Intro to Treating Digestive Issues Using

Local Palpation and Channel Theory

By

Albert Stern, L.Ac.

Leading Acupuncture CE Provider

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 2

ALBERT W STERN, L.AC

INTRO TO TREATING DIGESTIVE ISSUES USING SAYING HELLO

LOCAL PALPATION AND CHANNEL THEORY
INTRO & PREMISE

INTRODUCTION 3 INTRODUCTION 4

• Bastyr Univeristy
Author and illustrator of 

• School of Visual Arts
TCM Picture Book

• Instructor at Southwest (tcmpicutrebook.com)
Acupuncture College - Boulder
and Colorado School of Big Picture Book of Point Location 

Traditional Chinese Medicine Vol 1 and 2.

• Facilitate cadaver-anatomy Big Picture Book of Chinese Herbal

workshops for acupuncturists Formulas Vol 1 & 2
Colorado Learning Center of
Human Anatomy

(anatomylearningcenter.org)

Image Credit: anatomylearningcenter.org Image Credit: tcmpicutrebook.com

TEXT

Visceral

Painting Acupuncture
with hands
Manipulation
J.P. Barral

don Antonio Teaching
 Craniosacral

Healing Anatomy J. Upledger

Image Credit: stickrust.com

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 1
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 INTRODUCTION 7 INTRODUCTION 8

“In North America we have TCM practitioners and scholars who

cannot move beyond the classical approach…



…cannot acknowledge the usefulness of modern lab testing,
and cannot relate the usefulness of medical pathophysiology.” 



-Jake Fratkin, Notes from TCM Case Studies - 

Autoimmune Diseases

PALPATION ANATOMY

9 PALPATION 10

FOUR EXAMINATION METHODS

1. Asking Questions

2. Inspection

3. Auscultation & Olfaction

THE ART OF 4. Palpation

PALPATION

PALPATION 12

TRADITIONAL HARA DIAGNOSIS

Our Greatest Tool

image credit: http://www.itmonline.org/arts/shiatsu.htm Hara diagnosis chart based on Mubunsai's text of 1685.

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 2
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 PALPATION 13

APPLIED CHANNEL THEORY - WANG JU-YI

What Can We Feel

image credit: Applied Channel Theory by Wang Ju-Yi, Jason Robertson

PALPATION 15 PALPATION 16

PALPATION CAN REVEAL PALPATION CAN REVEAL

STRUCTURES MUSCLE TENSION
‣ Stagnation

Overall and Local

‣ Channel Involvement

Skin
Adipose Many systems use to Dx

Fascia Muscle/ ‣ Muscle Identification


Local trigger points
Organs
Bone ‣ Severity of Issue

Image Credit: tcmpicutrebook.com Image Credit: tcmpicutrebook.com

PALPATION 17

PALPATION CAN REVEAL

DEEP STRUCTURES
‣ Organs/Ligaments

Location, health, tissue
flexibility How Can We Feel
‣ Adhesions/
Obstructions

Stagnation, blockages,
dampness

Image Credit: tcmpicutrebook.com

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 3
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 PALPATION 19 PALPATION 20

ZONE #1: FINGER TIPS ZONE #2: CENTER OF PALM

‣ Most Common ‣ Deepest Aspect

‣ Focused ‣ Feeling and Emotion

‣ Similar to Reading ‣ Instinct

‣ Most Logical ‣ Temperature

‣ Direct Energy

PALPATION 21 22

PRACTICAL #1: HAND TO HAND

‣ With a partner or self, palms facing each other

‣ Move back and forth, circle

Working with Clients
‣ Focus: Center and outer palm

‣ Consider: warmth, pull, strength

APPLIED CHANNEL THEORY - WANG JU-YI

TEXT
CLIENTS 23 24

STARTING WITH CLIENTS

‣ Create Expectations

‣ Loose Clothing

‣ Directly on Skin is Best STOMACH

‣ Draping Creates Professionalism

‣ Creates Boundaries

‣ No Rush

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 4
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 STOMACH 25 STOMACH 26

THE STOMACH - WHAT IT DOES THE STOMACH - TRADITIONAL PATTERNS

Traditional Definitions ‣ Qi Deficiency ‣ Qi Rebelling Upward

▸ Receiving the food ‣ Yin Deficiency ‣ Cold

▸ Rotting and ripening ‣ Deficiency and Cold ‣ Retention of Food

‣ Fire ‣ Qi Stagnation
▸ Controls descending
‣ Damp Heat/Phlegm ‣ Blood Stagnation

Image Credit: http://emedicine.medscape.com/article/1899301-overview, webmd

STOMACH - LES 27 STOMACH - LES 28

THE STOMACH RELATIONSHIP - RECEIVING THE FOOD

#1: UPPER ASPECT
 SYMPTOMS
LOWER ESOPHAGEAL SPHINCTER
▸ Upper GI bloating near ribs ▸ Feeling uncomfortably 

full after meals
▸ Belching
▸ Regurgitation of food or 

▸ Difficulty swallowing sour liquid

▸ Chest or abdominal pain ▸ Shallow breathing

▸ Abdominal pain that worsens ▸ Difficulty receiving
when lying down or bending nourishment/emotions

over

Image Credit: http://emedicine.medscape.com/article/1899301-overview, webmd

STOMACH - LES 29 STOMACH - LES 30

RELATIONSHIP - RECEIVING THE FOOD #1. LOWER ESOPHAGEAL 


SPHINCTER
BIOMEDICAL RELATIONSHIPS
Distal end curves to left.
▸ Hiatal hernia
Transition from
▸ Heartburn
esophagus to stomach
▸ Gastroesophageal reflux
disease (GERD)

Left side of sternum

6th/7th costal cartilage

Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011.

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 5
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 STOMACH - LES 31 STOMACH - LES 32

#1. LOWER ESOPHAGEAL 


SPHINCTER
Transition from
esophagus to stomach

Left side of sternum

6th/7th costal cartilage

Image Credit: tcmpicutrebook.com

Image Credit: Mittal and Balaban.2 Copyright © 1997, Massachusetts Medical Society and http://www.nature.com/gimo/contents/pt1/fig_tab/gimo14_F1.html

STOMACH - LES 33 STOMACH - LES 34

INTERNAL SPHINCTER
 EXTERNAL SPHINCTER


(ESOPHAGEAL SPHINCTER) (DIAPHRAGMATIC SPHINCTER)

Passage through
Two layers of smooth diaphragm
muscles (longitudinal
and circular) thicken Left side of sternum
due to internal
5th rib space/xiphoid
pressure
process

Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011. Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011.

STOMACH - LES 35 STOMACH - LES 36

INTERNAL SPHINCTER
 EXTERNAL SPHINCTER


EXTERNAL 
 (ESOPHAGEAL SPHINCTER) (DIAPHRAGMATIC SPHINCTER)
SPHINCTER

(DIAPHRAGMATIC SPHINCTER) Associated with the Associated with the
health and tissue of the diaphragm, lungs or
stomach itself liver (hypochondriac area.)

Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011. Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011.

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 6
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 STOMACH - LES 37

PALPATION #1 - LOWER ESOPHAGEAL SPHINCTER AREA

Left side of sternum in 7th

costal cartilage and
between xiphoid between
ribs

Consider: muscle tension,

mobility tenderness,
temperature, compare vs
right side

STOMACH - LES 39 STOMACH - LES 40

PALPATION #2 - STERNUM PALPATION #3 - RIB/COSTAL CARTILAGE MOBILITY

Sternum 2/3rds down

3rd and 4th rib space/Kd

17, Kd 18

Coracoid Process/Lu 1area

Consider: are the ribs

moving with the breath,
movement equal left to
right, upward pull of
tension, point tenderness
Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011.

STOMACH - LES 41 STOMACH - LES 42

PALPATION #3 - RIB/COSTAL CARTILAGE MOBILITY POINT PRESCRIPTION


STANDARD ACUPUNCTURE DIAGNOSIS PLUS

Gentle pressure up and Open Channels

down on lower ribs
‣ Left St 19, St 18
Explore tissue directly
below the lower ribs ‣ Left Kd 21, 22

Consider: rib mobility, ‣ Moving/Dispersing Kd


tissue mobility, pull of or St.
tissue, heat ‣ Palpate Kd/St intercostal
spaces for tenderness or
tightness
Image Credit: Atlas of Human Anatomy 6th Ed., Frank Netter. Copyright 2011. Image Credit: A Manual of Acupuncture, Deadman, Al-Khafaji, Baker, Copyright 2001

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 7
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.
 STOMACH - LES 43 STOMACH - LES 44

POINT PRESCRIPTION

STANDARD ACUPUNCTURE DIAGNOSIS PLUS
POINT PRESCRIPTION

STANDARD ACUPUNCTURE DIAGNOSIS PLUS

Spleen Sinew Channel Related:

‣ Palpate around ‣ Breathing to stimulate diaphragm


umbilicus for tightness, UB 17, UB 13, Lu 1
tenderness or heat.
‣ Lv 3, Lv 14 - Move Qi in Hypercondriac area

‣ St 34, Kd 5 (Xi Cleft)

Image Credit: A Manual of Acupuncture, Deadman, Al-Khafaji, Baker, Copyright 2001

45

THANK YOU.

ALBERT W STERN, L.AC

ALBERT@ALBERTWSTERN.COM

© Albert Stern & Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: info@eLotus.org 8
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine.