-IBIS-1.5.0-
tx
immune system
chronic fatigue syndrome
acupuncture

patterns and combinations

after assessing the person and palpating, consider these patterns:
Spleen Xu (Deficiency); Kidney Xu (Deficiency); Cold; Liver Qi Stagnation/Constraint

» therapeutic notes:
• Avoid long retention of needles unless Constrained Liver Qi is predominant and even then watch not to sedate. Use very light stimulus. Patient should barely feel needles. (Ambrose)
• Chronic fatigue may be a part of a general pattern of glandular/lymphatic exhaustion that can often be rooted in or at least exacerbated by a chronic, often subclinical, infection in the sinuses and irritation in the oropharyngeal mucous membranes. This area is a common site of primary focal infection from which secondary infections derive. Palpation at reflex sites in proximity of TW-16 ("East Wind") and LI-10.5 and above and below the eyes will confirm this hypothesis. If tender and/or painful points are found, consider needling Lu-7 and the reactive points in the areas of "LI-10.5", "St-2.5", yu yao, east wind/TW-16, and "St-43". Sinus irrigation with saline solution is usually also helpful - see "patient handout: sinus wash". (Matsumoto) See also "sinusitis".

» illustrative combinations:
• "yu yao", "St-2.5", "east wind", "LI-10.5", Lu-7, and "St-43", with other points sensitive to palpation, for sinusitis and glandular/lymphatic exhaustion, esp. with a primary focal infection in the sinuses and oropharyngeal mucous membranes (Matsumoto)
• CV-8 (ginger moxa); UB-23, GV-4, LI-4, Lv-3, LI-11, St-36, CV-12, UB-38/43 and left TW-4 for neurasthenia (McWilliams, et al., Lesson 31, p. 158)
• PC-6 after Sp-4 (=): activate Chong Mai (Penetrating Vessel) to regulate digestion and nourish Xue (Blood); Master and Couple points of the Chong Mai (Penetrating Vessel)
• Kd-6 and Kd-27 (+): tonify Kidney Qi and strengthen adrenal glands (Matsumoto)
• CV-4 and St-36: tonify the Spleen and Kidney to strengthen the vitality (Finkelstein, p. 85)
• CV-4, CV-6 and UB-54/40: "address vacuity", i.e., Xu (Deficiency) (Ellis, et al, 1988, p. 220)
• PC-6, Ht-7, yin tang (threaded inferiorly), an mian, St-36 and Kd-3 (also consider GB-20, GV-20, TW-23, CV-12, UB-20, UB-18, Sp-6, UB-18, Sp-6, UB-15, UB-23, GV-4, CV-4, CV-6, Lv-2 and PC-4) for neurasthenia (Lee and Cheung, p. 305)
• an mian, Ht-7 and PC-6 (also consider yi ming, St-36 and Sp-6) for neurasthenia (Lee and Cheung, p. 305)
• GB-20, UB-11, UB-22, CV-4, PC-6, St-36 and UB-15; alternate with UB-10, GV-12, UB-14, UB-23, CV-6, Ht-5 and Sp-6 for neurasthenia (Lee and Cheung, p. 305)
• Sp-2, Kd-7, PC-7 and CV-6 (+) for lack of Will Power (McWilliams, et al., Lesson 31, p. 160)
• TW-5 and GB-4:1 open the Yang Wei Mai (Yang Linking Vessel) for which loss of strength, esp. during rainy or cold weather, is a symptom of Xu (Deficiency)
• UB-38/43, CV-4 and St-36 (D) for general weakness caused by prolonged illness (Shanghai, p. 201)
• Lv-3 and LI-4: open the Four Gates; expel Wind, stop pain; regulate Qi and Xue (Blood) circulation; remove Obstruction of the channels; open the Orifices; release bodily tension; relax clenching of jaws; free constraint; calm the mind; relieves mental cloudiness; provide sedative and analgesic effect; pacify Liver Yang (Finkelstein, p. 7; Flaws, 1989, p. 76)
• Kd-3, Sp-6, LI-4, GB-20 and Lv-2: reinforce the Kidney and nourishes Yin (Finkelstein, p. 53)
• Kd-3 and UB-23: nourish Kidney Yin and facilitates Jing (Essence) (Finkelstein, p. 53)
• Kd-3, UB-23 and UB-15: adjust disharmony of the Heart and Kidney (Finkelstein, p. 53)
• Kd-3, UB-23, GV-4 and CV-4 (all: D): support Kidney Yang (Finkelstein, p. 53)
• Kd-6, Kd-7 and Sp-6: nourish Yin and moistens dryness (Finkelstein, p. 54)
• GB-34 and CV-12 (+): strengthen the Spleen and Stomach to help transportation and transformation of water and cereals to support body resistance (Zheng Qi) (Finkelstein, p. 69)
• CV-12 and Sp-4: treat lack of appetite (Finkelstein, p. 89)
• St-36, CV-4 and CV-6: restore the primary Qi (Finkelstein, p. 20)
• St-36, Ht-7 and Sp-6: strengthen the Spleen; regulate the circulation of Qi; control the Xue (Blood); and calm the Shen (Flaws, 1989, p. 87)
• St-36 and Sp-6: regulate the Spleen and Stomach; nourish the Xue (Blood); descend Rebellious Qi; cultivate the growing source of Qi and Xue (Blood); treat Xu (Deficiency) Cold conditions of the Spleen and Stomach; and ease the Mind (Finkelstein, p. 19)
• St-36, Sp-6 and UB-20: invigorate the Spleen and benefit the Root of Post-Natal Qi and Xue (Blood) (Flaws, 1989, p. 70; Finkelstein, p. 19)
• St-36 and Kd-3: regulate the Qi of the Liver, Spleen and Kidney (Finkelstein, p. 20)
• St-36, CV-12 and Sp-6: tonify the Spleen; regulate the Qi; control the Xue (Blood); and treat Spleen Xu (Deficiency) syndrome (Flaws, 1989, p. 87; Finkelstein, p. 20)
• St-36 and CV-4: tonify Spleen and Kidney to strengthen vitality (Finkelstein, p. 20)
• UB-38/43, CV-4 and St-36 (D): for general weakness caused by prolonged illness (Shanghai, p. 201)
• St-36, LI-4 and Lu-7: tonify the essential Qi to strengthen Ying (Constructive) and Wei (Protective) Qi (Finkelstein, p. 20)
• CV-12 , CV-10 and CV-13: tonify the whole body Yang via the Triple Warmer (Finkelstein, p. 90)
• CV-12, UB-20, Sp-3 and Lv-13 (+ and D): invigorate Spleen Yang (Finkelstein, p. 90)


point analysis

»
palpate and consider:
UB-38/43 (+ and D): regulates Lung Qi; tonifies Yin of the whole body; tonifies Kidney; warms Yang; restores collapsed Yang; strengthens Xu (Deficiency); Pericardium psychospiritual associated point
UB-20 (+ and D): regulates Spleen Qi; tonifies Spleen and Stomach; benefits the Ying (Constructive) Qi; Spleen Shu Associated point
UB-23 (+ and D): strengthens Qi Hai; tonifies the Kidney; nourishes Kidney Jing (Essence); nourishes Yin and strengthens Yang; Kidney Shu Associated point
GV-4 (+ and D): pacifies the Shen; clears the Brain; strengthens the Kidney; benefits and replenishes the Kidney Yang; nourishes the Yuan (Original) Qi; relieves mental and physical exhaustion; strengthens the back, esp. benefits the lumbar vertebrae; reinforces and astringes the Jing (Essence); stimulates adrenals, testes and ovaries (Finkelstein, p. 77); frees the channels and invigorates the collateral vessels; "Gate of Life Fire"
• jing gong (+): tonifies Kidney Yang; warms the Jing (Essence)
ca. yu yao (=): clears Heat; dispels focal infection in the sinus cavities; removes Obstructions from the channel; treats glandular/lymphatic exhaustion (Matsumoto); locate tender abdominal point (s), palpate most tender or painful point over each eye and needle, usually superiorly, so that tenderness at abdominal reflex point decreases upon palpation (Matsumoto)
ca. St-2 (=): dissipates Heat and expels Wind; resolves focal infection in the sinus cavities; treats glandular/lymphatic exhaustion (Matsumoto); frees the channels and invigorates the collateral vessels; locate tender abdominal point (s), palpate most tender or painful point over each eye and needle, usually inferiorly, so that tenderness at abdominal reflex point decreases upon palpation (Matsumoto)
TW-16 and/or "east wind" (=): treats glandular/lymphatic exhaustion, esp. with focus in the sinuses and oropharyngeal mucous membranes (Matsumoto); palpate lateral aspects of neck for ashi (tender) points (Matsumoto)
• Ht-3 (+): pacifies the Shen and Soul; enhances stability with nervous exhaustion; clears Heat; regulates the Heart Qi; removes obstructions from the channels; relaxes the sinews and muscles; invigorates the collateral vessels; Heart He Sea Uniting and Water point; "Joy of Life" point (Finkelstein, p. 32)
• SI-5 (+): clears Heat; pacifies the Shen; clears the Brain; "very effective in helping the person to gain clarity and a sense of direction in life" (Maciocia, p. 274); spreads Lung Qi; transforms Phlegm; Small Intestine Fire and Horary point
PC-6 (=): pacifies the Shen; regulates the Qi; builds Zhong (Ancestral) Qi in the chest; harmonizes and spreads the Qi in the Middle and Upper Warmers; relieves Liver Qi Stagnation; Pericardium Luo Connecting point; Couple point of the Chong Mai (Penetrating Vessel)
• Lu-7 (+): opens the Lung; spreads Lung Qi by stimulating the descending and dispersing of Lung Qi; opens and regulates the Ren Mai (Conception Vessel); activates Wei (Protective) Qi; Lung Luo Connecting point
• Lu-9 (+): regulates all Yang Qi; moves Xue (Blood) and restores pulses; facilitates circulation of Lung Qi; tonifies Lung Qi and Lung Yin; tonifies Metal to cool inflammatory processes and restrain Wood, esp. the Liver; cools and clears Heat in the Lung, Liver and throat; clears and descends the Upper Warmer and Lung Qi; increases oxygen absorption; Lung Yuan Source, Earth and Tonification point; Hui Reunion point of Xue (Blood) vessels
"LI-10.5" (=): treats glandular/lymphatic exhaustion (Matsumoto); resolves focal infection in the sinus cavities; frees the channels and invigorates the collateral vessels; locate tender most tender point on each side of the neck, usually "east wind", posterior to LI-18, then palpate for the most tender or painful point, distal to the elbow crease, between the Large Intestine and Triple Warmer channels; needle each arm; verify location and angle of needle by diminishing of cervical tenderness (Matsumoto)
LI-10 (-): lowers nervous excitement; promotes the circulation of Qi and Xue (Blood); tonifies Qi and Xue (Blood) (Maciocia, p. 378); enhances action of the immune bodies (Finkelstein, p. 8); harmonizes the Stomach and soothes the Intestines; tonifies Yang Ming (Stomach and Large Intestine) and the internal duct of the Triple Warmer (Finkelstein, p. 8)
• LI-4 (+): regulates Qi and Xue (Blood); tonifies Lung Qi; activates Wei (Protective) Qi; Large Intestine Yuan Source point
Kd-27 (+): regulates Lung; tonifies Yuan (Original) Qi; fortifies the Spleen; stimulates Kidney function of reception of Qi; tonifies Kidney (especially Yang); associated point of all associated points
Kd-24 (=): revitalizes the sense of self; resurrects the Spirit (Worsley); pacifies the Shen; opens and releases the chest; tonifies the Kidney
Kd-16 (=): benefits the Heart; regulates the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel); "strengthens function of the Kidney, giving renewed strength to body and mind" (Finkelstein, p. 55); palpation: reflection of birth trauma (Matsumoto); Spleen reflex point (Nan Jing as per Matsumoto); adrenal cortex reflex point (Nasako as per Matsumoto); Kidney Mu Alarm point (Manaka as per Matsumoto)
knotty and/or tender abdominal points and areas (=): palpate to locate and needle to release Stagnation and facilitate flow of Qi and Xue (Blood) (Matsumoto and Birch; Seem; et al.)
CV-12 (+ and D): builds Heart Yang; regulates and harmonizes the Stomach; strengthens and calms the Spleen; transforms Dampness; transforms Rebellious Qi to ease nausea; benefits and soothes the Qi; raises Middle Qi; warms the Middle Warmer, Stomach and Intestines; facilitates ascension of the Clear and descension of the Turbid; regulates the Intestines and stops excessive bowel movements; Stomach Mu Alarm point; Hui Reunion point of the Fu (Yang organs)
CV-6 (+ and D): strengthens and moves the Qi, esp. in the Lower Warmer; influences the pituitary, thyroid and adrenals (Worsley, 1975, p. B-20); regulates Qi of Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel); raises Middle Qi; warms and strengthens the Lower and Middle Warmers (D); tonifies the Kidney; regulates and tonifies Yuan (Original) Qi; nourishes and invigorates Kidney Yang; warms Ming Men (Life Gate Fire) (esp. with D); reinforces the Jing (Essence); regulates Water Pathways and dispels Dampness; warms feet and hands; Dan Tien (Elixir of Long Life), with CV-5: important point for concentration of Qi in the body; "Sea of Qi"
CV-4 (+ and D): pacifies the Shen; grounds the Shen when there is Empty-Heat (Maciocia, p. 207); regulates the Qi and benefits Yuan (Original) Qi; nourishes Xue (Blood) and Yin; tonifies the Middle Warmer and strengthens Spleen; regulates and reinforces the Qi of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel); separates the Clear and the Turbid; nourishes and stabilizes the Kidney; roots the Ethereal Soul; strengthens and replenishes the Kidney Qi; warms the Kidney Yang, the Lower Warmer and Uterus (D); resolves Damp-Heat; Yuan (Original) Qi home; Small Intestine Mu Alarm point
• Sp-15 (+): promotes the flow of Qi; regulates the Spleen (especially Qi); ventilates and clears stagnant Qi of the organs
St-30 (= or + and D): warms the Lower Warmer to dissipate Cold; harmonizes the Xue (Blood) and Ying (Constructive) Qi; dispels Qi Stagnation and Xue Yu (Blood Stasis); treats pelvic and inguinal problems; distributes Jing (Essence) and Yuan (Original) Qi to the genitals, Chong Mai (Penetrating Vessel) and the five curious organs (Brain, Spine, Bones and Marrow, Gall Bladder and Uterus); Entry point of the Chong Mai (Penetrating Vessel) and the Sea of Nourishment; reflex indicator for weak immune system (Matsumoto); if the Chong Mai (Penetrating Vessel) is troubled St-30 will be tender to palpation (Finkelstein, p. 17)
St-30 (+): harmonizes the Xue (Blood) and Ying (Constructive) Qi; dispels Qi Stagnation and Xue Yu (Blood Stasis); distributes Jing (Essence) and Yuan (Original) Qi to the genitals, Chong Mai (Penetrating Vessel) and the five curious organs (Brain, Spine, Bones and Marrow, Gall Bladder and Uterus); Entry point of the Chong Mai (Penetrating Vessel) and the Sea of Nourishment; indicator for weak immune system (Matsumoto); if the Chong Mai (Penetrating Vessel) is troubled St-30 will be tender to palpation (Finkelstein, p. 17)
St-36 (+ with D): tonifies Qi and Xue (Blood); enhances immunity; benefits Spleen and Stomach; regulates Ying (Constructive) Qi; nourishes Kidney, Liver and Spleen; Stomach Earth and Horary point; Sea of Nourishment point
ca. St-43 (=): palpate for tender or painful point, on the Stomach channel or between the third and fourth metatarsals; needle to resolve focal infection in the sinuses and oropharyngeal mucous membranes and relieve glandular/lymphatic exhaustion (Matsumoto)
Sp-6 (+): nourishes Yin; strengthens the Spleen; clears Fire due to Xu (Deficiency); tonifies Qi and builds the Xue (Blood); benefits the Kidney; warms the Middle and Lower Warmers; Jiao Hui Intersecting point of the three Foot Yin channels
Sp-4 (=): pacifies the Shen; moves and strengthens the Spleen and Middle Warmer; tonifies Yuan (Original) Qi; harmonizes the Chong Mai (Penetrating Vessel) and circulation of Qi in the Middle Warmer; Spleen Luo Connecting point; Master point of the Chong Mai (Penetrating Vessel)
• Sp-2 (+): stimulates the flow of Qi; dispels Exterior symptom-complex; stimulates thymus (Finkelstein, p. 25); strengthens the Spleen; tonifies Spleen Yang; harmonizes the Stomach; returns Yang and stems counterflow; reduces Food Stagnation; eliminates Dampness and Phlegm caused by Spleen Xu (Deficiency); Spleen Fire and Tonification point
Kd-7 (+ and/or D): strengthens Wei (Protective) Qi; clears Heat and nourishes Yin; strengthens Spleen and rids body of excess fluids; tonifies Yuan (Original) Qi; strengthens and enriches the Kidney; stimulates adrenals, thyroid and testes; cools and clears Damp-Heat; moistens dryness; regulates the pores and sweating; disperses Stagnation; strengthens the back, esp. lumbars; Kidney Metal and Tonification point
Kd-6 (+): pacifies the Shen and stabilizes the Will; nourishes the Heart; clears Xu (Deficiency) Fire; balances excess or deficiency of any hormonal secretion and stimulates adrenals (Finkelstein, p. 53); brightens the eyes and sends Zhong (Ancestral) Qi to the eyes via the Yin Qiao Mai (Yin Motility Vessel); clears the Lung and tonifies Lung Yin; benefits the throat; sedates cough, esp. chronic; tonifies Kidney (especially Yin); moistens dryness; dispels Dampness; eliminates excess fluid retention and initiates diuresis; strengthens lower back and loins; frees the channels and invigorates the collateral vessels; sedates pain; Master point and Entry point of the Yin Qiao Mai (Yin Motility Vessel); Couple point of Ren Mai (Conception Vessel)
Kd-4 (+): nourishes the Shen and Yin; regulates the Kidney; reinforces the Liver and Kidney, the latter through longitudinal Luo vessels; facilitates the flow of Qi and Xue (Blood); harmonizes the Xue (Blood); supplements the Jing (Essence); "susceptibility to fright or anger; ... insufficiency of spirit qi" (Ellis, et al, 1988, p. 249); esp. with a person who is fearful and discontented, completely lacking in motivation and desiring only to lay around at home, possibly due to insecurity, lack of confidence, or a feeling of inferiority (Mann, p. 45); Kidney Luo Connecting point
Kd-3 (+ and/or D): tonifies the Kidney, Yuan (Original) Qi, Xue (Blood) and Jing (Essence); nourishes and enriches Kidney Yin, supplies Liver Yin, and tonifies Yin of the entire body; warms Cold; pacifies Xu (Deficiency) Fire; strengthens the Brain; nourishes the Yin to moisten the Lung, calm wheezing, and sedate cough; treats thyroid imbalance (Matsumoto); stimulates pancreas; tonifies Kidney Yang and Ming Men Fire (D); reinforces Kidney to accept Qi (Finkelstein, p. 53); regulates the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel); Kidney Yuan Source and Earth point
• GB-41 (-): dissipates Wind; removes Fire; brightens the eyes; harmonizes and regulates the Liver and Gall Bladder; removes Stagnancy of Liver Qi; clears Wetness (Damp Spleen) by draining into Dai Mai (Girdle Vessel), thereby increasing Spleen Qi and Xue (Blood) production, improving digestion, and warming the extremities; dispels Damp-Heat; Gall Bladder Wood and Horary point; Master point of the Dai Mai (Girdle Vessel); Couple point of the Yang Wei Mai (Yang Linking Vessel)
Lv-8 (+): drains Liver Fire; nourishes Liver Xue (Blood); clears and cools Damp-Heat; soothes the sinews and tendons; frees and facilitates the Lower Warmer; invigorates the collateral vessels; Liver He Sea Uniting, Water and Tonification point
Lv-3 (-): pacifies the Shen; "relieves anger and mellows spirits of those who are frustrated and jealous" (Finkelstein, p. 73); clears head and thinking; relieves headache; suppresses dizziness; adjusts and harmonizes the Liver; promotes smooth flow of Qi and Xue (Blood); disperses and eliminates Liver Qi Stagnation; regulates the Vital Qi, strengthens Raising Qi, and removes irregularities in the body Qi; subdues Liver Yang; calms and extinguishes Liver Wind; calms Stomach and expands chest; tonifies Liver Xue (Blood); Liver Yuan Source and Earth point

ear: liver; spleen; kidney; lung; sympathetic; shen men


footnotes

Reprinted from The Foundations of Chinese Medicine, Maciocia, Giovanni, 1989, by permission of the publisher Churchill Livingstone, a division of Elsevier Limited.