Bodymind-Energetic Palpation 67

Palpation as described in Chapter 7 brings the client, and his

bodymind awareness, into the center of the process, starting the
healing process with the interview rather than with the insertion
of needles. What is said by any health practitioner during the
intake can prod the placebo capacity, as some are now coming to
term it (the capacity for self-healing with minimal outside inter-
vention), or can hinder it severely! While Asian practitioners do
not teach about or make use of the placebo capacity and body-
mind awareness in most instances, we in the West must, it seems
to me, if we are to place acupuncture in the forefront of new
models of health rather than relegate it to a possibly outdated
pathological, medicallmedicalizing model. It takes time to pal-
pate in the way I describe, but this time is all part of the healing
process and part of the treatment, and sets the stage for a pow-
erful change once the needles are inserted. This palpation/eval-
uation/imaging process often provokes changes in and of itself,
with no needling. It also cuts down tremendously on the num-
ber of treatments a person needs. Except for trauma or acute
pain, which may require several treatments in close succession, I
tend to treat someone two or three times at first, with a week
between each session. Then, after the second or third treatment,
I give the next treatment two or sometimes even three weeks
later, another treatment a month later, a seasonal followup ses-
sion a few months later, and three or four treatments a year if the
client is using acupuncture for health maintenance as well as for
a specific set of complaints. This is easily only one half the num-
ber of treatments I used to perform, with better results overall
than when I treated more frequently. I believe this is because I
have learned how to capitalize on the treatment process by plac-
ing the client's capacities, not my treatment, at the center. I
believe that once prodded, the bodymind can go on to heal itself
68 Acupuncture Treatment Staging

with very little outside interference. So I interfere and intervene

as little as possible. I have found that the most significant
changes often occur after a break of two or three weeks when
the client is not being treated. If we acupuncture therapists treat
too much and too often, I believe we make our clients depend-
ent upon the treatments and impede their own capacity for self-
healing and bodymind integration.
Palpation is also a way of bringing closeness into the thera-
peutic process and lets the client know that what you know is real
(touching him at Liver 3 and C.V 10-11 and saying "You sure
hold it all in there, don't you?" is far more convincing and pow-
erful, and immediately therapeutic, than diagnostically pro-
nouncing "You have constrained Liver Qi"). The Real of somatic
energetic awareness touches deep layers of knowing and opens
the way for the needles to be catalysts, rather than invasions, in
the territory of the client's bodymind energetics.
An image came to me as I was trying to explain to my stu-
dents that Matsumoto was working from a very different place
than do TCM acupuncturists. While the latter focus on organ
patterns (ZangFu), Matsumoto is concerned instead with the
body constrictions that lie behind these organ dysfunctions.
The image was this. Imagine you have been called in by the
traffic authority in New York City to solve the traffic problem.
You forget to ask what the nature of this traffic problem is but
assume that there must be a terrible accumulation of cars in
downtown Manhattan, where the authorities want you to begin
your effort at problem solving. When you arrive for your first day
on the project, in downtown Manhattan in morning rush hour,
you are surprised to find an almost deserted situation with fewer
cars than one would expect even on the slowest New York day.
You therefore conclude that the real problem is this lack of cars
 Bodymind-Energetic Palpation 69

in downtown, and you order thousands of cars to be shifted from

other areas of the city. Shortly after these cars arrive, a bottleneck
on the cross-Bronx expressway clears up, an accident that has
stopped traffic dead in the Lincoln Tunnel is finally cleared away,
and the tens of thousands of cars stuck on the periphery of the
city come pouring into the now congested area that you have cre-
ated by diverting other cars to downtown.
Obviously, your most serious error on this project, one that
would doubtless cost you your job, was failing to ask for detailed
maps not just of downtown Manhattan, but also of all of the tun-
nels and bridges and access routes coming from the other bor-
oughs, New Jersey, and Connecticut. Without these maps as
guides, you could not possibly understand the nature of the local
congestion or lack of same in downtown Manhattan's traffic cir-
culation. Congestion on the periphery of the city is clearly
important for understanding the overall picture.
Well, I ventured with my students, many acupuncturists make
the same error in their own work. They learn the local patterns of
the ZangFu (downtown Manhattan) with very little understanding
of the nature of the possible constrictions and dysfunctions in the
various interconnected meridians and secondary vessels (the tun-
nels and bridges and access routes to "downtown"). They there-
fore focus their attention on the local state of the internal ZangFu
without the same attention to what has happened on the periph-
ery: in the regular meridians, their internal pathways, and the
union points between one meridian and another, where constric-
tions and congestion often occur, and the secondary vessels and
the eight extraordinary vessels. Ignorant of this complex set of
access routes, how could these acupuncturists ever hope to really
understand the true nature of the congestion and dysfunction they
find downtown, in the internal functions of the bodymind?
70 Acupuncture Treatment Staging

This question has concerned me for several years, and I am

delighted that Matsumoto is bringing a new consciousness to the
acupuncture community. Acupuncturists must know the stuff of
acupuncture well-that is to say, the meridial access routes that
lead into and out of the Sea of Qi inside the body. While a herbal-
ist needs to focus his gaze to this internal Sea, an acupuncturist
must be an expert in the periphery-access routes, tunnels, and
bridges that service this Sea.
The Japanese concept of "Kori" studied by Matsumoto and
Birch in Hara Diagnosis: Reflections on the Seal says this all very
well. Kori refers to tense, constricted areas of the body, often
manifested by pain, stiffness, and other subsidiary disturbances
that result from this accumulation of tension. Kori is generally
thought to be caused by a stressed lifestyle, poor diet, and lack of
adequate exercise, leading to an accumulation of tension in the
muscles. This tension in turn causes decreased oxygenation and
flow of nutrients to the tissues, resulting in further contraction
and tightening of the muscles, fascia, and connective tissues
causing more pain and stiffness, etc. While acupuncturists all
speak of "energy blockages," these can be seen more precisely,
physiologically, to entail constriction in four systems of the body.
The muscular tension of Kori constricts the lymph vessels, com-
promising the immune system; the venous system, resulting in
buildup of wastes such as carbon dioxide and lactic acid with
blood stasis; the arterial system, cutting down on oxygen and
nutrients to the tissues; and the nervous system, leading to irri-
tation, pain, and overly "facilitated" areas in which the nervous
impulses misfire (akin to the concept in osteopathy of "trigger
points"). These constrictions that compress the vital activities of
these four systems thereby compromise the functions of the
organs significantly.
 Bodymind-Energetic Palpation 71

Acupuncturists in Japanese traditions who pay attention to

these Kori areas, which can be found only through careful palpa-
tion, know that in releasing these constrictions they do not only
alleviate pain and tension in the affected zones but also free up
circulation in the lymph, venous, arterial, and nervous systems,
improving overall regulation of the bodymind and enhancing
immunity.
With patients who have Chronic Fatigue and Immune
Dysfunction Syndrome, referred to in Chapter 6, those who take
the time to palpate will find Kori to an impressive degree, with
trigger points and muscular nodules so prominent in some cases
as to warrant the diagnosis of fibromyalgia. Freeing up these
tense areas leads to improved functioning throughout these
patients' systems, with an increase in energy and stamina.
Matsumoto and Birch list the most common areas where
Kori develops, which I have reorganized as follows (see the table
on page 72) to show that they usually occur in the Yang meridi-
ans and zones, the big joints (areas where many divergent merid-
ians begin), Chung Mo (part of the Yang Ming system, as we will
see in Chapter 9) and the sternocleidomastoid (SCM) muscles of
the neck, so crucial in autonomic activity according to
Matsumoto's most recent studies.
Following are the points and zones that I palpate. Readers
may also wish to consult the works of Kiiko Matsumoto for the
various "palpation patterns" discovered by some Japanese practi-
tioners who respect meridian energetics and believe, as I do, that
the body speaks the language of energetics and that therapist and
client alike can learn to read this somatic energetic language.
 GREATER MERIDIAN UNIT TENDER POINTS

Taiyang Shaoyang Yangming Chung Mo Big Joints SCM Other

BI. 10 G.B. 20 & 21 St. 11-12 Ki 11-21 BI. 40 St. 9 Liv.9

S.1. I I T.H.15 St. 21-30 St. 30-21 G.B. 34 LI. 18

B1.34-34 G.B. 27-30 L.1. 4 & 10 C.V.2-14 St. 36 Sol. 16

BI. 54 T.H. 16 St. 36, 37, 39 Lu.5

BI. 57-61 G.B.31 Eyes of the Per. 3

knees
BI. 40 G.B. 34 From Taiyin = Ht.3
Lu. I & Sp. 16
BI. 57 G.B. 37-38
 Bodymind-Energetic Palpation 73

Greater Meridian Units-Three Levels of Being

Unit I
Taiyin or Greater Yin (Lungs-Spleen): Sp. 1, 3, 4, 5, 9, 10,
15,20,21; c.v. 12; Lu. 1, 5, 7, 8,9.
Yangming or Sunlight Yang (Large Intestine-Stomach): St.
43,39,37,36,30,25, 18, 12,4,3; L.1. 19-20, 18, 11,10,6,4.

Unit II
Shaoyin or Lesser Yin (Heart-Kidneys): Ht. 7, 3, 1; Kid. 27,
23,21,16,11,10,7,3,2,1; c.v. 23, c.v. 6.
Taiyang or Greater Yang (Small Intestine-Bladder): S.1. 3, 4, 6,
7,9,10, 11,18; Bl. 1,10,11,12,54,40,58,59,64,67; c.v. 3, 4.

Unit III
Jueyin or Absolute Yin (Pericardium-Liver): Per. 6, 5, 4, 1;
c.v. 17, 18; Liv. 3, 5, 8, 9, 13, 14; C. V. 10, 11.
Shaoyang or Lesser Yang (Triple Heater-Gall Bladder): T.H.
3, 5, 10, 15, 16, 22, 23; G.B. 1, 3, 13, 14,20, 21, 22, 24,26,29,
30,31,34,40,41,44.

Note: As shown above, the English translations for the

Greater Meridian Units are as follows: Taiyin = Greater Yin;
Yangming = Sunlight yang; Shaoyin = Lesser Yin; Taiyang =
Greater Yang; Jueyin = Absolute Yin; Shaoyang = Lesser Yang.
The italicized points are the key points of union where the two
meridians-Lungs with Spleen; Large Intestine with Stomach for
the first Unit-have energetic overlaps or places where their
energy is most concentrated. The other points are also key points
of each of the meridians. Thus, if I were palpating the Liver
meridian, I would palpate all the points of the Liver channel
under Jueyin above. But if I were palpating Jueyin as a Great
74 Acupuncture Treatment Staging

Meridian unit, I would palpate the italicized points: Per. 6, 5, 1;

C.V 10, 11, 17, 18; Liver 3,5,9,14. Palpation of both zones usu-
ally occurs for me simultaneously. If I initially suspect constric-
tion in the Liver zone as a result of the intake interview, I will
begin to palpate the Liver meridian (first on the left, as
Matsumoto emphasizes) on both sides to see if one side is excess
and the other is deficient and then move to palpation of the
Pericardium pathway on both sides. Often this will reveal upper
left and lower right imbalance, or the reverse-for example, with
excess in the Liver pathway on the leg on the left and of the
Pericardium pathway on the left arm points, with deficiency of
Jueyin, Liver, and Pericardium pathways on the right. Any of the
various combinations of upper/lower and right/left are possible,
and I check for these first.

ABDOMINAL STRESS REACTION PATTERNS

After observing abdominal palpation from Kiiko Matsumoto at a
seminar at the Tri-State College several years ago, and trying it
out with my clients for a year, I discussed with Kiiko the possi-
bility of two common abdomens, a deficient yang of Spleen and
Kidney abdomen, correlating with adrenal exhaustion and the
parasympathetic stress patterns (ZangFu patterns of Earth,
Metal, and Kidney Yang), and a constrained Liver Qi abdomen,
correlating with sympathetic stress reaction patterns (the Kidney
Yin, Wood, and Fire patterns of the ZangFu). She agreed, adding
that about 80% of the population have one or the other
abdomen, with 40% showing signs of one and 40% showing signs
of the other. The remaining 20% of the population have a com-
bination of the two, according to some Korean research that cor-
related these abdomens with sympathetic and parasympathetic
 Bodymind-Energetic Palpation 75

FIGURE 6

-----
( V 1,--
""'--"

Left: Abdomen of Fear and Exhaustion (parasympathetic

dominant): This constriction usually encompasses the duodenum,
especially to the left of the navel, the duodenojejunal junction,
and the adrenals, with repercussions throughout the small
intestine and bladder.

Right: Abdomen of Fight-or-Flight (sympathetic dominant):

This constriction usually encompasses the ascending colon and hepatic
flexion of the colon, the liver and gallbladder, the transverse
colon, and the lower aspect of the descending colon.
76 Acupunaure Treatment Staging

system activity. I therefore always check for these two common

Hara patterns and teach my clients simple visualizing techniques
and acupressure to focus their breathing on this Hara zone,
thereby bringing their energetic center back down to the core in
acupuncture-energetic terms. This often correlates, for me, with
Eight Extraordinary Vessel treatment in a way different from the
Japanese authors studied by Kiiko but consistent with their think-
ing and intention.
Also, I always palpate, where appropriate, the Mu and Shu
points, with special attention in these days of immune deficiency
to Bl. 14 and 43 (14 for panic syndromes and 43 for the immune
system); Bl. 17 and 18 for the diaphragm; and Bl. 18, 20, and 23
for the immune system, as discussed in Chapter 6. This palpation
is accompanied by statements appropriate to the imaging, as dis-
cussed above, and sets a clear context for the needling process.

COMMON VISCERAL CONSTRICTIONS

REFLECTING ON THE HARA

In a workshop I attended with the prominent French osteopath

Dr. Jean-Pierre Barral, author of Visceral Manipulation (Vols. 1
and 2), I was struck by the key sensitive areas he pointed out,
referring to specific visceral constrictions, which invariably were
points that I have come to focus on in my own practice, having
found them to be congested very frequently in my clients. If
Barral's theory of visceral constriction is correct-that once stres-
sors invade the surface muscles and fascia, they are absorbed by
the suspensory tissues, ligaments, and connective network that
binds the viscera to the peritoneum, the diaphragm, or each other
to maintain them in their proper place and motion-then the
acupuncture release of appropriate points will free up these inter-