Dr. Tran Viet-Dzung Tendino-Muscular Meridians May, 2001
Lake Chelan WA, May 2004
The tendino-muscular meridians (TMM) originate at jing well points of principle meridians & travel at a level below the dermis, where muscles, ligaments, tendons & nerves reside. Their function is to protect principle meridians from EPI invasion. The main symptom of EPI invasion of TMM is Bi syndrome, manifested as pain & paresthesia. The Ling Shu connects each TMM with a season & lunar month within each season. Practitioners may notice they’ll have several patients coming in with similar TM complaints at certain times of year. For example, 4 patients in late Spring with plantar fascitis. Reunion points are accumulation points common to the 3 TMM of each season. Disperse reunion points to clear EPI from TMM.
Spring - GB, BL & ST.
3 Yang Foot TMM. Reunion points SI-18, ST-8.
Summer - LI, SI & SJ.
3 Yang Arm TMM. Reunion points ST-8, SI-18.
Autumn - SP, K & LV.
3 Yin Foot TMM. Reunion points CV-2 or 3.
Winter - PC, LU & HT.
3 Yin Arm TMM. Reunion point GB-22.
GB TMM: 1st month of Spring (approx. March 21 – April 20) Symptoms: 4th toe pain, contracture, spasm, tightness or paresthesia. Lateral ankle pain or paresthesia. Lateral leg pain or paresthesia. Popliteal crease or lateral knee pain. Lateral thigh pain or paresthesia. Coccygeal pain. Lateral rib pain or spasm. Breast pain. Contra lateral neck pain or spasm, lateral blephera spasm.
GENERAL TX: Analgesic technique: disperse ah shi points by inserting 2 needles facing each other, one on either side of the ah shi point. Needle obliquely into the TM level, which is deeper than dermis level. Locally stimulate needles manually or with electro, until local distention occurs. Electro machine set on continuous mode, high frequency & high intensity (just below patient tolerance) for 5 minutes. Re-adjust as needed every 5 minutes, for a total of 15 minutes. Moxa can also be used to move pain out of affected area. Tonify principle meridian with GB-43 (ying spring point), GB-40 (yuan source point), contra lateral GB-44 (jing well point). SI-18 or ST-8 (reunion points of yang leg MTT.) Always add Yang Ming tonification points LI-4 & ST-36.
EX 1: Hypochondriac pain due to biliary cholic. Use analgesic technique at ah shi points. SJ-6, GB-43, GB-40, SI-18, GB-44. Use GB-34 (xi-cleft point) & LV-6 to regulate LV-GB system. Do not to allow GB-34 to bleed, as loss of Liver blood disrupts connection between LV & GB. LV-14. Moxa BL-18 & 19. LV-13 (influential point for Liver). Treat GB by needling CV-12 (influential for yang organs). CV-5, since this is a lower jiao problem & SJ Mu point brings water to balance K/LV in lower burner. LI-4 & ST-36.
EX 2: Breast pain – especially superficial or with very light palpation. CV-17 & K-25. Both needled towards affected breast. SP-21 (located in 6th intercostal space, mid-axillary line). GB-22 (located in 5th intercostal space). Needle ST-15 with electro to K-22. Electro between K-25 & either SP-21 or GB-22. Use analgesic technique (continuous mode, high frequency & high intensity.) SP-21 for general body pain (it is at level of an upper horizontal zone (analogous to Dai Mai at GB-26 level). Pain at top of nipple is associated with LV-GB. Disperse ah-shi point around GB-21. Disperse LV-3, SI-18 and/or ST-8. Tonify GB-43, GB-40, GB-44, LI-4 & ST-36.
EX 3: Lateral blephera spasm. Due to lack of water in muscles of eyelids. Need K water traveling along ShaoYang (SJ & GB) to moisten eye muscles. GB-4, 5 & 6 are near eye & can bring water to it. Tai yang extra point corresponds to water, too. It’s directly on superficial artery near eye. SJ-20 connects to GV-20, where all yang organs meet. GV-20 concentrates water & balances jing. SJ-20 connects to BL-7. GV-20 connects to SI-18 & ST-8. Needle both ST-8 points, pointed toward each other. Add GB-43, GB-40, GB-44, SJ-3 (to tonify SJ as Shao Yang). Tonify LI-4 & ST-36.
BL TMM: 2nd month of Spring (approx. April 21 – May 20) Symptoms: Pain in 5th toe that may radiate into heel. Plantar fascitis. Pain at approx. Bl-61. Lateral ankle pain. Popliteal knee pain, contracture, inflammation or hardness. Gluteal pain. Spinal pain, especially at GV-4. Feels like they are “broken in half.” Leans backwards to walk. Reduced range of motion rotating L or R. Shoulder or axilla pain. Posterior neck tightness. Skull or periorbital eye pain. Upper blephera inflammation or spasm.
GENERAL TX: Analgesic technique at ah shi points. Tonify principle meridian with BL-66 (ying spring point), BL-64 (yuan source point), and BL-67 (jing well point). LI-4 & ST-36. Disperse SI-18 and/or ST-8.
EX 1: Plantar fascitis. Find ah shi point near center of heel. Needle directly into it, all the way to bone. DO NOT HESITATE OR VACILLATE. Just do it with clear intention. Find another ah-shi point around BL-61. Use analgesic technique with electro between these two points. Tonify BL-67, BL-66, BL-64, LI-4 & ST-36. Disperse SI-18. Can use moxa to tonify.
EX 2: Spinal pain. Patient may feel as if they are breaking in half. Tendency is to lean backwards when they walk. Ah shi points using electro & analgesic technique. SI-3, BL-62. Oblique insertion of jiaji points at GV-4. GV-4, BL-23, BL-52. Tonify principle meridian with BL-66, BL-64 & BL-67. Tonify ST-36 & LI-4. Disperse SI-18.
EX 3: Posterior neck pain, skull pain, occipital headache or periorbital pain. Needle GV-1 & GV-16 (end points of longitudinal luo meridian). Curious point in center of posterior neck at level of cervical vertebrae 4, 1 cun lateral to the spine is empirical for neck pain. Angle towards BL-10. BL-10, GB-20 & SJ-16 are Window of the Sky points, which close when too much energy rises into head. They must be opened in order to maintain communication between upper & lower body. BL-10 treats K, GB-20 brings K water to LV. BL-7, connects Tai Yang (a water point) to brain via connection to GV-20. BL-2 accelerates water transport to brain. Tonify BL-66, BL-64 & BL-67, LI-4 & ST-36. Disperse SI-18.
ST TMM: 3rd month of Spring (approx. May 21 – June 20) Symptoms: Pain, tightness or cramps in 2nd toe. Antero-lateral ankle pain. Tight anterior tibialis muscle. Pain or tightness around GB-34 or ST-32. Hip pain at GB-30. Inflammation of femoral triangle that ascends to external genitalia or to CV-2 - CV-3 area. Tightening or clenching of abdomen. Pain at CV-12. Pain or spasm of lower jaw. Facial paralysis. Spasm of lower blephera.
GENERALTX: Analgesic technique at ah shi points. Tonify principle meridian with ST-44, ST-41 & ST-45. Disperse ST-8. Point it towards opposite ST-8. Tonify LI-4 & ST-36.
EX 1: Facial paralysis. This usually occurs when patient is tired & their wei qi is weak. Riding in a car or sleeping near an open window can result in facial paralysis. Due to WC or heat EPI. Determine which eye is affected & whether or not it is held open or closed. Have patient close both eyes. If upper eyelid is affected, patient won’t be able to close affected eye. If lower eyelid is affected, patient won’t be able to open affected eye. If GB TMM, strabismus occurs toward affected side. If contracture caused by WC EPI, mouth deviates toward affected side, & eye will remain open. For example, if L side affected by cold, L eye will remain open & mouth will deviate toward L. Thread L ST-6 towards ST-4. Contra laterally, thread ST-4 towards ST-6. Tonify ST-41, the Qing of the ST meridian, to bring heat to area to fight cold invasion. If blephera spasm is caused by heat, affected eye can’t open because heat expansion is pushing it closed. Heat will also push mouth to opposite side. So, if, L side affected by heat, L eye remains closed & mouth deviates to R. Thread L ST-4 towards ST-6, & R ST-6 towards ST-4. Tonify ST-44, ying spring point, to cool heat. LI-4, LI-11, ST-36 & GV-14. All yang meridians cross GV-14 & those meridians bring water to create wei qi, which must circulate to be effective. To circulate wei qi in face, bilaterally needle CV-22, CV-23, ST-5 & ST-9.
Differential diagnosis for the 3 yang leg TMM is blephera spasm. Lateral spasm or strabismus = GB. Upper eyelid = BL. Lower eyelid = ST.
LI TMM: 1st month of Summer (approx. June 21 – July 20) Symptoms: pain, contracture or paresthesia at LI-1, possibly radiating towards LI-5. Pain along dorsi-lateral aspect of forearm. Lateral epicondylitis. Frozen shoulder - patient cannot touch their opposite shoulder across front of their body. Contra lateral dislocation of jaw or TMJ. Contra lateral maxillary arthritis. Contra lateral migraine with pain at ST-8, across forehead, or wraps front & sides of head like a scarf. Migraine pain may extend to contra lateral neck.
GENERAL TX: Analgesic technique at ah shi points. Tonify LI-1, LI-4, LI-11 & ST-36. Disperse ST-8 (most likely) or SI-18. Point ST-8 towards opposite ST-8. Add SJ-5 & GB-41.
EX 1: Lateral epicondylitis (tennis elbow). Needle an elbow ah shi point toward hand. Find another ah shi point around LI-10.This ah shi point is almost always directly on tendon, ligament or bone. Needle this ah shi point toward elbow ah shi point. Electro with analgesic technique (continuous mode, high frequency & high intensity). Tonify LI-11, LI-4, ST-36 & LI-1. Disperse ST-8 needled towards contra lateral ST-8. SJ-5 (to release the exterior). Wei guan is outer gate, or external barrier. Add GB-41 (Master of Yang Wei Mai.)
EX 2: Frozen shoulder. This condition can be due to either LI principle meridian blockage or LI TMM. Generally, if it’s acute, it’s LI TMM. Chronic cases are usually a blockage in principle LI meridian. A quick test is to vigorously needle contra lateral LI-1. Then have them reach across their body to touch their opposite shoulder. If needling LI-1 helped that movement, it’s TMM. Disperse ah shi points using analgesic technique with electro. Tonify LI-11, LI-4, LI-1, ST-36, GB-41 & SJ-5. Disperse ST-8 toward opposite ST-8. If needling LI-1 did not improve movement, it’s principle LI meridian. Needle ST-37 ipsilaterally with deep, strong stimulation.
EX 3: Maxillary arthritis. Can affect upper or lower maxilla. If upper maxilla, contra lateral LI-4 & ST-7. Add ST-41, ST-44, ST-36 & LI-1. Disperse ST-8 toward opposite ST-8. Add SJ-5 & GB-41. If lower maxilla, use contra lateral ST-6 instead of ST-7.
SI TMM: 2nd month of Summer (approx. July 21 – Aug. 20) Symptoms: Pain in 5th finger that radiates to lateral wrist or medial epicondyle. Pain at SI-8. Pain in axilla or shoulder. Female patients cannot reach behind their back to remove their bra. Posterior neck pain or inflammation. Otalgia, tinnitus, or buzzing in ear. Migraine with neck & shoulder pain & ringing in ears. Maxillary pain.
GENERAL TX: Analgesic technique at ah shi points. Tonify SI-3, SI-4, SI-1, ST-36 & LI-4. Disperse ST-8 toward opposite ST-8. SJ-5 & GB-41.
EX 1: Ear pain. Can be otalgia, tinnitus or buzzing in ear. Find a zone about a finger’s width above ear. Insert 2 needles. SJ-17, slightly inferior to where we learned it… Tran’s location is right behind ear lobe. Should be tender to touch. Deep insertion, pointed toward inner ear. SI-19 (in front of tragus). SJ-21 & GB-2. Tonify SI-3, SI-4, SI-1, LI-4 & ST-36. Disperse ST-8 toward contra lateral ST-8. SJ-5 & GB-41.
SJ TMM: 3rd month of Summer (approx. Aug. 21 – Sept. 20) Symptoms: Pain in 4th finger that may radiate to wrist at SJ-4. Synovial cyst around SJ-3. Shoulder pain – patient cannot touch top of their head or behind their neck when their elbow is out to affected side. Lateral neck pain. Pain in front of the ear. Tongue retraction or migraine with tongue retraction.
GENERAL TX: Analgesic technique at ah shi points. Tonify SJ-3, SJ-4, SJ-1, SJ-5, GB-41, LI-4 & ST-36. Disperse ST-8 toward contra lateral ST-8.
EX 1: Synovial cyst. Find ah shi points around SJ-3 & SJ-5. Needle as close to the cyst as possible, unless patient is pre-surgery for cyst. Analgesic technique using electro (continuous mode, high frequency & high intensity). Add LI-4, ST-36, SJ-1. Disperse ST-8 toward contra lateral ST-8.
EX 2: Tongue retraction. SJ-17, CV-23 angled toward tongue. Contra lateral SJ-3, SJ-4, SJ-1 & ST-8. LI-4 & ST-36 – especially if there is atrophy of the tongue due to prolonged retraction.
Differential diagnosis for 3 yang arm TMM is frozen shoulder or migraine pattern. Inability to reach across body to touch opposite shoulder, migraine that travels across forehead or wraps around like a scarf = LI. Inability to reach behind the back (females can’t remove their bra by reaching behind their back), migraine with ear-ringing, neck & shoulder involvement = SI. Inability to touch top of head or back of neck with elbow extended laterally, migraine in front of ear only or with tongue retraction = SJ.
SP TMM: 1st month of Autumn (approx. Sept. 21 – Oct. 20) Symptoms: Pain in medial aspect of large toe. Hallux valgus syndrome. Medial malleolus pain. Medial knee pain. Women with medial knee pain frequently have hardening around SP-9. Medial thigh pain. Pain in femoral triangle. Pelvic pain that may radiate into external genitalia or to back. Umbilical pain. Patients may also exhibit hypochondriac, thoracic, or spinal pain. Chest fullness due to asthma phlegm.
GENERAL TX: Analgesic technique at ah shi points. Tonify SP-2, SP-3, SP-1, LI-4 & ST-36. Disperse CV-2 or CV-3 zone (reunion points).
EX 1: Hallux valgus syndrome. Needle SP-2 ah shi point toward joint. Needle SP-3 ah shi point towards joint. Analgesic technique with electro. LV-3 angled toward large toe. ST-42 needled where you feel dorsalis pedis artery pulsing. Dr. Tran uses ST-42 for any type of foot problem.
EX 2: Medial knee pain. The Ling Shu says to use BL-62 (Master of Yang Qiao Mai) for men with medial knee pain, & K-6 for women with medial knee pain. As always, find ah shi points around SP-9, use analgesic technique with electro. Then tonify principle meridian & Yang Ming (SP-2, SP-3, SP-1, and LI-4 & ST-36). Disperse reunion point(s) CV-2 and/or CV-3. If a patient has had knee surgery, don’t needle directly into the scar, but surround it with needles angled toward scar.
EX 3: Umbilical pain. K-16 & ST-25 are transit points for wei qi. Needle K-16 deeply, angled toward peritoneum, since it rules peritoneum. It brings wei qi from deep inside body, to surface. Moxa ST-25 to circulate wei qi brought forward by K-16. The ancient texts also use SJ-6 & GB-34 (don’t let it bleed!). Tonify SP-2, SP-3, SP-1, LI-4 & ST-36. Disperse CV-2 and/or CV-3.
EX 4: Thoracic or spinal pain. Yang energy stuck in the chest = fullness. CV-17 re-establishes balance in chest by bringing water from SJ & fire from PC. PC-6 opens chest. CV-22, K-27, SP-2, SP-3, SP-1, LI-4 & ST-36. Disperse CV2 and/or CV-3. If pain radiates to spine, SI-3 & BL-62 open Du Mai. Can also use GV-26. Can bleed it or use a quick, in & out insertion, angled toward base of nose. TCM theory explains loss of consciousness as disconnection between 7 orifices (2 eyes, 2 ears, 2 nostrils & mouth). GV-26 re-establishes connection, because it is located at center of 7 orifices. Tonify SP-2, SP-3, SP-1, LI-4, ST-36 & disperse CV-2 and/or CV-3.
K TMM: 2nd month of Autumn (approx. Oct. 21 – Nov. 20) Symptoms: Pain at K-1 or plantar aspect of 5th toe. Ling Shu describes K-1 at that location. Anterior plantar pain or contracture. Medial ankle pain around K-3. Popliteal pain around K-10. Differentiate between K & BL knee pain by testing reunion points for tenderness. If K, CV-2 area will be tender. If BL, SI-18 area will be tender. Medial thigh pain. Pelvic pain or pain radiating into external genitalia. Lower abdominal “heaviness” & lumbar pain causing patient to hunch forward when they walk. Para spinals ascending to occiput feel tight or painful. K TMM connects to BL TMM as both TMMs ascend the posterior aspect of the body. BL TMM travels along the spine & K TMM travels along para spinals. Differentiate via reunion point reactivity & treat accordingly.
GENERAL TX: Analgesic technique at ah shi points. Tonify K-3, K-7 K-1, LI-4 & ST-36. Don’t allow K-3 to bleed – can result in tachycardia. Disperse CV-2 and/or CV-3.
By now, we should have an idea of how to treat painful areas. Several TMMs have common symptoms (knee pain, back pain, lower abdominal pain, genital pain, etc.) Differential diagnoses & reunion point reactivity provide clarity. Use appropriate tonification of principle meridians involved & disperse proper TMM reunion points. Always remember to tonify Yang Ming.
A few interesting asides Dr.Tran discussed regarding Kidney Yin Xu….
EX 1: Tonification of Kidney Yin. CV-4 or CV-5 angled towards CV-4, K-7, CV-3, SP-6. Secondary tonification of K yang by using GV-4. Generally, to reduce xu heat, use earth points.
EX 2: Kidney stones and wei qi. Kidney yin xu can result in LV fire flare up. Internal LV heat can create internal wind – like leaves burning, which swirl around as they burn. Internal fire evaporates water, leaving only mineral crystals behind. CV-5 (SJ MU point) balances water level to reduce internal LV heat. CV-5 also dilates ureters to allow kidney stones to pass. CV-5 is where wei qi is formed. K water is heated by ministerial fire of LV. The resulting steam circulates throughout body as Yang energy, protecting against EPIs. It is Yang energy originating from Yin source (K & LV).
EX 3: Bone marrow dryness/xu. Again, LV heat & wind can flare up when K yin is xu. CV-5 (as discussed above) threaded toward CV-4. GB-16 brings water to head (located in line with center of eye, 1 cun posterior to anterior hairline). Tonify with perpendicular insertion. GB-39 (palpate from lateral malleolus superiorly along fibula. Where fibula “disappears”, you’ll feel tibial crest. Trace a line anteriorly from there, until you are between tibia & fibula). Needle deeply. K-7, LI-16, GV-20 & GV-15 needled obliquely toward each other. ST-36 & an extra point 3 cun distal & 1 cun lateral to ST-36. Dr. Tran calls this point ST-40. LI-4 & SP-3. Do NOT use moxa on these points, since marrow is already dry.
EX 4: Headache and vertigo. Differential diagnosis: K xu & LV shi = emptiness in lower jiao & fullness in upper jiao. Heavy head = vertigo or vertex headache. HT & SP xu =emptiness below & above. Empty head = vertigo. SP & ST xu = phlegm rises to head & gets stuck there. Shi Phlegm = vertigo. BL-10 (K), GB-20 (LV) & SJ-16 (window of the sky points). GV-16, GV-20, BL-7, GB-16 & BL-2 (angled toward Tai Yang extra point) bring water. LU-7 angled toward LI-4, SI-3 & LI-11 circulate ying energy, GB-34 (don’t let it bleed!) & LV-3 stifle wood (LV) fire with earth points. BL-17 & SP-10 circulate blood to push out wind.
CV-12 & Tran’s ST- 40 remove phlegm. Add appropriate primary channel tonification points & reunion points for the channel involved in your diagnosis (K, LV, HT, SP or ST). Tonify Yang Ming with LI-4 & ST-36.
LV TMM: 3rd month of Autumn (approx. Nov. 21 – Dec. 20) Symptoms: Pain or contracture at LV-1. Ankle pain around LV-4. Pain or contracture at adductor tubercle or around LV-8. Internal or external genital pain. Vaginal itching in females. Contracture (cold) or lengthening (heat) of penis in males, preventing erection that is TM in nature. Differentiate from impotence, which is K yang xu. Pain between CV-2 & pubic symphysis.
GENERAL TX: Ah shi points using analgesic technique. Tonify LV-8, LV-3 & LV-1. Dr. Tran needles LV-1 where 3 hairs sprout on large toe. The hairs, like little plants, need water to grow. He considers this location jing well point of Liver. For hairless patients, use traditional location at base of nail. Disperse CV-2 and/or CV-3. Don’t forget ST-36 & LI-4.
EX 1: Vaginal itching or dryness. There is a longitudinal luo meridian between LV-5 & CV-2 or CV-3. If this meridian is empty because of Liver blood xu or stagnant Liver qi in another area, vaginal itching results. Disperse ah shi points & CV-2 /CV-3. Tonify LV-5, LV-8, LV-3, LV-1, ST-36 & LI-4. Add GB-37 (Luo point connecting GB to LV.) For dryness, CV-7 has a branch to bring water to uterus. This branch is why Dr. Tran prefers CV-7 to CV-5 as SJ MU point.
EX 2: TM penile flaccidity. Always good to tonify K-3 (don’t let it bleed!), K-7 & K-1 when LV is involved. If heat prevents erection, disperse LV-5, CV-2. Tonify CV-3 (BL Mu point) to cool heat in genitals. Adds water to wood.) GB-34 (don’t let it bleed!), LV-8, LV-3, LV-1, ST-36 & LI-4.
Differential diagnosis for 3 leg yin TMM is radiation of lower abdominal pain. Radiation to umbilicus, thorax or ribs = SP. Radiation into buttocks, lower lumbar or para spinals = K. No radiation from pelvic region = LV.
PC TMM: 1st month of Winter (approx. Dec. 21 – Jan. 20) Symptoms: External or internal origin. If external origin, patient exhibits precordial and/or hypochondriac pain. Precordial pain mimics angina, & is worse after eating. Cardiac tests are normal. If internal origin, patient exhibits contracture of internal thoracic area. Stagnation in chest causes supraclavicular compression syndrome, cardiac pain, dyspnea, gastric reflux or hiatal hernia.
GENERAL TX: Analgesic technique at ah shi points. Tonify PC-7, PC-9, LI-4 & ST-36. Disperse GB-22.
EX 1: Precordial pain. The He Li pathway, called Great Luo of the stomach, is an empty channel that runs from stomach to diaphragm, through lungs & heart & descends to ST-18. Spleen hypo function resulting in damp or food accumulation backs up primary channel & eventually into the He Li pathway. This rising energy is yang. It ascends toward yang fire of heart. Yang plus yang = cardiac pain, angina, palpitations or tachycardia. Sure does sound like a MI. BE SURE it is not!!! If you have correctly diagnosed TMM of PC, needle ah shi points around K-25 & K-22. Angle needles toward each other. ST-15 & GB-22 angled towards painful area. Electro between K-25 ah shi point & GB-22. Second electro between ST-15 & K-22 ah shi point. Continuous mode, high frequency & intensity for 20 minutes, adjusting as needed every 5 minutes. CV-12 descends energy from digestive back-up. CV-17 brings water from SJ & fire from PC to balance yin/yang in chest. PC-6 opens chest via longitudinal luo. ST-18 (end of He Li pathway). Disperse ST-45. Tonify PC-7, PC-9, LI-4 & ST-36, SP-3 & SP-9 (To balance the treatment of ST with SP points).
EX 2: Thoracic pain due to internal origin. Thoracic contracture, gastric reflux, hiatal hernia, etc. CV-17, PC-6. CV-13 for gastric reflux. K-20 & K-21 are Chong Mai points bringing (deep) K fire to (surface) CV-13 area. Needle superficially. Disperse GB-22. Tonify PC-7, PC-9, LI-4 & ST-36.
LU TMM: 2nd month of Winter (approx. Jan. 21 – Feb. 20) Symptoms: Pain or contracture at LU-11, LU-9 or LU-5. Supraclavicular compression syndrome. Hypochondriac pain, dyspnea, depression.
GENERAL TX: Analgesic technique at ah shi points. Tonify LU-9, LU-11, CV-17, PC-6 & ST-12. Disperse GB-22.
EX 1: Dyspnea and asthma. Lungs are summit, kidneys are root. An intimate relationship exists between lung & kidney. During inhalation, qi enters lungs & descends to kidneys. Breathing pattern should be inhale, pause, exhale. Pause allows qi distribution to spleen, liver & heart. Dyspnea results when pathway between lungs & kidney is blocked, shortened or disrupted. Asthmatics cannot descend qi (air) to kidneys. Cortisone origin is adrenals - helps qi descend. Moxa BL-13 & BL-23. LU-1, LU-9, LU-11, K-3 & K-7 (K point combo acts like cortisone.) CV-17, PC-6, LI-4 & ST-36. Disperse GB-22.
HT TMM: 3rd month of Winter (approx. Feb. 21 – Mar. 20) Symptoms: External origin shows pain & contracture around HT-9, HT-7 or HT-3. Cardiac pain. Internal origin shows Fu Liang syndrome, an epigastric tumor superior to umbilicus. Sadness or mental disorders.
GENERAL TX: Analgesic technique at ah shi points. Tonify HT-9, HT-7, ST-36 & LI-4. Disperse GB-22.
EX 1: Fu Liang/umbilical tumor. Yin type = fixed, cold, patient wants to be alone. Yang type = accumulation, heat, moves around, hot palms, mental disturbances, patient wants to talk & have company. Too much fire destroys Po, leading to sadness. LU-9 preserves metal. HT-6 (xi-cleft), CV-17, HT-7, Yin Tang, SP-1 for anxiety, GB-20 for insomnia. ST-34 needled toward stomach. Mobilize ministerial fire with BL-13, BL-14, BL-15, BL-42, BL-43 & BL-44. Tonify LI-4 & ST-36, LV-13, CV-12, BL-20, BL-21, SP-3, SP-6 & Tran’s ST-40.
Differential diagnosis for 3 arm yin TMM is axillary & thoracic pain radiation. Axillary, thoracic & hypochondriac pain = PC. Axillary, thoracic & supraclavicular compression syndrome = LU. Axillary, thoracic & pain or tumor superior to umbilicus = HT.
A few more gems from Dr. Tran…………
EX 1: All-over body pain. Use SP-21 if articulations are generally painful. Ah shi points with analgesic technique. Disperse all reunion points - ST-8, SI-18, GB-22, CV-2 or CV-3 area. Tonify 12 tonification points, 12 source points, 6 yuan yang & 6 yuan yin points, jing well points of most affected TMM (along which channels do you find the majority of ah shi points?) General anti-spasm point is GV-8.
EX 2: Over-thinking & SP xu. Thinking without deciding upon an action prevents LV movement. So either think & act, or don’t think. Bloating = blockage of follow-through. ST yang qi normally descends, but rebels if SP function is blocked (belching, nausea, etc). Humidity (damp) accumulates & alters tongue. Scallops result due to SP lack of holding (maintaining) form. LV heat plus damp accumulation = fog obscuring clarity. Put out fire with GB-16 (shao yang), HT-7 & CV-14 (HT Mu). If fire not controlled, it affects HT & ying qi (qi of the blood). ST-36 to build qi. Tran’s ST-40 for phlegm - longitudinal luo goes to GV-20 (longitudinal luo of ST). Transverse luo goes to SP-3 (source point). At SP-3 level is SJ connection to ST-44. Wei qi metabolizes humidity. Increase wei qi circulation to decrease bloating, prevent phlegm buildup, etc. CV-5 builds wei qi.
ST-30, LV-13, LV-14 & CV-12 circulate wei qi.
EX 3: Dysmennorhea/Menopause. Chong Mai (PC-6 & SP-4) brings heat (generally, yin meridians bring heat) & Tai Yang brings water (yang meridians bring water). 3 leg yin meridians cross at CV-2 & ascend to CV-3 (BL Mu point). CV-3 brings water to the uterus, so is natural cleansing area in females, to prevent pelvic infections. Ba liao points are Tai Yang, so are secondary cleansing areas. BL-31 goes to uterus & then to contra lateral BL-31. Deeply needle contra lateral BL-31 for dysmenorrhea. Menopausal women may have decreased size of sacral foramen. Needle won’t penetrate the decreased opening. If you can’t deeply insert needle, don’t bother needling this point in menopausal women.
family lineage of Tong's acupuncture was written about by both Miriam Lee and
[a version of it] by Richard Tan. In both cases, the power of this
single-needle style acupuncture seems both strange and different.
There is no doubt this form of acupuncture can work wonders. In local public health sites, it proved its claims. It may be particularly good as an alternative system for pain treatments. Of course there is relevance for internal medicine.
The writings of Dr Yang, Wei-Chieh of Los Angeles, being translated, may be the best yet on this subject. His 3-day presentation in OCOM's DAOM program gave a taste of the coming book. We were encouraged by him to share this information. Readers who like this approach are referred to his book. Yang married Tong's daughter, and could be his top student prior to Tong's passing.
His work is unique in that it bridges the gap between Tong's Acupuncture and contemporary TCM through the NeiJing/Inner Classic.
The notes follow in rough format for the topic of treating pain with acupuncture:
Dr Yang, Wei-Chieh
3/5/05 --30th anniv.of Tong's death.
Over 40 yrs lic. exp.
He uses Tong pts 60-80% of time.
His book is ZhenJiu JingWei in Chinese, Korean, and soon English.
For now, have a look at Miriam Lee’s Master Tong’s Acupuncture.
Principles of Tong Ac--
· Local areas never needled.
· Distal treatment- the further the better.
Use few needles first: try unilateral first; if no effect, go bilateral.
For excess, sometimes same side is used.
Bleeding is always same side.
Said to have advantage in less frequently timed tx, when daily tx not possible.
Based on Neijing and I Ching.
Reading these will help.
~SJ 2, LI 3- best pts. Latter pt: needle close to the bone as possible --best for ANY type of pain.
Former pt is just prox of SJ 2 and called SanCha. This is the #3 of the ~BaXie pts. Tx thigh pain immediately: also for sleepiness. Can needle deeply, which will get shaoyang and taiyang since SI 3 will be accessed there. This pt was revealed a few yrs before Tong died. Needling close to bone, into tendon/ligament level tx liver.
For pn from trauma: 1 cun below ST 34 -- Jie Xue: Untie. Could use ST 34. XiCleft principle applies here.
Also the use of yangming to regulate qi and blood.
shu stream pts tx heaviness of body, pain of joints: many of them are used.
for yangming headache, ST 43 is used: the shu-stream. Note that yangming channel traverses TaiYang!!
ShaoYang- GB 43
UB 65 for taiyang
Vertex: liver 3 oft used --a shu-stream. Others use KI 1.
Du 20 tx sore throat since it tx head, tailbone since it is opposite end of spine. Du 1 bled for h/a. And K-1
So this one pt has 3 possible correspondences.
He uses UB 65 for vertex h/a --shu stream. Water promotes wood in this case.
frontal h/a- LI 3 very effective: shu. SP 4 very good also since Luo pt to activate sp st relationship.
prolonged h/a affects KI, so needle close to bone in chronic conditions. So needle LR 3, ST 43 more proximal to get closer to bone. These pts have their own names in Tong Ac.
LR 3's is HuoZhu / Ht Master- very impt for HT dz. the TaiChong pulse is here. So using this tx blood vessels and Ht.
Coma: usually Du 26, PC 6. If no effect, use HuoZhu above LR 3.
HuoZhu above LR 3 is also special pt for knee pain. Ancient texts had LR 3 for this joint; HuoZhu is better.
This pt tx chronic sore throat, since liver channel goes thru deep level of throat. Also as earth pt on wood channel, can tx earth-wood issues: fibromyalgia, stomachache, etc.
Tong always needled close to bone. Chronic dz always affects KI, which is affected by both yin and Qi deficiencies over time.
LU 5 releases spasm of palmar aspect of fingers, frozen shoulder.
Achilles for neck spasm.
5 pts for knee pn:
PC 6 contralat. w/ LR 3/HuoZhu ipsilat. to tx jueyin.
always move joint during tx.
Core of Tong Ac:
· KI- SJ
· SP- SI
Examples: pc 5 for hiccup: metal pt. in NeiJing metal used for voice issues.
P 7 for mouth sores.
80-90% of knee pain comes from the Heart. NeiJing: tx blood to calm the wind; wind and blood very related.
Bi tx by 4 gates. LI 4 master of Qi, LR 3 masters blood.
will help tendon-level pain. Essential for Parkinson's Dz. Mild insomnia.
Between LingGu and LI 3 is JianGu: middle jiao. LI 3 is upper jiao. So the whole bone is a hologram.
Use LR 2 for fire instead of 3.
Best result for insomnia: bleed ear apex. better than any other acup or herbal tx.
This pt is a super pt., along with SJ 2 area.
A goal is to find these super pts., with many indications.
Thumb has most impt pts., along with great toe: it has two very important Jing pts.
Yuan source pts closely related to KI and SJ.
Back to knee pn: 44.06 tx
Uh-Oh: some pts in this system have the same name, but different locations as TCM!!!
This uses muscle to tx muscle: thickness of deltoid. But this just works with weakness, difficult to raise leg.
33.12 XinMen tx bone spur issues on knee (harder to go downstairs than up). Also tailbone pn. Ex: knee pn: this pt with LR 3 close to bone.
Chronic stubborn pain requires more needles. Start unilateral, and then go bilateral.
Ce San Li 77.22, ce xia san li, ShenGuan 77.18 for chronic stubborn headaches.
ShenGuan is #1 for shoulder pain, frozen shoulder; frequent urination esp in elderly with qi xu, enlarged prostate; tonifies both KI and SP; diabetes, proteinuria; uremia (along with KI 3- earth pt of water ch; mirrors SP 9).
66.05 MenJin prox to ST 43: this is in the Top Ten Super pts. Wood pt on earth. Stomachache, diarrhea with pain better after defecation tx by TongXieYaoTong herbal formula. So this is good for most cases of diarrhea, dysmenorrhea, and droopy eyelids with SJ 2.
Because of name with 'metal' in it, it tx lung also: sinusitis: ST channel goes there.
In Tong Ac., a neighboring pt is often used to strengthen effect. Here ST 44 can be added. Then NeiJing calls this DaoMa. This is better for chronic conditions. 'You could miss the point, but not the channel.' So needling PC 7 and 5 will affect PC 6.
Tong applied 3 points sometimes.
Moving joints during tx draws qi to them: essential.
Forearm is upper, middle low jiao: PC 6 or SJ 6 upper, GanMen middle, XinMen lower: knee, coccyx.
Same for upper arm: LI 11 tx upper jiao: dizziness. Menieres syndrome use this pt with PC 6. JianZhong mentioned above tx Sp Damp in lower jiao: leucorrhea.
Face- upper middle and lower Ji. Du 26 is lower-mid, so low back. Pts on this line at SI 18 tx renal stones.
Thigh- upper towards knee --all the limbs are upside down, like the ear. The 3 SiMa pts 88.17-19 are jiaos.
The Huang pts.
Lower leg-SP 9 headache, ShenGuan just below it for shoulder; KI 7 for lower jiao.
Inner foot- SP 4 for mid jiao, SP 1 for lower jiao: hernia, uterine bleeding -- reverse of reflexology -- use both pts for uterine bleeding, since liver stores and spleen controls. Jing wells manage orifices.
Temporal relationship: Jing well for acute, and then moves up. Ying and shu streams dominate channels and exterior. Use wood pts for wind, liver, tendon... etc.
Shu stream Earth pts are also used for intermittent symptoms: Shaoyang syndrome, since it’s in the middle, as is the Shaoyang. XiaoChaiHuTang is used in difficult diseases. Shu stream pts are pivotal. therefore for pain, the She streams are often used.
He Sea are for Fu organs, since on yang channels they pertain to Earth.
Tong used the pts on the thigh a lot for chronic conditions, the three lines on the anterior aspect.
Chronic conditions also proceed to blood stasis, in tong's view. That's why he bled he-sea pts.
Acute: Jing well, common cold ying-spring, half interior: shu-stream, and chronic: he-sea.
3x/wk perfect, since by 3rd day the tx effect is subsiding. 2x OK.
1x not enough so must use herbs.
Tong used blood letting 30% of time. Blood stasis involved in difficult, chronic cases since Ming theorists. Also collaterals/luo are involved in chronic dz. Bleeding gives longer effect.
Bleeding TaiYang for headache and UB 40 for 'roids are examples.
CeSanLi x2, which are BETWEEN yangming and shaoyang. LI 3, SI 3 also possible additions. Electric sharp pains, going up and down like shaoyang, so use shu stream pt. Epilepsy and malaria are also shaoyangy this way, so shu-stream good. SI 3, LI 3 are wood and shu-stream pts.
or use 66.06, 7/ MuLiu, MuDou between yangming and shaoyang on middle toe.
or bleed ear apex.
or bleed TaiYang: ancients bled a lot to clear head.
LI 11 tx chest,
LU 5 does st, lu, ht
BLEED SAME SIDE, not opposite. Nerves cross over, not blood vessels.
sore throat: bleed SJ 2 with LU 10 on opp sides of either. He prefers to needle SJ 2. Have patient swallow.
or bleed ear apex.
if chronic, LR 3 could be very good.
San Jiao 2 = ~San Cha #3.
Retain 20-30 mins. generally.
Neck pain, stiffness: Ren 24 is ancient pt: ant/post relationship; better extension /flexion limitation; use w/ SI 3.
or SI 3, UB 65: LingShu 26 left right rotation= taiyang. Foot is better to use here.
All directions- use all 3.
or into achilles tendon to tx tendon issue, incl spasm. These are good for whiplash: 77.01, 2.
UB57 tx uterine spasm.
ShenGuan tx neck and shoulder. LU 10 area tx that, and back also.
Severe nausea: bleed between Du 16, 15.
Acute low back at left outer KI shu pt: use front corresponding pt, but opp side.
A tender pt is not always evident with contralateral needling, but results are better if you can find it.
1. same name: taiyang, taiyang. ex: GB 41 and SJ 3 are paired, so can use latter pt for DaiMai low back pain instead. Likewise, SI 1 can be subbed for UB 67 to turn fetus.
Finger pain- 5 Tigers Wu Hu #1, the most distal of these. Not over bone, but in soft tissue next to it. Bilat., but add SJ 5 opp worse side if one side is worse off.
#5 tx heel pain and ankle sprain, though for the latter LingGu used more -- or needle XiaoJie / Small Joint, an unlisted pt below #5, thru thenar eminence towards PC 7; make a fist to find it.
ShenGuan very good, often with GB 31.
Latter pt tx lateral pain, strong sedative; in his top 10 super point category.
NeiJing says that GB tx all dz in all other channels. this is from the GB-Ht relationship, along with its ubiquitous scalp points.
LingShu- Shaoyang dominates bones, Taiyang the tendons. So UB 65, SI 3 tx tendons. GB 34 indicated for bones as well as tendons. Of course there's GB 39. GB 31 best for bone spurs. Others: DU 26, SI 3, UB 65 since that channels parallels spine.
With ShenGuan for shoulder pain, one can add Yin or Yang LingQuan / SP 9, GB 34. Use the yin side when internal, and yang side with invasions. In the elderly, both are often at play.
KI deficiencies lead to increased chance of shoulder dislocation. Use Liu Wei Di Huang Wan as preventive.
There's 40 points for shoulder pain. ST 38 is conventional, or 37 --all good.
Zhong Ping- ex pt 1 c below ST 36 for shoulder pain. Much research on this.
LU also tx shoulder pain- reduce this water pt to sedate channel, activate Ke cycle; also close to tendon. If they are shaking, its wind of course: use PC 3. Also use affected side in this case.
Fifty year shoulder- 3-4 month duration requires longer tx, about 10. Often cervical involvement.
If harder to move forward= yangming; back = shaoyang, so use GB 34 or Zu Qian Jin, Zu Wu Jin p.98 #77.24, 25.
His favorite for general shoulder pain is SP 9, ~9, GB 34, LI 3 as guiding pt on affected side. These guiding pts are literally 'traction' pts, and are often shu-stream.
Example: UB 65 for sciatica on affected side to guide LingGu DaBai. The latter are therapeutic points -- always contralateral -- and the former are guiding (traction) points. This guiding method is Yang's addition: Tong didn't use them.
Sciatica- LingGu DaBai, no matter what channel.
L5/S1 usually taiyang radiation. No other points are better than these 2 for this!!! If mild, they are enough. Add more for more severity.
Case- severe sciatica with bone spur L5/S1: DU 26, SI 3, LingGu-DaBai alternating, GB 41, UB 65, blood letting UB 40 --but no more than 6 needles. Tx in afternoon for this patient were found to be better.
Number of needles-
A Ming dynasty doctor said not to make patients into a hedgehog.
If once a week, could be up to 8 needles. More frequent tx allows fewer needles.
Social changes in past 30 years have made patients unable to come in but once a week --and they have more health issues. Life spans increasing makes for more severe diseases. Therefore more needles are required now. However the goal of using fewer needles to attain better results applies.
Depth of insertion-
Point selection depends upon both space and time, as mentioned above. Three depths: heaven, human, earth. More superficial insertions affect higher regions in the body.
For ST 36, depth is crucial. It is like dosage in herbology. Heaven layer or first cun, mid human layer = 1.5 cun, for upper jiao, must get to earth layer at 2 cun. So the deeper here, the further away the point you get an effect.
SI 3: shoulder pain, so heaven layer = 1 cun. Low back: 1.5; leg pain = earth. Again, deeper is further away.
Severe diseases require depth.
Shallow, Heaven tx yang pathogens, such as EPI.
Yin pathogens, like Damp, are at human level.
Antipathogenic qi is at the deepest, earth layer. So deep needling strengthens upright qi. Likewise he-sea pts like LI 11 strengthen antipathogenic qi.
Retain needles longer with deeper insertions. Could go up to one hour.
Tong retained needles for ~45 minutes, since most of his patients had chronic conditions. Research in Shanghai found 40-50 minutes to be optimal for TCM tx, confirming this. But market economies speed up time. Yang leaves them in between 30-60 minutes. Blood circulates with qi, etc. every 28 minutes, 48 secs, described in NeiJing. So he does tx in 30 minute blocks.
Timing of Tx- Taiyang channel time is afternoon, which is why the sciatica case above worked better in afternoon. Bleeding UB 40 afternoon is best, but bleeding TaiYang best at noon.
The circulation in the Ren and Du mai- Ren 1=midnight, 1-3 am=Du 2; 3-5=Mingmen; 5-7=Du 8, 7-9=Du 12; 9-11=Du 16, noon=Du 20, 1-3 pm = Du 26 --so bleeding this pt afternoon is better. 3-5 PM =Ren 22, 5-7 pm = Ren 17, 7-9 pm = Ren 12; 9-11 = Rn 4.
Therefore midnight to 3 pm is yang time.
LU 5 same side; can use opp but not as good.
many types of elbow pain.
Linggu on affected side is good for tennis elbow, which is bone. Needle to touch bone. Or tx LI 11 on opp side, but close to bone: not textbook location.
inner elbow / golfer or student elbow: SI 3 same side, Xinmen opp. 33.12
CeSan Li x 2 for Taiyang ch. or shaoyang pain. Or opp SI 4, same side SI 3.
Dorsal pain use SJ 5 opp.
Carpal tunnel: same.
Yanglingquan GB 34 also.
SJ 2 close to bone, aka San Cha 3, esp for anterior.
more medial or jueyin channel: XinMen.
unlisted point for leg distention and pain: Ci Bai- between LuoZhen and SJ 3.
This point also tx neck, but not as well as LuoZhen.
JingZhi DT.08 also which is bled on the back.
LingGu DaBai best to start with. Facial paralysis. If <6>70 or repeated stroke harder, though not impossible.
Case- coma post-stroke with kidney failure; mask over Du 26. Needled PC 6, KI 1. Bled jing-well points.
An Gong Niu Huang Wan pills for stroke. Urination resumed and he awoke on 5th day. Completely recovered after 3 mos. Once a week tx.
He does a lot of these. Key points are bleeding jing-wells (even if on blood thinner) and using this medication.
Sometimes adds Du 20.
Resolve phlegm, move blood. Long dan cao helps to lower cranial pressure. TingLiZi eliminates cranial edema, also from ht/lu. Shichuangpu, gouqizi.
Tong tx stroke with Mu Huo / Wood Fire 7-8 mins. only, then tx LingGu DaBai. Stop after 7 tx with Mu Huo. This pt is between wood of jing-well and fire of ying-spring, hence wood-fire.
ShenGuan good to add at that point. If mental disorders, add Du 20, 24.
Liver and Heart are only 2 channels to go to head: wood and fire ascend.
He locates Du 20 at OCOM location it looks like: Du 20 here is posterior, at posterior fontanel.
PC 6 TX both brady- and tachycardia. ST 36 regulates ST acid.
LingGu is close to LI 5, DaBai is Wood, so these are like wood- fire. Close to bone, so Kidney. DaBai is big white, so has Lung relationship. What's left?
Sciatica = qi deficiency, sometimes stagnation to Tong.
PC 6 necessary.
If lateral, Si Ma could be good, since they tx Lung.
Angina- bleed PC 3, LU 5; needle ST 36, PC 6.
Ex pt HuoBao on underside of 2nd toe 55.01--Dr So used this point a lot for all kinds of things, according to Eric. This is ST toe linked with PC.
Case- female with stroke. PC 6, ST 36, and SiHua Wai: most important pt for blood letting. Look for blue veins. 3 fen lat to ST 40. FOR CHRONIC, STUBBORN, DIFFICULT CONDITIONS THERE MUST BE BLOOD STASIS. For STRANGE, COMPLICATED ONES, ITS PHLEGM. This point is close to ST 40, so there you go: when bled, its a double whammy, super combination. Lowers cholesterol!! Also bleed back shu pts for ht, pc for additional effect.
Nipple = St Ch- ST 34.
Breast is related to Liver, so tx LR 3. ST 43, which also tx lower abdominal pain.
half cun prox to SI 3: Wan Shun. Its twin is another half cun proximal. Use both.
Males left, females right is classical idea that works here.
SJ 6, GB 34.
GB 31 also helps, esp for cholecystitis/ gallstones.
Add GB 32 for added effect.
Herpes at ribs- bleed Si Hua Wai, mentioned above. Also tx head, face herpes. Simpler to bleed Ear Apex, but keep SJ 6, GB 34. BLEED AFFECTED SIDE, remember.
There are dozens...
Du mai- Du 26.
UB ch- SI 3 or B 65.
Dai Mai, more lateral: SJ 3.
Radiating to butt- LingGu.
Kidney stone- SI 18 'Ma Jin' go a half cun below even better: Ma Kuai Shui which tx renal stones in bladder.
Add SJ 3.5 for renal colic and gallstone pain.
SJ 3, 3.5 good for low back, nephritis.
SI 18 again, or just below.
Also 2 pts on index finger: Wai Jian, Fu Fian.
Add LR 2, LongDanXieGan Tang, etc. He uses Si Nie San plus JieGeng, Fuling. Niuxi possible, or if acute could add pugongying. He doesn't: it's very gentle and effective as it is.
Classical-based herbalists use fewer herbs. Same in acupuncture.
Ear apex bled for menopausal sx- noc sweats, insom.
SuWen mentions a Heart- ear connection.
Sweat is the fluid of the Ht.
That's why it works here.
XinMen helps sweating as well.
SangYe taken as a tea is gentle daily intervention.
**Bleeding Apex tx low back pain**
A channel branch goes from Du-20 to the Ear.
Fleshy ear helix indicates weak HT, along with soft personality. A hot helix denotes hot personality.
Early menses- heat,
s.t. both- Liver
irreg. - Sp
Eating and drinking draw qi to the core. Rice does this especially. Most pain is in limbs, as are ancient points. Pregnancy is a good time to eat rice- type foods.
Shen Guan tx finger pain also.
Stroke tx- manipulate Lu-5 close to tendon in on inhale. out on exhale.
Case- MuHuo, then Lu-5, then LI 3, 4 with Du 20 + just posterior.
Pulse increases with hunger.
Pregnancy- don't tx deep.
Pulse palpable on sides of mid finger that moves toward tip with progression of pregnancy. Male fetus has stronger left pulse, redder face.
Demo- SJ ~3, Apex
The hand, like the face, ear, etc., is a TaiJi with BaGua. This is the answer to why seemingly random pts on the hand are grouped together.
Bleeding is better for heart disease the regular needling.
He hasn't used moxa in over 3 yrs due to local cultural constraints. He does use it at home. Moxa, cupping, blood letting, needling are the 4 main methods.
Foods to avoid to speed tx for pain:
ice, ice drinks
greasy sticky fruit
(glutinous) 'sticky rice'
duck- cold (chicken is warm)
If 5 tx have no effect, check blood for RA/ rheumatoid arthritis or lupus.
Tong bled about 30% of his patients, the most severe cases. He never used herbs.
Yang uses ear pts for addictions.
Bent over back, forward or backward- Du 26, LI 11, and UB 60. The latter pt treats whole spine.
Dr Yang's father practiced martial arts. Yang practices qigong. For acupuncturists it is very advisable to practice some kind of breathing qigong. Herbalists don't need this as much. It's easy to get tired after treating 30 patients with acupuncture, or 100 with herbs. Needling consumes some qi. If you're strong, it's no problem. If you have weak patients, then you really need to take care.
The top ten super points-
most already mentioned.
1. Fu Ke- Gyn, all kinds, incl malposition, bleeding, myoma, infertility (add Huan Chao 11.06 opp side, alternating sides ea tx. May add ex pt betw SP 6 & malleolus where pricking a blue vein helps greatly). Best herb formula for miscarriage: Tai Shan Pan Shi San- also tx infertility. KI xu and bld stag are 2 major causes of infertility. Gui Zhi Fu Ling Wan + Danggui Shaoyao San for this also. Wen Jing Tang a personal favorite.
2. Ling Gu- Super pt of Super pts. Regulates qi, warms yang. Hemiplegia w/ Da Bai, with GB 31, Jian Zhong --same name, diff loc than TCM. Adding scalp for hemiplegia even better. Sciatica of any type, better than any conventional channel pt., w/ LI 3. By itself, Ling Gu tx elbow pn (ipsilateral), dizziness, groin (bilat) and inguinal pain (contralat), frozen shoulder, back pain, tinnitus, low appetite.
3. San Cha #3 near SJ 2 but closer to bone --for common cold, 5 sense organs, esp for sore throat, tinnitus, deafness, back pain, toothache; with DaBai for all headaches, thigh, myasthenia gravis esp of eyes, tachycardia, urticaria.
4. Men Jin 66.05- ST 43 closer to bone, "Gate of Metal", wood pt of earth channel and therefore versatile. For various gastroenteritis and diarrhea, migraine of taiyang, nasal obstruction, abdominal distention and bloating, dysmenorrhea, rectal prolapse.
5. Huo Zhu- closer to bone from LR 3. 'Fire Master". Palpable pulse. Special for HT failure, weakness, headache from HT; uterus- myoma, This is a more ancient location of LR 3. This gets wood- tendon and earth- flesh, and close to bone so helps KI: Most impt pt for rheumatism- difficult walking. Gastric problems from wood/earth probs. Dizziness, vertex h/a. Sore throat. Facial paralysis: deviated mouth and eyes. Combine with LingGu as the 'Posterior 4 Gates' / Hou Si Guan. Systemic pain, such as FM/ Fibromyalgia. By itself for genital and urinary problems, such as Lin Syndrome. TMJ/TMD.
6. Ear Apex- bleed it for extensive effects, incl common cold, migraine, hypertension, acute conjunctivitis, best one for insomnia, palpitations, profuse or nocturnal sweating --very good-, various skin dz, Shaoyang is wind, Taiyang is exterior: skin disease is wind; the ears are Shaoyang. Kidney opens to ear; another classic text says the Heart also opens to the ear.
7. That's all for now... You figure out the rest.
Herbs for genital itching:
Kushen 9g, Shechuangzi 15g for external wash.