Vater Treatment

Family: Digestive
Sequence: (10)Medulla (3)ONS (4)Ku old (8)Gal (max.) + (10)Liv (max.) verified by Dr. Diwakar Shukla
Used for: For digestion (ampulla of Vater function), fat digestion, bile flow. Specific for fat malabsorption.
Safety: 🟡 CAUTION: (10)Medulla contraindicated in cancer.
Explained in: Setting the Stomach

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From Setting the Stomach

Opening the door the bile comes through — the Vater treatment

103, 408, 10 — and max., a dose decided at the mat each day

Sometimes patients came who certainly got benefit from the above treatments, but after some days the pain came back. When the pain points were checked, a good deal of pain was found in Gal and Liv. (3) Gal (7) Liv was given, and other treatments too, but even so no special difference was found.

So, after much thought, an inference was drawn: if there is some blockage in the road by which the bile comes — in the ampoulla of Vater — then the bile will begin to congeal in the gall bladder itself, and its effect will fall on the liver too, will it not? And from there the question changed shape. It stopped being which point relieves this pain and became what all must be done to open this ampoulla of Vater.

Key teaching

The four requirements the Vater formula was built to meet

For the digestive system, the vagus, the tenth cranial nerve, is to be stimulated. (10) Medulla will do this work.

2. If this trouble comes again and again, then perhaps the navel has slipped, and that is to be corrected. ONS will set the navel.

3. The pineal gland is called the master gland. If it does not work properly, then too there will be disorder in the body's functions. (½) Ku – 40 seconds stimulates it.

4. The gall bladder and liver are to be stimulated more, so that their secretion comes out fast and whatever obstruction there is gets flushed out — pushed out forcefully. (8) Gal (max.) and (10) Liv (max.).

Read the list as a piece of construction rather than as four good ideas. Each line names a job, and then names the point that does that job. That is how a formula is built when it is built deliberately — and it is the clearest worked example of it anywhere in .

Table 9 — Card: Vater Treatment Seated Supine Prone

Written	I (10) Medulla (3) ONS (½) Ku – 40 seconds (8) Gal (max.) · II (10) Liv (max.)
The memory aid the therapy supplies	103, 408, 10
Family	Built from the therapy's own logic. Named after the ampoulla of Vater, the structure it was designed to open
Positions, in order	Seated → supine → prone → supine Seated Supine Prone
I · Step 1	(10) Medulla — seated; the nape, both sides Seated . To stimulate the vagus, the tenth cranial nerve
I · Step 2	(3) ONS — supine; both big toes gripped, the legs raised slowly to the height of the standing therapist's hand, held six seconds, and lowered very slowly Supine 6 sec . To set the navel
I · Step 3	(½) Ku – 40 seconds — prone, the heels facing each other; the therapist seated between the feet, the mid-sole on the sacrococcygeal region, normal pressure, one application held forty seconds Prone . To stimulate the pineal gland
I · Step 4	(8) Gal (max.) — right sole down the left thigh Left . To stimulate the gall bladder to release bile in greater quantity
II · Step 5	(10) Liv (max.) — right sole on the left arm above the elbow, left sole on the left thigh, together Left
What max. means	Not that (8) Gal or (10) Liv is given on all days — see the max. rule below
What it is for	To open any blockage in the ampoulla of Vater; to set the stomach, especially where after fried things there is a burning in the chest; to take out a great deal of pain at Gal and Liv; for those whose fats are not properly digested — who get sour belches after fried things or non-veg. By this treatment the whole abdomen gets 'set', and the pain of Gal also goes
How the blockage may be detected	An ultrasound may be done. There is one more way: if there is an obstruction in the common bile duct, then LAP — leucine amino-peptidase — will remain raised in the blood. LAP is a protein-digesting enzyme found in the pancreas, liver and small intestine. If LAP is more than normal, we understand there is a blockage in the ampoulla of Vater
Cardiac form	I (10) Left Medulla (3) ONS (½) Ku – 40 seconds (1) Gal · II (1) Liv
Why the cardiac form is reduced	In most such people cholesterol has been found high in the blood test. Since cholesterol is made only after fats are digested, we have to stimulate Gal and Liv less, so that fats are not digested too much and cholesterol does not increase
The prerequisite for heart patients	Patients of heart disease must first be given the Angina treatment only. After two to four days of that, when their health improves a little, this treatment may be given ▲ Take care
Its place in a longer treatment	Given before New Gal — see the very best method of treatment, below
Points taught in	Medulla — Seated I — Brain, Medulla, Neck; ONS — The Front of the Body II; (½) Ku — Face Down; Gal, Liv — The Front of the Body I

As soon as this treatment was given, the patient got such relief — what is there to say! So the inference was a hundred percent correct, and this treatment must have opened whatever obstruction there was in the road of the bile as far as the ampoulla of Vater. Therefore it was named the Vater treatment.

And one sentence in the account of it belongs to the whole therapy rather than to this formula. In this therapy we do not treat the disease; rather, we improve the body. Since our treatment brings a change in the body's chemicals, keeping that in mind the treatment is done the next day: this formula was made to improve the gall bladder and liver, so after each day's treatment those glands will work still better. The formula is not repeated because the disease is still there. It is repeated onto a body that is not the same body it met yesterday.

Here the word max., that is maximum, has a special meaning. It is not that (8) Gal or (10) Liv is to be given on all days.

Every day, before this treatment, the therapist must check the patient's Gal and Liv pain. According to the pain, how much Gal and Liv to give that day is to be decided by oneself.

For the first few days give (8) Gal or (10) Liv; but after some days, as the pain decreases, keep reducing the quantity — (3) Gal in place of (8) Gal, or (3) Liv in place of (10) Liv.

Key teaching

The max. rule — the most disciplined dosing instruction in the formulary

When the pain has gone completely and all the symptoms are right, stop the treatment.

That is a ceiling, a titration and a stopping rule written into a single word, and there is nothing else quite like it in . Everywhere else the bracketed integer at a chemical point is exact and may not be varied. Here the bracketed integer is a maximum, and today's number is decided by today's examination. (Figure 27.4)

THE METHOD, STEP BY STEP

Deciding today's dose of Gal and Liv under the max. rule

Four steps, every session, before the foot goes anywhere. Supine

Step 1 — palpate first, treat second. Find Gal and Liv with the fingertips as you would on a first visit, and grade what you find. Not "Gal tender" — a grade, written down, on the same scale you used yesterday.

Step 2 — read the grade against the last three sessions, not against the ceiling. The question is not is there pain but is there less pain than there was. A grade that has not moved in four days is telling you something about the plan, not about the dose.

Step 3 — choose the number, and write it. Early days, and a strong finding: (8) Gal, (10) Liv. As the finding softens, come down — (3) Gal, (3) Liv. The dose is now a variable, so it must appear on the card every single day. A card that says only Vater formula has recorded nothing.

Step 4 — honour the stop. When the pain has gone completely and all the symptoms are right, stop. Not taper indefinitely, not "continue for maintenance". A treatment that never ends is a treatment whose endpoint was never defined.

Vater — and the max. rule. The Vater treatment with the job each of its points was chosen for, and the max. rule drawn as a decision strip: the printed count struck out as a ceiling, today's finding on the left and today's count on the right, the four steps taken before the foot goes anywhere, and the three things to check before the formula is given at all.

TAKE CARE

Three things to check before the Vater formula is given at all

The heart patient goes to the Angina treatment first. Patients of heart disease must first be given the Angina treatment only. After two to four days of that, when their health improves a little, this treatment may be given. Then the cardiac form, with (10) Left Medulla and Gal and Liv cut to (1).

The forty-second (½) Ku is the longest single sustained pressure in this article, and duration is the variable that matters. It is given with normal pressure on a healthy sacrum, and on such a body it is within tolerance. It is not for a patient with thin bones, for one on long-term steroids, for a wasted or bed-bound patient, for anyone with a sore or broken skin over the sacrum, or for anyone who cannot feel the pressure or tell you about it. Look at the skin afterwards.

ONS raises both of the patient's legs off the mat. Do not give it where there is acute low back pain running below the knee, where a disc is suspected, after recent abdominal or pelvic surgery or a hernia repair, in pregnancy, or in a patient with a hip replacement. And the one finding that ends the session at once, wherever you meet it: numbness in the saddle area, new difficulty passing or holding urine, or weakness in both legs — that is a same-hour emergency and not a treatable presentation.

DID YOU KNOW?

The name on this formula belongs to a real doorway

Where the tube carrying bile from the liver and gall bladder meets the tube carrying the pancreas's enzymes, the two join for the last few millimetres and open into the gut through a single small opening. That short shared channel is the ampulla of Vater, and around it sits a ring of muscle that keeps the door shut between meals so that bile backs up into the gall bladder to be stored and concentrated.

It is a genuine bottleneck, and it is the reason a stone the size of a lentil can turn a person yellow. Everything the liver and the pancreas make for digestion has to get through one doorway, and the two of them share it.

Whatever one concludes about pressing a thigh, a formula named after that doorway was named by somebody who had looked up what it was.

A MISTAKE STUDENTS MAKE

Giving the printed number because it is printed

(8) Gal is written in the formula, so the therapist gives eight — on day one, day nine and day twenty-six, because that is the number written, and he is being faithful to it.

He has been faithful to the bracket and unfaithful to the word beside it. (8) Gal (max.) and (8) Gal are two different instructions, and the therapy took the trouble to mark the difference with a word it uses nowhere else.

The cost is not only wasted work. The whole point of this formula is to flush an obstruction with a strong secretion; once the obstruction is gone and the tenderness with it, eight applications are a large stimulus delivered for no reason to a patient whose signal has already resolved.

The rule for a card: where the formula says max., write today's number and today's finding on the same line. "Gal ++ today — gave (3)." Next week that line will tell you, and anybody else, whether the patient is getting better. ▲ Take care

Also explained in

Introduction Setting the Stomach
Give the Vater treatment in both its forms, apply the max.
What else the Chole treatment was found to do — and what it was withdrawn from Setting the Stomach
He was moved to the Vater treatment, and told plainly why, and it is taken up in the next section.
At a glance Setting the Stomach
hat the figures and the one plate of this article must show Plate — The forty-second hold at the base of the spine · PLATE — AND THE PROMPT TO REDRAW IT Caption: Step three of the Vater treatment.
How the families are named, and why the naming is worth learning How a Formula Is Built
Formulae which correct the function of certain organs of the body — the Vater treatment; the Medulla treatments.
The rule that makes this a gate Water and Salt
After two to four days of that, when their health improves a little, the Vater treatment may be given.
The three tiers — point, formula, treatment The Shorthand
Formulae which correct the function of certain organs — the Vater treatment; the Medulla treatments.
At a glance Water and Salt
After two to four days of that, when their health improves a little, the Vater treatment may be given — and then in its cardiac form, with (10) Left Medulla and Gal and Liv cut to (1).
Heart disorders When the Hand Must Stop
After two to four days of that, when their health improves a little, the Vater treatment may be given — and then in its cardiac form.

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