a comparison between TCM and Dr. Tan's Balance Method.pdf

Traditional Chinese Medicine (TCM) and Dr. Richard Tan’s Balance Method A comparison of theory and clinical application by Yan Lu, LAc An OCOM Doctoral Program Capstone Project 2007

This thesis is dedicated to my loving wife Qiong Li without whose love and understanding this would not have been possible. Her love and support and delicious cooking are invaluable. I would also like to thank the Oregon College of Oriental Medicine for the outstanding opportunity to continue my knowledge and deeper understanding of Chinese medicine. Particular thanks go to Eric Stephens, DAOM, L.Ac. for mentoring me during this project. Special recognition also goes to Beth Burch, ND, ZhaoXue Lu, PhD, L.Ac. for their help and support. Thanks to Zina Hurley, L.Ac. for helping me to understand the Balance method. Thanks to all others named and unnamed without whose help this would not have happened.

This thesis is dedicated to my loving wife Qiong Li without whose love and understanding this would not have been possible. Her love and support and delicious cooking are invaluable. I would also like to thank the Oregon College of Oriental Medicine for the outstanding opportunity to continue my knowledge and deeper understanding of Chinese medicine. Particular thanks go to Eric Stephens, DAOM, L.Ac. for mentoring me during this project. Special recognition also goes to Beth Burch, ND, ZhaoXue Lu, PhD, L.Ac. for their help and support. Thanks to Zina Hurley, L.Ac. for helping me to understand the Balance method. Thanks to all others named and unnamed without whose help this would not have happened.

Traditional Chinese Medicine (TCM) and Dr. Richard Tan’s Balance Method A comparison of theory and clinical application by Yan Lu, LAc An OCOM Doctoral Program Capstone Project 2007 Introduction

This project will seek to compare and contrast traditional acupuncture and Tan’s acupuncture approaches to clinical acupuncture practice by using literature review. As traditional acupuncture becomes more popular and more widely accepted in the West, there arise many styles of clinical acupuncture practice. Each of them claim that its’ style has amazing clinical results with patients. Tan’s style acupuncture is one of them. Dr. Tan teaches his style of acupuncture in the United States at many traditional Chinese medicine (TCM) schools. There are many acupuncturists that practice his style of acupuncture throughout the United States. The Oregon College of Oriental Medicine has taught his style of acupuncture for several years. This project will seek to compare and contrast traditional acupuncture and Tan’s acupuncture from a theoretical and clinical point of view. This will be achieved through examination examination of Dr. Tan’s books, interviews, as well as this author’s training and experience in TCM. It will focus on summarizing the essential similarities and differences between traditional acupuncture and Dr. Tan’s Balance Method, incorporating a comprehensive literature review, as well as clinician interviews. This project will discuss both clinical and theoretical similarities and differences. Since Tan’s acupuncture acupuncture derives from traditional acupuncture, it is assumed that many similarities in approach will be found. However, differences are also obvious. Traditional acupuncture is the root of different styles of acupuncture, it is taught in TCM schools around the world, and most acupuncturists practice it, however, Tan style acupuncture is becoming more and more popular in the United Stated. Fewer needles are used and patients can be treated in sitting position. Tan style acupuncture can be considered highly efficacious and efficient in treating patients from patient reports,

despite lack of scientific research to confirm these conclusions. By focusing on two popular, but quite different styles of acupuncture, this study will attempt to understand the differences and similarities that these styles offer. TCM Theory

Traditional Chinese Medicine, here after referred to as TCM, is based on theory developed over the last two millennia. These theories include Yin-Yang theory, Eight Principle theory, Zang-Fu theory and Five Element theory. The Five Element theory is a complicated system of acupuncture pertaining to the natural world. While it is a part of TCM theory, its clinical application is separate and distinct from TCM treatment. Therefore, this style of acupuncture will not be discussed in this paper. These other theories are discussed more fully below. TCM acupuncture treatment of disease is based on the Zang-Fu organ theory and meridian theory. Within TCM, there are many Microsystems of acupuncture, including but not limited to scalp acupuncture, ear acupuncture, nose acupuncture, eye acupuncture, hand acupuncture, etc…. these Microsystems can be used as adjunctive therapy. Before treatment can begin, however, a diagnosis must be determined. Diagnosis is made by what is commonly referred to as the four methods: inspection, auscultation, olfaction, and palpation. This results in a syndrome differentiation (this includes the yin-yang theory and eight principle theory also). TCM medicine is considered to be an empirical medicine. First there is Yin-Yang theory. Written between 300 and 100 BC, chapter 5 in the book Plain Questions, also called The Su Wen states, “Yin and yang are the laws of heaven and earth, the great framework of everything, the parents of change, the root and beginning of 1 life and death…” Yin and yang represent the basic duality of the universe, which is ultimately unified. One cannot exist without the other. Distinguishing between the yin and yang qualities of person’s constitutional make up or the qualities of one’s illness is important to diagnosis and is also used to determine treatment principles. Yin and yang also complement each other. Yin is considered to be female in nature, while yang is considered to be male in nature. In treatment, for example, yin includes the front of the body, the internal organs, the blood, and the lower part of the body. Yang includes the back of the body, the exterior, the qi, and the upper part of the body. When the yin and yang are not balanced excess or deficiency will appear, resulting in illness. When yin and yang are balanced, the body is at ease. A more detailed application of Yin-Yang theory is Eight Principle theory. The eight principles include: yin-yang (overall quality of illness), exterior-interior (the depth of illness), excess-deficiency (strength of illness), and hot-cold (the nature of illness). When differentiating syndromes using eight principles, these eight categories are used to analyze pathology as well as determine treatment principles. Qi and blood are the most basic substances within the body providing healthy life. Qi though considered a somewhat untranslatable Chinese medical word, is generally considered to be healthy moving energy. Hence, as stated in the Nan Jing or Classic of Difficulties written around the second century A.D., “Qi is the root of the human body;

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the stem and leaves would dry up without a root.” Likewise, blood is a substance that is greater than just the red fluid that circulates throughout the body, it functions to provide nd nutrition for the body. This is clearly defined in the 22 Problem of the Nan Jing which 3 states, “Blood dominates nourishment and moisture.” As two of the most basic and vital substances in the body, qi and blood are intimately related. It is commonly said that qi is the commander of blood, and blood is the mother of qi, and in this way these two substances greatly complement one another. th

Formed about the time of the Yin and Zhou Dynasties (16 century-221 B.C.), the five elements, namely wood, fire, earth, metal and water, are considered to be the five patterns within all phenomena including the human body, and are derived from observations of the natural world. As said in A Collections of Ancient Works, “Food relies on water and fire. Production relies on metal and wood. Earth gives birth to everything. They are 4 used by the people.” There is also Zang-Fu theory. Zang-Fu is a general term for the internal organs of the body. This theory is commonly used to treat internal organ dysfunction. There are five Zang organs and six Fu organs. The five Zang organs are heart, lung, liver, kidney and spleen (pericardium is considered as affiliation to the heart, not as separated organ). The six Fu organs are gall bladder, stomach, small intestines, large intestine, bladder and triple burner. The eleventh chapter of The Su Wen states, “The so-called five Zang organs store pure essential qi without draining it off, and for this reason they can be filled but not over-filled. The six Fu organs transmit water and food without storing them, and for this 5 reason they may be over supplied but cannot be filled up.” The main functions of Zang organs are therefore to manufacture and store essential substances (qi, blood and body fluid), while the Fu organs receive and digest food and dispel wastes. Zang-Fu theory is used to diagnose and treat internal diseases. Additionally there is the meridian theory. The meridians or channels are superficial flows of energy connecting with internal Zang-Fu organs. This theory is used clinically in the treatment of musculoskeletal conditions and pain. The acupuncture points are specific sites on those affected channels. There are twelve main channels and eight extra meridians. The twelve main meridians include: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Burner, Gall Bladder and Liver. The extra meridians are: Conception channel, the Governing channel, the Belt channel, the Penetrating channel, the Yang Heel channel, the Yin Heel channel, the Yang Linking channel, and the Yin Linking channel. Using these theories, a diagnosis can be made. For example, pain along a certain meridian, will dictate the need to use the meridian theory for treatment. Diseases of internal organs require the need to use Zang-Fu theory. In practice, Yin-Yang theory is incorporated into the Meridian and Zang-Fu theories. Examination of the meridians and acupoints are very important to determine appropriate treatment. This involves both observation and palpation. Changes of skin color, bruising, blistering, etc can be observed easily. Temperature changes in the skin as well as tenderness can be palpitated. Lumps, bumps and nodules, etc can be felt along the meridians. For example, a raised red

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lump on Liv14 indicates disharmony in the liver. Palpation also includes feeling both radial pulses. Subtle changes within each pulse position are determined and used for both diagnostic and treatment purposes. Dr. Tan’s balance method also uses palpation techniques. Meridian syndrome differentiation is used in order to determine which meridian is best used to create a positive outcome from treatment. It is essential to locate the area of illness and then, based on the pathway of meridians, determine treatment. Meridians are identified and treated according to symptoms presenting. For example, pain along the Large Intestine channel of the arm is treated according to meridian theory. Another example, small red itchy bumps on the Small Intestine channel on the back is meridian theory based. Disharmony of Zang-Fu organs can be treated with the organ’s corresponding meridian. For example, heart pain can be treated with Heart channel. Urinary problems can be treated with the Bladder channel, etc. Acupuncture treatment principles are based on either the location of the disease or the nature of the disease. (See previous discussion of syndrome differentiation of syndromes for location of disease.) Treating the nature of the disease is to regulate yin and yang, tonifying the healthy qi and expelling the pathogen. Regulating yin and yang indicates reducing excess and tonifying deficiency to restore yin and yang balance. For example, a febrile condition indicates a preponderance of yang, therefore, treatment focuses on subduing the yang and nourishing the yin. A cold condition would likewise indicate preponderance of yin and deficiency of yang. Treatment here would focus on warming the yang and dispelling the yin cold. A pathogen cannot enter the body and disturb the health if the patients’ constitutional qi is strong. Therefore, with any illness strengthening the vital qi is essential. Dispelling the pathogen is equally vital to the treatment. Methods of Selecting Acupuncture Points for TCM Treatment

The primary principles for selecting acupoints are to select along the meridians and according to the pathology. Within TCM, there are many styles of acupuncture, so point-selection can be varied and diverse. Some criteria for point selection are included below. Diagnosis is primary and will naturally lead to point selection. For example, musculoskeletal condition will benefit from meridian theory treatment. Local and distal points will be chosen according to the meridians affected. Diseases of internal organs will be treated according to Zang-Fu theory and appropriate points accordingly. 1. Selection of points in the front and back of the body: this method is called “paired-needling” in Chapter 7 of Spiritual Pivot . In clinic, find the tenderness in the chest or the abdomen area, then find the point on the back directly opposite the tender point, needle these two points obliquely. This method is mainly used to treat diseases in the chest or abdomen area. While it is similar, but not limited to the selection of back-shu and front-mu points, other channel points can also be used. For example, when treating stomachache, St21 can be selected in the front and BL50 (level with BL21) can be selected in the back. 2. Selection of points in the upper and the lower: the upper indicates the upper limbs and the area above the waist, while the lower indicates the lower limbs and the

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area below the waist. In chapter 9 of Spiritual Pivot ( Axis), it states, “When the disease is on the upper part, the acupoints down below can be picked, when the disease is on the lower part, the acupoints on the upper part can be picked, when the disease in the head, acupoints in the foot can be picked, when the disease in the waist, acupoints in the popliteal fossa can be picked”. This method is most widely applied in the clinic. For example, for stomachache, Pc6 and St36 can be selected; for pain in throat or in the teeth, LI4 and St44 can be selected; for prolapse of uterus or anus, GV20 can be selected; for headache or stiff neck, BL60 can be selected. These examples are the clinical application suggested by The Yellow Emperor’s Canon of Internal Medicine . 3. Selection of acupoints in the left and the right: This is based on the crossing–body character in meridians’ distribution. Opposing needling and contralateral needling in Yellow Emperor’s Canon of Internal Medicine is the clinical application of this method. It is mainly used in treating diseases in the face and head. For example, facial paralysis in the left, right LI4 can be selected. Because the meridians’ distribution is bilateral, when treating diseases of internal organs, points on the left and right are both selected to reinforce their effect. For example, stomach disease can be treated with BL21 and St36 on both left and right. In addition, there is also a method selecting the point on the healthy side to treat the disease on the ill side. For example, when treating paralysis and pain, this method can be used. 4. Selection acupoints internally and externally related: this method is based on the yin and yang, the internal-external relationship of Zang and Fu organs, and the meridians. For example, diseases in the yin meridians can be treated by the acupoints in the yang meridians, which are internally and externally related with the yin meridians, and vice versa. In chapter 28 of Spiritual Pivot it states, “When the cold energy enters the stomach, the chaotic energy of the Jue-syndrome diffuse, it runs from bottom to top and comes out from the stomach to cause eructation. When treating, apply invigorating therapy by pricking the acupoints of the Foot Taiyin channel of the Spleen and the Foot Yangming channel of Stomach.” In chapter 20 of Spiritual Pivot it states, “When the evil energy is in the kidney, pain in the bone, the yin-type bi-syndrome will occur. In the yin-type bi-syndrome, the painful location can hardly be pressed with the hand, the patient will have abdomen distension, lumbago, dyschesia, pain and stiffness in the shoulder, back and neck, and frequent dizziness. When treating, select Kid1 and BL60.” The above two examples are based on the internal and external relationship of Zang and Fu organs and meridians. This method can be applied in treating common diseases, but is not limited to yuan-source and luo-connecting points. 5. Selection of proximal acupoints: This is a method of selecting acupoints located on or near the area of the disease. This method can be divided into two types: selection of local points and selection of adjacent points. a. Selection of local points including ashi points (tender point) means to select acupoints located in the affected area. For example, the Taiyang acupoint is selected to treat temporal headache; St6 is selected to treat jaw pain, etc.

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b. Selection of adjacent points means to select acupoints located near the affected area. For example, BL7 is selected to treat nasosinusitis; and BL32 is selected to treat menstrual pain. 6. Selection of distal points is a method of selecting acupoints distal to the affected area. The acupoints selected in this condition are often located below the elbows and knees. This method for selecting acupoints is based on the pathways and interrelationships of channels and collaterals. For example, LI4 is selected to treat facial pain; Liv5 is selected to treat inguinal hernia pain; BL40 is selected to treat low back pain; Lu11 is selected to treat sore throat; Pc6 is selected to treat to treat nausea and vomiting; St36 is selected to treat digestive disorders. 7. General classification of Acupoints. Some of these classifications include a. The five shu points : The shu points, or antique points as they are sometimes called, are five acupoints located on each meridian generally below the knees and elbows. They are jing-well, ying-spring, shu-stream, jing-river and he-sea. Jing-well points are primarily used to treat fever. Ying-spring points are also used to treat febrile disease when the patients’ complexion is changing color. Shu-stream points treat joints pain and heaviness in the body. Jing-river points treat diseases affecting voice. Hesea points treat the corresponding internal organs. b. The yuan-source points: Each meridian has a yuan-source point generally located near the wrist or ankle. These points are said to contain yuan or source energy. c. The luo-connecing points : There are 15 luo-connecting points. These points connect the meridians internally and externally, so they treat symptoms of the two internally and externally related Zang-Fu paired channels. d. The xi-cleft points : or accumulating points are used to treat acute conditions. e. The back-shu points : they are points associated with their corresponding organs. These points are located near the spine. Generally these points are used to tonify their associated organ. f. The front-mu points : these points are located on the chest and abdomen. They are also used to treat internal organs. g. The eight confluent points: This is another classification of acupoints to treat certain specific conditions. For example GB34 treats muscles and tendons. h. Points with empirical function(s) . For example, GV14 clears heat and wind, GV20 can treat prolapse of internal organs. Methods of manipulating the needles

Manipulation refers to certain needling techniques used to achieve desired results. 1. Tonifying methods are used in cases of deficiency, including: a. heavy pressing of the needle to a deep region b. lifting the needle gently and slowly after the needle is inserted to a certain depth and the needle sensation appears

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c. rotating the needle gently and slowly with small amplitude when the needle is inserted to a certain depth d. inserting the needle slowly and withdraw it rapidly e. pressing the hole quickly to close on withdrawing of the needle f. the direction of the needle tip pointing, i.e. following the running course of the meridians g. Chapter 27 of Plain Questions states, “The reinforcing is achieved by inserting the needle when the patient breathes in and withdrawing the needle when the patient breathes out.” 2. Reducing methods are used in cases of excess: In The Classic of Medical th Problems , the 78 problem, it states, “Heavy pressing of the needle to a deep region is known as reinforcing, while forceful lifting of the needle to the superficial region is known as reducing.” Additional methods include: a. lifting the needle forcefully and rapidly while thrusting the needle gently and slowly b. rotating the needle rapidly with large amplitude c. inserting the needle rapidly and withdraw it slowly d. shake the needle to enlarge the hole on withdrawing of the needle e. the needle tip pointing downwards, i.e. against the channels course f. inserting the needle when the patient breathes out and withdraw the needle when the patient breathes in. Dr. Richard Tan’s Balance method Introduction The Balance Method consists of an acupuncture system based on balancing the meridians developed by Dr. Richard Teh-Fu Tan. Dr. Tan is from Taiwan and began his studies at seven years of age. Each summer he studied with three different masters. He worked in an emergency room of a busy hospital performing acupuncture. He later came to the United States and received an advanced education degree in engineering. He has been developing and presenting his theories in the United States since the early 1990’s. Dr. Tan has translated the classics into an understandable form with practical use. The balance system relies on two-step system: (1) identifying the affected meridian and (2) identifying the meridian to be treated to achieve health. It is a distal only system and de qi sensation is required when needling. Twisting and thrusting techniques are often used. Tonification and reducing techniques are not applicable. Needles are usually retained for forty-five to sixty minutes and re-stimulation of the needles must happen at least once during the treatment. Massage or Tuina may be performed before needling. Mirroring and imaging are used to choose acupoints on the chosen treatment meridian. The core of the balance method consists of five systems, however several more advanced systems have been developed. The root theory is the same as the theory in traditional Chinese medicine, but the clinical applications are quite different.

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Yin Yang and Bagua theory in the Balance Method Dr. Tan begins each seminar with Yin-Yang theory. In the beginning, there is Wu Ji – no limits in the universe. Then comes Tai Ji which indicates a boundary or limit. Therefore from one comes two.

Yin-yang has now developed into eight trigrams, also known as the Bagua:

Trigrams are read from the bottom line to the top line. The heaven Gua is balanced with the earth Gua with the 3 yang lines balanced with the 3 yin lines. So GV is balanced with CV. The lake Gua is balanced with mountain Gua: the 1st and the 2nd yang lines in the rd lake Gua are balanced with the 1st and the 2nd yin lines in the mountain, the 3 yin line rd in the lake Gua is balanced with the 3 yang line in the mountain Gua. So LU is balanced with Sp, LI is balanced with St. It is the same with other Guas. This explains the reason for the pairing in system one—balancing the body.

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Also important is the balance of the taiji symbol below.

☯ Noticing the Complete Balance As seen above, the taiji symbol balances yin and yang within itself. Yin is within yang, and yang is within yin, absolute yang becomes yin, absolute yin becomes yang. Complete balance is contained within the symbol (further discussion occurs later in the paper).

The Ba Gua are also balancing each other. As the emperor stands in the center of the Bagua looking outward, the lines of the Gua are read from the bottom to the top. Each trigram is balanced with another trigram. In the heaven trigram, for instance, three yang lines are balanced with the earth trigram which has three yin lines. Similarly lake is balanced with mountain, fire is balanced with water, thunder is balanced with wind.

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Mirror imaging Mirror imaging also helps in Balance Treatment point selection. After identifying the affected meridian, an appropriate distal meridian to needle is selected (more on how to select a meridian to follow). One mirrors the affected area onto a corresponding anatomical location on the chosen needled meridian. For example, knees correspond with elbows, ankles with wrists, feet with hands, hips with shoulders, etc. Imagery is a creative component in this system of acupuncture. The image is in the eye of the practitioner. For example, the hand can be treated for problems in the head. The foot may also be treated for problems in the head. The eyes of the knees might be needled to treat the actual eyes. The eyes might be treated for testicular pain. The nose can be needled for penile problems. Needling the middle finger can also treat penile pain. The image is clear, additionally, the hand Jueyin channel ends at the tip of the middle finger. Foot Jueyin channel circles the external genitalia. Needling around the mouth can treat problems with the anus and female genitalia. The side of the face can be needled to treat gluteal pain. The image here is cheek to cheek. Each limb can correspond with the trunk. The knee and elbow, the middle of each limb, corresponds with the middle of the trunk—the naval area. The sacrum can be treated by needling the foot or the hand, or by needling the sternum. Palpation for tenderness is helpful tool for deciding which image to use. Five basic systems The five core balance treatment systems show the connections between meridians and how to choose systematically which channel should be treated. Here is the pairing of affected meridians and the treatment meridians. 1. System 1 pairs channels according to the same Chinese meridian name. Hand channels balance foot channels, yin channels balance yin channels and yang channels balance yang channels. Namely, Hand Taiyang and Foot Taiyang balance each other. Hand Yangming and Foot Yangming balance each other, as do Hand Shaoyang and Foot Shaoyang meridians. Hand Taiyin balances with Foot Taiying, and Hand Shaoyin and Foot Shaoyin also balance each other. Hand and Foot Jueyin also balance each other. Furthermore, in this system, the Ren and Du channels balance each other. For example, a sprained ankle at right GB40 area is treated by needling left TB4. 2. System 2 consists of bie-jing or branching channels. In this system, hand channels are paired with foot channels and foot channels are paired with hand channels. This system pairs Taiyang with Taiyin, Shaoyang with Shaoyin, and Yangming with Jueyin. Hand Taiyang is paired with Foot Taiyin, Foot Taiyang with Hand Taiyin. Hand Shaoyang is paired with Foot Shaoyin, and Foot Shaoyang is paired with Hand Shaoyin. Hand Yangming is paired with Foot Jueyin, and Foot Yangming is paired with Hand Jueyin. For example, sprained ankle at Sp5 is treated by needling SI5 on either side. Needle the side that is more tender.

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In the above diagram, the words appear to be written opposite of what they should be. They demonstrate the intricate balance of this system. Refer to diagram on page 10. Start from the center guas and work outwards. Yang channels correspond with yang yao, yin channels correspond with yin yao. GB and SJ are yang channels, therefore, they form the first line of the gua, a yang line. Liv and Pc are yin channels, therefore they form the second line of the gua, a yin line. UB and SI are yang channels, therefore they form the third line of the gua, a yang line. These three lines form the fire gua. Kid and Ht are yin channels, therefore, the first line of the new gua is a yin line. St and LI are yang channels, therefore the second line of the gua is a yang line, Sp and Lu are yin channels, therefore the third line of the gua is a yin line. These lines form the water gua. Fire balances water. Every line in each gua balances with the corresponding line in the other gua. Keep the channel names plugged into each line of the two guas. Therefore, Taiyang is balanced with Taiyin, Jueyin balances Yangming, and Shaoyang balances Shaoyin. 3. System 3 consists of biao-li or exterior/interior pairs. This system pairs hand channels with hand channels based on corresponding Zang-Fu organ relationship. For example Small Intestine channel treats Heart channel, and Heart channel treats the Small Intestine channel. Yin channels treat yang channels, and yang channels treat yin channels. Hand Taiyin, Lung treats Hand Yangming, Large Intestine and vice versa. Leg Yangming, Stomach balances with Leg Taiyin, Spleen. Hand Shaoyin, Heart balances with Hand Taiyang, Small Intestine. Leg Taiyang, Urinary Bladder balances with Leg Shaoyin, Kidney. Hand Jueyin, Pericardium balances with Hand Shaoyang, Triple Burner. And Foot Shaoyang, Gall Bladder balances with Leg Jueyin, Liver. For example, wrist pain at left Ht7 is treated by needling right SI5. 4. System 4 consists of Chinese clock opposites. Important treatment information is contained within the Chinese clock. The clock links internally and externally paired channels-i.e. Lu and LI. the clock also links channels according to the same Chinese meridian names. For example, hand Yangming flows into foot yangming. Other clinical possibilities must also exist. Clock

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opposites are a treatment option. Yin balances the yang and hand channels balance foot channels. In this system, the Chinese clock is used to determine which meridians are selected. Identify the sick or affected meridian and using the Chinese clock, the channel to be needled will be opposite the clock from the sick meridian. Clock opposites are as follows:

In this system yin balance yang and yang balance yin channels, hand channels balance the foot channels and vice versa. For example, elbow pain at Ht3 is treated by needling GB34 on either side. Needle more tender side. 5. System 5 needles neighbors on the Chinese clock. The Chinese clock looks like this:

As previously stated in system 4, the Chinese clock has lots of clinical information to be used. Notice that many neighbors on the clock are already systematically paired. The lung and the Large Intestine are internally and externally paired. Large Intestine and

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Stomach comprise the Yangming paring. Stomach and Spleen are internally and externally paired. Spleen and Heart have not yet been paired. Might their relationship as neighbors on the clock be as clinically effective as the previously mentioned pairs? Yes. As there is overlap with other systems, in system 5, the focus is on these pairings: Spleen and Heart Kidney and Pericardium Lung and Liver

Hand channels are paired with foot channels, and foot channels are paired with hand channels. Yin channels are paired with yin channels and yang channels are paired with yang channels. For example, a sprained ankle at left Sp5 is treated by needling the right Ht7.

Clinical application of TCM versus Dr. Tan’s Balance Method in Pain treatment Headache

TCM In traditional Chinese medicine, headache has many different syndrome differentiations. For wind invasion, the points used to treat this type are divided into categories to treat headache according to its location. •

For occipital headache , use GB20, BL60, SI3.

•

For frontal headache, use St8, Yintang, GV23, LI4, St44

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For temporal headache , use Taiyang, GB8, TB5, GB41

•

For vertex headache , use GV20, SI3, BL67, Liv3.

These points are a mixture of local and distal points selected for use according to the location of the headache. In addition, it is notable that GB20 and SI3 are both empirical points to expel pathogenic wind. Similarly, BL60 and SI3 are points in the Foot and Hand Taiyang meridians. St8, Yintang and GV23 are local frontal headache points. LI4 and St44 are Hand and Foot Yangming points. LI4 also empirically dispels wind. For temporal headache, points on the Hand and Foot Shaoyang meridians are commonly used. TB5 also empirically dispels wind. For vertex headache, GV20 is local, SI3 opens the GV channel, and expel the wind, BL67 is jing-well point on the Foot Taiyang meridian. The vertex area belongs to Liver channel, therefore, Liv3, the source point of the Liver channel is selected. For headache due to liver yang rising, use the following points: • GB20, LIV2, LIV3, GB43, GV20, SP6 or KID3, GB5. Once again, these points are common local and distal points used to subdue liver yang. Liv2 is a ying spring point, therefore clearing heat. Liv3 is the source point. GB43 is also

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ying-spring point clearing heat. GB5 is a local point as is GB20 and GV20. Sp6 and Kid3 nourish the yin to anchor the yang. For qi and blood deficiency headache, treatment is aimed at building the qi and blood and bringing them to the head. •

GV20, St36, CV6, BL18, BL20 are needled.

GV20 brings the qi and blood to the headache, St36 and CV6 are used to tonify the qi. BL18 and BL20 are used to guild the blood. Balance Method Using the Balance Method to treat headache, location is the most important diagnostic tool employed. •

For frontal headache, considered to be a damp headache, Leg Yangming channel is used as it encompasses the face. Therefore, use Sp9 or St43. Sp9 is a he-sea point. He-sea points are used to dry dampness. St43 is the shu-stream point on the Foot Yangming channel; imagining that the foot is the head, St43 is in the location of the front of the head. If the location of the headache is specifically at GB13, treatment is different. Using system 1, which overlaps with system 5, treat pain in the foot Shao yang channel by needling TB 3. System 2 overlaps with system 4, needle Ht 8. System 3 overlaps with system 5, needle Liv 3.

•

For occipital headache , first determine which channels are affected, for Leg Shaoyang headache (GB20), point selection is based on palpation for the most tender points. Therefore, different points are possible. For example, using system one, Hand Shaoyang-TB4 is needled. Hand Shaoyin channel might be needled if using system 2, the bie-jing/branching channel or using the opposite clock-system 4. The point selected on this channel is Ht7. One other possible clinical approach might be using biao-li or exterior-interior pairs of system 3. In this system, the Foot Shaoyang channel is balanced with Foot Jueyin channel-Liver. The point selected on this channel using the mirror image is Liv4. If, however, the occipital headache is located on the Foot Taiyang meridian, the treatment is very different. Using system one, the Foot Taiyang channel is balanced with Hand Taiyang channel; SI 5 is needled. System 2 and system 4 overlap in this situation. The Foot Taiyang meridian is balanced with Hand Taiyin - Lung meridian; Lu9 is needled. Using system 3 the biao-li or exterior-interior pair, Foot Taiyang is balanced by Foot Shaoyin; Kid3 is therefore needled.

•

For temporal or Foot Shaoyang headache , meridian choices are already discussed under the heading of occipital headache. However, using the mirror image, point selection on each channel will be different, as temporal headache is more superior than that of the occipital headache. In system 1, Hand Shaoyang, TB3 is needled. In system 2 and 4, the Foot Shaoyang channel is balanced with Hand Shaoyin channel. Using the mirror image, Ht8 is needled. Finally, system 3 the interiorexterior relationship, Foot Shaoyang is balanced with Foot Jueyin—Liv3.

•

Vertex headache belongs to the Foot Jueyin channel. The internal channel of the Foot Jueyin ends at the vertex. Using system 1, Foot Jueyin is balanced with hand

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Jueyin; Pc8 or Pc9 is needled. System 2 branching channel, Foot Jueyin is balanced with Hand Yangming, therefore, LI1 or LI2 is needled. System 3, interior/exterior pair, Foot Shaoyang is balanced with Foot Jueyin; GB43 or GB44 is needled. In system 4 clock opposite, Hand Taiyang balances Foot Jueyin. SI 2 or SI 3 is needled. System 5, using clock neighbors, Hand Taiyin balances Foot Jueyin, therefore Lu10 or Lu11 is needled.

Neck Pain

TCM Neck pain has three different syndrome differentiations: wind-damp-cold invasion, qi and blood stagnation, and kidney deficiency. For pain in the back of the neck, a mixture of local and distal points will be used. •

Locally, BL10, BL11, GB20, GB21, GV14, SI11 and SI12 are needled. For windcold-damp invasion, add either TB5 or SI3 and Sp9.

•

For qi and blood stagnation, add LI4, Liv3, SI3, BL62. For kidney deficiency, add Kid3 or CV6.

•

For pain in the front or the side of the neck, needle St9, LI17, LI18, SI16 locally. The distal points remain the same as described above as per syndrome differentiation.

Balance Method For the balance method treatment, location of the pain remains essential. •

For Foot Taiyang neck pain, system 1 Hand Taiyang is needled; SI6A or SI5A is appropriate. System 2 and system 4 overlap each other. Therefore, Hand Taiyin channel is needled, Lu7. The master points are the obvious choice, and Lu8 or Lu9 may additionally be added as needed. System 3 interior-exterior pair, Foot Shaoyin channel, Kid3 to Kid7 is needled. System 5 in this case overlaps with system 1 and system 3.

•

For Foot Shaoyang neck pain, system1 Hand Shaoyang TB4 or TB5 is needled. System 2 branching channel overlaps with system 4. Therefore, Hand Shaoyin channel is needled; Ht4 to Ht7 might be chosen. Tenderness upon palpitation is the indicator in point selection. Sytem 3 internal-exterior pair Leg Jueyin channel is needled—Liv4, or possibly Sp6 is needled.

•

For pain in the Hand Yangming channel, using system 1, the Foot Yangming channel is needled—perhaps St41A. In system 2, branching channel Leg Jueyin is needled—possibly Liv4 or Sp6. For system 3 internal-external pairs, the Hand Taiyin channel is needled; once again we are focusing on the master point of the neck, Lu7. Lu8 or Lu9 may be needled as well. System 4, clock opposite, Leg Shaoyin channel is needled. Kid3 to Kid7 is a great choice. System 5 overlaps with systems 1 and 3.

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•

For pain in the Ren channel, needle the Du channel in the neck, and possibly add Lu7. It is interesting to note that using the Balance Method explains why Lu7 is the master point of the neck—its position on the wrist represents the image of the neck, and balances the channels just as described above.

Shoulder pain

TCM Shoulder pain has 3 different syndrome differentiations: qi and blood stagnation, windcold invasion, qi and blood deficiency. A mixture of local and distal points may be used. •

For pain in the front of the shoulder of the shoulder, the primary points to be needled are LI15, LI16, Lu1, Lu2 and Lu3. St38 is empirical point for shoulder pain.

•

For qi and blood stagnation, add LI4, Liv3.

•

For wind-cold invasion, add GB20 or TB5.

•

For qi and blood deficiency, add St36 and Sp6.

The points selected for each syndrome differentiation are applicable for each area of shoulder pain. •

For pain on the side of the shoulder, needle LI15, LI16, TW 14, LI14, TB13. St38 may also be needled.

•

For pain the back of the shoulder, needle SI9, SI10. SI11, SI12, SI13, SI14 and GB21are needled. Distally SI3 and St38 may be added.

Balance Method Again, as in all Balance Method treatments, location is the key to diagnosis and treatment. •

For Hand Taiyin shoulder pain and using system 1 treat the opposite Foot Taiyin channel, check for tender points from Sp6A to Sp7A. In system 2, branching channels, Foot Taiyang treats Hand Taiyin; this overlaps with system 5, clock opposites: palpate BL57 to BL58 area for the tender points and needle the Ashi. For system 3, internal –external pairs, Hand Yangming balances Hand Taiyin; check opposite side LI6 to LI7 for the tender points and needle. With system 5, neighbors on the clock, Foot Jueyin balances Hand Taiyin, palpate and needle tender point from Sp6A to Liv5.

•

For the treatment of Hand Yangming shoulder pain , system 1 is very interesting, as Foot Yangming balances Foot Yangming. This can explain why in TCM St38 is used frequently as an empirical point for shoulder pain. Needle all tender points in that area. Foot Jueyin balances Hand Yangming in system 2. Once again, palpate and needle tender points from Sp6A to Liv5. System 3, matching

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interior—exterior pairs, balances Hand Taiyin and Hand Yangming, check therefore the Lu6A area and needle the tender spots. In system 4, clock-opposite, Foot Shaoyin balances Hand Yangming; check Sp6 to Kid9 area. •

In the case of Hand Shaoyang shoulder pain , and using system 1, Foot Shaoyang balances Hand Shaoyang. Check GB36A to GB39A, palpate and needle the tender points. In branching channel, system 2, Hand Shaoyang is balanced with Foot Shaoyin; check Sp6 to Kid9 area and needle the tender spots. System 3 is interior-exterior paired channels; Hand Jueyin balances with Hand Shaoyang. Check Pc4 to Pc6 for tenderness. System 4 clock opposite; foot taiyin balances with hand shaoyang—palpate Sp6 to Sp6 for tender spots. System 5 overlaps with system 1 and system 3.

•

For Hand Taiyang shoulder pain , according to system 1, Foot Taiyang balances with Foot Taiyang; palpate BL57A to BL58A, possibly to BL59 and needle the tender spots. System 2 is branching channels, so Foot Taiyin balances with Hand Taiyang; palpate Sp6A to Sp7A. System 3, interior-exterior pairs, Hand Taiyang treats Hand Shaoyin; palpate Ht4A. In system 4 clock opposite (a big player), Foot Jueyin balances Hand Taiyang. Palpate Sp6A to Liv5 and needle all tender spots. System 5 overlaps with system 1 and system 3.

Back pain

TCM In general, GV and Bladder meridians are selected for treating back pain. Points include BL23, GV3 or GV4, BL40. There are three syndrome diagnoses for low back pain: damp-cold invasion, kidney deficiency, and traumatic injury. Each diagnosis has additional points. •

For damp-cold invasion, add BL25, BL26, and moxa BL23 and GV4.

•

For kidney deficiency, add BL52 and KID3. Moxibustion may be applicable as well if the kidney yang is deficient.

•

For traumatic injury, bleed BL40, needle GV26, Yaotongxue, and local Ashi points.

BL23 is the back shu point of the kidney, Kid3 is the yuan-source point on the kidney channel, and BL52 is the outer kidney point on the bladder channel—all three points reinforce the kidney. GV3 is the lumbar yang gate, GV4 is the life gate, so both of these points support the kidney as well. BL40 is known as the Ruler of the back (empirical point). Yaotongxue is an extra point on the hand that is also empirically used for low back pain. GV26 is a distal point used on the GV channel. Balance Method Mid and low back pain are approached similarly when treating with Dr. Tan’s balance method. Locating the meridians involved is of primary important. Obviously the Foot

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Taiyang channel traverses the entire back, and therefore is almost always involved. The Dai mai, Du channel, Gall Bladder channel and the internal branch of the Kidney channel can also be involved. •

Foot Taiyang meridian pain due to qi and blood stagnation: o

o

o

o

System 1 Hand Taiyang balances Foot Taiyang. Palpation is critical. SI3 or SI4 may be needled when using the image of the hand as the sacrum. Similarly the scapula can be used as the image of the sacrum. Therefore a tender point on the hand Taiyang channel on the upper back—SI9 to SI14—might be needled. If the tender point is at the wrist, it corresponds to BL23 area; palpate SI8, which is located at the middle of the arm. If the pain is at BL35 and BL36 area, SI18 might be needled using the image of cheek to cheek. System 2 branching meridian overlaps with system 4, the clock-opposite. Hand Taiyin balances the Foot Taiyang. If the pain is in the middle of the back—BL23 area—check Lu5 area. For lower gluteal pain at BL35 and BL36 area, using the mirror image, needle the opposite Lu1 or Lu2 area. It is an extremely simple and highly effective treatment. System 3 interior-exterior pairs Foot Shaoyin with Foot Taiyang. Abdominal palpation is critical. Several needles can be inserted on the channel where there is tenderness. For example, pain in BL 23 area might be effectively treated by needling Kid15 or Kid16 area, if that area is tender. Lower back pain might be treated by needling the upper end of the kidney channel—Kid26 or Kid27 Ashi. As kidney qi deficiency is usually a component of back pain, the yuan-source point of the kidney channel, Kid3, is frequently additionally needled. System 5 neighbors on the clock overlaps with system 1 and system 3.

•

For pain on the Du channel treat the tender spot on the Ren channel. Also Du points on the scalp can be effective.

•

Pain in the Foot Shaoyang channel can be located at either GB25 or GB30 area. o

o

o

Yan Lu, LAc

System 1 Hand Shaoyang balances with Foot Shaoyang. For pain at GB25, palpate TB10 or TB9 and one half, the points above and below the midpoint of the arm, the elbow. For pain in GB30, check TB14 or possibly the TB15 area. System 2 branching channels overlaps with system 4 clock-opposite. Hand Shaoyin balances Foot Shaoyang. For Pain in GB25, the midpoint of the back, check Ht3. For pain in GB30, check Ht8 area. System 3 interiorexterior pairs Foot Jueyin pain with Foot Shaoyang. For pain in GB25, check Tan’s Liv8 (located on the head of the tibia), or Liv13 (the midpoint on the abdomen). For GB30 pain area, check Liv3 (thinking of the foot as the sacrum), or Liv10 and Liv11 area. System 5 overlaps with system 1 and system 3.


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•

Pain in the Dai Mai channel : see treatment for Foot Shaoyang, Foot Taiyang, Du channel and Kidney channel. Possibly needle GB41 and TB5 to open up the Dai Mai.

•

Foot Shaoyin channel pain : the internal channel of the kidney runs through the low back, and therefore, it must be considered for treatment. o

o

o

o

o

System 1 Hand Shaoyin balances the Foot Shaoyin. For pain in the sacrum area, check Ht8. For pain in the wrist, check Ht3 area. For system 2 branching channels, Hand Shaoyang balances Foot Shaoyin channel. For sacrum pain, check TB3 or the extra-point on the TB channel called ZongBai. For pain in the waist, check TB9 and one half or the area around TB10. For system 3 the interior-exterior pairs, Foot Taiyang balances Foot Shaoyin. For pain at the waist, check BL40. For sacrum pain, check and needle the tender points on the foot. In System 4 the clock opposite, Hand Yangming balances Foot Shaoyin. This explains the extra points Lingu and Dabai, as well as LI4, work for the low back pain. In system 5 neighbors on the clock, Hand Jueyin balances Foot Shaoyin. Check Pc3 for mid-back pain Pc8 for sacrum area pain.

Both TCM and the Balance Method move qi and blood to relieve the pain. Although there are more differences clinically in treating low back pain, there are also several notable similarities. BL40 might be needled as might GV26 or other GV points on the head. Yaotongxue and Zongbai are in fact the same points. Treatment theory for low back pain is very different in TCM than in the Balance Method, however. In TCM, treatment is aimed at syndrome differentiation while the balance method treats channel pain. TCM includes local treatment and limited distal needling while the Balance Method has a variety of options for distal needling based the location of the pain and the systems used to treat it.

Hip pain

TCM Here, hip pain refers specifically to pain in the greater trochanter, or more superior-hip pain, and the channel most often affected is the Foot Shaoyang channel. There are three TCM syndrome differentiations: qi and blood stagnation, damp-cold invasion, and liver blood deficiency failing to nourish the tendons in this area. •

The points for qi and blood stagnation are GB29, GB31, GB40 and local Ashi points. GB29 is a local point, as well as GB31. GB40 is the source point on the Gall Bladder channel.

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•

For damp-cold invasion, needle GB29, the local point. GB31 might be used to dispel wind-cold. GB39 is the distal point to dispel cold in the Gall Bladder channel. GB41 may or may not be needled depending on the extent of the radiation of pain. It is the master of Dai Mai.

•

For liver blood deficiency, in addition to local points, Liv3 and GB34 are needled. Liv3 is the source point, GB34 is the influential point of tendons, and Sp6 is a great point for nourishing blood.

Balance Method For treatment of hip pain in GB meridian: •

System 1, Hand Shaoyang meridian is selected, TB14 to TB15 or TB4 and TB5 are palpated and needled.

•

System 2, Hand Shaoyin meridian is selected, Ht1A or Ht7 is needled.

•

System 3, Foot Jueyin meridian is selected, Liv4 area is needled.

•

System 4 overlaps with system 2.

•

System 5 overlaps with system 1.

Knee pain

TCM When treating knee pain, it is important to differentiate between kidney deficiency and a pain syndrome. Pain syndromes include cold-damp, bony-bi syndrome, and qi and blood stagnation due to injury or trauma. •

• •

•

For kidney deficiency, needle Kid3 and Kid10. Local tender points are also needled. Bony-bi syndrome can be treated with the same protocol as kidney deficiency. For cold and dampness, needle Sp9, St36, and GB34. These are he-sea points, which transform dampness. Local tender points are also needled. Moxibustion is applicable. Qi and blood stagnation can be treated with local tender points as well as LI 4 and Liv3.

Balance Method The mirror image for the knee is the elbow. As the knee is the midpoint of the leg, the midpoint of the trunk can effectively be the image used. Fortunately, there is also a useful trick employed: •

With the arm bent at 75 degrees, a needle can be threaded from LI11 to Ht3. Additional points can be needled. Using the five systems, find a sick channel or channels and needle the appropriate channel points in the elbow region or on the

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mid-point of the abdomen-navel level. For example, knee pain at St35 may be treated by needling LI11, Pc3, or Sp15. •

For knee pain in the Stomach meridian and using system 1, Hand Yangming meridian is selected; LI11 can be needled. For system 2, Hand Jueyin meridian is selected and Pc3 can be needled. System 3, internal –external pairs, one selects Foot Taiyin meridian; Sp9 to Sp10 can be needled. Sp15 can be needled if the abdominal imagery is useful. System 4 overlaps with system 3. System 5 overlaps with system 1.

•

For knee pain in the Spleen meridian, system 1, Hand Taiyin meridian is selected; Lu5 can be needled. System 2, Hand Taiyang meridian can be selected and SI8 can be needled. For system 3, Foot Yangming meridian can be selected; St36 can be needled. St25 can also be needled if the abdomen is treated. System 4, clock opposite system, utilizes Hand Shaoyang, the Triple Burner meridian; TB10 can be needled. System 5, clock neighbor, selects Hand Shaoyin meridian; Ht3 can be needled.

•

For knee pain in the Liver meridian, using system 1, Hand Jueyin meridian is selected; Pc3 can be needled. In system 2, Hand Yangming meridian can be selected, and LI11 can be needled. For system 3, Foot Shaoyang meridian can be selected; GB34 or GB33 can be needled. GB26 or GB25 can be needled if abdominal imagery is used. System 4, clock opposite, uses Hand Tai yang meridian, so SI8 can be needled. In system 5, clock neighbor, Hand Taiyin meridian can be selected; Lu5 can be needled.

•

For pain in the Kidney meridian, system 1, Hand Shaoyin meridian can be selected and Ht7 is needled. System 2, Hand Shaoyang meridian, can be selected; TB10 can be needled. In system 3, Hand Foot Taiyang meridian can be selected, and BL40 can be needled. BL23 may also be needled if abdomen is treated. System 4, Hand Yangming meridian can be selected, and LI11 can be needled. System 5, Hand Jueyin meridian can be needled at Pc3.

•

For knee pain in Bladder meridian using system 1, Hand Taiyang meridian can be selected and SI8 can be needled. For system 2, Hand Taiyin meridian is selected; Lu5 can be needled. In system 3, Foot Shaoyin meridian can be selected, needling Kid 10. Kid16 can be needled if treating the abdomen. System 4 overlaps with system 2. System 5 overlaps with system 1.

•

For knee pain in Gall Bladder meridian, system 1, Hand Shaoyang meridian can be selected; TB10 can be needled. System 2 selects Hand Shaoyin meridian, where Ht3 can be needled. In system 3, Foot Jueyin meridian is selected, so Liv7 to Liv 8 can be needled. Liv13 can be needled if the abdomen is treated. System 4 overlaps with system 2. System 5 overlaps with system 1.

Phantom limb pain

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TCM There is no classical treatment in the TCM text books for phantom limb pain. Certainly scalp acupuncture and auricular acupuncture are applicable. In Jiao’s scalp acupuncture, sensory zone 1 can be chosen. In Zhu’s scalp acupuncture, upper limb or lower limb zone can be needled. In auricular acupuncture, the sympathetic point and the corresponding limb-appendage points may be needled. The Balance Method does have an obvious advantage in the treatment of phantom limb pain. Because the Balance Method never needles locally, no protocol change is required. Most patients can identify the phantom area of pain, therefore, the affected channel is treated distally, using one of the five systems.

Balance Method Approach to Internal Syndromes

When treating musculoskeletal problems, a sick meridian is identified, and, using the five core systems as explained previously, a healthy meridian is needled to achieve balance and relive pain. When treating internal syndromes, the yin-yang balancing dynamic is used. A deeper understanding of what the Taiji symbol represents is therefore required.

☯

As Dr. Tan explains in his Dr. Tan’ Strategy of Twelve Magical Points: “The Taiji symbol originates from the wisdom of I-Ching, and represents the ebb and flow of the yin-yang forces. The Taiji forms the foundation of Chinese medicine. It illustrates the concept of mutual attraction of opposites and dynamic balance… The two rotating fish of the Taiji represent an active, global equilibrium between the yin and yang attributes. The yang emerges, increases, reaches its highest peak and recedes. Then yin emerges, increases, reaches its highest peak and recedes. Without the yin, there is no yang, without the yang, there is no yin. The two dots within the Taiji symbol suggest that the seed of the opposite energy is contained at the extreme point of each of the two forces. This alternating energetic rotation is a natural movement of opposite forces that can be utilized to create change in physical, mental, or emotional 6 conditions.” When treating internal syndromes, an alternating format of selected yin and yang meridians create the yin-yang balancing dynamic. The yin meridian of the upper right attracts the yang meridian on the upper left, the yang meridian on the upper left limb

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attracts the yin meridian on the lower left limb, the lower left yin attracts the lower right yang, the connection is completed with the lower right yang attracts the upper right yin. RIGHT

LEFT

Yin

Yang

Upper Limb (hand meridians)

☯ Yang

Yin

Lower Limb (foot meridians)

“In setting up treatment strategy, first determine the sick meridian, then apply the five 7 systems to select additional meridians to be needled in addition to the sick meridian.” There are many more advanced systems developed by Dr. Tan. One very simple, interesting, and highly effective system for point selection when treating internal disorders is using the lines (or Yao) of each hexagram (or Gong).

Gua Top Yao th 5 Yao th 4 Yao rd 3 Yao nd 2 Yao st 1 Yao

Yan Lu, LAc

Liv Liv8 Liv5 Liv4 Liv3 Liv2 Liv1

Ht Ht3 Ht4 Ht5 Ht7 Ht8 Ht9

Sp Sp9 Sp5 Sp4 Sp3 Sp2 Sp1

LU Lu5 Lu7 Lu8 Lu9 Lu10 Lu11


Kid Kid10 Kid7 Kid4 Kid3 Kid2 Kid1

Pc Pc3 Pc5 Pc6 Pc7 Pc8 Pc9

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Gua Top Yao th 5 Yao th 4 Yao rd 3 Yao nd 2 Yao St 1 Yao

GB GB34 Gb38 GB40 GB41 GB43 GB44

SI SI8 SI5 SI4 SI3 SI2 SI1

St St36 St41 St42 St43 St44 St45

LI LI11 LI5 LI4 LI3 LI2 LI1

UB UB40 UB60 UB64 UB65 UB66 UB67

SJ SJ10 SJ6 SJ4 SJ3 SJ2 SJ1

Quite simply, Dr. Tan has inserted the five transporting or antique points and yuan-source points into this chart. The points follow the anatomical flow of the channel. For the yin channels, as the shu-stream points and Yuan-source points are the same, Luo-connecting points are plugged in following the anatomical flow of the channel. It is a simple and effective system for point selection. This system selects individual points for treatment. When using this system, needling with a 1-4 combination or 3-6 combination are highly effective. The 2-5 combination is not effective clinically. Perhaps treatment involves both the Kidney and Sanjiao channels. When comparing these two guas, they are similar with the exception of line 3 and 6. Therefore by needling the points plugged into each line of these guas, each gua becomes the other gua (needle K3 and K10, and SJ 3 and SJ10). The 1-4 combination would not work here, as changing lines 1 and 4 of the Kidney and Sanjiao guas would not become the other gua. Changing the first and fourth lines of the Kidney gua manifests the Large Intestine gua. Similarly, changing the first and fourth line of the Large Intestine gua transforms it into the kidney gua. Therefore when treating the Large Intestine and Kidney channels, the 1-4 combination is used ( needle LI1 and LI4, and K1 and K4). Hand channels balance foot channels. Yin channels balance yang channels.

Clinical application of TCM vs. Dr. Tan’s Balance Method in Internal Syndromes Asthma

TCM Asthma can be divided into two types: excess and deficiency. The excess type includes wind-cold and phlegm-heat. Deficiency type includes lung deficiency and kidney deficiency. •

For wind-cold, needle and moxa BL12 and BL13. This will eliminate wind-cold and support the lungs. Needle GV14, Lu7 and LI4 to further eliminate the wind and regulate the lung qi. For phlegm-heat, needle BL13, Dingchuan, CV22, Lu5, Lu10 and St40. BL13, the back shu point of the lungs, supports lung function. The extra point, Dingchuan, literally translated as “stop wheezing,” is used to do just that. CV22 descends the lung qi. Lu5, the he-sea point on the Lung channel,

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transforms phlegm, while Lu10, the ying-spring point, clears heat. St40 clears phlegm. •

For lung deficiency, needle BL13, Lu9, St36 and Sp3. BL13 is the back shu point of the lung. Lu9 is the source point on the Lung channel. St36 is the he-sea point, therefore it transforms dampness. It also tonifies qi. Sp3 is the source point of the Foot Tai yin meridian. Tonifying this point will then tonify the qi of Hand Taiyin. Some people might consider the possibility of using five element theory here. St36 and Sp3 are each the earth point on the earth channel. Earth tonifies metal. Lungs belongs to the metal element.

•

For kidney deficiency, needle Kid3, BL23, BL13, CV17 and CV6. Kid3 is the source point on the kidney channel, and BL23 is the back shu point for the kidney. CV17 is the influential point of qi, and is located in the middle of the chest. Therefore, it supports the qi, and helps to pacify breathing. CV6, Qihai, tonifies the qi. These two points needled together help to support the kidney and regulate breathing.

Balance Method Start by asking the patient if he or she has trouble with inhalation or exhalation. Then ask the patient to point to the area where the breath stops. Most people can pinpoint exactly where the trouble starts. •

A common area of trouble for difficulty with inhalation is Kid24 to Kid26 area. The sick meridian is now identified as the Leg Shaoyin channel. Leg Taiyang balances Leg Shaoyin, so the foot channels have been chosen. Now to pick the hand channels, Hand Yangming balances Foot Shaoyin, via system 4, the clockopposite. Hand Taiyin balances Hand Yangming via system 3, the interiorexterior pairs. Furthermore, Hand Taiyin balances with Foot Taiyang via system 2, branching channels, and system 4, clock-opposite. R LI Kid

L Lu UB

The yin-yang balancing meridians have been chosen. Using imaging, point selection now begins: o

Starting with the Kidney meridian as it is the sick channel, palpate Kid9 area for tender spot. Using the foot as the head, Kid9 or Kid7 is the upper chest area, so, using the same imagery, UB57 and UB58 area is palpated for tenderness. Similarly, Lu6A and LI7 area are palpated for the tender spots. Here the image of the head is represented in the hand. Treatment has been selected. R LI7 Kid 9 or 7

Yan Lu, LAc

L Lu6A UB57, 58


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•

Using system 2, branching meridians, the channels are: R L TB Ht Kid GB

•

Using mirror imaging, point selection could look like this: R TB 6, 7, 8 area Kid 7, 8, 9 area

•

L Ht4A GB35 or 36

If however, the patient indicates that the Foot Yangming channel is the sick channel, the treatment could look very different (Hand Yangming balances Foot Yangming, and Hand Taiyin balances Foot Taiyin which would balances with Foot Yangming). If the asthma is more due to phlegm, the channel selection would look like this: R Lu St

L LI Sp

Using mirror imaging, if the patient’s breathing difficulties are near St18 area, point selection would look like this: R Lu6 St40

L LI7 and/or 8 Sp7A

If phlegm is a large contributing factor, he-sea points on these channels could be added. •

Similarly, if the asthma is stress induced, using system 2 branching channels, the treatment could look more like this: R L Pc LI St Liv Needling Jueyin points can reduce stress. In system 2 Jueyin is balanced with Yangming.

•

Again, St40 might be a great place to start with point selection, as it is the image of the chest area (here the foot represents the head). Pc4 or Pc5 might be needled. LI7 is palpated. Liv5 and Liv6 are palpated for tenderness. The point selection could look like this:

Yan Lu, LAc

R

L

Pc4 or 5

LI7 and/or 8

St 40

Liv5 and/or 6


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Insomnia

TCM In TCM, there are four primary syndrome differentiations for insomnia. All syndromes needle Ht7, Sp6, and Anmian. Ht7 is the source point on the Heart channel, Sp6 is the meeting point of the three Leg Yin channels. This point therefore nourishes yin. Anmian is an extra point for insomnia. Its name translates to “peaceful sleep.” For deficiency of heart and spleen, needle BL20, BL15, and do moxibustion on Sp1. BL20 is the back–shu point for the spleen, and BL15 is the back-shu for the heart. Moxibustion warms and tonifies the spleen and strengthens the heart. Sp1 is the jing-well point on the Spleen channel and is also a wood point. In the five element style acupuncture, wood controls earth, therefore, strengthening the earth channel-the Spleen is an example of the Ke cycle of control. It would counter act on an out of control wood element. Wood is the mother of the fire, and the heart belongs to the fire element. Therefore, burning moxa on this point strengthens the heart. If the disharmony is between the heart and kidney, needle BL15, BL23, and Kid3. BL23 is the back-shu point for the kidney, and Kid3 is the source point on the Kidney channel. For upper disturbance of liver fire, needle BL18, BL19 and GB12. BL18 is the back-shu point for the liver, and BL19 is the back-shu point for the Gall Bladder. GB12 clears the liver fire from the head. When treating dysfunction of the stomach causing insomnia –food stagnation with phlegm-heat disturbing Stomach qi, needle BL21 and St36. BL21 is the back-shu point for the stomach, and St36 is the he-sea point for the Stomach channel. Balance Method Insomnia can be caused by different reasons. Particularly chronic insomnia is usually caused by some degree of emotional distress. Highly effective treatment for this syndrome is: R TB Liv

L Pc GB

Using system 1, Foot Jueyin is balanced with Hand Jueyin, Foot Shaoyang is balanced with Hand Shaoyang. Further balance is created by using system 3, interior-exterior pairs. For point selection, as previously discussed, the Gong-Yao lines 3 and 6 or shu-stream and he-sea points are needled. R

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L


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TB3, 10 Liv3, 8

Pc7, 3 GB41, 34

Additional possibility exists. If the insomnia is caused by kidney yin fails to nourish the heart, the treatment could look like this. R TB Kid

L Ht GB

This is straightforward system 2, branching channel; Shaoyin is balanced with Shaoyang. Another possibility exists: R L SI Ht Kid UB Here Shaoyin is balanced with Taiyang via system 3 internal-external pairs. Deciding which system to use can be determined by palpation of points or analyzing other symptoms that may exist (patients seldom present with only one symptom—i.e. low back pain, digestive issues, etc…). In either of these choices, using shu-stream and he-sea points would be highly effective. This is an example of using the Gong-Yao lines 3 and 6 system. R TB3, 10 Kid3, 10

L Ht7, 3 GB41, 34

R SI3, 8 Kid3, 10

L Ht7, 3 UB65, 40

Mental and emotional disorders i.e. depression, anxiety, neurosis, use Shaoyang, Jueyin, lines 3-6 (shu-stream, he-sea points) as described previously under insomnia.

Epigastric Pain

TCM There are three main syndrome differentiations for epigastric pain. When treating retention of food, needle CV12, Pc6, St36 and Inner Neiting. CV12 is the front-mu point of the stomach. St36 is the he-sea point of the stomach. Pc6 is a luo-

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connecting point, it is also a master and couple point for the Yin Wei Mai and Chong Mai. Inner Neiting is an extra point which is used empirically to treat food retention. When treating the attack of the stomach by the liver qi, needle Liv14, CV12, Pc6, St36 and Liv3. Liv14 is the front-mu point of the liver, Liv3 is the source point of the Liver channel. When treating deficiency of the stomach with stagnation of the cold, needle CV12, CV6, BL20, Pc6, St36 and Sp4. Moxibustion is also applicable. CV6 tonifies the qi as its name indicates. Sp4 and Pc6 are the master and couple points for the Chong Mai and Yin Wei Mai. They are used to treat stomach disorders.

Balance Method When using balance method for epigastric pain, several treatment options exist. These options are also applicable for other digestive disorders. One must consider the location of the pain and evaluate if the condition is straight forward digestive condition i.e. weak spleen qi with dampness, or is the liver involved. If the epigastric pain is located on the Gall Bladder channel, the treatment is different than if the pain is located on the CV channel. Location of the pain directs the treatment. Here are some possible treatment examples: R LI Sp

L Lu St

The balancing of Taiyin with Yangming is an excellent starting point for any kinds of digestive concerns. In this treatment, it covers the entire digestive system from the beginning to the end. Using system 1 Hand and Foot Yangming balance each other as do Hand and Foot Taiyin. Additionally, using system 3, Spleen and Stomach balance each other internally and externally, as do the Lung and Large Intestine. Also, this treatment can be further balanced by using gong-yao system. This combination uses lines 3 and 6. So the points selected are: R LI3, 11 Sp3, 9

L Lu9, 5 St43, 36

Another possibility is: R TB Sp

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The hand channels are balanced internally and externally using system 3, as are the foot channels. Triple burner and spleen are opposite on the clock—system 4. Pericardium and stomach are also opposite on the clock, and using system 2, the branching system Hand Jueyin balances Foot Yangming. Another option additionally exists using the gong-yao system, lines 1 and 4 can be picked. It will look like this: R TB1, 4 SP1, 4

L Pc9, 6 St45, 42

Perhaps your patient is not fond of jing-well points being needled. Another point selection might be: R TB5 Sp9

L Pc6 St36

Here, luo points are picked in both hand channels. The nature of a luo point is to communicate information. St36 and Sp9 are the he-sea points in the foot channels. The he-sea point can transform dampness and because of their proximity to the middle of the limb, they treat the middle of the abdomen: the digestive system. Another possibility might be to only needle he-sea points. It would look like this: R TB10 Sp9

L Pc3 St36

Another option is: R LI Liv

L Pc St

Here Yangming is balanced with Jueyin via system 2, the branching system. Using the gong-yao system, lines 1 and 4 are picked. Points needled are: R LI1,4 Liv1,4

L Pc9, 6 St45,42

Another option for points could be once again to needle only he-sea points. R LI11 Liv8

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Another option for more gall bladder digestive problems is: R TB Liv

L Pc GB

Here Hand and Foot Jueyin balance each other as well as Hand and Foot Shaoyang. Liver and gall bladder are internally and externally paired, as are the triple burner and pericardium. Points using the gong-yao 3-6 system are: R TB3, 10 Liv3,8

L Pc7, 3 GB41, 34

Another point selection using the famous luo-communication points is: R TB5 Liv8

L Pc6 GB34

Maybe your patient wakes early before the dawn breaks and has daily diarrhea. The treatment would be: R LI Kid

L Pc St

Kidney is used here due to chronic deficiency, therefore causing this type of diarrhea. Foot Shaoyin is balanced with Hand Jueyin via system 5, neighbors on the clock. Foot Shaoyin is balanced with Hand Yangming via system 4, clock opposites. Hand and Foot Yangming balance each other via system 1, hand Jueyin and Foot Yangming are balanced through both system 2, branching channels, and system 4, clock-opposites. One further option exists—the Gong-yao system. Lines 1 and 4 can be used. That treatment looks like: R LI1, 4 Kid1, 4

L Pc9, 6 St45, 42

Fatigue

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TCM This syndrome manifests as fatigue and other symptoms present themselves accordingly. This condition can be caused either by excess or deficiency. Many possible diagnoses exist. Lung deficiency syndrome can be either qi deficiency or yin deficiency. Lung deficiency can be treated by needling Lu9, St36, CV6, and Sp6. Lu9 is the source point of the Lung channel. St36 and CV6 tonify the qi and support the lungs. Sp6 is the three leg yin point, it nourishes the yin. Generally, when the spleen is deficient, treatment is aimed at the qi or the yang. St36, Sp3, CV12, BL20, BL21 can be needled. Moxa is applicable. St36 tonifies the qi of the spleen. Sp3 is the source point on the Spleen channel. CV12 is the front-mu point of the stomach, and therefore tonifies the spleen. BL20 is the back-shu point of the spleen, BL21 is the back-shu point of the stomach. The heart can be deficient of qi, yang, blood or yin. Treatment is Ht5 or Ht7, Pc6 or Pc7, CV14, BL15 and Sp6. Ht5 is the luo point on the Heart channel, Ht7 is the source point of the heart. Pc6 is the luo point of the Pericardium channel, and Pc7 is the source point of the Pericardium channel. CV14 is the front-mu point of the heart, and BL15 is the back shu point of the heart. Sp6, three leg yin, nourishes the yin. The kidney is usually deficient of yang or yin. Needling Kid3 and Kid7, CV4, Sp6 and BL23 is helpful. Kid3 is the source point on the Kidney channel. Kid7 is the tonification point as defined through the five element system. CV4 tonifies the source qi, and BL23 is the back-shu point of the kidney. The liver may also be the cause of fatigue if the blood or yin is deficient is deficient. Liv8, Sp6, St36, BL17 and BL18 can be needled. Liv8 is the he-sea point on the Liver channel, BL17 is the back-shu point of the blood, BL18 is the back-shu point of the liver. Excess conditions may also be the root of the fatigue. Dampness or phlegm can be present, or the liver can disturbed. Sp6, Sp9, St36, St40, CV12, BL20 and CV9 can be needled to dispel dampness or phlegm. Sp9 is the he-sea point on the Spleen channel, St40 is the luo point on the Stomach channel, and CV9 is called the “water-separating” point. These points also help to dispel dampness and phlegm. The liver can have stagnant qi, yang rising, fire blazing, or wind blowing. Liv3, Liv8 or Liv14, Sp6, Pc6 or Pc7, GB34 and GB20 would be appropriate. Liv3 is the source point of the Liver channel, Liv8 is the he-Sea point, and Liv14 is the front-mu point of the liver. Pc6 is the luo point of the Pericardium channel, Pc7 is its source point. GB34 is the he-Sea point of the Gall Bladder channel. GB20 dispels wind.

Balance method In balance method, usually the more relationships between the selected channels are desired. In balance method, treatment for excess or deficiency may look similar. For example, treatment for blood deficiency may resemble a treatment for liver qi constraint.

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The possible involved organs may include any of the five yin organs. Based on the organs or the meridians involved, the five systems are discussed below. If the heart is involved, here are some treatment possibilities: R L Ht SI BL Kid Further insight reveals that the Gong-yao 3-6 applies. Therefore, point selection is simple. R Ht3, 7 BL65, 40

L SI3, 8 Kid3, 10

Here Hand and Foot Shaoyin balance each other and the Hand and Foot Taiyang channels balance them internally and externally paired. Another possibility is: R Ht GB

L TB Kid

This is straightforward system 2, branching channels, Shaoyin balancing with Shaoyang. The 3-6, gong-yao system can be used. R Ht3, 7 GB34, 41

L TB3, 10 Kid3, 10

Another possibility is: R Ht St

L SI Sp

Hand Shaoyin is balanced with Foot Taiyin through system 5, neighbors on the clock. The 1-4 Gong-yao system can be used. R Ht1, 4 St42, 45

L SI1, 4 Sp1, 4

Another possibility is:

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R Ht GB

L SI Liv

Here Hand Shaoyin and Hand Taiyang are internally and externally paired as are Foot Shaoyang and Foot Jueyin. Foot Shaoyang is the opposite-clock of Hand Shaoyin as are Hand Taiyang and Foot Jueyin. Furthermore, the 3-6 Gong-yao system is applicable. Therefore, the treatment is: R L Ht3, 7 SI3, 8 GB41, 34 Liv3, 8 If the lung is more the problem, several possibilities for treatment exist. R Lu St

L LI Sp

Here Hand and Foot Taiyin balance each other, and LI and St channels are internally and externally paired. The 3-6 Gong-yao system works. Therefore, the points are: R Lu9, 5 St43, 36

L LI3, 11 Sp3, 9

This will be also the same treatment if the spleen is deficient (although other treatment do exist). Another possibility is: R Lu GB

L LI Liv

Here system 5 clock-neighbors is used. The 1-4 Gong-yao system is applicable. Therefore, the points are: R Lu11, 8 GB44, 40

L LI1, 4 Liv1, 4

Another possibility is the branching system, balancing Taiyang with Taiyin. R Lu UB

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The 1-4 Gong-yao system also works here. The points therefore are: R Lu11, 8 UB67, 64

L SI1, 4 Sp1, 4

Another possibility is: R L Lu LI UB Kid Lu and UB are opposite on the clock, LI and Kid balance internally and externally as pairs. The 1-4 Gong-yao system works here, too. The points are: R Lu11, 8 UB67, 64

L LI1, 4 Kid1, 4

One last possibility exists. R Lu UB

L TB Sp

Here Lu and UB are opposite on the clock as are TB and Sp. The 1-4 Gong-yao system is applicable. R Lu11, 8 UB67, 64

L TB1, 4 Sp1, 4

If the liver is the source of the fatigue, the treatment will look like this: R TB Liv

L Pc GB

Here the Foot Jueyin channel is balanced with Hand Jueyin, and internally externally paired with Foot Shaoyang. It can be further balanced with the Triple Burner channel by using the 3-6 Gong-yao system. The points are: R TB3, 10 Liv3, 8

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Another possible treatment is: R LI Liv

L Pc St

Here Jueyin is balanced with Yangming through system 2, branching channels. The 1-4 Gong-yao system is applicable. The point selection is: R L LI1, 4 Pc9, 6 Liv1, 4 St45, 42 Other combinations for the liver have been previously discussed. If the spleen is the focus of the treatment, some possibilities have been discussed previously. A few more options remain. R TB Sp

L Lu GB

Here Foot Taiyin is balanced with Hand Taiyain, and is opposite the clock from Hand Taiyang, which is balanced with Foot Shaoyang. The 1-4 Gong-yao system applies. R TB1, 4 Sp1, 4

L Lu11, 8 GB44, 40

Another possibility is: R TB Sp

L Pc St

Here Foot Taiyin is balanced with Foot Yangming internally and externally, and is opposite the clock from Hand Shaoyang, which is balanced with Hand Jueyin internally and externally. Hand Jueyin is also opposite-clock of Foot Yangming. The 1-4 Gong-yao system is applicable. The treatment looks like this: R TB1, 4 Sp1, 4

L Pc9, 6 St45, 42

Another possibility is: R

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L


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TB Sp

Ht GB

Here Foot Taiyin is balanced with Hand Shaoyin, via system 5, clock neighbors. Foot Taiyin is opposite the clock from Hand Shaoyang as are Hand Shaoyin and Foot Shaoyang. Choosing yuan-source points might be helpful, or he-sea points to drain dampness. R TB4, 10 Sp3, 9

L Ht7, 3 GB40, 34

One more possibility exists: R LI Sp

L Ht St

Here Foot Taiyin is balanced with Hand Shaoyin via system 5, clock neighbors. Foot Yangming is balanced internally and externally with Foot Taiyin, and with Hand Yangming via system 1. The 3-6 Gong-yao system applies. The treatment looks like this: R LI3, 11 Sp3, 9

L Ht7, 3 St43, 36

The kidney might need a boost. Some treatment options have been discussed previously. A few options remain: R LI Kid

L Ht GB

Here Foot Shaoyin is balanced with Hand Shaoyin, Hand Yangming balances via system 4, clock opposite. Foot Shaoyang and Hand Shaoyin are opposite the clock as well. The 3-6 Gong-yao system is applicable. R LI3, 11 Kid3, 10

L Ht7, 3 GB40, 34

Another option is: R TB Kid

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Foot Shaoyin and Hand Jueyin are neighbors on the clock. Bladder is internally and externally related to Foot Shaoyin, as are the Triple Burner and Pericardium channels. Additionally Hand Shaoyang balances with Foot Shaoyin via system 2. The 3-6 Gongyao system is applicable. Treatment looks like this: R TB3, 10 Kid3, 10

L Pc7, 3 BL 65, 40

One last possibility remains. R TB Kid

L Pc St

Foot Shaoyin is neighbor on the clock with Hand Jueyin. Hand Shaoyang balances Foot Shaoyin via system 2. Foot Yangming balances Hand Jueyin also through system 2. Yuan-source and he-sea points might be the points of choice. R TB4, 10 Kid3, 10

L Pc7, 3 St42, 36

Dysmenorrhea

TCM Dysmenorrhea can be caused by excess or deficiency. Excess condition can be caused by stagnation of qi and blood, stagnation of cold, or damp-heat. To treat stagnation of qi and blood, needle Liv3, Sp4, Pc6, Sp8, Sp10, and St29. Liv3 is the source point of the Liver channel. Sp4 and Pc6 open the Penetrating vessel and regulates the blood in the uterus. Sp8 is the xi-cleft point on the Spleen channel, and Sp10 moves the blood. St29 is a local point that helps to regulates the blood in the uterus. For stagnation of cold, moxa is required. Needle and moxa CV4, CV6, St36. Needle St29 and Sp6. CV4 and CV6 tonify the qi, and, due to their location on the lower abdomen, dispels the cold when warmed with moxa. For damp-heat, needle Sp9, Sp6, Lu7, Kid6, CV3, St28 and BL32. Sp9 is the he-Sea point of the Spleen channel, Sp6, Three Leg Yin, moves the blood. Lu7 and Kid6 open the CV channel. CV3 and St28 resolve dampness from the uterus as does BL32. If deficiency is causing the fatigue, its root can be either qi and blood deficiency or kidney and liver yin deficiency. Needle Sp6, St36, CV4, and CV6. These points nourish and tonify qi and blood. BL23 and BL18 may be added to the protocol if necessary.

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Balance Method Dysmenorrhea is a pain in the abdomen or lower back associated with a woman’s menstrual cycle. As with all pain syndromes, the affected meridian needs to be identified and treated. Most women can locate the pain precisely and accurately. The channels involved include Ren Mai, Chong Mai, Liver, Gall Bladder, Kidney, Stomach, Spleen and Bladder. Many of the possible treatments have been discussed previously. Use of extraordinary channels has not yet been discussed. Here are some possible extraordinary channel treatments. R TB5 Sp4

L Lu7 GB41

Hand and Foot Taiyang balance each other. They are also the master points for the Ren and Chong Mai. Hand Shaoyang and Foot Shaoyang balance each other. They are also the master points for the Dai Mai and Yang Wei Mai. Triple burner is opposite the clock from the spleen. R Pc6 GB41

L TB5 Kid6

Hand and Foot Shaoyang balance each other. PC and TB balance each other internally and externally, while PC and KID are neighbors on the clock. Also, Hand Shaoyang balances with Foot Shaoyin through system 2. R Lu7 BL62

L SI 3 Sp4

This is system 2-branching channels; Taiyang balances Taiyin. R Lu7 BL62

L SI3 Kid6

In this treatment, all channels balance with Foot Taiyang. Kid6 balances internally and externally. Hand Taiyang balances with Foot Taiyang, and lung is opposite the clock.

Conclusion

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As discussed above, there are quite a few similarities between traditional acupuncture and Tan’s style of acupuncture. The differences among them are also distinct. Summary is made as below: Both styles of acupuncture use yin-yang theory, meridian theory, and Zang-Fu theory. Both styles use methods of selection of acupoints in the front and in the back of the body. Both styles use acupoints in the upper and lower body, the left and the right of the body, interior and exterior related points, and yuan-source and luo points. The frequency of treatment in both styles of acupuncture is similar. The differences between these two styles are also obvious. When applying Zang-Fu theory in traditional acupuncture, eight principles are also applied. Tan uses the Bagua theory in his system, which is not commonly used in traditional acupuncture. With the exception of system 3—internally-externally related pairs—Tan’s other four systems are very unique. When treating internal organ diseases, Tan’s yin-yang balance method is applied, which is not used in the same in traditional acupuncture. When selecting acupoints, Tan uses image to help select acupoints (this explains why many empirical points in traditional acupuncture work), and he never uses local acupoints. Traditional acupuncture use the five shu-trasnport points, the luo-connecting points, the xi-cleft points, the shu-mu points, the eight confluent points and also local points. During the treatment, Tan uses twisting and thrusting techniques to obtain the qi while massaging the patients. In traditional acupuncture, there are tonifying and reducing techniques. Retaining of needles in Tan’s style acupuncture is generally longer than in traditional acupuncture. Dr. Tan has patients move the affected area frequently during the treatment. It is very difficult to compare the efficacy and effectiveness of these two styles acupuncture or to make a conclusion on what condition to use which style of acupuncture. In order to answer that question, it will require high quality research to prove it. However, by interviewing different practitioners, some personal clinical experience can be helpful in clinical practice. Among the five practitioners being interviewed, all of them studied both TCM acupuncture and Dr. Tan’s acupuncture. Four of them use Dr. Tan’s method more often. Four of them combine TCM acupuncture, Tan’s acupuncture and other styles of acupuncture to treat diseases. Among these practitioners, treatments are diverse. No one particular treatment pattern choice appears. Treatment options and choices seem to excite balance method practitioners. For the for the balance method novice, these choices can seem frustrating. Each practitioner recommends practicing the balance method. Please see appendix for the interviews.

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Appendix:

The format for the interviews includes the practitioner’s educational background and clinical experience. These questions are asked: 1. What style of acupuncture do you practice? How long? 2. Do you use different style of acupuncture for different conditions? 3. Which system in the balance method do you use the most? Why? 4. Additional comments? Zina Hurley, L.Ac. Graduated from OCOM in 1993 with Master’s degree in acupuncture and oriental medicine. 1. She has studied with Dr. Tan since 1995. She practices the balance method since then. 2. She practiced traditional Chinese medicine for 2 years and got good results. After she studied the balance method, she likes the clear theory and view of the natural world. So she practices the balance method exclusively now. 3. It is a complicated question as for which system she most frequently uses. She uses all systems frequently including the systems not discussed in this paper, when facing new treatment challenge, she starts with system 1 and runs through each system (via palpation techniques) until she finds the solution. Nikki Medghalchy, L.Ac. Graduated from OCOM in 1999 with master degree in acupuncture and oriental medicine. 1. She learned Dr. Tan’s style of acupuncture in 1998. She has been using both traditional acupuncture and the balance method for 8 years. She has also uses Zhu’s scalp acupuncture for 8 years, and divergent channel therapy for 5 years. She has been using Japanese acupuncture for 2 years, Korea hand acupuncture for 1 year, and five-element acupuncture for 1 year. 2. She usually combines 2 or 3 methods mentioned previously when she treats patients. For pain syndrome, she likes to combine Tan’s acupuncture with Zhu’s scalp acupuncture. For internal organs’ diseases such as digestive problems, she likes to combine traditional acupuncture with Tan’s acupuncture and Zhu’s scalp acupuncture. For emotional problems, she likes to use five element acupuncture, for auto-immune problems, she likes to use Japanese acupuncture. 3. When practicing Tan’s acupuncture, she uses system 4, the clock opposite, most often. If the patients are not getting better in 10 minutes, she will run through the other 4 systems using the imaging system until she finds the most tender spots. She will use that system and needle the points she picked. She does not use the Bagua balance method to pick the points. Cole Magbanua, L.Ac. graduated from OCOM in 1997 with master degree in acupuncture and oriental medicine.

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1. He uses traditional channel theory combing with imaging system. He also uses Tan’s balance method. He usually likes to combine traditional Chinese acupuncture, Tan’s balance method, Master Tung’s method and his own balance method to treat patients. 2. He often combines all the methods mentioned above to treat different conditions. Sometimes he only uses traditional acupuncture with imaging system for pain. For example, TMJ pain in GB2 area, he may still select GB channel to treat the problem by applying the imaging system, he may needle the tender point between GB33 and GB34 on the same side of the body to see if it can get ride of the pain. If not, he may add Tan’s system 4, the clock-opposite, or system 1, the name pair. He does not use Tan’s Bagua balance method to select the acupoints. Another example, fatigue, for which there is no clear location, he will then make TCM Zang-Fu syndrome diagnoses according to ZangFu theory, because Zang-Fu organs are connected with channels and collaterals, so the sick meridians can be selected. He will chose acupoints according to yuan-source points or according to the imaging system and the sick organs. 3. For pain syndromes, he likes to use traditional channel theory with imaging systems, which means he may select the channel that runs through the painful area, then select the acupoints by applying the imaging system. For limb pain, he likes to add Tan’s system 1, name pair. For torsal pain, he likes to add Tan’s system 4, clock-opposite. For internal organs’ diseases, besides the three methods mentioned above, he also likes to add the common system used by both traditional acupuncture and Dr. Tan—internal and external relation. John Blank, L.Ac. graduated from OCOM in 1991 with master degree of acupuncture and oriental medicine. 1. He uses Dr. Tan’s style of acupuncture most of time for the last 10 years. He still occasionally uses TCM acupuncture. He also uses ear acupuncture, Master Tung’s acupuncture for 4 years, and Zhu’s scalp acupuncture for 17 years. 2. He uses Dr. Tan’s acupuncture for musculoskeletal conditions as well as internal organ’s diseases. He uses scalp acupuncture for stroke patients, ear acupuncture for drug and alcohol dependency. He uses TCM acupuncture when he cannot figure out what to do. He uses Master Tung’s acupuncture for gynecological conditions. 3. He uses all the five systems in the balance methods, because they work equally well. He said he knows which system to use due to his clinical experience. Genevieve Allen, L.Ac. graduated from OCOM in 1999 with master’s degree of acupuncture and oriental medicine. 1. She primarily practices Dr. Tan’s method for 7 years. She also practices TCM acupuncture and Zhu’s acupuncture for 7 years. 2. She uses TCM acupuncture for women’s issues and asthma. She uses Microstimulation by Hara palpation for digestive disorders, then she uses Tan’s method afterwards for the digestive disorders. She also uses Dr. Tan’s acupuncture for pain syndrome. She uses Zhu’s scalp acupuncture for central nerve system conditions. 3. She uses all the systems in the balance methods. She thinks they work equally well.

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4. When she practices Tan’s method on her patients, her patients noticed immediate change within the first few minutes. She likes the instant response. That is why she uses Tan’s method most of the time.

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a comparison between TCM and Dr. Tan's Balance Method.pdf

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