Monday, August 27, 2012

Abdominal contact needling (2)


(1) The purpose of abdominal contact needling

To give an order to the shallow qi of the whole body by moving the shallow qi on the abdomen.
As a result, it makes easier to evaluate the pulse and abdominal diagnosis.
Shallow qi on the abdomen is especially called as "Ju".

(2) Abdominal area

The abdomen here is the area between lower parts of rib cages and the pubis and both sides of the inguinal region (upper and lower boundaries), and betwen inner sides of the gallbaladder lines (left and right boundaries). However, in the real practice, one is not necessary to perform contact needling close to each boundary.

(3) Observation of the abdomen

The practitioner always has to be careful to notice changes of the skin on the abdomen. This is because when any changes occur, these changes are understood in terms of the movement of qi.

Firstly, be aware with objective characteristics of the surface of the skin, such as dryness and moisture, cold and heat, hard and soft, tension, texture and luster of the skin.

On the other hand, the subjective condition of the abdomen are, spontaneous pain, feeling of fullness, pressure and itciness, and abnormal sensation (hyperesthesia and hypoesthesia). In addition, borborygmus and succussion splash are the abdominal conditions felt both subjectively and objectively.

To palpate, wipe the sweat of the abdomen off with a towel, place both hands on both sides of the abdomen to compare the temperature of left and right, and check the condition of the skin of the whole abdomen with one's Oshide (pressing hand).

(4) Needles to be used

Basically, a 40 mm, number 3 silver filiform needle is used. However, when patients are very sensitive naturally or in the sensitive condition, and in the case of infants, a Teishin needle is used instead of a filiform needle.

(5) How to do the abdominal contact needling

[Contacting a needle to the abdomen]
As well as the insertion of a filiform needle, the hand posture of abdominal contact needling is based on what the Oshide, Sashide and a needle formed altogether, and the practitioner has his/her needle on the needle handle, and pushes the needle with the Sashide towards the direction of the needle body and presses the surface of the skin with the needle.

Here, it is important the needle tip is contacting the surface of the skin, but it is different from the filiform needle that if the needle does not insert, the practitioner moves to the next point quickly and repeat the same thing.

The point here is not to twist the needle so much to insert the needle. About pushing the needle, the pressure of it is depending on the flexibility of the needle body, so it is unappropriate if the pressure is too strong or too weak. It is better not to bend the needle if possible.

The duration of contacting a needle in each point is usually up to two seconds, but if the practitioner get used to the maneuver, the movement gets continuously and speeds up. One does not need to mind the depth of insertion. If the needle is easily inserted by such a pressure, it means that the body needs such quantity of stimulation, so it has no problem to insert.

Some people might think that it is enough only to contact a needle to the skin because it is "contact needling", but this idea causes some problems,  not only the treatment effect is not enough, but also it rather may cause the stagnation of qi.

[Withdrawal of a needle]
Next, one has to add an action to return the needle applied to the skin, and at the same time close the point with the index finger of the Oshide. This is the technique of tonification.

If one gives an uncomfortable pain to a patient during the needle manipulation, the problem lies on the top-bottom and right-left pressure of the Oshide, as well as a filiform needle, unless the needle tip has some problems.

The practitioner performs actions mentioned above to the whole of the abdomen.

[Abdomen as a plane]

In the abdomen, yin meridians and yang meridians are running through, and there are various acupuncture points, but one does not need to take these into account when performing contact needling. It is important to consider the whole abdomen as a "plane" and do contact needling.

Therefore, the rhythm of needling should not be the same all the time, and one may speed up or slow down up to the necessity.

The whole time taking for the abdominal contact needling is around one minute, and one repeats routines of needling the whole abdomen around three times.

Sometimes, a patient may start sweating. Do not leave this alone, this would let the body gets cold, and wipe the sweat off carefully.

(6) The observation of the abdomen after the abdominal contact needling.

One has to check the abdomen again after the abdominal contact needling. As well as other steps of therapy, it is important to check the effect of treatment after needling.

The most remarkable points here are spontaneous pain and pressure pain. Before contact needling, check the part of pain, and observe how it changes after contact needling. In theory, the changes of pain are getting stronger, getting less, and no change.

However, in the clinical practice, it rarely occurs that the pain gets stronger after the abdominal contact needling. If this may occur, it means the way of abdominal contact needling is not appropriate. The needle does not touch the skin, and it cannot give the stimulation that the body requires or the way of contact needling is so harsh that bringing the new disorder of qi, so one has to perform contact needling again with attentions.

One observes other conditions as well, but the point here is also the same with pain.

(7) The meaning of contact needling

It is notable that after contact needling, in some cases, the conditions such as pain disappear, but in other cases, they do not. This means that the abdominal contact needling plays some roles, and there are conditions applied to such cases, and those not.

In other words, the abdominal contact needling is a light stimulation, so there are conditions that easily change with the subtle stimulation and those not. Light means the condition of capability to insert a needle to the skin by just pushing a needle, and qi influenced by such needling is expressed as "shallow qi".

Here, the changes of the body by stimulation of needling and etc, is called "qi moves". The substance of changes is qi, but the condition to change is understood as a phenomenon that uneven qi is returning to the even state.

That is, when thinking how shallow qi of the abdomen, it is divided into those being even, and those not. The same thing can be applied to the whole body.

What to note is one should not understand like the effect of the abdominal contact needling would be something % stochastically. The individual difference is important, and do not judge the effect of the abdominal contact needling, applying the concepts of elements easy to change with a light manipulation and those not, but these changes are just means to know the movement of qi.

Whether the movement of qi is big or not should not be judged by how the main complaint, such as the pain, is in advance, but even strong pain disappears easily in the clinical experience. Do not judge the state of qi conceptually.

What to note in this step is that some conditions of the body change by the light manipulation of the needle.

**This article is translated from the book of "Toyo igaku koza dai 10 kan, Keiraku-Shakuju chiryo hen (Oriental Medicine Lectures, Vol.10, Meridian Shakuju Treatment)".