General tricks and Ideas

to consider in treatment

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 Dysmenorrhea
Two questions to ask patient:
1. On which days of the period do you have the maximum
bleeding?
1. On which days of the period do you have the maximum
pain?
The possible answers:
1. My maximum pain comes before the maximum bleeding
begins. When the maximum bleeding starts, my pain eases.
2. My maximum pain and the maximum bleeding time are the
same.

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 Dysmenorrhea
If the maximum pain comes before the maximum bleeding:
Meaning – the elimination function of blood is poor
Liver Qi deficiency, Bladder Qi deficiency
With Blood stagnation- dark
bleeding with clots, cramps

LI 4, Bl 18, Gb 37, Bl 28, Bl 58

Sp 8 and Ren 3 moxa only.
Tapping of sacrum

1 1
10 10 10

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 Dysmenorrhoea

If the maximum pain comes together with maximum bleeding:

Then, Bl
Ren 3 Sp 6 K 4 Bl 40

If this is together with excessive bleeding:

Then, Liv Add Liv 5

1 1

1 session per week

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 Constipation

• LI • LI
• Stools 1-2/week • Daily, more than
• No urge once
• Soft stools • Dry, hard rabbit
• Fullness,bloating stools
• Elimination a • Dry skin, dry person
problem in general • Haemorrhoids, anal
fissure
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 Constipation-Treatment

• LI • LI

• LI 4, St 25, TW 6 • LI 4, St 25, TW 6
• LI 11, Bl 25 • LI 5, Lu 9
• Paravertebral tapping • Ren 12
Between L2-S4 • K 10
• Exercise,spicy food • Drink water, relax

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 Yang Diarrhoea

Treatment:
LI/ SI
St 25, St 37 sed.(LI)
Urgent, painful stools
Ren 4, St 39 sed.(SI)
following colicky pain
Ren 12, LI 5/SI 2
Stinking, with blood/pus,
No spice, or coffee
Winds, watery stools
White rice, bland food
Large at first, then little

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 Yin Diarrhoea

• Sp/SI
• Treatment:
• Malabsorbtion
• Bl 20, 27
diarrhea
• St 36, Sp 1, SI 3
• Light coloured, • St 25, 37, 39
foamy, with • Ren 8, 12 moxa
undigested foods
• Always cooked and
• Distension, no pain warm food, warm
• Worse with raw, drink, small quantities
cold or fatty foods
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 Vomiting
If it improves with eating often and little, nausea does not
improve after vomiting -
St : P 6, Ren 12, Sp 21, eating little and often
Du 20 (simple carbohydrates, warm and cooked)
Spoon of honey mixed in water, after meals.
If it is all the time, eating makes it worse, better for a time
after vomiting –
Sp/ Liv : P 6, St 40, Bl 20, Bl 18, Gb 37, eat dry food.
and Sp 9.

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 Chronic Rhinitis
He yin lack of sleep
He yang cold in thorax
Possible causes:
•Allergy Liv blood or Sp Qi
•Low Immune system yin wind dampness

•Ascending Liv wind

•Sp Qi causing
damp stagnation
Lung
K yin
•Coldness in upper dryness
warmer
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Local and Distal Points Ex 1, LI 20, Gb 20
In every situation Sp 10 and St 40
When treating nose, always observe the skin in the
upper body – this gives info about dry-damp situation,
and if there is more heat or cold in Lung.
Headaches, if any, should be treated with local and
Symptomatic points.
Stools – frequency, consistency and colour are good
indications of Yin or Yang dominance in Lungs

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 symptom Imbalance Points
Blocked nose in Lu Qi stagnation of Bl 13, 20, LI 4, 6
bed,runny nose at dampness Wind elim.ton Gb 20
other times,alternate
Constant runny nose Lung leakage Ren 17,Lu 1, Bl 13
later change to Lu 9,
LI 11
Sneezing in mornings Lu Qi poor Bl 13, LI 11
on getting up adaptation to change
Sneezing/blocked Lu Wind symptom 1)Gb 20 wind-sed.
nose early morning-at heat cold Lu 7, K 10
around 4 am.-while This is an excess time 2)Gb 20 wind-ton.
still in bed for Lung, even though it LI 6, Bl 66
is a chronic problem, it
is the excess that is
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 Symptom Imbalance Points

Often sinusitis with Lu Qi with Gb 20 heat

coloured mucus, damp stagnation elimination, Bleed
may be with blood and intermittent Lu 11, Bl 13, LI 4
heat from this St 40
Sneezing only Wind-heat in Lu Lu 1, 8
when in contact Gb 20 wind
with pollen or other elimination sed.
allergen Tonify Liv blood:
Ren 14, Bl 15,
Sp10, Bl 17, Liv 5
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Headache - Questions to ask the patient:
Front – St; Side – Gb;
Where is your headache? Back- SI; Top - Liver
How would you describe it?
If it is radiating or shooting in nature, where does it
begin?
How does it begin? Is there an aura? And does it
develop to a high point? How soon does it develop?
How long do you suffer with headache? How often?
Any accompanying symptoms?
Any causes? Provoking factors? Helping factors?
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Description of headache:
Dull, worse after sleep – yin dominant
Pulsating, or worse after alcohol – yang dominant
Heavy, or worse after eating - damp
Pressure from out to in – damp(could be also band-like)
Pressure from in to out –wind-heat (exploding)
Starts slowly and develops to a bad headache (over 2 hrs)
- blood or Qi causing stagnation and damp-heat
Develops quickly to a severe headache (20-30 minutes) –
yin or yang excess
Pressure makes it better – blood deficiency
Pressure makes it worse – excess (damp or damp-heat)
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•If the headache travels, consider the starting point for
treatment.
•If there is an aura, treating this may prevent the
headache.
•The history of the headache shows you if this is an
excess or deficiency symptom, and therefore sedation
or tonification is necessary. To prevent further
episodes, it is important to tonify the deficiency,
during the interval.
or
•Consider the circumstances of the patient and the
situation which brings on the headache
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•What is the similarity between a post-menstrual migraine
(Gb) and a Friday afternoon headache? How will you treat?
These show blood deficiency – treat with Ren 14, Bl 15, Sp
10, Bl 17, Gb 39 and a herbal Iron formula.
•What is the cause of a premenstrual migraine? How could
you prevent it?
This is similar to a weekend migraine. There is stagnation of
blood and damp in Liver, and it needs to be circulated- with
points Bl 18, Gb37, LI 4 and St 40, Sp 9

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 Some good points for headache
• Behind eyes – H 3
• Frontal and both temples on waking – Sp 9
• Side, pulsating or tension type – H 8
• From back to front – Bl 60
• Top – Liv 2
• Always add – Gb 20, Ear points

For recurrent headaches, treat in the interval

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 Neck-shoulder pain
Yang Type Treatment:
•Thin,long neck, small upper Few local points-along
. Body, tensed person hairline- TW 17, Gb 12,
Gb 20, Bl 10
•Pain worse in first half of
night & second half of day Lu 7-Area Distal,Liv 3- tension
•Associated headaches in Energy-balance:
afternoon/evenings
Tonify upper warmer-
•Tender points along
Ren 14, Bl 15 for Heart
hairline
Lu 1, Bl 13 for Lung
•Stress related, pale person

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 Neck – Shoulder Pain
YIN TYPE
Thick, swollen appearance of Treatment:
neck, shoulder Many local points and
Pain and reduced mobility cupping massage
worse in second half of night St 40, Sp 9
and first half of day
Lu 7
Occipital headache on waking
Moxa on Du meridian
Hunched forward, edema on
C 7 vertebral prominence Less fatty foods; light
dinner
Dislike pressure on neck

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 Stomach Pain
Yang yin
-burning pain, radiating -dull, constant pain, ‘stone-like’
heaviness
-acid reflux, heart burn,vomiting
-worse in evenings, after meals
-worse when hungry, stressed or –cold, raw and fatty foods
with strong flavours
Better with cooked, warm and
-Better after eating bland food light foods
and relaxation
-nausea, passive worrier
-foul breath, active worrier
Bl 21, St 36, Ren 12 moxa, St 40
Ren 12, Pe 6, Liv 1,St 43,Sp21 (Sp 9), Plum blossom tapping at
In acute add: St 34 sedation, back (T 9-L 2 level) along Ex21.

St 42 sed., Bl 21 bleeding cup

Du 20
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 Chronic Recurrent Gastritis
St Fire-Heat St Damp-heat
-thin person, often hungry,thirsty, -obese person, thirst only with
stomach empties quickly meals, stomach empties slowly
-stomach pain when hungry, Stomach pain after eating, better
improves when eating bland, when empty, prefer warm drinks
prefers cool drinks
-reflux of food and acid, nausea,
-acid reflux, vomiting, pain in pain at nights after big meals
stress, worry, foul breath
-large tongue, teeth marks, thick and
-red tongue, dry yellow coating slimy white coating
Ren 12, P 6, Du 20, Liv 1, St 43 Bl 21, P 6, Sp 9, St 40
Fish, poultry, milk. Avoid strong Small meals, cooked and warm, No
flavours, coffee and alcohol refined carbohydrates, milk or fat

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 Bronchial Asthma
Wind-Heat in Lung
• Treatment:
• Not constant, may be
seasonal, allergic or
with infections • P 6, Ex 17, Ren 17
• Dry cough, broncho- • Allergy – Mp 10
spasms • Ton Yin – Lu 1, Lu7
• Thin dry skin,less body
• Wind elim- Bl 12
hair, bright pale colour
• Sensitive, emotional • Liv 5, Ren 14, Du 20
• Can have hay fever and * Acute – Lu 6 &LI 2sed
eczema
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 BRONCHIAL ASTHMA

Damp-cold in Lung
Constant,worse in cold, Treatment:
wet weather and nights & Gen: P 6, Ex 17, Ren22
early mornings.
mucus – St 40, Lu 5
Productive cough with
white foamy mucus Ton Lung Yang – Bl 13, 17

Thick, wet skin, much hair cupping (4 on back), moxa

Melancholic person LI 11, Lu 10

Can have blocked nose Master point – Ren 17

and yin eczema

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Points for calming the Patient
Against stage fright: He 9
Anxiety (restless patient): Ren 14, P 6,H 5,Du 20
Anxiety (fearful patient): Ren 14, Bl 15, H 9,
K 3, Bl 23
Depressive patient: Ren 14, Bl 15, Lu 1, Bl 13,P6
Suppressed aggression: Bl 18, Gb37, Di 4, Ma 40
Nervous patient: Liv 3, Lu 1, Du 20, P 6, H 7
Patient afraid of needle pain: Lu 7, Lu 1, Du 20

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3 Sub-groups of typical patients with joint pains

1. The pere-menopausal woman

2. The depressive and exhausted Patient

3. The damp, oedematous type

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1.The pere-menopausal woman

Treatment:
Symptoms: Kidney yin
deficiency Tonify Kidney yin –
Hot flushes,
with ascending K 4, Ren 3, Bl 40
night sweating heat to the
upper warmer Sp 6 descending technique
Restless sleep
Water (drink, use, cook in)
Hair loss, dryness
Mid-day rest
Tinnitus, dizziness
Avoid coffee, red meat and
Quickly exhausted direct exposure to heat

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 2. The depressive, exhausted Patient

Symptoms: Tonify blood, tonify

upper warmer –
Pale, cold, hunched
For depression – P 6,
Endogenous depression
Ren14,Bl 15, Lu 1, Bl 13
Easily sleeping
extremities Heart & Lung For Blood – tonify heart,
blood & Qi Bl 17, Sp 10, Gb 39
Dizziness, weakness deficient, empty
pulse in upper For Energy-
Always tired
warmer, Liver Ren 6, Bl 24, St 36
Tearful blood deficient

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 3. Damp, oedematous type

Symptoms: Treatment: Tonify Sp Qi,

circulate and eliminate
Edema in eyelids, hands
dampness –
and feet (or in face,
arms and legs), Sp 9, St 40, Bl 20 needle
and cupping, Bl 39
Stiffness and reduced
mobility when starting Avoid sugar, fats,
to move from rest,
Sp Qi with refined carbohydrate,
Fullness in the middle, stagnation of Fatty milk products. Eat
Semi solid stools body fluid cooked and warm, and
light, small meals in the
Heaviness of limbs
evenings
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 Treating the Pain - Bi Syndromes….

These could be external or internal problems:

1.Purely external causes – no interior reasons

ACUTE!

Local & distal points, moxa or cupping etc. locally

2. Exterior causes with some internal complications
Treat exterior locally and balance interior. SUB-ACUTE
3.Internal condition with some external signs and symptoms
Balance mainly the interior with minimum attention to exterior
CHRONIC
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 Treatment of Muscular-Skeletal Pain

•Local and Distal Points

•(with appropriate extra-ordinary therapy)
•Adjacent and Referred Points
•Symptomatic Points
•Influential Points
•Energy-balancing Points
•Treat the Person

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 Simple Rule:
One or two meridians affected balance the meridian+local
Many meridians affected treat the organ and less local

•Pain in bones and cartilage – balance Kidney

•Pain in muscle and tendon – balance Liver
•Pain in joints – balance Kidney and Liver

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 Muscular-Skeletal Pain - 4 TYPES
• HOT PAIN • Treatment:
• Sharp, • Cool, rest(immobilise)
incapacitating, • Electrical stimulation
• Radiating, worse in • Bleeding
Activity or tensing, • Few local, many
better at rest or distal points
relaxing • Balance Meridian
• May be inflammed

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 Sub-acute and Chronic Hot Pains
On a Meridian:

Backache or sciatica on Bl meridian-

Sub acute: K 4 (luo) and Bl 64 sedation
Treat Kidney points or Ren meridian points on the
anterior aspect of the pain
Chronic: Tonify K 7, Ren 3(Mu), Bl 40

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 Generalised Hot Pains in Joints

Joints are related to Kidney and Liver

or

K 4 Luo point, Tonify only K 7/10

Liv 5 Luo point. Liver yin will become
automatically tonified
(Sedation UB 64
Yuan point; Gb 40
Yuan point)
Avoid heat foods, drink water, gentle
exercise in water, cook in water
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 Muscular…..
• Cold Pain
• Worse at rest and • Treatment:
after rest • Many local points
• Better during • Few distal points
movement and • Local heat, moxa,
warm
• Massage, exercise
• Deep pain, tense
• Keep warm
• Balance meridian

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 Localised Cold Pains…
Many local needles, less distal points
Local Heat, Moxa, Massage, exercise

On affected meridian : or or

Backache – UB meridian –
Acute: sedate K 5; UB 63(Xi-cleft)
Sub-acute: Sedate K 3 (Yuan) & Tonify UB 58(luo)
Chronic: Tonify UB 67 or 66(House element point)
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 Generalised Cold Pain in Joints
Eat warm,
Joints relate to Kidney and Liver dress warm,
avoid raw &
In Kidney and Liver: cold food

or or

Sedate Liver 3/2 Sedate Liv 3 & Tonify K 3, UB 67,

Tonify UB 58 UB 23

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 Muscular…
• Damp pain
• Worst at beginning • Treatment:
of movement from • Local and distal
rest
• Local cupping
• Takes 2-3 hours of
movement to • St 40 (Sp 9)
improve • Treat also hot or
cold
• Stiffness, edemaOsteo-arthritis, if there is any.
starting stiffness
• Pressure pain and pain in general

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 Damp or Fixed Pains
-Because of exposure to exterior climatic factors;
-Or interior Spleen Qi deficiency causing stagnation of
body fluid in the joints

Points Spleen 9 (Lasix point) and St 40 are used to

eliminate and circulate fluid.
Avoid damp
Sp 9 for generalised dampness;
producing foods,
St 40 for localised dampness heavy evening
meals

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 CHRONIC & SUB-ACUTE DAMP PAINS
ARE TREATED AS DAMP STAGNATION

CHRONIC

Yin, water,
coolness,
structure
DAMPNESS, Qi, function,
THICK FLUID, circulation,
BLOOD, elimination
NUTRITION

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 Treat Sub-acute and Chronic Damp
Pain….
Luo-Connecting point of Yang meridian and
Back-Shu point of affected Meridian
Example:
Low Backache on UB – UB 28 and UB 58(luo)
Pain on medial knee on Sp – UB 20 and St 40
Trochanter bursitis (Gb) – UB 19 and Gb 37

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Damp-heat pains Damp-cold Pains

Treat damp as before; Treat damp as before;

Treat heat with – Treat cold with-
1.Bleeding or 1.Moxa or heat
2.Electro –stimulation 2.Hot needles
3.One point therapy 3.Exercise
4.Cool and rest 4.Massage

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 Muscular….
• Wind Pain
• Wandering • Treatment:
• Paroxysmal • Local and distal
• Or after wind • Wind eliminating
exposure points for the Area.
• Can be hot or cold
• Treat hot or cold
• Can originate from
Liver Blood or yin • Avoid sour, alcohol
• Balance Liver

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 Wind Eliminating Points
• Gb 20 - Head and Face

• SI 12 - Shoulder and Arm

• Gb 31 - Hip and Leg

• Ba Xie - Hands

• Ba Feng - Feet

• Bl 12 - Back, Lungs and Skin

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Wind elimination Sedation Wind Elimination Tonification
•In wandering pains of a severe •Wandering pains of a dull
nature. nature
•Radiating hot pains •Deep, cold or damp pains
•Incapacitating •Stiffness on beginning of
movement, improves slowly
•Worse on activity, better with
rest •Better with activity, worse at
rest
•Worse in menopause, with red
meat and coffee, red wine •Bad in winter, with lack of
exercise
•More common in the upper
body •More common in lower body

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 Wind Elimination Wind Elimination
Sedation Tonification

• Needle the point • Needle the point

• Twirl – thumb away from • Twirl – thumb towards
centre and back x 6 the centre and back x 9
• One thrust and three lifts • Three thrusts and one
x6 lift x 9
• Scrape handle away from • Scrape handle towards
body x 6 body x 9
• Leave needle 5 minutes • Leave needle 5 minutes
• Remove when exhaling • Remove during inhaling
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