Internal Diseases
COMMON COLD
Yang Jie-bin’s Medical Record
Yang, male, 35, first visit was on April 28, 1976
[Chief Complaint]
Headache and fever for one day
[Present Medical History]
The patient had slept without covering himself to stay warm, and on the following day began to experience dizziness, headache, aversion to wind cold without sweating which then turned into a fever, along with a runny nose, itchy throat, cough, insipid taste in the mouth, but with normal urine and stools.
[Examination]
Body temperature 40°C (104°F), white moist tongue coating, with a floating and tight pulse
[Diagnosis]
Common cold (wind cold constraining the exterior)
[Treatment Principles]
Dispel wind cold, resolve the exterior by means of diaphoresis
[Treatment]
|
DU 14 (dà zhuī) |
BL 12 (fēng mén) |
tài yáng (EX-HN5) |
|
LI 4 (hé gŭ) |
Moxibustion was applied after needling DU 14 (dà zhuī). Cupping was applied after needling BL 12 (fēng mén). Tài yáng (EX-HN5) and LI 4 (hé gŭ) were punctured with reducing method. After one treatment, he sweated and his fever relieved. After two treatments, his symptoms were greatly reduced. After three treatments, he was cured.
[Note]
Tài yáng (EX-HN5) and LI 4 (hé gŭ) were reduced to relieve exterior symptoms by dispelling wind through sweating. BL 12 (fēng mén) was punctured and cupped to dispel wind and diffuse the lung to relieve exterior symptoms. DU 14 (dà zhuī), the intersecting point of all yang channels, was punctured to strengthen the exterior and then treated with moxibustion to dispel cold. A course of three acupuncture and moxibustion treatments cured the patient.
Cheng Xin-nong’s Medical Record
Liu, male, 33, first visit was on September 6, 1986
[Chief Complaint]
Fever, cough, headache, neckache and backache for 10 days
[Present Medical History]
Patient was attacked by cold while sleeping at night 10 days previously. On the following morning he woke with a fever and coughing. He took Sù Xiào Găn Mào Jiāo Náng (Quick Effect Common Cold Capsule, 
) and Băn Lán Gēn Chōng Jì (Radix Isatidis Infusion, 
) but it did not relieve his symptoms. After taking the herbs his back felt cold, with a headache concentrated in the occipital region, soreness in the neck and back, and his entire body was achy. He had coughing with a sore throat, and profuse thin yellow sputum, a lack of taste, and slept poorly. His urine was dark yellow; stools were normal.
) and Băn Lán Gēn Chōng Jì (Radix Isatidis Infusion, ) but it did not relieve his symptoms. After taking the herbs his back felt cold, with a headache concentrated in the occipital region, soreness in the neck and back, and his entire body was achy. He had coughing with a sore throat, and profuse thin yellow sputum, a lack of taste, and slept poorly. His urine was dark yellow; stools were normal.[Examination]
Tongue borders and tip were red, with a thin white dry coat, the pulse was floating and rapid
[Diagnosis]
Common cold (due to cold in the exterior, with interior heat)
[Treatment Principles]
Dispel wind cold, promote diffusion of the lung to disperse heat
[Treatment]
|
DU 14 (dà zhuī) |
GB 20 (fēng chí) |
BL 13 (fèi shù) |
|
BL 9 (yù zhĕn) |
LI 17 (tiān dĭng) |
tài yáng (EX-HN5) |
|
BL 2 (cuán zhú) |
LU 7 (liè quē) |
LI 4 (hé gŭ) |
|
LU 11 (shào shāng) |
LU 11 (shào shāng) was bled using a three-edged needle. Other points were punctured with filiform needles that were retained for 30 minutes. After three treatments the symptoms disappeared.
[Note]
Exogenous wind cold blocks the exterior resulting in the lung qi failing to disperse, thus resulting in coughing. As the patient has already been ill for ten days there had been some transformation of cold into heat. DU 14 (dà zhuī) functions to disperse yang qi thereby relieving exterior symptoms. GB 20 (fēng chí) functions to dispel wind and relieve headache. Tài yáng (EX-HN5), BL 2 (cuán zhú), BL 9 (yù zhĕn), and GB 20 (fēng chí) all treat headache. LI 4 (hé gŭ), the yuán-source point of the hand taiyin lung channel, promotes sweating and resolves the exterior, and LU 7 (liè quē), the luò-connecting point of the hand taiyin lung channel, work together through their interior/ exterior relationship to promote diffusion of the lung thus to resolve the exterior. BL 13 (fèi shù) promotes diffusion of the lung to stop coughing, and LI 17 (tiān dĭng) used together with LU 11 (shào shāng) clear heat to treat sore throat.
Bleeding LI 1 (shāng yáng) and LU 11 (shào shāng) using a three-edged needle plus puncturing LI 4 (hé gŭ) with filiform needle and retaining the needle for 30 minutes is a very effective treatment for sore throat.
For carbon monoxide poisoning, in addition to routine treatment, puncturing LU 11 (shào shāng) and DU 26 (rén zhōng) with filiform needle can revive unconscious patients.
Xiao Shao-qing’s Medical Record
Zhang, male, 39, first visit was on October 5, 1979
[Chief Complaint]
Headache and fever for 4 days
[Present Medical History]
Four days previously due to not wearing enough clothing, the patient began to experience symptoms of headache, fever, coughing, nasal congestion and pain in the lower back
[Examination]
Throat was red, body temperature of 38.5°C (101.3°F), flabby tongue, with a thin yellow and slightly sticky coating, the pulse was rolling and rapid
[Diagnosis]
Common cold (due to wind heat attacking the lung)
[Treatment Principles]
Dispel wind, clear heat, resolve the exterior
[Treatment]
|
DU 14 (dà zhuī) |
BL 12 (fēng mén) |
GB 20 (fēng chí) |
|
BL 13 (fèi shù) |
BL 23 (shèn shù) |
LI 4 (hé gŭ) |
Acupuncture was given once a day with the needles being retained for 20 minutes. After one treatment, the headache and nasal obstruction disappeared, and there was also a reduction in the fever. After two treatments, he was cured.
[Note]
This is influenza. The seasonal epidemic pathogen attacks the lung and blocks the exterior, causing fever and whole body aches. DU 14 (dà zhuī), the intersection point of all the yang channels, it functions to resolve the exterior by circulating yang qi, additionally it calms the mind and clears heat. BL 23 (shèn shù) has a mother/son relationship that facilitates communication between the son (kidney) and the mother (metal), thus producing water to reinforce the body’s resistance. BL 12 (fēng mén), also knows as Rè Fŭ (the left side is called fēng mén and the right is known as Rè Fŭ), it is the intersection point of Du mai and the foot taiyang bladder channel, it dispels wind, diffuses the lung, and regulates qi to clear heat. When used together with GB 20 (fēng chí), BL 12 (fēng mén) has a stronger effect in dispelling wind and resolving the exterior. BL 13 (fèi shù), clears the lung, it is used in combination with LI 4 (hé gŭ) to resolve the exterior by promoting sweating.
Summary
Common cold, known as injury by wind (Shāng Fēng 
), includes symptoms of nasal congestion, runny nose and coughing, with chills, fever, and aching throughout the body. It is a common disease seen all year round, but most especially in the winter and spring. It is caused by a deficiency of the normal qi, when there is an invasion of wind cold or wind heat, or a disturbance of the lung’s ability to diffuse.
), includes symptoms of nasal congestion, runny nose and coughing, with chills, fever, and aching throughout the body. It is a common disease seen all year round, but most especially in the winter and spring. It is caused by a deficiency of the normal qi, when there is an invasion of wind cold or wind heat, or a disturbance of the lung’s ability to diffuse.Main points: DU 14 (dà zhuī), GB 20 (fēng chí), LI 4 (hé gŭ).
Tài yáng (EX-HN5), yìn táng (EX-HN3), and BL 2 (cuán zhú) are added for headache. LU 10 (yú jì) or LU 11 (shào shāng) are bled to treat sore throat. LU 5 (chĭ zé) and LU 9 (tài yuān) or BL 13 (fèi shù) are added for cough. LI 20 (yíng xiāng) is added to clear nasal congestion.
COUGH
Yang Jie-bin’s Medical Record
Fu, female, 27, first visit was on July 29, 1998
[Chief Complaint]
Coughing for one month
[Present Medical History]
The patient’s cough began a month ago after she experienced an attack of cold, which resulted in symptoms of dizziness, itchy and sore throat, nasal congestion, runny nose, chills with an aversion to wind, fatigue and full body achiness. The cough was worse at night. Neither taking Western drugs nor an injection of penicillin were helpful. During her visit she coughed repeatedly; the cough had a deep raspy sound, accompanied by white, foamy sputum, which was difficult to expectorate, and chest fullness. Her appetite, urine and stools were all normal.
[Examination]
Pale red tongue, with a thin white coating, pulse was deep and tight
[Diagnosis]
Cough (due to wind cold invasion)
[Treatment Principles]
Promote diffusion of the lung, resolve the exterior, transform phlegm, stop coughing
[Treatment]
|
①. |
DU 14 (dà zhuī) |
GB 20 (fēng chí) |
LI 4 (hé gŭ) |
|
BL 12 (fēng mén) | |||
|
②. |
BL 11 (dà zhù) |
LU 1 (zhōng fŭ) |
BL 13 (fèi shù) |
|
ST 36 (zú sān lĭ) |
The above two groups of points were alternately employed once a day, one group each time. Strong reducing stimulation was applied to scatter and disperse the pathogenic wind cold. The needles were retained for 30 minutes after arrival of qi and were restimulated once every 5 minutes using a lifting-thrusting and rotating motion. Cupping was applied after needling at DU 14 (dà zhuī), BL 12 (fēng mén), BL 11 (dà zhù), LU 1 (zhōng fŭ), and BL 13 (fèi shù) for 15 minutes, which resulted in dark purple marks. After two treatments, the coughing lightened up and sputum was reduced. After four treatments, the cough was almost gone. After six treatments, the cough, expectoration of sputum and fullness in chest basically disappeared. A one month follow-up showed no recurrence.
[Note]
DU 14 (dà zhuī) is needed to drain the exterior pathogen from the yang channels. BL 11 (dà zhù), GB 20 (fēng chí), LI 4 (hé gŭ) and BL 12 (fēng mén) scatter wind and disperse cold, and diffuse the lung to resolve the exterior. LU 1 (zhōng fŭ), the Front-mù, and BL 13 (fèi shù), the Back-shù of the lung, regulate lung qi, transform phlegm and stop coughing. ST 36 (zú sān lĭ), the earth point of the foot yangming stomach channel, it tonifies the earth to produce the metal, and eliminates dampness and phlegm. These points used together strenghthen [the body’s] ablity to scatter wind and resolve the exterior, stop coughing and transform phlegm; as the qi moves, phlegm will be accordingly eliminated and the cough will naturally stop.
Records in Acupuncture – Moxibustion for Difficult Diseases (Qí Nán Zá Bìng Zhēn Jiŭ Zhì Liáo)
Liao, female, 62, first visit was on November 16, 1996
[Chief Complaint]
History of coughing with white phlegm for more than 7 years
[Present Medical History]
The patient was constitutionally weak and easily caught colds. She often had coughing, chills, fatigue, along with fullness in chest and epigastrium, and loose stools. She had a history of long term use of cough medicines.
[Examination]
Pale tongue, with a white greasy coating, soggy and slippery pulse
[Diagnosis]
Cough (due to phlegm damp retention in the lung)
[Treatment Principles]
Strengthen the spleen to transform dampness and eliminate phlegm to stop coughing
[Treatment]
|
BL 20 (pí shù) |
LU 9 (tài yuān) |
SP 3 (tài bái) |
|
LV 13 (zhāng mén) |
ST 40 (fēng lóng) |
Moxibustion was applied to BL 20 (pí shù). Other points were needled using a tonifying method. The patient was treated once every other day, she was cured after 30 treatments. Afterwards, blistering moxibustion (Tiān Jiŭ 
) was applied once every ten days for six months to consolidate the effect.
) was applied once every ten days for six months to consolidate the effect.[Note]
The spleen fails in transportation and transformation, thus phlegm is produced due to damp retention, which then accumulates in the lung, causing cough with profuse sputum. Spleen deficiency leads to qi deficiency, leading to fatigue and loose stools. Pale tongue, with a white greasy coating, and a soggy and slippery pulse are the signs of phlegm damp. The yuán-source points are the places where there is a strong infusion of zang-qi, for this reason, LU 9 (tài yuān) and SP 3 (tài bái) are selected to tonify the lung and spleen. BL 20 (pí shù) and LV 13 (zhāng mén) are to strengthen and transport the spleen-qi and benefit the lung-qi. ST 40 (fēng lóng), luò-connecting point of the foot yangming stomach channel, strengthens the transport of the stomach and spleen qi in the middle jiao, which causes the fluids to disperse, naturally resulting in the transformation of dampness and phlegm.
Tiān Jiŭ (
), is a form of moxibustion, where irritating medicinals are applied to certain acupoints so as to cause blisters. This is often used in the treatment of asthma, chronic bronchitis, allergic rhinitis, chronic cough, weak constitution, susceptibility to common cold, chronic gastroenteritis, insomnia, and pain in low back and legs.
), is a form of moxibustion, where irritating medicinals are applied to certain acupoints so as to cause blisters. This is often used in the treatment of asthma, chronic bronchitis, allergic rhinitis, chronic cough, weak constitution, susceptibility to common cold, chronic gastroenteritis, insomnia, and pain in low back and legs.Zhao, male, 42, his first visit was on April 15, 1958
[Chief Complaint]
Cough for one year and hemoptysis for the previous three days
[Present Medical History]
The patient had been diagnosed with pulmonary tuberculosis a year ago, and was treated with streptomycin and isonicotinyl hydrazide. Presently he was emaciated, spoke with low a voice, coughed up bloody sputum, tidal fever, and night sweating. An injection of a hemostatic medication was not effective for him.
[Examination]
Pale tongue, with a white coating, and thready pulse
[Diagnosis]
Pulmonary tuberculosis with hemoptysis (due to yin deficiency of the lung)
[Treatment Principles]
Tonify yin of the lung to stop bleeding and coughing
[Treatment]
|
KI 1 (yŏng quán) |
The patient was treated in the prone position with moxibustion at KI 1 (yŏng quán) for 20 minutes, twice a day. After two treatments, the bloody sputum disappeared. With three days of successive treatments, the symptoms basically disappeared. He was advised to continue treatment to fight against the tuberculosis.
[Note]
This is a condition of yin deficiency producing internal heat, moxibustion can be applied in these cases. KI 1 (yŏng quán), is the jĭng-well point of the Kidney channel, it functions to open orifices, sedate and calm the spirit, is important for blood presentations; through the relation of opposites, it is a point on the lower part of the body that can treat problems in the upper part of the body.
Summary
Cough is known in Chinese as Ké Sòu (
). Ké is coughing with sound, but without phlegm; Sòu is coughing with phlegm, but without sound. Ké Sòu is coughing with both sound and phlegm. It includes coughing from both external attack and internal injury.
). Ké is coughing with sound, but without phlegm; Sòu is coughing with phlegm, but without sound. Ké Sòu is coughing with both sound and phlegm. It includes coughing from both external attack and internal injury.Coughing due to external attack is caused by wind, cold, heat and dryness invading the lung. Invasion of wind cold causes cough with thin phlegm, nasal congestion, runny nose, chills, a lack of sweating, thin white tongue coating, and a floating and tight pulse. Invasion of wind heat causes coughing with yellow thick phlegm, feverishness, headache, sweating, aversion to wind, and a floating and rapid pulse. Invasion of dryness and heat causes either a hacking cough or a cough with yellow phlegm that is difficult to expectorate, a dry and sore throat, and a rapid pulse.
Coughing due to internal injury is caused by dysfunctions of the zang-fu organs, which often start out as an acute illness, which does not resolve, thus leading to this kind of internal injury. Spleen deficiency produces phlegm damp, fullness in the chest, poor appetite, white greasy coating, and a soft floating pulse; liver fire attacking the lung produces coughing with hypochondriac pain, vomiting, sparse dense sputum, a red face with a dry throat, a yellow coated tongue and wiry rapid pulse; yin deficiency of the lung produces a hacking cough, or coughing with bloody sputum, tidal fever, night sweating, irritability, a hot sensation in the palms and soles, a red tongue, with a sparse coating, and a thready, rapid pulse.
Main points: BL 13 (fèi shù), RN 22 (tiān tū).
BL 12 (fēng mén) and LI 4 (hé gŭ) for coughing from external attack. DU 14 (dà zhuī) for fever. For bleeding use LU 11 (shào shāng). To treat sore throat use LU 5 (chĭ zé) and LU 6 (kŏng zuì) for coughing of blood. ST 36 (zú sān lĭ) and ST 40 (fēng lóng) are used for profuse phlegm and poor appetite. GB 34 (yáng líng quán) treats hypochondriac pain; for pain or a cold sensation on the back acupuncture can be applied followed by cupping.
ASTHMA
Shao Jing-ming’s Medical Records
Zhao, female, 13, first visit was on July 20, 1963
[Chief Complaint]
Asthma for more than 7 years
[Present Medical History]
When she was 6 years old, she had a common cold, which resulted in a lingering cough. In winter her cough would become worse, and it gradually developed into asthma. Presently, regardless of the season no matter whether it was summer or winter, whenever she was exposed to cold she had asthma attacks. During the attack, she had dyspnea, cyanotic lips, wheezing with phlegm in throat and an inability to lie flat.
[Examination]
Emaciated, with cold limbs, pale red tongue, with a white moist and slippery tongue coating, and a deep, thready and forceless pulse
[Diagnosis]
Asthma (due to cold phlegm in the lung)
[Treatment Principles]
Diffuse the lung, transform phlegm, calm wheezing
[Treatment]
|
DU 14 (dà zhuī) |
BL 12 (fēng mén) |
BL 13 (fèi shù) |
The needles were retained for 15 minutes after arrival of qi; during this time they were manipulated 2-3 times. After removing the needles, moxibustion was applied for 5 to 7 minutes. This treatment eased the wheezing. This treatment was given once a day. After ten treatments, her breathing was normal. The treatment schedule was changed to every other day after a week of rest. Ten more treatments were given to consolidate the effect. The following winter she did not have any attacks of asthma. When she did get a cold, there was just a bit of chest stuffiness and slight difficulty in breathing. In the following year, she had 20 more acupuncture treatments using the same method. In the third year, she was given another 10 treatments as a consolidation measure. Since then, her constitution was stronger and she no longer had asthma attacks.
[Note]
This patient had an invasion of pathogenic wind when she was small. The pathogen lingered in the lung for a long time, thus bringing about a weakness of wei qi, and instability of the exterior; when exposed to wind cold it would result in asthma. DU 14 (dà zhuī) diffuses the lung and regulates qi. BL 12 (fēng mén) eliminates wind and calms asthma. BL 13 (fèi shù) regulates the lung qi and strengthens resistance and stops coughing and wheezing.
Wu, male, 20, first visit was on May 23, 1996
[Chief Complaint]
Asthma for 12 years with a decline in his condition for the previous two years
[Present Medical History]
Twelve years previously, he had a common cold, which induced chest fullness and wheezing. He got better with treatment. But since then, he had had attacks from time to time; in the past two years it had become worse. Treatment with aminophylline and prednisone would give him symptomatic relief, but was not a cure for his bronchial asthma. This last episode lasted for more than one month and previous treatment methods were not effective.
[Examination]
The patient was thin and with a sallow complexion with dyspnea, panting, wheezing with phlegm in the throat, he found it difficult to expectorate the yellow sputum. Auscultation of both lungs revealed rales. His tongue was dark, pale and without moisture. His pulse was rapid and slightly slippery.
[Diagnosis]
Asthma (due to phlegm heat retention)
[Treatment Principles]
Promote the diffusion of the lung, regulate qi, transform phlegm, calm asthma
[Treatment]
|
BL 13 (fèi shù) |
DU 14 (dà zhuī) |
BL 12 (fēng mén) |
With acupuncture treatment he immediately felt relief upon arrival of the qi. Needles were retained for 30 minutes, after removal, his feeling of fullness in chest was greatly improved, but the rales in his lungs were unchanged. After five rounds of the same treatment the asthmatic breathing and wheezing stopped. Two courses (of 20 treatments) made all his symptoms disappear.
[Note]
DU 14 (dà zhuī) disperses yang to release the exterior and diffuse the lung to calm asthma. BL 12 (fēng mén) dispels pathogens and calms asthma. BL 13 (fèi shù) regulates qi of the lung, strengthens the exterior and calms asthma.
Xiao Shao-qing’s Medical Record
Zheng, male, 50, first visit was on September 21, 1994
[Chief Complaint]
Coughing and asthma for more than 30 years, in the previous month it had been worse.
[Present Medical History]
He began to have coughing and asthma after he had the measles when he was small. Afterwards, asthma attacks were often induced when he was exposed to cold or ate seafood. One month ago, his condition worsened after getting chilled. Use of an inhaler gave some symptomatic relief but, he had symptoms of coughing and wheezing, with fullness and pain in the chest which was worse at night, profuse white sticky phlegm that was difficult to expectorate, and was thirsty with a desire to drink. His appetite, urine and stools were normal.
[Examination]
Rough breathing, rales, pale tongue, with a white sticky coating, and a thin, wiry and slippery pulse
[Diagnosis]
Asthma (due to invasion of wind cold, phlegm damp in the lung)
[Treatment Principles]
Scatter wind cold from the lung, transform phlegm, stop coughing and calm asthma
[Treatment]
|
RN 17 (dàn zhōng) |
RN 22 (tiān tū) |
dìng chuăn (EX-B1) |
|
ST 40 (fēng lóng) |
PC 6 (nèi guān) |
LI 4 (hé gŭ) |
|
LU 7 (liè quē) |
RN 22 (tiān tū) was needled with a three inch filiform needle, which was inserted perpendicularly and obliquely along the posterior border of the manubrium of the sternum to a depth of about 2.5 inches; the point was stimulated with a twisting motion and then the needle was immediately withdrawn. RN 17 (dàn zhōng) was also needled with a three inch filiform needle, which was obliquely inserted to the depth about 2.5 inches and rotated while lifting and thrusting to produce a strong sensation. Other points were needled with an even method and then retained for 20 minutes; needles were stimluated once every 10 minutes. Treatment was given on a daily basis.
On the second visit, the patient’s coughing, wheezing, and chest pain showed signs of improvement. He was able to lie flat at night, and the sputum, while still profuse was easy to expectorate. Therefore, the previous treatment was applied again.
On the sixth visit, his coughing and wheezing had ceased, the sputum had become thin and sparse, and the rales were reduced. It was thought that the lingering pathogenic factors had been expelled, but the normal qi was still weak. BL 13 (fèi shù) and BL 23 (shèn shù) were used instead of LI 4 (hé gŭ) and LU 7 (liè quē). Acupuncture with a tonifying method, cupping and moxibustion were applied at RN 4 (guān yuán) and RN 6 (qì hăi). One more course of treatment cured him completely.
[Note]
The patient had suffered from asthma for 30 years, due to the length of this illness it was thought his lung, spleen and kidney surely must be weak thus invasion of wind cold disturbed the lung’s ability to diffuse. Due to qi deficiency of lung, spleen and kidney the water metabolism became disordered, thereby producing phlegm dampness. In the acute stage, the branch symptom (Biāo 
) of wheezing should be immediately brought under control. For this purpose, RN 17 (dàn zhōng), RN 22 (tiān tū) and dìng chuăn (EX-B1) were selected to descend qi to stop coughing and wheezing. PC 6 (nèi guān) was needled to regulate qi and relieve fullness and pain in the chest. ST 40 (fēng lóng) was used to transform phlegm. LU 7 (liè quē) and LI 4 (hé gŭ), is a combination of yuán and luò points, used together they scatter cold and eliminate wind. After the acute symptoms were relieved, the root cause (Bĕn 
) was treated by using BL 13 (fèi shù) and BL 23 (shèn shù) to tonify the generative cycle between the lung and kidney, and using RN 4 (guān yuán) and RN 6 (qì hăi) to support and firm up the original qi. Moxibustion and cupping were important methods in the treatment for this case.
) of wheezing should be immediately brought under control. For this purpose, RN 17 (dàn zhōng), RN 22 (tiān tū) and dìng chuăn (EX-B1) were selected to descend qi to stop coughing and wheezing. PC 6 (nèi guān) was needled to regulate qi and relieve fullness and pain in the chest. ST 40 (fēng lóng) was used to transform phlegm. LU 7 (liè quē) and LI 4 (hé gŭ), is a combination of yuán and luò points, used together they scatter cold and eliminate wind. After the acute symptoms were relieved, the root cause (Bĕn ) was treated by using BL 13 (fèi shù) and BL 23 (shèn shù) to tonify the generative cycle between the lung and kidney, and using RN 4 (guān yuán) and RN 6 (qì hăi) to support and firm up the original qi. Moxibustion and cupping were important methods in the treatment for this case.Summary
Asthma is an allergic disease of the respiratory tract. Characterized by repeated attacks of paroxysmal dyspnea with wheezing, it is difficult to treat. Professor Shao Jing-ming is experienced in treating such a disease. According to him, asthma is due to both the [root cause (Bĕn
)] of an underlying weakness in resistance due to a deficiency of the zang-fu organs, along with [branch (Biāo
)] excess due to invasion of external pathogens. The former refers to hypofunction of the lung, spleen and kidney and the latter to phlegm, dampness, blood stasis and external invasion. Promoting the lung’s function of diffusion, regulating qi, and transforming phlegm are the principles to follow for its treatment.
)] of an underlying weakness in resistance due to a deficiency of the zang-fu organs, along with [branch (Biāo)] excess due to invasion of external pathogens. The former refers to hypofunction of the lung, spleen and kidney and the latter to phlegm, dampness, blood stasis and external invasion. Promoting the lung’s function of diffusion, regulating qi, and transforming phlegm are the principles to follow for its treatment.Main points: DU 14 (dà zhuī), BL 12 (fēng mén), BL 13 (fèi shù).
As proven by the clinical practice, BL 13 (fèi shù) is on the foot taiyang bladder channel, it is a special point on the back that is infused with lung qi, this point is good at regulating the qi and strengthening resistance to stop coughing and wheezing. DU 14 (dà zhuī) also called the “meeting point of yang” is good to disperse yang qi to disperse wind cold and descend qi to calm asthma. BL 12 (fēng mén) is the meeting point of the foot tài yáng and Du channels which is used to disperse wind cold, drain heat pathogens, and regulate qi of the lung to stop coughing and wheezing; moxibustion on this point can stimulate the channel qi, consolidate exterior and prevent the common cold.
During an asthma attack, these three points used together can reduce pressure in the lower respiratory tract. When used in the acute stage, they improve the functioning of lungs. They are especially effective for bronchial asthma.
Points for symptomatic treatment: LI 4 (hé gŭ) is added for treating external pathogens. LU 5 (chĭ zé) and LU 9 (tài yuān) treat coughing. RN 12 (zhōng wăn) and ST 36 (zú sān lĭ) are used for profuse phlegm. RN 22 (tiān tū) and RN 17 (dàn zhōng) for phlegm blockage of the windpipe. BL 23 (shèn shù), RN 4 (guān yuán) and KI 3 (tài xī) for asthma of a deficiency type. BL 14 (jué yīn shù), BL 15 (xīn shù) and PC 6 (nèi guān) treat palpitations. LU 10 (yú jì) treats dry throat. LU 10 (yú jì), LU 6 (kŏng zuì) and LU 5 (chĭ zé) for hemoptysis. RN 12 (zhōng wăn), ST 36 (zú sān lĭ), ST 25 (tiān shū) and RN 6 (qì hăi) are used to treat epigastric fullness. SP 9 (yīn líng quán), ST 28 (shuĭ dào) and ST 36 (zú sān lĭ) are effective for edema of lower limbs.
Treatment should be given once a day during the acute stage and every other day when in the non-acute stage. Ten acupuncture sessions are considered one course of treatment. For adults, 1 inch needles are inserted to 0.5~0.8 inches in depth. For children, 0.5 inch needles are inserted to a depth of 0.2~0.3 inches. Needles are retained for half an hour and stimulated one or twice during that time. Application of tonifying or draining techniques are in accord with the patient’s individual condition. For children less than one year old, do not retain the needles.
Moxibustion and cupping are used accordingly.
HYPOCHONDRIAC PAIN
Cheng Xin-nong’s Medical Records
Xu, male, 47, first visit was on July 25, 1987
[Chief Complaint]
Chest discomfort for more than 2 years
[Present Medical History]
When fatigued the patient would have fullness and pain in the chest. Recently, there was an aggravation of the pain and it radiated to the back and arm. Neither bed rest nor treatment with glonoin brought him relief. The patient reported feeling tired, short of breath, with a cold feeling in the low back, and abdominal distention after eating. His sleep was not good; urine was yellow.
[Examination]
Dark lips with petechiae, blood pressure was normal at 120/80mm Hg, dark tongue, slightly thick coating, pulse was wiry, thin and rough with missed beats
[Diagnosis]
Obstruction of qi in the chest (Xiōng Bì 
) (qi deficiency and blood stasis)
) (qi deficiency and blood stasis)[Treatment Principles]
Tonify the qi, dredge channels and collaterals
[Treatment]
|
DU 14 (dà zhuī) |
RN 17 (dàn zhōng) |
RN 12 (zhōng wăn) |
|
RN 6 (qì hăi) |
PC 6 (nèi guān) |
LU 9 (tài yuān) |
|
ST 36 (zú sān lĭ) |
SP 6 (sān yīn jiāo) |
LI 15 (jiān yú) (left) |
All points were needled with even method.
[Note]
This patient is constitutionally weak in yang qi, so there is a feeling cold in low back and abdomen distention after eating. Yang qi deficiency in chest leads to blood stasis, so there is chest pain and discomfort. DU 14 (dà zhuī), is the intersection point of all the yang channels; it effectively circulates yang qi. RN 17 (dàn zhōng), is the meeting point of qi and Front-mù of the pericardium, it regulates the qi of the heart and stops pain. RN 12 (zhōng wăn), the meeting point of the fu organs and the Front-mù of the stomach, it strengthens the spleen and stomach, invigorates qi and blood, tonifies the qi of the middle jiao, and calms the mind. RN 6 (qì hăi) enhances the kidney and the primal qi. ST 36 (zú sān lĭ) tonifies and nourishes the spleen and stomach and supports post-natal qi. PC 6 (nèi guān) strengthens the heart, stabilizes the will and invigorates the channels to stop pain. LU 9 (tài yuān), the meeting point of the vessels, is used together with PC 6 (nèi guān) and SP 6 (sān yīn jiāo) to tonify qi, open the yang to get rid of blood stasis and open the channels. LI 15 (jiān yú) opens the channels and collaterals, and circulates qi and blood to stop pain.
Zheng, male, 58, first visit was on November 4, 1985
[Chief Complaint]
Left hypochondriac pain for 3 days
[Present Medical History]
The patient is bad-tempered and easily angered, a few days ago he had a quarrel with somebody. Afterwards, he lost his appetite, and had abdominal distention and acid regurgitation. Three days ago he suddenly had a pain in the left hypochondrium, which was made worse with coughing.
[Examination]
No obvious swelling in the left hypochondrium but there was tenderness, the tongue was pale with a thick greasy yellow coating, along with a wiry pulse.
[Diagnosis]
Hypochondriac pain (due to liver qi stagnation)
[Treatment Principles]
Calm the the liver, regulate qi, open the channels, stop pain
[Treatment]
|
GB 34 (yáng líng quán) |
LV 3 (tài chōng) |
ST 36 (zú sān lĭ) |
|
SJ 6 (zhī gōu) |
LV 14 (qī mén) (left) |
These points were needled with a draining method. After the treatment, the patient immediately felt much better and his appetite gradually returned and the abdominal distension and tenderness were reduced. After four rounds of the above treatment, he was cured.
[Note]
This patient’s habitual bad temper was damaging to his liver and resulted in qi stagnation in channels running to the hypochondria, thus there was distention and pain. The Miraculous Pivot (Líng Shū, 
) says: “If there is a pathogen in the liver, there will be pain in the hypochondria”. LV 14 (qī mén), the Front-mù of liver, LV 3 (tài chōng), the yuán-source point of liver, together with GB 34 (yáng líng quán), hé-sea of the gall bladder, are used to regulate the liver-qi, and together with SJ 6 (zhī gōu), work to dredge the channels and smooth the qi mechanism, thus opening the channels and smoothing the flow of qi and blood, with free flow there is no pain (
tōng zé bù tòng). ST 36 (zú sān lĭ) is to strengthen the spleen and open the stomach, use of this point helped to improve his appetite and reduce the abdominal distention.
) says: “If there is a pathogen in the liver, there will be pain in the hypochondria”. LV 14 (qī mén), the Front-mù of liver, LV 3 (tài chōng), the yuán-source point of liver, together with GB 34 (yáng líng quán), hé-sea of the gall bladder, are used to regulate the liver-qi, and together with SJ 6 (zhī gōu), work to dredge the channels and smooth the qi mechanism, thus opening the channels and smoothing the flow of qi and blood, with free flow there is no pain ( tōng zé bù tòng). ST 36 (zú sān lĭ) is to strengthen the spleen and open the stomach, use of this point helped to improve his appetite and reduce the abdominal distention.Yang Jie-bin’s Medical Record
Chen, female, 63
[Chief Complaint]
Right hypochondriac pain for 20 days
[Present Medical History]
Twenty days before, at night, she suddenly had a serious pain in the right hypochondriac region, which radiated to the back and was made worse with coughing and even breathing. She hurried to the emergency room and the x-ray examination showed no abnormalities with her heart and lungs. Administered a pain killer, sleeping pill, gentamicin (an antibiotic), and various herbal medicines, none of which brought her any relief. Now, in addition to the previous symptoms, she has dizziness, tinnitus, and dry throat.
[Previous Diagnosis]
Hypertension
[Examination]
Red face, strong constitution, troubled expression with a moaning voice, restlessness, tenderness in the area from the 3rd to 7th rib, slightly red tongue, sparse coating, wiry and tight pulse
[Diagnosis]
Hypochondriac pain
[Treatment Principles]
Open the channels and invigorate collaterals, regulate qi circulation, stop pain
[Treatment]
|
Right side: |
SJ 6 (zhī gōu) |
GB 34 (yáng líng quán) |
|
ST 18 (rŭ gēn) |
PC 1 (tiān chí) |
SJ 6 (zhī gōu) was needled through to PC 5 (jiān shĭ) with #28 2 inch filiform needle using strong stimulation to drain, GB 34 (yáng líng quán) and SP 9 (yīn líng quán) were needled in a similar fashion. The needles were retained for half an hour, during which time they were manipulated with lifting-thrusting and rotating once every 3 minutes. Cupping was applied to ST 18 (rŭ gēn) and PC 1 (tiān chí) for 15 minutes.
The pain stopped within twenty minutes and the patient was cured after this half hour treatment. The follow-up showed no recurrence of hypochondriac pain.
[Note]
SJ 6 (zhī gōu) is the fire point on the hand shaoyang sanjiao channel. Needling this point adjusts the qi of the channel and reduces the ministerial fire. GB 34 (yáng líng quán), the hé-sea point on the foot shaoyang gallbladder channel, treats fu organs to adjusts the qi of the fu organs, invigorates the collaterals to stop pain. Cupping on ST 18 (rŭ gēn) and PC 1 (tiān chí) removes local blood stasis to stop pain.
Summary
Chest and hypochondriac pain is due to qi stagnation and blood stasis. The heart yang is inactive and the lung qi is constrained, or overeating cold food causes cold accumulating in the middle jiao with counterflow rising up to the chest, this produces obstruction of the channels in the chest region, thereby resulting in chest and hypochondriac pain.
Main points: RN 17 (dàn zhōng), PC 7 (dà líng), LU 9 (tài yuān), PC 6 (nèi guān).
Add DU 14 (dà zhuī) and BL 15 (xīn shù) to activate the heart yang. Add BL 13 (fèi shù), LU 1 (zhōng fŭ) and LU 7 (liè quē) to diffuse the lung qi. Add RN 22 (tiān tū) and ST 40 (fēng lóng) to transform phlegm. Apply moxibustion at BL 13 (fèi shù), BL 15 (xīn shù) and RN 17 (dàn zhōng) after needling to relieve pain that radiates to the back and to dispel cold due to excessive yin. Add LV 2 (xíng jiān), SP 10 (xuè hăi), LI 4 (hé gŭ), SP 6 (sān yīn jiāo) to activate qi and improve blood circulation for those prolonged cases with qi stagnation and blood stasis.
Hypochondriac pain is related to liver and gallbladder diseases and further connected with the course of the shaoyang channels. In the Miraculous Pivot – Five Pathogenic Factors (Líng Shū: Wŭ Xié, 
•
) it says: “When the pathogen is in the liver, there will be pain in the hypochondria” Miraculous Pivot – Channels (Líng Shū: Jīng Mài, 
•
) says: “The patients with gallbladder diseases will have a bitter taste in the mouth, sigh frequently, suffer from pain in the heart and hypochondriac regions, and have difficulty in turning the body.”
•) it says: “When the pathogen is in the liver, there will be pain in the hypochondria” Miraculous Pivot – Channels (Líng Shū: Jīng Mài, •) says: “The patients with gallbladder diseases will have a bitter taste in the mouth, sigh frequently, suffer from pain in the heart and hypochondriac regions, and have difficulty in turning the body.”Intercostal neuralgia and pleurisy and hypochondriac pain caused by traumatic injury can be treated with the principle mentioned here.
Main points: GB 34 (yáng líng quán), SJ 6 (zhī gōu), LV 14 (qī mén).
Hypochondriac pain due to liver qi stagnation has symptoms of distending pain, chest fullness, bitter taste in the mouth and a wiry pulse; to treat add points such as BL 18 (gān shù), BL 19 (dăn shù) and GB 40 (qiū xū).
For hypochondriac pain due to blood stasis caused by trauma with symptoms such as stabbing pain, especially at night, along with stasis spots on the tongue and a wiry rough pulse; add BL 17 (gé shù) and LV 3 (tài chōng).
For hypochondriac pain which is due to phlegm retention caused by prolonged coughing and damp retained in the chest and hypochondria with symptoms such as dyspnea, white moist tongue coating and thin soggy pulse, RN 12 (zhōng wăn), ST 36 (zú sān lĭ) and BL 20 (pí shù) should be added.
EPIGASTRIC PAIN
Cheng Xin-nong’s Medical Records
Yan, male, 29, first visit was on December 2, 1985
[Chief Complaint]
Pain in the epigastric region for 7 years
[Present Medical History]
The patient began to have pain fixed in the epigastric region seven years ago. He was diagnosed with a duodenal ulcer, however the medicinal treatment he had received was not effective. He would experience a fixed indistinct dull pain that usually started one to two hours after eating and would be relieved by pressure. He preferred warm drinks. His appetite was normal, no nausea or vomiting. His urine and stools were normal.
[Examination]
Sallow complexion, tip of tongue red, with a slightly yellow coating, the pulse was weak wiry
[Diagnosis]
Epigastric pain (due to cold stagnation in the stomach)
[Treatment Principles]
Warm the middle jiao, dispel cold, circulate qi, stop pain
[Treatment]
|
RN 12 (zhōng wăn) |
RN 6 (qì hăi) |
PC 6 (nèi guān) |
|
SP 4 (gōng sūn) |
ST 36 (zú sān lĭ) |
SP 6 (sān yīn jiāo) |
Tonifying and even methods were applied. Moxibustion was applied to RN 12 (zhōng wăn). After one treatment, he reported feeling better. He was treated once daily for 10 consecutive days, after which the pain disappeared.
[Note]
In this case, the spleen and stomach both were diseased, due to a deficiency of yang in the middle jiao, the stomach qi was not harmonized, thus pain in the epigastric region. RN 12 (zhōng wăn), the Front-mù of the stomach, was used to harmonize the stomach by warming the yang to dispel cold. ST 36 (zú sān lĭ), Lower hé-sea of the foot yangming stomach channel, was used with SP 6 (sān yīn jiāo) the intersection point of the lower leg yin channels, to strengthen the stomach and construct the spleen. SP 4 (gōng sūn) is the luò-connecting point of the foot taiyin spleen channel, needling with PC 6 (nèi guān) of the pericardium channel connects them through the yinwei mai; they function to relax the chest, regulate the qi and harmonize the stomach.
Run, female, 60, first visit was on April 6, 1992
[Chief Complaint]
Pain in the epigastrium for 10 years
[Present Medical History]
Due to distending pain in the epigastrium this patient had an ultrasound examination and was subsequently given the diagnosis of cholecystitis. Ultrasound findings show she had a 0.6cm ×1.5cm stone in the gall bladder and a 1.4cm cyst on the right lobe of the liver. She experienced pain in the hypochondria, which would be accompanied by hiccups; symptoms could be relieved by warmth. She sometimes had palpitations. Her stools were loose.
[Examination]
Lusterless complexion, purple tongue with a thin yellow coating, right pulse was deep and thin, left pulse deep wiry.
[Diagnosis]
Epigastric pain (due to Liver qi attacking Stomach)
[Treatment Principles]
Dredge the Liver, regulate qi, harmonize the stomach, stop pain
[Treatment]
|
RN 17 (dàn zhōng) |
RN 12 (zhōng wăn) |
RN 6 (qì hăi) |
|
GB 24 (rì yuè) |
PC 6 (nèi guān) |
BL 21 (wèi shù) |
|
BL 19 (dăn shù) |
GB 34 (yáng líng quán) |
ST 36 (zú sān lĭ) |
|
LV 3 (tài chōng) |
GB 40 (qiū xū) |
Draining and even methods were applied. The distending pain in the epigastrium was gradually relieved and after 40 treatments she was cured.
[Note]
Feelings of depression stagnates liver qi, causing the liver qi to counterflow and attack the Earth organs, because the liver and stomach are out of harmony the turbid fails to properly descend, thus causing distending pain, hiccups and loose, but incomplete stools. Long-term constraint transforms into fire, involving the qi and blood, thus the purple tongue with yellow coating. RN 12 (zhōng wăn) and BL 21 (wèi shù), GB 24 (rì yuè) and BL 19 (dăn shù) is a combination of Front-mù and Back-shù points that harmonize the stomach, dredge the liver, and regulate qi to stop pain. BL 19 (dăn shù), GB 34 (yáng líng quán), LV 3 (tài chōng), and GB 40 (qiū xū) function to descend the upward rushing of liver qi thus helping to harmonize the stomach. PC 6 (nèi guān) and RN 17 (dàn zhōng) relax the chest and circulate qi. ST 36 (zú sān lĭ), RN 12 (zhōng wăn) and PC 6 (nèi guān) harmonize the stomach to stop pain. RN 6 (qì hăi) consolidates yuán-source qi and harmonizes qi and blood.
Tian Cong-huo’s Medical Record
X X, female, 34, first visit was on November 23, 2005
[Chief Complaint]
Repeated distending pain in the upper abdomen for two years, worse for one month
[Present Medical History]
Two years ago, this patient for no apparent reason had a distending pain in the upper abdomen, which was diagnosed as a duodenal ulcer. Medicinal treatment with a combination of Chinese and Western medicine was not effective. In the past month the pain became worse. After eating she would have bloating, acid regurgitation, belching, and a dislike of cold. She had one or two loose bowel movements every day; urine was yellow.
[Examination]
Gastroscopy showed there to be chronic superficial gastritis and weak peristalsis. The pathological findings included moderate chronic atrophic gastritis at the antral region, interstitial congestion, and glandular hyperplasia. She had a pale red tongue with a yellow greasy coating, and a thin, wiry pulse.
[Diagnosis]
Epigastric pain (due to damp heat retention in the middle jiao, Liver qi stagnation)
[Treatment Principles]
Adjust the qi mechanism, open and benefit the sanjiao.
[Treatment]
|
DU 14 (dà zhuī) |
DU 6 (jĭ zhōng) |
RN 12 (zhōng wăn) |
|
ST 21 (liáng mén) |
ST 36 (zú sān lĭ) |
PC 6 (nèi guān) |
|
LV 14 (qī mén) |
KI 16 (huāng shù) |
BL 20 (pí shù) |
|
BL 21 (wèi shù) |
To unobstruct the du vessel, an elongated needle (máng zhēn 
) 380 mm in length was used to needle from DU 14 (dà zhuī) through to DU 6 (jĭ zhōng). RN 12 (zhōng wăn), ST 21 (liáng mén), ST 36 (zú sān lĭ), PC 6 (nèi guān), LV 14 (qī mén), and KI 16 (huāng shù) were also needled. Cupping was applied at BL 20 (pí shù) and BL 21 (wèi shù).
) 380 mm in length was used to needle from DU 14 (dà zhuī) through to DU 6 (jĭ zhōng). RN 12 (zhōng wăn), ST 21 (liáng mén), ST 36 (zú sān lĭ), PC 6 (nèi guān), LV 14 (qī mén), and KI 16 (huāng shù) were also needled. Cupping was applied at BL 20 (pí shù) and BL 21 (wèi shù).The patient was treated three times a week, the long máng zhēn was used once a week; when the symptoms improved it was changed to a short máng zhēn and used less frequently. Other points were selected and needled accordingly.
With nearly two months’ treatment, the symptoms disappeared and the gastroscope showed that her chronic superficial gastritis had been cured.
[Note]
The du vessel connects with all the yang channels at DU 14 (dà zhuī). The dai – girdling vessel originates from the second lumbar vertebra. The yangwei mai meets the du vessel at DU 16 (fēng fŭ) and DU 15 (yă mén). The yangqiao mai connects with DU 16 (fēng fŭ) through the foot taiyang bladder channel. The du vessel, connects with the kidney which stores the original yang, and with all yang channels, the yang qi circulates externally and protects the body from invasion by external pathogenic factors; internally it warms the zang-fu organs, and plays a role in the formation of essence and blood. According to Professor Tian Cong-huo, the du vessel is responsible for yang diseases anywhere in the body, or for illness in any one of yang channels. Regulating the du vessel with an elongated needle that connects multiple points produces fast results, but because it is a strong treatment, it can be used only once a week or less. For this patient, the use of the elongated needle produced excellent effect in promoting the circulation of qi by adjusting the qi mechanism and opening the sanjiao; thus eliminating the symptoms of damp heat caused by stagnant liver qi.
Elongated Needle (máng zhēn 
) Regulating Du Vessel:
) Regulating Du Vessel:The position of the patient is extremely important when using this method; they should either be in lying prone, in a lateral recumbent position, or sitting erect with their back towards the doctor. Professor Tian’s Elongated needle (máng zhēn) technique consists of a quick insertion of the needle by grasping it near the tip, and using a flick of the wrist of the needling hand to pierce the skin. The needling hand then acts to insert the needle down along the posterior border of the spine, while the supporting hand controls the direction of the needle. Once the tip of the needle reaches its destination it can be manipulated to tonify or drain. In the interest of safety it is suggested to supplement or drain by means of respiration, rotating or rapid and slow insertion and withdrawal, not lifting-thrusting. To supplement ask the patient to inhale while manipulating the needle with the thumb by turning it forward, and closing the hole when withdrawing. To reduce, do the opposite. The rotation should be gentle and agile with an amplitude of 180°~360°. The 125~175 mm elongated needle may be retained for 20 minutes. The longer ones, of 380 mm, 500 mm, or 1200 mm are not retained. The needle should be kept straight when withdrawing in order to prevent difficulties in removal; violent withdrawal should be avoided.
Shao Jing-ming’s Medical Record
Liu, female, 29, first visit was on June 25, 1999
[Chief Complaint]
Stomach pain and abdominal distention for 5 months
[Present Medical History]
One year previously she began to have discomfort in the upper abdomen; sometimes a bearing-down distention. In the past five months due to being busy she did not have time to eat on a regular basis this resulted in stomach pain. Metoclopramide helped to mitigate the pain, but did not control it. She experienced symptoms of abdominal distension, poor appetite, fatigue, and poor sleep. The provincial hospital used a barium examination and diagnosed her with prolapse of the stomach (II). The treatment she had previously received was not effective.
[Examination]
The patient had a thin build, pale complexion which lacked luster, her spirit was fine, her abdomen pouched out and was tender with palpation, the tongue was pale with a thin coating, and a deep, slow pulse.
[Diagnosis]
Prolapse of the stomach (due to yang deficiency)
[Treatment Principles]
Strengthen the spleen, harmonize the stomach, lift and raise yang qi
[Treatment]
|
RN 12 (zhōng wăn) |
ST 36 (zú sān lĭ) |
wèi shàng (EX-CA2) |
|
PC 6 (nèi guān) |
HT 7 (shén mén) |
SP 6 (sān yīn jiāo) |
The patient was treated once a day, after six treatments, her appetite and sleep improved, as did her energy level. Afterwards the main points RN 12 (zhōng wăn), ST 36 (zú sān lĭ), and wèi shàng (EX-CA2) were needled every other day. After two courses of treatment, her symptoms disappeared and an x-ray examination showed that the stomach returned to normal position. One year follow-up did not manifest any recurrence.
[Note]
Prolapse of the stomach is commonly seen in clinic. Professor Shao holds that it is mostly caused by irregular food intake, fatigue due to overwork, prolonged illness, or childbirth which weakens the constitution and exhausts the spleen yang, resulting in the qi of the middle jiao being too weak to hold the organs in place. The main points are RN 12 (zhōng wăn), ST 36 (zú sān lĭ), wèi shàng (EX-CA2). The points for symptomatic relief include: PC 6 (nèi guān) for poor appetite, nausea and acid regurgitation; BL 20 (pí shù) and BL 21 (wèi shù) for abdominal distension; DU 20 (băi huì) for bearing-down sensation in abdomen and diarrhea; HT 7 (shén mén) and SP 6 (sān yīn jiāo) for insomnia. For those with yang deficiency, apply moxibustion.
Wèi shàng (EX-CA2), located 2 inches above the umbilicus and 4 inches lateral to the anterior midline, it functions to rapidly reinforce qi, strengthen the spleen, and lift the stomach, it is a good point for treating prolapse of the stomach. A 3~4 inches filiform needle is used, inserted obliquely towards RN 8 (shén què) to a depth 2.5~3.5 inches into the muscle. A medium strong stimulation is applied to produce a lifting and contracting sensation in the epigastric region. The direction and depth are important. Treatment should be given on an empty stomach. If the patient feels pain and discomfort from the treatment, they should rest for a while afterwards.
Summary
Stomach pain is common in cases of peptic ulcer, acute and chronic gastritis, and nervous stomach. It is often caused by irregular food intake, invasion of cold or depression. Upper abdominal pain is often accompanied by nausea, vomiting, abdominal distension, and belching. It may be worse under pressure or could be better by applying warmth and pressure. The deep and slippery pulse points to an excess condition, while a deep, thin and wiry pulse suggests a deficiency syndrome. The treating strategy is to harmonize the stomach to stop pain.
Main points: RN 12 (zhōng wăn), ST 36 (zú sān lĭ), PC 6 (nèi guān).
For distending pain due to food retention use: ST 21 (liáng mén), ST 44 (nèi tíng), SP 4 (gōng sūn).
Cold stagnation in the stomach resulting in the vomiting of clear fluids, with pain that is relieved by warmth, and a slow pulse apply moxibustion on: BL 20 (pí shù), BL 21 (wèi shù), RN 6 (qì hăi).
Liver attacking the stomach leading to hypochondriac pain needle: GB 34 (yáng líng quán), LV 3 (tài chōng).
HICCUP
Yang Jie-bin’s Medical Record
Yang, male, 30
[Chief Complaint]
Loud hiccups for more than 10 days
[Present Medical History]
Eleven days ago the patient began to have loud non-stop hiccupping after lunch, which was accompanied by abdominal distention, chest stuffiness, acid regurgitation, and headache, all of which made the patient tired. The patient was treated with both oral administration and injections of muscle relaxants, as well as sedatives and fiber, all were ineffective.
[Examination]
The patient was in robust health, but he had a pained expression, the continuous hiccupping made talking and breathing difficult, his tongue had a thin white coating, and his pulse was wiry and slippery.
[Diagnosis]
Hiccups
[Treatment Principles]
Relax the chest, smooth qi circulation, harmonize the middle jiao
[Treatment]
|
RN 17 (dàn zhōng) |
BL 17 (gé shù) |
GB 20 (fēng chí) |
|
PC 6 (nèi guān) |
C3~4 jiá jĭ (EX-B2) |
ST 36 (zú sān lĭ) |
RN 17 (dàn zhōng) was needled through to RN 16 (zhōng tíng), BL 17 (gé shù) was needled obliquely 1.5 inches toward the spine, PC 6 (nèi guān) was needled through to SJ 5 (wài guān), jiá jĭ (EX-B2) was obliquely needled 1.5 inches towards the spine, RN 12 (zhōng wăn) and ST 36 (zú sān lĭ) were needled in a standard fashion.
Both needling and cupping were used. Ten minutes later, the hiccuping had decreased and half an hour later it stopped. The patient slept 10 hours that day. One more treatment was given on the following day to consolidate the good result of the previous treatment. There were no recurrences after one week.
[Note]
Hiccups are due to an abnormal rising of qi. RN 17 (dàn zhōng) and BL 17 (gé shù) relax the chest to smooth the qi mechinsim. RN 12 (zhōng wăn), the Influential point of fu organs and Front-mù of the stomach, harmonizes the stomach and sends qi downward. PC 6 (nèi guān) needled through to SJ 5 (wài guān), should send a sensation into the chest that then directly regulates the qi activities of the sanjiao. ST 36 (zú sān lĭ), hé-sea point, regulates the qi of stomach. Jiá jĭ (EX-B2) comforts the chest to stop hiccups.
Summary
Hiccups are often caused by a disturbance of the stomach due to improper eating, which results in a failure of the qi to descend. Professor Yang Jie-bin utilizes the principle of harmonizing the stomach to descend the qi.
Main points: RN 17 (dàn zhōng), BL 17 (gé shù), RN 12 (zhōng wăn), PC 6 (nèi guān).
Assisted points: C3~4 jiá jĭ (EX-B2), ST 36 (zú sān lĭ).
A combination of local and distal points are used in this treatment. A #28 filiform needle is used to give strong dispersing. Needles are retained for half an hour, with a lifting-thrusting and rotating stimulation given once every three minutes. Arrival of qi is a must! After needling, cupping should be applied. Generally, this treatment brings rapid relief. For mild cases, needling of just PC 6 (nèi guān) or jiá jĭ (EX-B2) may immediately stop the hiccupping. When the usual points are not effective, pressing or needling SJ 17 (yì fēng) can be remarkably helpful.
ABDOMINAL PAIN
Feng Run-shen’s Medical Record
Fan, male, 37
[Chief Complaint]
Abdominal pain with an upward rushing sensation from below the umbilicus
[Present Medical History]
The patient began to experience abdominal distention after eating something cold. The pain started after he went to bed, there was feeling of distention with an upward rushing sensation from below the umbilicus, once every three to fives minutes. It became worse at midnight and caused him to sweat profusely. Afterwards he vomited and had thirst with a preference for warm drinks. He had scanty urination and had been constipated for the previous two days.
[Examination]
The patient had a greenish yellow complexion, purple lips, cold extremities, abdominal muscle tension and the pain was made worse with pressure, the tongue had a thin dry coating, and the pulse was thin, wiry and rapid, and weak at the bottom.
[Diagnosis]
Running piglet syndrome (
bēn tún) abdominal pain (due to cold qi being forced upward)
bēn tún) abdominal pain (due to cold qi being forced upward)[Treatment Principles]
Warm and tonify the spleen and kidney, dispel cold, descend counterflow
[Treatment]
|
RN 4 (guān yuán) |
ST 36 (zú sān lĭ) |
SP 6 (sān yīn jiāo) |
|
KI 6 (zhào hăi) |
LV 3 (tài chōng) |
These points were needled with a tonifying method and the pain was immediately relieved. Needle moxa was used to deeply warm the points. About 10 minutes later, the pain was completely relieved.
[Note]
This is a case of constitutional kidney yang deficiency. The consumption of cold food forces cold qi from lower jiao to run upward, thus causing pain and the sensation of something running upward to the chest. RN 4 (guān yuán) is used to warm the lower jiao, ST 36 (zú sān lĭ) is needled to strengthen the spleen and stomach, SP 6 (sān yīn jiāo) warms and moves the spleen yang and restores the kidney yang, LV 3 (tài chōng) and KI 6 (zhào hăi) to subdue the ascension of liver qi. The pain stops due to the spleen yang being warmed, and kidney qi strengthened; when the cold is dispelled and counterflow qi descended, the pain is reduced naturally.
Cheng Xin-nong’s Medical Record
Jin, male, 25, first visit was on January 21, 1984
[Chief Complaint]
Colicky pain in the umbilical region for one year
[Present Medical History]
Beginning one year ago, about once a month the patient would experience a paroxysmal colicky pain in the periumbilical region which would last for about 10 hours, and was accompanied by nausea and vomiting. Additionally he suffered from ascariasis. His appetite and sleep were both poor, daily bowel movements, but the stool was dry, urination was normal.
[Examination]
White tongue coat, tip of the tongue was red, the pulse was deep, thin and wiry
[Diagnosis]
Abdominal pain
[Treatment Principles]
Warm the middle jiao, tonify the spleen and stomach, regulate qi to stop pain
[Treatment]
|
PC 6 (nèi guān) |
SP 4 (gōng sūn) |
ST 36 (zú sān lĭ) |
|
SP 6 (sān yīn jiāo) |
RN 10 (xià wăn) |
RN 6 (qì hăi) |
|
ST 25 (tiān shū) |
Moxibustion was applied to ST 25 (tiān shū) and an even method acupuncture was applied to the other points.
[Note]
This abdominal pain related to ascariasis, which is a chronic disorder of the qi mechanism. The principle here is to warm the middle jiao, tonify the spleen and stomach, and regulate qi to stop the pain.
Summary
Abdominal pain refers to the pain in the area below the xiphoid process and above the pubis. The divergent channels of the foot taiyin and foot yangming enter into the abdomen, the liver channel also enters into lower abdomen, as does the ren vessel which runs through the interior of the abdomen. Abdominal pain is often related to these four channels.
Main points: RN 12 (zhōng wăn), ST 25 (tiān shū), ST 36 (zú sān lĭ), SP 6 (sān yīn jiāo), LV 3 (tài chōng).
RN 8 (shén què) and SP 4 (gōng sūn) are used together to treat retention of cold in the interior. SP 9 (yīn líng quán) is coupled with ST 44 (nèi tíng) to treat stagnation due to damp heat. RN 4 (guān yuán), BL 20 (pí shù), BL 21 (wèi shù), and LV 13 (zhāng mén) are added for deficiency cold in the middle jiao.
DIARRHEA
Record in Acupuncture – Moxibustion for Difficult Diseases (Qí Nán Zá Bìng Zhēn Jiŭ Zhì Liáo)
Sun, female, 58, first visit was on June 8, 1988
[Chief Complaint]
Abdominal pain and diarrhea in the morning for more than 2 years
[Present Medical History]
Every morning at about 6 a.m., the patient would begin to have chills, abdominal pain, and five to six loose bowel movements; after 8 a.m., the symptoms disappeared
[Examination]
Pale tongue, with a thin white coating, thin and weak pulse
[Diagnosis]
Diarrhea (due to yang deficiency with interior cold)
[Treatment Principle]
Warm the yang to stop diarrhea
[Treatment]
|
ST 36 (zú sān lĭ) |
ST 37 (shàng jù xū) |
DU 14 (dà zhuī) |
ST 36 (zú sān lĭ) and ST 37 (shàng jù xū) were treated with tonifying stimulation. DU 14 (dà zhuī) was treated for 30 minutes with moxibustion. The patient was treated once a day, with six treatments constituting one course. After two courses, the chills, abdominal pain and diarrhea were all improved; another two courses of treatment brought about a cure.
[Note]
Six o’clock in the morning is known as Măo (the fourth of the twelve Earthly Branches). During this period, yang qi arises. The yang qi of this patient is deficient; she has chills because it fails to arise. Măo is also the period for the qi of hand yangming large intestine channel to flow. As the large intestine is cold and deficient this patient has diarrhea. After Măo, her yang qi slowly rises, so the pain and diarrhea stop. ST 36 (zú sān lĭ) and ST 37 (shàng jù xū) are Lower hé-sea points, and are excellent in the treatment of fu organs. DU 14 (dà zhuī), the intersecting point of all yang channels, lifts and reinforces yang qi, especially with moxibustion. When the yang qi extends, it increases resistance to [cold] pathogens, thus her symptoms stop.
Lou Bai-ceng’s Medical Record
Zhang, female, 42 years old
[Chief Complaint]
Loose stools for nearly one year
[Present Medical History]
Due to improper dietary habits, the patient began to have loose stools two to three times a day. Recently, she had symptoms of abdominal distention, fatigue, and poor appetite.
[Examination]
Sallow complexion, listlessness, tender tongue with a white coating, and a soft thready pulse
[Diagnosis]
Diarrhea (due to spleen and stomach deficiency)
[Treatment Principles]
Strengthen the spleen, harmonize the stomach, stop diarrhea
[Treatment]
|
BL 20 (pí shù) |
ST 25 (tiān shū) |
ST 36 (zú sān lĭ) |
Acupuncture was performed using a lifting and thrusting tonifying method. After three treatments, the stools were firmer, after six treatments the patient’s stools were completely normal. A follow-up after half a year found no recurrence.
[Note]
Her loose stools were caused by weakness of transportation and transformation functions of the spleen and stomach. Back-shù point, BL 20 (pí shù), and ST 25 (tiān shū), Front-mù point, are the places where the qi of spleen and large intestine gather. They are used together with ST 36 (zú sān lĭ), the hé-sea point of the stomach channel, to strengthen the spleen, harmonize the stomach, and regulate the qi of stomach and intestines to stop diarrhea.
Summary
Diarrhea refers to abnormal frequency and liquidity of fecal discharge, which can be seen in cases of enteritis, intestinal tuberculosis, colitis, intestinal dysfunctions, and other such illnesses. Acute cases if not resolved, can lead to chronic illness.
Main points: RN 12 (zhōng wăn), ST 25 (tiān shū), BL 25 (dà cháng shù), ST 36 (zú sān lĭ).
DU 14 (dà zhuī), LI 11 (qū chí) and LI 4 (hé gŭ) are employed to treat diarrhea caused by external pathogenic factors. RN 6 (qì hăi) is added if there is cold damp. ST 44 (nèi tíng), SP 9 (yīn líng quán) and LI 4 (hé gŭ) are used to treat damp heat presentations. LV 13 (zhāng mén) and SP 3 (tài bái) are used to treat spleen deficiency. BL 23 (shèn shù), DU 4 (mìng mén), KI 3 (tài xī), RN 4 (guān yuán), and DU 20 (băi huì) can be used to treat any associated kidney deficiency.
CONSTIPATION
Yang Jie-bin’s Medical Record
Wang, male, 40, first visit was on March 17, 1964
[Chief Complaint]
Constipation for two months
[Present Medical History]
Two months ago he had diarrhea due to improper dietary habits. After being treated for the diarrhea, he ended up with constipation where he would only have a bowel movement once every three to four days; the stools were dry in the shape of sheep’s feces. Other symptoms included abdominal fullness, poor appetite and clear urine.
[Examination]
Tenderness in the area of ST 25 (tiān shū), pale red tongue, with a thin yellow greasy coating, deep excessive pulse.
[Diagnosis]
Constipation (due to qi stagnation and intestinal dryness)
[Treatment Principles]
Open and regulate the qi of the intestines, moisten the intestines
[Treatment]
|
SJ 6 (zhī gōu) |
ST 25 (tiān shū) |
BL 25 (dà cháng shù) |
|
KI 6 (zhào hăi) |
Treatment was given once a day with the needles retained for 30 minutes and manipulated once every three minutes. After one treatment, there was some urge to move the bowels. After three treatments, the stools became soft and discharged normally everyday in the morning. After four treatments, the bowels returned to normal.
[Note]
Constipation is usually caused by heat accumulated in the yangming. The intestines are dry and lacking fluids, thus causing the qi mechanism to stagnate. The treatment principle is to unobstruct the intestines by circulating the qi and moistening the intestines. ST 25 (tiān shū) and BL 25 (dà cháng shù) directly dredge the intestines. SJ 6 (zhī gōu), a distal point, opens the qi circulation of sanjiao to smooth the intestines. KI 6 (zhào hăi) replenishes the kidney water and produces essence and blood to nourish yin thus moistening dryness that unblocks the dry stool.
Lou Bai-ceng’s Medical Record
Du, female, 50
[Chief Complaint]
Constipation with difficulty in passing stool for two years
[Present Medical History]
She had irregular bowel movements where she would usually have one bowel movement every three to five days, or when the condition was worse, once every seven to eight days.
[Examination]
Moist tongue coating.
[Diagnosis]
Constipation (due to qi stagnation in intestines)
[Treatment Principles]
Regulate the qi mechanism, open the bowels
[Treatment]
|
BL 25 (dà cháng shù) |
SP 15 (dà héng) |
SJ 6 (zhī gōu) |
Acupuncture with a draining lifting-thrusting method was given once a day. One hour after each treatment she would pass a little stool. To help with the treatment she was asked to try to have a bowel movement at a regular time in order to facilitate the formation of a new habit. After 10 treatments, her stools became normal.
[Note]
This patient was constipated due to the qi stagnation in the intestines. BL 25 (dà cháng shù) is employed to circulate qi and remove stagnation. SP 15 (dà héng) is used to promote the spleen’s transportative function, thus aiding the movement of stool. SJ 6 (zhī gōu) is used to improve qi circulation of the sanjiao. Modern medicine holds that constipation is due to weak peristalsis. The mild lifting-thrusting method gently drains, and is used to strengthen peristalsis. If a strongly draining treatment is given, it will result in an inhibition of peristalsis.
Summary
Constipation, with difficult to pass stools which lasts for three or more days, can be due to both excess and deficiency presentations. The excess presentation refers to an obstruction of the intestines due to pathogenic factors, while in the deficient presentation it is a lack of moisture in the intestines, which causes a failure of the stool to move. Unobstructing and moistening the intestines are the treatment principles to follow.
Main points: ST 25 (tiān shū), BL 25 (dà cháng shù), ST 36 (zú sān lĭ), SJ 6 (zhī gōu).
For abdominal distention, add RN 12 (zhōng wăn) and RN 6 (qì hăi). For excess heat in intestines, add LI 11 (qū chí), LI 4 (hé gŭ) and BL 32 (cì liáo). For qi and blood deficiency, add BL 20 (pí shù) and BL 23 (shèn shù).
Lóng Bì (DYSURIA)
Lu Shou-yan’s Medical Record
Liu, male, 51, first visit was on December 7, 1962
[Chief Complaint]
Frequent and difficult urination for more than 10 years
[Present Medical History]
In 1950 the patient fractured his lumbar vertebra. Thereafter, he had frequent urination with turbidity and loose stools
[Examination]
There was a subjective sense of throbbing below the umbilicus, the abdomen was soft, along with soreness and distention upon palpation in the region of DU 4 (mìng mén) and DU 3 (yāo yáng guān), the pulse was thin, wiry and rapid, with the proximal position being floating and weak. The pulse located at right KI 3 (tài xī) was deeper and weaker than that of the left side, the ST 42 (chōng yáng) pulse was extremely strong, and the pulse at LV 3 (tài chōng) was wiry and full, the patient had a flabby tongue, dirty greasy coating.
[Diagnosis]
Lóng-bì (due to deficiency complicated with excess)
[Treatment Principles]
Replenish kidney yang, reinforce the kidney and du vessels, clear damp heat, and unobstruct the water passages
[Treatment]
|
RN 3 (zhōng jí) |
RN 6 (qì hăi) |
KI 10 (yīn gŭ) |
|
KI 3 (tài xī) |
BL 43 (gāo huāng) |
ST 28 (shuĭ dào) |
|
SP 6 (sān yīn jiāo) |
DU 3 (yāo yáng guān) |
BL 28 (páng guāng shù) |
|
BL 22 (sān jiāo shù) |
BL 39 (wĕi yáng) |
A combination of tonifying and draining methods of lifting – thrusting was employed.
BL 39 (wĕi yáng), BL 28 (páng guāng shù), SP 6 (sān yīn jiāo), BL 22 (sān jiāo shù) and ST 28 (shuĭ dào) were drained. The others were tonified. The needles were retained for 15 minutes. The patient was treated once a day, with 12 treatments constituting one course of treatment.
[Note]
The urinary bladder is the organ that stores urine, and with normal qi circulation urination is normal; when there are abnormalities, there will be urinary difficulty, which is known as Lóng-bì.
The sanjiao is the pathway of water, and when obstructed, urinary difficulties will appear, this is known as Bi – retention.
In the Plain Questions – On the Cavity of Bone (Sù Wèn: Gŭ Kōng Lùn, 
) is written: “du vesselalong the penis downis diseased, producing difficult urination, hemorrhoid and enuresis.”
) is written: “du vesselalong the penis downis diseased, producing difficult urination, hemorrhoid and enuresis.”This patient had damage to the du vessel due to the lumbar fracture, this damaged the qi, which then became deficient, resulting in poor nourishment of the lower jiao, impeding the qi transformation of the urinary bladder which then failed to properly discharge urine, at the same time there was a damp heat invasion; thus causing Lóng-bì. The weakness of the proximal pulse along with the deep and weak KI 3 (tài xī) pulse, points to kidney deficiency and a lack of nourishment in the lower jiao. Pulses that are wiry and rapid means there is heat. Turbid urination means there is damp heat falling downward.
BL 39 (wĕi yáng), the Lower hé-sea of sanjiao, and BL 28 (páng guāng shù) and BL 22 (sān jiāo shù) where drained to clear heat from the sanjiao and remove damp heat in urinary bladder. ST 28 (shuĭ dào) and SP 6 (sān yīn jiāo) were also drained to induce diuresis.
Tonification treatment was used on KI 10 (yīn gŭ), the hé-sea water point of the foot shaoyin kidney channel, KI 3 (tài xī), yuán-source point of the kidney, and BL 43 (gāo huāng), the point from which the foot shaoyin kidney channel enters into the kidney itself and which also connects with the urinary bladder. RN 6 (qì hăi), the sea of yuán-source primordial qi, was also tonified to replenish kidney yang. Additionally, DU 3 (yāo yáng guān) was selected to tonify yang of du vessel and RN 3 (zhōng jí), Front-mù of the urinary bladder, was treated with tonifying methods to strengthen its ability to transform bladder qi.
This patient’s condition is one of deficiency complicated by excess. Therefore, reducing the Back-shù points decreases the pathogenic heat in the urinary bladder; tonifying the Front-mù points promotes kidney yang. This treatment method can be considered to be one where there is draining with tonification.
Yang Yong-xuan’s Medical Record
Wang, male, 20
[Chief Complaint]
Retention of urine for two days
[Present Medical History]
This patient is mentally ill and sustained a severe injury to his left foot by jumping off a building, which lead to an amputation. After the operation, he suffered from urinary retention and abdominal distention.
[Examination]
Distal and middle pulse strong, proximal pulse was thin
[Diagnosis]
Bì – retention of urine (due to upper excess and lower deficiency)
[Treatment Principles]
Drain the excess, tonify the deficiency
[Treatment]
|
LI 6 (piān lì) |
LU 7 (liè quē) | |
|
Right side: |
LV 8 (qū quán) |
SP 9 (yīn líng quán) |
|
KI 3 (tài xī) |
A combination of tonifying and draining methods of rapid and slow insertion and withdrawal of the needle was employed. KI 3 (tài xī) was tonified and the other points were drained. Three hours after the treatment, the urination was smooth. More treatments were given to consolidate the effect.
[Note]
Plain Questions – Expounding on the Energies of Five Viscera (Sù Wèn: Xuān Míng Wŭ Qì, 
) says: “The urinary bladder is disordered, causing Lóng – dysuria.” Dysfunctions of lower jiao qi transformation or an accumulation of dampness and heat block the channels and collaterals which leads to a disruption of the function in the urinary bladder; this is usually an excess presentation. In this case the patient’s retention of urine with fullness in the lower abdomen is due to the failure of qi in the pelvis to go downward. The sudden onset of his urinary retention is due to heat. His pulse reflects excess in the upper jiao and deficiency in the lower. Professor Yang treated him by draining the taiyin and jueyin channels and tonifying the shaoyin to smooth the qi, thus allowing the urine to pass without difficulty.
) says: “The urinary bladder is disordered, causing Lóng – dysuria.” Dysfunctions of lower jiao qi transformation or an accumulation of dampness and heat block the channels and collaterals which leads to a disruption of the function in the urinary bladder; this is usually an excess presentation. In this case the patient’s retention of urine with fullness in the lower abdomen is due to the failure of qi in the pelvis to go downward. The sudden onset of his urinary retention is due to heat. His pulse reflects excess in the upper jiao and deficiency in the lower. Professor Yang treated him by draining the taiyin and jueyin channels and tonifying the shaoyin to smooth the qi, thus allowing the urine to pass without difficulty.Cao Huai-ren’s Medical Record
Zhang, male, 28
[Chief Complaint]
Dysuria for two days and dribbling scanty urination for one day
[Present Medical History]
Ten days before his visit the patient had the common cold for 10 days and began to experience difficulties in passing urine. Only 40ml urine was discharged in eight hours, then it completely stopped. He had an insufferable distending pain in his lower abdomen, sweating and frigid extremities.
[Examination]
The urinary bladder was full
[Diagnosis]
Bì – retention of urine (due to external pathogenic factors inhibiting the diffusion of lung qi)
[Treatment Principles]
Diffuse the lung, regulate the lower jiao
[Treatment]
|
LU 7 (liè quē) |
LU 9 (tài yuān) |
RN 4 (guān yuán) |
|
KI 6 (zhào hăi) |
LU 7 (liè quē) and LU 9 (tài yuān) were needled with the needles being retained for 10 minutes. RN 4 (guān yuán) and KI 6 (zhào hăi) were needled with strong stimulation and then immediatly removed. About 10 minutes later, the patient was able to urinate and the pain stopped.
[Note]
In this case urinary retention comes along with the common cold due to the lung’s ability to diffuse downward being obstructed by external pathogens, thus blocking the water pathways, resulting in not a single drop of urine being expelled.
LU 9 (tài yuān), yuán-source point of lung channel, LU 7 (liè quē) and KI 6 (zhào hăi) are the confluent points of their respective extraordinary channels, they all function to disperse lung qi. RN 4 (guān yuán) is the intersection point of the ren vessel with the three foot yin channels; it is an important point for treating urinary retention. As stated in the Experience on Acupuncture and Moxibustion Therapy (Zhēn Jiŭ Zī Shēng Jīng, 
): “The point RN 4 (guān yuán) is indicated in diseases with urine retention.” When combined with KI 6 (zhào hăi) it helps to promote qi transformation in the lower jiao.
): “The point RN 4 (guān yuán) is indicated in diseases with urine retention.” When combined with KI 6 (zhào hăi) it helps to promote qi transformation in the lower jiao.Summary
Lóng Bì (
) is a condition where it is either difficult to expel urine, the stream of urine is weak, even to the point of complete retention of urine without the ability to expel even a drop. This condition can be caused by either damp heat in the lower jiao, kidney yang deficiency or injury due to trauma.
) is a condition where it is either difficult to expel urine, the stream of urine is weak, even to the point of complete retention of urine without the ability to expel even a drop. This condition can be caused by either damp heat in the lower jiao, kidney yang deficiency or injury due to trauma.Main points: RN 3 (zhōng jí), SP 6 (sān yīn jiāo), BL 32 (cì liáo).
Associated points:
SP 9 (yīn líng quán) and BL 28 (páng guāng shù) are used to treat heat in the lower jiao. BL 23 (shèn shù) and RN 4 (guān yuán) are used with moxibustion to tonify kidney yang. BL 22 (sān jiāo shù) and RN 6 (qì hăi) are used for injury due to trauma.
In the treatment of Bì – retention of urine, if the routine points are not effective, LV 10 (zú wŭ lĭ) can be added as it is a point on the foot jueyin liver channel which “goes along the medial aspect of thigh, enters into the perineum, curves around the genitals and arrives in the lower abdomen.”
Lìn Zhèng (STRANGURIA)
Yang Jia-san’s Medical Record
X X, male, 71, first visit was on August 26, 1996
[Chief Complaint]
Frequent urination
[Present Medical History]
The patient needed to urinate once every hour in the daytime and six to seven times at night, he had accompanying symptoms of distending pain in the lower abdomen, and was diagnosed with benign prostate hypertrophy. Treatment with western medicine did not produce any significant results. He was referred for an operation, which he refused as he had a pacemaker, so came for acupuncture.
[Examination]
Tongue normal, with a thin white coating, pulse was deep and thin
[Diagnosis]
Lìn Zhèng – stranguria (due to qi Lìn deficiency syndrome)
[Treatment Principles]
Tonify yuán-source qi, regulate the qi mechanism
[Treatment]
|
LU 7 (liè quē) |
KI 6 (zhào hăi) |
SP 6 (sān yīn jiāo) |
Treatment was given once every other day using medium stimulation, which reduced the frequency to twice a night. After ten treatments his urination returned to normal.
Two weeks later, the patient returned complaining that one week after his last course of acupuncture he was getting up four to five times a night to urinate. He also had headache, dizziness, fatigue, and a poor appetite.
[Treatment]
|
Previous points plus: | ||
|
GB 20 (fēng chí) |
DU 20 (băi huì) |
LI 4 (hé gŭ) |
After treatment the patient urinated two to three times a night; his headache and dizziness disappeared. He was treated every other day for a month, during this time he usually would urinate once or twice a night, occasionally three times. He continued to have some lower abdominal discomfort. A three month follow up found that his condition had been stabilized.
[Note]
Benign prostate hypertrophy is a common disease seen in middle aged and elderly men. In mild cases it manifests with symptoms of frequent urination and a weak stream, in more serious cases there is urinary retention; this falls into the categories of Lìn Zhèng – stranguria and Lóng Bì – dysuria in traditional Chinese medicine. The causative factors are kidney qi deficiency, difficulties with qi transformation in the sanjiao, failure of the urinary bladder to properly open and close, retained dampness which creates stagnation transforming into heat, and damp heat clumping in the lower jiao; these are complicated patterns which are a mixture of both excess and deficiency. Professor Yang holds that the treatment should be aimed at tonifying yuán-source qi and regulating qi mechanism of the sanjiao. The basic point pair is LU 7 (liè quē) and KI 6 (zhào hăi). LU 7 (liè quē) is both a luò-connecting point and the confluent point, which opens to the ren vessel; it diffuses lung qi to open the water passages and it functions to tonify and regulate kidney qi. It is essential in cases of “frequent, but scanty urination”. KI 6 (zhào hăi) regulates and tonifies kidney qi, which in turn promotes the qi transformation of the urinary bladder. For cases where there is a significant deficiency, SP 6 (sān yīn jiāo), BL 23 (shèn shù) and BL 28 (páng guāng shù) should be used to tonify kidney qi. For significant signs of damp heat, which are accompanied by painful urination, SI 5 (yáng gŭ) and RN 4 (guān yuán) are used to clear heat and drain dampness.
EDEMA
Lu Shou-yan’s Medical Record
Xu, female, 54
[Chief Complaint]
Edema of the whole body
[Present Medical History]
The patient’s edema started in the lower limbs and gradually included the abdominal region and face. She was listless with cold limbs, had abdominal fullness, poor appetite, loose stools, and scanty urination.
[Examination]
Pale swollen tongue, with a moist, white coating, pulse was deep and thin
[Diagnosis]
Edema (due to spleen and kidney yang deficiency)
[Treatment Principles]
Warm the yang to strengthen the spleen, circulate qi to induce diuresis
[Treatment]
|
BL 13 (fèi shù) |
BL 20 (pí shù) |
BL 23 (shèn shù) |
|
RN 6 (qì hăi) |
RN 9 (shuĭ fēn) |
Moxibustion was applied to RN 9 (shuĭ fēn) for 5~10 minutes. The other points were also tonified. Warming needle moxibustion was applied to BL 20 (pí shù) and BL 23 (shèn shù) after the needles had been manipulated with a lifting-thrusting and rotating motion. RN 6 (qì hăi) was needled with a lifting-thrusting motion, but not retained.
On the second visit, her edema was reduced by half along with an increase in urine output; she still had loose stools, and a pale tongue with white coating, the pulse still was deep and thin. The above-mentioned points plus SP 9 (yīn líng quán) were treated. SP 9 (yīn líng quán) was first tonified with warming needle moxibustion and then drained.
On the third visit, her edema was almost completely gone. Her appetite improved and she felt energetic. There was no more abdominal distention. Urination and bowel movements had returned to normal. The tongue was slightly pale, with a thin white coating. To warm the yang, strengthen the spleen and consolidate the treatment, BL 20 (pí shù), BL 23 (shèn shù), RN 6 (qì hăi) and ST 36 (zú sān lĭ) were all tonified. BL 20 (pí shù) and BL 23 (shèn shù) were needled briefly and without retention the needles, warming needle moxibustion was applied on all other points.
[Note]
This patient manifests yin edema caused by spleen and kidney yang deficiency. Professor Lu selected BL 13 (fèi shù) to diffuse the lung qi, BL 20 (pí shù) to strengthen the spleen to control water, BL 23 (shèn shù) to reinforce kidney to warm yang, RN 6 (qì hăi) to replenish genuine yuán-source, and applied moxibustion to RN 9 (shuĭ fēn) to induce diuresis to relieve the edema. On the second visit, SP 9 (yīn líng quán), the water point of the earth channel, was tonified to strengthen the earth, and drained to control the water. Professor Lu’s simultaneous usage of draining while tonifying brings about wondrous effect in promoting urination to get rid of edema. On the third visit, the pathogenic factors were already mostly gone, but the normal qi was weak; strengthening the earth to control water was the right principle to follow to successfully resolve this patient’s edema.
Zheng Yi-zhong’s Medical Record
Ren, female, 21, first visit was on February 9, 1960
[Chief Complaint]
Facial edema and swollen feet, recurrent lumbar pain
[Present Medical History]
Half a year ago the patient was admitted into the hospital for pyelitis and discharged when improved. Afterwards she had repeated occurrences of edema, especially when exposed to cold. Today she presented with a puffy face and edema in her feet, lumbar pain and frequent and urgent urination
[Examination]
Urine: protein (+), WBC (+), platycyte (+), RBC 1~4. Pale red tongue with a thin white coating, deep and a slightly slow pulse
[Diagnosis]
Edema (due to kidney qi deficiency)
[Treatment Principles]
Warm and tonify the mingmen
[Treatment]
|
Moxibustion: |
BL 23 (shèn shù) |
Moxibustion was applied to BL 23 (shèn shù) once a day; 30 minutes each time. After one treatment, the edema was significantly improved. After 10 treatments, the symptoms disappeared and urination became normal. A one year follow-up showed no recurrence.
[Note]
The prolonged illness of this patient lead to kidney qi deficiency, with a weakness of the mingmen fire, producing a condition of deficiency cold which effected the water metabolism. Moxibustion to BL 23 (shèn shù) is very effective in warming and tonifying the mingmen, which activates the urinary bladder and promotes diuresis; thus treating edema.
Summary
Edema is attributed to weakness of the lung, spleen and kidney, so that water is out of control, thus running abnormally to the skin. Yin and yang, exterior and interior, deficiency and excess should be clearly differentiated for setting up treatment principles.
Invasion of wind damp is usually a sign of yang edema, characterized by its quick onset from face and head to the whole body. Internal factors usually induce yin edema which is often due to yang qi deficiency characterized by a slow onset from feet or eyelids and then progressing gradually to the entire body.
Main points for yang edema:
LI 4 (hé gŭ), LI 11 (qū chí), LU 7 (liè quē), BL 13 (fèi shù).
Main points for yin edema:
BL 20 (pí shù), BL 23 (shèn shù), RN 6 (qì hăi), RN 9 (shuĭ fēn), SP 9 (yīn líng quán).
Xiāo Kĕ (DIABETES)
Wang Fa-xiang’s Medical Record
Zhao, female, 49, first visit on March 7, 1995
[Chief Complaint]
Pain in the lower limbs for three weeks
[Present Medical History]
The patient suffered from diabetes for three years. She currently had symptoms, which included a dry month, thirst, fatigue, irritability, dizziness and tinnitus.
[Examination]
Fasting blood-glucose 14 mmol/L, glucose in urine (+++), dark tongue, thin pulse
[Diagnosis]
Xiāo Kĕ – diabetes (due to qi yin deficiency, obstruction of channels)
[Treatment Principles]
Benefit the qi, nourish the yin, invigorate the blood and open the collaterals
[Treatment]
|
BL 20 (pí shù) |
BL 23 (shèn shù) |
BL 40 (wĕi zhōng) |
|
ST 36 (zú sān lĭ) |
BL 57 (chéng shān) |
SP 6 (sān yīn jiāo) |
|
KI 3 (tài xī) |
KI 2 (rán gŭ) |
The patient must experience the sensation of “de qi” for this treatment to be effective. Tonify ST 36 (zú sān lĭ), and use an even method on the other points. Treatment should be given once a day, with 15 treatments constituting one course. After one course of treatment, this patient’s pain and thirst were greatly reduced, and fasting blood-glucose fell to 8 mmol/L. With another course of treatment, her pain and all the other symptoms disappeared. A follow-up found her condition to be stable.
[Note]
The pain in the lower extremities caused by Xiāo Kĕ – diabetes is due to hypofunction of the zang-fu organs resulting in a deficiency of qi, blood and body fluids, this insufficiency leads to poor nourishment of the limbs. This condition is primarily one of deficiency, but complicated by the excess of stasis. The lower limb pain in this patient is related to her diabetes. Therefore, the treatment should be focused on the spleen and kidney. As The Great Compendium of Acupuncture and Moxibustion (Zhēn Jiŭ Dà Chéng,
) summarized: Xiāo Kĕ is due to “exhaustion of kidney water, disharmony between water and fire, and dysfunction of both the spleen and kidney.”
) summarized: Xiāo Kĕ is due to “exhaustion of kidney water, disharmony between water and fire, and dysfunction of both the spleen and kidney.”BL 20 (pí shù), BL 23 (shèn shù), ST 36 (zú sān lĭ), SP 6 (sān yīn jiāo), KI 3 (tài xī) and KI 2 (rán gŭ) are used to treat the root of this patient’s illness; BL 57 (chéng shān) and BL 40 (wĕi zhōng) are added to relieve the resulting symptom pain.
Summary
Xiāo Kĕ (
), diabetes in modern medicine, relates to upper, middle and lower jiao, and all five zang organs, especially spleen and kidney. This disease can be seen to have three stages. In the initial stage, the pathological condition is one of heat that exhausts body fluid; thus manifesting as yin deficiency and dry heat, with symptoms such as thirst and ravenous appetite. Due to the depletion of body fluids there is a flaring of the stomach fire. Additionally, there is an accompanying deficiency of the spleen and kidney. The high sugar level of the urine is due to spleen deficiency resulting in incomplete absorption of the food essence, which then falls down into the bladder. The increased volume of urine is the outcome of kidney qi failing to control the water. In the middle stage yin deficiency leads to qi exhaustion. Therefore, signs of qi and yin exhaustion are both to be found. At the same time, signs of stasis appear due to the inability of qi to circulate the blood. Weakness of the zang-fu lead to a variety of complications and dysfunctions that are more severe as time goes on. In the late stage, the deficiency qi and yin become more severe and blood stasis aggravates the situation, thus are seen the manifestations of both yin and yang deficiency as more organs become diseased. This is why diabetes in the late stage is always complicated by the development of multiple pathologies.
), diabetes in modern medicine, relates to upper, middle and lower jiao, and all five zang organs, especially spleen and kidney. This disease can be seen to have three stages. In the initial stage, the pathological condition is one of heat that exhausts body fluid; thus manifesting as yin deficiency and dry heat, with symptoms such as thirst and ravenous appetite. Due to the depletion of body fluids there is a flaring of the stomach fire. Additionally, there is an accompanying deficiency of the spleen and kidney. The high sugar level of the urine is due to spleen deficiency resulting in incomplete absorption of the food essence, which then falls down into the bladder. The increased volume of urine is the outcome of kidney qi failing to control the water. In the middle stage yin deficiency leads to qi exhaustion. Therefore, signs of qi and yin exhaustion are both to be found. At the same time, signs of stasis appear due to the inability of qi to circulate the blood. Weakness of the zang-fu lead to a variety of complications and dysfunctions that are more severe as time goes on. In the late stage, the deficiency qi and yin become more severe and blood stasis aggravates the situation, thus are seen the manifestations of both yin and yang deficiency as more organs become diseased. This is why diabetes in the late stage is always complicated by the development of multiple pathologies.The treatment principles vary depending on the individual condition of the patient; which can include clearing of heat, moistening of dryness, tonification of qi, nourishment of the yin, strengthening of the kidney to consolidate the root, invigorating the blood, opening the collaterals, and cooling blood and promoting its circulation.
Points: Front: KI 2 (rán gŭ), KI 3 (tài xī), SP 6 (sān yīn jiāo), ST 36 (zú sān lĭ), PC 6 (nèi guān). Back: BL 20 (pí shù), BL 23 (shèn shù), BL 17 (gé shù).
LU 10 (yú jì) is added for thirst. ST 44 (nèi tíng) is used to treat voracious appetite. RN 4 (guān yuán) is used for polyuria. BL 40 (wĕi zhōng), BL 57 (chéng shān), and BL 60 (kūn lún) needled through to KI 3 (tài xī) treats pain or numbness of the lower limbs. LV 3 (tài chōng) and ST 9 (rén yíng) treat hypertension. ST 25 (tiān shū), SJ 6 (zhī gōu) and ST 40 (fēng lóng) are needled for constipation. ST 25 (tiān shū), ST 37 (shàng jù xū) and ST 39 (xià jù xū) can be added for diarrhea. BL 1 (jīng míng) and LV 3 (tài chōng) are points for treating problems with the eyes. HT 7 (shén mén) and PC 6 (nèi guān) treat palpitations. HT 7 (shén mén) and SP 6 (sān yīn jiāo) can be added for insomnia. RN 12 (zhōng wăn) and PC 6 (nèi guān) treat fullness in the chest. RN 17 (dàn zhōng) and PC 6 (nèi guān) are used for chest pain. LI 4 (hé gŭ) and KI 7 (fù liū) help to control sweating. SI 3 (hòu xī) and HT 6 (yīn xì) are used in particular for night sweating. LI 11 (qū chí) and SP 10 (xuè hăi) treat itching. LV 5 (lí gōu) is for perineal itching. KI 12 (dà hè), RN 4 (guān yuán) and LV 3 (tài chōng) can treat impotence; and moxibustion at RN 4 (guān yuán) and RN 8 (shén què) treats deficiency cold.
PALPITATIONS
Lu Shou-yan’s Medical Record
Li, male, 50
[Chief Complaint]
Palpitations
[Present Medical History]
This patient’s palpitations began after an extended period of feeling depressed due to having some kind of setback at work. The palpitations come and go, and he had a sense of fear which interfered with his sleep.
[Examination]
Flushed face, proximal pulse was thin and weak, distal pulse beating hard
[Diagnosis]
Palpitations (due to phlegm fire disturbing heart)
[Treatment Principles]
Expand the chest, relieve depression, transform phlegm, calm the mind
[Treatment]
|
BL 15 (xīn shù) |
RN 14 (jù quē) |
RN 4 (guān yuán) |
|
PC 6 (nèi guān) |
ST 40 (fēng lóng) |
LV 2 (xíng jiān) |
Tonifying-draining was done by means of lifting-thrusting. RN 4 (guān yuán) was tonified, PC 6 (nèi guān) was first drained and then manipulated to circulate the qi of the chest. BL 15 (xīn shù) first drained and then tonified (See the note below for an explanation of the Yang Hidden within Yin Method – [Yīn Zhōng Yĭn Yáng, 
] technique), all the other points were drained.
] technique), all the other points were drained.After three treatments the palpitations were significantly reduced and his sense of fear abated. Another month of acupuncture was given to consolidate the treatment.
[Note]
According to The Yellow Emperor’s Internal Classic (Huáng Dì Nèi Jīng,
) “over thinking and dissatisfaction” are causes of depression. If this continues over a prolonged period of time it will transform into fire, produce phlegm and consume the yin and blood. The phlegm is stirred up by fire which then disturbs the heart. In that the blood fails to nourish the heart, and the mind which is stored in the heart loses its abode, symptoms of palpitations with fear and poor sleep arise. This patient is suffering from phlegm fire, which developed from qi stagnation, that disturbs the mind which is stored in the heart. Professor Lu uses PC 6 (nèi guān) and RN 14 (jù quē) to expand the chest, relieve depression and calm the mind. LV 2 (xíng jiān) is drained to calm the liver thereby eliminating qi stagnation. PC 6 (nèi guān) is drained to quickly circulate qi of the chest. BL 15 (xīn shù) is first drained to remove fire and tonified to firm the deficient yang, Lu uses a particular method, which he describes as Drain First, Then Reinforce (Yin Zhōng Yĭn Yang). RN 4 (guān yuán) is tonified to replenish essence which nourishes the heart. ST 40 (fēng lóng) is drained to bring down turbid phlegm and stop it from disturbing the heart. In this way with three treatments the palpitations are greatly reduced and within one month the patient was cured.
) “over thinking and dissatisfaction” are causes of depression. If this continues over a prolonged period of time it will transform into fire, produce phlegm and consume the yin and blood. The phlegm is stirred up by fire which then disturbs the heart. In that the blood fails to nourish the heart, and the mind which is stored in the heart loses its abode, symptoms of palpitations with fear and poor sleep arise. This patient is suffering from phlegm fire, which developed from qi stagnation, that disturbs the mind which is stored in the heart. Professor Lu uses PC 6 (nèi guān) and RN 14 (jù quē) to expand the chest, relieve depression and calm the mind. LV 2 (xíng jiān) is drained to calm the liver thereby eliminating qi stagnation. PC 6 (nèi guān) is drained to quickly circulate qi of the chest. BL 15 (xīn shù) is first drained to remove fire and tonified to firm the deficient yang, Lu uses a particular method, which he describes as Drain First, Then Reinforce (Yin Zhōng Yĭn Yang). RN 4 (guān yuán) is tonified to replenish essence which nourishes the heart. ST 40 (fēng lóng) is drained to bring down turbid phlegm and stop it from disturbing the heart. In this way with three treatments the palpitations are greatly reduced and within one month the patient was cured.Yang Hidden within Yin Method (Yīn Zhōng Yĭn Yáng 
):
):This method involves manipulating the needle at both deep and shallow levels in the following way:
The needle is inserted first to the deep level, then manipulated to drain with six quick lifting and then slow inserting thrusts; the needle is then lifted to the shallow level and manipulated to tonify with nine quick thrusting and slow lifting motions. It is used to treat illness which first manifest with heat and then turn to cold.
This technique is the opposite of the Yin Hidden within Yang Method (Yáng Zhōng Yĭn Yīn, 
). Both of them are indicated for use in complicated syndromes with simultaneous presentations of deficiency and excess.
). Both of them are indicated for use in complicated syndromes with simultaneous presentations of deficiency and excess.Cheng Xin-nong’s Medical Record
Wu, female, 48, first visit was on May 11, 1992
[Chief Complaint]
Palpitations with shortness of breath for four years
[Present Medical History]
At the beginning of her illness the patient went to a hospital in Beijing for an examination, she was not found to have any problems with any of her organs. She had symptoms of heart palpitations, shortness of breath, insomnia and forgetfulness; she experienced dizziness, tinnitus, a sore back, dry stools, and scanty irregular periods, which were dark in color and contained clots.
[Examination]
Lustreless complexion, red tongue, thin contracted tongue and with cracks and a white coating, the pulse was deep, thin and wiry.
[Diagnosis]
Palpitations (due to yin deficiency with fire)
[Treatment Principles]
Moisten yin to reduce fire, calm the heart and mind
[Treatment]
|
RN 14 (jù quē) |
RN 17 (dàn zhōng) |
BL 15 (xīn shù) |
|
BL 23 (shèn shù) |
PC 7 (dà líng) |
PC 6 (nèi guān) |
|
HT 7 (shén mén) |
SP 6 (sān yīn jiāo) |
KI 3 (tài xī) |
|
LV 3 (tài chōng) |
BL 15 (xīn shù) and BL 23 (shèn shù) were treated with quick needling. SP 6 (sān yīn jiāo) and KI 3 (tài xī) where needled with a tonifying method; other points were treated with an even method.
After one course of treatment the patient’s palpitations and shortness of breath were reduced. She was given two more courses of treatment, although not in succession, to consolidate her condition, which stabilized with only occasional palpitations.
[Note]
Blood deficiency leads to the rise of deficient fire, disturbing the mind stored in the heart and leading to palpitations, shortness of breath and insomnia. BL 15 (xīn shù), the Back-shù of the heart, RN 14 (jù quē), the Front-mù of the heart, PC 6 (nèi guān), the luò-connecting point, and RN 17 (dàn zhōng) the influential point of qi, function together to tonify qi thus producing blood which nourishes the heart, thus stopping palpitations. The other points reduce fire through the moistening of yin and settle the heart and calm the mind.
Summary
Palpitations, known as Jīng Jì (
) in Chinese medicine, are treated using a combination of Back-shù and Front-mù points.
) in Chinese medicine, are treated using a combination of Back-shù and Front-mù points.Commonly used points: BL 15 (xīn shù), RN 14 (jù quē), HT 7 (shén mén), PC 6 (nèi guān).
For those who have heart blood deficiency, add BL 20 (pí shù) and BL 21 (wèi shù) to promote blood production; for yin deficiency with fire, add BL 18 (gān shù), KI 3 (tài xī), BL 23 (shèn shù) and LV 3 (tài chōng) to replenish yin to smooth the liver and improve communication between the heart and kidney; for yang deficiency with dampness, add RN 4 (guān yuán), RN 17 (dàn zhōng) and ST 36 (zú sān lĭ) to strengthen the spleen to transform fluids; for sudden fright, add sì shén cōng (EX-HN1) and yìn táng (EX-HN3) to settle and calm the mind.
Bú Mèi (INSOMNIA)
Lu Shou-yan’s Medical Record
Li, male, 33
[Chief Complaint]
Difficulties in falling asleep for half a year
[Present Medical History]
This patient had occasional difficulties with falling asleep; lately his sleep problem had became worse. Additionally he had dizziness, tinnitus, dry throat, irritability, seminal emissions and lumbar soreness.
[Examination]
Red tongue with a sparse coating, and a thin rapid pulse
[Diagnosis]
Insomnia (due to disharmony between heart and kidney)
[Treatment Principles]
Strengthen water to control fire, facilitate communication between the heart and kidney
[Treatment]
|
BL 15 (xīn shù) |
BL 23 (shèn shù) |
HT 7 (shén mén) |
|
SP 6 (sān yīn jiāo) |
Moxibustion with 3 grain-sized cones was done at BL 15 (xīn shù). Lifting-thrusting needling without retention of needles was done at the other points. BL 23 (shèn shù) and SP 6 (sān yīn jiāo) were tonified. HT 7 (shén mén) was drained.
Second visit: His condition was improved, red tongue, thin pulse.
[Treatment]
|
BL 14 (jué yīn shù) |
BL 23 (shèn shù) |
HT 7 (shén mén) |
|
SP 6 (sān yīn jiāo) |
KI 3 (tài xī) |
PC 6 (nèi guān) |
Moxibustion with 3 grain-sized cones was done at BL 14 (jué yīn shù). Lifting-thrusting needling without retention of the needles was done at the other points. BL 23 (shèn shù), SP 6 (sān yīn jiāo) and KI 3 (tài xī) were tonified. HT 7 (shén mén) and PC 6 (nèi guān) were drained.
Third visit: The patient could sleep soundly and his spirit felt much stronger. The dizziness, tinnitus, dry throat and irritability disappeared. He still had a red tongue, with a sparse coating, and a thin pulse. The treatment principles were still to facilitate communication between the heart and kidney, accompanied by tonifying and harmonizing the spleen and stomach to produce blood to calm the mind.
[Treatment]
|
PC 6 (nèi guān) |
HT 7 (shén mén) |
SP 6 (sān yīn jiāo) |
|
BL 20 (pí shù) |
ST 36 (zú sān lĭ) |
KI 3 (tài xī) |
Lifting-thrusting needling without retention of the needles was done. PC 6 (nèi guān) and HT 7 (shén mén) were drained. Other points were tonified.
[Note]
The heart is the house of mind and kidney the house of essence. Dizziness, tinnitus, seminal emissions and lumbar soreness are all signs of a deficiency of kidney essence; dry throat and irritability are indicative of yin deficiency with fire; a red tongue and rapid pulse point to the flaring of fire. Professor Lu treated this patient with the intent of strengthening water to control fire, and to facilitate communication between the heart and kidney. Moxibustion with 3 cones done at BL 15 (xīn shù) was to drive out the fire. HT 7 (shén mén) was drained to clear heart fire and settle the mind. Tonification of BL 23 (shèn shù) and SP 6 (sān yīn jiāo) was to strengthen water and control fire.
On the second visit, moxibustion with 3 cones at BL 14 (jué yīn shù) was employed to reduce heart fire, PC 6 (nèi guān) was drained to settle the mind, and KI 3 (tài xī) was tonified to replenish water. On the third visit, moxibustion was not used, but BL 20 (pí shù) and ST 36 (zú sān lĭ) were added to strengthen spleen and stomach, thus producing blood to calm the mind. Three treatments successfully cured this patient’s half year of insomnia.
Xiao Shao-qing’s Medical Record
Li, female, 67, first visit was on October 24, 1994
[Chief Complaint]
Insomnia for more than 30 years, worse in the past year
[Present Medical History]
One year ago, the patient’s insomnia became worse after the death of her husband. She could not sleep without taking medication. In 1992 after a cholecystectomy she began to have indigestion with diarrhea. At the time of her visit she had difficulties with falling asleep, and when she did sleep she had nightmares. She was dizzy and was in a low mood. She had a tendency to over-think, was anxious and had a poor appetite; her stools were also loose.
[Previous medical history]
Cholelithiasis. Cholecystectomy 2 years previously
[Examination]
Pale tongue, white greasy coating, wiry and slippery pulse
[Diagnosis]
Insomnia (due to phlegm retention with qi stagnation, restlessness of mind)
[Treatment Principles]
Transform phlegm, relieve stagnation, settle the heart, calm the mind
[Treatment]
|
DU 20 (băi huì) |
yìn táng (EX-HN3) |
dìng shén (EX-HN16) |
|
HT 7 (shén mén) |
PC 5 (jiān shĭ) |
ST 36 (zú sān lĭ) |
|
ST 40 (fēng lóng) |
SP 6 (sān yīn jiāo) |
LV 3 (tài chōng) |
An even method was applied; the needles were retained for 20 minutes and manipulated every 10 minutes. Treatment was given once a day.
On the second visit she said that she felt good after the previous treatment, but still did not sleep well. The same treatment was given to her. On the third visit, she said she slept for five hours without taking medication. After one course of treatment, she could sleep about 10 hours. The nightmares stopped, her appetite improved, her pulse was a bit slow but forceful and her tongue and coating tended toward normal.
[Note]
This patient generally is prone to overthinking, this easily leads to constraint of the liver qi. Add in the additional stress in her life and the stagnated liver qi is made worse, which then in turn attacks the middle jiao. Furthermore, the cholecystectomy damaged the qi of the middle jiao, hence the spleen and stomach are weak, and the production of phlegm is the result. The stagnated liver qi and phlegm disturb the heart, causing restlessness of mind, thus poor sleep. Professor Xiao used yìn táng (EX-HN3) and dìng shén (EX-HN16) in combination with DU 20 (băi huì) to open the du vessel to wake up the mind. HT 7 (shén mén) and PC 5 (jiān shĭ) were used to calm the mind and benefit consciousness. ST 36 (zú sān lĭ), SP 6 (sān yīn jiāo) and ST 40 (fēng lóng) are used to strengthen the spleen which in turn benefit dampness and transform phlegm. LV 3 (tài chōng) was treated to calm the the liver and regulate the qi. The success of this treatment is due to the principle of transforming phlegm, regulating stagnated qi, and settling the mind and calming the heart.
Dìng shén (EX-HN16) is located at the conjunction of the lower and middle 1/3 of the philtrum. Pinch the skin, and insert a 3 inch filiform needle horizontally about 2.5 inch at an angle of 15° to the subcutaneous level. It produces very strong sensations of soreness and distention. After a while, the patient will feel relaxed and may even fall asleep. This is an experiential point that Professor Xiao uses to treat insomnia with irritability. He also uses it to treat mental disorders such as epilepsy, and gets good result too.
Cheng Xin-nong’s Medical Record
Wu, male, 59, first visit was on September 12, 1992
[Chief Complaint]
Poor sleep over 30 years
[Present Medical History]
In the past three years, the patient could not sleep at all without the aid of a sleeping pill, he was completely dependent on them. Two years ago he went to a Beijing hospital to have his liver function tested, his blood test showed a higher than normal level of bilirubin and he was diagnosed with gastrointestinal dysfunction. At this time, he had difficulties in falling asleep, along with dream-disturbed sleep; especially when tired, he could not sleep at all. Additionally, he had abdominal distention, poor appetite, diarrhea after drinking milk, soreness in lumbar region, frequent flatulence, and bowel movements two to three times a day.
[Examination]
Patient’s tongue was pale purple, with a tip red and white coating; wiry pulse
[Diagnosis]
Insomnia (due to disharmony between spleen and stomach)
[Treatment Principles]
Strengthen the spleen, harmonize the stomach, settle the heart and calm the mind
[Treatment]
|
RN 12 (zhōng wăn) |
ST 25 (tiān shū) |
RN 6 (qì hăi) |
|
PC 6 (nèi guān) |
HT 7 (shén mén) |
ST 36 (zú sān lĭ) |
|
SP 6 (sān yīn jiāo) |
KI 3 (tài xī) |
RN 6 (qì hăi) and ST 36 (zú sān lĭ) were tonified; the other points were treated with an even method.
After four courses of treatment, his spleen and stomach functions gradually improved, his sleep was better and the dosage of the sleep medication was reduced by half. Another four courses of treatment, although intermittent, helped him to sleep six to eight hours each night without the need for medication.
[Note]
The spleen oversees transport and transformation of food essence and sends the clear essential substance upward to nourish. When this function has been weakened, the heart will lack nourishment. The stomach receives food and sends the roughly digested food downward. When the stomach qi is disharmonious it goes up instead of down, this upward movement will disturb the spirit [stored in the heart]; thus insomnia.
RN 12 (zhōng wăn), ST 25 (tiān shū), RN 6 (qì hăi) and ST 36 (zú sān lĭ) are selected to promote the spleen in its transportive and transformation function, harmonize the stomach in digestion and get rid of distention. PC 6 (nèi guān), HT 7 (shén mén) and SP 6 (sān yīn jiāo) are experiential points for treating insomnia. PC 6 (nèi guān) is the luò-connecting, HT 7 (shén mén) is the yuán-source, and SP 6 (sān yīn jiāo) is the intersection point of spleen, liver and kidney channels, they settle the heart and calm the mind. KI 3 (tài xī) and HT 7 (shén mén) open communication between the heart and kidney.
Summary
Bú Mèi (
) is modern medicine’s name for insomnia. “When yang enters into yin, one sleeps. When yang comes out of yin, one wakes up.” Zhang Jingyue says: “Sleep depends on yin that nourishes the mind. When the mind rests well, one sleeps well. When the mind is restless, one cannot sleep well.” Problems with sleep can be due to restlessness of mind which is the result of external pathological factors or it can be due to internal causes such a deficiency of the nourishing qi. Heart and spleen deficiency, yin deficiency with fire, liver and gall bladder fire or disharmony of the stomach are all common causes of insomnia. The treatment principles are to settle the heart and calm the mind. The stimulation of acupuncture points should not be strong, thus avoiding disturbing the mind.
) is modern medicine’s name for insomnia. “When yang enters into yin, one sleeps. When yang comes out of yin, one wakes up.” Zhang Jingyue says: “Sleep depends on yin that nourishes the mind. When the mind rests well, one sleeps well. When the mind is restless, one cannot sleep well.” Problems with sleep can be due to restlessness of mind which is the result of external pathological factors or it can be due to internal causes such a deficiency of the nourishing qi. Heart and spleen deficiency, yin deficiency with fire, liver and gall bladder fire or disharmony of the stomach are all common causes of insomnia. The treatment principles are to settle the heart and calm the mind. The stimulation of acupuncture points should not be strong, thus avoiding disturbing the mind.Related posts:
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