Acute Disorders

Kiran Phalke
Acute disorders
And treatments
Chest Pain

Abdominal Pain

Urinary
Retention

diarrhea constipation
 What is meant by acute?
• Sudden onset and lasts for sometime and then
may stop
• It can be very painful like kidney stones pain or
some colicky pain (experiencing or denoting severe pain
in the abdomen (colic) due to wind or intestinal obstruction)
• The reason cannot be quickly found out.
• Generally these are stomach pain or headache or
pain of trigeminal neuralgia.
• Pain of gall bladder stone.
 The Wind

• Wind is said to be the spearhead as it

promotes the opening of the pores and
the penetration of other “Evil” climates
such as Heat, Cold, and Humidity.
 What is exterior?
• Exterior refers to a disease on the defensive
exterior: skin, body hair, flesh. It involves a
battle between defense qi and an evil: wind,
cold, dampness, dryness, fire, or summer
heat. It can also be a battle with some kind of
epidemic qi. The disease is shallow and light
while on the exterior
Mechanism of acute exterior problems
• In exterior disease, the qi of the outside enters
the body through the skin, pores, mouth,
nose, etc. The patient feels feverish because
of the battle between the evil and defense qi.
He feels aversion to wind or cold because
defense qi is having a hard time guarding the
surface of the body.
 Modern explanation of acute pain
• Acute pain, for the most part, results from
disease, inflammation, or injury to tissues.
• This type of pain generally comes
on suddenly, for example, after trauma or
surgery, and may be accompanied by anxiety
or emotional distress. The cause of acute pain
can usually be diagnosed and treated.
However it takes time.
What does TCA think about acute pain
• Most important two things are Qi and blood.
• These must flow always in the meridians.
• If Qi and blood stop flowing then there will be
stagnation, pain,
• swelling and inflammation.
• This is a normal body reaction and not a
disease. However this must be resolved
quickly.
• How?
 QI AND BLOOD
• The Qi and blood keeps our body working
efficiently and gives us a feeling of well being.
• Let us see what can be done about this.
• We must have knowledge about 1) the
quantity or quality of Qi flowing in different
meridians of the body. The qi and blood are
not equal in all the meridians.
• 2) Xicleft points
• 3) ZiTong points
 Amount of Qi and Blood in channels
Channels Balance of Qi and blood

LU and SP More Qi Less blood

HT and KID More Qi Less blood
GB and TW More Qi Less blood
LI and ST More Qi More blood
UB and SI Less Qi More blood
LIV and PC Less Qi More blood
 Qi functions
• Warming

• Protecting

• Transporting

• Transforming

• Holding

• Raising
 Qi pathologies
• Qi sinking
• Prolapse

• Qi deficient
• Difficult breathing

• Qi stagnant
• Pain

• Qi rebellious
• Vomiting
 Directions of Qi of organs
• Lung Qi :Descends and disperses
• Heart Qi :Descends and partly goes up
• Spleen Qi :Goes upwards
• Stomach Qi :Goes downwards
• Large intestine Qi : Goes downwards
• Liver Qi :Goes in all direction but mainly
upwards
• Kidney Qi :Downwards & partly upwards
 Pain due to Qi stagnation
• The pain caused by qi stagnation can be
identified as:
• Dull or aching in nature
• Mobile, moving from place to place within the
body
• Relieved by heat, pressure or movement
 Shock can kill

• Shock suspends Qi and it affects heart yin

and spleen Qi and most of the time it will
cause headache.

• This is according to five elements law

 Stagnant Qi

• Stagnant Qi always tries to burst out from its place

and go somewhere as rebellious Qi
• stagnant qi tries to escape as rebellious qi, coughing
or nausea, with loss of appetite.
• Alternatively, stagnant qi starts to spread into other
areas, causing digestive disturbances such as
burning, or bowel pain with constipation or
diarrhea, or the urge to urinate
 Pain due to blood stagnation

• Acute pain due to blood stagnation differs from

acute pain due to qi stagnation in several ways.
• It is: Sharp, stabbing or throbbing in nature
• Fixed in one part of the body
• Aggravated by heat, pressure or movement.
• Troubles more in night when the blood returns to
liver.
• Must do blood letting.
 How can we treat acute pain
• Acupuncture is an effective way to move qi
and blood, dispersing stagnation and relieving
pain.
• There are special points which have properties
of moving Qi and moving blood or both.
• So let us see the properties of such points
 The points and their properties
• Hegu LI 4 Yuan : is able to regulate defensive
qi* and hence adjust the pores. (*Qi runs in
COULI)
• Hegu LI4 is a primary point to expel windcold
or windheat and to release the exterior.
• Zhizheng SI7 Luo It is able to release the
exterior. It is primarily used in cases of exterior
heat pathogen giving rise to febrile disease,
and is especially indicated when the onset is
characterized by neck and lumbar pain.
• Zhizheng SI7 5 cun above SI5
 Expels pathogens
• Feiyang BL58 Luo, a distal point of the foot
Taiyang channel, is able to expel pathogens
from the channel, release the exterior and
clears the upper portion of the channel. BL58
Feiyang 7 cun above BL60 on the posterior
border of the fibula about 1 cun lateral and
inferior to BL57
 Release the exterior
• LU7 Luo is indicated for chills and fever and nasal
congestion and discharge,
• LU7 Lieque 1.5 cun above the transverse crease of
the wrist, superior to the styloid process of the
radius
 Acute breast swelling
• Liangqiu ST34 acute disorders of the breast as
swelling, pain and abscess.
• acute epigastric pain
• ST34 Liangqiu 2 cun above
• the superior lateral border
• of the patella
• This is a Xi cleft point.
• Now we will see Xi cleft
• theory
 Accumulation (Xicleft) points
• These points are considered gaps or clefts (Xi)
where the Qi of the channels converges and
accumulates and goes deep inside.
• There are sixteen accumulation points: twelve
on the regular channels and four on the extra
channels
 Xi Cleft points

They are effective in acute disorders occurring

in the areas supplied by their respective
channels and those occurring in their
respective related organs.
For example, the points St34 and Lu б are
effective in epigastric pain and haemoptysis
(Haemoptysis is the coughing of blood)
respectively
• The xicleft points are diagnostic.
• They manifest acute disorders
• valuable in diagnosis.
• They diagnose disorders caused by irregularities
of qi and blood of certain zang or fu.
• For E.g. In stomach spasm and acute mastitis,
Liangqiu (ST34) will be tender when pressed.
• Hence, tenderness on Liangqiu (ST34) assist in
the diagnosis of stomach disorders.
• Tender sensation at Kuongzhui (LU6) when it is
pressed assist in the diagnosis of pneumonia
and hemorrhoid. Tender Waiqiu (GB36), the
xicleft point of gall bladder channel, assists the
diagnosis of gall bladder duct infection. Wenliu
(LI6), xicleft point of the large intestine, if
tender when pressed, often reflects digestive
tract perforation.
LU6 Kongzui - 7 cun above the
transverse crease of the wrist.
LI6 Pianli - 3 cun above the transverse
crease of the wrist (LI5) on the radial
side of the forearm.
GB36 Waiqui - 7 cun above the tip of
the lateral malleous on the anterior
border of the fibula.
•Most important
quality of XI cleft
points of Yin
meridians is they treat
blood disorders
• Xi Cleft points also act as a diagnostic
reflex point for their pertaining meridian
• They are palpated for sensitivity/flaccidity
to determine excess/deficiency of the
associated meridian
• They are observed for abnormal
coloration to determine if there is Heat
(red) or Cold (blue)
• Xi Cleft points are used in emergency
situations for severe leakage of
qi/blood/body fluids sweating, coughing,
bleeding, diarrhea, etc.
• 2) Indications
• Lu6
• Severe coughing
• Nausea/vomiting
• Coughing up blood
• Nose bleed
• Internal bleeding in the top part of the body
• LI7
• Pain in the mouth
• Tooth ache
• Bleeding gums
• Sore throat
• Pain of the tongue
• Pain when chewing
• St34
• Epigastric pain
• Swelling of the breasts

• Sp8
Acute menstrual pain , Dysentery,
Nocturnal emissions and
spontaneous seminal loss
especially Harmonizes
Qi and Blood
• Ht6
• Night sweats, Hot flashes , Chest pain
• Promotes diaphoresis (sweating, especially to an unusual degree as
a symptom of disease or a side effect of a drug.)
• Sweat is the fluid of the Heart due to its relationship with Blood

• SI6
• Pain in the shoulders & neck
• Tonify for longevity
• Bl63
• Acute lower back pain
• Seizures/epilepsy

Ki5
Painful urination
Menstrual pain
Lung Bi-obstruction
Pain of Kidney Stone
• Bl-59:-
• (Xi Cleft point of
• Yangchiao Mai)
• Pain of the lower limbs
• Blindness in one eye
• Eye pain

• Kid-8
• (Xi-Cleft point of
• Yinchiao Mai)
• Uterine and testicular pain
• GB35 (XiCleft point of Yangwei Mai)
• Chest/rib pain radiating
• towards the back
• Lower back pain
• Ki9 (XiCleft point of
• Yinwei Mai)
• Urogenital pain due to
• masses (e.g., kidney stones),
• Shan Pain
• Aids in detoxification
• Moves stagnation
• during
• the detoxification process
• (like constipation)
• P4
• Chest/heart pain
• Vomiting/blood while coughing
• More calming than Ht6

• SJ7
• Acute pain
• in the upper limbs
• Sudden deafness
• GB36
• Acute pain along flanks
• Neck pain
• Sciatica
• Liv6
• Pain related to hernias
• Retention of placenta
• Genital pain
• Kidney stones
• VI) ZhiTong Points
• Points which by themselves have the ability to
relieve pain
• LI11 or LI12
• For stiff (trigger) fingers
• Needle superficially
• Circular dispersal
• Snap muscles
• in that area
• Find where you can get the most “snap”
• St4 and St6
• Analgesic points for the face
• St26
• Relieves pain along the ST6
• trajectory of the
• Stomach meridian
• St31 St37
• All analgesic points
• St37 treats LI pain
• St26 also treats LI pain;
• it is a local point
• St41 and 42
• Analgesic points
• (St42 slightly less)
• Sp6
• Pain along the trajectory
• of the Spleen meridian
• Sp12 and Sp13
• Analgesic points
• Blood letting
• (for tailor position)
• Ht8 and Ht1
• Analgesic for pain
• along the Heart meridian
• (Ht1 slightly less so)
 What did we learn?
• 1) Locate the problem area and understand which
meridian is responsible
• 2) Release the exterior
• 3) Do blood letting ( Acubekam or Hijama
therapy)
• 4) Use specific point manipulation
• 5) Use needling on Xi cleft or bleed it
• 6) Use dual points which interact
• 7) Keep the patient in correct position
 Acute disorders practical examples at
my clinic
• 1) Epilepsy or Vasovagal syncope : K1 and or
DU26.
• Du26 yin and yang separates K1 is the most yin
point which can treat brain.
• 2) Headache : Bleed corresponding distal points
like GB44,SJ1,BL67,ST45. Distal treats proximal
diseases
• 3) Vertigo : Empirical point SI6
• Ask the patient to do

• 4) Urine obstruction : SP6 or ST36 needle moxa

• 5) Chest pain :Almost any type P6
• 6) Heart attack : Bleed Ht9 ( Then call
ambulance)
• 7) Acute asthma : Kid3 or P6
• Kidney holds lung Qi If not then rebellious so
Dyspnea
• 8) Acute abdominal pain: Strong manipulation
ST36 (distal point)
• 9) Acute Appendicitis : Painful area near ST37.
This moves the appendix & releases the
contents.
• 10) High fever :
Bleed Ear apex
BL40 and Bleed P9
• 11)Acute lumbar pain :
DU26,LU5,SI3, Yaotongxue
• 12) Vomiting & Nausea :
P6 (Distal point)
• 13)Acute diarrhea :
Moxa on REN8, SP1 or ST25
• 14) High and low blood pressure :
Liv3 and groove of posterior ear and LOW BP point
in the auricle
• 15) Acute pulse rate problems very low or high: P7
 Low and high BP points

Low BP point
• Shaoshang LU11 has a particularly strong
action on the opposite end of the channel
and may be needled or pricked to bleed in all
acute disorders of the throat and surrounding
tissues due to excess heat and fire poison.

• The fire poison is a condition that manifests

as reddish color rashes, boils and abscesses
• (The condition tends to develop very rapidly with
severe localized pain, redness and swelling, often
accompanied by fever. )
16) Acute trigeminal neuralgia:
Bleed GB1 or SUN x point.
17)) Whooping cough :
(finger walking in between metacarpals), LU6
18) Acute cold:
Acupressure GB20 (Fengqi) as it is a Feng (wind)
point which can bring cold with it in cold season.
19) Toothache:
Strong acupressure medial ear lobe.
20) Acute calf muscles contraction :
Ear reflex point.
 Some more acute problems
21) Acute Stroke :
Bleed jing well points.
22)Acute shivering, throat pain and fever
sensation:
DU14,LI11,LI4
23)Mouth ulcers:
Bleed SI1 remove 25 drops of blood
24)Acute heart area emptiness:
Bleed DU20 Immediate relief
 Works for sure
• Shaoshang LU11 for acute sore throat, throat
painful obstruction and mumps.
 Works for sure

• Wenliu LI 7 is indicated in the treatment of

acute disorders and pain affecting the Large
Intestine channel, and can clear heat and
detoxify poison in cases of clove sores,
carbuncle and furuncle, throat painful
obstruction, and heat and swelling of the face
Burning sensation due herpes zoster
anywhere
For most types of acute throat pain:
first needle
Baihui DU20 then Taichong LIV3,
Zhaohai KID6
and Sanyinjiao SP6
 XiCleft Points
Lung & Large Intestine
XiCleft Points
Stomach & Spleen
 XiCleft Points
Heart & Small Intestine
 XiCleft Points
Urinary Bladder & Kidney
 XiCleft Points
Pericardium & Triple Warmer
 XiCleft Points
Urinary Bladder & Kidney