Koo's Acupuncture & Herbal Clinic
(860) 232-1212 & 123 Park Rd, West Hartford, CT 06119
Acupuncture
The catagories of Acupuncture include: Needle, Moxa, Cupping, Acupressure and,  Gua Sha.

1) Needle : Fili form needle, three-edged needle, seven-star needle, plum-blossom needle, thumb-tack and grain type needles.   Acupuncture needle is produced with surgical grade steel and are varying lengths and thickness for specialized purposes.   

2) Moxibustion (aka Moxa) : moxa treats and prevents diseases by applying heat to points or certain locations of the human body.   The material mainly used is 'moxa wool' in the form of a cone or stick.   For Centuries moxibustion and acupuncture have been combined in clinical practice thus, they are usually teamed together in TCM(Traditional Chinese Medicine)

Function of Moxibustion :

1. To warm the meridian and expel cold.
2. To induce the smooth flow of Qi and blood.
3. To strengthen yang from collapse; Ki1, Du20
4. To prevent diseases and keep health; St36 , Rn6 , Du4 , Rn12

   Moxa is comes in the form of 'moxa wool', 'moxa cones', 'moxa stick' and methods of use are direct moxibustion and indirect moxibustion.   There is a possibility that the use of moxa could cause visible mark/scar on the skin and may cause blister

   However, newly developed moxa wool using the direct application method reduces the possibility of causing mark/scar on the skin.   By using a smaller moxa and placing it on the accurate point, even if mark/scar appears; mark/scar will disappear after about 6 months, atleast 70% of the time.

Contraindication of moxibustion:
(we Do Not to perform Moxa for)

1. acute pattern and heat pattern
2. face and head
3. person with hyper-sensitivity to heat
4. large blood vessels
5. lumbar-sacrum of pregnant women
6. belly

Cupping : it is a therapy in which a jar is attached to the skin surface to cause locl congestion through the negative pressure created by introducting heat in the form of an ignited material.   In the ancient China, it was called 'horn method' because animal was used to dispel pus.   Since this is simple and the therapeutic effect is good, this therapy was attracted with great attention and applied in a large scale by the broad masses and, also used as an auxillary method of acupuncture and moxibustion.

Types of jars/cups :

1. Bamboo Jars/Cups : section of bamboo 3-7cm in diameter and 8-10cm in length formed a cylinder.   One end was capped off like a drum and the other end's rim was made smooth to provide air tight seal to the skin.

2. Glass Cups/Jars : Glass cup is transparent, the local congestion at the site for moxibustion can be seen so as to control the treatment.

3. Plastic Cups/jars : Gone are the days of using bamboo and glass cupping methods.   Plastic has replaced the bamboo and glass jars/cups because they are more durable and still provide transparency.

Indication :

The cupping method has the function of warming and promoting the free flow of Qi and blood in the meridians, dimishing swellings and pains.   In the clinics, the cupping method is mainly used to treat bi syndrome caused by wind dampness such as, pain of the lower back, shoulders and, leg, gastro-intestinal disorders such as stomache, vomiting and, dirrea and the lung diseases such as coughing and asthema.   The cupping method combined with bloodletting is suitable to treat acute sprains accompanied by blood stasis.

Precautions ( we Do Not perform 'Cupping' for):

1. Skin Ulcer
2. Edema
3. Large blood vessel
4. High Fever
5. Convulsion
6. Abdominal and Sacrum regions of Pregnant women
7. person with 'Spontaneous Sweating'

After Cupping: There is a blood stasis or bruises at the local area, generally, it will disappear several days later but, will turn back to its original color within a few minutes for someone with no wind cold or blood stasis on the meridians.

Precautions and Contraindications in Acupuncutre Treatment :

1) it is advisable to apply a few needles OR to delay giving acupuncutre treatment to the patients who are either famished or over eaten, intoxicated, overfatigued or very weak.

2) It is contraindicated to puncture points on the lower abdomin and lumbosacral region for pregnant women under three months of pregnancy.   After three months of pregnancy, it is contraindicated to needle the points on the upper abdomin and lumbosacral region and those points causing strong sensation such as Li4, Sp6, Ub60, Ub67.

3) Points on the vertax infants should not be needled when the fontanel is not closed.   And retaining of needle is forbidden since the infants are unable to cooperate with the practitioner.

4) Needling should avoid the blood vessels to prevent bleeding, points of the chest and back should be carefully needled to avoid injury of the vital organs.

5) Historic medical literature of the past contraindicates certain points on the human body for puncutre or deep puncutre, most of these points are located close to the vital organs or large blood vessels, such as St1, located below the eyeball, Rn15 near the important viscera and, Sp11 near the femoral artery, etc.   These points should generally be punctured obliquely or horizontally to avoid accidents.

Management of Possible Accidents :
 
   Although acupunctureis safe and free from side effects, some accidents may take place owing to negligence of the contraindications, imperfect mainpulations or want of the knowledge of anatonomy.   If an accident occurs, the practitioner should keep calm, as long as he resolves the problem in time, serious consequence could be avoided.
 
The possible accidents are seen as follows:
 
1) Fainting : This is often due to nervous tension, delicate constitution, hunger, fatique, improper position or forceful manipulations. 
 
Manifestations: During acupuncture treatment there may appear dizziness, vertigo, palpitations, short breath, fidgets, nausia, pallor, cold sweating and, weak pulse.   In severe cases there maybe drop of blood pressure and, loss of consciousness.

Management: When the onset of fainting such as dizziness, vertigo, fidgets and nausia appear, stop needling immediately and withdraw all the needles then, help the patient lie down and offer him/her some warm of sweet water.   The symptoms will disappear with a short rest.   In severe cases, inaddition to the above management, press hard with the fingernail or needle: Du26, Pc9, Du25, Pc6, St36, Rn6, 4, Du20.   Moxa could also be used.   Generally, the patients will respond but, if not, other emergency measures should be taken.
 
2) Stuck Needle :
 
Cause : This may arise from nervousness, strong spasm of the local muscel after the insertion of the needle, twiring the needle with too large amplitude or in one direction only, causing muscle fibers to bind or, from change of position of the patient after the insertion of the needles.
 
Manifestations : after the needle is inserted, it is found at times difficult or impossible to rotate, lift and thrust the needles, this situation is known as 'stuck needle'.
 
Management : Ask the patient to relax.   If the needle is stuck due to excessive rotation in one direction, the condition will release when the needle is twiled in the opposite direction.   If the stuck needle is caused by the tension(which is temporary) leave the needle in place for a while.   Then, withdraw it by rotating or, by massaging the skin near the point or by inserting another needle nearby to transfer the patient's attention.   If the stuck needle is caused by the changing of the position of the patient, the original posture should be resumed and then withdraw the needle.
 
Prevention : Sensitive patients should be encouraged to release their tensions.   Avoid the muscle tendons during insertion, twirling with too large amplitude or in one direction only shall in no case be allowed in the process of manipulation, the posture of the patient should remain original.
 
6)  Acupuncture Point?

In the body, there are 12 meridians which includes 309 points and 28 governing meridian points, 24 conception meridian points and, extra 40 points for a total of 401 points.   The five shu points of yin and yang.

7) General introduction fo Acupuncture Treatment

General principles of Treatment
 
1) Regulation of yin and yang

The general principles of treatment are work out of the guidance of holistic concept and differentiation of syndromes.   the general principle in decision of the treating methods and prescriptions

2) Strengthen the body resistance and eliminating the Pathogenic Factors

3) Distinguishing the Primary from the Secondary

4) Treatment of diseases according to alimatric and seasonal conditions and the individual condition, geographical locations and the individual conditions.
 

Therapeutic Method :

1. Reinforcing : the reinforcing method is used to strengthen the body resistance and the Zang-Fu organ and replinish Yin, Yang, Qi and, Blood with acupuncture and moxibustion.

 
Kidney Qi deficiency Ub23, Rn4, Ki3 Reinforcing or moxa
Kidney Yin Deficiency Ki3, Ki6, Ub52 Reinforcing or moxa
Sp and St Qi Deficiency Rn12, Rn6, St36 Reinforcing or moxa
Deficiency of Qi and Blood Ub17, Ub20, St36, Sp6 Reinforcing or moxa

2. Reducing : the reducing method is to the pathogenic factors and remove stagnation in order to help restore the body resistance and, is advisiable to the cxcess syndrome.

Dispelling wind to relieve Gb20, Li4                             Reduce                         
Promoting defecation & reducing heat Li11, St25, St40 Reduce
Indigestion Rn11, St36, Sifeng Reduce
Invigorates to flow blood & removing blood stasis Corresponding points Reduce

3. Warming : The warming method is used to warm the meridians and remove obstructions from them, warm and nourish yang Qi, warm the middle energizer to dispel cold and restore yang from collapse.   Remove cold from the meridians by warmth.   Acupuncture with needle retaining or moxibustion is applied to the points along the meridian affected by the pathogenic cold.

Warming the middle energizer to dispel cold Rn12, St36                          Retaining 15/m or Moxa           
Restoring yang from collapse Rn12, St36 Retaining a needle or Moxa
     

Warming method can not be used for heat syndrome and moxibustion should be carefully used for syndrome of yin deficiency.

Dispelling the pathogenic heat Du14, Li11, Li4 Reducing                       
Heat syndrome in the zang-fu organ Jing(well), Ying(spring) point Reducing or bloodletting
clearing off heat and resuscitation Du26, 12 jing(well) points, (Lu11, Ht7, Pc9, Li1, Sj1) both sides Reducing of bloodletting

4. Clearing : The clearing method, known as a febrifugal approach, is used to clear off the pathogenic heat for resuscitation or, for heat syndromes.

5. Ascending : The ascending method is used to raise yang Qi and lift the zang-fu organs from sinking.   It is for failure of ascending pure yang and sinking of Qi.   Clinically, acupuncture with the reinforcing method and moxibustion is applied to the local points in conbination with Du20, Rn6, St36 to treatdizziness and vertigo due to failure of pure yang in ascending, sinking of Qi from the middle energizer, visceroptsis, prolapse of rectum and prolonged dysentery but, the ascending method shall not be used for patients with Yin deficiency and yang hyperactivity.

6. Descending : The descending method is used to make the upward perverted Qi down and to subdue yang.

Regulation of the Stomach by keeping its perverted Qi to descend Rn17, Rn12, Pc6, St36                                Balance of Qi                                
Sooting the liver & subduing liver yang Gb20, Liv3, Ki1 Reducing

But the decending method cannot be used for deficiency syndrome in the upperpart and excess in the lower part fo the body.  

8. The basic principle for prescription and selection of points:

1) Number of points in a prescription: Diseases vary in their occurance and development.   different prescriptions are used according to the different individuals and diseases.

2) Principle for point selection: Selection of points along the course of meridians is the basic principle in acupuncture treatment which is performed according to theory of that diseases are related to meridians.    In application there are three methods of points selection.   Namely, selecting points from the related meridian and, selecting points and, selecting points from several meridians.   The first refers a selection of points on the diseases meridian to which one of the origins is related.   The second, refers to a selection of points not only affected meridian but, also from the meridian related to the affected meridian according to the relations between the zang-fu organs and meridians.   Gemerally, point(s) on the body, the exteriorly-interiorly related meridains or points of the 'mother-son' related meridians are selected according to the theory of five elements, the third issued for symptoms caused by several disesaed meridians, i.e. when a patient does not respond to the selected points of one or two meridians, points of other meridians ahould be used also.   Since point selection along the meridians are guided by the theory of the zang-fu organs and meridians it is essential to have a full understanding of physialogy and pathology.   The running course of the meridians, the exterior and interior relationships or yin and yang and the function of points.

(1) Selection of nearby point : nearby refers to the local area of the disease or the adjacent area of the diseases.

a) Selection of local points : local refers to the viscinity of the diseases.
b) Selection of adjacent point : Adjacent refers to the location close to the diseased area.
c) Selection of distant points : distant refers to allocation far from the diseased area

Generally, these points are located below the elbows and knees.


     Nearby Point  Nearby Point
 Diseased Area  Distant Point   Adjacent point  Local Point 
 Forehead  Li4, St44  Du20  Gb14 
 Temple head  Sj5   Gb20  taiyang, Gb8
 Nape  Si3, Ub60  Du14  Ub101 (Gb20)
 Vertex  Liv3  around neck, point  Du20
 Eye  Si6, Liv3, (Li4)  Gb16 (Gb20)  Ub1 (St1)
 Nose  Lu7, St45, (Li4)  Du23  Li20, Yintang
 Mouth & Cheek  Li4, St41  S18  St4, St6, (St7)
 Ear  Si3 (Sj5), Gb43  Gb20  Gb2, Sj17, (Si19)
 Throat  Lu10, Ki6, (Li4)  Ub10  Rn23, Si17
 Chest/Trachea  Pc6, St40, (Lu7)  Lu1  Rn17
 Costal  Sj6, Gb34  Liv13  Liv14
 Upper Abdomen  Pc6, St36  St21  Rn12
 Lower Abdomen  Sp6, Liv8  St25  Rn4
 Lumbar  Ub40, Si3  Ub32  Ub23, Ub25
 Rectum  Ub57  Du1, Ub30(Ub54)  Du1, Ub30(Ub54)
** First take distant point then, later take nearby point

d) Selection of symtimatic points : This refers to the selection of the corresponding points according to some prominent symptoms.
 
 Symptoms  Points
 Fever  Du14, Li11, Li4
 Coma  Du26, Shixuan
 Night Sweating  Si3, Ht6
 Clenched Jaws  St7, St6, Li4
 Cough, Asthema  Rn22, Dingchuan
 Suffocated Chest  Rn17, Pc6
 Cardic Pain  Pc6, Pc4
 Hypochondriac Pain  Sj6, St36
 Abdominal Distention  Rn6, St36
 Constipation  Sj6, Ki6
 Epistaxis  Du36, Li4
   

Specific points on the four Extremities:
1) The Five-Shu points : These are five points of the twelve main meridians located below the elbow and knee.   namely, Jing(well), Ying(spring), shu(stream), Jing(river) and, He(sea).   They are imaged by the ancients as the flowing water, representing the volume of Qi in the meridians.

Five Shu Point Jing(well)       Ying (spring)  shu (stream) Jin(river)    He(sea)       
Yang meridian metal water wood metal earth
Ying meridian wood fire earth metal water
Main treatment Origin's .d
Metal's .d
Full of heart
fever
catch cold
wind-damp
rheumatism
neulogia
vise. d
lung's. d
chronic. d
intestinal. d
** The combination of mother and son for reinforcing and reducing

In addition to the selection of the five shu points according to their therapeutics, the five shu points can be selected according to the interpromoting, interacting, overreacting and, counteracting relation of the five elements to which they are respectively attributed.

2) The lower He(sea) points of the six-fu organs

The lower He(sea) points refer to the six he(sea) points pertaining to the six-fu organs along the three yang meridians of the foot.

3) The Yuan(primary) points are located in the vicinity of the wrist and ankle, the twelve yuan(primary) points are closely related to the zang and the six-fu organs and, they are the points where the primary Qi of the zang-fu organs are related.

4) The Luo(connecting) points : The Luo(connectint) points are situated at the places where the meridians are distributed and the cross of the two exteriorly-interiorly related meridains.   On the limbs, each of the twelve main meridians has a Luo(connecting) point which, connects with its respective exteriorly-interiorly related meridians.

5) The Xi(cleft) point : The Xi(cleft) points are those located at the sites where Qi and blood in the meridians are converged and accumulated.   There are sixteen Xi(cleft) points in all of the twelve main meridians.   In addition, they can be found on each yang heel, yin heel, yang link and, yin link vessel.   The  Xi(cleft) points are used primarily in treatment of acute diseases appearing in their corresponding organs.

6) The eight confluent points of eight extra meridians : the eight confluent points are those in the extremeties connecting the eight extra meridians.   Sp4 of the spleen meridian connects with the throughfare vessel and, Pc6 of the pericadium meridian links with the yin link vessel.   These two meridians are confluent in the chest, heart and stomach.   Gb41 of the Gallbladder meridian connects with the belt vessel.   These two meridians are confluent at the outer canter canthus, diaphragm.   Si3 of the Small Intestine meridian leads to the governor vessel and, Ub62 of the Bladder meridian connects with the yang heel vessel.   The two meridians are confluent at the inner canthus, nape, ear, shoulder, and back.   Lu7 of the lung meridian leads to the conception vessel and, Ki6 of the Kidney meridian connects with the Yin heel vessel.   The two meridians are confluent in the lung system, throat and diaghragm.   The eight confluent points are indicated in diseases of the extra meridians and their related regular meridians according to their connections. 

Confluent Point Regulates Meridians Extra meridian Indications
Pc6, Sp4 Pericardium Yin Link Vessel Heart, chest, stomach
same as above Spleen Thoroughfare same as above
Si3, Ub62 Small Intestine Governor Vessel Neck, shoulder, back, inner chanthus
same as above Bladder Yang, Heel Vessel same as above
Sj5, Gb41 Triple Energizer Ying Link Vessel Rectroauricle, cheek, outer chanthus
same as above Gallbladder Belt Vessel same as above
Lu7, Ki6 Lung Conception Vessel Throat, Chest, Lung
same as above Kidney Yin Heel Vessel same as above

7) The combination of the back-she points and front Mu point

The back shu point and the front my points maybe used independently or in conbination whenever, an internal organs affected, the back shu point or the front mu point pertaining to that organ may be prescribed.

Internal Organ back shu point front mu point
Lung Ub13 Lu1
Pericardium Ub14 Rn17
Heart Ub15 Rn14
Liver Ub18 Liv14
Gallbladder Ub19 Gb24
Spleen Ub20 Liv13
Stomach Ub21 Rn12
Triple Energizer Ub22 Rn5
Kidney Ub23 Gb25
Large Intestine Ub25 St25
Small Intestine Ub27 Rn4
Bladder Ub28 Rn3

8) The eight influential points of the eight tissues :

The eight influential points refer to the specific points which have particular effects in treatment of disorders relating to the zang-fu organs, Qi, blood, tendon, pulse, vessels, bone, marrow each of the influential points overlap the other points.

Tissue Influential Point
Zang organs Liv13
Fu organs Rn12
Qi Rn17
Blood Ub17
Tendon Gb34
Pulse, Vessels Lu9
Bone Ub11
Marrow Gb39


9) The crossing point :

The crossing points refer to those located at the intersection of two or more meridians including, the twelve main meridians and the eight extra meridians.