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Point Indication Review Point Selection

Point Indication Review Point Selection. ACR class 11. POINT SELECTION METHODS. Basic strategy: 1) Select a Local Point 2) Select a Distal point. SELECTING LOCAL POINTS. Local points - on, over or very near the diseased area. Most obvious method, yet very important

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Point Indication Review Point Selection

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  1. Point Indication ReviewPoint Selection • ACR class 11

  2. POINT SELECTION METHODS • Basic strategy: • 1) Select a Local Point • 2) Select a Distal point

  3. SELECTING LOCAL POINTS • Local points - on, over or very near the diseased area. • Most obvious method, yet very important • Should not be dismissed as simplistic or symptomatic • Much used in treating disorders of the organs.

  4. Examples include: • ST-25 or REN-8 for diarrhea. • REN-12 for nausea. • REN-17 for tightness of the chest. • L.I.-20 for diseases of the nose. • SI-19 for diseases of the ears.

  5. SELECTING ADJACENT POINTS • Adjacent points are located near the affected area. • Examples include: • SP-10, ST-34 or SP-9 for diseases of the knee joint. • L.I.-14 for diseases of the shoulder. • GB-21 or SI-11 for diseases of the breast.

  6. SELECTING DISTAL POINTS • Most frequently used method in acupuncture treatment. • The Ode to Elucidate Mysteries refers to the ‘four origins and three ends’. • Four origins - extremities of the limbs • Three ends - head, chest and abdomen

  7. Primary principle - choose a point from the involved channel. • Example: distal points from shaoyang channel (Sanjiao and Gall Bladder) will be selected for temporal headache, • distal points from yangming channel (Large Intestine and Stomach) will be chosen for pain of the face and forehead,

  8. distal points from taiyang channel (Bladder and Small Intestine) will be selected for occipital headache and pain, • points from the jueyin Liver channel will be selected for vertex headache.

  9. It is common practice to combine local, adjacent and distal points. Examples include: • GB-8, GB-20 and GB-43 for temporal headache. • ST-18, LIV-14 and GB-41 for breast diseases. • REN-12, REN-17 and ST-36 for Stomach diseases.

  10. SELECTING POINTS FROM ONE CHANNEL TO TREAT ITS INTERIORLY- EXTERIORLY RELATED CHANNEL • Most commonly observed in relation to the luo-connecting points, include: • L.I.-4 to assist the Lung function of distributing defensive qi. • L.I.-6 to promote the Lung function of regulating the water passages when this is impaired by exterior wind. • ST-40 to resolve phlegm due to disharmony of the Spleen.

  11. SELECTING POINTS FROM ONE PAIR OF THE SIX CHANNELS TO TREAT DISEASE OF THE OTHER • Examples include: • SJ-6 (hand shaoyang Sanjiao channel) to treat hypochondriac pain due to disharmony of the foot shaoyang Gall Bladder channel. • P-6 (hand jueyin Pericardium channel) to resolve stagnation of qi in the foot jueyin Liver channel in the chest and hypochondrium.

  12. SELECTING POINTS ACCORDING TO CHANNEL CONNECTIONS • Examples include • SP-6, the intersection of the Spleen, Liver and Kidney channels, to treat most diseases of the lower abdomen since all these channels pass through this area. • DU-14, the meeting point of the Governing vessel with all the yang primary channels to release pathogenic factors from the (yang) exterior.

  13. CROSS NEEDLING • Contralateral (“cross”) needling is commonly used either when the affected side is too painful to treat, or when, after needling, one wants the patient to mobilize the painful area. • Also used in acute painful disorders: select points from the ankle to treat the opposite wrist (and vice-versa), from the knee to treat the opposite elbow (and vice-versa) and from the hip to treat the opposite shoulder (and vice-versa).

  14. SELECTION OF EMPIRICAL POINTS • Frequently, the selection of distal points is determined by their historically established empirical effect. Examples include: • ST-38 for shoulder pain. • DU-10 for boils. • LU-7 for headache. • SI-4 for jaundice. • GB-36 for rabies.

  15. CHAIN AND LOCK POINT ASSOCIATION METHOD • Select points from the shoulder, elbow and hand or wrist to treat disorders of the upper limb and from the hip, knee and ankle to treat disorders of the lower limb.

  16. Pathogen Patterns

  17. Wind • (Exterior) LI4, LU7, GB20, BL12 • (Interior) GB16, GB20, DU20, GB31 • Cold • (Exterior) LI4, LU7, BL12 • (Interior) REN4*, REN12*, ST36* • Heat • (Exterior) LI4, LI11, DU14 • (Interior) LI11, DU14 (XS); K2, K6 (Def)

  18. Damp • SP9, BL20, REN9; add LI11 if Damp Heat • Summerheat • LI11, DU14; add SP9 if Damp • Phlegm • SP9, ST40; add LI11 if Heat • (Lung) LU5 • (Heart) P5

  19. Zang Fu Patterns

  20. Heart Patterns

  21. Heart Deficiency Patterns • HEART-QI DEFICIENCY Points: HE-5, P-6, BL‐15, Ren-17, Ren-6. • HEART-YANG DEFICIENCY Points: HE-5, P-6, BL‐15, Ren-17, Ren-6, Du‐14. • HEART-YANG COLLAPSE Points: Ren-6, Ren-4, Ren-8, Du-4, ST-36, P-6, BL-23, Du-20, Du-14, BL-15. • HEART-BLOOD DEFICIENCY Points: HE-7, P-6, Ren-14, Ren-15, Ren-4, BL-17, BL-20. • HEART-YIN DEFICIENCY Points: HE-7, P-6, Ren-14, Ren-15, Ren-4, HE-6, SP-6, KI-7, KI-6.

  22. Heart Excess Patterns • HEART-FIRE BLAZING Points: HE-9, HE-8, HE-7, Ren-15, SP-6, KI-6. • PHLEGM-FIRE HARASSING THE HEART Points: P-5, HE-7, HE‐ 8, HE-9, P-7, Ren-15, BL-15, Ren-12, ST‐ 40, SP-6, LIV-3, LIV-2, BL-20, Du-20, GB‐13, GB-15, Du-24. • PHLEGM MISTING THE MIND Points: HE-9, P-5, BL-15, ST-40, Du-26, Ren-12, BL-20. • HEART-BLOOD STAGNANT Points: P-6, P-4, HE‐7, Ren-17, BL-14, BL-17, SP-10, KI-25. • PERICARDIUM PATTERNS Points are mostly the same as Heart patterns but add REN-17, BL-14, P-8, etc

  23. Liver Patterns

  24. Liver Excess patterns • STAGNATION OF LIVER-QI Points: GB-34, LIV-3, LIV-13, LIV-14, T.B.‐6, P-6. • LIVER-FIRE BLAZING UPWARDS Points: LIV-2, LIV-3, GB-20, Taiyang, GB-13, L.I.-11 • DAMP-HEAT IN LIVER Points: LIV-14, GB-34, BL-18, Ren-12, SP-9, SP-6, L.I.-11, LIV-2. • STASIS OF LIVER-BLOOD Points: GB-34, LIV-3, BL-18, BL-17, SP-10, Ren-6. • STAGNATION OF COLD IN THE LIVER CHANNEL Points: Ren-3, LIV-5, LIV-1, LIV-3.

  25. Liver Deficiency Patterns • DEFICIENCY OF LIVER-BLOOD Points: BL-18, BL-20, BL-23, BL-17, LIV-8, SP-6, ST-36, Ren-4. • LIVER-YIN DEFICIENCY Points: LIV-8, SP-6, ST-36, Ren-4, KI-3, KI-6, LIV-2.

  26. Liver Deficiency/Excess Patterns • LIVER-YANG RISING Points: LIV-3, T.B.-5, P-6, G.B.-43, G.B.-38, BL-2, Taiyang extra point, GB-20, G.B.-9, G.B.-8, G.B.-6. If Liver Yin or Liver Blood deficiency: KI-3, KI-6, SP-6, LIV-8, ST-36 • EXTREME HEAT GENERATING LIVER WIND Points: LIV-3, Shixuan extra points, Du-20, Du-16, GB-20. • LIVER-BLOOD DEFICIENCY GENERATING WIND Points: LIV-3, GB-20, L.I.-4, TB-5, Du-19, SP-6, LIV-8, KI-3, BL-17, Ren-4

  27. LIVER-YANG RISING CAUSING WIND • a) Liver‐Yang Rising deriving from Liver‐Yin Deficiency Points: LIV-3, GB-20, L.I.-4, TB-5, Du-19, SP-6, LIV-8, KI-3 • b) Liver‐Yang Rising deriving from Liver‐ and Kidney-Yin Deficiency Points: same as above, add KI-6, Ren-4 to nourish Kidney Yin • c) Liver‐Yang Rising deriving from Liver‐Blood Deficiency Points: same as (a), add BL-17, Ren-4 to nourish Blood

  28. LIVER COMBINED PATTERNS • LIVER INVADING THE SPLEEN Points: LIV-14, LIV-13, G.B.-34, LIV-3, Ren-6, Ren-12, ST-25, SP-15 ST-36, SP-6, P-6 and SP-4 • LIVER INVADING THE STOMACH Points: LIV-14, LIV-13, G.B.-34, Ren-13, Ren-10, ST-36, BL-21. • LIVER-FIRE INSULTING THE LUNGS Points: LIV-2, LIV-14, Ren-17, Ren-22, P-6, LU-7, L.I.-11.

  29. Lung Patterns

  30. Lung Deficiency Patterns • LUNG-QI DEFICIENCY Points: LU-9, LU-7, Ren-6, BL-13, Du-12, ST-36, Ren-12. • LUNG-YIN DEFICIENCY Points: LU-9, Ren-17, BL-43, BL-13, Du‐12, Ren-4, KI-6, Ren-12, SP-6, LU-10, LI-11. • LUNG DRYNESS Points: LU-9, Ren-4, KI-6, SP-6, Ren-12, ST-36.

  31. Lung Excess Patterns • INVASION OF LUNGS BY WIND-COLD Points: LU-7, BL-12, Du-16. • INVASION OF LUNGS BY WIND-HEAT Points: LU-7, L.I.-4, L.L-11, LU-11, Du-14, BL-12, Du-16, GB-20, TB-5. • INVASION OF LUNGS BY WIND-WATER Points: LU-7, L.I.-6, L.I.-7, L.I.-4, BL-12, Ren-9, BL-13, Du-26. • LUNG HEAT Points: LU-5, LU‐10 LU-7, LU‐1, LI‐11, BL-13.

  32. Lung Phlegm Patterns • PHLEGM-HEAT IN THE LUNGS Points: LU-5, LU-7, LU-10, L.I.-11, LU-1, BL-13, Ren-12, ST-40. • DRY-PHLEGM IN THE LUNGS Points: LU-9, LU-7, KI-6, Ren-12, ST-36, SP-6, BL-13, REN-17, ST-40 • DAMP-PHLEGM IN THE LUNGS Points: LU-5, LU-7, LU‐ 1, Ren-17, ST-40, P-6, Ren-22, Ren-12, Ren-9, BL-20, BL-13. • COLD-PHLEGM IN THE LUNGS Points: Same as Damp-Phlegm pattern, add BL-23. • PHLEGM-FLUIDS OBSTRUCTING THE LUNGS Points: LU-5, LU-9, Ren-17, BL-13, ST-40, BL-43, Ren-12, ST-36, Ren-9, BL-20, BL-23.

  33. Spleen Patterns

  34. Spleen Deficiency Patterns • SPLEEN-QI DEFICIENCY Points: Ren-12, ST-36, SP-3, SP-6, BL-20, BL-21. • SPLEEN-YANG DEFICIENCY Points: same as for Spleen-Qi deficiency, add SP-9, Ren-9, ST-28, BL-22. • SPLEEN-QI SINKING Points: same as Spleen-Qi deficiency, plus Du-20, Ren-6, ST‐21, Du-1. • SPLEEN NOT CONTROLLING BLOOD Points: same as Spleen-Qi deficiency, plus: SP-10, BL-17, SP-1.

  35. Spleen Excess patterns • COLD-DAMPNESS INVADING THE SPLEEN Points: SP-9, SP-6, Ren-12, SP-3, ST-8. • DAMP-HEAT INVADING THE SPLEEN Points: SP-9, SP-6, Ren-12, SP-3, ST-8, BL-22, BL-20, REN-9, REN-11, ST-22, ST-28.

  36. Kidney Patterns

  37. Kidney Qi/Yang Deficiency Patterns • KIDNEY-YANG DEFICIENCY Points: BL-23, Du-4, Ren-4, Ren-6, KI-3, KI-7, BL-52, extra point Jinggong (0.5 cun lateral to BL-52). • KIDNEY-QI NOT FIRM Points: BL-23, Du-4, KI-3, BL-52, Ren-4, extra point Jinggong. • KIDNEY-YANG DEFICIENT, WATER OVERFLOWING Points: Du-4, BL-23, BL-22, BL-20, Ren-9, ST-28, SP-9, SP‐6, KI-7. For Heart add Du-14 (moxa), BL-15. For Lungs add LU-7, BL-13, Du-12. • KIDNEYS FAILING TO RECEIVE QI Points: KI-3, LU-7, KI-6, ST-36, BL‐ 23, Du-4, Ren-6, Ren-17, KI-25, Du-12, KI-7.

  38. Kidney Yin/Jing Deficiency Patterns • KIDNEY-YIN DEFICIENCY Points: Ren-4, KI-3, KI-6, KI-10, KI-9, SP-6, Ren-1. • KIDNEY-YIN DEFICIENT, EMPTY-FIRE BLAZING Points: KI-3, KI-6, KI-2, KI-9, Ren-4, KI-10, SP-6, HE-5, LU-7, LU-10. • KIDNEY-ESSENCE DEFICIENCY Points: KI-3, KI-6, Ren-4, BL-23, Du-4, GB-39, Du-20, Du-14, BL-15, BL-11.

  39. COMBINED PATTERNS

  40. Kidney Combination Patterns • KIDNEY- AND LIVER-YIN DEFICIENCY Points: KI-3, KI-6, LIV‐8, Ren-4, BL-23, BL‐20, BL-17, BL-18, BL-10, Du-20. • KIDNEY AND HEART NOT HARMONIZED Points: HE-7, HE-6, HE‐5, Yintang, BL-15, Ren-15, GB-13, Du-24, KI-3, KI-10, KI-9, Ren-4, P-6, SP-6. • KIDNEY- AND SPLEEN-YANG DEFICIENCY Points: KI-3, KI-7, BL-23, Du-4, BL-20, BL-21, ST-36, Ren-6, ST-37, ST-25, BL-25.

  41. Stomach Patterns

  42. STOMACH DEFICIENT & COLD Points: ST-36, Ren-12, BL-20, BL-21, Ren-6. • COLD INVADING THE STOMACH Points: ST-21, SP-4, Ren-13, ST-34. • STOMACH-YIN DEFICIENCY Points: Ren-12, ST-36, SP-6, SP-3, ST-44. • STOMACH-FIRE Points: ST-21, Ren-13, ST-44, ST-45, SP-6, Ren-12, P-6. • DAMP-HEAT IN THE STOMACH Points: SP-9, L.I.-11, LI-4, ST-34, REN-9, REN-11, REN-12, REN-13, ST-21, ST-25, ST-40, ST-44 • RETENTION OF FOOD IN THE STOMACH Points: Ren-13, Ren-10, ST-21, ST-44, ST-45, SP-4, P-6. • STASIS OF BLOOD IN THE STOMACH Points: Ren-10, ST-21, ST-34, SP-10, BL-17, BL-18.

  43. Small Intestine Patterns • FULL-HEAT IN THE SMALL INTESTINE Points: S.I.-2, S.I.-5, HE-5, HE-8, ST-39. • SMALL INTESTINE DEFICIENT AND COLD Points: Ren-6, ST-25, ST-39, ST-36, BL-20, BL-27.

  44. Large Intestine Patterns

  45. DAMP-HEAT IN THE LARGE INTESTINE Points: SP-9, SP-6, Ren-3, BL-22, ST-25, BL-25, BL-17, Ren-12, L.I.-11, ST-37, BL-20. • HEAT IN THE LARGE INTESTINE Points: Ren-4, L.I.-11, ST-37, ST-44, L.I.-2, SP-6, KI-6, Ren‐12. • COLD INVADING THE LARGE INTESTINE Points: ST-37, ST-25, ST-36, SP-6, LIV-3, ST-27. • LARGE INTESTINE DRY Points: ST-36, SP-6, KI-6, Ren-4. • LARGE INTESTINE COLD Points: ST-25, Ren-6, ST-36, ST-37, BL-25, BL-20.

  46. Gall Bladder Patterns • GALL-BLADDER DAMP-HEAT Points: G.B.-24, LIV-14, Ren-12, G.B.-34, Dannangxue, Du-9, BL-19, BL-18, BL-20, L.I.-11, T.B.-6. • GALL-BLADDER DEFICIENT Points: G.B.-40.

  47. Bladder Patterns • DAMP-HEAT IN THE BLADDER Points: SP-9, SP-6, BL-22, BL-28, Ren-3, BL-63, BL-66. • DAMP-COLD IN THE BLADDER Points: SP-9, SP-6, BL-22, Ren-3, ST-28, Ren-9, BL-28.

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