1/4/13 Beth Conroy Compendium - Stroke - Kiiko Matsumoto Japanese Style

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Stroke (Cerebrovascular attack)

Kiiko Matsumoto Japanese Style

Sources:1. Kiiko Matsumoto's Clinical Strategies In The Spirit Of Master Nagano Vol. 2(Pg 138-144)2. Kiiko Matsumoto's Clinical Strategies In The spirit Of Master Nagano Vol. 1(see below)

Categories Of Disharmony:

Constitutional: General:1. Oketsu (pg 40 Vol. 1)2. Adrenals (pg 82 Vol. 1)3. ST Qi Deficiency (pg 71 Vol. 1)4. Blood Pressure (pg 120 Vol. 1)5. Cardiac Problems (pg 120 Vol 1)6. SP Qi Deficiency (pg 71 Vol. 1) Specific: 7. Blood Stagnation in the Head (pg 48 Vol. 1)8. Basilar and Vertebral Artery Insufficiencies (pg 234 Vol. 1)9. Neurovascular Compression of the Neck (pg 227 Vol. 1)10. Pressure Pain Along The Spine (pg 205 Vol. 1)

Clinical Manifestations:Slurred SpeechNumbness, Tingling of upper/Lower Limbs"Funny/Weird Feeling" in points on Upper/Lower LimbsCognitive Disturbances: depression, anger/rage, confusion, dizziness

Palpatory Findings:Hara Reflexes

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1/4/13 Beth Conroy Compendium - Stroke - Kiiko Matsumoto Japanese Style

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Hara ReflexesPressure Pain at the NeckSensitive Dents on Upper/Lower Limb Skull PointsNumbness/Tingling on Upper/Lower Limb Points"Funny/Weird Feeling" in Points on Upper/Lower LimbsCold Spots On Upper/Lower Limb Points

Pulse/Tongue Findings: Rapid Pulse and No tongue diagnosis

Treatment Principles:Clear Constitutional Hara ReflexesReleasing Pressure Pain on All Sides of the Neck ( special attention must bepayed here for treatment success)

Treatment Strategy/Plan:It must be determined by the patient's doctor that the patient is

hemodynamically stable to spark the points on the skull using Pachi-Pachiand Triple Bypass Cords. Usually, after release from hospital it is safe. Incases where it is forbidden, manual stimulation of the skull points is done.

Skull point Stimulation is done with the insertion of 30mm Japanese #2needles at a 15'angle into the most sensitive upper and/or lower limb skullpoints. Palpation of these points is done after they are located by one of

two ways.

A. The first method is done by folding the ear towards the face. Animaginary line from the ear tip to GV20 is visualized. It is then divided into

three sections. These sections are determined by the sensitive dent feltone third from GV20 which constitutes the lower limb zone and a sensitive

dent found one third below lower limb which constitutes the upper limbzone.

B. The second method is done by visualizing an imaginary line that runs fromGV20 to GB1. This time the line is divided into four sections. A sensitivedent felt one-quarter inferior to GV20 is the lower limb zone, and one

quarter inferior to that is the upper limb zone.

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Once the sensitive skull limb points, either upper, lower or both are needledand stimulated for ten seconds with tiny in and out thrusts, the the

actually limbs are needled. The key points on the limbs are found on theYang Meridians. If there are no sensitive points on the Yang meridians,

Locate sensitive points on the Yin Meridians.

Key Yang points on Upper Limb are: LI4, 5, 14, 15, TW5, 8, 9, 10, SI5, 7 and8. If no Yang points are sensitive use points on the Dorsum of the Hand.

Key Yang points on the Lower Limb are ST31, 36 ST Qi Line (ST36-39),GB30, between GB30 and GB31, GB34, 38, BL38, 40, and 58. If no key

points are located points on the dorsum of the foot should be used. If noneare found on either Yang Meridians or the Dorsum of the foot use thepoints on the Yin meridians that present numbness. a 30mm to 50mm

Japanese #5 needle is inserted perpendicularly into the numbest or "weirdfeeling" points on both upper and lower limbs.

Attach a Triple Bypass cord to the points on the skull to the points on thelimbs. The Black Clip is placed onto GV20, the Green Clip is placed onto

Upper or Lower Limb Point on the skull, and the Red Clip is attached to thenumbest point on the actual limb.

When both limbs are affected needle both Upper and Lower Limb skullpints as well as the numbest or "weird Feeling" points on the actual limbsthemselves. Two long Triple Bypass Cords are attached between the skull

points and the points of the affected limbs with both black clips attached

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points and the points of the affected limbs with both black clips attachedto GV20. Once all points are needled the black clips are attched to thePach-Pachi pin. The needle at GV20 is sparked with three short bursts.

Reattach the black clips to GV20. When both limbs are stimulated attachboth black clips from GV20 to the Pachi-pachi. The patient will feel the

stimulation on the shull as well as the limbs. Kyutoshin moxa is then appliedto all the needles on the limbs as these points are usually cold.

When patient presents with Stagnation of Blood in the head and pressurepain at GV20 that could not be reduced significantly with Oketsu, the

Spleen and Pericardium Treatments (pg 49 Vol. 1) should be applied. Twoskull points are needled and connected to Triple Bypass Cord to the numbpoints of the limbs. The Green clip is attached to the skull point which is

most sensitive, Red Clip to second senitive skull point and the Black clip isattached to the numb point of the limb. Attach Black clip to Pachi-Pachi

and spark all the limb needles. Then the black clip is attached to the lowerlimb needle and then to the upper limb needle.

Local stimulation of the limbs may be done together with skull points ordone separately. When done together do the skull points first during the

second step of the treatment and the affected limbs during the third stepof the treatment as touch ups.

Principally the local treatment is cause the paralyzed muscles to twitchwith the Pachi-Pachi Sparker and The Triple Bypass Cords attached to the

key points of the upper and lower limbs. Adjustment of needles eitherdeeper insertion or location change is crucial for success and effectiveness

in this treatment.

Upper Limbs Upper limb needles are inserted at both Yaotongxue (N-UE-19, Lumbar PainPoints) or Yaotongxue between the fourth and fifth metacarpal bones andLI4 as well as TW9 or Master Nagano's immune point. Place the Black Clipon the proximal point and the Green and Red Clips are attached to thedistal points. The Green Clip is attached to the most sensitive point. Afterall needles are inserted attach the Black Clip to the back of the Pachi-PachiSparker and the proximal needle (usually TW9) should be stimulated withthree bursts of electricity. The hand should twitch as the needles aresparked. It is imperative that the hand twitches for the success of thistreatment If no twitches are accomplished, re-examine the needle depthand location, making sure the needles are in muscles.

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Lower Limbs:Lower Limb stimulation is done with the needles placed at LIV3 (or Liv2)GB41 and ST36 (or below GB34). Red and Green Clips are attached to distalpoints and the Black Clip to the proximal point. Then the Black Clip isattached to the Pach-Pachi Pin and spark the needle at ST36 (or needleabout one inch below GB34) three times. As above adjust the needles if notwitches in the foot.

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Aphasic Patients:For speech disorders, the Speech disorder point is between GB1 and theUpper Limb point of the Skull in a dent. Needle GV20, the Speech disorderpoint and either upper or lower extremity skull point. The Green Clip isplace on the most painful spot and the Red Clip is placed on second needleand the Black Clip to GV20's needle. Remove Black Clip, attach it to thePachi-Pachi and spark GV20. The needles should be sparked three timesevery five minutes.

In cases where the scalp is not painful upon palpation attach the Red Clip tothe point that was numb. If no difference upon palpation between limbs andspeech points on the skull, attach the Green Clip to the needle in theSpeech Point and the Red Clip to the upper/lower limb point. When Aphasicpatients are also paralyzed needle all four points connecting the Red Clip tothe Upper Limb point when first stimulating GV20. During the secondstimulation the Red Clip should be transferred to the Lower Limb pointneedle.

Again in the cases where Stagnation of Blood and Pressure Pain at GV20has not been reduced by Oketsu the Spleen and Pericardium treatments are

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has not been reduced by Oketsu the Spleen and Pericardium treatments areapplied. Needle the Lowe lLimb, Upper Limb and Speech Points of the skullare needled. The Black Clip is placed on the Speech Disorder Point, theGreen Clip to the to the most painful point between Upper and Lower Limbpoints, and the Red Clip to the remaining needle. Stimulate the Speechpoint three times in fifteen minutes.

KD1 may be used anytime during the treatment to reduce pressure pain atthe chest or throat. Once the pressure pain has been reduced at the throatST9 should be needled with the Speech Disorder point to benefit speech.ST9 is needled perpendicularly and very shallow with a 0.16mmx15mmneedle bilaterally.

Pain along the Spine and Back Treatment:The third step of the treatment on the back should concentrate on KD1 (ifnot done in steps one and two) I-Hi-Kon, GV4 and Lft SI11 to reducepressure pain at T7 and T5 as well as foot Bafeng for the brain andgummies at the Huato JiaJi points.

KD1 is one the most important points for balancing circulation in the brainand is especially helpful for Speech. It should be needled with the patientin prone position and should needled in the direction it changed thepressure pain in the chest and throat. THE NEEDLE IS NOT RETAINEDbut rather inserted and stimulated with minute in and out thrusts andpulled out in a clockwise rotation.

GV15 is added if the patient has a dry throat at a 10-45' angle upwardswith the flow of the meridian and eight direct thread size moxastimulations are added.

The Foot Bafeng are also very effective in regulating the flow of blood inthe brain and are very important for post-stroke patients who aredepressed.

A point outside BL40 will reduce pressure pain at GV4 and the KD Shu area.BL58 should change pressure pain at T7BL60 should change pressure at the occiputI-Hi-Kon is very important as a complementary traetment to the Basilar andVertebral Artery treatment ( performed in second step).

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After pain at GV4 is reduced needle the right Huato Jiaji point of thisvertebrae to reduce pressure pain at T&. Needle it at a 45' angle into thegummy. To further release pressure pain at T7 needle SI11.

After pressure pain at T7 is significantly reduced it is needled itself.Needle the Huato Jiaji at a 45' angle towards the midline. If the pressurepain on the T7 vertebra on GV line is difficult to reduce add 8-15 threadsize moxa stimulations.

If all or most of the vertebra are painful it is difficult to diagnose theexact problem and treat accordingly. To treat this reduce general pain withTW5 and Master Nagano's GB38. Palpate the area between GB38 and GB39for a sensitive spot and it is needled against the flow. of the meridian.Stimulate the needle every five minutes with tiny in and out thrusts.

TW5 should be needled perpendicularly in the exact location that furtherreduces pressure pain at the spine. Master Nagano's GB38 is the main pointwith TW5 as support. In step one the Shao-Yang supporting treatmentshould be done in step one to release the very tight SCM muscle, change therapid pulse and treat pain along the spine. Most stroke patients presentthese manifestations.

Once the pressure pain of the spine is released the back treatment maybegin. Frequently stimulate the needle at the GB38-39 area to benefittreatment. The remaining pressure pain at the spine is of diagnostic valueand points such as the HTJJ of T11 (sugar) and T7 can be needled (afterdistal treatment first).

If the area between the foramen magnum and the mastoid bone becomesvery red and thickened, bleed the red area after the distal treatment.Bleeding is done at the most discolored areas with a lancet, and the blood iswiped off with an alcohol soaked cotton swab. When blood is bright red andfluid do not bleed anymore. No more than two bleedings are done in onetreatment.

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Dizziness:Dizziness is a symptom that is common in many conditions and requiresfurther and thorough investigation It must be looked in context tocerebrovascular attack and must integrated into the overall treatment.

Pressure pain at GB23 is reduced with KD9 and TW9. If the patient is stillfeeling dizzy when rotating the head or or sitting up, needle GB23 at a 15"angle following the ribs toward the spine. Add 7-8 thread sized moxa to theneedle insertion.

On the ear the Brainstem point is used frequently for all the symptomaticpresentations related to equilibrium, dizziness, jagged movents and otherfunctions of the cerebellum and brain stem. Find the most sensitive point of thearea and see if while massaging it the pressure pain and tightness of theipsilateral SCM is reduced.

Patient Education/Recommendations: Patient must approach post-stroke recovery immediately and with a multi-disciplinary treatment approach.

Prognosis:Rehabilitation is usually good as long as a multi-disciplinary approach istaken soon after the initial hospitalization. If atrophy has not set in thenthere is a good chance of neuromuscular system rehabilitation.