7 The Core Treatment Model This chapter will describe the core treatment model of shonishin and ways of varying it according to need. As we have discussed, the basic approach for treating children uses tools that are tapped, pressed, stroked, or rubbed on the body surface. The various treatment tools were described briefly in the previous chapter. The treatment methods can be summarized as: Tapping: rapid tapping to an area or points, usually at a rate of 100–200 times per minute Stroking/rubbing1: rapid stroking over an area or along a surface, usually at a rate of 70–100 times per minute __________________ Pressing: continuous mild pressure to a point or small area Scratching: relatively rapid stroking motions over an area or along a surface The easiest way to apply the core treatment, the non-pattern-based root treatment to most babies and children, is to use either stroking with additional targeted tapping (Yoneyama and Mori 1964) or tapping alone (Hyodo 1986). Scratching administers a greater stimulation and thus dose, and is only feasible as an occasional substitute for stroking on children who have an “excess” constitution with stronger, fuller body type. It is thus occasionally used if the stroking is not producing sufficient changes. Pressing is a way of targeting specific acupoints or small areas of the body, and is thus used for stimulating points or areas to target relief of symptoms rather than help restore healthier functioning. The sections below will describe the core non-pattern-based root treatment model using stroking/rubbing and tapping methods. The power of this very simple treatment speaks for itself. There are many cases described in Section 5 that illustrate the effectiveness of this treatment. I draw attention to the case of Paul, patient of Manuel Rodriguez, in Chapter 20 (p. 139). Given that the doctors had diagnosed such a serious condition and that nothing they had done had improved the condition, the effects of that single treatment are remarkable. This very simple and light treatment helps produce changes in the circulation of children. As a result, one can sometimes see a small temporary increase in body temperature (about 0.5°C). Because of this it can be a problem if the body temperature is raised with a fever. If the body temperature is 37.8°C or higher (moderate or high fever) it is contraindicated to apply the core non-pattern-based root treatment described below. When the child does come for treatment, other strategies are needed. Where there is a mild elevated body temperature (less than 37.8°C) one should check whether to apply the core non-pattern-based root treatment, and if you decide to use it, do so more cautiously. The issue is, that in babies and toddlers, once a fever starts, it may “spike,” meaning that it can rise rapidly, which is distressing and dangerous. If your treatment causes the body temperature to rise a little, on a feverish child this can trigger a spiking of the temperature. Of course, the more common issue we encounter in clinical practice is that the appointment is cancelled when the child has a fever. I mentioned in Chapter 2 that many practitioners in Japan tend to work from home or have a clinic in a residential area. The feverish child can easily be brought for the few minutes needed to get to the clinic, so practitioners there may not have the appointment cancelled because the child is a little feverish. However, in the West, many of us have clinical practices in non-residential areas or we have patients coming from much further afield. It is very typical that the parent calls to cancel because of the difficulties of traveling with a feverish child, or because of problems in dealing with home care for other children. This seems to be especially so in Holland where most patients come to the clinic by bicycle. When the weather is cooler, getting a feverish child ready to come for treatment can be daunting. Therefore, most of the time, we don’t get to treat feverish children. If the child is brought for treatment with a fever, follow the precautions mentioned above. When the core non-pattern-based root treatment is avoided, the simple pattern-based root treatment can still be used, as can some of the symptomatic treatments and specific techniques to help lower the temperature such as pressing or needling the jing-well points (see Chapter 28, p. 238). There may be occasions when a feverish child is brought for treatment and you are concerned something more serious may be occurring. Parents should consult their general practitioner or pediatrician, if they have not done so already. Such referrals may on occasion be needed. Another precaution of the core non-pattern-based root treatment is that it cannot be applied over skin lesions. Thus, for the child with eczema or atopic dermatitis, one cannot apply stroking or rubbing techniques and tapping can only be applied around affected skin regions. On a first visit one needs to apply a milder, lower dose treatment approach. This is necessary to ensure that you do not over-treat and to give one time to observe the response of the baby or child to treatment. Then you can adjust doses and techniques accordingly in future treatments. A final note of caution is that in babies it is not uncommon for the core treatment to trigger an episode of loose bowels, as though the intestines were cleaning out. This is normal and not a problem. It is a good idea to caution the parents that this might occur and not to worry. If it happens it is usually in the few hours following treatment and is a onetime occurrence. The basic treatment pattern is administered in two different ways. One applies stroking techniques over most of the body and tapping to one or more discrete areas, or one only applies tapping over all areas. If the child will allow you to apply treatment without much resistance, it does not matter where or how you start, or with which technique. If the child is afraid, acting up with the parent, or being resistant, it can be useful to have the parent hold the child facing backward over the shoulder, while you stand behind the child. Treatment begins by applying tapping techniques to the area around GV-12, over the interscapular area. GV-12 is recommended for pretty much all pediatric conditions. Historically, moxa was used as a kind of family medicine technique and routinely applied on GV-12 on children to prevent illness and help recovery from illness. I use it routinely on babies and children both with tapping and at the end of a treatment with a press-sphere retained on it. It can have a strong calming action. Example Once, a mother came for treatment with bilateral sciatica. The sciatica had developed in the last month of pregnancy. She waited until after her daughter was born and came for treatment when the baby was 2 weeks old. After telling the story of her problems, and responding to questions during the intake, the woman tried to place her baby back in the crib and then get onto the table for treatment to begin. The baby started to cry and the mother was off the table to hold and quieten the baby. As soon as she was quiet, the mother tried again with the same result. This going back and forth from table to baby went on for a while and I was unable to start treatment. Then, on the next occasion, before the mother could rise from the table I went over to her daughter, holding one hand I raised her arm and reached behind with my other hand, applying a soft small-circular massage over the GV-12 area using the tip of my index finger. The baby immediately stopped crying, relaxed, and fell asleep. Treatment was able to commence undisturbed. After this, when we were ready to start treatment on future visits, I would first lightly massage GV-12 on her daughter, and then treatment would begin. Two years later I bumped into the woman on the street. She was pushing her daughter in a stroller. As we talked she excitedly told me that this little trick we had used for the treatments two years before was wonderful and it still worked! Whenever she needed to help her daughter settle down she would give mild rubbing over the GV-12 area.
Precautions and Contraindications of the Core Non-pattern-based Root Treatment
Techniques for Basic Treatment
Core Root Treatment: Stroking and Tapping Combination
The Lore of GV-12
