Bloodletting Therapy
(A clinically validated treatment method)
A clinically validated treatment method, bloodletting therapy has been a part of early medical history worldwide.
In Traditional Chinese Medicine (TCM), bloodletting therapy involves puncturing certain acupuncture points or superficial veins to release a small amount of blood. The procedure begins with routine skin disinfection, using a three-edged needle or a thick needle, with quick insertion and extraction, ensuring that the needle is not inserted too deeply. It is commonly used for conditions such as heatstroke, headaches, sore throat, carbuncles, and lower back pain.
The earliest written records of bloodletting therapy in TCM can be found in the Huangdi Neijing, stating, “The puncturing of collaterals involves the blood vessels of the small collaterals”; “When the blood is stagnant, it should be released to eliminate the bad blood.” It explicitly states that bloodletting can treat conditions such as mania, headaches, sudden deafness, heat-induced asthma, and nosebleeds. Legend has it that Bian Que used bloodletting at the Baihui (Hundred Meetings) point to cure Prince Guo’s “corpse syndrome,” and Hua Tuo used needle puncture and bloodletting to treat Cao Cao’s “head wind syndrome.” By the Tang and Song dynasties, this therapy had become one of the major practices in TCM.
Overview: Also known as “pricking blood therapy” or “collateral pricking therapy.” This method involves puncturing acupuncture points, pathological sites, or superficial blood vessels to release an appropriate amount of blood for therapeutic purposes. The three-edged needle originates from the ancient nine needles, specifically the “sharp needle.”
The Ling Shu: Nine Needles states that the sharp needle is primarily used for “draining heat and blood.” The ancients placed great importance on collateral bloodletting, as noted in the Suwen: Blood and Qi, which states, “In treating diseases, one must first remove the blood.” The Ling Shu: Nine Needles and Twelve Originals and Suwen: The Great Treatise on Yin and Yang also propose the treatment principle of bloodletting: “When the blood is stagnant, it should be released,” and “stagnant blood should be drained.” The Ling Shu: Official Needles describes methods such as “collateral pricking,” “supportive pricking,” and “leopard spot pricking” for bloodletting. The Ling Shu: Blood Vessels further clarifies the application scope of bloodletting therapy, stating, “When the blood vessels are full and swollen, they appear red,” and “small ones are like needles, while large ones are like chopsticks,” indicating that only those with significant blood stasis should be drained. This method has the effects of opening orifices, draining heat, invigorating blood, and reducing swelling.
Operational Methods
(1) Needles
The three-edged needle is usually made of stainless steel, with a thicker cylindrical handle and a three-edged body, having sharp edges on three sides. It comes in large, medium, and small sizes, with medium and small being the most commonly used. The needle should be sterilized before use, either through high-pressure sterilization or soaking in 70%-75% ethanol for 20-30 minutes.
(2) Puncturing Method
Before puncturing, the local skin should be disinfected with a cotton ball containing 2% iodine, followed by deiodination with an alcohol cotton ball. The correct way to hold the three-edged needle is to pinch the handle with the thumb and index finger, controlling the direction of the puncture, while the middle finger rests against the lower end of the needle body to control the depth of insertion. There are four methods of puncturing:
1. Point Puncture Method: Before puncturing, use the left thumb and index finger to press and squeeze the area above and below the intended puncture site to accumulate blood at the site. After disinfection, pinch or lift the puncture point with the left hand, while the right hand holds the needle, exposing the tip by 1-2 fen (a unit of measurement), and puncturing to a depth of 1-2 fen, then quickly withdrawing the needle. The left hand gently squeezes around the puncture site, and the right hand uses a disinfected cotton ball to wipe away the blood, allowing several drops to flow out. Finally, apply pressure to the puncture site with a disinfected cotton ball. This method is commonly used for points such as Shixuan, Shierjing, Yintang, and Cuanzhu.
2. Scattered Puncture Method: This method involves puncturing around the pathological area. Depending on the size of the lesion, more than 10-20 needles may be used, puncturing in a circular pattern from the edge of the lesion towards the center to promote the expulsion of stasis or edema, achieving the goal of “when the blood is stagnant, it should be released” and promoting new blood flow. This method is larger in area and involves more punctures compared to the point puncture method, commonly used for local blood stasis, hematomas, or stubborn skin conditions.
3. Bloodletting Method: First, use a rubber band to tie off the upper end (proximal end) of the puncture site. After local disinfection, apply pressure with the left thumb on the lower end of the puncture site, while the right hand holds the three-edged needle and punctures the vein at the site, immediately withdrawing the needle to allow blood to drip out naturally. Release the rubber band, and once the desired amount of blood is obtained, apply pressure to the puncture site with a disinfected cotton ball. The depth of puncture should be determined based on the depth of the vein and the amount of blood. This method is suitable for points on the limbs, such as Weizhong and Chize. It can be performed every 2-3 days, and for larger blood volumes, it can be done every 1-2 weeks. It is commonly used to treat acute vomiting, diarrhea, and heatstroke.
4. Pricking Method: Use the left hand to press the sides of the treatment area or pinch the skin to stabilize it, while the right hand quickly punctures the skin to a depth of 1-2 millimeters, then tilts the needle to break the skin and release a small amount of blood or fluid. Alternatively, the needle can be inserted about 5 millimeters deep, tilting the needle tip slightly to break the underlying fibrous tissue, then withdrawing the needle and covering the site with a dressing. This method is commonly used for vascular headaches, shoulder periarthritis, insomnia, epigastric pain, cervical spondylosis, and bronchial asthma.
(3) Effects
1. Open Orifices and Revive Spirit: For conditions such as heat invading the pericardium, phlegm-fire disturbing the heart, phlegm obstructing the orifices, and excessive anger damaging the liver, leading to symptoms like locked jaw, delirium, unconsciousness, and constipation, bloodletting can effectively open the orifices and revive the spirit. Clinically, it is often used to treat coma, convulsions, mania, and severe heatstroke.
2. Drain Heat and Expel Evil: The bloodletting method has a good effect of clearing heat and draining fire, especially suitable for externally contracted fevers and various Yang excess fevers. Clinically, it is often used to treat certain acute infectious diseases.
3. Transform Stasis and Unblock Meridians: The bloodletting method has the effect of unblocking the meridians, promoting the flow of Qi and blood, and removing stagnation. It is suitable for symptoms caused by Qi and blood stagnation in the meridians or local blood stasis. Clinically, it is used to treat vascular headaches, post-stroke sequelae, and various swellings and pains caused by injuries.
4. Regulate Qi and Nourish Ying: Bloodletting can harmonize the Ying and Wei, suitable for symptoms such as dizziness, headaches, chest tightness, abdominal pain, diarrhea, and insomnia caused by Qi and blood counterflow and disorder of Ying and Wei.
5. Detoxification and Emergency Rescue: Bloodletting has a good detoxifying effect for acute carbon monoxide poisoning, alcohol poisoning, infectious poisoning, and insect or snake bites, allowing toxins to be expelled with the blood.
(4) Acupuncture Point Selection
1. Specific Points: Specific points are often used for bloodletting due to their close correspondence with the internal organs and meridians, having special effects. For example, during emergencies, points like Shixuan or Shierjing are commonly punctured.
2. Extraordinary Points: Extraordinary points have significant effects on certain conditions, thus are often used for puncturing. For instance, puncturing Jinjun and Yuye for treating tongue swelling, or puncturing Taiyang for treating red, swollen, and painful eyes.
3. Other Pathological Reaction Points: For conditions like epigastric pain, vomiting, scrofula, and eye diseases, small dark red spots can be found on the chest, abdomen, or back, which are reaction points of the internal organs on the body surface and can be punctured for bloodletting. For visible veins, points on the head, under the tongue, axilla, elbow, back of the ear, and ear tip are often used for bloodletting. Additionally, bloodletting can be performed at sites of stasis, carbuncles, and skin diseases.
(5) Amount of Bloodletting
The effectiveness of bloodletting with a three-edged needle is closely related to the amount of blood released, which in turn is influenced by the patient’s constitution, the site of bloodletting, and the condition.
1. Minimal Amount: Less than 20 drops, including local congestion and seepage, mainly used for larger superficial conditions such as neurodermatitis, stubborn skin diseases, and chronic ulcers of the lower limbs.
2. Small Amount: More than 20 drops, mainly used for points on the head, face, and limbs (toes) and acute febrile diseases such as acute conjunctivitis and acute tonsillitis.
3. Moderate Amount: Less than 15 milliliters, mainly used for surgical infectious diseases and some acute conditions such as carbuncles, boils, and acute soft tissue injuries.
4. Large Amount: More than 15 milliliters, reaching dozens or even hundreds of milliliters, can be used for certain acute conditions such as stroke and mania.
During treatment, if a large amount of blood is released, it can be spaced out by a week, a month, or even half a year; if a small amount is released, it can be done every 1-2 days.
Health Applications
1. Hypertension: Puncture Taiyang and Yintang, releasing 1-2 milliliters each; puncture Quze and Weizhong, releasing 1-2 milliliters each; puncture Dazhui and Ganshu, releasing about 2 milliliters, plus cupping.
2. Headaches: ① For unilateral headaches, puncture the temporal vein on the affected side to release 2 milliliters. ② For frontal headaches, puncture both Taiyang and Yintang; for migraines, puncture both Taiyang and Shuaigu; for occipital headaches, puncture Dazhui and Baihui. Puncture visible veins around the selected points.
3. Fever: Puncture Shixuan and Yujie, releasing 10-20 drops; puncture Dazhui and Weizhong, releasing 2 milliliters.
4. Common Cold: Puncture Fengmen, Feishu, and Shaoshang, each releasing 3-5 drops; if accompanied by fever, puncture the ear tip to release 3-5 drops. Puncturing both Zhongchong and Shaoshang can prevent influenza.
5. Stroke Closed Syndrome: Puncture along the veins, ear back veins, or temporal veins to release 50-100 milliliters. For sequelae, puncture Baihui, Shixuan, and Weizhong, releasing several drops at each point. Prevention: puncture Zusanli, Quchi, and Dazhui, releasing several drops.
6. Cough: Puncture Chize and Fenglong, releasing several drops; or puncture Feishu, plus cupping. For chronic cough, the Yujie may show visible veins, puncture to release blood; if phlegm is stagnant, puncture Gongsun and Rangu, which may show purple veins, puncture to release blood, plus puncture Fenglong and cupping.
7. Stomach Pain: Puncture Zusanli to release 3-5 drops, plus Zhongwan and Liangqiu with cupping; puncture Neiguan and Gongsun, releasing 0.5-1 milliliters each.
8. Epilepsy: Puncture Fengfu to Changqiang, releasing 2-3 drops between each spinal spinous process; puncture Zhongwan, Jueque, Jiutai, and Shenting, releasing 2-3 drops at each.
9. Shoulder Periarthritis: Puncture the three shoulder points and Ashi points, releasing about 3 milliliters, plus cupping.
10. Lower Back Pain: Puncture visible veins at Weizhong, releasing about 3 milliliters. Puncture Shenshu and Ashi points, releasing about 1 milliliter each, plus cupping.
11. Stiff Neck: Puncture Tianzhu and Dazhu on the affected side, each releasing 0.5 milliliters; puncture Fengchi, Jianjing, and Ashi points, each releasing 0.5 milliliters.
12. Erysipelas: Puncture Xuehai, Diji, Yinbai, and Shaoshang, releasing several drops; at the lesion site and surrounding dilated small veins, puncture and cup, releasing several milliliters; puncture along the “red line” in segments, releasing several milliliters.
13. Hemorrhoids: Puncture the gum junction or small nodules on the frenulum, releasing 1-2 drops; puncture Weizhong, Changqiang, and Dajiang, releasing 5-10 drops.
14. Boils: Lightly puncture several drops of blood around the boil on healthy skin; puncture Dazhui and Chize at the distal or adjacent points of the meridian of the boil, releasing several drops.
15. Breast Abscess: Puncture Shanzhong after cupping, puncturing Shaoshang to release 3-5 drops; puncture Jianjing to puncture visible veins around the affected breast, releasing 2-4 milliliters.
16. Soft Tissue Sprains: Puncture the area of swelling and pain, plus cupping as needed.
17. Hordeolum: Puncture Quchi, Taiyang, and Ganshu, releasing 5 drops; puncture the ear tip to release about 10 drops; search for reaction points in the scapular area on the back (if no reaction point, puncture the Huhuang point), releasing several drops.
18. Smoking Addiction: Puncture Lieque, Zhongchong, Shenmen, and Zusanli, each releasing 5-10 drops; puncture the Sweet Spot (midpoint between Lieque and Zhongchong), releasing 5-10 drops; puncture ear points for lung, trachea, Shenmen, Pingjian, and brain, alternating between both ears.
Precautions
When using the three-edged needle clinically, the following points should be noted:
First, provide adequate explanation to prevent patients from fainting due to fear of pain. Before puncturing, consider the amount of blood to be released based on the condition; do not blindly release blood.
1. The local skin and needles must be strictly disinfected to prevent infection.
2. Familiarize yourself with the anatomical locations to avoid injuring deep arteries.
3. Generally, for patients with varicose veins in the lower limbs, select smaller veins at the edges and control the bleeding. For severe varicose veins, bloodletting is not advisable.
4. During point and scattered punctures, the puncture should be shallow, and the technique should be quick, with minimal bleeding.
5. Closely observe the patient’s reactions during the procedure for timely management. If a hematoma occurs, apply pressure to expel the blood, or use cupping; if it does not subside, apply heat to promote absorption. If an artery is accidentally punctured, apply pressure with a cotton ball to stop the bleeding or use other hemostatic methods.
6. Patients with deficiency syndromes, postpartum, or those with a tendency to spontaneous bleeding or persistent bleeding after injury should not undergo this treatment.
New needles should be sharpened on a whetstone before use, referred to as “opening the mouth.” Three-edged needles become dull with use and should also be sharpened to reduce patient discomfort during insertion.
Needles should be sterilized or disinfected before use. High-temperature sterilization or soaking in 75% alcohol for 30 minutes can be used.
Generally, bloodletting therapy includes point bloodletting, meridian bloodletting, stasis collateral bloodletting, micro-collateral bloodletting, reaction point bloodletting, distal bloodletting, local Ashi point bloodletting, treating upper diseases for lower symptoms, and vice versa. Since it primarily treats stubborn pain, the most commonly used method in clinical practice is stasis collateral bloodletting. The manifestation of stasis is generally vascular dilation, but do not consider varicose veins as stasis bloodletting points, as this will not yield effective results.
Bloodletting methods previously common include three-edged needle puncture, which is an ancient traditional method. Other methods include plum blossom needle puncture with cupping, ceramic blade cutting for bloodletting, leech bloodletting, and vacuum machine blood extraction. In recent years, disposable infusion needles have been used for bloodletting, each with its advantages and characteristics. However, traditional three-edged needle puncture remains preferred. The three-edged needle puncture differs from round-tipped needles in effectiveness. Using infusion needles for bloodletting may seem cleaner and less bloody, similar to the difference between plastic vacuum cupping and traditional bamboo fire cupping. Over the years, I have remained steadfast in my preference for bamboo fire cupping, not out of stubbornness, but due to my own understanding and experience gained through years of clinical practice. Although some may find three-edged needle puncture to appear frightening and bloody, during the process, neither my mind nor my eyes perceive it as dirty or terrifying. My mindset is fearless, focusing solely on achieving the best therapeutic effect.
Bloodletting methods include point puncture and scattered puncture, with the latter requiring sharp needles and speed. A quick motion can allow for six or seven punctures in a second, minimizing the patient’s pain. Aside from some painful local areas, point puncture remains the most commonly used method. The technique of holding the needle is crucial; if inexperienced, one can use the middle finger to gauge the depth to avoid puncturing too deeply and injuring nerves or blood vessels. My common technique is a quick jab, pressing the needle tip against the skin to create a small indentation, then quickly lifting the needle to puncture, allowing the stasis blood to flow out. It should be described as sliding in, similar to how an eel slips in, causing the patient to feel minimal pain during insertion.
Before bloodletting, it is best to wear disposable rubber gloves, as this makes the patient feel more secure and protects ourselves. After bloodletting, the gloves can be easily discarded, and hands can be cleaned easily. If puncturing in areas with arteries, first palpate to check for pulsation to avoid injuring arterial blood vessels. There are folk methods for puncturing arterial blood vessels, but it is best for the average person to avoid arterial puncture. If there is long-standing stasis, internal pressure can be high, often resulting in a jetting phenomenon. If the patient stands during bloodletting, the pressure increases, and the blood can spray several meters. Therefore, beginners should not be alarmed if blood sprays out; it is normal.
As long as it is not an artery, the blood will not have a regular pulsating spray. However, if internal pressure is too high, venous stasis may also exhibit pulsation with breathing, which is normal and should not cause anxiety. The stasis blood will gradually slow down, changing color from black to dark red, brown, and finally bright red. I generally judge the amount of blood based on color rather than milliliters. Of course, this is based on a thorough understanding of the patient’s constitution and condition.
The amount of blood released varies; it is not necessarily better to release more. Sometimes, too much can be counterproductive. It should be done appropriately, based on clinical experience. Therefore, bloodletting is not as simple as it appears. Similar symptoms may require only a few drops to be effective, while others may need 200 milliliters without effect. With more experience, one can determine that generally, 20-30 milliliters is common, with a maximum of over 200 milliliters, depending on the patient’s condition and constitution. If there is no stasis or the patient is inherently deficient in blood, excessive bloodletting can be harmful. It is important to release stasis blood moderately; if not fully released, the effect may not be ideal. After releasing stasis blood, it is beneficial to release a little normal blood to accelerate recovery.
Bloodletting in the lower back is primarily aimed at finding reaction points or stasis, and can yield 100-200 milliliters of blood, with very good results. After three-edged needle puncture, once natural bleeding stops, cupping can be used to thoroughly extract any remaining stasis blood. Cupping also has its techniques; it should not be applied cold. I generally heat the cupping vessel with an alcohol cotton ball until it is hot but not burning the skin, then apply it. Plastic vacuum cupping is not recommended; while it may be suitable for non-medical individuals, as a physician, one should avoid such unskilled practices. For effective results, traditional cupping is necessary; hence the name “fire cupping”—fire generates heat, which is essential for invigorating blood circulation and dispelling cold and dampness.
Bloodletting for headaches, whether rheumatic, traumatic, neurogenic, or stasis-type, has shown excellent results. For patients with less visible blood vessels at the temples, a towel can be placed around the patient’s neck, allowing them to pull the towel to compress the same-side carotid artery, causing the temporal blood vessels to bulge, making it easier to puncture. For headaches, a larger amount of blood is preferable, as patients often feel immediate relief and clarity after bloodletting. Many practitioners prefer to use cupping on the temples, but I believe it is best to avoid cupping after puncturing the temples, as it may compress the temporal artery, causing dizziness and discomfort. Allowing the blood to flow out naturally is sufficient; if the puncture is done well and the blood volume is adequate, cupping is unnecessary.
During bloodletting, it is best for the physician to wear disposable gloves. I am performing bloodletting for demonstration purposes, which is why I am not wearing gloves. I do not advocate for bare-handed bloodletting due to hygiene concerns; if there are cuts on the fingers, it can lead to infections. Especially when bloodletting on the head, it is inevitable to touch the patient’s face, and if blood from the hands contaminates the patient’s face, even if the patient does not complain, it can cause discomfort. Wearing disposable latex gloves provides a good impression for the patient.
Some believe that three-edged needle punctures leave larger wounds, are more prone to infection, and are less aesthetically pleasing, causing more pain. However, this is a misunderstanding. Three-edged needle puncture requires skill and must be practiced frequently to master. Many TCM techniques are highly personal; uniformity does not represent TCM, but rather Western medicine. Therefore, those without a solid foundation and practical experience in acupuncture cannot perform well, which is normal. If everyone could master it easily, it would be abnormal for not everyone to become a famous doctor. Some clever individuals may devise methods that allow students without any foundation to quickly grasp the technique, primarily to meet the needs of training programs.
Once the three-edged needle is punctured correctly, there will be no noticeable puncture marks, and the patient will not feel pain. Especially for facial temporal punctures, experience is required to perform well; poor technique can affect efficacy and facial aesthetics. Many novice doctors may feel nervous or clumsy during puncturing, making it difficult to achieve bleeding. If a patient is left with bruising or a “temporal mark” after cupping due to ineffective puncturing, it is not aesthetically pleasing. The technique of bloodletting is closely related to the physician’s mindset; a hesitant or fearful physician will yield different results compared to a skilled practitioner who appears relaxed and confident. This is why I often emphasize the importance of mindset for physicians; a fearless attitude allows one to fully utilize their skills.
Even when magnified, the puncture marks from bloodletting are minimal, resembling a small red mole on the face, and do not significantly affect aesthetics. After bloodletting, the puncture site should be disinfected with 75% alcohol cotton to ensure cleanliness. This is crucial; while we may not achieve therapeutic effects, we must avoid infections. Many individual practitioners lack proper disinfection awareness; I have seen many acupuncturists use 95% medical alcohol for disinfection, believing that higher concentrations yield better results. However, 75% ethanol is the most effective for disinfection. Since 1999, I have not had a single case of infection or inflammation in my acupuncture and bloodletting practice.
After disinfection, applying liquid bandage externally can prevent infection and redness, allowing for quick healing of the puncture site.
Bloodletting therapy can be applied to various body parts, including the head, neck, chest, back, abdomen, and limbs. The selected bloodletting points, aside from painful local areas, are often located along the meridians, yielding excellent results. Clinically, many patients have experienced significant recovery from long-standing ailments after bloodletting, often expressing heartfelt gratitude. Specific points for bloodletting are briefly introduced later; in reality, learning bloodletting therapy is easy, but mastering it requires guidance from a teacher and extensive clinical practice to rapidly improve skills.
It is worth mentioning that during the bloodletting process, some patients may experience worsening or recurrence of symptoms. This phenomenon is akin to snow melting on a sloped surface; as the upper snow melts, it slides down. Bloodletting is similar; once surface stasis appears, it flows from the body to the surface. Experiencing pain during treatment is a sign of stasis blood flowing out. These factors may lead to patients experiencing more severe pain or symptoms that were not present before treatment. This should not be viewed as a deterioration of the disease; rather, it is a “adjustment response” during the treatment process, which generally improves significantly after a few days. I once treated a farmer for lower back pain; after bloodletting, I advised her to return for a follow-up in seven days. The next day, her back pain worsened, but due to transportation difficulties, she endured the pain without seeking medical attention. Surprisingly, three days later, her back pain suddenly improved, and she continued to feel better each day. By the follow-up appointment, she reported no pain at all.
Observations of impurities during bloodletting and cupping:
1. If the blood is dark and thick, it indicates a long-standing condition, suggesting stasis blood has been stagnant for a long time.
2. If the blood contains water, it indicates rheumatic disease or liver disease.
3. If the blood contains jelly-like mucus, it indicates damp-heat stasis.
4. If the blood is very light, it indicates inflammation or an early-stage condition. Purple-red blood indicates a new injury.
5. If the extracted fluid resembles wash water, it indicates severe chronic dampness.
6. If clear liquid flows out, it indicates edema.
7. If blisters appear, it indicates excessive dampness.
8. If foamy liquid is extracted, it indicates wind evil.
9. If a large amount of blood is extracted, it indicates a longer disease course.
10. If a small amount of blood is extracted, it indicates a shorter disease course or deeper disease location.
11. When removing the cupping vessel, if a rush of warm air is felt, it indicates heavy damp-heat.
12. If bleeding is slow and multiple punctures are needed, it indicates Qi deficiency and blood deficiency.
13. If the blood is light and does not coagulate easily, it indicates blood deficiency.
14. If the blood settles quickly and coagulates, it indicates Qi deficiency.
15. If pain decreases during the day but worsens at night, it indicates stasis blood, requiring further puncturing until alleviated.
Bloodletting emergency technique for stroke:
When someone suddenly suffers a stroke, the microvessels in the brain are slowly rupturing. If someone has a stroke, do not panic, regardless of where the patient is (bathroom, toilet, or public place). Do not move them hastily, as this may accelerate the rupture of microvessels. Instead, support the patient in a seated position, preventing further falls. The best emergency method is bloodletting. If a three-edged needle is available, that is best; if not, use a disposable syringe needle, sewing needle, or large pin. If none of these are available, a piece of glass or a broken dish can be used, sterilized with fire if possible. If sterilization is not feasible, time is of the essence; quickly puncture the tips of all ten fingers (about one fen from the nail) to release blood. If blood does not flow, apply pressure with the hand. Ensure that all ten fingers bleed (1-2 drops per finger), and within a few minutes, the patient will naturally regain consciousness.
For patients with cerebral hemorrhage (stroke), those who bleed will inevitably be unconscious. For those trained in bloodletting, puncture Yintang, Taiyang, Taichong, and Shizhi to release 1-5 drops. If the mouth is also crooked, rub the earlobes until red and puncture each to release a few drops of blood, which can help promote early awakening and reduce the severity of paralysis. Remember: if a patient is unconscious for more than 24 hours, the rate of paralysis is over 90%. If it exceeds 72 hours, the rate of paralysis sequelae is 100%. It becomes extremely difficult to treat. Therefore, promoting early awakening is a priceless secret. Once the patient regains consciousness, puncture Dazhui, Quchi, and Weizhong, and the patient is likely to recover quickly. Some patients have been stabilized after bloodletting emergency treatment, and once their condition stabilizes, they can be sent for further medical examination, ensuring a safe transition from danger.
Most Useful Acupuncture and Bloodletting Prescriptions
20 Most Useful Acupuncture Prescriptions:
1. Acute lumbar sprain: Puncture Renzhong at a 15-degree angle towards the nasal root for strong stimulation, instructing the patient to rotate their waist. One treatment is sufficient!
2. Aphasia: Puncture both sides of Yongquan, or use electroacupuncture. Generally, 1-2 treatments suffice for recovery.
3. Migraine: Puncture Yanzhong and Xuankong on the affected side or bilaterally, leaving the needle for 30 minutes. Generally, one treatment is sufficient.
4. Acute myocardial infarction: Puncture both Neiguan points directly, applying strong stimulation for 2 minutes, then leaving the needle for 15 minutes. One treatment shows significant effects or cures.
5. Stiff neck: Puncture Houxi and Laogong. For short-term conditions, one treatment is sufficient.
6. Tongue protrusion: Puncture Neiguan, either directly or simultaneously. One treatment shows significant effects or cures.
7. Palpitations: Rapidly puncture Shenmen 0.3-0.5 inches deep, stimulating moderately after obtaining Qi. Leave the needle for 30 minutes, performing needle manipulation every 10 minutes. Once daily for 3-5 treatments is sufficient. Combining with Neiguan yields better results.
8. Rhinitis: Deeply puncture Yintang towards the nasal root 0.5-1 inch; generally, one treatment shows significant effects, with 3-10 treatments leading to recovery. Efficacy rate is 96%.
9. Acute tonsillitis: Puncture both Shaoshang points for bloodletting of about 1 milliliter. Generally, 1-5 treatments lead to recovery, with an efficacy rate of 97%. Alternatively, use penicillin skin test solution, puncturing each point about 2mm deep until a slight burning sensation is felt, then injecting 0.1ml at each point, twice daily for 4-6 treatments leads to recovery with a 100% efficacy rate.
10. Autism: Puncture the heart point and Shen-gen point (the depression at the base of the tongue), twice daily. 6 treatments constitute one course, with 3-20 treatments leading to recovery.
11. Persistent tearing: Puncture Chengqi (affected side), Ganshu, and Taichong, once daily for 1-3 treatments shows significant effects. Combining with oral herbal medicine can lead to faster recovery.
12. Hiccups: Moxibustion on Zhongwan and Weishu, 7-49 moxa sticks at each point. Generally, one treatment is sufficient.
13. Corns: Use a fire needle to quickly puncture the root of the corn until the patient feels pain, then withdraw the needle. Afterward, apply iodine and cover with a bandage; the corn will fall off within 1-4 weeks, with a 96% efficacy rate.
14. Amenorrhea: Puncture Changqiang 1.5-2 inches deep, leaving the needle for 30 minutes. 1-2 treatments are sufficient; if not effective, it is deemed ineffective.
15. Functional uterine bleeding (metrorrhagia): Puncture Yinbai. 1-2 treatments are sufficient!
16. Rectal prolapse: Puncture Baihui 2 inches deep along the skin, leaving the needle for 30 minutes, performing needle manipulation every 5 minutes. Generally, one treatment is sufficient.
17. Ankylosing spondylitis: Puncture Renzhong, Changqiang, and Yongquan, combining with tongue needle at liver and heart points. One treatment shows significant effects, with 1-5 treatments leading to recovery.
18. Epilepsy: Puncture tongue needle at heart and liver points, once daily. For mild cases, generally 3-10 treatments lead to recovery. For severe cases, combine with herbal medicine.
19. Throat obstruction: Puncture both Hegu points through Laogong, generally one treatment is sufficient. Alternatively, puncture Neiguan for similar effects; combining with three-edged needle bloodletting at both Shaoshang points yields better results!
20. Stomach pain: Puncture Xuehai, which can immediately relieve pain. For gastric prolapse pain, puncture the stomach-raising point (2 inches above the Tian Shu point, 2 fingerbreadths from the navel) at an angle.
Bloodletting Insights
1. For treating patients with cerebral hemorrhage (stroke):
Those who bleed will inevitably be unconscious. Puncture Yintang, Taiyang, Taichong, and Shizhi to release 1-5 drops, which can promote early awakening and reduce the severity of paralysis. Remember: if a patient is unconscious for more than 24 hours, the rate of paralysis is over 90%. If it exceeds 72 hours, the rate of paralysis sequelae is 100%. It becomes extremely difficult to treat. Therefore, promoting early awakening is a priceless secret. Once the patient regains consciousness, puncture Dazhui, Quchi, and Weizhong, and the patient is likely to recover quickly.
2. For bone nerve pain: If it is gallbladder meridian pain (outer thigh pain), carefully check the Yanglingquan and Fenglong points for any visible blood vessels; if present, bloodletting often leads to recovery.
3. For those prone to developing carbuncles and boils, bloodletting at the heart point is advisable.
4. For early-stage conjunctivitis or hordeolum before suppuration, puncture the temporal point, releasing 7-9 drops of blood, and puncture the middle toe on both feet to release 3-5 drops; this can lead to recovery by the next day.
5. For severe rheumatic leg pain, puncture 3 inches away from the third, fourth, and fifth thoracic vertebrae to release blood, often leading to significant effects; many patients with long-standing conditions have recovered after 1-2 treatments.
6. For gastric and duodenal ulcers, puncture the blue veins from Neiting to Jiexi, and puncture near the outer ankle. For gastric ulcers, search for blood vessels within 0.5 inches above and 2.5 inches below the Tiaokou point.
7. For chronic nephritis: (1) Puncture Shenshu for bloodletting; if yellow fluid is present, the patient will recover once the yellow fluid is expelled. (2) Puncture around the kidneys. (3) Puncture around the navel (do not puncture the center of the navel).
8. For hepatitis, puncture Yangjiao, Zusanli, Quze, Yanglingquan, and Sanyinjiao.
9. For liver cirrhosis with ascites: Use the hepatitis points plus Shenshu, Yaoyang, and Tiaokou (0.5 inches above and below) and Ganshu.
10. Effective points for hemorrhoids: (1) Puncture the Huajiao point (inside the mouth) to find the white granular point, which can lead to recovery in 1-3 treatments. (2) For red, swollen, and ulcerated anal areas, puncture Weizhong to relieve pain.
11. For insomnia: (1) Puncture Shenmen, Xingjian, and Zusanli. (2) Puncture Dazhui, Shendao, and Zhongwan, followed by cupping.
12. For cervical spondylosis: Puncture tender points, Tianzong, Jianzheng, and Chize points.
13. For any internal injuries to the chest, puncture Dazhui, Jianjing, and then the injury site.
14. For shoulder periarthritis: Puncture Shengu point (1.5 inches below Yanglingquan) and Chize point, which shows effects after one treatment.
15. For acute and chronic throat diseases: Puncture Dazhui, ear tip, ear back veins, Shaoshang, Quchi, and Taiyang, releasing blood to relieve pain.
16. For impotence: (1) Puncture Shenshu and Fuliu for bloodletting, plus Guanyuan and Bladder Shu with cupping for 15 minutes. (2) Puncture Sanyinjiao, Mingmen, and cupping at Shenshu and Xuehai.
17. For hypertension: Puncture Taiyang, Dazhui, ear tip, and Quchi; bloodletting will lower blood pressure immediately. Note: Do not drink water within one hour after bloodletting, or the effect will be diminished.
18. For asthma: (1) Puncture Dazhui, Feishu, Fengmen, Gaimang, and Lieque for bloodletting. Cupping at Zhongfu and Dazhui for 15 minutes.
19. For hyperlipidemia: Puncture Dazhui, Taiyang, Yaoyang, Weizhong, and Quchi.
20. For rheumatic heart disease: Puncture Yangjiao, Chize, and Taiyang.
21. For pterygium: Puncture Shaoze, Zhiyin, ear tip, and Dazhui, every other day for a 10-day course.
22. For otitis media: Puncture the outer ankle joint.
23. For epilepsy: Formula 1: puncture Taiyang, Quze, Weizhong, and Yangjiao. Formula 2: puncture Shaoshang and Renzhong for bloodletting. Formula 3: puncture Ganshu and Dazhui with cupping for 15 minutes. Formula 4: puncture the lower part of the cervical vertebrae and Neiguan with plum blossom needles for bloodletting.
24. For mental illness: Puncture Taiyang, Quze, Weizhong, Shuchong, Yangjiao, Fenglong, and Xinshu, followed by cupping.
25. For back diagnosis: The back should not have prominent blood vessels; if present, it indicates a pathological site. Long-term patients will have black moles on their backs.
Secrets of Bloodletting
For diseases that have not healed after prolonged treatment, bloodletting at the ankles, elbows, wrists, and knees, targeting visible blood vessels, can yield unexpected effects. This is my experience.
Bloodletting is generally not recommended at night; it is best performed in the late morning or early afternoon.
1. Patient, male, 52 years old, visited me on December 26, 2009, complaining of discomfort on the right side, especially difficulty turning the neck and lower back, with a feeling of tightness on the right side and headache with blood pressure at 230/160. I punctured the ear tip, ear back, Shixuan, and Shaoshang, each releasing 1-2 drops. The patient’s neck and lower back improved significantly, with blood pressure dropping to 190/130, and the headache and confusion disappeared. After two days of Western medicine treatment, the patient was able to work.
2. On December 30, 2009, a female patient, 85 years old, was found after falling outside for about 3 hours. Upon examination, her mouth was crooked to the right, her right eye was partially closed, she was aphasic, and her left limbs were numb and stiff, while the right side was basically normal. I instructed her family not to move the patient. I punctured Shixuan, Shaoshang, and ear tips, each releasing 2-3 drops, before sending her to the hospital. During various examinations at the hospital, her mouth returned to normal, and about 2 hours later, she could move her limbs, with only slight slurring in her speech. The patient expressed hunger and ate a bowl of porridge. When I left, the patient was smiling, and the family’s tense atmosphere was completely relieved. At this point, the hospital had not administered any medication.
Bloodletting Prohibitions
The “Bloodletting Prohibition Song”
When performing acupuncture, one must be aware of bloodletting prohibitions, as follows:
In the first month, the second day, the third day, the fourth day,
Fifth day, sixth day, seventh day, eighth day, ninth day,
Tenth day, eleventh month, and the twelfth month,
Especially avoid bloodletting on the last day of the lunar month.
This song is based on the lunar calendar to determine bloodletting prohibitions. For example, the second day of the first month, the second day of the second month, the third day of the third month, etc. Currently, it is the sixth month of the lunar calendar (Xinyou month), so July 27 is a bloodletting prohibition day.
On bloodletting prohibition days and at the end of the lunar month, bloodletting and acupuncture should be avoided, and blood donation is absolutely prohibited, as it may lead to illness. I once knew a young man who fell ill after donating blood during college, requiring hospitalization for about a month each year. This is likely related to the timing. In daily life, there are instances of individuals falling ill due to blood donation, so everyone should be cautious.
Unique Treatment Methods in Hui Medicine
Bloodletting method at the glabella: In Hui culture, this is commonly referred to as “picking the head.” The physician sits opposite the patient, using both thumbs to press the glabella (Yintang point) inward three times, then pinching the glabella with the thumb and index finger to puncture and release blood (using a regular sewing needle). This method is suitable for conditions such as wind-cold colds, headaches, body aches, frontal pain, and aversion to cold.
Temporal bloodletting method: The physician uses the thumb to stroke the forehead outward three times, then pinches the skin at the temporal point with the thumb and index finger, puncturing to release a small amount of blood. This method is suitable for colds, headaches, alternating chills and fever, blood stasis headaches, and hypertension headaches.
Fengmen bloodletting method: The patient stands with their back to the physician, exposing the Fengmen area. The practitioner first strikes the Fengmen area with their palm, exposing the superficial veins. At the midline of the Fengmen area (corresponding to Weizhong point), puncture to release a small amount of blood. This method is primarily used for wind-cold colds, body aches, lower back pain, and abdominal pain.
Middle finger bloodletting method: A red thread is tightly bound around the patient’s middle finger. The practitioner punctures the nail or tip of the middle finger to release blood. This method is suitable for wind-cold colds, pediatric convulsions, and women’s hysteria.
Outer ear bloodletting method: The patient sits with their back to the physician, exposing the outer ear. The practitioner stabilizes the ear, exposing the small veins, and punctures the upper third of the vein with a sharp bamboo stick (or a blunt ceramic piece), releasing a small amount of blood, depending on the severity of the condition. This method is suitable for throat swelling and congestion, tonsillitis, oral ulcers, skin scabies, and neurodermatitis.
Inner Yingxiang bloodletting method: A sharp bamboo stick is inserted 0.5 cm into the patient’s nostril, close to the nostril. The practitioner forcefully flicks the nostril to release a small amount of blood. This method is suitable for acute eye inflammation, red eyes, pharyngitis, and throat congestion.
Joint sprain bloodletting method: For local blood clots from joint sprains, Hui culture often employs local bloodletting combined with cupping to remove stasis, sometimes using children’s urine to promote blood circulation.
Puncturing method: Puncturing the four seams involves using a needle to extract a small amount of yellow mucus from the inner side of the second joint of a child’s finger, primarily used for pediatric malnutrition and chronic digestive disorders.
Puncturing for wool abscess: (Wool abscess corresponds to acute gastric spasms, acute cholecystitis, and other acute abdominal pain symptoms). The method involves first scraping the patient’s back with a smooth-edged coin or a small plate until slight stasis appears. Then, puncture the back with a sewing needle at the identified abnormal points. It may also involve using a small knife to cut. This method is suitable for acute gastritis, acute gastric spasms, and acute biliary colic.
Blowing method: The blowing method includes both the Duer spiritual therapy (a religious term) and blowing medicine. The Duer spiritual therapy involves a clean bowl in which an Imam (religious figure) writes scriptures on the bowl’s wall (in Arabic), adding tea leaves (or corresponding herbal tea) and pouring in boiling water. The Imam recites scriptures and blows into the bowl for the patient to drink. This method has a therapeutic effect on some mental illnesses.
Blowing medicine involves blowing residual carbon into the nasal cavity to stop bleeding. Using soapwort powder to blow into the nose can treat stroke-induced coma. The method of applying salt (i.e., Qingyan fire) to the throat can treat throat inflammation, while using egg yolk oil in the nose can treat nasal mucosa dryness, and using willow leaves, honeysuckle, and white chrysanthemum decoction can wash the eyes to treat acute conjunctivitis.
Bloodletting Q&A
1. Q: What kind of needle is used for bloodletting? Is deeper better?
A: The needle used for bloodletting therapy is a disposable puncture needle used in hospital blood tests. This needle has a separate tip, which can be replaced during use. If blood does not flow, the tip can be sharpened by 0.2-0.3mm (i.e., exposing more of the needle tip). For example, when bloodletting on the head or face, this method can be used. For areas with more muscle, the needle can be sharpened to expose more of the tip. The length of the needle tip used for bloodletting does not endanger vital areas, so there is no need to fear.
2. Q: If the stasis blood is flowing well, why does it suddenly stop?
A: Bloodletting does not need to be performed daily. When the stasis blood is flowing well, bloodletting can be done once a week; when the stasis volume is low, it can be done twice a week, with three extractions each time. It is common for stasis blood to flow well at times and then stop. The stasis in our bodies does not form overnight; it accumulates gradually from the day we are born. Over time, if the concentration is too high, it becomes less likely to flow. If the concentration is low, it flows out easily.
3. Q: If it hurts a lot, is it okay to stop for a while?
A: The intensity of pain during bloodletting is related to blood flow. If there is no pain, it is because blood flow is too low, leading to oxygen deficiency and cell suffocation. If the blood flows normally, those who do not feel pain can feel it; those who feel intense pain will also experience relief.
4. Q: What does it mean if the blood has bubbles?
A: It is not that there are bubbles in the blood; rather, it is due to improper suction during cupping, allowing air to enter from the sides. If the skin is rough or dry, the cup may not adhere well, creating gaps between the skin and the cup, allowing air to seep in and form bubbles. In this case, release the suction and wipe the blood extracted from the cupping site, then reapply the cup, and the bubbles will disappear.
5. Q: What dietary restrictions are related to bloodletting?
A: Avoid beef and do not wash the wound on the day of bloodletting.
6. Q: When can I expect to see improvement after bloodletting?
A: It is difficult to provide a clear answer to this question. Depending on the situation, some may see effects after just one bloodletting; others may take 3-6 months to see results. However, theoretically, this question can be answered. For headaches or muscle pain caused by blood flow obstruction, bloodletting can lead to immediate effects; however, for soft tissue injuries, symptoms caused by inflammatory tissue damage may take 45 days to show improvement. Ultimately, the amount of stasis blood plays a decisive role.
7. Q: What does it mean if blisters appear at the bloodletting site?
A: Blisters may occur if the cupping time is too long without bloodletting or if bloodletting is performed too frequently at the same site. If blisters appear, bloodletting can continue as long as the pain is bearable; however, if bloodletting needs to be stopped, the blisters can be punctured, and the yellow fluid can be wiped away.
Blisters that form during bloodletting will heal within a week as blood circulation improves, so there is no need to worry.
8. Q: How do scars form at the puncture site?
A: Scars at the bloodletting site vary based on individual symptoms. The worse the current condition, the more likely the puncture site will be black or blistered, with more severe scarring. If blood is thick and cannot be fully extracted, this can lead to such symptoms.
9. Q: What does it mean if the stasis blood contains yellow fluid?
A: Yellow fluid indicates long-term kidney dysfunction. If stasis blood is not transformed into fat, the capillaries in that area will become blocked. Uric acid and urea cannot be excreted normally, leading to yellow fluid. As bloodletting progresses, this phenomenon will disappear.
10. Q: Can I drink alcohol during bloodletting?
A: Alcohol should be avoided during bloodletting. Drinking can lead to oxygen deficiency, causing an increased heart rate, which raises blood pressure. The diluted stasis blood may move and block unexpected areas, although the risk is less than 5%. To prevent any issues, it is best to avoid alcohol.
11. Q: Can bloodletting be performed during menstruation?
A: Generally, bloodletting is not recommended during menstruation. This is not due to concerns about side effects, but because menstruation already depletes energy. Bloodletting therapy helps restore Yang Qi; as long as bloodletting is performed on points 2-3-6-8, Yang Qi can be restored. During bloodletting, temporary Yang Qi deficiency may occur, but once blood volume is replenished, conditions like erectile dysfunction and premature ejaculation can be treated.
12. Q: Is bloodletting suitable for rheumatoid arthritis?
A: Yes, and it is very effective. I had a patient who was bedridden due to rheumatoid arthritis; after 23 bloodletting sessions, she was able to get out of bed and now lives independently. Such patients may experience increased pain during bloodletting, which is actually a sign of improvement. If they persist, there is hope for recovery.
13. Q: Are there any side effects of bloodletting?
A: No. After using the bloodletting instruments, we disinfect them. Improper puncture sites will only affect recovery efficacy, not cause side effects.
14. Q: What about adjustment reactions after bloodletting?
A: After bloodletting, some individuals may experience discomfort. This can be due to either exacerbation of existing symptoms or the emergence of previously unknown pains. Both are normal adjustment reactions. The first type of adjustment reaction will disappear with rest and nutritional replenishment. The second type indicates the discovery of new disease sites, which should be treated seriously. For example, our diseases are like icebergs; they form over a long time. When one corner of the iceberg melts, the top of the mountain collapses. This phenomenon reflects in our bodies, which we call an “adjustment reaction.”
Adjustment reactions are temporary and not experienced by everyone. They vary based on the amount of stasis (waste) in each individual’s body. Adjustment reactions may occur in malfunctioning organs, sometimes without our awareness. Once the adjustment reaction concludes, the body feels significantly lighter. During the bloodletting process, multiple adjustment reactions may occur, which is a normal phenomenon.
15. Q: What should I pay attention to after bloodletting?
A: During bloodletting, avoid beef; otherwise, any digestible food is fine. On the day of bloodletting, do not shower, and avoid direct air conditioning on the puncture site. Consuming shrimp skins, grape juice, and iron supplements can aid in blood production.