Master Tung’s needling technique is simple. He didn’t use dispersion and tonification techniques; instead, he would insert the needle to the desired depth and achieve De Qi. In Chapter 77 of Lao Zi’s Tao Te Ching, it is written:

“The Tao of Heaven is like drawing a bow / Lower that which is high / Raise that which is low / Reduce that which has excess / Add to that which is lacking / The Tao of Heaven / Reduces the excessive / And adds to the lacking”.

Lao Zi compares the action of shooting an arrow to the Tao of heaven. To hit the target, one must aim the arrow by adjusting the bow up and down and pulling the string to the right tension – not too much, nor too little. Pulling too hard results in an overshoot, while pulling too lightly means the arrow won’t reach its target. Acupuncture follows a similar principle to the Tao of heaven, striving for balance: reducing in excess and adding in deficiency. Master Tung’s approach to the needle’s action aligns with this concept, as the needle seeks to balance the body: dispersing in cases of excess and tonifying in cases of deficiency, without the need for additional tonification and dispersion techniques. Chapter 77 continues:

“The Tao of people is not so / It reduces the lacking / In order to offer to the excessive / It reduces the lacking.”

The Tao of people depletes the deficient and enriches the excess. The Tao of people is similar to moxibustion and bloodletting techniques: moxibustion tonifies, while bloodletting disperses.

Master Tung often needled the side opposite to the disease. In Chapter 5 of the Basic Questions, it is written:

“Those who know well how to use the needles, from the yin they pull the yang and from the yang they pull the yin. With the right they treat the left and with the left they treat the right.”

Additionally, Chapter 63 states:

“given [a disease is] on the left, one selects the right, while given [a disease is] on the right, one selects the left.”

This technique is known as Miu Ci [缪刺]. In his book, Chuan Min Wang explains that Tung’s method of needling the opposite side is based on the Luoshu [洛書] Square (Wang, 2013). The Luoshu Square represents space and time and expresses geographic directions. Each of the nine regions of the empire is symbolized in the diagram, with the number 5 at the center representing the Five Phases. This diagram also forms the basis of Feng Shui (see The Luoshu Square). The Luoshu Square describes the post-heaven state and the aspiration to return to wholeness (pre-heaven). The number 10 represents wholeness; the word Shi 10 [十] also means “to complete,” “full,” or “the highest.”

In the Luoshu Square, opposite pairs always sum to 10: 1+9=10, 3+7=10, 4+6=10, 2+8=10. Including the central number 5, the sums are always 15, which reflects the time cycles represented in the diagram. The Chinese calendar is divided into 24 Solar Terms [二十四節氣], with each term containing 15 days.

The human body can be mapped onto the Luoshu Square: 9 represents the head, 1 represents the lower trunk, 3 represents the left side of the trunk, 7 represents the right side of the trunk, 4 represents the left hand, 2 represents the right hand, 8 represents the left leg, and 6 represents the right leg (see The Luoshu Square).

In the Luoshu Square, the upper part of the body balances the lower, and vice versa, with the navel line serving as the dividing line. Similarly, the right side balances the left and vice versa. Therefore, when a disease is located above, needles are placed below, and vice versa. For conditions on the right side, needling occurs on the left side, and vice versa. For instance:

• Pain in the right shoulder is treated by needling the left leg.
• Pain in the left hand is treated by needling the right leg.
• Pain on the right side of the head is treated by needling the left side of the leg.
• Pain on the right side of the lower abdomen is treated by needling the left side of the hand.
• Pain on the left side of the chest is treated by needling the right leg.

Disorders of the internal organs require a different needling approach. In Master Tung’s acupuncture, the primary treatment areas for such disorders are Zones 77 and 88. Typically, these zones are needled on the same side as the affected organ, while the hands are needled on the side opposite to the organ. For example:

• The Liver is located on the right side of the body. Therefore, Liver and Gallbladder diseases can be treated by needling 33.11 Gan Men on the left hand and 88.12-14 Shang San Huang on the right side of the thigh.
• The Spleen is located on the left side of the body. Thus, Spleen diseases can be treated by needling 11.18 Pi Zhong on the right hand, and 77.05-07 San Zhong on the left leg.
• For organs located on both sides of the body (Kidneys and Lungs), needling is performed on both sides unless the disease is known to be situated on one side, in which case the opposite hand and the corresponding leg are needled.
• Diseases of centrally located organs, such as the Heart, Stomach, and Intestines, are needled on both sides.

It is crucial to emphasize that when treating disorders of the limbs and internal organs, the external expression of the disease takes precedence over these guidelines. Needling is always performed in the area of the external expression of the disease, even if it contradicts the aforementioned rules. For example, in a case of pneumonia in the right lung, the rules suggest needling the left hand and the right leg. However, if the disease manifests on the right hand, such as at points 22.01-02 Chong Zi/Xian, the right side should be needled. Similarly, if the external expression of the disease is found at 88.17-19 Sima on the left, then those points should be needled on the left. Another example is a patient with right shoulder pain; according to the rules, the left leg should be needled, but if the external expression of the disease appears on the right leg, then the right leg should be needled instead.

In his book (Tung, 1973), Master Tung specifies various needle depths for different points, each having distinct therapeutic effects. For instance, under 11.01 Da Jian, he indicates that inserting the needle to a depth of 0.1 cun treats Heart diseases, while inserting it to a depth of 0.2-0.3 cun addresses diseases of the Small and Large Intestines. Under point 77.08 Si Hua Shang, he states that needling the point to a depth of 2 cun treats asthma, and to 3 cun, it treats Heart diseases.

Huo Wen Zhi describes three depths for point 33.14 Di Shi: 0.5-0.8 cun for colds and asthma, 1-1.2 cun for Heart diseases, and 1-1.5 cun for Kidney weakness and lower back pain. For point 44.09 Di Zhong, the depth is 1 cun for mild cases and 2 cun for severe cases, needling on both sides.

Similar to Dao Ma groups, the needle depth can be divided according to the Three Heaters: the surface depth corresponds to the Upper Heater, the middle depth corresponds to the Middle Heater, and the deepest depth corresponds to the Lower Heater. When targeting the Upper Heater, the needle is inserted at the upper level; for the Middle Heater, the needle is inserted at the middle level; and for the Lower Heater, the needle is inserted at the deepest level.

In Tung’s acupuncture, the Three Heaters are manifested on two planes: the first plane involves the division into the Three Heaters within the Dao Ma groups, and the second plane pertains to needle depth, which is also divided into the Three Heaters (see Illustration 20).

The angle of needle insertion is also significant, with some points having several needling angles. For example, Shang Shi (33) treats lower back pain and sciatica with perpendicular needling to a depth of 1-1.5 cun; it treats chest pain with oblique needling toward the radius; and it addresses middle and lower back pain, as well as pain in the scapula and arm, with oblique needling toward the elbow.

Point 22.05 Ling Gu is needled toward 22.09 Wan Shun Er when treating lower back disorders and toward 22.02 Chong Xian when targeting the chest and Lungs.

Transverse needling at Xing Ling (33) at a 15-degree angle toward the arm treats Heart diseases; at a 35-degree angle toward the arm, it treats chest diseases; and at a 45-degree angle toward the fingers, it treats hand and leg disorders. The three points can be threaded to treat a frontal headache.

I discovered by chance that the VAS can be used to determine the appropriate needling depth. After inserting the needle, I would check the points with a Bahr 3V hammer and almost always detected VAS. This led me to believe that I had needled the correct location.

One day, I stumbled upon an intriguing phenomenon: after inserting the needle, I took the patient’s pulse while holding the end of the needle. To my surprise, I felt the VAS response. I realized that holding the needle could generate VAS in active points, and from that day, I began to check the points in this manner.

On another occasion, after needling an active point, I took the patient’s pulse while simultaneously adjusting the needle depth. To my surprise, the VAS disappeared. When I returned the needle to the original depth, the VAS reappeared. This phenomenon repeated itself and led to a shift in my perception. VAS indicates a state of stress or imbalance, and the goal of needling active points is to restore balance to the body. By adjusting the needle depth, we can use the needle to cancel the VAS response. After inserting the needle, the practitioner can take the pulse while varying the needle’s depth to find the depth that cancels the VAS.

Often, after inserting the needle and manipulating it, Master Tung would ask his patients to move the affected area to check for improvement. Based on the results, he would decide whether to continue manipulating the needle or to needle a different point. Young Wei Chieh, one of his students, referred to this technique as Dong Qi Zhen Fa [動氣针法] – the Moving Qi Needling Technique (Young, 2014).

Master Tung’s needling technique is straightforward; he did not employ dispersion and tonification techniques. Instead, he inserted the needle to the desired depth, achieved De Qi, and asked the patient to move the affected area. Since one point can treat multiple conditions, Dong Qi allows the Qi to be directed to the affected area. If the disease is in the chest or abdomen, the patient may be asked to breathe deeply, or the area might be massaged while the patient focuses on it. This technique establishes a connection between the needle and the location of the disease and is particularly effective for treating pain and conditions where the location of the disease is known, such as shoulder pain or pressure in the chest.

Aside from moving the affected area, Qi can also be directed to the site of the disease by guiding the patient and practitioner’s attention. Intention plays a vital role in the art of healing, as both the patient’s and practitioner’s intentions hold healing power. Sun Simiao [孫思邈], a physician and writer of the Sui and Tang dynasties, who received the title “China’s King of Medicine” due to his significant contributions to Chinese medicine and his powerful treatments, wrote: “Medicine is intention. Those who are proficient at using intention are good doctors” (Sun Simiao, Qianjin Wing Fang [千金翼]).

To use intention during treatment, the patient is asked to focus their awareness on the painful area while lying with the needles. They are encouraged to observe the pain and remain present within it. While the practitioner manipulates the needle and the patient moves the affected area, the practitioner can also concentrate their intention on the affected area.

Many practitioners in the West leave needles in place for 15 to 30 minutes. However, in Master Tung’s acupuncture, needles are generally retained for 40 minutes to an hour, and in some cases, if possible, even longer. There is a prominent belief, particularly in the West, that leaving needles in for extended periods can exhaust the patient’s Qi. This belief is based on Chapter 12 of Ling Shu where it is written that needles are left in for ten breaths. However, Leo Lok, a Chinese medicine practitioner and scholar of ancient Chinese texts, found evidence in the ancient scripts supporting longer needle retention times (Lok, no date). He discovered cases where needles were left in for 20 breaths, 35 breaths, and even between 40 and 120 breaths. The idea that needles were left in for only ten breaths likely stems from a misinterpretation.

A remarkable phenomenon that frequently occurs during acupuncture treatment is when patients enter a deep meditative state, which can also lead to deep sleep. I refer to this state as “acupuncture sleep.” Sometimes, it takes time to enter this state, which often occurs after 20-30 minutes of treatment. Another observation that supports extended needle retention is seen in cases where I treated orthopedic issues accompanied by pain and restricted movement. After inserting the needles, I would ask the patient to move the affected limb (Dong Qi), but no change in the pain or mobility was initially observed. After 20 minutes, if there was still no improvement, I would wait another 20 minutes. Often, it was only after 40 minutes that improvement was seen. In these cases, more than 30 minutes were required for a shift to occur in the affected area.

When determining needle retention time, it is important to observe the patient and decide when to remove the needles based on their state. If the patient is in a meditative state or feels they can continue lying down, the needles should remain in place. However, if the patient appears restless, it is better to remove the needles.

Continue reading: Bloodletting