4:09 pm
November 17, 2011
11:36 pm
November 17, 2011
Hi Clark,
I have an acugraph (by Meridia) and the more I learn about it and how to use it the more I like it. I never use it in place of my own diagnosis and only take my first graph after I have done my initial consultation and at least 15 minutes of pulse taking. I talk to the patient about what I have found and then we do the graph. What I have been finding is that the acugraph always corroborates my findings.
I originally got it for marketing purposes and so far it's been great for that. Patients like seeing graphs and the acugraph has many different types of graphs based on 5-el, yin/yang imbalance/horary cycle etc. So as a tool to engage people in a conversation about CM it's brilliant. But, it's no where near as cool as paying attention in the treatment room and selecting points based on what arises between yourself and the patient...in my opinion.
Also, and I haven't tested this yet, but it can diagnose splits in meridians so it should be a quicker way to diagnose akabane imbalances. I only learned about akabane's this year in Lonny's CI class so have only done them a few times and haven't yet corroborated the findings with what the image has told me.
hope this helps:)
11:44 pm
October 4, 2011
I have certainly tended to go with Daniel on these types of devices. On the other hand Anne is a very seasoned and studied practitioner and I would not discount her observations. For me, I'd rather put the time into pulse diagnosis. For example, she takes pulse 15 minutes and I take it up to 30 minutes. I'd have more faith in that extra 15 minutes on each new patient paying bigger dividends over the long term. But, I don't know.
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8:23 am
Premium
October 4, 2011
9:07 am
October 4, 2011
Yes, it might be worth looking into what part of culture we are supporting when we use these things. There is a whole movement in our profession to 'distance' the practitioner from the patient – not just with devices like this – but also with, for example, the 'clean needle fanatics' who would have us needle with latex gloves on – and now the development of a double-sleeved needle insertion tube so you never have to touch the patient (contrast this with the class I had last weekend with Ed Neal where we were working on our subtle capacities during the act of needling to feel the needle going through skin, earth flesh, wood flesh, down to bone – and using that 'diagnostically' to assess the state of different levels of flesh.
Modern medicine went through the very same 'distancing' between patient and practitioner as more and more – the interaction relied on blood tests and imaging – and now, I don't even know if my doctor knows how to palpate, percuss, etc like my old doctor did.
I know we have to move forward and some 'old ways' have to be jettisoned – but I tend strongly towards preserving and even enhancing the core sensory aspects of patient-practitioner interaction in our medicine. To put it in the context of core principles of this website – 'we' are about pushing into and developing the interior of the cosmos, right? A life dedicated to interaction with and developing our capacities to engage with our patients through the senses – if taken as far as we can take it, and developed continually for the entire duration of our clinical life – is developing the interior of the cosmos – we are doing medicine through interiority. Any use of imaging and dependance on imaging of any kind engages with the exterior of the cosmos and becomes a detraction from and obstacle to the development of interiority in us and in our patients.
Reliance on machinery, whether it is 'accurate' or not (that is a whole other issue), will, I would suggest, dumb us down to the level of technicians with wow factor (which is essentially what so many doctors have become) and keep our gaze fixed on the exterior of the cosmos.
No offence meant here – just a serious inquiry.
5:33 pm
Premium
October 4, 2011
There was a physician in California that was the recipient of a grand award for teaching medical students how to do a physical exam with his own hands (and stethoscope and sphygmomanometer).
I thought to myself, "is that not a normal part of physicians' education?"
So the use of any technology, which I do know is here to stay (Carter Phipps book has a nice section on this) should not replace our own authentic engagement with our own senses and manual skills.
Still I don't see that there is anything inherently wrong with the use of this particular technology in the right hands and in the right context, which is always about the restoration of original nature and the cultivation of virtue. I mean the body is electrical and the how could any measurement of that be wrong, in and of itself?
5:44 pm
Practitioner
October 4, 2011
While I think something like this has great potential in the right hands, my experience is that the practitioners in my area that "talk it up" have not taken time to develop other diagnostic skills like pulse, tongue, palpatation, etc. so it does across as another "gadget" used in place of, rather than in conjunction with traditional diagnosis.
My state's Board of Acupuncture recently issued the following opinion on such machines:
"EAV (Electro-Acupuncture) and EEG Neurofeedback
The Board would like to remind you that the use of EAV and EEG Neurofeedback devices are not within the scope of the practice of acupuncture in Maryland. Practitioners may use these devices as an adjunct in their practice, but should clearly inform their patients that the use of these devices is not acupuncture."
5:53 pm
Premium
October 4, 2011
6:20 pm
Practitioner
October 4, 2011
Anna - I was present at the Board meeting where they discussed this in greater detail. I don't think the write-up in their newsletter is very helpful. The discussion was centered around a practitioner using the acu-graph as a primary source of diagnosis. The practitioner brought it to health fairs as a way to get people interested, but also used it during the initial intake instead of the four inspections - "to look", "to listen", etc. The Board discussion was centered around how their investigation into this machine was that it was replacing the four inspections in the hands of novice practitioners.
9:59 pm
Premium
October 4, 2011
12:05 am
November 17, 2011
All very good points. And all questions I have asked myself and continue to ask myself. The truth is I have only had the device for 8 months and don't use it with every patient. My only reason for getting it was as a marketing tool and it was never intended to replace diagnosis. But that's the kind of practitioner I am, I could never rely on a device to tell me what was so with a patient.
I wonder, is it a loss of integrity to use a tool with the intention of engaging them in a conversation that could open them up to the beauty and potential of this medicine?
One of the things I've noticed with the graph is that it can show inflammation in the system, which can of course be diagnosed on the pulse, but the pulse is so obscure to most clients that when they can actually see all of their reading going through the roof, they can relate it to themselves, as opposed to it being some weird science. And I am not one to downplay what is going on. I take it seriously and do my best to portray that. So I have noticed that as a positive.
My experience with the company making this product is that they rely solely on the graph and I don't think they do any pulse taking. So I truly don't know if using the machine without compromising my integrity as a practitioner (Everything I did before I still do, nothing has been replaced by this gadget) is progressive, regressive or neutral. I truly appreciate this topic coming up and your input.
1:22 am
Premium
November 15, 2011
As i have mentioned before Heiner Fruehoff uses an EAV device before recommending any herbs to his patients. I consider him at the top of the scale, so who am i to question the veracity of this used in the right hands? He was incredulous that he would do otherwise when questioned, considering it a necesary step to getting the right herb to the patient for the right reasons as the last step essentially.
For example, sadly in medicine in the field of psychiatry they make diagnosis and prescribe potentially lethal drugs and certainly mind altering drugs without considering more advanced insightful technological tests available only relying on themselves and their exams to make the right diagnosis. This strikes as arrogance or ignorance and fear. There are other areas that are similar in medicine but usually on the overdo side. Usually no one test is a stand alone test whether it be the tongue, the pulse, the eyebell test, the interview, ct scan , pet scan or one of these gadgets but a compilation of all of the above as needed. Probably the more tools you have, you can competently use and convey results to patients, the better served they will be. The emphsis is on competency.
I am not sure why one considers this outside the realm of acupuncture. Isnt akbane testing a part of the classical teachings of acupuncture? When i look at the concept behind these pieces of equipment they resemble a very refined akabane testing technique, if nothing else though more expensive than incense sticks. I guess akabane is relevant since Lonny devoted a chapter to it in his red book and our ga chapter of acupuncture devoted an afternoon to it, if memory serves. These pieces of equipment certainly take a lot more of the subjectivity between patient and doctor out of the equation than the tell me when it burns technique with a lit incense stick.
I think the Maryland board ought to go back and revisit this if they cant see this part of the acupuncture in it. Is someone as esteemed as Heiner Fruehoff that far off base to not be praticing within the confines of acupuncture according to Maryland by narrowing his focus to examining the electrical conduits of the body we may profess to be treating with needles? I would like to hear his opinion on it for sure.
Just like tongue and pulse diagnosis there is a learning curve that not everyone will suceed nor even understand. Just because you dont understand it, is not a ground to dismiss it. The test in and of itself shouldnt be negated because of this, any more than pulse taking or Kilko palpatory methods that i personally would love to delve into if there was enough time to learn competently, all superb in the right hands. They indeed have learning curves just as these instruments do and all can be misleading or confusing until learned well.
6:32 am
Premium
October 4, 2011
It looks like all the Board said was that while an acupuncturist may use the device, its use alone is not the practice of acupuncture. I suppose the concern is that someone may think of it as acupuncture without needles and that is misleading.
Again, it's all about context... there is nothing inherently wrong with these measuring devices and they can be used as part of a larger picture just like we do many other things in a developmental, integrative practice.
7:39 am
October 4, 2011
Sure, technology is,in some ways neutral, and dependant on the 'meme' using it to be expressed / harnessed. Nuclear power looks quite different being harnessed by a California Governor than by a North Korean despot. I would be REALLY interested to actually hear some detailed case reports by a highly developed practitioner where it is shared what full understandings about the patient were derived from pulse, tongue, interrogation, history, palpation, etc etc - how the patient might have received treatment based on all of that - and then how a device such as this added information / understanding / perspective to the case and to the relationship between practitioner and patient and life and how the treatment trajectory might have been modified or buttressed or changed / altered in some way as a result of inclusion of the device in the interaction.
8:38 am
Practitioner
October 4, 2011
Rick - my understanding of the Board's concerns were: 1) This device is not accepted by the medical community as reliable. Double blind studies used to diagnosis allergies against the medical standard "skin prick" test showed the device was erroneous in allergy diagnosis. And I believe the reading can be incorrectly influences by how hard or light the practitioner presses the probe to the point, and also how moist the wand the patient holds is.
Of course, pulse, palpatation, CSOE - these are all diagnostic tools that can have just as much practitioner error. However, they are within our scope, and I guess the thought is that these are the diagnosis that are at the crux of our medicine. I'm sure things like CT scans, MRI, etc. all went through the same issue of being a "new technology" that isn't proven enough for the Board to feel comfortable with practitioners marketing it to consumers.
2) Some of the EAVs claim to be able to treat in addition to diagnose. Again, taking money from a patient to "treat" their condition with an unproven machine that also diagnosed their condition is a consumer protection No-No.
So maybe as the test of time shows these machines to be accurate, reliable etc. then they can be used and the Board would approve it. But until then, I think it is acceptable that the Board stated they can only be used as an adjunct to treatment, not used as diagnosis and treatment itself.
As an aside, I have a patient who used one these with her naturopath to diagnosis food allergies, sensitivities, and endocrine system issues (thyroid, adrenals, etc.). Based on its results, the naturopath recommended various homeopathy, supplements, etc. It's results, at least in the thyroid and adrenal realm were contrary to both the patient's long standing repeated blood labs *and* my pulse readings. And every time she used the device she would show up with a floating pulse over the LR position. It got to the point where I could tell that she had used it before she even told me because I would immediately feel that floating pulse over LR. She would usually get pretty ill a few days later - which corresponds to the floating pulse indicating wind invasion. It was very concerning to me that every time she used it, this pulse condition would show up.
8:49 am
October 4, 2011
Interesting story . . . . I had a patient years ago who came to me, but was and had been regularly seeing a naturopath for years in Nova Scotia who was using one of these machines. During her time with me, she continued to see the naturopath and have her meridians 'read'. Her naturopath reported that he had never seen such remarkable 'response', 'balancing' via the machine between before and after her treatments with me. Nevertheless, because I didn't use a machine and he did, she stopped seeing me and continued to see him. I think she somehow felt that he was more 'current' with technology. Alfred North Whitehead referred to this as the illusion of 'misplaced concreteness'.
9:18 am
Premium
October 4, 2011
4:59 pm
October 31, 2012
Just to be clear, the Acugraph does not create a diagnosis. It graphs out the measurement of each channel in relationship to each other and shows which ones are showing excess and which ones are showing deficiency based on electrical conductivity or resistance. It's still up to the practitioner to make sense of of the reading and create their own diagnosis. It's simply extra information to use besides, tongue and pulse, abdomen and channel palpation etc. It does reveal information that traditional diagnosis wouldn't show, like splits in the channels. I also see a lot of high readings in kidney and spleen channels. What does that mean?! I'm still not sure, but it's definitely pointing to something. Electrical conductivity readings are objective and don't lie!
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