As clinicians, we know that acupuncture points have multiple energetics because of the numerous physiological functions that are regulated through the channel system. In this chapter I hope to share with the reader the clinical energetics and needle techniques of some common acupuncture points that obviously have actions consistent with their physiological functions, but are energetics and techniques that the practitioner may not have had the opportunity to explore. I hope that by way of anecdotal recounting, the usages of these points will remind the practitioner to think about the points in this way.
Case Study 1
Late one day a patient called the college when I was supervising student clinic. The clinic was totally booked but the patient claimed to be in dire need of treatment so we told her to come in and we would make room to treat her. When she arrived I had my teaching assistant do a complete interview and perform the physical exam, and after the assistant summarized the case for me I proceeded with the treatment.
The patient was a female in her mid-60 s who was suffering from an acute case of bronchitis that was brought on by exposure to cold. She was traveling the next day to a colder environment and was concerned about her health. Essentially she was coughing, couldn’t catch her breath or stop wheezing. Lying down made breathing more difficult so I treated her sitting up. First I palpated the three locations of Lung 5 (chi ze) described below. Because of time constraints and the emergency nature of the case, I needled Lung 5 in the tenderest place. Lung 5 was manipulated in a counterclockwise direction with a vigorous dispersion technique and augmented with Kidney 6 (zhao hai). Kidney 6 was needled towards the heel, which is considered a tonification technique as the needle is implanted in the direction of the channel. No further manipulation was required. Each needle was retained for about 15 minutes and the coughing and wheezing subsided immediately.
About a week later when the patient returned from her trip she called me and asked what I did in the treatment, which she thought was miraculous, why it was so simple, and why it had worked. She said that it wasn’t the type of treatment she was used to, however she was very pleased as she was able to travel without any incident and had not had a recurrence of the bronchitis even though the place she had traveled to was very cold.
Discussion—Point Combinations Lung 5 and Kidney 6 (Chi Ze—Foot Marsh and Zhao Hai—Shining Sea)
One of the first acupuncture points that a student typically learns is Lung 5 since points are usually taught in the order of the horary clock, beginning with Lung 1 (zhong fu). Chinese Lung 5 is located on the cubital crease, on the radial side of the tendon of the muscle biceps brachii with the elbow slightly flexed.
The Japanese have three locations of Lung 5. The first is located 1 cun above the standard Chinese Lung 5, the second is the Chinese Lung 5 proper, and the third one is located 1 cun below the standard Lung 5. Apply deep perpendicular pressure and see which pointis the most tender. That is the point to treat.
Lung 5 is the water point on the (metal) lung channel. As such, depending upon which needle technique is used, it can add or take away “water”from the channel. With a tonification technique water and yin are added, therefore the point can clear heat from the lungs (i. e., cool) and nourish lung yin (also adding water).
Because water is the figurative son of metal, Lung 5 is the sedation point of the lung channel. It can take away water and decrease rebellious lung qi manifested through symptoms of throat blockage, asthmatic breathing and coughing, hiccups, spitting blood, phlegm in the lungs, and fullness of the chest. Locally it is useful for spasmodic pain of the elbow.
Puncture Lung 5 perpendicularly 0.3 to 0.5 in. Note: it is forbidden to use moxa on this point. Moxa may shorten the biceps brachii tendon and permanently bend the elbow.
Kidney 6 is located in the depression directly below the medial malleolus. The Chinese also have an alternative location for Kidney 6, which is commonly referred to as “Japanese Kidney 6” because the Japanese use this location. It is located 1 cun directly below the medial malleolus at the junction of the red and the white skin. I use the Japanese location exclusively. The needle technique for that location is to puncture transversely and subcutaneously 0.1 to 0.2 in towards the heel (see Fig. 3.1a and 1b in Chapter 3).
Kidney 6 is the master of the yin qiao channel and a coupled point of the ren channel. It is traditionally regarded as the best point to nourish kidney yin, thereby facilitating the throat, clearing yin deficiency fire and rooting the qi. It opens the chest and is good for cold in the chest, and lung problems.
Case Study 2
The patient was a poor woman who was referred to me for free treatment by another practitioner because the patient lived closer to me and travel to her practitioner was problematic because of the patient’s pain and the expense of treatment. I did not know what she was coming to me for until she arrived in my office, sat down, “took off her hair,” to reveal a bald head and told me that she had terminal colon cancer that had metastasized to several organs. She was undergoing chemotherapy and was experiencing terrible systemic bodily pain as a result of that treatment. She was suffering so much that I was unable to question her beyond her name and the fact that she was dying. Seeing her in such discomfort I did not want to do too much prodding or needling and my general treatment approach anyway is always to use few needles to accomplish the therapeutic aim.
Immediately GB-34 (yang ling quan) came to mind and so that became the singular point I treated her with, sometimes with needles, sometimes only with palpation by pressing deeply into the point bilaterally for about 20 minutes. After that amount of time, she would look better, pick up her wig and depart happily until the following week. Even though the patient passed away about a month later as we knew she would, I was always struck by the power of the well-chosen point to provide such deep-seated relief and peace to a patient in great suffering.
Related posts:
Thoughts on Needling within the Clinical Encounter
Modern Use of the Six Divisions: A Practical Needling Strategy for Pain and Blockage
Liniments, Sprays, and Powders
The Relationship between Bunions, Sugar, and the Spleen
The Mineral Infrared Therapy Device
The Ancient Use of ST-36 (Zu San Li) with Different Needle Techniques and Point Combinations
