When Tung wrote his original book in 1973 most of the point indications were described in western medical terms. (1) Certainly, Tung was not a physician trained in western or modern medicine, and Tung’s acupuncture comes from pre-modern China. As such, western medical terms were not originally a part of the system. Some modern practitioners of Tung’s acupuncture (especially those initially trained in western medicine) claim that points should be chosen based primarily on modern western disease categories. They also believe this is how Tung practiced. Yet that is nothing more than revisionist fantasy. Tung practiced classical Chinese medicine based on classical Chinese concepts of disease. In his own writing Tung himself said that he used western disease terms for the purpose of modernizing and popularizing his system (爰用現代語文。撰述本書。旨在發揚國粹。廣起沉痾。). (2) Therefore, instead of disorders of “qi” he wrote about disorders of the nerves. Instead of “blood” he discussed disorders of the vasculature. This trend of westernizing Chinese medicine was not unique to Tung’s writing but rather was part of the Zeitgeist of the time in Asian medical practice.
That said, we are still stuck with lists of western indications. Part of the challenge of studying Tung’s system is ‘translating’ modern western disease terms back into diseases or syndromes that are recognizable by classically trained Chinese medicine practitioners. The other challenge we have is assigning syndrome pattern treatment guidelines to Tung’s points. Prior to the 1950s there was actually little point functions ascribed to acupuncture points, only lists of indications. Widespread use of functions was an outgrowth of the TCM movement that sought to describe points as we do herbs. While this may lead to some problems in understanding exactly how points are used, some modern Chinese medicine scholars have pointed out that (a) this practice does have historical antecedents in classical texts, and (b) it does make the process of learning to use points clinically more flexible, understandable and, therefore, useful. (3) Therefore, even though we are only given indications for Tung’s points, a careful evaluation of the points easily lets us generalize point functions. This work is being done quite a bit among Taiwanese authors yet little has made its way west because of the limited number of people writing about Tung’s points in English.
Originally in Tung’s system there was no use of needle techniques to supplement or drain points (i.e., acupuncture hand techniques of bu fa 補法 and xie fa 寫法 are absent). Rather than hand techniques, supplementing and draining is primarily achieved by point selection rather than needling method. In addition, point combinations or pairings (dui xue 對穴 or pei xue 配穴) further accentuate supplementation or drainage. This is in accord with classical texts such as the Nan Jing, which, in sections, rejects the idea that needle technique alone is effective at supplementing and draining at any individual point. Here we introduce one such point pairing.
One of the key point pairings in Tung’s acupuncture for general Qi supplementation is Ling Gu 22.05 with Si Hua Shang 77.08. Ling Gu 22.05 is located in the space between the thumb and first finger, proximal to He Gu LI-4. The Hand Yangming channel is full of both Qi and Blood, and other points on the same channel have a general supplementing function. This area of the hand is also a region of thick flesh right next to a bony junction. In terms of tissue resonance we can hence see that Ling Gu 22.05 stimulates both the Spleen-Earth and Kidney-Water, each respectively the locus of Latter Heaven Qi and Former Heaven Essence. These relationships are strengthened further by channel associations; the Hand Yangming communicates with the Leg Yangming Stomach (they are both branches of the Yangming channel system), as well as with the Leg Shaoyin (they are opposite on the diurnal circulation clock of channels). Therefore by itself, Ling Gu 22.05 has wide ranging effects than can include general supplementation.
Si Hua Shang 77.08 is located at Zu San Li ST-36, one of the most commonly used points for supplementation, especially of the Middle Jiao. Si Hua Shang 77.08 is the earth point on the earth channel, and a He-Uniting point. As such it has a special ability to achieve consolidation of Qi and Blood (i.e., it enhances storage cang 藏) in the Zang-Fu that are responsible for Latter Heaven production of Qi. Since both Ling Gu 22.05 and Si Hua Shang 77.08 are located on the Yangming, they are a harmonious combination. Together they are one of the best point combinations for general Qi supplementation.
In terms of needle technique, the supplementing effect of these points is enhanced by order of needle insertion. In this point combination the appropriate order of insertion is first Si Hua Shang 77.08 followed by Ling Gu 22.05. This is an example of 各經循環相生法 Following Channel Circulation Mutual Engendering Needle Method, an advanced concept in needling that I teach as part of Tung’s acupuncture. Inserting in this order is needling first the Leg Yangming Stomach channel followed by the Arm Yangming Large Intestine channel. In other words we needle an Earth channel followed by a Metal channel. The 69th chapter of the Nan Jing says, “in vacuity supplement the mother” (虛者補其母). One application of this is combining channels in the engendering cycle of the Five Phases. Thus, needling an Earth channel (mother) first followed by a Metal channel (child) has an effect of giving the point combination more of a supplementing effect without having to use supplementing or draining hand technique on each individual point.
After needling this point pair the clinician can apply moxibustion for further supplementation. Appropriate point additions for general Qi vacuity can include moxa on Si Hua Shang 77.08 (after needles are removed) or on Huo Fu Hai 33.07. If there are more signs of Middle Jiao insufficiency moxa can be applied to Zhong Wan REN-12. If there is insufficiency of the Defense-Wei then moxa Da Zhui DU-14. In this case the point combination of Ling Gu 22.05, Si Hua Shang 77.08 and moxa at Da Zhui DU-14 functions to treat sensations of cold, fatigue, and clammy skin or spontaneous sweat similar to Gui Zhi Tang or Gui Zhi Jia Huang Qi Tang. In all these cases the most effective method of supplementing with moxa is small (rice grain sized) cones burned directly on the skin.
There is more that can be explored in terms of point combination, order of insertion, needle depth, and other considerations that enhance treatment. Future essays will explore other similar advanced concepts, and the use of Tung’s points to treat pattern diagnoses. Hopefully this will stimulate thought and increase treatment efficacy with patients. For more information please take a look at our bookstore or class offerings.
Written during Small Cold in the year Jia Wu
References:
- Tung CC. 董氏針灸正經奇穴學 [Tung Lineage Acupuncture Study of Orthodox Channel Curious Points]. Taipei: Hsin Ya Publications Ltd; 1973.
- Tung CC. 董氏鍼灸正經奇穴學 [Tung Lineage Acupuncture Study of Orthodox Channel Curious Points]. Privately published notes; 1968.
- Deadman P., Al-Khafaji M. A Manual of Acupuncture. East Sussex, England: Journal of Chinese Medicine Publications; 1998.