A C U. Eight Principle/ Five Phase Treatment Strategy. by Alan Uretz, PhD with J. Hoyt

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1 A C U Eight Principle/ Five Phase Treatment Strategy by Alan Uretz, PhD with J. Hoyt

2 Preface When disease is abundant, do not presume to needle because it will injure, but needle once it has changed. Then there will be great glory. The superior technique is to prevent disease, not to cure when already diseased. Some people say chronic disease cannot be cured. This is speaking incorrectly. The skillful acupuncturist can take hold of the disease in the same way he pulls out thorns, washes stains, unties knots, or breaches obstructions. Disease, although chronic, still can be ended. Those who say diseases are incurable have not mastered the technique of acupuncture. On understanding the moving power and its way: The onset of a therapeutic effect is faster than shooting an arrow. Without understanding the moving power and the Dao, effects are wasted, like arrows failing to leave the bow. Ordinary doctors are in the dark; wondrous are the few who possess the unique skills. To go is to be in counterflow, to come is to be in the flow. Clearly knowing this, the first action will be without hesitation. Oppose the counterflow through seizing it by force and how can dispersion fail? Follow the energy flow to stimulate it and how can tonification fail? Ling Shu Eight Principle/Five Phase Treatment Strategy is the practical synthesis of diagnostic techniques, Traditional Chinese Medicine pattern identification and point location skills which will culminate in applying effective clinical protocols in a successful acupuncture practice. This book provides a historical, theoretical and practical overview of classical acupuncture theory, as presented in the Huang Di Nei Jing and Nan Jing, culminating in an interpretation of classical point selection according to these disciplines. Eight Principal/Five Phase Treatment Strategy seeks to promote an understanding of acupoint energetics in a historical context in order to lay the foundation for appropriate point selection and optimal treatment strategy. It is our intention to help foster superior technique, skillful treatment practice and perhaps to help further the understanding of qi and its wondrous moving power. 2

3 Table of Contents Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Acupuncture treatment dynamics Meridians and points Luo vessels, cutaneous and muscle regions Eight extraordinary vessels Acupuncture point energetics The five shu antique points Classical point categories Treatment of zang-fu patterns Appendix Point category charts Eight Principle/Five Phase Treatment Strategy, a teaching manual by Alan Uretz, Ph.D. with Jeannette Hoyt. Copyright 9/2008 by A. Uretz and J. Hoyt All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, or by photocopying, recording, or otherwise, without the prior consent of the authors. 3

4 Chapter 1 Acupuncture Treatment Dynamics 4

5 Acupuncture has its prohibitions. Fresh from sexual intercourse, do not needle; fresh from needling, do not have sexual intercourse. Already drunk, do not needle; already needled, do not drink. Fresh from labor, do not needle; already needled, do not labor. Already full of food, do not needle; already needled, do not eat to excess. Already starving, do not needle; already needled, do not fast. Already thirsty, do not needle; already needled, do not make thirsty. For great surprise or great anger, one must center the patient s qi, then needle. If the patient rides a carriage to come, have him lie down and rest for a time equal to eating a meal, then needle. If the patient comes by walking, have him sit and rest for a time equal to walking ten li (5 kilometers), then needle. These are the twelve prohibitions for those whose channels are disordered and qi scattered. Ling Shu 5

6 Cautions & Contraindications Fatigue Intoxication Overeating/Fasting Sexual Intercourse Pregnancy 6

7 Fresh from labor, do not needle; already needled, do not labor. If the patient rides a carriage to come, have him lie down and rest for a time equal to eating a meal, then needle. In cases of fatigue and extreme deficiency, common sense tells us to have the patient settle in order to allow the flow of correct qi to return to it s normal balance. This is also important for in terms of achieving a correct diagnosis: the pulse needs to return to its resting rate A cautionary note: Acupuncture treatment strongly invigorates (moves) qi and blood. Thus in cases of extreme deficiency, further depletion of the patient can result from treatment. The practitioner needs to consider other methods and tonification techniques that might be also be employed. Already drunk, do not needle; already needled, do not drink. Alcohol causes damp heat in the body and causes the qi to move chaotically. Ascending and descending qi flow can become imbalanced and the qi will not respond normally or optimally to acupuncture stimulation. Already full of food, do not needle; already needled, do not eat to excess. Already starving, do not needle; already needled, do not fast. The spleen/stomach system regularly renews the correct qi through the intake of food. If the patient has not eaten for several hours prior to treatment, they are in a state of temporary deficiency and syncope is real possibility. Conversely, when a person consumes a large meal, the qi of the body is directed to the spleen/stomach. to process the food leaving a relative deficiency of the correct qi. Fresh from sexual intercourse, do not needle; fresh from needling, do not have sexual intercourse. Sexual intercourse excites the qi to rapid movement and temporarily depletes the jing. The body needs rest to return to it s normal balance following intercourse. Acupuncture treatment take time to progressively reset the qi circulation Engaging in intercourse or alcohol use following treatment interferes with this rebalancing. One of the actions of acupuncture treatment is to descend the body s qi. This can have a therapeutic benefit in cases of imbalance of up and down qi movement of (counterflow qi). Acupuncture treatment also provides therapeutic methods for draining dampness and moving the gastro-intestinal tract. In cases of pregnancy, use of the points with strong descending or damp draining properties has the potential to prematurely induce labor (descend the fetus). 7

8 Therapeutic Effects of Acupuncture The basic principles of acupuncture treatment are as follows: Regulation of yin/yang Strengthening true qi (zhen qi) Eliminating evil qi (xie qi) Dredging the meridians 8

9 Yin and Yang The twin concepts of Yin and Yang reflect the principles of balance and harmony which are the foundations of Chinese Medicine. TCM seeks to explore the constant motion between Yin to Yang and back again. This perpetual motion begets energy and energy transformed is qi. Qi is the root and source of life and death. Thus, it is the motion of Yin to Yang that creates qi and is the fulcrum of the universe. In order to understand disease and its causes, one must study the motion of Yin becoming Yang and its resulting byproduct and creation, qi. The TCM practitioner seeks to order and control disease by controlling and regulating the flow of yin to yang. Examples of treatment strategies to regulate yin and yang are: Yin excess (excess cold disease) treatment principle Warm to counteract cold pathogen, invigorate qi and blood to counteract the stagnating effects of cold Treatment points include: REN6, REN12, UB13, UB20 (moxabustion) Yin excess (excess damp disorder) treatment principle Drain damp, support spleen to transform fluids Treatment points include: SP9, ST40, SP3, LU7 (deep, retained needling) Yang excess (excess heat disorder) treatment principle Clear heat from body, regulate qi and blood to counteract the raising and accelerating movements caused by heat Treatment points include: DU14, LI11, ST45,LU10 (shallow quick needling) Yang excess (external wind attack) treatment principle Clear exterior (remove wind), support lung downbearing and dispersing functions Treatment points include: GB20, UB12, UB13, DU16 (cupping and shallow needling). Treatment also depends upon location of disease. Kidney yin deficiency treatment principle (Hot disorder due to weakness of yin and thus its cooling function) Clear heat, tonify yin Treatment points include: KD3,KD6, KD7, KD10, SP6, UB23 (gentle tonifying method). 9

10 Strengthening True Qi True qi is the product of that which is received from heaven combined with grain qi, and which makes the body full. Nei Jing Translation note: True qi is called by various names including right qi, upright qi, correct qi and zhen qi. Heaven can be explained as meaning the congenital source of qi. Tonifying true qi means to correct the deficiency of the body s correct qi. Aspects of correct qi are: Qi Blood Yin Yang In order to tonify true qi, each of these elements needs to be tonified. Qi The source of qi in the body is the spleen/stomach system. Therefore, the earth element is the primary organ targeted. However a deficiency of qi can be made manifest in other related organs. They, too, must be considered. Related organs include lung, heart and kidney. Blood Blood is produced by the spleen in much the same way as qi. Blood is a little harder to tonify using only acupuncture. Yin The kidney is the house of yin and yang although other organs play a supporting role in yin production. Yang Tonifying yang means putting heat into the body. Moxabustion is the primary method used to do so. 10

11 Reducing Evil Qi Reducing evil qi means to clear pathogenic environmental energies that can attack the body. Following is a list of external evils and points that can be used to help eliminate evil qi engendered by these conditions: Wind: GB20, UB10, UB12, LU7 Heat: LU10, LI11, HT8, LV2 Damp: SP9, ST40, SP3, SJ5 Dry: LU5, LI10, SJ6 Dredging the Meridians Dredging the meridians is another method of reducing evil qi. Dredging means to invigorate stagnant qi and blood, to harmonize meridian circulation and to balance the ascending and descending movement of the body s qi. Points that help to invigorate qi and blood include: LI4, LV3, LV8, GB34, REN17. Points to harmonize meridian circulation include.: Luo and yuan points balance paired meridians (LU7, LI4). Entry and exit points harmonize sequential meridians; 5 shu (antique) points harmonize 5 element relationships. 11

12 The specific effects and methods of regulating yin and yang are: Tonifying/Reducing Point Selection Needle Technique Selection Warming/Clearing Ascending/Descending 12

13 All use of acupuncture is thus: to tonify hollowness,, to disperse fullness, to dredge stasis. The evil to be overcome will thus weaken. Ling Shu Tonifying/Reducing Point Selection Tonifying qi means to strengthen aspects of the correct qi including qi spleen and ancillary organ points, blood, yin and yang, Tonify qi (spleen): ST36, SP6, UB20, UB21, REN6 Tonify lung qi: LU9, SP3 Tonify heart qi: PC6, KD1, REN17 Tonify kidney qi: UB23, REN4, DU4 Tonify blood: ST36, SP6, UB17, KD3 Tonify yin: LU7, KD6, SP6, KD7 Tonify yang: UB23, UB52, DU4, REN4 Tonifying/Reducing Needling Technique Selection To tonify or disperse, results will be reached through the needles. Generally speaking, needling methods, slow then quick produces tonification, quick then slow produces dispersion. To disperse means one must support the inner being to allow a departure. Consequently, yang receives the needling and noxious qi flows out. Place and lead the needle, communicate in harmony with the inner being, and the blood will not scatter and the qi will not exit. To tonify means to follow, to assist, to agitate. Move the needle gently as if going or stopping, like a mosquito or gladfly bite. Detain the needle as if remaining or wandering. Remove the needle and withdraw fast, like the arrow leaves the bowstring. Empty or full, the nine needles are exceedingly wondrous. Ling Shu Thus, through needling, tonifying and reducing of qi can be achieved. Methods of needling include: 13

14 Lifting and thrusting/twirling and rotating Gentle movement tonifies, rough movement reduces Note: lifting and thrusting is contraindicated for certain points (eg GB21). Closing or leaving Closing the hole means holding the cotton ball gently on the point after withdrawal and is used for tonification (keeping the qi in). Leaving open the hole means quickly swabbing any blood after withdrawal but not holding closed and is reducing. Following the channel Following the channel (needling in direction of channel flow) is tonifying. Needling against channel flow is reducing. Needling in sync with respiration To insert during inhalation and withdraw during exhalation is to tonify. To insert during exhalation and withdraw during inhalation is reducing. Rapid and slow insertion and withdrawal Rapid insertion and slow withdrawal is reducing. Slow insertion and rapid withdrawal is tonifying. Warming/Clearing Moxabustion and acupuncture have their Dao Moxabustion and acupuncture s way are to obtain qi at the acupuncture holes. Treating the yin to cause sweating to an extreme will stop it in the yang. Treating the yang to cause sweating to an extreme will stop it in the yin....moxabustion can be effective when needling is not effective. When the qi is full, disperse; when hollow, tonify. When using firing to tonify, do not blow on the fire. In a moment it will go out by itself. When using the fire to disperse, quickly blow on the fire to propagate the action of the [moxa], then extinguish the fire. Ling Shu Warming and clearing are methods of treatment for hot and cold disorders. In general, warming is best achieved with moxa; however twirling the needle purposefully back and forth can also have a warming effect. Clearing heat can be achieved by bleeding certain points or by shallow needling. Rapid withdrawal of needling can also clear heat. 14

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