Tung’s Extraordinary Points: academic and clinical discussions

by Dr. Wei-Chieh Young
In recent years there has been increasing interest and inquiry into the various aspects of Tung’s extraordinary points, which is a very good phenomenon. However as a result of this popularity, individuals who have studied on their own without guidance are beginning to teach the work. Further there are several strange books spreading into the stores.  For these reasons, we need to support new learners in getting correct information, rather than exposing them to a body of knowledge built solely from reading and conjecture. This will empower new learners to provide proper treatment and to realize the true manifestation of Tung’s points. Through direct transmission we can support the strength and integrity of Tung’s lineage. Currently, several fellow apprentices and students have collectively discussed the various academic and clinical virtues of Tung’s work. After reorganization, the related contents will be published in this website with more research and discussion to follow.
　

General contents

• Dao Ma needling method; QianYin needling method

• Simplicity in point selections of Tung's Acupuncture but with developing potentials

• Yin and Yang; WuXing (Five Elements/Phases); TongQiXiangQiao (Creatures that have affinity in their nature seek one another. )(Like attracts like.)

• ZangFuBeiTong (Zang Fu extra relationships)

• ZhenFangXiangDui (correspondence of acupuncture and herbal prescriptions)

• Tai Ji and Quan Xi (Holography)

• YiJing, GuaXiang (images of Hexagrams ), TienRenHeYi (the unity of Heaven and Human) and Tung's Acupuncture

• Dui Ying (correspondences), QuXiangBiLei (image-establishing analogy)

• Zi Wu Liu Zhu (point selections of midnight and noon ebb flow) and Ling Gui Ba Fa (eightfold method of sacred tortoise)

• JueZhenZhenFa (extremely effective points and needling)
  　

July,2010(The Eleventh Round)

March, 2010 (The Tenth Round)

November, 2009 (the Ninth Round)

June, 2009 (The Eighth Round)

April 2009(The Seventh Round)

February 2009(The Sixth Round)

July,2010(The Eleventh Round) 

Question 1 : In acupuncture, when to select points on the affected side, and when to select only the point on the opposite side of the body is more appropriate?
Answer: This question may be answered with the following descriptions.
1. Treating pains: In general, in treating the pain syndromes, needling the opposite side of the body is more appropriate.  The reason is because the nerves cross to the opposite side of the body.  This matches the so-called “cross channel needling is called Miaoci, which means to needle the right side of the body when the disease is located in the left side”. (Ode of Elucidate Mysteries).

2.Treating functional disorders: Either the opposite or the same (affected) side of points may be selected, though sometimes the affected side is more effective.  For example, needling the opposite side point to treat the frozen shoulder is effective, but sometimes needling the affected side is more effective.  However, if the disorder is with pain, then selecting the opposite side point is better.  Or in this case, points on both sides may be selected.  Treating tinnitus, needling Fengshi (GB31) is very effective; however, needling the Fengshi (GB31) on the affected side is even better.  Treating Bell’s palsy (facial never paralysis), when the face slants toward to the right side, which indicates the disease (paralysis) is located on the left side, the left side (affected side) points should be selected.

3.Blood-letting: Because the blood vessels flow circularly without crossing to the other side, blood-letting in general is performed at the affected side of the body.  Although some points such as Jing-well points are selected on the opposite side as that in Miaoci, those cases are somehow treating pains as well. 

4.Supplementing or reducing technique: in some cases, selecting the affected side is more appropriate.

5.Moxibustion: Moxibustion is usually on the local and affected side.  For example moxa on the Yangchi (SJ4) (affected side) to treat uterus leaning to one side and hernia.
The above are the general guidelines.  The clinical applications should be flexible and change accordingly.

Question 2: Some people commented that when using Tung’s extraordinary points, only one disease can be treated at a time.  Is it so?

Answer: No, it is not like that.  This statement truly underrates the treatment scope of the Tung’s acupuncture.  Back to those old days when I followed Master Tung in the clinic, I remember most patients came to see him for various types of difficult, complicated and miscellaneous diseases.   Master Tung treated several diseases of a patient at one time.  In my clinical practice, most patients came to see me for difficult, complicated and miscellaneous diseases too.  I also treat several diseases of a patient in the same treatment.  It is not true that only one disease can be treated in the same treatment when using Tung’s acupuncture.  Since the indications listed in Master Tung’s original book were very simple, if a person copies the applications mechanically without elucidation, he will feel that way.  If that statement was true, then what about points of the fourteen channels? Are they also treating one disease at a time?  If a patient suffers from several diseases at a time and only one disease is addressed at a time, then how long is it going to take to treat him?

There are a few principles that need users’ attention when treating several diseases with single point.  First is Master Tung’s “Dong Qi (activating qi)” needling technique.  Some acupuncturists may not know or do not apply Dong Qi needling technique to the treatments.  Many points are able to treat multiple diseases, for example Xinmen (33.12) (heart gate) treats coccyx pain and knee pain.  If the patient only has the coccyx pain, when treated by Xinmen point without Dong Qi needling technique, since only one disease attracts the energy of the needling point, it will still work; although if combining with Dong Qi needling technique, the result will be better.  However, if the patient has several diseases, the energy of the single needling point Xinmen will be attracted and distributed among the several diseases and can not concentrate in treating certain disease. If the Dong Qi needling technique is applied, by activating the affected site to attract the energy of the point, then the effect will be more concentrated.  Several diseases can be addressed at the same time.  Take Xinmen as the example again, if the patient has coccyx and knee pains at the same time, he can exercise his lower back first and then his knee or vice versa while the acupuncturist twirls the needle.  In this case, both diseases can be treated properly. 

Another principle for single point treating multiple diseases is “focused disease, focused treatment.”  If the disease is concentrated in one organ or one site, then the treatment is specialized in it.  To treat multiple or miscellaneous diseases, the primary symptoms/patterns are addressed in the first priority and secondary symptoms/patterns are treated concurrently.  This is achieved by mastering the “disease mechanism”. If the disease mechanism is the same while the symptoms are numerous and complicated, only single or a small set of points are sufficient to treat multiple diseases.  Details for “Yi Bing Tong Zhi (different diseases treated by the same treatment methods) have been described in previous discussion questions.  Here I would not waste any more space for that.

Question 3: Some said that Linggu (22.05) point is the number one major point in Tung’s acupuncture.  What do you think?

Answer: Debating over which point is the very first or most primary point in Tung’s acupuncture has no practical meanings.  It is not meaningful either to debate over either ST36 or PC6 is the number one point in the fourteen channels.  “Linggu (22.05) is the most primary point in Tung’s acupuncture” was Lai Jin-Xiong’s (the senior fellow apprentice) personal comments.  After Master Tung successfully treated Cambodian President Long Nuo who suffered from the hemiplegia due to stroke, he passed the treatment records to his disciples.  Among the treatment records, the Linggu point was used 11 times, the highest frequency than other points (9 of them were Daoma with Dabai point).  The second rank was Zhongjiaoli (88.25) Daoma which was used for 10 times.  Shenguan (77.18) and Xiasanhuang (lower three emperors) were used 9 times.  From this record, Linggu was used most often.  However, in the Master Tung’ original book, the indications of Simashang, Simazhong, and Simaxia (88.17, 88.18, 88.19) points are up to 19 items which is more than that of Linggu point.  Then could it be said that Sima points are the primary points because they have the most indications?

We certainly can not make that statement by one single disease (for example hemiplegia due to stroke), nor the number of the indications listed in the book.  The statistics shall come from the Master Tung’s clinical cases.  I have compiled the statistics from 500 clinical cases by Master Tung. 

?       Shenguan (single point) in 38 cases for 32 diseases; Shenguan combining with other point/s (in general Daoma with Xiasanhuang) in 16 cases (for 14 diseases).  Shenguan was used in 54 cases in total. 

?       Linggu (single point) in 14 cases (for 10 diseases); Daoma of Linggu and Dabai was in 21 cases (for 17 diseases).  Linggu was used in 35 cases in total

?       Zhongjiaoli (single point) in 12 cases (for 9 diseases). Daoma of Zhongjiaoli and Xiajioli (88.27) in 23 cases (for 20 diseases).  Zhongjioli was used in 35 cases in total.

The statistics showed that Linggu, Zhongjioli, and Shenguan are the three primary points. And Shenguan is the number one major point.  Zhongjiaoli and Xiajioli Daom is the number one point pair.  Linggu is neither the number one major single point nor the pair point from the statistics.  But Linggu is definitely one of the three major points and it is very important point. 

Question 4: Why Linggu (22.05) is able to tonify qi and warm yang?

Answer: 1. Linggu (22.05) and Dabai (22.04) are the primary points in regulating and tonifying qi: Dabai communicates with the lung and corresponds to the metal.  It is located on the large intestine channel which also belongs to the metal.  Linggu is located attached to the bone that communicates with the kidney.  It treats both metal and water and have strong function in regulating qi.  There is a saying that tonifying the qi to the extreme will tonify the yang. Bu Yang Huan Wu Tang (Great Yang Restoration Pills) is an example.  The formula does not contain any warming and tonifying yang fire herbs such as Fu Zi and Gui Zhi, but when the tonifying qi herb Huang Qi is used up to four liang (about 120g), the formula is able to tonify yang.  Linggu and Dabai sandwich Hegu (LI4) point, the Yuan-primary point and is located where the flesh is plenty.  The location of the Hegu (LI4) has the thick flesh which corresponds to earth (spleen) and hence also has strong earth attribute. That makes the combination of Linggu and Dabai points able to regulate earth, metal, and water.  Points that treat earth, metal, and water simultaneously are most capable of tonifying qi.  Linggu and Dabai points tonify qi and also warm yang.

2. Linggu and Dabai are essential points in warming yang: There is a saying that yin deficiency is blood deficiency plus water fluid insufficiency; yang deficiency is qi deficiency plus fire insufficiency.  Tonifying qi until fire being generated will warm yang.  Dabai is close to Sanjien (LI3) which belongs to wood.  Linggu is close to Yangxi (LI5) which belongs to fire.  Needling both points will generate wood and flourish fire.  That is to say to generate fire and warm yang.  Linggu and Dabai points cleft the Hegu (LI4) point which is the qi-source point and is strong in regulating qi.  Huoying (66.03) and Huozhu (66.04) points cleft the Taichong (LV3) point which is strong in regulating blood.  Linggu and Dabai points tonify qi and warm yang (wood generating fire).  As different approaches contribute to same end, Bu Yang Huan Wu Tang is the most often selected formula to treat hemiplegia, and Linggu and Dabai are the most often and essential points in treating hemiplegia too.

Question 5: Both Zi Wu Liu Zhu (Midnight Noon Flow Ebb) and Ling Gui Ba Fa (Eight Methods of Miraculous Turtle) need Gan Zhi of the day and shichen (2-hour time period)” to decide the point.  Would you please teach me the quick method to calculate the Gan Zhi (heavenly Stems and Earthly Branches) of the day and shichen?
Answer: Reviewing the journals of the Chinese medicine in various regions in the past decades, one can find several dozens of articles on the topic “Quick Calculating Methods on Gan Zhi (Heavenly Stems and Earthly Branches”.  Those methods usually need to refer to certain tables or charts, or convert between several formulas, or memorize songs of the Gan Zhi of the January firsts.  Not only the memorizations are difficult, the calculations are not fast anyhow.   Besides, if the person does not bring the pamphlet of the ten thousand year calendar with him, then he will not be able to calculate.   In calculating the Gan Zhi of shichen, one needs to know the Gan Zhi of the day first.  Once the Gan Zhi of the day is calculated, the Gan Zhi of the shichen is quite simple.  I taught the theory of Yi Jing and Ba Zi (Eight Characters) before, and apply them to predict the constitutions and general health weakness of a person.  I have been using the following formulas to calculate the Gan Zhi of a day and shichen.  I believe it is a quick method. 

Formula A: 〔5(x-1)+((x-1)/4)r+15+y〕/10＝....the remainder is the Gan of the day
Formula B: 〔5(x-1)+((x-1)/4)r+15+y〕/12＝.....the remainder is the Zhi of the day

Explanation: “Y” is the total of days from January first of the year.  “X” is the last two digits of the year.  If the year is after year 2000, then use the last three digits instead (ex. 100, 101….). “r” is the integer (leave the remainder out).   Although I list two formulas above, in fact, there is only one to remember; because one divisor is 10 and the other 12. 

The 10 possible remainder from formula A:

The 12 possible remainder from formula B:

 Example:
1). Gan and Zhi of March 1^st, 2005

Gan of the day = 〔5(105-1)+((105-1)/4)r+15+(31+28+1)〕/10= 520+26+15+60=621/10=62…1 (the remainder is 1, refers to Jia)

Zhi of the day = 〔5(105-1)+((105-1)/4)r+15+(31+28+1)〕/12=

520+26+15+60=621/12=51…. 9 (the remainder is 9, refers to Shen)
Hence, the Gan and Zhi of March 1^st, 2005 is Jia and Shen.

 2). Gan and Zhi of May 1^st, 2010

Gan of the day:= 5×(110-1)+(110/4)r+15+(31+28+31+30+1)=545+27+15+121=708/10=70….. 8 (the remainder is 8, equals to Xin)

Zhi of the day: =:5×(110-1)+(110/4)r+15+(31+28+31+30+1)=545+27+15+121=708/12=59….0 (the remainder is 0, equals to Hai)
The Gan and Zhi of May 1^st, 2005 is Xin and Hai.

 As how to calculate the Gan and Zhi of the time (shichen), once the Gan and Zhi of the day are known, they are simple to calculate.  There are twelve shichen in a day.  There will be sixty shichen in five days, which equals to the sixty Jia Zhi.  Hence, the sixty shichen restart and circulate in every five days.  If the Zi shi (11:00pm-1:00am) of the Jia day is Jia Zi, then the Hai shi of the Wu day is Qui Hai and the Zi shi of the Ji day will be Jia Zi again.  As long as one knows the Heavenly Stem (Tien Gan) of the day, it is not difficult to calculate the Gan Zhi of the shichen on that day.  The below is the two songs of the starting Shichen of the day.  They help memorization.  One song takes Zi shi as the starting and is called “Wu Zi Jien Yuan Fa” (Five Zi establishing the start). The other takes Yin shi as starting and is called “Wu Hu Jien Yuan Fa” (Five Tiger establishing the start).  The first method is more popular.  It is as follow.

The song of Wu Zi Jien Yuan Fa
Jia Ji start from Jia Zi
Yi Gen start from Bing Zi
Bing Xin start from Wu Zi
Ding Ren start from Gen Zi
Wu Gui start from Ren Zi

That means:
On the days of Jia and Ji: the heavenly stem (Gan) of the Zi shi is Jia
On the days of Yi and Gen: the heavenly stem (Gan) of the Zi shi is Bing
On the days of Bing and Xin: the heavenly stem (Gan) of the Zi shi is Wu
On the days of Ding and Ren: the heavenly stem (Gan) of the Zi shi is Gen
On the days of Wu and Gui,: the heavenly stem (Gan) of the Zhi shi is Ren

The Gan Zhi of the rest shichen can be determined by following the sequence.  For example, the Gan Zhi of the Zi shi on Yi day is Bing Zi, so the Gan Zhi of Chou shi is Ding Chou, and the Gan Zhi of Yin shi is Wu Yin……   Another example, the Gan Zhi of Zi shi on Xin day is Wu zi, and so the Gan Zhi of Chou shi is Ji Chou, and Gan Zhi of Yin shi is Gen Yin, Gan Zhi of Mao shi is Xin Mao; Gan Zhi of Chen shi is Ren Chen…..  The rest follows the pattern.  

Question 6: Some people said “none of the Tung’s extraordinary points is same as any of the fourteen-channel point.  Is this statement true?

 Answer: That is not true.  The person saying so was not fully familiar with both the Tung’s extraordinary points and fourteen-channel points.  And he does not grasp the essence of the Tung’s acupuncture.  Take Quling (33.16) and Chize (LU5) as example.  Although both points are at the same location, due to different methods in locating and needling the points, they have different functions.  Quling (curved mound) is located at the prominence of the crooked elbow.  That is why the point is named “curved mound”.  Although it is located at the same location as Chize (LU5), because of the different methods to locate and insert the points, the functions of the points are different.  According to “Compendium of Acupuncture and Moxibustion” and “Golden Mirror”, the method to locate Chize (LU5) is “in the transverse cubital crease, while bending the elbow, follow the transverse crease, next to the tendons, the point is in the burial ground.”  The emphasis here is the “burial ground”.  He-sea points are mostly located at the sites with abundant flesh or hollow or cave places that collect lots of qi.  Puncture the point from the palmer side toward the dorsal side.  The indications include reversed lung qi, such as asthma and cough.  Because Chize is the son (water) point of the lung (metal) channel, it treats excess syndrome and fire syndrome of the lung channel, such as tonsillitis.  As for Qulin (33.16), the description of its location is “in the crease of the cubital fossa and on the radial side of the tendon…”  When needling this point, insert the needle attached to the tendon to treat various tendon disorders, such as frozen shoulder, elbow-wrist pain, which is the so-called “treat sinews with sinews.” 

Another example, the location of Huochun (33.04) in the original book “Tung’s Acupuncture: Extraordinary Points of the Regular Channels” is “3 cun proximal to the wrist crease on the dorsal side, in the depression in the middle of the tendons between the radius and ulna”.  The location of Zhigou (SJ6) according to the Compendium of Acupuncture and Moxibustion is “3 cun proximal to the dorsal crease of the wrist, in the depression between the radius and ulna bones”.  “Golden Mirror” says: “one cun superior to Waiguan (SJ5), in the depression of the radius and ulna”.  May I ask the difference of the locations between Zhigou (SJ6) and Huochun (33.04)?  “Chun” in Huochun means “to collaborate” or “to thread or string together”.  In Master Tung’s English version of book, the point was translated to “string together”.  The name of Zhigou (SJ6) (Branch Ditch) is named by the topography of the location, while Huochun (33.04) is named by its functions.  

Question 7: What is the holographic standpoint of the five transport points? How to apply the concept to clinic practice?
Answer: In Ling Shu, Jiu Zhen Shi Er Yuan (The Nine Types of Needle and the Twelve Yuan-source Points) says “The twenty seven qi flow and pour into the five transport points…” That means the twelve channels and the fifteen collaterals flow, pour into, exit from and enter to the five transport points.  This indicates that the five transport points are related to the whole body.  In Ling Shu, Guan Neng (According to the Official Ability) says “Understanding the functions of the five transport points, one is able to apply the swift and slow needling techniques according to the excess or deficient conditions of the diseases.  One also is able to recognize how the channel qi flows, and where does it bend, extend, enter and exit.  It follows certain rules.”  This paragraph indicates that mastering the five transport points is the prerequisite of successful clinical practice.  Both quotes reflect the importance of the five transport points.   

The connections of the five transport points and the body parts, and the five-element assignments of the five transport points complete the five transport points to a five-element sub-system.  This sub-system is connected to the five-element sub-system of the Zang Fu organs and together they constitute the holographic standpoint of the five transport points.  The five transport points of each channel are the holographic points of that channel.   Each channel may communicate and act on the respectively related organs through the five elements of the five transport points.

The holographic concept of the five transport points includes the holism, naturalism, and image-numberism.  The naturalism of the five transport points refers to the connections between space-time and the five transport points.  The flowing from shallow to the deep levels and the distribution locations of the five transport points decide the space nature of the five transport points.  For example, the Jing-well points correspond to the head region; Ying-spring points to the facial region; Shu-stream points to the neck or lumbar region (depends on the first or second level correspondence); Jing-river points belong to fire or metal which correspond to lung or heart; He-sea points belong to earth and water which correspond to spleen and kidney.  In addition, those points belong to wood correspond to liver and gallbladder.  Hence, when the diseases are related to the liver or gallbladder, points belong to wood may be chosen.  The rest five-element may be deduced by analogy.  The correspondence includes the five body tissue (skin, vessel, flesh, sinew, and bone) correspondence.  Those points belong to wood are able to treat sinew problems; points belong to fire to treat blood vessels…etc.  I have discussed this part in the previous rounds of the discussion questions.  Here I would omit the details. 

The time nature of the five transport points nurtures the ideology of the “oneness of heaven and humanity”.  The example applications of this concept are such as point selections according to acute (ex. Jing-well points), chronic (ex. Jing-river and He-sea points), or intermittent (Shu-stream points) conditions; and the point selections according to the four seasons a year or four timings a day; Midnight-Noon Ebb-Flow; and the Eight Methods of Magic Turtle.

   March, 2010 (The Tenth Round)
Question 1 : Why in One Needle Therapy Acupuncture only either side of body is needled?
Answer: The following aspects may explain this question.
1. Resonance Effect: In natural phenomena, the unity of opposites between matters is the main body of any exists. For example, up and down; left and right; anterior and posterior.  Channels are divided into Yin and Yang and distributed in the interior and exterior aspects of the Zang Fu organs.  When the acupuncture point of one side of body is needled, the other corresponding point located on the opposite side will generate the being-needled sensation as well.  Hence, for pain or diseases on both sides of body and interior organ diseases, it is fine to needle only one side of body and there is no need to needle both sides of body.  To treat pain, in general, the opposite of the more painful side or the opposite same name channel of the affected channel is selected.  For non-pain diseases, select male’s left side and female’s right side. For example, to treat knee pain of both sides, select the left Neiguan (PC6) and right Taichong (LV3) as a combination, or right PC6 and left LV3.  This type of point selection can reduce the total number of points at least half. 
 
2. Correspondence Balance: The right and left side of channels are not isolated, but mutually influence each other.  They cross and connect as well for retaining the dynamic balance between the upper and lower and left and right sides.  It is well known that it is not the same sides of upper and lower extremities are moving while walking, but the opposite upper and lower extremities are coordinating.  The coordination is retained mainly through the Du meridian.   The connecting vessel of the Du meridian breaks from the main channel at sacrum and coccyx (DU1) and travels upward to the nape and head.  It then travels downward to the scapula to connect to the foot Tai Yang channel and also penetrate into the spinal column (backbone).  The connecting vessel of the Du meridian is the control center to retain the communication between the left and right and up and down.  Needling the opposite point of the affected site will help the body gain the balance back.  For example, needling the lower body when the disease is in the upper body.  Needling the right side of the body when the disease is in the left part of the body.   It is not necessarily to needle both upper and lower or right and left sides.      

Question 2:  Why the effective points in treating the frozen shoulder are mostly located on Tai Yang and Yang Ming channels?
Answer: Tai Yang channels comprise hand Tai Yang small intestine channels and foot Tai Yang bladder channel.  Small intestine channel is closely related to and dominates the motion muscles of the upper limbs.  Hence it is particularly effective in treating pain in this range.  Points of the small intestine channel are very often selected for the impediments of the motor and sensory functions of the upper limbs.  Foot Tai Yang bladder channel rules the “tendons/sinews”, which are the most important parts in the motor function of the body.  Foot Tai Yang channel is often selected to treat various types of pains, tetanus, spasm and numbness due to overstrain.  The above mentioned diseases are related to tendons/sinews.  That is the meaning of “Tai Yang rules the tendons/sinews.”  Hand Yang Ming large intestine channel rules “Jin (body fluid)” related diseases.  Besides, the pathway of the hand Yang Ming channel travels up “the lateral aspect of the upper arm and over the shoulder”; and hence treats “pains of the shoulder and upper arm”.  As the “channel pathways reflect the channel’s indications”, the large intestine channel treats shoulder pain.  And because the hand Yang Ming channel is with abundant qi and blood, it is excellent at regulating qi and blood.

Frozen shoulder is closely related to hand Taiyang small intestine and hand Yangming large intestine channels.  Points selected to treat it are mainly located on those two channels.  The most often prescribed and effective herbal formulas for treating shoulder and neck/nape pain are Ge Gen Tang or Gui Zhi Jia Ge Gen Tang from the Shang Han Lun.  Ge Gen Tang and Gui Zhi Jia Ge Gen Tang are the formulas of Taiyang and Yangming channels.  The herbal prescriptions also support the statement of the first sentence of this paragraph.  To treat the frozen shoulder, other than the primary points on the hand Taiyang and hand Yangming channels, points on the lung, stomach, and spleen channels are often selected too, because the lung channel is the exterior-interior pair of the large intestine channel; the stomach channel is the hand-foot same name Yangming channel; the spleen channel is the pair channel of the small intestine according to the extraordinary connections of the Zang Fu organs.  Other channels or points related to tendons/sinews may be selected too.  Because the frozen shoulder is located on the upper part of the body, it is often to select the hand-foot same name channels, foot Yangming and foot Taiyang channels, to treat it. 

Based on the extraordinary connections of the spleen and small intestine, needling Shenguan (77.18), a point located on the spleen channel in the lower body to treat frozen shoulder is very effective.  Needling Xiajuxu (ST39) (the lower He-sea point of the small intestine channel) to treat the frozen shoulder is very effective too, because it treats both the hand and foot Taiyang and Yangming channels.  Shoulder pain is often treated with Houxi (SI3) too.  Blood-letting Shuanghe (DT.16) points on the back, especially the point corresponding to the Xiaochangshu (BL27), to treat the upper arm pain is also very effective.  ST38 penetrating to BL57 is a common point in treating the frozen shoulder.  ST38 is a point of the foot Yangming channel.  BL57 is a point of the foot Taiyang channel.  Combining both points will regulate both Yangming and Taiyang channels.  One needle connecting two channels; it will regulate qi and blood and sooth sinews and invigorate the collaterals.  Other points also give good results in treating the frozen shoulder, such as LI3 (Dabai (22.04)), LU5, GB34, ST37, SJ3, Sanchasan (A.04) (SJ2), GB21, LI10, BL2, SJ10, SI10, Zhongping point, SJ4, SI16, LI16, LI15, SI9.  (The above is cited from the content of the One Needle Therapy of Young Wei-Chieh.)

Question 3: Why do both Gongsun (SP4) and Menjin (66.05) treat frontal headache and eyelid ptosis?  What are the common mechanisms?
Answer: SP4 is the Lou-connecting point of the spleen channel.  The spleen and the stomach are the interior-exterior related organs.  Hence SP4 is the major point in treating stomach channel disorders.  Personally I most often use SP4 to treat pains located in the supraorbital and nasal bones, and frontal headache as well.  The results are superb.  It stops the pains promptly.  This is because the face and the frontal head belong to Yangming.  Needling one collateral point will treat both interior and exterior channels.  SP4 is also one of the eight confluent points.  It communicates with the Chong meridian.  As “Chong meridian is sea of blood”, SP4 is also effective in treating blood vessel headache.

Frontal headache is also called Yangming headache.  Menjin is located on the posterior to ST43 and attached to the bone (equals to the ancient location of the ST43).  It equals to the Shu-stream (wood) point of the Yangming stomach channel.  As “Shu-stream points govern heavy body sensation and joint pains”, they are the primary points in treating various pains of the respective channels.   ST43 is the wood point of the earth channel. It is very good at coursing the liver and strengthening the spleen, and hence is quite effective in treating the headache caused by qi stagnation and emotional disturbance due to liver depression.  The functions and indications of Menjin is the same as ST43.

The ptosis of the eyelids is related to qi and spleen deficiency.  To treat it, the best selections are points related to both earth and metal.   The ST43 equals to Menjin (door metal) when it is selected by attaching to the bone.  Menjin (door metal) is named so because the “metal” is related to “lung, and large intestine” and qi.  Menjin is on the stomach channel which belongs to earth.  Hence, it treats both the earth and metal, or spleen and lung.  It is also the Shu-stream point.  As “Shu-stream points govern body heaviness and joint pains,” it is very good in treating pains or heavy body sensation and lack of strength.  In addition, it also treats lateral headache located on the Taiyang points.  The point’s location also corresponds to the upper eyelids.  From the perspectives of the channel pathways, five-elements, and correspondence, they all conclude that Menjin is very effective in treating eyelid ptosis.   

SP4 is the luo-connecting point of the spleen channel. Spleen and stomach are the interior and exterior related organs.  Hence it is an essential point in treating various types of spleen and stomach disorders.  Spleen and stomach govern “flesh”.  Needling SP4 treats both spleen and stomach.  SP4 is the superb effective point in treating frontal headache.  It also corresponds to the range of the eyelid level.  From the perspectives of the channel pathways, five-elements or correspondence, they all support that SP4 is very effective in treating eyelid ptosis ad eyelid unable to lift up.

From the perspective of the Taichi holographic correspondence, SP4 and Menjin are located about the same level and correspond to about the same space too.  Both points are also related to spleen and stomach.  Hence they both can treat frontal headache and eyelid ptosis.  (The above is cited from the content of the One Needle Therapy of Young Wei-Chieh.)

Question 4:  How to apply the midnight-noon ebb flow (Zi Wu Liu Zhu) of the Ren and Du meridians to the clinical practice?
Answer: Ren and Du meridians connect into a circle. The ebb flow of their qi and blood circulates to a cycle.  Like the twelve channels, the qi and blood of the Ren and Du meridians change from day to night.  The ebb flow of the meridians also rises and falls from day to night.  There are certain opening points corresponding to certain time periods (shi chen).  There are two popular sayings about the ebb flow of the Ren and Du meridians.     

My personal clinical practice proved that the second saying is more accurate. The opening points of Yin, Mao and Chen time periods are on the back; and Si, Wu, and Wei on the head (refer to the chart).  This corresponds to the “During the Yang time periods, the points located on the Yang regions are opened.”  The opening points of the Shen, You, and Xu time periods are located on the front chest; and Hai, Zi and Chou are in the lower abdomen or lumbus. This matches “During the Yin time periods, the points located on the Yin regions are opened.”

Selecting opening points according to the time periods to treat diseases gives good results.  Combining the ebb flow of the twelve channels to select points give even better results.  For example, to treat lumbar sprain, it is common to needle DU26 combining with SI3 at Wei shi (1-3 pm).  The result is very good and usually it takes only one treatment to cure completely.  It is because the opening point of Wei shi is DU26.  DU26 along is also a very effective empirical point for lumbago.  At Wei shi, the ebb flow of the twelve channel flows to the small intestine channel.  Selecting the Shu-stream point of the small intestine, SI3, along is also a very effective empirical point in treating lumbago.  That is why this combination is outstandingly effective. Let me give another example. A patient with several protruded lumbar disks which caused severe sciatica was under so much pain that his body leaned toward to the right side to form a 45 degree ankle while walking.  He had seen several doctors during the past three years but none of the treatments helped.  I asked the patient come for treatment every other day (three visits a week) at Wei time-period (two o’clock in the afternoon).  The points selected were DU26, SI3 (both sides), BL65 (both sides) and were retained for one hour.  Blood-letting at BL40 was performed every ten days.  The total treatment was twelve visits and total blood-letting treatment was three times.  The entire treatment duration to cure the problem was only 28 days.  The patient could walk normally like ordinary people.  His posture was upright and without slanting to any angle.  Needling DU26 and SI3 at Wei period matched the ebb-flow time-period.  SI3 is also one of the eight confluent points, which communicates with the Du meridian.  The needles were retained for one hour until Shen time period (three o’clock in the afternoon), the time that energy flows to the bladder channel. Bladder channels clasp the spinal column.  The muscle-tendon channel of the bladder channel reaches the spinal column.  BL65 is the Shu-stream point.  Shu-stream points govern heavy body sensation and joint pains.  Blood-letting at BL40 at Shen time period (3-5 o’clock in the afternoon) every ten days amplified the effectiveness several folds.  Those are the reasons that the three-year-old severe sciatica was cured in 4 weeks.

I also often blood-letting at Taiyang point at Si, Wu, and Wei time periods to treat various major diseases and gained pretty good results.  It is because the qi and blood flows to the head region at those time periods (as at Si time period, DU16 is opened; Wu time period, DU20 is opened; Wei time period, DU26 is opened), particularly the Wu time period for the energy is focused at the top of head (DU20).

Question 5: Could you briefly talk about how to apply the point combination of the extraordinary connections of the Zang Fu organs (Zang Fu Bei Tong) to clinical practice?
Answer: Point selections based on Zang Fu Bei Tong is a very practical needling method.  Previous discussions have talked about the point selection from single channel, such as LI 11 on the large intestine channel to treat dizziness or vertigo related to the liver channel; and PC6 on the pericardium channel to treat stomach disorders.  However, the point combinations from mutually connected organs are more important and very often applied to clinical practice.  Examples are as below.

1. Extraordinary connections of lung and urinary bladder: LU5 on the lung channel and BL40 on the bladder channel compose the “four flex pair 四彎配”, which is the most important point combination for blood-letting.  It will treat many miscellaneous and difficult and complex diseases.  Lung channel is good at treating skin disorders while BL40 on the bladder channel is good at treating boil and carbuncles.   Blood-letting on BL40 and Zhiwu (11.26) point (on the lung channel) forms a great combination for various skin diseases.  Those are the effective combination examples of the extraordinary connections of the lung and bladder.

2. Extraordinary connections of the spleen and small intestine: Shenguan (77.18), a point on the spleen channel, and SI3, a point on the small intestine, form the very effective combination for treating the frozen shoulder.  Shenguan and Wanshuanyi (22.08) and Wanshuaner (22.09) form a good combination to expel dampness and effectively treat lumbago.  Those are the examples of the extraordinary connections of the spleen and small intestine.

3. Extraordinary connection of kidney and Sanjiao: Song of Jade Dragon and Ode of Jade Dragon both indicate that SJ6 and KD6 combination is for treating constipation.  Zhongzhu (SJ3) on the Sanjiao channel and Fuliu (KD7) on the kidney channel form a great combination in treating lumbago.  Those are the examples of the extraordinary connection of the kidney and Sanjiao.

4. Extraordinary connection of the heart and gallbladder: Fengshi (GB31) on the gallbladder channel and Shaofu (HT8) on the heart channel form a very good combination in expelling wind and stopping itchiness.  Qiaoyin (GB44) and Shenmen (HT7) form an effective combination on treating insomnia and dreamful sleep.  Those are the examples of the extraordinary connection of the heart and gallbladder.

5. Extraordinary connection of stomach and pericardium: The combination of Neiguan (PC6) and Zusanli (ST36) effectively treats stomach, heart, lung organ diseases, and many internal diseases, for example: digestive, circulation and respiratory system disorders.  The effectiveness is through the extraordinary connection of the pericardium and stomach.  This point combination is the most commonly used one in regulating heart, stomach and respiratory systems.

6. Extraordinary connection of liver and large intestine: The combination of Hegu (LI4) and Taichong (LV3) is called “four gates” which not only good at treating nasal disease (Song of Point Applications for Miscellaneous Disease), but also treats many major diseases.  It is particularly strong at sedating and also is the most commonly used point pair.  Besides, Dajien (11.01), Xiaojien (11.02) and Dadun (LV1) form an effective combination in treating hernia and frontal and posterior yin diseases (genital and anus disorders).  Those are the examples of the extraordinary connection of the liver and large intestine.

Question 6: Why both the small intestine and Sanjiao channels govern the ear diseases?  Why the indications of those two channels are similar?
Answer: Small intestine channel travels toward the head region.  It passes the neck and lateral head, enters the ears and terminates at facial region.  It is effective in treating febrile or blood-congestion diseases in those regions.  It is particularly effective in treating ear diseases.  Needling points of the small intestine will unobstruct the ears and benefit the orifices, mainly treat tinnitus, and weak of hearing.  Points selected for those problems are Tingguon (SI19), Wanshunyi (22.08) and Wanshuner (22.09) or (SI3, and SI4).

Hand Tai Yang governs the “humor (ye)” related disease. The described indications related to the above quote are deafness, yellowing of the eyes, swelling of the cheek, pain in the neck, submandibular region, shoulder, upper arm, elbow and posterior aspect of the forearm.  Several Tung’s extraordinary points that are located on the small intestine channel such as Yenhuang (11.23) (eye yellow) treats yellowish eyes; Wanshuner (22.09) Changmen (33.10) (intestine gate) and Ganmen (33.11 (liver gate) all treat liver diseases (including yellowish eyes).  Wanshunyi and Wanshuner are also essential points for treating tinnitus.

Hand Shao Yang governs the “qi” related diseases. The exterior channel diseases of Sanjiao include deafness, swelling of the throat, throat bi, (abnormal) perspiration, and pain in the outer and inner canthus. Sanjiao channel travels along the upper limb and the lateral head.  Most tinnitus and deafness are caused by qi deficiency or qi obstruction.  Clinically the points of Sanjiao channel are often selected to treat tinnitus and deafness.  For example, Zhongzhu (SJ3) in the fourteen-channels or Zhongbai and Xiabai in Tung’s acupuncture are essential points in treating tinnitus and deafness.  Blood-letting (pricking) Guanchong (SJ1), the Jing-well point of the Sanjiao channel, to treat swollen throat and throat obstruction is very effective.

Sanjiao channel travels along the upper limb toward the upper ankle of the ear (behind the ear), to the cheeks and infraorbital regions. It treats pains located on the frontal head, lateral head, chest, ribs, and upper limbs.  Because Sanjiao channel is yang channel, it mainly treats febrile diseases or blood-congested disorders located in the ears, nose, throat and facial regions.  The indications are similar to those of the large intestine and small intestine channels.   Sanjiao, large intestine, and small intestine channels have many in common.  Sanjiao and small intestine channel are very alike particularly the point locations.  Both channels are fire channels and hold the same position related to the monarch fire and prime minister fire.  Their indications are alike too.

Question 7: Foot Taiyin spleen channel not only is good at treating digestive system diseases, but also good at treating reproductive system diseases located in the lower abdomen.  Why is that?
Answer: Foot Taiyin spleen channels starts at Yinbai (SP1) point, runs along the medial and anterior aspect of the foot.  It continues travels upward to the lower abdomen and intersects with Zhongji (RN3), Guanyuan (RN4) points of the Ren meridian before homing to the spleen and connecting with the stomach.  It then continues upward and passes the lateral ribs and ascends to the side of the esophagus and finally proceeds up to the root of the tongue.

Spleen channel is good at treating reproductive system diseases.  Other than the points around toe tips (ex. Yinbai (SP1)), points between Sanyinjiao (SP6) and Chongmen (SP12) are effective for those diseases.  Xiasanhuang (the lower three emperors) points are effective points for treating reproductive system diseases.

Many gynecological disorders are caused by the spleen deficiency.  Sanyinjiao (SP6) is called “the Sanli ((foot) three miles) of the females” and is similar to Yinlingquan (SP9) that has very broad indications.  Xiehai (SP10) is also called “the sea of blood” and hence treats any blood-related diseases, for example, uterine bleeding and irregular menstruation.  Sanyinjiao (SP6) is believed to effectively treat breech delivery, transverse or oblique lie or any abnormal delivery since ancient.  To treat metrorrhagia, Yinbai (SP1), Diji (SP8) and Sanyinjiao (SP6) are selected to bring the blood back to the spleen.  It can be clearly seen from those examples that foot Taiyin spleen channel is closely related to reproductive organ diseases, especially uterine diseases.  The above mentioned diseases that are treated by Sanyinjio (SP6) can also be treated by Renhuang (77.21) point or Daoma of the Renhuang and Shenguan point for even stronger result. 

Question 8: Sanjiao channel is good at clearing fire. How to apply it to clinical practice?
Answer: Sanjio channel is exterior-interior related to the pericardium channel.  It not only is good at regulating qi, but also clearing heat, especially heat in the upper Jiao (its pathway runs to arm and head).  Clearing Sanjiao fire will benefit the upper orifices, such as Sanchasan (A.04) (Yimen) (SJ2) and Zhongzhu (SJ3) for fire eyes (red, swollen eyes).  To treat tinnitus and deafness, select Sanchasan (Yimen) (SJ2), Zhongbai (22.06) (Zhongzhu SJ3), and Huochan (33.04) (Zigou SJ6).  Select Zhongbai (Zhongzhu SJ3) and Weiguan (SJ5) to treat deaf-mute. To treat sore throat, needle Sanchasan (Yimen SJ2), and Zhongbai (Zhongzhu SJ3).

November, 2009 (the Ninth Round)

1. What is the difference between Tung’s palm diagnosis and other styles of palm diagnosis?

Answer: The Tung’s palm diagnosis was firstly made public in words in the Zhong Yi Yen Jiao (The Researches of the Chinese Medicine) in 1978, volume one.  It was written by my student Dr. Yen Wu-Cun in accordance with my teachings and writings. The content was not exactly same as that currently circulated on the internet.  Mine teachings and writings were the practical information resulted from experimenting, proving, and revising from Master Tung’s original teachings.  In response to many students’ request, I started to teach palm diagnosis in some doctoral programs in the recent years.

Tung’s palm diagnosis is closely related to channels (Jing-Luo).  It is not difficult to learn Tung’s palm diagnosis if one understands well the hand-foot same name channels and the extraordinary connections of the Zhang Fu organs.  The readers may refer to the article “The Discussion on the Tung’s Palm Diagnosis” authored by Dr. Tsai Ming-Zong published in the Symposium of Master Tung’s Extraordinary Points in 1999.  His article has details on the relations between channels and palm diagnosis.  The differences between Tung’s palm diagnosis and others are generally described as follows.

1.          Different Location/Regions Definition: The location definition in general palm diagnosis may accord to the eight trigrams, palmer lines, or other self-defined system.  The Zang Fu locations in Tung’s palm diagnosis are different from those currently populated styles.  In Tung’s palm diagnosis, other than the Zang Fu eight trigrams, the San Jiao locations, including the vertical and horizontal San Jiaos, are even more emphasized. Tung’s palm diagnosis particularly emphasized in the channel localization.  If one understands the same name channel communication, and the extraordinary connections of the Zang Fu organs, he will not have difficulties realizing Tung’s palm diagnosis.    

2.          Different Diagnosis Methods: General palm diagnosis more focuses on the lines, including those major lines such as Heaven line (Love Line), Human line (Wisdom Line)….and minor lines such as vertical, horizontal, island, and obstruction liens, ...etc.  Master Tung also observed the changes of color and luster, and flecks, but he most focused on the blue veins and shadow in every region, and secondly focused on the overall palm color and the temperature, muscle thickness or thinness, and indentation or convex in every region.  For example, the plumpness or concaveness in the range of the trigram Gen-mountain region, or Venus mount, reflects a person’s constitution (vitality) and kidney qi, either strong or weak.  If the muscle along the edge of palm of the Houxi (SI3) area is lack of elasticity or is concave, the diagnosis is kidney qi deficiency.  If the little finger is too short, it is also diagnosed as kidney qi deficiency.    

3.          Different action/purpose: Master Tung often needled in accordance with the veins and the shadows.  For example, the elevated blue veins along the edge of the palm about the Yuji point (LU10), can be diagnosed according to the upper, middle and lower positions to the shoulder or neck and upper back pain.  Needle directly on the site of the elevated veins on the palm can treat the related pains.  This was as a result of the discovery of the Chongzi and Chongxian points.  Also, if the elevated blue veins are around the middle and lower Jiao regions, plus the palm temperature is lower, the diagnosis is Spleen and Kidney Yang deficiency and the treatment is to needle Linggu and Shenguan.  If the palm temperature is high and there are many blue veins, the diagnosis is Liver and Kidney Yin deficiency with exuberant fire. And the treatment is to needle the Shenguan, Renhuang and Huoying points. 

2. How to master and learn Master Tung’s bloodletting technique well?

Answer: All the descendants of the Master Tung know well that the major feature of Master Tung’s treatment is bloodletting technique.  Without the knowledge and the skills to perform the bloodletting technique, one can not call himself a descendant of Master Tung.  The bloodletting technique can be used to judge if the Tung’s students learned the true teachings from the Master.   

First is to master the bleeding technique. The focuses are on the selections of needle tools and the targeted bloodletting sites.  The thicker needle shaft the easier to hold the needle and easier to give strength.  Master Tung called blood-letting technique “Dien Ci (point/dot pricking)”.   The so called Dien Ci (point pricking) is to use a three-edged needle to point on the vein and then prick perpendicularly and speedily on it.  With the needle slightly pressing down on the vein, the blood shall drip out easily.  The most suitable target for blood-pricking is those elevated/floating blue veins. They were felt protruded outward with gentle touch.  When pricking the lower extremities, Master Tung often asked the patient to lie down.  However, some veins float and shown while standing but invisible while lying down, that means those veins are located in the deeper or hidden layers, then the standing position is better than lying position.  In this case, if with lying position, the pricking depth has to be deeper, otherwise the blood won’t come out and also the patient might feel more pain from the pricking.   

It is advisable to first congest the blood at the bleeding site then prick it.  In this case, it is not necessary to squeeze the site for blood, and the blood will naturally flow out and the bleeding volume is also more.  How to congest the blood? For example, when bleeding the Jing-well points, the practitioner can squeeze the finger to make the blood congested at the finger tip and then prick.  With this technique, it is easy to bleed and there will not be much pain.  To bleed on the back, it is easier if the point has been pressed.  Because the back does not show the veins, even with this technique, sometimes the practitioner may need to squeeze or do cupping on the bleeding points to enhance the bleeding.  To bleed at Taiyang point, grasp the collar for a short while to congest the blood at head, and then gently prick the point with a sharpened three-edged needle, the blood should rush out like a spring.  Points located on the elbow and knee crests, such as UB40, LU5, and PC3, are easier to bleed, but if the practitioner presses on the vein before pricking, the blood is easier to flow out and the patient will feel little pain.     

Secondly is to master the points. The essential tip of the point selections of the bleeding technique is “the ability of loosening up and tightening up”.  The so-called “loosening up” means to broaden up.  It is common to bleed all Sihua-zhong, Sihua-xia and Sihua-wai when bleeding the calf.  This will reach the purpose of treating the upper, middle, and lower, the wholeness.  The so-called “tightening up” means to find the most important point among numerous points.  In Tung’s acupuncture, the back points are often in groups.  It will be too numerous if every point is used.  To refine the point selections and to amplify the effect of the major point, it is necessary if the most important point is selected.  For example, the back Sanjin (three-metal) points are bled to treat the knee pain.  The Sanjin (three metal) points equal to Puohu (UB42), Gaohuang (UB43), and Shentang (UB44).  The most commonly used point by Master Tung in treating the knee pain was the Xinxi (heart knee) and Dan (gallbladder) points located on the middle finger, the pericardium channel.  Hence, the major point among the three metal points is the Gaohuang (UB43) that is next to the Jueyinshu (UB14) (the back-shu point of Jueyin).  The upper and lower points, Puohu (UB42) and Shentang (UB43), act as Daoma needles that are to strengthen the major point.  From this I comprehend that Neiguan (PC6) point on the Jueyin channel is very effective in treating knee pain. (PC6 is the Luo-connecting point of the pericardium channel.)  Through the extraordinary connections of the pericardium and stomach, and that the stomach channel passes the knee eye, and that PC6 is located between two tendons, PC6 is very effective in treating the knee pain.    

3. What needs to be paid attention to when conducting the bloodletting therapy?

Answer: One needs to pay attention to the following aspects while conducting bloodletting therapy.

1. Weather: The bleeding volume is more and the result is better in the sunny days than in the rainy and cloudy days, since the blood vessels constrict more in the latter conditions.  In the sunny days of the summer, the yang qi floats outward and the blood vessel elevates upward, and hence it is the best season in a year to conduct the bloodletting therapy to treat the difficult and prolonged or miscellaneous diseases.  Weizhong (UB40), Chize (LU5), and points on the back are easier to bleed in summer than in winter.  Unless treating acute diseases, in the treatment of chronic diseases or pains, it is advisable to bleed the patients in good weather. 

2. Food and Drink: It is not suitable for bloodletting therapy when the patient is too hungry or too full.  Because when the patient is too hungry, the blood is more concentrated and will influence the volume of bleeding.  Do not perform the bloodletting therapy long after the last meal, because over-hunger causes needle fainting easily.  

3. Tools and Techniques: In modern times, the three-edged needles are used one time only (disposable).  The drawback of the disposable (one-time) three edged needle is that the needle-point is not sharp enough and the three blades (edges) are quite rough.  Also, because the needle is plated, it needs to be sharpened by sandpaper to be sharp enough. Once the tip of a three-edged needle and the three blades (edges) are sharp, then only gently prick the skin will cause bleeding.  That is why it is important to check the needle tip and its three edges before bloodletting.

        In bloodletting, simply pricking directly on the blue veins will cause bleeding.  Once bleeding, the patient instead does not feel pain.  If the blood does not come out, then the patient will feel pain.  In this case, prick another closely surrounding vein, and the blood shall flow out.  The theory is the same as punching two holes on the milk can to make the milk flow out.

4. Congesting blood at the point site: refer to question two, the technique.

5. Time: If bloodletting therapy is performed in coordinate with time, bleeding volume will be more and the result will be better.  For example, when bleeding at Taiyang point, the result is best if it is performed in a good weather at eleven o’clock in the morning or at a time close to noon when the yang qi flows more on the upper part of the body.  Bleeding to treat lumbago or spinal bone spur, the better time is in the afternoon.  It is at Wei time period (1pm-3pm) when the qi flows to hand Taiyang small intestine channel; and Shen time period (3pm-5pm) to foot Taiyang urinary bladder channel.  Hand and foot Taiyang channels travel to the back of the body, and hence it will be more effective to operate the bloodletting technique to treat sciatica or hemorrhoids during these two time periods.  As far as bleeding at Shaoyang (LU11) and other Jing-well points, it is not much relevant to time.  Because there are no blue veins at those locations, and they are commonly used for emergency, anytime is fine to bleed those points.   

4. When bleeding at the inner cheek, which side shall be chosen?  Some say the affected side, and some say the healthy side. What is your opinion?

Answer: Either affected or healthy side can be chosen when treating Bell’s palsy (mouth and eye deviation).  As the liver channel circulates around the inner mouth, bloodletting on either healthy or affected side works effectively since both are close to the channel.  However, the result is better if bloodletting on the affected side.  It is not necessary to search for the blue vein when bloodletting the oral cavity.  Request the patient to open the mouth widely and prick on the membranes on the center of the side of the oral cavity.  Seven or eight drops of blood are fairly enough.  After the pricking, ask the patient to rinse the mouth with salty water which will sterilize the wound and at the same time enhance the muscle tone.  That will increase the effectiveness.  Bloodletting at the side of the oral cavity is the best method to treat facial nerve paralysis.

5. Could you talk about the reasons the Heart opens into the orifices of the ears, and how that relates to bloodletting therapy and acupuncture?

Answer: The quote of the Heart opens to the ears is from Suwen, chapter four Jin Gui Zhen Yen Lun: “the color of the south is red, and enters into and communicate with the heart which opens into the orifice of the ears…” Wang Bing’s annotation was “the tongue is the official of the heart, the tongue is for speech, the tongue is not an orifice, and hence the ears are the orifice (of the heart)”.  Zhang Jing Yue said “the root of the tongue belongs to the heart; but the ears belong to both heart and kidney.”  They both agreed the relation between the heart and the ear orifices.   

Because most yin channels do not travel to the head, the five viscera opening to the orifices on the face are in fact through their interior-exterior related yang channels. The kidney opening to the orifice ears is through the bladder channel which travels to and opens in the orifice ears.  The heart channel, through its interior-exterior relation with the small intestine channel which enters into the ears, relates to the ears too. 

There are quite a few ear disorders that are related to the heart.  For example, the coronary heart groove on the earlobe is often used to assist the diagnosis of the coronary heart disease. Commonly seen tinnitus, and deafness are often related to the heart.  For example, insomnia, hypertension, and anemia that accompany with tinnitus are more effectively treated if the heart is treated.

   In Shang Han Lun, it says “Before the doctor feels the pulse, the patient presses his chest with interlaced fingers.  When the doctor instructs him to cough, he fails to do it accordingly. He must be deaf. A great deficiency after profuse or repeatedly perspiration has caused the deafness.”  It is effectively treated by Gui Zhi Gan Cao Tang which warms the heart yang.  I often use modified Xiao Cai Hu Tang to treat ear disorders.  One is because the gallbladder channel circulates and enters the ears; and another reason is based on the extraordinary connection of the heart and gallbladder.  I also often select Fengshi (GB31) to treat the deafness, tinnitus and insomnia due to heart yang deficiency.  The result is very good.  The reason is also based on the extraordinary connection of the heart and gall bladder.

I also often prick the ear apex to bleed to treat profuse sweating. The result is very good as the heart governs the sweat.  Pricking to bleed to treat insomnia is also very effective as the heart governs the spirit.  Pricking to bleed to treat skin disorders is also very effective.  As the urinary bladder travels to the ears, and the Taiyang governs the exterior; Shaoyang gallbladder channel circulates around the ears; and Shaoyang governs the wind, but so does the “all sores, pains, and itchiness belong to the heart”. 

6. Does the location of the extraordinary point Huofuhai (33.07) match that of the Shousanli (LI10)?  Do the point name and the location have any special implication or meaning to the treatment?  

Answer: From the direct perspective (view) the Huofuhai point does not fall on the location of the Shousanli (LI10).  But it does overlaps onto the Shousanli (LI10) with its particular way of locating the point.  Its indications and functions listed in Master Tung’s book also match those of the Shousanli (LI10).  “Huofu”, literally “fire fu-viscera”, indicates Sanjiao fu-viscera.  The point is defined on the Sanjiao channel, but is located with the arm twisted and then falls onto the Large Intestine channel and matches the Shousanli point.  Master Tung’s original book lists that its major indication is to supplement or tonify, and functions same as Zusanli (ST36) if moxibustion is performed.  The point is located at the region with abundant and thick muscles and hence is named “Hai (sea).”  Master Tung’s book indicates the location of the point as “the flesh bulges when pressure is applied, at the border of the protuberant flesh (of the radius.)”  The “flesh bugles” indicates that the abundance of the flesh on the location.  The site with abundant flesh will be able to treat spleen-stomach related disorders, and functions to supplementing qi. “The border of the protuberant flesh” indicates the point is related to sinew.  The differences between the sinew and flesh have been explained in details in the Advanced Tung’s Acupuncture Seminar.  They are involved with the applications and elucidations of the five-body-tissue needling method (Body Correspondence Needling Method). Here I would point out some key points. First, Jin is the flesh that can generate strength.  According to the explanation in Shuo Wen Jie Zi (Explaining Simple and Analyzing Compound Character), it says Ji is Roe (flesh).  As for Jin, it says Jin is the strength of Roe (flesh). Secondly, Jin (sinew) is the stripe-shaped flesh, for example, Zhenjin (77.01) and Zhenzhong (77.02) points. Thirdly, Jin (sinew) refers to the particularly bulged muscle/flesh. Juong Roe refers to the particularly bulged big muscle. For example, deltoid muscle, triceps brachii, gastrocnemius, those chunky shaped muscles belong to this category.  Huofuhai point is located on the border of the protuberant flesh, a particularly bulged flesh.  Hence, it is able to treat tendon/sinew related disorders according the “sinew treats sinew.”  And in fact it treats both sinew/tendon and flesh simultaneously.  It is superb effective in treating tennis elbow if combined with posterior Quchi (posterior LI11) which treats bone particularly.  Besides, Huofuhai point although is defined on the San Jiao channel, instead it is located on the large intestine channel.  Hence, it treats both Shaoyang (Sanjiao) and Yangming (large intestine) simultaneously.  Yangming channels are with abundant qi and blood; and hence this point is very good at regulating qi and blood.   

7. Both Muhuo point and the Daoma of Linggu and Dabai treat the sequela of stroke.  What are the common reasons?

Answer: Stroke is closely related to wind (wood) and phlegm (fire).  There are only two yin channels that travel to the head, which are wood (liver) and fire (heart) channels.  Liver wind (wood) and phlegm fire (fire) are two main reasons of wind stroke.  Wood fire channels and wood fire points are best selections for treating wind stroke and its sequela.

Muhuo (wood fire) point is named because first it is on the fire (pericardium) channel, and located closely to the Jing-well wood point. Another reason is that the point is located in between the Jing-well (wood) and Ying-spring (fire) points on the pericardium.  Muhuo point is located closely to the Zhongchong (PC1) point and has the functions to strengthen the heart and invigorate the blood.  It also strengthens and enhances other points that are used to treat the sequela of the stroke.  Supplementing wood fire or Muhuo has the effect of warming the yang (for the same reason, supplementing the mental and water (Jingshui) equals nourishing the yin).  This is similar to that prescribing the Bu Yang Huan Wu Tang and Zhen Wu Tang to treat the stroke or its sequela.

Dabai and Linggu points are also between wood and fire points.  Dabai is closely attached to the Sanjien (LI3) point, and has same attributes or nature as those of Sanjien (LI3) point.  Linggu point is between Hegu (LI4) (belongs to wood) and Yangxi (LI5) (belongs to fire) points.  It is located in between the wood and fire and bears the natures of the two elements.  Another explanation is that Linggu is located closely to the Yangxi (belongs to fire) and has the nature of the fire element.  In this case, Dabai belongs to wood while Linggu to fire.  Using both of them is as supplementing the wood and fire, and hence creates the effect of warming the yang.  Its function is like using the Bu Yang Huan Wu Tang and Zhen Wu Tang to treat the hemiplegia.

Muhuo point and Dabai-Linggu points both have the natures of the wood and fire and hence can treat wood-fire related diseases such as the sequela of the stroke.  Muhuo point is located closely to the Jing-well point and hence can open the brain orifice.  Linggu and Dabai are needled closely attached to the bone which corresponds to the kidney and communicates with the brain and hence can dredge and invigorate the qi and blood of the brain.  However, Muhuo point is located in between the Jing-well and Ying-spring points and hence is more suitable for newly developed diseases and is not suitable for long needle retention.  Dabai point is the Shu-stream point while Linggu is in between the Yuan-source point (Hegu LI4) and Jing-river point (Yangxi LI5), and both of them are needled attached to the bone; hence they are suitable for both newly-developed and chronic diseases and also are suitable for long needle retention.  (back to page top)
　

June, 2009 (The Eighth Round)

Question 1: You have mentioned that Qichi (LI11) and Neiguan (PC6) are effective in treating dizziness or vertigo.  Could you please give more details on your experience and their mechanisms?

Answer: Here I would like to give further explanation on my highly effective experience and the mechanisms.

1. The reasons of selecting Quchi (LI11) to treat dizziness/vertigo: Vertigo or dizziness is related to “wind” in Chinese medicine.  In Neijing, it is said “All kinds of wind, shaking, and vertigo syndromes belong to Liver.” Through the extraordinary connections of Liver and Large Intestine, it is effective in treating dizziness or vertigo by Quchi (LI11), Sanjien (LI3) or Linggu (22.05) point. Quchi (LI11) is the He-sea point of large intestine channel.  As He-sea points govern counter-flow qi and diarrhea; and according to Suwen, chapter Needling Method (Ci Fa Lun): “To descend wood, needle the point that Yangming channel enters”, which refers to Quchi point.  Quchi (LI11) is located on Yangming channel, which is abundant with qi and blood, and has strong effect in regulating qi and blood.  Hence, no matter the dizziness or vertigo is caused by Liver Yang hyperactivity, or Liver blood deficiency or Meniere’s syndrome, Quchi can treat all of them effectively.  Another explanation that is according to the Holographic correspondence is that Quchi (LI11) located on the starting of the forearm where corresponds to the head and hence treats the head.

2. The reasons of selecting Neiguan (PC6) to treat dizziness or vertigo: Hand Jueyin and foot Jueyin are same name channels and communicate with each other.  Selecting points on hand Jueyin channel to treat liver-wind diseases of foot Jueyin is effective in general.  Besides, hand Jueyin channel (Pericardium) and foot Yangming (Stomach) channel are related through the extraordinary connections.  Hence points of hand Jueyin (pericardium) channel are particularly effective in treating Stomach channel diseases.  Concluding the above reasons, needling Neiguan (PC6), the point good at enhancing qi and resolving phlegm, to treat dizziness or vertigo with vomiting or nausea is very effective.  That is why Neiguan (PC6) is the superb effective and common point in treating Meinere’s syndrome (vertigo with nausea and vomiting).  During my decades of clinical practice, I treated more than one hundred cases of Meinere’s syndrome with Quchi (LI11) and Neiguan (PC6) and all received instant result. Some vertigo patients with vomiting or nausea were so severe that they need someone to support them.  After the treatment, they could go home happily without assisting.  (The above is cited from Dr. Young Wei-chieh’s “Young Wei-chieh One Needle therapy.  The Korean version of this book will be published the fourth time this year.)

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

Answer: 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.
　

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

Answer: 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. 

Question 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?

Answer:

1.  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. 

2.  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.  

3. 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.

4. 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.

5. 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. 

　

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

Answer: 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.
　

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

Answer: 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 64^th 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.

Question 7: Why He-sea points treat zang fu organ diseases?  In Tung’s extraordinary points, how are those points that can treat zang fu organ diseases related to He-sea points?

Answer: In Lingshu, chapter 19 Si Shi Qi (Needling methods according to the four seasons): “if the pathogen (disease) is in the fu organs, select the He-sea points.”  In Suwen, chapter 38 Ke Lun (On cough): “to treat the cough of the zang organs, needle the Shu-stream points; to treat the cough of the fu organs, needle the He-sea points.”  Those statements indicate that the diseases of the six fu organs can be treated by He-sea points.  In Lingshu, chapter 4 Xie Qi Zang Fu Binjg Xing (The visceral diseases caused by evil qi): “…..how to treat the diseases of the internal fu organs? Qibo said: the He-sea points should be selected.” “Ying-spring and Shu-stream points treat the external channels; He-sea points treat internal fu organs.”

        The distribution of the five-shu points defines the point’s treatment scope which also relates to the point’s space and time natures.  The general idea of the above quotes is that Ying-sping and Shu-stream points are more suitable for treating body surface and channel disorders of the respective channel.  He-sea points are more suitable for treating internal body disorders of the six Fu organs.  Ying-spring and Shu-stream points are located at distal extremities where the channel qi is shallow and near the surface.  Hence, they are good at treating body surface (including external channel) disorders and five-sense organ disorders of the respective channel.  He-sea points are located closer to the body trunk than Ying-spring and Shu-stream points.  They are located around elbow and knee joints where the channel qi gathers together as one hundred rivers meet before pouring into the sea.  The surrounding of the He-sea points is thick muscle and tendons, and hence the channel qi is deep and abundant.  It is easier for those points to have needle sensations (gain the qi).  As the channel qi of those points are more abundant and travel deeper to the zang fu organs, they are good at treating zang fu organ disorders.   He-sea points are also good at treating prolonged or chronic diseases as the saying in Chinese medicine “prolonged diseases enter the fu organ.”  He-sea points are good at treating prolonged or chronic zang fu disorders.  Ying-spring and Shu-stream points are good at treating external contracted, newly developed, intermittent aggravation and amelioration, or half-deep/half shallow disorders.  Those point selection principles guide the clinical practice.

The so-called “He-sea points treat fu organ disorders” includes non-spiritual/will disorders.  (“When the disease is at the Zang (viscera), select the jing-well point.” Jing-well points treat spiritual and will/emotional or mental (Shen Zhi) disorders. ) He-sea points of yin channels belong to water and dominate pre-natal source qi and kidney qi.  They can supplement the deficiency of kidney water.  He-sea points of yang channel belong to earth and dominate middle qi or spleen qi.  They can supplement the deficiency of spleen and stomach.

        Because He-sea points are located around elbow and knee joints where the muscle and tendon tissues are thick, and comprise more channel or vessel qi; besides, they are closer to the body trunk than Ying-spring and Shu-stream points, they are good at treating zang fu disorders.  Hence, several point groups of the Tung’s extraordinary points are specialized in treating zang fu organ diseases, such as Sima three points (88.17, 88.18, 88.19) treat lung; Tungguan Tungshan Tungtien (88.01, 88.02, 88.03) treat heart; Tungshen Tongwei Tongbei (88.10, 88.11, 88.12); Tienhuang Minghuang Qihuang (88.13, 88.12, 88.14) treat liver.  They all are located on the thigh, superior to the He-sea points. As those locations are with abundant muscles, the channel qi is deeper and it is easier for those points to gain the qi.  Besides, they are located closer to the body trunk and hence are good at treating zang fu diseases.

        Also, the twelve divergent channels depart at elbow and knee areas (here they communicate with the five-shu points) and continue to travel toward to the heart.  This is another reason those point groups of treating major zang fu organ disorders in Tung’s points are allocated on the thighs, superior to the elbows and knees.  The “depart, enter, leave, reunite” of the 12 divergent channels complement the circulation inadequacy of the twelve regular channels.  For example, foot Shaoyang gall bladder channel does not travel to the heart, but because its divergent channel pass through the heart, the evidence of the extraordinary connections of heart and gall bladder is further proved.  The major points for treating spleen and stomach zang fu diseases Xiasanhuang (lower three emperors) three points are located on the calf, because the lower He-sea points of stomach, large intestine and small intestine are on the calf too. The three point groups for treating lung, heart, and kidney diseases are located between the stomach and spleen channels.  This also shows that in Tung’s acupuncture, the theory of the spleen and stomach is emphasized.

Question 8:  What is the theory and the specific usage of the needling method based on the mutual communication of the hand foot same name channels?

Answer: The point selection method of the same name channels is also called the needling method based on the mutual communication of the six channels.  It is developed from the point selection method of channel connection, and is a type of channel therapy.  The so called mutual communication of the six channels is hand Taiyin communicates with foot Taiyin; hand Yangming communicates with foot Yangming; hand Taiyang communicates with foot Taiyang; hand Jueyin communicates with foot Jueyin, hand Shaoyang communicates with foot Shaoyang.

        The point selection method based on “hand foot same name channels” is related to “Open-Pivot-Close” too.  Both hand and foot Taiyang govern Open and have unified movement rhythm and similar nature; both hand and foot Shaoyang govern Pivot and have unified movement rhythm and similar nature too.  Hand and foot same name channels have the unified movement rhythm and similar nature; hence their functions are interchangeable and this is called “mutual communication of the same name channels”.

There are communicating pathways between the “mutual communications of the same name channels.” For example hand and foot Taiyin channels are connected at Zhongfu (LU1) point; hand and foot Yangming channels at Yingxiang (LI20) point; hand and foot Shaoyin channels in the heart; hand and foot Taiyang channels at Qingming (UB1); hand and foot Jueyin channels at Tienchi (PC1); hand and foot Shaoyang channels at Tungziliao (GB1). 

The application of the “mutual communication of same name channels” is written in details in my writings of Zhen Jiao Bao Dien (Treasures on Acupuncture) and Lectures on Tung’s Acupuncture: Therapeutic System.  Here I would only give a brief summary.  The methods are as follows.

1. Mutual treatment of the same name channels: Usually the point of the opposite side channel is selected.  This method is more suitable for four extremity disorder.  The upper left side treats the lower right side; upper right side treats the lower left side; lower left side treat upper right side; lower right side treat upper left side.  For example, when the disease site is at the Jing-well point Shaoshang (LU1) of hand Taiyin channel, the Jing-well point of foot Taiyin channel Yinbai (SP1) is needled.  If the disease is at Shaofu (HT8), the Ying-sping point of hand Shaoyin channel, Rangu (KD2), the Ying-spring point of foot Shaoyin channel is needled.  The rest channel may be deduced by analogy.  This method does not rigidly adhere to acupuncture points.  For example, pain on the site of Chengshan (UB58) can be treated by needling the middle point of the opposite forearm on the hand Taiyang channel.  Although there is no acupuncture point on that specific location, the disorder can still be treated.  This method is mostly used for treating four extremity disorders, but can still be used for disorder on the body trunk.  For example, to treat the pain on the area of Shufu (KD27), moxibustion on Shaohai (HT3) and Shenmen (HT8) will resolve the pain instantly.

           2. Combination of the Hand and foot same name channels: the combination method is often seen on the ancient odes.  Let’s take several examples from “Ode of One Hundred Symptoms”.  For example, “deafness due to qi obstruction relies on Tinghui (GB2) and Yifeng (SJ17).”  Tinghui (GB2) is on gall bladder channel; and Yifeng (SJ17) on San Jiao channel.  This is an example of point combination of hand and foot same name (Shaoyang) channels.  Another example, “weary speech and somnolence are indicated in Tongli (HT5) and Dazhong (KD4).” Tongli (HT5) is a point of heart channel; and Dazhong (KD4) of kidney channel.  This is an example of point combination of hand and foot same name (Shaoyin) channels.  Also, “excrescence creeping over the eye, Ganshu (UB18) and Shaoze (SI1) are the points to attack.” Ganshu (UB18) is on the urinary bladder channel; Shaoze (SI1) on small intestine channel.  This is an example of hand foot same name (Taiyang) channels.   Besides, on Ode of Xi Hong: “heat disease but no sweat, Dadu (SP2) connects with Jingqu (LU8).” This is an example of hand and foot same name (Taiyin) channels. “Hand and foot/upper and lower Sanli (LI10 and ST36), food and qi stagnation should select them.”  This is an example of point combination of hand and foot same name (Yangming) channels.  Houxi (SI3), a point of hand Taiyang, and Shugu (UB65), a point of foot Taiyang, are good for neck pain and lumbar pain.  The ancient and contemporary examples are so numerous and can not be listed one by one.  Point combination of both hand and foot same name channels is a very practical method.

3. Mutual replacement of points of hand and foot same name channels:  Points on the holographically corresponding locations have similar functions and can be replaced by the other.  For example, Gongsun (SP4) can treat deficient cold of the spleen and stomach and indigestion.  The holographically corresponding point Yuji (LU10) can be used to treat deficient cold of the spleen and stomach and indigestion, too.  Zulinqi (GB41) can treat the ache circulated the waist. The holographically corresponding point Zhongzhu (SJ3) can be used for the same purpose.  Xuanzhong (GB39) can treat Louzhen (neck sprained).  The holographically corresponding point Waiguan (SJ5) can treat sprained neck too.  Shugu (UB65), a point of foot Taiyang channel, can treat neck and lumbar pain.  The holographically corresponding point Houxi (SI3), a point of hand Taiyang channel, can treat the same problem.  Zhiyin (UB67) can correct abnormal fetal position, a gynecological disorder.  Shaoze (SI1) also can treat gynecological disorder such as insufficient lactation. (back to page top)

April 2009(The Seventh Round)

Question 1 : Why Shu-stream points treat heavy body sensation and joint pains?

Answer: Shu-stream points all can treat heavy body sensation and joint pains (Shu-stream points govern heavy body and joint pains.)  Shu-stream points of Yang channels belong to wood, which dominates wind and corresponds to tendon.  Shu-stream points of Yin channels belong to earth, which dominates dampness and corresponds to flesh (muscle).  Heavy body sensation mostly relates to dampness; while joint pains to wind or dampness.  That is why wind-dampness related diseases and tendon-muscular pains are often treated with Shu-stream points.  Shu-stream points have the function to enhance qi and resolve dampness and hence are good at treating swelling and fullness, fatigue and sluggish, diarrhea, and pains. Shu-stream points are good at treating wind-dampness related diseases and hence heavy body sensation and joint pains. Shu-stream points are most often used in treating the pains in their respectively channels.  Besides, heavy body sensation and joint pains are often the results from either surplus dampness or deficient qi of earth.  Select Shu-stream point of Yin channels which belong to earth to supplement the deficient earth; select Shu-stream points of Yang channels which belong to wood to restrain earth’s surplus dampness and/or dredge the exuberant dampness pathogen.  That is why Shu-stream points all can treat heavy body sensation and joint pains.  Meanwhile, wood corresponds to liver; earth to spleen.  Pains that are often aggravated by emotional or liver-spleen disharmony are effectively treated by related Shu-stream points. Because wood dominates wind whose nature is impatient (acute), Shu-stream points of Yang channels, which belong to wood, are more often used to treat newly developed pains.  Earth dominates dampness, whose nature is slow and lingering, hence Shu-stream points of Yin channels are more often used to treat chronic or prolonged pains.
　

In my clinical practice, I often select the Shu-stream point of one channel to treat it’s respectively channel pain and the result is very satisfied. For example, select Shugu (UB65) to treat headache particular vertex headache, lumbar pain, neck pain, and sciatica distributed along Tai Yang channel; Xiengu (ST43) to treat frontal headache; Linqi (GB41) to treat temple headache, lateral lumbar pain and those pains located along Shao Yang channel.  The results are very good and they are all Shu-stream points.

Question 2 : Why Jing-river points can treat panting, coughing, cold and heat sensation?

Answer: Jing-river points all can treat panting, coughing, cold and heat sensations (Jing-river points dominate panting, coughing, cold and heat.)  Jing-river points of Zang organs (yin channels) belong to metal, which is related to voicing, correspond to Lung, which is related to wind cold. Panting and coughing are diseases related to voicing. Jing-river points are effective in treating diseases resulting in abnormal voicing. Panting, coughing, cold and heat sensations refer to wind-cold or wind-heat panting and coughing.  Jing-river points of Yin channels belong to metal and needle them with enhancing technique will assist in restraining its counter-control (fire) to treat wind-heat. Jing-river points of Yang channels belong to fire and needle them will treat wind-cold.  These are the reasons why Jing-river points all can treat panting, coughing, cold and heat.  Jing-river points of Yin channels dominate more on the panting and coughing and hence are mainly for internal injuries.  Jing-river points of Yang channels dominate more on cold and heat sensations, and hence are mainly for external contracted diseases.
　

For example, needle Jing-river point of Lung channel, Jingqu (LU8), will treat panting and coughing because this point has the function to regulate respiratory organs.  Kunlun (UB60), the Jing-river point of Bladder channel, can sedate panting (asthma) (Ode of Meticulous Light) and toothache (the Golden Mirror). Fuliu (KI6), Jing-river point of Kidney channel, also can sedate panting.  Jienshi (PC5) can treat loss of voice, hiccup, panting and coughing.  Those examples prove that this quote truly is valuable in clinical practice.
　

Question 3 : Why He-sea points all can treat counter-flow qi and diarrhea?

Answer: He-sea points all can treat counter-flow qi and diarrhea (He-sea points dominate counter-flow qi and diarrhea).  He-sea points treat Fu organ diseases.  He-sea points of Yang channels belong to earth, which dominates the post-natal foundation; while He-sea points of Yin channels belong to water, which dominates the pre-natal foundation.  Those points all can treat counter-flow qi and diarrhea.  The deficiency of Kidney water, pre-natal qi, will result in qi counter flow upward or rush downward (diarrhea).  Needle He-sea points of Yin channels, which belong to water, will regulate the pre-natal Yuan (source) qi and Kidney qi in order to supplement the deficiency of Kidney water to sedate the counter-flow qi.  Needle He-sea points of Yang channels, which belong to earth and dominate middle qi or Spleen qi, will supplement the deficiency of middle qi in order to treat deficient type asthma and stop the diarrhea caused by overabundant water qi.  Therefore, He-sea points all dominate counter-flow qi and diarrhea.
　

Every Zang Fu organ has its diseases caused by counter-flow qi.  Liver qi counter-flow results in Liver Yang hyperactivity; Lung qi in asthma and cough; Stomach qi in constipation and nausea and vomiting; Spleen qi in dry retching and abdominal distension; Kidney qi in difficulty in urination… etc.  They all can be treated by He-sea point of the respectively channel.  He-sea points have the functions to enhance channel qi, regulate the physiological activities of the internal organs, strengthen Spleen and Stomach, support the righteous qi and cultivate the source. He-sea points are good at treating rebellious qi, distension and stuffy sensation, diarrhea, etc. They are particularly effective in treating disorders resulting from irregular eating and drinking.  In clinical practice, Chizi (LU5) is often used to treat asthma (Ode of Miraculous Light), Zusanli (ST36) to treat abdominal distension, vomiting (Great Compendium; Song of Point Applications for Miscellaneous Disease; Ode of a Hundred Patterns) , sedating asthma (Ode of Xi Hong; Song of the Jade Dragon; Song of Point Applications for Miscellaneous Diseases; Song of Essentials of Needle Practice); Yinlingquen (SP9) to treat fullness of heart, chest, abdomen and hypochondria (Ode of Xi Hong; Golden Mirror).  Also Quchi (LI11), the He-sea point of Large Intestine, and Yanglingquen (GB34), the He-sea point of Gall Bladder, are used to treat hypertension due to Liver Yang hyperactivity and give good result. To treat diarrhea, Quchi (LI11), ST36, or SP9 gives remarkable result.  The quote “He-sea points dominate counter flow qi and diarrhea” truly makes sense.

Question 4: Tushui (earth water) and Shuijin (water metal) points, both Tung extraordinary points, are named with the Five Elements/Phases. What special meanings do the names carry, and how do they relate to the treatments?

Answer: Since Tushui is named with earth and water, it certainly has the function to treat earth (Spleen and Stomach) and water (Kidney) related disorders.  And since it is located on the Lung channel, its relationship with the metal must be considered too. So in fact this point treats earth, metal, and water related disorders, which are numerous. 
　

Why was this point named Tushui (earth water)?  One reason is the consideration of the point functions.  But more importantly it is because the point is located between the trigrams Gen and Kan palaces according to palm trigram chart.  Gen pertains to earth while Kan to water.  Hence the point was named Earth Water (Tushui). Since Tushui is located on Lung (metal) channel, it may be considered an Earth Metal Water (Tujinshui) point.

Why was another point named Shuijin (water metal)?  One reason is due to the consideration of point functions.  Another reason is also the considerations of Yi Jing  (Theoy of Changes) theory and trigram images.  Shujin point is located on face between trigram Qien and trigram Kan.  Trigram Kan pertains to water while trigram Qien to metal. Hence the point was named Water Metal (Shuijin).  This point also is located on the pathways of Large Intestine and Stomach channels.  Large Intestine channel belong to metal; Stomach channel to earth.  Hence this point may be considered as an Earth Metal Water (Tujinshui) point, too.

Both points are considered Earth Metal Water (Tujinshui) point and both carry strong regulating qi function, and hence both are effective points in treating asthma and cough.

Question 5: How do frequency of treatment sessions and treatment time relate to therapeutic effectiveness?

Answer: The relationships between acupuncture treatment time and frequency and therapeutic effectiveness may be considered from the following aspects.

(1)Total treatment time/length.  This depends on the length of the diseases and the constitutions of patients.  The earlier the treatments start, the shorter the total time is needed, and vice versa.  For instance, Lou Zhen (neck sprain), lumbar sprain and other types of traumas usually take one visit to cure if patient visits the acupuncture clinic on the same day of onset.  They may take two or three treatments to cure if patient visits the clinic several days after the onset.  The treatment length of acute or newly developed disorders generally is shorter than chronic and prolonged disorders, though there may be exceptions.  Generally, functional disorders take shorter time to see the result or cure than substantial disorders.

(2)Time intervals between treatment sessions: In general, continuous stimulus gives stronger effect.  If being treated early and continuously, the disorders usually will be cured in short time without combining herbal treatment.  Nowadays, most patients visit the clinic once a week.  In this case, even combining with herbal treatment, the diseases are taking longer to see results or cure.  Let’s take Bell’s palsy patients as example.  If they receive acupuncture treatments immediately after the onset and continuously everyday, most of them will be cured in five or six days without taking herbs.  In the winter of the year 1994, I got Bell’s palsy.  I received acupuncture treatments twice a day and was cured in only four days.  If patients receive acupuncture treatment twice a week, even they take herbs simultaneously, they might still take four to six weeks to cure.  Another example is severe pain caused by disorders such as trigeminal neuralgia.  The treatments should be just like extinguishing fire with water, continuously, non-stop until the fire is put off.  Otherwise, the pain stops or lessens after the treatment but will flare up two days later. Continuous acupuncture treatments will put off the fire and extinguish the wind in one vigorous effort.  The disorder so can be cured in a short time and without reoccurrence.   In the chapter Zhong Shi (Termination and Beginning) of Ling Shu: “after evaluating the pulse, the treatment frequency might be once a day, every two days, or twice day.”  According to experience, most disorders benefit more by treatments performed every other day.

Besides, due to the constitutions of small kids, it is said “needling little kids like putting one’s hand into hot soup (without retention), and it is fine to needle more than once a day.”  Small children don’t need deep puncture because their muscle and skin are shallow.  Because they won’t stay still for needle retention, needling them more than once a day will compensate the insufficiency results from shallow and brief needling.

(3)The best time to perform acupuncture treatment.   The acupuncture result will be better if the treatment is performed at a time in accordance with the channels and waning and waxing of qi and blood related to the disorders.  For instance, bloodletting Taiyang point can treat multiple disorders and is better performed in the morning since qi and blood circulates in the upper.  To treat insomnia by pricking at ear apex for several drops of blood, the best time will be in the afternoon when yang is about to enter Yin.  To treat lumbar pain, the best time is in the afternoon around Shen (1-3pm) and Wei (3-5pm), when qi and blood circulate Hand and Foot Taiyang.   Other methods for selecting the best time for treatment are such as according to the flow and ebb of channels, waxing and waning of qi and blood, and biological clocks.  They all will enhance the treatment effectiveness.
　

Question 6: What are the relationships between open-close-pivot and the Zang Fu organs and channels?

Answer: Open-close-pivot not only closely relates to the extraordinary connections of Zang Fu, but also decides the running sequences of channels.  Among the three Yin and three yang channels, Taiyin and Taiyang pertain to Open and hence are located the outmost. That is to say channels including Hand and Foot Taiyang, or Small Intestine and Urinary Bladder channels; and Hand and Foot TaiYin, or Lung and Spleen channels, are the Open.  When the pathogen cold attacks human body, it affects yang first and that will be the most outer yang, Taiyang.   Cold is a type of Yin pathogens and tends to affect the lower body, and hence it will affect Foot Taiyang first.  This is why in Shang Han Lun, Foot Taiyang, Urinary Bladder channel, is the first to be discussed.  When the pathogen heat attacks human body, it affects Yin first.  Heat is a type of yang pathogens and tends to affect the upper body, and hence it will affect Hand Taiyin first.  This is why in Wen Bing, the Hand Taiyin, Lung channel, is discussed first.  External pathogens damage Taiyang and Taiyin fist, and hence Taiyang and Taiyin pertain to Open.
　

Shaoyang and Shaoyin both are located at the Pivot position.  Shaoyang is located between the exterior and interior and their syndrome is characterized by alteration of chills and fever.  However, this syndrome could have concurrence of either the exterior or interior syndrome.  For example, Xiao Cai Hu Tang is indicated for Shaoyang syndrome.  But Chai hu Gu Zhi Tang is used for Shaoyang syndrome with predominance of the exterior, and Da Chai Hu Tang and Chai Hu Jia Long Mu Tang are used for Shaoyang syndrome with predominance of the interior.  Shaoyin syndrome has the tendency of transformation into either cold or heat syndrome.  When it transforms into a cold syndrome, Si Ni Tang and Zhen Wu Tang should be used.  When it transforms into a heat syndrome, Huang Lian E Jiao Tang should be used.
　

Yangming and Jueyin both occupy the middle (2^nd and 5^th) lines (Yao) in the hexagram Weiji *, and imply the significance of Close. In case of attack by cold, if yang goes to its extreme, it will enter Yangming and gives rise to severe condition with manifestations such as floccitation and failure to recognize people; if Yin cold goes to its extreme and enters Jueyin, it gives rise to Jue Ni syndrome (syncope).  In case of febrile diseases, when the pathogenic heat goes into Hand Jueyin, Pericardium, it gives rise to coma; when it goes into Foot Jueyin, it stirs up internal wind.  All these are critical and extreme conditions at the late stage of a disease that are Closing, manifesting the mental symptoms. 

*Hexagram Weiji:  shows the fire is in the upper and water in the lower, like the human body with the heart in the upper and the kidney in the lower.

The Open-Close-Pivot has close relationships with channels.  Let’s take Foot Three Yang channels as examples. Taiyang pertains to Open and is located the outermost on the back; Yangming pertains to Close and is located innermost on the chest and abdomen; Shaoyang pertains to Pivot and is located between the other two, distributed on the hypochondria.  The distribution of Tung’s extraordinary points also follows to this concept.
　

Try to make a loose fist shaped like a circle Taiji, you may find Open, Pivot and Close are connected to one another.  Let’s look at Shaoshang (LU11) and Shaoze (SI1) first.  One belongs to Taiyin channel and one to Taiyang channel.  Both pertain to Open. Guanchong (SJ1) belongs to Shaoyang channel and Shaochong (HT9) to Shaoyin. Both pertain to Pivot. Zhongchong (PC9) belongs to Jueyin channel and Shangyang (LI1) to Yangming channel.  Both pertain to Close. Thus there forms the law of movement through Opening, Pivoting, and Closing.  Extending the sole of the foot, Taiyang is neighbored with Taiyin, and Jueyin is neighbored with Yangming. Once one Japanese practitioner, Koubee Akabane, took Neizhiyin (medial zhiyin) which is located between Zhiyin (UB67) and Qiaoyin (GB44) to replace Yuangquan (KI1) when he did the “warm temperature sense of skin” test.  In this way, Shaoyang and Shaoyin are also closely neighbored.  This implies that Open-Close-Pivot has a certain arrangement sequence.

These concepts are the bases for the channel circulation sequence and distributions of pathways in Nei Jing.  They conform to what is in chapter 10 of Suwen: “Yangming is anterior to Taiyang”, and “Shaoyin is posterior to Taiyin … and Jueyin is anterior to Shaoyin.”  The three yang channels are on the yang aspect of the body, and the three Yin channels on the Yin aspect.  Then, according to yang polarity, Lung, Large Intestine (Dui), Heart, Small Intestine (Li), and Pericardium, Sanjiao (Zhen) are distributed on the upper limbs.  According to Yin polarity, Liver, Gall Bladder (Xun), Kidney, Urinary Bladder (Kan), Spleen, Stomach (Gen) are distributed on the lower limbs. Besides, according to the principle of Yin ascending and yang descending, the channels originate from or terminate at the tip of fingers.  For example, Taiyang channel runs along the lateral side of yang aspect of the small finger.  Shaoyang channel runs along the middle of the ring finger. On the analogy of this, other channels are distributed following the same way.
　

The counter-clockwise distribution of the Open, Pivot, and Close circles from the outer Taiyang to Shaoyang and Yangming to the end of yang and toward inner to Yin, Taiyin, Shaoyin and ends at Jueyin.  This circulation sequence conforms the transmission of the Six Channels in Shang Han Lun as Taiyang to Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin.
　

Question 7: In Tung’s acupuncture, what special meanings do the distributions and arrangements of Sima three points, Tungguan three points, and Tungshen three points imply?

Answer: The distributions of the 14 channels are related to Open-Pivot-Close as we mentioned in the previous question. Same theory explains the distribution and arrangements of Tung’s extraordinary points.  The distributions of Sima three points, Tungguan three points and Tungshen three points are close related to Open-Pivot-Close theory, too.  The Sima three points mainly treat Lung Taiyin diseases and hence pertain to Open and are located the outermost.  Tungguan three points mainly treat Heart Shaoyin diseases, and Tungshen three points treat Kidney Shaoyin diseases, in which both pertain to Pivot, and hence are located in the middle.  Three Yellow points treat liver diseases, which pertain to Close, and hence are located the innermost.

As far as the implication why Sima three points, Tungguan three points and Tungshen three points all are located between Spleen and Stomach channels, which symbolizes that Master Tung’s ancestor emphasized a lot on the Spleen Stomach Treaties.
　

February 2009(The Sixth Round)

Question 1: It is common for people to learn the applications of individual Tung’s points.  I wonder if the point combinations are important too.

Answer: Certainly it is important.  Each single point has its particular functions. However, point combinations in Tung’s acupuncture are even ingenious and make subtle difference.  It is said “reading between and beyond the lines.”  Points should be selected between and beyond lines too.  In Tung’s acupuncture, those wordless lines are the Five Phases.  Five Phases are the application core of acupuncture, either the 14 Channels or the Tung’s acupuncture.  One must master the Five Phases and apply them ingeniously to syndrome differentiation and clinical practice. Point combinations may be categorized into intra-promotion, intra-restraint, intra-communication, and intra-responding, etc.  In “The Applications of the Five Shu Points” I wrote in the early days has a general introduction on this part. I have given more detailed explanations in the recently ended Advanced Seminar (topics including “The Five Phases in Tung’s Acupuncture: perspectives of time, space, and imaging….”
　

Within the sub-categories of the point combinations, “Tong Qi Xiang Qio (similar energy attracts one another)” gives the highest effect.  Take asthma as an example. The disease relates to Lung, Spleen and Kidney.  Points pertain to metal and water should be selected primarily. But it would be even better if all earth, metal and water are addressed. Shuijin (water metal) point combining with Tushui (earth water) point creates very good result. Shuijin point is located on the pathways of Stomach and Large Intestine channels, and hence pertains to both earth and metal.  Its location falls to the Kan (water) region in the facial eight trigrams, and hence also pertains to water.  Selecting Shuijin point will treat all earth, metal, and water pertained diseases.  Tushui point is located between trigrams Gen (earth) and Kan (water) on the palm, and on the Lung (metal) channel; and hence also treats earth, metal and water pertained diseases.  Combining the two points is named Upper Lower Same Energy (Shang Xia Tong Qi) since both points pertained to earth, metal, and water but one located in the upper while the other in the lower. The combination not only is superb effective in the treatment of cough and asthma, but also effective in treating other diseases as long as differentiated as deficiency in Lung, Spleen and Kidney. This type of point combination is extensively and ingeniously used in Tung’s acupuncture and it makes the best use of point combination as it utilizes very few points to treat multiple diseases with high effectiveness.
　

Dao Ma is also a type of point combinations but also with the profoundness of combinations of the Five Phases, particularly the Big Dao Ma on calves and thighs. As long as one understands the Five Shu points, the profoundness is easy to comprehend.  Qian Yin points can form combinations by following the same principles.  There are also several types and variations.  Here I would not mention further.  
　

Question 2: There are several acupuncturists or doctors writing books specializing in Dao Ma needling method.  What are your opinions on those books?  Do you plan to write a book specializing in Dao Ma too?

Answer: Although there are several books specializing in Dao Ma popular in the market, non of them was written by Master Tung’s disciples (non of the authors is in the list of the 73 disciples).  Those authors had never seen Master Tung needle patients.  The accuracy and credibility of the books are questionable. Several months ago, some people asked me about Heng (horizontal) Dao Ma and I have replied (please refer to the April discussion questions).  I do not think it is necessary to make any more criticisms or opinions. 
　

In Master Tung’s later years, his point selections were even simpler and refiner. Three-needle Dao Ma was sometimes simplified to two needles.  Sometimes, he even used one needle to penetrate two points or even three points.  I often saw Master penetrated Linggu to Dabai to treat sciatica, which was a simple, refined needling method but with high effectiveness.  Currently those Dao Ma books circulated in the market mostly focus on padding out the arrangements of points.  That is to say merely groups of points are rearranged and categorized.  Those important subtle and profound meanings are not given by those books.  Simply putting two or three points together des not reflect the essentials and profoundness of Dao Ma.  Dao Ma must be analyzed together with the Five Phases, Yi Jing theory, and Kai-He-Shu (open-close-pivot) so to understand the special meanings of the point arrangements in Tung’s acupuncture, such as those points treating Zang Fu organ diseases are arranged and located on the thighs.  Those contents were lectured in the Advanced Seminars in October and November 2008 and received enthusiastic feedbacks.
　

Currently I do not have any plan to write a book specializing in Dao Ma, but I will introduce and give detail discussions in my future book specializing in advanced Tung’s acupuncture. The book contents are preliminarily completed and may be published after another two or three advanced seminar lectures and revisions.  During the lecture at the advanced seminar, the following discussions on Dao Ma were introduced.  Those topics will be introduced and explained in details in my future book specializing in advanced Tung’s acupuncture.  Readers may answer those review-questions related to Dao Ma first which will help them gain some inspirations.

1.         Advanced Dao Ma Needling Method

2.         The Meaning of Dao Ma Needling Method

3.         Specific Operations of Dao Ma Needling

4.         Dao Ma Needling Method versus Point Combinations

5.         Dao Ma Needling Method vs. Qi Ci and Pang Zhen Ci

6.         Required Conditions of Dao Ma Needling Method

7.         Tong Guan Zhen, Yu Zhen, and Zhi Fei Zhen

8.         Needling Sequence and Direction of Dao Ma Needling

9.         Distinction among Big, Medium, and Small Dao Ma

10.     The Meaning of the Arrangements and Distributions of Dao Ma on the Thigh Region

11.     Fu Dong (floating) Dao Ma and Hu Bu (complimentary) Dao Ma

12.     Dao Ma and Jing Luo (channels and network vessels), and San Cai (three talents/treasure)

13.     Dao Ma and Holography and needling depths
　

Question 3: May you please share your high efficacy experience on treating tennis elbow?

Answer: The condition is more formally known as lateral epicondylitis ("inflammation to the outside elbow bone"), which is a commonly and frequently occurring disease. The patient feels the lateral elbow achy and sore when the affected limb is in use and difficult and limited in lifting.  The pain is aggravated when the patient makes a fist and twists with strong strength, ex. twisting a towel; and alleviated at rest.  The pain is usually limited at the posterior side of the lateral condyle of humerus (lateral side of forearm).  The pain is gradually increased and may radiate to forearm or shoulder back regions. The pain is more severe at night.  Trigger points might be palpitated at the lateral epicondyle of humerus.  The pain is more obvious when lifting heavy objects with elbow straight or bending 90 degree angle; or when the forearm twists forwardly.  The general joint movements are normal.    

TCM regards tennis elbow as damaged tendon of the elbow and belongs to the scope of elbow impediment.  The causes are strong twisting or bending of the elbow region, over or extreme use of the elbow causing channel qi and tendon membrane damaged and qi and blood stagnation, which is the so called “lou sun”.  Tennis elbow might be triggered to occur by coldness.  The affected limb should avoid carrying heavy objects and moving around during the treatments.
　

Location: When the elbow is flexed on the chest, Quchi (LI11) is in the depression at the lateral end of the transverse cubitabl crease. Quhou is located posterior to Quchi at the endof the transverse cubitabl crease, anterior border of the bone.

Linggu (22.05)

Location: This point is located in the juncture between the index finger and thumb, the 1^st and 2^nd dorsal metacarpal bones, and directly opposite Zhongxian (22.02).

Analysis and Experience: Needling Linggu closely attached to the bone corresponds to Kidney and bone.  The technique, inserting a needle closely along the bone, is similar to the Duan Ci (short needling) described in Neijing.  In Lingshu, chapter 7 Guan Zhen: “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.” Besides, needling along the bone, through the transmission of bone membranes, to treat bone and joint diseases gives great result.  Tennis elbow, lateral epicondylitis of the humerus, belongs to bone bi-syndrome.  Needling Linggu along the bone to treat tennis elbow, lateral epicondylitis of the humerus, gives outstanding effect.  The focus of lateral epicondylitis of the humerus is on the lateral border of the Large Intestine channel.  Selecting Linggu on the affected side allows the patient to exercise the affected site and the acupuncturist to apply the Dong Qi (activating qi)needling technique. If needling Quchi on the opposite (healthy) side, plus Linggu on the affected side, then Linggu will carry the treatment as well as Guiding (Qian Yin) functions, and the effect will be enhanced. 

Huofuhai (33.07)
Location: 2 cun proximal to Huoshan (33.06), on the prominence of the muscle.  Although the point is defined on San Jiao channel, to locate it, place the palm on the chest, the point however is located on the radial side of the back of the forearm, about the location of Shousanli (LI10).  Request the patient to make a fist and flex the elbow, the point is in the depression of the Brachioradialis muscle.
Needling Technique: Select the point on the healthy side while the patient makes a fist and flex the elbow.  Insert the needle perpendicularly for about 1 cun.  After qi arrives, apply the lifting and thrusting and rotating techniques and stimulate strongly, meanwhile request the patient to exercise (flex and extend) the affected elbow for one to two minutes. Retain the needle for 30 minutes with manipulation once every ten minutes. Exercise the elbow while manipulation. 
Analysis and Experience: This point is located about the same location of Shousanli (LI10), which is an important point of Large Intestine channel.  Because Large Intestine channel is full of abundant qi and blood and has strong power to regulate qi and blood, and hence points of this channel will create strong needling sensation, can coursing the wind and invigorate the channel and are good at treating channel and network vessels related diseases.  Shousanli (LI10), because of the pathway of the Large Intestine channel, is an essential point in treating shoulder, back and arm pains recorded in all dynasties (refer to Ode of the Essetias of Understand, Song More Precious Than Jade, Ode of Xi Hong, Song of Points for Miscellaneous Diseases.)  Huofuhai (33.07) is on the prominence of the muscle, which is the muscle/flesh with proper disposition (Fen Roe). The ancients regarded Fen Roe as Jin (musculartendon) and hence this point is good at treating tendon related diseases. (For this part, I gave detailed explanations at the Advanced Tung’s Acupuncture Seminar in Oct. and Nov. 2008.  I shall give full discussion in my book in the future.)  Meanwhile, since Huofuhai (33.07) is defined on San Jiao channel, it also has the functions to supplement Kidney and treat bone related diseases; and hence is a superb effective point in the treatment of tennis elbow.  (The above is cited from “Single Needle Acupuncture Therapy” by Young Wei-chieh).
Remarks: A while ago, (Oct. 19) at the International Conference of Brain Medicine in Traditional Chinese Medicine held in Los Angeles, I was one of the keynote speakers.  At the end of the lecture, several presented doctors asked me about the treatment of pains. One asked about the treatment of tennis elbow.  One of my students, Dr. Lee responded him (also a Dr. Lee) that he recently treated five cases of tennis elbow by following my above described methods and all of them cured shortly.  His descriptions proved my above experience is very practical.

Question 4: What is the reason all Jing-well points treat fullness below the heart?

Answer: Jing-well points master the fullness below the heart.  “Below the heart” refers to the Pi (glomus) and fullness of Zhongwan (center stomach duct).  “Jing-well” points are located at finger or toe tips and there are twelve of them.  The ancients used the “well, the origin of water” as an analogy because the energy (qi) of channels and network vessels origins or departs here (finger or toe tips).  Those Jing-well points are able to treat the fullness of the heart.

There are several sayings about the so-called “man (fullness).”  One saying of “man” refers to the adverse lung qi.  Jing-well points of yang channel pertain to metal, correspond to Lung and dominate qi.  They correspond to depurative downbearing, and storing.  Jing-well points of yang channels are Lidui (ST45), Shouze (SI1), Shangyang (LI1), Zhiyin (UB67), and Guanchong (SJ1) which pertain to metal.  Needling those points has the depurative downbearing function and can lower qi to reduce fullness.  Another saying refer “man” to the undredged Liver qi.  Jing-well points of ying channels pertain to wood, correspond to Liver and dominate blood. They correspond to rising, dispersing, dredging and scattering.  Needling Jing-well points of yin channels, Shoushang (LU11), Yinbai (SP1), Shaoshang (HT9), Yungquan (KI1), Daduan (LV1), Zhongchong (PC8), will dredge liver, and regulate qi to eliminate the fullness.

Question 5: What is the reason Ying-spring points all can treat body heat/fever?

Question 6: What is the relationship between the amount of qi and blood and the therapeutics?

Answer: Biao Yo Fu (Song of Elucidate Mysteries) says “First (one should) examine the amount (of qi and blood), next should observe the qi  arrival.  Light, slippery, and slow, (qi) has not arrived; deep, rough, and tight, has arrived.” Here the “amount” is to generalize the amount of qi and blood of every channel.  Doing so is to know well (control) beneath the needle, waiting for the qi to arrive and so to conduct the supplementing or reducing manipulation technique accordingly.   
　

Currently the commonly used blood-letting points match the theory of qi and blood amount.  For example, Tai Yang channel has abundant blood but little qi, hence Weizhong (UB40) is often bled to treat body heat, headache, vomiting, abdominal pain, sores, carbuncles, boils and acne, etc, those excess heat syndrome, and receive very good effect.  Weizhong (UB40) treating lumbago, sciatica is particularly good.  Master Tung often bled the back to treat various diseases ranging extensively.  No matter the internal organ diseases or the four limbs diseases, all can be treated.  Chize (LU5) is the He-sea point of Lung channel and since Lung Tai Yin is with abundant qi but little blood, needling Chize (LU5) with the reducing technique can treat the excess syndrome of Lung, and impediment of tendon and bone.  It is also an essential point of blood letting technique, particularly for frozen shoulder, pains of the shoulder, wrist, and palm, nose bleeding, vomiting, stubborn skin ulcer, Sha (sand effusion) syndrome.

Yang Ming channel has both abundant qi and blood.  When the exterior contracted disease transmits to Yang Ming, the condition will become “abundant righteous qi fighting exuberant pathogen” and the patient has high fever and cloudy spirit.  To treat, reducing method or blood-letting technique is often applied.  For example, prick at Shangyang (LI1) and Shaoshang (LU11) for little blood can treat fever and sore throat caused by exterior contracted diseases.  This is in accordance with that Yang Ming channels have “abundant blood” and hence dredging the blood to treat the excessive. Besides, “excessive qi transforms to fire”, hence in clinical practice, when treating some diseases caused by or with fire or heat, such as red, swelling and painful eyes, toothache with heat/fire sensation, breast pain, sore, carbuncle, and furuncles, points of Yang Ming channels are often selected to clear the heat and dredge the fire so to detoxify toxin (relieve the fever). Those points are such as Erjien (LI2), Sanjien (LI3), Hegu (LI4), Shousanli (LI10), Quchi (LI11) of the Hand Yang Ming; and Neiting (ST44), Xiengu (ST43), Fengrong (ST40), Zusanli (ST36) of the Foot Yang Ming, all are the commonly selected points for clearing heat and dredging the fire.

I personally often bleed at Zusanli (ST36) to treat stomach diseases, asthma, and heart diseases.  I even more often bleed at Fenglong (ST40) to treat prolonged or strange, difficult, complex and miscellaneous diseases.  This is in accordance with the “abundant qi and abundant blood” and hence the channels are suitable to dredge.  Besides, Fenglong (ST40) is the meeting point of phlegm.  Bleeding at Fenglong (ST40) can resolve the stasis and expel phlegm.  As the point can treat (resolve) both stasis and phlegm, Fenglong (ST40) is a superb effective and essential point in the treatment of strange, difficult, complex and miscellaneous diseases.  Also, because Yang Ming channels have abundant qi and blood, they can be used to regulate and tonify qi and blood are to treat the deficiency of qi and blood, hence they are good at treating the squeal of stroke, such as hemiplegia and atrophy (wei) syndromes.

The above examples are the application of the theory of “amount of qi and blood”.  The theory of qi and blood amount directs us to consider the condition of qi and blood: vigorous or feeble, and to regulate qi and blood by tonifying the deficiency and dredging the excess.  The goal is to balance the yin and yang to cure the diseases.(back to page top)