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Class 2 - Needling Techniques Needle Angles Perpendicular - 90° (anything over 60°) Oblique - 45° (30°-60°) Horizontal/Transverse - 10°-20° (even up to 30°) Needle Depths Concerns 1) Concern is always safety of patient Only use 1 cun long needles, Transverse or Oblique Neck Upper Back (T1-T10) Downwards or towards back bone Chest Area Puncture lateral away from organs Lower than T10 Back, Limbs and Abdomen (well) Perpendicular (Ask for lower abdomen punctures for patient to relieve their bladder.) No lower back and Abdomen during pregnancy No abdomen during first two days of menstruation 2) Arrival of Qi 气 (de qi) Patient Sensation: Distention, Heavy, Tingle, Electric, Numbness Practitioner Sensation: Fish biting a hook Three reasons of Qi delay: 1) Improper Location of Point 2) Improper Depth of Point Too deep or too shallow no Qi Spring and Summer easy and shallow Winter and Autumn deeper 3) Patient's Body Constitution Week body, week Qi 3) Direction of Needle a) Tip towards area to affect b) Tonify (fill deficiency) or Sedate (get rid of excess) Sample method:   Tonify - follows direction of meridian   Sedate - against direction of meridian Yin Meridians - Upward (from chest to finger tip) Tonification and Sedating 1) Through point selection Yuan-source - most are tonify points Ren 6, Ren 4, Du 4, St 36, GB 39, etc. Jing-well - most are sedate points Lu 1, Li 20, etc. Ht and PC are exceptions it tonifies Ying-Spring - all points sedate Removes heat and sedates Mother points - Tonify Son point - Sedate Moxa - Tonify Cupping, Electric, and Bleeding - Sedate Needle Levels   o   |   -  =|=======================   | Heaven - tian - 天  -|-----------------------   | Human - ren - 人  -|-----------------------   | Earth - di - 地  ------------------------ Basic Promotion of De Qi - 得气 (Qi Arrival): 1. Lifting and Thrusting In thick areas Slight movements 2. Twirling and Rotating Rotate needle in place at same level Other Common Methods: 1) Tapping / Pressing - Xun Fa Tapping the direction of Qi to go Pressing down to prevent Qi movement in direction not desired Reducing Qi affect after needle removal possible through tapping out both directions away from point to remove sensation 2) Scraping - Gua Fa Very good at removing pain when sedating and used heavily and ashi points Scraping handle of needle 1) Scrape from tail towards root while holding needle to prevent increase of depth. Hold needle using two fingers on body side of needle, other side scraped with thumb nail on needle Tonify - Scrape down Sedate - Scrape up towards tail 3) Trembling - Can Fa Practitioner vibrations on needle from his owned tightened muscle coming from upper arm 4) Swing - Yao Fa (Blue Dragon Wags Tail) Usually with oblique needle Gentle movement in arc maintaining oblique insertion Very good to get Qi to pass a joint Can be used to sedate since hole is opened wider to release evil qi 5) Flying - Fei Fa (Red Phoenix Returns to Source) Warms or cools area Needle is pinched and lightly released with hand opened as hand is removed causing vibration on needle. Turning slightly but not enough to turn needle. Tonify - hand floats w/turn forward  Sedate - hand floats w/turn backwards 6) Quick and Lightly Rotating - Cuo Fa Very good strengthen Qi quickly and used for anesthesia before electricity Rotate needle back and forth between fingers 7) Flicking needle Promotes qi Light flick of needle Needling Techniques - Basic 1. Lifting and Thrusting - Ti Ca Bu Xie In thick areas Slight movements Tonify -  1. De Qi - 得气 2. life gentle from Earth-di level to Heaven-tian level 3. Insert slowly pressing strongly with fingers on needle greater strength tonifies more Sedate 1. De Qi - 得气 2. Pull gentle from Earth-di level to Heaven-tian level pressing strongly on needle. Greater strength sedates more 3. Insert back slowly 2. Twirling and Rotating - Nian Zuan Bu Xie Rotate needle in place at same level Tonify- Strong forward twirl than week rotate back all in same level (with possible very slight movement deeper and return) Sedate- Strong backward twirl than week rotate forward all in same level (with possible very slight movement shallower and return) 3. Rapid and Slow - Xu Ji Bu Xie Movement of needle Tonify - Slow movement in and out Slow rotation Sedate - Fast movement in and out Quick rotations 4. Open or Close - Kai He Bu Xie Used during removal of needle Sedate - Lift slow, vibrate in whole to open as leaving and leave whole open Tonify - Left needle more quickly, cover whole by pulling skin with cotton ball 5. Follow and Against - Ying Sui Bu Xie Direction of needle Tonify - Towards big number Follows direction of meridian Sedate - Towards smaller number Against direction of meridian  6. Special Respiration - Hu Xi Bu Xie According to patient respiration Tonify Thrust/Stimualte during exhalation Opposite direction of needle (needle in air out) warm air in system Sedate Thrust/Stimulate during inhalation Same direction of needle (needle in air in) Cold air in system Full pushing from the inside to push out evil qi 7. Open and Closed Points of Lunar Calendar - Zi Wu Liu Zhu Lunar Calendar (See Chart) Sedate - If point punctured just before open Tonify - If point punctured just after open time Needling Techniques - Comprehensive 1. Setting the mountain on fire - Shao Shan Huo Strongest method of tonification A) Insert needle until de qi B) Lift and thrust (Ti Ca) in tian level (gentle lift strong thrust) 9 times (yang #) C) Lift and thrust in ren level (gentle lift strong thrust) 9 times D) Lift and thrust in di level (gentle lift strong thrust) 9 times Can replace thrust with rotation tonify technique (Nian Zuan) 9 times if area to shallow.  For less strength use 3 times instead of 9 or even 1 at each level 2. Penetrating the heaven coolness - Tou Tian Liang Strongest method to sedate A) Insert needle until de qi B) Lift and thrust (Ti Ca) in di level (strong lift gentle thrust) 6 times (yin #) C) Lift and thrust in ren level (strong lift gentle thrust) 6 times D) Lift and thrust in tian level (strong lift gentle thrust) 6 times Can replace thrust with rotation sedate technique (Nian Zuan) 6 times if area to shallow.  For less strength use 2 times instead of 6 or even 1 at each level 3. Yin within the Yang - Yang Zhong Ying Yin Shallow Tonify, Deep Sedate Predominate Yang - excess is due to deficiency / deficiency causing excess Cold then fever symptoms Mixed excess and deficiency at same time A) Insert needle until de qi B) Lift and tonify (9 thrusts - gentle lift strong thrust) in shallow top 1/2 C) Insert to second 1/2 and sedate (6 thrusts - strong lift gentle thrust) 4. Yang within the Yin - Yin Zhong Ying Yang Deep Sedate, Shallow Tonify Predominate Yin - deficiency is due to excess / excess causing deficiency Fever then cold symptoms Mixed excess and deficiency at same time A) Insert needle until de qi B) In lower second 1/2 sedate (6 thrusts - strong lift gentle thrust) C) Lift and tonify (9 thrusts - gentle lift strong thrust) in shallow top 1/2 5. Midnight and noon hole dig - Zi Qu Dao Jiu Mixed excess and deficiency at same time (Severe Cases:) Treat edema and Qi stagnation A) Insert needle until de qi B) Strong thrust and gentle lift full space to qi 9 times C) Gentle thrust and strong lift full space to qi 6 times 6. Conflict Between Dragon and Tiger - Long Hu Jiao Zhan Uses rotating and twisting Stops chronic severe pain in particular in Zang Fu A) Insert needle until de qi B) Strong forward gentle back 9 times C) Gentle forward strong back 6 times

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