-IBIS-1.5.0-
tx
digestive system
appendicitis
acupuncture

patterns and combinations

after assessing the person and palpating, consider these patterns:
Accumulation of Damp-Heat due to Food Stagnation in the Intestines; Xue Yu (Blood Stasis) and Heat in Large Intestine; Liver Invading Spleen

» method: In acute conditions treatment is given 1-3 times a day, while in chronic cases it is given once daily or every other day

» illustrative combinations:
• lan wei xue, St-37 and St-36 (strong stimulation, several minutes manipulation, and 1-2 hours retention) for acute appendicitis; also consider: LI-4, PC-6, LI-11 and/or St-25 (Shanghai, p. 639)
• lan wei (four hours retention, pause for four hours and repeat, for one or two days), also add CV-12, St-36, UB-25, St-44 and PC-6 for appendicitis due to Damp-Heat in the intestines (McWilliams, et al, Lesson 31, p. 27)
• St-36, St-37, St-25, "appendicular point" (lan wei xue), and PC-6 for pain of acute appendicitis; also consider CV-13 with vomiting; and/or LI-11, LI-12 and LI-14 with high fever (Liu, p. 420)
• St-36, Kd-16, Sp-13, PC-6, LI-11, UB-24 and UB-25 for acute appendicitis (Shanghai, p. 640)
• Sp-10, UB-54/40, Sp-9, Sp-8, Sp-6, Lv-2, TW-10, LI-4 and LI-11 (strong stimulation) for acute appendicitis (Shanghai, p. 640; Lee and Cheung, p. 359)
• St-37 and St-36 for appendicitis; also consider LI-4 and LI-11 for high fever; St-25 for abdominal pain; and/or PC-6 for nausea and vomiting (Lee and Cheung, p. 358)
• UB-24, UB-25, St-3, Sp-12, Sp-10, Sp-9, Sp-6 and indirect moxa with a stick over the point of pain for chronic appendicitis (Shanghai, p. 640)
• Sp-3, St-43 and UB-25 for pain from intestinal abscess (Shanghai, p. 640);
• LI-11, LI-4 and Lv-12 (-): clear Heat to resolve fever
• LI-11 and St-36A (lan wei): has immediate anti-inflammatory effect on appendix (Finkelstein, p. 9)

» suggested protocol:
• Use strong stimulation and continuous needle manipulation for 2-3 minutes. Retain needles from 30 minutes to 2 hours, manipulate every ten minutes, treat every 6-8 hours. When symptoms and signs are alleviated, treatment may be given once daily with needles retained for 30 minutes. (Finkelstein)
• lan wei, St-25, Sp-13, St-29 and the spot where the pain is severe (obtain a light stimulus only from the painful spot); St-37, St-36; UB-25, UB-23, UB-47/52, CV-6; Sp-10, Sp-1 (++); Lv-1 (5 d. D:1/2 grain rice size) and tu yin (5 d. D:1/2 grain rice size); can also add: zhou jian (1 d. D), er xai (1 d. D), CV-5 (only for men).
• PC-6 and CV-12 for associated vomiting (Finkelstein)
• LI-4, LI-11, UB-54/40, GV-14 for associated fever (Finkelstein)

» Acupuncture therapy is relatively effective in the treatment of simple acute appendicitis. For severe cases, where the white blood cell count indicates the possibility of abscessed or ruptured appendix, acupuncture alone is insufficient and surgical removal of the appendix should be considered. The above prescription is satisfactory in chronic appendicitis. Treatment is given once daily or every other day. Moxibustion may be applied at local points. (Finkelstein)


point analysis

»
palpate and consider:
UB-54/40 (-): drains Summer-Heat; clears Heat from the Xue (Blood); transforms Damp-Heat; Bladder He Sea Uniting and Earth point
LI-11 (-): clears Heat; dispels Exterior conditions; regulates Qi and Xue (Blood); cools Xue (Blood); eliminates Dampness; frees the channels; Large Intestine Earth and Tonification point
LI-4 (-): regulates Qi and Xue (Blood); dissipates pathogenic Heat; releases the Exterior; reduces fever; sedates pain; frees the channels; clears Toxins; Large Intestine Yuan Source and Entry point
PC-6 (+): clears Heat; pacifies the Shen; facilitates the flow of Qi, esp. in the Upper and Middle Warmers; regulates Liver Qi; descends Rebellious Qi to resolve nausea, reduce eructations, and stop vomiting; enhances purification and dispersement of the Triple Warmer; drains the Triple Warmer; Pericardium Luo Connecting point; Couple point of the Chong Mai (Penetrating Vessel)
er bai: exerts specific influence on intestines (So, 1987, p. 219)
• CV-13 (-): invigorates the Qi; strengthens the Spleen and dissipates Dampness; dissipates Damp-Heat of Liver and Gall Bladder; harmonizes the Spleen and Stomach; clears Heat to relieve fullness in chest and epigastric region; descends Rebellious Qi and quells vomiting
• St-25 (-): regulates function of intestines; eliminates Qi Stagnation in and clears Heat from Large Intestine; transforms Dampness; Large Intestine Mu Alarm point
• St-29 (-): regulates the Lower Warmer; relieves local Qi Stagnation and Xue Yu (Blood Stasis); stops pain
• Lv-12 (-): clears Heat to resolve fever
• tender abdominal point(s): use light stimulus to facilitate Qi circulation
lan wei xue (-): regulates the intestines; transforms Damp-Heat (esp. intestinal); stops abdominal pain; specific point for appendix; usually retained, often for several hours
• GB-34 (-): regulates Large Intestine and increases peristaltic action; promotes activity in appendix to facilitate absorption and decrease inflammation; alleviates pain; clears and cools Dampness and Heat; Gall Bladder He Sea Uniting and Earth point
St-37 (=): rectifies the Spleen and harmonizes the Stomach; regulates and frees the Large Intestine; dispels Food Stagnation; clears Heat and resolves Damp; Large Intestine He Sea Lower Uniting point
St-36 (-): harmonizes digestion; benefits Spleen and Stomach; regulates Ying (Constructive) Qi; stops vomiting; descends Rebellious Qi; removes Food Stagnation; clears Heat from the Yang organs; Stomach He Sea Lower Uniting and Earth point
• Sp-10 (=): regulates Spleen Qi; clears Heat and Summer-Heat; harmonizes and tonifies Ying (Constructive) Qi; regulates and invigorates the Xue (Blood)
• Sp-1 (++): tonifies Spleen; pacifies the Shen; stimulates the flow of Xue (Blood); regulates the Xue (Blood); Spleen Jing Well and Wood point

ear: large intestine, appendix, lung, sympathetic, spleen, shen men, subcortex

» method: In acute conditions treatment is given 1-3 times a day, while in chronic cases it is given once daily or every other day

» if needles don't resolve pain:
• Lv-1 (d. D) and tu yin (d. D): five cones of direct moxa, one-half rice grain, each (So, 1987, p. 219)


footnotes