I read the following article by Dr. Amaro quite a while ago, but as a practitioner his message has stuck with me. Often, my new patients will start off our initial consultation with the words, “you are my last hope”, because they have been everywhere and tried everything prior to giving acupuncture a chance. The beauty of Chinese medicine is that it looks at everything going on in the body – both physical and emotional – to arrive at a treatment plan. Addressing constipation to treat back pain can be key for many patients when nothing else has worked. Dr. Amaro’s complete acupuncture point prescription for constipation referred to later in the article is: Ren 12, 5 and 4, SP16, ST25, 38, 40, GB34, LI2, 4, and BL25 and 42.
“The frog in the well—knows not of the great ocean”!
November 17, 2003
By: John A. Amaro D.C., FIAMA, Dipl.Ac.(IAMA)(NCCAOM), L.Ac. In the early 70’s when acupuncture was first being introduced to the United States through numerous media reports, the medical profession was less than accepting of this seemingly strange healing art. The first time I had ever heard the statement “The frog in the well knows not of the great ocean” was an angered Chinese response to the American scientific and medical communities allegations of “fraud, quackery and hypnosis regarding acupuncture. Since that time I have used this saying often whenever I respond to someone exhibiting what may be described as “tunnel vision” or the unwillingness to investigate a matter further than what is on the surface.
Since I am personally involved with both acupuncture and chiropractic which unfortunately are two professions which are often very misunderstood by both the public and the medical profession, I have uttered my sentiments about the frog many many times.
This article however has nothing to do with the politics of the profession, public or scientific misunderstanding or even tunnel vision for that matter, but it does have to do with thinking outside of the box. Something I refer to as “lateral thinking”.
How often are we as practitioners approached by a new patient seeking our help who reports to having been everywhere and done everything for their condition but to no avail? These patients tell horrendous stories of woe concerning pain, suffering, financial loss and considerable time, energy and emotional drain in their attempt to find relief from their conditions. Since both chiropractic and acupuncture are generally the last stop on the patient’s list of practitioners to see for their health condition, we often see the patient when they are at the extreme of frustration and loss of patience. Far too often a patient has already made up their mind before coming to our office that they’ll give this approach a try but just a very short one. In both acupuncture and chiropractic it behooves the practitioner to show a dramatic clinical response very early in treatment.
When seeing a patient who reports an extensive medical history and a multitude of doctors seen for their condition, it is imperative to engage our brains and creativity in lateral thinking. That is, to avoid tunnel vision. Remember, the frog in the well, knows not of the great ocean”.
A 24-year-old married pharmacy student sought care in my office for severe debilitating lumbar back pain. She reported having back pain for years but for the last three full years, the pain was virtually uncontrollable.
This patient stated she had seen three different orthopedics, a neurosurgeon, physical therapy and medical physicians specializing in pain. Her x-ray report stated no radiographic evidence of abnormality in the lumbar spine. Her MRI was likewise unremarkable.
Over the last three years, this patient had received three epidurals with no response. She further received three spinal nerve blocks which she admitted to very minimal response but lasted only a few days.
After my initial consultation with the patient, I asked if she could bring in her most recent x-rays for my review before we continued. When she returned with the films I held the x-ray overhead illuminating it through the sun coming into the treatment room window. It was then I inquired about what appeared to be apparent constipation as her colon revealed the mottled appearance seen in that condition. The size and shape of the colon was also of considerable question. She stated she has a history of constipation from the time she was eight years old. She reported having used mineral oil and enemas the vast majority of her life. A normal bowel movement is totally unheard of.
While in undergraduate college she complained of considerable abdominal pain and was diagnosed as “irritable bowel syndrome”. None of this information had ever been discussed prior to my comment about her being constipated as shown by the x-rays.
She was treated with my favorite acupuncture approach to constipation following one meridian balancing treatment as shown by the “Electro Meridian Imaging” evaluation.
The patient returned to the office the following week literally glowing stating she has had normal bowel movements multiple times through out the last four days and her back pain is completely gone. Her back pain has yet to return after almost two full months.
Perhaps one of my most striking cases of lateral thinking concerned a young man 32 years old who was escorted into the office by both his mother and wife. He required assistance to walk and needed constant attention in his everyday movements. The most obvious physical clue he was extremely ill other than his lack of ambulation was the fact his coloring was literally khaki green. He presented as an advanced case of cancer and AIDS.
He had just moved to Arizona from Georgia with his wife and child. The reason for his move as obviously ill as he was was that he would be dead according to his physicians within the next 3-4 months. He had moved to Arizona so his wife and little girl could be close to his mother when he passed.
He stated he had been diagnosed as “Whipple’s Syndrome” which is a malabsorption disease affecting the immune system of the body and often affects the heart, lung and brain. Symptoms include weight loss, fatigue, abdominal pain, loss of appetite and diarrhea. It is considered a rare disease and often fatal. Treatment consists medically of extensive antibiotic therapy and in his case, was taking millions of units of penicillin a day in an attempt to prolong his life. Whipple’s disease is caused by a bacteria which affects the villi of the small intestine which negatively affects nutrients from being absorbed into the body. In those cases that recover, recovery may take up to two years and full relapses are common making this disease one to monitor for years in survivors.
His reason for seeking my assistance in the office was primarily his mothers thought that possibly we could help ease his horrendous abdominal pain in the last days of his life. His “Electro Meridian Imaging” examination showed major pathologic splits in 10 of the 12 meridians with the other two being literally off of the charts. His condition was grave. In discussing more about Whipple’s Syndrome with him because frankly I had never come across it before, I palpated his abdomen and found it to be of the same general feel as the top of my desk. When I inquired about his abdominal pain and in his bowel habits his exact words were “I squeeze out a couple of rabbit turds every two or three weeks” I discovered this had been going on for over three years and perhaps longer than four years.
With this knowledge I treated him with as I have mentioned earlier in this article with my favorite acupuncture approach for constipation. Two days later he returned for a follow up treatment. At which time he asked “What did you do to me on that last visit” When I asked, “why do you ask” he responded with “because I had a major evacuation”. The definition of a major evacuation was that he was unable to flush the toilet at one time. He stated he was forced to remove some of the fecal material from the bowl into a bucket and flush it in increments.
In essence this gentlemen did not have what is known as Whipple’s Syndrome, he was merely severely constipated. The millions of units of penicillin he had been treated with was totally inappropriate. The rest of the story is that one month later he began working for a landscape company. He settled down with his family in Arizona and enjoyed hiking and taking his daughter to soccer practice. Incidentally, that was 16 years ago. He has been in perfect health for all of that time. He visits the office for routine maintenance treatment four times a year whenever the seasons change.
His physicians had never considered something as simple or as common as constipation. In this case, the frog in the well knew not of the great ocean.
Even though the illustration at the end of this article is specific to what I have referred to as my favorite acupuncture approach for constipation, sometimes just using a portion of this entire approach has incredible effects. Two of the most significant points for constipation are simply the combination of GB34 and ST40. This was taught to me 30 years ago in Asia. It has always been one of my most landmark approaches to constipation.
Years ago when I practiced in Kansas City, I attended a farmer from a neighboring town who walked with a considerable limp due to extreme osteoarthritis of the knee. As part of my approach to the treatment of his knee I used amongst other points GB34 and ST40. On his next visit this gentlemen also said “what did you do to me on that last visit”? When I inquired “Why”? He stated he was feeling considerable improvement in his knee and decided to take a walk out to the mailbox which before he would never had considered such a walk as it was over a half mile from the house. He stated that during the walk he experienced pain in his rectal area that became quite uncomfortable. It was then he realized he had just defecated in his pants. He went on to tell me that he had not experienced what most would consider a normal urge to evacuate in his memory. He had not moved his bowels without the use of an enema in over 25 years. The discomfort he had felt in his rectum was nothing more than a normal urge to evacuate. He did not recognize that urge as it had been years since he had experienced that sensation.
The gentlemen went on to have relatively good response with his knee however, he remained a general patient of mine until the day I moved to Arizona 10 years later, he never complained of constipation again. His bowels returned to a normal status. He told hundreds of people how he messed his pants. He was quite proud of it.
Always remember the importance of “lateral thinking” and realize everything is often times not the way it seems. “The frog in the well—-knows not of the great ocean”!
About the Author:
John Amaro, L.Ac, D.C. is a renowned author and teacher in the field of medical acupuncture. He is the founder of the International Academy of Medical Acupuncture. He has graciously given me permission to reprint his articles.