Point Indication Review Point Selection

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Point Indication ReviewPoint Selection

• ACR class 11

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POINT SELECTION METHODS

• Basic strategy
• 1) Select a Local Point
• 2) Select a Distal point

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SELECTING LOCAL POINTS

• Local points - on, over or very near the diseased
  area.
• Most obvious method, yet very important
• Should not be dismissed as simplistic or
  symptomatic
• Much used in treating disorders of the organs.

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• Examples include
• ST-25 or REN-8 for diarrhea.
• REN-12 for nausea.
• REN-17 for tightness of the chest.
• L.I.-20 for diseases of the nose.
• SI-19 for diseases of the ears.

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SELECTING ADJACENT POINTS

• Adjacent points are located near the affected
  area.
• Examples include
• SP-10, ST-34 or SP-9 for diseases of the knee
  joint.
• L.I.-14 for diseases of the shoulder.
• GB-21 or SI-11 for diseases of the breast.

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SELECTING DISTAL POINTS

• Most frequently used method in acupuncture
  treatment.
• The Ode to Elucidate Mysteries refers to the
  four origins and three ends.
• Four origins - extremities of the limbs
• Three ends - head, chest and abdomen

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• Primary principle - choose a point from the
  involved channel.
• Example distal points from shaoyang channel
  (Sanjiao and Gall Bladder) will be selected for
  temporal headache,
• distal points from yangming channel (Large
  Intestine and Stomach) will be chosen for pain of
  the face and forehead,

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• distal points from taiyang channel (Bladder and
  Small Intestine) will be selected for occipital
  headache and pain,
• points from the jueyin Liver channel will be
  selected for vertex headache.

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• It is common practice to combine local, adjacent
  and distal points. Examples include
• GB-8, GB-20 and GB-43 for temporal headache.
• ST-18, LIV-14 and GB-41 for breast diseases.
• REN-12, REN-17 and ST-36 for Stomach diseases.

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SELECTING POINTS FROM ONE CHANNEL TO TREAT ITS
INTERIORLY- EXTERIORLY RELATED CHANNEL

• Most commonly observed in relation to the
  luo-connecting points, include
• L.I.-4 to assist the Lung function of
  distributing defensive qi.
• L.I.-6 to promote the Lung function of regulating
  the water passages when this is impaired by
  exterior wind.
• ST-40 to resolve phlegm due to disharmony of the
  Spleen.

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SELECTING POINTS FROM ONE PAIR OF THE SIX
CHANNELS TO TREAT DISEASE OF THE OTHER

• Examples include
• SJ-6 (hand shaoyang Sanjiao channel) to treat
  hypochondriac pain due to disharmony of the foot
  shaoyang Gall Bladder channel.
• P-6 (hand jueyin Pericardium channel) to resolve
  stagnation of qi in the foot jueyin Liver channel
  in the chest and hypochondrium.

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SELECTING POINTS ACCORDING TO CHANNEL
CONNECTIONS

• Examples include
• SP-6, the intersection of the Spleen, Liver and
  Kidney channels, to treat most diseases of the
  lower abdomen since all these channels pass
  through this area.
• DU-14, the meeting point of the Governing vessel
  with all the yang primary channels to release
  pathogenic factors from the (yang) exterior.

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CROSS NEEDLING

• Contralateral (cross) needling is commonly used
  either when the affected side is too painful to
  treat, or when, after needling, one wants the
  patient to mobilize the painful area.
• Also used in acute painful disorders select
  points from the ankle to treat the opposite wrist
  (and vice-versa), from the knee to treat the
  opposite elbow (and vice-versa) and from the hip
  to treat the opposite shoulder (and vice-versa).

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SELECTION OF EMPIRICAL POINTS

• Frequently, the selection of distal points is
  determined by their historically established
  empirical effect. Examples include
• ST-38 for shoulder pain.
• DU-10 for boils.
• LU-7 for headache.
• SI-4 for jaundice.
• GB-36 for rabies.

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CHAIN AND LOCK POINT ASSOCIATION METHOD

• Select points from the shoulder, elbow and hand
  or wrist to treat disorders of the upper limb and
  from the hip, knee and ankle to treat disorders
  of the lower limb.

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Pathogen Patterns
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• Wind
• (Exterior) LI4, LU7, GB20, BL12
• (Interior) GB16, GB20, DU20, GB31
• Cold
• (Exterior) LI4, LU7, BL12
• (Interior) REN4, REN12, ST36
• Heat
• (Exterior) LI4, LI11, DU14
• (Interior) LI11, DU14 (XS) K2, K6 (Def)

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• Damp
• SP9, BL20, REN9 add LI11 if Damp Heat
• Summerheat
• LI11, DU14 add SP9 if Damp
• Phlegm
• SP9, ST40 add LI11 if Heat
• (Lung) LU5
• (Heart) P5

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Zang Fu Patterns
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Heart Patterns
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Heart Deficiency Patterns

• HEART-QI DEFICIENCY Points HE-5, P-6, BL-15,
  Ren-17, Ren-6.
• HEART-YANG DEFICIENCY Points HE-5, P-6, BL-15,
  Ren-17, Ren-6, Du-14.
• HEART-YANG COLLAPSE Points Ren-6, Ren-4, Ren-8,
  Du-4, ST-36, P-6, BL-23, Du-20, Du-14, BL-15.
• HEART-BLOOD DEFICIENCY Points HE-7, P-6, Ren-14,
  Ren-15, Ren-4, BL-17, BL-20.
• HEART-YIN DEFICIENCY Points HE-7, P-6, Ren-14,
  Ren-15, Ren-4, HE-6, SP-6, KI-7, KI-6.

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Heart Excess Patterns

• HEART-FIRE BLAZING Points HE-9, HE-8, HE-7,
  Ren-15, SP-6, KI-6.
• PHLEGM-FIRE HARASSING THE HEART Points P-5,
  HE-7, HE- 8, HE-9, P-7, Ren-15, BL-15, Ren-12,
  ST- 40, SP-6, LIV-3, LIV-2, BL-20, Du-20, GB-13,
  GB-15, Du-24.
• PHLEGM MISTING THE MIND Points HE-9, P-5, BL-15,
  ST-40, Du-26, Ren-12, BL-20.
• HEART-BLOOD STAGNANT Points P-6, P-4, HE-7,
  Ren-17, BL-14, BL-17, SP-10, KI-25.
• PERICARDIUM PATTERNS Points are mostly the same
  as Heart patterns but add REN-17, BL-14, P-8, etc

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Liver Patterns
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Liver Excess patterns

• STAGNATION OF LIVER-QI Points GB-34, LIV-3,
  LIV-13, LIV-14, T.B.-6, P-6.
• LIVER-FIRE BLAZING UPWARDS Points LIV-2, LIV-3,
  GB-20, Taiyang, GB-13, L.I.-11
• DAMP-HEAT IN LIVER Points LIV-14, GB-34, BL-18,
  Ren-12, SP-9, SP-6, L.I.-11, LIV-2.
• STASIS OF LIVER-BLOOD Points GB-34, LIV-3,
  BL-18, BL-17, SP-10, Ren-6.
• STAGNATION OF COLD IN THE LIVER CHANNEL Points
  Ren-3, LIV-5, LIV-1, LIV-3.

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Liver Deficiency Patterns

• DEFICIENCY OF LIVER-BLOOD Points BL-18, BL-20,
  BL-23, BL-17, LIV-8, SP-6, ST-36, Ren-4.
• LIVER-YIN DEFICIENCY Points LIV-8, SP-6, ST-36,
  Ren-4, KI-3, KI-6, LIV-2.

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Liver Deficiency/Excess Patterns

• LIVER-YANG RISING Points LIV-3, T.B.-5, P-6,
  G.B.-43, G.B.-38, BL-2, Taiyang extra point,
  GB-20, G.B.-9, G.B.-8, G.B.-6. If Liver Yin or
  Liver Blood deficiency KI-3, KI-6, SP-6, LIV-8,
  ST-36
• EXTREME HEAT GENERATING LIVER WIND Points LIV-3,
  Shixuan extra points, Du-20, Du-16, GB-20.
• LIVER-BLOOD DEFICIENCY GENERATING WIND Points
  LIV-3, GB-20, L.I.-4, TB-5, Du-19, SP-6, LIV-8,
  KI-3, BL-17, Ren-4

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• LIVER-YANG RISING CAUSING WIND
• a) Liver-Yang Rising deriving from Liver-Yin
  Deficiency Points LIV-3, GB-20, L.I.-4, TB-5,
  Du-19, SP-6, LIV-8, KI-3
• b) Liver-Yang Rising deriving from Liver- and
  Kidney-Yin Deficiency Points same as above, add
  KI-6, Ren-4 to nourish Kidney Yin
• c) Liver-Yang Rising deriving from Liver-Blood
  Deficiency Points same as (a), add BL-17, Ren-4
  to nourish Blood

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LIVER COMBINED PATTERNS

• LIVER INVADING THE SPLEEN Points LIV-14, LIV-13,
  G.B.-34, LIV-3, Ren-6, Ren-12, ST-25, SP-15
  ST-36, SP-6, P-6 and SP-4
• LIVER INVADING THE STOMACH Points LIV-14,
  LIV-13, G.B.-34, Ren-13, Ren-10, ST-36, BL-21.
• LIVER-FIRE INSULTING THE LUNGS Points LIV-2,
  LIV-14, Ren-17, Ren-22, P-6, LU-7, L.I.-11.

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Lung Patterns
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Lung Deficiency Patterns

• LUNG-QI DEFICIENCY Points LU-9, LU-7, Ren-6,
  BL-13, Du-12, ST-36, Ren-12.
• LUNG-YIN DEFICIENCY Points LU-9, Ren-17, BL-43,
  BL-13, Du-12, Ren-4, KI-6, Ren-12, SP-6, LU-10,
  LI-11.
• LUNG DRYNESS Points LU-9, Ren-4, KI-6, SP-6,
  Ren-12, ST-36.

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Lung Excess Patterns

• INVASION OF LUNGS BY WIND-COLD Points LU-7,
  BL-12, Du-16.
• INVASION OF LUNGS BY WIND-HEAT Points LU-7,
  L.I.-4, L.L-11, LU-11, Du-14, BL-12, Du-16,
  GB-20, TB-5.
• INVASION OF LUNGS BY WIND-WATER Points LU-7,
  L.I.-6, L.I.-7, L.I.-4, BL-12, Ren-9, BL-13,
  Du-26.
• LUNG HEAT Points LU-5, LU-10 LU-7, LU-1, LI-11,
  BL-13.

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Lung Phlegm Patterns

• PHLEGM-HEAT IN THE LUNGS Points LU-5, LU-7,
  LU-10, L.I.-11, LU-1, BL-13, Ren-12, ST-40.
• DRY-PHLEGM IN THE LUNGS Points LU-9, LU-7, KI-6,
  Ren-12, ST-36, SP-6, BL-13, REN-17, ST-40
• DAMP-PHLEGM IN THE LUNGS Points LU-5, LU-7, LU-
  1, Ren-17, ST-40, P-6, Ren-22, Ren-12, Ren-9,
  BL-20, BL-13.
• COLD-PHLEGM IN THE LUNGS Points Same as
  Damp-Phlegm pattern, add BL-23.
• PHLEGM-FLUIDS OBSTRUCTING THE LUNGS Points LU-5,
  LU-9, Ren-17, BL-13, ST-40, BL-43, Ren-12, ST-36,
  Ren-9, BL-20, BL-23.

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Spleen Patterns
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Spleen Deficiency Patterns

• SPLEEN-QI DEFICIENCY Points Ren-12, ST-36, SP-3,
  SP-6, BL-20, BL-21.
• SPLEEN-YANG DEFICIENCY Points same as for
  Spleen-Qi deficiency, add SP-9, Ren-9, ST-28,
  BL-22.
• SPLEEN-QI SINKING Points same as Spleen-Qi
  deficiency, plus Du-20, Ren-6, ST-21, Du-1.
• SPLEEN NOT CONTROLLING BLOOD Points same as
  Spleen-Qi deficiency, plus SP-10, BL-17, SP-1.

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Spleen Excess patterns

• COLD-DAMPNESS INVADING THE SPLEEN Points SP-9,
  SP-6, Ren-12, SP-3, ST-8.
• DAMP-HEAT INVADING THE SPLEEN Points SP-9, SP-6,
  Ren-12, SP-3, ST-8, BL-22, BL-20, REN-9, REN-11,
  ST-22, ST-28.

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Kidney Patterns
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Kidney Qi/Yang Deficiency Patterns

• KIDNEY-YANG DEFICIENCY Points BL-23, Du-4,
  Ren-4, Ren-6, KI-3, KI-7, BL-52, extra point
  Jinggong (0.5 cun lateral to BL-52).
• KIDNEY-QI NOT FIRM Points BL-23, Du-4, KI-3,
  BL-52, Ren-4, extra point Jinggong.
• KIDNEY-YANG DEFICIENT, WATER OVERFLOWING Points
  Du-4, BL-23, BL-22, BL-20, Ren-9, ST-28, SP-9,
  SP-6, KI-7. For Heart add Du-14 (moxa), BL-15.
  For Lungs add LU-7, BL-13, Du-12.
• KIDNEYS FAILING TO RECEIVE QI Points KI-3,
  LU-7, KI-6, ST-36, BL- 23, Du-4, Ren-6, Ren-17,
  KI-25, Du-12, KI-7.

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Kidney Yin/Jing Deficiency Patterns

• KIDNEY-YIN DEFICIENCY Points Ren-4, KI-3, KI-6,
  KI-10, KI-9, SP-6, Ren-1.
• KIDNEY-YIN DEFICIENT, EMPTY-FIRE BLAZING Points
  KI-3, KI-6, KI-2, KI-9, Ren-4, KI-10, SP-6,
  HE-5, LU-7, LU-10.
• KIDNEY-ESSENCE DEFICIENCY Points KI-3, KI-6,
  Ren-4, BL-23, Du-4, GB-39, Du-20, Du-14, BL-15,
  BL-11.

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COMBINED PATTERNS
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Kidney Combination Patterns

• KIDNEY- AND LIVER-YIN DEFICIENCY Points KI-3,
  KI-6, LIV-8, Ren-4, BL-23, BL-20, BL-17, BL-18,
  BL-10, Du-20.
• KIDNEY AND HEART NOT HARMONIZED Points HE-7,
  HE-6, HE-5, Yintang, BL-15, Ren-15, GB-13, Du-24,
  KI-3, KI-10, KI-9, Ren-4, P-6, SP-6.
• KIDNEY- AND SPLEEN-YANG DEFICIENCY Points KI-3,
  KI-7, BL-23, Du-4, BL-20, BL-21, ST-36, Ren-6,
  ST-37, ST-25, BL-25.

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Stomach Patterns
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• STOMACH DEFICIENT COLD Points ST-36, Ren-12,
  BL-20, BL-21, Ren-6.
• COLD INVADING THE STOMACH Points ST-21, SP-4,
  Ren-13, ST-34.
• STOMACH-YIN DEFICIENCY Points Ren-12, ST-36,
  SP-6, SP-3, ST-44.
• STOMACH-FIRE Points ST-21, Ren-13, ST-44,
  ST-45, SP-6, Ren-12, P-6.
• DAMP-HEAT IN THE STOMACH Points SP-9, L.I.-11,
  LI-4, ST-34, REN-9, REN-11, REN-12, REN-13,
  ST-21, ST-25, ST-40, ST-44
• RETENTION OF FOOD IN THE STOMACH Points Ren-13,
  Ren-10, ST-21, ST-44, ST-45, SP-4, P-6.
• STASIS OF BLOOD IN THE STOMACH Points Ren-10,
  ST-21, ST-34, SP-10, BL-17, BL-18.

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Small Intestine Patterns

• FULL-HEAT IN THE SMALL INTESTINE Points S.I.-2,
  S.I.-5, HE-5, HE-8, ST-39.
• SMALL INTESTINE DEFICIENT AND COLD Points Ren-6,
  ST-25, ST-39, ST-36, BL-20, BL-27.

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Large Intestine Patterns
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• DAMP-HEAT IN THE LARGE INTESTINE Points SP-9,
  SP-6, Ren-3, BL-22, ST-25, BL-25, BL-17, Ren-12,
  L.I.-11, ST-37, BL-20.
• HEAT IN THE LARGE INTESTINE Points Ren-4,
  L.I.-11, ST-37, ST-44, L.I.-2, SP-6, KI-6,
  Ren-12.
• COLD INVADING THE LARGE INTESTINE Points ST-37,
  ST-25, ST-36, SP-6, LIV-3, ST-27.
• LARGE INTESTINE DRY Points ST-36, SP-6, KI-6,
  Ren-4.
• LARGE INTESTINE COLD Points ST-25, Ren-6, ST-36,
  ST-37, BL-25, BL-20.

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Gall Bladder Patterns

• GALL-BLADDER DAMP-HEAT Points G.B.-24, LIV-14,
  Ren-12, G.B.-34, Dannangxue, Du-9, BL-19, BL-18,
  BL-20, L.I.-11, T.B.-6.
• GALL-BLADDER DEFICIENT Points G.B.-40.

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Bladder Patterns

• DAMP-HEAT IN THE BLADDER Points SP-9, SP-6,
  BL-22, BL-28, Ren-3, BL-63, BL-66.
• DAMP-COLD IN THE BLADDER Points SP-9, SP-6,
  BL-22, Ren-3, ST-28, Ren-9, BL-28.