i've been thinking a lot about applying "anatomy trains" concepts to the way i do acupuncture... some thoughts. first, i've been thinking a lot about insertion angles and insertion depth. what is the significance of these (often taken-for-granted) aspects of needling? sure, there is talk about achieving a proper depth in the tissue in order to "obtain the qi," but: what, concretely, is going on, what is the needle physically being inserted into? no one knows where the "qi" flows... some hold that the ying qi (nutritive qi), which is the main substrate flowing through the 12 + 2 main channels, is "midway deep" in the tissue, somewhere between bone and skin. thus, the presumption that to reach this channel qi, you need to insert from .5 to 1 cun in... HOWEVER, japanese stylists as a whole tend to opt for much more superficial insertion, actually a flat (transverse) insertion.
why the discrepancy? and does it matter?
i used to think of this solely in terms of cultural preferences: the chinese seem to like "hard stimulation," they want to "really feel" the obtaining of qi, whereas the japanese (whom, i've literally heard explicitly stated) are much too "sensitive," and require as minimal stimulation as possible... but lately, my ideas are shifting... i think that the flat insertion is for a purpose. it inserts into superficial fascia. and, as the "anatomy trains" text implies, fascia (myofascia, connective tissue) is the ubiquitous and much-overlooked substrate holding everything together (muscles to bones to internal organs) and ALLOWING COMMUNICATION between parts of the body... actual signal transferences...
needling into superficial fascia via transverse insertion is oftentimes MORE effective than "deep perpendicular needling" into, more often than not, simple muscle tissue... witness the effects of hinaishin intradermal needles, which, over time, accomplish what perpendicular insertion does not.
this gets into the issue of needling direction. here, the chinese texts talk about going "with or against" the "flow" of the meridian... as if the direction of flow was in itself unambiguous...
it has been argued (note in john pirog's text) that the directionality of the meridians is not necessarily unambiguous, and may in fact be the product of changing cultural perspectives... pirog believed that, originally, the channels ALL started distally, and flowed proximally, reflecting the "old culture's" belief that energy (good and bad) flowed INTO the human body... (reflecting man's ultimate dependence upon nature). the later culture redirected the flow of certain channels, such that there was an alternation in flow, with some channels flowing into the body, and others flowing out. this reflecting man's burgeoning sense of independence from nature, and thus a focus more upon his self-regulating mechanisms...
so if the "directionality" of meridians is not absolute, then what determines the "direction" of needle insertion?
i am slowly coming to believe that needle insertion direction is best determined through a consideration of "where" you would like fascia to "go", to "spread." this goes in line with the rolfing/structural integrationists focus on the directionality of strokes. while the run-of-the-mill bodyworkers just try to "soften tissue," without regard for "where it is going," rolfers appreciate the structural "tensegrity" of the body, and consider direction "vital" to the "information" that the rolfer seeks to integrate into the body...
why not look at needle insertion direction the same way?
in fact, looking at things in very concrete terms: if fascia is like the "plastic bag" containing the structural elements in the body, and if, like a plastic bag, it can be "pulled" and "stretched" in different directions via bodywork technique, then HOW MUCH MORE could it be "pulled" via a needle that literally "hooks into" the superficial fascia and "pulls" it in the direction of needle insertion!?
kiiko matsumoto herself seems to imply this perspective. for example, in her visceroptosis treatment, she utilizes st 13 (needled transversely, angled "up and out") in order to address palpable pain on st 30. the metaphor she uses is one of a shirt: when st 13 (below the clavicle) is pulled up and out, it "stretches" the entire shirt upwards... isn't this a fascial perspective on channel dynamics???
i am venturing to utilize acupuncture in a very different way. i call this "structural based acupuncture," because it does not deal with "channel energetics," it refuses to look upon the larger tcm ideas of channel symptomatology, etc. (which, while rich in information, has no reliable basis in present-day experience). the effects of points in this "structural based acupuncture" are mediated solely through the superficial fascia...
i believe this can be a potentially more consistent and profound form of acupuncture. it can be the basis for the discovery of "empirical points" for certain musculoskeletal conditions (ex. why st 38? for shoulder pain?). with the standard way of applying points, it's a hit or miss kind of thing. it's like hitting buttons randomly on a computer keyboard, in order to get results, without an understanding of the software... at least by thinking of the "points" as being potentially idiosyncratic and momentary accretions on the superficial fascia, we understand them as participating in a continuity which has an effect on global structure... and in this way we can potentially "discover" and use "points" intelligently and effectively.
i will experiment with patients, see how effective this perspective really is. and if i obtain good results, i will try to systematize my findings so my students can use this to adjust structure.
that would be cool.
after adjustment for structure, other, deeper imbalances could then be addressed. but i do believe that structure accounts for several "unexplained" symptomatology in itself, and the resolution of structural abberations could in itself "cure" a lot of patients...
well, we'll see.
fascinating!
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