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Oct. 2009 Posted by the Grand Master

When the Acupuncture Needle Does not Suffice

There are many of the classical acupuncture points (~ 365 points) that are uncommonly used and have fallen into the textbooks as assumed mere trivia for licensure exams but never find their way into regular clinical use. There are many reasons for this, but one point that is clear: a general and long term failure of the acupuncture community to understand the actual mechanism(s) of acupuncture, and to merely think all that needles do is "direct the flow of qi" assuming after puncture, all will be well. There are hundreds, if not thousands of websites with statements like: "Acupuncture works wonderfully to open the patient's own chi to flow freely which facilitates normal healing."  Suffice it to say, ch'i is most often not defined, and this simplistic approach is still lauded in the textbooks and contributes not only to poor clinical results but a poor medical image of our profession. 

To the neurologist, the thought of directing the flow of qi would raise numerous questions about neurotransmitter involvement, pain response mechanisms, referred pain patterns, and peripheral nerve conduction phenomena. To the physicist, the thought of directing the flow of qi with an external needle would face a wake of questions including the potential atmospheric bombardment of microwave radiation and conduction of corona ions upon an inserted needle acting essentially as an antenna. To the physical therapist questions would arise as to site of stimulation, whether nerve stimulation would be dermatomal, sclerotomal, or myotomal; and if sufficient voltage and amperage would achieve the desired effect. All of these being valid questions. However, these questions yield little clinical utility, one would think?

So what does the needle actually do? The answer is many things from ionization to intention. What is the effect of needling or its function to achieve the desired result is also another valid question. Most of these I have satisfied for myself after some thirty years of study, clinical application and deep speculation.  But I present here one overlooked aspect of the apparent nuance points we should heed for posterity.  But first, a little history...

According to the Chinese popular legend, Fu Xi (5000 B.C.E) was the earliest ancestor of human beings living in China. Throughout his life, it is writtten, he devoted himself to passing on how to be engaged in farming, fishing, hunting and animal husbandry, to the common people. In his works, Lu Shi , dealing mainly with historical events of ancient legendary, i.e. Luo Mi of the Southern Song Dynasty (1127 - 1279 A.D.) said: "Fu Xi tasted various medicinal herbs and made Bian-healing stone in order to cure common people of their diseases." Si Bin stone composed of limestone proved to be the desirable stone of fine quality with which the ancient Chinese people made instruments for use in Bian-healng skill. Si Bin stone functions both as permeating and dispersing like an " invisible needle " having a therapeutic effect on the deep part of human body, i.e. " Bian-healing skill is hired to serve as a way of medical treatment."  Jade needles, more finely pointed, from 2.5 - 18 cm long, have been unearthed from the period of the Shang and Zhou dynasties, 16 - 11th B.C.E., and are now kept in the Medical Museum of the Guangzhou University of Traditional Chinese Medicine. 

There is an interesting legend that the Chinese came to understand the power of acupressure points with the arrival around 10,000 BC, of incredible seven feet tall healers known as the Sons of Reflected Lights. These beings could see the aura and the meridians of people with the sensitive points showing up as tiny pinpricks of light. They healed by directing their own life force at the sick person from a distance of several feet. Over the centuries, their sensitivity and power decreased and they moved closer and closer to the body until they were using the pressure of their fingertips, eventually graduating to sticks and stones, bian-stones, aka acupuncture needles. The oldest massage tool yet to be discovered is supposedly a Neolithic jade ritual blade from the Longshan culture of China, dating back to the Shang dynasty, 2000 B.C. The oldest known text written about massage is the Chinese Cong-Fu of the Toa-Tse, which dates from 3000 BC. It was translated to French in 1700’s. Amma or anmo was their name of massage. They were the first to train blind masseurs.  Perhaps difficult to prove without any documented evidence but it makes a nice story.

Acupuncture we are told started in the stone age. According to historical records, the earliest needles to be used were of stone. The bian stone (a sharp flat stone) was used to cut sores and ulcers, and to prick on a certain part of the body to treat diseases. Some of the oldest needles found date from the Neolithic Age (2,500 B.C.). (picture) As technology advanced, bone fragments, bamboo sticks, bronze, iron, gold, and silver was used to make the needles. The advances in metallurgy, circa 1000 BC, contributed greatly to the advancement of the practice of acupuncture, but it was a very slow development. The best iron for making acupuncture needles was said to be that from the bit of the horse's bridle. It was supposed as experience in acupuncture grew towards the beginning of the Christian era, needle specifications and thinness became more exacting. 

A thorough reevaluation of all extant literature, as well as documents and archeological relics unearthed since the 1970s, confirms that acupuncture with the use of metallic needles is not as ancient as has generally been assumed, and that it did not, in fact, appear and gradually develop during China's Neolithic Age (c. 8000-2500 BC). Rather, this great invention arose quite late only two millennia ago. All evidence indicates that acupuncture with the metallic needle first appeared during the Warring States Period (475-221 BC), during the time of Bian Que, developed during the early Western Han Dynasty (206 BC-24 AD), during the time of Cang Gong, and had fully matured by the latter part of the Western Han Dynasty, at the time of the actual compilation of the Nei Jing (Yellow Emperor's Classic, c. 104-32 BC).

Suffice it to say, acupressure, massage and pricking, predated acupuncture, and ours is the art of acting on acting upon reflexes. There is a big difference between generalized massage and reflexology, both with their merits. Massage generally aims for systemic effects, the circulation of body fluids, relaxation or stimulation of muscles, invigoration of the organism, with a plethora of methods and techniques to achieve these goals. Action upon reflexes can be a highly specific art, from that of generalized effects, e.g. rolfing, to that of specific clinical effects, i.e. acupuncture. It is to this end, we go from the generalized invigoration, to achieving medical and definitive results with precise applications, anatomic locations, and modalities. This would be the aim of acupuncture treatment. 

In those early days of the Westernization of Chinese acupuncture, I was always fascinated and equally frustrated about the traditional approach to acupuncture (aka TCM), and equally realized the "cookbook" acupuncture formulas simply did not suffice. I recall one patient in my early career with recidivous tennis elbow only to be told sometime after a series of treatments, the patient had found a "reflexologist" at a shopping mall in Australia (while on vacation), and he quickly directed attention to his ankle, kneading and goading him into a minute of excruciating pain, only to find the chronic pain in the elbow completely disappeared and never to return. Five dollar tip or learned experience? That was most instructive and changed my approach and viewpoint of acupuncture forever. There have been many more lessons upon my worldwide path, but suffice to say I learned there are big differences between acupressure and acupuncture. Both equally have their merits, but equally achieve results quite differently, it would seem?

As an example, let's examine a few points while we pardon the pun. 

We have one such point called pu-yung, or "uncontainable," aka stomach 19. From its location and standardized (westernized) location - six inches above the navel and 2 in. lateral, on the inferior edge of the eighth rib, 2 cun lateral to Jujue (Ren 14), just medial to rib cartilage, with a puncture depth of 0.5 - 1 inch, we find here one location already lost. A mere puncture here would be thought to be strictly dermatomal, and that would be certainly the case provided one did not puncture the heart itself, and if one did not understand that the point's action would be yielded only upon puncture of the rib cartilage (fascia) itself. Would you ever imagine a skinny needle made stainless steel wire, inserted into the skin of a big belly would successfully treat "stomachache, gastrectasis (dilation of the stomach) with vomiting, or intercostal neuralgia"? 

As it turns out, the point's real secret lies with the fascial location "upon the rib cartilage," not just medial to it. It is located by hooking the finger along the inside margin of the ribs approximately two-thirds of the distance down from the lowest end of the breastbone or sternum. Generally, a slight notch in the rib margin will indicate you have the correct contact point, especially when the patient winces with some pain. Now find it for yourself and do a little digging and see if it is not tender (ah-shi, this Weihe point if tender, points to the need for hawthorne berry). The question is, do we have a definitive art, or is it sometimes there are just random connections between an illness and a tender spot? These are the times that the so-called acupuncture "technique of Ah shi" comes into play for most acupuncturists, if not all the time. Simply put, an unexplained pain or tender point anywhere on your body is the body's reflex to rebalance its energy circuits by causing pain at these tender points. 

However, these are not necessarily random points. We are hard-wired from birth through the ectodermal, embryonic layer with nerves that go more or less to the same places on all of us, allowing us to speak the same language, make the same facial grimaces universally, walk upright, and chew gum. If our neurological underpinnings were randomized, we could never associate collectively and be called "humanity." 

We all have nearly the same reflexes to cold, heat, horror and a hammer upon the knee cap, although we may have different emotions so related. A reflex is an ingrained response so as to protect the organism for survival and that includes the disease process. Simply put, were our reflexes randomized, we would not have acupuncture meridians, some 72 actually known to so few. But let's face it, the acupuncture meridians promoted by so many today (and many who know so little about them) were actually recorded over four thousand years ogo, and are in need of a real upgrade?

Suffice it to say, and more importantly, the entire acupuncture network of points are in dire need of an upgrade based on our current knowledge of histology, neurology, and such splendid arts as " Myofascial TriggerPoint Therapy," "Reflexology," "Shiatsu," etc. and the scores of personalized techniques that have been developed in the last one hundred years since the birth of osteopathy, reflexology, and chiropractic. 

We must also keep in mind, those most commonly used filiform needles today are an "improved" form of the ancient filiform needle, which was the long needle for puncturing thick muscles. Today, we would call it a nail. And as part of the original and ancient "nine needles," the round, blunt needle was used for pressing (palpation) and micromassaging. So the ancient puncture often did not discriminate between muscles, bone, and fascia, and I dare say, few westerners would undergo an ancient, acupuncture treatment, unless the clinic is located in a tattoo/body piercing shop. 

Now, getting back to pu-yang, this point is also marvelous to stimulate the flow of urine in dropsy, aka anasarca. Whenever you find swollen ankles in the obese or elderly, this point is always exquisitely tender. A few seconds of ischemic acupressure will stimulate a marvelous healing with other measures afforded. This is a definite, new indication to add to the acupuncture repertory (of serious import). 

Let's take another example (of a number of more than fifty so catalogued in the author's repertory), Lo-ku, aka Leaking Valley, Spleen 7, 6 inches above the tip of the medial malleolus, on the posterior edge of the tibia. Here we find again, that menacing, westernized conclusion that this point should be "punctured" and thus on the "posterior edge." And we are advised that this point will be indicated in "hysteria, neurasthenia, borborygmus, abdominal distention, leucorrhea" and of all things considered, "gonorrhea." Maybe we should also toss in "salpingitis," a usual outcome of a fulminate PID. So, do we trust the westernized, standardized (and mickey mouse) point location, or take serious import to the ancient and accumulated indications of our trusted physicians of the Orient? 

What I can tell you from experience is that tui-na massage along entire medial aspect of the tibia of both legs provides for major drainage and releasing effects for those constipated. I would suggest a little oil inside of shin bones, and by acupressure against underside of these bones, at points Spleen 6 through 7, pressing according to tolerance, will stimulate peristalsis and pain. For some people who have so much dysbiosis and colon trouble, even a mild contact can make them scream in pain or even nearly faint (hence its indication for hysteria). Treat these cases every day and show them how to do acupressure for themselves. A very important point and region that should not be neglected in any obese patient. The counter-irritation will induce more regularized peristalsis. 

Lastly, let's address those most important "extra points." I actually find more use of these points, outside the traditional meridians, than with. One such point is "release the spring." This point is located very close to L.I.10 (Arm San Li) or 2-3  body inches from the elbow crease upon the Large intestine Meridian. As shown in the diagram, to be at the point on each forearm where the two bones, radius and ulna, begin to spread apart. As the story goes, shock and pain to the body tenses the qi, like a “spring”.  If the qi is tensed, this  point is painful upon palpation. That's everyone today.  A few seconds of strong, continuous, ischemic palpation is marvelously refreshing, but not with needles, it won't work!  The point is between the muscles and compress the point down to the periosteum of the ulna to obtain the exquisite tenderness. This point can even help pain in a cancer patient. 

Another extra point, I refer to in my voluminous text, POINTS 2010, as VI-E8, is located by dividing the midline of the sole of the foot into 10 equal parts. This point is located 3.5 units anterior from the posterior edge of the heel.  The traditional acupuncture indications include Headache, insomnia, and is a foot anesthesia point for surgery. It is closely located in the center of the bottom of each foot just in front of the heel prominence. This releasing point has to do with electrical energy from the earth (ground) to man and travels clear to brain. It becomes tender wherever there is inflammation, of any type, acute or chronic, in the body. Ischemic pressure here for 5-10 seconds will revitalize the organism and is an excellent pretreatment. It is difficult to needle, again a palpation at a 45 degree angle towards and upon the calcaneal prominence with a micromassaging, rotary motion with a blunt probe will reveal the point deep in the fascia and its exquisite tenderness, which summons the therapeutic effect. 

Now, cranial points, these too are so often ignored and not understood. My mentor Dr. Voll made a detailed study of these in his later years which few found any import. With my new adaptive probe, we can now reliably measure these points and witness the indicator drops alluded to. However, exquisite tenderness still remains our best criteria for indication of treatment. We have one such point upon the temples which is exquisitely tender in practically all patients, upon ischemic palpation, and will start to relax all the muscles in the body. That point is Gall Bladder 4.


Acupuncture from the 1960's onward in North America brought us the topographic points to puncture but mainly with reference only to their dermatological-anatomic reference site. Body landmarks are described with reference to skin sites with little instruction as to the actual site of puncture beyond skin insertion. 

The term "trigger point" was coined in 1942 by Dr. Janet Travell to describe a clinical finding of painful points which can be felt as a tumor or band in the muscle, and a twitch response can be elicited on stimulation of the trigger point. Palpation of the trigger point reproduces the patient's complaint of pain, and the pain radiates in a distribution typical of the specific muscle harboring the trigger point. Thus we have successfully identifed the disturbing myotomal distributions in muscle tissue, where much of our patients daily aches and pains are harbored. 

The author brings to light a third dynamic, that was uncovered by the early osteopaths of the 20th century, but never really formalized into a therapeutic system, the tender points of the sclerotomes.  As most know, the embryological somite is divided into three segments: dermatome, myotome, and scleratome. Each of these structures can cause referred pain in a different type of referral pattern. A sclerotome is part of the somite, a structure in vertebrate embryonic development. Whereas dermatomes differentiate into skin and nerves, sclerotomes eventually differentiate into the bones of the vertebrae and most of the skull. Similar in distribution to the familiar dermatomes, sclerotomes, however, provide an element of depth to the sensory innervation based on the deep fascia as an embryologic boundary layer. Anatomical knowledge of sclerotomes can be used clinically in the diagnosis and treatment of visceral and other pains.

Although the acupuncture books describe the points by their topographic location, the exact loci of puncture is usually ill defined. In fact, a single acupuncture loci may be depicting several points at one time, depending upon the depth of puncture.

Dermatome Ah shi, Auricular
Trigger points
Points in the sinews
Viscerotome Abdominal fascial pts.

Sclerotogenous pain is reported by patients as deep, ill defined, dull, aching, and generally diffuse. Sclerotogenous pain does not follow dermatomes but does usually follow a sclerotome pain pattern of the spinal segmental nerves. The tissues that are included in sclerotogenous pain include ligaments, tendons, discs, periosteum and apophyseal joints. Upon palpation, the active points are usually exquisitely tender, marked by deposition of toxic salts and thus can have a hardened, even crystalline or granular feel.
A sclerotome is a deep somatic track that is innervated by the same signal spinal nerve and when the tissue of a sclerotome is irritated by mechanical or chemical irritants, pain is experienced as originating from all of the tissues that are innervated by the same nerve, or along the sclerotome, and even to remote intercalated areas up and down the spine. The Chart that follows shows the spinal levels C-1 through S-3.
The challenge over the years has been to electrically measure these loci using the Voll method and subsequently stimulate these exquisitely tender points and chart their ramifications. Since no historical scheme of pain referral exists, as in ancient acupuncture, it has been a daunting task to find the scant references, charts and curios, and by palpating and locating these loci, piece together the clinical applications and experiences. These have now been recorded in this Manual of Pressure Point Healing™.
Pain referral from joints or other soft tissue (fascial) structures typically does not assume a myotomal (trigger point) or dermatomal spread pattern. Pain arising from superficial, fascial soft tissue structures that can be identified by palpation often permits more precise localization of the causative tissue or structure. For example, a contraction like, ensheathing callus of the external iliotibial tract of the tensor fascia lata is indicative of a lymphatic congestion of the prostate gland or uterus. In this case it will be excruciatingly tender.
However, pain that is referred from extra-axial joint capsules and other periarticular structures, such as ligaments, tendons, bursae, and bone surfaces may be more difficult to differentiate since palpatory massage can radiate waves of relief throughout the entire organism as a post-algophobic incident. Pain from bone and periosteum is usually localized upon injury, but contact-release points can radiate throughout the body’s entire fascial network upon palpatory therapy. Some of our most powerful points will be found upon the periosteum of the skull (releasing neurotransmitters), ribs (Weihe points), hips, and extremities. For example, pain upon the periosteum of the inside shin bone is usually and generally exquisitely tender in colon stasis and dysbiosis.
Releasing points upon some well known structures make us, as acupuncturists, rethink our entire approach to reading the classics.

For example, the point Shen-Mai (Bl62) below the lateral malleolus of the ankle, is the ancient confluent point of the Yang Chiao vessel (Yang Motility Channel). The Yang Chiao starts near the point Bl-62, or the outer malleolus. It then climbs the lateral side of the leg and joins the meridian of the Gall Bladder at GB-35 that up to the lateral side of the tensor fascia lata. The essential symptom of a disturbance of the Yang Chiao is recorded as insomnia. But we know that stimulation at the level of the calcaneum and tissue structures around the malleolus has systemic effects, a direct effect on endocrine glands, and can reduce fits of epilepsy, meaning it is affecting directly the neurotransmitters of the brain. Suffice it to say, a tiny filiform needle inserted into its usual location of Bl62, does not generally yield these effects, but frank and decisive palpatory massage will.


These manuals, in development since 2004, are to introduce and explain to you these mixed patterns, and show you the complementary sclerotomal points upon the bones and ligaments. These Pressure Points will bring great healing responses to your patients. If you are an acupuncturist, never again be challenged for a point or formula for a particular condition. The Palpation Procedure protocol can be applied to all patients for a quick office workup. For more details, click here...
NOTE: The author is in his next revision of POINTS 2010, with the world's most extensive listing of points both classical, modern, strange and new; with the indications notes, tips and golden nuggets ascribed accumulated over thousands of years. The uses and methods of topical stimulation will be presented at his upcoming seminars in November, Miami and Las Vegas. 

Also to be debuted are the PALPATION REFERENCE CHARTS. A formal method of examination of the Significant Points of Palpation for a rapid clinical evaluation and spot efficacious treatment. 

Materia Medica

Vade Mecum of Topographical Points, Anatomically Defined

Materia medica is a Latin medical term for the body of collected knowledge about the therapeutic properties of any substance used for healing (i.e., medicines). In Latin, the term literally means "medical material/substance". 

A handbook is sometimes referred to as a vade mecum (Latin, "go with me") or pocket reference that is intended to be carried at all times. In our age, that means our vade mecum laptop. 

This massive volume is the world's most complete reference on more than 2,000 topographical points, on a pdf file, over 900 pages. 
This volume has been in development for over ten years. 

The author has compiled a complete Clinical Manual with specific protocols for the clinic, click here for more details. More can be learned at his upcoming seminars.


Books by the Author






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