Auxiliary Manipulations on Filiform Needles

Auxiliary manipulations on filiform needles refer to such techniques as sparrow pecking, vibrating, twirling, flying, flicking, scraping, arching, swinging, shaking, circling, and tapping on the handle (or body) of the needle after insertion.

1. Sparrow pecking technique

Introduction

This technique is named so because the technique is like a sparrow pecking at the corn. The name was given by Dr. Danan Cheng. It mainly functions to facilitate the arrival of qi and promote the circulation of qi. This technique also serves to strengthen and spread the needling sensation of patients.

 

Procedures

Insert the needle to the proper depth of the acupuncture point. Lift and thrust the needle continuously with small amplitude but with high frequency like a sparrow pecking at the corn. The wrist joint moves slightly up and down in the operation. The range of frequency is between 150 to 300 times per minute. The needle should be kept at the same depth ultimately.

 

The difference between sparrow pecking technique and technique of lifting and thrusting is the depth of needling. Sparrow pecking means vibrating the needle slightly and quickly in a fixed position, while the latter is moving the needle up and down with obvious change of needling depth.

 

Both sparrow pecking and vibrating apply quick lift-thrust movement in small amplitude to cause vibration of the needle. Those two techniques can be differentiated by the force used. Vibrating depends mainly on finger power causing gentle stimulation. Sparrow pecking, on the other hand, relies on the perpendicular movement of wrist joint, which brings about stronger stimulation to points.

 

Indications

In clinical practice, Sparrow pecking technique is applied to acupuncture points on the body with thin tissues or near vessels or muscle tendons. This technique could be used to substitute the technique of strong lifting and thrusting which is not suitable for those areas.

 

For example, this technique is applied on BaiHui(GV20), Touwei(ST8), Shangxing(GV23) and Yintang (Extra) for headache. It can be also applied to Shenmen(HT7), Anmian(Extra), Yintang(Extra) for insomnia. Xiyan(Extra) and Heding(Extra) for gonarthritis. Feishu(BL13), Lieque(LU7), Chize(LU5), and Taixi(KI3), for asthma. Fengchi(GB20) and Taichong(LR3) for dizziness and vertigo.

 

2. Vibrating

2.1 Introduction

This technique is vibrating the needle by rotating and lifting and thrusting it very quickly with small amplitude. It mainly functions to facilitate the arrival of qi and promote the circulation of qi. It also serves to tonify the deficiencies. This technique is from <BianQue’s Spiritual Guide to Acupuncture and Moxibustion, Jade Dragon Classic > written by Hui Chen of Ming dynasty. Dr. DanAn Cheng’s method of holding the needle with the thumb and index finger, applying lift-thrust movement quickly and lightly in a trembling way is based on this technique.

 

2.2 Procedures

Insert the needle to the proper depth of the acupuncture point. If Qi fails to arrive, hold the needle with the thumb and index finger. Rotate the needle forward and backward and at the same time move the needle up and down gently and rapidly. The operation of rotating, lifting and thrusting needs to be within very small amplitude while the frequency as high as possible like the hand trembling. Finger power should be chiefly used in this technique to make the needle quivering.

 

It tells Vibrating from Shaking by the amplitude of manipulation and force used. Shaking is obtained by moving the needle up, down, forward and backward forcefully with large amplitude. Vibrating is achieved by rotating, lifting and thrusting the needle gently with small amplitude.

 

2.3 Indications

In clinical practice, vibrating mainly functions to excite muscles and nerves(<Chinese Acupuncture and Moxibustion>). It can be applied to the acupuncture points all over the body. For example, this technique is applied to PiShu(BL20) and Weishu(BL21) for indigestion due to spleen qi deficiency. It can be also applied to Yingxiang(LI20), and Zanzhu(BL2) for rhinitis. Yangbai(GB14), Xiaguan(ST7), Quanliao(SI18), Chengjiang(CV24) and Jiache(ST6) for facial paralysis. Mingmen(GV 4), Shenshu(BL23), Guanyuan(CV4) and Zhongji(CV3) for retention of urine.

 

3. Twirling

Introduction

This technique is twirling the needle only in one direction, causing muscle fibers to wind around the needle. The tension on muscle can promote the circulation of Qi. This technique mainly functions to strengthen the needling sensation and effects of the reinforcing and reducing. In <Ode of the Golden Needle>, it states ‘twirling heals diseases’. <The Great Compendium of Acupuncture and Moxibustion> says ‘This technique can induce a warm or cool sensation at the punctured part’.

 

Procedures

Insert the needle to the proper depth of the acupuncture point. After the qi sensation is obtained, rotate the needle in one direction. According to the guideline set in <The Great Compendium of Acupuncture and Moxibustion>, rotating the needle forward from the transverse creases of the distal interphalangeal joint to the tip of the index finger with the thumb means the reinforcing. Rotating the needle backward from the tip of the index finger to the transverse creases of the distal interphalangeal joint means the reducing. This technique may be repeated three to five times during retaining the needle.

 

It may also tell the light twirling from the heavy twirling by the intensity of stimulation in clinical practice. Light twirling is obtained by rotating the needle slowly with an angle of 180 degrees. The patient has gentle feeling around the needle. Heavy twirling is achieved by rotating the needle rapidly with an angle of 360 degrees. The patient has strong needling sensation and the practitioner feels stuck sensation under the needle. If the patient does not feel or only has little needling sensation after the insertion and manipulation of the needle, heavy twirling could be used.

 

Thrusting the needle heavily while lifting the needle gently after heavy twirling for 5 to 7 minutes could induce a warm feeling at the punctured part. Lifting the needle heavily while thrusting the needle gently after heavy twirling for 5 to 7 minutes could induce a cool feeling under the needle.

 

3.3 Indication

In clinical practice, twirling is applied to acupuncture points on the head, neck, limbs, abdomen, waist and back. For example, this technique is applied to JianYu(LI15), Quchi(LI11), Huantiao (GB 30), Yanglingquan (GB 34), Xuanzhong(GB30) etc. for hemiplegia. It can be also applied to Zusanli (ST 36), Sangjuxu(ST37), Tianshu(ST25) and Zhongwan (R12) for Acute abdominal pain. Tianshu(ST25), Futu(ST32), Fenglong(ST40) for losing weight.

 

Appendix: stuck needling technique

This technique is derived from twirling. It is twirling the needle in one direction after inserting the needle to the proper depth, causing muscle fibers to bind around the body of the needle tightly. The operator feels difficult to rotate, lift or thrust the needle. Stuck needling technique, vibrating and scraping are often used together to spread and push the needling sensation to reach the diseased part of the body. On withdrawing the needle, twirl the needle in the opposite direction and then withdraw it slowly.

 

In clinical practice, stuck needling technique may be applied to acupuncture points on the head, neck, limbs, abdomen, waist and back without local large vessels. It is usually used to treat excess syndrome of stagnation of Qi and Blood. For example, this technique is applied to JianYu(LI15), Quchi(LI11), Huantiao (GB 30), Yanglingquan (GB 34), Xuanzhong(GB30) etc. for hemiplegia. It can be also applied to Zhongwan(CV12) for stomachache. Guanyuan(CV4) for dysmenorrhea. Zhubin(KI9) for renal colic. Fengchi(GB20) for migraine. Baihui(D20) for prolapse of rectum.

 

4. Flying

4.1 Introduction

This technique is named so because the technique is separating the fingers after twirling the needle just like a phoenix spreading its wings. It mainly functions to promote the circulation of Qi. This technique also serves to strengthen and spread the needling sensation. This technique is from <BianQue’s Spiritual Guide to Acupuncture and Moxibustion, Jade Dragon Classic > written by Hui Chen of Ming dynasty. The manipulation of Phoenix Spreading Wings (Feng Huang Zhan Chi) which was recorded in <The Great Compendium of Acupuncture and Moxibustion> (Jizhou Yang, Ming dynasty) is similar to this technique. This technique was also mentioned in other books such as <Elementary Medicine> and <Questions and Answers Concerning Acupuncture and Moxibustion>, but the author used different names. The comprehensive method of Chi Feng Feng Yuan is derived from this technique.

 

4.2 Procedures

Insert the needle to the proper depth of the acupuncture point. Hold the needle with the thumb and index finger. Twirl the handle of the needle gently for 1 to 3 times and then release it quickly. Separate the fingers just like a bird spreading its wings. The needle might be left slightly quivering on the point.

 

The amplitude of rotating the needle should be within 360 degrees. Twirling with too large amplitude should in no case be allowed in this technique. The direction of rotation is not important in the manipulation.

 

4.3 Indication

In clinical practice, flying may be applied to most of the acupuncture points all over the body. For example, this technique is applied to Guanyuan (CV4), Qihai(CV6) and Zhongji(CV3) for urination disturbance, retention of urine or impotence. It can be also applied to Taiyang(Extra), Yintang (Extra), Anmian(Extra), and Shenmen(HT7) for insomnia. Shenmen(HT7), Neiguan(PC6), Juque(CV14) and Xinshu(BL15) for palpitation.

 

5. Flicking

5.1 Introduction

This technique is flicking the handle of the needle slightly with the finger. It mainly functions to promote the circulation of Qi and strengthen the needling sensation. This technique also serves to intensify the effects of reinforcing deficiency or reducing excess.

 

This technique is derived from ‘flicking to cause congestion’ in <Plain Questions>. The original meaning of this method is flicking the acupuncture point to cause the local vessels congested before inserting the needle. In <Guide to the classic of Acupuncture >, it is stated ‘Flicking the handle of the needle’.

 

5.2 Procedures

Insert the needle to the proper depth of the acupuncture point. Cross the middle and index finger with the middle finger ahead, or cross the thumb and index finger with the thumb ahead. Flick the handle of the needle lightly with the index finger causing it to tremble. This technique is usually used for 5 to 10 times during the retaining period. Gentle manipulation is required to avoid stuck or bent needle.

 

5.3 Indication

In clinical practice, flicking could be applied to most acupuncture points all over the body. For example, this technique is applied to Taiyang(Extra), Zanzhu(BL2), SiBai(ST2), Xingjian(LR2) for juvenile myopia. It is also applied to Tianzhu(BL10), Jianyu(LI15), Quchi(LI1), Hegu(LI4), Biguan(ST31), Zusanli(ST36) etc. for infantile paralysis. Tianshu(ST25), Shangjuxu(ST37), and Sifeng(Extra) for infantile Diarrhoea. It is a kind of gentle stimulation suitable for sensitive and delicate constitution.

 

6. Scraping

Introduction

This technique is scraping the handle of the needle with the nail. It mainly functions to promote the circulation of Qi and spread the needling sensation. This technique was derived from <Plain Questions> and named so in <Elementary Medicine>.

 

Procedures

Scraping with one hand

Insert the needle to the proper depth of the acupuncture point. Place the thumb on the end of the needle to hold it steady. Scrape the handle with the nail of the index or middle finger of the same hand from top to bottom or vice versa. Or hold the handle of the needle with the thumb and middle finger. Scrape the handle with the nail of the index finger.

Scraping with both hands

Insert the needle to the proper depth of the acupuncture point. The thumb of the left hand is placed on the end of the needle. Bend the index fingers of both hands. Hold the body of the needle with the back of two index fingers to keep it steady. Scrape the handle with the nail of the right thumb.

 

The reinforcing is achieved by scraping the handle of the needle from the end toward the root of the needle while the reducing is from the root to the end.

 

6.3 Indication

In clinical practice, scraping is applied to acupuncture points around eyes and ears. It is also applied to acupuncture points on the fingers and toes with thin tissues. For example, this technique is applied to Tinggong(SI19), Tinghui (GB2) and Yifeng(TE17) for deafness and tinnitus. It can be also applied to Jingming(BL1) and Qiuhou(Extra) for optic atrophy. Shaoshang(LU11) Shangyang(LI1) and Lidui(ST45) for sore throat. Yinbai(SP1) for menorrhagia or uterine bleeding. Baxie(Extra) and Shixuan(Extra) for finger numbness. Bafeng(Extra) for toe pain.

 

7. Arching

7.1 Introduction

This technique is named so because the technique is bending the needle slightly in the shape of a bow. It mainly functions to promote the circulation of Qi. This technique also serves to push the needling sensation to go further along the meridian and reach the diseased part of the body.

 

There are two meanings of Arching according to <Questions and Answers Concerning Acupuncture and Moxibustion> written by JiWang of Ming Dynasty. The first one means the body of the needle is bent to form an arch. The other is holding the needle with the thumb and index finger and focusing all attention on the needling sensation under the tip of the needle. Patients are asked to hold their breath at that time to facilitate the arrival of Qi. Most modern practitioners follow the first method in their clinical practice.

 

7.2 Procedures

Insert the needle vertically to the deep level of the acupuncture point. Pull the needle from the deep level to the medium level. After the qi sensation is obtained, hold the handle of the needle with the thumb and index finger forcefully to keep the Qi around the tip of the needle. Press the needle body lightly with middle and ring finger. Bend it in the shape of a bow. The needle may be bent backward to push the needling sensation to move forward or bent forward to push the Qi to move backward.

 

Another method named Bending and Underlaying is derived from Arching. After the qi sensation is obtained, bend the needle to one side and underlay one finger between the body of the needle and skin. Stand the tip of the needle against the Qi to strength the needling sensation. Practitioners may bend the needle with the thumb and underlay the needle with the index finger or vice versa(<Collection of Acupuncture and Moxibustion>).

 

7.3 Indications

In clinical practice, arching is applied to the acupuncture points below the knee and elbow with thick muscles and strong needling sensation. For example, this technique is applied to Hegu (LI4), Yanglao (SI6), and Waiguan(TE5) for facial paralysis or facial spasm. It is also applied to Hegu (LI4) for toothache. Zusanli(ST36) and Shangjuxu(ST37) for epigastric pain. Weizhong(BL40) and Taixi(KI3) for low back pain. Neiguan(PC6), Ximen(PC4) for cardiopathy. Yanlingquan(GB34), xuanzhong(GB39), kunlun(BL60) for sciatica.

 

8. Swinging

Introduction

This technique is swinging the needle left and right. It mainly functions to spread the needling sensation and push the needling sensation to reach the diseased part of the body. The comprehensive method of Green Dragon swaying tail (Qing Long Bai Wei) is derived from this technique.

8.2 Procedures

Insert the needle to the proper depth of the acupuncture point. After the Qi sensation is obtained, withdraw the needle a little. Sway the needle slowly from one side to the other within the amplitude of 45 degrees. It is like the swing of the pendulum. There is no lifting, thrusting and rotating the needles in this manipulation.

 

It tells Swaying from Shaking by the different function. Shaking is used when withdraw the needle to expel the excess heat. Swaying is applied during retaining of the needle to strengthen the needling sensation.

 

8.3 Indication

In clinical practice, swinging is effective for syndromes of stagnation of qi and blood or obstruction in meridians. It is applied to acupuncture points on the body with thick tissues. For example, this technique is applied to Neiguan(PL6) and Ximen(PC4) for palpitation. It can be also applied to Quchi(LI11), shousanli(LI10), and Chize(LU5) for external humeral epicondylitis. Jianzhen(SI9), Binao(LI14) and Tiaokou(ST38) for periarthritis of shoulder. Fenglong(ST40) and Yanglingquan(GB34) for hyperthyroidism.

 

9. Shaking

Introduction

This technique is shaking the needle and enlarging the hole on withdrawing it. It mainly functions to relieve the pathogenic qi. It is stated in <Spiritual Pivot> that ‘Enlarge the acupuncture point to release Qi quickly’. In <Guide to the classic of Acupuncture>, it says ‘Shake the needle before withdraw it to reduce’.

 

Procedures

Hold the needle with the thumb and index finger. Pull the needle from the deep level to the shallow level slowly. Shake the needle in four directions, up, down, left and right, on withdrawing it. Enlarge the hole and allow the pathogenic factor going out of the body with the needle. Reducing method by keeping the hole open is usually applied together.

 

9.3 Indication

In clinical practice, shaking is one of the reducing methods and applied to excess heat syndrome. For example, this technique is applied to Quchi(LI11) and Dazhui(GV14) for fever. It can also be applied to Renzhong(DU26), Houxi(SI3) and Weizhong(BL40) for acute lumbar muscle sprain. Taiyang(Extra), Hegu(LI4), Taichong(LV3) for acute conjunctivitis. Quchi(LI11), Geshu(BL17), Xuehai(SP10) for urticaria or acne.

 

10．Circling

10.1 Introduction

This technique is moving the handle of the needle in a circle at acupuncture points on the abdomen clockwise or counter clockwise. It mainly functions to strengthen and spread the needling sensation. This technique is from <Guide to the Classic of Acupuncture>. It is stated in <Ode of the Golden Needle> that ‘circling over the abdomen’.

 

10.2 Procedures

Insert the needle vertically to the deep level of the acupuncture point. After the Qi sensation is obtained, pull the needle from the deep level to the superficial level. Hold the needle with the thumb and index finger. Lower the needle and move the handle of the needle in a circle clockwise or anticlockwise. Speed uniformity is required in this manipulation.

The reinforcing and reducing is achieved by Circling accompanied with the technique of lifting and thrusting. Generally, circling clockwise with thrusting the needle heavily is called the reinforcing, on the contrary, circling counter clockwise with lifting the needle heavily is known as the reducing. When repeated operation is conducted for several minutes, the patient may have a warm(reinforcing) or cool(reducing) sensation at the punctured part.

 

Light circling is obtained by moving the needle slowly. Patients may feel local slight soreness. Heavy circling is obtained by moving the needle rapidly. Patients may feel heaviness and distension around the point. Meanwhile, the operator should feel tenseness around the needle. If the patient does not feel or only has little needling sensation after the insertion and manipulation of the needle, heavy circling could be applied.

 

10.3 Indication

In clinical practice, circling is usually applied to acupuncture points on abdomen with loose tissues. In recent years, it is also employed to points on arms or legs with thick muscles. For example, this technique is applied to Zhongwan (CV12) and Tianshu(ST25) for abdominal pain, abdominal distension, diarrhea and so on. It can be also applied on the Fengshi(GB31) and Futu(ST32) for hemiplegia.

 

11. Tapping

11.1 Introduction

This technique is tapping against the tail of the needle. It mainly functions to promote the circulation of Qi. This technique also serves to keep the needling sensation. It is from <Copy of Plum Blossom Poem of Golden needle>.

 

11.2 Procedure

Insert the needle to the acupuncture point. After the Qi sensation is obtained, tap the needle on the tail vertically with the index or middle finger to get the needle to the certain depth layer by layer. Pull the needle back to the superficial level and tap again.

 

11.3 Indication

In clinical practice, tapping is applied to acupuncture points on the legs and arms with thick tissues. For example, this technique is applied to Huantiao (GB 30), Fengshi(GB31), Yanglingquan (GB 34), Weizhong (UB 40) and Chengshan(BL57) for sciatic pain. It can be also applied to Mingmen(GV4), Yaoyan(Extra), Yaoyangguan(GV3), Dachangshu (BL25), Guanyuanshu(BL26) and Ciliao(BL32) for low back pain.