"So long as the qi and Blood enjoy harmonious flow, none of the hundreds of disease can arise. Once they are depressed and suppressed, various diseases are produced." - Zhu Dan Xi
One of the most effective uses of acupuncture is clinical presentations in which stagnation plays a predominant role. One of the most important herbal formulas in Chinese medicine for stagnation issues, Yue Ju Wan (Escape Restraint Pill), can be used as a "skeleton" to formulate acupuncture point combinations, which the practitioner can flesh out as needed to address specific pattern issues, which are concomitant with stagnation.
The formula Yue Ju Wan addresses the six stagnations of qi, Blood, Phlegm, Damp, Fire and Food. These six stagnations are extremely common in the modern clinic and acupuncture point combinations can be modeled around this elegantly simple formula to address a diverse array of clinical presentation such as digestive disorders, menstrual issues, mental/emotional issues and acute/chronic pain. In this installment I will address some basic acupuncture point combinations, which can be used to address these six common stagnation patterns. The Heat stagnation is a particularly complex issue and we will address this in-depth in part II of this article.
Due to the complex interactions between the aforementioned six stagnations, the clinician can be presented with a vast array of pulse and tongue variables depending upon which aspect of the six stagnations takes precedence. The clinician will have to evaluate the symptoms, tongue and pulse and establish an approach which effectively targets all aspects of the patient's disease personality. One of the most effective ways to approach complex patterns with multiple levels of stagnation is to use the combination of Back Shu points with points on the front side of the body.
To address the six stagnations of qi, Blood, Damp, Fire, Food and Phlegm, the following Back Shu points can be used: UB 18, Back shu point of the Liver to address qi Stagnation; UB 17, influential point of Blood to address Blood Stasis, UB 20, Back Shu point of the Spleen to address Damp stagnation, UB 21, Back Shu point of the stomach to address Food Stagnation. The clinician can needle these points or use moxa or a combination of both. Points can be stimulated for 10 minutes and then points on the front of the body can be addressed.
Some effective points on the front of the body to address the six stagnations are as follows:
- Qi Stagnation: Liv 3 + LI4 (Four gates), Sp6, Ren 6, GB34, PC6, Liv 13, Liv 14, Ren 17
- Blood Stagnation: Sp 10, PC6 + Sp4 ( Chong), Sp21 ( moxa)
- Damp Stagnation: Sp 9, Liv 8, Ren 3, Ren 6, Ren 9, LI6
- Food Stagnation: Ren 10, Ren 12, Ren 13, ST 25, St 36
- Fire Stagnation: LI11 (this is complex and will be addressed in depth in the next installment)
- Phlegm Stagnation: Ren 10, Ren12, PC5, ST40
These point suggestions are just basic starting points and must be individually formulated to address each patient's unique specific pattern differentiation. The clinician must also add points to address any other aspects of the patient's pattern presentation as well.
Also, local points can be added to guide the effects to specific areas of stagnation as needed. In the winter time or in cold weather, I often use moxa exclusively on Back Shu points as well as Ren 4, Ren 6 and Sp 21 to move the six stagnations along with appropriate front points based on pattern differentiation.
Also, appropriate needle manipulation must also be taken into account as well. In my next column, I will address the issue of Heat stagnation in-depth and present some ways to use heat clearing herbal formulas as blueprints for point combinations much like used Yue Ju Wan to guide our point selection for targeting the six stagnations.
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