As practitioners of Oriental medicine, we know that acupuncture points are a nexus of physiological activities that govern certain body parts. These points may have certain elemental energies, such as "water" points that regulate water, or they may have domain over the zang fu organs or essential substances.
These functions are not automatically activated simply by sticking needles into a point. It could involve active twirling of the needle (a typical Chinese technique), or simply the subtle but equally effective positioning of a needle in relation to the flow of qi in the meridian (a common Japanese method).
In this article, I will illustrate these concepts by explaining the use of a particular point, ST36 (zusanli), and how it can achieve varied clinical effects in two ways: first, by the specific needle technique employed; second, by its combination with other points. I've chosen zusanli specifically because of its multiple clinical energetics and its importance in the clinician's repertoire of treatment points.
In the Chinese selection of points, ST36 is perhaps the most renowned. From a classical standpoint, we know it as the he-sea point of the stomach meridian. He-sea points are those in which the qi of the channel is deeply converged. Because of this, they have a direct effect upon the organ, in this case the stomach. Likewise, on a yang meridian, he-sea points correspond to earth points elementally. As such, this means these points can regulate earth energy be adding to or taking away that energy, for instance, dampness. The way to achieve this, however, is by way of needle technique. A tonification technique can strengthen the earth element; a dispersion technique can disperse excess earth energy. Therefore, we can appreciate the critical relationship of needle technique to point selection. Point selection, of course, is contingent upon the treatment in plan, which in turn is constructed in coordination with the diagnosis.
Returning specifically to ST36, as an earth point on an earth meridian, confers its additional status as an horary point. Horary points have the same elemental energy as the meridian on which they are located. Possessing this unique quality is analogous to a "double dose," so to speak, of that elemental energy. In the case of ST36, this makes it a very "earthy" point, but again, it is through needle technique that we decide what to do with that earth energy.
In terms of indications (clinical conditions that are a direct function of the classical energetics discussed above), ST36 is known for its use in treating the following conditions: gastric pain; vomiting; abdominal distention; indigestion; borborygamus; diarrhea; constipation; dysentery; mastitis; dizziness; mental disorders; hemiplegia; beriberi; aching of the knee joint; abscessed breast; edema of the limbs; difficult urination; incontinence; paralysis; seizures; asthma (lung or kidney type); duodenal ulcers; depression; and abdominal and gastric illness.
Now let us turn our attention to the use of ST36 with other acupuncture points, to see how they work synergistically, and to see which needle technique needs to be chosen to accomplish those results. Source materials for this discussion were obtained in a lecture I attended in 1988 at the International Training Center of the Academy of Traditional Chinese Medicine in Beijing, China, entitled "Very Famous Old Prescriptions for ST36." In lieu of a lengthy discussion, and for clinician convenience, this information is summarized in the table that follows. The practitioner may select any tonification (reinforcement) or dispersion (reduction) technique that he/she prefers. Standard point locations and depths of insertion should be used and, if required, can be consulted.
| Point Combination | Needle Method | Energetics | Clinical Conditions |
| ST36 (Sanyinjiao) and | Reinforce | To elevate the yang qi | For rheumatic disease, bi-syndromes, numbness of the legs |
| SP6 | Reinforce | To strengthen the yin and blood; for deficiency and cold of the spleen or deficiency of qi | |
| Overall, the main prescription to tonify the qi and blood | |||
| ST36 and | Reduce | He-Sea point to eliminate turbidity in the stomach | Diarrhea, vomiting, nausea, acid regurgitation, bi-syndrome, knee pain, beriberi of the foot |
| GB34 (Yanglingquan) | Reduce | He-sea point to clear heat in the liver and gallbladder | |
| Overall aim: to harmonize wood and earth. For diseases of wood and earth, such as retention of phlegm in the middle jiao | |||
| ST36 and | Reinforce both points or use even technique | As he-sea points, they strengthen the middle jiao, dispel damp, and promote transformation and transportation | Reduces edema caused by the heart and dysfunction of the kidney, dysuria, edema of the lower extremities, for digestion with abdominal distention, chronic diarrhea |
| SP9 (Yinlingquan) | |||
| ST36 and | Reduce | Promotes circulation of meridians and collaterals | Poliomyelitis, wei-syndrome |
| GB39 (Xuanzhong) | Reduce (apply moxa to GB39 to prevent wind-stroke) | Reduces/clears heat/fire in the gallbladder. A must for any marrow problem. Tonifies the marrow | Early signs of wind-stroke such as numbness or hemiplegia |
| For kidney problems caused by gallbladder fire | Hypertension | ||
| ST36 and | Reinforce | Strengthens earth, harmonizes stomach | For chronic hepatitis and jaundice |
| LR3 (Taichong) | Reduce | Pacifies the liver | |
| ST36 and | Moxa recommended over needle | Affects the fetus | Difficult labor, promotes menstrual flow |
| BL67 (Zhiyin) | |||
| ST36 and | Reinforce | For perversion of qi, any qi going the wrong way, brings qi down | Coma due to anger, sunstroke, toxic coma, respiratory failure, dehydration, makes blood pressure normal |
| ST36 and KI1 (Yongquan) | Reduce | ||
| ST36 and | Reinforce | Both points of the foot and hand yang ming | Acute or chronic rhinitis, nasal obstruction due to invasion of wind-cold (deficiency case) |
| LI20 (Yingxiang) | Reduce | ||
| ST36 and | Tonify | Benefits and stregthens the stomach | Deficiency couch caused by fatique, deficiency asthma |
| LU7 (Lieque) | Reduce | Resolves phlegm | |
| ST36 and | Reduce | Clears heat in the diaphragm and chest | Stifling sensation in the chest, dry retching, irritability, belching, irascibility, vomiting, acid regurgitation, lassitude |
| PC8 (Laogong) | Reduce | Clears heat in heart and lung, descends upward attack of heat | |
| ST36 and | Reduce | Clears heat in the diaphragm and chest | Stifling sensation in the chest, dry retching, irritability, belching, irascibility, vomiting, acid regurgitation, lassitude |
| PCS (Laogong) | Reduce | Clears heat in heart and lung, descends upward attack of heat | |
| ST36 and | Reduce | Reduces fire in the yang ming, clears heat in the stomach meridian | Toothache caused by upward attack of stomach fire, headache due to upward attack of heat in the yang ming, sore throat, frontal headache, redface |
| Li2 (Erjian) | Reduce | ||
| ST36 and | Reduce | ST36 for fu organs | Famous prescription for constipation due to depression of qi in 3 jiaos and dysfunction of spleen and stomach. Can use for constipation in pregnancy |
| TE6 (Zhigou) | Reinforce | TE6 for regulating qi of 3 jiaos of the fu organs | |
| ST36 and | Reinforce | Regulates the qi of the foot and hand yang ming | Stomach and intestinal problems. Good formula for health |
| LI10 (Shousanh) | Reinforce | For disorders of the qi of the stomach and intestines | Weakness in spleen and stomach, abdominal distention, fullness and pain, loose stools, irregular bowel movement, constipation, anorexia |
| Deficiency of qi and blood in general and in the elderly | Dizziness, vertigo, blurry vision, weakness of lower limbs, fatigue, hemiplagia, wei- and bi-syndromes, trembling of extremities due to qi and blood deficiency seen in older patients | ||
| Point Combination | Needle Method | Energetics | Clinical Conditions |
| ST36 and | Reduce | Very famous ancient prescripton to regulate the upper and middle jiao | Removes food retention |
| CV21 (Xuangi) | Reduce | Sends qi downward; when spleen and stomach lose the ability to transform and transport | Severe asthma, improper food intake, abdominal distention, nausea, anorexia, fullness, belching, loose stools, hard masses |
| Overall, the main prescription to tonify the qi and blood | |||
| ST36 and | Reinforce | He-sea point to eliminate turbidity in the stomach | Strengthens the spleen and stomach |
| CV11 (Jianli) | Reinforce | Harmonizes the stomach, ascends the clear, resolves damp | Eases the chest, chronic diarrhea due to dysfunction of the stomach and intestines |
| Main prescrption for stomach disorders and epigastric pain | Abdominal pain, spontaeous sweat, lassitude | ||
| ST36 and | Reinforce | Main prescription for stomach ulcer | Stomach ulcer, epigastric pain |
| CV12 (Zhong wan) | Reinforce | ||
| ST36 and | Reinforce | Regulates and harmonizes the qi of the stomach and intestines | Wide indications. Chronic diarrhea - reinforce; acute diarrhea - reduce; bacterial dysentery - reduce. Very effective in treating bacterial dysentery; constipation due to disorders of transportation in the intestines |
| ST25 (Tiantu) | Reinforce (retain needle two hours for dysentery) | Disorders of transportation in the intestines | |
| ST36 and | Reinforce | Main prescription to tonify qi; especially good for qi deficiency | Wide indications; after severe disease |
| CV6 (Qihai) | Reinforce (if qi is dranged, reduce) | ||
| ST36 and | Reinforce | Eliminates the pathogens | Tuberculosis of the lung deficiency due to fatique |
| BL43 (Gaohuang) | Reinforce | Strengthens the antipathogenic qi for keeping fit and healthy | |
| ST36 and | Reinforce or even | Harmonizes the blood, checks bleeding | Vomiting blood due to coldness in spleen (failure to control the blood) |
| BL17 (Geshu) | Reinforce (or even needle). Position tip of needle toward spine. | Produces blood | For upper respiratory and digestive tract |
| ST36 and | Reinforce | Promotes qi | Dizziness, blurry vision due to deficiency of liver blood |
| BL18 (Ganshu) | Reinforce* (Needle BL 18 first) | Replenishes blood | Lassitude due to dysfunction of stomach and liver, dysfunction of spleen and stomach |
| ST36 and | Reinforce | Decline of mingmen fire | Impotence, prospermia |
| GV4 (Mingmen) | Reinforce (moxa can be used) | ||
| ST36 and | Reinforce or even | Harmonizes the stomach, invigorates yang qi | Stops vomiting spontaneous sweat caused by yang xu |
| PC6 (Neiguan) | Movement | ||
| ST36 and | Reinforce | Tonic points | Premature ejaculation |
| CV4 (Guanyuan) | Reinforce | Abdominal crossing of 3 leg yen; better than SP6; includes function of SP6; tonifies source qi | Impotence due to qi xu |
| ST36 and | Reduce | Anti-inflammatory; lowers white blood cells when there is inflammation | White blood cell pathology |
| DU14 (Dazhid) | Reduce (can raise white blood cells with use of moxa) | ||
| ST36 and | Reinforce | Regulates the qi of stomach and intestines | Acute and chronic diarrhea due to qi dysfunction |
| LI4 (Hegu) | Reinforce (reduce if due to an accumulation of damp and heat) | Failure of qi to ascend or descend | Vomiting, nausea related to the intestines |
TrA-2, my primary needle location, I needle 95% of the time and I think it works the best. You’ll know you have the right point location when you discover the muscle twitching when applying electric stimulation.
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