An EV Case from Jennifer Spain in Raleigh, NC.

A few months ago, a friend, who is also an acupuncturist, reached out to me for help with a year-old neck injury.  He had been treating himself with adequate success over the past year, but recently had an unexplainable flare up that involved both the right side of his neck and his right shoulder.  The neck pain was tight and achy—similar to what he had been experiencing for the past year, though more severe, and the shoulder pain was a new, deep squeezing pressure inside the joint capsule. He hadn’t had much luck getting the pain to shift with the treatments he’d been giving himself. 

Upon examination, I found the yang rhythm at his left hip to be lowest, and channel listening guided me to the Urinary Bladder channel. Manual thermal diagnosis on his left leg indicated UB58 to be an active point, and the yang rhythm increased as I applied pressure to that point with my fingertip. His pulse was bilaterally deep, thin, and slippery; and he had very strong bilateral oketsu (blood stasis) signs. This pulse indicated hot fluids stagnating in the lower burner, and specifically to the use of a formula like Polyporus Decoction (zhū líng tāng). I inquired about any urinary symptoms, thirst, or dryness. He replied that he had been having some urinary difficulty, along with dry mouth and lips, and thirst since the onset of the flare up. This was interesting! I had an active bladder point, urinary symptoms, and a pulse that indicated a formula that moves hot, stagnant fluids out of the bladder. The strong oketsu signs also made sense in this context since blood will often heat up and become stagnant when the fluids become hot and stagnant. Additionally, this all seemed to relate very well to pain inside the shoulder joint which is full of synovial fluid, and the well-understood premise that blood stagnation can cause pain. 

Using acupuncture, I treated the left hip with left UB58, treated oketsu with Lv4 bilaterally, and treated the shoulder and neck with right LI11, and left GB41 and TB5. I also gave him Polyporus Decoction (zhū líng tāng) to take for a couple of weeks. Upon follow up, my friend reported that the squeezing pain in the shoulder joint completely resolved after a couple of days, and his neck pain returned to his prior baseline.  The urinary symptoms also completely cleared up, as well as the dryness and thirst.  

    The Engaging Vitality approach is all about listening to the body to see what’s showing up first, and then using Chinese medical theory to understand and make sense of it. There are so many theoretical relationships that this case made tangible for me, that I thought it might be interesting to share it. There is the contralateral relationship between the left hip and the right shoulder, the relationship between the fluids in the bladder and all the fluids in the body, the bladder organ and taiyang bladder channel relationship, and the relationship of interior blood disharmony and exterior pain along the taiyang areas of the body. 

One thing the EV instructors have repeated many times is that it’s more clinically useful to try to be helpful rather than be right. It would have been so easy to have given my friend an acupuncture treatment that used local points in the painful areas to release local stagnation, and then given him a formula like Cinnamon Twig Decoction plus Kudzu (guì zhī jiā gé gēn tāng) that theoretically addresses painful conditions in the neck. That might have seemed more right based on a symptomatic approach to treatment. Actually I found out later that my friend had taken a formula based on that approach with no effect. Polyporus Decoction (zhū líng tāng is actually a perfect fit in this context: it contains Alismatis Rhizoma (zé xiè), Poria (fú líng), and Polyporus (zhū líng) to move congested fluids, Asini Corii Colla (ē jiāo) to address the blood, and Talcum (huá shí) to cool. By listening first to my friend’s body, and then making sense of all the combined diagnostic information from the palpatory findings and the pulse, I was able to administer a treatment that was actually helpful and that also made sense within the context of Chinese medical theory.