Differentiating Qi Under the Needle

In the marketplace, we hear of dry needling being talked about more and more. As professional practitioners of Chinese medicine and acupuncture, it is important that we do not lose sight of our passion, purpose and belief in what we are doing, both for the sake of preserving the full practice of acupuncture and Chinese medicine, and for the sake of our patients. This article focuses on and differentiates the level of sophistication and efficacy we can offer as professional acupuncturists that is not provided through simpler practices, such as dry needling.

Professional acupuncture involves skillful needling at five depths: Xing (structure), Qi (energy), Yi (intention), Shen (spirit), Kong (space). Dry needling is performed at the Xing (structure) level only.

The Significance of Differentiating Qi Under the Needle

The ultimate goal of acupuncture treatment is to reconcile Qi and Blood and to balance Yin and Yang. The classic Ling Shu states: "Acupuncture is effective only if the Qi has arrived. Its effect, as one would describe, is as if the winds blow away the clouds and clear the azure sky. These all are the Dao of acupuncture." This writing speaks to the importance of achieving "De Qi" (get qi) when needling.

Achieving De Qi enables us to apply tonifying or dispersing needling techniques so that we may fill deficiency and disperse excess, which is the general principle of acupuncture. The general principle of acupuncture treatments is to fill deficiency and disperse excess. The Ling Shu states, "Empty or full, the nine needles are exceedingly wondrous. To tonify or disperse, results will be achieved through needling."

When it comes to performing tonifying or dispersing, we must not only know the needling techniques, but we must be able to discern whether it is evil qi or good qi under the needle. Ling Shu described very clearly that during needling, "When the Evil Qi comes out, it is tight and urgent. When the Grain Qi comes, it is slow and harmonious." In clinical practice, more than simply knowing this, we need to further differentiate the Qi under the needle.

The following quotes from the classics relate to grasping Qi movement, having an understanding of Qi while needling, and communicating with Qi:

• The essence of needling lies in the regulation of Qi."
• Follow the rules of Yin-Yang and embrace the laws of nature."
• The principles of using these fine needles are easy to say but difficult to master. Ordinary skills of acupuncture maintain the physical body; advanced skills maintain the spirit."
• Ordinary techniques guard the gates; advanced techniques control the moving power. At the core of this moving power, it is quiet and subtle. Its coming cannot be hurried; its going cannot be chased."

All of these quotes from the classics are related to grasping Qi movement, understanding of Qi while needling, and the communication with Qi. This communication happens at the Qi level or even at the spirit level. It is a communication between the acupuncturist and the patient. Simply put in modern language, it is a matter of finding a way to grasp the Qi and balance Yin-Yang by implementing the traditional methods of rationale, principle, formula, point, and technique. Doing so unifies Heaven and Man in the communication between the acupuncturist and patient at the various levels.

Five Steps of Qi Differentiation

During needling, Qi differentiation is crucial in order to obtain De Qi, hold Qi, and guide Qi. The Ancients called it "listening to the needle." In fact, it is similar to a kind of Qi differentiation method used by ancient acupuncturists in which the patient's Qi-Blood and flow of Qi can be sensed through the needles while doing vipassana meditation.

Step 1: Probing the Point

Here, "probing" carries a similar meaning just like knocking on doors, saying hello to the owner and seeking the owner's permission. In this step, the assisting hand and point palpation techniques are applied. Next, lifting-thrusting and twirling techniques are performed to sense the Qi-Blood under the needle within the same level and at different levels.

Step 2: Entering the Subconscious

This step emphasizes the importance of entering a "selfless" state, an in-between stage of the conscious and unconscious mind. The acupuncturist should synchronize with the patient's respiratory rhythm.

Step 3: Visualizing

This step requires the practitioner's exclusive attention and unified mind. It is a state of meditative contemplation, visualizing the energy traveling through the meridians.

Step 4: Gathering Qi

Having skills to gather Qi is an essential step of this process. These skills are learned in advanced study of needling techniques. We will not delve into those details within this discussion.

Step 5: Becoming Tranquil and Transcendent

Taoism has a saying: "a person has six roots (eyes, ears, nose, tongue, body, and intention) with intention as the leader." This suggests that we need to use our intention to mediate the induction and control of physiological perceptions.

When we utilize our imaginative power while in a state of absolute focus and tranquility, our mind can become one with the needle. In this state, our fingers will become extremely sensitive. As a result, the sensation of Qi, the texture of the skin, flesh, and internal organs will become highly differentiated under the needle. At this moment, we have to manipulate the needle naturally, intuitively, attentively, and yet not intentionally.

Editor's Note: The conclusion of this article, including the Four Sensations Under the Needle will be published in next month's issue.