25 Modern Use of the Six Divisions: A Practical Needling Strategy for Pain and Blockage

A unique needle strategy called the ‘six division treatment’ is a rapid and powerful needling style specifically suited to the treatment of acute painful disorders. This topic is discussed in depth in my first book, Holding the Tiger’s Tail.1 In this chapter further clarifications and clinical usages are addressed.

The six divisions tends to be remembered more as a philosophical explanation for the penetration of cold or wind-cold pathogen into the body and how its clinical manifestations change as it lodges itself in different energetic layers. Likewise, it has been used to explain the psychological and physical constitutional types that also correspond to these paired divisions.

In this related diagnostic and needling strategy, the use of two acupuncture points to treat acute internal, mental, or musculoskeletal conditions is employed. The points consist of the xi (cleft) points of the channels paired according to the six division paradigm. As we recall, xi(cleft) points are points that reflect accumulation or blockage in the organ/channel complex. In the six division framework, a channel in the upper part of the body is paired with one in the lower part. The theoretical justification of this as the Chinese say is, “as above, so below.” This worldview maintains that energetically the coupled channels work harmoniously together as a microcosmic circuit to regulate energy in the body.

The concept of combining the xi(cleft) points of the paired channels for blockage, with its most common manifestation of pain, is simple in design and execution. Before performing the technique, you the practitioner need to select the appropriate division to use. Differentiate the patient’s symptoms according to the major divisions involved and then correspondingly utilize the paired channels’ xi(cleft) points. For instance, acute menstrual cramps can be connected with the liver channel of foot jue yin because the liver stores the blood and infuses the uterus. Its coupled channel is the pericardium channel of hand jue yin. As we know, both channels are involved in blood regulation regulation and perfusing the lower abdomen, so it also makes sense to use the liver and the pericardium channels.

Using these two points, needle unilaterally with a vigorous dispersion technique, which corresponds to the treatment plan of dispersing accumulation. Insert needles according to the standard angles and depths of insertion using your preferred dispersion technique. I favor fast rotation of the needle in a counterclockwise direction. Because a strong de qi sensation is used, prepare the patient for the strength of the stimulus you are about to use, but likewise tell them this is the technique you need to employ in order to bring about the desired therapeutic effect in a short amount of time, which is to get rid of the blockage.

Only unilateral needling is necessary because of the vigorous stimulation employed. While there are various theoretical justifications for which side of the body to needle, I tend to select the side that corresponds to most of the major pulse systems. For instance, unequivocally the liver is felt on the left pulse so the left Liver 6 xi(cleft) point (zhong du) is selected. Pericardium is correspondingly felt on the left pulse as well so left Pericardium 4 xi(cleft) point (xi men) is chosen.

If the pain or blockage has a musculoskeletal component such as a sore low back, shoulder, neck, etc., have the patient mobilize the affected area while the needles are retained to enhance the therapeutic results. Needles may be retained for 20 minutes or simply inserted, strong qi obtained and dispersed, the affected area mobilized if relevant, and then removed for patient convenience since the work of the needles has been accomplished.

Table 25.1 lists the six divisions, their corresponding xi(cleft) points, angles and depths of insertion, side of the body to needle and some common disorders that can be used with this technique. This list is not intended to be exhaustive, only illustrative of some pain or accumulation conditions.

Table 25.1 Six division needling strategy

Reference

1. Gardner-Abbate S. Holding the Tiger’s Tail: An Acupuncture Techniques Manual in the Treatment of Disease. Santa Fe: Southwest Acupuncture College Press; 1996.