Volume 7, Number 4 | Winter 2012

Clinical Report 1 (Acupuncture)
A Case Where Blood Letting was Effective for Health
Problems Following Multiple Traffic Accidents
Takara Yamami

induration. Adding edema to those images thefindings of pressure hypersensitive indentation,pressure hypersensitive bulging, congestion, fine
floating vessels, edema are confirmed.

Ehime Prefectural Central Hospital,
Institute of Oriental Medicine
Basic therapeutic concepts

Introduction

Sequential analysis(temporalrecognition)

At the Ehime Prefectural Central Hospital, Instituteof Oriental Medicine we diagnose conditions basedon sequential and point location reaction analyzes.

Point location
reaction analysis(spatialrecognition)

Following the diagnosis we then apply traditional
Oriental medical techniques with reference to theTraditions frompredecessors(Sawada style,Fukaya style, Kudostyle, classics)

traditions handed down by our predecessors (mostly
Ken Sawada, Isaburo Fukaya, Kunisei Kudo, DomeiYakazu) (Figure 1). The sequential analysis allows

Diagnosis / systematic
pattern classification

comprehensive assessment of the patients mainly
based

on

his/herlifehistoryandfacilitates

understanding any health disorder related factors
up to the time of the patient's first visit. The analysisof reaction at the point locations confirms findings
obtained through inspection and palpation andcompares these to the signs. Regarding the point
location findings and acupuncture and moxibustion
treatment we refer mainly to the classics centering
around the "Compilation of the Twelve Principles of
the Nine Ancient Needles", emphasizing pressure
hypersensitive indentation, pressure hypersensitive
bulging, congestion, fine floating vessels, edema andsimilar findings and then administered techniques
likemoxibustion,acupuncture

andvesselpuncturing.
For images of the acupoint findings described mainlyin the "Compilation of the Twelve Principles of theNine Ancient Needles", where it says "凡用鍼者、虚則実之、満則泄之、宛陳則除之、邪勝則虚之。"deficiency states are identified by the character "員=yuan", which here indicates images of depression
and softening. Conditions described as repletenessor fullness are associated with congestion. The term
宛陳 = wan chen refers to fine floating vessels. A
state of prevailing evil is described as " 方 = fang"
and associated with images of bulging, swelling andApplication of traditional
medical techniques

Figure 1

Regarding acupuncture and moxibustion treatment
moxibustion serves as an excess technique. Further,regarding the needling technique the text says: "徐而疾則実": meaning the needles are slowly inserted
and quickly withdrawn, while "呼盡内鍼・候吸引鍼・推闔其門" means that the needles are inserted at
maximum expiration and withdrawn after waiting
for the inspiration, after which the insertion site of
the needles is massaged with the fingers to close theneedling hole; listed as a technique also considered
to be an excess technique (named: excess roundneedling). Next I would like to consider vessel
puncturing at the well points and skin vessel
puncturing as a form of purgative method and fine
floating vessel puncturing as an elimination method.
As a deficiency method "疾而徐則虚" the needle isquickly inserted and slowly withdrawn in case of
deficiency, "吸則内鍼・吸則轉鍼・候呼引鍼・呼盡乃去":describing that the needles are inserted duringinspiration, twirled also during inspiration andwithdrawn after waiting for the expiration so thatthe needle is completely withdrawn when theexpiration has been completed. This too is adeficiency technique (named deficiency needling).

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

19

Volume 7, Number 4 | Winter 2012

Moreover, in our institute we add as an excess

but the other children are independent and he now

method warming needles and as a deficiency method

lives only with his wife.

skin vessel puncturing.

The diagnosis derived from the sequential analysis

The patient visited out clinic with chief complaints

showed a correlation between the onset of healthof health impairments (neck and shoulder stiffness,

problems and multiple accidents, marriage, wife's

dull headaches, low back pain, numbness of the left

pregnancy and birth, newly-built house and trouble

leg and left arm etc.) following traffic accidents. Iwith the neighborhood, inferring a decreased

report this case here, because the treatment

resistance to blood stagnation and mental stresspresumably contributed to an improvement of theinduced health impairments.

QOL.

Regarding the sequential analysis both modern
Western as well as Oriental medical assessments are

Patient: 52 years, male, local public service employee

important and here in particular comprehension of(road and infrastructure maintenance).

the correlation between life events and healthimpairments. It is in this context important to[Sequential analysis]

understand what the patient thought at the time theChief complaints were neck and shoulder stiffness,

events occurred and how he behaved, how hedull headaches, low back pain, numbness of the leftinteracted with family members and society andleg and left arm etc. that occurred following traffic

imagine what happened to the family based on those

accidents. At the age of 51 he was hit by a car in aresults. Also, it must not be forgotten to take thehead-on collision while riding a motorcycle, themental state of the patient into account.

impact rendering him unconscious. The results of CT
and x-ray imaging did not show skull injuries,[Point location reaction analysis]

fractures or ruptures of internal organs and he wasChecking the reactions mainly at the site of the backdiagnosed with "rupture of the left biceps brachii

transport point, abdominal alarm points, sea points,

muscle" and whole body contusions. Starting aboutsource points. It is important to reduce prejudices

one month after the accident neck and shoulder

and confirm the reactions at the point locations

stiffness, dull headaches, low back pain, numbness

open-mindedly.

of the left leg developed. After a period of half a year

Pressure hypersensitive indentation (α) was found at

suddenly numbness of the left arm developed.

GV12, GV11, BL11, SI11 (left), BL45, BL20, BL23,

Currently, when he passes the accident site on hisBL52, BL25, CV4. Pressure hypersensitive bulging

way to work with his car, the dull headache(β) was found at BL10, GV13 (left), from TE15 –increases in intensity and continues until noon. For

BL43, BL17 – BL18, ST19 – LR14, ST36, LI11.

that reason he reported driving to be trying.

Edema (γ) was found at GV20. Fine floating vessels

Also, looking back at the patient's past life showed,(δ) were observed from GV12 – GV11, BL11 (left),that he had met with accidents at the age of 6, 18, 19,TE15 (right), TE14, SI10 (right), GV6, GV3, from the37 and 48 years, leading to health impairments. Hegreater trochanter down to the vicinity of GB31,married at 25, between 26 and 31 his children werebehind GB34 (left), anterior chest. Point location

born; at 39 he had a new house built and ran into

reactions like congestion (ω) was confirmed at GV20,

trouble with the neighborhood. Here too healthin posterior region of the neck and similar locations.

problems

theBased on the diagnosis derived from point reaction

mentioned events. The third son is still a student,

location analysis, the extensive development of finedeveloped

simultaneouslywithfloating vessels and the mental status the reactions

20

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 7, Number 4 | Winter 2012

found at GV20, upper governing vessel, BL17-18,

puncturing of deficiency bulging performed both

ST19 – LR14 suggested that the development ofduring the 7th treatment improved the low back pain

blood stagnation and a decreased resistance toand numbness of the leg.

mental stress had probably induced the healthApproximately 2.5 months following the first visit

impairments (Figure 2).

(completion of one treatment set) all chief complaints
were rated as "B". After 8 months (completion of twotreatment sets) the chief complaints were rated aseither "A" or "B". Moreover, symptoms other thanthe chief complaints had also improved (Figure 4).

[Acupuncture and moxibustion treatment]
The diagnosis based on sequential and point location
reaction analyzes coincide so that we treated points
at which blood stagnation and mentally induced
reactions were found. We punctured the fine floating
vessels at BL11 (left), GV12, GV6, GV3, GB31 (left),behind GB34 (left). Puncturing of indurations wasperformed at BL17. Tonifying puncturing wasperformed at GV12. We instructed the patient totreat himself with moxibustion at home at BL11,BL13, BL11, SI16 (left), BL20, BL52, BL25, LI11,
ST36. The acupuncture and moxibustion treatment
based mainly on the above described pattern wasperformed at a rate of once every 2 to 4 weeks. TheKampo formula Saibokuto 7.5 g was also prescribed(Figure 3).
[Course][Discussion]

During the 4th treatment we added puncturing ofThe sequential and point location reaction analyzes

indurations at BL43, during the 7th treatment also

showed blood stagnation (fine floating vessels) andpuncturing of indurations at TE15, BL17, which led

traumatic injuries from multiple accidents, theto improvements of the neck and shoulder stiffness,pooling of stagnant blood subsequently resulting in

numbness of the left arm and dull headache. Vessel

liver injury which then in turn led to thepuncturing of fine floating vessels at GV3 anddevelopment of the chief complaints associated withThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

21

Volume 7, Number 4 | Winter 2012

psychological symptoms. The sequential and point
locationreactionanalyzes

facilitatedacomprehensive understanding of the patient and theadministration of the acupuncture and moxibustion
treatment, but except for the chief complaints it was
not considered to relate to improvements in the othersymptoms.

The

acupunctureandmoxibustion

treatment corresponding to the findings at the point
locations had presumably been very effective forrelieving the symptoms.
[Conclusions]
The goal of medical care people are seeking is toswitch from therapy towards an improvement inQOL.

The

improvements

treatment
inof

diseasesfunctional

leads

disorders

toanddisabilities and we believe people are looking for allinclusive improvements of interferences with dailyliving. For that reason the problems should not beapproached using the skills of individuals, but rather
be subject of a team approach (Figure 5).

22

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)