seminar notes / cookbook acupuncture

Cookbook AcupunctureA Clinical Acupuncture Training Handbook

Designed for Practitioners of Acupuncture

Anatomical Acupuncture Chiropractic Acupuncture

Medical Acupuncture &

Acupuncture-Informed Trigger Point Dry Needling™

Jim Ventresca, Doctor of Oriental Medicine

Principal, AcuPractice Seminars

Edited by Claudia Welch

Note: The information in this book is true and complete to the best of my knowledge. This book is intended as an informative guide for those wishing to know more about health issues and acupuncture theories. This book is not meant to be used, nor should it be used, to diagnose or treat any medical condition. It is in no way intended to replace, countermand or conflict with the advice given to you by your physician or healthcare provider. The ultimate1 decision concerning care should be made between you and your doctor, or between any patient and her doctor. Information in this book is general and is offered with no guarantees on the part of the author or publisher. The author and publisher disclaim all liability in connection with the use of this book.

ISBN:

AcuPractice Press

Copyright Dr. Jim Ventresca / AcuPractice™ Seminars 1994 - 2015

..............................................................Author’s Note:! 10

..........................................................................Preface! 10

.......................................................Acknowledgments! 12

..................................................................Introduction! 13

........................................................2nd Edition Notes! 15

.........................Terminology & Literary Conventions! 15

.......................................................Reference Material! 177. The Basics: Chinese Medical theory 101 20

....................................................................Yin & Yang! 21

....................................................The Eight Principles! 22

...................................................The Vital Substances! 25

.........................................Pulse & Tongue Diagnosis! 30

.....................................................Meridians & Organs! 32

.......................................................The Five Elements! 37

.......................................................Causes of Disease! 418. The Organs 42

.....................................................................The Lungs! 43

....................................................................The Spleen! 44

.................................................................The Stomach! 45

.......................................................................The Heart! 46

Copyright Dr. Jim Ventresca / AcuPractice™ Seminars 1994 - 2015 2

.................................................................The Kidneys! 47

.....................................................The Urinary Bladder! 48

...........................................................The Pericardium! 48

.................................................................The San Jiao! 49

.......................................................................The Liver! 49

..........................................................The Gall Bladder! 519. Acupuncture Techniques Demystified 52

..............................................Clean Needle Technique! 53Risks to Acupuncture Providers! 55Acupuncture Patient Side Effects!55

................................Contraindications and Cautions! 56

............................................Office Setup/Patient Flow! 57

.................................Acupuncture Distal Techniques! 58

..............................................................Getting The Qi! 58

.................................................................Acupuncture! 59

...........................................Electro-Acupuncture (EA)! 61

.....................................................Laser Acupuncture! 66

..............................................................................Moxa! 66

.....................................................................TDP Lamp! 69

.....................................................Gua Sha & Cupping! 7010. Points & Meridians: The Raw Ingredients 74

.......................................................Meridian Overview! 74

3 Copyright Dr. Jim Ventresca / AcuPractice™ Seminars 1994 - 2015

...................................The 8 Extraordinary Meridians! 76Dr. Jim’s Tai Ji Treatment!78

...........................................................Points Overview! 79Body Measurements and General Point Location! 79

...................................Classic Point Categories Table! 80Controlling Points!81Hua Tuo Jia Ji Points! 82Yuan Source Points! 82Five Element Points! 84Tonification and Sedation Points!85Horary Points! 85Xi Cleft Points! 85Five Shu (Transport) Points! 86Luo Points!87Meeting or Influential Points! 87The Back Shu (Associated) Points! 88The Front Mu (Alarm) Points! 89Trigger Points aka Ah Shi Points!90

11. The Main Meridians & Their Major Points 90

................................Du Meridian “Governing Vessel”! 91

............................Ren Meridian “Conception Vessel”! 94

..............................................................Lung Meridian! 98

............................................Large Intestine Meridian! 100

......................................................Stomach Meridian! 104

..........................................................Spleen Meridian! 108

............................................................Heart Meridian! 111

............................................Small Intestine Meridian! 113

...........................................Urinary Bladder Meridian! 117

..........................................................Kidney Meridian! 123


.................................................Pericardium Meridian! 126

.......................................................San Jiao Meridian! 128

................................................Gall Bladder Meridian! 131

.............................................................Liver Meridian! 135

..................................................Extraordinary Points! 14012. Auricular Acupuncture: Microsystems & Extraordinary Meridians

142

.....................................................Hand Acupuncture! 143Selected Upper Body Hand Points! 143Other Hand Points! 143

..............................................Auricular Acupuncture! 145Ear Anatomy ! 146Major Auricular Points! 146Specific Auricular Treatments! 148Acupuncture Treatment of Chemical Dependency ! 148

.....................................................Scalp Acupuncture! 150Scalp Contraindications and Cautions! 151ScalpTechnique! 151Scalp Points! 154Head & Neck Points! 154Neck & Shoulder Points! 154Shoulder Arm & Hand Points ! 154Thorax Points! 155Low Back Points! 155

..................................................Chinese Scalp Lines! 156Based on Cortical Homunculus ! 156Finding the Lines: Lines of Measurement! 156Continence Line (AKA: Leg & Foot Motor & Sensory)! 158Motor Function Line! 160Sensory Perception Line! 160Tremor Control Line! 161Vision Line!161


Vertigo and Balance Line!161

.........The 8 Extraordinary Meridians In More Detail! 163Treatment Protocol for the Extraordinary Vessels! 167

........General Uses for the Extraordinary Meridians! 167

..................................................Dai Mai (Belt Vessel)! 167

................................Chong Mai (Penetrating Vessel)! 168

............................Ren Mai (Conception Vessel CV)! 168

.................................Du Mai (Governing Vessel GV)! 168

............................Secondary Extraordinary Vessels! 169Yin Qiao & Yang Qiao (Heel Vessels)! 169Yin Wei & Yang Wei (Linking Vessels)! 169Psychological Issues & Extraordinary Meridians!170

13. The Main Course: Treatment of Pain 173

..................................................Diagnosing The Pain! 173

............................................................Immobilization! 173

....................................................................Ice & Heat! 174

......................................................Treatment Results! 174

.....................................................................Palpation! 175

..........................................................Local Treatment! 175

.....................................................Moving Stagnation! 176

......Treating Pain: Local, Adjacent, & Distal Points! 177

.......................Sinew (Tendino-Muscular) Meridians! 179

..............Zonal Treatment for Treating Pain by Area! 179


.............................................................Microsystems! 181

..................The Main Local Points for Treating Pain! 183

The Recipes: Treating Specific Painful Conditions!184Headaches! 185Facial Pain! 185Neck Pain & Stiffness! 186Wrist & Hand Pain!186Arm & Shoulder Pain! 187Upper and Mid Back Pain!187Low Back & Hip Pain and Sciatica! 189Knee Pain!190Foot & Ankle Pain!190Abdominal Pain! 191

14. Review: National Board Exam & Program 191

................................................................Introduction! 191

...........................................................General Theory! 192Yin Yang! 192Eight Principles! 192Five Elements! 193Chronotherapy (The Horary Cycle)! 193

.......................................The Essential Substances :! 194Qi! 194Jing! 195Blood! 195Fluids: Jin Ye! 196

.......The Causes of Disease or Pathogenic Factors! 197

.........................................................................Organs! 197Lungs! 197Spleen! 198Heart AKA: The Emperor!198Liver! 199Kidney ! 200Pericardium! 200San Jiao! 201


Extraordinary (Curious) Organs! 201

....................................Tongue and Pulse Diagnosis! 201

............................................Clean Needle Technique! 202

..........................................Acupuncture Techniques! 203

..........................Acupuncture Points and Meridians! 204

...Auricular Acupuncture and Other Microsystems! 210

...........Name That Disharmony / Diagnosis Review! 21115. Internal Medicine 212

................................................................Introduction! 212Theoretical Principles Review! 212Meridian Review! 213Organs Review! 213Extraordinary Meridians! 213Extraordinary / Curious Organs! 214

........................Respiratory System and Conditions! 214Upper Respiratory Conditions! 214Lower Respiratory Conditions! 215Allergies! 216COPD: Asthma, Chronic Bronchitis, Emphysema, etc.! 216Immune System Weakness! 217Smoking Cessation! 217

...................Gastro-Intestinal System & Conditions! 217Oral Cavity (mouth, tongue, teeth, lips)! 217Pharynx and Esophageal!217Stomach! 218Intestinal / Colorectal! 219

.......................Genito-Urinary System & Conditions! 220Kidney Disease / Failure! 220Low Sex Drive, Impotence, Frigidity ! 220Urinary Tract Infections! 221Urinary Retention! 221


Male GU Conditions! 221Female GU Conditions! 222

....................................................WOMEN’S HEALTH! 223Introduction! 223Review Major Relevant Points:! 223Organs, Meridians, and Substances! 223Essential Etiology !226Essential Diagnosis! 228Treatment of the Most Common Disharmonies! 230Treatment of Internal Organs! 230Specific Disorders!233Disorders after childbirth:!239Infertility ! 240Breast lumps! 240Abdominal Masses! 240Polycystic ovary disease! 240Menopause! 240

...............Women’s Health: Name That Disharmony! 241


Author’s Note: This printing of this book is part of a process. I don't know when it will be what I hope it will become, but it’s getting there. It started out as a set of lecture notes that have been continuously updated since I began teaching Chinese Medical Theory at Southwest Acupuncture College in 1994. This time I thought I’d give it a full rewrite, and make it into a regular book. So, you can think of it as a book/course outline, that is that is being transformed into an educational narrative. I’d say I’m about 50% there, give or take. So, even though some of the recipes and instructions are still in outline form, I think you’ll find it a clinically useful, and maybe even fairly readable book.

Jim Ventresca, Prince Edward Island

July, 2015PrefaceA cookbook is a good thing. It’s a quick reference guide to help you create good results in the kitchen. This acupuncture cookbook can help you get good results in the clinic. “Cookbook Acupuncture” is a term I’ve heard since I began to study acupuncture in 1982. It is has been given a bad rap as an inferior approach to treatment. I disagree. In my experience, almost every practitioner I know and teacher I’ve studied with,uses recipes, although they usually call them point prescriptions. Of course, most of them justify their recipes with theories, but the recipes persist, and they get handed down and around from one person to another. Here’s how it goes:

“How do you treat stubborn low back pain?”

“Well, I always like to try such and such or if that doesn’t work, I’ll try this and that,”etc.


So why not just call it what it is, and get the information out to as many practitioners as possible?

Of course, differential diagnosis is important. Holistic treatment dictates that one address both the root causes and the branches of disorders. I assume that, as a healthcare provider, you already have at your disposal one or more means of treating the root causes of your patients’ disorders. We could fill a small library with books on how to treat the roots. This book is designed to help you manage the branches. That said, we will look into the basic theories underlying TCM diagnosis and treatment, with sufficient depth that the avid student will find sufficient detail to benefit her patients.

Comprehensive cookbooks go into great detail on all the theories and techniques associated with the recipes in the book. This isn’t one of those types of cookbooks. It’s more like a card file of recipes from your grandmother. Your grandmother would have assumed you already know the basics, yet she might still have written in a few a reminders such as, how to mix the pancake batter: “Mix only until the dry ingredients are moistened.” Because I assume you either have prior training, or are currently getting some, and have access to acupuncture charts, books, apps, and notes to fill in any gaps, this acupuncture cookbook only touches on the theories and techniques, as gentler reminders.

I’ve been cooking since I was a boy. Yet still, I find it helpful to keep a cookbook or two in my kitchen, and open them from time to time, for a quick reminder of how to make something I haven’t cooked for a while, to learn how to make a dish I haven’t tried before, or inspiration for something new. I hope you find that Cookbook Acupuncture serves a similar purpose in your clinic.


Acknowledgments

Since I began practicing and studying acupuncture and Oriental medicine many years ago, I’ve had many wonderful teachers and colleagues from many different acupuncture traditions. The techniques in this book are drawn from all of them. It would be difficult—if not impossible, to trace the origin of each of these techniques, but I am ever grateful for and to all the folks who helped me along the way. Most especially I would like to thank Dr. James Tin Yao So who inspired the first few generations of acupuncturists in the US, and started the New England School of Acupuncture; Don Halfkenny who taught me how to be practical, fair and reasonable in dispensing acupuncture healthcare; Kiko Matsumoto for teaching me how to reason within the boundaries of acupuncture; Jeffery Yuen for teaching me how to understand the underpinnings of this medicine; My classmate and old friend Jean Loius (Lalou) Begue for showing me the value of paying attention to the details; Skya Abbate and Anthony Abbate for giving me the opportunity to discover how best to teach this medicine; my brother Dr. Chuck Ventresca for his example of complete integrity as a physician and his mastery of the science and art of healing; and Dr. Claudia Welch, a skilled healer, deep thinker, talented author, wonderful editor, my inspiration, best friend, partner, and wife.


Introduction

State rules and regulations, or individual practitioners, may make clear distinctions between the terms, “acupuncture,” “dry needling,” “meridian therapy,” or “trigger-point needling,” but it’s all the same to me, and probably to your patients too. Each of these methods of healing involve placing acupuncture needles into patients to relieve pain, be it neuromuscular or organ related, physical, or emotional. They all require some knowledge and experience to get good results.

Whether you are a licensed acupuncturist, a doctor of: chiropractic, medicine, naturopathy, osteopathy, physical therapy, or Oriental medicine, this book assumes that you are a licensed healthcare practitioner, with acupuncture or dry needling in your scope of practice, and that you have taken or are currently taking at least basic acupuncture training. In other words, I assume that you already know how to insert a needle, which points are contraindicated in what conditions, how to find most of the important acupuncture points, and that you are qualified to practice. Hopefully you also know how to arrive at a basic TCM diagnosis like: Liver Qi Stagnation, Qi and Blood Stagnation, or Spleen Qi Deficiency.

That said, like all of us, you may still need an acupuncture chart to find the point you’re looking for, and you may need a little reference material to hone your diagnosis on a particular patient. That’s all part of the experience that comes with time. Every time you use a point or make a diagnosis, and see good results, you’ll remember that point or diagnosis.

The issue of who gets to practice acupuncture and how much training is necessary can be a hotly debated one. Individual state ,


and national laws and regulations allow various healthcare providers to practice acupuncture, or dry needling, or whatever you might call it, with certain minimum amounts of training. Because their laws allow them to employ these techniques, some health care providers naturally want to provide these therapies, They search out training programs that meet their minimum requirements.

I believe everyone who practices acupuncture should have the best training that can fit into the number of hours required by law. I have put in a great deal of time debating acupuncture laws rules and regulations over the last 30 years, and I’m glad I had the opportunity to do so.

Now however, I view my role exclusively as an educator, and as such I’ll leave the politics to others and concentrate on providing the best training possible to all acupuncture providers.

The information in this book is not complete in and of itself. It’s meant to serve as an adjunct to classroom study, and as a clinical handbook, once you’ve completed some studies. If you are hoping to practice acupuncture with only the information contained in this book, you will find yourself severely under-informed. However if you are using it as intended, it should serve you well.

This information is based on over 30 years of my personal experience treating patients and teaching acupuncture. It’s short, direct, and to the point. I really think it’s my best stuff. I hope you find it helpful.


2nd Edition Notes

This is the second edition of this book and is greatly expanded from my first attempt. The first edition of this book “The Acupuncture Cookbook” was aimed at assisting doctors who were already trained in acupuncture in honing their skills in treating pain.

This edition: Cookbook Acupuncture is meant to double as companion set of notes to AcuPractice™ Seminars’ programs and courses in Acupuncture, and in Acupuncture-Informed Trigger Point Dry Needling™, as well as a clinical handbook for licensed practitioners.

Terminology & Literary Conventions

Oriental Medicine includes all aspects of traditional medicine as is has been practiced throughout Asia (China, Japan, Korea, Taiwan, Vietnam, Tibet, and perhaps even India, etc.) for many centuries, and as it continues to be practiced around the world today.

Traditional Chinese Medicine (TCM) is the version of Oriental medicine that is taught and practiced in mainland China today. This brand of Oriental medicine was created in the late 1940s and early 1950s as a way to consolidate 20 centuries of traditional medical information into a coherent system of that could be taught in a reasonable amount of time, to a vast number of practitioners. While it doesn’t include every aspect of Oriental medicine, it is quite effective and is likely the most commonly practiced from of Oriental medicine in the world today.

Medical, Chiropractic, and Anatomical Acupuncture: These terms are generally applied to the type of acupuncture taught to


physicians in focus programs of between 100 and 300 hours. These programs vary widely with regards to the depth of information on Oriental medical diagnosis and the treatment of internal medical disorders. As a result the term has come to refer to acupuncture treatment that is primarily focused on neurological and musculoskeletal pain syndromes.

Trigger Point Dry Needling (TPDN) is a procedure that employs a single powerful needling technique, to treat neuromuscular and musculoskeletal pain syndromes. This needling technique is one acupuncture practitioners have been employing for centuries. The distinguishing factor is TPDN practitioner’s complete avoidance of any reference to acupuncture, coupled with a strict reliance on biomedicine & biomechanics for diagnostics and explaining mechanisms of action. It’s my belief that this strict avoidance of any acupuncture reference is more political than anything based on clinical effectiveness.

Acupuncture-Informed Trigger Point Dry Needling™ is the practice of coupling the needling technique one would recognize as Trigger Point Dry Needling, together with some of the more powerful systemic and energetic acupoints and approaches to treatment to argument clinical results. It seems a shame that healthcare professionals who practice trigger point dry needling can not offer their patients the simple addition of major acupuncture point combinations and needling techniques that carry the very real likelihood of improved clinical results, for what may be purely political reasons. As the name implies, Acupuncture-Informed Trigger Point Dry Needling™ is my answer to this sad state of affairs. I have trained many healthcare providers in acupuncture over many years, and having kept in touch with a good number of them, I find that some of them end up practicing just this style of treatment. This is likely due to the fact that their practices are mostly geared toward treatment of painful neuromuscular and musculoskeletal disorders, and they’ve found this a most useful approach.


Capitalization: Given that many technical Oriental medical terms are the same word as those used in western biomedicine, the accepted literary convention is to capitalize Oriental medical terms. For instance: “Blood” refers to the Oriental Medical term for the nutritive aspect of Qi, while “blood” refers to the red fluid found circulating in your blood vessels.

Organ and Meridian Abbreviations: ! LU: Lung ! ! LI: Large Intestine! SP: Spleen! ! ST: Stomach! HT: Heart! ! SI: Small Intestine! KD: Kidney ! ! UB: Urinary Bladder ! PC: Pericardium! SJ: San Jiao *! LR:Liver! ! GB: Gall Bladder! DU: (GV) Du Mai aka Governing Vessel !! REN: (CV) Ren Mai aka Conception Vessel

* San Jiao (SJ) is also known as:! ! TE Triple Energizer ! ! TW Triple Warmer! ! TH Triple Heater! ! TB Triple Burner

Reference Material

Clearly, the clinical application of acupuncture is difficult to convey in a book, so please forgive my self promotion. AcuPractice™ Seminars is the program I, my brother Dr. Charles Ventresca, and the rest of our Faculty have developed and offer, for training healthcare professionals in acupuncture. Most of our students are chiropractors, medical doctors, osteopaths, naturopaths, physical therapists and a few nurses here and there. If you need a training course, would like some additional training, or if you have a colleague who would like to study, please consider AcuPractice™ Seminars. We offer quality acupuncture education programs, that prepare healthcare providers to practice acupuncture safely and effectively.


We offer National Board Review classes, Classes on AcuPoints & Meridians, Needle Techniques, MicroSystems, Internal Medicine, Women’s Health, and the Treatment of Pain.

For dates, locations fees, hours, and the rest of the usual information, please visit us online: AcuPracticeSeminars.com

If you haven’t read The Web That Has No Weaver by Dr. Ted Kaptchuck, I highly recommend you get a copy and read it. It will provide you with most of the information you need to understand the basic theories of acupuncture and Oriental medicine. Even if you’re not going to use all the information in the book, you should at least make sure you are familiar with it, if only to be able to speak knowledgeably on the subject.

You might want have a good set of Acupuncture Charts. I recommend the kind that hang on your wall, so you have quick reference, and so your patients will become more interested in acupuncture. However you choose to reference them, you should have some way to easily locate points when you want them.

The industry standard reference book for acupuncture points is A Manual of Acupuncture by Peter Deadman & Mazin Al-Khafji with Kevin Baker. It’s a great textbook and contains most all you could want to know about acupuncture points. A Manual of Acupuncture App, is a wonderful resource for learning and reviewing points and meridians. This app even has a video of how to locate and needle every acupoint. This app gets my highest recommendation. At the time of this printing, there is no app for Android devices, however, even if you need to purchase an Apple device to use it, it’s worth the trouble and expense.

In addition to a resource for acupuncture points, a good set of Trigger Point Charts or one of the many good Trigger Point Apps, is really worth having. When you are treating pain, you will want to be able to quickly locate and treat the related trigger points. Of course you can simply palpate for the trigger points, but why reinvent the


wheel every day? Most common trigger points have already been discovered. The charts are worth having, and will get you in the ballpark for the most common trigger points. This is especially true for acupuncturists and others who haven’t had direct training in trigger points. If a Chinese doctor from the 17th century had taken the time to catalog all the Ah Shi (locally reactive) points, that were useful for treating pain, along with their referral pathways, those points would be taught in every acupuncture school. As it turns out, they were named and the cataloguing began in the mid to late 20th century, by Dr. Janet Travell, and she called them Trigger Points. I believe any acupuncture practitioner would be well-served by spending a little time learning how to find and work with them.

In order to get a clear perspective on how Oriental medicine views and balances health through lifestyle and diet I highly recommend Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness through Ayurveda, Chinese Medicine and Western Science by Dr. Claudia Welch. This book is geared toward women’s health, but is clinically applicable to all patients, men and women. I highly recommend it to all healthcare practitioners, and to patients as well. Especially women.

I also want to mention Close to The Bone, by David Legg, a very good book to find many of the “nuts and bolts” of treating painful musculoskeletal conditions.


1. The Basics: Chinese Medical theory 101

This section briefly introduces many clinically useful theories that form the basis of acupuncture and Oriental medicine. These theories can be successfully employed to enhance the practice of acupuncture with only a little effort spent in understanding them. These concepts are extremely important when treating internal disorders. They are less critical for neurological and musculoskeletal disorders, but can still be quite useful for crafting more effective acupuncture treatments for these maladies.

The Five Branches of Oriental Medicine

Acupuncture & Moxibustion includes all application of Physical Stimulus to AcuPoints: Needles, Heat, Pressure, Cold Laser Light, Milliamp Electrical Stimulation, etc.

Herbal Medicine includes the ingestion or topical application of natural, minimally-processed, medicinal substances.

Exercise: Tai Chi & Qi Gong cultivate and manipulate one’s vital energies (Qi).

Diet & Lifestyle: Michael Pollen’s advice on food is probably the best and most direct I’ve come across, and it blends well with the Oriental medical approach: “Eat Real Food (i.e. foods your great grandmother would recognize as food), Not Too Much, Mostly Plants.” Couple that with sufficient physical exercise, rest, and repose, and you’re well on your way to a healthy lifestyle.

Massage & Manipulation: There is long history of both of these modalities in the Orient.


Yin & Yang

Yin and Yang are among the most basic ideas underlying traditional Chinese philosophy and medicine. Volumes have been written on this subject, and it is a rich and interesting topic to discuss, with many implications that can be interpreted in all aspects of our existence. Yin and Yang encompass any opposite and complementary pairings that exist. Night and day, hot and cold, up and down, male and female, left and right, are but a few of the myriad of possible pairs we find in our universe. Here we will only concern ourselves with the aspects of Yin and Yang that directly apply to the practice of Oriental medicine. There are three sets of opposites that describe Yin and Yang in most clinical applications. Respectively, they are “Substance and Function,” “Internal and External,” and “Cooling and Warming.”

Yin represents the substance and substances of the body, the internal areas of the body, and the energies that cool and moisten the body, and provide for rest. Yang represents all functional aspects of the body, the body’s external aspects, and the energies that warm and activate the body.

The information contained in the following tables is helpful in understanding some of the the clinical significance of Yin & Yang.

FUNCTIONS OF YANG FUNCTIONS OF YIN

Provides Function Provides Substance

Warming Cooling

Moves, Activates, Circulates Provides Rest the Ability to Rest

Protects / Provides Defense Provides the Ability to Recover from Disease


Transforms Maintains Structure

Holds Up and In Place: Blood, Fluids, & Organs

Nourishes & Moistens: Blood, Fluids, & Organs

DISORDERS WHICH ARE YANG IN NATURE -

ASSOCIATED WITH

DISORDERS WHICH ARE YIN IN NATURE -

ASSOCIATED WITH Excess Yang or Deficient Yin Excess Yin or Deficient Yang

Acute / Rapid Onset Chronic / Slow OnsetExcess Activity / Insomnia Rest / Fatigue / SleepinessStretch Out To Sleep Curls Up In SleepHeat Signs: Red Efflorescences Rapid Pulse

Cold Signs: Pale Efflorescences Slow, / Not-Rapid Pulse

Thirst: Likes Cold Drinks No Thirst: Sips Warm DrinksLoud Voice - Extrovert Soft / Weak Voice - Introvert

YANG BODY AREASCONTRASTED WITH YIN AREAS

YIN BODY AREAS CONTRASTED WITH YANG AREAS

Superior InferiorPosterior AnteriorLateral Medial

External Internal

The Eight Principles

These are four sets of Yin/Yang pairs that help us begin to understand the nature of disorders, and form an Oriental medical


diagnosis. This diagnostic framework is usually combined with diagnostic information about the Organs, Meridians and Substances to arrive at a complete diagnosis. These four pairs of opposites are: Yin & Yang, Internal & External, Hot & Cold, Excess & Deficient.

Yin & Yang: Determination of whether a symptom or diagnosis is more Yin or More Yang can be based on the material presented in the preceding section on Yin & Yang.

Internal & External refer to either the location of the disorder or it’s etiology. For instance: A skin disorder is usually considered external. An emotional disorder or one pertaining to an Organ is generally considered internal. In addition, these designations can combine. For instance, a skin disorder which results from an emotional trigger such as stress, has an external location and and internal etiology, so would be considered both internal and external.

Excess and Deficiency manifest in many ways. Some examples are found in the tables on Hot & Cold, below. A few notable guidelines:

• Pain, Tension & Tightness are generally associated with Excess

• Weakness, Numbness and Tingling are generally associated with Deficiency.

• Somatic Accumulations, such as excess weight, tumors, cysts, and Stagnant Blood are excesses.

• Organ disharmonies such as Spleen Qi weakness, are often related to deficiencies.

• Again, these designations can also combine, as in the case of excess accumulation of adipose tissue arising out of a deficiency of the Spleen’s ability to fully digest the food and fluids one consumes.

Hot & Cold: Many disorders present with symptoms that indicate heat or cold. The tables below illustrate many of the most common clinical presentations.


DESCRIPTION OF CONDITION AKA TREATMENT PRINCIPLE

Yin Excess True ColdInvasion of Cold

Sedate YinWarm Cold

YANG EXCESS True HeatExcess Heat / Full Heat

Sedate YangCool Heat

Yin Deficiency False HeatHeat from Deficiency

Tonify YinNourish Yin

Yang Deficiency False ColdCold from Deficiency

Tonify YangRekindle Yang

Excess, Full, or True Heat Usually Seen in URI:

aka OPI Heat

Deficient Yin aka False Heat

Thirst Dry Mouth, Skin, Hair, etc.Red Face / Red eyes Malor FlushFull Sweat / Fever Night Sweats / Hot Flashes Painful SoreThroat Chronic Dry & Itchy ThroatStrong Cough Yellow Expectorant

Chronic Dry Weak Cough

Dark, Scanty, Urine (Burning if severe)

Dark Scanty Urine

Constipation w/ discomfort or Hot Diarrhea

Dry Stool

Pulse: Rapid & Full Pulse: Rapid, Weak & ThinTongue: Red Body / Yellow Coat

Tongue: Red / No Coat (Peeled)

Excess, Full, or True Cold Often Seen in URI: aka OPI Cold

Deficient Yang aka False Cold

Clear Copious Urine SAMEPreference for Warm Liquids SAME


Pale Face SAMEChills Cold Body, Hands, & FeetCramping Pain Better with Heat No Pain Associated

Cold Diarrhea Loose Stools / Undigested Food

Tongue: Thick White Coat Tongue: Pale Puffy / Wet CoatPulse: Excessive / Full Pulse: Weak & Slow

The Vital Substances

Qi (pronounced “chi”) is energy. One could write an entire book about the details and intricacies of Qi, in fact many people have, but not me, at least not today. The idea of Qi reaches well beyond it’s implications for Oriental medical theories, but we will limit our discussion to this application. Let us suffice it to say that Qi is the energy that flows throughout an individual, and activates all life’s processes, the Vital Force that keeps us alive and thriving. Qi is a Yang phenomena, and as such has Yang attributes.

The main functions of Qi are the following: • To Move, Transport and Activate: Any movement, be it

muscular, circulatory, respiratory, cellular, or otherwise depends on Qi. If the Qi becomes deficient or stagnant, movement is impaired and disharmonies result.

• To Warm: This function includes one’s ability to feel warm and comfortable as well as mediating the body’s “fires”. For instance, the “digestive fire” of the Spleen powers all our digestive processes.

• To Protect: The Wei Qi is expressed in our ability to fight off pathogenic influences like colds and flus. It is the shield that is our immune system.


• To Hold in Place: Organs, Fluids and Blood all need to be held in place. When they are not held in place edema, prolapsed organs, easy bruising, varicosities, hemorrhoids, dysfunctional uterine bleeding, and other disorders result.

Disharmonies of Qi: There are Two Main categories of Qi Disharmonies. Since Qi is mainly responsible for making things happen (i.e. activation) and for moving things, QI can either be Deficient or Stagnant.

• QI Deficiency (Qi Xu) results from malnutrition, overwork, insufficient rest & repose, chronic and acute illnesses, and often as a result of old age. Qi Xu can manifest in the entire body, the spirit, or a particular Organ. As we will see, many other disharmonies are built upon the following Qi Deficient symptoms: • Fatigue• Weakness• Malaise• Pale Face• Pale & Swollen Tongue• Weak Pulse• Organ Disfunction

• Mainly: Spleen, Lungs, Kidneys & Heart• Qi Stagnation (Qi Yu) results from trauma, Outside

Pernicious Influences (OPI), emotional upset, and inappropriate diet. The main symptoms include pain and emotions: • Pain:

• Dull, Achy, and Unfixed• Intermittent or traveling• Feels better with massage• Intercostal neuralgia

• Emotions:• Feeling stuck emotionally• Emotional outbursts • Uneven expression of emotions• Other Signs:

• Slightly Purple tongue


• Wiry Pulse• Plum Pit Throat aka “Feeling all choked up”

Two other disharmonies of Qi are Qi Collapse, and Rebellious Qi. When Qi becomes especially deficient it may collapse. There are two presentations of Collapsed Qi:• Spleen Qi Collapse = Prolapse. i.e. anus, uterus, bladder,

stomach…• Heart Qi Collapse = heart attack (MI)Rebellious Qi is Qi moving in the opposite direction from it’s normal orientation. while all organs can suffer from rebelious Qi two are most common• Rebellious Stomach Qi = Heartburn, nausea, vomiting,

acid reflux…• Rebellious Lung Qi = cough, sneezing, COPD, hiccough…

Blood (Xue). Blood is the nutritive aspect of the body’s Qi. Blood is a Yin phenomena, and as such has Yin attributes. The main functions of Blood are:

• To Nourish: When Blood is deficient, the lack of nourishment can be observed as fatigue, lack of muscle tone, and a pale and lusterless complexion.

• To Moisten: The lack of moistening can be seen in symptoms such as dry skin, dry hair and eyes and vaginal dryness. In addition, the Tendons need to be moistened. When the Tendons dry out, tics, twitches and tremors are commonly seen.

• To Provide the Ability to Rest: Blood Deficiency often results in difficulty falling asleep.

• To Recover & Restore our strength after illness. The Main Relationships of Blood:! Heart: Moves It Through Body! Liver: Stores and Releases (includes Menstrual Blood)! Spleen: Produces Blood & Holds It In the Vessels


Disharmonies Of Blood: Blood, like Qi can become Deficient, or Stagnant, but can also become overheated, know as Hot Blood.

Deficient Blood (Xue Xu) similar to Qi Xu arises from malnutrition, chronic Illness, congenital disease, old age, exhaustion from overwork, and also from a physical loss of blood. Also like Qi Xu, Xue Xu can manifest in the entire body, the spirit or a particular Organ. The signs & symptoms of Blood Xu are very Similar to Qi Xu, but with the addition of Lack of Both Nourishment and Moisture.

Fatigue, MalaisePale Lusterless FaceWeak Thin PulsePale & Thin TongueOrgan Dysfunction Dry SkinDry Brittle HairTwitches And Spasms (Due To Drying Out Of Tendons)Scanty/Light/Shortened/Infrequent MensesDizzinessDifficulty Falling Asleep (Yin Substance)Dry Eyes (Liver)Palpitations (Heart)

Stuck Blood (Xue Yu) Arises from trauma, or as a result of Qi stagnation. Like Qi Yu, one of the main symptoms of Xue Yu is pain. The Pain associated with Blood Stagnation is:

• Sharp and Stabbing • Fixed in Time & Space• Feels worse with massage• Associated with

• Tumors Or Cysts (Non-Moving)• Swollen Organs• Hematoma• Clots

Hot Blood is a condition associated with heat entering the Blood either from the outside or from internal causes. Heat in the Blood often causes bleeding or redness of the skin, as seen in red dry skin, pimples, rashes, or hemorrhage of fresh red blood such as hemorrhoids, uterine bleeding, or blood in the urine.


Jin-Ye: All physiological fluids of the body, with the exception of Blood.

• The Jin are the clear, watery, more Yang fluids such as tears and sweat.

• The Ye are the more Yin and thick fluids such as the internal moisture and synovial fluids.

• San Jiao, Kidneys, Spleen and Lungs: Produce and manage the fluids.

Jing is the Constitutional Energy that we inherit from our parents.

• Each of us is conceived and born with a potential, that manifests in our own unique physical, mental, and emotional makeup. How we take advantage of this potential varies from individual to individual.

• As we age we “use up” this constitutional energy. As our Jing is depleted over a normal lifetime the process of aging progresses.

• We conserve our Jing by living a healthy and balanced lifestyle.

• When the Jing is Deficient or depleted too quickly, signs of early aging occur. These include:• Poor Development In Children• Poor Concentration / Memory• Reproductive Disorders• Loose Teeth• Brittle Bones• Gray-Thinning Hair• Senility

Shen is an individual’s consciousness, and as such, it dictates one’s subjective experience of all aspects of life, joy and sorrow, pleasure and pain. When one’s Shen is disturbed, mental and emotional imbalances can be experienced. These imbalances can range from mild anxiety or depression, to a complete psychotic break. Treating the Shen is often part of the treatment plan when treating patients for painful conditions, as well as those who are


suffering from psycho-spiritual disharmonies. Calming the Shen relaxes the patient and allows for a more free flow of Qi and Blood. If the Shen is not at peace, it can result in further imbalances that lead to increased tension, which leads to further stagnation, which increases pain, which furthers the loss of peace-of-mind, and snowballs into more physical and psychological suffering. Disharmonies of Shen show up as:

• Emotional Problems, Psychological And Emotional Shock, Disturbances Of Psychological/Mental Nature

• Eyes That Lack Luster• Muddled Personality Forgetful And Slow• General Spiritual Disorder (Psychosis)

Pulse & Tongue Diagnosis

Palpation of the radial pulse and observation of the tongue have been in use as diagnostic indicators for many centuries in traditional Asian medicine. Mastering these techniques and acquiring the ability to diagnose a condition simply by feeling a pulse and looking at a tongue require many years of study and practice.

However, learning the basics of these diagnostic techniques is simple, and can be learned in a single session. In addition by using only the most basic parameters of tongue and pulse diagnostics, a doctor can glean much useful diagnostic information with only a little practice. The following table illustrates the most common and easy to detect pulse and tongue combinations that are often found in practice and can offer significant diagnostic direction.

Condition Tongue Pulse

Normal Normal Red Thin White Coat

Moderate Strength Slightly Slippery 60-80 BPM


Condition Tongue Pulse

Qi Deficiency Pale & PuffyThin White Coat

Weak

Yang Deficiency Pale & PuffyWet Coat

Weak & Slow

Blood Deficiency Pale Thin & DryThin White Coat

Weak & Thin

Yin Deficiency Red & Thin & DryNo / Peeled Coat

Weak & Thin & Rapid

True Excess Heat

Red & DryThick Yellow Coat

Full & Rapid

Dampness Greasy Coat Slippery

Qi Stagnation Slightly Purple Slightly Wiry

Blood Stagnation Dark Purple(Maybe Spots)

Definitely Wiry

OPI Heat Red Tip Red Edges

Rapid & Floating

OPI Cold Normal Floating

Long-Standing SP Xu

Scalloped Edges Weak in Middle Position

LR Qi Stagnation Slightly Purple Full & Wiry


Meridians & Organs

The Meridians and Organs of acupuncture have considerable areas of overlap. • Each of the Zang and Fu Organs has a corresponding set of

meridians. • The 6 Zang or Solid Organs and Meridians are classified as Yin.• The 6 Fu or Hollow Organs are classified as Yang. Each Zang

Organ is Paired with a Fu Organ, making up 12 Yin - Yang pairs. Yin Meridians and Organs, for the most part, address metabolic dysfunction and Internal Disharmonies, often referred to as Yin Disorders. In addition, many of the functions associated with the Yang Organs are orchestrated by, and treated through, the Yin Organs. For instance, the digestive functions western medicine associates with the large intestine, small intestine, gall bladder, liver, and pancreas, are all subsumed under the functioning of the Spleen. The points on these meridians become important for their effects in treating specific aspects of internal Organ function.

Yang Meridians are generally used to address the Yang disorders, those that manifest more on the surface or exterior of the body, such as musculoskeletal pain, tension, and tightness. Since the Yang meridians tend to treat pain along their respective pathways these pathways become, in some ways, more important than the functions of their individual points.

There are a few exceptions to the above rules and we will explore them as they arise.

The Organs and Meridians pair up in a two main ways. • The primary pairing of Yin and Yang, is known as the

Husband-Wife relationship. • A second grouping of Yin-Yin and Yang-Yang relationships is the

Six-Division Pairing.


•

The Husband-Wife / Yang-Yin Pairs are grouped according to the Five Elements, which are further explained in the next chapter.

YinWife

YangHusband

Element

Lung Lg. Intestine Metal

Spleen Stomach Earth

Heart Sm. Intestine Fire

Kidney Urinary Bladder Water

Pericardium San Jiao Fire

Liver Gall Bladder Wood

The Six-Division / Yang-Yang and Yin-Yin Pairs. Note: The Yang/Yang pairs play a significant role in the treatment of musculoskeletal, neuromuscular and painful conditions.

Divisions Yang-Yang Pairs

Grater Yang / Tai Yang Small Intestine & Urinary Bladder

Lesser Yang / Xiao Yang San Jiao & Gall Bladder

Effulgent Yang / Yang Ming Large & Intestine Stomach

Divisions Yin- Yin Pairs

Grater Yin / Tai Yin Lung & Spleen


Divisions Yang-Yang Pairs

Lesser Yin / Xiao Yin Heart & Kidney

Yielding Yin / Jue Yin Pericardium & Liver


The Great Loop Chart below, illustrates the flow of Qi among the Organs and Meridians within the context of both the Husband-Wife and Six- Division pairs.


The Horary Cycle in the table below, illustrates how the flow of Qi throughout an individuals meridians and Organs coincide with one’s diurnal 24 hour cycle.


The Five Elements

Wood, Fire, Earth, Metal and Water - Like Yin and Yang, Five Element Theory is another way of classifying phenomena. The Five Elements permeate traditional Chinese thought, and can be applied to almost everything.

The Five Elements comprise a diagnostic framework that blends nicely with Yin & Yang, the Organs and the Substances. However, in practice most TCM diagnosis discuss the Organs, Substances and Disharmonies or Pathogens without referring to the Five Elements. Still, they are useful for constitutional typing, diagnosis and prognosis. “Five Element Acupuncture” is a rich and effective sub-genre of acupuncture, which for he most part, will remain outside the scope of this book.

Each of these elements; The Elements, Wood, Fire, Earth, Metal & Water is related to a particular pair of Organs and Meridians, color, sound, odor, emotion, taste, body tissue, body type, climate, and other characteristics. There exist many relationships between these elements as illustrated below.


The Interrelationships of the Five Elements Notes:

1. The Solid Line Arrows which make up the Circle, represent the Creative (Sheng)Cycle also known as the Parent-Child Cycle

2. The Dotted Line Arrows which make up the Star represent the Control (Ko)Cycle, aka the Grandparent-Grandchild Cycle

3. The Fire Element also includes the Pericardium (Yin) and San Jiao aka Triple Warmer (Yang) Organs.

• Within each element are Yin and Yang aspects, sometimes referred to as the husband-wife relationship:

• Yin organs representing wives and Yang representing husbands.

• Aberrations of the Sheng, Creative, Parent/Child, or Generating Cycle• overproduction: hyper function generating Excess (Excess) • underproduction: hypo function creating Deficiency(Deficiency)• over-taxed, in which case the child drains the parent (Deficiency

producing exhaustion) (analog to underproduction)• Aberrations of the Ko, Control, Grandparent, or Over-Acting Cycle


WoodLiver

Gall Bladder

EarthSpleen Stomach

MetalLungs

Lg Intestine

WaterKidneys

FireHeart

• too much control, over-bearing, invasive and destructive (Excess producing Deficiency)

• insufficient restraint, too weak to be effective (Deficiency generating Excess)

• Reversed Ko cycle in which the child (normally restrained) rebels and insults the grandparent (Excess creates Deficiency)

The interrelationships of these Elements and their related attributes can create, and affect disharmonies between one another in many in varied ways.

The table below lists many of the attributes of each of these Elements and can assist in predicting the results of some of these interactions.

Because this is a complex system, and is not one we will be utilizing in this book to any significant degree, I leave it to be discussed and further explained in the classroom.

That said, the table below is helpful in understanding the breadth of the Five Elements, and deserves consideration.


Table of Five Element Attributes

CATEGORY WOOD FIREFIRE EARTH METAL WATER

ZANG: Solid Yin Organ

Liver Heart PC Spleen Lungs Kidney

FU: Hollow Yang Organ

Gall Bladder S I SJ Stomach Lg. Intestine Bladder

SEASON Spring SummerSummer Late Summer Fall Winter

CYCLE Birth GrowthGrowth Maturity Harvest Rest / Storage

CLIMATE Wind HeatHeat Damp Dry Cold

ORIFICE Eyes TongueTongue Mouth Nose Ears

SENSE Vision SpeechSpeech Taste Smell Hearing

BODY TISSUE Tendons Sinews

Blood Blood Vessels

Blood Blood Vessels

Flesh Muscles

Skin Teeth Bone Marrow

RESIDUES Nails ComplexionComplexion Lips Body Hair Head Hair

TONGUE Sides TipTip Center Behind Tip Root

COLOR Green RedRed Yellow White Blue/Black

SOUND ShoutingSighing

LaughingLaughing Singing Raspy Weeping

ResonantGroaning

OFFICE BenevolentGeneral

RighteousSovereignRighteousSovereign

Faithful Farmer

DecorousArchitect

WiseTreasurer

DUTY Plan RuleRule Nourish Create Order Store Essence

SPIRITSHun - Soul

PersonaShen - Spirit

ConsciousnessShen - Spirit

ConsciousnessYi -Thoughts

MemoryPo - Physical

VitalityZhi -Will

Commitment EMOTION Decisiveness

Control Anger

JoyBalanced Psychosis

JoyBalanced Psychosis

Harmonizing Deep Thought

Obsessive

StrengthSustainability Grief/Sadness

Survival Determination

FearBODY FLUID Tears SweatSweat Saliva Nasal

MucusInternal

MoistureTASTE ODOR Sour & Sharp Bitter & BurntBitter & Burnt Sweet &

FragrantSpicy & Pungent

Salty & Musty


Causes of Disease

External causes of disease are mainly what we call colds and flus, and are designated as Wind, Cold, Heat, Dryness, and Dampness, depending on their associated signs and symptoms. These pathogens are commonly used to represent the different manifestations of upper respiratory infections (URIs). They are often referred to as Outside Pernicious Influences (OPIs) Wind is usually the earliest stage of a URI. Cold is recognized by the presence of chills and body ache. Heat is characterized by red face, and tongue, and sore throat. Dampness produces excess mucous, and Dryness produces a dry cough. These pathogens also often combine in various ways.

In addition to upper respiratory infections, these external pathogens manifest in other disorders as well. A few examples follow: Cold can manifest as pain in the joints as in arthritis, bursitis, or other aches and pains which are worse in cold weather. Cold can also enter the lower part of the body (Lower Warmer) and cause cramping menstrual pain. Heat can enter the skin causing burning sores like boils, and carbuncles. Wind has similar effects to the wind we experience in nature, causing tremors and sudden unpredicted movements, or in extreme cases even paralysis. Dampness too is similar to what we find in nature. Like dampness in a basement, it’s hard to resolve. Pain and feelings of heaviness which linger and may be accompanied by swelling, tend to indicate Dampness. Dampness can collect as excessive mucous seen in the Lungs, or stools or as joint swelling. Overweight and other somatic accumulations are also signs of Dampness accumulating.

The Internal Causes of Disease are the Emotions. When any emotion is experienced inappropriately, it will effect the functioning of the Organs it is associated with. Whether one experiences or expresses an emotion too strongly, or insufficiently (repressing it) it will have consequences. Anger affects the Liver, Grief affects the


Lungs, Joy affects the Heart, Worry and Over Thinking affect the Spleen, and Fear affects the Kidneys.

Miscellaneous causes of disease are the many and various influences we encounter in our lives. Examples include, getting hit by a bus, bitten by a snake and contacting environmental toxins. In most western countries today the most common of the Miscellaneous causes of disease are likely: Inappropriate Diet, Inappropriate Exercise, Overwork, and Insufficient Rest and Repose.

The Organs

When we use the term “Organ” or the names of the Organs, in TCM, we do not infer the identical meaning as we understand them in current biological medicine in the West. We use these terms to address a complex system of interrelationships that, while they include the organs as we understand them, they also include emotions, thoughts, and other physical systems in the body, or body/mind/spirit. In this way the ancients in China could understand and work with all the aspects of an individual within the context of just a handful of systems. While modern biology cannot fully explain this approach, there are countless generations of experience to attest to its efficacy.

Each Organ has a specific job to perform. I will discuss the main jobs of each Organ, and the typical symptoms associated with their primary dysfunctions. There are, of course, many other associations for each Organ, but I’ll only address those associations that have clear clinical application, and are regularly encountered in daily practice. I am focusing on the functions of the Yin Organs, since they are the ones that perform most of the jobs that I address in this book. For the most part the Yang organs


support the Yin Organs in their operation. The only Yang Organ I’ll address here is the Stomach.

I have focused this edition of this book on the treatment of painful conditions. However, I did want to include at least a little direction on internal medicine. Perhaps in the next edition, I will give more detailed “recipes” for internal disorders. For now, I hope you and your patients find this, admittedly limited, set of directions helpful.

The Lungs

The Lungs are responsible for respiration, energy (QI) production, and protection from outside influences, similar to our concept of the immune system.

When the Lungs are functioning well, the individual is vital and strong. When they are in disharmony, we see respiratory problems like COPD, shortness of breath, and a tendency towards upper respiratory infections. When the Lungs are in disharmony, the following are some common possible symptoms:All types of respiratory disordersAll sinus disordersMany Skin DisordersCommon Colds and FlusFatigue

Treating The LungsTonify the Lungs: Lu 9, Lu 1, UB 13Colds and Flus: LI 4, LU 7, LI 20, Cough LU 5Sore Throat or other Heat in the Lungs: LU 10


The Large Intestine is the Yang/Fu organ associated with the Lungs. Occasionally the Large Intestine is involved in treatment of digestive disturbances, however the Spleen is generally treated in most of these situations. However as a Fu Organ, the Large Intestine Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.

The Spleen

The Spleen is responsible for managing all aspects of D iges t ion and Ass imi la t ion , Trans format ion and Transportation.

This is mainly seen as managing the transformation of food and fluids into energy, blood, body fluids and tissues. When the Spleen is not functioning well, food and fluids are not fully processed, one’s energy level drops, and digestive problems become apparent. These unprocessed products then accumulate in the individual as excess weight and phlegm and mucous.

The Spleen is in charge of Transportation and Transformation (T&T). It is associated with:! T&T of Qi, Blood & Jin Ye! Holding Blood Fluids & Organs in Place! Manifests In The Lips! Dislikes Dampness & Cold! Rules The Flesh & Muscles

When the Spleen is in disharmony, the following are some common possible symptoms:! Fatigue! All problems with the Lower Digestive Processes!! ! Bloating, Gas, Loose Stools, Tired After Eating! Overweight


! Underweight ! Muscle weakness/atrophy! Weakness of the flesh / flaccidity! Prolapses! Excessive or Insufficient Menstrual bleeding! Excessive Bruising! Blood in Stools! Mucous in Stools! Hemorrhoids!Treating The SpleenSince the Spleen mainly suffers from deficiencies of Qi, Yang, and Blood, it tends to respond best to Diet and Herbal Treatment. However, acupuncture can often be very helpful and is certainly worth a good try, especially if you can add some moxa for tonification. Also Tonifying the Kidneys is often helpful when treating the Spleen. Keep in mind that tonifying the Spleen can take some months.

When treating the Spleen, you will generally want to tonify all the points:

ST 36, SP 6, Ren 6, Ren 8 (moxa only), UB 20Adjust Diet: Cut out or reduce highly processed, cold and damp foods

The Stomach

The Stomach is responsible for the early digestive processes.

While the Spleen is responsible for all digestive processes, once the food has left the Stomach, problems with the Stomach itself are usually addressed directly. Heartburn, hiatial hernias, and stomach ulcers are all symptoms of Stomach disharmonies. Also as a Fu Organ, the Stomach Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.


When the Stomach is in disharmony, the following are some common possible symptoms:! Stomach Pain / Distention! Nausea! Vomiting! Belching! Acid Regurgitation , Heartburn, Ulcers! Bad Breath ! Increased/decreased appetite

Treating The Stomach The Main points for treating the Stomach are the same for most conditions: ! ST 36, SP 6, Ren 12, UB 21 ! If there’s Heat: add ST 44 and perhaps ST 45

The Heart

The Heart is the Organ that stores our “Shen.” The Shen is our spirit, or that aspect of awareness which is reflected in our eyes; our sense of “self” our perception of the world around us, and how we fit in. In a word, consciousness.

Disharmonies of the Heart can manifest as any disturbance of the consciousness, from mild anxiety or depression to severe psychological disorders. All these disorders fall under the term of “Shen Disturbance.” When the Heart is in disharmony, the following are some common possible symptoms:All disorders effecting the Mind: Spirit, Consciousness, Memory, & ThinkingMost Sleep disorders

Most Heart disorders can be effectively treated by treating the Pericardium.


The Small Intestine is the Yang/Fu organ associated with the Heart. It is seldom a cause of disease in and of itself. However as a Fu Organ, it’s Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.

The Kidneys

The Kidneys are responsible for the balance of Yin and Yang in the body. They regulate our constitutional energies, and manage reproductive, urogenital, and sexual functions.

Urinary, prostate, premature aging, and lowered libido are a few of the disharmonies we associate with the Kidneys.

The Kidneys are “housed” in the lower back, and so are responsible for the strength of our low back. This is useful in treating chronic low back and sciatic disorders.When the Kidneys are in disharmony, the following are some common possible symptoms:

Low back pain & weaknessPain & weakness of the Legs, Knees, & AnklesImpotence and InfertilityIncontinence PolyuriaLoss of hearing / TinnitusLower body EdemaProblems of growth and developmentSigns of premature aging SciaticaLow sex driveFearfulness & Lack of WillFatigue

Treating The Kidneys


Like the Spleen, Treating the Kidneys most always involves tonification. Like the Stomach most Kidney treatments involve the same points: ! KD 3, KD 16, UB 23, DU 4! If there’s Heat (from Yin Deficiency) add KD 2 and KD 7

The Urinary Bladder is the Yang/Fu organ associated with the Kidneys. As such it supports the Kidneys and can often be treated as an adjunct to treating the Kidneys. Only ins cases of Bladder infections do we usually address the Bladder itself. Otherwise we address Urinary Bladder problems via the Kidneys. However as a Fu Organ, the Bladder Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.

The Pericardium

The Pericardium is responsible for Setting the Order of the Heart. In other words, we treat the pericardium for all the organic functioning of the heart:

Treat the pericardium for tachycardia, bradycardia, irregular heartbeat, chest pain, palpitations, etc.The Pericardium also treats the psychological aspects (Shen) of the Heart.

Treating The Heart and PericardiumMost all aspects of the Spirit can be treated with the Tai Ji Treatment discussed earlier in the book (PC6, SJ 5, LR 3, GB 41)Fast, Slow or Irregular Heartbeat PC 5, Ht 7HT 8 will reset the order of the heartPC 8 for dream disturbed sleep


The San Jiao(aka Triple Warmer, Triple Heater, Triple Energizer, Triple Burner) plays an important role in explaining many concepts that are central to the theories of Chinese medicine.

“San Jiao” translates as “Three Burning Spaces.” Also, as a Fu Organ, it’s Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.

The Three Jiaos or Burning Spaces are:• Upper Jiao (Upper Burner): LU & HT, Responsible for

Respiration & Circulation• Middle Jiao (Middle Burner): SP & ST, Responsible for

Digestion & Assimilation• Lower Jiao (Lower Burner): KD, UB & Reproductive

Organs, Responsible for Elimination & Reproduction

The Three Jiaos are collectively responsible for Water Metabolism, Classically Described As A System Of Sluices Or Waterways

• Lungs Descends & Disseminate Fluids• Spleen Transforms Fluids and Transports them to Upper

Warmer• Kidneys Power Fluid Metabolism

The LiverThe Liver is responsible for the smooth and easy flow of energy and emotions in an individual. This includes assisting all processes, physical, mental and emotional in flowing smoothly and regularly. Muscle contraction, menstrual cycles, and managing the smooth flow of the emotions--especially anger, are just a few examples of this function. The Liver is like known as The “Free & Easy Wanderer,” the General, the City Planner, and the Traffic Cop.


It doesn't perform all the tasks in the body, but it facilitates the free flow of Qi in order for all the other organs to accomplish their jobs. The Liver is associated with:

Smooth and Easy Flow of Qi & EmotionsTendons & Muscles (Tension)Sea of Blood (Stores)Controls the Eyes Houses the Hun (Self) PlanningDislikes Wind, Heat, & Stagnation

When the Liver is in disharmony, the following are some common possible symptoms:! Stress Related Disorders, Anger / Irritability! Excessive muscular tension, esp. Neck and Shoulders!Contractures, spasms / uncoordinated movements ! !! ! Tics, Twitches & Tremors! Throat clearing/ feeling of plum pit in the throat ! Gynecological problems ! ! PMS w/ breast pain & distention! ! Painful Menses w/ clots & sharp stabbing pain! Meridian related Sx. ! ! Inguinal pain and Hernias! ! Acute inflammatory problems, Herpes, Conjunctivitis! Erratic mood swings / Moodiness / Irritability ! ! Quick to Anger /Volatile-violent outbursts! ! Frustration ! ! Compulsive energy! Eye problems: ! ! Tearing, blurry vision, night blindness, ! ! Floaters, photophobia & light sensitivity

Treating The LiverThe Liver is most prone to stagnation. Since it’s main job is to move Qi, any disharmony of the Liver will result in some degree of Liver Qi Stagnation. The Liver can also be affected by Xue Xu and Yin Xu.


Acupuncture is quite good for moving Liver Qi Stagnation, but the patient will have to make some lifestyle changes to keep the condition from returning. Some type of stress reduction technique needs to be employed by the patient. Usually people need to understand that rest, relaxation, and repose are as important as, or more important than, achieving their external goals. I know it's a tall order, but how else can you get folks to let go of vain strivings that are affecting their health?Patients should consider doing some gentle form of yoga, or tai chi or Qi gong. The gentle stretching of the tendons is a wonderful way to relax the Liver, and it usually helps with the stress too. (GENTLE stretching, not strenuous, hot, & sweaty types of yoga).One other thing is removing coffee from the diet. Coffee (not caffeine) has a particular affinity for the Liver, and I believe it contributes greatly to Liver Qi stagnation.! To sum up: ! ! Acupuncture once a week to move LR Qi. ! ! LR 3, GB 41, PC 6, SJ 5 ! ! Gentle Yoga! ! Quit Coffee! ! 1-3 months produces excellent results in most cases

The Gall Bladder is the Yang/Fu organ associated with the Liver. As such it supports the Liver and can often be treated as an adjunct to treating the Liver. It is seldom a cause of disease in and of itself. However as a Fu Organ, the Gall Bladder Meridian is important in diagnosing and treating surface conditions such as musculoskeletal and neurological pain.


2. Acupuncture Techniques DemystifiedIn China the term used for Acupuncture is “ZhenJiu” which means Acupuncture/Moxibustion. It’s as if those two words were not meant to be separated. I believe this is for the reason that there are strengths and weaknesses to all the modalities of Chinese medicine and they complement one another. Let me briefly name and describe the main interventions usually considered in Chinese medicine, and point out their strong points. Acupuncture is the physical stimulation of acupoints, on the surface of the body, with some external stimulator. The most common stimulator is an acupuncture needle. However point can be stimulated by many various means such as finger pressure, heat, electricity, laser light, magnets, as well as cupping, and guasha, which we will address below. It is my opinion that while there are arguments for each method of stimulating acupuncture points, needles work best in most cases. No one really likes getting needled, and so we can surmise that if needles weren’t superior for stimulating points, we’d probably use something a bit more comfortable. The strong point of acupuncture treatment is it’s ability to move stagnation. Since all painful conditions are a result of stagnation of one sort or another, acupuncture is particularly effective at treating painful conditions and an assortment of other conditions that are associated with stagnation or excess.

Moxibustion is the application of heat to acupoints, specifically by heating or burning an herb called “moxa” Moxa is a bastardization of the words “mo kusha”, Japanese for “burning herb.” The actual herb is artemisia vulgaris. This herb has significant properties that make it particularly effective for this purpose. Like acupuncture, moxa is effective in moving stagnation. Moxa is also effective for building deficiencies, especially deficiencies of Qi and Yang. In addition moxa is quite warming, and so treats Cold conditions.

Herbal Medicine is where Chinese medicine shines with most deficient internal conditions, and conditions where stagnations are


internal and chronic. While acupuncture and moxibustion can be helpful, many metabolic conditions can be treated more effectively when herbal medicine is added into the mix.

Physical Manipulation has a long history in the Chinese medical tradition. Tuina, a type of massage which is surprisingly similar in many ways to chiropractic, has been practiced for centuries, with good effect on structural correction.

Energetic Manipulation consists mainly of exercises such as Tai-Ji and Qi-Gong, which are used to both cultivate and manipulate Qi, for improved health. These exercises have proved to be particularly helpful in promoting balance, physically, mentally, and emotionally.

Before moving on to the techniques let’s consider hygiene and safety.

Clean Needle Technique1. ALWAYS:

a) Wash Hands Between Patients(1) # 1 for Infection Control(2) Soap & Running Water 10 Seconds Minimum

b) Establish a Clean Fieldc) Sanitize Hands Prior to Inserting Needles if Hands

Have Been Slightly Contaminated (1) Alcohol Based Hand Disinfectants are Acceptable

for Hand Washingd) Isolate Used Needles Immediatelye) Use Universal Precautions: Prevention of Exposure

and Prevention of Disease if Exposure Occurs.(1) Gloves, Gowns, Masks, Goggles etc. when

neededf) Use Sterile and/or Clean Equipment and Work Areas

as directed(1) Needles & other Instruments that Penetrate the

Skin or Touch the Mucous Membrane, must be sterile

(2) Always use Sterile Needles


(a) Use Single-Use Disposable Needles(b) Avoid Contamination when removing needles

from packaging (c) Never reuse or reinsert a needle(d) Never use a needle that’s been

contaminated. i.e dropped, miss-inserted g) Disinfection / Antisepsis/ 70% Isopropyl Alcohol

(1) Use on Clean Skin to reduce pathogens and inanimate objects on the skin

2. Clean Techniquea) Using Sterilization, Disinfection, Antisepsis, Washing,

etc.b) Clean Field

(1) The area prepared to contain acupuncture equipment & supplies

(2) Clean Tray or Paper Towel Work Surface(3) Sealed/Open Needles(4) Alcohol Swabs(5) Dry Cotton Balls(6) Gloves(7) Clean Instruments (8) Gua Sha Tool(9) Cups(10) Forceps(11) Ear Probe

c) Off the clean field(1) Waste container

(a) Plastic Lined Paper Bag(2) Biohazard Container(3) Other Non-Clean Items:

(a) Pens (b) Discarded Insertion tubes and wrappers

3. Cups and Guasha Toolsa) If no bleeding occurs: Cups May be Cleaned with

Soap and Waterb) If Bleeding occurs: Cups Must be Cleaned and

Sterilized


(1) Bleach Solution Sterilization for Non-Porous Items(a) 1:10 solution Bleach: Water (b) Soak for 1 hour

4. Biohazard Containersa) ONLY Needles go in in Biohazard Containers

(1) NO tubes, packaging, cotton balls, prep pads, etc.

(2) Cotton balls tinged with blood are disposed in double bagged waste

(3) Cotton balls are placed in BioHazard container ONLY IF ACTUALLY SOAKED WITH BLOOD

b) Check State regulations for Disposal, Storage and Transportation of biohazard containers.

Risks to Acupuncture Providers1. Needle Stick

a) Use Caution to Avoidb) CDC Recommends

(1) Consult a Physician Immediately(2) Test Source for HBV, HCV, HIV within 2 hours if

possible(3) Begin Treatment ASAP, if required

2. Blood Exposurea) Glove Carefully

3. Train Staff Carefully in a) Recognition of Contaminated Needlesb) Office Procedures Regarding Needlesc) Handling Contaminated Needlesd) Needle Sticks

Acupuncture Patient Side Effects1. High Risk Patients2. Use Universal Precautions3. Needle Sickness / Fainting

a) Vasovagal Responseb) Remove Needles, Have Patient Lie Downc) Perhaps a few sips of water

4. Pain / Bruising / Swelling at Needle Site


5. Stuck Needle6. Forgotten Needle7. Neuritis8. Moxa Burns

a) Use Cautionb) Assess Patient's Heat Tolerance

(1) Neural injury, diabetes, paralysis, etc. c) Treat w/ Western Medical Techniques

(1) Sterile dressing (2) Appropriate referral

9. Abscess10.Allergic Dermatitis11.Broken Needle

a) Leave some shaft visible12.Auricular Chondritis13.30 sec - 5 minutes direct pressure14.Organ Puncture

a) Veins/Arteriesb) Pneumothoraxc) Eyesd) Enlarged

(1) Heart(2) Liver(3) Spleen(4) Kidney

e) Spinal Cord(1) Exercise Caution With DU 15 & DU16

15.SeizuresContraindications and Cautions

16.Always use Caution when treating Patients who are or may bea) Pregnant b) Elderly c) Diabeticd) Very Tirede) Very Hungryf) Under the influence of any Mind Altering/Pain

Relieving Medications


g) Numb in an area to be treated

17.Points Contraindicated in Pregnancya) LI 4b) SP 6c) GB 21d) UB 60e) Points on the Abdomenf) Points on the Lower Back

18.GB 21 Contraindicated for patients with Heart Conditions19.Electro-Acupuncture Contraindicated for patients with

a) Pacemakers and other electrical implantsb) History of Seizure Disordersc) Strongly Recommended not to apply

electro-acupuncture across the heart (i.e. Chest to Back/ Left to Right/ Arm to Arm)

Before jumping into treatment techniques lets consider some information on setting up your office to accommodate acupuncture treatment.

Office Setup/Patient Flow20.Patient Scheduling

a) Order of Treatment Modality 21.Assistant(s)22.Gowns / Gym Shorts23.Treatment Tables

a) Bolstersb) Table Extendersc) Boards & Blocks

24.Stool/Chair25.Treatment Cart

a) Clean Field b) Treatment Supplies

26.Biohazard container27.TDP/Heat Lamp28.(Space) Blankets29.Timers30.Call Buttons


31.Formsa) Find Forms Online: www.AcuPracticeSeminars.com

(Resources Page)b) Intakec) Informed Consentd) Moxibustion Instruction/Consente) Cupping / Guasha Information Letter

32.Patient Education Handouts

Let’s look now at Acupuncture, Moxa, and other Basic Treatment Techniques.

Effective acupuncture treatment consists of point selection, location and needle technique. This chapter offers an explanation of how to apply some of the different acupuncture techniques to effectively treat many common disorders.

Acupuncture Distal TechniquesYou can often affect local pain with just distal techniques, but local treatment is usually necessary as well. In the section on treating specific conditions I will cover many useful distal treatment points and techniques.

Getting The Qi When you’re is performing acupuncture it is important to “Get the Qi.” But what does that mean? According to the prevalent teachings in China today, it means that the patient must feel a deep, aching, distending, electrical or traveling sensation. This doesn’t mean pain. The Qi sensation should be clear and strong to the patient, but not painful. When the patient reports the feelings associated with “getting the qi,” the practitioner can stop stimulation of the point and rest assured that she has contacted the Qi. A painful acupuncture treatment is seldom necessary.


There are, however plenty of other traditions of acupuncture where the practitioner does not depend on the patient’s report of feeling the Qi to ascertain that the Qi has been contacted. In fact, it could be easily argued that it is more important that the practitioner feel the Qi than the patient, since the practitioner is presumably more familiar with the feeling of Qi than the patient, and the practitioner knows better what to look for. But, how does the practitioner know what to feel, to be sure that she has contacted the Qi?

After 30 year of practice, I am pretty sure that I can feel the contact with the Qi, most of the time. Unfortunately, I can’t describe it in sufficient detail, in this book, to make it clear. I can however, sometimes demonstrate it to students, when we can be together. It is a skill that can be learned but cannot be easily taught. I’m sure you will find that this skill develops, as you gain more experience. Therefore, I suggest that, until and unless you know for sure, that you have developed this skill, you should ask the patient for feedback as to when you’ve contacted the Qi.

Acupuncture33.There are three basic types of needles:

a) Standard Acupuncture Needles(1) Designed to be inserted for between a few

seconds up to perhaps an hour. Usually for 20 minutes.

(2) Needle Selection Considerations(a) Ease of application and Insertion(b) Degree of Painlessness(c) Degree of Stimulation

i) Rotate / thrust etc.(d) Personal Preference(e) Electrical Conductivity(f) Ability to feel and transmit Qi

(3) Variables


(a) Thickness(b) Length(c) Handle

i) Metal / Plastic (4) AcuPractice Recommendation

(a) Seirin Brand Needlesi) Lhasa OMS 1-800-722-8775

www.lhasamedical.com(b) 30mm # 3 = 36 gauge Chinese / 0.20mm

i) General Utility Needle (10 to 1)ii) Blue Handle

(c) 40mm # 5 = 32 gauge Chinese / 0.25mmi) Stronger Stimulationii) Deeper Points

(d) 60mm # 8 = 28 gauge Chinese / 0.30mmi) Strongest Stimulationii) Deepest pointsiii) Chinese Scalp Acupuncture

b) Bleeding Needles are used to extract a few drops of blood from specific acupoints. Traditionally there were a few different types of “triangular needles.” Today we use lancets, usually with an auto-lancet device.

c) Retained Needles are small needles that are inserted and left in place for times ranging between a few hours and a few days(1) APS semi-permanent needles

(a) Stainless Steel, Gold, and Titanium (2) Interdermal needles: 6mm #1

B. There are three basic Needling Techniques which are used to achieve the effects of Tonification, Sedation, and Harmonization. While there :are many techniques employed by practitioners to achieve these results, we will look at the basic approach to each of them, which entails the amount and degree of stimulation applied.


1. Harmonizing or Even Technique is used when balance is desired, such as in the case of needling PC 6 to calm the Shen.a) Moderate Stimulusb) Moderate Thrustingc) Moderate Rotation

2. Tonification, used when deficiencies are treated, such as needling ST 36 for digestive weakness. a) Mild Stimulusb) Mild Thrustingc) Minimal Rotation

3. Sedation is mainly used for treating stagnation. As such it’s usually employed for painful and excess conditions, such as releasing trigger points.a) Strong Stimulusb) Strong Thrustingc) Great rotation

C. Needling Depths & Angles1. Angle of Insertion

a) Usually Perpendicular to the Skinb) Exceptions will be noted

2. Needling Depthsa) Avoid Organs and Blood Vesselsb) Consider the Underlying Structurec) Usually into the middle of the muscle under the pointd) Usually between ¼ and ¾ inch deep

D. Electro-Acupuncture (EA)1. Introduction

a) First used in the 1950s2. How does it Work?

a) Electrical signals travel to the Brain or Spinal Cord and encourage the production of Hormones and Neurotransmitters.

3. Often Used Fora) Acute & Chronic Pain (55%-85% success rate) b) Traumatic Injuryc) Paralysis


d) Surgical Anesthesia4. Two Types of Electro -Acupuncture

a) Microamps aka Microcurrent(1) Much Less stimulation(2) Function on a cellular level(3) Microcurrent is not covered in this book.

b) Milliamps(1) Standard Electro Acupuncture(2) The following material covers Millamp

Electro-Acupuncture c) Machines

(1) Quality Considerations (2) Expense (3) Precise Frequency and Intensity Adjustments(4) Number of Channels

d) AcupuncturePoint Detection / Elect. Stim. e) Quality of Biphasic Wave f) Recommended Machines

(1) Pointer Excel II(a) Non-Invasive Millamp Stimulation(b) Acupuncture Point Detection(c) Relatively Inexpensive(d) Works well

(2) E-Stim II (a) Milliamp & Microamp(b) 2 Channels(c) Inexpensive (d) Works Well

(3) ITO IC 1107(a) Milliamp Only(b) 3 Channels(c) Moderately Priced(d) Works Very Well

(4) Pantheon(a) Milliamp and Microamp(b) 4 Channels(c) Higher Price(d) Works Very Well


g) User Interface(1) On/Off Switch(2) Intensity Controls

(a) Click Off Before Turning Unit On(b) Reliability May be Dependent on Battery(c) Some Machines are Very Sensitive(d) Always turn up SLOWLY(e) Turn Intensity to Zero Before Switching any

other controls(3) Usually 3- 4 Channels (Output Jacks)(4) (+) (-) Switches(5) Intensity Multiplier(6) Frequency Multiplier (7) Frequency Modulation Controls(8) Visual freq. Indicator Light

(a) Continuous(b) Constant Hz (c) each pulse follows the preceding one

i) //////////////////////(d) Discontinuous

i) Irregularly Irregularii) Constant Hz / Random Time Slotsiii) //////-------//////////--------//////----------------///

(e) Dense - Dispersei) Varying Set c/s / Random Time Slotsii) / / / / ////////// / / / / / / //////////// / / / //////

(9) Acupuncture Point Detection(a) Pros & Cons

5. EA Principles a) Neural messages are sent to Brain or Spinal Cord

and Neurochemicals or Hormones are releasedb) Spinal Cord Stimulation

(1) Local AA effect, only(2) Stimulates Spinal Chord Reflex Arc Only(3) Enkephalin & dynorphin(4) NO Circulating Beta Endorphin production

c) Midbrain / Hypothalamus / Pituitary Stimulation(1) Systemic effect


(2) Similar to Da Qi Needle Stimulation(3) Including Acupuncture Anesthesia (AA) at a

distance(4) enkephalin, serotonin, & norepinephrine(5) Increased Hormonal Stimulation(6) Circulating Beta-Endorphin released into Blood &

CSFd) Pulse

(1) Pulse Width(a) 0.1-1.0 ms - microseconds

(2) Pulse Strength(a) 2.5-5.0 mA - milliamps

(3) Biphasic Pulse(a) Imperfectly Matched Biphasic Pulses lead to

the area where the Black (-) clip is placed, experiencing more stimulation(pain)

e) Intensity(1) Low Intensity

(a) At threshold of M. contraction(b) Observable M.(or needle) movement(c) May be useful for tonification

(2) High Intensity(a) 5-10 times the threshold for M. contraction(b) Intense M. Contractions

(3) Gradually increase every 5 min. for 30 min. until intense M. contractions are observed if necessary

f) Frequency(1) Low Frequency

(a) Individual M. Contractions(b) 1-4 Hz(c) Midbrain / Hypothalamus / Pituitary

Stimulation(2) High Frequency

(a) Tetanic M. Contraction(b) 50 Hz or Greater(c) Spinal Cord Stimulation Only

6. EA Treatmentsa) Needles


b) choose a heavy gauge (# 5-8) (1) Finer needle = greater resistance

c) Pair in areas of EQUAL sensitivity(1) face to face(2) Skin Nerves(3) hand to arm(4) Deep M. Nerves

d) High Frequency / Low Intensity (1) No Cumulative Effect(2) Spinal Cord Only(3) Intensive Local Anesthesia (4) Short onset

e) Low Frequency / High Intensity (1) Longer lasting Cumulative Effect(2) Midbrain & Hypothalamus-Pituitary(3) Systemic Effect

7. EA Contraindicationsa) Note: Amer. Assoc. for Medical Instrumentation

recommends levels below 250 mA @ 1.0 ms across the heart (arm to arm). This is 50 - 100 times higher than EA. devices generally deliver (2.5 -5.0 mA @ 1.0 ms)

b) No EA. W/ Pacemakers (Nat. Exam)c) FDA bans EA on Head d) No EA stim over Neck e) STRONG EA stim in spastic Musclesf) No EA Crossing the Heartg) In Pregnancy

(1) No EA Around Fetus(2) No EA on Strong Moving Points (3) No EA Below Bl23

h) Do not shine laser through pupils when treating around eyes

i) No laser to fontanels of infants (1)

8. Patients may experience the same side-effects as with needles, such as needle sickness, dizziness, fainting,


nausea, tiredness, headache, change in the site or degree of pain

E. Laser Acupuncture1. Low Level Laser Therapy / LLLT2. Recommended Laser for Acupuncture Treatment

a) Class III Lasersb) Wavelength

(1) Prime determinant of tissue penetration. c) Areas of thick skin or¬†muscle may require higher

doses for penetration than¬†finer skin areas e.g. ear. d) Lasers which penetrate less deeply / suitable for

acupuncture point stimulation and biostimulation. e) 630 - 680nm (nanometers) visible, coherent, bright

red f) 1.5mW - 5 mW

(1) up to 10 mW are availableg) A minimum of 1mw and 10-12seconds are required to

produce any sort of reactionh) HeNe (Helium Neon) gas or Diode i) Should shine @ 65 feet in a well lit room, 300 feet in a

dark room3. Use the same rules of point selection as needle

acupuncturea) Energetics

(1) Moving(2) Perhaps Warming

b) Trigger points/snap signs release c) To promote healing d) Wounds: ulcers, burns, pressure sores e) Skin infections such as herpes zosterf) Enhancing effect on healing wherever inflammation is

present F. Moxa

1. Actionsa) Warms

(1) Body(2) Meridians


(3) Limbs(4) Uterus

b) Expels Cold & Dampc) Revives Dying Yangd) Invigorates/Moves Qi & Bloode) Regulates Qi & Bloodf) Opens The 12 Primary Channelsg) Repairs Traumatized Tissue

2. Indicationsa) Painb) Coldc) Deficient Yangd) Stagnation

(1) Qi(2) Blood(3) Phlegm

3. Procedurea) Treat Upper Body before Lower Bodyb) Head & Body before Extremities

4. Cautions & Contraindicationsa) Not on Upper Body W/ Heatb) Pregnancy

(1) Not Direct(2) Not Near Fetus(3) Not on Moving Points

c) No Direct(1) Cv14, 15(2) Ht (3) Face - Hands(4) Scar(5) Bl1(6) St1(7) St9

5. Methods of Usea) Always Explain Procedure To Pt.b) Make sure the Patient Is In Control of the amount of

heat she can tolerate.c) ‚”Hot” is the Operative Term


6. Indirect Moxaa) Tonifys Spleen & Kidney Qi & Yangb) Warm Uterusc) Strengthen Digestiond) Most Painful Conditions especially those associated

with Cold.e) Seirin MoxSafe Smokeless Moxa System

(1) AcuPractice Seminars Recommended system for using indirect moxa

f) Pole / Roll(1) Straight vs. With Other Herbs(2) Bird Pecking / Warming Technique(3) Touch Pt. With Finger(4) Do Not Move the pole around(5) Hold 0.5 To 4 Inches Away(6) To Disperse hold pole close: 0.5 “- 1.0” away

form the skin(7) To Tonify hold pole at least 2.2 inches away

(a) The Object of the technique is to increase blood circulation to the area, NOT to scorch the skin.

(b) This Takes Time(c) 8-10 minutes minimum per point

g) Tiger Warmer(1) Milder odor than regular moxa Pole(2) Two Sizes Small and Large (Lion Warmer)

h) Belly Bowl(1) Well suited for Digestive and GYN disorders

i) Loose Moxa(1) Moxa Instrument(2) Moxa on Ginger(3) Moxa on Salt

(a) Special For CV8 7. Direct Moxa

a) AcuPractice Recommendation: Purchase Pre-rolled Direct Moxa (small size)

8. Treat Moxa Burn a) Blister


b) Use Standard Western Medical Treatment for Burnsc) Cover W/ Sterile Dressingd) If the burn is severe or becomes infected, seek

specialized Western medical attention.e) Antibiotic ointment, if any

G. TDP Lamp1. Interesting Read on Wikipedia2. Western Theory

a) USFDA Class II:Class of devices approved by the FDA for temporary relief from pain and arthritis

b) Far Infrared (below visible light) Heating Devicec) Increase Microcirculation d) Loosens Fascia e) Accelerate Natural Healing Processes

3. Oriental Theorya) Therapeutic substitute for moxibustionb) Reported to be the only mechanical device that can

add Qi to the body4. Application

a) Bare skin exposure with the lamp positioned 12-18¬†inches from the body

b) 15 - 30 minutesc) Replaceable Mineral Plate

(1) Proprietary formula of 33 trace elements(2) Estimated life of 1000 - 1500 hours. (3) When the mineral plate looks ash grey, it is time

to replace it.5. Dr. Jim’s Experience

a) Everyone should have and use TDP Lamps, but they are not exactly moxa

b) Replaces Moxibustion for:(1) Warming (2) Moving QI & Blood(3) Repairing Traumatized Tissue(4) Can Tonify Somewhat, when used together with

Spray Moxa


H. Gua Sha & Cupping1. Definitions:

a) Gua Sha: Scraping of the skin with a Blunt Instrument to release congestion in the exterior

b) Cupping: Stationary or Moving Suction Cups applied to the skin to help bring stagnation to the surface, and release it.

2. Gua Sha a) Scraping of the skin with a blunt instrumentb) Similar to Graston Techniquec) Often Causes Some Bruising d) Actions

(1) Stubborn Pain or Congestion with Sha‚Äù (2) Especially for upper and mid-back pain

e) ”Sha” or Evidence of significant bruising from Guasha(1) evidence of stagnation plus(2) blanching upon palpation

f) Traditional Indications(1) Reduce fever (2) Cough and dyspnea(3) Muscle and tendon injuries(4) Benefits circulation(5) Headache(6) Sunstrokes (7) Stiffness(8) Pain(9) Immobility(10) Digestive disorders(11) Urinary disorders(12) Gynecological disorders(13) To assist with reactions to food poisoning

g) Procedure(1) Lubricate(2) Instrument(3) Gua Sha Instrument(4) Porcelain Spoon(5) Smooth Coin


(6) Apply Gua Sha till Sha Appears(7) Follow with Indirect Moxa(8) to inhibit cold entering

h) Recommendations for Post- Gua Sha Patient Behavior(1) Immediately Post Tx.: Indirect Moxa/ TDP Lamp

over entire area treated(2) Keep area Warm and Covered for 12 -24 hr.(3) 48 - 72 hr. Avoid Excessive consumption of

(a) Flour Products/Baked Goods(b) Greasy/Fried Foods(c) Excessive Dairy (esp. cold)(d) A little alcohol may be helpful in some cases

3. Cuppinga) Stationary or Moving Suction Cups Applied to the

Surface of the Skinb) AcuPractice Seminars Recommendation: Silicone

Cupsc) Often Causes Some Bruising d) Indications

(1) Lungs(2) Upper & Mid-back Pain, Tension & Tightness(3) Low Back - Sciatica

e) Procedure(1) Lubricate Skin(2) Apply Cups

f) Stationary Cupsg) Leave in place for @ 20 minutesh) Moving Cups

(1) Pressure on Trailing Edge(2) Follow Natural Qi Flow(3) Think of it as a Cup Massage‚ or Cupping Gua

Shai) Recommendations for Post- Cupping Patient

Behavior (1) Same as for Gua Sha

II. Needle Technique Demo / Practice Session


A. Ideally all participants in hands-on classes should practice needling at least each of the following points.

B. Hands & Feet1. LI 4, LR 32. SJ 5, GB 413. PC 6, SP 44. LU 7, KD 65. SI 3, UB 62

C. Back: 1. Du 42. UB 233. Hua Tou Jia Ji Points

D. Leg & Arm1. St 362. Sp 63. KD 34. LI 145. LI 15

E. Hip & Waist1. GB 262. GB 30

F. Head1. Du 20 2. Tai Yang3. Yin Tang4. St 65. GB 14

G. Abdomen / Lower Warmer1. St 302. Ren 23. KD 164. Ren 12


3.4. Points & Meridians: The Raw Ingredients

Many of the most popular acupuncture points have multiple uses. Many of these points can be added to almost any treatment, for varied conditions. You will see these ubiquitous points show up in many different point prescriptions. Again, like in a cookbook, if you are in the baking section, you will see flour, sugar, salt, butter, etc. show up time and time again, but in different proportions and used in different ways to get various results. Similarly, you will see many of the same points again and again when treating similar problems like pain, or disorders of the head & neck, or digestive disorders.

There are many good and exhaustive resources on the acupuncture points, and it is not my aim to repeat that information here. (i.e. the Manual of Acupuncture App.) To keep emphasis on the most clinically useful material, I focus on the pathways of the Yang acupuncture meridians, and describe the locations and use for the points I find most useful, and which I commonly use. I also discuss these points and point combinations in the treatment many disorders.

Therefore, the lists of points by meridian are not complete nor is this an oversight or misprint. I have included only the points from each category that I have found to be particularly useful. I expect you will supplement this material with information from other sources, and from your own experience.

Meridian Overview

12 Primary Meridians: (AKA 14 Main Meridians) There are 12 Main Meridians which compose the Central Supporting Structure of the Meridian System. Most all the other meridians are in someway associated with these channels, and usually follow these pathways. Each of these meridians is associated with an Organ, and each


meridian is found bilaterally. For instance: The Large Intestine Meridian is found on both arms, beginning at the tip of the index finger and ending in the nasolabial groove. There is also a circadian flow of Qi through these meridians that follows the 6 Divisions, and the Horary Cycle.

Each of the 12 Main Meridians has it’s own Acupuncture Points located along its pathway. In addition, 2 of the 8 Extraordinary Meridians also have their own acupuncture points. There are therefore, 14 Meridians with discreet acupuncture points.

All the other meridians share points from these 14.

It might be good to again be reminded here that Yin meridians and their points are used mainly in relation to the Organs, and so treat more internal disorders. The Yang meridians, on the other hand, are used for more surface disorders, and will be employed principally in the treatment of pain syndromes, or other symptoms that appear along the path of the meridian itself.

12 Sinew Meridians (AKA Tendino-Muscular Meridians) circulate on the periphery of the body, and do not penetrate to the Zang/Fu or Organs. Therefore they are primarily used to treat acute and chronic musculoskeletal and neurological syndromes that include pain, tension, tightness, and various forms of paralysis and paresthesias. These meridians are associated with, and take their names from the twelve primary channels.They originate at the extremities (Jing-Well Points) and broadly follow the course of their associated primary channels. However, they are wider, and tend to follow the lines of major muscles and muscle groups, tendons & ligaments, expanding the influence of the primary meridians when treating muscles, tendons, and joints.

12 Divergent Meridians connect with and follow the course of their associated primary channels paired channels. Divergent meridians run deeper than Primary Meridians, and govern the inside of the


body. they are distributed on the Chest, Abdomen and Head, and extend the areas of influence of main meridians to these areas.Fo instance: The Divergent Channel of the Liver Meridian, extends the liver Meridian’s influence to the Head, despite the fact that the primary meridian only reaches from the foot to the chest.

12 Skin Regions / Channels Follow the pathways of and are related to the Main Meridians, and they help to explain Dx & Tx via the skin.

15 Luo Connecting Channels are made up of one small branching channel for each of the 12 primary channels, one each for the Ren & Du, and one for the Great Luo of the Spleen, They spread Qi from the Luo-connecting point of their own channel to connect with their paired channel. For instance Large Intestine 6 (luo pt) connects to Lung 7 (luo pt.) After joining with their paired channel they usually continue to follow their own pathways.

The 8 Extraordinary Meridians

I believe that these are the most powerful points on the human body. These points are the ones that affect some of the deepest and most primal energies of the body. If one looks at the actions and effects of these points and then couples them with the energetics of the Extraordinary Meridians they are truly “Extraordinary Points.” I choose from them first in almost all of my treatments, whether I am treating pain or internal disorders. Also, I often simply choose from these “Extraordinary Points” for their actions, energetic and/or effects. I will address the uses of the Extraordinary Meridians more extensively in a later chapters.

Master Point Coupled Point Extraordinary Meridian


SI3 BL62 Du MaiLu7 Ki6 Ren Mai

GB41 TW5 Dai MaiSp4 P6 Chong Mai

BL62 SI3 Yang Chiao MaiKi6 Lu7 Yin Chiao Mai

TW5 GB41 Yang Wei MaiP6 Sp4 Yin Wei Mai

Master Point Action / Energetic / Effect

SI3 Any Back Pain, Posterior Shoulder PainLu7 Circulates Fluids and Qi in the Head and Neck

GB41 Soothe the Liver and Gall Bladder Discomfort in the Waist, Hips, Intestines &

Pelvic RegionSp4 Digestive Disorders

Lower Abdominal DiscomfortBL62 Most Back PainKi6 Strengthens the KidneysSJ5 Calms the Spirit (Shen)

Expels PathogensP6 Abdominal Discomfort

Calms the Spirit


Dr. Jim’s Tai Ji Treatment

This isn’t really a point category, but these four points are so powerful when used together, that I consider them a category in and of themselves. A “Tai Ji” or “Great Ultimate” Treatment is one that accomplishes many objectives, in many different patients, and is used often to balance a patient, before or in lieu of, focusing on individual complaints. This particular Tai Ji Treatment is my favorite method for Harmonizing the Liver and Heart, which can be a very powerful method for calming the Shen/Mind/Spirit and freeing up many physical energies in the body. It uses three Extraordinary Meridian Master Points together with Liver 3. I use it regularly on patients to harmonize the Qi prior to beginning a more individualized treatment. I discovered this treatment quite by accident. I originally learned it (I thought) from my teacher, Kiko Matsumoto, and found myself using it more and more frequently on many different patients. The results were so profound that some 5 or 6 years later I ran into Kiko and mentioned how useful this treatment was. I was surprised when Kiko informed me that I had gotten it wrong. I had “heard” LR 3, when she said “SP 4.” After getting over my embarrassment, I realized how glad I was that I had mis-heard. I know that over the years, a lot of my patients, and patients of my students have benefited from my “mistake.”

Needle-on-the-LEFT Needle-on-the-RIGHTP6 LR3

GB41 SJ5

To enhance the calming effect of this treatment, I often add Yin Tang, and the Auricular points: Liver, Heart and Shen Men.


Points Overview

Acupuncture Points are often located in hollows or natural depressions on the surface of the body. With some practice one can easily palpate for most of the common acupuncture points.

Needling Depths: For most points needles are inserted between 0.25-1.0 inch (cun), in many cases needling into the middle of the muscle that is located below the point. Exceptions will be noted. Of course, one must always keep the anatomy in the area of the point in mind, to avoid needling into blood vessels, organs, and other sensitive structures.

Needle Directions: Needles are usually inserted perpendicular to the skin, Exceptions will be noted

Points are usually described as having both “indications” (individual symptoms treated: i.e. headaches) and “actions” (energetic uses: i.e. clears heat)

Body Measurements and General Point Location! The “Cun” is known as the personal inch. Based on the width of the patient’s thumb, it is the standard measurement for locating points. For instance: PC 6 is located two cun proximal to the wrist crease between the the tendons of palmaris longus and flexor carpi radialis. Two cun equals 2 times the width of the patient’s thumb.

General Comments On AcuPointsEvery practitioner of acupuncture has his or her own favorite points, and knows that there are some points that he/she has found that work best. Of course my point choice is based on my experience. When I look at the categories of points, I find that the actions that are associated with them are more applicable to some points,


within the category, than other points. So the following lists of points have been edited by my personal experience.

This is by no means meant to discount the experience of other practitioners and teachers. There are many acupuncture practitioners who I know, love, and respect, who use different points and techniques from those I generally choose and teach. I can only teach what I know, works. You’ll have to get information on other effective points and techniques from other teachers. Eventually you’ll discover what points and techniques work best for you and your patients.

Let me say just a few words about Points Below the Knees and Elbows. I like them. The most powerful points on the body are usually found from the knees and the elbows down. I don’t mean to indicate that the other body points are not powerful, they are, but I always seem to get better results with the arm and leg points. Now, please remember that I often use other points, like Front Mu and Back Shu points as well as Scalp and Ear points, but I often use them secondarily to the Points Below the Knees and Elbows.

Before we examine the meridians and their main points, let’s look at some of the categories of points and how they may be used.

Classic Point Categories Table

This table contains most of the classic point categories, and is what one might use to study for a national exam in acupuncture. Each of these categories have specific uses.

YIN Meridian

Jing Well

Wood

Ying Spring

Fire

Shu Stream Earth

Jing River Metal

He Sea Water

Yuan Source

Xi Cleft

Luo Back ShuUB

Front Mu

LU 11 10 9 8 5 9 6 7 13 LU 1SP 1 2 3 5 9 3 8 4 20 LR 13

HT 9 8 7 4 3 7 6 5 15 Ren 14


KD 1 2 3 7 10 3 5 4 23 GB 25

PC 9 8 7 5 3 7 4 6 14 Ren 17

LR 1 2 3 4 8 3 6 5 18 LR 14

YANG Meridian

Jing Well

Metal

Ying Spring Water

Shu Stream Wood

Jing River Fire

He Sea Earth

Yuan Source

Xi Cleft

Luo Back ShuUB

Front Mu

LI 1 2 3 5 11 4 7 6 25 ST 25

ST 45 44 43 41 36 42 34 40 21 Ren 12

SI 1 2 3 5 8 4 6 7 27 Ren 4

UB (BL) 67 66 65 60 40 64 63 58 28 Ren 3

SJ (TW) 1 2 3 6 10 4 7 5 22 Ren 5

GB 44 43 41 38 34 40 36 37 19 GB 24

One might reasonably assume that all the points in each of the above listed categories are effective as categorized. However, in my experience, that’s not always the case. The rest of this chapter contains commentaries on what I’ve found to be the more effective acupuncture points, drawn from the above categories together with other clinically important categories, including the Extraordinary Meridian Points, the Controlling Points and a few others.

Controlling Points

Again, while this not a classic category, these are points and combinations that are useful additions to any point prescription associated with the area in question. You may not find all of these listed in other books, but they all work well.


LI 4 & LR 3: Pain Anywhere in the BodyLI 4 & LU 7: Most any condition of the Head, Neck, Face, & MouthST 36: Controls Digestion & Tonifys QiP 6: Controls the Chest to Navel Area & Calms RestlessnessUB 40: Low Back PainSJ 5: Controls the HandSJ 3: Controls the EarLR 3: Commands & Moves Liver QI & Blood, Relaxes TendonsGB 26: Commands the Hips & Lower Warmer

Hua Tuo Jia Ji PointsA series of points 0.5 - .75 cun lateral each interspinous space), these points can influence any problem associated with the nerves exiting at the level of the spine where the point is located. Think about dermatomes as well as internal influences. These points are extremely effective at releasing the paraspinal muscles.

Yuan Source Points

The Source points of the Yin Meridians can always be added to a point prescription to affect the Organ being treated. I’m not sure the Yang Meridian Source points work all that well, but the Yin ones surely do. I believe that these points are probably the best points for affecting the basic Yin and Yang energies of the Organ, especially of the Yin Organs. When it comes to tonifying Qi, Xue, Yin or Yang, I’ve found the Yuan Source Points to be more powerful than the Back Shu Points or Du Points, with the possible exceptions of UB 23 & Du4

Ht 7: A very good point for tonifying Heart Yin, however I often use PC 6 in it’s place. I like Ht 7 for difficulty sleeping from Ht Yin Xu (Deficiency) and Heart Xue Xu.

PC 7: While this is a good point, I generally use PC 6 in it’s place, and PC 8 for dream disturbed sleep.


Lu 9: tonifies the Qi of the Lungs. The Lungs are the “Master of Qi.” Without their proper functioning the Qi cannot be utilized.

Sp 3, Liv 3, and Kid 3: I use these points to tonify their respective Organs. In fact, I often use them together as an alternative to SP 6


Five Element PointsWhen considering points from the Five Element classification I find that the Fire points and the Water points are just about the only ones I regularly choose from for their Element correlation. There are of course a number of effective ways to use the Five Element points to construct effective treatments based on the Sheng (Creative) and Ko (Controlling) Cycles, but as I said earlier, that topic is beyond the scope of this book. I use both the Fire and Water points to cool heat in their respective meridians or organs. When needling the Fire points I almost always obtain a strong stimulus to disperse heat.Fire Points

LR 2: is quite effective for reducing heat in both the Liver and the Gall Bladder. I use LR 2 as one of the principal points when treating oral and/or genital herpes, as well as shingles (herpes zoster) or any other LR/GB meridian heat. Red burning eyes, and Headaches with associated heat, also respond well to treatment with LR 2. I locate this point just proximal to the margin of the web between the big toe and the second toe. Needle it at a 45o angle in the direction of LR 3.

KD 2: is effective in treating burning urination and other manifestations heat in the lower warmer. It is also very effective in treating heat along the Kidney and Urinary Bladder meridians. Because of the close communication between the Kidneys and the Lungs in water metabolism, KD 2 can also be effective in treating hot skin conditions. I often combine it with LR 2.

LU 10: This seems to me to be a quintessential Fire point. For all hot Lung and skin conditions, this is the point of choice. I often couple it with LU 11. I locate this point in an unconventional way, and find that it is a very effective location. This point is located in the center of the belly of the thenar eminence. The point is needled toward the


metacarpal bone of the thumb. You will find that needling this point in this way will result in a strong stimulus, and good heat reduction.

Water PointsLU 5: is good for treating heat in the lungs, especially when the heat is accompanied by cough.KD 10: I use this point for treating heat from KD Yin Xu.

Tonification and Sedation Points

These are a subcategory of the Five element Points. While I don't use them much in practice, some practitioners find them helpful. They are commonly used for treatments based on electronic meridian testing , and so I will address the basic idea. Based on the five Element Production cycle (Wood> Fire> Earth> Metal> Water) The Tonification Point of an Organ is its Mother Point, or point that immediately precedes it’s Horary Point. For Instance: The Heart is within the Fire Element, Wood comes immediately before Fire, so the Wood Point (HT 9) is the Tonification Point. The Sedation Point of an Organ is its Child Point, or point that immediately follows it’s Horary Point. For Instance: The Heart is within the Fire Element, Earth comes immediately after Fire, so the Earth Point (HT 7) is the Sedation Point.

Horary Points

The Horary Points are also a subcategory of the Five Elements points. They are the points that are associated with the Associated Element of each Organ. For instance: The Heart is associated with the Fire Element. Therefore the Fire Point on the Heart Meridian (HT 8) is the Horary Point for the Heart.

Xi Cleft Points

Xi Cleft Points are traditionally used to treat pain along the pathway of their respective meridians. For instance: Large Intestine 7 is the Xi Cleft Point for the Large Intestine and therefore should treat pain


along the pathway of the Large Intestine Meridian. I haven’t found them particularly useful in clinic, however many practitioner seemingly have.

Five Shu (Transport) Points

I love the imagery created by the Five Shu Points:

The Qi lies deep but is assessable, like water in a well, at the Jing-Well. (@ finger and toe tips)At the Ying-Spring the Qi bubbles to the surface.The Qi gathers and begins to flow at the Shu-Stream. Force gathers and the Qi flows with vitality through the Jing-River. The Qi is flowing and moving as well as integrating as it forms the He Sea. (@ knees and elbows)

The Jing Well Points are at the tips of the fingers and toes, where the QI of each meridian is highly individuated. As we move though the Ying Spring, Shu Stream, and Jing River points, we proceed proximally up the limb arriving at the knees and elbows and the He Sea points, where the Qi is more internal and less individuated. That said, I find that the Jing-Well points are the main ones I choose for their Shu-point effects. But I use them all the time. When treating pain, I find that expressing a few drops of blood from the Jing-Well point of the effected meridian can be one of the most effective parts of the initial treatment.


Luo Points

The distribution of the effects of the Luo Points covers a multitude of areas over the body. With the exception of SP 21, I really only use P 6 and LR 5 for these purposes, as explained above. Sp 21 is the Great Luo, and will help to restore a healthy sense of comfort, symmetry and balance in the body. For instance it might help to restore proper proprioception, in an individual with post-stroke syndrome.

Meeting or Influential Points

The Qi Meets at CV 17: I use this point to move the Qi of the Chest and Upper Warmer. Always needle this point from superior to inferior at an oblique angle. Strong stimulation of this point is forbidden. I always needle it with a gentle stimulation, but I like to get the Qi to move slightly down toward the belly.

The Hollow Organs Meet at CV 12: This is a very good point to harmonize digestion and assimilation.

The Pulse Meets at Lu 9: Again, the Lungs are the Master of Qi. If the pulse is weak, consider the Lungs, and LU 9 is especially good for generating Qi, which in turn generates the pulse.

The Nerves and/or Tendons Meet at GB 34: It is a good point for treating tightness and tension in the muscles and tendons. It is especially useful for tension and tightness along the course of the Gall Bladder meridian and in the mid-to-upper back and neck. I locate and needle this point deeper, and in a slightly different direction, than most sources suggest. Begin at the junction of the heads of the tibia and the fibula. Palpate below the junction into the deep depression that is about 1.5 Cun distal to the junction. This is the insertion point. Using a needle that is long enough, insert at about a 30o – 45o angle so that the needle contacts the point, which lies under the junction of the heads of the femur and the tibia.


The Bones Meet at BL 11: Include it in treatments of broken bones, osteoporosis and osteoarthritis and other bone disorders.

The Back Shu (Associated) Points

While I don’t use many of the Back Shu Points, those I use, I use regularly. They are sometimes the points I use when choosing points to treat the root of a dermatome. However, just as often as not, I will choose one of the Hua To Jia Ji Points rather than the Back Shu Points. The Hua To Jia Ji Points are found on line with the Back Shu points, but only 0.5cun from the inter-spinus space. Many practitioners use these in place of the Back Shu points because they can be needled perpendicular to the skin and much deeper than Back Shu Points, and they release the paraspinal muscles very well.

UB 11 the Back Shu Point of the Bones: As mentioned above, this point is very good for helping with bone-knitting after a break, or any other bone disorders.

UB 13 the Back Shu Point of the Lung: This point is very good for pain and congestion in the lungs. I have found cupping at UB 13 to be helpful in quelling asthma attacks and relieving shortness of breath.

UB 18 the Back Shu Point of the Liver: A good point for moving Liver Qi Stagnation. I mainly use it when there is tension, tightness and pain in the mid and upper back.

UB 23 the Back Shu Point of the Kidney: Very good point for low back pain due to Kidney Qi, Yin or Yang Xu (deficiency). It is especially effective when used with Du 4 and combined with Moxa.

UB 29 the Back Shu Point of the Sacrum: Another good point I commonly use for lower back pain.


The Front Mu (Alarm) Points

The Front Mu Points are points that are particularly well suited for treating the internal Organs. Like Back Shu Points, I don’t use many of them, but the ones I use, I use often.

Ren 12 the Front Mu Point of the Stomach is very useful when treating Stomach disharmonies and pain.

Ren 17, the front Mu of the Pericardium, & Liver 14, the front Mu of the Liver, are both good points to treat when there is constriction, pain or discomfort in the chest or ribcage. I always combine them with Pericardium 6.

Stomach 25 the front Mu of the Large Intestine is useful when there is discomfort in the abdomen with constipation, diarrhea, or any gripping pain in the abdomen. Combine this point with Stomach 36, Pericardium 6, and Urinary Bladder 25.

Ren 3 the front Mu of the Bladder can be quite helpful in treating burning urination, frequent or difficult urination. Combine this point with Kidney 2 or 3, and Stomach 29 or 30.


Trigger Points aka Ah Shi Points

Last but certainly not least are the points that are most commonly used in the treatment of pain. I’m convinced that Ah Shi points (locally tender) and Trigger Points are the same phenomena. In the same manner that I’m using “acupuncture” to refer to all needling, I’ll just use the term “Trigger Point” in this text to refer to all points found by palpation, including Ah Shi Points. As far back as the classics, these points were discussed and their use described. However, I will offer one piece of advice. Whenever possible, find a point that is a recognized acupuncture point or Trigger Point. This is not hard; careful palpation moving slowly out from the painful, tight, and or tender areas, along muscle and/or meridian pathways will usually reveal Trigger Points that have been previously recognized. If you spend a bit of time pursuing these points you will be rewarded with better results then just needling the first tender point you find.

The Main Meridians & Their Major PointsI’m only listing the most common points I use. As mentioned above, there are a lot more good and useful points. The first two meridians I will consider are, the Du Meridian, and the Ren Meridian. Technically they belong to the Eight Extraordinary Meridians, and are not main meridians. However, while they have special significance, they also function like main meridians, in that the Ren and Du have their own points. The other 6 Extraordinary Meridians share points from other meridians.

Once again you may notice that the points on Yang Meridians tend to treat pain along the pathway of the meridian, and those on the Yin Meridians tend to treat more internal disorders.


Du Meridian “Governing Vessel” The pathway of the Du Meridian runs from the perineum, up through the middle of the spine, over the head, and ends at the upper lip. All points are on the posterior midline of the body. It is the most Yang meridian on the body. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Du is important, for treating any and all disorders of the back and specifically the spine.


Point Location Main UsesDu 1: Midway between the tip of

the coccyx and the anusHemorrhoids; Rectal or Other Prolapse; Rectal Bleeding

Du 2: On the hiatus of the sacrumSacral and Coccyx Pain

Du 4: With the patient in the prone position, it’s in the deepest hollow in the low back. Below the spinous process of the 2nd lumbar vertebrae

Controlling Point for Lower Back and KD; All Lower Back Problems, Especially Weakness;Kidney Deficiency

Du 14: Below the spinous process of the 7th cervical vertebrae

Controlling Point for Neck & Upper Back; Pain,Heat & Fevers in the Upper Body; Releases Exterior; Tonifies Wei Qi

Du 20: On the midline of the head, approximately on the midpoint of the line connecting the apexes of the two auricles

Any Excess Disorders of the Head; Any Prolapse In The Body; Connects with Brain; Clears the Mind; Headache

Du 25: At the tip of the nose Nasal/Sinus Congestion

Ren Meridian “Conception Vessel”The pathway of the Ren Meridian runs from the perineum, up the midline of the front of the body, ending just under the lower lip. All its points are on the anterior midline of the body. It is also the most Yin meridian on the body. Since Yin Meridians are often used to treat internal disorders, the Ren is important, for treating many internal disorders and especially those associated with reproductive function


Point Location Main UsesRen 2 On the midpoint of the upper

border of the symphysis pubis

Controlling Point for All GYN and Urogenital Disorders

Ren 4 On the midline of the abdomen, 3 Cun below the umbilicus

Tonify the Kidneys; All GYN & Urinary Disorders; Tonifies Jing, Yang, Yin, & Qi

Ren 6 On the midline of the abdomen, 1.5 Cun below the umbilicus

Tonify the Spleen; Relieves Stagnation in Abdomen

Ren 8 In the center of the umbilicus

Strengthen Digestion; Diarrhea; Yang Collapse(No Needle - Moxa Only)

Ren 12 On the midline of the abdomen, 4 Cun above the umbilicus

Harmonize the Stomach; All Abdominal Problems

Ren 17 On the anterior midline, at level with the 4th intercostal space

Descends the Qi of the Chest

Ren 22 In the center of the suprasternal fossa

Throat and Swallowing Problems

Lung MeridianThe pathway of the Lung Meridian runs from the second intercostal space, 2/3 the distance from the middle of the sternum to the acromion process, down the anterior surface of the arm and ending at the proximal radial corner of the nail of the thumb. Since Yin Meridians are often used to treat internal disorders, the Lung Meridian is important, for treating many internal disorders associated with the Lungs. These include all respiratory disorders and symptoms associated with colds and flus


Point Location Main UsesLU 1 Lateral and superior to the

sternum at the lateral side of the 1st intercostal space, 6 Cun lateral to the midline

Mu / Alarm Point of The Lungs: All Lung Disorders

LU 5 On the cubital crease, on the radial side of tendon of m. biceps brachii, with the elbow slightly flexed.

Strong, Productive Cough; Any Heat and/or Fullness in Lungs

LU 7 Superior to the styloid process of the radius, 1.5 Cun above the transverse crease of the wrist

Master Point of the Ren Mai; Controlling Point For Neck & Throat; Circulates the Qi of The Lungs. Luo Point; Use with LI 4 for Headaches and OPIs

LU 9 At the radial end of the transverse crease of the wrist, in the depression on the lateral side of the radial artery.

Source Point; Tonifies the Lungs; All Deficient Lung Problems

LU 11 On the thumb, 0.1 Cun proximal to the radial corner of the nail.

Jing Well Point: Clears Heat From The Lungs (Sore Throat, Tonsillitis, Etc); Moxa Opposite Side For Nosebleeds

Large Intestine MeridianThe pathway of the Large Intestine Meridian runs from the proximal radial corner of the index finger along the arm on the lateral border of the radial bone to the top of the shoulder, crossing the SCM on the neck to the lower border of the ala nsai, on the opposite side. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Large Intestine is important, for treating any and all disorders of arm, neck and head.


Point Location Main Uses

LI 1 On the radial side of the index finger, about 0.1 Cun proximal to the corner of the nail

Jing Well Point: acute pain on the meridian; Clears Heat from the Head and throat; (sore throat, tonsillitis, red burning eyes, etc)

LI 4 On the dorsum of the hand, between the 1st and 2nd metacarpal bones, approximately in the middle of the 2nd metacarpal bone on the radial side.

Controlling point for Head and Face: Main point for pain and other excesses in the head neck and arm. OPIs; CONTRAINDICATED IN PREGNANCY

LI 5 On the radial side of the wrist. When the thumb is tilted upward, it is in the depression between the tendons of muscle extensor pollicis longus and brevis.

Good local point for pain in the thumb and area

LI 11-12Two points, best palpated for. When the elbow is flexed, these points are in and around the area between the depression at the lateral end of the transverse cubital crease and a spot superior to the lateral epicondyle of the humerus.

Fever; elbow pain

LI 14 Just superior to the lower end of the deltoid muscle.

Deltoid and shoulder pain



LI 15- Anterior and inferior to the acromion, on the upper portion of the deltoid muscle.

Major points for shoulder joint pain

LI 16 When the arm is in full abduction, in the upper aspect of the shoulder, in the depression between the acromial extremity of the clavicle and scapular spine.

Major points for shoulder joint pain

LI 17-18 Two points best palpated for. On the lateral side of the neck, about level with the tip of the Adam's Apple, on the SCM.

Good local points for throat and neck problems

LI 20 In the nasolabial groove, at the level of the midpoint of the lateral border of the ala nasi.

any nose problem, including nasal or sinus congestion; often used with LI 4 and LU 7


Stomach MeridianThe Stomach meridian runs from the middle of the lower border of the eye socket down to the outer corner of the mouth, back to the mandible up to the corner of the hairline. It proceeds inferior along the mid-clavicular line over the ribcage, moves closer to the midline, and down to the upper border of the pubic bone. It travels down the leg along a trajectory just lateral to the crest of the tibia, ending at the proximal medial corner of the nail of second toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Stomach meridian is important, for treating any and all disorders of and eye, head, teeth, and leg


.


Point Location Main UsesST 3 Directly below the center of the

eye, at the level of the lower border of the ala nasi.

Sinus conditions; knee pain

ST 4Lateral to the corner of the mouth, directly below ST 3.

Facial paralysis; trigeminal neuralgia; herpes; mouth ulcers; gum problems; tooth pain

ST 5 Anterior to the angle of the mandible, on the anterior border of the masseter muscle.

lower jaw toothache

ST 6One finger-breadth anterior and superior to the lower angle of the mandible where the masseter attaches, at the prominence of the muscle when the teeth are clenched.

lower jaw toothache, Bruxism

ST 7 At the lower border of the zygomatic arch, in the depression anterior to the condyloid process of the mandible - located with mouth slightly slack.

TMJ; upper jaw toothache

ST 8 .5 Cun within the anterior hairline at the corner of the forehead, 4.5 Cun lateral to GV 24.

Frontal and band-like headaches

ST 25 2 Cun lateral to the center of the umbilicus.

any intestinal problems; front mu of LI;

ST 28 3 Cun below the umbilicus, 2 Cun lateral to CV 4

All GYN problems; damp heat in lower warmeThese ar; genital herpes; leucorrhoea.Cold and/or blood stagnation in lower warmer

ST 29 4 Cun below the umbilicus, 2 Cun lateral to CV 3



Point Location Main UsesST 30 5 Cun below the umbilicus, 2 Cun

lateral to CV 2.


ST 31 At the crossing point of the line drawn down from the ASIS and the line level with the lower border of the pubic symphysis, in the depression on the lateral side of sartorius, when the thigh is flexed.

Strengthens and moves the thigh and entire leg

ST 34When the knee is flexed, point is 2 Cun above the laterosuperior border of the patella.

xi cleft; acute breast discomfort; knee pain/weakness

ST 35When the knee is flexed, the point is at the lower border of the patella, in the depression lateral to the patellar ligament.

knee joint problems

ST 36 3 Cun below ST 35, one finger breadth lateral to the anterior crest of the tibia

Controlling point for Digestion: All digestive problems; builds qi and blood; regulates digestion

ST 408 Cun superior to the external malleolus two fingers breadth lateral to the anterior crest of the tibia.

Helps resolve phlegm anywhere in the body

ST 41

On the dorsum of the foot, at the midpoint of the transverse crease of the ankle, in the depression between the tendons of muscle extensor digitorum longus and hallucis longus, approximately at the level of the tip of the external malleolus.

Pain/ weakness and stiffness in the foot and ankle.


Point Location Main UsesST 44 Proximal to the web margin

between the 2nd and 3rd toes.Clear heat from head, face, mouth and gums

ST 45On the lateral side of the 2nd toe, .1 Cun proximal to the corner of the nail.

Jing Well Point: acute pain on the meridian; Clear heat from head, face, mouth and gums

Spleen MeridianThe pathway of the Spleen Meridian runs from the proximal medial corner of the nail of the great toe along the medial edge of the foot, up the leg following the posterior border of the tibia. At the waist it runs parallel to the midline, along the mid-clavicular line until it departs to end at the mid-axillary line midway, between the axilla and the free end of the 11th rib. Since Yin Meridians are often used to treat internal disorders, the Spleen Meridian is important for treating many internal disorders associated with the Spleen. These include all digestive disorders and symptoms associated with fatigue, and dampness


Point Location Main UsesSP 1 On the medial side of the

great toe, 0.1 Cun proximal to the corner of the nail.

Jing Well Point: Moxa for bleeding from deficiencies

SP 3 Proximal and inferior to the head of the first metatarsal bone, at the junction of the red and white skin.

Source Point: Tonifies SP

SP 4 In the depression distal and inferior to the base of the first metatarsal bone, at the junction of the red and white skin.

Master point of the Chong Mai, All menstrual disorders; All gastric disorders; masses in the abdomen

SP 63 Cun above the tip of the medial malleolus, on the posterior border of the medial aspect of the tibia.

strengthens SP, KD, yin, qi and blood; All GYN; moves the lower abdomen; calms the mind; all reproductive issues CONTRAINDICATED IN PREGNANCY

SP 9 On the lower border of the condyle of the tibia, in the depression on the medial border of the tibia.

All damp disorders; A mildly diuretic point

SP 21 On the mid-axillary line, midway between the axilla and the free end of the 11th rib.

Great Luo of the Spleen Helps restore a healthy sense of comfort, symmetry and balance in the body


Heart Meridian The pathway of the Heart Meridian runs from the middle of the axilla, down the medial surface of the arm and ending at the proximal radial corner of the nail of the pinky finger. Since Yin Meridians are often used to treat internal disorders, the Heart Meridian is important for treating disorders associated with the


Heart. These include all mental / emotional disorders and symptoms associated with sleep.


Point Location Main UsesHT 1 When the arm is abducted,

the point is in the center of the axilla, on the medial side of the axillary artery.

Seldom used. Deep needling can access m. subscapularis

HT 7 At the ulnar end of the transverse crease of the wrist, in the depression on the radial side of the tendon of muscle flexor carpi ulnaris.

Source Point: Most commonly used HT point all heart disorders. Nourishes the HT, Calms the Shen; relieves insomnia

HT 8 When the palm faces upward, the point is between the 4th and 5th metacarpal bones. When a fist is made, the point is where the tip of the little finger rests.

tachycardia; heat in the Heart; dream disturbed sleep, night terrors

HT 9 On the radial side of the little finger, .1 Cun proximal to the corner of the nail.

Jing Well Point: extreme heat in the Heart; loss of consciousness; tachycardia

Small Intestine MeridianThe pathway of the Small Intestine Meridian runs from the proximal ulnar corner of the pinky finger, along the arm on the lateral border of the ulnar bone, to the back of the shoulder, through the scapula, up to the back of the neck past the ear, and ending lateral to the eye. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Small Intestine is important for treating any and all disorders along its pathway, especially around the scapula and neck.


Point Location Main UsesSI 1 On the ulnar side of the little

finger, about .1 Cun proximal to the corner of the nail.

Jing Well Point: acute pain on the meridian; mastitis; insufficient lactation

SI 3 When a loose fist is made, the point is on the ulnar side of the hand, proximal to the 5th MP joint, at the end of the transverse crease at the junction of the red and white and skin.

Controlling point for Spine: Master Point of the DU Mai: stiff neck; all back pain; stroke, MS, Turette’s and other wind disorders

SI 6 When the palm faces the chest, the point is in the bony cleft on the radial side of the styloid process of the ulna.

xi cleft; pain in the meridian; stiff neck; Shoulder pain

SI 8 When the elbow is flexed, the point is located in the depression between the olecranon of the ulna and the medial epicondyle of the humerus.

local point for elbow pain/stiffness

SI 9 Posterior and inferior to the shoulder joint. 1 Cun above the posterior end of the axillary fold. local points for shoulder pain

and Range of MotionSI 10 Directly above SI 9, in the

depression inferior to the scapular spine.

local points for shoulder pain and Range of Motion

SI 11 In the infrascapular fossa, at the junction of the upper and middle third of the distance between the lower border of the scapular spine and the inferior angle of the scapula.

Most important local point for the upper back, and scapular area


Point Location Main UsesSI 17 Posterior to the angle of the

mandible, in the depression on the anterior border of the SCM.

local point for jaw, neck, and ear

SI 19 Anterior to the tragus and posterior to the condyloid process of the mandible, in the depression formed when the mouth is open.

benefits the hearing; jaw problems


Urinary Bladder MeridianThe Urinary Bladder Meridian runs from the medial inner canthus over the head just lateral to the midline, down the side of the neck where it separates into two pathways, running parallel to the midline of the back. One pathway is located at the distance of the medial border of the scapula, and the other is halfway between the medial border of the scapula and the midline. At the sacrum the meridian moves out to the buttocks and down to the center of popliteal crease, and the back of the calf, to the ankle where it runs just under the lateral maleoleous ending at the lateral proximal corner of the little toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Urinary Bladder is important, for treating any and all disorders of back, and legs. This meridian contains the “Back Shu Points.”


Point Location Main UsesUB 1 0.1 Cun superior and

slightly medial to the inner canthus

Main Point for All eye problems

UB 2 on the medial end of the eyebrow, or on the supraorbital notch

Alternate point for all eye problems

UB 10 1.3 Cun lateral to GV 15, in the depression on the lateral aspect of the trapezius muscle

All neck pain, weakness and stiffness

UB 11 1.5 Cun lateral to GV 13, at the level of the lower border of the spinous process of T1

Back Shu Point of the Bones: All bone problems; arthritis

UB 12 1.5 Cun lateral to the GV meridian, at the level of the lower border of the spinous process of T2

OPIs; headache; cough; stimulates wei qi


Back Shu Point of the LU: all lung problems; builds wei qi; chronic or acute


Back Shu Point of the HT: all heart problems


Back Shu Point of the Blood: All blood problems; tonifies blood; skin problems from heat in blood; Back Shu Point of the Diaphragm: Hiccough; Hiatial Hernia


Point Location Main UsesUB 18 1.5 Cun lateral to GV 8,

at the level of the lower border of the spinous process of T9

Back Shu Point of the LR: benefits all aspects of the liver; smooths, harmonizes, and tonifies liver


Back Shu Point of the GB: all GB problems


Back Shu Point of the SP: all SP problems; benefits all aspects of spleen

UB 21 1.5 Cun lateral to the GV meridian , at the level of the lower border of the spinous process of T12

Back Shu Point of the ST: benefits all aspects of the ST

UB 22 1.5 Cun lateral to the GV 5, at the level of the lower border of the spinous process of L1.

Back Shu Point of the SJ: regulates and transforms fluids;

UB 23 1.5 Cun lateral to GV 4, at the level of the lower border of the spinous process of the L2.

Back Shu Point of the KD: all KD pathologies; regulates all aspects of the KD

UB 25 1.5 Cun lateral to GV 3, at the level of the lower border of the spinous process of L4.

Back Shu Point of the LI: low back pain; colon problems; constipation, diarrhea, etc.


Point Location Main UsesUB 27 1.5 Cun lateral to the GV

meridian, at the level of the lower border of the 1st posterior sacral foramen.

Back Shu Point of the SI: used with CV 3 for damp heat in urine; sacroiliac joint problems

UB 28 1.5 Cun lateral to the GV meridian, at the level of the 2nd posterior sacral foramen.

Back Shu Point of the UB: all UB Problems

UB 31 In the 1st posterior sacral foramen.

These are the 8 Liao Points:Used for all genito-urinary, GYN, low back & leg problems

UB 32 In the 2nd posterior sacral foramen. These are the 8 Liao Points:

Used for all genito-urinary, GYN, low back & leg problemsUB 33 In the 3rd posterior

sacral foramen.


UB 34 In the 4th posterior sacral foramen


UB 35 On either side of the tip of the coccyx, .5 Cun lateral to the GV meridian.

Coccygeal pain

UB 40 Midpoint of the transverse crease of the popliteal fossa, between the tendons of muscle biceps femoris and muscle semitendinosis.

Controlling point for the low back: All Low back pain; clears heatNote: An Outdated Numbering System lables this point “UB 54”

UB 57 Directly below the belly of muscle gastrocnemius, on a line joining BL 40 and tendo-calcaneus, about 8 Cun below BL 40.

Upper back pain/tension; used with UB 67 for spasms of the calf;


Point Location Main UsesUB 60 In the depression

between the external malleolus and tendo calcaneus.

occipital headache; neck pain; distal point for sciatica; for labor pain; "aspirin point"

UB 62 In the depression directly below the external malleolus.

Master Point of the Yang Qiao Mai: Lateral musculoskeletal problems

UB 67 On the lateral side of the small toe, .1 Cun proximal to the corner of the nail

Jing Well Point: acute pain on the meridian; turning a breech fetus; used with UB 57 for spasms of the calf; back pain; tight hamstrings


Kidney MeridianThe pathway of the Kidney Meridian runs from the center of the ball of the foot, along the medial edge of the foot, under the medial maleolus, up the medial aspect of the leg posterior to the tibia. At the waist it runs parallel--and just lateral to--the midline, ending at the top of the sternum. The Kidney Meridian is important for treating many internal disorders. These include all growth development and aging, reproductive and urinary disorders, and symptoms associated with fatigue and general weakness.


Point Location Main UsesKD 1 On the sole, in the depression

when the foot is in plantar flexion, approximately at the junction of the anterior third and posterior 2/3.

emergency point; loss of consciousness; brings heat down fro the upper body

KD 2 Anterior and inferior to the medial malleolus, in the depression of the lower border of the tuberosity of the navicular bone.

Heat/Fire in the throat and lower warmer; UTIs

KD 3 In the depression between the medial malleolus and tendo calcaneus, at the level of the tip of the medial malleolus.

Source Point; All KD disorders; weakness in the knees; low back; lowered libido, E.D.

KD 6 In the depression of the lower border of the medial malleolus, or 1 Cun below the medial malleolus.

master point of yin qiao; Tonifies KD yin

KD 7 2 Cun directly above KD 3, on the anterior border of tendo calcaneus.

Tonifies KD Yin and Vaporizes fluids

KD 11-21

0.5 Cun lateral to Ren and level with the Ren points. KD 11 lateral to Ren 2 on the superior border of the symphysis pubis. KD 21 under the sternum

reinforce the Ren points

KD 16 .5 Cun lateral to the umbilicus, level

with CV 8. Strengthens the KD


Pericardium MeridianThe pathway of the Pericardium Meridian runs from the chest, down the medial surface of the arm, and ends at the tip of the middle finger. Since Yin Meridians are often used to treat internal disorders, and the Pericardium is closely related to the Heart Meridian, it is most commonly used to treat disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep, as well as organic heart

disorders.


Point Location Main UsesPC 4 5 Cun above the transverse

crease of the wrist, on the line connecting PC 3 and PC 7, between the tendons of palmaris longus and flexor carpi radialis

xi cleft point; chest pain; pain in the meridian

PC 5 3 Cun above the transverse crease of the wrist between the tendons of palmaris longus and flexor carpi radialis

calms the spirit; regulates Heart rhythm

PC 6 2 Cun above the transverse crease of the wrist between the tendons of palmaris longus and flexor carpi radialis

Master Point of the Yin Wei Mai: Controlling point for the Chest and Abdomen; calms the spirit

PC 7 In the middle of the transverse crease of the wrist, between the tendons of muscle palmaris longus and flexor carpi radialis.

Source Point: calms the spirit; regulates Heart rhythm

PC 8 On the transverse crease of the palm, between the 2nd and 3rd metacarpal bones. When the fist is clenched, the point is just below the tip of the middle finger.

tachycardia; heat in the Heart; dream disturbed sleep

PC 9In the center of the tip of the middle finger.

Jing Well Point: extreme heat in the Heart; loss of consciousness; tachycardia; night terrors


San Jiao MeridianThe pathway of the San Jiao is similar to that of the Small Intestine, but more radial on the forearm. It runs from the proximal ulnar corner of the ring finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, along the top posterior aspect of the trapezius, up to the back of the neck, around the ear, and ends just anterior to the tragus of the ear. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the San Jiao is important for treating any and all disorders along its pathway, especially around the shoulder, and ear.

Point Location Main UsesSJ 1 On the lateral side of the

ring finger, about 0.1 Cun proximal to the corner of the nail.

Jing Well Point; acute pain on the meridian

SJ 3On the dorsum of the hand between the 4th and 5th metacarpal bones, in the depression proximal to the metacarpophalangeal joint.

Controlling Point for the Ear

SJ 4On the transverse crease of the dorsum of the wrist, in the depression lateral to the tendon of muscle extensor digitorum communis.

Good local point for the wrist

SJ 5 2 Cun above TW 4, between the radius and the ulna.

Master Point of the Yang Wei Mai: local point


Point Location Main UsesSJ 10

When the elbow is flexed, the point is in the depression about 1 Cun superior to the olecranon.

Good Local Point for the elbow


SJ 14 Posterior and inferior to the acromion, in the depression about 1 Cun posterior to LI 15 when the arm is abducted.

Shoulder joint pain and ROM

SJ 15 About 1 Cun posterior to GB 21. Midway between GB 21 and SI 13, on the superior angle of the scapula.

Tightness, tension and pain in the neck and shoulders

SJ 17 Posterior and superior to the angle of the mandible. Posterior to the lobule of the ear, in the depression between the mandible and the mastoid process.

All Ear disorders

SJ 21 In the depression anterior to the supratragic notch and slightly superior to the condyloid process of the mandible. The point is located with the mouth slack.

All Ear and Jaw disorders

SJ 23 At the lateral end of the eyebrow

All disorders involving the side of the head/face; lateral headaches, eye pain, ear pain


Gall Bladder MeridianThe pathway of the Gall Bladder Meridian runs from the Lateral outer canthus, back and forth across the sides of the head, down the side of the neck, where it follows the top of the trapezius, down to the side of the ribcage, throughout the flanks, to the hip, and down along the most lateral aspect of the leg, to the ankle, where it runs under the lateral maleoleous and ends at the lateral proximal corner of the fourth toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Gall Bladder is important for treating any and all disorders of sides of the head, trunk, hip, and legs


.


Point Location Main UsesGB 1 0.5 Cun lateral to the outer

canthus, in the depression on the lateral side of the orbit.

Secondary point for eye problems

GB 2 Anterior to the intertragic notch, at the posterior border of the condyloid process of the mandible. The point is located with the mouth open.

Good local point for ear and jaw

GB 8 Superior to the apex of the auricle, 1.5 Cun within the hairline.

Lateral Headaches; post stroke speech disorders; enters the brain

GB 14

On the forehead, 1 Cun directly above the midpoint of the eyebrow.

All eye problems; frontal and temporal HA

GB 20

In the depression between the upper portion of the SCM and the trapezius, just below the occiput.

All Wind: internal LV wind and external OPI wind; opens the orifices of the head: All disorders effecting the eyes, ears, and nose; All Headaches, especially occipital

GB 21

Midway between GV 14 and the acromion, at the highest point of the shoulder.

Primary point for neck and shoulder tension, pain and tightness. (CONTRAINDICATED IF PATIENT IS PREGNANT, OR HAS A HEART CONDITION)


Point Location Main UsesGB 25 On the lateral side of the

abdomen, on the lower border of the free end of the 12th rib.

Front mu of KD; pain in lumbar region

GB 26

Directly below the free end of the 11th rib, where the LV 13 is located, at the level of the umbilicus.

Main Point on the Dai Mai; All GYN Disorders

GB 28

Anterior and inferior to the ASIS, 0.5 Cun anterior and inferior to GB 27.

Secondary Point on the Dai Mai; All GYN Disorders

GB 29 In the depression of the midpoint

between the ASIS and the great trochanter. 0. Main Points for Sciatica,

hip; lumbar to thigh, leg pain and paralysis

GB 30

At the junction of the lateral 1/3 and medial 2/3 of the distance between the greater trochanter and the hiatus of the sacrum.

Main Points for Sciatica, hip; lumbar to thigh, leg pain and paralysis

GB 31 On the midline of the lateral

aspect of the thigh, 7 Cun above the transverse political crease.

Main Points for Sciatica, lumbar to thigh, leg pain and paralysis

GB 34 In the depression anterior and in

inferior to the head of the fibula.

relaxes the tendons; good point for knee, sciatica and leg pain; pain anywhere in the body; shoulder pain


Point Location Main UsesGB 40 Anterior and inferior to the lateral

malleolus, in the depression on the lateral side of the tendon of m. extensor digitorum longus.

Ankle Pain

GB 41 In the depression distal to the

junction of the 4th and 5th metatarsal bones, on the lateral side of the tendon of m. extensor digiti minimi of the foot.

Master Point of the Dai Mai: All GYN and LV disorders

GB 44 On the lateral side of the 4th toe,

about .1 Cun proximal to the corner of the nail.

Jing Well Point; acute pain on the meridian

Liver MeridianThe pathway of the Liver Meridian runs from the proximal lateral corner of the nail of the great toe, along the medial edge of the foot, up the leg, posterior to the border of the tibia, between the Spleen and Kidney meridians. At the waist it runs parallel to the midline until it departs to the free end of the 11th rib, ending at the sixth intercostal space on the mid-clavicular line. Since Yin Meridians are often used to treat internal disorders, the Liver Meridian is important for treating many internal disorders associated with the Liver. These include many emotional disorders and symptoms associated with stagnation and wind.


Point Location Main UsesLR 1 On the lateral side of

the great toe, 0.1 Cun proximal to the corner of the nail.

Jing Well Point: restores consciousness; Inguinal pain; groin pulls; moves Qi in the lower warmer; genitourinary issues; stops bleeding

LR 2 On the dorsum of the foot, between the 1st and 2nd toes, proximal to the margin of the web.

LV fire and heat in the head; Heat in the Lower Warmer; Burning urination; red burning eyes; LV yang rising HA; Herpes I & II; Shingles; LV wind

LR 3 On the dorsum of the foot, in the depression distal to the junction of the 1st and 2nd metatarsal bones.

Source Point: Primary point to benefit all aspects of LV. Move LR QI, Quell LR Wind, etc.

LR 13 On the lateral side of the abdomen, below the free end of the 11th floating rib.

Front MU Point of the SP: Liver invading Spleen

LR 14 Directly below the nipple, in the 6th intercostal space.

Pain and tightness/fullness in the chest, ribs and breast


Point Helpful Translations

Location Main Uses

Bi Tong Nose Opening At the highest point of the nasolabial groove.

Stuffy-Runny Nose

Jian Nie Ling

Shoulder Out Front

Midway between the end of the anterior axillary fold and LI 15

Tai Yang Great Yang

Draw a line following path of lateral end of eyebrow down to intersection of line from outer canthus of eye, at intersection, in depression.

Eye Pain / DiscomfortHeadaches

Xi Yan Calf's Nose

A pair of points in the two depressions, medial and lateral to the patellar ligament, locating the point with the knee flexed. Lateral Xiyan overlaps with S 35.

Knee Pain

Yao Tong Xue

Back Pain Point

On the dorsum of the hand, midway between the transverse wrist crease and metacarpophalangeal joint, between the second and third metacarpal bones, and between the fourth and fifth metacarpal bones, 4 points in all on both hands.

Acute Back Pain/Sprain



Location Main Uses

Yin TangMidway between the medial ends of the two eyebrows.

Clams the Mind/Shen

An Mian Peaceful Sleep

Midpoint between Yifeng (SJ 17) and Fengchi (GB 20)

Calms the Shen for Insomnia

Point HelpfulTranslations

Location Main Uses

Hua Tou Jia Ji

A group of 34 points along both sides of the spinal column, 0.5 Cun lateral to the lower border of each spinous process from the first thoracic vertebra to the fifth lumbar vertebra.

Any disorders associated with the level of the spine

Luo Zhen Falling From Pillow

On dorsum of hand, between 2nd & 3rd metacarpal bones, 0.5 Cun posterior to metacarpophalangeal joint

Neck Pain

Shi Qi Zhuxia (Josen)

17th VertebraeBelow the spinous process of the 5th lumbar vertebrae

Low Back Pain

Ding Chuan Stop Asthma 0.5 Cun lateral to Dazhui (Du 14).

Stop / Reduce Asthma Attack



Location Main Uses

Ba Feng 8 Winds

On the dorsum of the foot, in the depressions on the webs between toes, proximal to the margins of the webs, eight points in all.

Foot/ Toe Pain

Ba Xie 8 Ghosts

On the dorsum of the hand, at the junction of the white and red skin of the hand webs, eight in all, making a loose fist to locate the points.

Hand / Finger Pain

Dan Nang Xue GB Point The tender spot 1-2 Cun

below G 34. Gall stones

He Ding Crane TopIn the depression of the midpoint of the superior patellar border.

Knee pain/ dysfunction

Shi Mian Lost Sleep In the center of the heel on the bottom of the foot

Heel & Knee Pain

Point HelpfulTranslations

Location Main Uses

Si Shen Cong

Four Spirits Cleverness

A group of 4 points, at the vertex, 1 Cun respectively posterior, anterior and lateral to Du 20

Clears the Mind

Yu Yao At the midpoint of the eyebrow.

Headache, Eye Pain

Zi Gong Xue Uterus Point 3 Cun lateral to Ren 3 All GYN

Extraordinary Points


5. Auricular Acupuncture: Microsystems & Extraordinary Meridians

Microsystems in general, are helpful in treating all painful conditions, as well as many internal disorders.

Auricular or Ear Acupuncture is commonly used by acupuncture practitioners in a majority of treatments. Ear points are easily accessible and can be added to most treatments to augment the primary points. Ear points are effective for both internal and external disorders.

I find Hand and Scalp Acupuncture to be it especially good for acute pain in the upper or Yang regions of the body.

Point location and treatment technique are both very important with microsystems. As there are many points in small areas with microsystems, one must find points precisely.

Once located, and needled, active or passive movement or functioning of the injured area should be employed during treatment if possible.

Look for immediate positive change during and after treatment. When microsystem points are located and treated appropriately, they often will yield immediate results.

Microsystems can be used exclusively for treatment, but are usually combined with primary acupuncture points.

There is contralateral ipsilateral


Hand Acupuncture

usually use opposite sidemove affected joint if possibleNeedling and Location TechniqueLocate at the epiphysis of the bone and needle in at a 45 degree angle to the point in the direction of the finger tips.Selected Upper Body Hand Points• Shoulder

• Radial side of the metacarpophalangeal joint of the index finger

• Shoulder pain• Nape & Neck

• Ulnar side of the metacarpophalangeal joint of the index finger

• Stiff neck• Migraine

• Ulnar side of the first interphalangeal joint of the ring finger• Migraine• Chest pain

• Headache• Ulnar side of the metacarpophalangeal interphalangeal joint of

the thumb• H/A• dizziness

Other Hand Points• Low Back (Loin & Leg)• Sciatic Nerve• Ankle• Polyhydrosis point

• Not lustrated. About ½ way between PC 7 & PC 8.• Works well for excessive sweating, (especially if it is linked to

the Shen)

143

Auricular Acupuncture General IntroductionTechniquesFind point exactlyActive or passive movementFor Yang disorders, palpate the Yang side of the ear for sensitivity and needle/seed it in addition to the Yin sideUsual ModalitiesNeedlesSeedsPress-balls Magnets


Ear Anatomy

Major Auricular Points

Shen Men

Heart

Liver

Kidney

Sympathetic N.

Stomach

Mouth

Thirst

Hunger

Nicotine

Shoulder-Arm-Hand

Back

Hip-Leg-Foot-Toe

Sciatica

Uterus

Toothache

Aspirin


Insomnia

Specific Auricular Treatments• Pain Protocols

• When treating pain, ear points corresponding to the region of pain, can be added to the treatment.

• Points should be carefully palpated for. • The Detox Protocol (Shen Men, Liver, Kidney, Heart,

Sympathetic N.) is useful in treating an number of disorders in addition to substance addictions. • Anxiety/ ADHD / PTSD (use as is)• Quit Smoking (add Nicotine Pt.)• Weight Loss ( Add Hunger & Thirst Pts.)

Acupuncture Treatment of Chemical Dependency A. Acupuncture is Not Complete in and of Itself for Detox. It

must be part of an integrated whole system, to achieve these results.1. Individual counseling2. Group support3. Case management4. Urine screening 5. Other conventional treatment approaches.

B. Get the patient to returnC. Remember the primary diagnosis.

1. Chemical Dependency is Primary2. It will kill faster than anything else

D. Withdrawal General Sx1. Severe Flu-Like Sx.2. fever3. chills4. insomnia5. cramping6. headaches7. agitation8. violent outbursts9. nausea


10.depression11.malaise / fatigue12.anxiety13.paranoia14.TCM

a) Def. QIb) Def. Yinc) Stuck Qid) Empty. Fire

E. Acute Medical Emergency from Withdrawal1. Alcohol2. Benzodiazepines3. Barbiturates

F. Effects of Acu Detox1. Decrease in Recidivism Rate2. High degree of outpatient compliance3. Reduced

a) Drug Cravingsb) Pain c) Muscle crampingd) Stress e) Anxietyf) Sleeplessness

G. Cost effectiveness1. 1 acupuncture provider, 1 Counselor, 1 Case Worker, & 1

admin. Can handle @ 30 patients in a two hour time period. Start to finish.

H. Treatment1. NADA Protocol

a) National Acupuncture Detox Associationb) Ear Protocol

(1) Shen Men(2) Liver(3) Heart(4) Kidney(5) Sympathetic N.

c) Patient Prep Station(1) Cotton


(2) Alcohol(3) Sharps container(4) Tissue(5) Mirror(6) Patients clean own ears(7) Patients Remove own needles(8) Patients clean up blood

d) Frequency of treatmente) DETOX Phase

(1) Lasts until pt. has put together 14 days clean & sober

(2) Weeks 0-2 of recovery(3) 1-2 Acupuncture. Tx. Daily(4) Group work(5) Case Management

f) Recovery Phase(1) Four Weeks(2) Weeks 3-6 of recovery(3) Three Acupuncture TX /week(4) Group Work(5) Case Management(6) Individual Counseling

g) Maintenance Phase(1) Weeks 7-10 of recovery(2) Acupuncture Tx. twice weekly(3) Group work(4) Case management(5) Individual Counseling(6) Re-Evaluation / Referral

Scalp AcupunctureA. Chinese Scalp Acupuncture is associated with Lines

1. Based On, Cortical Homunculus2. Western Function 3. Sensory / Motor areas etc.4. Chinese Scalp Lines: Generally Treat Contralateral Side


B. YNSA: Yamamoto’s New Scalp Acupuncture 1. Treatment Based on Discreet Points2. Based On Dr. Yamamoto’s Long Experience3. YNSA Points: Generally Treat Ipsilateral Side

C. All Points and Lines are palpated carefully to find the most reactive point for treatment

D. Scalp Contraindications and Cautions1. Contraindicated: Acute Stage Cerebral Hemorrhage: Wait

at least 4 weeks2. Caution During Pregnancy3. Contraindicated: Children With Fontanel Not Closed4. Caution: People who are Too Hungry or Nervous

E. Used for:1. All Painful Conditions 2. Especially effective in the upper body3. Neurological Conditions4. All Disorders Involving the Brain/CNS5. Post Stroke6. Cerebral Thrombosis / Embolism: Treat early 7. Post Stroke Prognosis

a) 1-3 mos: Excellentb) 3-6 mos: Very Goodc) 6-1 year: Goodd) Up to 3 years: Hopefule) After 3 years: Guarded

8. Phantom Limb Pain9. Spinal Chord Injury10.Post Traumatic Paralysis11.Brain Damage12.Multiple Sclerosis13.Muscular Atrophy14.Urinary Incontinence

F. ScalpTechnique


1. Pointsa) Palpate carefully for Discreet Point to Needle b) Needles: #2 or 3 X 30mm

2. Lines:a) Palpate carefully for Discreet Point to Needle b) If No Discreet Point is Reactive: Treat Entire Line c) Needles: #5 - # 8 X 30 - 60 mmd) Position Patient Sitting Upe) Transverse Needle Insertion / 15-250

3. Depth of insertiona) Five Layers of scalp

(1) Cutaneous(a) Thick(b) Rich in blood circulation (c) Painful to needle

(2) Subcutaneous(a) Firm(b) Dense(c) Short fibers(d) Major vessels and nerves (e) Painful to needle

(3) Galea aponeurofic layer(a) Tough & tensile fibrous Tissue(b) Very painful to needle

(4) Aerial tissue layer(a) Loose connective tissue(b) The Best Layer To Needle

(5) Periosteum (a) Outer layer of Skull(b) Very painful to needle

4. Minimizing Paina) Insert Quicklyb) Needle Correct Layerc) Check for shallow enough angle

5. Stimulationa) No Thrusting: Rotation Onlyb) For Best Results: Stimulate for 1-2 min. Every 10-15

min.


6. Needling Directiona) Generally From Superior to Inferiorb) Or Anterior to Posterior

7. Lay needlesa) 20-60 min.b) Up to Twelve Hours

8. If Possible: have patient Walk or Talk, Utilize or Move the affected part/faculty during treatment

9. Remove Needlesa) Always use Cottonb) Often bleeding

10. Interdermals, Electro Acupuncture, Moxa, and Massage Can All Be Used

G. Finding the Hairline:1. The Hairline can be found about 1cm superior to the

most superior wrinkle on the forehead.2. The Corner of the Hairline can be found @ 4-5 cm lateral

to the midline, about the same distance lateral to the middle of the eye, as the middle of the eye is from the midline of the face.


Scalp Points

II. Head & Neck PointsA. A Series of Discreet Points, corresponding to the cervical

vertebrae and occiput. B. The points are found on a 2 cm long Line, centered on the

hairline, 1cm lateral to the midpoint of the hairline.C. Any Pain/Disorder of the Face, Head, and NeckD. Any Disorder associated with the Cervical SpineE. Neurological Disorders F. Post Surgical ComplicationsG. Trigeminal NeuralgiaH. Bell's PalsyI. Headache/MigraineJ. Vertigo

III. Neck & Shoulder PointsA. A Series of Discreet Points, Found on a 2 cm long Line,

centered on the hairline, 2cm lateral to the midpoint of the hairline.

B. Any Pain/Disorder of the Neck, Clavicle, Shoulder and Scapular Regions.

C. ParalysisD. Post traumaE. Post operativeF. FracturesG. Upper Body CRPS / RSD H. Complex Regional Pain Syndrome / Reflex Sympathetic

Dystrophy Syndrome IV. Shoulder Arm & Hand Points

A. A Series of Discreet Points, which are found on a 2 cm long Line, beginning at the corner of the hairline, and extending diagonally toward the nose (Yin Tang).

B. These points correspond to the shoulder, which is found near the top/lateral end of the line; the arm in the middle; and the hand, at the inferior/medial end.

C. Any disorders of the Shoulder Joint, Scapular Region, Arm, Hand, Wrist & Fingers


D. PainE. ParalysisF. Post trauma/operativeG. FracturesH. DislocationsI. Carpal Tunnel Syndrome

V. Thorax PointsA. A Series of Discreet Points, corresponding to T1-T12.B. The points are found on a line, which begins about 1cm

lateral to the midline at the top border of the eyebrow. (This medial border corresponds to T-1) The line continues to the midpoint of the eyebrow at a 150 angle upward ending above the middle of the eyebrow. (The lateral end corresponds to T-12.)

C. Any Disorder associated with the Thorax or Thoracic Spine D. Back PainE. Rib PainF. AnginaG. Herpes ZosterH. Asthma / Bronchitis

VI. Low Back PointsA. A Series of Discreet Points, corresponding to the Lower

Back, Lumbar, and Belt Region. B. The Points are found about 1 cm above the Zygomatic Arch.

Beginning at the anterior hairline, and progressing to the anchor of the helix, then proceeding superiorly for about centimeter.

C. Primary Treatment points for Low Back Pain, Paralysis, and other disorders of the Lumbar Spine, Lower Body, and Lower Extremities


Chinese Scalp LinesBased on Cortical Homunculus

Finding the Lines: Lines of MeasurementI. Draw Two Lines

A. Anterior - Posterior Midline1. From Glabella to the EOP (External Occipital

Protuberance)2. Find Mid-point of the line3. Can be found by describing a plumb line from the top of

the ears to the A-P Midline


4. The Midpoint of the Anterior-Posterior Midline is a useful landmark for finding treatment lines.

B. Eyebrow - Occipital Line1. From center of eyebrow to EOP (Via the temple and

across the ear)2. The point at which this line crosses the anterior hairline is

a useful landmark for finding treatment lines.


Continence Line (AKA: Leg & Foot Motor & Sensory)

I. Beginning at a point 0.5 Cun lateral to the midpoint of the anterior-posterior midline, Draw bilateral lines, parallel to midline, in the posterior direction, 2 Cun in length

II. Needle From Anterior to PosteriorIII. Paralysis, Pain, Numbness of Lower Limb Opposite Side

A. The Function is similar to the functions of the upper 1/5th of both motor and sensory area together.

B. Urinary Incontinence1. Most All Urinary Problems

C. Prolapsed Urinary Bladder/ Uterus / StomachD. Bowel Disorders

1. Bowel Incontinence


2. Allergic Colitis3. Crohn's Disease4. Hemorrhoids

E. Post Traumatic Stress SyndromeF. ADHD (Attention Deficit Hyperactive Disorder)G. Multiple SclerosisH. Male Reproduction

1. Impotence2. Spermatorrhea

I. Female Reproduction1. Uterine Bleeding2. Endometriosis3. Prolapse Uterus


J. Swollen AnklesMotor Function Line

I. From Midpoint on Anterior - Posterior Midline go 0.25 Cun Posterior

A. Draw Line from this point to the point where the Eyebrow - Occipital Line crosses the anterior hairline @ the sideburn

B. Motor Area is divided into 5 partsC. Superior 1/5th of motor Area

1. Treats paralysis of Lower Limbs and Trunk on Opposite Side

D. Middle 2/5ths of motor Area 1. Treats paralysis of Upper on Opposite Side

E. Inferior 2/5ths of Motor Area1. Facial Paralysis on Opposite Side2. Nerve Damage3. Bell's Palsy4. AKA Speech 1 area5. Motor Aphasia

Sensory Perception Line

I. A Line Parallel to and 0.75 Cun Posterior to the motor areaA. Sensory Area is divided into 5 parts B. Superior 1/5th of Sensory Area

1. Parastisia of Lower Limb and trunk on the opposite side2. Phantom Pain of Lower Limb and trunk on the opposite

side3. Special Effects

a) Occipital H/Ab) Neck Pain / Stiffness

C. Middle 2/5ths of Sensory Area 1. Parastisia of Upper Limb on Opposite Side2. Phantom Pain of Upper Limb on the opposite side

D. Inferior 2/5ths of Sensory Area1. opposite Side2. Migraine H/A


3. Trigeminal Neuralgia 4. Toothache5. TMJ

Tremor Control Line

I. A Line Parallel to and 0.75 Cun Anterior to the motor areaA. From Midline to the inferior border of the hairlineB. Divided into Three PartsC. Superior Third for Lower LimbsD. Middle Third for Upper LimbsE. Inferior Third Head & NeckF. For Treatment of:

1. Any Involuntary movement or tremor2. Chorea3. Parkinson's Disease

Vision LineFrom a point 0.75 Cun lateral to, and level with, the EOP (External Occipital Protuberance) draw a line parallel to the midline, and 2.0 Cun in length, Superior from the EOP! Indications! ! Cortical Vision Disturbances! ! Glaucoma! ! Cataract

Vertigo and Balance LineFrom a point 2.0 Cun lateral to, and level with, the EOP (External Occipital Protuberance) draw a line parallel to the midline, and 2.0 Cun in length, Inferior beginning at the level of the EOP! Indications! ! Balance! ! Proprioception


The 8 Extraordinary Meridians In More Detail

Before we look at the Eight Extraordinary Meridians, lets consider the levels to which meridians penetrate the body.

Primary Meridians Access & Connect The Wei (External /Protective) & Ying (Internal / Nourishing) Levels

Divergent Meridians Connect The Wei & Yuan Levels, to translocate pathogens from the internal level to the external level to protect the Zang/Fu

Sinew / TM Meridians Access The Wei Level and are used for pathologies that manifest on the surface and in the joints, as well as those that cross from meridian to meridian, transversely:i.e. LI & SJ.

Luo Meridians Access The Ying Level and are the manifestation of internal pathogens. These meridians are created as needed, and may manifest as varicosities or phlegm nodules. They are best treated by releasing Xue through Plumb blossom & Lancet bleeding.

The Eight Extraordinary Vessels/Meridians Access and Treat at the Yuan QI or Jing Level. At this level we are working with with issues that are deeply embedded in our lives.

These are the 1st channels to develop in the embryo. Therefore, when working with the 8 Extraordinary Meridians we are reminding the body of what it was like when it was perfect.

The First cell division‚creates the Du, Ren, & Chong The Second division creates the DaiThe Third division creates the Yin Wei, Yang Wei, Yin Qiao & Yang Qiao


They are the foundation of Yin & Yang, and the 7 & 8 year cycles


Treatment Protocol for the Extraordinary Vessels

Use this protocol for internal medicine, women’s health and psychological & emotional disorders. Other options exist for the treatment of pain

Keep in mind that treating at the level of the Jing can take some time. It is not unusual to see results right away, and it is also not unusual for a course of treatment to take one to three months, at one treatment per week.

Use the following needling order, and be sure to obtain the Qi deeply, for each point. 1. Needle Master Point / Opening Point

• Right or Left - according to sex• Women / Right• Men / Left

2. Treat Coalescent Points on the Meridian, and other related points as needed

3. Needle Coupled Point /Closing Point4. Remove Needles in reverse order: Last in-First out

General Uses for the Extraordinary MeridiansDai Mai (Belt Vessel)• Points

• Master/Opening Point: GB 41 • Coupled/Closing Point: SJ 5• Major Coalescent Points: GB 26 (27-28)

• Opens the Lower Warmer• All lower warmer stagnation• Adjusts the Menses• Guides and Supports the Uterus• Supports the Low Back• Radiatiing Low Back Pain

• Influences flow of LR Qi


• Harmonizes ascending and descending of Qi

Chong Mai (Penetrating Vessel)“Wide Trunk Road”• Points

• Master/Opening Point: SP 4 • Coupled/Closing Point: PC 6• Major Coalescent Points: ST 30, KI 11 to 21

• Sea of blood • Controls The Menses• Harmonizes ascending and descending of Blood

Ren Mai (Conception Vessel CV)• Points

• Master/Opening Point: LU 7 • Coupled/Closing Point: KD 6• Major Coalescent Points: Ren 2 - Ren 15

• Sea of Yin• Yin Deficiency with Yin Stagnation• Supports Yin: Jing and Fluids• Supports Yin (sex) Hormonal Balance• Relate to int. and ext/ genitalia

Du Mai (Governing Vessel GV)• Points

• Master/Opening Point: SI 3 • Coupled/Closing Point: UB 62• Major Coalescent Points: Du 2 - Du 15

• Governs the Yang• Supports the Spine• Enters the Brain • Supports the CNS• Supports Yang (Stress) Hormonal Balance


Secondary Extraordinary VesselsYin Qiao & Yang Qiao (Heel Vessels)• Yin Qiao Points

• Master/Opening Point: KD 3 • Coupled/Closing Point: LU 7• Major Coalescent Point: KI 8

• Yang Qiao Points• Master/Opening Point: UB 62• Coupled/Closing Point: SI 3• Major Coalescent Point: GB 20

• Secondary for Excess patterns of Lower Jiao• Masses• Fibroids• Adhesions• Difficult delivery• External genitalia

Yin Wei & Yang Wei (Linking Vessels)• Yin Wei Points• ! Master/Opening Point: PC 6 • ! Coupled/Closing Point: SP 4• ! Major Coalescent Point: KI 9• Yang Wei Points• ! Master/Opening Point: SJ 5 • ! Coupled/Closing Point: GB 41• ! Major Coalescent Point: GB 21• Nourish Blood• Calm mind /Shen

Zonal Approach to the treatment of pain using the Extraordinary Meridians.The pathways of the 8 Extraordinary Meridians and their associated channels, together construct the Anterior, Posterior, Medial, and Lateral Zones. Treating the opening and coupled points can influence the flow of Qi throughout these Zones, effectively treating


many painful conditions. This Material is covered in detail in the Chapter on Treatment of Pain.Psychological Issues & Extraordinary Meridians

The language of Chinese Medicine is Psychosomatic. Although current translations of Chinese medical books often do not mention psychological disorders, translations can also be made in way that expresses the psycho-emotional aspects of the words. It is good to keep this in mind when considering points, and the Extraordinary Meridians. • Chronic Diarrhea or Purging = Not wanting to keep what you have• Angina = Heart Pain, Broken Heart• Nausea = Can’t stomach it, but can't let it go• Red Face = Anger, Frustration

Also it is worth noting that depression is often related to Blood Deficiency. The body begins to accumulate fluid as a substitute for Blood, Then Dampness accumulates and transforms into phlegm, which prevents the free flow of the emotions, and leads to depression. Phlegm nodules also form which contribute to further stagnation resulting in disorders like fibromyalgia, chronic fatigue, and Qi Stagnation.

The Extraordinary Meridians are particularly helpful in addressing some psycho-emotional issues. Below are some indications that may be helpful in pointing the direction for using them in such cases.

Dai / Belt Mai• Major Issues which accumulate over time, which we can't stand,

but can't get rid of• Unresolved Postnatal Issues,Trauma, Sentiments,

Emotions, Guilt, Inadequacies• All these accumulations, concentrations, and conglomerations

are deposited into the Dai/Belt Channel where they are stored.• When the Dai Mai gets saturated, it begins to leak out• This is like emptying the garbage, but we fill it up again & again• Physical Sx.


• Infertility, Impotents, Reproductive disorders, Sagging feeling in the waist, Excessive vaginal discharge, Diarrhea, Constipation

• Psycho-Emotional sx.• Feeling Stuck, Indecisive, Lack of clarity, Lack of

creativity, Inferiority

Chong / Penetrating Mai• Coming to terms with one's own nature, purpose, temperament

& culture• The Chong Mai penetrates the center of the body, joining

together the Kidney which stores Jing / Yuan Qi, the Spleen: which produces QI & Blood and the Heart which stores our consciousness

Ren / Conception Mai• Sea of Yin

• Yin Stasis, with Yin Deficiency• Yin forms the process by which we bond and form unions

• Original Bonding / Mother Child Bonding• Nurturing• Security & Trust, Contentment, Feeling at Home• Completion, Craving completion• Competence, and control over internal and external

environment

Du / Governing Mai• Governs the Yang: Tai Yang, Xiao Yang, & Yang Ming• Yang allows for separation from the mother

• Nurturing oneself• Ability to stand erect• Individuality• Moving into the World• Freedom of movement of head• Expression & temperance of desires / Taking risks• Survival Motivation


Yin Wei / Yin Linking Mai• Treats traumas which may have occurred at a significant turing

point in life, and which blocks full development• Devoting Qi & Blood to memories leaves less for the present

moment• Contingency• Always Asking “What if…?”• Not accepting oneself

Yang Wei Yang Linking Mai• Cast my net into the world• Forever searching for one's Role in Life• The process by which we move into a certain role in the world• Our choices and the process by which we don't choose• Commitment and lack of Commitment• Movement from Family Intimacy to Global commitments

Yin & Yang Qiao Yin & Yang Heel Mais• Focusing on the present moment

• Qiao = heel, stance, bridge, and motility• Yang Qiao = one's stance to the world• Yin Qiao = one's stance to oneself

• Polar Opposites• Yin Qiao

• Receiving of Qi• Introvert• Insomnia• Medial aspect of legs tight• “My Bad”

• Yang Qiao• Giving of Qi• Extrovert• Hypersomnia• Lateral aspect of legs tight• “Everyone's and Idiot”

The Chart of the 8 Extraordinary Meridian below, while not exhaustive, is included below for quick reference.


6. The Main Course: Treatment of PainAs mentioned above, there are three important facets to performing effective acupuncture treatment of pain: choosing the correct points, precise point location, the technique applied to the points.

Diagnosing The PainFirst, don’t get too complicated. A complicated diagnosis can often distract from a successful treatment. Most pain for example, whether it is back pain, neck pain or leg pain; whether it is from a musculoskeletal injury, arthritis, bursitis, an inflammatory reaction, or as part of a sequela of stroke; will manifest as obstruction of the meridians due to either Qi (energy) Stagnation or Xue (blood) Stagnation. When treating the pain with acupuncture and related techniques, it is often of little consequence to the treatment, whether it is from Qi or Xue Stagnation. The main difference between these two syndromes lies more in the prognosis rather than treatment approach. The treatment, with acupuncture and associated techniques, is usually the same. However, in general, a more aggressive approach is used for Xue stagnation than is used for Qi stagnation. This differentiation also carries more significance when choosing topical or internal application of herbs. The complications of Cold, Heat, Dampness, and Wind can also often influence the treatment, but this is secondary to moving the stagnation.

ImmobilizationA commonly overlooked point in the treatment of injuries is immobilization. When there is a soft tissue injury, such as a strain or sprain, it is important to immobilize the area as much as possible


until the discomfort has been relieved. When injured, the body’s response is to produce pain and swelling. This mechanism serves to protect the area and allows for natural healing to occur. In our society, we want to minimize down time and get back to work (or play) as soon as possible. So we reduce swelling, take pain relievers, or acupuncture and herbal wraps, and get right “back on our feet.” This approach may fit some societal needs, but it may not the best approach for one’s physical needs. Injuries take time to heal, and they require rest too. Many cases of chronic pain syndromes originally began with Qi and Xue stagnation, which stem from improper treatment of soft tissue injuries i.e. using the injured part too soon. I usually recommend that soft tissue injuries are well splinted, or wrapped, and that patients avoid using the affected part as much as possible, until most or all of the pain is gone. This leads to less trouble with Cold, Dampness, Stagnation, and the like, getting trapped in the meridians and causing future problems.

Ice & HeatThe problem of cold getting trapped brings up the question of the application of heat or cold to an injury. In acupuncture theory it is well established that cold can penetrate an injured joint and stagnate, causing additional pain and possibly long term problems. Therefore, I avoid ice or cold unless it’s absolutely necessary. Either way, I strongly recommend using heat (moxa or TDP lamp) on injuries as soon as it is feasible, to move stagnation.

Treatment Results The question that may surface when considering the treatment might be, “Do I need to see immediate change from the treatment?” Yes. There should be some change in the condition at the time of the treatment. This is not to say that the treatment is ineffective if you do not see immediate change, but immediate results are a very good indication that you have found an appropriate treatment. I suggest that you continue to try different approaches to the problem until you get immediate results. This is


not always possible, and the patient will often find improvement after some time, but it is preferable to get those “right-before-your-eyes” changes. So keep trying different techniques until you hit the one that clicks for that particular patient, at that particular time. While we are on the subject, consider that a strong acupuncture treatment for painful condition, will often leave the treated area sore, from the stimulation. This soreness should resolve in 12-24 hours. My brother tells all of his patients to wait 24 hours before judging the effect of a treatment. I think this is wise advice.

PalpationIt would be difficult to overstate the usefulness of palpation. I have seen many practitioners, some of whom I admire and respect, practicing with little or no palpation. While they may get good results, I don’t understand how they know what to treat. To me it is vitally important to know exactly where the Qi is, where it is not, where it flows smoothly, and where it is stuck. Simple palpation of the meridians, acupoints, and trigger points, can easily reveal much of this information.

In order to locate a trigger point, it is usually best to palpate muscles with deep cross-fiber palpation. Once a trigger point is located, be sure you keep track of it with your fingers, so you can be sure to accurately treat it with the needle.

This is what I mean by precise point location. Be sure you’ve located the point of disharmony before you place the needle.

Local TreatmentShould one treat the local area or avoid it? This is often debated amongst practitioners. I say treat it, in most cases. I hedge my bets here, because the practitioner must determine what will make the problem worse and what will make it better. If, for example, the patient reports that massage makes the problem worse, or if previous treatment to the area has resulted in an exacerbation of


the problem, these could be indications that direct treatment may be cautioned, or contraindicated. However, I seldom see direct treatment exacerbate a painful condition, and even in those occasional situations, a few days of respite from treatment has allowed the condition to return to its pre-treatment level of discomfort, or better. The caveat here is that some problems benefit more from local, adjacent, and distal treatment, while others respond better to distal treatment only. How to asses the difference prior to treatment is not always clear. You’ll have to trust your experience and intuition.

Moving StagnationIn order to alleviate pain, the stagnation needs to be moved. While this is obvious, it must be consistently focused upon. Whether it is Qi or Xue stagnation, often the best course of action is simply to move it.

I believe that moving stagnation takes precedence over building deficiencies, when treating pain, in almost every case.

This is an important treatment strategy. If one attempts to build deficiencies in the presence of stagnation, it can lead to increased stagnation, hence more pain, or pain that is more difficult to treat. I have often found that. once the stagnation is successfully resolved, then deficiencies can be tonified. If the patient is extremely deficient, there may be cause for concern, but most of the time the deficiency can be better addressed after the pain has been treated. Most individuals will easily tolerate a bit of a decrease in Qi if it results in significant pain relief. Remember that pain itself affects an individual’s Qi. Relieving the pain with a dispersing treatment can make the patient feel better, and often stronger as well. My wife asserts that she regularly feels a deficient patient’s weak pulses become stronger after strong Qi-moving therapies, like cupping. She believes this may be because Qi that was previously stagnant becomes available to the body, increasing the overall Qi of the body.


Treating Pain: Local, Adjacent, & Distal Points This is the standard approach for Treating Pain. The first question I look to answer is: “Where is the primary disharmony?” This is may seem obvious and, keeping in mind what I said earlier about not getting too complex, there is usually some looking to do. Diagnosis is like being a detective of sorts. One must find a number of clues before coming to a conclusion. If the problem is orthopedic in nature, the primary disharmony is usually at or near the site of the pain. When the primary disharmony exists someplace other than at the site of the pain, it is often found proximally. How does one assess if the primary disharmony is at the pain site or proximally, or distally for that matter? Palpation. I recommend that the practitioner look at the usual trigger points that are associated with the area of pain. (Get yourself a trigger point chart, if you don’t know them.) Then explore the local and adjacent musculature. If that isn’t sufficient, follow the dermatomes to the area on the back that corresponds to the more distal or more anterior pain, and then palpate. These dermatomes do not need to adhered to 100%. Rather, one should have an understanding of the pathways of the dermatomes and how they relate to the 12 main meridians and their corresponding Sinew (tendino-muscular) meridians and integrate the information gained from palpation to establish the most likely candidate areas for treatment.

All three of the following point types should be explored when treating pain.

Distal means you should use points that are distal to the pain and which affect the area of the pain. For instance: ! Bleeding a Jing point on the effected meridian (and/or)! Using LI 4 and Lu 7 for Pain in the head and/or neck (and/or)! Opening the Posterior Zone with SI 3 & UB 62 for back pain


Local means using points at the pain site: Trigger Points. It’s sometimes half-jokingly put this way: “If it hurts, put a needle in it.” I don’t mean to say that trigger points are the most important. The practitioner is well served by being conscious of the acupuncture points, and established trigger points and their proper location. The proper location is like using a map. A map shows you where the place is, but it is only approximate. The location indicated is only as good as the map. And the map is only a symbol. So the best practice is to know the location of the local acupuncture points and established trigger points to get you to the area where the Qi can be most easily accessed, and then palpate for the exact location of the point to be needled.

Adjacent means to palpate - radiating out from the painful site -for adjacent points that are reactive. In short, finding the associated trigger points. Some sources consider related points at adjacent joints to be adjacent points. For example, using LI 10 for shoulder pain. I have no problem with this, but it’s not a substitute for trigger point palpation.

It’s not a bad idea to choose local, adjacent, and distal points from standard points on the Yang meridians, whenever possible. The Yang meridians are best for treating Yang disorders, and most musculoskeletal and neurological pain syndromes are generally considered Yang disorders.

Major Yang Meridian Points to keep in the forefront of your mind, for easy and regular application as local, distal and adjacent points:! LI 1, 4, 10, 14, 15, 20! ST 6, 7, 30, 36, 44, 45! SJ 1, 3, 5! GB 2, 8, 14, 20, 21, 26, 34, 41, 44! SI 1, 3, 11, 18! UB 1, 2, 10, 13, 18, 23, 40, 60, 62, 67! DU 4, 14, 20! LR 1, 3, 13 (The Liver is the Exception the the Rule. Liver points work as well as Yang Meridian points, for treating pain.)


Sinew (Tendino-Muscular) MeridiansKeep the Pathways of the Yang Sinew Meridians in mind, and treat Jing Points to clear pain from them. The Sinew Meridians can make a tremendous difference when treating pain. Bleeding 3-10 drops from the jing points on the affected meridians is often my first treatment for pain, especially in acute injuries.

Zonal Treatment for Treating Pain by AreaThe following zones can be opened or activated by treating the distal points associated with them. Opening these zones is one of the best ways to begin a treatment for pain.

! Posterior Zone: SI 3, UB 62! Lateral Zone / Low Back/Hip/Sciatica: GB 41, SJ 5! Anterior (Internal) Zone: Lu7, KD 6! Anterior (External) Zone: LI4 - ST 36 ! Medial (Internal) Zone: Sp 4, PC 6! Medial (External) Zone: PC 6 – LR 3


Zonal Treatment Procedure: 1. Determine in which Zone the disorder is manifesting 2. Treat appropriate zonal point that lies closest to the pain3. Treat the second associated zonal point on the opposite

side4. Proceed with the rest of the treatment (Local, Distal,

Adjacent, Microsystems, etc.)

Example: Pain in Right Buttock1. Posterior Zone, (Lower Right Quadrant)2. Needle: UB 62 on the Right (Posterior Zone, Right Side,

Lower Body)3. Needle: SI 3 on the Left4. Palpate, and treat Local and Trigger Points as necessary,

etc.

! This is a simple procedure that has a big pay off.

Microsystems

I use points from the Ear, and Scalp in most all treatments for pain. While I have not covered them in this book, microsystems are very useful, and one should consider using them for all painful conditions. Microsystem points are particularly helpful in that, when treated correctly, they often have instant effects. Hence, you get clear and direct feedback on the effectiveness of your technique and diagnosis. You should know a good selection of points and lines from the following microsystems of acupuncture: Auricular Acupuncture, Scalp Acupuncture Points & Lines, and Chinese Hand Acupuncture. There are many good charts for finding these points.

The indications for most all Microsystem points are apparent from their names. For example, the foot point on the ear is good for


treating any problems associated with the foot. Perhaps in the next edition I will cover them in some detail.

Scalp Acupuncture can be especially effective, and when done correctly, it it’s no less comfortable than other forms of acupuncture. If you haven’t learned APS-USA (AcuPractice Seminars Unified Scalp Acupuncture), or YNSA (Yamamoto New Scalp Acupuncture), then I recommend that you learn one or the other. You’ll be glad you did.

The next page lists a group of points that are the main local points on various areas of the body, that are particularly useful for treating pain. All practitioners should be thoroughly familiar with them. They are points that you will likely be using over and over again in your practice.


The Main Local Points for Treating Pain

! Head! ! St 3, 5, 6, 7, 8 ! ! LI 20! ! GB 8, 14, 20!! ! DU (GV) 20! ! SI 18

_____________________________________________! Neck! ! GB 20, 21! ! ! UB 10! ! DU 14!! ! ! LI 17 area

_____________________________________________! Shoulder! ! GB 21!! ! ! LI 14, 15, 16! ! SJ 14, 15! ! ! SI 9,10,11,12

Jian Nei Ling (½ way between LI 15 and the superior anterior end of the axial crease)

_____________________________________________! Elbow! ! LI 11,12! ! ! SI 8! ! SJ 10

_____________________________________________! Wrist! ! LI4, 5! ! ! ! SJ 4! ! SI 3, 4, 5, 6

_____________________________________________! Hip! ! GB 26,27,29,30

_____________________________________________! Knee! ! St 35, 36! ! ! GB 34! ! SP 9 (Yin)

_____________________________________________! Ankle ! ! St 41! ! ! ! GB 40! ! UB 60, 61, 62


The Recipes: Treating Specific Painful Conditions

How To Use These Recipes

First, I will often begin a course of treatments by bleeding 8-10 drops from the Jing point(s) on the affected meridian(s). I usually find that this works well for the first treatment or two, and can substantially reduce pain and discomfort. Subsequent treatment of Jing points generally offers only marginal results.

Secondly, I usually open the appropriate Zone.

The next step I’m likely to take is to add in other distal points, chosen from the recipes below.

Then I’ll likely proceed with local and adjacent treatment as determined by palpation, informed by my knowledge of the appropriate acupuncture points and trigger points and their referral patterns.

While this is a good approach in many, if not most cases, it won’t work every time. If it doesn’t, it’s time to look more carefully at the particular patient and pattern, to determine the best course of treatment.


Headaches Note: During a headache, use only light/gentle stimulus on local pointsGeneral Headache Points: Use these points for all headaches, add specific points (below) for specific headaches! LI 4, LU 7, SJ 5, GB 41, LR 3, Ear Shen Men

! !

! Frontal Headache: ! St 36, St 8, GB 14, UB 2, Yu Yao !! One-Sided Headache: Tai Yang, GB 8 on the affected side

! Eye Headache / Pain: UB 2, GB 2 on affected side

! Occipital Headache: ! GB 20

! Vertex Headache: Du 20, Si Shen Cong

Of course many headaches are chronic, and may require a deeper look into the pattern of disharmony that is causing the headaches. Still, these treatments work well in many cases.

Facial Pain! TMJ and/or Tooth Pain: LI 4, LU 7, ST 44, ! ! Add 1 or more of the following based on pain location:

! ! St 3, St 4, St 5, St 6, St 7, SI 18! ! Scalp: ! Lower 2/5th of the Sensory Area ! ! ! on the opposite side

Trigeminal Neuralgia: Same as above: Use caution on same side of pain. Often it’s best to focus on distal points


and use local points on the opposite side from the pain, to avoid triggering the pain.

Neck Pain & Stiffness“Nape & Neck” and “Shoulder” Points on the Hand ( l o c a t e d i n b o t h p r o x i m a l m e t a p h y s e s o f t h e metacarpophalangeal joint of the index finger) should always be tried when treating neck pain & stiffness.

! Anterior Neck Pain/ StiffnessLI 4, LU 7, ST 36 Palpate and treat as necessary, local and adjacent trigger points, especially along the SCM and Scalene, following down to the pectoral region.

! Lateral Neck Pain / StiffnessLI 4, LU 7, SJ 5, GB 41, Palpate and treat as necessary, local and adjacent trigger points especially along the SCM and Scalene.

Posterior Neck Pain / StiffnessSI 3, UB 62, Palpate and treat as necessary, local and adjacent trigger points, especially along the trapezius and following tight muscles down into the back. The trigger points often cross the midline in the upper, mid and lower back, so be sure to palpate both sides of the spine.

Wrist & Hand PainThis is often associated with trigger points in the forearm. Palpate and treat as necessary, local and adjacent trigger points starting at the elbow and working your way down to the wrist. Of course you can and should treat local points, especially choosing from the effected Meridians. Perhaps choosing from the following:! LI 4, 5: !! LU 7, 8, 9, 10 ! SJ 3, 4


! SI 2, 3, 4, 5, 6 ! PC 7, 8

Arm & Shoulder PainAnterior Arm/Shoulder PainLI 4, ST 36, LI 14, LI 15, Jian Nei Ling Palpate and treat as necessary, local and adjacent trigger points.LU 7 and KD 6 might be substituted for LI 4 & St 36, if the pain is closer to the LU meridian, or if the first set of points are not effective.

Lateral Arm/Shoulder PainSJ 5, GB 41, LI 14, LI 15, GB 21, Palpate and treat as necessary, local and adjacent trigger points.

Posterior Arm/Shoulder PainSI 3, UB 62, SI 9 and/or SI 10, SI 11 and/or SI 12, Palpate and treat as necessary, local and adjacent trigger points.

Upper and Mid Back Pain

SI 3, UB62 to open the Posterior Zone

There are a number of good acupuncture points for treating the mid and upper back, including the traps, but the Treatments of choice for this area are Cupping and Gua Sha. Cupping and Gua Sha can often release stagnation in this area quite effectively, and should usually be part of the treatment approach.

Trigger points primarily, especially in the region of:! SI 11, and GB 21.

Also chose points from: ! Du 8 -14 and the associated Hua To Jia Ji Points


Low Back & Hip Pain and SciaticaThere are many influences on the low back and hips. Consider that the following Meridians all pass through and influence the lower back:

Urinary BladderDu Mai (Governing Vessel)Dai Mai (Belt Vessel)Gall Bladder

In addition the strength of the low back is dependent on the vitality of the Kidneys.

Given all that, I have found that Opening the Dai Mai with GB 41 & SJ 5 can be a highly effective treatment. That’s how I often begin a course of treatment. If you try this approach, you will be surprised at how often it gives very good results.

Another very good approach is to begin by Opening the Posterior Zone, with SI 3 & UB 62.

The following points all are useful local points for treating the low back and hips, and should be considered for treatment. Along with the usual palpation and treatment of Ashi and Trigger Points.! GB 26, Du 4, UB 23, UB 52, UB 25, UB 32.!Distal Points include UB 40, UB 60, UB 67


Knee PainKnees can be a little stubborn for a number of reasons. First, they take a lot of abuse from bearing excess weight, suffering from improper foot position when walking, and the relatively Yin location of the knees. Remember Yin is substantial, and the further down in the body one goes, the more substantial the problem becomes, and subsequently the tougher to move. That said, there are some good points to treat the knees.

Distally, in addition to the usual Jing points and Zonal points, you can stimulate Shi Mian (center of the heel). I usually use moxa for this, but you can also needle it.

Adjacent treatment generally consists of palpation above and below the knee, especially focusing on the calf to find trigger points.

Local Points: ST 36, 35, 34, GB 34, Sp 9, 10, Xi Yan, UB 40 Foot & Ankle PainOnce again, the Yin location of the feet sometimes makes them difficult to treat, so I recommend you use a lot of points on the feet. I feel patients benefit from even 10 -12 points on each foot, if needed. I mainly choose from the Yang meridians, but don’t limit myself to them. The Liver meridian can be very useful here too. Local points to choose from include:

Check the calf carefully for trigger pointsSP 6 and GB 39 together to open the meridians in the foot & AnkleAny of the Jing Points: UB 67, GB 44, ST 45, LR 1, Sp 1,ST 44, 42, 41 GB 43, 42, 40UB 60, 61, 62, 63, 64, 65LR 2, 3, 4 SP 2, 3, 4, 5


KD 2, 3, 4, 5, 6

Abdominal PainAbdominal Pain is clearly an internal medical problem and there are many reasons for it. With so many diagnosis resulting in abdominal pain, it’s difficult to offer comprehensive treatment advice in this work. However, there are a few treatments that can often help. As with all disorders, be sure you’ve diagnosed the patient carefully before beginning treatment.

Open the Dai Mai GB 41, SJ 5 ! And/OrOpen the Chong Mai SP 4, PC 6

Choose from: Ren 2, 4, 6, ST 25, REN 12

7. Review: National Board Exam & ProgramA. Introduction

1. This class will cover the information needed to effectively apply acupuncture in clinical settings, and to pass the National Boards in Acupuncture

2. Differing levels of understanding of the material apply to the various national exams.a) NBCEb) ACA / ABCAc) NCCAOM

3. Reference Material a) CookbookAcupuncture: by Jim Ventrescab) The Web That Has No Weaver: by Ted Kaptchuckc) Acupuncture Clean Needle Technique Manual

http://www.ccaom.org/cntprogram.aspd) The Foundations of Chinese Medicine: by Giovani

Maccocia


e) A Manual of Acupuncture: by Peter Deadman and Mazin Al-Khafaji with Kevin Baker

4. History: a) Nei Jing: Yellow Emperor’s Internal Classic of

Medicine(1) Oldest extant book on Acupuncture & Chinese

Medicine(2) Probably written between 300 and 100 BCE

b) The Nan Jing (1) Written in the Han Dynasty 206 BCE - 220 CE

c) Chiropractic Acupuncture in US Since 1970s5. The Five Branches of Oriental Medicine

a) Acupuncture/Moxibustionb) Herbal Medicinec) Exercise : Qi Gong Tai Ji(ABCA d) Diet/Lifestylee) Massage & Manipulation

B. General Theory1. Yin Yang

a) Everything consists of Yin & Yang(1) Relative terms that exist only in relationship to one

another(2) Nothing is totally Yin or totally Yang(3) Yang produces Yin and Yin produces yang(4) If Yin increases, Yang decreases and vice versa(5) Each is necessary for the other’s existence(6) Infinitely Divisible(7) Inter-transformational Inter-consuming &

Inter-supporting(8) At extremes Yin and Yang transform into one

anotherb) Functions of Yin & Yang Energies in the Bodyc) Yin/Yang Table of Correspondencesd) Anatomy of Yin/Yang Relationship Within Body

2. Eight Principlesa) Four Sets of Parameters

(1) Yin / Yang


(2) Excess / Deficient(3) Internal / External(4) Hot / Cold

b) Yin / Yang(1) Based on the other 6 principles

c) Excess / Deficient(1) There are Many Various Signs of Excesses and

Deficiencies in Organs, Substances, and Meridians.

d) Internal / External(1) Location of Disease or Etiology (2) Internal

(a) Many manifestations within the Organs Bones & Blood

(3) External(a) Skin(b) Muscles(c) Meridians (Channels & Collaterals)(d) Lungs:

i) Special Case: Upper Respiratory Infection (OPI/EPI/EPF)

e) Hot / Cold3. Five Elements

a) Cycles & Pathology(1) Within each phase/element are Yin and Yang

aspects, sometimes referred to as the husband-wife relationship

(2) REVIEW Creative or Generating Cycle (Sheng)(a) AKA: Mother / Son Cycle

(3) REVIEW Control Cycle (Ko)(a) AKA: Grandmother / Grandson relationship

b) REVIEW: AcuPractice’s Table of 5 Element Correspondences

4. Chronotherapy (The Horary Cycle)a) 3-5AM / LUb) 5-7AM / LIc) 7-9AM / STd) 9-11AM / SP


e) 11AM-1PM / HTf) 1-3PM / SIg) 3-5PM / UBh) 5-7PM / KDi) 7-9 PM / PCj) 9-11PM / SJk) 11PM - 1AM / GBl) 1-3AM / LR

C. The Essential Substances : 1. Qi, Xue (Blood), Jing (Essence), Shen (Spirit), Jin Ye

(Fluids)2. Qi

a) Energy, Prana, Life-force, Innateb) The Body Is It’s Physical Manifestationc) Circulates Inside and Outside the Meridians d) Origin

(1) Constitution(2) Food / Drink(3) Air/ Environment

e) Functions Of Qi!(1) Activation Or Movement(2) Warmth(3) Transformation (4) Defense (5) Containment

f) Imbalances Of Qi(1) Deficient Qi (Qi Deficiency)

(a) Signs & Symptoms (S&S)(b) Fatigue(c) Malaise(d) Pale Face(e) Weak Pulse(f) Pale & Swollen (Puffy) Tongue(g) Organ Dysfunction

(2) Collapsed Qi (a) S&S (Two Presentations)(b) Qi Deficiency S & S + Prolapse


(c) Qi Deficiency S & S + Heart Attack(3) Stagnant Qi (Qi Yu)

(a) S&S(b) Dull Achy Pain / Unfixed in Time And Space(c) Intermittent Or Traveling Pain (d) Feels Better With Massage Strokes(e) Intercostal Neuralgia (LR Qi Yu)

(4) Rebellious Qi (a) Moving In The Opposite Direction(b) S&S(c) Nausea / Vomiting / Acid Reflux(d) Cough / Sneezing

3. Jinga) AKA: Pre-Heaven Qi, Constitutional Qib) Formed At Conception; Inherited From The Parentsc) Governs Growth and Developmentd) Stored In The Kidneyse) Imbalance: Jing Deficiency

(1) Poor Development In Children(2) Poor Concentration / Memory(3) Reproductive Disorders(4) Loose Teeth(5) Brittle Bones(6) Gray-Thinning Hair(7) Senility

4. Blooda) Blood Is Yin In Relationship To Qib) Blood Is A Fluid and a Type of Qi c) Liquid Form Of Qi (Yin In Nature)d) Functions:

(1) Nourishes All Parts Of The Body(2) Moistens All Parts Of The Body(3) Esp. Tendons, Eyes, Hair(4) Maintains Physical Structure(5) Cools(6) Calms(7) Provides Rest & Ability to Rest

e) Relationships Of Blood:


(1) Heart: Moves It Through Body(2) Liver: Stores and Releases (includes Menstrual

Blood)(3) Spleen: Produces Blood & Holds It In the Vessels

f) Disharmonies Of Blood:(1) Deficient Blood (Xue Deficiency)

(a) Similar to Qi Deficiency, but with the addition of Lack of Nourishment, and Moistening

(b) Fatigue(c) Malaise(d) Pale Lusterless Face(e) Weak Thin Pulse(f) Pale & Thin Tongue(g) Organ Dysfunction (h) Dry Skin(i) Brittle Hair(j) Twitches And Spasms (Due To Drying Out Of

Tendons)(k) Scanty/Light/Shortened/Infrequent Menses(l) Dizziness(m)Difficulty Falling Asleep (Yin Substance)(n) Dry Eyes (Liver)

(2) Stuck Blood (Xue Yu)(a) Sharp, Stabbing Pain Fixed in Time & Space(b) Tumors Or Cysts (Non-Moving)(c) Swollen Organs(d) Hematoma

(3) Hot Blood(a) Red Dry Skin(b) Pimples(c) Rashes(d) Hemorrhage Of Fresh Red Blood

(Hemorrhoids, Uterine Bleeding, Urine)5. Fluids: Jin Ye

b) Includes All Normal Bodily Fluids Except Bloodc) Jin: Clear, More Yang, Wateryd) Ye: Thick, Internal, More Yin

6. Shen (Spirit)


a) Spirit That Is Stored In The Heart and Reflected in the Eyes

b) Emotional Problems, Psychological And Emotional Shock, Disturbances Of Psychological/Mental Nature

D. The Causes of Disease or Pathogenic Factors1. External Pathogenic Factors AKA The Evil Winds

a) Windb) Coldc) Dampd) Drynesse) Heatf) Summer Heat

2. Internal Pathogenic Factors AKA The Emotions a) Anger b) Joy c) Melancholy & Grief d) Meditation (Over thinking) e) Fear f) Fright

3. Miscellaneous Pathogenic Factorsa) Inappropriate Dietb) Inappropriate Exercisec) Inappropriate Timingd) Parasitese) Traumaf) Insect / Animal Bites g) Epidemicsh) Wrong Treatment

E. Organs1. Lungs

a) AKA: Tender Organ, Master Of Qib) Opens To The Nose & Throatc) Most Easily Affected By OPId) Dislikes Cold And Drynesse) Properties & Functions


(1) Liquefies, Descends, Disseminates & Circulates Fluids

(2) Governs Qi & Respiration(3) Rules The Exterior

f) Common Disharmonies:(1) LU Qi Deficiency(2) LU Yin Deficiency(3) Rebellious Qi in LU(4) OPI(5) Dampness. Phlegm in LU

g) Major S&S: Respiratory2. Large Intestine

a) The Official In Charge Of The Dregsb) Dependent Upon Lungs For Descending

3. Spleena) AKA: The Official In Charge Of Transportation And

Transformation (T&T)b) Governs T&T of Qi, Blood & Jin Yec) Holds Blood & Organs in Placed) Opens To The Mouth: Manifests In The Lipse) Dislikes Dampness & Coldf) Rules The Flesh & Muscles g) Common Disharmonies:

(1) SP Qi Deficiency(2) SP Blood Deficiency(3) SP Yang Deficiency(4) Dampness in SP

h) Major S&S(1) Lower Digestive(2) Fatigue

4. Stomach a) The Official In Charge Of Rotting And Ripeningb) Prepares Food and Drink for T&T by the Spleenc) Common Disharmonies:

(1) Rebellious ST Qi(2) Heat in the ST

d) Major S&S: Upper Digestive5. Heart AKA: The Emperor


a) Houses The Consciousness / Shen b) Rules Blood And Blood Vesselsc) Dislikes Heatd) Opens To The Tonguee) Manifests In The Complexionf) Common Disharmonies:

(1) Heart Blood Deficiency(2) Heart Yin Deficiency(3) Blood Stagnation in the Heart or Chest(4) Heat in the Heart

g) Major S&S(1) Psychological Disorders(2) Palpitations

6. Small Intestine a) Separates The Pure From The Impure

7. Liver a) AKA The General AKA Free & Easy Wandererb) In Charge of Planningc) Responsible for the Smooth and Easy Flow of Qi &

Emotionsd) Rules the Tendons & Muscles

(1) Tight/Tense Muscles(2) Tics, Twitches & Tremors Sea of Blood (Stores)

e) The Master Alchemist / transmutes and detoxifiesf) Opens To The Eyesg) Dislikes WIND (Heat / Stagnation)h) Houses the Hun (ego)i) Common Disharmonies:

(1) Liver Qi Stagnation(2) Liver Invading

(a) Stomach(b) Spleen(c) Lung

(3) Liver Blood Stagnation(a) Painful periods, Clots, Sharp Stabbing Pain

j) Major S&S:(1) Stress Related Disorders(2) Anger / Irritability


(3) Gynecological problems (4) Meridian related Sx.

(a) Damp-Heat in the Liver and Gall Bladder 8. Gall Bladder

a) The Official in Charge of Decision Makingb) Very Closely Related to the LR

9. Kidneya) AKA Root of Yin & Yang / Root of Lifeb) Opens To The Earsc) Dislikes Cold d) Functions

(1) Stores Jing(2) It houses the Will (3) Rules the Bones(4) Housed in the Low Back(5) Rules the Knees & Ankles(6) Governs birth, growth and reproduction. (7) Nourishes and Warms (supplies Yin & Yang to) the

Lower Warmere) Common Disharmonies:

(1) Deficiencies ONLY: NO Excess Conditions(2) KD Qi Deficiency(3) KD Yang Deficiency(4) KD Yin Deficiency(5) KD Jing Deficiency

f) Major S&S:(1) General Qi & Yang Deficiency S & Sx(2) General Yin Deficiency S & Sx(3) Low Back / Knee Pain and Weakness(4) Impotence and Infertility(5) Incontinence / Urinary Frequency (6) S&S of Premature Ageing

10.Urinary Bladder a) Transforming and excreting fluids via the power of KD

Qi11.Pericardium

a) The Minister: Insulates, Screens, & Protects The Heart


b) Maintains The Order Of The Heart Energyc) Treats All Heart Disorders Organic & Spirit

12.San Jiao a) AKA: Triple Heater, Triple Warmer, Triple Energizer

Triple Burnerb) Literally Three Burning Spacesc) Upper Jiao

(1) LU & HT(2) Respiration & Circulation

d) Middle Jiao(1) SP & ST(2) Digestion & Assimilation

e) Lower Jiao(1) KD, UB & Reproductive Organs(2) Elimination & Reproduction

f) The Three Jiaos are collectively responsible for Water Metabolism (1) Classically Described As A System Of Sluices Or

Waterways(2) Lung Adjusts Water

(a) Descends & Disseminates - Sends it down(3) Spleen Transforms Water

(a) T & T - Sends it Up(4) Kidney Rules Water

(a) Powers the Process13.Extraordinary (Curious) Organs

a) Fu Shape /Store Essencesb) Six Curious Organs

(1) Gall Bladder(2) Brain(3) Marrow(4) Bone(5) Blood Vessels(6) Uterus

F. Tongue and Pulse Diagnosis1. REVIEW Tongue

a) Areas


b) Colorc) Shaped) Coatinge) Moisturef) Features

2. REVIEW Pules a) Speedb) Strengthc) Positionsd) Qualities

3. REVIEW Tongue & Pulse Usual CombinationsG. Clean Needle Technique

1. Hand Washing2. Sterile Needles3. Clean Field4. Isolate Used Needles Immediately5. Universal Precautions: Prevention of Exposure and

Prevention of Disease if Exposure Occurs.6. Clean Technique

a) Using Sterilization, Disinfection, Antisepsis, washing, etc.

b) Clean Fieldc) Biohazard Container

7. Risks to Acupuncture Providers8. Risks to Acupuncture Patients

a) Needle Sickness / Faintingb) Pain / Bruising / Swelling at Needle Sitec) Stuck Needled) Forgotten Needlee) Neuritisf) Moxa Burnsg) Abscessh) Allergic Dermatitisi) Broken Needlej) Auricular Chondritisk) Pneumothoraxl) Organ Puncturem) Seizures


9. Contraindications and Cautionsa) Always use Caution when treating Patients who are or

may be(1) Pregnant (2) Elderly (3) Imunocomprimised (4) Diabetic(5) Very Tired(6) Very Hungry(7) Under the influence of any Mind Altering/Pain

Relieving Medications(8) Numb in an area to be treated

b) Points Contraindicated in Pregnancyc) LI 4

(1) SP 6(2) GB 21 (Caution)(3) Points on the Abdomen (Caution)(4) Points on the Lower Back (Caution)(5) GB 21 Contraindicated for patients with Heart

Conditionsd) Electro-Acupuncture Contraindicated for patients with

(1) Pacemakers and other electrical implants(2) History of Seizure Disorders(3) Strongly Recommended not to apply

electro-acupuncture across the heart (i.e. Chest to Back/ Left to Right/ Arm to Arm)

H. Acupuncture Techniques1. Acupuncture/Moxibustion

a) Needles(1) Standard(2) Retained(3) Bleeding

b) Moxa(1) Direct(2) Indirect

c) Electro-Acupuncture (1) Milliamp & Microamp(2) Invasive / Non-Invasive


2. Non-invasive Techniquesa) Cupping b) Guashac) LASERd) Pressballs / Seedse) Magnets

3. MoxaI. Acupuncture Points and Meridians

1. Body Measurements and General Point Location2. Point Categories

a) Front Mu /Alarm: Treat the Organ (Yin)b)c) Back Shu /Associated: Treat the Organ (Yang)d) Yuan / Source: Treat the Yuan/Jing Level of the Organe) Horary: Element Point that matches the Organf) Luo /Connecting: Connects Husband/Wife Meridiansg) Xi Cleft /Accumulation: Pain along the Meridianh) 5 Element/Command

(1) Wood/Mu(2) Fire/Huo(3) Earth/Tu(4) Metal/Jin(5) Water/Shui

i) Tonification / Mother (previous 5-element Sheng cycle point)

j) Sedation / Son (subsequent 5-element Sheng cycle point)

k) Transport (Shu Points)(1) Jing-Well aka Ting or Tsing(2) TM Meridian Clearing(3) Ying-Spring(4) Shu-Stream(5) Used with Jing-well for TM tx.(6) Jing-River(7) He-Sea

l) Ah Shi Points: Locally Reactive Points (Trigger Points)3. Du Meridian “Governing Vessel”


a) The pathway of the Du Meridian runs from the perineum, up through the middle of the spine over the head and ending at the upper lip. All its points are on the posterior midline of the body. It is also the most Yang meridian on the body. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Du is important, for treating any and all disorders of the back and specifically the spine.

4. Ren Meridian “Conception Vessel.”a) The pathway of the Ren Meridian runs from the

perineum, up the midline of the front of the body ending just under the lower lip. All its points are on the anterior midline of the body. It is also the most Yin meridian on the body. Since Yin Meridians are often used to treat internal disorders, the Ren is important, for treating many internal disorders and especially those associated with reproductive functions.

5. Lung/Feia) The pathway of the Lung Meridian runs from the

second intercostal space 2/3 the distance from the middle of the sternum to the acromion process, down the anterior surface of the arm and ending at the proximal radial corner of the nail of the thumb. Since Yin Meridians are often used to treat internal disorders, the Lung Meridian is important, for treating many internal disorders associated with the Lungs. These include all respiratory disorders and symptoms associated with colds and flus.

6. Large Intestine/ Da Changa) The pathway of the Large Intestine Meridian runs from

the proximal radial corner of the index finger along the arm on the lateral border of the radial bone to the top of the shoulder, crossing the SCM on the neck to the lower border of the ala nsai, on the opposite side. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Large Intestine is important, for treating any and all disorders of arm, neck and head.


7. Stomach/Wei a) The pathway of the Stomach meridian runs from the

middle of the lower border of the eye socket down to the outer corner of the mouth, then back to the mandible and up to the corner of the hairline. From there it proceeds down the front of the body along the mid-clavicular line over the ribcage, where it moves closer to the midline and down to the upper border of the pubic bone. From here it travels out to the leg and along a trajectory just lateral to the crest of the tibia, and on to the foot, ending at the proximal medial corner of the nail of second toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Stomach meridian is important, for treating any and all disorders of and eye, head, teeth, and leg.

8. Spleen/Pi a) The pathway of the Spleen Meridian runs from the

proximal medial corner of the nail of the great toe along the medial edge of the foot, up the leg following the posterior border of the tibia. At he waist it runs parallel to the midline along the mid-clavicular line until it departs to end at the mid-axillary line midway between the axilla and the free end of the 11th rib. Since Yin Meridians are often used to treat internal disorders, the Spleen Meridian is important, for treating many internal disorders associated with the Spleen. These include all digestive disorders and symptoms associated with fatigue, and dampness.

9. Heart / Xin a) The pathway of the Heart Meridian runs from the

middle of the axiclla down the medial surface of the arm and ending at the proximal radial corner of the nail of the pinky finger. Since Yin Meridians are often used to treat internal disorders, the Heart Meridian is important, for treating disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep.


10.Small Intestine/Xiao Chang a) The pathway of the Small Intestine Meridian runs from

the proximal ulnar corner of the pinky finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, through the scapula, up to the back of the neck past the ear and ending lateral to the eye. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Small Intestine is important, for treating any and all disorders along its pathway, especially around the scapula, and neck.

11.Urinary Bladder / Pang Guang a) The pathway of the Urinary Bladder Meridian runs

from the medial inner canthus up over the head just lateral to the midline, down the side of the neck where it separates into tow pathways, both running parallel to the midline of the back. One pathway is located at the distance of the medial border of the scapula, and the other is halfway between the medial border of the scapula and the midline. At the sacrum the meridian moves out to the buttocks and down to the center of popliteal crease, and throughout the back of the calf, to the ankle where it runs just under the lateral maleoleous ending at the lateral proximal corner of the little toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Urinary Bladder is important, for treating any and all disorders of back, and legs. It should also be noted that this meridian contains the “Back Shu Points.” These are specific points for each of the Organs.

12.Kidney / Shen a) The pathway of the Kidney Meridian runs from the

center of the ball of the foot along the medial edge of the foot, under the medial malleolus, up the medial aspect of the leg posterior to the tibia. At the waist it runs parallel and just lateral to the midline ending at the top of the sternum. Since Yin Meridians are often used to treat internal disorders, the Kidney Meridian is important, for treating many internal disorders


associated with the Kidney. These include all growth development and ageing, reproductive and urinary disorders and symptoms associated with fatigue, and general weakness.

13.Pericardium/ Xin Bao Luoa) The pathway of the Pericardium Meridian runs from

the chest down the medial surface of the arm and ending at the tip of the middle finger. Since Yin Meridians are often used to treat internal disorders, and the Pericardium is closely related to the Heart Meridian, it is most commonly used to treat disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep, as well as organic heart disorders.

14.Triple Heater / Triple Warmer / San Jiao a) The pathway of the San Jiao is similar to that of the

Small Intestine but more radial.. It runs from the proximal ulnar corner of the ring finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, along the top posterior aspect of the trapezius, up to the back of the neck around the ear and ending just anterior to the tragus of the ear. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the San Jiao is important, for treating any and all disorders along it’s pathway, especially around the shoulder, and ear.

15.Gall Bladder / Dana) The pathway of the Gall Bladder Meridian runs from

the Lateral outer canthus back and forth coursing the sides of the head, down the side of the neck where it follows the top of the trapezius, down to the side of the ribcage, throughout the flanks, to the hip, and down along the most lateral aspect of the leg, to the ankle where it runs under the lateral maleoleous ending at the lateral proximal corner of the fourth toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Gall Bladder is


important, for treating any and all disorders of sides of the head, trunk, hip, and legs

16.Liver / Gan a) The pathway of the Liver Meridian runs from the

proximal lateral corner of the nail of the great toe along the medial edge of the foot, up to the posterior to the border of the tibia between the Spleen and Kidney meridians. At he waist it runs parallel to the midline until it departs to the free end of the 11th rib, ending at the sixth intercostals space on the mid-clavicular line. The Liver Meridian is important, for treating many internal disorders associated with the Liver. These include many emotional disorders and symptoms associated with stagnation and wind.

17.Extraordinary Points18.Additional Meridians

a) The Eight Extraordinary Meridians. (1) Access the deepest energies of the individual(2) Equalizing Qi Reservoirs(3) Link Meridians and Organs (4) Zonal / Planar Tx. Of Pain(5) Master & Couple Points

(a) SI3 and BL62 (b) TH5 and GB41(c) LU7 and KI6(d) SP4 and P6. (e) Ren Mai

i) Master Point Lu 7(f) Du Mai

i) Master Point SI 3(g) Chong Mai

i) Master Point SP 4(h) Dai Mai

i) Master Point GB 41(i) Yang Wei Mai

i) Master Point SJ 5(j) Yin Wei Mai

i) Master Point PC 6


(k) Yang Qiao Maii) Master Point UB 62

(l) Yin Qiao Maii) Master Point KD 6

b) 12 Tendino-Muscular (Sinew) Meridians(1) Circulate on the periphery of the body.(2) Do not penetrate to the Zangfu.(3) Are associated with and take their names from the

twelve primary channels.(4) Originate at the extremities / Jing-Well Points(5) Broadly follow the course of their associated

primary channels but are wider.(6) Pain / Trauma

c) 12 Divergent Meridians(1) Connect with their paired channel(2) Deeper than Main Meridians(3) Govern the inside of the body

d) 12 Skin Regions(1) Related to the Main Meridians(2) Explain Dx & Tx via the skin

e) 15 Luo Connecting Channels(1) One small branching channel for each of the 12

primary channels, one each for the Ren & Du, and one for the Great Luo of the Spleen

f) Minute CollateralsJ. Auricular Acupuncture and Other

Microsystems1. Ear, Scalp, Hand

a) Find point exactlyb) Apply Active or Passive Movement During the

Treatmentc) Look For Immediate Change

2. Auricular Acupuncture a) Ear Anatomy is Crutial for Locating Points on Any

Examb) Major Points

(1) Shen Men


(2) Heart(3) Liver(4) Kidney(5) Sympathetic N(6) Thirst(7) Hunger(8) Nicotine(9) Shoulder-Arm-Hand-Finger(10)Back(11)Hip-Leg-Foot-Toe(12)Sciatica(13)Uterus(14)Toothache(15)Aspirin Pt.

K. Name That Disharmony / Diagnosis ReviewL. A Patient Presents with the following signs and symptoms:

Fatigue, loose stools, pale thin tongue with a white coat, pale and lusterless face, lack of appetite, weak limbs, and a weak and thin pulse.

M. A patient presents with the following signs and symptoms: Chronic neck and shoulder tension, pain in rib cage, plumb pit throat, pain on palpation on lower left side of the abdomen, angry disposition, slightly purple tongue, wiry pulse.

N. A patient presents with the following signs and symptoms: Palpitations, malaise, fatigue,, a weak thin pulse, forgetfulness, confusion, and pale thin tongue with white coat, a pale lusterless face, and a thin weak pulse.

O. A patient presents with the following signs and symptoms: Insomnia, chronic dry, sore throat, malor flush, restlessness, palpitations, weak legs, low back pain, dark scanty urination, thin red tongue with a peeled coat, thin rapid pulse.

P. A Patient Presents with the following signs and symptoms: Sore Low Back which feels weak, and somewhat better with heat, frequent clear copious urination, low sex drive, fatigue, pale face, weak and slow pulse, pale and puffy tongue with a wet coat.


Q. A patient presents with the following signs and symptoms: Asthma, restlessness, insomnia, thin and rapid pulse, thin red tongue with no coat.

R. A patient presents with the following signs and symptoms: Insomnia, thin pale tongue especially at the center and tip, pale lusterless face, palpitations, chronic diarrhea, fatigue, thin weak pulse.

7. Internal Medicine A. Introduction

1. Respiratory2. Digestive3. Genitourinary4. Emotional Disorders5. Women’s Health6. Herbal Medicine 7. Internal medical diagnosis, and treatment with all Chinese

Medical techniques, including Acupuncture, Herbs, Diet and Lifestyle.

8. Repetition of Disharmoniesa) You will notice a necessary repetition of disharmonies

in different disorders, which will assist you in learning and easily recognizing, and treating these problems.(1) i.e. Spleen Qi Deficiency may manifest as many

different disorders, including(a) ! Digestive: Looses Stools, Lack of

Appetite(b) ! Emotional: Depression(c) ! Women’s Health: Tendency to Miscarry

9. Theoretical Principles Reviewa) Eight Principles b) Four Sets of Parametersc) Yin / Yangd) Internal / Externale) Excess / Deficientf) Hot / Coldg) Five Elements h) The Essential Substances


i) Qi(1) Qi Generation(2) Functions of Qi!(3) Imbalances of Qi

j) Jing & Yuan Qik) Blood

(1) Functions:(2) Relationships Of Blood:

(a) Heart, Liver & Spleen(3) Disharmonies Of Blood:

l) Jin Ye m) Shenn) The Causes of Disease or Pathogenic Factors

(1) External Pathogenic Factors(2) Internal Pathogenic Factors(3) Miscellaneous Pathogenic Factors

10. Meridian Reviewa) Points from the Yin Meridians are the ones most often

chosen to treat internal disorders(1) LU, SP, KD, LR, Ht & PC

b) Some Yang Meridians are also commonly used(1) UB, ST

c) Extraordinary Meridians(1) Ren, Du, Chong, & Dai

11.Organs Reviewa) Lung (Fei) - Large Intestine (Da Chang)b) Spleen (Pi) - Stomach (Wei)c) Heart (Xin) - Small Intestine (Xiao Chang)d) Liver (Gan) - Gall Bladder (Dan)e) Kidney (Shen) - Urinary Bladder (Pang Guang)f) KIDNEY (SHEN)g) Pericardium (Xinbaoluo) -San Jiao (Triple

Warmer/Burner/Heater/Energizer) 12.Extraordinary Meridians

a) Originb) General Functionsc) Zonal Meridian Treatment


d) Psychological Transformatione) Du Mai (Governing Vessel)f) Ren Mai (Conception Vessel)g) Chong Mai (Penetrating Vessel)h) Dai Mai (Belt Meridian)i) Yang Wei Maij) Yin Wei Maik) Yin Qiao Mail) Yang Qiao Mai

13.Extraordinary / Curious Organsa) Gall Bladderb) Brainc) Marrowd) Bonee) Blood Vesselsf) Uterus

B. Respiratory System and Conditions1. Upper Respiratory Conditions

a) Sinus (1) Congestion

(a) Pathology / Basic Patternsi) Windii) Phlegmiii) Heativ) Cold

(b) Meridian Techniques(c) Dietary / Lifestyle / Herbal Recommendations

b) Headaches(1) Pathology (2) Phlegm(3) Meridian Techniques(4) Dietary / Lifestyle / Herbal Recommendations

c) Other Headaches(1) Qi Yu(2) Yang Ming(3) Tai Yang(4) Xiao Yang


(5) Liver(6) Infections(7) Pathology / Basic Patterns

(a) Wind / Heat / Phlegm(b) Wind / Cold / Phlegm

(8) Meridian Techniques(9) Dietary / Lifestyle / Herbal Recommendations

d) Ear Involvement(1) Pathology /Basic Patterns

(a) Heat(b) Cold


e) Common Cold/ Viruses (1) Wind Cold

(a) Pathologyi) Sneezing / Runny/Stuffy Noseii) White Mucous iii) Chillsiv) Headachev) Body Ache


(2) Wind Heat(a) Tai Yang / Shao Yang / Yang Ming

i) Pathologyii) Feveriii) Sore throativ) Laryngitisv) Yellow/Green Mucous

(b) Basic Patterns(c) Meridian Techniques(d) Dietary / Lifestyle / Herbal Recommendations

2. Lower Respiratory Conditions(1) Chest Cold / Heat

(a) Pathology(b) Basic Patterns(c) Meridian Techniques


(d) Dietary / Lifestyle / Herbal Recommendations(2) Chest Cold / Cold

(a) Pathology(b) Basic Patterns(c) Meridian Techniques(d) Dietary / Lifestyle / Herbal Recommendations

(3) Bronchitis (deeper level(a) Pathology / Basic Patterns

i) Lung Qi Deficiencyii) Lung Yin Deficiency


3. Allergies a) EENT (sinus, ears, eyes, post nasal)

(1) Pathology(a) Wind Damp

(2) Basic Patterns(3) Meridian Techniques(4) Dietary / Lifestyle / Herbal Recommendations

b) Seasonal(1) Pathology

(a) Wind Damp(2) Basic Patterns(3) Meridian Techniques(4) Dietary / Lifestyle / Herbal Recommendations

c) Environmental(1) Pathology(2) Basic Patterns(3) Meridian Techniques(4) Dietary / Lifestyle / Herbal Recommendations

d) Dietary(1) Pathology / Basic Patterns

(a) Spleen and or Kidney Qi /Yang Deficiency(2) Meridian Techniques(3) Dietary / Lifestyle / Herbal Recommendations

4. COPD: Asthma, Chronic Bronchitis, Emphysema, etc.


a) Pathology / Basic Patterns(1) Lung Qi Deficiency(2) Lung Yin Deficiency(3) Spleen Qi/Yang Deficiency(4) Kidney Qi/Yang Deficiency

b) Meridian Techniquesc) Dietary / Lifestyle / Herbal Recommendations

5. Immune System Weaknessa) Pathology / Basic Patterns

(1) Kidney & Liver Yin Deficiency(2) Lung Qi/Yang/Yin Deficiency(3) Wei Qi Deficiency


6. Smoking Cessationa) Pathology /Basic Patterns

(1) Kid, LR, LU Yin Deficiencyb) Meridian Techniquesc) Dietary / Lifestyle / Herbal Recommendations

C. Gastro-Intestinal System & Conditions1. Oral Cavity (mouth, tongue, teeth, lips)

a) Ulcers / Burning Pain(1) Pathology / Basic Patterns

(a) Stomach Heat / Fire(2) Meridian Techniques(3) Dietary / Lifestyle / Herbal Recommendations

b) Tooth pain – dental anesthesia(1) Pathology / Basic Patterns

(a) Yang Ming Excess(2) Meridian Techniques(3) Dietary / Lifestyle / Herbal Recommendations

c) Post-surgical Pain(1) Pathology / Basic Patterns

(a) Qi & Blood Yu(2) Meridian Techniques(3) Dietary / Lifestyle / Herbal Recommendations

2. Pharynx and Esophageal


a) Swallowing Problems(1) Pathology/Basic Patterns(2)(3) Meridian Techniques(4) Dietary / Lifestyle / Herbal Recommendations

b) Reflux Esophagitis(1) Pathology / Basic Patterns

(a) Rebellious Stomach Qi(b) Stomach Heat / Fire(c) Stomach Yin Deficiency(d) Liver Invading Stomach


c) Hiatial Hernia(1) Pathology / Basic Patterns

(a) Stomach Heat / Fire(b) Stomach Yin Deficiency(c) Liver Invading Stomach


d) Hiccups, Burping, Vomiting(1) Pathology /Basic Patterns

(a) Rebellious Stomach Qi(b) Chong Mai Disharmony


3. Stomach (1) Upset Stomach, Poor/ Weak Digestion(2) Pathology /Basic Patterns

(a) Stomach Yin Deficiency(b) Spleen Qi / Yang Deficiency


b) Food Poisoning(1) Pathology / Basic Patterns

(a) Summer Heat in Stomach and Intestines(b) True Cold in Stomach and Intestines

(2) Meridian Techniques


(3) Dietary / Lifestyle / Herbal Recommendationsc) Gastritis

(1) Pathology / Basic Patterns(a) Stomach Heat / Fire(b) Stomach Yin Deficiency(c) Liver Invading Stomach


d) Ulcers(1) Pathology / Basic Patterns

(a) Stomach Heat / Fire(b) Stomach Yin Deficiency(c) Liver Invading Stomach


e) Motion/Morning Sickness(1) Pathology / Basic Patterns

(a) Chong Mai Disharmony(b) Stomach Qi Rebellion(c) Liver Invading Stomach


4. Intestinal / Colorectala) Poor Digestion

(1) Pathology Basic Patterns(a) SP QI & Yang Deficiency(b) KD Qi & Yang Deficiency (c) Liver Invading Spleen


b) Gas and Distention(1) Pathology Basic Patterns

(a) SP QI & Yang Deficiency(b) KD Qi & Yang Deficiency(c) Liver Invading Spleen


c) IBS, and Chron’s Disease


(1) Pathology Basic Patterns(a) Liver Invading Spleen(b) SP QI & Yang Deficiency(c) KD Qi & Yang Deficiency


d) Hemorrhoids, Fissures, Fistulae(1) Pathology Basic Patterns

(a) Spleen Qi Collapse(b) SP QI & Yang Deficiency(c) Heat in Lower Warmer


e) Parasites(1) Pathology / Basic Patterns

(a) Damp Heat in Lower Warmer(b) Cold Damp in Lower Warmer(c) Summer Heat in Large Intestine


D. Genito-Urinary System & Conditions1. Kidney Disease / Failure

a) Pathology / Basic Patterns(1) Kidney Yang Deficiency(2) Kidney Jing Deficiency


2. Low Sex Drive, Impotence, Frigiditya) Pathology /Basic Patterns

(1) Shen Involvement(2) Kidney Qi / Yang Deficiency(3) Blood Deficiency

b) Meridian Techniquesc) Dietary / Lifestyle / Herbal Recommendationsd) Heightened Sex Drive

(1) Pathology /Basic Patterns(a) Kidney Yin Deficiency


(b) Liver Qi Stagnation(c) Liver Yin Deficiency(d) Liver Fire

3. Urinary Tract Infectionsb) Pathology / Basic Patterns

(1) Heat in Lower Warmer(2) Damp Heat in Lower Warmer(3) Cold Damp in Lower Warmer


4. Urinary Retentiona) Pathology /Basic Patterns

(1) Dampness in Lower Warmerb) Meridian Techniquesc) Dietary / Lifestyle / Herbal Recommendations

5. Male GU Conditionsa) Low sperm counts, Abnormal Motility/ Morphology,

Sterility(1) Pathology /Basic Patterns

(a) Kidney Qi / Yang Deficiency(b) Kidney Yin Deficiency(c) Blood Deficiency(d) Liver Qi Stagnation(e) Liver Blood Stagnation


b) BPH(1) Pathology /Basic Patterns

(a) Dampness in Lower Warmer(b) Kidney Qi / Yang Deficiency(c) Liver Qi / Blood Stagnation


c) Prostatitis(1) Pathology /Basic Patterns

(a) Kidney Yin Deficiency(b) Liver Qi / Blood Stagnation


(c) Liver Yin Deficiency(d) Liver Fire


6. Female GU Conditionsa) Endometriosis

(1) Pathology / Basic Patterns(a) Liver Blood & Qi Stagnation in Lower Warmer


b) Ovarian, Uterine Cysts and Tumors(1) Pathology / Basic Patterns

(a) Blood Stagnation(b) Phlegm


c) Prolapsed Urinary Bladder(1) Pathology Basic Patterns

(a) Spleen Qi Collapse(b) SP QI & Yang Deficiency(c) Liver Invading Spleen


d) Menstrual Pain(1) Pathology / Basic Patterns(2) Liver Qi Stagnation(3) Liver Blood Stagnation(4) Chong Mai Disharmony(5) Dai Mai Disharmony(6) Meridian Techniques(7) Dietary / Lifestyle / Herbal Recommendations

e) Infertility, Egg Production / Quality, Ovarian – Fallopian –Uterine – Vaginal Issues(1) Pathology / Basic Patterns

(a) Kidney Qi / Yang Deficiency(b) Spleen Qi / Yang Deficiency(c) Heart Qi / Yang Deficiency(d) Liver Qi Stagnation


(e) Liver Blood Stagnation(f) Chong Mai Disharmony(g) Dai Mai Disharmony(h) Ren Mai Disharmony(i) Du Mai Disharmony(j) Shen Involvement


8. WOMEN’S HEALTHA. Introduction

1. Women’s health take into account almost all the systems, organs, and substances in Oriental medicine, as well and most al of the treatment techniques.

2. Recommended Book Balance Your Hormones Balance Your Life: Claudia Welch

B. Review Major Relevant Points: 1. Liver2. Spleen3. Kidney4. Heart5. Du6. Ren7. Chong8. Dai9. Lower Abdomen

C. Organs, Meridians, and Substances 1. Jing (Essence)

a) Tian Guib) “Minister Fire”/ “Motive Force”/ Mingmen firec) Stored in the Mingmen

(1) Lower Dan Tian (2) Lower Field of Elixir (3) In Women it Includes The Uterus

(a) Zi Bao, Bao Gong,


i) Fetal Wrapper, Fetal Palace, Blood Chamber

d) In men it includes the “Room of Sperm”2. Kidneys

a) Store Jingb) Relevant Kidney pathology

(1) Jing Deficiency (2) QI / Yang Deficiency(3) Yin Deficiency

3. Menarche/Menopausea) “At 14 years if the Blood, Jing, Ren, and Chong are

full, the Tian Gui (Heavenly Dew) descends”b) “At 49 years when the Ren, Chong, Fluids, and Blood

become insufficient the Tian Gui withdraws”c) Blood

4. “Women’s physiology is rooted in blood. Men’s in Qi”5. Conception Relies on Blood, from Mother

a) Blood (post-natal Qi), essence (pre-natal Qi), Kid, LR, Ren, Chong, Yin

b) In Pregnancy Blood nourishes fetus so it does not irrigate Chong.(1) No menses(2) Blood becomes milk.

6. Livera) Responsible for smooth flow of Qi & Emotionsb) Stores Blood

(1) Menstrual Blood and. regular Blood(2) Delivers Blood to uterus

c) Moves the Qi that moves the Bloodd) LR Channel flows through breasts

(1) Breast pain & tendernesse) Relevant Liver Pathology

(1) LR Qi Stagnation(2) Yang rising(3) Liver wind(4) LR Blood Stagnation(5) LR Blood Deficiency (6) Damp Heat in Liver channel


7. Spleena) Produces Qi & Bloodb) Closely associated with Liver c) Amount of blood d) Timing of cycle e) Holds Blood in the vesselsf) Holds Organs & Fetus in placeg) Spleen Pathology

(1) SP Qi and Blood Deficiency(2) SP Qi and Blood Deficiency w/ Damp(3) SP Qi Not Holding (collapsed/sinking)

8. Hearta) Governs Bloodb) Pumps it thought the vesselsc) Turns it redd) Personality/identity e) Bao mai

(1) HT-UT connection(2) Shen/ emotions

9. Stomacha) Connected to Uterus via Chong Maib) Channel flows through breasts

(1) Breast milk10.Extraordinary Vessels (see pocket reference card at end

of notes)a) “Source of Creation” 1st channels in embryob) Du and Ren cut thru Dai, linking it w/ Ht, genitals,

umbilicus and Chongc) Du, Ren, Chong Arise from Mingmen and flow thru

uterus, Dd) Primary Extraordinary Vessels

(1) Dai Mai (Belt Vessel)(a) GB 41 / SJ 5(b) Opens the Lower Warmer(c) Influences LR Qi flow(d) Guides and supports Uterus & LW Qi

(2) Chong Mai (Penetrating Vessel)(a) SP4 / PC6


(b) Sea of blood (c) Controls menses(d) Access thru ST 30

i) KI 11 to 27(3) Ren Mai (Conception Vessel)

(a) LU7 / KD6(b) Sea of Yin(c) Connect to Yin, Jing and Fluids(d) Relate to int. and ext/ genitalia (e) Hormonal gateway

(4) Du Mai (Governing Vessel)(a) SI 3 / UB 62(b) Rules the Yang

e) Secondary Extraordinary Vessels(1) Yin/ Yang Qiao (Heel Vessels)

(a) Used for Excess patterns of LJ(b) Masses(c) Fibroids(d) Adhesions(e) difficult delivery(f) external genitalia

(2) Yin/Yang Wei (Linking Vessels)(a) Calm mind /Shen(b) Nourish Blood

D. Essential Etiology1. Exterior Pathogenic factors

a) Cold(1) Pain (Cramping Nature)(2) Warm it with moxa / TDP Lamp(3) Move it with acupuncture(4) Warm it with Herbs

b) Dampness(1) Heaviness(2) Transform it by tonifying the Spleen(3) Vaporize it by tonifying the Kidneys(4) Circulate it with the Lungs

c) Heat(1) Enters the Blood


(2) Cool it with Acupuncture or Herbs2. Internal: Emotions and Stress

a) Anxiety & Stress(1) Most Common Cause of Stagnation(2) Liver Qi & Blood(3) Chong Mai(4) Dai Mai(5) Spleen (6) Blood Deficiency(7) Emotional Stress @ Puberty

(a) Ren & Chongb) Sadness & Grief

(1) Ht(2) LR

c) Worry(1) SP

d) Anger(1) LR Qi Stagnation(2) LR fire

e) Fear(1) Kid

f) Shock(1) Ht, SP, Kid

g) Guilt(1) Dai Mai

3. Dieta) Blood & Qi Deficiency

(1) Dampness Collectsb) Overwork/exercise = too long w/o good rest, diet

(1) KD Yin Deficiency4. Pregnancy & Childbirth

a) Not enough rest afterb) Pre-existing Blood and/or KD Deficiencyc) Blood Deficiency

5. Abortiona) Blood Stagnationb) Blood & Qi Deficiencyc) KD Deficiency


6. Excess or Deficiency of Sexual activitya) Excess: During puberty, During period, During

pregnancy (1) KD Deficiency

b) Deficiency: Repressionc) LR Qi Stagnation

7. C-Sections, Other Abdominal Surgeries, & Hysterectomies a) Disruption of b) Renc) Chongd) Daie) Blood Stagnationf) Adhesionsg) Spleen and Kidney Deficiencies

8. Contraceptive pills & shotsa) Unpredictable

E. Essential Diagnosis 1. Reproductive Cycle

a) Menstrual phase(1) Blood moving(2) Liver Qi(3) Liver Blood(4) Scanty: move blood(5) Heavy: Stop bleeding

b) Post-menstrual phase(1) Blood/ Yin Deficiency(2) Depleted Chong and Ren(3) Western: follicle grows, estrogen levels rise due to

FSH direction(4) Nourish Liver blood and K yin

c) Mid-cycle phase (1) Blood and Yin gradually fill up in the Chong and

Ren(2) Western: ovulation. Ovum released from follicle

and corpus luteum develops due to LH(3) Promote ovulation by nourishing k Jing


(4) [also TX Du, Ren, Chong, due to their hormonal connection]

d) Pre-menstrual phase(1) Yang Qi rises(2) Liver Qi gears up to move liver blood(3) Tonify Yang if Deficiency / Move Liver Qi if

stagnant2. Questioning

a) Menarcheb) Cycle

(1) Amount(2) Color(3) Consistency(4) Pain

c) PMS(1) Pain

d) Vaginal dischargee) Fertility and pregnancy

(1) Childbirth(2) Miscarriage and abortion

f) Other3. Palpation

a) Pulse(1) Fast = Hot(2) Slow = Yang Deficient Cold

b) Abdomen and Muscles(1) Lack of integrity(2) Deficiency of Spleen and Kidney(3) Congestion in the Tissues(4) Masses / Fibroids

4. Observationa) Complexion & Lips

(1) Pale =Deficiency(2) Red = Heat

5. Tonguea) Body color

(1) Pale = Deficiency(2) Red = Heat


b) Shape(1) Puffy = Qi or Yang Deficiency(2) Thin = Blood or Yin Deficiency

c) Coating(1) Yellow = Heat(2) White = Not Hot(3) Sticky/Greasy = Dampness(4) No Coat / Peeled = Yin Deficiency

6. Odora) Vaginal discharge / Menstrual Blood

(1) Strong or unpleasant odor = Heat(2) NO Strong or unpleasant odor = Not Hot

F. Treatment of the Most Common Disharmonies 1. Castor Oil Packs/Massage

a) Move Stuck Qi, Blood, & Phlegm2. Warm Oil Massage (Abhyanga)

a) Tonify Yin & Quell WindG. Treatment of Internal Organs

1. Kidneysa) Tonify Yang

(1) Du Mai: SI 3 & UB 62(2) General Points: (3) KD3, UB23, DU4, REN4, KD16

(a) All with moxa and needlesb) Basic Herbal Patent Formula:

(1) Jin Gui Shen Qi Wanc) Tonify Yin

(1) Ren Mai: LU7, KD 6(2) General Points: (3) KD7, UB23, DU4, REN4, KD16

(a) All with needles(4) Basic Herbal Patent Formula:

(a) Liu We Di Haung Wand) Yin Deficiency/Heat

(1) Wise Women’s Well (K’an)(2) Two Immortals (Health Concerns)

e) Conserve Jingf) Diet/Lifestyle


2. Livera) Nourish Yin and Blood

(1) General Points: (2) LR3, UB18, DU8, LR14


(a) Yin: Liu We Di Haung Wan(b) Blood: Ba Zhen Tang

b) Soothe LR Qi(1) General Points: (2) LR 3, GB41, GB34, UB18, DU8, LR 14


(a) Xiao Yao Wanc) Move LR Blood

(1) General Points: (2) LR 3, LR 8, UB18, DU8, LR 14


(a) Tong Jing Wani) (Calm in the Sea of Life Pills)

d) Clear LR heat / fire(1) General Points: (2) LR 1, LR 2, UB18, DU8, LR 14(3) All with needles(4) Basic Herbal Patent Formula:

(a) Long Dan Xie Gan Wani) Very Cold / Caution

e) Quell LR Wind(1) General Points: (2) LR 3, GB34, GB20, UB18, DU8, LR 14

(a) All with needles3. Spleen

a) Tonify SP Qi and Blood(1) General Points:

(a) SP3, SP6, ST36, UB20, DU6, REN6, i) All with moxa and needles

(b) REN8


i) Moxa only(c) Basic Herbal Patent Formula: Ba Zhen Wan or

Gui Pi Wanb) Raise SP Qi

(1) General Points: (a) DU20,

i) Moxa Only(2) SP3, SP6, ST36, REN6, REN8

(a) All with moxa and needles(3) Basic Herbal Patent Formula:

(a) Bu Zhong Yi Qi Wani) Not for long term use

c) Harmonize SP and LR(1) General Points:

(a) SP6, LR3, LR13, UB18, UB20i) All with needles

(2) REN8(a) Moxa Only

(3) Basic Herbal Patent Formula: (a) Xiao Yao Wan

d) Tonify the SP and Resolve Damp(1) Diet Is Most Important(2) General Points:

(a) SP3, SP6, ST36, UB20, DU6, REN6, i) All with moxa and needles

(b) REN8i) Moxa only

(3) Basic Herbal Patent Formula: (a) Lui Jun Zi Wan

4. Hearta) Tonify Blood Deficiency

(1) General Points: (a) Ht7, SP6, St36, UB20, UB15

i) All with needles(b) REN8

i) Moxa Only(2) Basic Herbal Patent Formula:

(a) Gui Pi Wan or Suan Zao Ren Wan


b) Tonify Yin Deficiency(1) General Points:

(a) Ht7, KD3, LR3, UB15, UB23, UB18i) All with needles

(2) Basic Herbal Patent Formula: (3) Tian Wan Bu Xin Wan

5. Uterusa) Warm Cold

(1) General Points: (a) REN2, KD11, SP12, ST30, REN4, REN6

i) All with needles and Moxa(b) REN8

i) Moxa Only(2) Basic Herbal Patent Formula:

(a) Moxa Most Important Hereb) Move Blood

(1) General Points: (a) LR3, SP8, UB31-34, UB23, REN2, KD11,

SP12, ST30, REN4, REN6i) All with needles

(2) Basic Herbal Patent Formula: (a) Tong Jing Wan

c) Move QI(1) General Points:

(a) LR3, SP6, UB31-34, UB23, REN2, KD11, SP12, ST30, REN4, REN6i) All with needles

(2) Basic Herbal Patent Formula: (a) Xiao Yao Wan

H. Specific Disorders1. Menstrual Irregularities

a) Most Common Tx principles(1) Harmonize Dai, Chong, & Ren (2) Harmonize Liver(3) Tonify Blood (4) Tonify Spleen(5) Tonify Kidneys(6) Move (invigorate) Blood


b) Early periods (1) Cycle less than 28 days(2) etiology and pathology

(a) Qi Deficiency(b) Blood heat

i) Fullii) empty

(3) Differentiation and tx(a) SP Qi Deficiency(b) KD Qi Deficiency(c) Full heat from LR Qi Stagnation turning to fire

w/ Blood heat(d) Empty heat from LR and KD Yin Deficiency

c) Late periods(1) >28-30 day cycles(2) Etiology and pathology

(a) Pregnancy(b) Blood Deficiency(c) Cold in the uterus(d) Full cold (e) Empty cold (f) KD Yang Deficiency(g) Qi stag

d) Irregular Periods(1) Sometimes early; sometimes late(2) Not pathological, immediately pre-menopausal.(3) Always related to LR., and often to KD(4) Etiology & Pathology

(a) Emotional stress(b) LR Qi stag(c) LR Blood Deficiency(d) Overwork, too many children too close together(e) KD Yang Deficiency(f) KD Yin Deficiency

e) Heavy periods(1) Periods that occur regularly but are heavier than

normal(2) Can be subjective (30-80ml is broad range)


(3) Etiology and pathology:(a) Qi Deficiency(b) Blood Heat(c) Secondarily(d) Blood stasis

f) Scanty periods (not “late”)(1) Bleeding is very light, or lasts only 2-3 days(2) Etiology and pathology

(a) Blood Deficiency (of the liver, mostly)(b) KD Yang Deficiency:(c) KD Yin Deficiency:(d) Stasis of Blood(e) Phlegm obstructing the uterus

g) Long periods(1) Prolonged bleeding which may last 7-10 days w/

normal amt of bleeding and reg. cycle(2) Etiology and pathology

(a) Qi stag and Blood stasis(b) KD Yin Deficiency w/ empty heat

h) Painful periods(1) Diagnosis

(a) LR Qi stagnation(b) Blood Stasis(c) Cold in Uterus(d) Pain May be Secondary to:

i) Damp-Heatii) Stag LR Qi turns to fireiii) Qi, Blood, and or Yin Deficiency:

i) Bleeding Between Periods(1) SP/KD Yang Deficiency(2) Blood stasis(3) Damp Heat(4) LR and KD Yin Deficiency w/ empty heat

j) No Periods(1) Pregnancy(2) Blood Deficiency(3) Ht and SP Blood Deficiency(4) SP and KD Yang Deficiency


(5) LR and/or HT and/or KD Yin Deficiency(6) Stag of Qi and Blood(7) Damp-Phlegm in Uterus

k) Flooding and Trickling(1) “beng lou”

(a) beng = flooding, bursting through(b) lou = trickle metorrhagia

(2) Be sure to take the common western differentiations into consideration:(a) carcinoma of the cervix(b) carcinoma of the uterus(c) myomas(d) endometriosis(e) endometrial polyps

(3) There can be mixes of conditions (full and empty together)(a) Full Blood Heat(b) Liver Qi stag Turning into Heat(c) Stasis of blood(d) Damp Heat in the Uterus(e) SP not Holding Blood(f) KD Yang Deficiency(g) KD Yin Deficiency

2. Yeast Infections a) Dampness in the Lower Warmerb) Dai Mai, Lower Warmer Pointsc) Cold

(1) LR 3, KD 3, LR 5(2) Er Chen Wan(3) Wen Dai Tang

d) Heat(1) LR 2, KD 2, LR 5(2) Yu Dai Wan(3) Long Dan Xie Gan Wan

3. Genital Herpesa) Damp Heat in the LR Meridian b) LR 2, KD 2, LR 5c) Long Dan Xie Gan Wan


4. Problems at Period timea) PMS

(1) LR Qi stag(2) Prognosis and Prevention

b) Secondary(1) LR blood Deficiency(2) SP and KD Yang Deficiency(3) LR and KD Yin Deficiency(4) Phlegm fire harassing upwards

c) Pre-Menstrual Breast distention(1) LR Qi stag(2) Liver Blood Stasis(3) Secondary(4) Phlegm with Qi Stag(5) LR and KD Yin Deficiency

d) Headaches (1) Blood Deficiency(2) Secondary

(a) Liver Fire Blazing(b) Liver Yang Rising(c) Blood Stasis

e) Edema at period time(1) Face, hands, lower legs, ab. Usually before the

period(2) LR Qi Stagnation

f) Diarrhea: Before, during or after period(1) SP Qi Deficiency(2) Liver Qi stagnation invading the Spleen(3) KD Yang Deficiency

g) Dizziness at Period Time(1) Includes blurry vision and may occur before, during

or after the period(2) Blood Deficiency(3) KD and LR Yin Deficiency w/ Liver yang rising(4) Phlegm w/ SP Qi Deficiency

5. Disorders of Pregnancya) Cautions & Contraindications if a Woman Is or May Be

Pregnant


b) Forbidden Points:(1) LI4 & SP6 (2) GB 21, UB 67, UB 60

c) Any strong downward moving treatmentd) Points Below Umbilicus, Any Time During Pregnancye) Points Below Ren 12, Any Time After the First

Trimesterf) Forbidden Treatments

(1) Do Not Cause Sweating(2) No Diaphoretic Points or Herbs(3) Do Not Promote Downward Motion (4) No Purgative Points or Herbs (5) Do Not Promote Urination W/ Herbs That Drain

Damp(6) No Diuretic Points or Herbs

g) Restless Fetus(1) Kidney 9 Located 5 cun superior to KD 3(2) “Happy Baby Point” Dr. So: needle at end of first

and second trimester – baby will not have colic, and will respect his/her parents

h) Morning Sickness(1) Chong Mai Disturbance(2) Secondary: Liver Qi invading the St

i) Abdominal pain(1) Usually not severe but rule out ectopic pregnancy

or threatened miscarriage.(2) Qi Stagnation(3) Blood Deficiency

j) Breech Baby(1) UB 67

k) Threatened miscarriage / Habitual miscarriage(1) Etiology:

(a) Qi and Blood Deficiency(b) Ren, Du, and/or Chong weakness, (c) KD Deficiency

l) Falls, trauma (1) injure the Ren and Chong(2) Calm the Fetus, Chong ,and Ren


m) Constipation During Pregnancy(1) Common. Can’t use purging or downward Qi

promoting herbs or points(2) Etiology:

(a) Blood Deficiency(b) Liver- Qi stag(c) KD Yang Deficiency(d) KD Yin Deficiency

6. Disorders after childbirth:a) Postpartum Depression

(1) Ht Blood Deficiency(2) Secondary: Ht Yin Deficiency

b) Abdominal pain after childbirth(1) Blood Deficiency(2) Blood Stasis(3) Retention of Food

c) Persistent Discharge of lochia(1) >6 Weeks(2) Qi Deficiency(3) Blood Stasis(4) Blood-Heat

d) Lochial retention(1) Qi and Blood stagnation(2) Stagnation of Cold and stasis of Blood

e) Prolapse and Hemorrhoids after Childbirth(1) Blood Deficiency(2) Spleen Qi Sinking(3) Kid-Yang Deficiency

f) Constipation after Childbirth(1) Blood Deficiency(2) Spleen Qi Deficiency(3) Kid-Yang Deficiency(4) Kid-Yin Deficiency

g) Breast Milk not Flowing / Acute mastitis(1) Qi & Blood Deficiency(2) Liver-Qi stagnation

h) Acute Mastitis:(1) Toxic Heat affecting the Liver, St and GB


7. Infertilitya) Chong Mai, Dai Mai, b) KD Yang Deficiency, KD Yin Deficiencyc) Qi & Blood Deficiency d) Cold in Uteruse) Qi Stagnationf) Stasis of Bloodg) Dampness in the Lower Jiaoh) Blood Heati) Note: Male infertility can be from any of the above, but

is usually KD Yang Deficiency8. Breast lumps

a) Liver Qi Stagb) Disharmony of Ren and Chongc) Spleen Yang Deficiency w/ Phlegm

9. Abdominal Massesa) Qi massesb) Liver Qi stagc) Retention of Food and Phlegmd) Blood massese) Stagnation of Qi and Blood

10.Polycystic ovary diseasea) KD Yang Deficiency, Phlegm, Dampness and Blood

Stasis11. Menopause

a) KD Yin Deficiency(1) KD and Liver Yin Deficiency w/ Liver Yang rising(2) KD Yin and/or KD Yang Deficiency(3) KD and Ht Yin Deficiency

12.Osteoporosisb) Kidney Yin, Yang, or Jing Deficiency


Women’s Health: Name That Disharmony

1. A 24 year old woman presents with the following signs and symptoms: Excessive Menstrual Bleeding, the menstrual flow is pale and dilute, the patient also has loose stools, fatigue, pale thin tongue with a white coat, pale and lusterless face, lack of appetite, weak limbs, and a weak and thin pulse

2. A 24 year old woman presents with the following signs and symptoms: PMS Mood Swings, severe tenderness, and abdominal pain all increasing until the first day of bleeding; chronic neck and shoulder tension, pain in rib cage, plumb pit throat, pain on palpation on abdomen lower left side, slightly purple tongue, wiry pulse.

3. A 36 year old woman presents with the following signs and symptoms: Postpartum Depression, fatigue, palpitations, a weak thin pulse, forgetfulness, confusion, pale thin tongue with white coat. and a pale lusterless face.

4. A 48 year old woman presents with the following signs and symptoms: Insomnia, chronic dry, sore throat, malor flush, restlessness, palpitations, weak legs, low back pain, dark scanty urination, thin red tongue with a peeled coat, thin rapid pulse

5. A 48 year old woman presents with the following signs and symptoms: Lowered Libido, sore low back which feels better with heat, frequent clear copious urination, , fatigue, pale face, weak and slow pulse, pale and puffy tongue with a wet coat.

6. A 24 year old woman presents with the following signs and symptoms: Excessive White Leucorrhea, fatigue , chronic


diarrhea, palpitations, thin pale tongue with a greasy white coat, pale lusterless face, thin weak and slippery pulse.


seminar notes / cookbook acupuncture

Documents