• In the event of seriousness, needle according to the technique called
Ge Zu
(“claw of the pulse”) is recommended. But after needling, one must examine the
pulse. If the pulse is
changing (Da), tense (Xian) and hurried (Jin) or if the pulse
does not arrive under the finger, needling is contraindicated.”
EXPLANATIONS AND COMMENTARIES
I - Ma Shi explains:
“This paragraph speaks on the accumulation of the energy within the thorax and abdomen, responsible for numerous illnesses, and on the indications and contraindications of therapy.
According to the Suwen: 141.
“Wei, powerful energy originating from Shui Gu (Water-Cereals: foods), does not circulate in the
channels, but in the epidermo-dermal spaces and at the level of Yuan Ma (fibrous, serous and mucous membranes; peritoneum, aponeurosis...) and spreads within the thorax and abdomen. As a result, the stagnation of Wei energy within the thorax or abdomen is an unusual phenomenon, contrary to the rule, hence the appearance of illnesses of the limbs, thorax and abdomen.
Therefore, for example, thoraco-abdominal fullness is indicated by such clinical manifestations as dyspnea, energetic afflux toward the top... . How then do you treat it?”
Qi Bo recommends:
“1 - In the thoracic accumulation and Wei energy, it is advised to needle the points located at the upper part of the body:
_ Daying (St 5), located 1.2 cun from the inferior maxillary angle, _ Tiantu (CV 22), located in a crease 4 cun below the pharynx
_ and Lianquan (CV 23), located at the middle of the neck below the pharynx. Raise the neck to locate this point.
2 - In the abdominal accumulation of Wei energy, one must disperse:
_ Sanli (St 36), located 3 cun below the knee, at the external edge of the tibia, in the middle of the large muscular mass between the two muscles
_ and Qijie (Qichong- St 30), located 2 cun outside the anterior midline, on the femoral artery.
3 - In the thoraco-abdominal accumulation of Wei energy, one must needle the above-cited points: Daying (St 5), Tiantu (CV 22), Lianquan (CV 23), Sanli (St 36) and Qijie (Qichong- St 30) to which one adds the point Zhangmen (Li 13), located below the tip of the 11th rib.
• In serious accumulations of Wei energy, one must employ the method of grouping together”of the needling called Ge Zu (claw of pulse). But before needling, one must carefully observe the pulse:
_ if the pulse is changing, tense and hurried, it indicates the paroxysmal phase of the energy. One must wait for the calm phase to needle.
_ if the pulse is exhausted, it indicates the shortage of energy. One must tonify it’.” II - Zhang Shi states:
“This paragraph gives dissertation on the production and circulation of Wei (defensive) energy which follows the Luomai (secondary vessels) of the Yangming to spread toward the top, bottom amd 4 sides of the body.
When this energy is found blocked and accumulated in the thorax, it is necessary to needle Daying (St 5), Tiantu (CV 22) and Lianquan (CV 23) because these points are the sites of exit of the Wei energy toward the cutaneous system of the upper part of the body. 142.
Similarly, when it accumulates within the abdomen, it is necessary to needle Qijie (St 30; Qichong) and Sanli (St 36) because these points are the sites of exteriorization of the Wei energy toward the cutaneous system of the lower part of the body.
The Wei energy is a powerful energy originating from the Shui Gu (Water-Cereals: foods) whose metabolism is carried out at the level of the Stomach bowel.
The Foot Yangming (St) channel unites:
_ at the Renmai (CV) at the point Zhongwen (CV 12) to reach Chengjiang (CV 24) (see Figure 1)
_ and at the Daimai (channel of the belt), at the left and right of the umbilicus, to link up to Qijie (St 30) located at the groin.
Therefore, once metabolized, the Wei energy follows the Yangming (St) to become exteriorized at the cutaneous system. This is why, one needles the points noted above to treat diseases originating from the irregular circulation of Wei energy.”
III - N.V.N.:
1 - This paragraph emphasizes the importance of the points by which the Wei energy exteriorizes to the exterior to control the epidermo-dermal, muscular and osseous systems of the upper and lower part of the body because, according to Chapter 68 of this classic (“Top of the Diaphragm”): “... the key point is to examine the state of the Wei energy because its insufficiency is the cause of “100 diseases”.”
2 - As for the technique called Ge Zu (foot of pulse), it is that described in Chapter 7 of this classic (“Use of the Needles”) under the name “Hegu Ci” (needling reproducing the angle found at Hegu- Li 4):
“3 or 4 needles oriented toward the point of impact evoking the claw of a chicken.
This type of needling must touch “the spaces of distribution of the flesh” (Xi and Gu: small valleys and valleys).
This method treats Gu Bi (pain of the flesh: dermalgias). It responds to the spleen.” Ma Shi explains:
“At the left as at the right, needling consists of several needles directed in a fashion in the pattern of a claw of a chicken, its depth not exceeding the “spaces of distribution of the flesh”.
As the energy of the spleen controls the dermis (flesh), this method responds to the spleen organ.” In summary, “Hegu Ci” does not designate the needling of the point Hegu (LI 4). It is a general technique of needling:
_ after having implanted the needle to a specific depth, lift it up slightly and place it permanently at the level of the dermis. With the aid of 3 needles, form the ideogram (fishes) that evokes the image of a chicken claw.
143.
_ specific technique in the treatment of Bi of the flesh (dermalgia).
_ technique provoking reactive phenomena of the energy of the spleen because the spleen organ controls the system of connective tissues (flesh).
3 - Before needling, one must carefully examine the pulse because, according to Zhang Jing Yue: _ the changing, tense and hurried pulse is the sign revealing the emptiness of Yin
_ the exhausted pulse which does not reach the fingers, associated with markdely tense abdominal skin is the indicator of escaping of the Ying energy.
In these two cases, needling is absolutely contraindicated.
Figure 2 Figure 3
Points to needle in the case of accumulation of Wei (defensive) energy: _ Thoracic accumulation (Fig. 1)
_ Abdominal accumulation (Fig. 2)
_ Thoraco-abdominal accumulation (Fig. 3)