Tong's Acupuncture

The family lineage of Tong's acupuncture was written about by both Miriam Lee and [a version of it] by Richard Tan. In both cases, the power of this single-needle style acupuncture seems both strange and different.

There is no doubt this form of acupuncture can work wonders. In local public health sites, it proved its claims. It may be particularly good as an alternative system for pain treatments. Of course there is relevance for internal medicine.

The writings of Dr Yang, Wei-Chieh of Los Angeles, being translated, may be the best yet on this subject. His 3-day presentation in OCOM's DAOM program gave a taste of the coming book. We were encouraged by him to share this information. Readers who like this approach are referred to his book. Yang married Tong's daughter, and could be his top student prior to Tong's passing.

His work is unique in that it bridges the gap between Tong's Acupuncture and contemporary TCM through the NeiJing/Inner Classic.

The notes follow in rough format for the topic of treating pain with acupuncture:

Tong Acupuncture

Dr Yang, Wei-Chieh

3/5/05 --30th anniv.of Tong's death.

Over 40 yrs lic. exp.

He uses Tong pts 60-80% of time.

His book is ZhenJiu JingWei in Chinese, Korean, and soon English.

For now, have a look at Miriam Lee’s Master Tong’s Acupuncture.

Principles of Tong Ac--

• Local areas never needled.
• Contralateral.
• Distal treatment- the further the better.

Use few needles first: try unilateral first; if no effect, go bilateral.

For excess, sometimes same side is used.

Bleeding is always same side.

Said to have advantage in less frequently timed tx, when daily tx not possible.

Based on Neijing and I Ching.

Reading these will help.

HEADACHE-

~SJ 2, LI 3- best pts. Latter pt: needle close to the bone as possible --best for ANY type of pain.

Former pt is just prox of SJ 2 and called SanCha. This is the #3 of the ~BaXie pts. Tx thigh pain immediately: also for sleepiness. Can needle deeply, which will get shaoyang and taiyang since SI 3 will be accessed there. This pt was revealed a few yrs before Tong died. Needling close to bone, into tendon/ligament level tx liver.

For pn from trauma: 1 cun below ST 34 -- Jie Xue: Untie. Could use ST 34. XiCleft principle applies here.

Also the use of yangming to regulate qi and blood.

shu stream pts tx heaviness of body, pain of joints: many of them are used.

for yangming headache, ST 43 is used: the shu-stream. Note that yangming channel traverses TaiYang!!

ShaoYang- GB 43

UB 65 for taiyang

--shu stream.

Vertex: liver 3 oft used --a shu-stream. Others use KI 1.

Du 20 tx sore throat since it tx head, tailbone since it is opposite end of spine. Du 1 bled for h/a. And K-1

So this one pt has 3 possible correspondences.

He uses UB 65 for vertex h/a --shu stream. Water promotes wood in this case.

frontal h/a- LI 3 very effective: shu. SP 4 very good also since Luo pt to activate sp st relationship.

prolonged h/a affects KI, so needle close to bone in chronic conditions. So needle LR 3, ST 43 more proximal to get closer to bone. These pts have their own names in Tong Ac.

LR 3's is HuoZhu / Ht Master- very impt for HT dz. the TaiChong pulse is here. So using this tx blood vessels and Ht.

Coma: usually Du 26, PC 6. If no effect, use HuoZhu above LR 3.

HuoZhu above LR 3 is also special pt for knee pain. Ancient texts had LR 3 for this joint; HuoZhu is better.

This pt tx chronic sore throat, since liver channel goes thru deep level of throat. Also as earth pt on wood channel, can tx earth-wood issues: fibromyalgia, stomachache, etc.

Tong always needled close to bone. Chronic dz always affects KI, which is affected by both yin and Qi deficiencies over time.

LU 5 releases spasm of palmar aspect of fingers, frozen shoulder.

Achilles for neck spasm.

5 pts for knee pn:

PC 6 contralat. w/ LR 3/HuoZhu ipsilat. to tx jueyin.

always move joint during tx.

Core of Tong Ac:

• PC-ST
• KI- SJ
• LU-UB
• SP- SI
• HT-GB
• LR-LI

Examples: pc 5 for hiccup: metal pt. in NeiJing metal used for voice issues.

P 7 for mouth sores.

80-90% of knee pain comes from the Heart. NeiJing: tx blood to calm the wind; wind and blood very related.

Bi tx by 4 gates. LI 4 master of Qi, LR 3 masters blood.

will help tendon-level pain. Essential for Parkinson's Dz. Mild insomnia.

Between LingGu and LI 3 is JianGu: middle jiao. LI 3 is upper jiao. So the whole bone is a hologram.

Use LR 2 for fire instead of 3.

Best result for insomnia: bleed ear apex. better than any other acup or herbal tx.

This pt is a super pt., along with SJ 2 area.

A goal is to find these super pts., with many indications.

Thumb has most impt pts., along with great toe: it has two very important Jing pts.

Yuan source pts closely related to KI and SJ.

Back to knee pn: 44.06 tx

Uh-Oh: some pts in this system have the same name, but different locations as TCM!!!

This uses muscle to tx muscle: thickness of deltoid. But this just works with weakness, difficult to raise leg.

33.12 XinMen tx bone spur issues on knee (harder to go downstairs than up). Also tailbone pn. Ex: knee pn: this pt with LR 3 close to bone.

Chronic stubborn pain requires more needles. Start unilateral, and then go bilateral.

Ce San Li 77.22, ce xia san li, ShenGuan 77.18 for chronic stubborn headaches.

ShenGuan is #1 for shoulder pain, frozen shoulder; frequent urination esp in elderly with qi xu, enlarged prostate; tonifies both KI and SP; diabetes, proteinuria; uremia (along with KI 3- earth pt of water ch; mirrors SP 9).

66.05 MenJin prox to ST 43: this is in the Top Ten Super pts. Wood pt on earth. Stomachache, diarrhea with pain better after defecation tx by TongXieYaoTong herbal formula. So this is good for most cases of diarrhea, dysmenorrhea, and droopy eyelids with SJ 2.

Because of name with 'metal' in it, it tx lung also: sinusitis: ST channel goes there.

In Tong Ac., a neighboring pt is often used to strengthen effect. Here ST 44 can be added. Then NeiJing calls this DaoMa. This is better for chronic conditions. 'You could miss the point, but not the channel.' So needling PC 7 and 5 will affect PC 6.

Tong applied 3 points sometimes.

Moving joints during tx draws qi to them: essential.

Forearm is upper, middle low jiao: PC 6 or SJ 6 upper, GanMen middle, XinMen lower: knee, coccyx.

Same for upper arm: LI 11 tx upper jiao: dizziness. Menieres syndrome use this pt with PC 6. JianZhong mentioned above tx Sp Damp in lower jiao: leucorrhea.

Face- upper middle and lower Ji. Du 26 is lower-mid, so low back. Pts on this line at SI 18 tx renal stones.

Thigh- upper towards knee --all the limbs are upside down, like the ear. The 3 SiMa pts 88.17-19 are jiaos.

The Huang pts.

Lower leg-SP 9 headache, ShenGuan just below it for shoulder; KI 7 for lower jiao.

Inner foot- SP 4 for mid jiao, SP 1 for lower jiao: hernia, uterine bleeding -- reverse of reflexology -- use both pts for uterine bleeding, since liver stores and spleen controls. Jing wells manage orifices.

Temporal relationship: Jing well for acute, and then moves up. Ying and shu streams dominate channels and exterior. Use wood pts for wind, liver, tendon... etc.

Shu stream Earth pts are also used for intermittent symptoms: Shaoyang syndrome, since it’s in the middle, as is the Shaoyang. XiaoChaiHuTang is used in difficult diseases. Shu stream pts are pivotal. therefore for pain, the She streams are often used.

He Sea are for Fu organs, since on yang channels they pertain to Earth.

Tong used the pts on the thigh a lot for chronic conditions, the three lines on the anterior aspect.

Chronic conditions also proceed to blood stasis, in tong's view. That's why he bled he-sea pts.

Acute: Jing well, common cold ying-spring, half interior: shu-stream, and chronic: he-sea.

3x/wk perfect, since by 3rd day the tx effect is subsiding. 2x OK.

1x not enough so must use herbs.

Tong used blood letting 30% of time. Blood stasis involved in difficult, chronic cases since Ming theorists. Also collaterals/luo are involved in chronic dz. Bleeding gives longer effect.

Bleeding TaiYang for headache and UB 40 for 'roids are examples.

Trigeminal Neuralgia-

CeSanLi x2, which are BETWEEN yangming and shaoyang. LI 3, SI 3 also possible additions. Electric sharp pains, going up and down like shaoyang, so use shu stream pt. Epilepsy and malaria are also shaoyangy this way, so shu-stream good. SI 3, LI 3 are wood and shu-stream pts.

or use 66.06, 7/ MuLiu, MuDou between yangming and shaoyang on middle toe.

or bleed ear apex.

or bleed TaiYang: ancients bled a lot to clear head.

bleeding:

LI 11 tx chest,

LU 5 does st, lu, ht

UB 40

BLEED SAME SIDE, not opposite. Nerves cross over, not blood vessels.

sore throat: bleed SJ 2 with LU 10 on opp sides of either. He prefers to needle SJ 2. Have patient swallow.

or bleed ear apex.

if chronic, LR 3 could be very good.

San Jiao 2 = ~San Cha #3.

Retain 20-30 mins. generally.

Neck pain, stiffness: Ren 24 is ancient pt: ant/post relationship; better extension /flexion limitation; use w/ SI 3.

or SI 3, UB 65: LingShu 26 left right rotation= taiyang. Foot is better to use here.

All directions- use all 3.

or into achilles tendon to tx tendon issue, incl spasm. These are good for whiplash: 77.01, 2.

UB57 tx uterine spasm.

ShenGuan tx neck and shoulder. LU 10 area tx that, and back also.

Severe nausea: bleed between Du 16, 15.

Acute low back at left outer KI shu pt: use front corresponding pt, but opp side.

A tender pt is not always evident with contralateral needling, but results are better if you can find it.

Contralaterality:

1. same name: taiyang, taiyang. ex: GB 41 and SJ 3 are paired, so can use latter pt for DaiMai low back pain instead. Likewise, SI 1 can be subbed for UB 67 to turn fetus.

Finger pain- 5 Tigers Wu Hu #1, the most distal of these. Not over bone, but in soft tissue next to it. Bilat., but add SJ 5 opp worse side if one side is worse off.

#5 tx heel pain and ankle sprain, though for the latter LingGu used more -- or needle XiaoJie / Small Joint, an unlisted pt below #5, thru thenar eminence towards PC 7; make a fist to find it.

Shoulder pain-

ShenGuan very good, often with GB 31.

Latter pt tx lateral pain, strong sedative; in his top 10 super point category.

NeiJing says that GB tx all dz in all other channels. this is from the GB-Ht relationship, along with its ubiquitous scalp points.

LingShu- Shaoyang dominates bones, Taiyang the tendons. So UB 65, SI 3 tx tendons. GB 34 indicated for bones as well as tendons. Of course there's GB 39. GB 31 best for bone spurs. Others: DU 26, SI 3, UB 65 since that channels parallels spine.

With ShenGuan for shoulder pain, one can add Yin or Yang LingQuan / SP 9, GB 34. Use the yin side when internal, and yang side with invasions. In the elderly, both are often at play.

KI deficiencies lead to increased chance of shoulder dislocation. Use Liu Wei Di Huang Wan as preventive.

There's 40 points for shoulder pain. ST 38 is conventional, or 37 --all good.

Zhong Ping- ex pt 1 c below ST 36 for shoulder pain. Much research on this.

LU also tx shoulder pain- reduce this water pt to sedate channel, activate Ke cycle; also close to tendon. If they are shaking, its wind of course: use PC 3. Also use affected side in this case.

Fifty year shoulder- 3-4 month duration requires longer tx, about 10. Often cervical involvement.

If harder to move forward= yangming; back = shaoyang, so use GB 34 or Zu Qian Jin, Zu Wu Jin p.98 #77.24, 25.

His favorite for general shoulder pain is SP 9, ~9, GB 34, LI 3 as guiding pt on affected side. These guiding pts are literally 'traction' pts, and are often shu-stream.

Example: UB 65 for sciatica on affected side to guide LingGu DaBai. The latter are therapeutic points -- always contralateral -- and the former are guiding (traction) points. This guiding method is Yang's addition: Tong didn't use them.

Sciatica- LingGu DaBai, no matter what channel.

L5/S1 usually taiyang radiation. No other points are better than these 2 for this!!! If mild, they are enough. Add more for more severity.

Case- severe sciatica with bone spur L5/S1: DU 26, SI 3, LingGu-DaBai alternating, GB 41, UB 65, blood letting UB 40 --but no more than 6 needles. Tx in afternoon for this patient were found to be better.

Number of needles-

A Ming dynasty doctor said not to make patients into a hedgehog.

If once a week, could be up to 8 needles. More frequent tx allows fewer needles.

Social changes in past 30 years have made patients unable to come in but once a week --and they have more health issues. Life spans increasing makes for more severe diseases. Therefore more needles are required now. However the goal of using fewer needles to attain better results applies.

Depth of insertion-

Point selection depends upon both space and time, as mentioned above. Three depths: heaven, human, earth. More superficial insertions affect higher regions in the body.

For ST 36, depth is crucial. It is like dosage in herbology. Heaven layer or first cun, mid human layer = 1.5 cun, for upper jiao, must get to earth layer at 2 cun. So the deeper here, the further away the point you get an effect.

SI 3: shoulder pain, so heaven layer = 1 cun. Low back: 1.5; leg pain = earth. Again, deeper is further away.

Severe diseases require depth.

Shallow, Heaven tx yang pathogens, such as EPI.

Yin pathogens, like Damp, are at human level.

Antipathogenic qi is at the deepest, earth layer. So deep needling strengthens upright qi. Likewise he-sea pts like LI 11 strengthen antipathogenic qi.

Retain needles longer with deeper insertions. Could go up to one hour.

Tong retained needles for ~45 minutes, since most of his patients had chronic conditions. Research in Shanghai found 40-50 minutes to be optimal for TCM tx, confirming this. But market economies speed up time. Yang leaves them in between 30-60 minutes. Blood circulates with qi, etc. every 28 minutes, 48 secs, described in NeiJing. So he does tx in 30 minute blocks.

Timing of Tx- Taiyang channel time is afternoon, which is why the sciatica case above worked better in afternoon. Bleeding UB 40 afternoon is best, but bleeding TaiYang best at noon.

The circulation in the Ren and Du mai- Ren 1=midnight, 1-3 am=Du 2; 3-5=Mingmen; 5-7=Du 8, 7-9=Du 12; 9-11=Du 16, noon=Du 20, 1-3 pm = Du 26 --so bleeding this pt afternoon is better. 3-5 PM =Ren 22, 5-7 pm = Ren 17, 7-9 pm = Ren 12; 9-11 = Rn 4.

Therefore midnight to 3 pm is yang time.

Elbow pain-

LU 5 same side; can use opp but not as good.

many types of elbow pain.

Linggu on affected side is good for tennis elbow, which is bone. Needle to touch bone. Or tx LI 11 on opp side, but close to bone: not textbook location.

inner elbow / golfer or student elbow: SI 3 same side, Xinmen opp. 33.12

Wrist-

CeSan Li x 2 for Taiyang ch. or shaoyang pain. Or opp SI 4, same side SI 3.

Dorsal pain use SJ 5 opp.

Carpal tunnel: same.

Yanglingquan GB 34 also.

Thigh-

SJ 2 close to bone, aka San Cha 3, esp for anterior.

more medial or jueyin channel: XinMen.

Lower leg-

unlisted point for leg distention and pain: Ci Bai- between LuoZhen and SJ 3.

This point also tx neck, but not as well as LuoZhen.

JingZhi DT.08 also which is bled on the back.

Stroke-

LingGu DaBai best to start with. Facial paralysis. If <6>70 or repeated stroke harder, though not impossible.

Case- coma post-stroke with kidney failure; mask over Du 26. Needled PC 6, KI 1. Bled jing-well points.

An Gong Niu Huang Wan pills for stroke. Urination resumed and he awoke on 5th day. Completely recovered after 3 mos. Once a week tx.

He does a lot of these. Key points are bleeding jing-wells (even if on blood thinner) and using this medication.

Sometimes adds Du 20.

Resolve phlegm, move blood. Long dan cao helps to lower cranial pressure. TingLiZi eliminates cranial edema, also from ht/lu. Shichuangpu, gouqizi.

Tong tx stroke with Mu Huo / Wood Fire 7-8 mins. only, then tx LingGu DaBai. Stop after 7 tx with Mu Huo. This pt is between wood of jing-well and fire of ying-spring, hence wood-fire.

ShenGuan good to add at that point. If mental disorders, add Du 20, 24.

Liver and Heart are only 2 channels to go to head: wood and fire ascend.

He locates Du 20 at OCOM location it looks like: Du 20 here is posterior, at posterior fontanel.

PC 6 TX both brady- and tachycardia. ST 36 regulates ST acid.

LingGu is close to LI 5, DaBai is Wood, so these are like wood- fire. Close to bone, so Kidney. DaBai is big white, so has Lung relationship. What's left?

Sciatica = qi deficiency, sometimes stagnation to Tong.

Chest pain-

PC 6 necessary.

If lateral, Si Ma could be good, since they tx Lung.

Angina- bleed PC 3, LU 5; needle ST 36, PC 6.

Ex pt HuoBao on underside of 2nd toe 55.01--Dr So used this point a lot for all kinds of things, according to Eric. This is ST toe linked with PC.

Case- female with stroke. PC 6, ST 36, and SiHua Wai: most important pt for blood letting. Look for blue veins. 3 fen lat to ST 40. FOR CHRONIC, STUBBORN, DIFFICULT CONDITIONS THERE MUST BE BLOOD STASIS. For STRANGE, COMPLICATED ONES, ITS PHLEGM. This point is close to ST 40, so there you go: when bled, its a double whammy, super combination. Lowers cholesterol!! Also bleed back shu pts for ht, pc for additional effect.

Breast pain-

Nipple = St Ch- ST 34.

Breast is related to Liver, so tx LR 3. ST 43, which also tx lower abdominal pain.

Umbilicus-

half cun prox to SI 3: Wan Shun. Its twin is another half cun proximal. Use both.

Males left, females right is classical idea that works here.

Ribs-

SJ 6, GB 34.

GB 31 also helps, esp for cholecystitis/ gallstones.

Add GB 32 for added effect.

Herpes at ribs- bleed Si Hua Wai, mentioned above. Also tx head, face herpes. Simpler to bleed Ear Apex, but keep SJ 6, GB 34. BLEED AFFECTED SIDE, remember.

Low Back-

There are dozens...

Du mai- Du 26.

UB ch- SI 3 or B 65.

Dai Mai, more lateral: SJ 3.

Radiating to butt- LingGu.

Kidney stone- SI 18 'Ma Jin' go a half cun below even better: Ma Kuai Shui which tx renal stones in bladder.

Add SJ 3.5 for renal colic and gallstone pain.

SJ 3, 3.5 good for low back, nephritis.

Urethral pain-

SI 18 again, or just below.

Also 2 pts on index finger: Wai Jian, Fu Fian.

Add LR 2, LongDanXieGan Tang, etc. He uses Si Nie San plus JieGeng, Fuling. Niuxi possible, or if acute could add pugongying. He doesn't: it's very gentle and effective as it is.

Classical-based herbalists use fewer herbs. Same in acupuncture.

3/4/05

Ear apex bled for menopausal sx- noc sweats, insom.

SuWen mentions a Heart- ear connection.

Sweat is the fluid of the Ht.

That's why it works here.

XinMen helps sweating as well.

SangYe taken as a tea is gentle daily intervention.

**Bleeding Apex tx low back pain**

A channel branch goes from Du-20 to the Ear.

Fleshy ear helix indicates weak HT, along with soft personality. A hot helix denotes hot personality.

Early menses- heat,

late- cold,

s.t. both- Liver

irreg. - Sp

Eating and drinking draw qi to the core. Rice does this especially. Most pain is in limbs, as are ancient points. Pregnancy is a good time to eat rice- type foods.

Shen Guan tx finger pain also.

Stroke tx- manipulate Lu-5 close to tendon in on inhale. out on exhale.

Case- MuHuo, then Lu-5, then LI 3, 4 with Du 20 + just posterior.

Pulse increases with hunger.

Pregnancy- don't tx deep.

Pulse palpable on sides of mid finger that moves toward tip with progression of pregnancy. Male fetus has stronger left pulse, redder face.

Demo- SJ ~3, Apex

Bleeding needs to be at a sufficient amount, otherwise the results are limited.

The hand, like the face, ear, etc., is a TaiJi with BaGua. This is the answer to why seemingly random pts on the hand are grouped together.

Bleeding is better for heart disease the regular needling.

He hasn't used moxa in over 3 yrs due to local cultural constraints. He does use it at home. Moxa, cupping, blood letting, needling are the 4 main methods.

Foods to avoid to speed tx for pain:

ice, ice drinks

banana

greasy sticky fruit

(glutinous) 'sticky rice'

duck- cold (chicken is warm)

shrimp- hot

bamboo shoot

If 5 tx have no effect, check blood for RA/ rheumatoid arthritis or lupus.

Tong bled about 30% of his patients, the most severe cases. He never used herbs.

Yang uses ear pts for addictions.

Bent over back, forward or backward- Du 26, LI 11, and UB 60. The latter pt treats whole spine.

Dr Yang's father practiced martial arts. Yang practices qigong. For acupuncturists it is very advisable to practice some kind of breathing qigong. Herbalists don't need this as much. It's easy to get tired after treating 30 patients with acupuncture, or 100 with herbs. Needling consumes some qi. If you're strong, it's no problem. If you have weak patients, then you really need to take care.

The top ten super points-

most already mentioned.

1. Fu Ke- Gyn, all kinds, incl malposition, bleeding, myoma, infertility (add Huan Chao 11.06 opp side, alternating sides ea tx. May add ex pt betw SP 6 & malleolus where pricking a blue vein helps greatly). Best herb formula for miscarriage: Tai Shan Pan Shi San- also tx infertility. KI xu and bld stag are 2 major causes of infertility. Gui Zhi Fu Ling Wan + Danggui Shaoyao San for this also. Wen Jing Tang a personal favorite.
2. Ling Gu- Super pt of Super pts. Regulates qi, warms yang. Hemiplegia w/ Da Bai, with GB 31, Jian Zhong --same name, diff loc than TCM. Adding scalp for hemiplegia even better. Sciatica of any type, better than any conventional channel pt., w/ LI 3. By itself, Ling Gu tx elbow pn (ipsilateral), dizziness, groin (bilat) and inguinal pain (contralat), frozen shoulder, back pain, tinnitus, low appetite.
3. San Cha #3 near SJ 2 but closer to bone --for common cold, 5 sense organs, esp for sore throat, tinnitus, deafness, back pain, toothache; with DaBai for all headaches, thigh, myasthenia gravis esp of eyes, tachycardia, urticaria.
4. Men Jin 66.05- ST 43 closer to bone, "Gate of Metal", wood pt of earth channel and therefore versatile. For various gastroenteritis and diarrhea, migraine of taiyang, nasal obstruction, abdominal distention and bloating, dysmenorrhea, rectal prolapse.
5. Huo Zhu- closer to bone from LR 3. 'Fire Master". Palpable pulse. Special for HT failure, weakness, headache from HT; uterus- myoma, This is a more ancient location of LR 3. This gets wood- tendon and earth- flesh, and close to bone so helps KI: Most impt pt for rheumatism- difficult walking. Gastric problems from wood/earth probs. Dizziness, vertex h/a. Sore throat. Facial paralysis: deviated mouth and eyes. Combine with LingGu as the 'Posterior 4 Gates' / Hou Si Guan. Systemic pain, such as FM/ Fibromyalgia. By itself for genital and urinary problems, such as Lin Syndrome. TMJ/TMD.
6. Ear Apex- bleed it for extensive effects, incl common cold, migraine, hypertension, acute conjunctivitis, best one for insomnia, palpitations, profuse or nocturnal sweating --very good-, various skin dz, Shaoyang is wind, Taiyang is exterior: skin disease is wind; the ears are Shaoyang. Kidney opens to ear; another classic text says the Heart also opens to the ear.
7. That's all for now... You figure out the rest.

Herbs for genital itching:

Kushen 9g, Shechuangzi 15g for external wash.