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“This is an article about Lyme disease. The article focuses on explaining the main theories that you have to consider in this disease when analyzing it through the eyes of an acupuncturist or Chinese herbalists. Remember the article are to stimulate growth. Note that the references will be published on the seminar ragarding the topic given by Volden.

Welcome to read Lyme disease and Chinese medicine Enjoy.”

Nils Volden

 

Lyme disease: Tick-borne disease

 

It exist about 900 different types of tick in the world; most common is Lxodes ricius. These animals might transmit infectious agents to humans; normally bacteria, viruses and protozoa. Research estimate that ticks might transmit 16 diseases to humans; Lyme disease is one of them. Tick-borne diseases are difficult to spot on normal laboratory tests, and are therefore often overseen. Symptoms from a tick bite are normally body aches, fever, fatigue, joint pain and rash. Most common and – understood is Lyme disease, and a popular disease the last years in media. Let us explain Lyme disease to start to understand tick-borne diseases and use the occation to review many basic Chinese medicine theories.

 

Lyme disease is caused by the transmission of the bacteria Borrelia (remember this name) from a tick. This is why many call Lyme disease for Lyme borreliosis. On very important point here is that the tick needs to be connected to the human skin about 1.5 to 2 days to be able to transmit the bacteria; this is the only way to get this bacteria. The first symptom after the bite and infection is local redness. In half of the infected we find this local redness to develop a week after the bite. This redness might be itchy and painful. In the same timeframe we also find a development of fever, headache and fatigue. In some cases we find that over time the infection evolve and cause a loss of facial mobility, joint pain, neck rigidity, severe headache and palpitations. One important aspect here is that the symptoms is not stable, they tend to come and go in periods. You might be perfectly fine and shortly after very sick again. The average time lap of the disease is half a year. Note that we often confuse the symptoms for juvenile rheumatoid arthritis; remember not to do this mistake.

 

It is difficult to give this diagnosis since it depends on a history of a tick and antibodies. The blood test for antibodies tends to be negative the first period of the disease. It does not exist other objective tests for Lyme disease¸ many tests is relatively useless. The last years we also find many with a Lymes disease diagnosis that really don’t have it; remember that not all with Lymes disease have the disease! To classify somebody with Lymed disease we normally start with patient history that includes a tick-bite, and with that we normally initiate a treatment. The normal preventive treatment is doxycyline. This medicine is very strong and many chose to not undergo it on a preventative basis. When a person in infected by borrelia we normally use doxycyline and amoxicillin for three weeks; Some use these antibiotics for longer time, but it is no evidence of extra effect.

 

Then what does Chinese medicine have to offer against Lyme disease. First of all Lyme disease is not mentioned in any classical literature, but it exist similar disease patterns. Most common are Leptospirosis (Fort Bragg Fever) caused by Leptospira. Fort Bragg Fever is also transmitted from animals to humans; not through bite, but through animal urine. The common symptoms of Fort Bragg Fever are fever, shills, headache and muscle ache. This disease is normally analyzed by using the classical Chinese medical text Shang Han Lun. Interestingly enough, the pathology follows perfectly the normal disease transmission for days; making Shang Han Lun a good diagnostic guide. Lyme disease is frequently treated as Fort Bragg Fever Shang Han Lun style.

 

To understand this we need to take a short trip through the Shang Han Lun, just to understand how this works. First of all we need a pathogenic factor. Here we have a bacteria called Leptospira (could have been borrelia for that sake). It occurs more in the cold season and is therefore characterized as a Cold – and Yin Exogenious Pathogenious Factor (EPF). Through the years it has become normal to use leptospira inhibiting herbs preventively to reduce the growth of this EPF in the season. Most common are Isatis leaf, Isatis root, Ching-hao, Andrographis, Sanguisorba, Hu-chang, Coptis Gardenia, Chien-li-kuang, Scute, Phellodendron, Forsythia, Smilax and Verbena. These herbs were used for two qualities: eliminate Damp-Heat and antibiotic properties. The focus is on treating Heat and Damp-Heat. The cure rate estimated to be a stunning 97%, but proper investigations are missing and most likely this is not correct!

Let us change the analysis from Fort Bragg Fever to Lyme disease. The borrelia doesn’t jump into your bloodstream directly from a tick. The tick need to be connected to your skin for about 2 days biting to make borrelia enter. The first sign of something wrong is the reddish skin rash with a light swelling; 50% immediately and 50% after half a week to three weeks. This reddish swelling is normally named Damp-Heat in the Longituinal Luo meridians or simply Damp-Heat. Slowly after the bite we find the patient develop flu symptoms. First we find fever as the main symptom. This is the classical Tai Yang syndrome developing (according to Shang Han Lun) or EPF Wind-Cold transforming into Fire. The headache that follows is most likely of a Tai yang type; neck rigidity and pain in the back of the head; Urinary bladder Tendino muscular meridian. The sore throat (mostly the lateral sides) that also occurs is a sign of Fire; increasing temperature and fever due to the Tai yang syndrome. Tai yang syndrome might be seen as mainly the fever defense mecanism or the transformation of Wind-Cold to Heat and then to Fire. This is from we get increasing fever until it reaches its maximum. Remember that when the body temperature increases we find the formation of bacteria to become reduced. Let us say that the EPF Wind-Cold is Yin in nature and enjoy Yin, but the body uses a Yang defense mechanism to create a bad habitat for the EPF. The higher Yang (fever), the lower Yin (less bacteria). A reduced formation of bacteria gives Wei qi, our defensive energy, a better chance to eliminate them. A persons Wei qi are produced in San jiao. When the body temperature increases or Fire rises up in Tai yang, we also find two important details to pay attention to, frequent urination with just minor quantity of urine (like cystitis) and frequent defecation of a minor quantity. On top of this we find the person loose his interest in eating (Spleen yang xu) and develop slightly nausea (Stomach fire); against everything. If the Tai yang level last a long time we might start to develop arthralgia in big joints like knees and elbows; Het-Damp. It is also normal to get hot edema in the extremities. This is the process of cold transforming into Heat, and Heat transforming into Fire. Sometimes Heat is stored in the body as Heat-Damp. When the Heat is stored as Heat-Damp or Damp-Heat, we might name it a hidden pathogenic factor (HPF). The Damp-Heat is just waiting for a situation provoking it to continue its transformation to Fire; a HPF Damp-Heat activates to become a PF Heat-Damp. Often we observe these HPF in the skin as small eruption of something reddish. HPF manifests in the skin of the simple reason that the activation will involve a movement of qi in Po; the corporal soul. This movement is the transformation from Damp-Heat to Heat-Damp, and Po is responsible for this transformation. Depending of the amount of Damp-Heat and place it is stored we might get indicators of the severity. Some might develop digestion problems as irritable bowel syndrome (IBS); an increased sensitivity in the wall of the intestine – considered a Po Yang problem in relation to a Spleen Yang state (Yin xu or Yang shi). This is a slight inflammation of the small intestine that causes sensitivity or an allergy like situation. Normally we find a reaction against FODMAPs (Short Chain Carbohydrates: Fermentable, Oligo-, Di-, Mono-saccharides and Polyols) causing an inflammation in the digestive system with an elevated production of gas, and a liquid defecation (diarrhea). These symptoms will increase in severity as the Tai yang syndrome develops; Heat transforms to Fire, and Fire will increase the Yang in Po. Remember that the patient is in the Tai yang level as long the fever is increases. The maximum fever depends on Jing (acquired and congenital), the amount of Wei qi, – Qi and previous experiences with fever. When the fever doesn’t increase anymore (become stable high) we see this as a sign of a transformation of the disease to the next level, Shao yang.

 

If the EPF survives the Tai yang level treatment we find the transition to the Shao yang level. This is considered as a step to the worse, the disease develop from the Tai yang (related to the fu organs urinary bladder and the small intestine) to Shao yang (San Jiao and Gall bladder); tai yang is often called “Greater Yang”, and Shao Yang “Lesser Yang”. Most visible are the change in the pathology pattern from an increasing fever to a stable high fever. The increasing Heat has transformed into a stable Fire, and a Fire lasts. The time the person stay in Shao yang depends entirely on quality of the Wei qi produced by San Jiao. In short, the patient will have a high fever (normally 39 ^oC to 40^oC). Sometimes the fever is high just for a short period and sometimes for longer periods, everything depends on the Wei qi and if he is cured. After some time we find the person using up his Wei qi and start to use his qi. In that very moment we get an interesting change in Shao yang. This indicates that the main has developed from Shao yang to Yang ming, and the fever become intermittent; from 40^oC to 37.5^oC to 40^oC again. The time Yang ming is active depends totally on wei qi and jing. Yang ming is also called “Sunlight yang” and is related to the Fu organs large intestine and stomach. In Yang ming we might expect some changes in the large intestine and the stomach; some digestion abnormalities. This is the precursor to the second defense mechanism, purge.

Our main indicator that a person has developed from Yang ming to Tai yin is the absence of fever and a development of loose stools, nausea and vomiting. According to Shang Han Lun this disease has developed to the worse from external to internal; from a Yang level to a Yin level. The patient will feel better (regarding fever), but shortly after he increase his frequency of his toilet visits. At the same time we find a total loss of appetite and an increasing tiredness. Loss of appetite (Spleen yang xu) is due to the defense mecanism, and the tiredness is due to an increasing lack of Yong qi due to a deficient Ying qi or nutrients in Xue (blood). From being active, we find this patient to get more and more tired and less active. When the digestive system is empty of Gu qi he will not produce sufficient Yong qi to create an optimal Ying qi; a mix between Yong qi (nutrients), Zong qi (oxygen) and Yuan qi (congenital essence) in Xue. With a deficient Ying qi (Ying qi xu) the patient will feel tired; qi xu. At the same time as all this happen we will observe an increase in the respiration cycle; lung yin xu. Normally we have five hearts bets per respiration cycle, but here we find a decrease in the heart beats per respiration cycle; heart yang xu. The explanation for this is the development of a lack of Yong qi and due to that the Zong qi have problems in connecting to Xue; a lack of red blood cells makes the oxygen without a place to connect. With a Zong qi xu the patient feel totally tired and out of energy; qi xu. As a result our heart yang is consumed and a heart yang xu develop together with a relative increase of lung yang; lung yin xu. When the patient relatively stop emptying himself, breaths faster than normal (lung yin xu) and manifest a strong tiredness (qi xu) we say that he starts his transformation to Shao yin level; “Lesser Yin”. The purpose for the Tai yin level is to create a habitat low in nutrients for the bacteria in the blood. Then it is up to the Wei qi to fight down the EPF.

The classical symptom at Shao yin level is urination; a lot of urination. This is the person emptying Jin (liquid) from Xue (blood); remember that Tai yin level emptied the Xue for Yong qi (nutrients). This is more dramatic than Tai yin since the body is actually taking out liquid or water from our blood to create a habitat that is less favorable for the EPF. The person becomes even more tired and dry. Dry skin, mouth and everything lack humidity. This drying up of the system creates a very bad habitat for bacteria or EPF and the chance for the patient to get cured from the EPF increases. The main problem with weak patients is an increased possibility for death. As a complication of Shao yin t patient will be extremely weak, and he is not capable to maintain a normal life. It is close to impossible to eat or to have major activities. One of the best signals of a total Shao yin level is the presence of palpitation. The heart has a hard job with bombing around the Jinye deficient Xue; Xue lack the three essentials Zong qi, Yong qi and JinYe. In many cases you might smell something burned – the smell of Yang from heart zang. This is the smell of an overworked heart. When the person starts to feel better without any major reason we might suspect that he have moved on to the Jue yin stage; “Absolutely Yin”. As you soon will understand this is a false recovery.

In Jue yin we will observe that he get better; better without any special explanation or reason. This is sadly normally a sign for a worsening of the disease. When the patient is out of Qi we find him to activate the Jue yin stage. As we know liver stores xue, and here as a last resort the liver zang gives the little Xue that were stored into the circulatory system. Liver Xue will give a boost in the system and this might give help the patient to recover for a period. This doesn’t mean that the person is cured for anything. It just indicates that the body has emptied the last drops of Xue into the arteries and that the EPF still lives on. After receiving liver xue the person will function more or less for a while before he again drop back into a Tai Yin syndrome to combat the EPF, or he might die. The strongest signal for a Jue yin syndrome is the increase in palpitation or uncomfortable feeling in the chest. Before he felt his heart beating, but now it beats! This is simply a very bad sign. If the person is just feeling better, the person should go to rest and save his energy for vital processes.

The pathophysiology starts with an EPF Cold-Wind or Heat-Damp that activates different defense mechanisms that evolve from a Tai yang syndrome to a Jue yin syndrome (and possible death). The strength of wei qi and qi is primordial for the functioning of the person. The main Qi we speak about when discussing Six energy levels or Shang Han Lun is created by San Jiao. San Jiao is often called the triple energizer. This system explains how our body produces defensive energy; Wei qi. San Jiao is commonly divided into three parts: lower -, middle – and upper Jiao. The explanation has a two part explenation, and starts in the upper Jiao (Shang Jiao) where the mouth accepts food and drink. Upper jiao is often compared with a mist. The qi from upper jiao is sent down to the middle jiao (Zhong Jiao) for maceration and absorption of nutrients. Finally the dirty parts from the food and drink are excreted from the body in the lower Jiao (Xia Jiao) as stools and urine. The second part of the explanation is the rice of Wei qi from the lower Jiao. The kidney essence is stored in the lower Jiao and is activated by Mingmen, making Wei qi essence rise to the middle Jiao. Here we have to remember that kidney essence consist of both congenital essence that is basically our genetic factors or our potential to absorb nutrients and create Xue; mixed with our acquired essence that is the Xue circulating in our blood vessels together with the Xue stored in our liver zang; remember liver stores xue. When creating a mix between our congenital essence and the acquired essence we get our kidney essence that is activated by Mingmen in the lower Jiao. Mingmen is in short our ability to make this system work, the energy or the spark that makes our body regenerate and function. As an old Chinese master one way explained it to me, Mingmen is the function of yesterday’s blood to produce the blood of today. In the middle Jiao our Spleen creates fresh Yong qi (nutrients) from Gu qi (Food), Jin (liquid) from the liquids we drank, and put it into the circulation in the blood vessels. The Wei qi mixed with nutrients is sent up to the upper Jiao where the zang organ Lung is creating Zong qi (oxygen) from the Kong qi (air inside the lung). Zong qi is mixed with the Wei qi, nutrients from the middle Jiao and this creates a complete Wei qi. This wei qi is spread out to all the aspects of the body. The function of San Jiao is really to produce Xue, this Xue is called Wei qi. The more high quality Xue the better defense against EPFs.  Wei qi have both a nutritional value and a protective value. The protective value generates the name Defensive qi that normally is used on Wei qi.

When a person is attacked by an EPF he depends on multiple factors. First he needs some defense mechanisms (Tai yang (Fever) and Tai yin (emptying)). Then he needs Wei qi in the system to activate and maintain the defense mechanism. If wei qi is strong he might live for a long time in defense, but if wei qi is weak he have a limited time in defense. The depth and severity of the EPF penetration depends on wei qi. Wei qi depends on San jiao to create high quality Xue.

It is time to connect information. Let us go back to a Borrelia infection or an EPF. Western medicines seldom therapeutically support the natural defense mechanisms in the body and simply directly apply antibiotics. It is of little importance if the person has additional minor deficiencies.  Chinese medicine has a less reductionist approach to the patient since the focus is rather on the symptom complex and less on the actual complaint or symptom. When a Chinese medical trained doctor want to treat Lyme disease he will focus on the patient as one and not entirely on the manifestations from the borrelia bacteria in the patient blood. In literature we find little or no directions to the treatment of Lyme disease and Chinese medicine, but that does not change the methodology that color Chinese medicine. Borrelia is an EPF, and need to be treated as an EPF. Shan han lun and the six energy levels explains the EPF penetration. This makes us understand that this EPF and the reaction to the EPF is our focus of attention, and we need to analyze to understand its rhythm, frequency or resonance in the patient body. We got several focus areas that have to be looked at: the strength of Wei qi, the general amount of Qi and the affected energy level. Of cores a general analysis of the patient need to done as well. Let me walk you through this step by step how this can be done. Again, remember that no patient is the same, and all patients need to be treated individual; see this as a tip.

Chinese medicine uses observation and palpation as two important diagnostic skills. In this context the pulse diagnostics is a useful tool to gather information, and in this context we got four major pulses to pay attention to: Fu Mai, Chen Mai, Chi Mai and Shuo Mai. Fu Mai is a superficial pulse. This pulse is located in the exterior and feels weaker in the depth. Fu Mai indicates an external invasion of EPF. Normally EPF enters due to a Yin xu. Chen Mai is a deep pulse. This pulse is only palpable near the bone. Chen Mai indicates an interior syndrome. Normally this is a state where pathogens obstruct the flow of Qi and Xue. When a patient manifest Fu Mai (superficial pulse) it is normally an external syndrome or an EPF invading the body in Tai Yang – or Shao Yang level; frequently defense mechanism 1 – fever to stop bacteria from multiplying. If the patient doesn’t manifest Fu Mai, but rather a Chen Mai (deep pulse) we have an internal syndrome, Xue xu or a state where an EPF have penetrating deep to Tai Yin – or Shao Yin level; frequently defense mechanism 2 – emptying the body to take away nutrients from the bacteria. In short, most likely Fu Mai indicates external EPF (Tai Yang) and Chen Mai internal EPF (Tai Yin). Then you analyze the pulse per respiration cycle. If less than 4 beats per respiration cycle we call it a Chi Mai, a slow pulse. Chi Mai indicates a Cold syndrome; a stagnation of qi due to cold. If faster than 5 beats per respiration cycle we call it Shuo Mai, a rapid pulse. Shuo Mai indicates a Heat syndrome; a hyperactivity of Heat accelerating Qi and Xue. When a patient manifest Chi Mai (slow pulse) it normally indicates a cold syndrome or that an EPF that have penetrated deep into Tai Yin – or Shao Yin level; frequently defense mechanism 2 – emptying the body to take away nutrients from the bacteria. If the patient doesn’t manifest Chi Mai, but rather a Shou Mai (fast pulse) we have an external syndrome, a heat syndrome or a state where an EPF invading the body in Tai Yang – or Shao Yang level; frequently defense mechanism 1 – fever to stop bacteria from multiplying. In short, most likely Shou Mai indicates a cold syndrome EPF (Tai Yin) and Chi Mai heat syndrome (Tai Yang).

After finishing this pulse diagnosis we will have four possible pulses Fu Mai (Superficial), Chen Mai (Deep), Chi Mai (Heat) and Shuo Mai (Cold). We might expect the following combinations:

• Tai Yang syndrome:
  • Increasing Fu Mai and moderate Chi Mai
• Shao Yang syndrome:
  • Strong Fu Mai and strong Chi Mai
• Yang Ming syndrome:
  • Intermittent Fu – and Chen Mai
  • Intermittent Chi – and Shuo Mai
• Tai Yin syndrome:
  • Increasing Chen Mai and moderate Shuo Mai
• Shao Yin syndrome:
  • Strong Chen Mai and strong Chi Mai
• Jue Yin syndrome:
  • Moderate Chen Mai and moderate Chi Mai

These combinations are indications of affected level and might in some cases be different.

Observation is another aspect in Chinese medicine that is very important. In Lyme disease we got some aspects that are more frequent than others in tongue diagnosis. First we observe the colour of the tongue body. We got two colours that we need to pay attention to red – and pale colour. A red tongue body indicates a heat syndrome. A pale tongue body indicates a cold syndrome or Xue xu. A flaccid tongue indicates a Xu state in the body; normally caused by heat consuming JinYe. Red spots on the tongue indicate heat in Xue or accumulation of toxins. Normally this red spots present themselves on the tip of the tongue in the beginning of an illness, and after a time they move to cover the complete tongue body. A wet tongue indicates a cold syndrome, and a dry tongue indicates a heat syndrome. A white tongue coat indicates an external cold syndrome like an ordinary common cold or a digestion problem related to Cold-Damp in middle Jiao. A yellow Tongue coat indicates interior heat syndrome, Damp-Heat or Wind-Heat. The thickness of the tongue coat indicates the depth of the problem; the ticker the deeper. If the tongue coat changes in thickness, it indicates that the disease moves in the direction of the change. To sum up different plausible combinations:

 

• Tai Yang syndrome:
  • Body: Red
  • Coat: White thin
  • Spots: Red spots on the tip
  • Moist: Light moist
• Shao Yang syndrome:
  • Body: Deep red
  • Coat: Yellow thick
  • Spots: Red spots on most of the tongue
  • Moist: No
• Yang Ming syndrome:
  • Body: Alternating moderate red and moderate pale
  • Coat: Yellow/ White or Gray
  • Spots: Red big spots
  • Moist: No
• Tai Yin syndrome:
  • Body: Light Pale and light flaccid
  • Coat: White thin
  • Spots: Light red/ pale spots
  • Moist: Light most
• Shao Yin syndrome:
  • Body: Strongly Pale
  • Coat: White thick
  • Spots: Pale spots
  • Moist: No
• Jue Yin syndrome:
  • Body: Medium pale and flaccid
  • Coat: White thick
  • Spots: Pale spots
  • Moist: No

These combinations are indications of affected level and might in some cases be different.

After palpating the radial pulse and observed the tongue we have an idea about where the problem is located. Then we move to ask about the distinct symptoms of Lyme disease. The questioning might follow a pattern that look as this:

1. Did you discover a tick on your skin, if so how long time has it been there?
   1. Western medicine: More than one day; suspect borrelia infection
   2. Chinese medicine: Possible EPF
2. Did you get flu symptoms within a few days after the tick were removed?
   1. Western medicine: Suspect borrelia infection
   2. Chinese medicine: More chance for an EPF Cold-Wind invading
3. Did you get fever shortly after the tick bite?
   1. Western medicine: Suspect borrelia infection
   2. Chinese medicine: More chance for an EPF Cold-Wind transforming into Fire
4. Did you get neck rigidity and headache shortly after the tick bite
   1. Western medicine: Suspect borrelia infection
   2. Chinese medicine: Indication of Tai yang level due to invasion of EPF
5. Did you get sore throat after the tick bite?
   1. Western medicine: Suspect borrelia
   2. Chinese medicine: Indication of Fire and Tai yang level
6. Do you have less interest in eating and tend to have nausea?
   1. Western medicine: Digestion problem
   2. Chinese medicine: Spleen yang xu or the beginning of a Tai yang syndrome
7. Do you have pain in big joints (elbow and knees)?
   1. Western medicine: Arthralgia
   2. Chinese medicine: Heat-Damp or Fire, or beginning of Shao yang
8. Do you have a type of oedema that is hot in nature?
   1. Western medicine: Circulation problem
   2. Chinese medicine: Cold-Damp transforming into Heat
9. Do you feel that the problems you have do not correspond with the circumstances?
   1. Western medicine: Speculation
   2. Chinese medicine: Hidden pathogenic factor (HPF) that waits to continue its transformation
10. Do you have red skin eruptions?
    1. Western medicine: eczema
    2. Chinese medicine: Damp-Heat in Tai yang or Lung yang shi
11. Is your intestine more sensible than normal?
    1. Western medicine: Gastritis, Colitis or Irritable bowel syndrome (IBS)
    2. Chinese medicine: Damp-Heat in Middle Jiao or Tai yang syndrome

The more indicators the bigger chance for a borrelia infection from the tick or Lyme disease if you prefer.

 

Then we come to the treatment of Lyme disease. Not all want to go directly to antibiotics and prefer to try herbal treatment and/ or acupuncture first. The most popular herbal treatment is the Chinese medical treatment that has an antibiotic effect. In Chinese medicine we say that these herbs and herbal formulas have a heat clearing property. If the patient has indicators of cold we should adjust the herbal formula accordingly. The most important herb is Ching-hao. Ching-hao eliminates Damp-Heat. Lyme disease is normally of a Damp-Heat nature; the same goes for lupus, arthralgia, malaria and other mosquito transmitted parasites. Research have shown great results on Wei qi and autoimmune problems; Damp-Heat. When Lyme disease have afflicted the big articulations we normally also include Lonicera stem. The standard decoction used in Chinese medicine is composed by an anti-spirochete mixture: smilax, ching-hao, forsythia, hu-chang, andrographis and lonicera stem; all ingredients in equal parts and 15 grams per day and used three times a day.

 

Acupuncture treatment of Lyme disease is normally divided into three parts: The strengthening of Wei qi, the strengthening of Tai yang level, and finally the strengthening of Tai yin level. Let us look at the different parts. The strengthening of Wei qi: To be able to strengthen Wei qi we need to look at San Jiao to find the weakness there. San Jiao have three levels, and first we need to find what level that is affected. Lower Jiao is kidney essence related; Yuan qi. Middle Jiao is Spleen zang related; Yong qi. Upper Jiao is Lung Zang related; Zong qi. All patients need to be treated individually, but some directions of acupuncture point selection can be given. This does not mean that this is THE perfect points.

According to the afflicted level you select your acupuncture points; examples:

• Lower Jiao:
  • Kidney 3: Yuan source point Kidney zang
  • Kidney 10: He sea point Kidney zang
  • Ren 4: Special point for strengthening Lower Jiao
  • Du 4: Special point for activating Mingmen
• Middle Jiao:
  • Stomach 36: Distal point middle jiao
  • Spleen 4: Luo point Spleen zang
  • Ren 12: Front mu point fu organs
  • Pericardium 6: Distal point middle jiao
• Upper Jiao:
  • Lung 5: He sea point Lung zang
  • Ren 17: Influential point qi
  • Lung 1: Front mu point lung zang

 

According to additional Chinese medical diagnosis we might add some other points; examples:

• EPF
  • Du 14: Special point heat
  • Gall bladder 20: Special point wind
  • Large intestine 4 and Large intestine 11: Special point combination Heat
• EPF Cold-Wind invading
  • Du 4: Special point for warming the body; moxibustion
• EPF Cold-Wind transforming into Fire
  • Du14: Special point to reduce Fire
• Tai yang level due to invasion of EPF
  • Urinary bladder 54: Yuan source Urinary bladder fu organ
  • Small intestine 4: Youan source small intestine fu organ
• Indication of Fire in Tai yang level
  • Du14: Special point to reduce Fire
• Spleen yang xu
  • Stomach 36: He sea point stomach fu organ
  • Ren 12: Front mu point fu organs
• Heat-Damp
  • Ren 12: Front mu point fu organs
  • Stomach 40: Special point Damp
  • Large intestine 11: He sea point Large intestine
• Fire
  • Du 14: Special point heat
• Cold-Damp transforming into Heat
  • Du 14: Special point heat
• Hidden pathogenic factor (HPF) that waits to continue its transformation
  • Stomach 9: Special point HPF
  • Pericardium 6: Confluent point Yin wei
  • San Jiao 5: Confluent point Yang wei
• Damp-Heat in Tai yang
  • Stomach 40: Special point Damp
  • Du 14: Special point heat
• Lung yang shi
  • Large intestine 4 and Lung 7: Special combination for Yang shi in lung zang
• Damp-Heat in Middle Jiao
  • Stomach 36: He sea point stomach fu organ
  • Stomach 40: Special point Damp
  • Large intestine 4 and Large intestine 11: Special combination Damp-Heat
• Six energy level syndromes
  • Tai Yang syndrome:
    • Stomach 36: He sea point stomach fu organ
    • Small intestine 3: Shu stream small intestine
  • Shao Yang syndrome:
    • Du 4: Special point for warming the body; moxibustion
  • Yang Ming syndrome:
    • Continue with fever:
      • Stomach 36: He sea point stomach fu organ
    • Stop fever:
      • Du 14: Special point Heat (Bleed)
    • Tai Yin syndrome:
      • Ren 12: Front mu point fu organs
    • Shao Yin syndrome:
      • Kidney 2: Ying spring point kidney zang
    • Jue Yin syndrome:
      • Stomach 36: He sea point stomach fu organ
      • Ren 12: Front mu point fu organs
      • Large intestine 11: He sea point Large intestine

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