塔羅其實很簡單 Tarot For Teens

作者：M.J. 阿芭迪(M. J. Abadie)    譯者：盧娜      生命潛能出版

目錄

1.   認識塔羅牌
2.   解釋的藝術
3.   占卜準備
4.   大阿爾克那含義
5.   王牌
6.   解釋大阿爾克那
7.   小阿爾克那
8.   解釋小阿爾克那
9.   權杖
10. 錢幣
11. 寶劍
12. 聖杯
13. 牌陣

Introduction  序言

     「無論我們選擇如何解釋我們的心靈，都必須從一個前提開始，即整個人類跟一個宇宙整體互動著，在這個宇宙裡面，什麼都有可能。我們只需敞開心靈，釋出恐懼，自內心深處召喚神奇的命運精靈。」----阿芭迪(M.J. Abadie)  《心靈潛能》(Your Psychic Potential)

     什麼是塔羅牌？為何青少年要對它有興趣？簡單來說，塔羅牌是一種占卜法，有數百年甚至數千年的歷史。許多歷史時間都曾記載塔羅牌，中古時期尤為風行。塔羅牌是一種牌術，包括78張不同的牌，以一種「神諭」(occult)的工具知名。「神諭」這個字是指「隱藏」的意思，不帶任何負面意義。

     人類的世界愈來愈趨複雜，青少年每天都必須面對前所未聞的挑戰，因此有許多人轉而求助於各種不同形式的占卜術，像是塔羅牌、占星術、易經和如尼文(runes; 譯註：北歐文字占卜法)。

     尤其是現在，塔羅牌的花樣迷人多變、主題廣泛，像是印地安塔羅牌、童話人物和女神塔羅牌，使得青少年族群近來興起一股塔羅牌風潮。塔羅牌能夠迅術幫青少年描繪出任一瞬間生命的藍圖，以及切中所關切問題答案核心。

《格言》

「我們知道，宗教問題，或是以更普遍的用語來說，自我追尋，是現代精神官能症跟它所導致的重多現象一樣，都是一種神聖的疾病。」艾瑞旭‧諾伊曼(Erich Neumann)《藝術與無意識創造力》(Art and the Creative Unconscious)

     一直以來，占卜術以各種方式被用來算命、預測未來，但塔羅牌(其他占卜術亦同)主要的目，其實是在開發我們都擁有的內在智慧。這些占卜術全部抱持相同的目的，就是找出一個人在自己宇宙裡的位置，釐清自己內心裡想要什麼。我們是如此經常感到困或，而青少年由於經常現於情緒高漲狀態，加上缺少經驗，特別容易迷惑。

     然而重要的是，要明白不該用這些占卜術來預知未來，因為沒有人可以確定自己的未來。我們不是自己生命被動的旁觀者，而是主動的參與者。塔羅牌顯示讀牌時有哪些「能量」在流竄著，因為整個宇宙、包括我們的能量，總是在流動著，這些能量不是停滯或靜止不動的，而是不停的移動著，在今天是真實的事情，到了明天或是下個月後，也許已不再真切。

《格言》

「追尋是找出歌德(Goethe)在〈浮士德〉(Faist)裡說的，把世界緊緊凝聚在一起的，為我們在宇宙裡的位置建立秩序和意義的衝動的一種驅力表現。人類推進外太空語深入深海探索者類似，目的不外乎都是為了追尋完整和實現。」愛德華‧懷特蒙(Edward C. Whitmont, M.D.)〈女神復返〉(The Return of the Goddess)

     一般而言，是占卜深度和所提的問題而定，塔羅牌釋出的訊息只有幾天或幾週效期。因此，你應該小心且持續的運用塔羅牌，切勿憑單一次占卜結果做出任何攸關一生的重大決定。

塔羅牌的運作

     塔羅牌的意義一般被認為源自anima mundi，即世界之魂。這個知識來源就像個宇宙圖書館，裝滿整個人類族群累積的智慧，我們可以透過塔羅牌意象的意義來開發。這個集合庫裡都是宗教、神話、傳奇和童話故事裡的基本人物，這些原型人物為奧秘化深的影像早已深藏在我們的記憶裡。這也是為什麼在讀牌和解牌時接觸這些影像，可以讓它們隱藏的一面，從我們的記憶深處變成意識力，用來解答我們的問題，使我們的生活更加美好。

     塔羅牌是一種美秘的冥想工具，它們扮演刺激直覺得角色，而直覺又是無意識的出入口。它們說明了隱藏在我們的生命裡，我們卻經常不覺得因素。這些內在議題正秘密的形成生命的軌跡，指要適當使用塔羅牌，它們就會顯現出來。

     塔羅牌上的意象，特別是王牌(trump cards)，及整副牌裡被稱為大阿爾克那(Major Arcana)的22張主牌，與人基本的心理和精神經驗直接相關。研究和實際運用塔羅牌會讓人觸及內心深處，愈是深入、了解愈深。塔羅牌確實可以用來協助解答日常疑問和到出眼前的問題，但它真正的用途是用來協助靈性的發展與自我探索。

     

《格言》

「意象是神話的傳達工具、戰車、把傳奇故事和神話的更高形式----宗教，拖曳過心靈，穿過時光，越過歷史篇章。意象述說著那些產生自神話根源，依然深深影響著我門的思想和感覺得模式。」阿芭迪〈靈性自我的覺醒〉(Awaken to Your Spiritual Self)

     或許我們無從知道塔羅牌真正的歷史，但我們知道可以自由運用這些排和它們內含的智慧來解決問題，因而更了解自己的生命，使靈性的發展像上提升。塔羅牌訴說著一個人類生命發展的有力故事，這是人類全體冒險故事，我們各自依據占卜時所呈現的意象，展開冒險歷程。塔羅牌韌性之高令人驚奇，在歷經長久紛亂的世紀後，它和它所透露的意象依然持續至今，語我們緊緊相繫。

塔羅牌的結構

     塔羅牌供有78張，分成22張的大阿爾克那(Major Arcana)，亦被稱為王牌，以及小阿爾克那(Minor Arcana)，包含16章工停牌，跟現代紙牌一樣，有國王、王后、騎士和侍從，還有40張號碼牌(pip cards)。

     大阿爾克那最為重要，它們反映出所有人類在這世界裡，從新生的純真到自我實現的靈性旅程。據了解，大阿爾克那最為古老，宮廷牌和號碼牌似乎是後來才加入的，可能是在十四世記的時候。這些排顯然源自義大利一種被稱為塔羅奇(tarrochi)的橋牌遊戲。

     空停牌和號碼牌類似現代紙牌，分成權杖、錢幣(或星紋)、寶劍和聖杯四個花色。宮廷牌可以按是我們生命裡的人或我們所處的局勢，對青少年來講，特別是國王和王后，經常被解讀為跟他們正在交涉的重要成人有關，像是父母、師長和其他權威人物，它們代表整個人際關係網絡。另外，有些宮廷牌，特別是騎士和侍從，可以指出外在事件或內心狀況。

     號碼牌每種花色各有10張，共40張。這些號碼牌暗示日常生活裡所有東西，我們每天所關心的事情、日常事件，以及我們的回應和行為。此外，號碼牌具有數字特別的意義，我們將在後面討論。

了解原型意象

     大阿爾克那已原型意象為基礎，對這些原形的運作方式具有基本認識，將有助於更充分的解釋這些牌。原型是作用在人類心理中的一個心靈影像，是我們直覺本深的一個產品，是我們內心深處知道，但我們不曉得自己知道的某些東西。原型是人類全體共通的東西，舉例而言，就算我們沒有母親，內心裡對母親也都存有一種影像。當我們從原型的觀點來看世界時，切記依竊有形形式跟人類共通的基礎原型主義有關，並由它予以支持。這些反映出我們內在與外在的經驗，已下是原行世界觀的簡要說明：

• 世界被認為是宇宙更大整體或神聖心靈的一個映照，兩者互相影響，並凌駕於物質現實之上。萬事萬物是這個整體的部分，有其秩序和設計。一切絕非巧合或存屬意外，任何看似偶然的事物都是生命意義總體模式的一個暗示。
• 現時有許多面向，有些現象我們通常渾然不覺，但在有形和無形的世界裡，某個層面上，萬事萬物皆互為關連。
• 循環性變化過程是每個人及萬事萬物必經的一部分，依竊脫離不了出現、成長及衰退的歷程。
• 原型除支持有形形式外，亦是占星學概念和其他形式使用數字學的占卜法，包括塔羅牌所顯示的微妙數學或己和學員裡與模式的一個表現。

大阿爾克那的心路歷程

     透過原型意象的運用，22張大阿爾克那王牌代表一段心靈啟迪之路。求卜者從沒有號碼但以零代表的愚人(Fool)開始，隨著後續階段的發展翻牌，直到21號牌「世界」(world)出現。作為靈性發展的工具，每張牌各有其意義存在，代表深具個人意義的內心狀態和外在狀況。

     現在，簡短的看一下塔羅牌大阿爾克那的愚人之旅。重要的是，你要了解每個人都像愚人般來到世間，我們新生和無懼，準備好學習生命要教導我們的功課。愚人總是以ㄧ個大無畏青年的形象出現，凡事機極正面、活潑好動、勇於冒險，自信深獲宇宙的支持。愚人通常以青年為代表，性別不拘。

王牌0----愚人

     這是生命旅程的開始，在此階段，人是純真和可以信賴的。愚人無邪無慮，初生之犢和熱愛冒險犯難的他昂首望天，絕不垂首下望。儘管身處險境，他依然渾然不覺。經常有一隻小狗與他為伴，狗象徵尋路的能力，是心靈動物。愚人代表未被日常生活遮蔽的那個自由心靈的自我，幸運的是，在占卜裡出現愚人時，我們總能回歸那種狀態。

王牌I----魔術師

     魔術師其實是一張魔法牌，他出現時通常前面有一張道具桌，上面擺著魔法道具。他的工作是教導愚人運用宇宙的創造性能源、適當的工具和法器，以形成一個充滿目標和創造力的生命。魔術師了解世界是如何運作的，這不是指我們在周遭所見模糊的普通世界，而是在宇宙運轉背後的能源。魔術師指出你可以運用潛在的能力，如邏輯、意識、覺知、客觀性和能量，使得生命運作的更好。

王牌II----女祭司

     這是一張神秘和深奧的牌。魔術師指使用精神能亦來表明我們的希望和欲望，女祭司則指非物質的領域。她代表隱藏的心靈自我、它的一切過程我們看不見，像是直覺、心情、情緒和似乎不和邏輯但卻源自我們內心深處的反應。她統治黑夜和宇宙裡的一切，我們依稀知道，但那是單憑邏輯的心無法觸及的層面。女祭司出現是一道訊息，表示我們該深入內心尋求指引。

王牌III----皇后

     皇后是跟古代偉大女神有關的一個人物，她是宇宙之母。愚人遭遇人類內在與外在世界後，如今遇到原型之母。對青少年來講，讀牌時出現皇后經常稱為「婚姻牌」，她代表婚姻成為求卜者生活裡的一個議題。通常，這並不表示你即將結婚(當然要考慮你的年齡)，但意旨婚姻的意義或許占滿著你的欣。它也可以指加人的婚姻或是懷孕，因為皇后代表了生育和母性。

王牌IV----皇帝

     有趣的是，皇帝是跟皇后相對的男性人物，但卻追隨著她，這指出母性主義先於父性主義。皇帝在此世界有相當分量，代表權威、控制、理性、權力和支配力。皇帝表示為世俗的關心，經常代表少年掌控物質生活的需要。皇帝也可以暗示權威問題(取決於攤牌時它所在的位置)或發展自我力量的需要。

王牌V----教皇
     教皇是教導愚人如教會和國家等體制現實的人物。他象徵已建立的傳統價值和道德所需的狀況對立。教皇亦以教宗知名，象徵保守和正統，他反對改變和強化社會的社教禮節，對青少年來講，教皇(取決於攤牌時的所在位置)代表正面對一個問題，有時是個棘手難題。

王牌VI----戀人
     通過生命的精神和直覺層面，遇到基本的女性和男性主義，以及處理世俗需要後，如今愚人準備好面臨愛情的議題。但這未必是墜入情網的表示，戀人代表意識到另一方或雙重性。愛情是很棘手的事情，愈年輕就愈棘手。戀人出現是警告青少年要做選擇，現在所做的選擇能影響一生，無論選擇跟羅曼史有沒有關係。戀人未必表示羅曼史，但指出必須小心思考一切關係，像是友誼、愛情、性關係、吸引你的東西和原因。戀人是很重要的一張牌，經常在需要做重要選擇時出現。

王牌VII----戰車
     當戰車出現，表示愚人現在要面對讓生命裡的許多雙重性順利共處的挑戰。通常牌面上世一個戰士駕著一輛由一匹白馬和一匹黑馬拖著的戰車，這張牌透露友跟對立的東西調和的需要，無論對立的東西在我們的內心或是外在的世界裡。戰車說明生命涉及衝突和解決問題，問題通常透過妥協而獲得解決。舉例而言，假入你的父母正在談離婚，戰車就有可能出現，這是一個挑戰，要你在面對艱難的狀況下，保持平穩的軌道。不管你正面對哪種問題，戰車出現表是你需要做出平衡的行動。

王牌VIII--力量
     力量是一張很奇妙的牌，牌面上經常出現一個女人扳開獅嘴，或與森林之王纏鬥。力量透露愚人必須發展自信心和自尊心，進而在內心裡產生力量。由於力量幾乎總是以女性人物出現，對一個少女來講，力量時常表示她在孤軍奮戰。有時候得經過一段嘗試期。這張牌在少男身上的意義有點不同，它可以表是體力不是唯一，他需要思考和發展內在力量。

王牌IX----隱士
     隱士是力量的一個象徵人物，經常以一個高提著燈籠的老人形象出現。他代表來自「另一邊」的指引，或是需要這種指引。隱士教導愚人，無形世界的背後存在有強力的力量，為了接觸這些力量，一個人必須冥想和相信內心指引，只要去尋找，就能找到這些指引。跟所有的牌一樣，隱士傳遞的訊息視位置的不同而異。對青少年來講，隱是可能是要求停止一切活動一段時間，以便與「內心的指引」相會，運用內在的智慧。青少年在生活混亂或事情似乎顯得沒有意義時，隱士可能就會出現。當外來活動超過負荷，你需要時間獨處把事情整裡清楚時，隱士時常會出現。

王牌X----命運之輪
     這張牌暗示宇宙裡發生的事情不在愚人的掌控之下，愚人甚至連他自己的世界也控制不了。他顯示運作的力量也許無常和難以預測，但實際上是生命一個總體模式的部分。命運之輪不是一張壞牌，它表示我們先前的決定、選擇和業已進行的行動如今無法中輟。對青少年來講，出現命運之輪代表把一切事情視為理所當然並不是好想法。它是一個徵兆，表示你必須汲取「要怎麼收穫先怎麼栽」的教訓。

王牌XI----正義
     了解有我們難以掌控的力量後，愚人遇到正義，了解到儘管生命顯得無常，卻存在著固定的模式，而且，我們行動所造成的後果是可以衡量的。對青少年來講，正義出現表示有平衡與和諧的需要。舉例而言，也許你跟某人吵架或意見相左，如今覺得受到不公平的對待，但是為了把事情做對、搞清楚，你必須保持公正。你知道生命不見得公平，但重要的是採取正向的步驟，以確保自己處理事情的公平性。

王牌XII----倒吊人
     如今愚人已經及取前面的教訓，需要學習放手或重新開始。倒吊人牌面上經常出現一個人倒吊在樹幹上，一隻腳交叉放在另一腳後面。奇怪的是，他用這種倒掛的姿勢凝視宇宙，樣子卻顯得沒有一點不舒服。事實上，他看起來高興和樂觀極了！這張牌有趣且令人好奇，經長表示對生命採取全新觀點，或是尋求嶄新和意外的展望的可能性。對青少年來講，倒吊人可能在一段不快樂或不平靜的時間後出現，要求對目前的狀況有些新的想法，或指青少年可能有自己的生命被徹底顛覆了的感覺。在這裡，倒吊人代表放棄老舊的想法，並發展更適合心靈發展的新想法。倒吊人是質疑物質價值得一個召喚。

王牌XIII----死亡
     這張牌出現經常把人嚇壞，不過，死亡絕對不是一張壞牌，不該刻意把它解釋為你或你愛或你認識的人即將死亡的意思。死亡這張牌的意思是，有些事情或甚至比你年長的某個人面臨死亡，你非得釋懷。死亡代表過渡，就像你從國中畢業去念高中，或是從高中然後去念大學一樣，你必須把整個舊有的生命模式拋在腦後。死亡也代表轉變，可能是相當恐怖的。然而，沒有必要的轉變我們只會墨守成規，終歸毫無進展。死亡出現就像一記響鈴呼喚我們醒來，告訴我們有重大的改變即將到來，不管我們喜歡與否。

王牌XIV----節制
     節制是一張很可愛的牌，上面通常顯是一個長有一對翅膀的天使，頭部環繞著光環，並把水由一個杯子(或瓶子)倒進另一個杯子裡。天使可能是男性、女性或是中性。杯子一個是金的，另一個是銀的，代表心靈和物質世界不斷互相影響。節制表示愚人受到生命「調節」，如今了解到合作、平衡、協調、接納和創造性的必要。對青少年來講，節制這張牌出現暗是發展這些品質的需要，有時候反映出一段混亂或不確定的經驗。

     「捨棄尋找神，與創造出類似的事物，而從原點去尋找祂。學習是誰在你的心裡，是誰創造了萬事萬物，說：『是我的神，我的心，我的思想，我的靈魂，我的身。』試著去了解哀傷、歡樂、愛與恨是來自何處，只要你仔細研究這些事情，就會發現祂在你的心裡。」

默諾門斯Monoimus   真知派/諾斯底派 (Gnostic)大師

王牌XV----魔鬼
     模鬼這張牌跟死亡一樣，經常讓人感覺不安，特別是在求卜者相信真有魔鬼的時候。視牌的花樣而定，這張牌的確可以顯得相當兇惡。魔鬼真正的意義跟邪惡或懲罰無關，他通常跟鐵鍊一起出現，有時候會跟戴著鐵鍊的人一起出現。占卜者翻到魔鬼這張牌時經常會驚慌得透不過氣來，害怕會被他「抓住」。可是，魔鬼這張牌只表示一個人(或覺得)被困在一個令人窒息的狀況裡。仔細想想，這經常是人們自身的錯。對青少年來講，魔鬼出現可能表示需要把束縛自己的鐵鍊打破。這張牌經常顯示出求卜者的無知、任性、執迷、依戀物質、衝動和負面思想，而這一切都可以矯正。

王牌XVI----高塔
     高塔是另一張讓人感覺不安或恐懼的牌，上面經常顯示一棟高塔遭閃電擊中，有時候還有人飛出窗外。跟其他代表改變的牌一樣，高塔出現清楚表示你需要改變才能成長。高塔通常表是徹底的巨大改變，對青少年而言，它可能表是求卜者必須遠離自己的成長和發展具有破壞性的活動、人和行為。或說明求卜者需要面對某些跟自己有關的殘酷真相，並採取行動把一個情況矯正過來，以免它失控和爆發。把高塔這張牌當成一個警告，並認真的留意它所傳遞的信息。

王牌XVII----星星
     星星是我個人最喜歡的其中一張牌。經過前面幾張牌的嚴苛教訓後，假如愚人做好功課和學到教訓，他現在終於看見隧道盡頭的光芒。這是張寧靜和快樂的牌，上面通常顯是一個裸體女性人物跪在池塘或水池旁邊。她身處在美麗的田園中，拿著兩個水壺，把一個水壺的水倒進溪流裡，另一個水壺的水倒在地上。通常有顆大星星被一群小星星環繞著，大多數時候是七顆星星(昂宿星座有7顆星星)。星星代表希望和樂觀，她的赤裸象徵無掩飾的真實和純潔。她所倒的水是生命之水，有些回歸源頭，有些提供給大地孕育新生。星星這張最為快樂的牌出現在青少年求卜者的牌裡，通常表示求卜者自己的星星正在升起，它通常在成功克服了一段艱難的時期後出現。

王牌XVIII----月亮
      月亮這張牌可以讓那些對月亮象徵沒有全面了解的人感到迷惑。我們在月光下看東西的確不像在太陽光下清楚，月亮可愛的光芒讓我們看到的東西變得不同。月亮是張神奇和神秘的牌，它告訴占卜者注意求卜者內心深處的夢想和信息。你也許正感覺悶悶不樂，或只是處於心理作夢的狀態裡。月亮告訴你要注意自己和情緒上的需要，建議你該冥想和休息。

王牌XIX----太陽
     太陽是一張快樂和顏色鮮豔的牌，上面通常是一個裸身的小男孩，在燦爛的太陽光下騎著馬。有些牌上面的小孩不只一個，或是花樣改成一對牽著手的年輕情侶。太陽象徵進步，在黑夜的領土漫步後，愚人現在被帶到日光下，一切顯得快樂、充滿希望和輝煌燦爛。太陽在青少年占卜者的牌裡出現時，是一個明顯的徵兆，表示現在你的身心愉快，彷若新生，可能你剛度過一段麻煩不定的時期。太陽這張牌暗示愉悅就在眼前，而且你有意的計畫和個人的努力將有成功的回報。你可以到一個充滿陽光的地方去度個假。

王牌XX----審判
     被新升的太陽喚醒後，如今愚人聽見審判的喇叭聲，號令他考慮自己世俗的工作。這是重生和重建的時刻。受到基督教審判日的影響，有許多牌審判的花樣顯得相當負面，但其他文化認為審判是重新審視生命的時刻。青少年的牌陣裡出現審判時，表示此刻確實是治療和轉變的時候了。你可能一直在「沉睡」，或沒有留意四周的狀況，而且你要不是惹上麻煩，就是感到糊塗。審判這張牌是一個召喚，把你更高層次的自我喚醒。

王牌----世界
     現在來到大阿爾克那的終點，循環到此完成。我們的愚人經歷了一生有價值的學習後，如今已準備好心理學家所謂的「自我實現」。這張牌的牌面大多數是一個裸體女性，身纏一條長圍巾，每隻手拿著一根兩端尖頭的桿子，被一道藤蔓、葉子和花朵組成的環圍繞著。世界這張牌象徵由愚人開始探索心靈的旅程已經完成，它在青少年的牌裡出現時，透露出有些內在或外在的過程已經達成。它可能表示求卜者已經從高中畢業，決定往自己選擇的大學就讀，找到工作，或選擇好的職業。依現行狀況、所問問題和牌的位置而定，世界這張牌暗示你在眾多祝福下，正得道你正當賺取的東西。

     你愈了解塔羅牌，就愈清楚它的主旨跟人類基本心理和心靈經驗直接相關。隨著你繼續研究塔羅牌和實際使用它們，你對它們的了解就愈深入，而它們也愈能跟你的內在生命共鳴。

挑選塔羅牌

     如俗話說的，一張圖片代表了千言萬語。塔羅牌圖片直接道出人類內心的最深處。今日有十幾種花樣的塔羅牌供我們選擇，有些古意盎然，也不乏新穎的設計，運用像是美國原住民、女權主義、社會生態和許多其他的現代圖片和主題，嘗試把這個美好的自我發展體系帶入現代。只要到書店或專門店走一趟，就會發現裡面有各式各樣的塔羅牌任君挑選。
     挑選塔羅牌的時候，特別是你是初學者的情況下，跟著你的「感覺」走。本書對前述合乎78張牌標準的塔羅牌皆適用。
     最後，你想要用的牌或許不只一副，但最好還是從一副牌來開始學習。等到你完全熟悉一副牌和徹底了解它們的意義後，接著便可以嘗試其他花樣的牌。

萊德‧偉特的塔羅牌
     十九世紀至二十世紀初期期間，人們對巫術的風靡到達新的高峰，包括占星術、儀式魔法、希伯來秘法、諾斯底主義和風水等。這股風潮從未減退，終而導致今日我們所見設計豐富的塔羅牌。一個名叫金色曙光(Order of Golden Dawn)的團體於是產生，獻身於「魔法」研究和應用的復興。這個團體約於1887年成立，成員包括薩母爾‧黎德‧麥克逵格‧馬瑟斯(Samuel Liddell MacGregor Mathers)、阿萊斯特‧克勞利(Aleister Growley)、亞瑟‧愛德華‧偉特(Arthur Edward Waite)和保羅‧佛斯特‧卡斯(Paul Foster Case)等人。這些人在當時很有影響力，發表了許多文章。
     1910年，偉特委託藝術家兼戲劇家潘蜜拉‧柯爾曼‧史密斯(Pamela Coleman Smith)繪製了一副塔羅牌，這副牌出版作為塔羅牌圖片版的牌很快就變得相當出名。在許多具代表性的玄學影響下，它受歡迎的程度維持不墬，通常成為初學者的首選。因為它很基本，而且被很多塔羅牌書籍用來做為解釋牌義的基礎，因而成為青少年初學塔羅牌的良伴。本書即是以萊德‧偉特牌(Rider-Waite-Smith)為範本做說明。

1   認識塔羅牌

     塔羅牌是一種強而有力的工具，你必須小心地、虔敬地運用它。這不是說塔羅牌像電鋸那樣，使用不當時會傷害到你，而是說為了發揮它的效用，你絕對不能輕率或淺薄待之。你解釋牌義時所持的態度將會對它們的效用有很大的影響，因為塔羅牌包含的知識連接著你的心靈，直達你的內心最深處。你可以用塔羅牌來回答日常疑問，像是學校、考試、與父母和朋友間的關係、感情、錢財與工作，或是事業和大學等問題，但是它最高的價值在於發展你的直覺，進而提升你的心靈發展。

     有些人一聽到「心靈」這個字就放棄；它能引發衝突，有時候還能帶出負向的情緒，或是對未知的恐懼。許多以為心靈的力量很危險，這根本是胡思亂想。每個人都有或高或低的心靈力，就像音感，或是對數學、對電腦的了解程度有高有低一樣。如果你不懂音樂、音符或許便顯得即為神秘。對那些不懂得使用電腦的人來講，他們對電腦當然又敬又怕(這是我個人的經驗談)。不過，運用心靈這種直覺方法就跟用電腦語言和程式一樣，沒有什麼神秘可言。而且，直覺跟操控複雜電腦暗碼的能力不同，它是內建於人類有機體裡的一個元件。只要你知道並熟練它的規則和技術後，就會明白它一直是你的一部分。小孩子還不知道自己天生的能力，所以並不害怕，經常憑直覺做出驚人的表現。他們尚未被教導說，直接聽憑直覺，或是從理智心靈以外的一個源頭來取得資訊是「錯誤」或「可怕的」。

格言

佛法和菩薩被視為人人體內的潛能，不是後天獲得的，而是藉由領悟，或是柏拉圖所有的「參悟」。坎柏(Joseph Campbell)《神秘的意象》(The Mythic Image)

     因此，初學者首先必須先打開心胸，接受塔羅牌提供資訊的力量，對它提供的訊息嚴肅以待，並且永遠不能為了圖謀個人之利來試圖操控人或事。占卜術是一們藝術，跟所有藝術一樣，天分極為重要，不過就像學習任何新技能一樣，多練習就能變得愈熟練。換句話說，熟而生巧，不然起碼也能改善表現。

     就拿你想知道一個重大決定的可能後果來說，只要拿出你的塔羅牌，說出你的問題，但最好選一個特別、隱密和安靜的場所就可以。用牌之前，先讓自己徹底放鬆一下，慢慢地讓你有意識的心拋開腦海裡的思緒，讓自己沉入內心最深處。接著握住你的牌，或是洗一下牌，然後把心思集中在困擾你的問題上，讓它變成你的一部分。當你牌排出來時，要有信心能夠拿到正確的答案。

     相信你已經擁有取得答案和了解牌義的能力，因此，塔羅牌可以用來集中你的直覺力，一個取得內心解答的便捷方式。在我的經驗裡，塔羅牌經常先繞著問題表面轉，然後才深入到問題真正根源。套句心理學用語來說，用一個較簡單的問題來取代更伸的問題是很平常，但牌幾乎總會把可能被你藏在內心裡的問題指出來。它們具有一種直指問題核心的神秘能力，而且經常清楚得讓人驚訝，我自己便有許多類似的經驗。
     人類才剛開始探索幾乎有無限可能的直覺力。法國腦科權威專家提尼醫師(Dr. Frederic Tilney)率言：「在意識的驅策下，大腦的中心將會進化，以允許我們使用現在連想像也想像不出來的力量。」
     跟自己的心靈潛能接觸時，你有點像是樂團指揮，又有點像是樂團裡的樂器；你有意識的心是指揮，必須讓樂團的一切正常運作。這包刮你的「左腦」或是理智的心，以及你的「右腦」或是創意的心(右腦是直覺的中心和其他與生俱來的功能的主人，有些與生俱來的功能我們只模糊知道它們的存在，但卻不十分了解它們，比如作夢)。在此項工作上，塔羅牌提供一個絕佳的方式，把我們看似分開的部分全部整合在一起。

格言
意識形態世人類神聖的天賦，理性是人類的忠僕，我們創造了一個彰顯忠僕、忘卻天賦的社會。     愛因斯坦

     當你首度決定排個牌陣，你會自動把有意識的心專注在問題和牌陣上，這運用了直覺，為自我覺醒提供線索。塔羅牌的占卜明確、詳細，允許左腦和右腦平順互動，一旦你了解這個過程後，就能隨心所欲地接上宇宙能量儲存庫。塔羅牌把這股迷人的力量時時在在地放在你的手裡，就像是直覺得觸媒劑，然後製造出你需要的資訊。
     研究塔羅牌時，直接回應它們的影像，不要受到分析和理性的心所阻擾。讓內在得自我跟隨你的感覺，學習和使用牌義的解釋，並把它視為一個有用的指引，但牢記它們並非永誌不變。你可以跟著感覺，自由地發揮創意來解釋牌義，同時維持......這些解釋是經幾世紀發展而來的精隨，可是當你更加深入時，會發現每張牌都有許多可能的解釋，還有許多取決於不同音速的變數，比如它在牌陣理的位置、前後面的牌，總體感覺或牌的色調。舉例而言，牌陣的顏色也許看起來很黑暗，不過有一、兩張顏色明亮的牌，像是太陽，可以讓黑暗柔和下來。相反地，牌陣總體看來也許很正面，但卻包含一、兩張壞牌，使得整個牌陣改觀。只要你多加練習，就能熟練地領會出最合適的意義。
     首先，你會想找出每張牌的牌義，然後把它們放在一起占卜出答案，這需要研究和練習。我在經過多年的專業占卜後，學習到一次牌陣就像一個模板或一個區域，訊息經由此處流出。當然這並非一夜蹴成，首先要學習每張牌的標準牌義，最後你便能觸類旁通，取得牌陣的整體意義。

塔羅牌小秘方
     莎利‧吉爾哈特(Sally Gear-hart)在《女性塔羅牌》(A Feminist Tarot)一書裡說，把牌分成不同組，比較它們彼此間的關係，這樣比較容易記得每張牌的意思。
     我個人比較喜歡把牌視為一個整體，不過你可以用對你最有效的記憶方式。人各有不同，記憶的方式亦各有差別。如果把牌分成不同小組可以幫助你記住它們的意思，就照著做吧。
     大阿爾克那有許多不同層面的意義，這些層面的意義會隨著時間逐漸揭曉，就像在一個古老遺址裡挖掘考古一樣。有實際層面的意思，以皇后為例，她可能代表你的母親，或指你希望成為一個母親。也有世俗層面的意思，如魔術師可能暗示你想要一個更有創意的人生。還有心靈層面的意思，魔鬼可能告訴你，物質阻擋了你靈魂上的需求，該是你停止追求物質的時候了。

     基本塔羅牌包含78張牌，其中22張牌被稱為大阿爾克那。阿爾克那這個字源自arcane，意思是「神秘」或「秘密」，這些秘密代表了反映宇宙法則的未知宇宙。因此，大阿爾克那最為複雜，形成塔羅牌的中樞。你需要研究這些最為精深的牌，以了解它們多層的意義。

     不管你使用哪一種牌，每種牌的大阿爾克那牌每張都繪製有意義的象徵，只是主題各有不同而已。有些牌反映出自然得主題，或者跟某種傳統有關，像是美國印地安人、女神、亞瑟王傳說、希臘神話和其他許多種種，在此不予贅述。我們了解，每張大阿爾克那都有名稱和1到21的號碼，指有愚人的號碼為零。
     其他56張牌被稱做小阿爾克那，它們包含的資訊性質比較不重要，牌義亦比較容易了解。小阿爾克那跟普通的撲克牌一樣分成四種花色；權杖、錢幣、寶劍和聖杯(請注意：花色的順序音作者不同而異。我個人總是用權杖、錢幣、寶劍和聖杯的順序，以跟它們在星象學上代表火、土、風、水的順序對照)。每個花色有14張牌，其中有4張宮廷牌或稱Face牌：國王、王后、騎士和侍從(普通撲克牌指有三張宮廷牌，國王、王后和侍從)。每個花色還有一張1號號碼的Ace牌，其他是由2到10的號碼牌。
     小阿爾克那提共立即的資訊，每個花色代表一個你的活動和成長的分區如下：

• 權杖：精神活動，外在世界，工作或事業。
• 錢幣：錢財，安全感，生理世界。
• 寶劍：自我，面對的障礙，心靈問題。
• 聖杯：情緒，愛情，羅曼史，無意識。

     你是一個獨特的人，根據你特有的藍圖展現你的個性和內在的自我。這個成長的過程自有其實堅表，怎麼也快不起來。生命循環，於試種種發展的模式建立。定期算塔羅牌能夠透露出這些訊息，並建議新的方向，你可以把大阿爾克那用作為探索宇宙概念的指引，並運用在你當前的生命裡。

自習塔羅牌

     首先，你當然需要研究每張牌和它們的意義，其次你需要熟習各種不同的牌陣。本書有數個範例供參考，但你也可根據特別的問題和其他理由來自創牌陣。最後，你必須勤加練習。學習塔羅牌就跟學習任何其他技能一樣，必須多練習。多練習總讓我想起一則紐約的老笑話：有個觀光客趕不上音樂節，又迷了路，他匆忙地走到一個老猶太街販前面，急忙地問：「快告訴我如何去卡內基音樂廳！」

老人歌唱似地回答他：「練習，練習，練習啊。」

     練習的頻率和練習多少時間全看你自己決定。我的建議是多加練習，我剛開始認真研究牌義時，每天至少花一個鐘頭練習牌陣，並把牌義的解釋記錄下來。在此之前，我以先研究過每張牌的意象藝術，一心只鑽研意象的意義，從不嘗試占卜。這個方法對我個人非常有效，等我決心把所有意象的知識用來占卜時，我已經準備妥當了。不過，你也可以每天(經常)依點一點地學習，總要把占卜結果、提問的問題、牌陣和每張牌的位置記錄在記事簿裡。
     如果你無法在每天起床後撥出時間做練習，那就選定一個時段，固定在同一個時間點練習，就像做家庭作業或任何計畫一樣。這有如學習樂器，練習的時間愈多，自然而然地，愈能駕輕就熟。達成這個目標後，就可以專注占卜了。
     如果你希望和我一樣，開始研究塔羅牌和它的智慧，那麼我會建議，每次指專注於一張大阿爾克那牌上。研讀這張牌提供的解釋，把它跟對照的牌做比較，然後全心集中在這張牌上，直到你感覺到它的能量為止。研究完大阿爾克那後，接著研究小阿爾克那。每次研究一個花色的號碼牌，每個花色各自代表生命的一個領域。然後研究宮廷牌；國王、王后、騎士、侍從，宮廷牌經常用來代表人。你要熟悉這些影像，在你完成這個過程後，你便已準備好進行實際占卜了。
     另一個方法是純粹把牌排出來，然後把你面前的牌的意義找出來。這個過程會讓你逐漸記下牌的意義，尤其是你把它記在記事簿裡時。然而，如果你想做高品質的占卜，與其做整體性的了解，最好按部就班，先熟悉每張牌的意義。
     顯而易見地，你的熟練程度取決於你花多少時間努力，你可以結合短時間密集和長時間稀疏兩種方式練習。無論你選擇哪種方式，只要你研究塔羅牌和定期加以使用，你將會滿心欣喜地感謝這個美妙的智慧源頭，以及它揭露人類心靈的魔力。

格言
很少人明白自己看著的世界，只是自己想法和感覺裡的世界。    

沃理斯‧史蒂文(Wallace Steven)

2   解釋的藝術

     如今有許多不同主題的塔羅牌供售，於是你只能大概地依你對所挑選的牌的熟悉度來做解釋。許多塔羅牌都會內負一張書籤，解釋牌面上特別圖片的意思。不過，真正的塔羅牌皆以相同的結構為基礎，本書裡對牌義的解釋亦可以用在你選用的牌上。開始熟悉你選用的牌，你對牌的第一印象很重要，因為當你看著不同牌的圖片時，它們會引發你的直覺，這是毋需智能思考即能知曉的。這也是圖片的功能所在，不同的人會對不同的圖片出現反應。把本書是為一個指南，而不是一本說教的教科書。你在學習和使用塔羅牌時，牌面上的圖片會根據你個人的性情和直覺跟你產生共鳴。

     牢記塔羅牌的起源受到多元文化的影響，背後隱藏著神秘。你個人對牌的起源的反應是獨一無二的，就像你的指紋一樣。當你隨著研究和應用而有所進步後，無庸置疑地，無論在哪種情況下，你將發展出一個合乎你個人風格的敏銳感。然而，有些標準的解釋早已通過時間的考驗，最好先從這些開始學習起。經過一段時間的練習，學習到標準解釋後，你便可以在適當的解釋範圍裡，讓直覺做你的嚮導，做出你有所感應的解釋。

     重要的是，牌面上的圖片要能讓你感到舒服，假如牌面的設計對你沒有意義，請選另一副牌來使用。你跟選用的牌之間有和諧感是絕對必要的，這樣它們才能進入你的直覺深處。如果你對自己使用的牌很有感覺，占卜的效果就會更好。一切全看牌如何跟你說話，還有你對上面圖片的感覺來決定。因此，挑選一副你喜歡的牌，同時你的朋友對這副牌也有感覺，是學習解釋牌義的首要步驟。

〈悟性〉思維若缺乏了內容是空洞的；〈感性〉若缺乏了概念是盲目的。

悟性不能見，感性不能思，兩者聯和乃成知識。

康德 (Immanuel Kant)

《純裡性批判》

(Critique of Pure Reason)

了解塔羅牌的圖片

     大阿爾克那每張牌上的每個圖案各有其意義，對心靈有不同層次的作用。因此，你需要小心檢查你的牌，你愈注意圖案，就有愈多的意義潛入你的無意識裡。別忘了，解釋塔羅牌要運用直覺，這是一種不合乎邏輯和理性的活動。如果你習慣邏輯性的思考(大部分人皆如此)，剛開始這種全心的活動時，或許會有很奇怪的感覺。你也許會有一些奇怪和陌生的經驗，別被這種經驗嚇壞。你的直覺傷害不了你，如果你有任何不好的感覺，把製造不安的牌或圖片記下來。不好的資訊只是來自心靈的訊息，就像氣象預報一樣，如果氣相報告說會有暴風雨，我們可已做好預防措施，用不找害怕。

     你的無意識是一個巨大的資料庫，理面儲存了你甚至渾然不知的經驗。你的直覺具有神奇的能力，能夠連結上這個資料庫，結合直覺與創意，將有助於解釋牌義。直覺是一個發明器，具有龐大的創造力。小心檢查每張牌，特別是細節部分，直到你感受到每張牌為止。

塔羅牌小秘方

     挑張大阿爾克那牌帶在身上一天，思考它的意義，並經常隨不同的狀況拿出來觀看，看看它的牌面意象跟你的日常選擇和決定有何關聯。把你的經驗紀錄在塔羅記事簿裡。

     「有創造力的人能夠感覺出看起來不同的思想、事物或表現形式間的關係，並且能夠把它們結合成為某種新的形式。這種人具有把看似互不相連的東西連結在一起的力量。」

威廉‧波洛玟William Plomer

塔羅牌記事簿

     每張牌分頁記錄，最上面先寫下每張牌的名稱，把每次練習的印象和日期記錄好。隨著圖片更加深入你的無意識裡，揭露它們多面的自我，你的印象會跟著改變和延伸。

     從大阿爾克那或王牌開始，這些牌最為重要，圖案的象徵也最為複雜，包含了隱藏的知識。注意牌面上的主要人物，檢查它們的姿態、手足的位置(所謂的肢體語言)，以找出其中的意義。注意牌面上一起出現的小人物：人、動物和無生命的東西。觀察背景和前景，以及一切有象徵意義的圖案，不管它們有多微小。給自己時間習慣牌給你的印象，並期待隨著時間過去，當你對牌更加熟悉後，你對它們的印象會有改變(初學者通常先逐牌解釋牌義，然後再一起占卜出答案。這是一個很好的開始方式，隨著時間和經驗的累積，只要瞄一下牌你便會有整體的感覺)。

     占卜結果做成的詳細紀錄是最佳工具，讓你可以趕上學習的進度。你可以經常回來翻閱這些記錄來檢查你進步的速度，別分析你對牌的反應，只要記下心裡的想法即可。把初現的問題寫下來，以便做進一步研究。如此一來，你會創造出整個自我建設所需的建材，你會驚訝地發現，第一印象對你學習解釋牌義的過程有多麼重要。

     在此早期階段裡，有一段時間你仍會想要參考其他人對牌義的解釋，像是本書裡的介紹，但最終你會感覺沒此必要。你不會受到期它解釋的干擾，把圖片融為己有，它們也會跟你「說話」。

     這有點像演奏一部音樂作品，首先你必須學習作曲者寫的東西和目的所在，然後勤加練習，解放自己，用自己的方式來解釋，同時不為備曲子的基本意義。

著色遊戲

     這裡有個極佳的方式，讓你能夠了解你的牌和它們的圖片。影印你的大阿爾克那牌，把它們放大成你喜歡的尺寸，然後幫圖片著色，不要管它們原來是什麼顏色。如此一來，你連接上你的直覺心，展現出你個人對圖片的反應。舉例來說，女記思讓你想圖哪個顏色？

     當然，你可以幫小阿爾克那牌的圖片做同樣的著色遊戲。不過，請牢記，雖然號碼牌上一般都有圖片，但並不統一。有許多牌的號碼牌只有一些裝飾性圖案，沒有任何象徵意義的圖片。大阿爾克那上面的圖片最為重要，你要把它們刻印在你的無意識，它們會在此沉潛，變成你的一部分。請參考後面顏色的象徵性意義的介紹。

顏色的象徵意義

     注意牌面上圖片的顏色，以及你自己選用的顏色，這個方式可以用來了解顏色的象徵性意義。以下是一些顏色和一般適用的意義，你對某些顏色也許有不同的感覺。舉例而言，黃色代表樂觀，但或許你就是不喜歡黃色。如果你對某個顏色有不同的感覺，盡管跟這你的感覺走。沒有什麼一成不變的。

• 黑色：黑色其實沒有光線或色彩，可以是「基礎黑色」或哀傷的顏色。黑色代表專注、固定目標和決心，意義並不總是負面的。
• 藍色：藍色有很多色調，從粉藍到深藍都有，所以很難給與定義。淡藍色代表寧靜，像強朗的藍天。藍色一般代表平靜、放鬆、熱愛溫和與真實。深藍色令人聯想起內省、耐心、保守、深度了解和悲傷。
• 藍綠色：藍色和綠色混合後產生一種有復癒和撫慰效果的色彩。這是一種自然的色彩，可以跟自然的神秘體對話，美國印地安人把藍綠石(土耳其石)視為敬畏之物，這個顏色可能誘發幻象。
• 藍紫色：藍色和紫色可以混合出不色調的紫色，淡如薰衣草，深如靛色，這些色調富有靈性，待表反應和深入。
• 棕色：另一個自然色，有許多色調。淡棕色代表簡單和缺乏自我或虛飾。深棕色跟大地的力量有關，代表土地的根源、穩定性和熱愛家庭。
• 金黃色：太陽、金屬，暗示驕傲和自信，它代表力量、光輝、領導力、創造力和勝利。金黃色經常讓人想到力量和物質的東西。也可以代表幸運。
• 綠色：蓬勃生輝的自然色，跟生命本身有關。它代表自由、年輕和孕育力。綠色是美金紙鈔的顏色，讓人聯想起獲得和財富、機會、繁榮和經濟安全感。在德魯伊教的傳統裡，綠色是奧秘知識的代表色。
• 橘色：傳統上，橘色跟太陽、活力、能量和自我激勵有關。它是一種溫暖色，象徵行動和大膽、自我表達能力和創造力。橘紅色強調局色的行動品質：獨斷、競爭、熱誠、任性和強烈行動。
• 粉紅色：淡粉紅色象徵敏感和柔和的羅曼蒂克感，如玫瑰的深粉紅色強調羅曼蒂克的感覺。粉紅色象徵強感、愛情、對自我和他人的良好感覺，令人聯想起羅曼蒂克的想像、起發和音樂。如桃色的粉橘色調象徵溫暖和柔和，還有熱誠和能量。粉紫色帶有粉紅色的意義，但更為溫和、害羞或較不外向。
• 紫色：曾為貴族代表色的紫色一般象徵心靈性、啟發、意識狀態的改變和高創造力。紫色往往令人聯想起力量、權威和高階級(所謂的「著紫衣」)，同時象徵高貴、正義、忍讓和重上法律。
• 紅色：生命和能量的一個主色，熱血之色。紅色是光譜的最高震動，象徵活力、活動、怒氣、行動欲、欲望、熱情和性感。紅色亦可代表負面行動或過度衝動，跟紫色混合後創造出一種熱誠加神秘的色調。如褐紅色的較深色調結合了感性和知性，並加上期盼生命豐富，擁有愛情力量和世俗財產得欲望。
• 銀色：月亮金屬，代表月亮的能量和月夜的幽美。它令人想起羅曼史和愛情的神秘，象徵品德完整：誠實、理想主義、接納內心的訊息和對夜晚的一種魅惑。
• 白色：白色其實是一切顏色的結合，因此帶表融合與和諧。它象徵純潔(白色婚禮)與和平(白旗)，亦令人聯想起純真、心靈追尋、各種淨化、無負面性和整合一切身、心、鈴機能的欲望。
• 黃色：樂觀、喜悅、福音、快樂、幸運和魅力的色彩，黃色代表信心和自發、智慧、冒險和享受生命之樂。黃和綠混合產生出一種穩定安靜的色彩，如萊姆(lime)。黃綠色強調心持有像是挑戰等能量品質的智能和冷靜。

3   占卜準備

     你已經把中意的塔羅牌買回家，並開始使用牌來結交朋友，但你心裡仍然有些疑問：你該如何處理塔羅牌？該把牌保管在哪裡？下個步驟是什麼？

牌的處理

     在你用牌前，先用溫水把手徹底洗乾淨，最好用純淨的香皂，像是橄欖皂。把手擦乾，燒擦一點無油的乳液。小心保養好雙手，在你握住牌時，手是內心訊息的直接傳輸器。

     把你的塔羅牌當成珍藏般好好保管，用完後別隨便亂放。想好放牌的地方，每次用完後立即歸位。你對牌適當的尊敬和所花費的工夫是占卜成功的必要元素。

祈福儀式

     我發現每次用牌前，進行一次簡短的祈福儀式可以增強良好的占卜能力。這就像飯前禱告，你可以一個人意願進行簡單或複雜的儀式。也許簡短感謝牌背後的神其力量和感謝你使用它會讓你感覺舒服一點，也許你比較喜歡說一些祈禱詞，或是使用其他的祈福方式。我經常使用一種簡單的祈福儀式，就是把整副牌擺在桌上，然後用雙手握著，手掌朝下，默念或大聲說出如下禱詞：

     我召喚至高的力量來給這些牌祈福和保衛它們，我本著為善的本意來使用它。

學習洗牌

     大多數塔羅牌比一般的牌大，多練習才能學會洗牌。當你拆開一副新牌，新牌大多很硬，表面多經過潤滑處理，感覺起來很滑手。切牌幾次可以讓牌更滑順，每張牌分開處理後，整復牌會變得更軟和更容易切牌。

     洗牌是很個人化的一件事情。無論你決定使用哪種方式，感覺舒服最為重要。你可用任何方式洗牌，只要覺得舒服即可。有些占卜師洗牌的方式跟專業賭徒一樣，有些人洗牌的方式很溫和，次序也不同。你可以把牌分成小堆，然後把它們疊回一起，也許你喜歡把全部的牌舖在桌上，然後用手掌洗牌。請確定洗牌時牌面一定要朝下，每次幫自己占卜或做占卜練習前，都要先洗一下牌。

     如果你幫別人占卜，可以選擇自己洗牌或事讓求卜者來洗牌。有的人不肯讓別人碰自己的牌，有些人，包括我自己，則感覺由求卜者自己洗牌結果會比較靈驗。這全看你而定，如果你不想讓別人碰你的牌，也不會有問題。不過，如果你讓別人洗牌，把他(她)的脈動傳達到牌上，請確定在下一次占卜潛進行一次清牌儀式，後面會做清牌儀式的介紹。

     我占卜時會介紹不同的洗牌方式供客人選擇，如果客人很害羞或不願意洗牌，我會說「你只要雙手握住整副牌一會兒，同時想清楚你想要的占卜結果就可以了。」接著我便會開始洗牌。

     有一位我熟識的占卜師可以準確地握牌高舉過肩膀洗牌7次，而且他絕不允許客人碰他的牌一下。時間和經驗告訴他，這個方式最能讓他集中能力和切中牌義。

     洗牌的方式隨人的性情而異。或許你喜歡從頭到尾完全掌控，或許你也喜歡過程裡有別人參與。你不必苛守一個方式，隨著你占卜技術的進步，你的洗牌技巧也會跟著進步。你也許會發現，不同時間適用不同方式，最好保持彈性，不要墨守成規，以免妨礙直覺釋出訊息。

清牌

     每次用完牌後都要清牌，特別是幫別人占卜過後。如果你用另一副牌做私下練習，每次練習完便不用清牌。事實上，多加使用後，牌會變得跟你調和起來。不過如果你用同副牌(我並不建議這樣做)幫別人占卜，下次占卜前最好清牌一次。你用自己練習的牌來幫別人占卜時亦適用這個道理。

     清牌有許多方式，其中一種是只要對著牌說簡短的禱詞，然後說它們跟所有先前的脈動無關，以及準備好開始使用即可。另一種是美國印地安儀式，就是點燃一些鼠尾草葉，讓煙飄過牌的上面。清牌有四個元素，你可選用已下任何一個元素儀式，或是自創儀式。禱詞可以簡短，也可以很複雜冗長。我個人使用的方式很簡單：我集中心思清牌，同時把整副牌一張一張疊起來。情牌的程序你可以自行開發，只要你把現時的震動引往牌上，之後把它們清除即可。時記的儀式或使用的方式並不重要，你清牌的用意才最為重要。

清掉牌的元素

• 火：把整副牌放在明亮的太陽光下一小時，或在工作的地方洗牌時點燃一根蠟燭。隨時準備好蠟燭，洗完牌後即可把蠟燭吹熄。跟火神致謝，感謝祂的幫助。
• 土：把包好的牌打開放在一個淺容器裡，然後用一塊清潔的白紙蓋起來。紙上灑一些鹽巴，二十分鐘過後把鹽溶解後倒進水槽沖掉。跟土神致謝，感謝祂的幫助。
• 風：用一張摺好的乾淨白紙(或一些綁好的羽毛扇(最好是野外撿拾回來的)，清清地扇包好的牌。你也可以對著牌清清吹氣，說明你在清牌。跟風神致謝，感謝祂的協助。
• 水：水世清除負面情緒的一個絕佳元素。召喚水神，請求祂洗滌你的牌，同時往牌的上方空氣噴灑霧水。或是折取一小段樹枝沾點純水，然後在你用牌的區域裡揮灑。跟水神致謝，感謝祂的幫助。

牌的保管

     思考一下你想怎麼保管你的牌。皮革取自被屠殺的動物，因此我不建議用皮袋來裝牌。絲綢具有鎮靜和撫慰的特質，不過只要是用天然的布料都可以。

     基本的想法是找個地方，並且一直放在同個地方保管。如果你使用的牌不只一副，或許你會想把牌分開保管。無論如何，要怎麼保管全看你個人的喜好而定。

儀式

儀式的外在形式雖然重要，但它真正的力量來自你設計和使用儀式的用心。儀式的內在形式遠較外在形式重要，外在形式像一片聚鏡，為了某個目的，你可以透過它把心靈和宇宙的能量集中起來。

是你的覺醒狀態讓儀式變得有意義。就算儀式本身真正的形式具有力量，那只是圖片的天性被使用的緣故，是你的意識和用意創造出想要的效果。

塔羅牌儀式

     「儀式的部的在幫助我們專注在眼前的議題上。歷年來，有不同的人發現，某種行動模式可以幫助他們專注。他們把這些模式系統化變成儀式，最常用的如下：

     把牌存放在松木盒裡

     用絲巾(或棉布)把牌包好

     睡覺時把牌放在枕頭下

     別讓任何人碰你的牌

     把全部占卜結果攤在松木板上

     占卜時臉朝東

     占卜時點燃一根蠟燭(或香)

     面向占卜者

     洗牌和往左邊切牌三次

     別洗牌，往右邊切牌三次

     由求卜者洗牌

     由占卜者洗牌

     我覺得這些儀是非常個人化，如果你喜歡儀式，不妨一用。如果你已經養成習慣，像是把牌陣以外的牌握在手裡，而且這種習慣似乎能夠幫助你專注，那就用吧。沒有特別神聖的儀式，儀式的價值是在協助你專注占卜，大多數最有力的儀式都是我們自創的。哪種儀式給你對的感覺，就用它吧。」

架構問題

     占卜前你需先架構想問的問題，除非是你在某個狀況或問題上需要意見，不然或許你只是想了解一下現況而已。

     思考一下怎麼架構問題很重要。清晰的主題絕對必要，模糊的問題只會獲得不清楚的答案。舉例，別問「我的人生什麼時候會更好？」你反而要找出不如意的地方，架構出一個清楚的問題，像是「我如何改善跟母親的關係？」

     如果在學校遇到問題，主題依然要清楚，像是考試或老師等等。如果是朋友方面的問題，可以問「某鍕人(說清楚姓名)真正的情況是怎樣？」如果是愛情方面的問題，視著問「有什麼最好的辦法讓我維持跟某某人(說清楚名字)的關係？」

     其他可供參考的例子包括：「請指示我人生的下一步該怎麼走」，或是「有什麼是我現在需要知道的事情？」

     如果你清楚了解想要牌告訴你什麼，你會比問籠統的問題獲得更好的結果。不過，總體問一下人生並無妨，塔羅牌總會把可能被你迴避、忽略或未察覺的問題指出來。你的問題類型將決定牌陣，我們將在第十三張做詳細介紹。問題愈複雜，你就愈努力想把牌牌出來。結果，問題愈簡單，牌陣遇簡單，也愈是靈驗。

     經常概觀占卜結果，並記錄在記事本裡做參考，無疑是很好的練習方式。之後，當你在做新的占卜時，就可以跟以前的占卜結果做比較，以判斷進展的速度。你在幾星期或幾天前所關心的問題，通常已自行解決了，如尚未解決，你可以未懸而未決的問題尋求額外的意見。
     人生無常，塔羅牌占卜的結果無法永遠有效。塔羅牌跟你打一出生變固定不變的星象表不同，占卜的結果往往只適用於目前的狀況。我認為一次占卜的結果通常只能靈驗約三個月，這是由於事物不斷改變的天性使然。對青少年來說，改變似乎持續不斷，因為他們的生命還在形成階段，今天對他們最重要的事情，在幾星期或幾個月後就失去興致了。
     青少年很苦惱的戀愛關係尤其如此，迷戀某個人現在讓你受苦萬分，但也許很快就被其他心焦點給取代了。這不是說你當時的情緒並不重要，無論你有何感覺，都是激烈無比的。我總是非常認真看待青少年的情緒，就算知道它們很可能很快就會變化。成人的情緒一樣也會有起有落，有時候變化速度甚至比他們的青少年子女還快！如果你總是認真地看待自己，塔羅牌也會反映同樣的態度，給你有用的資訊和意見。只要把塔羅當成一個友善的顧問，你總能夠透過他真誠的協助某個人。
     問對問題需要練習和耐心，但一切努力終會有好的回報。最好第一次便能避免混淆和把它做對。問對問題似乎創造一個「能量區」，你可以安全地引用這些能量。這或許是因為當你問對問題時，能夠以一種極為神奇的方式活化你的感覺，已專注在眼前的問題上。當你架構出正確的問題時，有時候牌的靈驗性會準確讓你大吃一驚。我無法明確的告訴你這個過程如何管用，但我從經驗裡知道它的確管用。你和宇宙是有連結的，當你啟動心靈後，你會自動抽出你需要的牌。
     假設你正試著決定申請哪些大學，首先你需要思考你其帶從大學裡獲得什麼。你的目標是什麼？經濟上有問題嗎？你的父母想要你進另所大學嗎？如果你考慮好幾所大學，你可以一一地連續發問。力如你考慮州立大學和本地社區大學好了，你想去念州立大學，但父母希望你在附近的社區大學念頭兩年。一開始你可以問一個概括性的問題：「州立大學適合我去念嗎？」
     你解釋出來的答案將決定你下個問題是什麼，可能是「我去念州立大學會比較快樂嗎？」「州立大學的文憑能讓我找到想要的工作或事業嗎？」等等，如果你決定要念州立大學，你可能會問：「我怎麼能克服父母的反對呢？」「我的父母要我唸社區大學對嗎？」你也可以針對你考慮的每所大學一一發問。
     相同的方式在任何你長期面對的狀況上應該一樣管用。較不重要的日常問題比較簡單，可以一次問完。就說你同收到兩個約會邀請，不知道該接受哪個邀約才好，你可以問：「我跟某某人(註明姓名)一起會玩得開心嗎？」或是你正考慮加入某個俱樂部或社團，你可以問：「成為某某會員對我有利嗎？」
     當你一邊洗牌切牌一邊構思問題時，也可以思考一下適合的牌陣(請參閱第十三章)。心情放輕鬆，沉思你的問題，並且準備好接受牌告訴你的答案。你會一再地感到驚訝無比，就算是一個你小心構思的問題，它被忽略或沒有覺察的層面經常會浮現出來。以前述的大學問題為例，浮現出來的問題可能是你想違背父母的意思，或是想離開他們，所以就算你還沒準備好遠離家園，你也要去念州立大學。

塔羅小秘方--掉出來的牌
     如果你在洗牌時有一張牌掉出來，你要對它多加注意。以這種方式出現的牌非常重要，研究它有什麼意義，接著隨機把它切回整副牌裡，然後記續洗牌。

真正的問題
     敞開心胸接受塔羅牌給你的答案。如果占卜結果讓你很失望，等幾天後再來澄清。如果占卜的結果指出一個更深層的問題，注意這個問題非常重要。塔羅牌具有點出真正問題所在的神秘力量，像「我會在畢業舞會裡找到約會的對象嗎？」的一個問題，其實可能反應出你對自己的魅力沒有安全感，牌可能會清楚指明這個問題。牢記你可以相信你的牌，因為你可以相信你的直覺。然而，生命的重大選擇裡有太多的變數和其他原因，永遠別憑占卜結果做出任何認真和影響醫生的決定。把占卜結果是同指引，永遠別做任何有違你的原則或常識的事情。

4   大阿爾克那意義

     大阿爾克那可以有與多不同層面的解釋，你愈深入研究，愈能引用它們的多層意義，以及了解它們的象徵裡包含了幾近無窮的奧秘。

     在傳統社會裡，象徵的解釋有三個層面：個人、集體和普遍性的解釋。在個人層面上，象徵與個人目前的狀況相符合。身為青少年的你，首先關心的一定是個人問題，而初學者本來就應該先從個人的問題開始。就像俗話說的，要跑之前必須先學會走路。

格言

     生命的每個階段勢必會面臨一些改變，無論改變是大或小，都經常被青少年視為風險。青少年的問題之一，就是經常把事情、內在的感覺過度誇大。愚人正是適合青春期研究的一張好牌。瑞士占星師亞歷山大‧魯波特(Alexander Rupert)是我最喜愛的占星師之一，他花了很多時間研究生命的循環。他對這種風險做了以下的描述：

循環是測量改變。要實現目標就要改變，改變就會產生風險。許多人搞不清楚風險(risk)這個字的真正意思，經常把它跟災禍(catastrophe)混危一談。風險出自希臘文的kino，意思是「決定」，簡單來說就是「決定時刻」。風險是個轉類點，先於改變。

     隨著練習，你逐漸了解塔羅牌的深層意義。在集體層面上，塔羅牌的象徵可以應用在社區的動力或整個社會上。至於普遍層面上，象徵用來解讀大自然被發現的模式。這個深層解釋以神聖心靈和其他神秘之做跟我們連結。

王牌 II

女祭司 The High Priestess

     女祭司代表神秘的生命，她的出現表示有些事情尚待揭曉。她象徵女神的女性精神力量，萬物由此女神所創造，亦回歸到她不停旋轉的生命循環裡。她通常做在或站在兩根樑柱間，這兩根樑柱代表世界的善惡、明暗、真假和正負兩面。

     女祭司出現暗示你有些心事正準備浮現出來，你需要更加留意內心世界，像是夢想、想像力和直覺。你需要了解全部的自我，包括夜晚裡的自己，還有你在白天裡的個性和活動。你已準備好接受開發這一部分生命的重要性，但卻因為恐懼和墮性而退縮不前。另一個可能性是你內心裡藏著某些需要你去面對的東西。

女祭司的牌義

     你的內心世界需要被注意。心靈力正在工作。有興趣談的柏拉圖式、精神上的戀愛。捫心求取答案的時候。期待夢想帶來訊息。深藏的影響。研究玄術。注意到表面之下的無形世界。需要反省、思考和祈禱。需要諮詢智者的意見。報名學習和更高教育的課程。開發天賦。

在神話中，女祭司跟埃及女神愛西斯(Isis)有關連，愛西斯充分了解宇宙的工作，熟悉天界和她的丈夫歐西里斯(Osiris)所統治的冥界。她代表神聖智慧和聯合兩界的法則。

王牌 III

皇后  The Empress

     皇后代表美和愛，以及一切正面層面的愛與照顧在社會概念上的物質角色。皇后出現在青少年的卜卦裡時，通常表示有婚姻或母親方面的問題。依你的年齡而定，你可能只是在思考婚姻有何意義和你對它有何感覺而已，或是你可能期盼婚姻或積極尋覓結婚對象。你甚至可能懷了孕，或是知道某個人懷孕了。

     皇后可能指出你在情緒或生理上出現問題，或是你正身處某個狀況，亟需無條件的深愛和照顧。這張牌跟照顧的過程有關，你可能跟你的母親或某個行同你母親的重要人物有關的問題，或是你的母親對你的照顧有問題。有時候這張牌指出一個「令人窒息的母親」。皇后這張牌非常適合用來思考照顧、婚姻承諾或生活優渥方面的問題，通常代表正面意義，而且道出喜悅的面向。

皇后牌義

     各種豐時。富饒、繁榮、物質享受、創造力、活動、個人成長。照顧自己或別人。社交成為問題。耽溺於性關係。希冀遇到更多好事。母性本能被換起。過渡到人生的另一階段。跟自然和土地之母有關係。

皇后對應的事愛與和諧的金星，是一個有力量的女性人物，亦跟古代的母神相連。在基督教傳統裡，她類似聖母瑪莉亞。由於金星象徵女神，皇后是大自然與人類孕育力，以及需要社會責任的主要標誌。

UNDERSTANDING THE MESSAGES OF YOUR JOINTS For the Prevention and Care of Joint Pain

UNDERSTANDING THE MESSAGES OF YOUR JOINTS
For the Prevention and Care of Joint Pain
Jean-Pierre Barral DO, MRO(F)

ALSO BY JEAN-PIERRE BARRAL
Understanding the Messages of Your Body (Albin Michel, 2005)
Visceral Manipulation (with Pierre Mercier)
Visceral Manipulation II
Trauma: An Osteopathic Approach (with Alain Croibier)
Urogentital Manipulation
The Thorax
Manual Thermal Evaluation
Manual Therapy for the Peripheral Nerves (with Aain Croibier)
Manual Therapy for the Cranial Nerves (with Alain Croibier)
Manual Therapy for the Prostate
Visceral Vascular Manipulation (with Alain Croibier)
New Manual Articular Approach; Upper Extremity (with Alain Croibier)
New Manual Articular Approach; Lower Extremity (with Alain Croibier)

ACKNOWLEDGEMENTS
This book is dedicated to all the patients who have advanced my understanding of human beings and their health problems.
Although I may have covered only a small bit of ground here, I will endeavor to continue the journey along this infinite road.

CONTENTS
Introduction
PART ONE: An Articulated Body and Its Emotions
1    An Articulated Body
          The Innate and the Acquired
          By Accidents?
2    Emotions for Life
          Emotion: Between Reason and Instinct
          The Body Has a Gift for Memory
          Some Wounds Are Visible, Some Less So

PART TWO: Why Do Joints Hurt?
3    Causes of Pain
         Traumatism
         Rheumatism
         Poor Diet
         Hormonal Imbalances
         In Relationship to Our Organs
         The Emotions
         An Energetic Problem

4    Trauma
           At the Origin of Trauma: the Accident
          Reactions t Trauma
          Post-traumatic "Scarring"
          Can Pain Be Revived?
          Can a Trauma Be Healed?
          Is Immediate Treatment Necessary After an Accidents?
          Accepting Pain

5    Rheumatisms
         Arthrosis
         Arthritis
         Osteoporosis
         Medical Progress

6   Connections Between Joints and Organs
         Referred Pain
         Our Organs Also Articulate One with the Other 

PART THREE:  Messaes from Our Joints
7   The Ankle and Foot
         Function
         In Relationship to Our Organs
         What the Feet Represent
         Attitudes
         Foot and Ankle Problems
        Advice

8   The Knees
        Functions
        The Knees in Relationship to Organs
        What Knees Represent
        Knee Problems
        Advice

9   The Pelvis and Hips
        The Pelvis
        The Hips
        Hip and Pelvis Problems
        Advice

10 The Vertebral Column
        What It Represents
        Relationship with Our Organs
        Back Complaints
        Advice

11 Lumbar Column: Sacrum and Coccyx
       What the Lumbar Column Represents
       What the Sacrum Represents
       What the Coccyx Represents
       Coccyx Problems
       Advice for Backache
       Exercise

12 The Thoracic Column and the Thorax
       The Thoracic Column
       The Thorax
       What the Thoracic Spine Represents
       What the Thorax Represent
       Relationship Between the Thorax and Our organs
       Thoracic and Upper Back Problems
       Advice

13 The Cervical Column
       What It Represents
        Neck Problem
        Relationship with Our Organs
        Advice

14 The Shoulder
        What It Represents
        Relationship with Our Organs
        Shoulder Complaints
        Advice
        Exercise

15 The Elbow
        What It Represents
         Relationship with Our Organs
         Elbow Problems
        Advice

16 The Hand and Wrist
        What It Represents
         Relationship with Our Organs
         Wrist Problems
         Hand Problems

17 The Cranium and Jaw
         The Cranium
         What It Represents
          Cranial Problems
          Relationship with Our Organs
          Cranial Osteopathy
          The Jaw
          What It Represents                  
          Relationship with Our Organs
          Jaw problems
          Advice

PART FOUR: Taking Care of Yourself
18 When Pain Arises
          The Onset of Pain
          Listen to Pain
          Interpreting Symptoms
          Manual Therapies
          Basic Advice in Choosing a Therapist

19 To Be Lucid and to Remain So
          Be Aware of Limitations
          Be Aware of Your Fears
          Be Aware of Weaknesses

20 Eating Well
         Drink Water!
         Eat with Pleasure
         Is There an Eating Regimen Ideally Suited to joint Problems?
         A Healthful Diet
         Illnesses Have Their Foods
         Medicinal Foods
         Watch Your Weight
         Is There a Solution?

21 A Healthful Way of life
         Move and Practice a Physical Activity
         Pay Attention to Potbelly
         Sleep Well
         Have Your Vision Checked
         Breathe Well
         To Be Avoided

22 Stand Up Straight
        Good Posture
        Positions to Avoid
        Allow your Head and Body to live Together
        Service your Body

23 Natural Care
        Home Remedies

Conclusion
Glossary

Introduction~
     In Understanding the Messages of Your Body.  I explored the relationship between our organs and our emotions.  In this new book I share more of what I have learned in the course of more than forty years of osteopathic practice.  Observations about human nature are interwoven with a theoretical and practical understanding of structure and physiology.

     The workings of the body and spirit are closely and permanently linked.  Emontions, organs, and joints are interconnected.  They communicate with each other, and their messages can carry rich meaning.

     It is important to give some thought to the significance of pain and to understand that our weak points merit attention.   In these pages I will help you to interpret the messages of your joints.

• What are the possible meanings of joint pain?
• Are they entirely random?
• What do they express about our attitudes, postures, and general way of going about life?
• What can we do to prevent joint pain, and how can we treat it if it comes along?

     At the beginning of my career I was preoccupied with simply taking care of patients.  Over years of listening to people and their troubles, I began to turn my attention moore and more to the interrelationshps involved in the fascinating human machine.  I found that appreciating a person's pain in the global perspective of his ife provides much more effective help.

     People do not become therapists by chance.  Within every one of them is an urge to discover the mysteries of the human being.  Along with that is perhaps an inclination toward self-discovery.  Integrating psychological and philosophical aspects into physical care in order to decipher the profound causes of pan takes a lifetime.  It is a legitimate approach worth undertaking.  The road is long, and step-by-step perseverance is required.

     In reading this book, do not be surprised to encounter hypothetical formulas such as "a trauma can produce..." or "a treatment can result in......"  While these are meant to be helpful, they are sometimes contestable, as nothing is sure in medicine.  A treatment that might prove highly effective for one person may have no discernible effect on another.  Medicine is more of an art than a science, and this is particularly true of manual medicine.  That is why it is important to remain humble in the presence of a patient in pain and to ask questions.  This in itself is a sign that we are listening to the individual and taking in his situation.

     All of the examples I use are real cases.   Only the names have been changed to respect patient confidentiality.

PART ONE~
An Articulated Body and Its Emotions

1~   An Articulated Body

     The human body is a complex construction: a subtle, overlapping arrangement of systems in immediate and constant relationship.  Communication is interconnected thanks to the brain, which receives, processes, and transmits information between various elements.  The body is organized around a bony framework set on permanent alert.  Joints are a key part of this structure; without them we would not be able to move and live normally.  Movement involves joints functioning in an automatic sequence managed by the cerebellum, the part of the brain involved in coordination, posture, and balance.  Continual mechanical work of the skeleton can cause restriction of joint motion, aches and pains due to trauma and the passage of time, or to other factors that I will touch upon.

     Anatomical study reveals the numerous postural and positional changes that humans have undergone in the course of evolution.  Our skeleton, muscles, and ligaments have slowly transformed.  Man began as a cell.  Over a span of several million years that cell became a fish, then a reptile, then a bird, then a monkey, and so on.  While many questions remain and will persist about the process, anatomical variations testify to evolutionary change over time.  Since becoming a biped, man has found himself in a constant search for balance.

     Just imagine the process of Homo erectus becoming "vertical!""The species must have lacked any confidence.  Like an infant of today, walking had to be learned.

     For smooth movement and to maintain equilibrium, the human being relies on his sense of proprioception.  Proprioception is the inner awareness of movement and spatial information arising from muscles and joints.

     Sensory receptors allow position and location of information to be relayed between the muscles, joints, and the brain.  Nerve receptors located in the tissues inform the cerebellum, which analyzes the incoming data and sends our commands without delay:  This provides for the coordination of gestures and movements.

     As I described in Understanding the Messages of Your Body, our frame (the skeleton and its joints) also has its weak points.  These areas tend to bear the brunt of trauma, natural wear and tear, and poor posture.

     It is not uncommon to hear complaints about one particular joint or another.  People say things likes, "I have weak ankles," or "I have delicate intestines," or even "I always have pain on the same side."

     These expressions convey the burden that these weak points can put on our day-to-day existence.  They also emphasize the importance of our joints in daily activity.

The Innate and the Acquired

     

     Our individual constitution and joints are partly innate and partly acquired.

     Like begins well before birth.  The fetus is a living being, and the line between the innate and the acquired is far from clear.  For example, in the case of a mother who experience psychological complications during pregnancy, these events inevitably reverberate to the fetus.

     How then do we differentiate between the innate and the acquired in an infant who was troubled in utero?

     The importance of the innate is easily seen in families by observing siblings.  Children who have theoretically received the same education and nourishment are nevertheless quite different.

Innate Factors

     Innate qualities are the strengths and weaknesses that we receive at birth:

• genetics: that which comes from our ancestors.  Each of us is endowed with a relatively robust or weak constitution together with an individual form and structure that are dependent on our gencetic inheritance.
• congenital factors: repercussions of life in utero, in birth, and in delivery.

     Poor fetal position can weaken a side or a part of the body.  Malnutrition or the psychological environment of the mother during pregnancy can result in the development of scoliosis, kyphosis, bowleg, or knock-knee.

Acquired Factors

     Acquired factors are everything that comes along and marks us in the course of life.

• the family and social environment that guides our behavior through the active and passive messages of upbringing and education.
• the cultural and geographical milieu in which we live.  (A mountain dweller, for example, acquires a different constitution than someone raised in a city.)
• dietary habits that affect the physiological balance of bones, ligaments, and tendons.
• sports, particularly intensive sports, which place greater demand on some joints over others and involve certain activities that carry accident risk.
• daily habits and working posture.
• lifestyle the body may be subject to.
• visceral problems that can influence joint balance and stability.
• emotional shocks and psychological difficulties that tend to land on the body's weak points.  One such vulnerable place certainly can be a joint.

     Physiological age retraces the life experience of each individual and reflects what he has made of his body.  This physiological age can be very different from a person's chronological age.  One can be surprised by the physical differences between two people of the same age.  The innate and the acquired influence our behavior and attitudes.

     There can be times when life throws us so off-kilter that we might collapse, rise up, or even go into survival mode.  Somehow our behavior is automatically altered, and our normal bearing is either exacerbated or diminished.  The resulting conflicts n our body schema (the collection of processes that registers the posture of one's body parts in space) very often weakens the joints.

     Joints are dependent on the general functioning of the body:  its mechanical workings, any functional disturbances, and its ability to compensate and adapt.  It is easy to understand that a young Alpine dweller growing up as a skier in a family of mountaineers is at greater risk of spraining his knee than is an urban student who spends most of his time at the computer.  It also is conceivable that the computer science student can suffer neck pain from learning into the computer screen for hours on end.  If the student adds stress and poor diet to the mix, his problems surely will be amplified.

By Accident?

     Our acquired experience is not purely a game of chance (from the Arabic a-zahr, game of dice).  Rather, the acquired can be seen as a succession of events that do not play out like a roll of the dice but are somewhat orchestrated.  This being said, it is best to avoid trying to find an explanation for everything.  After all, there is best to avoid that outright escapes us or is unrecognized.

     While every trauma might be attributed to had luck, why not endeavor instead to find a glimmer of a deeper explanation?  This might help you to better understand your body and to take better care of its equilibrium, Consider, for example:

• Why did I have a third bike accident?
• Why do I have this recurrent neck muscle spasm?
• Why do I have this tendency to fall on my hands?
• Why am I developing tendonitis?
• Why do I have severe, deforming polyarthritis?

Could these be:

• warning signs of other functional disturbances?
•  alerting us to pay better attention?
• an unconscious revelation of ancestral or familial fears?
• the conflicting desire to refuse or to let go of something or someone?
• the response to a challenge to show your know-how or to prove your existence?
• a sign that you are not on the right path?
• a signal from your body to take better care of yourself or get more rest?
• an SOS, a final warning, urging you to change your diet, limit alcohol consumption, or alter your way of life?

     Some people remain deaf and blind to these harbingers of imminent declining health.  Often they are afraid of the harsh reality that they must change their habits.  It sometimes can be false bravado.  In this case it is useless to force a person to be more moderate.  He will not listen.

     Weigh your words carefully and send small subliminal message.  Be so diplomatic that they might have the impression that they came to a new conclusion themselves.

2~   Emotions for Life

     Emotion expresses itself.  It is written on a face as eyes light up for joy or a mouth gapes in astonishment.  It appears on the skin when we blush, go pale, or get goose bumps.  It is played out in gestures as we raise our hands to our face in dread.

     Depending on our education and the social setting in which we were raised, our emotions become suppressed and internalized to a greater or lesser degree.  While the person who manages to hide his entire emotional register is very strong indeed, he will find such a feat to be a grave error for his psychic equilibrium.  Still, we are not all the same when it comes to emotion.  We have not all been formed in the same school to react to events in a particular way.

Emotion: Between Reason and Instinct

     To some degree the physical mechanisms linked to emotions are under our control. For example, by breathing deeply we can relax our muscles and cardiac rhythm.

     It s only through observing and attempting to understand the expression of our emotion that we can better mange----or at least aspire to have some thoughtful control over----our instinctual drives.  This attitude does not come naturally; it requires considerable practice!  We cannot do away wit emotion entirely; however, it is best to avoid emotional excess.  The solution rests within.  Methods to help us maintain physical and mental well-being are numerous (see P.151).  Each of us arrives at our own nuanced results, as we all deal with emotion so differently.

Emotional Quotient
     IQ (intelligence quotient) was considered for a long time to be the only standard measure of intelligence.  EQ (emotional quotient) has been added to our current understanding of a new intelligence.

     Two people of equal IQ, and capable in theory of understanding and solving the identical problem, do not make the same decisions because their emotional reactions are different.  Why?  Very simply, we are not robots.  Each of us is endowed with his own complex emotionalism----the way he identifies, assesses, and harnesses emotions, even negative in making decisions.
 
     At the extreme, emotionalism can be either too impulsive or overly restrained by education.  Depending on the degree of awakening, emotion helps a person to advance, remain at a standstill, or, worse, to regress. 

   
     Antonio Damasio, an American neurologist, researcher, and internationally, recognized specialist in emotions, maintains that our intellectual and moral judgments are determined by our emotions and that sentiment arises from the awareness of certain emotions.  This implies that emotions precede and are independent from reason.  When circumstances provoke an intense emotional reaction, rare is he who manages to keep control.  Whenever our deep emotional nature manifests, it is the innate that is revealed.

Emotion: the Cement of Our Makeup

     It is said that experience molds character.  More accurately, it is the emotions accumulated over the course of a lifetime that make up the personality.  Painful experiences are sometimes described as trials or tests.  Confronted with the same challenge, two individuals often react and evolve differently.  Unconsciously, deep emotions direct the game and its outcome, as the following example illustrates.

     two brother lose their mother at the ages of twelve and fourteen.  They are brought up by their father who remarries.  Twenty years later, the eldest is married and father to a young child.  He thinks positively of the infant's future.  The second son is celibate and sickly.  he complains of various aches and pains, maintains a strong sense of injustice, and holds a severe grudge against life.  At birth, the two boys possessed different psychic aptitudes.  "My little ones did no have the same character," their father said.  "Astonishingly, when their mother died, the more indolent boy reacted combatively, and the one who had appeared so willful collapsed."

     How is it that behaviors alter so much, even in children so young?  It is said that by age seven the personality is largely determined, and parental education ends.  The preadolescent adds to his genetic inheritance the educational and moral values necessary to refine his already very personal emotional nature.

A Four-Level Pyramid
     An individual can be seen as constructed in four levels:

• the deep self,, which is the innate being and the future promise.
• the family, which develops feelings and disposition, shapes character, and instills precepts and values.
• the society into which the person must become integrated through his complement of initiations and difficulties to be faced.
• the individual himself who is formed by the symbiosis of the innate and the acquired.

     The sum total our life experiences--the combination of the inborn and the collected--is inscribed in the body as if on a recording device, complete with images and sound.  For example, at the moment of an accident, the shock of the event is preserved with all of its pain and emotion.  Time passes and the event seems to have been forgotten.  However, as soon as a similar stress occurs, the past and present become reconnected, reviving old fears that were in the repositories of memory.

     One of my patients had a bicycle accident when a dog jumped out in front of her.  She jammed on her brakes, which locked her wheel, throwing her forward onto the road.  At the same moment she heard the loud noise of a truck coming up just behind her.  Having no idea exactly where she had landed, her great fear was to be run over.  As it happened, the truck passed her by.  She suffered a jaw fracture and neck sprain.  Sometime later I treated her for persistent headache.  She could not imagine that her headaches could be linked not just to the mechanical problems but also to the memory of cervical vertebrae.  On the other hand, she confided that whenever she was on her bike and heard a truck coming, she became paralyzed to the point of falling in the ditch.

Fear had left a more lasting impression than pain did.

The Body Has a Gift for Memory

     We know that the body keeps the memory of shocks, be they physical or emotional.  Physical shocks are direct.  They cause harm, and the body reacts to the immediate pain they bring on.  The brain registers all physical and emotional suffering together and at the very same time.  Everything is written in our physical and psychic unconscious:

• genetics: diabetes, allergies, psoriasis, asthma, autoimmune disorder
• fetal life: deficiencies, infection, malformation, mechanical constraint in utero
• vaccinations: some can trigger allergic reactional in sensitive people
• infections: contracted during life
• physical trauma: falls, fractures, sprains, surgical intervention, accidents
• psychoemotional trauma: linked to family, education, friends, partners (divorce, separation, aggression, etc.)
• social trauma: unemployment, insecurity, socio-professional problems

     Shocks invariable leave their mark.  Negative emotional disturbances such as fear, stress, frustration, anger, condemnation, and guilt all transit though the brain, which in turn discharges the stress wherever it can.  The where the burning hot item is hastily passed to a neighbor.  The brain does the same thing with information.  Emotions that register as excessive or inadequate come knocking on our joints.  Depending on the force of the shock, our defenses can hold, be shaken up, or fail.

Some Wounds Are Visible, Some Less So

     The unconscious is capable of recording an accident in as little as one two thousandths of a second.  Immediately after an impact, physical wounds can be seen, felt, and cared for.  However, accompanying fear is dispatched from the brain to the joints along a route that is beyond our control.

     Following its own itinerary, fear permeates the unconscious with the slightest of ambient recollections for an event: every smell, sound, movement, agitation, or immobility; sometimes it is a heavy, cottony silence.  After an accident, the organism can develop a recurrent urinary or pulmonay infection.  Over time such infections can weaken an associated joint, making it susceptible to additional stress.  A joint has memory.  Emotion stored away can materialize as a new shock.

Tension Is Palpable

     The hand can feel physical and emotional tension.  A trained person--whether or not an osteopath--can easily find the physical weakness of strain or disease.  Placing no more than the weight of the hand on the body, the therapist will invariably be attracted in the direction of the problem area.  The mechanical attraction of the tissues pulls the hand toward it.  Tension loves the hand.  To feel emotional stress, manual touch must be extremely light, just at the limit of losing contact.  Placed on the cranium, the hand is quite able to discern where the brain has stored the biggest emotional tensions.  The osteopathic metier is empirical.  For this reason, objective scientific experiments are best repeated in order not to go down the wrong road.

PART TWO~

Why Do Joints Hurt?

3~   Causes of Pain

     A joint is endowed with an elaborate and finely tuned nervous system.  Movement mechanisms are very subtle.  Walking, for example, requires that the joints of the lower and upper extremities, the vertebral column, the pelvis, and even the organs move at the same time.  In order for walking to be neither halting nor expending of excessive energy, these parts of the body must continuously and concomitantly exchange information with the brain.  When a joint suffers, its tremendous sensitivity automatically sends millions of negative impulses to the pain centers of the brain. 

     Joint pain has numerous origins.  I will present each one briefly before offering a more in-depth study in the chapters that follow.

Traumatism

     It is easy to understand how a fall, an accident, and acts of physical aggression in general can create joint problems.  Lesions can be cartilaginous, osseous, ligamentous, or muscular.  They can involve tears, brusies, edema, swelling, joint locking, bleeding, etc.  Keep in mind that a joint problem can arise far from the site of traumatic impact due to the "collision" force enerated by the shock when it hits the body.  This collision energy travels through and across the body before stopping at a location where it produces a sprain, fracture, or lesion that affects a bone or an organ.

Rheumatism

     Rheumatism is a term used for the pain associated with inflammatory or degenerative processes seen in the joints, muscles, and connective tissues.  Rheumatism is a favored topic in the over-sixty age group.  "My rheumatism is acting up" is a common social expression that reinforces the notion that rheumatism is just a fact of life the must be endured.  However, the rheumatoid variety of arthrosis can exist before any symptoms manifest, and it sometime comes on prematurely in the young.

Poor Diet

     Dietary habits affect joints indirectly.  Everything that the body has trouble eliminating gradually changes acidity levels.  Waste products created and accumulated by the organism have a tendency to land in the soft tissue surrounding joints.  Specifically:

• the joint capsule.  This protective envelope normally maintains a negative pressure, creating a sort of void that facilitates cartilage sliding.
• the synovial pouch.  The internal part of the capsule produces synovial fluid.  Synovial effusion causes swelling around the knee.  Synovial fluid is like oil to our joints.  In a car, low oil levels cause the motor to overheat.  Metal parts can twist and buckle to the point of breaking.  Similarly, if there is insufficient synovial lubricant in our joints, they overheart, swell, and stiffen up.

Hormonal Imbalances

     Joints are made up of bone and cartilage surrounded by a capsule, synovial fluid, ligaments, and muscles.  Thus constructed, they react to all that affects their environment.  The soft tissue surrouding joints is hormonesensitive.  Hormonal imbalances, which mainly affect women, can cause muscle and tendon problems as well as joint dysfunctions such as carpal tunnel syndrome, rhizarthrosis, and arthrosis of the hip.  An imbalance of estrogen and progesterone is usually implicated, as fluctuations surges during puberty can cause knee pain in young adolescent women.

     

     Menopausal estrogen/progesterone imbalances (usually the effect of deficient progesterone) cause the soft tissue surrounding the joints to become stiffer and "fibrosed," and thus painful.  Additionally, certain menopausal medications congest the venous and lymphatic systems, provoking cyclical pelvic pain accompanied by lumbago.

     "What I have is not complicated," Jeanne, 53, declared.  "All my joint hurt."  Palpating and mobilizing her shoulders, wrists, elbows, knees, and spine all triggered pain.  On the other hand, while movements were painful, they were still possible.

     Radiographs shwed nothing more than slight innocuous arthrosis.  Jeanne had not had a menstrual cycle in two years.  It is important to keep in mind that menopause is a process not limited to the last menstrual period.  Familiar effects can last from two to three years, sometimes longer.  These may include hot flashes, sweats, emotional ups and downs, as well as digestive, skin, and joint problems.  In Jeanne's case, it is useless to hope for results by manipulating the vertebral column and other joints.  It is necessary to work with the organs of the liver, intestines, kidneys, and uterus.  It also is important to give general recommendations such as taking up swimming and stretching, and consuming soy and citrus fruit. 

In Relationship to our Organs

     It generally can be said that any organs might be involved in joint pain should they have trouble carrying out their role of providing for the major functions of the body.  Nevertheless, in forty years of practice, I have observed that some organs have more influence than others (see page 56). 

The Emotions 

     Everything is related.  The human body is a complex mechanism of  interconnections and exchanges between systems: articular, nervous, endocrine, respiratory, vascular, digestive, genital, and more.  The brain is capable of receiving ten billion bits of information a second.  Cells depend on each as they harmoniously organize to ensure the homeostasis that is vital to all major functions.

    

     Cells also communicate with our emotional system.  The limbic system is that group of brain structures involved in memory and emotion.  It unites the olfactory pathways (small is very important in emotion), the amygdala, hippocampus, septum (partition), and the corpus callosum.  Note that the cerebellum is also a player in analyzing our emotions and the reactions they cause.  This part of the brain is involved in memory too.

     Short-term memory loss is common after trauma, especially what is known as "rabbit punch" impact (see p.122).  Suppose yo suffer from recurrent joint pain.  Such pain will send negative messages to your brain, which in turn will wake up other messages previously recorded and stored.  The brain has a propensity to store the negative.  People who suffer from insomnia are quite aware of this.  When we cannot sleep during the night, our thoughts are rarely positive.  We ruminate over intangible problems and conflicts that seem difficult, if not impossible, to resolve.

     Philippe found himself the victim of a seemingly mild car accident that triggered cervical pain.  Several days later he developed a stomachache.  Philippe saw no connection between the two.  Nevertheless, osteopathic questioning revealed a link.  The cervical pain reverberated to the area of the brain where the emotional shock of his parents' divorce lay dormant.  They family breakup had caused a stomach ulcer.  This point on the stomach became his "weak point."

     In its desire to rid itself of accumulated negative messages, the brain discharges the stress.  It does this by using in reverse the same nerve pathways by which the trauma reached the brain, even if this amplifies the neck pain.  The old stomachache wakes up, and  a depressive emotional phase is initiated.  The fact that emotions generate physical pain is no longer in doubt.  We have all experienced it.

     The body cannot be dissociated from spirit and emotion.  They are totally interdependent  Modern man has invented nothing new as to emotion.  The closest we have come is to develop scanners able to detect areas of the brain that are stimulated and activated by emotion and information receptor sites.

     Emotions cause the body to react in a way that has important repercussions for health.  We know how much stress, anger, anxiety, and depression can harm our organisms.  Before symptoms worsen and cause physical deterioration or a weakened immune system, it is preferable to find antidotes other than medications.  Emotional support will someday be established within the  scope of  practice of therapists who deal with physical pain.  Doctors increasingly find themselves integrating emotional factors in the practice of medicine at the behest of their patients.

     As described above, our entire emotional experience is stored in the limbic system of our brain.  In my earlier book, Understanding the Messages of Your Body, I explained the brain as being like any other organ in its effort to rid itself of emotional tension.

     When we live through painful, dangerous, or conflicting situations, every brain cell reacts to the emotional upheaval.  These very real experiences enter the realm of the unconscious, where they lie dormant unless and until the slightest emotional stimulation might awaken them.

     At the age of seven Sophie was violently awakened by a thunderstorm.  Alone in her room, she was terribly afraid.  Her parents were not near; they were playing cards at the neighbors.  Her terror of thunderstorms continued in the from of nightmares up to age eighteen.  Around age forty she found herself riding home on a bike when a thunderstorm struck.  Heavy rain caused her bike to skid on the wet road.  She fell and hurt her knees and hands.  Once she picked herself up, she was seized with panic.  The memory of the stormy childhood night came rushing back.  From then on a double connection was established:  Whenever her knees hurt, even with mild swelling, she experienced fear.   Knee pain became forever linked to her cerebral fear centers.

     Having her knee treated was enough to eliminate part of the viscous knee-pain cycle.  She had no wish to consult a psychologist since her condition had become more or less tolerable.

     We often interpret messages from our bodies as a funcion of our knowledge, which is inevitable limited and culturally adapted.  The brain is an extremely mysterious organ.  Nobody can explain how this physical mass is able to think, or where and how it forms thoughts.  The brain trades in billions of pieces of information in a manner still far from our comprehension.  Weh the brain receives a stress, it stores it away in a small corner.  The brain is in continuous communication with the body, receiving and emitting information.  Messages are sent out to all parts of the body, including the organs and joints.

     Our joint system reacts to physical aggression as well as the discharge of nerve impulses coming from the brain.  Feeling emotionally ill at ease can trigger digestive problems such as stomach trouble, or it can set off joint pain.  The pain can be in a joint that suffered in the past, or t can be a new problem arising from emotional behavior or posture, like slouching.  In manual therapy it is important that we avoid thinking of joint pain as being invariably mechanical.

An Energetic Problem

     To carry  out its function, the organism uses energy from food we eat, air we breathe, our genetic inheritance, the electromagnetic field, energy from the brain, and doubtless innumerable unknown factors.  Our muscles and joints require energy to work.  In times of illness, significant fatigue, organ dysfunction, worry, or exposure to an area of electromagnetic disturbance, we can feel the effects and repercussions in our joint system.  A sprain, inflammation, or locked joint can show up as a consequence of a drop in energy.

     To regain lost energy it is advisable that we sleep more, avoid overeating in the evening, take suitable homeopathic remedies, and drink chamomile tea.  We easily can become mentally fatigued and not tired enough physically.  To counter this, you may consider walking home briskly from work and taking some time to yourself to listen to music rather than the continuous and frequently negative news cycle.

4~   Trauma 創傷

At the Origin of Trauma: the Accident

創傷的起源：意外事故

    An accident results from a conjunction of events, some of them beyond our control, others more foreseeable.  It is difficult to rationalize the role of destiny--that supposed supernatural force that predetermines the course of events.  How do we explain the coincidences that produce an accident at any given moment?

A Series of Factors

     In the most extreme cases, a sequence of events can upend two lives in one drama.

     Two cars set off on the same route at the same time--one from Dijon to Valence and the other from Valence to Dijon.  Before the journeys begin, we can predict that the drivers will pass each other at some unknown point.  Millions of cars driving from Dijon, fell asleep at the wheel.  At this hour there was no traffic on the road other than Pierre's car coming from the opposite direction.  A terrible fatality occurred as Gerard's car crashed into Pierre's car.  Pierre had no chance either to swerve out of the way or to accelerate.  He was killed instantly.

     Had the cars been two meters or a few seconds closer, the accident would not have happened.  Pierre would have escaped death.  However, from birth to the moment of tragedy, these two lives were unconsciously arranged to meet.  When fate is less cruel, we tend to call it luck or good fortune.  The encounter is imagined as the result of random circumstances--an event that might nt have happened if a few meters or seconds had intervened.

     It is possible to scroll down a parade of events leading to a meeting.  For example, the birth of two people is programmed by the birth of their parents and their grandparents, and so on.

Preoccupation, Carelessness, or Joint Weakness?

     In daily life we are confronted with all manner of risks and twists of fate.  How we react depends on our strengths and weaknesses.

     Alain dislocated his shoulder by falling into an empty swimming pool that he had been spring.  "He was lucky.  It could have been a lot worse," those around him said.  Alain explained how he slipped on the ledge of the pool rim.  Wet leaves caused him to lose his footing.  But why, you might ask, did he not see them and avoid this hazard?  The fact was he found this chore to be a burden.  When his friends remarked, "This was bound to happen.  You are careless," or "You should pay better attention.  You know you often lose your balance,"  he invariably replied, "In fact, I find cleaning the pool tedious.  Personally,  I loathe swimming.  I do it for the family."

     When we do something reluctantly, we unconsciously put ourselves in danger.

Preoccupation

     Jean tore his cruciate ligaments when he sprained his knee by missing a step.  He had been running late and was by a dossier he had a hard time completing.  He finished the file just twenty minutes before leaving the house, not long after the concierge had washed the stairs.  The concierge had taken time to place a small notice to be careful on the landing.  But Jean had failed to see the sign.  "It happened stupidly, and I fell on the same knee that had been bothering me for several months," he said.  However, his wife chimed in with,  "You had no business going down the stairs while reading that document you were so absorbed in."

     From the therapist's point of view, it is no by chance that the torn ligament was on the right knee.  Jean is right-handed, meaning he automatically leads with his right leg and naturally places more demand on it.  This is the leg he relies on to keep his balance.  However, this is only part of the  explanation.  His brain and cerebellum, which should have been vigilant, were instead focused on the dossier and unable to correctly analyze the data coming to them from his feet.

A Rupture of Perimeter Protection

     Around our bodies there is an invisible perimeter of security that protects s and prevents intrusions.  Physiologically our joints are defended by ligaments, cartilage, fat, muscles, fascia (muscle envelopes), and skin.  We instinctively define a personal space between ourselves and others.  In doing so we establish an enclosure of protection against malevolence, be it physical, material, psychic, or emotional.  Our mental state is conditioned by this protection.  Normally we allow nothing past this perimeter, whether a being, an object, a thought, or feeling.  Should this occur against our will, this unacceptable violation of our "body" territory is experienced as aggression, provoking fear and suffering.  We become alarmed.

     Traumas are attacks our perimeter protection.  The body is unable to defend itself against transgression.  The shield is broken.  Our defenses are blunted.

A Disturbed Electromagnetic Field

     Research conducted with engineering equipment demonstrates that this safety enclosure, or circle of vigilance, largely corresponds to the electromagnetic field that surrounds us.  This physical field is a combination of wavelengths--infrared, ultrasound, high frequency, radio waves, etc.----that is conducted especially from our brain and skin.  Globally the electric and magnetic fields extend from the earth's core and are what move the needle of the compass, for example.  Man is sensitive to these subtle, tiny waves produced at the center of the earth.

     Humans are sensitive as well to sources in the everyday environment----electric appliances, radio and television antennas, computers, cell phones, microwaves, etc.----that interfere with and influence our organisms.  These effects probably are not beneficial, as they disturb both our own and the earth's electromagnetic fields.  While the electromagnetic charge carried over electrical power lines is clearly marked and well defined, others flow in every direction, penetrating our bodies without our knowledge.

     As demonstrated by Michael Faraday in 1831, an electromagnetic field produces electric current.  The human body is a conductive material that exists in the midst of this electric current.  The nerve impulses that run through the brain and nerves are electric currents.  These impulses are propagated at such tremendous speed that the brain s instantaneously informed about what is happening in the body.  This is how we are able to make corrections in our movements or to the organism as a whole.  It is the electromagnetic field that alerts us to the presence of another entity, even before seeing it.  It allows us to detect positive or negative zones where we feel good or relatively less so, either in a given geographical location or in the company of a particular person.  It is through this awareness that we find ourselves spontaneously on the defensive or welcoming of an individual.

     We all have had the experience of feeling particularly well in certain rooms of a house--even more precisely, in particular areas of a room.  Take family members for example.  Each person generally will sit at the same place at the dinner table every night.  None are pleased if somebody else takes their chair!  Perhaps this unconscious arrangement depends on individual electromagnetic fields that organize and arrange us.  Perhaps we are allocated positions according to the spacing ascribed by those around us.

     If a stranger touches you, your first reaction is to think of danger.  Imagine a projectile, even something miniscule, suddenly thrown in someone's direction.  Just being aimed at, let alone hit, is interpreted as an act of aggression and a violation of one's protective ring.

     Did you know that when a bone fractures there is an immediate break in the continuity of the brain's electromagnetic field?  This interruption enables the brain to know exactly where the fracture is located, thus initiating the scarring and consolidating processes.  Granted, it is not possible to formally prove that electromagnetic waves have a direct effect on our joints.  Yet we could say the same of the effects of food!  Still, we know that poor health is the result of various factors: mechanical, digestive, hormonal, immune, psychological, emotional, and electromagnetic.  I will demonstrate later in the book that, when it comes to the vertebral column, the electromagnetic field has an indirect influence on our lumbar discs.

Reactions to Trauma

Immediate Reactions 

    With a fall or major blow there is pain, but are we really conscious of it?  Very curiously or organisms perceive small injuries more forcefully and immediately than they do serious injuries.  Think of the immediate pain caused by a burned or pinched finger.  Serious trauma, on the other hand, leaves us "in shock."  For a few moments we are dazed, in a trance.  When we come to our senses and pick ourselves up, we realize what just happened.  Often we forget the pain caused by the trauma.  It is as if the body is anesthetized and the brain disconnected.

Delayed Reactions

     Sometime after the trauma, consciousness awakens little by little and pain arrives n proportion to the trauma (bruise, hematoma, sprain, fracture, or ligament tear).  This delayed reaction can occur several hours or even days later.  Sometimes it can take months to accept the reality of an accident because the unconscious refuses to do so.  This refusal creates significant psychological tension that reverberates over the whole body----sometimes at the joints particularly.

     Anne and her granddaughter Lucie were in a car accident.  The car rolled over several times.  Lucie sustained cranial trauma with loss of consciousness.  Anne had a lot of bruising and a broken leg.  As long as her granddaughter remained in a coma, Anne experienced no pain and complained of nothing.  As soon as Lucie regained consciousness, her grandmother started to feel her own injuries. Curiously, she began by experiencing shoulder pain, even though other parts of her body were more injured.

     Amazing, you may say.  Not really if you consider that Anne's brain was so powerfully focused on Lucie's well-being that it obscured the information coming from her own body.  Of course she felt guilty.  Lucie's condition put everything else in the shade, as it were.  Once awakened, Anne's pain was referred to her left shoulder, which it turned out had been injured some years previously but without much aftereffect.  It seems that with the car accident the rain chose the weak point of the shoulder as an outlet for stress.

Here is another example:
     Marie was a victim in a serious car accident.  It entailed several rib fractures, a broken arm, and a concussion.  Immediately after the accident, when any of her friends asked, "How do you feel?"  she invariably replied that everything was fine and that it was no big deal.  Her positive way of seeing the situation quite amazed her friends who had thought of her as fragile.  They marveled at her strength.  Several months later, however, Marie became sad, depressed, and lost al motivation.  She began tirelessly repeating to whoever would listen that she nearly died in the accident.  The fear, too long repressed, suddenly broke through and engulfed her.  Since that cascading moment, her joint pain, which had become bearable, had become intolerable.

     Pain is an individual experience that can appear quite out of proportion to the trauma sustained.  Neither is it always commensurate to the seriousness of the injury.  A sprain can hurt more than a fracture.  Whatever degree of pain we feel, it is inscribed physically and psychically in our bodies and our brains.  Pain is both a signal calling for urgent care and a demand for protection.

The Cumulative Effects of Trauma

     Our bodily hard drive has a prodigious memory.  Nothing is forgotten.  A lifetime of traumas accumulates and can reappear at random with incredible force.  With this in mind, you should never neglect any shock or trauma.  Do not hesitate to consult an osteopath, physiotherapist, or other practitioner of manual medicine.  Just because an X-ray reveals nothing doesn't mean all is well.

 Emotional Resonances of Trauma

     A trauma can arouse old psychological issues.  By the same token, a troubling psychological event can have repercussions for a joint.  We never know which part of the body the brain will discharge its message onto.

     At age twelve, Florence landed in a curious state of depression following a knee injury.  Everyone reassured her, saying, "Don't worry.  It is nothing serious.  You will be back together in no time."  Physical evaluation revealed nothing serious.  She was referred to a psychotherapist who discovered in Florence a dread of familial instability.  Her parents argued continuously and often threatened to leave each other.  Florence was going through puberty with all its normal physiological changes.  The emotional disturbances crystallized on her weakened knee.

     Why the knee?  Two reasons:  The knee shares some nerves with the genital system, and the knee is the key joint of instability.  Psychological tension, together with hormonal imbalance, was reason enough for Florence's knee flare-up.  Psychological treatment and the end of puberty permitted Florence to resolve  her problem.

     The inescapable end of puberty makes me think of a phrase attributed to Jean Cocteau: "Youth is an illness easily cured."  He is not alluding to the psychological factors that accompany youth, but only to the time that passes so quickly!

     Around the age of fifty, Catherine live through an extremely difficult moment in her married life.  Separation seemed inevitable.  Once separated, she developed incapacitating lumbago that sometimes obliged her to lie down for several hours a day.

     While the words "lying down is not standing" states the obvious, the message couldn't be more clear.  Catherine's backache conveyed the fact that she was not able to cope with the separation and accompanying insecurity that she inevitably would have to face.  The lumbar vertebrae represented her state of balance and rootedness.  Staying in bed showed a refusal to accept reality  The separation had created a psychic state of deep insecurity which, in turn, caused spasm of the lumbar muscles.

Pains have their echo.

Post-traumatic "Scarring"

     Even if an accident is not caused by others, and no cuts or bleeding are involved, the event automatically ruptures an individual's physical and psychic perimeter protection.  This break is due to fear and aggression.  Trauma generates negative energy.  Shockwaves travel through the body until they reach the weak link in the organism, the place where they have the best chance of provoking a lesion.  If the injury is well treated, we feel no lasting, obvious effect.  On the other hand, we must be alert if a second trauma comes along.  There is always a risk that the preceding injury might resurface in an unexpected physical or psychological form.

     A good therapist can reduce pain and restore a measure of equilibrium to the weak point in the body, but he cannot guarantee the length of time healing will take.  One never entirely recovers from an attack, accident, or trauma.  One adapts and compensates.  The consequences of an accident are never necessarily fully discharged.  The underlying pain can always be revived.  The feeling of insecurity induced by the accident remains latent to some degree or another.  Even if we have no apparent aftereffects, the incident forever marks our spirit and neurons.

     Scarring is every bit as emotional as it is physical.  It is difficult to accept a fate such as an accident, not to mention come to terms with all the conditions leading up to it.  Every effort must be made toward psychic as well as physical restructuring.  Physiologically a sprain, a torn ligament, or any other joint lesion alters the surrounding tissues.  Repeated trauma to the same joint leads to degenerative arthrotic changes.  The fear and stress generated by the accident are added to the emotional stresses we have lived through previously.  Sometimes there is no clear relationship between events, but most of us know the phrase "the straw that broke the camel's back."  Accidental repercussions can be very damaging and create real depression in some people.

     Odile had three car accidents in a row, all involving whiplash.  She suffered from cervicobrachial neuralgia, known colloquially as sciatica of the arm.  As time went by, bone spurs (also referred to as parrot beak or osteophytes) developed on the margins of her cervical vertebra.  She complained of frequent headache, unfamiliar stomach problems, and back pain.  The lesional patterns followed by the successive traumas may have projected onto any number of joints and organs.

     Odile was not at fault in any of the accidents.  All of the impacts had come from behind.  As such, the insurance company had sided with her.  But three accidents s a lot!  She never ceased repeating, "What is it about me that I had these accidents?  It was not on purpose."

     Eventually, after finding no objective explanation for these "inopportune collisions," she decided to travel by train.  Even then she would say, "I hope I will not derail the train!"  She had adopted an avoidance attitude and kept a certain superstition in her heart.  "I feel more vulnerable, and I have a hard time coping with this feeling of insecurity," she admitted.  Odile was not able to put the idea of a curse out of her mind, on top of which she had marital problems.

Can Pain Be Revived?

     Try to remember a physical pain and it is nearly impossible.  You might say, "It was excruciatingly, horribly painful."  You can attempt to re-experience the time it happened, but you never quite manage to mentally reconstruct the pain.

     The brain memorizes physical pain but cannot revive it.  You would more easily reproduce a color, flavor, or depressed mood, as the brain retains an infinite number of things at the moment of trauma.

     When the passage of time, events come back and are progressively organized.  We are able to recompose the event with astonishing precision: the place, weather, noises, smells, movements around us, the people who were there, help that arrived, and what was going through our minds at the time.

     Once the pain subsides and joint is repaired, the "inscribed memory" of the trauma can sometimes alter our comportment.  Our body tends to adopt a defensive or withdrawn bearing.  This compensatory posture is harmful to joint equilibrium.  It is important to monitor these attitude changes that occur following trauma, as they often can cause pain to arise in other nerve centers in the joint system.  In the long run, poor posture wears out the joint system and weakens it.

Can a Trauma Be Healed?

      We never fully heal from trauma.  Injury is forever inscribed as an inescapable element of our physical and emotional existence.  It becomes part of our "curriculum vitae."  We can, however, avoid letting trauma endure in the form of major symptoms.

     Beyond obvious initial healing, restoration, and physical rehabilitation, trauma of any nature requires convalescence and psychological work.  We must try to understand why it happened and what it has changed in us, both the negative and the positive.

     Our perimeter protection was breached and trampled by the aggression sustained.  This is something we must accept as having happened as we rebalance our morale in addition to our physical selves.

     During the physical and psychological reconciliation phase, individual reactions can surprise us.   Those we though of as sturdy and strong can collapse in pain and become paralyzed with fear.  Others, whom we believed to be more fragile, outdo themselves at overcoming their handicap, oging beyond medical and self-imposed restrictions to show what they are capable of.

     Jean was the boss of construction company.  A born leader, he was always on the job and slept no more than four or five hours a night.  His workers considered him a "superman."  The body always has its limits, however.

     One day, Jean fell asleep at the wheel of his car and hit a tree.  Fortunately the airbags deplayed, cushioning the blow and its physical consequences.  Unfortunately, he event was a psyhological blow to Jean.

     Before the accident, things always seemed to go along just as they should without questions.  But now Jean began having doubts.  Making decisions became difficult.  He lost the indisputable confidence of a leader who had previously controlled next to everything.  His business continued to do well, but little by little competition began to gain market share.

     Jean consulted me for diffuse pains, but his main problem was that he become slightly unraveled.  He could not find his own self-image.  He had lost the former picture of a successful entrepreneur who understood risk and reward.  The accident had caused him to lose his social appearance of certitude.  He was not ready to confront any other more fragile and, to his mind, less acceptable aspect of his personality.  He did not wish to go to a psychotherapist.  "I am not crazy," he said, like so many proud and unyielding men.  He preferred to take any reflection alone, and in this he succeeded.  He worked less, tried to sleep better and longer, and tried to eat a balanced diet.  Even though he continued to have some shoulder pain, his life was better.  Above all, he was no longer a slave to his own self-image.

Paradoxically, an accident can be construed as a positive "encounter."  Following a knee sprain, with complications requiring long rehabilitation, a young athlete became interested in anatomy and biomechanics through contact with the physiotherapists who treated him.  Eventually he became a physiotherapist and specialized in sports injury, a field in which he excelled.  "I am passionate about my job,:" he liked to say.  "Without such a serious sprain, I certainly would never have been directed along this path, and I would have become somebody else entirely!"

     Some have a tendency to say that nothing is by chance.  This may be true, but the meeting of beings and events is surrounded in mystery.  We search for answers to try to make some sense of our lives.  Finding meaning in trauma should be part of any rehabilitation.  We should look for the root of the problem to understand the messages and emotional components involved in such abrupt meetings with our fragility and our mortality.  So many questions arise that are worth exploring after a trauma.  The idea is to work at the behavioral and psychological levels, with a goal to find the best individual therapeutic direction.

Is Immediate Treatment Necessary After an Accident?

     I am not referring here to violent accidents that create significant bodily injury for which hospitalization is vital for emergency care and a complete physical assessment.  In the case of less serious trauma, excepting fractures, hemorrhage, or visceral lesions, it is far from certain that immediate treatment is necessary.  The person is still dazed from the shock.  The "collisional" forces have not yet finished their deleterious work.  Pain and other symptoms generally intensify several days after an impact.

     Elodie fell from a wall, injuring her shoulder and neck.  Her friend advised her to see a practitioner immediately who "worked miracles,"  according to him.  The consultation happened on the same day.  After the treatent, Elodie did not feel too badly.

     During the night and following day, however, Elodie experienced sever pain.  Alarmed and worried, her friend called the practitioner who explained that such pains were a normal reaction and would disappear quickly.  Alas, this did not happen.  It took three weeks for Elodie to feel better.  She thought that the practitioner had not treated her correctly.  In fact, the therapist had simply treated the trauma too soon.  The pain had not yet completed its course.  It would have been better to let Elodie rest, with sedatives and pain medication.

Accepting Pain

     After an accident, the body tries first to integrate the traumatic forces and their emotional components.  It then allows the collision forces to make their way as far as the weak point, where they want to settle.  The patient must take the time to analyze the route that the trauma took through his body.  He must reflect on the effects and accept the waiting period of an appropriate recovery timetable, without frustration.  The stronger the trauma, the longer the acceptance time that must be allowed.

     Following trauma, athletes, for example, commonly pass through four phases:

• anger and frustration;
• reflection on the circumstances and reasons for the accident;
• acceptance of the waiting period for scarring to heal or rehabilitation to run is course;
• reflection on new ways to approach his discipline and his conduct in the sport (if still possible).

5~   Rheumatisms 風濕病

     "I have arthrosis."  How often I have heard this phrase in my office.  Arthrosis is not to be

                  關節病                          

confused with arthrits.

                        關節炎

Arthrosis 關節炎

     Arthrosis refers to any degenerative condition that causes local wear and tear at joint cartilages.  With time the disease can affect bone.  The affliction is brought on by age, repetitive strains, menopause, family tendencies, fractures, recurrent sprains, etc.  It is not inflammatory but rather mechanical in origin.

Cartilage

     When a joint is moving, cartilage friction is so negligible that it may be compared to a bar of soap gliding on wet marble.  With age, however, cartilage loses it smoothness.  Roughened cartilage provokes inflammation, particularly inflammation of the synovial sac, which responds to the irritation by secreting excess fluid.  Pain accompanies this inflammatory state.  With overuse, cartilage degrades and bone-on-bone joint play occurs.  These surfaces are neither made nor suited for gliding.  If this happens at the knee or hip, surgical intervention is inevitable sooner or later.

Parrot Beak or Osteophytes 鸚鵡喙或骨贅

     Parrot beak or bone spurs are bony projections that form along vertebral joint margins.  Calcified projections can form at the attachment of ligaments or small muscles.

     Osteophytes are not the cause but rather the consequence of joint damage.  These spurs are not necessarily painful, and they form naturally as a person ages.

A sign of Longevity

     Pain of mechanical origin is experienced during activity and can persist after physical strain.  It is relieved by rest and does not occur at night.  This type of joint stiffness is apparent upon waking, and it lessens during the course of the day.  People can have unbeknownst arthrosis that causes no pain.  This type of jint damage is three times more common in women than in men.  After age fifty it is natural that we all have some arthrosis.  Like any device, the "human machine" wears down.  Arthrosis is in itself indicative of a long life.

What to Do

     Keep in mind that arthrosis stiffens our joints.  To conserve good range of motion we must move, stretch, keep flexible, go to the gym, bike, swim (avoiding cold water), and reduce the consumption of dairy products to avoid waking up with a feeling of heavy joints.

A Beneficial Exercise

     If it is possible to install a bar in the house, suspension is an ideal excrcise.  Begin very slowly by first resting you feel on a stool or chair to lighten the weight of the body.  Progressively relax your shoulders, then push the stool away and maintain the stretching position for several seconds.  Suspending yourself too suddenly can damage the shoulder muscles and ligaments.

     It is equally important to pay attention to diet (refer to chapter 20).  Cervical arthrosis is specifically described in chapter 13.

Arthritis

     Arthritis refers to cartilage inflammation of infectious, immunological, or metabolic origin.  Unlike arthrosis, which results from mechanical wear, arthritis can affect even young people (juvenile arthritis).  It is characterized by spontaneous and theoretically random inflammatory episodes that are not attributable to any precise mechanical cause.  Arthritis can bring on acute or chronic joint pain that persists both at night and at rest.  During acute flare-ups the joint often swells and becomes rosy red and hot.

     Arthritis affects more women than men.  It is more common in Anglo-Sax-on and Scandinavian countries.  Cold and damp weather exacerbates it.  Over time, joints can become deformed.  While the reason for arthritis is not precisely known, it may be caused by many factors acting together.  It is thought to be partly genetic, environmental, stress-related, and the result of under activity, infection, or immune deficiency.  Diet certainly play a big role.

Deforming Rheumatoid Arthritis or Juvenile Chronic Polyarthritis

     Martine, a young, cheerful, motivated, and ambitious esthetician had just opened her own esthetics center.  She had long dreamed of creating her own business.  Having made it happen, she had every confidence in herself and her professional ability.  Since the day she opened her door, the appointment book was filled for days ahead.  Her clients said that she had "magic finger."  The only shadow on the horizon was that her financial obligations worried her.  She had never mastered accounting.  She wondered how she would ever manage to repay her bank loans.

     One morning Martne work up with numb fingers. Each day she felt her fingers retract and deform a bit more.  The rheumatologist she consulted diagnosed acute deforming rheumatoid arthritis.  "I have sorcerer's fingers,"  she said.  "This will not do in my practice."  She became dejected.

     Being courageous, however, Martine decided to take charge of her problem without resorting to medication.  Inflammation gradually spread from her hands and feet to encompass all the joints, including her jaw.  She was able to move only with great difficulty.  Her attitude was to make a mockery of her physical deformities, sometimes thinking of them as her friends, other times as enemies.  She was determined to thwart rather than become caught up in the spiral of fear she found in her body along the path of its weak points.

     Martine consulted many and various alternative health practitioners to help her with treatment and advice.  It would take six months for her to feel better, but better she did feel, apart from a few short flare-u[s.  It was six months of effort working her fingers and all her joints; six months of exercising her will and her mind so as not to allow the disease state to take hold; and six months to adopt better eating habits.

Ankylosing Spondylitis  僵直性脊椎炎

     Ankyosing spondylitis is a type of chronic inflammatory rheumatism found mainly in young men.  The hallmark of this condition nocturnal pain n the joints at the base of the spine.  Rest has no calming effect; however, physical exercise brings some relief.  It is vital to pay attention to nocturnal pain as it can be a sign of a visceral problem or inflammatory rheumatism.  By contrast, pain of mechanical origin is classically accentuated by activity and very much relieved by rest.

     Jeremy consulted me for increasngly annoying back pain.  "I have the feeling of being in a vice with my ribs squeezing me," he said.  Manual examination failed to identify any precise areas of pain, but I did find a group of stiff and sensitive vertebrae.  He joint pain had not arisen in connection with any strain or trauma, but rather had developed insidiously over time.  Imaging showed the involvement of the sacroiliac joint.  The test for HLA B27 was positive.  HLA B27 is the protein marker that is active in this type of disease and underscores its hereditary nature.

     Ankylosing spondylitis requires that the patient take imitative by studying the effect of medications and working with the physician to determine the correct dosage.  I advised Jeremy to consult a homeopath, to be vigilant about his food intake (carefully avoiding all animal protein), to drink small amounts of water at frequent intervals, and to have a weekly sauna to help eliminate toxins.  The sweat of persons with ankylosing spondylitis has a characteristic sour odor as the skin tries to get rid of what the organs are not capable of eliminating.  I asked him to do regular movement therapy and to absolutely avoid any forceful rehabilitation.    Flexibility must be restored slowly and gently.

     This affliction can be a long struggle, but some patients are very sucessful at coexisting with their condition.

What to Do

• Consult a  rheumatologist for a general assessment.  Ask questions about the risks and drawbacks of any proposed medical treatment.
• Without advocating self-medication, I would advise you to be a little bit your own doctor.  That is, listen to your own pain and symptoms and try to participate in understanding your condition.
• You might consult a homeopath who would prescribe treatment suited to your biological terrain.
• Embark on very gradual rehabilitation in water.
• Avoid red meat.
• Judiciously avoid all dairy.
• It is worth your while to analyze the whys and wherefores of the awakening of such a disease.  It had been lying dormant until a convergence of circumstances revived it.  Sometimes a small, seemingly insignificant event is enough to have brought it on.
• Search for the trigger factor: personal conflict, work trouble, accident, surgery, excess drinking or eating.
• Work by yourself or with the help of a therapist on both psychological and nutritional levels.
• Consult a manual therapist who can gently make the afflicted joints more supple.
• You might seek the help of an acupuncturist, phytotherapist (botanical medicine), or relaxation therapy practitioner.  There are many ways to take care of yourself.  The key is that you feel confident in, but never dependent upon, the therapist you choose.

Osteoporosis 骨質疏鬆

     Osteoporosis is a reduction in the protein matrix of bone.  It is detectable by X-ray as excessive transparency of bone and trabeculae.  Bone becomes spongy.  Instufficient calcium intake or deficient calcium absorption, which can be a digestive problem, are implicated.

     Densitometer devices reveal the presence of osteoporosis to varying degrees in many women.  Do not be alarmed if the test calculates an elevated fracture risk.  Be aware that osteoporosis is common in women and, with the exception of certain diseases, is largely attributable to menopause.  Due easily remedied.  It is quite normal that we lose of calcium that is not easily remedied.  It is quite normal that we lose height with age.  We have twenty-four discs.  A loss of just one millimeter per disc ca shorten us by two to three centimeters.  It is important to distinguish between ordinary and severe osteoporosis.

Advice

• To combat osteoporosis, drink calcium-rich mineral water.  Mineral levels vary from region to region.  Of the most common bottled brands in France, I would recommend Hepar or Contrex.
• The best assimilable cheese sources are Gruyere, Comte and Beaufort.  Consume a small slice before lunch.
• Movement is an excellent remedy, as it activates the circulation of blood that transports the cells used to make bone.
• Take some "good sun" before 11 a.m. and after 5 p.m., when there are fewer infrared and more ultraviolet rays.  Optimal bone health associates with vitamin D derived from the sun.
• It is important to take vitamin D in winter in the dosage recommended by your doctor or pharmacist.

Osteoporosis Is Not the Same as Osteopenia!

     Osteopenia is a sign of bone mineral density loss.  Sixty percent of vertebral fractures are linked to this deficiency.  In this case refrain from manipulation.  Half of the population over age eighty present with vertebral fracture due to osteopenia.

Medical Progress

     Tremendous advances have been made in pain management.  Morphine and its derivatives have changed the course of severe pain.  However, in the case of chronic rheumatic conditions, in the aftermath of accidents, and in all types of recurrent pain in general, advances are more measured.  Of course there has been some progress, but I notice that treatments remain symptomatic.  Anti-inflammatories are very quickly toxic.  A renowned rheumatologist has even affirmed that "their positive effects have never been proven."

     In the treatment of knee arthrosis, the injection of viscous products can bring durable relief lasting up to a year.  Surgical hip replacement achieves very convincing results, as does knee replacement, although knee surgery is a little more delicate.

     One can only marvel at advances in medical engineering.  Arthroscanners, MRIs, and ultrasounds are becoming more and more perfected.  They are allowing us to establish extremely in-depth diagnostics, even if the same cannor yet be said of the treatments that ensue.  The precision of these images is remarkable.  A lumbar arthosis or a herniated disc has little chance of going undetected.  But what about treatment when surgery is not indicated?

     It is common among the patients who bring an MRI to the consultation that many of them have exactly the same diagnosis: compressed disc between the fourth and fifth lumbar vertebrae.  What to do?  Generally I advise them to come in to see me during the acute phase, which allows me to better understand the source of their pain.  For example, lumbago is not the cause of a problem.  It is the consequence of several factors such as prolonged strain, poor nutrition, psychological tension, intestinal problems, prostate or gynecological conditions, and bad foot support, to name a few.

     Manual therapy offers gentle and effective treatment for the above problems.  Osteopaths employ specific techniques for the disc based on manipulations that address intradiscal pressure as well as the lumbar venous system.  Ask your practitioner if he is familiar with them.

6 ~ Connections Between Joints and Organs

     If our organs function well, our joints feel better.  If our joints function well, our organs feel better.

     

     Our bodies operate with a foolproof logic of reciprocity, a relationship of mutual dependence.  This is why it is our duty to watch over every element of our being.

Referred Pain

     Pay attention to sudden, intense joint pain that comes on mainly during the night.  This can indicate referred visceral pain.  It is a sign that an organ is expressing dysfunction and merits immediate attention.  Acute referred visceral pain also can arise after an ordinary fall, a particular effort, or a position of constraint.

     Anne-Marie is very purposeful.  She enjoys bustling around the house and in her garden.  One day she bent down on one knee to clean under an armoire.  She extended her other leg so that she would be able to crouch low to reach the dust against the wall.

     In standing back up she felt intense pain in her left groin.  "Oh dear," she said to herself.  "I have torn a muscle or put out a vertebra!"  This had happened once before.  This time the pain persisted, and she came to consult me.

     The lumbar spine and pelvis were a little sensitive, but they had kept their mobility.  However, palpation of her sigmoid colon (the lower part of  the colon just above the rectum) provoked very sharp pain.  It turned out that she suffered from inflammation of the sigmoid due to diverticulitis.  Moving her leg into extension had either triggered or amplified the symptoms.  She admitted to having intermittent pain but concluded: "You can't always be listening to yourself!"

     When a patient arrives with a precise idea of what is wrong and pretty much comes up with a diagnosis before the therapist does, the therapist must be vigilant.  Generally this type of patient will insist that the therapist concentrate on the painful area and nowhere else.  He believes he knows what he is suffering from and is not very good at accepting a more global investigation.  Such was Anne-Marie's case.  It turned out that manipulation of the sigmoid was what released the groin pain, without touching the lumbar spine, pelvis, or hips.

     Below is a concise list of the main visceral pain projections related to our joints in the absence of previous trauma.  Of course there are variations and exceptions.

Articulation                                                    Related Organ

Jaw and upper thoracic spine                           Heart

Neck                                                                 Throat, nose, ears, thyroid

Upper thoracic spine                                        Lungs, breasts, heart

Middle thoracic spine                                       Liver, stomach, pancreas, duodenum (junction 

                                                                          between stomach and small intestine)

Lower vertebral column                                   Kidneys, small intestine (seven meters long)

Upper lumbar spine                                          Kidneys, colon, ureters (the run from kidneys to 

                                                                          bladder)

Lower lumbar spine, pelvis, knees                   Urogenital organs: ovaries, uterine tubes, uterus, 

                                                                          prostate, bladder

Right shoulder                                                  Liver

Left shoulder, upper back                                 Stomach, pancreas

Inferior limbs                                                    Genital organs, intestine

Knees, hips                                                       Kidneys

Feet(3)                                                               Kidneys and genital organs are the organs that most

                                                                          frequently trigger foot pain

(3) There is a map of visceral projections on the feet.  It is at once complex and approximate.  Such a diagram does not mean that everything is in the feet, but neither is everything represented in other parts of the body.

     Let us take the kidneys as an example.  Pain provoked by a renal stone or kidney infection (nephritis, polynephritis) often spreads toward the lumbar spine, hips, and knee.  It is transmitted by nerve fibers of the kidney itself and some that pass around it.

     Maxime consulted me for slight diffuse lumbar pain and a more precise pain in his left knee.  My line of questioning revealed no recent or old trauma connected with the knee.  Nevertheless, he insisted that "in the middle of the night, even without moving, I feel my knee ache."

     Continuing the interview he disclosed that his father and grandfather had both suffered from kidney stones.  At once I understood the probable source of Maxime's pain and explained it to him.  Several days later he came to me and said, "I peed out the stone."  With that his backache disappeared.

     Anatomical interconnections make it possible to feel pain in a knee without kidney symptoms.  This is why the clinician must be circumspect and alert in cases of joint pain.  Our back muscles share nerve fibers with organs to the extent that a pain in the back is often far from being entirely mechanical.  It can signify an organ problem.

Our Organs Also Articulate One with the Other

     Our organs have articulations!  When we walk, our organs move with each step.  They are kept in place by ligaments and the pressure exerted by muscles.  Any loss of mobility or reduced slide and glide between organs has an irritating effect.

     We breathe about 20,000 times a day.  With each respiration, our organs follow the movements of the diaphragm, which is the muscle that makes us breathe.  Add to this the motion we impose on our organs in the course of our daily and recreational activities.  The millions of continuous visceral interactions required must be repeated harmoniously if they are not to cause irritations.

     An appendix scar can reverberate to nearby organs, such as the kidney, intestine, or ovary, and interfere with their normal articulations.  Compromised coordination between these organs can generate back or hip pain because the organs have special links with the lumbar spine and the lower extremities.

PART THREE

Messages from Our Joints

     In the following chapters, I will attempt to explain messages from our body in terms of each joint.  I will explore the physical and physiological connections of joint trauma as well as the psychoemotional repercussions.  A better understanding will enable you to pay more attention to your body----its attitudes, discomforts, and injuries--in order to participate in your own well-being.  To achieve the best possible oint health, you should approach life in general in the same way that you would practice sports.  That is, with physical, psychological, mental, dietary, and lifestyle preparedness.

7 ~ The Ankle and Food

     The foot is composed of 26 bones, 114 ligaments, and about 40 articulations.  Multiply these figures by two and you have an idea of the complexity of our footing.  Walking unrolls rather like organ music.  The cerebellum plays a whole set of pipes that must be played in total harmony to ensure good balance.  One false note and the whole instrument finds itself discordant.

     The ankle is make up of the inferior ends of the tibia and fibula (peroneus), which articulate on the talus (ankle) bone.  The feet and ankles form one system.  In the interest of readability, I will use the word "foot" to designate this system.

Function

     Man is one of the few mammals who now moves about on only two feet, The adaptation to the vertical balance left him somewhat weakened.  As bipeds, our feet must support the entire weight of our bodies.  Animals of similar build still walk on four legs.  Our feet are in direct contact with the ground.  They immediately inform the cerebellum about the smoothness, roughness, hazards, or unevenness of the terrain.  This data is vital to maintaining and preserving our stability.  Feet are meant to "keep our feet on the ground" so that we stay in contact with reality.  They are so exceptionally sensitive that even the smallest grain of sand in a  shoe can make walking insufferable.

In Relationship to Our Organs

     As alluded to earlier, the plantar surface has been mapped out to precise degrees.  These charts can appear overly elaborate.  It would seem difficult, for example, to recognize a dysfunction of the pituitary in the foot, let alone to treat it there.  On the other hand, the vast numbers of patients who have consulted me through the years have enable me to establish a relationship between the feet, the kidneys, and the intestines.  In simple terms, I find that the inside part of the plantar arch relates to the urogenital system, while the outside portion corresponds to the intestines.  This means that pain in the arch can indicate a problem in these areas.

What the Feet Represent

Our Roots

     Even if they are moving, our feet root us.  The expression "keep two feet on the ground" describes how they anchor, calm, and keep us stable physically and psychologicaly.  Any distortion of the ankle and foot disturbs this equilibrium and can cause psychological instability in the form of anxiety, timidity, and the inability to act.

Contact with Reality

     The feet represent our connection with concrete reality.  Firm footing requires certain vigilance on the part of the brain.  Someone who is scatterbrained or preoccupied is not paying full attention.  If just one foot-brain connection is missed at an inopportune moment, the foot can lose contact with what is underfoot and and in a twist.  When a person is subject to frequent ankle sprains, the message is clear: Either he is too much in his head and not enough in his body, or his body is in need of attention.  Apart from detecting and treating ligamentous weakness due to the sprain itself, the person might do well to examine his relationship to the concrete and search for better balance between dream and reality.

Instability

     Foot instability reflects physical, emotional, or relational instability.

     Frederic was preoccupied by an interview for a job he did not particularly want.  He was going to apply anyway because he needed the work.  Walking to the interview with his head in the clouds, he twisted his foot and suffered a sprain.  He arrived at the meeting limping.  His foot hurt, and he botched the interview.  His application was not accepted and he found himself almost relieved by the result.  His sprain represented his of interest in the potential position.

Attitudes

     It is possible to cheat with words but not as easily with the body.  What might be hidden behind screens of self-confidence is soon given away by the position of our feet or hands.  Observe people when they dance.  At the beginning they can be very attentive to the position and control of their gestures.  Little by little they let themselves go and are revealed.

Command and Counter-Command

     Feet that do not follow the brain's command are hesitant.  On the other hand, feet that seem to hesitate can be a mark a decision on how to proceed with a certain project or on what path to take in a particular situation.

Growing Up

     An adolescent who grows up too quickly can lose his physical bearings.  He can have a poor sense of where he is in space.  His gestures become awkward and clumsy.  He bangs into things and easily twists his feet.  He is no longer "small" but not yet "big."

Twisting the Foot

     To have "feet in the sand" with no stability denotes a lack of psychic strength, fear of confrontation, and fear f the future.

Dragging One's Feet

     By this attitude a person unwittingly shows that he is neither for nor against something.  as he is unwilling to confront or take action.

Crossing the Feet

     Crossed feet are a sign of protection or even closing.  Observe a person stretched out.  If he crosses his feet it is a sign that he is not entirely at ease and has closed his territory.  It also can indicate modesty.

As if Springing Along

     The person who appears to be walking on springs is unconsciously expressing a desire to escape from someone or from some problematic situation.  He dodges along not wanting to leave himself trapped in a "small territory."  He looks for a way to escape while knowing he cannot.  Such a person is at greater risk for uscle problems as opposed to joint problems.

Going Too Fast

     The person who trots along or walks very quickly does not wish to be approached or adominated.  He flees others and his own existence as well.

Piggeon-toed

     A person who presents with feet turned in and knees flexed shows a tendency for withdrawal and passivity, a certain timidity in facing up to events, and a lack of defense.  So revealed, this weakness leaves him vulnerable to the will of others.  Internal messages tend to run in a loop, and he finds emotional expression difficult.

Active Feet

     By contrast to the pigeon-toed, and energetic individual has active feet that are well positioned on the ground and ready to leap into action.

The "Plus" of a Firm Stance
     When standing, the best posture is to place the feet firmly on the ground in slight external rotation (eleven o'clock and one o'clock) with the chest forward.  This position exhibits natural confidence.  Faced with a panel of examiners or an important meeting, you have a better chance of managing the situation in this posture.  When the body is clearly present, securely occupying its space, and "well planted on two feet," behavior naturally follows with and openness of spirit and dialogue.  Such an attitude helps us to better understand others and to find our words more easily.  Healthy self-esteem and physical health generate good body position, which induces a reciprocal positive social attitude.

Foot and Ankle Problem

Sprain

     Sprain is the most common foot trauma.  It involves torsion of either the tibiofibular or the lateral collateral ligaments.  It is rare to get through life without an ankle sprain or simply a bad turn of the ankle.

Hallux Valgus (Bunion)

    A hallux valgus is a lateral deviation of the great toe.  It is much more frequent in females and even more common in women with intestinal problems.  The reason for this is not entirely known.  Statistically, however, hallux valgus runs in families.  A grandmother, mother, and daughter can all share the affliction.  Apparently genetics sometimes concentrates even in the foot.

     Monique, who had a mild tendency toward foot deformity, developed a large hallux valgus soon after menopause.  She complained of pain while walking.  This trouble embarrassed her.  "I have the impression that people are only looking at my feet, and this makes me uncomfortable in public," she said.  "I feel more and more awkward, even though a toe should be no big deal!"

Pins and Needles First Thing in the Morning

     Experiencing tingling sensations when you first step out of bed is linked to renal dysfunction in relationship to excess protein or dehydration.  What can be done?  Drink more water  and reduce protein intake.  Very often there is a family history of kidney stones.  If the condition persists, consult your doctor about having your kidneys checked.

Morton's Neuroma

     Morton's neuroma is characterized by a thickening of tissue that compresses and squeezes the nerves leading to your toes.  It very often shows up after years of poor foot support or as a compensation for pelvic or general body imbalance.  It can come on quickly after wearing tight new shoes unsuitable to your foot or following an excessively long walk.  To release the compressed nerve you can perform the exercise on page 68, or condult an osteopath or a kinesiotherapist.

Collapsed Plantar Arch

     Fallen arches are linked to age, menopause, and fatigue, as well as to mineral and trace element deficiencies (see P.176).  Several physiological factors can be associated: general fatigue affecting muscle tone, iron deficiency sometimes due to overabundant menstruation, intestinal polyps, or even a bout of depression.  A stretching regimen combined with a podiatrist's prescription for orthopedic insoles is the solution.

Sciatica

     

     Sciatica is compression of the sciatic nerve by a herniated lumbar disc.  It disturbs foot sensitivity and increases the risk of sprain.  It is worth knowing that as much as 90 percent of the foot's nerve supply comes from the sciatic nerve.  Consult your referring physician or a manual therapist (acupuncturist, osteopath, chiropractor).  Sciatica can be months or even years in the making.  It is no use looking for an immediate cause.

Cramping in Both Feet

     Bilateral cramping can be of venous origin.  Cramping in both feet is frequently accompanied by a sensation of heavy legs.  Cramping in just one leg is more connected to the articular or nervous system.  One also can experience pain in both feet from metabolic causes such as poor uric acid elimination on the part of the liver or kidneys.

     Simone was awakened suddenly by a sharp pain in the calf together with a severe foot cramp.  She insisted that this occurred "even though I never moved in my sleep!"  Simone was not aware that the muscles of her legs and feet are very sensitive to uric and lactic acid.  She may have simply overindulged in cheese or animal protein or had not drunk enough water the previous evening.

     A simple involuntary muscle contraction during a dream can induce a cramp.  This sort of cramp is not necessarily a mechanical event.  It is more likely to be of metabolic or chemical origin signifying that the muscle is not clearing wastes.  It also might point to a vascular problem that, if it occurs frequently, requires medical attention.

Trauma

     Any significant trauma to the lower extremity, such as severe knee or ankle sprain, hip arthrosis, or bone fracture, gradually alters the way the foot meets the ground.  The brain stops receiving precise and proper information from the foot.  Physical instability of this sort can intensify psychic imbalance if the person happen to have vulnerability in this direction.  Effects are cumulative.  The accident destabilizes the physical, which naturally has behavioral outcomes.

     France, who was by nature generous and joyous, suffered a severe car accident with injury to her foot.  "I was betrayed by my foot," she said.  "It was not very pretty to look at and prevented me from sustained physical activity.  Not having good contact with the floor disturbed me.  I became less sure of myself and then my behavior began to change.  I grew mistrustful and less nice."  Hapily she ventured to an osteopath and a podiatrist for rehabilitation.  After a few sessions she confided, "It seems that I am more likeable after all."

Advice

• Maximize your efforts to have a supple foot that is in good contact with the ground.  "Well on your feet, well on the road of life," you might say.  When your brain receives positive information coming from the body, the message is reinforced on a psychoemotional level.  Similarly, when we are happy, the whole body feels it.  Good ground contact, good shoes, and good joints are the ideal.
• Look to make the link between your foot pain and your attitude in life.  While the connection is certainly physical, it also can have to do with your feelings, psyche, and way of relating.  This endeavor will help you to find the attitude that will restore equanimity and self-confidence.  For example, a hallux valgus can oblige a person to deviate her foot, giving the impression that her body is betraying her.  Treating her bunion wil allow her to regain both her physical stability and her psychic equilibrium.
• Begin at the base of the body, which is easy to observe in detail.  Teach yourself to walk with stable foot alignment, toes oriented toward eleven o'clock and one o'clock.  Walk with a soft object, something easily kept in place, held on top of your head.  Keep in mind that foot position involves the rest of the body.  From a good base posture everything strings together in a logical sequence and fashion.  Walk a little first thing in the morning and in the evening before going to bed.  This brings awareness that enables you to feel your body.
• By changing your attitude you will influence the way you face life.  Pascal wrote: "If you want to believe in God, fall on your knees."  By this he meant that right body attitude generates right spiritual attitude.
• Show naturally that you exist.  Assert yourself by your physical presence.  Feeling your feet in all their breadth will impart a sense of confidence.
• Observe people who appear self-confident and remember their attitude.  Have a good look at how they hold themselves and the way they walk.
• For recurrent injury linked to deformations such as fallen arches, poor foot contact, or Morton's neuroma, adopt the use of proprioceptive insoles made only by podiatrists.  These insoles stimulate the various nerves on the bottom of the foot that inform the cerebellum (the balance center) as to where the feet are in space.  It is essential that correct or inappropriate commands.  Podiatry has envolved enormously; it now holds a central and active role in proprioceptive re-education as it works to rebalance foot support.

Exercise for General Practice and in Case of Morton's Neuroma

     Lie on your back and place both feet against the wall.  Position two tennis balls under the plantar arches and roll your feet on the balls.  Repeat several times.  This exercise is very beneficial for veins, lymphatic vessels, and joints.

• Women, be advised:  Pay attention to your choice of shoes.  Do not sacrifice your feet for the fashion of the day.  Your shoes must not be too pointed or too high so that you avoid cramping the toes and arching the lumbar spine.  They also must not be too tight or too open-toed so that you avoid the foot curling into hammer-toed positions.  Look for comfort.  Given all the models of footwear made today, you should have no trouble combining function with esthetics----although perhaps not the high fashion that comes at the expense of health.
• Regularly massage your own foot arches or have your partner massage them.  The foot is the most compressed part of the body.  Oil softens the foot and keeps the skin healthy and problem free.
• If you feel unsteady on your feet, begin a walk looking at your feet so that the brain can clearly register data about your relationship with the ground.  Afterward you will see that you can proceed more easily while looking up and about.
• For athletes, one suggestion is to war up by making small movements.  Focus your awareness on each part of your body from head to toe and then from your toes to your head.  Once all parts of your body feel well connected, gradually begin your sporting activity.  Skilled action and performance are within reach when we feel perfectly fluid in space.
• Practice running with good shoes that absorb and cushion shocks.  Try a few before choosing the right one.  The correct shoe gives you the impression of being lifted.  Run on soft terrain, not pavement, in order to reduce microtrauma.
• Be alert both to small pain and fatigue.  It is not normal to have chronic foot pain.  Fatigue fractures are very difficult to diagnose on X-ray.  Very often they are not seen until two or three months later during the consolidation phase.  Some fractures take years to mend.

     Jacques was an assiduous runner.  One day he felt a small pain in his foot that might pass unnoticed in a nonrunner, but not in Jacques.  This irritation began to ruin his life.  He could not run as enjoyably and effectively as was his habit.  "Running is how I get rid of my stress.  I absolutely must be able to run without pain!" he said.  Any treatment he tried failed.  The first radiographic tests showed a perfect foot.  Every therapist he consulted talked to him about stress, fatigue, and overwork, and inevitably recommended rest.  Jacques was convinced he had a real physical problem.  When a second X-ray showed a microfracture of a small bone in his foot, enough to cause such suffering, he was reassured.  It is never pleasant to experience a real physical problem only to have it deemed nothing but a stress or  fatigue issue.  Nevertheless, eighteen months were to pass before he could run normally again.  He told me with humor, "I had no idea that I could be so dependent on these feet of mine."

     In the case of fatigue fracture, it is necessary to stop activities that put pressure on the foot.  This includes jumping or standing on hard surfaces.  Biking and swimming are recommended, where the weight of the body is not resting on the feet.  Fatigue fracture can be thought of as a tiny fissure in the bone.  It is a common sports injury particular to athletes in excellent physical condition.  These fracture always occur on bones that support the weight of the body, such as the tibia, fibula (peroneus), and metatarsal bones of the lower extremity.

8 ~ The Knees

     The knee is the largest joint in the body.  It is formed by three bones: the femur, the tibia, and the peroneus (now internationally called fibula).  While the knee bones are strong, the joint is fragile due to our bipedal stance.

     The stability of the knee comes from ligaments, tendons, and muscles.  The bones articulate on their menisci, which act as shock absorbers in the knee joint, dispersing the weight of the body and cushioning the forces of jumping.

     The knee is a common site of pain and injury in athletes, particularly because of cruciate-ligament and meniscus damage.  The knee can be compared to the elbow (see p. 133) in that they are both intermediate hinge joints.  The knees, however, bear the weight of the body, making them more fragile.

Function

     The knee governs flexion and extension of the lower extremity.  Blocked beyond straightening at the front, the joint is designed to hinge backward.  The knee enables genuflection, submissiveness, and meditation, as well as jumping, dynamic momentum, and forward projection.

The Knees in Relationship to Organs

     In women the knees relate to the genital system, specifically the ovaries.  Knee problems are common in adolescent girls whose joints can all of a sudden swell and become painful for no apparent reason.  More thorough investigation often reveals the involvement of a nerve to the knee that becomes irritated as it passes behind the developing ovary.  In this scenario the only thing to do is to wait for puberty to end, plus avoid squatting, crouching, or being on the knees too long.  Consulting a homeopath for a constitutional remedy is an option.

Fig. 05:  The Knee

     The knee also relate to the kidneys.  In this instance, the symptoms generally appear in only one knee.  It is generally advisable to modify your diet and consult your physician as a precaution.

What Knees Represent

     A person's natural knee position tells us something about his state of well-being and level of self-confidence.  How the knees are held is an expression of our stance and behavior people standing, we generally see the knees as either somewhat flexed or tensed.

Knees Slightly Flexed

    Slightly flexed knees show a  lack of self-assurance, incertitude, fear of confrontation, fraily of being, or state of withdrawal.  The more bent the knees are, the greater the likelihood that the person is passive, submissive, resigned, or timid.  Whenever you feel like a victim or are fatigued or demoralized, your knees bend as if by reflex.  In these moments you reveal the burden of your life as well as your lack of energy and responsiveness.  You lose your bearings in time and space to the point of losing self-confidence and allowing yourself to be influenced by the opinion and judgement of others.

     If this occurs in passing, it has no significant consequences for your body.  It is simply a reflection of a mood.  If this attitude remains constant, however, the problem must be taken more seriously.  This posture can lead to ligamentous or cartilaginous knee strains and sometimes even osseous problems.  This is to say nothing of the psychological influences (timidity, retreating into oneself, meekness) on your general state of being.  Unrelenting compression on any one part of the body literally wears out the cartilages and weakens the joint involved.

     Dorothy, who worked in sales, was called in by her manager and reproached for having missed on important deal for the company.  She consulted me for generalized lumbar pan.  She imagined the cause to be the weight of the briefcase she perpetually carried on the same side.

     In the course of conversation I noticed her knees flex slightly.  She noticed it as well.  "Ah, yes," she said, "It is as if the weight of my words were too heavy for my knees.  What's worse I have had this sensation all day.  In fact, it happens a lot."

     The weight was not exactly where she wanted it to be.  Her all-too-frequent knee flexion had altered the alignment of her lumbar spine.  The awareness of the problem helped her.  I also recommended that she take time to look in a mirror and imagine herself in front of some dominant, impressive, perhaps even aggressive person, and to adjust her body position accordingly: shoulders down, sternum forward, directly facing the person with open plams facing forward.

Looked Knees

     Tensed knees are mainly a sign of confidence, combativeness, dynamism, and the desire to conquer.  In combination with other general body postures and the neck in extension (that is, very straight), the knees can reveal significant traits.

• ambition.  In addition to standing with his knees in extension, the ambitious person holds his head high.  The dominator bulges his torso forward.
• leadership.  The instigator intends to bring others around to his point of view.  He wishes to impose his views and has no tolerance for being challenged,
• seduction.  The seducer adds the forward projection of his pelvis.
• action.  The optimist, having and active temperament, keeps his knees in extension in contrast to the flexed knee of the pessimist.
• appearances.  Extension of the knees is clearly noticeable in the person who lives in the world of appearances.  He wants to occupy his space and often the space of others.  As a result, his sheer determination to appear confident eventually affects his joints.

     Fabien is a senior executive in on enterprise of which he is the principal driving force.  It is essentially thanks to him that the "wheel turns."  He came to see me for a meniscus type of pain.  He said, "Being essentially timid I make myself stand straight without bending at the knees.  I do this in order to appear credible when I speak and give orders."

     Since Fabien's natural position was to keep his knee flexed, such a change in posture had irritated his cartilages and menisci.  This artificially forced position revealed that he did not want to let go of control.  This is nevertheless what he had to do to be free of pain.  He needed to understand that it was not always necessary to be in seduction mode.

     Wheat is perferable: a passive attitude and good knees or an active attitude with meniscal pain?  It is better for Fabien to allow his fundamental nature to express itself without changing it?  The ideal is to experience your body as flexible and without tension.  It doesn't much matter whether you like your knees straight or flexed.  As long as it causes you no trouble or pain, there is no problem.  If your position becomes problematic, however, you need to learn to change it with the help of a manual therapist.  A few degrees difference is enough to put you at ease.

Knee Problems

     The knee is dependent on a great finesse of neurological connections.  Nerves, muscles, cruciate, and lateral ligaments must be perfectly in tune.  If the mechanoreceptor neurons are not able to transmit correct information to the cerebellum, the inferior limbs can no longer be guaranteed their function.  By nature the knee joint is not fit together well; in fact, it is altogether rather "poorly kept."  It is imperative, therefore, that its nerve connections be in perfect working order.

     Knee pain can originate as a dyfunction of the knee itself or in the aftermath of a fall or a sprain where the menisci or ligaments have been damaged.  Pain also can be the consequence of a lesion coming up from the foot or of a problem descending from the vertebral column or the hips.

     Julie grumbled about her knee.  No objective exam revealed even the smallest lesion.  On palpation her left leg was stiff and the ankle was considerably lacking in range of motion.  Needless to say, I asked her if she had incurred an ankle sprain.  "Yes, but it was a long time ago."  she said.  "Come to think of it, however, after the injury my foot remained swollen for more than a year."

     A poorly functioning ankle causes an ascending compensation from bottom to top.  First the knee is affected, then the hip, and finally the vertebral column.  Imagine the damage that can be done to the knee cartilage and meniscus from a deviated foot position.  In Julie's case, osteopathic treatment was simple enough.  One manipulation of the junction between the ankle and the cuboid bone (one of twenty-six bones of the foot)  restored her ankle range of motion almost immediately.  As a result, the intra-articular pressures of her knee were harmonized.

A Diet High in Sugar and Lactic Acid

     An overly sweet diet combined with an excess of lactic acid, which causes muscle contracuture, can underlie knee pain.

Intensive Sporting Activity
   
     Who is the sportsman who has not sprained a knee?  The phenomenon is so common as to prove the innate and acquired constitutional fragility of the joint.  Whether due to excessive fatigue, a period of stress, a lack of confidence, overtraining, or perhaps muscle weakness, knees are inherently vulnerable and injury cannot always be avoided.

     One seemingly harmless movement and the knee can snap.  The solution is to methodically strengthen the muscles of the lower extremity in conjunction with relaxation techniques.  In preparation for the winter season, champion skiers regularly and intensively cycle all summer.  Do not hesitate to bring out your bike.

Synovial Effusion

     When a knee is hurt, synovial fluix production increases.  This creates synovial effusion.  The immediate indication is to stop all activity and place ice on the joint.  Next, the ideal treatment is to apply a poultice of green clay to the posterior and anterior surfaces of the knee, keeping it on all night and repeating for eight days.

Popliteal Synovial Cysts

     Popliteal synovial cysts show up mostly in females during menopause.  They are located behind the knee.  Since they coincide with menopause, it is fair to say that there is probably a hormonal influence.  A decline in progesterone levels may be the underlying reason for cyst formation.  Surgery is rarely the solution since cysts have tendency to return because nature abhors a vacuum.  They can become problematic, however, if they provoke compression of the vascular or venous system.

Ruptured Ligaments

     Rupture of the cruciate ligaments is a characteristic accident of skiers.   Be wary on any ski trip of the third hour of the third afternoon.  Three risk factors converge at this critical moment: a rise in skier confidence, insufficient training, and afternoon digestion.  All of these are added to the fatigue of the first two days.  Note that almost all competitive sports carry risk for the knees.  In general, treatment consists of surgery in the young.  For those over forty, the bicycle is recommended as a way to build up knee muscles.

Advice

General recommendations:

• Be careful when crouching or going down on your knees.  Avoid doing it abruptly or too rapidly.  Do not hold the position for too long.  The knee requires delicacy and attention. 
• In flexion, certain knee attachments can become overly stretched.  If this happens for too long or too frequently, the attachments weaken, thin, and fray to the point that they tear one day for no reason.
• Bending the knees too much or spending long hours on bended knees cause the joint to suffer and develop arthrosis or synovidal effusion.  These disorders are common in tillers, floor layers, and those in monastic life.
• Long after meniscus surgery (meniscectomy), the body sometimes naturally constructs a kind of new meniscus to make the knee more functional.  Over time, the knee occasionally regains a measure of stability and solidity, but it is always less than it had originally,
• When the knee has been traumatized, as n a sprain, it has a tendency to lose extension.  This is termed a flexum.  The knee can no longer straighten fully and remains  a little flexed.  This flexion posture wears out the cartilage prematurely, fatigues the muscles, and causes the knee to swell.  Such flexion contractures occur almost automatically post surgery.  They are one of the main causes of knee arthrosis.  To avoid this happening after surgery, when you are sitting at rest, place the foot of the operated leg on a low table or stool, making sure that the knee is in extension.  If possible, place the other leg on top of the operated leg to put pressure on the extension.
• Be careful and pay attention not to cross your legs for too long.  It is not good for venous and lymphatic circulation.  Kept up for a long period, this position eventually tightens the whole body.
• Avoid certain foods such as charcuterie, fat, seafood, and chocolate; all of these can raise uric acid levels (see p.170).  I observe patients who experience a swollen knee in the fifteen minutes after eating seafood.  On one hand this can be due to metabolic problems involving the liver or kidneys.  On the other hand, a knee that has become particularly sensitive following a sprain or other trauma will be indirectly targeted as one of the organism's weak links.

The Cabbage Leaf
     Amazingly, the leaf of a green cabbage is an excellent remedy for the injured knee.  (Read the history of the soccer player on P.192)  Its anti-inflammatory power is incontestable.  Place two cabbage leaves in the oven for thirty seconds to soften.  Next, wrap them on the anterior and posterior surfaces of the knee, and maintain them in place with a bandage.  Keep the cabbage on through the night and repeat nightly for eight days.

• Bicycle riding is strongly recommended to support the flexibility and strength of the knee.  Since the body is not bearing down on the inferior limbs, the knees are unburdened by any weight.
• After a knee operation it is very difficult to recover muscular strength around the joint.  Rehabilitation is indispensable but not in itself sufficient.  Here too cycling assists muscle reinforcement.  I would urge you to adopt and develop cycling.

9 ~ The Pelvis and Hips 骨盆和臀部

The Pelvis 骨盆

     The pelvis is composed of two symmetrical bones: a right and a left.  These bones are fastened to the sacrum and coccyx in the back and to the pubis in front.  It is a central anchor for:

• both femurs at the coxofemoral junctions, which are the hip joints themselves;
• the vertebral column at the sacroiliac joints.

Function

     The pelvis is the crossroad of mechanical forces.  The pelvis redistributes these incoming movements between the lower limbs and the upper body.  Eighty percent of the mechanical forces received are directed onto the lower limbs.  Only 20 percent land in the sacrum.  The bony pelvis is a strong structure that is closed at the back, leaving the abdominal muscles to protect the organs in front.

     A woman's  pelvis is naturally broader than a man's.  The pelvis must be sturdy enough to support the infant for nine months in utero.  At the same time, it must be flexible enough to relax for birth and delivery.  Nature, in its wisdom, provides hormonal fluctuations that facilitate the opening and relaxation of the pelvis.  These hormones influence muscle tone and ligamentous elasticity.

What It Represents

• the strong element.  Just like n the old architectural dictum "The church and the town hall must be at the center of the village," the pelvis is the central structure of the body.  The much more mobile legs and vertebral column are fastened to it.
• our foundation.  In humans, the pelvis represents the house and its foundation.  As the sturdy, protective nest for the reproductive organs, the pelvis is the expression of our roots, our territoriality, and our family lineage, as well as our capacity to anchor ourselves.
• the sure element.  The pelvis develops into the bony symbol that maturity has been reached.

The Hips

     The hips are a pair of solid, compact joints situated between the pelvis and the femurs.  Considerable forces are exerted at the hips as they support the great amount of body weight passing through them in a vertical stance.  While largely determined by genetics, the shape of the hips can be altered due to fetal position in the womb.  Hip problems are routinely detected in newborns.  Rare congenital luxation aside, these commonplace problems are due to awkward fetal positioning of the lower extremities.  Mothers need not worry, as these hips recover easily.

     New data is coming to light telling us that the growth curve of the human species has evolved in recent decades.  Although this phenomenon seems to have slowed down, babies are bigger and thus more casily squeezed within their mothers' bellies.  The head, hips, and feet bear the consequences.  It is very useful for the mother to visit an osteopath following the birth of her baby.

Function

     Current language glosses over any distinction between hips hips and pelvis.  In true anatomical terms, the hip articulates with the pelvis.  More precisely, the hip is the junction between the head of the femur and the liac bone that makes up the pelvis (together with the sacrum and coccyx).

     The hips distribute most of our body weight onto the lower extremities.  The weight descends through the knees to reach the feet.  In turn, the feet automatically return upward forces that ascend to the knees and through the hips, pelvis, and vertebral column.

     A subtle play of lines of force runs continuously through our bodies.  When all goes well we move naturally and with ease.  This is not the case, however, if any one element fails to perform correctly.  Very often we only realize we are in good health when we suddenly feel unwell or become sick.  Reflecting on this curious paradox might encourage us to be a bit more conscious of our physical fitness.  When you are feeling well, take time during the day to be fully aware of what good shape you are in.  Tell yourself I feel well.  Repeat this while walking and at work in order to discover and enjoy a relaxing moment.

     Compared to the relatively static pelvis, the hips is very mobile.  It is not accurate to describe a person as being "flexible in the pelvis."  This suppleness derives from the joints linked to the pelvis: the femur and vertebral column.  The hip is a very strong joint rarely subject to sprain or luxation, except in cases of severe trauma or congenital disorders.  There are entire "hip" families where arthrosis is perpetuated through generations.