Agreement with contralateral needling

Naeun Lee， Bing Yang

New England School of Acupuncture，Mass College of Pharmacy and Health Sciences University

Introduction

“So, an adept doctor of acupuncture always needles the yang part when the yin part is ill, and needles the yin part when the yang part is ill. He adjusts the right to treat the left, and adjusts the left to treat the right. He must know himself to know his patients, and must know the exterior to know the interior” (Suwen Ch 5 Yin Yang Ying Xiang Da Lun) (Unschuld, 2003). 

The above statement from Suwen about the rules of yin yang to diagnosis and specific treatment method is powerful. It almost sounds as if this treatment principle is the most effective way in treating patients, and that this method is used by doctors who are known to be “skilled”. Needling yin part when yang part is ill, needling yang part when yin part is ill, and needling healthy side to treat unhealthy side has been widely known and used in clinic. This technique is also known as contralateral needling, which was first seen in the 7th chapter of Lingshu from Huangdi Neijing, and is called Ju Ci. This concept of balancing our body had been particularly used by Dr. Tan and Master Tung, whom their specific style of Ju Ci needling method has shown clinical effectiveness in many patients. Balancing our body with the theory of contralateral needling has been something I always wanted to explore further after I saw significant effect on not only myself as a patient but also on other patients in clinics. Furthermore, there are case studies and research that support the above contralateral needling theory which brought positive clinical outcome.

The contralateral needling and Dr. Tan’s 

balance method 

Dr. Tan’s Balance Method is a modern acupuncture system developed by Dr. Richard Teh-Fu Tan, based on classical Chinese medicine principles and lineage teachings. This method emphasizes immediate pain relief, distal point selection, and mirror and image theory, allowing practitioners to treat affected areas without needling directly at the site of pain.

The core concept of Dr. Tan’s approach is restoring the balance between interconnected meridian systems. Dr. Tan’s Five Systems balance style are stemming from classical Traditional Chinese Medicine (TCM) relationships, and his 5 balance systems are characterized by 1) Chinese Channel Name Sharing, 2) Bie Jing / Branching Meridians, 3) Bao Li / Interior-Exterior Zang-Fu relationships, 4) Chinese Clock Opposite, and 5) Chinese Clock Neighbors. By using structured relationships between channels and anatomical mirroring, the practitioner selects points that correspond energetically and anatomically to the affected region.

Dr. Tan’s style is widely recognized for being systematic, reproducible, and clinically efficient for treating musculoskeletal pain, neurological conditions, and functional disorders (Master Tung’s Acupuncture, n.d.).

 The contralateral needling is widely used in Dr. Tan’s style acupuncture, and his balance method is rooted in the above treatment method from Suwen. Its theory has a very close relationship to the 14 channels that run in our body. In Lectures on Tung’s Acupuncture, Dr. Young (2010) used the chapter “Ode to Elucidate Mysteries” from Compendium of Acupuncture and Moxibustion, which explained the clinical application of contralateral needling in relation to channels and the effectiveness of selecting distal points. It says, “To dredge the channels with distal points, needle the points on the foot to treat diseases of the head. Using contra lateral insertion, needle the right points for left diseases” (Young, 2010, p.11).  This theory of upper parts of the body treating lower parts of the body and vice versa, and right side of the body treating left side of the body and vice versa are examples of mirroring method, which utilizes the interconnectedness of meridians to balance and restore our body through meridian relationship. Pain in a specific area of the body is treated by utilizing a corresponding channel in different parts of the body, and the points are often selected in an area that are far from the location of the pain in order to dredge the channels. Furthermore, contralateral needling and its application to meridian is well explained by one of the systems from Dr. Tan’s balancing method. This is to needle the opposite meridian according to meridian name-sharing (Tan, 2003). For example, when foot Tai Yin SP meridian is unhealthy, needling the healthy hand Tai Yin LU meridian on an opposite side will restore one’s health. By recognizing what channels are affected and utilizing channels that are interrelated, the contralateral method can help balance and restore qi. 

Not only the relationship with channels, but contralateral needling can also be understood by the extraordinary connections between Zang-Fu organs and yin-yang relationship, as stated in Suwen. Other systems used by Dr. Tan’s style are using mutual attraction of channels (Bie-Jing) and using interior-exterior Zang-Fu organ pairs (Biao-Li) (Tan, 2003). For using mutual attraction of channels, Tai Yin channels are paired with Tai Yang channels, Shao Yin channels are paired with Shao Yang channels, and Yang Ming channels are paired with Jue Yin channels. This yin-yang relationship is special because it not only balances yin-yang channel relationship, but also balances the hand-foot channels, the extremities. For example, when foot Tai Yang BL meridian is ill, needling hand Tai Yin LU meridian will help restore one’s balance (Tan, 2003). Interior-exterior Zang-Fu organ pairs is also commonly used as balancing yin-yang opposite pairs – LU is paired with LI, SP is paired with ST, HE is paired with SI, KID is paired with BL, PC is paired with SJ, and LIV is paired with GB (Tan, 2003). For example, when hand Yang Ming LI meridian is ill, needling hand Tai Yin LU meridian is effective. Needle yang part when yin part is ill, and needle yin part when yang part is ill from Suwen is well shown in Dr. Tan’s balancing method. 

Clinical applications from case studies 

Contralateral needling is known to be commonly used to treat neurological disease as well as musculoskeletal disease to treat pain such as low back pain, stroke, trigeminal neuralgia, facial spasm, and etc. (Li et al., 2020). Several case studies and research for treating post-stroke hemiplegia, orofacial nociceptive behavior, and cervical spondylosis support the clinical efficacy of contralateral needling and balance method that are rooted in both Suwen and Huangdi Neijing.  

A clinical study by Liu et al. (2023) shows as a great example of using contralateral needling method combined with eye acupuncture for treating muscle spasm in post-stroke hemiplegia patients. Randomized controlled trial was used with 69 post-stroke hemiplegia patients, divided into two groups – one group with rehabilitation treatment such as occupational therapy, exercise therapy, hand function training, low-frequency electric pulse therapy, and etc., and another group with contralateral needling and eye acupuncture treatment. Contralateral needling method was applied through scalp acupuncture, which the acupoints of the scalp of the parietal midline, the anterior parietal temporal line, and the para parietal two lines were selected on the opposite side of the targeted limb. Also, selected points were chosen and needled on the healthy side – LI15, LU5, LI11, TW5, LI4, SP10, SP9, SP6, GB39, KID3, and LIV3. Along with the above contralateral needling, eye acupuncture was done in bilateral KID area, LIV area, lower jiao and upper jiao area. The result showed that the group who received contralateral needling combined with eye acupuncture treatment had a better and significant outcome in spastic improvement, neurological function, and daily living ability. Liu et al. (2023) further explained the neurophysiological mechanism behind the contralateral needling in treating post-stroke hemiplegia patients with muscle spasm can be that “acupuncture on the healthy side can cause motor reflex of the affected side, and the purpose is to keep the muscle of hemiplegia at a certain level of excitement, so as to promote the rehabilitation of exercise” (p. 235). From the perspective of neurophysiology, contralateral needling for treating patients with brain nerve disease can be understood as distributing brain nerves from the healthy side to unhealthy side. From TCM perspective, it can also be described as by needling the healthy side, the healthy side of qi and blood help in activating the residual healthy qi and blood that flow in the collaterals of the unhealthy side. 

Another study by Miura et al. (2007) explains the mechanism of contralateral needling from neurophysiological view. The study explores the clinical application and its efficacy of contralateral acupuncture treatment on rats that have orofacial nociceptive behavior. The experiment group received contralateral acupuncture on LI4 (Ho-Ku) while other control groups received formalin injection without acupuncture, ipsilateral LI4 acupuncture, and acupuncture treatment combined with naloxone. The study showed that the contralateral needling was as effective as ipsilateral acupuncture treatment and that “spinal interneurons have an important role in producing the Juci effect. Besides interactions between the two sides, projections of trigeminal afferents to the contralateral medullary horn contribute to the Juci effect” (Miura et al., 2007, p. 34). The contralateral treatment on LI4 stimulated neuronal activities and this “may exert their effects by modulating neuronal input from pathological region with which the Ho-ku region share a pathway” (Miura et al., 2007, p. 34). 

A study by Li et al. (2020) presents a few different cases which contralateral needling method was shown to be effective. One of the studies include the clinical application of contralateral needling through point selection based on targeted meridians for a patient who was diagnosed with cervical spondylosis and chronic muscular strain of neck and shoulder on the left side. The points on the right side below the elbow and knee were chosen after affected meridians were identified, which were Taiyang, Shaoyang, and Governor Vessels. For left side, LU7, SI3, SI5, SI7, TW5 were needled, and for right side, TW3, GB41, BL59 were needled. LU7, which is the confluent point of the yin Conception Vessels, was selected to balance with the yang Governor Vessels. With SI3 being the confluent point of the yang Governor Vessels, the choice of both LU7 and SI3 made yin and yang combination. The contralateral parts of the extremities, TW5 and GB41 were selected to treat shaoyang meridian, which TW5 being hand shaoyang and GB41 being foot shaoyang. The patient received this treatment 2x week, 5x as one course. After two courses of treatment, the patient’s symptoms were almost completely gone. This case shows how powerful it is to not only balance one’s left and right, but also balance one’s yin and yang. 

Limitations

Clinical findings from the above 3 studies by Liu et al. (2023), Miura et al. (2007), and Li et al. (2020) support the clinical efficacy of contralateral needling. However, findings from a study by Miura et al. (2007) particularly pose its limitation to the theory of contralateral needling. There was no significant difference in outcomes between contralateral and ipsilateral needling, and the result of the study concluded that the contralateral needling was “as effective” as ipsilateral needling, implying that contralateral needling is not shown to be more effective or superior than ipsilateral needling. Furthermore, more clinical research that includes comparing group of other needling methods is needed to show the clinical efficacy of using contralateral needling. 

Conclusion

Needling the yang part when yin part is ill, needling yin part when yang part is ill, adjusting the right to treat the left, and adjusting the left to treat the right. This theory from Suwen gives us a message to go back to the root of Chinese Medicine, which is balancing yin and yang. Although this contralateral needling and yin-yang balance method are not the only effective way in helping patients and more research is needed to prove its efficacy, they are nonetheless powerful in bringing positive clinical outcomes as shown in several case studies. Also, the continuation of the uniqueness of Master Tung and Dr. Tan’s contralateral needling style from an ancient text tells us how this particular approach in needling is profound. In order for this theory from Suwen be supported and widely be used and known in modern days, more evidence-based research and explanation from a neurophysiological view is needed.

References

Li, S., Li, R., & Guo, J. (2020). Examples of application of contra-part needling. World Journal of Acupuncture – Moxibustion, 30, 307-310. https://doi.org/10.1016/j.wjam.2020.11.007 

Liu, G., Li, T., Zhang, H., Yang, H., Wang, J., Zhang, Z., Liu, J., Zhang, W., Zhang, S., & Wang, Y. (2023). Clinical study of opposing needling combined with eye acupuncture therapy for treatment of muscle spasm in post-stroke hemiplegia patients. Acupuncture & Electro-Therapeutics Research, 48(3), 225–238. https://doi-org.ezproxymcp.flo.org/10.3727/036012923X168907527894626 

Master Tung’s Acupuncture. (n.d.). Dr. Richard Tan’s Balance Method: Introduction. eLotus CORE. https://www.mastertungacupuncture.org/acupuncture/tan-balance-method/system/intro 

Miura, K., Ohara, T., Zeredo, J. L., Okada, Y., Toda, K., & Sumikawa, K. (2007). Effects of traditional “Juci” (contralateral acupuncture) on orofacial nociceptive behavior in the rat. Journal of Anesthesia, 21(1), 31–36. https://doi-org.ezproxymcp.flo.org/10.1007/s00540-006-0443-4

Tan, R. T. (2003). Dr. Tan’s Strategy of Twelve Magical Points. Richard Tan. 

Unschuld, P. U. (2003). Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. University of California Press. 

Young, W. C. (2010). Lectures on Tung’s Acupuncture: Therapeutic System. American Chinese Medical Culture Center.

About the author:

Naeun Lee holds a Master’s degree in Acupuncture and Chinese Herbal Medicine at New England School of Acupuncture in 2025 and is currently completing her Doctorate in Acupuncture. She is passionate about empowering individuals to take an active role in their health by integrating traditional East Asian medicine principles with modern evidence-based knowledge. Outside of her academic and clinical training, Naeun enjoys spending time in nature with her family and incorporating natural ingredients into home-cooked meals and wellness practices. 

Bing Yang is a licensed acupuncturist and herbalist in Massachusetts. She received her Bachelor’s and Master’s degrees in Acupuncture and Chinese Medicine from Beijing University of Chinese Medicine in the 1990s and her Doctoral degree from Massachusetts College of Pharmacy and Health Sciences (MCPHS). Currently she is the associated professor and Director of Chinese Herbal Programs of New England School of Acupuncture, MCPHS and also maintains a private practice in Boston.