Rob Bekkering, Robert van Bussel
The Netherlands
A correct segmental diagnosis enables us to treat the real cause and avoid symptomatic treatment.
Medical acupuncturists, understanding the various segmental interactions and modulations, furthermore have the huge advantage, that they can decide if acupuncture really is the best therapy in certain cases, or that another form of segmental modulation will be more appropriate and effective. If we decide to use acupuncture treatment in a certain case, we should be able to explain, why acupuncture is the most suitable therapy for a certain patient, where we can find the most effective acupoints, how we should stimulate these points, and how deep (in which layer) we should insert our needles in order to obtain the desired result.
Many symptoms and most acupuncture effects are based on segmental reflexes. Not only the effects of the “local points”, but also the effects of many “distant points” can be explained via neuro-modulations.
In our workshop we shall explain the basic neuromodulating processes mediating the acupuncture effects, and we shall explain how we can examine the various segmental symptoms, and how we propose to modulate these processes. We shall also focus on the importance of vicious circles and perpetuating factors like myofascial triggerpoints, vertebral blockages etc.
We think that the use of neuro-modulating therapies like acupuncture should be restricted to functional symptoms, to the modulation of pain and to the symptomatic treatment of structural symptoms.
In the 1st part of our workshop we will explain the basic neuromodulating processes, in the 2nd half of our workshop we will work out the segmental acupuncture treatment of cardial and urinary problems.
At the end of this course we hope that it will be clear, how we build up a correct segmental diagnosis, and how we can decide which one of the segmental therapies will offer the best therapeutical possibilities for a particular disease or patient.
Many acupuncturists use acupuncture with good result in their everyday practice, and most of us are pleased with the results of our acupuncture treatment. Some of us balance uncomfortably between modern medicine and TCM.
Although we believe that old metaphysical concepts deserve the attention of doctors interested in medical philosophy, we also believe that medical doctors practicing acupuncture should be able to understand the why, where, and how of acupuncture treatment in an accepted neuroanatomical and neurophysiological way.
Avoiding the constant switching over between two separate paradigms ands using acupuncture in a complementary way is in our opinion the only way to integrate acupuncture in our modern medical system.
In our workshop we will show you that these two separate worlds are not so different as they seem to be, and that most barriers are mere “language barriers”.
A correct understanding of the basic segmental neuromodulating circuits will not only clarify why you are needling acupuncture points empirically known to be possibly effective, but also how you should stimulate these points in order to get the desired result. We shall show you that puncturing “acupoints” can stimulate totally different segments, depending on the layer reached by the needle, and every time we will emphasize on the 3-dimensional structure of these “points”, constantly asking ourselves which layer we want to modulate.
A correct segmental diagnosis will also be a great help in finding and eliminating segmental vicious circles caused by perpetuating factors. Pain, myofascial triggerpoints, joint blockages and other segmental disturbances can become the source of vicious circles maintaining the segmental disturbance, even when the original cause of the disturbance has subsided.
We will also see that formerly obscure relations between symptoms, which are usually overlooked, can often be explained via segmental interactions. Without a correct understanding of these segmental interactions we shall often wonder why a disease will persist after “correct” treatment, but recognizing and eliminating these vicious circles will make our acupuncture therapy much more effective!
The basics:
A segment consists of a dermatome, a myotome, a sclerotome and a viscerotome. All these parts are connected to one other via the same shared innervation, and in this way every part of a segment is able to modulate all the other parts of the same segment. These segmental modulations can explain why, for instance, visceral pathology can manifest itself in the skin (dermatome), in the muscles (myotome) and in the joints (sclerotome), and why vice versa, stimulation of the skin or muscle can influence the deeper layers of this same segment. The basic principle of segmental modulating therapies (like acupuncture, physiotherapy, TENS, manual therapy etc.) is the elimination of perpetuating factors and a segmental modulation. In acupuncture most “local points” and “Yu points” are nothing more than segmental points (depending on the layer we stimulate!).
In acupuncture we often use the “distant points” on the distal parts of the extremities very successfully to influence problems of the trunk and the viscerae. We shall see that many of these effects can be explained via the “secondary segmental relations” in the autonomic nervous system. If time permits we shall explain the anti-arrythmic and anti-emetic effects of PC6 in a neuro-physiological way.
We hope that you will enjoy our workshop, and that you can pick up some ideas, helping you to bridge the gap between modern medicine and TCM, and to choose the best of both!
East is East, West is West, and may the twain finally meet!
Secondary segmental modulations:
Segmental modulations