Classical Points Combinations and Clusters of Points in Acupuncture Therapy

Needling sequence. manipulation, and stimulation

In acute cases, involving pain, it is usually recommended, to begin the treatment with a distant point, manipulated in dispersion. In this case Chengshan is the appropriate point.

It is very important to locate Chengshan accurately, and then manipulate it in a small amplitude by the pull-thrust sedation technique. In cases of severe Heat, it is advisable to utilize the "Cooling the sky" technique on Chengshan until a cooling or numb sensation is achieved near the point, or around the haemorrhoids.

Next point is Chengqiang. This point is somewhat problematic, as many practitioners are reluctant to use it because of its anatomical location. Still, this is a very important point, and the patient should be told to wash the region properly before coming to the clinic. The needle may be inserted there perpendicularly, and manipulated by twirling movements after Qi has been obtained.

Paihui is needled last. It is either needled in a posterior direction, or from the left to the right, if the patient is lying on his stomach, and his right cheek on the bed.

In sinking haemorrholds condition, after the Heat and inflammation have subsided, moxa may be applied after needling, usually with the warming stick method. This moxibustion further enhances the raising of Spleen Yang-Qi, thus contracting the hemorrhoidal tissue inside. The same proceudre, though, may be executed with Jenchueh (CV-8), which possesses the same quality.

Herbal equivalent

Radix Sanguisorba (Di Yu) and Flos Sophora Japonica (Hwai Hua Mi) are usually used together for Hot and bleeding haemorrhoids. Both these herbs belong to the category of herbs that arrest bleeding. Both of them also cool the blood, and are therefore suitable for ulcerations, burns, and such skin problems. DI Yu, in ddition, clears Heat and promotes healing, and is suitable for external applications on such skin problems.

In addition, it is common to find in a formula for haemorrhoids herbs that treat Damp-Heat conditions such as Scutellaria Baicalensis (Huang Qin). This herb also enters the Large Intestine meridian and Is used for Intestinal-Wind, which is blood in the stools, and for intestinal abscess.

Herbs like Corydalis (Yan Hu Suo) that invigorate the blood and stop pain, may also be found in such fomulae. Minerals such as Succinum resin (Hu Po), which is a ground Amber, is also suitable, dueto its ability to reduce swelling, and promote healing of ulcerations, carbuncles and swollen scrotum.

In comparison with point Paihui, Radix Astragali (Huang Qi) may perfectly fit. This herb has the function of raising the Yang-Qi of the Spleen, and thus it is used in prolapsed syndromes, or bleeding, due to deficiency. It is a warm herb, it tonifies the Spleen and the Lung, and it may be added to a herbal formula that treats prolapsed anus with haemorrhoids, or sinking bleeding haemorrhoids.

Case history

Mrs. M., age 42, suffered for several years from recurrent bleeding haemorrhoids. Her last attack, which she defined as the severest of them all, had caught her abroad, on vacation. Various medicines prescribed for her were not of much help, and she came to me suffering great pain and discomfort.

Despite the fact that Mrs. M. was a physical-fitness teacher, she was slightly obese. When asked to describe the pain, she said that it had been a sharp pricking pain, with a sensation of heaviness and sinking.

Her pulse was Soggy, but Big in Cun position. Her tongue was scalloped, somewhat purplish-blue, and covered with many red points on the tip. It had also a thin yellowish layer.

As was evidenced by actually all the symptoms and signs, her case was a Damp-Heat stagnation of the rectal region, plus a pre-existing Spleen Qi Xu pattern.

Soggy pulse and scallopedtongue are basic qualities which point out a weak Spleen condition. The red points on the tongue, and the yellowish cover exhibit a Damp-Heat condition. The Big pulse, that had a Soggy quality as well in the Cun position, also showed a Damp excessive condition in the domain of the Large Intestine.

Her symptoms clearly matched with those signs, thus she exhibited a case that "goes with the current". This is a Chinese saying that suggests that whenever the signs match the patient's symptoms, the cause would respond relatively well to the treatment (73)

Mrs. M. was treated twice a day by the following formula: Chengshan (B-57), Changqiang (GV-1), Quchi (LI-11), Huiyang (B35).

Quchi was entered in the formula in order to treat Heat and Damp in the Large Intestine in general, as did Huiyang, locally.

In the second day the pain decreased markedly, and on the third day Quchi was substituted by Paihui (GV-20).

After five more treatments, once a day, with the revised formula, Mrs. M. was completely cured.