APR — Abdominal Pain

Two articles ago you learned how a formula is built. One article ago you learned what to do about the food that comes out looking as it went in. This article is about pain in the belly, and about the treatments made to release it — the three classes of APR, both generations of each, the formula the elderly ask for by name, and the acid treatment that closes the abdominal group.

The notation is closed. Every bracket, quoted letter, glyph, underline, colon and treatments suffix in this article was taught once and completely in Table 13 of How a Formula Is Built, "How a Formula Is Built". Nothing is explained again here. Every written rest is in Table 8 of that same article, with the reason given for it. If a line will not read, go back to those two tables; that is what they are for.

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Where this article begins

Formula No. 4, and the grading that decides what you give tomorrow

a little earlier this one closes the digestive family. It carries Formula No. 4 — (10) Medulla (4) Thrd 'P' (20) ↑\|↓ (8) Pan — so named because it cures the number-four pain of the abdomen, that is, intense pain. The formula itself, with its eye-disease indications and its own caveat, belongs to Setting the Stomach, "Setting the Stomach". The card notation that gave it its name — the old scale from one, next to nothing, to four, so much pain that the patient cries out even before the hand touches, and its replacement by Pan⁺⁺⁺⁺ over ⁺⁺, because numbers come before the point in a formula as well and a therapist could muddle the number of the pain with the number of the point — is taught whole in Uncommon Problems, "Points for Uncommon Problems", and recorded in Table 13 of How a Formula Is Built.

Why that matters here is the reason it was invented. With the pains graded before and after, it was known at once in which points, and how much, benefit the patient obtained from that day's treatment; the therapist could decide whether to give the same treatment tomorrow or another; and — a thing worth saying plainly — the patient obtained a great deal of reassurance. Everything in this article is judged that way. You will be grading Mu, Liv, Gas and Gal before and after, every day, and the grades are how you will know which of the three classes you have in front of you and whether you may move on.

APR — the abdominal-pain-releasing treatments

Releasing, not relieving — the four observations it was built on

The very foundation stone of this therapy is to check the pains around the navel and treat accordingly. So it is no surprise at all that within a few years of beginning, Guruji had attained formidable skill in removing abdominal pains of every kind. And as success grew, patients began to come from many provinces, with different habits and different ways of living — and most of them had a complaint of abdominal pain.

By then he already knew the thing that makes this therapy difficult to write down: a person falls ill because of his own habits, so even when the disease is one and the same, people of different habits and different ways will have to be given different treatments. That is a true statement and an inconvenient one. It means there can be no single answer.

Even so, he wanted to make one treatment that could be applied to the greatest number of people. Hold both halves of that sentence. The therapy knows that one treatment cannot be right for everybody, and it sets out to build the one that is right for the most. What follows is the record of that attempt, including the places where it did not work and had to be changed — which is the most useful thing in the article.

The reasoning, step by step

Four observations were laid end to end, and the formula fell out of them.

Say it in a kitchen. A pipe has been damaged, and the wall around the damage is swollen and angry. Two things are wrong at once: the swelling, and the fact that everything is now rushing through too fast to be of any use. You calm the swelling first and slow the rush second, and only then do you ask the household to start cooking again. That is the whole architecture of APR, in the order the parts are given.

The first version of APR

The first treatment was made for correcting loose motions or diarrhoea when they occur along with pain, and it has three parts, each with its purpose written beside it. (Figure 30.1)

Three things in that card deserve to be said aloud.

The Medulla number is part of the point. (30) Medulla is not a strong (10) Medulla. The whole graded series — (2), (4), (6), (8), (10), (12), (15), (20) and (30) — is a set of different treatments given at one site, each with its own work and its own bars, and it is taught in The Medulla Family, "The Medulla Family". The written prohibitions you already carry attach to (10) Medulla — not in diabetes, not in cancer; in heart patients, (10) Left Medulla only — and they are inherited by every formula that contains it. Read the number on the card before you decide which rule you are standing under.

(6) Adr carries its own two bars wherever it goes, and it goes into both of the diarrhoea classes below. It reduces immunity, so it is refused where immunity is already low; it reduces acid and raises alkali, so it is refused in high blood pressure. That is the pattern of every caution in this therapy: this point raises or lowers X; therefore withhold it where more or less of X is harmful. The reason is the memory hook.

(6) Swt is written without a side, and that is deliberate. Both palms stand on edge, pressure running inward toward the beads. Lt. Swt and Rt. Swt are different instructions with a different hand arrangement and a different direction of pressure, and they are not what this formula asks for.

Why one treatment was not enough — the three classes

Count the loose motions: more inflammation-work, later organ-work

Many patients obtained great benefit from that treatment. The abdominal pain also went out and the loose motions also stopped. And then a pattern appeared in the failures, which is where the interesting part of this article begins.

Those whose motions were fewer benefited from the above treatment. Those who had more loose motions did not have their loose motions stopped by it — that is, it did not make much difference to them.

Why so? And what is to be done about it? The answer, when it came, was not a new point.

Class A — abdominal pain with up to 4–5 loose motions

Table 3 — Card: APR class A, the first version Seated Prone Supine 6 sec

And there is a strengthened form of the same class, for when more is wanted.

Class B — abdominal pain with more than 5–6 loose motions

Table 4 — Card: APR class B, the first version Seated Prone Supine 6 sec

Look at what has actually changed between A and B, because it is a short list and it is the whole lesson. Swt is taken out of part I. Swt is halved in parts II and III. Part II is repeated. The abdominal organs are reached only at the third part, and only when the stools allow it. More inflammation-work, later organ-work — exactly as the teaching above predicted.

The halving of Swt to three is written as it stands. Note, without resolving anything, that (3) Swt has other uses of its own in the atlas, and that the revised generation below puts it back to six.

The revision — Gal and Spl taken out of an inflamed abdomen

Nothing added, nothing strengthened — two points taken out, and why

Benefit was certainly being obtained from those treatments. But even in that, some patients would be met with who did not get full relief.

And then came the thought that changed the whole group, and it came from asking what the points in part III actually do.

Table 6 — Card: APR class B, revised Seated Prone Supine 6 sec

The instruction that closes every diarrhoea treatment

A bowel slowed on purpose is given its speed back: NAN or FAN, one day

This one is yours to learn by heart, because it is the single most forgotten line in the abdominal group, and forgetting it undoes a good part of what the treatment achieved.

Why the therapy builds its slowing treatments this way is worth saying once, because it recurs. A treatment that deliberately slows the bowel is prescribed together with the treatment that undoes it. The Ulta Normal formula carries the same architecture in Setting the Stomach — ask about the motions daily, and as soon as the stool is formed like a banana, stop and give the Normal formula for at least one day. Here the same duty is written at the end of the whole APR group, and the antidote named is NAN or FAN. The underline is the visual interrupt; the closing instruction is the exit.

The third kind — abdominal pain without loose motions

The motility is correct, so go round the navel instead of slowing it

It is not always the case that every patient will have loose motions along with abdominal pain. There are some who have only abdominal pain, and no complaint at all about their motions. For them, some change is needed in the line of thinking.

Table 8 — Card: APR class C — abdominal pain with no loose motions Supine Side-lying Prone 6 sec

Look at the pairing at the end of parts III and IV, because it is a rule you already hold. (8) Ch. Only is balanced by (20) ↑\|↓ — Ch. Only reduces alkali, the Round arrow reduces acid, and matched by their counts they hold the balance the formula has set. That is one of the four inseparable pairs of How a Formula Is Built, and here it appears twice in one formula, closing two parts in succession. The acid-and-alkali pair itself belongs to Water and Salt, "Water and Salt"; what matters here is that you never write the first of them without the second.

Jeevan Dhara — the stream of life

The formula its patients named, in two versions — and the lighter wins

From this treatment the abdominal pain comes out at once. And something else happened that nobody had gone looking for. Given to the elderly, and to people with no particular complaint at all, it produced an immediate freshness and briskness. Many women to whom this treatment was given began to say that they had received a new life.

So the treatment acquired a second name, and it is the name everybody now uses.

This is a very effective treatment which gives benefit to persons of any age. In it, all the organs around the navel are provoked in one order. Especially to people of greater age, after this treatment is given, it feels as though they have obtained new life — on account of which this name was given to it.

There are two versions, and the therapy is candid about which it prefers.

The older, heavy version

Table 9 — Card: Jeevan Dhara, the heavy version Supine Side-lying Prone 6 sec

Fourteen stations, four positions, and well over a hundred six-second applications. This is the version the therapy itself calls heavy.

The present, lighter version

Nowadays this same treatment has been made lighter, and it is more effective. It can also be given to a patient of any age to remove fatigue or weakness in the body. (Figure 30.5)

Table 10 — Card: Jeevan Dhara, the present light version Supine Side-lying Prone 6 sec

Table 11 — Jeevan Dhara: heavy version against light version

The counts fall by something like three-quarters — the Round arrow from twenty applications to five, Ch. Only from eight to two, the kidney points from seven each to one each — and the result reported is not nearly as good. It is better. That deserves a sentence, because it cuts against the instinct every new therapist has.

The problem that remained

Results that faded in old disease, and the question that widened

The abdominal-pain formulas worked, and the therapy grew, and the growing brought the next question with it.

So the question was widened until it was no longer a question about a formula at all. When a human being is born, he is usually born healthy. One child in lakhs is ill on emerging from the mother's womb or even before it; generally children remain healthy for months or many months, and later fall ill from various causes. Why, then, do diseases come into the body at all?

The answer that came back is the doctrine of undigested food — the chemistry of the body, the three kinds of chemical it runs on, the two ways a missing chemical can be supplied, and the reason the whole system rests on the digestion and absorption of proteins and fats. That is taught whole, in order, in Clearing the Ash, "Clearing the Ash", together with every generation of the UDF formulas, the simplest treatment, OLD UDF read point by point, the (½) Ku treatment and the four symptom-matched formulas. It is not repeated here.

What belongs here is the relation between the two articles, and it is worth a line. APR releases a pain. UDF asks why the pain kept coming back. The first is what you give the person in front of you this afternoon; the second is what you give them so that this afternoon does not repeat itself every four months. A therapist who has only the first will be busy and will not get very far.

The HCl treatment formula

Six parts for the stomach's acid, given after UDF and never instead

The abdominal group closes with one more entry, and it sits at the far end of the road the last two articles have walked. It was made for a particular failure: it was seen in some patients that the UDF treatment has to be given again and again, and even then the problem does not get fully right. So this treatment was made, which works especially to increase the stomach's HCl acid.

Its place in a session, and the chain of purposes behind it — the UDF formula first, the wait of five to fifteen minutes, the HCl treatment second, and any further treatment last — is taught with its walkthrough in Clearing the Ash, "Clearing the Ash". What belongs here is the formula itself, as a formulary entry: its six parts in order, what each is aimed at, who it is for, and what travels with it.

The shape of the card is worth naming even though the reasoning belongs next door. The first four parts go after the switches; the last two do the ordinary work of digestion and absorption on a stomach that has just been switched on. Note also that (½) Ku – 6 secs here is written × 1 trt. — one session, the shortest Ku dosing anywhere in these two articles. The other timings of the same manoeuvre are different treatments: (½) Ku – 20 secs belongs to the UDF formulas of Clearing the Ash; (½) Ku – 40, 60 and 80 seconds belong to Water and Salt, "Water and Salt"; and the 13-second and 3-second timings belong to Cranial Nerve and Brain Formulas, "The Twelve Messengers". Read the seconds before you press. (Figure 30.6)

All the formulas of these three articles can be used to improve the working style of the stomach and the intestines. Ahead we shall see other formulas, which improve the work of other glands. (Figure 30.7)

Choosing, at the mat

What is in front of you, what to give, and the thing not to forget

Three patients

A bar that bit mid-course, a formula half-working, and a heavy version

At a glance

What the figures of this chapter have to show, and why

Questions students ask

1. I am nineteen and new. Why is the belly given its own group of formulas when everything else is arranged by disease? Because the pains around the navel are where this therapy begins. The very foundation stone is to check the pains around the navel and treat accordingly — so the abdomen is not one region among many, it is the reading instrument. A group of formulas aimed at it directly is the natural first thing to build, and historically it is what was built first. See also → The Navel Speaks First, "The Navel Speaks First".

2. Four or five motions, or more than five or six — what about a patient with exactly five? Use the class the patient's day actually looks like, and say why you chose it on the card. Five loose motions that are watery and leave him weak behave like class B; five that are soft and stop by afternoon behave like class A. And you have the safer instrument in your hands anyway: class B's own rule tells you to look at the stools before advancing to part III. Choose, look, and let the looking correct you.

3. Why is Swt in part I of class A but not in part I of class B? Because the classes are built on a stated principle: in the patient with more loose motions the inflammation is stronger, and until it is finished there is no meaning in provoking the other organs. So class B's opening is inflammation alone, and the motility work starts at part II, where it is given twice. The absence is the instruction — copy it as carefully as you would copy a count.

4. I am a doctor. What is actually being claimed by "stopping the motility"? Three separable things, and they are worth keeping apart. An observation — that this sequence is followed by fewer and firmer stools in patients with acute pain and diarrhoea. A protocol — fixed points, fixed counts, a fixed order, with a criterion for advancing. And a mechanism — that pressure over T6–T12 raises sympathetic outflow to the gut by way of the adrenal medulla, and that provoking the abdominal points against the peristaltic order slows transit. The first you can test at the mat this week by counting stools. The third is a hypothesis, and the therapy states it as its reasoning rather than as a finding.

5. My teacher gave the Ulta Normal formula as part III and my notes say (8) Pan (1) Mu – 3 points (1) Liv – 3 points. Which is right? Both are written, and they are two generations. The first version's part III is the Ulta Normal formula; the revised version's part III has Gal and Spl taken out for the reason given — the antiseptic bile and the antibody-making spleen. The revision was made because some patients were not getting full relief. Older versions are printed beside their successors in this therapy and they are not errors; know which one you are giving and know why.

6. The counts in class A's first version say (3) Mu (3) Liv, but the Ulta Normal formula I learned says (1) Mu – 3 points. Has something been mistyped? It is written as it stands, and the revised generation returns to (1) Mu – 3 points (1) Liv – 3 points. Give what is written on the card in front of you, and if you are the one writing the card, write which generation it is. The difference between an application and a station is in Table 13 of How a Formula Is Built and it is not a small one.

7. I am sixty-eight and learning this to treat my wife. The heavy Jeevan Dhara is beyond me physically. Have I lost anything by giving the light one? Nothing at all — you have gained. The therapy's own verdict on the light version is lighter, and more effective, and it is the version now given. Learn it as the formula and treat the heavy one as its history. And note the light version's extra indication, which is probably the one you will use most: fatigue or weakness in the body, at any age.

8. I work alone in a village. If I forget the NAN or FAN day, how bad is it? Bad enough to be worth a note on the card on day one. You will have spent a week deliberately slowing the peristalsis; NAN or FAN is what puts it back, and it takes one day. The patient who was not given it comes back a fortnight later constipated and blaming the treatment, and she is not wholly wrong. Write the ending when you write the beginning. See also → Weeks, Not Sessions, "Weeks, Not Sessions".

9. Can I give Jeevan Dhara to somebody who is perfectly healthy? That is one of the things it is for. Given to those who have no particular complaint it produces an immediate freshness and briskness, and the heavy version carries the line this treatment may be given to everyone. What you may not do is give it to somebody with loose motions, because the whole reasoning of class C is that the motility is correct and must not be tampered with — and the formula contains both of the points the revision withheld from an inflamed belly.

1. 10. Why does class C have no Medulla, no Adr and no Swt at all? Because it has no inflammation to damp and no motility to slow. Every point in classes A and B that is not an abdominal organ is there for one of those two jobs, and class C needs neither. What is left is the pure form of the thing this therapy is famous for: provoke all the organs of the abdomen, on all four sides of the navel.

11. Is the HCl treatment part of this article or the last one? It belongs to both and it is printed here as a formulary card because it closes the abdominal group. It is given 5 to 15 minutes after a UDF formula, never instead of one, and where it sits in a session, together with the reasoning behind its first four parts, is taught in Clearing the Ash, "Clearing the Ash". What you should carry from here is the card: six parts, the chief symptoms, the children it is especially for, and the Ku restriction.

12. (30) Medulla — is that not an enormous number? Am I pressing for three minutes? No. Thirty applications of six seconds each, released between, at both sides of the nape — and the number is a selector, not a strength. (30) Medulla is a different treatment from (20), from (15), from (10), given at the same site. What each number is for is The Medulla Family, "The Medulla Family", and the prohibitions written against (10) Medulla are written against that one. Read the number before you read the point.

Questions patients ask

"You are pressing my back and my legs. My pain is in my stomach." Yes — and I am not going to press your stomach, because that is not where the work is done. The organs inside your belly are supplied by nerves and vessels that can be reached from the back and from the limbs, and that is the route this therapy uses. It has a second advantage you will appreciate: a sore belly is not made sorer. If the pain leaves while my hands are nowhere near it, that is the treatment working exactly as it is meant to.

"Will this stop my loose motions today?" Often it eases very quickly — many people get up from the first treatment and say the twisting has gone. Whether the motions stop today I will not promise you. What I will do is count them with you tomorrow, and the day after, and the counting decides what I give you next. And I want you to do one thing that matters more than anything I do: keep drinking. Water with a little salt and sugar in it, all day. If you cannot keep it down, or if you feel faint standing up, we stop and you see a doctor today.

"Why do you keep asking about my stools? It is embarrassing." Because it is the one thing that tells me the truth about how the treatment is going, and because your answer decides what I do tomorrow. I am not asking out of curiosity, and I will ask in one sentence: how many times, and what shape. Some people find it easier to tell me once, twice, three times and loose, soft, formed. That is all I need, and I need it every day until we stop.

"My motions are normal now. Can I stop coming?" Almost. One more day. What we have been doing is deliberately slowing your bowel down so that it had time to take the water out, and there is one treatment whose job is to put the ordinary movement back. It takes a single session. If we skip it, there is a fair chance you come back in a fortnight with the opposite complaint, and I would rather you did not. Come tomorrow, and then I will examine you again from the beginning.

"My mother is seventy. Is she too old for this?" Not at all — this particular treatment was very largely made for people her age, and it is the one older people ask for by name. But I will give her the lighter form, which is the better one, and I will not put her through more than she needs. If she is tired when she gets up, I have given too much, and I will say so and reduce it. A treatment she needs help to stand up from has taken more than it gave.

"Should I stop my tablets while I take this treatment?" No — not one of them and not the dose, and please bring me the strip so that I can read the names. Some of what I do is decided by what you take: there are treatments in this group I must not give to somebody being treated for blood pressure, and I would only know that from the strip. Nothing here replaces a tablet. If your doctor later finds your numbers have changed, that is his decision to make and I would be glad of it.

"Is this the same as the nabhi setting my grandmother used to do?" It grew from the same soil, and I will not pretend it is identical. The old navel-setting of the households is one of the parents of this therapy and it is named as such openly. What has been added since is the part you are getting: a written order of points, a fixed count of seconds, a reason given for each step, and rules about when a treatment must stop. Your grandmother's hands knew something real. This is that knowledge written down so that it can be taught.

Words used here