Advanced Needling 2 Spring 2009 www.CatsTCMNotes.com Page 1 of
17 Course: Advanced Needling 2Date: J une 2009 Doc: Quiz 2 Study
Sheet This Study Guide covers classes 5, 6, and 7. Topics covered
are Dr. Tans Balance Method, Dr. Tans Five systems and Master Tong
technique and points. Dr. Tans Balance Method Basics Upon what is
Dr. Tans method based?TCM meridian theory and the contralateral
needling principles of the Neijing. What are the best clinical
applications for this method?Mostly for many types of pain and
pain-like sensations (numb, tingle, itch, burn, cramp, etc.), but
can also be used for some internal diseases and skin diseases. What
are the 5 basic steps you employ in a Dr. Tan type
treatment?1.Diagnosis of the sick meridian 2.Choose one of the five
systems to pick the meridian to be needled 3.Choose Mirror/Reverse
Mirror (for limb problems) or Imaging Format (for trunk problems)
4.Palpate chosen area for tenderness and ashi points. 5.Needle How
long are the needles retained and how often do you stimulate the
needles?Retention is 45 90 minutes, at least 1 stimulation The Five
Systems Know the systems by the numbers rather than by the names.In
each system, you first identify the sick meridian and then pair it
with the meridian you wish to treat. The systems help you pick this
meridian and each system has a formula you use to determine the
right one. System 1 Chinese Anatomical Imaging Pairs channels of
the same Chinese name Yin treats yin and yang treats yang. Hand
treats foot, foot treats hand Needle contralateral side.
Example:Hand Taiyang to Foot Taiyang, contralateral. Advanced
Needling 2 Spring 2009 www.CatsTCMNotes.com Page 2 of 17 System 2
Branching Channel Uses Chinese channel names so that Water
treatsFire and vice versa like so Yang treats Yin and vice versa
Hand treats Foot and vice versa Can needle either side, but if
condition is one sided, needle affected side. System 3
Interior/Exterior Relationship Interior/Exterior related
channels,i.e., LU to LI, KI to BL. Yang treats Yin and vice versa
Hand treats Hand, Foot treats Foot Needle contralaterally
Yang/FireYin/Water TaiyangTaiyin ShaoyangShaoyin YangmingJ ueyin
Example:Hand Shaoyang to Foot Shaoyin, either side. Example:
Problem on the ST channel (Foot Yangming) would be treated by the
Spleen (Foot Taiyin) Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 3 of 17 System 4 Chinese Clock/Opposites
Meridian selection based on the Chinese clockwhich follows the flow
of the channels (hand taiyinhand yangming, etc) Use the channel
opposite the diseased meridianon the clock. Remember that
Gallbladder is midnight, Heart is noon. You can figure out the rest
from there based on the flow of the channels. Yang treats Yin and
vice versa. Hand treats Foot and vice versa. Needle contralateral
or same side (ipsilateral) depending on where tenderness is. System
5 Chinese Clock/Neighbor Use the channel next to the diseased
meridian on the clock. Yin treats Yin, Yang treats Yang. Foot
treats Hand and vice versa. Needle contralateral side. Quick System
Comparison chart Look at the patterns below. Its pretty easy this
way SystemYang?Upper/lowerWhich side System 1 i.e. ShaoyinShaoyin
Yin YinHandFootContralateral System 2 i.e., Shaoyang Shaoyin
YangYinHandFootSame side or either side System 3 i.e., Internal
channelExternal channel YangYinHandHandContralateral System 4 Clock
opposites YangYinHandFootContralateral or either side System 5
Clock neighbors YinYinHandFootContralateral Example:KI channel prob
(foot)LI channel (hand), either side depending on
tenderness.Example:Liver channel problemLung channel (not
gallbladder!) on contralateral side. Advanced Needling 2 Spring
2009 www.CatsTCMNotes.com Page 4 of 17 Mirroring and Reverse
Mirroring Mirroring/Reverse Mirroring treats problems on the
limbs.Elbows and knees are pivot points for mirroring. Note that in
all of the five systems, with the exception of System 3, upper
limbs treat lower limbs and vice versa. Mirroring Like to like on
the upper and lower limbs: fingers to toes, wrists to ankles, upper
arm to thigh, etc. FingerToe HandFoot WristAnkle ForearmLower Leg
ElbowKnee Upper ArmThigh ShoulderHip Reverse Mirroring Still upper
limb to lower limb, but spin one of em around using the knee or
elbow as a pivot point so that you are matching the finger to the
top of the hip, elbow to knee, shoulder to ankle, etc. FingerTop of
hip HandHip WristHip joint ForearmThigh ElbowKnee Upper ArmLower
leg ShoulderAnkle Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 5 of 17 Imaging Format Choose imaging for
problems affecting the head and trunk. Imaging matches the area of
sickness on the head/trunk onto the four limbs of the body.
(Actually, imaging can be done anywhere auricular acupuncture is an
example of imaging) Points on the limbs that reflect the sick
portion of the head/trunk will often be tender, weak or
tight.Overlay a leg or arm on the trunk from perineum to top of
head with the elbow or knee at the umbilicus/L2 area.Like
mirroring, there is imaging and reverse imaging.J oints match up to
joints. For example: wrist/ankle matches up to sacral area in
imaging or neck/neck joints in reverse imaging. Imaging Sick
areaNeedled area Testicle/anusFinger/toe
Genitals/coccyx/sacrumHand/foot Bladder/lumbo-sacralWrist/ankle
Lower ab/lower backForearm/lower leg Umbilicus/L2Elbow/knee Upper
ab/rib cage/chest or mid to upper back Upper arm/upper leg Neck,
jaw, base of skullShoulder/hip joint Top of headTop of shoulder/top
of hip Reverse Imaging Sick areaNeedled area Top of the
headFinger/toe Head/base of skullHand/foot Neck/neck
jointWrist/ankle Upper ab, rib cage, chest, mid/upper back
Forearm/lower leg Umbilicus/L2Elbow/knee Lower ab/lower backUpper
arm/upper leg Genitals, coccyx, sacrumShoulder/hip joint Testicles,
anusTop of shoulder/top of hip Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 6 of 17 Master Tongs Orthodox Acupuncture
Uses 12 principle areas rather than 12 meridians, numbered to match
parts of the body.Know these! Body area pointsNumber Finger
points11 Palm/dorsal hand22 Forearm33 Arm44 Sole of foot55 Dorsal
foot66 Leg77 Thigh88 Ear99 Head/Face1010 BackDT Chest/AbdomenVT DT
stands for Dorsal Trunk VT stands for Ventral Trunk Some
characteristics to know about the use and theory Tong Points: Tong
techniques use very strong stimulation. Analogous Correspondence
Like tissue treats like tissue treat the bone for bone problems
with strong stimulation, muscle for muscle problems. Holographic
Correspondence Kind of like imaging theory or principles behind
auricular acupuncture using the ear as a hologram for the whole
body. Example: Picture a sitting Buddha superimposed over the face
for instance with the top of his head at the top of the face and
the sitting part at the mouth/chin area. 1010.19 and 1010.20 for
instance just below the mouth are the reflex area of Kidney and
treat lower back problems and asthma due to Kidney not grasping Qi.
Da Mao Needling Method Many identified points are actually sets of
multiple points (i.e. Mu is actually a 2 point combination, often
referred to as wood anger by Tong-iansby the Tong-ese?) These
combinations give greater punch to the effect. Many points use
between 2 and 4 needles. This is from the Nei jing. Advanced
Needling 2 Spring 2009 www.CatsTCMNotes.com Page 7 of 17 Activating
Qi or De Qi method Contralateral insertion plus movement of the
affected area to move or activate the Qi. Inducing Qi or Chien Yin
method Contralateral insertion plus same-side (ipsilateral) distal
needling at the Shu Stream point to guide the Qi. Distal
Bloodletting Master Tong techniques use it not just distally, but
all over, often combined with cupping.This is referred to as
treatment of vascular pathology as blood stagnation induces many
ailments. This may not shake out like you think, by the wayyou can
use bleeding on the back in the Tong system to treat knee problems!
There are 7 lines on the back: the two UB lines, the two J iaji
lines, and the Du line. Some of the points (like Liver 2 and 3) in
the Tong system may be slightly different than you learned them in
Point Locations. The original Master Tong system does not focus on
tonifying or reducingthough some of the disciples of Tong do add
this. Different depths give different effects(i.e., 77.18 at cun
=SP, 1 cun =KI) Slightly funky matching of collaterals: LungBladder
SpleenSmall Intestine HeartGallbladder KidneySan J iao Pericardium
Stomach Advanced Needling 2 Spring 2009 www.CatsTCMNotes.com Page 8
of 17 30 Most Common Master Tong Points Know the point number (not
the name), what indications the point has, and the imaging
principles as to why that point is for that indication. Finger
Points 11.06 Location: center of ulnar aspect of ring
finger.Indications:oGynecology: Uterine pain, tumors Irregular
menstruation Leucorrhea with redish cast Fallopian tube
blockageRetroversion of uterus Vaginal swelling Frequent
miscarriage 11.24 Location: 2 points ulnar margin of thumb. Divide
proximal phalanx into 3 equal parts, points lie on dividing
lines.Indications: oGynecology: Uteritis Pain (ac or chron) of
uterus Hysteroma Female sterility Irregular menses, dysmenorrhea,
menorrhea, scanty menses oOther:Distention of lower abdomen 11.17
(this is the Mu or Wood anger point) Location: 2 points on ulnar
aspect of index finger. Divide proximal phalanx into 3 equal parts,
points lie on dividing lines. (Draw a tic-tac-toe board. Insert on
the crossings on theulnar side.) Indications:oLiver stuff
Hyperactivity of Liver fire Irritability (Used clinically for
almost any emotional instability) Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 9 of 17 11.27 Five Tigers Location: 5
points on the radial border of the thumb. Divide the proximal
phalanx in half to find the mid point. Then find the and marks. The
other two lie inbetween. Indications: oBone swelling and pain of
the whole body.Point 1 is for hands Point 2 is for assistant for 1
and 3 Point 3 is for toes Point 4 is for dorsal ankle Point 5 is
for heel o1, 3 and 5 are most often used. Hand Points 22.01
Location:In thenar area, about 1 cun from skin fold, between 1st
and 2nd MCs. You can use the edge of the index finger, draw a
linestraight down, measure 1 cun from that skin fold. This isthe
flip side of Ling Gu, 22.05.Indications: oBack Pain oRespiratory:
Pneumonia (great point) Common cold Cough Asthma (great for kids
with asthma) 22.02 Location: At the joint between 1st and 2nd MCs,
about 1 cun distal and parallel with the edge of the 1st MC from
22.01.Flip side of Da Bai, 22.04.Indications oHigh fever oPneumonia
oPain Knee Pain Back Pain Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 10 of 17 22.04 Da Bai Location: 1.2 cun
distal to the bony junction of the 1st and 2nd MCs.Indications:
oAsthma in childhood (use blood letting) oHigh fever (most
effective) oSciatica due to Lung xu. 22.05 Ling Gu Location: At
bony junction of 1st and 2nd MCs, can deep insert through to 22.02
Indications oPain Sciatica, Lumbago Leg pain Migraine oHearing
problems Tinnitus Hearing impairment oParalysis Bells Palsy
Hemiplegia oGynecological Hyper or oligo-menorrhea Amenorrhea
Difficult delivery Polyuria Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 11 of 17 Lower Arm Points 33.10 intestine
gate Location: 3 cun proximal to pisiform bone on medial side of
ulna.Right on the edge of the bone.Indications: oLiver stuff:
Enteritis caused by hepatitis Dizziness Blurred vision 33.11 liver
gate Location: 6 cun proximal to pisiform bone on medial side of
ulna.Right on the edge of the bone. Indications: oVery effective
for acute hepatitis! 33.12 heart gate Location: 1.5 cun distal to
the olecranon on the medial side of the ulna Right on the edge of
the bone.Indications: oHeart stuff: Carditis Palpitations Chest
oppression oDry heaves/dry vomiting oInguinal region pain Insert
+movement plus Shu point of Liver (LV3) on affected side. Advanced
Needling 2 Spring 2009 www.CatsTCMNotes.com Page 12 of 17 Upper Arm
Points 44.06 Location: Center of deltoid muscle, center lateral
aspect of arm.Indications: oPain Knee: most effective -
contralateral insert Shoulder: contralateral insert oSkin
disorders, esp of neck oParalysis Hemiplegia Poliomyelitis and
infantile paralysis oArteriosclerosis oEpistaxis Dorsal Foot Points
66.05 Location: 2 cun proximal to the webbing between 2nd and 3rd
toes. J ust prox to ST 432 cun prox from ST 44. Indications:
oStomach/Intestine stuff: Enteritis Gastritis Abdominal pain
(combine with Ling gu) Dysentery Appendicitis Rectal prolapse
oMenstrual cramps oTemporal migraine oNasal congestion 66.06
Location: 1.5 cun proximal to the webbing between 3rd and 4th
toes.Single point treatment! Indications: oSplenomegaly oLiver
disease oCholecystitis oPoliomyelitis oLeukemia oIndigestion
oFatigue Advanced Needling 2 Spring 2009 www.CatsTCMNotes.com Page
13 of 17 66.07 Location: 1 cun proximal to the webbing between the
3rd and 4th toes Indications: Same as above minus leukemia
oSplenomegaly oLiver disease oCholecystitis oPoliomyelitis
oIndigestion oFatigue 66.10 Location: 1.5 cun proximal to the
medial side of 1st MTP Single point treatment! Preggers
contraindication! Indications: oDizziness/Vertigo oPalpitations
oHeart weakness due to hypertension Lower Leg Points 77.01
Location: On Achilles tendon 3.5 cun directly above heel. Right
between 2 malleoli. Relax the tendon first, use a 2 cun
needle,touch the bone.Indications: oNeck and back Pain:Spinal pain
Lumbago Neck pain (herniated disc, spinal stenosis) Occiput pain
oHydroencephalus 77.02 Location: 2 cun above 77.01 or 5.5 cun above
the heel.Indications: oSame as 77.01, combine with this point for
best effect. Advanced Needling 2 Spring 2009 www.CatsTCMNotes.com
Page 14 of 17 77.09 middle four flowers Location: 4.5 cun distal to
ST 36.Indications: oInsert 2 3 cun for these:Asthma Opthalmalgia
oBlood let for these:Carditis Arteriosclerosis Chest
oppression/restlessness Acute stomach ache Bony swelling The lower
3 emperors are:Heaven is SP 9 and then 77.18 is 1.5 cun below the
assistant to heaven.Earth point SP 7.5 Human - 77.21=SP 6 77.17
heavenly emperor Location: J ust below medial condyle of tibia.No
moxa, no preggers!Indications: oStomach Hyperchlorhydria (excess
stomach acid) Esophageal reflux oKidney Glomerulonephritis Diabetes
77.18 kidney gate Location: 1.5 cun below 77.17 Indications:
oStomach Hyperchlorhydria (excess stomach acid) Esophageal reflux
oEyes Squinting Astigmatism oAnemia oIdiopathic epilepsy oHysteria
oFrontal headache Advanced Needling 2 Spring 2009
www.CatsTCMNotes.com Page 15 of 17 oNasal pain oVertigo 77.19 Earth
emperor Location: 7 cun proximal to medial malleolus beside medial
border tibia.Not for preggers! Indications: oEdema
oGlomerulonephritis oDiabetes oEarly ejaculation oImpotence
oGonorrhea oHematuria oUterine myoma oLumbago due to KI xu 77.21
Human Emperor Location: 4 cun below 77.19 (3 cun above medial
malleolus) on medial posterior border of tibia.Basically, SP 6 Not
for preggers! Indications: oGonorrhea oImpotence oEarly ejaculation
oLumbago oHand numbness due to diabetes oDizziness oAcute neck pain
77.22 Location: 1.5 cun lateral to ST 36 on a horizontal
line.Indications: oToothache due to gingivitis oFacial nerve palsy
77.23 Location: 2 points first one is 2 cun below 77.22, 2nd one is
2 cun below that.Indications: oSame as 77.22. Advanced Needling 2
Spring 2009 www.CatsTCMNotes.com Page 16 of 17 Thigh Points Use
only these 3 in one leg. And only pick one or two for treatment.Use
one point each leg to tx hypertension. 88.01Location: Midline of
the anterior thigh, 5 cun superior to upper border of the
patella.Indications: oHeart stuff Heart disease Coronary disease
Acute pericarditis Cardiac rheumatism Palpitations oFloaters in
vision oStomach ache oCerebral ischemia 88.02 Location: Midline of
the anterior thigh, 2 cun above 88.01 (7 cun superior to upper
border of the patella). Indications: oSame as 88.01 88.03 Location:
Midline of the anterior thigh, 4 cun above 88.01 (9 cun superior to
upper border of the patella). Indications: oSame as 88.01 Advanced
Needling 2 Spring 2009 www.CatsTCMNotes.com Page 17 of 17 Face
Points 1010.19 Location: 0.4 cun directly below corner of the
mouth.Indications: oFibromyalgia and CFS due to KI xu oVertigo
oBlurred vision oLumbago, low back sprain/strain due to Qi blockage
1010.20 Location: 0.5 cun medial to 1010.19.Indications: Same as
above plus asthma/cough oFibromyalgia and CFS due to KI xu oVertigo
oBlurred vision oLumbago, low back sprain/strain due to Qi blockage
oAsthma, cough