When is Tonification without retention used?
mostly for Deficient patients
When is Tonification with retention is used?
To tonify a Deficiency when the patient is also agitated or when a number of points work together and need to be Tonified at the same time.
When is Even used?
a) for Mixed conditions when there is a need to reduce the Full aspect but a vigorous technique is not appropriate (e.g. because there is an underlying Deficiency)
b) for treating head points, where Reduction would not normally be used.
When is Reduction used?
a) to expel an External Pathogenic Factor when there is a very Full condition
b) remove stagnation when there is acute pain
c) for anaesthesia
Steps to needling with a guide tube
1) Insert using a guide tube by placing the needle over the point and ‘tapping’ the needle into the
point. The non-dominant hand should hold the base of the guide tube.
2) Remove the guide tube, and without touching the shaft of the needle, insert the needle to the
correct depth using the dominant hand to hold the handle of the needle.
3) If the needle needs to be supported (as in the case of 1.5+ cun needles) by the non-dominant
hand, either a sterile cotton wool ball should always be used to protect the shaft of the needle from touching the fingers, or a (clean) shorter guide tube can be used to assist the insertion.
Steps to needling wihout a guide tube
1) Hold the handle of the needle in the dominant hand. The needle tip just rests on the skin.
2) The two hands work together. Press down and stretch the skin with the non-dominant hand
(avoiding touching the shaft of the needle) and swiftly insert the needle with the dominant hand.
3) The non-dominant hand exerts strong pressure as this helps to avoid pain when inserting the needle (without strong pressure this insertion can be painful).
What are the directions for needling?
Tonification – with the flow of Qi
Even – perpendicular to the flow of Qi
Reduction – against the flow of the Qi
Alternatively, the needle sensation may sometimes be directed toward the diseased area, e.g. angling GB 30 downwards for channel problems affecting the leg or hip. Points over the lungs are angled obliquely.
Describe how to reach depth
Depth depends on body mass and location of the point being needled. As a general guide nail points are only needled to a depth of about 0.1 cun, whereas buttocks could be needled up to a depth of 2.5 or even 3
cun.
What is DeQi and what does it feel like?
DeQI is the name given to the sensation which indicates that the Qi has arrived at the point. It may be a sensation of a dull ache, soreness, heaviness, numbness, distension or electric sensation, but not pain.
Chinese people know the difference between suan (sensation), ma (numbness) and tong (pain).
If the shen is weak a patient may be over-sensitive to all needle sensation. If a patient has very Deficient Qi it will be much harder to obtain deQI. A good sensation of deQI is a sign of good health and a good prognosis.
What to do if DeQi is not obtained
If deQI is not obtained when the needle is first inserted, the needle can be moved in and out of the point until deQI arrives. This is known as ‘lift and thrust’ and the method employed depends on the needle technique being used.
How do you obtain Deqi for Tonification?
a) Lifting and thrusting for Tonification is carried out very slowly and gently with about one lift and thrust every 3 - 4 seconds and using only superficial movements of lifts and thrusts of 0.1 – 0.2 cun.
Lifting and thrusting is less forceful when using a gentle Tonification than a stronger Tonification. Pull the needle up with no emphasis on this movement. Push the needle back in again with more emphasis on this downward movement.
How do you obtain Deqi for Even?
a) Lifts and thrusts can be 0.2 – 0.3 cun with no emphasis on the upward or downward movement.
b) The speed of the Even technique should be half way between Tonification and Reduction.
How do you obtain Deqi for Reduction?
a) Lifting and thrusting is done using fairly rapid movements– about 6 lifts per 10 seconds – and
deeper lifts and thrusts – about 0.3 – 0.4 cun – than Tonification technique.
b) Pull the needle upwards as if pulling something out of the body. Emphasis should be on this upward
movement.
c) Push the needle in again with no emphasis on this movement.
What to do if Obtaining Deqi is Difficult?
Check the point location is correct.
Lift and thrust evenly and smoothly.
Leave needle for a while then try again to obtain deQI.
Change own internal state.
Name 7 other methods for obtaining deQI (in order of intensity)
‘Searching’ – change the angle and depth of the needle.
Rotating’ – gently rotating the needle 180 back & forth until deQI is obtained
Scraping’ – scrape the needle handle with your thumbnail or finger-nail.
‘Flicking’ – gently flicking the needle handle.
Shaking & trembling’ – gently vibrating the needle.
‘FlYing’ – rotate needle gently then quickly release fingers.
‘Following’ – massage channel above and below the point.
When can you manipulate the needle after deQI has been obtained?
After deQI has been obtained the needle can be lifted in and out of the point and rotated to get more
stimulation when doing Reduction. In the case of Tonification and Even, lifting and thrusting is only used to obtain deQI.
Explain the use of rotation for Tonification Technique
- Insert the needle to the required depth in the direction of the flow of energy
- Once deQI is obtained, turn the needle 180 degrees clockwise
Explain the use of Lifting and Thrusting and Rotating for Reduction Technique
Lifting and Thrusting, or Rotation, can be continued for anything from a few seconds to one minute
according to the strength of reduction required and the strength of the patient
Insert the needle to the correct depth against the flow of energy.
Lift and thrust to obtain deQI. Once deQI is obtained continue to lift and thrust, pulling the needle
upwards as if pulling something out of the body. Emphasis should be on this upward movement.
Push the needle in again with no emphasis on this movement. Or
Rotate the needle 360 degrees in an anti-clockwise direction and then back and forth between
anticlockwise and clockwise directions keeping the needle at the same depth. Emphasis should be on the anti-clockwise movement.
For stronger Reduction, manipulate the needle every 5 minutes.
Explain Retention of needle for Tonification
Sometimes needles are retained in a point and sometimes they are removed almost immediately. The
length of time depends on how quickly the pulses changes.
Tonification technique needles may be removed immediately or may be retained for 5 – 10 minutes (if the patient is agitated or when a number of points work together and need to be Tonified at the same time)
Explain retention of needle for Even and Reduction
Even or Reduction technique needles are retained usually for 15 – 20 minutes. Retention for longer
than 20 minutes has a greater reducing effect.
Explain how to withdraw the needle for Tonification, Even and Reduction
Tonification: The needle should be withdrawn swiftly and the hole closed by pressing a sterile
cotton wool ball over the point
Even: The needle should be withdrawn at medium speed and the hole left open
Reduction: The needle should be withdrawn slowly and the hole left open
Summarise needle technique for Tonifcation
Insert slowly and gently. With the flow of Qi. Slowly lift & thrust with
emphasis on the thrust. After deQI is obtained, rotate 180 degrees clockwise. Shorter retention. 5 – 10 minutes. Out Swiftly. Close the hole.
Summarise needle technique for Even
Insert medium speed perpendicular to the flow of Qi. Lift and thrust at medium speed with no emphasis on either
the lift or thrust. No manipulation is required once deQI is
obtained. Longer retention- 20 minutes. Out at medium speed. Leave hole open.
Summarise needle technique for Reduction
Insert swiftly to required
depth. Against the flow. Lift & thrust faster with
emphasis on the lift. After deQI is obtained, lift and thrust the needle, or rotate 360 degrees with
emphasis on anti-clockwise movement. Longer retention-20 minutes. Out slowly. Leave hole open.
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Heart Channel8
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Small Intestine Channel18
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Bladder Channel56
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Kidney Channel19
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Lung Channel9
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Large Intestine Channel16
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Stomach Channel13
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Spleen Channel9
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Pericardium Channel0
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Triple Burner Channel0
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Gall Bladder Channel0
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Liver Channel10
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Du (Governing) Channel0
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Ren (Conception) Channel0
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Needling66
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Pulse6
