1/4/13 Beth Conroy Compendium - Premenstrual Tension - KM Style

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PREMENSTRUAL TENSIONKM Japanese Style

Sources:1. Matsumoto, K. and Euler, D. (2007) Kiiko Matsumoto's Clinical Strategies, Vol. 12. Matsumoto, K. and Euler, D. (2007) Kiiko Matsumoto's Clinical Strategies, Vol. 2

Brief Overview:In the Chinese classic texts, a direct connection is drawn between the Heart and the Womb, orBao mai. In the KM style, treatment of gynecological issues is, therefore, often rooted inencouraging the free flow of blood, as well as emotion, to and from the Heart (Vol. 2, p266).Because of the Heart's involvement in regulating the uterus, emotional upset and stress has adirect impact on a woman's gynecological function. Premenstrual tension, specifically, isviewed by the KM style as being symptomatic of a larger problem, often but not exclusivelyseen in tandem with other gynecological dysfunction. It is seen to manifest either physically inthe form of pain and/or swelling, emotionally, or both. Primarily emotional PMS is, per the KMstyle, often associated with the disharmony of stagnant blood in the head, which is commonlyresponsible for "headaches, fatigue, and emotional problems during hormonal changes" (Vol. 2,p267). Physical manifestations of PMS, particularly lower abdominal cramping and/or swelling,are often associated with the Oketsu reflex.

Categories of Disharmony:1. Stagnation of blood ­ Oketsu, stagnation of blood in the head.2. Scoliosis3. Tailbone injury4. Thyroid imbalance5. SCM muscle injury6. Scars due to varicose vein operations

Clinical Manifestation:Swollen and painful breasts, abdominal bloating, abdominal and uterine cramping, stress,anxiety, irritability, insomnia, joint or muscle pain, headache, fatigue, acne, mood swings,changes in libido, changes in appetite.

Treatment Principles:Clear Oketsu by moving Blood in abdomenMove Blood in headRelieve pain in tailboneRelieve pain along spineBalance thyroid

Treatment Strategies:1. Oketsu (Vol. 1, p40)Palpatory findings: pressure pain at Oketsu reflex. In case of PMS, also check for scars fromvaricose vein operations.

Front: (L) LR4 + (L) LU5Supporting:

(B) Immune pts.(L) ST Qi line

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1/4/13 Beth Conroy Compendium - Premenstrual Tension - KM Style

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(L) ST Qi line(L) LR11­12(L) outside ST30

Back: (B) BL17 + (B) HJJ @ T7 + (L) BL35

2. Stagnation of Blood in the Head (Vol. 1, p49)Palpatory findings: pressure pain at GV20, often with Sishencong. In case of PMS, also checkfor scars from varicose vein operations.

Front

Step One

(B) SP6, 45 degree angle with flow(B) SP9, 10 degree angle with flow(B) PC Choice: If PC8(fire) is tender on palpation, needle PC5(metal) +PC3(water) at location/angle that reduces pain. If PC8 feels good onpalpation, needle perpendicularly. If PC8 induces neither pressure pain norcomfort, needle PC6 at 45 degree angle with flow.(B) LU5

Step Two (if pain upon palpation of cervical spine)

(B) KD10 + (B) LR8, 45­90 degree angle(B) TW5 (fast pulse) OR (B) TW9 (slow pulse), perpendicular insertion

Back: (B) I­Hi­Kon

3. Scoliosis (Vol. 1, p205)Palpatory findings: structural scoliosis, often with tenderness along HJJ line

Front: TW5 + GB39 + LU7 (Ipsilateral to top curve), KD7 (Opposite of top curve)Back: (B) BL11 + TTPs along HJJ line

4. ST27 area (Vol. 1, p303)Palpatory findings: pressure pain at ST27­28 area

Step One: Kawai­style ion cords treatment (Vol. 1, p320)

(R) SI3 with black clip + (L) BL62 with red clip(R) KD6 with black clip + (L) LU7 with black clip

Step Two: (L) ST27 with Kyutoshin, perpendicular insertion until resistance is met

5. KD Fire ­­> Metal/Water (Vol. 1, p442)Palpatory findings: pressure pain at KD2

(B) KD7 + 10

6. LR Fire ­­> Metal/Water (Vol. 1, p442)Palpatory findings: pressure pain at LR2

(B) LR4 + 8

7. Tailbone Injury (Vol. 1, pp185­188)Palpatory findings: pressure pain at coccyx, along tailbone up through GV4 area

Front

(B) KD7, upward at 15­45 degree anglemoxa on Hukaya's LU10 (ipsilateral to low back pain)

Back

GV14 (or surrounding HJJ) if coccyx is extremely painful(B) GB25, with Kyutoshin if cold(B) BL23, 15­45 degree angle with flow

Supporting:

1/4/13 Beth Conroy Compendium - Premenstrual Tension - KM Style

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Supporting:

KD16 (massage while palpating GV2), 45 degree angle toward midlineLU8, 10­15 degree angle toward LU9BL66, with 8 direct thread moxa stimulations if cold

8. Thyroid imbalance (Vol. 1, pp147­155)Palpatory findings: pressure pain at ST9, with HJJ @ C6­7

Hypothyroidism

Eustachian tube point + LU4 + TW4 ­ relieves pressure pain at ST9(B) KD9 + (B) LI15 (systemic detox treatment)Back (for patients with slow pulse)

BL43 with 15 direct thread moxa stimulations ­ relieves pressure pain atHJJ @ C6­7GV2, GV4, GV6, GV11, GV12, and/or GV14, where tender, at 15 degreeswith flowHJJ @ T4­7, where tender or gummy, at 45 degrees with flowHJJ @ C6­7, at 45 degrees toward spine, with 7­8 direct thread moxastimulations

Hyperthyroidism

KD fire ­­> metal/water; if KD2 not tender, needle KD9 and above TW9 insteadLU fire ­­> metal/waterCV6 (if rapid pulse) OR CV4 (if rapid pulse + autoimmune disorder), withKyutoshin if abdomen is coldLI15 ­ relieves pressure pain at ST9Back

Eustachian tube pointSugar points at HJJ @ T10­12, as tender, at 10­15 degrees with flow

9. Scarred neck ­ SCM muscle injuryPalpatory findings: pressure pain on SCM

TW5 + GB41 OR above TW9 + GB40, contralateral to most painful side, depending on

which relieves SCM pressure painSP4 + PC6 in case of scar bisecting ST11 to relieve SCM pressure painPC6 + GV20 in case of scar bisecting CV22HT3 OR HT7, in case of pressure pain at KD27 due to broken clavicle or scar, needled10­15 degrees with flow

10. KD13 area (Vol. 1, p343)Palpatory findings: pressure pain at KD13

LR5LR fire ­­> metal/water, if LR2 is tender and relieves pain at KD13LR8

11. Yaotongxue (Vol. 1, p393)Palpatory findings: pressure pain at atlas (C1) reflex on upper SCM

Yaotongxue (1 cun proximal to TW3), perpendicular insertion that does not exceed 3mm

Patient Education and Recommendations:Patient should be educated to pay attention to the precipitating factors of their PMS: when,during their cycle, it occurs; what alleviates the tension; what exacerbates the tension; if andhow symptoms change during treatment. Because of the direct connection between the Heartand the Uterus, patient should be careful to allow whatever emotions come up for them to flow,as restriction of emotion causes stagnation in the flow of the blood.

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as restriction of emotion causes stagnation in the flow of the blood.

Prognosis:PMS can be easily treated as a product of one of the aforementioned conditions and, ifsymptoms not fully eliminated, at least greatly reduced to the point of manageability.