handtq

Point Location -- What Am I Looking For?

The first principle in point location is the “Live Point” concept. Anatomical locations are just a guideline; real treatable acupuncture points need to be located by other criteria.

According to Sodo Okabe, there are five types of changes associated with acupuncture points:
1) Induration - a small nodule is felt at the point which may produce a dull pain when pressed
2) Tenderness - a hard area which produces a strong pain when pressed
3) Hyperesthesia - pain felt on the surface of the skin when stroked or lightly pinched
4) Depression - a small area into which the finger falls, often at source or tonification points
5) Congestion - a superficial, slightly bloated, pillow-like stagnation often found on the abdomen

Indurations tend to come in three types: Soft/spongy, medium and hard. In the Toyohari association, the names given to these are kyoro (moving), gomu (rubber) and karebone (bone-like). The softer indurations are less chronic and easier to treat. If a person has significant amounts of hardened tissue, their prognosis is accordingly much worse.

Depressions and sticky congestions are usually felt when looking for tonification points on Yin channels. Points on Yang channels usually have more tenderness or indurations.

The best way to find Live Points is to begin stroking lightly on the channels about five cm either side of a standard anatomical location. Concentrate of the fingertips and note any changes that you feel. Does your finger stop anywhere along the channel? Examine what you feel if it does -- is there a depression, a sticky feeling, a puffy feeling, or a nodule? Watch the face of the patient -- are they wincing, or has their breathing changed? You can also monitor the pulse for changes when palpating around acupuncture points, especially for tonification points. If the pulse improves while lightly touching the point, then the point should be good for tonification.

Basic Needle Technique for Tonification

1) Stand with feet shoulder-width apart, back straight, shoulders and arms relaxed.
2) Breathe into your abdomen, sink your qi
3) Stroke lightly along the channel with the left* index finger to look for the live point
4) When the point is found, keep the finger on the point and lightly rest the left hand on the skin
5) Turn the left index finger over slightly to reveal the point
6) Place the needle (+ tube) against your left index finger, bring it to rest on the point
7) Bring your left thumb to the left index finger to hold the tube/needle over the point (OSHIDE)

.......take a moment to check your posture, relax your shoulders, breathe normally......

8) Wait for the patient to exhale
9) Lightly tap the handle of the needle with the right index finger, almost flush with top of tube
10) Keep the left hand in place
11) Remove the tube with your right hand and grasp the needle with your left index & thumb
12) Flick the needle handle gently, twist it slightly or just wait
13) Focus attention on the needle tip to feel arrival of qi, or on patient’s reaction (breathing, etc)
14) When qi arrives, remove needle and close point or remove hands from needle and retain

This process is the same for all needle techniques, with the differences in manipulation, etc, for dispersion substituted. For contact needling, subtract step 9 -- don’t tap the needle in, just remove the tube and manipulate the needle.

*Right-handed practitioner assumed

Arrival of Qi -- How Do I Know If I’m Doing It Right?

Since the emphasis is on changes the practitioner feels when needling and not on the patient feeling a needle sensation, how do we know that the needling is effective? Eventually, the practitioner develops a sense of whether or not the needling is effective based on their experience, but for the beginner the following are things to look for:

1) The pulse positions become more evenly balanced, or the pulse quality and Yin/Yang balance becomes more harmonized (pulse moves toward the middle depth, slows down, becomes less scattered, etc)

2) Changes occur on the skin -- not just at the point, but along the channels, abdomen and face. The skin becomes more lustrous, color returns to the cheeks, etc.

3) Tender or hard areas become reduced

4) Cold hands or feet begin to warm up

5) The patient begins to breathe more deeply and evenly

6) Abdominal sounds become audible during needling

7) Symptoms are improved, feel “lighter” or disappear

8) The arrival of Qi at the point underneath the tip of the needle or the left hand

Some of these phenomena are subtle and take a while for the practitioner to recognize. The most obvious are the improvement in breathing, abdominal sounds and improvement in symptoms. Look for these first, and when they happen, notice any other changes, such as feelings in needling and supporting hands. Be aware of memorizing any physical sensations associated with good treatments, and you will be better able in the future to judge whether or not your treatments are effective.