Questions regarding second part of Course C

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Dear Dr. King,
I have some questions regarding second part of Course C.

1. Is there some “age limit” in using acupuncture?
First, from Course C I understood that “it is advisable to apply few needles or to delay giving acupuncture treatment to the patients who are over-fatigued or very weak”. Does it relate to elderly patients from certain age or we must decide for acupuncture indications individually according to the state of the patient?
Second, it is clear that for infants “retaining of needles is forbidden since the infants are unable to cooperate with the practitioner”. Does it mean that we can use only a short needling duration or it is preferably not to use acupuncture for infants till certain age?

2. Is diameter of the needle significant to induce the needling sensation?
In text of the Course noticed that “needles from Nos. 26-32 in diameter and l -3 cun in length are most frequently used in clinic”. Apparently they are needles from 0.25 to 0.40 mm in diameter. At the same time different companies sell acupuncture needles from 0.12 mm in diameter. For what cases are usable this needles?

3. In practicing needling method in second part of Course C among other points I needled point Zusanli (ST 36). I remembered your correspondence with Prof. Price about a depth of needle insertion in this point. I the past I did massage of this point and paid attention to the fact that in order to have correct location of the point and for arrival of Qi the posture of the patient is very important. Only when the knee of the patient was flexed at an angle of ninety degrees, it was possible to find this point correctly and to obtain essential sensation. So I used posture “sitting erect” for massage Zusanli. I tried to use the same posture for needling this point and really it was easier to insert needle at proper deep of 1 – 1.5 cun, than in supine posture when the leg was straightened.
I'd like to know what posture is applied for needling Zusanli in China clinics.

tutor

Dear Sophia,
Let's discuss your questions hereinbelow.
1). Generally speaking, there is no age limit for acupuncture, theoretically.
As your first question is concerned, it's not referred only to the elderly patients, it's the point involving all the patients! Even the very strong adult patients, even the men, they can easily suffer from needling fainting! Even the Chinese men could!
So you have to be sure the patients are in good condition, especially the ones who are fresh to acupuncture, no matter they fear, or not, they may have the needling fainting. It's a bit funny, those who do fear the needling would have a little less chance of the faining.
Secondly, we CAN use acupuncture for infants but we would often do it in an in-and-out way, so you make a thrusting, giving a little stimulation, to feel the Qi arrive, and pull out the needle and to do the next point.
To some infants who can understand you, you can tell them why the needling is given, if they can cooperate, i.e. they can tolerate the pain, you may for sure retain the needles for a while.
In China, acupuncture would be used for many disorders of motor impairment of infants, e.g. the residual of the labour injury.

...to be continued

tutor

[quote:42afc2d81d="Sophia"]
2. Is diameter of the needle significant to induce the needling sensation?
In text of the Course noticed that “needles from Nos. 26-32 in diameter and l -3 cun in length are most frequently used in clinic”. Apparently they are needles from 0.25 to 0.40 mm in diameter. At the same time different companies sell acupuncture needles from 0.12 mm in diameter. For what cases are usable this needles?.[/quote:42afc2d81d]

Yes, the thickness of the needle has also the significance in producing the needling sensation!
So in China, acupuncture physicians would use the needles 0.25 to 0.30 mm in diameter, and I used to find that the European people prefer thinner needles, so I would use the needles 0.25 mm in diameter to them.
But last year a friend of mine in Europe had asked me to buy some needles for him, so I had bought the ones 0.25mm in diameter, but he told me later that the needles are too thin!
So this year, I bought some thicker ones (0.30mm in diameter) for him and he was satisfied.
Personally I think the very thin needles are good for the use of needling the points in the face or for the embedding of needles, actually more for the latter.
In China, the very thin needles are not used much, or I'd say very rarely used.

tutor

[quote:106df44352="Sophia"]
3. In practicing needling method in second part of Course C among other points I needled point Zusanli (ST 36). I remembered your correspondence with Prof. Price about a depth of needle insertion in this point. I the past I did massage of this point and paid attention to the fact that in order to have correct location of the point and for arrival of Qi the posture of the patient is very important. Only when the knee of the patient was flexed at an angle of ninety degrees, it was possible to find this point correctly and to obtain essential sensation. So I used posture “sitting erect” for massage Zusanli. I tried to use the same posture for needling this point and really it was easier to insert needle at proper deep of 1 – 1.5 cun, than in supine posture when the leg was straightened.
I'd like to know what posture is applied for needling Zusanli in China clinics.[/quote:106df44352]

There are various ways of needling the point in China, some physicians would do it with the knee flexed, some would do it with the knee extended, some even do it with the patient "sitting erect", or some even do the point when the patient lies prone.
That's not because they like to do it in that posture, but because the patients have to take the postures for the needling of other points.
I think the best way is to let the patient lie supine but with the knee flexed under which a pillow is inserted, so the angle between the thigh and the lower leg could be in the range of 120 to 130 degrees.
For sure I cannot deny the applicability of the other postures.

tutor

Dear Dr. King,
Thank you very much for your explanation. It answers fully my questions.
It is interesting, that as you describe, patients “who do fear the needling would have a little less chance of the fainting”. May be adrenalin, their organism produces (more exactly system of Kidney produces in state of fearing) helps them to keep consciousness. So, fear to a certain extent is a helpful feeling to promotion of defense reaction, supporting to act and not to faint.

I appreciate you sincerely also for your comment to my topic “My experience of diagnostic methods”. Your description of the pulse diagnosis sounds like the symphony. Of course after this description I returned to reading about various types of the pulses, because I understood that I miss a lot without this diagnostic method. I hope to study the pulse diagnosis in China in future.

tutor

Dear Sophia,
Maybe you are right, those who fear the needling have a little less chance of the fainting probably have lessened the chance of fainting by their reaction to the pain through the fear!
It would be said the Kidney is the root of the body, so maybe fear is the utmost emotion. In another word, the water can play a stablizing role to the body, right?
To talk about the pulse diagnosis, it's only a little personal experience and maybe you know more than that. I think we all need to perfect our skills! So it's good you will come to Beijing to make a better clinical practice and polish your pulse skills.
I also asked the Tutor to post my opinions about the pulse in his forum.