Class Notes 2: Text Notes

POINT COMBINATIONS
CLASS NOTES 2

THE PROCESS OF POINT SELECTION
In many texts on the art of point selection, the process is broken into two stages: a general “brainstorming” phase, and a more specific phase, in which only the best and most appropriate points are selected.

For example, in Robert Johns’s book, “The Art of Acupuncture Techniques,” Johns talks about a POINT MATCHING phase and a POINT SELECTION phase.

POINT MATCHING “means choosing types of points that match the diagnosis.  It is correspondence of the diagnosis with acupuncture points of appropriate therapeutic value.  Point Matching is general in character.  It determines all the possible points that can treat a problem.”

POINT SELECTION is “choosing specific points from the larger number of acupuncture points determined by Point Matching.  Point Matching is general; Point Selection is specific.  This distinction is made in order to provide more clarity in the final selection of points used for treatment.”

In Wang Ju-Yi’s book, “Applied Channel Theory in Chinese Medicine,” there is a similar idea; however, some key differences are that Wang Ju-Yi looks at problems from a CHANNEL perspective first (and his idea of a CHANNEL corresponds more to the 6 Energy Levels rather than the Zang Fu channels), and only after selecting affected channels does he narrow his focus down to point selection.  Also, Wang Ju-Yi’s system does involve channel palpation as a means for confirming hypothesized diagnoses, so in this sense, it is a biased system of sorts.  (Page 40)

Regardless of the nuances, the central idea is that, in an ideal situation, the practitioner goes through a general phase of brainstorming, and then chooses/selects the best points of those for treatment.  POINT PAIRINGS and COMBINATIONS helps in this process, because one is able to do more with less.

WHEN SHOULD WE USE SPECIFIC POINT CLASSES?  A General Approach
Thinking about the Speed, Depth, and Extent of Flow Problem.
Think about the “speed” of flow in the channel, and how we could “restore” the flow to normal.

If we want to “MOVE” the energy in a channel/organ, we would BEST use:
Jing River
He Sea
Xi Cleft

If we want to “BUILD” the energy in a channel/organ, we would BEST use:
Shu Stream
Yuan Source

If we want to “RELEASE” pressure in a channel/organ, we would BEST use:
Jing Well
Xi Cleft
Luo Connecting

2) Think about the “depth” of the problem in the channel.

Shallow/External Problems are best treated via:
Jing River (and distal transport points)

Deep Problems are best treated via:
He Sea

3) Think about how widespread the problem is (i.e. one channel, paired channels, more than two channels)?

If the problem occurs in multiple channels, consider using:
Luo Connecting - Yuan Source

THE 8 PARAMETERS
Excess?
Jing Well
Xi Cleft

Deficiency?
(of Qi/Yang) Shu Stream
(of Yin) Ying Spring

Heat?
Ying Spring
(Yangming or Shaoyang)

Cold?
Shu Stream

Yin?
(Yin deficiency) Ying Spring

Yang?
(Yang deficiency) Shu Stream
Sometimes He Sea

Internal?
He Sea

External?
Jing River
sometimes Luo Connecting

Other Considerations:
Is there swelling?
Xi Cleft
sometimes Luo Connecting

Is there pressure in a channel?
Jing Well
Xi Cleft

Is the problem acute?
Jing Well
Xi Cleft
sometimes Jing River

Is the problem chronic?
Ying Spring
Shu Stream
Yuan Source
He Sea

Is there pain/bleeding?
Xi Cleft

SELECTING POINTS ON THE CHANNEL WHERE THE DISEASE IS LOCATED.
This is only effective when at least one of the following conditions exists:
Where onset of disease is relatively recent and condition has not yet begun to affect other channels.
Where other organs and channels are generally healthy.
Where disorder is primarily located in muscles or tendons, such as acute injuries and pain.

EXAMPLE:
A 35 year old male patient has begun to suffer from a swollen, sore throat (it started yesterday). He has a superficial rapid pulse, and a tongue with normal body color and a thin white coat. The patient suffers from no other symptoms, and is otherwise very robust.

POINT COMBINATIONS: ON A SINGLE CHANNEL (Not Local-Distal or Chain and Lock Method)
Let’s return to the point classes, and consider all the possible permutations of combining points on a SINGLE CHANNEL.

JING WELL COMBINATIONS
JING WELLS are used to release PRESSURE in a channel in EXCESS, and can be used in some cases to build flow in a channel in DEFICIENCY.

*Jing Well - Ying Spring --> This combo can be used for situations when there is a pressure buildup in a channel combined with deficiency heat. This means a mixed EXCESS and DEFICIENCY situation, on a SINGLE CHANNEL, which is strange, and difficult to read/diagnose if it does occur. The only real example of Jing Well-Ying Spring combo that is viable is Stomach 45 - Stomach 44, and that is only because Stomach 44 is an exceptional Ying Spring point in that it treats EXCESS heat in the Stomach channel.

examples:
Lu 11-Lu 10, LI 1-LI 2, St 45-St 44, Sp 1-Sp 2, Ht 9-Ht 8, SI 1-SI 2, UB 67-UB 66, Kid 1-Kid 2, Pc 9-Pc 8, SJ 1-SJ 2, GB 44-GB 43, Liv 1-Liv 2

*Jing Well - Shu Stream --> This is not a particularly viable combo, except perhaps in situations when you are building/tonifying energy in a channel. One point is primarily involved in releasing pressure, while the other is building Yang qi. Usually, you don’t want to be doing both of these things to a channel at the same time. Again, in some cases, you can use Jing Well points to BUILD energy in a channel (example: Kidney 1...), but even in these situations, it is rare to combine both points.

Lu 11-Lu 9, LI 1-LI 3, St 45-St 43, Sp 1-Sp 3, Ht 9-Ht 7, SI 1-SI 3, UB 67-UB 65, Kid 1-Kid 3, Pc 9-Pc 7, SJ 1-SJ 3, GB 44-GB 42, Liv 1-Liv 3

**Jing Well - Jing River --> One point releases energy/pressure in the channel, while the other flushes energy out of the channel to restore proper flow. Perhaps this combination could be used; at least, it somewhat makes sense.

Lu 11-Lu 8, LI 1-LI 5, St 45-St 41, Sp 1-Sp 5, Ht 9-Ht 4, SI 1-SI 5, UB 67-UB 60, Kid 1-Kid 7, Pc 9-Pc 5, SJ 1-SJ 6, GB 44-GB 38, Liv 1-Liv 4

**Jing Well - He Sea --> These points work at opposite “ends” of the channel, one working at the deep end, with a quick flow, and the other at the shallow end, releasing pressure. We don’t see this combination used very often, although it could potentially have its uses. For instance, St 45 - St 36 could be used to release pressure from an excessive stomach channel AND regulate and restore proper flow to the Stomach channel/organ.

Lu 11-Lu5, LI 1-LI 11, St 45-St 36, Sp 1-Sp 9, Ht 9-Ht 3, SI 1-SI 8, UB 67-UB 40, Kid 1-Kid 10, Pc 9-Pc 3, SJ 1-SJ 10, GB 44-GB 34, Liv 1-Liv 8

*Jing Well - Yuan Source --> For the same reason as above (Jing Well-Shu Stream), not a particularly viable option.

LI 1-LI 4, St 45-St 42, SI 1-SI 4, UB 67-UB 64, SJ 1-SJ 4, GB 44-GB 40

***Jing Well - Xi Cleft --> This is a potentially good combination, especially when there is a great deal of “pressure” in the channel, pain and swelling and excess. Examples would include: Lung 11 - Lung 6; Stomach 45 - Stomach 34

Lu 11-Lu 6, LI 1-LI 7, St 45-St 34, Sp 1-Sp 8, Ht 9-Ht 6, SI 1-SI 6, UB 67-UB 63, Kid 1-Kid 5, Pc 9-Pc 4, SJ 1-SJ 7, GB 44-GB 36, Liv 1-Liv 6

**Jing Well - Luo Connecting --> Again, a potentially good combination, if we are going to try to release pressure in a channel. Remember, the Luo Connecting channel is like an offramp. This combo would probably be best if there was a channel excess combined with collateral issues.

Lu 11-Lu7, LI 1-LI 6, St 45-St 40, Sp 1-Sp 4, Ht 9-Ht 5, SI 1-SI 7, UB 67-UB 58, Kid 1-Kid 4, Pc 9-Pc 6, SJ 1-SJ 5, GB 44-GB 37, Liv 1-Liv 5

***

YING SPRING COMBINATIONS
Ying Spring points are best when there is Deficiency heat/fever or chronic heat.

*Ying Spring - Shu Stream --> Ying Springs are for yin deficiency heat; Shu Streams are for yang deficiency with Dampness/Phlegm. While it is possible to have both going on at the same time, it is rare and difficult to diagnose this along a single channel.

Lu 10-Lu 9, LI 2-LI 3, St 44-St 43, Sp 2-Sp 3, Ht 8-Ht 7, SI 2-SI 3, UB 66-UB 65, Kid 2-Kid 3, Pc 8-Pc 7, SJ 2-SJ 3, GB 44-GB 43, Liv 2-Liv 3

**Ying Spring - Jing River --> Ying Springs clear yin deficiency heat. By some interpretations, Jing Rivers also nourish yin through movement of qi and fluids (think Kidney 7). This can be a potentially viable combination. An example would be: Kidney 7 - Kidney 2, or Lung 8 - Lung 10. Just remember that Jing Rivers have a quick motion that makes them favorable for EXTERNAL conditions, whereas Ying Springs are more suitable for chronic (internal) deficiencies.

Lu 10-Lu 8, LI 2-LI 5, St 44-St 41, Sp 2-Sp 5, Ht 8-Ht 4, SI 2-SI 5, UB 66-UB 60, Kid 2-Kid 7, Pc 8-Pc 5, SJ 2- SJ 6, GB 43-GB 38, Liv 2-Liv 4

**Ying Spring - He Sea --> Ying Springs clear yin deficiency heat. He sea points move and regulate at a deep level. This combination is potentially viable. St 44 and St 36, for example, might work for Stomach Heat along a channel (manifesting with a red face, frontal headaches, etc.) combined with Stomach organ stagnation and heat (rebellious stomach qi, constipation, etc.).

Lu 10-Lu 5, LI 2-LI 11, St 44-St 36, Sp 2-Sp 9, Ht 8-Ht 3, SI 2-SI 8, UB 66-UB 40, Kid 2-Kid 10, Pc 8-Pc 3, SJ 2-SJ 10, GB 43-GB 34, Liv 2-Liv 8

*Ying Spring - Yuan Source --> not very viable (due to reasons outlined above).

LI 2-LI 4, St 44-St 42, SI 2-SI 4, UB 66-UB 64, SJ 2-SJ 4, GB 43-GB 40

*Ying Spring - Xi Cleft --> While it may appear that these points can go together, Ying Springs are for deficiency heat, while Xi Clefts address pain/stagnation in a channel. This can be sort of ambiguous, because one is a more chronic deficiency condition, while the other is a more excess condition.

Lu 10-Lu 6, LI 2-LI 7, St 44-St 34, Sp 2-Sp 8, Ht 8-Ht 6, SI 2-SI 6, UB 66-UB 63, Kid 2-Kid 5, Pc 8-Pc 4, SJ 2-SJ 7, GB 43-GB 36, Liv 2-Liv 6

**Ying Spring - Luo Connecting --> This combo would be used for deficiency heat combined with problems along the collateral. This is definitely a possible scenario.

SHU STREAM COMBINATIONS
***Shu Stream - Jing River --> The Shu Streams are best thought of as tonification points; the addition of the Jing River acts as an accelerant, moving energy along a channel. This is potentially a good combo. An example would be Lung Qi Deficiency with an external Wind invasion (Lung 8 - Lung 9).
Lu 8-Lu 9, LI 3-LI 5, St 43-St 41, Sp 3-Sp 5, Ht 7-Ht 4, SI 3-SI 5, UB 65-UB 60, Kid 3-Kid 7, Pc 7-Pc 5, SJ 3-SJ 6, GB 43-GB 38, Liv 3-Liv 4

***Shu Stream - He Sea --> This is also potentially viable. When there is a yang qi deficiency of a channel/organ, combined with a need for deep regulation of the organ level. In actuality, this combo is used more for paired Yin-Yang channels, with the Yin Shu Stream/Yuan Source point, and the Yang He Sea point.

Lu 9-Lu 5, LI 3-LI 11, St 43-St 36, Sp 3-Sp 9, Ht 7-Ht 3, SI 3-SI 8, UB 65-UB 40, Kid 3-Kid 10, Pc 7-Pc 3, SJ 3-SJ 10, GB 42-GB 34, Liv 3-Liv 8

Shu Stream - Yuan Source --> The same point on Yin channels; on Yang channels, not particularly significant as a combo.

*Shu Stream - Xi Cleft --> These points are somewhat in opposition to one another. One tonifies/builds energy in the channel, while the other is releasing energy suddenly. This is usually seen as inappropriate, sort of like trying to fill a bathtub while it is being drained.

Lu 9-Lu 6, LI 3-LI 7, St 43-St 34, Sp 3-Sp 8, Ht 7-Ht 6, SI 3-SI 6, UB 65-UB 63, Kid 3-Kid 5, Pc 7-Pc 4, SJ 3-SJ 7, GB 42-GB 36, Liv 3-Liv 6

**Shu Stream - Luo Connecting --> This is viable, especially since shu streams are also yuan sources, and Yuan Source points and Luo Connecting points are a frequent combination... HOWEVER, it is usually not the case that we combine these points on the SAME CHANNEL.

Lu 9-Lu 7, LI 3-LI 6, St 43-St 40, Sp 3-Sp 4, Ht 7-Ht 5, SI 3-SI 7, UB 65-UB 58, Kid 3-Kid 4, Pc 7-Pc 6, SJ 3-SJ 5, GB 42-GB 37, Liv 3-Liv 5

**Jing River - He Sea --> Both points have a movement function, and when combined, could powerfully move and regulate energy to restore proper channel/organ function. I might use this when there is a need to regulate a channel from the deepest points out.

Lu 8-Lu 5, LI 5-LI 11, St 41-St 36, Sp 5-Sp 9, Ht 4-Ht 3, SI 5-SI 8, UB 60-UB 40, Kid 7-Kid 10, Pc 5-Pc 3, SJ 6-SJ 10, GB 38-GB 34, Liv 4-Liv 8

**Jing River - Yuan Source --> Again, this is potentially viable. Tonify and move.

LI 5-LI 4, St 41-St 42, SI 5-SI 4, UB 60-UB 64, SJ 6-SJ 4, GB 38-GB 40

**Jing River - Xi Cleft --> This combo is potentially useful, when there is a need to flush out a channel, combined with an excess of pressure within the channel.

Lu 8-Lu 6, LI 5-LI 7, St 41-St 34, Sp 5-Sp 8, Ht 4-Ht 6, SI 5-SI 6, UB 60-UB 63, Kid 7-Kid 5, Pc 5-Pc 4, SJ 6-SJ 7, GB 38-GB 36, Liv 4-Liv 6

*Jing River - Luo Connecting --> This is only occasionally useful on a single channel.

Lu 8-Lu 7, LI 5-LI 6, St 41-St 40, Sp 5-Sp 4, Ht 4-Ht 5, SI 5-SI 7, UB 60-UB 58, Kid 7-Kid 4, Pc 5-Pc 6, SJ 6-SJ 5, GB 38-GB 37, Liv 4-Liv 5

HE SEA COMBINATIONS
***He Sea - Yuan Source --> As implied earlier (in Shu Stream combinations), this is a viable combination (although usually with paired Yin-Yang channels).

**He Sea - Xi Cleft --> This combo is potentially useful, especially when there is acute pain/pressure combined with a need to regulate at the organ level (release pressure via bowel movement, etc.).

Lu 5-Lu 6, LI 11-LI 7, St 36-St 34, Sp 9-Sp 8, Ht 3-Ht 6, SI 8-SI 6, UB 40-UB 63, Kid 10-Kid 5, Pc 3-Pc 4, SJ 8-SJ 7, GB 34-GB 36, Liv 8-Liv 6

**He Sea - Luo Connecting --> This combo is potentially useful in some situations, when you have organ/bowel stagnation combined with collateral issues. I can think of applications for Stomach 36 - Stomach 40, for example...

YUAN SOURCE COMBINATIONS
*Yuan Source - Xi Cleft --> not viable, for reasons already stated.

***Yuan Source - Luo Connecting --> very viable. Used to restore balance between paired channels (although not very often on a single channel).

XI CLEFT COMBINATIONS
**Xi Cleft - Luo Connecting --> This is potentially viable, to release pressure on a single channel.