Definition of Bloodletting
Bloodletting therapy is a unique acupuncture treatment method in Traditional Chinese Medicine (TCM). It is one of the most commonly used therapeutic techniques since the era of the Nei Jing, which even considers bloodletting as the first choice for treating diseases and alleviating suffering.
According to the patient’s specific condition, a three-edged needle or a thick, sharp needle is used to puncture certain acupuncture points or superficial blood vessels on the patient to release a suitable amount of blood, achieving the therapeutic purpose.
Effects of Bloodletting1Antipyretic Effect
In TCM, fever is primarily categorized into two types: Yang excess heat and Yin deficiency. The antipyretic effect of bloodletting is applicable to the former.
Since Yang Qi excess inevitably leads to an abundance of blood, bloodletting can reduce this excess, thereby diminishing the evil heat in the blood vessels and normalizing the body’s Qi and blood.
2Analgesic Effect
TCM holds that “where there is flow, there is no pain; where there is pain, there is no flow.” This means that diseases with pain symptoms must have blockages in their meridians.
Bloodletting can directly expel the stagnant pathogenic factors from the meridians, adjusting the obstructed situation, allowing the meridians to flow freely, and pain can be immediately alleviated.
Many acute conditions, such as wind-cold and wind-heat, have shown rapid and effective results with bloodletting therapy.3Detoxifying Effect
The detoxifying effect in TCM refers to the symptoms that arise when the body cannot resist toxic evils due to pathological conditions, such as “red thread boils” caused by excessive toxic heat.
Bloodletting not only expels the invading toxins from the body but also, more importantly, restores normal bodily functions through the principle of “regulating blood and Qi,” inhibiting the expansion and regeneration of pathogenic evils.4Clearing Heat Effect
TCM believes that internal heat disturbance can lead to various diseases, often manifesting as irritability, limb pain and swelling, impatience, and even fever, confusion, and other symptoms.
Bloodletting can directly expel the heat evils along with the blood, making it suitable for various heat syndromes.
5Reducing Swelling Effect
Swelling and pain are often caused by Qi stagnation and blood stasis, leading to obstruction in the meridians.
Bloodletting can directly eliminate the stagnant Qi and pathogenic factors in the local meridians, promoting unobstructed flow and achieving the goal of reducing swelling.
6Anti-Itch Effect
Itching is a manifestation of wind evils present in the blood vessels, hence the treatment principle of “treating wind by first treating blood; when blood flows, wind will naturally dissipate.”
Bloodletting regulates blood and Qi, ensuring smooth blood flow, thus eliminating wind evils and stopping itching.7Relieving Numbness Effect
Qi deficiency can lead to blood failing to nourish the extremities, or blood deficiency can result in inadequate moisture, often causing numbness.
Using fine needles to puncture the acupuncture points on the affected limbs to release a small amount of blood is guided by the theory of blood moving Qi, yielding good results.
8Anti-Nausea Effect
Acute vomiting often results from excessive heat or liver Qi counterflow invading the stomach or food stagnation. Bloodletting can clear heat and pacify liver counterflow, as well as facilitate the downward movement of intestinal stagnation, thus calming nausea and stopping vomiting.
Methods of Bloodletting01Segmental Bloodletting Method
This method selects acupuncture points for bloodletting based on the location of the disease. For conditions affecting the head, puncture the Taiyang (Sun) point; for conditions above the navel, puncture the Chize (Cubital) or Quxi (Curved Ditch) points; for conditions below the navel, puncture the Weizhong (Middle of the Knee) point. These points are located at superficial large veins and are suitable for puncturing; the Ling Shu states that the Taiyin, Jueyin, and Taiyang meridians are all blood-rich meridians. For those with abundant blood, bloodletting is advisable, and the Taiyang point is an extraordinary point for treating head and facial diseases effectively, while Chize and Weizhong are connecting points, primarily addressing visceral diseases, hence their selection by practitioners.
In clinical practice, it is often necessary to combine other points for puncturing. This method is mainly used for deeper diseases or visceral conditions, where there are local primary symptoms accompanied by systemic symptoms.
For example, for headaches with red, swollen eyes accompanied by fever, puncture the Taiyang point for bloodletting and puncture the Hegu (Joining Valley) point; for headaches and sore throat with fever, puncture the Taiyang point for bloodletting and puncture the Shaoshang (Lesser Shang) and Quchi (Pool at the Bend) points; for red, swollen, painful breasts with fever, puncture the Chize point for bloodletting, combined with local hot compresses; for upper abdominal pain and vomiting with fever, puncture the Chize point for bloodletting and puncture the Zhongwan (Middle of the Abdomen) and Liangqiu (Beam Mound) points; for right lower abdominal pain with constipation and fever, puncture the Weizhong point for bloodletting and puncture the Zusanli (Three Mile) and Tianshu (Heavenly Pivot) points; for lower abdominal pain with purulent blood stools and fever, puncture the Weizhong point for bloodletting and puncture the Quchi and Tianshu points, etc.
02Meridian Following Bloodletting Method
This method is guided by the theory of “where the meridian passes, the treatment follows,” applying bloodletting along a specific meridian or several meridians affected by disease. In clinical practice, the disease is categorized by meridian, and bloodletting is performed along the surface meridians, following the rules of meridian pathways and collateral channels.
This method is not limited to acupuncture points or painful areas; it can also involve puncturing superficial veins along the meridian pathways, emphasizing “better to lose the point than to lose the meridian.”
For example, for acute low back pain occurring on both sides of the spine, it belongs to the obstruction of the foot Taiyang meridian, puncture the Weizhong point for bloodletting and puncture the most painful area of the lower back; for pain along the spine, puncture the Shenque (Spirit Gate) point for bloodletting and puncture the Qihai (Sea of Qi) and Taichong (Great Rushing) points; for wind-heat mastitis with sore throat and difficulty breathing, puncture the Shaoshang point for bloodletting and puncture the Tianzhu (Heavenly Pillar) point; for vertex headache, dizziness, and eye swelling, puncture the Baihui (Hundred Meetings) and Taiyang points for bloodletting and puncture the Fengchi (Wind Pool) point, etc.
03Pattern Differentiation Bloodletting Method
This method is guided by the theories of organ differentiation, Qi and blood differentiation, and meridian differentiation, selecting acupuncture points based on pattern differentiation for bloodletting.
For example, for women with dysmenorrhea and cold pain in the lower abdomen, where abdominal pain precedes menstruation, it indicates Qi stagnation and blood stasis, with obstruction in the foot three Yin meridians. Puncture the Sanyinjiao (Three Yin Intersection) point for bloodletting, which benefits the liver and kidneys and regulates the menstrual cycle, similar to the effects of the Four Substance Decoction, puncturing the Qihai point to regulate Qi, and moxibustion on the Guanyuan (Gate of Origin) point to warm the uterus, collectively achieving the effects of regulating Qi and blood;
for skin itching and redness, indicating heat in the blood, puncture the Sanyinjiao and Xuehai (Blood Sea) points for blood regulation, heat clearing, and menstrual regulation, supplemented by puncturing the Quchi point to disperse wind and the Shaofu (Lesser Palace) point to clear the heart and dissipate heat;
for acute ankle sprains, indicating local meridian Qi obstruction and blood stasis, puncture the Ashihole (Ah Shi point) and Taichong points for bloodletting to promote Qi and invigorate blood;
for carbuncles and boils, based on the principle that “all pain and itching sores belong to the heart,” puncture the Quxi point for bloodletting to drain heat from the heart meridian, and if accompanied by fever, puncture the Dazhui (Great Vertebra) and Quchi points. If the sore appears on the neck and back, puncture the Weizhong point for bloodletting to clear heat from the Taiyang meridian; if it appears on the ribs, puncture the Yanglingquan (Yang Mound Spring) point for bloodletting to clear heat from the Shaoyang meridian; if it appears on the limbs, puncture along the meridian or the Ashihole for bloodletting to drain meridian heat and detoxify.
04Local Bloodletting Method
This method applies bloodletting at the site of the disease, either at acupuncture points or in localized areas, and is more suitable for localized and superficial conditions.
For example, for swollen and stiff tongue, puncture the Jinjing (Golden Liquid) and Yuye (Jade Liquid) points for bloodletting; for toothache and swollen gums, puncture the affected area for bloodletting and puncture the Hegu point; for psoriasis with itching and scaling, use plum blossom needles to prick the local area for bloodletting, combined with cupping; for late-stage filariasis presenting as “rubber leg,” puncture the affected leg in various locations for bloodletting, puncturing the Zusanli and Sanyinjiao points; for joint sprains and swelling, puncture the painful area for bloodletting, etc.
05Emergency Bloodletting Method
This method is specifically used for emergencies and critical conditions, with four main characteristics:
① Located at the extremities, or puncturing the twelve Jing points;
② At superficial large veins;
③ Using extraordinary points outside the meridians;
④ Selecting points on the Du meridian and the Pericardium meridian.
This method provides strong stimulation, rapid effects, and can open meridians, expel heat, and awaken consciousness.
For example, for syncope, puncture the Shixuan (Ten Diffusions) points for bloodletting and puncture the Renzhong (Human Center) point; for stroke with locked jaw, puncture the Taiyang, Quxi, and Weizhong points for bloodletting, or puncture the twelve Jing points, puncturing the Yongquan (Gushing Spring) and Laogong (Palace of Labor) points; for snake bites on the upper limb, puncture the Quxi and Bayao (Eight Evils) points for bloodletting; for bites on the lower limb, puncture the Sanyinjiao and Bayfeng (Eight Winds) points for bloodletting.
For heatstroke, puncture the Quxi and Shixuan points for bloodletting, puncturing the Yongquan point, etc.
Corresponding Acupuncture Points for Different Symptoms1Intracerebral Hemorrhage (Stroke)
For any bleeding, there must be unconsciousness, so puncture the Yintang (Hall of Impression), Taiyang, Taichong, and Shizhi (Ten Fingers) points for 1-5 drops of blood to promote early awakening and reduce the degree of hemiplegia. Remember: if a patient is unconscious for more than 24 hours, the rate of hemiplegia is over 90%. If it exceeds 72 hours, there is a 100% chance of hemiplegic sequelae. Therefore, promoting early awakening is a priceless secret; once the patient awakens, puncture the Dazhui, Quchi, and Weizhong points for bloodletting to give the patient hope for recovery.
2Bone Nerve Pain
If it is pain from the Gallbladder meridian (outer thigh pain), carefully examine the Yanglingquan and Fenglong points for any visible blood vessels; if present, bloodletting often leads to recovery.
3Long Boils and Carbuncles
Puncture the heart point after bloodletting.
4Initial Stage of Conjunctivitis, Stye Not Yet Pus
Puncture the Taiyang point for bloodletting, squeezing out 7-9 drops of blood, and squeezing 3-5 drops from the tips of the middle toes will lead to recovery by the next day.
5Rheumatism
Puncture 3 inches beside the third, fourth, and fifth thoracic vertebrae for bloodletting, and many severe cases have been cured in 1-2 sessions.
6Gastric and Duodenal Ulcers
Puncture the blue veins from the Neiting (Inner Court) to the Jiexi (Stream of Relief) area, and near the outer ankle. For gastric ulcers, look for blood vessels within 0.5 inches above and 2.5 inches below the Neiting point.
7Chronic Nephritis
(1) Puncture the Ruyou (Confucian Scholar) point for bloodletting if there is yellow fluid; once the yellow fluid is gone, the patient will recover.
(2) Around the kidneys.
(3) Puncture around the navel (do not puncture the center of the navel).
8Hepatitis Bloodletting
Puncture the Yangjiao, Zusanli, Quxi, Yanglingquan, and Sanyinjiao points.
9Cirrhosis with Ascites
Use the acupuncture points for hepatitis plus: Shenyu (Kidney Shu), Yaoyang (Lumbar Shu), and Neiting (Inner Court) points (0.5 inches above and 0.5 inches outside), and Gan Shu (Liver Shu).
10Effective Points for Hemorrhoids
(1) Chaojiao (Mouth of the Mouth) point, find the white grain point inside the mouth, and 1-3 sessions will lead to recovery.
(2) For red, swollen, and ulcerated anal areas, puncture the Weizhong point, and the pain will immediately reduce.
11Insomnia
(1) Shenmen (Spirit Gate), Xingjian (Walking Between), Zusanli points.
(2) Dazhui, Shenda (Spirit Path), Zhongwan, puncture and then apply cupping.
12Cervical Spondylosis
Painful points, Tianzong (Heavenly Gathering), Jianzhen (Shoulder Needle), Chize points.
13Chest Internal Injury
Dazhui, Jianjing (Shoulder Well), and then the injured area.
14Shoulder Periarthritis
Puncture the Shen Guan (Kidney Gate) point (1.5 inches below Yanglingquan) and Chize point, effective after one session.
15Acute and Chronic Throat Diseases
Puncture the Dazhui, Erjian (Ear Tip), Yemian (Ear Back Vein), Shaoshang, Quchi, Taiyang points, bloodletting will reduce pain.
16Impotence
(1) Puncture the Shenyu, Fuliu (Reverting Flow) points for bloodletting, Guanyuan, and apply cupping on the Shenyu point for 15 minutes.
(2) Puncture the Sanyinjiao, Mingmen (Gate of Life), and apply cupping on the Shenyu and Xuehai points.
17Hypertension
Puncture the Taiyang, Dazhui, Erjian, and Quchi points for bloodletting, and blood pressure will drop immediately. Note: Do not drink water within one hour after bloodletting, or the effect will be diminished.
18Asthma
Puncture the Dazhui, Pulmonary Shu, Fengmen (Wind Gate), Gao Mang, and Liexue (Broken Sequence) points for bloodletting. Apply cupping on the Zhongfu and Dazhui points for 15 minutes.
19Hyperlipidemia
Puncture the Dazhui, Taiyang, Yaoyang, Weizhong, and Quchi points.
20Rheumatic Heart Disease
Puncture the Yangjiao, Chize, and Taiyang points.
21Otitis Media
Puncture the outer ankle joint for bloodletting.
22Epilepsy
(1) Puncture the Taiyang, Quxi, Weizhong, and Yangjiao points.
(2) Puncture the Shaoshang and Renzhong points for bloodletting. Apply cupping on the Gan Shu and Dazhui points for 15 minutes.
(3) Locate the painful points at the lower part of the cervical vertebra and the Neiguan (Inner Pass) point, using plum blossom needles to prick for bloodletting.
23Mental Illness
Puncture the Taiyang, Quxi, Weizhong, Shuchong (Artisan’s Point), Yangjiao, Fenglong, and Xinshu (Heart Shu) points for bloodletting and apply cupping afterwards.
For diseases that have not responded to treatment, when all methods have failed, one should puncture the blood vessels around the ankles, elbows, wrists, and knees, which may yield unexpected results.
Note: Bloodletting should generally not be performed at night; it is best done in the late morning or noon. This method is not suitable for individuals with weak constitutions, pregnant women, or those with poor coagulation mechanisms. It is particularly emphasized that the technique should be steady, precise, and gentle, rather than too forceful, and bloodletting should not be excessive.