Fire needle therapy, also known as Wēntōng method, is a commonly used acupuncture technique in clinical practice today. During the procedure, a specific fire needle instrument is used, which is first heated by igniting alcohol to make the needle tip red-hot. The heated needle is then quickly inserted into the acupuncture point on the body, achieving effects such as warming the meridians, dispelling cold, unblocking the meridians, promoting tissue regeneration, and alleviating pain.
The operational procedures for “fire needle therapy” are as follows:
(1) Determining the acupuncture point: In addition to directly needling the local lesion, whether selecting meridian points or locating tender points, it is essential to mark the chosen acupuncture point with a thumb nail in a “十” shape before disinfection to ensure the accuracy of the needling.(2) Disinfection: After determining the acupuncture point, use a 2.5% iodine alcohol cotton ball to draw concentric circles around the point for disinfection, followed by a 75% alcohol cotton ball to remove the iodine in the same manner. The procedure can be performed once the alcohol has dried.(3) Heating the needle: Ignite the alcohol lamp and determine the length of the needle to be heated based on the depth of needling. The needle must be heated until it is red-hot.(4) Inserting the needle: When the needle is glowing red, it should be quickly and accurately inserted into the acupuncture point, followed by a swift withdrawal of the needle. This process takes approximately 1/10 of a second.(5) Retaining the needle: Primarily using fast needling, most needles are not retained, while some may be retained for 1 to 5 minutes. For treating painful conditions with fire needles at distal points, a retention time of 5 minutes is required.(6) Withdrawing the needle: When withdrawing the needle, the practitioner should hold a disinfected dry cotton ball to wipe or press in case of bleeding or pus. The needle should be withdrawn quickly once it reaches a certain depth to minimize patient discomfort and prevent enlarging the needle hole, which could lead to small scars.(7) Post-needle handling: Generally, no special treatment is required after fire needle therapy; simply pressing the needle hole with a dry cotton ball is sufficient. This helps alleviate pain and protects the needle hole.Needling techniques of the Wēntōng method are classified based on indications: They can be divided into meridian needling, tender point needling, dense needling, surrounding needling, and dispersive needling.(1) Meridian needling: Based on clinical manifestations, fire needles are applied to meridian points to warm the meridians, promote qi and blood circulation, strengthen the body, expel pathogens, and adjust organ functions. This method is mainly suitable for internal medicine diseases, using fine and medium fire needles. The depth of insertion is relatively shallower than that of fine needles.(2) Tender point needling: The most prominent tender point at the lesion site is located, and fire needles are applied to this point to ensure smooth flow of qi and blood in the local meridians. This method is suitable for muscle, joint, and various neuralgias, primarily using medium fire needles, with deeper insertion as appropriate.(3) Dense needling: This method uses medium fire needles to densely stimulate the local lesion area, with the density depending on the severity of the condition, with closer spacing for more severe cases, typically 1 cm apart. Sufficient heat is used to alter local qi and blood flow, promoting metabolic processes in the affected tissues. This method is mainly suitable for hyperplastic and keratinized skin conditions, such as neurodermatitis. Generally, medium fire needles are selected, and the depth of needling should be moderate, ideally penetrating just through the diseased tissue while barely touching the normal tissue; too shallow or too deep is not advisable.(4) Surrounding needling: This fire needle technique involves needling around the lesion. The insertion points are often located at the junction of the lesion and normal tissue. Surrounding needling is mainly suitable for dermatological and surgical conditions, using medium fire needles, with an appropriate distance of 1 to 1.5 cm between each needle. The depth of needling should be adjusted according to the depth of the lesion; deeper lesions require deeper needling, while shallower lesions require shallower needling. Sometimes, direct needling into the collaterals to induce bleeding may be performed to eliminate stagnation, which is beneficial for local redness and swelling.(5) Dispersive needling: This technique involves dispersively needling the lesion area with fire needles. It is effective for treating numbness, itching, spasms, and pain. Typically, needles are inserted every 1.5 cm. Fine fire needles are preferred, with stimulation kept relatively shallow.
Wēntōng method classified by speed of needling:1. Fast needling method, 2. Slow needling method.(1) Fast needling method: This is the most commonly used fire needle technique, characterized by rapid insertion and withdrawal of the needle. “Fire needle therapy” primarily employs the fast needling method. Generally, the needle is inserted and withdrawn swiftly without pause, taking only 1/10 of a second for the entire process. The heat from the red-hot needle stimulates the meridian qi, promoting qi and blood flow, and warming the meridians.“Fire needle therapy” primarily uses the fast needling method. The quick insertion and withdrawal of the needle is an advantage of fire needles, making it time-efficient and minimizing patient discomfort.
(2) Slow needling method: After inserting the fire needle into the acupuncture point or area, it is retained for a short period before withdrawal. The retention time is typically 1 to 5 minutes. During the retention period, various tonifying or draining techniques may be applied. The slow needling method is effective for expelling necrotic tissue, draining pus, and dispersing masses. It is mainly suitable for conditions such as lymphatic tuberculosis, tumors, cysts, and various diseases involving necrotic tissue and abnormal hyperplasia.
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