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The

Five Element Acupuncture Handbook SecondEdition

SharonM. Smith,L.Ac., Dipl.Ac.(NCCAOM) Illustrations by BarbaraDonelan

Acknowledgments ideas' I As with most major projects,thisbook is the productof manypeople'senergyand Grissmer'Haig thank my many teacheis.nobert Duggan,Dianne Connelly,Jack Daniel,..Jane and Cyrie Ignatius,Zoe Brenner,Erica Lazaro,JuliaMeasures,PeterMarinakis,Leslie Shapero for the first Barnes.EdnaBrandtgavemehernotesandgraciouslysupportedmeasI taughttheory tlme. this handbook The studentswho taught me over the yearswere a major influenceo|Jh: way and what could be was put together. They made many valuablesuggestionsabout what they liked fortunate to be with improved t-o make the material more helpful to ttrem as learners. I am so students. Barbara Rise Two studentswere especiallyinvaluableto the production of this handbook. and clarity to the Donelan made the information come alive. Her editing skills gave consistency to her for her grateful words. Her graphics added anotherdimensionto the material. I am deeply Element Acupuncture' dedication and skills and for the many interesting conversationsabout Five She is truly a marvel. asked great I also want to thank AlexandraKnox who stepped in for the final editing; she the material' The questions,researchedsources and made suggestionsfor further clarification of look- I appreciateher subtle changesshe made in fonts and layout gave the handbook a fresh new generousgifts of her time and talents. as the Worsley I deeply appreciate that J. R. Worsley brought the information together Tradition of Five Eiement Acupuncture. Thank you Professor Worsley' seemingly My husband John deservesa million kisses and hugs for his support as I spent endlesshours at the computer - hours I could have spent with him.

Introduction the clearerit is to methat therearemanywaysto reachthe ThemoreI studyacupuncture, sametherapeuticend. The method reflectedin this handbookis derived primarily from J.R. There alsoknownasleamingtonAcupuncture. Acupuncture, ofFiveElement Worsley'sformulation are other types of Five ElementAcupuncture,notably Meridian Therapy as developedby the Japanese. EnergeticBlocks,and PointClassificatiorq Concepts, Thehandbookconsistsoffour sections: in a brief, fashion.Ideasarepresented in snapshot TreatmentTechniques.Eachsectionis presented discussion. presentation and classroom un-elaboratedstyle and are then expandedupon during Studentsareinvitedto addtheir own notesto thesepages. Thishandbookexplainsa sliceofWorsleyFiveElementAcupuncture.Thetheorypresented is in realityjust oneof the waysthat Five ElementAcupuncturehasbeentaughtat the Traditional AcupunctureInstitutein Columbia,Maryland.Overtheyears,practitionershavecreatedvariations on Worsley'soriginalmaterial. Despitesuchvariations,the primary body of informationin this tradition hasheld constant. It is my intentionin this handbookto presentthe centraltheoretical frameworkfor basicenergeticconceptsandtreatment,ratherthanthe details. Someof theinformationincludedis not from Worsley'sFiveElementtraditioq for example, the Over-ControllingandViolation Cycles,andthe TransportingPoints.Suchconceptsarewidely usedby bothFive Elementandpractitionersof othertraditionsandstyles. Theyarehigtrlyvaluable in understandingenergetics,and give Five Element practitionersa broader vocabulary for conversation.Any materialthat is outsidethe boundariesof Worsley'sFive ElementAcupuncture will be notedas such. theory is to providea coherent The majorbenefitof this handbookon acupuncture patients. Theoryhelpsus organizeour patholory,andfor treating energetics, basisfor understanding ofpatients,developtreatmentplans,andgenerallyprovidesa frameby whichto structure observation our practic. of urupnncture.Theoryis simplythe body of knowledgeand principlesderivedfrom astuteobservationandextensiveclinicalexperience. Llltimately,this handbookis intendedto serveas a referenceand guidefor students.The who taughtme informationin this handbookis the combinedknowledgeof my manyteachers-those whenI wasa studentandthosewho continueto teachme. It is my hopethat this acquiredwisdom will enrichthe practiceof all my students. SherrySmith Columbia,Maryland July, 1998

Table of Contents lll

lntroduction

Acknowledsments Five ElementAcupuncture. a J

Concepts ShengCycle

5 6 7 8 9 l0 11 t2 13 l4 14 l6

Law of Mother/Child Ke Cycle

ChengCycle Wu Cycle Law of Midday/Ivlidnight Law ofleast Action Law of Cure . . .

Law ofHusband/Wife CausativeFactor Level of Treatment . . .

Causesof Disease Point Classification Types ofPoints Command Points

SourcePoints Xi Cleft Points EntrvlExit Points ConceptionVesselandGovernorVessel AssociatedEffect Points(AEPs) Front Mu Points UpperKidneyPoints OuterBladderLine Points Influential Points TransportingPoints Windowsofthe Slcy. . . . . . ReunionPoints ForbiddenPoints First Aid Points

t9 2l 22 28 30 3l

32 35 36 37 39 4l 42 45 46

47 49

Energetic Blocks

Blocks vll

EnergeticBlocks con't: InternalDragonsandExternal Dragons AggressiveEnergY Block Husband/Wife UmbilicalPulse

5l 54 57 60 6l 63

Akabane Quality on the Pulses

CV/GV Block Entry/Exit SpiritBlock

65

67

TreatmentTechniques Tonificationand Sedation

70 72 74

Needle Technique

Moxibustion.. . . Transfers Readings What is Five-ElementAcupuncture? FromLeamingtonAcupunctureto TCM andBack Again Factor:A Forum Causative CausativeFactor Why Do PeopleGet Sick? The ChineseView F i v e E l e me n tT re a tme n tPr inciples.... TheParadoxofParadigmsandPoints asMetaPhor Possession ClinicalNote: The Mystery of AggressiveEnergy MoxaStickUsage... ForbiddenPoints MeridianNamesandAbbreviations

""'81 " " 83 ' ' ' 97 " " 103 " 109 ' ' ' ' ' 115 ' "" l 2l " " " 123 ' ' 127 ' ' 133 "'135 ' ' 137 ' ' ' 139

r4l

Index

vllr

l

Five ElementAcupuncture FiveElementAcupunctureris basedon nature. The Chineseobservedthe cyclesof nature in the rhythmsof dayandnight,andin the movementof all asthey arereflectedin the seasons, living thingsthroughbirth, growth, declineanddeath.Humanbeings,aspart of nature,are governedby the samelaws. a The five elementsarewood, fire, eartlqmetal,andwater. Eachelementrepresents with each seasonin nature'scycleanda phaseof a person'senergy.Themeridiansassociated job in orderfor the elementarelikenedio * Official of a kingdom. EachOfficialmustdo its of the person'senergymust kingdomto prosper.Likewisein eachpersonthe variousaspects functionwell for the personto enjoygoodhealth. WhenoneOfficialbecomesunableto do its job, otherOfficialsmust stepin to fulfill thosefunctions.Five ElementAcupunctureseeksto strengthenand supportthe person'senergyso that all Officialsin the kingdomfunctionwell. of the five elementsis important. Eachelementaffectsandis The inter-relationships affectedby all the others. In a person,the dynamicsamongthe elementsare observedin orderto understandhow bestto treat a patientwith acupuncture. Emphasisis placedon the with a setof correspondences. Eachelementis associated by areobserved ofcolor, sound,odor,andemotion.Thesecorrespondences correspondences person. in the seeing asking,feelingandsmellingin orderto discernthe stateof the elements The personcanthenbe treatedaccordingly. The roots of the traditionofFive ElementAcupuncturego backto ancientChina.Using theseroots alongwith informationfrom othersources,Dr. J. R. Worsleyof LeamingtonSpa, asit is taughttoday-2Later the informationinto a systemof acupuncture England,synthesized generationsof practitionerscontinueto addto the body of knowledgethroughtheir own in the treatmentroom. experiences

I

See "What is Five Elerneot Acupuncture?" page 83, aad "From Lramington Acupuncture to TCM and Back Agairl" page97'

2

For detailed information, see Eckmaru Peter, In lhe Footsteps of lhe Yellow Empetor. Cypress Book Company, 1996-

ShengCycle Generatingcycle or Creative cycle

Definition Everything that exists, from a single cell to planet Earth, goes through its own cycle of birth, maturity, decline, and death. This is a cycle of creation; there is no beginning and no end. At any given moment everything is in a stageof the Shengor creation cycle. The cycle can be observed in u -orn.nq in a lifetime, and in all periods of time in between. With the five elements,each elementis generatedby the precedingelement.Water generatesWood, Wood generatesFire, and so forth. Characteristics Energy moves in a clockwise direction on the cycleThe Qi3 moving in the Sheng cycle is alwaysin motion. The flow of movement in this cycle is from Yin Official to Yin Official and Yang Official to Yang Official. The Qi in this cycle is sharedby pairedmeridians. Wood : growth Wood createsFire Fire = maximal growth Fire createsEarth Earth : balance Earth createsMetal Metal : decline Metal createsWater Water : maximal decline Water createsWood

Clinical Significance Explainshow the Qi flows, essentialto both diagnosisand treatment planning. Provides a pattern with which to direct the flow of Qi in the patient.

'

Qi is often lranslated from the Chinese as "enerry."

Law of Mother/Child

Definition

I

The law of Mother/Child is a relationship that perpetuatesthe Sheng cycle. That is, the mother generatesthe child. Each of the five elements,Water, Wood, Fire, Earth, and Metal, is generatedby the elementthat precedesit. Thus, each elementis the Mother of the succeedingelement. The succeeding elementis the Child element.

Characteristics Symptomsmay show up in the Mother and/or the Child. Pathologt occurs when one or both Mother and/or Child are out of balance. An excessiveMother will causejust as much trouble as a deficient Mother. A strong Child may be well even though the Mother is out of balance. A Child that is sick for a very long time will eventuallydepletethe Mother. A healthyMother and Child reinforce each other.

Clinical Significance In diagnosis,to discern the health of the Mother and Child. If an imbalanceoccurs in an element,the Mother and the Child4 of that element may also be unbalanced. Treating the Mother may help the Child. Treating the Child may help the Mother.

o

Not" th"l "Motte/' and "Child" are relative teros. For exa.nrple: (1) The relatiorship of two elements: Fire is the Mother of Earth aod Earth is the Child of Fire. (2) The relationship of tbree elernents: Fire is the Mother of Earth and Metal is the Child of Earth

Ke Cycle Controlcvcle

Definition The Kes cycle prevents the Shengcycle from getting out of control. The Grandmother controls the Child's growth. Characteristics The Ke cycle exists simultaneouslywith the Shengcycle. Patholog occurs when the Child's growth is over-controlled (Cheng qtcle, page 8/ or uncontrolled (Wu cycle, page 9). Either one is as harmful as no growth at all. Energy moves only from Yin Official to Yin Official on the Ke cycle. Ke cycle pathways do not generatetheir own energy.

Metaphorically:

Earth guidesWater Water coolsFire Fire warmsMetal Metal prunesWood Wood holdsEarth

Clinical Significance To discernthe influence of the Grandmother on the Child. The paths of the Ke cycle can be used to transfer energy from one Yin Official to another Yin Official.

5

AJ"o "K'o" in the Wade Giles rraosfiteration-

Law of MiddaYlVlidnight Definition two-hour time period Each meridian'senergyflow is highestand functioning optimally during a These eachday. Conversely,its energyflow is lowest during the oppositetime of day. two hour time periodsare illustratedon the ChineseClock.s During the high phase,the Official is most accessible' During the low phase,the Official is least accessible' Characteristics Providesa guide to observedaily cycles'standard' time. The time periods are expressedin sun or Clinical Significance In diagnosis,this is the time when a patientmay feel best or worst. This law may be used as a guide to set daily rhythms in one'slife. The Horary pointe is used during the high phaseto accessthe official. In praaice, the first paired meridian may be treated at the end of its high phase, and the second paired meridian at the beginning of its high phase.

| 2 3 a t 6f

a lrorrlar

Pm

2 t /1 5 5 I t Sr0lll2

am

Treat the Btadder/Ill lvleridian just before5PM sun time and sun time. the Kidney/TVMeridian just after 5P1s.f

8

The time periods are shown by the Chinese clock in the ceoter of the Worsley Five Elenrent chart

9

Horuy means..hourly."

See page 24 for discwion

of time and sonal

t0

usge of Horary points.

Law of LeastAction Definition Do aslittle aspossibleto initiatethe desiredeffect. andwork within naturallaws. Qive simple,clear,direct messages Characteristics to awakenthe profoundnaturalselfEffectivetreatmentprovidesall the stimulationnecessary healingpowers of the body/mind/spiritand supportsself-healing;doesnot do the healing' Practitionerencourages Clinical Significance A simpletreatmentmakesclearthe specificeffect of a treatment. In practice,take into account: CausativeFactor (CF)to Level of treatment:body/mind/spirit Time of day Time ofyear

l0

So p"g" 14 for a discussion of Causative Factor.

ll

Law of Cure Definition processes. The Law of Curetr describesthe order and precedenceof the natural healing According to the principle of Law of Cure, healing occurs: . in reverse chronological order, from most recent to oldest 'from aboveto below . from within to without . from most important organ to least important organ Characteristics To identify the Law of Cure after acupuncturetreatments: Law of Cure usually occurs within 24 to 48 hours after treatment. It usually lasts no longer than 72 hours.12If it's longer, it is not the Law of Cure. Note: Skin reactions may persist longer. The patieni has experiencedthe problem before. If the problem is something new, it's not Law of Cure. The Law of Cure can show up as an emotional catharsis.Ask how the patient is doing in herself. If the patient reports feeling better inside, and the reaction does not threaten the patient's weil-bling, let it run its course. When in doubt, give the patient appropriate directives toward other treatment modalities. Healing can begin on any level: body, mind, or spirit. The patient may experiencefurther recurrencesof the Law of Cure until all possible healing has taken place. Clinical Significance The Law of Cure in action indicates effective treatmentAllows the practitioner to distinguish effective treatment from a new illness or an adversereaction to treatment.

II American edilion of Co*tuotio" Hering ( 1800 - I S80), a German physicia4 first mentioned tbe phe,romenon in his introduction to the first ..Chronic Diseases" vAere le zuggjea thaf ne oUservea certain thingF happening as cure developed The most i'oteresting was a cutaneous eruptioo at are simple observations' rbe end of a long cure of ctuolric?isease. Tbe most certain patt€f,n he saw was tbe "reverse rder." All tle other patterns 12 Homeopalbs do Dot use lhis time Farne; law of Cure can go on for weeks or months.

L2

Law of HusbandAilife Definition Pulsesof the Officialson the left side belongto the Husband. Pulsesof the Officials on the right sidebelongto the Wife. proper balanceoccurs when the pulseson the left side are slightly stronger in quality and quantity than the pulses on the right side. Characteristics

On the left side: Sorter(SI) SupremeController(HT) DecisionMaker (GB) Planner(LR)

Left Side

will (Kr)

SI GB BL

On the right side: Receiver (LI-J") Eliminator (LI) Processor(ST) Transporter(SP) Heart Protector @C)

HT LR KI

Right Side

LU SP PC

LI ST TE

Pathologt existswhenthe right sidepulsesare strongerthanthe left sidepulses. Pulsequantityandqualitymay be out of balance. Clinical Significance whenthe right sideis strongern quolity and quantity thantheleft The pulsesareunbalanced side. imbalanceindicatesa seriouscondition;it showsthat the patienthasgivenup A Husband/TVife controlof the directionof his/herlife; thereis a lack of movement. Whenpresent,a Husband/Wifeimbalancemayblock the cleardiscernmentof CFt3. Requireshigh-prioritytreatmentattention.

13

For a discussionofCF, seepage 14.

t3

CausativeFactor the concept in a The idea of CausativeFactor (CF)tn is a dynamic concept. Most practitioners use as the diagnosed highly personal way. One practitioner may treat only the elementthat has been for observing a patient's CF. Another might apply - itr. id"u of CF loosely, using it as a basis clear about energy in the moment. ivh"n having a conversationabout CF, both people have to be eachone's working definition. Definition CF is a term used in Worsley Five Element Acupuncture. It has beenunderstood as: . . .

The root problem or imbalance.One elementis the root causeof imbalance; A person's constitution, where an individual is designatedto be of one elementaltyPe; The central focus for treatment. This would be the elementthat has the greatest positive imPact on the Patient'

Characteristics May arise when a patient's energy cannot fully recover from the impact of congenital, constitutional, or emotional factors. It can also develop from physical trauma or illness. Where the most slgns- color, emotion, sound and /or odor - correspond to a given element. That element is determinedto be the CF. @xample: yellow color, singng voice and fragrant odor would classify a patient as an Earth CF). Reflects the interplay of energetic dynamics and phenomenain a person. A place of personalstruggle as well as a place of outward accomplishment. Clinical Significance

CF is the elementthroughwhich the patientreceivesthe most supportand makesthe most improvements. Treatingthe CF will affectall the other Officials. Treatingthe CF changesall the pulsesexceptsometimesthe CF itself. Experiencedpractitionersreport that one majorpoint of treatment(that is, one element)is clearin only aboutone-thirdof their patients.In anotherthird, two elementshave of impact. In the rest of their patients,the phenomena equalor indistinguishable two even pin one or to to the individualandhis or her symptomsaretoo complex elements.

lasee

"Carrsative Fac{or: AForunr," page 103, and "In Response'..Calsative Factor," page 109

l4

Causesof Disease Definition influences' Diseaset5reflectsthe bodyimind/spirit'sresponseto pathogenic world and to its own inner outside the to The body/mind/spirit has an equilibrium in ielation world: without equilibrium,diseaseoccurs' pathogensand keep the balancein Anti-pathogenic Qi, or Upright Qi, is the body's ability to fight of the pathogen and the antithe body. The practitioner needsto considerihe relative strength pathogenicQi (Diagram 1).

Diagram I pathogenic influence Diseasecan occur when the balancebetweenthe anti-pathogenicQi and the external changes or breaks down. Either the body is not sufficiently strong to adapt to internal

(Diagram2):

Diagram 2 3) or the external or internal influencesare too powerful for the body to adapt @iagram

Diagram 3 or a combination of both a weak anti-pathogenicQi and strong pathogen occurs'

t5

S"" "Why Do People Get Sick? A ChineseView," page I 15

16

Annut *|,esc--

Internal Causesof Disease:The Emotions Joy Anger Sadness Grief Worry, pensiveness Fear Fright 4 za+e- N-(

External Causesof Disease:Climate n Eat;lL

Wind Cold Fire - Heat Dryness SummerHeat Damp The abovecanbe combined;for example:wind-cold,damp-heat,etc.

MiscellaneousCausesof Disease Constitutio4 heredity Traum4 injury, surgery poisons,ePidemics Parasites, Wrong treatment Lifestyle Overwork, fatigue Underwork Sex Diet

Clinical Significance Knowing the causeof diseasewill influencethe choiceof treatment. Knowing the causeof diseaseallowsfor effectivepatienteducationto a particularcauseof disease' A patient'sCF maymakehim/hermore susoeptible Causeof diseaseis not the CF.

T7

Typesof Points Commandpoints: . Elementpoints: Horary Points TonificationPoints SedationPoints . Junctionpoints Sourcepoints Xi Cleft or AccumulationPoints EntrylExit points ConceptionVessel GovernorVessel AssociatedEffectPoints(AEPs) or Back Shupoints Front Mu or Alarm Points UpperKidneyor Spirit Points OuterBladderLine Points Influential or GatheringPoints Transportingpoints: ' JinBWell Points ' Ying SPringPoints . ShuStreampoints ' JingRiver points . He Seapoints . Lower Uniting points Windowsofthe Sky Reunionor CrossingPoints Forbiddenpoints First Aid pointsr5

16 The above list is not all-inclusive.

2l

ElementPoints Definition elements' Command points on the meridiansthat representeach of the five Characteristics Include horary, tonificatiorq and sedationpoints' the Shengcycle Their order on the meridiansand the body is distal to proximal and follows

on thei"*T:::tans.

tu'fln il -r f a-IvxFs Wood-+Fire-+ Earth-+ Metal Water. (So'trce

-+ Water -+ Wood -+ Fire + Earth. On the Yang meridians: Metal Clinical Significance

The nature or energy of each elementbecomesaccessibleat thesepoints' Ke cycles' Used to transfer .nogy from one elementto another following the Sheng and

23

.

(3oorcet4x'ts &tlq''' C'ob {

Horary Points Definition to its elementwhenusedaccordingto the Law of Thepointon eachmeridianthat correspond MiddayAvlidnightor in the seasonof the element. Example:the Wood point on the Gall BladdermeridiaqGB 4l from l lPM to lAM andlor duringthe spring.Seethe point tablebelow. Characteristics duringits horarytime. Powerfi.rlbecausethe energyof a meridianis moreaccessible Are not assafeas sourcepoints. Theytreatthe Officialswithout transferringenergyfrom or to anothermeridian. Clinical Significance time. Usedto treat the meridianat its most accessible seasorLcarriesan enhancedeffect. Whenusedin its corresponding treatments. Canbe usedalonefor seasonal Are generallytoffied but canbe sedated. Points Metal. Earth: Fire: Water: Fire. Wood:

LU8 LI 1 S T3 6 SP3 Fil8 SI5 BL 66 KI 10 PC8 TE6 GB 4I LRI

MeridianGutter MerchantYang Leg ThreeMiles SupremeWhite LesserPalace Yang Valley PenetratingValley Yin Valley Palaceof Weariness BranchDitch Foot AboveTears GreatEsteem

24

3AM-5AN4 5AM-7ANd 7AM-9ANd 9 Alvl - ll AM IIAM-IPM IPM-3PM 3PM-5PM 5PM-7PM 7PM.9PM 9PM-IlPM llPM-1AI{ lANd-3AM

TonificationPoints Definition The elementpoint of theprecedingelementon the Shengcycle,i.e.,the Mother point in the Child. For example,the Wood point on a Fire Official' Characteristics Canbe usedasa tonificationpoint only whentheMother hasrelatively moreenergythanthe child. Moves enerry by pulling or calling the energyfrom the Mother to the ChildTransfersylnto yin andyangto yang on the Shengcycle:

Clinical Significance Use of a tonification point requires understandingof the Law of Mother/Child. Fostersthe natural movement of the Shengcycle. Points

LU9 LI I1 ST4 I SP2 HT9 SI3 BL 67 KT7 PC9 TE3 GB 43 LR8

Very GreatAbyss CrookedPond ReleasedStream GreatCapital Little RushingIn Back Ravine Extremity of Yin ReturningCurrent RushingInto the Mddle Middle Islet Valiant Stream CrookedSpring

25

SedationPoints Definition The elementpoint of thefollowing elementon the Shengcycle, i.e., the Child point in the Mother. For example,a Fire point on a Wood Official. Characteristics Can be used as a sedation point only when the Mother hasrelatively more energy than the Child. Moves energy by dispersing or pushingthe energyfrom the Mother to the Child. Is not as direct a statementto the energy as the tonification point. Is more likely to be used when the quality or quantity of the Mother's energy is excessive. Clinical Significance Use of a sedation point requires understandingof the Law of Mother/Child. Fosters the natural movement of the Shengcycle.

Points LU5 LI2 ST 45 SP5 IlT7 SI 8 BL 65 KII PC7 TE 10 GB 38 LR2

OutsideMarsh SecondInterval Hard Bargain MerchantMound Spirit Gate SmallSea BoneBinder BubblingSpring GreatMound HeavenlyWell Yang Support Walk Between

26

Junction Points Luo or ConnectingPoints Definition points that connectandmove energybetweenthe yin andyangmeridianswithin an element. Part of a networkof connectingchannels. Characteristics Typicallythejunction point on the relativelymore deficientmeridianis tonified. meridianmaybe dispersed. thejunction point of the relativelymoreexcessive If necessary, Clinical Significance Usedto balancethe energybetweenpairedmeridians. Usedto treatAkabaneimbalances. Canbe usedat the end of a transferwhenthe pairedmeridiansare not in balancewith one another. x Car be usedwith the sourcepoint to reinforceits action. Points ' LIJ 7 LI6 ST 40 ' SP4 ' IfT 5 ' SI 7 BL 58 ' KI4 PC 6 ' TE 5 GB 37 . LR 5

'

Narrow Defile SidePassage AbundantSplendor Prince'sGrandson PenetratingInside Upright Branch Fly and Scatter GreatBell Inner FrontierGate Outer Frontier Gate Bright andClear InsectDitch

27

SourcePoints Yuan SourcePoints

Definition Points that contain the Source Qi, called Yuan Qi or Original Qi which comes from the KidneysSourceQi can be accessedfrom thesepoints.

Characteristics Are safe, simple, gentle, and powerfi.rl. Do not transfer energy. Are self-regulating. Can be tonified or dispersed. Can be used for their spirit.

Clinical Significance A treatment using sourcepoints is often the first CF treatment on a patient. Source points have far-reachingand longJasting effects. Often used to clear qualities on the pulses. Used to steady or ground a body point or spirit point, or to supplementa treatment.

Location On the Yin Meridians, thesepoints correspond to the Earth points. On the Yang Meridians, these points corespond to the points immediately proximal to the Wood points. For example, on the Bladder meridiaq BL 65 is the Wood point; the point immediately proximal to it is BL 64, which is the source point. On the Large Intestine meridiarq the Wood point is LI 3; the point immediately proximal to it, LI 4, is the source point.

28

Xi Cleft Points AccumulationPoints Definition The Chinesecharactermeansa cleft or fissure. Characteristics PlaceswhereQi andBloodrTconvergeand accumulate. Clinical Significance Oftenusedwhen an acutesituationarises. May alsobe usefulfor severeor persistentailments. for diagnosticpurposes. Canbepalpatedfor tenderness

Points LIJ 6 Ll7 ST 34 SP 8 IIf 6 SI 6 BL 63 KI 5 PC 4 TE7 GB 36 LR 6

GreatestHole Warm Current BeamMound Earth Motivator Yin Mound Nourishingthe Old GoldenGate Water Spring Gateof Qi Reserve Assemblyof Ancestors OuterMound Mddle Capital

17Iochioo",xur.

30

Entry/ExitPoints Definition Entry points are where the energy enters the meridian. Exit points are where the energy leavesthe meridian. Characteristics Connectthe meridiansin the sequenceof the Chineseclockr8- different from the Shengcycle flow. Entry and exit points are not always the first and last points on a meridian. Usually tonified. Clinical Significance Used to break blocks from one meridian to Example: SI to BL KI to PC TE to GB May be usedto clear a meridian.

the next, specifically from one element to the next. LR to LU

LI to ST SPto HT

Points Entry

LU I LI4 ST I SP I HT I SI I BL 1 KI 1 PC I d PCz? TE I GB I LR I CV I GV I

18

Middle Palace Joiningofthe Valleys ReceiveTears RetiredWhite Utmost Source Little Marsh EyesBright BubblingSpring HeavenlyPond HeavenlySpring Rushingthe FrontierGate Orbit Bone GreatEsteem Meetingof Yin Long Strength

Exit LU 7 LI20 ST 42 SP2l HT 9 SI 19 BL 67 Kl22 PC 8

Narrow Defile WelcomeFragrance RushingYang GreatEnveloping Little RushingIn ListeningPalace Extremity of Yin Walkingon the Verandah PalaceofWeariness

TE22 GB 4l LR 14 CV 24 GV 28

HarmonyBone Foot Above Tears GateofHope ReceivingFluid Mouth Crossing

S"" pug" l0 for discussionofChinese clock

3l

ConceptionVesseland Governor Vessel Definition Along with the otherextraordinarymeridians,the Conception(CV) andGovernorVessels(GV)'n act asreservoirsfor the mainchannels,which arelike rivers.CV andGV derivetheir energyfrom the Kidneys. Along with the PenetratingVessel,CV andGVare Anterior Heavenor pre-birthreservoirsof Qi. cyclesof womenand They circulateWei Qi or DefensiveQi andregulatethe seven-year the eight-yearcyclesof men.

Characteristics Often usedfor their spirit andtheir locationin anatomicalareasor in proximityto corresponding organs. Two of the eight extraordinarymeridians. Unlike other extraordinarymeridians,they eachhavetheir own points. May be usedfor their pointsalonewithout regardto their useasan extraordinarymeridian. To accessthe functionsof CV andGV asextraordinarymeridians,masterandcouplepointsmust be used.

Clinical Significance Reinforce treatment on the twelve meridians. Used for their spiritual connotation. May be used to 1:reata particular jiao or area of the body. Treat at a deep constitutional level.

re

Io chino".

R en Mai andDu Mai .

32

ConceptionVessel RenMo, RenMai, DirectingVessel,or Seaof Yin Channels

Definition This meridianrunsup the anteriormidlineof the body. Nourishesyin energy,includingthe reproductivesystem. Regulatesthe uterusandblood in women' Moves Qi in the lower burnerandthe uterus. Influencesall burners. Characteristics Has to do with receptivity. Is relativelymoreyin thanthe GovernorVessel. Associatedwith Earth asopposedto Heaven. Clinical Significance May be usedasa spirit treatment. Areasof influence:abdomerqthorax,lungs,throat, andface. Treatson a deepconstitutionallevel.

33

Governor Vessel Du Mo, Du Mai, GoverningVessel,or Seaof YangChannels

Definition This merridianrunsup the posteriormidlineof the body, over the headandendsat the upper gum line. TonifiesKidney yang and strengthensthe back. ExpelsWind. Nourishesthe spineandthe brain. the mentalandphysicallevelsof energyif they arelow or depleted. Strengthens Characteristics Is relativelymoreyangthan ConceptionVessel. with activity anddirection. Is associated with Heaven. Is associated Holdsthingsup. Clinical Significance Hasto do with standingupright. May be usedas a spirit treatment. Areasof influence:baclg spine,backof neckandhead. In women,is usuallycombinedwith CV. Treatson a deepconstitutionallevel.

34

AssociatedEffect Points(AEPs) Back ShuPoints,or Back TransportingPoints

Definition directlywith an Official. Pointson the backusedto communicate directly. Wherethe Qi of the Zang (solid organs)andthe Fu (hollow organs)canbe accessed The Chinesecharacterfor Shumeans"to transport." an-rttne(

characteristics

Bl,{der

lrht

Strongandpowerfulpoints. Generallyusedwith a sourcepoint. Relativelyyang in nature,but usedto treatyrn aswell. Influencethe expansive,activefunctionsof an Official. Clinical Significance Use only after determininga patient'sCF. Usewhentreatmentis not holdingor moving. Use in acuteor chronicsituations,but mostlychronic. May be palpatedfor tenderness. ShuandMu pointsmaybe combinedin treatment. Points BL 13 BL 14 BL 15 BL 16 BL 17 BL 18 BL 19 BL 20 BLzl BL 22 BL23 BL 24 BL 25 BL26 BL 27 BL 28 BL 29 BL 30

Lung Correspondence PericardiumCorresPondence HeartCorrespondence GovernorVesselCorrespondence DiaphragmCorrespondence Liver Correspondence GallbladderCorresPondence SpleenCorrespondence StomachCorrespondence ThreeHeaterCorrespondence Kidney Correspondence Seaof Qi Correspondence Large IntestineCorrespondence Orig" PassCorrespondence SmallIntestineCorrespondence BladderCorrespondence Mddle of the BackboneCorrespondence WhiteRingCorrespondence 35

Front Mu Points Front CollectingPointsor AlarmPointswhenuseddiagnostically Definition Where the structiveto energy of the Official is expressed. Points on the abdomenthat complementthe Back Shu points. The Chinesecharacter means"to collect." Characteristics Are found close to the corresponding organ. Are relatively yrn in nature. Fu organsare responsiveto Mu points. Clinical Significance Useful diagnostically. Used to treat an organ and local area around the organ. Mu and Shu points may be combined in treatment.

Point

Corresponding Oflicial or Jiao

Name

-/rt9

LUI ST 25

cv 12 LR 13 CV 14

cv4 cv3 GB 25 CV I5 CV5

cv7 cv t7 GB 24 LR 14

t-uz Lunglrtu i,UncZ 6u'o"u Large Intestine lttl Middle Jiao, Stomach Mtt 4 nca Spleen/vrrJ r t+a '"'iI-

Middle Palace HeavenlyPivot Middle Duct ChapterGate GreatDeficiency First Gate UtmostMiddle CapitalGate Dove Tail StoneGate Yin Crossing Betweenthe Breast SunandMoon Gate of Hope

Heart MU SmallIntestine SE tt'tO 3 ac/ lqct 'z(Bladder ftru KdneYrqu t*n'l'7ncz Pericardium/hU Triple Heater/4U ,-L4g1' nl tn'€ Lower Jiao Mu i fi'r Upper Jiao mu 4ft7's Gallbladder f4u 7 r's Liver MU tcr6a,J'

20 E-bodi.d or relatively morephysicalthan non-physical.Stustive is alsorelalively more yin in qudtty This Grnr was rntoducedby Manfred Porker! prominentscholarof Chinesemedicinein The Esscntialsof ChineseDiaenostics.ChineseMedicinePublicationsL14 1983.

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Upper Kidney Points Definition Spirit points in the Worsleytradition. Characteristics One or two may be used in a treatment. May be used in sequentialtreatments. Can be used with any CF. May be combined with Outer Bladder Line points. Clinical Significance Influencesa patient at the spirit level. Influencesthe upper jiao. Points: KI20

Through the Vattey and KI21 Dark Gate (Used together) For someonewho is fearful, trapped in fear. For someonewho may be lonely, suicidal;when everything seemsnegative. Someonefacing death. To guide a person out of the darknessof the valley.

KI21

Dark Gate When everything seemsnegative.

KI22

Walking on the Verandah Convalescentpoint after a long illness. For a senseofsafety and protection.

KI23

Spirit Seal (Shen) A sealis a patient'sidentity. Used if a patient is not connectedwith his/her own spirit. To reawaken the spirit. Often used after, or wittg K124.

l p'e+sy'e-ac* Q rtttg lL.LLLrr4 C,lbtuLVtr2ttClinical Significance Are usedcautiously,only whenthe patientis ready;the patientwill indicatewhenthat is. Are consideredlater ratherthanearlierin treatmentbecause. The patientmustbe stable; The patientmustbe ableto integratethe experience; A pJtientwho is not stableor strongenoughcouldbe overwhelmedby the experience. Usuallytriat the Window on a patient'sCF, althougha Windowmaybechosenin a non-CFelement whenthe non-CFelementhaspreviouslybeentreated. Windowscanbe openedby eithera strongor gentletonification. Windowscanbe dispersedifthey are stuckopen,for instance,drug abusecancausethis condition. A commandor sourcepoint shouldbe needledafter needlinga Window.

toluZ-A

Points

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SI 16 SI 17 BL l0 PC lcr or 2? TE 16 LU 3 LI l8 ST 9 CV 22 GV 16

HeavenlyWindow HeavenlyAppearance HeavenlyPillar HeavenlyPond or HeavenlySpring HeavenlyWindow HeavenlyPalace SupportandRushOut PeopleWelcome HeavenRushingOut Wind Palace

44

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