CMAC212 Session 8 Special Point Categories Focusing on Lung, Spleen & Stomach Chinese Medicine Department www.endeavour.edu.au
Session 8 Today we shall: o Explore points on the Lung channel o Explore points on the Spleen channel o Explore points on the Stomach channel o Analyse and construct point prescriptions o Clinical Practice Endeavour College of Natural Health www.endeavour.edu.au 2
Lung Channel LU 1, LU 5, LU 7, LU 9, LU 10 As a class differentiate each points use. What is the essence of each point? For example why would I use LU 5 over LU 9? 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 3
Lung 7 Point Prescriptions Prescription A o Lu 7 o KI 6 Prescription B o LU 7 o ST 40 Both of these point prescriptions use Lung 7 as one of the key points. Analyze and discuss the different focuses of these point prescriptions. Come up with a possible diagnosis including signs and symptoms. Include the therapeutic principle behind the point selection. Endeavour College of Natural Health www.endeavour.edu.au 4
Lung 7 Point Prescriptions LU 7 & KI 6 Here are two possible patterns that may indicate to use this point prescription. o Lung yin xu cough. LU 7 & ST 40 This point prescription would most likely be used for o Phlegm in the Lungs o Ren Mai imbalance Endeavour College of Natural Health www.endeavour.edu.au 5
LUNG CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER LU 1 Zhongfu LU 5 Chize LU 7 Lieque LU 9 Taiyuan LU 10 Yuji LU 11 Shaoshang LI 4 Hegu Front-Mu of LU Dispel fullness from chest Regulate LU Qi, stop cough, pain He-Sea Water Point Luo- Connecting Point Shu-Stream Earth Point Yuan-Source Point Ying-Spring Fire Point Jing-Well Wood Point Yuan-Source Point Clear LU Heat, activate LU D&D Expel LU phlegm Stimulate LU D&D, expel W-C circulate Wei Qi, open nose Tonify LU Qi, Yin, Regulate LU Qi Resolve phlegm Clear heat from Lungs Expel Wind, ease throat, activate LU D&D, open orifices etc. Dispel W, W-C, W-H, stimulate LU Disp function, tonify Qi Shi-type, penetration of interior e.g. heat and phlegm Heat in LU, Phlegm in LU Wind-cold attacking LU LU Qi/Wei Qi Xu LU Qi Xu, Yin Xu Phlegm Full or empty heat affecting LU Wind-heat attacking Lungs Specific for throat LU W-C, W-H General Qi Xu Reinforce Mainly Xu conditions, Bleed Reinforce Angle superiorly With LU 7, KI 7, SI 3 or SJ 5
LUNG CONDITIONS: PRIMARY POINTS SI 3 Houxi POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER Shu-Stream Eliminate Wind, W-C, LU Wind-Cold Wood Point W-H or Wind-Heat MP Du CP Yangqiao SJ 5 Waiguan UB 13 Feishu Ren 17 Shanzhong UB 12 Fengmen Luo-Connecting Point MP Yangwei CP Dai Back-Shu point of LU Front-Mu PE Influential Point for Qi Expel W-H, soothe ear Activate LU D&D, regulate & tonify LU Qi, Ying, Wei, stop cough Tonify & regulate Qi, dispel, clear LU, fullness, resolve phlegm Expel wind, regulate Ying & Wei Stimulate LU dispersing function W-H attacking LU All LU conditions LU Qi, Yin Xu phlegm in LU For first stage of penetration of Wind-cold in Shi Reinforce in Xu Reinforce Cup, reduce Angle inferiorly UB 43 Gaohuangshu Nourish Qi, Jing, LU Yin stop cough, asthma LU Qi or LU Yin Xu Reinforce -ginger in Qi Xu With ST36 to promote Qi
LUNG CONDITIONS: SECONDARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER KI 6 Zhaohai Tonify KI Yin For KI Yin Xu affecting LU Reinforce KI 7 Fuliu Jing-River Metal point Regulate sweat For LU W-C to induce sweat w/ LI 4, LU 7, SI 3 KI 9 Tonify KI Yin For KI Yin Xu Reinforce Zhubin affecting LU Du 12 Tonify LU LU Qi, Yin Xu Reinforce LI 11 Quchi PE 6 SI 17 Tianrong He-Sea Earth Point Luo- Connecting Point Clear heat, expel wind Open the chest & regulate Qi Clear heat and obstruction For W-H in LU Chest oppression e.g. phlegm Local point for sore throat
LUNG SYNDROMES CONDITION PRINCIPLE OF Rx DISTAL POINTS LU Wind- Cold LU Wind- Heat LU Damp- Phlegm LU Phlegm- Fluids LU Phlegmheat Release exterior, scatter cold, activate LU D&D function Release exterior, clear heat, activate LU D&D function Resolve phlegm, expel cold, activate LU D&D function SP Yang Xu PLUS Resolve phlegm in LU Resolve phlegm, clear heat, activate LU D&D function LU 7, LI 4, KI 7 SI 3, LU 7, KI 7 LU 11 (Bleed) LI 4, 11, SI 3, SJ 5 LU 5, 7 ST 40, PE 6 ST 40, LU 5 LU 9 LU 5, 7, ST 40 LU 10, LI 11 LOCAL POINTS UB 12 (Cup) UB 13 OTHER POINTS LI 20 Du 16, GB 20 SI 17 etc. Du 14, 16, GB 20 UB 12 LU 1, UB 13 Ren 22 Ren 17 UB 43 (ginger-moxa) Ren 12 UB 20 ST 36, Ren 12 UB 20 LU 1, UB 13 Ren 12 OTHER Scrape, cup Induce sweat if Wei Qi OK No moxa
LUNG SYNDROMES CONDITION PRINCIPLE OF Rx DISTAL POINTS LOCAL POINTS OTHER POINTS OTHER LU Qi Xu LU Yin Xu Tonify LU Qi, Warm Yang ( as often also KI/SP Yang Xu) Tonify Lung Yin, nourish body fluids, clear empty-heat LU 7, 9 LU 9 LU 10 UB 13, Du 12 UB 43 (T gingermoxa) Ren 17 UB 43 UB 13 Du 12 ST 36 Ren 6 Kl 6 LU 7 Ren 4 & 12 No moxa LU Dryness Moisten Lungs, nourish fluids LU 9 Kl 6 Ren 4 & 12 SP 6
Spleen Channel SP 3, SP 4, SP 6, SP 8, SP 9, SP 10, SP 21 As a class differentiate each points use. What is the essence of each point? For example why would I use SP 4 over SP 3? 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 11
Spleen Case Study Eliza comes to see you as she wants to lose weight. She has no appetite, eats very little, but continues to gain weight. She is tired all the time & describes a feeling of heaviness in her body. Eliza finds it hard to wake up in the morning and her head feels foggy. You notice her limbs are swollen and she has non-pitting edema. Eliza has a pale ulcer on her inner leg. She says it has been there for months and though it isn t painful, it worries her as it doesn t seem to be healing. What pulse presentation would you expect? What would Eliza s tongue look like? What do you think Eliza might say about her bowel movements? Are there any red flags or cautions you need to be aware of? Endeavour College of Natural Health www.endeavour.edu.au 12
Spleen Case Study Construct a point prescription to treat Eliza. Endeavour College of Natural Health www.endeavour.edu.au 13
SP 1 Yinbai SPLEEN CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER Jing-Well To stop bleeding Wood point SP 3 Taibai SP 6 Sanyinjiao SP 9 Yinlinquan Shu-stream Yuan-Source Earth Crossing point of leg 3 Yin He-Sea Water point Tonifies Spleen function of governing the blood Tonifies Spleen Qi Transform damp Tonifies Spleen Resolves damp Tonifies Yin and Blood Spleen Xu conditions Damp & phlegm conditions Spleen Xu Dampness in the Spleen Yin/Blood Xu conditions Transforms damp Dampness of Spleen/lower jiao Reinforce in deficiency Regulate/ for damp Reinforce in deficiency /Reg ulate for damp or regulate C/indicated in pregnancy UB 20 Pishu Back-Shu of Spleen Tonify Spleen Transform damp Reinforce/regulat e Blood & Ying Spleen Xu conditions Dampness in Spleen Blood/Ying deficiency Reinforce in deficiency Regulate in dampness
UB 21 Weishu SPLEEN CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER Back-Shu of Pacifies/tonifies ST Qi With UB 20: chronic Stomach SP/ST Xu Ren 12 Zhongwan Ren 6 Qihai ST 36 Zusanli ST 40 Fenglong Front-Mu of ST MH Influential Point for Fu He-Sea Earth point "Sea of Nourishment" Luo-Connecting Special point for phlegm Tonify Stomach and Spleen Transform Dampness in Spleen Tonify Qi and Yang Promote SP Ascending function Transform dampness Tonify Spleen and Stomach Tonify Qi and Blood Tonify Yin and Yang Transforms dampness Regulate Ying Wei Transform and resolve phlegm and damp All SP/ST disorders, primarily deficiency All Qi/Yang Xu syndromes Spleen Xu, Sp Collapsed Dampness in Spleen Xu conditions of SP/ST Dampness in Spleen Xu conditions of Yin/Yang/Qi Blood To promote Qi circulation Phlegm retention Reinforce in deficiency Regulate in dampness Reinforce in deficiency Even method for dampness Reinforce in deficiency Regulate for dampness Reinforce in deficiency Regulate in dampness to resolve phlegm Compare ST 21, Ren 13, 10
SPLEEN CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHOD OTHER UB 21 Back-Shu of Pacifies/tonifies ST Qi With UB 20: chronic Reinforce in Xu Weishu Stomach SP/ST Xu Regulate in Ren 12 Zhongwan Ren 6 Qihai ST 36 Zusanli ST 40 Fenglong Front-Mu of ST and MH Influential Point for Fu He-Sea, Earth "Sea of Nourishment" Luo- Connecting Special point for phlegm Tonify Stomach and Spleen Transform Dampness in Spleen Tonify Qi and Yang Promote SP Ascending function Transform dampness Tonify SP & ST Tonify Qi and Blood Tonify Yin and Yang Transforms dampness Regulate Ying Wei Transform and resolve phlegm and damp All SP/ST disorders, primarily deficiency All Qi/Yang Xu syndromes Spleen Xu, Sp Collapsed Dampness in Spleen Xu conditions of SP/ST Dampness in Spleen Xu conditions of Yin/Yang/Qi/Blood Promote Qi circulation Phlegm retention dampness Reinforce in deficiency Even method for dampness Reinforce in deficiency Regulate for dampness Reinforce in deficiency Regulate in dampness to resolve phlegm Compare ST 21, Ren 13, 10
SPLEEN CONDITIONS: SECONDARY POINTS DU 20 Baihui POINT CATEGORY ACTIONS INDICATIONS METHOD OTHER "100 Meetings" Strengthens Yang and Spleen Ascending Function Prolapse due to Spleen Qi Collapsed Reinforce moxa C/indicated heat & Yang Shi Ren 9 Shuifen Opens waterways, promotes fluid transformation Fluid retention/oedema /moxaneedle ST 28 Shuidao Opens water passages With Ren 9 to promote fluid transformation /moxaneedle UB 22 Sanjiaoshu Back-Shu Sanjiao Transforms and transports fluids With Ren 9 and ST 28 to promote fluid transformation /moxaneedle Du 9 Zhiyang Resolves Damp-heat Regulates LIV/GB Damp-heat in SP/LIV/GB Reducing method GB 34 Yanglinquan He-Sea Earth point Influential point for tendons Transforms damp-heat Damp-heat in SP/LIV/GB Reducing method LI 11 Quchi He-Sea Earth point Clears heat, transforms damp Damp-heat in Spleen Reducing method
Stomach Channel ST 9, ST 25, ST 36, ST 40, ST 44 As a class differentiate each points use. What is the essence of each point? For example why would I use ST 25 over ST 36? 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 18
Case Study Stomach Ulcer 55yo male MC: Severe, burning stomach pain with vomiting of blood. Onset: Started this yesterday after binging on whiskey which he drinks straight. Other S&S and background: He is unsure whether vomiting started due to excess alcohol. Had medical diagnosis of peptic ulcer and antibiotic treatment for Helicobacter pylori two months ago. Has been prescribed Nexium daily, but missed a couple of doses on weekend. Very stressed, 8/10. Negotiating a major business deal. Red face. Irritable ++ Poor sleep, which he thinks is due to the stomach pain. T: Red P: Strong, rapid, wiry Dx: Stomach & Liver Fire Endeavour College of Natural Health www.endeavour.edu.au 19
Case Study o Develop a treatment principle: o Ensure this covers symptoms and diagnosis. o Develop a treatment: o Choose four or more point categories appropriate to treat Dx. o Choose appropriate channels you will select points from. o Make a list of potential points from your list of categories. Include local and distal points. o Check point indications of your selection to ensure suitability. o Ensure one or two points will treat symptoms (stop the bleeding, pain and vomiting). o Ensure one or two points will treat the underlying organ diagnosis. o Finalize a selection of no more than six points to use in today s treatment. o Explain your point selection to the class. Endeavour College of Natural Health www.endeavour.edu.au 20
STOMACH CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHOD OTHER ST 45 Lidui Jing-Well Metal point Relieve food retention Clear Stomach heat Food retention in ST Fire in Stomach/eye ST 44 Neiting ST 41 Jiexi ST 36 Zusanli 2 ST 34 Liangqiu ST 21 Liangmen Ying-Spring Water point Jing-River Fire point He-Sea Earth point Sea of Nourishment Xi-Cleft Relieve food retention Clear Stomach heat Clear and cool fire in stomach Tonify Spleen and Stomach Tonify Qi and Blood Tonify Yin and Yang Clear obstructions from channel Subdue rebellious ST Qi Subdues and regulates ST Qi Relives pain, stops vomit Food retention in ST Fire in Stomach/face Fire in Stomach/forehead, throat All Xu conditions of SP/ST Xu conditions of Yin, Yang, Qi, Blood Acute pain/bleeding in organ due to congealed blood in ST Local point for ST Shi-type conditions Reinforce in deficiency Use with LI 4
STOMACH CONDITIONS: PRIMARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHOD OTHER UB 21 Back-Shu For Shi/Xu / Weishu Stomach conditions of ST Reinforce Ren 12 Zhongwan Ren 13 Shangwan Ren 10 Xiawan Liv 13 Zhangmen PE 6 Neiguan Front-Mu of ST MH Influential Point for Fu "Upper Stomach" "Lower Stomach" Front-Mu Spleen Influential point: zang Luo-Connecting MP Yinwei CP Chong Mai Regulate and subdue ST Qi Relieve food retention Tonify Stomach and Spleen Regulate ST Qi Subdue rebellious Stomach Qi Clear cold from ST Relieve food retention in ST Relieve food retention Harmonise ST Subdue ST Qi Calm mind All SP/ST disorders, primarily deficiency ST Qi ascending e.g. hiccup, vomit To send ST QI down e.g. food not moving down To move stagnation in MH e.g. food stagnation For ascending ST Qi Reinforce in deficiency Compare ST 21, Ren 13 & 10 /ginger moxa
STOMACH CONDITIONS : SECONDARY POINTS POINT CATEGORY ACTIONS INDICATIONS METHODS OTHER SP 4 Gongsun UB 17 Geshu SP 10 Xuehai UB 20 Pishu SP 3 Taibai SP 6 Sanyinjiao Ren 6 Qihai Luo-Connecting MP Chong CP Yinwei Mai Back-Shu Diaphragm Influential point for Blood "Sea of Blood" Back-Shu of Spleen Shu-Stream, Earth point Yuan-Source Tonify ST/SP Pacify ST Stop bleeding Dispel fullness Pacifies Stomach Invigorates Blood Moves Blood stasis Tonify SP Resolve Tonify SP Resolve damp Tonify Spleen Resolve damp Tonify Spleen Resolve damp For Shi-type pain in ST/SP Dampness in ST/SP Rebellious ST Qi (e.g. hiccup) Congealed blood conditions Congealed blood conditions Xu conditions of ST/SP Xu conditions of ST/SP Xu conditions of ST/SP Xu conditions of ST/SP Reducing in Shi conditions SP3 better for Xu SP4 better for Shi
SPLEEN & STOMACH SYNDROMES CONDITION PRINCIPLE OF Rx DISTAL POINTS LOCAL POINTS ADJACEN T POINTS OTHER Spleen Qi Xu Tonify SP Qi ST 36, SP 3, 6 Spleen Yang Xu Warm & tonify ST 36, SP 3, SP 6 -Spleen Qi Sinking Tonify and raise SP Qi Du 20, ST 36, SP 3, 6 Ren 12, UB 20, 21 Ren 12, UB 20, 21 Ren12 UB 20\21 Ren 9, ST 28, UB 22 (oedema) Ren 6 ST 21, Du 1 Spleen Not Tonify Spleen SP1, UB 17, Governing Blood Qi to hold the Blood, stop bleeding SP 10 ST 36, SP 3, 6 ST Qi Xu Tonify ST Qi ST 36 Ren 12, UB 21 Ren 6 ST Xu and Cold Food Retention in Stomach Warm and tonify ST Relieve the food retention ST 36 PE 6, ST 44/45, SP 4 Ren 12, UB 20, 21 ST 21, Ren 13/10 Ren 6
SPLEEN & STOMACH SYNDROMES CONDITION PRINCIPLE OF Rx Cold-damp invading SP/ST Cold invasion in Stomach Damp-heat in SP ST Fire (or Phlegm-Fire) ST Yin Xu Congealed Blood in Stomach Warm (expel)cold Transform and resolve damp Clear cold/warm ST Stop pain Stimulate ST descending function Clear the heat and transform the damp in SP Clear the fire in ST (and resolve the phlegm) Nourish the Yin ST Cool the heat Regulate the blood Stimulate ST descending DISTAL POINTS SP 3/6/9, ST 40 ST 34 SP 4 GB 34, LI 11 SP 9/6 UB 20 ST44/45/41 LI 4 ST 40 LOCAL POINTS Ren 12 UB 20 ST 8 ST 21 Ren 12/10 ginger-moxa UB 21 (scrape/cup) Du 9 ST 21 Ren 12 ST 4, LI 19 ST 36, SP 6 Ren 12, Ren 4, UB 23 ST 34, SP 4 Ren 12/13/10 SP 10 ST 21, UB 17 ADJACEN T POINTS OTHER PE 6, Ren 13 nausea SP 3, PE 6 not
Clinical Practice Endeavour College of Natural Health www.endeavour.edu.au 26
Clinical Practice o Break into groups of 2-3 students and choose a student with a lung, spleen or stomach 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 27
Case Study for Next Week Please work through the assigned case study on: Session 8 Lung, Spleen and Stomach. We will discuss your point prescriptions next week. Next weeks topic will be: Session 9 Small and Large Intestine. Please review these channels, points and pathologies before class. Endeavour College of Natural Health www.endeavour.edu.au 28
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