• Fire Needle

  Editor

Fire needle therapy involves the rapid insertion of a needle heated to red-hot into acupuncture points to treat diseases. As early as in the “Lingshu: Official Needles”, it is recorded: “For those who use the quenching needle, the burning needle is used to treat bi (obstruction).” The “Shanghan Lun” also discusses the indications and contraindications for fire needle therapy. The “Qianjin Yifang” states, “For treating boils and abscesses, the needle must be extremely hot.” The “Zhenjiu Dacheng” summarizes the experiences of using fire needles for treatment before the Ming dynasty, which can be referenced. This method has the effects of warming the meridians, dispersing cold, and promoting circulation, thus it can be used clinically for treating conditions such as cold-induced abscesses and swellings.

• Chinese Name

• 火针

• Foreign Name

• Fire Needle

• Property

• Traditional Chinese Medicine treatment tool

• Source

• “Lingshu: Official Needles”

Table of Contents

1. 1 Needles

2. ▪ History

3. ▪ Introduction to Fire Needle

4. 2 Operation Method

5. 3 Indications

6. 4 Precautions

7. 5 Clinical Applications

8. 6 Fire Needle Therapy

9. ▪ Overview

10. ▪ Needling Method

11. ▪ Contraindications

12. 7 Common Questions

13. 8 Notes

Needles

Editor

History

Fire needle therapy has a history of thousands of years in China, with the earliest records found in the “Huangdi Neijing”. With the clinical application and research by physicians throughout the ages, fire needle therapy has continuously developed and improved, becoming a unique medical system within acupuncture therapy.

Introduction to Fire Needle

Typically, a thicker stainless steel needle is used, such as a round needle or a 24-gauge 2-inch stainless steel needle. There are also specially made needles, such as spring-type fire needles, three-headed fire needles, and fire needles made from tungsten alloy. The spring-type fire needle allows for rapid insertion and easy control of the depth of needling, while the three-headed fire needle is often used for treating surface moles and warts.

Fire Needle

[Explanation] It is also known as burning needle or quenching needle.

[Indications] It is primarily used for treating bi pain caused by wind-cold muscle spasms, or paralysis where the needle is quickly inserted and withdrawn, and pressing the hole can stop the pain; if not pressed, it can be extremely painful. For abdominal masses caused by cold accumulation, the needle is inserted slowly and withdrawn while rotating to allow the impurities to flow out. For back abscesses with pus but no head, the needle is inserted to allow the pus to flow out without pressing the hole. When using fire needles, they should not be inserted too deeply, as this can injure the meridians; nor too shallow, as the disease will not be resolved. Fire needles should not be used on the face or on the feet during hot and humid summer months. Usage: Fill a bowl with sesame oil, light 14 wicks, coat the needle multiple times with sesame oil, and heat it over the flame until it glows red before use. If the needle is not heated red or has cooled down, it can cause harm and will not relieve pain.

Operation Method

Editor

1. Selection of Points and Disinfection: The selection of points for fire needles follows the same basic principles as for fine needles, determined by the specific symptoms. After selecting the acupuncture points, appropriate positioning should be taken to prevent the patient from changing positions, which could affect the accuracy of the point selection. The number of points selected should be minimal, and for patients with excess conditions or younger individuals, slightly more points may be selected. After determining the points, thorough disinfection is required. The disinfection method should first use iodine tincture, followed by alcohol cotton balls to remove iodine to prevent infection.

2. Heating the Needle: Heating the needle is a critical step in using fire needles. The “Zhenjiu Dacheng: Fire Needle” states, “Heat over a lamp until it glows red; using it in this way is effective. If it is not red, it cannot treat the disease and may harm the patient.” Therefore, the needle must be heated red before use to be effective.

A convenient method is to use an alcohol lamp to heat the needle, but there are also drawbacks. Some practitioners use a lighter and a disposable 5ml syringe (with a needle) for fire needle therapy for spinal injuries and pediatric cerebral palsy, which has shown definite efficacy.

3. Needling and Depth: When needling, use the heated needle to quickly insert into the selected acupuncture point and then swiftly withdraw it. Regarding the depth of needling, the “Zhenjiu Dacheng: Fire Needle” states: “Avoid going too deep, as it may injure the meridians; if too shallow, it cannot treat the disease, only lightly touching the surface.” The depth of fire needle insertion should be determined based on the condition, constitution, age, and the thickness of the muscle and depth of blood vessels at the needling site. Generally, for limbs and the waist and abdomen, the needle can be inserted slightly deeper, about 2-5 fen (0.6-1.5 cm), while for chest and back points, it should be shallower, about 1-2 fen (0.3-0.6 cm), and for the Jiaji points, it can be 3-5 fen (1-1.5 cm) deep.

Indications

Editor

Fire needles have the effects of warming the meridians, promoting circulation, and dispelling wind and cold. They are mainly used for bi syndrome, gastroptosis, epigastric pain, diarrhea, dysentery, impotence, scrofula, urticaria, irregular menstruation, dysmenorrhea, pediatric malnutrition, as well as flat warts and moles.

Precautions

Editor

1. Caution should be exercised when using fire needles on the face. The “Zhenjiu Dacheng: Fire Needle” states: “Fire needles can be used on all parts of the body, but should be avoided on the face.” This is because fire needle insertion may leave small scars; therefore, fire needles are generally not used on the face except for treating small areas of vitiligo, moles, and flat warts.

2. Fire needles should also not be applied to areas with major blood vessels and nerves.

3. After needling, if there is redness or swelling in the area that does not completely disappear, bathing should be avoided to prevent infection.

4. Fire needles should not be used for febrile conditions.

5. If there is itching at the needle site, do not scratch with hands to prevent infection.

6. Needle hole treatment: If the needle is inserted 1-3 fen deep, no special treatment is needed. If the needle is inserted 4-5 fen deep, apply a disinfected gauze pad and secure it with tape for 1-2 days to prevent infection.

Clinical Applications

Editor

1. Fire needle therapy for herpes zoster

Xu used a 26-gauge 1.5-inch needle heated over an alcohol lamp, quickly inserted it into the rash, and immediately withdrew it, puncturing each blister once and applying purple medicine.

2. Fire needle therapy for shoulder periarthritis

Xia used a 20-22 gauge thick needle or a sewing needle wrapped with cotton thread at the base, heated it until it turned red and white over an alcohol lamp, quickly and accurately inserted it into the affected side’s Jianyu point, and then swiftly withdrew it, applying a disinfected gauze pad to the needle hole once a week.

3. Fire needle therapy for incarcerated internal hemorrhoids

Zhang lightly pressed to determine the center of the hemorrhoid, used a No. 7 injection needle heated over a lamp, adhered sulfur powder, quickly inserted it into the center of the hemorrhoid, and immediately withdrew it, then applied gauze externally and used Sichuan pepper water for sitz baths.

4. Fire needle therapy for low back pain

Zheng divided patients into two groups, one group treated at Weizhong, Shenxu, and Yaoyan points, while the other group treated at Kunlun, Qihai, and Zhishi points. Both groups alternated, using fire needles connected to electricity until the needle tip turned red, inserting 3-5 mm deep, and quickly withdrawing.

5. Portable electronic fire needle therapy for surgical conditions

Connect the power supply, turn on the electronic fire needle treatment device indicator light, hold the fire needle handle, press the switch until the needle tip heats up and turns red, then operate. Aim the fire needle at the center of the lesion and quickly burn to the base; for papillomas, first pull the lesion outward with tweezers, then place the fire needle horizontally after heating, cutting from the root, which can be removed in seconds. Xu used this method to treat common warts, pigmented moles, papillomas, flat warts, keratoacanthomas, sebaceous gland tumors, and corns.

6. Fire needle therapy for pigmented moles and warts

Ma used fire needles of 0.5, 1.0, and 0.25 mm in diameter developed by Ansteel Automation, heating the needle tip over a lamp, quickly burning the affected area, and repeating until completely burned.

7. Fire needle combined with cupping therapy for knee joint effusion

After routine disinfection, use a fine fire needle heated to incandescence to quickly puncture the high protrusion of the joint; if effusion flows out, puncture 5-7 times; if the effusion is thick and difficult to expel, use a thicker fire needle heated red to puncture, then use the flash fire method for cupping, which can yield light yellow effusion, and bandage to secure the knee joint. After the effusion is eliminated, switch to local acupuncture points.

8. Fire needle therapy for lateral epicondylitis

Locate the tender points between the lateral epicondyle of the humerus and the neck of the radius, disinfect, quickly insert the fire needle 2-3 times, leave the needle for 1-2 minutes, and then apply cupping for 10 minutes.

9. Fire needle bloodletting therapy for gout

Main points: Xingjian, Taichong, Neiting, and Xian Gu. For damp-heat accumulation, add Qiu Xu, Dadu, and Taibai; for blood-heat stagnation, add Xuehai and Ge Shu; for phlegm obstruction, add Fenglong and Pi Shu; for liver and kidney yin deficiency, add Taixi and Sanyinjiao, all on the affected side. Use a thick fire needle for foot points and a fine fire needle for other points. After disinfection, quickly insert the heated fire needle 0.3-1 inch deep, 1-3 needles per point. For foot points, the amount of blood should be less than 100 ml each time.

10. Fire needle warming method for alopecia areata

Points: Ashi points, Shen Shu, Gan Shu. Use a three-headed fire needle for Ashi points, and a single-headed fire needle for the other two points, disinfect the area, and quickly puncture the heated fire needle at the acupuncture points.

11. Fire needle combined with external application at Yongquan point for recurrent oral ulcers

Expose the wound; if the wound is too large or numerous, first perform mucosal anesthesia, then puncture the wound with the heated fire needle, ensuring to clean without damaging normal mucosa, and then apply a paste of Wu Zhu Yu mixed with vinegar to the Yongquan point, securing it with musk bone-strengthening plaster for 24 hours.

12. Fire needle as the main treatment for stubborn facial nerve paralysis

Facial points: Yuyao, Sizhu Kong, Cuanzhu, Sibai, Yangbai, Xiaguan, Yingxiang, Dicang, Jiachao, Taiyang, and Touwei; select 5-6 points each time. Body points include Hegu, Zusanli, and Taichong. Use a single-headed fire needle (d=0.5mm) heated red to puncture the points, inserting 1-2 fen deep without leaving the needle; then use fine needles for needling, employing even tonification and reduction methods.

13. Fire needle therapy for fluorosis

Points: Jiaji points and Ashi points. Fluorosis is a local disease, and the number of points selected depends on the individual and symptoms. Fire needles should be heated until bright white, quickly inserted and withdrawn, about 1 inch deep, and after needling, apply cupping (using warm herbal decoction), changing when it cools, for 30-60 minutes each time.

Fire Needle Therapy

Editor

Overview

Fire needle therapy, also known as “quenching needle” or “burning needle”, is a method of rapidly inserting a needle heated to red-hot into the body to treat diseases.

The “Lingshu: Longevity and Short Life” states: “For those wearing coarse cloth, use fire to quench it.” The “Lingshu: Official Needles” states: “For quenching needles, the burning needle is used to treat bi.” Zhang Zhongjing’s “Shanghan Lun” contains records such as “burning needles induce sweating”, “fire reverses downward, causing agitation”, and “both exterior and interior are deficient, yin and yang qi are both exhausted, without yang, only yin remains, and further burning needles…” It was not until the Tang dynasty that Sun Simiao formally named it “fire needle” in the “Qianjin Yaofang”. The Ming dynasty’s Yangzhou’s “Zhenjiu Dacheng” describes it most thoroughly: “Frequently dip the needle in sesame oil, heat it until it glows red, and it will be effective. If it is not red, it cannot treat the disease and may harm the patient.” Ming dynasty Gao Wu’s “Zhenjiu Juying” states: “Fire needles can be used on all parts of the body, but should be avoided on the face. In summer, when the blood is abundant, it flows down to the feet, fire needles should not be recklessly used on the feet… Fire needles are suitable for breaking abscesses and toxins, causing pus to flow out when there is no head on the skin, but only pressing on soft swellings that are not firm.” This indicates that fire needles were widely used in clinical practice during the Ming dynasty. In modern times, fire needles are generally used in two situations: long needles for deep insertion, treating scrofula, elephantiasis, and abscesses to drain pus; short needles for shallow insertion, treating rheumatic pain and cold numbness of the skin.

Needling Method

1. Use 22-28 gauge stainless steel needles, with the needle handle wrapped in cloth to prevent heat conduction. During the procedure, disinfect the affected area and surrounding skin with iodine tincture and alcohol, then perform infiltration anesthesia with 2%-10% procaine (which can be mixed with 0.2% hydrochloric epinephrine to prevent bleeding) for about 2 minutes. Heat the needle over an alcohol lamp until it glows red, hold the affected area with the left hand, and insert the needle quickly into the affected area or its surroundings, then immediately withdraw the needle.

2. The depth of needling depends on the type of ulcer and the depth of the lesion. The number of needles used each time is determined by the size of the affected area, generally 1-3 needles.

3. The interval between needling should be 1-2 weeks.

Contraindications

1. Fire needles are contraindicated for pregnant women and the elderly or weak individuals due to their strong stimulation.

2. Fire heat conditions and local redness and swelling are not suitable for fire needle therapy.

3. Patients with hypertension, heart disease, malignant tumors, etc., are contraindicated.

Common Questions

Editor

1. Standardization of fire needle instruments

From the above information, it is clear that fire needle instruments are made from various materials, and many practitioners use steel wire or iron wire to make fire needles, making it difficult to ensure the efficacy and safety of fire needles. It is suggested to use standardized high-quality materials to develop various models of fire needles suitable for different diseases to meet clinical needs and facilitate the application and promotion of fire needle therapy.

2. Strengthening research on the mechanism of fire needle therapy

Any effective therapy has its theoretical and material basis. Fire needle therapy has a long history and unique efficacy, but our understanding of its therapeutic mechanisms is currently limited. Especially, there is a lack of modern scientific research methods to explain its therapeutic mechanisms. Only by clarifying the mechanisms of fire needle therapy can we provide objective and scientific evidence for its application, which will further benefit the development of fire needle therapy.

3. Reducing the pain of fire needle treatment

Further improvements in the quality and thickness of fire needle instruments, enhancing the operational skills of medical personnel, can increase efficacy and safety while minimizing the fear and pain caused to patients during fire needle treatment.

4. Continuing to expand the application range of fire needles and clarifying contraindications in clinical practice, further exploring the indications for fire needle therapy, such as its recent applications in beauty and mole removal, which have also achieved good results.

In summary, fire needle therapy has undergone thousands of years of accumulation from ancient times to the present, forming a distinct characteristic with definite efficacy. With the advancement of the times and rapid progress in science and technology, we must not only inherit the experiences of ancient fire needle therapy but also utilize modern scientific technology to develop it and give it new connotations, making this ancient and unique acupuncture therapy more suitable for the needs of social development and human health.

Notes

Editor

Fire needle, a type of needle instrument, is mentioned in the “Qianjin Yaofang”. Also known as burning needle or quenching needle, it is commonly made of stainless steel, 3-4 inches long, thick and round, sharp and pointed, with the handle made of horn, bamboo, or wood. Some are made of tungsten or molybdenum wire, resembling fine needles but slightly longer, dissipating heat quickly and not easily deforming. When used, the needle is heated red and quickly inserted into the selected area. Care must be taken to control the depth and location; it should not be used near blood vessels, internal organs, or joints. It is mainly used for abscesses, scrofula, stubborn skin diseases, and bi syndrome. It may also refer to the large needle among the nine needles of ancient times.

• References

• 1.郭长青 刘乃刚. 实用火针疗法: 化学工业出版社，2009-5

• Academic Papers

  Content from

• 陆卫卫，吴峻，邵荣世. 火针治疗慢性软组织损伤的实验研究. 《中国针灸》，2002

• 李彬，谢新才，王麟鹏. 火针治疗膝骨关节炎临床观察. 《北京中医药》，2011

• 盛丽，姚伟. 火针治疗子宫肌瘤50例临床观察. 《中国针灸》，1998

• 黄蜀，周建伟，张颜，陈纯涛. 火针疗法治疗痤疮1068例临床研究. 《上海针灸杂志》，2008

• 王宁，李志峰，吴海红. 火针疗法治疗中风后痉挛性偏瘫的临床疗效观察. 《针刺研究》，2015

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