14. SHENMEN (H-7), NEIGUAN (P-6), YINTAMG (EXTRA), SANYINJIAO (SP-6)

 

Main effect and clininal purpose

 

Manypoints and combinations exist in acupuncture for the purpose of relaxing the nervous system. This combination, however, is probably the most renowned for this purpose.

It is used to relax the Heart and calm the Shen, relieve tension and anxiety, and treat insomnia.

 

Points discussion

 

Shenmen, which is the Yuan-Source point of the Heart channel, is the most effective point used to relax the nervous system.

 

In this point's case, both clinical observation and theoretical background, support each other, and prove validity.

 

According to T.C.M. theory, the Shen, which is the Spirit, resides in the Heart. This means that any emotional hardship that one may encounter, will probably have its Impact upon the Heart. This may also mean that illnesses of the heart organ, or Heart meridian are bound to influence our Spirit (74).

 

Classical problems of the Spirit, according to T.C.M. are: insomnia, tension, anxiety, excessive dreaming, forgetfulness - for the light problems, and, for the more serious: hysteria, insanity, delirium, etc.

 

Shenmen, as the Yuan-source point of the Heart meridian, is connected via the Yuan energy, directly to the Heart. It is also considered the most important point on the Heart channel. Its indications are:

1. To calm the spirit.

2. To regulate Heart-Qi.

3. To remove obstruction from the Jing-Luo.

 

Thus, besides being used to supplement Heart Qi, or to tonify Heart-Blood or Yin, Shenmen is broadly used in all problems associated with the Spirit.

 

It is believed in T.C.M. that when the Heart lacks Blood, there is restlessness, insosmnia and palpitations. These symptoms arise because of shortage of Yin energy, thus the HeartYang, or Fire, flares up. To subdue this, Shenmen is utilized to "cool the Heart", or sedate its Fire, while, at the same time, other points are used to tonify the Yin and Blood. By doing so the harmony is restored, and Yin and Blood provide the substantial basis for the Heart Yang.

 

Neiguan has been discussed several times in this paper and there is no need to elaborate further. In this case it was chosen because of its traditional function “to tranquilize the Heart, and calm the mind".

 

In addition, Neiguan makes a very good couple with Shenmen, as clinical practice demonstrates, mainly because it is the most important point on the Pericardium channel, which is an organ closely related to the Heart.

 

Thus, each of these two accentuates the other point’s function of calming the Shen, and relaxing the Heart.

 

Yintang is an extra point, situated on the route of the Du Mai meridian, exactly between the eyebrows. Its Indications in the classics, are firstly to eliminate Wind-Heat, and secondly to calm the Spirit.

 

It is therefore used for rhinitis, sinusitis, headache and other Wind Heat induced problems.

For its second indication Yintang is often used for insomnia or restlessness. Traditionally the point is situated where the mystic "third eye" is located. This "third eye" is the "window of the soul", and mysticism attributes great mental powers to those who are able to use their "third eye".

 

Modern researchershave found in any case that stimulation of this point has an effect on producing electrical Alpha-waves in the brain. The Alpha-waves are typical in a state of deep sleep, or meditation. There are even acupuncture laser stimulators that have a special switch for Alpha-wave-form, and the practitioner is instructed to stimulate point Yintang, using this wave length (75), in cases of nervous tension, insomnia, etc.

 

Sanyinjiao was discussed under case Number 1 of this work. It is one of the most important and frequently used acupuncture points. It is also a member in the previously discussed "Six main points" category.

 

In this points-combination it was added in order to balance the treatment (please refer to Chapter B, paragraph IX).

 

Sanyinjiao is perhaps the most frequently used point to tonify Yin-Qi. It is the meeting point of the three leg Yin meridians, the Kidney, Liver and Spleen, and it has the effect of stimulating them all.

 

Due to its effect on the Yin in general, and on these three organs in particular, Sanyinjiao is a major point to tonify the blood, too. Taking into consideration the role that the three organs play in regard to the blood, we can understand the importance of Sanyinjiao, in relation to the blood.

 

The Kidneys are associated with Blood production by ruling the bone marrow (Jing), where blood is created. At the same time, the Kidneys provide the Yuan-Qi for the Spleen, in order to produce Blood, and for the Sea of Qi, under Tanzhong (CV-17), where blood is produced by the mutual cooperation of the Heart and Lungs, In the Upper-Jiao.

 

The Spleen rules the creation of Blood from the essence of food digested in the Stomach. Thus the volume of Blood is most dependent on the Spleen.

 

The Liverstores the Blood, and rules its movement and distribution, due to its Qi-sprinkling activities (76).

 

Thus, point Sanyinjiao plays a role in supplementing deficient Blood, and in circulating and invigorating stagnant Blood.

 

We should keep in mind the most frequent causes of insosmnia and restlessness, mentioned in relation to point Shenmen (H-7), in this combination.

 

The "Heart blazing Fire", or "Heart-Yang Shi", is due to, or in continuum, with Heart-Yin-Xu, or Heart-Blood-Xu. In either case, Sanyinjiao is utilized here to supplement both Yin and Blood, and thereby to reduce, or eliminate, Heart Fire.

 

This points-combination is constructed of three points that have a mutual assistance action on calming the Shen, by reducing Heart-Fire and regulating its activity. The fourth point gives the balance to the formula, by acting directly on the cause of the disharmony.

On this very principle many other points-combinations have been developed, especially points that reduce Heart-Fire on the one hand, and points that supplement Kidney-Water on the other hand.

 

Such combinations are:

• Tongli (H-5) - Dazhong (K-4)

• Tongli (H-5) - Zhaohai (K-6)

• Shenmen (H-7) - Taixi (K-3) (77)

Needling sequence, manipulation and stimulation

 

Shenmen and then Neiguan are needled first. These two points have the strongest and fastest response, and they are used to calm the patient as quickly as possible. Both points are used generally in sedation. In cases of patients too weak or too anxious, the stimulation should be mild, and skilful needle technique is important, in order to cause minimal pain to the patient.

 

Yintang is then needled in the same manner, and at last, Sanyinjiao, in tonification.

It is not necessary in this combination to cause a propagated needle sensation, as there is no specific area of discomfort or pain. It is enough to suspend the needles in situ after Deqi has arrived, without further manipulation.

 

When this combination is utilized for insomniatic patients, it is recommended to retain the needles for 30-40 minutes, and the treatment should be conducted as close to bedtime as possible (78).

 

Herbal equivalent

 

There are many herbal prescriptions that deal with unquiet Heart and troubled Spirit. There are even two categories of herbs that deal directly with these symptoms. One category is of herbs that "nourish the heart and calm the Spirit", and the other is "substances that settle and calm the Spirit".

 

The prescription that I have chosen to match the points-combination is constructed of two herbs that have a calming effect on the Spirit, and simultaneously nourish the heart and regulate its function, a third herb that has a direct effect on calming the Spirit, and a fourth herb that tonifies Blood and Yin.

 

The herbs are:

• Radix Polygale Tennifolia - Yuan Zhi

• Semen Ziziphy Spinosa - Suan Zao Ren

• Sclerotium Poria Cocos - Fu Shen

• Radix Rehmania Glutinosa - Shu Di Huang.

Yuan Zhi is used to calm the Spirit and facilitate Heart function, and is used mainly for nervous tension, anxiety and emotional problems hindering Heart function.

 

Suan Zao Ren also calms the Spirit, but, in addition, it nourishes the Heart Blood and Yin.

Fu Shen is a fungus similar to Fu Ling, but is located around the root, and is considered better for calming the Spirit.

 

Shu Di Huang is a widely used herb to tonify both Yin and Blood, in general, and it is used here to supplement the Yin susbtance for Heart function.

 

Thus, the mutual action of Yuan Zhi and Suan Zao Ren is very similar to the action of points Shenmen and Neiguan. Fu Shen may be compared to Yintang, especially when even its name -Fu Shen (Tockahoe Spirit) - implies its influence upon the Spirit (Shen).

Shu Di Huang in this formula imitates the role of Sanyinjiao, and its effect upon Blood creation, and Yin tonification.

 

The whole formula is thus effective in the treatment of: insomnia, dream disturbed sleep, anxiety, palpitations, weakness and anemia, forgetfulness, disorientation and lightheadedness, and the like.