9. What is “treatment points not forming a formula (you xue wu fang)”? How to improve it?

Many people knows “prescribed herbs not forming a formula (you yao wu fang) and “a formula without modified herbs (you fang wu yao)” while learning herbal prescriptions. The same problems happen to acupuncture too. The so called “using a formula without modified herbs (you fang wu yao)” means rigidly using the formula without changes or modifications according to individual patient’s condition. As the “prescribed herbs not forming a formula (you yao wu fang)” means merely gather a bunch of herbs without following any principles. Some acupuncture treatments fall into the above two circumstances. The acupuncturist merely puts one needle here, one there, without any principles. It is like shooting birds in the dark (making random attempts). One needs to understand the principles of herbal combination to successfully prescribe an effective formula. The same applied to acupuncture too. For instance, some acupuncturists needle Linggu (22.05), Dabai (22.04), Jioil (88.25), Xinmen (33.11), Shouwujin (33.08), Shouxienjin (33.09), Biyi (1010.22), etc. all together to treat sciatica. Sometimes they even add more points from the 14 channels. This is a typical example of gathering a bunch of points without principles. Certainly the treatment result will not be good. Acupuncture needs to be like prescribing a formula. It is said “Having Songs of Tang Tou Formulas (sets of prescriptions) in mind, one needn't to worry in clinic.” One needs to have sets of point prescriptions in mind as basis before selecting treatment points.

First is to memorize the application principles of the special points. For example, for the Five Transport points, one can memorize the texts in the Ling Shu in chapter 44 (’The Sequence of Qi and the Four Seasons within a Single Day’): When the disease is at the Zang, needle the Jing-Well point. If manifesting as a change in the color, needle the Ying-Spring point. When the disease attacks intermittently, needle the Shu-Stream point. When the disease manifests as changes in the patient’s voice, needle the Jing-River point. If there is disease of the stomach and irregular appetite, needle the He-sea point. In Ling Shu, in chapter 4 Disease Patterns of Zangfu as Caused by Pathogenic Qi says: the Ying-spring and Shu-stream points treat the exterior channels; and He-sea points treat the internal Fu. Classic of Difficulties (68th Difficulty) says “Jing-well points for fullness below the heart, Ying-spring points for heat of the body, Shu-stream points for heaviness of the body and pain of the joints, Jing-River points for dyspnea, cough, chills and fever, He-Sea points for rebellious Qi and diarrhea. If one can memorize those texts, he/she can apply them to the clinic practice potentially. Whenever encounter the pain, first select the Shu-stream point of the disease channel, because Shu-stream points govern the pain syndromes. When encounter the diseases of qi reverse, select the He-sea points of the channel. For example, cough is the qi reverse of the Lung, so first thing is to select the He-sea point of the Lung, Chize (LU5) to treat it. Hiccup, the qi reverse of the Spleen, select the He-sea point of the Spleen, Yinlingquan (SP9), or Jienshi (PC5) in the Pericardium channel, because “the disease manifested with voice (sound) change, select the Jing-river points, and also that the communication of the Pericardium and the stomach.

Secondly, memorize three to five classical songs or odes. For example, Bai Zheng Fu (Ode of a Hundred Patterns), Zhou Huo Ge (Song to Keep Up Your Sleeve), Biao Yo Fu (Song of Elucidate Mysteries), Xi Hong Fu (Ode of Xi Hong), Tong Xiuan Zhi Yao Fu (Ode of the Essentials of Understanding), Zha Bing Xue Fa Ge (Song of Points for Miscellaneous Diseases), Shen Yu Ge (Song More Precious Than Jade). All those are very popular and useful songs and odes. By memorizing those songs and odes myself, I gained very strong foundation in acupuncture. I also recommended my students to memorize those songs and odes so to skillfully select points in practice. Those songs and odes are set prescriptions. For example, in Xi Hong Fu (Ode of Xi Hong) and Zha Bing Xue Fa Ge (Song of Points for Miscellaneous Diseases), they both say the combination of Lei Xue (LU7) and Tai Yuan (LU9) treats the qi stabbing the two breasts, and temporal and frontal headache. The clinical experience proves it. Also, in Bai Zhen Fu (Ode of a Hundred Patterns), it says “sore throat, Yi Men (SJ2) and Yu Ji (LU10) can treat.” In my decades of clinical practice, I use Yi Men and Yu Ji to treat sore throat and always receive instant results. Another example, Za Bing Xue Fa Ge (Song of Points for Miscellaneous Diseases) says, “Urination obstruction, needling Yinlingquen (SP9) and Zusanli (ST36) will drain the urine like stream flow.” There are too many such examples to enumerate piece by piece. Those point prescriptions are very refined. They usually contain one or two points.

Having those prescriptions at hand make clinical practice convenient and create high efficacy. Besides, those prescriptions are very refined and contain only a few points. I have discussed the point combination of Tung's acupuncture in question 36. Here, I would only give a few examples. Master Tung had a formula to treat headache, Cesanli (77.22) and Shenguan (77.18), with very good clinical efficacy. Later, I developed it into Sanchayi (A.02) and Dabai (22.04) interchangeably needled on two hands to treat various headaches. The total number of points is reduced but still with good result. The reason of my development is as follows. Dabai (22.04) can treat frontal headache and facial disorders. Through the communication of large intestine and liver (Dabai pertains to wood and also communicates with liver), it is good at treating various headache. The point pertains to wood which governs wind and hence is good at treating exterior contracted diseases. Needling this point along the bone corresponds to the kidney and hence also treats chronic diseases. As for Sanchanyi (A.02), it is located in the Sanjiao channel and hence is good at treating lateral headache and Shaoyang disorders. Because of Ying-spring and Shu-stream points treat the exterior channels; it is also an essential point in treating exterior contracted diseases. Needling this point along the tendon and bone to reach the Shu-stream point where there is abundant flesh. Although needling one point, multiple points are penetrated. Hence, the functions and indications of this point are numerous and also cover the disorders of the spleen, liver and kidney. It works well on various types of headache, no matters they are due to internal injure or external contracted, but is particularly effective in the exterior contracted type. The combination of the above two points is more convenient and simpler than and is as effective as that of Cesanli (77.22), Cexiasanli (77.23) and Shenguan (77.18). This combination is developed on the principles of the five Shu points and the five tissue correspondence. Guided by the theory and proved by the clinical practice, this combination became a set prescription.

8. What is the relation between the inter-promotion and inter-restriction of the five elements and the channels?

According to the Ling Shu, chapter 10 Jing Mai (on Channels), “the hand Taiyin Lung channel starts from the middle Jiao and winds downward to connect with the Large Intestine….” Here, the middle Jiao includes the spleen and stomach. The text implies the meaning of “earth generates the metal”. It says the Spleen channel as “….another branch reached up from the stomach to pass through the diaphragm and enter the heart.” This described the communication between the Spleen and the Heart, in which means the fire generates the earth. In the description of the Hand Shaoyin channel, it says “the branch running straightly forward ascends from the heart system to the lung.” This may explain the “fire restrains the metal.” As far as the Kidney channel, it says “the Kidney channels runs straightly from the Kidney and ascends through the liver and diaphragm and enter the lung….; its branch separates in the lung, joins with the heart, and disperses in the chest to link with the Pericardium channel.” This statement describes the relations of the Liver and Kidney, Lung and Kidney, and Heart and Kidney, etc. The Liver channel says “its branch separates from the liver, crosses the diaphragm and spread in the Lung.” This connects to the “metal restrains the wood.”

7. Why is that only liver and heart channels travel to the head region?

The general rule of the yin yang categorization of Zang Fu is that Zang (viscera) (to store) belong to yin and Fu (bowel) (a palace) belong to yang. However, the five Zang (belong to the yin) could be further categorized into yin and yang. In Ling Shu, Yin Yang Xi Re Yue (The Yin and Yang of Human Body relate to Moon and Sun) says “the parts above the loins are Heaven which is yang; the parts below the loins are earth which is yin”. In fact, the divider between yin and yang of the Zang is the diaphragm. The Zang in the chest are yang and those in the abdomen are yin. The chapter also says “In the five Zang, the heart is the Taiyang in yang, the lung is the Shaoyin in yang, the liver is the Shaoyang in yin, the spleen is the extreme yin in yin, and the kidney is the Taiyin in yin.” (The above quote is also seen in Ling Shu, Nine Needles and Twelve Yuan-origins). In Su Wen, Jin Gui Zhen Yen Lun (The Truth in the Collections of Books of Golden Chamber) says “the back is yang. The heart is the yang in yang; the lung is the yin in yang. The abdomen is yin. The kidney is the yin in yin and the liver is the yang in yin. The extreme yin in yin is the spleen.”

The heart and liver both are “yang viscera”. The heart is the Taiyang in yang because it is located in the chest. The liver is located in the abdomen and is the Shaoyang in yin. The lung, kidney, and spleen all are “yin viscera”. The lung is Shaoyin in yang because it is located in theS chest and back. The kidney is Taiyin in the yin because it is located in the loins. The spleen is located in the abdomen and is the extreme yin in the yin.

In the five elements, the wood and fire are light and going upward, hence they govern ascending. The earth, metal, and water are heavy and sinking and hence govern descending. The yin channels travel upward (the foot three yin channels travel from feet to the chest; while the hand three yin channels travel from the chest to the hands.). Hence, the beginning five-element of the five transport points of the yin channels start from wood and then fire. The yang channels travel downward and hence the beginning five-element of the five transport points of those channels start from metal and then water. The heart (fire) and liver (wood) channels are yin channels but yang viscera. Because they belong to wood and fire, their nature is to ascend. That is why in the yin channels, only the yang viscera, the heart and liver channels travel upward from their internal pathways to the head region (no points on those pathways though). Because both the liver and heart channels go to the head, the disorders of the heart and liver will influence the spirit and will (Shen Zhi). The hyperactivity of the liver yang (such as the cerebral hemorrhage in western medicine term) and the phlegm confusing the heart orifice (brain thrombus) both will cause stroke. To treat it, needle the Muhuo (wood fire) point and Linggu and Dabai (the wood fire nature points) of the Tung’s acupuncture. The effectiveness of the point combination is very high.

6. Please discuss the applications of “the Pericardium governs the spirit, blood and sweat” in clinical practice.

The Heart governs the spirit, so does the Pericardium. The Pericardium tranquilizes the heart and pacifies the spirit and treats various heart disorders. The most commonly used points are Ximen (PC4) and Neiguan (PC6). The Pericardium also governs the blood. The Pericardium channel is a fire channel and hence it treats mostly feverish diseases. The Xi-cleft point, Ximen (PC4), is good at stopping various bleeding in the upper body, for instance, to stop coughing blood. To stop nasal bleeding, needle the Ximen (PC4). To treat vomiting blood, needle Daling (PC7), Ximen (PC4). The Pericardium also governs the sweat and so it will treat night sweat due to yin deficiency. Needling Ximen (PC4) and Jienshi (PC5) to stop night sweat is effective.

5. Please describe the meaning of “Taiyang governs the tendons” and its clinical applications.

The Bladder channel passes along the head, posterior aspect of the neck, back, lumbar region, buttock, the posterior of the leg, and the lateral of the ankle, etc. They are the most important tendon muscular constructions among the motor functions in our body. Taxation detriment of those regions often induces various types of pains, spasms, rigidity, numbness etc. Those disorders are related to the tendons. That is why it is said the Taiyang governs the tendons. The most commonly seen disorders of the Taiyang channel are the sciatica, pain, rigidity and spasm of the nape, back, lumbar and gastrocnemius muscle. Weizhong (BL40), Zhengjin (77.01), and Chengshan (BL57) are essential points in treating tendon disorders.