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J Acupunct Meridian Stud 2010;3(3):203-213
Sa-Ahm Five Element Acupuncture
Chang-Beohm Ahn1*, Kyung-Jun Jang1, Hyun-Min Yoon1, Cheol-Hong Kim1, Young-Kwang Min1, Chun-Ho Song2, Jang-Cheon Lee3
Department of Acupuncture and Moxibustion, College of Oriental Medicine Dongeui University, Busan, Korea 2 Department of Meridian and Acupoint, College of Oriental Medicine Dongeui University, Busan, Korea 3 Division of Pharmacology and Prescriptionology, School of Oriental Medicine, Pusan National University, Busan, Korea
Received: Jul 5, 2010 Accepted: Jul 15, 2010 KEY WORDS:
comparing-pulse diagnosis; differential diagnosis; Five-Shu points; meridian therapy; tonification and sedation
Abstract This study aimed to review the clinical basis for Sa-Ahm Five Element acupuncture. This form of acupuncture uses the Five-Shu acupoints and the tonification-sedation treatments based on the creation and control cycles of the Five Elements. A total of 28 books and papers from the ancient "Nan-Ching" to the modern "Medical Acupuncture" were used to study clinical practices. Sa-Ahm Five Element acupuncture could be practiced in different ways depending upon differential diagnoses. These diagnoses include theories of excess and deficiency of Yin and Yang, seven emotions, ZangFu (organ, viscera), and comparing pulse diagnosis and meridian therapy to meridian palpation. Clinical trials and guidelines for the practice of Sa-Ahm acupuncture should be created to allow for a more evidence-based clinical approach to using this technique.
1. Introduction
Sa-Ahm's acupuncture treatment consists of deficiency/excess treatments and coldness/heat treatments in which Five-Shu (Five-Transporting or 5-Shu) points are used according to tonification and sedation. This principle is based on creation and control cycles of the Five Element theory, as well as Nanjing's theories presented in the 50th and 69th issues [1]. Gao-Wu, in the Ming Dynasty of China (1519 A.D.), was the first acupuncturist to tonify deficiency and to sedate excess on the basis of either depletion or repletion of the promotion cycle. This technique has been referred to as the "four-needle method" [2,3].
About 360 years ago, a Korean named Sa-Ahm [4] proposed Five Element acupuncture, which simultaneously uses the Five-Shu points of promotion and control cycles, and is also known as the "fourneedle technique" [5] or the "eight-needle method" [3]. Clinically the Five-Shu points mostly focus on deficiency and excess treatments although these points can also be used for coldness and heat treatments. Lee [6,7] proposed the diagnosis of comparative pulse in the 1960s and Kim [8] proposed symptombased diagnosis. In particular, Kwon [9] used Sa-Ahm Five Element acupuncture (SAFEA) in constitutional acupuncture and Kim [10] proposed mind-based SAFEA. Detailed guidelines for symptom patterns need to be established, as there are many ways to
*Corresponding author. Department of Acupuncture and Moxibustion, College of Oriental Medicine, Dongeui University, Busan, Korea. E-mail: [email protected] ©2010 Korean Pharmacopuncture Institute
204 select Five-Shu points from various interpretations of Five Element acupuncture [1]. Other similar treatment methods have been derived using Five-Shu points as a means of tonification and sedation. These include meridian therapy [11] and Five-Element constitutional acupuncture [4]. Although Ahn [12] and Kim [10] have proposed criteria for the Sa-Ahm's treatment, Sa-Ahm's acupuncture is generally used today in accordance with viewpoints held by Korean practitioners without a clear set of differential diagnoses. This review will briefly cover Sa-Ahm's clinical treatment to allow for more effective use of this technique and to allow this treatment method to be understood in detail.
C.B. Ahn et al of congenital energy, which constitutes meridian energy along with acquired energy.
2.1.2. Understanding biomedical acupuncture
The powerful effects of acupoints located below the elbow and knee joints can be understood on the basis of neurological findings. As the limbs below the elbows and knees occupy larger areas in the sensory gyrus in the brain, so the acupoints below the elbows and knees also occupy a larger area in the cortical representation of the postcentral sensory gyrus in the brain [13].
2.1.3. Powerful energy polarity
Points between the finger tip and elbow or tip of the toe to the knee are among the most energetically powerful points of the body. These include the five transporting points and also the connecting and accumulation points as the polarity of energy is changing from Yin to Yang or Yang to Yin. These points are where the greatest therapeutic effects can occur [3].
2. Sa-Ahm's Clinical Treatment
2.1. Meaning and efficacy of Five-Shu points 2.1.1. Correlations of meridian's congenital energy with exterior-interior, root-trunk, path of meridian and Five-Shu points [12]
Meridian energy consists of congenital and acquired energy. The limbs below the elbows and knees are where the interior, root and fibula meridian paths are located. The congenital energy reflects on itself in the limbs below the elbows and knees, and the root of six yin meridians are found in the extremities. The yin meridians receive the congenital energy from each meridian. Even though the direction of the 12 meridians is divided into along and against the stream of Five-Shu points, the flow of Five-Shu points begins at the tips of the fingers and feet, regardless of yin or yang meridian. Distal, Five-Shu, accumulation, and alarm points are located in the limbs, below the elbows and knees. These points belong to the categories of interior, root and fibula paths, and are used in treatments for the head and trunk, as well as ZangFu. Acupoint efficacy is divided into local or distal actions. The distal points located below the elbow and knee joints have distal effects for treating the ZangFu, which are also located distally. The source point, the Back-Shu point and the alarm point, one each in six Zang, as well as three lower sea points, Back-Shu point and alarm point in six Fu diseases. The selection of acupoint located below the elbow and knee joints allows a distal acupuncture effect, including Five Element acupuncture, Yeonggu eight extra acupuncture and Bidung eight extra acupuncture and Tegeok constitutional acupuncture. These effects may be understood from the viewpoint
2.1.4. Energetic action
The energetic action of points situated along the section of channel between fingers/toes and elbows/ knees is much more dynamic than other points because the energy changes from Yin to Yang or Yang to Yin. The change in polarity and superficiality of the channel at the extremities accounts for the particularly dynamic action of the points at the fingertips and toes. These points are therefore frequently used in clinical practice [14].
2.2. Differential diagnosis according to Kim Dong-Pil [8]
The differential diagnosis for various symptoms and their tonification and sedation are presented in Tables 1 and 2.
2.3. Acupuncture stimulation [8]
Sa-Ahm Five-Element acupuncture can be applied together with stimulation techniques such as respiratory, rotational and directional methods (Table 3). Each stimulation, which results in tonification or sedation, is described below.
2.3.1. Rotational stimulation
Tonification and sedation occur depending upon clockwise or counter-clockwise rotations in accordance with direction of meridians (Table 3).
Five Element acupuncture
Table 1 Tonification and sedation for coldness and heat Differentiating symptom Five phases Wood Fire Five Zang Liver system Heart system Monarch Minister Earth Metal Water Spleen system Lung system Kidney system Yin Yang Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Coldness Pulse Tonification Deep Float Deep Float Deep Float Deep Float Deep Float Deep Float S15 & GB38 HE8 & LI2 SI5 & BL60 HT8 & KI2 TE6 & BL60 PC8 & KI2 SI5 & ST41 HT8 & SP2 SI5 & LI5 HT8 & LU10 SI5 & BL60 HT8 & KI2 Sedation KI10 & LI18 BL66 & GB43 KI10 & HT3 BL66 & SI2 KI10 & PC3 BL66 & TE2 KI10 & SP9 BL66 & ST44 KI10 & LU5 BL66 & LI2 KI10 & HT3 BL66 & SI2 Heat Tonification BL66 & GB43 KI10 & LI8 BL66 & SI2 KI10 & HT3 BL66 & TE2 KI10 & PC3 BL66 & ST44 KI10 & SP9 BL66 & LI12 SI5 & LI5 BL66 & SI2 KI10 & HT3 Sedation
E = excess; D = deficiency.
Table 2 Tonification and sedation for deficiency and excess Differentiating symptom 5 phases Wood Fire 5 Zang Liver system Heart system Monarch Minister Earth Metal Water Spleen system Lung system Kidney system Yin Yang Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Yin E & Yang D Pulse Deep Float Deep Float Deep Float Deep Float Deep Float Deep Float Deficiency Tonification BL66 & GB43 KI10 & LI8 GB41 & SI3 LR1 & HT9 GB41 & TE3 LR1 & PC9 SI5 & ST41 HT8 & SP2 ST36 & LI1 SP3 & LU9 LI1 & BL67 LU8 & KI6 Sedation LU8 & LR4 LI1 & GB44 KI10 & HT3 BL66 & SI2 KI10 & PC3 BL66 & TE2 LR1 & SP1 GB41 & ST4 HT8 & LU10 SI5 & LI5 SP3 & KI3 ST36 & BL40 Excess Tonification LI1 & GB44 LU8 & LR4 BL66 & SI2 KI10 & HT3 BL66 & TE2 KI10 & PC3 GB41 & ST43 LR1 & SP1 SI5 & LI5 HT8 & LU10 ST36 & BL40 SP3 & KI3 Sedation HE8 & LI2 SI5 & GB38 SP3 & HT7 ST36 & SI8 SP3 & PC7 ST36 & TE10 LU8 & SP5 LI1 & ST45 HT8 & KI10 BL66 & LI2 LR1 & KI1 GB41 & BL65
E = excess; D = deficiency.
Table 3
Rotating stimulation in Sa-Ahm acupuncture for males* To tonify: rotate clockwise AM To sedate: rotate counter-clockwise To tonify: rotate counter-clockwise AM To sedate: rotate clockwise To tonify: rotate counter-clockwise PM To sedate: rotate clockwise To tonify: rotate clockwise PM To sedate: rotate counter-clockwise
Left hand Yang meridian Right hand Yin meridian Right foot Yang meridian Left foot Yin meridian Left hand Yin meridian Right hand Yang meridian Right foot Yin meridian Left foot Yang meridian
*For female, it is the opposite.
C.B. Ahn et al Ahn et al believe that acupuncture points below the knees and elbows, including the Five-Shu, accumulation, connecting, alarm, lower sea and eight points belong to the categories of interior, root and the fibular pathways [12]. These acupoints can treat diseases relating to the ZangFu organ and the head/ trunk, and therefore Five-Element acupuncture using Five-Shu points may have more efficacy than other acupuncture treatment. The function of points below the elbows and knees needs to be viewed in terms of interior-exterior and root-trunk in relation to the Yin-Yang 11 meridian and foot-arm 11 meridian, which are the forms of the 12 regular meridians. The flow of interior-exterior, root-trunk, Yin-Yang 11 meridian, foot-arm 11 and Five-Shu points are centrifugal, as these meridians are understood to flow from the beginning of the meridian at the tip of the extremities, moving into the trunk and head [12].
2.3.2. Respiratory stimulation
Tonification occurs following the insertion of a needle as the patient exhales and removal of inhalation. Sedation occurs on insertion of the needle as the patient inhales and removal on exhalation.
2.3.3. Directional insertion
Tonification occurs when the needle is inserted in the inclined position following the direction of the flow of energy in the meridian. By contrast, sedation occurs following insertion of the needle in the inclined position in the opposite direction to the flow of energy in the meridian. In theory, the use of acupuncture stimulation may be possible in treatment but strong technical movements on acupoints located on shallow body surfaces, i.e. between finger tips and elbow or tips of toes and knee, may be hard for the practitioner to access. Clinically it is recommended that practitioners do not use strong stimulations.
3.1.2. Differential diagnosis
The scope of Sa-Ahm's treatment can be extensive because of its diverse laws, such as the promotion and inhibition cycle among the Five-Elements and their connected meridians. The meridian consists of three parts, that is, arm or foot, more or less of Yin and Yang, and one of six Zangs (organs) and six Fus (bowels). A total of 24 deficiency and excess symptoms exist across the six Zang and six Fu, but theories related to these symptoms are too arbitrary to assist in making a diagnosis. Although there are currently many clinical books on Sa-Ahm acupuncture in Korea, a definitive general standard for the selection of symptom patterns has not yet been proposed. The general use of Sa-Ahm acupuncture has previously been discussed in 1985 [12]. The method can be used mainly from a theoretical viewpoint of ZhangFus, etiology of disease as well as the more or less of 3 Yang and 3 Yin. For example, in the case of knee pain, we can use liver tonification (mostly deficiency) because, according to theory of ZangFu, the liver controls the muscles and joints. Secondly, in the case of headache due to increasing liver-yang, we may use liver sedation (mostly excess) given the etiology of the disease. Furthermore, in the case of backache due to dampness, we can use either spleen-sedation (excess) to sedate dampness or Yang Ming-tonification (deficiency of large intestine or stomach) to tonify dryness from the principle of more or less than 3 Yang and 3 Yin. The above three viewpoints cannot fully explain Sa-Ahm acupuncture, so a common differential diagnosis shared by many acupuncturists needs to be determined. Lee was the first to propose a differential diagnosis of deficiency and excess by simultaneously comparing six pulses of both wrists in the
3. Discussion
3.1. Clinical application of Sa-Ahm Five Element acupuncture
The clinical study of Five-Element acupuncture can be divided into three parts: the efficacy of the Five-Shu points, differential diagnoses and clinical application.
3.1.1. Efficacy of Five-Shu point acupuncture
The importance of Five-Shu points is based on their location. Acupoints, including the Five-Shu points, which are located below the elbows and knees, account for the powerful polarity as well as an energetic action, due to their change in polarity and superficiality of the channel at the extremities [3,14]. The particular function of the Five-Shu points has also been explained in terms of corresponding brain regions. Acupoints below the elbows and knees occupy a larger area in the cortical representation of the postcentral sensory gyrus in the brain and also contain more sensory receptors. Needling stimulation to these points may, therefore, induce a greater reaction and activity in the brain. This principle clearly supports the concept of using certain acupoints below the elbows and knees (the so-called Five-Shu points in the classic meridian system) as diagnosis and treatment points during acupuncture [13].
Five Element acupuncture 1960s [7]. However, his diagnosis was only focused on deficiency and excess, neglecting coldness and heat. Although he said that irregular forms of treatments were the manifestation of subtle changes in diseases, signs and symptoms are needed to support his assertions. Jae-won's comparative pulse diagnosis is very original in attempting to determine different symptoms, but a diagnosis made only using the pulse method is difficult. Comparative pulse diagnosis can therefore be an important guide in using Sa-Ahm acupuncture, despite its weakness. Kim [8] stated that he proposed the diagnosis method called "Sa-Ahm Five-Element acupuncture of disease symptoms," which differentiates symptoms by simultaneously comparing pulse, as he found that original Sa-Ahm acupuncture could not cope with changes in diseases. The diagnosis of disease and the factual results of that treatment are of no avail. He asserted that a floating pulse showed Yang excess and Yin deficiency, while a deep pulse demonstrated Yin excess and Yang deficiency on the basis that the medial pulse is neither floating nor deep, and is the manifestation of health. Kim also proposed, from his clinical experience, that more focus needs to be placed on the symptom of coldnessheat rather than the symptom of deficiency-excess when differentiating these two symptoms. This can be achieved by comparing both the right and the left Guan pulses. If the right Guan pulse is weaker than the left, the symptom is related to coldnessheat, while if the left Guan pulse is weaker than the right Guan pulse, the symptom is related to deficiency-excess. For example, looking at the symptom of coldness-heat, if the pulse is floating, the main symptom is Yang excess and Yin deficiency. The treatment is then to firstly to tonify the fire within the Yin meridian and to secondly sedate the coldness within the Yang meridian. In the heat symptom, if the pulse is deep, the main symptom is Yin excess and Yang deficiency. The treatment is to firstly tonify the coldness within the Yang meridian and to secondly sedate the heat within the Yin meridian. The acupoints need to be explained in detail. If we use Yin Deficiency and Yang Excess in liver coldness as an example (Figure 1), treatment includes tonification of the fire points in the Yin meridians (the liver-self meridian and heart-fire meridian) using the acupoints HT8 and LR2. Second, the water points of the Yang meridians (gallbladder-couple meridian and bladder meridian) are sedated using the points BL67 and GB43. If we take Yang Deficiency and Yin Excess in liver heat as an example (Figure 1), treatment includes tonification of the Water points of the Yang meridian (the gallbladder-self meridian and bladder meridian) using the points BL67 and GB43. We then sedate the fire points the Yin meridians (the
207 liver-self meridian and heart-fire meridian), using the points HT8 and LR2. These rules for coldness and heat can also be applied in the treatment of other meridians. Yin Deficiency and Yang Excess in spleen deficiency (Figure 2) can be treated firstly with the tonification of the motherly points (fire) of the mother meridian (heart), as well as the motherly (fire) point of the self meridian (spleen) using the points HT8 and SP2. Secondly, the suppressor (wood) point of the stomach meridian is dispersed, as well as the suppressor (wood) point of the suppressor (gallbladder) meridian among its related Yang meridians. The points ST43 and GB41 should be used. These rules for deficiency and excess can also be applied in the treatment of other meridians (Figure 2).
3.1.3. Clinical use and stimulation techniques in Five Element acupuncture
Kim's acupuncture treatment [8] is characteristic of simultaneous pulse diagnosis. It compares Guan pulses to determine coldness-heat or deficiencyexcess, but is still based on the original Sa-Ahm acupuncture treatment. The method used by Kim is more detailed than that of Lee [6,7] in that Kim used differentiation of coldness-heat and deficiencyexcess and set the criterion for Yin-Yang balance by standardizing medial pulse. Kim's theory is still contentious and not fully accepted as a standard of general treatment as it is difficult to decide differential symptoms by pulse diagnosis only. The merit of Kim's treatment can be understood as a great contribution to the objective use of Sa-Ahm acupuncture in spite of its weakness, which is on pulse-only diagnosis. Seem [15] also believes that treatments using the four-needle technique are very powerful, and should only be pursued when a strong energetic manipulation is required, and only when one is certain of the primary element or phase affected. This recommendation is because the four-needle technique tonifies twice, then disperses twice, leading to a very concentrated tonifying- or dispersing-action on the affected element and meridian. If one is not certain of the primary affected element, it is far more conservative to use more gentle tonification and dispersal points. Generally speaking, Sa-Ahm treatment primarily focuses on deficiency-excess symptoms rather than those of cold-heat symptoms, although the relationship between the deficiency-excess and coldheat symptoms needs to be studied in detail in order to create reasonable guidelines for effect-friendly treatments. As there are many different ways to select Five-Shu points from the various opinions concerning Five-Element acupuncture, we need to
Figure 1 Tonification and dispersal for coldness and fire Treatment for coldness Pulse float--Yin Deficiency and Yang Excess in the case of liver coldness (1) Treatment rule: first, tonify its fire among Yin meridians (2) Treatment meridian: fire points of heart and liver meridians (3) Selected points: HT8 and LR2 Treatment for heat Pulse deep--Yang Deficiency and Yin Excess in the case of liver's heat (1) Treatment rule: first, tonify its coldness among Yang meridians (2) Treatment meridian: water points of bladder and gallbladder meridians (3) Selected points: BL67 and GB4
C.B. Ahn et al
(1) Treatment rule: second, sedate its coldness among Yang meridians (2) Treatment meridian: water points of bladder and gallbladder meridians (3) Selected points: BL67 and GB43
(1) Treatment rule: second, tonify its fire among Yin meridians (2) Treatment meridian: fire points of heart and liver meridians (3) Selected points: HT8 and LR2
Figure 2 Tonification and dispersal for deficiency and excess Treatment for deficiency Pulse float--Yin Deficiency and Yang Excess in spleen deficiency Tonification (1) Treatment rule: first, tonify its motherly point in self- and mother meridians (2) Treatment meridian and point: motherly (fire) point of mother (heart) meridian as well as motherly (fire) point of self-meridian (spleen) (3) Selected points: HT8 and SP2 Treatment for excess Pulse float--Yin Deficiency and Yang Excess in liver excess Tonification (1) Treatment rule: first, tonify its suppressor point in its related suppressor Yin meridian (2) Treatment meridian and point: suppressor (metal) point of liver meridian as well as suppressor (metal) point of suppressor (lung) meridian (3) Selected points: LU8 and LR4 Sedation (1) Treatment rule: second, sedate its child point in its child-related Yang meridian (2) Treatment meridian and point: child (fire) point of gallbladder meridian as well as child (fire) point of child (small intestine) meridian (3) Selected points: GB38 and SI5 Sedation (1) Treatment rule: second, disperse its suppressor point in its suppressor-related Yang meridians (2) Treatment meridian and point: suppressor (wood) point of stomach meridian as well as suppressor (wood) point of suppressor (gallbladder) meridian (3) Selected points: ST43 and GB41
determine detailed guidelines for patterns of symptoms in the future. The main stimulation techniques are rotation (twisting), respiration (inhalation-exhalation), in the direction of and opposite to the flow of the meridian. These techniques can be used in clinic as with other acupuncture treatments. But they are hard to use as the points of Sa-Ahm are located on shallow skin-deep sites beneath the knee and elbow. Nevertheless, a simple and weak stimulation seems to be enough to gain the acupuncture effect.
3.2. Perspectives of acupuncture treatments
Most illnesses contain interruptions manifested by stagnation and irregularities and also imbalances caused by deficiency and excess through the meridian network. Acupuncture treatments, therefore, must cover these two aspects of illness to achieve acupoint efficacy and function of sedationtonification. In order to gain greater efficacy, we may combine acupuncture, based on acupoint efficacy, and the Sa-Ahm treatment, which is based on the
Five Element acupuncture tonification-sedation effects, to simultaneously correct interruptions and imbalances. In relations to the principles of acupuncture treatments, we propose that acupuncture based on acupoint efficacy to correct interruptions be called "branch treatment," and acupuncture based on tonification-sedation effects to correct imbalances be called "root treatment." Effective acupuncture treatment, therefore, is a combination of acupoint efficacy with Five Element acupuncture, that is, Sa-Ahm five acupuncture cannot be a more effective method without the coordination of acupoint's efficacy. Also, we may understand the functions of acupuncture based on the mechanism for acupuncture analgesia proposed by Stux and Pomeranz [16]. Acupuncture's mechanisms are connected to three centers, i.e. the spinal cord, midbrain, and hypothalamic-pituitary gland. Acupuncture on local acupoints activates all three centers. Acupuncture on distal points activations the midbrain and hypothalamic-pituitary gland. Given this view on the acupuncture mechanism, acupuncture analgesia could be better achieved using local and distal points. Seem [15] believes that a local point directs the treatment strategy to the affected energetic functional sphere or zone (in internal energetic disturbances) while the distal points serve to determine the nature of the energetic manipulation (such as tonification, dispersal, warming, cooling, harmonizing). The combination of local and distal points forms a pattern of treatment that resembles the pattern of the disharmony being treated. In its most sophisticated application, a treatment pattern and its effects will confirm the diagnosis of the pattern of disharmony. In order to give more effective acupuncture treatments for other diseases, combination methods that cover local, special and distal points should be used to increase efficacy and treat tonification or sedation for imbalances. More effective treatment when using Sa-Ahm Five-Element acupuncture could be achieved if Sa-Ahm Five-Element acupuncture was used as a root treatment to correct imbalances, while local points, special points and symptomatic treatments as branch branch treatment to correct interruptions in proper stimulation techniques. Various prominent acupuncturists have used these types of acupuncture point combinations for the treatment of backache. Ross [3] has used the following distal points for the treatment of back pain, BL40, 59, 60, 62, KI.3, 6, 7, SI.3, SP.3, GV.26, in combination with these local points, BL, 22-19, BL.31, 34, 52, 54, GV.2-5. Stux and Pomeranz [16] have used GV.3, 4, 20, BL. 23, 25-7, 32, 36, 37, 40, 54, 57, 58, 60 and Ah-Shi points to treat pain along the BL channel. Pain along the GB meridian was treated using the GV.3, 4, 20, GB. 30, 31, 34, 39, LI.4 acupoints [17].
3.2.1. Sa-Ahm Five Element acupuncture [12]
Sa-Ahm Five Element acupuncture is primarily focused on Five-Shu points, which is in stark contradiction to other treatments. For example, backache can be caused by disturbances of the urinary bladder meridian, so we use tonification or sedation of the UB meridian depending upon deficiency or excess. Also, backache can be caused by weakness of the kidney meridian, which we then treat by using tonification of the KI meridian. Finally backache is caused due to excessive dampness of the spleen, which can be diagnosed in obesity. We can then use tonification of the dry large intestine meridian or stomach meridian in order to make dampness dry. Sedation of the damp spleen meridian can also be used on rare occasions. The selection of tonification or sedation depends wholly upon the diagnosing practitioner. Backache is generally associated with kidney or urinary bladder functions. The Governor vessel, Du-Mai vessel and Gallbladder meridian, with little connection to other meridians, can also be involved in backache. Ross [3] and Stux and Pomeranz [16] treated backache according to the traditional methods, but approximately 350 years ago Sa-Ahm treated backache using a novel approach. He related backache to the malfunction of connected organs (i.e., the bladder, kidney and gall bladder) to the imbalance of Yin and Yang (6 Qi) while primarily using Five-Shu acupuncture points. We cannot but wonder how the combination of the acupoints distal to the elbow and knee joints can treat diseases such as backache, shoulder pain and so on. We may be able to understand this effect using Yun-Tao-Mao's neurobiological fact: as the limbs below the elbows and knees occupy larger areas in the sensory gyrus in the brain and the acupoints below the elbows and knees contain more sensory receptors, so needling stimulation to these points may induce a greater reaction and activity in the brain. This principle clearly supports the concept of using certain acupoints below the elbows and knees (the socalled Five-Shu points in the classic meridian system) as diagnosis and treatment points during acupuncture treatment. The points between the fingertip and elbow or tip of the toe and knee are among the most energetically powerful points of the body [3]. They include not only the Five-Transporting points, but also the connecting points and the accumulation points. This is said to be because between the fingers and elbows, or between toes and knees, the polarity of the energy is changing from Yin to Yang or Yang to Yin, and where polarity is changing is where the greatest therapeutic effects can be made.
210 As meridian theory is based on the Qi thesis of Yin-Yang and Five Element among organs, acupuncture treatment cannot be separated from these viewpoints. The clinical use of Sa-Ahm's acupuncture treatment seems to be core to oriental medicine as Sa-Ahm acupuncture is based on the control of Qi and blood among organs and channels. As the creation of blood originates from the energy, one could argue that the energy includes the blood, so the effect of Sa-Ahm Five Element acupuncture can be said to harmonize the function and flow of energy. The treatment protocol of Sa-Ahm which is focusing mainly on tonification and sedation of FiveShu point with main points firmly based on regular pattern, has a strong effect on imbalances of ZangFus, but little effect on diseases of interruption such as stagnation and irregularities in meridian networks. Thus, he also used points other than FiveShu point. Lee [6], Kim [8] and others [17] proposed a new form of Sa-Ahm Five Acupuncture treatment that involved diagnosing symptoms after pulse diagnosis (i.e., comparing measures six pulses). Although this method created a new approach to Sa-Ahm treatment, more verification is necessary before it is determined as a practical diagnostic method. There are other acupuncture treatments using Five-Element combinations: meridian therapy, which originated in Japan [11], and constitutional acupuncture originating from Korea and England [5,9]. Study into the relationship between these two forms of acupuncture and Sa-Ahm acupuncture treatment is necessary in the future. Denmei asserted the use of meridian therapy by using tonification and sedation of acupuncture after six-position pulse diagnosis [11]. He used root treatment based on tonification and sedation for four different deficiencies of the yin meridian (liver, spleen, lung and kidney), as well as symptomatic treatment that was based on symptoms and the stimulation of tender points. Denmei believes that the root treatment comes first and the symptomatic treatment second. Although Kim [8] and Shudo [11] used pulse diagnosis, their viewpoints are different in that Kim set a symptom of coldness-heat as well as a symptom of deficiency-excess for each 12 ZangFu respectively, according to pulse diagnosis. By contrast, Shudo set a symptom of yin meridian deficiency and yang meridian excess primarily, with little diagnosis of yin meridian excess. There is another traditional Japanese acupuncture meridian therapy [18] that is similar to that of Shudo Denmei. Acupuncturists of the Society of Traditional Japanese Medicine including Koei Kuwahara, Okada Meiyu, Okabe Somei and others summarized the traditional acupuncture treatment that was practiced in Japan in 1997. The members
C.B. Ahn et al of the Society and Shudo Denmei did differ from each other in that they set each pattern of imbalance respectively, although they did apply meridian therapies in treatment. Shudo Denmei primarily treated a pattern of yin meridian deficiency without using yin meridian excess, via the use of 11 different kinds of yin meridian deficiencies with little connection to excess. Shudo Denmei also used root treatment of yang meridians, which consists primarily of dispersing excess, in contrast to the practice that uses liver excess pattern in relation to spleen and lung deficiencies. As there seems to be some confusion, the differences between the two meridian therapies should be studied in order to achieve more effective clinical treatment and to understand why the methods used by Shudo Denmei and Sa-Ahm incorporate Five-Shu points. Attempting Shudo Denmei's method [11] for treatment may be worthwhile, even though more verification is necessary, as the use of root treatment and symptomatic treatment, as well as comparingpulse diagnosis, may be a good treatment approach. Sa-Ahm's treatment, as well as Kim's, can be considered root treatment from the viewpoint of Shudo Denmei. Broadly speaking, if Sa-Ahm Five Element acupuncture is used together with symptomatic treatment, it may provide a more ideal acupuncture treatment that could control and harmonize the function and flow of Qi and blood. Ross [3] suggests two main guidelines for the use of the Five Element system [3]. This system should be used if there is an energy block between two or more organs and if there is correspondence with the traditional function of the points. As the Five Element system is for interior conditions, it is not appropriate to treat exterior conditions such as wind, cold, wind heat and summer heat, as well as channel problems in which there is no organic involvement. The Five Element system is not so effective in the case of severe deficiency, severe acute excess, Yin-Yang pair imbalances, mixed deficiency and excess in one organ, stagnation in the joints, and stagnation at and between energy centers. Ross [3] further explains that the Five Element system can be used either alone or in combination with other methods of point choice. However, the other methods of point choice used must be secondary, and in harmony with, the Five Elements. Even though Ross' theory seems to be similar to Sa-Ahm's, Sa-Ahm used the Five Element system in all diseases, including difficult cases that Ross asserts are not appropriate [3]. Sa-Ahm acupuncture has also been viewed as a four-needle technique to be used in "Five Element constitutional acupuncture" for transferring qi from one organ to another [5]. This would be a rare case
Five Element acupuncture where the practitioner is unable to harmonize the qi of two elements along the Sheng cycle. The limitation of Five Element treatment have been described as "not applicable to the use of the secondary vessels and eight extraordinary meridians, and since the latter constitute the bulk of the energetic system of acupuncture, Five Element treatment strategies apply only seldom. The two dominant styles of practice in this country, TCM and Five Element acupuncture, both emphasize the ZangFu (called Officials by Five Element practitioners of the Worsley school) and the regular meridians only and ignore the complex surface and primal energetic networks, which, taken as a whole with the regular meridians, constitute human energetics. In this sense, they are "disembodied approaches to acupuncture" [19]. Interestingly enough, Japanese acupuncturist Kiiko Matsumoto and American acupuncturist Stephen Birch have collaborated to write a book named Five Elements and Ten Stems [20]. The book contents are based on Nan Ching's theory [21], diagnostics and practice. The essence of diagnosis is rooted particularly in pulse diagnosis combined with traditional procedures such as observation, hearing, questioning and palpation of the abdomen. Their treatments consist of meridian-element treatments using SaAhm's method, called Yanagiya's treatment, as well as local point treatment. Meridian-element treatment can be seen as a root treatment with local acupuncture as a branch treatment. Matsumoto and Birch conclude that we should not allow ourselves to become blinded by the correspondences and theories of the Five Element method. Their conclusion also applies to Sa-Ahm acupuncture [20]. The eminent Korean practitioner Do-Won Kwon [9] has used Sa-Ahm acupuncture in his Constitutional Acupuncture but it seems to lack coherent arguments, even though the use of acupuncture in many diseases refractory to various forms of acupuncture, including Five Element and traditional acupuncture styles, was upgraded. Kuon's Constitutional Acupuncture may need to be studied in detail in future. Applied Channel Theory in Chinese Medicine focuses on channel palpation in diagnosis and on stimulation technique in treatment. This method uses "point pairs" because these pairs are understood as having specific effects on the Qi transformation of one or more of the six channel systems, and the points are the Five Transport, source, cleft and collateral points [22]. Meridian acupuncture, which uses local-distant acupuncture, has also been proposed because the local points collect and stabilize the energy while the distant points cause it to circulate [23]. The two work together like a pitcher and catcher or a
211 wheel and axle. Median acupuncture is performed by first selecting the local points, then determining the meridian most implicated in the condition. Finally the distant points that best suit the condition are selected. This theory is different from that of Japanese meridian therapy in that although Japanese meridian therapy is based entirely on the laws of the five phases, the term "meridian style acupuncture" has been extended to mean any form of acupuncture that derives its strategies from classical energetic theory as founded in the Nei Jing and Nan Jing, rather than the theories of herbalism or modern science. In brief, we must apply pulse diagnosis, channel palpation and meridian-style acupuncture together with other procedures such as observation, hearing, questioning and abdominal palpation prior to SaAhm acupuncture treatment, and also set up guidelines for differential diagnosis. Also, we can attain more effective treatment if using Sa-Ahm Five Element acupuncture and root treatment of meridian therapy in order to correct imbalances, as well as channel theory and meridian style acupuncture, which use local-distal points, special points, and symptomatic treatment of meridian therapy, in order to correct interruptions in proper stimulation techniques without being wholly bound to Five Element.
3.3. Perspectives from medical acupuncture
The study of acupuncture using scientific models allows us to understand the effects of acupuncture treatment. Since the early 1970s, more than 500 randomized controlled trials have been performed to study acupuncture in North America, Europe, Australia, and New Zealand, mainly focusing on treatment of pain conditions. Other well-studied areas include emesis, ophthalmology and otolaryngology, substance abuse, cerebrovascular illnesses, neurological problems, gynecological complaints, asthma, and gastrointestinal problems [24]. Recently Cho et al [25] stated that, based on their knowledge of Western medicine, it is hard to believe that acupuncture treats organ-related disorders and diseases by direct control of organs. Acupuncture may first stimulate or activate the corresponding brain cortex via the central nervous system, thereby controlling chemical or hormone release to the diseased or disordered organs for treatment. Corresponding brain cortices and disease-related acupoints need to be consistent and related in terms of known medical techniques to increase the plausibility of the use of acupuncture. Yun-Tao Ma et al [13] have developed a unique treatment protocol, the Integrative Neuromuscular Acupoint System (INMAS), which is a result of the
212 biomedicalization of traditional acupuncture, that also succeeds in maintaining the essence of traditional oriental medicine. The INMAS makes it possible to succeed in providing both a standardized treatment protocol that Western scientific medicine demands and the adjustable personalized approach of oriental medicine. INMAS has all the characteristics required for a clinical procedure. First, simplicity, the whole procedure from evaluation of the patient to insertion of needles can be performed in a very short time in the clinic. Second, reproducibility, the procedure and therapeutic results are reliable and reproducible by any practitioner, beginner or experienced. Third, predictability, this method enables the practitioner to predict the results of the treatment. The mechanism behind the clinical effects of acupuncture needs to be investigated from a neurobiological standpoint. The "law" of Five Elements has been criticized as an uncompromising model of dynamic relations within the body, but is restored when it is considered as a method of systemic and organized expression of organic and clinical reality [26]. In the field of acupuncture, we find it difficult to accept the Five-Shu points and their therapeutic use according to the "law." The Five Elements in Chinese medicine, even more than the Five-Shu points of acupuncture, are not part of the basic nucleus, but it is necessary to examine this concept further. The five phases are often used to describe clinical processes and relationships to help in the conceptualization of proper treatments [24]. It is an explanatory theory and is not meant as a binding doctrine, though all East Asian traditional physicians recognize five phases as an important vocabulary in their semantic network, theoretical perspective, and clinical practice. Five Element treatment must include the use of the secondary vessels and Eight Extraordinary Meridians [19]. The Five Element treatment is only part of acupuncture and must be viewed as part of acupuncture overall. Huang Long-xiang has stated "Clinical realities that did not fit into an existing theory of Chinese Medicine were often suppressed to ensure continuity of the theories in a style that the Chinese call `cutting the foot to fit the shoe'" [27]. The most valuable discovery in acupuncture theory is the interrelatedness between parts of the body surface and between parts of the body surface and the internal organs. These are the "immortal pearls" of classic acupuncture. Acupuncture does not treat any particular pathological symptom but normalizes physiological homeostasis and promotes self-healing [13]. Thus acupuncture, in terms of its therapeutic mechanisms, is nonspecific and does not target any particular symptom or diseases but treats the body as a whole.
C.B. Ahn et al Understanding this nonspecific nature of acupuncture can provide an answer to the puzzling question: what symptoms and diseases can acupuncture treat? As a therapy, the efficacy of acupuncture depends on the ability to heal symptoms and maintain the self-healing potential in each patient. Sa-Ahm acupuncture did not show a significant effect on pain relief in osteoarthritis of the knee joint compared to the sham group [28]. This result could be interpreted that acupuncture, even Sa-Ahm acupuncture, cannot effectively treat joint disease, but more similar trials are needed to establish this conclusively. All reviews seem to agree with the NIH Consensus Panel that one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. Both sides of East-West dialectic undoubtedly have more to learn from each other and this cooperation needs to be expanded upon [24]. As scientific mechanisms behind acupuncture are being investigated at a surprising rate, and given that the Five-Shu points and Five Element theory are difficult to accept in clinical practice from a Western perspective, the need for evidence-based medicine is imperative and essential in relation to Sa-Ahm Five Element acupuncture. Therefore, the clinical verification of acupuncture treatment must be made by comparing the effects of Sa-Ahm acupuncture with acupoint efficacy and combined treatment.
4. Conclusion
When considering congenital energy, the Five-Shu points account for powerful polarity and energetic action, as they occupy a larger area in the cortical representation of the postcentral sensory gyrus in the brain and contain more sensory receptors. Five-Element acupuncture consists of tonification and sedation using Five-Shu points. Five Element acupuncture, also known as "tonification and sedation in self-meridian" on the basis of the creation cycle, was first proposed by Gao-wu during the Ming dynasty in China. Sa-Ahm developed this technique further by extending it into another meridian and using the destroyer cycle in self- and other-meridians. Original Sa-Ahm Five Element acupuncture can be used from the perspective of ZangFu, disease etiology, imbalanced Yang and Yin, the mind-only theory and the comparing-pulse diagnoses such as Jae-Won Lee and Dong-Pil Kim. The use of Five Element acupuncture can be applied from the teachings of original Sa-Ahm
Five Element acupuncture acupuncture, Japanese Meridian Therapy, channel palpation, meridian-style therapy and constitutional acupuncture. In cases of interruption, acupoints are selected based on local and special effects in correlation with efficacy. We select Five-Shu points for either deficiency or excess in relation to tonification and sedation in cases of imbalance. Overall acupuncture treatment that covers the treatment of interruptions and imbalances of illnesses should be selected. For example, more effective treatment may be achieved if we use Sa-Ahm acupuncture as a root treatment to correct imbalances but then combine it with meridian style acupuncture, channel therapy acupuncture (which uses local-distal points), special points, or symptomatic treatment meridian therapy, as branch treatments, to correct interruptions in proper stimulation technique. Results from clinical studies to compare the results and efficacy of treatments, i.e., those of Five Element treatment and those of combined treatments, are required in future to determine evidence-based practice. Investigation into the scientific mechanisms behind the efficacy of acupuncture should also continue.
Lee JW. The Secret of Sa-Ahm's Acupuncture Based on YinYang and Five Elements, Volume 2. Busan, Korea: Institute for Studying Five Element Acupuncture, 1958:26-7. Kim DP. Sa-Ahm's five element acupuncture and its usages. J Korean Orient Med Soc 1972:Winter Issue;122-3. Kwon DW. Constitutional Acupuncture. The International Journal of Acupuncture and Moxibustion. Tokyo: The Japan Society of Treatment of Acupuncture and Moxibustion, 1965:149-67. Kim HK. Revolutionary Review of Oriental Medicine (the details). Seoul, Korea: Sinlong-Bonche, 2001:73-170. Shudo D. Japanese Classical Acupuncture: Introduction to Meridian Therapy. Vista, CA: Eastland Press, 1989:151-207. Ahn CB, Choi DY. Theoretical study on five element acupuncture. Dongguk J 1986;5:287-309. Ma YT, Ma M, Cho ZH. Biomedical Acupuncture for Pain Management. London: Churchill Livingstone, 2005:12-3. Maciocia G. The Foundation of Chinese Medicine. London: Churchill Livingstone, 2005:783-5. Seem M. Acupuncture Energetics. Rochester, VT: Healing Arts Press, 1991:19-20, 50-1. Stux G, Pomeranz, B. Acupuncture. Berlin: Springer-Verlag, 1987:272. Gong TY. Sa-Ahm's five element acupuncture and its relation to medical prescription. J Korean Orient Med Soc 1977; 12:27-31. Society for Traditional Japanese Medicine, Kuwahara K. Traditional Japanese Acupuncture: Fundamentals of Meridian Therapy. Taos, NM: Paradigm Publications, 2003:287-306. Seem M. Acupuncture Imaging. Rochester, VT: Healing Arts Press, 1987:20. Matsumoto K, Birch S. Five Elements and Ten Stems. Taos, NM: Paradigm Publications, 1983:89-132, 170-1, 196. Unschuld PU. Nan-Ching (The Classic of Difficult Issues). London: University of California Press, 1986:474, 583, 617. Wang JY, Robertson JD. Applied Channel Theory in Chinese Medicine. Seattle, WA: Eastland Press, 2008:331-41,531-49, 551-77. Pirog JE. The Practical Application of Meridian Style Acupuncture. Berkeley, CA: Pacific View Press, 1996:3-4,16. Kaptchuk TJ. The Web That Has No Weaver: Understanding Chinese Medicine. New York: McGraw-Hill, 2000:357-80, 441-9. Cho ZH, Na CS, Wong EK, Lee SH, Hong IK. Functional magnetic resonance imaging of the brain in the investigation of acupuncture. In: Stux G, Hammerschlag R, eds. Clinical Acupuncture: Scientific Basis. Berlin: Springer, 2001:83-95. Beyens F. Reinterpretation of traditional concepts in acupuncture. In: Filshie J, White A, eds. Medical Acupuncture: A Western Scientific Approach. London: Churchill Livingstone, 2006:391-407. Hong LX, Zhong GZ, Jiu XS, Shi DG. The Historical Development of Acupuncture. Beijing: Huaxia Chubanshe, 2001:83,129. Lim S, Min MH, Choi YG, Kim YJ, Park HJ, Lee SC, et al. The effect of Sa-am acupuncture on knee osteoarthritis. J Meridian Acupunct 2009;26:53-66.
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10. 11. 12. 13. 14. 15. 16. 17.
19. 20.
This study was supported by a grant of Dongeui University (2010AA113).
21. 22.
1. Ahn CH, Jang KJ, Yoon HM, Kim CH, Min YK, Song CH, et al. A study of the Sa-Ahm five element acupuncture theory. J Acupunct Meridian Stud 2009;2:309-20. Gao W. Gatherings from Eminent Acupuncturists-Zhen Jiu Ju Ying. Taipei, Taiwan: Shinmunfung Publishing, 1980:154-9. Ross J. Acupuncture Point Combination: The Key to Clinical Success. London: Churchill Livingstone, 2004:75-99. Heng P. The Essence of Sa-Ahm's Acupuncture. Seoul, Korea: Heng-Lim Publisher, 1975. Hicks A, Hicks J, Mole P. Five Element Constitutional Acupuncture. London: Churchill Livingstone, 2005:383-4. Lee JW. The Secret of Sa-Ahm's Acupuncture Based on YinYang and Five Elements, Volume 1. Busan, Korea: Institute for Studying Five Element Acupuncture, 1958:171-2.
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Love Beaches? Artificial or Natural?
Mankind always enjoys what nature has given it. Nature always amazes the human being with its exotic creations. But sometimes nature also forgets to explore its own creations.Humans have found some natural things which were not explore by anyone before. In this article we have mentioned few beaches which were man made.
- Diamante Cabo San Lucas, Mexico – It is the 10acre artificial crystal lagoon. It was designed by a chilean biochemist. It is safe, family friendly environment and also includes white sand beach areas, private cabanas and a saltwater lagoon. You can sail, swim or kayak. It also has Tiger woods designed EI cardonal golf course.
- Artificial Beach, Male, Maldives – The city named Male was not having any natural beach, so the people made it on their own. Maldives is known for celeb visitors. The beach has calm waters and soft sand. People gather in the beach for water sports, carnivals and different shows happening daily or monthly.
- Larvotto Beach, Monte Carlo, Monaco – This beach is the only public beach in Monaco. In backside of the beach there are restaurants and bars which are open 24 hour. It is covered with luxury resorts. The crowd here comes to take fresh air of Monaco and enjoy in the white sand.
- Sentosa island, Singapore – It is 1,235 acre island, which is like a giant resort. There are three beaches that go up to island's southern coast which is made up of sand imported from Indonesia and Malaysia. It has many resorts and great attraction things which will amaze you.
- Streets Beach, Brisbane, Queensland, Australia – It was found in South Bank Park lands, which was former site for Brisbane's 1988 World expo. It is covered with huge lagoons which are filled with pure water, sandy beaches and tropical plants. The water is regularly recycled.
- sun city, south Africa – It has 70,000 square foot lagoons in the valley of Waves Water park, bordered with a beach with sea sand and palm trees. Sun city is known for luxury casino and resort. People come here for experiencing luxury.
Beaches are the best place to hangout. They calm you down and make your body relax. A lot of beaches offer adventure sports also. We hope this article may have helped you to pack your bags for the next trip to any one of these beaches.

subset: commoncrawl


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You must be logged in to obtain assetsContact Publisher | Support
Android scrolling page example. This GMS1, GMS2 demo includes horizontal and vertical page scrolling with the mouse. The best uses for this system are interactive books and scrolling menus for Android games.
I made this code while working for IcyProject (new starting company specialized for android interactive books). If you want to see how this code works on android you can download Azure Flame books on https://play.google.com/store/apps/details?id=com.IcyProjects.AzureFlameDawn or on https://play.google.com/store/apps/details?id=com.IcyProjects.AzureFlameZenith
UPDATE: Version 1.0.2 - Added clickable objects (white A, B, C, D and E buttons)
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After many years dedicated to the study of water, Nuno Nina concluded that it is more complex than was thought. And more than many still think.
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The metabolic functions of the body produce waste – acids. If we can't get them excreted efficiently, we'll start accumulating more acids than we can manage. This inevitably leads to a process of loss of health and, consequently, to disease. The fact that the ORP (oxidation-reduction potential) of water is negative makes it able to bind to the (positive) acids found in your body, thus enhancing the function of the kidneys. It also contains a high concentration of hydrogen, the broad therapeutic effects of which have been studied.
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Kidney electrical potential rising from 18.3% to 66.4%


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Leaders of provincial post office said that Bien Hoa City is the first one in Dong Nai province to offer home delivery services of public administrative documents. In 2014, provincial post office will be expanded its documents returning service at one-door agent of district-level People's Committee. Of which, Dinh Quan and Tan Phu District will provide this service at the beginning of April, 2014.
It is widely known that after two years of implementation, home delivery service of administrative documents at departments, agencies and localities receive support from the people since time-saving and traveling cost-effective are retained.
Governing authority: Dong Nai People's Committee
Person-in-charge: Mr. Pham Viet Phuong – Chief of Dong Nai People's Committee People's Committee Office
Address: No. 02 Nguyen Van Tri Street, Thanh Binh Ward, Bien Hoa City, Dong Nai Province.
Phone: (+84251) 3847292
Source "Dong Nai Portal" or www.dongnai.gov.vn as the source when you re-publish the information on this website


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Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wis.
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text: The Challenge of Obedience August 23, 2019/0 Comments/in Devotional Studies, Devotions /by Indestructible Daughters As Christians our general expectation is that if we just obey God and do what He tells us to do, then circumstances, although difficult, will somehow work out in the end. In the macro sense, that statement is certainly true. Ultimately, obedience to God is always the best choice. However, it is that little word "ultimately" that causes us to stumble. Taking giant steps of faith in a direction we believe to be right and then watching the results plummet can certainly challenge our faith. Obedience may seem quite unpleasant to us when we try to do the right thing and our efforts seem to explode in our face. We take a giant step forward, obey God with as much courage as we can muster, and still we end up frustrated and wondering if we read Him wrong. It's easy in many cultures to view ourselves as the center of the universe. We may spend hours seeking God on behalf of our family, our job, our education, and our future plans. But, life simply doesn't begin and end with us. Our needs and wants should not be the focal points of our lives and our prayers. As the cliché goes: if you start with "you," you'll end with "you" and you will accomplish little—starting with yourself and your problems can lead to confusion and to more discouragement. However, starting with God, laying it all at His feet, leads us to the only solid ground we'll ever know. Indestructible Daughters https://www.indestructibledaughters.com/wp-content/uploads/2019/08/Challenge-of-Obedience-1.jpg 686 1030 Indestructible Daughters https://www.indestructibledaughters.com/wp-content/uploads/2014/09/Indestructible-Daughters-Text-Logo-Header-80px1.png Indestructible Daughters2019-08-23 14:19:582019-08-23 14:25:15The Challenge of Obedience


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- £346 per week
- £49 per night
- 2 Guests
- 1 Bedroom
- 1 Bathroom
- 1 Pet
Beds & bedrooms
- Bed linen provided
- 1 double bed
- Washing machine
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How far to ...?
- Beach 3 miles
- Pub 1.5 miles
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Special Features
- WiFi
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Nearby activities
- Walking
- Watersports
- Fishing
- Golf
- Walk-in shower
Important - please note
House Rules
- Check in: 7:00pm
- Check out: 9:00am
2 Dolwen Farm is a delightful holiday cottage within the bustling courtyard of a working farm, whose farm shop is well known in the area. Fantastic for animal lovers, this is in a rural location with lovely views from the grounds over the surrounding countryside. Dolwen is 3 miles from Colwyn Bay, 6 miles from Conwy and Llandudno, and about 10 miles from the Snowdonia National Park.
'A welcome pack with eggs and bacon from the farm is included!' from Jacky, our local manager.
The Cottage: is a pretty barn conversion which adjoins WAG501, so ideal for extended families and groups of friends. The owners are on hand to offer a warm welcome and local information. Central heating.
Living room: large arched doors lead into this is a well-planned room which includes a leather sofa, Freeview TV/DVD and WiFi. Dining table and chairs.
Kitchen: is a handmade fitted cottage style kitchen with a Belfast sink, electric cooker, microwave and fridge. A shared utility room (with WAG501) houses the tumble dryer, washing machine and freezer.
The en suite bedroom is on the first floor
Bedroom 1: is a lovely beamed double room with dressing table and en suite shower room.
Shower room: has a shower cubicle, basin and WC
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*Note the pond is not fenced so children need to be accompanied at all times*
Dolwen is a great base from which to relax and enjoy the farm and its surroundings, or to explore the attractions of the local area. Colwyn Bay has a beach, watersports centre and the popular Mountain Zoo. The walled town of Conwy has lots of cafes, local breweries, pubs and independent shops, whilst Llandudno has a magnificent promenade, a tramway and cable car leading up to the summit of the Great Orme, also an artificial ski slope and toboggan run! Inland is the National Trust's Bodnant Garden, Bodnant Welsh Food centre and the mountains of Snowdonia.
The garden pond is not fenced so children should be supervised at all times
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No smoking inside please
Stunning views, lovely bacon & eggs provided which was much appreciated & help with local area
Excellent property, no problems at all. Very welcoming family.
This was the first time that we have dealt with Wales Cottage Holidays and have enjoyed very honest, straightforward and excellent service. The cottage was possibly the best we have ever stayed in within the UK. It was beautifully located, very clean, well equipped and comfortable. We were welcomed and made to feel at home, and generally had a thoroughly great time!


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How The Subconscious Controls Your Life! ~(Powerful information!)
11 Comments
The subconscious is responsible for 95% of the results that you have in your current reality. Once you reprogram your subconscious, it's a game changer. Only focus on what you want. What you focus on grows and gets planted into the subconscious mind. It's simple! Thank you for your work and inspiring me to make videos to spread knowledge to the world 🌎 Love to all 💙💫
But how im trying a lot to learn
Yes! The subconscious mind runs up to 90% of our daily actions and decisions. It holds our belief ststems and if we have beliefs based in lack instead of abundance, we are going to miss out on all he ideas and opportunities necessary in order to be the powerful creator beings we can be. We must shift these beliefs as the #1 intention for our lives in order to manifest heaven on earth. Peace
nice thank you
Your subconscious mind controls 95% of your life! only 5% is controlled by the conscious mind. Our subconscious mind is so powerful, we are powerful. Our Beliefs create our reality, when we create awareness and we are aware of our self-talk and the stories that we tell ourselves, we are more able to train our subconscious mind to let go of our limiting beliefs and be able to create the reality that we want!! Creating awareness is the first step 🙂
Awesome video sir! I've been in the process of reprogramming my subconscious for the past year. And I am seeing a BIG shift in the way I think, say, and do. Thanks to doing my affirmations, meditations, & creative visualizations daily. Again, Thanks for another blockbuster video! Peace!
Perfect timing for me thank u
Great sage just if I can talk to you 😇
We are only aware of about 5% of our cognitive activity, leaving our subconscious to run the show. It is important that we start to reprogram our subconscious mind if it is holding onto negative programming or limiting beliefs. ♥ Extraordinary video! 😊✨✨


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In a Nutshell
Holder of an RHS award of garden merit, these flowers are winter hardy, so once planted they produce a good looking display each year
Product Details
- Award-winning variety of Allium
- Flowers year after year with globes of eye-catching violet
- Produces round heads of violet stars
- Mixes easily with other shades of blue and purple in the garden
- Large, rich purple blooms can reach around 10cm in diameter
- Subtle and sweet fragrance
- Ideal for patio pots or planted in drifts in borders
- Long-lasting blooms
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- Winter hardy
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Images shown are for guidance only of the expected results from plants upon maturity. Different growing conditions may vary results.
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Delivery: £1.99 (not included). Allow 7 working days (Monday to Friday). Shipping only to most of GB mainland. Not available for the Scottish Highlands and islands.
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The weekend could not have been more exciting in Espoo, where the 2020 Finnish Nationals took place from February 29 to March 1. Second after the short program, Helsinki Rockettes won the Senior National title and skated their way to the Worlds. Team Fintastic won the Junior competition which was extremely tight.
On Sunday, more than 30 teams competed at the Loppi-Ice 2020, hosted in the Gatorade Center in Turku, a city on the southwest coast of Finland. With Junior and Novice ISU, this competition gathered also younger categories.
There was no doubt of the winners in Seniors on Sunday, when Team Unique got 139.94 points from their free program and earned total scores 216.69. In the Junior category, Team Fintastic also kept the leading position and won the competition with 182.39 points. For the Novices division (second segment), Team Dynamique got the gold medal with 73.88.
The first National Synchronized Skating Qualification in Finland started today in Espoo. After the short programs on Saturday, Team Unique leads the Senior competition. In Juniors, Team Fintastic took the first place and Finettes is the winner of today´s Novice competition.
After an exciting weekend full of drama, the Finnish champions are finally settled. Dream Edges won the Junior division and Marigold Ice Unity is the champion in the Senior category. Together with MIU, Team Unique will represent Finland at the World Championships in April even if Helsinki Rockettes are 2018 national vice-champions.
The Dumfries Ice Bowl, Scotland, was heaving with hoards of excited fans and skaters today with the culmination of the ISU event. 1500 competitor passes had been handed out for the 3 day competition and fans were sitting on steps and stood in crowds at the boards to watch the Junior and Senior events.
Finnish Junior and Senior teams continued competing on Sunday and skated their free programs. The atmosphere was as exciting as expected. Some changes happened compared to the situation after short programs. Discover the report of these second qualifications!
It has been an exciting two days in Turku, Finland this weekend. The winners of the Finnish first qualifications in the Junior and the Senior categories are now settled after the free program competition. Dream Edges is the gold medalist in the Junior category and Marigold Ice Unity brought the victory home in the Senior category.
One of the first international competitions of the season took place this weekend in Germany. The Berlin Cup featured Junior and Senior teams from across Europe and USA. Finland and the United States of America have each won 3 medals.
On Friday evening, 17 Juniors and Senior teams have warmed the German ice rink. The Cup of Berlin lived the ISU short programs. Skyliners from the USA and the Finnish Marigold IceUnity are for the moment atop of the competition.


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Seligman AZ (September 16, 2012) – On September 15, 2012, at approximately 9:30 in the morning, Yavapai County Sheriff's Office deputies responded to a report of two motorcycles involved in a collision on Crookton Road east of Seligman, Arizona.
Preliminary investigation revealed that a group of four motorcycles were traveling west on Crookton Road near Mile Post 147.5 when the leading motorcycle impacted debris, possibly from a tire, and lost control.
Deputies arrived and found three persons severely injured. Medical personnel treated the injured and determined 60-year-old Cathy Pizzullo, from Prescott Valley, Arizona had died. She was a passenger on the lead motorcycle in the group being driven by her husband.
The Prescott Valley, Arizona couple apparently struck the road debris first and lost control of their motorcycle. Mr. Pizzullo suffered injuries to his head and chest.
The driver on the second motorcycle in line collided with the lead motorcycle and he suffered back and torso injuries. His passenger was not hurt. Both injured riders were airlifted to Flagstaff Medical Center. The motorcyclists riding in the third and fourth positions were able to avoid a collision and stopped to render aid.
All involved in the accident were wearing helmets. The speed of the motorcycles has not been documented as of this writing.
Deputies spoke with the driver of an SUV towing a utility trailer traveling ahead of the motorcycle group. The SUV driver stated that he had attempted to avoid the tire debris in the road, but apparently struck it with his trailer, causing the debris to exit from behind the trailer and onto the roadway in front of the motorcycles. The people in the SUV also stopped to render aid.
An accident investigation team arrived on the scene to collect evidence and review the incident pending a final report. Cathy Pizzullo's cause of death determination is under evaluation by the Yavapai County Medical Examiner.
Citizens may contact the Yavapai County Sheriff's Office with information or questions at 928-771-3260.


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Our Dark Chocolate Mini Rice Cakes are more than just an ordinary chocolate treat. Made by combining wholegrain rice cakes with pure cocoa butter, these gluten and lactose-free treats are sure to surprise and delight. Containing no preservatives, artificial colours or flavours, and only 15 calories per cake! Gluten-free, palm and vegetable oil-free, vegan-friendly and all-natural, they are a delicious low fat treat.
Contains: Soy
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AussieSheepskin Classic Short UGG Boot
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Beautiful Pendleton jacket in bright red, with black and indigo geometric design running across front and back. With pockets and zip closure. A classic, hard-wearing garment in excellent condition.
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Clowns divorce: custardy battle. Simon Munnery
Thanks, Cindy.They're in the book.It was the third time around for 'The Sun Ain't Gonna Shine Anymore'.It was used twice in Season I (before we decided a track could not be used again in the same season).Its record:- a Gold in Week 12 of Season I (Prodigal Son),- a Bronze in Week 39 of Season I (Roy Roger Bridge),- a Gold in Week 10 of Season IX (Cindy Hood)Scott Walker's 'Sons Of' won the Gold in Week 25 of Season III (Frankie Teardrop).It was the second time around for the official release version of 'River Song'.It won the Gold in Week 4 of Season VII (t Bedford), with 59.5 points and 33.06% from 18 voters.This week it scored 46.5 and 29.06 from 16 voters.A demo version of 'River Song', apparently recorded with the Beach Boys in 1973, won the Silver in Week 43 of Season III (paul g adsett). It scored 37.5 and 25% from 15 voters.This is Dennis Wilson's Battle record:Holy Man (Dennis Wilson/Taylor Hawkins) (a Silver in Week 42 of Season II - Roy Roger Bridge),River Song (demo) (a Silver in Week 43 of Season III - paul g adsett),Farewell My Friend (a Gold in Week 9 of Season VI - Verden McCutcheon),River Song (a Gold in Week 4 of Season VII - t Bedford),Sound of Free (Dennis Wilson & Rumbo) (a Gold in Week 27 of Season VII - bonnie bella),River Song (a Silver in Week 10 of Season IX - Cindy Hood)It was the second time around for 'Everybody's Talkin''.It won the Silver in Week 35 of Season VI (Deb#1), with 44.5 points and 22.25% from 20 voters.This week it scored 42 and 26.25 from 16 voters.It was the sixth entry for Nilsson. His record so far is: Coconut (a Tin in Week 23 of Season II, 7th in Tin Play-Off - Cynthia D. Hood),Without You (a Bronze in Week 2 of Season III - DomesticAnimalNoises), 1941 (a Tin in Week 11 of Season V, 7th in Tin Play-Off - Tom Tobben), One (a Silver in Week 13 of Season V, 8th in Silver Play-Off - Peter Simpson), Everybody's Talkin' (a Silver in Week 35 of Season VI - Deb#1),Everybody's Talkin' (a Bronze in Week 10 of Season IX - Cindy Hood)It looks like 'Everybody's Talkin'' will be Harry's fourth entry in a play-off (Bronze).If it makes it and wins, both 'The Sun Ain't Gonna Shine Anymore' and 'River Song' will progress to a play-off (the Preliminary Final) for their first times.The 22 points and 13.75% of the vote for 'Eye of the Tiger' are the lowest scores for a song so far this season.
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Shade Print by Justina Blakeney®
Take retreat in the cool, shady palms of a secluded Moroccan garden... or at least pretend you are with a big ole art print on your wall! The vibrant greenery goes with anything & looks amazing with any color palette. This guy is a print of original photography snapped by Justina Blakeney® herself while she was venturing through Morocco.
Justina Blakeney is an artist, designer, and founder of Jungalow®. She employs watercolor, gouache, collage, and pen on paper to create her artworks and explores themes of identity and togetherness.
- Print of original photography taken by Justina Blakeney® in Morocco
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- Made in the USA
- Please allow 2-3 weeks for your delivery
- All prints are made to order and non-returnable
- Please allow 2-3 weeks for your delivery
- All prints are made to order and non-returnable


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#13 1368 007
Showin' Off II
by April M. Rimpo
20" x 36" x 2" | Watercolor GW | $2,000.00
Status: Hold
Current Location: HorseSpirit Arts Gallery
The trombone player in The Preservation Jazz Band strutted across the stage like a rooster. His playing was magnificent hit high notes and very low, as he extended the slide to its maximum length. He and his fellow musicians brought so much energy to the stage and such incredible music you could feel the electricity pulse through the audience. Smiles were pasted on all in attendance. My goal in Showin' Off II was to bring that tremendous energy to you through my painting. I hope you feel the joy. Gallery wrapped painting, where the image continues arouond the edge.


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Sakae Naa (Combretum quadrangulare)
Commonly used parts: Seeds and leaves.
Reported effects are: Stimulating, increased alertness, relaxation, euphoria and drowsiness.
This herb is used by farmers in Thailand as an alternative for Kratom.
Very little is known about this medicinal herb, but there are still many of its' properties available for use by both researchers and patients all over the world. Because this is a member of the family of trees, it is very difficult to move around and distribute to other areas of the world, which is why it is so hard to get a hold of it. The leaves are usually chewed raw and kept in the mouth for as long as possible so that they can be absorbed by the soft tissue. The oil can be added to food and drinks and taken on a regular basis. The Sakae Naa helps as a pain relief and also as a way to keep you energized. It has similar effects to coffee, but without the added dehydration.
What are herbal E-Liquids?
Only resin extracts contain the effective components such as alkaloids. And E-liquid with 4% resin extract only requires a few puffs from an e-cigarette to experience an herbs natural effects.
Even though there is only 4% of Resin Extract in this product, it might clog your e-cig after a while. You might want to use this Herbal E-Liquid in a dripper atomizer or in vape pen that can handle thicker Liquids.
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For additional information about our herbs don't hesitate to contact us or take a look into our herbal blog


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Reddit user RationalIdiot presented a very special offer to the alter of Photoshop Battle with this incredible picture of a hamster dressed up in a cozy little hoodie. Lets be totally honest... This hamster was just adorable in a hoodie and didn't need any photoshop battle... but seems like the Photoshop artists of Reddit were ready to go and needed to take this adorable cutie on all the adventures they could think of!
We're big fans of the subreddit photoshopbattles for reasons that should be obvious; it's hilarious to photoshop animals into weird situations. Take this brown bear for example, who was just chillin' at the Berlin Zoo the other day and is now all over the internet.
Buckle your seatbelts, this Uber has gone rogue. "Where TF My Uber Taking Me" memes are modified photos from the perspective of a back seat passenger, in which the passenger realizes their Uber driver is taking them to a bizarre destination. The first such meme featured a view from Pixar's Cars, but following variations delve into the world of video games and history.


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A home equity loan is another name for a second mortgage. You get a lump-sum check for "X" amount of money, and it comes with a fixed repayment program that spells out the interest rate, the size of.
1 Rate discount is applied after your application is accepted. Discount is available for new Fixed Equity Loan and Home Equity Line of Credit applications. You must set up and maintain monthly recurring automatic payments from your Navy Federal checking account for the life of the loan; otherwise, the 0.25% rate discount will be removed, and your loan will revert to the original note rate.
Understanding rates is important when you're trying to understand what a home equity loan is and how it is different from a line of credit. Fixed-rate home equity loans have interest rates that don't change during the life of the loan. variable-rate home equity lines of credit have rates that are linked to an index, such as Prime
. can get pretty heavy when homeowners want specific comparisons between fixed rate and variable rate loans. This calculator is designed for people who want to build home equity in the most.
Home equity loans (HEL) are a great option if your home value is significantly more than your mortgage balance. You can use a HEL for many.
Conforming 30 Year Fixed Rate Corpus Christi Mortgage Rates IBC Mortgage – Refinancing | Austin | San Antonio | Corpus. – IBC Mortgage offers competitive rates on mortgages, home loans, refi, refinancing, home equity loans, jumbo loans no money down mortgage and more in Austin, San Antonio and corpus christi tx, apply online today.


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The project has come to the point of desgining how the bike is going to look like. We decided to do 3D-printed bodywork as a test of what pros and cons come with it. I started modelling the Switchpad and dock for the displays. Here is a CAD model of something I've been working on.
Quite original, right? I don't know if it is good or bad thing but sure is something 😀
One important protective cover is the motorcover so your pants or shoes wont get in touch with the chains or the axle. Here's a sketch about that cover as well.
I will be doing a lot of modelling and printing during the next few weeks and the rest of the team is focused on getting power to the backwheel. Exciting times, stay tooned!


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Local News: Asheville and Hendersonville
Large crowd attends Buncombe Sheriff candidate Shad Higgins' fundraiser
Chief deputy of the Buncombe County Sheriff's Department Terry Rogers spoke on the roll of the Sheriffs department and leadership. Terry Rogers said, "Shad wants to make sure people are satisfied. He does that in his business, and he will do that in the Sheriff's department."
There was a lot of talk in the crowd regarding the opioid crisis in Buncombe County. Sharon Fitzgerald said, "I'm a lifelong Democrat, and I'm here to tell you my party has gone to hell. The people who are running it are the same anarchist's handing out needles to drug users on Haywood Road. Aiding drug users with needle programs just encourages more drug dealers to sell in Buncombe County. Dealers are coming here in droves. I am supporting Shad because I know he will put a stop to it."
The Leicester Leader will be at Shad Higgins opponent Democrat Quinton Miller's next fundraiser to see what his supporters have to say.