Casebook: Embracing spring

04 April 2023 | Practice
John Hamwee
Member: Oxfordshire
March is always my busiest month – I think it is for many of us. The reason, I think, is that the change from winter to spring is such a sharp and profound energetic shift. The other changes of season have nothing like this dramatic reversal.

For plants, it is a change from growing downwards, as the roots seek water through the winter, to growing upwards towards the emerging light and warmth.  In many animals it signals the time to stop hibernating and start mating.

For us humans, with our 21st century lifestyle, spring is even more challenging because we have not spent the winter resting and going inwards. Too depleted to embrace the uprush of spring, or too unbalanced energetically to cope with the change, we find ourselves struggling in various ways.

Here are three examples.


I have treated Peter for many years. He tends to come at irregular intervals, but he always comes in March because he reliably falls into a depression then. He started and runs a small charity employing 23 people. January and February are his busiest and most stressful times because it is then that he needs to raise the money to allow the charity to survive another year. Once funding has been secured, usually in early March, he collapses, losing all interest in his work, in his family and in life. Before he had acupuncture the depression would last until early June – the next change of season, of course.

The diagnosis is that his energy in March is out of synch with the energy of nature. He can’t respond to what is happening all around him – not least to his children wanting to play outdoors with him in the lighter evenings when he gets home from work – so he feels helpless, inadequate, joyless. As the spirits of those around him lift at the signs of new life, and his do not, he falls into a depression.

The remedy, in principle, is to give strength and sustenance to his wood energy. What I found difficult was choosing between a range of possible treatments.

I didn’t get much help from his pulses and tongue. The pulses were, as you would expect, weak and sinking. The tongue was perhaps a little more red than normal, and a little peeled at the sides, but it didn’t really show me what to do.

Most obviously, I tried tonifying the source points of wood, LIV 3 tai chong and GB 40 qiu xu; but it didn’t make much difference. I think it is because, not just with Peter, I have never had much response from GB 40 – I suspect I don’t really understand it. My next idea was to tonify the back-shu points, BL 18 gan shu and 19 dan shu, but there was no real response from him or his pulses.

I thought of tonifying wood with LIV 8 qu quan and GB 43 xia xi,  but I was nervous of the idea. For one thing, his water energy was pretty depleted, so could it really nourish wood? And would I just be creating a problem for his bladder and kidneys? With some misgivings I did try it once, but although it didn’t make him noticeably worse it didn’t help him either.

Next I tried stimulating his wood energy with the wood points on both wood channels, LIV 1 da dun and GB 41 zu lin qi. That was much better.

As is often the case for me, it is only after seeing the effects of points I have needled that I fully understand why I should have chosen them in the first place. For one thing, depression is a kind of stagnation and GB 41 has a powerful effect on spreading liver qi. More specifically, stagnation of liver qi often inhibits the movement of the diaphragm and the expansion of the rib cage. Hence, on a physical level there is not enough oxygen being taken in, and on an emotional level there is not enough inspiration. All this made me reflect that in the west we see depression as a psychological problem, but it is at least as useful to see it as an energetic one.

Many point names are simply descriptive of their anatomical location but there are alternative translations of their names, and some of these translations point to the effect of a point on the spirit. LIV 1 is a good example. ‘Big Mound’ is indeed the biggest joint at the end of the toes, but I have also read the translation ‘Great Esteem’. Certainly, when Peter is depressed he loses all self-esteem, so this point might well help to revive it.

The other combination that has helped him is LIV 3 tai chong and DU 20 bai hui. According to the old saying, human beings stand between heaven and earth, connecting both. Perhaps Peter’s depression comes, in part, from losing that interconnection, so needling points at either end of the body at the same time – points which are themselves connected, as DU 20 is at the end of the liver channel – felt right.


Jenny is a delightful woman in her mid-30s, bright, quick, enthusiastic, terrific fun to be with in the treatment room. She has an endless stream of good ideas, plans and projects. She wants to run a disco for disabled people because, as she told me, ‘Normals like us don’t want to dance with them’. She has a plan to convert a disused barn in mid-Wales into a bunk barn so that refugee families can have really cheap holidays. She decided to start a pop-up café in summer at the local pick-your-own where teenagers who have just finished their A levels, and are at a loose end, could learn some skills and earn some money. There are more plans too. The only trouble with all and any of them is that they are never realised.

Energetically, therefore, the diagnosis is a really powerful vision combined with really weak decision-making. She would do better to have fewer plans and more capacity to implement them. March, therefore, is the ideal time to harmonise liver and gall bladder with both luo points, LIV 5 li gou and GB 37 guang ming. Once I had done that I reflected that it might be a good treatment for Peter too; I often find that I discover what might help one patient from the treatment of another.

Finally, if the patient’s issue is some kind of new start in life, then the sort of treatments you might think of in March might be good at other times of the year too.


George’s wife of more than 40 years died 18 months ago and he isn’t doing well. He tells me that when he comes home from work her absence is still unbearable. Somewhat shamefacedly he adds, ‘I can’t be angry with her anymore, but somehow I am’.

He wants to retire and replant a local wood with native species but he worries that he would miss the companionship of his colleagues at work and might go a bit weird if he is on his own all day and night.

His tongue has the characteristic pallor of blood deficiency and his pulses are thin, so my first idea was to treat liver blood deficiency with LIV 6 zhong du and 8 qu quan. I followed that up with treating blood more generally with ST 36 zu san li, SP 6 san yin jiao and BL 17 ge shu.

He looked better and his posture became more upright, but there was still some barrier he couldn’t quite cross. Next, I tried combining hand and foot jue yin with LIV 3 tai chong and P 7 da ling. The pulses came up markedly and his face started to get some pink in it, but again there seemed to be something holding him back.

As so often, it was the obvious I had missed. He had told me he was angry with his wife, a powerful emotion which could find no means of expression. Anger enables us to initiate change and to grow, but his was frustrated. How?

Well the wisdom of the five elements tells us that grief can over-control wood via the ke cycle. So I finally thought of dispersing metal with LU 5 chi ze and LI 2 er jian and at the same time tonifying water with KID 7 fu liu and BL 67 zhi yin. I did no more that day as, according to the pulses, the energy seemed to be flowing on through to wood. The next time I saw him he looked very different, and told me he felt ready to change and make a new start in life.

The energy of spring is so strong that if it is blocked then pathology is not far behind. Fortunately, generations of masters of acupuncture have left us a number of wonderful ways to help it to flow naturally again; our job is to find the right one for an individual patient, yearning to embrace his or her own particular spring.