Course: Advanced Needle Theory and Techniques 2Date: May 2009 Doc:Study Materials Quiz 1 Nine Kinds Needling Techniques This is an acupuncture formulary about how to treat the Nine different kinds of disease. If its bolded below, it means Dr. Liu bolded it on his slides. Usually that means something. Name of techniqueWhat does it mean?Clinical applicationMethod Shu Needling (shu ci) Needle shu stream and back shu points Treats disorders of the Five Zang Needle the1)ying spring 2)shu stream 3)back shu for the organ/s in dysfunction Distal Needling (yuan dao ci) Treat the upper by needling the lower (distal points on the meridian) Treats the Six Fu organs (and their dysfunction in the head/trunk/viscera) Use the lower he sea points. Examples: ST 36 ST qi rebellion UB 40 d/h in UB/lo back pain GB 34 d/h/stones in GB ST 37 LI fluid xu ST 39 SI d/h UB 39 cant irrigate fluid in SJ Meridian Needling (jing ci) Treat meridian disordersTreat meridian disorders Qi/blood stagnationpain/blockage/sclerosis Needle the distal Shu points of the affected meridian as well as local points on the meridian. Collateral Needling (luo ci) Bleeding method used to needle the collaterals Treats excess and heat syndromes Use a 3-edged needle and needle the small collaterals shallowly to induce bleeding. Examples:LU 11 or LI 1 for sore throat LU 10 for excess LU heat DU 14 for heat syndrome Erjian for red/painful eyes Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 1 of 10 Muscular Needling (fen ci) Insert needle directly into the muscles Deep technique which treats muscular problems ofPain Flaccidity/atrophy Old wounds Insert the needle deeply and directly into the muscle. For muscles on the back, needle subcutaneously following the contour of the muscle. For GB 21, pinch the muscle up and needle through to avoid pneumothorax danger. Major Reducing (da xie ci) Eliminate and dredge(majorly reduce) stagnant blood and ascites Dredge pus and ascitesNote: Not really legal to do this here.

Incise or puncture to eliminate pus with blood in it. Also ascites, abscess, hematoma, edema. Cutaneous Needling (mao ci) Needle the skin shallowlyTreat cutaneous numbness, superficial diseases Needle shallowly into the skin rather than deeply into the layer between skin and muscle. Contralateral Needling (ju ci) Needle one side to treat the other.Treat disorders on the left by needling on the right (and vice versa...since Qi in the meridians exchanges from left to right/right to left) Same same Cauterized needling (Ciu Ci) Insert cauterizing/ed needle into the body Treat cold pain, scrofula, carbuncle 1/3 to of needle is heated until red, then inserted into an acupoint. NOTE: know the different kinds of shu needling and which they are from (which is 9 kinds, which is 12, which is ). That showed up on my test in several questions and I couldnt remember Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 2 of 10 Twelve Kinds Needling From the Neijing and treats diseases of the 12 meridians. This section is strictly about techniques (compared to the 9 kinds which was about acupuncture formulas).The 12 kinds are addressed in the chart below. If its bolded, Dr. Liu bolded it on the slides. Name of techniqueWhat does it mean?Clinical applicationMethod Symmetrical needling (ou ci) Yin yang needling method in which one needle is inserted front, another back Treats zang-fu organ diseases by using Front Mu/Back Shu combination Simultaneously needling the front mu and back shu. Use lateral recumbent position for this. Trigger needling (bao ci) (ConfusingTo repuncture after the needle is withdrawn) Treats Wandering Bi syndrome Find the painful spot. Needle and manipulate. If so, move to the next painful spot and repeat. Rehabilitative needling (Hui ci) Help restore function of affected part Treat bi syndrome due to muscle cramping by needling around the affected region.Usually around the joints Insert needle beside the joint Get needle sensation Withdraw so needle sits shallowly and have patient move the joint. Repeat, changing directions of the needle to dredge the meridian. Ranked needling(qi ci) Insert a needle then 1 on either side for a total of 3 insertions Treat deep Bi syndrome over a small area Similar to rehabilitative, but uses 3 needles rather than just one.Insert one needle in the center Insert a needle on either side of the center. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 3 of 10 Surrounded needling (yang ci) One needle in the center and four superficially around it Bi syndrome with superficial cold retention in a large area Insert one needle in the center of the area, and 4 superficially around it: upper, lower, left, right. Needled area is not concentrated.You can also do this deeply for deeper problems or shallowly for surface problems. Straight needling (zhi zhen ci) Skin is kneaded, needle inserted into diseased location Treats superficial and collateral problems by shallow needling Knead the point, then insert subcutaneously between the skin and muscle layers.SHALLOW! This is a form of threading. You could use it on the face, between the back shus, etc. Shu needling (shu ci) Directs yang away from yin to eliminate heat Eliminates pathogenic heat by directing yang away from yin. This is a reducing technique. Note: not the same as the 9 kinds which uses shu stream/back shu! Insert needle perpendicularly and deeply and get needle sensation. Withdraw slowly. Close bone needling (duan ci) (also called short needling) Needle the region near the bone.Treats deep diseases like bone Bi Insert slowly/deeply by slight shaking then rotate mildly when it gets near the bone.Superficial needling(fou ci) Oblique superficial needling Cold cramps of muscles and numbness syndromes. Oblique shallow needle on the superficial aspect of the muscle. Yin needling (yin ci) Bilateral simultaneous needling of points Treats Yin coldBilateral needling of points (i.e. both KI 3s) Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 4 of 10 Accompanied needling (pang zhen ci) Insert one needle into a selected point and another nearby Treat stubborn Bi syndrome with obvious tenderness and fixed location Dredges meridian and activates the collaterals over the tenderness. Insert one needle perpendicularly at the selected point and another obliquely beside it.Repeatedly sparse needling (zhuan ci) Helps subside soreness/swelling. Treats carbuncles, furuncles, erysipelas before they developpus. (Erysipelas is a severe skin disease caused by streptococcus infection in surface and surrounding tissue, marked by continued spreading inflammation.) Dr. Liu uses 3 needles in one hand at the same time, pricks the area and bleeds it. Shallow needle, quick withdrawal followed by bleeding. Kind of like 7 star or plum blossom, but those cover too large of an area. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 5 of 10 Five Needling Techniques Refers to the five Zang organs and needling the tissue corresponding to them therefore indirectly affecting their functions and the organs themselves. Remember what tissues correspond to what organs: Lung =skin Spleen =muscle Liver =tendons Heart =vessels Kidney =bone Name of techniqueWhat does it mean?Clinical applicationMethod Semi-needling (ban ci) Shallow needling of skin only Treatssuperficial w/c fever dyspnea Lung diseases Some skin diseases Needle is inserted only into the skin (shallowly) and then withdrawn quickly like you would pluck out a body hair rather than a smooth in /out motion. Kind of like flicking out a small splinter. Know the difference between this and other types of cutaneous/shallow needling! Leopard spot needling (baowen ci) Multiple points of bleedingTreats red, swollen, hot, painful dermatological diseases Regulates Heart Qi.This type of disease reflects blood heat and so treating that treats the heart qi also. Blood letting technique. Select one point at the center of the problem, needle sparsely around it for blood letting. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 6 of 10 J oint needling(guan ci) Guan means joint. Needling the tendons around the joint. Tendon Bi syndromes Regulate Liver QiNeedle into the tendons around the joints, taking care not to needle vessels (this is sharp pain there is no pain when needling tendons) Hegu needling(hegu ci) Gu means major muscle convergence. This is needling thick muscle. Treat muscular bi Can regulate Spleen Qi Insert deeply (1 1 cun needle) into thick muscle and get Qi. You can leave it in for a few minutes if you think its needed. Normally you move as soon as you get Qi. Withdraw shallowly and push obliquely to one side. Get Qi.Repeat to the other side. Get Qi.Go back to original insertion and retain. This is heavy stimulus. Similar to rehabilitative needling. Shu needling (shu ci)again! This time it refers to needling perpendicularly to the bone and then withdrawing straight to dredge the internal and external Obstructive pain of the bones and disease in deep regions Regulates Renal Qi Perpendicularly insert deeply to the bone Withdraw straight Retaining the needle is not generally done in this technique. J ust touch and go. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 7 of 10 Triple Layer Needling Technique All tissue from surface down can be separated into 3 layers unless a point is very very shallow (like on the scalp): Intradermal (shallow) Expels pathogenic factors, promotes blood circulation Subcutaneous (middle)Disperses yin Qi Intramuscular (deep) Antipathogenic Qi stimulation You must think about what the needle tip is touching and in what layer it is. This method removes pathogenic Qi and maintains the healthy/antipathogenic Qi. Divide these proportionally depending on the depth to the bone from the surface of the tissue. How to:1)Insert the needle into the shallow to expel pathogenic/promote blood circulation 2)Next insert into the middle to disperse the Yin Qi 3)Finally, insert deeply to stimulate antipathogenic Qi. Qi Directing Technique This technique treats adverse flow of Qi and blood. You insert to depth then manipulate slowly and evenly with lift/thrust and rotate methods. Once needling sensation is achieved you retain for a while. Nanjing Techniques to Know MethodClinical applicationMethod Needling of the WeiNeedle and stimulate the superficial Wei Qi without damaging the Ying Qi lying deeper Needle into the shallow layer and rotated or lift/thrusted only within this layer to get needling sensation. Needle transversely or perpendicular/shallow.Needling of the J ingNeedle and stimulate Ying Qi without damaging the Wei Qi Press on the point with the non-needling hand in order to disperse and move the Wei Qi at the surface. Insert needle to Ying level, manipulate to get qi sensation if necessary. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 8 of 10 Four Methods for Dredging Channels, Connecting Qi Qi and Blood stagnation in the channels. Note that there is no needle sensation shooting through the joints. NameClinical ApplicationMethod Blue Dragon Wagging Tail Directs QiStrengthens deficiencies Warms meridian to promote circulation of Qi and blood Treats abdominal masses Arthralgia Problems of Qi/blood yu and meridians Needle is inserted shallowly and obliquely (or deep first, then removed to shallow level) with tip of needle pointing to the location of the disease. Handle is slowly and barely rotated from R to L to transmit meridian Qi to distal region. Described as a steersman turning the helm. You not only rotate, but move left and right slightly. White Tiger Shaking Head Reducing method promoting Meridian Qi flow and reducing excess. First, insert perpendicularly deep into the muscle, get Qi. Withdraw shaking the needle like a tiger shaking its head or like ringing a bell. Shake, lift. At the same time you use the other hand to press the other side of the meridian to drive the meridian qi to flow to the other direction/location of disease. Black Tortoise Seeking for Hole Strongly promotes the circulation of Qi and needling sensation. Also dredges meridians and direct the needling sensation from shallow region to deep and other direction. To needle you insert to selected point, then withdraw shallowly and go different direction. This is referred to as seeking the hole which means you dont change directions and insert in one smoothe move, but in about 3: shallow, middle, deep. Do this in all 4 directions. Red Phoenix Meeting Its Source Promotes qi circulation maintains needling sensations dredges meridians and promotes the flow of meridian Qi.Treats various kinds of pain disorders and good to move Qi. Insert into deep region with needle sensation.Needle is then lifted to shallow, shaken to wait for Qi Then inserted to middle layer.Needle is then manipulated with flying technique like a phoenix spreading its wings which then promotes circulation of Qi. Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 9 of 10 Eight Methods for Treating Diseases NameClinical ApplicationMethod Heat inducing techniquePowerful strengthening method, especially for deficient cold. Builds Yang. Severe Bi cold syndrome. Can also use after a stroke and for atrophy. Needle is inserted and manip in 1) shallow, 2) middle, 3) deep layers. Manipulation is by tonifying-rotating or strong insertion/light lifting, lift/thrust (strong in gentle out), etc. . Nine times each layer. Repeat several times to induce heat. When you finally withdraw, close hole. Choose thick muscle area. Cool inducingMakes whole body cool for high fevers Insert, directly deep, do reducing tech and deep, then mid, then shallow layers. You can use swift/slow, lift thrust, nine/six numbers, close open and respiration method. Yin Hiding in YangColdFeverTonifying method of slow insert with heavy breath insert and quick withdrawl. This tonifies yang on the way in and reduces fever on the way out. Needle is inserted/manip in shallow and deep regions. Tonify shallow, reduce deep. Yang Hiding in YinHeatColdOpposite of previous Advanced Needling Technique and Theory 2 Spring 2009 www.CatsTCMNotes.com Page 10 of 10