Medical Acupuncture A Journal For Physicians By Physicians Spring I Summer 1999 - Volume 11 I Number 1 "Aurum Nostrum Non Est Aurum Vulgi"

chong mo

CHONG MO:

AN ENERGETIC APPROACH

James K. Rotchford, MD ABSTRACT Chong Mo is a Curious Meridian with many therapeutic indications in medical acupuncture. The clinical pertinence of Chong Mo is illustrated with case examples from a French Energetic perspective. A nonlinear approach to understanding and using Chong Mo is emphasized. KEYWORDS Acupuncture, Curious Meridian, Chong Mo, Review, French Energetics INTRODUCTION This review examines Chong Mo from both a historical and French Energetic perspective. The author believes that the common clinical approach to Chong Mo , which emphasizes its trajectory, is misleading . Chong Mo is an energy vector that acts as a fundamental signal involved in initiating human life, then promoting and transforming it. This review, however, is not meant to be a definitive or thorough academic discussion of Chong Mo, but stresses its clinical pertinence, including case examples from a French Energetic perspective. Some theoretical issues vis-a-vis their applicability to clinical situations will be explored. LITERATURE REVIEW In their book Extraordinary Vessels, Matsumoto and Birch- provide an excellent review of the traditional writings on the Curious Meridians: "The first complete and systematic treatment description of the extraordinary vessels is found in the Zhen Jiu Da Quan, written in 1439 AD, wherein the eight master or treatment points are clearly described." They review the more recent clinical work of Japanese practitioners Michi Tokito and Osamu Ito. They also thoroughly review a vessel treatment system developed by Yoshio Manaka , an elegant system with widespread clinical applications. It often involves ion pumping cords as "activators" of the respective extraordinary

(curious) Meridians. Matsumoto and Birch further explore the Curious Meridian system in Hara: Reflections on the See.; The textbook, Acupuncture: A Comprehensive Texi.; devotes 8 of 741 pages to the Curious Meridians (Eight Miscellaneous channels). Perhaps, the limited attention to the Curious Meridians and the emphasis on their trajectories is typical of what most acupuncturists learn during their training. The first paragraph of the chapter on the Eight Miscellaneous and Twelve Divergent Channels follows: The eight Miscellaneous and twelve Divergent channels comprise an important part of the channel system. The great majority of these vessels branch out from the twelve primary channels and, sharing the function of circulating Qi throughout the body, forrn a web of complex interconnections with the primary channels. Each of these channels has a distinct course which facilitates the functional relationships among the pri mary channels. At the same time, each has its own functional characteristics and clinical utility independent of the primary channels.s The notion of the Curious Meridians acting as ditches and reservoirs that help 'fill a depletion and drain a repletion goes back to the Nen-Chinqs. and the Twenty-Eighth Difficult Issue: Similarly, when the [conduits and network vessels] of man are filled [to overflowing, their surplus contents] enter the eight [single-conduit] vessels - where they are no longer part of the circulation - because the twelve [main] conduits cannot seize this [surplus]. When the [single-conduit vessels] receive evil influences which stagnate in them, swellings and heat will result. In this case one has to hit [the respective vessel] with a sharp

stone., This passage is perhaps part of the justification of the following paragraph: As a network of conduits criss-crossing the Primary channels, the Miscellaneous channels drain and store Qi and Blood from the Primary channels when it is excessive, and supply Qi and Blood when it is deflclent.s The Nan-Ching infers that the direction of pathological flow is unidirectional from the main Meridians to the Curious Meridians. This is consistent with the model of French Energetics. In addition, Qi and blood are much too "substantive" in nature to be contained within the Curious vessels. The tendency to give the Curious Meridians a substantive quality is highly misleading, akin to saying what is of importance in genetics is the structure of DNA without understanding that there is a vector of energy (information) stored and manifested via the DNA that is the essential. Similarly, the author

believes that the Curious Meridians are much more like energy signals containing information, than like anything material; therein, lies their importance. However, by understanding the extraordinary vessels as fields within fields that are capable of both changing the distribution and quality of energy used in the body and changing the signals that control the use of that energy, we are able to understand the broadest range of therapeutic options.j While Matsumoto and Birch show a clear appreciation of the Yang nature of the Curious Meridians, they nonetheless describe the Curious Meridians as topological entities, as do the vast majority of clinicians. Even Helms, a strong proponent of French Energetics, has emphasized the topographical characteristics of the Curious Meridians.s For pedagogical reasons, perhaps the tradition of clinically teaching the Curious Meridians from a topographical or even functional standpoint has practical merit. Concepts of energy "fields and nonlinear thinking are so new to our Western way of thinking that it behooves any good teacher to take this into account. Helms' chapter on the Curious Meridians is concise and is the best clinical reference in English. His discussion alone of Chong Mo, the endocrine protocols, and the clinical cases involving Chong Mo, make the textbook a must for all physician acupuncturists. The Curious Meridians are not mentioned in the textbook Chinese Acupuncture and Moxibustion,9. which was based on the Essentials of Chinese Acupuncture, used as a textbook by the International Acupuncture Training Centers in Beijing, Shanghai, and Nanjing. The author refers the reader to In the Footsteps of the YellowEmperor'l to fully explore how the political context in China has affected the teaching and practice of acupuncture in China. Suffice it to say that the Curious Meridians, by virtue of being Yang conveyors of information, allude to the notion of a higher design or destiny. In Mervelous Vessels: The Extraordinary Meridians, Desouttera thoroughly addresses the Curious Meridians. He reviews current literature and explores in depth each Curious Meridian's trajectory, symptoms, physical findings, and includes a thorough discussion of all acupuncture points associated with each Curious Meridian. Desoutter completes the book with a discussion of how to treat headaches and lower backaches using Curious Meridians. This author believes that his general principles are helpful about when to consider Curious Meridian therapy because they avoid topography and simple functional *issues: "tf the pathology which presents involves the individual's structure and/or profound transformations involved in the individual's life, address the Curious Meridians. In contrast, if the pathology is more related to the moment and issues of Daily life, treat the twelve ordinary rneridians.ts Unfortunately, the book has yet to be translated into English. Desoutter's approach contrasts with most of the literature on Curious Meridians. There is a tendency to translate the Nan-Ching and other ancient

texts too literally. It is no coincidence that conveyance of clinical acupuncture has been primarily an oral tradition. Studying the ancient texts of Oriental medicine is similar to reading Biblical text, echoing the enormous difficulties in translating from a language so different from our own and putting ideas into their proper context. When looking for truth, are we to interpret everything literally? Language and symbols, in general, reflect truth but fall short of completely conveying it. Notions of energy fields or specific understanding of energy was limited 2000 years ago. In the Daoist tradition, they discussed energy in terms of observable elements in nature. The movement of water, rivers, vessels, and Meridians are perhaps all just examples of an attempt to describe in common vernacular the notions inherent in discussing energy and its relationship to matter. To fully appreciate the conceptual theories upon which Oriental medicine is based, one should examine the mathematical order encoded in the trigrams and hexagrams of Yi Jing. French Energetics The Energetics of Living Systems, as inspired by the French physician Maurice Mussat.s is the result of exploring the mathematical order inherent in the trigrams and hexagrams of the Yi Jing. This theoretical construct clearly emphasizes the energetic aspect of the Curious Meridians. The "linear" aspect of Chong Mo is discussed, but takes on relatively little clinical importance. Chong Mo is clearly the result of the interplay of Tai Yin, Yang Ming, and Jue Yin energy fields. In musical term s, one could think of Chong Mo as a musical chord in which the 3 tones (energy fields) blend harmoniously to provide a context of life and health. When first learning energetics, this author thought of Chong Mo as a regulatory system very similar to our endocrine system, and was taught that any endocrine abnormality is a marker for a Chong Mo imbalance. Current appreciation of Chong Mo reflects it as a means to the source of all that is transformative in life. It goes far beyond the 'material" transformative functions of Tai Yin, Yang Ming, and Jue Yin, but clearly is related to the more "refined" and even spiritual transformations of our lives. Mussat, through his standard algebraic derivations, interposed the energies of the Curious Meridians on the Fuxi Graph I and Fuxi Graph 2 energy grids. The resulting diagram (FlillJr~) incorporates nearly all of the fundamental energy relationships of acupuncture. Mussat has demonstrated that both historically and algebraically, the law of Five Elements (human physiology from an acupuncture stand point) is a derivation of these primary energetic relations. The inner part of the energy grid relates to Graph 2 and structure, the middle layer relates to Graph 1 and the pri mary energy fields, and the outer Yang layer of organization portrays the Curious Meridians. Chong Mo sits at the top of the grid, reflecting its importance, like the emperor, as the intermediary between heaven and earth. Its character of being the Yang of Yang implies a movement toward Yin.

Chong Mo

(CV 4,5) suo PC6

--­ --------SP4

S125 8121 813

st. zs Bl26 GB 38

----------.U --n ---

--_: __ ..-.... ­ -------_ TH 5 GS 25 GS 41 S 63

~- .-U Tai Mo res 26, CV 4)

Du Mo

(CV 3,14)

GS 25 BL 59 _ 813 8L2 3 BL 62

GV3 GS 26 GV 4 LU 7

iliiii

- ---­ ­

- - - -U ----~-----K5 --

[=.:JOl63

Yang Qiao Mo

Ren Mo (CV 3,4,5)

(5110,11, GV 3)

---------- - G-tl -

--­ ------

.

TH 5 ST 25 GS41 Bl63

Yang Wei Mo (GV3, 14, GB 26)

---_ --- 0--------..0 K6

LR3 GV 9 LU 7

PC 6

GV 9

SP4

Yin Oe Me (CV 4,5)

Yin Qiao Me (K7 , CV 4,5,22) Fu Xi Gra phs 1 &. 2

with Curious Mer idi an Ov erlay

Just as oceans historically brought forth life on this planet, the sea of Chong Mo allows life itself to unfold. It has been called the Ocean of Blood , which relates primarily to its quality of being a progenitor of life (blood). In Oriental medicine, blood means much more than it does in Western physiology. As a comparison, Chong Mo could be seen as the signal that stimulates the bone marrow to produce more blood, whereas acupuncture points on the spleen and liver Meridians might be used, respectively, to promote the release and free flow of blood throughout the system. Another analogy is that lakes and seas are the source of water, but without the Yang of Chong Mo , the lakes and seas will dry up because the rain will stop. Similarly, Chong Mo is the source of blood but is not the actual blood. Mussat's general energy grid is important clinically for severa reasons . All 3 parts of each of the 8 locations frequently interact. A structural problem can cause an energy vector to radiate out through the primary energy field and/or into the corresponding Curious Meridian. In pathological processes, an inward migration from the Curious Meridian is less common but does occur. In general, each of the Curious Meridians tends to primarily cause other Curiou Meridians to resonate . The most common patterns seen are a movement from Ren Mo or Yang Qiao Mo into Chong Mo. Yang Wei Mo

tends to resonate into Du Mo, Yin Oe often causes problems in Dai Mo, and less commonly, Yin Qiao Mo resonates into Ren Mo orYang Qiao Mo. These movements around the outer Curious Meridian grid appear to move primarily in "two unit" derivations.s Also, a pattern of Yin to Yang movement will be presented in the clinical examples to follow. If Chong Mo remains out of balance for any period of time, the most likely clinical picture is a progressive and difficult medical history with major problems in all sectors. To treat pelvic problems, an N+1 movement from Dai Mo into Chong Mo is often used. Three important points on the lower extremities are used to activate and modulate Chong Mo: K13, LR 3, and ST 42. Is this approach used simply because a pathway of Chong Mo passes through these points? This is literal thinking. To practice better acupuncture, practitioners must think energetically and nonlinearly. Consider that the 3 points mentioned above are all Earth points. To treat Chong Mo, one places a needle into these Earth points to bring Yang (Heaven) into Yin (Earth). One is also activating Jue Yin and Yang Ming energy fields with these points, and so with the "Earth" flavor of Tai Yin, the Chong Mo chord is activated. To further reinforce the Earth color of the input, include a point such as SP 3, an Earth point on an Earth Meridian. Historically, almost all of the kidney points are associated with Chong Mo. Yet Shao Yin is not part of the Chong Mo triad (Tai Yin, Yang Ming, Jue Yin). It is also not a topographical issue. tfwe understand that Chong Mo represents a signal, Yang to Yin, Heaven to Earth, information to function, we can easily appreciate why the points along the kidney channel would always support a Chong Mo intervention or be involved in a Chong Mo disturbance. It is kidney energy that connects us with our ancestors and ultimately, the "original message," so why not use moxibustion on KII to help our patients remember the importance of bringing Yang into Yin? Thanks be to Dr Mussat for explaining the value of sexual intercourse 3 or 5 days after a Chong Mo intervention. This clearly helps consummate the movement from Yang into Yin. It also has brought many a smile to patients and probably, spouses alike. Practitioners should not hesitate to bring humor into their interventions. The best humor is Fire, which will accentuate any Chong Mo intervention. On a more serious note, imbalances in the proper expression of sexual energy are inevitably associated with Chong Mo disturbances. For example, sexual addiction or excessive masturbation might represent a compartmentalization and/or "dumping" of Chong Mo energy. Chong Mo is a beautiful melody and is meant to express itself in all areas of our lives. Indeed, there are patients in whom energy (Jing) needs to be conserved, and so, standard sexual activity is contraindicated. A lack of Yang in the pelvis is quite common in our society because we tend to have our energy in our heads, with a relative excess pattern above and a deficiency below. In clinical patterns of too much Yang above and too little below, one must consider harmonizing Chong Mo. Why? The idea is to provide a context in which the patient remembers to bring Yang into Yin. Other traditions in acupuncture might call this connecting the heart and the mind, or connecting the heart with the Jing of Ming Men. Via acupuncture, there are many ways to help remind the patient to bring Yang into Yin. The cases presented later are

examples of where Chong Mo activation was clearly indicated. ACUPUNCTURE POINTS ASSOCIATED WITH CHONG MO Reunion points have been described as those on the trajectory of Chong Mo that intersect with regular Meridians. Because the author wishes to minimize the notion of a trajectory when discussing Chong Me, the Yang of the Yang, these points will be reviewed as well as others associated with Chong Mo from a nonlinear standpoint. Master Point: SP 4 SP 4 in the Luo point on the Yin ofTai Yin predicts the connection with Yang Ming in Chong Mo. In some classic texts, ST 30 is the point of departure for Chong Mo. Indeed, the trigrammatic representation of this point illustrates Yang Ming, Jue Yin, and Tai Yang. Tai Yang probably is involved because of Chong Mo's Yang quality and its relationship with the governing vessel. The name of this point, Gongsun, means grandfather and grandson, which clearly allude to Chong Mo's function of connecting the past with the present through its link with ancestral energy. In some traditions, just needling SP 4 opens up Chong Mo, which makes sense if one knows the trigrammatic code for SP 4. Needling of the point implies all of Chong Mo. Coupled Point: MH 6 Much has been written about the point Neiguan. It clearly is used to connect the Yin to the Yang and so, is consistent with the Chong Mo melody. By needling Yang into this point, one mimics a movement from the external world through an inner gate toward the heart, a part of the Yin that needs to be connected to the Yang if life and harmony are to be maintained. Its trigrammatic representation is Shao Yin, Yang Ming, Shao Yin, which reflects a balance toward Yin in the Yang Ming/Shao Yin axis of life. Activation Point: KI1 It is known as Gushing Spring and also Earth Surge. KII represents the ting or start of Kidney energy and thus, is symbolic of going back to the source. It is also the point on the body where man (Yang) connects with Earth (Yin). This connection between Yang and Yin and returning to the source are important themes in the Chong Mo function. Entry Point/Upper Shu: BL 11 This point is synergistic with GV 28, which is a difficult and painful point to needle. BL II reflects one of the points of the body where Yang connects to Yin (GV 28-CV 24) and so, is consistent with the theme of Chong Mo. This point is also the Shu point for the bones. As such, it relates to a substantive Yin Kidney energy and its needling reflects a connection from Yang to Yin and a link to ancestral energy. In the Ling Shu is where this notion of entry and exit points are first reflected in the literature. As a result, these points have defined some topographical charts. Clearly, BL II is a good point to consider when dealing with too much Yang in the neck or head that can be reduced in conjunction with a Chong Mo treatment. Exit Points/Lower Shu: ST 37, ST 39 These points are lower Ho points for the LI and SI Meridians. They are used to bring Yang down along these Meridians and consequently, are consistent with the Yang to Yin melody of Chong Mo.

Starting Point: ST 30, CV 1 CV 1 is discussed in detail below. Mussat considered ST 30 to be almost essential for a Chong Mo intervention, at least as important as MH 6. ST 30 is used in patients with anorexia because it acts on both acquired Jing and innate Jing to promote the flow of Qi. This approach reflects the allowance of Yang to come into Yin to promote life. Needling 8T 30 is known to stimulate a desire for and joy in living. It is widely indicated in cases of sexual dysfunction. ST 30 is the last point on Yang Ming before it descends into the Yin of the legs, reinforcing the notion of the Yang into Yin movement. Reunion/Resonating Points (The general term used is reunion point but because the emphasis here is on the nonlinear aspect of Chong Mo, the term, resonating point, is added.) All the points of the Ren Mo and Du Mo resonate with Chong Mo. Chong Mo's action is on the absolute Yin, and engenders and divides into Yin and Yang, the Ren Mo, and Du Mo. This is why we can say the du mai, Ren mai and chong mai have different names but are all the same. Wang Bing.llt

REN MO CV 1 Meeting of the Yin is the name of this point and it is here, symbolically, that Yang connects with Yin to create life. Needling this point sends a powerful signal for the Yin to connect with Yang. CV 1 is an extremely powerful point often used in conjunction with GV 1 to address "blocks" in the Lower Heater. These are often associated with sexually shaming incidents, or even sexual abuse. The trigrammatic representation of this point is Yang Ming, Shao Yin, Shao Yin, which reflects the axis of life with a Yin emphasis. CV 4 harmonizes and circulates Ren Mo, the forward point of Ming Men, where the movement of Qi between the kidneys takes place. CV 7 resonates between Ren Mo, Chong Mo, and the KI Meridian, and stimulates the Yang of the kidneys. When both Ren Mo and Chong Mo are affected, CV 7 is a good point to use. CV 17 is the Mo point for MH (Jue Yin); it is a place where all Meridians concentrate. CV 17 fits into the theme as the ocean of the Twelve Meridians. It also is commonly used as a point to connect Heaven with the heart and the lungs. CV 22 resonates with ST 12 and hence, the Yang Ming of Chong Mo. Traditional teaching posits a channel that connects ST 12 to CV 22, but this author proposes that the connection is energetic. It may have something to do with the control of Yang descending into the Yin. One of the alternate names for ST 12 is Celestial Cover. This is also the point where Yang (the head) connects with Yin (the body). Du Mo All of the Governing Vessel points can be considered reunion/resonating points. Traditionally, trajectories of Chong Mo follow Du Mo just up to the level of BL 11; because BL 11 is trigrammatically synergistic with GV 28,

I~here is evidence that Chong Mo resonates with all of Du Mo up to GV 28,

where it reunites with Ren Mo. GV 4 is important because of its connection with Ming Men. GV 20 acts as a Du Mo connection with Liver (Jue Yin) and thus, is an intersection of all Yang energy, Jue Yin, and ancestral energy. It also is considered the crown chakra. and as such, needling it facilitates the descent of the Yang into Yin, a basic theme of Chong Mo.

KI Meridian All the points of the KI channel resonate with Chong Mo. Traditionally, KI 11 -21 are important reunion points: they are on the abdomen and as such, reflect a relationship with Yang Ming. Other points on the KI channel have also been discussed. As stated above, KI3 is important because it is the Earth point on the Meridian. The rationale for KII was also discussed earlier, KI8 might resonate well because its name implies belief, which, in turn, implies Heaven connecting with man, or Yang entering Yin.

CASE REPORTS Case 1 A 48-year-old woman presents with recurrent "sinus problems". She is of Tai Yin (metal) constitution: an artist with a long-standing history of varicose veins, dry skin, and a diathesis for constipation. She had serious depression requiring medications in her early 20s. The depressive episode followed the break-up of an intimate relationship with a man whom she intended to marry. In her early 30s, a radiography documented maxillary sinusitis treated successfully with antibiotics. At present, she has started to struggle with frontal headaches that have been diagnosed by a neurologist as migraines masking as sinusitis. She also has developed a greater sensitivity to coffee, with some associated irritability and insomnia if the coffee is consumed later in the day. Recently, her periods have started to be lrreqular. The patient also notes that if she eats extra amounts of sugar, she experiences nasal congestion. Discussion: This case is representative of symptom progression starting in Tai Yin, progressing through Yang Ming, and finally, being confronted with Jue Yin symptoms. The context is also Chong Mo because of her age and the issues of hormonal changes and the transformations she is experiencing. Linearly, Chong Mo has been used to treat sinusitis with ST I being an end point on Chong Mo. Treatment Suggestions: An initial intervention with Chong Mo might be quite effective in reducing some of the "sinus" symptoms. In addition to SP 4, ST 30, and MH 6, this author would consider adding LI4 (Metal source point and command point for head and sinuses), ST I (local point resonating with Chong Mo), and ST 42 (lower Earth point on Chong Mo facilitating an N+2 movement on Yang Ming). If the patient was not sensitive to electrical stimulation, the suggestion would be made to connect LR 3 (Earth point and parasympathetic switch helpful for headaches and sinus conditions) with SP 4, and stimulate with low-frequency electrical stimulation to CV 4. This would promote movement and support of the Yin to counterbalance the excessive

Yang in the head. Other complementary measures might be to include a "blood" tonic to help support Chong Mo function, and regular, but not excessive, sexual activity to "activate" Chong Mo. Meridian Passage, an herbal preparation for congealed blood, might help with healing of the earlier "betrayal" that occurred in her early 20s. tfthe patient responded well to this initial treatment, there are several options. One "elegant" option is to do a "balliage" of Chong Mo, which involves equilibrating first Tai Yin, the next session Yang Ming, the next Jue Yin, and finally, ending the series with another Chong Mo intervention similar to the fi rst. One more note on treating sinuses: because Du Mo is often involved in sinus problems and Du Mo is energetically related to Chong Mo at the top of the energy grid, one must consider that a Chong Mo disturbance has affected Du Mo, and that "mobilization" of Du Mo will be required to resolve the sinus problem. GV 23 (Shangxing), whether in tonification or dispersion, is an important point in treating sinuses, and its effectiveness can be augmented by formally opening up Du Mo.

Case 2 A 64-year-old white man presents with intermittent suprapubic discomfort and urinary urgency and frequency. He has undergone a urological workup and is status posttransurethral prostatectomy for benign prostatic hyperplasia. He has worked as a high school English teacher for most of his life, and has a Yang Ming constitution. For the most part, aside from some mild digestive problems, he has been in good health until about 10 years ago when he developed mild depression for which he has been taking fluoxetine. He lists about 30 supplements he takes to keep himself healthy. The "prostate" symptoms started 4 to 5 years ago and resulted in surgery that did little to alleviate his symptoms of intermittent suprapubic pain and urinary urgency. He was evaluated for dietary factors that could cause symptoms, but nothing aside from coffee was found that would affect the symptoms. When he was in his 20s and 30s, he was quite active sexually, engaging in sex sometimes 2 or 3 times a day. He appears emotionally sensitive, in need of respectful reassurance. His voice quivers with insecurity. He is nearsighted and wears fairly thick glasses. He looks healthy and is engaging in conversation. His tongue is pale with scalloped edges. An abdominal examination shows diffuse sensitivity but is otherwise normal. Palpation reveals a tight liver pulse and otherwise deep and relatively weak pulses. Discussion: This patient is not so clearly a case of a Chong Mo disturbance, yet a good argument could be made for that diagnosis. His constitution is basically Yang Ming according to his history and examination, but his nearsightedness and guardedness suggest a Jue Yin component to his personality. This author's experience teaches that Yang Ming individuals inevitably, without some important counseling or input, develop Jue Yin problems. They become angry or resentful because no one really appreciates the care or concern they show (a setup for a high school English

teacher). His depression, which has warranted ongoing treatment, could reflect a disturbance in Tai Yin, Yang Ming, or Ren Mo. Primarily suspected is a Ren Mo imbalance because of the midline discomfort problems that followed. So where does Chong Mo come into the picture? Yang Ming and Jue Yin are readily apparent in this patient. The Tai Yin tip-off is the supplements he takes, and the concern about whether he is taking all that he should. Also, many "bladder" problems are actually Tai Yin mucosal problems that resonate into the bladder sector. Finally, his younger sexual excesses point to a tendency for Chong Mo problems. In addition, a Ren Mo problem may have arisen from a Yin deficiency because of Jing deficiency secondary to excessive sexual activity in this patient's youth. In any event, the Figure illustrates that Yang Ming disturbances can express as or evolve into Ren Mo problems. Ren Mo problems often then evolve or resonate into Chong Mo. The prostate clearly is a sexual organ, and a disturbance there implies a Chong Mo disturbance. Treatment Strategies: There are all kinds of possibilities in this case, but to start with a simple Yang Ming equilibration sets the stage and touches on Tai Yin, Yang Ming, and Jue Yin. The patient's longstanding Jue Yin issues may have caused a disturbance in Dai Mo, which opens up the pelvis area to an up-and-down movement of energy, and is clearly indicated. The next treatment would be to open up Dai Mo and perform an N+1 movement into Ren Mo with stimulation of KI6 to CV 4 using electricity. (Moxa or heat on CV 3,4 is indicated.) SP 4 could be added to augment this movement from Yang to Yin. Indeed, this patient is Yin deficient, all the more reason to support the Yin by bringing Yang into Yin (Chong Mo melody). The next 5 sessions could be a balliage of Chong Mo with Chong Mo input followed by a Tai Yin equilibration, followed by a Yang Ming equilibration, and finishing included with a Jue Yin equilibration. The fifth treatment could again be Chong Mo. GV 20, CV 1, and GV 1 should be included (Rapport with the patient is now established). In the course of treatment, reduce supplements and prescribe some kidney and Jing tonics. This patient would be seen monthly for a year with conti nued support of the Vin, encouragement to minimize sexual excess, and continuation of heat/moxa to his lower Heater. Tai Chi would also be encouraged. Contraindications As alluded to earlier, there are many conditions in clinical acupuncture that a Chong Mo intervention can help. Rather than enumerate all the specific indications for Chong Mo, a brief discussion of those conditions for which Chong Mo is probably not indicated is much more succinct. Recent trauma is not a context in which to consider Chong Mo. A significant Yang condition in the lower extremities below the knees most likely would not respond to a Chong Mo inter vention. An exception here might be a stasis den-natitis, which originates from an excess of Yin. This Yin excess can lead eventually to an excess Yang in the superficial tendino-muscular Meridians. If one is dealing with a Yang condition that primarily originates in a Yin deficiency, Chong Mo most likely would be of limited use until the Yin deficiency was partially corrected. Chong Mo interventions might help prevent gouty attacks, but an acute flare-up of gout involving the feet is not a situation for Chong Mo

because it could make the gout symptomatically worse. When the clinical picture reflects primarily an issue of constitutional nature, Chong Mo should be evoked only if the condition becomes Yin by virtue of its chronicity.

CONCLUSIONS The study of Chong Mo has vast and important clinical implications. Its study is also an important exercise to help Westerners begin to think and react nonlinearly. We cannot hope to benefit from all that acupuncture has to offer if we continue to approach it from a linear conceptual model. Relational and energetic concepts need to be understood by practitioners if 21 st century acupuncture is to have a greater power and breadth of influence. REFERENCES 1. Matsumoto K, Birch S . Extraordinary Vessels. Brookline, Mass : Paradigm Publications; 1986. 2. Matsumoto K, Birch S. Hara: Reflec tions on the Sea. Brookline, Mass: Paradigm Publications; 1988. 3. O'Connor J, Bensky D, trans-eds. Acupuncture: A Comprehensive Text. Chicago, III: Eastland Press; 1981:67-75. 4. Unschuld PU. Nan-Ching: The Classic of Difficult Issues . Berkeley: Unlversity of Califomia Press; 1986 :327. Comparative Studies of Health Systems and Medical Care; \01 18. 5. Helms JM. Acupuncture Energetics : A Clinical Approach for Phy sl . cl . ans . Berkeley, Calif: Medical Acupuncture Publishers ; 1995. 6. Xinnong S, et ai, eds . Chinese Acupuncture and Moxibustion. Beijing, China : Foreign Language Press; 1987. 7. Eckman P. In the Footsteps of the Yellow Emperor. San Francisco, Calif: Cypress Book Co; 1996. 8. Desoutter B. Mervetlleux Vaisseaux, Les Meridiens Extraordinaires . Paris, France: Sauramps Editions; 1996: 1. 9. Mussat M. Energetique Physioloque de IAcupuncture. Paris , France: Librairie Ie Francois; 1979. 10. Nei Jing Jie Po Sheng Li Xue [Anatomy and Physiology of the Nei Jing]. 2nd ed. Taiwan: National Chinese Medical Herb Research Center Publishing Co; 1977 :121.

AUTHOR INFORMATION Dr James K. Rotchford is in private pract ice in Port Townsend, Washington. He is a graduate of the University of Washington's School of Medicine and completed a Preventive Medicine residency through the University of Washington School of Public Health. Dr Rotchford is a founding member of the American Academy of Medical Acupuncture (AAMA), and is President of the Medical Acupuncture Research Foundation. He is founding President of the Washington Chapter of AAMA, and acts as Web Dragon Master for the AAMA Website (www.medicalacupuncture.org). James K. Rotchford, MD, MPH 1334 Lawrence St Port Townsend, WA 98368 Phone : 260-385-4843 - Fax : 360-379-1441 - E-mail: [email protected] Back to Top

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