Five needling techniques

From:TCM_xiaozhong Time:12/11/2008 3:14:18 PM

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Basic Manipulations of Acupuncture for Learners

These five techniques are differentiated according to the relation between the five zang organs and five constituents( skin, vessel, tendon, muscle, bone).

1. Semi-needling Semi-needling means to needle the skin only. That is why it is called semi-needling. Method The needle is inserted only into the skin and then is quickly withdrawn like the pulling of a piece of body hair ( Fig. 3 - 26). Clinical Application To treat wind and cold attack of the superficies, fever, dyspnea and other diseases involving the lung as well as some skin diseases. Note This method is frequently used with cutaneous needle to treat children in modern times. 2. Leopard-spot needling

This technique is characterized by multiple points of bleeding which looks like leopard markings. Method To select one acupoint as the centre and to needle sparsely around for blood-letting ( Fig. 3 - 27 ). Clinical Application To treat tumescent and pyretic pain. Note Since the heart controls blood and vessels, this method works on the regulation of cardiac qi. 3. Joint needling

This technique means to needle the tendons around the joints of the body. Method This method focuses on needling the tendons around the joints. Since the tendons converge around the joints, the tendons and muscles of the four limbs all end near the joints (Fig. 3 -28). Clinical Application To treat obstructive disorder of the tendons. Note Cares should be taken not to impair the vessels and cause bleeding. 4. Hegu needling

This kind of needling refers to the needling of the region with thick muscles. The Chinese Character"Gu"means major muscular convergence. Method To insert the needle deep into the regions with thick muscles, then to withdraw the needle to the shallow region and push the needle obliquely to both sides ( Fig. 3 - 29 ). Clinical Application To treat obstructive problems. This technique is characterized by inserting the needle into the muscles. Since muscles are controlled by the spleen, this method can regulate splenic qi. Clinically this is a kind of heavy needling technique. 5. Shu needling

This technique means to insert the needle perpendicularly and to withdraw it straightly for the purpose of dredging the external and the internal, Method This method means to insert the needle perpendicularly deep to the bones and withdraw straightly (Fig. 3 -30). Clinical Application To treat obstructive pain of the bones ( including diseases located in the deep regions). Note Since kidney controls bones, this method can regulate renal qi.

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"ACUPUNCTURE NEEDLE TECHNIQUES"

John A. Amaro D.C., FIAMA, Dipl.Ac. According to ancient texts on Asian medicine, particularly the Internal Classic, two of the most significant techniques in acupuncture stimulation is that known as tonification (BU) and sedation (XIE) or sometimes referred to as reinforcing and reducing. That type of stimulation which is used to strengthen a slowed physiological function is tonification whereby that stimulation which is used to harmonize hyperactive physiologic functions is referred to as sedation. These techniques are known to acupuncturist the world over and are commonly used in clinical application. There are a number of methods to achieve either tonification or sedation some are more basic than others but they are all significant. When the acupuncture needle is inserted, rotation of the needle gently and slowly is tonification whereby rotating the needle rapidly produces a sedative effect. This concept is generally regarded as being attributed to the classic book The Miraculous Pivot. In addition to gentle or rapid rotation the direction of the rotation is also considered important. Clockwise rotation or to the right, is sedation, whereas rotation to the left or counter-clockwise is tonification. In addition to right and left rotation, The Miraculous Pivot mentions insertion andwithdrawal of the needle as being significant. Insertion of the needle slowly and withdrawing rapidly is tonification whereas insertion rapidly and withdrawing slowly is sedative in nature. In classic insertion and withdrawal, tonification is achieved by insertion of the needle slowly then withdrawal is performed by lifting rapidly to just below the surface of the skin before complete withdrawal and of course the opposite is true for sedation. Another factor which is considered in classic acupuncture, is closing or leaving open the hole from which the needle was withdrawn. At the time of withdrawal of the needle in order to tonify and to prevent the Qi energy from escaping, the acupuncturist will quickly close the hole by pressing on it. However, in sedation and in order to allow exogenous pathogenic factors to pour out of the body, from ancient times, the needle would be rotated and shaken in order to enlarge the hole then withdraw the needle allowing the pathogens to leave the body through the open hole. The classic book known as The Compendium of Acupuncture and Moxibustion states that in insertion of the needle in the direction against the flow of Chi is sedation whereas in tonification, the practitioner would insert the needle tip in the direction of the Chi flow. The classic known as Plain Questions states, tonification is achieved when the needle is inserted while the patient inhales and withdraws the needles on exhalation. Whereas to achieve a sedative effect, the needle is inserted on exhalation and withdrawn on inhalation. Another technique of tonification and sedation is quoted here from the text Classic on Medical Problems whereby it states. Heavy pressing of the needle to a deep level is referred to as tonification whereas forceful lifting of the needle to the superficial level is sedative. Following the arrival of "THE CHI" which is the sensation one feels following the arrival of the chi energy, tonification is obtained by lifting the needle gently and slowly while deep thrusting of the needle heavily and rapidly. In the sedative technique, the practitioner would lift the needle

forcefully and rapidly while, thrusting the needle gently and slowly. In a technique known as "Setting the Mountain on Fire', which is often administered in cases of deficiency cold syndromes, the needle is introduced in the tonification mode by slow insertion. Once the needle is inserted, thrusting the needle to three different levels namely inch, one inch and 1 inch by thrusting nine times each, this technique creates a warming sensation. The needle is then withdrawn rapidly and the hole is pressed. Another technique known as "Penetrating Heaven Coolness" is often administered in situations where the body is in excess and heat syndromes are manifested. In this technique, the needle is introduced in the sedation mode by rapid insertion and slow withdrawal. Once the needle is in place to the 1 inch level, the needle is lifted slightly and thrust six times. Following that, it is lifted to one inch and thrust and then lifted to inch and thrust again. The needle is withdrawn slowly and the hole left open. In needle application, the needle classically is retained for a period of time depending on where you studied acupuncture in the world, however, the general consensus is 20 minutes. However, the needle should never be removed while the body is experiencing the Chi phenomena and the body is literally holding on to the needle. During needle retention, various manipulations of the needle may be performed. Even though the foregoing rules of needle insertion, withdrawing, rotation, depth of penetration, open or closing the hole etc. are all factors to consider in classic acupuncture application, many practitioners worldwide and in Asia disregard these rules while others revere them. Thank God the body is a self healing mechanism and appears to be able to use stimulation by the acupuncture needle to its benefit even though the practitioner may or may not adhere to the rules mentioned in this article. The rules of needle stimulation mentioned here do not cover the entirety of techniques available for our use, but are considered the basic techniques which are generally known by all acupuncturist even though all acupuncturist may not use them. Study these, if you have not utilized these procedures, reconsider to see if your clinical results may be favorably affected. Best Wishes in "1998" THE YEAR OF THE TIGER (a great year, take advantage of it) John A. Amaro D.C.,FIACA, Dipl.Ac. Carefree, Arizona DrAmaro@IAMA.edu

Needling Techniques of Chinese Acupuncture Stimulation No one knows when exactly acupuncture was first used in medical treatment, but it definitely is well before recorded history. Unearthed relics show that ancient people used sharpened stones, bamboo and animal The "Nine needles" in Lingshu bones to perform the needling techniques. Nowadays, most modern physicians use sterile and disposable metallic needles of various lengths and thicknesses, so that they can be applied on different part of the body. In Chinese acupuncture practice, the commonly used needle size is 1.5 inches (40 mm) in length. Since the needles are long, fine and soft, strong and skillful hand manipulations are needed to ensure the needles insert smoothly and precisely into the skin with little pain. Proficient acupuncturists have trained themselves to hold the needle freely. They are capable of inserting and removing the needles quickly, and also twirling or rotating the needles flexibly. They are also required to practice needle technique on their own bodies so as to experience the exact feeling of manipulation and stimulation that the recipient gets. Extensive training and practice is needed to become skillful in needle manipulation. Basic Insertion Techniques Due to the anatomical features of the acupoint, needle insertion technique varies. Traditionally, the needle is inserted using both hands. In one hand, physicians hold the needle between 15 degrees to 90 degrees to the skin surface. They also use their fingers to press, hold-up, or

stretch the local skin surface and then guide the needle to be inserted in appropriate speed, force, depth and direction. Alternatively, a needling guide tube can be used. The needle is inserted into the tube and placed firmly on the point; physicians then tap firmly on the handle of needle so that it penetrates the skin. The guide is then removed and the needle is further adjusted as required. After the needle is inserted, physicians will look for the appearance of needling sensation. TCM calls this deqi literally, the "arrival of qi". The patient may feel a dull ache, heaviness, distention, tingling, or electrical sensation either around the needle or traveling up or down the affected meridian. Meanwhile, the practitioner may experience tightness and dragging around the needle similar to a fish taking the bait. This needling sensation varies greatly from person to person. Pain is not an expected response to most acupuncture stimulation, though certain acupoints may be involve some occasional pain. TCM focuses on this needling sensation, which is influenced by many factors, such as the constitution of a patient, severity of the illness, location of the acupoints and the needling techniques. In general, if the needling sensation occurs easily and the qi can travel to stimulate the lesion, the therapeutic effect will be better; if qi is difficult to secure, then the effect is not so good. For individuals who get this sensation slowly or faintly, the physician will further manipulate to adjust the position, direction and depth of the needle; this includes techniques like lifting and thrusting the needle into place, twirling the needle in a specific manner, plucking or scraping the handle of the needle, and also pressing the skin up and down along the course of the meridian with the fingers. Once again, techniques are carefully chosen based on the condition of the patient and the location of the acupoints. Common factors to determine the needling

techniques include: those with strong bodies or the more muscular regions may be inserted deeper and can accept more vigorous techniques; while the elderly, small children and those with weakened bodies, and for those regions with a thin skin layer should have shallower needle insertions and be stimulated more gently.

Different ways of needle insertions