ChineseA'~llpUlnctur,e

all(Il\1o),!~.ib·ustion
(Revised Edition)

Chief edi lor

CHENG )(] r\ NONG

FOREIGN LANGUACJES PRESS BEIJIt\G

 Fir,;! Edition 1987
Revi;ed Editicn 1999
Eighth Printing 2007

'Written b,'
Deng Liangyu,,:, Gan Yi. un, He Shuhui,
Ji Xiaoping" Li Yang, Wang Rufen,
Wang Wenjing, 'Nang Xu~tai, Xu Hengze,
Xue Xiuling and Yuan Jiuling

Edited b\
Cheng Youbang, I-Iuang Xinming, Jia Weicheng.,
Li Sheng, Qiu Maoliang and Yang Jiasan

Rel'isioll Editors
Zheng Qiwei, Xue Xiuling, Gu Yuehua, Li Yanchan,
Xu Yao, Lu Xiaozhen, Ding X aohong and Yi Sumei

Horne Page:
httpl/www.tl~l.com.cn
E-mail i\ddresse3:
info@tlp.com en
salei@fip.com.cll

ISBN 978- 7-119-0 1758-7

© Foreign Languages Press, Beijing, China, 1999
Published by Foreign Languages Press
24 Baiwanzhuang Road, Beijing 100037, China
Distributed by China International Book Trading Corporation
35 Chegongzhuang Xilu, B<:ijing 100044, China
PO. Box 399, Bei~ing, China

Printed in the People 5 Rep~lblic of China

 The science of acupuncture and moxibustion is an important part of tradi-
tional Chinese medicine. For thousands of years the Chinese people have
appreciated it for its nonpharmaceutJical treatment, simp.le application. wide
range of use, good curative effect, and low cost.
As part of Chinese science and culture acupuncture and moxibustion have
long been known in the world as a result of cultural exchange between China
and other countries. However, a global interest in acupuncture and moxibustion
and special enthusiasm for the subject have been growing in the past dozen
years. To offer further service to the Dther people and heip acupuncture and
moxibustion enrich the world's science and culture, the Ministry of Public
Health of China established three international acupuncture training centres in
research institutes and colleges of traditional Chinese medicine in Beijing,
Shanghai and Nanjing with the support of the Office of the Western Pacific
Region of the United Nations' World Health Organization. More than 1,000
foreign students from 120 countries and regions have been trained there in Jess
than ten years. \Vith their strong thirst for knowledge these students were not
satisfied with their basic understanding and sought more detailed information.
To meet their needs, the three training centres have organized advanced training
and research courses.
Chinese Acupuncture and Moxibustion, t}le textbook for these advanced cours-
es, was compiled by the three training centres, under the supervision of the
Ministry of Pubbc Health, in accordance with their teaching programme,
acupuncture theory and clinical experiences. Professor Cheng Xinnong, well-
known specialist of Chinese acupuncture and moxibustion, h,=aded the editorial
board for the compilation of this book. Both the Chinese and English editions
of Chinese Acupuncture and Moxibustion were examined and revised by a number
of specialists before publication.
Based on Essentials of Chinese Acupuncture and supplemented by the results
of many years of teaching and clinical experience, Chinese Acupuncture and
Moxibustion was continually revised, substantiated and perfected. As a valued
scientific gift from the home of acupuncture and mox]bustion, this book. we
hope. will be a good teacher and helpful friend to stuJ~nts and practitioners of
acupunctu re and moxibustion in the world.

Hu Ximing
Vice-M il1i~ter of the Ministo of Public Health.
Director of (lie State Administration of Traditional Chine~e
Medicine. the People's Republic of China
Chairman or the Chines,,~ Acupuncture aile! Moxibu~tion Societ~

September /1)87
 CONT'ENTS

PREFACE TO THE REVISED EDITION XHI

PREFACE

CHAPTER 1 A BRIEF HISTORY OF CHINESE ACUPt:~CTlRE A~D :\-10XI-

BUSTION
1. THE ORIGIN OF ACUPCNCTURE A~D MOXIBUSTIO~
11. THE ACI\DEMIC ACCOMPLISHME]\TS OF ANCIENT ACUPC'NCTURE
AND MOXIBUSTION
III. MODER~\f DECLINE AND NEW LIFE OF ACUPUNCTURE AND MOX1-
BUSTIOI\f 7

IV. REJUVENATION OF ACUPUNCTURE AND MOXIBUSTION IN :;\;EW

CHINA
V. THE DIS SEMINA TION OF ACUPUt'JCTURE AND MOXIBUSTION TO
THE WORLD ]()

CHAPTER 2 YI~- YANG Al"\fD THE FIVE EUEMENTS 12

I. Yfi\-Y ANG 12
l. The Basic Knowledge of the Theory of Yin and Yang 13
2. Application of the Theory of Yin and Yang In TraditIOnal Chinese Medicine 16
II. THE FIVE ELEME~TS 20
1. ClaSSification of Phenomena According to the Five Elements 20
2. Law of Movement of the Five Elements 21
3. Applicati01 of the Theory of the Five Elements In Traditional Chin,:se Medicine 24

CHAPTER 3 THE ZANG-FU ORGANS

1. THE FIVE ZANG ORGANS
l. The Heart
:!. The Liver
1 The Spleen
,I. Tbe Lung
5. The Kidne/ 35
II. THE SIX FU ORGANS 38
I. The G allbladcler
='. The Stomach
II CO:-iTE;\TS

3. The Sms.ll ] ntestine 39

4. The Large lntestine 39
5. The Blaclder 39
6. The Triple Energizer 40
III. THE EXTRA fU ORGANS 41
1. The Brain 41
2. The lteJUS 41
IV. THE RELATIONSHIPS AMONG THE ZANG-FU ORGANS 42
1. The Relationships Between the Zang Organs 4~·
2. The Relationship Between the Zang and the Fu Organs 4i
3. The Relationship Among the Fu Organs 4S

CHAPTER 41 QI, BLOOD AND BODY FLUID 51

I. QI 51
I. Classification and Production of Oi 51
2. Functions of Oi 53
II. BLOOD 54
I. Formation and Circulation of Blood 54
2. Function:;; of Blood 54
III. BODY FLUID 55
1. Formation and Distribution of Body Fluid 55
2. Function:; of Body Fluid Oingye) 56
IV. THE RELATIONSHIP BETWEEN QI, BLOOD AND BODY FLUID 56
I. The Rela:ionship Between Oi and Blood 57
2. The Relationship Between Oi and Body Fluid 57
3. The Relationship Between Blood and Body Fluid 58

CHAPTER 5 THE. MERIDIANS AND COL/LATERALS 59

I. THE BASIC CONCEPT OF THE MERIDIANS AND COL LATERALS 60
1. The Nomenclature of the Meridians and Collateral,; and Their C)mposition 60
2. Functions of the Meridians and CollaleraJs 61
3. Distribution of the Fourteen Meridians 64
4. Cyclical Flow of Qi in the Twelve Main Meridians 65
II. THE TWELVE MAIN MERIDIANS 65
1. The Lung Meridian of Hand-Taiyin 66
2. The Large Intestine Meridian of Hand-Yangming 66
3. The Stomdch Meridian of Foot-Yangming 68
4. The Spleen Meridian of Foot-Taiyin 69
5. The Heart Meridian of Hand-Shaoyin 69
6. The SrnalJ Intestine Meridian of Hand-Talyang 72
7. The Bladder Meridian of Foot- Taiyang 73
8. The Kidney Meridian of Foot-Shaoyin 73
9. The Peficardium Meridian of Hand-Jueyin 77
10. The Triple Energizer Meridian of Hand-Shaoyang 77
CO;-.!TENTS hi

11. The Gai Ibladder Meridian of Foot-Shaoyang 78

12. The Liver Meridian of Foot-Jueyin 81
III. THE EIGHT EXTRA MERIDIANS 82
I. Governor Vessel 83
2. Conception Vessel 83
3. Thorougbfare Vessel 83
4. Belt Vessel 84
5. Yang Heel Vessel 85
6. Yin Heel Vessel 85
7. Yang Link Vessel 88
8. Yin Link Vessel 88
IV. THE TWELVE DIVERGE"'T MERIDIANS AND FIFTEEN COLLATER-
ALS. 88
The Twelve Divergent Meridians 88
1. The First Confluence 90
2. The Second Confluence 90
3. The Third Confluence 90
4. The Fourth Confl uence 94
5. The Fifth Confluence 95
6. The SIxth Confluence 96
The Fifteen CoUaterals 97
l. The Three Yin Collaterals of Hand 97
2. The Three Yeng Collaterals of Hand 98
3. The Three Yang Collaterals of Foot 99
4. The Three Yin Collaterals of Foot 99
5. The Collatera;s of the Conception and Governor Vessels and the Major Collateral of the
Spleen 99
V. THE TWELVE MUSCLE REGIONS A.ND TWELVE CUTANEOUS RE-
GIONS 101
1 The Twelve Muscle Regions 101
2. The Twelve Cutaneous Regions 112

CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 115

I. CLASSIFICA nON AND NOMENCLATURE OF ACUPUNCTURE POINTS 115
1 Classification of Acupuncture Points 115
2. Nomenclature of Acupuncture Points 116
II. METHODS OF LOCA TING ACUPUNCTURE POINTS 117
1. Proportional Measurements 118
2. Anatomical Landmarks 121
3. Finger Mem,ur'~ment 121
III. SPECIFIC POINTS 122
1. Specific Points on the Limbs 122
2. Specific Points on the Head and Trunk 123
Appendix: Eight Influential Points 124
\': l O\i E:\ r:;

IV. A:~
OUTLJNE OF THE THERAPEUTIC PROPERTIES OF THE POf:-·nS OF
THE FOURTEEN MERIDIA;-,rS 11"~
I. The Remote Therapeutic Properties of the Points 114
2. The local and Adjacent Therapeutic PropCrlies of the Points 11:)

CHAPTER ~1 ACUPUNCTURE: POIl\TS OF THE TAIYIl\ Al\D \Al\GMING \IE-

RIDIAN 13S
1. THE LUNG MERIDIAN OF HA:!'fD-T AIYI='J 13S
I. Zhongfu (LU I) 2. Yunmen (LtT 2) 3. Twnfu (LC 3)
4. XiabaJ (LU 4) 5. Chize (Ll] :5" 6. KongzLi I I.L 6)
7. Li eq lit (L U 7) 8 lingqu(LU~) 9. TaJyuiln (L l: 9)
10. Yuji I LU 10) II.Shaoshang(I.U II)
II. THE LARGE INTESTINE MERIDIAN OF HAND-Y ANGMI:.JG 139
1. Shangyang (LI 1) 2. Erjian (U :2) J. Sanjian (1.1 J)
4. Hegu (LI 4) 5. Yangxi (LI 5) 6. Pianli ( Ll 6)
7. Wenliu (LI I) 8. Xial ian (JLI ~) 9. Shangli,lI1 (LI l)
10. Show,an Ii ( Ll 10) I l. Quehl I LI 1 I ) 11. Zhouliau (LI 11)
13. ShouwUJi (Ll !3) 14. Binao(LI 14) 15. J ianyu (U 15)
16.lugu,LlI6) 17. Tianding (LI 17) IS. fUlu (U 18)
19. Kouheliao (U 19) 20. '{ingxiang (U 20 I
III THE STOMACH MERIDIAN OF FOOT-YANGMING 145
1. Cheng'li (ST I ) 1. Sibai (ST 2) 3. Juliao (~;T 3)
4. Dieang ( S r 4 ) 5. Daying (ST 5 ) 6. liaehe (:~T 6)
7.Xiaguan(ST 7) 8. Touwei (ST IS) 9. Renying 1ST l) )
10. Shuitu (ST 10) 11 Qishe ( Sri] ) 11. QucpeJl(ST 12)
13.Qihu1ST 1::) 14. Kufang (ST 14) 15.Wuyi(STJ51
16. Yingehu,lI1g (ST 16) J I. Ruzhong (S1 17) IS. Rugen (Sf Ix)
19. Burong(ST 19) 20. Chengman (ST .~O) .2l. Liangmi:n 1ST 11 )
22. Guanmen (ST 22) 23. Taiyi (ST 23) .::'4. HuanlLlmcll (ST 24)
25. Tianshu ': ST 25) 26. Wailing 1ST 26) .~7. Daju (Sf 27)

28. Shuid,lo i, ST 28) 29. C;uilai (ST 2-) 30. Qiclwng 1ST 30)
31. Biguan (ST 31 ) 32. Futu (ST 3.~.1 33. YlI1shiST 33)
34. Llangqiu (ST 34) 35. Dubi (ST 35) 36. Zusanll (ST 36)
37. Shangjuxu (ST 37) 38. T iaokoll (S1 38) 39. XiaJuxll (ST 39)
40. fenglong (S1 40) 41. llexi (ST 4] ) 41. Chong) ang (ST 42 )
43. XiangJ (ST 43) 44. Neiting (ST 44 ) 45. Lid Ul (:; T 45 )
IV. THE SPLEEN MERIDIAN OF FOOT-TAIYIN
I. Yinbai ' SP 1) 1. Dadu (SP 1) 3, Taibai (~d) 3)
4. Gongsun (SP 4) 5. Shangqiu ISP 5) 6. Sanyinjiao (SP 6)
7. Lougu (SP 7) 8. Diji (SP 8 ) 9. YinJingquan (SP y)
10. Xuehai (SP 10) II. limen (S P J J ) 12. Chongmen i SP J 1 !
13. Fushe (SP 13) 14. Fujie (SF' 14, IS. Daheng I SF' 15 i
16. Fuai (SP 16) 17. Shidou (SP 17) i8. Tianxi (SP 18)
19. Xiongxiang (SP 19) 20. Zhourong (SP 20) 21, Dabao (SP .? 1 )
CHAPTER 8 ACLTPONCTURE POINTS OF THE SHAOYIN Al'iD TAIYANG ME-
RIDIANS 164
1. THE HEART MERIDIAN OF HAND-SHAOYJ:""- 1M
I. Jiquan (i-IT 1) 2. Qingling (HT ~') J. Shaohai (HI .3 )
4.. Lingdao I HT 4) S. Tongli (HT 5) 6 Yil1\i (HT 6)
7 Shcnmen !HT 7) S. Shaofu (HT X) 9. Shaochong (HT 9)
II. THE SMALL INTESTJNE MERIDIAN OF HAND-TAIYA1\"G 167
I. ShJoze (:;r I ) 2. Qiangu (SI 2) 3. HOLlXl (SI 31
4. \Vangu (S1 i,) 5. YanggulSI 5) 6. Yanglao ()l 61
7. Zhizlleng lSI 7) 8. Xiaohai (SI 8) 9. Jianzhen (S] 9)
10. ="iaoshu (S] 10) II. Tianzong (S1 • 1) 12. Bingfeng (SI l~)
13. Quyuan (SI 13) 14. Jianwaishu (SJ[ 14) 15.Jianzhong~hll(SJ 15)
16. Tianchuang (SI 16) 17. Tianrong (SI 17) 18 Quanliao (5118)
19. TinggongC~I 19)
Ill. THE BLADDER MERIDIAN OF FOOT-T AIYANG 17J
I. Jingming (BL 1) 2. Zanzhu (BL 2) 3. Meichong I HL 3)
4. Qucha ( BL 4 ) 5. Wuchu (BL 5) 6. Chengguallg ( HL 6)
7. Tongrian I BL 7:, X. Luoque IBL 8) 9. Yuzhen (BL 9)
10. Tianzhu(HL 10) I Dazhu (8L 11 ! J2 Fengmen (BL (2)
13 Feishu (BL 13J 14. Jueyinshu (BL 14) 15.Xinshu(HL151
16. Dushu (HL 16) 17.Gcshu(BLI7) 18.Gansl1u(BL U':)
19. Dansh u (Bl I 9 ) 20. Pishu (BL 20) 21. Weish u (BL 21 )
22. San]Iaosr u (BI 22) 23. Shenshu (HL n) 24. Qihaish 1.1 I J3L 2-11
15. Dachang!;hu (BL 25) 26. Guanyuansh u (BL 26) 27. Xiaochangshul BL n I
2x PangguaIlg~hu (BL 28) 29. Zhonglushu (HI. 29) 30. Baihllambu ( HL 30)
31. Shangliao (HL 31 ) 32. Ciliao (BL 32) 33. Zhongliao ( BL 33 I
34. Xialiao (HL 34) 35. H uiyang (BlL 35) 36. Chengfu ( BL 36)
37. Yinmen (BL 37) 38. Fuxi (BL 38) 39.Wei y ang (BL 39)
40. Welzhonr (HL 40) 41. Fufen (BL 41) 42. Pohu (BL 42)
43. Gaoh uang (HL .+3) 44. Shentang (BL 44) 45. Yixi (BL 45)
46. Geguan (HL 46) 47. Hunrnen (BL 4i') 48. Yanggang (BL 41:()
~9. Yishe ( BI 49) 50. Weicang I BL 50) .51. Huangmen (BI. 511
51. Zhishi IBL 5?) 53. Baoh uang (HL 53) 54. Zhibian (BL :5~i)
55. Heyang (HL 55) 56. Chengjin (BL 56) 57. Chengshar ': BL 57)
58. Feiyang (l3L 5x 1 59. Fuyang (BI. 59) (iO. Kunlun (BL 60)
() I. PucCln I BI. 61 ) 62 Shenmai (BL 62.1 63. Jinmen (BL (3)
b4. Jinggu (BL (4) 65. Shugu (BL (5) 66. lutonggu (BL 66)
67. Zhiyin (BL (7)
IV THE KIDNEY .\1ERIDIAN OF FOOT-SJ-lAOYIN 191
I. Yongquan (K] I) 2. Rangu (KI 2) 3. Taixi (K1 3)
". Dazhong (KI il) 5. Shuiquan I KI 5) 6. Zhaohai (Kl 6)
I. Fuliu (KI 7 ) 8. Jiaoxin (KI 8) 9. Zhubin (Kl 9)
10 YingulKI 10) 11. Henggu (KI 11) 12.Dahe(KI12)
J3 Qixue (KI 13.1 14. Siman (KI 14) 15. lhongzhu (KI IS)
16. Huangshu(KI16) 17. Shangq u (KI 17] Us. Shiguan (KI 18)
vi CONTENTS
~~~

19. Yindu (KI 19) 20. Futonggu (K[ 20) 21. You men (KI 21)
22. Bulang (KI 22) 23. Shenfeng (KI 23) 24. Lingxu :KI 24)
25. Shenc21ng (KI 25) 26. Yuzhong (KI 26 ) 27. Shufu (KI 27)

CHAPTER 9 ACUPUNCTURE POINTS OF JrEYIN AND SHAOYANG MERIDI-

ANS 199
I. THE PERICARDIUM MERIDIAN OF HAND-JUEYIN 199
1. Iianchi (PC I) 2. Tianquan (PC 2) 3. Quze (PC 3)
4. Ximen (PC 4) 5. lianshi (PC 5) 6. Neiguan (PC 6)
7. Daling (PC 7) 8. Laogong (PC 8) 9. Zhongch)ng (PC 9)
II. TRIPLE ENERGIZER MERIDIAN OF HAND-SHAOYANG 202
1. Guanchong (IE 1) 2. Yemen (TE 2) 3. ZhongzhLl (IE 3)
4.Yangchl(TE4) 5.WaiguanCIES) 6.Zhigou(TE6)
7. Huizong(TE7) 8. Sanyangluo(IE 8) 9. Sidu (IE 9)
10. I ianjing (IE 10) 11. Qinglengyuan (IE 11) 12. Xiaol uo (IE 12)
13. Naohui (IE 13) 14. Jianliao (IE 14) IS. Iianliao (IE 15)
16. Iianyou (IE 16) 17. Yifeng (TE 17) 18. Qimai erE 18)
19. Luxi (TE 19) 20. Jiaosun (TE 20) 21. Ermen (IE 21)
22. Erheliao (IE 22) 23. Sizhukong (IE 23)
III. THE GALLBLADDER MERIDIAN OF FOOT-SHAOYANG 209
1. Iongzihao (GB I) 2. Tinghui (GB 2) 3. Shangguan (G B 3)
4. Hanyan (GB 4) 5. Xuanlu (GB 5 ) 6. Xuanli (GB 6)
7. Qubin (GB 7) 8. Shuaigu (GB 8) 9. Iianchorg (GB 9)
10. Fubai (GB 10) 11. Iouqiaoyin (GB 11) 12. Wangu 1GB 12)
13. Benshen (GB 13) 14. Yangbai (GB 14) 15. Ioulinqi (GB 15)
16. Muchuang (GB 16) 17. Zhengying (GB 17) 18. Chenglirlg (GB 18)
19. Naokong (G1B 19) 20. Fengchi (GB 20) 21. Jianjing (GB 21)
22. Yuanye (CrB 22) 23. Zhejin (GB 23) 24. Riyue (GB 24)
25. Jingmen (GB 25) 26. Daimai (GB 26) 27. Wushu I. GB 27)
28. Weidao (GB 28) 29. Juliao (GB 29) 30. Huantiao (GB 30)
31. Fengshi (erB 31) 32. Zhongdu (GB 32) 33. Xiyangfuan (GB 33)
34. Yanglingquan (GB 34) 35. Yangjiao (GB 35) 36. Waiqiu :GB 36)
37. Guangming (GB 37) 38. Yangfu (GB 38) 39. Xuanzh:mg (GB 39)
40. Qiuxu 1GB 40) 41. Zulinqi (GB 41) 42. Diwuhui (GB 42)
43. Xiaxi (GB 43) 44. Zuqiaoyin (GB 44)
IV. THE LIVER MERIDIAN OF FOOT-JUEYIN 221
1. Dadun (LR 1) 2. Xingjian (LR 2) 3. Iaichong (LR 3)
4. Zhongfeng (LR 4) 5. Ligou (LR 5) 6. Zhongdu (LR 6)
7. Xiguan ILR 7) 8. Ququan (LR 8) 9. Yinbao (LR 9):
10. Zuwuli (LR 10) 11. Yinlian (LR 11) 12. Jimai (LR 12)
13. Zhangmen (LR 13) 14. Qimen (LR 14)

CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CON-

CEPTION VESSELS AND THE EXTRA POINTS 227
1. THE GOVERNOR VESSEL 227
CO\]TENTS vii

1. Changqiang (GV 1) 2. Yaoshu (GV 2) J Yaoyangguan (GV 3)

4. Mingmen (GV 4) 5. Xuanshu (GV 5) 6. Jizhong (GV 6)
7. Zhongshu (GV 7) 8. Jinsuo(GV 8) 9. Zhiyang IGV 9)
10. Lingtai (crv 10) 11.Shendao(GV 11) 12. Shenzhu (GV 12)
13. Iaodao «(iV 13) 14. Dazhui (GV 14) 15. Yamen (GV 15)
16. Fengfu (GV 16) 17. Naohu (GV 17) 18. Qiangjian (GV 18)
19. Houding (GV 19) 20. Baihui (GV 20) 21. Qianding (GV 21)
22. Xinhui (GV 22) 23. Shangxing (G V 2J ) 24. Shenting (GV 24)
25. Suliao (GV 25) 26. Shuigou (GV 26) 27. Duiduan (GV 27)
28. Yinjiao (G V 28)
II. IHE CONCEPTION VESSEL 235
1. Huiyin (CV I) 2. Qugu (CV 2) 3. Zhongji (CV 3)
4. Guanyuan (CV 4) 5. Shimen (CV 5) 6. Qihai (CV 6)
7. Yinjiao (CV 7) 8. Shenque (CV 8) 9. Shuifen (eV 9)
1O.Xiawan(CV 10) 11. Jianli(CV 11) 12. Zhongwan (CV 12)
13. Shangwan (CV 13) 14. Juque (CV 14) 15. Jiuwei (eV 1:5)
16. Zhongting I CV 16) 17. Tanzhong (CV 17) 18. Yutang (CV 18)
19.Zigong(CV 19) 20.Huagai(CV20) 21. Xuanji (eV 21)
22. Tiantu (ev 22) 23. Lianquan (ev 23) 24. Chengjiang (eV 24)
III. IHE EXTRA POINTS 242
I. I aiya ng (Exira 1) 2. Yintang (Extra 2) 3. Shanglianc; nan (Extra 3)
4. Erjian (Extra 4) 5. Yuyao (Extra 5) 6. Sishencong (Extra 6)
7. Qiuhou (Extra 7) 8. Jiachengjiang (Extra 8) 9. Jinjing, Yuye (Extra 9)
10. Bitong (Ext ra 8) II. Qianzheng (Extra 11 ) 12. Yiming (Extra 12)
13. Anmian I Extra 13) 14. Dingchuan(Extra 14) 15. Huatuojiaji (Extra 15)
16. Bailao (Extra 16) 17. Weiwanxiashu (Extra 17 )18. Shiqizhui (Extra 18)
19. Yaoqi(Ewa 19) 20. Plgen (Extra 20) 21. Yaoyan (Extra 21)
22. Zigongxue (Extra 22) 23. Jianqian (Extra 23) 24. Shixuan (Extra 24)
25. Sifeng (Extra 25) 26. Zhongkui (Extra 26) 27. Baxie (Ext ra 27)
28. Luozhen (Extra 28) 29. Yaotongxue (Extra 29) 30. Zhongquan (Extra 30)
31. Erbai (Extra 31) 32. Bizhong (Extra 32) 33. Zhoujian (Extra 33)
34. H uanzhong (Extra 34) 35. Baichongwo (Extra 35) 36. Xiyan (Extra 36)
37. Lanweixue (Extra 37) 38. Heding (Extra 38) 39. Dannangxue (Extra 39)
40. Bafeng (Extra 40)

CHAPTER 11 AETIOLOGY AND PATHOGENESIS 254

I. AETIOLOGY 254
1. The Six Exogenous Factors 254
2. The Seven Emotional Factors 258
3. Improper Diet, Overstrain, Stress and Lack of' Physical Exercises 259
4. Traumatic In.rury and Insect or Animal Bites 260
5. Phlegm Fluid and Stagnant Blood 261
II. PATHOGENESIS 262
j. Disharmony of Yin and Yang 262
2. Conflict Between Antipathogenic Qi and Pathogenic Qi 263
,,'iii

1. Abnormal Ascending or Dcscendlllg of Qi

CHAPTER 12 DIAGNOSTIC METHODS 266

l. INSPECTlON
l. ObSe;\alion of the Vitalil),
:2. Ob~en ation of the Colour
3. Obscnarion of the Appearallce
4. ObscnatllJn of the Five Sense Organs
5. ObsC[vation of the Tongue
II. AUSCULTA nON A\iD OLFACTION
] Listening
~. Smelling
III. INQC RING
I. Chills ;tnll Fever
2. Perspiratiun 275
J. Appeti.e, rhirst and Taste 276
4. Defecatio:l and Crinatioll 276
5. Pain 277
6. Sleep 279
7. ;"lenses allCi Leukorrhea 279
IV. PALPATlO\i 280
1. Feding the Pulse 281)
2. Palpation of Different Parts of the Body 284

CHAPTER 13 DIFFERENTIATION OF SY\jDROMES 2X6

1. DIFFERE:~TIA TIO::--J OF SYNDROMES ACCORDING TO EIGHT PRINCI-
PLES 286
I. EAierior alld Interior 287
2 Coid aId i--Ieat 2:-:9
J Deficiency and bces:, 29:'
4. Yin and Yang 295
fl. DIFFERE.\iTIA TlO.'l OF SYNDRUV[ES ACCORDING TO THE THEORY
OF QI A.~I~D BLOOD 296
I. of Oi
Syndr(}rne~; 296
2. of Blood
Syndrornc~, 29~
Appendix: DlffercntiJtiuI1 of Syndromes According to the Theory )f Wei, Qi, Ying and
Xue .21.)9
m. DIFFERE)JTJATlON OF SYNDROMES ACCORDING TO THE THEORY
OF ZA \lG-FU ORGANS 3IJJ
1. S)Jldromes of the Heart and Small Tmestlfle 303
2. Syndrorles of the Lung and Large Intestine 307
3. S)I1drones of the Spleen and Stomach 310
4. S~ndrome, of the Liver and Gallbladder 314
5 S) ndrome~ of the Kidney and Bladder Jlk
CO\ IE,IS ix

6. Complicatec S)ndromes of Zang·Fu Organs 321

Appendix: DifJen:ntiation of Syndromes Accotding to the Theory of Triple Energizer 325
IV. DIFFERE"nlATIO.'J OF SY,\,DROMES ACCORDING TO THE THEORY
OF MERIDrA"'\'S AND COLLA TERALS 327
l. Patl101ogi,.:al M.tnifestations of the Twelve ~rain Meridians 327
~. Pathologil:al ~fanifestations of th'': Eight EX.ra Meridians 329
3. Pathological ~1<lI1ifest"tioJls of Ihe Fifteen Collaterals 329
AppendIx: Dlflcrcntiatloll oj Syndromes According to the Theory of the Six Meridians 330

CHAPTER 14 ACLPU~CTURE TECHNIQlf]f~S 337

1. FILIFORM \El:DLE TH ERAPY 337
I. The SIruCi ur.~ and Specificalion 337
2. ';eedling Prawce 338
3. Preparations Prlllr to Trcctlrnen' 339
II NEEDU\iG METHODS 341
1. Insertion 34]
Angie and Dcptll of [nsertjQl1 343
.1. Mal1lpulatJOf1', dnd Arrival of Qi ("Jeedling Reaction) 345
,j Retdllllng anc Withdrawing the '-'ecdle 346
5. Reinforcing and Reducing Methods 347
lIl. PRECACnONS, CONTRAINDICA nONS AND MANAGEME~T OF POS-
SlBLE ACCIDENTS IN ACUPUNCTURE TREATMENT 350
I. PrecdutJon', and Contraindications in Acupuncture Treatment 350
:. ~1anagement of Possible ACCldents 350
AppendIX. Yang Jizhou\ Twelve Manipulations 352
IV. THE THREE-EDGED NEEDLE THERJIPY 354
I. \'eedJc 354
') Inciicatiolb 354
J Manipulatll)]1'l 354
4 Precautions 354
V. THE DERtvlAL ;"JEEDLE THF.RAPY 355
I Needle 355
::. Jndlcations 355
1. Manipulaticn 355
4. Precautions 356
VI. THE INTRADERMAL i'-fEEDLE THERAPY 356
1. '" eedJc 356
, indIcations 356
i Mampulation 356
4. Precautions 356
VIl. THE ~"'I~E CLASSICAL NEEDLES AND THE NEEDLING METHODS
LISTED I'. r:"JTER~AL CLASSIC 357
I. The:'; ine CLj~sJcal "J eedles 357
2. The .'!eedlin:! tlletllOds listed lfl Internal Classic 357
x CO"iTIl'IS

CHAPTER 15 MOXIBUSTION AND CUPPING METHOD 361

1. THE MATERIALS AND FUNCTIONS OF MOXIBUSTION 361
1. The Property of Artemisia Vulagaris Moxa 361
2. Functions of Moxibustion 362
3. Materials for Moxibustion 363
II. CLASSIFICATION OF MOXIBUSTION 363
1. Moxibustion with Moxa Cones 364
2. MoxibWition with Moxa Sticks 366
Appendix: The Great Monad Herbal Moxa Stick and Thunder-Fire Herbal Moxa Stick 367
III. APPLICATION OF MOXIBUSTI(}~ 368
1. The Process and Volume for Moxibustion 368
2. Contraindications 368
3. Management After Moxibustion 369
IV. CUPPING METHOD 369
1. Types of Jars 36~
2. Indications 369
3. ManipUlations 369
4. Precautions 37J

CHAPTER 16 A GENERAL INTRODCCTION TO ACUPUNCTURE TREAT-

MENT. 371
1. GENERAL PRINCIPLES OF TREATMENT 371
1. Regulation of Yin and Yang 371
2. Strengthening the Body Resistance and ELiminating the Pathog(:nic Factors 372
3. Distinguishing the Primary from the Secondary 373
4. Treatment of Diseases According to Climatic and Seasonal C::mdItions, Geographical
Locations and the Individual Conditions 374
II. THERAPEUTIC METHODS 375
1. Reinforcing 375
2. Reducing 376
3. Warming 376
4. Clearing 377
5. Ascending 377
6. Descending 377
III. THE BASIC PRINCIPLES FOR PRESCRIPTION AND SELECTION OF
POINTS 378
1. Acupuncture Prescription 378
2. Principles for Point Selection 379
IV. APPLICATION OF SPECIFIC POINTS 381
1. Specific Points on the Four Extremities 381
2. Specific Points on the Head and Trunk 390

CHAPTER 17 INTERNAL DISEASES 399

1. EMERGENCY DISEASES AND SYNDROMES CA USED BY EXOGENOUS
CO"" rE"lS --- - - ------ xi
---~--.---
--------~--------~- --- - - - - - - - - - - - - - - ----------- ~----

PATHoCrE>nc FACTORS 399

1. Wind Stroke 399
2. Syncope 402
3. SllmtJoke 404
4. Common cold 405
5. Malana 407
II. ZANG-FU SYNDROMES 410
1. Cough 410
2. Asthma 413
3. Epigastric Pa .. n 416
4. Vomiting 418
5. Hiccup 420
6. Abdominal Pain 421
:1. Diarrhoea 423
ii Dysentery 427
9. Abdominal Distension 430
10. Jaundice 431
II. Constipation 433
12. Prolapse cf Rectum 436
13. Edema 437
14. Nocturnal Elluresis 439
15. Urina[ion Disturbance 440
16. Retention of L:rine 443
17. Imporcnce (Appendix: Seminal Emission) 444
18. Insomnia I Appendix: Poor Memory) 447
19. Palpitation 451
20. Manic-Depre.,sive Disorders 453
~ I. Epilepsy 455
22. DlZziness 457
23. Melancholia 459
III. DISEASES OF HEAD, TRUNK AND LUMBAR REGIONS 462
1 Headache 462
2 Facial PalIl 465
3. Deviation or' Eye and Mouth 468
4. Pain in Hypochondriac Region 469
5. Low Back Pair: 471
6. Bi Syndrom.~ 474
7. Wei Syndrome 477

CHAPTER 18 GYNECOLOGICAL A~D OTHER DISEASES 481

I. GYNECOLOGICAL DISEASES 481
1. Irregular Menseruation 4S1
2. Dysmenorrhea 486
3. Amenorrhea 488
4, Uterine Bleeding 491
5. MorbId Leukorrhea 493
xii COYfDiTS
------~ ----------~-------- .. ----~-----.---

6. Morning Sickness 495

7. Prolonged Labour (Appendix: Malposition of Fetus) 497
8. Insufficient Lactation (Appendix: Lactifuge Delactation) 499
9. Prolapse of Uterus 50]
II. PEDIATRIC DISEASES 502
1. lnfantile Convulsion 502
2. Infantile Diarrhoea 505
3. Infantile Malnutrition 506
4. Infantile Paralysis 508
5. Mumps 510
III. EXTERNAL DISEASES 511
l. Urticaria 511
2. Erysipelas I Appendix: Herpes Zoster} 513
3. Boil and "Red-Thread BioI" 514
4. Breast Abscess 516
5. Intestinal Abscess 517
6. Goiter 518
7. Sprain and Contusion (Appendix: Torticollis) 520
IV. DISEASES OF EYES, EARS, NOSE AND THROA T 521
1. Deafnes!; and Tinnitus 521
2. Congestion, Swelling and Pain of the Eye 523
3. Thick and Sticky Nasal Discharge 524
4. Epistaxis 525
5. Toothache 526
6. Sore Throat 528
7. Optic Atrophy 529

SUPPLEMENTARY SECTION 531

EAR ACUPUNCTURE THERAPY 53]
ACUPUNCTURE ANALGESIA 551

BIBLIOGRAPHY 562

STANDARD l';OMENCLATURE OF ACUPUNCTURE POINTS OF FOURTEEN

MERIDV~S 564

STANDARD NOMENCLATURE OF EXTRA POINTS 57\

CROSS INDEX OF ACUPUNCTURE POIYfS (Pl'VYIN) 573

I~DEX 579
 PREJFACE TO THE: REVISED EJDITION

The English edition of Chinese Acupuncture and A1oxibustion has been reprint-
ed many times since it first appeared in J987. Acupuncture and moxibustion
circles all over the world value the book highly, and it is regarded as one of the
most authoritative textbooks on these subjects. It has become an essential text
in the Beijing, Shanghai and Nanjing International Acupuncture Training
Centers in China, and has played an important role in promoting the develop-
ment of acupuncture and moxibustion worldwide.
In 1998, the Beijing, Shanghai and Nanjing International Acupuncture
Training Centers and the Acupuncture & Moxibustion Institute of the China
Academy of Traditional Chinese Medicine decided to undertake the first revi-
sion of this book in order to improve its quality and meet the needs of the
development of acupuncture and moxibustion. Since the contents of the book
are already familiar to and have been accepted by acupuncture students and
practitioners all over the world, the revision has had to be handled with great
care, and no fundamental changes have been made to its framework. However,
a number of important revisions and readjustments to the content have been
made in the light of the existing needs of education, scientific research, medical
treatment and international academic exchanges in this field. The main revisions
and readjustments are as follows:
I. Corrections have been made to such mistakes as wrong words, phrases and
charts which occurred at the typesetting and prinlting stage.
2. The 10caT:ions of the 14 Meridian points and Extra points have been
standardized in the light of The Locations qf Acupuncture Points (G B 12346-90),
a national standard with legal effect which was issued by the PRC State Bureau
of Technical Supervision and has to be followed in the course of education,
scientific research, medical treatment and internal and external academic ex-
changes in the field of acupuncture and moxibustion. However, the directions
for locating the acupuncture points contained in the old edition have been
retained, for the cDnvenience of the readers.
3. The names of the 12 Meridians and their abbreviations, of the eight Extra
xiii
 (Hl" ES [ ,"'.I,T Pt \( TL RE\ '\ D \10XfBl S no'\

Meridians, and of the 361 Meridian points. and some basic acupuncture phrases
and terms [lave been standardized in the light of Standard Acupuncture :\iomen-
c1ature Part ] & Part 2, revised edition, approved and adopted by the World
Health Organization.
4. Inciluded as additional sections in the revised edition are Standard ~omen­
c1ature of the Acupuncture Points of the Fourteen Meridians and Standard
Nomenclature of the Extra Points approved and adopted by the World Health
Organization.
More abstruse contents have not been included in the revised edition. as they
will be covered in a comprehensive and systematic way tn a new book named
Supplement to Chinese Acupuncture & Moxibustion, to be published by the Foreign
Languages Press.
Since there are bound to be oversights and omissions. in the present \\ork,
readers are welcome to point them out so that they can be corrected during 1re
next revision.

Jail., 1999
 PREJi'ACE:

The science of acupuncture and moxibustion is an important component of

traditional Chinese medicine used in the prevention and treatment of disease.
This therapy has been accepted by the general population for thousands of years.
Since the founding of the People's Republic of China, great importance has been
attached by the Chinese Government to the investigation of acupuncture and
moxibustion. It has thus been greatly popularized and developed and is becom-
ing an increasjngly important componen t of world medicine.
With a view to offering further service to the people of the world, three
International !\cupuncture Training Centres were established in Beijing, Shang-
hai and Nanjmg. Since 1975. a number of acupuncture training courses have
been sponsored for more than one thousand foreign students from one hundred
countries and regions, using Essentials q/ Chinese Acupuncture* as the textbook.
Upon returning to their home countries these students applied what they had
learnt to their own practice to good effect. Many practitioners are not satisfied
with their understanding of the basic theories and seek more detailed knowledge.
Therefore, the\1inistry of Public Health has entrusted these three training
centres with the task of organizing advanced training and research courses.
Chinese Acupuncture and Moxibustion has been compiled to :)erve as the textbook
for these courses, and as a reference for foreign practitioners in their own study.
Based upon F,ssentiais of Chinese Acupuncture and supplemented with many
years of teaching and clinical experience, as well as recent research, the book
lays emphasis 011 the integration of theory with practice, in keeping with the
great heritage of traditional Chinese medicine. Chinese Acupuncture and !vloxi-
buslion consists of eighteen chapters. Chapter I is a brief history of Chinese
acupuncture and moxibustion, giving an outline of its origin and development,
Chapters 2 to 4 deal with the basic theories, primarily in relation to yin-yang,
five elements, .lang-fu, qi. blood, essence and body fluid. Chapters 5 to 10 give
an overall description of the 12 main meridians, 8 extra meridians, 12 divergent
meridians, 15 collaterals, 12 muscle regions, 12 cutaneous regions, acupuncture

* Published by t he Foreign Languages Press, Beijing, in 1975 and 1980.

xv
xvi CHI;\ESE ACLPU\,CTURE A"iD MOXIBUST!O"i

points of the 14 meridians and the extra points. Chapters I I and 12 are
concerned with etiology, pathogenesis and diagnostic methods, with emphasis
placed on pulse and tongue diagnosis. Chapter 13 is about differentiation of
syndromes according to the eight principi1es, the theories of qi and blood,
meridians and coJlaterals, and zang-fu organs, with brief differentiation accord-
ing to the theories of six meridians . wei, qi, ying, xue, and Triple Energizer.
Chapters 14 and l5 cover the techniques of acupunc·.:ure and moxibustion in
relation to commonly used needling methods and some acupuncture techniques
mentioned in Internal Classic. Chapter 16 is a general introduction to acupunc-
ture treatment, including general principles and methods of treatment, basic
principles for prescription and selection of points, and application of specific
points. Cha.pters 17 and 18 relate to the clinical management of 63 kinds of
diseases in internal medicine, gynecology, pediatrics, surgery and ENT. A
supplementary section is devoted to ear acupuncture and acupuncture anesthe-
Sia.
We are indebted to Wang Dai, Chen Xiuzhen, ZhOll Yunxian, Zheng Qiwei
and Liang Jingping for their great hc:lp in completing this work.
Our thanks also go to the people who helped wi::h the translation: Cha
Xiaohu, Du \Vei, Guo Gangjun, Huang Guoqi, Huang \Venquan, Jin Huide,
Qian Shangsan, Su Zhihong. Tao Jinwen, \-Vang Huizhu, Xu Bojun, Xu Yao,
Yao Yun, Zhang Kai and You Benlin.
We express special appreciation to Fang Tingyu. Su Zhihong, Xie Zhufan
and Zhang Kai who edited the English text.
We are grateful to Chen Jirui, Xu Yizhi and Wang Shengai for their valuable
editorial assistance.
Thanks are due also to Kuang Peihua and other staff editors of the Foreign
Languages Press for the great pains they have taken to check and improve the
typescript and proofs.
In conclusion, we sincerely appreciate comments and suggestions from our
readers so that we can make revisions in future editions.

August, 1987
 Chapter 1
1\ BRIEF HIST()ltY OF CHI~~ESE
ACUPUNC1[~URI~ AND
MOXIBlJSTI()N

I. THE ORIGIN OF in historical records for 550 B.C. say-

ACUPU:~CTURE AND ing: "Praise pleasant to hear that does
an ill turn is wors,~ than advice unpleas-
MOXIBUSTION ant to hear that acts like a stone." Fu
Qian in the second century explained
Acupuncture and moxibustion are that "stone" here meant bian stone.
important inventions of the Chinese na- Quan Yuanqi who lived around the 5th-
tion and originated as early as in the 6th centuries poil1led out: "biall stone is
clan commune pel'jod of primitive socie- an ancient appliance for external treat-
ty. The activities of human beings ap- ment and was known by three names: I.
peared in China about I}OO.OOO years needle stone; 2. bian stone; 3. arrow-
ago. It was about 100.000 years ago that headed stone. In fact. they are the same
China entered the clan commune period thing. Because there was no iron casting
which lasted till 4.000 years ago. I n the in ancient times. t he needles were made
ancient literature there were many le- of stone." This is correlated with the
gends about the origin of acupuncture fact that the stone instruments were ex-
and moxibustion such as Fu Xi"s crea- tensively used in the primitive society.
tion of the therapeutic techniques with Primitive period in China was divided
stone needles, and Huang Di"s invention into two stages. the Old Stone Age
of acupuncture and moxibustion. The (from remote antiq uily to 10.000 years
above mentioned Fu Xi and Huang Di ago) and the New Stone Age (from
in legend actually are the representa- 10.000-4.000 yean ago). I n the Old
tives of the clan commune of primitive Stone Age the ancestors knew how to
society. use stone knives and scrapers to incise
In the classics of two thousand years an abscess. drain pus and let blood out
ago. it was frequently cited that the for therapeutic purposes. With the accu-
acupuncture instruments were made of mulation of experiences the indications
stone and were named bian stone. For of the treatment by biall stone were
example. in Commentary on the Spring gradually increasecl . In the New Stone
and Autllmn Annals. 1here is a paragraph Age because of rhe improvement in
 their techniqu: of stone manufacturing. II. THE ACADEMIC
the ancient people were able to make ACCOMPLISHMENTS OF
biall stone as a special tool with more
medical usage, In China, a biall stone
ANCIENT ACUPUNCTURE
needle 4.5 CUll long was discovered in AND MOXIBUSTION
the \lew Stone Age ruins llIl Duolun
County of Inner Mongolia. At one end. From the twenty-first century B.c.
it is oval shaped with a semicircular when China entered the slave society to
edge used for incising boils and abscess- 476 B.c.. Chinese history went through
es. and at the other end, it is pyramid the Xia. Shanguld Western Zhou dynas-
shaped with a square based used for ties and the Sp-ing and Autumn Period.
bloodletting (see Fig. I-I). Two more Three thousancl years ago in the Shang
bian stones were discovered as funerary Dynasty the hieroglyphs of acupuncture
objects in a late New Stone Age grave and moxibustiol appeared in the inscrip-
in Rizhao County of Shandong Prov- tions on bones and tortoise shells. Be-
cause of the development of bronze cast-
ince. They are 8.3 cm and 9.1 cm in
ing techniques there appeared bronze
length respectively, with three-edged
medical needles. But biall stone was still
and cone-shaped ends used for bloodlet··
used as the main tool for treating diseas-
ting and regulating qi circulation. The
es. During this period the philosophical
discovered relics of bian stone have
thinking of yin-yang and five elements
provided powerful evidence that acu··
was formed, and in the field of medicine
puncture originated early llIl the primi" the ancient physicians had a preliminary
tive society. understanding of pulse, blood. body
According to the records of Chapter fluid. qi, shen :manifestations of vitali-
12 of Plain Questions: "The treatment ty), essence. fi v'e sounds. five colours.
with bian stone needle was originated in five flavours. six qi, eight winds., etc .. as
the east coa~,t of China where the inhab- well as the ideology of relevant adapta-
itants lived on fishery. and moxibustion tion of the human body to natural envi-
was originated in the north where the ronment. Thus germinated the sprout of
people subsisted on animal husbandry. the basic theory of traditional Chinese
Because it \vas cold and windy in the medicine.
northern areas, people had to warm From the Warring States Period (475
themselves by fire. Living in camps and B.C.-221 B.c.):o the Qin Dynasty (221
subsisting on milk, they easily suffered B.C.-207 B.C.) :l.nd to the Western Han
from abdominal pain and distension by Dynasty (206 RC.·A.D. 24). it was the
cold. suitable to be treated by heat. establishing and strengthening stage of
Through long-term accumulation of ex- the feudal system in China. With the
periences, moxibustion therapy and hot introduction anj application of iron in-
compression were created." struments. bian stone needles \vere re-
 placed by meta i medical need les. This ings on acupuncture and moxibustion
broadened the field of acupuncture appeared. Two silk scrolls recording me-
practice. bringing about a development ridians and coll:nerals written in the
of acupuncture by leaps and bOllnds. As third century B.C. were discovered in
recorded in the book Aliraculous Pivot. the excavation of the NO.3 Han Tomb
there were nine kinds of metallic nee- at Mawangdui. Hunan Province. which
dles at that time with different~hapes reflected the earliest outlook of the
and usage. They are named as nine nee- theory of meridians and collaterals. The
dles including the needles for punctur- book Huangdi's Internal Classic passed
ing. surgical incision and massage as on to now is a medical classic concern-
well. In 1968. in Mancheng County. He- ing the theory of traditional Chinese
bei Province. aG ancient tomb of the medicine. with ilS authorship ascribed
Western Han Dynasty buried in 113 to the ancient Erlperor Huangdi. It in-
B.c. was excavated. Among the relics. cludes two parts· !vliraculous Pivot. in
there 'Were four golden needles and another name H~jat1gdi's Canon of Acu-
five decaying silver ones (see Fig 1-2). pUllcture and Plain Questions. On the
These dIscoveries demonstrate the orig- basis of previous literature. it takes
inal shapes of the ancient needles. The the theories of yin-yang. five elements.
doctors of thi:; period treated diseases zang-fll. meridian~; and collaterals. men-
with multiple:echniques. For example. tality and spirit. qi and blood . body
the famous doctor Qin Yueren (or fluid. five emotions and six exogenous
named Bian Que) who lived in about pathogenic factor, as the basic know-
the fifth to fourth century B.c.. had a ledge of traditional Chinese medicine.
good command of medical knowledge in and acupuncture and moxibustion as the
various clinical branches; he treated pa- main therapeutic technique; it expL1ined
tients by needling. moxibustion. herbal the phYSIology ancl pathology of the hu-
decoction. massage and hot compres- man body. the principles of diagnosis.
sion. He rescued ,I critically ill prince by the prevention and treatment of diseases
acupuncture. and this story went down from the perspective of atheism. holistic
in history. Another famous doctor conceplion. the viewpoint of develop-
Chunyu Yi of the second century B.C. ment and change. and the relationship
was good at acupuncture-moxibustion between the humal body and the natur-
and herbal treatment. There is an ac- al environment. This laid a theoretical
count of his case reports of twenty-five foundation of Chinese medicine and
patients in the book Historical Records. pharmacology. including acupuncture
in 'Which four cases were treated by and moxibustion. During this period
acupuncture and moxibustion. In the also appeared the ~ooks Huangdi's Call-
Warring States P(~riod. ancient doctors an of Eighty-One Difficult Problems and
began to general ize and summarize Essentials of Points, Acupuncture and
medicine and pharmacology. and writ- Moxibustion. both related to the funda-
-I CIIJ:\ESE\UPl "C:T1RF~"I) \[():\lBl,,-rl()\
- - - - - - - - - - - - - - - - - - - - - . - -.. -~---------

mental theOJries of acupuncture and points when compared \vith other books.
moxibustion, but the latter book has Because the e.lrliest acupuncture books
been lost. contained mis1akes and differences. and
From the Eastern Han Dynasty (A. D. had missing information. the famous
25-220) to the Three Kingdoms Period medical doctor H uangfu Mi compiled the
(220-265), another generalization and book 5.l'stel71alic Classic oj' Acupuncture
summarizal ion of traditional Chinese and /\10xibustiol/ in .256-260 by collecting
medicine and pharmacology was made. the materials of acupuncture and mox-
Many famous doctors paid great atten- ibustion from the ancient books Plail!
tion to the study of acupuncture and Questiol1s, Cano/l 0/ Acupullcture dnd Es-
moxibustion. For example, Hua Tuo who sellIials ol Points, Acupullcture and ."vloxi-
was the pioneer to apply herbal anesthe- bustioll. The book consists of 1.2 \olumc~;
sia for surgical operations only selected with 121:1 chapters. Including .349 acu-
one to two points in acupuncture treat- pUllcture point~;. Hie edited and arranged
ment and took much notice to the propa- the contents (Iccording to the following
gation of needl ing sensation. He was order: the theories of zang-fu. qi and
ascribed tl1<.:: authorship of Canon of blood. meridians and collaterals. aCLl-
Afoxibustion and Acupuncture Preserved puncture poin.s. the pulse diagnosis.
in Pilloli' (lost), The outstanding medical manipulating tEchniques or' acupuncture
doctor Zhang Zhongjing also mentioned and moxibustion. and their clinical appli-
the methods of acupuncture, moxibus- cation in variou~ branches of medicine. It
tion, fire needling, warm needling, etc. in is the earliest exclusive and systemized
hIS book Treatise on Febrile and Miscella- book on acupuncture and moxibustion
Ileous Diseases. He stressed very much on and has been one of the most influential
combining acupuncture with medicinal works in the hi~.tory of acupuncture and
herbs as well as applying the treatment moxibustion.
according to the differentiation of symp- During the Jin Dynasty' and the
tom complex. During this period the bas- Northern and Southern Dynasties
ic theories of acupuncture and moxibus- (265. 51:1 1), the chaos I,\oas upheaved by
tion had already been formed, but the wars. The physicians advocated acupunc-
locations and names of acupuncture ture and moxibustion therapy very much
points were neither unified nor system- because of its ce'nvenient use in times of
ized. A bamboo scroll of medicine of the turmoiL and the masses of Chinese peo-
Eastern Han Dynasty which was excavat- ple also knew something about moxibus-
ed from Wuweii County in Gansu Prov- tion therapy. The famous doctor Ge
ince, mistook Zusanli (ST36) to be locat- Hong wrote thE book Prescriptions .lc)r
ed "five cun below the knee." Hua Tuo Emergellcies to p')pularize medical know-
located Back-ShU points as "one cun ledge. especially the therapeutic methods
bilaterally along the spine." wi1h a great of acupuncture md moxibustion. From
difference in locations and names of the the Jin Dynasty to the Northern and
 ClIAPTER 1 ,\ BRIEF HISTORY OF (fIll\:ESE \Cl'Pl'1\:CfU{E .\"n .\IUXIhl.'~TlCJ.\
--~----.--.---------------.------~--~~--------------.---- - --- -

Southern Dynasties, Xu Xi's family were shan of the Tang Dynasty compiled Ae/i-
expert in the art of healing for several jllII]cture Poims in Imeowl C/(lSsic. wh ic h
generations, including Xu Qiufu, Xu revised the relevant contents of Internal
Wenbo and Xu Shuxiang. all well known Classic: Wang Tao wrote the book The
in the history of acupuncture and moxi- Medical Secrets u/All Official, in which a
bustion. In this period there appeared host of moxibustion methOds of various
more and more monographs on acupunc" schools were recorded. During this per-
ture and moxibustion. and charts of acu" iod there appeared monographs on the
puncture points . such as AClIplll1clllre treatment of special diseases. for exam-
Chart from Lateral alld Posterior Views ple. the book Aloxibllsrioll MerllOd fur
and Diagrams qf Meridians and Points. ConsullljJtive Diseases written by Cui Zl1i-
During the Sui (581-618) and Tang di. in which moxibustion treatment of
dynasties (618-907), China was undergo- tuberculosis was described. It has been
ing the process of economical and cultur- found that the earliest block-printed edi-
al prosperity of the feudal society. The tion of acupunctu re and moxibustion is A
science of acupuncture and moxibustion New Collection of,1;foxibustion Tlzerapl'fol'
also had great development. The famous Emergency. which appeared in the year
physician Zhen Quan and his contempor- 862. specially describing the moxibustion
ary Sun Simiao both had good com mand therapy for emergencies. In the seventh
of the knowledge of traditional Chinese century. acupunc:ure and moxibustion
medicine and made deep study on acu- had already become a special branch of
puncture and moxibustion. The Tang medicine. and those specialized in this
government, in the years around 627-649. field were entitled acupuncturists and
ordered Zhen Quan and the others to moxibustionists. During the Tang Dynas-
revise the books and charts of acupunc- ty the Imperial Medical Bureau responsi-
ture and moxibustion. Sun Simiao com- ble for medical education was divided
piled Prescriptions W~~rth a Thollsand Gold into four departmtnts of medical special-
for Ernergencies (650-652), and A Supple- ities and one department of pharmacolo-
ment to the Prescriptions Worth a Thou- gy. And the department of acupuncture
sand Gold (6801-682), in which a great was also one of them. in which there was
deal of clinical experiences in acupunc- I professor of acupuncture. 1 assistant
ture treatment of various schools were professor, 10 instructors. 20 technicians
included. He also designed and made and 20 students. The acupuncture profes-
Charrs of Three Views. in which "the sor was in charge 0." teaching the students
twelve main meridians and the eight extra the meridian-collat,~rals and acupuncture
meridians were illustrated in various col- points, pulse diagnosis., and manipulating
ours, and there were altogether 650 methods of needling.
points." They are the earliest multicol- In the Five Dynasties (907-960).
oured charts of meridians and points, but Liao Dynasty (916·1125), Song Dynasty
have been lost. In addition, Yang Shang- (960-1279). J in Dynasty ( 1115-1234) and
(-,
----~~-----.---- -------------------_.----

Yuan DynaslY ( 1206-1368), the extensi ve doctors who were good at acupuncture
application of printing tech niq ue greatly and moxibustion. Some of them laid em-
promoted the accumulation of medical phasis on the theory and technique of a
literature and ~;peeded up the dissemina- part icular aspect. So different branches
tion and deyelopment of Chinese medi- of "cupuncture and moxibustion were
cine and pharmacology. Supported by the formed. For example. the publication of
Northern Song government. the famous Canon of AClIpdtlcture and Aloxibustioll
acupuncturist Wang Weiyi revised the lo- for Children's Diseases (lost). Moxibustion
cations of the acupuncture points and /'vfethods for Emergencies, The Secret of
their related meridians. and made a sup- MOXibustion for Abscess and Ulcer and so
plement to 1[he indications of acupunc- on. ~,howed the deep development of aCll-
ture points. In 1026, he wrote the book puncture and moxibustion into various
Illustrated Manual 011 the Points for Acu- branches of thc~ clinic. Xi Hong of the
puncture and lvloxibustion 011 a Nelt· early Southern Song Dynasty Who was
Bronze Figure, which was block printed from a famous ccupuncturist family. par-
and publish~d by the government. In ticularly stressd the manipulating tech-
1027. two bronze figures designed by nique of acupuncture. And his contem-
Wang Weiyi were manufactured. with the porary Dou C2 i wrote a book entitled
internal organs set inside and the merid- Bian Que's /Hedical Experiences. in which
ians and point~, engraved on the surface he highly praised the scorching moxibus-
for visual leaching and examination. tion, and even gave a general anesthesia
These achievements and measures prom- to avoid pain while applying scorching
oted the unification of the theoretical moxibustion. At the same time. Yang Jie
knowledge of acupuncture points and and Zhang Ji observed autopsies. and
meridians. The famous acupuncturllst advocated selecting acupuncture points
Wang Zhizhong of the Southern Song in the I ight of anatomical kno'W ledge. He
Dynasty wrote the book Canoll 01/ the Ruoyu and DOll Hanqin of the Jin and
Origin of Acupuncture and Moxibustion. in Yuan dynasties suggested that the acu-
which he laid stress on practical experi- puncture point~, should be selected ac-
ences including folk experiences. exerting cording to ziwu/iu::hu (Chinese two-hour
a great influence on later generations. time on the basis of Heavenly Stems and
The famous doctor Hua Shou of the Earthly Branches).
Yuan Dynast y did textual research on the III the Ming Dynasty ( 1368-1644) acu-
pathways of meridians and collaterals as puncture and moxibustion were worked
well as their relationship with acupunc- up to a climax that many problems were
ture points. In 1.341 he wrote t he book studied deeper and broader. There were
Exposition of the Fourteen Meridians. mon~ famous doctors specialized in this
which further developed the theory of field. Chen Hui ,)f the early stage of Ming
meridians and acupuncture points. In Dynasty. Ling Yun of the middle stage.
this period there were plenty of famous and Yang Jizhou of the later stage. all
 were known tar and wide In China. and From the establishment of the Qing
exerted a tremendous influence upon the Dynasty to the Opium War (1644-1840).
development of acupuncture and moxi- the medical doctors regarded herbal med-
bustion. The main accomplishments in ication as superior to acupuncture. there-
the Ming Dyn.lsty were: I. ExtenSive col- fore acupuncture and moxibustion grad-
lection and revision of the lJ terat ure of ually turned to a failure, In the eight-
acupuncture and moxibustion. e.g. the eenth century Wu Qian and his collabor-
chapter of acupuncture and moxibustion ators compiled the book Go/dell Mirror of
in the book Prescriptions (or Universal Re·· /v/edicine by the imperial order. In this
lief ( 1406). A Complere Collection of Acu- book the chapter "Essentials of Acupunc-
puncture and MD.'Cibustioll by XlI Feng in ture and Moxibustion in Verse" took the
the fifteenth century. All Exemplar), Col- practical form of rhymed verse with il-
lecttoll of Acupuncture and Moxibustioll bv lustrations. Li Xuechuan compiled The
Gao Wu in 1529. Compendium of Acu- Source 0/ AClipwicrure and Moxibustion
puncture and Mo'\ihustion in 1601 based ( 18 J7). in which s,:iection of acupuncture
on Yang J izhou\ work. Six Volumes Oil points according 10 the differentiation of
Acupuncture Prescriptions by Wu Kun in syndromes \vas emphasized. acupunc-
1618. and An Iliusrrated Supplement to ture and herbal medication were equally
S\slematic Compilation of the Internal stressed. and the 361 points on the Four-
Classic by Zhang J iebin in 1624. elC. All teen Meridians were systematically listed,
these works were the summarizatJon of Besides these books. there were many
the literature (If acupuncture and moxi- publications. but none of them were in-
bustion through lhe ages. 2, Stud:les on fluential. In 1822. the authorities of the
the manipulating methods of acupunc- Qing Dynasty declared an order to
ture, On the basis of single manipulation abolish permanently the acupuncture-
of acupuncture. more than twen1.y kinds moxibustion department from the Imper-
of compound manipulation were devel- ial Medica I College because "acupuncture
oped. and an al::ademical contention was and moxibustion are not suitable to be
carried out about different manipulation applied to the Enneror."·
methods. Questions and Answers Con-
cerning Acupuncture and Afoxibustion by
III. lVlODERN DECLINE AND
Wang Ji in 1530 was the representative
work of that academical dispute. 3, De-
NEW LIFE OF
velopment of warm moxibustion with ACUPUNCTURE AND
moxa stick from burning moxibustion MOXIBUSTION
with moxa cone, 4. Sorting out the pre-
vious records of acupuncture sites locat- Follmving the Opium War in 1840.
ed away from the Fourteen Meridians China fell into a semi Feudal and semico-
and formation (if a new category of extra Jonial ~,ociety. The Revolution of 1911
points. ended the rule of 1he Qing Dynasty. but
8 U/l\:ESI' ,\(TI'l't-;CTl'RF A\:[) \l()XIlll'~Tl(r\
-----~--------~---- -------- - - - - - - - - - - - -- -------------

the broad masses of Chinese people were tIed Illustration olthe Brol1::e Figure ll'itiz
in deep distress until the founding of Chinese and Western Medicine. paving the
New China . and acupuncture and moxi- way for studying acupuncture through
bustion were also trampled upon. Intro- combination OC traditional Chinese and
duction of Western medicine to China Western medicine in the history of acu-
should have been a good turn. but the puncture. In 1934 The Techllique alld
colonists used it as a medium for aggres- Principles oj' £lectro-QCUPUllcf lire and the
sion. They claimed: "Western medicine is StwfJ' of' Electro-acupullcture written by
vanguard of Christianity and Christianity Tang Shicheng et al. started the use or
is the forerunner promoting the sale of electro-acupuncture in China.
goods." With such a purpose, they de- At this period. acupuncture and mox·
nounced and depreciated Chinese tradi- ibustion gained their new life in the revo-
tional medicine, and even defamed acu- lutionary base area led by the Communist
puncture and moxibustion as medical tor- Pany of China. In October of 1944. after
ture and caUed the acupuncture needle a Chai rman Mao Zedong made a speech on
deadly needle. From 1914, the reaction- the United Front of Cultural Work at tIle
ary government of China continuously meeting of the cultural and educational
yelled to ban traditional medicine and workers in Shaanxi-Gansu-Ningxia bor-
adopted a serie~i of measures to restrict its der region, many medical doctors trained
development. resulting in a decline of in Western medicine began to learn and
Chinese traditional medicine including to do research work on acupuncture and
acupuncture and moxibustion. moxibustion, anj to spread the use in the
Because of the great need of the army of the base area. In April 1945. an
Chinese people for medical care. acu- acupuncture clillic was opened in the In-
puncture and moxibustion got its chance ternational Peac~ Hospital in the name of
to spread among the folk people. Many Dr. Norman Bethune in Yan'an. This \vas
acupuncturists made unrelenting efforts the tirst time that acupuncture and mox-
to protect and develop this great medical ibustion enterecl into a comprehensive
legacy by founding acupuncture associa- hospital. In 194;, the Health Department
tions, publishing books and journals on of Jinan Military Area Command com-
acupuncture, and launch ing correspond- piled and publislJed Practical Acupullcture
ence courses to teach acupuncture. alld .,\1oxibllstion. An acupuncture train-
Among tho~,e acupuncturists, Cheng Ing cOllrse was :;pol1sored by the health
Dan'an made a particular contribution. school affiliated to the Health Bureau
At this period, in addition to inheriting of the People's Government in Northern
the traditional acupuncture and moxibus- China in 1948. All these efforts like the
tion, they made efforts on explaining the seeds spread over tr.le liberated area. and
theory of acupuncture and moxibustion promoted the understanding of acupunc-
with modern science and technology. In ture ,md moxibustion for Western medi-
1899, Liu Zhongheng wrote a book enti- cal doctors.
CH\PTER j .\ BRlrF ,JlSTORY OF ClIll,fSE ACTI'I ","CTlRI: .\:-\[) \!O:\[]WSTJO:-\
- - - - - - - - - - - - - - - - . _ - - - - _ . _ . _ - - - - - - - - _.. - - - - - - - : . - - - ()
----"--------

IV. REJUVENATION OF Public Health was set up. It became the

ACUPUNCTURE AND Institute of Acupuncture and Moxibus-
tion a ttached to the Academy of T radi-
MOXIBUSTION IN
tional Chinese Medicine in 1955. Since
NE\VCHINA then the research organizations of tradi-
tional Chinese medicine and pharmacolo-
Since the founding of the People's Re- gy on provinciaL municipal and autono-
public of China. i:he Chinese Communist mous regional levels have been set up one
Party has paid great attention to illherit- after the other. In which the research
ing and developing the legacy of tradi- dlvisions of acupuncture and moxibus-
tional Chinese m;:dicine and pharmacol- tion are included. In a few provinces and
ogy. In 1950 Chairman Mao Zedong cities institutes of acupuncture and mox-
adopted an important policy to unite the ibustion have also been established.
doctors of both Western and traditional There are teaching and research groups
schools; in the same year. Comrade Zhu of acupuncture and moxibustion in every
De wrote an inscription for the Book Nel'l-' college of traditional Chinese medicine.
Acupuncture. pointing out, "Chinese acu- and in some of the colleges departments
puncture treatment has a history of thou- of acupuncture and moxibustion have
sands of years. It is not only simple and been founded. In many city hospitals spe-
economicaL but also very effective for cial clinical departments of acupuncture
many kinds of diseases. So this is the and moxibustion have been set up. Acu-
science. I hope that the doctors of both puncture and moxibustion have been car-
Western and traditional schools should ried out even in commune hospitals.
unite for the further improvement of its Many institutes and colleges of Western
technique and science." Comrade Deng medicine have put it into the teaching
Xiaoping also inscribed in the book New- curriculum and taken it as a scientific
ly Compiled Acupuncture with the follow- research item.
ing statement: "It is an important job for To apply moderll scientific knowledge
us to criticaUy assimilate and systema- to the research wOI"k Oil the basis of ex-
tize our multifarious scientific legacies." ploring and inheriting the traditional aCll-
With the support and concern of Party PUllcture and moxibustion is the promi-
and government leaders, authoritit:s of nent characteristic of the present re-
different levels took a series of mt~asures search on acupunctu re and moxibustion.
to develop the great cause of Chinese In the early 1950s, the main work was to
medicine. In this way acupuncture and systemmize the basic theory of acupunc-
moxibustion were unprecedentedly popu- ture and moxibustion. Ito observe its clin-
larized and promoted. ical indications. and to make a systematic
In July 1951. the Experimental Insti- exposition of acupuncture and moxibus-
lUte of Acupuncrure-Moxibustion Thera- tion with modern methods. From the la-
py affiliated directly to the Ministry of (er stage of the 1950s to the 1960s. the
)') (lll,\E~l V:l l'l'\C-;) KE .\ '\ll \lc)\:IB1~TI() \
- -~---------- ---- -_._--- --~---~.---".-----------

following were carried out: deep study of 693 gave the tille of Acupuncture Profes-
the ancient literature, extensive summar- sor to those wl-o L1Ught acupuncture stu-
ization of the clinical effect on various dents. It was also ill the sixth centur:~
disease entities. propagation of acupunc- that acupuncture and moxibustion wer,:
ture anesthesia in clinical lise . and exper- passed on to Japan. The Chinese Govern-
imental research to observe the effect of ment presented the book Canon oj' ACII-
acupuncture and moxibustion upon the pUl1ctllre to the Mikado of Japan in A.D.
functions of each system and organ. 552. Zhi Cong of Wu County brought
From the 1970s up to now. investigations Charts of' AClIjJUt1Clllre and :'v/oxibliSfiol1
have been done on the mechanism of and other medical books to Japan. In
acupuncture anesthesia and acupuncture the seventh century, the Japanese gov-
analgesia from the viewpoints of opera- ernment sent many doctors to China to
tive surgery. anesthesiology, neuroanato- study Chinese lledicine. In A. D. 70.2 the
my. histochemistry, analgesia physiolo- Japanese government issued an Imperial
gy. biochemistry. psychology and medi- Order to copy the medical educational
cal electronics. on the phenomena and system of the ell inese Tang Dynasty and
nature of the meridians from the view- set up a speciality of acupuncture and
point of propagated acupuncture sensa- moxibustion. Since the introduction or'
tion and other angles, and on the rela- Chinese acupuncture and moxibustion to
tionship between acupuncture points and Japan and Kon~a. acupuncture and mox-
needling sensation, between acupuncture ibustion have been regarded as an impor-
points and zang-fu organs. Now the ac- tant part of tleir traditional medicine
complishments of acupuncture and mox- and handed doY\. n up to now. \Vith the
ibustion research gained in China includ- cultural exchanges between Ch1l1a and
II1g sorting out of the ancient legacy, foreign countri;?s. acupuncture and mox"
the c1iniced dfecl and the theoretical re- ibustion were a so disseminated to SOLlth··
search by modern scientific methods are east Asia and the continent of India. If'
ill the forefront of the world. the sixth centllry. Mi Yun from Dun
Huang of Gansu Province introduced
V. THE DISSEMINATION OF Hua Tuo's therapeutic methods and pres-
criptions to Da,xilang State of north In-
ACUPUNCTURE AND dia. In the fourleenth century. Chinese
\ttOXIBUSTION TO acupuncturist Zou Yin went to Viet T\alll
TI-lE WORLD to treat disease~ for the Vietnamese no-
bles, and he Y\.as given the honour 0/
In the sixth century, acupuncture and Magi Doctor. Acupuncture and moxibus-
moxibustion were introduced to Korea. tion began to be introduced to Europe in
The Emperor Liangwu sent medical doc·· the sixteenth century. Later more and
tors and craftsmen to Baiji in A.D. 541. more people engagl;;~d in the cause of acu-
The Xinluo royal court of Korea in A.D. puncture and moxibustion. France made
an early contribution to spreading this countries. Up to now. more than one
therapy through Europe. hundred countrie~, have had acupunctur-
Since the founding of the Peopl,~'s Re- ists. and in some countries teaching and
public of China. the propagation of acu- scientific research on acupuncture and
puncture and moxibustion 10 the world moxibustion have been carried out v\ith
has been speeded up. In the 1950.s. China good results. Since its founding in 1979.
ga\e assistance to the Soviet Union and AII-Ch ina Associ" tion of Acupuncture
other Eastern European countries in and Moxibustion has strengthened the
training acupuncwrists. Since 19'75. at connections and e.J~Challges \vith the cor-
the request of the vl/orld Health Organ- responding academic organizations of
ization. the International Acupuncture various countries: and China will make
Training Cours,:s have been run in Bei- greater contributiwls to international de-
jing. Shanghai and Nanjing. and acu- velopment of acupuncture and moxibus-
puncturists havl~ been trained for many tion.
 Chapter 2
)TIN-YANG AND I'HE FIVE ELI~MENl'S

The theories of yin-yang and the five pointed out in Chapter 5 of the book
elements \Vere two interpretations of na- Plain Question: ''Yin and yang are the
tural phenomena that oniginated in an- laws of heaven and earth. the great
cient China. They reflected a primlitive framework of everything. the parents of
concept of materialism and dialectics change. the root and beginning of life
and played an active role in promoting and death .... "
the development of natura.1 science in This quote expresses the idea that all
China. Ancient physicians applied these nw:ural event~; and states of being are
two theories to the field of medicine. rooted in yin md yang. and can be ana-
greatly influencing the formation and lysed by the theory of yin-yang. The theo-
development of the theoretical system ry of yin-yan§:. however. does not itself
of traditional Chinese medicine. and refer to any CJncrete objective phenom-
guiding clinical work up to the present ena. It is. rather. a theoretical method
time. for observing ,wd analysing phenomena.
Briefly speaking. yin and yang are a phi-
losophical con:eptualization. a means 10
I. YIN-YANG generalize the two opposite principles
which may be observed in all related
The theory of yin-yang is a conceptual phenomena \Vithin the natural world.
framework which was used for observing They may represent two separate
and analysing the material world in all' phenomena with opposing natures. as
cient China. The early theory of yin-yang well as differ=nt and oppos:ite aspects
was formee in the Yin and Zhou dynas" within the same phenomenon. Thus th~
lies (sixteenth century-22 B.C). The term ancient Chinese people. in the course of
yin-yang fi rst appeared in The Book o.r their everyday life and work. came to
Changes. "Yin and yang reflect all the understand that all aspects of the natural
forms and characteristics existing in the world could be seen as having a dual
umverse. aspect. for e:<ample. day and night.
Up to the Spring and Autumn Period brightness and dimness. movement and
(770-476 RC) and the Warring States stillness. upward and downward direc-
Period (475-221 B.C). the application of tions. heat and cold. etc. The terms yin
the theory of yin-yang had been deeply and yang are applied to express these
rooted in all schools of thought. It was dual and opposite qualities. Chapter 5 of
l~
CHAPTER 2 Ylt\-YAr\G At\D THE FI\-E ELE\IEl\TS 1:\

the book Plain Questions states: "Water natural world into its opposite parts can
and fire are symbols of yin and yang." be carried out infinitely.
This means that water and fire represent It can be seen, therefore, that yin and
the two primary opposite aspects of a yang are at the same time opposite in
contradiction. Based on the properties of nature and yet interdependent. They both
water and fire, everything in the natural oppose and complement each other, and
environment may be classified as either exist within all natural phenomena. Tra-
yin or yang. Those with the basic pro- ditional Chinese medicine applies the yin-
perties of fire, such as heat. movement. yang principles of interconnection and
brightness, upward and outward direc- continuous transformation to the human
tions, excitement and potency, pertain to body to explain its physiology and pathol-
yang; those with the basic properties of ogy and to guide cl inical diagnosis and
water, such as coldness, stillness, dim- treatment.
ness, downward and inward directions,
inhibition and weakness, pertain to yin. 1. The Basic Knowledge of the Theory
Accordingly, within the field of medicine of Yin :and Yang
different functions and properties of the
body are classified as either yin or yang. 1) The opposition of yin and yang
For example, the qi of the body which The theory of yin-yang holds that every-
has moving and warming functions is thing in nature has two opposite aspects,
yang, while the qi of the body which has namely yin and yang. The opposition of
nourishing and moistening functions is yin and yang is mainly reflected in their
yin. ability to struggle with, and thus control
The yin-yang nature of a phenome- each other. For instance, warmth and
non is not absolute but relative. This heat (yang) may dispel cold, while cool-
relativity is reflected in two ways. On ness and cold (yin) may lower a high
the one hand, under certain conditions temperature. The yin or yang aspect
yin may change into yang and vice ver- within any phenomenon will restrict the
sa (the inter-transforming nature of yin other through opposition. Under normal
and yang), and on the other hand, any conditions in the human body, therefore,
phenomenon may be infinitely divided a relative physiological balance is main-
into its yin and yang aspects, reflect- tained through the mutual opposition of
ing its own inner yin-yang relationship. yin and yang. If for any reason this mu-
Day, for example, is yang, while night is tual opposition results in an excess or
yin. Each, however, can be further clas- deficiency of yin or yang, the relative
sified as follows: morning is yang with- physiological balance of the body will be
in yang, afternoon yin within yang, the destroyed, and disease will arise. Exam-
first half of the night yin within yin, ples are excess of yin leading to deficien-
and the second half of the night yang cy of yang, or hyperactivity of yang lead-
within yin. This differentiation of the ing to deficiency of yin. This is referred
14 CH1l\'ESE ACL'PL'l\'CTL'RE AND .\IOXIBCSTION

to in Chapter 5 of the book Plain Ques- 3) The inter-consuming-supporting fE~­

tions: "When yin predominates, yang will lationship of yin and yang The two as-
be diseased; when yang predominates, yin pects of yin and yang within any phe-
will be diseased." nomenon are not fixed, but in a state
2) The interdependence of yin and yang of continuous mutual consumption and
Yin and yang oppose each other and yet, support. For instance, the various func-
at the same lime, also have a mutually tional activities (yang) of the body will
dependent relationship. Neither can exist necessarily consume a certain amount
in isolation: without yin there can be no of nutrient substance (yin). This is the
yang, without yang no yin. Without up- process of "consumption of yin leading
ward movement (yang) there can be no to gaining of yang." On the other hand,
downward movement (yin). Without cold the production of various nutrient
(yin) there would be no heat (yang). Both substances (yin) will necessarily con-
yin and yang are the condition for the sume a certain amount of energy
other's existence, and this relationship is (yang). This is the process of "consump-
known as the interdependence of yin and tion of yang leading to the gaining
yang. The fifth chapter of Plain Ques- of yin." Under normal conditions, the
tions says, "Yin remains inside to act as a inter-consuming-supporting relation of
guard for yang, and yang stays outside to yin and yang is in a state of relative
act as a servant for yin." balance. If this relationship goes be··
When this is applied to the physiolo- yond normal physiological limits, how··
gy of the human body, yin corresponds ever, the rela1 Lve balance of yin ancl
to nutrient substances, and yang to yang will not be maintained, resulting in
functional activities. The nutrient subst- excess or deficiency of either yin or
ances remaJin in the interior, therefore yang and the occurrence of disease.
"yin remains inside," while the function- 4) The inter-transforming relationship
al activities manifest on the exterior, so of yin and yang The two aspects of yin
"yang remains outside." The yang on the and yang within any phenomenon are
exterior is the manifestation of the sub- not absolutely static. In certain circum-
stantial movement in the interior, so it stances, either of the two may transform
is known as "the servant of yin." The into its opposite, i.e. yang may transform
yin in the interior is the material base into yin, and yin into yang. If the inter-
for functional activities and is therefore consuming-suppor1ing relationship is a
called the "guard of yang." It is stated process of quantitative change, then the
in the Chapter "Manifestations of Yin inter-transformation of yin and yang is a
and Yang" of Illustrated Supplement to process of quali tative change.
the Classified Classics: "Without yang The fifth chapter of Plain Questions
there would be no production of yin; says, "Extreme yin will necessarily pro-
without yin there would be no produc- duce yang, and extreme yang will neces-
tion of yang." sarily produce yin .... Severe cold will give
CHAPTER 2 YIN-YA"G Al\O THE FI\'E ELE;\IENTS IS
----

birth to heat, and severe heat will give That is why there are three YIl1 and
birth to cold." three yang."
On the one hand, this illustrates the This quotation explains that the qi of
inter-transformation of yin and yang, and yin and yang may be greater or lesser in
on the other hand, the circumstances degree and that there are three sub-
needed for their transformation. Without divisions of yin and three of yang.
the combination of both internal and ex- Greater Yin is called Taiyin (the third
ternal factors, the transformation will not yin), Lesser Yin is called Shaoyin (the
occur. Acute febrile disease is an exam- second yin), Declining Yin is called Jue-
ple. Extreme heat severely consumes and yin (the first yin), Greater Yang is
damages the anti-pathogenic qi of the called Taiyang (the third yang), Ex-
organism. After persistent high fever, treme Yang is called Yangming (the sec-
severe cold manifestations may appear, ond yang), Scanty Yang is called Shao-
such as a sudden drop in body temper- yang (the first yang). The three yin and
ature, pallor, cold limbs and a fading the three yang are a further amplifica-
pulse. If proper emergency treatment is tion of yin and yang, and also reflect
given in time, the yang qi will be resusci- the consuming-supporting relationship
tated and there will be an improvement in of yin and yang. The differentiation of
the pathological condition, with the limbs syndromes applied to the development
becoming warm and the complexion and of febrile diseases is analysed with the
pulse returning to normal. The former is application of the Taiyang, Yangming,
yang transforming into yin, and the latter Shaoyang, Taiyin, Shaoyin and Jueyin
yin transforming into yang. categories.
5) The infinite divisibility of yin and The above mentioned is the basic con-
yang As already mentioned, yin and tent of the theory of yin-yang, the cardi-
yang are in a state of constant change. nal principles of which are explained by
This means that there are relative degrees the "Yin-Yang Figure" (Taijitu). In this
of both yin and yang. It is stated in the illustration, the white colour indicates
sixth chapter of Plain Questions: "Yin and yang, and the black colour yin. The op-
yang could amount to ten in number; position and interdependence of yin and
they could be extended to one hundred, yang are illustrated by the curved line
one thousand, ten thousand or infinity; showing the inter-consuming-supporting
but although infinitely divisible, yin and relationship. The white yang area con-
yang are based upon only one important tains a black spot (yin) and the black yin
principle." area a white spot (yang) indicating the
According to circumstances, yin and potential for int<i.~r-transformation, yin
yang can be amplified into three subdi- within yang and yang within yin. This
visions respectively. Chapter 66 of the illustration shows that all phenomena are
book Plain Questions says, "The qi of not isolated, but inter-connected, devel-
yin and yang may be lesser or greater. oping and changing.
16
UIl:\ESE AClPl':\CTlRE A:\O .\lOXIBl'STIOX

o Yang
• Yin

Fig, 1 Yin-Yang Figure

2. Application of the Theory of Yin and medial aspects yin. According to the na-
Yang in Traditional Chinese Medicine ture of their functional activities. the
zang organs are yin and the fu organs
The theory of yin-yang permeates all yang. Furthermore. within each of the
aspects of the theoretical system of tra- zang-fu organs, there are yin and yang
ditional Chinese medicine. It serves to aspects; for example, heart-yin and heart-
explain the organic structure, physiologi- yang, kidney-yin and kidney-yang., With-
cal functions and pathological changes of in the meridian system there are two
the human body, and in addition guides categories: yin meridians and yang me-
clinical diagnosis and treatment. ridians. Thus the opposition of yin and
1) Yin-yang and the organic structure yang manifests within all the upper, low-
of the human body When the theory of er, internal and external organic struc-
yin-yang is applied to explain the organic tures. Each contc:ins yin and yang quali-
structure of the human body, the under- ties and all of rhem can be classified
lying premise is that the human body is according to yin a nd yang. Thus, Chapter
an integrated whole. All its organs and 25 of the book Plain Questions says, "Man
tissues are organically connected and can has a physical shc,pe which is inseparable
be divided into two opposite aspects, from yin and yang."
namely yin and yang. In terms of anatom- 2) Yin-yang and the physiological func-
ical location, the upper part of the body tions of the human body The theory of
is yang and the lower part yin; the exter- yin-yang holds that the normal vital ac-
ior yang and the interior yin; the lateral tivities of the human body are based on
aspects of the four limbs yang and the the coordination of yin and yang in a
CHAPTER 2 YIN-YANG Al'.'O THE FIVE ELEMEl'.'TS

unity of opposites. Functional activities factors cause disease, this may lead to an
pertain to yang and nutrient substances excess of yang which consumes yin and
to yin. The various functional activities gives rise to heat syndromes. When yin
of the body depend on the support of the pathogenic factors cause disease, this
nutrient substances. Without nutrient may lead to preponderance of yin which !(!XJJ..tj\
substances, there would be no sustenance damages yang and gives rise to cold syn-
for functional activity. At the same time, dromes. When deficiency of yang fails
functional activities are the motive power to control yin, deficiency and cold syn-
for the production of nutrient substances dromes may appear, in which yang is
in the body. In other words, without the deficient and yin excessive. When defi-
functional activities of the zang-fu or- ciency of yin fluid fails to restrict yang,
gans, water and food cannot be trans- deficiency and hot syndromes may ap-
formed into nutrient substance. In this pear, in which yin is deficient and yang
way, yin and yang within the human body hyperactive (Fig. 2).
are mutually supportive. They act togeth- From the above it can be seen that
er to protect the organism from invasion although the pathological changes that
by pathogenic factors and to maintain a occur in disease are complicated and sub-
relative balance within the body. If yin ject to change, they can be generalized
and yang fail to support each other and and explained by: "imbalance of yin and
become separated, the vital activities of yang," "excess of yin leading to cold syn-
the body will cease. The third chapter of dromes," "excess of yang leading to heat
Plain Questions says, "When yin is stabil- syndromes," "deficiency of yang leading
ized and yang well-conserved, the spirit to cold syndromes" and "deficiency of yin
will be in harmony; separation of yin and leading to heat syndromes."
yang will cause exhaustion of essential In addition, deficiency of either yang
qi." qi or yin fluid may lead to the consump-
3) Yin-yang and pathological changes tion of the other, known as "mutual con-
in the human body The theory of yin- sumption of yin and yang." For example,
yang is also applied to explain pathologi- prolonged poor appetite is mainly attrib-
cal changes. Traditional Chinese med- uted to weakness of spleen-qi (yang),
icine considers that the occurrence of leading to insufficiency of blood (yin).
disease results from the loss of relative This is known as "deficiency of both qi
balance between yin and yang, and hence and blood due to weakness of yang affect-
an excess or deficiency of either. The ing yin." Another example is haemor-
occurrence and development of disease is rhage, where considerable loss of yin
related both to the anti pathogenic qi and blood usually leads to the syndrome of
to pathogenic factors. There are two deficiency of yang, manifesting as chilli-
types of pathogenic factors: yin and ness and cold limbs. This is known as
yang. Antipathogenic qi involves yin "deficiency of both yin and yang re-
fluid and yang qi. When yang pathogenic sulting from deficiency of yin affecting
18
CHINESE ACCPCNCTURE AKD MOXlBCSTIOl\·

Equilibrium of Yin and Yang

Yin Pathogenic Yang Pathogenic

Factor Factor

Preponderance of Yin Preponderance of Yang

Consumes Yang Consumes Yin
(Shi-Cold Syndrome) (Shi-Heat S~'ndrome)

Weakness of Yang Leads to Weakness of Yin Leads to

Preponderance of Yin. Preponderance of Yang.
(Xu-Cold Syndrome) (Xu-Heat Syndrome)

Yin Yang

Fig. 2 Preponderance and Weakness of Yin and Yang

CHAPTER 2 YIN -Y A\,' G A1\O THE FIVE ELEMENTS 19

yang." These pathological changes are all function of needling is to adjust the qi of
commonly seen in the clinic. yin and yang.
4) Yin-yang as a guide to clinical diag- In the clinical application of acupunc-
nosis and treatment The root cause for ture, the theory of yin-yang is applied
the occurrence and development of di- to determine not only the principles of
sease is imbalance between yin and yang. treatment, but also the selection of points
For this reason, however complicated and and the technique of needling and moxi-
changeable the clinical manifestations bustion to be used. For instance, combin-
may be, with a good command of the ing points from externally-internally re-
principle of yin-yang, we may grasp the lated meridians, as well as combining
key linking elements and analyse them Yuan-Primary and Luo-Connecting
effectively. Generally speaking, the na- points, are used extensively in clinical
ture of any disease does not exceed the practice. Both are methods of selecting
scope of analysis by yin-yang. Thus the points from related yin and yang meridi-
fifth chapter of Plain Questions says, "A ans. In addition. Back-Shu and Front-Mu
good doctor will observe the patient's points are often selected to treat diseases
complexion and feel the pulse, and thus of the zang-fu organs. The related Back-
take the first step in determining if it is a Shu points are mostly selected for diseas-
yin or a yang disease." es of the zang, and the related Front-Mu
Yin-yang is the basis for the differen- points for diseases of the fu. Alternative-
tiation of syndromes by the eight princi- ly, a combination of Back-Shu and Front-
ples, namely, yin, yang, interior, exterior, Mu points is applied to "select Front-Mu
cold, heat, deficiency and excess. Exter- points for yang diseases and Back-Shu
ior, heat and excess are yang, whilst in- points for yin diseases," in order to adjust
terior, cold and deficiency are yin. In this yin and yang in either excess or deficien-
way, complicated clinical situations can cy. Where acupuncture and moxibustion
be simplified, and a correct diagnosis are used together, apply moxa to the up-
. N
gIven. ,~ per part (yang) of the body first and the
Since the root cause for the occur- ~ lower part (yin) second, and "insert nee-
rence and development of disease is im~ dles deeply with retention for yin diseas-
balance of yin and yang, the basic princi- \ es, and shallowly without retention for
pIe in acupuncture treatment is to adjust yang diseases."
yin and yang, making "yin stabilized and From this we can see that in acupunc-
yang well-conserved" and restoring har- ture and moxibustion, the meridians, the
mony between them. The fifth chapter of points, and techniques for needling and
Miraculous Pivot says, "The essential tech- moxibustion are all closely related to the
nique of needling consists of striking a theory of yin and yang, emphasizing the
balance between yin and yang." vital role that yin and yang play in both
From this it can be seen that the basic theory and practice.
20
CllIl\"ESE ACL'Pl'l\"CTCRE A:\O ~IOXIBL'STIO~;

II. THE FIVE ELEMENTS classics in ancient times. In traditiona.l

Chinese medicine the theory of the five
The five elements refer to five catego- elements is applied to generalise and ex ..
ries in the natural world, namely wood, plain the nature of the zang-fu organs.
fire, earth, metal and water. The theo- the inter-relationships between them, and
ry of the five elements holds that all the relation between human beings and
phenomena in the universe correspond in the natural world. It thus serves to guide
nature either to wood, fire, earth, metal clinical diagnosis and treatment.
or water, and that these are in a state of
constant motion and change. The theory 1. Classific~ltion
of Phenomena
of the five elements was first formed in According to the Five Elements
China at about the time of the Yin and
Zhou dynaslties (16th century-22l B.C.). In early times, the Chinese people rec-
Historically it derives from observations ogmzed that wood, fire, earth, metal and
of the natural world made in early times water were indispensible in their daily
by the Chinese people in the course of lives as well as having different natures.
their lives and productive labour. Wood, For instance, the character of wood is to
fire, earth, metal and water were consid- grow and flouri~;h, ithe character of fire is
ered to be five indispensible materials for to be hot and flare up, the character of
the maintenance of life and production, earth is to give birth to all things, the
as well as representing five important character of metal is to descend and be
states that initiated normal changes in the clear, and the character of water is to be
natural world. As said in A Collection of cold and to flow downwards. Early doc-
Ancient Works: "Food relies on water tors applied the theory of the five ele-
and fire. Production relies on metal and ments in their extensive study of the
wood. Earth gives birth to everything. phys,iology and pathology of the zang-fu
They are used by the people." organs and tissues of the human body, and
Although having different charac- indeed all phenomena in the natural world
teristics, the five materials depend on that were related to human life. Using
each other and are inseparable. Thus in analogy, they classified all these, accord-
ancient times, people took these five ele- ing Ito their nature, function and form,
ments with their mutual relationships to into the five elements. They applied this
explain all phenomena in the natural theory to explain the complicated physio-
world. The primitive concept of the five logical and pathological relationships be-
elements was later developed into a more tween the zang-fu organs, and between
complex theory, which together with the the human body and the external environ-
theory of yin-yang, served as a concep- ment. This classification of phenomena
tual method and a theoretical tool for was minutely de!;cribed in the fourth and
understanding and analysing all phenom- fifth chapters of Plain Questions. The clas-
ena, and ran through various academic sification of the meridians according to
CHAPTER 2 YIN~YANG AKD THE FIVE ELE.V!E~-,;T-,S_ _ _ _ _ _~ _ _ _ _ __ 21

the five elements is based on the nature of As for the pericardium and triple
the zang-fu organs: energizer, the ancients considered that

Zang-fu Meridian Element

Liver Foot Jueyin Wood

Gallbladder FootShaoyang Wood
Heart Hand Shaoyin Fire
Small intestine Hand Taiyang Fire
Spleen Foot Taiyin Earth
Stomach Foot Yangming Earth
Lung Hand Taiyin Metal
Large intestine Hand Yangming Metal
Kidney Foot Shaoyin Water
Bladder Foot Taiyang Water
Pericardium Hand Jueyin Fire
Triple Energizer Hand Shaoyang Fire

the pericardium is a protective membrane water, and water, in turn, promotes

surrounding the heart, and prevents the wood. This interpromoting relationship
heart from being invaded by pathogenic of the five elements is known as the
factors. Since the heart pertains to fire, "mother-son" relationship, with each ele-
the pericardium also pertains to fire. The ment being the "son" of the element that
table I on the next page shows the five promotes it, and the "mother" of the one
categories of things according to the five it promotes.
elements. Acting means bringing under control
or restraint. In the interacting relation-
2. Law of Movement of the Five ship, wood acts on earth, earth acts on
Elements water, water acts on fire, fire acts on
metal, and metal in turn acts on wood
The law of movement of the five ele- (Fig.3). Here each of the five elements
ments mainly manifests in the following occupies the role of "being acted upon"
ways: interpromoting, interacting, over- (known as "under control") and of "act-
acting, counteracting, and mutual rela- ing upon" (known as "controller"). The
tion between mother and son. interacting relationship is therefore also
Promoting implies promoting growth. known as the "intercontrolling" relation-
Wood promotes fire, fire promotes earth, ship.
earth promotes metal, metal promotes Interpromoting and interacting are
 tv
N

Table 1. The Five Categories of Things According to the Five Elements

Nature . Human Body

Direc- I Tastes IColours Growth I Environ- ISeasons I Five ele-: Zang f Fu Five Five tis- Emotions Five
tions and Devel-i mental fact ments i ' sense sues notes
opment I tors I , organs
I I I I
East Sour Green Germina- i Wind iSpring Wood Liver GaIl- Eye Tendon i Anger Jiao
tion! I bladder
i i i i

South Bitter Red Growth I! Heat [summer Fire . Heart Sm~ll in- Tongue Vessel I Joy Zheng
,
I, testme

Middle Sweet Yellow Tra~sfor- Ii DampnessiLate Earth, Spleen Stomach Mouth Muscle i Worry Gong
matIOn :summer !
n
:r:
:;;
West Pungent I White Reaping I Dryness 'rlAutumn Metal I Lung Large in- Nose I Skin and I Grief and I Shang m
Cfi

I I I tp<;ctinp I h,,;r I ~~1,,~_ '"

ip
I , I -------- ..................... I ..l.l.lv.lU.l.l

I I i I I I Icholy
I
I
: I I I i I I i !
-c
r:
7.
North I Salty IBlack I Storing I Cold .Winter I Water : Kidney I Bladder Ear ! Bone I Fright I Yu n
....,
r:
I
I
I I !
I
I
I
I I I I and fear
I
I
I
;c
m
;,.
7.
o
<-
is
><
53
~
....,

I
Q
E<
CHAPTER 2 YIN-YANG AND THE FIVE ELEMENTS 2:'>

",--- .... _, ....

, ... ,
"
'" I
,
I
..~-- --
'\
.... ,
/' \',
I '\ ~ IntHrpromoting
I \ ~
/ \
,I \, --+- Intflracting and Overacting
, I I
\/ \ I ----.COunteracting
~, II
I
I ,
,1 I
, I
\ I
\ /
" ',.;' .,'
' ...... ---~----.".'"

Fig. 3 Interpromoting and Interacting Relationship of the Five Elements

two inseparable and indispensible aspects can also be called "'wood acting on earth."
of the five elements which both oppose The order of overacting is the same as
and cooperate with each other. Without that of interacting, except that overacting
promotion there can be no growth and is not a normal imeraction but a harmful
development; without interaction there condition occurring under particular cir-
can be no balance and coordination dur- cumstances. Counteracting means prey-
ing development and change. In the pro- ing upon other elements. The order of
motion of growth there must be control, counteracting is just the opposite to that
and in control there must be promotion of interacting. For instance, under nor-
of growth. The relative balance main- mal conditions, metal acts on wood. In
tained between promoting and acting the case of deficiency of metal qi, or
thus ensures normal growth and develop- hyperactivity of wood qi, the wood may
ment. When there is excess or insufficien- counteract on metal. Therefore it is stat-
cy of any of the five elements, there will ed in Chapter 67 of Plain Questions:
be abnormal inter promoting and interact- "When the qi of a given element is in
ing (known as "over-acting" or "counter- excess, it will overact on the acted ele-
acting") and disorders of "the mother ment and counteract on the acting ele-
affecting the son" and "the son affecting ment. When the qi of a given element is
the mother." (Fig. 4) in deficiency, it will be attacked by the
Overacting can be likened to launch- acting element and counteracted by the
ing an attack when a counterpart is weak acted element."
-it is an excessive acting on the ele- The mutual condition of "affecting be-
ment normally acted upon. It is com- tween mother and· son" refers to the
monly called "interacting" in the clinic. phenomenon of abnormal interpromot-
For example "wood overacting on earth" ing between the five elements. The pro-
24 CHI!\ESE ACCPt:!\CTl'RE A!\[) ~!OXmCST!O!\

Excess
Overacting

-()
Metal Wood Earth

Deficiency

0::8:=0
Metal Wood Earth

Fig. 4 Overacting and Counteracting among the Five Elements

mated element is considered as the son, physiological and pathological phenom-

and the promoting element as the moth- ena, and to guide clinical diagnosis and
er. "Affecting" means influencing in a treatment.
harmful way, including both "the mother 1) The five e.lements and the interrela-
affecting the son" and "the son affecting tionship between the zang-fu organs In
the mother." The order of "mother affect- this theory, each of the internal organs
ing the son" is the same as the interpro- pertains to one of the five elements. The
moting relationship, and the order of properties of the five elements serve as an
"son affecting the mother" is the rev- analogy to explain some of the physiolog-
erse. Under normal conditions, water ical functions or the five zang. In addi-
promotes wood. Abnormally, "water af- tion, the interpromoting and interacting
fecting wood" is known as "the mother relationships are used to explain some of
affecting the son," and "wood affecting
the interconnections between the zang-fu
water" is known as the "son affecting the
organs. The liver may serve as an exam-
mother."
ple, it is promoted by the kidney, pro-
moles the heart, is acted on by the lung,
3. Application of the Theory of the Five and acts on the spleen. The roles of the
Elements in Traditional Chinese other organs can also be explained in the
Medicine same way, and thus an integral relation-
When the theory of the five elements ship between the internal organs is gener-
is applied in traditional Chinese medi- alised.
cine, the c:lassification of phenomena ac- The meridian:~ have a close relation-
cording to the properties of the five ship with the zang-fu organs. They are
elements and their interpromoting, in- the passages by which the zang-fu organs
teracting, overacting and counteracting connect with one another according to
relationships are used to explain both the interpromoting and interacting rela-
CHAPTER 2 YIK~ YA"G Al\ 0 THE FIVE ELE.\1ENTS 2)

tionships of the five elements. In gener- whole,. and both Jinterpromoting and in-
al, the zang-fu organs connect with each teracting relationships exist among the
other directly through the meridians, ac- viscera. Thus when one internal organ is
cording to the cycles of the five ele- afflicted, other organs and tissues may
ments. The relationships between the liv- become involved. This is called "trans-
er, heart, spleen, lung and kidney can mission." According to the theory of the
serve as an example. In the meridian sys- five elements, intertransmission may fol-
tem, the Liver Meridian of Foot-Jueyin low either the interpromoting or the in-
and the Gallbladder Meridian of Foot- teracting cycles.
Shaoyang run through the heart; the Liv- Transmission following the inter-
er Meridian of Foot Jueyin runs on both promoting cycle involves disorders of
sides of the stomach which is externally- "the mother affecting the son" and "the
internally related with the spleen; the son affecting the mother." For example,
Kidney Meridian of Foot-Shaoyin as- when a liver disease is transmitted to the
cends and runs through the liver; the heart, it is called a disorder of "the moth-
Liver Meridian of Foot-Jueyin ascends to er affecting the son," and when a liver
the lung; the Kidney Meridian of Foot- disease is transmitted to the kidney, it is
Shaoyin ascends through the liver and called a disorder of "the son affecting the
lung, etc. By means of the interconnect- mother."
ing system of the meridians, the five ele- Transmission following the interact-
ments maintain a relative balance and ing cycle involves "overacting" and
coordination. "counteracting." When a liver disease is
The theory of the five elements is a transmitted to the spleen, it is called
naive theory with definite limitations. "wood overacting on earth," and when a
The laws of interpromoting and interact- liver disease is transmitted to the lung, it
ing can not reflect all the interrelation- is called "wood counteracting on metal."
ships between the zang-fu organs and It must be pointed out that mutual
their related tissues. Clinical practice, pathological influences among the vis-
however, has shown that these laws do cera exist objectively. Some of them can
reflect certain objective relationships be explained by disorders of "the mother
among the five zang organs and can be affecting the son," "the son affecting
used to determine diagnosis and treat- the mother," "overacting" and "counter-
ment. acting.'" Therefore the theory may serve
2) The five elements and pathological to explain those pathological transmis-
relationships among the zang-fu organs sions which are observed in clinical prac-
The occurrence of a disease is the patho- tice.
logical manifestation of the dysfunction 3) The five elements as a guide to clin-
of the zang-fu organs and their related ical diagnosis and treatment The theory
tissues, which may be due to a number of of the five elements is applied to synthes-
factors. The human body is an organic ize clinical data obtained through the
26 CHINESE ACUPUNCTURE AND MOXIBUSTION

four diagnostic methods, and determine 36) and Taichong (LR 3) will be selected.
pathological conditions according to the In general, the theories of yin and
natures and laws of the five elements. For yang and the five elements both encom-
instance, a patient with redness and pain pass rudimentary concepts of material-
of the eye and irritability suggests liver ism and dialeetics, and to some extent
problem; a red complexion accompanied reflect the objective laws of nature. They
by a bitter taste in the mouth suggests are of prime importance in explaining
hyperactivity of heartfire. physiological activities and pathological
In treatment, the five Shu Points cor- changes, serving to guide clinical prac-
respond to the five elements. The Jin- tice. In their clinical application, the two
well, Ying··Spring, Shu-Stream, Jing- principles are usually related. They sup··
River and He-Sea points of the yin me- plement each other and cannot be entire··
ridians correspond to wood, fire, earth, ly separated. In other words, when apply··
metal and water respectively, whilst those ing yin-yang theory, the five elements
of the yang meridians correspond to me- will be involved; when using the theory
tal, water, wood, fire and earth respec- of Ithe five elements, yin-yang will be
tively. Clinically they are selected for involved. When considering the theories
treatment according to the principle of of yin-yang and the five elements, it must
"reinforcing the mother" and "reducing be understood that they originated in
the son." In addition, it is common clini- clinical practice, have played a progres-
cal practice to determine the principle of sive role in the development of tradition-
treatment and selection of points accord- al Chinese medicine, and are still guiding
ing to pathological influences among the clinical practice to a large extent up to
zang-fu organs which follow the cycle of the present day. At the same time, owing
the five elements. For instance, in case of to the limitations inherent in the histori-
a disharmony between the liver and stom- cal development of ancient Chinese socie-
ach, "wood overacting on earth," the ty, the theories are incomplete and need
principle of treatment should be to pro- to be perfected through continuous re-
mote earth and restrain wood. Points search and summation in clinical prac-
such as Zhongwan (CV 12), Zusanli (ST tice.
 Chapter 3
THE ZANG-FU ORGANS
Zang-fu is the general term for the points out the basic differences between
internal organs of the human body, and the zang and the fu organs in their phys-
includes the six zang organs, the six fu iological functions.
organs and the extra fu organs. The Although the zang organs are differ-
heart, lung, spleen, liver, kidney and per- ent from the fu organs in terms of phys-
icardium are known as the six zang or- iological activities, there is a structural
gans. The gallbladder, stomach, small in- and functional connection by the way
testine, large intestine, bladder and triple of meridians and collaterals between
energizer are known as the six fu organs. individual zang and fu organ, between
The brain, marrow, bones, vessels, gall- the zang and fu organs collectively; and
bladder and uterus are known as the extra between the zang-fu organs on the one
fu organs. Since the pericardium is a hand, and the five sense organs and tis-
protective membrane of the heart, the sues on the other.
extra fu organs pertain respectively to the The theory of the zang-fu organs con-
other fu organs, it is generally called five siders the physiological functions and
zang and six fu organs. The main physi- pathological changes of the zang and fu
ological functions of the zang organs are organs, as well as their interrelationships.
to manufacture and store essential subst- This theory was called "Zang Xiang" by
ances, including vital essence, qi, blood ancient doctors. "Zang" refers to the in-
and body fluid. The main physiological terior location of the zang-fu organs, and
functions of the fu organs are to receive "Xiang" denotes their manifestations or
and digest food, and transmit and excrete "image." In other words, the zang-fu or-
the wastes. The eleventh chapter of Plain gans are located on the inside of the
Questions says: 'The so-called five zang body, but their physiological activities
organs store pure essential qi without and pathological changes are reflected on
draining it off, and for this reason they the exterior. The book Class([ied Classics
can be filled up but cannot be over filled. by Zhang liebin (1562-1639) states: "The
The six fu organs transmit water and zang-fu organs are situated interiorly and
food without storing them, and for this manifested exteriorly; therefore the theo-
reason they may be over supplied but ry of the zang-fu organs is called Zang
cannot be filled up." Xiang."
This description not only describes the There are two main aspects to the
functions of the zang-fu organs, but also theory of the zang-fu organs. Firstly the
28 CHINESE ACL'PllNCTCRE A]'\D ;\IOXlBl'STIO]'\

study of the physiological functions and pathological phenomena.

pathological changes of the zang-fu or- An example is the development of the
gans, tissues and their interrelationships. theory that the skin and hair are connect-
Secondly the physiology and pathology ed with the nose and lung, through obser-
of vital essence, qi, blood and body fluid, vation of cases of common cold due to
as well as the relationship between these invasion of the exterior of the body by
on the one hand and the zang-fu organs pathogenic cold. Typical symptoms of
on the other. nasal obstruction, running nose, chills,
Historically, the development of the fever and cough demonstrate this connec-
theory of the zang-fu organs in the tion.
course of extensive medical practice In- 3. The summary of rich experience ob-
volved three aspects: tained through lengthy clinical practice.
1. Ancient anatomical knowledge. An example is the development of the
The twelfth chapter of Miraculous Pi- theory of the kidney dominating bone. In
vot says: "A man is about eight chi tall in the treatment of fracture, application of
average; the external size of the body is the method of tonifying the kidney may
measurable because its skin and flesh are hasten the healing of bone.
visible, and also his pulse may be taken in To summarize, the comparatively in-
different regions. In addition, when a tegrated theory of the zang-fu organs,
man dies, his body may be dissected for which takes the five zang as its core, was
observation. For this reason, there are formed through a long period of clinical
established standards by which we deter- practice and observation.
mine the hardness and crispness of the
zang organs, the size of the fu organs, the I. THE FIVE ZANG ORGANS
quantity of food consumed, the length of
the vessels, the clarity and turbidity of
1. The Heart
the blood, the quantity of qi in the
body .... All these aspects of the human The heart is situated in the thorax and
body as outlined above are governed by a its meridian connects with the small in-
set of established standards." testine with which it is internally-
In addition, there are some descrip- externally related. The main physiolog-
tions in the fourteenth, thirty-first and ical functions of the heart are: domi-
thirty-second chapters of Miraculous Pi- nating the blood and vessels, manifesting
vot, as well as some descriptions in Clas- on the face, housing the mind, and open-
sics on Medical Problems. It can be seen, ing into the tongue.
therefore, that the practice of anatomy 1) Dominating the blood and vessels
in China predates the Christian era. All and manifesting on the face Dominating
these are the indispensable foundation of the blood and vessels means that the
the formation of zang-fu theory. heart is the motive force for blood circu-
2. Observation of physiological and lation, whilst the vessels are the physical
CHAPTER 3 THE ZANG-Fl: ORGANS 29

structures which contain and circulate for the performance of activities."

the blood. The blood circulation relies on This shows that mental activities and
cooperation between the heart and the thinking have their foundation in the
vessels, with the heart being of primary functions of the heart. Spirit, conscious-
importance. In the forty-fourth chapter ness, thinking, memory and sleep are
of Plain Questions, it is stated: "The heart therefore all related to the function of the
dominates the blood and vessels." heart in housing the mind. Blood is the
The physiological function of the main material basis for mental activities.
heart in propelling the blood relies on the It is controlled as well as dominated and
heart qi. When the heart qi is vigorous, regulated by the heart. So the function of
the blood will circulate normally in the the heart in housing the mind is closely
vessels to supply the whole body. Since related to that of the heart in controlling
the heart. blood and vessels are intercon- the blood and vessels. Therefore it is
nected, and there are many vessels on stated in the same chapter, 'The heart
the face, the prosperity or decline of the dominates vessels and the vessels house
heart qi and the amount of blood circu- mind."
lating will be reflected in changes in both 3) Opening into the tongue "Opening"
the pulse and complexion. If the heart refers to the close structural. physiologi-
qi is vigorous and the blood ample, the cal and pathological relationship between
pulse will be regular and strong and the a particular zang and one of the sense
complexion rosy. When the heart qi and organs. The tongue is connected to the
blood are deficient, the pulse will be Heart Meridian interiorly, and via this
thready and weak, and the complexion connection the heart dominates the sense
pale. As the ninth chapter of Plain Ques- of taste and the speech. When the func-
tions says: 'The glory of the heart is tion of the heart is normal, the tongue
manifested on the face, since the blood will be rosy, moist and lustrous, the sense
fills up the vessels." of taste will be normal, and the tongue
2) Housing the mind The word will move freely. On the other hand, dis-
"mind" has the broad meaning of the orders of the heart will reflect on the
outward appearance of the vital activities tongue. For example, deficiency of heart
of the whole body, and the narrow mean- blood may give rise to a pale tongue;
ing of consciousness, e.g. spirit and think- flaring up of heart fire may give rise to
ing. The theory of the zang-fu organs redness of the tongue tip and ulceration
holds that thinking is related to the five of the tongue body; stagnation of heart
zang organs, and principally to the phys- blood may give rise to a dark, purplish
iological functions of the heart. The tongue body or purplish spots on the
seventy-first chapter of Miraculous Pivot tongue. The sayings: "the heart opens
says: "The heart is the residence of the into the tongue," and "the tongue is the
spirit." The eighth chapter in the same mirror of the heart" reflect this close
book also says: "The mind is responsible physiological and pathological relation-
30 CHINESE ACUPL'NCTURE Ai':O MOXIBUSTIOi':

ship. daytime activities, the blood is released

from the liver, increasing the volume
Appendix: The Pericardium of blood in circulation. During rest and
sleep, the volume of blood required de-
The pericardium, known as "xin bao creases, and part of the blood remains in
luo," is a membrane surrounding the the liver. As Wang Bing said in the ex-
heart. Its meridian connects with the tri- planation on the tenth chapter of Plain
ple energizer with which it is externally- Questions: "The liver stores blood ... the
internally related. Its main function is to blood circulates in the vessels during ex-
protect the heart. When pathogenic qi ertion and remains in the liver during
invades the heart, the pericardium is al- rest. "
ways the first to be attacked, and invasion Because of its function of regulating
of the pericardium by pathogenic qi will the volume of circulating blood, the liver
often affect the normal function of the is closely related to all the activities of the
heart. For example, invasion of the inter- zang-fu organs and tissues. When the liv-
ior by pathogenic mild heat, which gives
er is diseased, dysfunction of the liver in
rise to symptoms of mental derangement
storing blood will affect the normal activ-
such as coma and delirium, is described
ities of the body, and lead to pathological
as "invasion of the pericardium by path-
changes of the blood itself. For example,
ogenic heat," although the clinical mani-
deficiency of liver blood may give rise to
festations are the same as those of the
blurred vision, spasm and convulsion of
heart. For this reason, the pericardium is
the tendons and muscles, numbness of
not generally regarded as an independent
the four limbs, and oligomenorrhoea or
organ, but as an attachment to the heart.
even amenorrhoea in females.
2) Maintaining the free flow of qi
2. The Liver The liver is responsible for the unres-
The liver is situated in the right hypo- trained, free going, and harmonious
chondriac region. Its meridian connects functional activity of all the zang-fu or-
with the gallbladder with which it is gans, including itself. The normal charac-
internally-externally related. Its main ter of the liver is to "flourish" and to
physiological functions are storing blood, dislike depression. Stagnation of liver qi
maintaining the free flow of qi, controll- due to emotional changes may affect the
ing the tendons, manifesting in the nails function of the liver in maintaining the
and opening into the eye. free flow of qi, manifesting in the follow-
1) Storing blood The liver stores ing three ways:
blood and regulates the volume in circu- i) The liver function and emotional
lation. The volume of blood circulating activity
in various parts of the body changes ac- In addition to the heart, emotional
cording to different physiological needs. activity is closely related to the live qi.
During vigorous movement and other Only when the function of the liver in
CHAPTER 3 THE ZANGFU ORGANS 31

maintaining the free flow of qi is normal iii) The liver function and qi and
can the qi and blood be harmonious and blood
the mind at ease. Dysfunction of the liv- The blood circulation relies upon the
er, therefore, is often accompanied by propelling function of qi. Although the
emotional changes such as mental depres- heart and lung play the main role in the
sion or excitement. When liver qi stag- circulation of qi and blood, the function
nates, for example, there may be mental of the liver in maintaining the free flow
depression, paranoia, or even weeping; of qi is also needed to prevent stagnation
when liver qi is hyperactive, there may be of qi and blood. Stagnation of qi and
irascibility, insomnia, dream-disturbed blood due to the failure of the liver in
sleep, dizziness and vertigo. Whilst dys- maintaining the free flow of qi may lead
function of the liver often leads to emo- to stuffiness and pressure in the chest,
tional changes, at the same time pro- distending or pricking pain in the hypo-
longed excessive mental irritation often chondriac region, dysmenorrhoea, and
leads to dysfunction of the liver in main- even the formation of palpable mass.
taining the free flow of 9i. 3) Controlling the tendons and mani-
ii) The liver function and digestion festing in the nails The tendons are the
The liver function of maintaining the main tissues linking the joints and mus-
free flow of qi is related not only to the cles and dominating the movement of the
ascending and descending function of the limbs. Since the liver nourishes the ten-
stomach and spleen, but also to the secre- dons of the whole body to maintain their
tion of bile. The liver therefore has an normal physiological activities, when liv-
important influence on digestion. Dys- er blood is consumed, it may deprive the
function of the liver may affect the secre- tendons of nourishment and give rise to
tion and excretion of bile, and the diges- weakness of the tendons, numbness of
tive function of the spleen and stomach, the limbs, and dysfunction of the joints
resulting in dyspepsia. When the liver in contraction and relaxation. When the
fails to maintain the free flow of qi, there tendons are invaded by pathogenic heat
may be symptoms of stagnation of liver of the liver, there may be convulsion of
qi such as distending pain of the chest the four extremities, opisthotonos and
and hypochondrium, mental depression clenching of the teeth.
or irascibility. If the descending function Manifesting in the nails means that
of the stomach is affected, there may also the state of the yin and blood of the liver
be belching, nausea and vomiting, and if affects not only the movement of the
the spleen's function of transportation tendons but also the condition of the
and transformation is affected, there may nails. When liver blood is ample, the ten-
be abdominal distention and diarrhoea. dons and nails are strong, and when liver
The former is called "attack of the stom- blood is deficient, the tendons will be
ach by liver qi" and the latter "dishar- weak and the nails soft and thin, with-
mony of the liver and spleen." ered, or even deformed and chipped. The
32 CHIl'\ESE ACUPLTl\:CT!'RE Al\:O MOXIBl'STIOl\:

tenth chapter of Plain Questions therefore transformation of water and food on the
says: 'The liver controls the tendons and one hand. and of dampness on the other.
manifests in the nails." The function of the spleen in trans-
4) Opening into the eye In the eight- porting and transforming essential subst-
ieth chapter of Miraculous Pivot, it says: ances refers to the digestion, absorption
"The essential qi of the five zang and six and transmission of nutrient substance.
fu organs flows upward to enter into the Since water and food are then main
eyes to generate vision." source of the nutrient substance required
Of the five zang and six fu organs, the by the body after birth. as well as being
liver is the main organ affecting the eyes the main material base for the manufac-
and vision. The liver stores blood and ture of qi and blood, the spleen is consi-
its meridian ascends to connect with the d~ to be the main zang organ for
eyes. Therefore, the seventeenth chapter the manufacture of qi and blood. When
of Miracular Pivot says: 'The liver qi is in spleen qi is vigorous, digestion. absorp-
communication with the eyes." tion and transmission are normal. Defi-
Whether the liver function is normal ciency of spleen gi and dysfunction of the
or not often reflects on the eye. For ex- spleen in transportation and transforma-
ample, deficiency of the yin and blood of tion may lead to poor appetite, abdominal
the liver may lead to dryness of the eyes, distention, loose stools, lassitude, emacia-
blurred vision or even night blindness. tion and malnutrition.
Wind heat in the Liver Meridian may The function of the spleen in trans-
give rise to redness, swelling and pain of porting and transforming dampness re-
the eyes. fers to the spleen's role in water metab-
olism. The spleen transports the excess
3. The Spleen fluid of the meridians, tissues and organs
and helps discharge it from the body. It
The spleen is situated in the middle ensures that the various tissues of the
energizer. Its meridian connects with the body are both properly moistened and at
stomach, with which it is internally- the same time free from retention of
externally related. Its main physiological Qampness. Dysfunction of the spleen in
functions are: governing transportation transportation and transformation and
and transformation, controlling blood, transformation may lead to retention of
dominating the muscles and limbs, open- dampness, with such clinical manifesta-
ing into the mouth and manifesting on tions as oedema, diarrhoea, phlegm and
the lips. retained fluid.
1) Governing transportation and trans- The spleen's functions of transporting
formation Transportation implies trans- and transforming water and tood on one
mission; and transformation implies hand, and water damp on the other are
digestion and absorption. This function interconnected, and failure of the trans-
of the spleen involves transportation and portation and transformation function
CHAPTER 3 THE ZANG-FU ORGANS
33

may give rise to clinical manifestations of sense of taste. When the spleen functions
either. normally, there will be good appetite and
The transportation and transforma- a normal sense of taste; when there is
tion function of the spleen relies on dysfunction of the spleen, there will be
spleen qi, which is characterized by as- Roor appetite, impaired sense of taste and
cending. If the spleen qi does not ascend, a stick sweetish sensation in the mouth
or indeed sinks, there may be vertigo, due to retention of pathogenic damp in
blurred vision, prolapse of the rectum the spleen.
after prolonged diarrhoea, or prolapse of The spleen dominates muscles, and
various other internal organs. Treatment the mouth is the aperture of the spleen.
is aimed at strengthening the ascending For this reason, the lips reflect the condi-
function of spleen qi. tion of the spleen's function of transport-
2) Controlling blood Controlling ing and transforming water and food.
blood means that the spleen qi has the When the spleen is healthy, there will be
function of keeping the blood circulating ample qi and blood and the lips will be
in the vessels and preventing extravasa- red and lustrous. Deficiency of spleen gi
tion. When the spleen qi is strong, the will lead to deficiency of qi and blood,
source for the manufacture of blood will and the lips will be pale or sallow.
also be strong, there will be ample qi and
blood in the body, and the blood will 4. The Lung
be prevented from extravasation. If the
spleen qi is weak and fails to control The lung, situated in the thorax, com-
blood, there may be various kinds of hae- municates with the throat and opens into
morrhage, such as blood stool uterine the nose. It occupies the uppermost posi-
bleeding and purpura. tion among the zang-fu organs, and is
3) Dominating the muscles and four known as the "canopy" of the zang-fu
limbs The spleen transports and trans- organs. Its meridian connects with the
forms the essence of food and water to large intestine with which it is internally-
nourish the muscles and the four limbs. externally related. Its main physiological
Adequate nourishment ensures well- functions are: dominating qi, controlling
developed muscles and proper function respiration, dominating dispersing and
of the limbs. If nourishment is inade- descending, dominating skin and hair,
quate, the muscles of the four limbs will and regulating the water passages.
be weak and soft. The forty-fourth chap- 1) Dominating qi and controlling res-
ter of Plain Questions therefore says: piration Dominating qi has two aspects:
"The spleen is in charge of muscles." dominating the qi of respiration and
4) Opening into the mouth and mani- dominating the qi of the whole body.
festing on the lips The spleen's function Dominating the qi of respiration
of transportation and transformation is means that the lung is a respiratory organ
closely related to food intake and the through which the qi from the exterior
34 CHINESE ACUPUNCTURE AND MOXIBUSTION

and the qi from the interior are able to tial part of water and food, warms the
mingle. Via the lung, the human body skin, fills up the body and moistens the
inhales clear qi from the natural environ- hair, like irrigation by fog and dew."
ment and exhales waste qi from the inter- The skin and hair, located on the sur-
ior of the body. This is known as "getting face of the body and including the sweat
rid of the stale and taking in the fresh." glands, serve as a protective screen to
The fifth chapter of Plain Questions says: defend the body from exogenous path-
"The qi of heaven is in communication ogenic factors. The skin and hair are
with the lung." warmed and nourished by defensive qi
Dominating the qi of the whole body and body fluid distributed by the lung,
means that the function of the lung in which controls respiration. The pores of
respiration greatly inn uences the func- the skin also have the function of dispers-
tional activities of the whole body, and is ing qi and regulating respiration. For
closely related to the formation of pecto- this reason, traditional Chinese medicine
ral qi, which is formed from the combi- says: "the lung dominates skin and hair"
nation of the essential qi of water and and "the pores are the gate of qi."
food, and the clear qi inhaled by the lung. The close physiological relationship
It accumulates in the chest, ascends to between the lung, skin and hair means
the throat to dominate respiration and is that they often affect each other patho-
distributed to the whole body in order to logically. For example, exogenous patho-
maintain the normal functions of the tis- genic factors often invade the lung
sues and organs. The tenth chapter of through the skin and hair, giving rise to
Plain Questions says: "All kinds of qi be- symptoms such as aversion to cold, fever,
long to the lung." nasal obstruction and cough, reflecting
When the function of the lung in dom- failure of the lung in dispersing. If lung
inating qi is normal, the passage of qi will qi is deficient, failure of the lung in dis-
be unobstructed and respiration will be persing the qi of water and food can
normal and smooth. Deficiency of lung result in the skin becoming wan and sal-
qi may lead to general lassitude, feeble low and lead to deficiency of the anti-
speech, weak respiration and shortness of pathogenic qi and hence susceptibility to
breath. catching cold. When lung qi fails to pro-
2) Dominating dispersing, skin and hair tect the surface of the body, there may be
Dispersing here means distributing. It is frequent spontaneous perspiration.
by the dispersing function of the lung 3) Dominating descending and regulat-
that defensive qi and body fluid are dis- ing the water passages As a general rule,
tributed to the whole body to warm and the upper zang-fu organs have the func-
moisten the muscles, skin and hair. The tion of descending, and the lower zang-fu
thirtieth chapter of Miraculous Pivot says: organs the function of ascending. Since
"Qi refers to the substance that originates the lung is the uppermost zang organ, its
in the upper energizer, spreads the essen- qi descends to promote the circulation of
CHAPTER 3 THE ZANG-FU ORGANS 35

qi and body fluid through the body and Kidney Meridian connects with the blad-
to conduct them downwards. Dysfunc- der with which it is internally-externally
tion of the lung in descending may lead related. Its main functions are: storing
to upward perversion of lung qi with essence and dominating human reproduc-
symptoms such as cough and shortness of tion and development, dominating water
breath. metabolism and the reception of qi, pro-
Regulating the water passages means ducing marrow to fill up the brain, dom-
to regulate the pathways for the circula- inating bone, manufacturing blood, man-
tion and excretion of water. The role of ifesting in the hair, opening into the ear,
the lung in promoting and maintaining and dominating anterior and posterior
water metabolism depends on the des- orifices.
cending function of lung qi. Dysfunction 1) Storing essence and dominating de-
may result in dysuria, oliguria and oe- velopment and reproduction "Essence" is
dema. the material base of the human body and
4) Opening into the nose The nose is of many of its functional activities. Kid-
the pathway for respiration. The respira- ney essence consists of two parts: congen-
tory and olfactory functions of the nose ital and acquired. Congenital essence is
depend on lung qi. When lung qi is nor- inherited from the parents, and acquired
mal, the respiration will be free and the essence is transformed from the essential
sense of smell acute. Dysfunction of the substances of food by the spleen and
lung in dispersing, for example, due to stomach. The congenital and acquired
invasion by wind-cold, will lead to nasal essence rely on, and promote, each other.
obstruction, runny nose, and anosmia. Before birth, congenital essence has pre-
Excessive pathogenic heat in the lung will pared the material base for acquired es-
lead to shortness of breath and vibration sence. After birth, acquired essence con-
of the ala nasi. stantly replenishes congenital essence. Of
Since the throat is also a gateway the two, acquired essence is the most
of respiration and an organ of speech, important.
through which the Lung Meridian passes, The function of the kidney in repro-
the flow of qi and the speech are directly duction and development relies entirely
affected by the state of the lung qi. When on kidney qi. In other words, the ability
the lung is diseased, it usually causes to reproduce, grow and develop is related
pathological changes in the throat, such to the prosperity or decline of the essen-
as hoarse voice and aphonia. tial qi of the kidney.
In childhood the essential qi of the
5. The Kidney kidney develops gradually and manifests
in changes in the skin and hair. It flour-
The kidneys are located at either side ishes in adolescence and at this time
of the lumbus, which is therefore des- males will have seminal emission, and
cribed as "the home of the kidney." The females the onset of menstruation, re-
36 CHINESE ACUPUNCTURE AKO :\10XlBUSTlON

flecting the ripening of the sexual func- formation of kidney qi from kidney es-
tion. In old age the essential qi of the sence relies on the evaporating function
kidney declines, reproductive ability and of kidney yang upon kidney yin. Both
sexual function finally disappear, and the kidney yin and kidney yang take the es-
body begins to wither. The first chapter sential qi stored in the kidney as their
of Plain Questions says: "At the age of material base. The essential qi of the
fourteen, a woman will begin to men- kidney therefore involves both kidney yin
struate, her Conception Vessel begins to and kidney yang.
flow, and the qi in the Thoroughfare Kidney yin is the foundation of the
Vessel begins to flourish. That is why she yin fluid of the whole body, which mois-
is capable of becoming pregnant.. .. At the tens and nourishes the zang-fu organs
age of forty-nine, the qi of the Concep- and tissues. Kidney yang is the founda-
tion Vessel declines, the qi of the Thor- tion of the yang qi of the whole body,
oughfare Vessel becomes weak and scan- which warms and promotes the functions
ty, the sexual energy becomes exhausted of the zang-fu organs and tissues. Yin
and menstruation stops, with the result and yang are both lodged in the kidney,
that her body becomes old and she can no which was therefore said to be "the house
longer become pregnant." of water and fire" by the ancients. Ac-
It also says: "At the age of sixteen, the cording to their nature, essence is yin,
kidney qi of a man becomes even more and qi is yang, so kidney essence is some-
abundant, his sexual function begins to times called "kidney yin" and kidney qi is
develop, and he is filled with semen that sometimes called "kidney yang." Kidney
he can ejaculate. When he has sexual yin and kidney yang both restrict and
intercourse with a woman, she can have promote each other in the human body
children .... At the age of fifty-six, sexual so as to maintain dynamic physiological
energy begins to decline, the semen be- equilibrium. Once this equilibrium is dis-
comes scanty, and the kidney weak, with rupted, pathological changes due to im-
the result that all parts of the body begin balance of yin and yang in the kidney
to age. At the age of sixty-four teeth and will manifest. If kidney yin is deficient
hair are gone." through exhaustion, it will fail to control
These quotations clearly reflect the yang which becomes hyperactive. Typi-
role played by the kidney in dominating cal symptoms are heat sensations of the
human growth, development and repro- chest, palms and soles, afternoon fever,
duction. This is why the kidney is consid- night sweats, and seminal emission in
ered to be "the congenital fouQdation" males or sexual dreams in females. If
and why traditional Chinese medicine at- kidney yang is deficient, leading to fail-
taches such great importance to it. ure in warming and promoting, there
The essential qi of the kidney includes may be symptoms such as lack of spirit,
kidney essence and the kidney qi trans- coldness and pain in the lumbar region
formed from kidney essence. The trans- and knees, aversion to cold, cold limbs,
CHAPTER 3 THE ZANG-FU ORGAl'\S

and impotence in men and frigidity and tion of reception and control. Only when
infertility in women. If kidney deficien- the kidney qi is strong can the passage of
cy is not accompanied by obvious cold qi in the lung be free, and the respiration
symptoms, it is usually called "deficiency smooth and even. If kidney qi is weak,
of kidney qi" or "deficiency of kidney the root of the qi is not firm, and the
essence." kidney will fail to receive qi, giving rise
2) Dominating water metabolism to shortness of breath and difficult inha-
Dominating water metabolism means lation which is worse after movement.
that the kidney plays an extremely impor- 4) Dominating bone, manufacturing
tant role in regulating the distribution of marrow to fill up the brain and manifesting
body fluid. Such a function relies on the in the hair The kidney stores essence
qi activity of the kidney. When the qi which produces marrow. The marrow de-
activity of the kidney is normal, then the velops in the bone cavities and nourishes
"opening and closing" of the kidney will their growth and development. When kid-
also be normal. Water is first received by ney essence is sufficient, the bone mar-
the stomach, and then transmitted by the row has a rich source of production and
spleen to the lung which disperses and the bones are well nourished, firm and
descends it. Part of the fluid reaches the hard. If the kidney essence is deficient, it
kidney where it is further divided into will fail to nourish the bones, leading to
two parts-the clear and the turbid by weakness and soreness of the lumbar re-
the qi activity of kidney yang. The clear gion and knees. weakness or even atrophy
fluid is transmitted up to the lung from of the feet, and maldevelopment. Since
which it is circulated to the zang-fu or- the kidney dominates bone, and the teeth
gans and the tissues of the body. The are the surplus of bone, ample kidney
turbid flows into the bladder to form essence will result in strong healthy teeth,
urine which is then excreted. The func- whilst deficiency of kidney essence will
tion of the kidney dominates this whole lead to loose or even failing teeth.
metabolic process. If the kidney fails to The marrow consists of two parts:
open and close, then disturbance of water spinal marrow and bone marrow. The
metabolism such as oedema or abnormal spinal marrow ascends to connect with
micturition will occur. the brain, which is formed by the collec-
3) Receiving qi Receiving qi means tion of marrow. The thirty-third chapter
that the kidney assists the lung in its of Miraculous Pivot therefore states: "The
function of receiving and descending the brain is the sea of marrow."
qi. The book Direct Guidebook of Medi- Essence and blood promote each oth-
cine states: "The lung is the governor of er. When the essence is sufficient, then
qi and the kidney is the root of qi." blood will flourish. The nourishment of
In other words, respiration depends the hair is dependent on a sufficient sup-
not only on the descending function of ply of blood, but its vitality is rooted in
the lung, but also on the kidney's func- the kidney qi. The hair, therefore, is both
38 CHINESE ACUPUNCTURE AND MOXIBL:STION

the surplus of blood on the one hand, and II. The Six Fu Organs
the outward manifestation of the kidney
on the other. Growth or loss of hair, its 1. The Gallbladder
lustre or withering, are all related to the
condition of the kidney qi. During the The gallbladder is attached to the liver
prime of life, the kidney qi is in a flour- with which it is externally-internally re-
ishing state and the hair is lustrous; in lated. Its main function is to store bile
old age the kidney qi declines and the and continuously excrete it to the intes-
hair turns grey and falls. The tenth chap- tines to aid digestion. When the function
ter of Plain Questions states: "The kid- of the gallbladder is normal, its qi des-
ney dominates bone and manifests on cends. Since the bile is bitter in taste and
the hair." yellow in colour, upward perversion of
5) Opening into the ear and dominating gallbladder qi may give rise to a bitter
anterior and posterior orifices The func- taste in the mouth, vomiting of bitter
tion of the ear in dominating hearing fluid, and failure to aid the stomach and
relies on nourishment by the essential qi spleen in digestion, resulting in abdomin-
of the kidney. The ear therefore pertains al distention and loose stools. Since this
to the kidney. When the essential qi of function of the gallbladder is closely re-
the kidney is sufficient, the ear is well lated to the liver's function of maintain-
nourished and hearing is acute. When the ing the free flow of qi, it is said that the
essential qi of the kidney is deficient, it liver and gallbladder together have the
will fail to ascend to the ear leading to function of maintaining the free flow of
tinnitus and deafness. qi. Similarly, the relation of the liver to
"Anterior orifice" refers to the urethra emotional changes is shared by the gall-
and genitalia which have the function bladder, and this is often taken into ac-
of urination and reproduction. "Posteri- count in the clinic when treating emo-
or orifice" refers to the anus which has tional symptoms such as fear and pal-
the function of excreting the faeces. Al- pitations, insomnia and dream-disturbed
though the discharge of urine is a func- sleep.
tion of the bladder, it also relies on the qi Although the gallbladder is one of the
activity of the kidney, as do the re- six fu organs, unlike the other five it
productive function and the excretion stores bile and does not receive water or
of faeces. Decline or deficiency of kidney food. For this reason it is also classified
qi, therefore, may give rise to frequen- as one of the "extra fu organs."
cy of micturition enuresis, oliguria and
anuria; seminal emission, impotence, pre- 2. The Stomach
mature ejaculation and infertility in
reproduction; and prolonged diarrhoea The stomach is located in the epigas-
with prolapse of rectrum or constipa- trium. It connects with the oesophagus
tion. above, and with the small intestine below.

---------
CHAPTER 3 THE ZANG-FU ORGANS 39

Its upper outlet is the cardia, called food, transmitting the residue of the food
Shangwan, and its lower outlet is the to the large intestine, and of the water to
pylorus-known as Xiawan. Between the bladder. Since the small intestine has
Shangwan and Xiawan is Zhongwan. the function of separating the clear from
These three areas together make up the the turbid, its dysfunction may not only
epigastrium. The Stomach Meridian is influence digestion, but also give rise to
connected with the spleen with which it an abnormal bowel movement and dis-
is externally-internally related. Its main turbance of urination.
function is to receive and decompose
food. Food enters the mouth, passes 4. The Large Intestine
through the oesophagus, and is received
The large intestine is located in the
by the stomach where it is decomposed
abdomen. Its upper end connects with the
and transmitted down to the small intes-
small intestine via the ileocecum, and its
tine. Its essential substances are trans-
lower end is the anus. The Large Intes-
ported and transformed by the spleen to
tine Meridian communicates with the
supply the whole body. The stomach and
lung with which it is externally-internally
spleen, therefore, act in conjunction and
related. The main function of the large
are the main organs carrying out the
intestine is to receive the waste material
functions of digestion and absorption.
sent down from the small intestine, ab-
Together they are known as the "acquired
sorb its fluid content, and form the re-
foundation." mainder into faeces to be excreted. Path-
When the function of the stomach is ological changes of the large intestine
normal, its qi descends. If the descending will lead to dysfunction in this transpor-
function is disturbed, there will be lack of tation function, resulting in loose stools
appetite, distending pain in the epigas- or constipation.
trium, nausea and vomiting.
5. The Bladder
3. The Small Intestine
The bladder is located in the lower
The small intestine is located III the abdomen. Its meridian connects with the
abdomen. Its upper end connects with the kidney with which it is externally-
stomach, and its lower end with the large internally related. The main function of
intestine. The Small Intestine Meridian the bladder is the temporary storage of
communicates with the heart with which urine, which is discharged from the body
it is externally-internally related. Its main through qi activity when a sufficient
functions are reception and digestion. It quantity has been accumulated. This
receives and further digests the food function of the bladder is performed with
from the stomach, separates the clear the assistance of the kidney qi. Disease of
from the turbid, and absorbs essential the bladder will lead to symptoms such as
substance and part of the water from the anuria, urgency of micturition and dysur-
40 CHINESE ACCPCNCTlJRE AND MOXmCSTION

ia; failure of the bladder to control urine ers combine with their related zang-fu
may lead to frequency of micturition. organs. and each functions differently in
incontinence of urine and enuresis. order to carry out the digestion, absorp-
tion, distribution and excretion of water
6. The Triple Energizer and food. The upper energizer dominates
dispersion and distribution. In other
The triple energizer is located "separ- words, in combination with the distribut-
ately from the zang-fu organs and inside ing function of the heart and lung, the
the body." It is divided into three parts: upper energizer distributes the essential
the upper, middle and lower energizers. qi of water and food to the whole body in
Its meridian connects with the peri- order to warm and nourish the skin and
cardium with which it is externally- muscles. tendons and bones, and regulate
internally related. Its main functions are the skin and pores. This function is des-
to govern various forms of qi. and serve cribed in the eighteenth chapter of Mirac-
as the passage for the flow of yuanqi and ulous Pivot: "The upper energizer is like
body fluid. Yuanqi originates in the kid- a fog."
ney, but requires the triple energizer as Here "fog" is used to describe the all-
its pathway for distribution in order to pervading vapour-like state of the clear
stimulate and promote the functional ac- and light essential qi of water and food.
tivities of the zang-fu organs and tissues The middle energizer dominates diges-
of the whole body. The chapter "Sixty- tion of water and food. It refers to the
sixth Question" of Classics on Medical functions of the spleen and stomach in
Problems, therefore, says: "The triple digesting food. absorbing essential sub-
energizer is the ambassador of yuanqi. stance, evaporating body fluid. and trans-
It circulates the three kinds of qi and forming nutrient substance into nutrient
distributes them to the five zang and six blood. This fUIlction is described in the
fu organs." same chapter: "The middle energizer
The digestion. absorption. distribution looks like a froth of bubbles."
and excretion of food and water are per- "A froth of bubbles" here refers to the
formed by the joint efforts of various appearance of the decomposed state of
zang-fu organs, including the triple ener- digested food.
gizer. The chapter "The Thirty-first The lower energizer dominates the se-
Question" in the book of Classics 011 Med- paration of the clear from the turbid and
ical Problems says: "The triple energizer the discharge of fluid and wastes from
is the passage of water and food." the body. This process mainly involves
It is also mentioned in the eigh th the urinary function of the kidney and
chapter of Plain Questions: "The triple bladder, and the defaecation function of
energizer is the irrigation official who the large intestine. The same chapter
builds waterways." states: "The lower energizer looks like a
The upper, middle and lower energiz- drainage ditch."
CHAPTER 3 THE ZANG-Fl' ORGAKS --II

In other words, the turbid water con- ascends the spinal column and enters the
tinuously flows downward to be dis- brain at point Fengfu (GV 16). Many
charged. If the water passage in the lower points of the Governor Vessel, therefore,
energizer is obstructed, there may be uri- are indicated in pathological conditions
nary retention, dysuria and oedema. of the brain.
Clinically. the terms upper, middle The brain is the organ of spirit, cons-
and lower energizer are often applied to ciousness and thinking. The seventeenth
generalise the functions of the internal chapter of Plain Questions says: 'The
organs of the chest and abdominal cavity. head is the residence of intelligence."
Above the diaphragm is the upper ener- This means that the brain is related to
gizer which includes the heart and lung; the activity of thinking. The thirty-third
between the diaphragm and umbilicus is chapter of Miraculous Pivot says: ""Defi-
the middle energizer which includes the ciency of the brain leads to vertigo and
spleen and stomach; and below the um- dizziness."
bilicus is the lower energizer which in- It pointed out that hypofunction of
cludes the kidney, intestines and bladder. the brain may lead to vertigo and blurred
vision. Li Shizhen of the Ming Dynasty
( 1368-1644) clearly indicated that "the
III. THE EXTRA FU ORGANS brain is the palace of the mind." In the
Qing Dynasty (1644-1911), Wang Qing-
The extra fu organs comprise the
ren in his book Revision of Medical Clas-
brain, marrow, bones, vessels, gallbladder
sics advanced the theory that "intellig-
and uterus. Since they are different from
ence and memory rely on the brain." He
the five zang and six fu organs. they are
considered that thinking, memory, vision,
called the "extra fu." The bones, marrow.
hearing, smelling and speaking are all
vessels and gallbladder have been dis-
dominated by the brain.
cussed in the section on the zang-fu or-
Although the ancients had some
gans, so only the brain and uterus will be
knowledge of the physiology and pathol-
considered here.
ogy of the brain, they ascribed the func-
tions of the brain to variolls zang-fu
1. The Brain
organs-the heart, liver and kidney in
The brain is located in the skull and particular. Many syndromes and treat-
connects with the spinal marrow. The ment of brain disturbances. therefore, are
thirty-third chapter of Miraculous Pivot included in the differentiation of SYIl-
says: 'The brain is a sea of marrow. Its dromes of the zang-fu organs.
upper part lies beneath the scalp at the
vertex at point Baihui (GV 20) and its 2. The Uterus
lower part at point Fengfu (GV 16 )."
Baihui (GV 20) and Fengfu (GV 16) The uterus. located in the lower ab-
are Points of the Governor Vessel which domen. presides over menstruation and
42 CHINESE ACl'PUNCTl'RE AND MOXIBl'STlOl\'

nourishes the foetus. It is closely related the relationships between the zang and fu
to the Kidney Meridian, Thoroughfare organs is of great significance in clinical
and Conception vessels. Since the uterus differentiation of syndromes and treat-
is related to the kidney, its reproductive ment. Interconnected by the meridian
function is dominated by the kidney qi. system, the zang and fu organs have an
Both the Thoroughfare and Conception internally-externally linked relationship.
vessels originate from the uterus, the For example, the Meridian of Hand-
Conception Vessel having the function of Taiyin enters the large intestine inferior-
regulating the qi of all the yin meridians, ly, 'and goes upward through the dia-
and the Thoroughfare Vessel the func- phragm to connect with the lung. The
tion of regulating the qi and blood of all Meridian of Hand-Yangming enters the
the twelve regular meridians. When the lung and descends to connect with the
kidney qi is vigorous and the qi and blood large intestine. In this way a close inter-
of the Thoroughfare and Conception ves- nal relationship between the lung and
sels sufficient, menstruation is normal, large intestine is maintained. The heart
and the uterus will perform its functions and small intestine, spleen and stomach,
of reproduction and nourishment of the liver and gallbladder and kidney and
foetus. If the kidney qi is weak, the qi and bladder are similarly closely related,
blood of the Thoroughfare and Concep- physiologically and pathologically, by
tion vessels will be deficient, and there means of the yin and yang meridians.
will be irregular menstruation, amenor- The six-second chapter of Plain Questions
rhoea or infertility. The uterus is also therefore says: "The zang organs are all
closely connected to the heart, liver and connected with the meridians for the
spleen. Since normal menstruation and transmission of qi and blood."
the nourishment of the foetus rely on the From this it can be seen that the func-
blood, which is dominated by the heart, tional activities. and internal-external re-
stored by the liver and controlled by the lationships of the zang-fu organs, are
spleen, dysfunction of these organs may based on the meridians system. Without
affect the normal function of the uterus. the interconnecting pathways of the me-
ridians, each of the zang-fu organs would
become an isolated and static organ, un-
IV. THE RELATIONSHIPS able to perform its functional activities.
AMONG THE ZANG-FU This interconnecting function of the me-
ORGANS ridians is reflected not only by the
internal-external connection between the
Although the zang and fu organs have zang and the fu organs, but also by rela-
different physiological functions, there is tionships within the zang and the fu or-
a very close relationship between them in gans themselves, thus forming an inter-
maintaining the normal functions of the nal criss-crossing network. For example,
body. An understanding of the theory of the Liver Meridian of Foot-Jueyin has a

------ ------- ----

CHAPTER 3 THE ZANG-FU ORGANS

branch which, "arising from the liver, The following is a brief introduction
passes through the diaphragm and flows to the relationships between the zang or-
into the lung," further connecting with gans, between the zang and fu organs,
the Lung Meridian of Hand-Taiyin and and between the fu organs.
thus forming a connection between the
lung and the liver. A branch of the Spleen 1. The Relationships Between
Meridian of Foot-Taiyin "arises from the the Zang Organs
stomach, passes through the diaphragm
and flows into the heart," where it con- 1) The heart and lung The heart
nects with the Heart Meridian of Hand- dominates blood and the lung dominates
Shaoyin, thus forming a connection be- qi. The circulation of blood relies on the
tween the spleen and heart. There are propelling function of qi, and at the same
similar connections between the kidney, time the qi is attached to the blood to
heart and lung; stomach, large intestine distribute it through the body. Both the
and small intestine; and between liver heart and the lung, qi and blood, rely
and stomach, etc. by means of the merid- upon each other. Without qi, the blood
ians and collaterals. will stagnate, leading to stagnation of
The mutual interconnections between blood; without blood, the qi will have no
the meridians, zang and fu organs mean base to rely upon and will scatter.
that when a particular meridian is di- Pathologically, deficiency of pectoral
seased due to invasion of pathogenic fac- qi due to weakness of the lung qi will lead
tors, there may be a transmission of path- to weakness and stagnation of blood cir-
ological changes to other meridians, culation, resulting in stuffiness in the
and related zang-fu organs, particularly chest, shortness of breath, palpitation,
externally-internally related ones. For in- and purplish lips and tongue. Conversely,
stance, when the Lung Meridian is invad- retardation of blood circulation due to
ed by pathogenic factors, it may effect deficiency of heart qi or weakness of
the large intestine, leading to constipa- heart yang, may impair the function of
tion and diarrhoea. When dysfunction of the lung in dispersing and descending,
the spleen in transportation and transfor- giving rise to cough, shortness or breath,
mation occurs, it may affect the stomach stuffiness in the chest and a sensation of
and kidney, giving rise to poor appe- suffocation.
tite, fullness and distention in the epi- Both the heart and lung are situated in
gastrium, and oedema. In general, only the upper energizer. During the develop-
by having clear understanding of the con- ment of febrile diseases, the pathogenic
nections between the meridians by which factors in the lung may not be transmit-
pathological changes are transmitted, can ted to the middle energizer by the normal
the practitioner grasp the relationships pathway, but invade the heart directly.
among the zang-fu organs and determine This is known as "invasion of the pericar-
treatment. dium by pathogenic factors through con-
44 CHINESE ACUPUNCTURE Ar-;D MOXIBCSTIOr-.:

trary pathway," showing the mutual con- of qi and blood, ensuring that the blood
nection between heart and lung in pathol- does not stagnate. This benefits the func-
ogy. tion of the heart in propelling blood.
2) The heart and spleen The heart Pathologically, the heart and liver in-
dominates blood and the spleen controls fluence each other. For instance, defi-
blood. The function of the spleen in ciency of heart blood often leads to
transportation and transformation de- deficiency of liver blood, resulting in pal-
pends on the propelling force of the pitations insomnia, dream-disturbed
yang qi of the heart and kidney. The sleep and pale complexion, accompanied
formation and flourishing of heart blood by dizziness, blurred and impaired vi-
rely upon the function of the spleen in sion, oligomenorrhoea or delayed men-
transporting and transforming the essen- struation. Hyperactivity of liver yang
tial substances of food and water. The may disturb the heart giving rise to head-
blood circulating in the vessels therefore, ache, redness of the eyes, and irritability,
is dominated by the heart and controlled accompanied by mental restlessness, in-
by the spleen. somnia and dream-disturbed sleep.
Pathologically the heart and spleen of- 4) The heart and kidney The heart
ten affect each other. For example, defi- dominates fire, is located in the upper
ciency of the source of blood due to part of the body and belongs to yang. The
deficiency of spleen qi, or haemorrhage kidney dominates water, is situated in the
due to dysfunction of the spleen in con- lower part of the body and belongs to yin.
trolling blood, may result in consumption The relationship between the heart and
of heart blood. Conversely overthinking, kidney, therefore, concerns the balance
which consumes heart blood, may affect between yin and yang, ascending and
the normal function of the spleen in descending. Under normal physiological
transportation and transformation. Both conditions, heart yang descends, together
conditions may give rise to palpitations, with the kidney yang, to warm kidney yin
insomnia, poor appetite, lassitude and and kidney water. In contrast, kidney yin
pale complexion, known as "deficiency of ascends, together with heart yin, to mois-
both heart and spleen." ten heart yang and prevent it from be-
3) The heart and liver The heart and coming hyperactive. This relationship of
liver have a close relationship, not only mutual communication and restriction is
with regard to emotional activities, but called "harmony of heart and kidney."
also to blood circulation. The heart dom- When water and fire are in harmony, a
inates blood and the liver stores it. Only relative balance between above and be-
when the heart blood is sufficient, can low, yin and yang, is maintained, ensur-
the liver store it and regulate its volume ing the normal physiological function of
in order to meet the physiological needs the heart and kidney.
of the body. The liver maintains the free Once the yin-yang balance between
flow of qi and "dredges" the circulation the heart and kidney is disrupted, patho-
CHAPTER 3 THE ZANG-FV ORGANS "i5

logical changes will occur. For instance, lung qi, therefore, depends greatly on the
when deficiency of kidney yin fails to tonifying action of spleen qi. On the oth-
ascend to nourish the heart, it usually er hand, the function of the spleen
leads to hyperactivity of heart yang, giv- in transporting and transforming wat-
ing rise to such manifestations as aching er fluid also relies on the coordination of
back and seminal emission, with mental the dispersing and descending function
restlessness, palpitations, insomnia and of the lung. The twenty-first chapter of
dream-disturbed sleep, indicating "dis- Plain Questions says: 'The spleen spreads
harmony between heart and kidney." the qi for flowing upward to the lung,
When deficiency of kidney yang fails to which regulates the water passages in or-
evaporate fluid which then floods and der to transmit the water fluid down to
ascends to depress the function of heart the bladder." It pointed out the internal
yang, there may be clinical manifestation physiological connection between the
such as edema, chills, and cold limbs, spleen and the lung.
accompanied by palpitations, shortness Pathologically, weakness of spleen qi
of breath and stuffiness in the chest, in- usually leads to deficiency of lung qi,
dicating "retained water afflicting the resulting in poor appetite, abdominal dis-
heart." tention and emaciation, accompanied by
The heart dominates blood and the feeble cough, lassitude and dislike of
kidney stores essence. Since essence and speaking. Dysfunction of the lung in dis-
blood promote each other, there is a mu- persing and descending may lead to ac-
tual causality between consumption of cumulation of body fluid and stasis of
kidney essence and deficiency of heart dampness in the spleen, resulting in
blood. The heart houses the mind and the cough with much expectoration and
kidney essence produces marrow which stuffiness in the chest, or abdominal dis-
communicates with the brain-the palace tention, borborygmus and oedema.
of intelligence. Either deficiency of kid- 6) The liver and lung This relation-
ney essence or of heart blood, therefore, ship is mainly manifested in the ascend-
may lead to symptoms of disturbance of ing and descending movement of qi. The
consciousness such as insomnia, poor me- lung qi normally descends and the liver qi
mory and dream-disturbed sleep. normally ascends, in order to maintain
S) The spleen and lung The relation- the harmonious function of the vital ac-
ship between the spleen and lung is close- tivities of the body. If the liver qi is
ly connected with qi and body fluid. The depressed, it may transform into fire
spleen dominates transportation and which goes upward along the meridian to
transformation and is considered to be consume the fluid of the lung, giving rise
the source of acquired qi and blood. The to such manifestations as hypochondriac
strength of the lung qi relies on a contin- pain, irritability, cough and haemoptysis,
uous supply of the acquired essence of known as "invasion of the lung by liver
water and food. The condition of the fire." Conversely, dysfunction of the lung
 46 CHINESE ACUPUNCTURE AND MOXIBl'STlON

in descending may lead to pathogenic Both of these conditions may give rise to
dryness and heat which descend to con- shortness of breath which is worse after
sume the yin of the kidney and liver, movement.
stirring up hyperactivity of liver yang. In The yin fluid of the lung and kidney
this case, in addition to cough, there may nourish each other, and kidney yin is the
be referred pain in the chest and hy- root of the yin fluid of the whole body.
pochondriac region, dizziness, headache Deficiency of lung yin may injure kidney
and redness of the face and eyes. yin, and deficiency of kidney yin may fail
7) The lung and kidney This associa- to nourish lung yin. Either may lead to
tion is mainly reflected in the movement deficiency of yin of both the lung and
of water and qi. Water metabolism is kidney, resulting in such manifestations
closely related to the functions of the as malar flush, afternoon fever, night
lung and kidney. Dysfunction of the lung sweat, dry cough, hoarse voice and weak-
in dispersing and descending, or dysfunc- ness and soreness of the lumbar region
tion of the kidney in evaporating water, and knees.
may not only affect normal water metab- 8) The liver and spleen This relation-
olism, but also infl uence each other, lead- ship is mainly reflected in the digestion
ing to further and more serious disturb- of water and food, and the circulation of
ance of water metabolism, and giving rise blood.
to such manifestations as cough, short- The spleen dominates transportation
ness of breath, difficulty in lying flat and and transformation, and the liver main-
oedema. In the sixty-first chapter of Plain tains the free flow of qi. When the liver
Questions it said, "Therefore when water performs this function normally, the as-
disease attacks, it will cause oedema in cending function of the spleen and the
the foot and enlarged abdomen in the descending function of the stomach will
lower part of the body, and asthma, with be coordinated to ensure normal diges-
inability to lie flat, in the upper part of tion, absorption and distribution of food.
the body, due to simultaneous occurrence In addition, if the essential substance of
of both the primary and secondary con- water and food transported and trans-
ditions." formed by the spleen is sufficient, liver
The lung dominates respiration and blood will flourish, as it has a rich source
the kidney dominates reception of qi. for its production. The liver stores blood
Only when the kidney is vigorous can the and the spleen controls blood. They coor-
inhaled qi be send downward through the dinate their activities to maintain the nor-
lung and be received by the kidney. When mal circulation of blood to satisfy the
kidney qi is deficient, and fails to receive needs of the body.
qi, the qi will remain floating above. Pathologically, stagnation of liver qi
When prolonged deficiency of lung qi may affect the spleen's function of trans-
affects the kidney qi, there will be dys- portation and transformation, resulting
function of the kidney in reception of qi. in hypochondriac pain, mental depres-

- - - - - - - - - - - - - - - - - - - - - - - - - ----------------------- - - -
CHAPTER 3 THE ZANG-Fe ORGANS 47

sion and irritability, accompanied by elude abdominal fullness, borborygmus,

poor appetite, abdominal fullness and loose stools, soreness and pain of the
distention, irregular bowel movement lumbar region and knees, aversion to cold
and lassitude, known as "stagnatiDn of and cold limbs, known as "deficiency of
liver qi leading to deficiency of the yang of both spleen and kidney."
spleen," or "disharmony of liver and 10) The liver and kidney The liver
spleen." stores blood and the kidney stores es-
If the spleen qi is weak, it may fail to sence. Liver blood relies on nourishment
control blood or lead to dysfunction by kidney essence, and the kidney essence
in transportation and transformation, relies on the supply of liver blood. Es-
which causes deficiency of the source sence and blood produce and supply each
of blood. Great loss or insufficiency of other, hence the saying "essence and
blood may lead to deficiency of liver blood have the same source," and "the
blood, giving rise to poor appetite, ema- liver and kidney have the same origin."
ciation, blurred vision, and oligomenor- Pathologically, when deficiency of
rhoea or amenorrhoea. kidney essence deprives the liver of nour-
9) The spleen and kidney This con- ishment, it will lead to deficiency of liver
nection is mainly reflected in the rela- yin, resulting in "deficiency of yin of both
tionship between congenital and acquired liver and kidney." Clinical manifestations
qi. The spleen is considered to be the may include soreness and weakness of the
acquired foundation, and the kidney the lumbar region and back, seminal emis-
congenital foundation. Kidney essence sion, tinnitus, dizziness, vertigo and dry-
relies on the supply of essential sub- ness of the eyes.
stances of water and food, transported If there is hyperactivity of liver yang,
and transformed by the spleen. The there may be headache, redness of the
spleen's transportation and transforma- eyes, and irritability. In prolonged cases,
tion function in turn relies on the warm- if kidney yin is also consumed, there may
ing and propelling activities of kidney be soreness and pain of the lumbar re-
yang. Thus the congenital promotes the gion, seminal emission and tinnitus.
acquired, and the acquired nourishes the
congenital. 2. The Relationship Between the Zang
Pathologically, the spleen and kidney and the Fu Organs
influence each other. When kidney yang
is deficient, it will fail to warm spleen This refers to the external-internal re-
yang, leading to deficiency of spleen lationship between the zang and the fu.
yang. When spleen yang is deficient, it The zang are yin and the fu yang. Yang
will lead to preponderance of yin and dominates the exterior and yin the in-
cold in the interior, which may impair terior. Via the meridians, each zang is
kidney yang and cause deficiency if pro- externally-internally related to one fu, as
longed. Clinically the symptoms may in- follows:
48 CHINESE ACUPUNCTURE AND MOXIBUSTION

1) The heart and small intestine Path- trient substance rely on the spleen. The
ologically, fire of excess type of the Heart stomach prepares the food for the spleen
Meridian may transmit pathogenic heat to transport and transform, whilst the
to the small intestine, resulting in oligur- spleen distributes nutrient substance to
ia, deep yellow urine and burning sensa- assist the stomach in moving body fluid.
tion during urination, known as "exces- Dysfunction of the stomach in reception
sive heat in the small-intestine." Con- may give rise to poor appetite and an
versely, heat in the small intestine may unpleasant and hungry sensation in the
ascend along the meridian to affect the stomach. Dysfunction of the spleen in
heart, leading to symptoms of mental transportation and transformation may
restlessness, redness and ulceration of the often lead to abdominal distension after
tongue, etc. eating and loose stools.
2) The liver and gallbladder The gall- The spleen dominates ascending and
bladder is attached to the liver, and they the stomach dominates descending. The
are externally-internally related through spleen distributes the essential substance
the meridians. Bile derives from the liv- of water and food up to the heart and
er. Clinically the differentiation of syn- lung. The stomach moves the digested
dromes of the liver and gallbladder water and food downwards. If the spleen
cannot completely be separated, and qi descends rather than ascends, there
manifestations of both often appear si- may be diarrhoea and prolapse of the
multaneously. For instance, both exces- rectum. If the stomach qi ascends rather
sive liver fire and excessive gallbladder than descends, there may be nausea, vom-
fire may present symptoms of pain in the iting and hiccups. The physician Ye Tian-
chest and hypochondrium, bitter taste in shi of the Qing Dynasty ( 1644-1911) said:
the mouth, dryness in the throat, and "The stomach dominates reception, and
irritability. In case of damp-heat in the the spleen dominates transportation and
liver and gallbladder, there may be jaun- transformation. The spleen is 'favourable'
dice and bitter taste in the mouth which when its ascending function is normal,
indicates the extravasation of bile, and and the stomach is 'favourable' when its
hypochondriac pain and mental depres- descending function is norma!."
sion which indicate stagnation of liver qi. The spleen is yin, prefers dryness and
3) The spleen and stomach Both the dislikes dampness. The stomach is yang,
spleen and stomach are situated in the prefers moistness and dislikes dryness.
middle energizer, and are externally- Being yin and yang in nature respective-
internally related via their meridians. ly, each needs the other. When pathogen-
The spleen dominates transportation and ic dampness invades the spleen, it may
transformation, and the stomach domi- injure the transportation and transforma-
nates reception. Reception and digestion tion function, and in turn, lead to the
of food mainly rely on the stomach, and production of dampness. When patho-
the absorption and distribution of nu- genic heat invades the stomach, it may
CHAPTER 3 THE ZANG--FU ORGANS 49

consume the body fl uid in the stomach, the kidney qi. Kidney qi assists the blad-
and deficiency of stomach yin may stir up der in metabolizing body fluid. When the
heat of deficiency type in the interior. kidney qi is sufficient and its checking
Since the spleen and stomach are mutual- function normal, the bladder opens and
ly connected physiologically, they also closes regularly so as to maintain normal
affect each other pathologically. For in- water metabolism. When the kidney qi is
stance, dysfunction of the spleen in trans- deficient, disturbance of checking func-
portation and transformation due to re- tion will lead to irregular opening and
tention of dampness may lead to inability closing of the bladder, resulting in dysur-
to ascend the clear, and affect the stom- ia, incontinence of urine, enuresis, and
ach function of receiving and descending. frequency of micturition. Pathological
Clinical manifestations include poor ap- changes in the storage and discharge of
petite, nausea, vomiting, and fullness and urine, therefore, are often related to both
distension of the epigastrium. Converse- the bladder and kidney.
ly, dysfunction of the stomach in des-
cending the turbid, due to irregular food 3. The Relationship Among
intake which causes retention of food, the Fu Organs
may also affect the function of the
spleen in transporting, transforming and The main function of the SiX fu or-
ascending the clear, giving rise to abdom- gans is transportation and transforma-
inal distension and diarrhoea. tion. They playa major role in a series of
4) The lung and large intestine The functional activities of digestion, absorp-
lung and large intestine are externally- tion and excretion.
internally related via their meridians. When food enters the stomach, it is
When the lung qi descends, the function digested and send down to the small in-
of the large intestine in transmission is testine for further digestion-separating
normal and bowel movement free. If the the clear from the turbid. The clear is the
large intestine is obstructed by stasis, it nutrient substance nourishing the whole
may prevent the lung qi from descending. body, of which the water-fluid part seeps
Clinically, when dysfunction of the lung into the bladder. The turbid is the waste
in descending fails to send down body matter entering the large intestine. The
fluid, there may be difficult bowel move- fluid seeped into the bladder is excreted
ment. If the large intestine is obstructed as urine by the action of qi, and the waste
due to excessive heat, it may lead to dys- matter in the large intestine is discharged
function of the lung qi, resulting in as faeces through the transportation and
cough and fullness in the chest. transformation function.
5) The kidney and bladder The kid- This process of digestion, absorption
ney and bladder are externally-internally and excretion mainly relies on: a) the
related via their meridians. The function function of the liver and gallbladder in
of the bladder relies on the condition of maintaining the free movement of the
 50 CHINESE ACUPUNCTCRE AND MOXIBUSTION

digestion, b) the function of the triple The close physiological connections

energizer in distributing yuan qi and cir- between the six fu organs are also reflect-
culating water fluid, and c) the unified ed pathologically. For instance, excessive
functions of the six fu organs, which heat in the stomach may consume body
transport and transform water and food fluid, lead to dysfunction of the large
and continuously receive, digest, transmit intestine in transportation, and result in
and excrete, alternating between empti- constipation. Constipation due to dryness
ness and fullness. They are "favourable" in the intestines may affect the stomach's
when they are clear and open, and "unfa- descending function, leading to upward
vourable" when they are obstructed. This rebellion of stomach qi and hence nausea
is stressed in the ancient sayings: "the fu and vomiting. Hyperactivity of fire in the
organs are favourable when they are un- galIbladder may invade the stomach, giv-
blocked," and "treatment to remove ob- ing rise to upward rebellion of stomach
struction in diseases of them plays the qi and hence nausea, vomiting and regur-
same role as the reinforcing method." gitation of yellow fluid.

- - - - - - - - - - ----- - -- ------ - -----~--------

 Chapter 4
QI, BLOOD AND BODY FLUID
Qi, blood and body fluid are funda- human body are explained by changes
mental substances which maintain the and movement of qi.
normal vital activities of the human
body. They are the material foundation 1. Classification and Production of Qi
for the physiological functions of the
zang-fu organs, tissues and meridians. Qi, Certain qualitative terms differentiate
blood and body fluid have an independ- qi in the human body according to its
ent relationship with the zang-fu organs, source, function and distribution. These
the tissues, and the meridians, whilst terms are: yuanqi (primary qi), zongqi
both theories together combine to ex- (pectoral qi), yingqi (nutrient qi) and
plain the physiological functions of hu- weiqi (defensive qi). In terms of their
man body. source they may be further classified into
congenital qi and acquired qi. Yuanqi,
which is derived from congenital essence
I. QI and inherited from the parents, is re-
ferred to as congenital qi. After birth,
According to ancient Chinese thought, zongqi, yingqi and weiqi are all derived
qi was the fundamental substance consti- from food essence, and are therefore
tuting the universe, and all phenomena known as acquired qi.
were produced by the changes and move- Congenital qi and acquired qi are
ment of qi. This viewpoint greatly influ- dependent on each other for their pro-
enced the theory of traditional Chinese duction and nourishment. Yuanqi stimu-
medicine. Generally speaking, the word lates and promotes the functional ac-
"qi" in traditional Chinese medicine de- tivities of the zang-fu organs and the
notes both the essential substances of the associated tissues of the body, which in
human body which maintain its vital ac- turn produce acquired qi. Thus yuanqi
tivities, and the functional activities of is the material foundation for the pro-
the zang-fu organs and tissues. duction of acquired qi. On the other
Essential substances are the founda- hand, acquired qi continuously nourish-
tion of functional activities. In this sense, es and supplements congenital qi. The
qi is too rarefied to be seen and its exist- relationship is therefore an interdepen-
ence is manifested in the functions of the dent one: congenital qi promotes ac-
zang-fu organs. All vital activities of the quired qi, which in turn nourishes con-
51

-- --- ._------
52 CHINESE ACCPl'NCTl:RE AND "-10XIBCSTION

genital qi. four limbs and trunk are all associated

Qi may also describe the functional with longqi.
activities of the zang-hI organs and me- 3) Yingqi (nutrient qi) Derived from
ridians. It is then referred to, for exam- the qi of food essence produced by the
ple, as qi of the heart, liver, lung, spleen, spleen and stomach, yingqi circulates in
stomach, kidney and meridians. These the vessels. Its primary function is both
are discussed further in the relevant to produce blood and to circulate with it,
chapters. providing further nourishment. As yingqi
1) Yuanqi (primary qi) Derived from and blood are so closely related, "ying
congenital essence, yuanqi needs to be blood" is the term commonly used to
supplemented and nourished by the qi refer to their joint functions.
obtained after birth from food essence. 4) Weiqi (defensive qi) Weiqi is also
Yuanqi takes root in the kidney and derived from the qi of food essence, but
spreads to the entire body via the triple unlike yingqi it circulates outside the ves-
energizer. It stimulates and promotes the sels. It functions to protect the muscular
functional activities of the zang-fu or- surface, defend the body against exog-
gans and the associated tissues. The more enous pathogenic factors, control the
abundant yuanqi is, the more vigorously opening and closing of the pores, moisten
the zang-fu organs and the associated the skin and hair, readjust body temper-
tissues will function. The human body ature, and warm up the zang-fu organs.
will then be healthy and rarely suffer Defending the body against exogenous
from disease. On the other hand, congen- pathogenic factors is its principal func-
ital insufficiency of yuanqi, or deficiency tion, hence the name weiqi.
due to a prolonged illness, may lead to As mentioned above, the zang-fu and
various pathological changes. meridians possess their own qi. Originat-
2) Zongqi (pectoral qi) Zongqi is ing from yuanqi, zongqi, yingqi and wei-
formed by the combination of qingqi qi, the qi of the meridians (which circu-
(clean qi) which is inhaled by the lung, lates throughout the meridian system) is
and the qi of food essence which is pro- a combination of the qi of food essence,
duced by the spleen and stomach. Zongqi qingqi inhaled by the lung, and essential
is stored in the chest. Its main functions qi stored in the kidney. The qi of the
are: meridians, therefore, is referred to as
i) To promote the lung's function of zhengqi or zhenqi (vital qi) flowing in the
controlling respiration. The strength or meridians. According to twenty-seventh
weakness of speech and respiration are chapter of Plain Questions, "Zhenqi (vital
related to the quality of longqi. qi) means the qi of the meridians." As the
ii) To promote the heart's function of basis of the functions of the meridians,
dominating the blood and blood vessels. the qi of the meridians greatly influences
The circulation of qi and blood, coldness the functions of the qi, blood and zang-fu
and warmth, and the motor ability of the organs of the entire body.
CHAPTER 4 QI, BLOOD AND BODY FLUID

2. Functions of Qi cles .... " Insufficiency of yang qi may im-

pair its warming effect, giving rise to
Qi acts extensively in the human body aversion to cold, and cold sensations of
by permeating all parts. There is no place the four limbs.
where does not have qi nor to where qi 3) Defensive function Qi defends the
does not penetrate. If the movement of qi body surface against exogenous patho-
ceases, the vital activities of the human genic factors. The seventy-second chapter
body will also cease. Abundant qi is the of Plain Questions therefore states: "The
basis of good health and weakness of qi existence of the antipathogenis qi in the
may lead to disease. Hence the statement interior prevents the pathogenic factor
from the Eighth Problem of Classic on from invading." Qi also combats patho-
Medical Problems, "Qi is the root of the genic factors once disease occurs, and
human body; the stem and leaves would brings about recovery by eliminating the
dry up without a root." Qi, distributed to invading pathogenic factors.
various parts of the body, characteristi- 4) Checking function Qi checks, con-
cally functions in the following different trols and regulates certain bodily sub-
ways: stances and metabolic products. For in-
1) Promoting function The growth stance, qi controls blood by keeping it
and development of the human body, the circulating in the vessels, and checks
physiological activities of the zang-fu and sweating, urination and seminal emission.
meridians, the circulation of blood and If this checking function of qi is im-
distribution of body fluid, are all depend- paired, spontaneous sweating, incontin-
ent on the promoting and stimulating ence of urine, premature ejaculation and
effect of qi. Deficiency of qi impairs this spermatorrhoea may occur.
promoting function, and thus produces 5) Qihua (activities of qi) Qihua has
pathological changes such as retarded two meanings. Firstly it refers to the
growth and development, hypofunction process of mutual transformation among
of the zang-fu organs and meridians, im- essence, qi, body fluid and blood. Accord-
paired blood circulation, dysfunction in ing to the fifth chapter of Plain Questions,
transforming and distributing body fluid, "Essence is transformed into qi." In his
and production of phlegm dampness in annotation of the same chapter, Wang
the interior. Bing, a physician in the Tang Dynasty
2) Warming function The normal says: "The activities of qi produce es-
temperature of the body is maintained sence; a harmonious supply of food es-
and readjusted by the warming function sence enables the body to grow." These
of qi. According to the Twenty-second statements explain the mutual transfor-
Problem of Classic on Medical Problems, mation of essence and qi.
"Qi dominates warming." The forty- Secondly, qihua implies certain func-
seventh chapter of Miraculous Pivot says: tional activities of the zang-fu organs.
"Wei (defensive) qi warms up the mus- According to the eighth chapter of Plain
54 CHINESE ACUPCNCTCRE AND MOXIBUSTION

Questions, "The bladder stores body fluid, blood is not consumed, it turns into
which is then excreted by the activities of essence in the kidney; if essence does
qi." The activities of qi here refer to the not leak out, it is transformed into
function of the bladder in discharging blood in the liver." Taking food essence
urme. and kidney essence as the material basis,
6) Nourishing function This refers to blood is formed by the functional ac-
yingqi-the nutrient substance formed tivities of zang-fu organs such as the
from food. Ying (nutrient) qi, which cir- spleen, stomach, heart, lung, liver and
culates in the blood vessels, is a part of kidney.
blood and provides nourishment to the After being formed, blood normally
whole body. circulates in the vessels throughout the
Although these six functions of qi are body, and is acted upon jointly by the
different, they cooperate with and sup- heart, liver and spleen. The heart domi-
plement each other. nates the blood and vessels, and the pro-
pelling force of heart qi is the basis of
blood circulation. The spleen qi controls
II. BLOOD blood and prevents extravasation. The
liver promotes the free flow of qi, stores
Blood is a red liquid circulating in the blood and regulates its volume. The coor-
vessels, and is a vital nutrient substance dination of these three organs ensures
in the body. continuous blood circulation in the ves-
sels throughout the body. Dysfunction of
1. Formation and Circulation of Blood any of them may cause abnormal blood
circulation. Deficiency of heart qi, for
As the fundamental substances re- instance, may lead to stagnation of heart
quired in blood formation originate blood. Dysfunction of the spleen in con-
from food essence produced by the trolling blood may lead to bloody stools,
spleen and stomach, these two organs uterine or subcutaneous bleeding, and ec-
are regarded as the source of qi and chymoses.
blood. The thirtieth chapter of Mirac-
ulous Pivot holds: "When the middle 2. Functions of Blood
energizer receives food essence it will
transform it into red fluid which is Blood circulates throughout the
called blood." body, passing through the five zang and
The seventy-first chapter of the same six fu organs in the interior, and the
book also says: "Ying (nutrient) qi skin, muscles, tendons and bones on the
flows into the vessels to be transformed exterior. In this way blood nourishes
into blood." Essence and blood may also and moistens the various tissues and
transform into each other. The book organs of the body. The Twenty-second
Zhang's General Medicine states: "If Problem of Classic on Medical Problems
CHAPTER 4 QI, BLOOD AND BODY FLUID 55

generalises this function of blood, say- dream-disturbed sleep.

ing: "Blood dominates nourishment and
moisture." The nourishing and moisten-
ing function of blood manifests clearly III. BODY FLUID
in the movement of the eye and four
limbs. According to the tenth chapter of Body fluid is a collective term for all
Plain Questions, "When the liver receives the normal fluids of the body. These are
blood, it gives rise to vision; when the saliva, gastric juice, intestinal juice and
feet receive blood they are capable of the liquids in the joint cavities, as well as
walking; when the palms receive blood tears, nasal discharge, sweat and urine.
they are capable of holding; and when
the fingers receive blood they are ca- 1. Formation and Distribution
pable of grasping." of Body Fluid
The forty-seventh chapter of Mi-
raculous Pivot says: "When the blood is in Body fluid is formed from food and
harmony, .. the tendons and bones will drink after their digestion and absorption
be strong and the joints will function by the spleen and stomach. The distribu-
smoothly." Insufficiency of blood may tion and excretion of body fluid prin-
impair its nourishing and moistening cipally rely on the spleen's function of
function, and give rise to symptoms such transportation, the lung's function of dis-
as impaired vision, dryness of the eyes, persing and descending and regulating
motor impairment of the joints, numb- water passages, and the kidney's function
ness of the four limbs and dryness and of controlling urination and separating
itchiness of the skin. the clear and the turbid. Of these three
Blood is the material foundation for organs, the kidney is the most important.
mental activities. A sufficient blood sup- The twenty-first chapter of Plain Ques-
ply ensures clear consciousness and a vig- tions explains the formation and distribu-
orous spirit. The twenty-sixth chapter of tion of body fluid by saying: "After food
Plain Questions states: "Qi and blood are enters the stomach, the qi of food essence
the foundation for human mental activi- and water is transmitted to the spleen,
ties." The thirty-second chapter of Mirac- which spreads it to the lung. The lung
ulous Pivot says: "Harmonious circulation regulates the water passages and trans-
of blood ensures a vigorous spirit." These mits the qi of water to the bladder below,
quotations explain the close relationship The qi of water then spreads in four
between blood and mental activities. De- directions and travels along the meridians
ficiency of blood, therefore, may produce of the five zang organs." When talking
mental disorders. An example is deficien- about the triple energizer as the pathway
cy of heart or liver blood which may of body fluid, the eighth chapter of Plain
result in mental restlessness, with symp- Questions states: "The triple energizer is
toms such as palpitation, insomnia and the irrigation official who builds water-
 56 CHINESE ACCPCNCTl'RE AND :-'10XIBCSTION

ways." ness of the stomach causes thirst; and

In addition, fluids sent downwards dryness of the intestines leads to consti-
from the stomach continue to be ab- pation.
sorbed by the small and large intestines.
A part of the fluid, after passing through 2. Functions of Body Fluid (Jingye)
the spleen, lung and triple energizer, is
excreted from the skin and hair as sweat. Body fluid moistens and nourishes
Another part of the fluid is sent down- various parts of the body. There are no-
wards to the bladder via the waterways of ticeable differences, however, in the na-
the triple energizer, and excreted from ture, form and location of different types
the body as urine, with the assistance of of body fluid. Clear and thin fluids are
the qi of the kidney and bladder. Acted referred to as "jing," whilst thick and
upon by all these zang-fu, body fluid heavy fluids are known as "ye." "Jing" is
reaches the skin and hair on the exterior, distributed on the muscular surface, and
and penetrates the zang-fu in the interior. has the function of warming and nourish-
thus nourishing all the tissues and organs ing the muscles and moistening the skin.
throughout the body. "Ye" is stored in the joints and orifices
To conclude, the formation, distribu- and has the function of moistening the
tion and excretion of body fluid is a joints, strengthening the brain and mar-
complicated process resulting from the row and nourishing the orifices. As both
coordinated activities of many of the "jing" and "ye" are normal fluids in the
zang-fu organs, especially the lung, body and are derived from the same
spleen and kidney. Pathological changes source-the qi of food essence-they
of these organs may consequently affect may be transformed into each other.
the formation, distribution and excretion Generally they are referred to together
of body fluid. For example, if there is by the term "jingye" (body fluid).
insufficient formation or excessive loss,
body fluid may be damaged or consumed.
IV. THE RELATIONSHIP
A disturbance in distribution of body
fluid may lead to its accumulation, result- BETWEEN QI, BLOOD AND
ing in retained fluid and oedema, or BODY FLUID
the formation of phlegm. Pathological
changes of body fluid may, in turn, im- Although qi, blood and body fluid
pair the functions of many zang-fu or- have their respective natures, they coor-
gans, for example invasion of the heart dinate with, promote and restrain one
by retained water produces palpitations; another in their functional activities.
retention of fluid in the lung results in Their close and complicated relationships
cough with asthmatic breathing; dryness often manifest in physiology and patllol-
of the lung due to consumption of body ogy, and are important in determining
fluid leads to unproductive cough; dry- treatment on the basis of differentiation

~'" -----~--
CHAPTER 4 QI, BLOOD AND BODY FLl'ID

of syndromes. tional activities of these three organs.

This is described as "qi circulation lead-
1. The Relationship Between Qi ing to blood circulation." Either weak-
and Blood ness in propelling blood due to qi defi-
ciency, or retardation of qi circulation,
Both ql and blood are the material may cause disorders of blood circulation,
foundation for the functional activities of or even stagnation of blood. That is why
the body. They originate from food es- in order to obtain good therapeutic ef-
sence and from essential qi in the kidney, fects in the treatment of blood stagna-
and their production depends on the tion, herbs which circulate qi, and qi
functional activities of the lung, spleen tonics. are often prescribed in combina-
and kidney. Qi mainly provides warmth tion with herbs to activate blood circula-
and motive force, whilst blood provides tion and remove stasis. The controlling
nourishment and moisture. This is des- function of qi ensures the normal circu-
cribed in the Twenty-second Problem of lation of blood in the vessels and prevents
Classic on Medical Problems, "Qi dom- extravasation. Deficiency of qi may im-
inates warmth while blood dominates pair this function of controlling blood,
nourishment." Qi is considered to be leading to various types of haemorrhage.
yang, while blood is yin. Their relation- This is known as --qi fails to control
ship may be summarized by the state- blood." To stop haemorrhage due to qi
ment: "Qi is the commander of blood and deficiency, the method of tonifying qi
blood is the mother of qi." "Qi is the must be used.
commander of blood" means that blood "Blood is the mother of qi" refers to
cannot be separated from qi in its forma- the fact that qi is "attached" to blood, and
tion and circulation. The material basis that qi does not function well in promot-
of blood is yin essence, the transforma- ing the physiological activities of various
tion of which into blood depends on qi. parts of the body unless it receives suffi-
Qi functions well in transforming yin es- cient nourishment from blood. In cases
sence into blood if it is abundant. Con- of massive bleeding, there will also be
versely, this function of qi is weakened if loss of qi. which is known as "qi follows
qi is deficient, so deficiency of qi may blood in becoming exhausted."
lead to deficiency of blood. For this rea-
son, when treating disorders resulting 2. The Relationship Between Qi
from blood deficiency, qi tonics are and Body Fluid
sometimes added to the prescription.
Since the heart qi dominates blood circu- Qi differs from body fluid in nature,
lation, the lung qi ensures normal distri- form and functional activities. There are
bution and the liver qi takes charge of the similarities between them, however. in
free flow of qi of the entire body, the their formation, circulation and distribu-
blood circulation depends on the func- tion. Both originate from food essence

-_.--- ._------------------
58 CHINESE ACUPUNCTURE AND MOXlBUSTIOl\:

and circulate throughout the body. other, there is a saying: "Body fluid and
The formation, distribution and excre- blood are of the same origin." Recurrent
tion of body fluid depend upon qi circu- or severe bleeding may injure body fluid
lation, and cannot be separated from the and result in thirst, scanty urination and
activities of the qi of zang-fu organs such dry skin. Severe consumption or loss of
as the lung, liver, kidney, triple energizer body fluid may also affect the source of
and bladder. Impairment of the activities blood, manifesting as exhaustion of both
of the qi of these organs may result in body fluid and blood. For this reason, it
pathological changes, for example, insuf- is not advisable to use diaphoretice for
ficient production or accumulation of haemorrhagic patients. The method of
body fluid. If the qi of these zang-fu breaking the blood (in which powerful
organs is deficient, and unable to exert its drugs are administered to dissolve blood
controlling function, there may be loss of sludge) or the bleeding method, should
body fluid. On the other hand, accumula- be avoided in treating patients with con-
tion of body fluid may hinder qi circula- sumption of body fluid due to ex-
tion and affect the functions of certain cessive sweating. The sixty-first chapter
zang-fu organs. Profuse loss of body of Miraculous Pivot states: "The first con-
fluid may also lead to massive dissipation traindication refers to a patient who is
of qi. emaciated: the second to a patient after
severe loss of blood; the third to a patient
3. The Relationship Between Blood after severe perspiration; the fourth to a
and Body }'luid patient after severe diarrhoea; the fifth to
a patient after loss of blood following
Since both blood and body fluid are childbirth. The reducing method is con-
liquids and their main function is to traindicated in all these circumstances."
nourish and moisten, they are considered The same essay also points out that care
yin. Body fluid is an important part of should be taken in the acupuncture clinic
blood, and when it passes out of the when treating patients who are emaciated
vessels, it forms body fluid. As body fluid due to deficiency of qi, or severe con-
and blood can be transformed into each sumption of qi, blood and body fluid.
 Chapter 5
THE MERIDIANS AND
COLLATERALS
The meridians and collaterals are tioning of various organs is thus ensured,
pathways in which the qi and blood of and a relative equilibrium maintained. It
the human body are circulated. They is stated in Chapter 10 of Miraculous
pertain to the zang-fu organs interior- Pivot that "so important are the meridians
ly and extend over the body exteriorly, and collaterals which determine life and
forming a network and linking the tis- death in the treatment of all diseases and
sues and organs into an organic whole. the regulation of deficiency and excess
The meridians, which constitute the conditions that one must gain a thorough
main trunks, run longitudinally and in- understanding of them. The importance
teriorly within the body; while the col- . of studying the theory of meridians and
laterals, which represent branches of the collaterals can indeed never be overem-
~eridians, run tran~v~rsely and superfi- phasized.
clal~y from the m~ndlans. Th~y. are col- The theory of meridians and colla-
lectIvely termed. Jmgluo
.. (mendlans
. and
. t era si was t
sys ema t'Ize d b y th e anCIen
. t
collaterals) m tradItIOnal Chmese medI- Ch' 1 . h' 1 d l' . 1
. Th' f 'd' d 1 mese peop e m t elr pro onge c mica
cme. IS system 0 men lans an co - . . . .
· 1d h l' practIce. Its formatIOn IS generally conSI-
1atera1s mc u es t e twe ve mam me-j1J . ., b'
rirli,,11 . h 'd' f'f dered to be m relatIOn to the 0 servatIOn
~s, elg t extra men Ians, 1 teen ~
collaterals, twelve divergent meridians, .c;a. f the sympto~s .and signs
twelve muscle regions and twelve cu-
0: diseases
a.nd the trans~lls~IOn of ne~dlmg s~nsa-
t.eneous regions. tIOn, t.he applIcatIOn of !uma .(Chmese
. It is said in Chapter 33 of Miraculous remedI.al massa~e), Daoym (~nclent deep
Pivot that "internally, the twelve main breathmg exerCIses), and anCIent anatom-
meridians connect with the zang-fu or- ical knowledge. Just like the other bas-
gans, and externally with the joints, limbs IC traditional Chinese medical theories,
and other superficial tissues of the body." such as that of the zang-fu organs, of qi
The meridians and collaterals are distrib- and blood, etc., the theory of meridians
uted both interiorly and exteriorly over and collaterals is of great significance in
the body, transporting qi and blood to guiding diagnosis and treatment in tradi-
nourish the zang-fu organs, skin, mus- tional Chinese medicine, and acupunc-
cles, tendons and bones. Normal func- ture in particular.
59
60 CHINESE ACUPUNCTURE AND MOXIBUSTIO]'\

I. THE BASIC CONCEPT OF the three factors: a) hand or foot, b) yin

THE MERIDIANS AND or yang, and c) a zang or fu organ. Both
the upper limbs (hands) and lower limbs
COLLATERALS
(feet) are divided into six regions, which
are supplied respectively by the three yin
Responsible for the circulation of qi (Taiyin, Shaoyin and Jueyin) and three
and blood and distributed both interior- yang (Yangming, Taiyang and Shaoy-
ly and exteriorly across the body, the ang) meridians. There exists an exterior-
meridians and collaterals have an exten- interior relationship between the three
sive coverage in contents. The following yin and three yang meridians:
is a general description of their nomen-
clature, functions, distribution and the Taiyin ---- Yangming
order of the cyclic flow of qi and blood. yin { Jueyin ---- ShaOyan g } yang
Shaoyin ---- Taiyang
1. The Nomenclature of the Meridians
and Collaterals and Their In accordance with the fact that the
Composition zang organs pertain to yin, the fu organs
to yang, and the medial aspect is attribut-
The twelve main meridians include ed to yin, the lateral aspect, to yang, the
the three yin meridians of the hand (the meridians that pertain to the zang organs
Lung Meridian of Hand-Taiyin, the Peri- are yin meridians,. which are mainly dis-
cardium Meridian of Hand-Jueyin and tributed on the medial aspect of the four
the Heart Meridian of Hand-Shaoyin), limbs. Those distributed on the medial
the three yang meridians of the hand aspect of the upper limbs are three
(the Large Intestine Meridian of Hand- yin meridians of the hand; while those
Yangming, the Triple Energizer Meridi- distributed on the medial aspect of the
an of Hand-Shaoyang and the Small In- . lower limbs are three yin meridians of the
testine Meridian of Hand-Taiyang), the foot. The meridians that pertain to the fu
three yang meridians of the foot (the organs are yang meridians, which mainly
Stomach Meridian of Foot-Yangming, travel along the lateral aspect of the four
the Gallbladder Meridian of Foot- limbs. Those traveling along the lateral
Shaoyang and the Bladder Meridian of aspect of the upper limbs are three yang
Foot-Taiyang), and the three yin meridi- meridians of the hand; while those trav-
ans of the foot (the Spleen Meridian of eling along the lateral aspect of the lower
Foot-Taiyin, the Liver Meridian of Foot- limbs are the three yang meridians of the
Jueyin and the Kidney Meridian of Foot- foot.
Shaoyin). They are called the twelve main ~ The eight extra meridians, different
meridians because they are the major from the twelve main meridians, are
trunks in the system. The nomenclature aIled the extra meridians in short.
of the twelve main meridians is based on Their nomenclature is explained as fol-
~~~.
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 61

lows. Du means governing. Running 2. Functions of the Meridians

along the midline of the back, the Du- and Collaterals
mai (Governor Vessel) governs all the
yang meridians. Ren means fostering The network of the meridians and col-
and responsibility. Going along the mid- laterals is closely connected with the tis-
line of the abdomen, the Renmai (Con- sues and organs of the body, and plays an
ception Vessel) is responsible for all important role in human physiology, pa-
the yin meridians. Chong means a vital thology, prevention and treatment of ail-
pass. As it regulates the flow of qi and ments.
1) Transporting qi and blood and regu-
blood in the twelve regular meridians,
the Chongmai (Thoroughfare Vessel) is lating yin and yang Under normal con- \
called "the sea of the twelve primary ciitions, the system of the meridians and
collaterals functions to transport qi and
meridians." Dai means a girdle. The
blood and regulate the balance between
Daimai (Belt Vessel) goes around the
yin and yang of the whole body. Chapter
waist, binding up all the meridians. Qiao
47 in Miraculous Pivot says: "The meridi-
means the heel. The one starting from
ans and collaterals transport blood and qi
below the external malleolus is the
to adjust yin and yang, nourish tendons
Yangqiaomai (Yang Heel Vessel), while
and bones, and improve joint function."
the one starting from below the internal
The meridians and collaterals are pas-
malleolus is the Yinqiaomai (Yin Heel sages for the circulation of qi and blood.
Vessel). Wei denotes connection and Transversely and longitudinally, they
network. The Yangweimai (Yang Link cross with each other in both the interior
Vessel) connects and networks the exte- and exterior of the body. "Nutrient qi
rior yang of the whole body, while the flows inside the meridians and defensive
Yinweimai (Yin Link Vessel) connects qi runs outside the meridians," thus the
and networks the interior yin of the interior and the exterior, the upper and
whole body. Besides, the twelve diver- lower portions and the left and right sides
gent meridians are those going out from of the body are kept in a close associa-
the main meridians and the fifteen col- tion, and a relative equilibrium of normal
laterals are branches arising from the life activities is maintained.
main meridians. Connected with their 2) Resisting pathogens and reflecting
own relating main meridians, the twelve symptoms and signs Under pathological
muscle regions and cutaneous regions of conditions, the system of the meridians
the twelve main meridians are named and collaterals exerts its functions of
after hand or foot, three yin or three combating pathogens and reflecting sys-
yang respectively as well. temic or local symptoms and signs. Chap-
The whole system of the meridians ter 71 in Miraculous Pivot points out,
and collaterals is shown in the following "When the lung and heart are involved in
table. a pathogenic invasion, the pathogenic qi
62 CHINESE ACUPUNCTURE AND MOXIBUSTION

lingers in both elbows; when the liver is collaterals assumes the responsibility of
involved, it lingers in both axillae; when transmitting needling sensation and re-
the spleen is involved, it stays in both gulating deficiency or excess conditions.
groins; when the kidney is involved, When acumoxibustion therapy is applied,
it stays in both popliteal fossae." This stimulation of the acupuncture points is
classical exposition shows that various transmitted to the relevant zang-fu or-
symptoms and signs of diseases of the gans. Consequently, normal free flow of
internal organs may find their way to the qi and blood is restored, the functions of
particular location where the correspond- zang-fu organs regulated, and diseases
ing meridians traverse. Occasionally, di- cured. It is said in Precious Supplementary
sorders of internal organs may give rise Prescriptions that "located on the cours-
to abnormal reactionary signs on the face es of the meridians and collaterals, acu-
or in the five sense organs. For instance, puncture points usher qi to the distant
flare-up of the heart fire may cause sites to achieve curative aims." Chapter 5
ulceration on the tongue; perverse ascen- in Miraculous Pivot states, "The key point
sion of the liver fire may lead to conges- in acupuncture treatment is to know how
tion and swelling of the eye; deficiency of to regulate yin and yang," meaning that
kidney qi may result in decrease of hear- the therapeutic action of acupuncture
ing, etc. Besides, when the anti pathogenic
and moxibustion is realized mainly
qi is deficient and pathogenic qi predom-
through the function of meridians and
inant, the meridians and collaterals may
collaterals in regulating yin and yang.
serve as passages for pathogen transmis-
"The arrival of qi," a phenomenon in
sion. Disorders of meridians and colla-
acupuncture, is the functional manifesta-
terals developing from the exterior may
traverse inward to impair the internal tion of the meridians and collaterals in
organs in the interior. Conversely, diseas- transmitting needling sensation. Thera-
es of internal organs may affect the me- peutic results are closely related to "the
ridians and collaterals, as is described in arrival of qi." Therefore, the first chapter
Chapter 22 of Plain Questions, "In a case in Miraculous Pivot points out, "In acu-
of liver disease, the pain in both hypo- puncture, the arrival of qi is essential
chondria may extend to the lower abdo- to obtaining therapeutic effects." And
men," and "a patient with a heart disease Chapter 9 in Miracular Pivot says, "Acu-
may have pain in the chest, fullness of puncture treatment must aim at regulat-
the costal region, pain in the hypochon- ing the flow of qi." To induce "the arrival
drium, back, shoulder, and even in the of qi" and to employ the reinforcing and
medial aspect of both arms." reducing methods in acupuncture are
3) Transmitting needling sensation and simply for the purpose of regulating the
regulating deficiency and excess conditions flow of qi, and neither of them can be
In the treatment and prevention of di- successful without the transmissive func-
sease, the system of the meridians and tion of the meridians and collaterals.
 CHAPTER 5 THE MERIDIANS AND COLLATERALS 63

Table 2. Classification of Meridians and Collaterals

LUng-Hand-Taiyin----Lieque (L 7)
Three Yin { Pericardium-Hand-Jueyin----Neiguan (P 6)
Heart-Hand-Shaoyin----Tongli (H 5)
Hand

1 Large Intestine-Hand-Yangming----Pianli (LI 6)

Three Yang { Triple Energizer-Hand-Shaoyang----Waiguan (SJ 5)
Small Intestine-Hand-Taiyang----Zhizen (SI 7)
Twelve
Main
Meridians ----(The Major Collateral of the Spleen)----Dabao (Sp 21) Fifteen

Spleen - Foot-Taiyin----Gongsun (Sp 4)

Foot Three Yin { Liver-Foot-Jueyin----Ligou (Liv 5)
Kidney-Foot-Shaoyin----Dazhong (K 4)

Stomach-Foot-Yangming----Fenglong (S 40)
Three Yang { Gallbladder-Foot-Shaoyang----Guangming (G 37)
Bladder-Foot-Taiyang----Feiyang (B 58)

overnor Vessel--Collateral of Governor Vessel----Changqiang (Du 1)

Conception Vessel--Collateral of Conception Vessel----Jiuwei (Ren 5)
Meridians Eight Thoroughfare vessell
Extra Belt Vessel
Meridians Yin Heel Vessel meet with the above 14 Meridians
Yang Heel Vessel
Yin Link Vessel
Yang Link Vessel

Twelve
Divergent
Meridians
Same as the twelve Main Meridians, fit to
the hand and foot, three yin and three yang
Twelve
Muscle
Regions

Twelve
Cutaneous- Regionalized on the body surface according to
Regions the distribution of meridians and collaterals
Minute Collaterals---split from collaterals and
distributed all over the body
64 CHINESE ACUPUNCTURE AND MOXIBUSTION

3. Distribution of the Fourteen toe by the meridian of Foot-Shaoyang;

Meridians the posterior border of the lateral aspect
and the lateral end of the little toe by the
The twelve main meridians together meridian of Foot-Taiyang, while the me-
with the Governor Vessel and Concep- ridian of Foot-Taiyin runs from the me-
tion Vessel are called "the fourteen me- dial end of the great toe to the middle of
ridians." The twelve main meridians are the medial aspect of the lower limb and
distributed symmetrically at the left and further goes round to its anterior border;
right sides of the body. Both Governor the meridian of Foot-Jueyin goes from
Vessel and Conception Vessel emerge the lateral and of the great toe to the
from the perineum, and ascend respec- anterior border of the medial aspect of
tively along the midlines of the front and the lower limb and further shifts to
back of the body. the middle; and the meridian of Foot-
Distribution in the Limbs: Shaoyin starts under the little toe, crosses
The medial aspect of the limbs attrib- the sole and further goes along the poste-
utes to yin, the lateral to yang. Each limb rior border of the medial aspect of the
is supplied by the three yin and three lower limb.
yang meridians. On the upper limbs, the Distribution in the Body Trunk:
anterior border of the medial aspect and In the thoracic and abdominal regions,
the radial end of the thumb are supplied the Conception Vessel is situated on the
by the meridian of Hand-Taiyin; the mid- midline. The first line lateral to it is the
dle of the medial aspect and the radial Kidney Meridian of Foot-Shaoyin, the
end of the middle finger by the meridian second lateral line is the Stomach Merid-
of Hand-Jueyin; the posterior border of ian of Foot-Yangming, and the Lung Me-
the medial aspect and the radial end of ridian of Hand-Taiyin and the Spleen Me-
the small finger by the meridian of Hand- ridian of Foot-Taiyin correspond to the
Shaoyin, while the meridian of Hand- third line. The Gallbladder Meridian of
Yangming goes from the radial end of Foot-Shaoyang is located at the lateral
the index finger to the anterior border of side of the hypochondrium and the lum-
the lateral aspect; the meridian of Hand- bar region, while the Liver Meridian of
Shaoyang from the ulnar end of the ring Foot-Jueyin is in the region of the an-
finger to the middle of the lateral aspect, terior external genitalia and hypochon-
the meridian of Hand-Taiyang from the drium. On the back, the Governor Vessel
ulnar end of the small finger to the pos- stays in the middle, while both the first
terior border of the lateral aspect. On the and second lines lateral to the Governor
lower limbs, the anterior border of the Vessel are the Bladder Meridian of Foot-
lateral aspect and the lateral and of the Taiyang.
second toe are supplied by the meridian Distribution in the Head, Face and
of Foot-Yangming; the middle of the la- Neck:
teral side and the lateral end of the fourth The Yangming Meridians of Hand
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 65

and Foot run in the facial region; and the Not only do the twelve main meridi-
Shaoyang Meridian of Hand and Foot ans have their fixed courses, but also they
travel in the lateral aspect of the head. cross at given places as follows: the yin
The Governor Vessel goes along the mid- meridians (the interior meridians) meet
line of the neck and head, while the Blad- the yang meridians (the exterior meridi-
der Meridian of Foot-Taiyang runs on ans) in the four limbs; the yang meridi-
both sides of the Governor Vessel. ans meet the yang meridians bearing the
Among the twelve main meridians, the same name on the head and face; and the
yin meridians pertaining to the zang or- three yin meridians of the hand and the
gans communicate with the fu organs, three yin meridians of the foot meet in
while the yang meridians pertaining to the chest.
the fu organs communicate with the zang
organs, thus forming an exterior-interior 4. Cyclical Flow of Qi in the Twelve
relation between yin and yang, the zang Main Meridians
and fu organs. The zang organs (the
lung, heart and pericardium) that are sit- The twelve main meridians link one
uated in the chest are connected with the another in a fixed order. A cyclical flow
yin meridians of the hand, while those of qi is maintained by the connection of
(the spleen, liver and kidney) in the ab- the meridians of the hand and foot, yin
domen are linked with the yin meridians and yang, exterior and interior. See the
of the foot. The six fu organs, however, following table 3.
are related to yang meridians in ac-
cordance with their respective exterior-
interior relations. All the three yang me- II. THE TWELVE MAIN
ridians of the hand and foot traverse the MERIDIANS
head and facial regions. In this way, be-
tween the twelve main meridians and the As the major part in the meridian
head, face, chest and abdomen a specific system, the twelve main meridians share
relationship is established. Chapter 38 of the following features. Each with its own
Miraculous Pivot states, "The three yin acupuncture points is distributed on a
meridians of the hand go from the chest fixed portion of the body surface; each
to the hand; the three yang meridians of pertains to either a zang or a fu organ
the hand run from the hand to the head; (those that pertain to the zang organ
the three yang meridians of the foot trav- communicating with the fu organ, and
el from the head to the foot; and the vice versa); among the meridians exists
three yin meridians of the foot go from an exterior-interior relation of mutual
the foot to the abdomen." The meridians connection; and each meridian presents
of the hand and foot are connected with its pathological manifestation(s), in case
each other, forming an interminable cir- its qi fails in a smooth flow. The courses
culation of yin and yang. of the twelve main meridians are des-

---------------------------------- - -----------
66 CHINESE ACUPUNCTURE AND MOXIBUSTION

Table 3. The Cyclical Flow of Qi in the Twelve Main Meridians

--~) pertaining and communicative (-- - -- - exterior and interior relations)

Zang Organs (Yin Meridians) Fu Organs (Yang Meridians)

(Interior) (Exterior)

Lung (1) ...: ____________-::; (2) Large Intestine

Spleen (4) ~------------~ (3) Stomach

J
J .
Heart (5) ...: ____________~ (6) smaf Intestine

Kidney (8) ~------------~ (7) Bladder

J
Pericardium (9) ~ (10) Triple Energizer
...:-------------~ J
L--_ _ Liver (12) ~------------~ (11) Gallbladder

cribed respectively in their circulative or- uously downward along the anterior bor-
der as follows. der of the radial side in the medial aspect
of the forearm (8) and enters cunkou (the
1. The Lung Meridian of Hand-Taiyin radial artery at the wrist for pulse palpa-
tion) (9). Passing the thenar eminence
The Lung Meridian of Hand-Taiyin (10), it goes along its radial border (11),
originates from the middle energizer, ending at the medial side of the tip of the
running downward to connect with the thumb (Shaoshang, LU 11) (12).
large intestine (1). Winding back, it goes The branch proximal to the wrist
along the upper orifice of the stomach emerges from Lieque (LU 7) (13) and
(2), passes through the diaphragm (3), runs directly to the radial side of the tip
and enters the lung, its pertaining organ of the index finger (Shangyang, LI 1)
(4). From the lung system, which refers where it links with the Large Intestine
to the portion of the lung communicating Meridian of Hand-Yangming. (See
with the throat, it comes out transversely Fig. 5)
(Zhongfu, LU 1) (5). Descending along
the medial aspect of the upper arm, it 2. The Large Intestine Meridian of
passes in front of the Heart Meridian of Hand-Yangming
Hand-Shaoyin and the Pericardium Me-
ridian of Hand-J ueyin (6), and reaches The Large Intestine Meridian of
the cubital fossa (7). Then it goes contin- Hand-Yangming starts from the tip of
CHAPTER 5 THE MERIDIANS AND COLLATERALS 67

• Yang meridian porn ts

Y in meridian poin ts

C. CrOOling points

Circulation
of meridian
- (includinllocation)

Yang mOf'd".. )
Yin meridian r p~ge with
pomts

1
and collateral • ~ - - Yana: meridian 1
Yin meridian
J PUS.!I.,e without
.
pomts

I~: 1.5c.

Fig. 5. The Lung Meridian of Hand·Taiyin

the index finger (Shangyang, LI I) (I). along the lateral anterior aspect of the
Running upward along the radial side of upper arm (5) to the highest point of the
the index finger and passing through the shoulder (Jianyu, LI 15) (6). Then, along
interspace of the 1st and 2nd metacarpal the anterior border of the acromion (7),
bones (Hegu, LI 4), it dips into the de- it goes up to the 7th cervical vertebra (the
pression between the tendons of m. exten- ,confluence of the three yang meridians Qf
sor pollicis longus and brevis (2). Then, the hand and foot) (Dazhui, GV 14) (8),
following the lateral anterior aspect of and descends to the supraclavicular fossa
the forearm (3), it reaches the lateral side (9) to connect with the lung (10). It then
of the elbow (4). From there, it ascends passes through the diaphragm (11) and
68 CHINESE ACUPCNCTCRE AND MOXIBUSTION

Fig. 6 The Large Intestine Meridian

of Hand·Yangming

enters the large intestine, its pertaining

organ (12).
The branch from the supraclavicular
fossa runs upward to the neck ( 13), pass-
es through the cheek ( 14) and enters the I
i
gums of the lower teeth (15). Then it
curves around the upper lip and crosses
the opposite meridian at the philtrum.
From there, the left meridian goes to the
right and the right meridian to the left,
to both sides of the nose (Yingxiang, LI
20), Where the Large Intestine Meridian
links with the Stomach Meridian of Foot-
Yangming (16). (See Fig. 6)

3. The Stomach Meridian of

Foot-Yangming
The Stomach Meridian of Foot-
Yangming starts from the lateral side of
ala nasi (Yingxiang, LI 20) (1). It ascends
to the bridge of the nose, where it meets
the Bladder Meridian of Foot-Taiyang Winding along the angle of the mandible
(Jing-ming, BL I) (2). Turning down- (Jiache, ST 6) (8), it ascends in front of
ward along the lateral side of nose the ear and traverses Shangguan (OB 3)
(Chengqi, ST I) (3), it enters the upper (9). Then it follows the anterior hairline
gum (4). Reemerging, it curves around (10) and reaches the forehead (11).
the lips (5) and descends to meet the The facial branch emerging in front of
Conception Vessel at the mentolabial Daying (ST 5) runs downward to Ren-
groove (Chengjiang, CV 24) (6). Then ying (ST 9) (12). From there it goes along
it runs posterolaterally across the lower the throat and enters the supraclavicular
portion of the cheek at Daying (ST 5) (7). fossa (13). Descending, it passes through
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 69

the diaphragm (14), enters the stomach, medial malleolus (3) up to the medial
its pertaining organ, and connects with aspect of the leg (4). It folIows the poste-
the spleen ( 15). rior aspect of the tibia (5), crosses and
The straight portion of the meridian goes in front of the Liver Meridian of
arising from the supraclavicular fossa Foot-Jueyin (6). Passing through the an-
runs downward (16), passing through the terior medial aspect of the knee and thigh
nipple. It descends by the umbilicus and (7), it enters the abdomen (8), then the
enters Qichong (ST 30) on the lateral side spleen, its pertaining organ, and connects
of the lower abdomen (17). with the stomach (9). From there it as-
The branch from the lower orifice of
the stomach (18) descends inside the ab-
cends, passing through the diaphragm
( 10) and running alongside the esophagus
(
domen and joins the previous portion of ( 11). When it reaches the root of the
the meridian at Qichong (ST 30). Run- tongue it spreads over its lower surface
ning downward, traversing Biguan (ST (12).
31) (19), and further through Femur- The branch from the stomach goes
Futu (ST 32) (20), it reaches the Knee upward through the diaphragm ( 13), and
(21). From there, it continues downward flows into the heart to link with the Heart
along the anterior border of the lateral Meridian of Hand-Shaoyin (14). (See
aspect of the tibia (22), passes through Fig. 8)
the dorsum of the foot (23), and reaches
the lateral side of the tip of the 2nd toe 5. The Heart Meridian of
(Lidui, ST 45) (24). Hand-Shaoyin
The tibial branch emerges from Zu-
sanli (ST 36), 3 cun below the knee (25), The Heart Meridian of Hand-Shaoyin
and enters the lateral side of the middle originates from the heart. Emerging, it
toe (26). spreads over the "heart system" (i.e., the
The branch from the dorsum of the tissues connecting the heart with the oth-
foot arises from Chongyang (ST 42) (27) er zang-fu organs) (1). It passes through
and terminates at the medial side of the the diaphragm to connect with the small
tip of the great toe (Yinbai, SP 1), where intestine (2).
it links with the spleen Meridian of Foot- The ascending portion of the meridian
Taiyin. (See Fig. 7) from the "heart system" (3) runs along-
side the esophagus (4) to connect with
the "eye system" (i.e., the tissues connect-
4. The Spleen Meridian of Foot-Taiyin
ing the eyes with the brain) (5).
The Spleen Meridian of Foot-Taiyin The straight portion of the meridian
starts from the tip of the big toe (Yinbai, from the "heart system" goes upward to
SP 1) (l). It runs along the medial aspect the lung (6). Then it turns downward and
of the foot at the junction of the red and emerges from the axilla (Jiquan, HT 1).
white skin (2), and ascends in front of the From there it goes along the posterior
70 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 7 The Stomach Meridian of Foot·Yangming

CHAPTER 5 THE MERIDIANS AND COLLA TERALS 71

Fig. 8 The Spleen Meridian of Foot-Taiyin

-------- -----~---- -----

72 CHINESE ACVPCNCTCRE AND MOXIBVSTION

border of the medial aspect of the upper chong, HT 9) (11) and links with the
arm behind the Lung Meridian of Hand- Small Intestine Meridian of Hand-
Taiyin and the Pericardium Meridian of Taiyang. (See Fig. 9)
Hand-Jueying (7) down to the cubital
fossa (8). From there it descends along 6. The Small Intestine Meridian of
the posterior border of the medial aspect Hand-Taiyang
of the forearm to the pisiform region
proximal to the palm (9) and enters the The Small Intestine Meridian of
palm (10). Then it follows the medial Hand-Taiyang starts from the ulnar side
aspect of the little finger to its tip (Shao- of the tip of the little finger (Shaoze, SI

Fig.9 The Heart Meridian of Hand-Shaoyin

CHAPTER 5 THE MERIDIANS AND COLLA TERALS 73

I) (I). Following the ulnar side of the a branch arises, running to the temple
dorsum of the hand it reaches the wrist (4 ).
where it emerges from the styloid process The straight portion of the meridian
of the ulna (2). From there it ascends enters and communicates with the brain
along the posterior aspect of the forearm from the vertex (5). It then emerges and
(3), passes between the olecranon of the bifurcates to descend along the posterior
ulna and the medial epicondyle of the aspect of the neck (6). Running down-
humerus, and runs along the posterior ward alongside the medial aspect of the
border of the lateral aspect of the upper scapula region and parallel to the verte-
arm (4) to the shoulder joint (5). Circling bral column (7), it reaches the lumbar
around the scapular region (6), it meets region (8), where it enters the body cavity
Dazhui (GV 14) on the superior aspect of via the paravertebral muscle (9) to con-
the shoulder (7). Then, turning down- nect with the kidney (10) and join its
ward to the supraclavicular fossa (8), it pertaining organ, the bladder ( 11 ).
connects with the heart (9). From there it The branch of the lumber region des-
descends along the esophagus ( 10), passes cends through the gluteal region (12) and
through the diaphragm (11), reaches the ends in the popliteal fossa (13).
stomach (12), and finally enters the small The branch from the posterior aspect
intestine, its pertaining organ ( 13). of the neck runs straight downward along
The branch from the supraclavicular the medial border of the scapula (14).
fossa (14) ascends to the neck (15), and Passing through the gluteal region
further to the cheek (16). Via the outer (Huantiao, GB 30) (15) downward along
canthus (17), it enters the ear (Tinggong, the lateral aspect of the thigh (16), it
SI 19) (18). meets the preceding branch descending
The branch from the neck (19) runs from the lumbar region in the popliteal
upward to the infraorbital region (Quan- fossa (17). From there it descends to the
liao, SI 18) and further to the lateral side leg (18) and further to the posterior as-
of the nose. Then it reaches the inner pect of the external malleol us ( 19). Then,
canthus (Jingming, BL 1) to link with the running along the tuberosity of the 5th
Bladder Meridian of Foot-Taiyang (20). metatarsal bone (20), it reaches the later-
(See Fig. 10) al side of the tip of the little toe (Zhiyin,
BL 67), where it links with the Kidney
Meridian of Foot-Shaoyin (21). (See
7. The Bladder Meridian of
Fig. 11)
Foot-Taiyang
The Bladder Meridian of Foot- 8. The Kidney Meridian of
Taiyang starts from the inner canthus Foot-Sh·aoyin
(Jingming, BL I) (1). Ascending to the
forehead (2), it joins the Governor Vessel The Kidney Meridian of Foot-
at the vertex (Baihui, GV 20) (3), where Shaoyin starts from the inferior aspect
74 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 10 The Small Intestine Meridian of Hand·Taiyang

of the small toe (1) and runs oblique- the postero-medial aspect of the thigh
ly towards the sole (Yongquan, KI I). (7) towards the vertebral column
Emerging from the lower aspect of the (Changqiang, GV 1), where it enters
tuberosity of the navicular bone (2) and the kidney, its pertaining organ (8), and
running behind the medial malleolus connects with the bladder (9).
(3), it enters the heel (4). Then it as- The straight portion of the meridian
cends along the medial side of the leg reemerges from the kidney (10). Ascend-
(5) to the medial side of the popliteal ing and passing through the liver and
fossa (6) and goes further upward along diaphragm (1 I), it enters the lung (12),
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 75

~--&-
12~ ----- -:-;.------<r /

/~ .....--~ /,

21 20

Fig. 11 The Bladder Meridian of Foot-Taiyang

76 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 12 The Kidney Meridian of Foot-Shaoyin

CHAPTER 5 THE MERIDIANS AND COLLA TERALS 77

runs along the throat ( 13) and terminates 10. The Triple Energizer Meridian of
at the root of the tongue (14). Hand -Shaoyang
A branch springs from the lung, joins
the heart and runs into the chest to link The Triple Energizer Meridian of
with the Pericardium Meridian of Hand- Hand-Shaoyang originates from the tip
Jueyin (15). (See Fig. 12) of the ring finger (Guanchong TE 1) (1),
running upward between the 4th and 5th
metacarpal bones (2) along the dorsal
9. The Pericardium Meridian of aspect of the wrist (3) to the lateral as-
Hand-Jueyin pect of the forearm between the radius
and ulna (4). Passing through the olecra-
The Pericardium Meridian of Hand-
non (5) and along the lateral aspect of the
Jueyin originates from the chest. Emerg-
upper arm (6), it reaches the shoulder
ing, it enters its pertaining organ, the
region (7), where it goes across and pass-
pericardium (1). Then, it descends
es behind the Gallbladder Meridian of
through the diaphragm (2) to the abdo-
Foot-Shaoyang (8). Winding over to the
men, connecting successively with the up-
supraclavicular fossa (9), it spreads in the
per, middle and lower energizer (i.e., Tri-
chest to connect with the pericardium
ple Energizer) (3). (10). It then descends through the dia-
A branch arising from the chest runs phragm down to the abdomen, and joins
inside the chest (4), emerges from the its pertaining organ, the upper, middle
costal region at a point 3 cun below the and lower energizer (i.e., Triple Energiz-
anterior axillary fold (T ianchi PC 1) (5) er) (11).
and ascends to the axilla (6). Following A branch originates from the chest
the medial aspect of the upper arm, it (12). Running upward, it emerges from
runs downward between the Lung Merid- the supraclavicular fossa (13). From
ian of Hand-Taiying and the Heart Me- there it ascends to the neck ( 14), running
ridian of Hand-Shaoyin (7) to the cubi- along the posterior border of the ear ( 15),
tal fossa (8), further downward to the and further to the corner of the anterior
forearm between the two tendons (the hairline ( 16). Then it turns downward to
tendons of m. palmaris longus and m. the cheek and terminates in the infraor-
flexor carpi radialis) (9), ending in the bital region (17).
palm (10). From there it passes along The auricular branch arises from the
the middle finger right down to its tip retroauricular region and enters the ear
(Zhongchong PC 9) (11). ( 18). Then it emerges in front of the ear,
Another branch arises from the palm crosses the previous branch at the cheek
at Laogong (PC 8) (12), runs along the and reaches the outer canthus (Sizhu-
ring finger to its tip (Guanchong, TE 1) kong, TE 23) to link with the Gallbladder
and links with the Triple Energizer Me- Meridian of Foot-Shaoyang (19). (See
ridian of Hand-Shaoyang. (See Fig. 13) Fig. 14)

.-~-~---~- ---
78 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 13 The Pericardium Meridian of Hand-Jueyin

11. The Gallbladder Meridian of front of the Triple Energizer Meridian

Foot-Shaoyang of Hand-Shaoyang to the shoulder (4).
Turning back, it traverses and passes be-
The Gallbladder Meridian of Foot- hind the Triple Energizer Meridian of
Shaoyang originates from the outer can- Hand-Shaoyang down to the supraclavi-
thus (Tongziliao, GB 1) (1), ascends to cular fossa (5).
the corner of the forehead (Hanyan, GB The retroauricular branch arises from
4) (2), then curves downward to the re- the retroauricular region (6) and enters
troauricular region (Fengchi, GB 20) (3) the ear. It then comes out and passes the
and runs along the side of the neck in preauricular region (7) to the posterior
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 79

,
I
I
.:
I

I
V
Fig. 14 The Triple Energizer Meridian of Hand-Shaoyang

aspect of the outer canthus (8). (13). From there it further descends into
The branch arising from the outer the chest (14), passes through the dia-
canthus (9) runs downward to Daying phragm to connect with the liver ( 15) and
(ST 5) (10) and meets the Triple Energiz- enters its pertaining organ, the gallblad-
er Meridian of Hand-Shaoyang in the der (16). Then it runs inside the hypo-
infraorbital region (11). Then, passing chondriac region (17), comes out from
through liache (ST 6) (12), it descends to the lateral side of the lower abdomen
the neck and enters the supraclavicular near the femoral artery at the inguinal
fossa where it meets the main meridian region (18). From there it runs superfi-
 80 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 15 The Gallbladder Meridian of Foot-Shaoyang

cially along the margin of the pubic hair

(19) and goes transversely into the hip
region (Huantiao, GB 30) (20).
The straight portion of the channel
runs downward from the supraclavicular
fossa(21), passes in front of the axilla (22)
along the lateral aspect of the chest (23)
and through the free ends of the floating
ribs (24) to the hip region where it meets
the previous branch (25). Then it descends
along the lateral aspect of the thigh (26) to
the lateral side of the knee (27). Going
further downward along the anterior as-
pect of the fibula (28) all the way to its
lower end (Xuanzhong, GB 39) (29), it
reaches the anterior aspect of the external
malleolus (30). It then follows the dorsum
of the foot to the lateral side of the tip of
the 4th toe (Foot-Qiaoyin GB 44) (31).
The branch of the dorsum of the foot
springs from Foot-Linqi (GB 41), runs
between the 1st and 2nd metatarsal bones
to the distal portion of the great toe and
terminates at its hairy region (Dad un, LR
1), where it links with the Liver Meridian
of Foot-Jueyin (32). (See Fig. 15)

-- -
- - - - -- - - - - - - - - - - - - - - - - - - - ----- ----
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 81

12. The Liver Meridian of Foot-Jueyin

The Liver Meridian of Foot-lueyin

starts from the dorsal hairy region of the
great toe (Dadun, LR I) (1). Running up-
ward along the dorsum of the foot (2),
passing through Zhongfeng (LR 4), 1 cun
in front of the medial malleolus (3), it
ascends to an area 8 cun above the medial
malleolus, where it runs across and behind
the Spleen Meridian of Foot-Taiyin (4).
Then it runs further upward to the medial
side of the knee (5) and along the medial
aspect of the thigh (6) to the pubic hair
region (7), where it curves around the ex-
ternal genitalia (8) and goes up to the low-
er abdomen (9). It then runs upward and
curves around the stomach to enter the
liver, its pertaining organ, and connects
with the gallbladder (10). From there it
continues to ascend, passing through the
diaphragm (11), and branching out in the
costal and hypochondriac region (12).
Then it ascends along the posterior aspect
of the throat (13) to the nasopharynx ( 14)
and connects with the "eye system" (15).
Fig. 16 The Liver Meridian of Foot-Jueyin Running further upward, it emerges from
82 CHINESE ACUPUNCTURE AND MOXIBUSTION

the forehead ( 16) and meets the Governor to govern the qi of all the yang meridians.
Vessel at the vertex. Running along the midline of the ab-
The branch which arises from the "eye domen and the chest, going upward to
system" runs downward into the cheek the chin, the Conception Vessel meets all
(18) and curves around the inner surface the yin meridians. Thus it is called "the
of the lips (19). sea of the yin meridians." Its function is
The branch arising from the liver (20) to receive and bear the qi of the yin
passes through the diaphragm (21), runs meridians.
into the lung and links with the Lung Me- The Thoroughfare Vessel runs par-
ridian of Hand-Taiyin (22). (See Fig. 16) allel to the kidney Meridian of Foot-
Shaoyin up to the infra-orbital region.
Meeting all the twelve main meridians, it
III. THE EIGHT EXTRA is termed "the sea of the twelve main
MERIDIANS meridians" or "the sea of blood." Its func-
tion is to reservior the qi and blood of the
The eight extra meridians are the Gov- twelve main meridians.
ernor Vessel, Conception Vessel, Thor- The Belt Vessel, which originates in
oughfare Vessel, Belt Vessel, Yang Heel the hypochondrium and goes around the
Vessel, Yin Heel Vessel, Yang Link Ves- waist as a girdle, performs a function of
sel and Yin Link Vessel. They are differ- binding up all the meridians.
ent from the twelve main meridians be- The Yang Heel Vessel starts in the
cause none of them pertains to the zang lateral aspect of the heel and merges into
organs and communicates with the fu the meridian of Foot-Taiyang to ascend,
organs of pertains to the fu organs and while the Yin Heel Vessel starts in the
communicates with the zang organs. And medial aspect of the heel and merges into
they are not exteriorly-interiorly related. the meridian of Foot-Shaoyin to go up-
Apart from the Governor Vessel and wards. Following their own courses, the
Conception Vessel which have their own two meridians meet each other at the
acupuncture points, the extra meridians inner canthus. Motion regulation of the
share their points with other main me- lower limbs is their joint function.
ridians. Strengthening the association The Yang Link Vessel is connected
among the meridians, they assume the with all the yang meridians and domi-
responsibility to control, join, store, and nates 'the exterior of the whole body; the
regulate the qi and blood of each merid- Yin Link Vessel is connected with all the
ian. yin meridians and dominates the interior
Running along the midline of the back of the whole body. The two meridians
and ascending to the head and face, the regulate the flow of qi in the yin and yang
Governor Vessel meets all the yang me- meridians, and help maintain coordina-
ridians. It is therefore described as "the tion and equilibrium between the yin and
sea of the yang meridians." Its function is yang meridians.
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 83

Table 4. Distribution of the Eight Extra Meridians and Their Connecting Meridians

Eight Extra Meridian Area Supplied \ Their Connecting Meridians

Governor Vessel Posterior Midline rFoot~Ya~gmi~g~nd R~-

Conception Vessel Anterior Midline • Foot-Yangming and Du
Thoroughfare Vessel 1st lateral line of the abdomen ! Foot-Shaoyin
I
Belt Vessel I Lateral side of the lumbar region I Foot-Shaoyang
I !
Yang Heel Vessel Lateral side of the lower extremities, I Hand and Foot-Taiyang, Hand and
!shoulder and head I Foot-Yangming and Foot-Shaoyang

Yin Heel Vessel . Medial aspect of the lower Foot-Shaoyin and Foot-Taiyang
!

, extremities and eye

! ! •
Yang Link Vessel i Lateral aspect of the lower I Hand and Foot-Talyang, Du, Hand

I extremities, shoulder and vertex and Foot-Shaoyang and Foot-

! I Yangming

Yin Link Vessel i Medial aspect of the lower I Foot-Shaoyin, Foot-Taiyin, Foot-

IIextremities, 3rd lateral line of the J ueyin and Ren

abdomen and neck

Governor Vessel the interior of the abdomen, passing

through Guanyuan (CV 4) and the other
The Governor Vessel arises from the points along the front midline (3) to the
lower abdomen and emerges from the throat (4). Ascending further, it curves
perineum (1). Then it runs posteriorly around the lips (5), passes through the
along the interior of the spinal column cheek and enters the infraorbital region
(2) to Fengfu (GV 16) at the nape, where (Chengqi, ST 1).
it enters the brain (3). It further ascends The coalescent points of the Concep-
to the vertex (4) and winds along the
tion Vessel are Chengqi (ST 1), Yinjiao
forehead to the columnella of the nose
(GV 28). (See Fig. 18)
(5).
The coalescent points of the Governor
Vessel are Fengmen (BL 12) and Huiyin Thoroughfare Vessel
(CV 1). (See Fig. 17)
The Thoroughfare Vessel starts from
the inside of the lower abdomen and
Conception Vessel
emerges at the perineum (1 ).. Ascending,
The Conception Vessel starts from the it runs inside of the spinal column
inside of the lower abdomen and emerges (2). Where its superficial branch pass-
from the perineum (1). It goes anteriorly es through the region of Qichong (ST 30)
to the pubic region (2) and ascends along and communicates with the Kidney Me-
84 CHINESE ACUPUNCTURE AND MOXIBUSTION

0---

Fig. 17 The Governor Vessel

rid ian of Foot-Shaoyin. Running along gu (KI 20) and Youmen (KI 21). (See
the both sides of the abdomen, it goes up Fig. 19)
to the throat and curves around the lips
(5). Belt Vessel
The coalescent points of the Thoro-
ughfare Vessel are Huiyin (CV 1), Heng- The Belt Vessel originates below the
gu (KIll), Dahe (KI 12), Qixue (KI hypochondriac region and runs oblique-
13), Simen (KI 14), Zhongzhu (KI 15), ly downward through Daimai (GB 26),
Huangshu (KI 16), Shangqu (KI 17), Wushu (GB 27), and Weidao (GB 28) (1).
Shiguan (KI 18), Yindu (KI 19), Futong- It runs transversely around the waist like
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 85

a belt (2). the external malleolus (2) and passes the

The coalescent points of the Belt Ves- posterior border of the fibula. It then
sel are Daimai (OB 26), Wushu (OB 27), goes onwards along the lateral side of the
and Weidao (GB 28). (See Fig. 20) thigh and posterior side of the hypochon-
drium to the posterior axillary fold. From
Yang Heel Vessel there, it winds over to the shoulder and
ascends along the neck to the corner of
The Yang Heel Vessel starts from the the mouth. Then it enters the inner can-
lateral side of the heel (Shenmai, BL 62), thus (Jingming, BL I) to communicate
Pushen (BL 61) ( 1). It runs upward along with the Yin Heel Vessel. Running furth-
er upward along the Bladder Meridian of
Foot-Taiyang to the forehead, it meets
the Gallbladder Meridian of Foot-
Shaoyang at Fengchi (OB 20) (3).
The coalescent points of the Yang
Heel Vessel are Shenmai (BL 62), Push en
(BL 61), Fuyang (BL 59), Femur-luliao
(GB 29), Naoshu (SIlO), lianyu (LI 15),
lugu (LI 16), Dicang (ST 4), Nose-luliao
(ST 3), Chengqi (ST 1), lingming (BL 1)
and Fengchi (GB 20). (See Fig. 21)

Yin Heel Vessel

The Yin Heel Vessel starts from the

posterior aspect of the navicular bone

Fig.18 The Conception Vessel

----------------------
-------------------
86 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig.19 The Thoroughfare Vessel Fig. 20 The Belt Vessel

(Zhaohai, KI 6) (1). Ascending to the pIe in front of Renying (ST 9) (7) and
upper portion of the medial malleolus then along the zygoma (8). From there, it
(2), it runs straight upward along the reaches the inner canthus (Jingming, BL
posterior border of the medial aspect of I) and communicates with the Yang Heel
the thigh (3) to the external genitalia (4). Vessel (9).
Then it goes upward along the chest (5) The coalescent points of the Yin Heel
to the supraclavicular fossa (6) and runs Vessel are Zhaohai (KI 6), and Jiaoxin
further upward lateral to the Adam's ap- (KI 8). (See Fig. 21)
 CHAPTER 5 THE MERIDIANS AND COLLATERALS 87

Fig. 21 The Yang Heel Vessel Fig. 21 The Yin Heel Vessel

--~~~---
88 CHINESE ACUPUNCTURE AND MOXIBUSTION

Yang Link Vessel (CV 23). (See Fig. 22)

The Yang Link Vessel originates from

the heel (J inmen, BL 63) (1 ) and emerges IV. THE TWELVE
from the external malleolus (2). Ascend- DIVERGENT MERIDIANS
ing along the Gallbladder Meridian of
Foot-Shaoyang, it passes through the hip
AND FIFTEEN
region (3). Then it runs further upward COLLATERALS
along the posterior aspect of the hypo-
chondriac and costal regions (4) and The Divergent Meridians and ColI at-
the posterior aspect of the axilla to the erals branch out from the twelve
shoulder (5) and to the forehead (6). It main meridians. The divergent meridi-
then turns backward to the back of the ans mainly run deeper in the body, with
neck, where it communicates with the the collaterals being mostly distributed
Governor Vessel (Fengfu, GV 16, Ya- on the body surface. They both streng-
men, GV 15) (7). then and connect the internally-externally
The coalescent points of the Yang related meridians. The divergent meridi-
Link Vessel are Jinmen (BL 63), ans govern the inside of the body, so they
Yangjiao (GB 35), Naoshu (S I 10), Tian- do not have points of their pertaining
liao (TE 15), Jianjing (GB 21), Benshen organs, while the collaterals control the
(GB 13), Yangbai (GB 14), Toulinqi (GB body surface, each of them has a Luo
15), Muchuang (GB 16), Zhengying (GB (Connecting) point, effective to certain
17), Chengling (GB 18), Naokong (GB diseases. The distribution of the twelve
19), Fengchi (GB 20), Fengfu (GV 16) divergent meridians and fifteen collater-
and Yamen (GV 15). (See Fig. 22) als are described as follows.

Yin Link Vessel The Twelve Divergent Meridians

The Yin Link Vessel starts from the The twelve divergent meridians,
medial aspect of the leg (Zhubin, KI 9) which branch out from the twelve main
(1), and ascends along the medial aspect meridians, are mainly distributed on the
of the thigh to the abdomen (2) to com- chest, abdomen and head. Their func-
municate with the Spleen Meridian of tion is to connect internally-externally
Foot-Taiyin (3). Then it runs along the related meridians, strengthen their rela-
chest (4) and communicates with the tion with the zang-fu organs and serve
Conception Vessel at the neck (Tiantu, as the extension of main meridians. The
CV 22), Lianquan (CV 23) (5). distribution of the Divergent Meridians
The coalescent points of the Yin Link is summarized as follows:
Vessel are Zhubin (KI 9), Fushe (SP 13), Most of them derive from the main
Daheng (SP 15), Fuai (SP 16), Qimen meridians at the regions of four limbs
(LR 14), Tiantu (CV 22) and Lianquan and then enter the thoraic and abdom-
CHAPTER 5 THE MERIDIANS AND COLLA TERALS
89

'"
t~I / \\
I
I /)j;rc

i 'S
;'

f
"3-

Fig. 22 The Yang Link and Yin Link Vessels

 CHINESE ACUPUNCTURE AND MOXIBUSTION

inal cavities. The Yin and Yang Diver- emerges at the nape to join the Bladder
gent Meridians run parallelly inside the Meridian of Foot Taiyang. (See Fig. 23)
body and emerge from the neck. In the
head region, the Yin Divergent Meridi-
2. The Second Confluence
ans connect the Yang Divergent meridi-
ans and then join the main meridians. 1) Divergent Meridian of the Stomach
Thus the twelve Divergent Meridians Meridian of Foot Yangming After deriv-
can be paired into six confluences ac- ing from the Stomach Meridian on the
cording to their internal and external thigh, it enters the abdomen, connects
relationship. with the stomach and disperses in the
The Divergent Meridians mainly run spleen. It then ascends through the heart
deeper in the body, supplementing the and alongside the esophagus to reach the
pathway that the main meridians do not mouth. It then runs upward beside the
reach. There are no points located on nose and connects with the eye before
the Divergent Meridians. finally joining the Stomach Meridian of
Foot Yangming. (See Fig. 24)
1. The First Confluence 2) Divergent Meridian of the Spleen
Meridian of Foot Taiyin After deriving
1) Divergent Meridian of the Bladder from the Spleen Meridian on the thigh, it
Meridian of Foot-Taiyang After deriv- converges with the Divergent Meridian
ing from the Bladder Meridian in the of the Stomach Meridian of Foot Yang-
popliteal fossa, it proceeds to a point ming and runs upward to the throat, and
five cun below the sacrum. Winding finally enters the tongue. (See Fig. 24)
round to the anal region, it connects
with the bladder and disperses in the 3. The Third Confluence
kidneys. Then it follows the spine and
disperses in the cardiac region and fin- 1) Divergent Meridian of the Gallblad-
ally emerges at the neck and converges der Meridian of Foot Shaoyang After
with the Bladder Meridian of Foot Tai- deriving from the Gallbladder Meridian
yang. (See Fig. 23) on the thigh, it crosses over the hip joint
2) Divergent Meridian of the Kidney and enters the lower abdomen in the pel-
Meridian of Foot Shaoyin After deriv- vic region and converges with the Di-
ing from the Kidney Meridian in the vergent Meridian of the Liver Meridian.
popliteal fossa, it intersects the Diver- Then, it crosses between the lower ribs,
gent Meridian of the Bladder Meridian connects with the gallbladder and spreads
on the thigh. It then runs upward, con- through the liver. Proceeding further up-
necting with the kidney and crossing the ward, it crosses the heart and esophagus
Belt Vessel at about the level of the 7th and disperses in the face. It then connects
thoracic vertebra. Further it ascends to with the eye and rejoins the Gallbladder
the root of the tongue and finally, Meridian of Foot Shaoyang at the outer
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 91

7. Emergi ng at the neck and

converging with Foot Taiyang.

the cardiac region.

:';'lonl:;J: anl1 t:rO:::'t:il n G t"h~;; Belt Ve

4. Dispersing in the kidney.
1~ t;e ?p- tt or2.C'!C verteb r 3

3.e necting with the bladder.

~
2. Proce ding to a point five
cun b low the sacrum and
windi g round to the anal region.

1. Di erging from Main Meridian

Foot Taiyang and entering

Divergent Meridian

Yang meridian
Yin meridian
Connecting line

x X Pertaining organ
..... •• Dispersing region
and connecting
organ

Fig. 23 Divergent Meridians of Foot-Taiyang and Foot-Shaoyin

92 CHINESE ACUPUNCTURE AND MOXIBUSTION

6. Running upward beside the nose and connecting

with the eye before finally jOining the Foot
Yangming Meridian

5. Following alongside the esophagus to reach the mouth

through the heart

Co necting with the stomach and

. dispersing in the spleen

ntering the abdomen

1. Deriving from the Main

of Foot Taiyin on the thi
converging with the Div Deriving from the Main
Meridian of Foot Yangm Meridian of Foot Yangming
on the thigh

Fig. 24 Divergent Meridians of Foot-Yangming and Foot-Tiayin

CHAPTER 5 THE MERIDIANS AND COLLATERALS 93

8. Rejoining the Foot Shaoyang

at the outer canthus
7. Dispersing in the face and
connecting with the eye

6. Following the esophagus an

coming out of the lower m

3. Entering the chest and co

with the Gallbladder
2. Crossing between the low
1. After deriving from the Main
Meridian On the thigh, it
--_ .... --
crossing over the hip point
and entering the lower ai, =-_
the [1ublic re Ion ...........

in the pelvic region and COnv

with the Divergent Meridian
of the Liver Meridian

Fig. 25 Divergent Meridians of Foot-Shaoyang and Foot·Jueyin

94 CHINESE ACUPUNCTURE AND MOXIBUSTION

canthus. (See Fig. 25) Intestine Meridian of Hand Taiyang Af-

2) Divergent Meridian of the Liver ter deriving from the Small Intestine Me-
Meridian of Foot Jueyin After deriving ridian at the shoulder joint, it enters the
from the Liver Meridian on the instep, it axilla, crosses the heart and runs down-
runs upward to the pubic region, and ward to the abdomen to link up with the
converges with the Gallbladder meridian Small Intestine Meridian. (See Fig. 26)
of Foot Shaoyang. (See Fig. 25) 2) Divergent Meridian of the Heart
Meridian of Hand Shaoyin After deriv-
4. The Fourth Confluence ing from the Heart Meridian in the axil-
lary fossa, it enters the chest and con-
1) Divergent Meridian of the Small nects with the heart. Then it runs upward

'ling the Sn-:a:i Intestine rvleridian at the ir,r'le r carrth'.Y.;

nning upwdrd across tne throat and ernerlJ":q .y. ,I: c ' ::
I

~~ ro-
I
I
\
\
. CrossinghM.. Heart
"" J -...J'__~_
-----------
I

1 . Denvlny horn trte i'v1ain ~e ic.'J;a., (:,

Ha:ld Snac~;y!r; in tr,C' a'(:lia~ . f(:s a

Fig. 26 Divergent Meridians of Hand-Taiyang and Hand-Shaoyin

 CHAPTER 5 THE MERIDIANS AND COLLA TERALS 95

across the throat and emerges on the crossing the arm and shoulder to reach the
face, and joins the Small Intestine Merid- breast. A branch separates at the top of the
ian at the inner canthus. (See Fig. 26) shoulder and enters the spine at the nape.
It runs downward to connect with the large
5. The Fifth Confluence intestine and lung. Another branch runs
upward from the shoulder along the throat
1) Divergent Meridian of the Large In- and emerges at the supraclavicular fossa;
testine Meridian of Hand Yangming Af- there it rejoins the Large Intestine Merid-
ter deriving from the Large Intestine Me- ian. (See Fig. 27)
ridian on the hand, it continues upward, 2) Divergent Meridian of the Lung Me-

Ascending aer'];,:, the Thioat and converg,ng with Y

~
.,..-- ~-~----------------- -- ... ~~~

---~.
Yan~min~
trig Witt', the Lung
1. Separating at
the top of the Shoul der
nd entering the Spine
Derjv:r~g frorn Hand Tai nning anter,;:)riv
long Hand Shaoyin into t

Drsper';;ng
\In The Large'lntestine
\,

Fig. 27 The Schematic Diagram for the Divergent Meridians of Hand·Yangming and Hand·Taiyin

-"~~-'~~~-~~----
 96 CHINESE ACUPUNCTURE AND MOXIBUSTION

ridian of Hand Taiyin After deriving 6. The Sixth Confluence

from the Lung Meridian at the axilla, it
runs anterior to the Pericardium Meridi- 1) Divergent Meridian of the Triple
an of Hand Taiyin into the chest, and Energizer Meridian of Hand Shaoyang
there it connects with the lung and then After deriving from the Triple Energizer
disperses in the large intestine. A branch Meridian at the vertex, it descends into
extends upward from the lung and the supraclavicular fossa crosses the up-
emerges at the clavicle, it ascends across per energizer, middle energizer and low-
the throat and converges with the Large er energizer and finally disperses in the
Intestine Meridian. (See Fig. 27) chest. (See Fig. 28)
..--------- ....... --
1. Deriving from the Main
Meridian at the ve
...
-- ... .............
"
"
Emerging behind the ear and then
" .... ....
.... ....
converging with the Hand Shaoyang .... ....

2.

the Divergent Meridian en

with Triple Energizer

Fig.28 Divergent Meridians of Hand·Shaoyang and Hand·Jueyin

CHAPTER 5 THE MERIDIANS AND COLLA TERALS 97

2) Divergent Meridian of the Pericar- All the collaterals possess the function of
dium Meridian of Hand J ueyin After transporting qi to different parts of the
deriving from the Pericardium Channel body. Besides, there are many smaller
at a point three cun below the axilla, it branches and subbranches which are
enters the chest and communicates with called Minute Collaterals and Superfi-
the Triple Energizer. A branch ascends cial Collaterals respectively. These Min-
across the throat and emerges behind the ute and Superficial Collaterals are distri-
ear and then converges with the Triple buted all over the body, possessing the
Energizer Meridian. (See Fig. 28) function of transporting qi and blood to
the body surface.
The fifteen collaterals
The fifteen collaterals-include the 1. The Three Yin Collaterals
twelve collaterals separating from the of Hand
twelve main meridians, the collaterials
1) The Collateral of the Lung Meridian
of the Conception Vessel and Governor
of Hand Taiyin It arises from Lieque
Vessel and the major collateral of the
(LU 7) and runs to the Large Intestine
spleen. They are distributed superficially
Meridian of Hand Yangming. Another
over the four limbs and in the anterior,
branch follows the Lung Meridian of
posterior and lateral aspects of the
Hand Taiyin into the palm of the hand
body. Their function is to connect
and spreads through the thenar emi-
the externally-internally related meridi-
ans and transport the local qi and blood nence. (See Fig. 29)
2) The Collateral of the Heart Meridi-
so as to promote the free circulation of qi
an of Hand Shaoyin It branches out at
and blood of the meridians.
The distribution of the fifteen coIlat- Tongli (HT 5). One cun above the trans-
erals may be summarized as follows: verse crease of the wrist, it connects with
Each of the collaterals has a Luo the Small Intestine Meridian of Hand
(Connecting) point, pertaining to the me- Taiyang. About one and a half cun above
ridian where it derives. The collaterals the wrist, it again follows the meridian
on the four limbs not only run to and enters the heart; it then runs to the
the externally-internally related meridi- root of the tongue and connects with the
ans but also possess other tributaries. The eye. (See Fig. 29)
collaterals on the trunk and collateral of 3) The Collateral of Pericardium Me-
the Conception Vessel disperse in the ab- ridian of Hand Jueyin It begins from
dominal region. The Collateral of Gover- Neiguan (PC 6). Two cun above the
nor Vessel disperses in the head and joins wrist, disperses between the two tendons
with the Bladder Meridian on the back. and runs along the Pericardium Meridian
The major collateral of the spleen dis- to the Pericardium, and finally connects
perses in the chest and hypochondrium. with the heart. (See Fig 29)

-------------------------
98 CHINESE ACUPCNCTCRE AND MOXIBUSTION

Running along
the arm to Jlanyu

Connecting with
the Hand Shaoyin

he
T6:vang rY1 ;<did,.1

Fig. 29 The Three Yin Collaterals of Hand and Three Yang Collaterals of Hand

2. The Three Yang Collaterals of Hand Fig. 29)

2) The Collateral of the Small Intestine
1) The Collateral of the Large Intestine Meridian of Hand Taiyang It originates
Meridian of Hand Yangming It starts from Zhizheng (SI 7). Five cun above the
from Pianli (LI 6) and joins the Lung wrist, it connects with the Heart Meridi-
Meridian of Hand Taiyin three cun above an. Another branch runs upward, crosses
the wrist. Another branch runs along the the elbow and connects with Jianyu (LI
arm to Jianyu (LI 15), crosses the jaw 15). (See Fig. 29)
and extends to the teeth. Still another 3) The Collateral of the Triple Energiz-
branch derives at the jaw and enters the er Meridian of Hand Shaoyang I t arises
ear to join the Thoroughfare Vessel. (See from Waiguan (TE 5), two cun above the
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 99

dorsum of the wrist, it travels up the (See Fig. 30)

posterior aspect of the arm and over the 2) The Collateral of the Kidney Merid-
shoulder, disperses in the chest, converg- ian of Foot Shaoyin It originates from
ing with the Pericardium Meridian. (See Dazhong (KI 4) on the posterior aspect
Fig. 29) of internal malleolus, it crosses the heel,
and joins the Bladder Meridian. A branch
3. The Three Yang Collaterals follows the Kidney Meridian upward to a
of Foot point below the pericardium and then
pierces through the lumbar vertebrae.
1) The Collateral of the Stomach Me- 3) The Collateral of the Liver Meridian
ridian of Foot Yangming It starts from of Foot Jueyin It starts from Ligou (LR
Fenglong (ST 40), eight cun above the 5), five cun above the internal malleolus
external malleolus, it connects with the and connects with the Gallbladder Merid-
Spleen Meridian. A branch runs along ian. A branch runs up the leg to the
the lateral aspect of the tibia upward to genitals. (See Fig. 30)
the top of the head, and converges with
the other Yang Meridians on the head
5. The Collaterals of the Conception
and neck. From there it runs downward
to connect with the throat. (See Fig. 30) and Governor Vessels and
2) The Collateral of the Bladder Merid- the Major Collateral of
ian of Foot Taiyang It arises from Fei- the Spleen
yang (BL 58), seven cun above the ex-
1) The Collateral of the Conception
ternal malleolus, it connects with the
Vessel It separates from the Governor
Kidney Meridian.
Vessel at the lower end of the sternum.
3) The Collateral of the Gallbladder
From Jiuwei (CV IS), it spreads over the
Meridian of Foot Shaoyang It begins
abdomen. (See Fig. 31)
from Guangming (GB 37), five cun
2) The Collateral of Governor Vessel
above the external malleolus, it joins the
It arises from Changqiang (GV 1) in the
Liver Meridian, and then runs downward
perineum, runs upward along both sides
and disperses over the dorsum of the
foot. (See Fig. 30) of the spine to the nape, and spreads over
the top of the head. When it gets to the
scapular regions, it connects with the
4. The Three Yin Collaterals of Foot
Bladder Meridian and pierces through
1) The Collateral of the Spleen Merid- the spine. (See Fig. 3 I)
ian of Foot Taiyin It branches out at 3) The Major Collateral of the Spleen
Gongsun (SP 4), one cun posterior to the It begins from Dabao (SP 21), emerges at
base of the first metatarsal bone, and three cun below Yuanye (GB 22) and
then joins the Stomach Meridian. A spreads through the chest and hypochon-
branch runs upward to the abdomen and driac region, gathering the blood all over
connects with the stomach and intestines. the body. (See Fig. 32)
100 CHINESE ACUPUNCTURE AND MOXIBUSTION

Converging with
the other yang
meridians on the
head and neck

Ligou Conver~inF Feiyang

with Shaoyang englon~ Converging
Converging with Shaoyin
with Taiyin
Gongsun Converging
with Yallgm1ng Converging with
ueyin and
dispersing over
the dorsum of the foot

Fig. 30 The Three Yang Collaterals of Foot and Three Yin Collaterals of Foot
CHAPTER 5 THE MERIDIANS AND COL LATERALS 101

p cf the head

to the nape
5. Reaching e scapu,e~
and con ecting wit
the Taiy g Meridian /, O'{'"
-- /
/

/
. ',,--

through the ine " reading over

,,
2. Runn g upward
~ ~ohsides
of the 5 ne

Fig.31 The Coliaterals of Conception and Governor Vessels

V. THE TWELVE MUSCLE muscle regions are deeply distributed un-

der the skin, while the cutaneous regions
REGIONS AND TWELVE are located in the superficial layers of the
CUTANEOUS REGIONS skin. As cutaneous regions cover an ex-
tensive area, they are generally known as
The muscle regions and cutaneous re- cutaneous regions of six meridians.
gions are the sites where the qi and blood
of the meridians nourish the muscles, 1. The·Twelve Muscle Regions
tendons and skin. Similar to the twelve
main meridians, they are also divided The twelve Muscle Regions, the con-
into three hand yin and three hand yang, duits which distribute the qi and blood of
three foot yin and three foot yang. The the twelve main meridians to nourish the

--------------------- - - - - - - - - - - - -------- -- ------------

102 CHINESE ACL'PUNCTURE AND MOXIBUSTION

the trunk, all connecting with the eyes;

the three yin Muscle Regions of the foot
connect with the genital region; the three
yang M usc1e Regions of the hand connect
with the angle of forehead; the three yin
Muscle Regions of the hand connect with
the thoracic cavity. In the treatment of
diseases, the Muscle Regions are mainly
indicated in muscular problems, such as
the hi syndrome, contracture, stiffness,
spasm and muscular atrophy. In Chapter
J Hvooch )ndr~3c. 13 of Miraculous Pivot, it says, "Where
~ao ~~ ~--- '-'9''):' there is pain, there is an acupuncture
,
point." That means muscle problems can
be treated by needling the local points.
1) Three Yang Muscle Regions of Foot
a) Muscle Region of Foot Taiyang
(Bladder) It starts from the little toe,
ascends to knot at external malleolus and
then at the knee. A lower branch sepa-
rates below the external malleolus, ex-
tending to the heel, and runs upward to
knot at the lateral aspect of the popliteal
fossa. Another branch starts at the con-
Fig. 32 The Major Collateral of the Spleen
vergence of the medial and lateral heads
of the gastrocnemius muscle and ascends
to knot at the medial side of the popliteal
muscles, possess the function of connect- fossa. These two branches join in the
ing all the bones and joints of the body gluteal region and then ascend along the
and maintaining the normal range of mo- side of the spine to the nape, where a
tion. The distribution is described as fol- branch enters the root of the tongue.
lows: Above the neck, the straight portion
The Muscle Regions originate from knots with the occipital bone and crosses
the extremities of the limbs and ascend to over the top of the head to knot at the
the head and trunk, but do not reach nose bridge. A branch spreads around the
zang and fu organs. Thus, they are not eye and knots at the side of below the
related to the zang-fu organs, and flow of nose. Another branch extends from the
qi and blood. The three yang Muscle lateral side of the posterior axillary fold
Regions of the foot are distributed in the to knot with Jianyu (LI 15). Another
anterior, lateral and posterior aspects of branch enters the chest below the axilla,
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 103

#1/1#--
-------- ...... ......

.---...., ,
.,'

Fig. 33 Muscle Region of Foot-Taiyang

\04 CHINESE ACUPUNCTURE AND MOXIBUSTION

emerges from the supraclavicular fossa to the lower ribs to connect with the
and then knots at Wangu (GB 12) behind spine. The straight branch runs along the
the ear. Still, another branch emerges tibia and knots at the knee. A subbranch
from the supraclavicular fossa and trav- connects with the fibula, and joins with
erses the face to come out beside the the Foot Shaoyang (Gallbladder). From
nose. (See Fig. 33) the knee, it ascends across the thigh and
b) Muscle Region of Foot Shaoyang knots in the pelvic region. Dispersing
(Gallbladder) It originates from the upward on the abdomen and knotting at
fourth toe, knots with the external mal- Quepen (ST 12), it extends to the neck
leolus. Then it ascends along the lateral and mouth, meeting at the side of the
side of the tibia where it knots with the nose and knotting below the nose. Above,
knee. A branch begins at the upper part it joins with the Foot Taiyang (Bladder)
of the fibula and continues upward along to form a muscular net around the eye. A
the thigh. One of its subbranches runs subbranch separates at the jaw and knots
anteriorly, knotting above Futu (ST 32). in front of the ear. (See Fig. 35)
Another subbranch runs posteriorly and 2) Three Yin Muscle Regions of Foot
knots with the sacrum. The straight a) Muscle Region of Foot Taiyin
branch ascends across the ribs, dispersing (Spleen) It starts from the medial side
around and anterior to the axilla, con- of the big toe and knots at the internal
necting first at the breast region and malleolus. Continuing upward and knot-
then knotting at Quepen (ST 12). Anoth- ting at the medial side of the knee, it
er branch extends from the axilla upward traverses the medial aspect of the thigh,
across the clavicle, emerging in front of and knots at the hip. Then it joins with
the Foot Taiyang (Bladder) Muscle Re- the external genitalia and extends to the
gion where it continues upward behind abdomen, knotting with the umbilicus.
the ear to the temple. Then, it proceeds From there, it enters the abdominal cav-
up to the vertex to join its bilateral coun- ity, knots with the ribs, and disperses
terpart. A branch descends from the tem- through the chest. An internal branch
ple across the cheek and then knots be- adheres to the spine. (See Fig. 36)
side the bridge of the nose. A subbranch b) Muscle Region of Foot Jueyin (Liver)
knots with the outer canthus. (See It originates from the dorsum of the big
Fig. 34) toe and knots anterior to the internal
c) Muscle Region of Foot Yangming malleolus. Then it runs upward along the
(Stomach) It arises from the second, medial side of the tibia and knots at the
middle and fourth toes, knots at the dor- lower, medial aspect of the knee. From
sum of the foot, and ascends obliquely there, it runs upward along the medial
along the lateral aspect of the leg where aspect of the thigh to the genital region,
it disperses at the tibia and then knots at where it converges with other Muscle
the lateral aspect of the knee. Ascending Regions. (See Fig. 37)
directly to knot at the hip joint, it extends c) Muscle Region of Foot Shaoyin (Kid-
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 105

Fig. 34 Muscle Region of Foot-Shaoyang

106 CHINESE ACUPUNCTURE AND MOXIBUSTION

~~~

----------

Fig. 35 Muscle Region of Foot·Yangming

CHAPTER 5 THE MERIDIANS AND COLLA TERALS 107

-------------

Fig. 36 Muscle Region of Foot-Taiyin

108 CHINESE ACUPUNCTURE AND MOXIBUSTION

ney) It begins beneath the little toe. To-

gether with the Muscle Region of Foot
Taiyin, it runs obliquely below the inter-
nal malleolus and knots at the heel, con-
verging with Muscle Region of Foot Tai-
yang (Bladder), knotting at the lower,
medial aspect of the knee, it joins with
Muscle Region of Foot Taiyin (Spleen)
and ascends along the medial aspect of
the thigh to knot at the genital region. A
branch proceeds upward along the side of
the spine to the nape and knots with the
occipital bone, converging with the Mus-
cle Region of Foot Taiyang (Bladder).
(See Fig. 38)
3) Three Hand Yang Muscle Regions
a) Muscle Region of Hand Taiyang
(Small Intestine) It starts from the tip of
the small finger, knots at the dorsum
of the wrist, and proceeds up along the
forearm to knot at the medial condyle of
the humerus in the elbow. Then it contin-
ues up along the arm and knots below the
axilla. A branch runs behind the axilla,
curves around the scapula and emerges in
front of the Foot Taiyang (Bladder) on
the neck, knotting behind the ear. A
branch separates behind the auricle and
enters the ear. Emerging above the auri-
cle, the straight branch descends across
the face and knots beneath the mandible,
then continues upward to link the outer
canthus. Another branch starts at the
mandible, ascends around the teeth and
in front of the ear, connects the outer
canthus and knots at the angle of the
forehead. (See Fig. 39)
b) Muscle Region of Hand Shaoyang
(Triple Energizer) It starts from the ex-
Fig, 37 Muscle Region of Foot·Jueyin
tremity of the fourth finger and knots at
CHAPTER 5 THE MERIDIANS AND COLLATERALS 109

Fig. 38 Muscle Region of Foot-Shaoyin

110 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 39 Muscle Region OT Hand-Taiyang Fig. 40 Muscle Region of Hand-Shaoyang

the dorsum of the wrist. Then, it ascends c) Muscle Region of Hand Yangming
along the forearm and knots at the olec- (Large Intestine) It begins from the ex-
ranon of the elbow. Proceeding upward tremity of the index finger and knots at
along the lateral aspect of the upper arm, the dorsum of the wrist. Then it goes
it crosses the shoulder and the neck, then upward. along the forearm, and knots at
converges with the Muscle Region of the lateral aspect of the elbow. Continu-
Hand Taiyang (Small Intestine). A ing up the arm, it knots at Jianyu (LI 15).
branch splits out at the angle of the man- A branch moves around the scapula and
dible and connects with the root of the attaches to the spine. The straight branch
tongue, Another branch proceeds upward continues 'from Jianyu (LI 15) to the
in front of the ear to the outer canthus, neck, where a branch separates and knots
then crosses the temple and connects at at the side of the nose. The straight
the corner of the forehead. (See Fig. 40) branch continues upward and emerges in
CHAPTER S THE MERIDIANS AND COLLA TERALS III

front of Muscle Meridian of Hand Tai- aspect of the arm and enters the chest
yang (Small Intestine). Then it crosses below the axilla. Emerging from Quepen
over the head, connecting at the mandible (ST 12), it knots anteriorly to Jianyu (LI
on the opposite side of the face. (See IS). Above, it knots with the clavicle, and
Fig. 41) below it knots in the chest, dispersing
4) Three Hand Yin Muscle Regions over the diaphragm and converging again
a) Muscle Region of Hand Taiyin at the lowest rib. (See Fig. 42)
(Lung) It arises from the tip of the b) Muscle Region of Hand Jueyin (Per-
thumb and knots at the lower thenar icardium) It arises from the palmar as-
eminence. Proceeding up laterally to the pect of the middle finger and follows the
pulse and along the forearm, it knots at Muscle Region of Hand Taiyin (Lung)
the elbow, then ascends along the medial upward. It first knots at the medial aspect

~~~~"-'/
---) \.
. . ~ ~.

....., /
'to. :~.
-.;'
.')
',-@:,J

Fig.41 Muscle Region of Hand-Yangming

-~.----- --- --- - _ . _ - - - - - - - _... - - - - - - - - - -

112 CHINESE ACUPUNCTURE AND MOXIBUSTION

Fig. 43 Muscle Region of Hand-Jueyin Fig. 42 Muscle Region of Hand-Taiyin

of the elbow, and afterwards below the uing upward and entering the chest below
axilla. Then it descends, dispersing at the the axilla, it crosses the Muscle Region of
front and back sides of the ribs. A branch Hand Taiyin (Lung) in the breast region
enters the chest below the axilla and and knots in the chest. Then it descends
spreads over the chest, knotting in the across the thoracic diaphragm to connect
thoracic diaphragm. (See Fig. 43) with the umbilicus. (See Fig. 44)
c) Muscle Region of Hand Shaoyin
(Heart) It begins from the medial side 2. The Twelve Cutaneous Regions
of the small finger, knots first at the
pisiform bone of the hand, and afterward The twelve cutaneous regions refer to
at the medial aspect of the elbow. Con tin- the sites through which the qi and blood
CHAPTER 5 THE MERIDIANS AND COLLA TERALS 113

Fig. 44 Muscle Region of Hand-Shaoyin

of the meridians are transferred to the taneous regions are twelve distinct areas
body surface. In the ancient medical clas- on the body surface within the domains
sics in Chapter 56 of Plain Questions, it of the twelve main meridians. It is also
says, "The Cutaneous Regions are the known as cutaneous regions of six merid-
part of meridian system located in the ians when the Hand and Foot meridians
superficial layers of the body, the Cu- are combined into six pairs. Since the
taneous Regions are marked by the regu- cutaneous regions are the most superfi-
lar meridians." In other words, the cu- cial part of the body tissues, they bear the
114 CHINESE ACCPUNCTURE AND :VIOXIBCSTION

protective function of the organism. laterals. It says again in Chapter 56 of

When this function is lost, the exogenous Plain Questions, "Blue-coloured skin sig-
pathogen may penetrate the skin to in- nifies local pain. Dark-coloured skin indi-
vade the collaterals and gain access to cates blockage of qi and blood. Yellow
meridians and zang-fu organs. In Chap- to red coloured skin refers to heat syn-
ter 56 of Plain Questions, it says, "Skin is dromes, and white coloured skin the cold
the place where the meridians are distrib- syndromes." Obviously, colour changes
uted. When the pathogen attacks the of the skin can tell presence of internal
skin, the sweat pores will open, and then disorders. Therapeutically, the cutaneous
the pathogen may advance toward the regions of paired meridians are interac-
collaterals, meridians and zang-fu organs tive. There are meridians of Hand-Yang-
through the sweat pore." The transmit- ming and Foot-Yangming. The meridian
ting order of a disease is: Skin-collat- of Hand-Yangming starts at the hand and
erals-meridians-zang organs-fu or- goes to the head, while the meridian of
gans. Conversely, symptoms and signs of Foot-Yangming originates in the head
internal diseases can also be projected and runs to the foot. They are diagnosti-
onto the skin through meridians and col- cally and therapeutically interactive.
 Chapter 6
AN INTRODUCTION TO
ACUPUNCTURE POINTS
Acupuncture points are the specific points distributed over the human body.
sites through which the qi of the zang-fu A great deal of work has been accom-
organs and meridians is transported to the plished by medical workers in the past to
body surface. The Chinese characters" JIfl generalize and systematize acupuncture
1C" for an acupuncture point mean res- points, which have been classified either
pectively "transportation" and "hole." In "by meridians" or "by body parts." Gen-
the medical literature of the past dynasties, erally speaking, acupuncture points fall
acupuncture points, the sites where acu- into the following three categories in
puncture treatment is applied, have other terms of their evolution.
terms such as "qi point" and "aperture." 1) Acupuncture points of the four-
Acupuncture points are not only the path- teen meridians Also known as "merid-
ways for the circulation of qi and blood, ian points," acupuncture points of the
but also the loci of response to diseases. In fourteen meridians are distributed along
acupuncture and moxibustion treatment, the twelve main meridians, the Governor
proper techniques are applied on the acu- Vessel and the Conception Vessel, totally
puncture points to regulate the functional amounting to 361. According to ancient
activities of the body, strengthen body re- medical records, the acupuncture points
sistance so as to prevent and treat diseases. of this category are the crystallization of
Medical practitioners of past ages have left rich clinical experience of medical work-
plentiful recordings describing the lo- ers in the past. All the points in this
cations and indications of acupuncture category can be used to treat disorders
points, formulating a systematical theory. of the related meridians and collaterais.
They are the most commonly used points
and form the main part of all acupunc-
I. CLASSIFICATION AND ture points. Those of the twelve main
NOMENCLATURE OF meridians are distributed symmetrically
ACUPUNCTURE POINTS in pairs on the left and right sides of the
body, while those of the Governor and
1. Classification of Acupuncture Points Conception vessels are single ones, align-
ing on the posterior and anterior midlines
There are numerous acupuncture respectively.
115
116 CHINESE ACCPUNCTURE AND MOXIBCSTION

2) Extra Points Extra points are ex- 2. Nomenclature of Acupuncture

periential points with specific names and Points
definite locations, but are not attributed
to the fourteen meridians. They are effec- Acupuncture points of the fourteen
tive in the treatment of certain diseases. meridians have their definite locations
Although scattered over the body, they and names. It is stated in Chapter 5 of
are still related to the meridians system. Plain Questions, Acupuncture points are
Some extra points are distributed along the sites into which qi and blood are
the courses of the fourteen meridians, for infused. Each has its own location and
example, Yintang (Extra I) is related to name." Precious Supplementary Prescrip-
the Governor Vessel, Lanwei (Extra 18) tions further points out, "Each point
is named with profound significance,"
to the Stomach Meridian of Foot-
which indicates that the name of each
Yangming. A survey of the ancient acu-
point has its own meaning.
puncture literature has revealed that
Most of the acupuncture points are
some meridian points were developed
nominated by way of analogy. The flow
from the extra points. Examples are
of qi and blood is similized by that of
Gaohuang (BL 43), which was added to
water; the prominence and depression of
the meridian points in Illustrated Manual
the tendons and bones are compared to
ofAcupuncture Points on the Bronze Figure
mountains and valleys; the characteristic
and Meichong (BL 3), which was add- local shape of the body is signified by
ed to the meridian points in Classic of
certain animals or utensils; and the acu-
Health-Promoting Acupuncture. Both were puncture point functions are analogized
formerly extra points. Therefore, extra by architectural structures, astronomical
points are said to be the preceding coun- or meteorological phenomena. Examples
terparts of meridian points. Clinically, are as follows.
they are the supplement to meridian 1) Names bearing analogy to water
points. flow, mountains and valleys Quchi (L I
3) Ashi Points Ashi Points are also 11, Crooked Pond), Chize (LU 5, Ulnar
called "reflexing points." "unfixed points" Marsh), Shaohai (HT 3, Young Sea), Tai-
or "tender spots." Chapter 13 of Mirac- yuan (LU 9, Great Deep Pool), Zhigou
ulous Pivot says, "Tender spots can be (TE 6, Limb Ditch), Jingqu (LU 8, Chan-
used as acupuncture points," and this was nel Ditch), Sidu (TE 9, Four Rivers),
the primary method for point selection in Fuliu (KI 7, Continuing Water Flow),
early acupuncture and moxibustion treat- Houxi (SI 3, Back Stream), Zhongzhu
ments. Without specific names and defin- (TE 3, Middle Water Margin), Hegu (LI
ite locations, Ashi Points are considered 4, Connected Valleys), Chengshan (BL
to represent the earliest stage of acupunc- 57, Sustaining Mountain), Liangqiu (ST
ture point evolution. Clinically, they are 34, Hill Ridge), Qiuxu (GB 40, Large
mostly used for pain syndromes. Mound), Yanglingquan (GB 34, Yang
CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 117

Mound Spring). 5) Points named according to anatomi-

2) Names bearing analogy to animals, cal terms Zhongwan (CY 12, Middle
plants or utensils Yuji (LU 10, Fish Stomach), Henggu (KIll, Pubis), Jianyu
Border), Dubi (ST 35, Calf Nose), Jiuwei (Ll 15, Shoulder Corner), Binao (Ll 14,
(CY 15, Turtledove Tail), Futu (ST 32, Arm Muscle Prominence), Zhouliao (LI
Prostrate Rabbit), Zanzhu (BL 2, As- 12, Elbow Foramen), Wangu (SI 4, Wrist
sembled Bamboo), Dazhu (BL 11, Large Bone), Biguan (ST 31, Thigh Joint), Jue-
Shuttle), Jiache (ST 6, Cheek Vehicle), gu (GB 39, External Malleolus).
Quepen (ST 12, Depression Basin), 6) Points named according to their
Tianding (LI 17, Heavenly Cooking Yes- therapeutic properties Feishu (BL 13,
sel). Lung Point), Guangming (GB 37, Bright-
3) Names bearing analogy to architec- ness), Chengqi (ST 1, Tear Receiver),
tural structure Shenmen (HT 7, Chengjiang (CY 24, Fluid Receiver),
Spiritual Gate), Qihu (ST 13, Qi Qihai (CY 6, Sea of Qi), Xuehai (SP 10,
Gate), Yingchuang (ST 16, Chest Win- Sea of Blood), Guangyuan (CY 4, Stor-
dow), Tilmyou (TE 16, Heaven Win- age of Primary Qi), Jingming (BL 1,
dow), Tiantu (CY 22, Heaven Chimney), Brightening Eyes), Yingxiang (LI 20,
Quyuan (SJ 13, Curved Wall), Tinggong Welcome Fragrance).
(S I 19, Hearing Palace), Neiting (ST
44, Interior Courtyard), Zhongfu (LU 1,
Central Mansion), Qishe (ST 11, Qi Res- II. Methods of Locating
idence), Dicang (ST 4, Earth Granary), Acupuncture Points
Kufang (ST 14, Storehouse), Zhishi (BL
52, Will Chamber), Yutang (CY 18, Jade Location of acupuncture points,
Palace), Bulang (KI 22, Step Corridor), whether accurate or not, will affect the
Lingtai (GY 10, Spirit Platform), Nei- therapeutic results. Great importance
guan (PC 6, Medial Pass), Juque (CY therefore has been attached to precise
14, Great Palace Gate), Fengshi (GB 31, location of acupuncture points by medi-
Windy Fair), Xiongxiang (SP 19, Chest cal practitioners in past ages.
Village), Jianjing (GB 21, Shoulder In the chapter Lyrics of Acupuncture
Well). and Profundities of Compendium of Acu-
4) Names bearing analogy to astronom- puncture and Moxibustion, it is said,
ical and meteorological phenomena Ri- "Methods of locating points are based on
yue (GB 24, Sun and Moon), Shangxing standard measurements. An acupunctur-
(GY 23, Upper Star), Taiyi (ST 23, ist should first of all have a clear idea of
Grand Yi "the second of the ten Heavenly these measurements and patient's body
Stems"), Taibai (SP 3, Venus), Xuanji build, and then observe the anatomical
(CY 21, the 2nd and 3rd stars of the Big landmarks on the patient. Some points
Dipper), Fengchi (GB 20, Wind Pool), should be located with the limbs flexed,
Yunmen (LU 2; Cloud Door). some with the body in a lying position .... "
118 CHINESE ACUPUNCTURE AND MOXIBUSTION

At present, commonly used in clinics of Miraculous Pivot. In the light of this

are three methods of acupuncture point record, the width or length of various
location, i.e., proportional measurement, portions of the human body are divid-
anatomical landmarks, and finger meas- ed respectively into definite numbers of
urement.
equal units as the standards for the pro-
portional measurement. These standards
1. Proportional Measurements
are applicable on any patient of different
The earliest record of proportional sexes, ages and body sizes. See Fig. 45 and
measurement can be found in Chapter 14 Table 5 for details.

f-r+---':_~ (. I).,
II ,

~ 7 18cun

I
,
/,/
" ,119cun
'

I ,
",.'
,
---~r--~I+.J.,,.a. ,
or'.. •..(
\ I
, I

16 cun

Fig.45 Bone Proportional Cun

 (")
::t

Table 5. Standards for Bone Proportional Measurement ~

::0
0,

;,.
z
Body Part Distance I Bone Propor- I Method Explana tion
..,Z
, tional Measure-
ment (cun) I
j . gc:::
From the anterior hairline to 12 cun Longitudinal The distance from the glabella to the anterior
..,
(")

Head o
z
the posterior hairline measurement hairline is taken as 3 cun. The distance from
Dazhui (GV 14) to the posterior hairline is Cl
taken as 3 cun. If the anterior and posterior ;,.
(")

hairlines are indistinguishable, the distance c:::

."
c:::
from the glabella to Dazh ui (G V 14) then is Z
(")

I taken as 18 cun. 2
::0
Between the two mastoid I 9 cun i Transverse meas- The transverse measurement is also used to '"
processes urement localize other points on the head. 2l
..,z
I.

(Jo

Chest and From the sternocostal angle to 8 cun ~ Longitudinal . The Longitudinal measurement of the chest
Abdomen the centre of the umbilicus measurement I and the hypochondriac region is generally
based on the intercostal space.
Between the centre of the 5 cun
umbilicus and the upper
border of symphysis pubis
Between the two nipples 8 cun Transverse meas- The distance between the bilateral Quepen
1

urement
j i (ST 12) can be used as the substitute of the
I transverse measurement of the two nipples.
1
1
!
Back Between the medial border of the 3 cun Transverse meas- 1

scapula and the posterior midline urement

,/
/'
/.~.- ...-- I I
thoracic vertebra, the iliac spine is about at the
same level of the 4th lumbar vertebra.

~
 tv
o

Lateral From the end of the axillary fold I 12 cun I Longitudinal

Side of on the lateral side of the chest to I measurement !
i i
the Chest the tip of the 11 th rib i
i I
Upper Ex Between the end of the axillary fold 9 cun I Longitudinal I Used for the three Yin and the three Yang
tremities and the transverse cubital crease I , measurement i Meridians of the Hand.
Between the transverse cubital 12 cun
crease and the transverse wrist
crease i
:
Lower Ex From the level of the upper border 18 cun I Longitudinal Used for the three Yin Meridians of the Foot.
tremities of symphysis pubis to the medial I measurement
epicondyle of femur
From the lower border of the 13 cun
medial condyle of tibia to the II I
tip of medial malleolus I I

From the prominence of the great 19 cun Longitudinal 1. Used for the three Yang Meridians of the
trochanter to the middle of patella measurement Foot.
i 2. The distance from the gluteal crease to the ()
I centre of patella is taken as 14 cun. ::r:
Z
I 3. The anterior level of the centre of the patella '" (f;

is about the same level of Dubi (ST 35), and '"

the posterior level, about the same level of ~
C
'"0
Weizhong (BL 40). c::
Z
Between the centre of patella and 16 cun I ...,()
I I c::
the tip of lateral malleolus i i ::>0

From the tip of the lateral 3 cun

I
'"
:>-
z
malleolus to the heel ti
, I
a::
o><:
@
c
...,uo
(5
z
CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 121

2. Anatomical Landmarks 1) Middle finger measurement When

the patient's middle finger is flexed, the
Various anatomical landmarks on the
distance between the two medial ends of
body surface are the basis for locating
the creases of the interphalangeal joints
points. Those landmarks fall into two
categories. is taken as one cun. This method is em-
1) Fixed landmarks Fixed landmarks ployed for measuring the vertical dist-
are those that would not change with ance to locate the limb points of the yang
body movement. They include the five meridians, or for measuring the horizon-
sense organs, hair, nails, nipple, umbili- tal distance to locate the points on the
cus, and prominence and depression of back. (See Fig. 46)
the bones. With them, it is easy to locate
points. The proportional measurement is
established on the basis of these ana tom-
icallandmarks. However, points that are
adjacent to or on such landmarks can be
located directly. Examples are Yintang
(Extra I) between the two eyebrows, Su-
liao (GV 25) on the tip of the nose, and
Shenque (CV 8) in the centre of the
umbilicus.
2) Moving landmarks Moving land-
marks refer to those that will appear only
when a body part keeps in a specific
position. For instances, when the arm Fig. 46
is flexed and the cubital crease appears,
Quchi (LI 11) can be located; and when
a fist is made and the transverse palmar 2) Thumb measurement The width of
crease appears, Houxi (SI 3) can be locat- the interphalangeal joint of the patient's
ed. Also employed in clinic are some sim- thumb is taken as one cun. The method
ple methods of point location. For exam- is also employed for measuring the verti-
ple, to locate Baihui (GV 20) directly cal distance to locate the points on the
above the apexes of the ears, or Fengshi limbs. (See Fig. 47)
(GB 31) when at attention. 3) Four-finger measurement The
width of the four fingers (index, middle,
3. Finger Measurement ring and little) close together at the level
of the dorsal skin crease of the proximal
The length and width of the patient's interphalangeal joint of the middle finger
finger(s) are taken as a standard for point is taken as three cun. It is used to locate
location. The following three methods the points on the limb and in the abdom-
are commonly used in clinic. inal region. (See Fig. 48)
122 CHINESE ACCPUNCTCRE AND MOXIBCSTION

1. SpeCific Points on the Limbs

1) Five Shu Points Each of the
twelve main meridians has, below the el-
bow or knee, five specific points, name-
ly, ling-Well, Ying-Spring, Shu-Stream,
ling-River and He-Sea, which are termed
Five Shu points in general. They are sit-
uated in the above order from the distal
end of extremities to the elbow or knee.
It is said in the first chapter of Mirac-
ulous Pivot that "the qi of the twelve main
Fig. 47 meridians and fifteen collaterals flow all
over the body. The flow of qi running in
the meridians from the extremities to the
elbow or knee is flourishing gradually."
The names of the five shu points image
the flow of meridian qi as the flow of
water. The ling-Well point is situated in
the place where the meridian qi starts to
bubble. The Ying-Spring point is where
the meridian qi starts to gush. The Shu-
Stream point is where the meridian qi
flourishes. The ling-River point is where
the meridian qi is pouring abundantly.
Finally, the He-Sea point signifies the
confluence of rivers in the sea, where the
meridian qi is the most flourishing.
Fig. 48 In addition, each of the six fu organs
has another He-Sea point in the three yang
meridians of the foot, known as the Lower
III. SPECIFIC POINTS He-Sea point. Chapter 4 of Miracular Pivot
says, "The Lower He-Sea Points of the
Specific points refer to those of the stomach, large intestine, small intestine,
fourteen meridians that have special Triple Energizer, bladder and gallbladder
properties and are grouped under special are Zusanli (ST 36), Shangjuxu (ST 37),
names. In view of their locations, they Xiajuxu (ST 39), Weiyang (BL 39), Wei-
can be classified into two major groups: zhong (BL 40) and Yanglingquan (GB 34)
one on the limbs, and the other one on respectively. Among these points, Zusanli
the head and the trunk. (ST 36), Weizhong (BL 40) and Yang-
CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 123

lingquan (GB 34) overlap with the rele- 4) Xi-Cleft Points The Xi-Cleft
vant He-Sea points in the Five Shu points. Point is the site where the gi and blood
The Lower He-Sea points are mostly em- of the meridian are deeply converged.
ployed to treat the disorders of the six f u Each of the twelve main meridians and
organs in clinic. the four extra meridians (Yin Heel Ves-
2) Yuan-Primary Points Each of the sel, Yang Heel Vessel, Yin Link Vessel
twelve main meridians has a Yuan- and Yang Link Vessel) has a Xi-Cleft
Primary Point, which is located on Point on the limbs, amounting to sixteen
the limbs. The Chinese character "JJJi:" in all. The Xi-Cleft Point is used to treat
(Yuan) means primary qi in this context. acute disorders in the area supplied by its
The chapter "The 66th Medical Problem" pertaining meridian and those of its per-
in Classic of Medical Problems describes taining zang or fu organ.
the relation between the Yuan-Primary S) Eight Confluent Points Eight Con-
Points and Yuan-Primary Qi. fluent Points refer to the ~ight points on
The Yuan-Primary Qi, originating be- the limbs where the main meridians com-
low the umbilicus and between the kid- municate with the eight extra meridians.
neys, is dispersed to the zang-fu organs They are Neiguan (PC 6), Gongsun (SP
and further to the limbs via Triple Ener- Al Houxj (SI 3), Shenmai (BL 62), Wai-
gizer. The sites where the Yuan-Primary guan (TE 5), Zulinqi (GB 41), Lieque
Qi is retained are Yuan-Primary Points, (LU 7) and Zhaohai (KI 6), which are
which are used to treat disorders of the respectively connected with the Yin Link
zang-fu organs. In the yin meridians, the Vessel, Thoroughfare Vessel, governor
Yuan-Primary Points overlap with the Vessel, Yang Heel Vessel, Yang Link
Shu-Stream Points of the Five Shu Vessel, Belt Vessel, Conception Vessel
Points. Each yang meridian, however, has and Yin Heel Vessel. The Eight Con-
its Yuan-Primary Point other than the fluent Points are used to treat a variety
Shu-Stream Point. of disorders of the corresponding eight
3) Luo-Connecting Points Each of extra meridians.
twelve main meridians has, on the limbs,
a Luo-Connecting Point to link its 2. Specific Points on the Head
exteriorly-interiorly related meridian. and Trunk
Each of the Governor and Conception
vessels, and the Major Collateral of the 1) Back-Shu Points Back-Shu points
~pleen has its Luo-Connecting Point on are specific points on the back where the
the trunk. They are termed "the Fif- qi of the respective zang-fu organs is
teen Luo-Connecting Points." A Luo- infused. It is stated in Chapter 51 of
Connecting Point is used to treat dis- Miraculous Pivot that "in the Back-Shu
orders involving the two exteriorly- Points you are looking for the reaction-
interiorly related meridians and those in ary spots of tenderness and soreness, or
the area supplied by the two meridians. the points on which pressure exerted re-
 124 CHINESE ACUPUNCTURE AND MOXIBUSTION

lieves pain and discomforts of the pa- gans, fu organs, qi, blood, tendon, vessel,
tient." Situated close to their respective- bone or marrow.
ly related zang-fu organs, the Back-Shu
points present abnormal reactions to the
dysfunction of their corresponding zang- IV. AN OUTLINE OF THE
fu organs. They are often used for disor- THERAPEUTIC
ders of the internal organs. PROPERTIES OF THE
2) Fro~t-Mu Points Front-Mu points POINTS OF THE FOURTEEN
are those points on the chest and abdomen
where the qi of the respective zang-fu or- MERIDIANS
gans is infused and converged. Located
close to their corresponding zang-fu or- The therapeutic properties of the
gans, the Front-Mu points playa signifi- points of the fourteen meridians are gen-
cant role in the diagnosis and treatment of eralized on the basis of the principle that
the disorders of the internal organs. the course of the meridian is amenable to
.3) Crossing Points Crossing points are treatment. Each of the points has its own
. those at the intersections of two or more therapeutic feature owing to its particu-
meridians. Distributed mainly on the. lar location and pertaining meridian. Ge-
head, face and trunk, and amounting to nerally speaking, however, all the points
over ninety in total. They are key points can be used to treat disorders of the areas
used to treat meridian disorders of the where they are located, and those adja-
areas where they are located. cent to their location. These are known
respectively as the local and adjacent
points with therapeutic properties. In ad-
Appendix
dition, some of the points ~an be used to
Eight Influential Points
treat disorders of the areas far away from
The Eight Influential points are first where they are located. These are known
recorded in the chapter "The 45th Medi- as the remote or distal points with thera-
cal Problem" of Classic on Medical Prob- peutic properties.
lems. They are Zhangmen (LR 13),
Zhong wan (CV 12), Yanglingquan (GB 1. The Remote Therapeutic Properties
34), Juegu, or Xuanzhong (GB 39), Ge- of the Points
shu (BL 17), Dazhu (BL 11), Taiyuan
(LV 9), and Tanzhong (CV 17), which The remote therapeutic properties of
respectively dominate the zang organs, fu the points form a major regularity which
organs, qi, blood, tendon, vessel, bone is establIshed on the basis of the meridian
and marrow. They coincide with some theory. Among the points of the fourteen
other specific points. Clinically, the cor- meridians, those located on the limbs,
responding influential point can be em- especially below the elbow and knee joints,
ployed to treat disorders of the zang or- are effective not only for local disorders
CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 125

but also for disorders of the remote zang- special distribution of the Conception
fu organs and tissues on the course of their and Governor vessels, their points have
pertaining meridians. Some even have sys- more systemic influence. The local and
temic therapeutic properties. For example, adjacent therapeutic properties of the
Lieque (LV 7) treats disorders not only points on the head, face and trunk are
on the upper limbs but also in the vertex, generalized in Table 7.
chest, lung and throat as well as exogenous The remote, adjacent, and local thera-
diseases; Yanglingquan (GB 34) is effec- peutic property of these points are de-
tive not only for diseases of the lower limbs termined by how far away their effects
but also for hypochondrium, biliary, he- reach from the location of points them-
patic, and mental disorders as well as ten- selves. The therapeutic properties, re-
don abnormalities such as spasm and con- mote, adjacent, or local points, are
vulsion. For detailed information, see nevertheless characterized by functional
Table 6. regulation. Clinical practice has proven
that puncturing certain points may bring
2. The Local and Adjacent Therapeutic forth biphasic regulation on diversified
Properties of the Points functional abnormalities of the body. For
instance, puncturing Tianshu (ST 25) re-
All the points in the body share a lieves both diarrhea and constipation;
common feature in terms of their thera- puncturing Neiguan (PC 6) corrects both
peutic properties, namely, all have local tachycardia and bradycardia. In addition
and adjacent therapeutic properties. Each to the general therapeutic properties of
point located on a particular site is able points, clinical attention should also be
to treat disorders of this area and of paid to the special therapeutic proper-
nearby organs. For example, Yingxiang ties of some points. Examples are Da-
(LI 20) and Kouheliao (LI 19) located zhui (GV 14), which has an antipyretic
beside the nose, and the neighboring effect, and Zhiyin (BL 67), which is indi-
points Shangxing (GV 23), Tongtian (BL cated in malposition of a fetus.
7) can all be effective to nasal disorders. To summarize all the points of a par-
Zhongwan (CV 12) and Liangmen (ST ticular meridian are indicated in the dis-
21) located in the epigastric region, and orders of that particular meridian. Points
the nearby points Zhangmen (LR 13) and of the exteriorly-interiorly related merid-
Qihai (CV 6) are used for gastric disor- ians can be combined to treat disorders
ders. The therapeutic properties of the of those meridians. Neighbouring points
points on the head, face and trunk are will have similar therapeutic properties.
judged according to this principle, so are The therapeutic properties of the points
those of the points on both the Concep- on the limbs should be catagorized me-
tion and Governor vessels and those of ridian by meridian, those points of the
the points situated bilaterally along the head, face and trunk, should be recog-
above two extra meridians. Owing to the nized in light of their locations.
 -
~

Table 6. Indications of Points of the Extremities with Relation to Meridians

~
Meridian Indications of Individual Indications of Two Indications of Three
Meridian Meridiansin Common Meridians in Common
Name of
the meridian

The Three Yin The Lung Meridian of Disorders of the lung and throat Disorders of Chest
Meridians of Hand-Taiyin
Hand
The Pericardium Meridian Disorders of the heart and Mental illness
of Hand-Jueyin stomach
The Heart Meridian of Disorders of the heart
Hand-Shaoyin

The Three Yang The Large Intestine Merid- Disorders of the forehead, face, Disorders of the eye,
Meridian of ian of Hand-Yangming nose, mouth and teeth throat and febrile
Hand diseases
The Triple Energizer Me- Disorders of the temporal and Disorders of the
n
ridian of Hand-Shaoyang hypochondriac regions ear :r:
Z
The Small Intestine Merid- Disorders of the occipital region m
tTl
ian of Hand-Taiyang and scapular region and mental :>-
illness n
c'tl
C
The Stomach Meridian of Disorders of the face, mouth, Mental illness, febrile R
>-l
Foot -Yangming C
teeth, throat, stomach and diseases ~
intestine :>-
The Three Yang The Gallbladder Meridian Disorders of the ear, temporal Disorders of the z
t:I
Meridians of of Foot-Shaoyang and hypochondriac regions eyes :::
Foot o~
iii
c
~
5
z
 ~
~
0\

:»-
The Gallbladder Meridian Disorders of the neck, dorso- z
of Foot-Taiyang lumbar region. (Back-Shu Points Z
-l
also for zang-fu disorders.) 1)
o
R
-l
The Spleen Meridian of Disorders of the spleen and Disorders of the external
Foot-Taiyin stomach genitalia, gynaecological ~
-l
diseases o
The Three Yin The Liver Meridian of Disorders of the liver F;
Meridians of Foot-Jueyin c:::
'"C
c:::
Foot z
n
-l
The Kidney Meridian of Disorders of the kidney, lung c:::
::0
Foot-Shaoyin and throat m

2l
z
-l
Vl

Indications of Conception and Governor Vessels

Meridian Indications of Individual Meridian Indications of Two Meridians

in Common

Conception Vessel Prolapse of Yang, collapse. (It is also for Disorders of zang-fu organs, mental
general tonification.) illness, gynaecological disorders

Governor Vessel Apoplexy, coma, febrile diseases, disorders

of the head and face

"
128 CHINESE ACUPUNCTURE AND MOXIBUSTION

Table 7. Indications of Points on the Head, Face and Trunk with Relation to Their Locations

Locations of Points Indications

Head, face, neck Disorders of the brain, eye, ear, nose, mouth,
teeth and throat
Chest, upper dorsal region (corresponding to Disorders of the lung and heart
the region between the 1st and 7th thoracic
vertebrae)
Upper abdomen, lower dorsal region (corres- Disorders of the liver, gallbladder, spleen and
ponding to the region between the 8th thoracic stomach
and the 1st lumbar vertebrae)
Lower abdomen, lumbosacral region (corres- Disorders of the kidney, intestine, bladder and
ponding to the region between the 2nd lumbar genital organs
and the 4th sacral vertebrae)
 CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 129

:.ir laoshan

Hancl-Jueyin Meridian
Hand-Shaoyang Meridian
Fig. 49 The Indications of the Points in the Upper Limbs
130 CHINESE ACUPUNCTURE AND MOXIBUSTION

Diseases at .. n"".,rlOn
Aspect of the

Gastrointestine, Chest,
Abdomen andAnterior--
Aspect of the Leg

0
in·
'"e:
~
s..
}>
~
~.
~
Cl Head, Face, Mouth,_
'"
:J
~:
Tooth, Throat

r Mental Disorders, __ _
Heat Disease
, Throat, Int€'stine

Fig. 50 The Therapeutic Propertie,s of the Points at the Lower Limbs

 CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 131

Disorders of Head, Eye, Ear, Chest and

ile diseases, Mental disorder . ,
HypochondriacRegion, Febrile Diseases
--
Foot-Taiyang Meridian

Foot-Shaoyang Meridian

Fig, 51 The Indications of the Points in the Lower Limbs

--------------------------- ----- - - - - ---_._-----

 132 CHINESE ACUPUNCTURE AND MOXIBUSTION

u\anding Xinhui

Qia

OCCipital Head --

igou

Eye, Head, f
Feng u
Nose, Nape ,----~
Tongue ;famen
Ear

Conception Vessel Meridian

Fig. 52 The Therapeutic Properties of the Points On the Head and Face
CHAPTER 6 AN INTRODUCTION TO ACUPUNCTURE POINTS 133

Meri'_i .-!"
Fig. 53 The Therapeutic Properties of the Points at the Chest and Abdomen
134 CHINESE ACUPUNCTURE AND MOXIBUSTION

d-Shaoyang Meridial

-- Pangguangshu

Foot-Taiyang Meridian
Fig. 54 The Therapeutic Properties of the Points on the Back and at the Lumbar Region
 Chapter 7
ACUPUNCTURE POINTS OF THE TAIYIN AND
YANGMING MERIDIANS

The Lung Meridian of Hand-Taiyin inch towards the lateral aspect of the
running from the chest to the hand, and chest. To avoid injuring the lung, never
the Large Intestine Meridian of Hand- puncture deeply towards the medial as-
Yangming going from the hand to the pect. Moxibustion is applicable.
head, are exteriorly-interiorly related, so Regional anatomy
are the Stomach Meridian of Foot- Vasculature: Superolaterally, the axil-
Yangming travelling from the head to the lary artery and vein, the thoracoacromial
foot and the Spleen Meridian of Foot- artery and vein.
Taiyin travelling from the foot to the Innervation: The intermediate supra-
abdomen (chest). The four meridians are clavicular nerve, the branches of the an-
mainly distributed on the extremities and terior thoracic nerve, and the lateral cu-
in the anterior aspect of the trunk. Their taneous branch of the first intercostal
acupuncture points are described as fol- nerve.
lows.

I. THE LUNG MERIDIAN OF

HAND-TAIYIN
... Yunmen (LU 2)

1. Zhongfu (Front-Mu Point of

the Lung, LV 1)
Location: Laterosuperior to the ster-
num, 1 cun below Yunmen (LV 2), at the
level of the first intercostal space, 6 cun
lateral to the anterior midline. (See
Fig. 55)
Indications: Cough, asthma, pain in
the chest, shoulder and back, fullness of
the chest. Fig. 55

Method: Puncture obliquely 0.5-0.8

135
136 CHINESE ACUPUNCTURE AND MOXIBUSTION

2. Yunmen (LV 2) 4. Xiabai (LV 4)

Location: In the superior lateral part Location: On the medial aspect of the
of the anterior thoracic wall, superior to upper arm, 4 cun below the anterior end
the coracoid process of scapula, in the of the axillary fold, or 5 Cun above the
depression of the infraclavicular fossa, 6 cubital crease, on the radial side of m.
cun lateral to the anterior midline. biceps brachii. (See Col. Fig. 1)
Indications: Cough, asthma, pain in Indications: Cough, fullness in the
the chest, shoulder and arm, fullness in chest, pain in the medial aspect of the
the chest. upper arm.
Method: Puncture obliquely 0.5-0.8 Method: Puncture perpendicularly
inch towards the lateral aspect of the 0.5-1 inch. Moxibustion is applicable.
chest. To avoid injuring the lung, never Regional anatomy
puncture deeply towards the medial as- Vasculature: The cephalic vein and
pect. Moxibustion is applicable. mus.cular branches of the brachial artery
Regional anatomy and vein.
Vasculature: The cephalic vein, the Innervation: The lateral brachial cu-
thoracoacromial artery and vein; infer-
taneous nerve at the place where the
iorly, the axillary artery.
musculo-cutaneous never passes through.
Innervation: The intermediate and la-
teral supraclavicular nerve, the branches
of the anterior thoracic nerve, and the 5. Chize (He-Sea Point, LV 5)
lateral cord of the brachial plexus. Location: On the cubital crease, in the
depression of the radial side of the ten-
3. Tianfu (LV 3) don of m. biceps brachii. This point is
Location: On the medial aspect of the located with the elbow slightly flexed.
upper arm, 3 cun below the end of axil- (See Fig. 56)
lary fold, on the radial side of m. biceps Indications: Cough, hemoptysis, after-
brachii. (See Col. Fig. 1) noon fever, asthma, sore throat, fullness
Indications: Asthma, epistaxis, pain in in the chest, infantile convulsions, spas-
the medial aspect of the upper arm. modic pain of the elbow and arm, masti-
Method: Puncture perpendicularly tis.
0.5-1 inch. Method: Puncture perpendicularly
Regional anatomy 0.5-1 inch.
Vasculature: The cephalic vein and Regional anatomy
muscular branches of the brachial artery Vasculature: The branches of the ra-
and vein. dial recurrent artery and vein, the cephal-
Innervation: The lateral brachial cu- ic vein.
taneous nerve at the place where the mus- Innervation: The lateral antebrachial
culocutaneous nerve passes through. cutaneous nerve and the radial nerve.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND Y ANGJI'IING MERIDIANS 137

6. Kongzui (Xi-Cleft Point, LV 6)

Location: On the palmar aspect of the
/ forearm, on the line joining Taiyuan (LV
9) and Chize (LU 5), 7 cun above the
transverse crease of the wrist. (See
Fig. 57)
Indications: Cough, pain in the chest,
asthma, hemoptysis, sore throat, spas-
modic pain of the elbow and arm.
Method: Puncture perpendicularly
0.5-1 inch. Moxibustion is applicable.
- - - Chize(LU 5)
Regional anatomy
Vasculature: The cephalic vein, the
radial artery and vein.
Innervation: The lateral antebrachial
Fig. 56
cutaneous nerve and the superficial ra-
mus of the radial nerve.

7. Lieque (Luo-Connecting Point,

Confluent Point, LV 7)

Chize(LU5) - - - - - Location: Superior to the styloid pro-

cess of the radius, 1.5 cun above the
5 cun
transverse crease of the wrist between
brachioradial muscle and the tendon of
Kongzui (LU 6) long abductor muscle of the thumb. (See
Fig. 57) When the index fingers and
Lieque (LU 7) 7 cun thumbs of both hands are crossed with
--- the index finger of one hand placed on
the styloid process of the radius of the
other, the point is in the depression right
under the tip of the index finger. (See
Fig. 58)
::J-
...J Indications: Headache, migraine, neck
Cl
c: rigidity, cough, asthma, sore throat, fa-
~o cial paralysis, toothache, pain and weak-
.,
~ ness of the wrist.
Method: Puncture 0.3-0.5 inch
obliquely upward. Moxibustion is appli-
Fig. 57 cable.
138 CHINESE ACUPUNCTURE AND MOXIBUSTION

9. Taiyuan (Shu-Stream and

Yuan-Primary Point,
Lieque (LU 7)
Influential Point of
Vessels, LV 9)
Location: At the radial end of the
transverse crease of the wrist, in the de-
pression on the lateral side of the radial
artery. (See Fig. 57)
Indications: Cough, asthma, hemop-
tysis, sore throat, palpitation, pain in the
chest, wrist and arm.
Fig. 58 Method: Puncture perpendicularly
0.2-0.3 inch. Avoid puncturing the radial
artery. Moxibustion is applicable.
Regional anatomy Regional anatomy
Vasculature: The cephalic vein, Vasculature: The radial artery and
branches of the radial artery and vein. velll.
Innervation: The lateral antebrachial Innervation: The lateral antebrachial
cutaneous nerve and the superficial ra- cutaneous nerve and superficial ramus of
mus of the radial nerve. the radial nerve.

8. Jingqu (Jing-River Point, LV 8) 10. Yuji (Ying-Spring Point,

LV 10)
Location: 1 cun above the transverse
crease of the wrist in the depression on Location: On the radial aspect of the
the lateral side of the radial artery. (See midpoint of the first metacarpal bone, on
Fig. 57) the junction of the red and white skin
Indications: Cough, asthma, fever, (i.e., the junction of the dorsum and palm
pain in the chest, sore throat, pain in the of the hand). (See Fig. 57)
wrist. Indications: Cough hemoptysis, sore
Method: Puncture perpendicularly throat, loss of voice, fever, feverish sen-
0.1-0.3 inch. Avoid puncturing the radial sation in the palm.
artery. Method: Puncture perpendicularly
Regional anatomy 0.5-0.8 inch. Moxibustion is applicable.
Vasculature: Laterally, the radial ar- Regional anatomy
tery and vein. Vasculature: Venules of the thumb
Innervation: The lateral antebrachial draining to the cephalic vein.
cutaneous nerve and the superficial ra- Innervation: The superficial ramus of
mus of the radial nerve. the radial nerve.
 CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 139

11. Shaoshang (Jing-Well Point,

LV 11)
Location: On the radial side of the
thumb, about 0.1 cun posterior to the
corner of the nail. (See Fig. 57) - - - Hegu (LI 4)
Indications: Sore throat, cough, asth- - - Sanjian (LI 3)
ma, epistaxis, fever, loss of conscious-
ness, mania, spasmodic pain of the
thumb.
Method: Puncture 0.1 inch, or prick
the point to cause bleeding.
Regional anatomy
Vasculature: The arterial and venous
network formed by the palmar digital
proprial artery and veins.
Fig. 59
Innervation: The terminal nerve net-
work formed by the mixed branches of Vasculature: The arterial and venous
the lateral antebrachial cutaneous nerve network formed by the dorsal digital ar-
and the superficial ramus of the radial teries and veins.
nerve as well as the palmar digital propri- Innervation: The palmar digital pro-
al nerve of the median nerve. prial nerve derived from the median
nerve.

II. THE LARGE INTESTINE

2. Erjian (Ying-Spring Point, LI 2)
MERIDIAN OF
HAND-YANGMING Location: In the depression of the ra-
dial side of the index finger, distal to
1. Shangyang (Jing-Well Point, LI 1) the 2nd metacarpal-phalangeal joint. The
point is located with the finger slightly
Location: On the radial side of the flexed. (See Fig. 59)
index finger, about 0.1 cun posterior to Indications: Blurring of vision, Epis-
the corner of the nail. (See Fig. 59) taxis, toothache, sore throat, febrile di-
Indications: Toothache, sore throat, seases.
swelling of the submandibular region, Method: Puncture perpendicularly
numbness of fingers, febrile diseases with 0.2-0.3 inch. Moxibustion is applicable.
anhidrosis, loss of consciousness. Regional anatomy
Method: Puncture 0.1 inch, or prick Vasculature: The dorsal digital and
the point to cause bleeding. plamar digital propria 1 arteries and veins
Regional anatomy derived from the radial artery and vein.

-------. ----- ---

140 CHINESE ACUPUNCTURE AND MOXIBUSTION

Innervation: The dorsal digital nerve

of the radial nerve, and the palmar digital Hegu (LI 4)

proprial nerve of the median nerve.

3. Sanjian (Shu-Stream Point, LI 3)

Location: When a loose fist is made,
the point is on the radial side of the index
finger, in the depression proximal to the
head of the second metacarpal bone. (See
Fig. 59) Fig. 60
Indications: Toothache, ophthalmal-
gia, sore throat, redness and swelling of paralysis, febrile diseases with anhidrosis,
fingers and the dorsum of the hand. hidrosis, abdominal pain, dysentery, con-
Method: Puncture perpendicularly stipation, amenorrhea, delayed labour,
0.5-0.8 inch. Moxibustion is applicable. infantile convulsion, pain, weakness and
Regional anatomy motor impairment of the upper limbs.
Vasculature: The dorsal venous net- Method: Puncture perpendicularly
work of the hand and the branch of the 0.5-1 inch. Moxibustion is applicable.
first dorsal metacarpal artery. Acupuncture and moxibustion are con-
Innervation: The superficial ramus of traindicated in pregnant women.
the radial nerve.
Regional anatomy
Vasculature: The venous network of
4. Hegu (Yuan-Primary Point, LI 4) the dorsum of the hand.
Location: On the dorsum of the hand, Innervation: The superficial ramus of
between the 1st and 2nd metacarpal the radial nerve.
bones, approximately in the middle of the
2nd metacarpal bone on the radial side. 5. Yangxi (Jing-River Point, LIS)
(See Fig. 59) Or, place in coincident po-
sition the transverse crease of the inter- Location: On the radial side of the
phalangeal joint of the thumb with the wrist. When the thumb is tilted upward,
margin of the web between the thumb it is in the depression between the ten-
and the index finger of the other hand. dons of m. extensor pollicis longus and
The point is where the tip of the thumb brevis. (See Fig. 59)
touches. (See Fig. 60) Indications: Headache, redness, pain
Indications: Headache, pain in the and swelling of the eye, toothache, sore
neck, redness, swelling and pain of the throat, pain of the wrist.
eye, epistaxis, nasal obstruction, rhinor- Method: Puncture perpendicularly
rhea, toothache, deafness, swelling of the 0.3-0.5 inch. Moxibustion is applicable.
face, sore throat, parotitis, trismus, facial Regional anatomy
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND YANGMING MERIDIANS 141

Vasculature: The cephalic vein, the Regional anatomy

radial artery and its dorsal carpal branch. Vasculature: The cephalic vein.
Innervation: The superficial ramus of Innervation: On the radial side, the
the radial nerve. lateral antebrachial cutaneous nerve and
the superficial ramus of the radial nerve;
6. Pianli (Luo-Connecting Point, LI 6) on the ulnar side, the posterior antebra-
chial cutaneous nerve and the posterior
Location: With the elbow flexed and antebrachial interosseous nerve.
the radial side of arm upward, the point
is on the line joining Yangxi (LI 5) and 7. Wenliu (Xi-Cleft Point, LI 7)
Quchi (LI I I), 3 cun above the crease of
the wrist. (See Fig. 61) Location: With the elbow flexed and
Indications: Redness of the eye, tin- the radial side of arm upward, the point
nitus, deafness, epistaxis, aching of the is on the line connecting Yangxi (LI 5)
hand and arm, sore throat, edema. and Quchi (LI I I), 5 cun above the crease
Method: Puncture perpendicularly or of the wrist. (See Fig. 61)
obliquely 0.5-0.8 inch. Moxibustion is ap- Indications: Headache, swelling of
plicable. the face, sore throat, borborygmus-, ab-
dominal pain, aGh,ing of the shoulder
and arm. ~~j ,at> Vrr- 1-1:..
Method: Puncture perpendicularly
Q.5- 1.0 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The muscular branch of
I }.2.
7 cun
r-
\
- -- - Quchi (LI 11)
---Shousanli (Ll10) c.ww\I
the radial artery, the cephalic vein.
Innervation: The posterior antebra-
chial cutaneous nerve and the deep ramus
'>-~r---'- ___ Wenliu (Ll7) of the radial nerve.
5 cun - - - Pianli (LI 6) I3<,uIrY
8. Xialian (LI 8)
'----+-~IPt----- Yangxi (LI 5)

Location: On the line joining Yangxi

(U 5) and Quchi (LI 11), 4 cun below the
cubital crease. (See Col Fig. 2)
Indications: Abdominal pain, borbor-
ygmus, pain in the elbow and arm, motor
impairment of the upper limbs.
Method: Puncture perpendicularly
Fig. 61 0.5- 1.0 inch. Moxibustion is applicable.
Regional anatomy: See Wenliu (LI 7)
142 CHINESE ACUPUNCTVRE AND MOXIBUSTION

9. Shanglian (LI 9) ing, diarrhea, febrile diseases.

Method: Puncture ))erpendicularly
Location: On the line joining Yangxi 1.0-1.5 inches. Moxibustion is applicable.
(LI 5) and Quchi (LI 11),3 cun below the Regional anatomy
cubital crease. (See Col Fig. 2) Vasculature: The branches of the ra-
Indications: Aching of the shoulder dial recurrent artery and vein.
and arm, motor impairment of the upper Innervation: The posterior antebra-
limbs, numbness of the hand and arm, chial cutaneous nerve; deeper, on the me-
borborygmus, abdominal pain. dial side, the radial nerve.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. 12. Zhouliao (LI 12)
Regional anatomy: See Wenliu (LI 7).
Location: When the elbow is flexed,
10. Shousanli (LI 10) the point is on the lateral side of the
upper arm, I cun above Quchi (LI 11), on
Location: On the line joining Yangxi the border of humerus. (See Col. Fig. 2)
(LI 5) and Quchi (LI II), 2 cun below the Indications: Pain, numbness and con-
cubital crease. (See Fig. 61) tracture of the elbow and arm.
Indications: Abdominal pain, diar- Method: Puncture perpendicularly
rhea, toothache, swelling of the cheek, 0.5-1.0 inch. Moxibustion is applicable.
motor impairment of the upper limbs, Regional anatomy
pain in the shoulder and back. Vasculature: The radial collateral ar-
Method: Puncture perpendicularly tery and vein.
0.8-1.2 inches. Moxibustion is applicable. Innervation: The posterior antebra-
Regional anatomy chial cutaneous nerve; deeper, on the me-
Vasculature: The branches of the ra- dial side, the radial nerve.
dial recurrent artery and vein.
Innervation: See Wenliu (LI 7). 13. Shouwuli (LI 13)

11. Quchi (He-Sea Point, LI 11) Location: On the lateral side of the
upper arm, on the line connecting Quchi
Location: When the elbow is flexed, (LI II) and Jianyu (LI 15),3 cun above
the point is in the depression at the later- Quchi (LI 11). (See Col. Fig. 2)
al end of the transverse cubital crease, Indications: Contracture and pain of
midway between Chize (LV 5) and the the elbow and arm, scrofula.
lateral epicondyle of the humerus. (See Method: Puncture perpendicularly
Fig. 61) 0.5-1.0 inch. Avoid injuring the artery.
Indications: Sore throat, toothache, Moxibustion is applicable.
redness and pain of the eye, scrofula, Regional anatomy
urticaria, motor impairment of the up- Vasculature: The radial collateral ar-
per extremities, abdominal pain, vomit- tery and vein.
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANGMING MERIDIANS 143

Innervation: The posterior antebra-

chial cutaneous nerve; deeper, the radial
nerve.

14. Binao (LI 14)

Jianyu (LI 15) - -
Location: On the lateral side of the
upper arm, on the line joining Quchi
(LI 11) and Jianyu (LI 15), 7 cun above
Quchi (LI 11), at the insertion of m.
deltoideus. (See Col. Fig. 2)
Indications: Pain in the shoulder and
arm, rigidity of the neck, scrofula. Quchi(Ll11)--- -

Method: Puncture perpendicularly or

obliquely upward 0.8-1.5 inches. Moxi-
bustion is applicable.
Regional anatomy
Vasculature: The branches of posteri- Fig.62
or circumflex humeral artery and vein,
the deep brachial artery and vein. lar nerve and axillary nerve.
Innervation: The posterior brachial
cutaneous nerve; deeper, the radial nerve.
16. Jugu (LI 16)
15. Jianyu (LI 15)
Location: In the upper aspect of the
Location: Antero-inferior to the ac- shoulder, in the depression between the
romion, on the upper portion of m. del- acromial extremity of the clavicle and the
toideus. When the arm is in full ab- scapular spine. (See Col. Fig. 2)
duction, the point is in the depression Indications: Pain and motor impair-
appearing at the anterior border of the ment of the upper extremities, pain in the
acromioclavicular joint. (See Fig. 62) shoulder and back.
Indications: Pain in the shoulder and Method: Puncture perpendicularly
arm, motor impairment of the upper ex-
tremities, rubella, scrofula. .
0.5-0.7 inch. Moxibustion is applicable.
Regional anatomy
Method: Puncture perpendicularly or
Vasculature: Deeper, the suprascapu-
obliquely 0.8-1.5 in~hes. Moxibustion is
applicable. lar artery and vein.
Regional anatomy Innervation: Superficially, the lateral
Vasculature: The posterior circumflex supraclavicular nerve, the branch of the
artery and vein. accessory nerve; deeper, the suprascapu-
Innervation: The lateral supraclavicu- lar nerve.
144 CHINESE ACUPUNCTURE AND MOXIBUSTION

17. Tianding (LI 17) 19. Kouheliao (LI 19)

Location: On the lateral side of the Location: Right below the lateral mar-
neck, at the posterior border of sterno- gin of the nostril, level with Renzhong
cleidomastoid muscle, beside the larynge- (Shuigou, GV 26). (See Col. Fig. 2)
al protuberance, at the midpoint of the Indications: Nasal obstruction, epis-
line connecting Futu (LI 18) and Quepen taxis, deviation of the mouth.
(ST 12). (See Col. Fig. 2) Method: Puncture obliquely 0.2-0.3
Indications: Sudden loss of voice, sore inch.
throat, scrofula, goiter. Regional anatomy
Method: Puncture perpendicularly Vasculature: The superior labial
0.3-0.5 inch. Moxibustion is applicable. branches of the facial artery and vein.
Regional anatomy Innervation: The anastomotic branch
Vasculature: The external jugular of the facial nerve and the infraorbital
vein. nerve.
Innervation: Superficially, the supra-
clavicular nerve. It is on the posterior 20. Yingxiang (LI 20)
border of m. sternocleidomastoideus just
where the cutaneous cervical nerve Location: In the nasolabial groove, at
emerges. Deeper, the phrenic nerve. the level of the midpoint of the lateral
border of ala nasi. (See Fig. 63)
Indications: Nasal obstruction, hypos-
18. Futu (LI 18)
mia, epistaxis, rhinorrhea, deviation of
Location: On the lateral side of the the mouth, itching and swelling of the
neck, level with the tip of Adam's apple, face.
between the sternal head and clavicular
head of m. sternocleidomastoideus. (See
Col. Fig. 2)
Indications: Cough, asthma, sore
throat, sudden loss of voice, scrofula,
goiter.
o
N
Method: Puncture perpendicularly
...J
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
'"c
.!!!
x
--
Vasculature: Deeper, on the medial '"c
>=
side, the ascending cervical artery and
vein.
Innervation: The great auricular
nerve, cutaneous cervical nerve, lesser oc-
cipital nerve and accessory nerve. Fig. 63

- - ------------ - - -
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 145

Method: Puncture obliquely or subcu- with the left thumb and puncture perpen-
taneously 0.3-0.5 inch. dicularly and slowly 0.5-1.0 inch along
Regional anatomy the infraorbital ridge. It is not advisable
Vasculature: The facial artery and to manipulate the needle with large am-
vein, the branches of the infraorbital ar- plitude.
tery and vein. Regional anatomy
Innervation: The anastomotic branch Vasculature: The branches of the in-
of the facial and infraorbital nerves. fraorbital and ophthalmic arteries and
veins.
Innervation: The branch of the in-
III. THE STOMACH fraorbital nerve, the inferior branch of
MERIDIAN OF the oculomotor nerve and the muscular
FOOT-YANGMING branch of the facial nerve.

1. Chengqi (ST 1) 2. Sibai (ST 2)

Location: Directly below the pupil, in
Location: With the eyes looking
the depression at the infraorbital fora-
straight forward, the point is directly be-
men. (See Fig. 64)
low the pupil, between the eyeball and the
Indications: Redness, pain and itching
infraorbital ridge. (See Fig. 64)
of the eye, facial paralysis, twitching of
Indications: Redness, swelling and
eye lids, pain in the face.
pain of the eye, lacrimation, night blind-
Method: Puncture perpendicularly
ness, twitching of eyelids, facial paralysis.
0.2-0.3 inch. It is not advisable to punc-
Method: Push the eyeball upward
ture deeply.
Regional anatomy
Vasculature: The branches of facial
artery and vein, the infraorbital artery
{,
................"'" and vein.
Innervation: The branches of the fa-

Chengqi(ST 1)
( .....
~~ ~
...
cial nerve. The point is right on the
course of the infraorbital nerve.

3. Juliao (ST 3)
Sibai (ST 2): C1===-
Juliao(ST3) - - , - - Location: Directly below the pupil, at
Dicang (ST 4) - - - - - ---.Ho.M1'V" the level of the lower border of ala
nasi, on the lateral side of the nasolabi-
al groove. (See Fig. 64)
Indications: Facial paralysis, twitch-
Fig. 64 ing of eyelids, epistaxis, toothache, swell-
146 CHINESE ACUPUNCTURE AND MOXIBUSTION

ing of lips and cheek. Puncture obliquely 0.3-0.5 inch. Moxi-

Method: Puncture perpendicularly bustion is applicable.
0.3-0.5 inch. Moxibustion is applicable. Regional anatomy
Regional anatomy Vasculature: Anteriorly, the facial ar-
Vasculature: The branches of the fa- tery and vein.
cial and infraorbital arteries and veins. Innervation: The facial and buccal
Innervation: The branches of the fa- nerves.
cial and infraorbital nerves.
6. Jiache (ST 6)
4. Dicang (ST 4)
Location: One finger-breadth (middle
Location: Lateral to the corner of the finger) anterior and superior to the lower
mouth, directly below the pupil. (See angle of the mandible where m. mas-
Fig. 64) seter is prominence when the teeth are
Indications: Deviation of the mouth,
clenChed, and depressive when it is
salivation, twitching of eyelids.
pressed. (See Fig. 65)
Method: Puncture subcutaneously
Indications: Facial paralysis, tooth-
1.0-1.5 inches with the tip of the needle
ache, swelling of the cheek and face,
directed towards liache (ST 6). Moxibus-
mumps, trismus.
tion is applicable.
Method: Puncture perpendicularly
Regional anatomy
0.3-0.5 inch, or subcutaneously with the
Vasculature: The facial artery and
tip of the needle directed towards Dicang
vein.
Innervation: Superficially, the branch- (ST 4). Moxibustion is applicable.
es of the facial and infraorbital nerves;
deeper, the terminal branch of the buccal
nerve.
~1"'----
5. Daying (ST 5) (
Location: Anterior to the angle of ~ )
mandible, on the anterior border of the . ~~~I!n __ Xiaguan (ST 7)

-
~_-~~ ___- Ji.""",STO,
attached portion of m. masseter where ~~ ~
the pulsation of facial artery is palpable,
in the groove-like depression appearing
when the cheek is bulged. (See Col. ~ '-I
Fig. 3)
Indications: Facial paralysis, trismus,
/
swelling of the cheek, pain in the face,
toothache. Fig. 65
Method: Avoid puncturing the artery.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 147

Regional anatomy
Vasculature: The masseteric artery.
Innervation: The great auricular
nerve, facial nerve and masseteric nerve.

7. Xiaguan (ST 7)
Location: On the face, anterior to the
ear, in the depression between the zygo-
Reny;ng(ST".!.~:...
matic arch and the mandibular notch.
This point is located with the mouth
closed. (See Fig. 65)
Indications: Deafness, tinnitus, otor-
rhea, toothache, facial paralysis, pain of
Fig. 66
the face, motor impairment of the jaw.
Method: Puncture perpendicularly
OJ-0.5 inch. Moxibustion is applicable.
branch of the facial nerve.
Regional anatomy
Vasculature: Superficially, the trans-
verse facial artery and vein; in the deep- 9. Renying (ST 9)
est layer, the maxillary artery and vein.
Location: Level with the tip of Adam's
Innervation: The zygomatic branch of
apple where the pulsation of common
the facial nerve and the branches of the
carotid artery is palpable, on the anteri-
auriculotemporal nerve.
or border of m. sternocIeidomastoideus.
(See Fig. 66)
8. Touwei (ST 8) Indications: Sore throat, asthma, goi-
Location: On the lateral side of the ter, dizziness, flushing of the face.
head, 0.5 cun above the anterior hairline Method: Avoid puncturing the com-
at the corner of the forehead, and 4.5 cun mon carotid artery, puncture perpendic-
lateral to the midline of the head. (See ularly 0.3-0.5 inch.
Fig. 65) Regional anatomy
Indications: Headache, blurring of vi- Vasculature: The superior thyroid ar-
sion, ophthalmalgia, lacrimation. tery on the bifurcation of the internal
Method: Puncture 0.5-1.0 inch subcu- and the external carotid artery.
taneously. Innervation: SuperfiCially, the cu-
Regional anatomy taneous cervical nerve, the cervical
Vasculature: The frontal branches of branch of the facial nerve; deeper, the
the superficial temporal artery and vein. sympathetic trunk; laterally, the descend-
Innervation: The branch of the au- ing branch of the hypoglossal nerve and
riculotemporal nerve and the temporal the vagus nerve.
148 CHINESE ACUPUNCTURE AND MOXIBUSTION
~----------~~----~----~----------------

10. Shuitu (ST 10) anterior midline. (See Col. Fig. 3)

Indications: Cough, asthma, sore
Location: At the midpoint of the line throat, pain in the supraclavicular fossa.
joining Renying (ST 9) and Qishe (ST Method: A void puncturing the artery.
11), on the anterior border of m. sterno- Puncture perpendicularly 0.3-0.5 inch.
cleidomastoideus. (See Col. Fig. 3) Deep puncture is not advisable. Moxibus-
Indications: Sore throat, asthma, tion is applicable.
cough. Regional anatomy
Method: Puncture perpendicularly Vasculature: Superiorly, the trans-
0.3-0.5 inch. Moxibustion is applicable. verse cervical artery.
Regional anatomy Innervation: Superficially, the inter-
Vasculature: The common carotid ar- mediate supraclavicular nerve; deeper,
tery. the supraclavicular portion of brachial
Innervation: Superficially, the cu- plexus.
taneous cervical nerve; deeper, the super-
ior cardiac nerve issued from the sym- 13. Qihu (ST 13)
pathetic nerve and the sympathetic trunk.
Location: At the lower border of the
11. Qishe (ST 11) middle of the clavicle, 4 cun lateral to the
anterior midline. (See Col. Fig. 3)
Location: At the superior border of Indications: Fullness in the chest,
the sternal extremity of the clavicle, be- asthma, cough, hiccup, pain in the chest
tween the sternal head and clavicular and hypochondrium.
head of m. sternocleidomastoideus. (See Method: Puncture obliquely 0.3-0.5
Col. Fig. 3) inch. Moxibustion is applicable.
Indications: Sore throat, pain and ri- Regional anatomy
gidity of the neck, asthma, hiccup, goiter. Vasculature: The branches of the
Method: Puncture perpendicularly thoracoacromial artery and vein; super-
0.3-0.5 inch. Moxibustion is applicable. iorly, the subclavicular vein.
Regional anatomy Innervation: The branches of the su-
Vasculature: Superficially, the anteri- praclavicular nerve and the anterior tho-
or jugular vein; deeper, the common ca- racic nerve.
rotid artery.
Innervation: The medial supraclavicu- 14. Kufang (ST 14)
lar nerve and the muscular branch of
ansa hypoglossi. Location: In the first intercostal
space, 4 cun lateral to the anterior mid-
12. Quepen (ST 12) line. (See Col. Fig. 3)
Indications: Sensation of fullness and
Location: In the midpoint of the su- pain in the chest, cough.
praclavicular fossa, 4 cun lateral to the Method: Puncture obliquely 0.3-0.5

-- ------------------------
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANGMING MERIDIANS 149

inch. 17. Ruzhong (ST 17)

Moxibustion is applicable.
Regional anatomy Location: In the fourth intercostal
Vasculature: The thoracoacromial ar- space, in the centre of the nipple, 4 cun
tery and vein and the branches of the lateral to the anterior midline. (See Col.
lateral thoracic artery and vein. Fig. 3)
Innervation: The branch of the anteri- Acupuncture and moxibustion on this
or thoracic nerve. point are contraindicated. This point
serves only as a landmark for locating
points on the chest and abdomen.
15. Wuyi (ST 15)
Regional anatomy
Location: In the second intercostal Innervation: The anterior and lateral
space, 4 cun lateral to the anterior mid- cutaneous branches of the fourth inter-
line. (See Col. Fig. 3) costal nerve.
Indications: Fullness and pain in the
chest and the costal region, cough, asth- 18. Rugen (ST 18)
ma, mastitis.
Method: Puncture obliquely 0.3-0.5 Location: On the chest, directly below
inch. Moxibustion is applicable. the nipple, on the lower border of breast,
Regional anatomy in the 5th intercostal space, 4 cun lateral
Vasculature: See Kufang (ST 14).
Innervation: On the course of the
branch of m. pectoralis major derived
from the anterior thoracic nerve.

16. Yingchuang (ST 16)

Location: In the third intercostal
space, 4 cun lateral to the anterior mid-
line. (See Col. Fig. 3)
Indications: Fullness and pain in the
chest and hypochondrium, cough, asth-
ma, mastitis.
Method: Puncture obliquely 0.3-0.5
inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The lateral thoracic ar-
teryand vein.
Innervation: The branch of the anteri-
or thoracic nerve. Fig. 67
150 CHINESE ACUPUNCTURE AND MOXIBUSTION

to the anterior midline. (See Fig. 67) 21. Liangmen (ST 21)
Indications: Pain in the chest, cough,
asthma, mastitis, insufficient lactation. Location: 4 cun above the umbilicus,
Method: Puncture obliquely 0.3-0.5 2 cun lateral to Zhongwan (CV 12). (See
inch. Moxibustion is applicable. Fig. 68)
Regional anatomy Indications: Gastric pain, vomiting,
Vasculature: The branches of the in- anorexia, abdominal distension, diarrhea.
tercostal artery and vein. Method: Puncture perpendicularly
Innervation: The branch of the fifth
0.8-1.0 inch. Moxibustion is applicable.
Regional anatomy
intercostal nerve.
Vasculature: The branches of the
eighth intercostal and superior epigastric
19. Burong (ST 19) arteries and veins.
Location: 6 cun above the umbilicus, Innervation: The branch of the eighth
2 cun lateral to 1uque (CV 14). (See Col. intercostal nerve.
Fig. 3)
Indications: Abdominal distension, 22. Guanmen (ST 22)
vomiting, gastric pain, anorexia. Location: 3 curt above the umbilicus,
Method: Puncture perpendicularly 2 cun lateral to lianli (CV 11). (See Col.
0.5-0.8 inch. Moxibustion is applicable. Fig. 3)
Regional anatomy Indications: Abdominal distension
Vasculature: The branches of the sev- and pain, anorexia, borborygmus, diar-
enth intercostal artery and vein, the rhea, edema.
branches of the superior epigastric artery Method: Puncture perpendicularly
and vein. 0.8-1.0 inch. Moxibustion is applicable.
Innervation: The branch of the sev- Regional anatomy: See Liangmen
enth intercostal nerve. (ST 21)

20. Chengman (ST 20) 23. Taiyi (ST 23)

Location: 5 cun above the umbilicus, Location: 2 cun above the umbilicus,
2 cun lateral to Shangwan (CV 13). (See 2 cun lateral to Xiawan (CV 10). (See
Col. Fig. 3) Col. Fig. 3)
Indications: Gastric pain, abdominal Indications: Gastric pain, irritability,
distension, vomiting, anorexia. mania, indigestion.
Method: Puncture perpendicularly Method: Puncture perpendicularly
0.5-1.0 0.7-1.0 inch. Moxibustion is applicable.
inch. Moxibustion is applicable. Regional anatomy
Regional anatomy: See Burong Vasculature: The branches of the
(ST 19) eighth and ninth intercostal and inferior
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANG~IING MERIDIANS 151

epigastric arteries and veins. intercostal nerve.

Innervation: The branches of the
eighth and ninth intercostal nerves. 25. Tianshu (Front-Mu Point of the
Large Intestine, ST 25)
24. Huaroumen (ST 24)
Location: 2 cun lateral to the centre of
Location: I cun above the umbilicus, the umbilicus. (See Fig. 68)
2 cun lateral to Shuifen (CV 9). (See Col. Indications: Abdominal pain and dis-
Fig. 3) tension, borborygmus, pain around the
Indications: Gastric pain, vomiting, umbilicus, constipation, diarrhea, dysen-
mania. tery, irregular menstruation, edema.
Method: Puncture perpendicularly Method: Puncture perpendicularly
0.7-1.0 inch. Moxibustion is applicable. 0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy Regional anatomy
Vasculature: The branches of the Vasculature: The branches of the
ninth intercostal and inferior epigastric tenth intercostal and inferior epigastric
arteries and veins. arteries and veins.
Innervation: The branch of the ninth Innervation: The branch of the tenth

Liangmen (ST 21) - - - - 8 cun

Tianshu CST 25)---- ----

Wailing (ST 26) - - - - - - -

5 cun
Guilai (ST 29) - - -

Fig. 68
152 CHINESE ACUPUNCTURE AND MOXIBUSTION

intercostal nerve. 0.7-1.2 inches. Moxibustion is applicable.

Regional anatomy
Vasculature: The branches of the sub-
26. Wailing (ST 26) costal artery and vein; laterally, the infer-
ior epigastric artery and vein.
Location: 1 cun below the umbilicus, Innervation: A branch of the subcos-
2 cun lateral to Yinjiao (CV 7). (See tal nerve.
Fig. 68)
Indications: Abdominal pain, hernia, 29. Guilai (ST 29)
dysmenorrhea.
Method: Puncture perpendicularly Location: 4 cun below the umbilicus,
0.7-1.2 inches. Moxibustion is applicable. 2 cun lateral to Zhongji (CV 3). (See
Regional anatomy: See Tianshu Fig. 68)
(ST 25) Indications: Abdominal pain, hernia,
dysmenorrhea, irregular menstruation,
27. Daju (ST 27) amenorrhea, leucorrhea, prolapse of the
uterus.
Location: 2 cun below the umbilicus, Method: Puncture perpendicularly
2 cun lateral to Shimen (CV 5). (See Col. 0.7-1.2 inches. Moxibustion is applicable.
Fig. 3) Regional anatomy
Indications: Lower abdominal disten- Vasculature: Laterally, the inferior
sion, dysuria, hernia, seminal emission, epigastric artery and vein.
premature ejaculation. Innervation: The iliohypogastric
Method: Puncture perpendicularly nerve.
0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy 30. Qichong (ST 30)
Vasculature: The branches of the elev-
enth intercostal artery and vein; laterally, Location: 5 cun below the umbilicus,
the inferior epigastric artery and vein. 2 cun lateral to Ougu (CV 2). (See Col.
Innervation: The eleventh intercostal Fig. 3)
nerve. Indications: Abdominal pain, borbor-
ygmus, hernia, swelling and pain of the
28. Shuidao (ST 28) external genitalia, impotence, dysmenor-
rhea, irregular menstruation.
Location: 3 cun below the umbilicus, Method: Puncture perpendicularly
2 cun lateral to Guanyuan (CV 4). (See 0.5-1.0 inch. Moxibustion is applicable.
Col. Fig. 3) Regional anatomy
Indications: Lower abdominal disten- Vasculature: The branches of the su-
sion, retention of urine, edema, hernia, perficial epigastric artery and vein. Later-
dysmenorrhea, sterility. ally, the inferior epigastric artery and
Method: Puncture perpendicularly vem.
CHAPTER 7 ACUPUNCTURE POlt\TS OF THE TAIYlt\ At\D YANG~lING :VIERIDIANS 15~

Innervation: The pathway of the il- Regional anatomy

ioinguinal nerve. Vasculature: Deeper, the branches of
the lateral circumflex femoral artery and
31. Biguan (ST 31) vem.
Innervation: The lateral femoral cu-
Location: On the anterior side of the taneous nerve.
thigh and on the line connecting the an-
terosuperior iliac spine and the 32. Futu (ST 32)
superiolateral corner of the patella, on
the level of the perineum when the thigh Location: On the line connecting the
anterior superior iliac spine and lateral
is fixed, in the depression lateral to the
border of the patella, 6 cun above the
sartorius muscle. (See Fig. 69)
laterosuperior border of the patella. (See
Indications: Pain in the thigh, muscu-
Col. Fig. 4)
lar atrophy, motor impairment, numb-
Indications: Pain in the lumbar and
ness and pain of the lower extremities.
iliac region, coldness of the knee, paralys-
Method: Puncture perpendicularly
is or motor impairment and pain of the
1.0-1.5 inches. Moxibustion is applicable.
lower extremities. beriberi.
Method: Puncture perpendicularly
1.0-1.5 inches. Moxibustion is applicable.
Regional anatomy
Biguan(ST31) -- Vasculature: The branches of the lat-
eral circumflex femoral artery and vein.
Innervation: The anterior and lateral
femoral cutaneous nerves.

33. Yinshi (ST 33)

Location: When the knee is flexed, the
point is 3 cun above the laterosuperior
border of the patella, on the line joining
Liangqiu(ST34) - - - - -
the laterosuperior border of the patella
and the anterior superior iliac spine. (See
Col. Fig. 4)
Indications: Numbness, soreness, mo-
tor impairment of the leg and knee, mo-
tor impairment of the lower extremities.
Method: Puncture perpendicularly
0.7-1.0 inch. Moxibustion is applicable.
Fig. 69 Regional anatomy
Vasculature: The descending branch
154 CHINESE ACUPUNCTURE AND MOXIBUSTION

of the lateral circumflex femoral artery.

Innervation: The anterior and lateral
femoral cutaneous nerves.
,....-l1-'M~~~- Dubi (ST 35)

34. Liangqiu (Xi-Cleft Point, ST 34)

- - Zusanli (ST 36)
Location: When the knee is flexed, the 8 cun

point is 2 cun above the laterosuperior ,- - --Shangjuxu CST 37)

: __ Fenglong (ST 40)
border of the patella. (See Fig. 69)
~M~''''- -- Tiaokou (ST 38)
Indications: Pain and numbness of the
-- Xiajuxu (ST 39)
knee, gastric pain, mastitis, motor im-
pairment of the lower extremities. 8 cun
Method: Puncture perpendicularly
0.5-\.0 inch. Moxibustion is applicable.
Regional anatomy: See Yinshi (ST 33)

35. Dubi (ST 35)

Location: When the knee is flexed, the Fig. 70

point is at the lower border of the patella,

in the depression lateral to the patellar mus, diarrhea, dysentery, constipation,
ligament. (See Fig. 70) mastitis, enteritis, aching of the knee
Indications: Pain, numbness and mo- joint and leg, beriberi, edema, cough,
tor impairment of the knee, beriberi. asthma, emaciation due to general defi-
Method: Puncture perpendicularly ciency, indigestion, apoplexy, hemiplegia,
0.7-1.0 inch. Moxibustion is applicable. dizziness, insomnia, mania.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The arterial and venous 0.5-1.2 inches. Moxibustion is applicable.
network around the knee joint. Regional anatomy
Innervation: The lateral sural cu- Vasculature: The anterior tibial artery
taneous nerve and the articular branch of and vein.
the common peroneal nerve. Innervation: Superficially, the lateral
sural cutaneous nerve and the cutaneous
36. Zusanli (He-Sea Point, ST 36) branch of the saphenous nerve; deeper,
the deep peroneal nerve.
Location: 3 cun below Dubi (ST 35),
one finger-breadth (middle finger) from 37. Shangjuxu (The Lower He-Sea
the anterior border of the tibia. (See Point of the Large Intestine, ST 37)
Fig. 70)
Indications: Gastric pain, vomiting Location: 6 cun below Dubi (ST 35),
hiccup, abdominal distension, borboryg- and one finger breadth (middle finger)
CHAPTER 7 ACUPU!\'CTCRE POINTS OF THE TAIYI!\' AND YANGMI!\'G MERIDIA!\,S 155

from the anterior border of the tibia. (See Vasculature: The anterior tibial artery
Fig. 70) and vein.
Indications: Abdominal pain and dis- Innervation: The branches of the su-
tension, borborygmus, diarrhea, dysen- perficial peroneal nerve and the deep
tery, constipation, enteritis, paralysis due peroneal nerve.
to stroke, beriberi.
Method: Puncture perpendicularly 40. Fenglong (Luo-Connecting Point,
0.5-1.2 inches. Moxibustion is applicable. ST40)
Regional anatomy: See Zusanli
(ST 36) Location: 8 cun superior to the tip of
the external malleolus, lateral to Tiaokou
38. Tiaokou (ST 38) (ST 38) about two finger-breadth lateral
to the anterior border of the tibia. (See
Location: 8 cun below Dubi (ST 35) Fig. 70)
and on finger breadth (middle finger) Indications: Headache, dizziness and
from the anterior border of the tibia. (See vertigo, cough, asthma, excessive spu-
Fig. 70) tum, pain in the chest, constipation, man-
Indications: Numbness. soreness and ia, epilepsy, muscular atrophy, motor im-
pain of the knee and leg, weakness and pairment, pain, swelling or paralysis of
motor impairment of the foot, pain and the lower extremities.
motor impairment of the shoulder, ab- Method: Puncture perpendicularly
dominal pain. 0.5-1.0 inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy
0.5-1.0 inch. Moxibustion is applicable. Vasculature: The branches of the an-
Regional anatomy: See Zusanli terior tibial artery and vein.
(ST 36) Innervation: The superficial peroneal
nerve.
39. Xiajuxu (The Lower He-Sea Point
of the Small Intestine, ST 39) 41. Jiexi (Jing-River Point, ST 41)
Location: 9 cun below (Dubi (ST 35) Location: On the dorsum of the foot,
and one finger breadth (middle finger) at the midpoint of the transverse crease
from the anterior border of the tibia. (See of the ankle joint, in the depression be-
Fig. 70) tween the tendons of m. extensor digito-
Indications: Lower abdominal pain, rum longus and hallucis longus, approx-
backache referring to the testis, mastitis, imately at the level of the tip of the
numbness and paralysis of the lower ex- external malleolus. (See Fig. 71)
tremities. Indications: Pain of the ankle joint,
Method: Puncture perpendicularly muscular atrophy, motor impairment
0.5-1.0 inch. Moxibustion is applicable. pain and paralysis of the lower extrem-
Regional anatomy ities, epilepsy, headache, dizziness and
 156 CHINESE ACUPUNCTURE AND .vIOXIBl'STION

foot, facial paralysis, muscular atrophy

and motor impairment of the foot.
Method: Avoid puncturing the artery.
Puncture perpendicularly 0.3-0.5 inch.
Moxibustion is applicable.
~+I ___ Jiexi(ST 41)
Regional anatomy
Vasculature: The dorsal artery and
vein of foot, the dorsal venous network
Chongyang (ST 42)
of foot.
Innervation: Superficially, the medial
dorsal cutaneous nerve of foot derived
lIH,O+--- Xiangu (ST 43)
from the superficial peroneal nerve;
,...,HH:++-·-- Neiting (ST 44) deeper, the deep peroneal nerve.
Lidui (ST 45)
43. Xiangu (Shu-Stream Point, ST 43)
Location: In the depression distal to
Fig. 71
the junction of the second and third me-
tatarsal bones. (See Fig. 71)
vertigo, abdominal distension, constipa- Indications: Facial or general edema,
tion. abdominal pain, borborygmus, swelling
Method: Puncture perpendicularly and pain of the dorsum of the foot.
0.5-0.7 inch. Moxibustion is applicable. Method: Puncture perpendicularly
Regional anatomy 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The anterior tibial artery Regional anatomy
and vein. Vasculature: The dorsal venous net-
Innervation: The superficial and deep work of foot.
Innervation: The medial dorsal cu-
peroneal nerves.
taneous nerve of foot.

42. Chongyang (Yuan-Primary Point, 44. Neiting (Ying-Spring Point, ST 44)

ST42)
Location: Proximal to the web margin
Location: On the dome of the instep between the second and third toes, in the
of the foot, between the tendons of long depression distal and lateral to the second
extensor muscle of the great toe and long metatarsodigital joint. (See Fig. 71)
extensor muscle of toes, where the pulsa- Indications: Toothache, pain in the
tion of the dorsal artery of foot is palpa- face, deviation of the mouth, sore throat,
ble. (See Fig. 71) epistaxis, gastric pain, acid regurgitation,
Indications: Pain of the upper teeth, abdominal distension, diarrhea, dysen-
redness and swelling of the dorsum of the tery, constipation, swelling and pain of

----- - - - - - - - - - - - - - - - - - - - - - - _ . _ - _ . - ._-_._._-----_._-_... _ . _ - - - - - - - - -
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND YANGMING MERIDIANS 157

the dorsum of the foot, febrile diseases. bloody stools, menorrhagia, uterine
Method: Puncture perpendicularly bleeding, mental disorders, dream-
0.3-0.5 inch. Moxibustion is applicable. disturbed sleep, convulsion.
Regional anatomy Method: Puncture subcutaneOUslY_~)'p
Vasculature: The dorsal venous net- inch. Moxibustion is applicable. ~r
work of foot. Regional anatomy
Innervation: Just where the lateral Vasculature: The dorsal digital artery.
branch of the medial dorsal cutaneous Innervation: On the anastomosis of
nerve divides into dorsal digital nerves. the dorsal digital nerve derived from the
superficial peroneal nerve and the plan-
45. Lidui (Jing-Well Point, ST 45) tar digital proprial nerve.

Location: On the lateral side of the 2. Dadu (Ying-Spring Point, SP 2)

2nd toe, 0.1 cun posterior to the corner
of the nail. (See Fig. 71) Location: On the medial side of the
Indications: Facial swelling, deviation great toe, distal and inferior to the first
of the mouth, epistaxis, toothache, sore metatarsodigital joint, in the depression
throat and hoarse voice, abdominal dis- of the junction of !qe r ea 3. whilf s¥.in.L_.U
tension, coldness in the leg and foot, feb- (See Fig. 72) ~~ 4 ~, u.-''T
rile diseases, dream-disturbed sleep, Indications: Abdomina distension,~.
mania. gastric pain, cons:i~~~+~~~, febrile diseas!(s~J§ _.
Method: Puncture subcutaneously 0.1 with anhidrosis. l.)IUUU4'Ja ~r
inch. Moxibustion is applicable. MethOd: Puncture perpendicularly
Regional anatomy 0.1-0.3 inch. Moxibustion is applicable.
Vasculature: The arterial and venous Regional anatomy
network formed by the dorsal digital ar- Vasculature: The branches of the me-
tery and vein of foot. dial plantar artery and vein.
Innervation: The dorsal digital nerve Innervation: The plantar digital pro-
derived from the superficial peroneal prial nerve derived from the medial plan-
nerve. tar nerve.

3. Taibai (Shu-Stream and

IV. THE SPLEEN MERIDIAN Yuan-Primary Point, SP 3)
OF FOOT-TAIYIN
Location: Proximal and inferior to the
1. Yinbai (Jing-Well Point, SP 1) I st metatarsophalangeal joint, in the de-
pression of the junction of the red and
Location: On the medial side of the white skin. (See Fig. 72)
great toe, 0.1 cun posterior to the corner Indications: Gastric pain, abdominal
of the nail. (See Fig. 72) distension, constipation, dysentery, vom-
Indications: Abdominal distension, iting diarrhea, borborygmu,s, sluggish-
158 CHINESE ACCPUNCTCRE AND MOXIBUSTION

Shangqiu (SP 5)
............
Gongsun (SP 4),
,

- ---
Yinbai (SP 1) ---.'t:~-:=::~~:;~..e-- __
--:~~-=::::"",
- - Dadu (SP 2)
~

Fig. 72

ness, beriberi. Innervation: The saphenous nerve and

Method: Puncture perpendicularly the branch of the superficial peroneal
OJ-O.5 inch. Moxibustion is applicable. nerve.
Regional anatomy
Vasculature: The dorsal venous net- 5. Shangqiu (Jing-River Point, SP 5)
work of the foot, the medial plantar ar-
Location: In the depression distal and
tery and the branches of the medial tarsal
artery. inferior to the medial malleolus, midway
between the tuberosity of the navicular
Innervation: The. branches of the sa-
bone and the tip of the medial malleolus.
phenous nerve and superficial peroneal
(See Fig. 72)
nerve.
Indications: Abdominal distension,
constipation, diarrhea, borborygmus,
4. Gongsun (Luo-Connecting Point, pain and rigidity of the tongue, pain in
Confluent Point, SP 4) the foot and ankle, hemorrhoid.
Method: Puncture perpendicularly
Location: In the depression distal and
0.2-0.3 inch. Moxibustion is applicable.
inferior to the base of the first metatarsal
Regional anatomy
bone, at the junction of the~ed ?d ~~e Vasculature: The medial tarsal artery
skin. (See Fig. 72) ..Jw~ . ~~~ and the great saphenous vein.
Indications: Gai'trji[-pa' , vomYting, Innervation: The medial crural cu-
abdominal pain and distension, diarrhea, taneous nerve and the branch of the su-
dysentery, borborygmus. perficial peroneal nerve.
Method: Puncture perpendicularly
0.5-0.8 inch. Moxibustion is applicable. 6. Sanyinjiao (SP 6)
Regional anatomy
Vasculature: The medial tarsal artery Location: 3 cun directly above the tip
and the dorsal venous network of the of the medial malleolus, posterior to the
foot. medial border of the tibia. (See Fig. 73)
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYII\ AND Y ANG;"'!ING MERIDIANS 159

Indications: Abdominal pain, borbor- lingquan (SP 9) and the medial malleo-
ygmus, abdominal distension, diarrhea, lus. (See Fig. 73)
dysmenorrhea, irregular menstruation, Indications: Abdominal pain and dis-
uterine bleeding, morbid leukorrhea, pro- tension, diarrhea, edema, dysuria, noctur-
lapse of the uterus, sterility, delayed la- nal emission, irregular menstruation, dys-
bour, nocturnal emission, impotence, en- menorrhea.
uresis, dysuria, edema, hernia, pain in the
Method: Puncture perpendicularly
external genitalia, muscular atrophy, mo-
0.5-1.0 inch. Moxibustion is applicable.
tor impairment, paralysis and pain of the
Regional anatomy
lower extremities, headache, dizziness
Vasculature: Anteriorly, the great sa-
and vertigo, insomnia.
Method: Puncture perpendicularly phenous vein and the branch of the genu
0.5-1.0 inch. Moxibustion is applicable. suprema artery; deeper, the posterior tib-
Acupuncture on this point is contraindi- ial artery and vein.
cated in pregnant women. Innervation: See Sanyinjiao (SP 6).
Regional anatomy
Vasculature: The great saphenous 9. Yinlingquan (He-Sea Point, SP 9)
vein, the posterior tibial artery and vein.
Innervation: Superficially, the medial
crural cutaneous nerve; deeper, in the
posterior aspect, the tibial nerve.

7. Lougu (SP 7)
Location: 6 cun from the tip of the
Yinlingquan (SP 9) _
medial malleolus, on the line connecting
the tip of the medial malleolus and Yin-
lingquan (SP 9), posterior to the medial Diji (SP 8) - - __
7 cun
border of the tibia. (See Fig. 73)
Indications: Abdominal distension,
Lougu (SP 7) -_
borborygmus, coldness, numbness and
paralysis of the knee and leg.
Method: Puncture perpendicularly Sanyinjiao (SP 6) - - - 6 cun
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Sanyinjiao
(SP 6).

8. Diji (Xi-Cleft Point, SP 8)

Location: 3 cun below Yinlingquan Fig. 73

(SP 9)', on the line connecting Yin-

160 CHINESE ACUPUNCTURE AND MOXIBUSTION

Location: On the lower border of the

medial condyle of the tibia, in the depres- Xuehai (SP 10)
,,
sion posterior and inferior to the midial ,
condyle of the tibia. (See Fig. 73)
Indications: Abdominal pain and dis-
tension, diarrhea, dysentery, edema,
jaundice, dysuria, enuresis, incontinence
of urine, pain in the external genitalia,
dysmenorrhea, pain in the knee.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Fig. 74
Regional anatomy
Vasculature: Anteriorly, the great sa-
phenous vein, the genu suprema artery; Vasculature: The muscular branches
deeper, the posterior tibial artery and of the femoral artery and vein.
veIn. Innervation: The anterior femoral cu-
Innervation: Superficially, the medial taneous nerve and the muscular branch
of the femoral nerve.
crural cutaneous nerve; deeper, the tibial
nerve.
11. Jimen (SP 11)
10. Xuehai (SP 10) Location: 6 cun above Xuehai (SP 10),
on the line drawn from Xuehai (SP 10) to
Location: When the knee is flexed, the
Chongmen (SP 12). (See Col. Fig. 5)
point is 2 cun above the mediosuperior
Indications: Dysuria, enuresis, pain
border of the patella, on the bulge of the
and swelling in the inguinal region, mus-
medial portion of m. quadriceps femoris.
cular atrophy, motor impairment, pain
Or when the patient's knee is flexed, cup and paralysis of the lower extremities.
your right palm to his left knee, with the Method: Puncture perpendicularly
thumb on the medial side and with the 0.5-1.0 inch. Moxibustion is applicable.
other four fingers directed proximally, Regional anatomy
and the thumb forming an angle of 45° Vasculature: Superficially, the great
with the index finger. The point is where saphenous vein; deeper on the lateral
the tip of your thumb rests. (See Fig. 74) side, the femoral artery and vein.
Indications: Irregular menstruation, Innervation: The anterior femoral cu-
dysmenorrhea, uterine bleeding, amenor- taneous nerve; deeper, the saphenous
rhea, urticaria, eczema, erysipelas, pain nerve.
in the medial aspect of the thigh.
Method: Puncture perpendicularly 12. Chongmen (SP 12)
0.5-1.2 inches. Moxibustion is applicable.
Regional anatomy Location: Superior to the lateral end
CHAPTER -; ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 161

of the inguinal groove, lateral to the pul- Vasculature: The eleventh intercostal
sating external iliac artery, at the level of artery and vein.
the upper border of symphysis pubis, 3.5 Innervation: The eleventh intercostal
cun lateral to Qugu (CV 2). (See Col. nerve.
Fig. 6)
Indications: Abdominal pain, hernia, 15. Daheng (SP 15)
dysuria.
Method: Avoid puncturing the artery. Location: 4 cun lateral to the center of
Puncture perpendicularly 0.5-1.0 inch. the umbilicus, lateral to m. rectus abdom-
Moxibustion is applicable. inis. (See Fig. 75)
Regional anatomy Indications: Abdominal pain and dis-
Vasculature: On the medial side, the tension, diarrhea, dysentery, constipa-
femoral artery. tion.
Innervation: Just where the femoral Method: Puncture perpendicularly
nerve traverses. 0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy
13. Fushe (SP 13) Vasculature: The tenth intercostal ar-
tery and vein.
Location: 4 cun below the centre of Innervation: The tenth intercostal
the umbilicus, 0.7 cun superior to Chong- nerve.
men (SP 12),4 cun lateral to the anterior
midline. (See Col. Fig. 6) 16. Fuai (SP 16)
Indications: Lower abdominal pain,
hernia. Location: 3 cun above the centre of
Method: Puncture perpendicularly the umbilicus, and 4 cun lateral to the
0.5-1.0 inch. Moxibustion is applicable. anterior midline. (Col. Fig. 6)
Regional anatomy Indications: Abdominal pain, indiges-
Innervation: The ilioinguinal nerve. tion, constipation, dysentery.
Method: Puncture perpendicularly
14. Fujie (SP 14) 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Location: 1.3 cun below Daheng (SP Vasculature: The eighth intercostal
15), 4 cun lateral to the anterior midline, artery and vein.
on the lateral side of m. rectus abdomin- Innervation: The eighth intercostal
is. (See Col. Fig. 6) nerve.
Indications: Pain around the umbili-
cal region, abdominal distension, hernia, 17. Shidou (SP 17)
diarrhea, constipation.
Method: Puncture perpendicularly Location: In the fifth intercostal
0.5-1.0 inch. Moxibustion is applicable. space, 6 cun lateral to the anterior mid-
Regional anatomy line. (See Col. Fig. 6)
162 CHINESE ACLJPLJNCTCRE AND MOXlBl'STlON

Daheng(SP 15) - - - - ~--

'\ /
'- -
Fig. 75

Indications: Fullness and pain in the eral thoracic artery and vein, the thoraco-
chest and hypochondriac region. epigastric artery and vein, the fourth in-
Method: Puncture obliquely 0.3-0.5 tercostal artery and vein.
inch. Moxibustion is applicable. Innervation: The lateral cutaneous
Regional anatomy branch of the fourth intercostal nerve.
Vasculature: The thoracoepigastric
vem. 19. Xiongxiang (SP 19)
Innervation: The lateral cutaneous
branch of the fifth intercostal nerve. Location: In the third intercostal
space, 6 cun lateral to the anterior mid-
18. Tianxi (SP 18) line. (See Col. Fig. 6)
Indications: Fullness and pain in the
Location: In the fourth intercostal
space, 6 cun lateral to the anterior mid- chest and hypochondriac region.
line. (See Col. Fig. 6) Method: Puncture obliquely 0.3-0.5
Indications: Fullness and pain in the inch. Moxibustion is applicable.
chest and hypochondrium, cough, hic- Regional anatomy
cup, mastitis, insufficient lactation. Vasculature: The lateral thoracic ar-
Method: Puncture obliquely 0.3-0.5 tery and vein, the third intercostal artery
inch. Moxibustion is applicable. and vein.
Regional anatomy Innervation: The lateral cutaneous
Vasculature: The branches of the lat- branch of the third intercostal nerve.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING .\IERIDIANS 16~

20. Zhourong (SP 20) 21. Dabao (Major Luo-Connecting

Point of the Spleen, SP 21)
Location: In the second intercostal
space, 6 cun lateral to the anterior mid- Location: On the lateral side of the
line. (See Col. Fig. 6) chest and on the middle axillary line. in
Indications: Fullness in the chest and the 6th intercostal space. (See Col. Fig. 6)
Indications: Pain in the chest and hy-
hypochondriac region, cough, hiccup.
pochondriac region, asthma, general ach-
Method: Puncture obliquely 0.3-0.5
ing and weakness.
inch. Moxibustion is applicable.
Method: Puncture obliquely 0.3-0.5
Regional anatomy inch. Moxibustion is applicable.
Vasculature: The lateral thoracic ar- Regional anatomy
tery and vein, the second intercostal ar- Vasculature: The thoracodorsal artery
tery and vein. and vein, the seventh intercostal artery
Innervation: The muscular branch of and vein.
the anterior thoracic nerve, the lateral Innervation: The seventh intercostal
cutaneous branch of the second intercos- nerve and the terminal branch of the long
tal nerve. thoracic nerve.
 Chapter 7
ACUPUNCTURE POINTS OF THE TAIYIN AND
YANGMING MERIDIANS

The Lung Meridian of Hand-Taiyin inch towards the lateral aspect of the
running from the chest to the hand, and chest. To avoid injuring the lung, never
the Large Intestine Meridian of Hand- puncture deeply towards the medial as-
Yangming going from the hand to the pect. Moxibustion is applicable.
head, are exteriorly-interiorly related, so Regional anatomy
are the Stomach Meridian of Foot- Vasculature: Superolaterally, the axil-
Yangming travelling from the head to the lary artery and vein, the thoracoacromial
foot and the Spleen Meridian of Foot- artery and vein.
Taiyin travelling from the foot to the Innervation: The intermediate supra-
abdomen (chest). The four meridians are clavicular nerve, the branches of the an-
mainly distributed on the extremities and terior thoracic nerve, and the lateral cu-
in the anterior aspect of the trunk. Their taneous branch of the first intercostal
acupuncture points are described as fol- nerve.
lows.

I. THE LUNG MERIDIAN OF

HAND-TAIYIN
... Yunmen (LU 2)

1. Zhongfu (Front-Mu Point of

the Lung, LV 1)
Location: Laterosuperior to the ster-
num, 1 cun below Yunmen (LV 2), at the
level of the first intercostal space, 6 cun
lateral to the anterior midline. (See
Fig. 55)
Indications: Cough, asthma, pain in
the chest, shoulder and back, fullness of
the chest. Fig. 55

Method: Puncture obliquely 0.5-0.8

135
136 CHINESE ACUPUNCTURE AND MOXIBUSTION

2. Yunmen (LV 2) 4. Xiabai (LV 4)

Location: In the superior lateral part Location: On the medial aspect of the
of the anterior thoracic wall, superior to upper arm, 4 cun below the anterior end
the coracoid process of scapula, in the of the axillary fold, or 5 Cun above the
depression of the infraclavicular fossa, 6 cubital crease, on the radial side of m.
cun lateral to the anterior midline. biceps brachii. (See Col. Fig. 1)
Indications: Cough, asthma, pain in Indications: Cough, fullness in the
the chest, shoulder and arm, fullness in chest, pain in the medial aspect of the
the chest. upper arm.
Method: Puncture obliquely 0.5-0.8 Method: Puncture perpendicularly
inch towards the lateral aspect of the 0.5-1 inch. Moxibustion is applicable.
chest. To avoid injuring the lung, never Regional anatomy
puncture deeply towards the medial as- Vasculature: The cephalic vein and
pect. Moxibustion is applicable. mus.cular branches of the brachial artery
Regional anatomy and vein.
Vasculature: The cephalic vein, the Innervation: The lateral brachial cu-
thoracoacromial artery and vein; infer-
taneous nerve at the place where the
iorly, the axillary artery.
musculo-cutaneous never passes through.
Innervation: The intermediate and la-
teral supraclavicular nerve, the branches
of the anterior thoracic nerve, and the 5. Chize (He-Sea Point, LV 5)
lateral cord of the brachial plexus. Location: On the cubital crease, in the
depression of the radial side of the ten-
3. Tianfu (LV 3) don of m. biceps brachii. This point is
Location: On the medial aspect of the located with the elbow slightly flexed.
upper arm, 3 cun below the end of axil- (See Fig. 56)
lary fold, on the radial side of m. biceps Indications: Cough, hemoptysis, after-
brachii. (See Col. Fig. 1) noon fever, asthma, sore throat, fullness
Indications: Asthma, epistaxis, pain in in the chest, infantile convulsions, spas-
the medial aspect of the upper arm. modic pain of the elbow and arm, masti-
Method: Puncture perpendicularly tis.
0.5-1 inch. Method: Puncture perpendicularly
Regional anatomy 0.5-1 inch.
Vasculature: The cephalic vein and Regional anatomy
muscular branches of the brachial artery Vasculature: The branches of the ra-
and vein. dial recurrent artery and vein, the cephal-
Innervation: The lateral brachial cu- ic vein.
taneous nerve at the place where the mus- Innervation: The lateral antebrachial
culocutaneous nerve passes through. cutaneous nerve and the radial nerve.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND Y ANGJI'IING MERIDIANS 137

6. Kongzui (Xi-Cleft Point, LV 6)

Location: On the palmar aspect of the
/ forearm, on the line joining Taiyuan (LV
9) and Chize (LU 5), 7 cun above the
transverse crease of the wrist. (See
Fig. 57)
Indications: Cough, pain in the chest,
asthma, hemoptysis, sore throat, spas-
modic pain of the elbow and arm.
Method: Puncture perpendicularly
0.5-1 inch. Moxibustion is applicable.
- - - Chize(LU 5)
Regional anatomy
Vasculature: The cephalic vein, the
radial artery and vein.
Innervation: The lateral antebrachial
Fig. 56
cutaneous nerve and the superficial ra-
mus of the radial nerve.

7. Lieque (Luo-Connecting Point,

Confluent Point, LV 7)

Chize(LU5) - - - - - Location: Superior to the styloid pro-

cess of the radius, 1.5 cun above the
5 cun
transverse crease of the wrist between
brachioradial muscle and the tendon of
Kongzui (LU 6) long abductor muscle of the thumb. (See
Fig. 57) When the index fingers and
Lieque (LU 7) 7 cun thumbs of both hands are crossed with
--- the index finger of one hand placed on
the styloid process of the radius of the
other, the point is in the depression right
under the tip of the index finger. (See
Fig. 58)
::J-
...J Indications: Headache, migraine, neck
Cl
c: rigidity, cough, asthma, sore throat, fa-
~o cial paralysis, toothache, pain and weak-
.,
~ ness of the wrist.
Method: Puncture 0.3-0.5 inch
obliquely upward. Moxibustion is appli-
Fig. 57 cable.
138 CHINESE ACUPUNCTURE AND MOXIBUSTION

9. Taiyuan (Shu-Stream and

Yuan-Primary Point,
Lieque (LU 7)
Influential Point of
Vessels, LV 9)
Location: At the radial end of the
transverse crease of the wrist, in the de-
pression on the lateral side of the radial
artery. (See Fig. 57)
Indications: Cough, asthma, hemop-
tysis, sore throat, palpitation, pain in the
chest, wrist and arm.
Fig. 58 Method: Puncture perpendicularly
0.2-0.3 inch. Avoid puncturing the radial
artery. Moxibustion is applicable.
Regional anatomy Regional anatomy
Vasculature: The cephalic vein, Vasculature: The radial artery and
branches of the radial artery and vein. velll.
Innervation: The lateral antebrachial Innervation: The lateral antebrachial
cutaneous nerve and the superficial ra- cutaneous nerve and superficial ramus of
mus of the radial nerve. the radial nerve.

8. Jingqu (Jing-River Point, LV 8) 10. Yuji (Ying-Spring Point,

LV 10)
Location: 1 cun above the transverse
crease of the wrist in the depression on Location: On the radial aspect of the
the lateral side of the radial artery. (See midpoint of the first metacarpal bone, on
Fig. 57) the junction of the red and white skin
Indications: Cough, asthma, fever, (i.e., the junction of the dorsum and palm
pain in the chest, sore throat, pain in the of the hand). (See Fig. 57)
wrist. Indications: Cough hemoptysis, sore
Method: Puncture perpendicularly throat, loss of voice, fever, feverish sen-
0.1-0.3 inch. Avoid puncturing the radial sation in the palm.
artery. Method: Puncture perpendicularly
Regional anatomy 0.5-0.8 inch. Moxibustion is applicable.
Vasculature: Laterally, the radial ar- Regional anatomy
tery and vein. Vasculature: Venules of the thumb
Innervation: The lateral antebrachial draining to the cephalic vein.
cutaneous nerve and the superficial ra- Innervation: The superficial ramus of
mus of the radial nerve. the radial nerve.
 CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 139

11. Shaoshang (Jing-Well Point,

LV 11)
Location: On the radial side of the
thumb, about 0.1 cun posterior to the
corner of the nail. (See Fig. 57) - - - Hegu (LI 4)
Indications: Sore throat, cough, asth- - - Sanjian (LI 3)
ma, epistaxis, fever, loss of conscious-
ness, mania, spasmodic pain of the
thumb.
Method: Puncture 0.1 inch, or prick
the point to cause bleeding.
Regional anatomy
Vasculature: The arterial and venous
network formed by the palmar digital
proprial artery and veins.
Fig. 59
Innervation: The terminal nerve net-
work formed by the mixed branches of Vasculature: The arterial and venous
the lateral antebrachial cutaneous nerve network formed by the dorsal digital ar-
and the superficial ramus of the radial teries and veins.
nerve as well as the palmar digital propri- Innervation: The palmar digital pro-
al nerve of the median nerve. prial nerve derived from the median
nerve.

II. THE LARGE INTESTINE

2. Erjian (Ying-Spring Point, LI 2)
MERIDIAN OF
HAND-YANGMING Location: In the depression of the ra-
dial side of the index finger, distal to
1. Shangyang (Jing-Well Point, LI 1) the 2nd metacarpal-phalangeal joint. The
point is located with the finger slightly
Location: On the radial side of the flexed. (See Fig. 59)
index finger, about 0.1 cun posterior to Indications: Blurring of vision, Epis-
the corner of the nail. (See Fig. 59) taxis, toothache, sore throat, febrile di-
Indications: Toothache, sore throat, seases.
swelling of the submandibular region, Method: Puncture perpendicularly
numbness of fingers, febrile diseases with 0.2-0.3 inch. Moxibustion is applicable.
anhidrosis, loss of consciousness. Regional anatomy
Method: Puncture 0.1 inch, or prick Vasculature: The dorsal digital and
the point to cause bleeding. plamar digital propria 1 arteries and veins
Regional anatomy derived from the radial artery and vein.

-------. ----- ---

140 CHINESE ACUPUNCTURE AND MOXIBUSTION

Innervation: The dorsal digital nerve

of the radial nerve, and the palmar digital Hegu (LI 4)

proprial nerve of the median nerve.

3. Sanjian (Shu-Stream Point, LI 3)

Location: When a loose fist is made,
the point is on the radial side of the index
finger, in the depression proximal to the
head of the second metacarpal bone. (See
Fig. 59) Fig. 60
Indications: Toothache, ophthalmal-
gia, sore throat, redness and swelling of paralysis, febrile diseases with anhidrosis,
fingers and the dorsum of the hand. hidrosis, abdominal pain, dysentery, con-
Method: Puncture perpendicularly stipation, amenorrhea, delayed labour,
0.5-0.8 inch. Moxibustion is applicable. infantile convulsion, pain, weakness and
Regional anatomy motor impairment of the upper limbs.
Vasculature: The dorsal venous net- Method: Puncture perpendicularly
work of the hand and the branch of the 0.5-1 inch. Moxibustion is applicable.
first dorsal metacarpal artery. Acupuncture and moxibustion are con-
Innervation: The superficial ramus of traindicated in pregnant women.
the radial nerve.
Regional anatomy
Vasculature: The venous network of
4. Hegu (Yuan-Primary Point, LI 4) the dorsum of the hand.
Location: On the dorsum of the hand, Innervation: The superficial ramus of
between the 1st and 2nd metacarpal the radial nerve.
bones, approximately in the middle of the
2nd metacarpal bone on the radial side. 5. Yangxi (Jing-River Point, LIS)
(See Fig. 59) Or, place in coincident po-
sition the transverse crease of the inter- Location: On the radial side of the
phalangeal joint of the thumb with the wrist. When the thumb is tilted upward,
margin of the web between the thumb it is in the depression between the ten-
and the index finger of the other hand. dons of m. extensor pollicis longus and
The point is where the tip of the thumb brevis. (See Fig. 59)
touches. (See Fig. 60) Indications: Headache, redness, pain
Indications: Headache, pain in the and swelling of the eye, toothache, sore
neck, redness, swelling and pain of the throat, pain of the wrist.
eye, epistaxis, nasal obstruction, rhinor- Method: Puncture perpendicularly
rhea, toothache, deafness, swelling of the 0.3-0.5 inch. Moxibustion is applicable.
face, sore throat, parotitis, trismus, facial Regional anatomy
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND YANGMING MERIDIANS 141

Vasculature: The cephalic vein, the Regional anatomy

radial artery and its dorsal carpal branch. Vasculature: The cephalic vein.
Innervation: The superficial ramus of Innervation: On the radial side, the
the radial nerve. lateral antebrachial cutaneous nerve and
the superficial ramus of the radial nerve;
6. Pianli (Luo-Connecting Point, LI 6) on the ulnar side, the posterior antebra-
chial cutaneous nerve and the posterior
Location: With the elbow flexed and antebrachial interosseous nerve.
the radial side of arm upward, the point
is on the line joining Yangxi (LI 5) and 7. Wenliu (Xi-Cleft Point, LI 7)
Quchi (LI I I), 3 cun above the crease of
the wrist. (See Fig. 61) Location: With the elbow flexed and
Indications: Redness of the eye, tin- the radial side of arm upward, the point
nitus, deafness, epistaxis, aching of the is on the line connecting Yangxi (LI 5)
hand and arm, sore throat, edema. and Quchi (LI I I), 5 cun above the crease
Method: Puncture perpendicularly or of the wrist. (See Fig. 61)
obliquely 0.5-0.8 inch. Moxibustion is ap- Indications: Headache, swelling of
plicable. the face, sore throat, borborygmus-, ab-
dominal pain, aGh,ing of the shoulder
and arm. ~~j ,at> Vrr- 1-1:..
Method: Puncture perpendicularly
Q.5- 1.0 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The muscular branch of
I }.2.
7 cun
r-
\
- -- - Quchi (LI 11)
---Shousanli (Ll10) c.ww\I
the radial artery, the cephalic vein.
Innervation: The posterior antebra-
chial cutaneous nerve and the deep ramus
'>-~r---'- ___ Wenliu (Ll7) of the radial nerve.
5 cun - - - Pianli (LI 6) I3<,uIrY
8. Xialian (LI 8)
'----+-~IPt----- Yangxi (LI 5)

Location: On the line joining Yangxi

(U 5) and Quchi (LI 11), 4 cun below the
cubital crease. (See Col Fig. 2)
Indications: Abdominal pain, borbor-
ygmus, pain in the elbow and arm, motor
impairment of the upper limbs.
Method: Puncture perpendicularly
Fig. 61 0.5- 1.0 inch. Moxibustion is applicable.
Regional anatomy: See Wenliu (LI 7)
142 CHINESE ACUPUNCTVRE AND MOXIBUSTION

9. Shanglian (LI 9) ing, diarrhea, febrile diseases.

Method: Puncture ))erpendicularly
Location: On the line joining Yangxi 1.0-1.5 inches. Moxibustion is applicable.
(LI 5) and Quchi (LI 11),3 cun below the Regional anatomy
cubital crease. (See Col Fig. 2) Vasculature: The branches of the ra-
Indications: Aching of the shoulder dial recurrent artery and vein.
and arm, motor impairment of the upper Innervation: The posterior antebra-
limbs, numbness of the hand and arm, chial cutaneous nerve; deeper, on the me-
borborygmus, abdominal pain. dial side, the radial nerve.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. 12. Zhouliao (LI 12)
Regional anatomy: See Wenliu (LI 7).
Location: When the elbow is flexed,
10. Shousanli (LI 10) the point is on the lateral side of the
upper arm, I cun above Quchi (LI 11), on
Location: On the line joining Yangxi the border of humerus. (See Col. Fig. 2)
(LI 5) and Quchi (LI II), 2 cun below the Indications: Pain, numbness and con-
cubital crease. (See Fig. 61) tracture of the elbow and arm.
Indications: Abdominal pain, diar- Method: Puncture perpendicularly
rhea, toothache, swelling of the cheek, 0.5-1.0 inch. Moxibustion is applicable.
motor impairment of the upper limbs, Regional anatomy
pain in the shoulder and back. Vasculature: The radial collateral ar-
Method: Puncture perpendicularly tery and vein.
0.8-1.2 inches. Moxibustion is applicable. Innervation: The posterior antebra-
Regional anatomy chial cutaneous nerve; deeper, on the me-
Vasculature: The branches of the ra- dial side, the radial nerve.
dial recurrent artery and vein.
Innervation: See Wenliu (LI 7). 13. Shouwuli (LI 13)

11. Quchi (He-Sea Point, LI 11) Location: On the lateral side of the
upper arm, on the line connecting Quchi
Location: When the elbow is flexed, (LI II) and Jianyu (LI 15),3 cun above
the point is in the depression at the later- Quchi (LI 11). (See Col. Fig. 2)
al end of the transverse cubital crease, Indications: Contracture and pain of
midway between Chize (LV 5) and the the elbow and arm, scrofula.
lateral epicondyle of the humerus. (See Method: Puncture perpendicularly
Fig. 61) 0.5-1.0 inch. Avoid injuring the artery.
Indications: Sore throat, toothache, Moxibustion is applicable.
redness and pain of the eye, scrofula, Regional anatomy
urticaria, motor impairment of the up- Vasculature: The radial collateral ar-
per extremities, abdominal pain, vomit- tery and vein.
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANGMING MERIDIANS 143

Innervation: The posterior antebra-

chial cutaneous nerve; deeper, the radial
nerve.

14. Binao (LI 14)

Jianyu (LI 15) - -
Location: On the lateral side of the
upper arm, on the line joining Quchi
(LI 11) and Jianyu (LI 15), 7 cun above
Quchi (LI 11), at the insertion of m.
deltoideus. (See Col. Fig. 2)
Indications: Pain in the shoulder and
arm, rigidity of the neck, scrofula. Quchi(Ll11)--- -

Method: Puncture perpendicularly or

obliquely upward 0.8-1.5 inches. Moxi-
bustion is applicable.
Regional anatomy
Vasculature: The branches of posteri- Fig.62
or circumflex humeral artery and vein,
the deep brachial artery and vein. lar nerve and axillary nerve.
Innervation: The posterior brachial
cutaneous nerve; deeper, the radial nerve.
16. Jugu (LI 16)
15. Jianyu (LI 15)
Location: In the upper aspect of the
Location: Antero-inferior to the ac- shoulder, in the depression between the
romion, on the upper portion of m. del- acromial extremity of the clavicle and the
toideus. When the arm is in full ab- scapular spine. (See Col. Fig. 2)
duction, the point is in the depression Indications: Pain and motor impair-
appearing at the anterior border of the ment of the upper extremities, pain in the
acromioclavicular joint. (See Fig. 62) shoulder and back.
Indications: Pain in the shoulder and Method: Puncture perpendicularly
arm, motor impairment of the upper ex-
tremities, rubella, scrofula. .
0.5-0.7 inch. Moxibustion is applicable.
Regional anatomy
Method: Puncture perpendicularly or
Vasculature: Deeper, the suprascapu-
obliquely 0.8-1.5 in~hes. Moxibustion is
applicable. lar artery and vein.
Regional anatomy Innervation: Superficially, the lateral
Vasculature: The posterior circumflex supraclavicular nerve, the branch of the
artery and vein. accessory nerve; deeper, the suprascapu-
Innervation: The lateral supraclavicu- lar nerve.
144 CHINESE ACUPUNCTURE AND MOXIBUSTION

17. Tianding (LI 17) 19. Kouheliao (LI 19)

Location: On the lateral side of the Location: Right below the lateral mar-
neck, at the posterior border of sterno- gin of the nostril, level with Renzhong
cleidomastoid muscle, beside the larynge- (Shuigou, GV 26). (See Col. Fig. 2)
al protuberance, at the midpoint of the Indications: Nasal obstruction, epis-
line connecting Futu (LI 18) and Quepen taxis, deviation of the mouth.
(ST 12). (See Col. Fig. 2) Method: Puncture obliquely 0.2-0.3
Indications: Sudden loss of voice, sore inch.
throat, scrofula, goiter. Regional anatomy
Method: Puncture perpendicularly Vasculature: The superior labial
0.3-0.5 inch. Moxibustion is applicable. branches of the facial artery and vein.
Regional anatomy Innervation: The anastomotic branch
Vasculature: The external jugular of the facial nerve and the infraorbital
vein. nerve.
Innervation: Superficially, the supra-
clavicular nerve. It is on the posterior 20. Yingxiang (LI 20)
border of m. sternocleidomastoideus just
where the cutaneous cervical nerve Location: In the nasolabial groove, at
emerges. Deeper, the phrenic nerve. the level of the midpoint of the lateral
border of ala nasi. (See Fig. 63)
Indications: Nasal obstruction, hypos-
18. Futu (LI 18)
mia, epistaxis, rhinorrhea, deviation of
Location: On the lateral side of the the mouth, itching and swelling of the
neck, level with the tip of Adam's apple, face.
between the sternal head and clavicular
head of m. sternocleidomastoideus. (See
Col. Fig. 2)
Indications: Cough, asthma, sore
throat, sudden loss of voice, scrofula,
goiter.
o
N
Method: Puncture perpendicularly
...J
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
'"c
.!!!
x
--
Vasculature: Deeper, on the medial '"c
>=
side, the ascending cervical artery and
vein.
Innervation: The great auricular
nerve, cutaneous cervical nerve, lesser oc-
cipital nerve and accessory nerve. Fig. 63

- - ------------ - - -
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 145

Method: Puncture obliquely or subcu- with the left thumb and puncture perpen-
taneously 0.3-0.5 inch. dicularly and slowly 0.5-1.0 inch along
Regional anatomy the infraorbital ridge. It is not advisable
Vasculature: The facial artery and to manipulate the needle with large am-
vein, the branches of the infraorbital ar- plitude.
tery and vein. Regional anatomy
Innervation: The anastomotic branch Vasculature: The branches of the in-
of the facial and infraorbital nerves. fraorbital and ophthalmic arteries and
veins.
Innervation: The branch of the in-
III. THE STOMACH fraorbital nerve, the inferior branch of
MERIDIAN OF the oculomotor nerve and the muscular
FOOT-YANGMING branch of the facial nerve.

1. Chengqi (ST 1) 2. Sibai (ST 2)

Location: Directly below the pupil, in
Location: With the eyes looking
the depression at the infraorbital fora-
straight forward, the point is directly be-
men. (See Fig. 64)
low the pupil, between the eyeball and the
Indications: Redness, pain and itching
infraorbital ridge. (See Fig. 64)
of the eye, facial paralysis, twitching of
Indications: Redness, swelling and
eye lids, pain in the face.
pain of the eye, lacrimation, night blind-
Method: Puncture perpendicularly
ness, twitching of eyelids, facial paralysis.
0.2-0.3 inch. It is not advisable to punc-
Method: Push the eyeball upward
ture deeply.
Regional anatomy
Vasculature: The branches of facial
artery and vein, the infraorbital artery
{,
................"'" and vein.
Innervation: The branches of the fa-

Chengqi(ST 1)
( .....
~~ ~
...
cial nerve. The point is right on the
course of the infraorbital nerve.

3. Juliao (ST 3)
Sibai (ST 2): C1===-
Juliao(ST3) - - , - - Location: Directly below the pupil, at
Dicang (ST 4) - - - - - ---.Ho.M1'V" the level of the lower border of ala
nasi, on the lateral side of the nasolabi-
al groove. (See Fig. 64)
Indications: Facial paralysis, twitch-
Fig. 64 ing of eyelids, epistaxis, toothache, swell-
146 CHINESE ACUPUNCTURE AND MOXIBUSTION

ing of lips and cheek. Puncture obliquely 0.3-0.5 inch. Moxi-

Method: Puncture perpendicularly bustion is applicable.
0.3-0.5 inch. Moxibustion is applicable. Regional anatomy
Regional anatomy Vasculature: Anteriorly, the facial ar-
Vasculature: The branches of the fa- tery and vein.
cial and infraorbital arteries and veins. Innervation: The facial and buccal
Innervation: The branches of the fa- nerves.
cial and infraorbital nerves.
6. Jiache (ST 6)
4. Dicang (ST 4)
Location: One finger-breadth (middle
Location: Lateral to the corner of the finger) anterior and superior to the lower
mouth, directly below the pupil. (See angle of the mandible where m. mas-
Fig. 64) seter is prominence when the teeth are
Indications: Deviation of the mouth,
clenChed, and depressive when it is
salivation, twitching of eyelids.
pressed. (See Fig. 65)
Method: Puncture subcutaneously
Indications: Facial paralysis, tooth-
1.0-1.5 inches with the tip of the needle
ache, swelling of the cheek and face,
directed towards liache (ST 6). Moxibus-
mumps, trismus.
tion is applicable.
Method: Puncture perpendicularly
Regional anatomy
0.3-0.5 inch, or subcutaneously with the
Vasculature: The facial artery and
tip of the needle directed towards Dicang
vein.
Innervation: Superficially, the branch- (ST 4). Moxibustion is applicable.
es of the facial and infraorbital nerves;
deeper, the terminal branch of the buccal
nerve.
~1"'----
5. Daying (ST 5) (
Location: Anterior to the angle of ~ )
mandible, on the anterior border of the . ~~~I!n __ Xiaguan (ST 7)

-
~_-~~ ___- Ji.""",STO,
attached portion of m. masseter where ~~ ~
the pulsation of facial artery is palpable,
in the groove-like depression appearing
when the cheek is bulged. (See Col. ~ '-I
Fig. 3)
Indications: Facial paralysis, trismus,
/
swelling of the cheek, pain in the face,
toothache. Fig. 65
Method: Avoid puncturing the artery.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 147

Regional anatomy
Vasculature: The masseteric artery.
Innervation: The great auricular
nerve, facial nerve and masseteric nerve.

7. Xiaguan (ST 7)
Location: On the face, anterior to the
ear, in the depression between the zygo-
Reny;ng(ST".!.~:...
matic arch and the mandibular notch.
This point is located with the mouth
closed. (See Fig. 65)
Indications: Deafness, tinnitus, otor-
rhea, toothache, facial paralysis, pain of
Fig. 66
the face, motor impairment of the jaw.
Method: Puncture perpendicularly
OJ-0.5 inch. Moxibustion is applicable.
branch of the facial nerve.
Regional anatomy
Vasculature: Superficially, the trans-
verse facial artery and vein; in the deep- 9. Renying (ST 9)
est layer, the maxillary artery and vein.
Location: Level with the tip of Adam's
Innervation: The zygomatic branch of
apple where the pulsation of common
the facial nerve and the branches of the
carotid artery is palpable, on the anteri-
auriculotemporal nerve.
or border of m. sternocIeidomastoideus.
(See Fig. 66)
8. Touwei (ST 8) Indications: Sore throat, asthma, goi-
Location: On the lateral side of the ter, dizziness, flushing of the face.
head, 0.5 cun above the anterior hairline Method: Avoid puncturing the com-
at the corner of the forehead, and 4.5 cun mon carotid artery, puncture perpendic-
lateral to the midline of the head. (See ularly 0.3-0.5 inch.
Fig. 65) Regional anatomy
Indications: Headache, blurring of vi- Vasculature: The superior thyroid ar-
sion, ophthalmalgia, lacrimation. tery on the bifurcation of the internal
Method: Puncture 0.5-1.0 inch subcu- and the external carotid artery.
taneously. Innervation: SuperfiCially, the cu-
Regional anatomy taneous cervical nerve, the cervical
Vasculature: The frontal branches of branch of the facial nerve; deeper, the
the superficial temporal artery and vein. sympathetic trunk; laterally, the descend-
Innervation: The branch of the au- ing branch of the hypoglossal nerve and
riculotemporal nerve and the temporal the vagus nerve.
148 CHINESE ACUPUNCTURE AND MOXIBUSTION
~----------~~----~----~----------------

10. Shuitu (ST 10) anterior midline. (See Col. Fig. 3)

Indications: Cough, asthma, sore
Location: At the midpoint of the line throat, pain in the supraclavicular fossa.
joining Renying (ST 9) and Qishe (ST Method: A void puncturing the artery.
11), on the anterior border of m. sterno- Puncture perpendicularly 0.3-0.5 inch.
cleidomastoideus. (See Col. Fig. 3) Deep puncture is not advisable. Moxibus-
Indications: Sore throat, asthma, tion is applicable.
cough. Regional anatomy
Method: Puncture perpendicularly Vasculature: Superiorly, the trans-
0.3-0.5 inch. Moxibustion is applicable. verse cervical artery.
Regional anatomy Innervation: Superficially, the inter-
Vasculature: The common carotid ar- mediate supraclavicular nerve; deeper,
tery. the supraclavicular portion of brachial
Innervation: Superficially, the cu- plexus.
taneous cervical nerve; deeper, the super-
ior cardiac nerve issued from the sym- 13. Qihu (ST 13)
pathetic nerve and the sympathetic trunk.
Location: At the lower border of the
11. Qishe (ST 11) middle of the clavicle, 4 cun lateral to the
anterior midline. (See Col. Fig. 3)
Location: At the superior border of Indications: Fullness in the chest,
the sternal extremity of the clavicle, be- asthma, cough, hiccup, pain in the chest
tween the sternal head and clavicular and hypochondrium.
head of m. sternocleidomastoideus. (See Method: Puncture obliquely 0.3-0.5
Col. Fig. 3) inch. Moxibustion is applicable.
Indications: Sore throat, pain and ri- Regional anatomy
gidity of the neck, asthma, hiccup, goiter. Vasculature: The branches of the
Method: Puncture perpendicularly thoracoacromial artery and vein; super-
0.3-0.5 inch. Moxibustion is applicable. iorly, the subclavicular vein.
Regional anatomy Innervation: The branches of the su-
Vasculature: Superficially, the anteri- praclavicular nerve and the anterior tho-
or jugular vein; deeper, the common ca- racic nerve.
rotid artery.
Innervation: The medial supraclavicu- 14. Kufang (ST 14)
lar nerve and the muscular branch of
ansa hypoglossi. Location: In the first intercostal
space, 4 cun lateral to the anterior mid-
12. Quepen (ST 12) line. (See Col. Fig. 3)
Indications: Sensation of fullness and
Location: In the midpoint of the su- pain in the chest, cough.
praclavicular fossa, 4 cun lateral to the Method: Puncture obliquely 0.3-0.5

-- ------------------------
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANGMING MERIDIANS 149

inch. 17. Ruzhong (ST 17)

Moxibustion is applicable.
Regional anatomy Location: In the fourth intercostal
Vasculature: The thoracoacromial ar- space, in the centre of the nipple, 4 cun
tery and vein and the branches of the lateral to the anterior midline. (See Col.
lateral thoracic artery and vein. Fig. 3)
Innervation: The branch of the anteri- Acupuncture and moxibustion on this
or thoracic nerve. point are contraindicated. This point
serves only as a landmark for locating
points on the chest and abdomen.
15. Wuyi (ST 15)
Regional anatomy
Location: In the second intercostal Innervation: The anterior and lateral
space, 4 cun lateral to the anterior mid- cutaneous branches of the fourth inter-
line. (See Col. Fig. 3) costal nerve.
Indications: Fullness and pain in the
chest and the costal region, cough, asth- 18. Rugen (ST 18)
ma, mastitis.
Method: Puncture obliquely 0.3-0.5 Location: On the chest, directly below
inch. Moxibustion is applicable. the nipple, on the lower border of breast,
Regional anatomy in the 5th intercostal space, 4 cun lateral
Vasculature: See Kufang (ST 14).
Innervation: On the course of the
branch of m. pectoralis major derived
from the anterior thoracic nerve.

16. Yingchuang (ST 16)

Location: In the third intercostal
space, 4 cun lateral to the anterior mid-
line. (See Col. Fig. 3)
Indications: Fullness and pain in the
chest and hypochondrium, cough, asth-
ma, mastitis.
Method: Puncture obliquely 0.3-0.5
inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The lateral thoracic ar-
teryand vein.
Innervation: The branch of the anteri-
or thoracic nerve. Fig. 67
150 CHINESE ACUPUNCTURE AND MOXIBUSTION

to the anterior midline. (See Fig. 67) 21. Liangmen (ST 21)
Indications: Pain in the chest, cough,
asthma, mastitis, insufficient lactation. Location: 4 cun above the umbilicus,
Method: Puncture obliquely 0.3-0.5 2 cun lateral to Zhongwan (CV 12). (See
inch. Moxibustion is applicable. Fig. 68)
Regional anatomy Indications: Gastric pain, vomiting,
Vasculature: The branches of the in- anorexia, abdominal distension, diarrhea.
tercostal artery and vein. Method: Puncture perpendicularly
Innervation: The branch of the fifth
0.8-1.0 inch. Moxibustion is applicable.
Regional anatomy
intercostal nerve.
Vasculature: The branches of the
eighth intercostal and superior epigastric
19. Burong (ST 19) arteries and veins.
Location: 6 cun above the umbilicus, Innervation: The branch of the eighth
2 cun lateral to 1uque (CV 14). (See Col. intercostal nerve.
Fig. 3)
Indications: Abdominal distension, 22. Guanmen (ST 22)
vomiting, gastric pain, anorexia. Location: 3 curt above the umbilicus,
Method: Puncture perpendicularly 2 cun lateral to lianli (CV 11). (See Col.
0.5-0.8 inch. Moxibustion is applicable. Fig. 3)
Regional anatomy Indications: Abdominal distension
Vasculature: The branches of the sev- and pain, anorexia, borborygmus, diar-
enth intercostal artery and vein, the rhea, edema.
branches of the superior epigastric artery Method: Puncture perpendicularly
and vein. 0.8-1.0 inch. Moxibustion is applicable.
Innervation: The branch of the sev- Regional anatomy: See Liangmen
enth intercostal nerve. (ST 21)

20. Chengman (ST 20) 23. Taiyi (ST 23)

Location: 5 cun above the umbilicus, Location: 2 cun above the umbilicus,
2 cun lateral to Shangwan (CV 13). (See 2 cun lateral to Xiawan (CV 10). (See
Col. Fig. 3) Col. Fig. 3)
Indications: Gastric pain, abdominal Indications: Gastric pain, irritability,
distension, vomiting, anorexia. mania, indigestion.
Method: Puncture perpendicularly Method: Puncture perpendicularly
0.5-1.0 0.7-1.0 inch. Moxibustion is applicable.
inch. Moxibustion is applicable. Regional anatomy
Regional anatomy: See Burong Vasculature: The branches of the
(ST 19) eighth and ninth intercostal and inferior
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND Y ANG~IING MERIDIANS 151

epigastric arteries and veins. intercostal nerve.

Innervation: The branches of the
eighth and ninth intercostal nerves. 25. Tianshu (Front-Mu Point of the
Large Intestine, ST 25)
24. Huaroumen (ST 24)
Location: 2 cun lateral to the centre of
Location: I cun above the umbilicus, the umbilicus. (See Fig. 68)
2 cun lateral to Shuifen (CV 9). (See Col. Indications: Abdominal pain and dis-
Fig. 3) tension, borborygmus, pain around the
Indications: Gastric pain, vomiting, umbilicus, constipation, diarrhea, dysen-
mania. tery, irregular menstruation, edema.
Method: Puncture perpendicularly Method: Puncture perpendicularly
0.7-1.0 inch. Moxibustion is applicable. 0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy Regional anatomy
Vasculature: The branches of the Vasculature: The branches of the
ninth intercostal and inferior epigastric tenth intercostal and inferior epigastric
arteries and veins. arteries and veins.
Innervation: The branch of the ninth Innervation: The branch of the tenth

Liangmen (ST 21) - - - - 8 cun

Tianshu CST 25)---- ----

Wailing (ST 26) - - - - - - -

5 cun
Guilai (ST 29) - - -

Fig. 68
152 CHINESE ACUPUNCTURE AND MOXIBUSTION

intercostal nerve. 0.7-1.2 inches. Moxibustion is applicable.

Regional anatomy
Vasculature: The branches of the sub-
26. Wailing (ST 26) costal artery and vein; laterally, the infer-
ior epigastric artery and vein.
Location: 1 cun below the umbilicus, Innervation: A branch of the subcos-
2 cun lateral to Yinjiao (CV 7). (See tal nerve.
Fig. 68)
Indications: Abdominal pain, hernia, 29. Guilai (ST 29)
dysmenorrhea.
Method: Puncture perpendicularly Location: 4 cun below the umbilicus,
0.7-1.2 inches. Moxibustion is applicable. 2 cun lateral to Zhongji (CV 3). (See
Regional anatomy: See Tianshu Fig. 68)
(ST 25) Indications: Abdominal pain, hernia,
dysmenorrhea, irregular menstruation,
27. Daju (ST 27) amenorrhea, leucorrhea, prolapse of the
uterus.
Location: 2 cun below the umbilicus, Method: Puncture perpendicularly
2 cun lateral to Shimen (CV 5). (See Col. 0.7-1.2 inches. Moxibustion is applicable.
Fig. 3) Regional anatomy
Indications: Lower abdominal disten- Vasculature: Laterally, the inferior
sion, dysuria, hernia, seminal emission, epigastric artery and vein.
premature ejaculation. Innervation: The iliohypogastric
Method: Puncture perpendicularly nerve.
0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy 30. Qichong (ST 30)
Vasculature: The branches of the elev-
enth intercostal artery and vein; laterally, Location: 5 cun below the umbilicus,
the inferior epigastric artery and vein. 2 cun lateral to Ougu (CV 2). (See Col.
Innervation: The eleventh intercostal Fig. 3)
nerve. Indications: Abdominal pain, borbor-
ygmus, hernia, swelling and pain of the
28. Shuidao (ST 28) external genitalia, impotence, dysmenor-
rhea, irregular menstruation.
Location: 3 cun below the umbilicus, Method: Puncture perpendicularly
2 cun lateral to Guanyuan (CV 4). (See 0.5-1.0 inch. Moxibustion is applicable.
Col. Fig. 3) Regional anatomy
Indications: Lower abdominal disten- Vasculature: The branches of the su-
sion, retention of urine, edema, hernia, perficial epigastric artery and vein. Later-
dysmenorrhea, sterility. ally, the inferior epigastric artery and
Method: Puncture perpendicularly vem.
CHAPTER 7 ACUPUNCTURE POlt\TS OF THE TAIYlt\ At\D YANG~lING :VIERIDIANS 15~

Innervation: The pathway of the il- Regional anatomy

ioinguinal nerve. Vasculature: Deeper, the branches of
the lateral circumflex femoral artery and
31. Biguan (ST 31) vem.
Innervation: The lateral femoral cu-
Location: On the anterior side of the taneous nerve.
thigh and on the line connecting the an-
terosuperior iliac spine and the 32. Futu (ST 32)
superiolateral corner of the patella, on
the level of the perineum when the thigh Location: On the line connecting the
anterior superior iliac spine and lateral
is fixed, in the depression lateral to the
border of the patella, 6 cun above the
sartorius muscle. (See Fig. 69)
laterosuperior border of the patella. (See
Indications: Pain in the thigh, muscu-
Col. Fig. 4)
lar atrophy, motor impairment, numb-
Indications: Pain in the lumbar and
ness and pain of the lower extremities.
iliac region, coldness of the knee, paralys-
Method: Puncture perpendicularly
is or motor impairment and pain of the
1.0-1.5 inches. Moxibustion is applicable.
lower extremities. beriberi.
Method: Puncture perpendicularly
1.0-1.5 inches. Moxibustion is applicable.
Regional anatomy
Biguan(ST31) -- Vasculature: The branches of the lat-
eral circumflex femoral artery and vein.
Innervation: The anterior and lateral
femoral cutaneous nerves.

33. Yinshi (ST 33)

Location: When the knee is flexed, the
point is 3 cun above the laterosuperior
border of the patella, on the line joining
Liangqiu(ST34) - - - - -
the laterosuperior border of the patella
and the anterior superior iliac spine. (See
Col. Fig. 4)
Indications: Numbness, soreness, mo-
tor impairment of the leg and knee, mo-
tor impairment of the lower extremities.
Method: Puncture perpendicularly
0.7-1.0 inch. Moxibustion is applicable.
Fig. 69 Regional anatomy
Vasculature: The descending branch
154 CHINESE ACUPUNCTURE AND MOXIBUSTION

of the lateral circumflex femoral artery.

Innervation: The anterior and lateral
femoral cutaneous nerves.
,....-l1-'M~~~- Dubi (ST 35)

34. Liangqiu (Xi-Cleft Point, ST 34)

- - Zusanli (ST 36)
Location: When the knee is flexed, the 8 cun

point is 2 cun above the laterosuperior ,- - --Shangjuxu CST 37)

: __ Fenglong (ST 40)
border of the patella. (See Fig. 69)
~M~''''- -- Tiaokou (ST 38)
Indications: Pain and numbness of the
-- Xiajuxu (ST 39)
knee, gastric pain, mastitis, motor im-
pairment of the lower extremities. 8 cun
Method: Puncture perpendicularly
0.5-\.0 inch. Moxibustion is applicable.
Regional anatomy: See Yinshi (ST 33)

35. Dubi (ST 35)

Location: When the knee is flexed, the Fig. 70

point is at the lower border of the patella,

in the depression lateral to the patellar mus, diarrhea, dysentery, constipation,
ligament. (See Fig. 70) mastitis, enteritis, aching of the knee
Indications: Pain, numbness and mo- joint and leg, beriberi, edema, cough,
tor impairment of the knee, beriberi. asthma, emaciation due to general defi-
Method: Puncture perpendicularly ciency, indigestion, apoplexy, hemiplegia,
0.7-1.0 inch. Moxibustion is applicable. dizziness, insomnia, mania.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The arterial and venous 0.5-1.2 inches. Moxibustion is applicable.
network around the knee joint. Regional anatomy
Innervation: The lateral sural cu- Vasculature: The anterior tibial artery
taneous nerve and the articular branch of and vein.
the common peroneal nerve. Innervation: Superficially, the lateral
sural cutaneous nerve and the cutaneous
36. Zusanli (He-Sea Point, ST 36) branch of the saphenous nerve; deeper,
the deep peroneal nerve.
Location: 3 cun below Dubi (ST 35),
one finger-breadth (middle finger) from 37. Shangjuxu (The Lower He-Sea
the anterior border of the tibia. (See Point of the Large Intestine, ST 37)
Fig. 70)
Indications: Gastric pain, vomiting Location: 6 cun below Dubi (ST 35),
hiccup, abdominal distension, borboryg- and one finger breadth (middle finger)
CHAPTER 7 ACUPU!\'CTCRE POINTS OF THE TAIYI!\' AND YANGMI!\'G MERIDIA!\,S 155

from the anterior border of the tibia. (See Vasculature: The anterior tibial artery
Fig. 70) and vein.
Indications: Abdominal pain and dis- Innervation: The branches of the su-
tension, borborygmus, diarrhea, dysen- perficial peroneal nerve and the deep
tery, constipation, enteritis, paralysis due peroneal nerve.
to stroke, beriberi.
Method: Puncture perpendicularly 40. Fenglong (Luo-Connecting Point,
0.5-1.2 inches. Moxibustion is applicable. ST40)
Regional anatomy: See Zusanli
(ST 36) Location: 8 cun superior to the tip of
the external malleolus, lateral to Tiaokou
38. Tiaokou (ST 38) (ST 38) about two finger-breadth lateral
to the anterior border of the tibia. (See
Location: 8 cun below Dubi (ST 35) Fig. 70)
and on finger breadth (middle finger) Indications: Headache, dizziness and
from the anterior border of the tibia. (See vertigo, cough, asthma, excessive spu-
Fig. 70) tum, pain in the chest, constipation, man-
Indications: Numbness. soreness and ia, epilepsy, muscular atrophy, motor im-
pain of the knee and leg, weakness and pairment, pain, swelling or paralysis of
motor impairment of the foot, pain and the lower extremities.
motor impairment of the shoulder, ab- Method: Puncture perpendicularly
dominal pain. 0.5-1.0 inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy
0.5-1.0 inch. Moxibustion is applicable. Vasculature: The branches of the an-
Regional anatomy: See Zusanli terior tibial artery and vein.
(ST 36) Innervation: The superficial peroneal
nerve.
39. Xiajuxu (The Lower He-Sea Point
of the Small Intestine, ST 39) 41. Jiexi (Jing-River Point, ST 41)
Location: 9 cun below (Dubi (ST 35) Location: On the dorsum of the foot,
and one finger breadth (middle finger) at the midpoint of the transverse crease
from the anterior border of the tibia. (See of the ankle joint, in the depression be-
Fig. 70) tween the tendons of m. extensor digito-
Indications: Lower abdominal pain, rum longus and hallucis longus, approx-
backache referring to the testis, mastitis, imately at the level of the tip of the
numbness and paralysis of the lower ex- external malleolus. (See Fig. 71)
tremities. Indications: Pain of the ankle joint,
Method: Puncture perpendicularly muscular atrophy, motor impairment
0.5-1.0 inch. Moxibustion is applicable. pain and paralysis of the lower extrem-
Regional anatomy ities, epilepsy, headache, dizziness and
 156 CHINESE ACUPUNCTURE AND .vIOXIBl'STION

foot, facial paralysis, muscular atrophy

and motor impairment of the foot.
Method: Avoid puncturing the artery.
Puncture perpendicularly 0.3-0.5 inch.
Moxibustion is applicable.
~+I ___ Jiexi(ST 41)
Regional anatomy
Vasculature: The dorsal artery and
vein of foot, the dorsal venous network
Chongyang (ST 42)
of foot.
Innervation: Superficially, the medial
dorsal cutaneous nerve of foot derived
lIH,O+--- Xiangu (ST 43)
from the superficial peroneal nerve;
,...,HH:++-·-- Neiting (ST 44) deeper, the deep peroneal nerve.
Lidui (ST 45)
43. Xiangu (Shu-Stream Point, ST 43)
Location: In the depression distal to
Fig. 71
the junction of the second and third me-
tatarsal bones. (See Fig. 71)
vertigo, abdominal distension, constipa- Indications: Facial or general edema,
tion. abdominal pain, borborygmus, swelling
Method: Puncture perpendicularly and pain of the dorsum of the foot.
0.5-0.7 inch. Moxibustion is applicable. Method: Puncture perpendicularly
Regional anatomy 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The anterior tibial artery Regional anatomy
and vein. Vasculature: The dorsal venous net-
Innervation: The superficial and deep work of foot.
Innervation: The medial dorsal cu-
peroneal nerves.
taneous nerve of foot.

42. Chongyang (Yuan-Primary Point, 44. Neiting (Ying-Spring Point, ST 44)

ST42)
Location: Proximal to the web margin
Location: On the dome of the instep between the second and third toes, in the
of the foot, between the tendons of long depression distal and lateral to the second
extensor muscle of the great toe and long metatarsodigital joint. (See Fig. 71)
extensor muscle of toes, where the pulsa- Indications: Toothache, pain in the
tion of the dorsal artery of foot is palpa- face, deviation of the mouth, sore throat,
ble. (See Fig. 71) epistaxis, gastric pain, acid regurgitation,
Indications: Pain of the upper teeth, abdominal distension, diarrhea, dysen-
redness and swelling of the dorsum of the tery, constipation, swelling and pain of

----- - - - - - - - - - - - - - - - - - - - - - - _ . _ - _ . - ._-_._._-----_._-_... _ . _ - - - - - - - - -
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYIN AND YANGMING MERIDIANS 157

the dorsum of the foot, febrile diseases. bloody stools, menorrhagia, uterine
Method: Puncture perpendicularly bleeding, mental disorders, dream-
0.3-0.5 inch. Moxibustion is applicable. disturbed sleep, convulsion.
Regional anatomy Method: Puncture subcutaneOUslY_~)'p
Vasculature: The dorsal venous net- inch. Moxibustion is applicable. ~r
work of foot. Regional anatomy
Innervation: Just where the lateral Vasculature: The dorsal digital artery.
branch of the medial dorsal cutaneous Innervation: On the anastomosis of
nerve divides into dorsal digital nerves. the dorsal digital nerve derived from the
superficial peroneal nerve and the plan-
45. Lidui (Jing-Well Point, ST 45) tar digital proprial nerve.

Location: On the lateral side of the 2. Dadu (Ying-Spring Point, SP 2)

2nd toe, 0.1 cun posterior to the corner
of the nail. (See Fig. 71) Location: On the medial side of the
Indications: Facial swelling, deviation great toe, distal and inferior to the first
of the mouth, epistaxis, toothache, sore metatarsodigital joint, in the depression
throat and hoarse voice, abdominal dis- of the junction of !qe r ea 3. whilf s¥.in.L_.U
tension, coldness in the leg and foot, feb- (See Fig. 72) ~~ 4 ~, u.-''T
rile diseases, dream-disturbed sleep, Indications: Abdomina distension,~.
mania. gastric pain, cons:i~~~+~~~, febrile diseas!(s~J§ _.
Method: Puncture subcutaneously 0.1 with anhidrosis. l.)IUUU4'Ja ~r
inch. Moxibustion is applicable. MethOd: Puncture perpendicularly
Regional anatomy 0.1-0.3 inch. Moxibustion is applicable.
Vasculature: The arterial and venous Regional anatomy
network formed by the dorsal digital ar- Vasculature: The branches of the me-
tery and vein of foot. dial plantar artery and vein.
Innervation: The dorsal digital nerve Innervation: The plantar digital pro-
derived from the superficial peroneal prial nerve derived from the medial plan-
nerve. tar nerve.

3. Taibai (Shu-Stream and

IV. THE SPLEEN MERIDIAN Yuan-Primary Point, SP 3)
OF FOOT-TAIYIN
Location: Proximal and inferior to the
1. Yinbai (Jing-Well Point, SP 1) I st metatarsophalangeal joint, in the de-
pression of the junction of the red and
Location: On the medial side of the white skin. (See Fig. 72)
great toe, 0.1 cun posterior to the corner Indications: Gastric pain, abdominal
of the nail. (See Fig. 72) distension, constipation, dysentery, vom-
Indications: Abdominal distension, iting diarrhea, borborygmu,s, sluggish-
158 CHINESE ACCPUNCTCRE AND MOXIBUSTION

Shangqiu (SP 5)
............
Gongsun (SP 4),
,

- ---
Yinbai (SP 1) ---.'t:~-:=::~~:;~..e-- __
--:~~-=::::"",
- - Dadu (SP 2)
~

Fig. 72

ness, beriberi. Innervation: The saphenous nerve and

Method: Puncture perpendicularly the branch of the superficial peroneal
OJ-O.5 inch. Moxibustion is applicable. nerve.
Regional anatomy
Vasculature: The dorsal venous net- 5. Shangqiu (Jing-River Point, SP 5)
work of the foot, the medial plantar ar-
Location: In the depression distal and
tery and the branches of the medial tarsal
artery. inferior to the medial malleolus, midway
between the tuberosity of the navicular
Innervation: The. branches of the sa-
bone and the tip of the medial malleolus.
phenous nerve and superficial peroneal
(See Fig. 72)
nerve.
Indications: Abdominal distension,
constipation, diarrhea, borborygmus,
4. Gongsun (Luo-Connecting Point, pain and rigidity of the tongue, pain in
Confluent Point, SP 4) the foot and ankle, hemorrhoid.
Method: Puncture perpendicularly
Location: In the depression distal and
0.2-0.3 inch. Moxibustion is applicable.
inferior to the base of the first metatarsal
Regional anatomy
bone, at the junction of the~ed ?d ~~e Vasculature: The medial tarsal artery
skin. (See Fig. 72) ..Jw~ . ~~~ and the great saphenous vein.
Indications: Gai'trji[-pa' , vomYting, Innervation: The medial crural cu-
abdominal pain and distension, diarrhea, taneous nerve and the branch of the su-
dysentery, borborygmus. perficial peroneal nerve.
Method: Puncture perpendicularly
0.5-0.8 inch. Moxibustion is applicable. 6. Sanyinjiao (SP 6)
Regional anatomy
Vasculature: The medial tarsal artery Location: 3 cun directly above the tip
and the dorsal venous network of the of the medial malleolus, posterior to the
foot. medial border of the tibia. (See Fig. 73)
CHAPTER 7 ACUPUNCTURE POINTS OF THE T AIYII\ AND Y ANG;"'!ING MERIDIANS 159

Indications: Abdominal pain, borbor- lingquan (SP 9) and the medial malleo-
ygmus, abdominal distension, diarrhea, lus. (See Fig. 73)
dysmenorrhea, irregular menstruation, Indications: Abdominal pain and dis-
uterine bleeding, morbid leukorrhea, pro- tension, diarrhea, edema, dysuria, noctur-
lapse of the uterus, sterility, delayed la- nal emission, irregular menstruation, dys-
bour, nocturnal emission, impotence, en- menorrhea.
uresis, dysuria, edema, hernia, pain in the
Method: Puncture perpendicularly
external genitalia, muscular atrophy, mo-
0.5-1.0 inch. Moxibustion is applicable.
tor impairment, paralysis and pain of the
Regional anatomy
lower extremities, headache, dizziness
Vasculature: Anteriorly, the great sa-
and vertigo, insomnia.
Method: Puncture perpendicularly phenous vein and the branch of the genu
0.5-1.0 inch. Moxibustion is applicable. suprema artery; deeper, the posterior tib-
Acupuncture on this point is contraindi- ial artery and vein.
cated in pregnant women. Innervation: See Sanyinjiao (SP 6).
Regional anatomy
Vasculature: The great saphenous 9. Yinlingquan (He-Sea Point, SP 9)
vein, the posterior tibial artery and vein.
Innervation: Superficially, the medial
crural cutaneous nerve; deeper, in the
posterior aspect, the tibial nerve.

7. Lougu (SP 7)
Location: 6 cun from the tip of the
Yinlingquan (SP 9) _
medial malleolus, on the line connecting
the tip of the medial malleolus and Yin-
lingquan (SP 9), posterior to the medial Diji (SP 8) - - __
7 cun
border of the tibia. (See Fig. 73)
Indications: Abdominal distension,
Lougu (SP 7) -_
borborygmus, coldness, numbness and
paralysis of the knee and leg.
Method: Puncture perpendicularly Sanyinjiao (SP 6) - - - 6 cun
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Sanyinjiao
(SP 6).

8. Diji (Xi-Cleft Point, SP 8)

Location: 3 cun below Yinlingquan Fig. 73

(SP 9)', on the line connecting Yin-

160 CHINESE ACUPUNCTURE AND MOXIBUSTION

Location: On the lower border of the

medial condyle of the tibia, in the depres- Xuehai (SP 10)
,,
sion posterior and inferior to the midial ,
condyle of the tibia. (See Fig. 73)
Indications: Abdominal pain and dis-
tension, diarrhea, dysentery, edema,
jaundice, dysuria, enuresis, incontinence
of urine, pain in the external genitalia,
dysmenorrhea, pain in the knee.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Fig. 74
Regional anatomy
Vasculature: Anteriorly, the great sa-
phenous vein, the genu suprema artery; Vasculature: The muscular branches
deeper, the posterior tibial artery and of the femoral artery and vein.
veIn. Innervation: The anterior femoral cu-
Innervation: Superficially, the medial taneous nerve and the muscular branch
of the femoral nerve.
crural cutaneous nerve; deeper, the tibial
nerve.
11. Jimen (SP 11)
10. Xuehai (SP 10) Location: 6 cun above Xuehai (SP 10),
on the line drawn from Xuehai (SP 10) to
Location: When the knee is flexed, the
Chongmen (SP 12). (See Col. Fig. 5)
point is 2 cun above the mediosuperior
Indications: Dysuria, enuresis, pain
border of the patella, on the bulge of the
and swelling in the inguinal region, mus-
medial portion of m. quadriceps femoris.
cular atrophy, motor impairment, pain
Or when the patient's knee is flexed, cup and paralysis of the lower extremities.
your right palm to his left knee, with the Method: Puncture perpendicularly
thumb on the medial side and with the 0.5-1.0 inch. Moxibustion is applicable.
other four fingers directed proximally, Regional anatomy
and the thumb forming an angle of 45° Vasculature: Superficially, the great
with the index finger. The point is where saphenous vein; deeper on the lateral
the tip of your thumb rests. (See Fig. 74) side, the femoral artery and vein.
Indications: Irregular menstruation, Innervation: The anterior femoral cu-
dysmenorrhea, uterine bleeding, amenor- taneous nerve; deeper, the saphenous
rhea, urticaria, eczema, erysipelas, pain nerve.
in the medial aspect of the thigh.
Method: Puncture perpendicularly 12. Chongmen (SP 12)
0.5-1.2 inches. Moxibustion is applicable.
Regional anatomy Location: Superior to the lateral end
CHAPTER -; ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING MERIDIANS 161

of the inguinal groove, lateral to the pul- Vasculature: The eleventh intercostal
sating external iliac artery, at the level of artery and vein.
the upper border of symphysis pubis, 3.5 Innervation: The eleventh intercostal
cun lateral to Qugu (CV 2). (See Col. nerve.
Fig. 6)
Indications: Abdominal pain, hernia, 15. Daheng (SP 15)
dysuria.
Method: Avoid puncturing the artery. Location: 4 cun lateral to the center of
Puncture perpendicularly 0.5-1.0 inch. the umbilicus, lateral to m. rectus abdom-
Moxibustion is applicable. inis. (See Fig. 75)
Regional anatomy Indications: Abdominal pain and dis-
Vasculature: On the medial side, the tension, diarrhea, dysentery, constipa-
femoral artery. tion.
Innervation: Just where the femoral Method: Puncture perpendicularly
nerve traverses. 0.7-1.2 inches. Moxibustion is applicable.
Regional anatomy
13. Fushe (SP 13) Vasculature: The tenth intercostal ar-
tery and vein.
Location: 4 cun below the centre of Innervation: The tenth intercostal
the umbilicus, 0.7 cun superior to Chong- nerve.
men (SP 12),4 cun lateral to the anterior
midline. (See Col. Fig. 6) 16. Fuai (SP 16)
Indications: Lower abdominal pain,
hernia. Location: 3 cun above the centre of
Method: Puncture perpendicularly the umbilicus, and 4 cun lateral to the
0.5-1.0 inch. Moxibustion is applicable. anterior midline. (Col. Fig. 6)
Regional anatomy Indications: Abdominal pain, indiges-
Innervation: The ilioinguinal nerve. tion, constipation, dysentery.
Method: Puncture perpendicularly
14. Fujie (SP 14) 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Location: 1.3 cun below Daheng (SP Vasculature: The eighth intercostal
15), 4 cun lateral to the anterior midline, artery and vein.
on the lateral side of m. rectus abdomin- Innervation: The eighth intercostal
is. (See Col. Fig. 6) nerve.
Indications: Pain around the umbili-
cal region, abdominal distension, hernia, 17. Shidou (SP 17)
diarrhea, constipation.
Method: Puncture perpendicularly Location: In the fifth intercostal
0.5-1.0 inch. Moxibustion is applicable. space, 6 cun lateral to the anterior mid-
Regional anatomy line. (See Col. Fig. 6)
162 CHINESE ACLJPLJNCTCRE AND MOXlBl'STlON

Daheng(SP 15) - - - - ~--

'\ /
'- -
Fig. 75

Indications: Fullness and pain in the eral thoracic artery and vein, the thoraco-
chest and hypochondriac region. epigastric artery and vein, the fourth in-
Method: Puncture obliquely 0.3-0.5 tercostal artery and vein.
inch. Moxibustion is applicable. Innervation: The lateral cutaneous
Regional anatomy branch of the fourth intercostal nerve.
Vasculature: The thoracoepigastric
vem. 19. Xiongxiang (SP 19)
Innervation: The lateral cutaneous
branch of the fifth intercostal nerve. Location: In the third intercostal
space, 6 cun lateral to the anterior mid-
18. Tianxi (SP 18) line. (See Col. Fig. 6)
Indications: Fullness and pain in the
Location: In the fourth intercostal
space, 6 cun lateral to the anterior mid- chest and hypochondriac region.
line. (See Col. Fig. 6) Method: Puncture obliquely 0.3-0.5
Indications: Fullness and pain in the inch. Moxibustion is applicable.
chest and hypochondrium, cough, hic- Regional anatomy
cup, mastitis, insufficient lactation. Vasculature: The lateral thoracic ar-
Method: Puncture obliquely 0.3-0.5 tery and vein, the third intercostal artery
inch. Moxibustion is applicable. and vein.
Regional anatomy Innervation: The lateral cutaneous
Vasculature: The branches of the lat- branch of the third intercostal nerve.
CHAPTER 7 ACUPUNCTURE POINTS OF THE TAIYIN AND YANGMING .\IERIDIANS 16~

20. Zhourong (SP 20) 21. Dabao (Major Luo-Connecting

Point of the Spleen, SP 21)
Location: In the second intercostal
space, 6 cun lateral to the anterior mid- Location: On the lateral side of the
line. (See Col. Fig. 6) chest and on the middle axillary line. in
Indications: Fullness in the chest and the 6th intercostal space. (See Col. Fig. 6)
Indications: Pain in the chest and hy-
hypochondriac region, cough, hiccup.
pochondriac region, asthma, general ach-
Method: Puncture obliquely 0.3-0.5
ing and weakness.
inch. Moxibustion is applicable.
Method: Puncture obliquely 0.3-0.5
Regional anatomy inch. Moxibustion is applicable.
Vasculature: The lateral thoracic ar- Regional anatomy
tery and vein, the second intercostal ar- Vasculature: The thoracodorsal artery
tery and vein. and vein, the seventh intercostal artery
Innervation: The muscular branch of and vein.
the anterior thoracic nerve, the lateral Innervation: The seventh intercostal
cutaneous branch of the second intercos- nerve and the terminal branch of the long
tal nerve. thoracic nerve.
 Chapter 8
ACUPUNCTURE POINTS OF THE SHAOYIN
AND TAIYANG MERIDIANS
The Heart Meridian of Hand-Shaoyin Vasculature: Laterally, the axillary ar-
going from the chest to the hand and tery.
the Small Intestine Meridian of Hand- Innervation: The ulnar nerve, medi-
Taiyang going from the hand to the head an nerve and medial brachial cutaneous
are exteriorly and interiorly related, so nerve.
are the Bladder Meridian of Foot-
Taiyang running from the head to the 2. Qingling (HT 2)
foot and the Kidney Meridian of Foot-
Shaoyin running from the foot to the Location: When the elbow is flexed,
abdomen (chest). The four meridians are the point is 3 cun above the medial end
mainly distributed on the extremities and of the transverse cubital crease (Shaohai
in the posterior aspect of the trunk. Their HT 3), in the groove medial to m. biceps
acupuncture points are described as fol- brachii. (See Col. Fig. 7)
lows: Indications: Pain in the cardiac and
hypochondriac regions, shoulder and
arm.
I. THE HEART MERIDIAN Method: Puncture perpendicularly
OF HAND-SHAOYIN 0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
1. Jiquan (HT 1) Vasculature: The basilic vein, the su-
perior ulnar collateral artery.
Location: When the upper arm is ab- Innervation: The medial antebrachial
ducted, the point is in the centre of the cutaneous nerve, the medial brachial cu-
axilla, on the medial side of the axillary taneous nerve and the ulnar nerve.
artery. (See Col. Fig. 7)
Indications: Pain in the costal and car- 3. Shaohai (He-Sea Point, HT 3)
diac regions, scrofula, cold pain of the
elbow and arm, dryness of the throat. Location: With the elbow flexed, at
Method: Avoid puncturing the ax- the midpoint of the line connecting the
illary artery. Puncture perpendicularly medial end of the cubital crease and the
0.5-1.0 inch. Moxibustion is applicable. medial epicondyle of humerus. (See
Regional anatomy Fig. 76)

164
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 165

Indications: Cardiac pain, spasmodic above the transverse crease of the wrist.
pain and numbness of the hand and arm, (See Fig. 76)
tremor of the hand, scrofula, pain in the Indications: Cardiac pain, spasmodic
axilla and hypochondriac region. pain of the elbow and arm, sudden loss of
Method: Puncture perpendicularly vOice.
0.5-1.0 inch. Moxibustion is applicable. Method: Puncture perpendicularly
Regional anatomy 0.3-0.5 inch. Moxibustion is applica-
Vasculature: The basilic vein, the in- ble.
ferior ulnar collateral artery, the ulnar Regional anatomy
recurrent artery and vein. Vasculature: The ulnar artery.
Innervation: The medial antebrachial Innervation: The medial antebrachial
cutaneous nerve. cutaneous nerve; on the ulnar side, the
ulnar nerve.
4. Lingdao (Jing-River Point, HT 4)
5. Tongli (Luo-Connecting Point,
Location: When the palm faces up- HT5)
ward, the point is on the radial side of the
tendon of m. flexor carpi ulnaris, 1.5 cun Location: When the palm faces up-
ward, the point is on the radial side of the
tendon of m. flexor carpi ulnaris, 1 cun
above the transverse crease of the wrist.
(See Fig. 76)
Indications: Palpitation, dizziness,
blurring of vision, sore throat, sudden
10.5 cun
loss of voice, aphasia with stiffness of the
,,
Lingdao (HT 4),
tongue, pain in the wrist and elbow.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy: See Lingdao
1.5 cun (HT 4)

6. Yinxi (Xi-Cleft Point, HT 6)

Location: When the palm faces up-
ward, the point is on the radial side of the
tendon of m. flexor carpi ulnaris, 0.5 cun
above the transverse crease of the wrist.
(See Fig. 76)
Indications: Cardiac pain, hysteria,
Fig. 76 night sweating, hemoptysis, epistaxis,
sudden loss of voice.

-----~~--~
166 CHINESE ACUPUNCTURE AND MOXIBUSTION

Method: Puncture perpendicularly

0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy: See Lingdao
(HT 4).

7. Shenmen (Shu-Stream and

Shaochong (HT 9)
......
Shaofu (HT 8)
Yuan-Primary Point, HT 7)
Location: At the ulnar end of the
transverse crease of the wrist, in the de-
pression on the radial side of the tendon
of m. flexor carpi ulnaris. (See Fig. 76)
Indications: Cardiac pain, irritability,
palpitation, hysteria, amnesia, insomnia, Fig. 77
mania, epilepsy, dementia, pain in the
hypochondriac region, feverish sensation
in the palm, yellowish sclera. Innervation: The fourth common pal-
Method: Puncture perpendicularly mar digital nerve derived from the ulnar
0.3-0.5 inch. Moxibustion is applica nerve.
-ble.
Regional anatomy: See Lingdao
9. Shaochong (Jing-Well Point,
(HT 4)
HT9)
8. Shaofu (Ying-Spring Point, Location: On the radial side of the
HT8) little finger, about 0.1 cun from the cor-
Location: When the palm faces up- ner of the nail. (See Fig. 77)
ward, the point is between the fourth and Indications: Palpitation, cardiac pain,
fifth metacarpal bones. When a fist is pain in the chest and hypochondriac re-
made, the point is where the tip of the gions, mania, febrile diseases, loss of
little finger rests. (See Fig. 77) consciousness.
Indications: Palpitation, pain in the Method: Puncture subcutaneously 0.1
chest, spasmodic pain of the little finger, inch, or prick with a three-edged needle
feverish sensation in the palm, enuresis, to cause bleeding. Moxibustion is applica-
dysuria, pruritus of the external geni- ble.
talia. Regional anatomy
Method: Puncture perpendicularly Vasculature: The arterial and venous
0.3-0.5 inch. Moxibustion is applicable. network formed by the palmar digital
Regional anatomy proprial artery and vein.
Vasculature: The common palmar Innervation: The palmar digital pro-
digital artery and vein. prial nerve derived from the ulnar nerve.
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY Al'>G .'v!ERIDIAl'>S 16:

II. THE SMALL INTESTINE,

MERIDIAN OF
HAND-TAIYANG
1. Shaoze (Jing-Well Point, SI 1)
Location: On the ulnar side of the
little finger, about 0.1 cun from the cor- Wangu (81 4) - - - -
ner of the nail. (See Fig. 78)
Indications: Headache, febrile diseas-
es, loss of consciousness, insufficient lac-
Qiangu (81 2)----
tation, sore throat, redness of the eye,
cloudiness of the cornea.
8haoze (811)-----
Method: Puncture subcutaneously 0.1
inch, or prick the point to cause bleeding.
Moxibustion is applicable.
Regional anatomy Fig. 78
Vasculature: The arterial and venous
network formed by the palmar digital
proprial artery and vein and the dorsal and vein.
digital artery and vein. Innervation: The dorsal digital nerve
Innervation: The palmar digital pro- and palmar digital proprial nerve derived
prial nerve and the dorsal digital nerve from the ulnar nerve.
derived from the ulnar nerve.
3. Houxi (Shu-Stream Point, One of
2. Qiangu (Ying-Spring Point, SI 2) the Eight Confluent Points, SI 3) .s-.1-
Location: When a loose fist is made, Location: When a loose fist is made.
the point is on the ulnar end of the crease the point is on the ulnar end of the distal
in front of the metacarpophalangeal joint palmar crease, proximal to the fifth me-
of the little finger, at the junction of the tacarpophalangeal joint, at the end of the
red and white skin. (See Fig. 78) transverse crease and the junction of the
Indications: Numbness of the fingers, red and white skin. (See Fig. 78)
febrile diseases, tinnitus, headache, red- Indications: Pain and rigidity of the
dish urine. neck, tinnitus, deafness. sore throat, man-
Method: Puncture perpendicularly ia, malaria, acute lumbar sprain, night
0.3-0.5 inch. Moxibustion is applicable. sweating, febrile diseases, contracture
Regional anatomy and numbness of the fingers. pain in the
Vasculature: The dorsal digital artery shoulder and elbow.
and vein arising from the ulnar artery Method: Puncture perpendicularly
168 CHINESE ACUPUNCTURE AND MOXIBUSTION

0.5-0.7 inch. Moxibustion is applicable. tery.

Regional anatomy Innervation: The dorsal branch of the
Vasculature: The dorsal digital artery ulnar nerve.
and vein, the dorsal venous network of
the hand. 6. Yang lao (Xi-Cleft Point, SI 6) ...0 - ~
Innervation: The dorsal branch de-
rived from the ulnar nerve. Location: Dorsal to the head of the
ulna. When the palm face the chest, the
4. Wangu (Yuan-Primary Point, SI 4) point is in the bony cleft on the radial
side of the styloid process of the ulna.
Location: On the ulnar side of the (See Figs, 78 and 79)
palm, in the depression between the base Indications: Blurring of vision, pain in
of the fifth metacarpal bone and the ha- the shoulder, elbow and arm.
mate bone. (See Fig. 78) Method: Puncture perpendicularly
Indications: Febrile diseases with an- 0.3-0.5 inch. Moxibustion is applicable.
hidrosis, headache, rigidity of the neck, Regional anatomy
contracture of the fingers, pain in the Vasculature: The terminal branches
wrist, jaundice. of the posterior interosseous artery and
Method: Puncture perpendicularly vein, the dorsal venous network of the
0.3-0.5 inch. Moxibustion is applicable. wrist.
Regional anatomy Innervation: The anastomotic branch-
Vasculature: The posterior carpal ar- es of the posterior antebrachial cu-
tery (the branch of the ulnar artery), the taneous nerve and the dorsal branch of
dorsal venous network of the hand. the ulnar nerve.
Innervation: The dorsal branch of the
ulnar nerve. 7. Zhizheng (Luo-Connecting Point,
SI7)
5. Yanggu (Jing-River Point, SI 5)
Location: On the line joining Yanggu
Location: At the ulnar end of the (SI 5) and Xiaohai (SI 8), 5 cun proximal
transverse crease on the dorsal aspect of to the dorsal crease of the wrist. (See
the wrist, in the depression between the Fig. 80)
styloid process of the ulna and the trique- Indications: Neck rigidity, headache,
tral bone. (See Fig. 78) dizziness, spasmodic pain in the elbow
Indications: Swelling of the neck and and fingers, febrile diseases, mania.
submandibular region, pain of the hand Method: Puncture perpendicularly
and wrist, febrile diseases. 0.5-0.8 inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy
0.3-0.5 inch. Moxibustion is applicable. Vasculature: The terminal branches
Regional anatomy of the posterior interosseous artery and
Vasculature: The posterior carpal ar- vem.
CHAPTER 8 ACUPUNCTCRE POINTS OF THE SHAOYIl': Al':D TAIYANG MERIDIAl':S 169

-----,
.~
" ... ,,'
)
\ \,

---~-- ;'"
... ..." \ "
" '\'-'I\ ....\.!'
........ :.;;iO~_~
...::--_J..~./
,-",'" I
~-~ l
Yanglao (SI 6)

Fig. 79

Innervation: Superficially, the branch 8. Xiaohai (He-Sea Point, SI 8)

of the medial antebrachial cutaneous
Location: When the elbow is flexed,
nerve; deeper, on the radial side, the pos-
the point is located in the depression
terior interosseous nerve. between the olecranon of the ulna and
the medial epicondyle of the humerus.
(See Figs. 80 and 81)
Indications: Headache, swelling of the
'+~~H"i--- Xiaohai (SI 8) cheek, pain in the nape, shoulder, arm
and elbow, epilepsy.
Method: Puncture perpendicularly
7 cun
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
---Zhizheng (SI 7) Vasculature: The superior and infer-
5 cun
ior ulnar collateral arteries and veins, the
- - - Yanglao (SI 6)
ulnar recurrent artery and vein.
Innervation: The branches of the me-
dial antebrachial cutaneous nerve, the ul-
nar nerve.

9. Jianzhen (SI 9) I.~ - 1.4r

Location: Posterior and inferior to the
shoulder joint. When the arm is adduct-
ed, the point is 1 cun above the posterior
Fig. 80 end of the axillary fold. (See Fig. 82)
Indications: Pain in the scapular re-
\-:'0 CHINESE ACUPUNCTURE AND MOXIBUSTION

Vasculature: The circumflex scapular

artery and vein.
Innervation: The branch of the axil-
lary nerve; deeper in the superior aspect,
the radial nerve.

10. Naoshu (SIlO)

Location: When the arm is adducted,
the point is directly above the posterior
end of the axillary fold, in the depression
inferior to the scapular spine. (See
Fig. 82)
I ndications: Swelling of the shoulder,
aching and weakness of the shoulder and
arm.
Fig. 81 Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
gion, motor impairment of the hand and Regional anatomy
arm. Vasculature: The posterior circumflex
Method: Puncture perpendicularly humeral artery and vein: deeper. the su-
0.5-1.0 inch. Moxibustion is applicable. prascapular artery and vein.
Regional anatomy Innervation: The posterior cutaneous

Btngfeng (SI 12) __

Naoshu (SllO)--- --~;110"'"""~

_I~_ _.JI---Quyuan (S113)

r _ _ _----Tianzong (SI 111

Jianzhen (SI 9)-

Fig. 82
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIYANG MERIDIANS 171

nerve of the arm, the axillary nerve; 13. Quyuan (SI 13)
deeper, the suprascapular nerve.
Location: On the medial extremity of
11. Tianzong (SIll) 0/1 . .
Location: On the scapula, in the de-
I.' the suprascapular fossa, about midway
between Naoshu (SIlO) and the spinous
process of the second thoracic vertebra.
pression of the center of the subscapular (See Fig. 82)
fossa, and at the level of the 4th thoracic Indications: Pain and stiffness of the
vertebra. (See Fig. 82) scapular region.
Indications: Pain in the scapular re- Method: Puncture perpendicularly
gion, pain in the lateroposterior aspect of 0.3-0.5 inch. Moxibustion is applicable.
the elbow and arm, asthma. Regional anatomy
Vasculature: Superficially, the des-
Method: Puncture perpendicularly or
cending branches of the transverse cervi-
obliquely 0.5-1.0 inch. Moxibustion is ap-
cal artery and vein; deeper, the muscular
plicable.
branch of the suprascapular artery and
Regional anatomy
veIn.
Vasculature: The muscular branches
Innervation: Superficially, the lateral
of the circumflex scapular artery and
branch of the posterior ramus of the
veIn.
second thoracic nerve, the accessory
Innervation: The suprascapular nerve.
nerve; deeper, the muscular branch of
the suprascapular nerve.
12. Bingfeng (SI 12) .,_. f
Location: In the centre of the supras-
14. Jianwaishu (SI 14)
capular fossa, directly above Tianzong Location: 3 cun lateral to the lower
(SIll). When the arm is lifted, the point border of the spinous process of the first
is at the site of the depression. (See thoracic vertebra where Taodao (GV 13)
Fig. 82) is located. (See Fig. 82)
Indications: Pain in the scapular re- Indications: Aching of the shoulder
gion, numbness and aching of the up- and back, pain and rigidity of the neck.
per extremities, motor impairment of Method: Puncture obliquely 0.3-0.7
the shoulder and arm. inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy
0.5-0.7 inch. Moxibustion is applicable. Vasculature: Deeper, the transverse
Regional anatomy cervical artery and vein.
Vasculature: The suprascapular artery Innervation: Superficially, the medial
and vein. cutaneous branches of the posterior rami
Innervation: The lateral suprascapu- of the first and second thoracic nerves,
lar nerve and accessory nerve; deeper, the the accessory nerve; deeper, the dorsal
suprascapular nerve. scapular nerve.
172 CHINESE ACUPUr-;CTURE AND MOXIBUSTIOt\

15. Jianzhongshu (SI 15) 0.3-0.7 inch. Moxibustion is applicable.

Regional anatomy
Location: 2 cun lateral to the lower Vasculature: The ascending cervical
border of the spinous process of the sev- artery.
enth cervical vertebra (Dazh ui, G V 14). . Innervation: The cutaneous cervical
(See Fig. 82) nerve, the emerging portion of the great
Indications: Cough, asthma, pain in auricular nerve.
the shoulder and back, hemoptysis.
Method: Puncture obliquely 0.3-0.6 17. Tianrong (SI 17)
inch. Moxibustion is applicable.
Regional anatomy: See lianwaishu (SI Location: Posterior to the angle of
14). mandible, in the depression on the ante-
rior border of m. sternoc1eidomastoideus.
16. Tianchuang (SI 16) (See Fig. 83)
Indications: Deafness, tinnitus, sore
Location: In the lateral aspect of the throat, swelling of the cheek, foreign
neck, posterior to m. sternoc1eidomastoi- body sensation in the throat, goiter.
deus and Futu (LI 18), on the level of Method: Puncture perpendicularly
the laryngeal protuberance. (See Col. 0.5-0.7 inch. Moxibustion is applicable.
Fig. 8) Regional anatomy
Indications: Sore throat, sudden loss Vasculature: Anteriorly, the external
of voice, deafness, tinnitus, stiffness and jugular vein; deeper, the internal carotid
pain of the neck. artery and internal jugular vein.
Method: Puncture perpendicularly Innervation: Superficially, the anteri-

- - - - - Tianrong (SI 17)

Fig. 83
CHAPTER 8 ACUPUNCTURE POINTS OF THE SI-IAOYIN AND T AIY ANG MERIDIANS 173

or branch of the great auricular nerve, the mouth is open. (See Fig. 84)
the cervical branch of the facial nerve; Indications: Deafness, tinnitus, otor-
deeper, the superior cervical ganglion of rhea, motor impairment of the mandibu-
the sympathetic trunk. lar joint, toothache.
Method: Puncture perpendicularly
18. Quanliao (SI 18) 0.5-1.0 inch when the mouth is open.
Moxibustion is applicable.
Location: Directly below the outer Regional anatomy
canthus, in the depression on the lower Vasculature: The auricular branches
border of zygoma. (See Fig. 84) of the superficial temporal artery and
Indications: Facial paralysis, twitch-
vein.
ing of eyelids, pain in the face, toothache, Innervation: The branch of the facial
swelling of the cheek, yellowish sclera. nerve, the auriculotemporal nerve.
Method: Puncture perpendicularly
0.5-0.8 inch.
Regional anatomy III. THE BLADDER
Vasculature: The branches of the
transverse facial artery and vein.
MERIDIAN OF
Innervation: The facial and infraorbi- FOOT-TAIYANG
tal nerves.
1. Jingming (BL 1)
19. Tinggong (SI 19)
Location: In the depression slightly
Location: Anterior to the tragus and above the inner canthus. (See Fig. 85)
posterior to the condyloid process of the Indications: Redness, swelling and
mandible, in the depression formed when pain of the eye, itching of the canthus,

_ Tinggong (SI 19)

Quanliao (SI 18)--

Fig. 84
174 CHINESE ACUPUNCTURE AND MOXIBUSTIOK

- Zanzhu (BL 2)
- Jingming (BL 1)

Fig 85

lacrimation, night blindness, colour the eyebrow, or on the supraorbital

blindness, blurring of vision, myopia. notch. (See Fig. 85)
Method: Ask the patient to close his Indications: Headache, blurring and
eyes when pushing gently the eyeball to failing of vision, pain in the supraorbital
the lateral side. Puncture slowly perpen- region, lacrimation, redness, swelling and
dicularly 0.3-0.7 inch along the orbital pain of the eye, twitching of eyelids, glau-
wall. It is not advisable to twist of lift and coma.
thrust the needle vigorously. To avoid Method: Puncture subcutaneously
bleeding, press the puncturing site for a 0.3-0.5 inch, or prick with three-edged
few seconds after withdrawal of the nee- needle to cause bleeding.
dle. Moxibustion is forbidden. Regional anatomy
Regional anatomy Vasculature: The frontal artery and
Vasculature: The angular artery and veIll.
vein, deeper, superiorly, the ophthalmic Innervation: The medial branch of the
artery and vein. frontal nerve.
Innervation: Superficially, the su-
pratrochlear and infratrochlear nerves; 3. Meichong (BL 3)
deeper, the branches of the oculomotor
nerve, the ophthalmic nerve. Location: Directly above Zanzhu, 0.5
cun within the anterior hairline, between
2. Zanzhu (BL 2) Shenting (GV 24) and Quchai (BL 4).
(See Col. Fig. 9)
Location: On the medial extremity of Indications: Headache, giddiness, epi-

---------~-------- --------
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 175

lepsy, nasal obstruction. cun lateral to the midline. (See Col.

Method: Puncture subcutaneously Fig. 9)
0.3-0.5 inch. Indications: Headache, blurring of vi-
Regional anatomy: See Zanzhu sion, nasal obstruction.
(BL 2). Method: Puncture subcutaneously
0.3-0.5 inch.
4. Qucha (BL 4) Regional anatomy
Vasculature: The anastomotic net-
Location: 0.5 cun directly above the work of the frontal artery and vein, the
midpoint of the anterior hairline and 1.5 superficial temporal artery and vein, the
cun lateral to the midline, at the junction occipital artery and vein.
of the medial third and lateral two-thirds Innervation: The anastomotic branch
of the distance from Shenting (GV 24) to of the lateral branch of the frontal nerve
Touwei (ST 8). (See Col. Fig. 9) and the great occipital nerve.
Indications: Headache, nasal obstruc-
tion, epistaxis, blurring and failing of 7. Tongtian (BL 7)
VISIOn.
Method: Puncture subcutaneously Location: 4 cun directly above the
0.3-0.5 inch. Moxibustion is applicable. midpoint of the anterior hairline and 1.5
Regional anatomy cun lateral to the midline. (See Col.
Vasculature: The frontal artery and Fig. 9)
vein. Indications: Headache, giddiness, na-
Innervation: The lateral branch of the sal obstruction, epistaxis, rhinorrhea.
frontal nerve. Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable.
5. Wuchu (BL 5) Regional anatomy
Vasculature: The superficial temporal
Location: 1 cun directly above the artery and vein and the occipital artery
midpoint of the anterior hairline and 1.5 and vein.
cun lateral to the midline. (See Col. Innervation: The branch of the great
Fig. 9) occipital nerve.
Indications: Headache, blurring of vi-
sion, epilepsy, convulsion. 8. Luoque (BL 8)
Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable. Location: 5.5 cun directly above the
Regional anatomy: See Quchai (BL 4). midpoint of the anterior hairline and 1.5
cun lateral to the midline. (See Col.
6. Chengguang (BL 6) Fig. 9)
Indications: Dizziness, blurring of vi-
Location: 2.5 cun directly above the sion, tinnitus, mania.
midpoint of the anterior hairline and 1.5 Method: Puncture subcutaneously
176 CHINESE ACUPUNCTURE AND MOXIBUSTION

OJ-0.5 inch. 11. Dazhu (Influential Point of

Regional anatomy Bone, BL 11)
Vasculature: The branches of the oc-
cipital artery and vein. Location: 1.5 cun lateral to Taodao
Innervation: The branch of the great (G V 13), at the level of the lower border
occipital nerve. of the spinous process of the first thorac-
ic vertebra.
9. Yuzhen (BL 9) Indications: Headache. pain in the
neck and back, pain and soreness in the
Location: 2.5 cun directly above the scapular region, cough, fever, neck rigid-
midpoint of the posterior hairline and 1.3 ity.
cun lateral to the midline, in the depres- Method: Puncture obliquely 0.5-0.7
sion on the level of the upper border of inch. Moxibustion is applicable.
the external occipital protuberance. (See Regional anatomy
Col. Fig. 9) Vasculature: The medial cutaneous
Indications: Headache and neck pain, branches of the posterior branches of the
dizziness, ophthalmalgia, nasal obstruc- intercostal artery and vein.
tion. Innervation: The medial cutaneous
Method: Puncture subcutaneously branches of the posterior rami of the first
0.3-0.5 inch. Moxibustion is applicable. and second thoracic nerves; deeper, their
Regional anatomy lateral cutaneous branches.
Vasculature: The occipital artery and
vem. 12. Fengmen (BL 12)
Innervation: The branch of the great
occipital nerve. Location: 1.5 cun lateral to the GV
Meridian, at the level of the lower border
10. Tianzhu (BL 10) of the spinous process of the second tho-
racic vertebra. (See Fig. 86)
Location: 1.3 cun lateral to the mid- Indications: Common cold, cough,
point of the posterior hairline and in the fever and headache, neck rigidity, back-
depression on the lateral aspect of m. ache.
trapezius. (See Col. Fig. 9) Method: Puncture obliquely 0.5-0.7
Indications: Headache, nasal obstruc- inch. Moxibustion is applicable.
tion, sore throat, neck rigidity, pain in the Regional anatomy
shoulder and back. Vasculature: The medial cutaneous
Method: Puncture perpendicularly branches of the posterior branches of the
0.5-0.8 inch. intercostal artery and vein.
Regional anatomy Innervation: Superficially, the medial
Vasculature: The occipital artery and cutaneous branches of the posterior rami
vem. of the second and third thoracic nerves;
Innervation: The great occipital nerve. deeper, their lateral cutaneous branches.
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 177

13. Feishu (Back-Shu Point of 15. Xinshu (Back-Shu Point of

the Lung, BL 13) the Heart, BL 15)
Location: 1.5 cun lateral to Shenzhu Location: 1.5 cun lateral to Shendao
(GV 12), at the level of the lower border (GV 11), at the level of the lower border
of the spinous (process of the third tho- of the spinous process of the fifth thorac-
racic vertebra. (See Fig. 86) ic vertebra. (See Fig. 86)
Indications: Cough, asthma, chest Indications: Cardiac pain, panic, loss
pain, spitting of blood, afternoon fever, of memory, palpitation, cough, spitting
night sweating. of blood, nocturnal emission, night
Method: Puncture obliquely 0.5-0.7 sweating, mania, epilepsy.
inch. Moxibustion is applicable. Method: Puncture obliquely 0.5-0.7
Regional anatomy inch. Moxibustion is applicable.
Vasculature: The medial cutaneous Regional anatomy
branches of the posterior branches of the Vasculature: The medial cutaneous
intercostal artery and vein. branches of the posterior branches of the
Innervation: The medial cutaneous intercostal artery and vein.
branches of the posterior rami of the Innervation: The medial cutaneous
third and fourth thoracic nerves; deeper, branches of the posterior rami of the
their lateral branches. fifth and sixth thoracic nerves; deeper,
their lateral branches.
14. Jueyinshu (Back-Shu Point of
the Pericardium, BL 14) 16. Dushu (BL 16)

Location: 1.5 cun lateral to the Gov- Location: 1.5 cun lateral to Lingtai
ernor VesseL at the level of the lower (GV 10), at the level of the lower border
border of the spinous process of the of the spinous process of the sixth thorac-
fourth thoracic vertebra. (See Col. Fig. 9) ic vertebra. (See Col. Fig. 9)
Indications: Cough, cardiac pain, pal- Method: Puncture obliquely 0.5-0.7
pitation, stuffy chest, vomiting. inch. Moxibustion is applicable.
Method: Puncture obliquely 0.5-0.7 Regional anatomy
inch. Moxibustion is applicable. Vasculature: The medial branches of
Regional anatomy the posterior branches of the intercostal
Vasculature: The medial cutaneous artery and vein, the descending branch of
branches of the posterior branches of the the transverse cervical artery.
intercostal artery and vein. Innervation: The dorsal scapular
Innervation: The medial cutaneous nerve, the medial cutaneous branches of
branches of the posterior rami of the the dorsal rami of the sixth and sev-
fourth or fifth thoracic nerves; deeper, enth thoracic nerves; deeper, their lat-
their lateral branches. eral branches.
 178 CHINESE ACL:PUNCTL:RE AND MOXIBUSTION

--------- - - - Fengmen(BL 12)

--------- r
- - - - - - - - - --Feishu(BL 13)
_ _ _ _ _ _ _ _ ~- Gaohuang (BL 43)

"",h"(BllS)

---- - - - , - Geshu(BL 17)

~"
----- - - - - - - Ganshu(BL 18)
- - - - - r - - - - - - Danshu (BL 19)
---- - - - - - - - Pishu(BL20)
----L--------WeiShU(BL21)

---f-------- Sanjiaoshu(BL22)

,
----~-------
-
Zhishi(BL52)
-------Shenshu(BL23)

---- - - - - - - - Dachangshu(BL25)
---- - - - - - - - Shangliao(BL31)
--- -j---- - - - Xiaochangshu (BL 27)
_____L ______ Pangguangshu(BL28)

!t:::L_______
-____ ------
----__ Zhibian(BL54)
Ciliao(BL32)
1----- --- - - - - - - Zhongliao(BL33)
L _______ - - - - __ Xialiao(BL34)

Fig. 86

17. Geshu (Influential Point of cough, spitting of blood, afternoon fever,

Blood, BL 17) night sweating, measles.
Method: Puncture obliquely 0.5-0.7
Location: 1.5 cun lateral to Zhiyang
inch. Moxibustion is applicable.
(G V 9), at the level of the lower border
of the spinous process of the seventh Regional anatomy
thoracic vertebra. (See Fig. 86) Vasculature: The medial branches of
Indications: Vomiting, hiccup, belch- the posterior branches of the intercostal
ing, difficulty in swallowing, asthma, artery and vein.

- - - - - - - - - - - - - - - - - ---------------------- ---- -----

------------------ ---- -------------- ---
CHAPTER 8 ACUPUNCTCRE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 179

Innervation: The medial branches of inch. Moxibustion is applicable.

the posterior rami of the seventh and Regional anatomy
eighth thoracic nerves; deeper, their lat- Musculature: M. latissimus dorsi, the
eral branches. site between m. longissimus and m. ilio-
costalis.
18. Ganshu (Back-Shu Point of Vasculature: The medial branches of
the Liver, BL 18) the posterior branches of the intercostal
artery and vein.
Location: 1.5 cun lateral to Jinsuo Innervation: The medial cutaneous
(GV 8), at the level of the lower border branches of the posterior rami of the
of the spinous process of the ninth tho- tenth and eleventh thoracic nerves; deep-
racic vertebra. (See Fig. 86) er, their lateral branches.
Indications: Jaundice, pain in the hy-
pochondriac region, redness of the eye, 20. Pishu (Back-Shu Point of
blurring of vision, night blindness, men- the Spleen, BL 20)
tal disorders, epilepsy, backache, spitting
of blood, epistaxis. Location: 1.5 cun lateral to Jizhong
Method: Puncture obliquely 0.5-0.7 (G V 6), at the level of the lower border
inch. Moxibustion is applicable. of the spinous process of the eleventh
Regional anatomy thoracic vertebra. (See Fig. 86)
Vasculature: The medial branches of Indications: Epigastric pain, abdomin-
the posterior branches of the intercostal al distension, jaundice, vomiting, diar-
artery and vein. rhea, dysentery, bloody stools, profuse
Innervation: The medial cutaneous menstruation, edema, anorexia, back-
branches of the posterior rami of the ache.
ninth and tenth thoracic nerves; deeper, Method: Puncture obliquely 0.5-0.7
their lateral branches. inch. Moxibustion is applicable.
Regional anatomy
19. Danshu (Back-Shu Point of Vasculature: The medial branches of
the Gallbladder, BL 19) the posterior branches of the intercostal
artery and vein.
Location: 1.5 cun lateral to Zhongshu Innervation: The medial cutaneous
(GV 7), at the level of the lower border branches of the posterior rami of the
of the spinous process of the tenth tho- eleventh and twelfth thoracic nerves;
racic vertebra. (See Fig. 86) deeper, their lateral branches.
Indications: Jaundice, bitter taste of
the mouth, pain in the chest and hypo- 21. Weishu (Back-Shu Point of
chondriac region, pulmonary tuberculos- the Stomach, BL 21)
is, afternoon fever.
Method: Puncture obliquely 0.5-0.8 Location: 1.5 cun lateral to the Gov-
 180 CHINESE ACUPUNCTURE AND MOXIBUSTION

ernor Vessel, at the level of the lower 23. Shenshu (Back-Shu Point of
border of the spinous process of the the Kidney, BL 23)
twelfth thoracic vertebra. (See Fig. 86)
Indications: Pain in the chest and hy- Location: l.5 cun lateral to Mingmen
pochondriac and epigastric regions, ano- (GV 4), at the level of the lower border
rexia, abdominal distension, borbor- of the spinous process of the second lum-
ygmus, diarrhea, nausea, vomiting. bar vertebra. (See Fig. 86)
Method: Puncture obliquely 0.5-0.8 Indications: Nocturnal emission, im-
inch. Moxibustion is applicable. potence, enuresis, irregular menstrua-
Regional anatomy tion, leukorrhea, low back pain, weakness
Vasculature: The medial branches of of the knee, blurring of vision, dizziness,
the posterior branches of the subcostal tinnitus, deafness, edema, asthma, diar-
artery and vein. rhea.
Innervation: The medial cutaneous Method: Puncture perpendicularly
branch of the posterior ramus of the 1-1.2 inches. Moxibustion is applicable.
twelfth thoracic nerve; deeper, its lateral Regional anatomy
branch. Vasculature: The posterior branches
of the second lumbar artery and vein.
22. Sanjiaoshu (Back-Shu Point of Innervation: The lateral branch of
Triple Energizer, BL 22) the posterior ramus of the first lumbar
nerve; deeper, its lateral branch.
Location: 1.5 cun lateral to Xuanshu
(GV 5), at the level of the lower border 24. Qihaishu (BL 24)
of the spinous process of the first lumbar
vertebra. (See Fig. 86) Location: 1.5 cun lateral to the Gov-
Indications: Borborygmus, abdominal ernor Vessel, at the level of the lower
distension, indigestion, vomiting, diar- border of the spinous process of the third
rhea, dysentery, edema, pain and stiffness lumbar vertebra. (See Col. Fig. 9)
of the lower back. Indications: Low back pain, irregular
Method: Puncture perpendicularly menstruation, dysmenorrhea, asthma.
0.5-1.0 inch. Moxibustion is applicable. Method: Puncture perpendicularly
Regional anatomy 0.8-1.2 inches. Moxibustion is applica-
Vasculature: The posterior branches ble.
of the first lumber artery and vein. Regional anatomy
Innervation: The lateral cutaneous Vasculature: The posterior branch of
branch of the posterior ramus of the the third lumbar artery and vein.
tenth thoracic nerve; deeper, the lateral Innervation: The lateral cutaneous
branch of the posterior ramus of the first branch of the posterior ramus of the
lumbar nerve. second lumbar nerve.
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIYANG MERIDIANS 181

25. Dachangshu (Back-Shu Point of ernor Vessel, at the level of the first
the Large Intestine, BL 25) posterior sacral foramen. (See Fig. 86)
Indications: Lower abdominal pain
Location: 1.5 cun lateral to Yaoyang- and distension, dysentery, nocturnal
guan (G V 3), at the level of the lower emission, hematuria, enuresis, morbid
border of the spinous process of the leukorrhea, lower back pain, sciatica.
fourth lumbar vertebra. (See Fig. 86) Method: Puncture perpendicularly
Indications: Low back pain, borbor- 0.8-1.2 inches. Moxibustion is applicable.
ygmus, abdominal distension, diarrhea, Regional anatomy
constipation, muscular atrophy, pain, Vasculature: The posterior branches
numbness and motor impairment of the of the lateral sacral artery and vein.
lower extremities, sciatica. Innervation: The lateral branch of the
Method: Puncture perpendicularly posterior ramus of the first sacral nerve.
0.8-1.2 inches. Moxibustion is applicable.
Regional anatomy 28. Pangguangshu (Back-Shu Point
Vasculature: The posterior branch of of the Bladder, BL 28)
the fourth lumbar artery and vein.
Innervation: The posterior ramus of Location: 1.5 cun lateral to the Gov-
the third lumbar nerve. ernor Vessel, at the level of the second
posterior sacral foramen. (See Fig. 86)
26. Guanyuanshu (BL 26) Indications: Retention of urine, enu-
resis, frequent urination, diarrhea, con-
Location: 1.5 cun lateral to the Gov- stipation, stiffness and pain of the lower
ernor Vessel, at the level of the lower back. (See Fig. 86)
border of the spinous process of the fifth Method: Puncture perpendicularly
lumbar vertebra. (See Col. Fig. 9) 0.8-1.2 inches. Moxibustion is applica-
Indications: Low back pain, abdomin- ble.
al distension, diarrhea, enuresis, sciatica, Regional anatomy
frequent urination. Vasculature: The posterior branches
Method: Puncture perpendicularly of the lateral sacral artery and vein.
0.8-1.2 inches. Moxibustion is applicable. Innervation: The lateral branches of
Regional anatomy the posterior rami of the first and second
Vasculature: The posterior branches sacral nerves.
of the lowest lumbar artery and vein.
Innervation: The posterior ramus of 29. Zhonglushu (BL 29)
the fifth lumbar nerve.
Location: 1.5 cun lateral to the Gov-
27. Xiaochangshu (Back-Shu Point of ernor Vessel, at the level of the third
the Small Intestine, BL 27) posterior sacral foramen. (See Col.
Fig. 9)
Location: 1.5 cun lateral to the Gov- Indications: Dysentery, hernia, stiff-
182 CHINESE ACUPUNCTURE AKD MOXIBUSTION

ness and pain of the lower back. Indications: Low back pain, dysur-
Method: Puncture perpendicularly ia, constipation, irregular menstrua-
0.8-1.2 inches. Moxibustion is applica- tion, morbid leukorrhea, prolapse of the
ble. uterus.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The posterior branches 0.8-1.2 inches. Moxibustion is applicable.
of the lateral sacral artery and vein, the Regional anatomy
branches of the inferior gluteal artery Vasculature: The posterior branches
and vein. of the lateral sacral artery and vein.
Innervation: The lateral branches of Innervation: At the site where the pos-
the posterior rami of the third and fourth terior ramus of the first sacral nerve
sacral nerves. passes.

30. Baihuanshu (BL 30) 32. CHiao (BL 32)

Location: 1.5 cun lateral to the Gov- Location: On the sacrum, medial and
ernor Vessel, at the level of the fourth inferior to the posteriosuperior iliac
posterior sacral foramen. (See Col. spine, just at the second posterior sacral
Fig. 9) foramen. (See Fig. 86)
Indications: Enuresis, pain due to her- Indications: Low back pain, hernia,
nia, morbid leukorrhea, irregular men- irregular menstruation, leukorrhea, dys-
struation, cold sensation and pain of the menorrhea, nocturnal emission, impo-
lower back, dysuria, constipation, tenes- tence, enuresis, dysuria, muscular atro-
mus, prolapse of the rectum. phy, pain, numbness and motor impair-
Method: Puncture perpendicularly ment of the lower extremities.
0.8-1.2 inches. Method: Puncture perpendicularly
Regional anatomy 0.8-1.2 inches. Moxibustion is applicable.
Vasculature: The inferior gluteal ar- Regional anatomy
tery and vein; deeper, the internal puden- Vasculature: The posterior branches
dal artery and vein. of the lateral sacral artery and vein.
Innervation: The lateral branches of Innervation: The posterior ramus of
the posterior rami of the third and fourth the second sacral nerve.
sacral nerves, the inferior gluteal nerve.
33. Zhongliao (BL 33)
31. Shangliao (BL 31)
Location: On the sacrum, medial and
Location: On the sacrum, at the mid- inferior to Ciliao (BL 32), just at the
point between the posteriosu perior iliac third posterior sacral foramen. (See
spine and the posterior midline, just at Fig. 86)
the first posterior sacral foramen. (See Indications: Low back pain, consti-
Fig. 86) pation, diarrhea, dysuria, irregular men-
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIYANG MERIDIANS 183

struation, morbid leukorrhea. 36. Chengfu (BL 36)

Method: Puncture perpendicularly
0.8-1.2 inches. Moxibustion is applicable. Location: On the posterior side of the
Regional anatomy thigh, at the midpoint of the inferior
Vasculature: The posterior branches gluteal crease. (See Col. Fig. 9)
of the lateral sacral artery and vein. Indications: Pain in the lower back
Innervation: On the course of the pos- and gluteal region, constipation, muscu-
lar atrophy, pain, numbness and motor
terior ramus of the third sacral nerve.
impairment of the lower extremities.
Method: Puncture perpendicularly
34. Xialiao (BL 34) 1.0-1.5 inches. Moxibustion is applicable.
Location: On the sacrum, medial and Regional anatomy
inferior to Zhongliao (BL 33), just at the Vasculature: The artery and vein run-
ning alongside the sciatic nerve.
fourth posterior sacral foramen. (See
Innervation: The posterior femoral
Fig. 86)
cutaneous nerve; deeper, the sciatic
Indications: Low back pain, lower ab-
dominal pain, dysuria, constipation, mor- nerve.
bid leukorrhea.
Method: Puncture Perpendicularly 37. Yinmen (BL 37)
0.8-1.2 inches. Moxibustion is applicable. Location: 6 cun below Chengfu (BL
Regional anatomy 36) on the line joining Chengfu (BL 36)
Vasculature: The branches of the in- and Wei zhong (BL 40). (See Col. Fig. 10)
ferior gluteal artery and vein. Indications: Pain in the lower back
Innervation: On the course of the pos- and thigh, muscular atrophy, pain,
terior ramus of the fourth sacral nerve. numbness and motor impairment of the
lower extremities, hemiplegia.
35. Huiyang (BL 35) Method: Puncture perpendicularly
1.0-2.0 inches. Moxibustion is applicable.
Location: On the sacrum, 0.5 cun lat- Regional anatomy
eral to the tip of the coccyx. (See Col. Vasculature: Laterally, the third per-
Fig. 9) forating branches of the deep femoral
Indications: Dysentery, bloody stools, artery and vein.
diarrhea, hemorrhoids, impotence, mor- Innervation: The posterior femoral
bid leukorrhea. cutaneous nerve; deeper, the sciatic
Method: Puncture perpendicularly nerve.
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy 38. Fuxi (BL 38)
Vasculature: The branches of the in-
ferior gluteal artery and vein. Location: 1 cun above Weiyang (BL
Innervation: The coccygeal nerve. 39) on the medial side of the tendon of
184 CHINESE ACUPUNCTURE AND MOXIBUSTION

m. biceps femoris. The point is located Indications: Stiffness and pain of the
with the knee slightly flexed. (See Col. lower back, distension and fullness of the
Fig. 10) lower abdomen, edema, dysuria, cramp
Indications: Numbness of the gluteal of the leg and foot.
and femoral regions, contracture of the Method: Puncture perpendicularly
tendons in the popliteal fossa. 0.5-1.0 inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy: See Fuxi (BL 38)
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy 40. Wei zhong (He-Sea Point, BL 40)
Vasculature: The superolateral geni-
cular artery and vein. Location: Midpoint of the transverse
Innervation: The posterior femoral crease of the popliteal fossa, between the
cutaneous nerve and the common tendons of m. biceps femoris and m. sem-
peroneal nerve. itendinosus. (See Fig. 87)
Indications: Low back pain, motor im-
39. Weiyang (Lower He-Sea Point of pairment of the hip joint, contracture of
Triple Energizer, BL 39) the tendons in the popliteal fossa, muscu-
lar atrophy, pain, numbness and mo-
Location: Lateral to Weizhong (BL tor impairment of the lower extremities,
40), on the medial border of the tendon hemiplegia, abdominal pain, vomiting,
of m. biceps femoris. (See Fig. 87) diarrhea, erysipelas.
Method: Puncture perpendicularly
0.5-1.0 inch, or prick the popliteal vein
with three-edged needle to cause bleed-
mg.
Regional anatomy
Vasculature: Superficially, the
femoro-popliteal vein; deeper and medi-
ally, the popliteal vein; deepest, the pop-
liteal artery.
Innervation: The posterior femoral
- - - Weiyang (BL39) cutaneous nerve, the tibial nerve.

41. Fufen (BL 41)

Location: 3 cun lateral to the Gover-
nor Vessel, at the level of the lower bor-
der of the spinous process of the second
thoracic vertebra, on the spinal border of
the scapula. (See Col. Fig. 9)
Fig.8?
Indications: Stiffness and pain of the
CHAPTER 8 ACLTPUNCTL'RE POINTS OF THE SHAOYIN Al\'D TAIY Al\'G MERIDIANS 18';

shoulder, back and neck, numbness of the thoracic vertebra, on the spinal border of
elbow and arm. the scapula. (See Fig. 86)
Method: Puncture perpendicularly Indications: Pulmonary tuberculosis,
OJ-0.5 inch. Moxibustion is applicable. cough, asthma, spitting of blood, night
Regional anatomy sweating, poor memory, nocturnal emis-
Vasculature: The descending branch sion.
of the transverse cervical artery, the pos- Method: Puncture perpendicularly
terior branches of the intercostal artery 0.3-0.5 inch. Moxibustion is applicable.
and vein. Regional anatomy
Innervation: The lateral branches of Vasculature: The posterior branch of
the posterior rami of the first and second the intercostal artery and the descending
thoracic nerves; deeper, the dorsal scapu- branch of the transverse cervical artery.
lar nerve. Innervation: The medial cutaneous
branches of the posterior rami of the
42. Pohu (BL 42) second and third thoracic nerves; deeper,
their lateral branches and the dorsoscap-
Location: 3 cun lateral to the Gover-
ular nerve.
nor Vessel, at the level of the lower bor-
der of the spinous process of the third
thoracic vertebra, on the spinal border of 44. Shentang (BL 44)
the scapula. (See Col. Fig. 9)
Location: 3 cun lateral to Shendao
Indications: Pulmonary tuberculosis,
(GV 11), at the level of the lower border
hemoptysis, cough, asthma, neck rigidity,
of the spinous process of the fifth thorac-
pain in the shoulder and back.
ic vertebra, on the spinal border of the
Method: Puncture obliquely 0.3-0.5
scapula. (See Col. Fig. 9)
inch. Moxibustion is applicable.
Indications: Asthma, cardiac pain,
Regional anatomy
palpitation, stuffy chest, cough, stiffness
Vasculature: The posterior branch of
the intercostal artery, the descending and pain of the back.
branch of the transverse cervical artery. Method: Puncture obliquely 0.3-0.5
Innervation; The medial cutaneous inch. Moxibustion is applicable.
branches of the posterior rami of the Regional anatomy
second and third thoracic nerves; deeper, Vasculature: The posterior branches
their lateral branches and the dorsoscap- of the intercostal artery and vein, the
ular nerve. descending branch of the transverse cerv-
ical artery.
Innervation: The medial cutaneous
43. Gaohuang (BL 43)
branches of the posterior rami of the
Location: 3 cun lateral to the Gover- fourth and fifth thoracic nerves; deeper,
nor Vessel, at the level of the lower bor- their lateral branches and the dorsoscap-
der of the spinous process of the fourth ular nerve.
186 CHINESE ACUPUNCTURE AND MOXIBUSTIOl\'

45. Yixi (BL 45) 47. Runmen (BL 47)

Location: 3 cun lateral to Lingtai (GV Location: 3 cun lateral to Jinsuo (GV
lO), at the level of the lower border of the 8), at the level of the lower border of the
spinous process of the sixth thoracic ver- spinous process of the ninth thoracic ver-
tebra, on the spinal border of the scapula. tebra. (See Col. Fig. 9)
(See Col. Fig. 9) Indications: Pain in the chest and hy-
Indications: Cough, asthma, pain of pochondriac region, back pain, vomiting,
the shoulder and back. diarrhea.
Method: Puncture obliquely down- Method: Puncture obliquely 0.3-0.5
ward 0.3-0.5 inch. Moxibustion is applica- inch. Moxibustion is applicable.
ble. Regional anatomy
Regional anatomy Vasculature: The posterior branches
Vasculature: The posterior branches of the intercostal artery and vein.
of the intercostal artery and vein. Innervation: The lateral cutaneous
Innervation: The medial cutaneous branches of the posterior rami of the
branches of the posterior rami of the seventh and eighth thoracic nerves.
fifth and sixth thoracic nerves; deeper,
their lateral branches. 48. Yanggang (BL 48)
Location: 3 cun lateral to Zhongshu
46. Geguan (BL 46) (G V 7), at the level of the lower border
of the spinous process of the tenth tho-
Location: 3 cun lateral to Zhiyang
racic vertebra. (See Col. Fig. 9)
(GV 9), at the level of the lower border Indications: Borborygmus, abdominal
of the spinous process of the seventh pain. diarrhea. pain in the hypochondriac
thoracic vertebra, approximately at the region, jaundice.
level of the inferior angle of the scapula. Method: Puncture obliquely 0.3-0.5
(Col. Fig. 9) inch. Moxibustion is applicable.
Indications: Dysphagia, hiccup, vom- Regional anatomy
iting, belching, pain and stiffness of the Vasculature: The posterior branches
back. of the intercostal artery and vein.
Method: Puncture obliquely 0.3-0.5 Innervation: The lateral cutaneous
inch. Moxibustion is applicable. branches of the posterior rami of the
Regional anatomy eighth and ninth thoracic nerves.
Vasculature: The posterior branches
of the intercostal artery and vein. 49. Yishe (BL 49)
Innervation: The medial cutaneous
branches of the posterior rami of the Location: 3 cun lateral to Jizhong
sixth and seventh thoracic nerves; deeper, (GV 6), at the level of the lower border
their lateral branches. of the spinous process of the eleventh

-- -----~---------- ---
---~---
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIYANG MERIDIANS 187

thoracic vertebra. (See Col. Fig. 9) Regional anatomy

Indications: Abdominal distension, Vasculature: The posterior branches
borborygmus, vomiting, diarrhea, diffi- of the first lumbar artery and vein.
culty in swallowing. Innervation: The lateral branch of the
Method: Puncture obliquely 0.3-0.5 posterior ramus of the twelfth thoracic
inch. Moxibustion is applicable. nerve.
Regional anatomy
Vasculature: The posterior branches 52. Zhishi (BL 52)
of the intercostal artery and vein.
Innervation: The lateral branches of Location: 3 cun lateral to Mingmen
the posterior rami of the tenth and elev- (GV 4), at the level of the lower border
enth thoracic nerves. of the spinous process of the second lum-
bar vertebra. (See Fig. 86)
50. Weicang (BL 50) Indications: Nocturnal emission, im-
potence, enuresis, frequency of urination,
Location: 3 cun lateral to the Gover- dysuria, irregular menstruation, pain in
nor Vessel, at the level of the lower bor- the back and knee, edema.
der of the spinous process of the twelfth Method: Puncture perpendicularly
thoracic vertebra. (See Col. Fig. 9) 0.5-1.0 inch. Moxibustion is applicable.
Indications: Abdominal distension, Regional anatomy
pain in the epigastric region and back, Vasculature: The posterior branches
infantile indigestion. of the second lumbar artery and vein.
Method: Puncture obliquely 0.3-0.5 Innervation: The lateral branch of the
inch. Moxibustion is applicable. posterior ramus of the twelfth thoracic
Regional anatomy nerve and the lateral branch of the first
Vasculature: The posterior branches lumbar nerve.
of the subcostal artery and vein.
Innervation: The lateral cutaneous 53. Baohuang (BL 53)
branches of the posterior ramus of the
eleventh thoracic nerve. Location: 3 cun lateral to the median
sacral crest, at the level of the second
51. Huangmen (BL 51) sacral posterior foramen. (See Col.
Fig. 9)
Location: 3 cun lateral to Xuanshu Indications: Borborygmus, abdominal
(GV 5), at the level of the lower border distension, pain in the lower back, anuria.
of the spinous process of the first lumbar Method: Puncture perpendicularly
vertebra. (See Col. Fig. 9) 0.8-1.2 inches. Moxibustion is applicable.
Indications: Abdominal pain, consti- Regional anatomy
pation, abdominal mass. Vasculature: The superior gluteal ar-
Method: Puncture obliquely 0.3-0.5 tery and vein.
inch. Moxibustion is applicable. Innervation: The superior cluneal
188 CHINESE ACUPUNCTURE AND ~IOXlBUSTION

nerves; deeper, the superior gluteal 56. Chengjin (BL 56)

nerve.
Location: On the line connecting Wei-
zhong (BL 40) and Chengshan (BL 57),
54. Zhibian (BL 54) in the centre of the belly of m. gastrocne-
Location: On the level of the 4th pos- mius, 5 cun below Weizhong (BL 40).
terior sacral foramen, 3 cun lateral to the (Col. Fig. 9)
median sacral crest. (See Fig. 86) Indications: Spasm of the gastroc-
Indications: Pain in the lumbosacral nemius, hemorrhoids, acute lower back
region, muscular atrophy, motor impair- pam.
ment of the lower extremities, dysuria, Method: Puncture perpendicularly
swelling around external genitalia, he- 0.8-1.2 inches. Moxibustion is applicable.
Regional anatomy
morrhoids, constipation.
Vasculature: The small saphenous
Method: Puncture perpendicularly
vein; deeper, the posterior tibial artery
1.5-2.0 inches. Moxibustion is applica-
and vein.
ble.
Innervation: The medial sural cu-
Regional anatomy
taneous nerve; deeper, the tibial nerve.
Vasculature: The inferior gluteal ar-
tery and vein.
Innervation: The inferior gluteal 57. Chengshan (BL 57)
nerve, the posterior femoral cutaneous Location: On the posterior midline of
nerve and the sciatic nerve. the leg, between Wei zhong (BL 40) and
Kunlun (BL 60), in a pointed depression
55. Heyang (BL 55) formed below the gastrocnemius muscle
belly when the leg is stretched or the heel
Location: 2 cun directly below Wei- is lifted. (See Fig. 87)
zhong (BL 40), between the medial and Indications: Low back pain, spasm of
lateral heads of m. gastrocnemius, on the gastrocnemius, hemorrhoids, consti-
the line joining Wei zhong (BL 40) and pation, beriberi.
Chengshan (BL 57). (See Col. Fig. 9) Method: Puncture perpendicularly
Indications: Low back pain, pain and 0.8-1.2 inches. Moxibustion is applicable.
paralysis of the lower extremities. Regional anatomy: See Chengjin (BL
Method: Puncture perpendicularly 56).
0.7-1.0 inch. Moxibustion is applicable.
Regional anatomy 58. Feiyang (Luo-Connecting
Vasculature: The small saphenous Point, BL 58)
vein; deeper, the popliteal artery and
vem. Location: 7 cun directly above Kunlun
Innervation: The medial sural cu- (BL 60), on the posterior border of fibu-
taneous nerve; deeper, the tibial nerve. la, about I cun lateral and inferior to
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 189

Chengshan (BL 57). (See Fig. 87) 60. Kunlun (Jing-River Point, BL 60)
Indications: Headache, blurring of vi-
sion, nasal obstruction, epistaxis, back Location: In the depression between
pain, hemorrhoids, weakness of the leg. the tip of the external malleolus and
Method: Puncture perpendicularly Achilles' tendon. (See Fig. 88)
0.7-1.0 inch. Moxibustion is applicable. Indications: Headache, blurring of vi-
Regional anatomy sion, neck rigidity, epistaxis, pain in the
Innervation: The lateral sural cu- shoulder, back and arm, swelling and
taneous nerve. pain of the heel, difficult labour, epi-
lepsy.
59. Fuyang (Xi-Cleft Point of the Method: Puncture perpendicularly
Yang Heel Vessel, BL 59) 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Location: 3 cun directly above Kunlun Vasculature: The small saphenous
(BL 60). (See Fig. 88) vein, the posteroexternal malleolar artery
Indications: Heavy sensation of the and vein.
head, headache, low back pain, redness Innervation: The sural nerve.
and swelling of the external malleolus,
paralysis of the lower extremities. 61. Pucan (BL 61)
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. Location: Posterior and inferior to the
Regional anatomy external malleolus, directly below Kun-
Vasculature: The small saphenous lun (BL 60), lateral to calcaneum, at the
vein; deeper, the terminal branch of the junction of the red and white skin. (See
peroneal artery. Fig. 88)
Innervation: The sural nerve. Indications: Muscular atrophy and

Fuyang(BL59)---- - ~

. Kunlun (BL60)_ .... __ ..... _

Shenmai (BL62) - __ _

Pucan(BL61) - ---
~,~------~~~~~~~~~~
Jinmen (BL63\ ' ~~~' I '-'- ..... - - - - _
ZutO~9U(BL66)---
I
Jinggu(BL64) ShU9U (BL65) Zhiyin(BL67)

Fig. 88

-- ---- ---- ---

190 CHINESE ACUPUNCTURE AND MOXIBUSTION

weakness of the lower extremities, pain in taneous nerve of foot; deeper, the lateral
the heel. plantar nerve.
Method: Puncture perpendicularly
OJ-O.5 inch. Moxibustion is applicable. 64. Jinggu (Yuan-Primary Point,
Regional anatomy BL64)
Vasculature: The external calcaneal
branches of the peroneal artery and vein. Location: Below the tuberosity of the
Innervation: The external calcaneal fifth metatarsal bone, at the junction of
branch of the sural nerve. the red and white skin. (See Fig. 88)
Indications: Headache, neck rigidity,
62. Shenmai (Confluent Point, BL 62) pain in the lower back and thigh, epi-
lepsy.
Location: In the depression directly Method: Puncture perpendicularly
below the external malleolus. (See 0.3-0.5 inch. Moxibustion is applicable.
Fig. 88) Regional anatomy: See Jinmen (BL
Indications: Epilepsy, mania, head- 63).
ache, dizziness, insomnia, backache, ach-
ing of the leg. 65. Shugu (Shu-Stream Point, BL 65)
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable. Location: Posterior to the fifth meta-
Regional anatomy tarsophalangeal joint, at the junction of
Vasculature: The external malleolar the red and white skin. (See Fig. 88)
arterial network. Indications: Mania, headache, neck ri-
Innervation: The sural nerve. gidity, blurring of vision, backache, pain
in the lower extremities.
63. Jinmen (Xi-Cleft Point, BL 63) Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.
Location: On the lateral side of the Regional anatomy
foot, directly below the anterior border of Vasculature: The fourth common
the external malleolus, on the lower bor- plantar digital artery and vein.
der of the cuboid bone. (See Fig. 88) Innervation: The fourth common
Indications: Mania, epilepsy, infantile plantar digital nerve and the lateral dor-
convulsion, backache, pain the external sal cutaneous nerve of foot.
malleolus, motor impairment and pain of
the lower extremities. 66. Zutonggu (Ying-Spring Point,
Method: Puncture perpendicularly BL 66)
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy Location: Anterior to the fifth meta-
Vasculature: The lateral plantar ar- tarsophalangeal joint, at the junction of
tery and vein. the red and white skin. (See Fig. 88)
Innervation: The lateral dorsal cu- Indications: Headache, neck rigidity,

~~- ------~- ----~ ~--- -~ ~ ----

CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIY ANG MERIDIANS 191

blurring of vision, epistaxis, mania.

Method: Puncture perpendicularly
0.2-0.3 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The plantar digital ar- 1/3
tery and vein.
Innervation: The plantar digital pro- Yongquan (KI1) -
prial nerve and the lateral dorsal cu-
taneous nerve of foot.
2/3

67. Zhiyin (Jing-WeU Point, BL 67)

Location: On the lateral side of the
small toe, about 0.1 cun from the corner
of the nail. (See Fig. 88)
Indications: Headache, nasal obstruc-
Fig. 89
tion, epistaxis, ophthalmalgia, malposi-
tion of fetus, difficult labour, detention
of after birth, feverish sensation in the and 3rd toes and the heel. (See Fig. 89)
sole. Indications: Headache, blurring of vi-
Method: Puncture superficially 0.1 sion, dizziness, sore throat, dryness of the
inch. Moxibustion is applicable. tongue, loss of voice, dysuria, infantile,
Regional anatomy convulsions, feverish sensation in the
Vasculature: The network formed by sole, loss of consciousness.
the dorsal digital artery and plantar digi- Method: Puncture perpendicularly
tal propria 1 artery. 0.3-0.5 inch. Moxibustion is applicable.
Innervation: The plantar digital pro-
Regional anatomy
prial nerve and the lateral dorsal cu-
Vasculature: Deeper, the plantar arte-
taneous nerve of foot.
rial arch.
Innervation: The second common
IV. THE KIDNEY MERIDIAN plantar digital nerve.
OF FOOT -SHAOYIN
2. Rangu (Ying-Spring Point, KI 2)
1. Yongquan (Jing-Well Point, KI 1)
Location: Anterior and inferior to the
Location: On the sole, in the depres- medial malleolus, in the depression on
sion when the foot is in plantar flexion, the lower border of the tuberosity of the
approximately at the junction of the an- navicular bone. (See Fig. 90)
terior one-third" and posterior two-thirds Indications: Pruritus vulvae, prolapse
of the line connecting the base of the 2nd of uterus, irregular menstruation, noctur-
192 CHINESE ACUPUNCTURE AND MOXIBUSTION

Zhaohai (KI6) ,
,

Fig. 90

nal emISSIOn, hemoptysis, thirst, diar- tibial artery and vein.

rhea, swelling and pain of the dorsum of Innervation: The medial crural cu-
foot, acute infantile omphalitis. taneous nerve, on the course of the tibial
Method: Puncture perpendicularly nerve.
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy 4. Dazhong (Luo-Connecting Point,
Vasculature: The branches of the me- KI4)
dial plantar and medial tarsal arteries.
Innervation: The terminal branch of Location: Posterior and inferior to the
the medial crural cutaneous nerve, the medial malleolus, in the depression ante-
rior to the medial side of the attachment
medial plantar nerve.
of Achilles' tendon. (See Fig. 90)
Indications: Spitting of blood, asthma,
3. Taixi (Shu-Stream and stiffness and pain of the lower back, dys-
Yuan-Primary Point, KI 3) uria, constipation, pain in the heel, de-
mentia.
Location: In the depression between
Method: Puncture perpendicularly
the tip of the medial malleolus and
0.3-0.5 inch. Moxibustion is applicable.
Achilles' tendon. (See Fig. 90)
Regional anatomy
Indications: Sore throat, toothache,
Vasculature: The medial calcaneal
deafness, tinnitus, dizziness, spitting of
branch of the posterior tibial artery.
blood, asthma, thirst, irregular menstrua-
Innervation: The medial crural cu-
tion, insomnia, nocturnal emission, impo- taneous nerve, on the course of the medi-
tence, frequency of micturition, pain in al calcaneal ramus derived from the tibial
the lower back. nerve.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.
5. Shuiquan (Xi-Cleft Point, KI 5)
Regional anatomy
Vasculature: Anteriorly, the posterior Location: 1 cun directly below Taixi
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND TAIY ANG MERIDIANS 193

(KI 3) in the depression of the medial 0.5-0.7 inch. Moxibustion is applicable.

side of the tuberosity of the calcaneum. Regional anatomy
(See Fig. 90) Vasculature: Deeper, anteriorly, the
Indications: Amenorrhea, irregular posterior tibial artery and vein.
menstruation, dysmenorrhea, prolapse of Innervation: The medial sural and me-
uterus, dysuria, blurring of vision. dial crural cutaneous nerves; deeper, the
Method: Puncture perpendicularly tibial nerve.
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy: See Dazhong 8. Jiaoxin (Xi-Cleft Point of the
(KI 4). Yin Heel Vessel, KI 8)
6. Zhaohai (the Eight Confluent Location: 0.5 cun anterior to Fuliu
Point, KI 6) (KI 7),2 cun above Taixi (KI 3) posterior
to the medial border of tibia. (See
Location: In the depression below the Fig. 91)
tip of the medial malleolus. (See Fig. 90) Indications: Irregular menstruation,
Indications: Irregular menstruation, dysmenorrhea, uterine bleeding, prolapse
morbid leukorrhea, prolapse of uterus, of uterus, diarrhea, constipation, pain
pruritus vulvae, frequency of micturi- and swelling of testis.
tion, retention of urine, constipation, epi-
Method: Puncture perpendicularly
lepsy, insomnia, sore throat, asthma.
0.5-0.7 inch. Moxibustion is applicable.
Method: Puncture Perpendicularly
Regional anatomy
OJ-0.5 inch. Moxibustion is applica-
Vasculature: Deeper, the posterior
ble.
tibial artery and vein.
Regional anatomy
Innervation: The medial crural cu-
Vasculature: Posteriorly, the posterior
taneous nerve; deeper, the tibial nerve.
tibial artery and vein.
Innervation: The medial crural cu-
taneous nerve; deeper, the tibial nerve. 9. Zhubin (Xi-Cleft Point of the
Yin Link Vessel, KI 9)
7. Fuliu (Jing-River Point, KI 7) Location: 5 cun directly above Taixi
Location: 2 cun directly above Taixi (KI 3) at the lower end of the belly of m.
(KI 3), on the anterior border of Achilles' gastrocnemius, on the line drawn from
tendon. (See Fig. 91) Taixi (KI 3) to Yingu (KIlO). (See
Indications: Edema, abdominal disten- Fig. 91)
sion, diarrhea, borborygmus, muscular Indications: Mental disorders, pain in
atrophy of the leg, night sweating, spon- the foot and lower leg, hernia.
taneous sweating, febrile diseases without Method: Puncture perpendicularly
sweating. 0.5-0.7 inch. Moxibustion is applicable.
Method: Puncture perpendicularly Regional anatomy
194 CHINESE ACUPUNCTURE AND MOXIBUSTION

Vasculature: Deeper, the posterior Method: Puncture perpendicularly

tibial artery and vein. 0.8-1.0 inch. Moxibustion is applicable.
Innervation: The medial sural and me- Regional anatomy
dial crural cutaneous nerves, deeper, the Vasculature: The medial superior gen-
tibial nerve. icular artery and vein.
Innervation: The medial femoral cu-
10. Yingu (He-Sea Point, KIlO) taneous nerve.

Location: When the knee is flexed, the 11. Henggu (KIll)

point is on the medial side of the poplit-
eal fossa, between the tendons of m. semi- Location: 5 cun below the umbilicus,
tendinosus and semimembranosus, at the on the superior border of symphysis pub-
level with Weizhong (BL 40). (See is, 0.5 cun lateral to Qugu (CV 2). (Col.
Fig. 91) Fig. 12)
Indications: Impotence, hernia, uter- Indications: Fullness and pain of the
ine bleeding, dysuria, pain in the knee lower abdomen, dysuria enuresis, noctur-
and popliteal fossa, mental disorders. nal emission, impotence, pain of geni-
talia.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The inferior epigastric
artery and external pudendal artery.
Yingu (KI10) - Innervation: The branch of the iliohy-
pogastric nerve.

12. Dahe (KI 12)

8 cun
Location: 4 cun below the umbilicus,
0.5 cun lateral to Zhongji (CV 3). (See
Fig. 92)
3 cun
Indications: Nocturnal emission, im-
potence, morbid. leukorrhea, pain in the
external genitalia, prolapse of uterus.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The muscular branches
of the inferior epigastric artery and vein.
Innervation: The branches of subcos-
Fig. 91 tal nerve and the iliohypogastric nerve.
 CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 195

13. Qixue (KI 13) Innervation: The tenth intercostal

nerve.
Location: 3 cun below the umbilicus,
0.5 cun lateral to Guanyuan (CV 4). (See
16. Huangshu (KI 16)
Col. Fig. 12)
Indications: Irregular menstruation, Location: 0.5 cun lateral to the umbil-
dysmenorrhea, dysuria, abdominal pain, icus, level with Shenque (CV 8). (See
diarrhea. Fig. 92)
Method: Puncture perpendicularly Indications: Abdominal pain and dis-
0.5-1.0 inch. Moxibustion is applicable. tension, vomiting, constipation, diar-
Regional anatomy rhea.
Vasculature: See Dahe (KI 12). Method: Puncture perpendicularly
Innervation: The subcostal nerve. 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
14. Siman (KI 14) Vasculature; See Dahe (KI 12)
Innervation: The tenth intercostal
Location: 2 cun below the umbilicus, nerve.
0.5 cun lateral to Shimen (CV 5). (Col.
Fig. 12) 17. Shangqu (KI 17)
Indications: Abdominal pain and dis-
tension, diarrhea, nocturnal emission, ir- Location: 2 cun above the umbilicus,
regular menstruation, dysmenorrhea, 0.5 cun lateral to Xiawan (CV 10). (See
postpartum abdominal pain. Col. Fig. 12)
Method: Puncture perpendicularly Indications: Abdominal pain, diar-
0.5-1.0 inch. Moxibustion is applicable. rhea, constipation.
Regional anatomy Method: Puncture perpendicularly
Vasculature: See Dahe (KI 12) 0.5-1.0 inch. Moxibustion is applicable.
Innervation: The eleventh intercostal Regional anatomy
nerve. Vasculature: The branches of the su-
perior and inferior epigastric arteries and
15. Zhongzhu (KI 15) vems.
Innervation: The ninth intercostal
Location: I cun below the umbilicus, nerve.
0.5 cun lateral to Yinjiao (CV 7). (Col.
Fig. 12) 18. Shiguan (KI 18)
Indications: Irregular menstruation,
abdominal pain, constipation. Location: 3 cun above the umbilicus,
Method: Puncture perpendicularly 0.5 cun lateral to Jianli (CV 11). (Col.
0.5-1.0 inch. Moxibustion is applicable. Fig. 12)
Regional anatomy Indications: Vomiting, abdominal
Vasculature: see Dahe (KI 12). pain, constipation, postpartum abdomin-

-------------- - - - - - - ----- ------- -- - -- --- ------.-------

196 CHINESE ACl'PCNCn:RE AND .\lOXIBUSTIOt\

Fig. 92

al pain, sterility. (KI 18).

Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. 20. Futonggu (KI 20)
Regional anatomy
Vasculature: The branches of the su- Location: 5 cun above the umbilicus,
perior epigastric artery and vein. 0.5 cun lateral to Shangwan (CY 13). (See
Innervation: The eighth intercostal Col. Fig. 12)
nerve. Indications: Abdominal pain and dis-
tension, vomiting, indigestion.
19. Yindu (KI 19) Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Location: 4 cun above the umbilicus, Regional anatomy: See Shiguan
0.5 cun lateral to Zhongwan (CY 12). (KI IS).
(See Col. Fig. 12)
Indications: Borborygmus, abdominal 21. Youmen (KI 21)
pain, epigastric pain, constipation, vomit-
ing. Location: 6 cun above the umbilicus,
Method: Puncture perpendicularly 0.5 cun lateral to Juque (CY 14). (Col.
0.5-1.0 inch. Moxibustion is applicable. Fig. 12)
Regional anatomy: See Shiguan Indications: Abdominal pain and dis-
CHAPTER 8 ACUPUNCTURE POINTS OF THE SHAOYIN AND T AIY ANG MERIDIANS 19'

tension, indigestion, vomiting, diarrhea, Regional anatomy

nausea, morning sickness. Vasculature: The fourth intercostal
Method: Puncture perpendicularly artery and vein.
0.3-0.7 inch. To avoid injuring the liver, Innervation: The anterior cutaneous
deep insertion is not advisable. Moxibus- branch of the fourth intercostal nerve;
tion is applicable. deeper, the fourth intercostal nerve.
Regional anatomy
Vasculature: See Shiguan (KI 18).
24. Lingxu (KI 24)
Innervation: The seventh intercostal
nerve. Location: In the third intercostal
space, 2 cun lateral to the anterior mid-
22. Buiang (KI 22) line. (See Col. Fig. 12)
Indications: Cough, asthma, fullness
Location: In the fifth intercostal in the chest and hypochondriac region,
space, 2 cun lateral to the Conception mastitis.
Vessel. (See Col. Fig. 12) Method: Puncture obliquely 0.3-0.5
Indications: Cough, asthma, disten-
inch. Moxibustion is applicable.
sion and fullness in the chest and hypo-
Regional anatomy
chondriac region vomiting, anorexia.
Vasculature: The third intercostal ar-
Method; Puncture obliquely 0.3-0.5
tery and vein.
inch. To avoid injuring the heart, deep
Innervation: The anterior cutaneous
insertion is not advisable. Moxibustion is
branch of the third intercostal nerve;
applicable.
deeper, the third intercostal nerve.
Regional anatomy
Vasculature: The fifth intercostal ar-
tery and vein. 25. Shencang (KI 25)
Innervation: The anterior cutaneous
branch of the fifth intercostal nerve; Location: In the second intercostal
deeper, the fifth intercostal nerve. space, 2 cun lateral to the anterior mid-
line. (See Col. Fig. 12)
Indications: Cough, asthma, chest
23. Shengfeng (KI 23)
pain.
Location: In the fourth intercostal Method: Puncture obliquely 0.3-0.5
space, 2 cun lateral to the anterior mid- inch. Moxibustion is applicable.
line. (See Col. Fig. 12) Regional anatomy
Indications: Cough, asthma, fullness Vasculature: The second intercostal
in the chest and hypochondriac region, artery and vein.
mastitis. Innervation: The anterior cutaneous
Method: Puncture obliquely 0.3-0.5 branch of the second intercostal nerve;
inch. Moxibustion is applicable. deeper, the second intercostal nerve.
198 CHINESE ACUPUNCTURE AND MOXIBUSTION
- --- ---

26. Yuzhong (KI 26) intercostal nerve.

Location: In the first intercostal 27. Shufu (KI 27)

space, 2 cun lateral to the anterior mid-
line. (See Col. Fig. 12) Location: In the depression on the
Indications: Cough, asthma, accumu- lower border of the clavicle, 2 cun lateral
to the anterior midline. (See Col. Fig. 12)
lation of phlegm, fullness in the chest
Indications: Cough, asthma, chest
and hypochondriac region.
pain.
Method: Puncture obliquely 0.3-0.5 Method: Puncture obliquely 0.3-0.5
inch. Moxibustion is applicable. inch. Moxibustion is applicable.
Regional anatomy Regional anatomy
Vasculature: The first intercostal ar- Vasculature: The anterior perforating
tery and vein. branches of the internal mammary artery
Innervation: The anterior cutaneous and vein.
branch of the first intercostal nerve, the Innervation: The medial supraclavicu-
medial supraclavicular nerve; the first lar nerve.
 Chapter 9
ACUPUNCTURE POINTS OF
JUEYIN AND SHAOYANG
MERIDIANS

The Pericardium Meridian of Hand- region.

Jueyin and the Triple Energizer Meridi- Method: Puncture obliquely 0.2-0.4
an of Hand-Shaoyang are externally- inch. Deep puncture is not advisable.
internally related, the former runs from Moxibustion is applicable.
chest to hand and the latter goes from Regional anatomy
hand to head. The Gallbladder Meridi- Vasculature: The thoracoepigastric
an of Foot-Shaoyang runs from head to vein, the branches of the lateral thoracic
foot, while the Liver Meridian of Foot- artery and vein.
Jueyin goes from foot to abdomen Innervation: The muscular branch of
(chest). These two meridians are also the anterior thoracic nerve, the fourth
externally-internally related. The above intercostal nerve.
four meridians are mainly distributed in
the lateral aspects of the trunk and the 2. Tianquan (PC 2)
four limbs. The points of the four merid-
ians are described as follows: Location: 2 cun below the level of the
anterior axillary fold, between the two
heads of m. biceps brachii. (See Col.
I. THE PERICARDIUM Fig. 13)
MERIDIAN OF Indications: Cardiac pain, distension
HAND-JUEYIN of the hypochondriac region, cough, pain
in the chest, back and the medial aspect
1. Tianchi (PC 1) of the arm.
Method: Puncture perpendicularly
Location: In the fourth intercostal 0.5-0.7 inch. Moxibustion is applicable.
space, 1 cun lateral to the nipple and 5 Regional anatomy
cun lateral to the antenor midline. (See Vasculature: The muscular branches
Col. Fig. 13) of the brachial artery and vein.
Indications: Suffocating sensation in Innervation: The medial brachial cu-
the chest, pain in the hypochondriac re- taneous nerve and the musculocutaneous
gion, swelling and pain of the axillary nerve.
199
200 CHINESE ACl'Pl'NCTl'RE AND MOXlBl'STIOl\;

3. Quze (He-Sea Point, PC 3) 4. Ximen (Xi-Cleft Point, PC 4)

Location: On the transverse cubital Location: 5 cun above the transverse

crease, at the ulnar side of the tendon of crease of the wrist, on the line connecting
m. biceps brachii. (See Fig. 93) Quze (PC 3) and DaJing (PC 7), between
Indications: Cardiac pain, palpitation, the tendons of m. palmaris longus and m.
febrile diseases, irritability, stomachache. flexor carpi radialis. (See Fig. 93)
vomiting, pain in the elbow and arm, Indications: Cardiac pain, palpita-
tremor of the hand and arm. tion, epistaxis, hematemesis, haemoptys-
Method: Puncture perpendicularly is chest pain, furuncle, epilepsy.
0.5-0.7 inch, or prick with a three-edged Method: Puncture perpendicularly
needle to cause bleeding. Moxibustion is 0.5-1.0 inch. Moxibustion is applicable.
applicable. Regional anatomy
Regional anatomy Vasculature: The median artery and
Vasculature: On the pathway of the vein; deeper, the anterior interosseous
brachial artery and vein. artery and vein.
Innervation: The median nerve. Innervation: The medial antebrachial

Quze(PC 3) - - - - -

7 cun

5 cun

Fig. 93
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 201

cutaneous nerve; deeper, the median Method: Puncture perpendicularly

nerve; deepest, the anterior interosseous 0.5-0.8 inch. Moxibustion is applicable.
nerve. Regional anatomy: See lianshi (PC 5).

5. Jianshi (Jing-River Point, PC 5) 7. Daling (Shu-Stream and

Yuan- Primary Point, PC 7)
Location: 3 cun above the transverse
crease of the wrist, between the tendons Location: In the middle of the trans-
of m. palmaris longus and m. flexor carpi verse crease of the wrist, between the
radialis. (See Fig. 93) tendons of m. palmaris longus and m.
Indications: Cardiac pain, palpitation, flexor carpi radialis. (See Fig. 93)
stomachache, vomiting, febrile diseases, Indications: Cardiac pain, palpitation,
irritability, malaria, mental disorders, stomachache, vomiting, mental disorders,
epilepsy, swelling of the axilla, contrac- epilepsy, stuffy chest, pain in the hypo-
ture of the elbow and arm. chondriac region, convulsion, insomnia,
Method: Puncture perpendicularly irritability, foul breath.
0.5-1.0 inch. Moxibustion is applicable. Method: Puncture perpendicularly
Regional anatomy 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The median artery and Regional anatomy
vein; deeper, the anterior interosseous Vasculature: The palmar arterial and
artery and vein. venous network of the wrist.
Innervation: The medial and lateral Innervation: Deeper, the median
antebrachial cutaneous nerves, the pal- nerve.
mar cutaneous branch of the median
nerve; deeper, the anterior interosseous 8. Laogong (Ying-Spring Point, PC 8)
nerve.
Location: At the center of the palm,
6. Neiguan (Luo-Connecting Point, between the 2nd and 3rd metacarpal
the Eight Confluent Point, PC 6) bones, but close to the latter, and in the
part touching the tip of the middle finger
Location: 2 cun above the transverse when a fist is made. (See Fig. 94)
crease of the wrist, between the tendons Indications: Cardiac pain, mental dis-
of m. palmaris longus and m. flexor radi- order, epilepsy, gastritis, foul breath, fun-
alis. (See Fig. 93) gus infection of the hand and foot, vom-
Indications: Cardiac pain, palpitation, iting, nausea.
stuffy chest, pain in the hypochondriac Method: Puncture perpendicularly
region, stomachache, nausea, vomiting, 0.3-0.5 inch. Moxibustion is applicable.
hiccup, mental disorders epilepsy, insom- Regional anatomy
nia, febrile diseases, irritability, malaria, Vasculature: The Common palmar
contracture and pain of the elbow and digital artery.
arm. Innervation: The second common pal-
202 CHINESE ACUPUNCTURE AND MOXIBUSTION

mar digital nerve of the median nerve. II. TRIPLE ENERGIZER

MERIDIAN OF
9. Zhongchong (Jing-Well Point, HAND-SHAOYANG
PC 9)
Location: In the centre of the tip of 1. Guanchong (Jing-WeU Point, TE 1)
the middle finger. (See Fig. 94) Location: On the lateral side of the
Indications: Cardiac pain, palpitation, ring finger, about 0.1 cun from the cor-
loss of consciousness, aphasia with stiff- ner of the nail. (See Fig. 95)
ness and swelling of the tongue, febrile Indications: Headache, redness of the
diseases, heat stroke, convulsion, feverish eyes, sore throat, stiffness of the tongue,
sensation in the palm. febrile diseases, irritability.
Method: Puncture superficially 0.1 Method: Puncture superficially 0.1
inch or prick with a three-edged needle to inch, or prick with a three-edged needle
cause bleeding. Moxibustion is applica- to cause bleeding. Moxibustion is applica-
ble. ble.
Regional anatomy Regional anatomy
Vasculature: The arterial and venous Vasculature: The arterial and venous
network formed by the palmar digital network formed by the palmar digital
proprial artery and vein. propria I artery and vein.
Innervation: The palmar digital pro- Innervation: The palmar digital pro-
prial nerve of the median nerve. prial nerve derived from the ulnar nerve.

2. Yemen (Ying-Spring Point, TE 2)

Location: When the fist is clenched,
the point is located in the depression
proximal to the margin of the web be-
tween the ring and small fingers, at the
Laogong (PC 8)
junction of the red and white skin. (See
Fig. 95)
Indications: Headache, redness of the
eyes, sudden deafness, sore throat, mala-
ria, pain in the arm.
Method: Puncture obliquely 0.3-0.5
Zhongchong (PC 9)
inch towards the interspace of the meta-
carpal bones. Moxibustion is applicable.
Regional anatomy
Fig 94 Vasculature: The dorsal digital artery
of the ulnar artery.
CHAPTER 9 ACUPCI\:CTCRE POII\:TS OF JUEYII\: AND SIIAOY ANG MERIDIANS 203

ulnar nerve.

4. Yangchi (Yuan-Primary Point,

TE4)
Location: On the transverse crease of
the dorsum of wrist, in the depression
lateral to the tendon of m. extensor digi-
torum communis. (See Fig. 95)
Indications: Pain in the arm, shoulder
and wrist, malaria, deafness, thirst.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.
Guanchong(TE 1) - - - - - - -
Regional anatomy
Vasculature: The dorsal venous net-
work of the wrist and the posterior carpal
artery.
Fig. 95
Innervation: The terminal branch
of the posterior antebrachial cutaneous
Innervation: The dorsal branch of the
nerve and the dorsal branch of the ulnar
ulnar nerve.
nerve.

3. Zhongzhu (Shu-Stream Point, TE 3)

5. Waiguan (Luo-Connecting Point,
Location: When the fist is clenched, the Eight Confluent Point, TE 5)
the point is on dorsum of the hand be-
tween the fourth and fifth metacarpal Location: 2 cun proximal to the dorsal
bones, in the depression proximal to the crease of the wrist, on the line connecting
fourth metacarpophalangeal joint. (See Yangchi (TE 4) and the tip of olecranon,
Fig. 95) between the radius and ulna. (See Fig. 96)
Indications: Headache, redness of the Indications: Febrile diseases, head-
eyes, deafness, tinnitus, sore throat, feb- ache, pain in the cheek, strained neck,
rile diseases, pain in the elbow and arm, deafness, tinnitus, pain in the hypochon-
motor impairment of fingers. driac region. motor impairment of the
Method: Puncture perpendicularly elbow and arm, pain of the fingers, hand
0.3-0.5 inch. Moxibustion is applicable. tremor.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The dorsal venous net- 0.5-1.0 inch. Moxibustion is applicable.
work of hand and the fourth dorsal me- Regional anatomy
tacarpal artery. Vasculature: Deeper, the posterior
Innervation: The dorsal branch of the and anterior antebrachial interosseous ar-
204 CHINESE ACUPUNCTURE AND MOXIBUSTION

teries and veins. heavy sensation of the shoulder and back,

Innervation: The posterior antebra- sudden hoarseness of voice.
chial cutaneous nerve; deeper, the poste- Method: Puncture perpendicularly
rior interosseous nerve and the anterior 0.8-1.2 inches. Moxibustion is applicable.
interosseous nerve. Regional anatomy: See Waiguan
(TE 5).
6. Zhigou (Jing-River Point, TE 6)
7. Huizong (Xi-Cleft Point, TE 7)
Location: 3 cun proximal to the dorsal
crease of the wrist, on the line connecting Location: At the level with Zhigou
Yangchi (TE 4) and the tip of olecranon, (TE 6), on the ulnar side of Zhigou (TE
between the radius and ulna, on the radi- 6), on the radial border of the ulna. (See
al side of m. extensor digitorum. (See Fig. 96)
Fig. 96) Indications: Deafness, pain in the ear,
Indications: Tinnitus, deafness, pain epilepsy, pain of the arm.
in the hypochondriac region, vomiting, Method: Puncture perpendicularly
constipation, febrile diseases, aching and 0.5-1.0 inch. Moxibustion is applicable.

/ Huizong (TE 7)
/
/
/
I

3 Cun

Fig. 96
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 205

Regional anatomy
Vasculature: The posterior antebra-
chial interosseous artery and vein.
Innervation: The posterior and medi-
al antebrachial cutaneous nerves; deeper,
the posterior and anterior interosseous
nerves.

8. Sanyangluo (TE 8)
Location: 4 cun proximal to the dorsal
crease of the wrist, between the radius
and ulna. (See Col. Fig. 14)
- - Tianjing (TE 10)
Indications: Deafness, sudden hoarse-
ness of voice, pain in the chest and hypo-
chondriac region, pain in the hand and
arm, toothache.
Method: Puncture perpendicularly Fig. 97
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Huizong
(TE 7). Indications: Migraine, pain in the
neck, shoulder and arm, epilepsy, scrofu-
9. Sidu (TE 9) la, goiter.
Method: Puncture perpendicularly
Location: On the lateral side of the 0.3-0.5 inch. Moxibustion is applicable.
forearm, 5 cun below the olecranon, be- Regional anatomy
tween the radius and ulna. (See Col. Vasculature: The arterial and venous
Fig. 14) network of the elbow.
Indications: Deafness, toothache, mig- Innervation: The posterior brachial
raine, sudden hoarseness of voice, pain in cutaneous nerve and the muscular branch
the forearm. of the radial nerve.
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. 11. Qinglengyuan (TE 11)
Regional anatomy: See Huizong
(TE 7). Location: I cun above Tianjing (TE
10) when the elbow is flexed. (See Col.

10. Tianjing (He-Sea Point, TE 10) Fig. 14)

Indications: Motor impairment and
Location: When the elbow is flexed, pain of the shoulder and arm, migraine.
the point is in the depression about 1 cun Method: Puncture perpendicularly
superior to the olecranon. (See Fig. 97) 0.3-0.5 inch. Moxibustion is applicable.
206 CHINESE ACUPUNCTURE AND MOXIBUSTION

Regional anatomy 14. Jianliao (TE 14)

Vasculature: The terminal branches
of the median collateral artery and vein. Location: On the shoulder, posterior
Innervation: The posterior brachial to lianyu (LI 15), in the depression infer-
cutaneous nerve and the muscular branch ior and posterior to the acromion when
of the radial nerve. the arm is abducted. (See Fig. 97)
Indications: Pain and motor impair-
ment of the shoulder and upper arm.
12. Xiaoluo (TE 12) Method: Puncture perpendicularly
Location: On the line joining the olec- 0.7-1.0 inch. Moxibustion is applicable.
ranon and lianliao (TE 14), midway be- Regional anatomy
tween Qinglengyuan (TE 11) and Naohui Vasculature: The muscular branch of
(TE 13). (See Col. Fig. 14) the posterior circumflex humeral artery.
Indications: Headache, neck rigidity, Innervation: The muscular branch of
motor impairment and pain of the arm. the axillary nerve.
Method: Puncture perpendicularly
0.5-0.7 inch. Moxibustion is applicable. 15. Tianliao (TE 15)
Regional anatomy Location: Midway between lianjing
Vasculature: The median collateral ar- (GB 21) and Quyuan (S I 13), on the
tery and vein. superior angle of the scapula. (See Col.
Innervation: The posterior brachial Fig. 14)
cutaneous nerve and the muscular branch Indications: Pain in the shoulder and
of the radial nerve. elbow, stiffness of the neck.
Method: Puncture perpendicularly
13. Naohui (TE 13) 0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
Location: On the line joining Jianliao Vasculature: The descending branch
(TE 14) and the olecranon, on the poste- of the transverse cervical artery; deeper,
rior border of m. deltoideus. (See Col. the muscular branch of the suprascapular
Fig. 14) artery.
Indications: Goiter, pain in the Innervation: The accessory nerve and
shoulder and arm. the branch of the suprascapular nerve.
Method: Puncture perpendicularly
0.5-0.8 inch. Moxibustion is applicable. 16. Tianyou (TE 16)
Regional anatomy
Vasculature: The median collateral ar- Location: On the lateral side of the
tery and vein. neck, directly below the posterior border
Innervation: The posterior brachial of mastoid process, on the level of the
cutaneous nerve, the muscular branch of mandibular angle, and on the posterior
the radial nerve; deeper, the radial nerve. border of sternocleido mastoid muscle.
CHAPTER 9 ACUPUNCTLJRE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 207

(See Col. Fig. 14) Regional anatomy

Indications: Headache, neck rigidity, Vasculature: The posterior auricular
facial swelling, blurring of vision, sudden artery and vein, the external jugular vein.
deafness. Innervation: The great auricular
Method: Puncture perpendicularly nerve; deeper, the site where the facial
0.3-0.5 inch. Moxibustion is applicable. nerve perforates out of the stylomastoid
Regional anatomy foramen.
Vasculature: The posterior auricular
artery. 18. Qimai (TE 18)
Innervation: The lesser occipital
nerve. Location: In the centre of the mastoid
process, at the junction of the middle
17. Yifeng (TE 17) and lower third of the curve formed by
Yifeng (TE 17) and Jiaosun (TE 20) pos-
Location: Posterior to the lobule of terior to the helix. (See Col. Fig. 14)
the ear, in the depression between the Indications: Headache, tinnitus, deaf-
mandible and mastoid process. (See ness, infantile convulsion.
Fig. 98) Method: Puncture subcutaneously
Indications: Tinnitus, deafness, otor- 0.3-0.5 inch or prick with a three-edged
rhea, facial paralysis, toothache, swelling needle to cause bleeding. Moxibustion is
of the cheek, scrofula, trismus. applicable.
Method: Puncture perpendicularly Regional anatomy
0.5-1.0 inch. Moxibustion is applicable. Vasculature: The posterior auricular

...... Sizhukong (TE 23)

............

J;,"'"" (TE 20)__ -----~. ,l i

Ylfeng (TE 17) - - - - -I..J~-ej

\
~

Fig. 98
208 CHINESE ACUPUNCTURE AND MOXIBUSTION

artery and vein. posterior border of the condyloid process

Innervation: The posterior auricular of the mandible. The point is located with
branch of the great auricular nerve. the mouth open. (See Col. Fig. 14)
Indications: Tinnitus, deafness, otor-
19. Luxi (TE 19) rhea, toothache, stiffness of the lip.
Method; Puncture perpendicularly
Location: Posterior to the ear, at the 0.3-0.5 inch. Moxibustion is applicable.
junction of the upper and middle third of Regional anatomy
the curve formed by Yifeng (TE 17) and Vasculature: The superficial temporal
Jiaosun (TE 20) behind the helix. (See artery and vein.
Col. Fig. 14) Innervation: The branches of the au-
Indications: Headache, tinnitus, deaf- riculotemporal nerve and facial nerve.
ness, pain in the ear, infantile convulsion.
Method: Puncture obliquely 0.3-0.5 22. Erheliao (TE 22)
inch. Moxibustion is applicable.
Regional anatomy Location: Anterior and superior to Er-
Vasculature: The posterior auricular men (TE 21), at the level with the root of
artery and vein. the auricle, on the posterior border of the
Innervation: The anastomotic branch hairline of the temple where the superfi-
of the great auricular nerve and the lesser cial temporal artery passes. (See Col.
occipital nerve. Fig. 14)
Indications: Migraine, tinnitus, lock-
20. Jiaosun (TE 20) Jaw.
Method : Avoid puncturing the artery,
Location: Directly above the ear apex, puncture obliquely 0.1-0.3 inch. Moxibus-
within the hair line. (See Fig. 98) tion is applicable.
Indications: Tinnitus, redness, pain Regional anatomy
and swelling of the eye, swelling of gum, Vasculature: The superficial temporal
toothache, parotitis. artery and vein.
Method: Puncture subcutaneously Innervation: The branch of the auri-
OJ-0.5 inch. Moxibustion is applicable. culotemporal nerve, on the course of the
Regional anatomy temporal branch of the facial nerve.
Vasculature: The branches of the su-
perficial temporal artery and vein. 23. Sizhukong (TE 23)
Innervation: The branches of the au-
riculotemporal nerve. Location: In the depression at the lat-
eral end of the eyebrow (See Fig. 98)
21. Ermen (TE 21) Indications: Headache, redness and
pain of the eye, blurring of vision, twitch-
Location: In the depression anterior ing of the eyelid, toothache, facial paral-
to the supratragic notch and behind the ySIS.
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 209

Method: Puncture subcutaneously Method: Puncture subcutaneously

0.3-0.5 inch. 0.3-0.5 inch.
Regional anatomy Regional anatomy
Vasculature: The frontal branches of Vasculature: The zygomaticoorbital
the superficial temporal artery and vein. artery and vein.
Innervation: The zygomatic branch of Innervation: The zygomaticofacial
the facial nerve and the branch of the and zygomaticotemporal nerve, the tem-
auriculotemporal nerve. poral branch of the facial nerve.

2. Tinghui (GB 2)
III. THE GALLBLADDER
MERIDIAN OF Location: Anterior to the intertragic
FOOT-SHAOYANG notch, at the posterior border of the con-
dyloid process of the mandible. The point
1. Tongziliao (GB 1) is located with the mouth open. (See
Fig. 99)
Location: 0.5 cun lateral to the outer Indications: Deafness, tinnitus, tooth-
canthus, in the depression on the lateral ache, motor impairment of the temporo-
side of the orbit. (See Fig. 99) mandibular joint, mumps, deviation of
Indications: Headache, redness and the eye and mouth.
pain of the eyes, failing of vision, lacri- Method: Puncture perpendicularly
mation, deviation of the eye and mouth. 0.5-0.7 inch. Moxibustion is applicable.

~
".. ----
-;: ---l~----- -
_-

-; _- Shuaigu(GB8)

Too"";,,,OB "

'.
,'
~~V"'1--
)'ll
""h"',OB2I

Fig. 99

----~-----~-- -----------------~----~-
210 CHINESE ACUPUNCTURE AND MOXIBUSTION

Regional anatomy the auriculotemporal nerve.

Vasculature: The superficial temporal
artery. 5. Xuanlu (GB 5)
Innervation: The great auricular
nerve and facial nerve. Location: Within the hairline of the
temporal region, midway of the border
3. Shangguan (GB 3) line connecting Touwei (ST 8) and Qubin
(GB 7). (See Col. Fig. 15)
Location: In the front of the ear, on Indications: Migraine, pain in the out-
the upper border of the zygomatic arch, er canthus, facial sweJJing.
in the depression directly above Xiaguan Method: Puncture subcutaneously
(ST 7). (See Col. Fig. IS) 0.3-0.5 inch. Moxibustion is applicable.
Indications: Headache, deafness, tin- Regional anatomy: See Hanyan
nitus, diplacusis, deviation of the eye and (GB 4).
mouth, toothache.
Method: Puncture perpendicularly 6. Xuanli (GB 6)
OJ-0.5 inch. Deep puncture is not advisa-
ble. Moxibustion is applicable. Location: Within the hairline, at the
Regional anatomy junction of the lower 114 and upper 3/4
Vasculature: The zygomaticoorbital of the distance between Touwei (ST 8)
artery and vein. and Qubin (GB 7). (See Col. Fig. IS)
Innervation: The zygomatic branch of Indications: Migraine, pain in the out-
the facial nerve and the zygomaticofacial er canthus, tinnitus, frequent sneezing.
nerve. Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable.
4. Hanyan (GB 4) Regional anatomy: See Hanyan
(GB 4).
Location: Within the hairline of the
temporal region, at the junction of the 7. Qubin (GB 7)
upper 114 and lower 3/4 of the distance
between Touwei (ST 8) and Qubin (GB Location: On the head, at a crossing
7). (See Col. Fig. 15) point of the vertical posterior border of
Indications: Migraine, vertigo, tinni- the temple and horizontal line through
tus, pain in the outer canthus, toothache, the ear apex. (See Col. Fig. IS)
convulsion, epilepsy. Indications: Headache, swelling of the
Method: Puncture subcutaneously cheek, trismus, pain in the temporal re-
0.3-0.5 inch. Moxibustion is applicable. gion, infantile convulsion.
Regional anatomy Method: Puncture subcutaneously
Vasculature: The parietal branches of 0.3-0.5 inch. Moxibustion is applicable.
the superficial temporal artery and vein. Regional anatomy: See Hanyan
Innervation: The temporal branch of (GB 4).
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYI!': AND SHAOY ANG MERIDIANS 211

8. Shuaigu (GB 8) Indications: Headache, tinnitus, deaf-

ness.
Location: Superior to the apex of the Method: Puncture subcutaneously
auricle, 1.5 cun within the hairline. (See 0.3-0.5 inch. Moxibustion is applicable.
fig. 99) Regional anatomy: See Tianchong
Indications: Migraine, vertigo, vomit- (GB 9)
ing, infantile convulsion.
Method: Puncture subcutaneously 11. Touqiaoyin (GB 11)
003-0.5 inch. Moxibustion is applica-
ble. Location: Posterior and superior to
Regional anatomy the mastoid process, at the junction of
Vasculature: The parietal branches of middle third and lower third of the
the superficial temporal artery and vein. curved line connecting Tianchong (G B
Innervation: The anastomotic branch 9) and Wangu (GB 12). (See Col.
of the auriculotemporal nerve and great Fig. 15)
occipital nerve. Indications: Pain of the head and
neck, tinnitus, deafness, pain in the ears.
9. Tianchong (GB 9) Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable.
Location: Directly above the posterior Regional anatomy
border of the auricle, 2 cun within the Vasculature: The branches of the pos-
hairline, about 0.5 cun posterior to Shuai- terior auricular artery and vein.
gu (GB 8). (See Col. Fig. 15) Innervation: The anastomotic branch
Indications: Headache, epilepsy, swell- of the great and lesser occipital nerves.
ing and pain of the gums, convulsion.
Method: Puncture subcutaneously 12. Wangu (GB 12)
0.3-0.5 inch.
Regional anatomy Location: In the depression posterior
Vasculature: The posterior auricular and inferior to the mastoid process. (See
artery and vein. Col. Fig. 15)
Innervation: The branch of the great Indications: Headache, insomnia,
occipital nerve. swelling of the cheek, retroauricular
pain, deviation of the eye and mouth,
10. Fubai (GB 10) toothache.
Method: Puncture obliquely 0.3-0.5
Location: Posterior and superior to inch. Moxibustion is applicable.
the mastoid process, at the junction of Regional anatomy
the middle third and upper third of the Vasculature: The posterior auricular
curve line connecting Tianchong (GB artery and vein.
9) and Wangu (GB 12). (See Col. Innervation: The lesser occipital
Fig. 15) nerve.
212 CHINESE ACUPUNCTURE AND MOXIBUSTION

13. Benshen (GB 13) region, pain of the orbital ridge, eye pain,
vertigo, twitching of the eyelids, ptosis of
Location: 0.5 cun within the hairline the eyelids, lacrimation.
of the forehead, 3 cun lateral to Shenting Method: Puncture subcutaneously
(GV 24). (See Col. Fig. 15) 0.3-0.5 inch. Moxibustion is applicable.
Indications: Headache, insomnia, ver- Regional anatomy
tigo, epilepsy. Vasculature: The lateral branches of
Method: Puncture subcutaneously the frontal artery and vein.
0.3-0.5 inch. Moxibustion is applicable. Innervation: The lateral branch of the
Regional anatomy frontal nerve.
Vasculature: The frontal branches of
the superficial temporal artery and vein, 15. Toulinqi (GB 15)
and the lateral branches of the frontal
artery and vein. Location: On the head, directly above
Innervation: The lateral branch of the the pupil and 0.5 cun above the anterior
frontal nerve. hairline, at the midpoint of the line con-
necting Shenting (GV 24) and Touwei
14. Yangbai (GB 14) (ST 8). (See Col. Fig. 15)
Indications: Headache, vertigo, lacri-
Location: On the forehead, directly mation, pain in the outer canthus, rhinor-
above the pupil, I cun directly above the rhea, nasal obstruction.
midpoint of the eyebrow. (See Fig. 100) Method: Puncture subcutaneously
Indications: Headache in the frontal 0.3-0.5 inch. Moxibustion is applicable.

2/3

1/3

Fig.100
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOYANG MERIDIANS 213

Regional anatomy 18. Chengling (GB 18)

Vasculature: The frontal artery and
veIn. Location: On the head, 4 cun above
Innervation: The anastomotic branch the anterior hairline and 2.25 cun lateral
of the medial and lateral branches of the to the midline of the head. (See Col.
frontal nerve. Fig. 15)
Indications: Headache, vertigo, epis-
taxis, rhinorrhea.
16. Muchuang (GB 16) Method: Puncture subcutaneously
Location: On the head, 1.5 cun above 0.3-0.5 inch. Moxibustion is applicable.
the anterior hairline and 2.25 cun lateral Regional anatomy
to the midline of the head. (See Col. Vasculature: The branches of the oc-
Fig. 15) cipital artery and vein.
Indications: Headache, vertigo, red Innervation: The branch of the great
and painful eyes, nasal obstruction. occipital nerve.
Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable. 19. Naokong (GB 19)
Regional anatomy Location: On the head and on the
Vasculature: The frontal branches of level of the upper border of external oc-
the superficial temporal artery and vein. cipital protuberance or Naohu (GV 17),
Innervation: The anastomotic branch 2.25 cun lateral to the midline of the
of the medial and lateral branches of the head. (See Col. Fig. 15)
frontal nerve. Indications: Headache, stiffness of the
neck, vertigo, painful eyes, tinnitus, epi-
17. Zhengying (GB 17) lepsy.
Method: Puncture subcutaneously
Location: On the head, 2.5 cun above 0.3-0.5 inch. Moxibustion is applicable.
the anterior hairline and 2.25 cun lateral Regional anatomy: See Chengling
to the midline of the head. (See Col. (GB 18).
Fig. 15)
Indications: Migraine, vertigo. 20. Fengchi (GB 20)
Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable. Location: In the depression between
Regional anatomy the upper portion of m. sternocleidomas-
Vasculature: The anastomotic plexus toideus and m. trapezius, on the same
formed by the parietal branches of the level with Fengfu (GV 16). (See Fig. 101)
superficial temporal artery and vein and Indications: Headache, vertigo, insom-
the occipital artery and vein. nia, pain and stiffness of the neck,
Innervation: The anastomotic branch blurred vision, glaucoma, red and painful
of the frontal and great occipital nerves. eyes, tinnitus, convulsion, epilepsy, infan-
214 CHINESE ACUPUNCTURE AND MOXIBUSTION

difficult labour.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
Vasculat ure: The transverse cervical
artery and vein.
Innervation: The posterior branch of
the supraclavicular nerve, the accessory
nerve.
Fengchl - - -
(GB20) 22. Yuanye (GB 22)
Location: On the mid-axillary line
when the arm is raised, 3 cun below the
axilla, in the 4th intercostal space. (See
Col. Fig. 15)
Fig. 101 Indications: Fullness of the chest,
swelling of the axillary region, pain in the
tile convulsion, febrile diseases, common hypochondriac region, pain and motor
cold, nasal obstruction, rhinorrhea. impairment of the arm.
Method: Puncture 0.5-0.8 inch to- Method: Puncture obliquely 0.3-0.5
wards the tip of the nose. Moxibustion is inch.
applicable. Regional anatomy
Regional anatomy Vasculature: The thoracoepigastric
Vasculature: The branches of the oc- vein, the lateral thoracic artery and vein,
cipital artery and vein.
Innervation: The branch of the lesser
occipital nerve.

21. Jianjing (GB 21)

Location: On the shoulder, directly
above the nipple, at the midpoint of the
line connecting Dazhui (GV 14) and the
acromion, at the highest point of the
shoulder. (See Fig. 102)
Indications: pain and rigidity of the
neck, pain in the shoulder and back, mo-
tor impairment of the arm, insufficient
Fig. 102
lactation, mastitis, scrofula, apoplexy,
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 215

the fifth intercostal artery and vein. 24. Riyue (Front-Mu Point of
Innervation: The lateral cutaneous the Gallbladder, GB 24)
branch of the fifth intercostal nerve, the
branch of the long thoracic nerve. Location: Directly below the nipple,
in the seventh intercostal space, 4 cun
lateral to the anterior midline. (See Fig.
23. Zhejin (GB 23) 103)
Indications: Pain in the hypochon-
Location: I cun anterior to Yuanye
driac region, vomiting, acid regurgi-
(GB 22), at the level of the nipple, in the
tation, hiccup, jaundice, mastitis.
4th intercostal space. (See Col. Fig. 15)
Method: Puncture obliquely 0.3-0.5
Indications: Fullness of the chest, inch. Moxibustion is applicable.
pain in the hypochondriac region, Regional anatomy
asthma. Vasculature: The seventh intercostal
Method: Puncture obliquely 0.3-0.5 artery and vein.
inch. Moxibustion is applicable. Innervation: The seventh intercostal
Regional anatomy nerve.
Vasculature: The lateral thoracic ar-
tery and vein, the fifth intercostal artery 25. Jingmen (Front-Mu Point of
and vein. the Kidney, GB 25)
Innervation: The lateral cutaneous
branch of the fifth intercostal nerve. Location: On the lateral side of the

- - - - Riyue(GB24)

Fig. 103
216 CHINESE ACUPUNCTURE AND MOXIBUSTION

abdomen, on the lower border of the free Method: Puncture perpendicularly

end of the twelfth rib. (See Fig. 104) 0.5-0.8 inch. Moxibustion is applicable.
Indications: Abdominal distention, Regional anatomy
borborygmus, diarrhea, pain in the lum- Vasculature: The subcostal artery and
bar and hypochondriac region. vein.
Method: Puncture perpendicularly Innervation: The subcostal nerve.
0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy 27. Wushu (GB 27)
Vasculature: The eleventh intercostal
artery and vein. Location: In the lateral side of the
Innervation: The eleventh intercostal abdomen, anterior to the superior iliac
nerve. spine, 3 cun below the level of the umbil-
icus. (See Col. Fig. 15)
26. Daimai (GB 26) Indications: Leukorrhea, lower ab-
dominal pain, lumbar pain, hernia, con-
Location: Directly below Zhangmen stipation.
(LR 13), at the crossing point of a verti- Method: Puncture perpendicularly
cal line through the free end of the elev- 0.5-1.0 inch. Moxibustion is applica-
enth rib and a horizontal line through the ble.
umbilicus. (See Fig. 104) Regional anatomy
Indications: Irregular menstruation, Vasculature: The superficial and deep
amenorrhea, leukorrhea, abdominal pain, circumflex iliac arteries and veins.
hernia, pain in the lumbar and hypochon- Innervation: The iliohypogastric
driac region. nerve.

Jingmen (GB 25) - - - - - Daimai(GB26)

Fig. 104
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 217

28. Weidao (GB 28) Vasculature: The branches of the su-

perficial circumflex iliac artery and vein,
Location: Anterior and inferior to the the ascending branches of the lateral cir-
anterior superior iliac spine, 0.5 cun an- cumflex femoral artery and vein.
terior and inferior to Wushu (GB 27). Innervation: The lateral femoral cu-
(See Col. Fig. 15) taneous nerve.
Indications: Leukorrhea, lower ab-
dominal pain, hernia, prolapse of uterus. 30. Huantiao (GB 30)
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable. Location: At the junction of the later-
Regional anatomy al 1/3 and medial 2/3 of the distance
Vasculature: The superficial and deep between the prominence of the great tro-
circumflex iliac arteries and veins. chanter and the hiatus of the sacrum
Innervation: The ilioinguinal nerve. (Yaoshu, GV 2). When locating the
point, put the patient in lateral recum-
29. Juliao (GB 29) bent position with the thigh flexed. (See
Fig. 105)
Location: In the depression of the Indications: Pain of the lumbar region
midpoint between the anterosuperior il- and thigh, muscular atrophy of the lower
iac spine and the prominence of the great limbs, hemiplegia.
trochanter. (See Col. Fig. 15) Method: Puncture perpendicularly
Indications: Pain and numbness in the 1.5-2.5 inches. Moxibustion is applicable.
thigh and lumbar region, paralysis, mus- Regional anatomy
cular atrophy of the lower limbs. Vasculature: Medially, the inferior
Method: Puncture perpendicularly gluteal artery and vein.
0.5-1.0 inch. Moxibustion is applicable. Innervation: The inferior gluteal cu-
Regional anatomy taneous nerve, the inferior gluteal nerve;

Huantiao (GB 30)

Fig. 105

---- .-----
218 CHINESE ACUPUNCTURE AND MOXIBUSTION

deeper, the sciatic nerve. thigh, 2 cun below Fengshi (G B 31), or 5

cun above the transverse popliteal crease,
31. Fengshi (GB 31) between m. vastus lateralis and m. biceps
femoris. (See Fig. 106)
Location: On the midline of the lateral Indications: Pain and soreness of the
aspect of the thigh, 7 cun above the trans- thigh and knee, numbness and weakness
verse popliteal crease. When the patient of the lower limbs, hemiplegia.
is standing erect with the hands close to Method: Puncture perpendicularly
the sides, the point is where the tip of the 0.7-1.0 inch. Moxibustion is applicable.
middle finger touches. (See Fig. 106) Regional anatomy: See Fengshi (GB
Indications: Pain and soreness in the 31 ).
thigh and lumbar region, paralysis of the
lower limbs, beriberi, general pruritus. 33. Xiyangguan (GB 33)
Method: Puncture perpendicularly
0.7-1.2 inches. Moxibustion is applicable. Location: 3 cun above Yangliangquan
Regional anatomy (GB 34), lateral to the knee joint, in the
Vasculature: The muscular branches depression above the external epicondyle
of the lateral circumflex femoral artery of femur. (See Fig. 106)
and vein. Indications: Swelling and pain of the
Innervation: The lateral femoral cu- knee, contracture of the tendons in pop-
taneous nerve, the muscular branch of liteal fossa, numbness of the leg.
the femoral nerve. Method: Puncture perpendicularly
0.5-1.0 inch.
Regional anatomy
32. Zhongdu (GB 32) Vasculature: The superior lateral gen-
Location: On the lateral aspect of the icular artery and vein.
Innervation: The terminal branch of
the lateral femoral cutaneous nerve.

34. Yanglingquan (He-Sea Point,

Influential Point of Tendon, GB 34)
Location: In the depression anterior
and inferior to the head of the fibula.
(Fig. 107)
-- - - Fengshi (GB 31) Indications: Hemiplegia, weakness,
-- --- Zhongdu(GB32) numbness and pain of the lower extremi-
7 cun
----- Xiyangguan (GB 33) ties, swelling and pain of the knee, beri-
beri, hypochondriac pain, bitter taste in
the mouth, vomiting, jaundice, infantile
Fig. 106 convulsion.
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOYANG MERIDIANS 219

peroneal artery and vein.

Innervation: The lateral sural cu-
taneous nerve.

- - - Yanglingquan (GB 34)

36. Waiqiu (Xi-Cleft Point, GB 36)
9 cun Yangjiao (GB 35) Location: 7 cun above the tip of the
external malleolus, on the anterior border
>--!!----.~_H---- Waiqiu (GB 36) of the fibula. (See Fig. 107)
- - - - Guangming (GB 37) Indications: Pain in the neck, chest,
7 cun thigh and hypochondriac region, rabies.
- - - - Yangfu(GB38)
Method: Puncture perpendicularly
- - - - Xuanzhong (GB 39)
0.5-0.8 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: The branches of the an-
terior tibial artery and vein.
Fig. 107 Innervation: The superficial peroneal
nerve.
Method: Puncture perpendicularly
0.8-1.2 inches. Moxibustion is applicable. 37. Guangming (Luo-Connecting
Regional anatomy Point, GB 37)
Vasculature: The inferior lateral gen-
icular artery and vein. Location: 5 cun directly above the tip
of the external malleolus, on the anterior
Innervation: Just where the common
border of the fibula. (See Fig. 107)
peroneal nerve bifurcates into the super-
Indications: Pain in the knee, muscu-
ficial and deep peroneal nerves.
lar atrophy, motor impairment and pain
of the lower extremities, blurring of vi-
35. Yangjiao (Xi-Cleft Point of the sion, ophthalmalgia, night blindness, dis-
Yang Link Vessel, G B 35) tending pain of the breast.
Method: Puncture perpendicularly
Location: 7 cun above the tip of the 0.7-1.0 inch. Moxibustion is applicable.
external malleolus, on the posterior bor- Regional anatomy
der of the fibula. (See Fig. 107) Vasculature: The branches of the an-
Indications: Fullness of the chest and terior tibial artery and vein.
hypochondriac region, muscular atrophy Innervation: The superficial peroneal
and paralysis of the leg. nerve.
Method: Puncture perpendicularly
0.5-0.8 inch. Moxibustion is applicable. 38. Yangfu (Jing-River Point, GB 38)
Regional anatomy
Vasculature: The branches of the Location: 4 cun above the tip of the
220 CHINESE ACUPUNCTURE AND MOXIBUSTION

external malleolus, slightly anterior to

the anterior border of the fibula, be-
tween m. extensor digitorum longus and
m. peronaeus brevis. (See Fig. 107)
Indications: Migraine, pain of the out-
er canthus, pain in the axillary region,
scrofula, lumbar pain, pain in the chest,
hypochondriac region and lateral aspect ZUlinqi(GB41) - - -

of the lower extremities, malaria. Diwuhui (GB 42) - -

Xiaxi(GB43) --""'\'lImll'"
Method: Puncture perpendicularly
Zuqiaoyin (GB 44) - - -
0.5-0.7 inch. Moxibustion is applicable.
Regional anatomy: See Guangming
(GB 37).
Fig. 108

39. Xuanzhong (Influential Point of tation, muscular atrophy of the lower

the Marrow, GB 39) limbs, pain and swelling of the external
malleolus, malaria.
Location: 3 cun above the tip of the Method: Puncture perpendicularly
external malleolus, on the anterior border 0.5-0.8 inch. Moxibustion is applicable.
of fibula. (See Fig. 107) Regional anatomy
Indications: Apoplexy, hemiplegia, Vasculature: The branch of the anter-
pain of the neck, abdominal distension, olateral malleolar artery.
pain in the hypochondriac region, muscu- Innervation: The branches of the in-
lar atrophy of the lower limbs, spastic termediate dorsal cutaneous nerve and
pain of the leg, beriberi. superficial peroneal nerve.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable. 41. Zulinqi (Shu-Stream Point,
Regional anatomy: See Guangming
the Eight Confluent Point, GB 41)
(GB 37).
Location: Posterior to the fourth me-
40. Qiuxu (Yuan-Primary Point, tatarsophalangeal joint, in the depression
GB40) lateral to the tendon of m. extensor digiti
minimi of the foot. (See Fig. 108)
Location: Anterior and inferior to the Indications: Headache, vertigo, pain
external malleolus, in the depression on of the outer canthus, scrofula, pain in the
the lateral side of the tendon of m. exten- hypochondriac region, distending pain of
sor digitorum longus. (See Fig. 108) the breast, irregular menstruation, pain
Indications: Pain in the neck, swelling and swelling of the dorsum of foot, spas-
in the axillary region, pain in the hypo- tic pain of the foot and toe.
chondriac region, vomiting, acid regurgi- Method: Puncture perpendicularly
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 221

0.3-0.5 inch. Moxibustion is applicable. 44. Zuqiaoyin (Jing-Well Point,

Regional anatomy GB44)
Vasculature: The dorsal arterial and
venous network of foot, the fourth dorsal Location: On the lateral side of the
metatarsal artery and vein. fourth toe, about 0.1 cun from the corner
Innervation: The branch of the inter- of the nail. (See Fig. 108)
mediate dorsal cutaneous nerve of the Indications: Migraine, deafness, tin-
foot. nitus, ophthalmalgia, dream-disturbed
sleep, febrile diseases.
42. Diwuhui (GB 42) Method: Puncture superficially about
0.1 inch. Moxibustion is applicable.
Location: Posterior to the fourth me- Regional anatomy
tatarsophalangeal joint, between the Vasculature: The arterial and venous
fourth and fifth metatarsal bones, on the network formed by the dorsal digital ar-
medial side of the tendon of m. extensor tery and vein and plantar digital artery
digiti minimi of foot. (See Fig. 108) and vein.
Indications: Pain of the canthus, tin- Innervation: The dorsal digital nerve.
nitus, distending pain of the breast, swell-
ing and pain of the dorsum of foot.
Method: Puncture perpendicularly IV. THE LIVER MERIDIAN
0.3-0.5 inch. OF FOOT-JUEYIN
Regional anatomy: See Foot-Linqi
(GB 41). 1. Dadun (Jing-Well Point, LR 1)

43. Xiaxi (Ying-Spring Point, GB 43) Location: On the lateral side of the
terminal phalanx of the great toe, 0.1 cun
Location: On the dorsum of foot, be- from the corner of the nail. (See Fig.
tween the fourth and fifth toe, proximal 109)
to the margin of the web, at the junction Indications: Hernia, enuresis, uterine
of the red and white skin. (See Fig. 108) bleeding, prolapse of the uterus, epilepsy.
Indications: Headache, dizziness and Method: Puncture subcutaneously
vertigo, pain of the outer canthus, tinni- 0.1-0.2 inch. Moxibustion is applicable.
tus, deafness, swelling of the cheek, pain Regional anatomy
in the hypochondriac region, distending Vasculature: The dorsal digital artery
pain of the breast, febrile diseases. and vein.
Method: Puncture perpendicularly Innervation: The dorsal digital nerve
OJ-O.5 inch. Moxibustion is applicable. derived from the deep peroneal nerve.
Regional anatomy
Vasculature: The dorsal digital artery 2. Xingjian (Ying-Spring Point, LR 2)
and vein.
Innervation: The dorsal digital nerve. Location: On the dorsum of the foot
222 CHINESE ACCPUNCTURE AND MOXIBCSTION

between the first and second toe, proxi- 3. Taichong (Shu-Stream and
mal to the margin of the web at the Yuan-Primary Point, LR 3)
junction of the red and white skin. (See
Fig. 109) Location: On the dorsum of the foot ,
Indications: Pain in the hypochon- in the depression distal to the junction of
drium, abdominal distension, headache, the first and second metatarsal bones.
dizziness and vertigo, congestion, swell- (See Fig. 109)
ing and pain of the eye, deviation of the Indications: Headache, dizziness and
mouth, hernia, painful urination, reten- vertigo, insomnia, congestion, swelling
tion of urine, irregular menstruation, epi- and pain of the eye, depression, infantile
lepsy, insomnia, convulsion. convulsion, deviation of the mouth, pain
Method: Puncture obliquely 0.3-0.5 in the hypochondriac region, uterine
inch. Moxibustion is applicable. bleeding, hernia, enuresis, retention of
Regional anatomy urine, epilepsy, pain in the anterior as-
Vasculature: The dorsal venous net- pect of the medial malleolus.
work of the foot and the first dorsal Method: Puncture perpendicularly
digital artery and vein. 0.3-0.5 inch. Moxibustion is applicable.
Innervation: The site where the dorsal Regional anatomy
digital nerves split from the lateral dorsal Vasculature: The dorsal venous net-
metatarsal nerve of the deep peroneal work of the foot, the first dorsal metatar-
nerve. sal artery.
Innervation: The branch of the deep
peroneal nerve.

4. Zhongfeng (Jing-River Point, LR 4)

Location: Anterior to the medial mal-
____ Zhongfeng (LR 4) leolus, midway between Shangqiu (SP 5)
and Jiexi (ST 41), in the depression on
the medial side of the tendon of m. tibi-
alis anterior. (See Fig. 109)
Indications: Hernia, pain in the exter-
nal genitalia, nocturnal emission, reten-
_ - - - Taichong (LR ~i)
tion of urine, distending pain in the hy-
- - - - - Xingjian(LR2)
pochondrium.
Method: Puncture perpendicularly
'''4~r---- Dadun(LR 1) 0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
Fig. 109 Vasculature: The dorsal venous net-
work of the foot and the anterior medial
malleolar artery.
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SIIAOY ANG MERIDIANS 223

Innervation: The branch of the medial nous nerve.

dorsal cutaneous nerve of the foot and
the saphenous nerve. 6. Zhongdu (Xi-Cleft Point, LR 6)

5. Ligou (Luo-Connecting Point, LR 5) Location: 7 cun above the tip of the

medial malleolus, on the midline of the
Location: 5 cun above the tip of the medial surface of the tibia. (See Fig. 110)
medial malleolus, on the midline of the Indications: Abdominal pain, hy-
medial surface of the tibia. (See Fig. 110) pochondriac pain, diarrhea, hernia, uter-
Indications: Retention of urine, enu- ine bleeding, prolonged lochia.
resis, hernia, irregular menstruation, leu- Method: Puncture subcutaneously
korrhea, pruritus valvae, weakness and 0.5-0.8 inch. Moxibustion is applicable.
atrophy of the leg. Regional anatomy
Method: Puncture subcutaneously Vasculature: The great saphenous
0.3-0.5 inch. Moxibustion is applicable. vein.
Regional anatomy Innervation: The branch of the saphe-
Vasculature: Posteriorly, the great sa- nous nerve.
phenous vein.
Innervation: The branch of the saphe- 7. Xiguan (LR 7)
Location: Posterior and inferior to the
medial condyle of the tibia, in the upper
portion of the medial head of m. gastroc-
nemius, 1 cun posterior to Yinlingquan
(SP 9). (See Fig. 110)
Indication: Pain of the knee.
Xiguan (LR 7) _
Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy
Vasculature: Deeper, the posterior
6 cun
tibial artery.
Innervation: The branch of the medial
Zhongdu (LR 6) - - 4_-J...-.J sural cutaneous nerve; deeper, the tibial
nerve.
Ligou (LR 5) - - - 7 cun
8. Ququan (He-Sea Point, LR 8)
Location: When knee is flexed, the
point is at the medial end of the trans-
verse popliteal crease, posterior to the
Fig.110 medial epicondyle of the tibia, in the
_22_4_ _ _ _ _ _ _ _ _ _ _ _ _ _ _~ _ _ _ _ _ CHINESE ACl'Pl'NCTCRE AND MOXIBUSTION

Fig. 111

depression of the anterior border of the Method: Puncture perpendicularly

insertions of m. semimembranosus and 0.5-0.7 inch. Moxibustion is applicable.
m. semitendinosus. (See Fig. 111) Regional anatomy
Indications: Prolapse of uterus, lower Vasculature: Deeper, on the lateral
abdominal pain, retention of urine, noc- side, the femoral artery and vein, the
turnal emission, pain in the external gen- superficial branch of the medial circum-
italia, pruritus vulvae, pain in the medial flex femoral artery.
aspect of the knee and thigh. Innervation: The anterior femoral cu-
Method: Puncture perpendicularly taneous nerve, on the pathway of the
0.5-0.8 inch. Moxibustion is applicable. anterior branch of the obturator nerve.
Regional anatomy
Vasculature: Anteriorly, the great sa- 10. Zuwuli (LR 10)
phenous vein, on the pathway of the genu
suprema artery. Location: 3 cun directly below Qi-
Innervation: The saphenous. chong (ST 30), at the proximal end of the
thigh, below the pubic tubercle and on
9. Yinbao (LR 9) the lateral border of m. abductor longus.
(See Col. Fig. 17)
Location: 4 cun above the medial epi- Indications: Lower abdominal disten-
condyle of the femur, between m. vastus tion and fullness, retention of urine.
medialis and m. sartorius. (See Col. Method: Puncture perpendicularly
Fig. 17) 0.5-1.0 inch. Moxibustion is applicable.
Indications: Pain in the lumbosacral Regional anatomy
region, lower abdominal pain, enuresis, Vasculature: The superficial branches
retention of urine, irregular menstrua- of the medial circumflex femoral artery
tion. and vein.
CHAPTER 9 ACUPUNCTURE POINTS OF JUEYIN AND SHAOY ANG MERIDIANS 225

Innervation: The genitofemoral nerve, Vasculature: The branches of the me-

the anterior femoral cutaneous nerve; dial circumflex femoral artery and vein.
deeper, the anterior branch of the obtu- Innervation: The genitofemoral nerve,
rator nerve. the branch of the medial femoral cu-
taneous nerve; deeper, the anterior
11. Yinlian (LR 11) branch of the obturator nerve.

Location: 2 cun directly below Qi- 12. Jimai (LR 12)

chong (ST 30), at the proximal end of the
thigh, below the pubic tubercle and on Location: Lateral to the pubic tuber-
the lateral border of m. abductor longus. cle, lateral and inferior to Qichong (ST
(See Col. Fig. 17) 30), in the inguinal groove where the
Indications: Irregular menstruation, pulsation of femoral artery is palpable,
leukorrhea, lower abdominal pain, pain 2.5 cun lateral to the anterior midline.
in the thigh and leg. (See Col. Fig. 18)
Method: Puncture perpendicularly Indications: Lower abdominal pain,
0.5-1.0 inch. Moxibustion is applicable. hernia, pain in the external genitalia.
Regional anatomy Method: Moxibustion is applicable.

Qimen (LR 14)

- - - - - - - Zhangmen (LR 13)

Fig. 112
226 CHINESE ACUPCNCTCRE AND MOXIBUSTION
-----------------------------------------------------------------
Regional anatomy Vasculature: The terminal branch of
Vasculature: The branches of the ex- the tenth intercostal artery.
ternal pudendal artery and vein, the pu- Innervation: Slightly inferiorly, the
bic branches of the inferior epigastric tenth intercostal nerve.
artery and vein; laterally, the femoral
vem.
14. Qimen (Front-Mu Point of
Innervation: The ilioinguinal nerve;
deeper, in the inferior aspect, the anterior
the Liver, LR 14)
branch of the obturator nerve. Location: Directly below the nipple,
in the sixth intercostal space, 4 cun later-
13. Zhangmen (Front-Mu Point of al to the anterior midline. (See Fig. 112)
the Spleen, Influential Point of Indications: Hypochondriac pain, ab-
Zang Organs, LR 13) dominal distention, hiccup, acid regurgi-
Location: On the lateral side of the tation, mastitis, depression, febrile di-
abdomen, below the free end of the elev- seases.
enth rib. (See Fig. 112) Method: Puncture obliquely 0.3-0.5
Indications: Abdominal distention, inch. Moxibustion is applicable.
borborygmus, pain in the hypochondriac Regional anatomy
region, vomiting, diarrhea, indigestion. Vasculature: The sixth intercostal ar-
Method: Puncture perpendicularly tery and vein.
0.5-0.8 inch. Moxibustion is applicable. Innervation: The sixth intercostal
Regional anatomy nerve.
 Chapter 10
ACUPUNCTURE POINTS OF THE GOVERNOR
AND THE CONCEPTION VESSELS AND
THE EXTRA POINTS

The Governor Vessel goes along the the coccygeal nerve, the hemorrhoid
back midline, while the Conception Ves- nerve.
sel goes along the front midline. These
two meridians and the twelve main me- 2. Yaoshu (GV 2)
ridians are called the fourteen meridians.
The experiential points which are not on Location: In the hiatus of the sacrum.
the fourteen meridians are called the ex- (See Col. Fig. 19)
tra points, which are introduced in this Indications: Irregular menstruation,
chapter. pain and stiffness of the lower back, he-
morrhoids, muscular atrophy of the low-
er extremities, epilepsy.
I. THE GOVERNOR VESSEL Method: Puncture obliquely upward
0.5-1.0 inch. Moxibustion is applicable.
1. Changqiang (Luo-Connecting Regional anatomy
Point, GV 1) Vasculature: The branches of the me-
dian sacral artery and vein.
Location: Midway between the tip of Innervation: The branch of the coc-
the coccyx and the anus, locating the cygeal nerve.
point in prone position. (See Figs. 113
and 114) 3. Yaoyangguan (GV 3)
Indications: Diarrhea, bloody stools,
hemorrhoids, prolapse of the rectum, Location: Below the spinous process
constipation, pain in the lower back, epi- of the fourth lumbar vertebra, at the level
lepsy. with the crista iliaca. (See Figs. 113 and
Method: Puncture perpendicularly 114 )
0.5-0.1 inch. Moxibustion is applicable. Indications: Irregular menstruation,
Regional anatomy nocturnal emission, impotence, pain in
Vasculature: The branches of the in- the lumbosacral region, muscular atro-
ferior hemorrhoid artery and vein. phy, motor impairment, numbness and
Innervation: The posterior ramus of pain of the lower extremities.
227
228 CHINESE ACl'PUI\'CTL'RE AI\'O MOXIBUSTION

Method: Puncture perpendicularly 4. Mingmen (GV 4)

0.5-1.0 inch. Moxibustion is applica-
Location: Below the spinous process
ble.
of the second lumbar vertebra. (See Figs.
Regional anatomy
113 and 114)
Vasculature: The posterior branch of Indications: Stiffness of the back,
the lumbar artery. lumbago, impotence, nocturnal emission,
Innervation: The medial branch of the irregular menstruation, diarrhea, indiges-
posterior ramus of the lumbar nerve. tion, leukorrhea.

- - - - - - - Dazhui(GV 14)

---------1 Taodao (GV 13)

Sh~,h"(GV12)

_________ - Lmgtai (GV 10)

-- - - - - - - -~Zh'Y'"g(GV91
- - - - Jinsuo (GV 8)

- - - - - Mingmen (GV 4)

- - - - - Yaoyangguan (GV 3)

------f--- Cha"g.m"g(GV 11

Fig. 113
CHAPTER 10 ACVPUNCTURE POINTS OF THE GOYER:"OH .\1\'0 THE COI':CEPTION \·ESSELS AI':I) TIlE EXTRA 229

Cervical vertebrae

Dazhui (GV 14) _ _ _ _ -'___""

Shenzhu (GV 12) - - -

Lingtai (GV 10) __

Thorasic vertebrae

Zhiyang (GV 9) - -

Jinsuo (GV 8) - - - ' _.--.....-.

Lumbar vertebrae
Mingmen (GV 4) - - - -

Yaoyangguan(GV31- - --

Sacral vertebrae

Changqiang (GV 1) - - - - - -

Fig. 114

Method: Puncture perpendicularly of the first lumbar vertebra. (See Col.

0.5-1.0 inch. Moxibustion is applicable. Fig. 19)
Regional anatomy: See Yaoyangguan Indications: Pain and stiffness of the
(GV 3). lower back, diarrhea, indigestion.
Method: Puncture perpendicularly
5. Xuanshu (GV 5) 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Yaoyangguan
Location: Below the spinous process (GV 3).
 230
CHINESE ACUPUNCTURE AND MOXIBUSTION

6. Jizhong (GV 6) 0.5-1.0 inch. Moxibustion is applicable.

Regional anatomy
Location: Below the spinous process
Vasculature: The posterior branch of
of the eleventh thoracic vertebra. (See
the ninth intercostal artery.
Col. Fig. 19)
Innervation: The medial branch of
Indications: Pain in the epigastric re-
the posterior ramus of the ninth thoracic
gion, diarrhea, jaundice, epilepsy, stiff-
nerve.
ness and pain of the back.
Method: Puncture perpendicularly
0.5-1.0 inch. 9. Zhiyang (GV 9)
Regional anatomy
Location: Below the spinous process
Vasculature: The posterior branch of
of the seventh thoracic vertebra, approx-
the eleventh intercostal artery.
imately at the level with the inferior an-
Innervation: The medial branch of the
gle of the scapula. (See Figs. 113 and 114)
posterior ramus of the eleventh thoracic
Indications: Jaundice, cough, asthma,
nerve.
stiffness of the back, pain in the chest
and back.
7. Zhongshu (GV 7) Method: Puncture obliquely upward
Location: Below the spinous process 0.5-1.0 inch. Moxibustion is applicable.
of the tenth thoracic vertebra. (See Col. Regional anatomy
Fig. 19) Vasculature: The posterior branch of
Indications: Pain in the epigastric re- the seventh intercostal artery.
gion, low back pain, stiffness of the back. Innervation: The medial branch of the
Method: Puncture perpendicularly posterior ramus of the seventh thoracic
0.5-1.0 inch. Moxibustion is applicable. nerve.
Regional anatomy
Vasculature: The posterior branch of 10. Lingtai (GV 10)
the tenth intercostal artery.
Innervation: The medial branch of Location: Below the spinous process
the posterior ramus of the tenth thoracic of the sixth thoracic vertebra. (See Figs.
nerve. 113 and 114)
Indications: Cough, asthma, furun-
c1es, back pain, neck rigidity.
8. Jinsuo (GV 8)
Method: Puncture obliquely upward
Location: Below the spinous process 0.5-1.0 inch. Moxibustion is applicable.
of the ninth thoracic vertebra. (See Figs. Regional anatomy
113 and 114) Vasculature: The posterior branch of
Indications: Epilepsy, stiffness of the the sixth intercostal artery.
back, gastric pain. Innervation: The medial branch of the
Method: Puncture perpendicularly posterior ramus of the thoracic nerve.
CHAPTER lO ACUPCNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 231

11. Shendao (GV 11) 0.5-1.0 inch. Moxibustion is applicable.

Regional anatomy
Location: Below the spinous process Vasculature: The posterior branch of
of the fifth thoracic vertebra. (See Col. the first intercostal artery.
Fig. 19) Innervation: The medial branch of
Indications: Poor memory, anxiety, the posterior ramus of the first thoracic
palpitation, pain and stiffness of the nerve.
back, cough, cardiac pain.
Method: Puncture obliquely upward 14. Dazhui (GV 14)
0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy Location: Below the spinous process
Vasculature: The posterior branch of of the seventh cervical vertebra, approx-
the fifth intercostal artery. imately at the level of the shoulders.
Innervation: The medial branch of (Figs. 113 and 114)
the posterior ramus of the fifth thoracic Indications: Neck pain and rigidity,
nerve. malaria, febrile diseases, epilepsy, af-
ternoon fever, cough, asthma, common
12. Shenzhu (GV 12) cold, back stiffness.
Method: Puncture obliquely upward
Location: Below the spinous process 0.5-1.0 inch. Moxibustion is applicable.
of the third thoracic vertebra. (See Figs. Regional anatomy
113 and 114) Vasculature: The branch of the trans-
Indications: Cough, asthma, epilepsy, verse cervical artery.
pain and stiffness of the back, furuncles. Innervation: The posterior ramus of
Method: Puncture obliquely upward the eighth cervical nerve and the medial
0.5-1.0 inch. Moxibustion is applicable. branch of the posterior ramus of the first
Regional anatomy thoracic nerve.
Vasculature: The posterior branch of
the third intercostal artery. 15. Yarnen (GV 15)
Innervation: The medial branch of
the posterior ramus of the third thoracic Location: 0.5 cun directly above the
nerve. midpoint of the posterior hairline, in the
depression below the spinous process of
13. Taodao (GV 13) the first cervical vertebra. (See Fig. 115)
Indications: Mental disorders, epilep-
Location: Below the spinous process sy, deafness and mute, sudden hoarseness
of the first thoracic vertebra. (See Figs. of voice, apoplexy, stiffness of the tongue
113 and 114) and aphasia, occipital headache, neck ri-
Indications: Stiffness of the back, gidity.
headache, malaria, febrile diseases. Method: Puncture perpendicularly
Method: Puncture obliquely upward 0.5-0.8 inch. Neither upward obliquely
232 CHINESE ACL'peNCTURE AND MOXIBUSTION

- - - Shangxing (GV 23)

Fengfu (GV 16) _ _ ,,'" Suliao (GV 25)

Yamen(GV 15) - -- - - Shuigou (GV 26)

Fig. 115

nor deep puncture is advisable. It is near post-apoplexy aphasia, hemiplegia, men-

the medullary bulb in the deep layer, tal disorders.
and the depth and angle of the puncture Method: Puncture perpendicularly
should be paid strict attention to. 0.5-0.8 inch. Deep puncture is not advi-
Regional anatomy sable. Medullary bulb is in the deep layer,
Vasculature: The branches of the oc- special attention should be paid in acu-
cipital artery and vein. puncture.
Innervation: The third occipital nerve. Regional anatomy
Vasculature: The branch of the occip-
16. Fengfu (GV 16) ital artery.
Innervation: The branches of the
Location: I cun directly above the third cervical nerve and the great occipi-
midpoint of the posterior hairline, direct- tal nerve.
ly below the external occipital protuber-
ance, in the depression between m. trape- 17. Naohu (GV 17)
zius of both sides. (See Fig. 115)
Indications: Headache, neck rigidity, Location: 2.5 cun directly above the
blurring of vision, epistaxis, sore throat, midpoint of the posterior hairline, 1.5
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 2:\:\

cun directly above Fengfu (GV 16), in 20. Baihui (GV 20)
the depression on the upper border of the
external occipital protuberance. (See Col. Location: On the midline of the head,
Fig. 19) 5 cun directly above the midpoint of the
Indications: Epilepsy, dizziness, pain anterior hairline, approximately on the
and stiffness of the neck. midpoint of the line connecting the apex-
Method: Puncture subcutaneously es of both ears. (See Fig. 115)
0.3-0.5 inch. Moxibustion is applicable. Indications: Headache, vertigo, tinni-
Regional anatomy tus, nasal obstruction, aphasia by apo-
Vasculature: The branches of the oc- plexy, coma, mental disorders, prolapse
cipital arteries and veins of the both of the rectum and the uterus.
sides. Method: Puncture subcutaneously
Innervation: The branch of the great 0.3-0.5 inch. Moxibustion is applicable.
occipital nerve. Regional anatomy
Vasculature: The anastomotic net-
work formed by the superficial temporal
18. Qiangjian (GV 18)
arteries and veins and the occipital arter-
Location: 4 cun directly above the ies and veins on both sides.
midpoint of the posterior hairline and 1.5 Innervation: The branch of the great
cun above Naohu (GV 17). (See Col. occipital nerve.
Fig. 19)
Indications: Headache, neck rigidity, 21. Qianding (GV 21)
blurring of vision, mania.
Method: Puncture subcutaneously Location: 3.5 cun di rectly above the
0.3-0.5 inch. Moxibustion is applicable. midpoint of the anterior hairline and 1.5
Regional anatomy: See Naohu (GV cun anterior to Baihui (GV 20). (See Col.
17). Fig. 19)
Indications: Epilepsy, dizziness, blur-
19. Houding (GV 19) ring of vision, vertical headache, rhinor-
rhea.
Location: 5.5 cun directly above the Method: Puncture subcutaneously
midpoint of the posterior hairline, 1.5 0.3-0.5 inch. Moxibustion is applicable.
cun directly above Qiangjian (GV 18). Regional anatomy
(See Col. Fig. 19) Vasculature: The anastomotic net-
Indications: Headache, vertigo, mania, work formed by the right and left super-
epilepsy. ficial temporal arteries and veins.
Method: Puncture subcutaneously Innervation: On the communicating
OJ-0.5 inch. Moxibustion is applicable. site of the branch of the frontal nerve
Regional anatomy: See Naohu (GV with the branch of the great occipital
17). nerve.

--~-------
234 CHINESE ACUPUNCTURE AND MOXIBUSTION

22. Xinhui (GV 22) 24. Shenting (GV 24)

Location: 2 cun posterior to the mid- Location: 0.5 cun directly above the
point of the anterior hairline, 3 cun midpoint of the anterior hairline. (See
anterior to Baihui (GV 20). (See Col. Col. Fig. 19)
Fig. 19) Indications: Epilepsy, anxiety, palpita-
Indications: Headache, blurring of vi- tion, insomnia, headache, vertigo, rhinor-
Sion, rhinorrhea, infantile convul- rhea.
sion. Method: Puncture subcutaneously
Method: Puncture subcutaneously 0.3-0.5 inch, or prick to cause bleeding.
Moxibustion is applicable.
003-0.5 inch. This point is prohibited in
Regional anatomy
infants with metopism. Moxibustion is
Vasculature: The branch of the fron-
applicable.
tal artery and vein.
Regional anatomy
Innervation: The branch of the fron-
Vasculature: The anastomotic net-
tal nerve.
work formed by the right and left super-
ficial ,temporal artery and vein and the
frontal artery and vein. 25. Suliao (GV 25)
Innervation: The branch of the fron- Location: On the tip of the nose. (See
tal nerve. Fig. 115)
Indications: Loss of consciousness,
23. Shangxing (GV 23) nasal obstruction, epistaxis, rhinorrhea,
rosacea.
Location: I cun directly above the Method: Puncture perpendicularly
midpoint of the anterior hairline. (Fig. 0.2-0.3 inch, or prick to cause bleeding.
115) Regional anatomy
Indications: Headache, ophthalmal- Vasculature: The lateral nasal branch-
gia, epistaxis. rhinorrhea, mental disor- es of the facial artery and vein.
ders. Innervation: The external nasal
Method: Puncture subcutaneously branch of the anterior ethmoidal nerve.
0.3-0.5 inch or prick to cause bleeding.
This point is prohibited in infants with 26. Shuigou (also known as Renzhong,
metopism. Moxibustion is applicable. GV26)
Regional anatomy
Vasculature: The branches of the Location: At the junction of the upper
frontal artery and vein, and the branches third and middle third of the philtrum.
of the superficial temporal artery and (See Fig. 115)
veIn. Indications: Mental disorders, epilep-
Innervation: The branch of the fron- sy, hysteria, infantile convulsion, coma,
tal nerve. apoplexy-faint, trismus, deviation of the
 Zhongfu (LU 1)

1
Tianfu (LU,8)
Xiabai (Wd4)
p

Color Fig. 1 The Lung Meridian of Hand-Taiyin

--- - -~--~- -- ----- ---~------ -----~-------~~-- -----

Color Fig. 2 The Large Intestine Meridian of Hand-Yangming
 - - -- Touwei (ST 8)
Chengqi (ST 1) "" fiih
l ....
i

Sibai (ST 2) - - t,:.

Juiiao (ST 3) __ !;
'!'
Dicang (ST 4) - - - \

Oishe ~J 11)

Shuida,o (ST 28)

Guiiai (ST 29)
Oichong (ST 30)

Color Fig. 3 The Stomach Meridian of Foot-Yangming ( I)

 L<
f

Biguan (ST 31)

l

\ i
Futu (S1132)
\
\
Yinshi (ST:!)
Liangqiu (ST :tlt,-
f:

Jiexi (ST .a.~lL_'!""'Lil

}<
Chongyang (ST 421

Neiting (ST

Color Fig. 4 The Stomach Meridian of Foot-Yangming (II )

 Jimen (Sp 11)
0:

Color Fig. 5 The Spleen Meridian of Foot-Taiyin ( I )

. -...- ------- .'-- .. _-

 Zhourong (SP 20)

Xiongxiang (SP 19)

Tianxi (SP 18)

Shidou (SP 17)

Fuai(SP 16)

Daheng (SP 15)

Fujie (SP 14)

Fushe (SP 13)

Chong men (SP 12)

Color Fig. 6 The Spleen Meridian of Foot-Taiyin ( II )

 j"

Sha~d(HT
l

Color Fig. 7 The Heart Meridian of Hand-Shaoyin

- - ------- - ----~-----
---------------
 4'>
,1

(81 15) Ji~St!tu ..

(81 ljJj Jianwaishu
(SI 13) Quyuan

($111) Tianzong

(81 5) Yanggu
(81 4) Wangu

Houxi

Color Fig. 8 The Small Intestine Meridian of Hand-Taiyang

--------- ------- ---

 (BL 6) Chengguang --__
(BL 7) Tongtian
(BL 5) Wuchu -
(BL8) Luoque (BL 4) Qucha (Quchai)
(BL 3) Meichong
," (BL 2) Cuanzhu

(BL 1) Jingming "

(BL 11) Dazhu

(BL 12) Fengmen (BL 41) Fufen
(BL 13) Feishu (BL 42) Pohu
(BL 14) Jueyinshu (BL 43) Gaohuang
(BL 15) Xinshu (BL 44) Shentan
(Bl 16) Dushu (Bl45) Yixi
(BL 17) Gesh\;l (BL 46) ~-4uqriF"

(BL 18) Ganshu

(BL 19) Danshu
(Bl20) Pishu

'k'~,~,;",~",(Bl21) Weish" (Bt.SO)iweicang

(fL,~)SanjiaOS~ :(Bl51rHua
!iKel231Shensh~ , (BLS2)",
f(8L 24) Qjhaishu
(Bl2k) DaLgshu
•• ' (BL 27) Xiaochangshu
(Bl26) Guanyuanshu
.••.•.• , (BL 28)Pangguangshu
(BI.-31) Shangliao -----
i~; (BL 32) Ciliao . ---- .•.. ~ - -_(BL 53) Baohuang
--- ---- (BL ~IZhonglushu

,
(@las) Zhongliao . ----
\"34) Xialiao'--" '-" ---. (Bl Zhibian
(B~$s) Huiyang ...• ". ( , aihuanshu

Color Fig. 9 The Bladder Meridian of Foot-Taiyang ( I )

 ................. (BL 36) Chengfu

.................. (BL 37) Yinmen

··~·····-·········(BL 38) Fuxi

'. ··················(BL 39) Weiyang
••••• ..... -......... (BL 40) Weizhong
".
···················(BL 55) Heyang

""""-""""""'(BL 56) Chengjin

...•••••.............. (BL 57) Chengshan

...•............... (BL 58) Feiyang
•••.......... (BL 59) Fuyang
.'
.. '

•• ············(BL 60) Kunlun

•••• (BL 60) Kunlun
./ •••• • (BL 62)Shenmai
'.' •••• ••..•. (BL 63) Jinmen
\~ Ii .J{
4
~'.
'
... <.....
•
.'(BL 65) Shugu

~ "-,'0 .~~~:: \~~ ~~ ~~~~g9U (BL 61) Pucan --.......... (BL 64) Jinggu

Color Fig. 10 The Bladder Meridian of Foot-Taiyang (II)

 ,{ an (KI 1)
t
1
j

Jiaoxin /<1 8)
. /
,,
Zhaohal (KI 6) ,'J./
Taixi (KI 3)
fazhong (KI 4)
, Shl,Jiquan (KI 5)
~~~~ (KI 2.)~~c>~"AeJS?;.>

Color Fig. 11 The Kidney Meridian of Foot-Shaoyin ( I )

 (KI 26) Yuzhong

(KI 25)Shencang

(KI24) Lingxu

(KI 23) Shenfeng

(KI 21) Youmen

(KI 20) Futonggu
(KI 19) Yindu
(~I 18) Shiguan
17) Shangqu

.1<1 16)
(KI15) ZIifl~Au
(KI 14)
(KI 13)
(KI12)
(KI11) Henggu

Color Fig. 12 The Kidney Meridian of Foot-Shaoyin (II)

 7) Daling

Laogong

9)Zhongchong

Color Fig. 13 The Pericardium Meridian of Hand-Jueyin

 Jiaasun (TE 20) . ,izhukong (TE 23)
. c •
Luxi (TE1:9)
,"::00000. Erheliao (TE 22)
Qima\~\(Te 1h) ,; '.
Yifen~\(TE 17) ·····.E~men (TE 21)
Tianyou (TE 16)

Jianliao (TE 14)

Xiaoluo (TE 12)

;.j

Guanchong (TE 1 .

Color Fig. 14 The Triple Energizer Meridian of Hand-Shaoyang

 Zhengying (GB 17)
: ,/ Hanyan (GB 4)
Muchuang (GB 16) ---------, _ _ 'L...' ".//" Chengling (GB 18)
Toulinqi (GB 15) ------ ,,/
... ,' Xuanli (GB 6)
Benshen (GB 13) -----
Yangbai (GB 14) ---~ _-- ...~ _ ...... --;- - ---- Shuaigu (GB 8)
Xuanlu (GB 5) - ... ~ -- --- Tianchong (GB 9)
Tongziliao (GB 1) --- ' ... _ ' --- Fubai (GB10)
Qubin (GB 7) --':................. ........ - _:-. Naokong (GB 19)
Shangguan (GB 3) ...... { _............... ~...- .... _ -~ Touqiaoyin (GB 11)
Tinghui (GB 2) .........:-: ,... ................ ...-...- -'- Fengchi (GB 20)
........
Wangu (GB 12) ..........

Jianjing (GB 21)

Juliao (GB 29)

Color Fig. 15 The Gallbladder Meridian of Foot-Shaoyang ( I )

 I\.IUC.l~'U 32)

XM-.dtbuan (G8 33)

I
t
Waiqiu (G8 36)

Color Fig. 16 The Gallbladder Meridian of Foot-Shaoyang (II)

 Yinliln (LR 11)
l···
zuJAn (LR to)
!'".

Zhongdu(L

Color Fig. 17 The Liver Meridian of Foot-Jueyin ( I )

 Oimen (LR 14)

"
;

Jimai (LR 12)

Color Fig. 18 The Liver Meridian of Foot-Jueyin ( II )

 Qianding (GV 21) -- Xinhui (GV 22)
Baihui (GV 20) - Shangxing (GV 23)
Shenting (GV 24)
Houding (GV 19)
Qiangjian.(GV 18)

Naohu (rAV 17)

,----
I
, ,
Fengfu (~V 16)
Suliao (GV 25)
Shuigou (GV 26)
I Y~en{GV 15) - Duiduan (GV 27)
I
I
I
Yinjiao (GV 28)

Dazhui (GVM}"
Taodao (GV 13)

Shenzhu (GV 12)

Shendao (GV 11)

Lingtai (GV 10)

Zhiyang (GV 9)

Jinsuo (GV 8)
Zhongshu (GV 7)
Jizhong (GV 6)

Xuanshu(Q\I 5}
Mingmen'GV 4)
,
",: !

Yaoyangguan (BV 3)

Changqiang (GV1,

Color Fig. 19 The Governor Vessel

/' Tiant~(~~)
Xuanji (CV 21)
Huagai (CV 20)

Zigong (CV 19)

...t . Yutang (CV 18)

,"!' Ta~ong (CV 17)
,"~, Zhongting (CV 16)
i· Jiuwei (CV 15)
Juque (CV 14)
Shangwan (CV 13)
Zhongwan (CV 12)
Jianli (CV 11)
Xiawan (CV 10)
Shuifen (CV 9)
Shenque (CV 8)
Yinjiao (CV 7)
Qlhai (CV 6)
Shimen (CV 5)
Guanyuan (CV 4) -----~- Huiyin (CV 1)

Zhongji (CV 3) .. / .
Qugu (CV 2)

Color Fig. 20 The Conception Vessel

CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 235

mouth and eyes, puffiness of the face, tery and vein.

pain and stiffness of the lower back. Innervation: The branch of the super-
Method: Puncture obliquely upward ior alveolar nerve.
0.3-0.5 inch.
Regional anatomy
Vasculature: The superior labial ar- II. THE CONCEPTION
tery and vein. VESSEL
Innervation: The buccal branch of the
facial nerve, and the branch of the in- 1. Huiyin (CV 1)
traorbital nerve.
Location: Between the anus and the
27. Duiduan (GV 27) root of the scrotum in males and between
the anus and the posterior labial commis-
Location: On the labial tubercle of the sure in females. (See Col. Fig. 20)
upper lip, on the vermilion border be- Indications: Vaginitis, retention of u-
tween the philtrum and upper lip. (See rine hemorrhoids, nocturnal emission,
Col. Fig. 19) enuresis, irregular menstruation, mental
Indications: Mental disorders, lip disorders.
twitching, lip stiffness, pain and swelling Method: Puncture perpendicularly
of the gums. 0.5-1.0 inch. Moxibustion is applicable.
Method: Puncture obliquely upward Regional anatomy
0.2-0.3 inch. Vasculature: The branches of the peri-
Regional anatomy neal artery and vein.
Vasculature: The superior labial ar- Innervation: The branch of the peri-
tery and vein. neal nerve.
Innervation: The buccal branch of the
facial nerve, and the branch of the in- 2. Qugu (CV 2)
fraorbital nerve.
Location: On the midpoint of the up-
28. Yinjiao (GV 28) per border of the symphysis pubis. (See
Col. Fig. 20)
Location: At the junction of the gum Indications: Retention and dribbling
and the frenulum of the upper lip. (See of urine, enuresis, nocturnal emission,
Col. Fig. 19) impotence, morbid leukorrhea, irregular
Indications: Mental disorders, pain menstruation, dysmenorrhea, hernia.
and swelling of the gums, rhinorrhea. Method: Puncture perpendicularly
Method: Puncture obliquely upward 0.5-1.0 inch. Great care should be taken
0.1-0.2 inch, or prick to cause bleed- to puncture the points from Qugu (CV 2)
mg. to Shangwan (CV 13) of this meridian in
Regional anatomy pregnant women. Moxibustion is appli-
Vasculature: The superior labial ar- cable.
236 CHINESE ACUPUNCTURE AND MOXIBUSTION

Regional anatomy 3. Zhongji (Front-Mu Point of the

Vasculature: The branches of the in- Bladder, CV 3)
ferior epigastric artery and the obturator
Location: On the anterior midline, 4
artery. cun below the umbilicus. (See Fig.
Innervation: The branch of the iliohy- 116 )
pogastric nerve. Indications: Enuresis, nocturnal emis-

Tanzhong (CV 17)

- Jiuwei (CV 15)

- Juque (CV 14)
- - Shang wan (CV 13)
- - Zhongwan (CV 12)
- - Jianli(CV 11)
- - - Xiawan (CV 10)
- - - Shuifen (CV 9)
- - Shenque (CV 8)

_ _ Qihai (CV 6)
3 cun
- - Shimen (CV 5)

- - Guanyuan (CV 4)

2 cun - Zhongji(CV3)

Fig.116
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 237

sion, impotence, hernia, uterine bleed- 5. Shimen (Front-Mu Point of Triple

ing, irregular menstruation, dysmenor- Energizer, CV 5)
rhea, morbid leukorrhea, frequency of
urination, retention of urine, pain in the Location: On the anterior midline, 2
lower abdomen, prolapse of the uterus, cun below the umbilicus. (See Fig. 116)
vaginitis. Indications: Abdominal pain, diar-
Method: Puncture perpendicularly rhea, edema, hernia, anuria, enuresis,
0.5-1.0 inch. Moxibustion is applica- amenorrhea, morbid leukorrhea, uterine
ble. bleeding, postpartum hemorrhage.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The branches of superfi- 0.5-1.0 inch. Moxibustion is applicable.
cial epigastric artery and vein, and the Regional anatomy
branches of inferior epigastric artery and Vasculature: See Zhongji (CV 3).
vein. Innervation: The anterior cutaneous
Innervation: The branch of the iliohy- branch of the eleventh intercostal nerve.
pogastric nerve.
6. Qihai (CV 6)
4. Guanyuan (Front-Mu Point of the Location: On the anterior midline, 1.5
Small Intestine, CV 4) cun below the umbilicus. (See Fig. 116)
Indications: Abdominal pain, enures-
Location: On the anterior midline, 3 is, nocturnal emission, impotence, her-
cun below the umbilicus. (See Fig.
nia, edema, diarrhea, dysentery, uterine
116 ) bleeding, irregular menstruation, dys-
Indications: Enuresis, nocturnal emis-
menorrhea, amenorrhea, morbid leukor-
sion, frequency of urination, retention rhea, postpartum hemorrhage, constipa-
of urine, hernia, irregular menstruation, tion, flaccid type of apoplexy, asthma.
morbid leukorrhea, dysmenorrhea, uter- Method: Puncture perpendicularly
ine bleeding, postpartum hemorrhage, 0.8-1.2 inches. This is one of the impor-
lower abdominal pain, indigestion, diar- tant points for tonification. Moxibustion
rhea, prolapse of the rectum, flaccid type is applicable.
of apoplexy. Regional anatomy: See Shimen
Method: Puncture perpendicularly (CV 5).
0.8-1.2 inches. This is one of the impor-
tant points for tonification. Moxibustion 7. Yinjiao (CV 7)
is applicable.
Regional anatomy Location: On the anterior midline,
Vasculature: See Zhongji (CV 3). cun below the umbilicus. (See Col.
Innervation: The medial branch of the Fig. 20)
anterior cutaneous branch of the twelfth Indications: Abdominal distention,
intercostal nerve. edema, hernia, irregular menstruation,

~~-.- .. - ---.--- . -------

238 CIIIKESE ACUPUNCTURE AKD ,,10XIBUSTION

uterine bleeding, morbid leukorrhea, pru- 10. Xiawan (CV 10)

ritus vulvae, postpartum hemorrhage, ab-
dominal pain around the umbilicus. Location: On the anterior midline, 2
Method: Puncture perpendicularly cun above the umbilicus. (See Fig. 116)
0.8-1.2 inches. Moxibustion is appli- Indications: Epigastric pain, abdomin-
al pain, borborygmus, indigestion, vomit-
cable.
Regional anatomy ing, diarrhea.
Method: Puncture perpendicularly
Vasculature: See Zhongji (CV 3).
0.5-1.2 inches. Moxibustion is applicable.
Innervation: The anterior cutaneous
Regional anatomy
branch of the tenth intercostal nerve.
Vasculature: See Shenque (CV 8).
Innervation: The anterior cutaneous
8. Shenque (CV 8) branch of the eighth intercostal nerve.
Location: In the centre of the umbili-
cus. (See Fig. 116) 11. Jianli (CV 11)
Indications: Abdominal pain, borbor- Location: On the anterior midline, 3
ygmus, flaccid type of apoplexy, prolapse cun above the umbilicus. (See Fig. 116)
of the rectum, unchecked diarrhea. Indications: Stomachache, vomiting,
Method: Puncture is prohibited. Mox- abdominal distention, borborygmus, ede-
ibustion is applicable. ma, anorexia.
Regional anatomy Method: Puncture perpendicularly
Vasculature: The inferior epigastric 0.5-1.2 inches. Moxibustion is applicable.
artery and vein. Regional anatomy
Innervation: The anterior cutaneous Vasculature: The branches of the su-
branch of the tenth intercostal nerve. perior and inferior epigastric arteries.
Innervation: The anterior cutaneous
9. Shuifen (CV 9) branch of the eighth intercostal nerve.

Location: On the anterior midline, 12. Zhongwan (Front-Mu Point of

cun above the umbilicus. (See Fig. 116) the Stomach, Influential Point of
Indications: Abdominal pain, borbor-
the Fu Organs, CV 12)
ygmus, edema, retention of the urine,
diarrhea. Location: On the anterior midline, 4
Method: Puncture perpendicularly cun above the umbilicus. (See Fig. 116)
0.5-1.0 inch. Moxibustion is applicable. Indications: Stomachache, abdominal
Regional anatomy distention, borborygmus, nausea, vomit-
Vasculature: See Shenque (CV 8). ing, acid regurgitation, diarrhea, dysen-
Innervation: The anterior cutaneous tery, jaundice, indigestion, insomnia.
branch of the eighth and ninth intercostal Method: Punctu re perpendicularly
nerves. 0.5-1.2 inches. Moxibustion is applicable.
CHAPTER 10 ACUPCNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 239

Regional anatomy and the chest, nausea, mental disorders,

Vasculature: The superior epigastric epilepsy.
artery and vein. Method: Puncture obliquely down-
Innervation: The anterior cutaneous ward 0.4-0.6 inch. Moxibustion is applica-
branch of the seventh intercostal nerve. ble.
Regional anatomy: See Zhongwan
13. Shangwan (CV 13) (CV 12).

Location: On the anterior midline, 5

16. Zhongting (CV 16)
cun above the umbilicus. (See Fig. 116)
Indications: Stomachache, abdominal Location: On the anterior midline, at
distention, nausea, vomiting, epilepsy, in- the level with the fifth intercostal space,
somnia. on the xiphosternal synchondrosis. (See
Method: Puncture perpendicularly Col. Fig. 20)
0.5-1.2 inches. Moxibustion is applicable. Indications: Distension and fullness in
Regional anatomy: See Zhongwan the chest and intercostal region, hiccup,
(CV 12). nausea, anorexia.
Method: Puncture subcutaneously
14. Juque (Front-Mu Point of 0.3-0.5 inch. Moxibustion is applicable.
the Heart, CV 14) Regional anatomy
Vasculature: The anterior perforating
Location: On the anterior midline of
branches of the internal mammary artery
the abdomen, 6 cun above the umbilicus.
and vein.
(See Fig. 116)
Innervation: The medial branch of the
Indications: Pain in the cardiac region
anterior cutaneous branch of the sixth
and the chest, nausea, acid regurgitation,
difficulty in swallowing, vomiting, men- intercostal nerve.
tal disorders, epilepsy, palpitation.
Method: Puncture perpendicularly 17. Tanzhong (Front-Mu Point of
0.3-0.8 inch. Moxibustion is applicable. the Pericardium, Influential Point
Regional anatomy: See Zhongwan of Qi, CV 17)
(CV 12).
Location: On the anterior midline,
at the level with the fourth intercostal
15. Jiuwei (Luo-Connecting Point,
space, midway between the nipples. (See
CVI5)
Fig. 116)
Location: On the anterior midline, Indications: Asthma, pain in the
cun below the xiphosternal synchondros- chest, fullness in the chest, palpitation,
is. Locate the point in supine position insufficient lactation, hiccup, difficulty
with the arms uplifted. (See Fig. 116) in swallowing.
Indications: Pain in the cardiac region Method: Puncture subcutaneously
240 CHINESE ACUPUNCTURE AND MOXIBUSTION

0.3-0.5 inch. Moxibustion is applicable. chest and intercostal region, asthma,

Regional anatomy cough.
Vasculature: See Zhongting (CV 16). Method: Puncture subcutaneously
Innervation: The anterior cutaneous 0.3-0.5 inch. Moxibustion is applicable.
branch of the fourth intercostal nerve. Regional anatomy
Vasculature: See Zhongting (CV 16).
18. Yutang (CV 18) Innervation: The anterior cutaneous
branch of the first intercostal nerve.
Location: On the anterior midline, at
the level with the third intercostal space. 21. Xuanji (CV 21)
(See Col. Fig. 20)
Indications: pain in the chest, cough, Location: On the anterior midline, in
asthma, vomiting. the centre of the sternal manubrium, 1
Method: Puncture subcutaneously cun below Tiantu (CV 22). (See Col.
0.3-0.5 inch. Moxibustion is applicable. Fig. 20)
Regional anatomy Indications: Pain in the chest, cough,
Vasculature: See Zhongting (CV 16). asthma.
Innervation: The anterior cutaneous Method: Puncture subcutaneously
branch of the third intercostal nerve. 0.3-0.5 inch. Moxibustion is applicable.
Regional anatomy
19. Zigong (CV 19) Vasculature: See Zhongting (CV 16).
Innervation: The anterior branch of
Location: On the anterior midline, the supraclavicular nerve and the anteri-
at the level with the second intercostal or cutaneous branch of the first intercos-
space. (See Col. Fig. 20) tal nerve.
Indications: Pain in the chest, asthma,
cough. 22. Tiantu (CV 22)
Method: Puncture subcutaneously
0.3-0.5 inch. Moxibustion is applicable. Location: In the centre of the supras-
Regional anatomy ternal fossa. (See Fig. 117)
Vasculature: See Zhongting (CV 16). Indications: Asthma, cough, sore
Innervation: The anterior cutaneous throat, dry throat, hiccup, sudden hoarse-
branch of the second intercostal nerve. ness of the voice, difficulty in swallow-
ing, goiter.
Method: First puncture perpendicu-
20. Huagai (CV 20)
larly 0.2 inch and then insert the needle
Location: On the anterior midline, at tip downward along the posterior aspect
the midpoint of the sternal angle, at the of the sternum 0.5-1.0 inch. Moxibustion
level with the first intercostal space. (See is applicable.
Col. Fig. 20) Regional anatomy
Indications: Pain and fullness in the Vasculature: Superficially, the jugular
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 24 I

arch and the branch of the inferior thy- Innervation: The branch of the cu-
roid artery; deeper, the trachea; inferior- taneous cervical nerve, the hypoglossal
ly, at the posterior aspect of the sternum, nerve, and the branch of the glossophar-
the inominate vein at aortic arch. yngeal nerve.
Innervation: The anterior branch of
the supraclavicular nerve.
24. Chengjiang (CV 24)
23. Lianquan (CV 23) Location: In the depression in the
centre of the mentolabial groove. (See
Location: Above the Adam's apple, in
Fig. 117)
the depression of the upper border of the
Indications: Facial puffiness, swelling
hyoid bone. (See Fig. 117)
Indications: Swelling and pain of the of the gums, toothache, salivation, men-
subglossal region, salivation with glosso- tal disorders, deviation of the eyes and
plegia, aphasia with stiffness of tongue mouth.
by apoplexy, sudden hoarseness of the Method: Puncture obliquely upward
voice, difficulty in swallowing. 0.2-0.3 inch. Moxibustion is applica-
Method: Puncture obliquely 0.5-1.0 ble.
inch toward the tongue root. Moxibus- Regional anatomy
tion is applicable. Vasculature: The branches of the in-
Regional anatomy ferior labial artery and vein.
Vasculature: The anterior jugular Innervation: The branch of the facial
vem. nerve.

Chengjiang (CV 24) - --

Fig. 117
242 CHINESE ACUPUNCTURE AND MOXIBUSTION

III. THE EXTRA POINTS 0.3-0.5 inch. Moxibustion is applicable.

1. Taiyang 3.Shanglianquan
Location: I cun below the midpoint of
Location: In the depression about one
the lower jaw, in the depression between
finger breadth posterior to the midpoint
the hyoid bone and the lower border of
between the lateral end of the eyebrow
the jaw. (See Fig. 118)
and the outer canthus. (See Fig. 118)
Indications: Alalia, salivation with
Indications: Headache, eye diseases,
stiff tongue, sore throat, difficulty in
deviation of the eyes and mouth.
swallowing, loss of voice.
Method: Puncture perpendicularly Method: Puncture obliquely 0.8-1.2
0.3-0.5 inch, or prick to cause bleeding. inches toward the tongue root.

2. Yintang 4. Erjian
Location: Midway between the medial Location: Fold the auricle, the point is
ends of the two eyebrows. (See Fig. at the apex of the auricle. (See Fig. 118)
118) Indications: Redness, swelling and
Indications: Headache, head heavi- pain of the eyes, febrile disease, nebula.
ness, epistaxis, rhinorrhea, infantile con- Method: Puncture perpendicularly
vulsion, frontal headache, insomnia. 0.1-0.2 inch or prick to cause bleeding.
Method: Puncture su bcutaneously Moxibustion is applicable.

Erjian

.! ~,~~~ ---
, \\.

Shanglianquan - - -
/
-~

Fig. 118
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 243

.:.} - - - -Sishencong

- -Jiachengjiang

Fig.119

5. Yuyao 7. Qiuhou
Location: At the midpoint of the eye- Location: At the junction of the later-
brow, directly above the pupil. (See Fig. al 114 and the medial 3/4 of the infraor-
119) bital margin. (See Fig. 119)
Indications: Pain in the supraorbital Indications: Eye diseases.
region, twitching of the eyelids, ptosis, Method: Push the eyeball upward
cloudiness of the cornea, redness, swell- gently, then puncture perpendicularly
ing and pain of the eyes. 0.5-1.2 inches along the orbital margin
Method: Puncture subcutaneously slowly without movements of lifting,
0.3-0.5 inch. thrusting, twisting and rotating.

6. Sishencong
8. Jiachengjiang
Location: A group of 4 points, at the
vertex, 1 cun respectively posterior, ante- Location: 1 cun lateral to Chengjiang
rior and lateral to Baihui (GY 20). (See (CY 24). (See Fig. 119)
Fig. 119) Indications: Pain in the face, deviation
Indications: Headache, vertigo, insom- of the eyes and mouth, spasm of facial
nia, poor memory, epilepsy. muscle.
Method: Puncture subcutaneously Method: Puncture obliquely 0.5-1.0
0.5-1.0 inch. Moxibustion is applicable. inch.

--- ------ -------------------

244 CHINESE ACUPUNCTURE AND MOXIBUSTION

Indications: Deviation of the eyes and

mouth, ulceration on tongue and
mouth.
Method: Puncture obliquely 0.5-1.0
inch.

12. Yiming

Location: 1 cun posterior to Yifeng

(TE 17). (See Fig. 121)
Indications: Eye diseases, tinnitus, in-
somnia.
Method: Puncture perpendicularly
0.5-0.8 inch.

Fig. 120
13. Anmian

Location: Midpoint between Yifeng

9. Jinjing, Yuye (TE 17) and Fengchi (GB 20). (See Fig.
Location: On the veins on both sides 121)
of the frenulum of the tongue, linjin is Indications: Insomnia, vertigo, head-
on the left, Yuye, on the right. (See Fig. ache, palpitation, mental disorders.
120) Method: Puncture perpendicularly
Indications: Swelling of the tongue, 0.5-0.8 inch.
vomiting, aphasia with stiffness of
tongue.
Method: Prick to cause bleeding.

10. Bitong
Location: At the highest point of the
nasolabial groove. (See Fig. 121) Bitong-

Indications: Rhinitis, nasal obstruc- - - -Anmian

tion, nasal boils.
Method: Puncture subcutaneously up-
ward 0.3-0.5 inch.

11. Qianzheng
Location: 0.5-1.0 cun anterior to the Fig. 121
auricular lobe. (See Fig. 121)
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 245

14. Dingchuan nous process from the first thoracic ver-

tebra to the fifth lumbar vertebra. (See
Location: 0.5 cun lateral to Dazhui Fig. 122)
(GV 14). (See Fig. 122) Indications: See the following table 8.
Indications: Asthma, cough, neck ri- Method: Puncture perpendicularly
gidity, pain in the shoulder and back, 0.5-1.0 inch in the cervical and chest re-
rubella. gion, puncture perpendicularly 1.0-1.5 in-
Method: Puncture perpendicularly ches in the lumbar region. Moxibustion is
0.5-0.8 inch. Moxibustion is applicable. applicable.

15. Huatuojiaji 16. Bailao

Location: A group of 34 points on Location: 2 cun above Dazhui (GV
both sides of the spinal column, 0.5 cun 14), 1 cun lateral to the midline. (See Fig.
lateral to the lower border of each spi- 123)

- - - - Huatuojiaji

Fig. 122

----------------- -------------------
246 CHINESE ACUPUNCTURE AND MOXIBUSTION

Table 8

Huatuojiaji Points Indications

T. 1 Diseases in the upper limbs.

2
3
4
5 Diseases in the chest region.
6
7
8
9
10
11
12 Diseases in the abdominal region.
L. 1
2
3 Diseases in the lower limbs.
4
5

Indications: Scrofula, cough, asthma, 18. Shiqizhui

whooping cough, neck rigidity.
Location: Below the spinous process
Method: Puncture perpendicularly
of the fifth lumbar vertebra. (See Fig.
0.3-0.5 inch. Moxibustion is applicable.
123)
Indications: Lumbar Pain, thigh pain,
17. Weiwanxiashu paralysis of the lower extremities, irregu-
lar menstruation, dysmenorrhea.
Location: 1.5 cun lateral to the low- Method: Puncture perpendicularly
er border of the spinous process of the 0.8-1.2 inches. Moxibustion is applicable.
eighth thoracic vertebra. (See Fig. 123)
Indications: Diabetes, vomiting, ab- 19. Yaoqi
dominal pain, pain in the chest and hypo-
chondriac region. Location: 2 cun directly above the tip
Method: Puncture obliquely 0.5-0.7 of the coccyx. (See Fig. 123)
inch. Moxibustion is applicable. Indications: Epilepsy, headache, in-
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR A:\O THE COr-;CEPTION VESSELS Ar-;O THE EXTRA 247

- - Bailao

- Weiwanxiashu

- - - - - - - Pigen

- - - - - - - Yaoyan
- - - - - - Shiqizhui

- - - - - - Yaoqi

Fig. 123

somnia, constipation. lumbar vertebra. (See Fig. 123)

Method: Puncture subcutaneously up- Indications: Hepatosplenomegaly,
ward 1.0-2.0 inches. Moxibustion is appli- lumbar pain.
cable. Method: Puncture perpendicularly
0.5-0.8 inch. Moxibustion is applicable.
20. Pigen
21. Yaoyan
Location: 3.5 cun lateral to the lower
border of the spinous process of the first Location: About 3.5-4 cun lateral to
248 CHINESE ACUPUNCTURE AND MOXIBUSTION

the lower border of the spinous process 22. Zigongxue

of the fourth lumbar vertebra. The point
is in the depression appearing in prone Location: 3 cun lateral to Zhongji
position. (See Fig. 123) (CY 3). (See Fig. 124)
Indications: Lumbar pain, frequency Indications: Prolapse of the uterus,
of urine, irregular menstruation. irregular menstruation.
Method: Puncture perpendicularly Method: Puncture perpendicularly
0.8-1.2 inches. Moxibustion is applicable. 0.8-1.2 inches. Moxibustion is applicable.

Jianqian- - -

4cun

Zigong--- -

Fig. 124
CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 249

Zhongkui_-

Zhongquan- _ _ _.

Fig. 125

23. Jianqian (also known as 25. Sifeng

Jianneiling)
Location: On the palmar surface, in
Location: Midway between the end of the midpoint of the transverse creases of
the anterior axillary fold and Jianyu (L I the proximal interphalangeal joints of the
15). (See Fig. 124) index, middle, ring and little fingers. (See
Indications: Pain in the shoulder and Fig. 125)
arm, paralysis of the upper extremities. Indications: Malnutrition and indiges-
Method: Puncture perpendicularly tion syndrome in children, whooping
cough.
0.8-1.2 inches. Moxibustion is applicable.
Method: Prick to cause bleeding, or
squeeze out a small amount of yellowish
24. Shixuan viscous fluid locally.
Location: On the tips of the ten fin-
26. Zhongkui
gers, about 0.1 cun distal to the nails.
(See Fig. 125) Location: On the midpoint of the
Indications: Apoplexy, coma, epilep- proximal interphalangeal joint of the
sy, high fever, acute tonsillitis, infantile middle finger at dorsum aspect. (See Fig.
convulsion, numbness of the finger tips. 125)
Method: Puncture 0.1-0.2 inch super- Indications: Nausea, vomiting, hic-
ficially, or prick to cause bleeding. cup.
250 CHINESE ACUPUNCTURE AND MOXIBUSTION

Method: Moxibustion is applied with shoulder and arm.

three moxa cones. Method: Puncture perpendicularly
0.5-0.8 inch.
27. Baxie
29. Yaotongxue
Location: On the dorsum of the hand,
at the junction of the white and red skin Location: On the dorsum of the hand,
of the hand webs, eight in all, making a midway between the transverse wrist
loose fist to locate the points. (See Fig. crease and metacarpophalangeal joint,
125) between the second and third metacarpal
Indications: Excessive heat, finger bones, and between the fourth and fifth
numbness, spasm and contracture of the metacarpal bones, four points in all on
fingers, redness and swelling of the dor- both hands. (See Fig. 126)
sum of the hand. Indication: Acute lumbar sprain.
Method: Puncture obliquely 0.3-0.5 Method: Puncture obliquely 0.5-1.0
inch, or prick to cause bleeding. Moxi- inch toward the centre of metacarpus
bustion is applicable. from both sides.

28. Luozhen 30.Zhongquan

Location: On the dorsal crease of the
Location: On the dorsum of the hand,
wrist, in the depression on the radial side
between the second and third metacarpal
of the tendon of common extensor mus-
bones, about 0.5 cun posterior to meta-
cle of fingers between Yangxi (L1 5) and
carpophalangeal joint. (See Fig. 126)
Yangchi (TE 4). (See Fig. 125)
Indications: Sore neck, pain in the
Indications: Stuffy chest, gastric pain,
spitting of blood.
Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.

31. Erbai

Louzhen Location: On the metacarpal aspect of

--
- -Yaotongxue
the forearm, 4 cun above the transverse
wrist crease, on the both sides of the
tendon of m. flexor carpi radialis, two
points on one hand. (See Fig. 127)
Indications: Hemorrhoids, prolapse of
the rectum.
Fig. 126 Method: Puncture perpendicularly
0.5-1.0 inch. Moxibustion is applicable.

- ------,--- -----~- -------- ~ - ----- ---------

CHAPTER 10 ACUPUNCTURE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 251

Method: Puncture perpendicularly

1.0-1.2 inches. Moxibustion is applicable.

33. Zhoujian

Bizhong_ Location: On the tip of the ulnar olec-

ranon when the elbow is flexed. (See Fig.
128)
Indication: Scrofula
Method: Moxibustion is applied with
seven to fourteen moxa cones.

Fig. 127

32. Bizhong
Location: On the lateral aspect of the
forearm, midway between the transverse
wrist crease and elbow crease, between
the radius and the ulna. (See Fig. 127)
Indications: Paralysis, spasm and con-
tracture of the upper extremities, pain of
the forearm. Fig. 128

Huanzhong-- -

Fig. 129
252 CHINESE ACCPUNCTCRE AND MOXIBUSTION

34. Huanzhong
Heding-_
Location: Midway between Huantiao --Xiyan

(GB 30) and Yaoshu (GY 2). (See Fig.

129)
Indications: Lumbar pain, thigh pain.
Method: Puncture perpendicularly Lanweixue-
1.5-2.0 inches. Moxibustion is applicable.

35. Baichongwo
Location: I cun above Xuehai (SP 10).
(See Fig. 130)
Indications: Rubella, eczema. gastro-
intestinal parasitic diseases.
Method: Puncture perpendicularly
l.(} 1.2 inches. Moxibustion is applicable.

36. Xiyan
Location: A pair of points in the two
Fig. 131
depressions, medial and lateral to the pa-
tellar ligament, locating the point with Method: Puncture perpendicularly
the knee flexed. These two points are also 0.5-1.0 inch. Moxibustion is applicable.
termed medial and lateral Xiyan respec-
tively. Lateral Xiyan overlaps with Dubi 37. Lanweixue
(ST 35). (See Fig. 131)
Indications: Knee pain, w~akness of Location: The tender spot about 2 cun
the lower extremities. below Zusanli (ST 36). (See Fig. 131)
Indications: Acute and chronic appen-
Xuehai (SP 10)
dicitis, indigestion, paralysis of the lower
... extremities .
Baichongwo-- - - . ~
Method: Puncture perpendicularly
' - ' - . . , _J 1.0-1.2 inches.

38. Heding
Location: In the depression of the
midpoint of the superior patellar border.
Fig. 130 (See Fig. 131)
Indications: Knee pain, weakness of
CHAPTER IO ACUPL'NCTL'RE POINTS OF THE GOVERNOR AND THE CONCEPTION VESSELS AND THE EXTRA 253

40. Bafeng
Location: On the dorsum of foot, In
the depressions on the webs between toes,
proximal to the margins of the webs, at
----Dannangxue the junction of the red and white skin,
eight points in all. (See Fig. 133)
Indications: Beriberi, toe pain, redness
and swelling of the dorsum of the foot.
Method: Puncture obliquely 0.5-0.8
inch. Moxibustion is applicable.

Fig. 132

the foot and leg, paralysis.

Method: Puncture perpendicularly
0.3-0.5 inch. Moxibustion is applicable.

39. Dannangxue
Location: The tender spot 1-2 cun di-
rectly below Yanglingquan (OB 34). (See
Fig. 132)
Indications: Acute and chronic chole-
cystitis, cholelithiasis, biliary ascariasis,
muscular atrophy and numbness of the Fig. 133
lower extremities.
Method: Puncture perpendicularly
0.8-1.2 inches.
 Chapter 11
AETIOLOGY AND PATHOGENESIS

The subject of aetiology is the study tors, the seven emotions, improper diet,
of the causative factors of disease, whilst over strain, lack of physical exercise,
the study of pathogenesis concerns the traumatic injuries, bites by insects or wild
actual bodily processes whereby disease animals, as well as stagnant blood and
occurs, develops and changes. Traditional phlegm fluid. The symptoms and signs of
Chinese medicine holds that there is nor- any disease reflect the pathological reac-
mally a state of relative equilibrium be- tions of the affected body to certain
tween the human body and the external causative factors. The causative factors,
environment on the one hand, and among therefore, are studied both as the objec-
the zang-fu organs within the body on the tive causes of disease, and in the specific
other hand. This equilibrium is not stat- ways they affect the body. On the basis of
ic, but is in a state of constant self- this understanding, traditional Chinese
adjustment, and in this way the normal medicine is able to identify the causative
physiological activities of the body are factors of disease by analysing the clin-
maintained. If external influences exceed ical manifestations. This is known as
the powers of adaptability of the organ- "seeking the causative factors by differ-
ism, or if the body itself is unable to entiating symptoms and signs." The study
adjust to changing conditions, then this of aetiology, therefore, is based on devel-
relative equilibrium will be lost, and di- oping a profound understanding of the
sease will develop. Whether a disease oc- characteristic clinical manifestations pro-
curs or not, whilst associated with the duced by each causative factor.
presence of the various causative factors,
is primarily determined by the physiolog- 1. The Six Exogenous Factors
ical adaptability of the body to the natu-
ral environment. This is the basic view- Wind, cold, summer heat, damp, dry-
point of traditional Chinese medicine re- ness and fire (warmth and heat) are the
garding pathogenesis. six climatic changes found in nature. Un-
der normal conditions, they do not pro-
duce pathological changes in the body
I. AETIOLOGY and are thus known as the "six types of
qi" in the natural environment. These six
Numerous factors can cause disease, types of qi will only cause disease if ei-
and these include the six exogenous fac- ther the climatic changes are extreme or
21)4
CHAPTER II AETIOLOGY AND PATHOGENESIS 255

sudden, or if the body's resistance is low. a) Wind is the primary exogenous

When responsible for inducing disease, pathogenic factor in causing disease,
these six types of qi are known as "the six since cold, damp, dryness and heat all
exogenous pathogenic factors." depend on wind to invade the body, it
All the six exogenous pathogenic fac- is stated in the forty-second chapter of
tors, when affecting the body, invade Plain Questions: "Wind is the leading cau-
from the exterior via the skin, mouth or sative factor of many diseases."
nose. For this reason, the pathological Pathogenic wind can not only combine
reactions they induce are known as "ex- with the other five exogenous factors, but
ogenous diseases." also with phlegm to form wind phlegm.
Diseases due to the six exogenous Facial paralysis, for example, is mostly
factors are closely related to seasonal seen as a consequence of the obstruction
changes in the weather and to living en- of wind phlegm in the meridians.
vironment. For example, heat syndromes b) Wind is a yang pathogenic factor
mostly occur in summer, cold syndromes and is characterized by "upward and out-
in winter, and damp syndromes are ward dispersion." It can therefore easily
usually caused by prolonged exposure to invade the upper part of the body, i.e. the
damp. Another term for these syndromes head and face, and the exterior portion of
is "seasonal diseases." the body, leading to impairment of the
Each of the six exogenous pathogenic opening and closing of the pores. Clinical
factors may affect the body singly or in manifestations are headache, nasal ob-
combination. Examples are common cold struction, itching or pain in the throat,
due to pathogenic wind and cold, or hi facial puffiness, aversion to wind and
syndrome due to pathogenic wind, cold sweating.
and damp, etc. In the process of causing c) Wind in nature blows in gusts and
disease, the six exogenous factors may is characterized by rapid changes. Disor-
influence each other, and may also, under ders caused by pathogenic wind, there-
certain conditions, transform into each fore, are marked by migratory symptoms,
other. For example, pathogenic cold may rapid changes and abrupt onset of di-
transform into heat in the interior of the sease. The migratory joint pain of wan-
body, and prolonged summer heat may dering hi syndrome, for example, which
result in dryness by consuming the yin of is caused by pathogenic wind, is known as
the body, etc. The properties of the six wind hi syndrome. Urticaria caused by
exogenous factors and their specific path- pathogenic wind is characterized by itch-
ological influences on the body are des- ing of the skin and wheals which appear
cribed as follows: and disappear from place to place.
1) Wind Wind is the predominant qi d) Wind is characterized by constant
of spring but may also occur in any of the movement. Moving pathogenic wind in
four seasons. Wind may easily invade the the body can cause dizziness, vertigo,
body after sweating, or whilst sleeping. fremitus, convulsions and opisthotonos.
256 CHINESE ACUPUNCTURE AND .\IOXIBUSTION

Examples are tetanus and deviation of thirst, profuse sweating and a surging
the mouth and eyes with spasm of the pulse.
facial muscles. b) Summer heat is characterized by
2) Cold Cold, the predominant qi of upward direction, dispersion and con-
winter, may occur in other seasons but sumption of body fluid. It usually affects
not as severely. Thin clothing, exposure the head and eyes, causing dizziness and
to cold after sweating, being caught in blurred vision. Due to its dispersing func-
rain, and wading in water in cold winter tion, pathogenic summer heat may cause
can give rise to invasion of pathogenic the pores to stay open. The excessive
cold. sweating that causes may consume body
a) Cold is a yin pathogenic factor fluid resulting in thirst with a strong
which consumes the yang qi of the body. desire to drink, dry mouth and tongue,
As a result the warming function of the scanty deep-yellow urine. In addition,
body will be impaired, resulting in symp- there will be symptoms of qi deficiency
toms such as cold limbs, cold pain in the such as reluctance to speak and lassitude.
epigastric and abdominal regions, diar- Severe invasion of summer heat may
rhoea containing undigested food, in- disturb the mind, resulting in sunstroke
creased flow of clear urine, etc. with the symptoms of sudden collapse
b) Cold is characterized by contrac- and coma.
tion and stagnation, resulting in impair- c) Since summer is often character-
ment of the opening and closing of the ized by high humidity, pathogenic sum-
pores, spasmodic contraction of tendons mer heat is frequently combined with
and meridians, and impaired circulation pathogenic damp. Clinical manifestations
of qi and blood. Accompanying symp- of summer heat and damp include dizzi-
toms include pain, aversion to cold, lack ness, heaviness in the head, suffocating
of sweating and restricted movement of sensation in the chest, nausea, poor appe-
the limbs. tite, loose stools and general lassitude, in
3) Summer Heat Summer heat is the addition to fever, restlessness and thirst.
predominant qi of summer, and unlike 4) Damp Damp is the predominant
the other exogenous factors, is only seen qi of late summer-the period between
in its own season. Summer heat diseases summer and autumn -which in China is
are induced by excessively high tempera- a hot, rainy season with abundant damp
tures, overexposure to the blazing sun everywhere. Many diseases related to in-
whilst working, and working or staying vasion by pathogenic damp occur at this
for too long in poorly ventilated places. time. Damp diseases may also be induced
a) Summer heat, characterized by ex- by living in damp conditions and places,
treme heat, is a yang pathogenic factor wearing clothes made damp by sweat or
which is transformed from fire. Clinical rain, frequent exposure to water, and pe-
manifestations characterized by yang riods of prolonged rain.
heat include high fever, restlessness, a) Damp is characterized by heaviness
CHAPTER 11 AETIOLOGY AND PATHOGENESIS 257

and turbidity. Patients often complain of a) Dryness consumes body fluid re-
dizziness, a heavy sensation in the head sulting in dryness of the nose and throat,
as though it had been wrapped in a piece dry mouth with thirst, chapped skin,
of cloth, heaviness of the body as though withered body hair, constipation and re-
it were carrying a heavy load, and sore- duced urination.
ness, pain and heavy sensations in the b) Pathogenic dryness often impairs
joints. There may be turbid discharges the function of the lung, the "delicate"
from the body, such as suppurating sores, zang, which has the function of dispers-
weeping eczema, profuse purulent leu- ing, descending and moistening. Dryness
korrhoea with a foul odour, turbid urine invades the lung through the nose or
and stools containing mucus and even mouth. When lack of moisture impairs
blood. the dispersing and descending functions
b) Damp is characterized by viscosity of the lung, there may be a dry cough
and stagnation. Patients affected by path- with scanty sticky or bloody sputum.
ogenic damp usually have a stubborn 6) Fire (warmth and heat) Fire,
sticky tongue coating, a viscous stool that caused by excess of yang qi, often occurs
is difficult to excrete, and obstructed in summer, but may be seen in other
urination. Diseases due to pathogenic seasons. Fire, warmth and heat vary in
damp tend to be prolonged and intracta- degree. Of the three, fire is the most
ble, such as fixed bi syndrome, damp severe and warmth the least severe, yet
fever (intestinal typhoid) and eczema. they all share similar Characteristics. The
c) Damp is a yin pathogenic factor terms of fire heat and warm heat, there-
which impairs yang and easily obstructs fore, are often used to describe their com-
qi circulation. Clinical manifestations in- mon features.
clude a full sensation in the chest, epigas- a) Fire is a yang pathogenic factor
tric distention, difficult and scanty urina- characterized by burning and upward di-
tion and hesitant bowel movements with rection. Clinical manifestations include
viscous stools. Since the spleen "likes high fever, restlessness, thirst, sweating,
dryness and dislikes damp," pathogenic mouth and tongue ulcers, swollen and
damp is likely to impair spleen yang, painful gums, headache and congestion
leading to distention and fullness in the of the eyes. Restlessness, insomnia, man-
epigastrium and abdomen, poor appetite, ia, emotional excitement and coma or
loose stools, reduced urination and oede- delirium may occur if pathogenic fire
ma, due to poor transportation and trans- disturbs the mind.
formation and inadequate dispersion of b) Pathogenic fire often consumes yin
body fluids. fluid. Burning pathogenic fire heat can
5) Dryness Dryness is the predomi- consume yin fluid and force it to the
nant qi of autumn, and in China often exterior of the body, leading to insuf-
occurs in this season which is usually ficiency of body fluid. Clinically, apart
very dry. from high fever, there may be thirst with
258 CHINESE ACUPUNCTURE AND MOXIBUSTION

desire to drink, dry lips and throat, con- nevertheless share similar clinical man-
stipation and deep-yellow scanty urine. ifestations. These pathological changes
c) Invasion by fire stirs up wind and are therefore referred to as endogenous
causes disturbance of blood. Excess of wind, cold, damp, dryness and fire (heat)
fire heat affects the Liver Meridian and in order to avoid ambiguity. Descriptions
deprives the tendons and meridian of of these pathogenic factors are ignored
nourishment, thus stirring up the liver here and are covered in the chapter on
wind. Clinical manifestations include the differentiation of syndromes of the
high fever, coma, convulsion of the four zang-fu organs.
limbs, neck rigidity, opisthotonos and up-
ward staring of the eyes. These symptoms 2. The Seven Emotional Factors
are known as "extreme heat stirring up
wind." The seven emotional factors in tradi-
When pathogenic fire heat disturbs tional Chinese medicine are joy, anger,
blood, it speeds up blood circulation and melancholy, worry, grief, fear and fright.
gives rise to very rapid pulse. In severe These are normal emotional responses of
cases, blood is forced out of the vessels, the body to external stimuli, and do not
leading to epistaxis, spitting of blood, normally cause disease. Severe, contin-
bloody stool, haematuria, uterine bleed- uous or abruptly occurring emotional
ing and menorrhagia. Pathogenic fire stimuli, however, which surpass the regu-
heat may stay in and rot the blood and lative adaptability of the organism, will
flesh, thus creating carbuncle, furuncle, affect the physiological functions of the
boil and ulcer. human body, especially when there is a
In addition to the six exogenous path- preexisting oversensitivity to them. The
ogenic factors occurring in nature, there qi and blood of the zang-fu organs will be
also exist some extremely infectious· nox- disrupted leading to disease. The seven
ious epidemic factors. Although the char- emotional factors, differing from the six
acteristics of these are similar to those of exogenous factors, directly affect the
warm heat, they are severely toxic and zang-fu organs, qi and blood. For this
can result in the sudden onset of severe reason, they are considered to be the
diseases such as plague. The medical lit- main causative factors of endogenous di-
erature of traditional Chinese medicine seases.
describes epidemics of many diseases rec- Ancient doctors believed that differ-
ognised by modern medicine, such as ent emotional factors tend to affect the
smallpox, cholera, diphtheria and toxic circulation of qi and blood of specific
dysentery. internal organs, resulting in the follow-
In addition to diseases caused by the ing clinical manifestations and patholo-
six exogenous pathogenic factors, there gy: "Anger injures the liver, joy injures
are many diseases caused by functional the heart, grief and melancholy injure the
disturbances of the zang-fu organs which lung, worry injures the spleen, and fear
CHAPTER 11 AETIOLOGY AND PATHOGENESIS 259

and fright injure the kidney." heart, liver or spleen individually, or may
"Anger causes the qi to rise up; joy impair the function of more than one of
causes it to move slowly; grief drastically these zang organs. For example, worry
consumes it; fear causes it to decline; can injure both heart and spleen, whilst
fright causes it to be deranged, and worry prolonged depression and anger may
causes it to stagnate." cause disharmony between the liver and
Many of these relationships are vali- spleen.
dated by clinical observation, but a con-
crete analysis of each individual case is 3. Improper Diet, Overstrain, Stress
necessary to confirm which internal or- and Lack of Physical Exercise
gan is impaired and what pathological
changes in the qi have developed. 1) Improper diet Although food is of
The heart, liver and spleen are course necessary for maintaining life, im-
most closely involved with pathological proper diet may be one of the causative
changes resulting from the seven emo- factors of disease, and may affect the
tional factors, although any of the five body in the following three ways:
zang organs may be affected. For exam- a) Overeating and malnutrition The
ple, excessive joy or fear may cause men- quantity of food consumed should be
tal disturbance and dysfunction of the appropriate to the requirements of the
heart in dominating mental activities. body. Either voracious eating or insuffi-
Clinical manifestations include palpita- cient food intake may result in disease. If
tions, insomnia, dream-disturbed sleep more food is eaten than the digestive
and mental confusion, and in severe cas- system can properly digest, the function
es, abnormal laughing and crying and of the spleen and stomach will be im-
mania. Prolonged anger or depression paired. Clinical manifestations include
can impair the liver's function of main- foul belching, sour regurgitation, disten-
taining the free flow of qi. Clinical man- tion and pain of the epigastric and ab-
ifestations include distention and pain dominal regions, loss of desire to eat,
in the hypochondriac region, irascibility, vomiting and diarrhoea. The forty-third
belching, sighing, the sensation of a for- chapter of Plain Questions states: "Ov-
eign body in the throat, and irregular ereating will inevitably impair the gastro-
menstruation. In severe cases, bleeding intestinal function." Insufficient food in-
due to impairment of the blood vessels take will fail to provide the basis for the
may occur. Worry, grief and melancholy manufacture of qi and blood. In the long
often affect the transporting and trans- run, there will be loss of weight and
forming function of the spleen, causing weakness of zheng (antipathogenic) qi.
epigastric and abdominal distention, an- b) Overindulgence in particular foods
orexia, etc. The human body can only obtain its nu-
The seven emotional factors may tritional needs when food intake is bal-
cause functional derangement of the anced. Overindulgence in one particular
260 CHINESE ACCPUNCTURE AND MOXIBCSTION

food may result in various forms of mal- overstrain or stress will weaken the anti-
nutrition or other diseases. For example, pathogenic qi and result in clinical man-
continuous intake of polished rice may ifestations such as loss of weight, lassi-
result in beriberi. The inhabitants of in- tude, disinclination to speak, palpitations,
land plateaus run a greater risk or suffer- insomnia, dizziness and blurred vision.
ing from simple goiter through drinking Excessive sexual activity will injure
only "Shash ui" (drinking water lacking in the kidney qi, resulting in symptoms of
iodine). Overindulgence in cold or raw deficiency such as soreness and weakness
food can easily injure spleen yang leading of the lumbar region and knee joints,
to the development of interior cold and dizziness, tinnitus, impotence, ejacu-
damp with the symptoms of abdominal lation praecox, lassitude and irregular
pain and diarrhea. Overindulgence in al- menstruation.
coholic drink or greasy, sweet and highly An excessively comfortable life and
flavoured food may produce damp heat, lack of physical exercise can impair the
phlegm and stagnation of qi and blood. circulation of qi and blood, weaken the
When the functions of the spleen and function of the spleen and stomach, and
stomach are impaired, there may be path- sap body resistance. Clinical manifesta-
ological changes such as full sensation in tions include softening of the bones and
the chest with profuse sputum, dizziness, tendons, poor energy, poor appetite, las-
vertigo, bleeding haemorrhoids and car- situde, obesity, and shortness of breath
buncles. on exertion. They may also induce other
c) Intake of unclean food If unclean, diseases.
decayed or poisonous food is eaten, the
functions of the spleen and stomach will 4. Traumatic Injury and Insect or
be impaired, resulting in pain and disten- Animal Bites
tion in the epigastric and abdominal re-
gions, nausea, vomiting, borborygmus Traumatic injuries include gunshots,
and diarrhoea. Unclean food may also incisions, contusions, scalds, burns, and
cause parasitic diseases or food poison- sudden contracture or sprain due to car-
mg. rying heavy loads. These can result in
2) Overstrain, stress or lack of physical muscular swelling and pain, stagnation of
exercise Normal physical exertion and blood, bleeding, injury to the tendons,
rest do not cause disease, and indeed fracture of the bones, dislocation of the
form the basic conditions for building up joints, etc. Invasion of exogenous patho-
the constitution and preventing disease. genic qi into the affected areas, profuse
Overstrain and stress or lack of physical bleeding, or injury to the internal organs
exertion, however, may cause disease, the can even cause coma or convulsions.
thirty-ninth chapter of Plain Questions Insect or animal bites including the
says: "Overstrain or stress consume the bites of poisonous snakes, wild beasts and
vital energy of the body." Prolonged rabid dogs may result in bleeding, pain
CHAPTER 11 AETIOLOGY AND PATHOGENESIS 261

and broken skin in mild cases, and toxi- go, and blurred vision. Accumulation of
cosis or even death in severe cases. phlegm and qi in the throat may lead
to a "foreign body sensation." Retained
5. Phlegm Fluid and Stagnant Blood fluid attacking the skin and muscles
may cause oedema, general aching and a
Phlegm fluid and stagnant blood are heavy sensation of the body; retention of
the pathological products of dysfunction fluid in the chest and hypochondrium
of the zang-fu organs. Both of them, may cause cough, asthmatic breathing,
however, having been produced, further distention and pain there; retained fluid
affect the zang-fu organs and tissues spreading to the stomach and intestines
-either directly or indirectly-and cause may lead to nausea, vomiting of sticky
numerous diseases. Phlegm fluid and fluid, discomfort in the epigastrium and
stagnant blood are therefore considered abdomen, and borborygmus.
to be a kind of pathogenic factor. Diseases caused by phlegm fluid cover
1) Phlegm fluid Phlegm fluid results a wide range, referring not only to those
from accumulation of body fluid due to with such symptoms as visible sputum,
dysfunction of the lung, spleen and kid- but also to those with clinical manifesta-
ney and impairment of water metabol- tions characterized by phlegm fluid. Gen-
ism. Phlegm is turbid and thick, whilst eral clinical manifestations include spit-
retained fluid is clear and dilute. The ting of profuse sputum or sticky fluid, a
term phlegm fluid is the short form of rattling sound in the throat, a full sensa-
the combination of the two. tion in the epigastric and abdominal re-
Diseases caused by phlegm fluid in- gions, vomiting, dizziness and vertigo,
clude numerous syndromes involving palpitations, sticky tongue coating and a
either substantial or non-substantial string-taut or rolling pulse.
phlegm fluid. Clinical manifestations 2) Stagnant blood Stagnant blood is
vary according to the area of the body mainly caused by impaired blood circula-
affected. Retention of phlegm in the tion due to either coldness or deficiency
lung, for example, may cause cough with or stagnation of qi. Traumatic injuries
profuse sputum and asthmatic breathing; may cause internal bleeding which accu-
phlegm afflicting the heart may lead to mulates and is not dispelled, leading to
palpitation, coma and depressive and stagnant blood.
manic psychosis; obstruction of the me- The clinical manifestations of stag-
ridians, bones and tendons by phlegm nant blood vary according to the area
may cause tuberculosis of the cervical affected. Stagnant blood in the heart, for
lymph nodes, subcutaneous nodules, sup- example, may result in a suffocating sen-
purative inflammation of deep tissues, sation in the chest, cardiac pain and
numbness of the limbs and body, and green purplish lips. Stagnant blood in the
hemiplegia; phlegm fluid affecting the lung can cause chest pain and haemoptys-
head and eyes may cause dizziness, verti- is. Stagnant blood in the gastro-intestinal
262 CHINESE ACUPCNCTURE AND MOXIBUSTION

tract can lead to haematemesis and of antipathogenic qi and the presence of

bloody stools. Stagnant blood in the liver pathogenic qi. Whilst both together con-
may cause hypochondriac pain and pal- stitute the two major factors underlying
pable masses in the abdomen. Stagnant the occurrence of disease, however, anti-
blood in the uterus can cause dysmenor- pathogenic qi is primary, being the inter-
rhoea, irregular menstruation, and a dark nal factor that allows the invasion of the
red menstrual flow with clots. Stagnant external factor i.e. pathogenic qi. The
blood on the body surface may cause a seventy-second chapter of Plain Questions
purplish or green colour of the skin and states: "Pathogenic qi cannot invade the
subcutaneous haematoma. body if the antipathogenic qi remains
Diseases due to stagnant blood, al- strong." The thirty-third chapter of the
though they can be varied, share certain same book further states: "The anti path-
common characteristics: ogenic qi must be weak if invasion of
a) Pain which is worse with pressure pathogenic qi takes place."
and stabbing in nature. This dialectical approach, which pays
b) Bleeding which is deep or dark attention to both internal and external
purple in colour containing clots. conditions, in particular, the former, has
c) Ecchymoses or petechiae, accom- played a major role in traditional Chinese
panied by pain in the affected parts, indi- medicine in understanding the nature of
cate stagnant blood retained in the super- disease and guiding clinical practice.
ficial portion of the body. The tongue Although diseases may be very com-
may be deep purple in colour or show plicated and varied, they can be general-
purple spots. ized and understood in terms of patho-
d) There may be fixed purplish masses logical processes in the following three
accompanied by pain. ways: disharmony of yin and yang, con-
flict between anti pathogenic qi and path-
ogenic qi, and abnormal descending and
II. PATHOGENESIS ascending of qi. These three aspects of
the development of disease are closely
The onset of disease can be general- interconnected.
ized as being due to disharmony of yin
and yang and conflict between xie (path- 1. Disharmony of Yin and Yang
ogenic) qi and zheng (antipathogenic) qi.
Antipathogenic qi, known as zheng qi, Disharmony of yin and yang refers to
refers to the functional activities of the pathological changes involving either ex-
human body as well as to its ability to cess or deficiency of yin or yang, occur-
resist disease. Pathogenic qi, known as xie ring when the body is invaded by patho-
qi, refers to all the various causative fac- genic qi. Disease will not occur unless the
tors of disease. For disease to occur, there body is invaded by pathogenic factors
must be present both a relative weakness which cause derangement of yin and yang
CHAPTER 11 AETIOLOGY AND PATHOGENESIS 263

in the interior. Yin-yang disharmony, i.e. and any pathogenic factors. This struggle
excess or deficiency of either yin or yang, has significance not only in relation to
is mainly manifested in the form of cold the onset of disease, but also to its pro-
and heat, and excess and deficiency syn- gression and transformations. To some
dromes. In general, heat syndromes of extent· this struggle can be described as
excess type will occur in cases of excess the main focus for the onset, progression
of yang, and cold syndromes of excess and transfomation of disease. Invasion of
type in cases of excess of yin. Cold syn- pathogenic qi results in conflict between
dromes of deficiency type will occur in the anti pathogenic qi and the pathogenic
cases of deficiency of yang, and heat syn- qi which destroys the yin-yang harmony
dromes of deficiency type in cases of of the body and causes functional dis-
deficiency of yin. In addition, in the turbance of the zang-fu organs and me-
course of the progression of disease, cold ridians, derangement of qi and blood and
syndromes may manifest some false heat abnormal ascending and descending of
symptoms, in which excess of yin walls qi, leading to various pathological
off yang, and heat syndromes some false changes. These mainly manifest as excess
cold symptoms in which excess of yang or deficiency syndromes. Syndromes of
walls off yin. excess type are likely to occur if there is
All the contradictions and changes oc- both hyperactivity of pathogenic qi and
curring in the disease process can be gen- sufficiency of antipathogenic qi. Syn-
eralized in terms of yin and yang. Th us dromes of deficiency type, or syndromes
all the zang-fu organs and meridians are of deficiency mixed with excess, are likely
classified in terms of yin and yang; and to occur if there is excess of pathogenic
qi and xue (blood), ying (nutrient) qi and qi and deficiency of antipathogenic qi.
wei (defensive) qi, exterior and interior. The twenty-eight chapter of Plain Ques-
ascending and descending of qi reflect tions states: "Hyperactivity of pathogenic
yin and yang contradictions. Functional qi causes syndromes of excess type and
disturbance, derangement between qi and consumption of essential qi will lead to
blood and between nutrient and defensive syndromes of deficiency type." Excess
qi all belong to disharmony of yin and here mainly refers to hyperactivity of
yang, which underlies the whole disease pathogenic qi, i.e. the pathological reac-
process and is the decisive factor in the tion dominated by excess of pathogenic
occurrence and development of disease. qi. It is commonly seen in the early and
middle stages of diseases due to invasion
2. Conflict Between Antipathogenic Qi of the exogenous pathogenic factors, and
diseases caused by retention of phlegm
and Pathogenic Qi
fluid, stagnant blood and water damp
The conflict between anti pathogenic as well as retention of food. Deficiency
qi and pathogenic qi refers to the struggle mainly refers to insufficiency of anti-
between the body's powers of resistance pathogenic qi which is the pathological
264 CHINESE ACl'PUNCTURE AND MOXIBUSTION

reaction dominated by decline of anti- matic breathing, and a suffocating sensa-

pathogenic qi. It is commonly seen in tion in the chest caused by failure of lung
diseases resulting from prolonged weak- qi to descend and disperse; belching and
ness of body constitution, poor function nausea caused by abnormal ascent of
of the zang-fu organs, and deficiency of stomach qi; loose stools and diarrhoea
qi, blood and body fluid due to a linger- caused by dysfunction of the spleen in
ing disease. transportation and transformation and
failure of its normal ascending function;
3. Abnormal Ascending or insomnia and palpitation caused by dis-
Descending of Qi harmony between heart and kidney; and
syncope due to derangement of qi, blood,
Ascending, descending, outward and yin and yang. Other examples are inabil-
inward movements are the basic forms of ity of the kidney to receive qi, upward
the transmission of qi in its circulation floating of yang, failure of clear yang to
through the body. Abnormal ascending ascend, and sinking of the qi of the mid-
and descending refer to pathological dle energizer. All of these can be gener-
states of the zang-fu organs, meridians, alized as pathological changes caused by
yin and yang, qi and blood in which they abnormal ascending and descending
fail to maintain their normal state of of qi.
governing ascent and descent of qi. Whilst all the zang-fu organs are in-
The functional activities of the zang- volved in the ascending and descending
fu organs and meridians, and the rela- of qi, the spleen and stomach qi plays an
tionships between the zang-fu organs, especially important role. This is because
meridians, qi, blood, yin and yang are spleen and stomach provide the material
maintained by the ascending, descending, basis for the acquired constitution. The
outward and inward movements of qi spleen and stomach lie in middle energiz-
circulation. Examples of this are the des- er which connects with the other zang-fu
cending and dispersing function of lung organs in the upper and lower energizers,
qi; the spleen's function of sending up and form the pivot of the mechanism
clear essence of food to the lung; the for ascending and descending of qi. The
stomach's function of sending down par- physiological functions of the human
tially digested food; the harmony be- body can be maintained only when both
tween the heart and kidney and between the ascending function of spleen qi and
fire (heart) and water (kidney). Abnor- the descending function of stomach qi
mal ascending or descending of q i may are normal. Harmonious functioning of
affect the five zang and six fu organs, the the spleen and stomach is therefore es-
interior and the exterior of the body, the sential to the ascending, descending, out-
four limbs and the nine orifices, leading ward and inward movements of the qi of
to a variety of pathological changes. the whole body. Neither aspect exists
Common examples include cough, asth- in isolation, however, the ascending of
CHAPTER 11 AETIOLOGY AND PATHOGENESIS 265

spleen qi and descending of stomach qi such as turbid phlegm will not be dis-
must cooperate with the ascending and pelled from the body. Numerous diseasf'
descending movement of the qi of the will result. An understanding of the in-
other zang-fu organs. If the ascending fluence of the ascending and descending
and descending functions of spleen and functions of spleen and stomach on the
stomach fail, the clear yang will not be physiological activities of the whole body
disseminated, acquired essence cannot be is therefore essential in clinical practice
stored, the clean qi in the atmosphere and when regulating the functions of these
food cannot be received, and substances two organs.
 Chapter 12
DIAGNOSTIC METHODS
There are four diagnostic methods, plying the four diagnostic methods, the
namely, inspection, auscultation and ol- doctor, therefore, can determine the
faction, inquiring and palpation. causative factors and nature of the di-
Inspection refers to the process in sease, thus providing basis for further
which the doctor observes with his eyes differentiation and treatment.
the systemic and regional changes in the Inspection, auscultation and olfac-
patient's vitality, colour and appearance. tion, inquiring and palpation are the
Auscultation and olfaction determine the four approaches to understand the path-
pathological changes by listening and ological conditions. They can not be
smelling. Inquiring means to ask the pa- separated, but relate to and supplement
tient or the patient's companion about one another. In the clinical situation,
the onset and progression of the disease, only by combining the four can a com-
present symptoms and signs, and other prehensive and systematic understand-
conditions related to the disease. Palpa- ing of the condition of the disease be
tion is a method of diagnosis in which the gained and a correct diagnosis made.
pathological condition is detected by feel- Any inclination to one aspect while neg-
ing the pulse and palpating the skin, epi- lecting the other three is one-sided,
gastrium, abdomen, hand, foot and other therefore, is not suggested.
parts of the body.
As human body is an organic entity,
its regional pathological changes may I. INSPECTION
affect the whole body, and the patholog-
ical changes of the internal organs may Inspection is a method of diagnosis in
manifest themselves on the body sur- which the doctor understands and pre-
face. The Medical Book by Master of dicts the pathological changes of internal
Danxi says: "One should observe and organs by observing abnormal changes in
analyse the external manifestations of the patient's vitality, colour, appearance,
the patient in order to know what is secretions and excretions. In their long-
happening inside the body. for the di- term medical practice, the Chinese phy-
sease of internal organs must have its sicians realized the close relationship
manifestations on the body surface." By between the external part of the body,
making analysis and synthesis of the especially the face and tongue, and the
pathological conditions formed by ap- zang-fu organs. Any slight changes ap-
266
CHAPTER 12 DIAGNOSTIC METHODS 267

pearing in these areas can tell pathologi- colour is considered normal.

cal conditions in various parts of the The colour and lustre of the face are
body. Inspection of the exterior of the the outward manifestations of the rela-
body, therefore, is of much help in diag- tive strength of qi and blood of the zang-
nosis. fu organs. Their changes often suggest
various pathological conditions. Observa-
1. Observation of the Vitality tion of these changes is valuable for diag-
nosing disease.
Vitality is the general manifestation of Here are the descriptions of the indi-
the vital activities of the human body, cations of the five discolorations.
and the outward sign of relative strength A red colour often indicates heat syn-
or qi and blood of the zang-fu organs, dromes, which may be of deficiency type
which take essential qi as the basis. By or of excess type. When the entire face is
observing vitality, one may get a rough red, it is a sign of a heat syndrome of
idea of the strength of the anti pathogenic excess type resulting from either expo-
qi of the human body and severity of the sure to exogenous pathogenic factors
disease; this is highly significant for the with the symptom of fever, or hyperactiv-
prognosIs. ity of yang of zang-fu organs. The pres-
If the patient is fully conscious and in ence of malar flush accompanied by tidal
fairly good spirits, responds keenly with fever and night sweating suggests an in-
a sparkle in the eyes, the patient is vigo- terior heat syndrome due to yin defi-
rous and the disease is mild. If the patient cIency.
is spiritless with dull eyes and sluggish A pale colour indicates cold syn-
response or even mental disturbance, the dromes of deficiency type and loss of
patient lacks vigour and the disease is blood. A pale complexion is often due to
severe. yin excess or yang deficiency. A bright
white face with a puffy, bloated appear-
2. Observation of the Colour ance is a sign of deficiency of yang qi.
If the pale face is withered, it signifies
Both the colour and lustre of the face blood deficiency.
are observed. There are five discolora- A yellow colour indicates syndromes
tions, namely, blue, yellow, red, pale and of deficiency type and damp syndromes.
dark grey. Observation of the lustre of When the entire body, including the face,
the face is to distinguish whether the eyes and skin, is yellow, it is jaundice. If
complexion is bright and moist or dark the yellowness tends toward bright or-
and haggard. ange, it is called yang jaundice resulting
People of different races have differ- from damp heat. If the yellow is smoky
ent skin colours, and there is wide var- dark, it is called yin jaundice resulting
iation among people of the same race. from either cold damp or long-term stag-
However, a lustrous skin with natural nation of blood. A pale yellow complex-
268 CHINESE ACUPUNCTURE AND MOXIBUSTION
c~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~~~~~~~_ _ _ _ _~~~~~

ion without brightness is a sign of defi- 3. Observation of the Appearance

ciency of both qi and blood.
A blue colour indicates cold syn- Appearance refers to the body shape
dromes, painful syndromes, stagnation of which can be described as strong, weak,
blood and convulsion. A pale complexion heavy or skinny; and to the movement
with a blue tinge is seen is a syndrome of and posture related to disease.
excessive yin and cold with the symptom Overweight with mental depression
of severe pain in the epigastrium and mostly suggests deficiency of qi and ex-
cess of phlegm damp. A thin person with
abdomen. Blue purplish face and lips
dry skin indicates insufficiency of blood.
with the intermittent pain in the precor-
Great loss of weight in the course of a
dial region or behind the sternum are due
long illness indicates the exhaustion of
to stagnation of the heart blood. Blue
the essential qi.
purplish face and lips accompanied by
The patient's movement and posture
high fever and violent movement of the
are outward manifestations of the patho-
limbs in children are signs of infantile
logical changes. There is a variation of
convulsion.
movement and posture in different di-
A dark grey colour indicates deficien-
seases. But on the whole, and active pa-
cy of the kidney and stagnation of blood.
tient is usually manifesting a yang syn-
A pale and dark complexion accompan-
drome, whilst a passive manner is usual-
ied with lumbar soreness and cold feet ly yin. For instance, a patient suffering
suggests insufficiency of the kidney yang. from the lung syndrome of excess type
A dark complexion without brightness, with excessive phlegm is likely to sit there
accompanied by scaly skin signifies pro- with the extended neck, whilst a pa-
longed stagnation of blood. tient with deficiency of qi manifesting as
Generally speaking, a lustrous and shortness of breath and dislike of speak-
moist complexion indicates that the di- ing tends to sit there facing downward.
sease is mild, qi and blood are not defi- Violent movement of the four limbs is
cient, and the prognosis is good; whilst a mostly present in wind diseases such as
dark and haggard complexion suggests tetanus, acute and chronic infantile con-
that the disease is severe, essential qi vulsion. The occurrence of weakness, mo-
is already injured, and the prognosis is tor impairment and muscular atrophy of
poor. the limbs suggests wei syndromes. The
As to the clinical significance of the presence of pain, soreness, heaviness and
colour of secretions and excretions, such numbness in the tendons, bones and mus-
as nasal discharge, sputum, urine and cles accompanied by swelling and res-
vaginal discharge, those clear and white tricted movement of the joints points to
in colour generally denote deficiency and hi syndromes. The appearance of numb-
cold, while those turbid and yellow In ness and impaired movement of the limbs
colour indicate excess and heat. on one side of the body indicates hemi-
CHAPTER 12 DIAGNOSTIC METHODS 269

plegia or wind stroke. it to nourish upwards. Purulent dis-

charge in the ear, known as "Tin Er"
4. Observation of the Five (suppurative infection of the ear), is
Sense Organs mostly caused by damp heat of the liver
and gallbladder.
1) Observation of the eye The liver 4) Observation of the gums Pale
opens into the eye, and the essential qi of gums indicate deficiency of blood. Red-
the five zang and six fu organs all goes ness and swelling of the gums are due to
up into the eye. Therefore, abnormal flaring up of the stomach fire. If redness
changes in the eye are not only associa ted and swelling of the gums are accompan-
with the liver, but also reflect the patho- ied by bleeding, it is due to injury of the
logical changes of other zang-fu organs. vessels by the stomach fire.
Apart from the expression of the eye, 5) Observation of the lips and mouth
attention should also be paid to the ap- This is to observe the changes of the lips
pearance, colour and movement of the
and mouth in colour, moisture and ap-
eye. For instance, redness and swelling of
pearance. Pale lips denote deficiency of
the eye are often due to wind heat or liver
blood. Blue purplish lips suggest either
fire. YelJow sclera suggests jaundice. Ul-
retention of cold or stagnation of blood.
ceration of the canthus denotes damp
Dry lips, deep red in colour, indicate
heat. Upward, straight forward or side-
excessive heat. Sudden collapse with open
ways staring of the eye is mostly caused
mouth is deficiency, whilst sudden col-
by disturbance of liver wind.
lapse with lock jaw is excess.
2) Observation of the nose This is to
6) Observation of the throat The fo-
observe the appearance and discharge of
the nose. The flapping of the ala nasi is cus is on abnormal changes of the throat
often present in asthmatic breathing due in colour and appearance. Redness and
to either heat in the lung or deficiency of swelling of the throat with soreness den-
qi of both the lung and kidney. Clear ote accumulation of heat in the lung and
nasal discharge is due to exposure to stomach. Redness and swelling of the
wind cold, whilst turbid nasal discharge throat with yellow or white ulcer spots
to wind heat. Prolonged turbid nasal are due to excessive toxic heat in the lung
discharge with stinki ng smell suggests and stomach. A bright red throat with
chronic rhinitis or chronic sinusitis. a mild soreness suggests yin deficiency
3) Observation of the ear Due atten- leading to hyperactivity of fire. If there
tion is paid to the colour of the ear and occurs a false membrane over the throat,
conditions of the internal ear. Dry and which is greyish white in colour, hard to
withered auricles, burnt black in colour, remove, bleeds foHowing forceful rub-
present in the patient with a prolonged bing and reg rows immediately, it indi-
or severe illness, are due to consump- cates diphtheria resulting from heat in
tion of the kidney essence not allowing the lung consuming yin.
270 _______________________________________~C~H~IN~'E~SE~AC~U~Pl~JN~'C~.T~UR~E~.~AN~D~M~O~XI~BL~lS~TI~O~N

5. Observation of the Tongue tongue proper refers to the muscular tis-

sue of the tongue, which is also known as
Observation of the tongue, also known the tongue body. The tongue coating re-
as tongue diagnosis, is an important pro- fers to a layer of "moss" over the tongue
cedure in diagnosis by inspection. It pro- surface, which is produced by the stom-
vides primary information for the
ach qi.
Chinese physicians to make diagnosis. A normal tongue is of proper size, soft
1) Physiology of the tongue The
in quality, free in motion, slightly red in
tongue directly or indirectly connects
colour and with a thin layer of white
with many zang-fu organs through the
coating which is neither dry nor over
meridians and collaterals. The deep
moist.
branch of Heart Meridian of Hand-
The tongue is divided into four areas ,
Shaoyin goes to the root of the tongue;
the Spleen Meridian of Foot-Taiyin trav- namely, tip, central part, root and border.
erses the root of the tongue and spreads The tip of the tongue often reveals the
over its lower surface; the Kidney Merid- pathological changes of the heart and
ian of Foot-Shaoyin terminates at the lung; its border reveals those of the liver
root of the tongue. So the essential qi of and gallbladder; its central part reveals
the zang-fu organs can go upward to those of the spleen and stomach; and its
nourish the tongue, and pathological root reveals those of the kidney. This
changes of the zang-fu organs can be method of diagnosing the pathological
reflected by changes in tongue con- changes of the zang-fu organs by dividing
ditions. This is why the observation of the tongue into corresponding areas is
the tongue can determine the pathologi- clinically significant (Fig. 134).
cal changes of the internal organs. 2) Tongue diagnosis
Observation of the tongue includes a) Tongue proper This is to observe
the tongue proper and its coating. The the colour and form of the tongue pro-

_ Kidney

- - - spleen and Stomach

Liver and Gallbladder "':: _ Heart and Lung

Fig. 134
 CHAPTER 12 DIAGNOSTIC METHODS 271

per. the heart and spleen. If a swollen tongue

i) Colour of the tongue proper is blue purplish and dark, it indicates
Pale tongue: A pale tongue is less red toxicosis.
than a normal tongue, and indicates syn- Thin tongue: A thin tongue is smaller
dromes of deficiency type and cold syn- and thinner than normal. A thin and pale
dromes caused by deficiency of yang qi or tongue indicates deficiency of qi and
insufficiency of qi and blood. blood. A thin, dry and deep red tongue
Red tongue: A red tongue is bright red indicates hyperactivity of fire due to de-
and redder than a normal tongue. It indi- ficiency of yin in which body fluid is
cates various heat syndromes including consumed.
interior heat syndromes of excess type Cracked tongue: Irregular streaks or
and interior heat syndromes of deficiency cracks on the tongue indicate excessive
type due to yin deficiency. heat consuming body fluid if the tongue
Deep red tongue: A deep red tongue is deep red in colour, and indicate defi-
indicates an extreme heat condition. In ciency of blood if the tongue is pale. A
exogenous febrile diseases, it indicates in- cracked tongue may be present in a nor-
vasion of the ying and xue (blood) sys- mal person. If so, the cracks are not deep,
tems by pathogenic heat. In endogenous and remain there all the time unchanged.
diseases, it indicates yin deficiency lead- This is considered normal.
ing to hyperactivity of fire. Thorny tongue: The papillary buds
Purple tongue: A blue purple tongue over the surface of the tongue swell up
indicates stagnation of blood which is like thorns. A thorny and red tongue
related to either cold or heat. A deep blue indicates accumulation of pathogenic
purplish tongue, dry and lustreless, is heat in the interior. The more severe the
related to heat, whilst a pale purplish and pathogenic heat is, the more enlarged and
moist tongue is related to cold. The pres- profuse the thorns will be.
ence of purplish spots on the tongue sur- Deviated tongue: A deviated tongue
face also indicates stagnation of blood. indicates windstroke or early threatening
ii) Form of the tongue proper signs of windstroke.
Swollen tongue: A swollen tongue is Rigid tongue: A rigid tongue lacks
larger than normal. If a swollen tongue is flexibility and is difficult to protrude,
delicate in quality and pale in colour, and retract or roll. A rigid tongue seen in
with tooth prints on the border, it indi- exogenous febrile diseases often indicates
cates yang deficiency of the spleen and invasion of the pericardium by heat, re-
kidney. The condition is due to im- tention of turbid phlegm in the interior,
paired circulation of body fluid produc- or excessive pathogenic heat consuming
ing harmful water, retained fluid, phlegm body fluid. A rigid tongue present in
and damp. If a swollen tongue is deep red endogenous diseases indicates windstroke
in colour occupying the entire space of or early threatening signs of windstroke.
the mouth, it indicates excessive heat in Flaccid tongue: A flaccid tongue is

-- ---~~--~--
---------- -~---~--- - - - -
272 CHINESE ACUPUNCTURE AND MOXIBUSTION

weak in motion, and often indicates ex- semination of the body fluid. A dry
treme deficiency of qi and blood or tongue coating, which looks coarse and
consumption of yin fluid depriving the feels lacking moisture indicates consump-
tongue of the nourishment. If a flaccid tion of body fluid due to excessive heat
tongue is pale, it indicates deficiency of or consumption of yin fluid not allowing
qi and blood. If it is deep red, it indicates it to nourish upwards. If there is exces-
collapse of yin. sive moisture over the tongue surface,
b) Tongue coating: and the saliva dribbles when the tongue
i) Quality of the tongue coating is stuck out in a severe case, it is a slip-
Thick coating and thin coating: The pery tongue coating. The condition is
tongue coating is considered thin if the caused by upward flooding of harmful
tongue proper can indistinctly be seen water and cold damp.
through it, and considered thick if the Sticky coating and granular coating:
tongue proper can not be seen through it. Both sticky and granular tongue coating
One can understand the severity of the help deduce the turbid damp in the intes-
pathogenic factors and progression of the tines and stomach. It is a sticky coating if
pathological conditions by distinguishing the tongue is covered by a turbid layer of
the thickness and thinness of the tongue fine greasy substance which is hard to be
coating. Generally speaking, a thin scrubbed. A sticky tongue coating is of-
tongue coating is present if the superfi- ten seen in syndromes resulting from re-
cial portion of the body is affected in a tention of turbid damp and phlegm or
disease, or if the disease is due to defi- retention of food. It will be a granular
ciency of the antipathogenic qi. Reten- coating if the granules on the tongue
tion of damp, phlegm or food in the surface are coarse, loose and thick like
interior, or inward transmission of the residue of making soy bean curds, and
pathogenic factor from the exterior may easily scrubbed. A granular tongue coat-
produce a thick tongue coating. Thicken- ing often results from excessive yang heat
ing coating indicates inward transmission bringing the turbid qi in the stomach
of the pathogenic factor from the exter- upwards. It is also seen in syndromes
ior, and is a sign of aggravation of the caused by retention of turbid phlegm or
disease. Thinning coating points to grad- retention of food.
ual elimination of the pathogenic factor, Peeled coating: The tongue with a
and is a sign of alleviation of the patho- part of its coating peeling off is known as
logical conditions. "geographic tongue." It is a sign of con-
Moist coating and dry coating: One sumption of qi and yin of the stomach. If
can understand the condition of the body the entire coating peels off leaving the
fluid by distinguishing the moisture and surface mirror smooth, the condition is
dryness of the tongue coating. A normal known as glossy tongue. It is a sign of
tongue coating is moist and lustrous, exhaustion of the stomach yin and severe
which is the manifestation of normal dis- damage of the stomach qi.
CHAPTER 12 DIAGNOSTIC METHODS 273

ii) Colour of the tongue coating ciency.

White coating: A thin and white coat- 3) Precautions in tongue diagnosis
ing is normal. Yet a white coating may a) As each disease undergoes a com-
appear in an illness. If so, it indicates plicated process, the conditions of the
exterior syndromes and cold syndromes. tongue proper and its coating are the
A thin and white coating is present in manifestations of interior complicated
exterior cold syndromes, whilst a thick pathological changes. The conditions of
and white coating is seen is interior cold the tongue proper mainly reflect deficien-
syndromes. cy or excess of the zang-fu organs and
Yellow coating: A yellow coating indi- relative strength of the essential qi. The
cates interior syndromes and heat syn- conditions of the tongue coating reflects
dromes. The deeper yellow the coating is, the depth and nature of the invading
the more severe pathogenic heat it indi- pathogenic factors. A comprehensive an-
cates. A light yellow coating points to alysis of the conditions of both the
mild heat; a deep yellow coating to severe tongue proper and its coating is required
heat; a burnt yellow coating to accumu- on the basis of their respective indica-
lation of heat. tions. The condition of the tongue proper
Grey coating: A grey coating indicates and that of its coating are generally con-
interior syndromes, and may be seen in formable; the disease to be indicated is
interior heat syndromes or syndromes re- often the outcome of combining the two.
sulting from cold and damp. If a grey For instance, retention of heat of excess
coating is yellowish and dry, it signifies type in the interior produces a red tongue
consumption of body fluid due to exces- with a dry and yellow coating; a pale
sive heat. If a grey coating is whitish and tongue with a moist and white coating is
moist, it implies retention of cold damp often present in cold syndromes of defi-
in the interior or retention of phlegm and ciency type. But such situations as the
fluid. As a grey coating often develops condition of the tongue proper does not
into a black coating, a greyish black coat- agree with the condition of its coating
ing is seen. may occur. Only by a comprehensive a-
Black coating: A black coating indi- nalysis can reliable information be prov-
cates interior syndromes due to extreme ided for furthur differentiation of syn-
heat or excessive cold. A black coating is dromes.
often the outcome of the further develop- b) It is desirable to observe the tongue
ment of a yellow coating or a grey coat- in direct natural light. The patient is re-
ing. It is present at the severe stage of an quired to protrude the tongue naturally.
illness. If a black coating is yellowish and c) Some food and drugs may colour
dry, possibly with thorns, it signifies con- the tongue coating, and the thickness
sumption of body fluid due to extreme and moisture of the tongue coating
heat. A pale black and slippery coating may change after eating or scraping the
implies excessive cold due to yang defi- tongue. Attention should be paid to the
27'1_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _(_:H_IN:-E~SE~A_Cl=_TP_UN_C_T_U_RE_AN_D_M=_O_Xc---"lB~US=_'T.::...:IO~N

exclusion of false phenomena induced by pertaining to asthma of deficient type.

such factors in the clinical situation. Coarse asthmatic breathing in loud tones
with the preference for exhalation sug-
gests retention of pathogenic factor in
II. AUSCULTATION AND the lung impairing the functions of qi.
OLFACTION This belongs to asthma of excess type.
c) Listening to the cough Cough is the
Auscultation and olfaction refer to lis- manifestation of dysfunction of the lung
tening and smelling. in dispersing and descending leading to
upward perversion of qi. Cough in a
coarse voice indicates a syndrome of ex-
1. Listening
cess type, cough in a feeble voice suggests
a) Listening to the speech In general, a syndrome of deficiency type. Unprod-
speaking lustily indicates syndromes of uctive cough or cough with a small
excess type, while speaking feebly and in amount of thick sputum implies injury of
low tones indicates those of deficiency the lung by pathogenic dryness or dry-
type. A hoarse voice or loss of voice in a ness of the lung due to yin deficiency.
severe case may be of deficiency type or
of excess type. If they are present in 2. Smelling
exogenous diseases with a sudden onset, Stench smell of a secretion or excre-
they are of excess type. Chronic or recur- tion usually indicates heat syndromes of
rent onset in endogenous diseases are of excess type; less stinking smell suggests
deficiency type. cold syndromes of deficiency type; foul
Incoherent speech in loud voice ac- and sour smell implies retention of food.
companied by impaired consciousness in- Different odours should be identified in
dicates a syndrome of excess type due to order to deduce the nature of the disease.
disturbance of the mind by heat. Repeat- The source of the odour should also be
ed s.peech in feeble voice accompanied by traced for determining the locality of the
listlessness suggests a syndrome of defi- disease.
ciency type of the heart resulting from
severe damage of the heart qi.
b) Listening to the respiration Fee- III. INQUIRING
ble breathing indicates deficiency of qi.
Forceful and coarse breathing accompan- Inquiring is asking the patient or the
ied by a loud voice suggests a syndrome patient's companion about the disease
of excess type due to excessive pathogenic condition in order to understand the
heat in the interior. pathological process.
Feeble asthmatic breathing accompan- Inquiries are made systematically with
ied by shortness of breath indicates defi- questions focused on the chief complaint
ciency of the qi of the lung and kidney, of the patient according to the knowledge

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CHAPTER 12 DIAGNOSTIC METHODS 275

necessary in differentiating a syndrome. drium.

Inquiring covers a wide range of top- High fever following chills occurring
ics. Here is a brief introduction to inquir- at a definite time of the day suggests
ing about the present illness. malaria.
3) Fever without chills Fever may oc-
1. Chills and Fever cur without chills. Persistent high fever
with aversion to heat instead of cold sug-
Apart from confirming the presence gests interior heat syndromes of excess
of chills and fever, we need to ask such type due to transmission of the pathogen-
questions as which is more severe, when ic factors from the exterior to the interior
they occur and what symptoms and signs with excessive heat in the interior. The
accompany them, for this information is accompanying symptoms and signs are
necessary for further differentiation of profuse sweating, severe thirst and a
syndromes; surging pulse. If fever occurs or becomes
1) Chills accompanied by fever Si- worse at a fixed hour of the day just like
multaneous occurrence of chills and fev- the sea waves, it is known as tidal fever.
er at the beginning of the disease indi- Tidal fever in the afternoon or evening,
cates exogenous exterior syndrome. It is accompanied by night sweating and a red
the manifestation of invasion of the body tongue with little moisture indicates defi-
surface by the pathogenic factor and its ciency of yin; afternoon fever with con-
contending with the anti pathogenic qi. stipation and fullness and pain in the
Exterior syndromes resulting from ex- abdomen suggests excess heat of the
posure to pathogenic wind cold usually Yangming Meridians.
manifest as severe chills and mild fever 4) Chills without fever The subjec-
with the accompanying symptoms and tive feeling of chills without fever indi-
signs such as absence of sweating, head- cates interior cold syndrome of deficien-
ache and general aching, and a superficial cy type. The patient may also have chilled
and tense pUlse. Exterior syndromes due appearance, cold limbs and a deep, slow
to invasion by pathogenic wind heat are and weak pulse.
characterized by mild chills and severe
fever; the patient also reveals thirst, 2. Perspiration
sweating and a superficial and rapid
pUlse. The patient should, first of all, be
2) Alternate chills and fever The pa- asked whether sweating is present or not.
tient may notice alternate attacks of Further inquiring deals with the feature
chills and fever. This is the representative of sweating and its accompanying symp-
symptom of intermediate syndromes. The toms and signs.
patient may also complain of a bitter Absence of sweating in exterior syn-
taste in the mouth, thirst and fullness dromes indicates invasion by pathogen-
and stuffiness in the chest and hypochon- ic cold; presence of sweating in exte-
276 CHINESE ACUPUNCTURE AND MOXIBUSTION
--------------------------------
rior syndromes suggests either exterior abdomen and a thick sticky tongue coat-
syndromes of deficiency type resulting ing suggests stagnation of qi of the spleen
from exposure to pathogenic wind, or and stomach caused by retention of food
exterior heat syndromes due to in- or retention of pathogenic damp.
vasion by pathogenic wind heat. The Excessive appetite and getting hungry
accompanying symptoms and signs are easily in a skinny patient indicate exces-
considered in differentiation. sive stomach fire.
Sweating that occurs during sleep and Hunger with no desire to eat or eating
stops upon wakening is known as night a small amount of food suggests impair-
sweating. It usually indicates deficiency ment of the stomach yin producing inter-
of yin with hyperactivity of yang heat. nal heat of deficiency type.
The patient may also present tidal fever Lack of thirst during an illness sug-
and a red tongue with little coating. gests that body fluid is not consumed.
Frequent sweating which is worse on It is present in cold syndromes or syn-
slight exertion is known as spontaneous dromes in which pathogenic heat is not
sweating. It is a sign of deficiency of qi noticeable. The presence of thirst indi-
and deficiency of yang. The patient may cates consumption of body fluid or reten-
also exhibit chills, listlessness and lassi- tion of phlegm damp in the interior
tude. preventing body fluid from ascending.
Profuse sweating accompanied by Further analysis is based on features of
high fever, mental restlessness, thirst thirst, amount of drinks to be taken and
with preference for cold drinks and a the accompanying symptoms and signs.
surging pulse indicates interior heat syn- A bitter taste in the mouth usually
dromes of excess type resulting from ex- indicates hyperactivity of the fire of the
cessive yang heat in the interior expelling liver and gallbladder. A sweetish taste
the sweat out. Profuse sweating accom- and stickiness in the mouth imply damp
panied by listlessness, feeble energy, cold heat in the spleen and stomach. Sour
limbs and a deep and thready pulse in a regurgitation means retention of heat
severe case is a critical sign indicating in the liver and stomach. Tastelessness
total exhaustion of yang qi. points to deficiency of the spleen with its
impaired function of transportation.
3. Appetite, Thirst and Taste
4. Defecation and Urination
Poor appetite present in the patient
with a prolonged illness manifesting as As the doctor does not observe the
emaciation, loose stools, lassitude and a change in defecation and urination of the
pale tongue with a thin white coating patient directly, it is necessary to make
indicates weakness of the spleen and inquiries.
stomach; poor appetite accompanied by Constipation due to dryness of stools
stuffiness in the chest, fullness in the usually indicates accumulation of heat or

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CHAPTER 12 DlAGNOSTIC METHODS 277

consumption of body fluid. Loose stools ture of the pain is significant for deduc-
suggest deficiency of the spleen or reten- ing its etiology and pathology, while iden-
tion of damp in the spleen. Watery stools tification of the locality of the pain helps
with undigested food imply deficiency of determine diseased zang-fu organs and
yang of the spleen and kidney. Bloody meridians.
stools with mucus and tenesmus result 1) Nature of the pain
from damp heat in the intestines and Distending pain: Distending pain
stagnation of qi in the intestinal tract. manifesting as severe distension, mild
Yellow urine generally indicates heat pain and moving from place to place is a
syndromes, while clear and profuse urine typical sign of qi stagnation. It often
indicates absence of the pathogenic heat occurs in the chest, epigastric, hypochon-
in an illness, or cold syndromes. Tur- driac and abdominal regions. But head-
bid urine suggests downward infusion ache with a distending sensation in the
of damp heat or downward leakage of head is due to upward disturbance by fire
turbid essence. Red urine implies injury and heat.
of the vessels by heat. Clear urine in- Pricking pain: Pricking pain, sharp in
creased in volume means infirmity of the nature and fixed in location, is a sign of
kidney qi and dysfunction of the bladder stagnation of blood. It usually occurs in
in controlling urine, while scanty yellow the chest, epigastric, hypochondriac and
urine with urgent and painful urination lower abdominal regions.
means downward infusion of damp heat Weighty pain: Pain with a heavy sen-
into the bladder. Dribbling urination or sation is a sign of damp blocking qi and
retention of urine in a severe case is blood, as damp is characterized by heav-
present not only in syndromes of defi- iness. It is often present in the head, four
ciency type due to exhaustion of the kid- limbs and lumbar region.
ney qi with its impaired function of con- Colicky pain: Colicky pain is a sign of
trolling urine, but also in syndromes of abrupt obstruction of the qi by substan-
excess type caused by obstructed qi activ- tial pathogenic factors.
ities of the bladder due to downward Pulling pain: Pulling pain which is
infusion of damp heat, stagnant blood or spasmodic in nature and short in dura-
stones. tion often relates to the disorders of the
liver. It is caused by liver wind.
5. Pain Burning pain: Pain with a burning
sensation and preference for coolness of-
Pain is one of the most common symp- ten occurs in the hypochondriac regions
toms complained of by the patient. Apart on both sides and epigastric region. It
from a thorough understanding of the results from invasion of the collaterals by
history and accompanying symptoms and pathogenic fire and heat or from exces-
signs, the nature and locality of pain sive yang heat due to yin deficiency.
must be asked. Differentiation of the na- Cold pain: Pain with a cold sensation

----_._._------------------
2~'8 CHINESE ACUPUNCTURE AND MOXIBUSTION

and preference for warmth often occurs may produce hypochondriac pain.
in the head, lumbar, epigastric and ab- Epigastric pain: Epigastrium (wan)
dominal regions. It is caused by patho- refers to the upper abdomen in which the
genic cold blocking the collaterals or lack stomach situates. It is divided into three
of warmth and nourishment in the zang- regions, namely, Shangwan, Zhongwan
fu organs and meridians due to deficien- and Xiawan (upper, middle and lower
cy of yang qi. wan respectively). Epigastric pain may
Dull pain: Dull pain is not severe. It result from invasion of the stomach by
is bearable lingering and may last for a pathogenic cold, retention of food in the
long period. It is usually present in cold stomach or invasion of the stomach by
syndromes of deficiency type. the liver qi.
Hollow pain: Pain with a hollow sen- Abdominal pain: Abdomen is divided
sation is caused by deficiency of blood into upper abdomen, lower abdomen and
leading to emptiness of vessels and retar- sides of the lower abdomen. The upper
dation of blood circulation. abdomen refers to the area above the
2) Locality of the pain umbilicus and pertains to the spleen. The
Headache: Head is the meeting place area below the umbilicus is the lower
of all the yang meridians and brain is the abdomen and pertains to the kidney,
sea of marrow. Qi and blood of the five bladder, large and small intestines and
zang and six fu organs all go up into the uterus. Both sides of the lower abdomen
head. If the pathogenic factors invade the is traversed by the Liver Meridian of
head and block the clear yang, or if stag- Foot-Jueyin. So according to the locality
nation of qi and blood in endogenous of the pain, the diseased zang-fu organs
diseases blocks the meridians and de- and meridians can be identified.
prives the brain of the nourishment, Abdominal pain caused by retention
headache will ensure. In cases of deficien- of cold, accumulation of heat, stagnation
cy of qi and blood, head fails to be nour- of qi, stagnation of blood, retention of
ished, and the sea of marrow becomes food or parasitic diseases is excess in
empty; headache due to this is of defi- nature, while that caused by deficiency of
ciency type. Headache due to disturbance qi, deficiency of blood or deficiency of
of the clear yang by the pathogenic factor cold is deficiency in nature.
is mostly of excess type. Lumbago: The kidney resides in the
Chest pain: As the heart and lung lumbar region. Lumbago may result from
reside in the chest, chest pain indicates obstruction of the meridians in the local
the pathological changes of the heart and area; besides, deficiency of the kidney
lung. failing to nourish the lumbar region is
Hypochondriac pain: The hypochon- often the cause.
driac region is traversed by the Liver Pain in the four limbs: Pain in the
and Gallbladder Meridians. Obstruction four limbs may involve joints, muscles or
or undernourishment of these meridians meridians. It is caused by retardation of

------------
CHAPTER 12 DIAGNOSTIC METHODS

qi and blood circulation due to invasion 1) Menses Inquiring in this aspect

of the exogenous pathogenic factors. covers menstrual cycle and period,
Besides, the duration of pain and amount, colour and quality of flow and
its response to pressure should also be the accompanying symptoms and signs.
asked. Generally, persistent pain in a re- If it is necessary, questions concerning
cent disease or pain which is aggravated the date of the last menstrual period and
by pressure indicates syndromes of excess age of menopause should be asked.
type. Intermittent pain in a prolonged Menses of a shortened cycle, excessive
illness or pain which is alleviated by pres- in amount, deep red in colour and thick
sure often occurs in syndromes of defi- in quality relates mainly to excessive heat
ciency type. in the blood; light coloured menstrual
flow profuse in amount and thin in qual-
6. Sleep ity indicates failure of qi to command
blood. A prolonged cycle with scanty pur-
Insomnia means either difficulty in plish dark discharge or blood clots sug-
falling asleep, or inability to sleep sound-
gests stagnation of blood due to cold;
ly, waking easily and being unable to fall
thin scanty and light-coloured flow im-
asleep again. Insomnia accompanied by
plies deficiency of blood. I rregular men-
dizziness and palpitations usually indi-
strual cycle is a sign of disharmony of the
cates failure of blood to nourish the heart
Flush and Conception vessels due to ob-
due to deficiency of both the heart and
struction of the liver qi.
spleen. Insomnia accompanied by rest-
Pre-menstrual or menstrual distending
lessness in mind and dream-disturbed
pain in the breasts and lower abdomen
sleep suggests hyperactivity of the fire of
which intensifies on pressure means stag-
the heart. Difficulty in falling asleep due
nation of qi and blood; cold pain in the
to an uncomfortable and empty sensation
lower abdomen during the period points
in the stomach or gastric discomfort after
to stagnation of blood due to cold; dull
a full meal implies derangement of the
pain in the lower abdomen during or
stomach qi leading to mental restlessness.
after the period which is alleviated by
If lethargy is accompanied by dizzi-
pressure is due to deficiency of qi and
ness, it indicates accumulation of phlegm
damp in the interior. A situation of being blood.
half asleep with general lassitude sug- 2) Leukorrhea Attention is paid to
gests deficiency of the yang of the heart the colour, amount, quality and smell of
and kidney. leukorrhea.
Watery leukorrhea whitish in colour
7. Menses and Leukorrhea and profuse in amount indicates deficien-
cy syndromes and cold syndromes; thick
Women patients are also asked about leukorrhea yellow or red in colour with
the menses and leukorrhea, and for mar- offensive smell suggests excess syn-
ried women the obstetric history. dromes and heat syndromes.

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280 CHINESE ACUPUNCTURE AND MOXIBUSTION
--------------------------------------------------------------------
IV. PALPATION wrist joint) is cun and that proximal to
guan is chi. There have been in different
Palpation is a method of diagnosis in ages various descriptions concerning the
which the pathological condition is de- relationship between these three regions
tected by palpating, feeling and pressing and their corresponding zang-fu organs.
certain areas of the body. It is discussed They are fundamentally conformable. It
under the headings of feeling the pulse is generally acknowledged that the three
and palpation of different parts of the regions of cun, guan and chi of the left
body. hand reflect respectively the conditions
of the heart, liver and kidney; and those
1. Feeling the Pulse of the right hand reflect the conditions of
the lung, spleen and kidney.
The location for feeling the pulse at In feeling the pulse, let the patient
the present time is above the wrist where take either sitting or supine position with
the radial artery throbs. It is divided into the arm placed approximately on a level
three regions: cun, guan and chi (Fig. with the heart, wrist extended and palm
135). The region opposite to the styloid facing upward. This position facilitates
process of the radius (the bony eminence smooth circulation of qi and blood. The
behind the palm) is known as guan, that doctor, by the side of the patient, first
distal to guan (i. e. between guan and the locates the guan region with the middle

Left hand

Right hand

Fig. 135
CHAPTER 12 DIAGNOSTIC METHODS 281

finger, then the cun and chi regions with Abnormal pulse readings and their
the index and ring fingers. The three clinical significance are as follows.
fingers are slightly flexed, presenting the 1) Superficial pulse (fu rnai) A super-
shape of an arch. The finger tips are ficial pulse can be easily felt with gentle
kept on the same horizontal level and touch. It indicates exterior syndromes,
the pulse is felt with the palmar side of and is present at the early stage of exog-
the fingers. The space between each two enous diseases. Invasion of the body sur-
fingers depends upon the height of the face by the exogenous pathogenic factor
patient. If the patient is tall and has long creates its contending with wei (defen-
arms, it is desirable to separate the fin- sive) qi. The pulsation is superficially
gers accordingly. If the patient is short situated, hence the superficial pulse. A
and has short arms, the three fingers are superficial pulse may also be present in
placed more closely. The method of "feel- prolonged endogenous diseases. In this
ing the pulse in the guan region with one case, the pulse is superficial, large and
finger" is adopted in infantile cases, for a weak, indicating outward floating of
body's pulse is not divided into these yang qi. This is a critical sign of the
three regions. disease.
The pulse is palpated by exerting three 2) Deep pulse (chen rnai) A deep
different finger forces, first lightly (su- pulse is felt only on heavy pressure. It
perficial palpation), then moderately indicates interior syndromes. If the pulse
(middle palpation) and finally heavily is deep and forceful, it indicates interior
(deep palpation). Generally the finger syndromes of excess type. When the path-
force of the same strength is exerted on ogenic factor invades the interior of the
the three regions at the same time and body, qi and blood circulation is blocked,
then feel the three regions separately ac- presenting a deep and forceful pulse. If
cording to the actual pathological condi- the pulse is deep and weak, it indicates
tions. interior syndromes of deficiency type.
The pulse is differentiated in terms of 3) Slow pulse (chi rnai) The rate is
depth (superficial or deep), speed (rap- slow, with less than four beats per breath
id or slow), strength (forceful or weak), (less than sixty beats per minute). A slow
shape (thick or thready, soft or hard) and pulse indicates cold syndromes. Oi con-
rhythm. Different conditions of the pulse tracts and blood flow stagnates on expo-
indicate different syndromes. sure to cold. The retarded circulation of
A normal pulse is smooth, even and qi and blood produces a slow pulse. If the
forceful with the frequency of four beats slow pulse is forceful, it indicates an in-
per breath. However, the pulse may vary terior syndrome of excess type caused by
due to age, sex, body constitution, emo- retention of yin cold in the interior. If the
tional state and climatic changes. Due slow pulse is weak, it indicates an interior
attention should be paid to distinguishing syndrome of deficiency type due to defi-
it from an abnormal pulse. ciency of yang qi.
28;_~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C_H_IN_'E_SE_AC_U_TP_UN_'C_T_UR_E_AN_'D_M_O_XI_B_US_T_IO_N

4) Rapid pulse (shu mai) The rate the momentum of roaring waves, it is
is quick, with more than five beats per called large pulse.
breath (more than ninety beats per min- A surging pulse indicates excessive
ute). A rapid pulse indicates heat syn- heat, and often occurs together with a
dromes. Induced by pathogenic heat, the rapid pulse. Excessive heat in the interior
blood circulation is accelerated, the result dilates the blood vessels and accelerates
being a rapid pulse. If excess heat is qi and blood circulation, thus producing
retained in the interior and the anti path- a surging pulse.
ogenic qi is still strong, their struggle will 8) Thready pulse (xi mai) A thready
induce a rapid and forceful pulse. Defi- pulse feels like a fine thread but is very
ciency of yin in a prolonged illness distinct and clear. It indicates deficiency
produces deficiency-heat in the interior, due to overstrain and stress or deficiency
presenting a rapid and weak pulse. A of qi and blood. It is often present in
rapid pulse may also be induced by out- patients with weak body constitution in a
ward floating of deficiency-yang. In this prolonged illness manifesting as yin defi-
case, the pulse feels rapid. large, weak ciency and blood deficiency. Deficiency
and empty. of yin and blood means the inability to
5) Pulse of deficiency type (xu mai) It fill the vessels. Qi is also deficient and
is the general term for all the forceless unable to activate the blood circulation,
pulses felt on the three regions and the hence the thready pulse.
three levels of pressure. 9) Rolling pulse (hua mai) A rolling
The pulse indicates syndromes of de- pulse feels smooth and flowing like pearls
ficiency type due to deficiency of qi and rolling on a dish. It indicates phlegm and
blood. Deficiency of qi and blood implies retained fluid, retention of food and ex-
weakness in activating blood circulation, cess heat. When excess type pathogenic
thus producing a pulse of deficiency type. factor is retained in the interior, the qi
6) Pulse of excess type (shi mail It is and blood circulation is activated, result-
the general term for all the forceful pul- ing in a smooth and flowing pulse. This
ses felt on the three regions at the three pulse often occurs in women during preg-
levels of pressure. nancy, indicating sufficient and harmo-
The pulse indicates syndromes of ex- nious qi and blood.
cess type. The struggle waged by the 10) Hesitant pulse (se mai) A hesi-
strong antipathogenic qi against the hy- tant pulse feels rough and uneven. It
peractive pathogenic factor brings on ex- indicates stagnation of qi, stagnation of
cessive qi and blood, thus creating a blood, impairment of essence and defi-
strong pulse of excess type. ciency of blood. Stagnation of qi and
7) Surging pulse (hong mail A surg- blood means blockage of vessels and im-
ing pulse is broad, large and forceful like paired circulation of blood. This condi-
roaring waves which come on powerfully tion produces a hesitant and forceful
and fade away. If a surging pulse lacks pulse. When the essence is impaired and
CHAPTER 12 DIAGNOSTIC METI_10_D_S_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _28--'-3

blood is insufficient, the vessels are not ious syndromes due to deficiency of both
filled and blood circulation is retarded. qi and blood.
This condition creates a hesitant and When blood is deficient, it fails to fill
weak pulse. the vessels: when qi is deficient, the pulse
11) String-taut pulse (xuan mai) A is deprived of strength. So the pulse feels
string-taut pulse feels taut, straight and deep, thready and forceless.
long, giving the feeling of a string of a 15) Abrupt pulse (cu mai) An abrupt
violin. It indicates disorders of the liver pulse feels hurried and rapid with irregu-
and gallbladder, painful syndromes, and lar missed beats. It indicates excessive
phlegm and retained fluid. yang heat, stagnation of qi and blood,
A string-taut pulse in disorders of the and retention of phlegm or food.
liver and gallbladder is due to disturb- Excessive yang heat means failure of
ance of the liver qi tightening the vessels; yin to restrain yang and thus producing
that in painful syndrome is due to tight- an abrupt pulse. If this pulse is present in
ness of the meridians and vessels; that in heat syndromes of excess type due to
retention of phlegm and fluid in the in- stagnation of qi and blood, retention of
terior is due to dysfunction of qi in trans- phlegm or food, or swelling and pain, it
portation. is abrupt and forceful. An abrupt and
12) Tense pulse (jin mai) A tense weak pulse is a sign of prostration.
pulse feels tight and forceful like a 16) Knotted pulse (jie mai) A knotted
stretched rope. It indicates cold, pain and pulse is slow with irregular missed beats.
retention of food. [t indicates excessive yin, accumulation
As cold is characterized by contrac- of qi, retention of cold phlegm and stag-
tion, the vessels contract on exposure to nant blood.
cold, thus producing a tense pulse. The Cold phlegm and stagnant blood block
pulse is also present in painful syn- the vessels, while excessive yin means
dromes, for painful syndromes are usual- failure of yang to arrive. Hence the knot-
ly caused by pathogenic cold. ted pulse.
13) Soft pulse (ru mai) A soft pulse 17) Regularly intermittent pulse (dai
is superficial and thready, and hits the mai) A regularly intermittent pulse is
fingers without strength. It indicates slow and weak with missed beats at regu-
damp disorders. lar intervals. It is associated with declin-
Pathogenic damp is characteristically ing zang qi; it also indicates wind syn-
viscous and stagnant, its invasion of the dromes, painful syndromes and disorders
vessels blocks qi and blood and gives rise due to emotional fear and fright, or trau-
to a superficial, thready and forceless matic contusions and sprains.
pulse. The declining of the qi of the zang
14) Weak pulse (ruo mai) A weak means insufficiency of qi and blood and
pulse is deep and thready, and hits the may create discontinuation of qi flowing
fingers without strength. It indicates var- in the vessels. Therefore the pulse is slow
284 CHINESE ACUPUNCTURE AND MOXIBUSTION
-------------------------------------------------------------------
and weak with regular missed beats at of deficiency type.
long intervals. The presence of a regular- 2) Palpation of the abdomen Ab-
ly intermittent pulse in wind syndromes, dominal pain which is alleviated by pres-
painful syndromes and disorders due to sure is associated with deficiency, while
emotional fear and fright or traumatic that aggravated by pressure is related to
contusions and sprains is due to disturb- excess. Abdominal distension and full-
ance of the heart qi leading to discontin- ness with tympanic note on percussion
uation of the qi flowing in the vessels. indicate stagnation of qi if the abdomen
As the process of a disease is complex, does not feel hard on pressure and the
the above described abnormal pulses do urination is normal. If the abdomen feels
not often appear in their pure form, the like a rubber bag containing water, and
combination of two pulses or more is dysurine is present, it suggests accumula-
often present. The condition of a number tion of fluid. Immovable hard masses in
of pulses present at the same time is the abdomen with pain at a definite site
called complicated pulse. The indication indicate stagnation of blood. Unfixed soft
of a complicated pulse is the combination masses or the intermittent feeling of an
of indications of each single pulse. For indefinite mass in the abdomen with un-
instance, a superficial pulse indicates ex- fixed painful areas indicate stagnation
terior syndromes, and a tense pulse indi- of qi.
cates cold syndromes, a superficial and 3) Palpation of acupuncture points
tense pulse, therefore, indicates exterior This method of palpation can be traced
cold syndromes. As a rapid pulse indi- back to the early medical book The Inter-
cates heat syndromes, a superficial and nal Classic. One of its parts Miraculous
rapid pulse indicates exterior heat syn- Pivot says: "In order to see if the Back-
dromes. Shu Point is located with accuracy, one
may press the region to see if the patient
2. Palpation of Different Parts feels sore or if the patient's original sore-
of the Body ness gets relieved, in which case, the
point has been located with accuracy."
Included is palpation of the epigas- The fifteenth chapter of the same book
trium, abdomen, hand, foot and acupunc- also states, "When the five zang organs
ture points. are diseased, the symptoms will manifest
1) Palpation of the epigastrium Epi- themselves in the conditions of the twelve
gastrium refers to the upper abdomen, is Yuan-Primary Points with which they are
also known as "below the heart." If this connected. If we fully grasp the connec-
area feels hard and pain is aggravated on tions between the zang organs and their
pressure, it indicates syndromes of excess corresponding Yuan-Primary Points as
type; when there is fullness in this area well as the latter's external manifesta-
with a painless reaction to pressure, and tions, there will be no difficulty for us to
the area feels soft, it indicates syndromes understand the nature of the diseases of
CHAPTER 12 DIAGNOSTIC METHODS 285

the five zang organs." cur at Weishu (BL 21) and Zusanli (ST
Clinical practice in the recent years 36); in disorders of the liver there may be
has demonstrated that during an illness tenderness at Ganshu (BL 18) and Qimen
tenderness or sensative reactions may oc- (LR 14): while in appendicitis, it may
cur along the courses of the involved occur at Shangjuxu (ST 37), the lower
meridians or at certain points where the He-Sea Point of the large intestine. These
qi of the meridian is converged. In gas- signs may assist in making dignosis for
tralgia, for instance, tenderness may oc- disorders of internal organs.

------ --_. ----------

 Chapter 13
DIFFERENTIATION OF SYNDROMES
~~chff~~~
Differentiation of syndromes is the these, differentiation according to eight
method in traditional Chinese medicine principles is the general method. Differ-
of recognizing and diagnosing diseases. entiation according to the theory of qi
In accordance with the basic knowledge and blood and that according to the
of traditional Chinese medicine, this theory of zang-fu organs are mainly
method entails making a comprehensive concerned with endogenous diseases,
analysis of the symptoms and signs ob- while differentiation according to the
tained by applying the four diagnostic theory of meridians and collaterals is
methods, in order to clarify their internal principally concerned with disorders of
relationships, and ascertain their causes meridians and collaterals. Each method
and nature as well as the relative strength has its own features and lays stress on
of the anti pathogenic qi and pathogenic a particular aspect while connecting
factor, and the direction of the patholog- with and supplementing the others. It is
ical development. essential to understand and possess a
Differentiation of syndromes and de- thorough knowledge, through clinical
termination of treatment are inseparable, practice, of the basic contents and char-
one relating to the other. The former is acteristics of each method.
the premise and foundation of the lat-
ter. The methods of treatment, so deter-
mined, may in turn test the validity of the I. DIFFERENTIATION OF
differentiation. Correct differentiation is SYNDROMES ACCORDING
a prerequisite for applying appropriate
methods and attaining anticipated re-
TO EIGHT PRINCIPLES
sults.
There are a number of methods in The eight principles refer to eight
traditional Chinese medicine for differ- basic categories of syndromes, namely,
entiating syndromes, including differen- yin and Yjlng, exterior and interior, £Q!fl
tiation according to eight principles, dif- and hejlt, and deficiency and excess. In
ferentiation according to the theory of differentiation of syndromes according
qi and blood, differentiation according to eight principles, these eight categories
to the theory of zang-fu organs and are applied in analysing various patho-
differentiation according to the theory logical manifestations determined by ap-
of meridians and collaterals, etc. Of plying the four diagnostic meth~, in-
286
~·4/~·A~jf~
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 287

dicating the location of the disease, its

nature and the relative strength of the
The skin, hair, muscles and their in-} Mt.
terspaces, and the superficial portion of
pathogenic factor and antipathogenic qi. meridians and collaterals of the human
The application of the eight princi- body belong to the exterior, while the} ~t.
ples forms the basis link, categorizing a five zang and six fu organs pertain to
variety of clinical manifestations in a the interior.
general way. It is thus possible to under- 1) Exterior syndromes Exterior syn-
stand and solve complicated problems dromes refer to pathological conditions
systematically in the process of making resulted from the invasion of the super-
diagnosis. ficial portion of the body by exogenous
Although this method classifies path- pathogenic factors. They are marked by
ological conditions into eight categories, sudden onset of symptoms with short
they are inseparable and interconnected. duration, and are often seen at the early
Attention should be paid to this in the stage of exogenous diseases. The chief
clinical situation in order to ensure a manifestations are an intolerance to
correct and comprehensive recognition cold (or wind), fever, thin tongue coat-
of disease. ing and a superficial pulse. The accom-
panying symptoms and signs are head-
1. Exterior and Interior ache, general aching, nasal obstruction
and cough. Clinical manifestations may
The categories of exterior and interior vary according to the invading patho-
form two principles which are used to genic factors and the body constitution
determine the depth of the diseased area of the patient. They are manifested as
and to generalize the direction of the cold, heat, deficiency and excess
development of a disease. (Tab. 9).

Table 9. Differentiation of Cold, Heat, Deficiency and Excess in Exterior Syndromes

Syrtdromes Symptoms and signs in common Distinguishing symptoms and signs

Ex terior cold Severe chills, mild fever, no sweating, ab-

sence of thirst, thin, white and moist tongue
coating, superficial and tense pulse.
Ex1:erior heat (ChillS, fever, headache, general Mild chills, severe fever, no sweating or
telling, thin tongue coating, sweating, thirst, thin and yellow tongue
superficial pulse. coating, superficial and rapid pulse.
Ex terior deficiency Sweating.
I
Ex terior excess No sweating.
 288 CHINESE ACUPUNCTURE AND MOXIBUSTION

2) Interior syndromes Interior syn- 4) The relationship between exterior

dromes refer to pathological conditions and interior In given conditions, exoge-
resulted from the transmission of exoge- nous pathogenic factors, if they are not
nous pathogenic factors to the interior of expelled from the exterior of the body,
the body to affect zang-fu organs, or may be transmitted to the interior, giving
from the functional disturbances of zang- rise to interior syndromes. This is known
fu organs. Interior syndromes cover a as "transmission from the exterior to the
wide range of pathological conditions ~r." Pathogenic factors in some in-
and may occur in the following three terior syndromes may be transmitted
conditions: transmission of persistent from the interior to the superficial por-
.3 ~pathogenic factors from the exterior to tion of the body. This is known as "~
_)~. the interior of the body to invade zang-fu mission from the interior to the exterior." ,.....L.
0f1~ans; direct attack on zang-fu organs The occurrence of the transmission main- ~J
by exogenous pathogenic factor~; drastic ly depends upon the relative strength of ~f:'
emotional changes, improper diet and o- the pathogenic factor and anti pathogenic
verstrain and stress, all of which affect qi. The transmission of pathogenic fac-
zang-fu organs directly, leading to func- tors from the exterior to the interior is
tional disturbances. For details of inte- often due to weakened body resistance to
rior syndromes, refer to the differentia- disease, or to hyperactivity of the patho-
tion of deficiency and excess, and to the genic factors, improper care, or incorrect
differentiation of syndromes according to or delayed treatment. The transmiSSiO~~l;c
the theory of zang-fu organs. of interior pathogenic factors to the ex- ocxl.
3) Differentiation of exterior and inte- terior i~ often the result of correct treat- J J..
rior syndromes The accompaniment of ment and care, and strengthened bod lI\&.oJ\
aversion to cold with fever, and changes resistance to disease. Generally speaking, Ei
in tongue coating and pulse are highly the inward transmission of pathogeniCj ;J
significant for differentiating exterior factors indicates an aggravation of the ~I

t
Ell.
1 and interior syndromes in exogenous feb-
rile diseases. Generally, fever accompan-
ied by aversion to cold suggests exte-
~e, while the outward transmission ~
represents a tendency of pathogenic fac-
tors in the interior being expelled, thus
rior syndromes; fever with no aversion indicating an alleviation of the disease.
Int: j to cold, or aversion to cold with no fever In the process of the development of
. \indicates interior syndromes. A thin and disease, there is a condition known as ext.+
t white tongue coating, possible with red "the exterior and interior being diseased :tnt.
t-i ~ tongue borders, is often seen in exterior simultaneously." This may appear at the
Syndromes. The appearance of other ab- early stage of a disease, when both exter-

]1 l
~
•
normal qualities of tongue coating often
indicates interior syndromes. A superfi,
cial pulse suggests exterior syndromes;
deep pulse suggests interior syndromes.
ior and interior syndromes are seen at the
same time. This also occurs when exoge-
nous pathogenic factors are transmitted
to the interior, while the exterior syn-

?~

~~~------~---
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 289

dromes are still present. Prolonged endo- yin gives rise to cold," Cold and heat
genous diseases complicated with recent syndromes are concrete manifestations of
exogenous diseases, or exogenous diseas- excess and deficiency of yin-yang. Dis-
es inducing acute attacks of chronic en- tinguishing between cold and heat syn-
dogenous diseases may also be the causes. dromes is important for guiding treat-
As exterior and interior syndromes are ment.
usually complicated with cold, heat, defi- 1) Cold syndromes and heat syndromes
ciency and excess, many different syn- Cold syndromes are pathological condi-
dromes are exhibited in "the exterior and tions resulted from exposure to exoge-
interior being diseased simultaneously," nous pathogenic cold or from deficiency
for example, exterior cold complicated of yang in the interior of the body. Heat
with interior heat, exterior deficiency syndromes are pathological conditions
with interior excess, and exterior excess caused by invasion of exogenous patho-
with interior deficiency. genic heat or by deficiency of yin in the
5) Intermediate syndromes Interme- interior of the body.
diate syndromes refer to pathological Since cold and heat syndromes are
conditions in which exogenous pathogen- opposite in nature, the symptoms and
ic factors fail to be transmitted complete- signs they manifest are entirely different.
ly to the interior, while the anti pathogen- Cold syndromes are revealed by aversion
ic qi is not strong enough to expel the to cold, preference for warmth, tasteless-
pathogenic factors to the body surface. ness in the mouth, absence of thirst, pal-
The pathogenic factors thus remain be- lor, cold limbs, lying with the body curled
tween the exterior and interior. The chief up, loose stools, clear urine which is
clinical manifestations are alternate chills increased in volume, pale tongue with
and fever, discomfort and fullness in white and moist coating, slow or tense
the chest and hypochondrium, vomiting, pulse. Heat syndromes manifest as fever,
anorexia, bitter taste in the mouth, dry preference for coolness, thirst with pre-
throat, blurred vision and string-taut ference for cold drinks, redness of face
pulse. For details, refer to the Shaoyang and eyes, irritability, restlessness, consti-
Syndrome in the chapter "Differentiation pation, deep-yellow and scanty urine, red
of Syndromes According to the Theory tongue with yellow and dry coating, and
of the Six Meridians." rapid pulse.
Deciding whether a syndrome is of
2. Cold and Heat heat or cold nature cannot be based on
one clinical manifestation alone. The cor-
Cold and heat are the two principles rect conclusion is reached after careful
used to differentiate the nature of a di- observation of all the clinical manifesta-
sease. According to the fifth chapter of tions. Of these, the presence of cold, heat
Plain Questions: "Predominance of yang and thirst and the conditions of complex-
gives rise to heat, and predominance of ion, four limbs, defecation, urination,
290 CHINESE ACUPUNCTURE AND MOXIBUSTION

tongue coating and pulse are the most a) Complicated syndromes of cold
important. Table 10 explains the differen- and heat The patient may have simul-
tiation of cold and heat conditions of taneous signs of heat in the upper half of
excess type in interior syndromes. the body, and of cold in the lower half.
2) The relationship between cold and The syndrome like this is known as "heat
heat syndromes Although cold syn- above with cold below." This is one of the
dromes and heat syndromes are opposite most frequently seen complicated syn-
in nature, they have a close relationship. dromes of cold and heat. Clinically the
They can exist simultaneously, manifest- "heat above" manifests as suffocation and
ing as complicated syndromes of cold and heat sensation in the chest and a frequent
heat. In given conditions, they can also be desire to vomit, whilst the "cold below"
transformed into each other, presenting presents abdominal pain which can be
either transformation' of cold syndromes alleviated by warmth, and loose stools,
into heat, or of heat syndromes into cold. The syndrome is often due to a compli-
When the disease has developed to a very cated etiology involving both cold and
severe stage, syndromes of true heat and heat. This leads to a pathological dishar-
false cold or true cold and false heat may mony of yin and yang of various zang-fu
appear. organs, and manifests as excess of yang

Table 10. Differentiation of Cold and Heat Syndromes

I
Cold syndromes i Heat syndromes
~------------------------------
Pallor, aversion to cold, absence of thirst or i Red complexion, fever, thirst with preference

drinking a little hot drinks, loose stools, clear i for cold drinks, constipation, deep-yellow and
urine increased in volume I scanty urine.

Pale tongue with white and moist coating. t

--------+--
Red tongue with yellow and dry coating,
Slow pulse. Rapid pulse.

in the upper part of the body and excess curs first and gradually changes into a
of yin in the lower part. heat syndrome. An example is exposure
Other frequently seen complicated to exogenous pathogenic cold which may
syndromes are cold on the exterior with lead to an exterior cold syndrome and
heat in the interior, and heat on the ex- produce such symptoms and signs as fe-
terior with cold in the interior. ver, aversion to cold, general aching, no
b) Transformation of cold and heat syn- sweating, white tongue coating and su-
dromes In transformation of a cold syn- perficial and tense pulse. If this patho-
drome into heat, the cold syndrome oc- genic cold goes deep into the interior of
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 291

the body and turns into heat, cold signs and a deep but forceful pulse. In addi-
such as aversion to cold will subside, but tion, there is thirst with preference for
fever persists and other heat signs such as cold drinks, irritability, dry throat, foul
irritability, thirst and yellow tongue coat- breath, scanty, deep-yellow urine, consti-
ing will occur in succession. This indi- pation and a deep red tongue with yellow
cates the transformation of exterior cold dry coating. In this syndrome, excessive
into interior heat. internal heat hinders the yang qi from
In transformation of a heat syndrome reaching the exterior.
into cold, the heat syndrome occurs first True cold with false heat refers to a
and gradually changes into a cold syn- syndrome in which there is real cold in
drome. An example is abrupt appearance the interior and false heat on the exterior.
of cold limbs, pallor, and a deep and slow Clinical manifestations are feverishness
pulse in the patient with high fever, pro- of the body, flushed face, thirst and a
fuse sweating, thirst, irritability, and a superficial pulse. However, the patient
surging and rapid pulse. These are the wants to cover up the body in spite of the
manifestations of the transformation of a feverishness, wants to take warm drinks
heat syndrome into a cold one. to relieve the thirst, and has a superficial
The mutual transformation of cold and weak pulse. In addition, there are
and heat syndromes takes place in cer- other cold signs such as clear urine, loose
tain conditions, depending crucially on stools and a pale tongue with white coat-
the relative strength of the pathogenic ing. In this syndrome, excessive yin cold
factor and anti pathogenic qi. Generally in the interior forces the yang qi to the
speaking, transformation of cold into exterior.
heat results from a strengthening of the It is clear that the appearance of a
antipathogenic qi and hyperactivity of disease does not necessarily reflect its
yang qi. Constitutional deficiency of essential nature in these types of syn-
yang, or exhaustion of yang qi during the dromes. Careful observation and analysis
course of a disease, may lead to a failure should be made, if the false and true
of the antipathogenic qi in resisting the phenomena are to be differentiated ac-
pathogenic factor, thus giving rise to curately. Attention should be paid to the
transformation of a heat syndrome into a following points: Whether the pulse is
cold one. forceful or weak; whether the tongue is
c) True and false phenomena in cold pale or red; whether the tongue coating
and heat syndromes True heat with false is moist or dry; whether there is thirst or
cold refers to a syndrome in which there not; whether the patient likes cold drinks
is heat in the interior of the body and or hot drinks; whether the chest and ab-
false cold on the exterior. The syndrome domen are warm or not; whether the
is manifested as cold limbs, but a burning urine is clear or yellow; and whether the
sensation in the chest and abdomen; no patient wants to cover up the body or
aversion to cold, but aversion to heat; not.
292 CHINESE ACUPUNCTURE AND MOXIBUSTION

3. Deficiency and Excess ment.

1) Syndromes of deficiency type and
Deficiency and excess are the two syndromes of excess type Deficiency re-
principles which are used to generalize fers to insufficiency of the anti pathogen-
and distinguish the relative strength of ic qi, and therefore syndromes of de-
the antipathogenic qi and pathogenic fac- ficiency type refer to pathological condi-
tor. According to the twenty-eighth chap- tions resulted from deficiency of the
ter of Plain Questions, "hyperactivity of antipathogenic qi. Excess refers to hy-
the pathogenic factor causes excess; con- peractivity of the pathogenic factor, and
sumption of essential qi causes deficien- therefore syndromes of excess type refer
cy." Distinguishing whether a syndrome to pathological conditions in which the
is of deficiency type or of excess type pathogenic factor is hyperactive, while
forms the basis for the determination of the antipathogenic qi remains strong.
promoting the anti pathogenic qi or elimi- a) Syndromes of deficiency type In-
nating the pathogenic factor in the treat- sufficiency of the anti pathogenic qi of

Table 11. Differentiation of Syndromes of Yin Deficiency and Yang Deficiency

Deficiency of yin Deficiency of yang

Afternoon fever, malar flush, heat sensation in Chills, cold limbs, listlessness, lassitude, spon-
the palms and soles, night sweating, dryness of taneous sweating, absence of thirst, clear urine
the throat and mouth, yellow urine, dry stools. increased in volume, loose stools.
Red tongue with little coating. Pale tongue with white coating.
Thready and rapid pulse. Weak pulse.

the human body may manifest as defi- b) Syndromes of yang deficiency and
ciency of yin, deficiency of yang, defi- syndromes of yin deficiency They gen-
ciency of qi or deficiency of blood, which eralize pathological conditions resulted
may form different syndromes. For syn- from deficiency of yang and yin of the
body. According to the inter-consuming-
dromes of qi deficiency and blood defi-
supporting relationship of yin and yang,
ciency, refer to differentiation of syn-
deficiency of yang leads to a relative ex-
dromes according to the theory of qi and
cess of yin, and deficiency of yin leads to
blood. The chief clinical manifestations a relative excess of yang. In addition to
of syndromes of yin deficiency and yang the clinical manifestations of deficiency
deficiency are described as follows (Tab. type, cold signs are seen in deficiency of
II ): yang, and heat signs are seen in deficien-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 293

cy of yin. However, they are essentially 2) The relationship between syndromes

different from cold and heat syndromes of deficiency type and syndromes of ex-
caused respectively by excess of yin and cess type While syndromes of deficien-
excess of yang. cy type and syndromes of excess type
c) Syndromes of excess type In syn- are essentially different, they are also
dromes of excess type, the clinical man- interconnected, and one may affect the
ifestations vary with the nature of the other. The clinical manifestations are
invading exogenous pathogenic factors described as follows.
and areas of the human body they in- a) Complication of deficiency and ex-
vade. The following factors are mainly cess When deficiency of the antipatho-
considered in distinguishing syndromes genic qi and excess of the pathogenic
of deficiency type from those of ex- factor manifest at the same time, this is
cess type: Body shape, spirit, strength known as a syndrome complicated with
of voice and breath, response to pres- deficiency and excess.
sure on painful areas, tongue coating Either deficiency of the antipathogen-
and pulse (Tab. 12). ic qi or excess of the pathogenic factor

Table 12. Differentiation of Syndromes of Deficiency Type and Syndromes of Excess Type

Syndromes of deficiency type Syndromes of excess type

Emaciation, listlessness, lassitude, feeble brea- Sturdiness, agitation, sonorous voice, coarse
thing, dislike of speaking, pallor, palpitations, breathing, distension and fullness in the chest
shortness of breath, insomnia, poor memory, and abdomen, pain aggravated by pressure, con-
spontaneous and night sweating, nocturnal I stipation or tenesmus, dysuria.
emission, nocturnal enuresis, pain alleviated
by pressure.
Dry tongue with no coating or little coating. Thick and sticky tongue coating.
Puls~: of deficiency type. Pulse of excess type.

may predominate in complicated syn- b) Transformation of deficiency and

dromes. There are also complicated syn- excess Although the pathogenic factor
dromes in which deficiency of the an- in syndromes of excess type may grad-
tipathogenic qi and excess of the patho- ually subside, the antipathogenic qi is
genic factor are on equal terms. Ap- already injured due to delayed or incor-
propriate methods of treatment are de- rect treatment, thus transforming syn-
termined on the basis of distinguishing dromes of excess type into syndromes of
which predominates and which is more deficiency type. An example is a heat
urgent. syndrome of excess type which man i-
294 CHINESE ACCPl'NCTURE AND MOXIBUSTION

fests as high fever, thirst, sweating and pulse. But further examination 0[" the
superficial and rapid pulse. If the di- patient will show a sonorous voice, coarse
sease persists for a long time and con- breathing, deep, slow but forceful pulse,
sumes body fluid, this may transform distension and fullness in the abdomen,
into a syndrome of deficiency type constipation, and red tongue with burnt-
showing emaciation, pallor, feebleness, yellow coating. All this reveals that the
little tongue coating or no coating, and accumulation of dryness and heat is the
thready and weak pulse. underlying cause of the pathological
In syndromes of deficiency type, in- changes, while the symptoms and signs
sufficiency of the anti pathogenic qi may indicating the syndrome of deficiency
impair the functions of certain zang-fu type are false phenomena.
organs in distribution and transforma- True deficiency with false excess re-
tion, and produce endogenous pathogenic fers to a syndrome of deficiency type
factors, thus eliciting various syndromes which is accompanied by symptoms and
of excess type. Excess resulting from de- signs similar to a syndrome of excess
ficiency like this is also known as defi- type. Deficiency of qi of the spleen
ciency complicated with excess, or as de- and stomach, for example, may lead to
ficiency of the root cause with excess of weakness in transportation and transfor-
manifestations. In deficiency of qi of the mation and give rise to distension, full-
spleen and lung, for example, dysfunc- ness and pain in the abdomen and
tion in transportation, transformation, stringtaut pulse. However, the distension
dispersing and descending may produce and fullness in the abdomen may be
endogenous pathogenic factors such as improved at times, while they usually
phlegm, retained fluid, harmful water or persist in syndromes of excess type. In
damp. addition, the abdominal pain is not ag-
c) True and false phenomena in defi- gravated by pressure, and is sometimes
ciency and excess False phenomena may alleviated by pressure. The pulse is
appear in syndromes of deficiency type string-taut, but it is also weak on heavy
and those of excess type. Special care palpation. So deficiency of the middle
should be taken to distinguish them. energizer leading to dysfunction in
True excess with false deficiency re- transportation is the underlying cause of
fers to a syndrome of excess type which the pathological changes, while the dis-
is accompanied by symptoms and signs tension, fullness and pain in the abdo-
similar to a syndrome of deficiency type. men indicating a syndrome of excess
An example is accumulation of dryness type are false phenomena.
and heat in the intestines and stomach, Distinguishing between true and false
which hinders circulation of qi and phenomena in deficiency and excess re-
blood, and elicits such symptoms and quires careful examination of the pa-
signs as indifference, a cold sensation of tient's pulse, tongue and other symp-
the body, cold limbs, and deep and slow toms and signs. Factors such as the

------~-------
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 295

strength of the pulse, toughness of the ing, hyperactivity and bright complexion
tongue and response to pressure on the fall into the category of yang syndromes,
painful area must be assessed. In addi- while those characterized by inhibi-
tion, the causative factors of the disease tion, quiescence, hyperactivity and sal-
and medication taken before should be -low complexion fall into the category of
considered. yin syndromes.
2) Collapse of yin and collapse of yang
4. Yin and Yang Collapse of yin refers to pathological
conditions resulting from massive con-
Yin and yang form a pair of princi- sumption of yin fluid. Collapse of yang
ples used to generalize categories of syn- refers to pathological conditions caused
dromes. Being the key link in the appli- by extreme exhaustion of yang qi in the
cation of the eight principles, yin and body.
yang are used to summarize the other Both collapse of yin and collapse of
three pairs of principles. Exterior, heat yang are critical syndromes in the process
and excess fall into the category of yang, of a disease. They may result from the
while interior, cold and deficiency fall further aggravation of yin deficiency and
into the category of yin. Yin and yang are yang deficiency. They may also occur as
also used to explain some of the patho- a result of an abrupt aggravation in acute
logical changes of the zang-fu organs and diseases, e.g. severe vomiting and diar-
tissues, e.g. syndromes of collapse of rhoea or great loss of blood may elicit
yin, syndromes of collapse of yang, syn- collapse of yin, and profuse sweating may
dromes of yin deficiency, syndromes of cause collapse of yang.
yang deficiency. As yin and yang depend upon each
1) Yin syndromes and yang syndromes other, in the case of collapse of yin, the
Yin syndromes refer to pathological con- yang qi has nothing to depend upon, and
ditions resulting from deficiency of yang therefore it dissipates from the body. In
qi in the body and retention of pathogen- collapse of yang, yin fluid is also con-
ic cold. Yang syndromes refer to patho- sumed. However, the predominating fac-
logical conditions caused by hyperactivity tors in the two syndromes are different,
of yang qi in the body and excess of and corresponding methods of treatment
pathogenic heat. Syndromes of deficiency must be adopted.
type and cold syndromes come within yin In addition to the various critical
syndromes; syndromes of excess type and symptoms and signs of the disease which
heat syndromes come within yang syn- occur initially, sweating may be seen in
dromes. Generally speaking, so far as the both syndromes. The distinguishing
clinical manifestations ae concerned, points are described as follows in
those characterized by excitation, fidget- Table 13:

---------------------
2% CHINESE ACUPUNCTURE AND MOXIBUSTION

Table 13. Differentiation of Syndromes of Collapse of Yin and Collapse of Yang

Collapse of Yin Collapse of Yang

Sticky sweat, feverishness of the body, warm Profuse cold sweat like pearls, coolness of the
hands and feet, shortness of breath, irritability, body, cold hands and feet, feeble breathing,
restlessness, thirst with preference for cold listlessness, absence of thirst or preference
drinks. for hot drinks.
--------~ --------
Red and dry tongue. Pale and moist tongue.
Thready, rapid and weak pulse. I Thready and fading pulse.

II. DIFFERENTIATION OF pathological changes resulting from hy-

pofunction of zang-fu organs.
SYNDROMES ACCORDING
Clinical manifestations: Dizziness,
TO THE THEORY OF QI blurring of vision, dislike of speaking,
AND BLOOD lassitude, spontaneous sweating, all of
which are worse on exertion; a pale
This method of differentiation uses tongue and a pulse of deficiency type.
the theory of qi and blood to analyse and Etiology and pathology: This syn-
categorize the pathological changes of qi drome is often due to weakness after long
and blood into syndromes. illness, feebleness in old age, improper
Although they form the material basis diet, or excess of strain or stress. Insuffi-
for the functional activities of zang-fu ciency of the antipathogenic qi and hypo-
organs, at the same time, qi and blood function of zang-fu organs result in dis-
depend upon zang-fu organs for their like of speaking and lassitude. Deficiency
production and circulation. Therefore of qi also implies weakness of qi in pro-
disorders of qi and blood may affect pelling blood normally, hence qi and
zang-fu organs, and disorders of zang-fu blood fail to go upward to nourish the
organs may affect qi and blood. head and eyes, the result being dizziness
and blurring of vision. In case of weak-
1. Syndromes of Qi ness of defensive qi, it fails to control
the opening and closing of pores, spon-
There are many pathological changes taneous sweating occurs. Because exer-
of qi, but they may generally be classified tion further consumes qi, it will also
into four syndromes, namely, deficiency cause aggravation of the above symp-
of qi, sinking of qi, stagnation of qi and toms. The pale tongue is a consequence
perversion of qi. of the deficient nutrient qi which fails to
1) Syndrome of deficiency of qi The go upward to nourish the tongue, and the
syndrome of deficiency of qi refers to deficient type pulse is due to weakness of

~------ --- -- --- --------- ~--- -------

CHAPTER 13 DIFFERENTIATION OF SYNDROMES 297

qi in moving blood. These symptoms have the following fea-

2) Syndrome of sinking of qi Sinking tures: Distension is more severe than
of qi is one of the pathological changes pain; both distension and pain wax and
resulting from deficiency of qi. It is char- wane with no fixed position; and the
acterized by a weakness in holding abili- onset is often related to emotions and the
ty within the category of qi deficiency. symptoms may be alleviated temporarily
Since it often occurs in the middle ener- by belching or flatus.
gizer, it is also known as "sinking of qi of As stagnation of qi has varied causes
the middle energizer." and may involve different zang-fu or-
Clinical manifestations: Dizziness, gans, there exist, aside from distension,
blurring of vision, lassitude, a bearing- stuffiness and pain, separate clinical
down distending sensation in the ab- manifestations. For details, refer to the
dominal region, prolapse of the anus or chapter dealing with differentiation of
uterus, gastroptosis and renal ptosis, a syndromes according to the theory of
pale tongue, a pulse of the deficient type. zang-fu organs.
Etiology and pathology: The etiology 4) Syndrome of perversion of qi In
of sinking of qi is the same as that of the syndrome of perversion of qi, there is
deficiency of qi. Dizziness, blurring of a dysfunction of the qi in ascending and
vision, lassitude, the pale tongue and descending which leads to upward dis-
pulse of the deficient type are common turbance of the qi of zang-fu organs.
symptoms and signs in the syndrome of This syndrome often refers to pathologi-
deficiency of qi. The bearing-down dis- cal changes resulting from upward dis-
tending sensation in the abdominal re- turbance of the qi of the lung and stom-
gion, prolapse of the anus or uterus, gas- ach, and from excessive ascending of the
troptosis and renal ptosis are all possible qi of the liver.
outcomes of weakness in holding ability. Clinical manifestations: Upward dis-
3) Syndrome of stagnation of qi The turbance of the lung qi manifests as
syndrome of stagnation of qi occurs coughing and asthmatic breathing. Up-
when qi in a certain portion of the body ward disturbance of the stomach qi gives
or of a specific zang-fu organ is retarded rise to belching, hiccups, nausea and
and obstructed. vomiting. Excessive ascending of the liver
Clinical manifestations: Distension qi causes headache, dizziness and vertigo,
and pain. coma, hemoptysis and hematemesis.
Etiology and pathology: This syn- Etiology and pathology: Upward dis-
drome is often due to mental depres- turbance of the lung qi is often due to
sion, improper diet, invasion of exoge- invasion of exogenous pathogenic factors
nous pathogenic factors, or sprains and or to retention of phlegm in the lung. In
contusions. Hindrance of qi circulation is either case, the lung qi fails in its func-
followed by obstruction of qi, which is tion to disperse and descend, but in-
the primary cause of distension and pain. stead ascends and disturbs, giving rise
298 CHINESE ACL~PUNCTURE AND MOXIBUSTION

to coughing and asthmatic breathing. to nourish the heart, may lead to disturb-
Retention of fluid, phlegm or food in ance of the mind, palpitations and insom-
the stomach, or invasion of the stomach nia appear. Numbness of the hands and
by exogenous pathogenic factors may all feet originates from the lack of nourish-
block qi circulation and deprive the stom- ment of meridians and collaterals. The
ach qi of its function in descending. Up- pale tongue is a result of the deficiency
ward disturbance of the stomach qi of blood depriving the tongue of nourish-
produces belching, hiccups, nausea and ment, whilst the thready pulse is a conse-
vomiting. quence of insufficient blood in the ves-
Injury of the liver by anger leads to sels.
excessive ascent of the liver qi and fur- 2) Syndrome of stagnation of blood
ther, to upward disturbance of qi and fire Stagnation of blood refers to the accumu-
of the liver, producing headache, dizzi- lation of blood in a local area due to
ness and vertigo, and even coma, hemop- hindrance of the blood circulation or to
tysis and hematemesis in severe cases. extravasated blood which has not been
dispersed or immediately expelled from a
2. Syndromes of Blood fixed location in the body.
Clinical manifestations: Pain, mass
There are three syndromes of blood, tumours, hemorrhage, and ecchymoses
namely, deficiency of blood, stagnation or petechice.
of blood and heat in the blood. Etiology and pathology: There are
1) Syndrome of deficiency of blood many causes of stagnation of blood, such
The syndrome of deficiency of blood oc- as sprains and contusions, hemorrhage,
curs when there is insufficient blood to retardation of qi circulation leading to
nourish zang-fu organs and meridians. retardation of blood circulation, deficien-
Clinical manifestations: Pallor or sal- cy of qi causing a weakness in the normal
low complexion, pale lips, dizziness, blur- movement of blood, and invasion of the
ring of vision, palpitations, insomnia, blood system by pathogenic cold or heat.
numbness of the hands and feet, a pale Pain, which is the main symptom, oc-
tongue and a thready pulse. curs as a consequence of obstruction by
Etiology and pathology: This syn- stagnant blood. The pain is fixed in loca-
drome is often due to weakness of the tion and stabbing in nature. Accumula-
spleen and stomach, hence qi and blood tion of stagnant blood in the local area
have an insufficient source, or due to forms mass tumours which have fixed
excessive blood loss, or drastic emotional positions and are firm on palpation. Ob-
changes which consume yin blood. Defi- struction of vessels by stagnant blood
ciency of blood deprives the head, eyes does not permit blood to circulate along
and face of nourishment, causing dizzi- the normal courses, and hence induces
ness, blurring of vision, pallor or sallow hemorrhage.
complexion and pale lips. Blood, failing Hemorrhage of this sort occurs re-
CHAPTER L\ DIFFERENTIA TIO],; OF SYNDROMES 299

peatedly and consists of purplish dark chapter of Miraculous Pivot, "Fine needles
flow and may exhibit clots. Stagnation of are applied to clear obstructions in me-
blood may also manifest with purplish ridians and collaterals and to regulate qi
spots on the skin and tongue. and blood." Another medical classic Pre-
Cold, heat, excess and deficiency may cious Supplementary Prescriptions holds,
all be causative factors of stagnation of "All diseases start from stagnation of
blood, hence syndromes associated with qi and blood. Needling may promote
these factors will be present along with smooth circulation of qi and blood .... " In
the symptoms and signs listed above. acupuncture clinics, suitable points are
3) Syndrome of heat in the blood selected, and different techniques of nee-
Heal in the blood refers to the syndrome dling and moxibustion are adopted to
which results either from endogenous regulate qi and blood and to restore their
heat in the blood system or from invasion harmonious states.
of the blood system by exogenous patho-
genic heat. Appendix:
Clinical manifestations: Mental rest-
lessness, or mania in severe cases, a dry Differentiation of Syndromes Accord-
mouth with no desire to drink, deep-red ing to the Theory of Wei (.:E Defense), Qi
tongue, rapid pulse, possible occurrence (9. Vital Energy), Ying ( 'i Nutrient)
of various hemorrhagic syndromes, pro- and Xue ( lfn. Blood).
fuse menstrual flow in women. This method of differentiation of syn-
Etiology and pathology: This syn- dromes employs the theory of qi and
drome is often due to either invasion of blood with flexibility in the analysis of
exogenous pathogenic heat or to obstruc- acute febrile diseases. Acute febrile di-
tion of liver qi turning into fire. Hyper- seases often occur when body resistance
activity of heat in the blood disturbs the is weak and there is invasion of the hu-
mind and results in mental restlessness or man body by febrile pathogen or pestilen-
even mania in severe cases. Consumption tial factors. They are characterized by
of yin blood leads to a dry mouth, but abrupt onset of symptoms and are li-
since heat is not in the qi system, the able to injure yin and undergo frequent
patient does not want to drink. Excessive changes.
heat accelerates the blood circulation and In the Qing Dynasty, Ye Tianshi attri-
hence a deep-red tongue and rapid pulse buted the occurrence of febrile diseases
appear. Hyperactive heat in the blood to the dysfunction of the wei, qi, ying and
system easily causes injury of the blood xue systems. Basically, he utilized the
vessels, the result of which is epistaxis, theory of wei, qi, ying and xue to ana-
hemoptysis, hematemesis, hematuria and lyse pathogenesis and differentiate syn-
profuse menstrual flow in women. dromes, to identify the transmission and
Acupuncture and moxibustion may re- transformation of febrile diseases, and
gulate qi and blood. As stated in the first thus to determine treatment. Wei, qi,
300 CHINESE ACUPUNCTURE AND MOXI13USTION

ying and xue not only generalize the cold. Dysfunction of defensive qi in
pathological manifestations of febrile di- opening and closing the pores leads to
seases, but also represent four different either absence of or only slight sweating.
stages of pathological development in Hindrance of defensive qi may also in-
terms of the depth and severity of di- duce disturbance of the qi of the meridi-
sease. The most superficial is the wei ans, which may further cause headache.
stage; the next in depth is the qi stage; Furthermore, as the skin and body hair
deeper still is the ying stage, and the xue are related to the lung, hindrance of de-
stage occurs when the disease lies deep- fensive qi may lead to dysfunction of the
est. Diseases of the wei and qi stages are lung in dispersing, which manifests as
mild and superficial, whilst diseases of coughing. The throat is the gateway of
the ying and xue stages are deep and the lung, so invasion of the lung by feb-
severe. rile pathogen may give rise to swelling
1) Syndrome of the wei (defense) stage and pain of the throat. Slight thirst is a
The syndromes of the wei stage refers to consequence of the consumption of body
pathological changes resulting from dys- fluid by febrile pathogen. Red tongue
function of wei (defensive) qi due to in- borders and tip, thin and white tongue
vasion of the muscles and body surface coating, and superficial and rapid pulse
by exogenous febrile pathogen. The wei are signs of exterior heat.
system is the exterior defense of the hu- The principle of treatment is to re-
man body and includes the skin and mus- lieve the exterior syndromes with cool
cles on the body surface. As it functions and pungent mild diaphoreties and to
to readjust body temperature and resist dissipate sweat through the wei system.
exogenous pathogenic factors, it is close- The method of promoting lung qi in dis-
ly related to defensive qi and the lung. persing and descending is used in con-
Invasion by pathogenic factors may re- junction. If acupuncture is applied,
sult in pathological changes of the lung points are mainly selected from the Lung
and defensive qi. Meridian of Hand-Taiyin, the Large In-
Principal clinical manifestations are testine Meridian of Hand-Yangming, the
fever, mild aversion to wind and cold, Governor Vessel and the Bladder Merid-
headache, cough, absence of sweating or ian of Foot-Taiyang.
slight sweating, mild thirst, swelling and 2) Syndromes of the qi (energy) stage
pain of the throat, red tongue tip and The syndromes of the qi stage are inte-
borders, thin and white tongue coating, rior heat syndromes in which the febrile
and a superficial and rapid pulse. pathogen is transmitted inwards to af-
This syndrome is often seen at the fect zang-fu organs. In this stage there is
early stage of acute febrile diseases. The fierce contension between the excessive
retention of febrile pathogen at the body pathogenic factor and the strong anti-
surface hinders defensive qi resulting in pathogenic qi, which manifests in hyper-
fever and slight aversion to wind and activity of yang and heat.
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 301

As invasion of the qi system by excessive yang and heat appear in the

the pathogenic factor involves differ- form of fever with aversion to heat, deep-
ent zang-fu organs, various related path- yellow urine, a red tongue with a yellow
ological manifestations will occur. Fre- coating and a rapid pulse. Since the path-
quently seen syndromes of the qi stage ogenic factor has left the body surface,
are retention of heat in the lung, reten- there is no aversion to cold. Consumption
tion of heat in the chest and diaphragm, of body fluid by excessive heat leads to
retention of heat in the stomach, and thirst. Disturbance of the mind by heat
retention of heat in the intestinal tract. gives rise to mental restlessness. Reten-
The main pathological manifestations tion of heat in the lung impairs the lung's
of syndromes of the qi stage are fever, function in descending, resulting in disor-
aversion to heat as opposed to aversion to ders of qi which manifest as coughing
cold, a red tongue with a yellow coating and chest pain. The heat in the lung
and a rapid pulse. These are often accom- condenses body fluid to phlegm, present-
panie:d with mental restlessness, thirst ing profuse, thick and yellow sputum.
and deep-yellow urine. Retention of heat in the chest and dia-
In retention of heat in the lung, phragm hinders the passage of qi, and
cough, asthmatic breathing, chest pain, restlessness and uneasiness become ap-
and e:xpectoration of thick yellow sputum parent. When the exterior is affected by
may be seen. Retention of heat in the excessive heat, a persistent high fever
chest and diaphragm may present mental occurs. Heat in the interior forces out the
restlessness and uneasiness. In retention body fluid and profuse sweating results.
of heat in the stomach, there maya ppear Consumption of body fluid by excessive
high fever, dysphoria, thirst with prefer- heat gives rise to dysphoria, thirst with
ence for cold drinks, profuse sweating, preference for cold drinks, and dry, yel-
dry and yellow tongue coating, a rapid low tongue coating. Excessive movement
and rolling pulse or a superficial, large of qi and blood due to hyperactive inte-
and forceful pulse. Retention of heat in rior heat causes rolling and rapid pulse or
the intestinal tract may exhibit tidal fe- superficial, large and forceful pulse. Re-
ver, constipation or faecal impaction with tention of heat in the intestinal tract com-
watery discharge, fullness, hardness and bines with wastes and blocks the qi of
pain in the abdomen, dry, yellow or even fu organs, resulting in fullness, hardness
burnt-black tongue coating with thorns and pain in the abdomen, constipation or
on the tongue, and a deep and forceful faecal impaction with watery discharge.
pulse of the excess type. Excess of the Yangming fu organ with
The common feature in syndromes of interior hyperactivity of heat and dryness
the qi stage is excessive heat. As febrile manifests as afternoon fever, dry, yellow
pathogen invades the qi system and caus- or even burnt-black tongue coating with
es a vigorous struggle between the anti- thorns on the tongue, and deep and force-
pathogenic qi and the pathogenic factor, ful pulse of the excess type.
302 CHINESE ACCPUNCTURE AND MOXIBl'STION

The principle of treatment is to clear of febrile pathogen injures the ying (nu-
heat from the qi system. Points are select- trient) yin, the outcome of which is fe-
ed from the Governor Vessel, Yangming verishness of the body which is worse at
Meridians of Hand and Foot, and merid- night, and dry mouth without a strong
ians related to the diseased organs or desire to drink. As ying (nutrient) qi
areas. The method to treat excessive heat flows to the heart, heat in the ying system
in the stomach and retention of heat in disturbs the heart, giving rise to mental
the intestinal tract is identical to that restlessness and insomnia. Delirium is a
used from syndromes of the Yangming sign of invasion of the pericardium by
Meridian and Yangming fu organ in the pathogenic heat, whilst faint skin rashes
differentiation of syndromes according to appear due to injury of the blood ves-
the theory of the six meridians. sels by heat. The deep-red tongue and
In principle, points of the Lung Me- thready, rapid pulse are also signs of
ridian of Hand-Taiyin and Large Intes- invasion of the ying system by heat.
tine Meridian of Hand-Yangming are The method of treatment is to clear
used for retention of heat in the lung. off heat from the ying system. Acupunc-
Points of the Pericardium Meridian of ture or bleeding by pricking the vessels
Hand-Jueyin, Heart Meridian of Hand- may be adopted as auxiliary methods.
Shaoyin and Stomach Meridian of Foot- Points are mainly used from the Heart
Yangming are usually selected for reten- Meridian of Hand-Shaoyin, the Pericar-
tion of heat in the chest and diaphragm. dium Meridian of Hand-Jueyin and the
3) Syndrome of the ying (nutrient) Governor Vessel.
stage The syndrome of the ying stage is 4) Syndrome of the xue (blood) stage
more severe and marked by further pene- The syndrome of the xue stage represents
tration of febrile pathogen. Ying refers to further development of the invasion of
the qi in the blood, which flows internally the ying system by the pathogenic factor.
to the heart. The syndrome of the ying It arises from excessive heat stirring the
stage is thus characterized by inj ury of blood and further disturbing the mind.
ying yin and disturbance of the mind. Chief manifestations are burning heat
Chief manifestations are feverishness of of the body, mania, delirium, obvious
the body which is worse at night, dryness skin rashes; or hematemesis, hemoptysis,
of the mouth without a strong desire to epistaxis, bloody stools and hematuria; a
drink, mental restlessness, insomnia, a dark deep-red tongue.
deep-red tongue and a thready, rapid As the heart dominates the blood and
pulse. In severe cases, faint skin rashes, houses the mind, injury of ying blood by
delirium and cama may occur. heat leads to a burning sensation of the
This syndrome is often a consequence body and dark deep-red tongue. Excessive
of the inward transmission of diseases heat stirs the blood causing obvious skin
from the qi system, which has not been rashes, hematemesis, hemoptysis, bloody
correctly treated. The further penetration stools and hematuria. Heat in the xue

~---~--- -------~--------~----~
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 303

system also disturbs the mind, the result is thus provided for determining treat-
being mania and delirium. ment. The differentiation of syndromes
The method of treatment is to cool the according to the theory of zang-fu organs
blood and to eliminate toxins. Acupunc- is therefore closely combined, in clinical
ture may assist by eliminating heat, application, with the eight principles and
promoting mental resuscitation, relieving the theory of qi and blood.
convulsion and calming the mind. Points The zang-fu organs are interrelated
are selected mainly from the Governor and their diseases may affect one anoth-
Vessel, Yangming Meridians of Hand er. A disease may be confined to a single
and Foot, Shaoyin Meridian of Hand and zang or fu organ, or two or more organs
Jueyin Meridians of Hand and Foot. may be diseased at the same time. Pro-
ceeding from the concept of the unity of
the organism, attention should be paid to
III. DIFFERENTIATION OF the interrelation and mutual influence of
SYNDROMES ACCORDING zang-fu organs when making a differen-
TO THE THEORY OF tiation. Only in this way can a compre-
ZANG-FU ORGANS hensive and correct diagnosis be made.

The differentiation of syndromes ac- 1. Syndromes of the Heart and

cording to the theory of zang-fu organs is Small Intestine
used to analyze and synthesize the clini-
cal data obtained by applying the four The physiological functions of the
diagnostic methods. In this way the di- heart are dominating blood and ves-
seased zang-fu organs are identified, and sels, and housing the mind. Pathologi-
the causes and nature of the disease are cal changes manifesting as disturbance of
ascertained. blood circulation and abnormal mental
However diversified the types of di- activities come within the diseases of the
seases, and complex the clinical manifes- heart. Since the heart opens into the
tations may be, their mechanisms are at- tongue, pathological changes of the
tributed to the dysfunction of zang-fu tongue such as inflammation or ulcera-
organs along with the impairment of the tion of the tongue can be treated on the
qi, blood or body fluid produced by the basis of differentiation of syndromes of
zang-fu organs. In making a differentia- the heart.
tion clinically, the diseased organs should The physiological functions of the
be identified first on the basis of their small intestine are dominating digestion
physiological functions and pathological and separating the "clear" from the "tur-
characteristics, and then the nature of the bid." Therefore the disorders of the small
disease such as cold or heat and deficien- intestine are actually included in the dis-
cy or excess is distinguished according to orders of the spleen. The syndrome of
the eight principles. Reliable information pain due to the disturbance of the qi of
:\04 CHINESE ACUPUNCTURE AND MOXIBUSTIOr-;

the small intestine is described here only. of qi leads to hypofunction of zang-fu

1) Deficiency of the heart qi, deficien- organs, bringing on listlessness and lassi-
cy of the heart yang Clinical manifesta- tude. Deficiency of the heart yang de-
tions: Both deficiency of the heart qi and prives the blood of warmth and gives rise
deficiency of the heart yang may exhi- to retardation of blood circulation, the
bit palpitation and shortness of breath, accompanying symptoms and signs being
which become worse on exertion, spon- chills, cold limbs, cyanosis of lips and a
taneous sweating and a thready, weak purplish dark tongue. Extreme deficiency
pulse or a missed-beat pulse. Deficiency of yang creates an abrupt prostration and
of the heart qi also manifests as listless- severe dissipation of zong (pectoral) qi
ness, lassitude and a pale tongue with from the body with critical signs of pro-
white coating. The accompaniment of fuse sweating, cold limbs, feeble brea-
chills, cold limbs, cyanosis of lips and a thing, mental cloudiness or even coma,
pale, swollen and delicate tongue or a and a feeble fading pulse.
purplish dark tongue indicates deficiency 2) Deficiency of the heart blood, defi-
of the heart yang. Profuse sweating, cold ciency of the heart yin Clinical mani-
limbs, feeble breathing, a feeble fading festations: Both deficiency of the heart
pulse and mental cloudiness or even blood and deficiency of the heart yin may
coma are all critical signs of prostration . manifest as palpitation, insomnia, dream-
of the heart yang. disturbed sleep and poor memory. If
Etiology and pathology: They are there are also pallor, pale lips, dizziness
usually caused by gradual declining of and vertigo, a pale tongue and a thready
the heart qi after a long illness, damage and weak pulse, this suggests deficiency
of yang qi by an abrupt severe disease or of the heart blood. The accompaniment
weakness of the qi of zang due to old age of mental restlessness, dryness of the
or to congenital deficiency. Insufficiency mouth, heat sensation in the palms and
of the heart qi or heart yang implies soles, tidal fever, night sweating, a red
weakness of the heart in propelling the tongue and a thready and rapid pulse
blood, which explains palpitation and indicates deficiency of the heart yin.
shortness of breath. As exertion con- Etiology and pathology: They often
sumes qi, they become worse on exertion. result from a weak body constitution,
Insufficiency of blood in the vessels due asthenia after a long illness or mental
to weakness of blood circulation leads to irritation which consumes the heart
a thready and weak pulse. A missed-beat blood and heart yin. Insufficiency of yin
pulse is produced by discontinuation of blood deprives the heart of nourishment,
the qi of vessels due to weakness of the leading to palpitation and poor memory.
heart in propelling the blood. In case of Disturbance of the mind results in insom-
deficiency of qi and yang, the muscles nia and dream-disturbed sleep. Blood de-
and body surface fail to be controlled, ficiency with inability to nourish up-
spontaneous sweating results. Deficiency wards may produce dizziness and vertigo,

.. ---~ . . . ~.---~.--~-.- _ ...•.. - . . .~-- .. ~ --

.. --- ----~
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 305

pallor, pale lips, and a pale tongue. The may cause retardation of general blood
insufficient blood in the vessels is the circulation, which is the cause of cyanosis
cause of a thready and weak pulse. Insuf- of the face, lips and nails, a purplish dark
ficiency of the heart yin produces defi- tongue or purplish spots on the tongue
ciency type heat in the interior, which and a thready and hesitant pulse or
causes mental restlessness, dryness of the a missed-beat pulse. Deficiency of the
mouth, heat sensation in the palms and heart yang and stagnation of the heart
soles, malar flush, tidal fever, night blood hinder yang qi from reaching the
sWt~ating, a red tongue and a thready and four limbs and body surface, and thus
rapid pulse. inducing cold limbs and spontaneous
3) Stagnation of the heart blood Clin- sweating.
icall manifestations: Palpitation: intermit- 4) Hyperactivity of the heart fire
tent cardiac pain (stabbing or stuffy in Clinical manifestations: Mental restless-
nature in the precordial region or behind ness, insomnia, flushed face, thirst, ulcer-
the sternum) which often refers to the ation and pain of the mouth and tongue,
shoulder and arm, a purplish dark tongue hot and deep yellow urine; hesitant and
or purplish spots on the tongue and a painful urination in severe cases; a red
thready and hesitant pulse or a missed- tongue and a rapid pUlse.
beat pulse. In severe cases there may Etiology and pathology: The syn-
occur cyanosis of face, lips and nails, cold drome is often due to mental depression
limbs and spontaneous sweating. which turns into fire in prolonged cases;
Etiology and pathology: The syn- to retention in the interior of the body
drome often results from insufficiency of of exogenous pathogenic factors turning
the heart qi and heart yang which causes into fire; or to excessive indulgence in
retardation of blood circulation. The at- pungent and hot food, cigarette smoking
tack may be induced and the disease ag- or alcoholic drinking, all of which pro-
gravated by mental irritation, exposure to duce heat and fire over a long period of
cold after over strain and stress, or exces- time. The heart fire produced in the in-
sive indulgence in greasy food and alco- terior attacks the heart and results in
holic drinking, for all of which may elicit disturbance of the mind, which is the
accumulation of phlegm and stagnation cause of mental restlessness and insom-
of blood. Stagnation of blood in the ves- nia. As the tongue is the sprout of the
sel of the heart creates palpitation and heart, the hyperactive heart fire flares
cardiac pain (stabbing pain if stagnation upwards and causes ulceration and pain
of blood predominates; stuffy pain if ac- of the mouth and tongue. Consumption
cumulation of phlegm predominates). As of body fluid by fire and heat gives rise
the: Heart Meridian of Hand-Shaoyin to thirst, hot and deep yellow urine, and
traverses the shoulder region and the me- even hesitant and painful urination in
dial aspect of the arm, referred pain there severe cases. Flushed face, a red tongue
occurs. Stagnation of the heart blood and a rapid pulse are the outcomes of

------------ - - --- --~---- ---------

 306 CHINESE ACUPUNCTURE AND MOXIBUSTION

hyperactivity of pathogenic heat which 6) Pain due to disturbance of the qi of

accelerates the blood circulation. the small intestine Clinical manifesta-
S) Derangement of the mind ("phlegm tions: Acute pain of the lower abdomen,
misting the heart," "phlegm-fire disturbing abdominal distension, borborygmus; or
the heart") Clinical manifestations: The bearing-down pain in the testes referring
syndrome of "phlegm Il1isting the heart" to the lumbar region; white tongue coat-
often displays mental depression and ing and a deep string-taut pulse.
dullness, or incoherent speech, weeping Etiology and pathology: The syn-
and laughing without an apparent reason, drome is often due to improper diet, lack
or sudden collapse, coma and gurgling of care in wearing clothing appropriate
with sputum in the throat. White, sticky to the weather, or carrying excessive
tongue coating and a string-taut and roll- weights. These may give rise to obstruc-
ing pulse are present. tion and sinking of the qi of the small
The syndrome of "phlegm-fire dis- intestine. Obstruction of the qi of the
turbing the heart" often exhibits derange- small intestine brings on acute pain of
ment of the mind, mania, aggressive the lower abdomen, abdominal distension
and violent behavior, insomnia, dream- and borborygmus. Sinking of the qi of
disturbed sleep, flushed face, coarse the small intestine effects bearing-down
breathing, constipation, deep-yellow ur- pain in the testes referring to the lumbar
ine, yellow sticky tongue coating and a region. The white tongue coating and the
rolling rapid forceful pulse. deep, stringtaut pulse are both signs of
Etiology and pathology: The syn- stagnation of qi.
drome of "phlegm misting the heart" is Since the heart functions to dominate
often due to mental depression which the blood and vessels and to house the
results in retardation of qi circulation mind, pathological changes with palpita-
and consequent inability of qi in distrib- tion, insomnia and mental disorders as
uting body fluid. The accumulation of the main symptoms and signs are treated
body fluid forms phlegm, which mists the according to differentiation of syndromes
heart and produces the above symptoms of the heart. Points are mainly select-
and signs. Once the obstructed qi turns ed from the Heart Meridian of Hand-
into fire, which changes body fluid to Shaoyin and the Pericardium Meridian of
phlegm by condensation, the phlegm and Hand-Jueyin. The corresponding Back-
fire intermingle and disturb the mind, the Shu Points are also used. The syndromes
result would be the occurrence of exces- of the small intestine often manifest
sive phlegm fire in the interior which themselves in disturbance of the digestive
manifests as mania, aggressive and vi- function. The deficiency syndromes of
olent behaviour, insomnia, dream- the small intestine are included in the
disturbed sleep, a yellow, sticky tongue deficiency syndromes of the spleen. Their
coating and a rolling, rapid and forceful treatment is directed at the spleen and
pulse. stomach. The heat syndrome of excess

------------------------------ ---
CHAPTER 13 DIFFERENTIATION OF SYNDROMES

type of the small intestine is similar to sence of thirst, nasal obstruction, watery
hyperactivity of the heart fire. The pain- nasal discharge; possible chills and fever;
ful syndrome due to disturbance of the qi absence of sweating, headache, a thin,
of the small intestine may be included in white tongue coating and a superficial,
the syndromes of accumulation of cold in tense pulse. Invasion of the lung by wind
the Liver Meridian. The suitable Back- heat generates cough with yellow puru-
Shu., Front-Mu and Lower He-Sea Points lent sputum, thirst, sore throat; possibly
are ;generally selected as the main points with heat sensation of the body and
and points of the Spleen, Stomach, Heart aversion to wind; headache, thin yellow
and Liver Meridians are used in combi- tongue coating and a superficial rapid
nation, according to actual pathological pulse.
conditions. Etiology and pathology: The syn-
drome is due to invasion of the lung
2. Syndromes of the Lung and system by exogenous pathogenic wind
Large Intestine complicated with either cold or heat. In-
vasion of the lung by wind cold impairs
The lung is the hub of vital energy. It the lung's function in dispersing and des-
dominates qi, in particular, zong (pecto- cending and produces cough with mucoid
ral) qi, which is formed in the lung; it sputum. As the lung opens into the nose,
controls respiration and takes charge of invasion of the lung by pathogenic cold
dispersing and descending; it relates ex- affects the corresponding orifice and
ternally to the skin and hair and opens gives rise to nasal obstruction with wat-
into the nose. Pathological changes of the ery nasal discharge. Since the lung is
lung mainly manifest as insufficiency of closely related to the skin and hair, inva-
zong (pectoral) qi and dysfunctions in sion of the body surface by wind cold
respiration, dispersing and descending. causes disharmony of ying (nutrient) qi
As the lung is a delicate organ and most and wei (defensive) qi, producing chills
susceptible to cold or heat, and it relates and fever, absence of sweating, and heat
to the skin and hair, it is often the first and body aches. A thin, white tongue
organ to be affected when exogenous coating and a superficial, tense pulse are
pathogenic factors invade the body. both signs of wind cold affecting the
The large intestine functions to trans- body surface. Invasion of the lung by
mit the waste products and excrete them wind heat impairs the function of the
from the body. Pathological changes of lung in dispersing and descending, mani-
the large intestine mainly manifest as festing as cough with yellow purulent
dysfunctions in transmission. sputum. The consumption of body fluid
1) Invasion of the lung by pathogenic by pathogenic heat is the cause of thirst.
wind Clinical manifestations: Invasion Upward disturbance of wind heat gener-
of the lung by wind cold displays such ates sore throat. The invasion of the body
signs as cough with mucoid sputum, ab- surface by wind heat impedes wei (defen-
308 CHINESE ACUPUNCTURE AND MOXIBUSTION

sive) qi, which explains heat sensation of pus; chest pain on coughing, dryness of
the body, aversion to wind and headache. the mouth, yellow urine, constipation, a
A thin, yellow tongue coating and a su- red tongue with yellow sticky coating and
perficial, rapid pulse are both signs of a rolling rapid pulse.
wind heat affecting the body surface. Etiology and pathology: This syn-
2) Retention of phlegm damp in the drome is often due to invasion of exoge-
lung Clinical manifestations: Cough nous pathogenic wind heat, or invasion
with much frothy or white, sticky spu- of wind cold which goes to the interior of
tum, fullness and stuffiness in the chest, the body and turns into heat after a peri-
gurgling with sputum in the throat, od of retention. Heat in the lung changes
shortness of breath or asthmatic breath- body fluid into phlegm by condensation.
ing; orthopnea in severe cases; white The phlegm and heat intermingle and
sticky tongue coating and a rolling pulse. impair the descending function of the
Etiology and pathology: This syn- lung, the result being cough, asthmatic
drome is often due to recurrent attacks of breathing, chest pain and yellow, thick
cough following exposure to exogenous sputum. Phlegm heat blocks the vessels
pathogenic factors. This impairs the of the lung, which leads to decomposition
lung's function in disseminating body and thereby produces pus, effecting ex-
fluid, the accumulation the syndrome pectoration of bloody pus. Consumption
may result from the dysfunction of the of body fluid by pathogenic heat gives
spleen in transportation, which leads to rise to dryness of the mouth and yellow
the formation of phlegm damp. When urine. Failure of the lung qi in descend-
this remains in the lung, the above symp- ing is the cause of constipation. Yellow,
toms will be induced or become worse sticky tongue coating, a red tongue and a
on exposure to pathogenic wind cold. rolling, rapid pulse are all signs of reten-
Phlegm damp blocks the passage of qi tion of phlegm heat in the interior.
and impairs the function of the lung qi, 4) Deficiency of the lung qi Clinical
bringing on cough with much sputum, manifestation: Feeble cough, shortness
stuffiness in the chest, asthmatic brea- of breath which is worse on exertion,
thing, gurgling with sputum in the clear dilute sputum, lassitude, lack of
throat, and in severe cases, orthopnea. desire to talk, low voice, aversion to wind,
Expectoration of frothy or white, sticky frigid appearance, spontaneous sweating,
sputum, white, sticky tongue coating and a pale tongue with thin white coating and
a rolling pulse are all signs of retention a weak pulse of the deficient type.
of phlegm damp in the interior. Etiology and pathology: This syn-
3) Retention of phlegm heat in the lung drome is often due to a prolonged cough
Clinical manifestations: Cough, asthmat- which damages the qi and gradually leads
ic and coarse breathing; flapping of ala to weakness of the lung qi. Or it may be
nasi in severe cases; yellow, thick sputum due to overstrain and stress, or to weak-
or expectoration of foulsmelling bloody ness of yuan (primary) qi after a pro-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 309

longed illness, either of which may cause being cough with a small amount of spu-
insufficiency of lung qi and impairment tum, dryness of the mouth and throat.
of the lung's function in dominating qi. Injury of the lung vessels by cough pro-
Feeble cough results from weakness of duces blood tinged sputum. Deficiency of
the lung qi and impairment of the lung's yin leads to hyperactivity of fire, result-
function in dominating qi and in descend- ing in afternoon fever, malar flush, night
ing. Shortness of breath and asthmatic sweating and heat sensations in the palms
breathing are the outcome of lack of qi and soles. A red tongue with a small
following impairment of the lung's func- amount of coating, and a thready rapid
tion in dominating qi. Insufficiency of pulse are both signs of heat due to defi-
the lung qi does not allow the qi to per- ciency of yin.
form its function in distributing body 6) Damp heat in the large intes-
fluid, the accumulation of which forms tine Clinical manifestations: Abdom-
clear and dilute sputum. Weakness of wei inal pain, tenesmus; blood and mucus in
(defensive) qi at the body surface pro- the stools, or, diarrhoea with yellow,
duces aversion to wind, frigid appear- watery stools; a burning sensation of
ance, spontaneous sweating. Lassitude, the anus; scanty deep-yellow urine; pos-
lack of desire to talk, low voice, a pale sible fever and thirst; a yellow, sticky
tongue with thin, white coating and a tongue coating and a rolling rapid pulse
weak pulse of the deficient type are all or soft rapid pulse.
signs of deficiency of qi. Etiology and pathology: This syn-
5) Insufficiency of the lung yin Clin- drome often occurs in summer and au-
ical manifestations: Unproductive cough, tumn when pathogenic summer heat,
cough with a small amount of sticky spu- damp and toxic heat invade the intestines
tum, or cough with blood tinged sputum; and stomach. It may also be due to irre-
dryness of the mouth and throat, after- gular food intake, excessive eating of raw
noon fever, malar flush, night sweating, and cold food, or intake of unclean food,
heat sensations in the palms and soles, a all of which may injure the spleen, stom-
red tongue with a small amount of coat- ach and intestines. Abdominal pain is the
ing and a thready rapid pulse. outcome of retention of pathogenic damp
Etiology and pathology: This syn- heat in the intestines, which results in
drome is often due to a prolonged cough retardation of qi circulation. Damp heat
which consumes the lung yin; to over- injures the blood vessels of the intestinal
strain and stress; or to invasion of exog- tract and thus creates blood and mucus in
enous pathogenic dryness which causes the stools. Retention of damp heat in
insufficiency of the lung yin and, further, the large intestine impairs its function
the production of deficiency type heat in of transmission, eliciting diarrhoea with
the interior. Consumption of yin deprives yellow, watery stools, burning sensation
the lung of moisture and allows upward in the anus and scanty, deep yellow urine.
disturbance of the lung qi, the result Consumption of body fluid by excessive

-------------- ---------------- --
310 CHINESE ACUPUNCTURE AND MOXIBUSTION

heat gives rise to fever and thirst. Yellow, or even-movement methods. The Back-
sticky tongue coating and a rolling, rapid Shu, Front-Mu and Lower He-Sea points
pulse or a soft, rapid pulse are all signs are mainly used to treat syndromes of the
of retention of damp heat in the inte- large intestine. As the large intestine is
rior. closely related to the spleen and stomach
7) Consumption of the fluid of the in its physiological functions, the rele-
large intestine Clinical manifestations: vant points of the Stomach Meridian of
Dry stools, constipation, dryness of the Foot-Yangming and of the Spleen Merid-
mouth and throat, a red tongue with little ian of Foot-Taiyin may be added accord-
moisture or with dry yellow coating and ing to the symptoms and signs.
a thready pulse.
Etiology and pathology: The syn- 3. Syndromes of the Spleen
drome often occurs to people in old age, and Stomach
to women after delivery, or in the late
stage of a febrile disease when there is The spleen functions to dominate
consumption of body fluid. Insufficiency transportation and transformation and
of fluid in the large intestine leads to control blood. When its qi ascends,
dryness, thus constipation ensues. Dry- its function is normal. So pathological
ness of the mouth and throat, a red changes of the spleen often manifest as
tongue with little moisture or with dry dysfunction in transportation and trans-
yellow coating and a thready pulse are all formation and in controlling blood and as
signs of deficiency type heat due to con- sinking of the spleen qi.
sumption of fluids. The stomach functions to receive and
To treat syndromes of the lung, points digest food. When its qi descends, its
of the Lung Meridian of Hand-Taiyin function is normal. So pathological
and its Back-Shu Point are often used as changes of the stomach often manifest as
main points. To treat its syndromes of dysfunction of its qi in descending and as
excess type, points of the Large Intes- poor digestion.
tine Meridian of Hand-Yangming may The spleen and stomach dominate re-
be used in addition. Reducing manipula- ception, digestion, transportation and
tion method is applied; cupping or bleed- transformation by sending the "clear" up-
ing methods may also be used to promote wards and bringing down the "turbid."
smooth circulation of the qi of meridians They serve as the source of qi and blood,
and to restore the functions of the lung which nourish the whole body. That is
qi in dispersing and descending. The why the spleen and stomach are called
lung's syndromes of deficiency type are the "source of acquired constitution."
treated by combining points of the in- 1) Deficiency of the spleen qi Clinical
volved meridians, such as the Spleen Me- manifestations: Sallow complexion, ema-
ridian of Foot-Taiyin and the Kidney Me- CIatIOn, lassitude, dislike of speaking,
ridian of Foot-Shaoyin, with reinforcing reduced appetite, abdominal distension,
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 311

loose stools; or a bearing-down sensation function in transportation and transfor-

in the abdominal region, viscera ptosis, mation, which produces an insufficient
prolapse of the anus; a pale tongue with source of qi and blood, that explains
thin white coating and a slowing-down pale complexion, lassitude and dislike of
weak or soft thready pulse. speaking. Weakness of the spleen qi indi-
Etiology and pathology: The syn- cates inability of the spleen to control
drome is due to weakness after a pro- blood, which leaks from the vessels and
longed illness, to overstrain and stress or thus elicits purpura, bloody stools, exces-
to improper diet, all of which damage the sive manstrual flow and uterine bleeding.
spleen qi. Weakness of the spleen qi im- A pale tongue and a thready weak pulse
plies hypofunction in transportation and are both signs of deficiency of qi and
transformation, which gives rise to re- blood.
duced appetite, abdominal distension and 3) Deficiency of the spleen yang Clin-
loose stools. Dysfunction of the spleen in ical manifestations: Pallor, the four limbs
transportation and transformation pro- being not warm; poor appetite; abdomin-
duces an insufficient source of qi and al distension which is worse after eat-
blood, the result being sallow complex- ing or dull pain in the abdominal re-
ion, emaciation, lassitude and dislike of gion which is better with warmth and
speaking. Weakness after a prolonged ill- pressure; loose stools; a pale and delicate
ness hinders the spleen qi in ascending, tongue with white coating and a deep
and instead it sinks, resulting in bearing- slow pulse.
down sensation in the abdominal region Etiology and pathology: This syn-
and possible prolapse of the uterus, pro- drome is a further development of defi-
lapse of the anus, gastroptosis or renal ciency of the spleen qi. It may also result
ptosis. A pale tongue with thin white from the intake of excessive raw and cold
coating, and a slowing-down weak pulse food or greasy and sweet food: or from
or a soft thready pulse are all signs of excessive administration of herbs of cold
deficiency of qi. nature, both of which damage the spleen
2) Dysfunction of the spleen in controll- yang. Deficiency of the spleen yang im-
ing blood Clinical manifestations: Pale pairs the spleen's function in transporta-
complexion, lassitude, dislike of speak- tion and transformation, bringing on re-
ing, purpura, bloody stools, excessive duced appetite, abdominal distension and
menstrual flow, uterine bleeding, a pale loose stools. Insufficiency of the spleen
tongue and a thready weak pulse. yang causes stagnation of yin cold and
Etiology and pathology: This syn- blockage of qi, the result being a dull
drome is due to weakness after a pro- pain in the abdominal region. The patient
longed illness, or to overstrain and stress, likes warmth and pressure in a cold syn-
either of which may weaken the spleen's drome of deficiency type. Deficiency of
function in controlling blood. Deficiency the spleen yang is unable to warm up the
of the spleen implies impairment of its qi and blood and to promote their smooth
312 CHINESE ACUPUNCTURE AND MOXIBCSTJON

circulation, thus pallor ensues and the face, eyes and skin; loose stools, scanty,
four limbs are not warm. A pale and yellow urine, yellow, sticky tongue coat-
delicate tongue with white coating and a ing and a soft rapid pulse.
deep slow pulse are both signs of defi- Etiology and pathology: This syn-
ciency of the spleen yang. drome is often due to invasion of exoge-
4) Invasion of the spleen by cold damp nous pathogenic damp heat. It may also
Clinical manifestations: Fullness and dis- result from excessive indulgence in grea-
tension in the epigastrium and abdomen, sy and sweet food, or alcoholic drinking,
loss of appetite, sticky saliva, heaviness all of which may produce damp heat in
of the head and body, loose stools or the interior. Retention of damp heat in
diarrhoea, white sticky tongue coating the stomach and spleen impairs their
and a soft pulse. functions in reception, digestion, trans-
EtiOlogy and pathology: This syn- portation and transformation, causing
drome may be due to wading in water, fullness and distension in the epigastrium
being caught in the rain, sitting and and abdomen, loss of appetite, nausea,
sleeping in a damp place or excessive vomiting and loose stools. Excessive
eating of raw and cold food. The syn- damp heat gives rise to a sticky and bitter
drome may also result from excessive taste in the mouth and scanty yellow
endogenous damp. In all these cases, the urine. As damp is characterized by heavi-
yang of the middle energizer may be ness and viscosity, blockage of the qi by
strained and the function of the spleen damp leads to heaviness of the body and
in transportation and transformation im- lassitude. Damp heat stirs up the bile
paired. Invasion of the spleen by cold which, therefore, permeats the muscles
damp impairs the spleen's function in and skin, presenting bright yellow face,
transportation and transformation, re- eyes and skin. Yellow sticky tongue coat-
sulting in fullness and distension in the ing and a soft rapid pulse are both signs
epigastrium and abdomen, loss of appe- of retention of damp heat in the interior.
tite, loose stools or diarrhoea. As damp is 6) Retention of food in the stomach
characterized by heaviness and viscosi- Clinical manifestations: Distension, full-
ty, blockage of the cold damp produces ness and pain in the epigastrium and
sticky saliva, and heaviness of the head abdomen, foul belching sour regurgita-
and body. White, sticky tongue coating tion, and anorexia, vomiting and hesi-
and a soft pulse are both signs of exces- tant bowel movements, thick and sticky
sive damp in the interior. tongue coating, rolling pulse.
S) Damp heat in the spleen and stomach Etiology and pathology: This syn-
Clinical manifestations: Fullness and dis- drome may be due to irregular food
tension in the epigastrium and abdomen, intake, voracious eating or eating of
loss of appetite, nausea, vomiting, bitter food which is difficult to digest. Reten-
taste and stickiness in the mouth, heavi- tion of food in the stomach blocks the
ness of the body, lassitude; bright yellow qi passage in the epigastrium and abdo-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 313

men and thus causes distension, fullness yang complicated with retention of cold
and pain there. Dysfunction in digesting and fluid in the interior.
food brings the turbid qi upward, which 8) Hyperactivity of fire in the stomach
is the cause of foul belching, sour re- Clinical manifestations: Burning sensa-
gurgitation, anorexia and vomiting. Re- tion and pain in the epigastric region;
tention of the turbid part of the food sour regurgitation and an empty and un-
blocks the large intestine and impairs comfortable feeling in the stomach; thirst
its function in transmission, resulting in with preference for cold drinks; vora-
hesitant bowel movements. Thick, sticky cious appetite and getting hungry easily;
tongue coating and a rolling pulse are vomiting, foul breath; swelling and pain
both signs of retention of food. or ulceration and bleeding of the gums;
7) Retention of fluid in the stomach due constipation, scanty yellow urine; a red
to cold Clinical manifestation: Epigas- tongue with yellow coating and a rapid
tric fullness and pain which are worse on pulse.
exposure to cold and better to warmth; Etiology and pathology: This syn-
reflux of clear fluid or vomiting after drome may result from excessive eating
eating; white, slippery tongue coating of hot and greasy food which turns into
and a slow pUlse. heat and fire, or from emotional depres-
Etiology and pathology: This syn- sion which leads to invasion of the stom-
drome is often due to a constitutional ach by the liver fire. Hyperactivity of fire
deficiency of the stomach yang compli- in the stomach burns body fluid and thus
cated by invasion of exogenous pathogen- produces burning pain in the epigastric
ic cold; or to intake of excessive raw and region and thirst with preference for cold
cold food which causes retention of cold drinks. If obstruction of the liver qi turns
in the stomach. Retention of cold in the into heat, it may impair the function of
stomach blocks the stomach qi and pro- the stomach in descending, thus causing
duces epigastric fullness and pain, which sour regurgitation and an empty and un-
are worse on exposure to cold but better comfortable feeling in the stomach. Hy-
to warmth, for exposure to cold may peractivity of heat in the stomach may
aggravate the retention while exposure to result in hyperfunction of the stomach in
warmth may disperse cold and effect a digesting food, that is the reason for vo-
smooth circulation of qi. Impairment of racious appetite and getting hungry easi-
yang qi in a prolonged disease implies ly. Excessive heat in the stomach may
inability of yang qi to distribute body make the stomach qi disturb upward,
fluid., Thus the retained fluid is formed. vomiting ensues. Since the Stomach Me-
If the retained fluid remains in the stom- ridian traverses the gums, upward dis-
ach and also disturbs upward, reflux of turbance of the stomach fire along the
clear fluid and vomiting after eating fol- meridian causes foul breath, swelling and
low. White, slippery tongue coating and a pain or ulceration and bleeding of the
slow pulse are both signs of deficient gums. Constipation, scanty yellow urine,
_31_4~~~_ _ _~_.~~_~~_ _ _ _ _ _ _ _ _C.::::H-=IN=--='ESE ACL'PUNCTCRE AND MOXIBUSTION

a red tongue with yellow coating, and a Stomach Meridian of Foot-Yangming are
rapid pulse are all signs of hyperactivity used as the main points. They are com-
of fire and heat in the interior. bined with points from the Liver Meridi-
9) Insufficiency of the stomach yin an of Foot-Jueyin and the Pericardium
Clinical manifestations: Burning pain in Meridian of Hand-Jueyin. Reinforcing or
the epigastric region, an empty and un- reducing needling technique, or moxibus-
comfortable sensation in the stomach, tion is applied according to actual condi-
hunger with no desire to eat; or dry vom- tions.
iting and hiccups; dryness of the mouth
and throat; constipation; a red tongue 4. Syndromes of the Liver and
with little moisture and a thready rapid Gallbladder
pulse.
Etiology and pathology: This syn- The liver functions to promote the
drome may be due to hyperactivity of free flow of qi, dominate the tendons and
heat in the stomach which consumes the open into the eye. Pathological changes
stomach yin or to consumption of the yin of the liver mainly manifest themselves
fluid by persistent pathogenic heat at the in dysfunctions of the liver in storing
late stage of a febrile disease. Consump- blood and in promoting the free flow of
tion of the stomach yin deprives the qi, and in disorders of the tendons.
stomach of moisture and impairs its The gallbladder functions to store and
function of descending, the result being excrete the bile and thus assist in the
burning pain in the epigastric region, an digestion of food. The qi of the gallblad-
empty and uncomfortable sensation in der is Closely related to the human emo-
the stomach, dry vomiting and hiccups. tions. Since the gallbladder and liver are
Insufficiency of fluid in the stomach im- externally and internally related, the two
pairs the function of the stomach in re- organs are often diseased at the same
ceiving food, the consequence is hunger time.
with no desire to eat. With Deficiency of 1) Stagnation of the liver qi Clinical
stomach yin the fluids fail to be sent manifestations: Mental depression; irrit-
upwards, creating dryness of the mouth ability; distending or wandering pain in
and throat. Constipation, a red tongue the costal and hypochondriac regions;
with little moisture and thready rapid distension of the breasts; stuffiness in the
pulse are all signs of deficiency of yin chest; sighing; epigastric and abdominal
producing interior heat. distension and pain; poor appetite; belch-
Since the spleen and stomach are re- ing; or possibly a foreign body sensation
lated externally and internally, disease of in the throat; irregular menstruation
either of them often affect the other. The and dysmenorrhea in women; thin white
Back-Shu, Front-Mu, Yuan-Primary, tongue coating and a string-taut pulse. In
Luo-Connecting and He-Sea Points of prolonged cases, there may be pricking
the Spleen Meridian of Foot-Taiyin and pain in the costal and hypochondriac re-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 315

gions or palpable mass may be present. of waves; yellow urine and constipation;
The tongue is purplish dark in colour, or hematemesis, hemoptysis or epistaxis; a
there are purplish spots on the tongue. red tongue with yellow coating and a
Etiology and pathology: The syn- string-taut rapid pulse.
drome is often due to mental irritation Etiology and pathology: This syn-
which impairs the function of the liver in drome may be due to obstruction of the
promoting the free flow of qi and results liver qi turning into fire with upward
in stagnation of the liver qi, leading to disturbance of the qi and fire or to exces-
retardation of the qi circulation, thus sive indulgence in cigarette smoking, al-
presenting mental depression, irritability, coholic drinking or greasy food, which
distending pain in the costal and hypo- may lead to accumulation of heat and
chondriac regions and breasts, stuffiness production of fire. Since fire is character-
in the chest and sighing. Transverse inva- ized by upward movement, the effect of
sion of the spleen and stomach by the the liver fire on the head and eyes may
liver qi produces epigastric and abdomin- prodUce distending pain in the head, diz-
al distension and pain, poor appetite and ziness and vertigo, redness, swelling and
belching. Retardation of the qi circula- pain of the eyes and a bitter taste and
tion allows damp to collect and phlegm dryness in the mouth. The liver relates to
may be formed; the phlegm and qi may the emotion of anger and irritability is
accumulate in the throat, resulting in a the consequence of hyperactivity of the
foreign body sensation in the throat. Af- liver fire. Excessive liver fire burns the
fected by dysfunction of qi, the circula- Liver Meridian and brings about a burn-
tion of both qi and blood is retarded and ing pain at the costal and hypochondriac
disharmony of the Thoroughfare Vessel region. When the liver fire attacks the ear
and Conception Vessel may result. This along the Gallbladder Meridian, there
can cause irregular menstruation and may be tinnitus, which has abrupt onset,
dysmenorrhea. Long standing obstruc- sounds like waves and is not alleviated by
tion of the liver qi, leading to stagnation pressure. The injury of blood vessels by
of qi and blood, may elicit palpable mass- the liver fire may produce hematemesis,
es, accompanied by pricking pain in the hemoptysis or epistaxis. Yellow
costal and hypochondriac regions, a pur- urine, constipation, a red tongue with
ple tongue or a tongue with purplish yellow coating and a string-taut rapid
spots, and a string-taut pulse. pulse are all signs of hyperactivity of the
2) Flare-up of the liver fire Clinical liver fire in the interior.
manifestations: Distending pain in the 3) Rising of the liver yang Clinical
head; dizziness and vertigo; redness, manifestations: Headache with distend-
swelling and pain of the eyes; a bitter ing sensation in the head, dizziness and
taste and dryness in the mouth; irritabil- vertigo, tinnitus, flushed face and red
ity; burning pain in the costal and hypo- eyes, irritability, insomnia with dream-
chondriac regions; tinnitus like the sound disturbed sleep, palpitations, poor memo-
316 CHINESE ACUPUNCTURE AND MOXIBUSTION

ry, soreness and weakness of the low back blood.

and knees, a red tongue and a string-taut a) Liver yang turning into wind Clin-
thready rapid pulse. ical manifestations: Dizziness and verti-
Etiology and pathology: This syn- go, headache, numbness or tremor of the
drome may be due to mental depression, limbs, dysphasia, a red and tremulous
anger and anxiety. They produce obstruc- tongue and a string-taut rapid pulse. In
tion of the liver qi which later turns into severe cases there may be sudden col-
fire. The fire consumes the yin blood in lapse, coma, stiffness of the tongue,
the interior and does not allow yin to aphasia, deviation of the mouth and eye,
restrain yang. The syndrome may also and hemiplegia.
result from constitutional deficiency of Etiology and pathology: This syn-
the yin of the liver and kidney, in which drome often occurs to patients with a
case, the liver yang fails to be restrained. constitutional deficiency of yin and ex-
Excessive ascending of the yang and qi of cess of yang. It may be induced by such
the liver is the cause of headache with factors as drastic emotional changes,
distending sensation in the head, dizzi- overstrain and stress and excessive alcoh-
ness and vertigo and tinnitus. Hyperactiv- olic drinking, all of which may further
ity of the liver yang may produce red- consume yin and give rise to abrupt ris-
ness of the face and eyes, and irritability. ing of yang. Subsequently the liver wind
When there is deficiency of yin leading to is produced. The disturbance of the head
excess of yang, the mind fails to be nour- and eyes by the liver yang produces diz-
ished and the harmonious state of yin ziness, vertigo and headache. The ten-
and yang is broken. As a result, such dons may be deprived of nourishment by
symptoms as palpitations, poor memory, either insufficiency of the liver yin or
insomnia with dream-disturbed sleep en- constitutional excess of phlegm leading
sue. Deficiency of the yin of the liver and to obstruction of qi and blood, and this
kidney deprives the tendons and bones of may cause numbness or tremor of the
nourishment and thus brings on soreness limbs, and dysphasia. Sudden onset of
and weakness of the low back and knees. rising liver yang may stir up wind and
A red tongue and a string-taut rapid produce upward movement of qi and
pulse are both signs of deficiency of yin blood, which, in combination with
leading to hyperactivity of fire. phlegm fire, clouds the "clear cavity," and
4) Stirring of the liver wind in the in- thus creating sudden collapse and coma.
terior The occurrence of such symp- Invasion of the meridians by wind
toms and signs as dizziness and vertigo, phlegm hinders the qi and blood circula-
convulsion, tremor and numbness, as a tion and brings on stiffness of the tongue
part of a process of pathological changes with aphasia, deviation of the mouth and
is referred to as liver wind, which may eye and hemiplegia. A red tongue and a
result from hyperactivity of the liver string-taut rapid pulse are both signs of
yang, extreme heat and deficiency of hyperactivity of the liver yang.
CHAPTER 13 DIFFEREKTIA TION OF SYNDROMES ____________________________~~17

b) Extreme heat stirring wind Clinical invasion of the meridian by cold may
manifestations: High fever, convulsion, block the qi and blood circulation and
neck rigidity, upward staring of the eyes; thus leading to pain. Cold disperses with
in severe cases, opisthotonus, coma and warmth and thus pain is relieved; when
lock jaw; a deep-red tongue and a string- cold accumulates, the pain becomes
taut rapid pulse. worse. White, slippery tongue coating
Etiology and pathology: This syn- and a deep string-taut pulse are both
drome may occur in exogenous febrile signs of interior cold.
diseases where excessive pathogenic heat 6) Insufficiency of the liver blood
stirs up the liver wind. If excessive path- Clinical manifestations: Pallor, dizziness
ogenic heat induces high fever, this may and vertigo, blurring of vision, dryness of
scorch the tendons, producing convul- the eyes, night blindness, numbness of
sion, neck rigidity, upward string of the the limbs, spasms of the tendons, scanty
eyes and opisthotonos. Disturbance of menstrual flow or amenorrhea, a pale
the mind by heat leads to coma. A deep- tongue and a thready pulse.
red tongue and a string-taut rapid pulse Etiology and pathology: This syn-
are both signs of disorders of the liver drome may be due to insufficient produc-
with excessive heat. tion of blood, to excessive loss of blood
c) Deficiency of blood producing wind or to consumption of the liver blood by a
Deficiency of the liver blood deprives the prolonged illness. Deficiency of the liver
tendons of nourishment and thus stirs up blood deprives the heat and the eyes of
deficiency type wind in the interior. For nourishment and may result in pallor,
clinical manifestations, etiology and pa- dizziness and vertigo, blurring of vision,
thology refer to the syndrome of insuffi- dryness of the eyes and night blindness.
ciency of the liver blood. When the liver blood fails to nourish the
S) Retention of cold in the Liver Me- limbs and tendons, there may be numb-
ridian Clinical manifestations: Lower ness of the limbs and spasms of the ten-
abdominal distending pain, with bearing- dons. Insufficiency of the liver blood
down sensation in the testes; contracted empties the sea of blood, th us bringing
scrotum; pain aggravated by cold and on scanty menstrual flow and amenor-
alleviated by warmth; white tongue coat- rhea. A pale tongue and a thready pulse
ing, slippery, deep and string-taut pulse. are the consequence of deficiency of
Etiology and pathology: This syn- blood.
drome is due to invasion of the Liver 7) Damp heat in the liver and gallblad-
Meridian by exogenous pathogenic cold der Clinical manifestations: Hypochon-
which blocks the qi and blood circulation. driac distension and pain, bitter taste in
The Liver Meridian curves around the the mouth, poor appetite, nausea, vomit-
external genitalia and passes through the ing. abdominal distension, scanty and yel-
lower abdominal region. As cold is char- low urine, yellow, sticky tongue coating
acterized by contraction and stagnation, and a string-taut rapid pulse. In addition
318 CHINESE ACUPUNCTL'RE AND MOXIBUSTION

there may be yellow sclera and skin of the pruritus vulvae and yellow foul leukor-
entire body or fever. The occurrence of rhea may result.
eczema of scrotum, swelling and burning The pathological changes of the liver
pain in the testes or yellow foul leukor- cover a wide range. Since the liver and
rhea with pruritus vulvae suggests damp gallbladder are externally and internally
heat in the Liver Meridian. related, disorders of the liver may affect
Etiology and pathology: This syn- the gallbladder, and vice versa. The two
drome may be due to invasion of exoge- organs may th us be diseased at the same
nous pathogenic damp heat or to exces- time. Principally needling is applied to
sive eating of greasy food which produces treat their disorders. Points of the Liver
damp heat in the interior. In either case, Meridian of Foot-Jueyin and Gallblad-
damp heat accumulates in the liver and der Meridian of Foot-Shaoyang are of-
gallbladder. The accumulation of damp ten used, accompanied by relevant points
heat impairs the function of the liver and of the Spleen, Stomach, Kidney, Concep-
gallbladder in promoting the free flow of tion and Governor Vessels according to
qi, causing hypochondriac pain. The up- symptoms and signs.
ward overflow of the qi of the gallbladder Reducing method is used for syn-
leads to a bitter taste in the mouth. The dromes of excess type; reinforcing meth-
accumulation of damp heat also impairs od for syndromes of deficiency type;
the function of the spleen and stomach in even-movement method for syndromes
ascending and descending, eliciting poor complicated between deficiency and ex-
appetite, nausea, vomiting and abdominal cess or syndromes of deficiency of the
distension. Downward infusion of damp root cause with excess of manifestations.
heat into the bladder brings on scanty,
yellow urine. Yellow, sticky tongue coat- 5. Syndromes of the Kidney
ing and a string-taut rapid pulse are both and Bladder
signs of damp heat in the liver and gall-
bladder. Once the function of the liver The kidney functions to store essence,
and gallbladder in promoting the free serving as the source of reproduction and
flow of qi is impaired, the bile, instead development; to dominate water metabol-
of circulating along its normal route, ism, thus maintaining the balance of the
spreads to the exterior and results in yel- body's fluid; to dominate bones and pro-
low sclera and skin of the entire body. duce marrow, thus keeping the bones
The presence of damp heat induces the qi healthy and strong; and to open into the
to stagnate and fever may appear. Since ear, the urinogenital orifice and the anus.
the Liver Meridian curves around the Therefore, the kidney is regarded as the
external genitalia, downward infusion of congenital foundation of life. Pathologi-
damp heat along the Liver Meridian may cal changes of the kidney most often
produce eczema of the scrotum, or swell- manifest as dysfunction in storing ess-
ing and pain of the testes; and in women, ence, disturbance in water metabolism,
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 319

abnormality in growth, development and Clinical manifestations: Pallor, cold

reproduction. limbs, soreness and weakness of the lum-
The physiological function of the bar region and knee joints, impotence,
bladder is to store and discharge urine. infertility, dizziness, tinnitus, a pale
So pathological changes of the bladder tongue with white coating and a deep
chietly manifest as abnormal urination. weak pulse.
1) Deficiency of the kidney qi Clini- Etiology and pathology: This syn-
cal manifestations: Soreness and weak- drome may be due to a constitutional
ness of the lumbar region and knee deficiency of yang, or weakness of the
joints, frequent urination with clear u- kidney in old age. It may also be due to a
rine, dribbling of urine after urination or prolonged illness, or to excessive sexual
enuresis; incontinence of urine in severe activity, both of which may injure the
cases; spermatorrhea and premature eja- kidney and produce deficiency of the kid-
culation in men; clear, cold leukorrhea in ney yang. In yang deficiency, the warm-
women; a pale tongue with white coating ing function of yang is impaired, hence
and a thready weak pulse. cold limbs and pallor. Deficiency of the
Etiology and pathology: This syn- kidney yang deprives the bones, ears,
drome may be due to weakness of the brain, marrow of nourishment and may
kidney qi in old age or insufficiency of cause soreness of the lumbar region and
the kidney qi in childhood. It may also weakness of the knee joints, dizziness and
result from overstrain and stress, or pro- tinnitus. When the kidney yang is insuf-
longed illnesses, both of which may lead ficient, the reproductive function is im-
to weakness of the kidney qi. As the paired with impotence in men, and in-
kidney resides in the lumbar region, when fertility (due to cold uterus) in women
the kidney qi is deficient, it may fail to resulting. A pale tongue with white coat-
nourish this area and give rise to soreness ing and a deep weak pulse are both sings
and weakness of the lumbar region and of insufficiency of the kidney yang.
knee joints. Weakness of the kidney qi 3) Insufficiency of the kidney yin
implies an inability of the bladder to con- Clinical manifestations: Dizziness, tinni-
trol urination, hence frequent urination tus, insomnia, poor memory, soreness
with clear urine, dribbling after urina- and weakness of the lumbar region and
tion, enuresis and incontinence of urine. knee joints, nocturnal emission, dryness
Deficiency of the kidney qi weakens its of the mouth, afternoon fever, malar
function of storage, and thus spermator- flush, night sweating, yellow urine, con-
rhea, premature ejaculation, and clear, stipation, a red tongue with little coating
cold leukorrhea result. A pale tongue and a thready rapid pulse.
with white coating and a thready weak Etiology and pathology: This syn-
pulse are both signs of deficiency of the drome may be due to a prolonged illness,
kidney qi. or to excessive sexual activity. It may also
2) Insufficiency of the kidney yang occur in the late stage of febrile diseases.
320 CHI1\ESE ACL'PU1'\CTURE A1'\O MOXIIlUSTI01'\

In these cases the kidney ym IS con- m the urine form stones, which cause
sumed. Deficiency of the kidney yin sudden discontinuation of urination in
weakens the kidney in its function of mid-stream, turbid urine of stones in the
producing marrow, dominating bones urine. Damp heat may injure the vessels
and nourishing the brain; the result is and thus hematuria occurs. Blockage of
dizziness, tinnitus, poor memory, sore- the bladder is the cause of lower abdom-
ness and weakness of the lumbar region inal distension and fullness. Since a disor-
and knee joints. Deficiency of yin pro- der of a fu organ may affect its corres-
duces endogenous heat, hence afternoon ponding zang organ, lumbago appears.
fever, malar flush, night sweating, dry- Yellow sticky tongue coating and a rapid
ness of the mouth, yellow urine and con- pulse are both signs of accumulation of
stipation. Disturbance in the interior by dam p heat in the interior.
heat of the deficiency type is the cause of When the kidney yin and kidney yang
nocturnal emission. Disturbance of the are properly stored and kept from leak-
mind by heat leads to insomnia. A red ing, the kidney functions effectively. Syn-
tongue with little coating and a thready
dromes of the kidney are mostly of de-
rapid pulse are both signs of deficiency of
ficiency type; and this is reflected in
yin leading to endogenous heat.
treatment. The Back-Shu Point of the
4) Damp heat in the bladder Clinical
kidney and points of the Conception and
manifestations: Frequency and urgency
Governor Vessels and the Meridian of
of urination, burning pain in the urethra,
Foot-Shaoyin are mainly selected. Points
dribbling urination or discontinuation of
of the Spleen Meridian of Foot-Taiyin,
urination in mid-stream; turbid urine,
Stomach Meridian of Foot-Yangming,
deep-yellow in colour, hematuria; or
Liver Meridian of Foot-Jueyin and Lung
stones in the urine; possible lower ab-
dominal distension and fullness or lum- Meridian of Hand-Taiyin are used in
bago; yellow sticky tongue coating and a combination. Moxibustion and reinforc-
rapid pulse. ing needling technique are applied for
Etiology and pathology: This syn- deficiency of yang qi. Only needling with
drome may be due to invasion of exoge- reinforcing or even-movement technique
nous pathogenic damp heat which accu- is applied for deficiency of yin. Since the
mulates in the bladder. It may also result syndromes of the bladder often involve
from excessive eating of hot, greasy and the kidney, the two organs are often
sweet food, leading to downward infusion treated at the same time. The Back-Shu
of damp heat to the bladder. Accumula- Point and Front-Mu Point of the bladder
tion of damp heat impairs the function of and points of the Conception Vessel, the
the bladder, resulting in frequency and Kidney Meridian of Foot-Shaoyin and
urgency of urination, burning pain in the Spleen Meridian of Foot-Taiyin are nee-
urethra, dribbling urination and yellow dled with even-movement or reducing
urine. Condensed by heat, the impurities method.
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 321

6. Complicated Syndromes of harmony between the heart and kidney

Zang-Fu Organs leads to disturbance of deficiency type
fire and produces weakness in controlling
Syndromes in which two organs or the release of sperm with the symptom of
more are diseased at the same time, or in spermatorrhea in dreams. A dry throat,
succession, are known as "complicated tidal fever, night sweating, a red tongue
syndromes." The commonly seen compli- with little coating and a thready rapid
cated syndromes of the zang-fu organs pulse are all signs of deficiency of yin
are described as follows. leading to hyperactivity of fire.
1) Disharmony between the heart and 2) Deficiency of the qi of the lung and
kidney Clinical manifestations: Mental kidney Clinical manifestations: Asth-
restlessness, insomnia, palpitations, poor matic breathing, shortness of breath, and
memory, dizziness, tinnitus, dryness of more exhalation than inhalation, all of
the throat, soreness of the lumbar re- which become worse on exertion; low
gion, spermatorrhea in dreams, tidal fe- voice, cold limbs, blue complexion, spon-
veL. night sweating, a red tongue with taneous sweating, incontinence of urine
little coating and a thready rapid pulse. due to severe cough; a pale tongue with
Etiology and pathology: The syn- thin coating and a weak pulse of deficien-
drome is often due to prolonged illnesses, cy type.
overstrain and stress, or excessive sexual Etiology and pathology: This syn-
activity, all of which may injure the yin drome is often due to prolonged cough
of the heart and kidney. It may also result which affects the lung and kidney in suc-
from drastic emotional changes leading cession, resulting in deficiency of qi of
to obstruction of qi which turns into fire. both organs. It may also be due to over-
The heart fire may become hyperactive in strain and stress which injures the kidney
the upper part of the body and fail to qi and impairs the kidney's function of
infuse downwards to harmonize the kid- receiving qi. The lung controls respira-
ney. The resulting imbalance between the tion and the kidney dominates the recep-
heart and kidney disturbs the regulation tion of qi. "The lung is the commander of
of water and fire. When the kidney yin is qi and the kidney is the root of qi." With
insufficient, it may fail to rise up to deficiency of the qi of the lung and kid-
harmonize the heart. The resulting hy- ney, there may be asthmatic breathing,
peractivity of the heart fire may disturb shortness of breath, and more exhala-
the mind and manifest as mental rest- tion than inhalation, all of which be-
lessness, insomnia and palpitations. Con- come worse on exertion. Deficiency of
sumption of the kidney essence leads to the lung leads to weakness of zong (pec-
emptiness of the sea of marrow and pro- toral) qi, causing low voice. Yang qi,
duces dizziness, tinnitus and poor memo- being deficient, fails to warm up the ex-
ry. Undernourishment of the lumbar terior, resulting in cold limbs and a blue
region causes soreness of the back. Dis- complexion. Deficiency of qi may cause

----- --- --- - --------------

322 CHINESE ACUPl'NCTURE AND MOXIBUSTION

weakness of wei ( defensive) yang, which both signs of deficiency of yin producing
explains spontaneous sweating. Weakness endogenous heat.
of the kidney qi may impair the function 4) Deficiency of the yin of the liver and
of the bladder in controlling urine, incon- kidney Clinical manifestations: Diz-
tinence of urine in coughing appears. A ziness, blurring of vision, dryness of the
pale tongue with thin coating and a weak throat, tinnitus; heat sensation in the
pulse of deficiency type are both signs of chest, palms and soles; soreness and
deficiency of yang qi. weakness of the lumbar region and knee
3) Deficiency of the yin of the lung and joints; malar flush, night sweating; noc-
kidney Clinical manifestations: Cough turnal emission; scanty menstrual flow; a
with a small amount of sputum, or with red tongue with little coating and thready
bloodtinged sputum; dryness of the rapid pulse.
mouth and throat; soreness and weakness Etiology and pathology: This syn-
of the lumbar region and knee joints; drome is often due to drastic emotional
tidal fever, malar flush, night sweating, changes and overstrain and stress which
nocturnal emission; a red tongue with injure yin blood; or to a prolonged illness
little coating and a thready rapid pulse. which consumes the yin of the liver and
Etiology and pathology: This syn- kidney. Deficiency of the yin of the liver
drome is often due to prolonged cough and kidney deprives the head and eyes
which injures the lung, giving rise to of nourishment and thus produces dizzi-
insufficiency of the yin fluid, which ness, blurring of vision and tinnitus. De-
spreads from the lung to the kidney. ficiency of yin produces endogenous heat
It may also result from overstrain and and thus results in heat sensation in the
stress, which consumes the kidney yin chest, palms and soles, malar flush, night
and thus prevents the kidney yin from sweating, dryness of the throat, a red
nourishing the lung. In either case, defi- tongue with little coating and a thready
ciency of the yin of both organs results. rapid pulse. Disturbance by deficiency
Insufficiency of the lung yin deprives the type fire in the interior causes nocturnal
lung of moisture, resulting in cough with emission. Deficiency of the yin of the
a small amount of sputum and dryness of liver and kidney leads to a disturbance of
the mouth and throat. Deficiency of yin the regulation of the Thoroughfare and
produces endogenous heat eliciting tidal Conception Vessels, hence the scanty
fever, malar flush and night sweating. menstrual flow.
Injury of the lung vessels by deficiency S) Deficiency of the yang of the spleen
type heat may produce blood-tinged spu- and kidney Clinical manifestations: Pal-
tum. Insufficiency of the kidney yin lor, cold limbs; soreness and weakness of
brings on soreness and weakness of the the lumbar region and knee joints; loose
lumbar region and knee joints, and noc- stools or diarrhoea at dawn; facial puffi-
turnal emission. A red tongue with little ness and edema of the limbs; a pale swol-
coating and a thready rapid pulse are len delicate tongue with thin white coat-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 323

ing and a deep weak pulse. that is the reason for general lassitude.
Etiology and pathology: This syn- Deficiency of qi does not allow normal
drome is often due to a prolonged illness distribution of body fluid, the accumula-
which consumes qi and injures yang, the tion of which forms phlegm damp. The
disease spreading from the spleen to the retention of phlegm damp in the lung
kidney. It may also result from deficiency impairs the lung's function in descending
of the kidney yang with the spleen yang and thus produces cough with profuse,
failing to be warmed and thus producing dilute and white sputum. Dysfunction of
injury of the yang qi of both organs. the spleen in transportation manifests as
Dysfunction of the yang of the spleen poor appetite and loose stools. Deficiency
and kidney in providing warmth causes of both the lung and spleen impairs the
pallor, cold limbs and soreness and weak- function of qi in circulating fluid, result-
ness of the lumbar region and knee ing in accumulation of harmful water
joints. Insufficiency of yang qi does not and damp and producing facial puffiness
allow normal digestion, transportation and edema of feet. A pale tongue with
and transformation of food; the result is white coating and a weak pulse are both
loose stools or diarrhoea at dawn. De- signs of deficiency of qi.
ficiency of yang qi implies inability to 7) Imbalance between the liver and
transport and transform body fluid; the spleen Clinical manifestations: Disten-
result is accumulation of harmful water sion, fullness and pain in the costal and
and damp on the body surface, which hypochondriac regions; mental depres-
manifests as facial puffiness and edema sion or irritability; poor appetite, abdom-
of the limbs. A pale swollen and delicate inal distension, loose stools; thin tongue
tongue with thin white coating and a coating and a string-taut pulse.
deep, weak pulse are both signs of defi- Etiology and pathology: This syn-
ciency of yang. drome is often due to injury of the liver
6) Deficiency of the qi of the lung and by mental depression or irritation, or to
spleen Clinical manifestations: Gener- injury of the spleen by irregular food
al lassitude; cough with profuse, dilute, intake or overstrain and stress. In both
white sputum; poor appetite, loose cases, the liver qi invades the spleen
stools; in severe cases, facial puffiness transversely, resulting in an imbalance
and edema of the feet; a pale tongue with between the two organs. Dysfunction of
white coating. the liver in promoting the free flow of qi
Etiology and pathology: This syn- produces distension, fullness and pain in
drome is often due to prolonged cough the costal and hypochondriac regions,
which may cause deficiency of the lung mental depression or irritability. Invasion
and later affect the spleen; or the defi- of the spleen by the liver qi impairs the
ciency of the spleen which weakens the spleen's function of transportation; poor
source of the lung qi. Deficiency of qi appetite, abdominal distension and loose
implies hypofunction of zang-fu organs; stools result. A string-taut pulse is a sign
324 CHINESE ACUPUNCTURE AND MOXIBl?STION

of liver disorders. after an illness; chronic hemorrhage; or

8) Disharmony between the liver and worry, overstrain and stress. In any case,
stomach Clinical manifestations: Dis- the heart blood is consumed and the
tension and pain in the costal, hypochon- spleen qi is weakened. On the other hand,
driac and epigastric regions; belching, a weakness of the spleen qi may fail to
acid regurgitation, an empty and uncom- provide a source for the production of qi
fortable sensation in the stomach; mental and blood, and thus make the heart blood
depression or irritability; a thin tongue even more deficient. Deficiency of qi and
coating and a string-taut pulse. blood causes sallow complexion, general
Etiology and pathology: This syn- lassitude, a pale tongue with thin, white
drome is often due to injury of the liver coating and a thready, weak pulse. Defi-
by mental depression or irritation, and ciency of the heart blood deprives the
injury of the stomach by irregular food heart and mind of nourishment, eliciting
intake or overstrain and stress. The re- palpitations, poor memory, insomnia and
sulting hyperactivity of the liver and dream-disturbed sleep. When deficiency
weakness of the stomach, therefore, leads of the spleen impairs its function of
to disharmony between the liver and transportation, there may be reduced ap-
stomach. Dysfunction of the liver in pro- petite, abdominal distension and loose
moting the free flow of qi produces men- stools. Deficiency of qi and blood may
tal depression or irritability, and disten- weaken the Thoroughfare Vessel, and
sion, fullness and pain in the costal and manifest as scanty menstrual flow or
hypochondriac regions. Invasion of the even amenorrhea. Weakness of the spleen
stomach by the liver qi impairs the des- qi implies inability of the spleen in con-
cending function of the stomach, mani- trolling blood, and thus results in profuse
festing as distension and pain in the menstrual flow.
epigastric region, belching, acid regurgi- 10) Invasion of the lung by the liver fire
tation and an empty and uncomfortable Clinical manifestations: Burning pain in
sensation in the stomach. A string-taut the costal and hypochondriac regions;
pulse is a sign of disorders of the liver. paroxysmal cough or even hemoptysis in
9) Deficiency of both the heart and severe cases; quick temper, irritability,
spleen Clinical manifestations: Sallow restlessness, heat sensation in the chest,
complexion, general lassitude, palpita- bitter taste in the mouth; dizziness, red
tions, poor memory, insomnia, dream- eyes; a red tongue with thin yellow coat-
disturbed sleep, reduced appetite, abdom- ing and a string-taut rapid pulse.
inal distension, loose stools; irregular Etiology and pathology: This syn-
menstruation in women; a pale tongue drome is often due to mental depres-
with thin white coating and a thready sion leading to obstruction of the liver
weak pulse. qi which turns into fire. The upward
Etiology and pathology: This syn- invasion of the lung by the liver fire
drome may be due to poor recuperation results in this syndrome. Obstruction of
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 325

qi turns into hyperactive fire and impairs concerned, there are two categories,
the liver's function in promoting the free namely, febrile pathogens, and damp
flow of qi, manifesting as burning pain heat. Pathological changes resulting from
in the costal and hypochondriac regions, febrile pathogens are analysed with the
quick temper and irritability. Upward in- theory of wei, qi, ying and xue, while the
vasion of the lung by the liver qi and fire differentiation of pathological changes
impairs the lung's descending function, due to damp heat is described below.
leading to paroxysmal cough. Injury of 1) Damp heat in the upper energizer
the vessels of the lung by fire and heat Damp heat in the upper energizer is the
creates hemoptysis. Flaring up of the liv- early stage of invasion of the organism by
er fire gives rise to restlessness, heat sen- damp heat. The disease is often located in
sation in the chest, bitter taste in the the lung, skin and hair. As damp is close-
mouth, dizziness and red eyes. A red ly related to the spleen and stomach,
tongue with thin yellow coating and damp heat in the upper energizer is often
string-taut rapid pulse are both signs of accompanied by symptoms and signs of
hyperactivity of the liver fire in the inte- these two organs. The main clinical man-
rior. ifestations are severe aversion to cold,
mild fever or absence of fever, a heavy
Appendix: Differentiation of sensation in the head as if it were tight-
syndromes according to the theory of ly wrapped by a cloth, heaviness of the
the triple energizer limbs and trunk, a stifling sensation in
the chest, absence of thirst, dull facial
Differentiation of syndromes accord- expression, epigastric fullness and disten-
ing to the theory of the triple energizer. sion, poor appetite, borborygmus, loose
This method of differentiation is stools, white sticky tongue coating and a
based upon the method of differentiating soft slowing-down pulse.
syndromes according to the theory of This syndrome is often due to inva-
wei, qi, ying and xue in conjunction sion of pathogenic damp which remains
with the principles governing transmis- in the muscles and body surface, and
sion and transformation of acute febrile blocks the spleen qi internally. Invasion
diseases. of the muscles and body surface by path-
Acute febrile diseases result from the ogenic damp hinders wei yang, resulting
invasion of different febrile pathogens in in severe aversion to cold, although accu-
the four seasons of a year. There are mulation of damp heat may also lead to
various types of acute febrile diseases fever. Heaviness of the head as if it were
with different features, for the invading tightly wrapped by a cloth is found when
pathogenic factors in the four seasons are damp in the muscles and body surface
different and the patients' constitutional causes heaviness of the limbs and trunk.
reaction to these pathogenic factors va- Obstruction by damp of yang qi in the
ries. So far as the nature of the disease is chest produces a stifling sensation in the
326 CHINESE ACUPUNCTURE AND MOXIBUSTION
-------

chest. Since excessive damp does not con- there may be heaviness of the limbs and
sume body fluids, no thirst appears. The trunk, distension and fullness in the chest
turbid damp clouding the clear yang and epigastrium, nausea, vomiting, anor-
gives rise to dull facial expression. Reten- exia, thirst with desire to drink only a
tion of damp in the spleen and sto- little, scanty and deep-yellow urine, loose
mach impairs their functions of re- but hesitant stools; and in severe cases,
ception, digestion, transportation and dull facial expression with few words
transformation, manifesting as epigastric said or mental cloudiness; a sticky white
fullness and distension, poor appetite, tongue coating with a yellow tinge and a
borborygmus and loose stools. As this is soft rapid pulse.
still at the early stage of the disease, This syndrome may result from trans-
damp has not yet turned into heat. Damp mission of damp heat in the upper ener-
obstructing qi circulation produces sticky gizer, or from invasion of pathogenic
white tongue coating and a soft slowing- summer heat and damp. In either case the
down pulse. spleen and stomach are injured. It may
If damp has not turned into heat, the also be due to improper diet which pro-
method of treatment is to warm and dis- duces damp heat. Excessive damp heat
perse damp on the exterior and in the with heat wrapped in damp gives rise to
interior. If heat signs are already pro- fever which is indistinct at the first touch
nounced, the method of treatment is to of the skin, and becomes pronounced af-
disperse heat and resolve damp. In acu- ter being felt for a rather long time; and
puncture treatment, points are mainly se- to fever which is worse in the afternoon.
lected from the Yangming Meridians of Damp heat is lingering and difficult to be
Hand and Foot and the Taiyin Meridians resolved, this is the cause of recurrent
of Hand and Foot according to symptoms fever. Retention of damp heat causes re-
and signs. tardation of qi circulation and hence dys-
2) Damp heat in the middle energizer function in ascending and descending.
Damp heat in the middle energizer is This results in distension and fullness in
the middle stage of a damp heat di- the chest and epigastrium, nausea, vom-
sease, which exhibits mainly symptoms iting and anorexia. Heat consumes body
and signs of invasion of the spleen and fluid, but as damp dominates over heat,
stomach by damp. Obstruction of the there is a thirst with desire to drink only
middle energizer may affect both the up- a little. Retention of damp heat in the
per and lower energizer, thus manifesting middle energizer impairs the spleen's
as fever which is indistinct at the first function in transportation. This aspect of
touch of the skin, but becomes pro- retardation of qi circulation is evidenced
nounced after being felt for a rather long in the scanty and deep-yellow urine and
time; or fever which recurs after reduced the loose but hesitant stools. Obstruction
by sweating; or fever which is more of the clear cavity by damp heat gives rise
pronounced in the afternoon. In addition to a dull facial expression with few words
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 327

said, or mental cloudiness, the sticky Stomach Meridians.

white tongue coating with a yellow tinge
and the soft rapid pulse are both signs of
damp heat. IV. DIFFERENTIATION OF
The method of treatment is to clear SYNDROMES ACCORDING
off heat, resolve damp and promote the TO THE THEORY OF
smooth circulation of qi. In acupuncture MERIDIANS AND
treatment, the main points are selected
from the Spleen Meridian of Foot-Taiyin
COLLATERALS
and the Stomach Meridian of Foot-
This method uses the theory of merid-
Yangming.
ians and collaterals to identify pathologi-
3) Damp heat in the lower energizer
cal changes according to the areas trav-
Damp heat lodged in the lower energizer
ersed by them and according to their
mainly affects the large intestine and
related zang-fu organs. As meridians are
bladder and hence manifests as abnormal
the main pathways in the system, their
urination and defecation. The symptoms
pathological manifestations may be used
and signs are retention of urine, thirst
as primary evidence in making differen-
with desire to drink only a little, consti-
tiation.
pation, hardness and fullness in the lower
abdomen, a sticky yellow or white tongue
1. Pathological Manifestations of
coating and a soft rapid pulse.
Damp heat retained in the bladder
the Twelve Main Meridians
impairs its function of controlling urine, As each of the twelve main meridians
this explains retention of urine. Accumu- is identified by its specific pathway and
lation of damp in the lower energizer its relation with the specific zang-fu or-
prevents body fluid from rising and a gan, the pathological manifestations of
thirst with desire to drink only small disorders of the twelve meridians may be
quantities ensues. Damp retained in the grouped under two headings:
large intestine impairs its function of Dysfunction of the zang-fu organ to
transmission, blocking the qi of the fu which the diseased meridian is related.
organs and causing constipation and Disorders of the area supplied by the
hardness and fullness in the lower abdo- meridian.
men. The sticky yellow or white tongue Hence, the pathological manifesta-
coating and the soft, rapid pulse are both tions of the twelve meridians are des-
signs of damp heat. cribed as follows.
The method of treatment is to conduct a) The Lung Meridian of Hand-Taiyin
the turbid downwards and relieve ac- Cough, asthmatic breathing, hemoptysis,
cumulation. In acupuncture treatment, congested and sore throat, a sensation of
points are mainly selected from the Con- fullness in the chest; pain in the supra-
ception Vessel, Bladder, Spleen and clavicular fossa, shoulder, back and ante-
328 CHINESE ACCPCNCTURE AND MOXIBCSTION

rior border of the medial aspect of the malaria, pain of the eyes, lacrimation
arm. when exposed to wind, nasal obstruction,
b) The Large Intestine Meridian of rhinorrhea, epistaxis, headache; and pain
Hand-Yangming Epistaxis, watery nasal in the nape, back, low back, buttocks and
discharge, toothache, congested and sore posterior aspect of the lower limbs.
throat; pain in the neck, anterior part of h) The Kidney Meridian of Foot-
the shoulder and anterior border of the Shaoyin Enuresis, frequent urination,
lateral aspect of the upper limb; borbor- nocturnal emission, impotence, irregular
ygmus, abdominal pain, diarrhea and dy- menstruation, asthmatic breathing, hem-
sentery. optysis, dryness of the tongue, congested
c) The Stomach Meridian of Foot- and sore throat, edema, pain in the lum-
Yangming Borborygmus, abdominal bar region and in the posteriomedial as-
distension, edema, epigastric pain, vomit- pect of the thigh, weakness of the lower
ing, hunger, epistaxis, deviation of the limbs and heat sensation in the soles.
mouth, congested and sore throat; pain i) The Pericardium Meridian of Hand-
in the chest, abdomen and anterior bor- Jueyin Cardiac pain, palpitation, men-
der of the lateral aspect of the lower tal restlessness, stuffiness in the chest,
limbs; fever and mania. flushed face, swelling in the axilla, de-
d) The Spleen Meridian of Foot-Taiyin pressive and manic mental disorders,
Belching, vomiting, epigastric pain, ab- spasm of the upper limbs and heat sensa-
dominal distension, loose stools, jaun- tion in the palms.
dice, heaviness of the body, lassitude, j) The Triple Energizer Meridian of
stiffness and pain in the root of the Hand-Shaoyang Abdominal distension,
tongue, swelling and coldness in the me- edema, dysuria, deafness, tinnitus, pain
dial aspect of the thigh and knee. in the outer canthus, swelling of the
e) The Heart Meridian of Hand- cheeks, congested and sore throat; and
Shaoyin Cardiac pain, palpitation, hy- pain in the retroauricular region, shoul-
pochondriac pain, insomnia, night sweat- der, and lateral aspect of the arm and
ing, dryness of the throat, thirst, pain in elbow.
the medial aspect of the upper arm and k) The Gallbladder Meridian of Foot-
heat sensation in the palms. Shaoyang Headache, pain in the outer
f) The Small Intestine Meridian of canthus, pain in the jaw, blurring of vi-
Hand-Taiyang Deafness, yellow sclera, sion, bitter taste in the mouth, swelling
sore throat, swelling of the cheeks, dis- and pain in the supraclavicular fossa,
tension and pain in the lower abdomen pain in the axilla; and pain along the
and pain in the posterior border of the lateral aspect of the chest, hypochon-
lateral aspect of the shoulder and arm. drium, thigh and lower limbs.
g) The Bladder Meridian of Foot- /) The Liver Meridian of Foot-Jueyin
Taiyang Retention of urine, enuresis, Low back pain, fullness in the chest, pain
manic and depressive mental disorders, in the lower abdomen, hernia, vertical
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 329

headache, dryness of the throat, hiccups, region, eversion of the foot and spasm of
enuresis, dysuria and mental disturbance. the lower limbs.
f) The Yin Heel Vessel Epilepsy, leth-
2. Pathological Manifestations of argy, pain in the lower abdomen; pain in
the Eight Extra Meridians the lumbar and hip regions referring to
the pubic region; spasm of the lower
The eight extra meridians function to limbs and inversion of the foot.
strengthen the relationship between the g) The Yang Link Vessel Exterior
twelve main meridians and regulate their syndromes such as chills and fever.
qi and blood. They are closely related to h) The Yin Link Vessel Interior syn-
the liver and kidney as well as the extra dromes such as chest pain, cardiac pain
organs such as the uterus, brain and mar- and stomachache.
row. On the basis of their physiological
functions and the areas they traverse, the 3. Pathological Manifestations of
pathological manifestations of the eight the Fifteen Collaterals
extra meridians are briefly described be-
low. Each of the fourteen meridians (i.e.
a) The Governor Vessel Stiffness and the twelve main meridians, the Concep-
pain in the spinal column, opisthotonos, tion and Governor vessels, has a collater-
headache and epilepsy. al, and in addition there is the Major
b) The Conception Vessel Leu- Collateral of the Spleen. They branch off
korrhea, irregular menstruation, infertil- from their respective meridians on the
ity in both women and men, hernia, four extremities and circulate over the
nocturnal emission, enuresis, retention body surface. They function to streng-
of urine, pain in the epigastric region and then the relation between each pair of
lower abdomen, and pain in the genital externally and internally related meridi-
region. ans and transport qi and blood to various
c) The Thoroughfare Vessel Spasm tissues and organs of the human body.
and pain in the abdomen, irregular men- Supplementary to the pathological mani-
struation, infertility in both women and festations of the meridians, the patholog-
men, and asthmatic breathing. ical manifestations of the collaterals are
d) The Belt Vessel Distension and listed below.
fullness in the abdomen, weakness of the a) The Collateral of Hand-Taiyin
lumbar region, leukorrhea, prolapse of Heat sensations in the wrist and palm,
the uterus; and muscular atrophy, weak- shortness of breath, enuresis and fre-
ness and motor impairment of the lower quent urination.
limbs. b) The Collateral of Hand-ShaoYin
e) The Yang Heel Vessel Epilepsy, in- Fullness in the chest and diaphragm and
somnia, redness and pain in the inner aphasia.
canthus, pain in the back and lumbar c) The Collateral of Hand-Jueyin Car-
330 CllINESE ACUPUNCTURE AND MOXmUSTIol\

diac pain and mental restlessness. 0) The Major Collateral of the Spleen
d) The Collateral of Hand- Yangming General aching, and weakness of the
Toothache, deafness, a cold sensation in joints of the four limbs.
the teeth, and a stifling sensation in the
chest and diaphragm. Appendix: Differentiation of
e) The Collateral of Hand- Taiyang Syndromes According to the Theory
Weakness of joints, muscular atrophy of the Six Meridians
and motor impairment of the elbow, and
warts on the skin. Differentiation of syndromes accord-
j) The Collateral of Hand-Shaoyang ing to the theory of the six meridians
Spastic or flaccid cubital joint. and subsequent determination of treat-
g) The Collateral of Foot- Yangming ment belong to the theoretical system
Depressive and manic mental disorders, expounded in the book On Febrile Diseas-
muscular atrophy and weakness in the es Due to Invasion of Cold. It represents
lower leg, congested and sore throat, and the development and application of the
sudden hoarseness of voice. theory of meridians and collaterals from
h) The Collateral of Foot- Taiyang Internal Classic. This method is mainly
Nasal obstruction, watery nasal dis- used in the differentiation of exogenous
charge, headache, pain in the back and diseases. The pathological manifestations
epistaxis. of these exogenous diseases at different
i) The Collateral of Foot-Shaoyang stages of development are classified into
Coldness in the foot, paralysis of the six syndromes according to their charac-
lower limbs and inability to stand erect. teristics. These are Taiyang, Yangming
j) The Collateral of Foot- Taiyin Ab- and Shaoyang syndromes, and Taiyin.
dominal spasm, and cholera with vomit- Shaoyin and Jueyin syndromes. The
ing and diarrhoea. former three are known as the three yang
k) The Collateral of Foot-Shaoyin Re- syndromes, while the latter three are re-
tention of urine, lumbago, mental rest- ferred to as the three yin syndromes.
lessness and stifling sensation in the Differentiation of syndromes accord-
chest. ing to the theory of six meridians is close-
/) The Collateral of Foot-Jueyin ly related to the meridians and zang-fu
Priapism, pruritus in the pubic region, organs. In terms of the meridians, the
swelling of the testes and hernia. Taiyang, Yangming and Shaoyang Me-
m) The Collateral of Conception Vessel ridians traverse the posterior, anterior
Distending pain and pruritus of abdom- and lateral aspects of the body respective-
inal skin tissues. ly. Consequently Taiyang syndrome may
n) The Collateral of the Governor Vessel exhibit neck rigidity and pain in the pos-
Stiffness of the spinal column, a heavy terior aspect of the head and neck; Yang-
sensation in the head, and tremor of the ming syndrome may manifest as flushed
head. face, and fullness and pain in the abdo-
CHAPTER 13 DIFFEREr-;'TIATION OF SYNDROMES 331

men~ and in Shaoyang syndrome, fullness ysis of the stages of pathological devel-
and distension in the costal and hypo- opment. including rules governing the
chondriac regions are present. As for the transmission and transformation of di-
three yin syndromes, the abdominal pain seases that result from the invasion of
and diarrhoea of Taiyin syndrome, the exogenous pathogenic cold. In this con-
dryness of the mouth and throat of text it cannot be equated with differentia-
Shaoyin syndrome, and the pain and heat tion of syndromes according to the theo-
sensation in the heart, and vertical pain ries of meridians and collaterals, and of
of Jueyin syndrome all relate to areas the zang-fu organs.
three yin meridians traverse. When corre- Differentiating syndromes according
lated to the zang-fu organs, the three to the six meridians entails making an
yang syndromes identify pathological analysis and synthesis of various patho-
changes of the six fu organs. The bladder, logical manifestations of exogenous di-
for example, is the fu organ of Taiyang. seases and their development in terms of
When pathogenic factors are transmitted the strength of resistance to the disease,
from the meridian to the fu organ, hence the virulence of the pathogenic factors
affecting the function of the bladder, re- and the depth of disease. In this way,
tention of harmful water and dysuria the pathology is determined, which sub-
may appear. The downward transmission sequently serves as a guide to treatment.
of dryness and heat of the stomach, the In the three yang syndromes, the anti-
fu organ of Yangming, may lead to symp- pathogenic qi is strong and the pathogen-
toms and signs of the gastrointestinal ic factor is hyperactive; the disease tends
tract such as constipation, and abdominal to be active, manifesting syndromes of
pain which is aggravated by pressure. heat and excess nature. Treatment is
Pathogenic invasion of the gallbladder, aimed at eliminating the pathogenic fac-
the fu organ of Shaoyang, may give rise tors. In the three yin syndromes, the
to a bitter taste in the mouth and hypo- pathogenic factor is hyperactive, while
chondriac pain. Similarly, differentiation resistance to the disease is weak; the di-
of the three yin syndromes is based upon sease tends to be inactive manifesting
pathological changes of the five zang or- syndromes of cold and deficiency nature.
gans. Examples are deficiency of the In this case the emphasis of the treatment
spleen yang in Taiyin syndrome, deficien- is laid on promoting the anti pathogen-
cy of the heart and kidney in Shaoyin ic qi.
syndrome and disturbance of the liver qi Although syndromes of the six merid-
in Jueyin syndrome. Thus, it can be seen ians differ, they are interrelated. Gener-
that differentiation of syndromes accord- ally, exogenous diseases develop from the
ing to the theory of the six meridians exterior to the interior. However, there
reflects pathological changes of the me- are exceptions such as concurrent diseas-
ridians and zang-fu organs. Integral to es in which there is a simultaneous on-
this method of differentiation is the anal- set of disease in two or three meridians;

-------------~--- --- -- ---- ----------- - - - - - - -

332 CHINESE ACUPUNCTURE AND MOXIBUSTION

overlapping of diseases in which another superficial and slowing-down pulse sug-

meridian is affected even before the pre- gests invasion of Taiyang by wind, while
viously affected meridian has been cured; absence of sweating with a superficial
direct invasion of one of the six meridi- and tense pulse points to invasion of Tai-
ans by exogenous pathogenic factors; and yang by cold. Acupuncture treatment is
transmission of diseases between a pair of aimed at eliminating exterior syndromes
externally and internally related meridi- and promoting smooth circulation of the
ans. In order to arrive at a correct diag- qi of the meridians. Points are selected
nosis and hence to obtain the anticipated from the Governor Vessel and the Tai-
results from treatment, a good command yang Meridians of Hand and Foot.
of the basic and complicated syndromes 2) Shaoyang syndrome The Shao-
is required. yang syndrome is an outcome of the
1) Taiyang syndrome The Taiyang transmission and transformation of the
syndrome is an exterior syndrome often Taiyang syndrome. The pathogenic fac-
seen at the initial stage of exogenous tors have left the exterior represented by
disease. The main pathological manifes- Taiyang, but yet they have not reached
tations are fever, aversion to cold, stiff- the interior represented by Yangming.
ness and pain at the posterior aspect Since the pathogenic factors remain be-
of the head and neck, and a superficial tween the exterior and interior, the
pulse. Shaoyang syndrome is actually an inter-
Taiyang dominates the exterior of the mediate syndrome. Its main pathological
body, serving as the screen to the six manifestations are alternate chills and
meridians. When pathogenic wind cold fever, fullness in the costal and hypo-
invades the body, Taiyang is the first to chondriac regions, anorexia, mental rest-
be affected. Hindrance of wei yang from lessness, vomiting, a bitter taste in the
dispersing induces fever and aversion to mouth, dryness of the throat, blurring of
cold. Injury of the Taiyang Meridian by vision and a string-taut pulse.
pathogenic factors leads to disorders of When the pathogenic factor invades
the qi of the meridian, which, by its path- Shaoyang, it contends with the anti path-
way, manifests as stiffness and pain of ogenic qi between the exterior and the
the posterior aspect of the head and neck. interior. Subsequently, the qi circulation
A superficial pulse appears when the is hindered and its ascending and des-
pathogenic factor invades the muscles cending function is impaired. Alternate
and body surface, and the anti pathogenic chills and fever are the outcome of the
qi moves outwards to resist it. As patients struggle between the pathogenic factor
have different body constitutions and the and the antipathogenic qi. Pathogenic in-
invading pathogenic factors may differ in vasion of the Shaoyang Meridian specifi-
nature and severity, pathological changes cally leads to disorders of the qi of the
and clinical manifestations of the Tai- meridian, which, as determined by its
yang syndrome will vary. Sweating with a pathway, manifests as fullness in the cos-
CHAPTER 13 DIFFERENTIATION OF SYNDROMES

tal and hypochondriac regions. Anorexia flushed face. Heat expells and consumes
and vomiting are due to upward disturb- body fluids, which results in profuse
ance of the stomach qi, when the patho- sweating, extreme thirst and dry yellow
genic factor in Shaoyang has reached the tongue coating. Excessive Yangming heat
stomach. Inward disturbance of Shao- disturbs the mind, which is expressed as
yang fire results in mental restlessness. mental restlessness and irritability. The
Upward attack of the fire of the gallblad- strength of both the antipathogenic qi
der along the Shaoyang Meridian pro- and the pathogenic factor accompanied
duces a bitter taste in the mouth, dryness with vigorous endogenous heat causes
of the throat and blurring of vision. Ob- the superficial and forceful pulse. The
struction of the qi of the liver and gall- method of treatment is to clear off heat
bladder causes string-taut pUlse. The using points of the Yangming Meridians
method of treatment is to harmonize of Hand and Foot and the Governor Ves-
Shaoyang by selecting points from the sel.
Shaoyang and Jueyin meridians. b) The syndrome of the Yangming
3) Yangming syndrome The Yang- fu organ exhibits pathological manifes-
ming syndrome represents a stage of ex- tations such as feverishness of the body
treme struggle between the anti pathogen- which is more pronounced in the after-
ic qi and the pathogenic factor. It is an noon, constipation, fullness and pain in
interior heat syndrome of excess type. In the abdomen aggravated by pressure,
terms of location and characteristics of restlessness, delirium, dry yellow tongue
pathological manifestations, the Yang- coating or burnt-yellow coating with
ming syndrome can be classified into thorns on the tongue, and a deep and
two categories, namely, syndrome of the forceful pulse of excess type.
Yangming Meridian and syndrome of the When the interior heat of Yangming
Yangming fu organ. Insubstantial heat mingles with the dry faeces, the qi of the
spreading all over the body suggests the fu organ is obstructed producing consti-
syndrome of the Yangming Meridian; pation and a fullness, also pain in the
substantial heat accumulating in the fu abdomen which may be aggravated by
organs indicates the syndrome of the pressure. The accumulation of heat in the
Yangming fu organ. interior and flourishing of the qi of
a) The main pathological manifesta- the Yangming Meridian in the after-
tions of the syndrome of the Yangming noon combine to exhibit feverishness of
Meridian are high fever, profuse sweat- the body which is more pronounced in
ing, extreme thirst, flushed face, mental the afternoon. The upward attack of
restlessness, dry yellow tongue coating pathogenic dryness and heat mixed with
and a superficial and forceful pulse. turbid qi disturbs the mind, manifesting
Pathogenic invasion of Yangming as restlessness and delirium. The dry yel-
leads to hyperactivity of endogenous low tongue coating or burnt-yellow coat-
heat, which results in high fever and ing with thorns on the tongue, and the
334 CHINESE ACUPUNCTURE AND MOXIBUSTION

deep, forceful pulse of excess type are the The method of treatment is to warm
consequences of consumption of body up the middle energizer and to disperse
fluid by excessive heat and accumulation cold. The Back-Shu, Front-Mu and He-
of dry faeces in the interior. The method Sea Points of the Spleen Meridian of
of purgation is used in the treatment. Foot-Taiyin and the Stomach Meridian
Principally, the Front-Mu Points and of Foot-Yangming are selected as well as
Lower He-Sea Points of the Yangming points from the Conception Vessel. Both
Meridians of Hand and Foot are selected. needling and moxibustion are used.
Points of the Spleen Meridian of Foot- 5) Shaoyin syndrome The Shaoyin
Taiyin may be used in conjunction. syndrome refers to pathological changes
4) Taiyin syndrome The Taiyin syn- of the heart and kidney. When Shaoyin
drome refers to a cold syndrome of defi- is diseased, the anti pathogenic qi is ex-
ciency type resulting from deficiency of tremely deficient. That is why the Shao-
the spleen qi and retention of cold damp yin syndrome is characterized by system-
in the interior. Its main pathological ic weakness. In the Shaoyin syndrome,
manifestations are abdominal fullness, there is hypofunction of the heart and
vomiting, poor appetite, diarrhoea, ab- kidney, manifesting either as deficiency
dominal pain which is alleviated with of yang leading to excess of yin or defi-
warmth or pressure, absence of thirst, a ciency of yin leading to hyperactivity of
pale tongue with white coating, and a fire. When yang is deficient and yin is
slow or slowing-down pulse. excessive, the pathogenic factors, influ-
This syndrome is often due to consti- enced by excessive yin, turn into cold.
tutional deficiency of the spleen yang, When yin is deficient leading to hyperac-
direct invasion by pathogenic cold or in- tivity of fire, the pathogenic factors turn
appropriate treatment of the three yang into heat.
syndromes. a) The cold syndrome of Shaoyin This
Insufficiency of the yang of the mid- syndrome principally exhibits aversion to
dle energizer implies not only dysfunc- cold, lying in a curled up position, list-
tion of the spleen in transportation and lessness with desire to sleep, cold limbs,
transformation, hence resulting in reten- diarrhoea with undigested food, absence
tion of cold damp in the interior, but also of thirst or preference for hot drinks,
abnormal ascent and descent of qi which profuse, clear urine, a pale tongue with
is the cause of abdominal fullness and white coating and a deep feeble thready
pain, diarrhoea, vomiting and a poor ap- pulse.
petite. As it is a cold syndrome of defi- This syndrome is often due to defi-
ciency type, the abdominal pain can be ciency of yang of the heart and kidney
alleviated by warmth or pressure. This is complicated with direct invasion of
also the cause of the absence of thirst, the Shaoyin by exogenous pathogenic cold.
pale tongue with white coating and the Deficiency of yang implies failure to
slow or slowing-down pulse. warm up the body, the consequences are
CHAPTER 13 DIFFERENTIATION OF SYNDROMES 335

aversion to cold, lying in a curled up hyperactivity of the heart fire and a dis-
position and cold limbs. Furthermore, in- turbance of the balance between water
sufficiency of yang qi leads to listlessness and fire, this explains mental restlessness
with a desire to sleep. Deficiency of and insomnia. As heat consumes the kid-
yang of Shaoyin deprives the spleen of ney yin, dryness of the mouth and throat,
warmth, therefore impairing its function a red or deep-red tongue ensue. Deficien-
in transportation and transformation and cy of yin and hyperactivity of fire give
causing diarrhoea with undigested food. rise to a rapid thready pulse.
Deficiency of yang leading to excess of The method of treatment is to nourish
cold may also manifest as absence of yin and clear off fire. Points are select-
thirst. But thirst may appear if yang de- ed from the Heart Meridian of Hand-
ficiency of the lower energizer does not Shaoyin and Kidney Meridian of Foot-
allow upward distribution of body fluids, Shaoyin.
or if excessive diarrhoea consumes body 6) Jueyin syndrome Jueyin means
fluids. In either case, the patient prefers tha t yin is on the verge of extinction,
hot drinks and does not drink large while yang is starting to grow, and that
quantities. Copious, clear urine, a pale there is yang within yin. When Jueyin is
tongue with white coating and a deep diseased, the anti pathogenic qi is exhaust-
thready pulse are all signs of yang defi- ed, and there is derangement of the bal-
ciency resulting in yin excess. ance between yin and yang. Hence this
The method of treatment is to recover manifests principally as a complicated
yang and eliminate cold. Points are se- syndrome of cold and heat. The main
lected from the Conception Vessel, Kid- symptoms and signs are emaciation,
ney Meridian of Foot-Shaoyin and Spleen thirst, feeling of a stream of air ascending
Meridian of Foot-Taiyin. Both acupunc- to the chest region, a hot and painful
ture and moxibustion should be used with sensation in the chest, hunger with no
the emphasis placed on moxibustion. desire to eat, cold limbs, diarrhoea, and
b) The heat syndrome of Shaoyin The vomiting or vomiting of round worms.
main pathological manifestations are In this syndrome, there is heat in the
mental restlessness, insomnia, dryness of liver and gallbladder, and cold and defi-
the mouth and throat, deep-yellow urine, ciency in the stomach and intestines. The
a red or deep-red tongue, and a rapid syndrome is characterized by complica-
thready pulse. tion of cold and heat, disturbance of qi
This syndrome is often due to persist- and poor transportation and transforma-
ence of pathogenic heat which consumes tion of food. Consumption of body fluids
the kidney yin, or to constitutional defi- by pathogenic heat induces emaciation
ciency of yin complicated with pathogen- and thirst. Upward movement of yang
ic invasion which subsequently turns into heat gives rise to a feeling of a stream, of
heat. air ascending and a hot and painful sen-
Deficiency of the kidney yin leads to sation in the chest. Hyperfunction of the
336 CHINESE ACUPUNCTURE AND MOXIBUSTION

liver in promoting the free flow of qi The warming method is combined

results in hunger. But the stomach and with the method of clearing off heat
intestines are cold and deficient which do in the treatment; the method of simul-
not allow normal digestion and transmis- taneous elimination and reinforcement is
sion of food; this explains hunger with no adopted. Points are selected from the Liv-
desire to eat. Disturbance of qi in the er Meridian of Foot-Jueyin, Conception
stomach and intestines may cause vomit- Vessel and Gallbladder Meridian of Foot-
ing and diarrhoea. When yang qi fails to Shaoyang. Points of the Spleen Meridian
reach the four limbs, there will be cold. of Foot-Taiyin are used in conjunction.
 Chapter 14
ACUPUNCTURE TECHNIQUES

Acupuncture is a procedure by which The common filiform needles vary in

diseases can be prevented and treated length and diameter Tables 14, 15.
through proper insertion of needles into Needles from gauges 26-32 in diame-
points accompanied by different manipu- ter and 1-3 cun in length are most fre-
lations. Today those commonly used are quently used in clinic. The needle tip, in
filiform needle, dermal needle, intrader- general, should be as sharp as a pine
mal needle, and three-edged needle, in needle, the body is round and smooth,
which the filiform needle is widely and flexible and resilient, which is valued as
mostly used. In this chapter the following the best quality. The filiform needles
information is given. should be well stored to avoid damage.
The damaged needles may cause discom-
fort to patient or bring about accidents.
I. FILIFORM NEEDLE The needle tip should be preserved with
THERAPY special care by observing the following
instructions.
1. The Structure and Specification 1) Unused needles are suggested to
store in a box with layers of gause or in
The filiform needles are widely used
a tube with dry cotton balls placed at the
at present in clinic. It is made of gold,
silver, alloy, etc., but most of them are
made of stainless steel. A filiform needle
_- Handle
may be divided into five parts:
1) Handle the part webbed with fili-
gree either of copper or stainless steel;
2) Tail the part at the end of the
handle;
-- _- Root

3) Tip the sharp point of the needle;

4) Body the part between the handle _--- Body
and the tip; and
5) Root the demarcation line between
the body and the handle (Fig. 136). _---Tip
The length and gauge refer to the
dimension of the needle body. Fig. 136

337

----- - - - - - - - - - - -
33Il________________________________________c_,H_IN~'E~SE~A~Cl~'P~U~NC~T~U_R~E~A_ND~~~IO~X=IB~US~T~IO~N

both ends to protect the needle tips. 2. Needling Practice

2) On boiling water sterilization, nee-
dles should be bound steadily by gauze in As the filiform needle is fine and flex-
case the needle tip hits against the wall of ible, it is very difficult to insert it into the
an autoclave. skin without some strength exerted by the
3) On manipUlation, insertion of the fingers and conduct manipulations. An
needle should be neither too forceful nor appropriate finger force is the guarantee
too fast to prevent it from getting bent. to minimize the pain and raise the thera-
If the needle tip touches the bones, the peutic effects. The training of fingers
needle should be withdrawn a little to may start with a short and thick filiform
avoid bending. needle, progressing to a finer and longer

Table 14. Length

eurt 0.5 1.5 2 2.5 3 3.5 4 4.5 5

mm 15 25 40 50 65 75 90 100 115 125

Table 15. Diameter

Gauge 26 28 30 32 34

Dia. (em) 0.45 0.38 0.32 0.26 0.22

one before clinical application. cise until you feel it easy to insert and
]l) Practise with sheets of paper Fold rotate the needle. As your finger force
fine and soft tissues into a small packet grows stronger, the thickness of the pa-
about 5 x 8 cm in size and I em in per packet may be increased (Fig. 137).
thickness, then bind the packet with 2) Practise with a cotton cushion
gauze thread. Hold the paper packet in Make a cotton cushion of about 5-6 cm.
the left hand and the needle handle with in diameter wrapped in gauze. Hold the
the right hand. Insert the needle into the cushion with the left hand and needle
packet and rotate in and out clockwise handle with the right hand. Jnsert the
and counter-clockwise. At the beginning, needle into it and practise a rotating lift-
if you feel the needle stuck or difficult to ing and thrusting procedure. According
rotate, take it easy and continue the exer- to the required postures during acupunc-
CHAPTER 14 ACUPUNCTCRE TECHKIQI'ES :339

acupuncture treatment.

3. Preparations Prior to Treatment

1) Inspection of the instruments N ee-
dIes of various size, trays, forceps, moxe
wool, jars, sterilized cotton ball, 75% al-
cohol or 1.5% iodine tincture, or 2% gen-
tian violet, etc. should be carefully in-
spected and prepared before use.
2) Posture of the patient An approp-
riate posture of a patient is significant in
correct location of points, manipulation
Fig. 137 for acupuncture and moxibustion, pro-
longed retaining of the needle, and in
ture and the reinforcing and reducing prevention of fainting, bent needle, stuck
approach, practise the basic manipula- needle or broken needle. The selection of
tion techniques. This purpose is to prac- a proper posture is therefore of impor-
tise the different manipulations in acu- tance clinically. Generally, the practition-
puncture (Fig. 138). er must be able to work without hindr-
3) Practise on your own body This ance and the patient is relaxed and feels
may follow the manipulation methods on comfortable. The commonly-used pos-
the paper packet and the cotton cushion tures adopted in the clinic are as follows:
so as to have personal experience of the a) Sitting in flexion: suitable for the
needling sensation in clinical practice. points on the head, neck and back (Fig.
Only by this can the practitioner really 139).
possess and produce beneficial results in b) Sitting erect with elbows resting on a
table: suitable for the points on the head,
arm and shoulder (Fig. 140).
c) Lateral recumbent: suitable for the
points at the lateral side of the body (Fig.
141 ).
d) Supine posture: suitable for the
points on the head and face, chest and
abdominal region, and areas of the four
limbs (Fig. 142).
e) Prone posture: suitable for the
points on the head, neck, back, lumbar
and buttock regions, and the posterior
Fig. 138 region of the lower limbs (Fig. 143).

~---.- -----------
3~.~)______________________________________________C=H=I=N=ES=E~A=C=UP=U=N=C=T=U=R=E=A=N='D~M=O=X=I=BU=S=T=IO~N

Fig. 140 Setting errect with elbows

Fig. 139 Sitting in flexion resting on a table

Fig. 141 Lateral recum bent

Fig. 142 Supine

Fig. 143 Prone

CHAPTER 14 ACUPUNCTURE TECHNIQUES 341

3) Sterilization: 1. Insertion
a) Needle sterilization:
Autoclave sterilization: Needles The needle should be inserted coordi-
should be sterilized in an autoclave at 1.5 nately with the help of both hands. The
atmospheric pressure and 125T for 30 posture for insertion should be correct so
minutes. that the manipulation can be smoothly
Boiling sterilization: Needles and oth- done. Generally the needle should be held
er instruments are boiled in water for 30 with the right hand known as the punc-
minutes. This method is easy and effec- turing hand. The left hand known as the
tive without any special equipment. pressing hand pushes firmly against the
Medicinal sterilization: Soak the nee- area close to the point. In the first chap-
dles in 75% alcohol from 30-60 minutes. ter of Miraculous Pivot, it says: "Needle
Then take them out and wipe off the must be inserted into the body with the
liquid from the needles with a piece of right hand assisted by the left hand." In
dry cloth. At the same time, the needle the book Classic on Medical Problems, it
tray and forceps which have directly con- is said that: "An experienced acupunctur-
tacted with the filiform needles should ist believes in the important function of
also be sterilized in the same way. the left hand, while an inexperienced be-
Besides, needles used to treat some lieves in the important function of the
infectious cases should be sterilized and right hand." It is further stated in Lyrics
stored in separate place. of Standard Profoundities that: "Press
b) Skin disinfection: heavily with the left hand to disperse qi
The area on the body surface selected and insert the needle gently and slowly to
for needling must be sterilized. General- avoid pain." These explanations show the
ly, points on the local area must be ster- importance of the coordination of the
ilized with 75% alcohol, or first with 2.5% right and left hands on insertion. Accord-
iodine, and then it is removed by a 70% ing to the length of the needle and the
alcohol cotton ball. If the disinfected area location of the point, different methods
is accidentally polluted, a second sterili- of insertion are employed.
zation is imperative. The practitioner's 1) Inserting the needle aided by the
fingers should be sterilized routinely. pressure of the finger of the pressing hand

II. NEEDLING METHODS

Various needling techniques and mani-

pulations, which attach importance to in-
sertion and withdrawal of the needle, have
been summarized by practitioners based Fig. 144
on their experience in the past dynasties.
342 CHINESE AClJPUl\:CTlJRE AND MOXIBUSTION

index finger of the right hand. As the

needle tip is directly over the selected
point, insert the needle swiftly into the
skin with the left hand, meanwhile the
right hand presses the needle downward
to the required depth. This method is
suitable for puncturing with long needles,
such as those used in needling Huantiao
(GB 30), Zhibian (BL 54), etc. (Fig. 146).
3) Inserting the needle with the fingers
stretching the skin Stretch the skin
where the point is located with the thumb
Fig. 145 and index finger of the left hand, hold the
needle with the right hand and insert it
Press beside the acupuncture point with into the point rapidly to a required depth.
the nail of the thumb or the index finger This method is suitable for the points on
of the left hand, hold the needle with the the abdomen where the skin is loose, such
right hand and keep the needle tip closely as Tianshu (ST 25), Guanyuan (CY 4),
against the nail, and then insert the nee- etc. (Fig. 147).
dle into the point. This method is suitable 4) Inserting the needle by pinching the
for puncturing with short needles such as skin Pinch the skin up around the point
for needling Neiguan (PC 6), Zhaohai with the thumb and index finger of the
(KI 6), etc. (Fig. 145). left hand, insert the needle rapidly into
2) Inserting the needle with the help of the point with the right hand. This meth-
the puncturing and pressing hands Hold od is suitable for puncturing the points
the needle tip with the thumb and the on the head and face, where the muscle
index finger of the left hand, leaving and skin are thin, such as Zanzhu (BL 2),
0.2-0.3 cm. of its tip exposed, and hold Dicang (ST 4), Yintang (Extra), etc. (Fig.
the needle handle with the thumb and 148).

Fig. 146 Fig. 147

CHAPTER 14 ACUPUNCTURE TECHNIQUES 343

This method is used for the points

close to the important viscerae or where
the muscle is thinner. Generally, the nee-
dle is inserted obliquely to form an angle
of approximately 45° with the skin sur-
face. Points such as Lieque (LU 7) in the
u pper extremity, J iu wei (CV 15) of the
abdominal region, Qimen (LR 14) of the
chest, and the points on the back, are
often needled in this way.
c) Horizontal insertion (also known as
transverse insertion):
This method is commonly used in the
Fig. 148 areas where the muscle is think, such as
Baihui (GV 20), Touwei (ST 8) on the
2. Angle and Depth of Insertion head, Zanzhu (BL 2), Yangbai (BL 14)
on the face, Tanzhong (CY 17) on the
In the process of insertion, angle and chest, etc. (Fig. 149).
depth are especially important in acu- 2) Depth of needle insertion General-
puncture. Correct angle and depth help ly, a proper depth of needling induces
to induce the needling sensation, bring better needling sensation without hurt-
about the desired therapeutic results and ing the important viscerae. In clinic the
guarantee safety. Different angles and depth of insertion mostly depends upon
depths at the same point punctured pro- the constitution of the patient, the loca-
duce varied needling sensation and ther- tion of points and the pathological condi-
apeutic effects. Appropriate angle and tion. For the elderly often suffering from
depth depends upon the location of the deficiency of qi and blood, or for infants
points, the therapeutic purpose, the pa- with delicate constitution, and such areas
tient's constitution and the type of figure, as the head, face and back region, shallow
fat or thin. insertion is advisable. For the young and
1) The angle formed by the needle and middle-aged with strong or fat constitu-
the skin surface Generally, there are tions, or for the points on the four ex-
three kinds: perpendicular, oblique and tremities, buttocks and abdominal region,
horizontal. deep insertion is adopted.
a) Perpendicular insertion: 3) Waiting for and promoting qi If qi
Perpendicular, in which the needle is fails to arrive after manipulation, some
inserted perpendicularly, forming a 90° measures have to be taken, such as tem-
angle with the skin surface. Most points porarily retaining the needle and then
on the body can be punctured in this way. rotating again until qi is obtained. This is
b) Oblique insertion: called "waiting for qi." If, after the inser-
.~44 ______________________________________~C~,H~IN~'E~SE~AC~L~TPU~N~'C~T~UR~E~A~N~D~M~O~XI~BU~TS~TI~O~N

Perpendicular Oblique Horizontal

Fig. 149

tion and manipulation of the needle, the Questions and Answers on Acupuncture and
patient does not feel or only has little Moxibustion that: "If qi does not flow
needling sensation, the method of pro- smoothly, pluck the needle lightly and
moting qi should be used. The six auxi- make qi travel faster."
liary manipulations are seen below. The plucking method used to promote
a) Pressing: qi flow is for patients with retarded qi
Slightly press the skin along the sensation due to qi deficiency.
course of the meridian. It is described in c) Scraping:
Compendium of Acupuncture and Mox- When the needle is retained the thumb
ibustion that "the related meridian is and index finger of the left hand support
pushed up and down to promote the cir- the body of the needle where it enters the
culation of qi and blood." skin, while the thumb of the right hand
The main purpose of this method is to is placed on the tail end to hold the
encourage the movement of qi through needle steady, then scrap the handle with
the related meridian and facilitate its sen- the nail of the index or middle finger of
sation at the point. It is used in patients the right hand upward from downward
whose needling sensation is delayed. or vice versa. Scraping is used to spread
b) Plucking: the needling sensation.
Pluck the handle of the needle lightly, d) Shaking:
causing it to tremble and strengthening Shaking of the needle can strengthen
the stimulation to obtain qi. In Com- the needling sensation. In the book Ques-
pendium of Acupuncture and Moxibustion, tions and Answers on Acupuncture and
it says: "First, pluck the handle of the Moxibustion, it is said that "shaking is an
needle, after the arrival of qi, insert the aid for qi flow." Moreover, shaking the
needle a bit deeper. This is the reinforc- needle may be used as an auxiliary meth-
ing method." It is also pointed out in od for reducing, i.e. before withdrawal of
CHAPTER 14 ACUPUNCTURE TECHNIQUES 345

the needle, shake the needle to drive the 1) The fundamental manipUlation tech-
pathogenic factors out. In Compendium niques
of Acupuncture and Moxibustion, it says, a) Lifting and thrusting:
"First, shake the handle of the needle to After the needle tip penetrating the
cause arrival of qi. When qi arrives, with- skin surface, the needle body is perpen-
draw the needle a little, which is known dicularly lifted and thrust in the point.
as the reducing method." This, known as lifting and thrusting, is
e) Flying: applied only when the needle is inserted
In the book Introduction to Medicine, it to a certain depth. But it is not approp-
says: "Twirling the needle quickly for riate to lift and thrust too much, other-
three times is known as 'flying'." Twirl wise, local pain or damage of the local
the needle and separate the thumb and tissues may take place.
index finger from it for several times b) Twirling or rotating:
until the needling sensation is streng- After the needle has reached its de-
thened. sired depth, twirl and rotate the nee-
f) Trembling: dle backward and forward continuous-
Hold the needle with the fingers of the ly. Generally, the needle is rotated with
right hand and apply quick lift-thrust an amplitude from 180° to 360°. Rotat-
movement in small amplitude to cause ing clockwise or counter-clockwise alone
vibration. It is stated in Classic of Divine may twine the muscle fibers and pro-
Resonance that "hold the needle with the duce pain.
thumb and index finger of the right hand, 2) Arrival of qi In the process of
lift and thrust it rapidly and lightly in a acupuncture, no matter what manipula-
trembling way to promote qi." Therefore tion it is, the arrival of qi must be
it is applied to strengthen the needling achieved. In the first chapter of Mirac-
sensation and activate the flow of qi and ulous Pivot, it is described that "acupunc-
blood. ture therapy does not take effect until the
arrival of qi." In Ode of Golden Needle it
3. Manipulations and Arrival of Qi is said: "Quick arrival of qi suggests good
(Needling Reaction) effects in treatment; slow arrival of qi
shows retarded effects in treatment." It
Manipulations: Needle manipulations indicates that the arrival of qi is especial-
may induce needling reaction, for which ly important in acupuncture treatment.
several methods should be applied. a) Signs of the arrival of qi:
The arrival of qi refers to a feeling of When the patient feels soreness,
soreness, numbness, distension or heavi- numbness, heaviness and distension
ness around the point after the needle is around the point, or their transmission
inserted to a certain depth. At the same upward and downward along the meridi-
time the operator may feel tenseness ans, It IS a sign of the arrival of qi.
around the needle. Meanwhile, the operator should feel
 346 CHINESE ACUPUNCTURE AND MOXIBUSTION
--------------------------------------~~~~~~~~~~~~~

tenseness around the needle. Lyrics of pendium of Acupuncture and Moxibustion

Standard Profoundities says: "It seems a it is said, "In case of arrival of the spirit
fish bites on fishing pulling the line qi, a tense appears under the needle." The
downward." This is a vivid description to first chapter of Miraculous Pivot says, "A
whether the arrival of qi is obtained or point is the place where the spirit qi
not. enters and flows out." The function of
b) Factors influencing the arrival of qi: acupuncture is to regulate the meridian
i) Inaccurate location of the points: qi. The arrival of qi is a manifestation of
It is very important to locate points the normal activity of the spirit qi. There-
correctly in acupuncture treatment. In fore, it is important in observation of the
case of inaccurate location, the required therapeutic effects.
needling sensation will be affected.
ii) Improper depth of the needle inser- 4. Retaining and Withdrawing
tion: the Needle
A given depth of insertion to each
point is required. Either too deep or too 1) Retaining "Retaining" means to
shallow affects the arrival of qi. hold the needle in place after it is inserted
iii) Imperfect manipulation: to a given depth below the skin. Path-
The needle manipulation is requisite ological conditions decide the retaining
for the arrival of qi. The operator should and its duration. In general, the needle is
practise it perfectly, otherwise, the ex- retained for fifteen to twenty minutes
pected effects can not be achieved. after the arrival of qi. But for some
iv) Weak constitution and dull sensa- chronic, intractable, painful and spastic
tion: cases, the time for retaining of the needle
In chapter 67 of Miraculous Pivot it may be appropriately prolonged. Mean-
describes, "An individual with abundant while, manipulations may be given at in-
yang qi may have a quick needling sen- tervals in order to strengthen the ther-
sation; a healthy person responds with apeutic effects. For some diseases the
a normal rate to acupuncture, neither duration may last for several hours. For
quick nor slow; and a man with exces- patients with a dull needling sensation,
sive yin and deficient yang, (i.e. delicate retaining the needle serves as a method to
constitution and dull sensation) may wait for qi to come.
have a slow needling sensation." For 2) Withdrawing On withdrawing the
severe cases there may not appear the needle, press the skin around the point
needling sensation, and the therapeutic with the thumb and index finger of the
results are bad. pressing hand, rotate the needle gently
Acupuncturists in the past dynasties and lift it slowly to the subcutaneous
attached importance not only to the arri- level, then, withdraw it quickly and press
val of qi, but also to the activity of the the punctured point for a while to pre-
"spirit qi" in the meridians. In Com- vent bleeding.

------------------ ~--
CHAPTER 14 ACUPUNCTURE TECHNIQUES 34"

5. Reinforcing and Reducing Methods internal environment of the human body.

For this purpose certain manipulations
Reinforcing and reducing are two cor- are created. Acupuncturists in past ages
responding methods based on the guide developed and summarized a lot of rein-
line set in Internal Classic, i.e. reinforcing forcing and reducing methods which are
for the deficiency syndrome and reducing still commonly used in clinic.
for the excess syndrome. The method 1) The basic reinforcing and reducing
which is able to invigorate the body re- methods
sistance and to strengthen the weakened a) Reinforcing and reducing by /ffling
physiological function is called reinforc- and thrusting the needling:
ing, while that which is able to eliminate In Classic on Medical Problems, it
the pathogenic factors and to harmonize states, "Heavy pressing of the needle to
the hyperactive physiological functions is a deep region is known as reinforcing,
known as the reducing. Clinically, rein- while forceful lifting of the needle to the
forcing or reducing method is applied superficial region is known as reducing."
according to the functional conditions of It tells the reinforcing from the reducing
the patient. by the force and speed used. After the
Under different pathological con- needle is inserted to a given depth and the
ditions acupuncture may produce differ- needling sensation appears, the reinforc-
ent regulating functions, or the effects of ing is obtained by lifting the needle gent-
the reinforcing and reducing. If an indi- ly and slowly, while thrusting the nee-
vidual is subject to a collapse condition, dle heavily and rapidly. The reducing is
acupuncture functions to rescue yang achieved by lifting the needle forcefully
from collapse: when an individual is un- and rapidly while thrusting the needle
der a condition of internal pathogenic gently and slowly.
heat, acupuncture functions to expel the b) Reinforcing and reducing by tWirling
heat outwards. Acupuncture can not only and rotating the needle:
relieve the stomach and intestine spasms, The reinforcing and reducing of this
but also strengthen the stomach and in- kind can be differentiated by the ampli-
testine peristalsis. This dual regulating tude and speed used. When the needle is
function is closely related to the condi- inserted to a certain depth, rotating the
tion of antipathogenic qi of the human needle gently and slowly with small am-
body. If it is vigorous, the meridian qi is plitude is called the reinforcing, on the
easy to be activated and the regulating contrary, rotating the needle rapidly with
function is good. On the contrary, if it is large amplitude is known as the reduc-
lowered, the meridian qi is difficult to ing. In the seventy-third chapter of Mi-
be excited and the regulating function is raculous Pivot, it says, "Twirling the nee-
poor. dle slowly is the reinforcing and twirling
Acupuncture is an approach which the needle rapidly to promote the flow of
can promote the transformation of the qi is the reducing method." In addition,
 CHINESE AClJPl'NCTCRE AND MOXIBCSTION

the reinforcing and reducing methods are achieved by keeping the hole open or close:
distinguished by clockwise or counter- In Chapter 53 of Plain Questions, it
clockwise rotation of the needle. In other says, "Excess is due to the entrance of the
words, the right rotation is the reducing pathogenic factor into the human body
method, and the left rotation is the rein- whereas deficiency is due to exit of the
forcing method. In Guide to Acupuncture vital qi." On withdrawing of the needle,
it describes, "Rotating the needle forward shake it to enlarge the hole and allow
with the thumb means the reinforcing; the pathogenic factor going out. This is
rotating the needle backward with the called the reducing method. Conversely,
thumb means the reducing." Of course, pressing the hole quickly to close it and
twirling of the needle doesn't follow on preventing the vital qi from escaping is
direction. There is a difference only be- called the reinforcing method.
tween the speed of rotation and the force e) The reinforcing and reduCing
used. For example, in forth turning, the achieved by the direction the needle tip
needle is rotated forcefully and rapidly pointing to:
by the thumb, however, in back turning, In Compendium of Acupuncture and
the needle is rotated gently and slowly by Moxibustion, it says, "The three yang me-
the thumb. The right rotation is just in ridians of hand run from the hand up to
the opposite way. the head. The needle tip pointing down-
c) The reinforcing and reducing wards, i.e. against the meridian course, is
achieved by rapid and slow insertion and known as the reducing method. The op-
withdrawal of the needle: posite direction of the needle tip pointing
This is another kind of reinforcing to, i.e. following the running course of
and reducing method distinguished by the meridian, is known as the reinforcing
the speed of insertion and withdrawal of method."
the needle. In the first chapter of Mirac- f) The reinforCing and reducing
ulous Pivot, it says that "inserting the achieved by means of respiration:
needle slowly and withdrawing it rapidly In Chapter 27 of Plain Questions, it
is the reinforcing method, and inserting states, "The reinforcing is achieved by
the needle rapidly and withdrawing it inserting the needle when the patient
slowly is the reducing method." In the breathes out and withdrawing the needle
thJlrd chapter of Miraculous Pivot the when the patient breathes in. The reduc-
same explanation is given. During mani- ing is achieved in an opposite way."
pulations the reinforcing method is per- In addition to the above-mentioned
formed by inserting the needle to a given methods, even reinforcing and reducing
depth slowly and lifting it rapidly just movement is also used in clinic. This
beneath the skin, and a moment later method is used in treating diseases which
withdraw it. The reducing method is per- are a typical to deficiency or excess na-
formed just in a opposite procedure. ture. Lift, thrust and rotate the needle
d) The reinforcing and reducing evenly and gently at moderate speed to
CHAPTER 14 ACUPUNCTURE TECHNIQUES 349

cause a mild sensation and withdraw the until a warm feeling is got. Quickly with-
needle at moderate speed as well. draw the needle and press the hole (Fig.
2) Comprehensive reinforcing and re- 150).
ducing methods b) "Penetrating-heaven coolness":
a) Setting the mountain on fire: This method is derived from the re-
This method is derived from the rein- ducing procedures of slow and rapid in-
forcing procedures of slow and rapid in- sertion, lifting and thrusting and keeping
sertion, lifting and thrusting and keeping the hole open or close. When this method
the hole open or close. When it is applied, is employed, the patient has a cool sensa-
the patient feels warm at the punctured tion at the punctured part. This method
part. This method is often used to treat is usually applied to the excess syndrome
the diseases of deficiency-cold nature. and heat syndrome. After it is inserted
During the operation, after the needle is quickly to a certain depth, the needle is
inserted slowly beneath the skin the nee- repeatedly lifted thrice according to the
dle is repeatedly thrust thrice according deep, medium and superficial sequences
to the superficial, medium and deep se- and thrust once. At a depth of 1.5 cun
quences, and lifted once. At a depth of and the arrival of qi achieved the needle
0.5 cun and the arrival of qi achieved the is lifted quickly and thrust slowly for six
needle is lifted and thrust for nine times. times. After that the needle is lifted to a
Then the needle is inserted to a depth of depth of I cun and given the same oper-
1 cun and lifted and thrust for another ation. Then the needle is further lifted to
nine times. After that the needle is insert- a depth of 0.5 cun and given the same
ed to a depth of 1.5 cun, and lifted and operation too. Repeated operation can be
thrust for nine times too. Repeated oper- conducted for several times until a cool
ation can be conducted for several times feeling is got (Fig. 150).

Setting the mountain on tire Penetrating heaven coolness

--.:-;:-- .:- .--~ .:;:.....- -= .=-----=.

Superficial -t tt Superficial
--------- ---------
Medi~m___ )J______ _ t+ Medium

t1~--~:p--
Deep ~ f
Fig. 150
350 CHINESE ACCPUNCTlJRE AND MOXIBUSTION

III. PRECAUTIONS, 5) Historic medical literature of the

CONTRAINDICATIONS AND past contraindicates certain points on the
human body for puncture or deep punc-
MANAGEMENT OF ture. Most of these points are located
POSSIBLE ACCIDENTS IN close to the vital organs or large blood
ACUPUNCTURE vessels, such as Chengqi (ST I) located
TREATMENT below the eyeball, Jiuwei (CY 15) near
the important viscera, Jimen (SP 11)
1. Precautions and Contra indications near the femoral artery, etc. These points
in Acupuncture Treatment should generally be punctured obliquely
or horizontally to avoid accidents.
I) It is advisable to apply few needles
or to delay giving acupuncture treatment 2. Management of Possible Accidents
to the patients who are either famished
or overeaten, intoxicated, overfatigued or Although acupuncture is safe and free
very weak. from side-effects, some accidents may
2) It is contraindicated to puncture take place owing to negligence of the
points on the lower abdomen and lum- contraindications, imperfect manipula-
bosacral region for women pregnant un- tions, or want of the knowledge of anat-
der three months. After three months omy. If an accident really occurs, the
pregnancy it is contraindicated to needle practitioner should keep calm. As long as
the points on the upper abdomen and he solves the problem in time, serious
lumbosacral region, and those points consequences can be avoided. The possi-
causing strong sensation such as Hegu ble accidents are seen as follows:
(LI 4), Sanyinjiao (SP 6), Kunlun (Bl 1) Fainting
60) and Zhiyin (Bl 67). Cause: This is often due to nerv-
3) Points on the vert ax of infants ous tension, delicate constitution, hun-
should not be needled when the fontanel ger, fatigue, improper position or to the
is not closed. In addition, retaining of too forceful manipulation.
needles is forbidden since the infants Manifestations: During acupuncture
are unable to cooperate with the practi- treatment, there may appear dizziness,
tioner. vertigo, palpitation, short breath, fidgets,
4) Needling should avoid the blood nausea, pallor, cold sweating, weak pulse.
vessels to prevent bleeding. Points of the In severe cases, there may be cold extrem-
chest and back should be carefully nee- ities, drop of blood pressure, and loss of
dled to avoid injury of the vital organs. consciousness.
In Chapter 16 of Plain Questions, it says, Management: When fainting aurae
"If you puncture the points at the chest such as dizziness, vertigo, fidgets and
and abdominal region, you should avoid nausea appear, stop needling immediately
hurting the five zang organs." and withdraw all the needles. Then help
CHAPTER 14 ACUPUNCTURE TECHNIQUES 351

the patient to lie down, and offer him changing of the position of the patient,
some warm or sweet water. The symp- the original posture should be resumed
toms will disappear after a short rest. In and then withdraw the needle.
severe cases, in addition to the above Prevention: Sensitive patients should
management, press hard with the fin- be encouraged to release their tensions.
gernail or needle Shuigou (GV 26), Avoid the muscle tendons during inser-
Zhongchong (PC 9), Suliao (GV 25), tion. Twirling with too large amplitude or
Neiguan (PC 6) and Zusanli (ST 36), or in one direction only shall in no case be
apply moxibustion to Baihui (GV 20), allowed. In the process of manipulation,
Qihai (CV 6) and Guanyuan (CV 4). the posture of the patient should remain
Generally, the patient will respond, but if original.
not, other emergency measures should be 3) Bent needle
taken. Cause: This may result from unskill-
2) Stuck needle ful manipulation or too forceful manipu-
Cause: This may arise from nervous- lation, or the needle striking the hard
ness, strong spasm of the local muscle tissue, or a sudden change of the patient's
after the insertion of the needle, twirling posture for different reasons, or from an
the needle with too large amplitude or in improper management of the stuck nee-
one direction only, causing muscle fibers dle.
to bind, or from a change of the position Manifestations: It is difficult to lift,
of the patient after the insertion of the thrust, rotate and withdraw the needle.
needles. At the same time, the patient feels
Manifestations: After the needle is in- palO.
serted, it is found at times difficult or Management: When the needle is
impossible to rotate, lift and thrust the bent, lifting, thrusting, and rotating shall
needles. This situation is known as stuck in no case be applied. The needle may be
needle. removed slowly and withdrawn by fol-
Management: Ask the patient to re- lowing the course of bend. In case the
lax. If the needle is stuck due to exces- bent needle is caused by the change of the
sive rotation in one direction, the con- patient's posture, move him to his origin-
dition will release when the needle is al position, relax the local muscle and
twirled in the opposite direction. If the then remove the needle. Never try to
stuck needle is caused by the tension of withdraw the needle with force.
the muscle temporarily, leave the needle Prevention: Perfect insertion and gen-
in place for a while, then withdraw it by tle manipulation are required. The pa-
rotating, or by massaging the skin near tient should have a proper and com-
the point or by inserting another needle fortable position. During the retaining
nearby to transfer the patient's atten- period, change of the position is not al-
tion. lowed. The needling area shall in no case
If the stuck needle is caused by the be impacted or pressed by an external
3:.~'2_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C_HI_N_ES_E_A_C_UP_U_'N_CT_U_R_E_A_N_D_M_O_X_IB_L_TST_IO_N

force. Manifestations: Local swelling, disten-

4) Broken needle sion and pain after withdrawal of the
Cause: This may arise from the poor needle.
quality of the needle or eroded base of Management: Generally, a mild hema-
the needle, from too strong manipulation toma will disappear by itself. If the local
of the needle, from strong muscle spasm, swelling and pain are serious, apply local
or a sudden movement of the patient pressing, or light massage, or warming
when the needle is in place, or from moxibustion to help disperse the hema-
withdrawing a stuck needle. toma.
Manifestations: The needle body is Prevention: A void injuring the blood
broken during manipulation and the bro- vessels.
ken part is below the skin surface. 6) After-effect
Management: When it happens, the Cause: It is mostly due to the un-
patient should be asked to keep calm to skilled manipulation and forceful stimu-
prevent the broken needle from going lation.
deeper into the body. If the broken part Manifestations: After withdrawal of
protrudes from the skin, remove it with the needle, there may remain an uncom-
forceps or fingers. If the broken part is at fortable feeling of soreness and pain,
the same level of the skin, press the tissue which may persist for a long period.
around the site until the broken end is Management: For the mild cases,
exposed, then remove it with forceps. If press the local area, and for severe cases,
it is completely under the skin, surgery in addition to pressing, moxibustion is
should be resorted to. applied to the local area.
Prevention: To prevent accidents, Prevention: Too forceful manipu-
careful inspection of the quality of the lation shall in no case be applied.
ne:edle should be made prior to the treat-
ment to reject the needles which are not Appendix: Yang Jizhou's Twelve
in conformity with the requirements Manipulations
specified. The needle body should not be
inserted into the body completely, and a Yang Jizhou, an acupuncturist of the
little part should be exposed outside the Ming Dynasty, summarized the twelve
skin. On needle insertion, if it is bent, the kinds of manipulations, of which all but
needle should be withdrawn immediately. the warming technique in the mouth are
Never try to insert a needle with too adopted in today's acupuncture treat-
much force. ment.
5) Hematoma 1) Needle insertion assisted by the
Cause: This may result from injury thumb nail: Before the needle is insert-
of the blood vessels during insertion, or ed, press heavily on the point with the
from absent pressing of the point after thumb nail to disperse qi and blood. In
withdrawing the needle. this way puncturing does not damage the
CHAPTER 14 ACUPUNCTURE TECHNIQUES 353

defensive qi. This approach functions in factors. Scratch the needle with the
four aspects: fixing the point to be nee- thumb nail up and down along the course
dled; dispersing qi and blood to avoid of the meridian to dispel the pathogenic
injuring the defensive qi; distracting the factors from the meridians.
patient's attention to reduce pain; avoid- 7) Withdrawing On withdrawal of
ing bleeding. the needle, the practitioner should con-
2) Attentive insertion and manipula- centrate his mind and pull the needle
tion Hold the needle handle with the slowly to the three levels. For reinforc-
right hand, thrust and rotate it deep ing, heavy thrusting is applied, while for
into the muscles with force. After three reducing, forceful withdrawal is used.
breathings, lift the needle to the part 8) Twisting A needle should not be
just below the skin. After another three twisted too tight, otherwise, it will be
breathing, the needling sensation may entangled by the muscles, causing sharp
appear. Then other manipulations may pain. In stagnation of qi twist the needle
be followed. to promote smooth flow of qi and blood,
3) Warming the needle in the mouth and to disperse the defensive qi.
(omitted)
9) Turning To treat the disease in the
4) Entering of the needle a) Before
upper region, turn the needle forth ward
needling, the patient and practitioner
to make qi ascend, and to treat the di-
should keep even breath to calm the
sease in the lower region, turn the needle
mind. b) The point should be located
backward to make qi descend. Lifting the
accurately, for example, points of the
needle to the middle level, and turning
yang meridians on the four extremities
the needle backward is the reinforcing
should be located between the tendons
and bones, while those of the yin meridi- method, and vice versa. The purpose is to
promote smooth flow of qi.
ans on the four extremities located at the
10) Retaining Before withdrawing
place with the fingers responding to the
arteries. the needle, keep the needle subcutaneous-
5) Pressing After the insertion and ly for a while, then withdraw it. The
manipulation of the needle, but the pa- purpose is to keep the qi stable at the
tient does not feel the needling sensation, punctured part.
lightly press the skin with fingers along 11) Shaking When the needle is
the course of the meridian on which the withdrawn in the level, shake the needle
point is located, both above and below. twice at each level to enlarge the punc-
The purpose is to make smooth flow of tured hole.
qi and blood and to facilitate the arrival 12) Pulling On withdrawal of the
of qi. needle, be sure that it is not stuck tight-
6) Scratching If an inserted needle is ly. Then use the fingers to lift the nee-
difficult to lift, thrust or even withdraw, dle out carefully-as if "pulling a tiger's
the needle is stuck by the pathogenic tail. "
354 CHINESE ACUPCNCTURE AND MOXIBUSTION
---------------------------------------------------------------
IV. THE THREE-EDGED swiftly about 0.05-0.1 cun deep at the
NEEDLE THERAPY area for bloodletting and withdraw the
needle immediately. After pricking, press
the punctured hole with a dry cotton ball
1. Needle until the bleeding stops. This is the most
The three-edged needle is developed widely used method in clinics, for exam-
from the lance needle of the Nine Nee- ple, pricking Weizhong (BL 40) to treat
dles created in the ancient times. The lumbago due to stagnation of blood,
needle is shaped in a round handle, a pricking Shaoshang (LU 11) to treat sore
triangular head and a sharp tip (Fig. throat, pricking Quze (PC 3) and Wei-
lSI ). zhong (BL 40) to treat acute vomiting,
pricking Taiyang (Extra) or apex of the
ear to treat acute conjunctivitis.
2) Clumpy pricking Prick around a
small area or a reddened swelling, then
Fig. 151 The Three-edged Needle press the skin to make the decayed blood
escape. This method is mostly used for
carbuncles, erysipelas, etc.
2. Indications 3) Pricking During the operation,
pinch up the local skin with the left hand,
The three-edged needle functions to prick the skin 0.5 cun deep with a three-
promote the smooth flow of qi and blood edged needle to make bleed. If there is no
in meridians, dispel blood stasis and elim- bleeding, press the punctured part until
inate the heat. It is advisable to treat bleeding occurs. This method is mostly
blockage of the meridians, blood stasis, used to treat multiple follicucitis. For
excess syndrome and heat syndrome, mUltiple carbuncles of the neck, try to
such as high fever, loss of consciousness, find the red spots at the both sides of the
sore throat, local congestion or swelling. vertebra, and then prick them with a
three-edged needle till bleeding.
3. Manipulations
4. Precautions
There are three kinds of manipula-
tions. I) Aseptic operation IS applied to
1) Spot pricking This is a method prevent infection.
known as collateral pricking in ancient 2) For spot pricking, the operation
times used to treat disease by pricking the should be slight, superficial, and rapid.
small vessels with a three-edged needle to Bleeding should not be excessive. Avoid
obtain a little bloodletting. During the injuring the deep large arteries.
operation hold the handle of the three- 3) Pricking shall in no case be a p-
edged needle with the right hand, prick plied for those with weak constitution,
CHAPTER 14 ACUPUNCTURE TECHNIQUES 35S

for pregnant women and those suscepti- tached vertically to a handle five to six
ble to bleeding. inches long.
2) The plum-blossom needle Com-
posed of five stainless steel needles in a
v. THE DERMAL NEEDLE bundle and attached to a handle perpen-
THERAPY dicularly one foot long.
The tip of the needles should not be
1. Needle too sharp, but on the same level with
equal space between them, otherwise,
The dermal needle is also known as pain or bleeding may happen during tap-
the plum-blossom needle and seven-star ping.
needle, which is made of five to seven
stainless steel needles inlaid onto the end 2. Indications
of a handle. It is used to prick the skin
superficially by tapping to promote the This superficial tapping is particularly
smooth flow of qi in the meridians and suitable to treat disorders of the nervous
regulate the functions of the zang-fu or- system and skin disease. It is used for
gans (Fig. 152). headache, dizziness and vertigo, insom-
1) The seven-star needle Composed nia, gastrointestinal disease, gynecologi-
of seven short stainless steel needles at- cal disease, skin disease, painful joints
and paralysis.

3. Manipulation
After routine and local sterilization,
hold the handle of the needle and tap
vertically on the skin surface with a flex-
ible movement of the wrist (Fig. 153).
The tapping may be light or heavy. Tap
slightly until the skin becomes congested,
or tap heavily until slight bleeding ap-

~
tJ
1) Seven·star 2) Plum-blossom
Needle Needle

Fig. 152 The Dermal Needle Fig. 153

35(.~j_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _c.::..::H=IN~TE=SE=__=_=A.:::._CU~TP.:::._U=___NC=_=T~U=___RE=___.::..::AN:..:.:TD::........:..M::..:O.::..::X=:.IB:.::.:US:...::T.::..::IO::..:..:N

pears. The area to be tapped may be developed from the ancient method of
along the course of the meridians, or on needle retaining. It can exert the contin-
the points selected, or on the affected uous stimulation produced by the im-
area, or along the both sides of the spinal planted needle.
column. I) The thumbtack-type needle, which
is about 0.3 em long with a head like a
4. Precautions thumbtack; and
2) The grain-like needle, about I ern
1) The tips of the needles should be long with a head like a grain of wheat.
even and free from any hooks. On tap-
pill1g, the tips of the needles should strike 2. Indications
the skin at a right angle to the surface to
reduce pain. It is mostly used in clinic to treat some
2) Sterilize the needles and the local chronic or painful diseases which need
area to be treated. After heavy tapping, long time retaining of the needle, such as
the local skin surface should be cleaned headache, stomachache, asthma, insom-
and sterilized to prevent infection. nia, enuresis, abnormal menstruation,
3) Tapping is not allowed to apply to dysmenorrhen, etc.
the local trauma and ulcers.
3. Manipulation
The grain-like needle is applied to
VI. THE INTRADERMAL
points or tender spots on various parts of
NEEDLE THERAPY the body while the thumbtack-type needle
is generally applied to the ear region.
1. Needle Embed the sterilized needle into the
point, leaving its handle lying flat on the
The intradermal needle is a kind of skin surface, and fixing it with a piece of
short needle made of stainless steel wire, adhesive tape.
especially used for embedding in the skin.
There are two types: the thumbtack type
4. Precautions
and grain-like type. The intradermal nee-
dle is also known as "embedding needle," I) The duration of implantation de-
pends on the pathological conditions in
different seasons. In summer, the needles
--0 are generally retained for one to two days
1) Thumbtack Type 2) Grain-like Type
because of excessive sweating which is
likely to cause infection. In autumn or
winter, the retaining duration may be
longer according to the need in specific
Fig. 154 The Intradermal Needle
cases.
CHAPTER 14 ACUPUNCTURE TECHNIQUES 357

2) Try to avoid embedding the intra- 5) Stiletto needle, 4 inches long, 0.25
dermal needle at the joints to prevent inch wide, shaped as a sword, used for
pain on motion. pain and drainage of pus.
3) In the purulent infected area or 6) Round-sharp needle, 1.6 inches
skin ulcers it is not allowed to embed the long with a thin round body and a slight-
needle. ly large head, mainly used for sudden
4) During the embedding period, keep attack of rheumatic arthritis and pain.
the area around the needle clean to pre- 7) Filiform needle, l.6 inches long
vent infection. with a sharp tip and a thin body, used for
cold, heat and painful conditions.
8) Long needle, 7 inches long with a
VII. THE NINE CLASSICAL round and sharp tip and big body, used
NEEDLES AND THE to treat disorders of the deep tissue or
NEEDLING METHODS persistent bi-syndrome.
LISTED IN INTERNAL 9) Big needle, 4 inches long with a
CLASSIC slightly round tip shaped as a stick, used
to treat joint disorders due to the reten-
tion of water.
1. The Nine Classical Needles
The nine classical needles are those of 2. The Needling Methods Listed in
different forms used in the ancient times. Internal Classic
In Chapter 7 of Miraculous Pivot, it is
stated that "each of the nine needles, Many different needling methods are
long, short, big or small, has its specific described in Internal Classic, in which the
usage." seventh chapter of Miraculous Pivot has
1) The shear needle, 1.6 inches long concentrated a lot of needling methods
with a round head and sharp tip like an including the location of the points.
arrow, often used for superficial diseases. 1) The nine needlings In Chapter 7 of
2) Round-point needle, 1.6 inches long Miraculous Pivot, it says, "There are nine
with a oval-rounded tip, used for disor- needlings applied to cope with nine dif-
ders of the muscles or for massage treat- ferent diseases."
ment. a) Shu-point needling, used in treat-
3) Spoon needle, 3.5 inches long with ment of disorders of the five zang organs,
a round needle body and slightly sharp by which the needle is inserted at Ying-
tip, used for blood vessels disease and (Spring) Points of the yin meridians and
pressing purpose. the Shu-(Stream) Points. Strictly speak-
4) Lance needle, 1.6 inches long with ing, this is a combining method in selec-
a triangle needle body and a sharp and tion of points.
pyramid tip, served as a scalpel for heat- b) Distant needling, used in treatment
toxin abscesses or for blood-letting. of disorders of the six fu organs, by

-----_. ---
358 CHll'\ESE ACCPL;KCTL'RE AND MOXIBUSTION
-----------------------------------------------------------~~~

which the needle is inserted at the points terior regions of the body respectively in
in the upper region distant from the af- order to treat cardialgia and thora-
fected regions located below. The Lower codynia.
He··(Sea) Points of the six fu organs of b) Trigger needling, used to treat wan-
the three yang meridians of foot are often dering pains. When pains are not local-
selected. This is a combining method in ized in one definite area, perpendicular
selection of points. insertion of the needle into the affected
c) Meridian needling, used to treat an regions should be applied with no imme-
affected meridian by needling along that diate withdrawal, and the needle may be
meridian or the meridian related to the removed after a pressure has been ap-
affected part. plied to the affected region with the left
d) Collateral needling, used to cause hand.
bleeding of the subcutaneous small ves- c) Lateral needling, a method to nee-
sels to eliminate blood stasis and treat the dling one side of the painful muscle, and
collateral diseases. shaking the needle forward and back-
(~) Crack needling, used to needle the ward, anteriorly and posteriorly, right
space between two muscles to treat mus- and left so as to expand the needle hole
cular pain. and relax the muscle. This method is used
o Evacuation needling, used with a to treat rheumatic pains.
stiletto needle to perform surgical opera- d) Triple needling, a method in which
tion and remove purulent blood. the needles are inserted at three spots
g) Shallow needling, used to treat su- simultaneously, with one in the centre
perficial disorders. The dermal needle and two on both sides to treat rheuma-
used is developed from this method. tism caused by cold pathogenic factor
h) Contralateral needling, indicating that attacks the body on a small scale but
the needling applied to the points on the with a deep penetration.
right side when the affected region is on e) Quintuple needling, a method in
the left or vice versa. which the needles are inserted at five
i) Heat needling, used with a red-hot spots with one in the centre and the
needle to treat rheumatism. The fire four scattered around it. This method is
puncture developed from this method is applied to treat a relatively large area
now used to treat scrofula and ulcers of disorders caused by cold pathogenic fac-
yin nature. tor.
2) The twelve need lings In Chapter f) Straight needling across the skin, a
7 of Miraculous Pivot it says, "There are method in which the skin in the region
twelve needlings in response to various in which the points involved are located
diseases of the twelve main meridians." is pushed up with the fingers, and then
al Coupled needling, a method in the needle is inserted at the points and
which the needle is inserted at two cor- across the skin. This method is used to
responding points in the frontal and pos- treat diseases caused by the cold patho-
CHAPTER 14 ACUPUNCTURE TECHNIQUES :'>~9
--~----------------------------------------------

gemc factor with the superficial Inva- "There are five need lings developed to
sion. treat various diseases associated with the
g) Shu-point needling, a method in five zang organs."
which the needle is perpendicularly in- a) Extreme shallow needling, a tech-
serted into a few points deeply and nique involving shallow insertion and
withdrawn rapidly to treat heat condi- immediate withdrawal of the needle
tion caused by excess of qi. without any injury of the muscles. This
h) Short needling, a method in which technique is developed in response to
the needle is inserted with slight shak- the diseases associated with the lungs,
ing down to the bone that suffers from and it is a technique which functions to
rheumatism. And then the needle is reduce the superficial pathogenic factors
gradually pushed further into the body used in treatment of fever due to ex-
until its tip reaches the region close to ogenous pathogenic factors, cough and
the affected bones. After that, the nee- asthma.
dle is moved up and down as if rubbing b) Leopard-spot needling, a tech-
the bones. This method is applied to nique in which needles are used to
treat bone rheumatism caused by cold. pierce small blood vessels around the
i) Superficial needling, a method in affected area to eVacuate the points on
which an oblique or shallow insertion is the left, on the right, in the front, on
applied to treat muscular spasms caused sludged blood. This technique is devel-
by cold. oped in response to the disease associat-
j) Yin needling, a method in which ed with the heart by virtue of the fact
the needling is applied to Taixi (K 3), a that the heart is in control of the blood
point of the Kidney Meridian of Foot- and blood vessels. This method may be
Shaoyin on both feet behind the medial used to treat swellings and pains.
malleolus to treat cold limbs and cold c) loint needling, a technique in
conditions. which the needle is inserted rapidly into
k) Adjacent needling, a method in the muscles around the joints of the
which the needling is applied to the af- extremities, but to avoid bleeding, to
fected part vertically and laterally with treat rheumatism of tendons. This tech-
one needle each to treat prolonged rheu- nique is developed in response to the
matism. diseases associated with the liver by vir-
I) Repeated shallow needling, a meth- tue of the fact that the liver is in con-
od in which the needle is repeatedly in- trol of tendons.
serted vertically and superficially and d) Hegu needling, a technique in
withdrawn rapidly to cause bleeding of which the needle is inserted into the mus-
the affected part in treating carbuncles cles of the affected area, obliquely right
and erysipelas. and left just like the claws of the chicken
3) The five needlings In the seventh to cure rheumatic pain of the muscles.
chapter of Miraculous Pivot, it describes, This technique is developed in response
360 CHINESE ACL'PUNCTL'RE AND ~\'IOXIBUSTION
-----------------------------------------------------------------
to the diseases associated with the spleen bone to treat osteal pain. This technique
by virtue of the fact that the spleen is in is developed in response to the diseases
control of the muscles. associated with the kidney by virtue of
e) Shu-point needling, a technique in the fact that the kidney is in control of
which the needle is thrust deeply to the the bones.
 Chapter 15
MOXIBUSTION AND CUPPING METHOD

Moxibustion treats and prevents di- its growth. The leaves of the Qizhou Ar-
seases by applying heat to points or cer- temisia are thick with much more wool.
tain locations of the human body. The Moxa cones and sticks made of this kind
material used is mainly "moxa-wool" in of Artemisia are thought the top quality
the form of a cone or stick. For centuries, used in moxibustion.
moxibustion and acupuncture have been In A New Edition of Materia Medica
combined in clinical practice, thus they appears the following description: "The
are usually termed together in Chinese. moxa leaf is bitter and acrid, producing
Chapter 73 of Miraculous Pivot states, "A warmth when used in small amount and
disease that may not be treated by acu- strong heat when used in large amount.
puncture may be treated by moxibus- It is of pure yang nature having the abil-
tion." In Introduction to Medicine it says, ity to restore the primary yang from col-
"When a disease fails to respond to med- lapse. It can open the twelve regular me-
ication and acupuncture, moxibustion is ridians, travelling through the three yin
suggested. " meridians to regulate qi and blood, expel
Cupping method is a therapeutic ap- cold and dampness, warm the uterus,
proach by attaching small jars which a stop bleeding, warm the spleen and stom-
vacuum is created. Cupping, sometimes ach to remove stagnation, regulate men-
used in combination with acupuncture, is struation and ease the fetus.... When
elucidated herewith. burned, it penetrates all the meridians,
eliminating hundreds of diseases." Yang
qi can be activated by the Artemisia leaf
I. THE MATERIALS AND for its warm nature. The acrid odour of
FUNCTIONS OF the leaf can travel through the meridians,
MOXIBUSTION regulate qi and blood, and expel cold
from the meridians, and its bitter nature
1. The Property of Artemisia resolves dampness. As a result it is used
as a necessary material in moxibustion
Vulagaris Moxa
treatment. In addition, the moxa wool
Artemisia Vulgaris is a species of can produce mild heat, which is able to
chrysanthemum. The one produced in penetrate deeply into the muscles. If it is
Qizhou is known as the best kind for replaced by other materials, an intoler-
moxa as the climate and soil is good for able burning pain will result, and the
362 CHINESE ACL'PCNCTURE AND MOXIBl'STION

effect is found poor than the moxa wool. the body and liver yang syndrome due to
upward flowing of yang qi so as to lead
2. Functions of Moxibustion the qi and blood to go downward. In
Chapter 64 of Miraculolls Pivot, it is
1) To warm meridians and expel cold pointed out that "when there is an excess
Abnormal flow of qi and blood in the of qi in the upper portion, the qi should
body is usually resulted from cold and be brought downward by needling the
heat. Cold causes slow flow or even stag- points in the lower portion." If the disor-
nation of qi, and heat results in rapid der is due to deficiency in the upper
flow of qi. "Normal heat activates blood portion and excess in the lower portion of
circulation and cold impedes its smooth the body and due to sinking of qi caused
flow." Since stagnation of qi and blood is by deficiency, such as prolapse of anus,
often relieved by warming up the qi, mox- prolapse of uterus, prolonged diarrhoea,
ibustion is the right way to generate the etc., moxibustion to Baihui (GV 20) may
smooth flow of qi with the help of the lead yang qi to flow upward.
ignited moxa wool. In Chapter 75 of Mi- 3) To strengthen yang from collapse
raculous Pivot it says, "If stagnation of Yang qi is the foundation of the human
blood in the vessels cannot be treated by body. If it is in a sufficient condition, a
warming-up with moxibustion, it cannot man lives a long life; if it is lost, death
be treated by acupuncture." In Chapter occurs, Yang disorder is due to excess of
48 of Miraculous Pivot it states, --De- yin, leading to cold, deficiency and ex-
pressed symptoms should be treated by haustion of the primary qi characterized
moxibustion alone, because depression is by a fatal pulse. At this moment moxibus-
due to blood stagnation caused by cold, tion applied can reinforce yang qi and
which should be dispersed by moxibus- prevent collapse. In Chapter 73 of Mirac-
tion." It is easy to understand that moxi- ulous Pivot it says, "Deficiency of both yin
bustion functions to warm up the me- and yang should be treated by moxibus-
ridians and promote blood circulation. tion."
Therefore, it is mostly used in clinic to 4) To prevent diseases and keep healthy
treat diseases caused by cold-dampness In Preciolls Prescriptions appears the fol-
and persistent diseases caused by patho- lowing description: "Anyone who travels
genic cold penetrating into the deep mus- in the southwest part of China, such as
cles. Yunnan and Sichuan provinces, should
2) To induce the smooth flow of qi and have moxibustion at two or three points
blood Another function of moxibustion to prevent sores or boils and to avoid
is to induce qi and blood to flow upward pernicious malaria, epidemic diseases and
or downward. For example, moxibustion pestilence." It is often said, "If one wants
is given to Yongquan (KI I) to treat the to be healthy, you should often have
disorders caused by excess in the upper moxibustion over the point Zusanli (ST
part and deficiency in the lower part of 36 )." In Notes on Bian Que's Moxibustion,
CHAPTER 15 MOXIBUSTION AND CUPPING METHOD

it says, "When a healthy man often has

moxibustion to the points of Guangyuan
(CV 4), Qihai (CV 6) Mingmen (GV 4)
and Zhongwan (CV 12), he would live a
very long life, at least one hundred years'
life." Clinical practice has proved that
moxibustion is very much helpful in
preventing disease and keeping healthy."
Fig. 155
3. Materials for Moxibustion
moxa cones. Simply roll moxa wool (oth-
Moxa wool, moxa cones, moxa sticks, er herbal medicine may be mixed in) into
matches and a tray should be ready be- the shape of a cigar, using paper made of
forehand. mulberry bark (Fig. 156).
1) Making of moxa cones Place a
small amount of moxa wool on a board,
knead and shape it into a cone with the II. CLASSIFICATION OF
thumb, index and middle fingers in three MOXIBUSTION
sizes. The smallest is as big as a grain of
wheat; the medium size is about half a From the ancient times until now rich
date stone, and the largest is the size of clinical experience has been gained in the
the upper part of the thumb. The two moxibustion therapy. At first only the
smaller cones are suitable for direct Mox- moxa cones were used. But now var-
ibustion, while the largest for indirect ious approaches have been developed
moxibustion (Fig. 155). and used clinically, i.e. moxibustion with
2) Making of moxa stick It is much maxa cones, with moxa sticks, and with
more convenient to use moxa sticks than warming needle (Tab. 16).

Table 16. Classification of Moxibustion

Scarring moxibustion
Direct moxibustion {
Nonscarring moxibustion

Moxa cones
Ginger insulation
Moxibustion
Indirect moxibustion Garlic insulation
{
Moxa sticks Salt insulation
Warming needle Monkshood cake insulation
364 CHINESE ACCPCNCTCRE AKD MOXIBL'STION

Fig. 156

1. Moxibustion with Moxa Cone to ten units. This method may lead to a
local burn, blister, festering and scar af-
Moxibustion with moxa cones may be ter healing. Indications are certain chron-
direct or indirect. Direct moxibustion is ic diseases such as asthma.
to place a moxa cone directly on the skin
b) Nonscarring moxibustion:
and ignite it, while indirect moxibustion
A moxa cone is placed on a point and
is to place a moxa cone indirectly on the
ignited. When half or two thirds of it is
skin but insulated with some different
burnt or the patient feels a burning dis-
medical substances. The names are no-
comfort, remove the cone and place an-
menc1atured according to the names of
other one. No blister should be formed
the different medical substances, for ex-
ample, ginger used as the insulator is and there should be no festering and
called moxibustion with ginger; salt used scar formation. Indications are diseases
for insulation is called moxibustion with of chronic, deficient and cold nature such
salt. One moxa cone used at one point is as asthma, chronic diarrhoea, indiges-
called one unit. tion, etc.
1) Direct moxibustion A moxa cone 2) Indirect moxibustion
place directly on the point and ignited The ignited moxa cone does not rest
is called direct moxibustion, and is also on the skin directly but is insulated from
known as "open moxibustion," which was the skin by one of four types of materials.
widely used in the ancient times with a) Moxibustion with ginger:
better results. This type of moxibustion is Cut a slice of ginger about 0.5 cm
subdivided into scarring moxibustion and
nonscarring moxibustion according to
whether the local scar is formed or not
after moxibustion (Fig. 157).
a) Scarring moxibustion (also known
as "festering moxibustion"):
Prior to moxibustion, apply some
onion or garlic juice to the site in order
to increase the adhesion of the moxa cone
to the skin, then put the moxa cone on
the point and ignite it until it completely
burns out. Repeat this procedure for five Fig. 157
CHAPTER 15 MOXIBCSTJOK AKD Cl!PPING METHOD 365

scrofula, tuberculosis, the early stage of

skin ulcer with boils, poisonous insect
bite, etc.
c) Moxibustion with salt:
This is usually applied at the umbili-
cus, so it is also called "moxibustion at
Shenque (CY 8) point." Fill the umbilicus
with salt to the level of the skin, place a
large moxa cone on the top of salt and
then ignite it. (If the patient's umbilicus
Fig. 158 is not concave in shape, a piece of wet
needle can be put around the umbilicus
thick, punch numerous holes on it and
place it on the point selected. On top of then fill salt in it. The moxa cone can be
this piece of ginger, a large moxa cone placed and ignited on the top of it.) This
is placed and ignited. When the patient method is effective in cases of abdom-
feels it scorching, remove it and light inal pain, vomiting and diarrhoea, pain
another. This method is indicated in around the umbilicus, pain caused by
symptoms caused by weakness of the hernia, prolonged dysentery, etc. In addi-
stomach and spleen such as diarrhoea, tion, moxibustion with salt has the func-
abdominal pain, painful joints and symp- tion to restore to yang from collapse, e.g.
toms due to yang deficiency. symptoms of excessive sweating, cold
b) Moxibustion with garlic: limbs and undetectable pulse. Large
Cut a slice of garlic about 0.5 cm thick moxa cones may be used successively un-
(a large single clove of garlic is desir- til sweating stops, pulse restores and the
able), punch holes in it, put it on the four extremities get warm (Fig. 159).
point with the ignited moxa cone above. d) Moxibustion with monkshood cake:
Renew the cone when the patient feels it A coin-sized cake made of monkshood
scorching. This method is indicated in powder mixed with alcohol. is punched

Fig. 159
 CHINESE ACl'PU"CTCRE AND MOXIBUSTION

with numerous holes in it, and placed on 2) "Sparrow-pecking" moxibustion

the site for moxibustion with the moxa When this method is applied, the ig-
cone ignited and burnt on the top of it. nited moxa stick is rapidly pecked over
Since it is of heat nature, the monks- the point, paying attention not to burning
hood may warm yang and expel cold. the skin. In addition, the ignited moxa
This method is only suitable to treat stick may be evenly moved from left to
deficient, and persistent yin-cold syn- right or in circular movement (Fig. 162).
dromes, such as impotence and ejacula- 3) Moxibustion with warming needle
tion precox caused by declination of the Moxibustion with warming needle is a
Mingmen (vital gate) fire. method of acupuncture combined with
moxibustion, and is used for conditions
2. Moxibustion with Moxa Sticks in which both the retaining of the needle
and moxibustion are needed. The mani-
Apply a lighted moxa stick over the
selected point. It is easy to control heat pulation is as follows:
and time during moxibustion, and the After the arrival of qi and with the
therapeutic effect is good, so it is often needle retained in the point, wrap the
used today. This method includes two needle handle with a unit of moxa wool
kinds: mild-warm moxibustion and and ignite it to cause a mild heat sensa-
sparrow-pecking moxibustion. tion around the point. This method func-
1) Mild-warm moxibustion tions to warm the meridians and promote
Apply an ignited moxa stick over the the free flow of qi and blood so as to
point to bring a mild warmth to the local treat painful joints caused by cold-damp,
area for five to ten minutes until the local numbness with cold sensation and par-
area is red (Fig. 160). alysis (Fig. 162).

Fig. 160 Fig. 161

CHAPTER I S MOXIBUSTION AND CUPPING METHOD 367

of paper are made, then put a layer of

clean moxa wool on the top and tightly
roll them together like a fire cracker in
shape, and naste the outside with a piece
of white mulberry paper. The whole stick
is fixed by the egg white, and dried in
a cool place without sunshine. Leakage
should be avoided.
Method: The area for moxibustion
Fig. 162 should be examined and marked. Burn
one stick completely and rapidly put the
Appendix: The Great Monad Herbal ignited stick in a piece of dry cloth which
Moxa Stick and Thunder-Fire has been folded into seven layers. Then
Herbal Moxa Stick direct the cloth with the ignited moxa
stick in it to the skin to produce a heat
1) The Great Monad Herbal Moxa sensation on the affected area and make
Stick it penetrate into the deep muscles. If the
Compositions: patient feels it scorching, the stick may
150 g of moxa wool, be lifted a little. When the heat sensation
10 g of sulphur, becomes normal, press and iron the af-
5 g of musk, fected area until the heat on the ignited
5 g of Resina Boswelliae Carterii, end extinguishes. Ignite another stick and
5 g of Myrrha, go on ironing the affected area. In order
5 g of Colophonium, to get good results and keep the heat on
5 g of Cassia Twig, the affected area, it is better to prepare
5 g of Eucommia Bark, two sticks in turn for use. This method
5 g of Bitter Orange, can warm and promote the free flow of
5 g of Spina Gleditsiae, qi and blood, dispel cold and dampness.
5 g of Herba Asari, It is, therefore, used for painful joints
5 g of Rhizoma Ligustici Chuanxiong, caused by wind, cold and dampness, and
5 g of Radix Angelicae Pubescentis, for prolonged diseases and pains such as
5 g of Squama Manitis, abdominal pain, dysmenorrhea, hernia,
5 g of Realgar, etc.
5 g of Radix Angelicae Dahuricae, and 2) Thunder-fire herbal moxa stick
5 g of Scorpion. Get two sheets of paper ready. One is
These herbs are mixed together and thick, the other is thin. One sheet is par-
ground into fine powders, put some pow- alleld with the other which has been al-
ders on a piece of paper and cover it with ready folded into double layers. On the
another piece of paper. Several layers of top of the double-folded paper, place a
fine powder covered with several layers layer of clean moxa wool. Slightly tap it
 CHINESE ACUPUNCTCRE AND MOXIBUSTION

with a wooden ruler or a rattan stick until ditions.

it spreads squarely with even thickness. The volume for moxibustion, includ-
Then put some herbal powders on the ing the size of moxa cone or duration of
moxa wool and roll them together like a the moxa stick application should be in
fire cracker in shape. After that it is parallel to the patients' pathological con-
wrapped up with a sheet of thin paper ditions, general constitution, age and the
and fixed with egg white. The stick is site where moxibustion is to be applied.
dried in a cool place without sunshine. Generally, three to seven moxa cones are
Avoid leakage of the roll. used for each point, and ten to fifteen
Compositions: minutes for the application of moxa
100 g of moxa wool, stick.
15 g of Eagle Wood,
15 g of Radix Inulae Helenii,
15 g of Resina Boswelliae Carterii,
2. Contraindications
15 g of Notopterygium, I) Excess syndrome, and heat syn-
15 g of dried ginger, and drome (including high fever caused by
15 g of Squama Manitis.
common cold or heat due to yin deficien-
These herbs should be ground into
cy) are not allowed to be treated by mox-
fine poWder, and a little musk is added
ibustion. It is stated in Treatise on Febrile
after sieving.
Diseases that "a patient with feeble and
The method and indications are the
rapid pulse should not be treated by mox-
same as those of the Great Monad Herbal
ibustion. Although the heat of moxibus-
moxa stick.
tion is weak, strong internal impact may
produce," indicating that improper moxi-
III. APPLICATION OF bustion may bring bad results.
MOXIBUSTION 2) Scarring moxibustion should not be
applied to the face and head, and the area
in the vicinity of the large blood vessels.
1. The Process and Volumn for According to the recordings of ancient
Moxibustion literature, there are certain points which
The Precious Prescriptions points out are advisable to acupuncture but not suit-
that "Moxibustion is generally applied to able for moxibustion, because most of
yang portion first, then yin portion; clin- them are close to the vital organs or
ically it is applied to the upper part first arteries. Examples are Jingming (BL I),
and then the lower part." Treat the back close to the eyeball, and Renying (ST 9),
first, the abdominal region second; the above a large artery.
head and body first and the four extrem- 3) The abdominal region and lumbos-
ities second. But the sequence should be acral region of the pregnant woman are
given according to the pathological con- not allowed to use moxibustion.
CHAPTER 15 MOXIBUSTION AND CUPPING METHOD 369

3. Management After Moxibustion lows:

1) Bamboo jar Cut down a section of
After moxibustion, different degrees bamboo 3-7 em in diameter and 8-10 em
of burns may remain in the local region, in length, forming a cylinder shaped as a
or there is only a slight red sign of burn- drum. One end is used as the bottom, and
ing which will disappear very soon. But the other as the opening. The rim of the
sometimes, a few blisters result on the jar should be made smoothly. The bam-
skin surface. Take care not to let small boo jar is light, economical, easy to make
blisters break. They can be healed by and available in many places.
themselves. Large blisters should be 2) Glass cup Since the glass cup is
punctured and drained. If pus is formed, transparent, the local congestion at the
the blister should be dressed to prevent site for moxibustion can be seen so as to
further infection. control the treatment.

IV. CUPPING METHOD 2. Indications

The cupping method has the function
Cupping is a therapy in which a jar is of warming and promoting the free flow
attached to the skin surface to cause local of qi and blood in the meridians, dispell-
congestion through the negative pressure ing cold dampness, diminishing swellings
created by introducing heat in the form and pains. In clinics, the cupping meth-
of an ignited material. In the ancient od is mainly used to treat hi syndrome
times in China, cupping method was caused by wind dampness, such as pain of
called "horn method." the low back, shoulders, and leg, gastro-
The animal horn was used to dispel intestinal disorders such as stomachache,
pus. Along with continual development vomiting, and diarrhoea, and the lung
in clinical practice, the materials for disease such as cough and asthma.
making jars and the methods have been The cupping method combined with
greatly improved. The range of indica- bloodletting is suitable to treat acute
tions has been expanded, since this meth- sprains accompanied by blood stasis.
od is simple and the therapeutic effect is
good. This therapy was attracted with 3. Manipulations
great attention and applied in a large
scale by the broad masses, and also used 1) Fire throwing method Throw a
as an auxillary method of acupuncture piece of ignited paper or an alcohol cot-
and moxibustion. ton ball into the cup, then rapidly place
the mouth of the cup firmly against the
1. Types of Jars skin on the desired location. This method
is applied to the lateral side of the body,
There are a great variety of jars, but otherwise the burning paper or cotton
the commonly used clinically are as fol- ball may fall and hurt the skin.
370 CHINESE ACUPUNCTURE AND MOXIBUSTION

2) Fire twinkling method Clamp a 2) The burning flame should be

cotton ball soaked with 95% alcohol with stronger enough to create a vacuum.
the forceps or nippers, ignite it and put it Hold the cup with the rim close to the
into the cup, and immediately take it out local area and cup it to the skin rapidly
and place the cup on the selected posi- and deftly, otherwise, there will be no
tion. therapeutic effects.
Generally, the cup is sucked in place 3) It is not advisable to apply cupping
for ten minutes. The skin becomes con- to the patient with skin ulcer, edema, or
gested with violet coloured blood stasis on an area overlying large blood vessels,
formation. On withdrawing the cup, hold to the patient with high fever and convul-
the cup with the right hand, and press the sion; or to the abdominal and sacral re-
skin around the rim of the cup with the gions of the pregnant women.
left hand to let air in. In addition, cup- 4) It is not suitable to apply cupping
ping may be combined with the bloodlet- to the patient susceptible to spontaneous
ting technique. First sterilize the area for bleeding or endless bleeding after
cupping and prick a small vein with a trauma.
triangular needle or intrademal needle, 5) After cupping, there is a blood sta-
and the cupping follows. sis or bruise at the local area. Generally,
it will disappear several days later. Small
4. Precautions blisters occurring on the skin will absorb
naturally several days later. If the blisters
I) The patient should select a comfort- are severe, draw out the liquid by a sterile
able position. Cups in different sizes are syringe, apply gentian violet and cover
used according to the cupping location. them with gause to prevent infection.
Generally, the areas where the muscle is In case cupping is combined with
abundant and elastic, free from hairs and bloodletting, remove the blood from the
bone ridges are selected. punctured hold with a dry cotton ball.
 Chapter 16
A GENERAL INTRODUCTION TO
ACUPUNCTURE TREATMENT
Acupuncture therapy takes the theo- is therefore a fundamental principle in
ries of traditional Chinese medicine as clinical treatment. In the fifth chapter of
guidance to treat patients with acupunc- Miraculous Pivot, it points out that "how
ture and moxibustion based upon dif- to regulate yin and yang is most impor-
ferentiation of syndromes. This chapter tant in acupuncture treatment."
deals mainly with the general laws of Yang in excess makes yin suffer and
acupuncture therapy. The descriptions yin in excess makes yang suffer. Exces-
for the principles of treatment, the meth- sive heat (yang) is likely to injure yin
ods, the basic guidelines for prescription essence, while excessive cold (yin) is like-
and selection of points are as follows: ly to damage yang qi. In treatment, re-
duce excessive heat or expel cold through
the methods of "removing the excess" and
I. GENERAL PRINCIPLES "reducing the preponderance." On regu-
OF TREATMENT lating the preponderance of yin or yang,
attention should be paid to the condition
The general principles of treatment whether a corresponding yin or yang de-
are worked out under the guidance of ficiency exists. If one is deficient, consi-
the holistic concept and differentiation deration should be given to both yang
of syndromes. The general principles are reduction and yin reinforcement, dispell-
of universal significance in decision of ing cold and warming yang simul-
the treating methods and priscriptions. taneously.
Yin in deficiency fails to control yang,
1. Regulation of Yin and Yang manifested by deficiency heat syndrome
and yang hyperactivity due to yin defi-
The occurrence of any diseases is, fun- ciency. Yang in deficiency fails to con-
damentally speaking, due to the relative trol yin, as shown in deficiency cold syn-
imbalance of yin and yang. Namely, the drome and excess of yin due to yang
normal inter-consuming-supporting rela- deficiency. In the fifth chapter of Plain
tionship between them is disturbed by Questions, it says, "Treat yin for yang
either preponderance or discomfiture of problems and treat yang for yin prob-
yin and yang. Regulation of yin and yang lems," indicating that hyperactivity of
372 CHINESE ACUPUNCTURE AND .\10XlBl'STION

yang due to yin deficiency should be To strengthen the body resistance is to

treated by strengthening yin to control reinforce the antipathogenic qi and build
yang, while cold (yin) due to yang defi- up health. Once the body resistance
ciency should be treated by reinforcing against disease is strengthened, the path-
yang to control yin. If they are both ogenic factors are eliminated. Once the
deficient, yin and yang should be rein- pathogenic factors are removed, the body
forced. In treating diseases marked by yin resistance will be reinforced. Since they
or yang deficiency, try to achieve yang are closely related to each other, streng-
from yin and achieve yin from yang, be- thening the body resistance is beneficial
cause they are interdependent. For exam- to dispelling the pathogenic factors and
ple, the Front-Mu Points and Back-Shu vice versa.
Points are used respectively to regulate Clinically, the condition of the path-
and replenish yin qi and yang qi of the ogenic factors and antipathogenic qi
zang-fu organs. should be carefully observed, upon
Yin and yang are considered the gen- which, strengthening the body resistance
eral principle for differentiation of syn- first or dispelling the pathogenic factors
dromes. In a broad sense, "relieving defi- first can be determined. For patients with
ciency by the tonifying method, reducing weak body resistance but pathogenic fac-
excess, dispelling cold by the warming tors not yet strong enough, the body re-
method, nutrient and defensive qi regula- sistance is strengthened first. For pa-
tion, and qi and blood promotion" all fall tients with excessive pathogenic factors
into the aspect of regulation of yin and but body resistance not yet damaged, the
yang. Acupuncture therapy is to apply prime task is to eliminate the pathogenic
different techniques of manipulations to factors. But for patients with weak body
points to treat diseases by means of regu- resistance and excessive pathogenic fac-
lating yin and yang. tors as well, both methods should be em-
ployed simultaneously. Try to distinguish
2. Strengthening the Body Resistance what is primary from what is secondary.
and Eliminating the Pathogenic For those with weak body resistance
Factors priority should be placed on building
body resistance and do something to get
The course of a disease is actually the rid of the pathogenic factors, and vice
process of struggle between the antipath- versa. When the patient is in a relatively
ogenic qi and pathogenic factors. Mobil- critical condition attacked by excessive
izing the antipathogenic qi to defeat the pathogenic factors, and the body resist-
pathogenic factors is the right way to ance is too weak, for which the pathogen-
cure the disease. Therefore, strengthen- ic factors are not eliminated, strengthen
ing the body resistance and eliminating the body resistance first and then remove
the pathogenic factors are also the impor- the pathogenic factors. If the patient is
tant principles in clinical treatment. in a very poor condition with excessive
CHAPTER 16 A GENERAL INTRODlJCTION TO ACUPUNCTl'RE TREATMENT 373
----------------------------~~

pathogenic factors, but with weak body the same time.

resistance, eliminate the pathogenic fac- Trying to find out the primary or root
tors first, and then strengthen the body cause is of importance. In clinic, the na-
resistance. ture and the primary aspect of a disease
should be well commanded so as to treat
3. Distinguishing the Primary from the root cause. Some diseases, although
the Secondary their symptoms are different, the etiology
and pathogenesis are the same, so they
The conception of the primary and the can be treated by the same method. For
secondary are relative to each other in- example, in case of sore throat due to yin
volving different meanings. In terms of deficiency of the kidney and low back
the antipathogenic qi and pathogenic fac- pain due to yin deficiency of the kidney,
tors, the former is the primary, and the the treatment to nourish the kidney yin is
latter is the secondary. Judged by the adopted. This is called "treating differ-
etiology and manifestation, the etiology ent diseases with the same method." For
is the primary, and the manifestation is some other diseases, although their symp-
the secondary. As to the localization of a toms are alike, the etiology and patho-
lesion, the internal portion is the pri- genesis are different, different methods
mary, and the external is the secondary. therefore should be used to treat the root
As ~or the clinical course of a disease the cause. For instance, headache due to liver
origiinal is the primary, while the compli- yang hyperactivity should be treated by
cation is the secondary. This concept re- nourishing yin to reduce yang, but head-
presl~!nts the two opposite aspects of one ache caused by both qi and blood defi-
entity during the course of a disease. The ciency should be treated by reinforcing qi
symptom is generally the phenomenon and blood. However headache caused by
and the secondary aspect, the root cause invasion of the meridians by wind cold
is generally the nature and the primary must be treated by diminishing wind
aspect. cold. This is called "treating the same
Clinically, a disease should be assessed disease with different methods."
according to such different situations Under certain circumstances, the
of the primary, the secondary, the root symptoms are very critical, if not treated
cause, the symptoms, the acute, and the immediately, they shall affect the treat-
chronic so as to ascertain the main aspect ment of the root cause or perhaps cause
of the contradictions, and thus treat- death, in this case it is necessary to ob-
ed accordingly. Under general circum- serve the principle of "treating the symp-
stances, the primary or root cause should toms first when they are acute, and treat-
be found first, but if the symptoms are ing the root cause when these symptoms
acute, they should be treated first. If the are relieved." For example, a patient with
symptoms and root cause are both ser- chronic cough and asthma caught a com-
ious., they should be taken into account at mon cold, accompanied with fever and
374 CHINESE ACUPUNCTURE AND MOXIBUSTION

aversion to cold, common cold sh auld be geographical locations, patient's age, con-
treated first because it is the acute aspect. stitution and others must be taken into
After the common cold is relieved, treat consideration to determine an appro-
chronic cough and asthma which are the priate method in acupuncture treatment.
primary aspect. But if the primary and 1) Climatic and seasonal conditions
secondary aspects are both serious, they In accordance with the characteristics of
must be treated at the same time. climate and seasons, appropriate thera-
Prevention is also an important aspect peutic methods are used. It is said in
in treating the primary aspect. It includes Chapter 9 of Miraculous Pivot, "In spring,
prevention before the attack of a disease the pathogenic factors and most likely to
and prevention from deterioration after attack the superficial layer; in summer,
occurrence of a disease. China has long they are most likely to attack the skin; in
rich experience in health care, such as autumn, they are most likely to attack the
Qigong, Taiji, Baduanjin, etc. Acupunc- muscles; and in winter, they are most
ture and moxibustion is also one of the likely to attack the tendons and bones. In
traditional remedies to prevent diseases. treatment of such disorders, the tech-
Zusanli (ST 36), for example, is an im- niques should remain consistent with the
portant tonifying point. Moxibustion to it seasons." Generally, in spring and sum-
is not only good for preserving health, mer, shaIlow acupuncture is applied, and
but also good for preventing many kinds in autumn and winter, the deep acupunc-
of diseases. Importance is attached to ture is preferred.
early diagnosis and treatment of disease In addition, the acupuncture time is
for fear of its negative development. Dur- also important. For instance, treatment
ing the prevention and treatment of di- of malaria is usually applied two to three
seases, doctors are requested to know the hours before its attack, and dysmenor-
laws of their occurrence and development rhea is usually treated before the men-
and the ways of their transmission. It is strual periods.
recorded in Treatise On Febrile Disease, 2) Geographical locations The appro-
"If the illness is going to invade other priate therapeutic methods should be de-
meridians, needle Foot-Yangming Merid- termined according to different geo-
ian to stop the development." The impor- graphical locations. Climate and life style
tance of preventing diseases from trans- vary in different regions, so do the
mission is clearly stated here. physiological activities and pathological
changes, therefore, the methods of treat-
4. Treatment of Diseases According to ment should be different. In Chapter 12
Climatic and Seasonal Conditions, of Plain Questions it says, "In the north ...
Geographical Locations and people live in highlands and mountains,
exposed to bitter wind and severe cold.
the Individual Conditions
People there prefer outdoor dwelling and
The climatic and seasonal conditions, milk, that's why they are susceptible to
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTFRE TREATMENT :,>75

gastric distention due to accumulation of II. THERAPEUTIC METHOD

cold for which moxibustion is advisable."
"In the south ... it is damp, foggy and The therapeutic methods are worked
dewy, people there prefer to sour taste out under the guidance of the treating
and preserved food, so they have tight principles and differentiation of syn-
muscles and red skin. People in this re- dromes, including selection of points and
gion are susceptible to cramps of tendons application of acupuncture and moxibus-
and rheumatism, for which acupuncture tion. Acupuncture therapy concerns the
is advisable." The above shows that ther- theory, method, prescription and point.
apeutic methods are closely related to Clinically, the four are closely related to
geographical locations, life style and na- one another. According to Internal Clas-
ture of diseases. sic and other medical literature as well
3) Individual conditions Treatment is as the clinical experiences, there are six
also based on age, sex and constitution. kinds of therapeutic methods, name-
For example, men and women are differ- ly, the reinforcing, reducing, warm-
ent in physiology, women have menstrua- ing, clearing, ascending and descending.
tion, pregnancy and puerperal problems,
so the points should be carefully selected 1. Reinforcing
when treatment is given. People of differ-
ent ages are different in physiology and The reinforcing method is used to
pathology. As to constitution, there are strengthen the body resistance and the
strong, weak, more heat, more cold. Be- zangfu organs and replenish yin, yang, qi,
sides, the sensitivity to acupuncture va- blood with acupuncture and moxibustion.
ries individually. In Chapter 38 of Mir- It is indicated to the deficiency syndrome.
aculous Pivot, it says, "A middle-aged It is said in Chapter 10 of Miraculous
strong person with sufficient qi and Pivot that "reinforcing is applied in case
blood, and hard skin may, if being at- of deficiency," and said again in Chapter
tackl~d by the pathogenic factors, be 73 of Miraculous Pivot that "yin and yang
treated by a deep needling with the needle deficiency should be treated by moxibus-
retained for some time." It says again, tion." The commonly-used reinforcing
"Since an infant has weak muscles and methods are as follows:
less volume of blood and qi, acupuncture For reinforcing kidney qi, Shenshu
treatment is given twice a day with shal- (BL 23), Guanyuan (CY 4), Taixi (KI 3),
low needling and weak stimulation." It is etc. are used either with the reinforcing
further pointed out in Chapter 5 of Mir- method or moxibustion.
aculous Pivot that "a deep needling with For reinforcing qi of the spleen and
the needle retained for some time should stomach, Zhongwan (CY 12), Qihai (CY
be applied to physical labourers, whereas, 6), Zusanli (ST 36), etc. are used either
slow insertion of the needle should be with the reinforcing method or moxibus-
given to mental workers." tion.
376 CHINESE ACUPUNCTURE AND MOXIBUSTION

For replenishing qi and blood, Pishu For promoting defecation and reduc-
(BL 20), Geshu (BL 17), Zusanli (ST 36), ing heat, Quchi (LI II), Tianshu (ST 25)
Sanyinjiao (SP 6), etc. are used either and Fenlong (ST 40) are needled with the
with the reinforcing method or moxibus- reducing method.
tion. For invigorating blood circulation and
For nourishing kidney yin, Taixi (KI removing blood stasis, the corresponding
3), Zhaohai (KI 6), Zhishi (BL 52), etc. points are pricked to bleed to treat blood
are used with the reinforcing method. stagnation.
But the reinforcing method shall in no For removing indigestion, Jianli (CY
case be used if the pathogenic factors are II), Zusanli (ST 36) and Sifeng (Extra)
excessive and strong, or if the pathogenic are punctured with the reducing method.
factors are not yet completely eliminated, But the reducing method shall not be
or if the deficiency syndrome is associat- applied to the deficiency syndrome or to
ed with excessive and strong pathogenic cases of deficiency complicated with the
factors. excess syndrome.

2. Reducing 3. Warming
The reducing method is to dispel the The warming method is used to warm
pathogenic factors and remove stagna- the meridians and remove obstructions
tion in order to help restore the body from them, warm and nourish yang qi,
resistance, and is ad visable to the excess warm the middle energizer to dispel cold
syndrome. In the tenth chapter of Mirac- and restore yang from collapse, etc. It is
ulous Pivot, it says that "excessive and applied for cold syndromes. In Chapter
strong pathogenic factors should be elim- 74 of Plain Questions, it says, "Cold syn-
inated by the reducing method," and it dromes should be treated by the warm-
says again in the first chapter of Mirac- ing method," and says again in the tenth
ulous Pivot that "in acupuncture thera- chapter of the same book that "retain
py ... the excessive and strong pathogenic needles for cold syndromes." In Chapter
factors must be dispelled" and "fullness 73 of the same book it states that "if the
should be relieved." It is stated in the regular meridians become tight, moxibus-
fifth chapter of Plain Questions that tion is applied." In Chapter 64 of Mirac-
"blood stagnation should be treated by ulous Pivot, it points out that "in case of
bleeding." coagulation, give warmth and promote
The commonly used reducing meth- the free flow of qi," and further stated in
ods are as follows: Chapter 48 of the same book that "mox-
For dispelling wind to relieve the ex- ibustion is applied in case of cold in
terior syndrome, Fengchi (GB 20), Hegu blood."
(LI 4), etc. are needled with the red ucing The commonly used warming meth-
method. ods are as follows:
CHAPTI:R 16 A GENERAL INTRODUCTION TO ACU\'UNCTURE .~TR:.:.::E~AT~M-=E.:...-NT-=--_ _ _ _ _ _ _ _ _ _~3~.:...:...i7

Remove cold from the meridians by For clearing off heat and resuscita-
warmth. Acupuncture with needle retain- tion, Renzhong (GV 26) and the twelve
ing or moxibustion is applied to the Jing-(Well) Points (LU II, HT 9, PC 9,
points along the meridian affected by the LI I, TE I, and SI I on both sides)
pathogenic cold. are needled with the reducing method
For warming the middle energizer to or bloodletting.
dispel cold, Zhongwan (CV 12) and Zu-
sanli (ST 36) are punctured with needle 5. Ascending
retaining or moxibustion.
For restoring yang from collapse, The ascending method is used to raise
moxibustion is applied to Guanyuan (CV yang qi and lift the zang-fu organs from
4) and Shenque (CV 8) to treat cold sinking. It is for failure of ascending pure
extremities due to the decline of yang qi. yang and sinking of the qi in the middle
But the warming method cannot be energizer. Chapter 74 of Plain Questions
used for heat syndromes, and moxibus- says that "prolapse must be treated by the
tion should be carefully used for syn- ascending method." In Chapter IO of Mi-
drome of yin deficiency. raculous Pivot, it says that "ptosis must be
treated by moxibustion." The Chapter 74
of the same book points out "qi descend-
4. Clearing
ing from the upper portion must be cor-
The clearing method, known as a fe- rected by pushing it up."
brifugal approach, is used to clear off the Clinically, acupuncture with the rein-
pathogenic heat for resuscitation, or for forcing method and moxibustion is ap-
heat syndromes. In Chapter 74 of Plain plied to the local points in combination
Questions, it states that "heat syndromes with Baihui (GV 20), Qihai (CV 6) Guan-
should be treated by swift needling." yuan (CV 6), Zusanli (ST 36), etc. to treat
Compendium of Acupuncture and Moxi- dizziness and vertigo due to failure of pure
bustion says that "the internal pathogenic yang in ascending, sinking of qi from the
heat must be cleared off." middle energizer, visceroptosis, prolapse
The commonly used clearing methods of rectum and prolonged dysentery.
are as follows: But the ascending method shall not be
For dispelling the pathogenic heat, used for patients with yin deficiency and
Dazhui (GV 14), Quchi (LI II) and Hegu yang hyperactivity.
(LI 4) are often needled with the reduc-
ing method. 6. Descending
For heat syndromes in the zang-fu
organs, the ling-eWell) Point and Ying- The descending method is used to make
(Spring) Point of the affected meridians the upward perverted qi go down and to
are often needled with the reducing meth- s.ubdue yang. In Chapter 74 of Plain Ques-
od or bloodletting. tions, it says that "upward perverted flow
378 CHINESE ACUPUNCTURE AND MOXIBUSTION

of qi should be checked by the descending decided on basis of differentiation of syn-

method." In Chapter 64 of Miraculous Pi- dromes. The following is an brief introduc-
vot, it says, "Conduct the qi downward if it tion to the basic principles for prescription
is excessive in the upper part," and says and selection of points.
again in Chapter 19 of the same book,
"Apply acupuncture to Zusanli (ST 36) to
1. Acupuncture Prescription
make the perverted qi of the stomach des-
cend." In clinics, the commonly used des- 1) Nature of an acupuncture prescription
cending methods are as follows: Acupuncture prescription refers to the de-
For regulation of the stomach by sired plan to be conducted in treating cer-
keeping its perverted qi to descend, Tan- tain diseases. The selection of points and
zhong (CY 17), Zhongwan (CY 12), Nei- methods used are included. The prescrip-
guan (PC 6) and Zusanli (ST 36) are tion should list the combination of points,
needled with the even movement. methods of manipulation-reinforcing or
For soothing the liver and subduing reducing, duration and frequency of treat-
liver yang. Fengchi (GB 20), Taichong ment, etc. Generally, a list of points in the
(LR 3) and Yongquan (KI 1) are needled order from upper to lower portion of the
with the reducing method. body, from the back to the abdominal re-
But the descending method cannot be gion, or from the most important ones to
used for deficiency syndromes or defi- the secondary ones should be made. Then
ciency syndrome in the upper part and put down a particular point on one side or
excess in the lower part of the body. In bilateral sides, methods of manipulation,
addition, the descending method can be duration of needle retaining and course of
subdivided into many approaches, but treatment, etc.
they are not discussed in this section. In the prescription, the following sym-
bols are commonly used for methods of
III. THE BASIC PRINCIPLES mani pulation:
T or + stands for reinforcing;
FOR PRESCRIPTION AND -L or - stands for reducing;
SELECTION OF POINTS or ± stands for even movement;
:.: stands for cutaneous needle;
Acupuncture and moxibustion is a ther- 0-- stands for imbedding needle;

apy by needling or moxibustion to certain t stands for bleeding with a three-

points of the human body. Therefore, pro- edged needle;
per prescription including selection and 6. stands for moxibustion;
combination of points and the method of x stands for moxibustion with moxa
treatment employed are significant to the sticks;
curative effects. In prescription, points t stands for warming needle.
should be selected according to their func- 2) Number of points in a prescription
tions and the planned method should be Diseases vary in their occurrence and
CHAPTER 16 A GENERAL INTRODlJCTlOI' TO ACUPUNCTURE TREA._T_M_EI'_'T_ _ _ _ _ _ _ _ _ _ _--=---=-J79

development. Different prescriptions are a point is used. For instance, Ximen (PC
used according to the different individ- 4) is prescribed to treat cardiac pain.
uals and diseases. It is stated in Chapter Shuigou (GY 26) is for pain in the back
74 of Plain Questions that "diseases may and lumbar region. Moreover, an even
appear in severity or mildness, treatment prescription means a pair of points select-
shou:ld be given according to individual ed, e.g. the combination of Back-(Shu)
conditions, and prescriptions may be Point with Front-(Mu) Point, Yuan-
large or small." In Chapter 59 of Mi- (Primary) Point with Luo-(Connecting)
raculous Pivot it says that "diseases are Point, and the upper part points with the
changeable, thus there are countless lower part points of the body of the Eight
methods of treatment to be considered by Confluent Points.
reference to the condition. A mild case
should be treated by selecting a few 2. Principles for Point Selection
points, while a severe case treated by
selecting many points." Generally, there Selection of points along the course
are five acupuncture prescriptions ac- of meridians is the basic principle in
cording to the number of points selected. acupuncture treatment, which is per-
They are "big prescription," "small pres- formed according to the theory of that
cription," "odd prescription," "even pres- diseases are related to meridians. In ap-
cription," and "compound prescription." plication there are three methods of
The big prescription refers to the selec- point selection, namely, selecting points
tion of a great number of points, and is from the affected meridian, selecting
applied to a wide range of disorders in points from the related meridian, and
the zang-fu organs, meridians and colla- selecting points from several meridians.
terals. For instance, a prescription for The first refers to a selection of points
hemiplegia caused by windstroke and epi- on the diseased meridian to which one
lepsy are often treated by selection of a of the organs is related. The second
large number of points. A small prescrip- refers to a selection of points not only
tion refers to the selection of less points from the affected meridian, but also
and is widely used in common ailments, from the meridian related to the affect-
such as malaria and epigastric pain. A ed meridian according to the relations
compound prescription refers to the ap- between the zang-fu organs and meridi-
plication of two or more than two groups ans. Generally, points of the exteriorly-
of points with different functions for interiorly related meridians or points of
complicated cases which have two or over the "mother-son" related meridians are
two symptoms simultaneously. For in- selected according to the theory of Five
stance, when headache appears at the Elements. The third is used for symp-
same time with diarrhoea, the prescrip- toms caused by several diseased meridi-
tions for both should be used. In addi- ans, i.e. when a patient does not respond
tion, an "odd prescription" indicates only to the selected points of one or two
 CHINESE ACUPUNCTURE AND MOXIBUSTION

meridians, points of other meridians area. Generally, these points are located
should be used too. Since point selection below the elbows and knees. It is said in
along the meridians is guided by the Chapter 70 of Plain Questions, "Points on
theory of the zang-fu organs and merid- the lower portion should be selected for
ians it is essential to have a full under- the upper problems, points on the upper
standing of physiology and pathology, should be selected for the lower prob-
the running course of the meridians, the lems, and points on the side of the body
exterior and interior relationship of yin should be selected for middle problems."
and yang and the function of points. For example, Zusanli (ST 36) is selected
There are three categories of point to treat epigastric and abdominal disor-
selection: ders, Hegu (Ll 4) is selected to treat
1) Selection of nearby points Nearby facial disorders, Xingjian (LR 2) is select-
refers to the local area of the disease or ed to treat swelling and red eyes, and
the adjacent area of the disease. Baihui (GY 20) is selected to treat chron-
a) Selection of local points Local re- ic dysentery (Table 17).
fers to the vicinity of the disease. For Selection of the distant points forms
example, Jingming (BL 1) and Zanzhu an important part in the point selection.
(BL 2) are selected for eye disease; Juliao For example, points on the four extremi-
(ST 3) and Yingxiang (Ll 20) for nose ties are selected for disorders of the head,
disease; Tinggong (SI 19) and Tinghui trunk and zang-fu organs. The system of
(GB 2) for ear disease; Zhongwan (CY meridians is a crisscross network running
12) for epigastric disease and Taiyang longitudinally and transversely, super-
(Extra) for headache. When there is an ficially and deeply. In combination of
ulcer, wound or scar in the local area, points, different approaches are conduct-
select adjacent points instead of the local. ed, such as combining the above with the
b) Selection of adjacent points Adja- below, combining the left with the right
cent refers to the location close to the (or crossing combination), combining the
diseased area. For instance, Shangxing exterior with the interior, and combining
(GY 23) and Tongtian (BL 7) are selected the local with the distant.
for nose disease; Fengchi (GB 20) and Selecting points on the left side to treat
Fengfu (GY 16) for headache; and disorders on the right side and vice versa
Zhangmen (LR 13) and Tianshu (ST 25) is known as the crossing combination of
for gastric pain. The adjacent points may points. It is clearly analyzed in the
be used independently or in combination fifth chapter of Plain Questions as the
with the local points. Points from the "contralateral puncture" (see Chapter 14).
head and trunk selected for problems of 3) Selection of symptomatic points
the five sense organs and zang-fu organs This refers to the selection of the corres-
are within this category. ponding points according to some prom-
2) Selection of distant points Distant inent symptoms. For example, Dazhui
refers to a location far from the diseased (GY 14) and Quchi (Ll 11) are selected
 Table 17. Examples for Distant and Nearby Point Selection o 0 0
-, -< . . . 10:r:
C/'J (') ::l...... ~
-1 Adjacent Points (1)Orro~ >-l
Diseased area I Distant Points Local Points
Forehead Hegu(LI4), Neiting(ST 44) Baihui (GV 20) Yangbai (GB 14) (') (') = . . .
~ ~ .:0
c.
o 0""" ~
::s
P5
-.,
(1)
Ii]
0:,
Temple head Waiguan (TE 5), Zu1inqi (GB 41) Fengchi (GB 20) Taiyang (Extra), Shuaigu (GB 8) ::s~----~
;J>

Nape Houxi (SI 3), Kunlun (BL 60) Dazhui (GV 14) Tianzhu (BL 10) o (1)
-, ::s ~ ~"'1
....
Cl

Eye Yanglao (SI 6), Taichong (LR 3) Muchuang (GB 16) Jingming (BL 1) f""'+-~-~
'"Z
Nose Lieque (LU 7), Lidui (ST 45) Shangxing (GV 23) Yingxiang (LI 20)
::r _::S
(1) ...... ~ 0..
'"g;r
::s "'1
Mouth and cheek Hegu (LI 4), Jiexi (ST 41) Quanliao (SI 18) Dicang (ST 4 ), Jiache (ST 6) (1) (1) (1) C/'J
Z
I
Zhongzhu (TE 3), Xiaxi (GB 43) Fengchi (GB 20) Tinghui (GB 2), Yifeng (TE 17) SS",::r >-l
Ear "0 (1) ~ E.
Throat Yuji (LU 10), Zhaohai (KI 6) Tianzhu (BL 10) Lianquan (CV 23), Tianrong (SI 17) ::j' "'1 (1) OQ b
o
...... OQ (") 0 c
Chest Neiguan (PC 6), Fenglong (ST 40) Zhongfu (LV 1) Tanzhong (CV 17) (') (1) ...... = o
e:..a2..---- >-l

...... a
Costal region Zhigou (TE 6), Yang1ingq uan (G B 34) Zhang men (LR 13) Qimen (LR 14) is
"o(') z
Upper abdomen Neiguan (PC 6), Zusanli (ST 36) Liangmen (ST 21) Zhongwan (CV 12) 8. ~ ~ -< >-l
Lower abdomen Sanyinjiao (SP 6), Ququan (LR 8) Tianshu (ST 25) Guanyuan (CV 4) ::s (1) "'1 N o
Weizhong (BL 40), Houxi (SI 3) Ui~~O'\
Lumbar region Ciliao (BL 32) Shenshu (BL 23), Dachangshu (BL 25) ...... '-'
;J>
o
Rectum Chengshan (BL 57) Baih uansh u (BL 30) Changq iang (G V I) ~ o~
r:
-0
(j:;" '" ::s c
'" 0.. Z
o
>-l
r::
;!:l
(") "0 '" ~ .................. 0 ....., . . . .J ----
::l ~ -, c ....... '"0 ...... '0 '0 '"
~ 0 '0 $::l '" ::r ::s -, - """'l C/'J ~ ::l ......
'" < o ~ 9 ~. g
...... o..::s
<ii' ::;.; ~
......
::r -m
"'1 - ......
0.. ----
tTl a'
...... >-1
-
(5" a' _.::::
"'1<"'.>
0..
(1)
~.o
0.. ...... ::s ~ (1) .0 ::s ...... -. '< (1) (1) _
< o::r ......
(1) "'1 s (1) ....
'-' ::l ......
0 ::s
a' . . .
"'1 ...... ::r
::sO
......
::l
(')
'< (1)
~
n' ::s C/'J
'0 9. ~ ~ ~ 0 ~
;J>
'" (JQ "" "'...... ...... ::s
::S(JQ~3'<(")0....:l
~ - 0 "0 '""" (') '" (1) '"
(") 9l §(")
......
'2.. ("). ~ '" s (1) ~ 0"..,~"'1
...... ~
......
::r ~
rJ1~
'" "'::::(") '" p.J
'0
"'1:;::=
_. ::r '0 ' " (1)
","'1 0 "'1
cr:::s"'1 ...... ~(1)'-"'- ...... ::s=-
0.. ::r <; ~
~ ~

...... (1)
...... """l
...... (D
rJJ.
'CI
::r . J (')
~
"'1
0"
(1)
::I:::r ~
(1)
'" 0
(1)
(').
(1) (")
"'1 ......
...... ~
,-.,'""i "-' =
0
_.
....... '"
---- _ .
CFJ '"Z
>-1
O::S (1)
OQ"'1
~. 0..
0
(1) ~ .......... S
So
(1)"'1
(1) (1) ~ ""'s·
;:c
3"'1 ~ ::;. A 0" -
'-OQ
::s 0.. '"
0 ~
....
.........
~ ~(1)~"'1
...... "'1 ...... 0.."""
(1) (1) (1) _. ::s
ci.-.......J9:(")
............
::s 2. ::r
~ '0
--:l
::s 0
~>
trj~
~
0"
'"
--,';;;"(1)(i)
:7",
(')
~
'0
0(1)
"'1 ~::s -,
"'1(1)
~ OQ......
(1)OQ~-
( 1 ) ' -< ~ r;. ~. '" "'1 ~ OQ (") ~ '" ...... ~~ (1)00(bOQ
_ . .0 ~ ............ 0 "'1 "'1 0.. ' <; 0 ...... ,
(D
~~ ~(1)"O ...... ~ .., ~. (") 0
~ <:a ~~
::s ...... (') '""i ::r::s 3 0.: (1) ---- ~ <::r en "'C
... ....
...... 0 ...... """"'1 0
(1)...... 0 '<"'1
- ~ ;So
...... '" ~~
00
'-' ::r I::
0" ......
~
..,
'<
~::r (1) (') ...... '0 0" :;:0 .......
=
(') - , 1.,1
.....
~ ::? ~ (1) -,
...... 0 '"
:r~"""'''O"'1
ri 0" § (il '<
...... ~ (1) '" '" ...... (1) .JIo ::r :;::
(1) =-
<';-' . . . . . . =
~-
(D
5! ~
-. =
"'=(1)::S::l
~
::s ...... (1)::s
~
~
~ ~
(1)::r~
::r ::r ...... '" (1)
~
~~
~>
(1)
S
o
'" .......
c. ...... ..."
0 0
.

-
0 '" '" (1) - 0 . (1) -"'1 ...... ---.,(1) ,. ...... ::r "'1 ~ '" (1) (1) ::s "0
(1) '"
<;
< _....... '" <
a'
::s......
'""i ..... (1) '-" ::s (1) '<~.
~ ~ ~ 0:: (1)
\J
0

S-
;. =
::;"0 ::r(1)~3(1)
(1) "'1 -
,<0..(1);-
(b ~ (') n' r:.
0
~~
O~
::: ::s
::r~(il(1)
...... ..,
'0 (1) a (') 0
o (") :::: "'::r
::r
...... (1) (JQ ::s ::l ---- 0 '" '" =- !2.~ 5"~ ......
~ <: 8"~ ~ ='!'" ~O ~'O~><
OQ,o ...... ~
a' .g ~ ~
............ '0 ...... '0
~ 0 '< .....
~ _ (1)
r:. o...w
"'1
<s
~
tI:l
"""'0
2. -
(') 0 0
::s (1) (') (1)
"'1 ~ 0 (1)
::s,
0" 0.. ...... 0
(1) "'1::l ZZ (1) ;::-: ...... 3
'" 0 0 ;:c 0" ~ "'1 ......::s ...... ~ ...... '""i
~ ~
~O 02..8,'2..
< = -. < "'1 '< 0" (1) (1) ...... ::I: ::s ::s ::s ::r
"'1
"""'~=(1)
0.. 3 ' 3
(1)~::S~"""
...... (1)

"'1
~a::r
~ '< ~.
'" ...... 0 8 (1) 0 0
(') -,...... (') -
~-<:"'cp~o..s(1)
~ ~ ~
'" C/'J
~
::-;" (1) ,.
=
.... ~
"0
'0
""'0'
::s
~ ::s C/'J ::s (1) <: ...... ~
...... ...... '0
0 ...... (1) ...... '" :::;
............. '" OQ
::s -,
rJ1~
-,
...... ::s ~
::r 0 C. CZl
~(1)

~ ::r (1) ~= ~C/'J_"'1 - ...... ::l 0 (') 0 -, ...... 0 (1) tTl (b ~

,. ~...... :;.... ~...... 3 ...... ,. ::r ...... ...... ~ .... ::s ::s ...... ::s ....... 0 '" 3 "'1 (1)
'O"'1::r.o ...... ::l (1)
0.. 0..
::r~ = (1) 0.."'1
I' £, 0............ (1) ~ (1) ~ = QQ' :; o 0" ...... ::s OJ.'
- . ('b ('t) _ .... :::: ('b ('b ':-' I ",rD ('t)
00..(')0.., "',' '7 ~. 9 (TQ
00
382 CHINESE ACUPUNCTURE AND MOXIBUSTION

flows like a stream are called stream the Lower He-(Sea) Points are taken as
points; the points where qi flows the main points.
through are called river points; and the
points where qi gathers are called sea The Combination of Mother and Son
points." The sixty-eight problem in Clas- Points for Reinforcing and
sic on Medical Problems says that "Jing-
Reducing
(Well) Points are indicated in the full-
ness of the chest; Ying-(Spring) Points In addition to the selection of the
in the febrile diseases; Shu-(Stream) Five Shu Points according to their ther-
Points in the heavy sensation of the apeutic properties, the Five Shu Points
body and painful jOints; Jing-(River) can be selected according to the inter-
Points in cough and asthma due to promoting, interacting, overacting and
pathogenic cold and heat; and He-(Sea) counteracting relations of the Five Ele-
Points in diarrhea due to perversive ments to which they are respective-
flow of qi." Generally speaking, Jing- ly attributed. The Jing-(Well), Ying-
(Well) Points are indicated in mental (Spring), Shu-(Stream), Jing-(River) and
illness related to the zang organs; Ying- He-(Sea) Points of the yin meridians are
(Spring); Shu-(Stream) and Jing-(River) attributed to the Five Elements in the
Points are indicated in disorders along order of wood, fire, earth, metal and
the outer course of the affected meridi- water, but those of the yang meridians
ans. Points on the yin meridians are in the order of metal, water, wood, fire
indicated in the disorders of the internal and earth. Based on the interpromoting
organs. The He-(Sea) Points are indicat- relation of the Five Elements, each me-
ed in problems related to the fu organs, ridian has a "mother" point and a "son"

Table 18. Example for Symptomatic Point Selection

Symptoms Points

Fever Dazhui (GV 14), Quchi (LI 11), Hegu (LI 4)

Coma Shuigou (GV 26), Shixuan (Extra)
Night sweating Houxi (S1 3), Yinxi (HT 6)
Clenched jaws Xiaguan (ST 7), Jiache (ST 6), Hegu (LI 4)
Cough, asthma Tiantu (CV 22), Dingchuan (Extra)
Suffocated chest Tanzhong (CV 17), Neiguan (PC 6)
Cardiac pain Neiguan (PC 6), Ximen (PC 4)
Hypochondriac pain Zhigou (TE 6), Yanglingquan (GB 34)
Abdominal distention Qihai (CV 6), Zusanli (ST 36)
Constipation Zhigou (TE 6), Zhaohai (K1 6)
Convulsion Hegu (LI 4), Taichong (LR 3)
Epistaxis Shangxing (GV 23), Hegu (LI 4)
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTCRE TREATMENT 383

point. For instance, the Lung Meridian perficial slippery forceful pulse, Chize
relates to metal, the "mother" of metal (LU 5), the "son point" of the Lung
is earth, then the "mother point" of the Meridian is used with the reducing
Lun;g Meridian is Taiyuan (LU 9) which method. Chize (LU 5) attributes to wat-
attributes to earth. The "son" of metal er, which is promoted by metal, so
is water, so the "son point" of the Lung Chize (LU 5) is the son point of the
Meridian is Chize (LU 5) which attrib- Lung Meridian.
utes to water. The "mother point" of a b) Reinforcing or reducing the related
meridian has a reinforcing effect, while meridian:
the "son point" has a reducing effect. Reinforcing or reducing the related
Reinforce the mother for deficiency meridian is applied on the basis of the
syndrome and reduce the son for excess relations of the Five Elements of the
syndrome when this principle is applied zang-fu organs. For example, the defi-
for treatment, but differentiation of syn- ciency syndromes of the Lung Meridian
dromes should be done to see the affect- can be treated by reinforcing Taibai (SP
ed meridian and organ, as well as the 3), the earth point of the Spleen Merid-
presl~ntation of excess and deficiency be-
ian, which relates to the Lung Meridian
fore the selection of points. In practice
(the spleen pertains to earth; the lung
the two methods are used: reinforcing
pertains to metal, which is promoted by
or reducing the affected meridian and
earth). In contrast, the excess syndrome
reinforcing or reducing the related me-
of the Lung Meridian can be treated by
ridian.
reducing Yingu (KIlO), the water point
a) Reinforcing or reducing the affected
of the Kidney Meridian, which relates
meridian:
to the Lung Meridian. (The kidney per-
For example, when the Lung Merid-
tains to water, the lung pertains to me-
ian is involved in a deficiency syndrome
with symptoms of chronic cough, asth- tal, which promotes water.) In addition,
ma on exertion, weak voice, profuse the mother and son points can be select-
sweating and thready weak pulse, the ed from the exteriorly-interiorly related
"mother point" of the Lung Meridian meridians. For example, the deficiency
Taiyuan (LU 9) is used with the rein- syndrome of the Lung Meridian can be
forcing method. (Taiyuan (LU 9) attrib- treated by reinforcing Quchi (LI 11),
utes to earth. The lung pertains to the mother point of the Large Intestine
metal, which is promoted by earth, so Meridian, but the excess syndrome of
Taiyuan (LU 9) is the mother point of the Lung Meridian can be treated by
the Lung Meridian.) When the Lung reducing Erjian (LI 2), the son point of
Meridian is involved in an excess syn- the Large Intestine Meridian. (The large
drome with abrupt onset of cough, intestine pertains to metal. Erjian attrib-
dyspnea, coarse voice, stuffy sensation utes to water, which is promoted by
in the chest, failure to lie flat, and su- metal.) (Tables 19, 20, 21)
384 CHINESE ACUPUNCTURE AND MOXIBUSTIOK

Table 19. The Five Shu Points of the Yin Meridians

~
iveShU I II III IV V
Point (Wood) (Fire) I (Earth) . (Metal) (Water)
Meridian Jing-(Well) Ying-(Spring)i Shu-(Stream) i Jing-(River), He-(Sea)
i i i
Lung Shaoshang i Yuji !Taiyuan· Jingqu : Chize
Hand-Taiyin (LUll) I (LUlO) i(LU9) [(LU8) i (LU 5)

Pericardium Zhongchong I Laogong :Daling r Jianshi I Quze

Hand-Jueyin (PC 9) I (PC 8) i(PC 7) I(PC 5) I (PC 3)
----~'--------~-------+I----------
Heart Shaochong I Shaofu iShenmen i Lingdao i Shaohai
Hand-Shaoyin (HT 9) i (HT 8) j(HT 7) !(HT 4) I (HT 3)
Spleen Yinbai i Dadu iTaibai : Shangqiu : Yinlingquan
Foot-Taiyin (SP 1) i (SP 2) :(SP 3) !(SP5) j(SP9)
Liver Dadun I Xingjian !Taichong i Zhongfeng i Ququan
Foot-Jueyin (LR 1) i (LR2) i(LR 3) (LR 4) i (LR 8)
I
I !
Kidney Yongquan i Rangu iTaixi i Fuliu . Yingu
Foot-Shaoyin (KI1) ; (KI 2) !(KI3) !(KI 7) (KI1O)
~

Table 20. The Five Shu Points of the Yang Meridians

~
I , [

I j
II i III IV V
- Point (Metal) i (Water) I (Wood) (Fire) i (Earth)
Meridian ling-eWell) ! Ying-(Spring)! Shu-(Stream) I Jing-(River) : He-(Sea)
I •
Large Intestine Shangyang I Erjian iSanjian jYangxl j Quchi
Hand-Yangming (LI 1) i (LI 2) :(LI 3)
I
;(LI 5)
I
! (LI ll)
I
I • •.
Triple Energizer Guanchong I Yemen jZhongzhu iZhigou ! Tlan)lllg
Hand-Shaoyang (IE 1) ! (TE 2) I(IE 3) :(TE6) 'I(TE 10)
I

Small Intestine Shaoze IQiangu IH OUXI.

I
[
rYanggu I Xiaohai
Hand-Taiyang (SI 1) 'i (SI 2) i(SI 3)
I
I(SI 5) i (SI 8)
Stomach Lidui I Neiting !Xiangu [Jiexi I Zusanli
Foot-Yangming (ST 45) ! (ST 44) I(ST 43) I(ST 41) ! (ST 36)
Gallbladder Zuqiaoyin !, Xiaxi :Zulinqi Yangfu I Yanglingquan
Foot-Shaoyang (GB 44) i (GB43) i(GB 41) (GB 38) r (GB 34)
!
Bladder Zhiyin ,j Zutonggu IShugu Kunlun i Weizhong
Foot-Taiyang (BL 67) I (BL 66) [(BL65) (BL 60) i (BL 40)
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTURE TREATMENT 385

Table 21. The "Mother" and "Son" Points for Reinforcing and Reducing

I
Meridian , Mother Point I Son Point

(Reinforcing) : (Reducing)
I

Lung Meridian of Hand-Taiyin Taiyuan (LV 9) I Chize (LV 5)

Large Intestine Meridian of Hand- Quchi (LI 11) I Erjian (LI 2)

Yangming
i
Stomach Meridian of Foot- Jiexi (ST 4) i Lidui (ST 45)
Yangming

Spleen Meridian of Foot-Taiyin Dadu (SP 2) I Shangqiu (SP 5)

i

Heart Meridian of Hand-Shaoyin Shaochong (HT 9) I Shenmen (HT 7)

Small Intestine Meridian of Hand- . Houxi (SI 3) I Xiaohai (SI 8)

Taiyang

Bladder Meridian of Foot-Taiyang i Zhiyin (BL 67) : Shugu (BL 65)

i

Kidney Meridian of Foot-Shaoyin i Fuliu (KI 7) 1 Yongquan (KI 1)

i

Pericardium Meridian of Hand- i Zhongchong (PC 9) I Daling (PC 7)

Jueyin i
I

I
Triple Energizer Meridian of ! Zhongzhu (TE 3) I Tianjing (TE 10)
Hand-Shaoyang
I
Gallbladder Meridian of Foot- •Xiaxi (GB 43) , Yangfu (GB 38)
Shaoyang
I

Liver Meridian of Foot-Jueyin •Ququan (LR 8) , Xingjian (LR 2)

I

2:) The Lower He-(Sea) Points of the related to the three yang meridians of
Six Fu Organs The Lower He-(Sea) foot on each of which there is a Lower
Points refer to the six He-(Sea) Points He-(Sea) Point." At the same time, the
pertaining to the six fu organs along the three yang meridians of foot communi-
three yang meridians of foot. In the cate with the three yang meridians of
fourth chapter of Miraculous Pivot it says, hand. The stomach, bladder and gallblad-
"The six fu organs, i.e. stomach, large der pertain to the three yang meridians of
intestine, small intestine, gallbladder, foot, while the large intestine, small intes-
bladder and triple energizer are closely tine and triple energizer not only com-
386 CHINESE ACUPUNCTURE AND MOXIBUSTION

municate with the three yang meridians treated by Shangjuxu (ST 37); biliary
of hand, but also closely connect with the pain and vomiting are treated by Yang-
three yang meridians of foot. The stom- lingquan (GB 34) (Tab. 22).
ach communicates with Zusanli (ST 36); 3) The Yuan-(Primary) Points The
the large intestine with Shangjuxu (ST Yuan-(Primary) Points are located in
37); the small intestine with Xiajuxu (ST the vicinity of the wrist and ankle. The
39), all pertaining to the Stomach Merid- twelve Yuan-(Primary) Points are close-
ian of Foot-Yangming. The large intes- ly related to the five zang and the six fu
tine and the small intestine pertain to the organs, and they are the points where
stomach. It means that their physiolog- the primary qi of the zang-fu organs is
ical activities work upward and down- retained. Disorders of the zang-fu or-
ward. The bladder and triple energizer gans are usually relieved by needling the
communicating with Weizhong (BL 40) twelve Yuan-(Primary) Points. The first
and Wei yang (BL 31 ) respectively pertain chapter of Miraculous Pivot says, "When
to the Bladder Meridian of Foot-Taiyang, the five zang organs are diseased, the
owing to the water passage of triple ener- symptoms will manifest themselves in
gizer connected with the bladder. The the conditions of the twelve Yuan-
gallbladder communicates with Yangling- (Primary) Points with which they are
quan (GB 34), a point of the Gallbladder connected. Each of the five zang or-
Meridian of Foot-Shaoyang. As it is men- gans is connected with its own Yuan-
tioned in the fourth chapter of Mira- (Primary) Point. For this reason, if we
culous Pivot, "The disorders of the six fu fully grasp the connections between
organs can be treated by the He-(Sea) zang organs and their corresponding
Points." For example, gastric pain and Yuan-(Primary) Points as well as the
sour regurgitation are treated by Zusan- latter's external manifestations, there
Ii (ST 36); dysentery or appendicitis is will be no difficulty for us to under-

Table 22. The Lower He-(Sea) Points Pertaining to the Six Fu Organs

Six Fu-Organs Lower He-(Sea) Point

Stomach Zusanli (ST 36)

Large intestine Shangjuxu (ST 37)
Small intestine Xiajuxu (ST 39)
Gallbladder Y anglingq uan (G B 34)
Bladder Weizhong (BL 40)
Triple Energizer Weiyang (BL 39)
CHAPTER 16 A GENERAL INTRODUCTION TO ACCPCNCTl'H.E TREATMENT 387

stand the nature of the diseases of the Luo-(Connecting) Points are situated at
five zang organs .... The twelve Yuan- the places where the meridians are
(Primary) Points are effective for treat- distributed and the cross of the two
ing the diseases of the five zang and six exteriorly-interiorly related meridians.
fu organs." Similar to the Shu-(Stream) On the limbs, each of the twelve main
Points there is a Yuan-(Primary) Point meridians has a Luo-(Connecting) Point,
on the yang meridians. The Yuan- which connects with its respective
(Primary) Points are closely related to exteriorly-interiorly related meridians.
triple energizer and primary qi. That's why the Luo-(Connecting) Points
The primary qi originates from the are indicated in the syndromes of their
kidneys, distributing over the whole body respective exteriorly-interiorly related
and concerning the qi activities. It travels meridians. Guide to the Classics of Acu-
over each yang meridian through triple puncture states that "the Luo-
energizer. The place where the primary qi (Connecting) Points are located between
is centred is the location of the Yuan- two meridians .... If they are punctured,
(Primary) Point. Therefore, they are in- symptoms of the exteriorly-interiorly re-
dicated in deficiency and excess syn- lated meridians can be treated." For ex-
dromes of their respective related organs ample, the spleen and stomach are
(Tab. 23). exteriorly-interiorly related, Gongsun
,t) The Luo-(Connecting) Points The (SP 4), the Luo-(Connecting) Point of the

Table 23. The Yuan-(Primary) Points

Meridian Yuan-(Primary) Point

Lung Meridian of Hand-Taiyin Taiyuan (LV 9)

Large Intestine Meridian of Hand-Yangming Hegu (LI 4)
Stomach Meridian of Foot-Yangming I Chongyang (ST 42)
Spleen Meridian of Foot-Taiyin Taibai (SP 3)
Heart Meridian of Hand-Shaoyin Shenmen (HT 7)
Small Intestine Meridian of Hand-Taiyang Wangu (SI 4)
Bladder Meridian of Foot-Taiyang Jinggu (BL 64 )
Kidney Meridian of Foot-Shaoyin Taixi (KI 3)
Pericardium Meridian of Hand-Jueyin Daling (PC 7)
Triple Energizer Meridian of Hand-Shaoyang Yangchi (TE 4 )
Gallbladder Meridian of Foot-Shaoyang Qiuxu (GB 40)
Liver Meridian of Foot-Jueyin Taichong (LR 3)
 CHINESE ACUPUNCTURE AND MOXIBUSTION

Spleen Meridian can treat not only the Foot-Taiyang in the vicinity of scapula to
diseases of the Spleen Meridian, but also connect the qi of the back. Dabao (SP
those of the Stomach Meridian. In addi- 21) is the Luo-(Connecting) Point of the
tion, there are Luo-(Connecting) Points Spleen Meridian, the collateral of which
of the Governor and Conception vessels is distributed on the hypochondrium to
and a major Luo-(Connecting) Point of connect the qi and blood of the body.
the Spleen on the trunk. Jiuwei (CV 15) Therefore, Jiuwei (CV 15) can be used
is the Luo-(Connecting) Point of the for abdominal disease; Changqiang (GV
Conception Vessel, the collateral of 1) for back disorders, and Dabao (SP 21)
which is distributed on the abdomen for all the joint problems (Tab. 24).
to connect the qi of the abdomen.
Changqiang (GV 1) is the Luo- The Combination of the
(Connecting) Point of the Governor Ves- Yuan-(Primary) Points and the
sel, with its collaterals ascending bilater- Luo-(Connecting) Points
ally along the spine, and is distributed on
the head, joining the Bladder Meridian of The Yuan-(Primary) Points and Luo-

Table 24. The Luo-(Connecting) Points

Meridian Luo-(Connecting) Point

Lung Meridian of Hand-Taiyin Lieque (LU 7)

Large Intestine Meridian of Hand-Yangming Pianli (LI 6)
Stomach Meridian of Foot-Yangming Fenglong (ST 40)
Spleen Meridian of Foot-Taiyin Gongsun (SP 4)
Heart Meridian of Hand-Shaoyin Tongli (HT 5)
Small Intestine Meridian of Hand-Taiyang Zhizheng (SI 7)
Bladder Meridian of Foot-Taiyang Feiyang (BL 58)
Kidney Meridian of Foot-Shaoyin Dazhong (KI 4)
Pericardium Meridian of Hand-Jueyin Neiguan (PC 6)
Triple Energizer Meridian of Hand-Shaoyang Waiguan (TE 5)
Liver Meridian of Foot-Jueyin Guangming (GB 37)
Gallbladder Meridian of Foot-Shaoyang Ligou (LR 5)
Conception Vessel Jiuwei (CV 15)
Governor Vessel Changqiang (G VI)
The Major Luo-( Connecting) Point of the Spleen Dabao (SP 21)
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPGNCTl'RE TREATMENT 389

(Connecting) Points may be used inde- 6), the Xi-(Cleft) Point of the Lung
pendently or in combination. The combi- Meridian of Hand-Taiyin is effective to
nation of them is called the "host and hemoptysis; Wenliu (Ll 7) of the Large
guest combination," which is applied ac- Intestine Meridian of Hand-Yangming is
cording to the occurring order of the helpful to borborygmus and abdominal
diseases on the exteriorly-interiorly relat- pain; Liangqiu (ST 34) of the Stomach
ed meridians. When a meridian is first Meridian of Foot-Yangming works for
affected, its Yuan-(Primary) Point is epigastric pain, Ximen (PC 4) of the
used, while for second affected meridian, Pericardium Meridian of Hand-Jueyin is
its lLuo-(Connecting) Point is used. For effective to cardiac pain and fullness of
instance, both the Lung Meridian and the the chest (Tab. 25).
Large Intestine Meridian are diseased, 6) The Eight Confluent Points of the
but the former is affected first, Taiyuan Eight Extra Meridians The Eight Con-
(LL! 9), its Yuan-(Primary) Point is se- fluent Points are those in the extremi-
lected as a main point, and Pianli (LI 6), ties connecting the eight extra merid-
the Luo-(Connecting) Point of the Large ians. Gongsun (SP 4) of the Spleen Me-
Intestine Meridian is used as a combining ridian connects with the Thoroughfare
point. On the contrary, if the Large Intes- Vessel; and Neiguan (PC 6) of the Per-
tine Meridian is diseased first and then icardium Meridian links with the Yin
the Lung Meridian, Hegu (LI 4), the Link Vessel. These two meridians are
Yuan-(Primary) Point should be pres- confluent in the chest, heart and stom-
cribed as a main point, while Lieque (LU ach. Zulinqi (GB 41) of the Gallbladder
7), the Luo-(Connecting) Point as a com- Meridian connects with the Belt Vessel,
bining point. This method is adopted and Waiguan (TE 5) of the Triple Ener-
when the externally-internally related me- gizer Meridian connects with the Yang
ridians are affected. And it is known as Link Vessel. These two meridians are
the combination of the exterior-interior confluent at the outer canthus, retroaur-
points. icie, cheek, shoulder and diaphragm.
5» The Xi-(Cleft) Points The Xi- Houxi (SI 3) of the Small Intestine Me-
(Cleft) Points are those located at the ridian leads to the Governor Vessel, and
sites where qi and blood in the me- Shenmai (BL 62) of the Bladder Merid-
ridians is converged and accumulated. ian connects with the Yang Heel Vessel.
There are sixteen Xi-( Cleft) Points in all The two meridians are confluent at the
of the twelve main meridians. In addi- inner canthus, nape, ear, shoulder and
tion, they can be found on each Yang back. Lieque (LU 7) of the Lung Merid-
Heel, Yin Heel, Yang Link and Yin ian leads to the Conception Vessel, and
Link vessels. The Xi-(Cleft) Points are Zhaohai (KI 6) of the Kidney Meridian
used primarily in treatment of the acute connects with the Yin Heel Vessel. The
diseases appearing in their correspond- two meridians are confluent in the lung
ing organs. For example, Kongzui (LU system, throat and diaphragm. The
390 CHINESE ACUPUNCTURE AND MOXIBUSTION

Table 25. The Xi-(Cleft) Points

Meridian I Xi-(Cleft) Point

Three Yin LUng Meridian of Hand-Taiyin Kongzui (LU 6)

Meridians Pericardium Meridian of Hand-J ueyin Ximen (PC 4)
of Hand Heart Meridian of Hand-Shaoyin Yinxi (HT 6)

Three Yang Large Intestine Meridian of Hand-Yangming Wenliu (LI 7)

Meridians Triple Energizer Meridian of Hand-Shaoyang Huizong (TE 7)
of Foot Small Intestine Meridian of Hand-Taiyang Yanglao (SI 6)

Three Yin Stomach Meridian of Foot-Yangming Liangqiu (ST 34)

Meridians Gallbladder Meridian of Foot-Shaoyang Waiqiu (GB 36)
of Foot Bladder Meridian of Foot-Taiyang Jinmen (BL 63)

Three Yang Spleen Meridian of Foot-Taiyin Diji(SP8)

Meridians Liver Meridian of Foot-Jueyin Zhongdu (LR 6)
of Hand Kidney Meridian of Foot-Shaoyin Shuiquan (KI 5)

Yang Heel Vessel Fuyang (BL 59)

Extra Yin Heel Veso;;el Jiaoxin (KI 8)
Meridians Yang Link Vessel Yangjiao (GB 35)
Yin Link Vessel Zhubin (KI 9)

Eight Confluent Points are indicated in Confluent Point on the upper limb can
diseases of the extra meridians and their be combined with the Confluent Point
related regular meridians and their re- on the lower limb. For example, Nei-
lated regular meridians according to guan (PC 6) is combined with Gongsun
their connexions. Introduction to Medi- (SP 4) to treat diseases of the heart,
cine says that "among the 360 points on chest and stomach. Houxi (SI 3) is com-
the whole body, 66 points located at bined with Shenmai (BL 62) for diseases
the four extremities are important, and of the neck, shoulder, back and inner
among these 66 points, the Eight Con- canthus (Tab. 26).
fluent points are considered the most
important." In practice, the Eight Con- 2. Specific Points on the Head
fluent points may be used independent- and Trunk
ly. For instance, problems of the Gover-
nor Vessel are treated by Houxi (SI 3), 1) Back-Shu Points The specific
disorders of the Thoroughfare Vessel points on the back are called the Back-
are treated by Gongsun (SP 4) or the Shu Points, where the qi of the zang-fu
CHAPTER 16 A GENERAL INTRODLTCTlON TO ACUPCNCTURE TREATMENT ::\91

organs is infused. They are named in Chapter 51 of Miraculous Pivot, it says,

accordance with their corresponding "In order to make sure of the point locat-
zang-fu organs, such as the Back-Shu ed accurately, one may press the part to
Point of the heart is called Xinshu (BL see if the patient's original pain gets re-
15); the Back-Shu Point of the lung is lieved, if so, the point has been located
called Feishu (BL 13); the Back-Shu correctly." The Back-Shu Points are indi-
Point of the liver is called Ganshu (BL cated in diseases of the corresponding
18) and so on. When the zang-fu organs zang-fu organs. For instance, Feishu (BL
are ~ diseased, there appears a tenderness 13) may be used for the problems of the
in the corresponding Back-Shu Point. In lung; Ganshu (BL 18) is used for the

Table 26. The Eight Confluent Points of the Eight Extra Meridians

Con11uent Point I
Regulate Meridian Extra Meridian Indications

Neiguan (PC 6) Pericardium Yin Link Vessel Heart, chest,

I
Gongsun (SP 4) Spleen Thoroughfare Vessel i
I
stomach
Houxi (SI 3) Small Intestine Governor Vessel Neck, shoulder,
Shenmai (BL 62) Bladder Yang Heel Vessel back inner canthus
Waiguan (TE 5) I Triple Energizer i Yang Link Vessel Retroauricle, cheek,
Zulinqi(GB41) Gallbladder Belt Vessel outer canthus
Lieque (LV 7) Lung Conception Vessel Throat, chest,
Zhaohai (KI 6 ) Kidney Yin Heel Vessel lung

problems of the liver, etc. In addition, the Front-(Mu) Points are those located at
Back-Shu Points can be used for the ill- the chest and abdomen, where the qi of
ness of the sense organs. For instance, the zang-fu organs is infused. Since they
Ganshu (BL 18), the Back-Shu Point of are situated closely to their respective
the liver, may be chosen to treat eye related zang-fu organs, any problems of
troubles, as eye is the opening of the the zang-fu organs can be seen in the
liver. Shenshu (BL 23), the Back-Shu corresponding Front-(Mu} Points. For
Point of the kidney, can be prescribed to instance, a tenderness may appear in Ri-
treat ear disorders, as ear is the opening yue (GB 24) or Qimen (LR 14) if the
of the kidney. gallbladder is affected, and if the stom-
~n The Front-(Mu) Points The ach is diseased, there is a tenderness in
,-,-39_2_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _c~H=IN~E=SE~ACCPCNCTURE AND MOXIBUSTION

Zhongwan (CY 12). Therefore, the M u Points may be used independently or

Front-(Mu) Points are mainly applied to in combination. Whenever an internal or-
treat disorders of the zang-fu organs and gan is affected, the Back-Shu Point or the
in the local areas. For example, liver Front-Mu Point pertaining to that organ
disorders associated with hypochondriac may be prescribed. The application of
pain may be treated by needling Qimen both may strengthen the therapeutic ef-
(LR 14), and abdominal pain due to large fects. For instance, Weishu (BL 21) on
intestine disorders may be relieved by the back and Zhongwan (CY 12) on the
needling Tianshu (ST 25). abdomen may be selected for gastric dis-
The Back-Shu Points and the Front- orders; or Pangguangshu (Bl 28) in the
Mu Points work for diseases of the zang- sacral region and Zhongji (CY 3) in the
fu organs. In addition, they are of differ- lower abdomen for disorders of the blad-
ent nature of yin and yang. The Back-Shu der.
Points located on the back pertain to 3) The Eight Influential Points of the
yang, while the Front-Mu Points located Eight Tissues The Eight Influential
on the chest and abdomen pertain to yin. Points refer to the specific points which
It is stated in the sixty-seventh problem have particular effects in treatment of
of Classic on Medical Problems, "Diseases disorders relating to the zang-fu organs,
of the zang organs (yin) are manifested qi, blood, tendon, pulse and vessels,
in the Back-Shu Points, and the diseases bone and marrow. Each of the Eight
of fu organs (yang) are manifested in the Influential Points overlaps the other
Front-Mu Points." Therefore, the Back- point. It is said in Classic on Medical
Shu Points are mainly used to treat the Problems, "Zhongwan (CY 12) is the
problems of five zang organs, and the Influential Point of the fu organs;
Front-Mu Points are mainly effective to Zhangmen (lR 13) is the Influential
the problems of six fu organs. For exam- Point of the zang organs; Yanglingquan
ple, Xinshu (BL 15) is helpful to the (GB 34) is the Influential Point of ten-
heart diseases; Ganshu (BL 18) works for dons; Xuanzhong (GB 39) is the In-
the liver diseases; Zhongwan (CY 12) fluential Point of marrow; Geshu (BL
is effective to the stomach diseases and 17) is the Influential Point of blood;
Tianshu (ST 25) is good for the large Dazh u (BL II) is the Infl uential Point
intestine diseases. of bone; Taiyuan (lU 9) is the Influen-
This is one of the methods to treat tial Point of pulse and vessels; and Tan-
yang disease from yin and vice versa zhong (CY 17) is the Influential Point
(Table 27). of qi. For interior heat syndrome, Tan-
zhong (CY 17), the Influential Point of
The Combination of the Back-Shu qi is applied." In clinics, they are used
not only for heat syndromes, but also
Points and the Front-Mu Points
for all kinds of diseases of the eight
The Back-Shu Points and the Front- tissues. For example, Zhangmen (lR
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTURE TREATMENT .'>93

Table 27. The Back-Shu Points and Front-(Mu) Points

Internal Organs Back-Shu Point Front-(Mu) Point

Lung Feishu (BL 13) Zhongfu(LV 1)

Pericardium Jueyinshu (BL 14) Tanzhong (CV 17)
Heart Xinshu (BL 15) Juque (CV 14)
Liver Ganshu (BL 18) Qimen (LR 14)
Gallbladder Danshu (BL 19) Riyue (GB 24)
Spleen I
Pishu (BL 20) Zhangmen (LR 13)
Stomach Weishu (BL 21) Zhongwan (CV 12)
Triple Energizer Sanjiaoshu (BL 22) Shim en (CV 5)
Kidney Shenshu (BL 23) Jingmen (GB 25)
Large Intestine Dachangshu (BL 25) Tianshu (ST 25)
Small Intestine Xiaochangshu (BL 27) Guanyuan (CV 4)
Bladder Pangguangshu (BL 28) Zhongji (CV 3)

13) may be selected for diseases of the 4) The Crossing Points The Cross-
zang organs and Geshu (BL 17) may be ing Points refer to those located at the
used for disorders of blood (Tab. 28). intersection of two or more meridians,
including the twelve main meridians and
the eight extra meridians. There are
Table 28. The Eight Influential Points about ninety crossing points and most
of them are distributed on the trunk,
the head and the face. They can be used
Tissue Influential Point to treat disorders of the pertaining me-
ridians and the intersected meridians.
Zang organs Zhang men (LR 13) Generally, they are often used to treat
Fu organs Zhongwan (CV 12) the diseases appearing simultaneously in
Qi ! Tanzhong (CV 17) meridians intersecting each other. For
example, Guanyuan (CV 4) and Zhongji
Blood Geshu (BL 17)
(CV 3) located at the intersection of
Tendon Yanglingq uan (G B 34 ) three yin meridians and the Conception
Pulse:, vessels Taiyuan (LV 9) Vessel may be used to treat diseases of
Bone Dazhu(BL 11) the three foot yin meridians. Sanyinjiao
Marrow Xuanzhong (GB 39) (SP 6), a crossing point in the three foot
394 CHINESE ACUPUNCTCRE AKD MOXIBUSTION

yin meridians is used for diseases of the Highlights, the Illustrated Manual oj Acu-
Liver, Spleen and Kidney Meridians. points on the New Bronze Figure, Com-
The number of the Crossing Points pendium oj Acupuncture, and Illustrated
increased after the publication of Syste- Supplement to the Ciassffied Classics.
matic Classic oj Acupuncture, Plain Ques- The following is made based on Syste-
tions edited by Wang Bing, Medical matic Classic oj Acupuncture (Tab. 29).

Table 29. The Crossing Points on the Yang Meridians

\ Meridian

\ OJ
en

;>
en
o.J

....
OJ)
!::
t":l
OJ)
!::
t":l
>,
OJ)
!::
t":l
>,
1:>0
!::
t":l
>,
0
!::
·s
OJ)
OJ)
.....!::
S
OJ)
OJ
en

;>
en
o.J
OJ
en
<J)
o.J
;>
OJ
\
OJ)
.....t":l>, 'Cil 0 t":l !:: ~
OJ Remarks
0 t":l ..s::: !:: t":l .....!:: o.J en
en
Point !::
....o.J f-< f-<
-.b
..s:::
I{l
C/l
I
t":l
>-.... >-"0
I ......l :r: o.J
;>
....0
I
.... "0
....
\
I OJ) OJ)
I > !:: !:: 0 !:: !:: !::
, 0 0 t":l
:r: 8 t":l 0 t":l t":l t":l OJ
0 ~ ~ :r: ~ :r: >- >- ~

.~
I

Shenting (G V 24) 0 x x
------~--~ -+---
Shuigou (GV 26) 0 x x !
.. _----- --~---

Baihui (GV 20) 0 x

Naohu (GV 17) 0 x
----------_.

Fengfu (GV 16) i

0 x
r·· --------
,
.---~-----.--

Yarnen (GV 15) !

0 x
Dazhui (GV 14) 10 x x x
--------------
:--t
Taodao (GV 13) i 0 x
Changqiang (GV 1) i 0 Knotting at Shaoyin
I
I
Jingrning (BL 1) ,
0 X X
- - - - .. - . ---
Dazhu (BL 11) 0 x
.-------- .--.--

Fengmen (BL 12) x 0

Fufen (BL 41) 0 x

CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTURE TREATMENT 395

Fuyang (BL 59) o x x I Xi-(Cleft) of Yang

i Heel Vessel
Shenmai (BL 62) o x X i Promoted by Yang
I Heel V essel
Pucan (BL 61 ) o ~~-x~~x~~-+l Root of Yang Heel
; Vessel
Jinmen (BL 63) 0 X X I Collateral of Yang

I Link Vessel
I

Naoshu (SI 10) o X X X

Bingfeng (SI 12) [,I 0 X X X X

Quanliao (SI 18) 0 X

Tinggong (SI 19) ,Ox X

Tongziliao (GB 1) I X 0 X

Shangguan (GB 3) I 0 X X
-+-~~~~~ -~~~~--~~~~--~-+~~- ~---
Hanyan (GB 4) I 0 X X

Xuanli (GB 6) X 0
------
Qubin (GB 7) X 0

Shuaigu (GB 8) X 0
Fubai 1GB 10) X 0
Touqiaoyin (GB l1)i X 0

Wangu (GB 12) I X 0

Benshen (G B 13) I 0 X

Yangbai (GB 14) I 0 X

Toulinqi(GB_15_)_1--___X_ _ _~O_ _ _ _ _ _~_ _X_ _ _ __ _ _ i - - - - - - - - -

MUChUang(GB_l_6_}r'_ _ _ _ _ _ 0_ _ _ _ _ _ _ _ _
X_ _ _ _ _t _ _ _ _ _ __
Zhengying (GB 17) , O x
Chengling (GB 18) 0 X

Naokong (GB 19) 0 X

Fengchi (GB 20) 0 X

---------
Jianjing (GB 21) 0 X
3% CHINESE ACUPUNCTURE AND MOXIBUSTION

Riyue (GB 24) o I Meeting with Foot-

IT'
, alym.
-----tj- --------
Huantiao (GB 30) I X 0 I
------~ -----
Daimai(GB26) I 0 X
-----_. --------'-_._._-------
Wushu (GB 27) L_______O
I -------t--
X

Weidao (GB 28) I 0 X I

- - - - - - - - - _ - - - - i -_ _ _ _ _ _ _ . . _____ _
Juliao (GB 29) I 0 X
I
Yangjiao (GB 35) : 0 X Xi-(Cleft) of Yang
Link Vessel
Tianliao (TE 15) o X
- - - - - --------------i---------------
I
Yifeng (TE 17) X 0
------------ ----------+-
Jiaosun (TE 20) X 0 X '
--j--- -------------- ----i-------- - - - - -
Erheliao (IE 22) X X 0
Chengqi (ST 1) o X i Meeting with Concep-
: tion Vessel
------·---i-----~----------·~-

Juliao(ST 3)
- - - - -__
o X
. -----____ . ------1---- _________ _
I
Dicang (ST 4) o X X
i
--------+--- - - - - - - - ---------t---------------.--
Xiaguan (ST 7) X o
-------l---
Touwei (ST 8) X 0 X

Qichong (ST 39) 0 I Starting point of

• Thoroughfare Vessel

Binao (LI 14) 0 Meeting with the col-

i lateral of Hand-
: Yangming

Jianyu (LI 15) 0 X

Jugu (LI 16) 0 x

Yingxiang (LI 20) X 0

* "0" indicates the meridian of origin and "x " the crossing meridian.
CHAPTER 16 A GENERAL INTRODUCTION TO ACUPUNCTURE TREATMENT 397

The Crossing Points on the Yin Meridians

\\ Meridianl

~
cJj

:>
cJj
<U

.....>.
0 .....>.
0 .....>.
~ .....0>.
~
cJj
cJj
~
rJ}
cJj
-
:>
0)
cJj
cJj
<U

....<U
0 .....>.
0 0
..... <U <U
~
Remarks
Point .....
0
..... ..... >. <U 0
0
~
:> :> ..c:all
..... ~ <U ~ ~ ..c: ~ ~
0.. ~
E-<I ~ 0-, ..c: ~ .....0 ~
~
<U 0-, I ~ I
<U
U ..... ~ ~ ..... ~ .....l ::x:: 8
8
I
I 0 0 0 0
i 0 8 ~ ~
8 ~
0 0 0
..c:
!U ~ ::x:: ~ ::x:: ~ ::x:: ~ ~ E-<
-- ~I

Chengjiang (CV 24) i 0 Meeting with Foot-

I
i Yangming
II
x
I~
Lianquan (CV 23)
Tiantu (CV 22) x
----+--.
Shangwan (CV 13) 10 Meeting with Foot-
i Yangming & Hand-
i Taiyin
i
Zhongwan (CV 12) ]0
I
i Promoted by Hand-
:1Taiyang, Shaoyang &
i
I
I Foot-Yangming

Xiawan (CV 10) 0 x I

Yinjiao (CV 7)
1

:0 x !
I
.-----.-----l-.
Guanyuan (CV 4) x x x i
10
Ii

Zhongji (CV 3) 10 x x x
!
Qugu (CV 2) 10 X I
I
I I
H uiyin (CV 1) 10
I
X I Along with Governor
I
I & Thoroughfare Ves-

I
I sels
I
!
I I

Sanyinjiao (SP 6)I 0 x X

I
Chongmen (SP 12) I 0 x
Fushe (SP 13) 0 x x
Daheng (SP 15) 0 x
Fuai(SP 16) 0 x
Zhongfu (LU 1) x 0
398 CHINESE ACUPUNCTURE AND MOXIBUSTION

Zhangmen (LR 13) 0 I Meeting with Foot-

I Shaoyang
Qimen(LR 14) x 0 x i
i
Tianchi (PC 1) 0 i Meeting with Foot-
i Shaoyang
I
Henggu (KI 11) x I
0
i
Dahe (KI 12) 0 x
I
Qixue (KI 13) 0 x !

Siman (KI 14) 0 x

Zhongzhu (KI 15) 0 x
Huangshu (KI 16) 0 x
Shangqu (KI 17) 0 x
Shiguan (KI 18) 0 x
--~--

Yindu (KI 19) 0 x

Futonggu (KI 20) 0 x
Youmen (KI 21) 0 x
i
Zhaohai (KI 6) 0 x !
I
Promoted by Yin
I Heel Vessel
Jiaoxin (KI 8) 0 x ! Xi-(Cleft) of Yin
I Heel Vessel
I
Zhubin (KI 9) 0 x i Xi-(Cleft) of Yin
I Link Vessel
I
 Chapter 17
INTERNAL DISEASES

I. :E:MERGENCY DISEASES strain and stress, or invasion of exoge-

AND SYNDROMES CAUSED nous pathogenic wind, all leading to up-
surge of liver yang and heart fire, which
BY EXOGENOUS makes qi and blood go upward together
PATHOGENIC FACTORS with turbid phlegm, disturbing the mind
and resulting in this disease. In mild cases
1. Wind Stroke there are only symptoms showing dys-
function of the meridians and collaterals,
Wind stroke is an emergency case while in severe cases both dysfunction of
manifested by falling down in a fit with zang-fu organs and that of the meridians
loss of consciousness, or hemiplegia, and collaterals are manifested. The syn-
slurred speech and deviated mouth. It is drome indicating the attack on the zang-
characterized by abrupt onset with path- fu organs may be subdivided into tense
ological changes varying quickly like the (excess) type and flaccid (deficiency)
wind,. from which the term "wind stroke" type.
comes. Tense (excess) syndrome results from
disturbance of the mind by the phlegm
Etiology and Pathogenesis heat, or collection of excessive fire in the
Wind stroke often occurs in the aged heart and liver, while flaccid (deficiency)
who are in poor health, with deficiency of syndrome results from deficiency of the
qi and blood or deficiency in the lower primary qi or collapse of the kidney yang.
part of the body and excess in the upper In untreated or improperly treated cases,
part. It may be caused by deficiency of the tense syndrome tends to become flac-
the kidney yin due to sexual indulgence, cid and the prognosis is often poor.
or by irregular food intake, which
impedes the transportation and transfor- Differentiation
mation function of the spleen, leading to a) Attack on the zang-fu organs:
production of phlegm from accumulated i) Tense syndrome:
dampness and transformation into heat. Main manifestations: Falling down in
Then there appears imbalance of yin and a fit with loss of consciousness, tightly
yang in the zang-fu organs. Other causa- closed hands and clenched jaws, flushed
tive factors are exasperation, agitation, face, coarse breathing, rattling in the
alcohol indulgence or overeating, over throat, retention of urine, constipation,

399
400 CHINESE ACL'PL'NCTCRE AND MOXIBCSTION

red tongue with thick yellow or dark grey als

coating, string-taut, rolling and forceful There are two categories. One is that
pulse. only the meridians and collaterals are
Analysis: Wind stirred up by upsurge attacked without the zang-fu organs
of liver yang sends qi and blood up- being involved. The other is that after
wards, which together with the accumu- wind stroke the functions of the affected
lated phlegm fire disturb the mind, lead- zang-fu organs have been restored, yet
ing to sudden loss of consciousness with there exists stagnation of qi and blood in
tightly closed hands and clenched jaws, the meridians and collaterals.
flushed face, coarse breathing, retention Main manifestations: Hemiplegia,
of urine and constipation. Excessive wind numbness of the limbs, deviated mouth,
phlegm brings about ratting in the throat. slurring of speech, accompanied by head-
Red tongue with thick yellow coating or ache, dizziness, vertigo, twitching of
dark grey coating, string-taut, rolling and muscles, red eyes and flushed face, thirst,
forceful pulse are the signs of wind com- dryness of the throat, irritability, string-
bined with phlegm fire. taut and rolling pulse.
ii) Flaccid syndrome: Analysis: Wind phlegm enters the me-
Main manifestations: Falling down in ridians and collaterals due to imbalance
a fit and sudden loss of consciousness of yin and yang, or after treatment the
with mouth agape and eyes closed, snor- functions of the affected zang-fu organs
ing but feeble breathing, flaccid paralysis have been restored, but wind phlegm
of limbs, incontinence of urine, flaccid still blocks the meridians and collaterals,
tongue, thready, weak pulse, and in sev- causing retarded circulation of qi and
ere cases cold limbs, or flushing of face blood. Hence appears hemiplegia, numb-
as rouged, fading or big floating pulse. ness of the limbs, deviated mouth and
Analysis: Severe weakness of primary slurring of speech. If complicated with
qi, separation of yin and yang and ex- upsurging of liver yang, and upward dis-
haustion of qi in the zang organs are turbance of wind yang, the symptoms are
indicated in mouth agape, eyes closed, headache, dizziness, vertigo and twitch-
snoring but feeble breathing, flaccid par- ing of muscles. If there is excessive fire
alysis, and incontinence of urine. Flaccid in the heart and liver, there may be red
tongue and thready weak pulse suggest eyes and flushed face, thirst, dryness of
the deficiency of blood and prostration of the throat and irritabiljty. Stagnation of
the kidney yang. If complicated with cold wind phlegm in the meridians and colI at-
limbs, flushed face, fading or big floating erals leads to a string-taut and rolling
pulse, it is a critical case, indicating ex- pulse.
haustion of yin in the lower portion of
the body and upward going of the isolat- Treatment
ed yang. a) Attack on the zang-ju organs:
b) Attack on the meridians and collater- i) Tense syndrome
CHAPTER 17 INTERNAL DISEASES 401

Method: Points of the Governor Ves- ans of Hand and Foot supply the cheeks,
sel, the Liver Meridian of Foot-lueyin Xiaguan (ST 7), liache (ST 6) and Hegu
and the twelve ling-eWell) points are se- (LI 4) are chosen to promote the circula-
lected as the main points to promote re- tion of qi and blood for relieving the
suscitation, reduce wind and fire and re- clenched jaws. Yamen (GV 15) and Lian-
solve phlegm. Either reducing method or quan (CV 23), being local and adjacent
pricking, to cause little bleeding, is ap- points of the tongue, and Tongli (HT 5),
plied, the Luo-(Connecting) point of the Heart
Prescription: Baihui (GV 20), Shui- Meridian, may relieve stiffness of tongue.
gou (GV 26), Fenglong (ST 40), Tai- ii) Flaccid syndrome
chong (LR 3), Yongquan (KI I), twelve Method: Moxibustion is applied to
ling-(Well) points on both hands (LU 11, points of the Conception Vessel to res-
HT 9, PC 9, LI I, TE 1, SI 1). tore yang from collapse.
Supplementary Points: Prescription: Shenque (CV 8), Qihai
Clenched laws: Xianguan (ST 7), (CV 6) (indirect moxibustion with salt),
liache (ST 6), Hegu (LI 14). Guanyuan (CV 4).
Aphasia and stiffness of tongue: Ya- Explanation: Shenque (CV 8), Qihai
men (GV 15), Lianquan (CV 23), and (CV 6) and Guanyuan (CV 4) are located
Tongli (HT 5). on the lower abdomen along the Concep-
Explanation: As the condition is due tion Vessel and are the main points effec-
to disturbance of the heart by phlegm fire tive for collapse. Heavy moxibustion ap-
associated with upsurging of liver yang plied on Guanyuan (CV 4), a meeting
and upward flowing of qi and blood, Bai- point of the Conception Vessel and three
hui (GV 20) and Shuigou (GV 26) are yin meridians, can strengthen the pri-
selected to regulate qi of the Governor mary qi, and restore yang from collapse.
Vessel, effecting resuscitation, Yongquan b) Attack on the meridians and collater-
(KI 1) is selected to conduct the heat als:
downward, and Taichong (LR 3) to sub- Method: Points along the Governor
due the upsurging of qi in the Liver Vessel and the yang meridians of the
Meridian and pacify the liver yang. Prick- affected side are mainly used to regulate
ing the twelve ling-eWell) points on both qi and blood, remove obstruction from
hands, where qi of the three yin and three the meridians and collaterals and reduce
yang meridians meet, may dispel heat the wind. Needle with even movement
and regain consciousness. The spleen and first from the healthy side and then the
stomach are the source of phlegm pro- affected side.
duction. Fenglong (ST 40), the Luo (Con- Prescription: Baihui (GV 20), Tong-
necting) point of the Stomach Meridian tian (BL 7), Fengfu (GV 16).
can invigorate the functions of the spleen Upper limbs: lianyu (LI 15), Quchi
and stomach and help to resolve the tur- (Ll 11), Waiguan (TE 5), Hegu (LI 4).
bid phlegm. Since the Yangming Meridi- Lower limbs: Huantiao (GB 30),

-----------------
402 CHINESE ACUPUNCTURE AND MOXIBUSTION

Yanglingquan (G B 34), Zusanli (ST 36), facial region.

liexi (ST 41).
Supplementary points: Remarks
Upward disturbance of wind yang: a) Wind stroke is referred to cerebral
Reducing is applied to Fenchi (GB 20) hemorrhage, thrombosis, embolism, su-
and Taichong (LR 3), and reinforcing to barachnoid hemorrhage, etc. When the
Taixi (KI 3) and Sanyinjiao (SP 6). acute stage is over, there may be se-
Excessive fire in the heart and liver: quelae, such as hemiplegia, monoplegia,
Reducing is applied to Daling (PC 7) aphasia, etc.
and Xingjian (LR 2), and reinforcing to b) Prophylactic measures for wind
Taixi (KI 3). stroke:
Deviated mouth: Dicang (ST 4), The old aged with deficiency of qi and
liache (ST 6). excessive phlegm, or with manifestations
Explanation: Governor Vessel is the of upsurging of liver yang marked by
sea of all yang meridians. Baihui (G V dizziness and palpitations, may have pre-
20), Fengfu (GV 16) combined with monitory symptoms such as stiff tongue,
Tongtian (BL 7) can eliminate wind and slurred speech and numbness of the fin-
remove obstruction from the meridians ger tips. Attention should be paid to diet
and collaterals. Since the yang meridians and life style and avoid overstraining.
dominate the exterior of the body and qi, Frequent moxibustion on Zusanli (ST 36)
points of the yang meridians are selected and Xuanzhong (GB 39) may prevent an
to regulate qi and blood of the body and attack of wind stroke.
promote smooth circulation in the upper
and lower portions of the body. For the 2. Syncope
upper disturbance of wind yang, Fengchi
(GB 20) and Taichong (LR 3) are select- Syncope is manifested by sudden
ed to reduce the wind and pacify the fainting, pallor, cold limbs and loss of
liver. Reinforcing applied to Taixi (KI 3) consciousness, which are often resulted
promotes the production of the kidney from emotional excitement, fright, or de-
yin to nourish the liver. Reinforcing ap- bilitation and overstraining.
plied to Sanyinjiao (SP 6) nourishes yin
and pacifies yang. Etiology and Pathogenesis
For excessive fire in the heart and a) Deficiency type:
liver, reducing Daling (PC 7) and Xing- Syncope of this type is often caused by
jian (LR 2) can eliminate the fire, while general deficiency of the primary qi and
reinforcing to Taixi (KI 3) nourishes yin failure of clear yang in ascending due to
to reduce the fire. Dicang (ST 4) and over strain or grief and fright, or by
liache (ST 6) are selected for the purpose exhaustion of qi after profuse bleeding.
of promoting a free circulation of qi in b) Excess type:
the meridians and collaterals around the It is due mainly to emotional disturb-
CHAPTER 17 INTERNAL DISEASES 403

ances, such as anger, fear and fright, breathing. Deep and excess-type pulse is
leading to deranged flow of qi, which a sign of excess syndrome.
rushes upwards to the heart and chest, Syncope manifested by sudden loss
blocking the windpipe and disturbing the of consciousness should be distinguished
mind, or due to upsurging of liver yang, from wind stroke and epilepsy.
and upward flowing of qi followed by Wind stroke: Loss of consciousness is
perversion of blood flow after a fit of complicated by hemiplegia and deviated
anger, leading to disturbance of the mind, mouth. Usually there are sequelae after
and resulting in loss of consciousness. restoration to consciousness.
Epilepsy: Loss of consciousness is ac-
Differentiation companied by conVUlsions, expectoration
a) Deficiency syndrome: of frothy saliva or yelling. When the
Main manifestations: Feeble breath- consciousness is regained the patient be-
ing with mouth agape, spontaneous comes as normal as usual.
sweating, pallor, cold limbs, deep and
thready pulse. Treatment
Analysis: Dizziness, vertigo, loss of a) Deficiency syndrome:
consciousness, feeble breathing are the Method: Points of the Governor Ves-
symptoms caused by deficiency of pri- sel and Pericardium Meridian are select-
mary qi with sudden perversion of its ed as the main points to promote resusci-
flow, sinking of qi in the spleen and tation, reinforce qi and invigorate yang.
stomach and failure of the clear yang in Reinforcing is applied in acupuncture,
ascending. Cold limbs are caused by fail- combined with moxibustion.
ure of yang qi to reach there. Weakness Prescription: Shuigou (GV 26), Bai-
of primary qi and disabilities of vital qi hui (GV 20), Neiguan (PC 6), Qihai (CV
in controlling the pores are shown in 6), ZusanIi (ST 36).
spontaneous sweating, and mouth agape. Explanation: Shuigou (GV 26), Bai-
Deep thready pulse also suggests defi- hui (GV 20) and Neiguan (PC 6) are the
ciency of vital qi. points for resuscitation. Qihai (CV 6) and
b) Excess syndrome: Zusanli (ST 36) are good for reinforcing
Main manifestations: Coarse breath- qi and invigorating yang.
ing, rigid limbs, clenched jaws, deep and b) Excess syndrome:
excess-type pulse. Method: Reducing is applied to points
Analysis: Perversion of qi after a fit of the Governor Vessel and Pericardium
of anger makes qi activity impeded and Meridian to promote resuscitation and
blood rushing upward together with qi to regulate the flow of qi.
disturb the mind, and hence occur sud- Prescription: Shuigou (GV 26), Hegu
den collapse, loss of consciousness, (LI 4), Zhongchong (PV 9), Laogong
clenched jaws and rigid limbs. Obstruc- (PV 8), Taichong (LR 3), Yongquan
tion of qi in the lung gives rise to coarse (KI I).
404 CHINESE ACUPCNCTURE AND MOXIBUSTION

Explanation: Shuigou (GY 26) and that may penetrate the pericardium and
Zhongchong (PC 9) are used to promote disturb the mind, followed by impair-
resuscitation. Hegu (LI 4) and Taichong ment of consciousness. Sunstroke, ac-
(LR 3) are the points for regulating the cording to its clinical manifestations,
circulation of qi and blood. Laogong (PC may be classified into mild and severe
8) and Yongquan (KI I) promote a clear types.
mind and smooth flow of qi and blood."
Differentiation
Remarks a) Mild type:
This condition includes simple faint- Main manifestations: Headache, dizzi-
ing, postural hypotension, hypoglycemia, ness, profuse sweating, hot skin, coarse
hysteria, etc. breathing, dry mouth and tongue, dire
thirst, superficial, large and rapid pulse.
3. Sunstroke Analysis: Pathogenic summer heat
tends to attack the head and gives rise to
Sunstroke is an acute case occurring headache and dizziness. Hot skin results
in summer, manifested by high fever, from the accumulation of pathogenic
irritability, nausea, or even followed by summer heat in the body surface. Profuse
collapse and loss of consciousness. The sweating, coarse breathing, dry mouth
onset of this disease is due mostly to and tongue, dire thirst are all due to
prolonged exposure to the sun, or to an evaporation of body fluid by the summer
environment with high temperature. heat. Superficial, large and rapid pulse is
a sign showing the presence of the path-
Etiology and Pathogenesis ogenic summer heat.
Summer heat, a pathogenic factor, b) Severe type:
is prevalent in summer time when the Main manifestations: Headache, dire
weather is scorching. Long exposure to thirst, and shortness of breath at first,
the sun and to an environment with and then collapse, loss of consciousness,
high temperature damages qi. Invasion sweating, deep and forceless pulse.
of pathogenic summer heat in a condi- Analysis: This syndrome mostly oc-
tion of lower resistance brings about sun- curs in those doing physical labor in the
stroke. Summer heat is a pathogenic fac- scorching summer sun. Overfatigue plus
tor of yang nature with a tendency to the attack of summer heat results in low-
attack the human body quickly. There- ered body resistance and excessiveness of
fore the onset is abrupt and the changing the pathogenic factor with consumption
of the pathological condition is rapid. of qi and body fluid. So there are head-
Pathogenic summer heat is likely to dam- ache, dire thirst and shortness of breath
age the primary qi and consume the body at the very beginning. The pathogenic
fluid, leading to exhaustion of qi and yin. summer heat can rapidly penetrate into
Furthermore, pathogenic summer heat the interior, affecting the pericardium
CHAPTER 17 INTERNAL DISEASES 405

and disturbing the mind. Therefore loss ficially to remove the heat from the
of consciousness follows. Sweating and blood. Blood letting at Shixuan (Extra)
deep, forceless pulse indicate exhaustion can reduce heat and promote resuscita-
of qi and body fluid. tion.

Treatment Remarks
a) Mild type: a) This illness includes thermoplegia,
Method: Reducing is applied to the thermospasm, heliosis, etc.
points of the Governor Vessel, Pericar- b) Scraping therapy: It is a popu-
dium and Large Intestine Meridians to lar treatment for mild sunstroke. Dip
eliminate the summer heat. a smooth spoon into water or vegetable
Prescription: Dazhui (GV 14), Nei- oil and scrape the both sides of the spine,
guan (PC 6), Quchi (LI II), Weizhong the neck, intercostal spaces, shoulder re-
(BL 40). gions, cubital and axilla fossae until pur-
Explanation: Dazhui (GV 14), the plish red color appears.
meeting point of the Governor Vessel
and all yang meridians, Weizhong (BL 4. Common Cold
40)., also named Xuexi, and Quchi (LI
11)., an important point for eliminating Common cold is an exogenous ailment
heat, are used to dispel the summer heat. with headache, nasal obstruction, aver-
Neiguan (PC 6), the Luo-(Connecting) sion to wind and fever as its main mani-
point of Jueyin Meridian of Hand, is festations. It often results from lowered
chosen to reduce the fire and to protect superficial resistance and invasion of the
the heart. exogenous pathogenic factors. It may oc-
b) Severe type: cur in any season. According to the dif-
Method: Reducing is applied to the ference in weather, pathogenic factors
points of the Governor Vessel to promote and body constitution, the manifestations
resuscitation, and to dispel the summer can be classified into two types: wind
heat. cold and wind heat.
Prescription: Shuigou (GV 26), Bai-
hui (GV 20), Shixuan (Extra), Quze (PC Etiology and Pathogenesis
3), Weizhong (BL 40). This disease is often due to delicate
Explanation: Summer heat is a patho- constitution and weakened body resist-
genic factor of yang nature, which is apt ance which makes the body inadaptable
to attack the pericardium and disturb the to intense changes of the weather with
mind. Shuigou (GV 26) and Baihui (GV abnormal cold or warmth. Then the exog-
20) are selected to promote resuscitation. enous pathogenic wind invades the body
Quze (PC 6), the He-(Sea) point of Hand- through the pores, skin, mouth and nose,
Jueyin, Weizhong (BL 40), the He-(Sea) leading to manifestations related to lung
point of Foot Taiyang are pricked super- and the defensive function. Very often
406 CHINESE ACUPl~NCTURE AND MOXIBUSTION

pathogenic wind combined with other white tongue coating and superficial
pathogenic factors like pathogenic cold tense pulse are the signs showing the
causes a wind cold syndrome, or with invasion of the lung and the superficial
pathogenic heat causes a wind heat syn- defensive system by pathogenic wind and
drome. Invasion of exogenous pathogenic cold.
wind and cold may retard the lung's dis- b) Wind heat:
persing function and block the pores, Main manifestations: Fever, sweating,
while invasion of exogenous pathogenic slight aversion to wind, pain and distend-
wind and heat may impair the lung's des- ing sensation of the head, cough with
cending function by the evaporating heat, yellow, thick sputum, congested and sore
and lead to abnormal functioning of the throat, thirst, thin white or yellowish
pores. In addition, since the patient's tongue coating, superficial and rapid
body build is different and the internal pulse.
and external causes are mutually influ- Analysis: Pathogenic wind heat often
enced, the manifestations after invasion attacks the body through the nose and
by the pathogenic factors must be varied. mouth. The lung is involved first. Patho-
For patients with yang deficiency, wind genic wind of yang nature is character-
cold syndrome is mostly seen, while for ized by upward and outward dispersion.
those with yin deficiency, wind heat syn- When a fight goes on between the patho-
drome is often found. genic wind heat and the body resistance,
fever, slight aversion to wind and sweat-
Differentiation ing result. When the pathogenic wind
a) Wind cold: heat attacks the head, symptoms like pain
Main manifestations: Chills, fever, an- and distending sensation occur in the
hidrosis, headache, soreness and pain head. In case the lung fails in dispersing
of the limbs, nasal obstruction, running and descending, there appears cough with
nose, itching of the throat, cough, hoarse yellow, thick sputum. When the patho-
voice, profuse thin sputum, thin white genic wind heat stifles the air passage,
tongue coating, superficial and tense there is congested sore throat with thirst.
pulse. Thin, white or yellowish tongue coating,
Analysis: Invasion of the body surface and superficial rapid pulse are the signs
by pathogenic wind and cold impairs the showing the lung and the defensive sys-
dispersing function of the lung and af- tem being attacked by the pathogenic
fects the nose, causing nasal obstruction wind heat.
and discharge. Pathogenic cold is of yin
nature, which is likely to damage yang. Treatment
Impairment of superficial yang is man- a) Wind cold:
ifested by exterior symptoms such as Method: Reducing is applied to the
chills, fever, anhidrosis, headache, even points of the Governor Vessel, Taiyang
soreness and pain of the limbs. Thin and Shaoyang Meridians to eliminate
CHAPTER 17 INTERKAL DISEASES 407

wind cold and relieve exterior symptoms. Explanation: The Governor Vessel is
Even movement combined with moxibus- the sea of all the yang meridians. Dazhui
tion is applied to patients with weakened (GV 14), a point where all the yang me-
constitutions. ridians meet, is used to eliminate heat
Prescription: Fengfu (GV 16), Feng- and other pathogenic factors of yang na-
men (BL 12), Fengchi (GB 20), Lieque ture. Hegu (LI 4) and Quchi (LI 11) are
(LU 7), Hegu (LI 4). the Yuan-(Primary) point and the He-
Explanation: Fengfu (GV 16) is used (Sea) point of the Yangming Meridian of
to relieve the exterior symptoms, elimi- Hand respectively. Since the Yangming
nate wind and check headache. Fengmen and Taiyin Meridians of Hand are exter-
(BL 12), a point of the Taiyang Meridian nally and internally related, reducing ap-
which dominates the surface of the whole plied to these two points can clear lung qi
body, is selected to regulate the circula- and reduce heat. Yuji (LU 10), the Ying-
tion of qi in this meridian, to eliminate (Spring) point of the Lung Meridian, in
wind cold and to relieve chills and fever. combination with Shaoshang (LU 11),
As the pathogenic cold has attacked the can eliminate heat from the lung and ease
surface of the body, and the lung is the the throat. Waiguan (TE 5), the Luo-
organ related to the skin and hair, Lieque (Connecting) point of the Shaoyang Me-
(Ll] 7), the Luo-(Connecting) point of ridian of Hand connecting with the Yang
the Lung Meridian, is used to promote Link Vessel, can dispel pathogenic fac-
the dispersing function of the lung and to tors of yang nature in the exterior of the
check cough. Fengchi (GB 20), a point at body and eliminate heat.
the intersection of the Foot Shaoyang
and Yang Link Vessels, of which the Remarks
latter dominates yang and the exterior, is a) The above treatment can also be
used to eliminate wind cold. Since the used for other viral and bacterial infec-
Taiyin and Yangming Meridians are ex- tions of the upper respiratory tract as
ternally and internally related, Hegu (LI well as influenza. However, common cold
4), the Yuan-(Primary) point of the should be distinguished from other infec-
Yangming Meridian, is used to eliminate tious diseases with similar symptoms at
the pathogenic factors and relieve the the early stage.
exterior symptoms. b) Prophylactic measures: Moxibus-
b) Wind heat: tion is applied daily to Fengmen (BL 12)
Reducing is applied to the points or Zusanli (ST 36) to prevent common
of the Governor Vessel, Shaoyang and cold during its prevalence.
Yangming Meridians to eliminate wind
heat. 5. Malaria
Prescription: Dazhui (GV 14), Quchi
(L1 11), Waiguan (TE 5), Hegu (LI 4), Malaria is a disease characterized by
Yuji (LU 10), Shaoshang (LU 11). paroxysms of shivering chills and high
 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~CHINESE .\CCrl:r\CTL'RE AND MOXII3CSTION
_408

fever occurring at regular intervals, most- ic factors. If the pathogenic factors and
ly found in late summer and early au- the antipathogenic factors are separated
tumn, but also sporadically occurring in from each other, or if the pathogenic
other seasons. The causative factor is the factors avoid fighting with the ying and
malarial pestilential factor. The recur- wei, there appears an interval between
rence of chills and fever varying with the the paroxysms.
condition of yin and yang and body con- b) Only when the body resistance is
stitution, may be once every day, every weak, the pestilential factor invades the
second day or every third day, known body. Weakened body resistance may be
respectively as quotidian malaria, tertian due to abnormal daily life, overstrain, or
malaria and quartan malaria according to deficiency of qi and blood caused by im-
the interval between attacks. In chronic proper transportation and transforma-
cases there may be a mass in the hypo- tion function of the spleen and stom-
chondriac region, termed "malaria with ach as a result of irregular food intake.
splenomegaly." Zhang Jingyue once said: "Malaria is an
exogenous disease .... Only in the condi-
Etiology and Pathogenesis tion of delicate health, or overstrain and
The disease is believed to be caused stress, is one apt to be attacked by the
mainly by the malarial pestilential fac- malarial pathogenic factor."
tor together with invasion of pathogenic In a word, the causative factor is the
wind, cold, summer heat and dampness. pestilential factor, but the condition of
Improper food intake, overstrain and body resistance plays a very important
stress, and irregular daily life can predis- role. One with the body resistance vigo-
pose one to malaria by weakening the rous enough to prevent the invasion by
body resistance. Invasion of the Shao- pathogenic factors seldom suffers from
yang Meridian by the pathogenic factors malaria, whereas one with lowered body
causes ying-wei disharmony, resulting in resistance is apt to be attacked.
malaria.
a) The pestilential factor together Differentiation
with the pathogenic wind cold, summer Main manifestations: Paroxysms of
heat, and dampness invades the body, shivering chills and high fever with gen-
resides in the portion between the exter- eral hot sensation, preceded by yawning
ior and interior, and moves outward and and lassitude. There appear intolerable
inward between ying and wei. When they headache, fI ushed face and red Ii ps, sti-
move inward to struggle with yin, there fling feeling in the chest and hypochon-
are chills, and when they move outward driac region, bitter taste and dry mouth,
to fight with yang, there is fever. It is and dire thirst. At the end of the parox-
clear that the paroxysm of chills and ysm the patient breaks out in profuse
fever depends on the struggle between perspiration and fever subsides with the
the anti pathogenic factors and pathogen- body felt cool. Thin, sticky and yellow
CHAPTER 17 INTERNAL DISEASES '10')

tongue coating, string-taut and rapid yang Meridians to regulate the Governor
pulse. In chronic cases a mass in the Vessel and to harmonize the Shaoyang
hypochondriac region-splenomegaly is Meridians. Treatment is given two hours
usually found. prior to the paroxysm. If chills are pre-
Analysis: Occurrence of shivering dominant during the paroxysm, acupunc-
chillis and high fever is due to the fight of ture is advised to combine with moxibus-
the pathogenic factors against ying and tion. If fever is the dominant symptom,
wei in the portion between the exterior acupuncture alone is employed.
and interior of the body. There appears Prescription: Dazhui (GV 14), Tao-
an interval between paroxysms of chills dao (GV 13), Houxi (SI 3), lianshi (PC
and fever if the pathogenic factors avoid 5), Yemen (TE 2), Zulinqi (GB 41).
fighting with ying and wei. Yawning, Supplementary points:
lassitude and chills with shivering are High fever: Quchi (L I II) with reduc-
caused by the invasion of pathogenic fac- ing method.
tors which suppress yang qi. General hot Malaria with splenomegaly: Needling
sensation, intolerable headache, flushed of Zhangmen (LR 13) and moxibustion
face and red lips indicate that the accu- at Pigen (Extra).
mulated pathogenic cold has turned into High fever with delirium and mental
heat. The stifling feeling in the chest and confusion:
hypochondriac region, and bitter taste in Prick the twelve ling-(Well) points
the mouth suggest that the pathogenic (LU II, HT 9, PC 9, L I L TE I, S I I).
factors in the Shaoyang Meridian and in Explanation: Dazhui (GV 14), the
the portion between the exterior and in- meeting point of the three yang meridi-
terior impair the circulation of qi and ans and the Governor Vessel, can pro-
blood. Thirst results from the consump- mote the circulation of qi in the yang
tion of the body fluids by heat. Thin, meridians and help to eliminate patho-
sticky and yellow tongue coating, string- genic factors, in combination with Tao-
taut and rapid pulse are the signs related dao (G V 13), which can remove ob-
to the presence of cold and heat and the struction from the Governor Vessel and
contradiction between the anti pathogen- regulate yin and yang. They are the chief
ic factors and pathogenic factors. The points for malaria. Yemen (TE 2) and
chronic case with a mass formed in the Zulinqi (GB 41), two points along the
hypochondriac region is due to deficiency Shaoyang Meridians can harmonize qi of
of qi and blood and stagnation of exces- the Shaoyang Meridians. Houxi (SI 3), a
sive phlegm in the meridians and collater- point of Taiyang Meridian of Hand, can
als. activate the circulation of qi in the Tai-
yang Meridian and the Governor Vessel
Treatment and drive patogenic factors out. lianshi
Method: Reducing is applied to the (PC 5), a point of lueyin Meridian of
points of the Governor Vessel and Shao- Hand, is an empirical point for malaria.
410 CHINESE ACUPUNCTURE AND MOXIBUSTION

Combination of all the above mentioned ic factors, the qi of the lung is blocked
points can promote the circulation of qi and fails to descend, thus resulting in
in the yang meridians, and help to elimi- cough.
nate pathogenic factors, relieve both the Since the weather changes in different
symptoms, harmonize ying and wei, and seasons, the exogenous pathogenic fac-
check malaria. Quchi (LI 11), a point of tors attacking the human body are var-
Yangming Meridian of Hand, combined ious. Cough is therefore divided into two
with Dazhui (GV 14) can dispel heat. types: wind cold and wind heat.
Zhangmen (LR 13), the influential point b) Internal injury:
dominating zang organs can regulate qi Cough resulted from functional im-
in the zang organs. Pigen, an extra point, pairment of the zang-fu organs falls into
is selected to treat the mass in the hypo- the category of cough due to internal
chondriac region. injury, such as cough caused by dryness
Acupuncture treatment of tertian ma- of the lung with deficiency of yin leading
laria has achieved better effects. Perni- to failure of the qi of the lung to descend,
cious malaria should be treated by acu- or by disorders of the other organs affect-
puncture in combination with medicine. ing the lung. For example, in case of
weakened spleen yang, the accumulated
dampness may be turned into phlegm
II. ZANG-FU SYNDROMES which goes upward to the lung, affecting
the normal activities of qi and leading
1. Cough to cough. Stagnation of liver qi may be
Cough, a main symptom of the lung turned into fire, which flares up and in-
problems, may result either from attack jures the lung fluid, also resulting in
by exogenous pathogenic factors disturb- cough. As said in Internal Classic:
ing the dispersion of qi of the lung, or "Cough can be caused by disturbance not
from disorders of the lung itself or oth- only of the lung, but of any other zang-fu
er diseased zang-fu organs affecting the organs." No matter which zang-fu organ
lung. is dysfunctioned, cough may result if
the lung is affected. The commonly seen
Etiology and Pathogenesis cough caused by internal injury in clinic
a) Invasion by the exogenous pathogenic results from dryness of the lung with
factors: deficiency of yin, and blockage of the
The lung dominates qi and is regarded lung by phlegm.
as an umbrella protecting the five zang
organs. Upward it connects the throat Differentiation
and has its opening in the nose, govern- a) Invasion by the exogenous pathogenic
ing respiration. Externally it associates factors:
with the skin and hair. Once the 1ung i) Wind-cold type:
is attacked by the exogenous pathogen- Main manifestations: Cough, itching
CHAPTER 17 INTERNAL DISEASES 411

of the throat, thin and white sputum, in the lung and in the superficial part of
aversion to cold, fever, anhidrosis, head- the body.
ache, nasal obstruction and discharge, b) Internal injury:
thin, white tongue coating and superficial i) Blockage of the lung by phlegm:
pulse. Main manifestations: Cough with pro-
Analysis: Cough, itching of the fuse, white and sticky sputum, stuffiness
throat, thin and white sputum, nasal ob- and depression of the chest, loss of appe-
struction and discharge result from the tite, white, sticky tongue coating and roll-
attack of the lung by pathogenic wind ing pulse.
cold., which is stagnated in the respiratory Analysis: "The spleen is considered as
tract, affecting the dispersion of the qi of the source in the production of sputum
the lung. Headache, aversion to cold, fe- and the lung as a container to store it." If
ver and anhidrosis are due to wind cold the spleen fails in its transformation and
affecting the skin and hair, and residing transportation, the water dampness will
on the body surface. Thin, white tongue no longer be transported and then gath-
coating and superficial pulse indicate the ered to form phlegm, which goes upward
presl~nce of the pathogenic factors stay- to the lung, affecting the qi of the lung
ing in the lung and in the superficial part and causing its failure in descending. The
of the body. result is cough with profuse sputum or
ii) Wind-heat type: with white, sticky sputum. If water damp-
Main manifestations: Cough with yel- ness stays in the middle energizer, im-
low, thick sputum, choking cough, thirst, pairing its activity, there may be stuffi-
sore throat, fever, or headache, aversion ness and depression of the chest and lots
to wind, sweating, thin, yellow tongue of appetite. White, sticky tongue coating
coating, superficial and rapid pulse. and rolling pulse are due to internal ob-
Analysis: In case of the attack of the struction by the phlegm.
lung by the pathogenic wind heat, the ii) Dryness of the lung with deficiency
function of the lung in clarifying the of yin:
passage and sending down the qi is im- Main manifestations: Dry cough with-
pair,ed. The fluids are heated and turned out sputum or with scanty sputum, dry-
into phlegm, and so cough with yellow, ness of the nose and throat, sore throat,
thic:k sputum or choking cough takes spitting blood or even coughing blood,
place. When the heat in the lung injures afternoon fever, malar flush, red tongue,
body fluid, thirst and sore throat occur. thin coating, thready and rapid pulse.
When the pathogenic factors stay in the Analysis: Dryness is easy to consume
skin and hair, their conflict with the body the body fluid. If the lung is injured by
resistance gives rise to headache, aversion dryness, the function of the lung will be
to wind, sweating and fever. Thin, yel- impaired, manifested by dry cough with-
low tongue coating, and superficial rapid out sputum or with scanty sputum, dry-
puls.e are the signs of wind heat staying ness of the nose and throat, or sore
412 CHINESE ACCPUNCTCRE A1':O MOXIBCSTI01'\

throat. If the lung vessels are injured by b) I nterna! i/~jur.v:

dryness, blood in the sputum or hemop- i) Blockage of the lung by phlegm:
tysis results. If there is deficiency of yin Method: Select the Back-Shu point
of the lung with endogenous heat, after- and the points of the Yangming Meridian
noon fever and malar flush may be pres- of Foot as the principal points. Both rein-
ent. Red tongue, thin coating, and forcing and reducing methods should be
thready rapid pulse are the signs indicat- considered in acu puncture treatment, or
ing deficiency of yin and dryness of the combined with moxibustion to strengthen
lung. the function of the spleen and to resolve
phlegm.
Treatment Prescription: Feishu (BL 13), Zhong-
a) Invasion by exogenous pathogenic wan (CY 12), Chize (LU 5), Zusanli (ST
factors: 36), Fenglong (ST 40).
Method: Select the points from the Explanation: The Back-Shu point and
Taiyin and Yangming Meridians of Hand the Front-Mu point are the points where
as the principal ones. Both acupuncture qi of the zang-fu organs converges. Fei-
and moxibustion are applied in case of shu (BL 13) and Zhongwan (CY 12) are
wind cold, while only acupuncture is used selected in combination with Zusanli (ST
in case of wind heat to activate the dis- 36), the He-(Sea) point of Yangming Me-
persing function of the lung and to re- ridian of Foot, to strengthen the function
lieve the symptoms. of the spleen and harmonize the stomach,
Prescription: Lieque (LU 7), Hegu (U remove dampness and resolve phlegm.
4), Feishu (BL 13). Chize (LU 5), the He-(Sea) point of the
Supplementary points: Lung Meridian, is able to reduce the
Pain and swelling of the throat: pathogenic factors from the lung and re-
Shaoshang (LV II). lieve cough. Fenglong (ST 40), the Luo-
Fever and aversion to cold: Dazhui (Connecting) point of the Yangming Me-
(GV 14), Waiguan (TE 5). ridian of Foot, is selected to strengthen
Explanation: The Taiyin and Yang- smooth transport of qi in the spleen and
ming Meridians of Hand are exteriorly- stomach. Thus the body fluids are nor-
interiorly related. Lieq ue (LU 7), the mally distributed following the free flow
Luo-(Connecting) point, and Hegu (LI of qi and phlegm is resolved.
4), the Yuan-( Primary) point, are select- ii) Deficiency of yin with dryness of
ed in combination with Feishu (BL 13) to the lung:
strengthen the functional activities of the Method: Select the Back-Shu point
lung, to relieve symptoms and to elimi- and Front-Mu point of the Lung
nate the exogenous pathogenic factors, Meridian as the principal points.
resulting in smooth flow of qi of the lung Even-movement is applied in acupunc-
and the normal dispersing function of the ture treatment to nourish yin, eliminate
lung. dryness and descend lung qi.
CHAPTER 17 INTERNAL DISEASES 41:\

Prescription: Feishu (BL 13), Zhong- of the back till the skin becomes red or
fu (LU I), Lieque (LU 7), Zhaohai bleeds slightly.
(KI 6).
Supplementary points: 2. Asthma
Kongzui (LU 6) and Geshu (BL 17) in
case of coughing blood. Asthma is a common illness character-
Explanation: The selection of Feishu ized by repeated attacks of paroxysmal
(BL 13) and Zhongfu (LU I) is a method dyspnea with wheezing.
of combining Back-Shu point and Front- Generally speaking, it involves a va-
M u point. It is used to regulate the lung riety of disorders resulting from disturb-
passage and descend lung qi. Lieque (LU ance of qi activities, and can be divided
7), the Luo-(Connecting) point of the into two types: deficiency and excess.
Lung Meridian of Hand-Taiyin, is con-
nected with the Conception Vessel. Zhao- Etiology and Pathogenesis
hai (JIG 6) is a point of the Kidney Me- The causative factors are varied from
ridian of Foot-Shaoyin curving around the exogenous pathogenic factors to
the genital organ. The two points located weakened body resistance. Asthma due to
up and down are selected as a combina- exogenous pathogenic factors is of excess
tion of the Eight Confluent points to type, and that due to weakened body
nourish yin, eliminate dryness, clear the resistance is of deficiency type.
throat and descend the lung qi. Kongzui a) Excess type:
(LU 6), the Xi-(Cleft) point of the lung, Wind-cold type: It denotes asthma due
is indicated in acute cases of the lung. to invasion of wind cold, which impairs
Geshu (BL 17) is a blood point of the the smooth flow of the lung qi, injures
Eight Influential Points. The two points the skin and hair, and makes the pores
are used in combination to stop bleeding. closed. Since the lung and the superficial
defensive system are weakened, the lung
Rt~marks qi fails to disperse and descend, leading
a) If cough is accompanied by fever to cough.
and asthma, see "Common Cold" and Phlegm-heat type: It refers to asthma
"Asthma." due to failure of the spleen in transfor-
b) Cough is often seen in common mation and transportation, resulting in
cold, acute and chronic bronchitis, pneu- production of phlegm from the accumu-
monia, bronchiectasis and pulmonary lated dampness. Long-standing retention
tuberculosis. of phlegm turns into heat, or excessive
c) Cupping: fire of the lung evaporates the fluids to
Fe:ngmen (BL 12), Feishu (BL 13). phlegm. When the phlegm fire stays in
d) Dermal needle therapy: the lung, the lung qi is stagnated and the
Tap along the Governor Vessel and normal activity of the lung is impaired.
the Bladder Meridian on the upper part Failure of the lung qi in descending func-
414 CHINESE ACUPUNCTURE AND MOXIBUSTION

tion results in asthma. signs of wind cold staying in the lung and
b) Deficiency type: the defensive system.
i) Lung deficien~y: A prolonged and ii) Phlegm-heat type:
protracted cough can weaken and injure Main manifestations: Rapid and short
the lung qi. Overstrain and internal inju- breathing, strong and coarse voice, cough
ry can also bring about deficiency of with thick yellow sputum, sensation of
the lung qi. In either case, shortness of chest stuffiness fever, restlessness, dry-
breath and dyspnea may occur. ness of the mouth, thick yellow or sticky
ii) Kidney deficiency: Overwork and coating, rolling and rapid pulse.
sexual indulgence can injure the kidney. Analysis: Phlegm heat turned from
A severe or chronic disease weakens the dampness or long-standing phlegm fire
body resistance and damages the essential gathered in the lung blocks the air pas-
qi. Long-standing asthma also affects the sage, causing impairment of the lung
kidney. In any of the above cases, failure qi, and thus presenting rapid and short
of the kidney in receiving qi may give rise breathing, strong and coarse voice, and
to asthma. cough with thick yellow sputum. When
the phlegm stays in the lung, sensation of
Differentiation chest stuffiness appears. Fever, restless-
a) Excess type: ness and dryness of the mouth are due to
i) Wind-cold type: the presence of the fire heat. Thick yel-
Main manifestations: Cough with thin low or sticky coating, rolling and rapid
sputum, rapid breathing, accompanied by pulse are the signs of the phlegm heat.
chills, fever, headache, and anhidrosis at b) Deficiency type:
the early stage, absence of thirst, white i) Lung deficiency:
tongue coating, superficial and tense Main manifestations: Short and rap-
pulse. id breathing, feeble voice, weak and low
Analysis: The lung is in charge of sound of coughing, sweating on exertion,
respiration and is associated with the skin pale tongue, pulse of deficiency type.
and hair, which are first attacked by wind Analysis: The lung dominates qi.
cold in the invasive procedure. If wind When there is deficiency of the lung qi
cold resides in the lung, stagnation of qi the function of the lung is impaired.
and failure of the lung qi in dispersing There appear short and rapid breathing,
result in cough with thin sputum and feeble voice, weak and low sound of
rapid breathing. If wind cold still resides coughing. When the lung qi is weak, and
in the superficial part of the body to the superficial defensive system is not
make the pores close, there appear chills, strong, even mild exertion will induce
fever, headache and anhidrosis. Since the sweating. Pale tongue and pulse of defi-
wind cold has not transformed into heat ciency type are the signs of deficiency of
yet, thirst is absent. White tongue coat- the lung qi.
ing, superficial and tense pulse are the ii) Kidney deficiency:
CHAPTER 17 INTERNAL DISEASES 415

Main manifestations: Dyspnea on ex- rna.

ertion after long-standing asthma, severe b) Phlegm heat:
wheezing, indrawing of the soft tissues Method: Points of the Hand-Taiyin
of the neck, short breath, lassitude and and Foot-Yangming Meridians are select-
weakness, sweating, cold limbs, pale ed as the principal points with reducing
tongue, deep and thready pulse. method applied to resolve phlegm, reduce
Analysis: long-standing asthma af- heat and soothe asthma.
fects the kidney which is the source of qi. Prescription: Feishu (Bl 13),
The kidney in lowered functioning fails Dingchuan (Extra), Tiantu (CV 22),
to receive qi, and therefore dyspnea Chize (lU 5), Fenglong (ST 40).
on exertion, severe wheezing and short Explanation: Chize (lU 5), the He-
brealh appear. When there is deficiency (Sea) point of the Hand-Taiyin Meridian,
of the kidney qi in a chronic case, ema- is able to reduce phlegm heat and soothe
ciation and lassitude happen. Exhausted asthma. Fenglong (ST 40), a point of
kidney yang may lead to weakening of the Foot-Yangming Meridian, is able to
the superficial defensive yang, and hence strengthen the spleen function and re-
sweating. If the yang qi fails to warm up solve phlegm. Feishu (Bl 13) is applied
the body surface, cold limbs appear. Pale to clear the lung and regulate the flow of
tongue, deep and thready pulse are the qi. Tiantu (CV 22) is in function to des-
signs, of weakened kidney yang. cend qi and resolve phlegm. Dingchuan
(Extra) is an empirical point to pacify
Treatment breathing.
a) Wind cold: c) Deficiency type:
Method: Points of the Hand-Taiyin i) lung deficiency:
and Hand-Yangming Meridians are se- Method: Points of the Hand-Taiyin
lected as the principal points. Reducing and Foot-Yangming Meridians are select-
method is applied in combination with ed as the principal points with reinforc-
mox:ibustion to eliminate wind cold and ing method applied to strengthen the
soothe asthma. lung qi. Moxibustion is also advisable.
Prescription: Feishu (Bl 13), Feng- Prescription: Feishu (Bl 13), Taiyuan
men (Bl 12), Dazhui (GY 14), Lieque (lU 9), Zusanli (ST 36), Taibai (SP 3).
(lU 7), Hegu (L1 4). Explanation: Taiyuan (lU 9), the
Explanation: Feishu (Bl 13) and Yuan-(Primary) point of the lung Me-
Fengmen (Bl 12) are the points of the ridian, is able to reinforce the lung qi.
Fool-Taiyang Meridian and located in Feishu (BL 13) used in acupuncture and
the vicinity of the lung. They are able to moxibustion, can strengthen the lung qi.
clear the lung and, eliminate wind. Da- Zusanli (ST 36) is the He-(Sea) point
zhui (GV 14), Lieque (lU 7) and Hegu of the Stomach Meridian of Foot-
(L1 4) are in function to eliminate wind Yangming. Taibai (SP 3) is the Yuan-
and cold, clear the lung and soothe asth- (Primary) point of the Spleen Meridian.
416 CHINESE AC[]PCNCTCRE AND MOXII3CSTION

The lung pertains to metal and the spleen (CY 12) and Pishu (BL 20) may streng-
to earth, which is able to promote metal. then the function of the spleen and rein-
"Reinforce the mother in case of deficien- force qi.
cy." ZusanJi (ST 36) and Taibai (SP 3)
are selected here to strengthen the lung Remarks
through invigorating the spleen and This condition includes bronchial
stomach. asthma, asthmatic bronchitis, obstruc-
ii) Kidney deficiency: tive pulmonary emphysema and dyspnea
Method: Points of the Foot-Shaoyin present in some other diseases. However.
Meridian and Conception Yessel are se- for severe dyspnea, a combined treatment
lected as the principal points with rein- should be taken into account.
forcing method applied to strengthen the
kidney function in receiving qi. Moxibus- 3. Epigastric Pain
tion is also advisable.
Prescription: T aixi (KI 3), Shensh u Epigastric pain is a common symp-
(BL 23), Feishu (BL 13), Tanzhong (CY tom, often characterized by repeated re-
17), Qihai (CY 6). currence. Since the pain is close to
Supplementary points: the cardia, it was also named "cardio-
Persistent asthma: Shenzhu (GY 12), abdominal pain" or "cardiac pain" in an-
Gaohuang (BL 43). cient times.
Deficiency of the spleen: Zhongwan
(CY 12), Pishu (BL 20). Etiology and Pathogenesis
Explanation: Taixi (KI 3), the Yuan- a) Irregular food intake, preference
(Primary) point of the Kidney Meridian, for raw and cold food and hunger injure
is able in combination with Shensh u (BL the spleen and stomach, causing failure
23) to strengthen the primary qi of the of the spleen in transportation and trans-
kidney. Tanzhong (CY 17), the qi point formation and failure of the stomach qi
of the Eight Influential Points, and Fei- in descending, then pain appears.
shu (BL 13), the Back-Shu point of the b) Anxiety, anger and mental depres-
lung, are needled to reinforce qi and pac- sion damage the liver, causing failure of
ify breathing. Qihai (CY 6), an important the liver in dominating free flow of qi,
point to reinforce qi, is able to regulate qi adversely attacking the stomach, imped-
in the lower energizer, reinforce the kid- ing its activity and hindering its qi des-
ney, strengthen the primary qi, invigorate cending, then pain appears.
yang and control essence. Puncture on c) Generally lowered functioning of
these points strengthens the kidney in the spleen and stomach, due to invasion
receiving qi and pacify breathing. Moxi- of pathogenic cold, which is stagnated in
bustion on Shenzh u (G Y 12) and the stomach, causes failure of the stom-
Gaohuang (BL 43) may relieve chronic ach qi in descending, then pain oc-
asthma, while moxibustion on Zhongwan curs.

"~--"---~-- - - - - - --- --"- --------"--

CHAPTER 1- It-:TERNAL DISEASES 417

Differentiation pulse are the signs of attack of the stom-

a) Retention of food: ach by the perversive liver qi.
Main manifestations: Distending pain c) Deficiency of the stomach with stag-
in the epigastrium, aggravated on pres- nation of cold:
sure or after meals, belching with fetid Main manifestations: Dull pain in the
odor, anorexia, thick, sticky tongue coat- epigastrium, which may be relieved by
ing, deep, forceful or rolling pulse. pressure and warmth, general lassitude,
Analysis: Retention of food in the regurgitation of thin fluid, thin, white
stomach makes the stomach qi fail to tongue coating, deep, slow pulse.
descend, then distending pain in the epi- Analysis: Lowered function of the
gastrium and belching with fetid odor spleen and stomach with cold inva-
occur. Retention of food is an excess sion retards trans porta tion and trans-
condition, pain is therefore aggravated formation, so dull pain appears in the
upon pressure. Since the stomach is in- epigastrium. The spleen dominates the
jured by retention of food, pain becomes limbs. If the spleen yang is weak, general
worse after meals and anorexia appears. lassitude occurs, as well as the regurgita-
Thick, sticky tongue coating, deep, force- tion of thin fluid. Since the condition is
ful or rolling pulse are the signs of reten- due to deficiency and cold, pain is re-
tion of food. lieved on pressure and by warming. Thin,
b) Attack of the stomach by the liver qi: white coating and deep slow pulse are the
Main manifestations: Paroxysmal signs of lowered function of the spleen
pain in the epigastrium, radiating to the and stomach with cold stagnation.
hypochondriac regions, frequent belch-
ing accompanied by nausea, vomiting, Treatment
acid regurgitation, abdominal distension, a) Retention of food:
anorexia, thin, white tongue coating, Method: The Front-(Mu) point of the
deep, string-taut pulse. stomach and the points of the Yangming
Analysis: Stagnation of the liver qi Meridian of Foot are selected with reduc-
makes the liver fail to dominate the free ing method applied to remove retention,
flow of qi. If the depressed liver qi at- pacify the stomach and relieve pain.
tacks the stomach, pain in the epigas- Prescription: Jianli (CY 11), Neiguan
trium appears. As the Liver Meridian (PC 6), Zusanli (ST 36), Inner-Neiting
locates along both hypochondriac re- (Extra ).
gions, the pain is wandering and may be Explanation: Zhongwan (CY 12) is
referred to both hypochondriac regions. the Front-(Mu) point of stomach, Zusan-
In case of stagnation of the qi, belching Ii (ST 36), the Lower He-(Sea) point of
occurs, even symptoms like nausea, vom- the Stomach and Neiguan (PC 6), a Con-
iting, acid regurgitation, abdominal dis- fluent Point. They are indicated in stom-
tension and anorexia may appear. Thin, ach, heart and chest disorders, and used
white tongue coating and deep string-taut in combination to pacify the stomach and

---------- ..- ---

418 CHINESE ACUPUNCTURE AND MOXIBUSTION

relieve pain. Inner-Neiling (Extra) is an Moxibustion on Pish u (BL 20) streng-

empirical point to treat retention of food. thens the spleen, pacifies the stomach,
b) Attack of the stomach by the liver qi: dispels cold and relieves pain. Indirect
Method: Points of Jueyin and Yang- moxibustion with ginger on Qihai (CY
ming Meridians of Foot are selected as 6) is most desirable in the treatment of
the principal points with the reducing chronic gastric pain due to cold of defi-
method applied to remove the stagnation ciency type, as ginger and moxa together
of liver qi, to pacify the stomach and to have the function of dispelling cold.
relieve pain.
Prescription: Qimen (LR 14), Zhong- Remarks
wan (CY 12), Neiguan (PC 6), Zusanli a) Epigastric pain is a symptom found
(ST 36), Taichong (LR 3). in peptic ulcer, gastritis, gastric neurosis
Explanation: Qimen (LR 14) is the and diseases of the liver, gallbladder and
Front-(Mu) point of the liver and Tai- pancreas.
chong (LR 3) is the Yuan-(Primary) b) Cupping: Cupping is applied with
point of the Liver Meridian. The two are large or medium-sized cups mainly to the
used in combination to remove the stag- upper abdomen or Back-Shu points for
nation of liver qi, regulate the flow of qi ten to fifteen minutes.
and relieve pain. Zusanli (ST 36), Zhong-
wan (CY 12) and Neiguan (PC 6) are 4. Vomiting
applied to pacify the stomach, relieve
pain and check vomiting. Vomiting is a common symptom in
c) Deficiency of the stomach with stag- clinic, resulting from the failure of the
nation of cold: stomach qi to descend, or from other
Method: The Back-Shu points and disorders affecting the stomach. It may
points of the Conception Vessel are se- occur in many diseases, but the most
lected as the principal points with both common causes are retention of food,
acupuncture and moxibustion to warm attack of the stomach by the liver qi and
up the middle energizer, dispel cold and hypofunction of the spleen and stomach.
regulate the flow of qi and relieve pain.
Prescription: Zhongwan (CY 12), Etiology and Pathogenesis
Qihai (CY 6), Pishu (BL 20), Neiguan Overeating of raw, cold and greasy
(PC 6), Zusanli (ST 36), Gongsun (SP 4). food leads to upward perversion of the
Explanation: Acupuncture and moxi- stomach qi, resulting in vomiting.
bustion at Zhongwan (CV 12) and Zusan- Emotional disturbance and depression
Ii (ST 36) warm the middle energizer, of the liver qi harm the stomach, impair-
dispel cold, regulate the flow of qi and ing the downward movement of the stom-
relieve pain. Neiguan (PC 6) and Gong- ach qi, causing vomiting.
sun (SP 4), the Confluent Points, are Weakness of the spleen and stomach
indicated to treat stomach disorders. or overstrain leads to hypofunction of the
CHAPTER 17 INTERNAL DISEASES 419

stomach in transportation and transfor- the signs of the stagnation of the liver qi.
mation, then causing retention of food. c) Hypofunction of the spleen and stom-
The stomach qi ascends instead of des- ach:
cends. Main manifestations: Sallow complex-
ion, vomiting after a big meal, loss
Differentiation of appetite, lassitude, weakness, slight-
a) Retention of food: ly loose stool, pale tongue, thin, white
Main manifestations: Acid fermented tongue coating, thready and forceless
vomitus, epigastric and atxlominal disten- pulse.
sion, belching, anorexia, loose stool or Analysis: Weakness of the spleen and
constipation, thick, granular tongue coat- stomach leads to hypoactivity of the yang
ing, rolling and forceful pulse. in the middle energizer, which fails to
Analysis: Retention of food impedes receive food and water, so vomiting ap-
the function of the spleen and stomach in pears after a big meal. If the spleen fails
transportation and transformation. Since in transportation and transformation, the
qi in the middle energizer is stagnated, essentials of water and food no longer
there appear epigastric and abdominal supply the body for nourishment, there
distension, belching and anorexia. Reten- may appear lassitude, weakness, los of
tion of food leads to upward flowing of appetite and slightly loose stool. Pale
the turbid qi, so acid fermented vomitus, tongue, thin white tongue coating, and
and loose stool or constipation occur. thready and forceless pulse are the signs
Thick, granular tongue coating and roll- of weakness of the spleen and stomach.
ing, forceful pulse are the signs of reten-
tion of food. Treatment
b) Attack of the stomach by the liver qi: Method: The points of Yangming and
Main manifestations: Vomiting, acid Taiyin Meridians of Foot are selected as
regurgitation, frequent belching, distend- the principal points to activate the des-
ing pain in the chest and hypochondriac cent of qi and to pacify the stomach. For
regions, irritability with an oppressed retention of food, reducing is indicated,
feeling, thin, sticky tongue coating, for attack of the stomach by the liver qi,
string-taut pulse. even movement is usually used to soothe
Analysis: Depressed liver qi attacks the liver and regulate the flow of qi, and
the stomach, causing upward perversion for weakness of the spleen and stomach,
of the stomach qi, so there occur vomit- reinforcing combined with moxibustion
ing, acid regurgitation, frequent belch- is used to strengthen the function of the
ing, distending pain in the chest and spleen and warm up the middle energizer.
hypochondriac regions. In case of stag- Prescription: Zhongwan (CV 12), Zu-
nation of the liver qi, irritability with an sanli (ST 36), Neiguan (PC 6), Gongsun
oppressed feeling occurs. Thin, sticky (SP 4).
tongue coating and string-taut pulse are Supplementary points:
420 CHINESE ACl'PUNCTCRE AND MOXIBUSTION

Retention of food: Xiawan (CY 10). 5. Hiccup

Attack of the stomach by the liver qi:
Taichong (LR 3). Hiccup is an involuntary spasm of the
Weakness of the spleen and stomach: glottis and diaphragm, causing the char-
Pishu (BL 20). acteristic sound. Occasional attack of hic-
Persistent vomiting: Jinjing, Yuye cup suggests a mild case and can be
( Extra). removed without medication, but if it
Explanation: Zusanli (ST, 36) is the persists, treatment is required. Hiccup is
He-(Sea) point of the Stom~~h Meridian mostly caused by irregular diet, stagna-
and Zhongwan (CY 12), the Front-Mu tion of the liver qi and presence of cold
in the stomach, leading to upward per-
point of the stomach. The two points
version of the stomach qi instead of des-
used together are effective in pacifying
cending.
the stomach and activating the descent of
qi. Neiguan (PC 6) and Gongsun (SP 4),
Etiology and Pathogenesis
one of the pair-points of the Eight Con-
Irregular food intake causes failure of
fluent points, relieve the fullness of the
the stomach qi to descend, or emotional
chest and stomach. Xiawan (CY 10), a
frustration stagnates the liver qi, leading
point located in the epigastrium, is able
to upward perversion of the stomach qi.
to regulate the stomach qi and remove The attack of the stomach by cold,
stagnation by applying reducing method overeating of raw and cold food, or tak-
needling at Taichong (LR 3), the Yuan ing drugs of cold nature gives rise to
(Primary) point of the Liver Meridian retaining of the stomach yang and up-
regulates the function of the liver. Pishu ward perversion of qi.
(BL 20), a point where the spleen qi is
infused, used in combination with Zusan- Differentiation
Ii (ST 36) and Gongsun (SP 4), may a) Retention of food:
reinforce the spleen qi and invigorate the Main manifestations: Loud hiccups,
qi in the middle energizer to perform the epigastric and abdominal distension, an-
function of transportation and transfor- orexia, thick, sticky tongue coating, roll-
mation and to restore the normal activi- ing and forceful pulse.
ties of qi. Pricking Jinjing (Extra) and Analysis: Retention of food in the
Yuye (Extra) to cause bleeding is an ex- stomach disturbs the function of the
perienced method for checking vomiting. spleen and stomach in transportation and
transformation and impedes the qi activ-
Remarks ities in the middle energizer. "The sto-
Vomiting as described here may be mach is in normal function when its qi
found in acute and chronic gastritis, descends." Failure of its qi to descend
cardiospasm, pylorospasm and neurotic may lead to loud hiccups, epigastric
vomiting. and abdominal distension, and anorexia.
CHAPTER 1-; INTERl'.'AL DISEASES 421

Thick, sticky tongue coating, and rolling, ture and moxibustion are used for cold in
forceful pulse are the signs of retention the stomach. The treatment is aimed at
of food. pacifying the stomach, facilitating the
b) Stagnation of qi: descent of qi and checking hiccup.
Main manifestations: Continual hic- Prescri ption: Gesh u (BL 17), Zhong-
cups, distending pain and feeling of op- wan (CY 12), Neiguan (PC 6). Zusanli
pression in the chest and hypochon- (ST 36).
drium, thin tongue coating, string-taut Supplementary points:
and forceful pulse. Retention of food: Juque (CY 14),
Analysis: The liver qi, if stagnated, Inner-Neiting (Extra).
will attack the stomach, causing upward Stagnation of qi: Tanzhong (CY 17),
perversion of stomach qi, therefore, hic- Taichong (LR 3).
cup, distending pain in the chest and Cold in the stomach: Shangwan (CY
hypochondrium, and feeling of oppres- 13).
sion appear. String-taut and forceful Explanation: Zhongwan (CY 12), Nei-
pulse is a sign of stagnation of qi due to guan (PC 6) and Zusanli (ST 36) may
depression of the liver. pacify the stomach, subdue the ascending
c) Cold in the stomach: qi and relieve the oppression feeling in
Main manifestations: Slow and force- the chest. Geshu (BL 17) is able to check
ful hiccups which may be relieved by heat the perversive ascending of qi and stop
and aggravated by cold, discomfort in the hiccup. Juque (CY 14) and Inner-Neiting
epigastrium, white, moist tongue coating, (Extra ) pacify the stomach and remove
slow pulse. stagnation. Tanzhong (CY 17) relieves
Analysis: The stomach qi fails to des- the depressed feeling in the chest and
cend because of stagnated cold, so hiccup diaphragm and checks hiccup. Taichong
is forceful. In case of disturbance of the (LR 3) may pacify the liver qi. Moxibus-
stomach qi, discomfort in the epigas- tion to Shangwan (CY 13) may warm the
trium occurs. If cold gets heat, smooth middle energizer to dispel cold, promote
circulation of qi results, and then hiccup the smooth distribution of yang and
is relieved; but if cold gets worse, hiccup check hiccup.
is aggravated. White, moist tongue coat-
ing and slow pulse indicate the presence Remarks
of cold in the stomach. Cupping therapy:
Commonly used points; Geshu (BL
Treatment 17), Geguan (BL 46), Ganshu (BL 18),
Method: The points of the Stomach Zhongwan (CY 12), Rugen (ST 18).
Meridian and some other points related
are selected as the principal points. Re- 6. Abdominal Pain
ducing is applied for retention of food
and stagnation of qi, while both acupunc- Abdominal pain is a frequently en-
422 CHINESE ACl'PUNCTCRE AND MOXIBUSTION

countered symptom in clinic, often ac- Analysis: Cold is of yin nature and
companied with many zang-fu disorders, characterized by causing contraction and
of which dysentery, epigastric pain, ap- stagnation. If cold enters the body, yang
pendicitis, and gynecologic diseases will qi will get obstructed, then sudden vi-
be discussed in other sections. In this olent pain and cold limbs appear. Since
section only accumulation of cold, hy- cold stays inside, thirst is absent. Clear
poactivity of the spleen yang and reten- and profuse urine and loose stool are due
tion of food are related. to weakness of the stomach and spleen
yang and failure in transportation and
Etiology and Pathogenesis transformation. The flow of yang qi is
a) Since cold is characterized by caus- usually obstructed by cold and facilitated
ing contraction and stagnation, accumu- by warmth, so pain responds to warmth
lation of cold due to invasion of the but gets worse by cold. Deep, tense or
abdomen by the pathogenic cold or inju- deep, slow pulse, and thin white tongue
ry of the stomach and spleen yang due to coating are the signs of accumulation of
overeating of raw and cold food im- cold.
pairs the transportation and transfor- b) Hypoactivity of the spleen yang:
mation function, resulting in abdominal Main manifestations: Intermittent
pam. dull pain which may be relieved by
b) Hypoactivity of the spleen yang or warmth or by pressure and aggravated by
general deficiency of yang qi leads to cold or by hunger and fatigue, lassitude,
impairment of transportation and trans- aversion to cold, thin, white tongue coat-
formation, and stagnation of cold damp- ing, deep, thready pulse.
ness, resulting in abdominal pain. Analysis: Intermittent duD pain which
c) Retention of food due to voracious may be relieved by warmth or by pressure
eating or intake of too much fatty and and aggravated by cold or by hunger and
hot food impedes the function of the fatigue indicates cold of deficiency type.
stomach and intestines in transmission Hypoactivity of the spleen yang causes
and digestion, nutrients and wastes mix- loose stool and aversion to cold. If the
ing together to obstruct qi, resulting in spleen qi is weak, lassitude occurs. Thin
pain. white tongue coating and deep, thready
pulse also indicate cold of deficiency
Differentiation type.
a) Accumulation of cold: c) Retention of food:
Main manifestations: Sudden onset of Main manifestations: Epigastric and
violent abdominal pain which responds to abdominal distending pain which is ag-
warmth and gets worse by cold, loose gravated by pressure, anorexia, foul
stool, absence of thirst, clear and profuse belching and sour regurgitation, or ab-
urine, cold limbs, thin white tongue coat- dominal pain accompanied by diarrhoea
ing, deep, tense or deep, slow pulse. and relieved after defecation, sticky
CHAPTER 17 INTERNAL DISEASES 423

tongue coating, rolling pulse. Prescription: Pishu (BL 20), Weishu

Analysis: In case of retention of food (BL 21), Zhongwan (CY 12), Zhangmen
in the intestines and stomach, epigastric (LR 13), Qihai (CY 6), Zusanli (ST 36).
and abdominal distending pain occurs. Explanation: Pishu (BL 20) and
Pain is aggravated by pressure because of Zhangmen (LR 13), Weishu (BL 21) and
excess condition. Anorexia is due to re- Zhongwan (CY 12) are selected, known
tention of food, foul belching and sour as combinations of the Back-Shu and
regurgitation due to indigestion of food. Front-Mu points. Both acupuncture and
Pain is relieved after diarrhoea because moxibustion are used to invigorate the
the ,circulation of qi in the fu organs spleen and stomach yang. Qihai (CY
becomes smooth. Sticky tongue coating is 6) and Zusanli (ST 36) are needled to
due to retention of food and collection of strengthen the function of the spleen and
dampness, while rolling pulse is the sign stomach.
of indigestion. c) Retention offood:
Method: The points of the Concept~on
Treatment Yessel and Yangming Meridian of Foot
a) Accumulation of cold: are selected as the principal points with
Method: Points of the Conception reducing method applied to remove re-
Yessel, Taiyin and Yangming Meridians tention of food.
of Foot are selected as the principal Prescription: Zhongwan (CY 12),
points with reducing method applied in Tianshu (ST 25), Qihai (CY 6), Zusanli
combination with moxibustion to warm (ST 36), Inner-N eiting (Extra).
the stomach and dispel cold. Explanation: Zhongwan (CY 12), Zu-
Prescription: Zhongwan (CY 12), sanli (ST 36), Tianshu (ST 25) and Qihai
Shenque (CY 8), Zusanli (ST 36), Gong- (CY 6) are applied to regulate the flow of
sun (SP 4). the stomach qi. Inner-Neiting (Extra) is
Explanation: Zhongwan (CY 12), Zu- an empirical point to treat indigestion.
sanli (ST 36) and Gongsun (SP 4) are The above points are used together to
used to strengthen the function of the remove retention of food and relieve pain
spleen and stomach, and to warm and by promoting the flow of qi.
promote the flow of qi in the fu organs.
Indirect moxibustion with salt is applied 7. Diarrhoea
to warm the stomach and dispel cold.
b) Hypoactivity of the spleen yang: Diarrhoea refers to abnormal frequen-
Method: The Back-Shu points and the cy and liquidity of fecal discharges. It is
points of the Conception Yessel are se- usually due to disorders of the spleen,
lecte:d as the principal points with rein- stomach, large and small intestines. In
forcing method applied in combination light of the manifestations of the disease
with moxibustion to warm and activate and the course, it is clinically divided into
the spleen and stomach yang. acute and chronic. The former is mostly
424 CHIKESE ACl'Pl':\CTl'RE AND MOXIllCSTION

caused by indigestion due to excessive Excessive intake of food. particularly

eating or improper diet and attack of greasy food, leading to impairment of the
external cold dampness, leading to dys- stomach and spleen in transportation and
function in transmission of intestinal transformation, or eating of raw, cold,
contents, or caused by invasion of damp dirty food, injuring the spleen and stom-
heat in summer or autumn; the latter is ach, all bring about diarrhoea.
caused by deficiency of the spleen and Diarrhoea may also be caused by
stomach, leading to failure in transporta- weakened function of the spleen and
tion and transformation. stomach due to irregular daily life or
It is essential to distinguish diarrhoea other factors. Since the spleen has the
and dysentery. function in transformation and transpor-
tation, diarrhoea may occur if this func-
Etiology and Pathogenesis tion is affected.
The causative factors are complicated. The spleen yang is closely related to
but functional disturbance of the spleen the kidney yang. The fire of Mingmen
and stomach is inevitably involved path- (Vital gate) (kidney yang) may help the
ogenetically. The stomach dominates re- spleen and stomach to "digest and trans-
ceiving food while the spleen dominates form food into chyme." In case the kid-
transportation and transformation. In ney yang is weak, the spleen yang is weak
case the spleen and stomach are diseased, as well and fails to digest and transform
the normal digestion and absorption of food into chyme, thus diarrhoea occurs.
food is impaired, leading to mixing of Zhang Jingyue said: "The kidney is the
food essence and wastes. When they des- passgate of the stomach and makes the
cend through the large intestine, diar- urino-genital orifice and the anus as its
rhoea occurs. openings. The passing of both urine and
As to the factors of diarrhoea due to stool is dominated by the kidney. Now
functional disturbance of the spleen and the kidney yang is weak, leading to dec-
stomach, there are many as follows. line of Mingmen (Vital gate) fire, and
Diarrhoea may be caused by the six excess of cold; therefore, diarrhoea oc-
exogenous pathogenic factors, among cu rs."
which mostly by cold, dampness and
summer heat. The spleen is in preference Differentiation
to dryness but dislikes dampness, which aJ AClite diarrhoea
usually causes diarrhoea. Besides the s u- i) Cold-dampness:
perficial portion of the body and the Main manifestations: Watery diar-
lung, the stomach and intestines may be rhoea, abdominal pain and borborygmi,
affected by the pathogenic cold or sum- chilliness which responds to warmth, abs-
mer heat, resulting in diarrhoea. In the ence of thirst, pale tongue, white tongue
latter case, however, the diarrhoea is also coating, deep, slow pulse.
often related to dampness. Analysis: When the cold-dampness at-
CHAPTER 17 INTERNAL DISEASES 42=;

tacks the stomach and the intestines, dis- iii) Retention of food:
turbing the function of the spleen in Main manifestations: Abdominal pain
sending food essence and water upward relieved after bowel movements, borbor-
and that of the stomach in sending the ygmi, diarrhoea with fetid stools, epigas-
contents downward, the food essence and tric and abdominal fullness and dis-
the waste can not be separated, moving tension, belching, anorexia, thick filthy
downward together through the large in- tongue coating, rolling, rapid or deep,
testine, so watery diarrhoea with borbor- string-taut pulse.
ygmi occurs. If the qi of the stomach and Analysis: Retention of food impairs
intestines is stagnated, abdominal pain the stomach function in sending its con-
appears. Cold-dampness is a combination tents downwards and the transmitting
of yin pathogenic factors and easy to function of the intestines, so there are
dama.ge yang qi. When yang qi is blocked, epigastric and abdominal fullness and
chilliness which responds to warmth and distension, abdominal pain and borboryg-
absence of thirst occur. Pale tongue, mi. After the undigested food turns pu-
white tongue coating, and deep, slow trid, diarrhoea with offensive fetid stools,
pulse are the signs of excess of internal belching and anorexia occur. After the
cold. wastes are discharged, abdominal pain
ii) Damp heat: relieves. Thick filthy tongue coating, and
Main manifestations: Diarrhoea with rolling, rapid or deep, string-taut pulse
abdominal pain, yellow, hot and fetid are the signs of retention of food.
stools, burning sensation in the anus, b) Chronic diarrhoea:
scanty urine, or accompanied by gener- i) Deficiency of the spleen:
al feverish feeling, thirst, yellow, sticky Main manifestations: Loose stool with
tongue coating, rolling and rapid pulse. undigested food, anorexia, epigastric dis-
Analysis: When the intestines and tress after eating, sallow complexion, las-
stomach are attacked by the damp heat in situde, pale tongue, white tongue coating,
summer or autumn, the transmitting and thready, forceless pulse.
transformation function is disturbed, and Analysis: In case of weakness of the
diarrhoea appears. If the damp heat spleen and stomach, the spleen qi fails to
pours down, diarrhoea happens as soon ascend and digestion is impaired; there-
as the: abdominal pain is brought about. fore, loose stool with undigested food
If the heat stays in the intestines, there appears. As the weakened spleen fails to
appear diarrhoea with yellow, hot and digest and transport the food, anorexia
fetid stools and burning sensation in the and epigastric distress after eating occur.
anus. When excessive heat evaporates the Persistent diarrhoea further weakens the
dampness, there are scanty urine, general spleen and stomach, affecting the pro-
feverish feeling and thirst. Yellow, sticky duction of food essence and formation of
tongue coating, and rolling, rapid pulse qi and blood, and thus resulting in the
are the signs of excess of damp heat. sallow complexion and lassitude. Pale

--- - - - - - - - - - - - - - -
426 CHINESE ACUPUNCTURE AND MOXIBUSTION

tongue, white tongue coating, and Prescription: Tianshu (ST 25), Zusan-
thready, forceless pulse are the signs of Ii (ST 36).
weakness of the spleen and stomach. Supplementary points:
ii) Deficiency of the kidney: Cold dampness: Zhongwan (CY 12),
Main manifestations: Pain below the Qihai (CY 6).
umbilicus, borborygmi and diarrhoea Damp heat: Neiting (ST 44), Yin-
usually occurring at dawn, relieved after lingquan (SP 9).
bowel movements, and aggravated by Retention of food: Inner-Neiting (Ex-
cold, abdominal distension sometimes, tra)
cold lower extremities, pale tongue, white Explanation: Tianshu (ST 25), the
tongue coating, deep, forceless pulse. Front-(Mu) point of the large intestine is
Analysis: Pain below the umbilicus applied to regulate the transmitting func-
and diarrhoea with borborygmi at dawn tion of the intestines. Zusanli (ST 36), the
are due to hypoactivity of the kidney He-(Sea) point of Yangming Meridian of
yang and the declined Mingmen fire. Foot, is used to adjust the flow of the
Zhang Jingyue stated: "Yin should be at stomach qi. Moxibustion to Zhongwan
maximum in case yang qi is not restored. (CY 12) and Qihai (CY 6) is applied
The kidney fails to hold its contents be- to warm the spleen and stomach, dispel
cause of the declined Mingmen fire, thus cold, regulate the flow of qi and re-
diarrhoea results." Abdominal aversion solve dampness. Neiting (ST 44) and
to cold, and sometimes distension, cold Yinlingquan (SP 9) are needled to elimi-
lower extremities, pale tongue, white nate damp-heat from the large intestine.
tongue coating, deep, forceless pulse are For retention of food; Inner-Neiting (Ex-
the signs of deficiency of the yang qi in tra) is used to regulate the function of the
the spleen and stomach. spleen and stomach and remove reten-
tion.
Treatment b) Chronic diarrhoea:
a) Acute diarrhoea: i) Deficiency of the spleen:
Method: The points of the Yangming Method: The points of the Spleen Me-
Meridian of Foot are selected as the prin- ridian and some other points concerned
cipal points. are selected as the principal points with
Cold-dampness: Reducing method in the reinforcing method and moxibustion
combination with moxibustion (with gin- to strengthen the function of the spleen
ger) is applied to warm the stomach and and stop diarrhoea.
resolve dampness. Prescription: Pishu (BL 20), Zhang-
Damp heat: Reducing is used to elimi- men (LR 13). Taibai (SP 3), Zhongwan
nate heat and dampness. (CY 12), Zusanli (ST 36).
Retention of food: Reducing is used to Explanation: Pishu (BL 20). a Back-
regulate the function of the spleen and (Shu) point of the spleen, Zhallgmen (LR
stomach and remove stagnation. 13), the Front-(Mu) point of the spleen,
CHAPTER 17 INTERNAL DISEASES 427

Taibai (SP 3), the Yuan-(Primary) point crine and metabolic disorders, and neu-
of the Spleen Meridian, in combination rotic troubles.
with Zhongwan (CY 12) the Front-(Mu)
point of the stomach, and Zusanli (ST 8. Dysentery
36), the He-(Sea) point of the Stomach
Meridian, are needled with moxibustion Dysentery is characterized by abdom-
to invigorate the spleen yang, strengthen inal pain, tenesmus and frequent stools
the function of transportation and trans- containing blood and mucus. It is a com-
formation and stop diarrhoea. mon epidemic disease in summer and au-
ii) Deficiency of the kidney: tumn. It is called "red-white dysentery,"
Method: The points of the Kidney "bloody dysentery," "purulent and bloody
Meridian, Conception and Governor ves- dysentery" or "heat dysentery," and
sels are selected as the principal points known as "persistent dysentery" if it lasts
with the reinforcing method and moxi- for a long time, and "intermittent dysen-
bustion to warm and reinforce the kidney tery" if it comes on and off.
yang. The common patterns are damp-heat
Prescription: Shenshu (BL 23), Pishu dysentery, cold-damp dysentery, food-
(BL 20), Mingmen (GV 4), Guanyuan resistant dysentery and intermittent dy-
(CY 4), Taixi (KI 3), Zusanli (ST 36). sentery.
Explanation: Shenshu (BL 23) is the This disease is often due to the inva-
Back-(Shu) point of the kidney and Taixi sion by the epidemic damp heat and in-
(KI J) is the Yuan-(Primary) point of the ternal injury by intake of raw, cold and
Kidney Meridian. Needling to these two unclean food, which hinders and dam-
poims with the reinforcing method can ages the stomach and intestines.
warm the kidney yang and invigorate the
kidney qi. Moxibustion to Mingmen (GV Etiology and Pathogenesis
4) and Guanyuan (CV 4) is able to rein- The summer epidemic heat damp-
forcf the Mingmen fire and strengthen ness invades the stomach and intestines,
the kidney yang so as to warm the spleen impeding the flow of their qi and blood.
and kidney and promote digestion. This Pus and blood are formed from the stag-
is known as a treatment of the root cause. nated qi and blood in struggling against
Pishu (BL 20) and Zusanli (ST 36) are heat dampness, and hence occurs dysen-
used to strengthen the spleen function tery. In case dampness is preponderant to
and stop diarrhoea. heat. white dysentery results, in case heat
preponderant to dampness, red dysentery
Remarks appears, and in case both dampness and
This condition may be involved in heat are excessive, red-white dysentery
acute and chronic enteritis, indigestion, occurs.
intestinal parasitic diseases, diseases of Preference for fatty and sweet food,
the pancreas, liver and biliary tract, endo- internal accumulation of damp heat plus
 Cl~nNESE ACl'PUNCTl'RE AND MOXIBUSTION
_42_8_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

irregular diet, or intake of unclean food of the intestine are injured by damp heat,
leads to stagnation of qi and blood in the blood, pus and mucus appear in stools.
fu organs, which turns into pus and blood Burning sensation of the anus, and scanty
in the stool and results in dysentery. yellow urine are also manifestations of
Excessive intake of raw, cold, or dirty down-pouring of damp heat. When the
food leads to internal accumulation of summer heat and dampness attack the
cold dampness, impeding the stomach body, the body resistance will fight
and intestines. The stagnated qi in the against it, so there are chills and fever. In
large intestine also injures the blood, case of excess of pathogenic heat, rest-
leading to discharge of pus and blood and lessness and thirst result. Sticky tongue
resulting in cold-damp dysentery. coating and rolling or soft pulse indicate
Although the above-mentioned etio- dampness, while yellow tongue coating
logical factors can be classified into the and rapid pulse suggest heat.
exogenous pathogenic factors and food b) Cold damp dysentery:
intake, the two are usually mutually af- Main manifestations: Difficult defeca-
fected. tion, white mucus in stoois, preference
The disease is in the intestine, but for warmth and aversion to cold, mostly
closely related to the stomach. If the ep- accompanied with fullness in the chest
idemic toxic and damp heat attack the and epigastrium, lingering abdominal
stomach, which fails to receive food, pain, tastelessness in the mouth, absence
food-resistant dysentery occurs. If dysen- of thirst, white, sticky tongue coating,
tery lasts longer, the body resistance is deep, slow pulse.
weaker and the spleen qi becomes more Analysis: Accumulation of internal
insufficient, persistent or intermittent dy- cold dampness damages the spleen and
sentery therefore appears. stomach and blocks the qi flow of the
large intestine. Cold is characterized by
Differentiation causing contraction and stagnation, while
a) Damp-heat dysentery: dampness is characterized by turbidity,
Main manifestations: Abdominal so there are fullness in the chest and
pain, tenesmus, mixing of pus and blood epigastrium, difficult defecation, white
in stool, burning sensation of the anus, mucus in stools. Cold dampness is a yin
scanty and yellow urine, or chills, fever, pathogenic factor and apt to damage
restlessness, thirst, yellow, sticky tongue yang qi. When the yang qi is blocked and
coating, rolling, rapid or soft, rapid fails to disperse, preference for warmth,
pulse. aversion to cold and lingering abdominal
Analysis: In case the damp heat stag- pain result. Tastelessness in the mouth,
nates in the intestines, the qi and blood absence of thirst, sticky tongue coating
are blocked, leading to disturbance of are the signs of accumulation of damp-
transmission, so abdominal pain and ness. Deep, slow pulse is the sign of ex-
tenesmus occur. When the blood vessels cessive cold.
CHAPTER 17 INTERNAL DISEASES 429

c) Food-resistant dysentery: point of the large intestine are selected as

Main manifestations: Frequent stools the principal points to remove stagnation
with blood and pus, total loss of appetite, from the intestines. Reducing is used for
nausea, vomiting, yellow, sticky tongue the damp-heat dysentery, both acupunc-
coating, soft, rapid pulse. ture and moxibustion are used for the
Analysis: This condition is developed cold-damp dysentery, and acupuncture
from the damp-heat dysentery. The epi- and moxibustion, with both reinforcing
demic summer heat dampness, when ac- and reducing methods, are used for the
cumulated in the intestines, may attack persistent dysentery.
the stomach and impair its function in Prescription: Tianshu (ST 25),
sending its contents downwards. Thus the Shangjuxu (ST 37).
stomach fails to receive food, and the Damp-heat dysentery: Quchi (L I 11),
appetite is totally lost. The stomach qi Hegu (L I 4) are added.
ascends instead of descends, so nausea Cold-damp dysentery: Zhongwan (CV
and vomiting occur. Yellow, sticky 12) is added with moxibustion to Qihai
tongue coating, and soft, rapid pulse are (CV 6) and Yinlingquan (SP 9).
the signs of damp heat. Food-resistant dysentery: Zhongwan
d) Intermittent dysentery: (CV 12) and Neiguan (PC 6) are added.
Main manifestations: Dysentery oc- Intermittent dysentery: Pishu (BL 20),
curring on and off, difficult to cure, las- Weishu (BL 21), Guanyuan (CV 4) and
situde, aversion to cold, somnolence, an- Zusanli (ST 36) are added.
orexia, pale tongue, sticky coating, soft Supplementary points:
pulse. Fever: Dazhui (GV 14).
Analysis: In case of the weakened Tenesmus: Zhonglushu (BL 29).
body resistance with existence of the Prolapse of rectum: Baihui (GV 20)
pathogenic factors impairing the trans- with moxibustion, Changqiang (GV I).
mitting function of the stomach and in- Explanation: It is recorded in Internal
testim:, the condition is complicated with Classic that the He-(Sea) points are ap-
mixed deficiency and excess, and so the plied for the diseases of the fu organs.
disease is lingering and recurrent. When Therefore, Tianshu (ST 25), the Front-
the spleen yang is weak, and the qi is (Mu) point of the large intestine, and
short, there may be lassitude, aversion to Shangjuxu (ST 37), the He-(Sea) point of
cold and somndlence. Soft pulse and per- the large intestine, are selected as the
sistent sticky coating are the signs of principal points to remove stagnation of
continuing presence of dampness. qi in the large intestine. Dampness will be
resolved in case qi is regulated. Quchi (L
Tn:atment I II) and Hegu (L I 4) may dispel the
Method: The points of Yangming Me- damp heat from the stomach and intes-
ridians of Hand and Foot as well as the tines. Moxibustion to Zhongwan (CV 12)
FronHMu) point and Lower He-(Sea) and Qihai (CV 6) is appJied to warm the

. ------- -_._. ---- - - - - -----------

430 CHINESE ACUPUNCTURE AND MOXIBUSTION

spleen and stomach, remove cold and re- impairs the stomach and intestines, caus-
gulate the flow of qi. Yinlingquan (SP 9) ing dysfunction of transportation and
is needled to strengthen the spleen func- transformation, thus the retained food is
tion to resoive dampness. For food- stagnated and blocks the flow of qi, or
resistant dysentery, Zhongwan (CV 12) the stagnated food turns into heat, which
and Neiguan (PC 6) are used to pacify enters the stomach and intestines, caus-
the stomach and resolve dampness. Acu- ing abdominal distention.
puncture with both reinforcing and re- b) Because of the weakened function
ducing methods and moxibustion may of the spleen and stomach or general
warm the spleen and stomach and elimi- debility due to long i1lness, the spleen and
nate the intestinal stagnation. Guanyuan stomach fail in their transporting func-
(CV 4), the Front-(Mu) point of the tions, so the circulation of qi in the stom-
small intestine, is applied to separate the ach and intestines is impaired, resulting
food essence from the waste, reinforce qi in abdominal distention.
and activate yang. In addition, abdominal distention may
also follow an abdominal operation.
Remarks
This condition includes acute and Differentiation
chronic bacillary and amebic dysentery. a) Excess condition
Main manifestations: Persistence of
9. Abdominal Distention distention and fullness in the abdomen,
which is aggravated by pressure, abdom-
Abdominal distention is common in inal pain, belching, foul breath, dark yel-
clinic. Distention and fullness are likely low urine, constipation, sometimes asso-
to occur in both the upper and lower ciated with fever, vomiting, yellow thick
abdomen. The stomach is located in the tongue coating, rolling, rapid and force-
upper abdomen, while the small and large ful pulse.
intestines are in the lower; they jointly Analysis: Undigested food retained in
complete the storage, digestion, and assi- the stomach gives rise to distention and
milation of food and excretion of the fullness in the epigastrium, foul breath,
wastes. Once the stomach and intestines belching, and even vomiting, and when it
lose their functions, abdominal distention is retained in the intestines, there will be
and pain, belching, vomiting, etc. will fullness and pain in the abdomen and
occur. This section deals with the syn- constipation. Retention of food is an ex-
dromes mainly manifested by abdominal cess condition. This is why the pain is
distention due to disorders of the stom- aggravated by pressure. Fever, dark yel-
ach and intestines. low urine, yellow thick tongue coating,
rolling, rapid and forceful pulse are the
Etiology and Pathogenesis signs of excessive heat in the stomach.
a) Irregular or excessive food intake b) Deficiency condition
CHAPTER 17 INTERNAL DISEASES 431

Main manifestations: Abdominal dis- He-(Sea) point of the stomach, Tianshu

tention relieved by pressure, borborygmi, (ST 25), the Front-(Mu) point of the
loose stools, loss of appetite, lassitude, large intestine and Shangjuxu (ST 37),
listlessness, clear urine, pale tongue with the Lower He-(Sea) point of the large
white coating and forceless pulse. intestine, are used as a combination of
Analysis: Qi deficiency of the spleen Front-(Mu) and Lower He-(Sea) points
and stomach results in dysfunction of to regulate the function of the stomach
transportation and transformation. Con- and intestines in order to maintain nor-
sequently there are loss of appetite, bor- mal flow of qi and relieve the distention.
borygmi and loose stools. Pain relieved Hegu (L I 4) and Qihai (CV 6) are com-
by pressure is due to deficiency. Failure bined to adjust the circulation of qi,
in cn:ating qi and blood due to impaired while Yinlingquan (SP 9) can eliminate
transportation and transformation is the damp heat. Taibai (SP 3) and Guanyuan
cause of lassitude and listlessness. Pale (CV 4) are beneficial to strengthen the
tongue with white coating, and forceless spleen and stomach and to help transpor-
pulse are signs of qi deficiency in the tation and transformation.
spleen and stomach.
Remarks
Treatment This condition is involved in gas trip-
Method: The points of Yangming Me- tosis, acute gastrectasia, enteroparalysis,
ridian of Foot are selected as the princi- intestinal obstruction, gastrointestinal
pal points. The excess condition is treated neurosis, etc.
by the reducing method to regulate the qi
flow in the fu organs while the deficiency 10. Jaundice
condition is treated by the reinforcing
method or combined with moxibustion to Jaundice is mainly manifested by yel-
invigorate the function of the stomach low discoloration of the sclera, skin and
and spleen and to adjust the circulation urine, resulted from the dampness in the
of qi to relieve the distention. spleen and heat in the stomach, leading
Prescription: Zhongwan (CV 12), to abnormal circulation of the bile which
Tianshu (ST 25), Zusanli (ST 36), spreads to the skin surface. It is divided
Shangjuxu (ST 37). into yang jaundice and yin jaundice ac-
Supplementary points: cording to its nature.
Excess condition: Hegu (L I 4), Qihai
(CV 6), Yinlingquan (SP 9). Etiology and Pathogenesis
Deficiency condition: Guanyuan (CV The seasonal and epidemic pathogen-
4), Taibai (SP 3). ic factors accumulate in the spleen and
Explanation: Application of Zhong- stomach, leading to internal formation
wan (CV 12), the Front-(Mu) point of and collection of damp heat. Dampness
the stomach, Zusanli (ST 36), the Lower after mixed with heat is apt to penetrate
 432 CHINESE ACUPUNCTURE AND MOXIBUSTION

deeper, while heat mixed with dampness Analysis: Steaming of the damp heat
is apt to get more exuberant. The liver makes the bile spread to the skin sur-
and gallbladder are steamed by the heat face. Heat being a yang pathogenic fac-
in the spleen and stomach, leading to tor makes the yellow discoloration of the
overflow of the bile to the skin surface, skin lustrous. Fever, thirst scanty dark
thus jaundice appears. yellow urine are due to excessive damp
Irregular diet injures the spleen and heat, which damages the body fluid, and
stomach, causing disturbance in trans- disturbs the activity of the bladder. When
portation and transformation and inter- the dampness is collected, the pure yang
nal formation of dampness, which trans- fails to be distributed and heaviness of
forms into heat. Damp heat stains the the body results. In case of obstruction of
skin yeJIow. the qi in the fu organs, fullness in the
Overstrain or general weakness of the abdomen occurs. Stuffiness of the chest
spleen qi may give rise to hypoactivity of and nausea are due to the steaming of
the yang in the middle energizer, leading damp heat, leading to upward perversion
to failure in transportation and transfor- of the turbid contents of the stomach.
mation and stagnation of cold dampness, YeHow sticky tongue coating is due to
thus yin jaundice results. As said in A accumulation of damp heat, and string-
Guide to the Clinic Treatment, "The cause taut, rapid pulse due to excessive heat in
of yin jaundice is the dampness produced the liver and gallbladder.
from cold water. If the spleen yang fails b) Yin Jaundice:
to resolve the dampness, the normal dis- Main manifestations: Sallow skin,
tribution of bile is impaired, affecting heaviness of the body, weakness, loss of
the spleen, soaking into the muscles, and appetite, epigastric stuffiness, lassitude,
spreading to the skin which turns yellow aversion to cold, absence of thirst, pale
as if it were smoked." tongue, thick, white tongue coating, deep
Yin jaundice can also result from an slow pUlse.
improperly treated yang jaundice which Analysis: The stagnation of cold
leads to injury of the yang qi, hypoactiv- dampness in the spleen and stomach
ity of the spleen yang, and internal col- impedes the distribution of yang qi, lead-
lection of cold dampness. ing to overflow of the bile, thus the skin
is sallow. Jn case the dampness stays in
Differentiation the spleen, the spleen yang is hypoactive
a) Yang jaundice: and the transporting and transforming
Main manifestations: Lustrous yellow function is impaired, therefore, heaviness
skin and sclera, fever, thirst, scanty dark of the body, weakness, loss of appetite
yellow urine, heaviness of the body, full- and epigastric stuffiness occur. A version
ness in the abdomen, stuffiness of the to cold and lassitude are due to weakness
chest, nausea, yellow, sticky tongue coat- of the yang qi. Since this case is of
ing, string-taut, rapid pulse. cold-damp nature, thirst is absent. Pale

-------------~--- -----~ -~~- ---- --

434 CHINESE ACUPUNCTURE AND MOXIBUSTION

depression, or lack of movement can cerned with transmission. When there is

cause ~tagnation of qi, impairing the accumulation of heat in the stomach
transmitting function of the large intes- and intestines, which consumes the body
tine. As a result, the wastes are retained fluid, or stagnation of qi, disturbing the
inside and unable to move downward, normal function of the large intestine,
and hence constipation. constipation may result. Fever and dire
The coexistent deficiency of qi and thirst indicate internal preponderance of
blood can result from internal injury by pathogenic heat. When the heat in the
overstrain or improper food intake, or stomach and intestines causes evapora-
happen after an illness or delivery or in tion, there is foul breath. The yellow and
the aged people. Qi deficiency results in dry tongue coating reveals the damage of
weakness of the large intestine in trans- the body fluid by the heat, while the
mission, while blood deficiency gives rise roIling and forceful pulse is a sign of
to shortage of body fluid, then the large excess in the interior. Emotional disturb-
intestine can no longer be moistened. Ap- ance leads to stagnation of qi in the liver
parently both qi and blood deficiency can and spleen, thus resulting in frequent
cause difficult evacuation of the feces, belching, and fullness and distending
and hence constipation. pain in the abdomen or hypochondrium.
Constitutional debility or senile decay Since the spleen fails in transportation
results in retention of the endogenous and transformation, there is loss of ap-
cold in the stomach and intestines. Con- petite. Thin, sticky tongue coating and
sequently the yang qi is obstructed and string-taut pulse are the signs of dishar-
the body fluid fail in distribution. Diffi- mony between the liver and spleen.
culty of the large intestine in transmis- b) Deficiency condition:
sion leads to constipation. Main manifestations: In cases of defi-
ciency of qi and blood, pale and lustreless
Differentiation complexion, lips and nails, dizziness
a) Excess condition and palpitation, lassitude, shortness of
Main manifestations: Infrequent and breath, pale tongue with thin coating,
difficult defecation from every three to thready and weak pulse; in cases of ag-
five days, or even longer. In case of accu- glomeration of cold, pain and cold sen-
mulation of heat, there are fever, dire sation in the abdomen, preference for
thirst, foul breath, rolling and forceful warmth and aversion to cold, pale tongue
pulse, yellow, dry tongue coating; in case with white and moist coating, deep slow
of stagnation of qi, there are fullness and pulse.
distending pain in the abdomen and hy- Analysis: Constipation can be caused
pochondriac regions, frequent belching, either by qi deficiency, resulting in fail-
loss of appetite, thin sticky tongue coat- ure of the large intestine in transmission,
ing and string-taut pulse. or by blood deficiency with shortage of
Analysis: The large intestine is COIl- body fluid unable to moisten the large
CHAPTER' 17 INTERNAl. DISEASES 4~5

intestine. Endogenous cold stays in the cold can be relieved by moxibustion to

stomach and intestines, leading to ag- warm the fu organ for defecation.
glomeration of yin qi, failure of yang qi Prescri ption : Dachangsh u (BL 25 ),
in transportation, and weakened trans- Tianshu (ST 25), Zhigou (TE 6), Zhaohai
mission of the large intestine, and hence (KI 6).
difficulty of defecation. Deficiency of qi Accumulation of heat: Quchi (L I 11),
and blood fails to ascend to nourish the Hegu (L I 4).
upper por.tion, so there are pale and Stagnation of qi: Zhongwan (CY 12),
lustreless complexion and lips, lassitude Taichong (LR 3).
and shortness of breath. In case of blood Deficiency of qi and blood: Pishu (BL
deficiency, the heart is poorly nourished, 20), Weishu (BL 21), Zusanli (ST 36).
hence palpitation. When the head and Agglomeration of cold: Moxibustion
eyes fail to be nourished, dizziness re- to Shenque (CY 8) and Qihai (CY 6).
sults. Since the nail is the external mani- Explanation: The causes of constipa-
festation of the liver, there will be tion are different, but they are common
lustreless nails when the liver blood is in impairing the transmitting function of
insufficient. When cold is agglomerated, the large intestine. Therefore, the Back-
the circulation of qi is impeded, this ac- (Shu) point Dachangshu (BL 25) and the
counts for the cold pain in the abdomen. Front-(Mu) point Tianshu (ST 25) of the
Cold! is of yin nature, and disorders large intestine are applied to promote the
caused by cold can be relieved by flow of qi in the large intestine, the trans-
warmth, so there is preference for mission can be regained when the qi of
warmth and aversion to cold. Pale tongue . the fu organ flows smoothly. Zhigou (TE
with thin coating, thready weak pulse are 6) can promote the flow of qi in the three
the signs of insufficiency of qi and blood, energizers. When the qi in the three ener-
while pale tongue with white, moist coat- gizers is in normal circulation, the qi of
ing shows the internal cold due to yang the fu organ will circulate freely. Zhigou
deficiency. (TE 6) combined with Zhaohai (KI 6) is
a pair of principal points in treating con-
Treatment stipation. Quchi (L I II) and Hegu (L I
Method: The Back-(Shu) and Front- 4) can reduce the heat from the large
(Mu) points of the Large Intestine Me- intestine. Zhongwan (CY 12), the In-
ridian are mainly selected. For the excess fluential Point of the fu organs, is select-
condition the reducing method is applied ed to lower the qi of the fu organ. The
to eliminate the heat, moisten the intes- reducing method applied to Taichong
tine, and remove the stagnation of qi, (LR 3) is to soothe the liver qi. Reinforc-
while for deficiency condition, the rein- ing to Pishu (BL 20), Weishu (BL 21) and
forcing method is used to reinforce qi Zusanli (ST 36) is able to reinforce qi in
and nourish blood, and moisten the intes- the spleen and stomach. Once the spleen
tines for defecation. Constipation due to and stomach qi is vigorous, qi and blood
436 CHINESE ACUPUNCTURE AND MOXIBUSTION

can be produced as a natural con- itself in its normal position, so the

sequence, so this is the approach of treat- rectum prolapses. Insufficiency of the
ing the root cause of constipation in spleen and stomach qi brings about dys-
deficiency conditions. Moxibustion to function of transportation and transfor-
Shenque (CV 8) and Qihai (CV 6) is mation, causing deficiency of qi and
offered to reduce cold and loosen the blood, thus lassitude and weakness of the
bowels. limbs appear. Qi deficiency fails to nour-
ish the upper portion of the body. Dizzi-
12. Prolapse of Rectum ness results from the failure of nourish-
ing the head and eyes, and palpitation
Prolapse of rectum likely happens to from the failure of nourishing the heart.
infants, the old aged, and those with gen- Pale tongue with white coating, thready
eral debility after a long illness. and feeble pulse are the signs of qi defi-
ciency.
Etiology and Pathogenesis
This disease is mostly caused by defi- Treatment
ciency of the primary qi, sinking of the Method: Points of the Governor Ves-
spleen and stomach qi and disability of sel are mainly applicable with the rein-
restraining due to long-standing diar- forcing method and moxibustion.
rhoea or dysentery, or due to constitu- Prescription: Baihui (GV 20), Da-
tional weakness after severe diseases. changshu (BL 25), Changqiang (GV 1),
Zusanli (ST 36).
Differentiation Explanation: Rectum is the distal part
Main manifestations: The onset is of the large intestine. Reinforcing Dach-
slow, to start with distending and drag- angsh u (BL 25) can replenish the q i of
gling sensation of rectum during defeca- the large intestine. Baihui (GV 20) is the
tion, and returning to normal after the meeting poin t of the Governor Vessel
bowel movement. If it is sustained with- and the three yang meridians, and qi
out proper treatment, recurrence may pertains to yang, subjected to the Gover-
happen by overstrain and the prolapsed nor Vessel, therefore moxibustion to Bai-
rectum fails to return spontaneously hui (GV 20) can invigorate yang qi, and
without the aid of the hand. improve the elevating and contracting
Sometimes there are lassitude, weak- function. Changqiang (GV 1), a pOint of
ness of limbs, sallow complexion, dizzi- the collateral of the Governor Vessel,
ness and palpitation. The tongue is pale located near the anus, is selected as a
with white coating, and the pulse thready local point. Zusanli (ST 36) can reinforce
and feeble. qi for elevation. The combination of Bai-
Analysis: Deficiency of the primary qi hui (GV 20), Changqiang (GV 1) and
leads to the sinking of the spleen qi. and Zusanli (ST 36) follows a principle-to
failure of the large intestine in holding elevate when there is subsidence.
CHAF'fER 17 INTERNAL DISEASES 4.37

Remarks edema appears.

Picking therapy: Pick any spot on the b) Living in a damp place, wading
paraspinal muscle bilaterally in between through water or drenching by rain makes
the third lumbar vertebra and the second water dampness attack the body. Irregular
sacral vertebra. food intake causes failure of the spleen in
normal transportation and transformation
13. Edema and impairment of downward flow of
water dampness. In either case there may
Subcutaneous retention of fluid which be overflow of water dampness to the
leads to puffiness of the head, face, eyelids, superficial part of the body, resulting in
limbs, abdomen and even the whole body edema.
is called edema. The causative factors are c) Overstrain injures the spleen, leading
invasion of the body by the exogeneous to gradual weakness of the spleen qi, which
pathogenic wind and water dampness, and fails to distribute the essence to the lung
internal injury by food or overstrain, and to the whole body. Water is also
which results in disturbance of water retained if the spleen function in trans-
circulation and overflow of water. Since porting and transforming fluid is im-
the water circulation in the body is related paired. Once the spleen fails to control
to the regulatory function of the lung qi, water and lets it flow over, edema results.
transporting function of the spleen qi, d) Indulgent sexual activities damage
activity of the kidney qi and water commu- the kidney qi, and also the function of the
nication of the three energizers, the func- bladder. Retention of water follows and
tional derangement of the lung, spleen, edema results.
kidney and three energizers may lead to According to the above-mentioned,
edema. Clinically edema is divided into edema resulting from invasion by wind,
two patterns: yin edema and yang edema, drenching by rain and irregular food
according to their etiology and pathogene- intake is of yang nature, while that result-
SIS. ing from overstrain, internal injury and
indulgent sexual activity, leading to weak-
Etiology and Pathogenesis ness of the spleen and kidney, is of yin
a) Invasion of the wind upon the lung nature. However, the prolonged yang ede-
causes dysfunction of the lung in disper- ma may lead to gradual weakness of the
sion. The lung dominates the surface of the body resistance and increased water reten-
body and is associated with the skin and tion, and turn into yin edema. Pathogenet-
hair. If the lung is attacked by wind, the ically, edema is Closely related to the
lung qi fails to regulate the water passages dysfunction of the lung, spleen and kidney.
and send the water down to the bladder,
leading to the confrontation between wind Differentiation
and water and the overflow of water to the a) Yang edema:
superficial part of the body, and thus Main manifestations: Abrupt onset of
438 CHINESE ACUPUNCTl'RE AND MOXIBUSTION

edema with puffy face and eyelids and then complexion is sallow. Weakened kidney
anasarca, lustrous skin, accompanied by yang with declined Mingmen fire is insuf-
chills, fever, thirst, cough, asthma and ficient to warm the body, so there is
reduced urine output, thin white tongue aversion to cold with cold limbs. The
coating, superficial or rolling, rapid pulse. lumbus is the house of the kidney. If the
Analysis: In case of internal accumula- kidney qi is weakened and water dampness
tion of water and external invasion by excessive, soreness is felt in the back and
wind, confrontation between them causes loins. In case of hypoactivity of the spleen
an abrupt onset of edema starting from the yang, the function of transportation and
upper portion of the body, as the wind is a transformations is weak, so epigastric
pathogenic factor of yang nature and fullness, loss of appetite, abdominal dis-
characterized by upward going. If the tension and loose stools result. Pale
function of the bladder is impaired, the tongue, white coating, deep, thready pulse
urine output is reduced. When the wind are also signs of deficiency of the spleen
water attacks the lung, cough, asthma, and kidney yang with excess of water
aversion to wind and chills result. If heat dampness.
is dominant, there are thirst, fever and
rolling rapid pulse. Thin white tongue Treatment
coating and superficial pulse indicate wind a) Yang edema:
water of cold nature. Method: The points of the Lung and
b) Yin edema: Spleen Meridians are selected as the prin-
Main manifestations: Insidious onset cipal points. Even movement is applied to
of edema, at first on the pedis dorsum or clear the lung, relieve the exterior symp-
eyelids, and then over the whole body, toms and remove the retained fluid. After
especially remarkable l;>elow the lumbar the exterior symptoms are relieved, refer
region, accompanied by sallow complex- to method for yin edema.
ion, aversion to cold, cold limbs, soreness Prescription: Lieque (LV 7), Hegu (L
of the back and loins, general weakness, I 4), Pianli (L I 6), Yinlingquan (SP 9),
epigastric fullness, abdominal distension, Weiyang (BL 39).
loss of appetite, loose stools, pale tongue, Explanation: Edema above the lum-
white coating, deep, thready pulse. bus should be treated by diaphoresis,
Analysis: Because of weakness of yang therefore, Lieque (LV 7) and Hegu .(L I
in the spleen and the kidney, yin is in excess 4) are used to clear the lung and re-
and qi fails to transport water, causing lieve the exterior symptoms by diaph-
overflow of water dampness in the lower oresis, while edema below the lumbus
portion of the body, and hence appears should be treated by diuresis, then Pianli
pitting edema which is especially remark- (L I 6) and Yinlingquan (SP 9) are ap-
able below the lumbar region. In case of plied to remove dampness and promote
lowered function of the spleen and kidney, diuresis. Weiyang (BL 39) is able to regu-
qi is unable to nourish the face, so the late the qi activity of the triple energizer
CHAPTER 17 INTERNAL DISEASES 439

and water passages. night and during sleep. As a morbid

b) Yin edema: condition, it is mostly seen in children over
Method: The points of the Spleen and the age of three years and occasionally in
Kidney Meridians are selected as the adults. It is mainly caused by deficiency of
principal points. Reinforcing in combina- kidney qi with disability of the bladder to
tion with moxibustion is applied to warm restrain the urine discharge.
the spleen and kidney.
Prescription: Pishu (BL 20), Shenshu Etiology and Pathogenesis
(BL 23), Shuifen (CY 9), Guanyuan (CY The normal excretion of urine is main-
4), Fuliu (KI 7), Zusanli (ST 36). ly concerned with the activities of the
Supplementary points: kidney qi and the restraining function of
Facial puffiness: Shuigou (GY 26). the bladder. The kidney is in charge of
Edema on the pedis dorsum: Zulinqi micturition and defecation, and responsi-
(GB 41), Shangqiu (SP 5). ble for the formation of urine, while the
Explanation: Yin edema is caused by bladder stores and excretes urine. If the
decline of the kidney yang that fails to kidney qi is insufficient, it will be unable
control water and by weakness of the to maintain the function of the bladder in
splee:n qi that leads to impairment of restraining the urine discharge, and thus
transportation in the middle energizer. occurs enuresis. Ancient doctors there-
Acupuncture and moxibustion to Pishu fore believed that enuresis is due to defi-
(BL .20), Shenshu (BL 23) and FuJiu (KI 7) ciency. As stated in General Treatise on
may warm the primary yang of the spleen the Etiology and Symptomology of Dis-
and kidney and remove cold water. Moxi- eases: "Enuresis is caused by cold in the
bustion to Shuifen (CY 9) and Guanyuan bladder of deficiency type, which renders
(CY 4) may promote the water circulation the bladder unable to restrain the urine
and reinforce the primary qi respectively. discharge." Dai Sigong once said, "Invol-
Reinforcing on Zusanli (ST 36) promotes untary urination during sleep is due to
the transporting and transforming func- cold in the kidney causing incontinence
tion of the spleen and stomach, restoring of urine."
normal distribution of the fluid.
Differentiation
Remarks Main manifestations: Involuntary
In the context of edema, acute and micturition during sleep with dreams,
chronic nephritis and malnutrition are once in several nights in mild cases, or
included. several times a night in severe cases; sal-
low complexion, loss of appetite, and
14. Nocturnal Enuresis weakness in the prolonged cases, pale
tongue, white coating, thready pulse
Nocturnal enuresis is referred to invol- weak at the chi region.
untary discharge of the urine occurring at Analysis: Deficiency of the kidney qi
440 CHINESE ACUPUNCTURE AND MOXlBl1STION

with failure of the bladder in restraining Meridian which curves round the geni-
the urine discharge causes nocturnal en- tals, can promote the circulation of qi of
uresis. Long duration of the disease un- the meridian and strengthen the thera-
dermines the kidney qi, and consequently peutic effect.
the spleen falls into loss of warming, its
function of transportation and transfor- Remarks
mation being disturbed. Therefore, the The chief causative factor of this dis-
appetite is lost. Deficiency of the spleen ease is the underdevelopment of cerebral
qi fails to distribute the essence of food micturition centre and treatment of acu-
to nourish the whole body. This is why puncture and moxibustion provides satis-
the complexion is sallow and the patient factory effect. As for enuresis caused by
is lacking in strength. Pale tongue with organic diseases, such as deformity of
white coating, and thready pulse weak at urinary tract, cryptorachischisis, organ-
chi region are signs of deficiency. ic cerebral diseases and oxyuriasis, the
treatment should be given to the primary
Treatment disease.
Method: The Back-(Shu) and Front-
(Mu) points of the kidney and bladder 15. Urination Disturbance
are selected as the principal points, with
reinforcing or moxibustion to strengthen Urination disturbance is manifested
the kidney and reinforce qi. by frequency of urination, painful urina-
Prescription: Shenshu (BL 23), Pang- tion and incontinence of urination, re-
guangshu (BL 28), Zhongji (CV 3), San- sulting mainly from accumulation of heat
yinjiao (SP 6), Dadun (LR 1). in the bladder, and sometimes also from
Supplementary points: emotional factors and deficiency of the
Enuresis with dreams: Shenmen kidney.
(HT 7). According to the clinic manifesta-
Loss of appetite: Pishu (BL 20), Zu- tions, urination disturbance is divided
sanli (ST 36). into five kinds, i.e. dysuria caused by
Explanation: The kidney is exteriorly- calculi, dysuria caused by qi dysfunction,
interiorly related to the bladder, so the dysuria with milky urine, dysuria caused
Back-(Shu) points of the kidney and blad- by overstrain and painful urination with
der are applied. Zhongji (CV 3) is the blood.
Front-(Mu) point of the bladder. Com-
bined use of the above three points con- Etiology and Pathogenesis
tributes to reinforce the kidney qi and the Eating too much fatty or sweet food
restraining function. Sanyinjiao (SP 6) is or drinking too much alcohol leads to
added to adjust the qi of the three yin accumulation of damp heat in the lower
meridians. Moxibustion to Dadun (LR energizer, where the urine is condensed
1), the Jing-(Well) point of the Liver into calculi, which may be either small as
CHAPTER 17 INTERNAL DISEASES 441
----------------
gravd or large as stones, staying in var- charged in the urine, dark yellow turbid
ious portions of the urinary tract from urine and painful urination occur. If a
the kidney to the bladder or the u reth ra, large stone obstructs the outer orifice of
causing dysuria. the bladder, urination may suddenly be
In case the damp heat accumulates in interrupted, accompanied by unbearable
the bladder, or the heart fire shifts to the pain. In case the calculi cause internal
bladder, the heat injures the blood vessels injury, bloody urine appears. When the
and forces the blood to extravasate, then calculi have been formed, the signs of
painful urination with blood results. If internal heat may sometimes become ob-
the damp heat accumulates in the lower scure and the tongue coating turns to
energizer, impairing the control of the normal.
flow of the chylous fluid, viscous urine b) Dysuria caused by qi dysfunction:
like milk appears, known as dysuria with Main manifestations: Difficult and
milky urine. hesitant urination, fullness and pain of
Damage of the liver by anger, produc- the lower abdomen, thin, white tongue
tion of fire from stagnated qi or obstruc- coating, deep, string-taut pUlse.
tion of qi due to stagnation, leading to Analysis: Emotional depression leads
accumulation of qi and fire in the low- to qi dysfunction, failure of the liver in
er energizer, impedes the activity of the qi spreading and stagnation of qi in the
bladder. Therefore, urination is difficult, bladder. So there are fullness and pain of
painful and incontinent, known as dysur- the lower abdomen, and difficult and hes-
ia caused by dysfunction of qi. itant urination. In case of depression of
Indulgent sexual activities or mental the qi in the liver, deep, string-taut pulse
stress leading to deficiency of the kidney occurs.
qi, or sinking of the spleen qi due c) Painful urination with blood:
to deficiency, causes painful urination Main manifestations: Hematuria with
which often recurs on overstrain, known pain and urgency of micturition, burning
as dysuria caused by overstrain. sensation and pricking pain in urination,
thin, yellow tongue coating, rapid, force-
Differentiation ful pulse.
a) Dysuria caused by calculi: d) Dysuria with milky urine:
Main manifestations: Occasional pres- Main manifestations: Cloudy urine
ence of calculi in the urine, dysuria, dark with milky or creamy appearance, ureth-
yellow turbid urine, or sudden interrup- ral burning pain in urination, red tongue
tion of urination, unbearable pricking proper, sticky coating, thready, rapid
pain during urination, pain of the lumbus pulse.
and abdomen, or presence of blood in the Analysis: This condition is due to
urine, normal tongue coating. downward shift of damp heat, which ac-
Analysis: When the gravel and stones cumulates in the bladder and affects the
formed by damp heat fail to be dis- qi function. The bladder fails to check

-~-~-------------- -
 CHINESE ACUPCNCTURE AKO MOXIBUSTION

the downward flow of fatty liquid, so (BL 23), Zhaohai (KI 6).
there are cloudy urine with milky or even Dysuria caused by overstrain: Baihui
creamy appearance and urethral burning (GV 20), Qihai (CV 6), Zusanli (ST 36).
pain in urination. Red tongue proper, Explanation: Urination trouble is
sticky coating, thready rapid pulse are chiefly due to affections of the bladder,
the signs of deficiency of kidney yin and so Pangguangshu (BL 28) and Zhongji
stagnation of damp heat. (CV 3), the Front-(Mu) point of the
e) Dysuria caused by overstrain: bladder, are needled to promote the ac-
Main manifestations: Difficulty in ur- tivity of the bladder. Yinlingquan (SP 9),
ination with dribbling of urine, occurring the He-(Sea) point of the Spleen Merid-
off and on, exacerbated after overwork, ian, is combined to promote diuresis,
and usually refractory to treatment, weak restoring the qi function and free urina-
pulse. tion. Dysuria caused by calculi is due to
Analysis: Overstrain, indulgence in the accumulation of damp heat in the
sex and drinking or taking too much lower energizer and condensation of ur-
drugs cold in nature for treating other ine. Therefore, Wei yang (BL 39), a point
kinds of dysuria lead to deficiency of the of the Bladder Meridian of Foot-Taiyang
spleen and kidney, and failure of the and also the Lower He-(Sea) point of
yang qi to ascend. That is why urination triple energizer, is applied to reduce
is exacerbated after overwork and refrac- damp heat from the lower energizer and
tory to treatment. Weak pulse is the sign strengthen the function of the bladder.
of qi deficiency. Xingjian (LR 2), the Ying-(Spring) point
of the Liver Meridian, is used to dispel
Treatment the fire from the Liver Meridian and
Method: The Back-(Shu) and Front- relieve pain for dysuria caused by qi
(Mu) points of the bladder are selected as dysfunction. Xuehai (SP 10) and Sanyin-
the principal points. Reducing alone or j iao (SP 6) are applied to remove the
combination of reinforcing and reducing heat from the lower energizer and stop
methods is applied to promote the activ- bleeding. If dysuria with milky urine
ity of the bladder. lasts longer, deficiency of the kidney
Prescription: Pangguangshu (BL 28), fails to check the downward flow of
Zhongji (CV 3), Yinlingquan (SP 9). fatty liquid, so Shenshu (BL 23) and
Supplementary points: Zhaohai (KI 6) are needled to reinforce
Dysuria caused by calculi: Wei yang the kidney qi. Dysuria caused by over-
(BL 39). strain is due to weakness of both spleen
Dysuria caused by qi dysfunction: and kidney. Baihui (GV 20), the meeting
Xingjian (LR 2). point of all the yang meridians, in com-
Painful urination with blood: Xuehai bination with Qihai (CV 6) and Zusanli
(SP 10), Sanyinjiao (SP 6) .. (ST 36) may reinforce the qi of the
Dysuria with milky urine: Shenshu spleen and kidney.
CHAPTER 17 INTERNAL DISEASES -i-i3

Remarks Main manifestations: Scanty hot urine

This morbid condition includes uri- or retention of urine, distension and full-
nary infection and urolithiasis. ness of the lower abdomen, thirst but
without desire to drink, constipation, red
16. Retention of Urine tongue with yellow coating, rapid pUlse.
Analysis: In case of accumulation of
Retention of urine is a disease manifest- heat in the bladder, scanty hot urine or
ed by difficult urination, distending pain retention of urine appears. When water
in the lower abdomen and even blockage of and heat combined together, impair the
urine. The mild case refers to difficulty in function of the bladder, distension and
urination and dripping of urine, while the fullness of the lower abdomen occur.
severe case to failure in urination with Since the body fluid fails to be normally
distension and feeling of urgency. distributed, thirst results but there is no
This disease results from dysfunction desire to drink. Red tongue with yellow
of qi in the bladder. As said in Internal coating, rapid pulse, or constipation are
Classics: "The bladder is in charge of due to accumulation of heat in the lower
storing liquid. Normal urination suggests energizer.
the qi is in function. Its dysfunction caus- h) Decline of Mingmen fire:
es retention of urine." Main manifestations: Dribbling urina-
tion, attenuating in force of the urine
Etiology and Pathogenesis discharge, pallor, listlessness, chilliness
He:at accumulates in the bladder, or below the lumbus, weakness of the loins
heat of the kidney shifts to the blad- and knees, pale tongue, deep, thready
der. Accumulation of heat in the blad- pulse weak at the chi region.
der impedes the qi function and leads to Analysis: Dribbling urination, atten-
retention of urine. uating in force of the urine discharge
The kidney and the bladder are is due to deficiency of the kidney yang
exteriorly-interiorly related. The function which affects the transmitting function.
of the: bladder depends upon the warming Pallor, listlessness and pale tongue are
function of the kidney yang. In case of due to decline of the Mingmen fire and
weakness of the kidney yang and decline failure of qi in reaching the bladder.
of Mingmen fire, the bladder may be too c) Damage of the qi of the meridian:
weak to discharge the urine. Main manifestations: Dribbling Urina-
Traumatic injury or surgical opera- tion or retention of urine, distension and
tion hindering the qi of the meridians or dull pain in the lower abdomen, purplish
damaging the zang organs, causes reten- spots on the tongue, hesitant, rapid pulse.
tion of urine too. Analysis: After a traumatic injury or
surgical operation on the lower abdomen.
Differentiation the qi of the Bladder Meridian is dam-
a) Accumulation of heat in the bladder: aged and blood stasis occurs, so there
 CHINESE ACUPUNCTURE AND MOXIBUSTION

appear dribbling urination, retention of yang. Moxibustion to Baihui (GY 20) and
urine, distension and pain in the lower Guanyuan (CY 4) is to invigorate the
abdomen. Purplish spots on the tongue, kidney qi. Urination will be free in
hesitant, rapid pulse are the signs of smooth qi circulation. Since deficiency of
blood stasis. the kidney qi makes triple energizer fail
to promote the circulation of water,
Treatment Yangchi (TE 4), the Yuan-(Primary)
a) Accumulation of heat in the bladder: point of triple energizer, is needled to
Method: The Back-(Shu) points and strengthen the function of triple energiz-
Front-( M u) points are selected as the er and promote circulation of water.
principal points. Reducing method is ap- c) Damage of the qi in the meridian.
plied to remove heat and promote diure- Method: The Front-(Mu) point of the
SIS. bladder is selected as the principal point.
Prescription: Pangguangsh u (BL 28), Even movement is applied to promote
Zhongji (CY 3), Sanyinjiao (SP 6), Wei- circulation of the qi in the meridian and
yang (BL 39). restore the function of the bladder.
Explanation: Pangguangsh u (B L 28), Prescription: Zhongji (CY 3), Sanyin-
the Back-(Shu) point of the bladder, and jiao (SP 6), Shuidao (ST 28), Shuiquan
Zhongji (CY 3), the Front-(Mu) point of (KI 5).
the bladder, are needled to reduce heat Explanation: A traumatic injury or
from the bladder and adjust its function. surgical operation can injure the blood
Sanyinjiao (SP 6) may dispel heat from vessels and impede the activity of
the lower energizer. Weiyang (BL 39), the bladder, thus urodialysis appears.
the Lower He-(Sea) point of triple ener- Zhongji (CY 3), the Front-(Mu) point of
gizer, promotes the circulation of water. the bladder, is needled to adjust the func-
These points, used together, reduce heat tion of the bladder and promote urina-
and promote diuresis. tion. Sanyinjiao (SP 6) may promote the
b) Decline of the Mingmen Fire: circulation of blood and qi in the merid-
Method: The points relating to the ian. Shuiquan (KI 5), the Xi-(Cleft) point
Kidney Meridian are selected as the prin- of the Kidney Meridian of Foot-Shaoyin,
cipal points. Reinforcing or moxibustion combined with Shuidao (ST 28), may
is applied to warm the kidney yang. promote urination, and relieve distension
Prescription: Mingmen (GY 4), Shen- and pain.
shu (BL 23), Baihui (GY 20), Guanyuan
(CY 4), Yangchi (TE 4).
Explanation: In case of deficiency of 17. Impotence
the kidney qi and decline of the Mingmen (Appendix: Seminal Emission)
fire, the kidney qi should be reinforced,
so Mingmen (GY 4) and Shenshu (BL Impotence is referred to lack of copu-
23) are needled to reinforce the kidney lative power in males.
CHAPTI,R 17 INTERNAL DISEASES 445
---------------------------------------------
Etiology and Pathogenesis production and opens into the urethra.
Impotence is generally due to indul- spermatic duct and the anus. Insufficien-
gence in sex or excessive masturbation, cy of the kidney yang and the decline of
which makes Mingmen fire decline and Mingmen fire wither up the reproductive
exhausts the kidney essence. It may also ability. leading to impotence. Owing to
be due to fear, fright or worry, which yang deficiency, the body cannot be
damages the qi of the heart, spleen and warmed, resulting in pallor, cold extrem-
kidney. Just as said in Treatment of Inter- ities, dizziness, and listlessness. As the
nal Disorders:"The inability of penis to lumbar region is the house of the kidney,
erect is due to the injury of the internal kidney deficiency gives rise to soreness
organs, which is mainly caused by the and weakness of the loins and knees.
exhaustion of kidney essence from indul- Only with the help of the activity of the
gent sexual activity, or by worry damag- kidney, can normal urination be per-
ing the mind, or by fright leading to formed. If the kidney yang fails in con-
dysfunction of the kidney." trolling urination, there appears frequent
Greasy food and wine may damage the urination. Pale tongue with white coat-
function of the spleen and stomach in ing, and deep, thready pulse are the signs
transportation and transformation, caus- of yang insufficiency. If the heart and
ing dampness to turn into heat. The spleen qi is damaged, there is poor pro-
damp heat drives downward to make the duction of qi and blood. If blood is inad-
penis unable to erect. resu Iting in impo- equate for nourishing the heart, palpita-
tence. However, impotence of the damp tions and insomnia occur.
heat type is not very common. Zhang b) Downward flowing of damp heat:
Jingyue said, "Seven to eight out of ten Main manifestations: Inability of the
impotent patients are caused by the dec- penis to erect, complicated with bitter
line of fire. Only a few of them are due taste in the mouth, thirst. hot and dark
to excess of fire." red urine, soreness and weakness of the
lower extremities, yellow, sticky tongue
Differentia tion coating, soft, rapid pulse.
a) Decline of Mingmen Fire: Analysis: The penis consists of two
Main manifestations: Failure of the cylindrical bodies. As said in Internal
penis in erection, or weak erection, pal- Classic: "If the damp heat stagnates in
lor, cold extremities. dizziness, listless- the penis. the major body becomes soft
ness, soreness and weakness of the loins and short, and the small body gets loose
and knees, frequent urination, pale and long. The former is known as con-
tongue with white coating, deep thready tracture, while the latter known as atro-
pulse. If the heart and spleen qi is dam- phy and weak." The downward flowing of
aged, palpitations and insomnia may be the damp heat makes the cylindrical bod-
present. ies loose and weak, resulting in inability
Analysis: The kidney dominates re- of the penis to erect. If the damp heat
 CHINESE ACI TPUNCTURE AND MOXIIWSTION

ascends, there will be bitter taste in the jiao (SP 6), Yinlingquan (SP 9), Zusanli
mouth or thirst. If the damp heat is trans- (ST 36).
mitted to the small intestine, and then to Explanation: This condition is caused
the bladder, hot and dark red urine oc- by the downward flowing of damp heat
curs. Soreness and weakness of the lower from the Spleen Meridian. Zhongji (CY
extremities, yellow, sticky tongue coat- 3), Sanyinjiao (SP 6) and Yinlingquan
ing, and soft, rapid pulse indicate the (SP 9) are therefore selected to soothe
presence of damp hea 1. and regulate the qi of Spleen Meridian to
eliminate the damp heat. Zusanli (ST 36)
Treatment is the He-(Sea) point of the Stomach Me-
a) Decline of Mingmen Fire: ridian of Foot Yangming. Because of the
Method: Points of the Conception interior-exterior relationship between the
Vessel and Kidney Meridian are select- Spleen and Stomach Meridians, Zusanli
ed as the principal points. Reinforcing (SI 36) is chosen to dispel dampness by
method with moxibustion is applied to improving the function of the spleen in
invigorate the kidney yang. transportation and transformation. Heat
Prescription: Guanyuan (CV 4), will disappear when dampness is dis-
Mingmen (GV 4), Shenshu (BL 23), pelled. The above points combined to-
Taixi (KJ 3). gether are suitable for the treatment of
Supplementary points: For damage of impotence caused by damp heat.
the qi of the heart and spleen: Xinshu
(BL 15), Shenmen (HI 7), Sanyinjiao Remarks
(SP 6). Impotence in most cases is a function-
Explanation: Guanyuan (CY 4) is the al disorder, for instance, sexual neuras-
meeting point of the Conception Vessel thenia.
and the three foot yin meridians. Rein-
forcing is used to promote the primary Appendix: Seminal Emission
qi and invigorate the kidney function.
Mingmen (GV 4), Shenshu (BL 23) and Seminal emission may be divided into
Iaixi (KI 3) are used to strengthen the two types: nocturnal emission and sper-
kidney yang. Xinshu (BL 15), Shenmen matorrhea. Generally, in adult males. un-
(HI 7) and Sanyinjiao (SP 6) are good married or married, occasional emission
for activating the qi of the heart and is not pathological.
spleen. a) Nocturnal emission:
b) Downward flowing of damp heat: Nocturnal emission is mainly due to
Method: Points of the Conception overcontemplation or excessive sexual ac-
Vessel and Spleen Meridian are selected tivities which lead to disharmony be-
as the principal points. Reducing method tween the heart and kidney. If the heart
is applied to eliminate the damp heat. fire fails to descend and control the kid-
Prescription: Zhongji (CV 3), Sanyin- ney water, the kidney water cannot as-
CHAPTER 1"7 INTERNAL DISEASES ..!47

cend and cool the heart fire. When water and seminal fluid.
deficiency and fire excess disturb the Prescription: Shenshu (Bl 23), Dahe
essence, nocturnal emission happens in (KI 12), Sanyinjiao (SP 6), Guanyuan
dreams. Moreover, there are dizziness, (CY 4), Qihai (CY 6).
palpitation, listlessness, lassitude and Explanation: Shenshu (Bl 23) and
scanty yellow urine, red tongue, and Sanyinjiao (SP 6) are needled to reinforce
thready, rapid pulse. Treatment is given the kidney qi. Guanyuan (CY 4), the
by applying acupuncture with reducing meeting point of the Conception Vessel
method to the points of the Heart Merid- and three foot yin meridians, and Qihai
ian of Hand Shaoyin and with reinforcing (CV 6) are two important points for invi-
method to the points of the Kidney Me- goration. Moxibustion applied to these
ridian of Foot Shaoyin. two points can warm and strengthen the
Prescription: Shenmen (HT 7), Xin- primary yang. Dahe (KI 12) is combined
shu (BL 15), Taixi (KI 3), Zhishi (Bl 52). to assist the control of the kidney ess-
Explanation: Shenmen (HT 7) and ence.
Xinshu (Bl 15) are needled to lower the
heart fire and harmonize the heart and 18. Insomnia
kidney. Taixi (KI 3) is used to activate (Appendix: Poor Memory)
the kidney qi, and Zhishi (Bl 52) to
control the essence. Insomnia has different patterns: diffi-
b) Spermatorrhea: culty in falling asleep after retiring, early
Spermatorrhea is usually due to dam- awakening, intermittent waking through
age of the kidney after a prolonged ill- the period of attempted sleep, and even
ness, indulgent sexual activity, or stub- inability to sleep all the night.
born nocturnal emission. In exhaustion Insomnia is often accompanied by diz-
of the kidney essence, the loss of yin ziness, headache, palpitation, poor me-
affects yang. The primary qi of the kid- mory and mental disorders.
ney becomes insufficient, the storage of
essence fails and seminal fluid is dis- Etiology and Pathogenesis
charged involuntarily. Clinical manifesta- a) Anxiety and overwork damage the
tions are frequent spermatorrhea at day heart and spleen. Blood is exhausted and
or night, particularly if there is a desire the mind is disturbed in case of damage
for sex, pallor, lassitude, listlessness, pale of the heart, while qi and blood produc-
tongue, and deep, thready, weak pulse. tion becomes poor in case of deficiency
Treatment is given by applying acupunc- of the spleen qi. Blood deficiency is un-
ture with reinforcing method and moxi- able to nourish the heart, leading to in-
bustion to the points mainly selected somnia. Just as Zhang Jingyue described,
from the Kidney Meridian of Foot- "Overwork and anxiety cause exhaustion
Shaoyin and Conception Vessel to streng- of blood and disturb the mind. As a re-
then the kidney and control the essence sult, insomnia follows."
448 CHINESE ACLJPCNCTL'RE AND MOXInIJSTION

b) Congenital deficiency, indulgent kidney. With harmonious condition be-

sexual activity, or a prolonged illness tween the heart and kidney, the mind is
damages the kidney yin. The kidney wa- at ease. Whenever there is anxiety, de-
ter fails to ascend smoothly to the heart pression, or overwork to damage the
to check the heart fire, and the heart heart, spleen, liver or kidney, essence and
yang is therefore hyperative alternatively. blood are consumed and mutually affect-
A violent emotional fit can induce flaring ed, resulting in insomnia.
of the heart fire which fails to descend to
the kidney to control the kidney water. Differentiation
The kidney yin is therefore deficient. De- a) Deficiency of both the heart and
ficiency of kidney yin injures the will and spleen qi:
excess of the heart fire disturbs the mind. Main manifestations: Difficulty in
In either case there is a disharmony be- falling asleep, dream-disturbed sleep, pal-
tween the heart and the kidney, and pitation, poor memory, lassitude, listless-
hence insomnia. ness, anorexia, sallow complexion, pale
c) Emotional depression causes the tongue with a thin coating, thready, weak
stagnation of qi in the liver. The stagnant pulse.
qi of long duration is transformed into Analysis: When there is impairment
fire, which flares up to disturb the mind, of the heart and spleen, blood is insuf-
and then insomnia occurs. ficient to house the mind, so dream-
d) Irregular food intake damages the disturbed sleep, poor memory and palpi-
spleen and stomach. The accumulated tation occur. Sallow complexion and pale
undigested food produces phlegm heat tongue are manifestations of a poor
in the middle energizer, which in turn blood supply which is unable to nourish
causes dysfunction of the stomach and the upper part of the body. Dysfunction
insomnia, as stated in Internal Classic that of the spleen and stomach in transporta-
sleep is disturbed if the function of the tion and transformation causes anorexia.
stomach is in disharmony. Deficiency of qi and blood leads to qi
In summary, insomnia is related to declining and blood shortage, resulting in
dysfunction of the heart, spleen, liver and lassitude, listlessness, thready and weak
kidney, although there are many other pulse.
causative factors. Blood is made from b) Disharmony between the heart and
food essence and supplies the heart with kidney:
nourishment. Blood is stored in the liver Main manifestations: Restlessness, in-
and the liver is soothed by the blood. somnia, dizziness, tinnitus, dry mouth
Blood is controlled by the spleen, where with little saliva, burning sensation of
production of essence from blood contin- the chest, palms and soles, red tongue,
ues. The essence is stored in the kidney. thready rapid pulse, or nocturnal emis-
When the kidney essence ascends to the sion, poor memory, palpitation, low back
heart and the heart qi descends to the pain.
CHAPTIER 17 INTERNAL DISEASE~ 449

Analysis: Restlessness, poor memory, the middle energizer, obstructing the pas-
palpitation, nocturnal emission and low sage, and thus giving rise to suffocating
back pain are due to deficiency of the feeling and distending pain in the epigas-
kidney and hyperactivity of the heart tric region and difficulty in defecation.
fire. Dry mouth with little saliva, burning Therefore, sleep is disturbed. The undi-
sensation of the chest, palms and soles, gested food staying in the middle energiz-
red tongue and thready rapid pulse are er forms dampness and produces phlegm,
the signs of yin deficiency in the lower so the tongue coating is sticky and the
energizer with fire flaring up. Dizziness pulse rolling.
and tinnitus result from the flaring up of
the ministerial fire due to deficiency of Treatment
the kidney yin. Method: Points of the Heart Meridian
c) Upward disturbance of the liver fire: are selected as the main points to calm
Main manifestations: Irritability, the heart and soothe the mind.
dream-disturbed sleep, fright and fear Deficiency of the heart and spleen:
accompanied with headache, distending Reinforcing method with moxibustion in
pain in the costal region, bitter taste in combination is applied to strengthen the
the mouth and string-taut pulse. heart and spleen.
Analyses: The liver fire flares up Disharmony between the heart and
to disturb the mind, causing dream- kidney: Even movement is applied to har-
disturbed sleep, fright and fear. When the monize the heart and kidney.
flaring fire of the liver attacks the head, Upward disturbance of the liver fire:
headache occurs. The liver qi in long Reducing is applied to subdue the liver
stagnation is transformed into fire, lead- fire.
ing to irritability. The liver fire flares up Dysfunction of stomach: Reducing is
with upward flow of the bile, producing applied to regulate the stomach qi.
bitter taste in the mouth. When the fire Prescription: Shenmen (HT 7), San-
stagnates in the Liver Meridian, there is yinjiao (SP 6), Anmian (Extra).
distending pain in the costal region. The Supplementary points:
string-taut pulse is a sign of hyperactivity Deficiency of the heart and spleen:
of the liver. Pishu (BL 20), Xinshu (BL 15), Yinbai
d) Dysfunction of the stomach: (SP I, moxibustion with small moxa
Main manifestations: Insomnia, suffo- cones).
cating feeling and distending pain in the Disharmony between the heart and
epigastric region, belching, or difficult kidney: Xinshu (BL 15), Shenshu (BL
defecation, sticky tongue coating, and 23), Taixi (KI 3).
rolling pulse. Upward disturbance of the liver fire:
Analysis: With the dysfunction of the Ganshu (BL 18), Danshu (BL 19), Wan-
spleen and stomach in transportation and gu (OB 12).
transformation, the food accumulates in Dysfunction of the stomach: Weishu
450 CfIlNESE ACUPUNCTURE AND ,VlOXIBIJSTION

(BL 21), Zusanli (ST 36). brain, hypomnesia and forgetfulness. It

Explanation: Shenmen (HT 7), the differs from lack of intelligence and na-
Yuan-(Primary) point of the Heart Me- tural endowments. The condition in most
ridian, calms the heart and soothes the cases is caused by insufficiency of the
mind. Sanyinjiao (SP 6), the crossi ng heart and spleen and deficiency of the
point of the Liver, Spleen and Kidney kidney essence. As Wang Yang said, "Ess-
Meridians, regulates the three meridians. ence and will are both stored in the kid-
Anmian (Extra) is an extra point for in- ney. If the kidney essence is deficient, the
somnia. Xinshu (BL 15), the Back-(Shu) will is weakened. Poor memory appears
point of the heart, and Pishu (BL 20), the when the will fails to cooperate with the
Back-(Shu) point of the spleen, are com- heart." In Prescriptions Based on Three
bined to reinforce the spleen and nourish Pathogenic Factors, it says: 'The spleen
the heart. Yinbai (SP 1), the ling-(Well) dominates the recollection and thinking.
point of the Spleen Meridian, is effective Recollection refers to the power of call-
for dream-disturbed sleep. Xinshu (BL ing back the past facts to the mind, and
15) reduces heart fire. Shenshu (BL 23) thinking depends also on the action of
and Taixi (KI 3) reinforce kidney water. the heart. ... Since the spleen is troubled,
The combination of these points is to collection is impaired, and the mind is
harmonize the heart and kidney. The uneasy, so memory is poor." The heart
combination of Ganshu (BL 18), Danshu and spleen dominate the blood. Over-
(BL 19) and Wangu (GB 12) is to subdue thinking injuring the heart and spleen
the fire of the liver and gallbladder. The consumes blood and leads to poor memo-
combination of Weishu (BL 21) and Zu- ry. The kidney dominates essence and
sanli (ST 36) is to regulate the stomach marrow, which can be consumed or ex-
and soothe the mind. hausted by indulgent sexual activity. The
brain is therefore poorly nourished, caus-
Remarks ing forgetfulness. The old aged also tend
Dermal needle therapy: Tap Sishen- to have poor memory due to the kidney
chong (Extra), Back-(Shu) points or decline.
Huatuojiaji (Extra) slightly from above The treatment is mainly to replenish
downward two to three times. Treat once the blood of the heart and reinforce the
daily or every other day. Ten treatments spleen and kidney. Reinforcing method is
constitute a course. Next course of treat- applied to Sishencong (Extra), Xinshu
ment begins after an interval of two to (BL 15), Pishu (BL 20), Zusanli (ST 36),
three days. Shenshu (BL 23), and Zhaohai (KI 6).
Explanation: Sishencong (Extra) is an
Appendix: Poor Memory empirical point for treatment of poor
memory. Xinshu (BL 15) and Pishu (BL
Poor memory is a trouble character- 20) are applied to strengthen the heart
ized by the functional decline of the and spleen. Shenshu (SL 23) and Zhao-
CHAPTER \7 INTERNA L DISEASES 4;\
---
hai (KI 6) promote the kidney essence, the heart and spleen, and impedes the
produce marrow and replenish the brain. production of qi and blood. Deficiency of
Zusanli (ST 36) reinforces the spleen and qi and blood fails to nourish the heart,
stomach in transportation and transfor- which affects the housing of the mind,
mation, and replenishes qi and blood. causing palpitation.
c) Hyperactivity of the fire due to yin
19. Palpitation deficiency:
Injury of kidney yin by indulgent sex-
Palpitation refers to unduly rapid ac- ual activity, or debility after a prolonged
tion of the heart which is felt by the disease renders the kidney water unable
patient and accompanied by nervousness to check the heart fire. Disharmony be-
and restlessness. tween the heart and kidney with flaring
Mild palpitation is mostly due to a fire disturbing the mind causes palpita-
sudden fright and overstrain. The general tion.
condition is comparatively good and the d) Retention of hamiful fluid:
symptoms are of short duration. A seri- Retention of harmful fluid due to de-
ous case is often due to prolonged inter- pression of the heart yang or due to
nal injury. The general condition is com- deficiency of the spleen and kidney yang
paratively poor and the symptoms are disturbs the heart, resulting in palpita-
severe. tion.

Etiology and Pathogenesis Differentiation:

a) Disturbance of the mind: a) Disturbance of the mind:
A timid person is likely to have palpi- Main manifestations: Palpitation, fear
tation when he or she is frightened by and fright, irritability, restlessness,
strange noises, surprising objects, or dan- dream-disturbed sleep, anorexia, white,
gerous environments. In Chapter 19 of thin tongue coating, a little bit rapid
Plain Questions, it says: "Fright makes qi pulse. In cases of phlegm heat, yellow,
disturbed because the heart has nothing sticky tongue coating, rolling, rapid
to rely on, the mind has no place to house pulse.
and the thinking has nothing to focus Analysis: Fear makes the qi flow dis-
on." There are other pathogenic factors ordered, and fright makes qi descend. A
causing palpitation, such as internal ac- disturbed mind is out of self-control, so
cumulation of phlegm heat, mental de- there are palpitation, fear and fright,
pression and anger, dysfunction of the dream-disturbed sleep, irritability and
stomach and upward perversion of restlessness. White thin tongue coating
phlegm fire. and a little bit rapid pulse are the signs of
b) Insufficiency of qi and blood: disturbance of the mind. Yellow sticky
Persistent disease, weak constitution, coating, and rolling, rapid pulse indicate
loss of blood, or overthinking damages the presence of phlegm heat.
452 CHINESE ACCPUNCTURE AND MOXIBUSTION

b) Insufficiency of qi and blood: in the chest and epigastric region, lassi-

Main manifestations: Palpitation, tude, weakness, cold extremities, white
lustreless complexion, dizziness, blurring tongue coating, string-taut, rolling pulse.
of vision, shortness of breath, lassitude, In case of deficiency of yang in the spleen
pale tongue with tooth prints, thready, and kidney, scanty urine, thirst without
weak or intermittent pulse. desire to drink, white, slippery tongue
Analysis: Palpitation is due to insuffi- coating, deep, string-taut or rapid pulse.
ciency of qi and blood, which fails to Analysis: Accumulation of dampness
nourish the heart. Lustreless complexion forms the harmful fluid, which depresses
is due to the insufficient qi and blood the heart yang. When the yang qi is un-
unable to lustre the complexion. Dizzi- able to reach the extremities, they are
ness is due to the poor nourishment of cold and weak. White tongue coating,
the brain by the insufficient qi and blood. string-taut, rolling pulse suggest the pres-
The heart dominates the blood and ves- ence of harmful fluid. Unsmooth circula-
sels and is manifested in the tongue. tion of qi resulting from yang deficiency
Therefore insufficient qi and blood of the spleen and kidney gives rise to
makes the tongue pale with tooth prints, scantiness of urine and thirst without
and the pulse thready, weak or intermit- desire to drink. White, slippery tongue
tent. coating and deep, string-taut pulse are
c) Fire hyperactivity due to yin defi- due to yang deficiency of the spleen and
ciency: kidney and retention of fluid. Rapid
Main manifestations: Palpitation, pulse indicates the decline of the heart
restlessness, irritability, insomnia, dizzi- yang.
ness, blurring of vision, tinnitus, red
tongue with little coating, thready, rapid Treatment
pulse. Method: The Back-(Shu) and Front-
Analysis: Kidney yin in deficiency (M u) points of the heart, and points of
state fails to check the heart fire, leading the Heart and Pericardium Meridians are
to disturbance of the mind, and resulting selected as the main points. Even mOve-
in palpitation, irritability and insomnia. ment method is applied for disturbance
When yin deficiency is present in the of the mind to calm the heart. Reinforc-
lower part of the body, and yang hyper- ing method is used for insufficiency of qi
activity in the upper, there may be dizzi- and blood to nourish the heart and ease
ness and tinnitus. Red tongue with little the mind. Reinforcing combined with re-
coating, and thready rapid pulse are the ducing method is applied for fire hyper-
signs of yang hyperactivity due to yin activity due to yin deficiency to nourish
deficiency. yin and subdue the fire. For retention of
d) Retention of harmful flUid: harmful fluid, reducing method is ap-
Main manifestations: Palpitation, ex- plied first and then reinforcing in combi-
pectoration of mucoid sputum, fullness nation with moxibustion to warm yang
CHAPTER 17 INTERNAL DISEASES 45.~

and dissolve the harmful fluid. Prescrip- can replenish kidney yin. Jueyinshu (BL
tion: Xinshu (BL 15). Juque (CY 14). 14) can clear heart fire. Guanyuan (CY
Shenmen (HI 7), Neiguan (PC 6). 14), Shuifen (CY 9) and Yinlingquan (SP
Supplementary points: 9) can invigorate the heart yang, streng-
Disturbance of the mind: Iongli (PC then the spleen and remove the harmful
5), Qinxu (GB 40); if accompanied with fluid.
phlegm heat: Fenglong (ST 40), Danshu
(BL 19). Remarks
Insufficiency of qi and blood: Pishu Palpitation described here may be in-
(BL 20), Weishu (BL 21), Zusanli (ST volved in neurosis, functional disorders
36). of the vegetative nervous system and car-
Fire hyperactivity due to yin deficien- diac arrhythmia of various origins.
cy: Jueyinshu (BL 14), Shenshu (BL 23),
Taixi (KI 3). 20. Manic-Depressive Disorder
Retention of harmful fluid: Shuifen
(CY 9), Guanyuan (CY 4), Shenque (CY Depressive disorder is manifested by
8), Yinlingquan (SP 9). mental dejection, reticence or incoherent
Explanation: The combination of speech, while man ic disorder by shout-
Shenmen (HT 7), the Yuan-(Primary) ing, restlessness and violent behaviors.
point of the Heart Meridian, and Xinshu As described in Classic on Medical Prob-
(BL 15) with Juque (CY 14). the Front- lems, depressive disorder is caused by
(Mu) point of the heart, and Neiguan excessive yin, while manic disorder by
(PC 6), the Luo-(Connecting) Point of abundan t yang.
the Pericardium Meridian can regulate qi The most important etiological factor
and blood of the heart to ease the mind. of manic-depressive disorder is emotion-
The combination of T ongli (HT 5), the al injury. Pathogenetically, phlegm plays
Luo-(Connecting) point of the Heart Me- the primary role. Depressive disorder is
ridian, and Qiuxu (GB 40), the Yuan- due to stagnation of phlegm combined
(Primary) point of the Gallbladder Me- with qi, while manic disorder is due to
ridian, can calm the mind and regulate phlegm fire. Although they are different
the gallbladder. Fenglong (ST 40), the in symptomatology, they are related to
Luo-(Connecting) point of the Stomach each other. A prolonged depressive disor-
Meridian, and Danshu (BL 19), the Back- der, in which fire is produced by phlegm
(Shu) point of the gallbladder, can dis- stagnation, may change into manic disor-
solve phlegm and dispel heat. Pishu (BL der, while a protracted manic disorder, in
20) and Weishu (BL 21) can regulate the which the stagnated fire is gradually dis-
spleen and stomach to promote qi and persed, but the phlegm is still existing,
blood production. Zusanli (ST 36) is can change into depressive disorder.
an important point to reinforce qi and Therefore, they are termed together as
blood. Shenshu (BL 23) and Taixi (KI 3) manic-depressive disorder.
454 CHINESE ACCPUNCTl'RE AND MOXlBl'STJON

Etiology and Pathogenesis: pulse is due to the accumulation of

a) Depressive disorder: phlegm and qi.
In most cases it is caused by over- b) Manic disorder:
contemplation and emotional depression, Main manifestations: Sudden onset,
which lead to dysfunction of the liver and irritability, being easy to anger, insomnia,
spleen. There are stagnant liver qi and loss of appetite, followed by excessive
accumulated fluid due to impaired trans- motor activity with increased energy and
portation, which turns into phlegm. Then violent behaviors, yellow, sticky tongue
the phlegm pervertedly goes upward to coating. String-taut. rolling and rapid
invade the mind. pulse.
b) Manic disorder: Analysis: Anger damages the liver.
In most cases it is caused by anger that The liver fire flares up and agitates the
injures the liver, leading to its failure in phlegm heat of Yangming to disturb the
dispersing. The stagnated qi transforms mind. Therefore, the patient is irritable,
into fire, which evaporates the body fluid unable to fall asleep and easy to anger.
to produce phlegm fire. The phlegm fire Because of the disturbance of the mind
pervertedly rushes upward and disturbs by the phlegm heat, violent behaviors
the mind. take place. The limbs are the founda-
In addition, this disease has a heredi- tion of all the yang actions. Preponder-
tary trend and often a positive family ant yang makes the limbs move energetic,
history. thus, the physical strength and motor
activity are increased. The combination
Differentiation: of phlegm and heat. leads to yellow,
a) Depressive disorder: sticky tongue coating, string-taut, rolling
Main manifestations: Gradual onset, and rapid pulse.
emotional dejection and mental dullness
at the initial stage, followed by incoher- Treatment
ent speech, changing moods, or mute- a) Depressive disorder:
ness, somnolence, anorexia, thin, sticky Method: Even movement method is
tongue coating, string-taut, thready or applied to the points of the Heart and
string-taut rolling pulse. Liver Meridians to soothe the liver, calm
Analysis: Overcontemplation and the heart and dissolve the phlegm.
emotional dejection make the liver qi Prescription: Xinshu (BL 15), Ganshu
stagnated and the spleen qi fail to as- (BL 18), Pishu (BL 20), Shenmen (HT 7),
cend. The stagnated qi combined with Fenglong (ST 40).
the phlegm disturbs the mind, leading to Explanation: This condition is caused
mental disorders. The stagnated phlegm by the stagnation of phlegm and qi,
in the middle energizer gives rise to an- which injures the heart, liver and spleen.
orexia and thin, sticky tongue coating. Xinshu (BL 15) is used to clear the heart,
String-taut thready or string-taut rolling Ganshu (BL 18) to remove the liver stag-
CHAPTER I"' INTERNAL DISEASES

nation, Pishu (BL 20) to promote the Huiyin (CY I), Quchi (L I II), and She-
spleen qi circulation, Shenmen (HT 7) xiazhongfeng (an extra point located at
and Fengiong (ST 40) to dissolve the the midline of the under side of the
phlegm for calming the mind. tongue ).
b) Manic disorder:
Method: Reducing method is applied 21. Epilepsy
to the main points of the Governor Yes-
sel and Pericardium Meridian of Hand Epilepsy occurs in seizures, manifest-
Jueyin to calm the heart, ease the mind, ed by falling down in a fit, loss of cons-
reduce the heat and dissolve the phlegm. ciousness, foam on the lips, or screams
Prescription: Dazhui (GY 14), Fengfu with eyes staring upward, and convul-
(GY 16), Shuigou (GY 26), Neiguan (PC sions. After some minutes, consciousness
6), Fenglong (ST 40). returns. and the patient's condition be-
Supplementary points: comes normal.
Mania with extreme heat: Prick the Besides the typical seizures. there may
twelve Jing-(Well) points on hand (LU be variations. It can be a momentary loss
11, HT 9, PC 9, LI 1, TE L SI 1) to bleed of attention or consciousness with eyes
for reducing heat. staring directly forward, or prolonged
Explanation: Dazhui (GY 14) and loss of consciousness associated with con-
Shuigou (GY 26) are used to reduce heat vulsions and foam on the lips. Epileptic
for clearing the mind. Fengfu (G Y 16) is fits may occur at any time, in various
selected for mental disorders as Mirac- frequency and with different severity. It
ulous Pivot states: "The brain is the sea of is often preceded by an "aura" of dizzi-
marrow, its upper part reaches the vertex ness, depression sensation of the chest,
of the cranium, and its lower part reaches and listlessness. Generally speaking, epi-
point Fengfu (GY 16)." Neiguan (PC 6) lepsy is an excess condition. hut frequent
is combined with Fenglong (ST 40) to recurrence can lower the body resistance.
clear the heart and dissolve the phlegm.
Etiology and Pathogenesis
Remarks a) Fear and fright: Fear makes qi dis-
a) The condition described here in- ordered and fright makes qi descend, af-
cludes the depressive and manic types of fecting the liver and kidney and leading
schizophrenia in modern medicine. to stirring of the deficiency wind.
b) Thirteen points for manic- b) Dysfunction of the liver in smooth-
depressive disorder: Prick to bleed ac- ing flow of qi, or irregular food intake
cording to the order of Shuigou (GY 26), damaging the spleen and stomach, makes
Shaoshang (LU 11), Yinbai (SP 1), Da- the dampness of food and drinks accu-
ling (PC 7), Shenmai (BL 62), Fengfu mulate as phlegm, which combined with
(GY 16), liache (ST 6), Chengjiang (CY the stagnated liver qi, disturbs the mind
24), Laogong (PC 8), Shangxing (GY 23), and causes epilepsy.

---------- - - ------ ---------------

456 ~ _ _ _ _ _ _ _ _ ~It\ESE _ACCPLJt\CTLJRE AKD MOXIBLJSTIO/\

c) Epilepsy may result from heredi- tongue with white coating and thready,
tary factors, but in most of the hereditary rolling pulse.
cases it comes on in early childhood. Analysis: Listlessness is due to damage
of the vital qi by frequent epileptic fits.
Differentiation With insufficiency of blood, the complex-
a) During seizure ion is lustreless. There is dizziness if the
Main manifestations: A typical sei- brain lacks blood supply, and palpitation if
zure is preceded by dizziness, headache the heart is poorly supplied with blood.
and suffocating sensation in the chest. Due to the depression of the spleen yang,
and immediately followed by falling the food cannot be transformed into
down with loss of consciousness, pallor, essence, and dampness and phlegm are
clenched jaws, upward staring of the produced, so there are anorexia and pro-
eyes, convulsion, foam on the lips, fuse sputum. Deficiency of the kidney
screaming as pigs or sheep, and even essence causes soreness and weakness of
incontinence of urine and feces. Gradual- the loins and limbs. Pale tongue with white
ly, the patient regains consciousness, and coating and thready, rolling pulse suggest
the symptoms disappear. Apart from consumption of qi and blood and accumu-
fatigue and weakness, the patient can Jive lation of phlegm dampness.
a normal life. White sticky tongue coat-
ing, and string-taut, rolling pulse. Treatment
Analysis: Dizziness, headache and a) During seizure:
suffocated sensation in the chest are the Method: Points of the Governor and
prodromal symptoms which show the up- Conception Vessels and Liver Meridian
ward perversion of the wind phlegm. The are selected as the main points with re-
liver wind stirs up with the phlegm to ducing method to dissolve the phlegm,
disturb the mind. Therefore, there are induce resuscitation. soothe the liver and
loss of consciousness, con vulsions and dispel the wind.
upward staring of the eyes. The foam on Prescription: Shuigou (GV 26), Jiuwei
the lips is owing to the ascending wind (CV 15), J ianshi (PC 5), Taichong (LR
phlegm. White, sticky tongue coating and 3). Fenglong (ST 40).
rolling pulse are the signs of retaining of Explanation: Shuigou (GV 26) and
the phlegm. Since the wind phlegm is Jiuwei (CV 15) are used for resuscitation.
irregularly accumulated and dispersed, Jianshi (PC 5), Fenglong (ST 40) and
the seizures are paroxysmal, and the pa- Taicong (LR 3) are used to calm the
tient behaves as normal after the seizure. heart, ease the mind. dissolve the phlegm
b) After seizure: and dispel the wind.
Main manifestations: Listlessness, b) After seizure:
lustreless complexion, dizziness, palpita- Method: Points of the Heart, Spleen
tion, anorexia, profuse sputum, weakness and Kidney Meridians are selected as
and soreness of the loins and limbs, pale the main points with even movement to
CHAPTER 17 INTERNAL DISEASES 457

nourish the heart, ease the mind, streng- an illusion of bodily movement with ro-
then the spleen and reinforce the kidney. tatory sensation like sitting in a sailing
Prescription: Xinshu (BL 15), Yin tang boat or moving car, and even accompa-
(Extra), Shenmen (HT 7), Sanyinjiao (SP nied by nausea, vomiting and sweating.
6), Taixi (KI 3), Yaoq i (Extra).
Supplementary points: Etiology and Pathogenesis
Daytime seizure: Shenmai (BL 62). a) Hyperactivity of the liver yang:
Night seizure: Zhaohai (KI 6). The liver is analogized as wind and
Phlegm stagnation: Zhongwan (CY wood, characterized by movement and
12), Fenglong (ST 40). ascending. Overcontemplation, anxiety,
Severe deficiency of qi and blood: depression or anger can damage the liver
Guanyuan (CY 4), Zusanli (ST 36). yin, resulting in hyperactivity of liver
Explanation: Xinsh u (BL 15), Yintang yang. Dizziness occurs in case the liver
(Extra) and Shenmen (HT 7) are used for yang moves as the wind and ascends to
nourishing the heart and easing the mind, attack the brain. Or the kidney water,
and Sanyinjiao (SP 6) and Taixi (KI 3), generally in deficiency, fails to nourish
for strengthening the spleen and reinforc- the liver. Dizziness occurs in case the
ing the kidney. Yaoqi (Extra) is an em- liver is lack of nourishment, which leads
pirical point for epilepsy. Shenmai (BL to hyperactivity of liver yang. In both
62), a point of Yang Heel Vessel, is nee- situations there is deficiency in the I wer
dled for the daytime seizure, while Zhao- but excess in the upper part 0 the
hai (KI 6), a point of Yin Heel Vessel, is body.
needled for night seizure. Zhongwan (CY b) Deficiency of qi and blood:
12) and Fenglong (ST 40) are applied to The heart and spleen are damag d by
regulate the stomach and dissolve the overwork and over contemplation i case
phlegm. Guanyuan (CY 4) and Zusanli of a weak constitution after a di ease.
(ST 36) are used to regulate and replenish The damaged spleen fails to produ e qi
qi and blood. and blood, leading to deficiency. In case
the brain is poorly nourished by q and
Remarks blood, dizziness occurs.
The above description refers to many c) Interior retention of phlegm mp-
types of epileptic seizures including grand ness:
mal, petit mal, psychomotor and focal In a person with generally abu dant
seizures. For secondary epilepsy, the pri- phlegm dampness, irregular food i take
mary disease should be treated actively. and overwork damage the stomac and
the spleen, impairing their functi n in
22. Dizziness transportation and transformation and
leading to production of dampnes and
The mild case can be relieved by clos- phlegm. Then the stagnant phlegm a d qi
ing one's eyes, while the serious case has may impede the ascending of clear yang
458 CHIl\'ESE ACCPUNCTURE AND MOXIBl'STION
-----
and the descending of the turbid yin, and insufficient, thereby, the complexion is
thus dizziness occurs. lustreless, and the iips and the nails are
pale. Deficiency of blood leads to pal-
Differentiation pitation and insomnia. Deficiency of qi
a) Hyperactivity of liver yang: gives rise to weakness, lassitude, anorex-
Main manifestations: Dizziness aggra- ia, and is aggravated by overwork. Pale
vated by anger, irritability, flushed face, tongue and thready, weak pulse are the
red eyes, tinnitus, bitter taste in the signs of deficiency of qi and blood.
mouth, dream-disturbed sleep, red c) Interior retention of phlegm damp-
tongue proper with yellow coating, ness:
string-taut, rapid pulse. Main manifestations: Dizziness with a
Analysis: Anger damages the liver yin, heavy feeling of the head and suffocating
causing hyperactivity of the liver yang, sensation in the chest, nausea, profuse
which transforms into fire. When the fire sputum, anorexia, somnolence, white,
flares up, flushed face, red eyes and irrit- sticky tongue coating, soft, rolling pulse.
ability appear. The spirit stored in the Analysis: Dizziness with a heavy feel-
liver is upset by disorders of the liver, ing of the head is the sign of the pure
then dream-disturbed sleep occurs. The yang disturbed by phlegm dampness. Suf-
red tongue proper with yellow coating, focating sensation in the chest and nau-
bitter taste in the mouth, string-taut, rap- sea are caused by qi obstructed in the
id pulse are the signs of yin deficiency middle energizer. Anorexia and somnol-
resulting in fire hyperactivity. ence are due to the spleen yang deficien-
b) Deficiency of qi and blood: cy. White, sticky tongue coating, soft
Main manifestations: Dizziness ac- and rolling pulse are the signs of phlegm
companied by pallor and lustreless com- dampness.
plexion, weakness, palpitation, insomnia,
pale lips and nails, lassitude, pale tongue Treatment
proper, thready and weak pUlse. Dizzi- a) Hyperactivity qf liver yang:
ness occurs mostly after a serious disease Method: Points of the Liver Meridian
or loss of blood and is aggravated by and Kidney Meridian are selected as the
overwork. Loss of consciousness happens main points to nourish yin and pacify
in severe cases. yang. Reinforcing and reducing methods
Analysis: Dizziness is inevitable be- are applied with either one first accord-
cause deficiency of qi and blood fails to ing to the condition of the disease.
nourish the brain. The heart dominates Prescription: Fengchi (GB 20), Gan-
the blood and is manifested in the com- shu (BL 18), Shenshu (BL 23), Taixi (KI
plexion. The spleen dominates the trans- 3), Xingjian (LR 2).
portation and transformation to manu- Explanation: The reinforcing method
facture qi and blood. If the heart and applied to Shenshu (BL 23) and Taixi (Ki
spleen are injured, qi and blood will be 3) is to replenish the kidney water, while
CHAPTER ! 7 INTERNAL DISEASES 459

the reducing to Ganshu (RL 18), Xing- ing qi and harmonizing the stomach to
jian (LR 2) and Fengchi (GB 20) is to check vomiting.
pacify the liver yang.
b) Deficiency of qi and blood: Remarks
Method: Points of the Conception a) Dizziness may be explained as der-
Yessel and the Bladder and Stomach Me- angement of the equilibrium of the sen-
ridians are selected as the main points ses in modern medicine. Clinically, the
with reinforcing method in combination symptom is mostly seen in hypertension,
with moxibustion to replenish qi and arteriosclerosis, neurosis, and otogenic
blood. diseases.
Prescription: Baihui (GY 20), Pishu b) Dermal needle therapy:
(BL 20), Guanyuan (CY 4), Zusanli (ST Main points: Baihui (GV 20), Taiyang
36), Sanyinjiao (SP 6). (Extra), Yin tang (Extra), and Huatuojiaji
Explanation: Moxibustion to Baihui (Extra).
(GV 20), which is located at the vertex, is Method: Tap once or twice daily with
to make qi and blood ascend to the head moderate stimulation. Five to ten treat-
to nourish the brain and check dizziness. ments constitute one course.
Guanyuan (CY 4) is used to strengthen
the primary qi. Pishu (BL 20) and San- 23. Melancholia
yinjiao (SP 6) are for invigorating the
spleen and stomach to produce qi and Melancholia is a general term for di-
blood. sorders resulted from emotional depres-
c) Interior retention of phlegm damp- sion and stagnation of qi. The symptoms
ness: due to emotional frustration, and depres-
Method: The Back-(Shu) and Front- sion of qi which lead to stagnation of
(Mu) points of the spleen and stomach blood, accumulation of phlegm, retention
are selected as the main points with even of food, collection of fire, and dishar-
movement method to resolve phlegm and mony of the zang-fu organs fall into this
eliminate dampness. category. Zhu Danxi said: "There is no
Prescription: Touwei (ST 8), Pishu disease when qi and blood are in har-
(BL 20), Zhongwan (CV 12), Neiguan mony. Once depression occurs, disease
(PC 6), Fenglong (ST 40). results. "
Explanation: Pishu (BL 20) and
Zhongwan (CV 12) are needled to streng- Etiology and Pathogenesis:
then the spleen and stomach for elimi- Generally speaking, melancholia is
nating dampness. Fenglong (ST 40), the caused by emotional injuries resulting in
Luo-(Connecting) point of the stomach, disharmony of the activity of the zang
is to make qi descend and resolve phlegm. organs. As said in Chapter 28 of Mirac-
Touwei (ST 8) is for dizziness. Neiguan ulous Pivot: "Grief, sorrow, worry and
(PC 6) is for relaxing the chest, regulat- anxiety disturb the mind and disturbance
460 CHINESE ACUPUNCTURE AND MOXIBUSTION

of the mind will affect all the five zang dominal distension. If the stomach qi
and six fu organs." fails to descend, belching and anorexia
a) Depressed anger may give rise to occur. When the liver qi encroaches the
many disorders of the liver with impair- spleen, abdominal pain, vomiting and ab-
ment of the free flow of qi. Then the liver normal bowel movement result. Thin,
qi may go upward to attack the mind, or sticky tongue coating and string-taut
conquer the spleen and stomach, or coun- pulse are the signs of disharmony be-
teract the lung, or go downward to the tween the liver and stomach.
intestines, leading to various illnesses. b) Transformation of depressed qi into
b) Too much worry may depress the fire:
liver and suppress the spleen, causing the Main manifestations: Headache, dry-
failure of the spleen in transportation ness and bitter taste in the mouth, irrit-
and transformation, which brings about ability, distress of the chest, hypo-
accumulation of dampness and phlegm chondriac distension, acid regurgita-
and retention of undigested food. Ag- tion, constipation, red eyes, tinnitus, red
glomeration of the dampness, phlegm tongue with yellow coating, string-taut,
and undigested food in a long duration is rapid pulse.
apt to produce fire. Overanxiety may also Analysis: When the depressed qi is
lead to dysfunction of the qi and con- transformed into fire, it flares up along
sumes yin (nutrients and blood) generat- the Liver Meridian, resulting in head-
ing many symptoms. ache, red eyes and tinnitus. When the
liver fire evaporates the fluid and heat
Differentiation accumulates in the stomach and intes-
a) Depression of the qi in the liver: tines, dryness and bitter taste in the
Main manifestations: Mental depres- mouth and constipation occur. If the liv-
sion, distress of the chest, hypochondriac er is hyperactive, it will encroach the
pain, abdominal distension, belching, an- stomach, leading to failure of the stom-
orexia, or abdominal pain, vomiting, ab- ach in descending function, then distress
normal bowel movement, thin, sticky of the chest, hypochondriac distension,
tongue coating, string-taut pulse. and acid regurgitation occur. Irritability,
Analysis: In case of emotional inju- yellow tongue coating, string-taut, rapid
ry, the liver fails to the harmonious pulse are the signs of the fire in the liver.
and flourishing, so mental depression c) Stagnation of phlegm (also known as
appears. The Liver Meridian of Foot- globus hystericus):
Jueyin runs up to the lower abdomen Main manifestations: Feeling of a
and curves around the stomach and then lump choking in the throat, hard to spit
branches out in the costal and hypochon- it out or to swallow it, thin, sticky tongue
driac regions. In case of stagnation of the coating, string-taut, rolling pulse.
qi of the liver, there may appear distress Analysis: The depressed liver qi acts
in the chest, hypochondriac pain and ab- over the spleen and stomach, leading to
 CHAPTER 17 I~TERNAL DISEASES 461
-------------------
disturbance of transportation and trans- Prescription: Gansh u (BL 18), Tan-
formation. Dampness derived from the zhong (CY 17). Zhongwan (CY 12), Zu-
water and food taken is gathered and sanli (ST 36), Gongsun (SP 4), Taichong
turned into phlegm, which combined (LR 3).
with qi, stays in the throat, giving rise Explanation: Tanzhong (CY 17), the
to chocking feeling. Thin, Sticky tongue influential point of qi, is able to regulate
coating and string-taut, rolling pulse are the flow of qi. Ganshu (GB 18) and
the signs of the stagnation of phlegm Taichong (LR 3) are the Back-(Shu)
with qi. point and Yuan-(Primary) point of the
d) Insufficiency of blood (also known as liver respectively. When used in combina-
hysteria): tion, they may soothe the liver and re-
Main manifestations: Grief without move depression. Zhongwan (CY 12) and
reasons, capricious joy or anger, suspi- Zusanli (ST 36) may harmonize the stom-
cions, liability to get frightened, palpita- ach and make the stomach qi descend.
tion, irritability, insomnia, or sudden Gongsun (SP 4), the Luo-(Connecting)
distress of the chest, hiccup, sudden point of the Spleen Meridian, may streng-
aphonia, convulsion, or loss of conscious- then the spleen and harmonize the stom-
ness in severe cases, thin, white tongue ach.
coating, string-taut, thready pulse. b) Transformation of depressed qi into
Analysis: Because of overcontempla- fire:
tion and emotional frustration, the qi Method: Points of the Liver, Gall-
function is impaired and the blood is bladder and Stomach Meridians are se-
gradually consumed, leading to poor lected as the principal points. Reducing
nourishment of the mind, thus the above- method is used to dispel the fire from the
mentioned symptoms occur. In case the liver and strengthen the stomach func-
qi is blocked, there may be sudden dis- tion.
tress of the chest, hiccup, sudden aphonia Prescri ption: Shangwan (CY 13), Zhi-
and convulsion. Thin white tongue coat- gou (TE 6), Yanglingquan (GB 34),
ing, and string-taut thready pulse are the Xingjian (LR 2), Xiaxi (GB 43).
signs of a long-standing stagnation of qi Explanation: Xingjian (LR 2) and
that damages blood. Xiaxi (GB 43), the Ying-(Spring) points
of the Liver and Gallbladder Meridians,
Treatment may dispel fire from the liver and gall-
a) DepreSSion of qi in the liver: bladder. Zhigou (TE 6) in combination
Method: The influential point of qi with Yanglingquan (GB 34) may treat
and the points of the Liver Meridian are distress of the chest, hypochondriac dis-
selected as the principal points. Even tension, bitter taste in the mouth and
movement method is applied to soothe constipation. Shangwan (CY 13) may
the liver, strengthen the spleen and har- harmonize the stomach and regulate the
monize the stomach. flow of qi to treat acid regurgitation.

---------------~-------- ----_. ------- -------- ---~~ . - . -.. ~--------

462 _ _ CH_INESE
_ AClJPUNCTl'RE AND MOXIBUSTION

c) Stagnation of phlegm: 26), Yongquan (KI I).

Method: Points of the Liver Meridian Explanation: Taichong (LR 3) is se-
and Conception Vessel are selected as the lected to soothe the liver and remove
principal points. Even movement method depression. Juque (CV 14), the Front-
is applied to soothe the liver, remove the (Mu) point of the Heart Meridian, Shen-
depression, regulate the flow of qi and men (HT 7), the Yuan-(Primary) point,
resolve phlegm. combined with Sanyinjiao (SP 6) of the
Prescription: Tiantu (CV 22), Tan- Spleen Meridian, may nourish blood, re-
zhong (CV 17), Neiguan (PC 6), Feng- fresh and tranquilize the mind. Neiguan
long (ST 40), Taichong (LR 3). (PC 6) and Tanzhong (CV 17) may re-
Explanation: Taichong (LR 3) is ap- move the depression of the chest. Gong-
plied to soothe the liver and remove the sun (SP 4) and Tiantu (CY 22) cause the
depression. Tiantu (CV 22) is needled to qi to descend and check hiccup. Tongli
descend the qi and treat the throat trou- (HT 5) and Lianquan (CV 23) are effec-
ble. Neiguan (PC 6) is used to remove tive in the treatment of aphonia. Hegu (L
depression from the chest and regulate I 4) is taken to regulate the flow of qi.
the flow of qi. Tanzhong (CV 17), the Yanglingquan (GB 34), the Influential
influential point of qi, Fenglong (ST 40), point of the tendons, is used to check
the Luo-(Connecting) point of the stom- convulsion and relieve pain. Shuigou
ach, used together, may promote the cir- (GV 26) and Yongquan (KI I) are used
culation of qi and resolve phlegm. for resuscitation.
d) InSUfficiency of blood:
Method: Points of the Heart and Liver Remarks
Meridians are selected as the principal This condition is seen in hysteria and
points. Even movement method is ap- neurosis in Western Medicine.
plied to nourish blood, soothe the liver
and refresh and tranquilize the mind.
Prescription: Juque (CV 14), Shen- III. DISEASES OF HEAD,
men (HT 7), Sanyinjiao (SP 6), Taichong TR UNK AND LUMBAR
(LR 3). REGIONS
Supplementary points:
Distress of the chest: N eiguan (PC 6), 1. Headache
Tanzhong (CV 17).
Hiccup: Gongsun (SP 4), Tiantu (CV Headache is a subjective symptom. It
22). can be induced by various acute and
Sudden aphonia: Tongli (HT 5), Lian- chronic diseases. As it covers a wide
quan (CV 23). sphere, this section only deals in detail
Convulsion: Hegu (L I 4), Yang- with headache as the predominant symp-
lingquan (GB 34). tom. If headache is an accompanying
Loss of consciousness: Shuigou (GV symptom in the development of a certain
CHAPTER 17 INTERNAL DISEASES 463

disease, it will disappear automatically as stress, poor health with a chronic disease,
soon as the disease is cured. This type of or congenital deficiency. Deficiency of qi
headache is not to be discussed here. prevents the clear yang from ascending,
The head is the place where all the and deficiency of blood does not nourish
yang meridians of hand and foot meet, the mind, so there is headache.
and qi and blood of the five zang organs
and six fu organs all flow upward to the Differentiation
head. Attacks of endogenous or exoge- a) Headache due to invasion of patho-
nous factors may cause headache due to genic wind into the meridians and collater-
derangement of qi and blood in the head als:
and retardation of circulation of qi in the Main manifestations: Headache oc-
meridians that traverse the head. Head- curs on exposure to wind. The pain may
ache caused by exogenous pathogenic extend to the nape of the neck and back
factors is mostly due to invasion of regions. It is a violent, boring and fixed
pathogenic wind into the meridians and pain, accompanied by string-taut pulse
collaterals. It is said: "When the patho- and thin white tongue coating. Such a
genic wind invades the human body, it syndrome is also termed "head wind."
first attacks the upper portion of the Analysis: Pain comes from obstruc-
body." Headache caused by endogenous tion of qi in the meridians and collaterals
factors often originates from hyperfunc- on the head caused by invasion of the
tion of the liver yang, or deficiency of exogenous pathogenic wind. Owing to the
both qi and blood. excess of the pathogenic factor, the pain
is violent and boring. Wind is a yang
Etiology and Pathogenesis pathogenic factor and apt to attack the
a) Invasion of pathogenic wind into upper portion of the body. So the pain
the upper meridians and collaterals caused by wind may extend to the nape
caUSt~S derangement and obstruction of qi of the neck and back region. The fixed
and blood. With stagnation in the collat- pain is due to blood stagnation derived
erals . sudden weather change or exposure from qi stagnation. String-taut pulse and
to wind usually precipitates and attack of thin white tongue coating are the signs of
headache. meridians and collaterals being invaded
b) In patients with excessive yang by pathogenic wind.
of body constitution, headache may be b) Headache due to upsurge of liver-
caused by upsurge of liver yang due to yang:
stagnation of qi or injury of the liver Main manifestations: Headache,
after a fit of anger, which damages the blurred vision, severe pain on the bilater-
ym. al sides of the head, irritability, hot
c) Headache may also be caused by temper, flushed face, bitter taste in the
deficiency of both qi and blood because mouth, string-taut and rapid pulse, red-
of irregular food intake, overstrain and dened tongue with yellow coating.
464 CHINESE ACUPUNCTURE Ar-:D MOXJI3USTlor-:

Analysis: Headache and blurred vision and nape of the neck is related to the
are due to rising of excessive liver-yang Bladder Meridian of Foot-Taiyang. pain
which attacks the head. Bitter taste in the at the forehead and supraorbital region is
mouth suggests accumulation of heat in related to the Stomach Meridian of Foot-
the Gallbladder Meridian derived from Yangming, pain in bilateral or unilateral
the upsurge of liver-yang which affects temporal region is related to the Gall-
the gallbladder, as the liver and gallblad- bladder Meridian of Foot-Shaoyang, and
der are externally and internally related. that in the parietal region is related to the
Severe pain on the bilateral sides of the Liver Meridian of Foot-Jueyin.
head is because the Gallbladder Meridian
travels bilaterally on the side of the head. Treatment
String-taut and rapid pulse, reddened a) Headache due to invasion of patho-
tongue with yellow coating are signs of genic wind into meridians and collaterals:
heat in the gallbladder and liver. Method: To dispel the wind, remove
c) Headache due to deficiency of both qi obstruction in the meridians and collater-
and blood: als, regulate the qi and blood and check
Main manifestations: Lingering head- the pain by puncturing the local points
ache, dizziness, blurred vision, lassitude, combined with distal points along the
lustreless face, pain relieved by warmth related meridians. The reducing method
and aggravated by cold, overstrain or with needle retention is used.
mental stress, weak and thready pulse, Prescription: Occipital headache:
tongue with thin and white coating. Fengchi (GB 20), Kunlun (BL 60), Houxi
Analysis: Lingering headache is due to (S J 3).
the head being affected by the deficiency Frontal headache: Touwei (ST 8),
of qi that fails to make the clear yang Yintang (Extra), Shangxing (GV 23),
ascend and the turbid yin descend. Pain Hegu (L I 4), Neiting (ST 44).
aggravated by overstrain and stress is due Temporal headache: Taiyang (Extra),
to further consumption of qi. Lassitude, Shuaigu (GB 8), Waiguan (TE 5), Zulin-
pain which is relieved by warmth and qi (GB 41).
aggravated by cold suggest failure in dis- Parietal headache: Baihui (GV 20),
tribution of yang qi. Lustreless face, diz- Houxi (S I 3), Zhiyin (BL 67), Taichong
ziness and blurred vision indicate poor (LR 3).
nourishment of the face and head due to Explanation: The above prescriptions
deficiency of blood. Pale tongue with thin are formulated by combining local points
white coating and weak, thready pulse are with distal points according to the loca-
signs of deficiency of both qi and blood. tion of headache and the affected merid-
Clinically, varieties of headache ian.
should be also differentiated according to Occipital headache-points of the Tai-
the locality and the related meridians and yang Meridians of Hand and Foot.
collaterals. Pain in the occipital region Frontal headache-points of the Yang-
CHAPTER 17 INTERNAL DISEASES 465

ming Meridians of Hand and Foot. liver, spleen and kidney. Since the liver
Temporal headache-points of the stores blood, the spleen controls blood,
Shaoyang Meridians of Hand and Foot. and the kidney stores and produces ess-
Parietal headache-points of the Tai- ence and blood, these three points can be
yang Meridians of Hand and Foot plus used to strengthen essence in the kidney
those of the Jueyin Meridian of Foot. and to tonify qi and blood. Zusanli (ST
b) Headache due to upsurge of liver 36), punctured with the reinforcing
yang: method, can benefit the stomach which is
Method: Select points of Jueyin and the productive source of qi and blood.
Shaoyang Meridians of Hand and Foot as
the principal points to pacify the liver Remarks
yang. Puncture with the reducing a) Headache occurs in various diseases
method. of modern internal medicine, surgery,
Prescription: Fengchi (GB 20), Baihui neurology, psychosis, ear, nose, throat,
(GV 20), Xuanlu (GB 5), Xiaxi (GB 43), etc. Acupuncture gives gratifying results
Xingjian (LR 2). in migraine, and in vascular and neurotic
Explanation: The Jueyin Meridian of headache.
Foot reaches the parietal region and the b) Dermal needle and cupping thera-
Shaoyang Meridians run up to the bilat- pIes:
eral sides of the head. Combining the Main points: Area along LIto S 4 of
local points with distal points can reduce the spine.
heat in the meridians and pacify the liver Secondary points: Fengchi (GB 20),
yang. Taiyang (Extra), Yangbai (GB 14).
c) Headache due to deficiency of both qi Method: Tap on the area from Lito
and blood: S 4 of the spine. Then tap on the local
Method: To tonify and regulate circu- area and along the afflicted meridians.
lation of qi and blood, promoting the For acute pain, Taiyang (Extra) and
clean qi to ascend and the turbid qi to Yangbai (GB 14) may be tapped to slight
descend by needling points of the Gover- bleeding, then apply cupping.
nor and Conception vessels and the cor-
responding Back-(Shu) points. Puncture 2. Facial Pain
with the reinforcing method.
Prescription: Baihui (GV 20), Qihai Facial pain is a kind of severe pain
(CV 6), Ganshu (BL 18), Pishu (BL 20), occurring in transient paroxysms in a cer-
Shenshu (BL 23), Zusanli (ST 36). tain facial region. It mostly occurs in one
Explanation: Qihai (CV 6) is chosen side of the forehead, maxillary region or
to tonify the primary qi, and Baihui (GV mandibular region. The onset is abrupt
20) is for lifting up the clean yang. Gan- like an electric shock, and the pain is
shu (BL 18), Pishu (BL 20), and Shenshu cutting, burning and intolerable. Fre-
(BL 23) are the points associated with the quent recurrence denotes a chronic dis-
 CHINESE ACUPUNCTURE AND MOXlBCSTION

ease. In most cases it starts after middle minutes. It may recur several times a day.
age III women. Tender points can be found on the su-
praobital foramen, infraorbital foramen,
Etiology and Pathogenesis cheek foramen, lateral side of ala nasi,
A sudden attack of this disease is due angle of the mouth, and nasolabial
to invasion of the meridians and collater- groove, where pressure induces the attack
als on the face by pathogenic wind cold of pain. The pain is often accompanied
which contracts the meridians and colI at- by local spasm, running nose and lacri-
erals and retards the circulation of qi and mation, salivation, or by exterior symp-
blood. In Chapter 38 of Plain Questions, toms with string-taut and tense pulse.
it says: "When pathogenic cold comes Analysis: Pain is ca used by the ob-
and stays in the meridians it impedes and struction of circulation of qi and blood in
slows down the circulation. If it lodges the meridians and collaterals on the face
outside the vessels, the blood supply is due to invasion of pathogenic wind and
decreased, and if it remains in the vessels, cold. Pain aggravated by pressure sug-
the passage of qi is obstructed, resulting gests that the pathogenic factors are in
in a sudden attack of pain." excess. Burning pain comes from the
Facial pain may also arise from exces- fierce fight between the antipathogenic qi
sive fire of the liver and stomach which and pathogenic factors. String-taut and
flares up and attacks the face. The fire in tense pulse is the sign of invasion by
the stomach is produced by retention of pathogenic wind cold. Endogenous wind
food caused by irregular food intake. The heat comes from prolonged accumulation
fire of the liver is due to the stagnation of exogenous pathogenic cold wind, giv-
of qi in the liver. Furthermore, facial ing rise to spasm, running nose, lacrima-
pain may be due to deficiency of yin tion and salivation.
producing excess of fire in the patients b) Facial pain due io excessive jive in
with a body constitution of yin deficiency the liver and stomach:
and excessive sexual activity which con- Main manifestations: The attack of
sumes essence. In addition, diseases of pain as described above is accompanied
the teeth, mouth, ear, nose, or mental by irritability, hot temper, thirst, consti-
disorders may also induce facial pain. pation, yellow and dry tongue coating,
and string-taut, rapid pulse.
Differentiation Analysis: Irritability and hot temper
a) Facial pain due to invasion by path- are due to fire caused by prolonged de-
ogenic wind and cold: pression of the liver qi. Burning pain is
Main manifestations: Abrupt onset of caused by endogenous heat coming from
pain occurs like an electric shock. The prolonged retention of food in the stom-
pain is cutting, boring and intolerable, ach, which rises to the face through the
but transient and paroxysmal. Each at- Stomach Meridian. Thirst and constipa-
tack lasts a few seconds or one to two tion are due to heat in the stomach. Yel-
CHAPTER I"" INTERNAL DISEASES 467

low dry tongue coating, string-taut and Prescription: Pain at supraobital re-
rapid pulse are signs of accumulation of gion: Yangbai (GB 14), Taiyang (Extra),
fire in the liver and stomach. Zanzhu (BL 2), Waiguan (TE 5).
c) Facial pain due to deficiency of yin Pain at maxillary region: Sibai (ST 2),
and excessive fire: Quanliao (S I 18), Yingxiang (L 1 20),
Main manifestations: Insidious pain, Hegu (L I 4).
emaciation, malar flush. soreness in the Pain at mandibular region: Xiaguan
lumbar region, Jassitude, pain aggravated (ST 7). liache (ST 6), Daying (ST 5),
by fatigue, thready and rapid pulse, red- Jiachengjiang (Extra), Hegu (LI 4).
dened tongue with little coating. Supplementary points:
Analysis: The kidney stores essence Invasion by pathogenic wind and cold:
and dominates water. When the kidney Fengchi (GB 20).
essence is insufficient, lassitude, soreness Excessive fire in the liver and stom-
in the lumbar region and emaciation oc- ach: Taichong (LR 3), Neiting (ST 44).
cur. lnsufficiency of kidney water fails in Deficiency of yin and excessive fire:
controlling fire, which flares up along the Zhaohai (KI 6), Sanyinjiao (SP 6).
meridians and reaches the face, causing Explanation: The above prescriptions
malar flush and facial pain. Thready, rap- are formulated by combining the local
id pulse, reddened tongue with little coat- points with the distal points according to
ing are signs of deficiency of yin with the location of pain and the meridians
flaming fire. affected. For instance, Xiaguan (ST 7),
Jiache (ST 6) and liachengjiang (Extra)
Treatment are the points located at the mandibular
Method: Select the local points in region. Hegu (LI 4) and Waiguan (TE 5)
combination with distal points according are the points along the Hand- Yangming
to the location of pain and the meridians and Hand-Shaoyang Meridians which go
affected. For facial pain due to invasion upward to the facial region. The above
of pathogenic wind and cold, reducing prescription has the effect of promoting
method is used to promote the circulation circulation of qi of the meridians and
of qi and blood in the diseased area. For collaterals in the affected area, and the
facial pain due to excessive fire in the function of reducing excess and relieving
liver and stomach, the points along the pain. Fengchi (GB 20), the meeting point
Foot-lueyin and Yangming Meridians of the Foot-Shaoyang Meridian and Yang
are punctured with the reducing method Link Vessel, can be used to dispel wind and
to bring down the fire. For facial pain to check pain. Taichong (LR 3) and
due to deficiency of yin and excessive Neiting (ST 44) can be chosen for the
fire, the points along the Foot-Shaoyin purpose of eliminating excessive fire in the
Meridian should be added and punctured liver and stomach. Zhaohai (KI 6) and
with the reinforcing method to nourish Sanyinjiao (SP 6) nourish the yin and
the yin and to dissipate the fire. reduce the fire. For a chronic disease, local
_468
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ CHINESE ACUPUNCTURE AND MOXIllUSTION

points on the affected side can be punc- usually right after waking up, incomplete
tured with the reinforcing method, shal- closure of the eye in the affected side,
low insertion and needle retention. Or the drooping of the angle of the mouth, sali-
reducing method with long retaining of vation and inability to frown, raise the
needles can be applied to the correspond- eyebrow, close the eye, blowout the
ing local points of the healthy side. cheek, show the teeth or whistle, and in
some cases pain in the mastoid region or
Remarks headache, thin white tongue toating, su-
a) Facial pain is referred to trigeminal perficial tense or superficial slow pulse.
neuralgia in modern medicine. Analysis: It is known that the Foot
b) Acupuncture is effective in pain of and Hand Yangming and Shaoyang Me-
primary trigeminal neuralgia. For secon- ridians supply the facial region, and the
dary trigeminal neuralgia accompanying Muscle Meridians of Hand and Foot
intracranial diseases or lesions of the Yangming and Shaoyang also reach the
nervous system, in which the pain is forehead, cheek, and the front of the ear.
usually continuous with paroxysms of ag- The above manifestations of deviation of
gravation, treatment should be aimed at the eye and the mouth are due to the
its primary cause. flaccidity of affected muscles leading to
the imbalance of facial muscles between
3. Deviation of Eye and Mouth the two sides. The paralytic muscles are
caused by stagnation of qi in the meridi-
Deviation of the eye and the mouth is ans and malnutrition of the regions of the
derived from invasion of the meridians muscle meridians after the invasion of
and collaterals and muscle meridians in pathogenic wind and cold.
the facial region by exogeneous patho-
genic wind and cold. It can occur in pa- Treatment
tients of any age, but mostly at the age of Method: To eliminate wind and re-
twenty to forty, and more frequently in move the obstruction of meridians by
males. applying even-movement mainly to the
points of Hand and Foot Yangming Me-
Etiology and Pathogenesis ridians, and also to the points of Shao-
Deviation of the eye and the mouth is yang Meridians.
due to paralysis of the facial muscles Prescription: Yifeng (TE 17), Yangbai
caused by the attack of pathogenic wind (GB 14), Taiyang (Extra), Quanliao (S
and cold on Yangming and Shaoyang I 18), Xiaguan (ST 7), Dicang (ST 4),
Meridians, which leads to malnutrition of Jiache (ST 6), Hegu (L I 4).
the muscle regions of the meridians. Supplementary points:
Headache: Fengchi (GB 20).
Differentiation Difficulty in frowning and raising the
Main manifestations: Sudden onset, eyebrow: Zhanzhu (BL 2), Sizhukong
CHAPTER 17 INTERNAL DISEASES 469

(TE 23). used as an adjuvant method to acupunc-

Incomplete closing of the eye: Zanzhu ture. The affected side may be treated
(BL 2), Jingming (BL 1), Tongziliao (GB with small cups once every three to five
1), Yuyao (Extra), Sizhukong (TE 23). days.
Difficulty in sniffing: Yingxiang (LI d) If the healthy side of the face is
20). stiff, shallow puncture and needle retain-
Deviation of the philtrum: Renzhong ing at the local points of the healthy side
(GV 26). can be applied in combination with nee-
I nability to show the teeth: J uliao dling of the affected side.
(ST 3).
Tinnitus and deafness: Tinghui 4. Pain in Hypochondriac Region
(GB 2).
Tenderness at the mastoid region: Hypochondriac pain is a subjective
Wangu (GB 12), Waiguan (TE 5). symptom commonly seen in the clinic. It
Explanation: Hegu (L I 4), the Yuan- may be unilateral or bilateral. The classic
(Primary) point of the Large Intestine book Miraculous Pivot points out: "Patho-
Meridian of Hand-Yangming, can elimi- genic factors in the liver give rise to
nate pathogenic wind from the head and hypochondriac pain." Chapter 22 of Plain
facial region. Wangu (GB 12) and Ting- Questions says: "When the liver is diseased,
hui (GB 2) can eliminate wind and re- it causes pain below the ribs on both sides,
lieve headache. Yangbai (G B 14), Tai- and then refers to the lower abdomen." As
yang (Extra), Zanzhu (BL 2), Sizhukong the meridian of the liver supplies the
(TE 23), Tongziliao (GB 1), Yuyao (Ex- hypochondriac regions, and the liver is
tra)" Juliao (ST 3), Renzhong (GV 26), externally and internally related with the
Dicang (ST 4), Jiache (ST 6), Yingxiang gallbladder, the occurrence of hypochon-
(LI 20) and Quanliao (TE 17) are all local driac pain is mostly concerned with disor-
points of the involved meridians and have ders of the liver and gallbladder.
the effect of eliminating wind and invigo-
rating circulation of meridians. Etiology and Pathogenesis
a) The liver is situated in the hypochon-
Remarks driac region. Its meridians supply bilateral
a) This condition is seen in peripheral hypochondriac regions. If it is diseased, it
facial paralysis or Bell's palsy in modern will cause hypochondriac pain. The liver is
medicine. the organ in the category of wind and wood
b) In long-standing cases, the warming of Five Elements, and prefers to be in a
needle or moxibustion may be used to the harmonious state with free flow of qi.
points Taiyang (Extra), Jiache (ST 6), Emotional depression may restrain the
Dicang (ST 4), Juliao (ST 3), and Xia- liver function, causing poor circulation of
guan (ST 7). qi in the meridians, often resulting in
c:) Cupping therapy: Cupping may be hypochondriac pain.
470 CHINESE ACl'PUNCTURE AND MOXIBl'STION

b) The prolonged stagnation of the plish tongue proper, deep and hesitant
liver qi, or traumatic injuries such as pulse.
sprain and contusion may cause stasis of Analysis: Fixed stabbing pain in the
blood in collaterals, resulting in hypo- hypochondriac region is caused by stag-
chondriac pain. nation of blood following stagnation of qi
c) Poor health associated with chronic in the hypochondriac region. Pain inten-
disease, overstrain and stress, may cause sified at night suggests that blood as a yin
deficiency of essence and blood, which in factor is apt to stagnate at night which is
turn produces poor nourishment of the the yin time of a day. Pain due to stagna-
liver and its collaterals, resulting in hypo- tion of blood is a condition of excess, so
chondriac pain. it is aggravated by pressure. Dark pur-
plish tongue proper, and deep, hesitant
Differentiation pulse are signs of blood stagnation.
a) Excess type: b) Deficiency type:
i) Stagnation of qi: Main manifestations: Dull pain lin-
Main manifestations: Distending pain gering in the costal and hypochondriac
in the costal and hypochondriac region, region, dryness of the mouth, irritability,
stifling sensation in the chest, sighing, dizziness, blurring of vision, red tongue
poor appetite, bitter taste in the mouth, with little coating, weak, or rapid and
thin white tongue coating, string-taut thready pulse.
pulse. Severity of the symptoms varies Analysis: Dull pain in the costal and
with the changes of emotional state. hypochondriac region indicates deficien-
Analysis: Distending pain in the coas- cy of essence and blood which causes
tal and hypochondriac region suggests poor nourishment of the collaterals of
obstruction of the collaterals due to fail- the liver. Dryness of the mouth and irrit-
ure of the liver in maintaining the free ability suggest deficiency of yin with en-
flow of qi. Severity of the symptoms va- dogenous heat. Dizziness and blurring of
ries with the emotional state because of vision are due to the shortage of essence
the close relationship between emotional and blood. Red tongue with little coating,
changes and stagnation of qi. Stifling sen- and weak or rapid and thready pulse are
sation in the chest and signing indicate signs of deficiency of essence and blood
uneven qi activity. Poor appetite shows with endogenous heat.
that the spleen is being attacked by the
liver qi. Thin white tongue coating and Treatment
string-taut pulse are the signs of depres- a) E_~cess type:
sion of the liver. Method: Points are mainly selected
ii) Stagnation of blood: from Jueyin and Shaoyang Meridians of
Main manifestations: Fixed stabbing Foot to remove the stagnation of liver
pain in the hypochondriac region, inten- qi and the obstruction in the collaterals.
sified by pressure and at night, dark pur- Needling with reducing method is to be
CHAPTER 17 INTER;-':AL DISEASES 471

applied. spleen and stomach which are the main

Prescription: Qimen (LR 14), Zhigou source of producing qi and blood.
(TE 6), Yanglingquan (GB 34).
Supplementary points: Remarks
Stagnation of qi: Taichong (LR 3), a) Hypochondriac pain is seen in dis-
Qiuxu (GB 40). eases of the liver and gallbladder, contu-
Stagnation of blood: Geshu (BL 17), sion of the hypochondriac region, inter-
Ganshu (BL 18). costal neuralgia and costal chondritis.
Explanation: The Shaoyang Meridian b) Application of Huatuojiaji points
supplies the lateral aspect of the body; so of the corresponding segments gives grat-
Zhigou (TE 6) and Yanglingquan (GB ifying effect to relieve pain in the treat-
34) are used to relieve pain by regulating ment of intercostal neuralgia.
the qi of the Shaoyang Meridian. Qimen c) Dermal needle therapy: Tap the
(LR 14), the Front-(Mu) point of the skin over the affected hypochondriac
Liver Meridian, eases the liver and re- area, and then apply cupping. This meth-
lieves pain in the hypochondrum. Tai- od is indicated in hypochondriac pain due
chong (LR 3) and Qiuxu (GB 40) regu- to sprain or contusion. It has the action
late the qi of the liver and gallbladder. of removing stasis and relieving pain.
Geshu (BL 17) and Ganshu (BL 18) can
activate blood circulation and remove 5. Low Back Pain
stasis.
b) Deficiency type: Low back pain (pain in the lumbar
Method: Nourish essence and blood, region) is closely associated with disor-
invigorate circulation of qi, and relieve ders of the kidney for the lumbus is the
pain by applying reinforcing method to seat of the kidney.
points of the Foot-Jueyin Meridian and Clinically, low back pain can be found
Back-(Shu) points. in various diseases. This section only
Prescription: Qimen (LR 14), Ganshu deals with the following etiological fac-
(BL 18), Shenshu (BL 23); Zusanli (ST tors: 1. Invasion of exogenous pathogenic
36), Sanyinjiao (SP 6), Taichong (LR 3). cold and damp; 2. Deficiency of qi of the
Explanation: Ganshu (BL 18), the kidney; and 3. Sprain or contusion.
Back-(Shu) point of the liver, Shenshu
(BL 23), the Back-(Shu) point of the Etiology and Pathogenesis
kidney, Qimen (LR 14), the Front-(Mu) a) Invasion by pathogenic cold and
point of the liver, Taichong (LR 3), the damp:
Yuan-(Primary) point of the Liver Me- In this case low back pain is due to
ridian, used in combination, can nourish obstruction of circulation of qi in me-
essence and blood, readjust the liver and ridians and collaterals. The precipitating
relieve pain. Zusanli (ST 36) and Sanyin- factors may be living in cold and damp
jiao (SP 6) strengthen the function of the places, exposure to the rain or wading in
 CHIKESE ACUPUNCTURE AND MOXIB{'STION

water, or being drenched with sweat. of protracted pain and soreness, accom-
b) Deficiency of the kidney qi: panied by lassitude and weakness of the
In this case low back pain is generally Joins and knees, aggravated by fatigue
due to excessive sexual activity that con- and alleviated by bed rest. In case of
sumes essence and qi, resulting in poor deficiency of kidney yang, cramp-like
nourishment of the meridians in the lum- sensation in the lower abdomen, pallor,
bar region. normal taste in the mouth, cold limbs,
c) Trauma due to sprain or contusion: pale tongue, deep thready or deep slow
Trauma may cause injury of qi and pulse. In case of deficiency of kidney
blood in the meridians and collaterals, yin, irritability, insomnia, dry mouth and
leading to stagnation of qi and blood, throat, flushed face, feverish sensation
thus producing low back pain. in the chest, palms and soles, red-
dened tongue proper with scanty coat-
Differentiation ing, thready weak or thready rapid pulse.
a) Cold damp: Analysis: The lumbar region is said to
Main manifestations: Low back pain be the "dwelling house of the kidney."
usualJy occurring after exposure to cold The kidney dominates the bones, pro-
and damp and aggravated on rainy days. duces marrow and stores essence. When
heavy sensation and stiffness of the mus- the kidney has insufficient essence, the
cles in the dorsolumbar region, limitation bone is lacking of marrow, and the result
of extension and flexion of the back, pain is soreness and pain in the lumbar region
radiating downwards to the buttocks and accompanied by weakness of the knees.
lower limbs, cold feeling of the affected Over strain and stress consume essence
area, white and sticky tongue coating, and qi, and make the pain worse. Pain
deep and weak, or deep and slow pulse. is lessened by bed rest, which makes qi
Analysis: Pathogenic cold and damp quiescent. In case of deficiency of kidney
characterized by viscosity and stagnation yang, the kidney fails to warm the lower
block the meridians and collaterals, caus- abdomen and the limbs. This gives rise to
ing retarded circulation of qi and blood. cramp-like sensation in the lower abdo-
This produces heaviness, cold sensation men and cold limbs. Deficiency of yang
and pain in the lumbar region and limita- causes pallor, pale tongue. deep thready
tion of extension and flexion of the back. or deep slow pulse. When yin is deficient,
Stagnation of qi and blood becomes worse kidney water is unable to ascend to re-
on cloudy and rainy days, and so does the duce the heart fire. This results in irrit-
pain. Accumulation of cold and damp ability and insomnia. Deficiency of yin
gives rise to the white sticky tongue causes excessive internal heat, which
coating and the deep, weak or deep, slow gives rise to the following symptoms:
pulse. flushed face, feverish sensation in the
b) Kidney deficiency: chest, palms and soles, dryness of the
Main manifestations: Insidious onset mouth and throat, reddened tongue with
 CHAPTER 17 INTERNAL DISEASES 473

little coating, thready weak or thready Deficiency of the kidney yang: Ming-
rapid pulse. men (GY 4). Yaoyan (Extra).
c) Trauma: Deficiency of the kidney yin: Zhishi
Main manifestations: History of (BL 52), Taixi (KI 3).
sprain of the lumbar region, rigidity and Traumatic injury: Renzhong (OY 26),
pain of the lower back which is generally Yaotongxue (Extra), Ahshi point.
fixed in a certain area, and is aggravated Explanation: The low back is the
by pressure and by turning the body, pink "dwelling house of the kidney." Shenshu
or dark purplish tongue proper, string- (BL 23) can be selected to tonify the qi of
taut hesitant pulse. the kidney. Moxibustion may also be ap-
Analysis: Muscular strain in the lum- plied to this point to eliminate cold and
bar region causes retardation of qi and damp. Yaoyangguan (GY 3) is a local
blood and further leads to stagnation of point. Weizhong (BL 40) is one of "Four
blood in the meridians and collaterals. Key Points." and an important distal
The result is the fixed severe pain which point for the treatment of low back pain.
can be aggravated by pressure. String- Dachangshu (BL 25) and Guanyuanshu
taut pulse is associated with pain, dark (BL 26) can dispel wind and cold, re-
purplish tongue proper and hesitant move obstruction in meridians, and re-
pulse and signs of blood stasis. lieve pain. Combination of acupuncture
and moxibustion applied to Mingmen
Treatment (GY 4) and Yaoyang (Extra) can tonify
Method: Points are mainly selected the kidney yang and strengthen the kid-
from the Governor Yessel and the Foot- ney essence as well. Zhishi (BL 52) and
Taiyang Meridian to promote the circu- Taixi (KI 3) are selected for the purpose
lation of qi and blood, to relieve pain, of nourishing the kidney yin. As the Gov-
to relax the muscles and to activate the ernor Yessel travels along the spine, Ren-
blood circulation in the collaterals. Acu- zhong (GY 26) is a distal point effective
puncture and moxibustion are applied to- for treating rigidity and pain of the lum-
gether for cold-damp type. In case of bar region. Yaotongxue (Extra) is an em-
deficiency of the kidney yang, apply nee- pirical point used in treating sprain of the
dling with reinforcing method and moxi- lumbar region.
bustion. For deficiency of the kidney yin,
puncture with reinforcing method. For Remarks
traumatic low back pain, apply reducing a) Low back pain may be seen in renal
method or pricking to cause bleeding. diseases, rheumatism, rheumatoid ar-
Prescription: Shenshu (BL 23), Yao- thritis, hyperplastic spondiIities, muscle
yangguan (OY 3), Weizhong (BL 40). strain or traumatic injury of the lumbar
Supplementary points: region.
Cold damp: Dachangshu (BL 25), b) When the lumbar vertebrae are
Ouanyuanshu (BL 26). diseased, the corresponding Huatuojiaji

---- "-"---~---
474 CHIi\ESE ACUPUi\CTURE AND MOXIBlJSTIOi\

points may be punctured perpendicularly Bi syndromes are caused by obstruction

1.0-1.5 inches. Needles are retained. Here, of qi and blood due to 1. invasion of the
acupuncture therapy is only a supple- meridians and collatcrals by pathogenic
mentary method of treatment wind, cold and damp; 2. general weakness
of the body with deficiency ofyangqi; and
6. Bi Syndromes 3. dysfunction of the pores, and weakness
of defensive yang. The book Prescriptions
Bi syndromes are the syndromes char- for Succouring the Sickness points out, "It
acterized by obstruction of qi and blood is because of weakness of the body with
in meridians and collaterals due to inva- poor function of the pores that invasion of
sion of pathogenic wind, cold and damp, wind, cold and damp to produce bi syn-
and manifested by soreness, pain, numb- dromes is possible."
ness and heavy sensation of ihe limbs and b) Body constitution:
joints, and limitation of movement. The body constitution differs in the
Clinically, bi syndromes are common in natures of heat and cold. In case of the
the areas where the weather is cold, wet body constitution with exuberant yang qi
and windy, occurring in persons of either and accumulated heat, invasion of patho-
sex and any age. In mild cases there are genic wind, cold and damp will give rise
only soreness and pain in limbs and joints, to heat bi. Furthermore, long-standing
aggravated by the change of weather. In wind, cold and damp bi syndromes may
severe cases the soreness and pain are turn into heat bi as the pathogenic fac-
marked and recur repeatedly, accompa- tors in the meridians and collaterals are
nied by swelling of the joints and even transformed into heat.
deformity and limitation of movement.
Bi syndromes may be classified into Differentiation
four types according to etiology and man- a) Wandering bi:
ifestations: I. Wandering bi is character- Main manifestations: Wandering pain
ized by migrating pain and caused chiefly in the joints, especially the wrists, elbows,
by pathogenic wind; 2. Painful bi is knees and ankles; limitation of move-
characterized by severe pain and caused ment, chills and fever. thin and sticky
chiefly by pathogenic cold; 3. Fixed bi is tongue coating, superficial and tight or
characterized by marked soreness, numb- superficial and slow pulse.
ness and heaviness and caused chiefly by Analysis: Pain in the joints is a com-
pathogenic damp; and 4. Heat bi is charac- mon manifestation of all the bi syn-
terized by heat manifestations and sudden dromes caused hy wind, cold and damp
onset. that obstruct qi and blood circulation in
meridians and collaterals. As stated in
Etiology and Pathogenesis Chinese medicine, "There is pain if there
a) Attack of pathogenic faclors on indi- is obstruction." Wandering pain is due
viduals with weakened body resistance: mainly to invasion by pathogenic wind
CHAPTER 17 INTERNAL DISEASES

which is characterized by constant move- terized by heaviness. When it is in an

ment and changes. Chills and fever result excessive state, it invades the limbs and
from the struggle between anti pathogenic joints, causing retarded circulation of qi
factors and pathogenic factors after the and blood, and resulting in numbness and
invasion. Superficial tense or superficial heaviness. Pathogenic damp is a yin fac-
slow pulse indicates inv<lsion of exoge- tor, characterized by viscosity and stag-
nous pathogenic wind on the exterior of nation. So the pain caused by damp is
body; and thin and sticky tongue coating also fixed in location. The condition be-
shows the initial stage of invasion by comes worse on cloudy and rainy days for
pathogenic wind, cold and damp. the weather change brings about more
b) Painful bi: stagnation of qi and blood. Soft pulse and
Main manifestations: Severe stabbing white sticky tongue coating indicate the
pain in the joints, alleviated by warmth presence of pathogenic damp.
and aggravated by cold, with fixed local- d) Heat bi:
ization but no local redness and hotness, Main manifestations: Arthralgia in-
thin and white tongue coating, string-taut volving one or several joints, local red-
and tense pulse. ness, swelling and excruciating pain with
Analysis: Severe pain is due to retard- limitation of movement, accompanied by
ed circulation of qi and blood in the fever and thirst, yellow tongue coating,
meridians and collaterals caused by ex- rolling and rapid pulse.
cessive cold. Cold is a yin pathogenic Analysis: Local redness, swelling and
factor, characterized by causing contrac- pain of the joints are the result of the
tion. The pain is localized because of the transformation of pathogenic factors into
congealing effect of cold. Pain alleviated heat. Movement is limited because of
by warmth suggests that heat improves swelling and deformity of joints. Fever,
the circulation of blood. Cold causes thirst, yellow tongue coating, rolling and
further stagnation of blood, and hence rapid pulse are the signs of excessive
aggravates the pain. The absence of local heat.
redness and hotness is characteristic of In addition, bi syndromes may also be
affection by pathogenic cold. String-taut classified according to the locality of the
and tense pulse is associated with cold diseased area as follows:
and pain. White tongue coating is a sign Skin bi: Numbness of the skin with
of pathogenic cold. cold sensation.
c) Fixed bi: Muscle bi: Soreness, numbness and
Main manifestations: Numbness and pain of the muscles.
heavy sensation of rhe limbs, soreness Tendon bi: Soreness, pain and stiff-
and fixed pain of the joints, aggravated ness of the tendons and muscles.
on cloudy and rainy days, white and Vessel bi: Pain due to blockage of
sticky tongue coating and soft pulse. vessels.
Analysis: Pathogenic damp is charac- Bone bi: Soreness, heaviness and pain
4_76_,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C.=H=INESE ACUPUNCTURE AND MOXIBUSTION

of joints which fail to perform their func- Pain in the lumbar region: Renzhong
tions of lifting, extension and flexion. (GV 26), Shenzhu (GV 12), Yaoyang-
guan (GV 3).
Treatment Pain in the hip joint: Huantiao (GB
Ahshi points together with the local 30), luliao (GB 29), Xuanzhong (GB 39).
and distal points along the yang meridi- Pain in the thigh region: Zhibian (BL
ans supplying the diseased areas are se- 54), Chengfu (BL 36), Yanglingquan
lected for the purpose of eliminating (GB 34).
wind, cold and damp. Wandering bi, heat Pain in the knee joint: Heding (Ex-
bi and tendon bi are mainly treated by the tra), Dubi (ST 35), Medial Xiyan (Ex-
reducing method. Subcutaneous needles tra), Yanglingquan (GB 34), Yinlingquan
may also be applied. For painful bi and (SP 9).
vessel bi, it is better to use moxibustion, Numbness and pain in the leg: Cheng-
and apply needling as an adjuvant treat- shan (BL 57), Feiyang (BL 58).
ment with deep insertion and prolonged Pain in the ankle: liexi (ST 41),
retaining of the needles. For severe pain, Shangqiu (SP 5), Qiuxu (GB 40), Kunlun
intradermal needles or indirect moxibus- (BL 60), Taixi (KI 3).
tion with ginger may be used. Fixed bi, Numbness and pain in the toes: Gong-
skin bi, muscle bi and bone bi may also sun (SP 4), Shugu (BL 65), Bafeng (Ex-
be treated by combined acupuncture and tra).
moxibustion, or together with warming Pain in the back: ShuigOll (GV 26),
needle, or tapping plus cupping. Shenzhu (GV 12), Yaoyangguan (GV 3).
Prescriptions: General pain: Houxi (Sf 3), Shenmai
Pain in the shoulder joint: lianyu (LI (BL 62), Dabao (SP 21), Geshu (BL 17),
15), lianliao (TE 14), lianzhen (TE 19), lianyu (LI 15), Quchi (LI 11), Hegu (LI
Naoshu (SI 10). 4), Yangchi (TE 4), Huantiao (GB 30),
Pain in the scapula: Tianzong (SIll), Yanglingquan (GB 34), Xuanzhong (GB
Bingfeng (SI 12), lianwaish u (SI 14), 39), liexi (ST 41).
Gaohuang (BL 43). Supplementary points: 1. Wandering
Pain in the elbow: Quchi (LI 11), bi, vessel bi: Geshu (BL 17), Xuehai
Chize (LV 5), Tianjing (TE 10), Waiguan (SP 10); 2. Painful bi: Shenshu (BL 23),
(TE 5), Hegu (LI 4). Guanyuan (CV 4); 3. Fixed bi: Zusanli
Pain in the wrist: Yangchi (TE 4), (ST 36), Shangqiu (SP 5); 4. Heat bi:
Yangxi (LI 5), Yanggu (SI 5), Waiguan Dazhui (GV 14), Quchi (LI 11); 5. Ten-
(TE 5). don bi: Yanglingquan (GB 34); and 6.
Stiffness of the fingers: Yanggu (SI Bone bi: Dazhu (BL 11), Xuanzhong
5), Hegu (LI 4), Houxi (SI 3). (GB 39).
Numbness and pain in the fingers: Explanation: The above prescriptions
Houxi (SI 3), Sanjian (LI 3), Baxie (Ex- are formulated by selection of the local
tra). and distal points on the meridians supply-
CHAPTER 17 1NTERNAL DISEASES 477

ing the diseased areas. The principle of lingquan (OB 34), the Influential Point
the treatment is to remove obstruction of the tendon, is used to treat the tendon
from the meridians and collaterals and to bi. Dazhu (BL II), the Influential Point
regulate ying (nutrient qi) and wei (de- of the bone, Xuanzhong (OB 39), the
fensive qi) for elimination of wind, cold Influential Point of the marrow, can be
and damp. When the skin and muscles used together in treating the bone bi.
are diseased, shallow insertion should be
used. When bones and tendons are affect- Remarks
ed, deep insertion with retaining of the a) Bi syndromes may include such dis-
needles is recommended. The methods of eases as rheumatic fever, rheumatic ar-
acupuncture and moxibustion depend on thritis, rheumatoid arthritis, fibrositis,
symptoms and signs. Houxi (SI 3) com- neuralgia and gout.
municates with the Oovernor Vessel, and b) Dermal needle and cupping ther-
Shenmai (BL 6) with the Yangqiao Me- apies: Heavy tapping to induce slight
ridian. They are a set of the Eight Con- bleeding along the two sides of the spine
fluent points for the treatment of the or the local area of the affected joint plus
diseases of the shoulder, back, lumbar cupping is often used for the treatment of
region, legs, muscles, tendons and bones. skin bi and muscle bi associated with
Dabao (SP 21) is the major Luo- numbness, and bone bi characterized by
(Connecting) point of the spleen which stiffness and limitation of movement or
connects qi of the whole body, and Oeshu deformity of the joint.
(BL 17) is the Influential Point of the c) Acupuncture is effective in treating
blood. Combination of these two points mild bi syndromes. For severe cases, a
can be used to treat general pain. Dazhui long period of treatment is necessary. In
(OV 14) and Quchi (LI II) are used to chronic cases with exhaustion of ying
treat heat bi. Oeshu (BL 17) and Xuehai (nutrient qi) and wei (defensive qi) and
(SP 10) have the function of activating undernourishment of tendons and mus-
and nourishing the blood. The selection cles, the bi syndrome may turn into a wei
is based on the principle: "Wind will be syndrome.
naturally eliminated if blood circulates
smoothly." Fengchi (OB 20), the most 7. Wei Syndromes
important point for dispelling wind, can
be combined with Oeshu (BL 17) and The wei syndrome is characterized by
Xuehai (SP 10) to treat wandering bi and flaccidity or atrophy of the limbs with
vessel bi. Shangqiu (SP 5) and Zusanli motor impairment. It is also called "flac-
(ST 36) strengthen the function of spleen cid lame," for the leg is usually involved.
and stomach and eliminate damp to re- The wei syndrome was first described in
lieve the fixed bi. Ouanyuan (CV 4) and Chapter 44 of Plain Questions as a syn-
Shenshu (BL 23) strengthen the kidney drome mainly caused by heat in the lung
fire and relieve the painful bi. Yang- with the lobes scorched. The physicians
478 CHINESE ACCPUNCTl'RE AND MOXIBL'STlOI'

of later generations further developed the limb results from malnourishment of

this theory. Zhang Jingyue (1156-1228 the tendons due to exhaustion of body
A.D.) pointed out, "It is not a few cases fluid. This condition may be caused by
of wei syndromes that are due to the invasion of the lung by exogenous patho-
injury of primary qi leading to deficiency genic heat, or excessive heat remaining in
of essence which fails to irrigate, or defi- the lung after an illness.
ciency of blood which fails to nourish." b) Damp heat:
On the treatment of wei syndromes, Exogenous pathogenic damp invades
Chapter 44 of Plain Questions puts for- in the body, and the accumulation of
ward the theory: "Only points along damp is eventually transformed into heat
the Yangming Meridians are selected in which damages the muscles and tendons.
treating wei syndromes." The stomach is Hence, the muscles and tendons become
believed to be the sea of water and food, flaccid. The wei syndromes may also be
and the source of acquired essence. The caused by excessive intake of greasy food
Foot-Yangming Meridian is enriched which produces internal accumulation of
with qi and blood. The twelve meridians, damp heat, resulting in the stagnation of
tendons, bones, and muscles need the ac- qi and blood in the meridians and coli at-
quired qi and blood for nourishment, erals.
while the production of blood in the liver c) Deficiency of yin in the liver and
and essence in the kidney depends upon kidney:
the transformation of water and food. Since the liver stores blood and con-
Therefore, regulating the function of the trols the tendons, and the kidney stores
Stomach Meridian of Yangming is the essence and dominates the bones, pro-
main principle in treating the wei syn- longed illness or indulgent sexual activity
dromes. In clinical practice, treatment is causes loss of essence and blood, result-
determined according to differentiation ing in malnutrition of the tendons. Con-
of the syndrome as well as locality, etiol- ditions affecting the proper function of
ogy and pathogenesis of the disease. In a the liver and kidney may therefore also
chronic bi syndrome there may be pro- give rise to the wei syndrome.
longed motor impairment of the joint d) Trauma:
because of pain. In this case there devel- Contusion causes injury of the merid-
ops muscular atrophy or flaccidity of the ians and leads to retarded flow of qi and
limb on account of disuse. It should be blood in the meridians. As a reSUlt, the
differentiated from the wei syndrome muscles and tendons are poorly nour-
which is characterized by absence of ished, and become flaccid. Thus occurs
pain. the wei syndrome.

Etiology and Pathogenesis Differentiation

a) Burning heat in the lung: a) Heat in the lung:
The muscular flaccidity or atrophy of Main manifestations: Muscular f1ac-
CHAPTER 17 INTERNAL DISEASES 479

cidity of the lower limbs with motor im- heat.

pairment, accompanied by fever, cough, c) Deficiency of yin of the liver and
irritability, thirst, scanty and brownish kidney:
urine, reddened tongue with yellow coat- Main manifestations: Muscular flac-
ing, thready and rapid or rolling and cidity of the lower limbs with motor im-
rapid pulse. pairment, combined with soreness and
Analysis: Fever and cough are the re- weakness of the lumbar region, seminal
sults of the invasion of the lung by the emission, prospermia, leukorrhoea, dizzi-
pathogenic heat. Irritability, thirst and ness, blurring of vision, reddened tongue,
scanty, brownish urine indicate that the thready and rapid pulse.
body fluid has been damaged by the in- Analysis: In deficiency of yin of the
ternal heat. Muscular flaccidity and mo- liver and kidney the muscles, tendons and
tor impairment result from malnutrition bones are poorly nourished by essence
of the tendons and muscles and damage and blood, and hence occurs muscular
of essence and body fluid. The thready, flaccidity with motor impairment. Sore-
rapid pulse and reddened tongue with ness and weakness of the lumbar region,
yellow coating indicate that the body seminal emission and leukorrhoea are the
fluid has been injured by heat. The roIl- result of deficiency of essence in the kid-
ing, rapid pulse is associated with exces- ney. Since the kidney is located in the
sive heat. lumbar region, it stores essence, and its
b) Damp heat: meridians connect with the Thorough-
Main manifestations: Flaccid or slight fare Vessel and the Conception Vessel.
swollen legs, a little hot sensation on Dizziness and blurring of vision are
touch, general heaviness, sensation of caused by preponderance of yang in the
fullness in the chest and epigastric re- liver arising from deficiency of yin in the
gion, painful urination, hot and brownish kidney. Reddened tongue, thready and
urine, yellow sticky tongue coating, soft rapid pulse are signs of deficiency of yin
and rapid pu Ise. of the liver and kidney.
Analysis: Flaccidity of the legs is due d) Trauma:
to the stagnation of qi and blood in the Main manifestations: History of trau-
tendons and muscles caused by pro- ma, flaccid paralytic limbs, may be ac-
longed accumulation of internal damp- companied with incontinence of urine
heat. General heaviness is also due to and feces, relaxed or hesitant pulse, pink
accumulation of damp-heat. When damp- or dark purplish tongue with thin white
heat is accumulated in the chest, fullness coating.
sensation in the chest and epigastrium Analysis: Flaccid paralytic limbs arise
results. Hot, brownish urine, and painful from obstruction of the circulation of qi
urination suggest the downward flow of and blood at the injured site of trauma.
damp heat. Yellow sticky tongue coating, Incontinence of urine and feces is mainly
and soft rapid pulse are signs of damp- due to dysfunction of the kidney which
_480
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C_H_IN_'E_SE_AC_'U_Pl_lN_'CTURE AND MOXIBUSTION

fails to control urine and feces. In case of responding level of spinal injury.
trauma, the Governor Vessel which dom- Incontinence of urine: Zhongji (CV
inates the yang qi of the whole body is 3), Sanyinjiao (SP 6).
affected, and the qi activity of all zang-fu Incontinence of feces: Dachangshu
organs may be impaired, including the (BL 25), CHiao (BL 32).
function of the kidney in controlling ur- Explanation: In the above prescription
ine and feces. Damage of qi of the kidney points the Yangming Meridians are pre-
causes incontinence of urine and feces. dominating. This is based upon the state-
Hesitant pulse and dark purplish tongue ment in Internal Classic: "Only points
indicate blood stasis. along the Yangming Meridians are select-
ed to treat paralysis of the limbs." Yang-
Treatment lingquan (GB 34) and Xuanzhong (GB
Method: Main points are selected 39), the Influential Points of tendon and
from the Yangming Meridians to pro- marrow respectively, are added to enhance
mote circulation of qi in the meridians, the effect of nourishing the tendons and
bones. Feishu (BL 13) and Chize (LV 5)
and to nourish the tendons and bones. If
are used to dissipate heat from the lung.
heat or damp heat in the lung is the main
Pishu (BL 20) and Yinlingquan (SP 9)
etiological factor, the reducing method
eliminate damp heat. Ganshu (BL 18) and
should be used to dissipate heat. In case
Shenshu (BL 23) are chosen to tonify the
of deficiency of yin in the liver and kid-
yin in the liver and kidney. Huatuojiaji
ney, the reinforcing method should be
points are selected to regulate qi in the
employed. For trauma, puncture the Governor Vessel. Zhongji (CY 3) and
points on the affected side with even Sanyinjiao (SP 6) are taken to adjust the qi
movement method. in the kidney and bladder. Dachangshu
Prescription: (BL 25) and Ciliao (BL 32) improve the
Upper limb: Jianyu (LI 15), Quchi (LI function of the large intestine.
11), Hegu (LI 4), Waiguan (TE 5).
Lower limb: Biguan (ST 31), Huan- Remarks
tiao (GB 30), Xuehai (SP 10), Liangqiu a) The wei syndrome is seen in acute
(ST 34), Zusanli (ST 36), Yanglingq uan myelitis, progressive myatrophy, myath-
(GB 34), Jiexi (ST 41), Xu an zhong (GB enia gravis, multiple neuritis, sequeUae of
39). poliomyelitis, periodic paralysis, hysteri-
Supplementary points: cal paralysis, traumatic paraplegia, etc.
Heat in the lung: Chize (LU 5), Fei- b) Since the wei syndrome needs a
shu (BL 13). long period of treatment, the patients
Damp heat: Pishu (BL 20), Yin- should cooperate with the doctor during
lingquan (SP 9). the treatment. Tapping with dermal nee-
Deficiency of yin in the liver and kid- dles in the affected areas and along the
ney: Ganshu (BL 18), Shenshu (BL 23). affected meridians may also be added to
Trauma: Huatuojiaji points at the cor- the treatment.

- ~-------- ---
 Chapter 18
GYNECOLOGICAL AND OTHER DISEASES

I. GYNECOLOGICAL overtake of pungent food, overdosage

DISEASES of the warm property drugs acting on
uterus, or to fire transformed from stag-
nated liver qi, etc. All of these lead to the
1. Irregular Menstruation injury of the Thoroughfare and Concep-
Irregular menstruation refers to any tion vessels by excessive heat, bringing
about antedated menstruation.
abnormal change in menstrual cycle, in
ii) Qi deficiency:
quantity and color of flow, and oth-
This is caused by overexertion, impro-
er accompanying symptoms. Common-
per diet leading to weakness of the spleen
ly seen cases are antedated and postdated
qi and insufficient qi in the middle ener-
menstruation, irregular menstrual cycle.
gizer, which fails to control the men-
Menstruation earlier than due time by
strual flow, resulting in antedated men-
seven to eight days, or even twice a
ses. Dr. Zhang lingyue pointed out, "If
month, is regarded as antedated men- the pulse does not reflect excessive heat
struation, while menses later than due internally it means antedated menstrua-
time by eight to nine days or even once tion is caused by qi deficiency of the
every forty to fifty days is considered as heart and spleen that fail to control the
postdated menstruation. blood."
Menopathy is caused by many factors, b) Postdated menstruation:
such as the exogenous pathogenic cold, i) Blood deficiency:
heat and damp, emotional disturbances The blood may be marred due to
-worries, depressed rage, indulgence in chronic hemorrhage, debility resulted
sexual life, grand multiparity, etc., lead- from chronic diseases and mUltiparity.
ing to the disharmony between qi and Irregular diet and overexertion may in-
blood and the injury of the Thoroughfare jure the spleen and stomach, causing in-
and Conception vessels. sufficiency of blood in the Thoroughfare
and Conception vessels. Finally, postdat-
Etiology and Pathogenesis ed menstruation occurs.
a) Antedated menstruation: ii) Cold in the blood:
i) Heat in the blood: It is due mostly to constant yang defi-
It is due to abundance of the internal ciency and internal growth of cold, or
heat, yin deficiency and yang excess, or due to overtake of raw and cold food,

481
482 CHINESE AClJPl'NCTURE AND MOXIBL,STIOJl:

exposure to rain and cold during the Analysis: Dark red, thick and profuse
menstrual periods. Then the pathogenic menses indicate internal excessive heat,
cold invades the Thoroughfare and Con- which impairs the heart and liver, leading
ception vessels, impeding the free flow of to restlessness and fullness in the chest.
blood, hence the menstrual cycle delays. When the heat shifts from the heart
iii) Qi stagnation: down to the small intestine there appears
It is due to emotional depression, dis- scanty and dark yellow urine. The yellow
turbing the qi activity and resulting in qi tongue coating and the rapid pulse are
stagnation. The stagnated qi impairs the signs of internal heat.
smooth flow of blood which leads to ab- ii) Qi deficiency:
normal function of the Thoroughfare Main manifestations: Profuse, thin
and Conception vessels. The sea of blood and light red menses in shortened cycle,
cannot be filled up at due time, and post- lassitude, palpitation shortness of breath,
dated menstruation occurs. subjective empty and heavy sensation in
c) Irregular menstrual cycles: the lower abdomen, pale tongue with thin
i) Qi stagnation in the liver: coating, weak pulse.
It is due usually to depressed rage that Analysis: The spleen qi dominates the
hurts the liver and disturbs the storage of middle energizer and controls blood. Qi
blood, which leads to dysfunction of the insufficiency fails to check the blood,
blood in the Thoroughfare and Concep- there occurs disturbance of the Thor-
tion vessels and uterus, hence irregular oughfare and Conception vessels, leading
menstrual cycles. to profuse, thin and light red menses in
ii) Kidney deficiency: shortened cycle. Lassitude, shortness of
It is due to marriage at an immature breath and empty heavy sensation are
age, indulgence of sexual life, grand mul- manifestations of qi deficiency. Palpita-
tiparity, etc., which consume the essence tion and pale tongue account for blood
and blood. The kidney qi fails to conduct deficiency, and the weak pulse is a sign
its function in storing essence and ad- of qi deficiency.
justing the Thoroughfare and Concep- b) Postdated menstruation:
tion vessels, resulting in irregular men- i) Blood deficiency:
strual cycles. Main manifestations: Scanty and light
red menses in delayed cycle, empty and
Differentiation painful feeling in the lower abdomen,
a) Antedated menstruation: emaciation, sallow complexion, lusterless
i) Heat in blood: skin, dizziness and blurred vision, palpi-
Main manifestations: Shortened cycle, tation and insomnia, pink tongue with
dark red and thick blood flow in large little coating, weak and thready pulse.
quantities, restlessness, fullness in the Analysis: Owing to a chronic disease,
chest, brown urine, reddened tongue with weak body constitution or chronic hem-
yellow coating, rapid and forceful pulse. orrhage, blood cannot form the timely
 CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 48;1

tide in the sea of blood, bringing about suits in scanty and delayed menses with
scanty and light red menses in delayed distending pain in the lower abdomen.
cycle. When the blood fails to nourish the When the qi fails to travel smoothly,
uterus, there is an emptiness and pain in mental depression and stuffy chest pres-
the lower abdomen. When the meridians, ent. Since the Liver Meridian runs
vessels, muscles and skin are undernour- through the costal and hypochondriac re-
ished, there may appear emaciation, sal- gions, the stagnated liver qi gives rise to
low complexion and lustreless skin. When the distension in the hypochondrum and
the liver and heart fail to be nourished by breast. String-taut pulse is a typical sign
blood, dizziness, blurred vision, palpita- of liver disorder and qi stagnation.
tion and insomnia occur. If the tongue c) Irregular menstrual cycles:
is malnourished and the vessels are not i) Qi stagnation in the liver:
filled up, there present pink tongue and Main manifestations: Alteration of
weak thready pulse. menstrual cycles and quantity of blood
ii) Cold in the blood: flow, thick, sticky, and purple colored
Main manifestations: Scanty and menses difficult to flow, distension in the
dark-colored menses in delayed cycle, col- hypochondriac region and breast, dis-
ic pain in the lower abdomen, slightly tending pain in the lower abdomen, men-
alleviated by warmth, cold limbs, thin tal depression, frequent signing, thin
and white tongue, deep and slow pulse. white tongue coating and string-taut
Analysis: The invasion of pathogenic pulse.
cold during menstruation impedes blood Analysis: Depressed rage injuries the
flow, leading to scanty and dark-colored function of the liver, leading to un-
menses in delayed cycle. Cold in the smooth flow of qi and blood and disturb-
uterus hinders the smooth flow of qi and ance in the sea of blood, and finally to the
blood and then there appears colic pain. alteration of menstrual cycles and quant-
. Cold, yin by nature, injures yang qi and ity of blood flow. The stagnation of liver
brings about cold limbs. Thin and white qi causes impeded flow of blood, bringing
tongue coating, deep and slow pulse are about difficult menstruation, distension
signs of cold syndromes. in the hypochondriac region and breast,
iii) Qi stagnation: and distending pain in the lower abdo-
Main manifestations: Scanty and dark men. Frequent sighing may help to re-
red menses in delayed cycle, distending lieve the stagnated qi. String-taut pulse is
pain in the lower abdomen, mental de- a typical sign of liver qi stagnation.
pression, stuffy chest alleviated by belch- ii) Kidney deficiency.
ing, distension in the hypochondria and Main manifestations: Scanty, light red
breast region, thin, white tongue coating blood flow in altering cycles, dizziness
and string-taut pulse. and tinnitus, weak and aching of the low-
Analysis: Stagnated qi of the liver er back and knees, frequent night urina-.
brings about retarded blood flow and re- tion, loose stools. pale tongue with thin

- - - - - - - -----------------
4&i CHINESE ACUPUNCTURE AND MOXIBUSTION

coating, deep and weak pulse. Explanation: Quchi (LI 11) is the He-
Analysis: When there is insufficiency Sea Point of the Hand-Yangming Merid-
of kidney qi, disharmonized Thorough- ian while Xuehai (SP 10) is the Jing-
fare and Conception vessels bring on the River Point of the Foot-Taiyin Meridian.
derangement of the flow and ebb of tide When they are used together, heat is re-
in the sea of blood, resulting in the al- moved from blood. Zhongji (CY 3), the
teration of menstrual cycles. Insufficient intersecting point of the three yin merid-
kidney qi decreases the essence and ians of foot, works to regulate the Thor-
blood, leading to scanty, thin and light oughfare and Conception vessels and
red menses. Since the kidney dominates remove internal heat from the lower
bones, generates marrow, and has its energizer. Shuiquan (KI 5), Xi-Cleft
opening in the ear, and the Kidney Me- Point of the Kidney Meridian, streng-
ridian runs through the waist, deficiency thens yin, reduces heat and regulates
condition of the kidney causes lack of menses. All the points used together
marrow, impairs audibility and malnour- serve the purpose of clearing off heat and
ishes the waist, bringing on dizziness, regulating menstruation. Xingjian (LR 2)
tinnitus, sore and weak in knees and the is added to clear away the heat from the
lower back. When the kidney fails to liver in case of stagnated liver qi trans-
control urination and defecation there forming into fire. Rangu (KI 2) is used
appear frequent urination and loose to nourish yin, reduce heat and to regu-
stools. Pale tongue with thin coating and late menses.
deep weak pulse indicate kidney yang ii) Qi deficiency:
deficiency. Method: Select the main points from
the Conception Vessel, Foot-Taiyin and
Treatment Foot-Yangming Meridians to replenish qi
a) Antedated menstruation: so as to restore its function in controlling
i) Heat in the blood: blood. Acupuncture is applied with the
Method: Points of the Spleen and Kid- reinforcing method.
ney Meridians are selected as the princi- Prescription: Qihai (CY 6), Sanyinjiao
pal points. Acupuncture with the reduc- (SP 6), Zhongwan (CY 12), Zusanli (ST
ing method is applied to regulate the 36).
Thoroughfare and Conception vessels Explanation: Qihai (CY 6) can regu-
and clear off heat from blood. late qi of the whole body. Qi is the com-
Prescription: Quchi (LI 11), Zhongji mander of blood and when it is abundant
(CV 3), Xuehai (SP 10), Shuiquan (KI 5). blood is totally controlled by it. Sanyin-
Supplementary points: jiao (SP 6), Zhongwan (CY 12) and Zu-
Liver qi transforming into fire: sanli (ST 36) are chosen to build up the
Xingjian (LR 2). spleen qi, and strengthen spleen qi, con-
Yin deficiency with internal heat: trols blood. All the points applied togeth-
Rangu (KI 2). er attain the purpose of replenishing qi
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 485

and controlling blood. Method: Points of the Foot-Jueyin

b) Postdated menstruation: and Foot-Yangming Meridians are select-
i) Blood deficiency and cold In the ed as the principal points. Acupuncture is
blood: applied with the reducing method to ac-
Method: Points of the Conception tivate qi and blood flow.
Vessel and Foot-Taiyin Meridian are se- Prescription: Tianshu (ST 25), Qixue
lected as the principal points. In case of (KI 13), Diji (ST 8), Taichong (LR 3).
blood deficiency, acupuncture is applied Supplementary points:
with the reinforcing method to replenish Fullness of the chest: Neiguan (PC 4).
qi and nourish blood. Moxibustion is also Distension in the hypochondriac re-
advisable. In case of cold in the blood, gion and breast: Qimen (LR 74).
acupuncture is given with the even move- Analysis: Tianshu (ST 25) and Qihai
ment method. Strong stimulation of mox- (CY 6) are located on the Foot-Yangming
ibustion is used to warm up the meridians Meridian. Qixue (KI 13) can promote qi
and disperse cold. and blood flow and regulate the Thor-
Prescription: Guanyuan (CY 4), Qihai oughfare and Conception vessels. Diji
(CY 6), Sanyinjiao (SP 6). (SP 8), a qi point of the blood system can
Supplementary points: adjust blood and qi circulation. Taichong
Dizziness and blurred vision: Baihui (LR 3), the Yuan-(Primary) Point of the
(GY 20). Liver Meridian can soothe the liver and
Palpitation and insomnia: Shenmen regulate liver qi. The points are used
(HT 7). together to achieve free flow of qi and
Explanation: Guanyuan (CY 4), an blood. Neiguan (PC 6) is chosen to re-
intersecting point of the three yin merid- move fullness from the chest and adjust
ians of foot connects the uterus. When qi. Qimen (LR 14) is added to regulate qi
the reinforcing method is applied to so as to weed out the distension in the
Guanyuan (CY 4) and Sanyinjiao (SP 6), hypochondriac region and breast.
qi and blood are promoted, the Thor- c) Irregular menstrual cycles:
oughfare and Conception vessels are re- i) Qi stagnation in the liver:
gulated and then cold is dispelled from Method: Points of the Conception
them. Qihai (CY 6) assists to adjust qi Vessel and Jueyin Meridian are selected
and blood so that the Thoroughfare and as the principal points to ease the liver
Conception vessels are well regulated and and regulate the Thoroughfare and Con-
menses comes on time. Baihui (GY 20) ception vessels. Acupuncture is given
helps ascend qi and blood, nourishing with the even movement method.
the head and eliminating dizziness and Prescription: Qihai (CY 6), Siman (KI
blurred vision. Shenmen (HT 7) pacifies 14), Jiansi (PC 5), Ligou (LR 5).
the mind in case of palpitation and in- Supplementary points:
somma. Distension in the hypochondriac re-
ii) Qi stagnation: gion and breast: Tanzhong (CV 17), Qi-

---- --------------
486 CHINESE AClJPl!NCTURE AK[) MOXIBUSTION

men (LR 14). xin (KI 8). The irregular menstrual cycles
Mental depression: Shenmen (HT 7), get redressed naturally once the kidney
Taichong (LR 3). can carry out well its function in storing
Explanation: Qihai (CY 6) and Siman essence. Yaoyan (Extra) aims at the sore
(KI 14) can promote the flow of qi and and weak low back and knees, while Yin-
blood, regulate Thoroughfare and Con- gu (KI 10) strengthens the bones through
ception vessels. Located on the Jueyin kidney activation. Taixi (KI 3) and Bai-
Meridians, lianshi (PC 5) and Ligou (LR hui (GY 20) are added to promote mar-
5) remove stagnation of the liver qi and row and nourish the brain by means of
treat disordered menses. The irregular tonifying kidney to treat dizziness and
menstrual cycles will be removed once tinnitus.
the liver restores its normal function and
the Thoroughfare and Conception vessels Remarks
are harmonized. Tanzhong (eY 17) and Included in this disorder is the irregu-
Qimen (LR 14) are incl uded in t he pres- lar menorrhea resulted from dysfunction
cription to soothe the liver and relieve the of antehypophysis or from ovarian dys-
stagnated qi of the liver and distending function.
pain in the hypochondriac region and
breast. Shenmen (HT 7) and Taichong 2. Dysmenorrhea
(LR 3) ease the mind and relieve depres-
sion. Dysmenorrhea refers to the pain ap-
ii) Kidney deficiency: pearing in the lower abdomen and lower
Method: Points on the Conception back before, after or during menstrua-
Yessel and Foot-Shaoyin Meridian are tion. The pain, sometimes intolerable, oc-
selected as the principal points. Acupunc- curring during the cycle of menses is
ture is given with the reinforcing method. known as painful menstruation.
Moxibustion is used to replenish the kid- Dysmenorrhea is principally ascribed
ney qi and regulate the Thoroughfare to the impeded flow of qi and blood in
and Conception vessels. the uterus. Deficiency or stagnation of qi
Prescription: Guanyuan (CY 4), Shen- and blood may cause unsmooth flow of
shu (BL 23), liaoxin (KI 8). menstruation. Dysmenorrhea is clinically
Supplementary points: classified into deficiency and excess type.
Sore and weak low back and knees:
Yaoyan (Extra), Yingu (KI 10). Etiology and Pathogenesis
Dizziness and tinnitus: Baihui (GV a) Excess syndrome:
20), Taixi (KI 3). It is due to stagnation of the liver
Explanation: Shenshu (BL 23), the qi, which fails to carry the free flow of
Back-Shu point of the kidney, can streng- blood. The impaired flow of blood causes
then congenital essence when used to- disharmony between the Thoroughfare
gether with Guanyuan (CY 4) and liao- and Conception vessels and stagnation of
CHAPTER 18 GYNECOLOGICAL Al'iD OTHER DlSEASES
----
blood in the uterus, resulting in pain. pulse are signs of qi stagnation and blood
Another cause is the affection of external stasis. When the cold and damp retain in
cold or intake of cold drinks during men- the uterus and surround the blood, there
strual periods, which hurts the lower present impeded scanty menses with clots
energizer, and makes the cold retain in and pain in the lower abdomen. Since the
the uterus. Finally there appears retarded uterus connects with the kidney, se-
menstruation with pain. vere pain refers to the waist and back.
b) Deficiency syndrome: Warmth alleviates the pain for it accel-
In circumstances of qi and blood defi- erates the flow of blood. White tongue
ciency due to either weak body-build or coating, deep and string-taut pulse are
chronic disease, menstruation drains up signs of collection of internal cold and
the sea of blood and deprives the uterus damp ..
from nourishment, then pain occurs. b) De/icienc.v syndrome:
Main manifestations: Dull pain ap-
Differentia tion pearing by the end of or after menstrua-
a) Excess syndrome: tion, alleviated by warmth and pressure,
Main manifestations: Pain in the low- pink, scanty and thin menses, thready
er abdomen, usually starting before men- and weak pulse accompanied by aversion
struation, retarded and scanty and dark to cold, cold extremities, pale complex-
purple menses with clots, distending pain ion, palpitation and dizziness.
in the lower abdomen, alleviated by pass- Analysis: When qi and blood is insuf-
ing out the clots, distension in the hy- ficient the sea of blood is not able to
pochondriac region and breast, purplish provide enough nutrients to the uterus.
tongue with purple spots on its edge, This is the cause of dull pain, which can
deep and string-taut pulse; pain and cold be alleviated by pressure and warmth.
feeling in the lower abdomen referring to Deficiency of both qi and blood also gives
the waist and back, alleviated by warmth, ground to scanty pink and thin menses.
scanty dark red menses with clots. sticky Severe deficiency of qi and blood causes
and white tongue coating, deep string- the failure of the heart and head to be
taut pulse. nourished, leading to palpitation, dizzi-
Analysis: The depressed liver qi gives ness and pale complexion. The weakened
rise to the distending pain in the low- yang qi after a chronic disease is the
er abdomen, hypochondriac region and cause of aversion to cold and cold ex-
breast, and scanty and impeded menses. tremities. Thready and weak pulse indi-
Qi stagnation inevitably leads to blood cates deficiency of both qi and blood.
stasis, so the menses appears dark purple
with clots. The release of clots helps to Treatment
weed out a little stagnation, alleviating a) E'(cess syndrome:
the pain. Purplish tongue with purple Method: Acupuncture is given with
spots on its edge. deep and string-taut the reducing method. Points of the Con-
488 CHINESE ACUPUNCTURE AND MOXIBUSTION

ception Vessel and Foot-Taiyin Meridian b) Deficiency syndrome:

are selected as the principal points. Both Method: Points of the Conception
acupuncture and moxibustion are used in Vessel, Spleen and Kidney Meridians are
case of cold syndromes to adjust qi activ- selected as the principal points. Acupunc-
ities, invigorate blood flow and restore ture is given with the reinforcing method
the functions of meridians. and moxibustion to regulate qi and blood,
Prescription: Zhongji (CY 3), Ciliao warm up and nourish the Thoroughfare
(BL 32), Hegu (LI 4), Xuehai (SP 10), and Conception vessels.
Diji (SP 8), Taichong (LR 3). Prescription: Guanyuan (CY 4), Pishu
Supplementary points: (BL 20), Shenshu (BL 23), Zusanli (ST
Distending pain in the lower abdo- 36), Sanyinjiao (SP 6).
men: Siman (KI 14), Shuidao (ST 28). Explanation: Guanyuan (CY 4) is an
Pain with cold feeling in the lower intersecting point of the three foot-yin
abdomen: Guilai (ST 29), Daju (ST 27). meridians. When moxibustion is applied
Explanation: Zhongji (CY 3) serves to to it and Shenshu (BL 23), it may warm
regulate the qi in the Thoroughfare and up the lower energizer, benefit essence,
Conception vessels. When it is applied blood and finally the Thoroughfare and
together with Xuehai (SP 10), Diji (SP Conception vessels. Pishu (BL 20), Zu-
8), the Xi-(Cleft) Point of the Spleen sanli (ST 36) and Sanyinjiao (SP 6)
Meridian, may invigorate blood flow grouped together can tonify the spleen
and menstruation. Taichong (LR 3), the and stomach, and benefit qi and blood.
Yuan-(Primary) Point of the Liver Me- Dysmenorrhea is naturally removed
ridian can free the stagnated liver qi, when the uterus is nourished by abun-
paired with Hegu (LI 4) can regulate qi dant qi and blood, and the balanced equi-
and blood flow and eliminate pain. Ciliao librium of the Thoroughfare and Con-
(BL 32) is an empirical point for dysme- ception vessels.
norrhea. For distending pain in the lower
abdomen it is used together with Siman Remarks
(KI 14), Shuidao (ST 28) to regulate This disorder often involves in patho-
the Thoroughfare and Conception ves- logical changes of the genitalia, and re-
sels and remove blood stasis and pain. lates to endocrinal and neuropsychiatri-
Moxibustion applied to Guilai (ST 29) cal factors. If dysmenorrhea is secondary,
and Daju (ST 27) warms up the related treatment should be given to the primary
meridians and eliminates pain in the low- cause.
er abdomen. The above points used to-
gether are to promote the flow of qi, 3. Amenorrhea
remove blood stasis, warm up meridians
and dissipate cold. Thus dysmenorrhea Menstrual flow begins at about four-
gets cured when the Thoroughfare and teen in healthy girls. Menstruation that
Conception vessels are well adjusted. does not come until 18 or suppression of

--- ~ --- -----

CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 489

menstruation for over three months is with purplish spots on its borders, deep
called amenorrhea. Stop of menses dur- string-taut pulse.
ing gestation period and lactation period Analysis: Worry and anger cause qi
is of normal physiological phenomena. stagnation and failure of it to control
The causative factors of amenorrhea fall blood, bringing on blockage of the Thor-
into deficiency and excess types. The de- oughfare and Conception vessels and
ficiency type is mostly seen due to defi- amenorrhea. The abnormal function of qi
ciency of blood, and the excess type is gives rise to lower abdominal distending
caused by excessive pathogenic factors pain and fullness in the chest and epigas-
obstructing the passage of menses. trium. Blood stasis retaining in the sea of
The clinical differentiation and treat- blood hinders menstrual flow, manifest-
ment are usually conducted in the light of ed by the abdominal pain aggravated by
blood stagnation and blood depletion. pressure and hard mass in the lower ab-
domen. Purple tongue coating with pur-
Etiology and Pathogenesis plish spots on its borders and deep string-
a) Blood stagnation: taut pulse are signs of stagnation of qi
It is due to the seven emotional dis- and blood.
turbances, stagnation of liver qi resulting b) Blood depletion:
in retardation of both qi and blood in the Main manifestations: Delayed men-
uterus and obstruction in the passage of strual cycle, gradual decrease of menses
menses. and amenorrhea, sallow complexion in
b) Blood depletion: prolonged cases, laSSitude, vertigo and
Improper intake of food or overstrain dizziness, poor appetite, loose stools, dry
undermines the reproducing source of qi skin, pale tongue with white coating, slow
and blood, severe or chronic diseases that weak pulse, all of which are signs of
consume blood, or by grand multipara or deficiency of qi and blood; dizziness and
indulgence in sexual life that exhaust ess- tinnitus, sore and weak low back and
ence and blood, all of which may drain knees, dry mouth and throat, hot sensa-
the sea of blood, deprive the Thorough- tion in the palms, soles and epigastrium,
fare and Conception vessels of nourish- afternoon fever and night sweating, pale
ment and result in amenorrhea. tongue with little coating, string-taut and
thready pulse, all of which are signs of
Differentiation deficiency of essence and blood.
a) Blood stagnation: Analysis: Blood is transferred from
Main manifestations: Absence of food through the function of transporta-
menses for months, lower abdominal dis- tion and transformation of the spleen,
tending pain aggravated by pressure, and dysfunction of the spleen leads to
hard mass in lower abdomen, distension blood deficiency. Blood deficiency causes
and fullness in the chest and hypochon- malnutrition of the Thoroughfare and
driac region, dark purple tongue coating Conception vessels and the voidness in

~---- - - -----
 490 CHll'\ESE ACL:Pl 'NCTl'RE AND MOXIBUSTION
------

the sea of blood. Hemorrhage causes ex- Explanation: Zhongji (CY 4), an in-
haustion of blood, and finally delayed tersecting point of the three foot-yin me-
menstrual cycle and the gradual decrease ridians, may regulate the Thoroughfare
of menses till amenorrhea. Blood defi- and Conception vessels and dredge the
ciency fails to nourish the muscles, skin blockage from the lower energizer. Gui-
and head, bringing on sallow complexion, lai (ST 29) is chosen as a local point
dry skin, vertigo and dizzines and lassi- to remove blood stasis from the uterus.
tude. Dysfunction of transportation and Xuehai (SP 10) and Taichong (LR 3)
transformation of the spleen gives rise applied together can regulate the liver qi,
to poor appetite and loose stools. Pale and relieve stagnation and stasis. Hegu (L
tongue with white coating and slow, weak 14) and Sanyinjiao (SP 6) can get qi and
pulse are signs of blood depletion. Since blood down to restore the normal men-
the kidney dominates bone and marrow, struation. Siman (KI 14) may be added
while the brain is the sea of marrow, when there is pain and hard mass in the
deficiency in the kidney may lead to diz- lower abdomen aggravated on pressure.
ziness, tinnitus, sore and weak low back b) Blood depletion:
and knees. Yin deficiency produces inter- Method: Select points of the Concep-
nal heat manifested by the dry mouth and tion Vessel, Liver, Spleen and Kidney
throat, hot sensation in palms, soles and Meridians. Acupuncture is used with the
epigastrium, afternoon fever and the reinforcing method. Moxibustion is ap-
night sweating. Pale tongue and string- plied sometimes to tonify blood and res-
taut thready pulse are signs of deficiency tore menses.
of essence and blood. Prescription: Guanyuan (CY 4), Gan-
shu (BL US), Pishu (BL20), Shenshu (BL
Treatment 23), Zusanli (ST 36), Sanyinjiao (SP 6).
a) Blood stagnation: Explanation: The spleen. the founda-
Method: Points of the Conception tion of the acquired essence, abstracts
Vessel, Foot-Taiyang and Foot-JlIeyin nutrient particles from food and trans-
Meridians are selected as the principal forms them into qi and blood. When
points. Acupuncture with the reducing blood supply is abundant the menstrual
method is used to remove the stagnation cycle is normal. So Pishu (BL 20), Zusan-
and regulate the circulation of qi and Ii (ST 36) and Sanyinjiao (SP 6) are se-
blood in the meridians. lected to strengthen the function of the
Prescription: Zhongji (CY 3), GlIilai spleen and stomach. The kidney is the
(ST 29), Xuehai (SP 10), Taichong (LR foundation of congenital essence, and
3), Hegu (L I 4), Sanyinjiao (SP 6). ample kidney qi guarantees sufficient qi
Supplementary points: and blood. For this reason Shenshu (BL
Pain in the lower abdomen with hard 23) and Guanyuan (CV 4) are chosen to
mass aggravated by pressure: Siman (KI replenish kidney qi. Ganshu (BL 18) is
14). selected to promote the blood in the liver,

._-- ._-_.- -------------------- ..- - - - - _._--- - - - - - - - - - -

CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 491

where blood is stored. When the spleen, excess of yang, exposure to external path-
liver and kidney carry out well their func- ogenic heat, indulgence in spicy food and
tions of controlling blood, storing blood disturbance of the seven emotions, etc.,
and essence respectively, the Thorough- which transform into internal fire. The
fare and Conception vessels are well Thoroughfare and Conception vessels are
nourished and amenorrhea is cured. injured by heat and there appears bleed-
ing. It may also be due to exasperation
Remarks that hurts the liver. Abundant liver fire
Included in this disease is amenorrhea expels the blood out of its shedding
resulted from endocrinal and neuropsy- house, causing metrorrhagia.
chiatrical factors. b) Qi deficiency:
Worries, irregular intake of food and
4. Uterine Bleeding overstrain may damage the spleen qi.
A weakened spleen is unable to restrict
Vaginal hemorrhage beyond men- blood, instabilizes the activities of the
strual period, either copious or contin- Thoroughfare and Conception vessels
uously dripping, is generally defined as and finally metrorrhagia presents.
metrorrhagia. The copious bleeding with
a sudden onset is referred to as profuse Differentiation
metrorrhagia, and the scanty bleeding a) Excessive heat:
with a gradual onset as continuous scanty Main manifestations: Sudden onset of
uterine bleeding. Although they are dif- profuse or prolonged continuous vaginal
ferent in manifestations, the two are in- bleeding in deep red color, fidgets, insom-
tertransmutable during the process of the nia, dizziness, red tongue with yellow
disease course. Chronic profuse bleeding coating, rapid pulse.
consumes qi and blood, leading to contin- Analysis: The blood escape is due to
uous scanty bleeding, whereas prolonged excessive internal heat. When the heat
scanty bleeding becomes worse, it inevit- disturbs the mind there present fidgets
ably turns to profuse bleeding. In terms and insomnia. Dizziness is caused by the
of severity, the profuse bleeding is severe upward going of heat. Red tongue with
and the scanty bleeding is comparatively yellow coating and rapid pulse are signs
mild. It says in Recipes for Saving Lives, of heat in the blood.
"Vaginal bleedings are of the same scope b) Qi deficiency:
of a disease, while the mild one is called Main manifestations: Sudden profuse
continuous scanty bleeding and the se- bleeding or continuous scanty bleeding
vere one is named profuse metrorrhagia." marked by light red and thin blood, lassi-
tude, shortness of breath, apathy, anorex-
Etiology and Pathogenesis ia, pale tongue, thready weak pulse.
a) Excessive heat: Analysis: It is caused by the failure of
The causative factors may be constant the qi in control of blood and the disor-
492 CHINESE ACUPUNCTURE AND MOXIBUSTION

dered Thoroughfare and Conception ves- of varied symptoms, Quchi (L I 11) is

sels, lassitude, shortness of breath and added to dissipate the pathogenic heat,
apathy are manifestations of qi deficien- and Shaofu (HT 8) is used to clear away
cy in the middle energizer. Anorexia de- the heart fire, and Taichong (LR 3) to
rives from the dysfunction of the spleen reduce the liver fire.
in transportation and transformation. b) Qi deficiency:
The light-colored and thin blood is due to Method: Select the points of the Con-
failure of blood to be warmed up. The ception Vessel and Foot-Taiyin Meridian
pale tongue and thready weak pulse are as the principal points. Acupuncture with
signs of deficiency of qi and blood. the reinforcing method and moxibustion
are employed to promote the restricting
Treatment function of qi.
a) Excessive heat: Prescription: Baihui (GV 20), Guan-
Method: Mainly select points of the yuan (CV 4), Zusanli (ST 36), Sanyinjiao
Conception Vessel and Foot-Taiyin Me- (SP 6), Yinbai (SP 1), Yangchi (TE 4).
ridian. Acupuncture with the reducing Supplementary points:
method is used to clear off heat and stop Spleen qi deficiency manifested by an-
bleeding. orexia and loose stools: Pishu (BL 20),
Prescription: Zhongji (CV 3), Xuehai Weishu (BL 21).
(SP 10), Yinbai (SP 1), Ququan (LR 8). Explanation: Guanyuan (CV 4) can
Supplementary points: adjust the Thoroughfare and Conception
Affection of external heat: Quchi (L I vessels, promote the restricting function
11). of qi and stop uterine bleeding. Sanyin-
Excessive heart fire: Shaofu (HT 8). jiao (SP 6), Yinbai (SP 1) and Zusanli
Excessive liver fire: Taichong (LR 3). (ST 36) are together used to tonify the
Explanation: Zhongji (CV 3), the spleen and foster the restriction of qi
meeting point of the three foot yin me- on blood. Moxibustion applied to Bai-
ridians and the Thoroughfare and Con- hui (GV 22) helps the ascending of yang
ception vessels, is used to adjust the qi of qi, an application of the principle of
the Thoroughfare and Conception vessels using upper points for lower disorders.
so as to check the escape of blood. Yin- Yangchi (TE 4) is the Yuan-(Primary)
bai (SP 1), the ling-eWell) Point of the Point of the Triple Energizer Meridian,
Spleen Meridian, is often helpful to me- which maintains the qi in general. Nee-
trorrhagia. Ququan (LR 8) functions to dling Yangchi (TE 4) with the reinforc-
sooth and regulate the liver qi. Xuehai ing method may build up the functions of
used (SP 10) with the reducing method the Thoroughfare and Conception vessels
may remove heat from blood to stop and foster the restriction of qi on blood.
bleeding. All the points functioning to-
gether can clear heat, reduce fire, regu- Remarks
late meridians and cease bleeding. In case This disease includes functional uter-
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 493

ine bleeding due to ovarian dysfunction, damp heat turns out to be leukorrhea.
but organic disorders of the reproductive
system must be excluded. Differentiation
a) Deficiency in the spleen:
5. Morbid Leukorrhea Main manifestations: Profuse thiCk,
white or light yellow vaginal discharge
Morbid leukorrhea is a disease symp- without smell, pale or sallow complexion,
tomized by persistent excessive mucous lassitude, poor appetite and loose stools,
vaginal discharge. edema in the lower limbs, pale tongue with
The chief causative factors of leukor- white sticky coating, slow weak pulse.
rhea are deficiency of the spleen qi and Analysis: On account of deficiency in
stagnation of the liver qi, downward in- the spleen, the downward infusion of
fusion of damp heat or kidney qi de- water and damp form leukorrhea. With
ficiency, leading to dysfunctions of the deficiency in the spleen, the sapped yang
Thoroughfare, Conception and Belt ves- qi in the middle energizer gives rise to
sels, and leukorrhea. The ancient doctors poor appetite, loose stools and edema in
classified the condition by its color into the lower limbs, lustreless and pale or
white, yellow, red, red-white and multi- sallow complexion, cold extremities and
colored leukorrhea, among which white lassitude. Pale tongue with white sticky
and yellow leukorrhagia are commonly coating and slow pulse are signs of defi-
seen in clinic. ciency in the spleen.
b) Deficiency in the kidney:
Etiology and Pathogenesis Main manifestations: Profuse and
a) Deficiency in the spleen: continuous discharge of thin and tran-
Improper diet and overstrain hinder sparent whites, severe soreness of the low
the spleen qi from transforming and back, cold sensation in the lower abdo-
transporting nutrient particles, which ac- men, frequent and excessive urine, loose
cumulate in the lower energizer and turn stools, pale tongue with thin coating, and
to damp and finally leukorrhea appears. deep pulse.
b) Deficiency in the kidney: Analysis: Deficient kidney yang
Constant deficiency of kidney qi, causes Belt and Conception vessels to
grand mUltipara, dysfunctions of the Belt slacken its restriction of essence, result-
and Conception vessels lead to leukor- ing in the continuous vaginal discharge.
rhea. The dimmed fire in the Mingmen is too
q) Damp heat: weak to warm up the bladder and spleen
The presence of excessive damp due and brings on frequent urine in large
to deficiency in the spleen, changes into volume and loose stools. Sore low back is
heat. Prolonged stagnated liver qi may due to a weakened kidney that is situated
transform into heat and amalgamate with here. When the weak kidney yang fails to
the damp. The downward infusion of keep the uterus warm, there appears a
494 CHIl':ESE ,\CCPCl':CTCRE Al':D l\IOXIBCSTlO:\,

cold sensation in the lower abdomen. and Yangming Meridians. Acupuncture

Pale tongue with thin white coating and with the reinforcing method and moxi-
deep pulse are signs of deficiency of the bustion is used to build up the spleen and
kidney yang. remove damp, regulate Conception Ves-
c) Damp heat: sel and stabilize Belt Vessel.
Main manifestations: Sticky, viscous Prescription: Daimai (BL 26), Qihai
and stinking yellow leukorrhea in large (CV 6), Baihuanshu (Bl 30), Yin-
quantity, itching in the vulva, dry stool, lingq uan (SP 9), Zusanli (ST 36).
scanty and yellow urine, soft and rapid Explanation: Daimai (BL 26), an in-
pulse, sticky yellow coating, or leukorrhea tersecting point of the Bel t Vessel and
in reddish yellow color, bitter taste in the Foot-Shaoyang Meridians, stabilizes the
mouth, dry throat, irritability with a Belt Vessel and is a cure for leukorrhag-
feverish sensation, palpitation, insomnia, ia. Qihai (CV 6) regulates qi, resolves
yellow coating, string-taut and rapid pulse. damp, adj usts the Conception Vessel and
Analysis: The downgoing damp and stabilizes the Belt Vessel. Baihuanshu
heat hurt the Conception and Belt ves- (BL 30) is selected as an adjacent poi nt to
sels. This is the cause of leukorrhagia. check leukorrhagia. Yinlingq uan (SP 9)
The pathogenic heat amalgamated with and Zusanli (ST 36), major point in this
damp gives rise to the yellow color, visi- prescription, are paired to build up the
cosity and stench of the whites and the spleen and remove damp.
itching in the vulva. The internal accu- b) Deficiency in the kidney:
mulation of the pathogenic damp is the Method: Select points mainly from
cause of dry stools and scanty yellow the Conception Vessel and Foot-Shaoyin
urine. Soft rapid pulse and yellow sticky Meridian. Acupuncture with the rein-
tongue coating are signs of damp and forcing method and moxibustion are used
heat. There appear irritability, bitter taste to promote yang qi. tonify the kidney and
in the mouth and dry throat, when the stabilize the Conception and Belt vessels.
pathogenic heat is transformed from the Prescription: Shenshu (BL 23), Guan-
stagnated liver qi. Heat in the blood yuan (CV 4), Dahe (Kl 12), Daimai (Bl
causes reddish leukorrhea. When heat 26), Fuliu (KI 7).
disturbs the mind there present irritabili- Explanation: Shenshu (Bl 23), Guan-
ty, feverish sensation, palpitation and in- yuan (CV 4), Dahe (KI 12) and Daimai
somnia. The string-taut rapid pulse and (BL 26), a combination of adjacent and
yellow coating imply accumulated heat in distal points, are applied together to pro-
the Liver Meridian. mote yang qi and tonify the kidney so as
to restore its storing function, and stabi-
Treatment lize the Conception and Belt vessels, and
a) Deficiency in the spleen: finally ch eck leukorrhagia. Daimai (Bl
Method: Main points are selected 26) is selected aiming at leukorrhagia.
from the Conception Vessel, Foot-Taiyin c) Damp heat:
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 495

Method: Mainly select points from 6. Morning Sickness

the Conception Vessel and Foot-Taiyin
Meridian. Acupuncture with the reduc- Morning sickness is marked by a
ing method is employed to clear heat, group of symptoms including nausea,
remove damp, adjust the Conception vomiting, dizziness, anorexia within the
Vessel and stabilize the Belt Vessel. first trimester of gestation. It is a com-
Prescription: Zhongji (CV 3), Ciliao monly seen disorder appearing in early
(BL 32), Sanyinjiao (SP 6), Taichong stage of pregnancy. Severe condition may
(LR 3). emaciate the pregnant woman very quick-
Supplementary points: ly and trigger off other diseases.
Itching in the vulva: Ligou (LR 5). The factors are due mostly to deficien-
Reddish leukorrhea: Xuehai (SP 10). cy of stomach qi, upward flux of the fetal
Excessive heat: Quchi (L I 11). qi invading the stomach, and perversive
Explanation: Zhongji (CV 3) is the flow of stomach qi.
Front-(Mu) Point of the bladder. It
works to clear damp heat of the lower Etiology and Pathogenesis
energizer when it is applied with the re- It is caused by constant deficiency of
ducing method. Ciliao (BL 32) clears heat the stomach qi, ceasation of menstrua-
and resolves damp to check leukorrhagia. tion after pregnancy and hyperfunction
Sanyinjiao (SP 6), an intersecting point of the Thoroughfare Vessel, which fUr-
of the three yin meridians of foot tonifies ther affect the Yangming Meridian, lead-
the spleen, removes damp and reduces ing to perversive flowing of the feeble
the liver fire. The above points grouped stomach qi together with the qi in the
together serve the purpose of clearing Thoroughfare Vessel, hence nausea and
heat, resolving damp, adjusting the Con- vomiting. In some cases, when the blood
ception Vessel and stabilizing the Belt flows to nurture the fetus there results in
Vessel. Ligou (LR 5) cures the itching in insufficient liver blood and hyperactivity
the vulva by removing damp and heat of liver yang accompanied by weakened
away from the Liver Meridian. Xuehai spleen and stomach, leading to nausea
(SP 10) eliminates reddish leukorrhea by and vomiting.
clearing heat from blood. In case of ex-
cessive heat, Quchi (L I 11) is used to Differentiation
clear the heat. The right usage of the a) Deficiency in the spleen and stomach:
auxiliary point can enhance the therapeu- Main manifestations: Nausea and
tic results. vomiting of liquid or undigested food
immediately after meals, fullness and dis-
Remark tending feeling in the chest, lassitude and
This disease covers infections in the sleepiness, pale tongue with white coat-
reproductive organs such as vaginitis, ing, slippery and weak pulse during the
cervicitis, endometritis and annexitis, etc. first trimester of pregnancy.

- - - - - - - - -- ------ -
496 CHINESE ACUPUNCTURE AND MOXIBUSTIOr;

Analysis: Blood centered in the lower bitter or sour liquid. Yellowish coating
abdomen after pregnancy, the qi of the and string-taut slippery pulse are signs of
Thoroughfare Vessel gushes upward and disharmony between the liver and the
the stomach qi is unable to descend due stomach.
to the weakened spleen and stomach.
The stomach qi does not go downward, Treatment
instead, upward with the qi of the Thor- a) Deficiency in the spleen and stomach:
oughfare Vessel, causing nausea, anoex- Method: Select points mainly from
ia and vomiting right after intake of the Foot-Yangming and Foot-Taiyin Me-
food. Weakened spleen and stomach ridians. Acupuncture with the even
leads to the insufficiency of yang qi in movement method is applied to build up
the middle energizer, manifested by full- the spleen, harmonize the stomach and
ness and distension in the epigastrium, quell the perversive flowing of qi so as to
lassitude and sleepiness, and vomiting of check vomiting.
liquid. Pale tongue with white coating Prescription: Zhongwan (CV 12),
and weak slippery pulse are signs of Shangwan (CV 13), Neiguan (PC 6), Zu-
deficiency in the spleen and stomach sanli (ST 36), Gongsun (SP 4).
after pregnancy. Explanation: Zhongwan (CV 12), the
b) Disharmony between the liver and Confluential Point of the fu organs and
stomach: Front-(Mu) Point of the stomach, func-
Main manifestations: Vomiting of bit- tions to harmonize the stomach when
ter or sour liquid, epigastric fullness adopted together with Shangwan (CV
and hypercondriac pain, frequent belch- 13). Zusanli (ST 36), the He-(Sea) Point
ing and sighing, mental depression, dizzi- of the Stomach Meridian, can tonify the
ness and eye distension, yellowish tongue spleen, harmonize the stomach and quell
coating and string-taut slippery pulse in the adversive flow of the stomach qi.
the early stage of gestation. Gongsun (SP 4) is the Luo-( Connecting)
Analysis: The stagnated liver qi trav- Point of the Spleen Meridian as well as
els adversely along the Liver Meridian the Confluential Point linking the Thor-
via the stomach to diaphram, hypochon- oughfare Vessel. When it is paired with
drium and chest, which causes nausea, Neiguan (PC 6), it amplifies its function
vomiting, epigastric fullness, distending of quelling the upward going of stomach
pain in the chest and hypochondrium, qi and checking vomiting. All the points
frequent belching and mental depression. grouped together achieve the aim of ton-
Dizziness and eye distension are conse- ifying the spleen, harmonizing the stom-
quence of the upward influx of the liv- ach, descending the stomach qi and stop-
er qi. The liver and gallbladder are ping vomiting.
interiorly-exteriorly related. When there b) Disharmony between the liver and
is internal liver heat fire of the gallblad- stomach:
der discharges, resulting in vomiting of Method: Select points chiefly from
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 497

the Foot-Yangming and Jueyin Meridi- Etiology and Pathogenesis

ans. Acupuncture with the even move- a) Deficiency of qi and blood:
ment method is used to relieve liver stag- Weak constitution with insufficient qi,
nation and harmonize the stomach so as exhaustion through premature contrac-
to check vomiting. tion, premature amniorrhea, and deple-
Prescription: Tanzhong (CY 17), tion of blood due to hemorrhage, all lead
Zhongwan (CY 12), Neiguan (PC 6), Zu- to prolonged labor. In Understanding of
sanli (ST 36), Taichong (LR 3). Childbirth, it says, "Physical weakness
Explanation: Since deficiency in the and early exertion of force have exhaust-
spleen and stomach and upward flow of ed the mother before the baby is deliv-
liver qi are significant to the disease, ered and thus the baby gets stuck. Dry-
Zhongwan (CY 12) and Zusanli (ST 36) ness in the vagina also brings about diffi-
are used to tonify the spleen and harmo- cult delivery."
nize the stomach, Tanzhong (CY 17), the b) Qi stagnation and blood stasis:
Influential Point of qi, is to bring qi down. Fear or too much worry over the
Neiguan (PC 6), Taichong (LR 3) from the forthcoming delivery retards qi and stag-
Jueyin Meridians are to soothe the liver, nates blood. Extreme leisure during ges-
regulate the qi, counteract the abnormal tation leads to impaired flow of qi and
upflow of qi and check vomiting. blood. Affection of external cold during
delivery hinders the circulation of qi and
Remarks blood. All of them are causative factors
a) Acupuncture should not be applied of prolonged labor. lust as Golden Mirror
to many points, nor with strong stimula- of Medicine says, "Prolonged labor de-
tion when the fetus is still young in the rives from various factors such as seeking
early stage of gestation, lest the fetal qi comfort and ease and too much sleep,
should be affected. both of which lead to retarded flow of qi;
b) It is appropriate to keep the patient or from fright and worry over the oncom-
in bed and away from raw, cold or greasy ing labor...and obstruction of vagina by
food. In the hope of adjusting and replen- blood stasis from an injured uterus."
ishing the stomach qi, multiple meals
with a little intake of food is advisable. Differentiation
a) Deficiency of qi and blood:
7. Prolonged Labor Main manifestations: Dull and parox-
(Appendix: Malposition of Fetus) ysmallabor pains with mild weighing and
distending sensation, or profuse hemor-
Parturition lasting over twenty-four rhage in light color, pale complexion, las-
hours is defined as prolonged labor. It is situde, palpitation, shortness of breath,
often due to weak contraction and force- pale tongue, weak pulse.
less contraction of the womb, or narrow Analysis: Since both qi and blood are
pelvic fetal and malposition of fetus. deficient and the puerperant is too weak

---~ ~----~~~----~~--- ---~-----~---~~ --~----~

498 CHINESE ACUPCNCTURE AND MOXIBUSTION

to have uterus contraction, there are mild Zhiyin (BL 67) is an effective and empir-
abdominal pain, mild heavy and distend- ical oxytocic point. The three points thus
ing sensation, and the delivery duration is used together fulfil the set purpose of
prolonged. Qi deficiency leads to profuse tonifying qi and blood and quickening
hemorrhage in light color, pale complex- the delivery.
ion, lassitude, palpitation, and shortness b) Stagnation of qi and blood:
of breath. Pale tongue and weak pulse are Method: Points are chiefly chosen
signs of deficiency of qi and blood. from the Hand-Yangming and Foot-
b) Qi stagnation and blood stasis: Taiyin Meridians. Acupuncture is given
Main manifestations: Sharp pains in with the reducing method to regulate qi
the waist and abdomen, scanty hemor- and blOOd, activate qi so as to quicken the
rhage in dark red color, prolonged deliv- delivery.
ery course, dark bluish complexion, de- Prescription: Hegu (LI 4), Sanyinjiao
pressive mood, fullness in the chest (SP 6), Zhiyin (BL 67).
and epigastrium, frequent nausea, dark Explanation: Hegu (LI 4) is the
tongue, deep forceful pulse. Yuan-(Primary) Point of the Hand-
Analysis: The retarded circulation of Yangming Meridian and Sanyinjiao (SP
qi and blood gives rise to the sharp pain 6) is an intersecting point of the three
in the waist and abdomen and prolonged foot yin meridians. The two paired to-
course of delivery. The stagnated qi does gether may regulate qi and blood, clear
not ascend as usual, bringing about the off stasis and speed up the delivery. Zhi-
dark bluish complexion, fullness and dis- yin (BL 67) is an effective and empirical
tension in the chest and epigastrium, and oxytocic point.
frequent nausea. The dark tongue, deep
and forceful pulse indicate qi stagnation Remarks
and blood stasis. Acupuncture and moxibustion carry
an oxytocic effect to the prolonged labor
Treatment due to weak uterine contraction. Meas-
a) Deficiency of qi and blood: ures other than acupuncture and moxi-
Method: Points are chiefly chosen bustion should be taken in case of pro-
from the Foot-Yangming and Foot- longed labor caused by uterine deformity
Taiyang Meridians. Acupuncture is given or contracted pelvis.
with the reinforcing method with moxi-
bustion to tonify qi and blood, and quick- Appendix: Malposition of Fetus
en the delivery. Malposition of fetus refers to the
Prescription: Zusanli (ST 36), Sanyin- lying of the fetus in uterus for thirty
jiao (SP 6), Zhiyin (BL 67). weeks after conception. It is usually seen
Explanation: Zusanli (ST 36) and San- in multipara or those with lax abdominal
yinjiao (SP 6) may generate qi and blood wall. No symptoms are found in most
and tonify the spleen and stomach, while cases. It is only made known by prenatal
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES ,,99

examination. The commonly seen are Etiology and Pathogenesis

breech, transverse position, etc. a) Deficiency of qi and blood:
Milk is transformed from qi and
Treatment blood, the origin of which are nutrient
Zhiyin (BL 67) is selected. substances of food or the acquired ess-
Method: Moxibustion is applied to ence. Either the weakness of the spleen
Zhiyin (BL 67) bilaterally for fifteen to and stomach or profuse loss of qi and
twenty minutes while the pregnant wom- blood during delivery may effect the for-
an sits in chair or lies supinely in bed mation of milk. Zhang Jingyue in his
with the belt unclasped. Give the treat- book Observations of Women points out,
ment once or twice every day till the fetal 'The qi and blood in women's Thorough-
position is corrected. Zh iyin (BL 67) is fare and Conception vessels turn into
the Jing-(Well) Point of the Foot-Taiyang menses when it descends, and transforms
Meridian, and an empirical point for fe- into milk when it ascends. The delayed or
tal malposition. The reported success rate insufficient secretion of milk after deliv-
is over 80%. It works more effectively in ery is due to the insufficiency of qi and
multiparae than primiparae. Moxibustion blood. Those who have no milk secretion
is much more widely adopted than acu- definitely suffer from the weakness of
puncture, the latter is sometimes served the Thoroughfare and Conception ves-
for the same purpose though. sels. "
There are many causative factors of b) Liver qi stagnation:
the fetal malposition, they should be ex- It is caused by mental depression after
amined carefully. Other measures should delivery impaired dispersing of the liver
be taken if the malposition results from qi, disorder of qi and blood, blockage of
such factors as contracted pelvis, uterine the meridians, and obstructed flow of
deformity, etc. milk, finally bringing on the insufficient
lactation. The book The Literati's Care of
8. Insufficient Lactation Parents goes, "Sobbing, crying, grief, an-
(Appendix: Lactifuge Delectation)
ger, depression lead to obstruction of the
milk passage."
Insufficient lactation refers to the
common clinical symptom that milk se- Differentiation
cretion of a nursing mother is insuffi- a) Deficiency of qi and blood:
cient to feed the baby. In some cases Main manifestations: Insufficient se-
there may even be no secretion of milk at cretion of milk after delivery or even
all. Ancient people named it as lack of absence of milk, or decreasing secretion
milk and halted milk flow due to defi- during lactation period, no distending
ciency of qi and blood or to stagnation of pain in the breast, pale complexion, dry
the liver qi. It is clinically divided into skin, palpitation, lassitude, poor appetite,
deficiency and excess types. loose stools, pale tongue with little coat-
500 CHINESE ACUPUNCTURE AND MOXIBUSTION

ing, weak and thready pulse. is to remove the stagnation of liver qi,
Analysis: Because of the deficiency of free obstruction from the meridians and
qi and blood, the weakened transforming promote secretion of milk.
source of milk leads to scanty secretion Prescription: Rugen (ST 28), Tan-
without distension in breasts. Insufficient zhong (CY 17), Shaoze (SI I).
qi and blood makes pale face and dry Supplementary points:
skin. Palpitation ensues on malnutrition Deficiency of qi and blood: Pishu (BL
of the heart and blood. Dysfunction of 20), Zusanli (ST 36), Sanyinjiao (SP 6).
the spleen and insufficiency of qi in the Liver qi stagnation: Qimen (LR 14),
middle energizer give rise to lassitude, Neiguan (PC 6), Taichong (LR 3).
poor appetite and loose stools. Pale Explanation: Since breast is where
tongue and weak thready pulse are signs Foot-Yangming Meridian passes and
of deficiency of both qi and blood. Rugen (ST 28) is located on the Stom-
b) Liver qi stagnation: ach Meridian of Foot-Yangming at the
Main manifestations: Absence of milk breast, Rugen (ST 28) is used here to
secretion after delivery, distending pain restore the free flow of qi in the Yang-
in breast, mental depression, chest dis- ming Meridian so as to promote the lactic
tress and hypochondriac pain, epigastric secretion. Tanzhong (CY 17), the Con-
distension, loss of appetite, pink tongue fluential Point of qi, serves to regulate qi
and string-taut pulse. and promotes the flow of milk. Shaoze
Analysis: Liver carries out the dispers- (SI I) is an effective and empirical lac to-
ing function of qi. Mental depression af- genic point. Pishu (BL 20), Zusanli (ST
ter delivery impairs liver qi, which ob- 36) and Sanyinjiao (SP 6) are used to
structs the milk flow, leading to the regulate and tonify spleen and stomach,
distending pain in the breast, and hypo- promote the transformation of milk from
chondriac pain. Disharmony of the stom- blood. Qimen (LR 14) and Taicong (LR
ach causes epigastric distension and loss 3) are to remove stagnation of liver qi.
of appetite. String-taut pulse is another Neiguan (PC 6) is added to regulate qi
sign of stagnated liver qi. flow in the chest and restore the free flow
of milk.
Treatment
Method: Mainly select the points Remarks
from the Foot-Yangming Meridian. Acu- While receiving acupuncture for in-
puncture is given with reinforcing meth- sufficient lactation, the mother should
od and moxibustion in case of deficiency also be advised to have nutrient diet, to
of qi and blood to tonify the qi and blood take plenty of soup, and to apply correct
so as to promote lactic secretion. Acu- nursing method.
puncture with either reducing or even
movement method or with appropriate Appendix: Lactifuge
moxibustion in case of liver qi stagnation Those who do not want to nurse the
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 501

infant after delivery can check milk se- several inches, sinking sensation In the
cretion by acupuncture. lower abdomen, lassitude, palpitation,
Point selection: Zulinqi (OB 41), shortness of breath, frequent urine, leu-
Ouangming (OB 37). korrhagia, pale tongue with thin coating,
Ten-minute moxibustion is applied to weak pulse.
each point after acupuncture. Treatment Analysis: Since the qi is too weak to
is given once every day, three to five conduct its sustaining function of uterus,
treatments in the following day. prolapse of uterus appears. It is relieved by
lying down and aggravated by prolonged
9. Prolapse of Uterus standing, with a sinking sensation in the
lower abdomen and frequent urine. The
Prolapse of uterus refers to descent of weakened spleen and stomach lead to
the uterus into the vagina, or descent of lassitude. Malnutrition of heart results in
the front wall of the vagina with the palpitation and shortness of breath. The
uterus. Usually it is the result of the downward going of pathogenic damp
sinking of inadequate qi, kidney qi defi- turns to excessive leukorrhea. Pale tongue
ciency, unstable Thoroughfare and Con- and weak pulse are signs of qi deficiency.
ception vessels, and the loss of restriction b) Kidney deficiency:
by Belt Vessel. Main manifestations: Prolapse of
uterus, sore and weak low back and legs,
Etiology and Pathogenesis bearing sensation in the lower abdomen,
Its occurrence is often due to insuffi- dryness in the vagina, frequent urine,
ciency of the qi in the middle energizer dizziness, tinnitus, pink tongue, deep weak
caused by weak constitution, or early phys- pulse.
icallabor after delivery before qi and blood Analysis: The kidney is located at the
are fully restored, or exhaustion in delivery, low back. With the kidney in deficiency,
or overstrain to counteract constipation, all the Thoroughfare and Conception vessels
of which bring about sinking of qi, which become weakened, and the Belt Vessel
fails to keep the uterus in position. Another loses its restricting function, thus there
cause is frequent pregnancy and delivery, appear the prolapse of uterus, frequent
and indulgence in sexual life overconsum- urine, sore and weak low back and legs.
ing the kidney qi and incur the loss of res- Dizziness, tinnitus and dry vagina derive
triction by the Belt Vessel and weakened from the insufficiency of essence and
functioning of the Thoroughfare and Con- blood. Deep weak pulse and pink tongue
ception vessels, hence prolapse of uterus. are signs of kidney deficiency.

Differentiation Treatment
a) Qi deficiency: a) Qi deficiency:
Main manifestations: Drop of the Method: Points are chiefly chosen
uterus in the vagina or out of the vulva from the Conception Vessel and Foot-
502 CHINESE ACl'PUNCTl'RE AND MOXIBCSTIOI\'

Yangming Meridian. Acupuncture is ap- peutic effect.

plied with reinforcing method and moxi-
bustion to replenish qi, and restore the
prolapsed uterus in place. II. PEDIATRIC DISEASES
Prescription: Baihui (GY 20), Qihai
(CY 6), Zhongwan (CY 12), Zusanli (ST 1. Infantile Convulsion
36), Guilai (ST 29).
Explanation: Baihui (GV 20) is locat- Infantile convulsion is commonly seen
ed at the vertex on the Governor Yes- in pediatrics, manifested by series of
seI. Its selection indicates to "use upper muscle contractions accompanied by im-
points for the lower disorders." Qihai pairment of consciousness.
(CY 6) is selected to replenish qi so as It can be brought about by various
to strengthen its sustaining function. causes, incl uding invasion of seasonal
Zhongwan (CY 12) and Zusanli (ST 36) pathogenic factors, accumulation of in-
are used to build up the qi of the middle ternal phlegm-heat, protracted vomiting
energizer. Guilai (ST 29) is used as a and diarrhoea, deficiency condition of
local point to lift the uterus. the spleen with hyperfunction of the liv-
b) Kidney deficiency: er. It occurs in any season, mostly in
Method: Points are mainly selected those aged from one to five. Since the
from the Conception Vessel and Foot- onset may be either sudden or gradual
Shaoyin Meridians. Acupuncture is given and the symptoms may show a deficiency
with the reinforcing method and moxi- condition or an excess condition, infan-
bustion to replenish the kidney qi so as to tile convulsion can be classified into two
keep the uterus in position. ' types: acute and chronic.
Prescription: Guanyuan (CV 4), Zi-
gong (Extra), Ququan (LR 8), Zhaohai Etiology and Pathogenesis
(KI 6). a) Acute infantile convulsion:
Explanation: G uanyuan (CY 4) is a i) Invasion of seasonal pathogenic fac-
point concerning with the primary qi, and tors:
functions to benefit kidney and lift the The skin and muscles of infants are
uterus. Zigong (Extra) is an extra point frail, hence they are easily attacked by
effective for prolapse of uterus. Ququan external pathogenic wind, which turns
(LR 8) and Zhaohai (KI 6) paired together into fire in the interior. Infants always
can tonify the kidney, nourish the tendons have excess activity of the liver, the heat
and sustain the uterus. therefore is liable to stir up liver wind,
thus wind and fire bring about the im-
Remarks pairment of consciousness and convul-
The patient should be advised to avoid sion. The exogenous pathogenic heat can
overstrain when receiving acupuncture also penetrate deep into the pericardium,
treatment. Rest can amplify the thera- or the body fluid is consumed by heat and
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES

turned into phlegm which blocks the the convulsion is due to the invasion of
mind, resulting in loss of consciousness exogenous pathogenic heat.
and convulsion. If fever, anorexia, vomiting, abdomin-
ii) Accumulation of phlegm fire: al distention and pain, sputum gurgling
Irregular food intake leads to stagna- in the throat, constipation or defecation
tion in the stomach and intestines, ob- with stinking smell are present, it is due
structing the flow of qi and producing to phlegm heat.
phlegm heat which turns into wind, If there is no fever, but cold limbs,
hence the disease. disturbed sleep or lethargy, crying and
iii) Sudden fright: fearing after waking, and intermittent
Infants have weak mind with insuffi- contraction of muscles, and the convul-
cient vital qi. Sudden seeing of strange sion is probably caused by sudden fright.
things and hearing of strange sounds may Analysis: Invasion of pathogenic heat
disturb their qi and blood and stir their can be transmitted internally to the per-
mind, causing convulsion. icardium, so the fever is accompanied
b) Chronic infantile convulsion: with irritability or impaired conscious-
Its onset is gradual. In most cases it is ness. Since there is constitutional excess
associated with a deficiency condition, of liver in infancy, the pathogenic heat
such as persistent dysentery, severe vom- can induce the liver wind. With the help
iting and diarrhoea, or excessive adminis- of the fire the liver wind stirs upwards,
tration of purgatives cold or cool in na- resulting in upward gazing, lockjaw, and
ture that injures the spleen and stomach, neck rigidity. Accumulation of phlegm
damaging the source of essential nu- heat and turbid dampness in the stomach
trients, and leading to deficiency of blood and intestines obstructs the circulation of
which fails to nourish the liver. As a qi, thus causing anorexia, vomiting, ab-
result, the wind caused by the condition dominal distention and pain, and consti-
of deficiency is stirred up internally, giv- pation. Fright harms the mind, hence
ing rise to convulsion. In addition, the there is crying with fear.
chronic infantile convulsion can also be b) Chronic infantile convulsion:
the result of the acute cases that have not Main manifestations: Emaciation,
been treated properly. pale complexion, lassitude, lethargy with
eyes open, intermittent convulsion, cold
Differentiation limbs, loose stool containing undigested
a) Acute infantile convulsion: food, clear and profuse urination, deep
Main manifestations: U nconscious- and weak pulse.
ness, upward gazing, lo~kjaw, neck rigid- Analysis: Chronic illness damages the
ity, opisthotonos, contracture of limbs, spleen and stomach, causing disorders in
rapid and string-taut pulse. digestion and transportation, thus there
If fever, headache, cough, congested are emaciation, pallor and lassitude. In-
throat, thirst, and irritability are present, sufficiency of the source of essential nu-

------------ ---- -- ------

504 CHINESE ACUPCNCTlJRE AND MOXIBUSTION

trients gives rise to the deficiency of yin ogenic heat can be brought down by
and blood, so that the liver fails to be puncturing Dazhui (GV 14) and Quchi
nourished, and consequently the wind (LI 11). The application of Twelve Jing-
caused by the condition of deficiency is (Well) Points can eliminate the heat from
stirring. Therefore, the victim has lethar- all the meridians. For those with exces-
gic sleep with open eyes and intermittent sive phlegm heat, Zhongwan (CV 12),
convulsion. The kidney is also involved in Fenglong (ST 40) and Hegu (LI 4) are
a long-standing case. Yang deficiency of used to regulate the spleen and stomach
the kidney and spleen is manifested by for removing the phlegm heat. Combina-
loose stools with undigested food, pro- tion with Qimai (TE 18) clears away the
fuse and clear urination, cold limbs and heat from the Triple Energizer Meridian
deep forceless pulse. to relieve convulsion. Sishencong (Extra)
has the action of tranquilization for those
Treatment suffering from fright. The supplemen-
a) Acute infantile convulsion: tary points, Laogong (PC 8) and
Method: Points of the Governor Ves- Yongquan (KI I), are used to calm down
sel and the Liver Meridian of Foot Jueyin the mind and stop convulsion.
are selected as the principal points. The b) Chronic infantile convulsion:
reducing method is applied to promote Method: Points of Conception and
the restoration of consciousness, elimi- Governor vessels are selected as the prin-
nate heat and suppress wind. cipal points. The reinforcing method and
Prescription: Yintang (Extra), Shui- moxibustion are applied to adjust yin and
gou (GV 26), Taichong (LR 3). yang for sedation and relief of convulsion.
Supplementary points: Prescription: Baihui (GV 20), Shen-
Invasion of pathogenic heat: Dazhui ting (GV 24), Guanyuan (CV 4), Sanyin-
(GV 14), Quchi (LI 11), Twelve Jing- jiao (SP 6), Zusanli (ST 36).
(Well) Points (LU II, LI I, HT 9, SI 1, Supplementary points:
PC 9, TE 1). Yang deficiency of the spleen and kid-
Convulsion due to phlegm heat: ney: Pishu (BL 20), Shenshu (BL 23),
Qimai (TE 18), Zhongwan (CV 12), Hegu Zhongwan (CV 12).
(LI 4), Fenglong (ST 40). Deficiency of blood: Taichong (LR 3),
Convulsion due to fright: Sishencong Rangu (KI 2).
(Extra), Laogong (PC 8), Yongquan Explanation: Since chronic infantile
(KI I). convulsion is due to the condition of
Explanation: Yintang (Extra) has a deficiency, Baihui (GV 20) and Shenting
sedative action, while Shuigou (GV 26) (GV 24) are used for tranquilization, and
can regulate the Governor Vessel and Guanyuan (CV 4), Sanyinjiao (SP 6) and
promote resuscitation. Puncturing Tai- Zusanli (ST 36) to reinforce body resist-
chong (LR 3) with reducing method is to ance and alleviate convulsion. Applica-
subdue the liver wind. An excess of path- tion of Pishu (BL 20) and Zhongwan (CV
CHAPTER 18 GYNECOLOGICAL ACll:=-)~O~T.::.::.HE=R~DI=SE=A:::.:SE=-S_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~5=05

12) builds up the spleen and stomach and Etiology and Pathogenesis
strengthens the source of essential nu- The weak spleen and stomach of child-
trients. Shenshu (BL 23) is combined ren are apt to be injured by irregular diet,
with the above points to reinforce the contaminated food, or improper attend-
kidney and invigorate the yang in order ing. Dysfunction of the spleen and sto-
to dispel the cold. Taichong (LR 3) and mach in transportation and transforma-
Rangu (KI 2) nourish yin and blood to tion leads to indigestion. The undigested
subdue the wind and stop convulsions. food and water can not be separated but
go together into the large intestine. This
Remarks accounts for the diarrhoea. It says in
a) Acute infantile convulsion is in- Chapter 43 of Plain Questions, "'Overin-
volved in the infections of the central take of milk and food will harm the in-
nervous system and toxic encephalopa- testines and the stomach." Therefore, in-
thies, e.g. epidemic cerebrospinal menin- ternal damage by food is an important
gitis and pneumonia with toxemia. Acu- factor of diarrhoea. Since the zang-fu
puncture has a certain antipyretic and organs of infants are delicate, the attack
antispasmotic effect. However, it is neces- of exogenous pathogenic factors can also
sary to make the diagnosis timely and give rise to impairment of transporta-
adopt a comprehensive treatment. tion and transformation function of the
b) Chronic infantile convulsion is most- spleen and stomach, and hence diarrhoea.
ly caused by long duration of vomiting and
diarrhoea, metabolic disorders, malnutri- Differentiation
tion and chronic infections of the central Main manifestations: Abdominal dis-
nervous system, or transmitted from acute tension is accompanied by borborygmi
convulsion. So the comprehensive treat- and frequent fits of pain. The fit of pain
ment should also be adopted. is followed by bowel movements, and the
pain will be relieved after defection.
There are several times of defecation
2. Infantile Diarrhoea
a day with sour and putrid feces. The
Infantile diarrhoea is a common di- diarrhoea caused by overfeeding is
sease in pediatrics, characterized by dis- marked by presence of undigested milk
harmony of the spleen and stomach with and food in the fecal discharge, frequent
frequent bowl movements, and loose or eructation, anorexia, sticky tongue coat-
watery feces. Since the children's spleen ing, rolling and full pulse. In diarrhoea
and stomach are weak, this disease is caused by damp heat, there are loose
easily caused by either invasion of exog- stools with yellow color and offensive
enous pathogenic factors or internal inju- smell, abdominal pain, fever and thirst,
ry of milk and food. It may occur in any burning sensation at the anus. scanty and
season, but more frequently in summer dark urine, yellow and stick tongue coat-
and autumn. ing, rolling and rapid pulse.
506 CHINESE ACUPUNCTCRE AND MOXIBUSTION

Analysis: Undigested milk or food ac- Supplementary points:

cumulated in the intestines and the stom- Diarrhoea due to overfeeding: lianli
ach causes abdominal distension with (CY II), Qihai (CY 6).
borborygmi and frequent attacks of pain Diarrhoea due to damp heat: Quchi
with the desire of emptying the bowels. (LI 11), Hegu (LI 4), Yinlingquan (SP 9).
The pain is relieved after defecation Analysis: Tianshu (ST 25) is a point
as the food stagnation is somewhat re- of the Stomach Meridian of Foot Yang-
moved. Stagnation of food leads to putre- ming, and also the Front-(Mu) Point of
faction, making the feces sour and pu- the large intestine, while Shangjuxu (ST
trid. The weakened spleen and stomach 37) is the Lower He-( Sea) Point of the
fail to digest food, hence there is undig- large intestine. The combination of these
ested milk or food in the feces. The pu- two points can regulate the intestines and
trid turbidity may ascend, so there is check diarrhoea. Sifeng (Extra) can pro-
frequent eructation. Dysfunction of the mote digestion to remove the stagnation,
spleen and stomach in transportation and and strengthen transportation to stop
transformation gives rise to anorexia. diarrhoea. If the diarrhoea is due to over-
The sticky tongue coating and rolling feeding, lianli (CY II) and Qihai (CY 6)
pulse are both the signs of food retention. are combined in order to remove the stag-
The pathogenic damp heat accumu- nation of food, alleviate abdominal dis-
lated in the stomach and the intes- tension and fullness, and reinforce the
tines causes impairment of transpor- spleen and stomach. If the diarrhoea is
tation. When the damp heat flows caused by damp heat, Quchi (LI 11),
downward, there are loose stools with Hegu (LI 4) are used to clear away the
yellow color and offensive smell, and ab- heat, and Yinlingquan (SP 9) to eliminate
dominal pain. Accumulation of damp dampness and check diarrhoea.
heat in the stomach and intestines brings
on fever and thirst. Burning sensation at Remarks
the anus and scanty dark urine are also a) Attention should be paid to severe
due to the downward flow of damp heat. diarrhoea which may lead to the critical
Yellow sticky tongue coating and rolling condition of the damage of both yin and
rapid pulse are signs of damp heat. yang, collapse of qi and exhaustion of
ym.
Treatment b) The diet should be restricted and a
Method: Points of Foot Yangming light diet of small quantity is preferable.
Meridian are mainly recommended with
in-and-out puncturing to adjust the
3. Infantile Malnutrition
spleen and stomach, eliminate damp heat
and stop diarrhoea. Infantile malnutrition is characterized
Prescription: Tianshu (ST 25), by emaciation, sparse hair, distended bel-
Shangjuxu (ST 37), Sifeng (Extra). ly with outstanding blue veins, loss of
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 507

appetite, and listlessness. and anorexia. Then, distended belly with

The cardinal causes of this disease are protruding umbilicus due to internal stag-
irregular intake of food, improper nurs- nation, sallow complexion, emaciation,
ing, parasitosis, and general debility due scaly and dry skin, sparse hair, dirty and
to a chronic illness which injures the sticky coating of the tongue, or complete
spleen and stomach. loss of coating, and weak pulse. The above
symptoms are related to deficiency of the
Etiology and Pathogenesis spleen and stomach. If there is abnormal
Irregular intake of food may impair intake of food with irregular hunger or
the spleen and stomach. It is important to satiety, or craving for unnatural articles of
feed the children regularly with suitable food, the malnutrition is probably due to
food. Irregular food intake with indul- parasitosis.
gent ingestion of greasy, sweet, raw and Analysis: Long retention of undigest-
cold food usually leads to retention of ed food or milk causes production of
undigested food. Long-standing food re- heat, so there is slight fever or tidal fever
tention damages the spleen and stomach, in the afternoon and crying with irritabil-
so that the refined nutrient from food ity. When the spleen fails in transporta-
and milk fails to be transported. Thus the tion, the damp heat is liable to be ac-
qi and blood in zang-fu organs are lack cumulated, hence there are loose bowel
of nourishment, resulting in malnutrition movements with offensive odor, rice-
and emaciation with insufficiency of qi water-like urine, dryness of the mouth
and fluid. Malnutrition may also be due and abdominal distension. Impairment of
to improper feeding or feeding with indi- the spleen and stomach results in anorex-
gestible food which in the long run will ia and the long time stagnation causes
bring on emaciation, deficiency of qi and potbelly and protruding umbilicus. The
fluid, and retardation of development. In impaired spleen and stomach fail to di-
addition, improper nursing after a chron- gest food and transport the refined nu-
ic disease or parasitosis may also impair trients to nourish zang-fu organs, qi and
the functions of the spleen and stomach blood, skin, muscles and hair. This is
and consume body fluid. Thus food can manifested by sallow complexion, ema-
not be digested, and stagnancy of undig- ciation, scaly dry skin and sparse hair.
ested food will lead to transformation The grimy and sticky tongue coating re-
into heat and ultimately to malnutrition. veals the internal retention of food, while
the complete loss of coating demonstrates
Differentiation exhaustion of body fluid. Weak pulse in-
Main manifestations: Gradual onset of dicates impairment of the spleen and sto-
slight fever or tidal fever in the afternoon, mach. Parasites in the abdomen disturb
dryness of the mouth, abdominal disten- the stomach and intestines, resulting in
sion, diarrhoea with offensive odor, rice- abnormality of food ingestion and crav-
water-like urine, crying with irritability, ing for unnatural food.

.---~.-------------
508 CHINESE ACUPUNCTURE AND MOXIBUSTION

Treatment sequellae of poliomyelitis. The causative

Method: Points of Foot Taiyin and factor of this disease is the invasion of
Foot Yangming Meridians are selected to epidemic pathogenic factors, which in-
reinforce the spleen and remove the stag- jures the meridians.
nation. Superficial pricking with filiform
needles is applied and the needles are not Etiology and Pathogenesis
retained. This disease is mainly due to invasion
Prescription: Xiawan (CY 10), Wei- of pathogenic wind, dampness and heat.
shu (BL 21), Pishu (BL 20), Zusanli (ST These epidemic pathogenic factors invad-
36), Sifeng (Extra), Taibai (SP 3). ing the lung and stomach through the
Supplementary points: mouth and nose, accumulate and turn
Baichongwo (Extra) for parasitosis. into heat which gets into and obstructs
Analysis: Infantile malnutrition is af- the meridians. Consequently qi and blood
ter all due to dysfunction of the spleen fail to circulate normally to nourish ten-
and stomach in transportation and trans- dons, vessels and muscles, hence there is
formation. If the spleen and stomach are paralysis of the limbs. Long-lasting ill-
active in function, the food stagnation ness will lead to deficiency of essence and
can be removed and the source of essen- blood and affect the liver and kidney, so
tial nutrients can be regained. So Xia- the tendons and muscles are withered.
wan (CY 10) is applied to harmonize the This is the reason why in the later stage
stomach and eliminate heat. Zusanli (ST of this disease there are flaccidity of ten-
36), the Lower He-(Sea) Point of the dons, atrophy of muscles and deformity
stomach, is used to build up earth and to of bones.
replenish the qi in the middle energizer.
Taibai (SP 3), the Shu-(Stream) Point of Differentiation
the Spleen Meridian, is employed to rein- Main manifestations: Paralysis may
force the spleen and remove the stagna- occur in any part of the body, especially
tion. Sifeng (Extra) is an extra point in the lower limb with weakness of the
beneficial for treating infantile malnu- muscles and cold skin. Paralysis of the
trition. Application of Pishu (BL 20) and abdominal muscles is revealed by bulg-
Shenshu (BL 23) can invigorate the qi ing of the abdomen during crying. In a
of spleen and stomach and restore their chronic case there is muscular atrophy of
function of transportation and transfor- the affected part with deformity of the
mation. Baichongwo (Extra) is a special trunk, and the paralysis is intractable.
point to treat parasitosis. Analysis: All the limbs and the skele-
ton of the human body rely on the nour-
4. Infantile Paralysis ishment of qi and blood that circulate in
the meridians and collaterals. When the
Infantile paralysis is in range of "wei pathogenic factors attack the meridians
syndrome." What is stated here is the and collaterals, ying (nutrient qi) and wei
CHAPTER 18 GYl'iECOLOGICAL AND OTHER DISEASES 'i09

(defensive qi), qi and blood lose their cun lateral to the lumbar vertebrae from
normal flow, and tendons, vessels and the first to the fifth).
muscles fail to be nourished. Therefore, Paralysis of abdominal muscles:
the limb becomes paralyt.ic and the skin Liangmen (ST 21), Tianshu (ST 25),
cold. Long standing of the disease not Daimai (GB 26), Guanyuan (CY 4).
only leads to muscular atrophy by im- Supplementary points:
paired qi and blood supply, but also ex- Contracted knee: Yinshi (ST 33).
hausts the essence and blood. and affects Reverse flexion of knee: Chengfu (BL
the liver and kidney. The liver dominates 36), Weizhong (BL 40), Chengshan (BL
tendons while the kidney is in charge of 57).
bones, so the injury of the liver and kid- Inversion of foot: Fengshi (GB 31),
ney causes poor nourishment of the ten- Shenmai (BL 62), Qiuxu (GB 40).
dons and bones. As the result, the Eversion of foot: Zhaohai (KI 6),
tendons become flaccid while the Taixi (KI 3).
bones deformed, and the paralysis is in Difficult intorsion and extorsion of
tractable. hand: Yangchi (TE 4), Yangxi (LI 5),
Houxi (SI3), Sidu (TE 9), Shaohai
Treatment (HT 3),
Method: Points of Hand and Foot Drop of wrist: Sidu (TE 9), Waiguan
Yangming Meridians are selected as the (TE 5).
principal points to regulate the circula- Analysis: This prescription follows
tion of qi in the meridians so as to nour- the principle in internal classic that "only
ish the tendons and bones. The methods select the points of Yangming Meridians
of reducing, reinforcing and even move- for the treatment of paralysis." Yang-
ment can be adopted in different cases. lingquan (GB 34), the Influential Point
Points of diseased side are punctured of tendons, and Xuanzhong (GB 39), the
usually, but in a long course of treatment, Influential Point of bones, are used to
the healthy side and the affected side of enhance the function of nourishing the
the body can be needled alternatively. tendons and bones. Other points, such as
Prescription: Dazhui (GV 14), Tianzhu (BL 10), Wai-
Paralysis of the upper limb: guan (TE 5), Huantiao (GB 30), Liang-
Jianyu (LI 15), Quchi (LI 11), Hegu men (ST 21), Tianshu (ST 25), Daimai
(LI 4), Waigl!an (TE 5), Dazhui (GV 14), (GB 26), Sanyinjiao (SP 9), Kunlun (BL
Tianzhu (BL 10). 60), are all local points to remove the
Paralysis of the lower limb: obstruction of meridians for a smooth
Biguan (ST 31), Zusanli (ST 36), flow of qi. Huatuojiaji points, the extra
Jiexi (ST 41), Huantiao (GB 30), Yang- points with the action of adjusting the
lingquan (GB 34), Xuanzhong (GB 39), functions of the zang-fu organs and re-
Sanyinjiao (SP 6), Kunlun (BL 60), Hua- moving the obstruction of meridians, are
tuojiaji points at the lumbar region (0.5 also used as the local points.

--------~~- - --------- -- -------------

510 CHINESE ACUPUNCTURE AND MOXIBUSTIOK
-------------
Remarks Analysis: Since the disease is caused
This disease should be treated as early by exogenous attack of the epidemic
as possible, in combination with the func- pathogenic heat, there is the exterior syn-
tional exercises for strengthening the drome of chills and fever at the begin-
therapeutic effect. ning. Agglomeration of the pathogenic
heat in the Shaoyang collaterals results in
5. Mumps the redness, pain and swelling in the pa-
rotid region, and dysmasesia. If the path-
Mumps is an acute infectious disease ogenic heat is intense, it will consume the
characterized by painful swelling in the fluid of the Yangming collaterals, result-
parotid region, caused by epidemic wind ing in dryness of the mouth, constipation,
heat. It happens in all the seasons of a dark urine, etc. The Shaoyang Meridians
year, but mostly in winter and spring. It are interiorly-exteriorly related with the
is more frequently seen among preschool Jueyin Meridians and the Foot Jueyin
children, but seldom in those under two Meridian winds around the genital or-
years. gans, so when the pathogenic factor is
transmitted internally to the J ueyin Me-
Etiology and Pathogenesis ridian, there are redness, swelling and
Mumps is mainly due to invasion of pain of the testis. Yel10w tongue coating
the epidemic pathogen which enters the and superficial rapid pulse are signs of
body via the mouth and nose. Together invasion of pathogenic heat.
with phlegm fire it obstructs the col1ater-
als of Shaoyang Meridians, causing ab- Treatment
normal circulation of qi and blood and Method: Points of Shaoyang and
bringing on pain and swelling in the pa- Yangming Meridians are mainly recom-
rotid region, probably associated with mended. The superficial puncturing with
chills and fever. red ucing method is adopted to expel wind
and heat and remove the agglomeration.
Differentiation Prescription: Jiache (ST 6), Yifeng
Main manifestations: At the onset (TE 17), Waiguan (TE 5), Quchi (Ll II),
there are chills and fever, redness, pain Hegu (LI 4).
and swelling in unilateral or bilateral pa- Supplementary points:
rotid regions, and dysmasesia. When the Chills and fever: Lieque (LU 7).
pathogenic heat is intense, the redness, High fever: Dazui (GV 14), Twelve
pain and swelling in the parotid region Jing-(Well) Points (LU 11, LI I, PC 9, TE
are more marked, and there are pain and 1, HT 9, SI 1).
swelling of the testis, high fever with Swelling and pain of testis: Taichong
irritability, dryness of the mouth and (LR 3), Ququan (LR 8).
constipation, dark urine, yellow tongue Analysis: Mumps is located in the
coating, and superficial and rapid pulse. area pertaining to Shaoyang Meridians.
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 511

Yifeng (TE 17), the meeting point of III. EXTERNAL DISEASES

Hand and Foot Shaoyang Meridians, is
used to resolve the local stagnation of qi
1. Urticaria
and blood. Since the Hand Yangming
Meridian travels liP to the face, Jiache Urticaria is commonly seen in clinic. It
(ST 6), Quchi (Ll 11) and Hegu (LR 4) is an eruption of the skin characterized by
are applied to eliminate the pathogenic transitory, flat-topped wheals which look
heat. Waiguan (TE 5), the meeting point like measles or are as large as broad beans.
of Hand Shaoyang Meridian and Yang- It is apt to appear after exposure to wind,
wei Meridian, is employed in combina- so traditional Chinese medicine terms it
tion with the points from Yangming Me- "wind wheal." Because it comes and goes,
ridian, to expel the wind, dissipate the it is also named "hidden rash." In some
aggiomeration, and clear away the path- cases it may repeatedly occur and have not
ogenic heat. Lieque (LU 7) is combined been cured for months or years.
to disperse wind and alleviate the exte- Its etiology and symptoms are des-
rior symptoms for those suffering from cribed clearly in ancient literature, e.g. in
chills and fever. Dazhui (GV 14) and the book of Synopsized Prescriptions of
Twelve ling-eWell) Points are used to Golden Chamber it says, "If the pathogen-
bring down the high fever. Taichong ic qi attacks the meridians, hidden rash
(LR 3) and Ququan (LR 8) regain the with itching would appear."
normal circulation of qi in Foot Jueyin
Meridian for those with the pain and Etiology and Pathogenesis
swelling of testis. a) It is due to stagnation of dampness
in the skin and muscles which are again
Remarks attacked by wind heat or wind cold. The
a) Mumps is also called epidemic confrontation against dampness is going
parotitis. Acupuncture and moxibustion on between the skin and muscles, so there
provides satisfactory effect. appears wind wheal.
b) Moxibustion Therapy with Medulla b) It may be caused by accumulated
Junci. heat in the stomach and intestines with
Point: Jiaosun (TE 20) further attack of the pathogenic wind
Method: Two pieces of rush pith which could neither be dispersed from
soaked with vegetable oil are ignited and the interior nor removed from the exte-
aimed at the point Jiaosun (TE 20). Re- rior. So pathogenic wind heat stays be-
move them quickly as soon as there is a tween the skin and muscles, and results
sound of burning of the skin. Usually in wind wheal.
the swelling will subside after one treat- c) It may also be due to intesti-
ment. The treatment can be repeated the nal parasitosis such as ascariasis, an-
next day if the swelling is not completely cylostomisasis, fasciolopsis, etc., or due
gone. to intake of fish, shrimp or crab leading
512 CHINESE ACUPUNCTURE AND MOXIBUSTION

to disharmony of the spleen and stomach obstruction of qi in the fu organs. Rapid

with accumulation of damp heat in the pulse and yellow tongue coating indicate
skin and muscles. existence of interior heat.

Differentiation Treatment
Abrupt onset with itching wheals of Method: The reducing method is ap-
various sizes or with pimples rising one plied to disperse wind damp and elimi-
after another. It might be aggravated nate heat in the blood. Points of the
or lessened by the changing of weather. Spleen and Large Intestine Meridians are
Acute conditions subside quickly. It is selected as the principal points. Tap-
divided into the following types accord- ping on the diseased area with a "plum-
ing to clinical symptoms: blossom" needle is advisable.
a) Wind heat: Prescription: Quchi (LI II), Hegu (LI
Main manifestations: Red rashes with 4), Weizhong (BL 40), Xuehai (SP 10),
severe itching, superficial and rapid Sanyinjiao (SP 6).
pulse. Supplementary points:
Analysis: Red color indicates heat; it- Wind heat: Dazhui (GY 14).
ching is caused by wind. Superficial and Wind damp: Yinlingquan (SP 9).
rapid pulse is a sign of wind heat. Accumulated heat in the stomach and
b) Wind damp: intestine: Tianshu (ST 25), Zusanli (ST
Main manifestations: White or light 36).
red rashes accompanied by heaviness of Explanation: Wind rash is mainly
the body, superficial and slow pulse, caused by stagnation of the pathogenic
white and sticky tongue coating. wind, heat or damp in the skin and mus-
Analysis: White or light red rashes cles or due to accumulated damp heat
and heaviness of the body indicate stag- in the stomach and intestine, so points
nation of wind damp in the skin and Quchi (LI II) and Hegu (LI 4) of Hand-
muscles. White sticky tongue coating and Yangming Meridian are used to disperse
superficial slow pulse are signs of wind the pathogenic factors from the skin and
damp. muscles. Xuehai (SP 10) and Weizhong
c) Accumulation of heat in the stomach (BL 40) are combined with the former
and intestines: points to eliminate heat in the blood,
Main manifestations: Red rashes com- Sanyinjiao (SP 6) is to remove dampness,
plicated by abdominal or epigastric pain, Dazhui (GY 14), the point where all the
constipation or diarrhoea, thin yellow yang meridians meet, is used to reduce
tongue coating and rapid pulse. heat, and YinJingquan (SP 9) removes
Analysis: Red color shows heat. Epi- damp. The reducing method applied to
gastric and abdominal pain with constipa- Tianshu (ST 25) and Zusanli (ST 36) is
tion suggests accumulated heat in the to dredge the accumulated heat from the
stomach and intestines, which causes the stomach and intestines.
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 513
---------------------------
2. Erysipelas dark urine, yellow sticky tongue coating,
(Appendix: Herpes Zoster) soft and rapid pulse, it is a damp heat
syndrome. High fever, vomiting, delirium
Erysipelas is an acute contagious in- and convulsion indicate invasion of the
fectious skin disease characterized by pathogenic factors into the interior of the
sudden onset of chills, fever, local red- body.
ness and swelling which may take place Analysis: Erysipelas is caused by inva-
on any site of the body and rapidly ex- sion of exogenous wind heat or damp
tend. heat from the stomach and intestines into
the blood, skin and muscles. Therefore
Etiology and Pathogenesis the affected skin is red and painful. If it
Erysipelas is mostly due to accumulat- is caused by exogenous wind heat stagnat-
ed damp heat in the spleen and stomach ing in the skin and muscles, there are
flowing downward to the leg; or due to chills and fever. If it is caused by damp
obstruction of qi and blood in meridi- heat in the stomach and intestines, there
ans caused by pathogenic wind and tox- are high fever, thirst, stuffy sensation in
ic heat. Therefore the pathogenic heat the chest, poor appetite, constipation and
infects the blood, and then the skin and dark urine. When the pathogenic factor
muscles. Or it is due to invasion of toxin penetrates into the pericardium, delirium
into the wound in the skin. The erysipelas and convulsion occur.
arising in face and head is mostly evoked
by wind heat, that in the hypochondriac, Treatment
lumbar and hip regions is usually caused Method: Points of the Yangming Me-
by liver fire, that on the leg by damp ridian are selected as the principal points.
heat, and in new-born babies by internal The reducing method is applied to elimi-
heat. nate heat and relieve toxin, or prick the
points to bleed.
Differentiation Prescription: Quchi (LI 11), Hegu (LI
Main manifestations: Rapid onset of a 4), Quze (PC 3), Weizhong (BL 40), Xue-
well demarcated patch of redness, hot- hai (SP 10), Ashi points.
ness and burning pain, rapidly extending Supplementary points:
in size; change in color of the patch from Wind heat: Fengchi (GB 20).
bright red to dull red in several days and Damp heat: Zusanli (ST 36), Yin-
then healing with desquamation. If ac- lingquan (SP 9).
companied by chills, fever, acute head- Fever: Dazhui (GV 14).
ache, red tongue proper with thin yellow Pathogenic toxin attacking the inter-
coating, and superficial rapid pulse, it is ior: Twelve Jing-(Well) points (LU 11, LI
a wind heat syndrome. If accompanied by L PC 9, TE 1, HT 9, SI 1), Laogong
fever, irritability, thirst, stuffy sensation (PC 8).
in the chest, poor appetite, constipation, Constipation: Zhigou (TE 6).
514 CHINESE ACCPCNCTURE AND MOXIBUSTION

Explanation: Quchi (L1 1]) and Hegu contents are transparent at first, but turn
(Ll4) disperse wind heat from the Yang- turbid in five to six days. Resolution of
ming Meridians. Reducing Xuehai (SP 10) the cutaneous lesions after decrustation
and bloodletting of Weizhong (BL 40), without scar formation occurs in about
Quze (LI 11) and Ashi points are to clear ten days. In some cases pain lasts longer.
off heat from the blood, i.e. "eliminating
the accumulated heat by reducing meth- Treatment
od." The reducing method used to Zusanli Firstly, the head and the tail of the
(ST 36) and Yinlingquan (SP 9) is to dispel location of herpes zoster should be distin-
damp heat. Pricking the twelve J ing-(WeII) guished. The area where the skin lesions
points to cause bleeding and reducing first appeared is considered as the tail,
Laogong (PC 8) are to expel heat from the while the extending part of herpes as the
skin and heart. Reducing Dazhui (GY 14) head of its locality. Prick the skin around
and Fengchi (OB 20) remove the patho- herpes zoster with a three-edged needle to
genic heat and relieve exterior symptoms. cause a little bleeding: five pricks at 0.5
Zhigou (TE 6) is used for constipation by cun from the head of the herpes zoster
removing heat. area and then five pricks at 0.5 cun from
the tail, and also several pricks along
Remarks both sides. Then select Quchi (LI II),
Strict sterilization is necessary to Xuehai (SP 10), Weizhong (BL 40),
avoid infection. If ulcer occurs due to Yanglingquan (GB 34), Taichong (LR 3).
mixed infection, or if there is septicae- Explanation: Pricking the skin around
mia or pyemia, comprehensive treatment herpes zoster with a three-edged needle to
should be applied. cause bleeding is to reduce the pathogen-
ic toxin. Quchi (LI II) dispels wind and
Appendix: Herpes Zoster clears off heat. Xuehai (SP 10) and Wei-
Herpes zoster occurs mainly in the zhong (BL 40) eliminate heat in the
lumbar and hypochondriac regions with blood. Yanglingquan (GB 34) and Tai-
small red vesicles like beads forming a chong (LR 3) reduce damp heat from the
girdle around the waist. It is mostly liver and gallbladder.
caused by endogenous damp heat, hyper-
activity of fire in the liver and gallbladder 3. Boil and "Red-Thread Boil"
or affection of exogenous toxin. At the
onset there is stabbing pain of the affect- Boil frequently occurs on the face,
ed skin, which soon becomes erythema- head and extremities. It has different
tous. Patches of blisters in the size of names according to its location and form,
mump-beans or soybeans are evolved, e.g. "philtrum boil" if it is located at the
forming a bandlike distribution with median line of the upper lip, "snake-head
clearcut interspaces between the patches. boil" if it occurs at the finger tip which
The blisters are thick-walled and their looks like the head of a snake, "red-
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 515

thread boil" if there is a red line extend- tors are in the exterior portion of the
ing outward from the boil. body, there are chills and fever. Toxici-
ty and heat travel along the vessels and
Etiology and Pathogenesis bring about a red thread-like line extend-
Boil is usually caused by fatty and ing proximally. High fever, restlessness
spicy food or contamination of the skin. and impairment of consciousness are due
The former may~lead to accumulation of to invasion of the pathogenic heat and
heat in zang-fu organs and then produc- toxicity into the pericardium. Reddened
tion of endogenous toxicity. The latter tongue with yellow coating and rapid
may result in invasion of the exogenous pulse are signs of toxic heat.
toxic factor and stagnation of qi and
blood. It would be dangerous if the path- Treatment
ogenic toxic factor is transmitted into the Method: Points of the Governor Ves-
meridians and the zang-fu organs. sel and Hand-Yangming Meridian are se-
lected as the principal points. The re-
Differentiation ducing method or pricking with a three-
Main manifestations: Boil on the edged needle to cause bleeding is used.
head, face or extremity first appears like For red-thread boil, prick with a three-
a grain of millet in yellow or purple edged needle to cause bleeding at two-
color. A blister or pustula with a hard inch intervals along the red line proxi-
base is formed, usually accompanied by mally towards the focus.
tingling. Later there is increased redness, Prescription: Lingtai (GV 10), Shen-
swelling and pain with burning sensation, zhu (GV 12), Ximen (PC 4), Hegu (LI 4),
often accompanied by chills and fever. Weizhong (BL 40).
Sometimes a red thread-like line extends Supplementary points;
proximally if the boil toxicity attacks the Points may be selected along the me-
interior, there will be high fever, restless- ridians related to the location of the boil,
ness, dizziness, vomiting, impaired cons- e.g. boil on the face: Shangyang (LI I),
ciousness, reddened tongue with yellow Quchi (LI 11); on the tip of fingers:
coating, and rapid pulse, indicating that Quchi (Ll 11), Yingxiang (LI 20); on
the toxicity is deeply rooted. temporal region: Yanglingq uan (G B 34),
Analysis: When the toxic heat stays in Zuqiaoyin (GB 44); and on the fourth or
the skin and muscles and drops into the fifth toe: Yanglingquan (G B 34), Ting-
meridians, resulting in stagnation of qi hui (GB 2).
and blood, a swollen enduration is Explanation: Lingtai (GV 10) is an
formed. Since the stagnation is not se- empirical point for the treatment of boil.
vere, there is only mild tingling. further Shenzhu (GY 12) readjusts the qi of all the
accumulation of heat and toxicity causes yang meridians in order to disperse heat.
aggravation of redness, swelling and Ximen (PC 4), the Xi-(Cleft) Point of the
burning pain. Since the pathogenic fac- Pericardium Meridian is effective for
516 CHINESE ACUPUNCTURE AND MOXIBUSTION
~------------------------------------------

eliminating heat in the blood and stopping Differentiation

pain, and Hegu (LI 4) for removing the Main manifestations: Redness, swell-
exogenous pathogenic factors from the ing and pain of the breast, mostly occur-
exterior of the body. Weizhong (BL 40) is ring after delivery. At the early stage when
effective for clearing away toxin from the the abscess has not yet been formed, there
blood. These points used together act on is a lump in the breast accompanied by
relieving toxicity and dispersing heat. swelling, distension, pain, difficult lacta-
Pricking the points to cause bleeding tion, chills, fever, headache, nausea, and
expels toxin and heat from the blood. dire thirst. Growing of the lump with local
Points combined with the main ones are bright redness and intermittent throbbing
used to remove the obstruction of qi and pain indicates suppuration.
blood of the local meridians. The selection Analysis: Since the stagnated liver qi
of points along the meridians related to and obstructed lactation lead to produc-
diseased area is based upon the following tion of heat, there occurs redness, swelling,
theory: 'The therapeutic effect will reach and pain of the breast with difficult
where the meridian is opened up." lactation. The confrontation between the
exogenous pathogenic factors and the
Remarks body resistance causes chills, fever and
Another effective method for treating headache. The pathogenic heat in the
boil is to prick and tilt with a three-edged stomach disturbs the descending of the
needle into small papules found alongside stomach qi, manifested by nausea and dire
the thoracic vertebrae. Treatment is giv- thirst. Unrelieved stagnation of milk may
en once a day. produce heat. "Extreme heat causes putrid
muscle, and pus follows." So there is
4. Breast Abscess growing of the lump in the breast with
bright redness, burning and intermittent
Breast abscess is an acute purulent throbbing pain.
disorder of the breast mostly found in
lactation period after delivery. It is rare Treatment
in the duration of pregnancy. Method: The reducing method is ap-
plied to regulate the qi of the Liver and
Etiology and Pathogenesis Stomach Meridians, remove stagnation
It is caused by retention of milk in the and disperse heat. Points of Foot-Jueyin,
breast due to mental depression affecting Foot-Shaoyang and Foot-Yangming Me-
the qi of the liver or due to overtaking of ridians are selected as the principal points.
fatty food that brings about stagnation of Prescription: Jianjing (GB 21), Tan-
heat in the Stomach Meridian or due to zhong (CV 17), Rugen (ST 18), Shaoze
obstruction of the milk duct after in- (SI 1), Zusanli (ST 36), Taichong (LR 3).
vasion of exogenous toxic fire into the Supplementary points:
breast through the rupture of the nipple. Chills and fever: Hegu (LI 4), Wai-
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES _ _ _ _ _ _ _ _ _ _ _ _ _ _~517
----
guan (TE 5). cording to the ancient literature, it can be
Distension and pain in the breast; Zu- classified into large-intestinal abscess and
linqi (GB 41). small-intestinal abscess. The abscess with
Explanation: The nipple is on the Liv- pain around Tianshu (ST 25) is known as
er Meridian, and the breast is located in "large-intestinal abscess," while that with
the area where the Stomach Meridian is pain around Guanyuan (CY 4) is named
distributed. The breast abscess is caused "small-intestinal abscess." Because exten-
by pathogenic heat in the stomach and sion of the right leg is limited, it is also
the stagnation of liver qi. That is why called "leg-contracted intestinal abscess."
Taichong (LR 3) is used to remove the
stagnation, Zusanli (ST 36) and Rugen Etiology and Pathogenesis
(ST 18) are to lower the stomach fire in Intestinal abscess is caused by irregu-
order to eliminate the accumulation of lar intake of food, retention of undigest-
pathogenic factors in the Yangming Me- ed food, undue cold and warmth, or run-
ridian. Tanzhong (CV 17) is to regulate ning after a big meal. All these factors
the activity of qi and remove obstruc- may give rise to dysfunction of the intes-
tion of lactation. Foot-Shaoyang Meridi- tines in transmission with accumulation
an runs along the chest and hypochon- of damp heat and stagnation of qi and
driac regions, so Jianjing (G B 21) is used blood, which in combination will lead to
to adjust qi circulation and remove ob- suppuration and abscess formation.
struction of qi in the chest and hypochon-
driac regions, being an effective point in Differentiation
treating the breast abscess. Shaoze (SI 1) Main manifestations: At the onset
is an empirical point for the treatment of there is sudden paroxysmal pain in the
the breast abscess. Hegu (LI 4) clears the upper abdomen or around the umbilicus.
heat away from the Yangming Meridian. Soon the pain becomes continuous and
Waiguan (TE 5) connecting the Yangwei localized in the right lower abdomen near
Meridian is used to treat chills and fever. Tianshu (ST 25), accompanied by tender-
Zulinqi (GB 41) spreads qi and blood and ness, mild contracture of the abdominal
removes obstruction of lactation so as to wall, difficulty in extension of the right
relieve distension and pain in the beast. leg, fever, chills, nausea, vomiting, con-
stipation, dark urine, thin, sticky and yel-
Remarks low tongue coating, rapid and forceful
This condition corresponds to acute pulse. If the pain is severe and there is
mastitis in modern medicine. contracture of the abdominal wall with
marked tenderness or palpable mass, ac-
5. Intestinal Abscess companied by high fever and spon-
taneous sweating, forceful and rapid
Intestinal abscess is an acute abdominal pulse, the condition is serious.
disorder occurring in the intestines. Ac- Analysis: Intestinal abscess is due to
518 CHINESE ACUPUNCTURE AND MOXIBUSTION

accumulation of damp heat and stagna- 37).

tion of qi and blood that obstructs the Supplementary points:
pathway of the stomach and intestines. Fever; Dazhui (GV 14), Hegu (LI 4).
So it is manifested by localized abdomin- Vomiting: Neiguan (PC 6), Zhongwan
al pain and tenderness. Intestinal abscess (CV 12).
mostly occurs in the appendix which is Explanation: Lanwei (Extra) is an em-
located in the right lower abdomen, and pirical point in treating the intestinal ab-
hence severe abdominal pain is present scess. Shangjuxu (ST 37), the lower
in this quardrant. Stagnation of qi and He-(Sea) Point of the large intestine,
blood, imbalance between the nutrient qi together with Tianshu (ST 25), the Front-
and defensive qi, and confrontation be- (Mu) Point of the large intestine, are
tween the pathogenic factors and the used to remove accumulation of damp
body resistance result in fever and chills. heat from the intestines and to promote
When the stomach qi fails to descend, qi circulation and stop pain. Quchi (LI
there are nausea and vomiting. Yellow- 11), the He-(Sea) Point of the Large In-
sticky tongue coating and rapid, forceful testine Meridian, is used to eliminate heat
pulse indicate an excess syndrome caused from the intestines. Dazhui (GV 14) and
by accumulation of damp heat in the Hegu (LI 4) are used to strengthen the
stomach and intestines. Sharp pain with antipyretic action. Neiguan (PC 6) and
contracture of the abdominal wall, tend- Zhongwan (CV 12) are used to harmo-
erness, local mass, high fever, spon- nize the stomach and stop vomiting.
taneous sweating, and rapid forceful
pulse indicate suppuration with collec- Remarks
tion of pus and extreme heat in the Yang- "Intestinal abscess" is chiefly referred
ming Meridians. to acute simple appendicitis in modern
medicine, for which acupuncture treat-
Treatment ment is considered effective. If there is
Method: To disperse damp heat, regu- appendicial abscess or tendency to per-
late qi circulation and stop pain by reduc- forate, other therapeutic measures
ing method. Points of the Yangming should be resorted to. For chronic appen-
Meridians are selected as the principal dicitis, the above-mentioned points may
points. Needles are retained for a long time also be used. Acupuncture is given once
from thirty to one hundred twenty min- a day or every other day. Moxibustion
utes. Manipulation is given every ten may be applied locally at the same time.
minutes, and treat every six to eight hours.
When the symptoms and signs are alleviat- 6. Goiter
ed, treatment should be given once daily
with needles retained for thirty minutes. Goiter denotes Gn enlargement of the
Prescription: Tianshu (ST 25), Quchi thyroid gland, causing a swelling in the
(LI 11), Lanwei (Extra), Shangjuxu (ST front part of the neck, which is not ac-
CHAPTER 18 GYNECOI.OGICAL AND OTHER DISEASES 519

companied by pain, ulceration or skin ritability, tremor of the hands, sweating,

discoloration. According to the records stuffiness in the chest, palpitation, string-
of ancient literature, it can be classified taut, slippery and rapid pulse, and irregu-
as "qi goiter," "flesh goiter" and "stone lar menstruation.
goiter." In this section only "qi goiter"
and flesh goiter" are discussed. Treatment
Method: Activate blood circulation
Etiology and Pathogenesis and remove blood stasis, and disperse the
Goiter may be caused by exasperation, agglomeration through promoting the qi
anxiety or mental depression which leads circulation by reducing method. Points of
to stagnation of qi and accumulation of Hand Shaoyang and Yangming Meridi-
fluid forming phlegm. It also occurs in ans are selected as the principal points.
certain localities where the soil and water Prescription: Naohui (TE 13), Tian-
are not good. In the book General Trea- ding (LI 17), Tianrong (SI 17). Tiantu
tise on the Etiology and Pathogenesis. it (CY 22). Hegu (LI 4), Zusanli (ST 36).
says:"Mountainous areas with black soil Supplementary points:
where the spring takes its source are not Liver-qi stagnation: Tanzhong (CY
good for permanent dwelling, because 17), T aichong (LR 3) with even move-
drinking the spring water causes goiter." ment.
Generally speaking, qi goiter is mostly Palpitation: Neiguan (PC 6), Shen-
caused by drinking mountainous water men (HT 7) with the reinforcing method.
and qi stagnation, and flesh goiter by Exophthalmos: Sizhukong (TE 23),
stagnation of qi and accumulation of Zanzhu (BL 2), Jingming (BL I),
phlegm damp. Fengchi (GB 20) with even movement.
Hot temper, anxiety and sweating:
Differentiation Sanyinjiao (SP 6) and Fuliu (KI 7)
Main manifestations: Oi goiter is with even movement.
marked by diffusive swelling in the neck, Explanation: Naohui (TE 13) is a
soft, gradually increasing in size with un- point of the Triple Energizer Meridian of
clear margins, normal color. absence of Hand-Shaoyang. Triple energizer domi-
pain; in some cases big and drooping, nates the qi of the whole body. So Naohui
accompanied with dyspnea and hoarse- (TE 13) is used to remove obstruction
ness of voice. The size of the goiter usual- from the meridians in order to relieve qi
ly changes with emotions. stagnation and phlegm accumulation for
Flesh goiter often occurs in individ- the goiter. Tianding (LI 17), Tianrong (SI
uals below forty, more frequently in 17) and Tiantu (CY 22) are located on
women than in men, a few oval movable the neck. Puncturing them is to regulate
lumps below the Adama's Apple with the local circulation of qi and blood. to
smooth surface and without pain, accom- remove blood stasis and disperse agglom-
panied by exophthalmos, hot temper, ir- eration. Hegu (LI 4) and Zusanli (ST 36)

'- - - , - -- ----------------
520 CHINESE ACUPUNCTURE AND MOXIBUSTION

belong respectively to the Hand and cles and tendons of the trunk or limbs
Foot Yangming Meridians, which pass without fracture, dislocation or wound.
through the neck region. They have the Main manifestations are pain and
action of promoting qi circulation in swelling of the injured areas, and motor
the Yangming Meridians and eliminat- impairment of the joints.
ing stagnation of qi and blood. Tanzhong
(CY 17) is an Influential Point of qi, and Etiology and Pathogenesis
Taicong (LR 3) is the Yuan-(Primary) Local stagnation of qi and blood in the
Point of the Liver Meridian. Both are meridians of diseased areas is due to in-
used to regulate the circulation of the jury of tendinous tissues and joints by
liver qi. Shenmen (HT 7) is the Yllan- violent movement, awkward posture of
(Primary) Point of the Heart Meridi- the body, bruise, falling, traction or over-
an, and N eigllan (PC 6), the Luo- twisting.
(Connecting) Point of the Pericardium
Meridian. They are effective for palpita- Differentiation
tion. Sizhukong (TE 23), Zanzhu (BL 2) Main manifestations: Local swelling
and Jingming (BL 1) are local points. and pain, redness or ecchymosis. A new
Fengchi (GB 20) connects with the eye injury is slightly swollen with tenderness.
region. These four points are used togeth- Large area of swelling together with motor
er to readjust the circulation of qi and impairment of the joints is found in
blood in the eye region so as to control serious cases. Old injury is characterized
exophthalmos. Sanyinjiao (SP 6) and Fu- by absence of marked swelling but repeat-
liu (KI 7) are used to reinforce yin and ed recurrence due to invasion of exoge-
check yang in order to relieve irritability, nous pathogenic wind, cold and damp. The
boulimia and excessive perspiration. injury mostly happens in the shoulder,
elbow, wrist, back, hip, knee, and ankle.
Remarks Analysis: Sprain or contusion at any
1. The morbid condition described place of the body is due to tendinous
here refers to simple goiter and hyperthy- injury with local qi stagnation and blood
roidism in modern medicine. stasis, manifested by swelling and pain
2. The method of puncturing with with tenderness. In a protracted case, qi
several needles surrounding the goiter and blood are consumed, and their circu-
and with one needle in the center has a lation in the meridians tends to be fur-
fairly good effect of reducing the goiter. ther obstructed by exposure to wind, cold
and damp. That is why pain is exacerbat-
7. Sprain and Contusion ed in bad weather.
(Appendix: Torticollis)
Treatment
Sprain and contusion here refer to the Ashi points are used as the princi-
injury of soft tissues, such as skin, mus- pal points. Local and distal points of
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES ~21
----------------------------------------~

involved meridians may be combined to caused by an awkward sleeping posture

ease tendons and activate blood circula- or attack of wind cold on the nape that
tion, relieving swelling and pain. Apply leads to disturbance of local circulation
needling plus moxibustion to the local of qi in the meridians. Its main manifes-
points and needling alone to the distal tations are stiffness and pain of the neck
points. and nape, and wry neck towards one side
Prescription: Ashi points. with motor impairment.
Supplementary points: Method: Points of the Governor Ves-
Neck; Tianzhu (BL 10), Houxi (SI 3). sel and Taiyang Meridians are selected as
Shoulder joint: Jianjing (GB 21), Jian- the principal points. The reducing meth-
yu (LI 15). od and moxibustion are applied to Da-
Elbow joint: Quchi (LI II), Hegu zhui (GV 14), Tianzhu (BL 10), Jianwai-
(Ll 4). shu (SI 14), Xuanzhong (GB 39), Houxi
Wrist joint: Yangchi (TE 4), Waiguan (SI 3) to expel wind and disperse cold,
(TE 5). and to relax tendons and activate blood
Hip joint: Huantiao (GB 30), Yang- and qi circulation in the meridians. Kun-
lingquan (GB 34). lun (BL 60) and Lieque (LU 7) are add-
Knee joint: Dubi (ST 35), Neiting (ST ed for inability of flexion and extension.
44). Zhizeng (SI 7) is added for difficulty in
Ankle joint: Jiexi (ST 41), Qiuxu (GB rotating the neck so as to promote the qi
40), Kunlun (BL 60). circulation of Taiyang Meridians. Cup-
Explanation: Local and distal points ping may be applied after needling, or
from the affected meridians are select- Laozhen (Extra) is used alone for stiff
ed to promote the circulation of qi and neck.
blood in the meridians. Moxibustion to
the local points promotes the circulation
of qi and blood by warmth so as to relieve
swelling and pain, and to speed up the IV. DISEASES OF EYES,
recovery of the injured tissues. EARS, NOSE AND THROAT
Remarks 1. Deafness and Tinnitus
Needling can be applied to the healthy
side at the area corresponding to the af- Both deafness and tinnitus are audito-
fected area. When manipulating the nee- ry disturbances. Tinnitus is characterized
dle, ask the patient to move the sprained by ringing sound in the ears felt by the
joint. Alleviation or subsidence of pain patient and deafness is failing or loss of
may be expected. hearing. Because of the similarities be-
tween these two conditions in etiology
Appendix: Torticollis and treatment, they are discussed to-
Torticollis here refers to wry neck gether.
)22 CHINESE AClJP[lNCn,RE AND ~10XIBUSTION

Etiology and Pathogenesis a sign of invasion of the exogenous path-

Deafness and tinnitus can be divided ogenic wind.
into two types: deficiency and excess. b) Deficiency type:
The excess type is caused by fury of Main manifestations: Protracted deaf-
fright with upward rush of wind fire of ness, intermittent tinnitus aggravated by
the liver and gallbladder that obstructs strain and eliminated by pressing, dizzi-
the qi circulation in the Shaoyang Me- ness, soreness and aching of the lower
ridians or caused by invasion of patho- back, seminal emission, excessive leukor-
genic wind blocking the orifice. The de- rhea. thready and weak pulse.
ficiency type is due to deficiency of the Analysis: Hypofunction of the kidney
kidney qi and failure of essential qi to makes essential qi fail to ascend and fill
ascend to the ear. up the orifices, so there are deafness,
tinnitus and dizziness. The loin is the
Differentiation house of the kidney, so hypofunction of
a) Excess type: the kidney causes soreness and aching of
Main manifestations: Sudden deaf- the lower back. Deficiency of the kidney
ness, distension sensation and constant qi with impaired restraining function or
ringing in the ear that can not be elimi- deficiency of yin with flaming up of the
nated by pressing. In the case of upward asthenic fire that stimulates the seminal
perversion of pathogenic wind fire of the organs causes emission. Since the kidney
liver and gallbladder, there are flushed loses its function of restricting the Belt
face, dry mouth, irritability and hot tem- Vessel, there is excessive leukorrhea.
per, forceful and string-taut pulse. In the Thready and weak pule are signs of defi-
case of invasion by exogenous pathogenic ciency condition.
wind, there appear headache and superfi-
cial pulse. Treatment
Analysis: The pathogenic fire of the Method: Points of Shaoyang Meridi-
liver and gallbladder that flames up along ans of Hand and Foot are used as the
the related meridians results in deafness, principal points. The reducing method is
tinnitus, headache, flushed face, bitter applied for excess condition, while the
taste in the mouth and dryness of the reinforcing method for deficiency condi-
throat. Hyperfunction of the liver causes tion. Moxibustion is also advisable.
hot temper, and irritability is brought Prescription: Yifeng (TE 17), Tinghui
about by the pathogenic heat disturbing (GB 2), Xiaxi (GB 43), Zhongzhu (TE 3).
the mind. Forceful and string-taut pulse Fire preponderance in the liver and
indicates the excess condition of the liv- gallbladder: Xingjian (LR 2), Zulinqi
er and gallbladder. When the pathogenic (GB 41).
wind attacks the exterior of the body and I nvasion of exogenous pathogenic
obstructs the orifices, deafness, tinnitus wind: Waiguan (TE 5), Hegu (LI 4).
and headache occur. Superficial pulse is Hypofunction of the kidney: Shenshu
CHAPTER 18 GYNECOLOGICAL AND OTHER DL<;EASES 523

(BL 23), Mingmen (GV 4), Taixi (KI 3). Differentiation

Explanation: The Shaoyang Meridians Main manifestations: Congestion,
of Hand and Foot travel io the ear re- swelling and pain of the eye, photophob-
gion, so points of Shaoyang Meridians ia, lacrimation and sticky discharge. In
are used, e.g. Zhongzhu (TE 3), Yifeng the case of wind heat, there occur fever,
(TE 17) to Hand-Shaoyang, Tinghui (GB superficial and rapid pulse. In the case of
2) and Xiaxi (GB 43) of Foot-Shaoyang, preponderance of fire in the liver and
to regulate the qi circulation in the me- gallbladder, there are bitter taste in the
ridians. In the prescription, two local and mouth, irritability with feverish sensa-
two distal points are combined. Xingjian tion, constipation and string-taut pulse.
(LR 2) and Zulinqi (GB 41) are used to Analysis: when the pathogenic wind
clear away the pathogenic fire from the heat attacks the eye, congestion, swelling
liver and gallbladder, and to connect the and pain of the eye, photophobia, lacri-
upper and lower portions of the body. mation and sticky discharge take place.
Waiguan (TE 5) and Hegu (Ll 4) ex- Headache, fever and superficial-rapid
pel pathogenic wind. Shenshu (BL 23), pulse are also signs of exogenous attack
Mingmen (GV 4) and Taixi (LR 3) rein- of the pathogenic wind heat. The liver
force the essential qi of the kidney. has its specific body opening in the eyes,
and the Gallbladder Meridian starts at
Remarks the outer canthus. Upward disturbance
Tinnitus and deafness may be present of fire in the liver and gallbladder may
in various diseases, most of which seen in bring about congestion, swelling and pain
acupuncture clinic are neural. of the eye, bitter taste in the mouth, and
irritability. String-taut pulse is a sign of
2. Congestion, Swelling and the liver trouble.
Pain of the Eye
Treatment
Congestion, swelling and pain of the Method: Distal and local points are
eye is an acute condition in various exter- used in combination to disperse wind
nal eye disorders. heat. Needling is given with the reducing
method.
Etiology and Pathogenesis Prescription: Jingming (BL 1),
This condition is mostly due to exoge- Fengchi (GB 20), Taiyang (Extra), Hegu
nous pathogenic wind heat causing ob- (LI 4), Xingjian (LR 2).
struction of qi circulation in the meridi- Supplementary points:
ans, or due to preponderance of fire in Wind heat: Waiguan (TE 5).
the liver and gallbladder which flares up Fire preponderance in the liver: Tai-
along the related meridians, causing qi chong (LR 3).
stagnation and blood stasis in the merid- Explanation: The liver has its specif-
ians. ic body opening in the eyes; Shaoyang,
524 CHINESE ACUPUNCTl!RE AND MOXIBIlSTION

Yangming and Iaiyang Meridians all run by wind heat. Both may lead to dysfunc-
up to the eye region. Therefore Fengchi tion of the lung and invasion of the path-
(GB 20) and Hegu (LI 4) are used to ogenic factors upon the nose through the
regulate the qi circulation of the Yang- upper respiratory tract.
ming and Shaoyang Meridians in order to
dispel wind and heat. Jingming (BL I) is Differentiation
where the Iaiyang and Yangming Merid- Main manifestations: Nasal obstruc-
ians meet, and is used to disperse the tion, loss of the sense of smell, yellow
local accumulated heat. Xingjian (LR 2), fetid nasal discharge, thick and sticky,
the Ying-(Spring) Point of the Liver Me- accompanied by cough, dull pain in the
ridian, can conduct the qi of the Jueyin forehead, rapid pulse, reddened tongue
Meridian downward so as to remove the with thin, white and sticky coating.
heat from the liver. Taiyang (Extra), Analysis: Pathogenic heat accumulat-
an adjacent point to the eye region, is ed in the lung impedes the descending of
pricked to bleed to reduce heat and re- the lung qi, then pathogenic heat rushes
lieve swelling. In case of wind heat, Wai- up to the nose, causing nasal obstruction.
guan (IE 5) is used to clear it away from Pathogenic heat consumes the body fluid
the head and eyes. Taichong (LR 3), the and changes it into phlegm and mucus, so
Yuan-(Primary) Point of the Liver Me- there is turbid and fetid nasal discharge.
ridian, is selected to clear off the fire Cough results from adverse flow of the
from the liver and gallbladder. lung qi. When extreme heat in the lung
and stomach further disturbs the upper
Remarks orifices, pain with distension occurs in
This condition is involved in acute the forehead. Reddened tongue and rapid
conjunctivitis, pseudomenbranous con- pulse are signs of pathogenic heat in the
junctivitis, epidemic kerato-conjunctivi- lung.
tis, etc. in modern medicine.
Treatment
3. Thick and Sticky Nasal Discharge Method: Points of the Hand-Taiyin
and Hand-Yangming Meridians are se-
It is accompanied by nasal obstruction lected as the principal points to smooth
and loss of the sense of smell. the flow of the lung qi and expel patho-
genic wind heat by applying the reducing
Etiology and Pathogenesis method.
Occurrence of thick and sticky nasal Prescription: Lieque (LU 7),
discharge is related to the attack of path- Yingxiang (LI 20), Bitong (Extra), Hegu
ogenic factors on the lung which has its (LI 4), Yintang (Extra).
specific body opening in the nose. Exog- Explanation: Lieque (LU 7) smoothes
enous wind cold may transform into heat. the flow of the lung qi and eliminates the
Sometimes, the lung is directly attacked pathogenic wind. The Hand-Yangming
CHAPTER 18 GYKECOLOGICAL AKD OTliER DISEASES

Meridian is exteriorly-interiorly related rapid pulse.

to the Hand-Taiyin Meridian. and travels Analysis: Extreme heat in the lung
by the sides of nose. So Hegu (L1 4) and goes up to the nose. forcing blood to rush
Yingxiang (LI 20) are selected to regulate out of the vessels. The heat also causes
the qi circulation in the Hand- Yangming dysfunction of the lung in spreading and
Meridian and to clear away the heat from descending of qi. The reverse flow of qi
the lung. Yintang (Extra) is close to the results in cough. Reddened tongue and
nose, and Bitong (Extra) is located at the rapid pulse are signs of heat in the
sides of the nose. Both have the action of lung. Sometimes epistaxis occurs when
removing the obstruction and eliminating the stomach fire flares up along the me-
heat from the nose. ridians to the nose. and injures the blood
vessels. Thirst and preference for cold
Remarks drinking are caused by the stomach heat
This condition corresponds to chronic consuming the fluid. Exhaustion of fluid
rhinitis and chronic nasosinusitis in mod- causes constipation. The stomach heat
ern medicine. makes foul breath. Irritability and rest-
lessness are due to extreme heat in the
4. Epistaxis Yangming Meridians disturbing: the heart
mind. Reddened tongue with yellow coat-
Etiology and Pathogenesis ing and forceful rapid pulse are signs of
The lung qi flows up to the nose. the stomach heat.
The Foot-Yangming Meridian starts at b) De/iciell(v of yin with preponderance
the side of the nose. If there is accumu- of /ire:
lated wind heat in the lung or pathogenic Main manifestations: Epistaxis ac-
fire in the stomach, they would rush up- companied by malar flush. dryness of the
ward to the nose. If there is yin deficien- mouth. feverish sensation of the palms
cy leading to upflaring of the asthenic and soles. afternoon fever. night sweat-
fire. the blood would flow up together ing. thready and rapid pulse.
with the fire. All of these cause blood to Analysis: When deficiency of the kid-
rush out of the vessels. resulting in epis- ney yin causes the asthenic fire to flare
taxis. up to the nose. blood vessels are 1I1jured,
resulting in epistaxis. Malar flush. dry-
Differentiation ness of the mouth. feverish sensation of
a) Extreme heat in lung and stomach: the palms and soles, and afternoon fever
Main manifestations: Epistaxis ac- are manifestations of the asthenic fire
companied by fever, cough. reddened associated with yin deficiency. Night
tongue, superficial and rapid pulse: or sweating is ~~Iso due to the asthenic fire
dire thirst with preference for cold drink. that forces 11 e moisture to he given off.
constipation, foul breath. reddened Thready and rapid pulse is a sign of yin
tongue with yellow coating. forceful and deficiency.
S26 CHINESE ACUPUNCTURE AND MOXIBUSTION

Treatment nasal disorders and acute febrile diseases.

Method: Points of the Hand-Yangmi ng In addition to acupuncture treatment,
and Governor vessels are selected as the other therapeutic measures should be
principal points. The reducing method is adopted according to its primary cause.
applied to clear off the heat and stop bleed-
ing for extreme heat in the lung and stom- 5. Toothache
ach. The even movement is used to nourish
yin and descend the fire for deficiency of Toothache is a common ailment. It
yin with preponderance of fire. may be due to wind fire, stomach fire,
Prescription: Yingxiang (LI 20), Hegu asthenic fire, and dental caries.
(LI 4), Shangxing (GV 23).
Supplementary points: Etiology and Pathogenesis
Heat in the lung: Shaoshang (LU 11). The Hand and Foot Yangming Merid-
Heat in the stomach: Neiting (ST 44). ians go into the upper and lower gums
Deficiency of yin with preponderance respectively. Toothache may be due to
of fire: Zhaohai (KI 6). flaring up along the meridians of the
Explanation: The Hand-Yangming pathogenic fire transformed from patho-
Meridian and Hand-Taiyin Meridian are genic heat in the large intestine and
exteriorly and interiorly related. The stomach, or from exogenous pathogenic
Hand-Yangming Meridian connects with wind that attacks and accumulates in the
the Foot-Yangming Meridian. So Yangming Meridians. The kidney con-
Yingxiang (LI 20) and Hegu (LI 4) are trols bones and the teeth are the odds and
selected to clear off heat and stop bleed- ends of the bones. Deficiency of the kid-
ing. The Governor Vessel is the sea of all ney yin with flaring up of the asthen-
the yang meridians. Extreme yang forces ic fire may also give rise to toothache.
blood to rush out. So Shangxing (LI 20) Sometimes toothache is due to dental car-
is used to reduce heat of the Governor ies caused by overintake of sour and
Vessel. The lung has its specific body sweet food.
opening in the nose. Shaoshang (LU 11),
the ling-eWell) Point of the Lung Merid- Differentiation
ian, is used to reduce heat of the lung. a) Toothache due to stomach fire:
Neiting (ST 44), the Ying-(Spring) Point Main manifestations: Severe tooth-
of the Stomach Meridian, is good for ache accompanied by foul breath, thirst,
eliminating the stomach fire. Zhaohai constipation, yellow tongue coating,
(KI 6), one of the Confluential Points of forceful and rapid pulse.
the Eight Extra Meridians, has the action Analysis: Accumulated heat in the
of nourishing yin and reducing fire. stomach and intestines results in consti-
pation. Upsurging of the stomach heat
Remarks causes yellow tongue coating and foul
Epistaxis may be caused by trauma, breath. Thirst is due to the exhaustion of
CHAPTER 18 GYNECOLOGICAL AND OTHER DlSEASES 527

body fluid by heat. Severe toothache is selected.

due to the stomach heat flaring up along Prescription: Hegu (LI 4), liache (ST
the meridians. Forceful and rapid pulse 6), Neiting (ST 44), Xiaguan (ST 7).
also indicates the stomach fire. Explanation: Hegu (LI 4) of the con-
b) Toothache caused by wind fire: tralateral side is used to disperse patho-
Main manifestations: Acute toothache genic heat from the Hand-Yangming Me-
with gingival swelling accompanied by ridian. Neiting (ST 44), the Ying-
chills and fever. superficial and rapid (Spring) Point of the Stomach Meridian,
pulse. is used to reduce the fire in the stomach.
Analysis: The exogenous pathogenic Xiaguan (ST 7) and liache (ST 6) are
wind invades the Yangming Meridians local points to stop pain and regulate the
and turns into fire. Then occurs the qi circulation in the Foot-Yangming Me-
toothache with gingival swelling. When ridian.
the exogenous pathogenic factors strug- b) Toothache caused by wind fire:
gle against the body resistance in the Method: The reducing method is ap-
muscles and skins, there are chills and plied to dispel wind and clear off heat.
fever as exterior symptoms. Superficial Points of the Triple Energizer Meridian
and rapid pulse is a sign of wind-fire. of Hand-Shaoyang are selected.
c) Toothache caused by deficiency of the Prescription: Yemen (TE 2), Fengchi
kidney yin: (GB 20), Hegu (LI 4), liache (ST 6),
Main manifestations: Dull pain off Xiaguan (ST 7), Waiguan (TE 5).
and on, loose teeth, absence of foul Explanation: Waiguan (TE 5) is the
breath, reddened tongue, thready and Ying-(Spring) Point of the Triple
rapid pulse. Energizer Meridian of Hand-Shaoyang.
Analysis: The kidney controls bones Fengchi (GB 20) is used to dispel wind
and the teeth are the odds and ends of the and clear off fire. Hegu (LI 4), liache (ST
bones. The kidney in deficiency state fails 6) and Xiaguan (ST 7) are selected to
to keep the teeth strong, so they are loose. regulate the qi circulation in the Yang-
Flaring up of the asthenic fire leads to ming Meridians of Hand and Foot and to
dull pain. Since nothing is accumulated eliminate heat for relieving pain.
in the stomach, there is no foul breath. c) Toothache caused by deficiency of the
Thready, rapid pulse and reddened kidney yin:
tongue are due to heat caused by yin Method: The even movement method
deficiency. is applied to nourish yin and lower the
fire. Points of the Foot-Yangming and
Treatment Foot-Shaoyin Meridians are selected.
a) Toothache due to stomach fire: Prescription: liache (ST 6), Xiaguan
Method: The reducing method is ap- (ST 7), Taixi (KI 3).
plied to eliminate heat and stop pain. Explanation: The teeth relate to the
Points of Hand-Yangming Meridian are kidney and are situated at the place

_.----- ---~-- -~- --------------

 CIIIl\'ESE MTi'l'l\'CTt:RE AND ;\IOXIBl'STIOf'l

where the Stomach Meridian and Large Analysis: Exogenous pathogenic wind
Intestine Meridian go through. Thus heat invades the exterior portion of the
Taixi (Kl 3) is used to nourish yin of the body, leading to chills, fever and head-
kidney and lower the asthenic fire. Jiache ache. After having been transmitted to
(ST 6) and Xiaguan (ST 7) rei ieve pai n the lung system the pathogenic wind heat
by regulating the qi in the meridians. causes sore throat and dysphagia. The
lung is exteriorly-interiorly related with
Remarks the large intestine. Since the pathogenic
Toothache described here is involved heat consumes the body fluid. there are
in acute and chronic pulpitis, dental car- symptoms of thirst and constipation.
ies, peridental abscess and pericoronitis. Reddened tongue with thin yellow coat-
ing, superficial and rapid pulse are signs
6. Sore Throat of the pathogenic wind heat invading the
lung.
Sore throat is commonly seen. It can b) Svndrome of deficiel1(V a/yin:
be divided into two types: excess and Main manifestations: Gradual onset
deficiency. without fever or with low fever, slightly
congested throat with intermittent pain
Etiology and Pathogenesis or pain during swallowing, dryness of the
The throat communicates with the throat, more marked at night, feverish
stomach and the lung through the esoph- sensation in the palms and soles. red-
agus and the trachea respectively. Sore dened and furless tongue, thready and
throat of excess type (excess of heat) is rapid pUlse.
due to exogenous pathogenic wind heat Analysis: The Kidney Meridian of
that scorches the lung system or due to Foot-Shaoyin travels to the throat. Be-
the accumulated heat in the Lung and cause the kidney yin is insufficient to run
Stomach Meridians that disturbs upward. up to moisten the throat, the throat is
Sore throat of deficiency type (deficiency slightly congested with mild pain on and
of yin) is due to the exhaustion of the off and with dryness more marked at
kidney yin that fails to flow upward to night. Feverish sensation in the palms
moisten the throat, while the asthenic fire and soles, reddened and furless tongue,
flares up instead. thready and rapid pulse are signs of defi-
ciency of yin that causes yang preponder-
Differentiation ance.
a) Syndrome of excess of heat:
Main manifestations: Abrupt onset Treatment
with chills, fever, headache, congested a) Syndrome of excess of heat:
and sore throat, thirst, dysphagia. consti- Method: To disperse wind and elimi-
pation, reddened tongue with thin yellow nate heat by puncturing the points of
coating, superficial and rapid pulse. Hand-Taiyin and Foot-Yangming Merid-
CHAPTER 18 GYNECOLOGICAL AND OTHER DISEASES 529

ians with the reducing method. chronic pharyngitis.

Prescription: Shaoshang (LU II),
Hegu (LI 4), Neiting (ST 44), Tianrong 7. Optic Atrophy
(SI 17).
Explanation: Pricking Shaoshang (LU Optic atrophy is a chronic eye disor-
11) to let a few drops of blood out is used der marked by gradual degeneration of
to clear off the heat from the lung and the vision acuity. At the early stage there
relieve pain. Hegu (LI 4) disperses ex- is only blurring of vision, but at the late
terior pathogenic factors from the Lung stage the eyesight may be totally lost.
Merdian and the accumulated heat from
the Yangming Meridians. Neiting (ST Etiology and Pathogenesis
44), the Ying-(Spring) Point of the Stom- a) Deficiency of the kidney and liver
ach Meridian, reduces heat in the stom- yin leads to consumption of the essence
ach. Tianrong (SI 17) is a local point used and blood that nourish the eyes.
to ease the pain of a sore throat. b) Dysfunction in transportation and
b) Syndrome oj dejiciencycoj yin: transformation of the spleen due to irreg-
Method: To nourish yin and descend ular diet and overstrain results in inade-
fire by -puncturing with the reinforcing quate supply of the essential nutrients for
method at points of Shaoyin Meridians of the eyes.
Hand and Foot as the principal points. c) Dysfunction of the liver with stag-
Prescription: (a) Taixi (KI 3), Yuji nation of qi and blood in emotional trou-
(LU 10), Lianquan (CY 23) (b) Zhaohai bles causes failure of the essential qi to
(KI 6), Lieque (LU 7), Futu (LI IS). flow upwards to nourish the eyes.
The above two prescriptions may be
used alternatively. Differentiation
Explanation: Taixi (KI 3) is the Yuan- a) Dejiciency oj the liver and kidney
(Primary) Point of the Kidney Meridian yin:
which runs up to the throat. Yuji (LU 10) Main manifestations: Dryness of the
is the Ying-(Spring) Point of the Lung eyes, blurred vision, dizziness, tinnitus,
Meridian. Combination of the two points nocturnal emission, aching of the lower
nourishes yin and reduces the fire. Zhao- back, thready and weak pulse, reddened
hai (KI 6) and Lieque (LU 7), a pair of the tongue with scanty coating.
Eight Confluent POints, relieve sore throat Analysis: Dryness of the eyes and
by leading the asthenic fire downward. blurred vision are due to failure of the
Futu (LI 18) and Lianquan (CY 23) are essential nutrients to nourish the eyes in
local points for relieving pain. deficiency of the liver and kidney yin.
The lumbus is the seat of the kidney.
Remarks When the kidney is in a deficiency state,
Sore throat as described here is in- there is aching of the lower back. Defi-
volved in acute tonsilitis, acute and ciency of the kidney yin may lead to
530 CHINESE ACUPUNCTURE AND MOXIBUSTION

nocturnal emission when there is hyper- pulse is the sign of a liver disease.
activity of the asthenic fire, and to dizzi-
ness and tinnitus when there is yang Treatment
preponderance. Thready and weak pulse, Method: To reinforce the liver and
reddened tongue with scanty coating are kidney and nourish qi and blood by punc-
signs of yin deficiency. turing the points of the Foot-Shaoyang
b) Deficiency of qi and blood: and Taiyang Meridians with reinforcing
Main manifestations: Blurred vision, method for deficiency of the liver and
weakness of breath, disinclination to talk, kidney yin and deficiency of qj and blood.
lassitude, poor appetite, loose stools, Even movement is applied to the same
thready and weak pulse, pale tongue with points to remove the stagnation of the
thin white coating. liver qi.
Analysis: The essential qi of all the Prescription: Fengchi (OB 20), Jing-
zang-fu organs flows up to the eyes. ming (BL 1), Qiuhou (Extra), Ouang-
When qi and blood in a deficiency state ming (OB 37).
can not nourish the eyes, the vision Deficiency of the liver and kidney yin;
becomes blurred. Qi deficiency of the Taicong (LR 3), Taixi (KI 3), Oanshu
spleen and stomach causes weakness of
(BL 18), Shenshu (BL 23).
breath, disinclination to talk, lassitude,
Deficiency of qi and blood: Zusanli
poor appetite and loose stools. Thready
(ST 38), Sanyinjiao (SP 6).
and weak pulse, pale tongue with thin
Stagnation of the liver qi: Qimen (LR
and white coating are signs of deficiency
14), Taichong (LR 3), Yanglingquan (OB
of qi and blood.
34).
c) Stagnation of the liver qi:
Main manifestations: Blurred vision, Explanation: The Foot-Shaoyang and
emotional depression, dizziness, vertigo, Taiyang Meridians connect with the eye
hypochondriac pain, bitter taste in the region, so Fengchi (OB 20), Ouangming
mouth, dry throat and string-taut pulse. (OB 37), Jingming (BL 1) are selected to
Analysis: The liver has its specific regulate the qi circulation in the meridi-
body opening in the eyes. Stagnation of ans and to improve the eyesight. Qiuhou
the liver qi causes general obstruction of (Extra) is an extra point effective for eye
qi and blood which fail to ascend to nour- diseases. Oanshu (BL 18), Shenshu (BL
ish the eyes. So the vision is blurred. The 23), Taixi (KI 3) and Taichong (LR 3) are
Liver Meridian passes by the hypochon- used to reinforce the yin of the liver and
driac region, so there is hypochondriac kidney. Zusanli (ST 36) and Sanyinjiao
pain when the liver qi is stagnated. Re- (SP 6) reinforce qi and blood. Qimen (LR
tarded qi may turn into fire, which flares 14), Taichong (LR 3) and Yanglingquan
up to cause dizziness, vertigo, bitter taste (OB 34) remove stagnation of the
in the mouth and dry throat. String-taut liver qi.
 EAR ACUPUNCTURE THERAPY

Ear acupuncture therapy treats and thin layer of fat and connective tissue
prevents diseases by stimulating certain supplied by numerous nerves. The main
points on the auricle with needles. nerves are the great auricular and the
Ear acupuncture therapy has long lesser occipital derived from the second,
been used in China, and is recorded in third and fourth cervical spinal nerves, and
Chapter 24 of Miraculous Pivot that "Jue auricule-temporal branch of the trigemin-
headache with the symptoms of acute al nerve, vagus, the mixed branch of the
pain in the head, and hot sensations in facial nerve and the glossopharyngeal
the vessels in front of and behind the ear nerves, and sympathetic nerves.
should be treated by bloodletting in order To facilitate location of ear points,
to reduce the heat, then to be followed by the anatomical structures of the auricu-
needling at the points of Foot Shaoyang lar surface relating to ear acupuncture
Meridian." In the twentieth chapter of are briefly described as follows:
Miraculous Pivot it says, "When the path-
ogenic factor attacks the liver, it will 1. Helix: The prominent rim of the
cause pain in the ribs on both sides ... for auricle.
the pain caused by internal blood stagna- 2. Helix tubercle: A small tubercle at
tion ... needle at the blue vessels around the posterior-inferior aspect of the helix.
the ear to relieve the dragging pain." In 3. Helix cauda: The inferior part of
other classical medical literature there the helix, at the junction of the helix and
are descriptions on stimulating certain the lobule.
auricular areas with needle, moxibustion, 4. Helix crus: A transverse ridge of
massage, and herbal suppository to treat helix continuing backward into the ear
and prevent diseases. Those methods are cavity.
still used as folk remedies. 5. Antihelix: An elevated ridge anteri-
or and parallel to the helix. Its upper part
branches out into the superior and infer-
I. ANATOMICAL ior antihelix crus. It includes the princi-
TERMINOLOGY OF THE pal part of antihelix.
AURICULAR SURFACE 6. The principal part of antihelix: The
roughly vertical portion of the antihelix.
Ear is an organ of hearing symmetrical- 7. Superior antihelix crus: The super-
lyon both sides of the head. The auricle is ior branch of the bifurcation of the an-
composed of a plaie of elastic cartilage, a tihelix.

531
532 CHINESE ACUPL'NCTURE AND MOXIBlCSTION
---~

8. Inferior antihelix crus: The anterior 12. Supratragic notch: The depression
branch of the bifurcation of the antihelix. between the helix crus and the upper
9. Triangular fossa: The triangular de- border of the tragus.
pression between the two crura of the 13. Antitragus: A small tubercle op-
antihelix. posite to the tragus and inferior to the ear
10. Scapha: The narrow curved de- lobe.
pression between the helix and the anti- 14. Intertragic notch: The depression
helix. between the tragus and antitragus.
11. Tragus: A small, curved flap in IS. Helix notch: The depression be-
front of the auricle. tween the antitragus and antihelix.

Superior antihelix crus Helix Tubercle

Triangular fossa
Helix

Inferior antihelix crus Scapha

Cymba concha

Helix crus
Antihelix
Supratragic notich
Cavum concha

Helix notch
Tragus
Antitragus

I ntertrag ic notch Helix Cauda

Fig. 163 Anatomical Structure of the Auricular Surface

EAR ACUPUNCTURE THERAPY 535

16. Ear lobe: The lowest part of the a summary of the distribution of auricu-
auricle where there is no cartilage. lar points:
17. Concha: The hollow formed by the Points located on the lobule are relat-
antitragus, between the anterior part of ed to the head and facial region, those on
the helix and inferior antihelix crus. the scapha to the upper limbs, those on
18. Cymba concha: The concha super- the antihelix and its two crura to the
ior to the helix crus. trunk and lower limbs, and those in the
19. Cavum concha: The concha infer- cavum and cymba conchae to the internal
ior to the helix crus. organs. (See Fig. 164)
20. Orifice of the external auditory 1) Helix Crus and Helix: Points in-
meatus: The opening in the cavum con- clude Middle Ear on Helix Crus, Lower
cha shielded by the tragus. Rectum. Urethra, External Genitalia, Ear
21. The superior auricular root: The Apex and Helix 1-6 on helix.
area where the superior border of auricle 2) Scapha: Points include Finger,
attaches to the scale. (See Fig. 163) Wrist, Elbow and the corresponding parts
22. The inferior auricular root: The of the upper limbs.
area where ear lobe attaches to the face. 3) Antihelix: It includes the corres-
(See Fig. 163) ponding site of the trunk and the lower
limbs.
4) Tragus: Point Nose is on the outer
II. AURICULAR POINTS aspect of Tragus. At its border are points
Superior Tragic Apex and Inferior Tragic
Auricular points are specific stimulat-
Apex. Points Throat and Internal Nose
ing points on the auricle. When disor-
are on the inner aspect of Tragus.
ders occur in the internal organs or oth-
5) Antitragus: Points Forehead, Occi-
er parts of the body, various reactions
put and Temple are on the outer aspect
may appear at the corresponding areas of
of Antitragus. At the tip of the border
the auricle, such as tenderness, decreased
of Antihelix is the Point Middle Border.
cutaneous electric resistance, morpholog-
Point Brain is on the inner aspect of
ical changes, and discoloration. There-
Antihelix.
fore , these sites are also referred to as
6) Intertragic Notch: Point Intertragic
tender spots, conductant points or reflex
Notch is inferior to the orifice of external
spots. Thus, making a diagnosis, those
auditory meatus and on the intertragic
phenomena can be taken into considera-
notch. The areas anterior-inferior and
tion. Stimulating the sensitive sites serves
to prevent and treat diseases. posterior-inferior to the intertragic notch
orderly are points Anterior Intertragic
Notch, Posterior Intertragic Notch and
1. Distribution of Auricular Points
Inferior Intertragic Notch.
Ear points are distributed on the auri- 7) Triangular Fossa: Points include
cle in a certain pattern. The following is Ear-Shenmen, Triangular Depression
 534 CHINESE ACUPUNCTURE AND MOXIBUSTION

and Superior Triangle. various internal organs. Point Digestive

8) Cymba Conchae and Cavum Con- Tract is around helix crus. Posterior to the
chae: They are the corresponding areas for external auditory meatus is the Mouth
o Ear Apex

o Finger "'\.
Anterior Ear Apex ° \
superi/O' T"~gu,; F~~, '\nt~rnal oT~U.be~~:r ya~"g.H,''',
Triangular Fossa'
/ / HipO WrISt

End of ,n:::i21\~:::~lsC---~:~~:",~ B"~OCk ...."."",".... '\m\bO~'\' V,,".,,~

~~v;f> ~~~A,...bdomen -i OElbO\W
Urethra 0' C; 'O\?>~ I ~ Kidney'" g Helix 2
0 ~eo.. (\?>~-l :.:::>~ P-ancreas, Gall B ladder ~
\ I'- u~~ ----, Middle of cymba Concha;:;·
Lower Portion of Rectum ......,<:'-eo !$"+~U'.---7 -'~u~ \ < Thoraci)C Vertebrea

~
0 ....eo'> ....... !::' I ~ I oOeo '"
Superior Tragus 0 eo \<' g,C/J I <i>-'l/Ou ... , Liver 0 ii;
",'b~($ or? ~?I'E1t /~ \, Chest ~
1'/,; to ,___ , '"
~ 1"'. ..-( E> ~ , Shoulder
so/)
I 'ha9/.J'
.""<Ir..,

I- - -, s. - -
<>!ac .,- '-Spleen
0 • Ic
1Il'-
(")
~
0 I
Upper Apex of Tragus I Lung _, riFf ! ;:;'
,--. Cll ~

J-'
ct9 Ol

'Trachea i ~~~~' yertebrea 0

''\ 0
\. .. ' <
Pharyns and Larynx
o I 1__ "" ... _ ; ,,' ~
,.-....-
Ol
Nose Lung ~

-__ ,_-- --
Central Rim '"/
Sanjiao -"~~ Occiput °
- - __ ~ Antigragic Apex
: °Temple
Intertragus 0
I Forehead
Anterior Tragic Notch 0
", - - - - - .., - - - - - -
--- -
o Posterior Tragic Notch

'"f";~";' No'''' : TO;,'"' : F"" . , . .

S--: -:-- ~-~~e~~--~Helix5

Anterior Ear Lobe I Eye I Internal Ear
I I
- - -:- - --Areai --- Lower Root of Auricle

I 0 I
I Tonsil I

Fig. 164 Triple Energizer

.--------.-----
EAR ACUPUNCTURE THERAPY

point, then respectively are points Esoph- pect of Point Eye is Point Cheek.
agus, Cardiac Orifice, Stomach, Duoden- 10) The back of auricle: There are
um, Small Intestine, Appendix, Large Points Groove of Inferior Antihelix Crus,
Intestine, etc. Point Stomach is at the area Root of Auricular Vagus Nerve, Superior
where helix crus terminates. Point Liver is Root of Auricle and Inferior Root of
at the posterior aspect to Points Stomach Auricle, etc.
and Duodenum. Above Point Small Intes-
tine is Kidney. Point Bladder is above large 2. Location, Action and Indications of
intestine. Between Liver and Kidney is Ear Acupoints
Point Pancreas. Point Spleen is inferior to
Point Liver and close to the border of Numerous writings about the name,
antihelix. In the centre of cavum is Point location, action and indications of ear
Heart. Between Point Heart and Point acupoints have been recorded in Chinese
Mouth is Point Trachea. Among Points medical literature for centuries. In recent
Intertragus, Brain and Lung there is Point years new ear acupoints have been re-
Triple Energizer. ported, but these reports vary. The table
9) Ear Lobe: In the middle of ear lobe in the appendix for location, action and
is Point Eye. Above this point is Point indications of ear acupoints is made ac-
Tongue, in front of it are the four points cording to the International Standardiza-
of ear lobe. Posterior to Point Eye is tion of Ear Acupoints established by
Point Internal Ear, inferior to it is Point All-China Society of Acupuncture and
Tonsil, and at the posterior-superior as- Moxibustion.

Appendix: Location, Action and Indications of Ear Acupoints

Anatomi- I Name of Former Location Action and Indications
cal Portion i Point Name
+!-M-i-dd-I-e-=E=-a-r--ll-=D-i-a-ph=-r-a-g-m-+H::=-el-:-ix-cr--u-s-----~l'-::D=-e-s-ce-n-d-:-:-in-g-u-p-w-a-r-d:-r-ev-e-r-:si-ve
I I :qi of stomach, expelling wind
: i and regulating the function of
. diaphragm.
Indications: hiccup, jaundice,
symptoms and diseases of diges-
I tive system and skin.
!Lower Por- On the end of helix ap- Constipation, anus prolapse, ex-
Ition of Rec- proximate to superior ternal and internal hemor-
tum tragic notch. rhoids, tenesmus.
i
iUrethra On helix at level with the Enuresis, frequent, urgent and
lower border of inferior painful urination, retention of
antihelix crus. urine.
i
Helix Crus IExternal On helix at level with the Inflammation of external geni-
and Helix I Genitalia upper border of inferior I tal organs, eczema of the peri-
antihelix crus. : neum, impotence.
536 CH[NESE ACUPllNCTCRE AND MOX[Bl'STlOr-:

Front Ear Hemarrhoi- i Area between Ear Apex: External and internal hemor-
Apex dal Nucleus· and Superior Root of I rhoids (It is used as assistant
Auricle. : diagnosis for hemorrhoids).
Ear Apex At the tip of auricle and Removing heat and wind, anti-
superior to helix when spasmotism and analgesia, pac-
folded towards tragus. ifying liver and clearing vision.
Indications: fever, hyperten-
! sion, inflammation of eyes,
I painful diseases.
Liver Yang ! At auricular tubercle. Liver qi stagnation, liver yang
preponderance.
Helix 1-6 Region from lower bor- Clarifying heat and relieving
der of auricular tubercle i pain, pacifying liver and re-
to midpoint of lower bor- i moving wind.
der of lobule is divided Indications: fever, tonsillitis,
into five equal parts. The hypertension.
i points marking the divi-:
i sions are respectively He- :
lix 1, Helix 2, Helix 3,!
Helix 4, Helix 5, Helix 6. '
Finger At the top of scapha Pain and dysfunction at corres-
ponding area of the body.
Interior Urticaria or Midpoint between Fin-. Expelling wind and stopping it-
Tubercle Allergic ger and Wrist. ~ ching.
Point
Wrist Midway between Elbow: Pain and dysfunction at corres-
I •
and Finger. pondmg area of the body.
Scapha Elbow Midway between Finger Pain and dysfunction at corres-
and Clavicle. ponding area of the body.
Shoulder Midway between Elbow. Pain and dysfunction at corres-
and Clavicle. ' ponding area of the body.
Clavicle On scapha at level with i Pain at corresponding area, per-
helix-tragic notch. i ipheral arthritis of the should-
er, Takayashu's disease (pulse-
less disease).
Toe Superior and lateral an- i Pain and dysfunction of corres-
gle of superior antihelix ponding area of the body.
crus.
Superior Heel Superior and medial an- Heel pain.
Antihelix gle of superior of antihe- I
Crus lix crus.
Ankle Midway between heel Ankle sprain, pain and dys-
and knee. function at corresponding area
of the body.
EAR ACUPUNCTURE THERAPY 5,7

Knee Middle portion at super- Pain and dysfunction at corres-

ior antihelix crus. ponding area of the body (such
as sprain and arthritis of the
knee joint).
Hip At inferior 1/3 of the su- j Pain at corresponding area.
I perior antihelix crus. '
Inferior Buttocks At lateral 1/3 of the in- Pain at corresponding area.
Antihelix ferior antihelix crus.
Crus
Ischium Sciatic At medial 2/3 of the in- Sciatica
: Nerve ferior antihelix crus
End of Infer- Sympathet- The terminal of inferior Antispasmotism and analgesia,
ior Antihelix ic Nerve antihelix crus. nourishing yin and supporting
Crus yang.
Indications: pain of internal or-
gans, palpitation, spontaneous
sweating, night sweating; func-
tional disorders of autonomous
nerve system.
Antihelix Cervical A curved line from helix- Strengthening spine and nour-
Vertebrae tragic notch to the ishing marrow.
Thoracic branching area of super- Indications: pain at cor res-
Vertebrae ior and inferior antihelix ponding part of the spine.
Sacral crus can be divided into
Vertebrae 3 equal segments. The
lower 1/3 of it is Cervical
Vertebrae, the middle
1/3 is Thoracic Verte-
brae, and the upper 1/3
is Lumbosacral Verte-
, brae.
I

Neck On the border of cavum Strained neck, wry neck, pain

conchae of Cervical Ver- or dysfunction of the neck.
tebrae.
Chest On the border of cavum Pain and stuffiness of the chest,
conchae of Thoracic Ver- or pain at the corresponding
tebrae. part of the body.
Abdomen On the border of cavum Abdominal or gynecological
conchae of Lumbosacral diseases, lumbago.
Vertebrae.
Ear-Shenmen At bifurcating point be- Sedation, easing mind, reliev-
tween superior and infer- ing pain, clearing heat.
ior antihelix crus, and at
the lateral 1/3 of trian-
gular fossa.

- . ------- ---------
538 CHINESE ACUPUNCTURE AND MOXIBUSTION

Triangular Triangular Tiankui In the triangualr fossa Supporting yang and nourish-
Fossa Depression Uterus and in the depression ing essence, regulating men-
Seminal close to the midpoint of strua tion and harmonizing
Palace helix. blood.
Indications: gynecological dis-
eases and symptoms, impo-
tence, prostates, etc.
Superior Lowering At the superior-lateral Pacifying liver and removing
Triangle Blood Pres- angle of Triangular Fos- wind.
sure sa. Indication: hypertension.
Superior Tra- Ear On the supra tragic notch Nourishing kidney-water, sub-
gus close to helix. duing liver yang.
Indications: ear disease, dizzi-
ness and vertigo.
Nose External In the centre of lateral Removing obstructions from
Nose aspect of tragus. the meridians in the nose re-
gion.
Indica tions: brandy-nose or
nose furunc1es, nasal obstruc-
tion, and other nose problems.
t

Tragus Supratragic Tragic At the tip of upper pro-' Reducing heat and relieving
Apex Apex tuberance on border of pain.
tragus.
Infratragic Adrenal At the tip oflower tuber- Reducing heat and relieving
Apex cle on border of tragus. pain, anti-spasmotism and ex-
pelling wind.
I
Pharynx- Upper half of medial as- Clarifying obstructions of the
I Larynx pect of tragus. pharynx and larynx.
! Indications: acute and chronic
pharyngitis and chronic laryn-
gitis and tonsillitis.
Internal Nose Lower half of medial as- Removing obstructions of the
pect of tragus. nose.
Indications: allergic rhinitis
and other nose diseases.
Antitragic Soothing At the tip of antitragic. Strengthening the lung and
Apex Asthma or stopping asthma, clearing up
Parotid heat and antitoxic, and expel-
ling wind.
Indications: asthma, bronchi-·
tis, parotitis and itching skin.
Middle Bor- Brain Midpoint between an- Replenishing brain and easing
der titragic apex and helix- mind.
tragic notch. Indications: oligophrenia (in-
complete development of intel-
ligence), enuresis, etc.
EAR ACUPUNCTURE THERAPY 539

Occiput ! A t posterior superior cor- i Sedation and analgesia, easing

! ner of lateral aspect of: mind and removing wind.
antitragus. Indications: dizziness, head-
ache, insomnia, etc.
Antitragus Temple Taiyang On antitragus between Sedation and analgesia.
Forehead and Occiput. Indication: Shaoyang head-
ache.
Forehead At anterior inferior cor- Sedation and anal gesia.
ner of lateral aspect of Indications: Yang Ming head-
antitragus. ache.
Brain Subcortex Reinforcing marrow and re-
plenishing brain, relieving pain
and easing mind.
Indications: oligophrenia, in-
somnia, dream disturbed sleep,
tinnitus due to kidney deficien-
cy.
Mouth Close to posterior and su- Clearing up heart fire, remov-
perior border of orifice ing pathogenic wind.
of external auditory mea- Indications: facial paralysis,
tus. stomatitis, etc.
Periphery Esophagus At medial 2/3 of inferior Regulating function of dia-
helix crus aspect of helix crus. phragm and harmonizing stom-
ach.
Indications: dysphagia, esopha-
gitis, etc.
Cardiac At area where helix crus Harmonizing stomach and re-
Orifice terminates. plenishing spleen, reinforcing
middle energizer and easing
mind.
Indications: insomnia, gastritis,
gastroduodenal ulcer and other
diseases and symptoms of gas-
tric region.
Duodenum i At lateral 1/3 of superior Warming middle energizer and
aspect of helix crus. harmonizing stomach.
Indications: duodenal ulcer,
pylorospasm, etc.
Small Intes- At middle 1/3 of super- Reinforcing spleen and har-
tine ior aspect of helix crus. monizing middle energizer,
nourishing heart and producing
blood.
Indications: indigestion, palpi-
tation, etc.
Appendix Between Small Intestine Clearing up damp heat from
and Large Intestine lower energizer.
540 CHINESE ACUPUNCTURE AND MOXIBUSTION

i Indications: appendicitis, diar-

, rhoea, etc.
Large Intes- At medial 1/3 of supcr- Clearing up lower energizer, re-
tine ior aspect of helix crus. plenishing lung-qi.
Indications: diarrhoea, consti-
pation.
Liver At posterior aspect of Clearing up liver and brighten-
Stomach and Duoden- ing vision, promoting smooth
urn. circulation of qi and blood to
relax muscles and tendons.
Indications: liver-qi stagnation,
eye diseases and disorders of
lateral-lower abdomen.
Cymba Pancrease Between Liver and Kid- Replenishing gallbladder and
Conchae ney. building up stomach, removing
liver-qi stagnation and liver-
wind.
Indications: diseases and symp-
toms of bile duct, pancreasitis,
migraine, etc.
Kidney On the lower border of Reinforcing kidney and pro-
inferior antihelix crus, moting hearing, strengthening
directly above Small In- bone and filling up marrow.
testine. Indications: nephritis, lumba-
go, tinnitus, diplacusis, sperma-
torrhea, impotence, etc.
Ureter Between Kidney and Stone and colic pain of ureter.
Bladder.
Bladder On the lower border of Replenishing lower energizer
inferior antihelix crus, and reinforcing lower sap.
directly above Large In- Indications: lower back pain,
testine. sciatica, cystitis, enuresis, re-
tention of urine.
Angle of At medial superior angle Clarifying lower energizer, re-
Cymba of Cymba Conchae. moving obstruction from the
Conchae urethra.
Indication: prostatitis.
Middle Cym- Periphery In the center of Cymba Regulating middle energizer
ba Conchae Umbilicus Conchae. and harmonizing spleen.
Indications: low fever, abdom-
inal distension, ascariasis of
bile duct, impaired hearing,
parotitis, etc.
Heart In the central depression Tranquilizing heart and easing
of cavum conchae. mind, regulating ying-blood, re-
lieving pain and itching.

------------------------- ------- ---------

EAR ACUPUNCTURE THERAPY 541
----

Indications: insomnia, palpita-

tion, hysteria, night sweating,
i
I
angina pectoris, etc.
Cavum [Lung Around Heart. Promoting smooth circulating
Conchae of qi and blood, diuresis, rein-
forcing deficiency and clearing
I up heat, nourishing skin and
ih .
i aIr.
; Indications: cough and asthma,
skin diseases, hoarseness of
voice; commonly used point of
acupuncture anesthesia.
Trachea In the area of Lung, be- Stopping cough and dispelling
tween Mouth and Heart. I phlegm.
'Indications: cough and asthma.
Spleen Inferior to Liver, at lat- Digesting food, producing ying-
eral and superior aspect blood, nourishing muscles,
of cavum conchae. building up spleen qi.
Indications: abdominal diar-
rhoea, distension, chronic in-
digestion, stamotitis, functional
uterus bleeding, etc.
i Triple Superior to Intertragus. Removing obstruction from the
: Energizer water passages, clearing up heat
i I
and stopping itching.
Intertragus . Endocrine At the base of cavum Removing liver-qi stagnation,
conchae in the intertrag- regulating menstruation and
ic notch. activating blood circulation, ex-
pelling pathogenic wind, rein-
forcing lower energizer.
Indications: skin diseases, im-
potence, irregular menstrua-
tion, climacteric syndrome,
: dysfunction of endocrine, etc.
Frontal Trag- Eye 1 On lateral and anterior Clearing up liver and brighten-
ic Notch side of intertragic notch. ing vision.
Indications: glaucoma, pseu-
domyopia and other eye diseas-
es.
Lower Tragic Elevating On the inferior aspect of Reinforcing qi and elevating
Notch Blood Pres- intertragic notch. yang.
sure Point Indication: hypotension.
Ear Back Tragic Eye2 On lateral and inferior Clearing up liver fire and
Lobule Notch aspect of intertragic brightening vision.
I notch. Indications: ametropia, exter-
nal eye inflammation, etc.

~- --- - - - .-.-------.--------~-------
::..54:..:2_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _--=C:.:.;H=iN--=ESE ACUPUNCTURE AND MOXIBUSTION

Cheek On the ear lobe, at poste- Removing obstructions from

rior and superior aspect the meridians on facial region.
of Eye. Indications: facial paralysis
and other facial problems.
Tongue In the centre of the 2ndClearing up heart fire.
section of lobule. Indication: glossitis.
Jaw In the centre of the 3rdToothache, submandibular ar-
section of lobule. thritis, etc.
Section 4 of Neuras- Communicating water with
In the 4th section of ear
Ear Lobe thenic lobe. fire, tranquilizing heart and
Point easing mind.
Indications: toothache, neuras-
thesnia.
Eye In the 5th section of ear Brightening vision.
lobe. Indications: acute conjunctivi-
tis, electric ophthalmia, myopia
and other eye diseases.
Internal Ear In the 6th section of the Relieving vertigo and improv-
ear lobe. ing hearing.
Indications: tinnitus, impaired
hearing, auditory vertigo, etc.
Tonsil In the 8th section of the Relieving throat problems.
ear lobe. Indication: acute tonsillitis.
Upper Root Middle Sta- At the upper border of Relieving pain and asthma.
of Auricle sis or Spi- the auricular root. Indications: headache, abdom-
nal Cord inal pain, asthma.
Lower Root Spinal Cord On the lower border of Relieving pain and asthma.
of Auricle the juncture between the Indications: headache, abdom-
ear lobe and the cheek. inal pain, asthma.
Root of Au- At the junction of re- Opening orifice and relieving
ricular Vagus troauride and mastoid, pain, easing zang-fu organs.
Norve level with helix crus. Indications: headache, nasal
obstruction, ascariasis of bile
duct, etc.
Back Auri- Groove of In- Groove for Through the backside of Pacifying liver and descending
cle ferior Helix Lowering superior antihelix crus reversing qi of the liver, reliev-
Crus Blood Pres- and inferior antihelix ing skin disease.
sure crus, in the depression as Indications: hypertension, skin
a "Y" form. I diseases.

Heart At the upper back of the Clearing and reducing heart

ear. fire, tranquilizing heart and
easing mind, relieving pain.
Indications: furuncles, insom-
i nia, dream-disturbed sleep, hy-
: pertension, headache, etc.
 EAR ACUPUNCTURE THERAPY 543

Spleen In the middle at the back Building up spleen and har-

of the ear. monizing stomach, producing
ying-blood and nourishing mus-
cles.
Indications: abdominal disten-
sion, diarrhoea, indigestion, etc.
Liver On the back of ear, at Removing liver-qi stagnation
lateral aspect of Spleen. and harmonizing stomach,
Inourishing tendons and activat-
i ing blood circulation.
I Indications: distension and
. i fullness of chest and hyper-
I i chondriac region, acute appen-
i Idicitis, soreness and aching of
I the lower back, etc.
Lung I On the back of the ear, at IReinforcing lung and soothing
Imedial aspect of Spleen. i asthma, clearing up heat, re-
lieving problems of skin and
li hair.
I Indications: asthma, diseases
' and symptoms of digestive sys-
I [tern, fever, etc.
I Kidney i At the lower part of the INourishing kidney water, im-
i, retroauricle. II proving hearing, strengthening
i
i II I• bone, filling up marrow.
. I Indications: headache, insom-
I I nia, dizzin.ess, vertigo, irregular
I menstruatlon.

3. Examination Methods of Ear acupuncture. The following are common-

Acupuncture ly used methods of detection:
1) Detecting the tender spot Press
When an internal organ or a part of with a probe or the handle of a filiform
the body is diseased, reactions can be needle the disease-related corresponding
detected at the corresponding areas on area, to ascertain the most sensitive
the auricle. For example, a reaction can point.
be detected at Point Stomach when the 2) Observing by naked eye Look for
stomach is ill. Clinical practice has prov- any abnormality or discoloration of the
en that stimulating these reaction points auricle such as scalling, blisters, papulae,
yields good therapeutic results. There- hard nodules, pigmentation, or morpho-
fore, detecting reaction points should be logical changes such as in blood vessels of
combined with consulting an auricular the auricle.
acupoint chart in the application of ear 3) Detecting electrical changes Ob-

----------- -----------
544 CHINESE ACUPUNCTURE AND MOXIBUSTION

serving changes in electrical resistance, exteriorly-interiorly related to the small

capacity, and potential at auricular intestine; Point Gallbladder for temporal
points. The most commonly used method headache as the temporal region is sup-
is to determine the conductant point of plied by the Gallbladder Meridian of
skin resistance by instrument. Those au- Foot-Shaoyang: Point Liver for pain, red-
ricular points with low electrical resist- ness and swelling of the eyes, since the
ance can be displayed on a screen, or by liver opens to the eyes.
an indicator, or by sound, through the 3) Selection of points according to clin-
apparatus. This is used for clinical diag- ical experience e.g. Point Ear Apex can
nosis. be selected for pain, redness and swelling
of the eyes; Points Helix 2, 4, and 6 for
pain and swelling of the throat.
III. CLINICAL
APPLICATION OF EAR 2. Manipulation Methods of Ear
ACUPUNCTURE Acupuncture

Ear acupuncture is used for preven- Different methods have been devel-
tion and treatment of disease, and also oped on the basis of filiform needling,
for acupuncture anesthesia. This chapter such as embedding needles and needling
mainly deals with its application to clini- with electrical stimulation. However, fili-
cal treatment and disease prevention. form needling remains the most widely
used.
The technique is performed as fol-
1. Principles for Selection of Points
lows:
Point selection can be on the following 1) Probing the sensitive spot and asep-
bases: tic procedure After diagnosis and point
1) Selection of points according to dis- prescription detect the sensitive spots by
ease location Auricular points corres- probing or by an electric acupoint detec-
ponding to the diseased areas are selected tor. When tenderness or low electrical
for treatment, e.g. Point Stomach for gas- resistance areas are found, then mark
tralgia, Point Shoulder for shoulder pain. the spot for needling. Auricular points
2) Selection of points according to should be swabbed with 75% alcohol or
the theories of traditional Chinese medi- 20% iodine as routine asepsis.
cine According to the theories of zang- 2) Method of needle insertion Sta-
fu or meridians and collaterals, corres- bilize the auricle with the left hand. Hold
ponding auricular points are selected for the filiform needle of 0.5 or 1 cun with
treatment, e.g. Point Lung can be selected the right hand and insert swiftly and
for skin diseases because the lung domi- perpendicularly into the point avoiding
nates the skin and hair; Point Small In- penetration through the ear. Generally, a
testine for arrythmia as the heart is sensation of pain, and occasionally heat,
EAR ACUPUNCTURE THERAPY 545

distension, soreness, or heaviness are felt. the neck by moving it about. Apply nee-
Patients experiencing these sensations dling plus moxibustion on the tender spot
usually obtain satisfactory therapeutic re- of the neck region. Alleviation or subsid-
sults. If acupuncture sensation does not ence of pain may be expected. Treat once
appear, then the direction of needling daily.
should be adjusted to obtain sensation. 4) Acute sprain Selection of points:
3) Retention and removal of nee- Ear-Shenmen, Brain, and Tender spots
dles Needles are usually retained for 25 corresponding to sprained areas. Apply
to 30 minutes, but in cases with severe strong stimulation with filiform needle.
pain or chronic seizures, needles may be Needles are retained for 30 to 60 minutes,
retained for a longer period, or needle treat once daily. After needle insertion,
embedding may be applied. After the nee- patient may have congestion or heat sen-
dle is removed, press the puncture hole sation of the auricle; the patient should
with a dry cotton ball to avoid bleeding, then exercise the affected area. At the
swab with iodine at once to avoid infec- same time, warm moxibustion or massage
tion. can be added to enhance the therapeutic
effect.
5) Sciatica Selection of points: Is-
3. Prescriptions for Common
chium. Puncture the affected side first. If
Diseases
there is not much improvement, needle
1) Headache Selection of points: the same auricular point of the healthy
Forehead, Occiput and Brain, Middle side. Apply strong stimulation. Needles
Border, Ear Apex. Apply strong stimula- are retained for I to 2 hours, treat once
tion with filiform needles. Needles are daily or every other day.
retained for 30 to 60 minutes. Ten treat- 6) Phantom limb pain Selection of
ments constitute a course. points: Ear-Shenmen, Forehead, Brain,
2) Migraine Selection of points: other auricular points of corresponding
Forehead, Temple, Occiput, Ear- areas. Several needles may be inserted at
Shenmen. one point. Give strong stimulation with a
Secondary points: Neck, Heart, Liver, filiform needle. If necessary, treatment
Ear Apex and Helix 6. Apply electric can be increased twice or three times
acupuncture once every other day. Select per day, with 3 to 5 days constituting a
3 to 5 points for each treatment. During course.
an attack, bloodletting on Helix 6 and Ear 7) Postoperative incision pain Se-
Apex can be added. lection of points: Ear-Shenmen, Brain,
3) Stiff neck Find tenderness or Ear Apex, Lung and other ear points
most sensitive spot at Forehead and Cer- corresponding to operative incision. Ap-
vical Vertebrae. Apply strong stimula- ply strong stimulation with a filiform
tion. Needles are retained for 60 minutes, or electric acupuncture. Needles are re-
during which the patient should exercise tained I to 2 hours, treat once daily.
546 CHINESE ACUPUNCTURE AND MOXIBUSTION

8) Postoperative abdominal disten- men, End of Inferior Antihelix Crus and

sion Selection of points: Large Intestine Brain. Puncture the affected side first,
and Small Intestine, Stomach, End of In- then the healthy side. If there is not much
ferior Helix Crus, and Spleen. Apply relief, apply strong stimulation with re-
strong stimulation with intermittent rota- tention of needles for 20 to 40 minutes or
tion of needles or with electric acupunc- with electric acupuncture.
ture. Needles are retained for one to two 13) Pain caused by cancer or tu-
hours. mor Selection of points: Brain, Heart,
9) Perifocal inflammation of the Ear Apex and other auricular points cor-
shoulder Selection of points: Shoulder, responding to the pathological areas.
Clavicle, Infra Tragic Apex. Secondary points: End of Inferior An-
Secondary points: Liver, Spleen and tihelix Crus, Liver and Ear-Shenmen.
Brain, Tender spots in the cavum con- Choose 4 to 6 points for each treatment;
chae. Treat once daily with a filiform use both sides alternatively. Treat once
needle or electric acupuncture. Choose 3 daily. Or apply acupoint injection with
or 4 points for each treatment. Treatment 0.1-0.3 m! Dolantin subcutaneously and
course vari~s according to the individual obliquely from Ear-Shenmen to the ante-
disease condition. rior and inferior aspect of this point.
10) Acute cholecystitis and gall- After injection, remove the needle slowly
stones Selection of points: Penetrating in order to avoid the out flow of drug
the right Ear-Shenmen towards Ab- from the needle hole.
domen, End of Inferior Helix Crus and 14) Transfusion reaction Selection of
Gallbladder; penetrating Gallbladder 0.2 points: Ear-Shenmen, Infratragic Apex
cm below towards Duodenum, and the and Brain. Apply strong stimulation with
left Gallbladder penetrating towards a filiform needle. Continue the retention
Duodenum. Give electric stimulation for of needles for 30 minutes after the stop-
20 to 40 minutes once a day. Three to 5 ping of chills.
treatments are considered as a course. 15) Acute bacterial dysentery Se-
11) Ascariasis in the biliary duct Se- lection of points: Large Intestine, Small
lection of points: Liver, Gallbladder, Intestine and Lower Portion of Rectum.
Duodenum and Root of Auricular Vagus Apply strong stimulation with a filiform
Nerve. Puncture right side first. Stimu- needle. Treat once or twice a day for 3 to
late left side if there is not much im- 7 days.
provement in pain. During retention, ro- 16) Tertian malaria Selection of
tate the needles once every five to ten points: Infratragic Apex, Brain and Inter-
minutes. After abdominal pain stops, tragus. Treat once daily or every other
western medication or Chinese medicinal day or two hours before estimated time
herbs should be administered. of attack. Retain needles until the attack
12) Colic pain due to ureteral calcu- is over. Rotate the needles twice or three
lus Selection of points: Kidney, Abdo- times during retention.

----------------
 EAR ACUPUNCTURE THERAPY )47

17) Epidemic parotitis (mumps) Se- for 30 to 60 minutes. Rotate needles twice
lection of points: Antitragic Apex, or three times during needle retention.
Cheek, Subcortex and Brain. Apply Treat once daily.
strong stimulation with a filiform nee- 21) Hypertension Selection of
dle. Treat once or twice daily. Three points: Infratragic Apex, Groove of I!1-
days constitute a treatment course. ferior Antihelix Crus, Helix and Ear-
Scorching moxibustion with oily herbal Shenmen.
lampwick also can be applied on Ear Secondary points: Intertragus, Fore-
Apex or between Small Intestine and head, Temple, Liver and Kidney. Fili-
Kidney. Moxibustion can be applied on form needle, electric acupuncture or nee-
the affected side for swelling of one side, dle embedding can be used according to
or bilaterally for mumps of both sides. different conditions. Treat once daily or
Moxibustion is given once a day until every several days. Choose 4 or 5 points
swelling subsides. for each treatment. Ten treatments are
18) Bronchial asthma Selection of considered as a course. A one-week rest
points: Lung, Trachea, Infratragic Apex, interval is instituted between courses.
Antitragic Apex and Ear-Shenmen. 22) Hiccough Selection of points:
Secondary points: Root of Auricular Sensitive spots near Middle Ear or Root
Vagus Nerve, Kidney, Triple Energizer of Auricular Vagus Nerve. Puncture with
and Large Intestine. Apply strong stimu- strong stimulation. For refractory cases
lation with a filiform needle. One treat- needle embedding is applied following
ment is given daily during an attack. filiform needling.
Choose 4 or 5 points bilaterally or unila- 23) Vomiting Selection of points:
terally for each treatment with retention Stomach, Liver, Spleen and Ear-
of needles for 30 minutes. After the sta- Shenmen. Treat once daily, for severe
bilization of condition, treatment is re- cases twice or three times per day. One
duced to once every other day. During course is composed of 3 to 5 treatments.
remission needle embedding can be ap- Use mild stimulation during early stage
plied to consolidate effectiveness. of treatment.
19) Acute bronchitis Selection of 24) Chronic gastritis Selection of
points: Lung, Trachea and Ear-Shenmen. points: Stomach, End of Inferior Antihe-
Secondary points: Occiput, Infratrag- lix Crus and Lung.
ic Apex and Root of Auricular Vagus Secondary points: Liver, Spleen,
. Nerve. Treat once daily or every other Mouth and Intertragus. Embedding
day with a filiform needle. Choose 3 or 4 method with herbal seeds or any kind of
points bilaterally for each treatment. granules is applied after filiform needling
20) Paroxysmal tachycardia Se- or electric acupuncture. Needle once dai-
lection of points: Heart, End of Inferior ly with 3 to 5 points each time.
Antihelix Crus, Ear-Shenmen and Brain. 25) Gastric or duodenal ulcer Se-
Apply mild stimulation. Retain needles lection of points: Stomach or Duodenum,
548 CHINESE ACUPUNCTURE AND MOXIBUSTION

End of Inferior Antihelix Crus, Brain and Treat once every other day. Ten treat-
Mouth. ments constitute a course. Mild stimula-
Secondary points: Triple Energizer, tion should be given during the recovery
Ear-Shenmen, Liver, Spleen and Middle stage.
Ear. Filiform needling is applied at 3 to 30) Facial neuritis Selection of
5 points each time. In the acute stage points: Eye, Cheek, Liver and Mouth.
treat once daily, and during remission Secondary points: Spleen, Forehead,
once every other Jay. Ear-Shenmen and Infratragic Apex. Dur-
26) Acute diarrhoea Selection of ing acute stage apply mild stimulation
points: Large Intestine (puncture three with a filiform needle at 3 to 5 points on
needles) and Stomach. Stimulation is giv- the affected side for each treatment. Af-
en according to the patient's constitution. ter being treated for several days, change
For severe cases treat once every 2 to 4 to electric acupuncture with low frequen-
hours, and reduce to once every other day cy or dense-dispersion wave-form. Treat
or twice a week after relief of symptoms. once daily or once every other day.
Retain needles for 30 minutes. 31) Sequelae of cerebrovascular acci-
27) Enuresis Selection of points: dent Selection of points: Brain, Middle
Kidney, Bladder, Liver and Brain. A fili- Border, Liver, Triple Energizer, and oth-
form needle or electric acupuncture is er auricular points corresponding to the
applied at 3 or 4 points for each treat- paralytic sides of the body. Secondary
ment. Treat once daily or once every points are added according to different
other day, and reduce to once a week symptoms. For aphasia add Heart and
after therapeutic effect is stable. Spleen, and for dysphagia add Mouth,
28) Neurasthenia Selection of Root of Auricular Vagus Nerve, and
points: Ear-Shenmen, Heart, Brain and Throat. Treat once every other day after
Middle Border. stabilization of diseased condition and
Secondary points: Kidney, Liver and recovery from unconsciousness. One
Intertragus Apply mild stimulation with course of treatment is composed of 15 to
a filiform needle or electric acupuncture 20 sessions.
once daily. Choose 4 or 5 points and use 32) Dysmenorrhea Selection of
alternatively at each treatment. points: Depression in Triangular Fossa,
29) Hysteria Selection of points: Intertragus and Root of Auricular Vagus
Heart, Brain, Occiput and Middle Border. Nerve. Choose one or two pairs of points
Secondary points: Liver, Intertragus. and treat once daily by strong stimulation
Ear-Shenmen and other corresponding with a filiform needle or electric acu-
points. During an attack apply strong puncture. Retain the needles until acute
stimulation with a filiform needle or elec- pain is relieved.
tric acupuncture. Choose 3 or 4 points on 33) Functional bleeding of
both ears according to different symp- uterus Principal points: Depression in
toms. Retain the needles for 20 minutes . Triangular Fossa, Intertragus and Ear-

. -~-------
EAR ACUPUNCTURE THERAPY 549

Shenmen. tain the needles for one to two hours.

Secondary points: Spleen, Brain, Liver Needle embedding is also applicable. For
and Middle Ear. Treat once daily with a severe itching treatment may be applied
filiform needle at 3 to 5 points. Retain twice daily. One additional course of
the needles for 30 to 60 minutes. Ten treatment should be administered after
treatments constitute one course. symptoms are controlled in order to con-
34) Insufficient lactation Selection solidate the therapeutic effect.
of points: Puncture the most painful spot 38) Herpes zoster Selection of
at Chest with mild stimulation. Retain points: Lung, Brain, Intertragus and oth-
the needles for 15 minutes. Treat once or er corresponding points. Apply strong sti-
twice daily for I to 3 days. mulation with a filiform needle. Retain
35) Itching of the skin Selection of the needles for two hours. Treat once or
points: Ear-Shenmen, Lung, Brain, Infra- twice daily, and reduce to once every
tragic Apex and Interior Tubercle. other day after relief of symptoms. Ten
Secondary points: Liver, Spleen, treatments constitute a course.
Heart, Intertragus, Pancreas and Gall- 39) Verruca plana Selection of
bladder. Treat once every other day by points: Ear-Shenmen, Lung, Brain, Large
filiform needling or electric acupuncture. Intestine, Occiput and Intertragus. Use
Choose 3 to 5 pairs of points at each needle embedding at two or three points
treatment, five to ten treatments consti- for each treatment. Retain the needles
tute a course. If it is necessary to contin- one to three days. Ten treatments consti-
ue the treatment, one week of rest should tute one course.
be instituted after one course of treat- 40) Stye Selection of points: Ear
ment. Embedding method with herbal Apex. Apply strong stimulation with a
seeds or other granules is also applicable filiform needle. Retain the needle for 15
once every week. to 20 minutes. Treat once or twice daily.
36) Urticaria Selection of points: In- Or select Anterior Tragic Notch, Posteri-
terior Tubercle, Infratragic Apex, Anti- or Tragic Notch and Liver of the affected
tragic Apex and Liver. Apply strong sti- side. Electric acupuncture is applied once
mulation with a filiform needle. Treat daily with retention of needles for 15 to
once daily or every other day. Ten treat- 20 minutes. Treatment should be admin-
ments are considered one course. Severe istered promptly after the onset of style,
itching may be treated twice or thrice to ensure swifter subsidence.
per day. For chronic urticaria, patients 41) Acute conjunctivitis Selection of
should persist in a prolonged course of points: Bloodletting on Ear Apex or on
therapy. minor veins of retroauricle. Treat once
37) Neurodermatitis Selection of or twice daily. Or puncture Eye, Ear-
points: Lung, Infratragic Apex, lntertra- Shenmen and Ear Apex with a filiform
gus and other corresponding points. needle and strong stimulation. Retain the
Treat once daily or every other day. Re- needles for 30 minutes.
550 CHINESE ACUPUNCTURE AND MOXIBUSTION
~--------------------------------------------

42) Electric ophthalmalgia and snow for 20 minutes. Or apply strong stimula-
blindness Selection of points: Puncture tion at Cheek with a filiform needle. Re-
Eye with a filiform needle and strong tain the needle for 30 minutes.
stimulation. Retain the needle for 15 to
30 minutes. Or use electric acupuncture
on Eye, Liver and Kidney for 15 to 20 IV. PRECAUTIONS
minutes.
43) Congestive glaucoma Selection of 1. If sudden dizziness, nausea, stuffi-
points: Bloodletting on Groove of Low- ness of the chest or other fainting symp-
ering Blood Pressure or Ear Apex. Treat toms occur during treatment, the patient
once daily or every other day. Or se- should be managed in the same man-
lect Eye, Liver, Anterior Tragic Notch ner as during ordinary body acupunc-
or Posterior Tragic Notch. Use filiform ture. During initial visits, patients should
needles or embedding granules at these be in a reclining position in order to
points. avoid fainting.
44) Tinnitus and impaired hearing Se- 2. Strict antisepsis is necessary to
lection of points: Ear, Liver and Kidney, avoid infection of the auricle. In case of
unilateral or bilateral. Apply strong sti- inflammation or redness of the needle
mulation with a filiform needle or elec- hole or distension and pain of the auricle,
tric acupuncture once daily or every oth- timely and appropriate measures should
er day. Retain the needles for 30 to 60 be taken such as applying 2% iodine or
minutes. One course consists of 15 to 20 oral administration of anti-inflammation
treatments. drugs. Needling is contraindicated if
45) Acute tonsillitis Selection of frost-bite or inflammation is present on
points: Bleeding the veins of retroauricle the auricle in order to avoid diffusion or
Ear Apex, or Helix 3, 4 and 6 once every inflamma tion.
day. Or needling Throat and Helix 4 and 3. Ear acupuncture is not advisable for
6 with strong stimulation once or twice women during pregnancy if there is a
per day. Retain the needles for one hour. history of miscarriage. Aged and weak
Needle embedding can be added after patients with hypertension and arterio-
filiform needling. sclerosis should have proper rest before
46) Hoarseness Selection of points: and after needling.
Lung, Throat, Neck, Trachea, Heart, 4. While there are extensive indications
Large Intestine and Kidney. Apply mild for ear acupuncture, it still has its limita-
stimulation at 2 or 3 pairs of points. Five tions. The therapeutic effects for some
treatments compose one course. diseases are not satisfactory, or only symp-
47) Toothache Selection of points: tomatic relief is achieved, therefore, in
Apply strong stimulation at Ear Apex treating some disorders, it is necessary to
with a filiform needle. Retain the needle combine some other therapies.
 ACUPUNCTURE ANALGESIA
Acupuncture analgesia (abbreviated diac, pulmonary, hepatic or renal condi-
to A.A.) is an analgesic method built on tion and those who are too sick to sustain
the basis of relieving pain and regulating drug anaesthesia.
the physiological function of the human
body by needling. The procedure pro- 2. Reduced Physiological Disturbance
duces an absence of pain by stimulating
and Rapid Recovery
certain points when the patient under-
goes an operation in full consciousness. It As acu puncture functions to regulate
is considered an important achievement the physiological condition of the human
in the successful integration of tradition- body, doctors are able to take immediate
al Chinese and Western medicine. measures with acupuncture according to
the subjective signs of the patient to
avoid the physiological disturbance
I. THE CHARACTERISTICS caused by severe pain. Blood pressure,
OF ACUPUNCTURE pulse and respiration rates during the
ANALGESIA operation remain relatively stable in most
cases. After the operation, patients' phys-
iological state remain normal, as mani-
1. Safe in Wide Indications fested in early regaining of appetite and
Extensive clinical practice has proven ambulatory activities, and satisfactory
that acupuncture analgesia is completely healing of wound. All these are condu-
safe. Millions of surgical operations with cive to an early recovery.
acupuncture analgesia have been carried
out in China and none of them led to 3. Subjective Cooperation of
death attributed to needling. Acupunc- the Patient and Improvement of
ture analgesia does not produce any side- Operative Results
effects and accidents which might hap-
pen when drug anaesthesia is employed. The patient under acupuncture anal-
What is more, it does not result in res- gesia is mentally alert and able to com-
piratory tract infection, gastrointestinal municate with the surgeons. This enables
dysfunction, abdominal distension and the surgeon to judge operative results as
retention of urine. It, therefore, is more the operation proceeds. During thyroid-
suitable to the aged patients with weak ectomy, for instance, the patient's phona-
constitution, and the patients with car- tion may be tested; in total laryngectomy,
5';1
552
'-'------ - - - - - - - - - - -
CHINESE ACUI'l';-':CTl'RE AKD MOXIBUSTION

the swallowing movement can be and muscular tension which is likely to

checked; in eye surgery for strabismus, cause discomforts due to retraction of
eyeball movement can be examined; in internal organs in an introabdominal op-
amputation of trigeminal sensory root eration. In this case, administrating a
and craniocerebral operation, the limits small dose of anesthetic drug or punctur-
of facial anesthetic region can be ob- ing some acupoints will relieve the pain
served. The close coordination between and discomforts of the patients.
the patient and surgeon ensures the desir-
able operative results.
II. PREOPERATIVE
4. Simple Apparatus and Easy PREPARATIONS FOR
to Popularize ACUPUNCTURE
ANALGESIA
Acupuncture analgesia does not re-
quire any sophisticated medical equip-
1. Explanatory \Vork to the Patient
ment and is not restrained by preferential
environment. The only requisites for suc- As the patient under acupuncture an-
cess are to observe the patient's pain en- algesia is mentally alert during the surgi-
durance carefully, select well-indicated cal operation, it is essential to consider
cases, locate the points accurately and his attitude toward acupuncture analge-
puncture skillfully. The practice across sia and his spiritual behavior because
the nation has proven that acupuncture these may affect his physiological func-
analgesia is more practical in backward tion, pain endurance and ability to accept
regions where emergency surgery is pos- the operation. It is necessary to let the
sibly delayed due to lack of necessary patient know in detail the characteristics,
medical equipment. methods, process, effects of acupuncture
Acupuncture analgesia was created in analgesia, the operative procedures, and
the 1950s in China. With researching for the reaction and sensation caused by nee-
more than twenty years, some notewor- dling. It is also important to make the
thy experiences have been accumulated. patient mentally relaxed so that he can
Like any other science and technology, cooperate with the surgeons to ensure the
acupuncture analgesia has a long way successful operative results.
to go from imperfection to perfection.
Though the mechanism of acupuncture 2. Preliminary Test of Needling and
analgesia has been preliminarily outlined, Pain Endurance
further studies are still needed to reach a
thorough explanation. Acupuncture anal- Before acupuncture analgesia, one or
gesia is able to raise pain threshold and more points may be selected on the body
endurance, but there still exist some of the patient for preliminary test of nee-
drawbacks, such as incomplete analgesia dling. With this, the patient can experi-

---~------------------------- ------- -----

ACUPUNCTURE ANALGESIA 553

ence the needling sensation, free his ner- III. PRINCIPLES OF

vousness from acupuncture analgesia and SELECTING POINTS FOR
adapt himself to the needling stimulation.
On the other hand, when he knows the ACUPUNCTURE
tolerance of the patient, the surgeon can ANAI.JGESIA
decide the method and intensity of stimu-
lation in the operation. Also, physical or Since it is through stimulating certain
chemical stimulation can be applied to particular acupoints of the body that the
measure the patient's pain endurance. acupuncture analgesia works, it is impor-
Anyway, the purpose of pain endurance tant for the operators to be well versed in
the appropriate needling stimulation as
test is for precise determination of the
well as the accurate point location.
stimulation intensity in acupuncture an-
The commonly used methods in se-
algesia.
lecting points are summarized as follows:

3. Practice of Deep Breathing 1. Selecting Points According to

Instruct the patient under thoracic- the Theory of Meridians
abdominal operation to practise slow, deep Traditional Chinese medicine holds
abdominal breathing before operation. It that the twelve regular meridians connect
can relieve stuffiness of the chest, heavy interiorly with the zang-fu organs and
sensation and dyspnea after the chest is exteriorly with the four limbs. Each of
opened up. In abdominal surgery, deep the meridians has its own pathway and
breathing helps to ease the patient of the connects with the other in view of the
muscular spasm, nausea and vomiting exterior-interior relationship. The meth-
caused by retraction of internal organs. od of selecting points along the meridians
is therefore based on the concept embod-
4. Preoperative Plan of Acupuncture ied in the theory of the meridians "where
Analgesia a meridian traverses, there is a place ame-
nable to treatment."
The close cooperation between the
acupuncturists, surgeons and nursing staff 2. Selecting Points According to
is indispensable for successful operation
Syndrome Differentiations
with acupuncture analgesia. The patient's
psychological state, case history and focus Traditional Chinese medicine em-
of infection should be brought to thorough phasizes the concept of the organic in-
analysis and discussion. Prediction of the tegrity of the human body. When any
problems possibly occurring under opera- portion of the body is diseased, various
tion and corresponding emergency meas- symptoms and signs may be manifested
ures will guarantee a safe opera tion on a through the meridians connecting with
fully conscious patient. that portion. In acupuncture therapy, it

----~ --------
554 CHINESE ACUPUNCTURE AND MOXIBUSTION

is important to apply the theory of zang- supplies the operative site; 2) selecting
fu organs and theory of meridians to points in a remote segmentation, that is
syndrome differentiations, so is it in acu- in an area not supplied by the same or
puncture analgesia. Before selecting the adjacent spinal nerve of the operative
points, symptoms and signs of a disease site; 3) stimulating the nerve trunk with-
must be differentiated and then their in the same segmentation, that is to
relation with the zang-fu organs and me- stimulate directly the peripheral nerve
ridians be found out. Attention should which supplies the operative site. For
also be paid to the patient's responses instance, Hegu (lI 4) and Neiguan (PC
that may be elicited in the operative 6) are points of the adjacent segmenta-
procedure. For example, in the chest op- tion in thyroidectomy, while Neiting (ST
eration, the patient is likely to experi- 44) and Zusanli (ST 36) are points in
ence palpitation, shortness of breath and the remote segmentation. Futu (LI 18)
anxiety in the preoperative period or is regarded as a point for direct stimu-
during the operation. According to the lation of the cutaneous cervical nerve
theory of traditional Chinese medicine, plexus, known as stimulating the nerve
these symptoms are caused by the dis- trunk within the same segmentation.
turbance of heart qi. Thus, Ximen (P 4) The implication of selecting points in
and Neiguan (P 6) are usually selected the adjacent and remote segmentation in
to tranquilize the heart, sedate the mind acupuncture analgesia is different from
and regulate the heart qi. that of selecting the neighbouring and
distal points in acupuncture therapy.
3. Selecting Points According to The latter only denotes the relative dis-
tance between the location of the points
Segmental Innervation
chosen and the affected area to be treat-
Clinical practice and scientific exper- ed. Selecting points far from the affected
iments with acupuncture analgesia show site is known as the method of selecting
that the nervous system is involved in distant points, while selecting points
pain suppression and physiological regu- near the affected site is known as the
lation of acupuncture analgesia. In other method of selecting adjacent points.
words, the functional integrity of ner- Neither method is related to segmental
vous system is a prerequisite to produce nerves of the puncturing site and oper-
needling sensation and analgesic effect. ative site. For example, for analgesia in
Based on the relation of the segmental thyroidectomy, Hegu (lI 4) and Nei-
innervation between the puncturing site guan (PC 6) are chosen as adjacent
and the operative site, there are three points according to segmental innerva-
ways to select points, i.e. I) selecting tion; but from the point of view of the
points in the adjacent segmentation, or relative distance between these points
in an area that is supplied by the same and the operative site on the neck, they
spinal nerve or an adjacent nerve that are considered as distant points.
ACUPUNCTURE ANALGESIA 555
--~----------------------

4. Selecting Auricular Points 1. Hand Manipulation

This is to select the corresponding au- This is the basic stimulative method.
ricular areas according to the operative Even if electro-stimulation is applied, it is
site and its involved internal organs. For also started with hand manipulation. The
example, auricular Stomach Point is cho- electro-apparatus is not employed until
sen for subtotal gastrectomy. Auricular the patient feels the needling sensation.
points are also selected according to the Hand manipulation is to lift-thrust and
theory of zang-fu organs. For instance, twist-rotate.
"the lung dominates skin and hair; and
Lung Point is often chosen in various 2. Electric Stimulation
operations; while the kidney dominates
the bone," and Kidney Point is often se- After the desired needling response is
obtained by the hand manipulation, the
lected in orthopedic surgery.
outlet of the electric acupuncture appar-
Moreover, reaction spots on the auri-
atus is attached to the handle of the
cle may be selected as well. When an
filiform needle, and the current will get
internal organ or area of the body is
through to the body. Clinically, the elec-
affected, some reaction spots with tend-
tric pulsating is divided into continuous,
erness, reduction of electro-resistance,
sparse-dense and intermittent three
deformation of auricular structure and
kinds, mostly in the form of biphasic
discoloration may occur on the corres-
spike or rectangular wave 0.5 to 2 msc. in
ponding auricular areas. These reaction
width. But biphasic sinusoid or irregular
spots may be chosen for acupuncture an-
sound wave may also be used. The fre-
algesia. quencies of electric pulse are of two
According to therapeutic experience,
kinds: two to eight times per second and
Ear-Shenmen and Inferior Crus, i.e. Sym-
forty to two hundred times per second.
pathetic Nerve Point are effective for The stimulation force should be adjusted
sedation and pain suppression. They are according to the patient's tolerance. Ge-
therefore widely used in auricular acu- nerally, acupuncture analgesia requires
puncture analgesia. powerful stimulation which may be in-
creased gradually up to the highest limit,
the one which the patient can stand. Each
time of continuous electro-stimulus can
IV. MANIPULATION not be too long, in case it produces too
TECHNIQUES much stimulation to destroy patient's
needling sensation. If a longer electro-
Based on the arrival of qi, hand- stimulus is needed, the intermittent elec-
manipulation and electro-pulsating sti- tric pulsating can be selected. The stimu-
mulation are commonly used in acupunc- lation should be started from zero and
ture analgesia. added to the desired level gradually and

---~---~-~-------- ~---~~--~
556 CHINESE ACUPUNCTURE AND MOXIBUSTION

when it is turned down, it should be sia. Though some operation with acu-
reduced slowly. It is not advisable to pro- puncture analgesia can be done without
duce abrupt stimulus, which may make the help of any adjuvants, the analgesia
the patient unbearable. effect will be more favorable if small
doses of adjuvants are administered be-
3. Induction and Retaining of fore or during the operation.
the Needle I. Adjuvants for preoperative admin-
istrations: Usually Dolantin is given in-
Needling or electric stimulation mani- tramuscularly or dropped intravenously
pulated on the selected points for a desir- fifteen to thirty minutes prior to an oper-
able length of time prior to the operation ation, generally 50 mg dose each time for
is known as induction. The intensity of adults, and 0.5 mg each kg body weight
needling stimulation should be proper and for children. When necessary, Prometha-
induction period is about twenty minutes, zine (Phenergan) is added at the same
or longer if the result of pain endurance time, 25 mg for adults, and 0.5 mg each
test is unfavorable. By means of induction, kg body weight for children; or Chlor-
the patient may adapt himself to the promazine (Wintermin) 12.5 mg for ad-
stimulus of acupuncture analgesia. At the ults, and 0.5 mg each kg body weight for
same time, it can also regulate the function children.
of various internal organs of the body, Atropine and Hyoscine (Scopolamine)
preparing the patient for surgical opera- are used in order to keep the respiratory
tion. At certain operative stages when the tract unblocked. Atropine is given 0.5 mg
operative stimulus is mild, hand manipu- for adults, and 0.01 mg each kg body
lation may be stopped or the current for weight for children subcutaneously or in-
electric stimulation cut off. This is so- tramuscularly; hyoscine is given 0.3 mg
called retaining of the needle. Before the for adults subcutaneously or intramuscu-
operation proceeds to a stage of vigorous larly with the exception of the aged and
stimulation, it is necessary to restart the infants.
hand manipulation or electric stimulation 2. Adjuvants during operations: Some
so as to maintain and strengthen the proper adjuvants are given according to
analgesic effect. different stages of operations and differ-
ent reactions the patients show. Adju-
vants for local analgesia are mainly
V. ADJUVANTS administered, for instance, Neocaine
(Procaine Hydrochloride), Lidocaine
In order to enhance the effect of acu- (Xylocaine), Dicaine (Pantocaine), etc.,
puncture analgesia and guarantee the op- for local infiltration and blockage. The
eration to go on smoothly, some adju- amount of the adjuvants being used
vants in small doses should be given to should be as small as possible so as to
almost every case of acupuncture analge- lessen patients' discomforts. Heavy doses
ACUPUNCTURE ANALGESIA 557
------
of some sedatives will not only do harm 2. The patient's chief complaint
to the health of the patient, but also cause should be attended during the operation.
unconsciousness or hypnotism. The pa- When discomfort occurs, appropriate
tient will be unable to communicate and measures should be taken in time to re-
cooperate with the surgeons, and thus the lieve it, and the patient should be com-
result of the acupuncture analgesia and forted to maintain his confidence. The
the operation will be affected. amount of the adjuvants should be pro-
per, either overdose or underdose is
harmful to the patient's health or to the
VI. REMARKS proceeding of the operation.
3. In order to promote the effect and
1. Because the patient is fully conscious lessen the subcortex bleeding, an appro-
during the operation under acupuncture priate dosage of physiological saline with
analgesia, surgeons should preoperatively the addition of a little adrenal may be
make the whole procedure of the operation used subcutaneously in the incision re-
known to the patient so as to gain the gion before the skin incision in some
patient's cooperation. Surgeons should operations.
have an amiable attitude, well-prepared 4. Patients may regain appetite and
measures, observing blood pressure, pulse ambulatory activity soon after an opera-
and respiration rate attentively during the tion under the guidance of the medical
operation, and reducing the patient's dis- workers besides general nursing care, and
comforts as far as possible. those are conducive to an early recovery.

Some Examples of Selecting Points for Acupuncture Analgesia

Operation Selecting Points

Cranial operation i A. Xiangu (ST 43), Zulinqi (GB 41), Taichong (LR 3),
I Quanliao (S I 18). (All on the diseased side.)
: B. Hegu (LI 4), Neiguan (PC 6), Quanliao (S I 18) .
Retina Detachment .-----+!i A. Hegu
.
(LI 4), Zhigou (TE 6). (Both on the diseased
SIde.)
I! B. Auricular points: Forehead towards Eye 1 (Anterior
, Intertragic Notch), Eye 2 (posterior Intertragic
Notch), Yangbai (GB 14) towards Yuyao (Extra). (All
on the diseased side.)
Operations of trichiasis for entropion \ A. Hegu (LI 4) (Bilaterally)
Correction of strabismus B. Taichong (LR 3), Guangming (GB 37).
A. Hegu (LI 4), Zhigou (TE 6), Yangbai (GB 14) towards
; Yuyao (Extra), Sibai (ST 2) towards Chengqi (ST 1).
! (All on the diseased side with electric stimulation.)
! B. Hegu (LI 4), Zhigou (TE 6), Houxi (S I 3), Jingmen
i (GB 25).

--------
5~8 CHIr-:ESE ACUPUNCTURE AND MOXIBUSTION

Cataract couching A. Hegu (LI 4), Waiguan (TE 5) towards Neiguan (PC
6). (Both on the diseased side.)
B. Hegu (LI 4), Zhigou (TE 6). (Both on the diseased
side. )
--------t--
Enucleation of eyeball A. Hegu (LI 4), Waiguan (IE 5), Houxi (SI 3). (All on
the diseased side. If the eyeball is sensitive, administer
1% dicaine for surface anaesthesia during the opera-
tion.)
B. Auricular points: LUng, Liver, Kidney, Eye 1, Eye 2,
Ear-Shenmen, Sympathetic Nerve (Inferior Antihelix
Crus.)
Iridectomy A. Hegu (LI 4), Waiguan (TE 5), Neiting (ST 44). (All
bilaterally. At the first two points, give hand manipu-
lation. For the last one, retain the needle after nee-
dling sensation is produced.)
-------+----------
Shortening of sclera A. Hegu (LI 4), Zhigou (TE 6), Yangbai (GB 14) towards
Yuyao (Extra), Sibai (ST 2) towards Chengqi (ST 1).
(All on the diseased side with electric stimulation.)
B. Hegu (LI 4), Zhigou (TE 6). (Both on the diseased side
with electric stimulation.)
Replantation of pterygium ; A. Auricular points: Eye, Liver. (Both on the diseased
I side.)
i
Exenteration of orbit i A. Hegu (LI 4) (Bilaterally), Zhigou (TE 6). Auricular
: points: Forehead towards Eye 1, Ear-Shenmen to-
! wards Sympathetic Nerve. (Both bilaterally.)
I
Resection of tumor in parotid glands : A. Fenglong (ST 40), Yangfu (GB 38), Fuyang (BL 59),
II Xiangu (ST 43), Taichong (LR 3), Xiaxi (GB 43). (All
bilaterally. Needles are retained after needling sensa-
I tion is produced.)
B. Neiting (ST 44), Neiguan (PC 6) towards Waiguan
(TE 5).
Operation in the submaxillary region ! A. Fenglong (ST 40), Yangfu (GB 38), Fuyang (BL 59),
. Taichong (LR 3), Gongsun (SP 4), Neiguan (PC 6).
(All on the diseased side.)
B. Auricular points: Maxillary, Kidney, Ear-Shenmen
towards Sympathetic Nerve, Lung.
-~---- ---------------
Plastic operation of the tempromendi- A. Fenglong (ST 40), Yangfu (GB 38), Fuyang (BL 59),
bular joint Taichong (LR 3), Gongsun (SP 4), Hegu (LI 4). (The
first four points on both sides and the last two on the
diseased side.)
,

Resection of the mixed tumor of the i A. Hegu (LI 4), Neiguan (PC 6), Gongsun (SP 4).
I
palate
Radical mastoidectomy I A. Waiguan (TE 5), Yanglingquan (GB 34). (Both bilat-
I
erally with electric stimulation.)
ACUPUNCTURE ANALGESIA 559

B. Hegu(LI 4), Zhigou (TE 6). (Both on the diseased

side.)
Auricular points: Ear-Shenmen, Lung, Kidney, Ear
(Tragion). (All on the diseased side. In the induction
period use the auricular points only.)
Operation to expose the tympanic A. Hegu (LI 4), Houxi (S I 3), Waiguan (TE 5). (All on
cavity both sides.)
Tympanotomy A. Hegu (LI 4). (Bilaterally or on the diseased side.)
B. Waiguan (TE 5) towards Neiguan (PC 6), Yang-
lingquan (GB 34), Hegu(LI 4).
Total laryngectomy A. Auricular points: Ear-Shenmen towards Sympathetic
Nerve, Forehead towards Ear-Asthma (at the apex of
antitragus), Adrenal (at lower tubercle on border of
Tragus), Hegu (LI 4), Zhigou (TE 6). (All on the left
side.)
B. Hegu (LI 4), Neiguan (PC 6), Renying (ST 9).
----------------------------+i-------------
Tonsillectomy , A. Auricular points: Throat, Tonsil. (Both bilaterally.)
I B. Hegu (LI 4). (Bilaterally)
I
Tooth extraction I A. for upper teeth: Jiache (ST 6), Quanliao (SI 18). For
: lower teeth: Daying (ST 5).
I

Lateral nasal incision : A. Hegu (LI 4), Zhigou (TE 6), Juliao (ST 3) towards
! Sibai (ST 2). (All on the diseased side.)
Radical maxillary sinusotomy I A. Hegu (LI 4), Zhigou (TE 6). (During the induction
period, Juliao (ST 3) towards Dicang is added.)
B. Hegu (LI 4), Neiguan (PC 6), Neiting (ST 44),
, Yingxiang (LI 20).
---+-
Radical frontal sinusotomy i A. Yangbai (GB 14) towards Zanzhu (BL 2), Juliao (ST
. 3) towards Sibai (ST 2), Hegu (LI 4), Zhigou (TE 6).
(All on the diseased side.)
N--a-sa-l-po-l-y-pe-c-to-m--y--------------+!-A-. Hegu (LI 4) o-r-Y--in-g-x-ia-n-g-(-L-I-2-0-)-.-(B-i-la-t-er-a-n-y-o-r-o-n
i the diseased side.)
i B. Auricular points: Lung, Nose, Ear-Shenmen towards
i Sympathetic Nerve.
---------------------------TI------
Resection of thyroid adenoma A. Hegu (LI 4), Neiguan (PC 6).
II

B. Futu (LI 18).

I Auricular points: Ear-Shenmen, Lung, Neck, Endo-
_______________________ ---L crine (Intertragus).
Separation of mitral valve : A. Neiguan (PC 6), Hegu (LI 4), Zhigou (TE 6). (All on
---l. the diseased side.)
_R_es_e_ct_io_n__o_f_pe __________--+1 A. Hegu (LI 4), Neiguan (PC 6). (Both bilaterally.)
__rI_·c_ar_d_iu_m
Pneumonectomy : A. Binao (LI 14). (On the diseased side.)
i B. Hegu (LI 4), Neiguan (PC 6) or Waiguan (TE 5)

- - _ . _ - _..... - .---_. - -----

 CHINESE ACl:PUNCTURE AND MOXIBl:STION

towards Neiguan (PC 6), Sanyangluo (TE 8) towards

Ximen (PC 4).
---------------+----- ---------------
Gastric operation A. Zusanli (ST 36), Shangjuxu (ST 37), (Bilaterally or on
the diseased side.)
B. Auricular points: Ear-Shenmen, Lung, Sympathetic
Nerve, Gastric. (All on the left side.)
Splenectomy A. Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6),
Taichong (LR 3). (All on the diseased side.)
B. Auricular points: Lung, Spleen, Sympathetic Nerve,
Ear-Shenmen, Triple Energizer.
Appendectomy A. Shangjuxu (SP 37), Lanwei (Extra). (All bilaterally.)
B. Hegu (LI 4), Neiguan (PC 6), Gongsun (SP 4). (All
bilaterally. )
Herniorrhaphy A. Zusanli (ST 36), Weidao (GB 28). (Both bilaterally.)
B. Yinlingquan (SP 9), Sanyinjiao (SP 6). (Both on the
diseased side.)
Cesarean section A. Zusanli (ST 36), Sanyinjiao (SP 6), Daimai (GB 26),
Neimadian (Extra), located at the midpoint of the line
joining Yinlingquan (SP 9) and internal malleolus.
(All bilaterally.)
B. Auricular points: Ear-Shenmen, Lung, Uterus (Trian-
gular fossa), Abdomen.
--------------------+-----
Panhysterectomy with resection of A. Yaoshu (GV 2), Mingmen (GV 4), Daimai (GB 26),
appendixes of the uterus Zusanli (ST 36), Sanyinjiao (SP 6), Zhongliao (BL 33)
or Ciliao (BL 32). (All bilaterally.)
B. Auricular points: Uterus, Lung, Ear-Shenmen, Abdo-
men, Endocrine (in cavum conchae), External Geni-
tals.
Tubal ligation A. Zusanli (ST 36), Foot-Zhongdu (LR 6). (Both bilater-
ally.)
B. Zusanli (ST 36), Sanyinjiao (SP 6), Daimai (GB 26),
Qiecou (peri-incision acupuncture).
-----------------------~------------ -----------------
Hemorrhoidectomy A. Sanyinjiao (SP 6), Ciliao (BL 32), Chengshan (BL 57).
B. Auricular points: Lung, Lower Portion of Rectum.
(Both on the diseased side with electric stimulation.)
-------------------------+-------
Nephrectomy A. Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36), San-
yinjiao (SP 6), Taichong (LR 3). (All on the diseased
side. )
B. Auricular points: Ear-Shenmen, Lung, Waist, Ureter.
(All on the diseased side.)
-----------------+----
Clore-reduction of shoulder joint A. Auricular points: Shoulder towards Shoulder Joint,
Ear-Shenmen, Sympathetic Nerve, Kidney. (All on
the diseased side.)
B. Hegu (LI 4). (Bilaterally.)
ACUPUNCTURE ANALGESIA 561

Auricular points: Shoulder, Arm. (Both bilaterally.)

Open-reduction of fracture of the hu- A. Jianzhen (SI 9), Jianyu (LI 15), Houxi (SI 3), Hegu
merus (LI 4), Neiguan (PC 6).
B. Auricular points: Ear-Shenmen, Lung, Arm, Elbow.
Amputation of forearm A. Chize (LU 5), Qingling (HT 2). (Both bilaterally.)
Internal fixation of fractures of the fe- A. Zusanli (ST 36), Fenglong (ST 40), Fuyang (BL 59),
mural neck with three-flanged nail Waiqiu (GB 36), Juegu (Xuanzhong GB 39), Sanyin-
jiao (SP 6), Qiuxu (GB 40), Xiangu (ST 43). (All on
the diseased side with electric stimulation.)
B. Auricular points: Ear-Shenmen, Sympathetic Nerve,
Coxa, Ischium Lung, Kidney.
Resection of valvula semilunaris and A. Futu (ST 32), Yinlingquan (SP 9), Yanglingquan (GB
fusion of articulatio genus 34), Xuehai (SP 10), Liangqiu (ST 34), Sanyinjiao (SP
6), Huantiao (GB 30), Fengshi (GB 31).
B. Auricular points: Sympathetic Nerve, Kidney, Knee,
Lung.
Amputation of lower portion of leg A. Huantiao (GB 30), Zhibian (BL 54), Fengshi (GB 31),
Yanglingquan (GB 34), Yinglingquan (SP 9), Sanyin-
jiao (SP 6).
B. Auricular points: Ear-Shenmen, Lung, Kidney, Is-
chium towards Sympathetic Nerve. (All on the dis-
eased side with electric stimulation.)