Things you didn't learn in acupuncture school about breast cancer and how to treat it. Chris Powell, one of the voices behind Yin Yang Podcast, goes over minute details of the pulse (Empty and Muffled) in relation to cancer that he learned from Shen and Hammer. From there he expounds upon how to formulated herbal prescriptions with modifications from his 20 plus years of experience.
Breast Cancer and Pulse picture
By Chris Powell
Many pulses obviously exist at any given moment in time in the body. The typical pathological pulse picture will vary depending upon disease and level of involvement, i.e. taiyang, shaoyang, etc. As it pertains to cancer in general, and most often in breast cancer, the two qualities of most significance are the muffled quality and the Empty quality. I am using the terms as taught by John Shen and Leon Hammer, but I am also providing my own clinical experience in the treatment of cancer over the last 20 years.
The Empty quality, as defined by Shen and Hammer, is a quality that “is found in the superficial layer and is accessed at the Qi depth of the pulse. The Empty quality separates and diminishes significantly, or even disappears, as pressure increases to the blood and organ depths.” I describe this sensation as if you have a tube filled with a substance like Jell-O. When one presses on this tube you will feel the Jell-O squish out to the sides of your fingers. This is, in my opinion, a perfect way to describe the sensation beneath the fingers. This quality is often confused with the Hollow quality that most learn in schools, but it clearly not the same sensation or, more importantly, the interpretation. Whereas the Empty quality will have NO substance with increasing pressure applied to the pulse, the Hollow quality will have a harder and wiry sensation at the surface and at the bottom. It will appear empty in the middle levels, but will reappear as one goes deeper into the pulse nearing the organ depth or bone.
My clinical experience with the Empty quality is quite profound when it comes to cancer treatment. It can be a predictor of things to come so to speak. The important part to remember is that with the Empty quality one will find that the yin fluids are sinking down and away whilst yang is floating up and out. This is significant if one will remember that the separation of yin and yang can portend serious illness and death. This is physiology that has become chaotic at a very deep level. I will often find in the most serious of situations, and most often in hospice, this pulse will present itself. The final stages of this pulse will have just a sensation at the superficial level, with no waveform, and nothing beneath. Often called the “flat line” pulse for obvious reasons.
The Muffled quality, I believe, is purely a Shen and Hammer description and generally indicates a neo-plastic process. One can “palpate a distinct quality, but the sensation is slightly muted and unclear, as if a towel or blanket separated one’s fingers from the pulse.” I often describe it as a pulse that you can definitely feel the beat beneath the fingers. However, you will NOT feel any defined borders to the pulse. I often equate this to being able to feel a guitar string or a string of spaghetti lying on a counter top and being able to feel the edges to pick it up. With a Muffled quality, one cannot feel the edges. It is amorphous. As mentioned above, one can feel the beat, but no defined borders. Once again, this is a condition of separated yin and yang and complete chaos in the body. Again, this is a definition of cancer at the cellular level. Shen and Hammer often described this quality appearing only when serious illness was present in the body. Dr. Shen often described this sensation with extreme and protracted cases of qi and blood deficiency. My clinical experience suggests the same finding.
The herbal formulas listed below are guidelines that are often used in Chinese medicine clinics for the treatment of breast cancer and the concomitant effects often experienced with cancer treatment. However, the formulas provide a glimpse into treatment regimens as well as the causative factors in breast cancer.
The formation of cancer in the breast is often due to impaired function in the meridians that course the breast and underlying constitutional pathologies, i.e. phlegm, toxic fire, etc. What is truly important to understand is the mechanism that fails with the transportation of qi, blood, and fluids that course the body and the breast. Many breast cancer patients often will describe a fullness or tightness in the rib area of the body. We do know that this is often found when stagnant liver qi has inhibited the channel qi that flows through the Shaoyang. The Gallbladder channel descends into the chest, goes through the diaphragm, influences the liver and harnesses it, and heads directly into the Gallbladder along the inside of the ribs. As this condition escalates, the gallbladder fire will influence the spleen and stomach, hence Wood retrains Earth and spleen and stomach function is impaired. The channels become blocked and can lead to stagnant qi and stagnant phlegm and the formation of tumors. This condition is often wrongly treated with purgative herbs or toxic heat clearing herbs. What is truly needed is a harmonizing formula in the midst of cancer. For instance, in my clinical experience it is often found that a patient will exhibit “chai hu” pulses. What this actually means is that both guan positions on the pulse will be elevated over the other positions. Of course this indicates a total failure in the pivot mechanism and formulas such as Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction) can be used with exceptional results. In my clinical experience with breast cancer, it is often the result of evil qi that is depressed in the shaoyang that inhibits the pivot mechanism, which causes the impairment of free coursing and internal depression of gallbladder fire. As this happens, the Sanjiao fails to keep the “sluices” moving and the clear fluids begin to cloud and become sticky. Water Rheum will collect in the shaoyang causing a chest bind to appear with fullness in the chest and ribs. This impairment leads to further gathering of toxic fluids and the development of cancer most often.
The above description is just a thought process on cancer, the breast, and disease through impairment of normal physiological function in the body. It is where Chinese medicine is so exceptional in treating disharmonies within the body. All of the herbal formulas listed are used quite effectively in the clinic. This generally is my personal experience in the clinic in treating breast cancer.