YNSA Treatment Protocol and Practical Procedures
The Yellow Emperor asked Shao-shih: “I have heard it said that the existence of man encompasses firmness and softness, weakness and strength, short and long duration, as well as yin and yang [regions]. I should like to discover in what relationship all this stands to the methods [of therapy].”
Ch’i Po: “In yin there is yang, in yang there is yin. When one is knowledgeable about yin and yang, he can apply needle treatments methodically. When the origins of illness have been comprehended, the application of needles can be carried out on the basis of the [proper] principles. Carefully assess the causes of the affliction … Therefore it is said that when the illness is located in the yin-in-yin [region], apply needles to the brook transportation [points] of the yin [channels]. If the illness is located in the yang-in-yang [region], apply needles to the confluence [points] of the yang [channels]. If the illness is located in the yin-in-yang [sphere], apply needles to the stream [points] of the yin [channels]. If the illness is located in the yang-in-yin [sphere], apply needles to the network [channels].”1—Huang-di Nei-jing Su-wen
The following are a list of straightforward office guidelines that the author has used over the years, having assimilated and mastered Dr. Yamamoto’s YNSA technique.
1. Always make your medical diagnosis first.
2. Then decide if YNSA is indicated on this patient today by history, physical exam, and patient’s receptivity to acupuncture.
3. Next, formulate an Oriental Medical diagnosis; this could be Traditional Chinese Medicine (TCM), Eight Principle, Five Phase, or YNSA Neck Diagnosis.
4. Formulate the main goal of your treatment; for example, pain relief to the left arm and shoulder, or balance Five Phase (pulse diagnosis).
5. Do other procedures before YNSA, such as manipulation, prescriptions, counseling, or other TCM, Energetics body acupuncture, but leave various pharmaceutical, trigger point, or nutraceutical injections to the very end of the visit, after YNSA.
6. Palpate the LI-4, he gu, point to determine which side is most tender. If you can not tell the difference with the patient’s help, then palpate both left and right liver (LR) neck diagnostic points simultaneously, to see which one is most tender. If you still can not tell which is most tender, then go to the kidney (KI) neck diagnostic point left and right, palpating simultaneously to see which one is tender. If you still can not tell, go to the YNSA abdominal diagnosis techniques. If you still can not tell, do TCM or Five Phase radial pulse diagnosis.
7. Palpate the liver (LR) YNSA neck diagnosis point on the tender side to determine if the sternocleidomastoid muscle (SCM) is hard or soft. If the SCM is soft, treat in YANG and if firm, treat in YIN. About 90% of the time, it is hard/firm, so you treat in the YIN phase. The remaining 10% of the time it is soft, therefore you treat in YANG.
8. Treat Basic points first. Palpate for tenderness and find the little mountain/hill associated with the Basic point that the history and physical examination indicate needs to be treated.
9. Have your acupuncture needles very close to you as you palpate with one hand using a single finger or thumb, indent the scalp soft tissue with that thumbnail or fingernail. Then with needle in hand, place the needle at the correct marked spot at the desired angle to achieve its greatest effect.
10. Follow the YNSA Basic point treatment protocol. When finished, move on to perform the YNSA neck and/or YNSA abdomen and/or TCM radial pulse diagnosis. The YNSA neck diagnosis is preferred to see if tenderness is gone, verifying proper needle placement.
11. Next, follow the YNSA treatment protocol in this book as needed.
12. Piqué the most tender Ypsilon point on the most tender side first. Continue treating all positive Ypsilon points until the LI-4, he gu, point is no longer tender on both sides. At that point you are finished and the patient will have maximum pain relief and a harmonically balanced electromagnetic field as demonstrated by the Oriental Medicine pulse diagnosis, if done correctly.
13. Have the patient lie down and rest while the needles do their work for ~20 minutes.
14. Remove the needles, do any other pharmaceutical or nutraceutical injections, although quite often trigger points are no longer needed, and discharge the patient for that day with standard acupuncture precautions listed below.