Acupuncture Pulse Diagnosis and the Constitutional Conditional Paradigm by Peter Eckman

REVIEW

Dr Eckman summarises and shares 50 years’ worth of clinical experience in acupuncture and research into classical Chinese medical texts, distilled into his unique method of diagnosis and treatment: constitutional conditional acupuncture (CCA).

His initiation into the world of acupuncture was with Korean practitioners. From the beginning he was exposed to the idea of constitution, fundamental to Korean healing methods. Though he has studied and worked with many teachers, Dr Eckman has remained faithful to and developed further the idea of healing as a return to one’s individual constitutional state of harmony – our original nature. In his words, ‘Ultimately all acupuncture treatment should be based on the Spirit (神 shén), as this aspect of our existence is a fundamental and unchanging part of our original or true nature (Constitution). Remaining in touch with or returning to our true nature is thus the basis for maintaining health and curing disease.’ (p 41)

CCA diagnosis involves determining the individual’s constitution. There are 20 constitutions, each corresponding to one of ten zang fu that have a tendency to excess or deficiency. The constitution is the person’s original and lifelong make-up. The next step is to diagnose the present condition, which can be an unbalanced relationship of the constitutional organ with a connected organ through the control cycle or a blockage, perhaps involving an extraordinary vessel. Then the treatment is formulated, mostly using Korean four-needle formulas.

In CCA the prime method for diagnosing the patient’s constitution and present condition is the pulse.

Dr Eckman has developed his own method of pulse diagnosis based on Neijing, Nanjing and Maijing (The Pulse Classic). Most of the material contained in this 460-page book will be new to a TCM or five element practitioner. Whether this is exciting or daunting depends on the individual. The book does require concentration and perseverance – however, it is fluid, clear and entertaining (as the ‘donkey business’ subtitle playfully suggests).

Ideally, the reader should be familiar with the CCA basics. Dr Eckman explains his method in the June 2018 issue of the JCM and his previous books. The Compleat Acupuncturist (2014) narrates how the CCA method was developed, while Grasping the Donkey’s Tail (2017) explores the meaning and clinical application of passages from the classical Chinese medical texts.

After explaining the concepts of constitution and condition and the mechanisms of qi in the first and second chapter, Dr Eckman lays down the topics for discussion in the rest of the book: What are the natural standards for locating the radial pulses of the 12 organs/officials? (Not what you learned in school.) Does the laterality of treatment points matter, and how can the optimal choice be made? Practically speaking, how does the pulse indicate whether the hand or foot branch of one of the six great meridians is imbalanced? How can one best distinguish an excess from a deficient pulse? Can one detect Akabane imbalances from the pulse? Just what is ministerial fire (in the classics), and why is fire included as one of the six climatic factors? How can one clearly distinguish problems due to malfunctions of the extraordinary meridians from those of the regular Meridians? (p 70)

A whole chapter is devoted to Dr Eckman’s main current interest: diagnosing and treating cancer. It covers, among other topics, the ‘metastatic signal’ detectable in the pulse, and cancer treatment protocol.

There are 58 case histories of patients Dr Eckman has treated in San Francisco and in China, where he has been invited to teach several times.

Summing up the pulse diagnosis, Dr Eckman concludes that ‘at any moment, each person experiences the biggest threat as the target of its innate homeostatic response mechanisms… that we are able to perceive in the pulse patterns that reflect the struggle going on, whether between organism and environment, organism and pathogen, or simply malfunctions of the organism within itself.’ (p 345)

This book should inspire acupuncturists seeking to refine their diagnostic and treatment methods and expand their understanding of mechanisms of health and disease.

Olga Fedina

Acupuncturist: Valencia, Spain

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