TCM: My Complete List of Blocks to Treatment


I was in student clinic when I lamented to one of my instructors, "This patient has come in for eight weekly treatments and their neck pain hasn't gone away yet.  Every week it's the same - I treat them on a Friday, their pain is relieved for a few days and it's back again by Friday!"

"Have you tried the Dragons?" my professor asked me.  "No," I replied.  "What's that?"

My teacher quickly broke down how to do Internal and External Dragons from Five-Element acupuncture.  In fact, upon graduation, he would give me Hicks & Hicks' book that contained this protocol and more.  I performed both Dragons protocol over the course of treatment nine and ten, and to my astonishment the patient never had neck pain again.  I was sold.

Herein are all three protocols I borrow from other styles and approaches to help any patients who do not respond to treatment.  There is nothing more disheartening than a patient who doesn't improve a little bit even after one treatment.  After every 'blocks' treatment I go right back to my previous TCM-Style Acupuncture acupoint prescription.

It should go without saying that even though I am looking to rid any blocks to treatment I am always pointing my finger back to myself questioning whether I can make a better diagnosis and treatment.

Protocol name: Internal & External Dragons
Style: Five Element Constitutional Acupuncture

Internal Dragons
1 Fen (1/4 Cun) below REN15

Internal Dragons is used for any condition where we believe the patient to have something inside of them that is affecting their ability to heal. Example: mental, emotional, spiritual, Inner-Gate; In my mind it is like we are asking the patient to take anything they are holding onto in their Heart and purge it through the digestive system.

External Dragons:

External Dragons is used for any condition where we believe the patient to be affected by anything outside of them. Example: addictions, toxic relationships, Outer-Gate; In my mind it is like we are asking the patient to take anything they are holding onto in their Mind and purge it through the urinary system.

Depending on how much time I have with my patient I will either decide to perform only Internal Dragons in one session and External Dragons in a separate session (preferred), or both in the same one-hour treatment (15-minutes given for each treatment). Typically, Internal is used before External but as we have shown ourselves many times over again in clinic there are no hard-fast rules in this medicine other than keeping our patients safe.

Protocol name: Fear & Shock (modified)
Style: Kiiko Matsumoto Acupuncture

1 Cun inferolateral to the umbilicus at 4 o'clock
1 Cun inferolateral to the umbilicus at 8 o'clock

This modified protocol was taught to me by a senior acupuncturist and has proven very useful over the years.  Fear & Shock is the next protocol I perform if the Dragons have failed. The clock measurements are actually 'reflective' points - where we can push to see if they are sore (very similar to Front-Mu and Back-Shu); however, I just needle them.

It was recommended to me to perform this treatment for 15-20 minutes and then take pulse diagnostic again.  Every time the pulse has changed for me and given me a clearer picture to help create a new TCM-Style acupuncture treatment.  Sometimes I will give another treatment in the same session based on the new information.

Protocol name: Aggressive Energy
Five Element Constitutional Acupuncture

Place all needles very superficially - just so they are standing up, not floppy, but not into the muscle:

All Zang organs are needled except for the Heart - as in Five Element acupuncture it is believed that the Pericardium protects the Heart.  The needles are placed and left superficially until any Deqi/reddening around the needles dissipates - this can take up to 45 minutes.  Some practitioners use this protocol as part of their initial consultation - viewing which organs display Deqi and believing these to be imbalanced.

I can't stress enough how I never blame a block to treatment as the reason my patient is not responding to acupuncture.  I always believe that I can make a better point prescription, going deep into the basic diagnostics.  Maybe I didn't ask the right questions.  Maybe I just need more patience - allowing each treatment to build on the last (I recall two different situations where a man who had had four back-to-back strokes took four treatments to regain his ability to walk unassisted, whereas a woman took nine treatments for her tennis elbow to respond).

Yes, there may be external circumstances that will affect treatment such as repetitive strain to an injury or high-levels of stress that are beyond my control, but I still prefer to place the blame on me - the practitioner - for when a patient feels nothing post-treatment.  I am the facilitator after all and my patient is giving away their time and money.

And I am carrying 5000 years of Chinese medicine history on my back.  I take that pretty seriously.

Kenton Sefcik