Chinese Medical Theory and Tung’s AcupunctureIn Tung’s original book there is no discussion of Chinese medical theory, and in his own teaching, Tung rarely mentioned any theory to his students. There is some controversy in the community of Tung’s Acupuncture practitioners about how much Chinese medical theory should be used to understand, explain, and teach the system.The title of Tung’s original 1973 text gives the first insight into this question. The original book in Chinese was called “Dong Shi Zhen Jiu Zheng Jing Qi Xue Xue; A Study of Tung’s Lineage Acupuncture and Moxibustion – Primary Channel Extra Points.” The term chosen to describe Tung’s points is notably 正經奇穴 Zheng Jing Qi Xue – “Primary Channel Extra Points,” and is a clear reference to his points being located in relation to the channels of regular acupuncture. Certainly, many points in Tung’s system overlap conventional acupuncture points with identical indications (e.g., Huo Chuan 33.04 is located at Zhi Gou SJ6; used in both Tung’s and conventional acupuncture to treat constipation). Likewise, some of Tung’s points are named in relation to either conventional channels or acupuncture points (e.g., Ce San Li 77.22 translates as “next to San Li,” a reference to its location lateral to Zu San Li ST36). It is clear that Tung’s points relate to the channels and conventional acupuncture points, and can therefore be understood in reference to Chinese medical theory. This topic will be explored in much greater depth in the chapters that follow.According to one of Tung’s direct disciples, Dr. WeiChieh Young, every time questions were raised to Tung, he would say, “Observe for yourself, then think about it” (WeiChieh Young, 2008a, p. 269270). This is certainly the reason why the original canon of point indications was broadened or changed over time and that in the course
Pain Management with Tung’s Acupuncture – An Introduc9on Treatment of Pain with Tung’s Acupuncture – An Introduction 董氏特效治痛鍼灸療法 DR HENRY MCCANN, 馬爾博 TCM Kongress 2020 Pain in our Clinics ! Moderate to severe pain is one of the most common reasons for primary care visits in the United States " McCarberg BH, Nicholson BD, Todd KH, Palmer T, Penles L The impact of pain on quality of life and the unmet needs of pain management: results from pain sufferers and physicians participating in an Internet survey Am J Ther 2008;15:312-320 DAOM, LAC 中醫博士 ! Pain is the most common condition treated in the acupuncture clinic (40%) " Pain in Chinese Medicine Ward-Cook K, Hahn T, ed NCCAOM 2008 Job Task Analysis, Jacksonville: NCCAOM, 2010 Pain in Chinese Medicine ! Descriptions of treating pain account for 痛病必瘀 a significant portion of early medical literature, such as the Huang Di Nei Jing ! Pain is associated with stagnation, and in classical literature caused by cold Tong Bing Bi Yu 疼（疒＋冬） © Dr Henry McCann, 2020 There must be stasis in painful disorders 不通則痛，通則不痛 Bu Tong Ze Tong, Tong Ze Bu Tong If there is no free flow there is pain, establish free flow and there will be no pain Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Case Study – Lumbar Pain ! April 2015; 50 year old female, acute lumbar pain after air travel; patient complained of bilateral lower back pain with pain slightly worse on the left; reduced range of motion with limited left trunk rotation ! Main treatment point = Right Zheng Shui 正水穴 ! Secondary points = Left Wan Shun Yi 22.08, Wan Shun Er 22.09 ! ROM normalized almost as point inserted and patient asked to stand and move; pain also almost completed abated soon after needles inserted Zheng Shui 正水穴 ! Location: point group; on the horizontal midline of the posterior proximal phalanx of the 5th (small) finger; one point on the midline of the finger (over the bone), and then one point each on the ulnar and radial margins of the phalangeal bone ! Functions: Drains the lower jiao, rectifies water and disperses swelling ! Indications: Pyelitis (inflammation of the renal pelvis), cystitis, urethritis, sour pain of the lumbar region, back pain, aching pain in the leg bones, injury and pain of the lateral leg ! Needle: 0.1-0.2" insertion Wan Shun Yi 腕順一穴 22.08 & Wan Shun Er腕順二穴 22.09 Zheng Shui 正水穴 ! Location: On the ulnar margin of the hand on the junction of the red ! ! ! ! © Dr Henry McCann, 2020 and white skin, 2.5 cun distal to the wrist joint crease, 0.5 cun proximal to Hou Xi (S.I.-3); and 1.5 cun distal to the wrist joint crease, cun proximal to Wan Shun Yi (22.08); on the Small Intestine channel on the Small Intestine channel Functions: Enriches the Kidneys and disinhibits urine, frees the Kidneys and settles pain Indications: Headache, back pain (especially due to Kidney vacuity), fatigue, nephritis, pain and fatigue of the whole body, dizziness (due to Kidney depletion), sciatica, edema of the limbs; epistaxis（Wan Shun Yi 22.08 only); hip pain (Wan Shun Er 22.09) Needle: 0.5-1.0" perpendicular insertion Pain Management with Tung’s Acupuncture – An Introduc9on Wan Shun Yi 腕順一穴 22.08 & Wan Shun Er腕順二穴 22.09 TCM Kongress 2020 Tung Family Acupuncture ! Family lineage dating back to Han Dynasty* ! Passed down from father to eldest son ! Incorporates unique set of extra points, as well as 14 channel points Characteristics of Tung’s Acupuncture ! Pre-TCM classical acupuncture system ! Extensive use of unique extra points ! Almost exclusive use of distal (distant) point treatment; points needled mostly contralaterally ! Minimal number of needles per treatment (usually < needles) ! Use of special point combination and stimulation techniques, including bleeding © Dr Henry McCann, 2020 Tung’s Points ! “Orthodox channel extra points” 正經奇穴 ! Distributed over entire body ! Organized by zone of distribution; have an original Chinese name and a modern numbering system (e.g., Ling Gu 22.05) ! Not originally associated with channels, but rather “reflex areas” 神經 ! Each zone functions similar to a microsystem Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Zone Characteristics Point Distribution Zone Location Number of Points Fingers 27 (55) Palm and dorsal hand 11 (22) Forearm Upper Arm Plantar aspect of foot Dorsal Foot Leg/Calf 28 (2) Thigh 32 (12) Ear 10 Head 25 (2) Ventral and Dorsal Trunk 160+ VT and DT 16 17 (9) 6 ! Certain zones have special characteristics ! Finger, hands, head treat more acute conditions and get faster symptom relief ! Leg and thigh (especially thigh) treat more chronic and recalcitrant conditions ! Trunk points are mostly bled, not needled Bleeding Points (examples) Core Theory Acupuncture Point Location Needling ? Indication Results Black box: causal chains are unknown A model is required which links acupuncture points and their effects in a reliable, rational, and reproducible way © Dr Henry McCann, 2020 Pain Management with Tung’s Acupuncture – An Introduc9on GUIDING PRINCIPLE: CORRESPONDENCE “Heaven, Earth and Humanity [are] in Harmony” 天地人和 Tiān Dì Rén Hé According to Chinese philosophy man is a microcosm or hologram of the natural world with structural and functional characteristics corresponding to those of its immediate environment and nature, as well as to those of the universe On a smaller scale, analogous rules of correspondence can be observed within the human organism: parts of the body can be viewed as microsystems or holograms representing the whole Likewise, channels and tissues have various correspondences This provides us with a reliable tool for point selection TCM Kongress 2020 Humans and Nature are in Harmony ! 天地人和 Tiān Dì Rén Hé ! Humans are a Microcosm or Hologram of the natural world ! In the body we have numerous Taiji Holograms (TaijiQuanxi太極全息） " Quan Yang L 周易与中医学 [The Zhou Changes and Chinese Medicine] Beijing: Beijing Science Technology Publishing House, 1999 Humanity and the Universe ! “A human body is the image of Heaven and Earth” ! 人身應天地 ! “A human body is a small Heaven and Earth” ! 人身小天地 " Zhang Jie Bin (in the Lei Jing) ! “Yin and Yang are the Dao of Heaven and Earth” ! 陰陽者天地之道也 " Yin Yang Ying Xiang Da Lun (Su Wen Ch 5) © Dr Henry McCann, 2020 Xi = Microsystem/Hologram Rules of Diagnosis and Treatment ! Holographic Correspondence ! Identifying diseased locations of the body to choose treatment location ! Channel Correspondence ! Identify diseased channels to choose treatment channels ! Tissue Correspondence ! Identify diseased Zang-Fu and tissues to choose point location and needling methods FOR MORE INFORMATION ON THESE CORRESPONDENCES PLEASE SEE: McCann H, Ross H-G Practical Atlas of Tung’s Acupuncture Munich: Müller and Steinicke20, 2018 Shubs J The foundations of channel theory Journal of Chinese Medicine 100 Oct 2012:53-61 Young WC Lectures on Tung’s Acupuncture: Therapeutics Rowland Heights, CA: American Chinese Medical Culture Center, 2008 Wang M 董氏奇穴精要整理 Shenyang: Liaoning Science and Technology Publishing House, 2011 Pain Management with Tung’s Acupuncture – An Introduc9on Holographic Correspondence TCM Kongress 2020 Tung’s Correspondence of arm and Leg [Large Taiji] ! Large Taiji Holograms ! ! ! Body mapped out onto large regions of the body Limb to limb, trunk to limb Elbow and knee are pivot points " Originally described in philosophical, martial arts & Dao Yin / Qigong writings ! Small Taiji Holograms ! ! Body mapped out onto small structure, such as long bones Ear, hand or scalp acupuncture are examples of this mapping Tung’s Korrespondenz Arm – Bein [Großes Taiji] Tung’s Correspondence of the extremities [Large Taiji] Large Taiji: Correspondence between head, trunk and extremities Knee-navel-elbow level Genital area Tung’s Korrespondenz der Extremitọten [Groòes Taiji] â Dr Henry McCann, 2020 Groòes Taiji: Abbildung von Kopf und Rumpf auf Extremitäten Pain Management with Tung’s Acupuncture – An Introduc9on Small Taiji TCM Kongress 2020 Small Taiji - Kleines Taiji ! Most completely described by Zhang Yingqing, developer of ECIWO theory in early 1970s (prior to publication of any material on Tung’s acupuncture correspondences) ! Similar time period of other microsystem development such as Korean hand acupuncture by Tae Woo Yoo ! ECIWO describes that all small parts of the body are microsystems (全息), and all long bones can be microsystems " Zhang YQ ECIWO and Its Applications to Medicine Jinan: Shandong Science and Technology Press, 1991 Zhang YQ ECIWO and Its Applications to Medicine Jinan: Shandong Science and Technology Press, 1991 Small Taiji – Long Bones Kleines Taiji – Röhrenknochen Small Taiji – Palm Diagnosis McCann H, Ross H-G Practical Atlas of Tung’s Acupuncture Munich: Mü̈ller and Steinicke, 2018 © Dr Henry McCann, 2020 Pain Management with Tung’s Acupuncture – An Introduc9on Small Taiji – Palm Diagnosis Wu Zang Bie Tong 五臟別通: Branching Connections of the Five Zang ! Branching connections describe Yin-Yang channels pairings (as opposed to Yin-Yin or Yang-Yang as described already) ! Described in many early classics such as the Yi Xue Ru Men (Entering the Gate of Medicine – Ming Dynasty); derived also from Su Wen Chapter ! Also known as Zang Fu Bie Tong 臟腑別通 (Young) McCann H, Ross H-G Practical Atlas of Tung’s Acupuncture Munich: Müller and Steinicke, 2018 Young WC Lectures on Tung’s Acupuncture: Therapeutics Rowland Heights, CA: American Chinese Medical Culture Center, 2008 Wang M 董氏奇穴精要整理 Shenyang: Liaoning Science and Technology Publishing House, 2011 © Dr Henry McCann, 2020 TCM Kongress 2020 Channel Correspondence - same Name Channels Korrespondenz von Leibahnen gleicher Namen ! Taiyang ↔ Taiyang ! UB ↔ SI ! Bl ↔ Dü ! Shaoyang ↔ Shaoyang ! GB ↔ SJ ! GB ↔ SJ ! Yangming ↔ Yangming ! St ↔ LI ! Ma ↔ Di ! Taiyin ↔ Taiyin ! Sp ↔ Lu ! MP ↔ Lu ! Shaoyin ↔ Shaoyin ! Kd ↔ Ht ! Ni ↔ He ! Jueyin ↔ Jueyin ! Lv ↔ Pc ! Le ↔ Pe Yin Yang Li He Lun (SW6) Three Yang Three Yin 太陽為開 Taiyang is the open 陽明為闔 Yangming is the close 少陽為樞 Shaoyang is the pivot 太陰為開 Taiyin is the open 厥陰為闔 Jueyin is the close 少陰為樞 Shaoyin is the pivot Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Channel Correspondence Wu Zang Bie Tong 五臟別通 ! Taiyang ↔ Taiyin ! Shaoyang ↔ Shaoyin ! Yangming ↔ Jueyin Clock Channel Correspondence ! UB ↔ LU ! Bl ↔ Lu ! SI ↔ SP ! Dü ↔ MP ! GB ↔ HT ! GB ↔ He ! SJ ↔ KD ! SJ ↔ Ni ! ST ↔ PC ! Ma ↔ Pe ! LI ↔ LR ! Di ↔ Le Tissue Correspondence From Guan Zhen (Ling Shu 7) ! ! The first is called one-half piercing (ban ci) For one-half needling, shallowly insert, then quickly withdraw the needle without injuring the flesh It is like plucking a fine hair and is used to treat the skin qi It is in resonance with the lungs ! 二曰豹文刺，豹文刺者，左右前後針之，中脈為故，以取經絡之血者，此心 之應也。 ! The second is called the leopard's spots piercing (bao wen ci) Leopard's spots piercing involves piercing in left and right, front and back [to the diseased location] This strikes the vessels, and is used to remove blood from the channels and network vessels It is in resonance with the heart © Dr Henry McCann, 2020 Tissue Correspondence Needle To Treat ! Skin ! Skin and Lung ! Vessels ! Vessels and Heart ! Flesh ! Flesh and Spleen ! Sinew ! Sinew and Liver ! Bone ! Bone and Kidney Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Acupuncture Points Acupuncture Points Diseased Regions Diseased Channels Diseased Tissues Holographic Correspondence Channel Correspondence Tissue / Zang Correspondence Potentially effective Areas, Channels, and Points Inspection Palpation Therapeutic Point(s) Needle Rules and Methods ! Needle distal (distant) and contralateral; bleed Distant Point Needling ! “Hence, those who know well how to use the ! Dao Yin (Guiding) 導引針法or Dong Qi (Moving) needles [i.e., the superior acupuncturist], from the yin they pull the yang and from they yang they pull the yin With the right they treat the left and with the left they treat the right.” ! Simple stimulation technique, long retention ! Yin ipsilateral ! Dao Ma (Coupled Horses) Technique 倒馬針法 ! Also called Hui Ma 回馬 Technique 動氣針法 McCann H, Ross H-G Practical Atlas of Tung’s Acupuncture Munich: Müller and Steinicke, 2012 Li GZ 台灣董氏針灸倒馬針刺療法 [Taiwan’s Tung Lineage Dao Ma Needle Therapy] Taipei: Zhi Yuan Bookstore, 1999 Wang M 董氏奇穴精要整理 Shenyang: Liaoning Science and Technology Publishing House, 2011 © Dr Henry McCann, 2020 Yang Ying Xiang Da Lun, SW5; tr Unschuld, 2011, vol I, p.120 ! 故善用鍼者，從陰引陽，從陽引陰，以右治左，以左治右 10 Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 How we treat pain? Needling and Movement ! “When the physical body is joyful while the mind suffers, 不通則痛，通則不痛 Bù Tōng Zé Tòng, Tōng Zé Bú Tòng If there is no free flow there is pain, establish free flow and there will be no pain disease is engendered in the vessels Treat it with cauterization [moxa] and piercing.” " The physical body is not damaged or overtaxed Mind/emotions leads to diseases in the circulation of Ying/Wei Mind-intent leads and the Qi follows (意到氣到) " 形樂志苦，病生於脈，治之以灸刺 ! “When the physical body is joyful and the mind is joyful as well, disease is engendered in the flesh Treat it with needles and stones.” " The ‘body is joyful’ means no laboring or physical movement leading to stagnation " 形樂志樂，病生於肉，治之以鍼石 Needling and Movement ! “When the physical body suffers while the mind is joyful, disease is engendered in the sinews Treat it with ironing and pulling.” " Here there is injury to the muscles and connective tissue (sinews 筋) The circulation of Qi and Blood in the channels and vessels is not yet systematically damaged Ironing is the application of poultices or other topical application of hot medicinal substances (e.g., herb packs), and pulling is movement therapy such as Dao Yin (導引) or Dao Yin / Dong Qi needle technique " 形苦志樂，病生於筋，治之以熨引 Case Study – Lumbar Pain ! 80 year old with severe lumbar pain She has a history of kidney cancer (treated by nephrectomy year ago), and a diagnosis of osteoporosis and spinal stenosis She is very stiff and has difficulty walking upright Hands are cold on palpation and the Kidney region is very pale Pulse is deep and weak ! Su Wen 24 (Blood, Qi, Body, Mind 血氣形志); translations based on Unschuld, 2011 © Dr Henry McCann, 2020 11 Pain Management with Tung’s Acupuncture – An Introduc9on Case Study – Lumbar Pain ! Dx: Kidney vacuity cold with blood stasis ! Tx: Shui Tong 1010.19 threaded to Shui Jin 1010.20, Wan Shun Yi 22.08, Wan Shun Er 22.09, Ren Huang 77.21 (i.e., San Yin Jiao SP-6) ! Rx: Du Huo Ji Sheng Tang " Du Huo 9g, Xi Xin 3g, Fang Feng 9g, Qin Jiao 9g, Sang Ji Sheng 12g, Du Zhong 12g, Dang Gui 12g, Chuan Xiong 6g, Sheng Di 12g, Bai Shao 12g, Fu Ling 12g, Huai Niu Xi 12g, Dang Shen 12g, Gui Zhi 9g, Zhi Gan Cao 6g; 5:1 granular concentrated dosed 4g b.i.d TCM Kongress 2020 Shui Tong 水通穴 1010.19 & Shui Jin 水金穴 1010.20 ! Location: 0.4 cun inferior to the corner of the mouth (Shui Ting), and 0.4 cun obliquely medial (and a little inferior) to Shui Tong ! Functions: Benefits the Kidneys, secures the Root, warms the channels and frees the network vessels ! Indications: Low back pain, acute lumbar sprain, rheumatism, vertigo, dizziness, fatigue, dyspnea, asthma ! Needle: Oblique needling from medial to lateral to connect Shui Tong 1010.19 and Shui Jin 1010.20 Shui Tong 水通穴 1010.19 & Shui Jin 水金穴 1010.20 How we treat pain? ! “For Fixed Painful Obstruction that does not leave, with long term Cold that has no end, choose San Li (ST36)” LS19 ! 著痺不去，久寒不已，卒取其三里 不榮則痛 Bù Róng Zé Tòng “If there is no nourishment, there is pain” © Dr Henry McCann, 2020 12 Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Ling Gu 靈骨穴 22.05 Ling Gu 靈骨穴 22.05 ! Location: On the dorsum of the hand, at the junction of the first and second metacarpal bones, on the Large Intestine channel ! Functions: Frees the channels and quickens the network vessels, clears and regulates Lung qi, frees and descends the Stomach and intestines, frees the qi and disperses stasis ! Indications: Migraine, low back pain, sciatica, facial paralysis, hemiplegia, tinnitus, deafness, menstrual disorders (irregular, scanty, profuse, absent), polyuria, incontinence, foot pain, intestinal pain, difficult labor, angina pectoris, emphysema, pneumonia ! Needle: 0.5-2.0" perpendicular insertion; can be needled through to the thenar eminence (Hand Taiyin Channel) ! Notes: Contraindicated in pregnancy Metacarpal Three Needles 掌三針 ! Dao Ma Point Group on second metacarpal (Zhang 掌 stands for ‘metacarpal’ 掌骨) ! Ling Gu 靈骨 22.05, Da Bai 大白 22.04, and Zhong Kui 重魁 ! Indications: Emphysema, back pain, hemiplegia, irregular menses, dysmenorrhea, pneumonia, sciatica, lumbar pain, pediatric asthma, high fever, headache, nasal pain, trigeminal neuralgia; all chronic diseases, unusual diseases, all diseases of Qi stagnation or that lead to stagnation of the Qi © Dr Henry McCann, 2020 Wu Hu 五虎穴 11.27 ! Location: point group; evenly distributed on the radial side of the ! ! ! ! proximal phalanx of the thumb at the border between the palmar and dorsal surfaces of the thumb (on the junction of the red and white skin) Functions: Opens the channels and quickens the network vessels, disperses swelling and stops pain Indications: Rheumatoid arthritis, osteoarthritis, osteoporosis, acute injury; pain of hands, fingers, feet, toes, heels Specific indications: #1- pain of fingers palm, #3- toe pain, #4- dorsal foot pain, instep pain, #5- heel pain; #2- assistant to form Dao Ma with #1 or #3 Needle: 0.1-0.2" insertion Note: Can be combined with Ling Gu 22.05 and Da Bai 22.04 to treat bony swelling 13 Pain Management with Tung’s Acupuncture – An Introduc9on Wu Hu 五虎穴 11.27 TCM Kongress 2020 Shou Jie 手解穴 22.10 ! Location: On the palm, between the 4th and 5th metacarpals, 0.5 cun proximal to the distal transverse crease; on the Heart channel Overlaps with Shao Fu HT-8 ! Functions: Regulates and harmonizes the qi and blood, courses the channels and quickens the network vessels, settles and tranquilizes, quiets the spirit ! Indications: Iatrogenic effects of acupuncture treatment (e.g., dizziness or pain/numbness), severe trauma, intense pain (from disordered movement of Qi and Blood), sciatica, lumbar pain, trigeminal neuralgia, pain of the entire body, post-surgical pain, food poisoning, ingestion of toxic herbs, severe and acute pain from gastroenteritis, use as acupuncture anesthesia for tooth extraction or uterine surgeries (experience of Taiwanese authors) Shou Jie 手解穴 22.10 Shou Jie 手解穴 22.10 ! Needle: 0.3-0.5" perpendicular insertion; retain needle for to minutes to treat iatrogenic effects of acupuncture (if effect was caused by one specific needle, apply needle on opposite side of the body); for severe trauma or generalized pain syndromes longer retention is applicable © Dr Henry McCann, 2020 14 Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 How we treat pain? ! Chronic pain patients often present with depression; one study of chronic pain patients on opioids found that 61% had major depression " Bouckoms AJ, et al Chronic nonmalignant pain treated with long-term oral narcotic analgesics Ann Clin Psychiatry 1992;4:185–92 ! Depression makes pain feel worse " Fishbain DA Approaches to treatment decisions for psychiatric comorbidity in the management of the chronic pain patient Med Clin North Am 1999;83(3):737–60 ! Pain causes depression as often as depression causes pain " Merskey H Psychological medicine, pain, and musculoskeletal disorders Rheum Dis Clin North Am 1996;22(3):623–39 Zu Jiu Li 足九里 How we treat pain? ! Neijing recognizes that pain and emotional disorders are related; the Ju Tong Lun (SW39) describes pain first and then goes on to describe emotional states and how they effect the qi and blood internally ! 諸痛瘡癢皆屬於心 All pain, sores and itching are subordinate to the Heart ! From Zhi Zhen Yao Da Lun 至真要大論, Su Wen 74 痛則不鬆，不鬆則痛 Tong Ze Bu Song, Bu Song Ze Tong “Pain causes an non-relaxation, non-relax causes pain” Zu Jiu Li 足九里 ! Location: Zhong Jiu Li 中九里穴 88.25 is located at the midpoint of the median line of the lateral thigh, where the tip of the middle finger touches when a person stands erect with their arms hanging by their sides; Shang Jiu Li 上九里穴 88.26 is 1.5 cun anterior to Zhong Jiu Li 88.25, between the Gallbladder and Stomach channels; Xia Jiu Li 下九 里穴 88.26 is 1.5 posterior to Zhong Jiu Li 88.25 ! Functions: Benefit qi and treat blood, free and disinhibit the joints, soothe the sinews and transform stasis ! Indications: Migraine, low back pain, cervical spondylosis, numbness and pain of the hand and arm, facial paralysis or pain, dizziness, tinnitus, leg or knee pain, hemiplegia, bone spurs, lack of strength in the nerves (神經無力); lung diseases or inflammation; arm pain; abdominal pain or distention © Dr Henry McCann, 2020 ! Needle: 1.5” – 3” perpendicular insertion ! Notes: Zhong Jiu Li 88.25 with Ling Gu or San Cha San treats hemiplegia; with Tian Huang 77.17 treats shoulder pain or frozen shoulder; with Upper Three Yellows (Shang San Huang) treats wandering pain, although treatment takes time; Xia Jiu Li 88.27 together with Jian Zhong 44.06 treats migraine 15 Pain Management with Tung’s Acupuncture – An Introduc9on Zu Jiu Li 足九里 TCM Kongress 2020 Channel Diagnosis & Zang-Fu Diagnosis ! Kidney Zang governs bones ! 病之在骨也 [Kidney] disease is located in the bones (Su Wen 4) ! 腎生骨髓 Kidney engenders the bone and marrow (Su Wen 5) ! Leg Shaoyang Gallbladder Channel governs bones ! 是主骨所生病者 (Ling Shu 10) Case Study – Finger Laceration ! 51 year old female injured left hand with hedge trimmer June 2016 Had lacerations to the ring and middle fingers, and fractured distal phalanges Upon presentation months later there was still significant swelling of the fingers, pain at the MCP joints, and numbers in the fingers Pain was worse with cold and in rainy weather © Dr Henry McCann, 2020 Case Study – Finger Laceration ! Dx: Late stage injury with blood stasis and cold- damp in the sinews and network vessels ! Treatment: (R) Shui Qu 66.09, Mu Liu 66.06, Men Jin 66.05, Wu Hu 11.27 (#1, 2); TDP lamp over (L) hand ! Patient was asked to move through treatment while needles retained 30-45 mins; even with first treatment there was diminution of pain and stiffness immediately upon needle insertion 16 Pain Management with Tung’s Acupuncture – An Introduc9on Case Study – Finger Laceration TCM Kongress 2020 Case Study – Finger Laceration ! Herbal Formula: ! Gui Zhi 30g, Wei Ling Xian 15g, Fang Feng 15g, Wu Jia Pi 15g, Shen Jin Cao 15g, Gu Sui Bu 15g, Xu Duan 15g, Jing Jie 9g, Ru Xiang 9g, Mo Yao 9g, (Zhi) Fu Zi 9g ! Decocted and then Epsom salt stirred into decoction; used as external soak References References ! Hu BQ 董氏針灸全集驗證（上下冊）[A Complete Inventory of Tung’s Acupuncture, Vol and 2] Taipei: Zhi Yuan Bookstore, 1998. ! Hu BQ 董氏奇穴圖譜治療學 [Illustrated Study of Treatment by Tung’s ! ! ! ! ! Lineage Curious Points] Taipei: Zhi Yuan Bookstore, 1999. Li GZ 台灣董氏針灸倒馬針刺療法 [Taiwan’s Tung Lineage Dao Ma Needle Therapy] Taipei: Zhi Yuan Bookstore, 1999. Li GZ 台灣董氏針灸經穴學 [Taiwan’s Tung Lineage Study of Channel Points] Taipei: Zhi Yuan Bookstore, 2011 McCann, H Pricking the Vessels: Bloodletting Therapy in Chinese Medicine London: Singing Dragon, 2014. Unschuld P Tessenow H Huang Di Nei Jing Su Wen Berkeley: University of California Press, 2011. Unschuld P Huang Di Nei Jing Ling Shu Berkeley: University of California Press, 2016 © Dr Henry McCann, 2020 ! Other References can be found in: McCann H, Ross H-G Practical Atlas of Tung’s Acupuncture, 6th Ed Munich: Verlag, Müller and Steinicke, 2018 ! Original Chinese text of the Neijing and Nanjing can be found at ctext.org 17 Pain Management with Tung’s Acupuncture – An Introduc9on TCM Kongress 2020 Dr Henry McCann, DAOM, LAc ! Dr McCann’s clinic: ! www.newjerseyacupuncture.com ! For more information on Dr McCann’s teaching please visit: ! www.asianmedicine.org ! www.classicaltaiji.org © Dr Henry McCann, 2020 18