200 Hour Program NOTES July 2013.Pages

AcuPractice™ Seminars

200-Hour Program Lecture Notes

These notes are designed as supplemental meatirial for classroom lectures presented by AcuPractice™ Seminars. They are not a complete work without explanation by experianced faculty.

Edited: July, 2013

The information in this book is true and complete to the best of our knowledge. This book is intended as an informative guide for those wishing to know more about health issues and acupuncture theories. This book is not meant to be used, nor should it be used, to diagnose or treat any medical condition. It is in no way intended to replace, countermand or conﬂict with the advice given to you by your physician or healthcare provider. The ultimate decision concerning care should be made between you and your doctor, or between any patient and her doctor. Information in this book is general and is offered with no guarantees on the part of the author or publisher. The author and publisher disclaim all liability in connection with the use of this book.

Acupuncture: The Clinical Fundamentals 4 Yin Yang 7 Powerpoint: Clinical Acupuncture Theory - Online Class # 202 9 Eight Principles 9 Powerpoint: Clinical Acupuncture Theory - Online ClassPowerpoint: Clinical Acupuncture Theory - Online Class # 203 11 Five Elements 11 AcuPractice’s Table of 5 Element Correspondences 14 Chronotherapy (The Horary Cycle) 15 The Essential Substances 16 The Causes of Disease or Pathogenic Factors 24 Organs 25 Introduction to Tongue and Pulse Diagnosis 33 Usual Tongue & Pulse Combinations 39 Acupuncture Techniques DemystiUied 40 Weekend 2 Introduction 40 Clean Needle Technique 40 OfUice Setup/Patient Flow 43 Risk to Acupuncture Providers 44 Acupuncture Patient Side Effects 45 Contraindications and Cautions 47 Needle Selection 47 ToniUication, Sedation, and Even Needling 49 Needling Depths & Angles 49 Electro-Acupuncture 49 Laser Acupuncture 55 Moxa 57 TDP Lamp 63 Gua Sha & Cupping 64 Needle Technique Demo / Practice Session 67 Acupuncture Points and Meridians 1 69 Weekend 3 Introduction 69 Points Overview 69 Body Measurements and General Point Location 69 Basic Material for Point Usage 71 Du Meridian “Governing Vessel” 73 Ren Meridian “Conception Vessel.” 75 Lung/Fei 77 Large Intestine/ Da Chang 79 Stomach / Wei 81 Acupuncture Points and Meridians 2 87 Weekend 4 Introduction 87 Review of Weekend # 3 87 Overview of the Meridians 87 Point Categories 90 Heart / Xin 91 Small Intestine/Xiao Chang 93 Urinary Bladder / Pang Guang 95 Kidney / Shen 99 Pericardium/ Xin Bao Luo 101 Triple Heater / Triple Warmer / San Jiao 103 Gall Bladder / Dan 105 Liver / Gan 109 Respiratory, Digestive & Genitourinary Disorders 112

Weekend 5 - Internal Medicine I: Introduction 112 Theoretical Principles Review 112 Meridian Review 118 Organs Review 118 Respiratory System and Conditions 125 Gastro-Intestinal System & Conditions 129 Genito-Urinary System & Conditions 133 Acupuncture Microsystems and the Extraordinary Meridians 137 Weekend 6 Introduction 137 Hand Acupuncture Points 137 Auricular Acupuncture 140 Acupuncture in the Treatment of Chemical Dependency 145 APS-USA: AcuPractice™ Seminars UniUied Scalp Acupuncture 151 Acupuncture for the Treatment of Pain 176 Weekend 7 Introduction 176 The Basics 176 Point Selection 178 Advanced SpeciUic Needling Techniques 178 The Meridians for Pain 181 The Microsystems for Pain (Auricular/ Hand / APS-USA) Treatment 184 Palpation & Treatment of Local and Adjacent Areas of Pain 184 Treatment of Sinew (T-M) Meridians 185 General Needle Techniques For Pain 185 Needling Styles & Strategies 185 Electro Acupuncture 188 Gua Sha & Cupping 188 Moxa 188 Ginger Compress 189 Zonal (Planar) Approach to The Treatment of Pain 189 SpeciUic Treatment of Pain by Bodily Region 193 Recap: What you need to know for the Treatment of Pain 201 Women’s Health 205 Weekend 8 Introduction 205 Recommended Book Balance Your Hormones Balance Your Life: Claudia Welch 205 Name That Disharmony / Diagnosis Review 205 Review Major Relevant Points from: 206 Jing (Essence) 206 Blood 207 Extraordinary Vessels (see pocket reference card at end of notes) 209 Essential Etiology 210 Essential Diagnosis 213 Treatment of the Most Common Disharmonies 217 SpeciUic Disorders 222 Women’s Health: Name That Disharmony: Final Review 233 Women’s Health Reference Tables 234 National Board Exam Review & Program Review 235 Weekend 9 Introduction 235 Clinical Review / Weekend 10 282 AcuPractice Forms 283

1. Acupuncture: The Clinical Fundamentals

1. Weekend 1 Introduction

a. 200-hour Program

1. Seminars = 150 hours

a. 10-Weekends

b. 100 Didactic Classroom-Hours

c. 50 Hands-on Clinical Hours

2. Chinese Medical Theory 101 = 50 hours

a. Correspondence Course

1. Additional / Makeup Hours

a. Clinical Acupuncture Theory = 20 hours

1. Online Classes

b. Advanced Acupuncture Practitioner Symposium = 12 hours

1. Teleconference Classes

c. Faculty

d. Regulations

1. Hours Requirements a. States b. NBCE Exam c. ACA Exam

e. Theoretical Principles Presented this weekend

1. Reviewed in All Subsequent Seminars 2. Basis of all Internal Oriental Medical (Acupuncture & Herbal ) Treatment 3. Less important for AcupunctureTx. Of Musculoskeletal / Neurological Disorders

f. Required Books: 1. The Web That Has No Weaver: Ted Kaptchuck

4. Required for Chinese Medical Theory Correspondence Course 5. A “Must Read” for all acupuncture practitioners 2.The Acupuncture Cookbook: Jim Ventresca

6. Board Exam Review

7. Clinical Handbook

8. Classroom Adjunct

g. Recommended Books

2. Balance Your hormones Balance Your life: by Claudia Welch

a. Yin & Yang view of Hormones, Lifestyle, Diet, and Health Highly Recommended for All Women and Men Who Treat Women

2. A Manual of Acupuncture: by Peter Deadman and Mazin Al-Khafaji with Kevin Baker

a. The premier textbook on acupuncture points.

1. Acupuncture Clean Needle Technique Manual

a. http://www.ccaom.org/cntprogram.asp

b. All the information needed on Clean Needle Technique is in this book.

c. You may went to read it, right before taking the national exam

3. Close To The Bone: by David Legge

a. Sydney College Press

b. A wonderful book, on the treatment of pain with acupuncture. We highly recommend it to all our students.

4. Acupuncture Points and Meridians: by David Legge

a. A nice little point handbook, for your pocket

b. Special Thanks to Dr. David Legg for allowing us to reproduce his meridian diagrams in our notes.

Powerpoint: Clinical Acupuncture Theory - Online Class # 201 h. Eastern Paradigm 1. Holistic / Homeostatic medicine 2. Laws of the universe govern people 3. Non-Reductionist: Relationships predominate over causal factors 4. Phycological - Spiritual - Physical Language of Chinese Medicine 5. One of the oldest living traditional medicines h. Chinese Medicine History: 1. Legends and History intertwined in dating of ancient material 2. Seminal & Important Books a. Nei Jing: Yellow Emperor’s Internal Classic of Medicine 1. Oldest extant book on Acupuncture & Chinese Medicine 2. Probably written between 300 and 100 BCE 3. Divided into two books: Su Wen & Ling Shu a. The Nan Jing 1. Companion to the Nei Jing 2. Written in the Han Dynasty 206 BCE - 220 CE 3. Famous Doctors a. Huangdi (Huang Ti): The Yellow Emperor 1. Mythical Emperor: 1500 - 2000 BCE 2. Said to have written the Nei Jing a. Zhang Zhong Jing 1. Circa 160 CE 2. Wrote: Shang Han Lun b. Sun Si Miao 1. Circa 581 CE 2. Wrote on Morality in Medicine 3. Drew the First Acupuncture Charts 4. Pioneered OB/GYN c. Li Shi Zhen 1. A Most Famous Dr. 1593 CE (Late Ming) 2. Well known for Establishing Radial Pulse Diagnosis 3. 9 positions, 27 categories 4. Wrote: The Great Pharmacopoeia d. Yang Ji Zhou 1. Considered by many to be the foundation of modern Acupuncture/Moxibustion: Early 1500s CE (Ming) 2. Wrote: Zhen Jiu Da Cheng (Great Compendium of Acupuncture/Moxibustion) 3. Dr. Tin Yao So, my teacher, is part of this lineage. 4. Progression to TCM a. 3,000 years of Folk Medicines b. 1800s to 1940s Western Cultural Invasion c. 1949 – Mao Ze Dong’s Revolution in China: d. 1949-Present - Institutionalized Traditional Chinese Medicine (TCM) j. The Five Branches of Oriental Medicine 1. Acupuncture/Moxibustion

a. Zhenjiu 1. Herbal Medicine 2. Exercise a. Qi Gong b. Tai Ji 3. Diet/Lifestyle 4. Massage & Manipulation a. Tuina 5. Some PeopleAlso Include a. Meditation b. Feng Shui k. Popular Styles of Acupuncture 1. Medical/Chiropractic Acupuncture a. Meridian Based Acupuncture 1. TCM 2. Japanese Acupuncture 3. Five Element Schools 4. American Acupuncture

1. Yin Yang [ a. General Theory 1. Everything consists of Yin & Yang a. Yin & Yang are Relative terms that exist only in relationship to one another b. Nothing is totally Yin or totally Yang 1. Yang produces Yin and Yin produces Yang a. Each is necessary for the other’s existence b. If Yin increases, Yang decreases and vice versa 2. Yin & Yang are Inﬁnitely Divisible 3. Yin & Yang are Inter-transformational Inter-consuming & Inter-supporting 4. At Extremes Yin and Yang transform into one another b. Main Uses of YIN/YANG in Clinical Settings

1. To explain physiology and pathology 2. To serve as a broad guide to Diagnosis and Treatment Most Clinically Useful Associations of Yin & Yang

CLINICAL ASSOCIATIONS OF YANG CLINICAL ASSOCIATIONS OF YIN Function Substance Action Result Of Action Happens In The Present Happened In The Past Incipient-Just Beginning, Completing, Sustaining Setting Loose, Setting In Motion, Dynamic Responsive, Static, Quiescent Transforming, Causing Change Conserving, Preserving Dissolving, Dispersing, Expanding Condensing, Contracting

Functions of Yin & Yang Energies in the Body

FUNCTIONS OF YANG ENERGY IN THE BODY FUNCTIONS OF YIN ENERGY IN THE BODY Warms Cools Moves, Activates, Circulates Provides Rest the Ability to Rest Holds Up and In Place: Blood, Fluids, Nourishes & Moistens: Blood, Fluids, & Organs & Organs Transforms - Brings About Change Maintains Structure Protects / Provides Defense Provides the Ability to Recover from Disease

Yin/Yang Table of Correspondences DISORDERS WHICH ARE YANG IN NATURE DISORDERS WHICH ARE YIN IN NATURE ARE ARE ASSOCIATED WITH ASSOCIATED WITH Excess Yang or Deficient Yin Excess Yin or Deficient Yang Acute / Rapid Onset Chronic / Slow Onset Activity / Daytime / Insomnia Rest / Nighttime / Sleepiness Stretch Out To Sleep - Throws Off Covers Curls Up In Sleep - Likes To Be Covered Heat Signs: Red Efflorescences / Rapid Cold Signs: Pale Efflorescences / Slow, or Pulse / at least Not Rapid Pulse Thirst: Likes Cold Drinks No Thirst: Sips Warm Drinks Loud Voice - Extrovert Soft/Weak Voice - Introvert

Anatomy of Yin/Yang Relationship Within Body BODY AREAS WHICH ARE YANG (CONTRASTED BODY AREAS WHICH ARE YIN (CONTRASTED WITH YIN AREAS) WITH YANG AREAS) Superior Inferior Posterior Anterior

Powerpoint: Clinical Acupuncture Theory - Online Class # 202

A.Eight Principles

1. Four Pairs of Opposites a. Internal / External b. Hot / Cold c. Excess / Deficient d. Yin / Yang

2. Internal / External a. Location of Disease or Etiology

1. Internal a. Many manifestations within the Organs Bones & Blood

2. External a. Skin b. Muscles c. Meridians (Channels & Collaterals) d. Lungs:

Hot / Cold

DESCRIPTION OF PATHOLOGY TREATMENT PRINCIPLE CONDITION NORMAL BALANCED CONDITION N/A N/A

TRUE EXCESS YIN CONDITION TRUE COLD SEDATE YIN

TRUE EXCESS YANG CONDITION TRUE HEAT SEDATE YANG

DEFICIENCY OF YIN CONDITION FALSE HEAT TONIFY YIN (HEAT FROM DEFICIENCY) “DEFICIENT HEAT” DEFICIENCY OF YANG CONDITION FALSE COLD TONIFY YANG (COLD FROM DEFICIENCY) “DEFICIENT COLD”

Hot Excess, Full or True Heat Deficient Yin (False Heat) (Usually Seen in OPI Heat) (A Condition which is Yang in Nature) Thirst Dry Mouth Red Face / Red eyes Malor Flush Full (Daytime) Sweat Night Sweats Full Fever PM Fever / PM Hot Flashes / Heat in 5 Hearts Sore/Painful Throat Chronic, Dry, Scratchy Throat Strong Cough Chronic, Dry, Weak Cough Dark, Scanty, Urine (Burning if severe) Dark, Scanty Urine Constipation (w/ discomfort) / Hot Diarrhea Dry Stool / Constipation Full, Rapid, Pulse Thin, Rapid, Pulse Red Tongue / Yellow Coat Red Tongue / No Coat (Peeled)

Cold Excess /Full / True Cold Deficient Yang (False Cold) (Often Seen in OPI Cold) (A Condition which is Yin in Nature) Clear Copious Urine SAME Preference for Warm Liquids SAME Cramping Pain Better with Heat SAME No Thirst SAME Chills Cold Body /Hands & Feet Pale Face Pale Face Cramping Pain No Pain Associated Cold Diarrhea Loose Stools / Undigested Food Thick White Tongue Coat Pale Puffy Tongue / Wet Coat

Cold Diarrhea Loose Stools / Undigested Food Thick White Tongue Coat Pale Puffy Tongue / Wet Coat Full & Tight Pulse Weak & Slow Pulse © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 10

4. Excess / Deficient a. There are Many Various Signs of Excesses and Deficiencies in Organs, Substances, and Meridians. They will be discussed in future lectures.

5. Yin / Yang a. Based on the other 6 Principles and the Nature of the Disorder

Powerpoint: Clinical Acupuncture Theory - Online ClassPowerpoint: Clinical Acupuncture Theory - Online Class # 203

B. Five Elements

1. 5 Element Diagnosis a. The 5 Elements can be helpful in Diagnosis and Prognosis. b. Colors c. Sounds d. Smell e. Emotions f. Tastes g. Tissues h. Orifices i. Weather /Climate j. Body Type

2. Treatment a. Five Phases in Treatment:

1. Constitutional typing often follows a five element scheme

2. Many options exist for applying this theory to treatment, a. 5 Element Based Treatment largely depends on one's level of understanding and willingness to design creative strategies using the principles, 11 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

b. Often includes various ways of transferring Qi between organs using the five Shu (transport) points. We will not address this form of treatment in any substantial manner. © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 12

FIRE

Sheng Cycle >

EARTH

Ko Cycle> WOOD

METAL WATER

3. Cycles & Pathology a. All this happens simultaneously to effect a balanced and harmonious order b. Within each phase/element are Yin and Yang aspects, sometimes referred to as the husband-wife relationship c. Creative or Generating Cycle (Sheng)

1. AKA: Mother / Son Cycle a. The clockwise circle shows creative, productive, inter-promoting relationships. Wood - Fire - Earth - Metal - Water

2. Deficiency Creates Deficiency (2) a. Deficient Mother Can’t Nourish the Son. Son becomes Weak b. Deficient Son Drains the Mother. Mother becomes Weak b. Deficient Son Drains the Mother. Mother becomes Weak

3. Excess Creates Excess (1)

d. Control Cycle (Ko)

1. AKA: Grandmother / Grandson relationship

2. The clockwise star illustrates restraining, inhibiting, or controlling relations. Wood - Earth - Water - Fire - Metal

3. Excess Creates Deficiency (2) a. Excessive Grandmother exercises too much control, over Grandson. Grandson becomes Weak. b. Excessive Grandson rebels and exercises too much control, over Grandmother. Grandmother becomes Weak

4. Deficiency Creates Excess (1) Weak Grandmother exercises too little control, over Grandson. Grandson becomes Excessive.

C. AcuPractice’s Table of 5 Element Correspondences Powerpoint: Clinical Acupuncture Theory - Online Class # 204 CATEGORY WOOD FIRE EARTH METAL WATER SEASON Spring Summer Late Summer Fall Winter CYCLE Birth Growth Maturity Harvest Rest / Storage ZANG: Solid / Liver Heart PC Spleen Lungs Kidney Yin Organ FU: Hollow / Gall Bladder S I SJ / TW Stomach Lg. Intestine Bladder Yang Organ CLIMATE Wind Heat Damp Dry Cold ORIFICE Eyes Tongue Mouth Nose Ears SENSE Vision Speech Taste Smell Hearing BODY TISSUE Tendons Sinews Blood & Flesh & Muscles Skin Teeth, Bone & Blood Vessels Marrow TONGUE Sides Tip Center Behind Tip Root RESIDUES Nails Complexion Lips Body Hair Head Hair COLOR Cyan (Green) Red Yellow White Black (Blue) SOUND Shouting Laughing Singing Weeping Groaning (Sighing) OFFICE General Sovereign Minister of Architect Treasurer & DUTY Planning Ruling Agriculture Create Order Store Essence Nourishing STORAGE Soul Consciousness Intent Vitality Determination Benevolence Righteous Faith Decorum Wisdom SPIRITS Hun Shen Yi Po Zhi (Soul) (Spirit) (Thoughts) (Skeleton) (Will) Persona / Ego: Heart / Mind Memory Yin Soul Intention / Yang Soul Recollection Stays with the Commitment / Leaves at Death, body @ Death Follow Through EMOTION Decisiveness Joy Harmonizing Strength Determination Control Enlightenment Preoccupation Sustainability Fear Anger Obsessive Grief/Sadness

EMOTION Decisiveness Joy Harmonizing Strength Determination Control Enlightenment Preoccupation Sustainability Fear Anger Obsessive Grief/Sadness BODY FLUID Tears Sweat Saliva Nasal Mucus Internal Moisture TASTE Sour Bitter Sweet Pungent Salty Hot/Spicy © ODOR1994 - 2013 JamesSour Ventresca AcuPractice™Burnt FragrantSeminars - www.AcuPracticeSeminars.comPutrid Musty 14

D. Chronotherapy (The Horary Cycle) Powerpoint: Clinical Acupuncture Theory - Online Class # 205 Horary Cycle - Qi Generation

FIRE

EARTH

SP HT SI 9 –11 AM 11AM – 1 PM 1 – 3 PM

WATER ST UB 7 – 9AM 3-5 PM

LI KI 5 –7AM 5 –7 PM

METAL LU PC 3 – 5 AM 7 – 9 PM

LR GB SJ 1-3 AM 11 PM – 1AM 9 – 11 PM

FIRE

E. The Essential Substances

1. Qi, Xue (Blood), Jing (Essence), Shen (Spirit), Jin Ye (Fluids)

2. Qi a. Energy, Prana, Life-force, Innate b. The Body Is It’s Physical Manifestation c. Circulates Inside and Outside the Meridians d. Origin

1. Constitution

2. Food / Drink

3. Air/ Environment

3. Qi (& Blood) Production

1. Gu Qi / AKA: Grain or Food Qi

2. Zong Qi / AKA: Gathering or Essential QI

3. Zheng Qi / AKA: True Qi

4. Ying Qi / AKA: Nutritive Qi

Powerpoint: Clinical Acupuncture Theory - Online Class # 206 Qi & Blood a. Functions Of Qi

1. Activation Or Movement

2. Warmth

3. Transformation

4. Defense

5. Containment b. Four Directions Of Qi In The Body

1. Up Bearing

2. Down Bearing

3. Entering

4. Exiting c. Imbalances Of Qi

1. Deficient Qi (Qi Deficiency) a. Origin

1. Malnutrition

2. Exhaustion From Overwork

3. Chronic Illness

4. Congenital Disease

5. Old Age b. Can Manifest In:

1. Entire Body

2. Spirit

3. A Particular Organ 2. Spirit

3. A Particular Organ c. Signs & Symptoms (S&S)

1. Fatigue

2. Malaise

3. Pale Face

4. Weak Pulse

5. Pale & Swollen (Puffy) Tongue

6. Organ Dysfunction

2. Collapsed Qi a. S&S (Two Presentations)

1. Qi Deficiency S & S + Prolapse

2. Qi Deficiency S & S + Heart Attack

3. Stagnant Qi (Qi Yu) a. Origin

1. Trauma

2. Outside Pernicious Influences (OPI)

3. Emotional Upset

4. Inappropriate Diet b. S&S

1. Dull Achy Pain / Unfixed in Time And Space

2. Intermittent Or Traveling Pain

3. Feels Better With Massage Strokes

4. Intercostal Neuralgia (LR Qi Yu)

4. Rebellious Qi a. Moving In The Opposite Direction b. S&S

1. Nausea / Vomiting / Acid Reflux

2. Cough / Sneezing 1. Nausea / Vomiting / Acid Reflux

2. Cough / Sneezing

5. Blood a. Blood Is Yin In Relationship To Qi b. Blood Is A Fluid and a Type of Qi

1. Liquid Form Of Qi (Yin In Nature) c. Functions:

1. Nourishes All Parts Of The Body

2. Moistens All Parts Of The Body a. Esp. Tendons, Eyes, Hair

3. Maintains Physical Structure

4. Cools

5. Calms

6. Provides Rest & Ability to Rest d. Relationships Of Blood:

1. Heart: Moves It Through Body

2. Liver: Stores and Releases (includes Menstrual Blood)

3. Spleen: Produces Blood & Holds It In the Vessels e. Disharmonies Of Blood:

1. Deficient Blood (Xue Deficiency) a. Origin

1. Malnutrition

2. Chronic Illness

3. Congenital Disease

4. Old Age

5. Exhaustion From Overwork 4. Old Age

5. Exhaustion From Overwork

6. Loss of blood b. Can Manifest In:

1. Entire Body

2. Spirit

3. A Particular Organ c. Signs & Symptoms (S&S)

1. Similar to Qi Deficiency, but with the addition of Lack of Nourishment, and Moistening

2. Fatigue

3. Malaise

4. Pale Lusterless Face

5. Weak Thin Pulse

6. Pale & Thin Tongue

7. Organ Dysfunction

8. Dry Skin

9. Brittle Hair

10. Twitches And Spasms (Due To Drying Out Of Tendons)

11. Scanty/Light/Shortened/Infrequent Menses

12. Dizziness

13. Difficulty Falling Asleep (Yin Substance)

14. Dry Eyes (Liver)

15. Palpitations (Heart)

2. Stuck Blood (Xue Yu) a. Sharp, Stabbing Pain Fixed in Time & Space b. Tumors Or Cysts (Non-Moving) c. Swollen Organs d. Hematoma d. Hematoma

3. Hot Blood a. Red Dry Skin

b. Pimples c. Rashes d. Hemorrhage Of Fresh Red Blood (Hemorrhoids, Uterine Bleeding, Urine)

4. Jing

Powerpoint: Clinical Acupuncture Theory - Online Class # 207 Jing Shen & Fuids

1. AKA: Pre-Heaven Qi, Constitutional Qi

2. Formed At Conception; Inherited From The Parents

3. Governs Growth and Development

4. Stored In The Kidneys

5. Imbalance: Jing Deficiency a. Poor Development In Children b. Poor Concentration / Memory c. Reproductive Disorders d. Loose Teeth e. Brittle Bones f. Gray-Thinning Hair g. Senility

G. Shen (Spirit)

1. Spirit That Is Stored In The Heart and Reflected in the Eyes

2. Lightest, Most Insubstantial Of All Substances

3. Origin a. Birth & Acquired From Life Experience

4. Function: a. Birth & Acquired From Life Experience

4. Function: a. Guides Bodymind b. Dysfunction Causes Physical/Mental Disease

5.Disharmonies Of Shen:

a.Emotional Problems, Psychological And Emotional Shock, Disturbances Of Psychological/Mental Nature

b.Eyes That Lack Luster

c.Muddled Personality Forgetful And Slow

d.General Spiritual Disorder (Psychosis)

F. Fluids: Jin Ye

1. Includes All Normal Bodily Fluids Except Blood

2. Jin a. Clear, More Yang, Watery b. Provides Moisture To Surface Of Skin And Flesh c. Provides Moisture To Mucous Membranes d. Transformed By Lungs Into Sweat

3. Ye a. Thick, Internal, More Yin b. Lubricates Bones, Brain, Organs, Joints c. Circulates In The Blood & Gives Luster To Skin 23 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

G. The Causes of Disease or Pathogenic Factors Powerpoint: Clinical Acupuncture Theory - Online Class # 208 OPI Emotions Patho

1. External Pathogenic Factors a. The Evil Winds

1. Wind

2. Cold

3. Damp

4. Dryness

5. Heat

6. Summer Heat

2. Internal Pathogenic Factors a. The Emotions

1. Anger

2. Joy

3. Melancholy & Grief

4. Meditation (Over thinking)

5. Fear

3. Miscellaneous Pathogenic Factors a. Inappropriate Diet b. Inappropriate Exercise c. Inappropriate Timing d. Parasites e. Trauma f. Insect / Animal Bites g. Epidemics h. Wrong Treatment i. Excess Sex j. Drug Use, Contact / Environmental, Etc. k. Perhaps Bad Feng Shui

H. Organs Powerpoint: Clinical Acupuncture Theory - Online Class # 209 Into to Organs

1. Introduction to the Organs 1.Spheres of Influence 2.Zang Fu Diagnosis 3.Organ Main Jobs a.Lungs - Rule Respiration b.Spleen - Orchestrates Digestion c.Heart - Stores the Consciousness d.Liver - Spreads the Qi e.Kidney - Root of Yin &Yang, Stores Jing 4.Primary Organ Disharmonies 5.Organ Associations 6.Yin vs Yang Organs 5.Organ Associations 6.Yin vs Yang Organs 7.Organs & Meridians 8.Husband & Wife 9.Six Devisions

2. Lung Powerpoint: Clinical Acupuncture Theory - Online Class # 210 LU LI a. AKA: Tender Organ, Master Of Qi b. Opens To The Nose & Throat c. Most Easily Affected By OPI d. Dislikes Cold And Dryness e. Properties

1. Liquefies

2. Descends

3. Disseminates

4. Circulates f. Functions

1. Govern Qi & Respiration

2. Rules The Exterior g. Common Disharmonies:

1. LU Qi Deficiency

2. LU Yin Deficiency

3. Rebellious Qi in LU

4. OPI

5. Dampness. Phlegm in LU h. Major S&S

1. Respiratory 1. Respiratory

2. Large Intestine a. The Official In Charge Of The Dregs b. Dependent Upon Lungs For Descending

3. Spleen Powerpoint: Clinical Acupuncture Theory - Online Class # 211 ST SP a. AKA: The Official In Charge Of Transportation And Transformation (T&T)

1. Governs T&T of Qi, Blood & Jin Ye b. Holds Blood & Organs in Place c. Opens To The Mouth d. Manifests In The Lips e. Dislikes Dampness & Cold f. Functions g. Rules The Flesh & Muscles h. Common Disharmonies:

1. SP Qi Deficiency

2. SP Blood Deficiency

3. SP Yang Deficiency

4. Dampness in SP

4. Stomach a. The Official In Charge Of Rotting And Ripening

1. Prepares Food and Drink for T&T by the Spleen b. Common Disharmonies:

1. Rebellious ST Qi

2. Heat in the ST

3. Major S&S a. Upper Digestive

5. Heart Powerpoint: Clinical Acupuncture Theory - Online Class # 212 HT SI PC SJ a. AKA: The Emperor b. Houses The Consciousness / Shen c. Rules Blood And Blood Vessels d. Dislikes Heat e. Opens To The Tongue f. Manifests In The Complexion g. Common Disharmonies:

1. Heart Blood Deficiency

2. Heart Yin Deficiency

3. Blood Stagnation in the Heart or Chest

4. Heat in the Heart 3. Blood Stagnation in the Heart or Chest

4. Heat in the Heart

5. Major S&S a. Psychological Disorders b. Palpitations

6. Small Intestine a. Separates The Pure From The Impure

11. Pericardium

a. The Minister: Insulates, Screens, & Protects The Heart

b. Maintains The Order Of The Heart Energy

c. Treats All Heart Disorders Organic & Spirit

12. San Jiao (Triple Warmer)

a. AKA: Triple Heater, Triple Warmer, Triple Energizer

b. San Jiao: Literally Three Burning Spaces

1. Upper Jiao

a. LU & HT

b. Respiration & Circulation

2. Middle Jiao

a. SP & ST

b. Digestion & Assimilation

3. Lower Jiao

a. KD, UB & Reproductive Organs

b. Elimination & Reproduction

c. The Three Jiaos are collectively responsible for Water Metabolism (Classically Described As A System Of Sluices Or Waterways)

1. Lung Adjusts Water 1. Lung Adjusts Water

a. Descends & Disseminates

2. Spleen Transforms Water

a. T & T (Sends it Up

3. Kidney Rules Water

7. Liver Powerpoint: Clinical Acupuncture Theory - Online Class # 213 LR GB a. AKA

1. The General a. Charge of Planning

2. Free & Easy Wanderer a. Maintains easy going internal environment

3. Sea of Blood (Stores)

4. The Master Alchemist / transmutes and detoxifies b. Opens To The Eyes c. Dislikes WIND (Heat / Stagnation) d. Responsible for the Smooth and Easy Flow of Qi & Emotions e. Rules the Tendons & Muscles f. Houses the Hun (ego) g. Controls the eyes h. Common Disharmonies:

1. Liver Qi Stagnation

2. Liver Invading a. Stomach b. Spleen c. Lung c. Lung

3. Liver Blood Stagnation a. Painful periods, Clots, Sharp Stabbing Pain

4. Damp-Heat in the Liver and Gall Bladder i. Major S&S:

1. Stress Related Disorders

2. Tight/Tense Muscles

3. Tics, Twitches & Tremors

4. Anger / Irritability

5. Gynecological problems

6. Meridian related Sx.

8. Gall Bladder a. The Official in Charge of Decision Making b. Dislikes Wind c. Very Closely Related to the LR

9. Kidney

Powerpoint: Clinical Acupuncture Theory - Online Class # 214 KD UB a. AKA

1. Root of Yin a. HT, LR

2. Root of Yang a. SP

3. Root of Qi

4. Root of Life b. Opens To The Ears c. Dislikes Cold d. Functions d. Functions

1. Stores Jing

2. It houses the Will

3. Rules the Bones

4. Housed in the Low Back

5. Rules the Knees & Ankles

6. Governs birth, growth and reproduction.

7. Nourishes and Warms (supplies Yin & Yang to) the Lower Warmer e. Common Disharmonies:

1. Deficiencies ONLY: NO Excess Conditions

2. KD Qi Deficiency

3. KD Yang Deficiency

4. KD Yin Deficiency

5. KD Jing Deficiency f. Major S&S:

1. General Qi & Yang Deficiency S & Sx

2. General Yin Deficiency S & Sx

3. Low Back / Knee Pain and Weakness

4. Impotence and Infertility

5. Incontinence / Urinary Frequency

6. S&S of Premature Ageing

10. Urinary Bladder a. Transforming and excreting fluids via the power of KD Qi

13. Extraordinary/Curious Vessels/Organs Powerpoint: Clinical Acupuncture Theory - Online Class # 217 Extraordinary Organs & Meridians a. Extraordinary / Curious Organs

1. Fu Shape /Store Essences 1. Fu Shape /Store Essences

2. Six Curious Organs a. Gall Bladder b. Brain c. Marrow d. Bone e. Blood Vessels

f. Uterus b. Extraordinary Meridians

1. Names a. Du Mai (Governing Vessel) b. Ren Mai (Conception Vessel) c. Chong Mai (Penetrating Vessel) d. Dai Mai (Belt Meridian) e. Yang Wei Mai f. Yin Wei Mai g. Yin Qiao Mai h. Yang Qiao Mai

2. Origin a. Created at conception b. Deep energies

3. General Functions a. Reservoirs of Qi

I. Introduction to Tongue and Pulse Diagnosis

1. Tongue

Powerpoint: Clinical Acupuncture Theory - Online Class # 218 Tongue Dx.

A. Areas A. Areas

1. See 5 Element Chart

a. Color

1. Normal a. Pale Red b. Thin White Coat

2. Pale 2. Pale a. Qi Deficiency b. Blood Deficiency c. Yang Deficiency

1. False Cold

3. Red a. Heat

1. True Heat

1. Internal

2. External

2. Yin Deficiency

1. False Heat

4. Purple a. Stagnation b. Light Purple = Qi Stagnation c. Dark Purple = Blood Stagnation b. Shape

1. Normal

2. Thin a. Less Substance

1. Yin Deficiency

2. Thin & Red / No Coat

3. Blood Deficiency

4. Thin & Pale

3. Puffy a. Qi Deficiency

1. WHITE Coat b. Yang Deficiency b. Yang Deficiency

1. WET Coat c. Coat

1. Thin White a. Normal

2. Thick White a. True Cold

3. Yellow

a. True Heat

4. Wet a. Yang Deficiency (False Cold)

5. No Coat (Peeled) a. Yin Deficiency (False Heat)

6. Greasy a. Dampness or Phlegm d. Usual Tongue Combinations

1. Pale & Puffy with a WHITE Coat a. Qi Deficiency

2. Pale & Puffy with a GREAZY WHITE Coat a. Spleen Qi Deficiency

3. Pale & Puffy with a WET Coat a. Yang Deficiency

4. Pale and Thin a. Blood Deficiency

5. Red and Thin with Little to No Coat (Peeled) a. Yin Deficiency

6. Red with a Yellow Coat 6. Red with a Yellow Coat a. Internal Heat

7. Scalloped Edges a. Spleen Qi/Yang/Blood Deficiency

3. Pulse Powerpoint: Clinical Acupuncture Theory - Online Class # 219 Pules Dx a. Rate

2. Rapid a. More then 80 BPM b. Heat

1. True or False

3. Slow a. Less than 60 BPM b. False Cold (Yang Deficiency) b. Strength / Size

1. Normal

2. Full a. Excess Condition

3. Weak a. Deficient Condition

4. Thin a. Deficient Yin or Blood c. Quality

1. Slippery a. Dampness

2. Wiry a. Stagnation 2. Wiry a. Stagnation

1. Usually liver

3. Tight a. Pain b. True Cold d. Usual Pulse Combinations

1. Weak a. Qi Deficiency

2. Weak & Slow a. Yang Deficiency

3. Weak & Thin a. Blood Deficiency

4. Thin & Rapid a. Yin Deficiency

5. Full & Rapid a. Excess Heat

1.Usual Tongue & Pulse Combinations

Condition Tongue Pulse Normal Normal Red Moderate Strength Thin White Coat Fills Middle - Touches Superﬁcial & Deep Slightly Slippery

Qi Deﬁciency Pale & Puffy Weak Thin White Coat

Yang Deﬁciency Pale & Puffy Weak & Slow Wet Coat

Blood Deﬁciency Pale & Thin Weak & Thin Dry Thin White Coat

Yin Deﬁciency Red & Thin Weak & Thin & Rapid Dry No / Peeled Coat

True Excess Heat Red Full & Rapid Dry Thick Yellow Coat

Dampness Greasy Coat Slippery

Qi Stagnation Slightly Purple Slightly Wiry

Blood Stagnation Dark Purple Deﬁnitely Wiry (Maybe Spots)

OPI Heat Red Tip Rapid & Floating Red Edges

OPI Cold Normal Floating

Long-Standing SP Xu Scalloped Edges Weak in Middle Position

LR Qi Stagnation Slightly Purple Full & Wiry

2. Acupuncture Techniques Demystified

A. Weekend 2 Introduction Powerpoint: Clinical Acupuncture Theory - Online Class # 220 CNT

2. Acupuncture/Moxibustion

a. Needle Types 1. Standard 2. Retained 3. Bleeding

b. Moxa 1. Direct 2. Indirect

c. Non-invasive 1. Moxa

a. Direct b. Indirect 2. Cupping 3. Guasha 4. LASER 5. Pressballs / Seeds 6. Magnets 7. Electro-Stim 6. Magnets 7. Electro-Stim

a. Invasive / Non-Invasive 8. Essential oils

B. Clean Needle Technique

1. ALWAYS:

a. Wash Hands Between Patients

b. Establish a Clean Field

c. Sanitize Hands Prior to Inserting Needles if Hands Have Been Slightly Contaminated

d. Use Sterile Needles

e. Isolate Used Needles Immediately

2. Universal Precautions: Prevention of Exposure and Prevention of Disease if Exposure Occurs.

a. Use with All Patients

b. Hand Washing

1. # 1 for Infection Control

2. Soap & Running Water 10 Seconds Minimum

3. Alcohol Based Hand Disinfectants are Acceptable for Hand Washing

c. Gloves, Gowns, Masks, Goggles etc. when needed

d. Use Sterile and/or Clean Equipment and Work Areas as directed

3. Sterile vs. Clean

a. Sterilization

1. Needles & other Instruments that Penetrate the Skin or Touch the Mucous Membrane

2. Bleach Solution for Non-Porous Items

a. 1:10 solution Bleach: Water

b. Soak for 1 hour

c. Use within 24 hours

b. Disinfection / Antisepsis/ 70% Isopropyl Alcohol c. Use within 24 hours

b. Disinfection / Antisepsis/ 70% Isopropyl Alcohol

1. Use on Clean Skin to reduce pathogens and inanimate objects on the skin

c. Clean Technique

1. Using Sterilization, Disinfection, Antisepsis, washing, etc.

4. Clean Field

a. The area prepared to contain acupuncture equipment & supplies

b. Clean Tray or Paper Towel Work Surface

1. Sealed/Open Needles

2. Alcohol Swabs

3. Dry Cotton Balls

4. Gloves

5. Clean Instruments

a. Gua Sha Tool

b. Cups

c. Forceps

d. Ear Probe

e. Etc.

c. Off the clean field

1. Waste container

a. Plastic Lined Paper Bag

2. Biohazard Container

3. Other Non-Clean Items:

a. Pens

b. Discarded Insertion tubes and wrappers

c. Etc.

5. Needles Must be Sterile

a. Use Single-Use Disposable Needles

b. Avoid Contamination when removing needles from packaging b. Avoid Contamination when removing needles from packaging

6. Cups and Guasha Tools

a. If no bleeding occurs: Cups May be Cleaned with Soap and Water

b. If Bleeding occurs: Cups Must be Cleaned and Sterilized (Bleach Solution)

7. Biohazard Containers

a. Needles ONLY in Biohazard Containers

1. Cotton balls, ONLY IF SOAKED WITH BLOOD

2. Cotton balls tinged with blood are disposed in double bagged waste

b. Disposal

c. Storage

d. Transportation

8. All Participants should cooperate in setting up a complete clean field at each table.

C. Office Setup/Patient Flow

1. Patient Scheduling

2. Order of Treatment Modality

3. Assistant(s)

4. Gowns / Gym Shorts

5. Treatment Tables

a. Bolsters

b. Table Extenders

c. Boards & Blocks

6. Stool/Chair

7. Treatment Cart

a. Clean Field

8. Treatment Supplies 8. Treatment Supplies

9. Biohazard container

10. TDP/Heat Lamp

11. (Space) Blankets

12. Timers

13. Call Buttons

Forms

a. Find Forms Online: www.AcuPracticeSeminars.com

1. Resources Page

b. Intake

c. Informed Consent

d. Moxibustion Instruction/Consent

e. Cupping / Guasha Information Letter

f. Patient Education Handouts

D. Risk to Acupuncture Providers

1. Train Staff Carefully in

a. Recognition of Contaminated Needles

b. Office Procedures Regarding Needles

c. Handling Contaminated Needles

d. Needle Sticks

2. Needle Stick

a. Use Caution to Avoid

b. CDC Recommends

1. Consult a Physician Immediately

2. Test Source for HBV, HCV, HIV within 2 hours if possible

3. Begin Treatment ASAP, if required 3. Begin Treatment ASAP, if required

3. Blood Exposure

a. Glove Carefully

b. Double Glove when necessary

E. Acupuncture Patient Side Effects

1. High Risk Patients

a. Use Universal Precautions

2. Needle Sickness / Fainting

a. Vasovagal Response

b. Remove Needles, Have Patient Lie Down

c. Perhaps a few sips of water

3. Pain / Bruising / Swelling at Needle Site

4. Stuck Needle

5. Forgotten Needle

6. Neuritis

7. Moxa Burns

a. Use Caution

b. Assess Patient’s Heat Tolerance b. Assess Patient’s Heat Tolerance

1. Neural injury, diabetes, paralysis, etc.

c. Treat w/ Western Medical Techniques

d. Sterile dressing

e. Appropriate referral

8. Abscess

9. Allergic Dermatitis

10. Broken Needle

a. Leave some shaft visible

11. Auricular Chondritis

12. Pneumothorax

13. Organ Puncture

a. Eyes

b. Veins/Arteries

1. 30 sec – 5 minutes direct pressure

c. Enlarged

1. Heart

2. Liver

3. Spleen 2. Liver

3. Spleen

4. Kidney

d. Spinal Cord

1. Exercise Caution With DU 15 & DU16 (GV 15 & GV 16)

14. Seizures

F. Contraindications and Cautions

1. Always use Caution when treating Patients who are or may be

a. Pregnant

b. Elderly

c. Diabetic

d. Very Tired

e. Very Hungry

f. Under the influence of any Mind Altering/Pain Relieving Medications

g. Numb in an area to be treated

2. Points Contraindicated in Pregnancy

a. LI 4

b. SP 6

c. GB 21

d. Points on the Abdomen

e. Points on the Lower Back

3. GB 21 Contraindicated for patients with Heart Conditions e. Points on the Lower Back

3. GB 21 Contraindicated for patients with Heart Conditions

4. Electro-Acupuncture Contraindicated for patients with

a. Pacemakers and other electrical implants

b. History of Seizure Disorders

c. Strongly Recommended not to apply electro-acupuncture across the heart (i.e. Chest to Back/ Left to Right/ Arm to Arm)

G. Needle Selection

1. Considerations

a. Ease of application

1. Insertion

2. Rotate / thrust etc.

3. Painlessness

b. Degree of Stimulation

c. Personal Preference

d. Conductivity

1. Electrical

2. Ability to feel and transmit Qi

2. Variables

a. Thickness

b. Length

c. Handle

1. Filliform (Wound) / Solid

Metal / Plastic

3. AcuPractice Recommendation

a. “Seirin” Brand Needles

1. Lhasa OMS 1-800-722-8775 www.lhasamedical.com

2. 30mm # 3 = 36 gauge Chinese / 0.20mm

a. General Utility Needle (10 to 1) 2. 30mm # 3 = 36 gauge Chinese / 0.20mm

a. General Utility Needle (10 to 1)

b. Blue Handle

3. 40mm # 5 = 32 gauge Chinese / 0.25mm

a. Stronger Stimulation

b. Deeper Points

c. Chinese Scalp Acupuncture

4. 60mm # 8 = 28 gauge Chinese / 0.30mm

a. Strongest Stimulation

b. Deepest points

5. Interdermals: 6mm #1

H. Tonification, Sedation, and Even Needling

1. Even / Harmonizing

2. Tonification

a. Mild Stimulus

b. Mild Thrusting

c. Moderate rotation

3. Sedation

a. Strong Stimulus

b. Strong Thrusting

c. Great rotation

I. Needling Depths & Angles

1. Angle of Insertion

a. Usually Perpendicular to the Skin

b. Exceptions will be noted

2. Needling Depths

a. Avoid Organs and Blood Vessels a. Avoid Organs and Blood Vessels

b. Consider the Underlying Structure

c. Usually into the middle of the Muscle under the point

d. Usually between 1/4and 3/4 inch deep

J. Electro-Acupuncture

1. Introduction

a. First used in the 1950s

b. How does it Work?

1. Electrical signals travel to the Brain or Spinal Cord and encourage the production of Hormones and Neurotransmitters.

c. Often Used For

1. Acute & Chronic Pain (55%-85% success rate)

1. Placebo 30-35%

2. Morphine has a 70% success rate

2. Traumatic Injury

3. Paralysis

4. Dental / Surgical Anesthesia

2. Two Types of Electro -Acupuncture

a. Milliamps

1. Standard Electro Acupuncture

b. Microamps aka Microcurrent

1. Much Less stimulation

2. Function on a cellular level

3. Machines

a. Quality Considerations

1. Expense

2. Precise Frequency and Intensity Adjustments

3. Number of Channels

4. APD / Elect. Stim. 3. Number of Channels

4. APD / Elect. Stim.

5. Quality of Biphasic Wave

b. Recommended Machines

1. E-Stim II

a. Milliamp & Microamp

b. 2 Channels

c. Inexpensive

d. Works Fine

2. ITO IC 1107

a. Milliamp Only

b. 3 Channels

c. Moderately Priced

d. Works Well

3. Pantheon

a. Milliamp and Microamp

b. 4 Channels

c. Higher Price

d. Works Very Well

4. User Interface

a. On/Off Switch

b. Intensity Controls

1. Click Off Before Turning Unit On

2. Reliability May be Dependent on Battery

3. Some Machines are Very Sensitive

a. Always turn up SLOWLY

4. Turn Intensity to Zero Before Switching any other controls

5. Usually 3- 4 Channels (Output Jacks)

a. (+) (-) Switches

c. Intensity Multiplier (+) (-) Switches

c. Intensity Multiplier

d. Frequency Multiplier

e. Frequency Modulation Controls

1. Visual freq. Indicator Light

2. Continuous

a. Constant Hz

b. each pulse follows the preceding one

c. //////////////////////

3. Discontinuous

a. Irregularly Irregular

b. Constant Hz / Random Time Slots

c. ///////------//////////------//////------///

4. Dense - Disperse

a. Varying Set c/s “sweeps” / Random Time Slots

b. / / / / ////////// / / / / / / //////////// / / / //////

f. Acupuncture Point Detection

1. Pros & Cons

5. Principles

a. What Happens

1. Neural messages are sent to Brain or Spinal Cord and Neurochemicals or Hormones are released

a. Spinal Cord Stimulation

1. Local AA effect, only

a. Stimulates Spinal Chord Reflex Arc Only

1. Enkephalin & dynorphin

b. NO ß-endorphin production

b. Midbrain / Hypothalamus / Pituitary Stimulation

1. Systemic effect

2. Similar to Da Qi Needle Stimulation 1. Systemic effect

2. Similar to Da Qi Needle Stimulation

3. Including AA at a distance

4. enkephalin

5. serotonin

6. norepinephrine

7. Increased Hormonal Stimulation

8. ß-endorphin released into Blood & CSF

b. Pulse

1. Pulse Width

a. 0.1-1.0 ms - microseconds

2. Pulse Strength

a. 2.5-5.0 mA - milliamps

3. Biphasic Pulse

a. Imperfectly Matched Biphasic Pulses lead to the area where the Black (-) clip is placed, experiencing more stimulation(pain)

c. Intensity

1. Low Intensity

a. At threshold of M. contraction

1. Observable M.(or needle) movement

b. May be useful for tonification

2. High Intensity

a. 5-10 times the threshold for M. contraction

1. Intense M. Contractions

a. Gradually increase every 5 min. for 30 min. until intense M. contractions are observed if necessary

d. Frequency

1. Low Frequency

a. Individual M. Contractions

b. 1-4 Hz a. Individual M. Contractions

b. 1-4 Hz

c. Midbrain / Hypothalamus / Pituitary Stimulation

2. High Frequency

a. Tetanic M. Contraction

b. 50 Hz or Greater

c. Spinal Cord Stimulation Only

6. Treatments

a. Needles

1. choose a heavy gauge (# 5-8)

a. Finer needle = greater resistance

2. Pair in areas of EQUAL sensitivity

a. face to face

1. Skin Nerves

b. hand to arm

1. Deep M. Nerves

b. High Frequency / Low Intensity

1. No Cumulative Effect

a. Spinal Cord Only

2. Intensive Local Anestesia

3. Short onset

c. Low Frequency / High Intensity

1. Longer lasting Cumulative Effect

a. Midbrain & Hypothalamus-Pituitary

2. Systemic Effect

7. Contraindications

a. No EA. W/ Pacemakers (Nat. Exam)

b. FDA bans EA on Head

c. No EA stim over Neck c. No EA stim over Neck

d. STRONG EA stim in spastic Muscles

e. No EA Crossing the Heart

f. In Pregnancy

1. No EA Around Fetus

2. No EA on Strong Moving Points

3. No EA Below Bl23

g. Note: Amer. Assoc. for Medical Instrumentation recommends levels below 250 mA @ 1.0 ms across the heart (arm to arm). This is 50 - 100 times higher than EA. devices generally deliver (2.5 -5.0 mA @ 1.0 ms)

K. Laser Acupuncture

1. Low Level Laser Therapy / LLLT

2. Recommended Laser for Acupuncture Treatment

a. Class III Lasers

3. Wavelength

a. Prime determinant of tissue penetration.

1. Areas of thick skin or muscle may require higher doses for penetration than finer skin areas e.g. ear.

b. Lasers which penetrate less deeply / suitable for acupuncture point stimulation and biostimulation.

1. 630 – 680nm (nanometers) visible, coherent, bright red

c. 1.5mW - 5 mW

1. up to 10 mW are available

2. A minimum of 1mw and 10-12seconds are required to produce any 1. up to 10 mW are available

2. A minimum of 1mw and 10-12seconds are required to produce any sort of reaction

d. HeNe (Helium - Neon) gas or Diode

e. Should shine @ 65 feet in a well lit room, 300 feet in a dark room

4. Use the same rules of point selection as needle acupuncture

a. Energetics

1. Moving

2. Perhaps Warming

b. Trigger points/snap signs release

5. To promote healing

a. Wounds: ulcers, burns, pressure sores

b. Skin infections such as herpes zoster, labialis and genitalis.

c. Enhancing effect on healing wherever inflammation is present

6. Contraindications

a. Do not shine laser through pupils when treating around eyes

b. No laser to fontanels of infants

7. Cautions

a. Conditions which may be treated but requiring experience and caution

1. tumorous tissues

2. pregnancy

3. unstable epilepsy

b. Children and the elderly may require smaller doses. b. Children and the elderly may require smaller doses.

8. Side-effects Patients may experience:

a. The same as with needles

1. treatment reaction / needle sickness

a. Dizziness

b. Fainting

c. nausea

d. tiredness

e. headache

2. change in the site of pain

3. increased pain.

9. Demonstration /Practice

L. Moxa

1. NOTE: Due to restrictions in some Facilities (Hotels) moxa demonstration and practice (with burning moxa) may be limited to a brief outdoor experience. However, a practical experience can be obtained by going through the motions with unlit moxa. While it is not optimal, this technique will give you some physical memory to start with.

2. Properties

a. Warm

b. Bitter

c. Anti-Bacterial

3. Actions

a. Warms

1. Body

2. Meridians

3. Limbs 3. Limbs

4. Uterus

b. Expels Cold & Damp

c. Revives Dying Yang

d. Invigorates/Moves Qi & Blood

e. Regulates Qi & Blood

f. Opens The 12 Primary Channels

g. Repairs Traumatized Tissue

4. Indications

a. Pain

b. Cold

c. Deficient Yang

d. Stagnation

1. Qi

2. Blood

3. Phlegm 2. Blood

3. Phlegm

e. Internal Uses

1. Warms the Uterus

2. Kills Tapeworms

Procedure

a. Treat Upper Body before Lower Body

b. Head & Body before Extremities

c. Cautions & Contraindications

1. Not on Upper Body W/ Heat

2. Pregnancy

a. Not Direct

b. Not Near Fetus

1. Moving

3. No Direct

a. Cv14, 15

1. Ht

b. Face - Hands

1. Scar

c. Bl1

d. St1

e. St9

6. Methods of Use

a. Always Explain Procedure To Pt.

1. Patient Is In Control

a. “Hot” is the Operative Term

b. Indirect

1. Belly Bowl (Bong Re)

a. Very good to tonify Spleen & Kidneys

b. Remove resin a. Very good to tonify Spleen & Kidneys

b. Remove resin

2. Tiger Warmer

a. Milder odor than regular moxa Pole

Two Sizes Small and Large (Lion Warmer)

3. Pole / Roll

a. Straight vs. With Other Herbs

b. Bird Pecking / Warming Technique

1. Touch Pt. With Finger

2. Do Not Move the pole around

3. Hold 0.5 To 4 Inches Away

a. To Disperse hold pole close: 0.5 – 1.0 “ away form the skin

b. To Tonify hold pole at least 2.0 inches away, usually 2.5 - 4” away.

c. The Object of the technique is to increase blood circulation to the area, NOT to scorch the skin.

d. This Takes Time

e. 8-10 minutes minimum per point

4. On Needle

a. Heated Needle

b. Pole Segment 3/4 X 3/4

c. Loose Moxa

5. Moxa Instrument

6. Moxa on Ginger

a. Thickness Of 2 Quarters

b. Holes Or Not

c. Apply When Hot

d. Use Once Only c. Apply When Hot

d. Use Once Only

e. Indications

1. Cold ST/SP Disharmonies

2. Cold Joint Pain

3. Cold Lung Disharmonies

7. Moxa on Garlic

a. Use care not to burn the patient. Garlic can cause chemical burns, even without the added heat from the Moxa.

b. Fresh

c. Thick Slices or Mashed

d. Indications

1. Special For Inflammation

a. Carbuncles

b. Boils

2. Insect Bites

8. Moxa on Salt

a. Special For CV8

b. Indications

1. Cold Abd. Pain

2. Nausea / Vomiting

3. Diarrhea

4. Cold / Deficiency Constipation

c. Direct

1. AcuPractice Recommendation: Purchase Pre-rolled Direct Moxa (SMALL SIZE)

2. Holding Medium for Direct Moxa

a. Lip Balm (Burt’s bees)

b. None

c. Ointment / Oil

1. As little as possible c. Ointment / Oil

1. As little as possible

3. Shape

a. Football-shaped Cone

b. Tightly Rolled

1. Retain Shape

c. Roll In One Direction Only

4. Sizes

a. ½ Sesame Seed

b. Sesame Seed

c. ½ Rice Grain

d. Rice Grain

e. Red Bean (Adzuki)

f. Green Bean (Pea)

g. Yellow Bean (Soy Bean)

h. Peanut

i. Chestnut

5. Thread Moxa

a. Use Ultra Pure Moxa

b. Thread

c. Tonify and or Disperse

Treat Moxa Burn

a. Blister

1. Cover

2. Do Not Break

3. If It Breaks

a. Cover W/ Sterile Dressing

b. Standard Treatment for 3rd Degree Burns

1. If the burn is severe or becomes infected, seek specialized Western medical attention. 1. If the burn is severe or becomes infected, seek specialized Western medical attention.

2. Keep wound clean

3. Cover W/ Sterile Dressing

4. Antibiotic ointment, if any

8. Moxa Practical

a. Direct Non-Scaring with Pre-Rolled Moxa

b. Belly Bowl

c. Tiger Warmer

d. Moxa Pole

1. Tonify

2. Disperse

e. Moxa on Needle

M. TDP Lamp

1. Interesting Read on Wikipedia

2. Western Theory

a. USFDA Class II:Class of devices approved by the FDA for temporary relief from pain and arthritis

b. Far Infrared (below visible light) Heating Device

c. Increase Microcirculation

d. Loosens Fascia

e. Accelerate Natural Healing Processes

3. Oriental Theory

a. Therapeutic substitute for moxibustion

b. Reported to be the only mechanical device that can add Qi to the body a. Therapeutic substitute for moxibustion

b. Reported to be the only mechanical device that can add Qi to the body

4. Application

a. Bare skin exposure with the lamp positioned 12-18 inches from the body

b. 15–30 minutes

5. Replaceable Mineral Plate

a. Proprietary formula of 33 trace elements

b. Estimated life of 1000–1500 hours.

c. When the mineral plate looks ash grey, it is time to replace it.

6. Dr. Jim’s Experience

Everyone should have and use TDP Lamps, but they are not exactly moxa

a. Replaces Moxibustion for:

1. Warming

2. Moving QI & Blood

3. Repairing Traumatized Tisssue

b. Can Tonify Somewhat, when used together with Spray Moxa

N. Gua Sha & Cupping

1. Definition

a. Gua Sha

1. Scraping of the skin with a Blunt Instrument to release congestion in the exterior

b. Cupping

1. Stationary or Moving Suction Cups applied to the skin to help bring stagnation to the surface, and release it.

2. Gua Sha

a. Scraping of the skin with a blunt instrument

1. Similar to Graston Technique

b. Often Causes Some Bruising b. Often Causes Some Bruising

c. Actions

1. Stubborn Pain or Congestion with “Sha”

a. Especially for upper and mid-back pain

2. “Sha”

a. evidence of stagnation plus

1. blanching upon palpation

2. “Sha” upon cupping

d. Traditional Indications

1. Reduce fever

2. Fatigue caused by exposure to heat or cold.

3. Cough and dyspnea

4. Muscle and tendon injuries

5. Benefit circulation

6. Headache.

7. Sunstrokes

8. Stiffness

9. Pain

10. Immobility.

11. Digestive disorders.

12. Urinary disorders

13. Gynecological disorders.

e. To assist with reactions to food poisoning

f. Procedure

1. Lubricate

2. Instrument

a. Gua Sha Instrument

b. Porcelain Spoon

c. Smooth Coin Porcelain Spoon

c. Smooth Coin

3. Apply Gua Sha till Sha Appears

4. Follow with Indirect Moxa

a. to inhibit cold entering

g. Recommendations for Post- Gua Sha Patient Behavior

1. Immediately Post Tx.: Indirect Moxa/ TDP Lamp over entire area treated

2. Keep area Warm and Covered for 12 -24 hr.

3. 48 - 72 hr. Avoid Excessive consumption of

1. Flour Products/Baked Goods

2. Greasy/Fried Foods

3. Excessive Dairy (esp. cold)

a. A little alcohol is OK

3. Cupping

a. Stationary or Moving Suction Cups Applied to the Surface of the Skin

b. Often Causes Some Bruising

c. Indications

1. Lungs

2. Upper – Mid-back

3. Low Back - Sciatica

d. Procedure

1. Lubricate

2. Light with a good lighter (Aim & Flame®)

e. Stationary Cups

1. Leave in place for @ 20 minutes e. Stationary Cups

1. Leave in place for @ 20 minutes

f. Moving Cups

1. Pressure on Trailing Edge

2. Follow Natural Qi Flow

g. Think of it as a “Cup Massage” or “Cupping Gua Sha”

h. Recommendations for Post- Cupping Patient Behavior

1. Same as for Gua Sha

O. Needle Technique Demo / Practice Session

1. Ideally all participants should practice needling at least each of the following points.

2. Hands & Feet

a. LI 4, LR 3

b. SJ 5, GB 41

c. PC 6, SP 4

d. LU 7, KD 6

e. SI 3, UB 62

4. Back:

a. Du 4 4. Back:

a. Du 4

b. UB 23

c. Hua Tou Jia Ji Points

5. Leg & Arm

a. St 36

b. Sp 6

c. KD 3

d. LI 14

e. LI 15

6. Hip

a. GB 26

b. GB 30

7. Head

a. Du 20

b. Tai Yang

c. Yin Tang

d. St 6

e. GB 14

8. Abdomen / Lower Warmer

a. St 30

b. Ren 2

c. KD 16

d. Ren 12

9. GuaSha / Cupping Demo / Practice

10. Moxa Demo / Practice

11. Electro-Acupuncture Demo / Practice 10. Moxa Demo / Practice

11. Electro-Acupuncture Demo / Practice

3. Acupuncture Points and Meridians 1

A. Weekend 3 Introduction

Powerpoint: Clinical Acupuncture Theory - Online Class # 215 Intro to Points & Meridians

B. Points Overview

1. Locations

a. Often Located in Hollows/Natural depressions in the body

2. Needle Depths

a. Generally 0.25-1.0 inch (cun)

b. Exceptions will be noted b. Exceptions will be noted

3. Needle Directions

a. Usually perpendicular to the skin

b. Exceptions will be noted

4. Indications

a. Individual uses for the points: i.e. headaches

5. Actions

a. Energetic uses for the points: i.e. clears heat

C. Body Measurements and General Point Location

1. Measurement Illustrations taken from: The Manual of Acupuncture by Peter Deadman and Mazin Al-Khafaji with Kevin Baker

2. The Cun / Personal Inch

D. Basic Material for Point Usage

Powerpoint: Clinical Acupuncture Theory - Online Class #215 Intro Points & Meridians

1. Clinical Applications

2. Actions & Indications

3. Point Categories

a. Front Mu /Alarm

1. Treat the Organ

2. Yin Aspect

b. Back Shu /Associated

1. Treat the Organ b. Back Shu /Associated

1. Treat the Organ

2. Yang Aspect

c. Yuan Source

1. Treat the Yuan/Jing Level of the Organ

d. Horary

1. Element Point that matches the Organ i.e. Fire Point of the Heart

2. Treat the Organ

3. Especially associated with the Horary Cycle

e. Luo /Connecting

1. Connects Husband/Wife Meridians

f. Xi Cleft /Accumulation

1. Pain along the Meridian

g. 5 Element/Command

1. Wood/Mu

2. Fire/Huo

3. Earth/Tu

4. Metal/Jin

5. Water/Shui

h. Tonification / Mother (previous 5-element Sheng cycle point)

1. i.e. Wood Point of the Heart

i. Sedation / Son (subsequent 5-element Sheng cycle point)

1. i.e. Earth Point of the Heart

j. Transport (Shu Points)

1. In order from distal end to the elbow/knee

2. “The flow of Qi from the extremities to the elbows/knees is flourishing” (Nei Jing)

3. Jing-Well aka Ting or Tsing

a. TM Meridian Clearing

4. Ying-Spring a. TM Meridian Clearing

4. Ying-Spring

5. Shu-Stream

a. Used with Jing-well for TM tx.

6. Jing-River

7. He-Sea

a. Lower He-Sea

1. LI – St37

2. SI – St39

3. SJ – UB39

k. Ah Shi Points

1. Locally Tender Points

2. Use established points whenever possible

3. Locate carefullyMeridian Pathway Overview

Powerpoint: Clinical Acupuncture Theory - Online Class #215 Intro Points & Meridians Powerpoint: Clinical Acupuncture Theory - Online Class # 216 Meridian Pathways Importance or Meridian Pathways in Diagnosis and Treatment

E. Du Meridian “Governing Vessel”

1. The pathway of the Du Meridian runs from the perineum, up through the middle of the spine over the head and ending at the upper lip. All its points are on the posterior midline of the body. It is also the most Yang meridian on the body. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Du is important, for treating any and all disorders of the back and specifically the spine. 73 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

Point Location Main Uses Name Du 1: Midway between the tip of the Hemorrhoids; Rectal or Other Prolapse; coccyx and the anus, locating Rectal Bleeding the point in prone position. Du 2: On the hiatus of the sacrum. Sacral and Coccyx Pain

Du 4: In the deepest hollow in the Controlling Point for Lower Back and KD: low back. Below the spinous

Du 4: In the deepest hollow in the Controlling Point for Lower Back and KD: low back. Below the spinous process of the 2nd lumbar All Lower Back Problems, Especially vertebrae. Weakness; Any Kidney Deficiency Du 8 In the depression below the Tightness in tendons, muscle spasms. All spinous process of the 9th Liver Disorders thoracic vertebrae. Level with UB 18 Du 14: Below the spinous process of Controlling Point for Neck & Upper Back: Pain, the 7th cervical vertebrae. Heat & Fevers in the Upper Body; Releases Exterior; Tonfies Wei Qi; Du 20: On the midline of the head, Any Excess Disorders of the Head; Any approximately on the midpoint Prolapse In The Body; Connects with Brain; of the line connecting the Clears the Mind; Headache apexes of the two auricles Du 25: At the tip of the nose Nose/Sinus Congestion

Du 26 Above the upper lip on the Revival Point: Fainting etc. midline, at the junction of the Coccyx / Low Back Pain upper third and lower two thirds of the philtrum.

F. Ren Meridian “Conception Vessel.”

1. The pathway of the Ren Meridian runs from the perineum, up the midline of the front of the body ending just under the lower lip. All its points are on the anterior midline of the body. It is also the most Yin meridian on the body. Since Yin Meridians are often used to treat internal disorders, the Ren is important, for treating many internal disorders and especially those associated with reproductive functions. 75 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

Point Location Main Uses Name Ren 2 On the midpoint of the upper Controlling Point for All GYN and border of the symphisis pubis. Urogenital Disorders

Ren 4 On the midline of the abdomen, 3 Tonify the Kidneys; All GYN & Urinary

border of the symphisis pubis. Urogenital Disorders

Ren 4 On the midline of the abdomen, 3 Tonify the Kidneys; All GYN & Urinary Cun below the umbilicus Disorders; Tonifies Jing, Yang, Yin, & Qi Ren 6 On the midline of the abdomen, 1.5 Tonify the Spleen; Relieves Stagnation in Cun below the umbilicus Abdomen Ren 8 In the center of the umbilicus Strengthens All Digestion & Assimilation;

Diarrhea; Yang Collapse (No Needle-Moxa Only) Ren 9 1 cun superior to the umbilicus Strengthen Spleen Dry Dampness Ren 12 On the midline of the abdomen, 4 Harmonize the Stomach; All Abdominal Cun above the umbilicus Problems Ren 17 On the anterior midline, at level Descend the Qi of the Chest with the 4th intercostal space Ren 22 In the center of the suprasternal fossa Throat and Swallowing Problems

G. Lung/Fei

1. The pathway of the Lung Meridian runs from the second intercostal space 2/3 the distance from the middle of the sternum to the acromion process, down the anterior surface of the arm and ending at the proximal radial corner of the nail of the thumb. Since Yin Meridians are often used to treat internal disorders, the Lung Meridian is important, for treating many internal disorders associated with the Lungs. These include all respiratory disorders and symptoms associated with colds and flus. 77 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

Point Location Main Uses Name LU 1 Lateral and superior to the sternum at Mu / Alarm Point of The Lungs: All Lung the lateral side of the 1st intercostal Disorders space, 6 Cun lateral to the Ren Mai channel. LU 3 On the antero-lateral aspect of the Somnolence, insomnia, sadness, weeping, upper arm, 3 cun inferior to the disorientation and forgetfulness, associated with axillary fold grief & loss LU 3 On the antero-lateral aspect of the Somnolence, insomnia, sadness, weeping, upper arm, 3 cun inferior to the disorientation and forgetfulness, associated with axillary fold grief & loss LU 5 On the cubital crease, on the radial Strong, Productive Cough; Any Heat and/or side of tendon of m. biceps brachii, Fullness in Lungs; located with the elbow slightly flexed. LU 7 Superior to the styloid process of Master Point of the Ren Mai: the radius, 1.5 Cun above the transverse crease of the wrist Controlling Point For Neck & Throat: Circulates the Qi of The Lungs. Luo Point; Use with LI 4 for Headaches and OPIs LU 9 At the radial end of the transverse Source Point; Tonifies the Lungs; All crease of the wrist, in the Deficient Lung Problems depression on the lateral side of the radial artery. LU 10 On the thenar eminence of the Fire Point: Clears Lung Heat, Sore /Strep hand, in a depression between the Throat, Loss of Voice midpoint of the shaft of the first metacarpal bone and the thenar muscles LU 11 On the thumb, 0.1 Cun proximal to Jing Well Point: Clears Heat From The the radial corner of the nail. Lungs (Sore Throat, Tonsillitis, Etc); *Moxa Opposite Side For Nosebleeds *

H. Large Intestine/ Da Chang

1. The pathway of the Large Intestine Meridian runs from the proximal radial corner of the index finger along the arm on the lateral border of the radial bone to the top of the shoulder, crossing the SCM on the neck to the lower border of the ala nsai, on the opposite side. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Large Intestine is important, for treating any and all disorders of arm, neck and head. 79 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

Point Location Main Uses Name LI 1 On the radial side of the index finger, about Jing Well Point: acute pain on the 0.1 Cun proximal to the corner of the nail meridian; Clears Heat from the Head and throat; (sore throat, tonsillitis, red burning eyes, etc) LI 4 On the dorsum of the hand, between the 1st CONTRAINDICATED IN and 2nd metacarpal bones, approximately in PREGNANCY the middle of the 2nd metacarpal bone on Controlling Point for Head and Face: the radial side. Main point for pain and other excesses in the head neck and arm. OPIs; the radial side. Main point for pain and other excesses in the head neck and arm. OPIs; LI 5 On the radial side of the wrist. When the Good local point for pain in the thumb is tilted upward, it is in the thumb and area depression between the tendons of muscle extensor pollicis longus and brevis. LI 11 Fever; Hot Skin Disorders, Any When the elbow is flexed, this point is at the Heat in the Upper Warmer lateral end of the transverse cubital crease.

LI 12 When the elbow is flexed, this point is located in the depression 1 cun proximal to and 1 cun Good Local Point for Pain lateral to L.I.-11. LI 14 Just superior to the lower end of the deltoid Deltoid and shoulder joint pain muscle. LI 15- Anterior and inferior to the acromion, on the upper portion of the deltoid muscle. LI 16 When the arm is in full abduction In the Major points for shoulder joint pain upper aspect of the shoulder, in the depression between the acromial extremity of the clavicle and scapular spine.

LI 17-18 Two points best palpated for. On the lateral side Good local points for throat and neck of the neck, about level with the Adam's Apple, problems on both sides of the SCM. LI 20 In the nasolabial groove, at the level of the Runny Stuffy Nose, any nose midpoint of the lateral border of the ala nasi. problem; often used w/ LI 4 and LU 7

I. Stomach / Wei

1. The pathway of the Stomach meridian runs from the middle of the lower border of the eye socket down to the outer corner of the mouth, to the mandible and up to the corner of the hairline. It proceeds down the front of the body along the mid-clavicular line over the ribcage, where it moves closer to the midline and down to the upper border of the pubic bone. It travels out to the leg and along a trajectory just lateral to the crest of the tibia, and on to the foot, ending at the proximal medial corner of the nail of second toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Stomach meridian is important, for treating any and all disorders of and eye, head, teeth, and leg. 81 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

Point Location Main Uses Name ST 2 Directly below the center of the eye, at the level of the lower border of the Sinus conditions; eye disorders zygomatic arch ST 3 Directly below the center of the eye, at the level of the lower border of the ala nasi, Sinus conditions; knee pain on the lateral side of the nasolabial groove. ST 4 Facial paralysis; trigeminal neuralgia; Lateral to the corner of the mouth, directly herpes; mouth ulcers; gum problems; groove. ST 4 Facial paralysis; trigeminal neuralgia; Lateral to the corner of the mouth, directly herpes; mouth ulcers; gum problems; below ST 3. tooth pain ST 5 Anterior to the angle of the mandible, on the anterior border of the masseter lower jaw toothache muscle. One finger breadth anterior and ST 6 superior to the lower angle of the mandible where the masseter attaches, lower jaw toothache, Bruxism at the prominence of the muscle when the teeth are clenched. ST 7 At the lower border of the zygomatic arch, in the depression anterior to the TMJ; upper jaw toothache condyloid process of the mandible - located with mouth slightly slack. ST 8 .5 Cun within the anterior at the corner Frontal and band-like headaches of the forehead, 4.5 Cun lateral to GV – ST 9 Anterior to the SCM, level with the tip of Caution: Artery the adam’s apple

2 Cun lateral to the center of the ST 25 any intestinal problems; front Mu of LI; umbilicus.

ST 28 3 Cun below the umbilicus, 2 Cun lateral All GYN problems; damp heat in lower to CV 4 warmer; genital herpes; leucorrhoea. Cold and/or blood stagnation in lower warmer; ST 29 4 Cun below the umbilicus, 2 Cun lateral All GYN problems; damp heat in lower to CV 3 warmer; genital herpes; leucorrhoea. Cold and/or blood stagnation in lower warmer; ST 30 5 Cun below the umbilicus, 2 Cun Main Coalescent Point for Chong Mai lateral to CV 2. All GYN problems; damp heat in lower warmer; genital herpes; leucorrhoea. Cold and/or blood stagnation in lower © 1994 - 2013 James Ventresca AcuPractice™warmer; Seminars - www.AcuPracticeSeminars.com 82

Point Location Main Uses Name ST 31 At the crossing point of the line drawn down from the ASIS and the line level with Strengthens and moves the thigh and the lower border of the pubic symphisis, in entire leg the depression on the lateral side of sartorius, when the thigh is flexed. When the knee is flexed, point is 2 Cun xi cleft; acute breast discomfort; knee ST 34 above the laterosuperior border of the pain/weakness patella. When the knee is flexed, the point is at the lower border of the patella, in the ST 35 knee joint problems depression lateral to the patellar

When the knee is flexed, the point is at the lower border of the patella, in the ST 35 knee joint problems depression lateral to the patellar ligament. ST 36 3 Cun below ST 35, one finger breadth Controlling Point for Digestion: lateral to the anterior crest of the tibia All digestive problems; builds Qi and blood; regulates digestion 8 Cun superior to the external Helps resolve phlegm anywhere in the ST 40 malleolus two fingers breadth lateral to body the anterior crest of the tibia. On the dorsum of the foot, at the midpoint of the transverse crease of the ankle, in the depression between the tendons of Pain/ weakness and stiffness in the foot ST 41 muscle extensor digitorum longus and and ankle. hallucis longus, approximately at the level of the tip of the external malleolus. ST 44 Proximal to the web margin between Clear heat from head, face, mouth and the 2nd and 3rd toes. gums

ST 45 Jing Well Point: acute pain on the On the lateral side of the 2nd toe, .1 meridian; Clear heat from head, face, Cun proximal to the corner of the nail. mouth and gums

J. Spleen / Pi

The pathway of the Spleen Meridian runs from the proximal medial corner of the nail of the great toe along the medial edge of the foot, up the leg following the posterior border of the tibia. At he waist it runs parallel to the midline along the mid-clavicular line until it departs to end at the mid-axillary line midway between the axilla and the free end of the 11th rib. Since Yin Meridians are often used to treat internal disorders, the Spleen Meridian is important, for treating many internal disorders associated with the Spleen. These include all digestive disorders and symptoms associated with fatigue, and dampness. fatigue, and dampness.

Point Location Main Uses Name SP 1 On the medial side of the Jing Well Point: Moxa for bleeding from great toe, 0.1 Cun proximal to deficiencies the corner of the nail. SP 3 Proximal and inferior to the head of the first metatarsal Source Point: Tonifies SP bone, at the junction of the red and white skin.

Source Point: Tonifies SP bone, at the junction of the red and white skin. SP 4 In the depression distal and Master point of the Chong Mai inferior to the base of the first metatarsal bone, at the All menstrual disorders; All gastric junction of the red and white disorders; masses in the abdomen skin. SP 6 3 Cun above the tip of the CONTRAINDICATED IN PREGNANCY medial malleolus, on the posterior border of the medial Strengthens SP, KD, yin, Qi and blood; All aspect of the tibia. GYN; moves the lower abdomen; calms the mind; all reproductive issues SP 9 On the lower border of the condyle of the tibia, in the All damp disorders; A mild diuretic point depression on the medial border of the tibia. SP 15 4 Cun lateral to the center of the umbilicus, lateral to the muscle secondary point for treating intestinal disorders; rectus abdominus. SP 21 On the mid-axillary line, 6 Cun below the axilla, midway whole body pain and/or weakness between the axilla and the free end of the 11th rib.

4. Acupuncture Points and Meridians 2

A. Weekend 4 Introduction

B. Review of Weekend # 3

1. Review Body Measurements

2. Review Point Categories

3. Review Major Points 3. Review Major Points

a. Du Mai

1. 2, 4, 20, 26, etc.

b. Ren Mai

1. 2, 4, 6, 8, 12, 15, 22, etc.

c. Lung Mai

1. 1, 5, 7, 9, 11, etc.

d. Large Intestine Mai

1. 1, 4, 14, 15, 16, 17-18, 20, etc.

e. Stomach Mai

1. 3, 4, 5, 6, 7, 8, 30, 31, 34, 35, 36, 38, 40, 44, 45, etc

f. Spleen Mai

1. 3, 4, 6, 8, 9, 21, etc.

C. Overview of the Meridians

Powerpoint: Clinical Acupuncture Theory - Online Class #215 Intro Points & Meridians Powerpoint: Clinical Acupuncture Theory - Online Class # 216 Meridian Pathways

1. 12 (14) Main Meridians

a. Central Supporting Structure of the Meridian System

b. Circadian Qi flow

1. Six division designation

c. Yin Meridians

1. Internal Medicine

d. Yang Meridians

1. Musculo-skeletal

2. The Eight Extraordinary Meridians.

a. Ren Mai

1. Master Point Lu 7

b. Du Mai 1. Master Point Lu 7

b. Du Mai

1. Master Point SI 3

c. Chong Mai

1. Master Point SP 4

d. Dai Mai

1. Master Point GB 41

e. Yang Wei Mai

1. Master Point SJ 5

f. Yin Wei Mai

1. Master Point PC 6

g. Yang Qiao Mai

1. Master Point UB 62

h. Yin Qiao Mai

1. Master Point KD 6

i. Access the deepest energies of the individual

j. Equalizing reservoirs

k. Link Meridians and Organs

l. Planar Approach to Tx. Of Pain

m. Master & Couple Points

1. SI3 and BL62

2. TH5 and GB41

3. LU7 and KI6

4. SP4 and P6.

3. 12 Tendino-Muscular (Sinew) Meridians

a. Circulate on the periphery of the body.

b. Do not penetrate to the Zangfu.

c. Are associated with and take their names from the

d. twelve primary channels. c. Are associated with and take their names from the

d. twelve primary channels.

e. Originate at the extremities / Jing-Well Points

f. Broadly follow the course of their associated primary

g. channels but are wider.

h. Follow the lines of major muscles and muscle groups, tendons & ligaments

i. Envelop or “Knot Into” all joints

j. Pain / Trauma

k. Diagnosis

1. Look for area of diffuse pain, considered excess in the TM meridian

l. Treat acute and chronic painful / tight conditions

4. 12 Divergent Meridians

a. Connect with their paired channel

b. Deeper than Main Meridians

c. Govern the inside of the body

d. Distributed on the Chest, Abdomen and Head

e. Extend the areas of influence of main meridians

1. i.e. yin meridians to the head

5. 12 Skin Regions

a. Related to the Main Meridians

b. Explain Dx & Tx via the skin

6. 15 Luo Connecting Channels

a. One small branching channel for each of the 12 primary channels, one each for the Ren & Du, and one for the Great Luo of the Spleen a. One small branching channel for each of the 12 primary channels, one each for the Ren & Du, and one for the Great Luo of the Spleen

b. Spread from the Luo-connecting point of their own channel to connect with their paired channel.

c. After joining with their paired channel they usually continue to follow their own pathways:

D. Point Categories All This Information Should be Memorized for National Exams The Bolded Information is Particularly Useful in Clinical Situations (accd. to Drs. Jim & Chuck) Non-Bolded Points are also commonly used by many practitioners and are often quite effective. Reference The Notes from “Acupuncture Points & Meridians 1” (Weekend #3) for more information on these categories. YIN Jing Ying Shu Jing He Yuan Xi Luo Back Shu Front Meridian Well Sprin Strea River Sea Source Accumulatio Connectin Associate Mu Wood g Fire m Metal Wate n g d Alarm Earth r LU 11 10 9 8 5 9 6 7 UB 13 LU 1 SP 1 2 3 5 9 3 8 4 UB 20 LR 13 HT 9 8 7 4 3 7 6 5 UB 15 REN 14 KD 1 2 3 7 10 3 5 4 UB 23 GB 25 PC 9 8 7 5 3 7 4 6 UB 14 REN 17 LR 1 2 3 4 8 3 6 5 UB 18 LR 14

YANG Jing Ying Shu Jing He Yuan Xi Luo Back Shu Front Meridian Well Sprin Strea River Sea Source Accumulatio Connectin Associate Mu Metal g m Fire Eart n g d Alarm Wate Wood h r LI 1 2 3 5 11 4 7 6 UB 25 ST 25 ST 45 44 43 41 36 42 34 40 UB 21 REN 12 SI 1 2 3 5 8 4 6 7 UB 27 REN 4 UB (BL) 67 66 65 60 40 64 63 58 UB 28 REN 3 SJ (TW) 1 2 3 6 10 4 7 5 UB 22 REN 5 GB 44 43 41 38 34 40 36 37 UB 19 GB 24 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 90

E. Heart / Xin

1. The pathway of the Heart Meridian runs from the middle of the axiclla down the medial surface of the arm and ending at the proximal radial corner of the nail of the pinky finger. Since Yin Meridians are often used to treat internal disorders, the Heart Meridian is important, for treating disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep. associated with sleep.

Point Location Main Uses Name HT 1 When the arm is abducted, the point Inability to raise arm (deep is in the center of the axilla, on the needling can access m. medial side of the axillary artery. Subscapularis) HT 3 at the medial end of the transverse Chest Pain, Calms Shen, Red cubital crease when the elbow is fully Eyes flexed HT 7 At the ulnar end of the transverse Source Point: Most commonly crease of the wrist, in the used HT point, all heart depression on the radial side of the disorders. Nourishes the HT, tendon of muscle flexor carpi Calms the Shen; relieves ulnaris. insomnia HT 8 When the palm faces upward, the point is between the 4th and 5th tachycardia; heat in the Heart; metacarpal bones. When a fist is dream disturbed sleep, night made, the point is where the tip of terrors the little finger rests. HT 9 Jing Well Point: extreme heat in On the radial side of the little finger, .1 the Heart; loss of consciousness; Cun proximal to the corner of the nail. tachycardia

G. Small Intestine/Xiao Chang

1. The pathway of the Small Intestine Meridian runs from the proximal ulnar corner of the pinky finger along the arm on the lateral border of the ulnar bone 1. The pathway of the Small Intestine Meridian runs from the proximal ulnar corner of the pinky finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, through the scapula, up to the back of the neck past the ear and ending lateral to the eye. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Small Intestine is important, for treating any and all disorders along its pathway, especially around the scapula, and neck.

Point Location Main Uses Name SI 1 On the ulnar side of the little finger, Jing Well Point: acute pain on the meridian; about .1 Cun proximal to the corner of mastitis; insufficient lactation the nail. SI 3 When a loose fist is made, the Master Point of the DU Mai: point is on the ulnar side of the

the nail. SI 3 When a loose fist is made, the Master Point of the DU Mai: point is on the ulnar side of the hand, proximal to the 5th MP joint, Controlling point for Spine: at the end of the transverse crease at the junction of the red and white stiff neck; all back pain; stroke, MS, and skin. Turette’s and other wind disorders SI 6 When the palm faces the chest, the point is in the bony cleft on the xi cleft; pain in the meridian; stiff neck; radial side of the styloid process of Shoulder pain the ulna. SI 8 When the elbow is flexed, the point is located in the depression between the local point for elbow pain/stiffness olecranon of the ulna and the medial epicondyle of the humerus. SI 9 Posterior and inferior to the shoulder joint. 1 Cun above the posterior end of the axillary fold. local points for shoulder pain and Range of SI 10 Directly above SI 9, in the Motion depression inferior to the scapular spine. SI 11 In the infrascapular fossa, at the junction of the upper and middle third of the distance between the Most important local point for the upper lower border of the scapular spine back, and scapular area and the inferior angle of the scapula. SI 17 Posterior to the angle of the mandible, in the depression on the anterior local point for jaw, neck, and ear border of the SCM. SI 19 Anterior to the tragus and posterior to the condyloid process of the benefits the hearing; jaw problems mandible, in the depression formed when the mouth is open.

H. Urinary Bladder / Pang Guang

1. The pathway of the Urinary Bladder Meridian runs from the medial inner canthus up over the head just lateral to the midline, down the side of the neck where it separates into tow pathways, both running parallel to the midline of the 1. The pathway of the Urinary Bladder Meridian runs from the medial inner canthus up over the head just lateral to the midline, down the side of the neck where it separates into tow pathways, both running parallel to the midline of the back. One pathway is located at the distance of the medial border of the scapula, and the other is halfway between the medial border of the scapula and the midline. At the sacrum the meridian moves out to the buttocks and down to the center of popliteal crease, and throughout the back of the calf, to the ankle where it runs just under the lateral maleoleous ending at the lateral proximal corner of the little toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Urinary Bladder is important, for treating any and all disorders of back, and legs. It should also be noted that this meridian contains the “Back Shu Points.” These are specific points for each of the Organs.

Point Location Main Uses Name UB 1 0.1 Cun superior and slightly medial to the Main Point for All eye problems inner canthus UB 2 on the medial end of the eyebrow, or on the UB 1 0.1 Cun superior and slightly medial to the Main Point for All eye problems inner canthus UB 2 on the medial end of the eyebrow, or on the Alternate point for all eye problems supraorbital notch UB 10 1.3 Cun lateral to GV 15, in the depression All neck pain, weakness and on the lateral aspect of the trapezius muscle stiffness UB 11 1.5 Cun lateral to GV 13, at the level of the Back Shu Point of the Bones: All lower border of the spinous process of T1 bone problems; arthritis UB 12 1.5 Cun lateral to the GV meridian, at the level OPIs; headache; cough; stimulates of the lower border of the spinous process of T2 Wei Qi UB 13 Back Shu Point of the LU: all lung 1.5 Cun lateral to GV 12, at the level of the problems; builds Wei Qi; chronic lower border of the spinous process of T3 or acute UB 14 1.5 Cun lateral to the GV meridian, at level with Local Point for Upper Back Pain the lower border of the spinous process of T4 UB 15 1.5 Cun lateral to the GV 11, at the level of Back Shu Point of the HT: all heart the lower border of the spinous process of problems T5 UB 16 1.5 Cun lateral to GV 10, at the level of the Local Point for Upper Back Pain lower border of the spinous process of T6 Back Shu Point of the Blood: All blood problems; tonifies blood; 1.5 Cun lateral to GV 9, at the level of the UB 17 skin problems from heat in blood; lower border of the spinous process of T7 Back Shu Point of the Diaphragm: Hiccough; Hiatial Hernia UB 18 Back Shu Point of the LR: benefits 1.5 Cun lateral to GV 8, at the level of the all aspects of the liver; smoothes, lower border of the spinous process of T9 harmonizes, and tonifies liver UB 19 1.5 Cun lateral to GV 7, at the level of the Back Shu Point of the GB: all GB lower border of the spinous process of T10 problems UB 20 Back Shu Point of the SP: all SP 1.5 Cun lateral to GV 6, at the level of the problems; benefits all aspects of lower border of the spinous process of T11 spleen UB 21 1.5 Cun lateral to the GV meridian , at the Back Shu Point of the ST: benefits level of the lower border of the spinous all aspects of the ST process of T12 UB 22 1.5 Cun lateral to the GV 5, at the level of the Back Shu Point of the SJ: lower border of the spinous process of L1. regulates and transforms fluids; UB 23 1.5 Cun lateral to GV 4, at the level of the Back Shu Point of the KD: all KD lower border of the spinous process of the pathologies; regulates all aspects L2. of the KD UB 24 1.5 Cun lateral to the GV meridian, at the level of © the 1994 he - lower2013 James border Ventresca of the spinous AcuPractice™ process Seminars of Local - Point www.AcuPracticeSeminars.com for Low Back Pain L3. 96

Point Location Main Uses Name UB 25 Back Shu Point of the LI: low 1.5 Cun lateral to GV 3, at the level of the back pain; colon problems; lower border of the spinous process of L4. constipation, diarrhea, etc. UB 26 1.5 Cun lateral to the GV meridian, at the level

back pain; colon problems; lower border of the spinous process of L4. constipation, diarrhea, etc. UB 26 1.5 Cun lateral to the GV meridian, at the level of the lower border of the spinous process of Local Point for Low Back Pain L5. UB 27 1.5 Cun lateral to the GV meridian, at the Back Shu Point of the SI: used level of the lower border of the 1st posterior with CV 3 for damp heat in urine; sacral foramen. sacroiliac joint problems UB 28 1.5 Cun lateral to the GV meridian, at the Back Shu Point of the UB: all UB level of the 2nd posterior sacral foramen. Problems UB 29 1.5 Cun lateral to the GV meridian, at the level Local Point for Low Back Pain of the 3rd posterior sacral foramen. UB 30 1.5 Cun lateral to the GV meridian, at the level Local Point for Low Back Pain of the 4th posterior sacral foramen. UB 31 In the 1st posterior sacral foramen. UB 32 In the 2nd posterior sacral foramen. These are the 8 Liao Points: Used for all genito-urinary, GYN, UB 33 In the 3rd posterior sacral foramen. low back & leg problems

UB 34 In the 4th posterior sacral foramen UB 35 On either side of the tip of the coccyx, .5 Coxxygeal pain Cun lateral to the GV meridian. Just below the buttock, on a line directly UB 36 superior to UB 40, in the centre of the Local Pain transverse gluteal crease in a depression between the hamstring muscles. UB 40 Midpoint of the transverse crease of the (used popliteal fossa, between the tendons of Controlling point for the low back: to be muscle biceps femoris and muscle All Low back pain; clears heat #54) semitendinosis. UB 57 Directly below the belly of muscle Upper back pain/tension; used gastrocnemius, on a line joining UB 40 and with UB 67 for spasms of the calf; tendo-calcaneus, about 8 Cun below UB 40. UB 60 occipital headache; neck pain; In the depression between the external distal point for sciatica; for labor malleolus and tendo calcaneus. pain; "aspirin point" UB 62 In the depression directly below the external Master Point of the Yang Qiao Mai: malleolus. Lateral musculoskeletal problems UB 67 Jing Well Point: acute pain on the On the lateral side of the small toe, .1 Cun meridian; turning a breech fetus; proximal to the corner of the nail 97 © 1994-2013 James Ventresca AcuPractice™ Seminars back pain; - tight hamstrings www.AcuPracticeSeminars.com

Urinary Bladder Meridian

I. Kidney / Shen

1. The pathway of the Kidney Meridian runs from the center of the ball of the foot along the medial edge of the foot, under the medial malleolus, up the medial aspect of the leg posterior to the tibia. At the waist it runs parallel and just lateral to the midline ending at the top of the sternum. Since Yin Meridians foot along the medial edge of the foot, under the medial malleolus, up the medial aspect of the leg posterior to the tibia. At the waist it runs parallel and just lateral to the midline ending at the top of the sternum. Since Yin Meridians are often used to treat internal disorders, the Kidney Meridian is important, for treating many internal disorders associated with the Kidney. These include all growth development and aging, reproductive and urinary disorders and symptoms associated with fatigue, and general weakness.

Point Location Main Uses

Point Location Main Uses Name KD 1 On the sole, in the depression when the foot is in plantar emergency point; loss of flexion, approximately at the consciousness; brings heat down from junction of the anterior third the upper body and posterior 2/3 of the sole. KD 2 Anterior and inferior to the medial malleolus, in the Heat/Fire in the throat and lower depression of the lower border warmer; UTIs of the tuberosity of the navicular bone. KD 3 In the depression between he Source Point: All KD disorders; medial malleolus and tendo weakness in the knees; low back; calcaneus, at the level of the lowered libido, erectile dysfunction tip of the medial malleolus. KD 6 In the depression of the lower Master point of the Yin Qiao Mai; border of the medial malleolus, or 1 Cun below the medial Tonifies KD yin malleolus. KD 7 2 Cun directly above KD 3, on the anterior border of tendo Tonifies KD Yin and Vaporizes fluids calcaneus. KD 11-21 These points are 0.5 Cun lateral to CV line and level with the Ren points. KD 11 begins lateral to Coalescent Points of the Chong Mai. Ren 2 on the superior border of Reinforce the Ren points the symphysis pubis. KD 21 is under the sternum KD 16 Alternate Front Mu Point of the Kidney .5 Cun lateral to the umbilicus, level with CV 8. Strengthens the KD KD 22- 27 Beginning at the bottom of the Sternum, these points run to the These points soothe the Spirit, and should depression on the lower border of be palpated for tenderness the clavicle, and are all 2 Cun lateral to the Ren meridian.

J. Pericardium/ Xin Bao Luo J. Pericardium/ Xin Bao Luo The pathway of the Pericardium Meridian runs from the chest down the medial surface of the arm and ending at the tip of the middle finger. Since Yin Meridians are often used to treat internal disorders, and the Pericardium is closely related to the Heart Meridian, it is most commonly used to treat disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep, as well as organic heart disorders.

101 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Point Name Location Main Uses PC 3 On the transverse cubital crease, in the depression immediately to Clears Heat in the Blood, Fever the ulnar side of the aponeurosis of the biceps brachii muscle PC 4 5 Cun above the transverse crease of the wrist, on the line connecting PC 3 and PC 7, xi cleft point; chest pain; pain in the meridian between the tendons of palmaris longus and flexor carpi radialis PC 5 3 Cun above the transverse crease of the wrist between the calms the spirit; regulates Heart rhythm tendons of palmaris longus and flexor carpi radialis PC 6 2 Cun above the transverse Master Point of the Yin Wei Mai: crease of the wrist between the tendons of palmaris longus and Controlling point for the Chest and Abdomen; flexor carpi radialis Calms the spirit PC 7 In the middle of the transverse crease of the wrist, between the Source Point: calms the spirit; regulates tendons of muscle palmaris Heart rhythm longus and flexor carpi radialis. PC 8 On the transverse crease of the palm, between the 2nd and 3rd metacarpal bones. When the tachycardia; heat in the Heart; dream fist is clenched, the point is just disturbed sleep below the tip of the middle finger. PC 9 In the center of the tip of the Jing Well Point: extreme heat in the Heart; loss of middle finger. consciousness; tachycardia; night terrors

1. The pathway of the San Jiao is similar to that of the Small Intestine but more radial.. It runs from the proximal ulnar corner of the ring finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, along the top posterior aspect of the trapezius, up to the back of the neck around the ear and ending just anterior to the tragus of the ear. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the San Jiao is important, for treating any and all disorders along it’s pathway, especially around the shoulder, and ear. NOTE: The San Jiao (SJ) and it’s points are also called: Triple Warmer (TW), Triple Burner (TB), Triple Heater (TH), and Triple Energizer (TE)

. .

San Jiao / Triple Heater / Triple Warmer

Point Name Location Main Uses SJ 1 On the lateral side of the ring finger, about 0.1 Jing Well Point: acute pain on the Cun proximal to the corner of the nail. meridian; SJ 3 On the dorsum of the hand between the 4th and 5th metacarpal bones, in the depression Controlling Point for the Ear proximal to the metacarpophalangeal joint. SJ 4 On the transverse crease of the dorsum of the wrist, in the depression lateral to the tendon of Good local point for the wrist muscle extensor digitorum communis. SJ 5 2 Cun above TW 4, between the radius and Master Point of the Yang Wei the ulna. Mai: SJ 6 3 Cun above TW 4, between the radius and the Constipation, Tinnitus ulna. SJ 7 Level with and on the ulnar side of SJ 6 Deafness, Tinnitus SJ 10 When the elbow is flexed, the point is in the depression about 1 Cun superior to the Good Local Point for the elbow olecranon. SJ 14 Posterior and inferior to the acromion, in the depression about 1 Cun posterior to LI 15 Shoulder joint pain and ROM when the arm is abducted. About 1 Cun posterior to GB 21. Midway Tightness, tension and pain in SJ 15 between GB 21 and SI 13, on the superior the neck and shoulders angle of the scapula SJ 17 Posterior and superior to the angle of the mandible. Posterior to the lobule of the ear, All Ear disorders in the depression between the mandible and the mastoid process SJ 21 In the depression anterior to the supratragic notch and slightly superior to the condyloid All Ear and Jaw disorders process of the mandible. The point is located with the mouth slack. SJ 23 All disorders involving the side of At the lateral end of the eyebrow the head/face; lateral headaches, eye pain, ear pain

1. The pathway of the Gall Bladder Meridian runs from the Lateral outer canthus back and forth coursing the sides of the head, down the side of the neck where it follows the top of the trapezius, down to the side of the ribcage, throughout the flanks, to the hip, and down along the most lateral aspect of the leg, to the ankle where it runs under the lateral maleoleous ending at the lateral proximal corner of the fourth toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Gall Bladder is important, for treating any and all disorders of sides of the head, trunk, hip, and legs

105 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Point Name Location Main Uses GB 1 0.5 Cun lateral to the outer canthus, in the depression on the lateral side Secondary point for eye problems of the orbit. GB 2 Anterior to the intertragic notch, at the posterior border of the condyloid Good local point for ear and jaw process of the mandible. The point is located with the mouth open. GB 8 Superior to the apex of the Lateral Headaches; post stroke auricle, 1.5 Cun within the speech disorders; enters the brain hairline. GB 14 On the forehead, 1 Cun directly All eye problems; frontal and temporal above the midpoint of the HA eyebrow. GB 20 Opens the Orifices of the Head: In the depression between the All Wind: internal LV wind and upper portion of the SCM and the external OPI wind; All disorders trapezius, just below the occiput. effecting the eyes, ears, and nose; All Headaches especially occipital; GB 21 Controling Point for Neck and Shoulder Tension, Pain and Midway between GV 14 and the Tightness. acromion, at the highest point of the shoulder. CONTRAINDICATED IF PATIENT IS PREGNANT, OR HAS A HEART CONDITION GB 25 On the lateral side of the abdomen, on the lower border of Front Mu of KD; pain in lumbar region the free end of the 12th rib. Main Coalescent Point on the Dai GB 26 Mai; At the Upper Border of the Iliac Crest, usually at the level of the All GYN Disorders umbilicus. Sciatica / Belt / Hip Pain

On the lateral side of the abdomen, GB 27 Secondary Point on the Dai Mai; All GYN anterior to the superior iliac spine, 3 Disorders Cun below the umbilicus. © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 106

Point Name Location Main Uses Point Name Location Main Uses

Anterior and inferior to the ASIS, 0.5 Secondary Point on the Dai Mai; All GYN GB 28 Cun anterior and inferior to GB 27. Disorders

GB 29 IN the depression of the midpoint between the ASIS and the great trochanter. When locating this point, put patient in lateral recumbent position with thigh and knee both flexed to about 900. GB 30 At the junction of the lateral 1/3 and medial 2/3 of the distance between the greater trochanter and the hiatus Main Local Points for Sciatica, of the sacrum. When locating this hip; lumbar to thigh, leg pain and point, put patient in lateral paralysis recumbent position with thigh and knee both flexed to about 900. GB 31 On the midline of the lateral aspect of the thigh, 7 Cun above the transverse political crease. When the patient is standing erect with hands at sides, the point is where the tip of the middle finger touches. GB 34 relaxes the tendons; good point for In the depression anterior and in knee, sciatica and leg pain; pain inferior to the head of the fibula. anywhere in the body; shoulder pain GB 40 Anterior and inferior to the lateral malleolus, in the depression on Yuan Source Pt. Ankle Pain the lateral side of the tendon of m. extensor digitorum longus. GB 41 In the depression distal to the junction of the 4th and 5th Master Point of the Dai Mai: metatarsal bones, on the lateral side of the tendon of m. extensor All GYN and LV disorders digiti minimi of the foot. GB 44 On the lateral side of the 4th toe, Jing Well Point: acute pain on the about .1 Cun proximal to the meridian; corner of the nail.

1. The pathway of the Liver Meridian runs from the proximal lateral corner of the nail of the great toe along the medial edge of the foot, up to the posterior to the border of the tibia between the Spleen and Kidney meridians. At he waist it runs parallel to the midline until it departs to the free end of the 11th rib, ending at the sixth intercostals space on the mid-clavicular line. The Liver Meridian is important, for treating many internal disorders associated with the Liver. These include many emotional disorders and symptoms associated with stagnation and wind.

Point Location Main Uses Name LR 1 Jing Well Point: restores consciousness; On the lateral side of the great Inguinal pain; groin pulls; moves Qi in the toe, 0.1 Cun proximal to the lower warmer; genitourinary issues; stops corner of the nail. bleeding LR 2 LV fire and heat in the head; Heat in the On the dorsum of the foot, Lower Warmer; Burning urination; red between the 1st and 2nd toes, burning eyes; LV yang rising HA; Herpes I & proximal to the margin of the web. II; Shingles; LV wind LR 3 Source Point: On the dorsum of the foot, in the depression distal to the junction Primary Point to Benefit All Aspects of LV. of the 1st and 2nd metatarsal bones. Move LR QI, Quell LR Wind, etc. LR 4 On the ankle, anterior to the prominence of the medial malleolus, in the significant depression just Spreads Liver Qi, Regulates the Lower Jiao, medial to the tendon of tibialis Clears Liver Heat. anterior when the ankle is extended (dorsiflexed) LR 13 On the lateral side of the Front MU Point of the SP: Liver invading abdomen, below the free end of Spleen the 11th floating rib. LR 14 Directly below the nipple, in the Pain and tightness/fullness in the chest, ribs 6th intercostal space. and breast

109 © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com The Liver Meridian’s Internal Pathway: Encircles the Genitals, Enters the Breast, .Enters the Throat, Encircles the Lips, and Enters the Eyes.

Liver Meridian Internal Pathway Connections

1. Points which lie off or are not part of the Main Meridians. There are hundreds of these points. These are some of the most common ones

Point Name Location Main Uses Yin Tang Midway between the medial ends of the two eyebrows. Clams the Shen Draw a line following path of lateral end of eyebrow down Eye Pain / Tai Yang to intersection of line from outer canthus of eye, at Discomfort intersection, in depression. Headaches Calms the Shen An Mian Midpoint between Yifeng (SJ 17) and Fengchi (GB 20) for Insomnia Stuffy-Runny Bi Tong At the highest point of the nasolabial groove. Nose Midway between the end of the anterior axillary fold and LI Jian Nie Ling 15 A pair of points in the two depressions, medial and lateral Xi Yan to the patellar ligament, locating the point with the knee Knee Pain flexed. Lateral Xi Yan overlaps with S 35. On the dorsum of the hand, midway between the transverse wrist crease and metacarpophalangeal joint, Acute Back Yao Tong Xue between the second and third metacarpal bones, and Pain/Sprain between the fourth and fifth metacarpal bones, A group of 34 points along both sides of the spinal column, Release the Back Hua Tou Jia Ji 0.5 Cun lateral to the lower border of each spinous process Muscles On dorsum of hand, between 2nd & 3rd metacarpal bones, Luo Zhen Neck Pain 0.5 Cun posterior to metacarpophalangeal joint Shi Qi Zhui Below the spinous process of the 5th lumbar vertebrae Low Back Pain (Josen) Ding Chuan 0.5 Cun lateral to Dazhui (Du 14). Stop Asthma On the dorsum of the foot, in the depressions on the webs Ba Feng between toes, proximal to the margins of the webs, eight Foot Pain points in all. On the dorsum of the hand, at the junction of the white and Ba Xie red skin of the hand webs, eight in all, making a loose fist Hand Pain to locate the points. Acute & chronic Dan Nang Xue The tender spot 1-2 Cun below G 34. cholecystitis In the depression of the midpoint of the superior patellar Patellar/Knee He Ding border. Pain Shi Mian In the center of the heel on the bottom of the foot Heel & Knee Pain A group of 4 points, at the vertex, 1 Cun respectively Benefits: Wind, Si Shen Cong posterior, anterior and lateral to Baihui (Du 20). Eyes, Ears, Shen Yu Yao At the midpoint of the eyebrow. Benefits Eyes Zi111 Gong © Xue1994 - 2013 James Ventresca3 Cun lateral AcuPractice™ to Zhongji Seminars (Ren 3) - www.AcuPracticeSeminars.comBenefits Uterus

5. Respiratory, Digestive & Genitourinary Disorders

A. Weekend 5 - Internal Medicine I: Introduction

1. Internal Medicine is divided into three weekends.

a. Weekend 1: Respiratory, Digestive & Genitourinary

b. Weekend 2: Herbal Medicine & Emotional Disorders

c. Weekend 3: Women’s Health

2. All 3 weekends focus on internal medical diagnosis, and treatment with all Chinese Medical techniques, including Acupuncture, Herbs, Diet and Lifestyle.

3. Repetition of Disharmonies

a. You will notice a necessary repetition of disharmonies in different disorders, which will assist you in learning and easily recognizing, and treating these problems.

1. i.e. Spleen Qi Deficiency will show up in all three weekends, and may manifest as many different disorders, including

a. Digestive: Looses Stools, Lack of Appetite

b. Emotional: Depression

c. Women’s Health: Tendency to Miscarry

B. Theoretical Principles Review

Powerpoint: Clinical Acupuncture Theory - Online Classes 201-220

1. Eight Principles

a. Four Sets of Parameters

1. Yin / Yang

2. Internal / External

3. Excess / Deficient

4. Hot / Cold

TRUE EXCESS YIN CONDITION TRUE COLD SEDATE YIN YIN EXCESS (EXCESS YIN)

TRUE EXCESS YANG CONDITION TRUE HEAT SEDATE YANG YANG EXCESS (EXCESS YANG)

DEFICIENCY OF YIN CONDITION FALSE HEAT TONIFY YIN YIN DEFICIENCY (DEFICIENT YIN) (HEAT FROM DEFICIENCY)

DEFICIENCY OF YANG CONDITION FALSE COLD TONIFY YANG YANG DEFICIENCY (DEFICIENT (COLD FROM DEFICIENCY) YANG)

DEFICIENCY OF BOTH YIN & YANG N/A TONIFY BOTH YIN & (DEFICIENT YIN & YANG) YANG

TRUE EXCESS OF BOTH YIN & N/A SEDATE BOTH YIN & YANG YANG (EXCESS YIN & YANG)

Five Elements

FIRE

EARTH

WOOD Ko Cycle>

METAL

WATER

a. Within each phase/element are Yin and Yang aspects, sometimes referred to as the husband-wife relationship

b. Sheng, Creative, Mother /Son, Generating Cycle

1. Aberrations of the Sheng Cycle

a. overproduction: hyper function generating Excess (Excess)

b. underproduction: hypo function creating Deficiency(Deficiency)

c. over-taxed, in which case the child drains the parent (Deficiency producing exhaustion) (analog to underproduction)

2. Ko, Control, Grandparent, Over-Acting Cycle

a. The clockwise star of the Ko Cycle

b. Aberrations of the Ko Cycle

1. too much control, over-bearing, invasive and destructive (Excess producing Deficiency)

2. insufficient restraint, too weak to be effective (Deficiency generating Excess)

3. a reversed Ko cycle (counteracting) in which the child (normally restrained) rebels and insults the grandparent (Excess creates Deficiency)

CATEGORY WOOD FIRE EARTH METAL WATER QI Wind Heat Damp Dry Cold ZANG Liver Ht / Pc. Sp. (pancreas) Lungs Kidney FU Gall Bladder Sm. Int. / TW Stomach Lg. Intestine Bladder STORAGE Soul Consciousness Intent Vitality Determination EMOTION Decisiveness Joy Harmonizing Strength Determination Control (+) (-) Preoccupation Sustainability Fear Anger Obsessive Grief/Sadness ORIFICE Eyes Tongue Mouth Nose Ears BODY TISSUE Tendons Sinews Blood & Flesh & Muscles Skin Teeth, Bone & Blood Vessels Marrow TONGUE Sides Tip Center Behind Tip Root

a. Review Qi Generation

b. Qi

1. Functions of Qi

a. Activation Or Movement

b. Warmth

c. Transformation

d. Defense

e. Containment

2. Imbalances of Qi

a. Deficient Qi

b. Collapsed Qi

c. Stagnant Qi

d. Rebellious Qi

c. Jing & Yuan Qi

1. Governs Growth and Development

2. Stored In The Kidneys

3. Determining Strength of the Constitution of the Individual

4. Gradually Is Used Up And Depleted In Normal Lifetime

d. Blood

1. Blood Is Yin In Relationship To Qi

2. A Level of Activity As Well As a Fluid.

3. Functions:

a. Nourishes All Parts Of The Body

b. Moistens

c. Maintains

d. Cools

e. Calms

f. Provides Rest

4. Relationships Of Blood:

a. Heart, Rules Blood And Moves It Through Body

b. Liver, Stores Blood

c. Spleen Governs Blood

1. Holds It In Place, In Vessels

d. Spleen Also Produces Blood

5. Disharmonies Of Blood:

a. Deficient Blood

b. Congealed Blood

c. Hot Blood

e. Jin Ye

1. Review Jin Ye Production

f. Shen

1. The Spirit That Is Stored In the Heart

2. Disharmonies of Shen:

a. Muddled Personality Forgetful and Slow

b. Insomnia

c. Eyes That Lack Luster

d. Emotional Problems, Psychological and Emotional Shock,

e. General Spiritual Disorder (psychosis)

4. The Causes of Disease or Pathogenic Factors

a. External Pathogenic Factors

1. The Evil Winds

a. Wind

b. Cold

c. Damp

d. Dryness

e. Heat

f. Summer Heat

b. Internal Pathogenic Factors

1. The Emotions

a. Anger

b. Joy

c. Melancholy & Grief

d. Meditation (Over thinking)

e. Fear

f. Fright

c. Miscellaneous Pathogenic Factors

1. Inappropriate Diet

2. Inappropriate Exercise

3. Excess Sex

4. Inappropriate Timing

5. Parasites

6. Trauma

7. insect/animal bites

8. Epidemics

9. Wrong Treatment

10. Also

a. Poor Feng Shui

b. Drug Use

c. Contact / Environmental

C. Meridian Review

1. Points from the Yin Meridians are the ones most often chosen to treat internal disorders

a. LU

b. SP

c. KD

d. LR

e. Ht

f. PC

2. Some Yang Meridians are also commonly used

a. UB

b. ST

3. Extraordinary Meridians

a. Ren

b. Du

c. Chong & Dai 1. To be covered in further detail at future seminars

D. Organs Review

1. Lung (Fei) - Large Intestine (Da Chang)

a. Lung (Fei)

1. The Tender Organ

2. The Official Who Is Master Of Qi

3. The Bright Lid Of The Internal Organs

4. Opens To The Nose & Throat

5. Most Easily Affected By OPI

6. Dislikes Cold And Dryness

7. Properties

b. Descends

c. Disseminates

d. Circulates

8. Functions

a. Govern Qi & Respiration

b. Rule The Outside Of The Body

b. Large Intestine (Da Chang)

1. The Official In Charge Of The Dregs

2. Dependent Upon Fei For Descending

2. Spleen (Pi) - Stomach (Wei)

a. Spleen (Pi)

1. The Official In Charge Of Transportation And Transformation

2. Opens To The Mouth

3. Manifests In The Lips

4. Dislikes Dampness (& Cold)

5. Functions

a. Governs Transportation And Transformation

b. Holding

c. Up bearing

d. Raising

e. Transforming

f. Dominates The Muscles & Four Limbs

b. Stomach (Wei)

1. The Official In Charge Of Rotting And Ripening

3. Heart (Xin) - Small Intestine (Xiao Chang)

a. Heart (Xin)

1. The Supreme Ruler

2. Opens To The Tongue

3. Manifests In The Complexion

4. Dislikes Heat

5. House The Shen (Spirit)

6. Rules Blood And Blood Vessels

b. Small Intestine (Xiao Chang)

1. Official In Charge Of Separating The Pure From The Impure

4. Liver (Gan) - Gall Bladder (Dan)

a. Liver (GAN)

1. The Official Who Is In Charge of Planning

2. The General (who plans and coordinates)

3. The Master Alchemist (who transmutes and detoxifies)

4. Sea of Blood

5. Free & Easy Wanderer

a. sprinkles Qi

b. maintains easy going internal environment

6. Opens To The Eyes

7. Dislikes WIND (Heat / Stagnation)

8. Functions

a. Regulates the harmonious distribution of Qi throughout the body/ even flowing, uniform spreading of Qi)

b. Rules the Muscles

c. Houses the Hun

d. Stores the Blood (Blood)

e. Controls the eyes

f. Produces feelings of anger, frustration, irritability and depression

9. Disharmony May Manifest As:

a. Liver Qi Stagnation

1. invading St.

3. invading Lu.

b. Liver Blood Stagnation

1. Painful periods

2. Clots

3. Sharp stabbing pain

c. Liver and Gall Bladder invaded by Damp-Heat

d. Meridian related Sx.

1. Inguinal pain and Hernias

2. Pain, discomfort, sensitivity and/or tension or abnormal sensations are commonly experienced and reported in:

a. flanks

b. breasts

c. the region of the diaphragm

d. throat

e. may be elicited upon palpation in:

1. the subcostal region

2. the left lower quadrant of the abdomen

3. the vicinity of Lv-14

e. Emotional problems irritability

f. Gynecological problems

b. GALL BLADDER (DAN)

1. The Official in Charge of Decision Making

2. Dislikes Wind

3. Disharmony May Manifest As:

a. Rash Angry Decisions

b. Deficiency(Deficiency) patterns:

c. indecisiveness

5. Kidney (Shen) - Urinary Bladder (Pang Guang)

a. KIDNEY (SHEN)

1. The Strong Official from Whom ingenuity derives

a. If the body were an empire the Kidney would be the Laborer (who works diligently)

b. The Root of Qi

c. Root of Life

d. Root of Preheaven

2. Opens To The Ears

3. Dislikes Cold (Dryness)

4. Functions

a. Stores Jing

b. Foundation Yin and Yang

c. It houses the Will

d. Rules the Bones.

e. Housed in the Low Back

f. “Rules the Knees & Ankles”

g. Produces Marrow (brain, spinal cord and CSF).

h. Governs birth, growth and reproduction.

1. reproductive organs and genitalia

2. assists the Heart function of Housing the Shen.

5. Disharmony May Manifest As:

a. Low back pain

b. Impotence and Infertility

c. Incontinence

d. Urinary frequency

e. Loss of hearing

f. Edema

b. URINARY BLADDER (PANG GUANG)

1. The Official In Charge of the District

a. Final Separations of Clear from Turbid

2. Functions

a. Transforming and excreting fluids by the power of Qi

b. Receives the "dirty" part of fluids after Small Intestine and Kidney separate them from the "clean" fluids

6. Pericardium (Xinbaoluo) - Triple Warmer (San Jiao)

a. Pericardium (Xinbaoluo)

1. The Official Who Protects The Heart

2. Functions

a. Protects The Heart

1. First Line Of Defense

2. Receives OPI Before It Reaches The Heart

3. Disharmony May Manifest As:

a. Pain, Discomfort Or Abnormal Sensations Are Usually Experienced In The Chest

b. Triple Warmer (San Jiao)

1. San Jiao Literally Three Burning Spaces

a. Simultaneously Monitors And Regulates The Internal Environment To Maintain Optimal Operating Temperatures.

b. The Yang Of The San Jiao Metabolic Process Is Like A “Fire” That Provides Heat With Which To Process Materials And Energy.

c. The Yin Of The San Jiao Is “Water” Among Other Functions It Is An Important Means Of Heat Dissipation To Keep The System From Overheating.

2. The Official In Charge Of Irrigation

a. Classically Described As A System Of Sluices Or Waterways - The Form Of The Water Is Different In Each Warmer.

1. Lung Adjusts Water

3. Kidney Rules Water

7. Extraordinary/Curious Vessels/Organs

a. Extraordinary Meridians

1. Origin

a. Created at Conception

b. Developed During Lifetime

2. General Functions

a. Zonal Meridian Treatment

b. Reservoirs / Repositories of Primal Qi

c. Psychological Transformation

3. Names

a. Du Mai (Governing Vessel)

b. Ren Mai (Conception Vessel)

c. Chong Mai (Penetrating Vessel)

d. Dai Mai (Belt Meridian)

e. Yang Wei Mai

f. Yin Wei Mai

g. Yin Qiao Mai

h. Yang Qiao Mai

b. Extraordinary / Curious Organs

1. Fu Shape /Store Essences

2. Six Curious Organs

a. Gall Bladder

b. Brain

c. Marrow

d. Bone

e. Blood Vessels

f. Uterus f. Uterus

E. Respiratory System and Conditions

1. Upper Respiratory Conditions

a. Sinus

1. Congestion

a. Pathology / Basic Patterns

1. Wind

2. Phlegm

3. Heat

4. Cold

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

2. Headaches

a. Pathology

1. Sinus Headaches

a. Phlegm

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

d. Other Headaches

1. Qi Yu

a. Yang Ming

b. Tai Yang

c. Xiao Yang

d. Liver

3. Infections

a. Pathology / Basic Patterns

1. Wind / Heat / Phlegm

2. Wind / Cold / Phlegm

b. Meridian Techniques b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

4. Ear Involvement

a. Pathology /Basic Patterns

1. Heat

2. Cold

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

b. Common Cold/ Viruses

1. Wind Cold

a. Pathology

1. Sneezing / Runny/Stuffy Nose

a. White Mucous

2. Chills

3. Headache

4. Body Ache

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

2. Wind Heat

a. Tai Yang / Shao Yang / Yang Ming

b. Pathology

1. Fever

2. Sore throat

3. Laryngitis

4. Yellow/Green Mucous

c. Basic Patterns

d. Meridian Techniques

e. Dietary / Lifestyle / Herbal Recommendations e. Dietary / Lifestyle / Herbal Recommendations

2. Lower Respiratory Conditions

a. Chest Cold / Heat

1. Pathology

2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

b. Chest Cold / Cold

1. Pathology

2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

c. Bronchitis (deeper level

1. Pathology / Basic Patterns

a. Lung Qi Deficiency

b. Lung Yin Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

3. Allergies

a. EENT (sinus, ears, eyes, post nasal)

1. Pathology

a. Wind Damp

2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

b. Seasonal

1. Pathology

a. Wind Damp

2. Basic Patterns 2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

c. Environmental

1. Pathology

2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

d. Dietary

1. Pathology / Basic Patterns

a. Spleen and or Kidney Qi /Yang Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

4. COPD: Asthma, Chronic Bronchitis, Emphysema, etc.

1. Pathology / Basic Patterns

a. Lung Qi Deficiency

b. Lung Yin Deficiency

c. Spleen Qi/Yang Deficiency

d. Kidney Qi/Yang Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

5. Immune System Weakness

a. Pathology / Basic Patterns

1. Kidney & Liver Yin Deficiency

2. Lung Qi/Yang/Yin Deficiency

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

6. Smoking Cessation

1. Pathology /Basic Patterns

a. Kid, LR, LU Yin Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

F. Gastro-Intestinal System & Conditions

1. Oral Cavity (mouth, tongue, teeth, lips)

a. Ulcers / Burning Pain

1. Pathology / Basic Patterns

a. Stomach Heat / Fire

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

b. Tooth pain – dental anesthesia

1. Pathology / Basic Patterns

a. Yang Ming Excess

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. Post-surgical Pain

1. Pathology / Basic Patterns

a. Qi & Blood Yu

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

2. Pharynx and Esophageal

a. Swallowing Problems

1. Pathology 1. Pathology

2. Basic Patterns

3. Meridian Techniques

4. Dietary / Lifestyle / Herbal Recommendations

b. Reflux Esophagitis

1. Pathology / Basic Patterns

a. Rebellious Stomach Qi

b. Stomach Heat / Fire

c. Stomach Yin Deficiency

d. Liver Invading Stomach

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. Hiatial Hernia

1. Pathology / Basic Patterns

a. Stomach Heat / Fire

b. Stomach Yin Deficiency

c. Liver Invading Stomach

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

d. Hiccups, Burping, Vomiting

1. Pathology /Basic Patterns

a. Rebellious Stomach Qi

b. Chong Mai Disharmony

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

3. Stomach

a. Upset Stomach, Poor/ Weak Digestion

1. Pathology /Basic Patterns

a. Stomach Yin Deficiency Pathology /Basic Patterns

a. Stomach Yin Deficiency

b. Spleen Qi / Yang Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

b. Food Poisoning

1. Pathology / Basic Patterns

a. Summer Heat in Stomach and Intestines

b. True Cold in Stomach and Intestines

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. Gastritis

1. Pathology / Basic Patterns

a. Stomach Heat / Fire

b. Stomach Yin Deficiency

c. Liver Invading Stomach

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

d. Ulcers

1. Pathology / Basic Patterns

a. Stomach Heat / Fire

b. Stomach Yin Deficiency

c. Liver Invading Stomach

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

e. Motion/Morning Sickness

1. Pathology / Basic Patterns

a. Chong Mai Disharmony

b. Stomach Qi Rebellion

c. Liver Invading Stomach c. Liver Invading Stomach

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

4. Intestinal / Colorectal

a. Poor Digestion

1. Pathology Basic Patterns

a. SP QI & Yang Deficiency

b. KD Qi & Yang Deficiency

c. Liver Invading Spleen

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

b. Gas and Distention

1. Pathology Basic Patterns

a. SP QI & Yang Deficiency

b. KD Qi & Yang Deficiency

c. Liver Invading Spleen

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. IBS, and Chron’s Disease

1. Pathology Basic Patterns

a. Liver Invading Spleen

b. SP QI & Yang Deficiency

c. KD Qi & Yang Deficiency

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

d. Hemorrhoids, Fissures, Fistulae

1. Pathology Basic Patterns

a. Spleen Qi Collapse

b. SP QI & Yang Deficiency

c. Heat in Lower Warmer b. SP QI & Yang Deficiency

c. Heat in Lower Warmer

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

e. Parasites

1. Pathology / Basic Patterns

a. Damp Heat in Lower Warmer

b. Cold Damp in Lower Warmer

c. Summer Heat in Large Intestine

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

G. Genito-Urinary System & Conditions

1. Kidney Disease / Failure

a. Pathology / Basic Patterns

1. Kidney Yang Deficiency

2. Kidney Jing Deficiency

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

2. Low Sex Drive, Impotence, Frigidity

a. Pathology /Basic Patterns

1. Shen Involvement

2. Kidney Qi / Yang Deficiency

3. Blood Deficiency

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

3. Heightened Sex Drive

a. Pathology /Basic Patterns

1. Kidney Yin Deficiency

2. Liver Qi Stagnation 1. Kidney Yin Deficiency

2. Liver Qi Stagnation

3. Liver Yin Deficiency

4. Liver Fire

4. Urinary Tract Infections

a. Pathology / Basic Patterns

1. Heat in Lower Warmer

2. Damp Heat in Lower Warmer

3. Cold Damp in Lower Warmer

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

5. Urinary Retention

a. Pathology /Basic Patterns

1. Dampness in Lower Warmer

b. Meridian Techniques

c. Dietary / Lifestyle / Herbal Recommendations

6. Male GU Conditions

a. Low sperm counts, Abnormal Motility/ Morphology, Sterility

1. Pathology /Basic Patterns

a. Kidney Qi / Yang Deficiency

b. Kidney Yin Deficiency

c. Blood Deficiency

d. Liver Qi Stagnation

e. Liver Blood Stagnation

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

b. BPH

1. Pathology /Basic Patterns

a. Dampness in Lower Warmer a. Dampness in Lower Warmer

b. Kidney Qi / Yang Deficiency

c. Liver Qi / Blood Stagnation

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. Prostatitis

1. Pathology /Basic Patterns

a. Kidney Yin Deficiency

b. Liver Qi / Blood Stagnation

c. Liver Yin Deficiency

d. Liver Fire

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

7. Female GU Conditions

a. Endometriosis

1. Pathology / Basic Patterns

a. Liver Blood & Qi Stagnation in Lower Warmer

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

b. Ovarian, Uterine Cysts and Tumors

1. Pathology / Basic Patterns

a. Blood Stagnation

b. Phlegm

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

c. Prolapsed Urinary Bladder

1. Pathology Basic Patterns

a. Spleen Qi Collapse

b. SP QI & Yang Deficiency Spleen Qi Collapse

b. SP QI & Yang Deficiency

c. Liver Invading Spleen

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

d. Menstrual Pain

1. Pathology / Basic Patterns

a. Liver Qi Stagnation

b. Liver Blood Stagnation

c. Chong Mai Disharmony

d. Dai Mai Disharmony

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

e. Infertility, Egg Production / Quality, Ovarian – Fallopian –Uterine – Vaginal Issues

1. Pathology / Basic Patterns

a. Kidney Qi / Yang Deficiency

b. Spleen Qi / Yang Deficiency

c. Heart Qi / Yang Deficiency

d. Liver Qi Stagnation

e. Liver Blood Stagnation

f. Chong Mai Disharmony

g. Dai Mai Disharmony

h. Ren Mai Disharmony

i. Du Mai Disharmony

j. Shen Involvement

2. Meridian Techniques

3. Dietary / Lifestyle / Herbal Recommendations

8. Time permitting; we will discuss additional conditions associated with menstruation and pregnancy.

a. These topics are covered in detail in the Women’s Health Seminar. a. These topics are covered in detail in the Women’s Health Seminar.

6. Acupuncture Microsystems and the Extraordinary Meridians

A. Weekend 6 Introduction

1. Class Format

a. 12-hour UBCC Sponsored CCE Class: Saturday 12 noon - 6:00pm / Sunday 8 -11am & 12:30-3:30pm

b. 3-Hour Demo/Hands-On Practice Session: Sat 6:00 - 7:30 PM / Sunday 11am - 12:30pm

a. Location and Needle Technique is very important with Microsystems

b. We will practice needling most, if not all, the points discussed this weekend.

2. Review

a. Meridian Pathways Review b. Major Points Review

c. Theory / Diagnostic Frameworks d. Other Q & A 3. Microsystems Treatment a. Ear, Scalp, Hand b. Find point exactly c. Apply Active or Passive Movement During the Treatment d. Look For Immediate Change e. Addition of Primary Acupoints to most treatments

B. Hand Acupuncture Points

1. General Comments

a. Good for all pain

1. Especially good for acute pain a. Good for all pain

1. Especially good for acute pain

2. Especially good for pain in Yang Areas

b. in combination with body points for chronic pain

c. usually use opposite side

d. move affected joint if possible

2. Needling and Location Technique

a. Locate at the epiphysis of the bone and needle in at a 45 degree angle to the point in the direction of the finger tips.

b. Shoulder

1. Radial side of the metacarpophalangeal joint of the index finger

2. Shoulder pain

c. Nape & Neck

1. Ulnar side of the metacarpophalangeal joint of the index finger

2. Action & Effects

3. Stiff neck

d. Migraine

1. Ulnar side of the first interphalangeal joint of the ring finger

2. Migraine

3. Chest pain

e. Headache

1. Ulnar side of the metacarpophalangeal interphalangeal joint of the thumb

2. H/A

3. dizziness

4. Other Hand Points

a. Low Back (Loin & Leg)

b. Sciatic Nerve

c. Ankle

d. Polyhydrosis point

1. Not lustrated. About ½ way between PC 7 & PC 8.

2. Works well for excessive sweating, (especially if it is linked to the 1. Not lustrated. About ½ way between PC 7 & PC 8.

2. Works well for excessive sweating, (especially if it is linked to the Shen)

C. Auricular Acupuncture

1. General Introduction

a. Techniques

1. Find point exactly

2. Active or passive movement

b. For Yang disorders, palpate the Yang side of the ear for sensitivity and needle/seed it in addition to the Yin side

2. Usual Modalities

a. Needles

b. Seeds

3. Ear Anatomy Review:

a. Helix

b. Crus of the Helix

c. Antihelix

d. Upper Crus of the Anti Helix

e. Lower Crus of the Anti Helix

f. Triangular fossa

g. External Auditory Canal

h. Lobe

i. Tragus

j. Antitragus

k. Cavum Concha

l. Cymba (Upper Concha)

m. Scaphoid Fossa

Foot Hand

Junction Sup/Inf Crux of Antihelix

Forearm Asprin Uterus Shen Men Leg

Symp. N. Sciatica Knee Prostate

Thigh

Crux of Helix Kidney Upper Arm

Hip

Liver Sacrum Shoulder Thirst Lumbar Hunger Thorasic Nicotine Heart Cervical

4. Major Auricular Points

a. Shen Men

b. Heart

c. Liver

d. Kidney

e. Sympathetic N.

f. Stomach

g. Mouth

h. Thirst

i. Hunger

j. Nicotine

k. Shoulder-Arm-Hand-Finger

l. Back

m. Hip-Leg-Foot-Toe

n. Sciatica

o. Uterus

p. Toothache

q. Aspirin Pt.

r. Insomnia Pts. r. Insomnia Pts.

5. Specific Auricular Treatments

a. Pain Protocols

b. Anxiety/ ADHD / PTSD

c. Quit Smoking

d. Weight Loss

D. Acupuncture in the Treatment of Chemical Dependency

Chemical Dependency

a. Definition

1. An harmful dependence is present if, the use of alcohol or other mood-altering substance is causing disruption in the individual’s personal, social, spiritual or economic life, - or in the life of the individual’s family - and the individual does not terminate the use of the substance.

2. Emotional importance is attached to the chemical

b. Addiction (alcoholism) Classified as a Disease in 1956

1. The disease can be described

a. Compulsion to use/drink

2. The course of the disease is predictable

a. Gets worse

3. The disease is primary

a. Not a symptom of emotional disorder

b. Causes mental/emotional/physical problems

4. The disease is permanent

a. when you have it you have it

5. The disease is terminal a. when you have it you have it

5. The disease is terminal

a. Overdose

b. Cardiopulmonary disease

c. High Blood Pressure

d. Liver problems

e. Bleeding ulcers

g. TB

h. Suicide

i. Homicide

j. AIDS

k. AUTO/other Accidents

2. Withdrawal

a. General Sx

a. Severe Flu-Like Sx.

b. fever

c. chills

d. insomnia

e. cramping

f. headaches

g. agitation

h. violent outbursts

i. nausea

j. depression

k. malaise / fatigue

l. anxiety

m. paranoia

b. TCM

1. Def. QI

2. Def. Yin 1. Def. QI

2. Def. Yin

3. Stuck Qi

4. Lots of Empty. Fire

c. Acute Medical Emergency from Withdrawal

1. Alcohol

2. Benzodiazepines

a. Anti-Anxiety Meds

b. *-Azepams

1. Ativan / Xanax

3. Barbiturates

a. Anti-Seizure Meds

b. *-Barbatols

4. Cold Turkey May Lead To Seizures (1 in 10)

5. Seizures May Lead To Death (1 in 10)

6. sweating

7. fever

8. tremor

9. anxiety

10. cramps

11. hallucinations

d. Non-Emergency Withdrawal

1. Synthetic and Natural Opiates/Narcotics

2. Opium, Morphine, Heroin, Hydrocodone, Oxycoten, Methadone

a. Withdrawal Symptoms, not life threatening, but severe.

b. May last up to 6 mos.

3. Effects

a. Decrease in Recidivism Rate

b. High degree of outpatient compliance

1. They like it b. High degree of outpatient compliance

1. They like it

2. They feel good during and after w/out medications

c. Reduced

1. Drug Cravings

2. Pain

3. Muscle cramping

4. Stress

5. Anxiety

6. Sleeplessness

d. Cost effectiveness

1. 1 acupuncture provider, 1 Counselor, 1 Case Worker, & 1 admin. Can handle @ 30 patients in a two hour time period. Start to finish.

Treatment

a. NADA Protocol

1. National Acupuncture Detox Association

3. No Need to Reinvent the Wheel

4. Acupuncture is Not Complete in and of Itself for Detox. It must be part of an integrated whole system, to achieve these results.

a. Individual counseling

b. Group support

c. Case management

d. Urine screening

e. Other conventional treatment approaches.

5. Get the patient to return

6. Remember the primary diagnosis.

a. Chemical Dependency is Primary

b. It will kill faster than anything else

7. Frequency of treatment

a. DETOX Phase 7. Frequency of treatment

a. DETOX Phase

1. Lasts until pt. has put together 14 days clean & sober

a. Weeks 0-2 of recovery

b. 1-2 Acupuncture. Tx. Daily

c. Group work

d. Case Management

b. Recovery Phase

1. Four Weeks

a. Weeks 3-6 of recovery

b. Three Acupuncture TX /week

c. Group Work

d. Case Management

e. Individual Counseling

c. Maintenance Phase

a. Weeks 7-10 of recovery

b. Acupuncture Tx. twice weekly

c. Group work

d. Case management

e. Individual Counseling

f. Re-Evaluation / Referral

b. Treatment Setting

1. Private vs Public

c. Point selection

1. Ear Protocol

a. Shen Men

b. Liver

c. Heart c. Heart

d. Kidney

e. Sympathetic N.

2. During Treatment

a. 20-45 minutes

b. Sit Quietly

c. No War (drug) Stories

3. Other Helpful things

a. Herbal Tea

b. Breathing Exercises

c. Nutrition

d. Purpose

d. Risks and Cautions

1. Contraindications

a. None really

1. Drug Use is more risky

b. Pregnant

1. 5.25 prenatal Visits

a. 80-90% Drug negative Toxicology

b. Birth weight up 40%

2. Less points

a. Avoid Liver

b. Avoid SM

c. Avoid Kid.

2. HIV/Hepatitis

a. Frequent among Addicts

b. Be Careful

1. Have a Pt. Prep Station Be Careful

1. Have a Pt. Prep Station

a. Cotton

b. Alcohol

c. Sharps container

d. Tissue

e. Mirror

2. Patients clean ears

3. Patients Remove needles

4. Patients clean up blood

f. Demonstration / Practice

1. Points

a. Location

b. Needling

E. APS-USA: AcuPractice™ Seminars Unified Scalp Acupuncture

1. There are a number of different Styles of Scalp Acupuncture.

2. This class will cover AcuPractice™ Seminars’ Unified Scalp Acupuncture: APS- USA .

3. The Most Popular Styles of Scalp Acupuncture

a. Chinese Scalp Acupuncture

2 Main Styles

a. Jiao Tai Fa’s Technique

b. Zhu Ming Qing’s Technique

2. Treatment is associated with Lines

a. Based On

1. Homunculus

2. Brain Map

3. Western Function

4. Sensory / Motor areas etc. 3. Western Function

4. Sensory / Motor areas etc.

b. Chinese Scalp Lines Generally Treat Contralateral Side

b. YNSA: Yamamoto’s New Scalp Acupuncture

1. Treatment Based on Points

a. Discreet Points

b. Based On Somatype / Homunculus

c. YNSA Points Generally Treat Ipsilateral Side

4. APS-USA - AcuPractice™ Seminars’ Unified Scalp Acupuncture

a. Employs the most clinically effective Points, Lines, and Protocols found within the more popular styles of Scalp Acupuncture.

1. As With Chinese Scalp: Lines Generally Treat Contralateral Side

2. As With YNSA: Points Generally Treat Ipsilateral Side

3. All Points and Lines are palpated carefully to find the most reactive point for treatment

5. Contraindications and Cautions

a. Contraindicated: Acute Stage Cerebral Hemorrhage: Wait at least 4 weeks

b. Caution During Pregnancy

c. Contraindicated: Children With Fontanel Not Closed

d. Caution: People who are Too Hungry or Nervous

6. Used for:

a. All Painful Conditions

1. Especially effective in the upper body

b. Neurological Conditions

c. All Disorders Involving the Brain/CNS

d. Post Stroke

1. Cerebral Thrombosis / Embolism: Treat early

2. Post Stroke Prognosis

a. 1-3 mos: Excellent 2. Post Stroke Prognosis

a. 1-3 mos: Excellent

b. 3-6 mos: Very Good

c. 6-1 year: Good

d. Up to 3 years: Hopeful

e. After 3 years: Guarded

3. Note: Cerebral Hemorrhage: Scalp Line Tx. Contraindicated for one to three months

e. Phantom Limb Pain

f. Spinal Chord Injury

g. Post Traumatic Paralysis

h. Brain Damage

i. Multiple Sclerosis

j. Muscular Atrophy

k. Urinary Incontinence

7. Technique

a. Points

1. Palpate carefully for Discreet Point to Needle

2. Needles: #2 or 3 X 30mm

b. Lines:

1. Palpate carefully for Discreet Point to Needle

2. If No Discreet Point is Reactive: Treat Entire Line

3. Needles: #5 - # 8 X 30 - 60 mm

c. Position Patient Sitting Up

d. Transverse Needle Insertion / 15-250

e. Depth of insertion

1. Five Layers

a. Cutaneous 1. Five Layers

a. Cutaneous

1. Thick

2. Rich in blood circulation

3. Painful to needle

b. Subcutaneous

1. Firm

2. Dense

3. Short fibers

4. Major vessels and nerves

5. Painful to needle

c. Galea aponeurofic layer

1. Tough & tensile fibrous Tissue

2. Very painful to needle

d. Aerial tissue layer

1. Loose connective tissue

2. The Best Layer To Needle

e. Periosteum

1. Outer layer of Skull

2. Very painful to needle

f. Minimizing Pain

1. Insert Quickly

2. Needle Correct Layer

3. Check for shallow enough angle

g. Stimulation

1. No Thrusting: Rotation Only

2. For Best Results: Stimulate for 1-2 min. Every 10-15 min.

h. Needling Direction h. Needling Direction

1. Generally From Superior to Inferior

2. Or Anterior to Posterior

i. Lay needles

1. 20-60 min.

2. Up to Twelve Hours

j. If Possible: have patient Walk or Talk, Utilize or Move the affected part/faculty during treatment

k. Remove Needles

1. Always use Cotton

2. Often bleeding

l. Interdermals, Electro Acupuncture, Moxa, and Massage Can All Be Used

8. APS-USA Points

a. Finding the Hairline:

1. The Hairline can be found about 1cm superior to the most superior wrinkle on the forehead.

2. The Corner of the Hairline can be found @ 4-5 cm lateral to the midline, about the same distance lateral to the middle of the eye, as the middle of the eye is from the midline of the face. b. Head & Neck Points (YNSA “A” point)

1. A Seires of Descreet Points, corresponding to the cervical vertebrae and occiput.

2. The points are found on a 2 cm long Line, centered on the hairline, 1cm lateral to the midpoint of the hairline.

3. Any Pain/Disorder of the Face, Head, and Neck

4. Any Disorder associated with the Cervical Spine

5. Neurological Disorders

6. Post Surgical Complications

7. Trigeminal Neuralgia

8. Bell’s Palsy

9. Headache/Migraine

10. Vertigo

c. Neck & Shoulder Points (YNSA “B” point)

1. A Seires of Descreet Points, Found on a 2 cm long Line, centered on the hairline, 2cm lateral to the midpoint of the hairline.

2. Any Pain/Disorder of the Neck, Clavicle, Shoulder and Scapular Regions.

3. Paralysis

4. Post trauma

5. Post operative

6. Fractures

7. Upper Body CRPS / RSD

a. Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy Syndrome

d. Shoulder Arm & Hand Points (YNSA “C” point) d. Shoulder Arm & Hand Points (YNSA “C” point)

1. A Seires of Descreet Points, which are found on a 2 cm long Line, beginning at the corner of the hairline, and extending diagonally toward the nose (Yin Tang).

2. These points correspond to the shoulder, which is found near the top/lateral end of the line; the arm in the middle; and the hand, at the inferior/medial end.

3. Any disorders of the Shoulder Joint, Scapular Region, Arm, Hand, Wrist & Fingers

4. Pain

5. Paralysis

6. Post trauma/operative

7. Fractures

8. Dislocations

9. Carpal Tunnel Syndrome

e. Thorax Points (YNSA “E” point)

1. A Seires of Descreet Points, corresponding to T1-T12.

2. The points are found on a line, which begins about 1cm lateral to the midline at the top border of the eyebrow. (This medial border corresponds to T-1) The line continues to the midpoint of the eyebrow at a 150 angle upward ending above the middle of the eyebrow. (The lateral end corresponds to T-12.)

3. Any Disorder associated with the Thorax or Thoracic Spine

a. Back Pain

b. Rib Pain

c. Angina

d. Herpes Zoster

f. Low Back Points (YNSA “D” point)

1. A Seires of Descreet Points, corresponding to the Lower Back, Lumbar, and Belt Region.

2. The Points are found about 1 cm above the Zygomatic Arch. Beginning at the anterior hairline, and progressing to the anchor of the helix, then proceeding superiorly for about centimeter.

3. Primary Treatment points for Low Back Pain, Paralysis, and other disorders of the Lumbar Spine, Lower Body, and Lower Extremities

9. APS-USA Lines

a. Lines of Measurement

1. Draw Two Lines

a. Anterior - Posterior Midline

1. From Glabella to the EOP (External Occipital Protuberance)

2. Find Mid-point of the line

a. Can be found by describing a “plumb line from the top of the ears to the A-P Midline

b. Eyebrow - Occipital Line

1. From center of eyebrow to EOP (Via the temple and across the ear)

b. Continence Line (AKA: Leg & Foot Motor & Sensory)

1. Beginning at a point 0.5 Cun lateral to the midpoint of the anterior- posterior midline, Draw bilateral lines, parallel to midline, in the posterior direction, 2 Cun in length

2. Needle From Anterior to Posterior

3. Paralysis, Pain, Numbness of Lower Limb Opposite Side

a. The Function is similar to the functions of the upper 1/5th of both motor and sensory area together. a. The Function is similar to the functions of the upper 1/5th of both motor and sensory area together.

4. Urinary Incontinence

a. Usefull for most All Urinary Problems

5. Prolapsed Urinary Bladder/ Uterus / Stomach

6. Bowel Disorders

a. Bowel Incontinence

b. Allergic Colitis

c. Crohn’s Disease

7. Hemorrhoids

8. Post Traumatic Stress Syndrome

9. ADHD (Attention Deficit Hyperactive Disorder)

10. Multiple Sclerosis

11. Male Reproduction

a. Impotence

b. Spermatorrhea

12. Female Reproduction

a. Uterine Bleeding

b. Endometriosis

c. Prolapse Uterus

13. Swollen Ankles

c. Motor Function Line 1. From Midpoint on Anterior - Posterior Midline go 0.25 Cun Posterior

2. Draw Line from this point to the point where the Eyebrow - Occipital Line crosses the anterior hairline @ the sideburn

3. Motor Area is divided into 5 parts

a. Superior 1/5th of motor Area

1. Treats paralysis of Lower Limbs and Trunk on Opposite Side

b. Middle 2/5ths of motor Area

1. Treats paralysis of Upper on Opposite Side

c. Inferior 2/5ths of Motor Area

1. Facial Paralysis on Opposite Side

a. Nerve Damage

b. Bell’s Palsy

2. AKA Speech 1 area

a. Motor Aphasia

d. Sensory Perception Line

1. A Line Parallel to and 0.75 Cun Posterior to the motor area

2. Sensory Area is divided into 5

a. Superior 1/5th of Sensory Area

1. Parastisia of Lower Limb and trunk on the opposite side 1. Parastisia of Lower Limb and trunk on the opposite side

2. Phantom Pain of Lower Limb and trunk on the opposite side

3. Special Effects

a. Occipital H/A

b. Neck Pain / Stiffness

b. Middle 2/5ths of Sensory Area

1. Parastisia of Upper Limb on Opposite Side

2. Phantom Pain of Upper Limb on the opposite side

c. Inferior 2/5ths of Sensory Area

1. opposite Side

a. Migraine H/A

b. Trigeminal Neuralgia

c. Toothache

d. TMJ

e. Tremor Control Line

1. A Line Parallel to and 0.75 Cun Anterior to the motor area

a. From Midline to the inferior border of the hairline

2. Divided into Three Parts

a. Superior Third for Lower Limbs

b. Middle Third for Upper Limbs

c. Inferior Third Head & Neck

3. For Treatment of:

a. Any Involuntary movement or tremor

b. Chorea

c. Parkinson’s Disease

f. Vision Line

1. Location

a. From a point 0.75 Cun lateral to, and level with, the EOP 1. Location

a. From a point 0.75 Cun lateral to, and level with, the EOP (External Occipital Protuberance) draw a line parallel to the midline, and 2.0 Cun in length, Superior from the EOP

2. Indications

a. Cortical Vision Disturbances

b. Glaucoma

c. Cataract

g. Vertigo and Balance Line

1. Location

a. From a point 2.0 Cun lateral to, and level with, the EOP (External Occipital Protuberance) draw a line parallel to the midline, and 2.0 Cun in length, Inferior beginning at the level of the EOP

F. The Three Levels Accessed by Acupuncture Meridians:

1. Wei, Ying, Yuan

2. Primary Meridians a. Access & Connect The Wei & Ying Levels 3. Divergent Meridians a. Connect The Wei & Yuan Levels b. Translocate pathogens from the internal level to the Wei level to protect the Zang/Fu

4. Sinew a. TM Meridians b. Access The Wei Level c. Used for transverse Pathologies b. Access The Wei Level c. Used for transverse Pathologies 1. Pathologies that cross from meridian to meridian, transversely 2. i.e. LI & SJ

5. Luo Meridians a. Access The Ying Level b. Luo meridians are the manifestation of internal pathogens and these meridians manifest and are created as needed.

c. Manifest as varicosities or phlegm nodules d. Are best treated by releasing Xue 1. Plumb blossom & Lancet bleeding

e. Store unresolved emotions & ideas 1. Shen is stored in the Xue, Luo Points affect the Xue 2. Issues that we have not dealt with in our lives © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 164

a. not about processing, just releasing.

1. By releasing the blood via plumblossoming, you don’t have to process, just release. a. You are trying to wound the person to get them to release their own wounds.

2. makes you become more aware.

f. By the time we get to the 8 Extraordinary Vessels, we are working with issues that are deeply embedded in our lives,

G. 8 Extraordinary Vessels/Meridians Powerpoint: Clinical Acupuncture Theory - Online Class # 217 Extra Organs & Meridians

1. Access and Treat at the Yuan Level a. Foundation of Yin & Yang, & 7/8yr cycles b. Distribution of Yuan Qi is not equal 1. Based on constitution and “Ba Gua questions” and what you need to become

c. Jing cannot be separated from Xue or other Fluids d. Yuan Qi moves from the moving Qi between the Kidneys, 1. To the Back Shu Points, via the Du Mai 2. To the Antique/Shu Points via the San Jiao

1. “Source of Creation” 1st channels in embryo

a. Du, Ren, Chong Arise from Ming Men and flow thru uterus, 1. “Source of Creation” 1st channels in embryo a. Du, Ren, Chong Arise from Ming Men and flow thru uterus,

1. First “cell division” creates the Du, Ren & Chong

a. Du, & Ren cut thru Dai, linking it w/ Ht, genitals, umbilicus and Chong

1. Second division creates the Dai

b. Third division creates the Yin Wei, Yang Wei, Yin Qiao and Yang Qiao

2. Standard Treatment Technique for the Extraordinary Vessels a. Used this Protocol for Internal Medicine, Women’s Health and Psychological/Emotional Disorders 1. Other Options Exist for The Treatment of Pain b. Needling Order:

1. 1st Needle Master Point /Opening Point a. Right or Left according to sex b. Women / Right c. Men / Left

2. 2nd Treat Coalescent Points on the Meridian, and other related points as needed

3. 3rd Needle Coupled Point /Closing Point 4. Remove Needles in reverse order: Last in-First out c. Obtain the Qi deeply 1. Lifting/Thrusting (mild stim) 2. Shaking (moderate stim) 3. Vibrating/ Tapping (intense stim) d. Classical Moxa Technique 1. Du: 1 cone d. Classical Moxa Technique 1. Du: 1 cone 2. Ren: 7 cones 3. Chong, Dai, Yin Wei, Yin & Yang Qiao: 3 cones 4. Yang Wei: 2 cones e. Expectations / Courses of Treatment 1. Treating at a Deep (Yin) Level Takes Time 2. 1 Course = Once a Week for Three Months

4. Primary Extraordinary Vessels a. Dai Mai (Belt Vessel) 1. Opens the Lower Warmer a. All lower warmer stagnation 2. Adjusts the Menses a. Guides and Supports the Uterus 3. Supports the Low Back a. Radiatiing Low Back Pain © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 166

4. Influences flow of LR Qi 5. Harmonizes ascending and descending of Qi 6. Points a. Master/Opening Point: GB 41 b. Coupled/Closing Point: SJ 5 c. Major Coalescent Points

1. GB 26 (27-28)

b. Chong Mai (Penetrating Vessel)

a. Wide Trunk Road 1. Controls The Menses 2. Sea of blood a. Harmonizes ascending and descending of Blood 3. Points a. Master/Opening Point: SP 4 b. Coupled/Closing Point: PC 6 c. Major Coalescent Points

1. ST 30

2. KI 11 to 27

c. Ren Mai (Conception Vessel “CV”) 1. Yin Deficiency with Yin Stagnation c. Ren Mai (Conception Vessel “CV”) 1. Yin Deficiency with Yin Stagnation 2. Supports Hormonal Balance 3. Sea of Yin a. Supports Yin, Essence and Fluids 4. Relate to int. and ext/ genitalia 5. Points a. Master/Opening Point: LU 7 b. Coupled/Closing Point: KD 6 c. Major Coalescent Points

1. Ren 2 – Ren 15

d. Du Mai (Governing Vessel “GV”) 1. Supports the Spine 2. Supports the CNS a. Enters the Brain 3. Rules the Yang

4. Points a. Master/Opening Point: SI 3 b. Coupled/Closing Point: UB 62 c. Major Coalescent Points

1. Du 2 – Du 15

5. Secondary Extraordinary Vessels a. Yin Qiao & Yang Qiao (Heel Vessels) 1. Secondary for Excess patterns of LJ a. Masses b. Fibroids c. Adhesions d. Difficult delivery e. External genitalia 2. Yin Qiao Points a. Master/Opening Point: KD 3 b. Coupled/Closing Point: LU 7 c. Major Coalescent Point: KI 8 3. Yang Qiao Points a. Master/Opening Point: UB 62 3. Yang Qiao Points a. Master/Opening Point: UB 62 b. Coupled/Closing Point: SI 3 c. Major Coalescent Point: GB 20 b. Yin Wei & Yang Wei (Linking Vessels) 1. Nourish Blood 2. Calm mind /Shen 3. Yin Wei Points a. Master/Opening Point: PC 6 b. Coupled/Closing Point: SP 4 c. Major Coalescent Point: KI 9 4. Yang Wei Points a. Master/Opening Point: SJ 5 b. Coupled/Closing Point: GB 41 c. Major Coalescent Point: GB 21

6. Zonal (Extraordinary Meridian) Approach to The Treatment Of Pain

a. Compiling the pathways of the 8 Extraordinary Meridians and their associated Meridians, the Body can be mapped by Zones

b. Treating the opening and coupled points can influence the flow of Qi throughout the Zone

c. This Material is covered in detail in the Treatment of Pain Class.

3. Psychological & Emotional Issues and the Extraordinary Meridians a. The Psychosomatic language of Chinese Medicine 1. Examples a. Chronic Diarrhea:

1. Not wanting to keep what you have

2. Chronic purging b. Heart Pain c. Angina

1. Broken Heart d. Nausea

1. Can’t Stomach it, but can’t let it go e. Red Face

1. Anger, Frustration etc. e. Red Face

1. Anger, Frustration etc.

b. Depression is often related to Blood Deficiency 1. Sense of emotional vulnerability, 2. Easily startled and overly sensitive, 3. Need to fidget 4. Disturbance in sleep 5. Depression: 6. Body begins to accumulate fluid as a substitute for blood a. Dampness accumulate transforms into phlegm, b. Phlegm nodules form; c. Phlegm causes stagnation and stasis d. i.e. Fibromyalgia, chronic fatigue:

c. Qi Stagnation 1. Prevents the Free Flow of The Emotions

4. 8 Extras Access the Yuan Qi/Jing Level a. Distribution of Jing Qi is not equal b. Inheritance, astrology and past existence influence the Jing and it’s distribution into the 5 elements

c. Affect one’s genetic Blueprint, or Constitution d. Issues deeply embedded in our lives, e. The foundation for the cycles of change (7 and 8 yr.) f. Help one to fulfill one’s destiny: “Ba Gua Questions/Lessons” 1. Health, Abundance, Prosperity, Intimacy, Children, Vocation, Travel/Adventure, Wisdom g. Help to answer the 3 Questions 1. Who I am, Where I Am Going, Who Is In Charge? h. Address Issues deeply embedded in our lives i. Ancestries 1. 1st Ancestry a. Chong, Ren, Du b. Early Childhood c. How You Bond, Connect and Become Comfortable with the World b. Early Childhood c. How You Bond, Connect and Become Comfortable with the World

2. 2nd Ancestry a. Yang Wei, Yin Wei b. The 7 & 8 year cycles c. The Linking of Time & Space, In the Past 1. e

3. 3rd Ancestry a. Yin & Yang Qiao b. Present moment view of Oneself & the World 4. Timeless a. Dai 1. Things which accumulate over time 2. We can’t stand it, but can’t get rid of it

a. Trauma b. Sentiments c. Emotions d. Guilt e. Inadequacies 2. All Accumulations, concentrations, conglomerations are deposited into the Belt Channel a. It is stored b. It Rots c. It Smells d. When the Dai Mai Gets Saturated, the Crap Leaks Out e. This is like emptying the garbage, but we fill it up again & again 3. Physical Sx. a. Infertility b. Impotents c. Lack of clarity d. Lack of creativity c. Lack of clarity d. Lack of creativity e. Reproductive disorders f. Inferiority g. Sagging feeling in the waist h. Leucorrhoea i. Vaginal discharge j. Diarrhea k. Constipation

6. Chong Mai a. Conflict with one’s own nature and culture 1. Coming to terms with one’s own nature, purpose & temperament

b. Treatment series usually begins with Dai or Chong to affect the blueprint c. Connects 1. Kidney – prenatal 2. Sp – postnatal 171 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

3. Ht - diffuses in chest

7. Ren Mai a. Sea of Yin b. Yin Stasis, with Yin Deficiency a. d

c. The process by which we bond and form unions 1. Original Bonding / Mother Child Bonding a. Mother’s breath & Heartbeat

d. Nurturing 1. Security & Trust, Contentment, Feeling at Home 2. Completion, Craving completion 3. Competence, and control over internal and external environment

8. Du Mai a. Beginning of Separation 1. Nurturing oneself

b. Supports the Yang: Tai Yang, Xiao Yang, & Yang Ming 1. Nurturing oneself

b. Supports the Yang: Tai Yang, Xiao Yang, & Yang Ming 1. Ability to stand erect

c. Individuality 1. Moving into the World 2. Freedom of movement of head

d. Society & Morality 1. Expression & temperance of desires / Taking risks 2. Moving through Time & Space

e. Survival Motivation f. Communicates with UB &KD in Gluteus

9. Yin Wei Mai a. Trauma at Some Point in Life, which blocks full development b. Themes & Lessons 1. Devoting Qi & Blood to memories leaves less for the present moment 2. Contingency © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 172

a. Asking “What If?” b. Not accepting who one is

10. Yang Wei Mai a. Cast my net into the world b. How one lives one’s life 1. Forever searching for one’s Role in Life 2. The process by which we move into a certain role in the world

c. Our choices and the process by which we don’t choose d. Commitment and lack of Commitment e. Movement from Family Intimacy to Global commitments

11. Yin & Yang Qiao Mai a. Focusing on the present moment b. Qiao = heel/stance/bridge/motility 1. Yang Qiao = one’s stance to the world 2. Yin Qiao = one’s stance to oneself 1. Yang Qiao = one’s stance to the world 2. Yin Qiao = one’s stance to oneself

c. Polar Opposites 1. Yin Qiao a. Receiving of Qi b. Introvert c. Insomnia d. Medial aspect of legs tight e. “My Bad” 2. Yang Qiao a. Giving of Qi b. Extrovert c. Hypersomnia d. Lateral aspect of legs tight e. “Everyone’s and Idiot”

The Chart of the 8 Extraordinary Meridian, on the next page, contains material on the Treatment of Pain, and Women’s Health. This material will be covered in more detail, in the classes dedicated to those subjects. They are included here for your ease of reference. © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 174

Mai Coalescent Zone(s) General Emotional Women’s Health Indications Points Influenced Indications Indications Dai Belt GB 26, 27 Lateral All Letting Go of Opens Lower Warmer: GB 41, SJ 5 & 28 Belt Congestion Negative Emotions, Moves Liver Qi , Resolves Not Time- (LR13, Low Back in Lower Lethargy, Trauma, Damp Heat and Cold in specific REN 8, Warmer or Indecision, Guilt, Lower Warmer KD16, Belt Area Stagnation, & ST25, Inadequacies SP15, UB52, UB 23, DU4) Chong ST 30, Medial Sea of Blood Comfort with One’s Controls Menses: Penetrating K 11- KI 27 (internal ♀’s Health Nature & Purpose Regulates Menstrual SP 4, PC 6 REN 1 (7) disorders) Digestive Quantity & Flow, Enters 0 -7 yrs (LR14, Nourishment Uterus LR3) Ren REN 2-15 Anterior Sea of Yin Nourishment Yin Aspects of Conception REN 1-24 (internal Yin Security, Trust, Fertility/ConceptionRegula LU 7, KD 6 S1, disorders) Deficiency Contentment, tes Yin Hormones Menstrual 0 -7 yrs DU28 with or Feeling At Home in Timing without Yin the World, Int. & Ext. Genitalia Stagnation ♀Archetype Du DU 1-15 Posterior Governs Individual Identity Governs the Yang of Governing DU 1-28 Spine Yang Express & Temper fertility & Conception SI 3, BL 62 B12, Spine Desires, Self Regulates Yang Hormones

Du DU 1-15 Posterior Governs Individual Identity Governs the Yang of Governing DU 1-28 Spine Yang Express & Temper fertility & Conception SI 3, BL 62 B12, Spine Desires, Self Regulates Yang Hormones 0 -8 yrs REN1 ♂ Archetype Discovery, Moving Connects to into the world, the Brain & Standing up, Taking CNS Risks Yin Wei K 9, Medial Emotional Traumas Nourish Blood Calm the Yin Linking SP 13, 15 & (internal Associated with 7 & Mind, Affect the Heart PC 6, SP 4 16, LR 14, disorders) 8 yr. cycles, Living in Past REN 22 & Present, Addictions, 23 PTSD, Yang Wei GB 21, 13 Lateral Intimacy- Family to Yang – 20,ST 8, Global: Shouldering Linking DU 15 16, Responsibilities, SJ 5, GB 41 SJ 15, SI Choices & Past 10,GB 35, Commitments UB 63 Yang Qiao GB 20, SI Posterior Excessive Global Acceptance Secondary for Masses, Yang Heel 10, UB 1, Restlessnes / Frustration Fibroids, Adhesions, BL 62, SI 3 59 & 61, s, Anxiety, (Excess in Lower Warmer) Present GB 29, LI Insomnia 15 & 16, ST 1, 3 & 4 Yin Qiao KI 8, Anterior Deficient Self Acceptance / Yin Heel UB 1, (Internal Restlessnes Frustration KD 6, LU 7 ST 9, ST12 disorders) s Anxiety, Present Insomnia Yang Ming ST 36 Anterior Note: The Yang Ming, Jue Yin, 4-Gates, and Dr So, Point Bright Yang LI 4 Meridian Combinations Are Not Extraordinary Meridians. Pain 175 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Jue Yin LR 3 PC 6 Medial Sooth Emotions Calms Mind Yielding Yin Meridian Pain

1. Acupuncture for the Treatment of Pain

A. Weekend 7 Introduction

2. Point selection / prescriptions

3. Palpation skills

4. Techniques for the Treatment of Pain

5. Specific Treatment Protocols

B. The Basics

1. Usually expect immediate results from proper treatment

2. Injury + Time = Increased Stagnation & Accumulations

a. Wind Stagnation transforms to Qi Stagnation, which transforms to Blood Stagnation and Accumulation of Phlegm

3. Local / Distal and Adjacent Treatment: Standard Operating Procedure for Pain

a. Treating Locally a. Treating Locally

1. Finding and treating the local points

a. Palpation

b. Needle technique

b. Adjacent Palpation & Treatment

c. Distal Treatment

4. Don’t get too complicated

a. Qi Stagnation or Blood Stagnation

b. Complications of:

1. Cold

2. Heat

3. Damp

4. Wind

c. Stagnation needs to be moved

1. Moving Stagnation almost always takes precedence over building deficiencies, when treating pain.

2. Most individuals will tolerate a slight decrease in Qi if it results in significant pain relief.

3. Pain affects an individual's Qi.

d. The importance of moving and not moving an affected area or joint

1. Immobilizing a soft tissue injury 5. Application of Heat vs Cold

a. Heat Moves / Cold Contributes to Stagnation

6. Meridian Based Diagnosis

a. Where is the primary disharmony?

1. Usually at the site of the pain

2. Often proximal to the pain

a. Sometimes in the back 2. Often proximal to the pain

a. Sometimes in the back

b. DU or UB channels

c. Diagnose by palpation

1. Where is the Qi?

C. Point Selection

1. Introduction

Points Below the Knees and Elbows

3. The Controlling Points (Accd. to Drs. Jim & Chuck)

a. LI 4 & LU 7 control the Head, Neck, Face, & Mouth

b. ST 36 controls the Digestion & Qi

c. P 6 controls the Chest to Navel Area

d. UB40 controls the Back

e. SJ 5 controls the Hand

f. SJ 3 controls the Ear

g. LR 3 controls the Liver

h. GB 26 controls the Lower Warmer h. GB 26 controls the Lower Warmer

4. Jing Well Points

a. Clear the Sinew Meridians

b. Bleed 8-10 drops

5. Luo Points

a. LR 5 for the Genitals

6. Back Shu Points

a. Used with Corresponding Du Points

b. UB 18 Liver

c. UB 23 Kidney

D. Advanced Specific Needling Techniques

1. Each of these techniques will be demonstrated, and then practiced by each participant, on at least one representitive point, to assure proficiency.

2. Point Bleeding

a. Release 2- 10 drops of blood

b. Jing-Well Points

c. Du 14, Clears Heat

d. High Blood Pressure

1. Pc 3, UB 40

2. Ear:

a. Apex

b. Lower Blood Pressure Groove

3. Directing the Qi Along a Meridian or to a Specific Area

a. Manual Pressure on Meridian

1. SJ5

b. Crossing Needle

a. Du14

1. Left and right 1. Left and right

b. Jian Nei Ling

1. Where you want it

c. Getting Da Qi

a. UB 40 Down to KD 1

4. Points on the Palm

1. P8, HT8

E. Bottom of the foot

1. KD1

2. Center of Heel (women’s Knee Pt)

F. Long Needles

1. Short Tubes

Surrounding The Dragon

H. Connecting Points(Through & Through)

1. LI 20 –> Bi Tong

2. UB60 -> Kid3

3. TW5 -> Pc6 2. UB60 -> Kid3

3. TW5 -> Pc6

4. Liv3 -> Kid1

5. LI4 -> SI3 (P8)

I. Specific Points

1. UB 1

2. GB 20

3. LI 17/18

4. Du Points

5. Hua To Jia Ji

a. Deep Needle

b. Threading w/ Long Needle

6. 8 Liao

7. Du 2

8. Upper Warmer Ren Points

9. Middle Warmer Ren Points

10. Lower Warmer Ren Points

11. DU 1 / Ren 1

J. The Meridians for Pain

1. 12 /14 Main Meridians

a. Central Supporting Structure of the Meridian System

b. Circadian Qi flow: Six division designation

c. Contra lateral Meridian Treatment

1. Treat same point on opposite side c. Contra lateral Meridian Treatment

1. Treat same point on opposite side

2. Treat same level of tissue

d. 6 Division Paired Meridian Treatment

1. Yang Meridians (Primary)

a. Yang Ming: LI / ST

b. Shao Yang: SJ / GB

c. Tai Yang: SI / UB

2. Yin Meridians (Secondary)

a. Tai Yin: LU / SP

b. Jue Yin: P / LR

c. Shao Yin: HT / KD

3. Opposite Joint Six Division Treatment

a. Wrist / Ankle

b. Elbow / Knee

c. Shoulder / Hip

d. Neck / Loins

2. 12 Tendino-Muscular Meridians (TMM) (aka: Sinew)

a. Attend, But Not Limited To Muscular Regions

b. Principally for Pain & Trauma

1. Acute and Chronic

2. Painful and/or Tight Conditions

c. Envelop or “Knot Into” All Joints

d. Broader Pathways

1. Crossover from Meridian to meridian

a. Look for areas of diffuse pain

e. Branches Extend Pathways

1. GB: Connects with Sacrum 1. GB: Connects with Sacrum

2. ST: Connects to Lumbar

3. UB: Encircles Shoulder & Eye; - Follows GB Pathway on Lower Leg

f. TMM Points

1. Points are shared by both Main Meridians and TMM

2. Jing Well Points Clear Pain from TMM

a. Bleed Jing –Well Point of the TM

1. Drain excess from meridian a. Bleed Jing –Well Point of the TM

1. Drain excess from meridian

2. 8- 10 drops of blood

3. look for immediate change in the pain/tension

g. Classically Recommended for Treating TMM:

1. Shu-Stream Points

a. LI 3, SJ 3, SI 3, GB 41, UB 65, St 43

2. Principal TM Points

a. ST12,30,41,45

b. SP 1,5,9,12

c. UB 36,39,40,61,67

d. KD 1,3,10

e. GB 34,40,44

f. LR1,4,8

3. 8 Extra Meridians

a. Traditional and Zonal Treatment of Pain

K. The Microsystems for Pain (Auricular/ Hand / APS-USA) Treatment

1. Find point exactly

2. Employ Active or Passive Movement During Treatment

3. Ear

a. For Yang disorders, palpate the Yang side of the ear for sensitivity and needle/seed it also

L. Palpation & Treatment of Local and Adjacent Areas of Pain

1. Begin with Local Pain Area

Locate carefully Locate carefully

1. Palpate many points in a small area

2. Palpate from different directions

2. Locate Muscle “Bundles”

a. Use Cross-Fiber Palpation

b. Look for “Snap Signs”

3. Follow Muscle Bundles to Adjacent Areas

4. Releasing Muscle Fibers

a. Needle Into Belly of “Primary Bundle” in Painful area

1. Engage Muscle Vesiculation

2. Fatigue Muscle

b. Follow tight M. to next adjacent bundle (distal or proximal)

1. Engage Muscle Vesiculation

2. Fatigue Muscle

c. Repeat until all M. bundles are released

M. Treatment of Sinew (T-M) Meridians

1. Bleed Jing –Well Point of the Meridian

a. Drain excess from meridian

b. 8- 10 drops of blood

c. look for immediate change in the pain/tension

2. Treat principal TM points both distal and proximal to the painful/tense area

a. ST12,30,41,45

b. SP 1,5,9,12

c. UB 36,39,40,61,67

d. KD 1,3,10 c. UB 36,39,40,61,67

d. KD 1,3,10

e. GB 34,40,44

f. LR1,4,8

N. General Needle Techniques For Pain

1. Strong Stimulus

a. Always Distally

b. Often Locally

c. Two Handed Insertion Of Longer Needles With Smaller Tube

O. Needling Styles & Strategies

1. Needling Depths

a. General 1/4” - 3/4” into the underlying muscle

b. Specific

2. Angle of Insertion

a. Usually Perpendicular to the Skin

b. Except when it’s not J.

3. Getting the “Da Qi”

a. What is it?

b. Why is it necessary?

c. Do you need to feel it?

d. Who feels it?

e. Where is it?

1. Angle of insertion

2. Depth of insertion

4. Chinese Style

a. Tends to be stronger stimulation

b. Usually thicker needle b. Usually thicker needle

c. Getting Da Qi

5. Japanese Style

a. Tends to be lighter stimulation

b. Usually thinner needle

c. Da Qi comes to needle

6. Laying Needle Time

a. Stimulus characteristics are important

b. Standard Tx.

1. 20 minutes

2. Moderate stimulation

3. Circulation of Qi

4. Maxim endorphinergic reaction

c. Sha or Kwai Tx.

1. 1-10 seconds

2. Dr. So

a. Very strong stimulus

b. Good for pure excess conditions

d. Intensive Tx.

1. 20 – 30 minutes

2. Strong stimulation

3. Re-stimulate every few minutes

4. Used for Scalp, chronic inflammation, etc

e. 30 - 45 minutes

1. Minimal stimulation

P. Electro Acupuncture

1. Settings

a. Hi Frequency > 50 Hz

b. Low Frequency <5 Hz

c. Low Intensity = Threshold of M. Contraction

d. High Intensity = 5-10 x Threshold of M. Contraction

2. Sustained Results

a. Low Frequency / High Intensity

3. Instant / Temporary Results

a. High Frequency / Low Intensity 3. Instant / Temporary Results

a. High Frequency / Low Intensity

4. Needles

a. Choose Thicker Needles

b. Insert into belly of M.

c. Pair in Areas of Equal Sensitivity

Q. Gua Sha & Cupping

1. Stubborn Pain or Congestion with “Sha” and/or blanching upon palpation

2. Upper and Mid-Back Pain: Gua Sha & Moving Cups

3. Lower Back and Hip Pain: Stationary Cups

4. Post- Gua Sha / Cupping Recommendations

a. Protect from Cold Invasion

b. Immediately Post Tx.: Indirect Moxa / Heat Lamp

c. 24 - 72 hr. Post Tx.: Keep area Warm, Avoid Congesting Foods; A little alcohol is OK

R. Moxa

1. Actions

a. Warms: Body, Meridians, & Uterus

b. Expels Cold And Damp

c. Invigorates / Moves & Regulates Qi & Blood

d. Dries Damp / Moves Phlegm

e. Opens The 12 Primary Channels

f. Repairs Traumatized Tissue

2. Cautions & Contraindications

a. Do Not Use Moxa Therapy W/ Heat

b. Do Not Use Moxa Therapy During Pregnancy

c. Treat All Moxa Burns with standard Western Medical interventions

d. Always Explain Procedure To Pt. c. Treat All Moxa Burns with standard Western Medical interventions

d. Always Explain Procedure To Pt.

3. Indirect Moxa Forms

a. Pole / Roll: To Disperse hold pole close: 0.5” – 0.75” away form the skin

b. On Needle

c. Instrument / Box

d. Belly Bowl

4. Moxa Techniques for Pain generally heat the points quicker than moxa for tonification.

S. Ginger Compress 1. Used mainly for muscular pain and spasms 2. Highly effective for acute injuries

T. Zonal (Planar) Approach to The Treatment of Pain

1. Understanding the Zones

Tai Yin LU* Xiao Yin HT* Jue Yin PC* Yang Ming LI Tai Yang SI Xiao Yang SJ ST UB GB Tai Yin SP* Xiao Yin KD* Jue Yin LR* Anterior Zone Posterior Zone Lateral Zone

*Yin Meridians are mostly used to treat internal disorders. While they are used to treat pain in some instances, they are primarily used to support the Yang Meridians. Therefore the strict assignment of Zones above applies to the primarily to the Yang Meridians, and only partially to the Yin Meridians 189 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

The pictures which follow, are taken from A Manual of Acupuncture by Deadman, Al-Khafaji & Baker · The Cutaneous Regions are the Classical Pathways of the meridians associated with the surface of the body. · They follow a broadened version of the 12 Primary Channels, paired according to the 6 Divisions. (Approx.) © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 190

By combining the 8 Extraordinary Meridians and the Six Divisions one arrives at all Zones Name of (Meridian) Mai Master Couple Zone Notes Point Point DU MAI (Governing SI 3 UB 62 Posterior All Posterior Vessel) Pain Yang Qiao (Yang Heel) Mai UB 62 SI 3 Posterior DAI MAI (Belt Vessel) GB 41 SJ 5 Lateral & All Lateral & Beltway Beltway Pain Yang Wei (Yang Linking) SJ 5 GB 41 Lateral Mai YANG MING LI 4 ST 36 Anterior Primary Anterior CONNECTION Zone

Mai YANG MING LI 4 ST 36 Anterior Primary Anterior CONNECTION Zone Ren (Conception) Mai LU 7 KD 6 Anterior Secondary Yin Qiao (Yin Heel) Mai KD 6 LU 7 Anterior Anterior Zone JUE YIN CONNECTION PC 6 LR 3 Medial Primary Medial Chong (Penetrating) Mai SP 4 PC 6 Medial Secondary Yin Wei (Yin Linking) Mai PC 6 SP 4 Medial Medial Zone

Posterior Zone Lateral Zone SI / UB GB / SJ Du Mai / Yang Qiao Mai Dai Mai / Yang Wei Mai SI 3 / UB 62 GB 41 / SJ 5 Yin Support HT 7 (or PC 6) & KD 3 Yin Support LR 3 & PC 6

Anterior Zone (Primary) Medial Zone (Primary) LI / ST PC / LR LI 4 & ST 36 PC 6 / LR 3 Yin Support LU 9 (or 7) & SP 3 (or 6) Yin Support Inherent

Anterior Zone (Secondary) Medial Zone (Secondary) Ren Mai / Yin Qiao Mai Chong Mai / Yin Wei Mai LU 7 / KD 6 SP 4 / PC 6 Yin Support Inherent Yin Support Inherent

2. Zone Based Treatment Sequence

a. Select Zone:

1. Posterior / Anterior / Lateral / Medial

b. Treat Master Point Closest to the Pain:

1. Upper / Lower, Right / Left

c. Treat Coupled Point on Opposite Side

d. Treat Yin Supporting Points

1. As Necessary d. Treat Yin Supporting Points

1. As Necessary

e. Local & Adjacent Points

1. Trigger (Ah Excess ) Points

2. Cross Fiber Palpation

3. Following the Affected “Meridian Chains”

f. Coalescent Points

g. Ancillary Treatment

1. Microsystems

a. Can be used any time during treatment

2. TCM

3. Expect Immediate Results

U. Specific Treatment of Pain by Bodily Region

1. Head & Neck

a. Specific Local Technique: LI 4& Lu7 Strong Stimulus

b. Local Points

1. Du 20

2. GB 8

3. GB 14

4. UB 1

5. GB 1

6. GB 20

7. UB 10

8. All Points on the SCM

9. ST 6, 7

c. Distal Points

1. LI 4 / LU 7

2. LI 1

3. ST 44-45 2. LI 1

3. ST 44-45

4. UB 67

5. LR 3

6. GB 41

d. Microsystems

1. APS-USA

a. Head & Neck point

b. Neck & Shoulder Point

c. Palpate Lower 2/5 of Contralateral Sensory Line

2. Ear

a. Palpate & Observe Head & Neck Area Superior to Lobe and along lower portion of antihelix

3. Hand

a. Nape & Neck

b. Palpate & Observe Tip of Middle Finger

2. Shoulder Joint / Upper Arm

a. Specific Local Technique: Electro-Acupuncture

b. Local

1. LI 14, 15, 16

2. Jian Nei Ling

3. SI 9, 10

4. SJ 13, 14

c. Distal

1. LI 1, 4, 10

2. SI 1, 3, 6

3. SJ 5

d. Microsystems

1. APS-USA

a. Neck & Shoulder Points

b. Shoulder Arm & Hand Points a. Neck & Shoulder Points

b. Shoulder Arm & Hand Points

c. Palpate Lower and middle 2/5 of Contralateral Sensory Line

2. Ear

a. Palpate & Observe Shoulder Joint Area in the Scaphoid Fossa, level with the crus of the helix

3. Hand

a. Nape & neck, Shoulder

3. Upper Back / Shoulder Blade

a. Specific Local Technique: Moving Cups / Gua Sha

b. Local

1. SI 11, 12

2. GB 21

3. SJ 15

4. Upper Hua Tou Jia Ji Points (HTJJ)

5. Upper UB Points

c. Distal

1. SI 1, 3, 6

2. SJ 5

3. GB 34

4. UB 60, 62

d. Microsystems

1. APS-USA

a. Neck & Shoulder Points

b. Shoulder Arm & Hand Points

c. Thorax Points

2. Hand

a. Shoulder

b. Upper Back lines b. Upper Back lines

3. Ear

a. Palpate & Observe upper spine Area along antihelix; level with bottom of Tragus and crus of helix

4. Chinese Scalp

a. Palpate middle 2/5 of Contralateral Sensory Line

4. Elbow

a. Local Treatment Technique: Adjust First (when possible)

b. Local

1. SI 8

2. SJ 10

3. LI 11

c. Distal

1. LI 1 & 4

2. SI 1 & 3

3. SJ 1 & 5

d. Microsystems

1. APS-USA

a. Shoulder Arm & Hand Points

b. Palpate middle 2/5 of Contralateral Sensory Line

2. Ear

a. Palpate & Observe elbow Area in the Scaphoid Fossa, level with lower crus of the antihelix

5. Hand / Wrist

a. Local

1. LI 4, 5, 3

2. SJ 5, 4

3. SI 3, 4, 5, 6

4. LI 4 thru to P 8

5. Baxie 4. LI 4 thru to P 8

5. Baxie

b. Distal

1. LI 1

2. SI 1

3. SJ 1

c. Microsystems

1. APS-USA

a. Shoulder Arm & Hand Points

b. Palpate upper 1/5 of Contralateral Sensory Line

2. Ear

a. Palpate & Observe Hand Area in the superior region of the Scaphoid Fossa.

6. Mid Back / Thorax

a. Specific Local Technique: Cupping/Gua Sha

b. Local

1. SI 11

2. HTJJ

3. UB 18

c. Distal

1. GB 34

2. LR 3

3. PC 6

4. UB 60, 62

5. SI 3

6. UB 57

d. Microsystems

1. APS-USA

a. Thorax Points

b. Palpate Thoracic Line a. Thorax Points

b. Palpate Thoracic Line

2. Ear

a. Palpate & Observe Along anti Helix level with Heart & Lung Areas

7. Lower Back / Hip

a. Specific Local Techniques 1. Open Dai Mai 2. Open Du Mai 3. Stationary Cups

b. Local

1. GB 26

2. UB 23, 52

3. UB 31, 32

4. Du 4

5. UB 25

6. Josen

c. Distal

1. UB 62, 67, 60

2. SI 3

3. UB 40

d. Microsystems

1. APS-USA

a. Low Back Points

b. Palpate upper 1/5 of Contralateral Sensory Line

2. Hand

a. Loin & Low Back, Sciatic

3. Ear

a. Palpate & Observe Lumbar Spine Area on antihelix @ level of 3. Ear

a. Palpate & Observe Lumbar Spine Area on antihelix @ level of crus of helix

8. Groin / Thigh

a. Specific Local Technique: Bleed LR 1

b. Local

1. ST 31

2. LR 11

c. Distal

1. LR1, 3, 5, 8

2. ST 45

d. Microsystems

1. APS-USA

a. Low Back Points

b. Palpate upper 1/5 of Contralateral Sensory Line

c. Continence / Foot Motor Sensory

2. Hand

a. Sciatic

3. Ear

a. Palpate & Observe Superior and Inferior Crus of the Antihelix

9. Knee

a. Specific Local Technique: Direct Moxa on Patella

b. Local

1. ST 36, 35, 34

2. GB 34

3. SP 9, 10

4. Medial Eye of Knee 3. SP 9, 10

4. Medial Eye of Knee

5. He Ding

6. UB 40 (deep)

c. Distal

1. ST 44

2. GB 41

3. LR 3

4. Jing Points

d. Microsystems

1. APS-USA

a. Palpate upper 1/5 of Contralateral Sensory Line

b. Continence / Foot Motor Sensory

2. Ear

a. Palpate & Observe Superior and Inferior Crus of the Antihelix

10. Ankle / Foot

a. Specific Technique: Treat Multiple Points & Ear Points

b. Local

1. All Yang Points

2. LR 2,3,4

3. Sp 5 (Swelling)

c. Distal

1. Jing Points

d. Microsystems

1. APS-USA

a. Palpate upper 1/5 of Contralateral Sensory Line

b. Continence / Foot Motor Sensory

2. Ear

a. Palpate & Observe Superior and Inferior Crus of the Antihelix @ the helix

3. Hand @ the helix

3. Hand

a. Ankle

W. Recap: What you need to know for the Treatment of Pain

1. This is a basic “Study Guide” of what should be in a doctor’s knowledge base, for treating pain.

2. Local, Distal & Adjacent: Standard TCM Approach

a. Pathways The Primary Meridians

3. Pathways of the Sinew Meridians

a. Especially The Stomach, Urinary Bladder, & Gall Bladder

4. Zonal Treatment

a. Eight Extra Meridians

1. Associated Zones

2. Master/Opening and Couple/Closing Points

b. Du / Yang Qiao / Posterior Zone

1. SI 3, UB 62

c. Dai / Yang Wei / Lateral Zone

1. Also: Low Back/Hip/Sciatica

2. GB 41, SJ 5

d. Ren / Yin Qiao / Anterior (Internal) Zone

1. Lu7, KD 6

e. Yang Ming / Anterior (External) Zone

1. LI4 - ST 36

f. Chong / Yin Wei / Medial (Internal) Zone

1. Sp 4, PC 6

g. Jue Yin / Medial (External) Zone

1. PC 6 – LR 3 1. PC 6 – LR 3

5. Microsystems

a. APS-USA

b. Hand

c. Ear

d. Chinese Scalp

6. The Controlling Points (Accd. to Drs. Jim & Chuck)

a. LI 4 & LU 7 control the Head, Neck, Face, & Mouth

b. ST 36 controls the Digestion & Qi

c. P 6 controls the Chest to Navel Area

d. UB40 controls the Back

e. SJ 5 controls the Hand

f. SJ 3 controls the Ear

g. LR 3 controls the Liver

h. GB 26 controls the Lower Warmer

7. Hua Tuo Jia Ji Points

a. 0.5 cun lateral to interspinous space

b. Use with Corresponding Du Points

c. Use with Back Shu Points

1. UB 13 Lung: Upper Back

2. UB 18 Liver: Mid Back

3. UB 23 Kidney: Low Back

8. Yin Meridian Source Points

9. Yang Meridian Jing Points

a. + LR 1 (Yin)

10. Major Distal Points

a. Jing Well Points a. Jing Well Points

1. All Yang: UB 67, GB 44, ST 45, LI 1, SJ 1, SI 1

2. Yin: LR 1

b. LI 4

1. Lu 7

c. LR 3

d. SI 3, 6

e. SJ (TW) 3, 5

f. GB 31,34, 39, 41

g. ST 36, ST 41, 44

h. UB 40 (54), 57, 60, 62,

11. Main Local Points

a. Head

1. St 3, 5, 6, 7, 8

2. LI 20

3. GB 8, 14, 20

4. DU (GV) 20

5. SI 18

b. Neck

1. GB 20, 21

2. UB 10

3. DU 14

4. LI 17 area

c. Shoulder

1. GB 21

2. LI 14, 15, 16

3. SJ 14, 15

4. SI 9,10,11,12 3. SJ 14, 15

4. SI 9,10,11,12

5. Jian Nei Ling

d. Elbow

1. LI 11,12

2. SI 8

3. SJ 10

e. Wrist

1. LI4, 5

2. SJ 4

3. SI 3, 4, 5, 6

f. Hip

1. GB 26,27,29,30

g. Knee

1. St 35, 36

2. GB 34

3. SP 9 (Yin)

h. Ankle

1. St41

2. GB40

3. UB 60, 61, 62

2. Women’s Health

A. Weekend 8 Introduction

1. Women’s health take into account almost all the systems, organs, and substances in Oriental medicine, as well and most al of the treatment techniques.

2. Recommended Book Balance Your Hormones Balance Your Life: Claudia Welch

C. Name That Disharmony / Diagnosis Review Claudia Welch

C. Name That Disharmony / Diagnosis Review

1. A Patient Presents with the following signs and symptoms: Fatigue, loose stools, pale thin tongue with a white coat, pale and lusterless face, lack of appetite, weak limbs, and a weak and thin pulse.

a. What is the best working diagnosis for this patient?

2. A patient presents with the following signs and symptoms: chronic neck and shoulder tension, pain in rib cage, plumb pit throat, pain on palpation on lower left side of the abdomen, angry disposition, slightly purple tongue, wiry pulse.

a. What is the best working diagnosis for this patient?

3. A patient presents with the following signs and symptoms: Malaise, fatigue, palpitations, a weak thin pulse, forgetfulness, confusion, and pale thin tongue with white coat, a pale lusterless face, and a thin weak pulse.

a. What is the best working diagnosis for this patient?

4. A patient presents with the following signs and symptoms: insomnia (difficulty staying asleep), chronic dry, sore throat, malor flush, restlessness, palpitations, weak legs, low back pain, dark scanty urination, thin red tongue with a peeled coat, thin rapid pulse.

a. What is the best working diagnosis for this patient?

5. A Patient Presents with the following signs and symptoms: sore low back which feels better with heat, frequent clear copious urination, low sex drive, fatigue, pale face, weak and slow pulse, pale and puffy tongue with a wet coat.

a. What is the best working diagnosis for this patient?

6. A patient presents with the following signs and symptoms: asthma, restlessness, insomnia, dry stools with constipation, thin and rapid pulse, thin red tongue with no coat.

a. What is the best working diagnosis for this patient?

7. A patient presents with the following signs and symptoms: insomnia (difficulty falling asleep), thin pale tongue especially at the center and tip, pale lusterless face, palpitations, chronic diarrhea, fatigue, thin 7. A patient presents with the following signs and symptoms: insomnia (difficulty falling asleep), thin pale tongue especially at the center and tip, pale lusterless face, palpitations, chronic diarrhea, fatigue, thin weak pulse.

a. What is the best working diagnosis for this patient?

D. Review Major Relevant Points from:

a. Liver

b. Spleen

c. Kidney

d. Heart

e. Du

f. Ren

g. Chong

h. Dai

i. Lower Abdomen

E. Jing (Essence)

1. Tian Gui

2. “Minister Fire”/ “Motive Force”/ Mingmen fire

3. Stored in the Mingmen

a. Lower Dan Tian

b. Lower Field of Elixir

c. In Women it Includes The Uterus

1. Zi Bao, Bao Gong,

2. Fetal Wrapper, Fetal Palace, Blood Chamber

d. In men it includes the “Room of Sperm”

4. Kidneys

a. Store Jing

b. Relevant Kidney pathology

1. Jing Deficiency 1. Jing Deficiency

2. QI / Yang Deficiency

3. Yin Deficiency

5. Menarche/Menopause

a. “At 14 years if the Blood, Jing, Ren, and Chong are full, the Tian Gui (Heavenly Dew) descends”

b. “At 49 years when the Ren, Chong, Fluids, and Blood become insufficient the Tian Gui withdraws”

F. Blood

1. “Women’s physiology is rooted in blood. Men’s in Qi”

2. Conception Relies on Blood, from Mother

1. Blood (post-natal Qi), essence (pre-natal Qi), Kid, LR, Ren, Chong, Yin

3. In Pregnancy Blood nourishes fetus so it does not irrigate Chong.

1. No menses

2. Blood becomes milk.

4. Liver

1. Responsible for smooth flow of Qi & Emotions

2. Stores Blood

a. Menstrual Blood and. regular Blood

3. Delivers Blood to uterus

4. Moves the Qi that moves the Blood

5. Channel flows through breasts

a. Breast pain & tenderness

a. Relevant Liver Pathology

1. LR Qi Stagnation

a. Yang rising

b. Liver wind

2. LR Blood Stagnation b. Liver wind

2. LR Blood Stagnation

3. LR Blood Deficiency

4. Heat in the Blood

5. Damp Heat in Liver channel

5. Spleen

1. Produces Qi & Blood

2. Closely associated with Liver

a. Amount of blood

b. Timing of cycle

3. Holds

a. Blood in the vessels

b. Organs & Fetus in place

a. Spleen Pathology

1. SP Qi and Blood Deficiency

2. SP Qi and Blood Deficiency w/ Damp

3. SP Qi Not Holding (collapsed/sinking)

6. Heart

1. Governs Blood

a. Pumps it thought the vessels

b. Turns it red

1. Personality/identity

2. Bao mai

a. HT-UT connection

3. Shen/ emotions

7. Stomach

1. Connected to Uterus via Chong Mai

2. Channel flows through breasts

a. Breast milk

G. Extraordinary Vessels (see pocket reference card at end of notes) a. Breast milk

G. Extraordinary Vessels (see pocket reference card at end of notes)

1. “Source of Creation” 1st channels in embryo

a. Du and Ren cut thru Dai, linking it w/ Ht, genitals, umbilicus and Chong

b. Du, Ren, Chong Arise from Mingmen and flow thru uterus, D

2. Primary Extraordinary Vessels

a. Chong Mai (Penetrating Vessel)

1. SP4 / PC6

2. Origin of all extraordinary vessels

3. Sea of blood

4. Controls menses

5. Access thru ST 30

6. Shares

a. CV1 & 7

b. KI 11 to 27

7. Perhaps determines pineal / transitory hormonal changes?

a. “The Chong rises to the forehead where it oozes into the Yang and irrigates the Yin”

b. Ren Mai (Conception Vessel)

1. LU7 / KD6

2. Relate to int. and ext/ genitalia

3. Connect to yin, essence and fluids

4. Sea of yin channels

5. Hormonal gateway

c. Du Mai (Governing Vessel)

2. SI 3 / UB 62

3. Rules the Yang

d. Dai Mai (Belt Vessel)

1. GB 41 / SJ 5 1. GB 41 / SJ 5

2. Influences LR Qi flow

3. Harmonizes ascending and descending of both SP and K

4. Guides and supports Uterus Qi and Jing

5. Opens the Lower Warmer

3. Secondary Extraordinary Vessels

a. Yin/ Yang Qiao (Heel Vessels)

1. Used for Excess patterns of LJ

a. Masses

b. Fibroids

c. Adhesions

d. difficult delivery

e. external genitalia

b. Yin/Yang Wei (Linking Vessels)

1. Calm mind /Shen

c. Nourish Blood

H. Essential Etiology

1. Exterior Pathogenic factors

a. Cold

1. Pain (Cramping Nature)

2. Warm it with moxa / TDP Lamp

3. Move it with acupuncture

4. Warm it with Herbs

b. Dampness

1. Heaviness

2. Transform it by tonifying the Spleen

3. Vaporize it by tonifying the Kidneys

4. Circulate it with the Lungs

c. Heat c. Heat

1. Enters the Blood

2. Cool it with Acupuncture or Herbs

2. Internal: Emotions and Stress

a. Anxiety & Stress

1. Most Common Cause of Stagnation

a. Liver Qi & Blood

b. Chong Mai

c. Dai Mai

2. Spleen

a. Blood Deficiency

b. Emotional Stress @ Puberty

1. Ren & Chong

c. Sadness & Grief

1. Ht

2. LR

d. Worry

1. SP

e. Anger

1. LR Qi Stagnation

2. LR fire

f. Fear

1. Kid

g. Shock

1. Ht, SP, Kid

h. Guilt

1. Dai Mai

2. Mostly KD and Ht

3. Qi Stagnation or Deficiency or sinking 2. Mostly KD and Ht

3. Qi Stagnation or Deficiency or sinking

3. Diet

a. Blood & Qi Deficiency

b. Dampness Collects

4. Overwork/exercise = too long w/o good rest, diet

a. KD Yin Deficiency

5. Pregnancy & Childbirth

a. Not enough rest after

b. Pre-existing Blood and/or KD Deficiency

c. Blood Deficiency

6. Abortion

a. Blood Stagnation

b. Blood & Qi Deficiency

c. KD Deficiency

7. Excess or Deficiency of Sexual activity

a. Excess: During puberty, During period, During pregnancy

1. KD Deficiency

b. Deficiency: Repression

1. LR Qi Stagnation

8. C-Sections, Other Abdominal Surgeries, & Hysterectomies

a. Disruption of

1. Ren

2. Chong

3. Dai

b. Blood Stagnation

1. Adhesions

c. Spleen and Kidney Deficiencies 1. Adhesions

c. Spleen and Kidney Deficiencies

9. Contraceptive pills & shots

a. Unpredictable

I. Essential Diagnosis

1. Menstrual phase

a. Blood moving

b. Liver Qi

c. Liver Blood

1. Scanty: move blood

2. Heavy: Stop bleeding

2. Post-menstrual phase

a. Blood/ Yin Deficiency

b. Depleted Chong and Ren

c. Western: follicle grows, estrogen levels rise due to FSH direction

1. Nourish Liver blood and K yin

3. Mid-cycle phase

a. Blood and Yin gradually fill up in the Chong and Ren

b. Western: ovulation. Ovum released from follicle and corpus luteum develops due to LH

1. Promote ovulation by nourishing k Jing

2. [also TX Du, Ren, Chong, due to their hormonal connection]

4. Pre-menstrual phase

a. Yang Qi rises

b. Liver Qi gears up to move liver blood 213 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com c. Tonify Yang if Deficiency / Move Liver Qi if stagnant The 4 Phases of the Menstrual Cycle Excerpted from Obstetrics & Gynecology in Chinese Medicine : Giovanni Maciocia

2. First identify the differentiated dz. Then the pattern.

3. Questioning: 3. Questioning:

a. Menstruation

1. Menarche

2. Cycle

3. Amount

4. Color

5. Consistency

6. Pain

7. PMS

8. Pain

9. Vaginal discharge

10. Fertility and pregnancy

11. Childbirth

12. Miscarriage and abortion

13. Other

4. Palpation

a. Pulse

1. Fast

a. Hot

2. Slow

a. Yang Deficient Cold

b. Abdomen and Muscles

1. Lack of integrity

a. Deficiency of Spleen and Kidney

2. Congestion in the Tissues

a. Masses / Fibroids

5. Observation

a. Complexion & Lips a. Complexion & Lips

1. Pale

a. Deficiency

2. Red

a. Heat b. Tongue

1. Body color

a. Pale

1. Deficiency

b. Red

1. Heat

2. Shape

a. Puffy

1. Qi or Yang Deficiency

b. Thin

1. Blood or Yin Deficiency

3. Coating

a. Yellow

1. Heat

b. White

1. Not Hot

c. Sticky/Greasy

1. Dampness

d. No Coat / Peeled

1. Yin Deficiency

c. Odor

1. Vaginal discharge / Menstrual Blood

2. Strong or unpleasant odor 1. Vaginal discharge / Menstrual Blood

2. Strong or unpleasant odor

a. Heat

3. NO Strong or unpleasant odor

a. Not Hot

J. Treatment of the Most Common Disharmonies

1. Castor Oil Packs/Massage

a. Move Stuck Qi, Blood, & Phlegm

2. Warm Oil Massage (Abhyanga)

a. Tonify Yin & Quell Wind

3. Treatment of internal organs

a. Kidneys

1. Tonify Yang

a. Du Mai: SI 3 & UB 62

b. General Points:

1. KD3, UB23, DU4, REN4, KD16

a. All with moxa and needles

c. Basic Herbal Patent Formula:

1. Jin Gui Shen Qi Wan

2. Tonify Yin

a. Ren Mai: LU7, KD 6

b. General Points:

1. KD7, UB23, DU4, REN4, KD16

a. All with needles

c. Basic Herbal Patent Formula:

1. Liu We Di Haung Wan

2. Yin Deficiency/Heat

a. Wise Women’s Well (K’an)

b. Two Immortals (Health Concerns) a. Wise Women’s Well (K’an)

b. Two Immortals (Health Concerns)

3. Tonify Yin and Yang

4. Conserve Jing (the basis of Yin & Yang)

a. Diet/Lifestyle b. Liver

1. Nourish Yin and Blood

a. General Points:

1. LR3, UB18, DU8, LR14

a. All with needles

b. Basic Herbal Patent Formula:

1. Yin: Liu We Di Haung Wan

2. Blood: Ba Zhen Tang

2. Soothe LR Qi

a. General Points:

1. LR 3, GB41, GB34, UB18, DU8, LR 14

a. All with needles

b. Basic Herbal Patent Formula:

1. Xiao Yao Wan

3. Move LR Blood

a. General Points:

1. LR 3, LR 8, UB18, DU8, LR 14

a. All with needles

b. Basic Herbal Patent Formula:

1. Tong Jing Wan

a. (Calm in the Sea of Life Pills)

4. Clear LR heat / fire

a. General Points:

1. LR 1, LR 2, UB18, DU8, LR 14

a. All with needles a. All with needles

b. Basic Herbal Patent Formula:

1. Long Dan Xie Gan Wan

a. Very Cold / Caution

5. Quell LR Wind

a. General Points:

1. LR 3, GB34, GB20, UB18, DU8, LR 14

a. All with needles

c. Spleen

1. Tonify SP Qi and Blood

a. General Points:

1. SP3, SP6, ST36, UB20, DU6, REN6,

a. All with moxa and needles

2. REN8

a. Moxa only

b. Basic Herbal Patent Formula: Ba Zhen Wan or Gui Pi Wan

2. Raise SP Qi

a. General Points:

1. DU20,

a. Moxa Only

2. SP3, SP6, ST36, REN6, REN8

a. All with moxa and needles

b. Basic Herbal Patent Formula:

1. Bu Zhong Yi Qi Wan

a. Not for long term use

3. Harmonize SP and LR

a. General Points:

1. SP6, LR3, LR13, UB18, UB20 1. SP6, LR3, LR13, UB18, UB20

a. All with needles

2. REN8

a. Moxa Only

b. Basic Herbal Patent Formula:

1. Xiao Yao Wan

4. Tonify the SP and Resolve Damp

a. Diet Is Most Important

b. General Points:

1. SP3, SP6, ST36, UB20, DU6, REN6,

a. All with moxa and needles

2. REN8

a. Moxa only

c. Basic Herbal Patent Formula:

1. Lui Jun Zi Wan d. Ht

1. Tonify Blood Deficiency

a. General Points:

1. Ht7, SP6, St36, UB20, UB15

a. All with needles

2. REN8

a. Moxa Only

b. Basic Herbal Patent Formula:

1. Gui Pi Wan or Suan Zao Ren Wan

2. Tonify Yin Deficiency

a. General Points:

1. Ht7, KD3, LR3, UB15, UB23, UB18

a. All with needles

b. Basic Herbal Patent Formula: a. All with needles

b. Basic Herbal Patent Formula:

1. Gui Pi Wan or Suan Zao Ren Wan

e. Uterus

1. Warm Cold

a. General Points:

1. REN2, KD11, SP12, ST30, REN4, REN6

a. All with needles and Moxa

2. REN8

a. Moxa Only

b. Basic Herbal Patent Formula:

1. Moxa Most Important Here

2. Move Blood

a. General Points:

1. LR3, SP8, UB31-34, UB23, REN2, KD11, SP12, ST30, REN4, REN6

a. All with needles

b. Basic Herbal Patent Formula:

1. Tong Jing Wan

3. Move QI

a. General Points:

1. LR3, SP6, UB31-34, UB23, REN2, KD11, SP12, ST30, REN4, REN6

a. All with needles

b. Basic Herbal Patent Formula:

1. Xiao Yao Wan

K. Specific Disorders K. Specific Disorders

1. Menstrual Irregularities

a. Most Common Tx principles

1. Harmonize Dai, Chong, & Ren

2. Harmonize Liver

3. Tonify Blood

4. Tonify Spleen

5. Tonify Kidneys

6. Move (invigorate) Blood

b. Early periods

1. Cycle less than 28 days

2. etiology and pathology

a. Qi Deficiency

b. Blood heat

1. Full

2. empty

3. Differentiation and tx

a. SP Qi Deficiency

b. KD Qi Deficiency

c. Full heat from LR Qi Stagnation turning to fire w/ Blood heat

d. Empty heat from LR and KD Yin Deficiency

c. Late periods

1. >28-30 day cycles

2. Etiology and pathology

a. Pregnancy

b. Blood Deficiency

c. Cold in the uterus

1. Full cold

2. Empty cold 2. Empty cold

a. KD Yang Deficiency

d. Qi stag

d. Irregular Periods

1. Sometimes early; sometimes late

a. Not pathological, immediately pre-menopausal.

2. Always related to LR., and often to KD

3. Etiology & Pathology

a. Emotional stress

1. LR Qi stag

2. LR Blood Deficiency

b. Overwork, too many children too close together

1. KD Yang Deficiency

2. KD Yin Deficiency

e. Heavy periods

1. Periods that occur regularly but are heavier than normal

a. Can be subjective (30-80ml is broad range)

2. Etiology and pathology:

a. Qi Deficiency

b. Blood Heat

c. Secondarily

1. Blood stasis

f. Scanty periods (not “late”)

1. Bleeding is very light, or lasts only 2-3 days

2. Etiology and pathology

a. Blood Deficiency (of the liver, mostly)

b. KD Yang Deficiency:

c. KD Yin Deficiency:

d. Stasis of Blood

e. Phlegm obstructing the uterus

g. Long periods

1. Prolonged bleeding which may last 7-10 days w/ normal amt of bleeding and reg. cycle

2. Etiology and pathology

a. Qi stag and Blood stasis

b. KD Yin Deficiency w/ empty heat

h. Painful periods

1. Diagnosis

a. LR Qi stagnation

b. Blood Stasis

c. Cold in Uterus

d. Pain May be Secondary to:

1. Damp-Heat

2. Stag LR Qi turns to fire

3. Qi, Blood, and or Yin Deficiency:

i. Bleeding Between Periods

1. SP/KD Yang Deficiency

2. Blood stasis

3. Damp Heat

4. LR and KD Yin Deficiency w/ empty heat

j. No Periods

1. Blood Deficiency

a. Ht and SP Blood Deficiency

2. SP and KD Yang Deficiency

3. LR and/or HT and/or KD Yin Deficiency

4. Stag of Qi and Blood

5. Damp-Phlegm in Uterus 5. Damp-Phlegm in Uterus

k. Flooding and Trickling

1. “beng lou”

a. beng = flooding, bursting through

b. lou = trickle metorrhagia

2. Be sure to take the common western differentiations into consideration:

a. carcinoma of the cervix

b. carcinoma of the uterus

c. myomas

d. endometriosis

e. endometrial polyps

3. There can be mixes of conditions (full and empty together)

a. Full Blood Heat

b. Liver Qi stag Turning into Heat

c. Stasis of blood

d. Damp Heat in the Uterus

e. SP not Holding Blood

f. KD Yang Deficiency

g. KD Yin Deficiency

2. Yeast Infections

a. Dampness in the Lower Warmer

1. Dai Mai, Lower Warmer Points

a. Cold

1. LR 3, KD 3, LR 5

2. Er Chen Wan

3. Wen Dai Tang

b. Heat

1. LR 2, KD 2, LR 5

2. Yu Dai Wan

3. Long Dan Xie Gan Wan

3. Genital Herpes

a. Damp Heat in the LR Meridian

1. LR 2, KD 2, LR 5

2. Long Dan Xie Gan Wan

4. Problems at Period time

a. PMS

1. LR Qi stag

a. Prognosis and Prevention

2. Secondary

a. LR blood Deficiency

b. SP and KD Yang Deficiency

c. LR and KD Yin Deficiency

d. Phlegm fire harassing upwards

b. Pre-Menstrual Breast distension

1. Etiology

2. LR Qi stag

a. Liver Blood Stasis

3. Secondary

a. Phlegm with Qi Stag

b. LR and KD Yin Deficiency

c. Headaches

1. Blood Deficiency

2. Secondary

a. Liver Fire Blazing

b. Liver Yang Rising

c. Blood Stasis

1. Face, hands, lower legs, ab. Usually before the period

2. LR Qi Stagnation

e. Diarrhea: Before, during or after period

1. SP Qi Deficiency

2. Liver Qi stagnation invading the Spleen

3. KD Yang Deficiency

f. Dizziness at Period Time

1. Includes blurry vision and may occur before, during or after the period

2. Blood Deficiency

3. KD and LR Yin Deficiency w/ Liver yang rising

4. Phlegm w/ SP Qi Deficiency

5. Diseases of Pregnancy

a. Cautions & Contraindications of Pregnancy

1. If a Woman Is or May Be Pregnant

2. Forbidden Points:

a. LI4 & SP6

b. GB 21, UB 67, UB 60

c. Any strong downward moving treatment

d. Points Below Umbilicus, Any Time During Pregnancy

e. Points Below Ren 12, Any Time After the First Trimester

3. Forbidden Treatments

a. Do Not Cause Sweating

1. No Diaphoretic Points or Herbs

b. Do Not Promote Downward Motion

1. No Purgative Points or Herbs

c. Do Not Promote Urination W/ Herbs That Drain Damp

1. No Diuretic Points or Herbs

b. Restless Fetus

1. Kidney 9

a. “Happy Baby Point” Dr. So: needle at end of first and second trimester – baby will not have colic, and will respect his/her parents

b. Located 5 cun superior to KD 3

c. Morning Sickness

1. Chong Mai Disturbance

2. Secondary

a. Accumulation of Phlegm

b. Stomach Qi Deficiency w/ empty cold

c. St Yin Deficiency

d. Stagnant Liver Qi invading the St

e. St Heat

f. Ht Qi Deficiency

g. HT Fire

d. Abdominal pain

1. Usually not severe but rule out ectopic pregnancy or threatened miscarriage.

2. “relatively frequent during pregnancy”

3. Qi Stagnation

4. Blood Deficiency

5. Empty Cold

e. Breech Baby

f. UB 67

g. Threatened miscarriage

1. TCM Types

a. Miscarriage Already Taking Place

1. Severe ab pain, uterine contractions and profuse vaginal bldg. W/ passing clots/ tissue and. Os of cervix is dilated

1. a harmless vaginal bleeding during the 1st month of pregnancy

c. Toi Lou = “Vaginal Bleeding during Pregnancy”:

1. threatened miscarriage, w/ vaginal bleeding

d. Tai Dong Bu An = “Restless Fetus”:

1. threatened miscarriage, w/ vaginal bleeding, backache, ab pain and a bearing-down feeling

e. Duo Tai = “Falling Fetus”:

1. miscarriage w/in the first 3 months

f. Xiao Chan / Ban Chan = Small Labor” or “Half Labor”:

1. miscarriage after 3 months

g. Hua tai = “Slippery Fetus”:

1. habitual miscarriage

2. Etiology:

a. Qi and Blood Deficiency

b. Blood Heat

c. Ren, Du, and/or Chong weakness,

1. may be manifesting as KD Deficiency

d. Falls, trauma

1. injure the Ren and Chong

3. Tx: Treat the Root and “Calm the Fetus” and tonify Chong and Ren

h. Constipation during Pregnancy

1. Common. Can’t use purging or downward Qi promoting herbs or points

2. Etiology:

a. Blood Deficiency

b. Liver- Qi stag

c. KD Yang Deficiency

d. KD Yin Deficiency

6. Diseases after childbirth:

a. Postpartum Depression

1. Ht Blood Deficiency

2. Secondary

a. Ht Yin Deficiency

b. Ht Blood Stasis

b. Abdominal pain after childbirth

1. Blood Deficiency

2. Blood Stasis

3. Retention of Food

c. Persistent Discharge of lochia

1. >6 Weeks

2. Qi Deficiency

3. Blood Stasis

4. Blood-Heat

d. Lochial retention

1. Qi and Blood stagnation

2. Stagnation of Cold and stasis of Blood

e. Prolapse and Hemorrhoids after Childbirth

1. Blood Deficiency

2. Spleen Qi Sinking

3. Kid-Yang Deficiency

f. Constipation after Childbirth

1. Blood Deficiency

2. Spleen Qi Deficiency

3. Kid-Yang Deficiency

4. Kid-Yin Deficiency

1. Qi & Blood Deficiency

2. Liver-Qi stagnation

3. Acute Mastitis:

a. Toxic Heat affecting the Liver, St and GB

7. Infertility

a. Chong Mai, Dai Mai,

b. KD Yang Deficiency, KD Yin Deficiency

c. Qi & Blood Deficiency

1. Tonify Spleen, Tonify Kidney

d. Cold in Uterus

e. Qi Stagnation

f. Stasis of Blood

g. Dampness in the Lower Jiao

h. Blood Heat

i. Note: Male infertility can be from any of the above, but is usually KD Yang Deficiency

8. Breast lumps

a. Liver Qi Stag

b. Disharmony of Ren and Chong

c. Spleen Yang Deficiency w/ Phlegm

9. Abdominal Masses

a. Qi masses

1. Liver Qi stag

2. Retention of Food and Phlegm

b. Blood masses

1. Stagnation of Qi and Blood

10. Polycystic ovary disease

a. KD Yang Deficiency, Phlegm, Dampness and Blood Stasis

11. Menopause

a. KD Yin Deficiency

b. KD and Liver Yin Deficiency w/ Liver Yang rising

c. KD Yin and/or KD Yang Deficiency

d. KD and Ht not harmonized

12. Osteoporosis

a. Kidney Yin, Yang, or Jing Deficiency

L. Women’s Health: Name That Disharmony: Final Review 1. A 24 year old woman presents with the following signs and symptoms: excessive menstrual bleeding, the menstrual flow is pale and dilute, the patient also has loose stools, fatigue, pale thin tongue with a white coat, pale and lusterless face, lack of appetite, weak limbs, and a weak and thin pulse. What is the best working diagnosis for this patient?

2. A 24 year old woman presents with the following signs and symptoms: PMS mood swings, severe tenderness, and abdominal pain all increasing until the first day of bleeding; chronic neck and shoulder tension, pain in rib cage, plumb pit throat, pain on palpation on abdomen lower left side, slightly purple tongue, wiry pulse. What is the best working diagnosis for this patient?

3. A 36 year old woman presents with the following signs and symptoms: postpartum depression, fatigue, palpitations, a weak thin pulse, forgetfulness, confusion, pale thin tongue with white coat. and a pale lusterless face. What is the best working diagnosis for this patient?

4. A 48 year old woman presents with the following signs and symptoms: insomnia, chronic dry, sore throat, malor flush, restlessness, palpitations, weak legs, low back pain, dark scanty urination, thin red tongue with a peeled coat, thin rapid pulse. What is the best working diagnosis for this patient?

5. A 48 year old woman presents with the following signs and symptoms: lowered libido, sore low back which feels better with heat, frequent clear copious urination, , fatigue, pale face, weak and slow pulse, pale and puffy tongue with a wet coat. What is the best working diagnosis for this patient?

6. A 36 year old woman presents with the following signs and symptoms: asthma, restlessness, insomnia, dry stools with constipation, thin and rapid pulse, thin red tongue with no coat. What is the best working diagnosis for this patient?

7. A 24 year old woman presents with the following signs and symptoms: excessive white leucorrhea, fatigue , chronic diarrhea, palpitations, thin pale tongue with a greasy white coat, pale lusterless face, thin weak and slippery pulse. What is the best working diagnosis for this patient?

M. Women’s Health Reference Tables

Mai Master Coupled Women’s Health Indications Coalescent Points Point Point Controls Menses: Chong SP4 P6 REN 7, 1, ST 30, Regulates Menstrual Quantity & Flow, Enters K 11- KI 27 Uterus Yin Aspects of Fertility/Conception: Ren LU7 KD6 REN 2- 15, S1, Regulates Hormones w/Du, Menstrual DU28 Timing Int. & Ext. Genitalia Governs the Yang of fertility & DU 2-4 Du SI3 UB62 B12, Conception REN1 Regulates Hormones with the Ren Mai (thru hypothalamus & Pituitary & adrenals) Opens Lower Warmer: Dai GB41 SJ5 GB 26, 27 & 28 Moves Liver Qi Resolves Damp Heat and Damp Cold in Lower Warmer Nourish Blood Calm the Mind, Affect the Yang SJ5 GB41 GB 13 – 21, DU 15 & 16, SJ 15, SI 10, Wei Heart GB 35, UB 63,

Yin Wei P6 SP4 K 9, LR 14, SP 13, 15 & 16, REN 22 & 23 Secondary for Masses, Fibroids, Adhesions, UB 1, 59 & 61, GB 20 & 29, Yang UB62 SI3 SI 10, LI 15 & 16, ST 1, 3 & 4, Qiao (Excess in Lower Warmer)

Yin KD6 LU7 UB 1, ST 9, KI 8 Qiao

Condition Common Formula Blood Stagnation Tong Jing Wan LR Qi Stagnation Xiao Yao Wan Qi & Blood Deficiency Ba Zhen Tang LR Blood Deficiency Suan Zao Ren HT & SP Blood Deficiency Gui Pi Wan Sp Qi Deficiency Sinking Bu Zhong Yi Qi Wan LR / GB Damp Heat Long Dan Xie Gan Wan LR / KD Yin Deficiency Lui Wei Di Huang Wan KD Yang Deficiency Jin Gui Shen Qi Wan Stop Bleeding / Move Blood Yunan Bai Yao Yin Deficiency/Heat. Wise Woman’s Well (K’an) © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Two Immortals (Health Concerns) 234

3. National Board Exam Review & Program Review

A. Weekend 9 Introduction

a. This class will cover the information needed to effectively apply acupuncture in clinical settings, and to pass the National Boards in Acupuncture

b. Differing levels of understanding of the material apply to the various national exams. 1. NBCE 2. ACA 3. NCCAOM

1. This is a Review Class assumes that each participant either knows the information being presented, and knows where to find supplemental information. A. Books 1. The Acupuncture Cookbook: by Jim Ventresca 2. The Web That Has No Weaver: by Ted Kaptchuck 3. Acupuncture Clean Needle Technique Manual http://www.ccaom.org/cntprogram.asp 4. The Foundations of Chinese Medicine: by Giovani Maccocia 5. A Manual of Acupuncture: by Peter Deadman and Mazin Al-Khafaji with Kevin Baker B. History: 1. Seminal & Important Books a. Nei Jing: Yellow Emperor’s Internal Classic of Medicine 1. Oldest extant book on Acupuncture & Chinese Medicine a. Probably written between 300 and 100 BCE b. The Nan Jing 1. Written in the Han Dynasty 206 BCE - 220 CE C. The Five Branches of Oriental Medicine 1. Acupuncture/Moxibustion 2. Herbal Medicine 3. Exercise : Qi Gong Tai Ji 4. Diet/Lifestyle 5. Massage & Manipulation D. Yin Yang 1. General Theory a. Everything consists of Yin & Yang b. Yin & Yang are Relative terms that exist only in relationship to one another c. Nothing is totally Yin or totally Yang d. If Yin increases, Yang decreases and vice versa e. Yang produces Yin and Yin produces yang 235 © 1994 - 2013 Jamesf. VentrescaEach AcuPractice™ is necessary Seminars for the other’s - www.AcuPracticeSeminars.com existence g. Yin & Yang are Inﬁnitely Divisible e. Yang produces Yin and Yin produces yang 235 © 1994 - 2013 Jamesf. VentrescaEach AcuPractice™ is necessary Seminars for the other’s - www.AcuPracticeSeminars.com existence g. Yin & Yang are Inﬁnitely Divisible

h. Yin & Yang are Inter-transformational Inter-consuming & Inter-supporting i. At extremes Yin and Yang transform into one another

Functions of Yin & Yang Energies in the Body FUNCTIONS OF YANG ENERGY IN THE BODY FUNCTIONS OF YIN ENERGY IN THE BODY Warms Cools Moves, Activates, Circulates Provides Rest the Ability to Rest Protects / Provides Defense Provides the Ability to Recover from Disease Transforms - Brings About Change Maintains Structure Holds Up and In Place: Blood, Fluids, & Organs Nourishes & Moistens: Blood, Fluids, & Organs

2. Yin/Yang Table of Correspondences DISORDERS WHICH ARE YANG IN NATURE DISORDERS WHICH ARE YIN IN NATURE ARE ARE ASSOCIATED WITH ASSOCIATED WITH Excess Yang or Deficient Yin Excess Yin or Deficient Yang Acute / Rapid Onset Chronic / Slow Onset Activity / Daytime / Insomnia Rest / Nighttime / Sleepiness Stretch Out To Sleep - Throws Off Covers Curls Up In Sleep - Likes To Be Covered Heat Signs: Red Efflorescences / Rapid Pulse / Cold Signs: Pale Efflorescences / Slow, or at least Not Rapid Pulse Thirst: Likes Cold Drinks No Thirst: Sips Warm Drinks Loud Voice - Extrovert Soft/Weak Voice - Introvert

3. Anatomy of Yin/Yang Relationship Within Body BODY AREAS WHICH ARE YANG (CONTRASTED BODY AREAS WHICH ARE YIN (CONTRASTED WITH YIN AREAS) WITH YANG AREAS) Superior Inferior Posterior Anterior Lateral Medial External Internal

E. Eight Principles Four Sets of Parameters a. Yin / Yang b. Excess / Deﬁcient c. Internal / External d. Hot / Cold 2. Yin / Yang a. Based on the other 6 principles 3. Excess / Deficient a. There are Many Various Signs of Excesses and Deﬁciencies in Organs, Substances, and Meridians. 4. Internal / External a. Location of Disease or Etiology 1. Internal a. Many manifestations within the Organs Bones & Blood 2. External a. Skin b. Muscles c. Meridians (Channels & Collaterals) d. Lungs: 1. Special Case: Upper Respiratory Infection (OPI/EPI/EPF)

Hot / Cold

DESCRIPTION OF PATHOLOGY TREATMENT PRINCIPLE CONDITION

NORMAL BALANCED CONDITION N/A N/A

TRUE EXCESS YIN CONDITION TRUE COLD SEDATE YIN

TRUE EXCESS YANG CONDITION TRUE HEAT SEDATE YANG

DEFICIENCY OF YIN CONDITION FALSE HEAT TONIFY YIN (HEAT FROM DEFICIENCY)

DEFICIENCY OF YANG CONDITION FALSE COLD TONIFY YANG (COLD FROM DEFICIENCY)

a. Hot Excess, Full or True Heat Deficient Yin (False Heat) (Usually Seen in OPI Heat) (A Condition which is Yang in Nature) Thirst Dry Mouth Red Face / Red eyes Malor Flush Full (Daytime) Sweat Night Sweats Full Fever PM Fever / PM Hot Flashes / Heat in 5 Hearts Sore/Painful Throat Chronic, Dry, Scratchy Throat Strong Cough Chronic, Dry, Weak Cough Dark, Scanty, Urine (Burning if severe) Dark, Scanty Urine Constipation (w/ discomfort) / Hot Diarrhea Dry Stool / Constipation Full, Rapid, Pulse Thin, Rapid, Pulse Red Tongue / Yellow Coat Red Tongue / No Coat (Peeled)

b. Cold Excess /Full / True Cold Deficient Yang (False Cold) (Often Seen in OPI Cold) (A Condition which is Yin in Nature) Clear Copious Urine SAME Preference for Warm Liquids SAME Cramping Pain Better with Heat SAME No Thirst SAME Chills Cold Body /Hands & Feet Pale Face Pale Face Cramping Pain No Pain Associated Cold Diarrhea Loose Stools / Undigested Food Thick White Tongue Coat Pale Puffy Tongue / Wet Coat Full & Tight Pulse Weak & Slow Pulse

F. Five Elements

FIRE

Sheng Cycle >

EARTH

Ko Cycle> WOOD

METAL WATER

1. Cycles & Pathology a. Within each phase/element are Yin and Yang aspects, sometimes referred to as the husband-wife relationship b. Creative or Generating Cycle (Sheng) 1. AKA: Mother / Son Cycle 2. Deficiency Creates Deficiency (2) 3. Excess Creates Excess (1) c. Control Cycle (Ko) 1. AKA: Grandmother / Grandson relationship 2. Excess Creates Deficiency (2) 3. Deficiency Creates Excess (1) 239 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

2. AcuPractice’s Table of 5 Element Correspondences CATEGORY WOOD FIRE EARTH METAL WATER SEASON Spring Summer Late Summer Fall Winter CYCLE Birth Growth Maturity Harvest Rest / Storage ZANG: Solid / Liver Heart PC Spleen Lungs Kidney Yin Organ FU: Hollow / Gall Bladder S I SJ Stomach Lg. Intestine Bladder Yang Organ CLIMATE Wind Heat Damp Dry Cold ORIFICE Eyes Tongue Mouth Nose Ears SENSE Vision Speech Taste Smell Hearing BODY TISSUE Tendons / Blood & Flesh Skin Teeth, Bone & Sinews Blood Vessels Marrow TONGUE Sides Tip Center Behind Tip Root RESIDUES Nails Complexion Lips Body Hair Head Hair COLOR Green Red Yellow White Black (Blue) SOUND Shouting Laughing Singing Weeping Groaning OFFICE General Sovereign Minister of Architect Treasurer & DUTY Planning Ruling Agriculture Create Order Store Essence Nourishing STORAGE Benevolence Righteous Faith Vitality Wisdom SPIRITS Hun Shen Yi Po Zhi (Soul) (Spirit) (Thoughts) (Skeleton) (Will) EMOTION Anger Joy Over Thinking Grief Fear BODY FLUID Tears Sweat Saliva Nasal Mucus Internal Moisture TASTE Sour Bitter Sweet Pungent Salty ODOR Sour Burnt Fragrant Putrid Musty © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 240

G. Chronotherapy (The Horary Cycle) 1. 3-5AM / LU 2. 5-7AM / LI 3. 7-9AM / ST 4. 9-11AM / SP 5. 11AM-1PM / HT 6. 1-3PM / SI 7. 3-5PM / UB 8. 5-7PM / KD 9. 7-9 PM / PC 10. 9-11PM / SJ 11. 11PM - 1AM / GB 12. 1-3AM / LR H. The Essential Substances 1. Qi, Xue (Blood), Jing (Essence), Shen (Spirit), Jin Ye (Fluids) 2. Qi a. Energy, Prana, Life-force, Innate b. The Body Is It’s Physical Manifestation c. Circulates Inside and Outside the Meridians d. Origin 1. Constitution 2. Food / Drink 3. Air/ Environment e. Functions Of Qi 1. Activation Or Movement 2. Warmth 3. Transformation 4. Defense 5. Containment f. Imbalances Of Qi 1. Deficient Qi (Qi Deficiency) a. Signs & Symptoms (S&S) 1. Fatigue 2. Malaise 3. Pale Face 4. Weak Pulse 5. Pale & Swollen (Puffy) Tongue 6. Organ Dysfunction 2. Collapsed Qi a. S&S (Two Presentations) 1. Qi Deficiency S & S + Prolapse 2. Qi Deficiency S & S + Heart Attack 3. Stagnant Qi (Qi Yu) a. S&S 1. Dull Achy Pain / Unfixed in Time And Space 2. Intermittent Or Traveling Pain 3. Feels Better With Massage Strokes 4. Intercostal Neuralgia (LR Qi Yu) 2. Intermittent Or Traveling Pain 3. Feels Better With Massage Strokes 4. Intercostal Neuralgia (LR Qi Yu) 4. Rebellious Qi 241 © 1994 - 2013 James Ventresca AcuPractice™a. Moving Seminars In The Opposite - www.AcuPracticeSeminars.com Direction b. S&S 1. Nausea / Vomiting / Acid Reflux

b. Formed At Conception; Inherited From The Parents c. Governs Growth and Development d. Stored In The Kidneys e. Imbalance: Jing Deﬁciency 1. Poor Development In Children 2. Poor Concentration / Memory 3. Reproductive Disorders 4. Loose Teeth 5. Brittle Bones 6. Gray-Thinning Hair 7. Senility 4. Blood a. Blood Is Yin In Relationship To Qi b. Blood Is A Fluid and a Type of Qi 1. Liquid Form Of Qi (Yin In Nature) c. Functions: 1. Nourishes All Parts Of The Body 2. Moistens All Parts Of The Body a. Esp. Tendons, Eyes, Hair 3. Maintains Physical Structure 4. Cools 5. Calms 6. Provides Rest & Ability to Rest d. Relationships Of Blood: 1. Heart: Moves It Through Body 2. Liver: Stores and Releases (includes Menstrual Blood) 3. Spleen: Produces Blood & Holds It In the Vessels e. Disharmonies Of Blood: 1. Deficient Blood (Xue Deficiency) a. Signs & Symptoms (S&S) 1. Similar to Qi Deficiency, but with the addition of Lack of Nourishment, and Moistening 2. Fatigue 3. Malaise 4. Pale Lusterless Face 5. Weak Thin Pulse 6. Pale & Thin Tongue 7. Organ Dysfunction 8. Dry Skin 9. Brittle Hair 10. Twitches And Spasms (Due To Drying Out Of Tendons) 11. Scanty/Light/Shortened/Infrequent Menses 12. Dizziness 13. Difficulty Falling Asleep (Yin Substance) 14. Dry Eyes (Liver) 2. Stuck Blood (Xue Yu) 13. Difficulty Falling Asleep (Yin Substance) 14. Dry Eyes (Liver) 2. Stuck Blood (Xue Yu) a. Sharp, Stabbing Pain Fixed in Time & Space © 1994-2013 James Ventresca AcuPractice™b. Tumors Seminars Or Cysts - www.AcuPracticeSeminars.com (Non-Moving) c. Swollen Organs 242 d. Hematoma

5. Fluids: Jin Ye a. Includes All Normal Bodily Fluids Except Blood b. Jin: Clear, More Yang, Watery c. Ye: Thick, Internal, More Yin 6. Shen (Spirit) a. Spirit That Is Stored In The Heart and Reﬂected in the Eyes b. Disharmonies Of Shen: 1. Emotional Problems, Psychological And Emotional Shock, Disturbances Of Psychological/Mental Nature I. The Causes of Disease or Pathogenic Factors 1. External Pathogenic Factors a. The Evil Winds 1. Wind 2. Cold 3. Damp 4. Dryness 5. Heat 6. Summer Heat 2. Internal Pathogenic Factors a. The Emotions 1. Anger 2. Joy 3. Melancholy & Grief 4. Meditation (Over thinking) 5. Fear 6. Fright 3. Miscellaneous Pathogenic Factors a. Inappropriate Diet b. Inappropriate Exercise c. Inappropriate Timing d. Parasites e. Trauma f. Insect / Animal Bites g. Epidemics h. Wrong Treatment i. Excess Sex j. Drug Use, Contact / Environmental, Etc. k. Perhaps Bad Feng Shui J. Organs 1. Lung a. AKA: Tender Organ, Master Of Qi b. Opens To The Nose & Throat c. Most Easily Affected By OPI d. Dislikes Cold And Dryness b. Opens To The Nose & Throat c. Most Easily Affected By OPI d. Dislikes Cold And Dryness e. Properties 243 © 1994 - 2013 James Ventresca1. AcuPractice™Liquefies Seminars - www.AcuPracticeSeminars.com 2. Descends 3. Disseminates

g. Common Disharmonies: 1. LU Qi Deficiency 2. LU Yin Deficiency 3. Rebellious Qi in LU 4. OPI 5. Dampness. Phlegm in LU h. Major S&S 1. Respiratory 2. Large Intestine a. The Ofﬁcial In Charge Of The Dregs b. Dependent Upon Lungs For Descending 3. Spleen a. AKA: The Ofﬁcial In Charge Of Transportation And Transformation (T&T) 1. Governs T&T of Qi, Blood & Jin Ye b. Holds Blood & Organs in Place c. Opens To The Mouth d. Manifests In The Lips e. Dislikes Dampness & Cold f. Functions g. Rules The Flesh & Muscles h. Common Disharmonies: 1. SP Qi Deficiency 2. SP Blood Deficiency 3. SP Yang Deficiency 4. Dampness in SP 5. Major S&S a. Lower Digestive b. Fatigue

4. Stomach a. The Ofﬁcial In Charge Of Rotting And Ripening 1. Prepares Food and Drink for T&T by the Spleen b. Common Disharmonies: 1. Rebellious ST Qi 2. Heat in the ST 3. Major S&S a. Upper Digestive Heart a. AKA: The Emperor b. Houses The Consciousness / Shen c. Rules Blood And Blood Vessels d. Dislikes Heat e. Opens To The Tongue c. Rules Blood And Blood Vessels d. Dislikes Heat e. Opens To The Tongue f. Manifests In The Complexion g. Common Disharmonies: © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 1. Heart Blood Deficiency 244 2. Heart Yin Deficiency 3. Blood Stagnation in the Heart or Chest

b. Palpitations 6. Small Intestine a. Separates The Pure From The Impure 7. Liver a. AKA 1. The General a. Charge of Planning 2. Free & Easy Wanderer a. Maintains easy going internal environment 3. Sea of Blood (Stores) 4. The Master Alchemist / transmutes and detoxifies b. Opens To The Eyes c. Dislikes WIND (Heat / Stagnation) d. Responsible for the Smooth and Easy Flow of Qi & Emotions e. Rules the Tendons & Muscles f. Houses the Hun (ego) g. Controls the eyes h. Common Disharmonies: 1. Liver Qi Stagnation 2. Liver Invading a. Stomach b. Spleen c. Lung 3. Liver Blood Stagnation a. Painful periods, Clots, Sharp Stabbing Pain 4. Damp-Heat in the Liver and Gall Bladder i. Major S&S: 1. Stress Related Disorders 2. Tight/Tense Muscles 3. Tics, Twitches & Tremors 4. Anger / Irritability 5. Gynecological problems 6. Meridian related Sx. 8. Gall Bladder a. The Ofﬁcial in Charge of Decision Making b. Dislikes Wind c. Very Closely Related to the LR 9. Kidney a. AKA 1. Root of Yin a. HT, LR 2. Root of Yang a. SP a. HT, LR 2. Root of Yang a. SP 3. Root of Qi 4. Root of Life Opens To The Ears 245 © 1994 - 2013 Jamesb. Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Dislikes Cold c. d. Functions

7. Nourishes and Warms (supplies Yin & Yang to) the Lower Warmer e. Common Disharmonies: 1. Deficiencies ONLY: NO Excess Conditions 2. KD Qi Deficiency 3. KD Yang Deficiency 4. KD Yin Deficiency 5. KD Jing Deficiency f. Major S&S: 1. General Qi & Yang Deficiency S & Sx 2. General Yin Deficiency S & Sx 3. Low Back / Knee Pain and Weakness 4. Impotence and Infertility 5. Incontinence / Urinary Frequency 6. S&S of Premature Ageing 10. Urinary Bladder a. Transforming and excreting ﬂuids via the power of KD Qi Pericardium a. The Minister: Insulates, Screens, & Protects The Heart b. Maintains The Order Of The Heart Energy c. Treats All Heart Disorders Organic & Spirit 12. San Jiao (Triple Warmer) a. AKA: Triple Heater, Triple Warmer, Triple Energizer b. San Jiao: Literally Three Burning Spaces 1. Upper Jiao a. LU & HT b. Respiration & Circulation 2. Middle Jiao a. SP & ST b. Digestion & Assimilation 3. Lower Jiao a. KD, UB & Reproductive Organs b. Elimination & Reproduction c. The Three Jiaos are collectively responsible for Water Metabolism (Classically Described As A System Of Sluices Or Waterways) 1. Lung Adjusts Water a. Descends & Disseminates 2. Spleen Transforms Water a. T & T (Sends it Up 3. Kidney Rules Water 13. Extraordinary (Curious) Organs a. Fu Shape /Store Essences 13. Extraordinary (Curious) Organs a. Fu Shape /Store Essences b. Six Curious Organs 1. Gall Bladder 2. Brain © 1994-2013 James Ventresca3. AcuPractice™Marrow Seminars - www.AcuPracticeSeminars.com 4. Bone 246 5. Blood Vessels

2. Ren Mai (Conception Vessel) 3. Chong Mai (Penetrating Vessel) 4. Dai Mai (Belt Meridian) 5. Yang Wei Mai 6. Yin Wei Mai 7. Yin Qiao Mai 8. Yang Qiao Mai b. Origin 1. Created at conception 2. Deep energies c. General Functions 1. Reservoirs of Qi 247 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

K. Tongue and Pulse Diagnosis Condition Tongue Pulse Normal Normal Red Moderate Strength Thin White Coat Fills Middle - Touches Superﬁcial & Deep Slightly Slippery

Qi Deﬁciency Pale & Puffy Weak Thin White Coat

Yang Deﬁciency Pale & Puffy Weak & Slow Wet Coat

Blood Deﬁciency Pale & Thin Weak & Thin Dry Thin White Coat

Yin Deﬁciency Red & Thin Weak & Thin & Rapid Dry No / Peeled Coat

True / Excess Heat Red Full & Rapid Dry Thick Yellow Coat

Dampness Greasy Coat Slippery

Qi Stagnation Slightly Purple Slightly Wiry

Blood Stagnation Dark Purple Deﬁnitely Wiry (Maybe Spots)

OPI Heat Red Tip Rapid & Floating Red Edges

OPI Cold Normal Floating

Long-Standing SP Xu Scalloped Edges Weak in Middle Position

LR Qi Stagnation Slightly Purple Full & Wiry

Tongue A. Areas

L. Clean Needle Technique 1. ALWAYS: a. Wash Hands Between Patients & Whenever Contaminated b. Use Sterile Needles c. Establish a Clean Field d. Wash Hands Prior to Inserting Needles if Hands Have Been Contaminated e. Isolate Used Needles Immediately 2. Universal Precautions: Prevention of Exposure and Prevention of Disease if Exposure Occurs. a. Use with All Patients b. Hand Washing 1. # 1 for Infection Control 2. Soap & Running Water 10 Seconds Minimum Alcohol Based Hand Disinfectants are Acceptable for Hand 1. # 1 for Infection Control 2. Soap & Running Water 10 Seconds Minimum 3. Alcohol Based Hand Disinfectants are Acceptable for Hand Washing c. Gloves, Gowns, Masks, Goggles etc. when needed d. Use Sterile and/or Clean Equipment and Work Areas as directed 249 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

3. Sterile vs. Clean a. Sterilization 1. Needles & other Instruments that Penetrate the Skin or Touch the Mucous Membrane 2. Bleach Solution for Non-Porous Items a. 1:10 solution Bleach: Water b. Soak for 1 hour c. Use within 24 hours b. Disinfection / Antisepsis/ 70% Isopropyl Alcohol 1. Use on Clean Skin to reduce pathogens and inanimate objects on the skin c. Clean Technique 1. Using Sterilization, Disinfection, Antisepsis, washing, etc. 4. Clean Field a. The area prepared to contain acupuncture equipment & supplies b. Clean Tray or Paper Towel Work Surface 1. Sealed/Open Needles 2. Alcohol Swabs 3. Dry Cotton Balls 4. Gloves 5. Clean Instruments a. Gua Sha Tool b. Cups c. Forceps d. Ear Probe e. Etc. c. Off the clean ﬁeld 1. Waste container a. Plastic Lined Paper Bag 2. Biohazard Container 3. Other Non-Clean Items: a. Pens b. Discarded Insertion tubes and wrappers c. Etc. 5. Needles Must be Sterile a. Use Single-Use Disposable Needles b. Avoid Contamination when removing needles from packaging 6. Cups and Guasha Tools a. If no bleeding occurs: Cups May be Cleaned with Soap and Water 6. Cups and Guasha Tools a. If no bleeding occurs: Cups May be Cleaned with Soap and Water b. If Bleeding occurs: Cups Must be Cleaned and Sterilized (Bleach Solution) 7. Biohazard Containers a. Needles ONLY in Biohazard Containers 1. Cotton balls, ONLY IF SOAKED WITH BLOOD © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 2. Cotton balls tinged with blood are disposed in double bagged 250 waste b. Disposal

a. Train Staff Carefully in 1. Recognition of Contaminated Needles 2. Ofﬁce Procedures Regarding Needles 3. Handling Contaminated Needles 4. Needle Sticks b. Needle Stick 1. Use Caution to Avoid 2. CDC Recommends a. Consult a Physician Immediately b. Test Source for HBV, HCV, HIV within 2 hours if possible c. Begin Treatment ASAP, if required c. Blood Exposure 1. Glove Carefully 2. Double Glove when necessary 9. Acupuncture Patient Side Effects a. High Risk Patients 1. Use Universal Precautions b. Needle Sickness / Fainting 1. Vasovagal Response 2. Remove Needles, Have Patient Lie Down 3. Perhaps a few sips of water c. Pain / Bruising / Swelling at Needle Site d. Stuck Needle e. Forgotten Needle f. Neuritis g. Moxa Burns 1. Use Caution 2. Assess Patient’s Heat Tolerance a. Neural injury, diabetes, paralysis, etc. 3. Treat w/ Western Medical Techniques 4. Sterile dressing 5. Appropriate referral h. Abscess i. Allergic Dermatitis j. Broken Needle 1. Leave some shaft visible k. Auricular Chondritis l. Pneumothorax m. Organ Puncture 1. Eyes 2. Veins/Arteries a. 30 sec – 5 minutes direct pressure 3. Enlarged a. Heart b. Liver 3. Enlarged a. Heart b. Liver c. Spleen d. Kidney 4. Spinal Cord

a. Exercise Caution With DU 15 & DU16 (GV 15 & GV 16) n. Seizures 10. Contraindications and Cautions a. Always use Caution when treating Patients who are or may be 1. Pregnant 2. Elderly 3. Imunocomprimised 4. Diabetic 5. Very Tired 6. Very Hungry 7. Under the inﬂuence of any Mind Altering/Pain Relieving Medications 8. Numb in an area to be treated b. Points Contraindicated in Pregnancy 1. LI 4 2. SP 6 3. GB 21 (Caution) 4. Points on the Abdomen (Caution) 5. Points on the Lower Back (Caution) c. GB 21 Contraindicated for patients with Heart Conditions d. Electro-Acupuncture Contraindicated for patients with 1. Pacemakers and other electrical implants 2. History of Seizure Disorders 3. Strongly Recommended not to apply electro- acupuncture across the heart (i.e. Chest to Back/ Left to Right/ Arm to Arm) M. Acupuncture Techniques 1. Introduction a. Acupuncture/Moxibustion 1. Needles a. Standard b. Retained c. Bleeding 2. Moxa a. Direct b. Indirect b. Electro-Acupuncture 1. Milliamp & Microamp 2. Invasive / Non-Invasive c. Non-invasive Techniques 1. Cupping 2. Guasha c. Non-invasive Techniques 1. Cupping 2. Guasha 3. LASER 4. Pressballs / Seeds 5. Magnets 2. Clean Needle Technique a. ALWAYS:

1. Wash Hands Between Patients & Whenever Contaminated 2. Use Sterile Needles 3. Establish a Clean Field 4. Wash Hands Prior to Inserting Needles if Hands Have Been Contaminated 5. Isolate Used Needles Immediately b. Universal Precautions: Prevention of Exposure and Prevention of Disease if Exposure Occurs. 1. Use with All Patients 2. Hand Washing a. # 1 for Infection Control b. Soap & Running Water 10 Seconds Minimum c. Alcohol Based Hand Disinfectants are Acceptable for Hand Washing 3. Gloves, Gowns, Masks, Goggles etc. when needed 4. Use Sterile and/or Clean Equipment and Work Areas as directed c. Sterile vs. Clean 1. Sterilization a. Needles & other Instruments that Penetrate the Skin or Touch the Mucous Membrane b. Bleach Solution for Non-Porous Items 1. 1:10 solution Bleach: Water 2. Soak for 1 hour 3. Use within 24 hours 2. Disinfection / Antisepsis/ 70% Isopropyl Alcohol a. Use on Clean Skin to reduce pathogens and inanimate objects on the skin 3. Clean Technique a. Using Sterilization, Disinfection, Antisepsis, washing, etc. d. Clean Field 1. The area prepared to contain acupuncture equipment & supplies 2. Clean Tray or Paper Towel Work Surface a. Sealed/Open Needles b. Alcohol Swabs c. Dry Cotton Balls d. Gloves e. Clean Instruments 1. Gua Sha Tool 2. Cups 3. Forceps 1. Gua Sha Tool 2. Cups 3. Forceps 4. Ear Probe 5. Etc. 3. Off the clean ﬁeld a. Waste container 1. Plastic Lined Paper Bag b. Biohazard Container

c. Other Non-Clean Items: 1. Pens 2. Discarded Insertion tubes and wrappers 3. Etc. e. Needles Must be Sterile 1. Use Single-Use Disposable Needles 2. Avoid Contamination when removing needles from packaging f. Cups and Guasha Tools 1. If no bleeding occurs: Cups May be Cleaned with Soap and Water 2. If Bleeding occurs: Cups Must be Cleaned and Sterilized (Bleach Solution) g. Biohazard Containers 1. Needles ONLY in Biohazard Containers a. Cotton balls, ONLY IF SOAKED WITH BLOOD b. Cotton balls tinged with blood are disposed in double bagged waste 2. Disposal 3. Storage 4. Transportation 3. Risk to Acupuncture Providers a. Train Staff Carefully in 1. Recognition of Contaminated Needles 2. Ofﬁce Procedures Regarding Needles 3. Handling Contaminated Needles 4. Needle Sticks b. Needle Stick 1. Use Caution to Avoid 2. CDC Recommends a. Consult a Physician Immediately b. Test Source for HBV, HCV, HIV within 2 hours if possible c. Begin Treatment ASAP, if required c. Blood Exposure 1. Glove Carefully 2. Double Glove when necessary 4. Acupuncture Patient Side Effects a. High Risk Patients 1. Use Universal Precautions b. Needle Sickness / Fainting 1. Vasovagal Response 2. Remove Needles, Have Patient Lie Down 3. Perhaps a few sips of water 1. Vasovagal Response 2. Remove Needles, Have Patient Lie Down 3. Perhaps a few sips of water c. Pain / Bruising / Swelling at Needle Site d. Stuck Needle e. Forgotten Needle f. Neuritis g. Moxa Burns 1. Use Caution

2. Assess Patient’s Heat Tolerance a. Neural injury, diabetes, paralysis, etc. 3. Treat w/ Western Medical Techniques 4. Sterile dressing 5. Appropriate referral h. Abscess i. Allergic Dermatitis j. Broken Needle 1. Leave some shaft visible k. Auricular Chondritis l. Pneumothorax m. Organ Puncture 1. Eyes 2. Veins/Arteries a. 30 sec – 5 minutes direct pressure 3. Enlarged a. Heart b. Liver c. Spleen d. Kidney 4. Spinal Cord a. Exercise Caution With DU 15 & DU16 (GV 15 & GV 16) n. Seizures 5. Contraindications and Cautions a. Always use Caution when treating Patients who are or may be 1. Pregnant 2. Elderly 3. Imunocomprimised 4. Diabetic 5. Very Tired 6. Very Hungry 7. Under the inﬂuence of any Mind Altering/Pain Relieving Medications 8. Numb in an area to be treated b. Points Contraindicated in Pregnancy 1. LI 4 2. SP 6 3. GB 21 (Caution) 4. Points on the Abdomen (Caution) 5. Points on the Lower Back (Caution) c. GB 21 Contraindicated for patients with Heart Conditions d. Electro-Acupuncture Contraindicated for patients with 5. Points on the Lower Back (Caution) c. GB 21 Contraindicated for patients with Heart Conditions d. Electro-Acupuncture Contraindicated for patients with 1. Pacemakers and other electrical implants 2. History of Seizure Disorders 3. Strongly Recommended not to apply electro- acupuncture across the heart (i.e. Chest to Back/ Left to Right/ Arm to Arm) 6. Toniﬁcation, Sedation, and Even Needling

a. Even / Harmonizing b. Toniﬁcation 1. Mild Stimulus 2. Mild Thrusting 3. Moderate rotation c. Sedation 1. Strong Stimulus 2. Strong Thrusting 3. Great rotation 7. Moxa Actions 1. Warms a. Body b. Meridians c. Limbs d. Uterus 2. Expels Cold & Damp 3. Revives Dying Yang 4. Invigorates/Moves Qi & Blood 5. Regulates Qi & Blood 6. Opens The 12 Primary Channels 7. Repairs Traumatized Tissue Indications 1. Pain 2. Cold 3. Deﬁcient Yang 4. Stagnation a. Qi b. Blood c. Phlegm c. Cautions & Contraindications 1. Signs / Symptoms of Heat 2. Pregnancy a. Direct b. Near Fetus 3. Cv14, 15 a. Ht 4. Face - Hands a. Scar 5. Bl1 6. St1 7. ST9 8. Over a Tendon 6. St1 7. ST9 8. Over a Tendon 9. Over a Major Blood Vessel Methods of Use 1. Indirect a. Belly Bowl (Bong Re) b. Tiger Warmer c. Pole / Roll d. On Needle

e. Moxa Instrument f. Moxa on Ginger g. Moxa on Garlic h. Moxa on Salt 2. Direct a. AcuPractice Recommendation: Purchase Pre- rolled Direct Moxa (SMALL SIZE) Treat Moxa Burn 1. Blister a. Cover b. Do Not Break c. If It Breaks 1. Cover W/ Sterile Dressing 2. Standard Treatment for 3rd Degree Burns a. If the burn is severe or becomes infected, seek specialized Western medical attention. b. Keep wound clean c. Cover W/ Sterile Dressing d. Antibiotic ointment, if any f. Moxa Practical 1. Moxa on Needle 2. Belly Bowl / Ren 8 3. Moxa Pole 4. Tiger Warmer 8. Gua Sha & Cupping Gua Sha 1. “Scraping” of the skin with a blunt instrument a. Similar to Graston Technique 2. Often Causes Some Bruising 3. Releases congestion/stagnation 4. Mainly used for stuck/stubborn pain Cupping 1. Stationary or Moving Suction Cups Applied to the Surface of the Skin 2. Often Causes Some Bruising 3. Releases congestion/stagnation pain 4. Opens the Lungs/Chest N. Acupuncture Points and Meridians Body Measurements and General Point Location a. The Cun / Personal Inch b. Arm, Leg, Chest Neck & Head Measurements 1. Point Categories a. Front Mu /Alarm b. Arm, Leg, Chest Neck & Head Measurements 1. Point Categories a. Front Mu /Alarm 1. Treat the Organ 2. Yin Aspect b. Back Shu /Associated 1. Treat the Organ 2. Yang Aspect c. Yuan Source 1. Treat the Yuan/Jing Level of the Organ

d. Horary 1. Element Point that matches the Organ i.e. Fire Point of the Heart 2. Treat the Organ 3. Especially associated with the Horary Cycle e. Luo /Connecting 1. Connects Husband/Wife Meridians f. Xi Cleft /Accumulation 1. Pain along the Meridian g. 5 Element/Command 1. Wood/Mu 2. Fire/Huo 3. Earth/Tu 4. Metal/Jin 5. Water/Shui h. Tonification / Mother (previous 5-element Sheng cycle point) 1. i.e. Wood Point of the Heart i. Sedation / Son (subsequent 5-element Sheng cycle point) 1. i.e. Earth Point of the Heart j. Transport (Shu Points) 1. In order from distal end to the elbow/knee 2. “The flow of Qi from the extremities to the elbows/knees is flourishing” (Nei Jing) 3. Jing-Well aka Ting or Tsing a. TM Meridian Clearing 4. Ying-Spring 5. Shu-Stream a. Used with Jing-well for TM tx. 6. Jing-River 7. He-Sea a. Lower He-Sea 1. LI – St37 2. SI – St39 3. SJ – UB39 k. Ah Shi Points 1. Locally Reactive Points © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 258

2. Point Categories Chart ) . YIN Jing Ying Shu Jing He Yuan Xi Luo Back Shu Front Meridia Well Sprin Strea River Sea Source Accumulatio Connectin Associate Mu n Wood g m Metal Wate n g d Alarm Fire Earth r LU 11 10 9 8 5 9 6 7 UB 13 LU 1 SP 1 2 3 5 9 3 8 4 UB 20 LR 13 HT 9 8 7 4 3 7 6 5 UB 15 REN 14 KD 1 2 3 7 10 3 5 4 UB 23 GB 25 PC 9 8 7 5 3 7 4 6 UB 14 REN 17 LR 1 2 3 4 8 3 6 5 UB 18 LR 14

YANG Jing Ying Shu Jing He Yuan Xi Luo Back Shu Front Meridia Well Sprin Strea River Sea Source Accumulatio Connectin Associate Mu n Metal g m Fire Eart n g d Alarm Wate Wood h r LI 1 2 3 5 11 4 7 6 UB 25 ST 25 ST 45 44 43 41 36 42 34 40 UB 21 REN 12 SI 1 2 3 5 8 4 6 7 UB 27 REN 4 UB (BL) 67 66 65 60 40 64 63 58 UB 28 REN 3 SJ (TW) 1 2 3 6 10 4 7 5 UB 22 REN 5 GB 44 43 41 38 34 40 36 37 UB 19 GB 24 259 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

4. Du Meridian “Governing Vessel” a. The pathway of the Du Meridian runs from the perineum, up through the middle of the spine over the head and ending at the upper lip. All its points are on the posterior midline of the body. It is also the most Yang meridian on the body. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Du is important, for treating any and all disorders of the back and specifically the spine. Point Location Main Uses Name Du 1: Midway between the tip of the Hemorrhoids; Rectal or Other coccyx and the anus, locating the Prolapse; Rectal Bleeding point in prone position. Du 2: On the hiatus of the sacrum. Sacral and Coccyx Pain

Du 4: In the deepest hollow in the low Controlling Point for Lower back. Below the spinous process Back and KD: All Lower Back of the 2nd lumbar vertebrae. Problems, Especially Weakness; Kidney Deficiency Du 14: Below the spinous process of the Controlling Point for Neck & 7th cervical vertebrae. Upper Back: Pain, Heat & Fevers in the Upper Body; Releases Exterior; Tonfies Wei Qi; Du 20: On the midline of the head, Any Excess Disorders of the approximately on the midpoint of Head; Any Prolapse In The the line connecting the apexes of Body; Connects with Brain; the two auricles Clears the Mind; Headache Du 25: At the tip of the nose Nose/Sinus Congestion © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 260

5. Ren Meridian “Conception Vessel.” a. The pathway of the Ren Meridian runs from the perineum, up the midline of the front of the body ending just under the lower lip. All its points are on the anterior midline of the body. It is also the most Yin meridian on the body. Since Yin Meridians are often used to treat internal disorders, the Ren is important, for treating many internal disorders and especially those associated with reproductive functions.

Point Location Main Uses Name Ren 2 On the midpoint of the upper Controlling Point for All GYN border of the symphisis pubis. and Urogenital Disorders Ren 4 On the midline of the abdomen, 3 Tonify the Kidneys; All GYN & Cun below the umbilicus Urinary Disorders; Tonifies Jing, Yang, Yin, & Qi Ren 6 On the midline of the abdomen, 1.5 Tonify the Spleen; Relieves Cun below the umbilicus Stagnation in Abdomen Ren 8 In the center of the umbilicus Strengthen Digestion; Diarrhea; Yang Collapse (No Needle-Moxa Only) Ren 12 On the midline of the abdomen, 4 Cun Harmonize the Stomach; All above the umbilicus Abdominal Problems Ren 17 On the anterior midline, at level Descend the Qi of the Chest with the 4th intercostal space Ren 22 In the center of the suprasternal fossa Throat and Swallowing Problems 261 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

6. Lung/Fei a. The pathway of the Lung Meridian runs from the second intercostal space 2/3 the distance from the middle of the sternum to the acromion process, down the anterior surface of the arm and ending at the proximal radial corner of the nail of the thumb. Since Yin Meridians are often used to treat internal disorders, the Lung Meridian is important, for treating many internal disorders associated with the Lungs. These include all respiratory disorders and symptoms associated with colds and flus.

Point Location Main Uses Name LU 1 Lateral and superior to the sternum at Mu / Alarm Point of The Lungs: the lateral side of the 1st intercostal All Lung Disorders space, 6 Cun lateral to the Ren Mai channel. LU 5 On the cubital crease, on the radial Strong, Productive Cough; side of tendon of m. biceps brachii, Any Heat and/or Fullness in located with the elbow slightly Lungs; flexed. LU 7 Superior to the styloid process of Master Point of the Ren Mai: the radius, 1.5 Cun above the Controlling Point For Neck & transverse crease of the wrist Throat: Circulates the Qi of The Lungs. Luo Point; Use with LI 4 for Headaches and OPIs LU 9 At the radial end of the transverse Source Point; Tonifies the crease of the wrist, in the Lungs; All Deficient Lung depression on the lateral side of Problems the radial artery. LU 11 On the thumb, 0.1 Cun proximal to Jing Well Point: Clears Heat the radial corner of the nail. From The Lungs (Sore Throat, Tonsillitis, Etc); Moxa Opposite Side For Nosebleeds

Tonsillitis, Etc); Moxa Opposite Side For Nosebleeds

7. Large Intestine/ Da Chang a. The pathway of the Large Intestine Meridian runs from the proximal radial corner of the index finger along the arm on the lateral border of the radial bone to the top of the shoulder, crossing the SCM on the neck to the lower border of the ala nsai, on the opposite side. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Large Intestine is important, for treating any and all disorders of arm, neck and head.

Point Location Main Uses Name LI 1 On the radial side of the index finger, Jing Well Point: acute pain on the about 0.1 Cun proximal to the corner of meridian; Clears Heat from the Head the nail and throat; (sore throat, tonsillitis, red burning eyes, etc) LI 4 On the dorsum of the hand, between Controlling point for Head and Face: the 1st and 2nd metacarpal bones, Main point for pain and other approximately in the middle of the 2nd excesses in the head neck and arm. metacarpal bone on the radial side. OPIs; (CONTRAINDICATED IF PATIENT IS PREGNANT) LI 5 On the radial side of the wrist. When the Good local point for pain in the thumb thumb is tilted upward, it is in the and area depression between the tendons of muscle extensor pollicis longus and brevis. LI 11-12 Two points, best palpated for. When the Fever; elbow pain elbow is flexed, these points are in and around the area between the depression at the lateral end of the transverse cubital crease and a spot superior to the lateral epicondyle of the humerus. LI 14 Just superior to the lower end of the Deltoid and shoulder pain deltoid muscle. LI 15- Anterior and inferior to the acromion, Major points for shoulder joint pain on the upper portion of the deltoid

LI 15- Anterior and inferior to the acromion, Major points for shoulder joint pain on the upper portion of the deltoid muscle. LI 16 When the arm is in full abduction In the upper aspect of the shoulder, in the depression between the acromial extremity of the clavicle and scapular spine. LI 17-18 Tow points best palpated for. On the Good local points for throat and neck lateral side of the neck, about level with problems the tip of the Adam's Apple, on the SCM. LI 20 In the nasolabial groove, at the level of any nose problem; often used with LI the midpoint of the lateral border of the 4 and LU 7 263 ©ala 1994 nasi. - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

8. Stomach/Wei a. The pathway of the Stomach meridian runs from the middle of the lower border of the eye socket down to the outer corner of the mouth, then back to the mandible and up to the corner of the hairline. From there it proceeds down the front of the body along the mid-clavicular line over the ribcage, where it moves closer to the midline and down to the upper border of the pubic bone. From here it travels out to the leg and along a trajectory just lateral to the crest of the tibia, and on to the foot, ending at the proximal medial corner of the nail of second toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Stomach meridian is important, for treating any and all disorders of and eye, head, teeth, and leg.

Point Location Main Uses Name ST 3 Directly below the center of the eye, at the level of the lower border of the Sinus conditions; knee pain ala nasi, on the lateral side of the nasolabial groove. ST 4 Facial paralysis; trigeminal Lateral to the corner of the mouth, neuralgia; herpes; mouth ulcers; directly below ST 3. gum problems; tooth pain ST 5 Anterior to the angle of the mandible, on the anterior border of the masseter lower jaw toothache muscle. One finger breadth anterior and ST 6 superior to the lower angle of the mandible where the masseter lower jaw toothache, Bruxism attaches, at the prominence of the muscle when the teeth are clenched. ST 7 At the lower border of the zygomatic arch, in the depression anterior to the condyloid process TMJ; upper jaw toothache ST 7 At the lower border of the zygomatic arch, in the depression anterior to the condyloid process TMJ; upper jaw toothache of the mandible - located with mouth slightly slack. ST 8 .5 Cun within the anterior hairline at the corner of the forehead, 4.5 Cun Frontal and band-like headaches lateral to GV 24. ST 25 2 Cun lateral to the center of the any intestinal problems; front umbilicus. Mu of LI; ST 28 3 Cun below the umbilicus, 2 Cun lateral to CV 4 All GYN problems; damp heat ST 29 4 Cun below the umbilicus, 2 Cun in lower warmer; genital lateral to CV 3 herpes; leucorrhoea. Cold and/or blood stagnation © 1994-2013 James Ventresca AcuPractice™in Seminars lower warmer; - www.AcuPracticeSeminars.com 264

ST 30 5 Cun below the umbilicus, 2 Cun lateral to CV 2. ST 31 At the crossing point of the line drawn down from the ASIS and the line level with the lower border of the pubic Strengthens and moves the thigh symphisis, in the depression on the and entire leg lateral side of sartorius, when the thigh is flexed. When the knee is flexed, point is 2 xi cleft; acute breast discomfort; ST 34 Cun above the laterosuperior border knee pain/weakness of the patella. When the knee is flexed, the point is at the lower border of the patella, ST 35 knee joint problems in the depression lateral to the patellar ligament. ST 36 3 Cun below ST 35, one finger Controlling point for breadth lateral to the anterior crest Digestion: All digestive of the tibia problems; builds Qi and blood; regulates digestion 8 Cun superior to the external Helps resolve phlegm anywhere ST 40 malleolus two fingers breadth lateral in the body to the anterior crest of the tibia. On the dorsum of the foot, at the midpoint of the transverse crease of the ankle, in the depression between Pain/ weakness and stiffness in ST 41 the tendons of muscle extensor the foot and ankle. digitorum longus and hallucis longus, approximately at the level of the tip of the external malleolus. ST 44 Proximal to the web margin Clear heat from head, face, between the 2nd and 3rd toes. mouth and gums

ST 45 Jing Well Point: acute pain on On the lateral side of the 2nd toe, .1 the meridian; Clear heat from Cun proximal to the corner of the nail. head, face, mouth and gums

On the lateral side of the 2nd toe, .1 the meridian; Clear heat from Cun proximal to the corner of the nail. head, face, mouth and gums

9. Spleen/Pi a. The pathway of the Spleen Meridian runs from the proximal medial corner of the nail of the great toe along the medial edge of the foot, up the leg following the posterior border of the tibia. At he waist it runs parallel to the midline along the mid-clavicular line until it departs to end at the mid-axillary line midway between the axilla and the free end of the 11th rib. Since Yin Meridians are often used to treat internal disorders, the Spleen Meridian is important, for treating many internal disorders associated with the Spleen. These include all digestive disorders and symptoms associated with fatigue, and dampness.

Point Location Main Uses Name SP 1 On the medial side of the great toe, Jing Well Point: Moxa for 0.1 Cun proximal to the corner of the bleeding from deficiencies nail. SP 3 Proximal and inferior to the head of the first metatarsal bone, at the Source Point: Tonifies SP junction of the red and white skin. SP 4 In the depression distal and Master point of the Chong Mai, inferior to the base of the first All menstrual disorders; All metatarsal bone, at the junction of gastric disorders; masses in the red and white skin. the abdomen SP 6 strengthens SP, KD, yin, Qi and blood; All GYN; moves 3 Cun above the tip of the medial the lower abdomen; calms the malleolus, on the posterior border mind; all reproductive issues of the medial aspect of the tibia. (CONTRAINDICATED IF PATIENT IS PREGNANT) SP 9 On the lower border of the condyle of All damp disorders; A mild the tibia, in the depression on the diuretic point medial border of the tibia.

All damp disorders; A mild the tibia, in the depression on the diuretic point medial border of the tibia. SP 15 4 Cun lateral to the center of the secondary point for treating umbilicus, lateral to the muscle rectus intestinal disorders; abdominus. SP 21 On the mid-axillary line, 6 Cun below whole body pain and/or the axilla, midway between the axilla weakness and the free end of the 11th rib.

10. Heart / Xin a. The pathway of the Heart Meridian runs from the middle of the axiclla down the medial surface of the arm and ending at the proximal radial corner of the nail of the pinky finger. Since Yin Meridians are often used to treat internal disorders, the Heart Meridian is important, for treating disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep.

Point Location Main Uses Name HT 1 When the arm is abducted, the point Seldom used, deep needling can is in the center of the axilla, on the access m. subscapularis medial side of the axillary artery. HT 7 At the ulnar end of the transverse Source Point: Most commonly crease of the wrist, in the used HT point all heart depression on the radial side of the disorders. Nourishes the HT, tendon of muscle flexor carpi Calms the Shen; relieves ulnaris. insomnia HT 8 When the palm faces upward, the point is between the 4th and 5th tachycardia; heat in the Heart; metacarpal bones. When a fist is dream disturbed sleep, night made, the point is where the tip of terrors the little finger rests. HT 9 Jing Well Point: extreme heat in On the radial side of the little finger, .1 the Heart; loss of consciousness; Cun proximal to the corner of the nail. tachycardia 267 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

11. Small Intestine/Xiao Chang a. The pathway of the Small Intestine Meridian runs from the proximal ulnar corner of the pinky finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, through the scapula, up to the back of the neck past the ear and ending lateral to the eye. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Small Intestine is important, for treating any and all disorders along its pathway, especially around the scapula, and neck.

Point Location Main Uses Name SI 1 On the ulnar side of the little finger, Jing Well Point: acute pain on about .1 Cun proximal to the corner of the meridian; mastitis; the nail. insufficient lactation SI 3 When a loose fist is made, the Controlling point for Spine: point is on the ulnar side of the Master Point of the DU Mai: hand, proximal to the 5th MP joint, stiff neck; all back pain; at the end of the transverse crease stroke, MS, Turette’s and other at the junction of the red and white wind disorders and skin. SI 6 When the palm faces the chest, the xi cleft; pain in the meridian; stiff point is in the bony cleft on the radial neck; Shoulder pain side of the styloid process of the ulna. SI 8 When the elbow is flexed, the point is located in the depression between the local point for elbow olecranon of the ulna and the medial pain/stiffness epicondyle of the humerus. SI 9 Posterior and inferior to the shoulder joint. 1 Cun above the posterior end of the axillary fold. local points for shoulder pain SI 10 Directly above SI 9, in the and Range of Motion depression inferior to the scapular

posterior end of the axillary fold. local points for shoulder pain SI 10 Directly above SI 9, in the and Range of Motion depression inferior to the scapular spine. SI 11 In the infrascapular fossa, at the junction of the upper and middle Most important local point for third of the distance between the the upper back, and scapular lower border of the scapular spine area and the inferior angle of the scapula. SI 17 Posterior to the angle of the mandible, in the depression on the anterior local point for jaw, neck, and ear border of the SCM. SI 19 Anterior to the tragus and posterior to the condyloid process of the benefits the hearing; jaw mandible, in the depression formed problems when the mouth is open. © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 268

12. Urinary Bladder / Pang Guang a. The pathway of the Urinary Bladder Meridian runs from the medial inner canthus up over the head just lateral to the midline, down the side of the neck where it separates into tow pathways, both running parallel to the midline of the back. One pathway is located at the distance of the medial border of the scapula, and the other is halfway between the medial border of the scapula and the midline. At the sacrum the meridian moves out to the buttocks and down to the center of popliteal crease, and throughout the back of the calf, to the ankle where it runs just under the lateral maleoleous ending at the lateral proximal corner of the little toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Urinary Bladder is important, for treating any and all disorders of back, and legs. It should also be noted that this meridian contains the “Back Shu Points.” These are specific points for each of the Organs.

Point Location Main Uses Name UB 1 0.1 Cun superior and slightly medial to Main Point for All eye problems the inner canthus UB 2 on the medial end of the eyebrow, or on Alternate point for all eye problems the supraorbital notch UB 10 1.3 Cun lateral to GV 15, in the All neck pain, weakness and depression on the lateral aspect of the stiffness trapezius muscle UB 11 1.5 Cun lateral to GV 13, at the level of the Back Shu Point of the Bones: All bone lower border of the spinous process of T1 problems; arthritis UB 12 1.5 Cun lateral to the GV meridian, at the OPIs; headache; cough; stimulates level of the lower border of the spinous Wei Qi process of T2 UB 13 1.5 Cun lateral to GV 12, at the level of Back Shu Point of the LU: all lung the lower border of the spinous process problems; builds Wei Qi; chronic Wei Qi process of T2 UB 13 1.5 Cun lateral to GV 12, at the level of Back Shu Point of the LU: all lung the lower border of the spinous process problems; builds Wei Qi; chronic of T3 or acute UB 14 1.5 Cun lateral to the GV meridian, at level with the lower border of the spinous Local Point for Upper Back Pain process of T4 UB 15 1.5 Cun lateral to the GV 11, at the level of Back Shu Point of the HT: all heart the lower border of the spinous process of problems T5 UB 16 1.5 Cun lateral to GV 10, at the level of the Local Point for Upper Back Pain lower border of the spinous process of T6 UB 17 Back Shu Point of the Blood: All blood problems; tonifies blood; skin 1.5 Cun lateral to GV 9, at the level of the problems from heat in blood; Back lower border of the spinous process of T7 Shu Point of the Diaphragm: 269 © 1994 - 2013 James Ventresca AcuPractice™ SeminarsHiccough; - Hiatialwww.AcuPracticeSeminars.com Hernia

UB 18 1.5 Cun lateral to GV 8, at the level of Back Shu Point of the LR: benefits the lower border of the spinous process all aspects of the liver; smoothes, of T9 harmonizes, and tonifies liver UB 19 1.5 Cun lateral to GV 7, at the level of the Back Shu Point of the GB: all GB lower border of the spinous process of T10 problems UB 20 Back Shu Point of the SP: all SP 1.5 Cun lateral to GV 6, at the level of the problems; benefits all aspects of lower border of the spinous process of T11 spleen UB 21 1.5 Cun lateral to the GV meridian , at the Back Shu Point of the ST: benefits all level of the lower border of the spinous aspects of the ST process of T12 UB 22 1.5 Cun lateral to the GV 5, at the level of Back Shu Point of the SJ: regulates the lower border of the spinous process of and transforms fluids; L1. UB 23 1.5 Cun lateral to GV 4, at the level of Back Shu Point of the KD: all KD the lower border of the spinous process pathologies; regulates all aspects of the L2. of the KD UB 24 1.5 Cun lateral to the GV meridian, at the level of the he lower border of the spinous Local Point for Low Back Pain process of L3. UB 25 1.5 Cun lateral to GV 3, at the level of Back Shu Point of the LI: low back the lower border of the spinous process pain; colon problems; of L4. constipation, diarrhea, etc. UB 26 1.5 Cun lateral to the GV meridian, at the level of the lower border of the spinous Local Point for Low Back Pain process of L5. UB 27 1.5 Cun lateral to the GV meridian, at the Back Shu Point of the SI: used with level of the lower border of the 1st CV 3 for damp heat in urine; posterior sacral foramen. sacroiliac joint problems UB 28 1.5 Cun lateral to the GV meridian, at the Back Shu Point of the UB: all UB level of the 2nd posterior sacral foramen. Problems UB 29 1.5 Cun lateral to the GV meridian, at the UB 28 1.5 Cun lateral to the GV meridian, at the Back Shu Point of the UB: all UB level of the 2nd posterior sacral foramen. Problems UB 29 1.5 Cun lateral to the GV meridian, at the Local Point for Low Back Pain level of the 3rd posterior sacral foramen. UB 30 1.5 Cun lateral to the GV meridian, at the Local Point for Low Back Pain level of the 4th posterior sacral foramen. UB 31 In the 1st posterior sacral foramen.

UB 32 In the 2nd posterior sacral foramen. These are the 8 Liao Points: Used for all genito-urinary, GYN, UB 33 In the 3rd posterior sacral foramen. low back & leg problems

UB 34 In the 4th posterior sacral foramen UB 35 On either side of the tip of the coccyx, .5 Coxxygeal pain Cun lateral to the GV meridian.

UB 40 Midpoint of the transverse crease of the (used to popliteal fossa, between the tendons of Controlling point for the low back: be #54) muscle biceps femoris and muscle All Low back pain; clears heat semitendinosis. UB 57 Directly below the belly of muscle gastrocnemius, on a line joining UB 40 Upper back pain/tension; used with and tendo-calcaneus, about 8 Cun UB 67 for spasms of the calf; below UB 40. UB 60 occipital headache; neck pain; In the depression between the external distal point for sciatica; for labor malleolus and tendo calcaneus. pain; "aspirin point" UB 62 In the depression directly below the Master Point of the Yang Qiao Mai: external malleolus. Lateral musculoskeletal problems UB 67 Jing Well Point: acute pain on the On the lateral side of the small toe, .1 meridian; turning a breech fetus; Cun proximal to the corner of the nail used with UB 57 for spasms of the calf; back pain; tight hamstrings

13. Kidney / Shen a. The pathway of the Kidney Meridian runs from the center of the ball of the foot along the medial edge of the foot, under the medial malleolus, up the medial aspect of the leg posterior to the tibia. At the waist it runs parallel and just lateral to the midline ending at the top of the sternum. Since Yin Meridians are often used to treat internal disorders, the Kidney Meridian is important, for treating many internal disorders associated with the Kidney. These include all growth development and ageing, reproductive and urinary disorders and symptoms associated with fatigue, and general weakness. Point Location Main Uses Name Point Location Main Uses Name KD 1 On the sole, in the depression when the foot is in plantar flexion, emergency point; loss of approximately at the junction of the consciousness; brings heat down anterior third and posterior 2/3 of the fro the upper body sole. KD 2 Anterior and inferior to the medial malleolus, in the depression of the Heat/Fire in the throat and lower lower border of the tuberosity of the warmer; UTIs navicular bone. KD 3 In the depression between he Source Point: All KD medial malleolus and tendo disorders; weakness in the calcaneus, at the level of the tip of knees; low back; lowered the medial malleolus. libido, erectile dysfunction KD 6 In the depression of the lower master point of yin Qiao; border of the medial malleolus, or Tonifies KD yin 271 ©1 1994 Cun - below 2013 James the medial Ventresca malleolus. AcuPractice™ Seminars - www.AcuPracticeSeminars.com

KD 7 2 Cun directly above KD 3, on the Tonifies KD Yin and Vaporizes anterior border of tendo calcaneus. fluids KD 11-21 These points are 0.5 Cun lateral to CV line and level with the Ren points. KD 11 begins lateral to Ren 2 on the reinforce the Ren points superior border of the symphysis pubis. KD 21 is under the sternum KD 16 .5 Cun lateral to the umbilicus, level Strengthens the KD with CV 8. KD 22- 27 Beginning at the bottom of the Sternum, these points run to the These points soothe the Spirit, depression on the lower border of the and should be palpapated for clavicle, and are all 2 Cun lateral to tenderness the Ren meridian.

14. Pericardium/ Xin Bao Luo The pathway of the Pericardium Meridian runs from the chest down the medial surface of the arm and ending at the tip of the middle finger. Since Yin Meridians are often used to treat internal disorders, and the Pericardium is closely related to the Heart Meridian, it is most commonly used to treat disorders associated with the Heart. These include all mental / emotional disorders and symptoms associated with sleep, as well as organic heart disorders. Point Name Location Main Uses PC 4 5 Cun above the transverse crease of the wrist, on the line connecting PC 3 and PC xi cleft point; chest pain; pain in the 7, between the tendons of palmaris meridian longus and flexor carpi radialis PC 5 3 Cun above the transverse crease of the wrist between the tendons of calms the spirit; regulates Heart palmaris longus and flexor carpi rhythm radialis

the wrist between the tendons of calms the spirit; regulates Heart palmaris longus and flexor carpi rhythm radialis PC 6 2 Cun above the transverse crease of Master Point of the Yin Wei Mai: the wrist between the tendons of Controlling point for the Chest palmaris longus and flexor carpi and Abdomen; calms the spirit radialis PC 7 In the middle of the transverse crease of Source Point: calms the spirit; the wrist, between the tendons of muscle regulates Heart rhythm palmaris longus and flexor carpi radialis. PC 8 On the transverse crease of the palm, between the 2nd and 3rd metacarpal tachycardia; heat in the Heart; dream bones. When the fist is clenched, the disturbed sleep point is just below the tip of the middle finger. PC 9 Jing Well Point: extreme heat in the In the center of the tip of the middle Heart; loss of consciousness; finger. tachycardia; night terrors © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 272

15. Triple Heater / Triple Warmer / San Jiao a. The pathway of the San Jiao is similar to that of the Small Intestine but more radial.. It runs from the proximal ulnar corner of the ring finger along the arm on the lateral border of the ulnar bone to the back of the shoulder, along the top posterior aspect of the trapezius, up to the back of the neck around the ear and ending just anterior to the tragus of the ear. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the San Jiao is important, for treating any and all disorders along it’s pathway, especially around the shoulder, and ear.

Point Location Main Uses Name SJ 1 On the lateral side of the ring finger, about 0.1 Jing Well Point: acute pain on the Cun proximal to the corner of the nail. meridian; SJ 3 On the dorsum of the hand between the 4th and 5th metacarpal bones, in the Controlling Point for the Ear depression proximal to the metacarpophalangeal joint. SJ 4 On the transverse crease of the dorsum of the wrist, in the depression lateral to the tendon of Good local point for the wrist muscle extensor digitorum communis. SJ 5 2 Cun above TW 4, between the radius and Master Point of the Yang Wei the ulna. Mai: local point SJ 10 When the elbow is flexed, the point is in the depression about 1 Cun superior to the Good Local Point for the elbow olecranon. SJ 14 Posterior and inferior to the acromion, in (posterio the depression about 1 Cun posterior to LI Shoulder joint pain and ROM

SJ 14 Posterior and inferior to the acromion, in (posterio the depression about 1 Cun posterior to LI Shoulder joint pain and ROM r to LI 15) 15 when the arm is abducted. About 1 Cun posterior to GB 21. Midway Tightness, tension and pain in the SJ 15 between GB 21 and SI 13, on the superior neck and shoulders angle of the scapula SJ 17 Posterior and superior to the angle of the mandible. Posterior to the lobule of the ear, All Ear disorders in the depression between the mandible and the mastoid process

SJ 21 In the depression anterior to the supratragic notch and slightly superior to the condyloid All Ear and Jaw disorders process of the mandible. The point is located with the mouth slack. SJ 23 All disorders involving the side of At the lateral end of the eyebrow the head/face; lateral headaches, eye pain, ear pain 273 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com

16. Gall Bladder / Dan a. The pathway of the Gall Bladder Meridian runs from the Lateral outer canthus back and forth coursing the sides of the head, down the side of the neck where it follows the top of the trapezius, down to the side of the ribcage, throughout the flanks, to the hip, and down along the most lateral aspect of the leg, to the ankle where it runs under the lateral maleoleous ending at the lateral proximal corner of the fourth toe. Since Yang Meridians are often used to treat disorders along the pathway of the meridian, the Gall Bladder is important, for treating any and all disorders of sides of the head, trunk, hip, and legs

Point Name Location Main Uses GB 1 0.5 Cun lateral to the outer canthus, in the depression on the lateral side of the Secondary point for eye problems orbit. GB 2 Anterior to the intertragic notch, at the posterior border of the condyloid Good local point for ear and jaw process of the mandible. The point is located with the mouth open. GB 8 Lateral Headaches; post stroke Superior to the apex of the auricle, 1.5 speech disorders; enters the Cun within the hairline. brain GB 14 On the forehead, 1 Cun directly above All eye problems; frontal and the midpoint of the eyebrow. temporal HA GB 20 All Wind: internal LV wind and external OPI wind; opens the In the depression between the upper orifices of the head: All disorders portion of the SCM and the trapezius, effecting the eyes, ears, and external OPI wind; opens the In the depression between the upper orifices of the head: All disorders portion of the SCM and the trapezius, effecting the eyes, ears, and just below the occiput. nose; All Headaches especially occipital; GB 21 Primary point for neck and Midway between GV 14 and the shoulder tension, pain and acromion, at the highest point of the tightness. ((CONTRAINDICATED shoulder. IF PATIENT IS PREGNANT, OR HAS A HEART CONDITION) GB 25 On the lateral side of the abdomen, on Front Mu of KD; pain in lumbar the lower border of the free end of the region 12th rib. GB 26 At the Upper Border of the Iliac Crest, Main Coalescent Point on the usually at the level of the umbilicus. Dai Mai; All GYN Disorders GB 27 On the lateral side of the abdomen, Secondary Point on the Dai Mai; All anterior to the superior iliac spine, 3 Cun GYN Disorders below the umbilicus.

GB 28 Anterior and inferior to the ASIS, 0.5 Cun Secondary Point on the Dai Mai; All anterior and inferior to GB 27. GYN Disorders GB 29 IN the depression of the midpoint between the ASIS and the great trochanter. When locating this point, put patient in lateral recumbent position with thigh and knee both flexed to about 900. GB 30 At the junction of the lateral 1/3 and medial 2/3 of the distance between the greater trochanter and the hiatus of GB 29, 30, 31: Main Points for the sacrum. When locating this point, Sciatica, hip; lumbar to thigh, leg put patient in lateral recumbent pain and paralysis position with thigh and knee both flexed to about 900. GB 31 On the midline of the lateral aspect of the thigh, 7 Cun above the transverse political crease. When the patient is standing erect with hands at sides, the point is where the tip of the middle finger touches. GB 34 relaxes the tendons; good point In the depression anterior and in for knee, sciatica and leg pain; inferior to the head of the fibula. pain anywhere in the body; shoulder pain GB 40 Anterior and inferior to the lateral malleolus, in the depression on the Ankle Pain lateral side of the tendon of m. extensor digitorum longus. GB 41 In the depression distal to the junction of the 4th and 5th metatarsal Master Point of the Dai Mai: All

digitorum longus. GB 41 In the depression distal to the junction of the 4th and 5th metatarsal Master Point of the Dai Mai: All bones, on the lateral side of the GYN and LV disorders tendon of m. extensor digiti minimi of the foot. GB 44 On the lateral side of the 4th toe, about Jing Well Point: acute pain on the .1 Cun proximal to the corner of the nail. meridian;

17. Liver / Gan a. The pathway of the Liver Meridian runs from the proximal lateral corner of the nail of the great toe along the medial edge of the foot, up to the posterior to the border of the tibia between the Spleen and Kidney meridians. At he waist it runs parallel to the midline until it departs to the free end of the 11th rib, ending at the sixth intercostals space on the mid-clavicular line. The Liver Meridian is important, for treating many internal disorders associated with the Liver. These include many emotional disorders and symptoms associated with stagnation and wind.

Point Location Main Uses Name LR 1 Jing Well Point: restores On the lateral side of the great toe, consciousness; Inguinal pain; 0.1 Cun proximal to the corner of the groin pulls; moves Qi in the lower nail. warmer; genitourinary issues; stops bleeding LR 2 LV fire and heat in the head; On the dorsum of the foot, between Heat in the Lower Warmer; the 1st and 2nd toes, proximal to the Burning urination; red burning margin of the web. eyes; LV yang rising HA; Herpes I & II; Shingles; LV wind LR 3 On the dorsum of the foot, in the Source Point: Primary point to depression distal to the junction benefit all aspects of LV. Move of the 1st and 2nd metatarsal LR QI, Quell LR Wind, etc. bones. LR 4 On the ankle, anterior to the

of the 1st and 2nd metatarsal LR QI, Quell LR Wind, etc. bones. LR 4 On the ankle, anterior to the prominence of the medial malleolus, in the significant depression just Spreads Liver Qi, Regulates the medial to the tendon of tibialis Lower Jiao, Clears Liver Heat. anterior when the ankle is extended (dorsiflexed) LR 13 On the lateral side of the abdomen, Front MU Point of the SP: Liver below the free end of the 11th invading Spleen floating rib. LR 14 Directly below the nipple, in the 6th Pain and tightness/fullness in the intercostal space. chest, ribs and breast

18. Extraordinary Points Point Name Location Main Uses Midway between the medial ends of the two Yin Tang Clams the Shen eyebrows. Draw a line following path of lateral end of eyebrow down to intersection of line from Eye Pain / Discomfort Tai Yang outer canthus of eye, at intersection, in Headaches depression. Midpoint between Yifeng (SJ 17) and Fengchi An Mian Calms the Shen for Insomnia (GB 20) Bi Tong At the highest point of the nasolabial groove. Stuffy-Runny Nose Midway between the end of the anterior Jian Nie Ling axillary fold and LI 15 A pair of points in the two depressions, medial and lateral to the patellar ligament, Xi Yan Knee Pain locating the point with the knee flexed. Lateral Xi Yan overlaps with S 35. A group of 34 points along both sides of the spinal column, 0.5 Cun lateral to the lower Release the Muscles of the Hua Tou Jia Ji border of each spinous process from the Back first thoracic vertebra to the fifth lumbar vertebra. On dorsum of hand, between 2nd & 3rd Luo Zhen metacarpal bones, 0.5 Cun posterior to Neck Pain metacarpophalangeal joint Shi Qi Zhui Below the spinous process of the 5th lumbar Low Back Pain (Josen) vertebrae Ding Chuan 0.5 Cun lateral to Dazhui (Du 14). Stop Asthma Shi Qi Zhui Below the spinous process of the 5th lumbar Low Back Pain (Josen) vertebrae Ding Chuan 0.5 Cun lateral to Dazhui (Du 14). Stop Asthma On the dorsum of the foot, in the depressions on the webs between toes, Ba Feng Foot Pain proximal to the margins of the webs, eight points in all. On the dorsum of the hand, at the junction of the white and red skin of the hand webs, Ba Xie Hand Pain eight in all, making a loose fist to locate the points. Acute and chronic Dan Nang Xue The tender spot 1-2 Cun below G 34. cholecystitis In the depression of the midpoint of the He Ding Patellar/Knee Pain superior patellar border. In the center of the heel on the bottom of the Shi Mian Heel & Knee Pain foot A group of 4 points, at the vertex, 1 Cun Benefits: Wind, Eyes, Ears, Si Shen Cong respectively posterior, anterior and lateral to Shen Baihui (Du 20). 277 © 1994 - 2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com Yu Yao At the midpoint of the eyebrow. Benefits Eyes

Zi Gong Blood 3 Cun lateral to Zhongji (Ren 3) Benefits Uterus

19. Additional Meridians a. The Eight Extraordinary Meridians. 1. Access the deepest energies of the individual 2. Equalizing Qi Reservoirs 3. Link Meridians and Organs 4. Zonal / Planar Tx. Of Pain 5. Master & Couple Points a. SI3 and BL62 b. TH5 and GB41 c. LU7 and KI6 d. SP4 and P6. 6. Ren Mai a. Master Point Lu 7 7. Du Mai a. Master Point SI 3 8. Chong Mai a. Master Point SP 4 9. Dai Mai a. Master Point GB 41 10. Yang Wei Mai a. Master Point SJ 5 11. Yin Wei Mai a. Master Point PC 6 12. Yang Qiao Mai a. Master Point UB 62 13. Yin Qiao Mai a. Master Point KD 6 b. 12 Tendino-Muscular (Sinew) Meridians 1. Circulate on the periphery of the body. 2. Do not penetrate to the Zangfu. 3. Are associated with and take their names from the twelve primary channels. 2. Do not penetrate to the Zangfu. 3. Are associated with and take their names from the twelve primary channels. 4. Originate at the extremities / Jing-Well Points 5. Broadly follow the course of their associated primary 6. channels but are wider. 7. Follow the lines of major muscles and muscle groups, tendons & ligaments 8. Envelop or “Knot Into” all joints 9. Pain / Trauma 10. Diagnosis a. Look for area of diffuse pain, considered excess in the TM meridian 11. Treat acute and chronic painful / tight conditions c. 12 Divergent Meridians 1. Connect with their paired channel 2. Deeper than Main Meridians 3. Govern the inside of the body 4. Distributed on the Chest, Abdomen and Head 5. Extend the areas of inﬂuence of main meridians a. i.e. yin meridians to the head © 1994-2013 James Ventresca AcuPractice™ Seminars - www.AcuPracticeSeminars.com 278

d. 12 Skin Regions 1. Related to the Main Meridians 2. Explain Dx & Tx via the skin e. 15 Luo Connecting Channels 1. One small branching channel for each of the 12 primary channels, one each for the Ren & Du, and one for the Great Luo of the Spleen 2. Spread from the Luo-connecting point of their own channel to connect with their paired channel. 3. After joining with their paired channel they usually continue to follow their own pathways: f. Minute Collaterals Probably the minor blood vessels at the surface of the skin

O. Auricular Acupuncture and Other Microsystems 1. Microsystems Treatment a. Ear, Scalp, Hand b. Find point exactly c. Apply Active or Passive Movement During the Treatment d. Look For Immediate Change 2. Auricular Acupuncture a. Ear Anatomy is Crutial for Locating Points on Any Exam 1. Helix & Crus 2. Antihelix & Upper & Lower Crus 3. Tragus 4. Antitragus 5. Lobule 6. Cavum Concha 7. Symba Concha 8. Scaphoid Fossa 9. Triangular Fossa 7. Symba Concha 8. Scaphoid Fossa 9. Triangular Fossa

c. Major Points 1. Shen Men 2. Heart 3. Liver 4. Kidney 5. Sympathetic N 6. Thirst 7. Hunger 8. Nicotine 9. Shoulder-Arm-Hand-Finger 10. Back 11. Hip-Leg-Foot-Toe 12. Sciatica 13. Uterus 14. Toothache 15. Aspirin Pt.

d. NADA Detox Tx: 1. Shen Men 2. LR 3. KD 4. HT/LU 5. Sympathetic N.

Foot Hand

Junction Sup/Inf Crux of Antihelix Leg Forearm Asprin Uterus Shen Men

Symp. N. Knee Elbow Sciatica

Prostate

Kidney Thigh Upper Arm Crux of Helix

Hip Shoulder Liver Sacrum Thirst Lumbar Hunger Thorasic Thirst Lumbar Hunger Thorasic Nicotine Heart Cervical

Head

P. Name That Disharmony / Diagnosis Review

1. A 24 year old woman presents with the following signs and symptoms: excessive menstrual bleeding, the menstrual flow is pale and dilute, the patient also has loose stools, fatigue, pale thin tongue with a white coat, pale and lusterless face, lack of appetite, weak limbs, and a weak and thin pulse.

5. A 52 year old man presents with the following signs and symptoms: sore low back which feels better with heat, frequent clear copious urination, low sex drive, fatigue, pale face, a weak and slow pulse, and a pale & puffy tongue with a wet coat. & puffy tongue with a wet coat.

6. A 22 year old man presents with the following acute signs and symptoms: severe sore throat, fever, restlessness, dry stools with constipation, full and rapid pulse, red tongue with a yellow coat.

7. A 44 year old man presents with the following signs and symptoms: fatigue, chronic diarrhea / loose stools often containing mucous, overweight, pale swollen tongue with a greasy white coat, pale face, and a slippery, weak pulse.

8. A 36 year old man presents with the following signs and symptoms: asthma, restlessness, insomnia, chronic dry non-productive cough, thin and rapid pulse, thin red tongue with no coat.

1. Clinical Review / Weekend 10

This class is devoted to diagnosing and formulating treatment plans and treatments for patients. Participating doctors bring in patients, who are questioned and examined by the class. This class draws on all the previous theoretical and practical training in the program.

Participants should bring all clinical reference materials to class.

2. AcuPractice Forms If you want these forms in a Word Document, so you can cut and paste them into your office forms: Please find them on our Website, on the Resources Page. Note: Some of the fonts have been reduced to fit these pages

Sample Symptom Survey to Supplement to Your Ofﬁce Intake Please “check” the symptoms or conditions you experience frequently:

Sp/St Ht/P Lu/LI Ki/UB Liv/GB __ excessive appetite __ insomnia __ cough __ low back pain __ eye problems

__ loose stool/diarrhea __ palpitations __ shortness of breath __ knee problems __ jaundice

__ digestive problems, __ cold hands and feet __ decreased sense of __ hearing impairment __ difficulty digesting smell oily foods

__ vomiting __ nightmares __ nasal problems __ ear ringing __ gall stones

__ belching, burping __ mentally restless __ skin problems __ kidney stones __light-colored stool

__ heartburn/reflux __ laughing for no reason __ claustrophobia __ decreased sex drive __ soft or brittle nails

__ stomach bloating __ chest pains __ colitis/diverticulitis __ hair loss __ easily angered

__ obsession in work, __ poor memory __ constipation __ urinary problems __ difficult relationships

__ blood in stool __ sadness __ allergies __ dental problems __ difficulty making decisions __ lack of appetite __ Depression __asthma __ fatigue __dizziness

__ hemorrhoids __ Anxiety __ get sick easily __edema __headaches

__easily bruised __ hemorrhoids __ Anxiety __ get sick easily __edema __headaches

__easily bruised

__ I usually feel warm __ I usually feel chilled

Please indicate if the following pertain to you: NOTE: This Symbol ♀: before a question, indicates that it is for Women only.

Kidney Yin Deficiency:

□ Do you have lower back weakness, soreness or pain?

□ Do you have ringing in your ears?

□ Is your hair prematurely gray?

□ Do you have dark circles under your eyes?

□ Do you have night sweats?

□ Are you prone to hot flashes?

□ Would you describe yourself as “afraid” frequently?

□ Do you have dizziness?

□ Do you have knee problems?

□ ♀: Do you have vaginal dryness?

□ ♀: Is your mid-cycle cervical mucus scanty or missing?

Kid Yang Deficiency:

□ Is your back sore or weak?

□ Are your feet cold, especially at night?

□ Are you typically colder than those around you?

□ Is your libido low?

□ Are you often fearful?

□ Do you wake up at night or early in the morning because you have to urinate?

□ Do you urinate frequently, and is the urine diluted and/or profuse? □ Do you wake up at night or early in the morning because you have to urinate?

□ Do you urinate frequently, and is the urine diluted and/or profuse?

□ Do you have early morning loose, urgent stools?

□ ♀: Do you have low back pain pre-menstrually?

□ ♀: Do you have profuse vaginal discharge?

□ ♀: Do you feel cold cramps during your period that respond to a heating pad?

Spleen: (Qi , Blood, and/or Yang Deficiency)

□ Are you often fatigued?

□ Do you have poor appetite?

□ Is your energy low after a meal?

□ Do you feel bloated after eating?

□ Do you crave sweets?

□ Do you have loose stools, abdominal pain, or digestive problems?

□ Are your hands and feet cold?

□ Are you prone to feeling sluggish?

□ Are you prone to heaviness or grogginess in the head?

□ Do you have varicose veins?

□ Are you prone to worry?

□ Have you been diagnosed with low blood pressure?

□ Do you sweat a lot without exerting yourself?

□ Do you feel dizzy or light-headed, or have visual changes when you stand up fast?

□ Are you often sick, or do you have allergies?

□ Have you ever been diagnosed with hypothyroid or anemia?

□ Do you have hemorrhoids or polyps?

□ ♀: Is your menstruation thin, watery, profuse, or pinkish in color? □ ♀: Is your menstruation thin, watery, profuse, or pinkish in color?

□ ♀: Are you more tired around ovulation or menstruation?

□ ♀: Do you ever spot a few days or more before your period comes?

□ ♀: Have you ever been diagnosed with uterine prolapse?

□ ♀: Are your menstrual cramps accompanied by a bearing down sensation in your uterus?

Blood Deficiency:

□ Do you have dry, flaky skin?

□ Are you prone to getting chapped lips?

□ Are your fingernails or toenails brittle?

□ Is your hair brittle or dry?

□ Do you have diminished nighttime vision?

□ Are your lips, the inner side of your lower eyelids, or tongue pale in color?

□ ♀: Do you get dizzy or light-headed around your period?

□ ♀: Are you losing hair on your head?

□ ♀: Are your menses scant or late?

Blood Stasis:

□ Do you experience periodic numbness of your hands and feet, especially at night?

□ Do you have varicose or spider veins?

□ Do you have red cherry spots (hemangiomas) on your skin?

□ Do you have chronic hemorrhoids?

□ Do you have dark spots in your eyes?

□ Have you been diagnosed with any vascular abnormality or blood clotting disorder? □ Have you been diagnosed with any vascular abnormality or blood clotting disorder?

□ ♀: Does your menstrual blood contain clots?

□ ♀: Have you been diagnosed with endometriosis or uterine fibroids?

□ ♀: Do you have piercing or stabbing menstrual cramps?

□ ♀: your menstrual flow ever brown or black in color?

□ ♀: Do you feel mid-cycle pain around your ovaries?

□ ♀: Do you have painful, unmovable breast lumps?

Liver Qi Stagnation: □ Are you prone to emotional depression?

□ Are you prone to anger and/or rage?

□ Are your pupils usually dilated and large?

□ Do you have difficulty falling asleep at night?

□ Do you experience heartburn or wake up with a bitter taste in your mouth

□ ♀: Do you become irritable pre-menstrually?

□ ♀: Do you feel bloated or irritable around ovulation?

□ ♀: Does it feel as if your ovulation lasts longer than it should?

□ ♀: Are your breasts sensitive/sore at ovulation?

□ ♀: Do you experience nipple pain or discharge from your nipples?

□ ♀: Do you have a lot of pre-menstrual breast distension or pain?

□ ♀: Do you become bloated pre-menstrually?

□ ♀: Are your menses painful?

□ ♀: Do you feel your menstrual cramps in the external genital area?

□ ♀: Is your menstrual blood thick and dark, or purplish in color?

Heart: (Any Disorder) Heart: (Any Disorder)

□ Do you wake up early in the morning and have trouble getting back to sleep?

□ Do you have heart palpitations, especially when anxious?

□ Do you have nightmares?

□ Do you seem low in spirit or lacking vitality?

□ Are you prone to agitation or extreme restlessness?

□ Do you fidget?

□ Do you sweat excessively, especially on your chest?

Excess Heat:

□ Are your mouth and throat usually dry?

□ Are you often thirsty for cold drinks?

□ Do you often feel warmer than those around you?

□ Do you wake up sweating or have hot flashes?

□ ♀: Do you breakout with red acne, especially pre-menstrually?

□ ♀: Do you have a short menstrual cycle?

□ ♀: Do you have vaginal irritation?

Dampness:

□ Do you feel tired and sluggish after a meal?

□ Do you have cystic or pustular acne?

□ Do you have urgent, bright, or foul-smelling stools?

□ Are you overweight?

□ Do you have a wet, slimy tongue? □ Do you have a wet, slimy tongue?

□ Does your body feel like a barometer? Can you sense when it will rain?

□ ♀: Does your menstrual blood contain stringy tissue or mucus?

□ ♀: Are you prone to yeast infections and vaginal itching?

□ ♀: Do you have fibrocytic breasts?

♀For Women Only:

Age of first period ______Date of last period ______Number of children (live births) ______

Number of days between periods (your cycle) ______Number of days of flow______♀ Check All that Appply: Color of flow: □ pale/light red □ red □ bright red □ dark red □ dark red/brown □ dark red/purple # of pads you use per day: 1st day ___2ND day __3RD day ___4th day ___ Pain and Cramping: □ No / □ Yes □ mild □ moderate □ severe 1st day ___2ND day __3RD day ___4th day ___Before flow ___After flow Amount of flow: □ even throughout □ clots □ No / □ Yes 1st day ___2ND day __3RD day ___4th day ___Before flow ___After flow □ spotting □ No / □ Yes 1st day ___2ND day __3RD day ___4th day ___Before flow ___After flow □ light □ No / □ Yes 1st day ___2ND day __3RD day ___4th day ___Before flow ___After flow □ heavy □ No / □ Yes 1st day ___2ND day __3RD day ___4th day ___Before flow ___After flow

Other symptoms related to menses: □ Discharge □ PMS □ Headache □ Nausea

□ Constipation □ Diarrhea □ Swollen Breasts □ Mood Swings □ Increased Appetite □ Decreased Appetite □ Insomnia □ Constipation □ Diarrhea □ Swollen Breasts □ Mood Swings □ Increased Appetite □ Decreased Appetite □ Insomnia

Have you ever been diagnosed with: □ fibroids □ fibrocystic breasts □ endometriosis □ ovarian cysts □ PID

□ polycystic ovary syndrome □ STD ______

Fertility Information

# of IVF procedures______# of IUI procedures______

Has a physician diagnosed a difficulty with fertility due to: □ Female Factor □ Male Factor □ Unexplained

Informed Consent for Oriental and Chiropractic Medical Treatment I hereby request and consent to the performance of acupuncture treatments, chiropractic, and other procedures within the scope of the practice of Oriental and chiropractic medicines, for the purposes of demonstration for students only, on me, or on the patient named below, for whom I am legally responsible, by the doctor of Oriental medicine named below and/or other doctors of Oriental medicine who now or in the future treat me while employed by, working or associated with or serving as back-up for the doctor named below, including those working at the clinic or office listed below or any other office or clinic, whether signatories to this form or not.

There are some risks to treatment, including but not limited to some bruising of the skin and or/ slight bleeding. If moxibustion or heat therapies are used there is a risk of burn and/or scarring. The risk of infection is small when all needles are sterile. Needles are considered sterile when they are either disposable or are autoclaved according to applicable state legal requirement.

I have had an opportunity to discuss with the doctor named below the nature and purpose of Oriental and chiropractic medicine. I understand that results are not implied nor guaranteed.

I DO NOT EXPECT THE DOCTOR TO BE ABLE TO ANTICIPATE AND EXPLAIN ALL RISKS AND COMPLICATIONS. I WISH TO RELY ON THE DOCTOR TO EXERCISE JUDGMENT WHICH THE DOCTOR FEELS AT THE TIME IS IN MY BEST INTEREST, BASED UPON THE FACTS THEN KNOWN, DURING THE COURSE OF THE PROCEDURE.

I UNDERSTAND THAT I HAVE THE CHOICE TO ACCEPT OR REJECT THE PROPOSED DIAGNOSTIC PROCEDURE OR I UNDERSTAND THAT I HAVE THE CHOICE TO ACCEPT OR REJECT THE PROPOSED DIAGNOSTIC PROCEDURE OR TREATMENT, OR ANY PART OF IT, BEFORE OR DURING THE DIAGNOSIS OR TREATMENT.

I understand that the doctor is not providing Western (allopathic) medical care, and that I should look to my Western primary care practitioner (i.e. MD) for those services and for routine check-ups.

I have read, or have had read to me, the above consent. I have also had an opportunity to ask questions about its content, and by signing below I agree to the above-named procedures. I intend this consent form to cover the entire course of treatment for my present condition and for any future condition(s) for which I seek treatment.

PATIENT’S NAME (print) ______

PATIENT SIGNATURE: x (Indicate relationship if signing for patient) (Or Patient Representative)

DATE: r I have discussed the above information with the patient, including the risks, benefits, and alternatives to the proposed treatment. DOCTOR’S SIGNATURE:______Date:______Consulting Doctor:

Protocol for Moxibustion Treatment Purpose: In recognition of the risks involved with moxibustion treatment; including but not limited to a risk of burn and/or scarring and the risk of infection if burning occurs, the following procedure is to be followed when applying moxibustion.

1. All patients must be informed of the risks, benefits, and alternatives to moxibustion, prior to treatment. All attending physicians must go over the “Informed Consent for Moxibustion Treatment” form with each patient, prior to treatment.

2. All patients must understand and sign the “Informed Consent for Moxibustion Treatment” form prior to treatment.

3. All moxibustion in the office is to be performed by the attending physician. The only exception to the above rule follows: The patient may perform moxibustion on him/herself under the doctor’s direct line-of-sight supervision, as part the process of teaching the patient the procedure for home self-application.

Indirect Moxa: All indirect moxa is to be applied only until the patient’s skin becomes red and warm to the touch, sufficient to achieve the desired level of therapeutic action. The attending physician will continually monitor the temperature of the patient’s skin to insure against inadvertent burning.

Moxa Poles are to be to be closely monitored, and held a minimum of 1 inch from the skin at all times. The attending physician must continually monitor the temperature of the patient’s skin, in order to adjust or remove the moxa pole as necessary.

Moxa on Needle is to be closely monitored. Line-of sight is not sufficient. The attending physician must be within necessary.

Moxa on Needle is to be closely monitored. Line-of sight is not sufficient. The attending physician must be within close proximity, to remove the moxa if the patient is in danger of being burned, by the moxa getting too hot, falling off the needle, or any other mishap.

Moxa on Salt, Ginger, or Aconite is to be closely monitored. Line-of sight is not sufficient. The attending physician must be within close proximity, to remove the moxa if the patient is in danger of being burned, by the moxa getting too hot, falling off the medium, or any other mishap.

Moxa Instruments are to be closely monitored during application. The attending physician must continually monitor the temperature of the patient’s skin and the moxa instrument, in order to remove it if the patient is in danger of being burned.

Moxa Boxes are to be closely monitored during application. The attending physician must continually monitor the temperature of the patient’s skin and the moxa box, in order to remove it if the patient is in danger of being burned.

Direct Moxa: After informing the patient of the procedure, the attending physician must apply the direct moxa, as is medically necessary, while closely monitoring the patient and the procedure. Burns are to be cared for as described below.

Care For Moxa Burns: • Small moxa burns are to be kept clean and covered with a sterile dressing. Patients are to be advised of the signs of infection, and instructed to seek emergency medical care, should any signs of infection develop. • Any moxa burns which are large or severe are to be treated with standard first aid treatment. Patients with such burns are to be immediately referred to a qualified Western medical professional (i.e. M.D., D.O., C.N.P., N.P.) for prompt treatment. If necessary, the attending physician should accompany, and escort the patient to a qualified practitioner for appropriate care.

Informed Consent for Moxibustion Treatment I hereby request and consent to the performance of the moxibustion treatments, which I have initialed below, on me (or on the patient named below, for whom I am legally responsible) by the doctor of Oriental medicine named below and/or other doctors of Oriental medicine who now or in the future treat me while employed by, working or associated with or serving as back-up for the doctor named below, including those working at the clinic or office listed below or any other office or clinic, whether signatories to this form or not.

There are some risks to moxibustion treatment, including but not limited to a risk of burn and/or scarring. The risk of infection is also present if burning occurs.

I Understand That All Moxibustion Includes The Application Of Heat to acupuncture points, and other areas of my body, by manipulating a burning herb, in various ways, to allow the heat to warm and penetrate my skin. I understand that this procedure may result in burns and scarring.

Patient’s Initials______Date: ______

I Agree To Treatment With Indirect Moxa. I understand that this treatment includes the application of burning moxa near my skin. I understand that this procedure is not intended to result in burns and scarring, but that burning and scaring is a definite possibility. Patient’s Initials______Date: ______

I Have Been Instructed To Apply Indirect Moxa To Myself. I have been instructed in this procedure, by my doctor, and I understand the instructions. I realize that this procedure includes the application of burning moxa near my skin. I understand that this procedure is not intended to result in burns and scarring, but that burning and scaring is a definite possibility.

Patient’s Initials______Date: ______that burning and scaring is a definite possibility.

Patient’s Initials______Date: ______

I Agree To Treatment With Direct Moxa. I understand that this includes the direct application of burning moxa to my skin and often results in burns and scarring. In fact, burning and scarring may even be part of the therapeutic action, and may be intentional, on the part of the doctor.

Patient’s Initials______Date: ______I have had an opportunity to discuss with the doctor named below the nature and purpose of this moxibustion treatment. I understand that results are not guaranteed. I DO NOT EXPECT THE DOCTOR TO BE ABLE TO ANTICIPATE AND EXPLAIN ALL RISKS AND COMPLICATIONS. I WISH TO RELY ON THE DOCTOR TO EXERCISE JUDGMENT WHICH THE DOCTOR FEELS AT THE TIME IS IN MY BEST INTEREST, BASED UPON THE FACTS THEN KNOWN, DURING THE COURSE OF THE PROCEDURE.

I UNDERSTAND THAT I HAVE THE CHOICE TO ACCEPT OR REJECT THE PROPOSED PROCEDURE OR TREATMENT, OR ANY PART OF IT, BEFORE OR DURING THE TREATMENT. r I have discussed the above information with the patient, including the risks, benefits, and alternatives to the proposed treatment. DOCTOR’S SIGNATURE:______Date:______

Directions for Self-Treatment at Home with Moxa

PLEASE READ ALL THESE INSTRUCTIONS THROUGH THOROUGHLY BEFORE USING MOXA ON YOUR SELF.

There are risks involved with moxibustion treatment. The risks include, but are not limited to, A risk of burn and/or scarring, and the risk of infection if burning occurs. The following procedure is to be followed when applying moxibustion.

4. All patients must be informed of the risks, benefits and alternatives to moxibustion prior to treatment. An attending physician must go over the “Informed Consent for Moxibustion Treatment” form with each patient, prior to instruction for moxa use, or purchase of moxa from this office

5. All patients must understand and sign the “Informed Consent for Moxibustion Treatment” form prior to treatment, instruction for use, or purchase of moxa from this office.

6. Patients must demonstrate, to the attending physician’s satisfaction, the ability to perform moxibustion on him/her self prior to any purchase of moxa in the office. Using Moxa at Home: All moxa is to be applied only until your skin becomes sufficiently red, and/or warm to the touch, to achieve the desired level of therapeutic action. Your doctor will instruct you in this. You must continually monitor the temperature of your skin, to insure against inadvertent burning. In order to prevent inadvertent burns, do not use moxa on areas that are numb or have any lack of feeling. Using the Moxa Pole/Stick: Moxa Poles (sticks) are to be to be closely monitored, and held a minimum of 1 inch from the skin Using the Moxa Pole/Stick: Moxa Poles (sticks) are to be to be closely monitored, and held a minimum of 1 inch from the skin at all times. You must continually monitor the temperature of your skin, in order to adjust or remove the moxa pole as necessary.

Light one end of the moxa pole with a lighter, the way you would light an incense stick. When it’s well-lit, blow out the flame. It will smoke and, when you blow on this end now, it should glow red at the tip. The tip of the moxa stick is now Very Hot and could burn you if you are not careful, so please be careful. Once the moxa stick is lit, bring it to about an inch from the skin for only about one second, and then move it to about six inches above the skin for about two seconds. Repeat this one-second-close-two-seconds-far “pecking” motion for about five minutes or until your skin becomes sufficiently red and/or warm as you have been shown. If at any time your skin should get too hot, remove the moxa stick far from your person. Moxa Poles can be a little tricky to put out, so it is recommended that you put a few drops of water on the burning tip of the pole just sufficient to put it out completely. If you are judicious in the amount of water used, the pole should be dry enough by the next day to be lit again. If not, you can carefully cut off the damp tip and relight it. Care for Moxa Burns: • All moxa burns are to be treated as burns, with standard first aid treatment. • Small moxa burns where there is no broken skin are to be kept clean and covered with a sterile dressing. Should any signs of infection develop, you are advised to seek emergency medical care from a qualified Western medical professional (i.e. M.D., D.O., C.N.P., N.P.) • For Burns that are Severe, Large, Or Break the Skin the Patient Should Immediately Seek a Qualified Western Medical Professional (i.e. M.D., D.O., C.N.P., N.P.) for Emergency Treatment.