NOTES ON FIRST AID IN TRADITIONAL CHINESE MEDICINE

Dr. Francesco Longo

Veterinary Physician
Specialist in Animal Reproduction
Expert in Traditional Chinese Veterinary Medicine and Veterinary Acupuncture
Florence, Italy

According to the medical interpretation of the I CHING, emergency treatment is

represented by Hexagram 4 MNG (Youthful Folly), which consists of the two Trigrams
Kan Water (lower Trigram) and Kn Mountain (upper Trigram); the gloss by King
Wn states: Proceeding from obscurity, youthful folly has success. It is not I who seek
the young fool; the young fool seeks me.
Hexagram 4 MNG corresponds to the acupoints of the Governor Vessel between GV
19 (Houding) and GV 28 (Yinjiao) which affect the median axis of the nape, cerebellum,
cerebrum and head, and promote the balance of ideas and feelings.
In obscurity, it is necessary to follow a simple course of action that takes the darkness into
account: obscurity is nothing more than the confusion that precedes clarity.
Essentially, the idea expressed is that of an emergence from obscurity, or in other words
from a condition of shock or lack of consciousness that is recovered by means of the
needles: the patients consciousness (Shen) rises to the surface bit by bit, contributing to
resuscitation and enabling the patient to regain his or her senses. (1)
First aid procedures are a little-known clinical application of Chinese Traditional Veterinary
Medicine (CTVM).
Any condition that involves a state of shock is due to an alteration in energy circulation
between Yin and Yang, a kind of disconnection between the two major organic
components that can lead to a subsequent decompensation of Qi (energy), Xue (blood)
and Jin Ye (body fluids).
Cases of emergency are traditionally classified as follows:
High fever: due to - Wind Heat that affects the Lung
- Retention of Toxic Heat
- Summer Heat that disturbs the Heart
- Seasonal epidemic disorders.

Syncope: due to sudden disorders expressed in various ways:

- Qi
- Xue
- Phlegm
- Diet
- Cold
- Heat
Collapse: due to exhaustion of the Yuan Qi resulting from constitutional deficiency, loss of
body fluids or hemorrhages; it manifests itself with three different states:
- Yin
- Yang
- Yin / Yang
Sunstroke: where Summer Heat disturbs Yang and exhausts Qi; it can occur in two forms:
- Moderate
- Severe (2)
Shock: takes several forms:
- Qi stagnation: sudden loss of consciousness, deep wheezy
breathing, pallor, pale tongue, deep tense pulse (Chen Xuan).
- Xue stagnation: deep, slow breathing, lockjaw, trembling of the
limbs, pale or purplish mucus membranes, tongue purplish or with
dark spots, fast thready pulse (Xi Shuo).
- From phlegm: caused by emotional and psycho-behavioral
excesses, with noisy, labored breathing, accompanied in some
cases by regurgitated mucus, pale tongue with a damp whitish
coating, deep fine pulse (Chen Xi).
Transient Cerebral Ischemia: also manifests itself in different ways:
- Liver and Kidney Yin deficiency: hyperesthesia of the limbs
followed by loss of strength, heavy body, anxiety and irritability,
reddened and thinly coated tongue, tense fast pulse (Xian or
Shuo).
- Xue stagnation: hyperextension of one of the front or rear limbs,
vertigo, asthenia, anxiety, swollen, dark and thinly coated tongue,
fine fast pulse (Xi Se).
Arterial Hypertension: expressed in different forms:
- Heart Yang deficiency: vertigo, difficulty walking, tachycardia,
asthenia, cold skin, cold extremities, depression, pale scalloped
tongue with no coating, deep fine pulse (Chen Xi).
- Heart and Kidney Yang deficiency: asthenia, weakness of the loins
and knees, aversion to cold, polyuria, depression, pale tongue with
a thin whitish coating, deep fine pulse (Chen Xi).
- Yang leakage: reeling gait, nausea, vomiting, pale uncoated
tongue, deep fine pulse (Chen Xi).
- Spleen and Stomach Qi deficiency: generalized weakness, weak
limbs, lack of appetite, pale tongue with whitish coating, retarded
pulse (Huan). (3)

Heat stroke: caused by:

- Toxic heat that affects Heart and chest (Upper Burner).
- Intense work in excessively hot and humid weather.
- Dehydration.
- Poor ambient ventilation.
Causes: weakness, muscle spasms, hypernea, restlessness,
instability, reddened mucus membranes, red tongue, fast
accelerated pulse.
Cold stroke: due to
-

Sudden drop in ambient temperature.

Perverse Cold Wind attack.
Causes: nasal discharge, trembling, fever, cough, pale tongue,
slow pulse. (4)

The acupoint which is best known for its shock inhibiting action is GV 26 (Renzhong), the
point that connects the Governor Vessel (Du Mai, Sea of Yang) to the Conception Vessel
(Ren Mai, Sea of Yin), and specifically creates a connection with CV 24 (Chengjang) and
with the Yang Ming energy level which manages acquired energy.
Acupoint GV 26 (Renzhong) has sympathomimetic effects and can be used to treat
respiratory and cardiac depressions.
It is located at the center of the nasal filter, while the external and internal branch of the
infraorbital nerve and the maxillary nerve originate from its base. (5)
A special technique is used in needling this point: after insertion, the needle is rotated
back and forth while being raised and lowered, thus achieving energetic stimulation for
around 30 to 60 seconds. The needle is then removed, and after a pause of a few
minutes, is reinserted for another energetic stimulation, repeating the operation until the
depression is resolved.
During these operations, however, other maneuvers are carried out on the acupoints
indicated below.
At times, the point will bleed, an event which is to be considered as indicating that the Du
Mai meridian has been unblocked and drained.
Traditionally, GV 26 (Renzhong) is located at the meeting point of the Stomach and Large
Intestine channels, and its functions are to revive consciousness, calm Shen, clarify the
brain, clarify Heat, dispel Wind and gleires, and treat Yang collapse. (6)

This point is mentioned by Ge Hong (circa 265 420 AD) in his Zhou Hou Bei Ji Fang
(Prescriptions Behind the Elbow for Emergencies).

This work lists 109 acupuncture and moxibustion prescriptions for emergencies, 99 of
which can be implemented using moxa alone: it would appear that Ge Hong was the first
physician to introduce moxibustion in first aid.

The other essential acupoints mentioned in this text that can be used for emergencies
include:
CV 1 (Huiyin), CV 3 (Zhongjin), CV 4 (Guanyuan), CV 6 (Qihai), CV 8 (Shenque), CV 14
(Juque), GV 14 (Dazhui), GV 20 (Baihui), LR 1 (Dadun), HT 7 (Shenmen), ST 36
(Zusanli), SP 6 (Sanyinjiao), KI 1 (Yongquan). (7)
In reality, before using GV 26 (Renzhong), it is advisable to stimulate the specular
acupoint at the tip of the tail called Wei Jian: this produces a clear movement of energy
towards the head, and reactivates Qi circulation along the Du Mai; microbleeding at this
acupoint is also often used to unblock the meridian.
Only afterwards should the practitioner proceed with manual stimulation of Yu Tang, a
bilateral acupoint located at 0.5 cun lateral to the midline of the third ridge of the hard
palate, and of Tong Guan, bilateral, on the ventral surface of the tongue, between the
lingual frenum and sublingual veins.
On the first point, intense finger pressure is applied with a rubbing movement, while the
second point is activated by pulling the tongue fairly energetically towards the outside of
the mouth. (8)
Some authors regard these acupoints as belonging to the Du Mai and classify them with
the codes GV 28 01 (Shunqi or Yu Tang) and GV 28 03 (Jinjin or Tong Guan). (9)
Once these maneuvers have been performed at the tail, palate and tongue, GV 26
(Renzhong) is needled.
Another effective point for resuscitation is Er Jian, located at the tip of the ear, to which
we can add Shen Men (at the center of the base of the triangle formed by the tip of the
ear) and the Sympathetic Nerve area (on the border of the antihelix).
Another important group of acupoints used in resuscitation is that of the Ting points, i.e.,
the points located at the ends of the phalanges that are all indicated for the same
purposes: they treat syncopes and revive Shen.
In particular, these points include: SI 1 (Shaoze, which dispels Heat and Wind Heat,
increases Jin Ye and has an antitoxic effect), HT 9 (Shaochong, specific for loss of
consciousness). (10)

Discussing these points, the Nan Jing states: The place of outlets directs the Ting
points; the Ting points treat fullness below the heart (11), and these points are typically
used in order to bring about an intense change in Yin / Yang energy polarity.

Other extra points outside the meridian lines can also be used for the extremities:
- Ba Xie: These are points located in the interdigital spaces of the front limbs.
Action: dispel Wind, clarify Heat, decontract the tendons.
- Ba Feng: These are points located in the interdigital spaces of the hind limbs.
Action: dispel Wind and the other pathogenic factors carried by the Wind.
Another specific point is HT 7 (Shenmen): not only does its name which means Spirit
Gate clearly indicate its function, but it is traditionally said to calm and revive Shen in
harmonization, refresh the Heart, calm Heart Qi and treat tachycardia, regulate the blood
and treat psycho-behavioral disorders.
The other category of points that can be used in rapidly arising pathologies is that of the
Xi points, whose name means cleft or fissure, because they are located in the deep
cavities between the bones and tendons, where Qi and Xue accumulate. (12)
In clinical practice, they are used for diagnostic purposes, as they can develop nodes or
thickening when the channel to which they belong is involved, and to treat acute
conditions (Xi points of the Yang meridians) and hemorrhages (Xi points of the Yin
meridians). (13)
A point with documented efficacy in stopping hemorrhages is PC 4 (Ximen), which
refreshes Xue and Heat in the Upper Burner, and frees the diaphragm.
The second generation Qi Mai (curious meridians) have specific Xi points, including: BL 59
(Fuyang) for Yang Qiao Mai, KI 8 (Jiaoxin) for Yin Qiao Mai, GB 35 (Yangjiao) for Yang
Wei Mai, and KI 9 (Zhubin) for Yin Wei Mai. (14)
A classic technique is the Four Gates method: bilaterally needling points LI 4 (Hegu) and
LR 3 (Taichong) calms hyperactivity of Liver Yang and internal Wind. (15)
Finally, in all acute disorders that entail an immediate accumulation of Tan, i.e., Phlegm,
or Dampness Catarrh that can occlude and clog the Heart, it is essential to use ST 40
(Fenglong), which calms Shen, transforms Heart gleires and tranquilizes the Heart, dispels
Wind and Wind Dampness, blocks dyspnea caused by fullness, and regenerates liquids.
(16)

The other fundamental acupoint in first aid, especially when the patient is in lifethreatening or critical condition, is GV 20 (Baihui): uniting all the meridians, it calls energy
back to the sincipit, helping the consciousness to be regained or to pass to Heaven.

As Huangfu Mi maintains: The intention is to harmonize: this is all the art of

Acupuncture! (17)

References
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Agricultural Press; Beijing 1995; 43,44,46,249.
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S.C.I.V.A.C. National Congress; Rimini 2004; 226 - 227.
17)Huangfu Mi: Zhenjiu Jiayi Jing; Guy Trdaniel Editeur; Paris 2004; 384.

F. Longo: Notes on First Aid in Traditional Chinese Medicine, in

Proceedings of the 56th S.C.I.V.A.C. National Concress; June 1/3, 2007
(pp. 227 - 229) Rimini.