Experiencing Acupuncture by John Hamwee

Author:John Hamwee
Language: eng
Format: epub
Publisher: Jessica Kingsley Publishers
Published: 2020-04-21T00:00:00+00:00

6

Pauline’s Headaches and

Treating the Patient

HEADACHES COME IN A HUNDRED DIFFERENT shapes and sizes, maybe more. The pain can be sharp and intense, fixed and throbbing, dull and achy, like a tight hat or an iron vice. The head may feel full to bursting with cotton wool or as if it is holding a bag of coins which rattle around and bang against the inside of the skull. It can be worse in the morning, the evening, on waking, just before a period, or at random intervals. The pain can be on one of the temples, on both, on the forehead, the back or top of the head, deep inside, just behind the eyes or a combination of some, or many, of the above. Quite a few are accompanied by nausea or disturbed vision – indeed the eyes can be so badly affected that the sufferer has to stay in a darkened room until they pass. Sitting upright may take the edge off one person’s headache while lying down may relieve another’s. A firm massage on the skull may feel great or terrible. And so on.

So the starting point with any headache is to accept straight away that what works for one person may not work for anyone else; and that where a patient has more than one kind of headache, which is not unusual, what helps one of their headaches might not help with the others.

All of which presents any medical practitioner with a fundamental challenge. The basic procedure of all medicine is to look at the patient’s signs and symptoms and then fit them into one of the well-known categories of illness or disease. The Western doctor who comes to the conclusion that her patient’s headache is caused by meningitis or intracranial pressure, for example, is using exactly the same kind of reasoning as an acupuncturist diagnosing Kidney Yin deficiency leading to Liver Yang rising. They are both seeing in their patient an instance of something which they and others have seen before, and so will treat as they have treated before. But although it would be ridiculous to ignore all the learning and experience which is summed up in the generalisations of the medical textbooks, still, both doctor and acupuncturist are uncomfortably aware that their generalisations won’t necessarily apply to the particular headache of the particular patient in front of them.

The solution to this dilemma has been pointed out by many wise doctors over the centuries, but Sir William Osler said it as well as anyone: ‘The good physician treats the disease; the great physician treats the patient who has the disease’ (Osler, cited in Adams 1999, p.67). In other words the treatment, however deeply rooted in the classifications of theory and practice, has to be crafted anew for each patient.

It isn’t always easy to do so, and many practitioners, especially when short of time and under pressure of work, tend to ignore this truth and fall back on treating the disease, hoping to offer symptomatic relief. When

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