Here is a guest post from a student of mine, Guy Sedan, from Israel.  I love the simplicity of this case and the process Guy went through to determine treatment, including taking into account the boy’s fear of needles.

Eleven years old boy. Severe abdominal pain especially in stressful situations like in school. About 5 times a year this situation culminates to fecal incontinence.   He is an intelligent, imaginative kid, yet his demeanor reflects some fear. Slightly chubby.

Gets irritated easily.

Tongue (picture on the left): Fluted edges, red spots in the sides, thick white coating, and a slight dip at the root of the tongue.

Pulse: wiry in the Guan positions

Diagnosis: Depressive Liver heat, Damp in the middle Jiao

Treatment plan: course the Liver, transform dampness from the middle Jiao

Acupuncture: Sp-9, GB-34 both  Bilaterally, CV-12, very shallow needling, with Seirin 0.12 mm needles.

A week later, the patient reports great improvement with the pain. The tongue (picture on the right), reflects the improvement in the T&T of fluids.

Explanation:

GB-34 and Sp-9 are both He (Uniting) -Sea points. I chose these points for the following reasons:

  1. These points are relatively not painful. This boy feared being needled
  2. In 68th difficulty in Nan Jing it is said:

合主逆氣而泄
He (uniting) points master movement contrary to the proper course, as well as diarrhea.

These points treat conditions were Qi is flowing in the wrong direction (逆氣 – Nì qì) which in this case is reflected in the pain and diarrhea. The Spleen fails to spread the fluids, which eventually causes diarrhea.

In the Zhen Jiu Da Cheng, under 腸痔大便門 (Intestines, Hemorrhoids and Defecation Category), it is said :

出泄不覺：中脘

Diarrhea without realizing it (incontinence of stool) Zhong Wan (Cv-12)