Sunday, September 10, 2006

TCM and Massage 2

<- Part 1

MERIDIAN GATE POINTS


Gate points allow energy from one meridian to pass into the next.


LU7 - CO4

CO20 - ST1

ST42 - SP1

SP21 - H1

H8 - SI1

SI19 - BL1

BL67 - KI1

KI22 - PC1

PC8 - 3H1

3H23 - GB1

GB44 - LI1

LI14 - CV12 - LU1


Gate points should be opened regularly to allow free circulation of energy within the organism.


Open points by rotational pressure, only until muscle relaxes. Completely open one side before doing the other side.


LU1 - between 1st and 2nd rib, intercostal space below shoulder fossa - acromial extremity of the clavicle.


LU7 - shake patient's hand - Lung 7 is where you index finger falls on the side of the patient's wrist.


CO4 - on hand, between second metacarpal bone and the end of the crease formed when thumb is adducted.


Open points first. Then strip down arm from LU1 to LU7, then up from CO4 to LU7. Repeat the lot.


CO20 - beside flare of nose.


ST1 - below eye, in center of orbit.


Open points. Strip around ridge of cheekbone, eye socket from CO20 to ST1, then down ST meridian (straight down).


ST42 - 2 tsun below middle of joint in ankle in center of top of foot.


SP1 - Medial (inner) side of big toe


Open, then strip ST42 to SP1, then up SP meridian.


SP21 - under armpit at natural fold of axilla (where latissmus dorsi joins ribs, about 2 rib spaces below nipple line)


H1 - right in center of armpit/axilla


Open points, strip SP21 to H1.


H8 - where little finger bends onto heart line on hand (lateral side of little finger beside nail (SI1 is on lateral/ulnar side of fingernail?)) - between 4th and 5th metacarpals.


SI1 - lateral (ulnar) side of little finger.


Open - strip to H8, then from SI1 up SI.


SI19 - in soft skin in tragus of ear, depression formed with jaw slighly open


BL1 - inner canthus of eye, right in the corner


Stand to the side, open points together, then strip from ear around eye and up forehead (bladder meridian). Lock off skin while doing this.


BL67 - lateral side of little toe.


K1 - divide foot into three. K1 is in center of line for first third measured from toe. Depression appearing in the foot when in plantar flexion.


Pull down BL into BL67 then from K1 up side of foot.


K22 - On line between nipples, halfway between CV and nipple. come down one rib space.


PC1 - 1 tsun lateral to nipple.


Open - strip K22 to PC1.


PC8 - Where middle finger bends to head line on hand


3H1 - lateral side of ring finger


Pull through PC to PC8 then 3H1 up ring finger


3H23 - lateral edge of eyebrow


GB1 - 1 tsun lateral to the eyebone (0.5 lateral to outer edge of cantus of eye)


Open - strip 3H23 - GB1. Lock off skin.


GB44 - lateral side of 4th toe next to corner of nail


LI1 - lateral side of corner of nail on big toe


Open, strip down second last toe, then push up foot from LI1.


LI14 - two rib spaces directly below nipple


CV12 - 4 tsun above umbilicus


Open, strip LI14 - CV12


energy will flow from CV12 up CV to LU1


Do the other side.


Back Massage


1. Lay patient on table, face down.

Shoulders level with top of pillow, which is placed under chest. Smooth back the hair to observe the spine and relax the patient.


No oil is used in Chinese massage, as the friction is used to generate heat and blood flow.


i) Strip neck to shoulders. Run thumbs down trapezius muscle, from lowest tufts of hair at base of skull to shoulders. Move with flow and even pressure. Let hands move in circles, to stimulate the circular flow of ch'i.


ii) Next strip down bladder meridians, 1.5 inches either side of centre of spine (GV - governor vessel), from base of neck to sacrum. Use thumbs. Use circular movements and learn to flow.



iii) Next strip around the bottom of the scapulae (shoulder blades), with thumbs, similar method to i) and ii) above.


With i), ii), and iii), the skin should turn red along the path of the thumb strokes as the skin and muscle heat up and blood and ch'i flow increase.
The direction of ch'i flow in bladder meridians is neck to sacrum.


The direction of ch'i flow in governor vessel is sacrum to neck.



2. Depress GB20 and GB21.


i) GB20 is on each side of the neck, where the lowest tufts of hair are. Press in (thumb or finger) and depress in a rotary motion. Press smoothly.


GB21 is is on the trapezius muscle, halfway between the center of the spine and the shoulder bone (depression on skin around deltoid muscle if patient's head rests on their hands). Press in and rotate as for GB20.


ii) next go to the side of patient. Place one thumb on the near side GB20, place the other thumb on top, and squeeze the soft tissue of the neck between the thumbs and fingers. Move 0.5 inches down neck and repeat. Keep moving down at half inch interval as far as practicable, i.e. until you run out of neck.


3. Depress 1.5 inches bilateral of spine (on bladder meridian) from base of neck to sacrum.


Do not press on neck because of possible injury. Start from large vertebrae at base of neck.


Feel with fingers for the soft spaces between the vertebrae. Move directly out 1.5 inches to each side to locate points on BL meridian. Press these points with both thumbs from above (either standing to one side or kneeling astride them). Press using bodyweight rather than muscle. Press gradually. It is OK if vertebrae click. Move down the back, pressing level with soft inter-vertebral spaces all the way down, until hard bone at the base of spine (the sacrum) is reached. Press hard and do not be tentative - but apply pressure gradually.


4. Three finger pressure to center line of spine from base of neck to lumbar region.


The GV points are in the center of the spine in the soft spaces between the vertebrae. From atop the patient, put the middle finger on the GV point, and the index and ring fingers on the BL point on each side (1.5 in. each side of GV point). The palm rests on the spine below the fingers. Place the other hand atop that one and press down, using body weight, contracting the fingers to press on the three points. Do not press just on the fingers, but allow the force to go through the palm and focus in the fingers. Press gradually. Move down one vertebra at a time until the palm rests completely on the sacrum.



5. Double palm press to the sacrum.


One palm on sacrum, other palm on top. Apply deep pressure using body weight. This is good to relieve congestion on the pelvic floor.


With this press and the next, pressure should be applied gradually, like 1-2-3 on, 3-2-1 off.


6. Double palm press to BL meridian - lower, middle and upper back.


One palm atop the other.

Press same way as for 5, on lower back on BL meridian, then middle, then upper back on bladder meridian, on the same side, then shift sides, and do upper, middle then lower back on bladder meridian, so presses proceed on a circular fashion. Perform two or three cycles.



7. Double forearm press to spine and BL meridian.


First press to lower part of back. Place forearm om spine with land toward patient's sacrum, elbow toward head. Move the arm so the curve of the arm fits the curve of the back, using the softer part of the arm. Place the other forearm on top and press, using bodyweight. Repeat on each side of the spine, 1.5 inches out to each side (BL meridian).


Next do the upper part of the back. Reverse direction of forearm (elbow to sacrum, hand to head). Same principles apply as for lower back. Press first to spine,then to either side of spine on BL meridian.


8. From sacrum to neck - "ripple technique" up spine.


Grab the skin and soft tissue at the base of the spine between the thumb and two fingers of both hands. Ripple up the spine, keeping the fold of tissue between the fingers (GV).


9. Pinch/Pluck with fingers from sacrum to upper back up BL meridian.


At each BL point, pich with thumb and two fingers, grabbing a flap of skin. Pluck by grasping this flap of skin between index and middle finger of other hand. Pull skin down and away from body. Do not be too soft.


Proceed up one side of the spine and down the other, on the BL points (1.5 inches to either side of center of soft spaces of spine). Direction is not really important here, as we are stimulating the spinal nerves coming off the bladder meridian rather than stimulating ch'i flow in the meridian itself.


10. Vibration with double palm, 1.5 inches bilateral to spine.


This is done in a similar pattern and method to the double palm press (6 above). Place the palms one atop the other on the lower back on the BL meridian. Press down using bodyweight, and allow the arms to vibrate the palms. Proceed to middle, then upper back, then upper, middle, lower on the other side following the bladder meridian.


11. Cup palm beating to spine from sacrum to upper back.


Place hand, relaxed but slightly belled/cupped on lower spine with fingers toward sacrum. Strike hand lightly with other relaxed fist. Move gradually up the spine, continuing striking, to upper back.


Finish the massage with a light rub (stripping).


BACK OF THE LEG


BL 50 is located in the center of the back of the leg, on the crease between the buttock and the thigh. Wrap both hands around the leg and press BL50 with both thumbs. Move down leg, pressing at 1" intervals, stopping 2" above the crease of the knee joint.


Do NOT apply pressure in the region between 2" above and 2" below the knee. This region is filled with delicate lymph nodes, blood vessels, nerves, etc. which are easily damaged.



Back of Leg

Next we massage BL54. BL54 is in the centre rear of the knee, right in the crease where the knee bends. Place the thumb on this point and bend the leg to 90 degrees from kneecap with the free hand. Rotate gently to stimulate BL54.


Straighten the knee and lay the lower leg back on the table. Press as before starting at BL56 (2" down from knee joint/BL54, top of calf muscle) moving down leg at 1" intervals, finishing at BL57 (where calf muscle joins achilles tendon).


Do not press too hard on the lower leg.


To finish the massage, strip lightly down the center back of the leg.


FOOT


Imagine a line drawn from the heel to each toe. Grasp the foot with both hands. Leaving the bony part of the heel, press with thumbs on either side of each line moving from heel to ball of foot, moving from big toe one to little toe line.


Imagine the big toe divided into four sections from ball to toe. Press and pull the inner section with thumb and fingers of one hand while press/pulling the little toe with the thumb and fingers of the other.


Foot

Then do the next big toe section and fourth toe.


Then do the next big toe section and third toe.


Then do the next big toe section and second toe.


BACK/OUTSIDE OF ARM


Arm should be bent to about 90 degrees.


Wrap both hands around arm. Separate bicep and tricep with fingers. Start pressing at join of muscles near shoulder. Press with thumbs, wrapping tricep around humerous. Proceed down arm, pressing at 1" intervals, until hardness of elbow is reached.


CO11 is the point at the eind of the skin crease at outside of elbow when the arm is bent. Apply rotation to this point.


Next press all the way down the forearm at 1" intervals in the crease between radius and ulna.


After this, strip and pull the hands and fingers. Use bodyweight. Wrap hand around each finger and pull.


INSIDE OF ARM - HANDS, FINGERS


Turn patient onto his/her back.


Imagine a line drawn between bicep and tricep (visible on many people). Start at inside of arm on this line, about where armpit hair starts. Wrap hands around arm, press on line with thumbs. Like outside of arm, press tricep around humerus, rolling bicep and tricep around the bone. This breaks up congestion and allows energy to flow more smoothly in H, LU, PC meridians. Move down this line pressing at 1" intervals to the elbow.


To do this, stand to one sode of patient and lock his hand under your upper arm. Let his arm bend, and be relaxed. Repeat a couple of times.
Now lower the arm to the table and work on the forearm. Press at 1" intervals down the middle of the inside of the arm, between the two tendons at the wrist intil the hard bone of the wrist is reached.


This is the Pericardium (PC) meridian. 2" below the wrist, between the two tendons, is PC 6. Pressure (hitting on this point) relaxes the throat. This can be useful in the case of children or adults with objects caught in their throat.


To do this, lock the patient's hand against your hip, but do not press hard on the wrist bone. If you press properly, the patient's hand will close slightly with the pressure. Do this several times.


Next we do the hand. Lock the patient's hand and fingers with your two hands. Let the patient's index and ring fingers go between the little and ring fingers of your hands. Interlock your fingers snugly with the patient's to hold the hand still.


Hand

Use your fingers under his hand to support the hand bones. We use the thumbs to strip the palm. We strip the palm out to the thumb (LU meridian), middle finger (PC meridian) and little finger (H meridian). Only strip the palm, using the thumbs. You can strip one or two meridians simultaneously. It is OK to use a fair bit of pressure.



Next press out along these meridians using the thumbs, palm only. You can rest the patient's hand on the table to do this.
Next do the fingers. Press between the separation lines on the fingers, on all fingers. Can do one or two fingers simultaneously.


Next, restrip the hand as before.


Then turn the hand over and strip each finger lightly from wrist to fingertips, as for the back of the arm.


Now, grab the patient's hand with both of yours, locking your fingers into the palm and press outward, stripping the back of his hand with both your palms (double palm strip to upper hand).


After this carefully bend the patient's elbow and place the palm on the abdomen.


FRONT OF LEG - INSIDE


Patient still on back.


Lift the patient's leg, binding the knee so that the foot rests on the table next to the other knee. Allow the bent knee to fall outward, but not all the way, Lift it up off the stretch and let his knee rest on your hip.


Imagine two dividing lines one on either side of the adductor tendon.


Wrap your hands around the leg, press your thumbs onto the groove next to the forward side of the tendon, starting approximately where the pubic hair finishes. Move up this groove, pressing at 1" intervals, at the same time palpitating the muscles with the fingers. Stop when you reach the hard fibers of the knee. Repeat the procedure following the groove on the other side of the adductor tendon.



Next press at 1" intervals underneath the inside of the tibia (SP meridian), pulling the calf muscle away from the tibia.


Next lift the leg so that the knee points vertically. We now massage the outside of the thigh. Look for the line on the quadricep where the long ligament runs. Starting 3" below the hip, press at 1" intervals along this line. At the same time push the knee across to stretch the outside and back of the hips. Continue down to the knee.
Next come down the outer side of the tibia, pressing the muscle away from the tibia (ST meridian). Press at 1" intervals to the ankle, and once again push the knee across.


Now carefully straighten the leg, lay it down and turn the foot outward. Look for the line of colour across the inside surface of the foot. Press from heel to ball at 0.5" - 1" intervals just below this line along the soft tissue.



ABDOMINAL MASSAGE


Digestion - Mouth, Oesophagus, Stomach.


The actual digestion of food occurs in Small Intestine (SI), Middle Heater (3H2).


Liver and Gall Bladder enter into SI. GB stores bile, which goes into SI.


The spleen and pancreas produce enzymes which assist in digestion.


The iliocaecal valve joins small intestine and large intestine (colon).



Abdominal massage utilises Stomach, Liver, Gall Bladder, Spleen/Pancreas, Small Intestine, Ileocaecal Valve, and Colon.


1. Press colon from descending (left) to ascending (right) colon for pain spots.


Start pressing up the inside of the left hip with fingers. One can feel the intestinal tube. Watch for muscular reaction - the result of pain.


The transverse colon cannot be easily reached, so go over and down the inside of the right hip.


2. Tap sound colon from ascending to ascending to show empty spaces or blockages.



Place index and middle fingers of one hand on colon. Tap them with same two fingers of other hand. Follow the same path as in 1 above.


3. Double palm press to umbilicus.


Place centre of palm over umbilicus. Fingers point to ribs, hand is straight up and down. Allow the hand to fit into the natural curve of the ribs. Bodywieght can be used. Press 5 times, 5 seconds each time. This is done to:


  • Release gas buildup
  • Allow patient to feel your touch and gain confidence
  • Relax the abdomen.

Press in time with patient's breathing.


4. Milk the liver.


NB - if either side of abdomen is enlarged, we have either an enlarged liver (right side) or spleen (left side). SEE A DOCTOR ASAP.


Place the thumb of the right hand an inch below the patient's right ribs, thumb extended, curve of the thumb and index finger following the line of the rib curve. Place the left hand on the rib cage. Pres easily, bringing hand together, using bodyweight only.



This excretes old bile from the liver and bladder into the small intestine.


5. Milk the spleen.


Done for similar reasons to milking the liver (4 above). It is done from the left side similarly to the above with hands reversed, or from the right side using the thumbs on the left ribs.


6. Fishtail figure 8 the small intestine.


This is a double finger motion from below ribs to 3" above sympusis pubis bone. Use one hand place upon the other. Start on the liver side. Do very close and shallow horizontal figure 8's (more like infinity symbols), movement coming from the wrists. Move gradually down the abdomen, finishing about 3" below the umbilicus.



Perform about 10 times quickly, always starting from the right (liver) side.


This motivates intestinal movement/peristalsis, promotes blood flow to intestine, and stimulates intestinal nerves.


7. Circular massage with two finger pad mass clockwise to iliocaecal valve.


The iliocaecal valve is located on a line between the top of the ilium and the umbilicus, two thirds of the way towards the umbilicus (one third of the way is the appendix alarm point).


Put two fingers of one hand on the spot and place the two fingers of the other on top of them. Rotate clockwise with fingers in and out, going a little deeper each time.


This stimulates the opening and closing of the valve. The pressure is always clockwise to follow the intestinal direction.


8. Colon strip from ascending to descending with knife hand.


Using the knife hand, strip up the ascending colon, following the inside of the right ilium. Strip across the bottom of the ribs once and down the other side once.


Repeat this procedure several times.


9. Circular pressure to CV12.


Go clockwise. CV12 is 4 tsun above the umbilicus.


  • Stomach Mu point
  • Middle Heater Mu point
  • meeting point of yin meridians

10. Circular pressure to ST25.


ST 25 is located 2 tsun bilateral to the umbilicus. Press one side down with one thumb, while rotating the other side - then swap.


Colon Mu point


11. Circular pressure to CV4.


Clockwise. 3 tsun below umbilicus.


SI Mu point.


Additional Points.


CO4 is located at the highest point on the fold of skin on the hand next to the thumb when the thumb is folded next to the hand.


ST36 is located 3 tsun below the center (or is it lower edge?) of the patella (kneecap) then one tsun lateral to the edge of the tibia. Abdomen point.


CO 11 - elbow point, end of skin crease on outside of elbow when arm is bent. Temperature point.


CO1 is located 4 fen from the edge of the nail (towards thumb) of the index finger. Toothache point.


SP6 is located 3 tsun above the ankle, just off the tibia, center inner side of leg. Meeting point of spleen. liver, and kidney meridians.


CV17 is a chest point. On the line between the nipples.


FACE MASSAGE


The main principle of face massage is to pull outward from the centre on the face.


Patient is face up on table. You stand behind them at the head end of the table.



1. Strip forehead.


Do one side, then the other. Lock off the skin on one side while stripping the other side, to get a push-pull effect on the skin.


i) strip point between eyebrows up to hairline.


ii) strip inner edge of eyebrow up to hairline.


iii) strip center of eyebrow up to hairline.


iv) strip outer edge of eyebrow up to hairline.


v) strip outer edge of eyebrow horizontally out to hairline at temple.


vi) strip from center of forehead out horizontally.


2. Depress three points on either side (upper/lower) of eye socket.


Press bony edge of eye socket not eyeball itself.


3. Strip along eye socket.


Strip in circular fashion, firm outwards, no pressure back in. do both ways around eye. Use the middle fingers. One can use the thumb of the other hand on the ridge of the nose to lock off the skin on one side.


Do 2 and 3 on one eye, then the other.


4. Double thumb to eyes.


Rest the inner joint of the thumbs on the forehead, ans rest only the outer joint of each thumb on the closed eyes. SOFTLY - for rest.


5. Strip cartilage of nose.


Lock fingers under jawbone. Use thumbs to strip down nose.


6. Strip from inner canthus (corner of eye next to nose) out along the natural cheek line under the cheek bone.


Allow the full hand to wrap around cheek and jawbone.


7. Depress and rotate CO20.


4 fen lateral to widest point of nose. Good for sinus congestion.


8. Bilateral circular pressure to cheekbones.


Use heels of hands. Massage cheekbones in a spiral fashion out to ears, right side clockwise, left side anticlockwise. Can lock fingers under jawbone.


9. Depress soft spots between tooth root remnants around mouth.


Start at center and move out.


10. Ask patient to click their teeth 9 times


9 is a yang number.


11. Pinch pull one side of jaw 3 times from ear to chin.


turn head to side

.

12. Push middle finger down underside of jaw

from 3H17 (join of ear and jaw, under earlobe) to chin. Pull back on top side of jaw with index finger, back to ear.


Do 11 and 12 on one side, then the other. Turn head to side while doing this.


13. Double palm pressure along forehead.


Push out from centre of forehead, then down along cheekbones to jaw. Can lock finger under jaw here.


14. Lock fingers under jaw and vibrate gently.


15. Strip around ear then down alternately front and behind the sternocleidomastoid muscle.


Press firm down, no pressure back up.


16. Strip inside ear with thumbs - to lobe.


Do 15 and 16 one side then the other. Turn head to side.


CHEST DRAINAGE PROCEDURE - LYMPHATICS


Chest drainage procedure uses


  • Neck
  • Deltoids
  • Pectorals
  • Sternum
  • Armpits/Axillae
  • Arms to elbows

All actions are towards the heart - bringing Yang downwards.


For this procedure, and also face massage, a good pillow can be made from a block of wood wrapped in a towel and place under the head.


To drain the chest, we must drain HEAD THROAT and CHEST. To do this we must drain the chest *first*, before we can drain the throat into the chest. So we work from the bottom up.


We must recognise these areas



  • Clavicle
  • Top line of pectoral muscle
  • Deltoid.

1. With hands spaded together (palms flat, one atop the other), go from the hole in the throat (CV22), light up the clavicle, around the deltoid, and firm pressure back down the top line of the pec and then down toward the sternum in the centre. Can also go up the pectoral line, around the deltoid and down the clavicle. But always, light up (away from the centre), heavy down (toward the center).


Chest

2. Hold the head with one hand. Strip with fingers and palm with the other hand from back of neck to throat. Push your hand one way while turning the head the other way. Do NOT strip the adam's apple, but rather the muscle groups on each side. Do about ten times each side.


3. Repeat 1.


4. Decongest attachment points of ribs to sternum. Start where the clavicle attaches to the sternum. Press 5 times on each point, flat pressure, moving down to one rib space below the nipple. Wrap hands around points.


5. Place both hands around the tops of the pectoral muscles. Let hands rest into shoulders. Stretch the clavicles and pectorals backwards. Rotate the hands in while pressing out. Use body weight.


6. Place hands on shoulders, Press, spreading chest and shoulders backwards.


7. Press with joined hands (palms together), using knife hand down the sternum,move and separate hands out around rib cage around into armpits, pull up with palms to top of pectorals into center, andthen strip out along tops of pecs with thumbs. Repeat 5 times.


Chest

8. Follow the same sequence as 7, but now go down arms and back up and around neck as well as the moves in 7. Repeat 5 times.


Chest

9. After finishing 8, pull lightly up the neck and through hair with fingers, pulling hair gently.


Aside on Spring


We go from winter (yin) into spring - the birth of Yang in Yin.


In spring we should rise early. We should shake our muscles and brush our skin and hair to bring the external warmth to the internal.


We should still retire early, for the nights are still cold. We should not expose ourselves to the cold.


Becuse spring is the season of birth, we should praise people and not take away. We should allow our energy to come out freely, without blocking it. In particular do not repress ANGER - the emotion of Wood, spring.


Behaviour


Behaviour is a reflection of what goes on in a person's mind. As such it is a signal for diagnosis.


Emotions


Psychological movement forms, limited in time, which bring about a change in the organism.


Emotional effect on health:


Depressing situation -> mind depressed -> psychological depression


If the depressing situation lifts after a short period, there will be no permanent effect.


If the depressing situation continues for a long time, the psychological depression will lead to a physical manifestation (yin and yang). The liver is depressed, leading to digestive problems.


If the depressive situation is lifted, the psychological depression may continue because the liver is depressed.


Effect of a Toxin on Mind and Body


Food, Alcohol, Drugs, Poisons.


The toxin will affect the liver first, as the liver must deal with it. If the patient comes to us before physical symptoms manifiest themselves, we must help them by pursuading them to stop self-toxification.


If the toxin keeps being ingested, liver activity will increase, bringing ANGER. So many drunks and addicts have an angry disposition and bearing. We can treat the patient at this stage by getting him to stop toxifying himself, and by sedating the overactive liver function.


Continued toxification may bring about the weakening and ultimate destruction of the liver. Anger weakens and grief comes to the fore. Treat by stopping the toxification and tonifying the liver.


If the patient refuses to stop toxifying himself, there is nothing more we can do. Pass him on to a counsellor.


Constipation


Any delay in the evacuation of the bowels.


Ask patient:


Last bowel movement


How often he moves his bowels


Diet - usual, and any unusual food


Emotional stress


Any accompanying symptoms


Condition of faeces - hard/soft, thick/thin


Colour

If blood, dark or light?


If dark, blood comes from upper intestinal tract


If light, blood comes from close to rectum.


if white - indicates no bile - hepatitis - HOSPITAL


if dark - yang diet


if light - yin diet


Psychological Conditions

Affects spirit - heart


Soul - liver -> tendons


Contemplation - spleen - muscles


The condition of the temdons and muscles can result in tightening of the anal sphincter


We can use a calming technique to relax the muscles and tendons.


Colon 4 (on the hand) - may be used to treat psychologically based constipation - should free bowels within 24 hours


Treatment of Constipation

The following Yu points may be useful:


BL18LiverTh9
BL19GBTh10
BL20S/PTh11
BL21STTh12
BL223HL1
BL25ColonL4
BL27SIS1

Procedure

1. Search bowel with fingers (colon press) and "tap sound" the colon. Patient is on his back. Ask patient about his condition. What does he mean by "I am constipated"? etc.


2. Turn patient onto stomach. Place a hot pack on the back over the area D9-S1 and leave for 20 minutes, to stimulate and relax the back.


3. Stimulate the above points (BL18-BL27), moving down. Use short light rotational pressure until muscle breaks and relaxes. Move down.


4. Turn patient over again, and apply the abdominal massage techniques.


5. Apply circular pressure to CV12, ST25, ST27. ST25 is two tsun lateral to the umbilicus. ST27 is 2 tsun directly below ST25.


6. Advise patient to drink more water, eat more fibre, practise abdominal and reverse breathing (mornings).


Diarroea


Excessively frequent passage of excessively watery faecal matter.


Causes

  • Diet - reaction to drugs alcohol, poisons
  • Emotional origin - disturbance affects entire alimentary canal. Any change or stress is of particular interest
  • Bacteria, virus, cancer, bowel disease
  • Physical - liver problems

Two types of Diarroea

Hot:



  • accompanied by temperature
  • hot evacuation
  • may be abdominal pain prior to evacuation
  • possible sweating
  • possible increased urination
  • generally acute occurrence
  • YANG

Cold:


  • No pain
  • No temperature, may be accompanied by chills
  • may often be chronic condition
  • YIN

Look at colour - brown to yellow


Cold diarroea is due to cold in body


Hot diarroea is due to heat in body


Severe diarroea may lead to dehydration (especially hot diarroea). Advise patient to drink plenty of water.


Treatment of Diarroea

Treat by balancing Yin and Yang.


For HOT - cooling foods and herbs, deep pressure to sedate.


For COLD - Moxibustion to heat up and tonify. Yin type may bring, or be due to, weakness.


Possible imbalances causing Diarroea

If FIRE is disturbed, it will have a resultant effect on METAL (Lung/Colon). Fire melts Metal - fluid in colon. Emotions affect Shen (spirit), which may unbalance FIRE. Ko Cycle.


EARTH may affect METAL through the Sheng Cycle. Possible spleen or stomach problems may thus have a resultant effect on the colon.


The problem may come from the lungs, which may affect the colon. It is well known that people who have had surgery to the pulmonary veins have a very definite alarm signal. If the patient calls for a bedpan in a hurry, this indicates blood clots in the veins (pulmonary embolism) and possible imminent death without immediate intervention.


The heart may affect the small intestine - producing blood in the urine or faeces.


Too much bile may cause diarroea. If the lungs/colon (Metal) are under stress, the liver may go unchecked and the diarroea may worsen.


Massage

For cold diarroea:


Moxa


  • BL23 (Kidney Yu point, see below)
  • CV12 (Stomach / Middle Heater Mu point and meeting of Yin meridians)
  • ST25 (Colon Mu point)

For hot diarroea:


  • Sedate GV14 - the main heat/temperature point in the body. It also controls the motor nerves. GV14 is located on the centre line of the back between C7/Th1.
  • Sedate BL23 - Kidney Yu point, controlling Water. It also controls the adrenal glands which secrete adrenalin, which excites the heart and CNS producing Fire. Excess water for too long hurts the heart and may lead to a heart attack (via the adrenals). Adrenals also produce cortisone, a relaxant. So BL23 is connected to the hormonal system.
  • Tonify CV12 - Stomach Mu point, meeting of Yin meridians. Tonify to harmonise and regulate overactivity.
  • Sedate ST25 - Colon function (Mu) pount
  • Sedate CO11 - Colon point on limbs - temperature point
  • Sedate CO10 - associated Colon point - 2 tsun below CO11, towards hand
  • Sedate CO1 - start of Colon meridian - can slow rate of chi flow through Colon meridian
  • Sedate ST34 - sore/alarm point in digestive upsets. When massaged will calm down digestion. When soreness stops, digestion will calm. Located outside of top of patella, 6 tsun above ST36.
  • Sedate ST36 - main digestion (stomach) point. Harmonises energy in stomach. Located 3 tsun below bottom of patella, 1 tsun lateral from ridge of tibia.
  • Tonify SP9 - to remove damp heat. Located by running hand up inside edge of tibia. Point is located where bone starts to curve towards knee.

Procedure:


GV14/BL23 - 10 seconds on, 5 seconds off. Deep pressure, 10 times.


CV12 - light pressure, rotate for 1 minute.


ST25 - deep pressure for 10 seconds, release and rotate, put pressure straight back on again.


Strip from CO11 to CO10 (checking the energy flow, then press both points simultaneously. 10 seconds, 10 times.


CO1 - press with fingernail or fingers. 10 seconds, ten times.


Strip ST34 to ST36, then press both points - 10 seconds, ten times.


Rotate SP9.


Reflex Areas


Area of reaction away from the area of origin.


Back

Shoulder and neck soreness indicates Liver problems.


Right side of Th3-Th5 - Heart.


Right side of Th6-Th7 - Stomach.


Below right scapula (right of Th8) - secondary Liver zone.


Lumbar region (especially L2-BL23) - Kidneys.


Front

Front and vack shoulder girdle - Liver.


Left pectoral muscle and down left arm - Heart (like angina).


Just below xiphoid process (lowest part of sternum) - Stomach.


Approx. above umbilicus - SI.


Approx. below umbilicus - Colon, Bladder.


Point 1/3 of way between edge of ilium and umbilicus - Appendix.


ST37 - 1 tsun below ST36 - secondary appendix point.


Baths and Packs


General

All substances mentioned can be obtained from produce stores.


The bath should be filled to neck level. Water should be bearably hot.


N.B. Always take into account your patient's age and strength with regard to temperature and duration of the bath. You should watch patient carefully and get him/her out of the bath if there is any untoward reaction.


Epsom Salts bath

Fill bath, throw in 4 handfuls of Epsom Salts. Leave patient in bath for maximum of ten minutes. The epsom salts will draw the fluid from the joints, and this is good for rheumatism, arthritis, lumbago, etc. This bath can be taken once a week.


Bran bath

Buy steel cut, or rough, bran.


Take a kilo of bran, put into one corner of a pillowcase. Fold pillowcase in half twice. Put pillowcase in bath under taps and run hot tap over it, filling bath. The water will turn brown. When bath is full, squeeze water out of pack into bath. Patient can stay in for 20 minutes maximum.


This bath is good for skin disorders, and particularly it sedates and relaxes an overwrought nervous system. Remember to watch your patient.


Chamomile and Hops bath

Use 1/2 kilo chamomile, 1/2 kilo hops. Follow same procedure as for the bran bath.


Patient can stay in bath up to 20 minutes. This bath is good for insomnia and nervous tension.


Eucalyptus Oil bath

Get "Double D" eucalyptus oil.


Put patient in full bath, then add four capfuls of oil (otherwise oil will sting sensitive parts of the skin). Mix well. Patient should inhale the fumes as they rise, breathing deeply. Good for simus problems, cold and chills.


Foot bath

A foot bath can be very useful and beneficial. Note that:


Liver, Kidney, Spleen/Pancreas meridians start in the feet


Gall Bladder, Bladder, Stomach meridians finish in the feet.


Use a bowl, tray or trough, deep enough to cover the ankles. Place feet in bowl. Add warm water first, then hot, to allow feet to adjust to the temperature. Can use just hot water, or stir in a tablespoonful of mustard.


Good for nervous conditions - Liver, Spleen, Kidney meridians.


Also - cold in body, high blood pressure, insomnia (draws bllod to feet, away from brain), stimulates kidneys and urination.


For insomnia - foot bath, play with walnuts in hands, roll feet over a coke bottle - stimulate kidneys, rest brain/CNS.


Packs

For localised effect.


Bran Pack

Same procedure as for bran bath. Place pack in a bowl of hot water.


You will need a supply of towels and rubber gloves for handling. Soak in water, then wrap in a towel.Wring the water from the pack by winding up the towel.


Place another folded towel over the area to be treated.There should be at least two thicknesses of towel between the pack and the patient's skin. Place the pack with the towel wrapped around it on this towel. Place another towel over the top. To retain heat longer, place plastic cling wrap over the pack.


The pack should be left on the patient until it cools (c. 30 minutes). This allows the body to regulate itself.


Heat brings Yang stimulation. The body will compensate by expanding (vasodilation, Yin). The body will enter a Yin state and then regulate itself.


Make sure pack covers treatment area completely.


For neck, etc. can use a hair dryer or heat lamp. Good for cold problems.


Lindseed Pack

Use 250g of lindseed and crush to a powder. Mix with HOT water to make a paste.


Bronchial problems and asthma - use for about two hours. this procedure draws mucus from the respiratory tract.


Place several thicknesses of cotton cloth (sheet, gauze, etc.) over chest. Apply paste about 7mm thick with knife over cloth. Put a piece of cotton over the top and cover the lot with a hot towel. Place plastic wrap over the top to keep the heat in. The procedure can also be applied on the back, for the lungs.



For localised pain, wrap some bran inside a handkerchief. Soak in hot water, apply 3-6 drops of Zheng Gu Shui (available from Chinese stores). Use this to knead deeply into tissue - use continuous form massage on any joint.


Do not apply for more than two hours


DO NOT USE ON A PREGNANT WOMAN


For bruises, sprains, etc.


Cramps


Uncontrolled muscular contraction. Can be caused by overexertion, cold (particularly at night), or nerve impediment.


At night, blood circulation slows down, and any toxic wastes will attend to accumulate in the extremities. These wastes mat serve to block nerve pathways. They may include uric and lactic acid.


One can take Glauber Salts to "flush out" the system.


Leg cramps and Lower back:


Apply pack(s) first - to lumbo/sacral region, and to legs themselves. The nerves for the legs originate in the lower back.


Procedure

Pinch/bruise BL23 (Kidney Yu point)


Pinch/bruise BL27 (SI Yu point)


Pinch/bruise BL28 (Bladder Yu point)


Pinch/bruise the skin by pinching it between the index and middle fingers, or finger and thumb. Bruising the skin will bring continuous stimulation to the point as the body works to rebuild the damaged capillaries. Pinch/bruise, then rotate with thumbs.


Push skin away from spine. Place one thumb on the spine holding the skin down. Press and push the skin away from the spine with the other thumb.


Compress deeply with double palm over sacrum.


Massage Hua To points. The Hua To points are located 1/2" out from the centre line of the spine, right on the nerve ramifications. Use a heat rub and start from the sacrum, massaging liniment into points in a circular fashion. Move up through the lumbar region.


Pinch/bruise BL54 - lower back.


Pinch/bruise BL56,BL57 - sciatic nerve.


Rotate SP9.


If pain/cramp is one sided, you need only work on the one leg. if not, do both legs and SP9. For lower back, need only do BL54. To pinch BL54 lift the lower leg slightly. Also rotate after pinch.


You can also apply cup palm technique, vibration, knife hand chopping, fist, etc. to lower back with good results.


Moxibustion


Moxa uses a herb - Mugwort, Artisimus Vulgaris. It is dried and stored, then crished and rolled.


Moxa involves burning the herb on or close to the skin. It is a Yang (stimulation) technique.


Direct Application - Moxa Punk

A small cone is formed from crushed, powdered moxa. The cone is placed on the skin and lit. The cone is removed (with tweezers, etc) when the patient feels the burning/pain sensation. May be used several times on the one point.


Indirect Application - Moxa Roll

Light one end of the roll and fan until the entire end is glowing, like a cigarette. Bring the burning end close to (but not touching) the skin in a pecking motion. Repeat for 3 to 10 minutes. Use one finger to stop the roll before it touches the skin. Good for weak people (Yin constitution).

For general health, moxa the following points once a month:



  • CV6 (Chi Hoy)
  • CV12 (Middle Heater, Stomach, meeting point of Yin meridians)
  • ST36 (Metabolism)
  • BL23 (Kidney)
  • GV4 - Door of Life

GV4 is located on the spine between the two BL23 points, directly between L2 and L3.


Note that GV24 and both BL23 points can be stimulated at the same time of using the indirect method.


Cupping


There are two types of cup, glass and bamboo. There are no essential differences in their use.


Glass cups are heavier, and transparent, allowing one to watch their effect. They are used more to draw (suppurate).


Bamboo cups are lighter, but opaque. They are useful for bruises and the like.


Cups can be used on the shoulders, back, abdomen and limbs. The area to be treated determines the size of cup to be used.


NEVER use on the face.


NEVER use on the abdomen of a pregnant woman.


Cups can be used to treat

  • bruises
  • tightness
  • for suppuration (pus, fluid, etc.)
  • nerve impedance
  • gas in addomen

A cup is a cylinder with one close end used to SUCK on the skin and underlying tissue. It promotes blood flow, nerve energy flow, lymphatic flow, and pulls skin up.


Direct Application

Soak a ball of cotton wool in methyl alcohol or similar. Hold the ball in tweezers, and light it. Use the cotton to take air from the cup by placing into the cup - only for a short time, otherwise cup will get too hot). Take cotton ball out and immediately place cup on the desired spot. Give it a slight twist as you put it on to promite suction.


Leave on for some time, e.g. 15 min for a bruise, 30 minutes for a slipped disk.


Migrating Application

First cover area to be treated (usually bladder meridians on back, and spine) with oil. Apply cup as for direct application. Use both hands to move the cup up and down both sides of the spine, and up and down the spine itself. Watch out for any conspicuous bruising - this may indicate a problem with the nerve ramification of the associated organ. After removing the cup, use thumb pressure to massage the bruising away. This method provides a very powerful stimulation to the bladder meridian.


Removing Cup

Push skin down on one side of the cup to release the vacuum. Do not pull the cup straight off as this may mark the skin.

Points to be used

Big cup over L5 - for lower back.


Yu points - to relieve congestion in organ (Lung, Kidney, etc.)


Abdomen - CV12, ST25 etc., CV8 (umbilicus) - particularly for gas in abdomen - approx. 20 mins.


Can be used on boils, etc. Use 7 star hammer (plum blossom hammer) to break up pus, etc. before cupping.


Available (this was 1982) from: Burlington Centre, Catrician Health Centre - "Chinese Glass/Bamboo Cups".


Headaches


Head pain.


From the Chinese viewpoint there are two types of headache:


  1. Upsurging Headache - from Yang meridians congesting in the head, usually due to tension, etc.
  2. True Headache - brain headache

Causes

1. Tension. Tension affects Liver. Anger tightens tendons, muscles -> circulatory constriction -> pain. We must look at possible Kidney (sheng cycle) or lung (ko cycle) problems as they may affect the liver.


2. Vertebral alignment. A misplaced cervial vertebra may impinge on a nerve to the head, causing pain.


3. Eyestrain (from glare, etc.). Affects Liver similar to tension.


4. Virus. Cold hitting bladder meridian (Water). One of the first symptoms of typhoid fever is severe headache, and pain in back and loins. If patient cannot bend neck back and forth - BL meridian is affected. If they can't move neck side to side, SI meridian is affected.


5. Injury. A head blow may bring concussion, and/or the head musculature may spasm -> pain.


6. Diet. Too much sugar or an allergic reaction may bring on a headache.


7. Congestion - sinus, etc. pressure may impinge on nerves bringing about head pain.


8. Aneurysm - ballooning blood vessel in the brain. HOSPITAL, QUICK! [my aunt died of an aneurysm]


9. Tumour.


10. Tooth problems. A filling, etc. pressing on a nerve.


Modes of Headache

Frontal Headache - may be caused by a heavy day or a lot on the patient's mind.


Occipital Headache (back of the head) - may be caused by anxiety (fear without reason).


Temple Headache - to do with migraine, ec.


If headaches are regular or frequent, ask for a doctor's report before attempting treatment. Tests - EEG, cat scan, spinal tap (cervical/lumbar), MRI, etc.


Migraine

Severe head pain, accompanied by nausea, irritability, vision problems - "fight with the self". Liver is affected, heat from liver affects heart/spirit/shen.


When treating a headache, always watch closely for appearance of other problems. If the headache is tension related, then if we take the pain away, the tension may manifest itself elsewhere.


Biorythms

If headache appears monthly or periodically, get the patient's biorythms done. If it does fall in a regular critical period, get the patient in several days before the next critical period and work on them to free the muscles and meridians.


Ask the patient what time of day they get the headache, and apply the Chinese clock. As well, get them to try to relax if the headache is stress-related.


Points for Headache


General (to relax musculature)

GV20 - Right on crown of head, 5 tsun back from natural hairline on forehead. Use deep pressure, 10 seconds on, 5 seconds off, 10 times.


GV19 - 6.5 tsun back from hairline, 1.5 tsun back from GV20. Same pressure.


GV16 - Between skull and C1, right in the nape of neck. Same pressure.


BL4. (BL1 - medial corner of eye/socket. BL2 - inner edge of eyebrow. BL3 - on hairline, directly above BL1 and BL2. BL4 - 1 tsun lateral on hairline out from BL3). Same pressure.


BL7.


BL10. Between C1 and c2, right on muscle body. Same pressure.


3H20. directly behind highest part of ear, right on natural hairline.


GB21, GB20, BL13, BL38 - same pressure.


Specific Points

Frontal Headache - CO4 - stimulate - to free energy flowing from lung into colon meridians.


Occipital Headache - Stimulate GB20, GB21, GB39.


Migraine - LU7 (interlock thumbs with patient - Lu7 is where your index finger falls on their wrist). Apply opposite side to headache, as it affects colon meridian, which crosses over the body on the way to the head. Tai Yang (extra point) - 1 tsun lateral to eye in depression on temple - deep pressure.


Temporal Headache - Tai Yang.


Top of head - GV20, BL60 (halfway between outer lateral malleolus (ankle bone) and achilles tendon).


Make sure patient isn't looking into the light. Let them rest and relax for some minutes before treatment.


Deafness and Ear Problems


Deafness and sore ears can occur for a variety of reasons:


1. Damage to nerves between inner ear and brain - permanent damage, requires cochlear implant or similar.


2. Ruptured eardrum - can be repaired surgically.


3. Locking of small bones (hammer, anvil, stirrup) in middle ear - can be repaired surgically.


4. Foreign objects or polyps in ear canal.


5. Wax buildup in ear canal - treat using Cerumol (from a chemist) or warm olive oil. Put several drops in ear canal to soften wax, flush out in shower.


6. Eustacian tube problems. Eustacian tube runs from ear to mouth to equalise pressure on both sides of eardrum. The tube may become infected, with sore throat, etc. This may cause a hard lump behind ear, in mastoid antrum.


Massage can be used to treat external ear blockage, eustacian tube problems, and meridian pathway problems (in the yang meridians).


Treatment

First pack neck and ear.


Points

3H17


3H23 - outer end of natural eyebrow


SI19 - middle point of tragus (bone triangle in front of ear)


GB2 - bottom point of tragus


GB20


Active Points

(Can't work out whether this section applies to headache or ear problems from my notes. Should work out OK for either, I guess)


3H5 - 2 tsun above pivot of wrist, on back of arm - meeting of meridians


3H3 - form a fist. 3H3 is behind and between the knuckles of the ring and middle fingers.


SI3 - On the lateral side of hand, opposite side of little finger knuckle from 3H3.


3H3 and SI3 take energy from the gall bladder meridian into their own meridians.


After doing these points, go down the muscles of the back of the neck with deep pressure. Then strip the back down the bladder meridian, paying special attention to the kidney points (BL23).


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Further Information


For anatomy - any decent anatomy book - Gray's Anatomy, Structure and Function in Man, etc.


Meridian diagrams - taijiworld.com - lots of stuff on Dim Mak and TCM here. "Free Books" and then, "Dim Mak Point Location" is what you want.
Bear in mind that the owner of the site is asking you to buy his book if you download this information. It's your karma that has to deal with that, so be nice.


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