Lu Shouyan (1909-1969), male, from Kunshan, Jiangsu Province. His father, Li Peiqing, was renowned for his gold needle technique. Lu inherited his family teachings and excelled in his studies, starting his medical practice in 1927. He published articles in newspapers under the title “Yan Lu Medical Talks,” advocating for acupuncture medicine. In 1948, he co-founded the Chinese Acupuncture Research Society with his wife, Dr. Zhu Ruguang, and established correspondence courses and study classes in acupuncture. In 1958, he collaborated with the original Shanghai Teaching Model Factory to create the first electric model of the human body with meridians and acupoints in China. In 1964, he was awarded the second prize for national industrial products. His major works include “Authentic Acupuncture,” “Illustrated Study of Meridians,” “Introduction to Acupoints,” “Collection of Acupuncture Techniques,” and “Atlas of Acupuncture Points.” He served in various roles, including as a consultant at the Second Military Medical University, director of the acupuncture department at Shanghai University of Traditional Chinese Medicine, director of the acupuncture department at Longhua Hospital, director of the Shanghai Acupuncture Research Institute, member of the National Science and Technology Commission, vice chairman of the Shanghai Traditional Chinese Medicine Association, and chairman of the Shanghai Acupuncture Society.
1. Academic Characteristics and Medical Expertise
Lu dedicated his life to the theory and clinical research of acupuncture, gradually forming his academic thoughts and medical style. He particularly emphasized the guiding role of meridian theory in clinical practice. He pointed out that it is essential to identify the location of the disease and which meridian it belongs to; only after understanding the relationship between the disease location and the meridian can one correctly select acupoints. This academic thought permeated his clinical practice from diagnosis to treatment, achieving remarkable therapeutic effects.
1.1 Proficient in Pulse Diagnosis, Emphasizing the Influence of Kidney Qi and Stomach Qi on the Body
Lu believed that pulse diagnosis is one of the crucial bases for determining the techniques of acupuncture, including whether to tonify or drain, as well as the depth and contraindications of needling. The correctness of this method directly relates to improving the efficacy of acupuncture. Based on ancient literature and his clinical experience, he proposed that in addition to palpating the cun (寸) pulse, one should also assess the “Kidney Interstitial Qi,” “Deficiency Pulse,” “Chongyang (冲阳),” “Taixi (太溪),” “Hanyan (颔厌),” and “Taichong (太冲)” pulses, while carefully palpating the skin along the meridians and related acupoints. This comprehensive pulse diagnosis method reflects his academic thought of using meridian theory as the main basis for diagnosis and treatment.
(1) Emphasis on “Kidney Interstitial Qi”
Lu believed that “Kidney Interstitial Qi” is the source of life in the human body and must be carefully assessed. The original qi should be hidden and not excessive; its movement should be slow and not abrupt, corresponding to four or five beats with the cun pulse. If the original yin is insufficient and yang qi is excessive, the pulse will be tight and rapid, indicating the need to tonify the original yin qi by needling Taixi, Fuliu, Shenshu, and Guanyuan acupoints. If the original yang qi has declined, the pulse will be irregular, and the disease may change; moxibustion should be applied to Guanyuan and Qihai acupoints to warm and stabilize the original yang, preventing sudden collapse.
(2) Palpating the “Deficiency Pulse” to Diagnose Stomach and Zong Qi
Lu believed that the pulse should be soft and not tight, slow and not urgent. If the pulse is weak and does not respond to palpation, it indicates a deficiency of Zong Qi and a lack of Stomach Qi. If the pulse is seen to move externally, it indicates a leakage of Zong Qi, which is a sign of critical illness, necessitating urgent tonification of Feishu, Pishu, and Weishu acupoints to nourish the middle earth and manage lung qi. Additionally, tonifying the Zhongfu acupoint can help regulate the body’s qi mechanism, thus offering hope for recovery from illness.
(3) Emphasis on Taixi and Chongyang Pulses to Differentiate Disease Progression and Prognosis
Lu placed great importance on the deficiency and excess of Kidney Qi and Stomach Qi. Therefore, he paid special attention to the diagnosis of Taixi and Chongyang pulses. These two pulses belong to the Kidney and Stomach meridians, respectively, and correspond to the right Guan (关) and both Chi (尺) pulses. Lu often diagnosed these two pulses to help assess the severity of the disease. If the Chongyang pulse is strong, it indicates that Stomach Qi is still present, and although the disease is severe, there is still vitality; if the Chongyang pulse is absent, it indicates that Stomach Qi is exhausted, which is a critical sign. However, if the “Chongyang” pulse is occasionally absent while the Taixi pulse remains strong, it indicates that Kidney Qi is not exhausted, and the root of life is not severed; even in critical conditions, there is still hope for recovery. If the Taixi pulse is absent, it indicates that the disease is in a critical state.
Lu observed that, in addition, if there is excess above and deficiency below, the cun pulse is often larger than the “Chongyang” and “Taixi” pulses; if there is deficiency above and excess below, the cun pulse is often smaller than the “Chongyang” and “Taixi” pulses. If the “Chongyang” pulse is hyperactive, it often indicates excess Stomach fire; if the “Taixi” pulse is dominant, it indicates that the fire of the heart is often intense.
(4) Clear “Hanyan” Pulse and Liver Qi in “Taichong” Pulse
In cases of excessive liver yang, the Hanyan pulse often beats more vigorously, while the cun and Taichong pulses are often thin and weak. In cases of deficiency of both spleen and kidney, where the middle qi is sinking, the Hanyan pulse is weak and difficult to palpate, and the cun and Taichong pulses are also correspondingly thin and weak. For the former, Lu advocated tonifying (or warming moxibustion) the Yongquan acupoint to guide qi and blood downward, while draining the Xuejian acupoint to pacify the liver and extinguish wind, and tonifying Taixi to nourish water and contain wood. For the latter, moxibustion should be applied to Baihui to guide the clear yang upward; additionally, Pishu, Shenshu, and Zusanli acupoints should be needled to tonify the spleen and kidney to treat the root cause.
(5) Detailed Examination of Left and Right Dominance in Cun Pulse Diagnosis
In pulse diagnosis, although ancient practitioners believed that “men are left and women are right” is the norm, Lu believed that the pulse’s left and right dominance indicates a deviation. This is not a good sign, as it suggests an imbalance of qi and blood, often a precursor to a stroke, thus it should not be ignored and should be appropriately addressed to prevent disease before it occurs.
Comprehensive pulse diagnosis can grasp the overall condition of the patient, aiding in accurate differentiation, thus often leading to better therapeutic effects. This can be seen in the following case: A young female patient had experienced joint pain for over ten years, accompanied by palpitations (heart rate 120-130 beats/min), cold intolerance, poor appetite, facial and ankle edema, cyanosis of the fingers and toes, shortness of breath, chest tightness, insomnia, pale complexion, and a weak constitution, with ineffective treatment for a long time. The diagnosis revealed a thin and rapid cun pulse, with no spirit in the Chi pulses, and a rapid movement of qi below the navel, with a slightly responsive pulse to the clothing. The tongue was crimson with a thin coating, indicating insufficient Kidney Qi, leakage of Zong Qi, chaotic movement of fire, and failure of meridian qi to circulate. The treatment plan was to calm the heart and settle the spirit, dispel obstruction and open the meridians, while also stabilizing Kidney Qi. The prescription included needling Shenmen, Xinmen, Neiguan, Hegu, and Taichong for draining, and tonifying Guanyuan and Zusanli. The technique involved twisting and lifting. After three treatments, the palpitations improved, and sleep became more restful. After 20 treatments, the various symptoms gradually disappeared and stabilized, with the pulse becoming slower and more vital, and the movement below the clothing no longer responding, with the movement of qi below the ribs becoming slower and not urgent, allowing her to return to work. Another case involved a young male patient who, due to excessive labor, had depleted his true essence, leading to an inability to transform essence into qi, resulting in asthma, accompanied by dizziness, frequent nocturnal emissions, palpitations, forgetfulness, fatigue, and lower back pain, with a ten-year history and ineffective treatment. The pulse was deep, thin, and rapid, with a large Chi pulse, and a strong Taixi pulse. The tongue had a thin coating and was crimson. This was due to deficiency of both lung and kidney, with yin deficiency and yang excess. The treatment plan was to nourish yin, descend qi, and stabilize essence and calm the spirit. The prescription included needling Feishu, Guanyuan, and Shenshu, while draining Taixi, Fuliu, and Shenmen. The technique involved lifting and inserting. After four treatments, sleep improved, dizziness ceased, nocturnal emissions stopped, energy increased, and the pulse became deep and thin, with Taixi calming down. The fire of the heart had subsided, and Taixi was changed to a tonifying method to enhance the nourishing effect on the kidneys. A total of 12 treatments were given, and all symptoms resolved.
2. In-Depth Study of Needling Techniques, Effective Tonification and Drainage
Lu believed that the correct application of needling techniques is the key to achieving results. When treating internal organ diseases, the use of tonification and drainage techniques is indeed more effective than not using them.
Given the various records of needling techniques in historical texts, which are often conflicting and complex, making it difficult for later generations to follow, Lu comprehensively studied various ancient needling methods, analyzing, summarizing, and categorizing them to systematize and clarify them.
(1) Techniques are divided into three categories: basic techniques, auxiliary techniques, and composite techniques. Basic techniques can be further divided into five types: insertion and withdrawal, lifting and inserting, twisting, direction of needling, and retention of needles, which are basic actions in the needling process. Auxiliary techniques are summarized into sixteen single methods, while composite techniques refer to the comprehensive application of various single basic operations.
(2) Functions are divided into three categories: Lu classified the functions of techniques into three types: inducing (催) qi, guiding qi, and tonification and drainage. The so-called “inducing qi” refers to methods that promote the acquisition of qi through needling. “Guiding qi” refers to methods that direct qi and blood to the disease location. “Tonification and drainage” are techniques designed according to the deficiency and excess of diseases.
(3) Purposes are divided into two categories: Lu categorized the purposes of tonification and drainage into “harmonizing yin and yang” and “regulating Ying and Wei”. The former addresses the “excess” and “deficiency” of qi in the organs and meridians, where “inviting yang inward” is for tonification, and “guiding yin outward” is for drainage, represented by slow tonification and drainage techniques, applicable to all diseases of the organs and meridians characterized by cold, heat, deficiency, and excess. The latter addresses the “over” and “under” of the movement of Ying and Wei qi, where “following and assisting” is for tonification, and “meeting and seizing” is for drainage, represented by following and assisting tonification and drainage techniques, applicable to all diseases characterized by stagnation of the meridians and disharmony of Ying and Wei. Techniques such as “opening and closing tonification and drainage” and “breathing tonification and drainage” also belong to the category of “harmonizing yin and yang”. The techniques of “retaining needles” and “nine-six” are commonly used, depending on the combined techniques. For composite needling techniques, Lu analyzed their combination rules and functional principles, categorizing them into three types and eighteen methods: ① Simple combinations of tonification or drainage techniques: formed by combining techniques of the same functional nature, which can enhance the therapeutic effect, represented by “burning mountain fire” and “piercing sky coolness”. ② Interleaved combinations of tonification and drainage techniques: alternating application of tonification and drainage techniques can achieve both effects, represented by “yang hidden in yin” and “yin hidden in yang”. ③ Mutual combinations of tonification and drainage techniques with guiding qi techniques: formed by combining techniques that tonify deficiency and drain excess with those that guide meridian qi, which has a strong effect on promoting qi and blood circulation and removing stagnation, represented by “green dragon wagging its tail” and “white tiger shaking its head”. This provides a basis for selection in clinical applications.
(4) Creation of five types of guiding qi techniques: Guiding qi techniques are needling methods that have a special sensation conduction phenomenon that can enhance therapeutic efficacy. Lu categorized them as “twisting guiding qi technique,” “lifting and inserting guiding qi technique,” “breathing guiding qi technique,” “pressing guiding qi technique,” and “needle tip guiding qi technique”. To further study the pathways of needling effects and the essence of meridian phenomena, he collaborated with Zhongshan Hospital affiliated with Shanghai Medical University, using multi-directional electromyography to observe the effects of guiding qi techniques on sensation generation, conduction direction, and corresponding electrical changes in acupoints. The observational results showed: ① The relationship between the direction of needling and the sensation conduction direction of the patient: it was found that among 99 needling instances using guiding qi techniques, the sensation conduction direction matched the direction of needling in 70 instances, reaching 71%, with a higher match rate when needling downward than upward. The downward match rate reached 93%, while the upward match rate was 66%. ② The relationship between the direction of needling and the electrical changes at various measured acupoints: when applying guiding qi techniques downward at Zusanli, electrical responses appeared at acupoints below Zusanli in 69% of cases, while upward needling resulted in electrical responses at acupoints above Zusanli in 62%, with no significant electrical responses at other acupoints. ③ The relationship between the direction of needling, sensation conduction direction, and the appearance of electrical changes at acupoints: among 99 needling instances, 52 showed complete agreement, accounting for 53%; 38 showed partial agreement, accounting for 37%; and only 9 showed no agreement, accounting for 10%, indicating a certain relationship among the three. ④ The relationship between guiding qi techniques and general needling techniques on sensation conduction direction: it was found that 71% of cases using guiding qi techniques showed directional sensation conduction, while only 43% of general needling techniques did, indicating a significant difference. This preliminarily confirmed that the directional nature of sensation conduction varies significantly with different techniques.
(5) Research on “burning mountain fire” and “piercing sky coolness”: Lu conducted in-depth discussions on these two composite techniques, from their origins to their applications, and proposed his insights on the key to successful operation: ① Accurately grasping the levels of insertion and withdrawal and the amplitude of lifting and inserting, requiring clear levels and even lifting and inserting. ② Stimulation must be moderate. ③ The procedure must be performed on the basis of obtaining qi. The sensation of heat often arises from the foundation of soreness and distension; coolness often arises from the deepening of heaviness. ④ Patients should be instructed to concentrate and carefully experience sensations to avoid neglecting subtle responses. ⑤ If the purpose of the three degrees of treatment is not achieved, combining with 10-15 minutes of needle retention often enhances efficacy. In clinical practice, Lu applied the “burning mountain fire” and “piercing sky coolness” techniques to treat 11 diseases, including painful obstruction, postpartum rheumatism, gastric prolapse, cyanosis of the fingertips, cold and fever, spleen yang deficiency, kidney yang deficiency, deficiency heat, damp-heat, and muscle atrophy, with a total of 32 cases, achieving effective results in 21 cases, while 11 cases showed no significant efficacy. Among these 11 cases, 7 did not obtain qi during needling, thus the efficacy was poor, indicating that these two techniques have clinical practical value. It was also observed that during 136 needling instances, the “burning mountain fire” technique was applied in 82 instances, with a sensation of heat in 73 instances, accounting for 89%, while the “piercing sky coolness” technique was applied in 54 instances, with a sensation of coolness in 43 instances, accounting for 79%, resulting in a positive response rate of 84%. Further observation of body temperature showed that after applying the burning mountain fire technique, body temperature increased in 58 instances, accounting for 71%, while after applying the piercing sky coolness technique, body temperature decreased in 32 instances, accounting for 60%, with a positive rate of 66% for both.
To further clarify the principles of action of the “burning mountain fire” and “piercing sky coolness” techniques, Lu collaborated with the biochemical research group at Shanghai University of Traditional Chinese Medicine to conduct experiments on the effects of these two techniques on body temperature and certain bodily fluid components, with the entire experimental process designed according to the double-blind principle. The experimental results showed that “burning mountain fire” generally caused a rise in body temperature, with significant increases in blood sugar and plasma citric acid levels; “piercing sky coolness” generally caused a decrease in body temperature, with significant decreases in blood sugar and plasma citric acid levels, while the “plain needling” technique had no significant effect on the three. The experimental results were further confirmed by variance analysis, demonstrating significant differences among the three techniques: “burning mountain fire,” “piercing sky coolness,” and “plain needling.”
Lu’s series of studies on the “burning mountain fire” and “piercing sky coolness” techniques indicate that they not only have subjective sensation changes but also have a material basis. He once treated a middle-aged male patient with a history of asthma, who suddenly experienced dizziness and was unable to move for over ten hours, finding it difficult to lie flat, with a spinning sensation that worsened with movement, low speech, chest tightness, and a pale complexion. This was attributed to deficiency of yang qi, insufficient true qi, and counterflow of qi. The treatment plan was to pacify the liver and harmonize the stomach. The prescription included needling Zusanli and draining Taichong. The technique involved combining needle tip following and tonification and drainage techniques to guide qi downward; lifting and inserting tonification techniques to harmonize yin and yang. Needles were retained for 20 minutes. When needling Zusanli, the initial sensation was empty, but after applying the inducing qi technique, a sensation of tightness appeared under the needle after four minutes, yet the patient still showed no significant response. The needle was gently lifted to the Tianbu point and inserted at a downward angle of about one inch, at which point the patient felt a soreness and distension sensation radiating along the tibia to the dorsum of the foot at the “Fuyang” point, and the chest also felt slightly lighter. The needle was then withdrawn by one inch, and with the same technique, the needle was inserted straight down without moving for about one minute, at which point the patient felt the needling sensation reach the toes, and the slight pulsation indicated that the chest tightness symptoms had disappeared, and the chest felt relaxed. The second acupoint, Taichong, was needled, and the needle was twisted for about three minutes, obtaining qi, followed by slow lifting and pressing techniques for over 20 times to drain the counterflow of liver yang. The patient immediately felt light-headed, dizziness ceased, and he was able to turn his head and look around. Upon follow-up the next day, the patient was nearly recovered, though still slightly fatigued and with weak limbs. The lifting technique was reapplied to tonify the stomach at Zusanli, with needle retention for five minutes to harmonize stomach qi, and after removing the needle, the patient felt slightly more energetic. On the following day, follow-up showed that symptoms had disappeared and physical strength had returned.
3. Strong Advocacy for Warm Needling, Retained Needling, and Moxibustion
Lu realized that warm needling not only has the function of warming and promoting meridian qi but also helps enhance the effectiveness of techniques. Therefore, he strongly advocated for its use. He believed that applying moxa to the needle tip, using the warmth of the moxa fire, can penetrate deep into the skin through the needle body. When meridian qi is deficient, using tonification techniques combined with warm needling can help promote the movement of meridian qi, achieving a warming and tonifying effect; when meridian qi is obstructed by external pathogens, using drainage techniques can help expel the pathogenic qi, allowing the meridians to open and the blood qi to circulate. Thus, warm needling can be applied in both tonification and drainage techniques. However, it is generally not advisable to use warm needling in cases of high fever, local redness and swelling, or convulsions and tremors where needles cannot be retained. Regarding warm needling and moxibustion, Lu believed they are two entirely different treatment methods. Warm needling aims to provide warmth to assist the insufficiency of needling strength, while moxibustion aims to use the heat of fire to invigorate yang and warm the meridians. Therefore, when using warm needling, the moxa cone should not be too large or numerous; generally, one cone is sufficient.
”Retained needling” and “moxibustion” cannot be found in ancient literature, but Lu, through his years of clinical practice alongside his father, believed that during hot summer days, when the body’s pores are open and yang qi is abundant, needling or moxibustion can easily expel external pathogens trapped deep within the muscles and bones through sweating, achieving remarkable results whether tonifying deficiency or draining excess. For example, asthma often occurs in autumn and winter; if moxibustion is performed during the summer, targeting acupoints such as Dazhui, Fengmen, Feishu, Jueyinshu, Tiantu, and Zhongfu, it can reduce the frequency of attacks or prevent them altogether in winter. Continuous moxibustion for three summer days can lead to a complete cure, which is an effective method of treating winter diseases in summer.
4. Draining the South and Tonifying the North as a Method of Balancing
The method of draining the south and tonifying the north is proposed in response to the pathological changes of “excess in the east” and “deficiency in the west”. The “excess in the east” refers to wood excess, while the “deficiency in the west” refers to metal deficiency. Draining the south means draining fire, while tonifying the north means tonifying water. Under the pathological mechanism of wood excess and metal deficiency, wood excess generates fire, and fire excess overcomes metal, so treatment must drain fire to rescue metal to control liver wood. This is the method of draining the child of excess. However, why not tonify the earth mother for metal deficiency but instead tonify water? Lu believed this is a temporary method proposed by ancient practitioners through practice. If the earth is intact, tonifying it will lead to excess, which can hinder water. If water is deficient, it cannot control fire, and if fire is excessive, it will further damage metal. Thus, tonifying water is proposed; if water is not deficient, it can control fire, and if fire weakens, it will not harm metal, allowing metal deficiency to be treated, and metal can then control wood, thus balancing wood. Based on this reasoning, if fire is excessive and water is deficient, when metal is intact, wood can be tonified and earth drained; if earth is excessive and wood is deficient, when water is intact, fire can be tonified and metal drained; if metal is excessive and fire is deficient, when wood is intact, earth can be tonified and water drained; if water is excessive and earth is deficient, when fire is intact, metal can be tonified and wood drained.
5. Light and Heavy Stimulation Should Only Be Considered as Dosage
Currently, some believe that the tonification and drainage techniques of needling can be replaced by light and heavy stimulation, meaning that light stimulation can excite the nerves, which is tonification, while heavy stimulation can inhibit the nerves, which is drainage. Recent practices have shown that this viewpoint does not fully align with the facts. Light stimulation can excite, and heavy stimulation can inhibit; this is the nerve’s response to stimulation, while tonification and drainage techniques are considered from the perspective of meridians and qi and blood, which are fundamentally different and should not be equated. Lu believed that completely replacing tonification and drainage techniques with light and heavy stimulation requires further discussion.
Light and heavy stimulation are not absolutely unrelated to tonification and drainage techniques. Any needling action inherently includes the degree of stimulation. For example, in the lifting and inserting tonification and drainage technique, during tonification, one presses tightly and lifts slowly, while during drainage, one presses slowly and lifts tightly; the so-called tightness and slowness are based on the standard of light and heavy stimulation. Tightness implies heaviness, while slowness is synonymous with lightness. Therefore, in both tonification and drainage techniques, there is an inherent inclusion of light or heavy stimulation. Similarly, in the twisting tonification and drainage technique, the left and right turns also involve the issue of light and heavy stimulation; left turning means applying more force when twisting left and less force when twisting right, while right turning means applying more force when twisting right and less force when twisting left. Thus, light and heavy stimulation should only be regarded as “dosage” and should not be conflated with tonification and drainage techniques.
6. The Retained Needling’s Tonification and Drainage Effects Determine the Nature of the Techniques
Retained needling and tonification and drainage are generally believed to have short-term retention for tonification and long-term retention for drainage. Currently, the method of retained needling is widely used for various diseases, and it indeed yields good results. Therefore, some have questioned the tonification and drainage effects of retained needling. Lu believed that the duration of retained needling is relative, not absolute. Moreover, the tonification and drainage effects of retained needling also depend on the nature of the techniques applied. For example, when retained needling is performed after tonification, it can enhance the tonifying effect; when retained needling is performed after drainage, it can enhance the draining effect. The unique characteristic of retained needling is that it can deepen and strengthen the stimulation of the techniques, thus exerting greater force. During the process of retained needling, tonification or drainage techniques can be repeatedly applied, allowing several weaker stimuli to combine and enhance the tonification and drainage effects. Therefore, retained needling is an important link in the process of tonification and drainage through needling.
2. Selected Medical Cases
Case 1: Vomiting
Chen X, male, 68 years old.
He experienced stomach pain, poor appetite, and vomiting of sour fluid, with pain worsening upon eating, lasting for a year. After treatment with both traditional and Western medicine, there was no significant effect, and vomiting worsened, leading to fatigue. After seven days of supportive therapy in the hospital, his overall condition improved, and he was discharged for recovery. Two months later, he returned to work, but 20 days later, the old illness recurred, with fatigue, coldness, and severe vomiting, making it impossible to eat. After several treatments with both traditional and Western medicine proved ineffective, the patient lost confidence, and his family prepared for the worst. That afternoon, Lu was invited for a consultation. The diagnosis indicated deficiency of spleen yang, with no fuel to digest food. The treatment plan was to warm and tonify the spleen and stomach, applying moxibustion.
Prescription: Zhongkui and Zusanli.
Treatment process: Each acupoint received 11 moxa cones, alternating between the two acupoints. After moxibustion, vomiting ceased immediately. The next day, moxibustion was applied to Zusanli, and the stomach felt warm and comfortable, allowing him to eat porridge, with a significant reduction in stomach pain. Afterward, herbal treatment was administered, and appetite gradually increased, allowing him to get out of bed and walk within ten days, returning to work after a month.
【Note】In this case, prolonged vomiting led to deficiency of spleen yang, with no fuel to digest food, making the condition critical, which could not be remedied without moxibustion. “Zhongkui” is an extraordinary acupoint outside the meridians, known for treating food stagnation and vomiting, which Lu had successfully used multiple times in clinical practice.
Case 2: Tremor (Cerebellar Pontine Atrophy)
He XX, male, 34 years old, first diagnosed on January 29, 1964.
He had been unsteady on his feet for four years, experiencing headaches and dizziness, with blurred vision and occasional tremors, often leaning to the right while walking, difficulty swallowing, fatigue, and irritability. After being diagnosed with “cerebellar pontine atrophy” at X Hospital, he sought acupuncture treatment. Upon examination, his tongue was swollen with a thin yellow coating, and the cun pulse was thin and rapid. The patient had deficiency of both kidneys, with excessive wind yang, and due to prolonged illness, both qi and yin were inevitably deficient. The treatment plan was to tonify the kidneys, soften the liver, and elevate the clear and descend the turbid.
Prescription: ① Fengchi, Fengfu, Sizhu Kong, Xingjian, Kunlun, Weizhong. ② Liver Shu, Kidney Shu, Fuliu, Taixi, Zusanli.
Treatment process: The first group of acupoints used draining techniques, while the second group used tonifying techniques. The lifting and inserting technique was applied without retaining needles. By October 20, 1964, during the fifth treatment, the condition had improved, and he could walk without assistance. By November 17, 1964, during the eighth treatment, the condition had significantly improved, with increased strength in the lower limbs, especially on the left side. After each treatment, symptoms improved significantly within 2-3 days, although vision remained poor with double vision. The pulse was thin, the tongue was pale with cracks, and the coating was thin and greasy. The treatment plan was to further tonify the liver and kidneys, elevate the clear and descend the turbid. The prescription included needling Fengchi, Fengfu, Sizhu Kong, Xingjian for draining, and tonifying Liver Shu, Kidney Shu, Zusanli, Taixi, Guangming, and Taichong. The lifting and inserting technique was applied without retaining needles (when needling Sizhu Kong, the patient felt warmth in the soles of his feet). A complete course of treatment was given, achieving satisfactory results.
【Note】In this case, the patient was diagnosed with “cerebellar pontine atrophy” by Western medicine, and various treatments had proven ineffective. The effectiveness of acupuncture was primarily due to addressing both the symptoms and the root cause, with a combination of tonification and drainage techniques, which is key in treating chronic stubborn diseases. The patient experienced dizziness, irritability, blurred vision, and unsteady gait, with a thin and rapid pulse and a swollen tongue with a yellow coating, indicating deficiency of both liver and kidney, with excessive wind yang. Therefore, Lu used Fengchi, Fengfu, and Xingjian to drain the excessive yang of the liver and gallbladder to treat dizziness; Sizhu Kong was used to clear the hidden heat of the liver and gallbladder to improve vision, which are symptomatic treatments. Simultaneously, tonifying Liver Shu, Kidney Shu, Taixi, and Fuliu to nourish kidney qi to benefit the liver is the root treatment. Zusanli was used to regulate the spleen and stomach, which is the principle of “treating atrophy by targeting the Yangming meridian.” Weizhong and Kunlun were used to regulate the qi and blood of the foot taiyang, as the foot taiyang governs the tendons, and the taiyang qi rises at the Shen pulse, harmonizing the qi and blood of the foot taiyang can strengthen the tendons and improve walking ability.
Case 3: Tinea
Zhang XX, male, 32 years old, first diagnosed on October 14, 1963.
He had tinea on the back of his neck, with unbearable itching, dryness, and scaling, resembling cowhide. Since 1954, he had undergone treatment with acupuncture and medicine, achieving temporary relief but recurring three times over nearly ten years. This time, the condition showed signs of spreading. The diagnosis indicated that it was due to wind-dampness obstructing the skin. The treatment plan was to dispel wind, benefit dampness, and open the meridians.
Prescription: Fengchi, Fengmen, Sanyinjiao, Yinlingquan, Weizhong, Tianjing.
Treatment process: The twisting and lifting technique was applied, with the tinea area treated using a seven-star needle for 15 minutes. By October 21, 1963, during the fourth treatment, the itching had decreased, but the stubborn tinea remained dense, with dry skin. This was due to blood heat generating wind, combined with dampness invading the skin. The treatment plan was to further moisten the skin. The prescription included needling Fengchi, Fengmen, Weizhong, Xuehai, and Tianjing for draining, and tonifying Shaohai. The twisting and lifting technique was applied, with the tinea area treated using a seven-star needle for 15 minutes. By November 1, 1963, during the sixth treatment, the stubborn tinea had reduced itching, with some improvement, but the local skin remained dry and rough. The condition was due to wind-heat accumulating in the blood, with dampness obstructing the skin. The treatment plan was to continue with the previous prescription, supplemented with external washing. The prescription included needling Fengchi, Xuehai, Tianjing, Dazhu, and Tianzhu, with tonifying Shaohai. The twisting and lifting technique was applied, with the tinea area treated using a seven-star needle for 15 minutes. The external washing prescription included: 12g of Cangzhu, 9g of Huangbai, 9g of Baizhi, 9g of Huangqin, 9g of Kushi, 6g of Sulfur, 9g of Tuji, 12g of Difuzi, 30g of Haifeng Teng, and 15g of Gonglaoye. The above prescription was decocted with 15g of rice vinegar for washing the affected area 3-4 times daily, followed by drying and applying a small amount of Vaseline. The combination of herbal washing and acupuncture was used, and by the sixth treatment, the condition had improved, and after two months, he was cured.
【Note】Ancient scholars classified tinea into five types: damp tinea, stubborn tinea, wind tinea, horse tinea, and cow tinea. Although the symptoms vary, they all stem from heat and dryness in the blood, leading to wind toxins flowing to the skin, with some cases involving dampness. Therefore, the treatment should focus on dispelling wind, benefiting dampness, and cooling the blood. Lu selected Fengchi and Fengmen to dispel wind; drained Sanyinjiao and Yinlingquan to benefit water and promote dampness; Weizhong to cool the blood; and Tianjing as the combined earth acupoint of the Sanjiao fire meridian, effectively draining the child, with a cooling effect. The tinea area was treated with a seven-star needle, which is a variation of the “hair needle” and “half needle” methods from the “Neijing” to dispel the wind toxins obstructing the skin. After four treatments, the itching decreased, and the prescription was adjusted to include Xuehai to cool the blood, as “all pain and itching sores belong to the heart,” and Shaohai was tonified to nourish water to control heart fire. By the sixth treatment, the condition had improved, and the prescription was adjusted to reduce the wind-dampness and cooling blood acupoints, while continuing to use the seven-star needle for shallow needling in the local area, along with larger Weizhong and Tianzhu to drain and open the qi of the meridians, supplemented with washing, leading to a cure after two months.
Case 4: Stomach Pain
Xie XX, male, 44 years old.
He experienced sudden stomach pain lasting for a day, and after treatment, the pain did not subside, leading to an emergency visit that evening. Upon diagnosis, both hands had a weak pulse, the tongue was pale and tender, the complexion was pale, the limbs were cold, and the spirit was lethargic, with vomiting of clear fluid and dizziness. This indicated deficiency of spleen and stomach cold, with yang qi not circulating. The treatment plan was to warm the middle, dispel cold, and regulate qi.
Prescription: Needling Neiguan and tonifying Zusanli.
Treatment process: The needle tip was used for tonification and drainage, combined with lifting techniques. Both Neiguan acupoints were twisted simultaneously, and after obtaining qi, the needle tip was angled upward and inserted about one inch, holding still to wait for qi. The patient immediately felt a soreness and distension radiating to the chest and stomach, with immediate relief of stomach pain and bloating. The pulse slightly improved. After needling Zusanli, the patient was able to return home with his wife after 10 minutes. Follow-up the next day showed that he had recovered.
【Note】Lu emphasized the importance of tonification and drainage techniques in clinical practice, believing that “all diseases arise from deficiency and excess,” and acupuncture must utilize tonification and drainage to strengthen the righteous qi and expel evil, harmonizing qi and blood. In this case, the stomach pain was due to insufficient yang qi in the middle jiao, leading to qi stagnation, so the treatment plan involved both tonification and drainage techniques, using the needle tip to guide qi directly to the disease location, resulting in immediate relief of pain, while tonifying Zusanli to support stomach qi, allowing the stomach to relax and all symptoms to resolve.
Case 5: Edema
Xu XX, female, 54 years old.
The edema began in the lower limbs, with poor appetite, loose stools, short and painful urination, gradually extending to the abdomen, facial swelling, fatigue, cold limbs, bloating, and abdominal distension. The tongue was pale and swollen, with a white and slippery coating, and the pulse was deep and thin. This indicated deficiency of spleen and kidney yang, with inability to transform water, leading to internal stagnation of water qi. The treatment plan was to warm yang, strengthen the spleen, promote qi, and benefit water.
Prescription: Feishu, Pishu, Shenshu, Qihai, and Shuifen.
Treatment process: The lifting and inserting technique was applied. Warm needling was used at Pishu and Shenshu, while Qihai was needled without retention, and Shuifen was moxibustioned for 5-10 minutes. During the second diagnosis, there was an increase in urination, and the overall edema had reduced by half, with relief of abdominal bloating. However, there was still loose stools, and urination was clear and prolonged, with a pale tongue and white coating, and a deep and thin pulse. The treatment plan was adjusted to include Feishu, Pishu, Shenshu, Qihai, Yinlingquan, and Shuifen. The lifting and inserting technique was applied, with warm needling at Yinlingquan, while other acupoints were needled without retention, and Shuifen was moxibusted. During the third diagnosis, urination was smooth, and the overall edema had nearly disappeared, with improved appetite and abdominal bloating relieved. Urination was normal, and the spirit was improved, with a slightly pale tongue and thin white coating. The treatment plan was to tonify yang and harmonize the earth. The prescription included needling Pishu, Shenshu, Qihai, and Zusanli, continuing with the lifting and inserting technique. Warm needling was applied at Zusanli, while Qihai was needled with warm needling, and Pishu and Shenshu were needled without retention. A total of three diagnoses were conducted, leading to recovery.
【Note】In this case, the patient presented with poor appetite, short urination, and loose stools, with a deep and thin pulse and a pale swollen tongue, indicating deficiency of spleen and kidney yang. According to pulse diagnosis, this indicated a condition of yin water. Lu selected Feishu to tonify the lungs and promote qi, Pishu to strengthen the spleen to control water, Shenshu to benefit the kidneys and warm yang, and Qihai to tonify true essence, while moxibustion at Shuifen was used to promote urination and clear the bladder. Thus, after diagnosis, urination increased, and edema gradually subsided. During the second diagnosis, Yinlingquan was added to benefit water, tonifying it to support the earth, and draining it to promote water, with both tonification and drainage techniques being the essence of Lu’s methods, leading to recovery after three diagnoses.
Case 6: Acute Convulsions (Meningitis)
Chen XX, male, 7 years old.
The patient presented with opisthotonos, delirium, high fever, and a red, peeled tongue with little moisture. High fever consumed fluids, leading to internal wind movement. The treatment plan was to drain heat, rescue yin, extinguish wind, and calm the spirit.
Prescription: ① Needling: Drain Fenglong, Fengchi, Fengfu, Dazhui, Shenda, Zhongshu, and Jizhong. ② Herbal medicine: One grain of Shenxi Dan crushed and swallowed, with 9g of Banlangen, 9g of Yuanshen, 9g of Jinhua, 9g of Lianqiao, 90g of Zhuye, decocted for oral administration.
Treatment process: The next day, during follow-up, the patient had a significant decrease in black stools, and his spirit was clear, with cessation of convulsions, allowing for recovery after four days.
【Note】In traditional Chinese medicine, meningitis is referred to as “convulsion syndrome,” which is a critical condition. Lu selected Fenglong to drain phlegm heat and calm the spirit; Fengchi, Fengfu, and Dazhui to clear heat and extinguish wind; and Shenda, Zhongshu, and Jizhong to drain the stagnation of the governor vessel, combined with herbal medicine, leading to rapid improvement in the patient’s condition.
Source: “Essentials of Contemporary Chinese Acupuncture Clinical Practice”
Editor: Zhang Ke
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