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Class 4 - Precautions and Contraindications Points with Contraindication and Cautions Pregnancy A. Forbidden (unless to induce or remove pain in labour): LI 4, SP 6 (strongest point to cause miscarriage), UB 60, UB 67 B. Careful: GB 21 C. Lower abdomen and back (including sacral area) Menstruation A. Careful during second day of cycle on: lower abdomen points (as they can cause uterine bleeding) Infants (up to 6 months) E. Head points (Du-22 to Du 24) up to age 6 months (Moxa allowed) General A. St 17 - nipple, no moxa or acupuncture B. Ren 8 - umbilicus, indirect moxa only Points that require care A. Large artery relate points such as: Lu 9, St 30, St 42, St 9, Li 18 B. Ren 22 - only quickly needle as it causes caughing C. Upper back (above T10) and chest (concern for pneumothorax)    D. St 1 and other eye points E. Ren 15, Sp 11 - near sternalcostal angle do to possible enlargement of heart Patient Constitution Issues Avoid needling when: Just having over eaten, over tired, over emotional, over hungry intoxicated Delay or limit needles: Large amount of sweating or sever diarrhea (do to possible fainting)

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