8: How did Master Tung make flexible use of the Yin Yang and Wu Xing (five elements)?

There are yin and yang in a point. Differentiating a disease and selecting effective points are based on yin and yang. All creatures can be symbolized by one of the eight diagrams (Gua: divinatory symbols), which are based on yin and yang. The symptoms (descriptions) of a disease can be differentiated to yin and yang too. Selecting the treatment point in accordance with the yin and yang gives good result and better result if combining with the five-elements. For example, frozen shoulder with the symptoms “arm and shoulder unable to extend and lift”. The thinking logic would be like this: coldness governs “contraction”, hence “unable to extend” is due to coldness and the disease is water-related. Also, the arms and shoulder being heavy and difficult in lifting up belong (similarity) to damp earth, since the earth governs heavy and sinking, those damp diseases. The frozen should with the above characteristics belong to cold-damp (earth-water), and yin disease. The treatment is achieved by selecting points related to earth and water, such as Yinlingquan (SP9) (which is a water point in the earth channel). (The reason to choose the point on the spleen channel is because spleen governs the dampness and heaviness.) The point Shenguan (77.18), located very closely to Yinlingquan (SP9), can also be chosen to treat it or can be used as a Daoma point to supplement the effect. In addition, its correspondence to the neck and shoulder area in the holographic picture enables it a primary choice in this disease pattern. If the frozen shoulder is characterized with “shoulder unable to turn around”, as the shoulder is able to extend but unable to contract, it belongs to wood-tendon disorder, a yang disease. It is a wind-damp (wood-earth) disorder and can be treated by selecting points located between the Shaoyang (wood) and Yangming (earth), such as Zuwujin (77.25) and Zuqianjin (77.24). The qianjin (thousand metals) and wujin (five metals) in the point names also symbolize the heaviness. Or it can be treated effectively by needling Yanglingquan (GB34), because Yanlingquan is the earth point in the wood channel, and is one of the confluent points governing tendon. In Neijin, chapter Nine needles and Twelve source points, it says “when the disease is on the upper part of body pertaining to Fu bowel organs, select Yanglingquan (GB34),” another reason of its effectiveness.

Needling Chize (LU5) with draining technique to treat frozen shoulder is also very effective. The reasons can also be explained by the eight diagrams (xiang shu) (象 xiang: the diagrams, and 數 shu: position of strokes) and the five-elements. A disease characterized with “able to flex, but unable to extend” is well treated by Chize (LU5) (if needled by closely attaching the needle to the tendon, the Quling (33.16) point is needled in fact, the result is even better). The reasons are: 1. needling closely along the tendon to treat tendon (Quling (33.16) point of Tung's acupuncture is needled instead with this technique); 2. draining Chize (LU5) is draining the metal (Chize (LU5) is the son water point of the metal. As it is said to drain the excess, apply the draining technique on its son point), which will reduce the metal in over-controlling the wood. Once the wood is released, the shoulder will be able to lift. From the perspective of the image analogue, in accordance with the 19 bing ji (disease pathomechanisms) theory, it is said “all types of coldness and contraction”. The unable to extend implies that there is coldness and the yin is surplus. Since Chize (LU5) is located in the yin channel at the concave area, the point bears strong yin nature. Besides, Chize (LU5) is the water point, also yin nature and so draining Chize (LU5) is to drain the surplus yin. Once the surplus yin is drained, the coldness will be removed and the contraction no longer exists, and so the frozen shoulder is relieved.

Another example of making flexible use of the five elements is that Master Tung used Sima points (88.17, 88.18, and 88.19) to treat eye redness and glaucoma. The sclera (the white of eye) pertains to metal. Eye redness is analogized as “fire over-controlling metal”. Tonifying the metal will weaken the wood. Once the wood is weakened, it fails to generate the fire. Hence the fire is unable to over-control the metal. Or it may be explained as follows. Sima (88.17, 88.l8, and 88.19) points are in the stomach channel, the earth channel. Earth is the son of fire. Needling the son point will drain the fire, and hence the fire is unable to over-control the metal. As for the glaucoma, the mechanism is often due to liver wind exuberant. Tonifing the metal will put the wood under control. Or it maybe said that the Sima points are on the earth channels, needling them will course the earth and reduce the wood.

The core thoughts of Tung's acupuncture are yin yang and the five elements. The inter-promotion and inter-restraint of the five-elements in the Tung's acupuncture is actually secondary important. The most important is the Tong Tou (Tong Gen and Tou Zhi) and Liu Zhuan (flow and transform). Some points give better results when the patients are needled with lying position; while some others needle with sitting or standing position. This is related to the ascending, descending, opening, closing, storing or flowing of the yin yang and qi blood.

7: Does every acupuncture point have its own combination of yin and yang and five elements?

This is a very good question. I asked the same question to Master Tung back in the old times. I grasp the answer through the practice of the Tung's acupuncture. Every herb has its very particular nature (four natures) and flavor (five flavors). The four natures, cold-hot-warm-cool, correspond to the yin and yang; and the five flavors (sour-bitter-sweet-pungent-salty) correspond to the five elements. A human body resembles a small cosmos. Certainly every point, under the Tung's acupuncture or the 14 channel system, in our body has its particular combination of yin and yang and five elements. A point's yin and yang is related to the point's location including those aspects: five tissues, five transport points, and channels and collaterals. For example, the muscle bulge area pertains to yang, and hence the names of the points often contain the words such as mountain, mound, village, and seas (山陵里海). The main function of those points is to regulate qi. Points such as the Sima points (88.17, 88.18, 88.19), Shousanli (LI10), and Jienzhong (44.06) all carry the function of regulating qi. The concave of a muscle pertains to yin, and hence the names of the points often contain the words such as ditch, brook, swamp and ravine (溝溪澤谷). The main function of those points is to regulate the blood. For example, Neiguan (PC6) and Huozhu (66.04) points, etc. A point's yin and yang combination also is related to its five-transport and five-elements. The point's yin and yang combination is also based on its five element natures, metal, water, wood, fire and earth. It is also related to its channel's yin and yang nature, for example yin within yin, yin within yang, yang within yang and yang within yin. All those form the moving directions of a point to ascend, descend, exit and enter. The applications of the points are hence very flexible.

Certainly every point has its five-element nature. The five-elements of the five transport points are well known. I certainly do not need to give examples. For other points, their five element nature is related to its belonging channel, organ, and five tissues. For example, if a point's tissue is attaching to a bone, then its nature bears water property; if it is attaching to a tendon, then its nature bears wood nature. Those Tung's points on the back region related to the organs and bowels such as Wuling (DT04), Shuangfong( DT.05), Jiohuo (DT.06), Sanjin (DT.07), Jingzhi (DT08), Jinlin (DT.09), Dingzhu (DT.10), Huoxin (DT.11), indicate their five element nature in their own names. Their names are given according to their surrounding organs or bowels.

5: Why in Tung's acupuncture the heart and lung are often discussed and treated together?

The points of the heart channel starts from the auxiliary at Jiquan (HT1), run downward along the medial side of the upper arm and then lower arm and end at the tip of the small finger. The points distributes along the ulnar nerve. The channel pathway originates in the heart, emerges from the lung artery and descends to connect with the small intestines. Its branch exits at the lung artery, ascends alongside the esophagus to connect with the eyes. Another branch also exits at the lung artery, passes through the lung and auxiliary at Jiquan (HT1), and run along the arm. The heart channel emerges at the lung artery for three times. Hence the disorders related to the heart also relate to small intestines, lung, esophagus and eyes. The heart disorders are also related to the digestive and respiratory disorders. In Tung's acupuncture, the heart and the lung are often discussed and treated together.

4: The points in the lung channel can treat lung diseases but also heart diseases. Why is that? Are there any special features of the needling techniques when needling points in the lung channel?

All vessels converge in lung. The pulse connects to the heart. Hidden pulse is treated by lung points, for instance Taiyuan (LU9). The points in the lung channel are most often used to treat respiratory system disorders, and secondarily to treat heart disorders. That is why many Tung's points treating the respiratory disorders can treat heart disorders. For instances, Renshi (33.13), Dishi (33.14), Tienshi (33.15), Quling (33.16) points located in the lung channel treat lung disorders as well as heart disorders. The lung channel also is related to the digestive system. One feature of the needling techniques of the lung channel is that no matter the diseases are in the respiratory system, heart, or lung, the needling depth is shallow to gain effect. The needling depth should not be too deep as it is said the lung governs the skin: puncturing the skin to treat the lung. Qimen (33.01), Qizheng (33.03) are needled subcutaneously to treat hemorrhoid. The anus is also called pomen (the door of po). The lung governs the po. Quit smoking is treated by needling Leiqu (LU7) penetrating to Yangxi (LI5) subcutaneously. That is a technique also addresses the lung. Shuijin (1010.20), a point to treat lung system disorders is also needled subcutaneously.

3: What is the Method of Selecting Five Shu Points of the Same Five-element Category (同氣相求療法)

I. Inter-promotion: This method is developed from the inter-promotion relation among the five elements. For instance, Taiyuan (LU 9) is the earth (Shu-Stream) point of the metal (Lung) and therefore can be used to supplement the earth to generate metal to treat lung qi deficiency; Shangqiu (SP 5), the metal point of the earth channel, can also be used to reinforce qi to treat diseases due to deficiency of qi in the middle energizer. No more examples are given here, since this is similar to the mother-son reinforcing-reducing method.

II. Inter-restriction: This method is developed from the inter-restriction relation among the five elements. For instance, Erjian (LI 2), the water point of the Large Intestine Meridian, is very effective for diseases of this meridian due to heat or fire such as toothache, and Neiting (ST 44) is also effective for toothache for the same reason; Yemen (TE 2), the water point of the Triple Energizer Meridian, is effective for diseases of the meridian due to heat or fire,. Chize (LU 5), the water (He-Sea) point of the Lung Meridian, can be used to treat diseases of the meridian due to fire, and is therefore the specific point for sore throat and tonsillitis.

III. Genuine Five Elements: Genuine five elements refers to genuine metal in metal, genuine earth in earth, genuine fire in fire, and so on. Zusanli (ST 36), the genuine earth of the earth meridian, has strong effect in regulating the spleen and stomach; Dadun (LR 1), also a wood point of the wood (Liver Meridian), is extremely effective for impotence, hernia and metrorrhagia, since these diseases are all diseases of the tendons, and the Liver Meridian circles around the genitalia and Liver stores blood. Laogong (PC 8), also a fire point of the fire (Pericardium Meridian), has excellent effect of purging fire, clearing away heart fire and chest fire and causing fire to descend, and therefore is often used to treat canker sore and heart stuffiness effectively.

IV. Inter-relation This is the most widely used method in the method of selecting points of the same five-element category, the principle of which is to fully utilize the close relation between the five elements and the visceral manifestations in the clinical practice. The application of this method to the clinical practice will be to select the meridian according to the primary disease mechanisms and the corresponding five-element points in this meridian according to the secondary disease mechanisms. For example, Xiangu (ST 43), the wood point of the earth meridian, is often used to treat diseases due to incoordination between the wood and earth (liver and spleen), especially diarrhea with abdominal pain, headache, migraine and dysmenorrhea; Yinlingquan (SP 9), the water point of the earth meridian, has strong effect of tonifying the earth and controlling water and is therefore used to induce diuresis in the treatment of edema. Houxi (SI 3) is the wood point of the Taiyang Meridian, and since wood controls the tendons it can be used to treat diseases along the Taiyang Meridian that are related to tendon, such as stiff neck, waist and legs; Yongquan (KI 1), the wood point of the water (Kidney Meridian), can also be used to treat vertex pain (or Jueyin headache) with the same mechanism, and is used as an important point for epilepsy and wind syndromes since wood dominates wind and the Jing-Well point has strong tranquilizing effect.

V. Inter-connection: This is a method in which two points of the same five-element category are used in combination. For instance, Chize (LU 5) is the water point of the metal (Lung Meridian) and Fuliu (KI 7) is the metal point of the water (Kidney Meridian). The two points used together have the effect of connecting metal with water to treat dysfunction of the lung and kidney with good effect. The author often uses these two points to treat chronic bronchitis and bronchial asthma effectively. Similarly, Shaohai (HT 3) is the water point of the fire (Heart Meridian) and Rangu (KI 2) is the fire point of the water (Kidney Meridian). The two points can be used in combination to treat diseases due to incoordination or disharmony between the heart and kidney, such as symptoms often seen in neurasthenia like insomnia, dream-disturbed sleep, seminal emission, palpitation, poor memory, vertigo, tinnitus, dry mouth and throat, aching loin and knees, afternoon fever, spontaneous sweating, etc.