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Dr. Cheng Haiying, Chief Physician at Beijing Traditional Chinese Medicine Hospital, specializes in acupuncture for otorhinolaryngological diseases. She successfully treated a patient with diplopia using fine needles, fire needles, and water needles.
Mr. Wang, male, 69 years old. Chief complaint: double vision in both eyes accompanied by right upper eyelid ptosis for 1 month. The patient developed double vision without obvious cause a month ago, accompanied by right upper eyelid ptosis. He visited a nearby hospital where his vision was found to be normal, bilateral retinal artery sclerosis grade I was noted, and a cranial MRI showed generally normal results. He was diagnosed with “incomplete paralysis of the extraocular muscles” and was treated with intravenous infusions of Ozagrel sodium, Kaishi, Shuxue Ning, and Dingluo Dier for one week, with slight symptom relief. Current symptoms: double vision, unable to cross the street alone. He feels a loss of balance when viewing with the right eye alone, accompanied by soreness and swelling in both eyes, and occasional paresthesia in the right side of the face and shoulder. No dizziness, nausea, or visual rotation was observed, and there were no issues with limb movement or numbness. Appetite and sleep were normal, and bowel and bladder functions were regular. The tongue was pale with a thin white coating, and the pulse was slippery. The patient has a 16-year history of type 2 diabetes, with generally acceptable blood sugar control. Physical examination: clear consciousness, fluent speech, equal and round pupils, sensitive light reflex, normal vision, right upper eyelid ptosis, and symmetrical facial wrinkles. Diagnosis: deficiency of essence and qi, with insufficient nourishment to the eyes. Treatment principle: to open the meridians, promote qi flow, and nourish the organs. Treatment methods: ① Fire needles: heat fine needles until red, then quickly puncture the bilateral Yangbai (阳白), Taiyang (太阳), Cuanzhu (攒竹), Sibai (四白), and the Ah Shi points on the upper eyelid, followed by pressing with a dry cotton ball on the puncture sites for a moment, five times a week. ② Water needles (acupoint injection): dissolve 1.5 mg of adenosylcobalamin in 2 ml of sterilized water for injection, injecting 0.4-1.0 ml of the solution at each acupoint based on the depth of the acupoint, selecting bilateral Yangbai, Cuanzhu, Taiyang, and Sibai, five times a week. ③ Fine needles: select bilateral Yangbai, Cuanzhu, Taiyang, Sibai, Biceps (臂臑), Quchi (曲池), Hegu (合谷), Zusanli (足三里), Guangming (光明), Sanyinjiao (三阴交), Taixi (太溪), and Taichong (太冲), retaining the needles for 30 minutes, five times a week.
One week later, the patient reported no double vision when looking straight ahead, but still experienced double vision when strabismic. The right eyelid ptosis significantly improved, allowing for normal daily activities. Due to the patient’s schedule, treatment was changed to twice a week. After continuing the treatment for one month, the patient reported that both diplopia and eyelid ptosis had disappeared, with only slight diplopia when the right eye was turned to the right side, and the paresthesia in the right side of the face and shoulder had resolved. Continued treatment was administered for consolidation.
Note: Diplopia, known in Traditional Chinese Medicine (TCM) as “Shiqi” (视歧), is characterized by seeing one object as two. The “Neijing” (内经) states: “The essence and qi of the five organs and six bowels all ascend to the eyes and become the essence… When the essence disperses, diplopia occurs, and two objects are seen.” Under normal circumstances, the essence of blood from the five organs and the clear yang qi from the six bowels ascend to nourish the eyes, allowing for clear vision. In this case, the patient has a 16-year history of diabetes and is over seventy years old. Chronic illness combined with age can lead to a gradual decline in the essence and qi of the organs, preventing adequate nourishment to the eyes, resulting in diplopia.
The “Neijing” states: “Yangming is the sea of the five organs and six bowels.” The “Classics” states: “Yangming is the convergence, where yang qi is stored internally, being the interior of the three yang channels.” The Yangming meridian, being internal, stores yang qi to nourish the internal organs; thus, deficiencies in the essence and qi of the five organs and six bowels can be treated through the Yangming meridian. The acupoints selected in this case, including Sibai, Biceps, Quchi, Hegu, and Zusanli, all belong to the Yangming meridian, aiming to promote the flow of Yangming qi. “Yangming has abundant qi and blood,” and needling these points can invigorate qi and blood, ensuring sufficient essence and qi to nourish the eyes for clear vision. Yangbai, Sibai, Taiyang, and Cuanzhu are distributed around the eyes, facilitating the local meridian qi and blood flow, complemented by the Yin meridian points Sanyinjiao and Taixi to nourish the liver and kidney essence and blood. The combination of these points, both local and distal, ensures smooth meridian flow and sufficient essence and qi, nourishing the eyes for clear vision. Additionally, Biceps is an acupoint inherited from the renowned TCM physician He Purin, known for its effectiveness in treating eye diseases.
Acupoint injection is a therapy based on the ancient theory of meridians and acupoints, incorporating modern chemical medications. Compared to intramuscular injections, it allows the medication to reach the site of the disease more quickly and effectively. Injecting the medication into the acupoints around the eyes not only directly nourishes the local nerves but also allows the medication to act directly on the affected meridians and acupoints, achieving optimal results.
Furthermore, Dr. Cheng Haiying used fire needles to stimulate local acupoints around the eyes, invigorating yang qi, opening the meridians, and promoting the circulation of qi and blood around the eyes. This approach breaks the traditional taboo against using fire needles on the face (as stated in “Zhenjiu Dacheng: Fire Needles”), leveraging the advantages of fire needles to accelerate recovery from eye diseases.
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