahini.
1 Tbsp avocado oil Ground black pepper and sea salt, to taste 200C/400F/gas mark 6 Method
3 Treat staff members with respect and courtesy, and refrain from intervening in the management relationship that staff have with the Chief Executive Officer of the BAcC.
At the same time, it is also important to come to decisions and of course that sometimes involves, with all due respect, to follow one particular line of development rather than another. Ideally, respect is still paid by finding consensus, sometimes compromises and sometimes necessary clarifications, so that all parties involved feel heard and involved.
4 Treat other GB and Committee members with courtesy, and work together in a cooperative and collaborative manner, in good faith and in a spirit of mutual trust and respect.
1 Respect confidentiality; understand what confidentiality means in practice for the Council, its Governing Board and Committees and the individuals involved with it.
I remember reading the handbook for the first time just before my introduction to the GB and feeling a bit overwhelmed by all the rules and regulations and some of the corporate language used. Since then however, I have gone back to the handbook multiple times to check how this, that and the other are regulated. It gives us a very good framework and helps us to be consistent in our work.
In this 60-page document, which is given to all of us who come to serve on the Governing Board, I have come across five entries regarding respect – four of them in the code of conduct applicable to all GB and committee members and one in the operational guidance for the GB and all committees. They read as follows:
On reflection
2 Respect the provisions of the Data Protection Act 1998, and subsequent data protection legislation, in handling sensitive information which the role may confer upon them.
We welcome up to two observers at all meetings. If you are interested in attending, please let us know 14 days before the date to allow for receipt of all relevant information. You can download the agenda when available by clicking on the meeting date on the BAcC website Minutes of previous meetings are available on request.
When thinking about my approach in writing for this autumn issue, I went back to check whether and where the word, and sentiment, of respect is used in the BAcC Governance Handbook.
Pia Huber 〉 p.huber@acupuncture.org.uk Member and chair of the BAcC and Governing Board, Pia Huber, offers her insider view on current matters of organisational business and governance
BAcC/GBHuberPiaChair
5 Respect medical science and promote ethical medical practice.
TuesdayTuesdayGBUpcomingmeetings11October13December
28 Community Acu. | Issue #36 | Autumn 2022
Interestingly three entries deal with respect for rules and processes while two use the word in relation to other people, which is what came first to my mind when I thought about it. Indeed, having respect for other people, their opinions and their views is very important to me.
One of the strategic aims of the BAcC is to observe good governance. Just the other day a friend asked me what governance actually means. Indeed, the answer is not straightforward, but one definition I found online seems to describe it quite well: ‘Governance is the framework of authority and accountability that defines and controls the outputs, outcomes and benefits from projects, programmes and portfolios. The mechanism whereby the investing organisation exerts financial and technical control over the deployment of the work and the realisation of value.’ Having now been on the GB for just under four years I have learnt a great deal about governance, although the handbook still plays a role in answering occasional questions I have. We are planning to update the present version – including the use of inclusive language and reviewing our methods of governance. Of course, this review must and will pay full respect to the history, present and future of the organisation and its members, so that the BAcC can further improve how it functions to give the best possible service to all.
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PSA: the mark of quality
Being a registrant on an Accredited Register – and being able to use the associated Quality Mark –demonstrates commitment to professional standards and ethical behaviour and increases public confidence. The job of the Professional Standards Authority (PSA) is to educate stakeholders in the healthcare sector as to the importance of the benefits of the programme. There is increasing recognition that Accredited Registers offer tangible benefits in areas such as safeguarding vulnerable patients and providing employers with assurance in recruiting roles which are not regulated by law. Our robust complaints handling process demonstrates that registrants are held accountable and builds on thatWeassurance.alsoaimto ensure that the government of the day considers the value of Accredited Register practitioners in developing national policy. For example, in supporting proposals for a holistic approach to mental health and wellbeing, our response to the Department of Health and Social Care’s discussion paper for a new mental health plan for England focused on the range of services available and the assurance that the Quality Mark provides.
In the ten years since its creation the Accredited Registers programme has grown to include over 100,000 registrants working in over 60 roles and continues to expand. We have recently received applications from eight new registers, with further announcements due in the coming weeks. With this growth, together with increasing recognition from the NHS and government, we believe the benefits for registers and registrants are stronger than ever. Following a comprehensive review, we introduced an important ‘public interest’ test which evaluates whether benefits of activities practised by our registrants outweigh the risks. We believe this will strengthen the assurance the programme offers to patients, services users, employers, and to other interested parties. Although we have yet to assess the BAcC against the public interest test, most recently we highlighted as good practice the BAcC’s work in publishing comprehensive information concerning the evidence base for acupuncture, and its advertising guidance for registrants, along with its vision for equality, diversity and inclusion. All of this will help in signposting BAcC registrants as a top choice for people wishing to improve their health and wellbeing through receiving acupuncture.
PSASmithKarenCommunications & Marketing Officer
Closer to home, you should have recently received news from the BAcC concerning a new updated marketing toolkit for all registrants. This package is designed to support you in your marketing activity and to raise awareness of the Accredited Register programme and its benefits, which in turn benefits you as a healthcare practitioner. We do hope you find this kind of offering useful and we welcome any feedback via our BAcC contact Ian Appleyard 〉 i.appleyard.acupuncture.org.uk
Earlier this year we announced the running of a pilot, in collaboration with the Association of Child Psychotherapists, to test the rollout of higher-level disclosure and barring service (DBS) checks. As these checks are currently mainly undertaken by employers, this leaves a potential safeguarding gap for patients and service users seeking treatment from self-employed practitioners. The aim of the pilot was to see whether Accredited Registers could access this level of checks despite not being an employer. The results have been positive and consultation will take place in October 2022 on whether to roll the checks out more widely. Those of you who work in the NHS are no doubt seeing first-hand the pressures caused by workforce shortages, and we believe that the DBS check programme is well-placed to provide pragmatic and flexible solutions. For example, the registration of psychological practitioner roles as part of the Improving Access to Psychological Therapies programme with the British Psychological Society or the British Association for Behavioural & Cognitive Psychotherapies. Both organisations are in the final stages of their accreditation assessments. A recent application from the Health Practice Associates Council (HPAC), which registers pre-emergency clinicians below the grade of paramedic, is also supported by the Care Quality Commission (CQC). The CQC have now written to providers, highlighting a ‘best practice’ approach to recruiting from the HPAC Register for relevant roles responsible for transporting patients receiving secure and mental health services. Our article published by NHS Employers also highlighted how the programme can help employers in the NHS to improve regulation and safety standards. We believe that the increase in NHS-related Accredited Registers will help raise the profile of accreditation. Greater awareness of our accreditation Quality Mark should benefit practitioners working both in the NHS, and privately. We are working with NHS colleagues to achieve such awareness, most recently with the publication of the article on the NHS Employers website, as well as with additional news and updates in NHS workforce newsletters and bulletins.
ElioBasagniMember:ICOM
We were also pleased with the many commendations we received, including praise for the strength of our policies; the thoroughness of our formative offer and the high standards of our teachers; the bursary scheme to help disadvantaged students access tuition; the support we provide for students with dyslexia; and the provision of a wellbeing tutor for the benefit of all. The panel also recognised our consistent focus on the centrality of students and patients and confirmed the effectiveness of our new online teaching and assessment methods. The current ethos of ICOM considers transparency and inclusivity as paramount, and this was also
50 but still 養 yang
It is always a special time for us to welcome new and unique.butacademicstartstudentsreturningfortheoftheyear,thisyearisOurnew intake of students will join us just as we celebrate the 50th anniversary of the founding of the college in 1972 and soon after completing our scheduled reaccreditation process with the British Acupuncture Accreditation Board (BAAB). Half a century has given us much to be grateful for. From its beginnings at a kitchen table in Gerrards Cross, and then later from 1977 at our premises in East Grinstead, the International College of Oriental Medicine (ICOM) has been continuously shaped by generations of academics/practitioners in the attempt to become a first-class acupuncture training college with both a prestigious international reputation and a warm Preparationsheart.arewell underway for a well-deserved birthday celebration at the end of September. Many graduates and staff from the last 50 years will be reunited with old friends and new associations will be developed, all whilst enjoying the party vibes in a chilled and festive atmosphere. There will also be opportunities to look back at the history of our college and see how far we’ve come. And although it is important for us to commemorate ICOM’s past, we see this year also as an opportunity to set our course for the future. Earlier this year, we welcomed members of the BAAB and after a thorough review, we were delighted to be awarded a full reaccreditation for another six-year cycle. We were grateful for the attitude shown by the BAAB panel. The mix of online observations blended with on-site meetings was helpful and worked well. As a small institution it allowed all members of faculty and students to attend and participate remotely. The whole community found the process to be positive and developmental, as it transcended a ‘tick box’ exercise and proved to be genuinely insightful for us. Beneficial change has already been implemented as a result of the visit, and programme delivery will improve as a consequence.
30 Community Acu. | Issue #36 | Autumn 2022
Top: points class with Giovanni 1976; above: student clinic 2006
Harriet leaves the BAAB
Harriet Lansdown Lead Accreditation Officer: BAAB
None of BAAB’s work would be possible without the BAcC itself, and it is a remarkable achievement that together, we have been able to overcome many challenges to the acupuncture profession, and still maintain such high standards for the practice of acupuncture.
I feel especially proud of the respect the BAAB has achieved during my tenure. Our recognition as a professional, statutory and regulatory body (PSRB) by the Quality Assurance Agency (QAA); the mutual membership agreement with the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), giving BAcC members an easy route to practise in the USA; and the wide appreciation of the swift mitigations and reassurance we offered the course providers and their students during the Covid crisis.
Above: some of our many graduating students over the years; below: full reaccreditation for another six years 201420041987 201119932021 31CommunityAcu. | Issue #36 | Autumn 2022
The opportunity to work alongside Professor Mike Saks in the last three years has been especially rewarding; his longstanding appreciation of acupuncture combined with his world-leading expertise in accreditation and regulation has opened a window to the wider world we need to be able to see.
Managing the development of our work, through the support and advice of our committee and Board members; seeking and following up on internal and external feedback; building and maintaining links with higher education organisations and other health professionals; engaging with international partners and encouraging colleagues to collaborate, consult and challenge has been a real joy for me.
I have decided to bring forward my retirement as – for various reasons – a fresh approach is now needed from a new lead accreditation officer. If it is helpful to the BAAB in ensuring a smooth transition, I have expressed my willingness to act in an interim consultancy role, providing mentorship of the staff team and of the new lead accreditation officer.
commended by the BAAB during their review. Everyone's voice is heard and matters, everyone is invited and encouraged to contribute to our development. Open debate is fostered and welcome. We have an extraordinary and diverse team of faculty and staff working trainingthecontinueachievingtowardsourgoals.OurintentionistotodevelopICOMacupunctureprogrammebeyond the current three years, by introducing a mentoring scheme with the aim of supporting alumni – no matter when they graduated – and developing shared clinical practices. Indeed, we feel a deep sense of gratitude towards our founder, Dr van Buren, and the path he started following in the early sixties together with a small group of pioneers; and we are also aware that any tradition can only be kept alive if it evolves to meet the changing requirements of the times. ICOM will always be rooted in the classical teachings of oriental medicine, but by critically revising our knowledge and clinical results, we will keep looking for more contemporary ways to serve our patients and their changing needs. In order to do so we must strengthen our shared clinical practices. As we look forward to the next 50 years, ICOM will strive to enrich its community, maintaining a close contact with recent and past graduates, supporting less advantaged communities and strengthening our international connections. We feel that our ultimate goal can be nothing other than to make acupuncture more accessible to everyone, especially the most vulnerable, in accordance with the ultimate mission of all Chinese medicine practitioners, which is yang sheng 養生… to nourish and protect life.
I have the greatest respect for the dedicated and creative work of the teachers and managers in the accredited course providers who have been both inspirational and challenging to work with.
August 2022 After nearly ten years serving as lead accreditation officer for the British Acupuncture Accreditation Board (BAAB), I have decided to step down and will be leaving my job on the 6th October 2022.
Over these years, it has been a privilege to work with the staff team, members of the Accreditation Committee, and of the Board. So many people have given their time, expertise, wisdom and good humour to ensure that the acupuncture profession, as represented by the BAcC, continues to meet the same standards of education as other health professionals in the UK.
A few words from Catherine: ‘My favourite point? I don’t have one, but my favourite treatment style of all the ones I studied is abdominal acupuncture with Dave Shipsey – thanks Dave. It is so gentle, so effective and so easy to learn and can all be done with the patient lying comfortably face up! ‘What a wonderful profession we have! In all my 30 years I never had a boring day and was always stimulated, challenged, and energised by working one-to-one with people. Chinese medicine is so absorbing and I’m extremely grateful to my teachers for giving me such a great foundation. ‘What would I say to a younger me as a new acupuncturist? Be assured that you can’t put everyone’s complaint right in three treatments and the patient benefits from your time, care, listening and attention as well as your clinical skills.’ After many years of providing care and love to the profession, I felt these two amazing souls deserved a farewell party. It was our first face-to-face regional group event since Covid and we merged it with our Christmas party. We gave them some lovely flowers and a small cash donation each towards something special for their retirement. I think both mentioned spending it on books – probably more learning! It was always a real pleasure to have these two very wise and beautiful spirits at our regional group events. I hope they will make some guest appearances in the future as it will be lovely to catch up with them both.
Whether you are a student, new graduate, or seasoned acupuncturist, you are all welcome to our regional group events. You will make some great friends, gain sage advice and most of all, I hope you’ll then feel connected to the amazing community of acupuncturists –like a tree root network.
retireesLancashire
Regional
In December 2022 the Lancashire Regional Group held a wonderful retirement party for our dear friends and colleague Anna Krypczyk and Catherine Swales. Here’s a little more about these wonderful and inspiring dear acupuncture friends and the party we held in their honour. Plus, I managed to glean a juicy tip from them for our new acupuncture family members. Anna Krypczyk graduated from the Northern College of Acupuncture (NCA) in 2003 after studying for seven years in total for acupuncture and Chinese herbal medicine. She was taught by many well-known and well revered teachers including Richard Blackwell, Charles Buck and of course, the late Hugh MacPherson. Before studying acupuncture, Anna was a biomedical scientist in the histopathology department at Blackpool Victoria Hospital. She loved this work but after receiving some acupuncture for a back problem she caught the bug and her endless thirst for knowledge led her to study it.
32 Community Acu. | Issue #36 | Autumn 2022
Total respect and admiration for two
Much Sandralove, UPCOMING MEETING Friday 18 to Sunday 20 November, 10-5pm, £270 〉 Jamie Hamilton –Shiatsu Tools for Acupuncturists 〉 Tonic Acupuncture, Longridge, Preston, Lancashire Come and learn some amazing shiatsu techniques to use in our clinics – a very hands-on three-day immersive and interactive weekend NB Sunday maybe slightly shorter if content allows
All funds after costs covered will go towards future RG events
Catherine’s retirement plans include a big move to Grange-over-Sands in Cumbria, lots of walking, and continuing with her book group – started in 1997, they have read over 200 books together… that’s some dedication to reading!
Anna’s top tip for any newly qualified acupuncturist? ‘Consolidate what you have learned and practise that before adding extra skills.’ Thank you, Anna, for all you have done to enhance our profession. The acupuncturists you have developed and your amazing work with patients and community have helped our profession immeasurably.CatherineSwales had a very interesting profession before acupuncture whisked her away – she was a museum training officer in Scotland and NW England. But fascinating as that sounds, Sarah Price enticed her towards acupuncture with her interesting stories when they first met – Catherine was hooked and signed up to study at the NCA at their 1989 open day. She loved her college days in Acombe in York, which she recalls as being tough due to working full time and studying at the weekend but also fun. At that time TCM was taught by Hugh MacPherson, Nick Haines and Richard Blackwell, and they only had two textbooks –Ted Kaptchuk’s The Web That Has No Weaver and Giovanni’s Foundations of ChineseCatherine’sMedicine.recollections of how she had no internet for her study, her essays were all typed up on a typewriter, course notes were all scribbled down as quickly as possible, no PDF handouts like we get these days – it just sounds like another lifetime ago! Sorry Catherine, I hope that doesn’t make you feel old. Thank you for enduring that difficult way to learn –without the early adopters in the UK the profession would simply not be where it is today. Catherine’s career has also included inspiring many of the student acupuncturists of Lancashire by providing observational placements in her clinic.
Anna has also given her expertise and time to many students in Lancashire by offering observational placements. Many students in the area including myself, have had inspiration from her sharing her clinic and knowledge. In retirement Anna plans to spend more time with her loved ones, she enjoyed a Mediterranean cruise last April and will be doing lots of reading. Of course, if you know Anna, you’ll also know she is a self-confessed CPD addict who will now find time to complete some courses she had signed up for during her working days. She’s also a volunteer in the Lancashire Healing Hub, providing NADA healing circle sessions to anyone displaced/affected by war. Her favourite points are BL 1 jing ming and ST 1 shao ze… Wow, the effects these points can have are like the profound impact Anna has had on the acupuncture community in Lancashire.
I first met Anna in 2008 when she taught me anatomy and physiology at Manchester Metropolitan University. She was a great teacher, so warm and friendly, but also so good at making difficult information more understandable.
ALL MEMBERS WELCOME For details and booking 〉 regionalgroupevents/688136buytickets.at/SandraHart 〉 07908 806027 〉 baccnorthwestrg@gmail.com round-up
And with many get-togethers still happening via Zoom you'll receive a warm welcome at any meeting anywhere in the UK. Check out the events calendar on the new BAcC website. And don't forget to log on to access full details of each event and to contact the local coordinator.
I am very pleased to be helping to host the vast array of webinars and resources we have for the BAcC’s latest campaign Let`s talk about… Boundaries and Consent. I speak to members on a daily basis about concerns in their practice and as a result of these conversations particular subjects have been highlighted as requiring closer discussion. I think the past and scheduled webinars will help practitioners deal with some of the more unusual situations they are faced with in clinic, giving them the tools to react appropriately and comfortably. We are also building the website resources page so that practitioners can access help quickly when needed. Expert Flora McCabe gave us a real in-depth insight into the world of litigation and consent.
I have really enjoyed the discussions and less formal webinars on boundaries, and I do hope they’ve given our practitioners a sense of community and support. No doubt they have provided much food for thought and discussion within your peer discussions, mentor sessions and regional groups. One of our recent webinars was designed to help practitioners understand the legal and practical side of situations where there is a hint or declaration of domestic abuse. I found it really useful discussing this alongside members with the DASH charity, who support people experiencing domestic abuse and who are kindly working with us. We are also excited to be hosting former policeman, teacher of mental health first aid and mental health campaigner Anthony Sigrist`s webinar about suicidal thoughts. I was fortunate enough to attend another presentation by Anthony and I feel certain that this resource will be invaluable for members, not only in their practice but also in their home and social lives, and perhaps even help to save lives. This webinar will be a frank and honest discussion about suicide, including topics such as how to spot the warning signs and how to respond if you know or suspect someone is suicidal. We will also cover clinical considerations such as breaking patient confidentiality and referral pathways. We are also working with the National Society for the Prevention of Cruelty to Children (NSPCC) to provide some training for those members wishing to familiarise themselves with legislation regarding child safeguarding. There will also be practical guidance and discussion on the many areas of child safeguarding. And although this training will not take place until autumn, I feel that this valuable resource belongs with the many others in our Boundaries and Consent campaign. All in all, I hope that practitioners have found this campaign to be full of really valuable discussions and presentations. Our aim is to enhance your toolbox to help you feel comfortable discussing difficult topics with your peers and patients alike. I feel it will help us protect our patients and ourselves as practitioners in a harmonious and therapeutic manner, allowing us to build healthy relationships and give the best treatment possible – just one more reason that we are the most highly thought of professionals in our field. Always remember that we are here to help you and if you wish to discuss anything further with me or anyone at the BAcC, please don’t hesitate to get in touch, either by email is and or by calling the main BAcC number and selecting safe practice.
If you practise in Hampshire and you think you might be interested in taking over from Sahar, please get in touch with the BAcC learning and events manager, Helen Gibb. And the same goes for any other members who would like to help build their local network of acupuncturists –either by setting up a new group or taking over in an area that’s already established.
Helen Gibb 〉 020 8735 1222 〉 h.gibb@acupuncture.org.uk Go online for RG withinformationRegionalmeetingsgroupshelpcirculateandcanprovideyoulocalforumsandsupport
HannahcampaignBowie-CarlinMember&SafePracticeOfficer
As a result and as part of the campaign we have reviewed and updated the consent form, which has proved a mammoth task. We have sought the best legal and professional advice, and we hope that the revised form and accompanying document will help reassure practitioners that they have the best advice and protection possible should a complaint arise.
Hannah Bowie-Carlin 〉 h.bowie-carlin@acupuncture.org.uk 〉 020 8735 0400 Hampshire Sahar Hooti writes: Dear fellow Hampshire colleague… I’ve enjoyed meeting you throughout the past few years. Due to life and work commitments, it’s now time for me to step down as your regional group coordinator. I do hope that someone in the area is able to take over from me and keep things going. Running the group needn’t be time consuming – especially if you run it jointly with a fellow member and generate ideas amongst the existing group for meeting topics. As I’m sure anyone currently involved will agree, the benefits are many, including: • connections that you can make • being a central hub in your community • helping out new local members and graduates • creating opportunities to socialise with other practitioners in the area. Thank you to all who have supported me over my time as Hampshire RGC and I wish my successor(s) all the very best.
33CommunityAcu. | Issue #36 | Autumn 2022
Let’s talk about… our latest
For more information, visit www.worldlandtrust.org
TRIBUTE
Some years ago I started seeing him for acupuncture treatment. His treatments were quite different from what I had experienced before and he very much had his own style. After the initial traditional diagnosis (TD) the treatment proceeded in the following manner: I would stand in boxer shorts with my back to him, whilst he looked at my spine and gait, and then I would lie down on my front on the couch where he would scan the posterior and sides of my body. I would then turn over and he would repeat the same procedure with me lying on my back.
Gordon’s touch was incredibly light – very similar to that of JR Worsley, as I recall from a part physical TD I had done by him in front of my class whilst studying at Leamington in 1986-89. Gordon would be guided to just two points by feel and intuition – one on either side, and on one occasion, one on one side and one on the Ren meridian. He was meticulous in his preparation and then inserted two short gold needles into the two points, covered me with a light cotton cloth and left the needles in for 20 minutes. During this period he would carry out what I assumed were craniosacral adjustments, which were just very gentle and inobtrusive.
Gordon had interests in many things like Biodynamic gardening and he and his wife Ursula both played recorders. They also practised Qi Gong regularly together. He was good on a metal lathe and he and Ursula completed courses in chainsaw maintenance and crosscutting, followed by courses in working with small- and mediumsized trees. There were always carefully stacked rows of firewood in the front garden.
Gordon Parfett Gordon graduated from the European School of Osteopathy in July 1977 and worked at Inglewood Health Hydro in Hungerford, Berkshire with its principal Robin Kirk. He built his own practice in Stroud, initially working from home. He was a member of the Society of Osteopaths from 1978 and became a founder member in May 1984. He studied a craniosacral course at the British School of Osteopathy in 1983. In 1984 Gordon travelled to Tibet with a few people and visited monasteries in the wilds of the country during his time Branchingthere.out he gained a Bachelor of Acupuncture degree in 1987 at the International College of Oriental Medicine (ICOM). He continued to work from a clinic in Stroud and after moving to Powys in 1993 he maintained his Stroud practice until he became established at his new homeGordonclinic.was interested in Japanese meridian therapy and studied with Dr Stephen Birch in 2010. He also took an auricular acupuncture course with a particular emphasis on addiction. As a keen cyclist he once cycled to Egypt and back and was also in two semi-professional cycling teams in Europe. While living both in Asti in the Piedmont region of Northern Italy and in the Dordogne region of France for periods, he learnt to speak Piedmontese like a local and French. He was a fine linguist and his Italian accent had no trace of English sound at all. A very gentle person, Gordon met his wife Ursula in 1995 through mutual friends and they started going out the next year and married in 2010.
A sensitive and bright man with many loyal patients, who is sadly missed.
I would always leave feeling very restored and my back and neck were both in really good shape whilst I was treated by Gordon. He was a modest and unassuming man and acted with great integrity and respect.
Acu. helps to save the trees
The World Land Trust has certified our Acu. Arts,Colourgraphicprinters,asoneofonly a handful of carbon neutral companies. To gain certification, the company had to demonstrate they measure their greenhouse gas emissions, actively work to reduce them, and balance their residual emissions by protecting carbon richJohnhabitats.Scardarella of Colourgraphic Arts told us: ‘We are really excited to be a member of the World Land Trust and that we can now produce work with our carbon emissions offset. This helps the World Land Trust to protect crucial areas from deforestation and degradation while also helping prevent the release of carbon dioxide into the atmosphere and preserve invaluable eco‘Whatsystems.itmeans for Acu. is that we can offset your carbon footprint on any print-work we produce for you. You can then use the World Land Trust logo on your publications and you will receive a certificate stating how much carbon you have offset and how much land can be protected by printing jobs in this manner. We can do this on any job that is printed and on any paper you use. ‘As a guide, if we were to carbon balance a print run of 550 items of Acu. magazine, and effectively make a donation to the World Land Trust to do it, your impact on the environment would be the equivalent of saving 60 kg of carbon dioxide from going into the atmosphere. With this support the World Land Trust can protect 12 square metres of critically threatened tropical forest.’
34 Community Acu. | Issue #36 | Autumn 2022
More personally and as a patient: I first heard about Gordon when I moved to Hay-on-Wye in 2000, from the owners of the Hay Wholefoods shop. Eventually I met him somewhere and we discussed acupuncture and enquired about colleagues that we both knew. Now and again I would bump into him walking around Hay, or hand in hand with his wife Ursula, always sporting his ubiquitous French beret.
Sandy Sandaver Member: Herefordshire with many thanks to Gordon’s widow, Ursula Parfett, for her help in putting this together
I’ve been getting to know the organisation, our members, our Board and other stakeholders at a very busy time. As ‘the new girl’, I really appreciate the guidance and dedication of our staff team – my new colleagues – who are working so hard, every day to serve our members. I’m also incredibly grateful to those very supportive members who have reached out with their offers of help, support, advice and, of course, content! Content is our friend. For anyone unfamiliar with this term, content comes in various forms – text, image, video, audio. It can be engaging, relevant, reliable, interesting and enlightening – providing value to our different audiences. From the dropin sessions (coffee and comms) that I’ve been hosting to date, I hear that members need support in this area, to help with their social media presence and promotion of their practices.
BACC OFFICE CHIEF EXECUTIVE 1 Jennifer Norton 020 8735 j.norton@acupuncture.org.uk1206
OFFICE ADMINISTRATOR 7 Shadda Draey 020 8735 s.draey@acupuncture.org.uk1207
Hidden somewhere in the pages of this Acu. is a teensyweensy Moxi...
Just find little Moxi by 30 September to be in with a chance of winning our latest Moxa Moments t-shirt designed by Mr Moxi himself, Toon Min. Email details of your sighting to editor@acupuncture.org.uk
I’m currently reviewing what strategic comms might look like for the BAcC –and the support and investment that we might consider to achieve this. At the same time I’m running very quickly on the ground, looking at the ‘now’ and the quick wins – the posts, the blogs, the press articles, the case studies – that we can all be involved with.
SAFE PRACTICE OFFICER 11 Hannah Bowie-Carlin 020 8735 h.bowie-carlin@acupuncture.org.uk1226
Try a spot of autumn Moxi
Unsurprisingly, I need members’ help too – I definitely can’t do this alone.
LEARNING & EVENTS MANAGER 4 Helen Gibb 020 8735 h.gibb@acupuncture.org.uk1222
PUBLICATIONS MANAGER 10 Ann Gordon 020 8735 a.gordon@acupuncture.org.uk1204
617 2 9 1211 108 53 4
MEMBERSHIP ENGAGEMENT OFFICER 5 Lucia Misikova 020 8735 l.misikova@acupuncture.org.uk1209
POLICY & RESEARCH MANAGER 8 Ian Appleyard 020 8735 i.appleyard@acupuncture.org.uk1203
MEMBERSHIP MANAGER 6 Stephen Rainbird 020 8735 s.rainbird@acupuncture.org.uk1208
Caroline Hedges Communications Manager Caroline Hedges 〉 020 8735 1216 〉 c.hedges@acupuncture.org.uk
I’d like to think we’re all in this together, so don’t be surprised if I come a-calling
35CommunityAcu. | Issue #36 | Autumn 2022
FINANCE MANAGER 3 Juliana Zipperlin 020 8735 j.zipperlin@acupuncture.org.uk1201
SYSTEMS & OPERATIONS MANAGER 12 Gloria Jean-Baptiste Flament 020 8735 gloria.jbf@acupuncture.org.uk1217
COMMUNICATIONS MANAGER 2 Caroline Hedges 020 8735 c.hedges@acupuncture.org.uk1216
PROFESSIONAL CONDUCT OFFICER 9 Caroline Jones 020 8735 c.jones@acupuncture.org.uk1213
calling…Caroline
I joined the BAcC staff team back in May usopportunityThere’sbeenamanagercommunicationsasandwhatwhirlwindit’ssofar!Firstimpressions?somuchfortoeducate, promote and influence, and just so little time! Our members are a dedicated and passionate bunch who, quite rightly, want the best for the membership and the profession. All are keen to see progress – and, as much as I’d like to achieve this instantly, Rome wasn’t built in a day.
SUBMISSIONS Acu.
Charlotte ToMargaretMichaelKatarzynaMelanieJoanneMargaretAlexandraElizabethJaneChristopherBarnardBuckleyEagleshamEarleyIllingworthKeatingKirkMarkePerlickaPhillipsShuttleworthapplyforadmission to the BAcC, please give details of your graduation to the membership team by emailing membership@acupuncture.org.uk or by phoning 020 8735 1209. We very much look forward to welcoming you into membership and supporting you throughout your acupuncture career. 〉 Advertisements OPPORTUNITIES
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FOR SALE Clinic in Well-establishedBirminghamacupuncture practice – over 30 years – within a multidisciplinary clinic. Low rent and friendly colleagues. Good position off a local high street, with parking. Please contact 07914 852781 for more information. the winter issue of Acu. we’ll be taking your hand and heading down into the darkness… to the most yin of yin. What do you find when the light has gone out? Stillness, calm, confusion, fear, reflection? How do we attend to the darkness in life and in practice? How do we work with negativity? What does darkness mean to the body? Send your ideas, submissions and pictures to editor@acupuncture.org.uk is for you and by you, so we invite you all to share your opinions, knowledge and images in these pages: articles can be up to 1,800 words, letters up to 500 please use generic terms rather than brand names where applicable submissions are published subject to space we may edit for length or clarity with permission of the author reserve the right to edit or decline any submission in which the content: may be in breach of libel laws may damage the reputation of the BAcC or its members denigrates another individual or organisation is found to be inaccurate or misleading is considered to be inappropriate to the something to say but you don’t feel confident as a writer, the editorial team is here to help you work your thoughts piece. your copy for the next issue of Acu. to full details of our policy, guidelines and rates, please contact a keep full records of our decision and all relevant
OurKentacupuncturist has retired from our Maidstone clinic after 20 years, leaving a vacancy for an acupuncturist one day a week but could expand. See clinic website and please email us at bowermountclinic@gmail.co.uk if interested in joining us – www.bowermountclinic.com AcupuncturistLondon and Chinese herbalist required to join busy practice in East Dulwich, specialising in women’s health. Experience with fertility, gynaecology and obstetrics is essential. Please email info@conceive.org.uk – http://conceive.org.uk – or call Claire on 07957 641946, if you are interested. WeLondonare looking for practitioners to join our wellestablished teams in our Windsor and Chiswick practices on part-time basis. The roles would suit enthusiastic practitioners with a desire to grow and develop their clinics. For further information, please contact daniel.elliott@londonacupuncture.co.uk
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Toheresee all our upcoming CPD events, scan the QR code to the left or head to our website by clicking here And courses coming material in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. are available from
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We pride ourselves on our excellent variety of CPD events & courses. Our reputation means we often co-host events, both online and at the college, with highly regarded and specialised practitioners in the industry, such as: We offer a series of one year postgraduate courses to qualified acupuncturists. Each year we teach diploma courses in: 9508889 To find out more scan the QR code to the right, or head to our website by clicking here in the know... our newsletter to keep up to date with new diploma course launches, CPDs & news by scanning the QR code to the right, or by clicking
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Upgradeyourskills andconnect withcolleagues! Fundamentalsof AppliedChannelTheory JamieHamiltonFarnham 2Days. £230 7-8October2022(Friday&Saturday) In-DepthMaiJingPulseDiagnosis JamieHamiltonFarnham 2Days £230 2-3December2022(Friday-Saturday) AdvancedAppliedChannelTheory JasonRobertson Edinburgh 3Days CostsTBC 9-11November 2023 www.eastwestcollege.co.uk EastWestInnovativeCPD College TOYOHARI-JAPANESE NEEDLE THERAPY AN EIGHT-WEEKEND, TWENTY-DAY POSTGRADUATE PROGRAMME October 2022 - June 2023 Course Directors: Stephen Birch and Junko Ida Toyohari is a form of Japanese Meridian Therapy that focuses on training sensitivity to qi in diagnosis and treatment. Blind practitioners of Meridian Therapy formed the Toyohari system and developed systematic treatment approaches, very refined non-inserted needling techniques, various symptomatic treatment methods and highly developed feedback techniques that allow for accelerated learning of these subtle yet powerful methods. Cost : £2,100 For more information and your application form contact Neil at: T: 07773 331807 E: toyohari2022@gmail.com W: www.toyohari.org.uk Location: College of Integrated Chinese Medicine (CICM), Reading, RG1 7SB The Third Toyohari Training Programme in the UK Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
Wholesalepricingforacupuncturists Discoverthenewsupereffectivetreatmentforarthritisandmusclepain.UsingPurpleDragon JointandMuscleSalve(formerlyknownasPro-Salve)inconjunctionwithaheatlampisan incredibleadjuncttoacupuncturepractice,asdemonstratedbyJasonRobertsononhis workshopsatEastWestCollege. Thisproductisalsoidealforsellingontoyourpatients,extendingtheeffectofthetreatment betweenvisits.Visitourwebsiteformoredetailsaboutourwholesalepriceandrecommended resaleprice: purpledragonremedies.co.uk Harnessthepower ofnaturalherbswith PurpleDragon JointandMuscleSalve Purple Dragon Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
“ As practitioners we offer our patients guidance, support and encouragement –it seems a good idea to offer it to ourselves” Isobel Cosgrove Contact your nearest practitioner to join a group, or for individual sessions The following practitioners have all completed Postgraduate training in mentoring/supervision specifically for acupuncturists and are in ongoing supervision with senior members of the network.MENTORING/SUPERVISIONwww.mentoringsupervision.orgHerefordshire&WelshBorders Sandy01497Sandaver821625 West Yorkshire Caitlin Allen 07971 927675 Jackie07789Pamment905390 Birmingham & Hereford Lucy Fox 07941 413805 Birmingham Holly07790Timmermans205797 Ireland Susan Evans 07966 885894 London & Brighton Sarah07808Matheson633643 Oxford Sue01865Pennington776759 Reading Magda Koc 0118 996 8574 Somerset & Dorset Jane 01935Robinson422488 SouthEnglandWest Sally Blades 07896 369885 Bristol & SomersetNorth Charlotte07900Brydon-Smith814100 Glasgow Francesca Howell 07895 108473 Manchester/Cheshire/Lancashire Joshua Enkin 0161 434 0195 Oxfordshire & Berkshire Frances Turner 07510 710245 Lancashire Cathy01524Chapman67707 Leamington Spa & the Midlands Debbie Collins 07960 040985 Kim Chan 07947 361021 Hertfordshire/StAlbans Sarah Barnard 07968 140516 Leicestershire & East Midlands Cath 07547Esworthy054666 London Shelley Berlinski 07903 824150 Natalie Rose Johnson 07444 919040 Watford Mary Hurley 01923 240793 Cambridge Frankie Luckock 07717 285248 Mid & West Norfolk Kate Angelika07899Stewart953806Strixner07791516733 North Yorkshire Julie 07512Williams304444 Naomi Nash 07725 842979 Argyll, West Coast of Scotland Emma01546Vaughan606611 Hertfordshire Kate Henley 07887 565174 Helen Thomas 07790 363867 Yorkshire Dales & Cumbria Judith Blair 07553 266452 Gail 07946Lazarus231075 Pia 07719Huber987933 London cont. Isobel07791Cosgrove581608 Caroline Haigh 07754 198764 Surrey Susan Adams 07799 638577 Sarah Collison 07940 585133 Vera Wong 07966 538828 Mina Haeri 07957 726072 Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
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Discover more: Email us at: enquiries@nca.ac.uk | Call us on: +44(0)1904 343305 Register your interest and book an introductory event on our website atGrowwww.nca.ac.ukinto the future WITH OUR ONLINE COURSES STARTING SEPTEMBER 2023 CALLING ALL UK AND INTERNATIONAL PRACTITIONERS!Certificate in Chinese Medicine Nutrition MSc/PGDip in Chinese Herbal Medicine *MSc in AcupunctureAdvancedPractice and MSc in Acupuncture ResearchImprove your patients’ outcomes with our brand new (entirely online) Certificate in Chinese Medicine Nutrition which will give you the knowledge you need to integrate nutrition advice into your practice. We have been teaching herbs for over 30 years and know how to develop confident and effective practitioners! This is now an online course for class and clinic and after two years you will qualify and add herbs to your practice. Are you a busy practitioner wanting to gain a masters AND develop your practitioner skills and knowledge? Our online masters courses for practitioners can now be studied by taking modules at a pace that suits you. *subject to validation FIND OUT https://bit.ly/3PqXXSFMORE:FIND OUT https://bit.ly/2RunCvSMORE: FIND OUT https://bit.ly/3IAOyG7MORE: AVA LORENC NCA RESEARCH SUPERVISOR FOR OUR ONLINE MASTERS COURSES Ava shares medicinecomplementaryperspectivesheronresearch LAURIE HEAPS UK - MSC IN ACUPUNCTURE What dosages of acupuncture do UKbased acupuncturists use to surveypractitionerArelatedendometriosis-treatsymptoms?mixedmethods NICOLA WARDAUGH UK - MSC IN ACUPUNCTURE sectionalFire:thepeopleacupunctureeffectsperceptionParticipants’ofofauricularonaffectedbyGrenfellToweracross-survey NORA GIESE DENMARK - MSC IN ADVANCED ORIENTAL MEDICINE endometriosisacupunctureguidelinesofDevelopmentprovisionalforin Access these videos and connect with the presenters at: nca.ac.uk/research-showcase Building the Evidence NCA RESEARCH PRESENTATION SHOWCASEgrow developresearchlearn inspire enquire explore lead create investigate discover analyseexamine move-forward collaboratepioneer Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
Disclaimer:
The BAAB currently has two vacancies
Lead Accreditation Officer a flexible part time role working from home.
Chair of Accreditation Board - responsible and accountable for the Leadership and Management of BAAB.
Closing date for applications 27 September Interviews will be held week of 10 October. If you are interested in either position, please visit the BAAB website for full details or contact angela@baab.org.uk for an application pack. www.baab.org.uk/ Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
An Acupuncture Career at Sea Embark on a life-changing journey – Global provider and innovator in the fields of wellness, beauty, rejuvenation and transformation. Hiring Acupuncturists to work on board cruise ships worldwide. – Develop marketing and management skills while earning income. – Refi ne your skills and change lives while visiting exotic destinations. – Be a part of this amazing and rewarding experience. – Applicants must be professional, outgoing and passionate about Traditional Chinese Medicine. For information please contact: interviews@londonwellnessacademy.com APPLY ONLINE: LONDONWELLNESSACADEMY.COM Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk
Speakers: Akopyan
Ian GilRobinYairAmyBeverleyAppleyarddeValoisDinMaimonSunleyTon ARRC Symposium 16 September PointsMeeting2022
Aram
Proud sponsors We look forward to seeing delegates back in person in Staffordshire this September, to celebrate recent studies in the areas of cancer, osteoarthritis and heart disease.
Thank you to all that have booked to attend the conference this year. We look forward to seeing you all in September! Thank you to our sponsors for supporting the conference. The BAcC Annual Conference 17-18 September PointsMeeting2022 Proud headline sponsors of the BAcC Annual Conference
