Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations. Issues in the Lower Jiao from the pelvic area to the lower back/legs range include such clinical presentations as chronic lower back pain, chronic or acute UTI's, yeast infections and joint pain/inflammation. In this short article, I will cover important TCM patterns which can address these Lower Jiao issues and present 3 Needle Formulas for clinical application.
Some of the most common and most clinically relevant patterns for Lower Jiao issues are: Damp Heat, Cold Damp, Qi/Blood Stasis and Kidney/Liver Vacuity. While this is far from exhaustive, these four patterns are foundational in the majority of chronic and acute issues in the Lower Jiao. Let's examine each one of these patterns and explore Three Needle Formulas which can be used to resolve the patterns of disharmony.
This is one of the most common clinical pattern presentations and is almost always a contributing factor in chronic recalcitrant cases manifesting in the Lower Jiao.
Damp Heat can manifest in such issues as yeast infections, urinary tract infections, prostatitis, fungal infections and joint pain (often referred to as Damp Heat Bi). The following three needle formulas should always be examined in cases of Damp heat.
Sp 9 + GB 34 + Liv 5
This is an excellent formula for chronic knee pain with inflammation which is worse in damp humid environments and/or joint pain which is recalcitrant and stubborn in nature. The points Sp 9 and GB 34 should be needled with strong stimulation until the Qi sensation is felt in the knee area and often down into the foot. This point combo can also be of great use in chronic or acute vaginal yeast infections and/or UTI. In these cases, needle the points Sp 9 and GB 34 with draining techniques and stimulate Liv 5 until the Qi sensation travels/radiates into the pelvic area.
GB 34 + Liv 3 + Kid 2
This is an excellent formula for addressing Damp Heat sinking into the Lower Jiao causing such issues as cystitis, vaginal yeast infections or menstrual irregularities. The points GB 34 and Live 3 should be needled with strong sensation until the Qi sensation is felt radiating throughout the entire leg and into the pelvic area if applicable.
Kid 2 should be needled with even stimulation until the Qi sensation is felt into the foot or lower leg area. If there is bleeding due to Heat or severe itching, substitute Liv 2 for Liv 3 in the above Three Needle Formula.
Sp 9 + Ren 6 + Liv 2
This is a highly effective Three Point Formula for Damp Heat which has seeped into the Lower Jiao and manifests as chronic painful issues in the pelvic area which could range from urinary/prostate issues, menstrual issues and intestinal issues. The points Sp 9 and Ren 6 should be needled with strong stimulation until the Qi sensation of felt throughout the pelvic area and the point Liv 2 should be needled with strong draining technique.
This pattern manifest symptoms similar to Damp Heat except without the obvious Heat signs and the symptoms tend to be insidious and not as intense and significantly exacerbated by cold damp environments and tend to be aggravated by lack of movement.
Kid 7 + Sp 6 + Ren 6
This three point formula warms, courses and drains. Stimulation should be strong and even on Kid 7 and Ren 6 and Sp 6 should be needled with supplementing technique. Moxa can also be used on Ren 6 for a stronger therapeutic effect.
Kid 3 + St 36 + Ren 6
This three point formula is a key group which benefits most by the use of moxa in Cold Damp conditions. The warm Qi sensation should be felt radiation throughout the entire lower jiao for be clinical efficacy. The needle technique should be even on Kid 3 and Ren 6 with a strong supplanting technique on St 36.
St 36 + Ren 6 + Sp 10
This is an effective three point formula for clinical presentations in which Damp and Cold have caused concomitant Blood Stasis. Moxa can also be used quite effectively with this three point formula. Needle sensation should be steady and strong on all points until a dispersive warm sensation spreads throughout the Lower Jiao and should be sustained by the combined use of needle and moxa.
I have not listed in-depth point indications in this short article, as I assume practitioners have access to sources which can provide this in a comprehensive manner. In a future article, we will cover the patterns of Qi/Blood Stasis and Kidney/Liver Vacuity, as well as ways to integrate Three Needle Formulas into ear acupuncture protocols.