6: Why do Jing-well points of Yang channels begin with phase/element metal; Yin channels with phase/element wood?

The sequences of the Five Phases of the five transport points on yang channels and yin channels are different and are greatly related to clinical applications, hence one must memories them well. In the Classic of Difficulties, the 64th Difficulty: “The yin Jing-wells are wood; the yang Jing-wells are metal; the yin Ying-springs are fire; the yang Ying-springs are water; the yin Shu-streams are earth; the yang Shu-streams are wood; yin Jing-rivers are metal; yang Jing-rivers are fire; the yin He-seas are water; the yang He-seas are earth.” That is to say the Five-Phase sequence on the yin channels is Jing-well wood, Ying-spring fire, Shu-stream earth, Jing-river metal, He-sea water; on the yang channels Jing-well metal, Ying-spring water, Shu-stream wood, Jing-river fire, and He-sea earth.
But why do yin Jing-well points start with wood and yang Jing-well points with metal? There are many articles related to this question, but they seem not grasping the essential points. According to my researches, I believe that is decided by the attributes (nature) of the Five Phases. Metal and water belong to yin for they are sinking, heavy and down bearing; wood and fire belong to yang for they are floating, light, and up bearing. Hence the nature (qi and quality) of the Five Phases decide the channel directions of going upward or downward; as well as the five-phases of the Five-Shu points of yin and yang channels.

The locations of Zang Fu may further explain the channel directions. The area above diaphragm is Yang. Lung and Heart both locate above diaphragm and hence their channel pathways travel above, along the hands/arms. Their exterior-interior channels Large Intestine and Small Intestine follows them and hence travels along hands. Spleen, Liver, and Kidney all locate below the diaphragm. Their channels also travel the lower part of body, along feet/legs. Their exterior-interior channels, Stomach, Gall Bladder, and Bladder channels follows them and travel along the feet/legs.

Secondly, according to the Shi Chen (traditional 12 two-hour periods) flowing sequence of the Zang Fu channels, which starts at yin shi (3:00am~5:00am) and ends at chou shi (1:00am~3:00am), every Shi Chen corresponds to one channel or Zang Fu. Lung channel corresponds to yin shi; large intestine to mao shi; stomach to chen shi; spleen to si shi; heart to wu shi; small intestine to wei shi; urinary bladder to shen shi; kidney to you shi; pericardium to xu shi; san jiao to hai shi; gall bladder to zi shi; liver to chou shi. The qi and blood of every channel is at its peak at and waning after its Shi Chen.

Yin, wu, xu, three combine to form fire (yin-wu-xu fire 3-unity); hai, mao, wei, three combine to form wood; si, you, chou, three combine to form metal; shen, zi, chen, three combine to form water. Lung (yin), Heart (wu), and Pericardium (xu), the three hand yin channels combine to form fire; San Jiao (hai), Large Intestine (mao), Small Intestine (wei), the three hand yang channels combine to form wood. Because wood and fire are light, up bearing and floating, they belong to yang. Hence those channels travel upper part of body through hands. Spleen (si), Kidney (you), Liver (chou), the three foot yin channels combine to form metal; Urinary Bladder (shen), Dan (zi), Stomach (chen), the three foot yang channels combine to form water. Because metal and water are sinking and down bearing, which belong to yin, hence those channels travel lower part of body through feet.

The circulation of hand and foot three yin and three yang channels of TCM manifest the mutual assistance between yin rising and yang sinking, which is in correspondence with the theory of Yi (Classic of Changes). In the theory of Yi, Kun gua is earth, belongs to yin and its position is in the lower; Qien gua is heaven, belongs to yang and its position is in the upper. The earth qi rises and the heaven qi sinks, by which the earth and the heaven moves toward each other and the greatness or the peaceful and prosperous times (Tai gua) can be formed. The heaven and the earth are the macro cosmos while human body is the micro cosmos. “Yin rising and yang sinking” symbolizes the Heaven and Human Unity, the earth and the heaven in communication to form the greatness (Tai), or the upper and the lowers’ mutual assistance or interaction. Try stand with both of your hands raised up to the head and review the foot three yin channels travel from foot to chest; hand three yin channels from chest to hands, hand three yang channels from hand to head; foot three yang channels form head to foot, which manifest the spirit of yin rising and yang sinking. Because wood and fire are light, up bearing and rising, the five transport points of the uprising yin channels start from wood and fire; because metal and water heavy, sinking and down bearing, the five transport points of the down bearing yang channels start with metal and water.

Yin opposites to yang; Firmness opposites to yieldingness; Yang is firm and yin is yielding; metal is firm and wood is yielding; firmness and yieldingness mutual assistance. Yang Jing-wells are metal and yin Jing-wells are wood. According to the Five-Phase relationships, metal counter-controls wood. The yang Jing-wells are geng metal; the yin Jing-wells are yi wood. Yi and geng however is a matching (he). Just like yin and yang although opposite to each other, but mutually assist each other and constitute the “husband and wife” relationship. The rest four phases could be applied the same way: Jia Ji matching, Bing Xin matching, Ding Ren matching, Wu Kui matching. Yin and yang are self-generating, but mutually controlling. Although mutually controlling, they are mutually promoting too. The “controlling within generating” relationship implies the meaning of Cybernetics.

5: What are the functions of the Xi-cleft points?

Xi-cleft points are good at treating acute/urgent diseases as well as pain syndromes. “Xi” means “cleft”, where the channel qi gathers deeply. When channels travel and meet with circuitous or crooked parts of body, qi and blood will gather and irrigate at those cleft sites. Other than the stomach xi-cleft point which is located slightly superior to the knee, the rest of xi-cleft points are distributed inferior to the elbow or knee. Xi-cleft points are where channel qi and blood gather around and hence they are with abundant qi and blood and with strong function of regulating qi and blood. The major indication of xi-cleft point is to treat acute zang fu disorders and pains of its respective channel.

Some believe the xi-cleft points of yin channels is more for blood related disorders while the xi-cleft points of the yang channels more for pain syndromes. However, according to the experience, to treat acute pains or blood disorders of channels, xi-cleft points of either yin or yang channels work well. For example, the xi-cleft point of lung channel, Kuongzhui (LU6) is quite effective for asthma (even more effective if combined with Chize (LU5) or Yuji (LU10)); hemoptysis; bronchiectasis; lung tuberculosis (paired with Yinxi (HT6). Ximen (PC4) is effective for fright palpitation, unpeaceful spirit (paired with Shenmen (HT7)), angina, premature beat (combined with Xinshu (UB15), Tanzhong (Ren15)). In a word, xi-cleft points are mostly used to treat acute syndromes and pains caused by sudden stagnation or imbalance of the channel qi. The disorders are usually excessive syndromes.

Dishi point (33.14) in Tung’s extraordinary point is located very close to the xi-cleft point of lung channel, Kuongzhui (LU6) and is very effective for acute disorders of lung such as common cold and asthma. Jiexue point (88.28) is located very close to Liangqiu (ST34), the xi-cleft point of stomach channel which is with abundant qi and blood, and hence is particularly good at regulating qi and blood to treat disturbance of qi and blood and fainting caused by acupuncture.

Besides, many researches and experiences conclude that xi-cleft points are diagnostic. Xi-cleft points distinctly manifest acute disorders and hence are valuable in diagnosis. They also help diagnose disorders caused by irregularities of qi and blood of certain zang or fu. For example, in stomach spasm and acute mastitis, Liangqiu (ST34) will be tender when pressed. Hence, tender on Liangqiu (ST34) assist in the diagnosis of stomach disorders. Also, tender sensation at Kuongzhui (LU6) when it is pressed assist in the diagnosis of pneumonia and hemorrhoid. Tender Waiqiu (GB36), the xi-cleft point of gall bladder channel, assists the diagnosis of gall bladder duct infection. Wenliu (LI6), xi-cleft point of the large intestine, if tender when pressed, often reflects digestive tract perforation.

4: Why Linggu (22.05) and Dabai (22.04) are super effective points for sciatica? What are the reasons if they are not effective or the effectiveness duration is short?

There is one valuable and important tip in point selection and that is the “concentration”. When select points from different channels, one must pay attention to the restraining or attacking relations between or among channels. Sciatica usually involves with three channels: lateral (Shao Yang wood), posterior (Tai Yang water), and anterior (Yang Ming earth). If all three channels are needled at the same time, restraining between channels will occur: wood restrains earth; and earth restrains water. The result is far less effective than only needle on Bladder channel or Gall Bladder channel. Since the Daoma of Linggu and Dabai only apply one channel, the result is concentrated and strong.

Linggu and Dabai are located on the lateral side of the second metacarpal bone. From the perspective of holographic theory, Linggu corresponds to lower jiao and lumbar and legs in the upright direction of the second metacarpal bone to the whole body; Dabai corresponds to lower jiao and lumbar and leg in the reversed direction. Both points can treat lumbar and legs (including sciatica). When they are used together to treat lower jiao, lumbar and leg, the effectiveness is certainly strong.

From the perspective of the hand-trunk correspondence, fingers correspond to the genital area, palm corresponds to hip area and lower back and hence points of this area treat sciatica. Besides, from the perspective of hand-foot reversed correspondence, hand also corresponds to the hip area and hence treats sciatica. Both correspondences indicate the treatment of sciatica. Hence, Linggu and Dabai, the two points on hand, treat sciatica with superb effectiveness.

Both of the insertions of Linggu and Dabai are along and close to the bone. The technique matches the saying in Lingshu, chapter 7 Guanzhen: ““The so-called Duan Ci is to treat bone bi-syndrome. After the insertion, wave the needle slightly to advance the needle and cause the tip of the needle to approach the bone; and apply lifting and thrusting method to rub the bone.” This is similar to the “using bone to treat bone” technique in the Ti Ying (body correspondence) needling methods. The insertion is effective in treating bone pain including sciatica.

From the perspective of the “using body (tissues) to treat (disease) images” in the Ti Ying needling methods: through the extraordinary connection of the large intestine channel and liver channel (belongs to wood), large intestine also corresponds to wood and treat tendon diseases; the element of Dabai point is also wood and hence treats tendon related diseases. Since both points are close to the bone; and as “using bone to treat bone”, both points treat tendon and bone (wood and water) simultaneously. The sciatica is usually related to water (bladder channel) and wood (gall bladder channel). Or it belongs to the liver channel if the pain is at groin, both points can still treat it through the extraordinary connection of the large intestine and liver. If the pain falls in the yangming channel, through the communications of the same name hand and foot channels, these two points also can treat.

As far as the question of why the result is not good, it is mostly caused by improper technique. The needling depth plays an essential role in the treatment: shallow depth or heaven division treats local diseases or diseases close to the needling point; medium depth or human division treats diseases located farther to the needling point; and deep depth or earth division treats diseases even farther. Using points located in the upper body to treat the diseases located in the lower, it is necessary to needle deep enough to gain effect. (Also see the previous discussion questions for more details.) Linggu and Dabai both points must be needled to the earth division (average 1.5 cun to 2.0 above) to gain good result. If the needling depth is not deep enough, the result is certainly not good. Besides, if the Dongqi (activating qi) technique (asking the patient to exercise the disorder site) is not incorporated, the result is even less effective. If the needling depth is not deep enough, the righteous qi can not be regulated. It is said that the local, shallow or heaven division needling is to drain the pathogens residing in yang division/layer; medium or human division needling is to drain the pathogens residing in yin division; and earth division needling is to strengthen the grain qi or righteous qi. The sciatica pain mostly is chronic, prolonged and cold nature. To gain a lasting effect, the needle must reach to the earth division and long retained to strengthen the grain qi and righteous qi. If the needling depth is not deep enough or the needle retention is not long enough, the treatment effect is neither prominent nor lasting.

3: Why Jiexue ( 88.28) and Muhuo (11.10) points are not supposed to retain the needle for long time?

In our previous discussions (question 3, the third round), the time nature of a point once discussed this question.

1. Jing-well points treat the most acute/urgent diseases. “When diseases are at the Zang, select Jing-well points.” Ancient people believe that loss of Shen (spirit) and consciousness indicates the diseases are at the Zang. In wind stroke, other than loss of consciousness, one’s spirit is often changed. Jing-well points are able to wake brain and open orifices, quite Shen (spirit) and clear heat, drain excess and expel evils. Jing-well points are often used at emergency such as sudden disorder of spirit and will. Jing-well points are used for acute syndromes. As they are located finger or toe tips which are with very thin muscle, they mostly are pricked with a three-edged needle and do not retain the needle.

2. Ying-spring points are for secondly acute/urgent diseases. “Ying-springs treat exterior channels.” “Ying-spring points master body heat.” Here, “exterior channels” relate to “channels” as well as “exterior evils.” Externally contracted syndromes are wind-“cold” or wind-“heat”. Ying-spring points belong to “water” or “fire” and hence are good at externally contracted diseases. Externally contracted diseases are not as urgent as loss of consciousness in wind stroke, but wind evil is migratory and changeable, and often causes diseases suddenly and hence they also belong to urgent diseases, but less urgent than wind stroke. Ying-spring points are located posterior to the Jing-well points and the diseases they treat are less acute/urgent than those of Jing-well points. Sanchasan (A.04) and Muxue (11.11) in Tung’s extraordinary points commonly used for common cold are located closely to Ying-spring points. The diseases they treat although are newly contracted, but are less urgent compared to wind-stroke. Those points usually do not retain the needle for long either. Muhuo (11.10) point is located between Jing-well point and Ying-spring point and is not supposed to retain the needle for too long.

Jiexue (88.28) is located closely to Liangqiu (ST34), the Xi-cleft point of Stomach. Xi-cleft points are usually for acute disorders and pains due to sudden channel obstruction or qi disturbance. They are particularly effective for acute disorders or pains on their respective channel. Jiexue (88.28) is located closely to Xi-cleft point Liangqiu (ST34) of the Stomach, which is with abundant qi and blood. Hence it is particularly good at regulating qi and blood and treating qi and blood disturbance and fainting resulting from acupuncture. Because qi and blood disturbance and fainting resulting from acupuncture are acute syndromes and not internal acute abdominal disorders, it is not appropriate to retain for too long. If Xi-cleft point is used to treat acute abdominal disorders, it is suggested to needle deep with strong stimulation and long retention.

2: How to apply Zang Fu Bei Tong (extraordinary connections of Zang Fu organs) theory to acupuncture?

This is a broad question. The applications of Zang Fu Bei Tong are numerous and flexible. Here I would only give a brief introduction. A general application is the mutual-treatment, which means the communicating/connecting organs mutually treat each other.

1. The extraordinary connection of Lung and Urinary Bladder

Lung governs soothing qi; while Urinary Bladder circulates water. Using Lung channel points to treat Bladder channel diseases imply the meaning of “lifting the cap to release water in the kettle.” Needle Leique (LU7) to treat frequent urination or profuse urine; Chize (LU5) to treat urinary diseases and lumbago. Besides, needling Yuji (LU10) can treat backache along the distribution of Bladder channel. Needling the back-Shu points on the Bladder channel can treat asthma; Weizhong (UB40) to treat skin diseases and severe sores are very effective. Those are the examples of extraordinary connections of Lung and Bladder.

In the application of Tung’s points, Chongzi (22.01) and Chongxian (22.02) located on the Lung channel are often selected to treat backache along the Bladder channel. The disorders of the uterus are also related to the Bladder channel (for details, please read chapter one of the Lecture on Tung’s Acupuncture: Therapeutic System). And hence the selection of Chongzi and Chongxian can be used to treat hysteromyoma and this therapeutic effect is closely related to the extraordinary connection between the Lung and the Bladder. The therapeutic effect of point Fuke (11.24) located on the Lung channel, which can treat gynecological diseases, uterine diseases in particular, is also based upon the theory of extraordinary connection of Zang Fu.

Some Tung’s points located on face such as Majinshui (1010.13), Makuaishui (1010.14), Liukuai (1010.16), Qikuai (1010.17), etc., although they are not located on the Lung channel, can treat urinary difficulty and stones. This is because the ideas of “opening the upper orifice to activate the lower orifice”; and “lifting the cap of a teapot to release the water in it.”

2. The extraordinary connection of Spleen and Small Intestine.

In acupuncture treatment, Wangu (SI4) is often used for obesity. In ancient classical literature, it is often selected to treat jaundice due to damp heat (see Tong Xue Zhi Yao Fu—Ode of Commonly Used Important Points; Yu Long Ge—Song of Jade Dragon and Yu long Fu—Ode of Jade Dragon). Wangu (SI4) is the yuan-source point of the small intestine and can eliminate dampness and strengthen the spleen. The Tung’s extraordinary point Ganmen (33.11) is also located on the small intestine channel and is indicated in hepatitis for the same reasons as those of the Wangu (SI4). All the ancient and contemporary physicians considered it is important that hepatitis should be treated by eliminating the dampness. In cases of Yang jaundice due to acute hepatitis, emphasis of treatment should be placed on the Yangming; while in case of Yin jaundice in chronic hepatitis, the emphasis should be placed on eliminating dampness. The small intestine is the organ of irrigation and has very strong ability to eliminate dampness. Besides, the spleen point Yinlinquan (SP9) can be selected to treat periarthritis of the shoulder with great result. The point Shenguan (77.18), located 1.5 cun inferior to Yinlinquan can treat frozen shoulder with even more remarkable effect. Selecting Shenguan to treat hand numbness due to cervical spondylosis is also based on the extraordinary connection of the spleen and the small intestine. Xinmen (33.12) point is selected to treat knee pan because it has dual functions of eliminating dampness and strengthen the heart.

3. The extraordinary connection of Heart and Gall Bladder

In acupuncture, needling point Fengshi (GB31) of the gallbladder channel is very effective for insomnia, heart disease and cholecystitis. Needling point Shenmen (HT7) of the heart channel is also very effective for deficiency of qi of the heart and gallbladder. Besides, the extraordinary point Yanhuang (11.23) located on the heart channel is effective for yellowish eyes. All these are examples of extraordinary connections of Zang Fu. Hand Jiexue (22.10) or Shaofu (HT8) of the heart channel is particularly effective in expelling the wind to stop itchiness; as “all sores, pains, itchiness belong to the heart”. However, gall bladder channel also has the function to expel the wind. The extraordinary connection between heart and gall bladder also explains the effectiveness. Fengshi (GB31) is the number one effective point for all kinds of pains, which could be explained by the extraordinary connections between heart and gall bladder too.

4. The extraordinary connections of Kidney and San Jiao

In the treatment of nephritis, Master Tung often used Zhongbai (22.06) and Xiabai (22.07). The two points were also used to treat edema. Besides, Zhongzhu (SJ3) is often selected to treat lower back pain, as well as waist pain. Zhishen (11.15) point is located on the ring finger (San Jiao channel) and it can treat dry mouth due to kidney deficiency. Master Tung’s another extraordinary point Huanchao (11.06) is often needled to treat infertility. Those points are located on the San Jiao channel and they function through the extraordinary connection of Zang Fu to strengthen the kidney.

5. The extraordinary connections of Liver and Large Intestine

In acupuncture, needling Quchi (LI11) can treat hypertension due to liver yang hyperactivity and various kinds of vertigo. The extraordinary point Linggu (22.05) located on the large intestine channel is effective for vertigo. And the points Dajian (11.01), Xiaojian (11.02), Waijian (11.04) and Fujian (11.03) located on the large intestine channel can treat hernia. Point Mu (11.17) on the large intestine channel can treat hernia of the liver channel as well as disorders related to wind. Besides, needling Taichong (LV3) of the liver channel can treat diarrhea with abdominal pain. All these are examples in which the theory of extraordinary connections of zang fu is used.

6. The extraordinary connections of Pericardium and Stomach

Needling point Neiguan (PC6) of the pericardium channel is very effective for stomachache, all kinds of stomach disorders and knee pain. This is through the extraordinary connection of pericardium and stomach. The stomach point Zushanli (ST36) is also very effective for stuffiness in the chest due to heart disease. Master Tung often used Tongguan (88.01), Tongshan (88.02) and Tongtian (88.03) to treat heart disease. All these points are located on the stomach channel, indicating the extraordinary connection of the pericardium and stomach.

The above are the examples explaining the basic application of extraordinary connections of Zang Fu organs. Due to the space limit, the more important application of mutual compliment and combination will be addressed later.