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the most difficult acupoints for needling

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#1
Post time: 2009-05-06 10:07:09
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Hi

What do you think which points are difficult for needling ?

and how should be neiguan (pc 6) needling to avoid patient pain ?


Tommy

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Tommy

Posted: Tue Aug 22, 2006 6:27 pm    

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#2
Post time: 2009-05-06 10:07:37
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Dear Tommy,
I'm not quite sure which one is the most difficult point for needling. Many would say BL 2 and ST 1 are difficult in needling.
In fact, they are not really dangerous, but the internal bleeding would cause the patients look black and blue in the face

Neiguan (PC 6) is not of any difficulty in needling!
One could just use a small needle, 1 cun needle, and press the point before inserting the needle, then give a gentle insertion, and make very gentle lifting and thrusting for couple of times, that's enough.

What's the difficulty?

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David King
Posted: Sun Aug 27, 2006 12:28 pm    

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#3
Post time: 2009-05-06 10:07:59
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thank you

what about needling fengchi point( Gb 21) is it safe ?

Tommy

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Tommy

Posted: Mon Aug 28, 2006 12:08 am    

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#4
Post time: 2009-05-06 10:08:24
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Generally speaking, it's safe to needle Fengchi (GB20), it's not GB 21!!!

But you should know what angle of the needling, the needle should be inserted toward the chin.

D.K.

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David King
Posted: Mon Aug 28, 2006 10:18 pm    

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Post time: 2009-05-06 10:08:52
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thank You

Of course Fengchi is GB 20 ( my mistake)

I have question about back - Shu points . Is any easy way to locate them?


Tommy

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Tommy

Posted: Tue Aug 29, 2006 1:11 pm    

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Post time: 2009-05-06 10:09:13
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I think it's not difficult to find them!
From Du 14, you might find T1, then 3 vertebrae down, you find BL 13, the one for lung, and then, you might find the others on the upper back.

From the lower angle of scapula, you might find T 7, and then the ones on the middle back, and from the anterior and superior iliac spine, you find the L4, then the ones on the lumbar region.

Is that easy?

D.K.

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David King

Posted: Wed Aug 30, 2006 12:27 pm    

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Post time: 2009-05-06 10:09:42
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Dear Tutor

Could you explain how lieque point should be needling ? which direction ?
how deep ?


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Tommy

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Posted: Thu Sep 07, 2006 1:47 pm    

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Post time: 2009-05-06 10:10:05
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Dear Tommy,
Is there anything about the needling in the text in regard with the needling of the point?

In any sense, the point should be needled horizontally with the needle inserted upward to the elbow. It cannot needled very deep, I think the text says the depth is about half cun.

Is that right?

D. K.

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David King

Posted: Sat Sep 09, 2006 1:46 pm    

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Post time: 2009-05-06 10:10:27
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[quote:3a96295fb6="Tommy"]I have question about back - Shu points . Is any easy way to locate them?[/quote:3a96295fb6][quote:3a96295fb6="David King"]I think it's not difficult to find them! (...) [/quote:3a96295fb6]

The answer of Dr. King (see his post) is, of course, correct. However, a remark should be made.

It is easy indeed to locate those points, [i:3a96295fb6]but[/i:3a96295fb6] you need to have the basic skills in palpating the spine. So, to find the T1 spinous process, you should first look at the patient's neck from behind, where the C6 and C7 spinous processes are normally the most obvious in the lower part. You can differentiate between C6 and C7 by passively flexing and extending the patient's neck. With this movement, the C6 spinous process moves in and out and the C7 spinous process remains stationary. The next spinous process down from C7 is T1 and so on, counting down. As for the scapula inferior angle, I would not rely too much on its position, as, besides obvious anatomical deviations, the size of the scapula varies greatly, and its inferior angle might normally lie somewhere between T7 and T9. In fact, if your patient is lying face down (with his/her arms resting towards the floor), it is rather the spinous process of T6 which is located at the height of the angle in most cases (due to rotation of the scapula). As for using the level of the highest points of the iliac crests as a landmark, the line joining those two points usually crosses the spine in the L4-L5 interspace. After moving down to the first hard mass, the fingers will be resting on the spinous process of L5. Palpation of the iliac crests should be performed from the caudal direction. Palpation from the cranial direction might result in a layer of soft tissue padding over the crests, and therefore lead to errors in finding the right level. Moving towards the head, the interspaces and spinous processes of the remaining lumbar vertebrae can be palpated. However, in about 20% of subjects the spinous process of L5 is found at this level (Peuker E., Cummings M., 2003), so you might want to double check it, possibly by counting down from the spinous process of T1.

You can find a comprehensive discussion of many other anatomical issues related to acupuncture in the excellent series of articles called [i:3a96295fb6]Anatomy for the Acupuncturist - Facts & Fiction[/i:3a96295fb6] by Drs. Elmar Peuker (Germany) and Mike Cummings (U.K.) published in [i:3a96295fb6]Acupuncture in Medicine[/i:3a96295fb6] (2003; 21 (1-2):2-8; (3):72-79; (4):122-132), which can be downloaded (PDF) from the following links:
http://www.acupunctureinmedicine.org.uk/showarticle.php?artid=457
http://www.acupunctureinmedicine.org.uk/showarticle.php?artid=469
http://www.acupunctureinmedicine.org.uk/showarticle.php?artid=473

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Sergiy

Posted: Mon Sep 11, 2006 6:06 am    

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10#
Post time: 2009-05-06 10:10:48
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[quote:2b478280cc="David King"]
In any sense, the point should be needled horizontally with the needle inserted upward to the elbow.[/quote:2b478280cc]

I am a little bit confused . Even though it does say so in the text of course C, does it mean that, in the case of Lieque (LU7), you cannot do reinforcing by pointing the needle tip following the running course of the meridian (LU), i.e. in the distal direction (“the reinforcing and reducing achieved by the direction the needle tip pointing to”, described in Part 2 of the course C text)? Also, I have read somewhere (I do not remember the source, but I can find it if needed) that for the treatment of disorders of the thumb joints, Lieque (LU7) is needled distally towards the thumb, while for its other clinical applications, LU7 is normally needled proximally in the direction of the elbow. Is it not correct?

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Sergiy

Posted: Mon Sep 18, 2006 7:27 am    

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