CMAC212 Session 9 Special point categories Focusing on: Small & Large Intestine Chinese Medicine Department www.endeavour.edu.au
Session 9 Today we shall: o Discuss point prescriptions for the take home cases. o Consider the difference when treating the fu and the channel with Large Intestine and Small Intestine point prescriptions. o Explore points on the Large Intestine channel o Explore points on the Small Intestine channel o Construct case studies looking at both channel and fu. o Clinical Practice Endeavour College of Natural Health www.endeavour.edu.au 2
Point Prescription Discussion To commence todays class: Write the point prescriptions on the board for each of the cases you worked on at home in relation to Lungs, Spleen and Stomach. Explain to the class why you took the approach you did and what your point prescription is all about. Is there a class consensus as to what would be the best approach? Endeavour College of Natural Health www.endeavour.edu.au 3
Fu vs. Channel o The major points on the Small and Large Intestine channels do not always have a major impact on their related Fu. o The majority of points on the Large and Small Intestine channels treat the channel only? o What types of points might we select to treat the fu? Endeavour College of Natural Health www.endeavour.edu.au 4
Large Intestine Channel LI 4, LI 10, LI 11, LI 15, LI 20 As a class, differentiate each points use. What is the essence of each point? For example why would I use LI 4 over LI 11? Considerations include: o Identify each point s category o Discuss each point s function & therapeutic indications. o When would you use this point? What might be the presenting illness? What other point/s might be used with it? o When would each point be contra-indicated or used with caution? Endeavour College of Natural Health www.endeavour.edu.au 5
Small Intestine Channel SI 3, SI 5, SI 6, SI 10, SI 11, SI 16, SI19 As a class differentiate each points use. What is the essence of each point? For example why would I use SI 5 over SI 6? Considerations include: o Identify each point s category o Discuss each point s function & therapeutic indications. o When would you use this point? What might be the presenting illness? What other point/s might be used with it? o When would each point be contra-indicated or used with caution? Endeavour College of Natural Health www.endeavour.edu.au 6
Case Studies Endeavour College of Natural Health www.endeavour.edu.au 7
Case Study Working in groups construct 2 different case studies. o One case study will focus on a pathology of the Small or Large Intestine Channel. o The other will focus on a pathology of the Small or Large Intestine Fu. Endeavour College of Natural Health www.endeavour.edu.au 8
Case Study Include in your case study o Signs and symptoms o Patient history / Lifestyle o Pathogenesis o Diagnosis o Treatment Principle o Point prescription, including reference to any special points. Endeavour College of Natural Health www.endeavour.edu.au 9
Case Study Share your cases & critique each others point prescriptions. Endeavour College of Natural Health www.endeavour.edu.au 10
LARGE INTESTINE CONDITIONS - PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER ST 25 Tianshu UB 25 Dachang shu ST 37 Shangju xu Front-Mu Back-Shu Lower He- Sea Promotes function of LI Clears heat, Regulates Qi Relieves food retention Promotes function of LI Relieves fullness and swelling Regulates ST/Intestines function eliminates damp-heat Dispels food retention Any condition of Stomach/intestines Any chronic condition of LI Any disorder of LI Fu Damp-heat in LI Reinforce in Xu condition in Shi condition Reinforce in Xu condition in Shi condition Reinforce in Xu in Shi LI 2 Erjian SP 15 Daheng SJ 6 Zhigou Ying-Spring Water point Jing-River Fire point Clears heat Promotes LI and SP T&T Resolves damp, regulates Qi Removes obstruction from LI Clears heat, regulates Qi Heat in intestines causing dry stools and constipation Chronic constipation (Xu, dampness, obstruction) To clear heat from and move LI Reinforce in Xu condition in Shi condition
SMALL INTESTINE CONDITIONS - PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER UB 27 Xiaochan gshu ST 39 Xiajuxu SI 2 Qiangu ST 27 Daju Back Shu point Lower He- Sea point Ying-Spring Water point Promotes the Function of Sl Resolves damp/ clears heat Regulate function of ST and intestines, eliminate dampheat, stop pain Clears heat (int/ext) Clears heat from SI & UB Moves Qi stagnation in LH Any SI disorder Any SI disorder Heat in SI & UB causing urinary pain Qi Stagnation in LH -Qi tied/pin Reinforce Xu Shu Reinforce in Xu condition Shu condition These are secondary actions Also for LI
SMALL & LARGE INTESTINE CONDITIONS - SECONDARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER LIV 13 Front-Mu of SP Promotes flow of Stagnation of Qi in abdomen Zhangmen Influential point liver Qi GB 34 Yanglinqua n Ren 6 Qihai LIV 3 Taicdong SP 6 Sanyinjiao HE 5 Tongli HE 8 Shaofu LI 11 Quchi LI 4 Hegu of Zang He-Sea Earth point Influential pt for tendons Promotes smooth flow of Liv Qi With Ren 6 and LIV 3 for stagnation in lower abdomen "Sea of Qi" Regulates Qi For Qi stagnation in abdomen Shu-Stream Earth point Yuan-Source point "Leg 3 Yin" Promotes smooth flow of Liv Qi Promotes smooth flow in Liv Qi Luo-Connecting Calms mind, benefits UB Ying-Spring Calms Mind Fire point Clears heat in HT He-Sea Clear heat from LI Earth point Yuan-Source Clears heat from LI Move bowels For Qi stagnation in abdomen For Qi stagnation in abdomen For SI/HE heat affecting HE, mind and UB For SI/HE heat affecting HE & mind For heat in LI causing dryness and constipation For heat in LI causing constipation w/ GB 34 move Qi in LJ Relieve pain Note: LIV also 'resides' in LH
LARGE INTESTINE AND SMALL INTESTINE SYNDROMES CONDITION PRINCIPLE OF TREATMENT DISTAL POINTS LOCAL POINTS OTHER POINTS Full heat in SI Clear the heat in HT & SI ST 39, SI 2, 5 HE 8, 5 SI Qi Pain Move Qi in LH ST 39 ST 25, 27, 29, LIV 13 Harmonise LIV Lanwei or other Ahshi Ren 6 Remove obstruction from LJ, point move SI Qi GB 34, SP 6, LIV 3` SI Deficient and Cold Damp-Heat in LI Heat in LI Heat obstructing LI Large Intestine Dry Cold Invading LI Warm & tonify SI, SP Yang Xu PLUS Clear the heat, resolve the damp, stop diarrhoea Clear heat in LI & ST Promote body fluids Promote bowel movement ST 39 ST 25, UB 27 ST 37 SP 9, 6 ST 37, ST 44, LI 11, LI 2 LI 4, SJ 6 ST 25, UB 25 Ren 12, Ren 3, UB 22 ST 25, UB 25 SP 15 Promote fluids in LI ST 36, SP 6, KI 6 Ren 4, ST 25 UB 17, 20 SP 6 Ren 4, 12, KI 6 OTHER Reducing method No moxa Reducing Reducing Moxa not applicable Expel the cold and warm the lower burner ST 37, ST 36, SP 6, LIV 3 ST 25 ST 27 Reducing plus moxa Look to cold SP syndrome Collapse of LI Look to SP Qi sinking PLUS Ren 6, ST 25 Reinforce plus Large Intestine Cold moxa Look at SP Yang Xu ST 37 ST 25, UB 25 Reinforce plus moxa
Clinical Practice Endeavour College of Natural Health www.endeavour.edu.au 15
Clinical Practice o Break into groups of 2-3 students and choose a student with a Small or Large Intestine channel or organ pathology pattern to treat. o Construct a diagnosis and point prescription. Utilise some of the skills that you have learnt so far palpate mu points, yuan/source points. Treat using special point categories. Have fun! o Share your findings with the class or pick an interesting case as a class discussion. Endeavour College of Natural Health www.endeavour.edu.au 16
Case Study for Next Week Please work through the assigned case study on: Session 9 Small and Large Intestine. We will discuss your point prescriptions next week. Next weeks topic will be: Session 10 Heart, Pericardium & San Jiao. We shall also cover Sun Si Mao Ghost points & Window of Heaven points. Please review these channels, points and pathologies before class. Endeavour College of Natural Health www.endeavour.edu.au 17
Endeavour College of Natural Health endeavour.edu.au 18