Remember when you were in school and you had that really cool teacher who played games with you and you actually learned something? I’m going to be that really cool teacher today. We’re going to play a game.
“The Graphing Game”
It takes time to become excellent at graph analysis, but the rewards are awesome! Expert Graph Analysis skills help you become a better practitioner.
Sometimes I play “The Graphing Game” with my patients. I’ll graph them BEFORE they tell me any current symptoms and then I guess what’s wrong, based on the graph. Patients love this! They’re amazed that I am so “smart!”
Are you ready to play?
This will be a two-part blog. In today’s blog, I’m going to post a graph. Your job is to analyze it and tell me what you think.
We need participation to make this work. Take a look at the graphs below and tell me your thoughts. Simply respond below in the comments section of this blog post so everyone can see your thoughts.
I’ll post a follow-up blog next week and tell you what was really happening with the patient and see how well you did at your analysis.
Really, there isn’t a wrong answer. The goal is to become really comfortable thinking about the graph from multiple perspectives.
Okay—let’s do this!
All of the really great teachers I knew had tricks up their sleeve to help with class participation. I’ve got a little trick up my sleeve too.
Until next week…
(Read ‘The Graphing Game—Part 2’ here.)
~Kimberly
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Kimberly Thompson, L.Ac.
Acupuncture Research Analyst
Miridia Technology
This person possibly has allergies and/or asthma (Lu/Sp), high stress with associated headache/migraine or tension headache (Lv/GB), difficulty falling asleep with mind racing (Sp/St/Lv/Gb/Ub), could also have shoulder issues (yang arm channels), could also have low back issues (LI/SI/UB) Let’s throw in some digestive problems (Sp/St/LI/SI) Maybe even IBS if we include the Lv/GB imbalance.
THe low low graph often occurs in elderly, women, dark skin people, or people who are dehydrated.
Spleen and stomach Qi deficiency with dampness. Liver excess, possibly stagnation or lv yang rising symptoms. Have they had their Gallbladder removed?
I’m just a student….
I would suspect breathing issues, easily sweating, skin issues, and digestive issues.
They may wake up from 3-5am coughing, potentially cock-crow diarrhea, morning fatigue. Also could have the flip side with constipation. I’m curious if they are experiencing any grief in their life currently?
This person has deficient metal with some over-control with fire and potential insulting from LV wood.
I think this could be asthma and or allergies. Both lung and large intestine are weak. High spleen and low stomach looks like digestive weakness with dampness which goes along with asthma or allergies. High liver indicating Liver Qi stagnation and low Gallbladder which can be suppressed by excess dampness also fits.
Digestive disturbances, Pain, Fatigue, perhaps some breathing issues or allergies, emotional disturbances
Stag LV, fatigue in the mornings, digestive weakness, Exit Entry block between LV and LU.
This patient had an allergy and an imbalance between LR/GB and SP/ST. In TCM wood attack the earth. There is also a blockage in Taiyang. So migraine, naussea and necktension can be the complaint of the patient.
There are so many possibilities.
Chance we would be seeing a progressing TaiYang Syndrome.
Perhaps the LV and SP being excess reflects the middle burner now being involved.
If this is a Jing Well graphing perhaps upper back and or shoulder pain involving TaiYang Excess
with some Liver Qi and/ or blood stagnation. In this case the LU and LI and GB deficiencies would resolve when we release the Excess in the TaiYang (BL and SI) to flow downstream. Sharing some of that Excess of the LV with its mate the GB could be helpful.
According to Adrian Larsen I would not substract a Zang Fu problem from the reading but rather do a Japanese meridian balance. Sedate the xi-cleft point of LR (LR6) and hope that the folowing channels in the energy cycle who are low LU-LI-ST will fill up. Besides that you can use the yuan source and luo connecting points of the two paired imbalanced channels ST-SP and GB-LR. ST42-SP4 and GB40-LR5
For the Zang Fu I would stay with my tongue-pulse-anamnese.
Lung and Large intestine are low in energy so this person has allergies and slow sluggish lymphatic system. The low energy of stomach, gallbladder and stress high level of the liver and spleen looks like poor digestion with anger and frustration. Small Intestine is stressed along with digestion/absorption it governs the pituitary gland so there could be hormonal issues. Energy graph shows very slow started this person doesn’t do mornings. 11 up spike of energy until 3 pm when it tapers down some. Then back up from 3 to 11 when they go to bed then awake at 3 am.
It has to do with a skin problem, maybe itching, and possibly somewhere inflamation.
This incertainty gives also stress.
What I love about AcuGraph is that each type of graph yields different, clinically significant information. From the Baseline Graph, I perceive respiratory and/or skin issues (LU/LI deficient), neck and shoulder tension (SI channel inflammation), heavy menses if this is a woman (SP/LV excess), possible diabetes or varicosities in either gender, skeletal frame problems (BL excess), and poor assimilation (both GB and ST deficient).
The yin/yang graph refines this further: likely asthma (tai yin imbalance), tendency to catch colds and flu easily (tai yang inflammation), constipation probably associated with malabsorption (yang ming deficiency).
The By Element graph confirms respiratory and skin problems (Metal deficiency), risk of diabetes developing, probably with stomach acidity (Stomach yin deficiency with Spleen qi deficiency), Liver yin deficiency with Gallbladder deficiency suggesting conditions like sciatica and developing osteoporosis).
And the Energy Cycle graph suggests that this person does NOT sleep well….every meridian during the nighttime hours is out of whack. Probably tosses and turns, possibly long waking in the middle of the night or too-early waking with an inability to get back to sleep.
This person may have shortness of breath or asthma, back pain, neck pain, digestive problems, headaches, menstrual problems, anger, and bladder symptoms.
liver overacting on spleen
Definite allergy/asthma issues, possible skin issues, possible neck and shoulder pain as well as possible low back pain, headaches and insomnia and throw in some possible digestive issues!
Digestive problems – challenges with turing food into energy
points more to digestive disorder with inflammation. There is also Liver qi stagnation & the patient has an underlying deficiency They may also experience frequent waking with much dreaming
Emotional distress in the morning and Insomnia in the nigh with some asthmatic attack
It is evident that the patient has serious bowel issues and lower back issues. if the patient is male, he also has a prostate disorder. The graphs show liver yang rising and the excess spleen point to menstrual disorders / pelvic involvement due to hormonal issues if the patient is female. A weak metal element indicates chilly extremities, aversion to cold and possibly a stiff shoulder too. It is possible that the patient is on steroids which may partly explain high qi inspite of multiple abnormalities.
From the base line; The over all Qi level on 102 give this patient the chance of apparent good health or looking well wherever condition he or she is suffering.
From the Yin/Yang: there are imbalance in Tai yin and Shao Yang, excess in Tai Yang and deficiency in Yang Ming,
Element graph: imbalance in Earth and Wood with deficiency in Metal element.
Energy Cycle: low energy early hours of the day reasonable well during the day and may have disturbed sleep mostly at liver meridian time.
Clinical symptoms; since there is multiple imbalances symptoms could go from general over all fatigue or to specific condition like many described above including lower back pain.
Therapeutic approach: depending of the specificity of symptoms we can use Tai yin/Tai yang imbalance protocol. or balance protocols if there is a specific pain complain like lower back with sciatica pain or neck and shoulder pain. Ear acupuncture if there is any sort fatigue or feeling emotionally low particularly with an overall Qi 102.
Another aspect to consider on the therapeutic approach is how long ago the patient is suffering the symptoms to consider using extra-meridians points or Tai yin/Yang Ming protocols.
How I read this graph also depends on male/ female – I see the Lung Meridian is deficient and may show signs of getting the onset of a cold or recovering from a cold, sinus, allergies etc. According to Fratkin when you Tonify the lung the other channels will follow. Also, I read the small intestine and urinary bladder channels to affect the neck , back and spine perhaps sciatica. I see the gallbladder ch as a hip pain , bursitis, hip replacement. The liver is interesting on the graph because a lot of my older male patients have prostate issues and of course the women have menstrual . The tendons and ligaments perhaps go with my back and hip reading. Often groin pain as well . Check the Psoas. If that is the case it could throw the stomach channel b/c of knee issues . Not excluding the obvious digestive issues with the si, a higher TE and LI and stomach . A bit more energy in the lower vs. upper so balance with Kimberlys sj5-gb41. Good thing they found you . Fix em’ up 🙂
I would expect this patient to present with allergies or some sort of respiratory disorder. I would also expect to see some digestive issues and low back or leg pain. This patient is likely not sleeping well and has low energy in the early morning.
Looks like an upper respiratory issue, possibly allergies. My conclusion is based on Tai Yin, Tai Yang, Yang Ming presentation. I primarily practice balance method, however, I always start with the baseline graph. This graph clearly tells the story as the lung is low indicating a potential for an upper respiratory issue. This is further validated by the fact that most of the pathways that go to the sinuses are out of balance with spleen being excess indicating phlegm dampness. The excess liver makes it look a bit more like an allergy presentation rather than a sinus infection where I would have expected to see more excess particularly in LI and ST. Flip to the yin/yang graph and you can clearly see the tai yin/tai yang/yang ming imbalance which is typically thought to be respiratory in nature either allergies or an external attack. Of course you then can differentiate between the two because you have the patient in front of you.
Fun!
I just want to say that I”m LOVING all of your participation. The thing that I am enjoying the most if how insightful all of you are. Clearly, you are using AcuGraph at it’s full potential. You guys ROCK!
It would be fun to share all this insight with this patient. Clearly, the patient has some health issues. If he/she won’t listen to me, then maybe I’ll have to let you guys talk to him/her! 😉
Keep the responses coming. This is fun!
~Kimberly
a belt block. Most difficiancy lower body. Problems with fooddigestion, resorption li,si,st gb. St and sp both important for chi distribution to the organs. Bl and sp. I quess urinary problems. Li possibilty musscles Prostat or femal cystitis
I can see excess of SP, LR , BL and ID and defficiancy of LI, GB and ST
There are more defficiency and the yang channels than the yin ones. There is a good level of energy based on the blue line. The patient can have differents syntoms, like abdominal and pulmonay problems. With syntoms in muscules and tendons.
Probables problemas respiratorios y alergias, problemas digestivos con probable distinción abdominal y gases, gastritis, dolores de cuello y hombros, problemas tendinomusculares de los canales yang del pie, bloqueo de cintura.
would need confirmation with iriscope, but as seen:
problems with breathing, perhaps smoker:yin + deficiency
Digestive deficiency and possibly GB stones: yang and deficient channels
Possibly hormonal disturbance: yin and excess in Si/BL
possibly heartburns: yin and excess Sp+LR
Best regards
Serge
So I haven’t used this graphing system in a while. Just a quick glance I see an excess in SI/UB channels. Could be pain related — Qi stagnation due to some sort of pain/trauma in neck/shoulder and/or back.
From a different perspective (I’m not an acupuncturist ? but use AcuGraph in my kinesiology practice), I would say there are definite digestive issues – lack of hydrochloric acid (low ST energy, resulting in poor everything downline from there – SI, LI, GB) and blood sugar problems (SP, Lv, perhaps affecting Ki which I would read as being low) leading to leaky gut (SI over energy), which would then be dragging down the immune system (person perhaps catches colds easily – Lu, Sp). On top of it all, I’d consider grief issues, with Metal being the worst element (Lu/LI being very low together), for which, perhaps, the person tries to suppress with eating sugar a lot. Perhaps dehydrated too. Supplement with Hcl, get her off sugar and get her hydrated while working with the grief issues and might see some big changes. Add stuff to help heal the gut (Glutamine, etc) and bring the liver back (might even be a bit of a fatty liver at this point) with milk thistle,etc. Monitor the adrenals during it all.
I wonder what this person does for breakfast, lunch, dinner and late snack…? I wonder how this person handles fasting and high carb meals…? I might want to review Campbell-McBride’s GAP diet and the Metabolic Typing test (in Wolcott and ? ( in the Metabolic Typing book…) to think again about protein needs… I’m interested to learn how the graphs reflect dietary practices and needs…
Grief, loneliness, poor nutrition and dehydration; emotional distress predominates.
Very low energy cycle during normal sleep times, than spike up probably do to use of caffeine and stress. Chronic fatigue will set in if already not – probably labled with “Fibromyalgia”. Some great comments from everyone.
I love AcuGraph I have almost eight years using AcuGraph as a support tool for my diagnostic and therapeutic decision. I do Source point and Jing Well point test in each one of my patients on each visit. Furthermore I do not give a single diagnosis opinion or guess diagnostic until I see the AcuGraph results and then I matched with the perceptive clinical history to understand potential underline causes and to do the case analysis and organise my therapeutic plan. However there are three rules that I insist with my trainee people;
1 be sure that the technic and test is properly applied.
2 AcuGraph provide you a lot of useful clinical information but avoid to use AcuGraph as a fortune teller tools.
3 Respect the data obtained from each person as they can help you to reach faster results.
Those could be the reasons way I would not like to best guess the potential symptoms of the patient in this Graph example. I would like to suggest rather than a guessing game a bit more clinical discussion based SAOP model.
Thanks for your feedback Alvaro. Of course having the patient right before you and knowing their history is the best way to diagnose. The learning skill we are developing in this game is the ability to recognize certain commonalities with graph results.
The combined knowledge of so many practitioners is very interesting. In my next blog I’ll give details about the patient and then we can further fine-tune diagnostics.
~Kimberly
As we can see here this person has SI, SP, LR & BL High and LU, LI, ST & GB is low, so he could suffer allergenic problem, cough, breathing difficulty, constipation, skin rash, high stress, headache, dizziness, sleeping disturb, digestive problem, retention urine and weakness .(more or less)
Lots of digestive complaints due to the imbalances in the SI, LI, GB. LV, ST
Possibly lower back pain with the BL meridian being high
Belt block,asthma,chest pressure,Problem in extremities,Neck and Shoulder tension,vision Problem,diabetic.
The Liv(yin)/GB(yang) imbalance begins a low energy cycle that gets blocked when the SP spikes. I believe correcting the Liv/GB issue could help with balancing this person and giving them more energy in the morning. There are emotions underlying this for sure. The LU and desire to “take in air and oxygen” may be a big component here, of course knowing the PX helps one see that, but I would be looking at that, especially if it appears again. That, together with the BL being high … again may only be this once, but I do see this in emotionally based PX. Many of whom have serious underlying issues. There is a underlying digestive component here also. Kimberly, this is fun …. thanks and can’t wait to see more!
Asthma,Allergy, Virus, Cough, thyroid issue. Possible associated fatigue and emotional instability.
Problemas digestivos por alergia ( ¿a leche?) con compromiso respiratorio.
My concern would be headed toward Chronic Fatique.
The imbalances, excesses, and deficiencies may possibly be some kind of damp heat condition…excesses in liver, spleen and maybe some diarrhea and nausea disrupting the ability to eat properly