Dai Mai 帶脈 Case and Tung's Acupuncture

The last two weeks in the Nanjing (難經) class that I teach in NYC we spent time going over classical references to the Eight Extraordinary Vessels. Also, this last month or so we have been practicing Dai Mai (帶脈) exercises in the Daoist Neigong / Qigong class that I teach regularly here in New Jersey. Inspired by both, I’ve been reading some Extraordinary Vessel books out of China, so I thought I’d discuss a Dai Mai case study here and include some musings about Tung acupuncture treatments related to treating that vessel.

This Dai Mai case comes from Qi Jing Ba Mai Yu Zhen Jiu Lin Chuang 奇经八脉与针灸临床 by Mei Jianhan and Yang Yuhua (Beijing: People’s Medical Publishing House, Beijing). This case is of a 38 years old male worker by the name of Zhang suffering from Kidney Fixity (腎著). Kidney Fixity is described in the Jin Gui Yao Lue, and is a condition where Kidney vacuity leads to cold damp being “fixed” on the interior, usually leading to pain and heaviness in the lower back. In the Jin Gui the treatment given is Gan Cao Gan Jiang Fu Ling Bai Zhu Tang. In this case of course the treatment given is acupuncture.

Zhang’s main complaint was low back pain of 2-3 years duration. He reported a sensation of cold and severe heaviness in the lumbus, with difficulty turning side to side. Pain was worse at night. He had frequent urination and sloppy stool. There was some edema in the lower extremities. The pulse was deep and slow, and the tongue coating was grayish. The disease started when he would sweat during manual labor. After, while resting, the cold sweat on his body penetrated internally to the muscle layer leading to cold-damp Bi impediment. His Wei-defense was impaired allowing invasion of cold evils, thereby depleting the Qi. This led to a weakening of the Dai Mai. The treatment principle was to warm the cold, expel damp, diffuse impediment and stop pain.

The points treated were Wei Dao GB-28, Dai Mai GB-26, Ming Men DU-4 and Wei Zhong BL-40. All points were treated with even supplementing and draining technique, then warming needle moxa was done on all points except Wei Zhong. During the second examination, the pain had diminished and the original prescription was repeated, except that time bleeding Wei Zhong. Similar treatments continued and within 10 treatments he was mostly better.

I really like this type of Extraordinary Vessel approach that does not need to include the so-called master/couple points so common in modern practice (I tend not to use them in my own treatments that often). Chewing on this idea, I’ve seen many patients with similar complaints that could be diagnosed as Kidney Fixity with impairment of the Dai Mai. A typical Tung acupuncture protocol would be to needle Dao Ma groups such as the Shen Tong San Zhen (腎通三針; i.e., Tong Shen 88.09, Tong Wei 88.10 and Tong Bei 88.11), with bleeding of the Posterior Thigh Zone (大腿股後區; pp. 114-115 of my bloodletting book). Interestingly, bleeding this area of the leg is a classical treatment for the Dai Mai…

In the Ci Yao Tong (Piercing Lower Back Pain, SW41) there is a description of low back pain related to the Transverse Network Vessel (衡絡之脈). According to Zhang Zhicong, this vessel is actually a description of the Dai Mai. When afflicted, usually due to injury from improper lifting, the appropriate treatment is to bleed the spider nevi on a horizontal line on the posterior thigh proximal to Wei Zhong. In many cases of chronic low back pain this is precisely the area, in addition to those at Wei Zhong, where I observe dark veins.

This Tung protocol replicates the same treatment strategy as the Dai Mai case study above. The Shen Tong San Zhen points, especially Tong Bei 88.11, secure the kidney, bank the origin, warm the channels, and scatter cold. Bleeding the Posterior Thigh Zone is a specific treatment for the Dai Mai. Together these points strengthen the Kidney, warm cold, and expel evil that has penetrated into the Dai Mai. I do believe that there are other Tung points and protocols that regulate the Eight Extraordinary Vessels and perhaps in future points I’ll discuss this idea more.