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Touch diagnosis for root and local tx. point and tx. methods

Points on the channel
Consideration is given to the meridians that flow through the area of the chief complaint as to which needs to be treated.

Points from pulse picture
The pulse diagnosis results are thought of in regards to the chief complaint.


Supplementary points
Consideration is also given to the front alarm points and back transport points (transport points) associated with the pattern of imbalance as other possible treatment areas.

Points prepared from touch DX. on the effected area
The local area can also be treated without relation to the pattern of imbalance



Touch diagnosis

Pressure Pain
Resistance 
Indurations 
Depressions and Protuberances
Dampness and Dryness
Cold and Heat



1. Pressure Pain
Pressure pain on yin channels  → to points selected for the root treatment. 
Pressure pain on yang channels → the local treatment area,  
   deficient-type pain excess-type pain.
Any points with pressure pain that center on the alarm points or back transport points are included in the local treatment.
 As a basic rule areas with pressure pain are treated with extremely shallowly inserted retaining needles, but depending on the conditions, can also be treated with direct moxibustion or intradermal needles.


2. Resistance
Right subcostal → Lung shaku → a LU def. LR ex. or a SP def. LR ex. pattern.
Left subcostal → Liver shaku → LR def. heat pattern.
 Cone moxibustion or moxa-on-the-handle needles are good to use for these conditions.  Extremely shallow retention needles can also be used.
Lower abdomen → Blood stasis.
 
3. Indurations
Indurations are smaller than areas of resistance, and can range from being as hard as a rock to being soft like a clump of fat.
Indurations are frequently accompanied by pressure pain.  In most cases indurations themselves can be thought of as excess, and so are commonly treated with dispersion. 
Extremely shallow retention needles can be used for indurations.  Direct moxibustion can also be applied until it feels hot.


4. Depressions and Protuberances
No strength at the superficial level of the skin, Area of ki and blood deficiency. points since they almost never are accompanied by pressure pain. → Contact needling
The other kind is raised but then caves in when pressed to reveal a point The point is raised and blocked off due to an abundance of deficient-type heat.
 The point can be treated after pressing reveals it.   These points have a deficiency of nutritive blood and so frequently are accompanied by pressure pain.  But, they should be tonified whether they are root treatment or local treatment points.


5. Dampness and Dryness 
Damp skin:  An abundance of deficient-type heat.
 the dampness to be caused by sweat leaking from pores that are not closed properly due to a deficiency of yang ki.
 Extremely shallow retaining needles are appropriate,
Dry skin is almost always caused by blood stasis,
 Moxa-on-the-handle needles are good for blood stasis beside or below the navel.  The prognosis is not good if the patient is thin and weak and has dry skin.

6. Cold and Heat
The lower abdomen, especially around CV-4, CV-5, and CV-6, is commonly cold.  At such a time o-kyū moxibustion should be used at these points.  There will usually be little pressure pain or resistance.  The points will be mostly depressed.  Of course this is a condition of ki and blood deficiency.
A feeling of heat is common in CV-17, along the governing vessel and the paravertebral points.  All of these points can be used as treatment points.  They will usually reveal pressure pain


 


 


Order of Treatment

Step 0  [A] Treating the Thoracoabdominal Region and Supplementary points [B] Treating the Affected Area [C] Harmony points
Step 1 Root Treatment Primary pattern
Step 2 Root Treatment Secondary Pattern
Step 3 Root Treatment Yang Meridian
Step 4  [A] Treating the Back and Supplementary points [B] Treating the Affected Area [C] Harmony points
Step 5  [A] Finish needling [B]Moxibustion



Chishin (置鍼Retaining Needle)

Tube Preparation
Two hand
One hand


Media
Two hand P.
Media
One hand Tube P.

Tapping
with sideling or pushing 
Tap with index finger
  with middle finger on the side of the tube
Tap by index finger with middle finger
By index finger nail
  side of the tube
With clean needle  

 


Media
Sideling Tapping
Media
Tap by Index F.
Media
Tap by Index with M.F. on the side
Media
Tap by index with middle F.
Media
Tap by nail
Media
Tap the side of the needle
Media
Tap wuth clean N.T.
   

Purpose:
Used for tonification and dispersion of nutritive ki (blood) during the local treatment.
Recently there are many people who use retaining needles during the root treatment, but in such cases, the practitioner needs to always pay close attention to the movements of the patient's ki. For those who cannot feel ki, they should determine any adjustments to the retention time by observing the pulse.

If needles are retained for too long, ki will be lost rather than gathered. This can most easily happen on the hands or feet, and so it is not advisable to retain needles there.

Tonification:
For tonification, #00 to #2 gōshin needles are retained on the abdomen or back. The points to focus on are those that are opened or revealed by pressing, or in other words, those points that are deficient in nutritive ki (blood).
  Chishin-1  Chishin-2 
Gold or silver needles for elderly people who have weak bodies.
The insertion depth should be about 1mm so that the needle falls over to the side.


 


Chishin-1 Retain needle for tonification
Chishin-2 Retain needle for dif.Ex.
Tonification:2
The number of needles should be adjusted according to the pathological condition. But, for the abdomen use at least four needles and not more than eight, and for the back use at least two and not more than twenty. The needles should be retained from ten to thirty minutes.   Retain needle on the Hara  
Generally, gentle tonification is used when there are acute symptoms, and more needles and longer retention times are used for chronic problems.

Media
Retain needle on the Hara
 
Dispersion:
If the patient is constitutionally a yang-type person or constitutionally tends to have blood stasis, needles are retained at indurations both on the abdomen and back. 
Various depths can be used, from 2mm to greater than 1cm.
 Chishin-3

Dispersion:2
Thin gōshin needles are usually used, but thicker needles can also be used if needed.
The number of needles and the length of retention time are the same as for tonification, but should, of course, be adjusted according to the hardness and number of the indurations.
Retain needle on the back

 
Chishin-3 Retain needle for dispersion

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