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Benjamin Duglas
Posted on Friday, November 21, 2003 - 23:23:   

The topic of sedating and tonifying needle techniques is very perplexing, I know, for both students and practitioners. I would like to know how do you see this subject and what is your personal approach to both tonifying and sedating needle techniques.
Thank you very much for your time,
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Shmuel Halevi
Posted on Saturday, November 22, 2003 - 11:34:   

It is indeed so, Ben. There are dozens of seemingly contradicting methods and techniques, some of them are listed even in the ancient books of TCM in their contradicting nature. Many of these techniques, especially those that are described in the ancient scriptures, are of a very esoteric nature, most of them have not been clinically validated, yet, as far as I know, many Western practitioners still apply them devoutly and schools still teach them without second thought. Closing the needle hole with the finger after withdrawal, for instance, for tonification purposes (so that the Qi won't escape..) is described in the Nei Jing. I can still see many Western (and sometimes Chinese) practitioners perform this act of Shamanism very devoutly despite its apparent anachronism. I have spent quite a number of years trying to validate this method in my clinic, with absolutely no significant (or other) change in the treatment results. I nevertheless succeeded in validating the following few premises:

1. Needle direction: for sedation, point the needle contrary to the channel's direction and make the Deqi propagate in this direction. V.v. for tonification.
2. Stimulus: For sedation purposes use strong stimulation with a wider range of twirling manipulations. V.v. for tonification.
3. Puncture: Swift and deep puncture for sedation, slow and gradual puncture for tonification.
4. Suspension: For sedation suspend the needle much longer than tonification, especially if pain and fever are involved.
5. Needle: For sedation use thicker needles and use blood letting when appropriate. V.v. for tonification.
Despite the above, each treatment must be modified and tailored in every specific case according to the age, tolerance and general health condition of the patient.
You must also bear in mind that there are other valid and potent needle manipulations and technique suitable for specific syndromes, rather than plain tonification or sedation purposes. There is warm needle (moxa on top of the needle) for tonification and strengtheneing, as well as dispersing the damp energy method, scarring moxibustion for a greater dispersing effect, the Huici needle manipulation for blood stasis, Fire needle for cold-bi and many more. An adept acupuncturist, in my opinion, must have a knowledge of all these useful techniques as well as some other self-invented needle techniques which naturally comes with experience.

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Bobbi Aqua
Posted on Monday, November 24, 2003 - 15:47:   

I really found this interesting. I agree with everything but thought I'd add that my Korean Teacher, Jang Jing who I believe to be an excellent Oriental Physician taught that to sedate counter clockwise emphasizing the upward motion of needle needle 6 times and to tonify clockwise emphasizing the inward motion 9 times.
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Shmuel Halevi
Posted on Monday, November 24, 2003 - 19:23:   

Yes Bobby, this is another variation of a technique described in the Nei Jing and subsequent works in ancient China. I can agree with the counter clockwise and v.v. for sedation and tonification respectively, yet, the numbers 6/9 are shamanistic relics without any significant value. You can find these techniques in "the burning of the mountain" needle technique for Yang Qi tonification and the "cooling the sky" technique for sedation purposes. What counts is the technique of manipulation and NOT the number of times it is performed - I have experimented on this too many years in order to be quite confident about it. BTW, also the breathing in and out during insertion and withdrawal of the needle is of no clear significance for tonification and sedation purposes. As for the direction of the twirling: c.w. or c.c.w., your teacher has simplified a method also mentioned in the classics. By this method you need to rotate the needle in the direction of the meridian flow for tonification, and counter its flow for sedation. Many practitioners (including me...) have found that c.w. and c.c.w. rotation without reference to the meridian direction, will still do the job.
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Anne Jeffres
Posted on Tuesday, November 25, 2003 - 03:09:   

Another twist, so to speak, on needle rotation for sedating and tonifying. Jeffrey Yuen, Dean of Acupuncture at the Swedish Institute in NY teaches from the Ling Shu. He said that proper needle rotation is toward midline (Ren, Du) for tonifying, and away from the midline for sedating, instead of CW and CCW. I have not tried it clinically.

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