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First in a Series ADVANCED PRINCIPLES AND TECHNIQUES Second Edition in Acupuncture Unique Point Applications and Case Studies for Effective Pain Treatment RICHARD TAN, O.M.D., L.Ac. and STEPHEN RUSH, L.Ac.
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Page 1: Twelve and Twelve in Acupuncture

First in a Series

ADVANCED PRINCIPLES AND TECHNIQUES

Second Edition

~welve an~ ~welve in Acupuncture

Unique Point Applications and Case Studies for Effective Pain Treatment

RICHARD TAN, O.M.D., L.Ac.

and STEPHEN RUSH, L.Ac.

Page 2: Twelve and Twelve in Acupuncture

Efwelve an~ Efwelve in Acupuncture

ADVANCED PRINCIPLES AND TECHNIQUES

Second Edition

RICHARD TAN, O.M.D., L.Ac. and

STEPHEN RUSH, L.Ac.

SAN DIEGO, CALIFORNIA

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'

Copyright© 1991 by Richard Tan, O.M.D., L.Ac.

All rights reserved. No part of this book may be used or reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except in the section "Case Treatment Matrix" and the "Feedback Form," without prior written permission of the publisher.

For information contact Richard Tan, O.M.D., L.Ac. 4550 Kearny Villa Rd., Ste. 107, San Diego, CA 92123 Fax:(619)277-9037

Editors: Pam Gay, Cheryl Warnke, Keith Robbins Design and Typography: Cheryl Warnke Fonts: Times Roman, Gazelle

First Edition-March 1991 Second Edition-August 1996

Printed in San Diego, California.

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'

Acknowle~gments

This book represents the first step in the fulfillment of a dream of a series of practical, timely, and lasting

acupuncture texts. I would like to express my thanks to everyone who helped me with the initial project.

This book also represents the special encouragement and collaboration of my longtime friend and fellow practitioner Steve Rush, who co-authored this text.

My heartfelt thanks to my father, who initiated me into he practice of acupuncture, and to my mother for her solid encouragement every step of the way. Special hanks to Pamela Gay, for her persistent efforts with

editing and keeping us organized. I would also like to thank Cheryl Warnke for

contributing her skills in typesetting and design.

My love and appreciation to my wife and three sons for their patience, strength, and understanding while

I was working on this extra task of writing the book. My greatest appreciation is to the needles and herbs,

and the dynamic healing system in all of us.

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' Contents

Preface.................................................................................... iii Acknowledgments.................................................................. vi Introduction . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. .. . .. . . .. .. 1 How to Use This Book.......................................................... 7 The Twelve Extra Points-Functions and Locations............ 13 TheTwelveRegularMeridianPoints-UniqueApplications .. 29 Five Case Studies of Ling Ku, Da Bai, Zong Bai Combination

Case 1: The Cane Man .. . .. . .. . .. . .. .. .. . .. .. .. .. .. .. .. .. .. . .. . .. . .. ... .. .. . 3 8 Case 2: The Limiting Low Back ....................................... 41 Case 3: The Overworked Knee ......... ........................ ........ 44 Case 4: Teen-Aged Sciatica .............................................. 46 Case 5: Elbow with Shooting Pain . .. .. .. .. .. . .. . .. . .. .. . .. . .. ... .. . .. 48

Three Case Studies of Chung Tze-Chung Hsien Combination Case 1: The Scoliosis Housewife ...................................... 52 Case 2: Twice Rear-Ended Computer Operator ................ 55 Case 3: The Once-Treated Retired Mom .. .... .................... 57

Six Case Studies Involving Mu Huo, So Jing Dian, Gan Men and Yen Huang

Case 1: Stroke Fingers .. .. . .. .. .. .. .. .. .. .. . .. .. .. .. .. . .. . .. .. .. . .. . ... .. .. .. 60 Case 2: The Wheelchair Patient ....................... .... ............. 62 Case 3: A Once-Treated Pain in the Neck ......................... 64 Case 4: TMJ Syndrome and Accompanying Neck Pain ... 66 Case 5: Chronic Hepatitis.................................................. 68 Case 6: The Yellow Housewife......................................... 70

Three Case Studies Involving Mu Guan and Gu Guan Case 1: The Travel Agent with Sore Hands ...................... 74 Case 2: Banker with Bone Swelling .................................. 77 Case 3: The Writer's Heel Spur ........................................ 80

Regular Meridian Point Case Studies Case 1: Involving San Jiao 2, Lady with Tired Blood .. .. .. 84 Case 2: Involving Pericardium 3, A Pain in the Thumb ... 86

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' Case 3: With Pericardium 7 & 6, A Twist in the Kitchen .... 89 Case 4: Pericardium 9, 11-Year-OldwithaSoreThroat .... 91 Case 5: Involving Heart 4, Hairdresser's Neck Pain ......... 92 Case 6: Involving Heart 4, OneTreatmentSurfer'sNeck .. 94 Case 7: Involving Heart 5, TwistedHipintheBasement ... 96 Case 8: With Small Intestine 4, Boy with Invasion

of Summer Heat in the Eyes ........................................ 98 Case 9: Pericardium 6, Tom Knee from Karate Class ...... 100 Case 10: Pericardium 6 & Liver 3, Dance Teacher

with Arthritic Knees .................................................. 102 Case 11: With Large Intestine 11, Steve's Knees ............. 1 04 Case 12: With Large Intestine 11, The Bicyclist's Knee .. 106

Three Case Studies Involving Large Intestine 12, 13 and 14 Case 1: The Dentist with Extreme Back Pain ................... 110 Case 2: The Woman Waking Up with Spine Pain ............ 112 Case 3: Large Intestine 14, TheHighPressureSalesman ... 114

Case Treatment Matrix .......................................................... 117 Some Final Considerations .................................................... 123 Feedback Form ...................................................................... 125 Conclusion ............................................................................. 127 Bibliography .......................................................................... 129 Index 1-Point Description and Case Studies ..................... 131 Index 2-Symptoms/Conditions ........................................... 132 Appendix 1: Regular Meridian Points-Locations ............... 133 Other Books by Richard Tan ................................................. 135 Order Form ............................................................................ 137

ii

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1're{ace

After being involved with the practice and profession of acupuncture in the United States for several years, I am surprised to fmd that so many American practitioners en­counter so much trouble in the treatment of pain. Many practitioners do not realize that acupuncture is often capable of relieving pain within seconds, if proper point selection and needle technique are employed. For some reason, in the United States there seems to be a great deal of literature available concerning acupuncture for a variety of chronic, emotional, and stress-related problems. Yet there is very little material being published that addresses effective methods and strategies for the treatment of what acupunc­ture is most noted for in the Orient-its treatment of pain. My primary motive in writing this book is to enable the reader to become familiar with some very powerful tech­niques for pain treatment-the most essential and tradi­tional application of acupuncture.

A widespread belief concerning acupuncture that I have encountered is the concept that the patient must "believe in

iii

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tv I Twelve and Twelve in Acupuncture .,

it" or be "willing to give up their pain" before acupuncture can be effective. While the significance of mental and emotional factors in the overall healing process has been well documented, I must take exception to the notion that it is relevant to acupuncture's pain-relieving function.

In fact, I actually prefer patients who are openly skeptical concerning the treatment of acupuncture. I feel that their feedback relating to the effectiveness of the treatment is more reliable than if they are influenced by a belief system telling them that it should work-thus raising the possibility of placebo or trance-phenomena effects. When applied cor­rectly, the points and techniques of this book will be effec­tive-regardless of the patient's mindset. Also, I feel that our profession's reputation with other medical professionals will be enhanced by an increase in our collective ability to effectively treat pain of a non-psychosomatic origin.

Some of the twelve extra points discussed in this book are from the notes of Master Tong Jing Tsang. Dr. Tong, a brilliant acupuncturist known for his abilities in pain treat­ment, has largely remained unknown to non-Chinese practi­tioners. I have retained the names that the late Dr. Tong used in referring to these points; even though, in the past, some of these points were named differently by other doctors. A written anatomical description of each point location is provided, along with a graphic illustration for each of the extra points. Steve and I have structured and indexed this book into the style of a "workbook" or reference book, in order to enhance its ease of use in a clinical situation. Please refer to the "How to Use This Book" section for further details. It is our intention that the case study format we have

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Preface I v I

included will not only be informative, but also enjoyable to read. It should be noted that while the extra point functions are not entirely our original findings, many of the new regular channel point functions are. These case studies have been selected to be representative of the hundreds of cases we have compiled in our research of these points and their applications.

I have been involved in the study of Traditional Chinese Medicine for over 20 years, and I have been fortunate enough to have studied from several true masters. This book repre­sents some of the best part of my knowledge in the treatment of disorders involving pain.

Richard Tan, O.M.D., L.Ac.

AUTHORS' NoTE TO THE SECOND EDITION

Over the past five years we have had the gratifying opportu­nity to reach many practitioners in our field with ideas via this, our first book. Twelve and Twelve in Acupuncture has enabled us to present effective distal point acupuncture techniques to practitioners across the U.S. and abroad. It is our hope that as a result the clinical efficacy of everyone who has tried these methods in practice has been upgraded. Since the publication of our second book, Twenty-Four More in Acupuncture in 1994, we have received even more positive feedback from readers who appreciate our endeavor to fill a

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vi I Twelve and Twelve in Acupuncture .. '

niche in the acupuncture literature for material focusing on effective technique frrst, and philosophical theory second. In the dozens of acupuncture seminars that Dr. Tan has con­ducted around the country in these past few years, he has also stressed the importance of our work's clinical effectiveness by demonstrating (whenever it was allowed) his techniques upon patients provided by those attending. The simple expe­rience of witnessing the distal points quickly relieving pain, restoring range of motion, and returning sensation to numb or paralyzed body areas has impressed observers more than any lecture or written material ever could have.

At this point in time, we are readying ourselves for the process of fulfilling a promise that we made to our readers in 1991. The philosophical and theoretical foundations of Dr. Tan's work are from many sources, and he has synthesized them into a few highly efficient approaches, the exposition of which will be the focus of our third book, due by the end of 1997.

Please note that aside from "cleaning up" the copy, this second printing is identical to the first edition, except for the addition of one new appendix of point locations added for the "regular" channel points.

Once again, we would like to offer our thanks and apprecia­tion to all of our readers who have expressed their support of our efforts over these last five years. Please stay tuned. The best is yet to come.

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,.

. ''

1ntr£'~ucti£'n

As most of us in the profession know, acupuncture dates back some 2,000-plus years in Chinese history, yet is considered a new modality here in the West. Such are the quirks of history, that if not for the experience of James Reston on the Nixon China tour, interest in acupuncture might not have been kindled at all. As a result, many similar and even more impressive reports of acupuncture began to reach our culture. Stories of seemingly miraculous cures and surgical anesthe­sia were circulated. Thus, acupuncture had arrived to stay in the United States. However, a problem regarding acupunc­ture quickly surfaced. In several scientific studies and clini­cal trials conducted in the United States, it failed to work with a consistently high rate of efficacy. Such preliminary results, as we also know, were seized upon by conserva tive medical authorities as "evidence" by which many attempted to prove that acupuncture was in fact little more than an elaborate placebo. One assumption commonly adopted by such thinkers equates the concept of "scientific" with complex high-tech gadgetry; an equation which the traditional tools of Chinese Medicine obviously cannot fit into.

1

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2 I Twelve and Twelve in Acupuncture

Yet, acupuncture can fit into and fulfill one of the basic requirements of scientific protocol; simply put, it is a phe­nomenon whose effects are consistently reproducible when it is correctly applied. It is now apparent that early clinical trials conducted in this country were often carried out with less than even a rudimentary knowledge of Traditional Chinese Medical treatment principles and point selection strategies. That any positive results at all were generated by these studies is quite surprising, and even encouraging when viewed within this context.

The ball is now in our court. As practitioners of Traditional Chinese Medicine, we can disprove current misconceptions by virtue of the fact that acupuncture does work, and it works quickly, effectively, and even dramatically, and is remark­ably free from side effects.

The tradition of Chinese Medicine encompasses a medical practice with vast practical experience and many valid thera­peutics which, coincidentally, often succeed where Western medicine does not. Traditionally, acupuncture's forte in the Orient has been a means to rapidly reduce or eliminate pain. There, a good doctor is expected to be able to produce relief from pain with each treatment, in many cases often within seconds of inserting the needles and obtaining the Qi sensation.

Many new possible applications for acupuncture are being discovered and are gaining valuable publicity for our pro­fession. However, acupuncturists should also continue, for the sake of consistency, to improve their effectiveness in pain treatment. Also, acupuncturists need not perceive themselves as practicing in competition with other medical professionals, but rather as complementing their specialties

Page 13: Twelve and Twelve in Acupuncture

Introduction I 3

in a synergistic way.

Currently, many Western authorities on TCM stress the idea that an understanding of its theory must be interpreted within the context of a poetic, symbolic, intuitive system. While the poetry and beauty of Chinese medical philosophy is admi­rable and significant, in the opinion of the authors, it is not accurate to depict this aspect as the singular or dominant mode of its thought.

In fact, we believe that the basic underlying system behind the flowery images of Chinese Medicine and all other fields of traditional Chinese thought is a system of highly logical binary mathematical concepts which are expressed collec­tively as the I Ching, also known as the Book of Changes. Faced with a lack of information concerning this deeper structure and its relationship to the more superficial poetic structure, many modem authors understandably feel the need to explain Chinese medical philosophy via what amounts to the only model available to them. It is our intention to address this issue of "philosophical deficit" in future publications.

The scope of this acupuncture text is concerned with achiev­ing a high degree of clinical effectiveness in the treatment of pain. We, as practitioners of acupuncture, are sharing our knowledge and expertise by listing these unique points and their indications for use. This unique method complies with the traditional standards of excellence that acupuncture has come to be noted for in China.

With this book's detailing of the practical application of this special method of acupuncture, we endeavor to mark­edly improve clinical proficiency in these areas for all

Page 14: Twelve and Twelve in Acupuncture

4 I Twelve and Twelve in Acupuncture

practitioners who implement it. The points and techniques for effective treatment contained herein will prove to be a valuable asset to the repertoire of all who practice them.

There are several advantages inherent in this method that differ from the more conventional style of acupuncture.

First, an effort is made to minimize the number of needles used. Generally, fewer than six needles are used in a typical acupuncture treatment. This is most often welcome to patients who fear the "pincushion" effect of current treat­ment styles.

Second, the area of pain or injury is almost never directly needled. Distal points are usually selected. This relieves the patient's, as well as the practitioner's, anxieties and con­cerns about further trauma being introduced to an already injured or sensitive area.

Third, another benefit of distal treatment is that it leaves the painful area needle-free; the area is then left open for massage or manipulation while needles are in place. If, for example, a patient is being treated for knee pain, he might be asked to move his knee through its range of motion while distal points are being stimulated. The resulting effect is often quite powerful for removing blocked Qi.

Fourth, this method also lends itself to a greater degree of flexibility. Several treatment routes are available to the practitioner in order to help move beyond therapeutic plateaus that often arise during the course of a series of treatments.

Last, and perhaps the most significant and attractive feature

Page 15: Twelve and Twelve in Acupuncture

Introduction I 5

of this method, is that beneficial healing results occur very quickly. In most cases, these results occur almost simultane­ously with the Qi sensation: a final feature most encouraging to the patient and TCM practitioner alike.

Stephen Rush, 1991

Page 16: Twelve and Twelve in Acupuncture

t/iow to ~se £(his ~ook

Considerable care and attention has been taken in structuring this book for the purpose of being "user-friendly" by the practitioner in the clinic. Two sets of indices have been provided, which will speed access to the information within. "Index 1" lists the points discussed and all the references to them throughout the book. "Index 2" lists symptoms and conditions discussed in the case studies and elsewhere. In addition, in order to maximize the potential for positive results from this book, a few other considerations need to be discussed:

1. Point Locations

A. 12 Extra Points

To the best of our knowledge, this is the first time that most, if not all, of the extra points in this book have been published in the English language. It is our hope that the written point locations will be thoroughly clarified by the accompanying illustrations of them. In addition, as is indicated in the case of some of this group of points, the importance of utilizing the 'Ah Shi,' or sensitive spot method, through probing the

7

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8 I Twelve and Twelve in Acupuncture

region of the point's location for the exact point of maximal energetic sensitivity, must be emphasized. In many cases, the proper 'Ah Shi' location can be the main factor that deter­mines a treatment's effectiveness-especially where we have so indicated.

B. Meridian or Regular Points

We utilize the nomenclature of the Chinese Acupuncture and Moxibustion (Beijing), a virtually universal text in California and elsewhere, so that the reader may easily access its excellent written and pictorial descriptions of the meridian point locations.

2. Qi Sensation

It has been our finding that in order to obtain the results described, it is necessary that a sensation be obtained by stimulation of the specific points. Whether the medium is acupuncture, electro-acupuncture, electrical stimulation such as Pomeranz's Code-A-Tron, TENS, or pressure, this rule holds true. The degree of stimulation can be significant without being truly painful. Of course, individuals will vary according to many factors in the degree of stimulus required. Some of the factors will include: age, degree of pain being treated, the age of the injury or disorder being treated, and the variation in sensitivity of the points themselves. The age of the patient, if very advanced, is a cause for extra care in obtaining a good, but not excessive stimulus. The same care should also be taken in cases where the patient is weakened by constitution, or a long disease process. Often, the higher the level of pain the patient is experiencing, the stronger the stimulus required. Also, the more recent or acute condition will elicit a stronger Qi sensation.

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How to Use This Book I 9

The practitioner will discover with experience which of these points are generally apt to produce these stronger sensations. It should be noted here, however, that the points Ling Ku and Da Bai can be counted upon to be very sensitive, and generate a very strong sensation when needled or stimu­lated correctly. Initially, the practitioner should exercise some care with new points in order to avoid overstimulation of them. Overstimulation can be unpleasant and frightening to the patient, and in extreme cases, can even cause fainting.

3. Treatment Frequency

As you will notice from reading the case studies, the fre­quency of the treatment, in most cases, is two to three times per week. As symptoms diminish, it is possible to decrease the frequency accordingly. It is to be expected that a degree of the symptom, especially if it is pain, will reassert itself in the interval between the treatments. The time between treat­ments themselves should not be so great that the symptom reverts to its pre-treatment level.

4. Patient Cautions

Due to the fact that rapid pain relief is a consistent phenome­non with these points, it should be emphasized here that the practitioner must urge the patient to continue 'babying' the body; and increase motion and activity gradually, under the practitioner's direction.

5. Aggravation

It should be noted that in approximately 10 to 15% of the cases we have treated (and the case studies are only a small representative sample of them), an aggravation of the

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10 I Twelve and Twelve in Acupuncture

symptoms will occur in the frrst 24 hours following a treatment. The patient should be reassured in this event that it is a good sign; the aggravation will subside within 24 to 48 additional hours, leaving the symptoms signifi­cantly improved.

6. Numbness or Pain

It is important to emphasize that these points will have a powerful effect on the corresponding areas they treat, whether the problem involves pain, numbness, or any other abnormality in the region. They function in a much greater capacity than that of a simple pain-killer.

7. Reader Advice

Last, the authors wish to strongly encourage you to read the entire case studies section with extra care, as much valuable additional information is contained within it.

In conclusion, this book has been structured in 'workbook' style to facilitate its use by anyone who utilizes meridian or acupoint therapy. Chiropractors, osteopaths, bodyworkers, and certainly acupuncturists should find it easy to use in their daily practice. The authors consider this to be the frrst book of a series; as such, it constitutes the first segment of a 'work in progress.' That progress would be greatly aided by feedback given to us concerning any of the subject matter.

We are continuously researching new treatment modalities, points, and concepts, with the goal of consolidating many ideas and methods into a new, more efficient, and versatile theory. Towards this end, please be aware of the "Feedback Form" provided at the back of this book. We welcome your questions, comments, and suggestions.

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How to Use This Book I 11

Also, we are in the process of organizing a series of lectures and clinical workshop-demonstrations for professionals, that will cover and expand upon this book's material. Interested parties may contact us for information concerning times and locations at the address or fax number provided on the "Feedback Form" on page 125.

Although we consider ourselves to be lifelong students of the healing arts, we have confidence in the effectiveness of the information we are sharing with you in this book. And, we look forward to the possibility of sharing more with you in the future.

* Please note that for this second edition, an appendix containing the point locations for the twelve regular channel points listed in this book can be found beginning on page 133.

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Efhe Efwelve ~xtra 1'oints-Lfunctions

an~ Locations

13

Page 22: Twelve and Twelve in Acupuncture

14 I Twelve and Twelve in Acupuncture

• LINGKU

LOCATION-In the depression, just distal to the junction of the first and second metacarpal bones. Approximately 0.5 cun proximal to Large Intestine 4 (Hegu), on theY ang Ming line.

NEEDLING INFORMATION-Needle perpendicularly, 0.5 to 0.9 cun in depth.

INDICATIONS • Sciatica Used with Da Bai and also Zong Bai on occasion. Effective for lateral part of leg, and low back pain. L 4-5 type sciatica. May also be effective in combination with SI3 (Hou Xi). Use contralaterally to symptom. • Shooting-type pains throughout the body Pains which originate in one area or site, and project or shoot down a limb, energetic channel, or to another part of the body. For example, neck pain extending down the trapezius, and most dermatome-related pains, are treatable with Ling Ku. Needle contralaterally. • Pain in the elbow joint Needle on the same side as the pain. • Headache, head area symptoms Can be used in combination with Large Intestine 4 or 3, or used alone for head area symptoms, bilaterally or contralaterally. • Painful and/or frequent urination Needle the point bilaterally.

CONTRAINDICATION-Not for use on pregnant women.

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Twelve Extra Points-Functions and Locations I 15

Ling Ku is a powerful point that shares with its neighbor, Hegu, the characteristic of having many and varied func­tions. It possesses a strong 'Qi regulating' effect, which can explain, in part, its variety of indications. The 'Teh-Qi' sensation produced by needling Ling Ku can be quite intense. Ling Ku has also been used in certain cancer-related point prescriptions.

CASE STUDIES-Pages: 38, 41, 44, 46, 48, 52, 55, 60, 86, 96, 102, 110, 114

l

LingKu

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16 I Twelve and Twelve in Acupuncture

• DABAI

LOCATION-About 0.5 cun proximal to LI3 (Sanjian), on the Yang Ming line.

NEEDLING INFORMATION-Needle perpendicularly, under the bone, 0.3 to 0.7 cun in depth.

INDICATIONS

LI3

L14

• For children with high fever or asthma Bleed the point bilaterally. • Use with Ling Ku for sciatica See "Ling Ku" information.

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DaBai

CASE STUDIES­Pages: 38,41,44,46

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Twelve Extra Points-Functions and Locations I 17

• ZHONGBAI

LOCATION-About 0.5 cun proximal to San Jiao 3 (Zhongzhu), on the Shao Yang line.

NEEDLING INFORMATION-Needle perpendicularly, 0.3 to 0.5 cun deep.

INDICATIONS • Low back pain in L2-3 area Especially if aggravated by standing up from a sitting position. Needle contra­laterally if pain is one-sided. • Edema Especially in the limbs. Needle bilaterally.

Zong Bai is often included in the Ling Ku-Da Bai com­bination for treatment of sciatica.

CASE STUDIES­Pages:38,41,44,46

I

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18 I Twelve and Twelve in Acupuncture

• CHUNGTZE

LOCATION-On the palmar surface, about 1 cun medial to the midpoint of the web-margin between the thumb and index finger, on a line drawn from this intersection to Pericardium 7 (Da Ling). 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needling perpendicularly, 0.3 to 0.5 cun deep.

INDICATIONS • Upper back pain Occurring between the medial border of the scapula and spine. Needle contralaterally. Usually combined with Chung Hsien.

• Asthma in children Needle bilaterally.

Chung Tze is almost always used in conjunction with its companion point, Chung Hsien.

CASE STUDIES-Pages: 52,55,57

ChungTze

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. -'

'

Twelve Extra Points-Functions and Locations I 19

• CHUNG HSIEN

LOCATION-Along same line as described in the location for Chung Tze; about 1.0 cun proximal or medial to Chung Tze. 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needle perpendicu-larly, approximately 0.3 to 0.5 cun in depth.

INDICATIONS • Upper back pain Located between the spine and medial border of the scapula. Needle contralaterally in combination with Chung Tze. • Cough and pneumonia Needle bilaterally in com­bination with Chung Tze. • Asthma in children Needle bilaterally in combination with Chung Tze. • Knee pain Needle contralaterally .

CASE STUDIES­Pages: 52, 55, 57

.......-...;:::

I

Chung Tze

.____ _ ___,__ Chung Hsien

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20 I Twelve and Twelve in Acupuncture

• MUHUO

LOCATION-In the center of the dorsal aspect of the distal interphalangeal joint of the middle finger.

NEEDLING INFORMATION-Needle perpendicularly to a depth of up to 0.1 cun.

INDICATIONS • For paralysis of all types Especially useful in one­sided paralysis (hemiplegia). Needle contralaterally.

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MuHuo

The frrst treatment with Mu Huo should consist

of continuous steady stimulus of the point for 5 minutes, then withdrawal of the needle. The second treatment should be given 5 days later, with the stimulus lasting 3 minutes. The third treatment should be administered after another 5 day interval, with the stimulus lasting only one minute.

CASE STUDY: Page: 60

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Twelve Extra Points-Functions and Locations I 21

• BAGUAN

LOCATION-In the notch formed just distal to the epi­condyle of the proximal phalangeal bone of the middle finger, on either side of the bone.

NEEDLING INFORMATION-Needle towards the epi­condyle of the bone, with the shaft of the needle angled about 45 degrees from the middle fmger. Needle to a depth of 0.1-0.2 cun. Needle both sides of the bone.

INDICATIONS

• Motor or sensory deficit in the lower limb Needle contralaterally.

CASE STUDY-Page: 62

Ba Guan

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22 I Twelve and Twelve in Acupuncture

• SO JING DIAN

LOCATION-In the depression, approximately level with San Jiao 3 (Zhongzhu), between the third and fourth metac­arpal bones. 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needle perpendicularly, 0.3 to 0.5 cun in depth.

INDICATIONS • Neck pain Good for all types of neck pain, but especially effective for pain of the Shao Yang, Tai Yang, and Du channels. Needle contralaterally when pain is one-sided.

l

CASE STUDIES­Pages:64,66

SJ 3

So Jing Dian

Zong Bai

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Twelve Extra Points-Functions and Locations I 23

• GANMEN

LOCATION-On the Tai Yang line, approximately 6 cun distal to Small Intestine 8 (Xiaohai). 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needle perpendicularly, 0.5 to 0.8 cun in depth.

INDICATIONS • Disease and dysfunction of the liver Can be applied either bilaterally or contra­laterally.

CASE STUDY-

. ·~· . f

.· Page:68

Gan Men ---1-----

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24 I Twelve and Twelve in Acupuncture

• YENHUANG

LOCATION-In the center of the palmar aspect of the middle segment of the fifth fmger.

NEEDLING INFORMATION-Needle perpendicularly, 0.1 to 0.2 cun in depth.

INDICATIONS • Yellowing of the conjunctiva; hepatitis; jaundice.

CASE STUDY-Page: 70

Yen Huang __ _,___

I

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Twelve Extra Points-Functions and Locations I 25

• MUGUAN

LOCATION-Level with Gu Guan (see page 25), about 0.5 cun distal to the prominence of the pisiform bone. 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needle perpendicu-larly 0.2 to 0.5 cun in depth.

INDICATIONS • Swollen joints; rheumatoid arthritis throughout the body; "bone swelling;" heel pain Needle contra­laterally. Typically used with its companion Gu Guan.

CASE STUDIES-Pages: 74, 77,80

\ . ---=--·--

Ui

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26 I Twelve and Twelve in Acupuncture

• GUGUAN

LOCATION-In the depression (about 0.5 cun) distal to the prominence of the scaphoid bone. 'Ah Shi' location is appropriate.

NEEDLING INFORMATION-Needle perpendicu­larly 0.2 to 0.5 cun in depth.

INDICATIONS • Same as Mu Guan.

-~ , ....... ··-~

Iii Gu Guan

CASE STUDIES­Pages:74, 77,80

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£fhe rrwelve ~egular J\!ter[~[an 1'oints­~nique Applications

Locations for these points are in Appendix I

Page 133

29

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30 I Twelve and Twelve in Acupuncture

• SJ2 San Jiao 2 (Yemen)

INDICATIONS • Used for tiredness of the eyes or a sensation of heaviness in the eyes This is indicated and is used especially when this symptom coincides with hepatitis.

NEEDLING INFORMATION-Needle bilaterally.

CASE STUDIES-Pages: 68, 84

• P3 Pericardium 3 (Quze)

INDICATIONS • Used for thumb pain.

NEEDLING INFORMATION-Needle on the same side as the pain.

CASE STUDY-Page: 86

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Twelve Extra Points-Functions and Locations I 31

• P7 Pericardium 7 (Daling)

INDICATIONS • Used for sciatica Especially on the posterior and medial aspect of the thigh.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDY-Page: 89

• P9 Pericardium 9 (Zhongchong)

INDICATIONS • Used for throat pain.

NEEDLING INFORMATION-Needle bilaterally.

CASE STUDY-Page: 91

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32 I Twelve and Twelve in Acupuncture

• HT4 Heart 4 (Lingdao)

INDICATIONS • Used for pain in the neck and trapezius area.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDIES-Pages: 92, 94

• HT5 Heart 5 (Tongli)

INDICATIONS • Used for sciatic pain More effective for sciatic pain of the posterior region of the thigh.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDY-Page: 96

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Twelve Extra Points-Functions and Locations I 33

• 814 Small Intestine 4 (Wangu)

INDICATIONS • Used for treatment of pain in the eye.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDY-Page: 98

• P6 Pericardium 6 (Neiguan)

INDICATIONS • Used for pain in the knee.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDIES-Pages: 89, 100, 102

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34 I Twelve and Twelve in Acupuncture

• LI11 Large Intestine 11 (Quchi)

INDICATIONS • Used for pain in the knee.

NEEDLING INFORMATION-Needle contralaterally. Use deep insertion, 1.5 to 2 cun.

CASE STUDIES-Pages: 68, 100, 102, 104, 106

• LI12 & 13 Large Intestine 12 (Zhouliao) & 13 (Shouwuli)

LOCATION-At the level of Large Intestine 12 and 13, but a little bit posterior to their actual textbook location, more on the surface of the bone or even the posterior surface of the humerus. 'Ah Shi' location is appropriate here.

INDICATIONS • Used for pain in or along the spine.

NEEDLING INFORMATION-Needle contralaterally.

CASE STUDIES-Pages: 110, 112

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Twelve Extra Points-Functions and Locations I 35

• LI14 Large Intestine 14(Binao)

INDICATIONS • Used for dizziness related to high blood pressure or hypertension.

NEEDLING INFORMATION-Needle bilaterally.

CASE STUDY-Page: 114

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~iVe Case Stu~ies of I.ing 1<.u-L()a ~ai-hong ~ai

Combination

37

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0

38 I Twelve and Twelve in Acupuncture

0

Case 1 £(he Cane ~an

Patient is a 40-year-old male who came for treatment of an acute low back injury. He was barely able to walk, even with the assistance of a cane. The patient's complaints were of an especially bad pain on the left side. His pain was evident while he was at rest. It was also exacerbated by movement. An examination of the patient revealed severe muscle strain. The patient reported that he had been lifting and twisting while moving heavy boxes 2 weeks prior, and noticed the pain within the next 24 hours. On a scale of0-10, the patient rated his pain as "above 9." Patient needed assistance to get onto the table.

The Ling Ku-Da Bai-Zong Bai combination was used. Needling was done contralaterally in the right hand. A substantial Qi sensation was obtained. The patient was then instructed to move his hip in a rocking motion from side to side. He reported immediate relief from pain. The time that elapsed from the insertion of the needles to the Qi sensation was approximately 30 seconds. The needles were left in

0

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Five Cases of Ling Ku-Da Bai-Zong Bai I 39

place and stimulated every 5 minutes. The total treatment time was approximately 45 minutes from start to finish. Post-treatment, the patient arose from the table unassisted, and carried his cane outside. Within the next 12 days, treatments two and three were administered in the same fashion. At each treatment, the patient reported increased pain relief and less recurrence of the symptoms between treatments.

The fourth treatment used the Ling Ku combination plus Tai Chong or Liver 3 on the opposite side. Liver 3 was chosen because of its role as one of the "four gates." It facilitates the energy flow throughout the body. In this case especially, it allowed energy flow from the low back down through the left leg. After the fourth treatment, the patient had regained full flexibility of his lower back and reported greater than 90% pain relief.

CONCLUSION

Each of the four treatments lasted 45 minutes. They were administered over a total of 20 days. The patient progressed from a very severe low back muscle strain, which had virtually immobilized him, to a dramatic recovery enabling him to engage fully in normal activities.

COMMENTARY

This case illustrates the effectiveness of the Ling Ku-Da Bai-Zong Bai combination when the primary source of pain and injury is muscular. Even though the Ling Ku combina­tion is generally utilized more frequently in cases involving disc problems, its use with our "cane man" patient demon-

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40 I Twelve and Twelve in Acupuncture

strates that distal points, and no local needling, can obtain immediate and superior results.

It can be noted here that use of these distal points allows the patient to assist in his own recovery, by moving at specific intervals during the treatment.

The psychological value of the patient's involvement in this treatment process is considerable, helping to emphasize the importance of his own commitment to healing.

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0

Five Cases of Ling Ku-Da Bai-Zong Bai I 41

0

Case 2 ~he .£[m[t[ng £ower ~ack

0

0

Case 2 involves a 67-year-old female. Her main complaint was low back pain, which had progressed to such a degree that her activities were extremely limited. Patient could not recall the exact circumstances of how and when her pain began. Patient is also an overweight, insulin-dependent diabetic with high blood pressure. She had trouble lying down on and getting up from the table. Pain was bilateral and determined, upon palpation, to be severe. Surface capillary distension was noticed in the area behind the knees around Urinary Bladder 40. Dr. Tan bled these areas, as this is an important procedure to use prior to acupuncture treatment for acute low back problems.

The Ling Ku-Da Bai-Zong Bai combination was applied contralaterally to the side of the back that seemed to be the most sensitive. The patient reported some improvement. At the time of her second treatment, Dr. Tan added the hand and foot Tai Yang Shu points, Urinary Bladder 65 being contra­lateral to Small Intestine 3 and Ling Ku. The patient reported

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that her condition seemed 20 to 30% improved. Her third treatment was 3 days later. It must be stressed here that limited or decreased normal activities are allowed and even encouraged, as long as they do not interfere with the healing process. For treatments 2 and 3, the Tai Yang points were deleted. At the time of her third treatment, the patient had regained flexibility in the lower back. The fourth treatment was again preceded by bleeding the posterior surface of the knee along the Tai Yang channel, in the vicinity ofUB40, to clear the channel for needling. After treatments 5, 6, and 7, using the Ling Ku-Da Bai-Zong Bai combination, the pa­tient's back pain was virtually gone.

CONCLUSION

Each of the treatments lasted approximately 50 minutes. There were a total of7 treatments administered over a 26 day interval. The Ling Ku combination was used in each treat­ment, with very satisfactory results.

COMMENTARY

As with the case of the "cane man," this case demonstrates the effectiveness of the Ling Ku combination in treatment of low back pain without disc involvement. Also worthy of note is the importance accorded here to bleeding therapy in the UB40 region. The authors feel that without this procedure beforehand, the Ling Ku-Da Bai-Zong Bai combination or any other acupuncture prescription would not be as effective. Due to her additional medical compli­cations (age, diabetes, high blood pressure), it would be prudent to expect her recovery to be somewhat slower than it actually was. Needless to say, our "limited lower back" patient was pleased with the results.

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Five Cases of Ling Ku-Da Bai-Zong Bai I 43

SUMMARYOFCASES1AND2

The Ling Ku-Da Bai-Zong Bai combination was utilized in these two cases for localized pain in the L5 region of the lower back. Disc involvement in these cases was determined to be negative. The Ling Ku combination is most effective at the level of the L5 area and the sacroiliac juncture. These two cases illustrate the fairly rapid and beneficial results obtained for severe low back pain, regardness of whether the condition is chronic or acute in nature.

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0

Case 3 £(he Overworke~ 1<nee

0

0

Case three is a 25-year-old female. She had sustained a serious injury to her left knee while on the job. She had undergone multiple surgeries, as well as additional anesthe­sias for orthopedic manipulations of her knee. Patient devel­oped a sciatic problem that was on the same side of her body as the injured knee. Leg-raising tests indicated lA and L5 were associated with the origin of pain. Even slight foot rotation with the leg elevated resulted in pain in her lower back. The left knee was swollen and lacked mobility. Knee flexion and extension were extremely limited. Pain was aggravated by sitting and riding in a car. Her pain ranged from mild to advanced.

The Ling Ku-Da Bai-Zong Bai combination was selected to treat her for her problems relating to sciatica. Patient reported significant relief after the frrst treatment. As the treatments progressed, given approximately every 3 days, the patient could extend her leg much further, and con­tinued to report significant relief after each treatment.

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Five Cases of Ling Ku-Da Bai-Zong Bai I 45

CONCLUSION

In all, nineteen treatments were given over a period of 55 days. To date, the "overworked knee" patient has reported no recurrence of her sciatica pain.

COMMENTARY

In all likelihood, this patient's sciatica was most likely due to her body's compensation for the awkwardness of the knee. Much medical attention had been given to her knee injury, with increasingly poor results. Her sciatica was largely overlooked by her other medical practitioners. Fortunately for this young lady with the "overworked knee," we were able to provide the solution.

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0

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0

Case 4 1een-Age~ Sciatica

0

Patient is a 17 -year-old male, who complained of pain on the lateral and posterior aspects of the upper right leg. Foot extension tests reproduced the pain down the area of the lower leg and into the ankle. This sciatic pain ranged from moderate to severe. It interfered with the patient's sleep and restricted his activities-especially standing or sitting for two hours or more. The patient believed his pain was due to overexertion from biking and baseball playing the week prior.

The Ling Ku-Da Bai-Zong Bai combination was chosen due to L4 and L5 involvement. The patient was treated twice a week, two or three times a week on the average. Three treatments a week would have been preferable, but this could not always be worked into the patient's busy schedule. After ten treatments, the patient reported only sporadic sciatic pain which occurred upon exertion, or prolonged sitting or stand­ing. Due to his active life style, the patient re-aggravated his condition on a number of occasions, each requiring addi-

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Five Cases of Ling Ku-Da Bai-Zong Bai I 47

tional treatment. After the final treatment, the patient re­ported being free of pain, and follow-ups reveal no recur­rence of pain. Range of motion is normal.

CONCLUSION

The Ling Ku combination was administered in each treat­ment. In all, there were thirty treatments encompassing a time span of 86 days. The patient progressed from a moder­ate/severe pain level to being virtually pain free. He was able to regain his full range of vigorous physical activities.

COMMENTARY

Youth is usually a powerful plus on the side of the healing process, but in this case, an excess of energy caused our "teenage sciatic" to repeatedly aggravate his condition, thus lengthening the recovery time.

SUMMARY OF CASES 3 AND 4

Cases 3 and 4 illustrate good examples of the effectiveness of the Ling Ku-Da Bai-Zong Bai combination on L5 type sciatica. There is an emphasis on stressing to the patient the necessity of regularly spaced treatments, which should be two or preferably three times a week. Also, the patient should be cautioned to comply with the need for rest, and to avoid overexertion and reaggravation of the area of injury. When the treatments were concluded for these two cases, both patients were virtually pain free.

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0

48 I Twelve and Twelve in Acupuncture

0

Ca5e 5 E£lbow with

Shooting 1'ain 0

0

Patient is a 38-year-old physically active male. He came in for treatment of pain in his right elbow. He had tried resting and taken off work, but had experienced no improvement. His work involved lifting objects weighing 20 to 30 pounds with either arm. The patient estimated the onset of the pain as approximately three months prior to his coming in for treatment. The pain had been progressively worsening and was determined, from palpation and resistance testing, to be severe in nature. The patient described a shooting pain originating in his elbow, and radiating down his forearm to his hand. The patient was unable to fully flex, extend or rotate his elbow. He held his arm close to his body and avoided using it.

For treatment of his condition, Ling Ku was chosen on the same (right) side. And, to support this, two points were chosen on the opposite knee. The two points chosen corre­sponded to the same energetic lines as the area of major pain in the elbow: Tai Yang and Shao Yin. Specifically, the points

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Five Cases of Ling Ku-Da Bai-Zong Bai I 49

used on the opposite knee were Urinary Bladder 40 and Kidney 10. A fairly significant Qi sensation was obtained on all the points. The patient reported feeling immediate im­provement within seconds of the needles being inserted. A week later, just prior to the second treatment, the patient reported 50% improvement. He also mentioned that he had returned to work and hadn't noticed much aggravation. After the second treatment, the patient once again noted significant improvement. A week later, at the end of the third treatment, the patient was virtually pain free.

At that time, he questioned the necessity of any additional treatments at all. And, based on his assessment of his recov­ery, he declined further treatment for this condition.

CONCLUSION

There were a total of three treatments spaced over two weeks. Each treatment lasted 30 minutes and involved Ling Ku on the same side and UB40 and K 10 on the opposite knee. Patient was totally satisfied with the three treatments, and one year later reported being pain free with no recurrence of any prior symptoms.

COMMENTARY

The use of Ling Ku to treat elbow pain is interesting in that the same-side application departs from its other normally contralateral uses. The theoretical reason for this is not entirely clear, but empirically speaking, we find it to be so. Also of interest is the selection of distal points on the analogous, contralateral joint (the knee). This concept de­rives from an I -Ching theoretical approach to acupuncture, and will be discussed in depth in future publications.

'

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~hree Case Stu~ies of ChuntJ ~ze-Chung 4tsien

Comb{nat{on

51

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0

Case 1 ~he Scoliosis cHousewifo

0

0

Patient is a 30-year-old female, whose chief complaint was of pain in the upper thoracic region between the spine and the scapula, on the left side. She rated her pain as a 7 on a scale of 0 to 10-moderately severe. Her pain was aggravated by scoliosis she had since childhood. Patient had received chiropractic treatment, but her improvement had reached a therapeutic plateau. The patient's condition was possibly due to sprained ligaments from repetitive stress of household chores, and particularly by driving. Of course, her spinal curvature was considered to be the underlying causative factor.

The Chung Tze-Chung Hsien combination was selected. Needling was done on the right side of the body. To balance this, Ling Ku was chosen on the opposite side. The patient reported pain relief approximately 5 minutes after needle insertion. She was asked to move her shoulder while lying on the treatment table. This established the confirmation of her pain relief. We continued to treat her in this fashion, occa-

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Three Cases of Chung Tze-Chung Hsien I 53

sionally changing the sides for the points. This was due to the fact that she would sometimes experience this upper back pain on the opposite (right) side. The pain was always one­sided, although it did switch sides at times. Usually, the patient reported a corresponding pain in the region of her neck, on the opposite side of the back pain, thus making the selection of Ling Ku even more appropriate. Ling Ku' s location is especially significant in this case, due to its being anatomically opposite that of Chung Hsien. This facilitates a theoretical Yin/Yang balance between the left and right sides. Prior to each treatment the patient found it painful to sustain abduction against minimal resistance, or lower her arm smoothly and rotate her shoulder. After each treatment, she could easily and painlessly exhibit an increased range of motion.

During the course of these treatments, there were other aches and pains which would appear, in addition to the channel complication. These were addressed without dis­turbing the basic effect of Chung Tze-Chung Hsien. This patient was very consistent in her treatment schedule, and responded very well-reporting after 6 weeks' treatment, that the upper back scapula symptom was cleared up, and had not returned.

CONCLUSION

Each of the twelve treatments lasted 30 to 40 minutes. They were administered over a six-week period. The patient pro­gressed from moderately severe pain, to a state free of pain, and a demonstration of full range of motion in the region of the upper back scapula on both sides.

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COMMENTARY

Just as we often seek to establish a Yin-Yang balance with point selection, the body itself seeks to create such a balance. If there is pain, loss of motion or function, the body compen­sates through structural shifts. This phenomenon is clearly visible in many cases involving spinal problems, as it is here with our "scoliosis housewife."

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' ·-

0

Three Cases of Chung Tze-Chung Hsien I 55

0

Case 2 ~ w{ce ~ear-E£n~e~ Computer Operator

0

This case involves a 37-year-old female of slight build. She was a computer operator whose life style was fairly seden­tary. Her complaint of pain on the upper right side of the thoracic scapular region, and other areas as well, was due to a rear-end auto collision. She was in rather severe pain-9 on a subjective 0 to 10 scale.

The Chung Tze--Chung Hsien combination was selected due to her complaints. Her pain was primarily, in Chinese terms, along the Tai Yang and Du channels with some involvement of the Shao Yang channel as well. Because the pain was on the right side, the combination was needled on the left side, and balanced on the right side with Ling Ku, because she also experienced coinciding neck pain. The treatment for this kind of acute problem, which involved significant soft tissue damage, spanned a period of two to three weeks. Good results were obtained with each treatment. However, due to aggravations from overwork at the computer and weekend yard work, the symptoms would return. Even though they

l

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56 I Twelve and Twelve in Acupuncture

were to a lesser degree, the patient still had discomfort. Fairly significant results were obtained after twelve treatments. But at that time she had another auto accident-she was once again rear-ended. The original symptoms were severely aggravated. The patient required another twenty-three treat­ments before this condition was stabilized. Each treatment resulted in less pain intensity, and frequency of occurrence. This encompassed an additional time span of 3 months. Due to the patient's sensitivity to various foods and drugs, herbs were utilized with caution. But, their use did prove beneficial in consolidating the effects of the treatments.

CONCLUSION

Each of the thirty-five treatments averaged 30 to 45 minutes in length. They were administered over 4 months' time. We continue to see this patient from time to time, for an occa­sional pain reactivation due to some strenuous activity or slight mishap. After one or two treatments, she goes on her way with no further problem.

COMMENTARY

Complications during a course of treatments are encountered more often than not. This case presented two particularly challenging examples of such complications. The first was the patient's constitution, "Qi and blood deficient" in nature, making her frail and low in energy. Such individuals often respond slowly to treatment for trauma. However, she was responding well to treatment, when complication number two struck-the second rear-end collision. In cases such as these, the value of an extensive, flexible, therapeutic reper­toire becomes even more evident to the practitioner.

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0

Three Cases of Chung Tze-Chung Hsien I 57

0

Case 3 ~he Once-~reate~ ~et[re~ c5\tom

0

0

This case involves a 64-year-old female-retired mother of two children. She leads a fairly sedentary life due to health problems involving being overweight with significant hy­pertension, including potential cardiac complications. Her condition arose a week to ten days prior to coming in for treatment. She had a very severe pain of the upper thoracic and scapular region on the left side. Her physicians could find no underlying pathology to explain the pain, and their prescribed medications were ineffective. Patient complained of an inability to turn her head, as well as an inability to sleep without being awakened by pain. It was determined that there was spasming of the left trapezius muscle, and possibly cervical disc compression.

The Chung Tze-Chung Hsien combination was used and was needled on the opposite (or right) side. A strong stimulus was obtained within 5 minutes of needle insertion. The needles were left in place for an additional35 to 40 minutes, and were stimulated periodically throughout this time. At the

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58 I Twelve and Twelve in Acupuncture

completion of the treatment, the patient reported having no more pain. She was able to tum and roll her head from side to side, with no discomfort whatsoever. Full motion was restored. She left the office with complete pain relief. This one treatment amounted to a cure, since the patient reported no further recurrence of pain at all.

CONCLUSION

Patient received one treatment lasting 45 minutes. She re­ceived complete and total pain relief for a condition which had caused severe upper left side pain, had interfered with her sleep, and had prevented her from turning her neck.

COMMENTARY

Although diagnosis in Western medical terms was difficult, Chinese medicine can clearly define this as a case involving "obstruction of Qi in the channels." The problem, however, lies in identifying exactly which channels are involved. Virtually all of the upper Yang meridians were implicated, and taking into account the numerous "crossing points," and "internal connections" found in the affected area, this clearly defined condition becomes a challenge to treat. In such a case as this "once treated retired mom," we can really appreciate the beauty of the Chung Tse--Hsien combination, in that it treats a zone in the body-much as foot reflexology does. Thus, we can bypass a potentially confusing situation, and greatly simplify the treatment.

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' ' ... ' ' '

Six Case Stu~ies InvolVin_g Mu <Huo.

So Jing ~ian. Gan Men anO 'Yen <11uang

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60 I Twelve and Twelve in Acupuncture

0

Case 1 Stroke EfinlJers

0

0

Patient is a 50-year-old male who had suffered a stroke, and had limited use of his left hand-being unable to extend his fingers. He also complained of low back pain.

The Mu Huo point was chosen to treat his left arm and hand. In addition, his low back pain was treated with Urinary Bladder 'Ah Shi' points, and Ling Ku. The opposite, or right hand was used for needling. The patient had instantaneous improvement in his ability to extend the fingers of his left hand. When he returned for his second treatment, he reported that the effect held up consistently for two days, before incomplete extension began to recur. Mu Huo was needled again, and improvement was once again instantaneous. Improvement continued steadily for the next six treatments. During this time, the patient used his hand in a normal manner, his strength and endurance gradually returning. At the conclusion of the treatments, the patient had regained full use of his left hand. He was able to resume all his former activities, including golfmg.

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StudiesofMuHuo-SoJingDian-GanMen-YehHuang I 61

CONCLUSION

Each of the eight treatments lasted 45 minutes. They were administered over a total of 40 days. The patient progressed from a year's dysfunction of the fmgers of his left hand, to full recovery, with a return to normal activities and sports.

COMMENTARY

It should be mentioned that the patient with "stroke fingers" had received another form of acupuncture treatment, with no significant results, prior to seeing us. The process of stroke rehabilitation treatment is a difficult one, and once again, the importance of a versatile treatment repertoire is paramount.

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0

Case 2 f{he ~heelchair ~at[ent 0

The patient is a 74-year-old male confined to a wheelchair. He has a neurological disorder which prevents him from being able to stand or walk. There has been no real diagnosis for this man in Western medical terms. The patient had lost his sense of balance, and had begun to gradually lose the ability to stand or walk upright.

Ba Guan was needled on the right side, due to his left leg being debilitated. The patient was able to come in for treatment only 1 day a week. After the first treatment, there was a slight response in his leg. After the second treatment, he could extend his leg at the knee. At the end of two months, his progressive weakness had stopped.

CONCLUSION

The patient received six treatments in six weeks. No progress against the total disorder was made. The patient was never able to stand or walk again. However, he had responded in a limited, though definite way.

t

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StudiesofMuHuo-SoJing Dian-GanMen-YehHuang I 63

COMMENTARY

This case is interesting from the standpoint that a condition that had been undiagnosable in Western terms, had re­sponded to treatment, and showed partial recovery. One cannot help but wonder what else could have been achieved by treating on a regular basis with Ba Guan, herbs and therapy. Two months after treatment, "the wheelchair pa­tient" could still extend his leg.

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64 I Twelve and Twelve in Acupuncture

0

Case 3 A Once-rrreate~ 1'ain in the ~eck

0

0

Patient is a female in her mid-thirties, who came to us with neck pain. She had limited rotation, only 20 degrees, on both sides of the neck. She had been treated, only moments before, with acupuncture, acupressure, electro-stimulation, and manipulation. The response was very limited, with little relief. Dr. Tan had the patient sit in a chair in the waiting area, as that was the only space available at the time. A needle was inserted in So Jing Dian point on both hands. Within seconds, the pain was eliminated. The needles remained in place for 15 minutes while the patient was asked to rotate her neck from side to side. The patient left the office virtually pain free, and with full 90 degree rota­tion on both the left and right sides.

CONCLUSION

The patient received one treatment with So Jing Dian, and received complete pain relief in a matter of seconds.

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StudiesofMuHuo-SoJing Dian-GanMen-YehHuang I 65

SUMMARY

Different treatment methods should be expected to vary in the interval between their application, and the onset of their effects. In many instances, as in the case of our "once-treated pain in the neck," point So Jing Dian's effect takes place almost immediately.

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0

Case 4 o f(:M_J Sun~rome an~ o

Accompanu£ng ~eck ~a[n

Patient is a 30-year-old female. She experienced TMJ syn­drome due to jaw misalignment. She had a great deal of pain and stiffness whenever she attempted to tum her head. The patient's history revealed that she incurred a childhood fall and later, whiplash from an auto accident, both of which contributed to her neck pain.

The So Jing Dian point was needled. The neck point was needled on the right, if her left side had the pain; and vice versa. Patient reported pain relief within 2 minutes. The relief held up for 48 hours, and then the pain would re­establish itself, but to a lesser degree. So, progress was steady-with diminishing pain and gradual restoration of motion. At the completion of her treatments, after ten weeks, the patient was free from neck pain. She has occa­sional flare-ups due to stress, overwork, or sleeping in the wrong position. Flare-ups are infrequent and are cleared up in one to three treatments. The patient now moves her head normally.

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StudiesofMuHuo-SoJing Dian-GanMen-YehHuang I 67

CONCLUSION

Patient received a total of seventeen treatments. They were administered over 7 4 days. The patient reported complete relief, and regained full rotation, flexion, and extension. She now comes in for treatments for occasional flare-ups.

COMMENTARY

We do not intend here to suggest that a problem as complex as TMJ syndrome can be effectively treated with only one point. But this case is interesting, in that our TMJ patient's complication of neck pain was effectively addressed by the use of So Jing Dian.

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0

Case 5 Chronic ~epatitis

0

0

Patient is a male in his mid-thirties who came in for chronic hepatitis-his second occurrence within three years. The patient was very ill and complained of fatigue, nausea, and vomiting. His eyes had a yellowing of the sclera. Palpation of his abdomen revealed enlargement of the liver, and accompanying sensitivity.

The decision was made to treat the patient with acupuncture and herbs. Point Gan Men was used along with Liver 5, Gall Bladder 41, Large Intestine 11 and other cooling points. San Jiao 2 was used due to the symptoms of tiredness and heaviness of the eyes. The patient was treated three days a week. In addition, he was given several herbs for clearing damp heat in the liver. The first treatment consisted of Gan Men, LV5 and San Jiao 2, all needled bilaterally. At the end of six treatments (the second week), the patient showed signs of definite improvement. His skin color returned to near normal, and his fatigue was beginning to recede. Blood tests ordered by his M.D. showed that the liver

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StudiesojMuHuo-SoJing Dian-GanMen-YehHuang I 69

enzymes were beginning to return to a normal level. After fifteen treatments, the patient was only slightly fatigued, but was still aware of a hardness in the liver area. After twenty­five treatments within the span of 60 days, the patient appeared normal; although he complained of a rash on his lower legs. This rash is seen as a final stage of recovery for hepatitis disorders. Blood tests revealed a further im­provement and function in the liver enzyme level. After twenty-six treatments, the patient returned to work on a limited basis. He came in for additional treatments until he was free of any and all complications. Blood tests were run a third time and revealed that the liver enzyme level was normal.

CONCLUSION

This patient came in regularly for a total of thirty-five treatments, from mid-April to the end of July. The point prescription was largely composed of Gan Men, San Jiao 2 and occasionally Gall Bladder 41. The patient progressed from a severe state of debilitating hepatitis to full recovery of his health, and a return to a normal work and activity schedule.

COMMENTARY

Chronic hepatitis can be a very stubborn condition to treat. In this case it was the patient's second bout with it. He was unable to work for six months as a result of the first episode. With our treatment, he was able to return to work after only 9 weeks.

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CONCLUSION

Patient received a total of fifteen treatments. Each treatment lasted 40 minutes. Treatments were administered over a period of 50 days. In addition, the patient came in once a week for one more month to receive her herbal formula, which she took twice a day. The patient was completely better at the end of that time. To date, one year from the conclusion of her treatment, there has been no recurrence of the hepatitis or further complaints of fatigue.

COMMENTARY

In this case, herbal therapy played a major role in the patient's recovery. Still, we believe that points like Yen Huang and Gan Men can significantly speed the recovery process.

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£(hree Case Stu~ies lnVDlVin~ Mu Quan

an~ ~u Quan

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0

Case 1 rrhe rrravel Agent with Sore ~an~s

0

Patient is a 40-year-old female. As a travel agent, she does a lot of walking. She also enjoys various outdoor activities. Her complaint when she came to us was of a rheumatoid-like arthritis-mainly, swelling and stiffness in the knuckles and phalangeal joints of the hands and fingers. Her occupation involved computer and phone work. She indicated a much lesser, occasional swelling in the toes. It was clearly deter­mined upon examination that she had severe pain, swelling, and stiffness in the fmgers and toes.

For treatment, the Mu Guan and Gu Guan combination was chosen. These two points are classically known as being indicated in cases of "bone swelling." They were used contralaterally in the treatment plan, to the side that was giving her the most trouble. So, if her left hand was the most painful or stiff on a particular day, then Mu Guan and Gu Guan were needled on the right hand. This was done in conjunction with needling and/or bleeding 'Ah Shi' points on the left hand, specifically in the region of the knuckles and

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the joints affected. Immediately following the first treat­ment, the patient felt some degree of improvement in the pain and stiffness that she was experiencing. The patient reported marked improvement in her symptoms and a slight, but visible, decrease in swelling 24 hours after the treatment. Following the second and third treatments, the patient expe­rienced considerable improvement. Flexion and extension of the fingers had increased 60%, and strength was gradually being restored. At the time of the third treatment, bleeding therapy on the most swollen joints was again used in con­junction with contralateral needling of Mu Guan and Gu Guan. After this treatment, an actual aggravation occurred, lasting 24 hours.

So, for the fourth treatment, Mu Guan and Gu Guan were assisted by the use of San Jiao 5, on the opposite side. Gall Bladder 41 and Liver 3 were also included for the purpose of circulating Qi through the body more effectively. The patient reported no further aggravation between treatments. For treatments 5 and 6, the same point combination was used­Mu Guan and Gu Guan on one side and 'Ah Shi' points on the other. In the treatment process, the patient has basically opted for an occasional treatment and a maintenance type of approach, with which she feels quite satisfied. She comes in for treatments when she begins to notice some swelling or pain. The patient feels quite satisfied with her improvement.

CONCLUSION

In this case, 6 treatments were administered over a 45-day period. The intervals were irregular, yet the results obtained in this long-standing three year problem were quite satisfac­tory to the patient. She progressed from severe pain, stiffness

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and swelling in both hands, to hands that are visibly normal and are relatively pain free.

COMMENTARY

The Mu Guan and Gu Guan combination was utilized in this case for swollen joints and rheumatoid arthritis-like symp­toms. The needling and/or bleeding of the 'Ah Shi' points in the region of swelling and stiffness was used in conjunction with Mu Guan and Gu Guan, to remove Qi obstruction and/ or blood stagnation. It seems appropriate that points indi­cated in traditional fashion for conditions of bone-swelling, would be effective in the case of our "travel agent with sore hands."

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0

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0

Case 2 ~anker w[th ~one Swell£n~

0

Patient is a 49-year-old female. She is a bank loan officer who leads a fairly active life-style. Her initial complaint was for painful rheumatoid arthritis-like symptoms, specifically in the area of the knuckles of the fmgers and also in her hands, feet, elbows, and other body joints as well. This condition had been worsening over two to three years, and was not responding to conventional medical treatment. Also, she had tried many different "alternative" treatments-all with little or no results. Her hands were the most bothersome area of pain for her, since the accompanying stiffness and swelling made her work on the computer keyboard especially diffi­cult. The patient reported a constant pain of7 on a subjective scale of 0 to 10.

For treatment, Mu Guan and Gu Guan were administered, as well as some local 'Ah Shi' points in the areas of pain on the metacarpo-phalangeal joints and the inter-phalangeal joints. The 'Ah Shi' points were selected on the hand opposite the one Mu Guan and Gu Guan were needled. Immediately

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following the first treatment, the patient experienced an increased mobility in both hands, and a reduction in pain and swelling. On the third day, the patient reported for the second treatment with basically the same complaint, but of a dimin­ished degree. She was treated in the same manner. Additional points were added or deleted to accommodate changes in her condition as it varied and improved. The patient came for treatments about three times a week for a period of a month­or twelve treatments initially. Then, the decision was made to augment the acupuncture treatment with an herbal for­mula, to support and improve the duration of the acupunc­ture effect. This herbal formula was prescribed for the next three months of treatment.

CONCLUSION

There were about forty-eight treatments administered over a period of four months. Each treatment lasted about an hour and involved Mu Guan and Gu Guan on one side, and 'Ah Shi' points on the other. An herbal formula supplemented the last three months of treatment. The patient had an excess of 80% improvement and relief, with a total absence of visible swelling and irritation in the distal joints of the hands. Hand motion was closely examined at this time, and tendon force was even, balanced and painless.

COMMENTARY

This case of the "banker with bone swelling" involved a severe condition of painful rheumatoid-like arthritis in the joints-especially in the hands. Mu Guan and Gu Guan proved to be the most effective point combination for treat­ment of this patient, as well as opposite 'Ah Shi' points.

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Additionally, an herbal formula was administered for this systemic condition of rheumatoid inflammation to enhance the acupuncture effect. The patient's progress was one of steady improvement, and revealed a quite impressive record of response and recovery. We were also impressed by the sheer number of mainstream and alternative therapies this patient had tried prior to seeing us, all with little or no result.

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0

Case 3 1'he ~r[ter's <Heel Spur

0

0

Patient is a 45-year-old female. She is a fairly active elemen­tary school teacher, librarian and writer. Her original com­plaint was for an extremely painful multi-spiked heel spur on the left heel. It had been recently diagnosed by an orthopedic surgeon, and was verified by x-rays. The patient also has spondylolysis in L5 on the left side, and has had several broken bones in the past.

Examination was verified by very little (less than two pounds) thumb pressure being exerted on the heel, which elicited an immediate and strong response to pain. Mu Guan and Gu Guan were selected for treatment due to their direct benefit in cases of heel pain. After needling to obtain the Qi sensa­tion, up to 10 pounds of pressure could be exerted on the heel with little aggravation. Progress was steady and after 13 treatments, the pain was virtually gone. Two more consoli­dating treatments were performed. Patient reported no recur­rence of the problem for a follow-up period of six months. She returned to the orthopedic surgeon, and x-rays then

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showed a reduction of excess calcium buildup, and only a slight rounded protuberance in the calcaneus.

CONCLUSION

In this case, 15 treatments were administered over a seven week period. The results were very satisfactory to the patient. She progressed from severe heel pain, with a visible and awkward limp, to normal pain-free walking.

CO:MMENTARY

The Mu Guan and Gu Guan combination was utilized in this case of the "writer's heel spur" for a painful and multi -spiked condition on the left heel. Bone spurs can be considered in accordance with these points' traditional indication for "bone swelling." Their physically analogous position on the palm 'heel' also made their selection for this problem theoretically appropriate. The condition had been bothering the patient for 2 months prior to treatment. The patient was told by an orthopedic surgeon that surgery would be necessary to even temporarily relieve the pain. This was a very good case, as the progress and results were very successful for both the patient and the doctor.

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~egular .5\tt.eri~ian ~oint Case Stu~ies

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0

Case 1 Involving San Jiao 2 [a~u with ~ire~ ~loo~

0

0

Patient is a 35-year-old female, who sought treatment pri­marily for headaches and insomnia problems. The nature of her complaints was considered to be "of a blood deficiency type." These symptoms occur in chronic hepatitis; however, it had been determined that hepatitis was not present in this case. Later into the treatment plan, the patient also reported a throbbing in her eyes when she was tired.

The initial phase of her treatment plan focused on her symptom of headaches and insomnia. The eye symptom did not arise until later in her treatment, and was addressed at that time. San Jiao 2 is used for tiredness and heaviness of the eyes-especially in hepatitis or hepatitis-like condi­tions. San Jiao 2 was balanced bilaterally on the foot with Liver 3 to help harmonize the hand Shao Yang and foot Jue Yin channels.

After twenty treatments, the patient reported no recurrence of any of her symptoms. At that point, the treatment was concluded; and, to date there has been no recurrence whatso-

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ever, and the patient is very satisfied with her good health. CONCLUSION

Each of the twenty treatments lasted 30 to 40 minutes. They were administered over a total of 10 weeks. The patient progressed to a state of full recovery and a return to all prior normal activities.

COMMENTARY

This case is interesting due to the patient's complaints that seem to be, in some ways, similar to chronic hepatitis. At the beginning of the treatments, the "lady with the tired blood" sought treatment primarily for headaches, tiredness, and insomnia. However, as these symptoms abated, the com­plaint of a "throbbing in the eyes that was like a return of the headaches" emerged to require an additional six treatments. Throughout the course of treatments Liver 3 was needled bilaterally on the foot to balance San Jiao 2. All the treat­ments proved successful, and hastened the full recovery to health from what had been a long-standing condition, unre-

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0

Case 2 o Involving ~er[car~[um 3 o

a ~a[n [n the £(humb

sponsive to Western medical treatment.

Patient is a 50-year-old busy professional woman in rela­tively good health. Her chief complaint was of pain in the most proximal segment of the left thumb joint. An orthope­dist had diagnosed her problem as a degeneration of the articular surface of the thumb joint, a condition often associ­ated with "wear and tear" phenomena. The joint appeared normal to visual inspection, but was very sensitive to palpa­tion. She was unable to flex or extend it beyond a fraction of its normal range of motion. Surgical correction was recom­mended as the only likely remedy for this situation. For treatment, we used Pericardium 3 on the left arm and Liver 3 on the right foot to balance it. Ling Ku was used on the right hand for additional balance. It should be noted that most of the pain she experienced was on the palmar aspect of the thumb joint, so the dorsal aspect of that joint on the right hand was needled. A relatively shallow insertion affects the Yin/Yang balance aspect in this case. After the first treat-

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ment, the patient reported an immediate and significant relief. She could extend and flex the thumb joint, but she still had a relatively weak pinch strength. After the second treatment 3 days later, the patient demonstrated about a 50% improvement in the mobility of her thumb, and a reduction of pain. After ten treatments, she experienced no more pain, and had full restoration of mobility. Three more treatments were given to consolidate the effects.

The patient's thumb condition was considered to be due to cold and damp, with underlying kidney deficiency, which was detected from pulse and tongue diagnosis. She was given the herbal formula Tiger Bone and Eucommia. She was closely monitored for any side effects of dizziness or diffi­culty in sleeping, which can often result from such a "warm" formula. She did quite well and experienced no side effects. She used the formula for 1 month longer after the acupunc­ture treatments. Follow up on her condition after 1 year resulted in no return of the symptoms.

CONCLUSION

This patient came in for a total of thirteen treatments, for what had been diagnosed as a painful degeneration of the thumb joint. After seven weeks, the patient was symptom­free and had regained full mobility in her thumb joint. The patient was also given an herbal formula which she contin­ued to take for 1 month after the conclusion of the acupunc­ture treatments. Patient is now normal and fully active.

COMMENTARY

In this case, as in others, the patient was intrigued by the

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experience of actually feeling the pain in her thumb disap­pear as the needle was stimulated.

The herbal formula used in this case was considered to be an important part of the patient's treatment. It supplied the "substance" needed to regenerate the thumb joint. The acu­puncture can be thought of as having directed the flow of energy to the right place. We feel that the combination of herbs and acupuncture helped to shorten the total recovery time, and also helped consolidate the results. Our "pain in the thumb" patient has thus far escaped the forecasted need for joint replacement surgery.

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0

Case 3 ~[th 1'er[car~[um 7 an~ 1'er[car~[um 6

A ~wist in the 1<itchen 0

0

Patient is a 70-year-old woman who was working in her kitchen when she twisted suddenly to catch a falling object. She felt a sudden sharp shooting pain travel from her right lower back, down to her knee along the medial aspect of the thigh. Afterwards, she experienced pain in the medial aspect of the knee and it seemed to her to be connected to a shooting pain originating in the inguinal area. She described it as traveling down the medial aspect of her thigh. Also, she had numbness in her left palm; the time of its onset was unclear.

The treatment plan chosen was Pericardium 7 and Pericar­dium 6 on the left side, balanced on the right with Spleen 4 and Spleen 6. In terms of the shooting pain and the knee pain, the patient reported instant relief from pain, with 70% improvement in the frrst treatment. The patient stated that walking and stair climbing would cause further aggravation. However, the pain frequency and intensity was still 50% less than she had originally experienced. Following the second treatment, the numbness in her left palm had disappeared. In

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the subsequent seven treatments, progress was continual, although setbacks occurred-possibly due to overactivity on the part of the patient. After nine treatments, the patient reported 80% improvement overall with 20% of the original symptom reasserting itself. At this time, the treatments were alternated with one treatment being P6-P7 prescription and the next treatment, 3 days later, consisting of Ling Ku balanaced by Spleen 6. This pattern was followed for an additional twelve treatments, at which time the problem was completely resolved.

CONCLUSION

Each of the twenty-one treatments lasted about 40 minutes. Treatments were administered every 3 days. The patient progressed from sciatica-like pain and hand numbness to completely normal, pain-free movement.

COMMENTARY

Again, in this case we see an interesting polarity aspect displayed. Right side hip and knee pain accompanied by left hand numbness. The points used to treat the hip and knee, (Pericardium 6 and 7) could also be applied to the numbness in that hand, and apparently for our "twist in the kitchen" patient, they did just that.

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0

Case 4 9[ L(Jer[car~[um 9 11-"'ear-Ol~ wfth a

Sore ~hroat 0

0

Here we have a one treatment case--early onset. The patient was an ll-year-old boy. It was October-typical autumn weather. He caught a cold and had a slight fever and sore throat. It was established and getting worse. Pericardium 9 was bled bilaterally. That was all that it took. The sore throat responded immediately. This is a classic case of early onset wind-cold phenomenon.

CONCLUSION

This is a one-treatment case which resulted in total relief for an established sore throat.

COMMENTARY

This case illustrates how quickly the response is to bleeding Pericardium 9 for a sore throat. The "11-year-o1d with a sore throat" recovered immediately and required no further treat­ment.

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0

Case 5 Involv{ntJ cHeart 4

cHa{r~resser·s ~a~{at{ntJ ~eck ~a{n

~L==============~ o ~============~

0

Patient is a 36-year-old female. She's a hairdresser-a profession where it is common to develop pain and tension in the upper shoulders and neck. She developed this pain from holding her arms up all day. The tension created from such an awkward position was easily aggravated by emo­tional stress. In addition to suffering the neck pain and stiffness, which was most pronounced when rotating to the left, she was suffering from occasional pain radiating down either arm. This condition had been worsening over a period of 3 years. During this time, the patient had sought medical help, and her condition had been diagnosed by traditional Western medicine as due to bulging disks at C4 and C6. In addition to muscle relaxants, this patient had tried chiro­practic, other acupuncture treatments, physical therapy, and massage. According to the patient, all of these prior treat­ments had yielded little or no relief. According to the patient's symptoms, Heart 4 was indicated for treatment. This point is specifically indicated for rotational neck pain, as well as pain in the trapezius area.

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For a treatment plan, Heart 4 was chosen on the opposite (or right) side, as well as one other 'Ah Shi' point on the Heart channel. The 'Ah Shi' point was usually found near Heart 7. The effect was impressive. As soon as the Qi sensation was obtained, the pain ceased immediately, and she remained pain-free for at least 24 hours. The patient was able to rotate her neck slightly more, though she still had not regained full rotation. Steady progress in the degree of rotation, as well as the lessening of the pain radiating to the arms, was evidenced during the next 5 weeks as the patient came in twice a week for treatments.

To date, the patient comes in for treatment every 4 to 6 weeks as needed.

CONCLUSION

Patient received a total of ten treatments, each lasting 40 minutes. Treatments were administered over a period of 5 weeks. In addition, these treatments were easily supple­mented with other points on the Spleen and Gall Bladder meridians to simultaneously address additional health con­cerns of the patient. At the conclusion of ten treatments, the patient had regained full range of motion in the neck and had no residual stiffness or pain.

COMMENTARY

Although a follow-up orthopedic examination was not per­formed, the symptoms associated with bulging vertebral discs disappeared completely following this series of treat­ments. It should be emphasized that, whenever possible, it is important to objectively verify (x-ray, etc.) dramatic im­provement, such as this "hairdressers neck pain."

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0

Ca5e 6 Involv£~ ~eart 4

One £1 reatment 5ur~r·5 ~eck

~============~ 0

0

Patient is a 32-year-old female. She is very athletic and likes to surf. She had been bothered for several years with a chro­nic stiff neck. Her pain was specifically intense upon neck rotation to the right. This patient, being strong-willed, insisted upon prior manipulation as being essential and helpful. Tui Na acupressure was administered on those points involving muscle and tendon tension, in order to relax all the soft tissues in the neck area. This was followed with a typical Chinese style of cervical adjustment. These ma­nipulations did relieve stiffness to a significant degree. However, these initial procedures did not eliminate pain upon neck rotation to the right.

Heart 4 on the left and an appropriate 'Ah Shi' point were needled, a strong stimulus being obtained with both. The pain upon rotation was immediately eliminated. Since the client had experienced prior acupuncture treatment, she was skeptical about the possibility of such quick initial relief. She was convinced, however, when none of the

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Regular Meridian Point Case Studies I 95

pain or discomfort resurfaced.

CONCLUSION

This interesting one-treatment case, diagnosed in terms of Chinese medicine as being of the wind-damp variety, led to long-standing relief for the patient.

CO:MMENTARY

This case demonstrates the effectiveness derived from a combination of Tui Na manipulation and the needling of Heart 4. Even though a series of treatments was recom­mended, and probably would have resulted in long-term, if not permanent improvement, this "one-treatment surfer's neck" responded immediately and brought her the relief she had been seeking .

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0

Case 7 Involving clieart 5

f{wisteo cHip in the ~asement

0

We have here a 59-year-old male who was at work in his basement workshop at home. He was working on a furniture project. While trying to open a frozen shut vise he wrenched his hip area. He experienced a shooting pain that traveled down the medial and posterior side of his right thigh. When he came for treatment, Heart 5 was selected for the left side and balanced on the opposite side by Ling Ku, due to neck and shoulder stiffness on the left side. He was treated in a seated position, and he was asked to stand with the needles in place, since he reported that they didn't particularly bother him. Upon standing, he could not detect the shooting pain. He sat back down for 25 to 30 minutes. He remained in a seated position for the duration of the treatment. He was treated three more times. On subsequent treatments, he was treated in a prone position. He was treated on a Mon­day and again on Wednesday. The same combination: H5 on the left and Ling Ku on the right was used. These points

t

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were balanced on the lower limb with Gall Bladder 39 on the left side and Spleen 6 on the right side. This treatment was repeated on the following Monday, and afterwards there were no further complaints from him concerning this mild shooting pain. The neck stiffness was also alleviated.

CONCLUSION

In all, three treatments were given over a period of 10 days. Each treatment lasted 35 minutes. There has been no recur­rence of pain or stiffness in this patient.

CO:MMENTARY

By feeling comfortable enough to stand with H5 and Ling Ku in place, the patient was able to verify the effectiveness of this point prescription. Our "twisted hip in the basement" progressed from a bothersome shooting pain in the medial and posterior aspect of the thigh, to complete recovery.

t

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0

Ca5e ~ ~ith Small Inte5t[ne 4 ~"8 with Inva5[on of

Summer t/ieat in the L£ue5 0

0

This case involved a 14-year-old boy. He was an avid camper and had been camping in the desert near summer­time, when it was very hot. He returned from the trip, and developed a feeling as if he had sand in his eyes. Symptoms appeared approximately 3 days after the camping trip. He was rubbing his eyes, and they were red and swollen. Close examination did not reveal the presence of sand or other particles in the eyes. In addition, he suffered from an irritat­ing nosebleed. All of these symptoms together can be diagnosed as an exogenous heat syndrome.

The treatment was directed primarily at the eye symptom, and it involved needling Small Intestine 4 bilaterally, since both eyes were involved. After the first treatment, the irrita­tion and swelling around the eyes disappeared the next day. After the second treatment, all the pain was gone and never recurred.

t

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~

' ' I

Regular Meridian Point Case Studies I 99

CONCLUSION

This was a two-treatment case-a treatment, in this instance, of some sort of invasion of summer heat-(summer heat being a Chinese medical pathogen term). The needling of SI4 alone was adequate to eliminate frrst, the symptoms of swelling; and secondly, the pain involving the eye area.

COMMENTARY

This case is typical in having the surrounding area, tempera­ture, and activities fit right in with the diagnosis and treat­ment procedure. This was a case clearly consistent with Chinese medical data and experience. Two treatments were administered on two consecutive days and all swelling and pain entirely disappeared in our 14-year-old "boy with inva­sion of summer heat in the eyes."

l

....

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Case 9 ~ith ~ericar~ium 6

1"'orn 1<.nee from 1<.arate Class

0

0

This patient is a 36-year-old man, an artist, who was practic­ing karate in a class situation. He tore the anterior cruciate ligament of his left knee. It was badly damaged, and it had to be surgically repaired, via arthroscopic surgery. The third day after surgery, while still on crutches, he came in for treatment. He was not able to bend the leg. It was very swollen. There was only 10 degrees of flexion from a supine position.

While lying down, Pericardium 6 was administered on the opposite side, and Liver 3 was used on the same side as the injury. These were the only two points used for his first treatment. A strong sensation was obtained at both points, with the sensation at P6 travelling downwards into the thumb and forefinger. While P6 was stimulated, patient was asked to move his knee. He achieved an additional 20 degrees of flexion within 3 minutes of insertion of the needles.

Three days later, he came in for the second treatment. At that time, he reported that the pain and stiffness had returned

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the second day, but had diminished considerably the third day. Mobility was still about 30 degrees. This time, the treatment was altered. Large Intestine 11 was used-with deep insertion, on the right side, and was enhanced with Ling Ku (because of its strong Qi moving effect). The progress in the second treatment was an additionallO to 15 degrees of flexion. This was maintained when he returned for the third treatment, at which time it was visibly evident the swelling was decreasing. This was now 10 days from the date of surgery. The physical therapist noted his progress was much faster than anticipated, and difficult to explain. She did not know he was receiving acupuncture. After the fifth treat­ment, he was able to walk with only a slight limp.

Seven days later, after the sixth treatment, there was no longer any limp. He left the office carrying his crutches. He was advised to proceed cautiously, but he apparently felt he no longer needed support in walking.

CONCLUSION

Patient received a total of six treatments. Each treatment lasted approximately 50 minutes. The treatments began with P6 and L V3, and were alternated at the time of each subse­quent treament with LI 11 and Ling Ku. In less than three weeks after surgery, the patient had ceased to use crutches and the swelling, stiffness and pain were gone. His recovery was extremely rapid and complete.

COMMENTARY

It is worth noting the necessity, in this and similar cases, to obtain a strong Qi sensation when treating distally. Our "tom knee from karate class" was able to resume a normal, pain­free life, less than a month after surgery.

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0

Case 10 1'ericar~ium 6 an~ Liver 3

LQance 1eacher with Arthritic 1<nees

0

0

This patient is a dance instructor. She came in with extreme pain in her knees. She was not able to bend them even slightly without a lot of pain. She loved to dance and had even been advised to have surgery for knee replacement, just to be able to continue walking.

For treatment, Pericardium 6 and Liver 3 were used. These were alternated on each subsequent treatment, every three days, with Large Intestine 11 and Ling Ku. Seven treatments were administered on a regular basis. With each treatment, the patient reported less and less pain, swelling and stiffness, and more flexibility. At the time of the last treatment, there was no evidence of pain or stiffness in her knees, and she had no further complaints.

CONCLUSION

There were seven treatments administered over a time period of23 days.The patient's knees slowly and steadily returned from a severe arthritic condition to normal appearance and

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! ~ t

Regular Meridian Point Case Studies I 103

use. All pain and stiffness and swelling were eliminated using this alternating Pericardium 6 and Liver 3 combination one treatment and the combination Ling Ku and LI 11 the next. Our dance teacher is now happily back on the dance floor again.

COMMENTARY

This case of "the dance teacher with arthritic knees" was of special interest, because she was not convinced of much benefit from acupuncture, but this was her last hope before she was to give up her career. The fact that this patient can still dance as well as before her knee problems surfaced, demonstrates the effectiveness of this powerful point combi­nation of P6 and L V3 alternated with LI 11 and Ling Ku for all types of knee pain.

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0

Case 11 ~ith Large Intestine 11

Steve·s 1<nees 0

0

This case is of my own knee injury. I sustained an injury to my left knee. This injury was similar to one I had to my right knee several years previously. The injury to that knee had not responded to conventional acupuncture and I resorted to surgery which left me on crutches for 3 months. In addition, recovery was incomplete. The injury to the left knee pro­gressed on the day of injury to a diminishing degree of flexion-only 10 to 15 degrees. It was difficult to put any weight on it or move it, and it was painful and stiff. Interest­ingly, as with the previous knee injury, there was very little visible swelling.

Treatment was Large Intestine 11 inserted deeply into the right elbow. Ten minutes later, wheniwasaskedtomovemy knee, it would move 45 degrees. Within the half hour, after manipulation of the needle and the knee, the range of motion returned to normal. I moved my knee easily and painlessly as the needle was manipulated. After enduring pain for the previous 24 hours, and after my experience with the previous

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' I

I '

r

• r t

Regular Meridian Point Case Studies I 105

right knee injury, this relief came as a total surprise. (It should be noted here that this was my initial exposure, at least on an experiential level, to Dr. Tan's method of acupuncture). After two more follow-up treatments, the knee was pain free, and it was completely recovered.

CONCLUSION

I received a total of three treatments. Each treatment lasted about 40 minutes. Treatments were administered over a period of 10 days. I felt pain-free after the initial treatment, and regained complete range of motion. Two follow-up treatments eliminated the residual aches and stiffness .

COMMENTARY

Aside from being my own experience, this case was also very interesting due to the fact that both knees were injured while doing the same activity (surfmg). Also, the onset and progression of symptoms were identical. Now, years later, I can definitely say that the knee treated with acupuncture is faring much better than the one operated on.

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0

Case 12 o ~lth Large Intestine 11 o

rrhe ~[cucllst·s 1<nee

This patient is a female, aged 38, who is an acupuncturist, as well as a dancer, swimmer, and bicyclist. Her new bicycle caused an injury to her right knee, which resulted in extreme pain, stiffness and loss of motion. She sensed the pain in her knee as being on theY ang Ming, or outer surface of the knee. This made the choice of Large Intestine 11 even more appropriate.

Once again, a fairly deep insertion was used and within 15 minutes, she experienced approximately 75% return in range of mobility, and reduction of pain as well. She had a series of three treatments, after which the symptoms were no longer detectable. She was once again able to climb stairs with ease, and engage in all her prior sports activities. The only excep­tion was riding her new bike, which was equipped with an elliptical, or uneven, front sprocket. Since she is able to ride other bicycles without aggravation, it may well be that the elliptical sprocket was the cause of her injury .

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Regular Meridian Point Case Studies I 107

CONCLUSION

This patient received a total of three treatments for severe knee pain and stiffness. Initially, she was unable to put weight on it, and flexion was limited to a little less than 45 degrees. At the conclusion of third treatment, the patient was able to flex her knee and stand and climb as before her injury.

COMMENTARY

This case reveals additional evidence for the advantageous and practically essential use of LI 11 in alleviating knee pain and stiffness. Progression to complete recovery in this case of "the bicyclist's knee," as well as in my case prior to this one, bear witness to the efficacy in applying this form of acupuncture treatment.

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£(hree Case Stu~ies lnv"lving J:ar11e

Intestine 12, 13 an~ 14

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0

110 I Twelve and Twelve in Acupuncture

*NOTE: THESE POINTS MUST BE LOCATED VIA THE AH SID METHOD.

0

Case 1 ~he ~entist with ~xtreme ~ack ~ain

0

This frrst case is of a dentist in his early thirties. He had been suffering for many years with various types of borderline subclinical back complaints. After a car accident, his pain in the lower thoracic and upper lumbar regions increased dramatically. After a day of bending over patients, he found his pain would radiate out from his spine, to the side of his body and extend towards the abdomen.

Large Intestine 12 and 13 were most sensitive to the patient. So they were selected with Ling Ku, along with balancing points on the opposite side. Relief was noticed after the third treatment when the patient rated his pain as dropping from a 7 to a 3 on a 0 to 10 scale. Every 3 days, the patient would have a treatment as the pain would reassert itself, usually after about 48 hours. After twenty treatments,

0

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Three Case Studies With LI 12, 13 and 14 I 111

the condition was stabilized. However, the structural condi­tion does not seem to be self-healing, and the pain frequently reasserts itself. So occasional treatments are given when he experiences a flare-up.

CONCLUSION

This is an ongoing case which required an initial twenty treatments to stabilize. As the patient is still experiencing pain and discomfort, he continues to receive treatments in a pain management strategy. This includes advising him to regulate his posture at work, take frequent breaks, and perform therapeutic stretches on a daily basis.

COMMENTARY

The patient maintains a hopeful attitude that he will once again be able to participate in sports and remain pain-free. Meanwhile, he tells us that had it not been for acupuncture, he feels he would be unable to continue his dental practice. Our "dentist with extreme back pain" is now on a path of treatment which we feel may, in time, be a road to recovery.

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0

Case 2 o Lfhe ~oman ~aking ~p o

with Spine 1'ain 0

The patient is a female, approximately 30 years old. She is an active, busy housewife and mother of two. She awoke one morning with extreme pain in her spine in the lower thoracic region. She had pain in the upper lumbar region also. The patient was in such pain from this unexpected phenome­non, that a house call was required in order to treat her. Her pain and stiffness was so debilitating, that she could not stand up.

For treatment, Large Intestine 12 and 13 were used. Once again, the 'Ah Shi' location must be emphasized. The patient reported immediate relief and was able to get up and get dressed and go about her business for the day.

CONCLUSION

This was a once-treated condition of a very painful and stiff spine. The needling of LI12 and LI 13 brought the patient complete relief.

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Three Case Studies With Ll 12, 13 and 14 I 113

COMMENTARY

This case, although not diagnosed by an M.D. or orthopedist, is very impressive due to the amount of relief generated for a symptom so severe that the patient couldn't walk. After her treatment, our "woman waking up with spine pain" was able to go about her daily activities, albeit carefully.

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0

Case 3 0[ !arg~ Intestine 14 ?fhe tHigh 1'ressure

Salesman 0

0

The patient is a 47-year-old male. His occupation is a manager of sales.

It is a highly stressful job and requires a lot of overtime. When the patient came to us, his chief complaint was of high blood pressure and dizziness. Also, he was 20 to 30 pounds overweight. His blood pressure at the time of the examina­tion was 170 over 100.

The treatment administered to him was bilateral needling of the points Ling Ku and Spleen 6, in addition to Large Intestine 14. After the third treatment, the patient's blood pressure had been lowered to 140 over 90. However, it was unstable. This means that it tended to climb and lower at varying times of the day (he would self-monitor his blood pressure at intervals, 3-4 times daily). The treatments were continued in order to deal with the instability of the pressure, even though the overall pressure was lower. After ten treat­ments, the blood pressure was once again found to be 140 over 90, but it now remained stable throughout the day. This

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Three Case Studies With LI 12, 13 and 14 I 115

was interpreted as another sign of progress. Six more treat­ments were administered, at which time the blood pressure had reduced itself to 130 over 85, and was stable. At this point, after sixteen treatments, further treatments were dis­continued for a period of approximately six months. At the 6-month follow-up, the patient had not experienced recur­rence of the high blood pressure.

CONCLUSION

Each of the sixteen treatments lasted 45 minutes. They were administered over a period of 8 weeks. The patient's high blood pressure problem progressed to a lower, though fluc­tuating pressure and then to a steady lower pressure of a desired normal range.

CO:MMENTARY

This case was interesting from the standpoint thatourpatient' s blood pressure was lowered and stabilized entirely by acu­puncture treatments alone, without having to support the process with an herbal prescription. Also worthy of note was the fact that as of 6 months following his treatment, our "high pressure salesman" was still within normal blood pressure range.

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Case ~reatment Matrix

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WHY A CASE TREATMENT MATRIX?

The following pages constitute an outline of seven basic steps which we have included in order to facilitate patient assessment, diagnosis and treatment. In writing the book, we followed this form, which we ourselves designed. We want to allow you, the reader and practitioner, to see what we used to establish our process of writing up the cases.

We feel this is the only form of its kind that combines both a Western and an Oriental integration of medical examina­tion, terminology, and treatment. This Case Treatment Ma­trix has become one of our basic tools. We included it to share with you. We see this seven-step matrix becoming a valuable tool used by many practitioners. You may not find it possible to utilize this matrix in its entirety with every patient you treat. But, we are sure that you will find some of its features useful in each case you have.

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Case rrreatment JVtatriX

1. PATIENT ASSESSl\1ENT A. Patient's age, sex, lifestyle (sedentary or active) B. Patient's initial complaint and expressed concerns

When condition arose Circumstances under which the condition arose

C. Specific area of pain-patient's rating of: 0-10

2. DOCTOR'S PROGNOSIS A. Severe, advanced, moderate, or mild level of pain

Aggravating & Alleviating Factors & Asso­ciated Manifestations (What makes it better or worse-or has no effect) Prior treatments by (M.D., etc.) and involving (Massage, etc.)

B. Skeletal & nervous systems (Western scientfic terms)

Bones, Joints, Muscles, Soft Tissue, Tremors, Dizziness Are these systems inter-involved?

C. Functions Functional regions involved-Chinese Terms Functional capability: Movement in degrees or limits in percentages Type of movement: flexion, extension, rotation, adduction, abduction

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D. Demeanor and Appearance Skin, Hair, Eyes, Nails, Tongue, Pulse, Stature &Size Patient's Reactions

E. Complications Determination of comorbidity (Pre-existing condition that affects the treatment)

3. IMPLEl\IENTATION A. Procedure to alleviate pain-points chosen

Treatment Points Balancing Points

B. Duration of treatment and needle stimulation intervals

Here the practitioner asks, and the patient responds, as to gradual or instant relief and to time-as one minute after needles inserted, immediately, etc.

C. Patient's cues-non-verbal & verbal regarding level of pain, or immediate relief or comfort

Pain Frequency Pain Intensity

4. DOCUMENTATION: FREQUENCY OF TREATMENTS A. Number of times the patient returned for treatment

and progress Gradual Progress or Sudden Progress Continuous or Plateau-involved Progress

B. Length of time each treatment C. Total number of treatments and time span in days,

weeks, or months

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120 I Twelve and Twelve in Acupuncture

D. Demeanor and Appearance Skin, Hair, Eyes, Nails, Tongue, Pulse, Stature & Size Patient's Reactions

E. Complications Determination of comorbidity (Pre-existing condition that affects the treatment)

3. IMPLEMENTATION A. Procedure to alleviate pain-points chosen

Treatment Points Balancing Points

B. Duration of treatment and needle stimulation intervals

Here the practitioner asks, and the patient responds, as to gradual or instant relief and to time-as one minute after needles insened, immediately, etc.

C. Patient's cues-non-verbal & verbal regarding level of pain, or immediate relief or comfort

Pain Frequency Pain Intensity

4. DOCUMENTATION: FREQUENCY OF TREATMENTS A. Number of times the patient returned for treatment

and progress Gradual Progress or Sudden Progress Continuous or Plateau-involved Progress

B. Length of time each treatment C. Total number of treatments and time span in days,

weeks, or months

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CaseTreatmentMatrix I 121

5. EVALUATION A. Response of areas of the body to treatment(s)

Including changes in pulse B. Outcome of patient's condition

Treatment analysis C. Patient's perception and/or feedback

6. SUMMARY A. Assessment of treatment: what works best B. How patient performs

Compare with return to full function C. Doctor's statement as to the success of the

treatment

7. FURTHER CONSIDERATION A. Comparison with another patient's condition B. Comparison of point use with a similar case or

body pain C. Advice given to the patient relative to exertion

during treatment, etc. D. Follow up data-2 weeks to 6 months past the

final treatment

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t_

Some ~ina[ CDnsi~erations

FAMILIARITY IS THE KEY

Once you have made yourself familiar with these points, and the cases that demonstrate their effectiveness, you will possess a new and effective method of responding to many types of chronic pain. However, you need to achieve results that are reliable and consistent every time. That is one major purpose of this text. Another purpose is to have you, the practitioner, assist us. And so, we sincerely request your feedback as to your success in the usage of these points.

THE FEEDBACK FORM

We are adding a form for you to copy and mail or fax back to us explaining your success, problems, or questions as to the usage of these points in your practice. We want to be available to you as an additional teaching factor of this text. We want you to know that we can, and want to be contacted; and that as we print additional texts, we will provide even more information to assist you. See the form on page 125.

A BIGGER PICTURE

We are available as seminar leaders for groups in your area. We will come and meet with several people, or a large group, and demonstrate and teach what we know. And we invite you to come here to the clinic. Here, you can see

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firsthand how the treatment plan works.

AS THE FUTURE EXPANDS

Within the next ten years, we want to have a series of meaningful and demonstrably effective texts for use by acupuncturists, chiropractors, M.D.'s, osteopaths, physical therapists, and other practitioners of meridian-related thera­pies. We intend to convey absolute proof of the medicinal worth, and effectiveness, of our entire style and form of acupuncture. Our style and form are being shared with the world by means of this frrst text in a planned series-and by means of your feedback to us.

YOU ARE INCLUDED

As you respond to us via the feedback form, we will be contacting many of you in order to use some of your re­sponses and experiences with patients in our future texts.

Thank you,

Richard Tan and Stephen Rush

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Have a good life longer than the mountains

Conclusion As we labored over this text, we sought to convey to you our genuine enthusiasm for this fresh and effective approach to pain treatment.

After rewriting several sections several times, we let the book take its own course within our parameters of a consis­tently meaningful and functional guide.

We know you will come to trust this material. As you apply it, you will discover on your own that it is reliable and effective.

Looking at the even larger picture of rising nationwide health care costs, we see sophisticated technology devel­oped to administer numerous expensive tests. "Appropriate care" is a burning issue. Patients in pain want someone to help them without overtreating, overmedicating, overtesting and overcharging. No matter how well patients may know that the human body is an extremely sophisticated and complicated organism, when there is pain, they want a reliable person to "fix it" as soon as possible.

Applying the principles in this unique text on acupuncture will assist you in helping the patient quickly reach and maintain a state of health that is pain-free.

We wish you the very best in your practice of Oriental Medicine.

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BIBLIOGRAPHY

Acupuncture: A Comprehensive Text, Shanghai College of Traditional Medicine. Seattle, Washington: Eastland Press, 1981.

Dr. Tong's Notes, by Hu Bing Chuan, Taiwan, 1987 (Chinese).

Chinese Acupuncture and Moxibustion. Beijing, China: For­eign Language Press, 1987.

Jin Juo Ching Wei, by Dr. Yang Wei Je, Taipei, 1975 (Chinese).

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~.

I

t

f

INDEX 1 Point Description and Case Studies

For each of the twenty-four points, the description, location, needling information, indications, contraindications, and pages of case studies are listed below.

Point Description Case Studies

LingKu 14-15 38,41,44,46,48,52,55,60, 86,96, 102,110,114

DaBai 16 38,41,44,46 Zong Bai 17 38, 41, 44,46 ChungTze 18 52,55,57 ChungHsien 19 52,55,57 MuHuo 20 60 BaGuan 21 62 SoJing Dian 22 64,66 GanMen 23 68 Yen Huang 24 70 MuGuan 25 74,77,80 GuGuan 26 74,77,80 SJ2 30 68,84 P3 30 86 P7 31 89 P9 31 91 H4 32 92,94 H5 32 96 SI4 33 98 P6 33 89, 100, 102 Llll 34 68, 100, 102, 104, 106 LI12 34 110,112 LI13 34 110,112 LI14 35 114

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INDEX2 Symptoms/Conditions

~tis--25,26,74,77,102

Asthma-16, 18,19 Bone/Joint Swelling-25, 26, 75, 77 Chronic Hepatitis---68, 70 Cough--19 Dizziness--35,114 Edema-17 Elbow Pain-14, 48 EyesHeavyffked--30,68,84 Eye Pain--33, 98 Fever-16 Hand Numbness-89 Hand Paralysis--60 Headache---14 Head Area Pain-14 Heat Syndrome-98 Heel Pain or Spur--25, 26, 80 Hemiplegia--20 Hepatitis--24, 30, 84 HipPain-96 Hypertension-35, 114 Insomnia--84 Jaundice--24, 68, 70 Knee Pain and Swelling-19, 33,

34,44,89, 100,102,104,106

Liver Disease/Dysfunction-23, 68, 70

Lower Back Pain-17, 38, 41, 60, 110

Motor/Sensory Deficit in Lower Limb--21, 62

Neck Pain-22, 23, 32, 55, 57, 64, 66,92,94,96

Neurologic Disorder---62 Paralysis-20 Pneumonia-19 Sciatica-14, 16,31,32,44,46,89 Sclera, Y ellowing-24, 68 Scoliosis--52 Shooting Pain-14, 48, 89,96 ShoulderPain-18, 92,96 Spine Pain-34, 110, 112 Surface Capillary Distension-41 Summer Heat in the Eyes--98 Thoracic/Scapular Pain-52, 55, 57 ThroatPain-31,91 Thumb Pain-30, 86 TMJ Synd.rome---66 Upper Back Pain-18, 19,52 Urination,Painfitl-14

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.. I

.Appen~{x 1 REGULAR MERIDIAN POINT LOCATIONS

San Jiao 2-Located between the fourth and fifth metacarpophalyngeal joint, proximal to the web margin. Locate the point with the hand forming a loose fist. See fig. A, below.

Small Intestine 4-0n the ulnar edge of the hand, at the junction of the red and white skin, in the depression between the fifth metacarpal and triquetra! bones. See fig. A, below.

Pericardium 3-Located on the elbow crease, in the depression on the ulnar side of the tendon Small

of m. biceps. See fig. B, p. 134.

Pericardium 7-0n the medial aspect of the wrist crease, in the depression between the tendons of m. palmaris longus and m. flexor carpi radialis. See fig. B, p. 134.

Pericardium 9-In the center of the tip of the middle finger. See fig. B, p. 134.

Heart 4-Located about two fingers ( 1.5 cun) above the medial wrist crease on the radial side of the tendon of m. flexor carpi ulnaris. Palpate this area for the exact location of the most sensi-tive spot. That is the correct point loca­tion. See fig. B, p. 134.

133

i )

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134 I Twelve and Twelve in Acupuncture

Heart 5-Located 1 cun above the wrist crease on the radial side of the tendon of m. carpi flexorulnaris. (For locating most heart channel points, the palm should be facing up.) See fig. B, left.

Percardium 3 Pericardium 6-Located two to three fmgers above the medial wrist crease, be­tween the tendons of m. palmaris longus and m. flexor carpi radialis. See fig. B, left.

Pericardium 6 Large Intestine 11-With the elbow flexed to about 90 degrees, the point is located in the depression palpated proxi­mal to the lateral epicondyle of the hu­

Heart4 merus. See fig. C, below.

Large Intestine 12 & 13-Located two to four fmgers above the lateral epicon­dyle of the humerus, on the posterior aspect of the humerus. Palpate for sensi­

tive spots. See fig. C, below.

Large Intestine 14--Just above the lower end of the deltoid, on the radial side of the humerus directly above Large Intestine 11. See fig. C, right.

Large Intestine 14

Large Intestine 12 &13

Large Intestine 11

Page 130: Twelve and Twelve in Acupuncture

OrnER BooKS BY RICHARD TAN:

~ wenty-Lfl'ur J\1l're in Acupuncture

The second in a series of books by Richard Tan, L.Ac., o.M.o. and Stephen Rush, L.Ac. focusing on unique acupuncture point usage and case studies for the dramatic and highly effective method of pain treatment by use of distal point strategy. This book is a "must have" for those who have this, the first book in a series, Twelve and Twelve in Acupuncture. See order form on page 137.

Shower of Jewels FENG SHUI: AN AMusiNG YET PRAcncAL GUIDE

TO ANCIENT PRINCIPLES OF PLACEMENT AND

GEOENERGY MANIPuLATION

By Richard Tan, L.Ac., o.M.o. and Cheryl Warnke, L.Ac.

Reap the benefits of health, wealth, and happiness with Feng Shui!

ence our lives through our environment, and it can teach us how to alter these forces to our benefit. Shower of Jewels is the most easy-to-understand and applicable book on the market about Feng Shui to date. No longer do you or your patients need to feel like hapless victims of their surroundings and circumstances. By using Feng Shui principles you can gain the power to create an environ­ment to work to your advantage. See order form on page 137.

135

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.t.·

. ..

~welve an~ ~welve in Acupuncture Will prove itself a valuable

addition to your clinical library. Written in a workbook-style that will speed access to the material within, you will encounter many

unique ideas, and much new material, available in English for

the first time. This first in a series of new acupuncture texts will dramatically improve your effectiveness in the treatment of many common pain conditions.

'


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