A Journal For Physicians By Physicians
Spring / Summer 1998 - Volume 10 / Number 1 "Aurum Nostrum Non Est Aurum Vulgi"


Medical Acupuncture




By Michael L. Buffington, M.D., Private Practice/Family Medicine and Medical Acupuncture, De Queen, Arkansas and Hobart Bell, B.S., Director and Clinical Embryologist/President, Embryology Associates, Inc., Boulder, Colorado

ABSTRACT      The Five Phases Paradigm, described by ancient Taoists, is a graphic representation of all so-called terrestrial phenomena into five organizing poles placed equidistantly along the circumference of a circle. This paradigm has been used for more than two millennia to describe and predict the complex phenomena and relationships associated with health and disease. The Myers-Briggs Type Indicator, developed in this century, is a multiple-choice test designed to assess normal personality types according to eight categories of personality preferences grouped into four opposing pairs. Sixteen distinct combinations of the four basic pairs have been described. In this paper, the derivation of ascribing the 16 personality types codified by the Myers-Briggs typology to the Five Phases Paradigm is described. Relating the variety of personality types to this ancient Oriental system provides a deeper understanding of individual types, and the dynamic interplay that exists between them. It also provides a unique model by which personality types can be shown to correlate with specific disease entities. A working knowledge of such a model system provides the medical therapist with a means for more accurate diagnoses, and ultimately, therapeutic options more efficaciously applied.
KEYWORDS       Five Phases Paradigm, Acupuncture, Myers-Briggs Type Indicator, Typology
INTRODUCTION       The Five Phases Paradigm is simultaneously a very basic and highly sophisticated model of living systems. Such systems are said to be in a state of either equilibrium (health) or disequilibrium [disease] (1). Equilibrium is susceptible to both exogenous and endogenous influences. Examples of exogenous influences that can disrupt equilibrium include climatic extremes of wind, cold, and heat. Examples of endogenous influences include changes in brain chemistry associated with various emotional states such as anxiety, depression, and panic disorder. The behavioral changes associated with these endogenous influences can often be correlated with certain medical syndromes such as irritable bowel syndrome and insomnia.      The Myers-Briggs Type Indicator (MBTI), developed in this century, is a particularly successful system of personality typing. As originally devised, it was an attempt to classify individuals according to the theories of personality and psychological type developed by Carl Jung (2). An essential ingredient of his theories was that the apparently endless and ubiquitous variations observed in human behavior, rather than due to chance, was the logical consequences of a few basic, observable, and classifiable differences in mental functioning.      The purpose of this report is twofold: 1) documenting the rationale behind relating each of the personality types described in the Myers-Briggs system of typology to specific patterns of disease reflected on the Five Phases model used by acupuncturists and herbalists, and 2) applying the above relationships to clinical medicine by combining the two systems.      Basics of the Five Phases Paradigm are briefly reviewed, and elements essential to the Myers-Briggs system are presented. Correlation between the 16 personality types and the Five Phase's model is described in a series of sequential steps. The assumptions underlying such steps are noted at relevant points. Finally, the relevance of the resulting Five Phases/ Myers-Briggs Type Indicator model to medical practice is discussed.
THE FIVE PHASES PARADIGM AND ITS ORIGINS      The Five Phases Paradigm According to Taoist theory, the physical universe, more specifically, planet Earth, can be described as consisting of a variety of interrelated phenomena. Such phenomena are diverse and include the structure of DNA and the cyclic patterns of weather. The Taoist organization of these phenomena reduces them to a model of five groupings, considered most appropriately as "phases." The more traditional texts symbolize these phases as five elements, and are given the metaphors of wood, fire, earth, metal, and water (Figure 1).

     The placement of each of the five phases making up any particular correspondence system is crucial; all members within each group reflect qualitative similarities. Thus, there are intrarelationships within each grouping of the Five Phases, and interrelationships between groupings.
THE PRINCIPLE OF YIN AND YANG      The Taoist and Oriental acupuncturist viewed the physical universe as divisible into two broad categories that were both opposite and complementary. Together, they created a balance point or fulcrum, a seesaw. The two poles of material phenomena were labeled, "Yin and Yang." Qualities associated with Yin included solid, heavy and structured. Qualities related to Yang were light, hollow, or nonmaterial. Taoists developed a kind of shorthand to designate Yin and Yang. A broken line represented Yin. An unbroken line represented Yang. These lines were then combined into sets of three, indicating that all phenomena can be represented by a code consisting of three lines. In its earliest form, the principle of Yin and Yang, and the trigrammatic relationships resulting from the variety of combinations of Yin and Yang, were represented as eight values arranged over the circumference of a circle (Figure 2). For the Taoist, this relationship was known as the "Xi Fu Graph." The more contemporary French school of acupuncture termed this arrangement Graph 8, or, G8. Students of Taoism will also recognize Graph 8 as one of two primary graphs integral to the I Ching.
The Binary Code      In modern terms, the Yin and Yang model and its trigrams can be described in accordance with a binary code of zero and one. Yin is designated by the integer 0; Yang by 1. Maximum Yin becomes 000; maximum Yang 111. The Xi Fu Graph thusly would be illustrated as shown in Figure 3.
THE MYERS-BRIGGS TYPE INDICATOR      The Type Indicator The Myers-Briggs Type Indicator (MBTI) is a method of personality assessment designed to determine personality type. Intended for use with normal subjects, it has been described as a forced-choice, self-reporting, self-administered test (3-5). As noted in the introduction, origins of this system of typology are based primarily on the theories of personality proposed by Carl Jung (2). Use of the MBTI has been extensive in the fields of education and psychology. Use of this Type-Indicator in the field of medicine has been minimal to date.      Myers and Briggs defined eight basic psychological preferences in assessing personality types: Extraversion and Introversion, Sensing and iNtuition, Thinking and Feeling, Judging and Perceiving. An exhaustive description of each personality type is limited by space. However, a brief description conveys the essential attributes of each. More detailed descriptions are available in previous publications (6,7).      The distinction between the Extraverted (E) and the Introverted (1) preferences is based on the source of one's energy. The outer world energizes the Extravert; it drains the Introvert. A truism closely associated with the Extravert is, "What you see is what you get." Extraverts are characterized by a readiness to exhaustively verbalize feelings and thoughts; a desire for the company of others, rather than one's self. Introverts are characteristically reflective, wanting solitude. A truism of the Introvert is, "Don't judge a book by its cover."      Sensing (S) and iNtuiting (N) relates how the individual perceives stimuli and gathers information. The Sensor utilizes the senses as the primary vehicle for gathering information about the world, relying much on facts and details. The Sensing personality is very literal in his or her perception of the world. A truism reflective of the Sensor is, "Let's get to the point." The Sensing function prefers information in small amounts. The iNtuiting individual prefers to translate the material derived from the senses, through the intuition, to find underlying meanings and relationships. The iNtuiting personality is more figurative in perceiving the world. The world of ideas is preferred over the world of objects. Information is preferred in the context of the larger scale. A truism associated with the iNtuitor is, "Give me the big picture."      The Thinking (T) and Feeling (F) personality types distinguish how each makes decisions regarding relationships. The Thinking individual is very logical and detached; conclusions are the result of a reliance upon objective values. To be "just" is a primary aim. A truism for the Thinker is, "An eye-for-an-eye, a tooth-for-a-tooth." The Thinking function honors the "letter of the law." The Feeling type, by contrast, is more apt to rely on subjective values in reaching a decision about relationships. Mercy is a significant aspect of any decision. The Feeling personality carefully measures the impact of the decision on others; readily empathizes with them. A truism relating to the Feeling person is, "Let he who is without sin cast the first stone."      The final pair of type variables contrasts Judging (J) and Perceiving (P). Judging individuals are concerned with people as objects. Perceiving types are more interested in ideas or material objects. Such variables reflect the way one prefers to relate to one's environment. The Judging personality prefers to structure the environment, schedule events definitely, and relate to the world according to decisions, rather than spontaneity. A truism of the Judging person is, "A man's home is his castle." The Judging function honors home; his family is structured and guided. The Perceiving individual prefers to respond to the environment, rather than structure it; this one is more likely to be flexible, spontaneous, and open-ended. The Perceiver looks to the future. His truism might be, "Don't cry over spilled milk."      The eight personality preferences described in the Myers-Briggs typology are thusly grouped as sets of two opposing tendencies; therefore, reflecting a dualistic view of personality. Given the two poles of each set, the test supposes that every person has a preference for either of the two dimensions.      Implicit in this system is the belief that the preferences exhibited by the personality have a genetic basis; considered to be specific manifestations of an inner propensity.
Type Categories      A numerical score is obtained from the MBTI test for each of the eight personality dimensions above. The larger value obtained for each of the four pairs of opposites is regarded as the preference of the individual. If one considers all the variations of each of the four Type combinations, 16 personality types are possible: ISTJ, ISFJ, INFJ, INTJ, ISTP, ISFP, INFP, INTP, ESTP, ESFP, ENFP, ENTP, ESTJ, ESFJ, ENFJ, and ENTJ. The individual is typed according to I of these 16 possible combinations of 4 traits.
ASCRIBING THE MYERS-BRIGGS PERSONALITY TYPES TO THE FIVE PHASES PARADIGM      A number of fundamental principles associated with the Five Phases Paradigm and the basic tenets of the Myers-Briggs typology system has been explored. The derivation of ascribing the Myers- Briggs personality types to the G5 model can now be undertaken.      Meaningfully placing the 16 combinations of the 4-letter personality types upon the Five Phase's model, two assumptions must be made: (1) The eight fundamental preferences are gathered in groups of two, reflecting four sets of opposites. Such opposites, and the dynamics of tension and complementarily implicit between them, correspond to the same dynamics supposed between the opposites first elucidated in the Xi Fu graph (Graph 8 and Figure 2). The eight fundamental personality preferences are genetically based. Personality is assumed to be a part of the constitutional heritage.
Myers-Briggs Preferences, and Yin and Yang      The first task in adapting the Myers-Briggs personality typology to the Five Phases Paradigm is to translate the four sets of eight preference letters of the MBTI to binary expressions that can be arranged in a coherent fashion on the right poles of the Xi Fit graph (Graph 8). This graph illustrates the varieties of states between maximum Yin and maximum Yang; i.e., between two pairs of the most basic integers making up universal phenomena. A choice must then be made as to which of the four basic pairs of indicators of personality types can be said to be the most basic integers of personality. Summarily, which of the four paired and opposite traits of Extraversion and Introversion, Sensing and iNtuiting, Thinking and Feeling, and Judging and Perceiving can be considered the prime mover of personality dynamics?
Assigning the First Pair of Myers-Briggs Preferences      Conceivably, one might regard Extraversion and Introversion as the most basic preference pairs, because Yin and Yang relate to form and movement of energy. Yin and Yang embody motions of energy. Extraversion and Introversion embody notions of the source, direction, and intensity of an individual's energy. For this reason, Carl Jung regarded this pair of opposites as the most fundamental one. However, Extraversion and Introversion, Sensing and iNtuiting, and Thinking and Feeling require a more fundamental impetus before they are manifested. That impetus is decision-making (Judging) or information-gathering (Perceiving). Judging and Perceiving are required before any of the other pairs come into play. It is through these functions that the individual first relates to the external world, verbally and behaviorally. Judging and Perceiving are reflections of the way one confronts either material gathered or presented. The Judging function leads one in the direction of controlling the environment. The Perceiving function creates a receptivity to the environment wherein one reacts to stimuli, rather than being proactive. Judging and Perceiving are the most fixed of the preferences; thusly, the most difficult to manipulate consciously. Extraversion and Introversion defines how one interacts with the world, either actively or passively. Ultimately, the basic personality traits, Judging and Perceiving, are considered to be the primary personality sets from which all others proceed.      The second task before us is to assign these two variables to the maximum Yin and maximum Yang positions along the circle of Graph 8. Doing this requires analysis of the Yin and Yang of Judging and Perceiving. The Judging function relates to rules, structure, i.e., institutionalization. The Judging personality tends to prefer the past; the past is established and more fixed. Time is frequently an essential element in the judgment process. Conversely, the Perceiving function is less fixed, and the perceiving personality finds lack of structure a more compatible partner. For this individual, the prospect of many options is desirable; the Perceiver relates more readily to the future.      Yin is allied with the more tangible aspects of our universe, i.e. matter earth and structure. Judging can then 'be as' signed a Yin value. Similarly, Yang is associated with the less tangible, the nonmaterial, and the nonstructured. Perceiving is then assigned a Yang value. Figure 5 illustrates the initial assignment of these fundamental personality types to Graph 8. These types are assigned to the intermediate stages of Yin and Yang as well, anticipating the derivation of the varieties of personality types.
Assigning the Second Pair of Myers-Briggs Preferences      The third task is to determine the placement of a second set of groupings of preference variables, Thinking and Feeling. The Thinking function is intimately related to logic and objective analysis, the objective world. This function is a closer ally to the traditional concepts of Yin. Conversely, the Feeling function is more subjective and relative; more closely aligned with Yang. Assignment of this second set of Type preferences is illustrated in Figure 6. Note that each of the Yin and Yang values of Thinking and Feeling, respectively, are placed in accordance with the Yin and Yang lines of the trigram (Figure 4). Hence, Thinking occurs at the 5:00 (great Yin), 6:00 (maximum Yin), 7:00 (lesser Yang), and 9:00 (Yang brilliance); whereas, Feeling occurs at the 11:00 (great Yang), 12: 00 (maximum Yang), 1:00 (limit of Yin), and 3:00 (less Yin) positions.


Assigning the Third Pair of Myers-Briggs Preferences       The Sensing and iNtuiting functions are the pair of traits perhaps most amenable assigning to Graph 8. Sensing is recognized as relating to the sensate world or the world of objects, suggesting a Yin quality. The iNtuiting function is closely tied to the world of ideas and imagination, suggesting Yang attributes. Distribution of this set of opposites is shown in Figure 7. Sensing occurs at the 3:00 (less Yin), 6:00 (maximum Yin), 7:00 (lesser Yang), and 11:00 (great Yang); iNtuiting occurs at the 12:00 (maximum Yang), 1:00 (limit of Yin), 5:00 (great Yin), and 9:00 (Yang Ming) positions.
The Eight Energies, the Myers-Briggs Preferences, and the Binary Code      Maintaining a strict correspondence between the MyersBriggs preferences and the trigrams will equate the six preferences discussed thus far with three Yin-Yang phases of the trigram. The preferences, Judging, Thinking, and Sensing, are considered Yin; the preferences, Perceiving, Feeling, and iNtuitive, are considered Yang. In the binary code, these relationships translate to: J=O, T=O, S=O; and P- 1, F= 1, N= 1. Thusly, the preceding Figure 7 completes the representation of equivalency between three of the four sets of MyersBriggs preferences and Graph 8. Incorporating the eight energy axes described by the Taoists, Graph 8 now appears as shown in Figure 8.      However, a fourth set of preferences is integral to the Myers-Briggs concept of typology, Introversion and Extraversion. These dualities can be said to be descriptors primarily of social interaction; hence, they are reserved for placement on the Five Phases Paradigm.
Binary Coding of the Five Phases Model      Space does not permit a complete description of the events associated with transformation of Graph 8 (Figure 2), to Graph 5 (Figure 1). Briefly, the transition is comprised of a series of movements. Graph 8 (a dynamic model of balanced energy in the universe), moves to Graph 8 (a representation of early structuring of energy). Thence, to Graph 6 (deletion of maximum Yin and Maximum Yang, as the manifestation of such extremes in living systems does not have a material expression). Finally, to Graph 5 (a pentacoordinated system organizing essential phenomena). A series of 10 trigrams result from these movements; 5 on the inside (Yin), and 5 on the outside (Yang). The binary coding of Graph 5 thus appears as shown in Figure 9.      Strict derivation of Graph 5 necessarily assigns four duplicate trigrams at the Wood location. Later authorities have assigned the Yang aspects of two of these meridians to the Fire element (Figure 1, see page 14).
Assignment of the Three Sets of Myers-Briggs Preferences to the Five Phases Paradigm      Placement of the preferences defined by Myers and Briggs to the Five Phases paradigm, according to the binary codes, results in the graphic model illustrated in Figure 10.
Assigning the Fourth Pair of Myers-Briggs Preferences to the Five Phases Paradigm      Showing a parallel correspondence between the Myers-Briggs typology and the Five Phases Paradigm, the last pair of opposites described by the Myers-Briggs system, Introversion and Extraversion, is assigned to Graph 5.      The element, Fire, is associated with the sun, light, heat; rising and exuding energy. Extraverts, focusing the direction of their energy outward and responding more readily to the external world, can be said to be associated with Fire. The Earth, bringing forth life and creation, can similarly be said to be an expression of Extraversion. It is the base, resulting in growth and fecundity.      Conversely, Wood, represented by the tree, arises from roots deeply embedded in the earth. It is a type of potential awaiting kinetic manifestation during the growing season; thus, a Yin quality. The element, Metal, associated with solidity, strength, and durability, can also be regarded as having Yin qualities. Water, because it is of the earth and an essential aspect of all life, is also a Yin quality. Thus, Wood, Metal, and Water are regarded as Yin elements. Reflecting inwardness, they are associated with Introversion.      Determining the Yin and Yang for the Five Elements, and their relationship to the Introverted and Extraverted preferences, the derivation of the parallel association between the MBTI and the Five Phases Paradigm is complete (Figure 11).
Conformity of the Nomenclature between the G5/MBTI and the Myers-Briggs System      The sequence of three-letter combinations obtained from applying the type letters to the trigram (Figure 11) must be altered -- when adhering to the nomenclature established by the MBT1 for the 16 varieties of four-letter combinations. These changes are as follows:       A. The Yin Family of Trigrams           000, JTS, is rewritten to read STJ           001, JTN, is rewritten to read NTJ           010, JFS, is rewritten to read SFJ           011, JFN, is rewritten to read NFJ      B. The Yang Family of Trigrams          100, PTS, is rewritten to read STP          101, PTN, is rewritten to read NTP          110, PFS, is rewritten to read SFP          111, PFN, is rewritten to read NFP
     Such changes are a matter of convenience only; binary code values associated with the original letter type are not changed. In its final forrn, the G5/MBTI model appears as illustrated in Figure 12.
Maximum Yin and Maximum Yang and the Myers-Briggs Type Indicator      Applying each of the eight Myers-Briggs preferences to the trigrams of Graph 8 - results in a peculiarity involving those personality types associated with maximum Yin and maximum Yang: ESTJ (000) and ISTJ (000), and ENFP (111) and INFP (111), respectively, As noted earlier, Graph 8 undergoes interaction with Figure 8, and is transformed ultimately to Graph 5. During this transformation, maximum Yin and maximum Yang are deleted; such extremes of forms do not have an expression on Graph 5. Interestingly, the combinations of personality type that are obtained from realizing the letter combinations according to the trigrams of these poles of maximum Yin and Yang, also do not exist in material fonn. The binary values, Extraverted 000 and 111, and Introverted 000 and 111, are considered to be hidden or silent regulators that have no visible expression on Graph 5. Such personalities arising at the 000 and 111 locations must of necessity "borrow" a personality. This notion appears to find confirmation in the work by Bates and Keirsey (8). These authors describe the primary quest of the NFP (111 in the binary code) as that of "looking for identity." Application of the G5/MBTI, in the normal and the patient population, suggests the most frequent tendency of the NFP is to assume the personality of the binary value closest to it, i.e., 110 or Tai Yang. Other borrowings occur as well. The NFP may also assume the binary value to its left, Graph 8, i.e., 011 or Jue Yin. Alternatively, the NFP may travel the length of Graph 8, assuming all or any of the personalities in a lifetime. The NFP personality is nicknamed "chameleon" or "masquerader," for good reason. An example of such a protean personality type is provided in a subsequent section.      The other binary "ghost" is associated with maximum Yin, 000. These personali ties more often mimic the next highest binary value, 001 or Tai Yin. Such types are less likely to mimic other personalities due to their extreme state of groundedness (Yin).
BIOPSYCHOTYPE AND THE FIVE ELEMENTS      The term, "biopsychotype," comprises the fundamental biological and psychological predilections of an individual. Biopsychotype, thus, is reflective of the individual's most basic fabric; the consequence of inherent strengths and weaknesses. An excess of one or the other can become manifested as illness. Illness can then be said to be a reflection of the basic constitution of an individual. Similarly, the strength and weaknesses of a particular constitution will also be reflected in the personality of the individual. Whether or not one favors any strength or bends to any weakness, one's behavior is directed in ways reflective of the basic nature. Consequently, a system of preferences is established. Such preferences range from eating habits, to a propensity for abstraction; from relying more on a sense of vision, instead of hearing as the primary means of perceiving the world; from an inclination toward willfulness, rather than consideration. The preferences of the individual can lead to an endogenous source of imbalance; thusly, disease.      Brief descriptions follow of the biopsychotypes as they relate to each element of the Five Phases Paradigm: 1. Wood Element      The body of a person associated with the Wood element typically has wide shoulders; the musculature is well-developed. The eyes are large with a prominent brow. The skin tends to wrinkle early in life. Organ vulnerability is correlated with the liver, gallbladder, and the sympathetic and parasympathetic systems. The finger joints of the hands are knotted; palms and fingers are deeply lined. Persons of Wood constitution may have a wavering concentration and weak memory. Too many projects are often begun. Movement, both physical and mental, is evident. There is often an overly enthusiastic optimism about life, to the point of nervousness. Woody Allen typifies the classic Yin Wood set of characteri stics; Salvador Dali epitomizes a Yang Wood character type. 2. Fire Element .    Persons associated with the Fire element typify organ vulnerability correlating with the heart as spirit, and the small intestine. The body appears agile; the hands long, the fingers slender. Temperament of the person of Fire constitution is active, sometimes rebellious, and successful. This person usually has considerable intelligence, a remarkably accurate memory. The classic Yang Fire personality is Auntie Maine; the classic Yin Fire personality is Don Knotts. 3. Earth Element      The body of a person associated with the Earth element is characterized by being round and fleshy; the face, round. The hands are large and thick, with the palms taking on the form of a square. Organ vulnerability typically involves the spleen, pancreas, and stomach. A tropism for, or against, sweets exists. The Yin type has a tendency to autoimmune disorders. A general optimism about life prevails (the typical bon vivant). Among well-known personalities, Orson Wells embodies the Yang Earth type. Felix Unger, made famous in "The Odd Couple," embodies the Yin Earth type. 4. Metal Element      Morphologically, the Metal body is characterized by having a long stature, a slightly hunched posture. It tends to be supple and agile. Pale skin is common. The surface of the body is especially sensitive to cold, turning pale and then, blue. The Metal constitution is associated with vulnerability of the lungs and large intestine. Calmness, with an inclination to reflection, is generally present. Typically, the Yin expression of these individuals is sad and pessimistic. Intellectually, this person tends toward exact observation, with a preference for analysis and abstraction. The classic Yin Metal personality is Sherlock Holmes; Gary Cooper personifies Yang Metal personality traits. 5. Water Element      The body of a person associated with the Water element tends to be erect, the head held high. Associative organ vulnerability is the kidneys, adrenal glands, reproductive organs, or urinary bladder. The hand is spatulate and short, the palm and fingers puffy and soft. Typically, the Yin person of Water constitution is relatively frail with a variety of sensitivities. There is often a tropism for salt; a susceptibility to dust and mold allergies. Disinterest in life is not uncommon. Well-known personalities, demonstrating the Yin Water set of traits, include Peter Lorre. The Yang Water character type is epitomized by General Patton.
BIOPSYCHOTYPE AS PRESCRIBED BY THE G5/MBTI MODEL      Incorporation of the Myers-Briggs Type system into the Five Phases model is termed the G5/MBTI paradigm. In the previous section, personality types based solely on the Five Phases Paradigm profiled the individual according to a combination of biological and psychological characteristics. Here, the description of personality again utilizes biological and psychological characteristics, but is extended by the incorporation of the Myers-Briggs typology. The G5/MBTI paradigm can thus be said to be a paradigm of extended biopsychotypes.      Lengthy descriptions of each of the structural biopsychotypes prescribed by the G5/ MBTI model are again beyond the confines of this paper. The descriptions that follow are limited to cursory statements of each type in accordance with their relationship to each of the Five Elements, and broadly categorized according to whether the type is Extraverted or Introverted. Readers of this article will be more familiar with energetics, and less familiar with the Myers-Briggs personality characteristics associated with each of the Five Elements. Emphasis is placed on the latter. Descriptions of the Myers-Briggs types are again drawn primarily from the work of Kroeger and Thuesen (6). A more detailed, expanded treatment of the relationship between the Myers-Briggs personality types and the Five Phases Paradigm will be the subject of a future publication. Included will be a discussion of the broader inferences about character and health.
1. Extraverts
A. Fire Element     1. Extraverted Tai Yang as Masquerader = 111 = ENFP      Yang organ vulnerability: small intestine. Morphology: commonly, reddish complexion, small head, rounded body. Temperament (borrowed): an imposing attitude, excessively selfassured, good memory. ENFP (borrowed): convinced he or she has something you need, is thusly persuasive. Anything goes, at least once, for this "masquerader." Characteristically, this individual will overextend physically; is typically, argumentative. A pithy description of this type: "Giving life an extra squeeze" (6).      2. Extraverted Tai Yang = 110 = ESFP      Yang organ vulnerability: small intestine. Morphology: a reddish complexion, small head, rounded body. Temperament: an imposing attitude, excessively self-assured, a good memory. ESFP: socially gregarious and warm to-a-fault. The attitude is generally, "do it! " This person is accepting of themselves and others; generally, exhibits high needs for others. An apt description: "You only go around once in life."      3. Extraverted Shao Yang = 100 = ESTP      Yang organ vulnerability: parasympathetic nervous system. Morphology: solidly built, often with well-developed muscles. Temperament: clear thinking and decisive, imaginative and productive, authoritative. ESTP: feisty, but practical; lives always in the present, is uncomplicated. Psychology is viewed with skepticism. This person is frequently unorthodox. A brief description: "The ultimate realist."      4. Extraverted Je Yin = 0 11 = ENFJ      Yin organ vulnerability: sympathetic nervous system. Morphology: tendency to be small and thin. Temperament: tends to chronic anxiety and emotional instability; becomes irritated and angers easily. ENFJ: this individual is socially hungry and charismatic, opinions are usually highly theoretical, apt to live in either the past or future. Verbal skills are usually high. The extraverted Jue Yin usually exhibits an illdefined nurturing of others. An appropriate description: "A smooth-talking persuader."      5. Extraverted Shao Yin=010 = ESFJ      Yin organ vulnerability: heart. Morphology: a rather oval face, with high color. Temperament: outgoing, loud in dress and manner, flamboyant. ESFJ: gracious and caring. This person is quite social by nature, naturally friendly, is likely to be a host or hostess. A fitting description: "Host and hostess of the world."
B. Earth Element      1. Extraverted Tai Yin as Masquerader = 000 = ESTJ      Yin organ vulnerability: spleen. Morphology: round and fleshy. Temperament (borrowed): calm, generous, not particularly ambitious. EARTH (borrowed): practical and closed. This individual is objective in outlook, organized, displays a great need to take charge of situation; end justifies the means. A suitable description: "One of life's administrators."      2. Extraverted Yang Ming = 101 = ENTP      Yang organ vulnerability: stomach. Morphology: round and fleshy. Temperament: the classic bon vivant, affable and jovial; an expression radiating benevolence and reassurance. ENTP: frequently entrepreneurial, with views that are often visionary. There is a tendency to one-upmanship; interdependency is common. Inventive, the ENTP displays considerable enthusiasm, is involved in a multitude of activities. A concise description: "One exciting challenge after another."      3. Extraverted Tai Yin = 001 = ENTJ      Yin organ vulnerability: spleen. Morphology: round and fleshy, with slightly yellow or earthy complexion; clean and neat in appearance. Temperament: calm. EARTH: exceptionally clear in work and word. A need to control and keep the world in order propels this personality type to unusual leadership abilities. Thus, life is a chessboard with players to be moved. A short description: "Life's natural leaders."
A. Wood Element      1. Introverted Shao Yang = 100 = ISTP      Yang organ vulnerability: gallbladder. Morphology: long physique, wide shoulders; somewhat greenish or bronzed complexion. Temperament: active, open and frank, difficulties in decision-making. ISTP: this individual is socially adept, practical, and objective. Tendencies are to live in the immediate moment, to try anything once. Introverted Shao Yang individuals are especially clever with their hands and feel rewarded when such skills are recognized and applauded. Interpersonal skills are not obvious. This person usually exhibits limited or very defined caring. A pithy description: "Ready to do anything once."      2. Introverted Jue Yin = 0 11 = INFJ      Yin organ vulnerability: liver. Morphology: small and thin, but not without muscles; complexion tends to be pale and dull. Temperament: chronic anxiety, emotional instability, and a tendency to inhibition. INFJ: avoidance of conflict and a drive for harmony. The personality is complex and intricate, intuitive and often psychic. This individual is compliant and willing to bend; exhibits great caring and concern for others, is frequently admired by other people. A terse description: "An inspiration to others. " B. Metal Element      1. Introverted Tai Yin as Masquerader = 000 = ISTJ       Yin organ vulnerability: lung and skin. Morphology: long, thin, angular; upper body somewhat hunched. Temperament (borrowed): sedentary and nonemotive, with a tendency to abstraction and brooding. ISTJ (borrowed): this Masquerader possesses a great sense of responsibility, is especially keen on regulations. The tendency is to be very private. Typically, this personality is closed and fixed, is extremely demanding, impatient, and compulsive. A significant description: "Doing what should be done."      2. Introverted Yang Ming = 10 1 = INTP      Yang organ vulnerability: large intestine. Morphology: thin and angular. Temperament: a sangfroid, which usually makes this person capable and effective; theoretical and conceptual. INTP: a quest for flawlessness and competency. The Introverted Yang Ming person is usually reticent, relatively impersonal, and socially inept. Relationships are based on intellectual challenge. A brief description: "Love of problem-solving."      3. Introverted Tai Yin = 001 = INTJ      Yin organ vulnerability: lung and skin. Morphology: narrow chest and shoulders, thin and angular features, a white skin tending toward an unhealthy aspect. Temperament: a tendency to asthenia in all activities, somewhat apathetic, prone to abstractions and ruminating. INTJ: typically impersonal and independent, little need for others. Of the 16 types, this is the most independent. This person's first tendency is to "think about it" before acting. A strong tendency to be critical of oneself and others is usually present. There is a natural propensity to organization, and a preference for the larger view. Making everything better is of paramount importance. A pointed description: "Everything has room for improvement." C. Water Element      1. Introverted Tai Yang as Masquerader = 111 = INFP      Yang organ vulnerability: bladder. Morphology: muscular and sturdy; frequently, large head and long spine. Temperament (borrowed): often indecisive and excessively analytical. INFP (borrowed): characteristically, idealistic, noble service is an essential. This individual is open, interpersonal, flexible, with a low need to take charge. This person is caring of others, appears conceited or "above" others. A pithy description: "Performing noble service to aid society."      2. Introverted Tai Yang = 110 = ISFP      Yang organ vulnerability: bladder. Morphology: muscular and sturdy; frequently, a large head and long spine. Temperament: often indecisive and excessively analytical; egotistically indifferent. ISFP: feeling misunderstood in work and word is typical. A need to keep strict order, an unusually low need to lead others is characteristic. A tendency to live in the here-and-now, to concentrate on being harmonious from moment-to-moment is prevalent. Interactions with life become data for intra- and interpersonal relating for this individual. A purposefull description: "Sees much, but shares little."      3. Introverted Shao Yin = 010 = ISFJ      Yin organ of vulnerability: kidney. Morphology: thin, pale skin, early male balding. Complexion is frequently pallid and lifeless. Temperament: fearful and anxious, melancholic, prefers to live privately. ISFJ: a high regard for duty. This person is inclined to be subservient, pays little attention to his or her own needs; very much a codependent, takes commitments to others very seriously. A telling description: "An inspiration to others."
APPLICATION OF THE G5/MBTI TO THERAPEUTICS: THE MBTI, BIOPSYCHOTYPE, AND ENERGETICS      To the extent that correspondence between the G5 and the Myers-Briggs typology is valid, one can legitimately assume that any personality type determined by the MBTI necessarily suggests a picture of the individual in both the normal and pathological states described by the Five Phases Paradigm. Examples of application of the G5/MBTI in the clinical setting would be the following: A 32-year-old white female enters the clinic as a new patient. The staff administers and scores the MBTI. From the results, it is determined that the patient most closely resembles the ESTJ profile. Referring this finding to the G5/MBT1 chart (Figure 12), the patient is determined to be associated most closely with the Earth element on the Yin side. This, in turn, is associated with the spleen as the visceral organ most characteristic of this type (see the Yin-Yang or Zang-Fu Organ model, Figure 13). Since the spleen is an organ of the Tai Yin meridian, the physician will anticipate frequent problems for this patient will lie within the sphere of influence of this particular meridian. Examples of medical syndromes typically correlated with persons of this type are those of the HLA histocompatibility antigen system, anemia, and rheumatoid arthritis. A medical history will then be taken by the physician as part of initially consulting with the patient. Indeed, the chief complaint is swollen, painful joints. Upon testing, her rheumatoid titer is positive at 1:320. The diagnosis is confirmed by three avenues; the MBTI, G5, and the laboratory. A Tai Yin treatment protocol is prescribed.      A second patient appears at the clinic. Results from the MBTI for this relatively timid, rather nervous and myopic 47-year-old white male, suggest the INFO personality type. This type is most closely associated with the Wood element on Graph 5, and the liver organ. Typically, such individuals are characterized by the presence of cardiovascular difficulties, commonly high or low blood pressure, and symptoms of liver dysfunction, including hepatitis. The consultation reveals an individual sensitive to caffeine, and prone to episodes of high blood pressure. The treatment protocol is based on the Joe Yin principal meridian.      A third patient seen occasionally in the clinical setting is the individual whose scores on the MBTI suggest an ENFP, which has no absolute representation in Graph 5. This 29-year-old white female, imposing in attitude and somewhat authoritative, complains primarily of low back pain and cystitis, which places her at the Fire location. This patient has borrowed the Extraverted Tai Yang personality. Nevertheless, such a patient will frequently return to the clinic with symptoms consistent with those associated with an Introverted Tai Yang profile (e.g., diffuse lumbar pain), or any other of the 12 personality types. These patients are usually healthy but fragile in their biochemical makeup. They may present primarily with functional complaints. They often have a liver enzyme P-450 deficiency. Thusly, normal doses of allopathic drugs make them sick. They gravitate toward alternative therapeutics such as herbs and vitamins. Typically, they respond well to acupuncture and make up a significant portion of patients found in an acupuncturist's practice. This person is often inconsistent from one visit to the next, wandering over the various patterns established by the GO paradigm. Rather than a view of this patient as exasperatingly contradictory, a sound knowledge of the dynamics integral to the G5/MBTI paradigm allows the practitioner to recognize the patient as altogether consistent with his or her chameleonic nature. Treatment will reflect the phase manifested at that particular time.
DISCUSSION      The Myers-Briggs Type Indicator, first devised in the early 1960s, has been shown by independent investigators to be an accurate predictor of personality type (4). Specifically, researchers have examined the relative independence of the four paired scales measured by the test. The test has proven adequate levels of sensitivity (an accurate measure), reliability (repeatability), and stability [agreement between original and subsequent testing] (4). Furthen-nore, studies on the intercorrelations of type category scores, reflecting the level of independence of the four pairs of eight type categories - suggest that the E-I, S-N, and T-F scales are relatively independent of each of other. Only the S-N scale appears to correlate consistently with the J-P scale (4).      The MBTI has not been used to any significant degree in medical therapeutics, in spite of its accuracy and increasing application in the workplace and a variety of arenas. However, a few exceptions exist. In the field of Myers-Briggs typology, for example, attempts to show correlation between personality type and certain medical entities such as coronary heart disease (CHD) exist. Thorne reported that CHD patients were significantly more likely to be associated with the Sensing and Feeling dimension (10). Shao Yang individuals are especially clever with their hands, and feel rewarded when such skills are recognized and applauded. These authors suggest that the MBTI can be used by medical practitioners to predict those patients who may be at greater risk for heart disease. Insight into correlations between specific personality types and disease states may be largely ignored by physicians and support staff, due to absence of convincing evidence that the Indicator may indeed be so structured.      In the present article, the 16 personality types defined by the Myers-Briggs system of typology have been assigned to specific loci on the Five Phases Paradigm. The assignments were made after careful consideration of the basic tenets of ancient Chinese philosophical and medical thought, and a few key assumptions about Yin and Yang as they apply to Western ideas of personality. A comparative analysis between character types described by the ancient Graph 5 paradigm, and the personality types described by the MBTI at the same locus on the graph, cannot be reliably made. Insofar as one is allowed the license to extend the original intentions of the ancient Chinese scholars to more contemporary practitioners, the two are assumed to be roughly parallel.      Merging of the two systems dramatically enhances the usefulness of the Five Phases Paradigm for medical practitioners, to the extent that the equivalency will be verified clinically and statistically. Accurate assessment of the personality type, in turn, accurately defines a biopsychotype as defined by the G5 paradigm. Knowledge of the biopsychotype, in combination with an understanding of the energy axis of the primary or presenting problem of a patient, constitutes the energetic equation (2). Appropriate care of the patient results from such an equation.      Associations between personality type and Chinese thought have been attempted by other Westerners, and those in the field of acupuncture, notably, Requena (11); and those who have undertaken studies of the I Ching, notably Grant (12). Requena, utilizing eight character types defined by Berger (13), claimed correspondence between these types and acupuncture temperaments. The basis for the Requena method is the Characterologic Evaluation Test (CE40). This exploits variables of emotive (E) and non-emotive (nE), active (A) and non-active (nA), and primary (P) and secondary (S). This test is the primary means of determining, in decreasing order of importance, an individual's characterologic preferences. Unfortunately, the author himself claims that the accuracy of the CE40 is less than 45%, a level considerably less than optimal. Secondly, an implicit bias in the CE40 questions may skew the results to a particular type (7). Finally, in terms of equation of the right character types of Berger with the six temperaments of Chinese acupuncture, the Requena approach appears to be binarily flawed.      We can assume that the qualities of emotive and non-emotive are polar opposites. If we further assume that emotive is Yang and non-emotive Yin, then the binary value for emotive is 1, and nonemotive, 0. Similarly, active would be Yang and non-active Yin; Yang would be primary and Yin, secondary. Thus, Yang Ming metal (a Yang meridan) = nEAS (010); the Tai Yin metal (a Yin meridian) = nEnAS (000). However, this coding demands that both types are Yin meridians, which is a contradiction. The letters can be rearranged in an attempt to derive a valid code. If Yang Ming is rearranged to 100 (which are not the binary value given in Graph 8), the result is AnES. Tai Yin metal becomes nAnES (000).      To force this translation to work, the sequence of character variables must be active, emotive, and primary (rather than emotive, active, and primary). Similarly, non-emotive, non-active, and secondary must become non-active, non-emotive, and secondary. By this contrivance, Yang Ming earth (nEAP) is rearranged to AnEP (101). Tai Yin earth (nEnAP) is rearranged tonAnEP (00 1). The binary code is now in accordance with that for Graph 8. However, there remains a contradiction between the two aspects of the Yang and Yin meridians. Consequently, the Requena attempt is flawed as both a type indicator and a typology accurately correlated with those concepts traditionally associated with the Graph 5 model. This method appears to suffer most from the lack of a mathematically-coherent substructure.      Grant's theory attempted to relate the MBTI indicator to the hexagrams described in the 1 Ching (14). The 64 hexagrams represent all of the possible permutations between maximum Yin of six divided lines, and maximum Yang of six undivided lines. The hexagram comprises two trigrams placed one above the other; The relationship between the two trigrams constitutes and expresses the nature of the two together, i.e., the single hexagram. Line spellings inherent to all of the 64 hexagrams are derived from the 8 already illustrated in the Fu Xi Graph (Figure 2). It is again not possible here to explore all interpretations associated with the hexagrams and the 1 Ching. The method Grant used to combine the 1 Ching and Types begins initially by obtaining the psychological type based on the MBTI scores. The four-letter codes are then assigned to the inner four of the six lines of the hexagram, the region referred by the ancient Chinese as the nuclear trigrams. The Myers-Briggs codes of E, S, T, and J are translated into solid or Yang lines; the codes 1, N, F, and P are translated into Yin or divided lines. An estimate of archetypal preferences is then made. Consequently, lines one and six of the hexagram are determined. Having obtained the entire hexagram, the 1 Ching is then consulted. Advice proposed for this hexagram is then considered an amplification of one's type and archetype.      The Grant approach differs fundamentally from the Myers-Briggs and the Five Phases. The E, S, T, and J considered by Grant to be Yang are diametrically opposite the designation by the authors that E, S, and T, are considered Yin, in keeping with the original notions of the Yin and Yang duality. Likewise, that 1, N, F, and P considered by Grant to be Yin, contrasts with the designation that 1, N, and F are Yang. Furthermore, no distinction is made between the Introversion/Extraversion sets of preferences and the other three sets of preferences. Thus, these preferences are weighted equivalently in their transcription to the hexagram. In addition, this writer believes the course taken to derive lines 1 and 6 of the hexagram is a meandering one, and appears unduly manipulated to achieve a desired end. Although there are interesting aspects to Grant's work, it does not appear to reflect the predominant understanding of the nature of Yin and Yang, the trigrammatic and hexagrammatic relationships, or the characterology lying between the differentiated personality and the elemental descriptors.      Fledgling attempts to correlate Western typologies with disease entities, especially those of Requena and Myers-Briggs, underscore the tendency of workers in typology to expand their constructs into other domains. Such attempts by Myers-Briggs devotees must be regarded as inevitable, especially by those also involved in medical practice as physicians and allied health professionals. This paper anticipates this progression by providing typologists with a sound basis on which they can relate the 16 personality types to biopsychotypes. Transition of M13T1 usage into the domain of medical diagnosis, therapeutics, and prognosis is eased.
CONCLUSIONS      Our derivation of the correspondence between Myers-Briggs personality types and the Five Phases Paradigm has relied on an approach similar to that inspired by Mussat (15). Helms (16) describes it as one that emphasizes the symmetric and mathematical order traditionally associated with the trigrams. Mussat used this underlying order as a guiding principle by which the multiple models of acupuncture espoused by various schools and cultures could be reconciled. His effort seeks to create a system not only internally consistent, but practical in its application. Accepting the legitimacy of this approach, this author adopted a similar method for assimilating the 16 personality types of the MyersBriggs system into the Graph 5 model.      Any attempt to reconcile Type-constructs developed in recent times in the West, with paradigms originating in ancient China, is not without risk. Nonetheless, given preliminary data, evidence indicates the two approaches have been brought together in a meaningful way, vis-a-vis, with a fidelity to the underpinnings of both. The compass of the one is extended by association with the other. Therefore, addition of the Myers-Briggs personality types to the Five Phases Paradigm can be viewed as an enrichment of an already elegant system of diagnosis and therapeutics. Similarly, addition of the Five Phases Paradigm to the Myers-Briggs system of typology markedly enhances the value of the Type-Indicator. Suggestive not only as a biological basis for each of its defined personality types, it is a larger information base about the range and nuances of types.      Personality is assumed to be genetically determined; as such, a defined quantity and therefore, measurable. The G5/MBTI correlates the mental and emotional with the physical parameters of the person and body. Hence, it is useful as a means of determining more exactly a patient's energetic equation. The diagnostic branch of the Five Phases Paradigm is made considerably more refined for the practitioner of acupuncture by the inclusion of the Myers-Briggs typology. The authors anticipate verification by others in the clinical setting as to the ease, accuracy, and efficacy of the G5/MBTI system. Substantiation of initial results is sought from other practitioners of Chinese medicine and acupuncture.
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  • AUTHORS' INFORMATION Dr. Michael L. Buffington is in private practice in De Queen, Arkansas, specializing in family medicine and medical acupuncture. He is past President of the American Foundation of Medical Acupuncture; founding member of the AAMA; member, American Holistic Medical Association.

    Michael L. Buffington, M.D. P.O. Box 272, De Queen, Arkansas 71832 Phone: 870-642-8010 - Fax: 870-642-8068 Email: MBuff@Bigplanet.com

    Hobart Bell, B.S. is President, Embryology Associates, Inc.; Director of Embryology Laboratory; Director of Research, Conceptions Reproductive Associates, P.C. He is a member, American Society for Reproductive Medicine, Alpha, Society of Embryologists.

    Hobart Bell, B.S. 845 Morgan Drive, Boulder, CO 80303 Phone: 303-543-9576 - Fax: 303-794-8310 Email: Hobart@PCISYS.net
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    Acupunct Med. 2014 May 8. doi: 10.1136/acupmed-2013-010473. [Epub ahead of print]
    Poor multi-rater reliability in TCM pattern diagnoses and variation in the use of symptoms to obtain a diagnosis.
    Birkeflet O1, Laake P, Vøllestad NK.
    Author information

    Pattern differentiation and diagnosis are fundamental principles of Traditional Chinese Medicine (TCM). Studies have shown low inter-rater reliability in TCM pattern diagnoses. This variability may originate from both the identification and the interpretation of symptoms and signs.
    To examine the inter-rater reliability in TCM pattern diagnoses made in the style of Maciocia for 25 case histories by eight acupuncturists and to explore the impact of demographic factors on the diagnostic conclusion. Further, the association between the diagnosis and the presence of symptoms was examined for a single TCM diagnosis.
    Eight acupuncturists independently diagnosed 25 women (15 fertile, 10 infertile) based on written case histories. Descriptive statistics, logistic regression and inter-rater reliability (κ) were used.
    Poor inter-rater reliability on TCM patterns (κ<0.20) and large variation in the number of TCM pattern diagnoses were found. Sex, duration of practice and education had a highly significant effect (p<0.001) on the use of TCM patterns and working hours had a significant effect (p=0.029). There was considerable intra- and inter-rater variation in the use of symptoms to make a diagnosis. Symptoms occurring frequently as well as infrequently were inconsistently used to diagnose Liver Qi Stagnation. The study was limited by a small sample size.
    The results showed extensive variation and poor inter-rater reliability in TCM diagnoses. Demographic variables influenced the frequency of diagnoses and symptoms were used inconsistently to set a diagnosis. The variability shown could impede individually tailored treatment.

    Evid Based Complement Alternat Med. 2014;2014:836026. doi: 10.1155/2014/836026. Epub 2014 Apr 27.
    Do changes in electrical skin resistance of acupuncture points reflect menstrual pain? A comparative study in healthy volunteers and primary dysmenorrhea patients.
    She YF1, Ma LX2, Qi CH3, Wang YX4, Tang L4, Li CH5, Yuan HW6, Liu YQ7, Song JS8, Zhu J2.
    Author information

    Electrical skin resistance (ESR) measurements were performed with a four-electrode impedance detector at 10 points bilaterally on the first day of and the third day after menstruation in 48 healthy volunteers and 46 primary dysmenorrhea (PD) patients, to assess whether ESR changes of acupuncture points can reflect menstrual pain or not. The results showed statistical reductions in ESR imbalance ratio between left and right side that were detected at SP8 (Diji) and GB39 (Xuanzhong) (P < 0.05), and a statistical increase was detected at SP6 (Sanyinjiao) (P = 0.05) on the first day of menstruation compared with those values on the third day after menstruation in dysmenorrhea group. No significant differences were detected at other points within and between two groups (P > 0.05). This study showed that the imbalance of ESR at uterine-relevant points in PD patients is not significantly different from those of healthy women on both the 1st day of and the 3rd day after menstruation. The ESR imbalance ratio of certain points can either be lower or higher during menstruation in PD patients. The ESR property of acupuncture points needs to be investigated in further clinical trials with appropriate points, diseases, larger sample sizes, and optimal device.

    Evid Based Complement Alternat Med. 2009 Sep;6 Suppl 1:21-9. doi: 10.1093/ecam/nep079.
    Psychological profile of sasang typology: a systematic review.
    Chae H1, Park SH, Lee SJ, Kim MG, Wedding D, Kwon YK.
    Author information

    A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition.

    J Acupunct Meridian Stud. 2014 Feb;7(1):44-51. doi: 10.1016/j.jams.2013.01.022. Epub 2013 Feb 15.
    Inter-operator variability of electrodermal measure at Jing Well points using AcuGraph 3.
    Sharma B1, Hankey A2, Nagendra HR3, Meenakshy KB4.
    Author information

    Recent studies have found that many factors, both biological and operator induced, influence electrodermal measurements. Here, we report on operator variability for a series of measurements made by four operators at Jing-Well points on 132 individuals of both sexes (68 males and 64 females) by using the AcuGraph 3 'Digital Meridian Imaging Tool': Operator 1 (16 males, 12 females), Operator 2 (18 males, 13 females), Operator 3 (15 males, 21 females), and Operator 4 (19 males, 18 females). The individuals studied were attending a yoga therapy program for type 2 diabetes mellitus and were assessed on the 1st day of treatment. Large inter-operator variations in overall acumeridian energy readings were observed. For individual meridians, the AcuGraph 3 measure differed by up to 42 points for minimum values and 67 points for maximum values. After normalization, the data showed similar patterns between different acumeridians. This suggested that variations were caused by operators applying different pressures when making measurements. Thus, inter-operator variability should be considered when interpreting electrodermal measurements made by several different operators. Unless inter-operator variability is taken into account, actual values may not have meaning; only then can readings for the same population taken by different operators be evaluated correctly.
    Copyright © 2014. Published by Elsevier B.V.