APM Acupuncture in Clinical Practice

325 Pages·2012·1.76 MB·English

by  Mark Seem

APM Acupuncture in Clinical
Practice
st
Classical Approaches for the 21 Century

Mark D. Seem, PhD, LAc

© APM Acupuncture, P.C. and Mark D. Seem July 2012
TSCA students, faculty and alumni are free to scan or otherwise incorporate any parts of
this book into any of their clinical devices/resources by simply citing this source. All others
must obtain permission directly from the author at: [email protected].
TABLE OF CONTENTS

Dedication 3
Prologue 5
APM Acupuncture Jingluo Charts 9

Master Systems Chart 14

Regular Meridian/Circuit
Chart 20

Four Patterns Chart 37
APM and APM
Acupuncture Defined 46
Introduction 52
PART ONE:
PROFESSIONAL DIMENSION 54
Chapters:
1. APM Clinical Training 54
2. Human Centerdness 58
3. History of TCM Compromise 60
4. APM Big Picture 64
5. APM Charting 68
6. APM Learning Objectives 70
7. Human Dimension 72
8. APM Needling Techniques 73
9. Classical Chinese Acupuncture 78
PART II:
PHILOSOPHICAL FOUNDATIONS 79
10. Beginning with the Ling Shu 79
11. Ordinary Skills 90
12. Yang Tends Toward Excess:
Thorns, Stains, Knots, Obstructions 120
13. Acupuncture as Physical
Medicine/ the Role of Location 140
14. The Spirit Uprooted 162
15. The Sages of Antiquity 188
16. Self Cultivation East and West 198

  2
PART III:
APM ACUPUNCTURE PRAGMATICS 213
17. APM Case in Point 213
18. Acupuncture Needling and Tacit
Knowing 238
CONCLUSION AND BEGINNING 266
a. Key APM Concepts 266
b. APM Clinical Katas 269
c. APM Clinical Readiness 304
APPENDICES
1. Etiology and Pathology in APM 308
2. APM Physical Assessment 318

  3
DEDICATION--ACUPUNCTURE IMAGING IN CHART
FORM

The unusual prologue below to a new book, by way of revised APM Acupuncture charts, is
dedicated to Bruce Park, MS/Ac, a serious and dedicated student of mine and now a
graduate of the Tri-State College of Acupuncture.

Bruce challenged me to clarify APM Acupuncture in book and chart form and introduced
me, and others at the college, who were studying the Ling Shu together, to the Learning of
the Mind-and-Heart through the Scroll known as ‘rooted in spirit’.

This way of beginning to come to the present has the distinct advantage of putting the
conclusion, the outcome first, showing what APM Acupuncture is as it has emerged until
now.

I did not always receive these challenges well, as I was deeply agitated at times by what I
found to be wanting in my own APM Acupuncture teaching in particular, and in acupuncture
practice in North American as a whole. I lashed out once in anger at Bruce in class, who had
shown me various APM charts and forms of his own design over time, which he felt might
be beneficial to all students. I realize now that this was because I did not feel like my own
APM chart that figures in the back of Acupuncture Physical Medicine was correct and if I
could not pinpoint what was wrong with this picture how could anyone else?

I now know that Bruce’s efforts to clarify APM in chart form, and with class notes that he
shared generously with other students, was done not out of disrespect for me and my
teaching efforts, but out of reverence for what he found to be a style of practice that
resonated deeply for him. He displayed that same reverence for deep, embodied learning in
the Ling Shu class and it was infectious, and caused me for one to research and then dig
deeply into the Neo-Confucian Learning of the Mind-and-Heart which is at the root of such
embodied study and practice.

The third step in this Neo-Confucian learning, derived from the Confucian classic The Great
Learning, is to make the will sincere, to commit to this learning as a search for li, the
principle or coherence in all things, which leads to a seriousness and a reverence for what
one is studying which keeps one engaged in the Dao of human becoming (ren). In this way
one learns the deep logic or coherence in what one is studying, and learns how to become
a more authentic human being at the same time.

  4
After serious and reverent reflection I realize what Bruce was really challenging me to do
was to transform the APM Acupuncture learning at the college to become more. I have
come to realize that the only way to do that is to remove myself from the position of a
‘sage on the stage’ as is common to say in academe these days, to become at most a ‘guide
on the side’ and mostly a serious student and practitioner myself, abiding in reverence for
this amazing practice which has been a way of life for me for three decades.

Bruce Park showed me reverence and I did not know how to receive it. That is the most
valuable lesson I have ever learned in my AOM career, and perhaps in my life. I shall take
that lesson to heart, literally, for the rest of my days. I will gladly
consider myself a fellow traveler with Bruce, if he permits, whose serious Buddhist training
has allowed him to walk much further along the way, and who will assuredly have much to
share with us all about abiding in reverence for this wonderful practice.

To Bruce Park,

With Love and Gratitude,

Mark Seem

  5
PROLOGUE

DECLARATION OF INDEPENDENCE

th
This is July 4 , 2012.

Close to Thanksgiving 2010 my search for the PRC Chinese-language original
version of a text prepared by leading academies of Chinese Medicine to serve as a
core textbook for the new TCM colleges bore fruit, and it became clear that the
Zhongyi Xuegailun of 1958 was the textbook translated in Hanoi in the 60s, which
Dr. Nguyen Van Nghi translated into French in 1971, and which I translated into
English (from the 1977 third edition) for the Quebec Institute of Acupuncture in
1979. I found this reference in Felix Mann’s Meridians of Acupuncture first written in
the early 60’s, as presented in Mann’s complete work, Handbook of Acupuncture
where he clarified that in studying this and other Chinese medicine academy texts
during his research in PRC, that were being prepared for the same purpose, he was
struck by differences between these PRC texts and the work of George Soulie de
Morant whom he had relied heavily upon in his early writings on the meridians, as
did most European acupuncturists in those early days.

In my new book, APM Acupuncture in Clinical Practice I do my best to correct for
errors in Van Nghi’s work, I place this early pre-TCM text in perspective as one that
could have been adopted by the new TCM colleges, but was not, and show how the
original teachings on ‘merdian acupuncture’ as it was often termed in those days, by
Felix Mann, and taken up by Yitian Ni who cites him, who uses his way of
differentiating the various meridian systems in terms of and based on the 12
meridians and their circuits, is critical for a clear understanding of Classical Chinese
Acupuncture jingluo pattern differentiation and treatment.

In writing this book, I am especially interested in correcting for errors which have
crept into the training I have overseen at the Tri-State College of Acupuncture for
the past 33 years, and which has in turn created confusion and obfuscation about

  6
meridian acupuncture, as I was fond of calling it for at least 2 decades, in other
AOM colleges in the Tri-State region.

I am referring specifically to the meridian teachings of Jeffrey Yuen, a former
student who never graduated from the Tri-State College of Acupuncture when it
was in Stamford, Connecticut twenty years ago, who went on to develop a teaching
of allegedly secret Daoist lineage trainings that were, at least twenty years ago
when he began this venture, derived from the Van Nghi text I was using when I
taught in Stamford, and which I translated into English for the Quebec Institute of
Acupuncture to assist non-French speaking students. The errors he inherited from
this training in Van Nghi’s approach at the college I founded, based on this teaching
as endorsed by the Montreal school, have followed him, as they have me, as he
founded a curriculum at the now defunct Swedish Institute of Massage
Acupuncture program, which he apparently transferred to the NYC branch of
Pacific College of Oriental Medicine where what is referred to as a ‘Classical
Chinese Acupuncture’ style overseen by some very senior faculty formerly from
the Swedish institute who were trained at our college or other branches of the
Montreal school, or who were subsequently taught by these senior faculty, a few of
whom have been practicing for three decades.

In making these points it is not my interest to criticize anyone. We all have done the
best we could using sources in translation that have often gone out of print (the
Chinese text, and Van Nghi’s translation of the Vietnamese version of it, and Felix
Mann’s texts have all gone out of print).

I am doing this because my introduction to Van Nghi’s work starting in 1978 to non-
French speaking students, faculty and practitioners not only in the Tri-State region,
but throughout North America, Canada, England and Holland, where I taught
extensively for many years, has served as a foundation for a significant number of
AOM practitioners who treat from a ‘meridian acupuncture’ perspective.

If this book helps correct for errors they have undoubtedly come across in many
cases themselves if they have been at it for more than a decade, or if it helps re-
ignite interest in jingluo practice inspired by the classics which they may, like so
many, have abandoned as TCM became the dominant form of acupuncture
practice in English-speaking countries I will be very content.

  7
And in the meantime, this text shall serve as my declaration of independence from
French-Vietnamese sources that were academically fascinating but clinically
deficient because they were based on translations twice removed (Van Nghi’s
Translation of the Vietnamese Trung Y Hoc, itself a translation of the 1958 PRC
ZhongYi Xuegailun all of which are now out of print), but more importantly because
they failed to clarify that this training was rooted in 1958, and never bore fruit in the
new TCM colleges. Van Nghi suffered greatly from the cold shoulder the TCM
college world showed to him when he petitioned to be recognized as a pioneer of
European acupuncture and TCM. This was denied time and time again as the late
Oscar Wexu, President of the Quebec Institute of Acupuncture shared with me
then. They doubtless knew full well that his life’s work consisted merely in
translating books from Hanoi, which were translations of books from China that the
TCM academic world passed over in favor of ones that portrayed a ZangFu
orientation.

I have come to believe, and have based the training in Classical Chinese
Acupuncture and APM at the college on the premise that acupuncture is a highly
personal affair, and requires tacit and tactile understanding that can be called upon
in an instant when treating because it has been internalized through deep learning
and practice.

th
This way of embodied learning is something that struck me when I trained with 8
degree Japanese world champion Takahiko Ishikawa in judo in Philadelphia from
1965-1970, where he allowed me to assist in children’s classes. Here was a master
of his art, who also had a PhD in religion and was a top ranking GO champion as
well and it is only now that I appreciate the extent to which his martial arts training
paralleled his training in GO and was also founded on training and study of East
Asian religio-philosophy.

It is to that ancient and classical Chinese literature and practice that I directed my
attention this past year, as I realized that the French, following the Vietnamese and
the PRC Chinese, in fact left out major aspects of what makes Classical Chinese
Acupuncture and Medicine classical in the first place, and so powerful. These
reflections are included for those who are interested in how physical self-
cultivation, and spiritual cultivation of the mind-and-heart went hand in hand in the

  8
several hundred years leading up to the development of Acupuncture and Chinese
Medicine as passed on in the early written texts, something the Su Wen bemoans in
Scroll one as a lost tradition.

The process that I have endured in digging deep into the issues and problems
raised during and by this inquiry has been long and hard and has taken a certain toll.

It has made me realize that while I was cast as an expert in French meridian
acupuncture, too young and too early in my career, what that was was not clear
then, or now. Furthermore, it has made me realize that the best I can offer is to
keep looking for the li (principle, coherence) underneath jingluo acupuncture,
which is still my passion.

This task will be much less daunting now that several of us at the college and
especially those on the APM Team will be studying with Andrew Nugent-Head,
MSOM, who has spent 25 years in PRC learning Classical Chinese Medicine from
the Yin Style Ba Gua tradition, which is founded on physical (Daoyin, martial arts)
and mental (Daoism, Confucianism) approaches to self-cultivation, with a
dedication to cultivating ones medical arts as a lifelong learning process.

In the process of doing the research and reflection that lead to this book, I realized
what is not included in Travell, perhaps because she struggled so vigorously to free
physical medicine, as she was coming to see it, from its moorings in psychosomatic
medicine and plant it squarely on the side of the soma, was the interplay
nonetheless between ‘the psyche and the body process’ as Dr. Flanders Dunbar
from Columbia University called it in her groundbreaking Emotions and Bodily
Changes.

APM Acupuncture corrects for this lack.

This rigid demarcation of a somatic territory where myofascial pain and
dysfunction would play out free from emotional turmoil, trauma and stress is as
lopsided as the over-emphasis on the side of the psyche Travell fought against,
where patients with chronic pain would be seen to suffer from a psychosomatic
disorder best treated in psychotherapy.

  9
It is my experience in the vast majority of cases of chronic pain that I treat, where
the patients are also being treated by other physical medicine practitioners
(orthopedists, neuroloigists, osteopaths, physical and occupational therapists and
massage therapists) that the side of the psyche is being totally overlooked in favor
of a narrow physical medical perspective.

There is no reason why any acupuncturist woud make this mistake, if they adhere
to the classical Chinese acupuncture teachings that the main cause of internal
dysfunction and disease are the 7 emotions when they become inhibited or
expressed excessively. Unfortunately, too many North American TCM practitioners
ignore the side of the psyche as well, framing the patient’s problem from a much
more materialist perspective that is dominant in PRC that is aligned with modern
scientific medicine and so looks askance, in fact, at classical theory and practice,
paying it lip service only in this regard.

And unfortunately, too many North American TCM practitioners, especially if they
ractice herbal medicine, see their terrain as ‘internal medicine’ and look down on
any physical medicine approach to acupuncture and Chinese medicine as
tantamount to tuina which they disdain or consider a lowly step-child of TCM.

It is a frequent occurrence for APM practitioners trained at the Tri-State College of
Acupuncture to see patients for chronic pain and dysfunction who were treated by
TCM practitiners to no avail, who clearly had no phsyiocal medicine perspective or
skills.

APM practitioners, on the other hand, who ignore or even disdain getting involved
on the side of the psyche without a network of some mindbody and bodymind
practitioners are selling their patients short on the benefits they couod derive from
a more comprehensive approach.

And so after 25 years of developing an approach to acupuncture as physical
medicine, which it was and always should have remained as Andrew Nugent-Head
shows in his powerfuil ‘tangible Qi’ video and teachings, and knowing that the
physical medicine training at the college is probably the strongest in North America
and will only get that much more powerful and clinically effective under his ifluence
and training, I am ready to return full force to the bodymind energetic approach I

  10