Needling sequence, manipulation and stimulation

 

In this points-combination the needling procedure generally starts with Dingchuan, in a sitting position. The patient bends forward with his arms crossed beneath his forehead, and then Dingchuan is punctured 0.5 cun laterally, slightly below both sides of the prominence of seventh cervical vertebra.

 

After needling, the point is manipulated in dispersion for 2-3 minutes. Usually the patient experiences an immediate relief from wheezing and dyspnea.

 

After 5-15 minutes, the patient's position is changed to supine, and the rest of the points are needled, in this order: Neiguan, Tiantu, Tanzhong and Fenglong.

 

All the points are needled to sedate, and disperse Phlegm.When it is desired to accentuate the needle sensation, the technique of "wagging the tail" is utilized (65). By this technique, after obtaining Qi, the needle handle is "wagged" back and forth, until the patient senses a strong reaction along the meridian. This procedure is said to move the Yang- Qi, and by so doing to disperse Phlegm stagnation.

 

In the case of children, Tinatu is usually removed after Deqi, whereas with adults the needle is left in situ during the whole treatment.

 

The proceudre of "wagging the tail", may be performed on Neiguan, if the patient is robust enough to tolerate it, and on Fenglong as well. However, attention must be paid to avoid a strong reaction which might occur after the treatment. In some patients, Fenglong has a strong impact on Phlegm movements in the body, and this may aggravate their condition at the beginning of the treatment. It is advisable in such cases, to instruct these patients to keep using their "Western medicine" broncho-dilators until their basic condition has been significantly improved.

 

It has been observed that scarring moxibustion is also very effective in stubborn asthma. The points suitable for this technique, from among this combination's points, are Neiguan, Tanzhong and Fenglong.

 

In order to perform this correctly, a tiny cone of white moxa is placed over the point, preferably after needling it, and burned to its end. Immediately afterwards the procedure is repeated, with slightly larger cones, on the same spot, three to seven more times. There are some specific ointments which may be utilized to heal the wound, after pus has emerged. One of them, and a very good one too, is "Red Jade Ointment" (66), in the case of a serious wound, or simply egg’s white, for a relatively mild wound.

 

Herbal equivalent

 

This points-combination may be compared to the following herbal formula:

• Semen Pruni Armeniaca (Xing Ren)

• Fructus Perilla Frutescentis (Su Zi)

• Bulbus Fritillaria Thunbergi (Zhe Bei Mu)

• Rhizoma Pinellia Teranta (Ban Xia)

• Radix Cynanchi Stautoni (Bai Gian)

• Stalactitum (E Guan Shi)

This herbal prescription is a combination of herbs that have an effect on cough due to rebellious Lung-Qi, and accumulation of Phlegm.

 

One component, though, is E-Guan-Shi, which is a mineral, and has a general effect on strenghtening Yang, and transforming Phlegm. It may be compared to point Fenglong, even though it does not affect the Spleen directly.

 

In order to achieve a more straightforward effect on strengthening the Spleen, and thereby resolving Phlegm, it is suitable to add to the formula herbs such as Codonopsis Pilosula (Dang Shen), or Radix Glycyrrhiza (Gan Cao), both of which tonify the Qi via the Spleen, and also have the effect of reducing Phlegm.

 

Xing Ren may be compared to both Dingchuan and Tiantu, in its ability to stop wheezing and redirect Lung-Qi downward.

 

Su Zi is used to stop wheezing and dissove Phlegm. It is mainly used when copious Phlegm obstructs the air passages.

 

Zhe Bei Mu is also suitable for the same indications, only it is more appropriate for dealing with Heat in the Lungs, as well.

 

Ban Xia and BaiQian are both used to treat wheezing and cough due to rebellious Qi and Phlegm.

 

Case history

 

Mrs. M., age 36, suffered since childhood from severe hay fever and urticaria on her upper back and shins.

 

Two years prior to her visit in my clinic, she began to experience occasional asthmatic attacks, until this condition became permanent.

 

Mrs. M. had a "barking" cough and wheezing, and congested chest, with a sensation of lodged phlegm which could not be expectorated.

 

Her pulse was very Soggy and Slippery. Chi position was not palpable at all, and the pulse of her Lungs was small and hard.

 

Her tongue was pink-pale, wet and scalloped; the coating was white and damp.

 

On evaluating the different aspects of this information, I came to the conclusion that Mrs. M. was on the verge of an externally inflicted disease turning into an internal disharmony.

 

The history of many years of stubborn hay-fever, along with the wet and white-coated tongue, pointed to an external Damp, and probably Cold, origin of the problem.

 

The Slippery and Soggy pulse, with the scalloped tongue, suggested a weak Spleen, and accumulation of Damp and Phlegm.

 

The congested pulse on the right cun position, with chest stuffiness and wheezing, demonstrated a concentration of phlegm in her chest, probably phlegm which had become too viscose to allow itself to be expectorated.

 

The points-combination above was, therefore, utilized, in order to act directly on the phlegm, disperse and eliminate it. Point Neiguan was intermittently switched with the couple Hegu (LI-4) and Liehchueh (L-7). This couple has already been discussed several times in this work. (See Chapter B, paragraph III, case history Number 9.) Here it was chosen for its marked effect on redirecting rebellious Lung-Qi, and eliminating stagnation in the upper respiratory tract.

 

It is interesting to note here that whenever Mrs. M. had come to the treatment demonstrating dyspnea and wheezing, point Dingchuan, manipulated in the fashion described above, had, in five minutes, relieved her symptoms completely.

After five sessions only, the urticaria and the itchy skin have both disappeared. Her asthmatic condition improved gradually, and after ten treatments Mrs. M. reported that she had no further dyspnea and wheezing.

 

I then changed her prescription in order to place an emphasis on the "BIAO" - the root - of her body condition. The principle was to tonify both Lung and Spleen Qi, strengthen Wei Qi, while still occasionally using points that release exterior conditions, such as: Fengmen (B-12), Fengfu (GV-16) etc.

 

Today, after one and a half years, Mrs. M. suffers no more from eitherasthma or urticaria. She nevertheless has, even though to a much lesser extent, occasional hay-fever attacks.

It is very important, during the course of such treatment, to emphasize to the patient the importance of avoiding Phlegm, or Damp producing foods. These would be especially milk products, sweets and very sweet food, overly greasy food, fried food with much oil, and salt.

 

It is no less important to stress the essential role of physical exercise, and breathing techniques.