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Treatment of conditions arising out of earlier conditions


Hello All,

I’m not sure whether this belongs in Theory or Questions.

I have someone who has had a long history of “unhappy liver.” About 3 years ago they had symptoms of Liver Qi
Stagnation. Now with no treatment they have progressed to have symptoms of Liver Fire Blazing, Liver Yang Rising, and Damp Heat in Liver. It seems to me that all three of those (and the 900 symptoms) might all be resolved by treating Liver Qi stagnation, with less overstimulation of the body by treating fewer points. I suspect based on their symptoms descriptions that further back, this person had Spleen Deficiency which untreated led to Liver Qi Stagnation, but that going back that far would be precipitous and that the Spleen Deficiency symptoms will reappear to be treated at the proper time of the body as the Liver Qi stagnation unwinds.

I also want to help address anxiety - won’t that happen naturally by treating the Liver Qi Stagnation? Fewer points always being better?

Thank you for your consideration of this issue.



The number of points is somewhat irrelevant as long as they are all individually and collectively justified by the treatment approach. But a clear and well defined and justified approach is always better than chasing an array of symptoms/diagnoses.

I would suggest you generally start by reading our acupuncture treatment plan guidelines. While basic it may help to guide your treatment preparation.

As many things are interrelated in Chinese Medicine and we appreciate that and use this fact in the medicine, it can make the diagnostic process confusing. Generally you have to try to think of the progression of the disease - did they start getting worse after a longer protracted illness, or perhaps a defined period of stress, or did it appear suddenly…

Questions along those lines get you to the idea of what was there before what you are seeing now which makes it easier to see the progression and more defined interrelationships.

Then, generally, speaking you clear first and tonify later. So even if a person has spleen qi deficiency signs, unless all of their signs are true deficiency you wouldn’t start by tonifying. With heat signs, like the patient you are describing, you would at best lead to no improvement and at the worst, you would actually deepen their condition. But… you also cannot clear incredibly strongly if there are deficiencies, as opposed to a patient with full heat, for example, as that can make them worse, or at least not better. This is where understanding the patients history is critical in the process.

Generally speaking you take the most excess signs, clear them first and give the body time to come inline. As you are alluding to many things will start to take care of themselves once the largest imbalances are corrected. As the body starts to function more in balance, then you foster that, generally by movement and/or tonification.

In the simplest terms, clear heat first, move stagnation, then tonify if necessary.

As for your other question about addressing anxiety - if your diagnosis and approach is correct, yes, any symptoms in western terms that are arising from those imbalances should correct in due time.

If you would like to describe (1) what you are basing your diagnosis on in clinical terms, and/or (2) what points/techniques you are using - we may be able to offer more direct recommendations/guidance…


Thank you, this is very helpful. I will come back and write something longer if needed, just thanking you now for this very helpful reply.

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