UNWILLING TO OBEY (2013)
Miguel was a fifteen-year-old adolescent brought in by his mother. He was slender, medium-sized, with white skin, thin hands and long fingers, and his appearance was still child-like. It struck me that his attitude was very calm for a boy his age. He kept his arms lazily crossed throughout the entire consult, and limited his movements to occasionally tilting his head to speak, without any hand movements to express himself.
His mother brought him in to see me for migraines that had increased over 3 years. They began suddenly at a summer camp (which Michael did not want to go to), forcing him to return home. At the time of the consult he had an average of 1-2 headaches per week, with a maximum duration of 3 days. The attacks were preceded by vomiting and began as a feeling of ocular and forehead pressure, with occasional sharp pain and significant photophobia and aversion to noise. The symptoms were accompanied by feelings of instability and fatigue. They occurred when “doing things that he didn’t want to do” and were relieved after a few hours (with the help of painkillers) when he relaxed.
“What was it about this summer camp that you didn’t like?” I asked when we were alone. “Being forced to follow the herd”, he replied. Michael knew exactly what he was feeling and what he wanted. He did not like being told what to do and, in this sense, that being at summer camp implied total obedience.
His parents were barely concerned about their son who – unlike his classmates, who he maintained good relationships with – does not seem to need any company over the weekends, which he spends entirely at home reading or entertaining himself.
The quiet appearance of this teenager, who never cried and maintained a high degree of control over what he said, was betrayed by some small details: he used to bit his nails, and occasionally had a feeling of constriction in the throat (mei he qi) .
The parts of his medical history that stood out included asthmatic bronchitis, tonsillitis and repeated otitis, an adenectomy, a hydrocele and two inguinal hernias.
He was generally cold, yet sweats sometimes at night and his ears get red. The tongue had a fine, white film on it, and the tip was pointy and elevated. The Spleen and Lung pulses were superficial.
His medical history (tonsillitis, adenoids, bronchitis) and physique, and the fact that he does not support injustice, led me to the conclusion that he had a Metal constitution. Furthermore, the pulses that stood out were the taiyin meridians. However, his smug behavior, the clarity of what he wanted and the great control he exerted over his actions drew me to a taiyang resonance.
After reviewing the symptoms of the points, my doubts were concentrated in lieque LU-7 (“broken sequence”) and chengguang BL-6 (“receiving the light”). I chose to start with the latter because of the significance of photophobia and the clinical characteristics of the headache that – according to Jean Marc Kespi – corresponded to Yang’s barrier function, descending down the cranium to the face.
I saw him again after fifteen days. Miguel had virtually no headaches over this time. At the same time, there were also changes in his behavior: in class, when asking about the lesson, while interrupting his classmates, he suddenly cut in with “shut up, asshole!” an unthinkable reaction which silenced the entire class. Also, his mother was surprised because, while playing the play-station, her son has repeatedly been angry, unable to contain profanity and swearing, which even to himself was very strange: “I think the doctor did something to me”…
That same day, at the end of my shift, I reviewed the information contained in “Le Banquet des Points” (no. 42) on chengguang BL-6. To my amazement, I discovered that one of the meanings of the character Cheng is also “receive orders”, “to obey”.
At our third visit (a month after the last visit), the migraines had only appeared in the last week, with an intensity of 60% of original ones without painkillers. It also had not been triggered by situations that he did not control. He was still more expressive and, in his spare time, a little more sociable.
By the fourth session (a month later), Miguel had not had any attacks. In addition, his mother told me she thought he was “stretching out” in recent weeks. I repeated the same acupoint and I scheduled a follow up for within 2 months.
Reflecting on the elements of the clinical examination, I venture that the lack of openness to the exterior level of taiyang, coupled with the Metal constitution of this young man, resulted in a difficulty of taiyin assimilation, reflected by his pulses and, probably, by his low level of physical development.
Finally, the result of this treatment to this taiyang young man, so unwilling to follow directions, increases my admiration for the wisdom of the acupuncturists of old – who, necessarily, had to know all the chengguang BL-6, resonances to be able to utilize an ideogram whose diverse readings allow for its identification – and to my dismay, the brief, cryptic and subtle way chosen to transmit their knowledge.