The Art of Palpation

I just read an article in the latest issue of The Journal of Chinese Medicine (one of my favorite sources for articles on Chinese medicine) debating the validity of acupuncture research studies reporting that true acupuncture doesn't outperform sham acupuncture. 

2015-10-22_point1

Putting aside other criteria necessary for effective acupuncture treatments that may not be taken into account with studies using sham acupuncture, the article argues whether the efficacy of the treatments used in the studies could be affected by the use of textbook acupuncture point locations, rather than points found through diagnostic palpation. 

2015-10-22_point2

The author states that according to many traditional acupuncture practitioners around the world, points are usually referred to as 'areas or fields' in which the actual point will lay and that they can be either 'active' or 'dormant.' If the active point is not found through palpation, and the incorrect or dormant area is needled, the outcome of the treatment will be mediocre. 

The article went on to give examples of specific sensations that the practitioner will feel with different points, what sensations a patient should feel when the active point is identified, and how it should be needled to retain the proper sensation. 

In modern oriental medicine schools, acupuncture point location is taught using measurements as described in textbooks, such as The Manual of Acupuncture  by Peter Deadman. Most students come to memorize the locations, as they provide basic knowledge on point location and their knowledge is required to pass the national Acupuncture and Point Location board exam. What is rarely taught is that these point locations are meant to be used to identify the general area of the point -- a starting off point to palpate and locate the active point -- as locations differ for each patient and will even vary depending on the time of day. 

2015-10-22_point3

Since I began needling patients in the clinic a few weeks ago, I've been taking the time to try and feel the points, massaging and palpating the general area before inserting the needle rather than using the textbook measurements to find points. I'm surprised to find that in this short amount of time, I've been able to feel the areas in the way that the article described. It's really quite remarkable. 

2015-10-22_point4
Point Location Descriptions as illustrated in A Manual of Acupuncture

In this newfound practice of palpation, I've found a way to sincerely enjoy learning how to needle and feel the various sensations and energetic differences in the body. And I now realize that needling is an art form. In my commitment to becoming a successful acupuncture artist, I'm committed to finding practices to improve the motor and sensory functions of my hands to develop greater sensitivity and fine motor skills. In addition to practicing manual palpation and needling, I've been inspired to play my ukulele more often, do daily Qi Gong, paint, and maybe even learn calligraphy!