Yang Tianye 1, Supervisor: Wang Yin 2
1. Department of Rehabilitation, Guangwai Hospital, Xicheng District, Beijing, 100055
2.Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053
Abstract: Professor Wang Yin believes that the spleen and stomach are the core of the body. In clinical diagnosis and treatment, he attaches great importance to regulating the spleen and stomach. Based on the foundation of “Ten Ancient Needles” of Wang Leting, combined with his own years of clinical experience, he created an acupuncture method for regulating the spleen and stomach. The acupoints are mainly from the Ren, the Spleen, and the Stomach channels. Through regulating the spleen and stomach, replenishing qi and blood, promoting qi circulation, and nourishing the five internal organs, various difficult and complicated diseases are treated. The basic acupoints are Zhongwan CV12, Liangmen ST21, Tianshu ST25, Zhongzhu KD15 with Siman KD14 and Qixue KD13 with one needle threaded through the three points, threading from Daheng SP15 through Zhongji CV3, and Zusanli ST36. The acupuncture method combines channel penetration and tonifying and purging acupuncture. This paper will introduce these ideas with applications for spleen and stomach disorders and insomnia.
Keywords: spleen and stomach regulating acupuncture; Wang Yin; famous Chinese medicine experience
Professor Wang Yin is the chief physician of the Acupuncture Department of Guang’anmen Hospital of China Academy of Chinese Medical Sciences, a master’s tutor, a director of the Chinese Acupuncture Association, and a consultant of the Beijing Acupuncture Association. Professor Wang Yin has been engaged in TCM clinical practice, teaching and scientific research for nearly 50 years and has rich clinical experience. In clinical diagnosis and treatment, he pays great attention to the regulation of spleen and stomach. Based on the “Ten Ancient Needles” of Wang Leting, combined with his own years of clinical experience, he created the “Acupuncture Method for Regulating Spleen and Stomach”. The points are primarily from the Ren, Spleen and Stomach channels. By regulating the spleen and stomach, replenishing qi and blood, promoting qi circulation, and nourishing the five internal organs, various complicated diseases can be addressed.
1. Theoretical basis of the academic thought of regulating spleen and stomach
In the Huang Di Nei Jing Su Wen Huangdi asks: “I have heard that when the five epidemics come, they are all easily transmitted, regardless of size, the symptoms are similar. If no treatment is given, how can people not be affected?” Qibo said: “Those who are not infected have upright qi in their bodies, and evil cannot interfere. They avoid the toxic qi.” The sentence “[When there is] upright qi in the body, evil cannot interfere” in the text succinctly summarizes the concept of pathogenesis in the Nei Jing, which has important guiding significance for the diagnosis, prevention, treatment, and rehabilitation of diseases. “Upright Qi” is one of the more important and basic concepts in traditional Chinese medicine, referring to the summation of the functional activities of the human body, including the viscera, channels, qi, and blood, as well as the body’s ability to resist disease and recover. Traditional Chinese medicine believes that upright qi has the functions of defense, maintaining the body’s internal balance, immune monitoring, etc., and has certain benefits for one’s own health. If the body’s qi is insufficient, or relatively weak, it is easy for evil energy to enter the body, causing the body’s yin and yang to be out of balance, and the organs and channels to become disordered, which in turn causes disease. “Evil Qi” is a general term for all pathogenic factors. “Evil Qi” in traditional Chinese medicine includes all kinds of pathogenic factors that may cause dysfunction of the human body and imbalance of the internal and external environment, including the six exogenous evils, epidemic diseases, internal injuries, seven emotions, improper diet, too much work or rest, as well as external injuries, and insect and animal bites and stings. The body “containing upright qi” is a sign of health, so we should pay attention to maintaining upright qi, preventing injuries and maintaining normal functions; after injuries and illnesses, we should emphasize supporting upright qi and unblocking the movement of qi to promote functional recovery. Acupuncture, massage, medicine, and diet are all effective measures to maintain upright qi. Maintaining upright qi, on the one hand, is to replenish the qi, blood, Yin and Yang of the internal organs, strengthen the material basis of the body, and overcome the decline of body functions; on the other hand, eliminating pathogenic factors, regulating channels, and smoothing qi and blood can also achieve the purpose of maintaining upright qi. The principle of maintaining upright qi is to regulate original qi (Yuan Qi), which is a general term for the material basis of life activities and their functions. It is the most basic and important qi in the human body and can be said to be the root of all qi. Therefore, the dominant position of upright qi and the external conditions of negative energy determine that in the clinical treatment of diseases, special emphasis should be placed on protecting the upright qi.
The Jin Gui Yao Lue states that “[when] the spleen is strong in all seasons one cannot receive evils”, which is a specific expression of the idea that “upright qi exists inside, and evil cannot enter”. In the physiological activities of the human body, the spleen and stomach are the source of qi and blood production and the foundation of vital energy. The two are in the middle of the human body and are the hub of the qi mechanism. The spleen is in the center of the five visceral organs and can irrigate the other four viscera, because the spleen earth produces lung metal, benefits kidney water, nourishes liver wood, and replenishes heart fire. Therefore, any deficiency of qi and blood in the other four visceral organs can be treated through the spleen and stomach. In the etiology and pathogenesis of diseases, Li Dongyuan’s Treatise on the Spleen and Stomach, in Discussion on the Transmission and Transformation of Spleen Qi and Deficiency says: “After reading various articles and referring to them, I found that the sufficiency of the original qi is always due to the spleen qi being intact, and then it can nourish the original qi. If the stomach qi is weak, and the diet is doubled, the spleen qi will be damaged, and the original qi will not be sufficient, and various diseases will arise.” From this, it can be seen that “if the spleen and stomach are damaged, all kinds of diseases will arise”, so protecting the normal function of the spleen and stomach is often the key to treating diseases. Professor Lu Zhizheng, the first master of traditional Chinese medicine, inherited Li Dongyuan’s concept of “internal damage to the spleen and stomach, [allows] all kinds of diseases will arise”, Ye Gui’s concept of “nourishing the stomach yin”, and Wu Cheng’s “regulating spleen yin”, and further elaborated on these ideas. Lu believes that the spleen and stomach are the foundation of the body. The body’s nutrients are transported and transformed by the spleen and stomach. Suppose the spleen and stomach function are damaged. In that case, the transport and transformation will be disrupted, the ascending and descending will be disordered, dampness will be generated internally, and the qi will be blocked, which will lead to various diseases. Therefore, regulating the spleen and stomach is the top priority in treating various diseases [1].
Professor Wang Yin believes that people nowadays live at a fast pace, study hard, work under great pressure, and think too much, which can easily damage the spleen and stomach. In addition, their material life is rich, and people eat too much fatty and sweet food, and are fond of spicy and cold foods, which leads to the spleen and stomach receiving and transporting disorders, thus, the function of the spleen and stomach in modern people is often insufficient. Therefore, in clinical practice, great emphasis is placed on the regulation of the spleen and stomach. After years of exploration and experience accumulation, a unique acupuncture formula for regulating the spleen and stomach was formed based on the ” Ten Ancient Needles” of “The King of Golden Needles” Wang Leting, which plays the role of regulating the spleen and stomach, replenishing qi and blood, promoting qi circulation, and nourishing the five internal organs.
In clinical practice, Professor Wang emphasizes the importance of regulating the spleen and stomach. Through years of exploration and accumulation of experience, he has developed a unique acupuncture prescription for regulating the spleen and stomach, building on the “ Ten Ancient Needles” of the Golden Needle King, Wang Leting. This method effectively regulates the spleen and stomach, benefits qi and blood, smooths the qi mechanism, and nourishes the five viscera.
2. Acupuncture prescription
2.1 Acupoint selection:
The main acupoints are Zhongwan CV12, Liangmen ST21, Tianshu ST25, Zhongzhu KD15 threaded with Siman KD 14 and Qixue KD13 (three acupoints with one needle), Dahengtou SP15 Zhongji CV3, and Zusanli ST 36. This acupoint prescription is derived from a variation on the “Ten Ancient Needles” of Want Leting. The ten ancient needles are as the upper, middle and lower venter points (Shangwan CV 13, Zhongwan CV12 and Xiawan CV10), Qihai CV4, Tianshu ST25 (bilateral), Zusanli ST36 (bilateral), Neiguan PC6 (bilateral), which has the effect of tonifying the middle burner and replenishing qi.
2.2 Meaning of the prescription:
Zhongwan CV12 and Liangmen ST21: Zhongwan CV12 is in the Ren channel, which is the meeting point of the three yang channels and six bowels hollow organs（bowels）, the gathering point of the stomach, where the bowels gather, and can open the bowels and harmonize the stomach. Liangmen ST21 belongs to the stomach channel, which is thought of as a Portal. Insert the needle from Liangmen ST21 and pierce towards Zhongwan CV12, to open the stomach gate and open the Ren channel.
Zhongzhu KD15 with Siman KD14 and Qixue KD13 (one needle and three points): Professor Wang Yin believes that although the Ren channel is the “sea of the yin channels”, it starts below Zhongji CV3 and does not belong to any viscera. It is connected to the viscera’s channels through intersection points. It is the channel for the visceral qi and blood to gather and flow. It is good at opening but not good at replenishing. The kidney’s primordial qi is the innate essence, which is difficult to replenish. It can only be continuously nourished and protected by the essence of water and grain. Therefore, these points are needled by threading downward, embracing the ren channel on both sides, to lead the essence of qi and blood into the dantian. The purpose is to lead the fire back to its origin. When used together with the stomach’s mu point Zhongwan CV12, it can play a role in the harmony of the innate and the acquired.
Daheng SP15 penetrates to Zhongji CV3: Daheng is a spleen channel point, located 4 inches lateral to the umbilicus, also known as Shenqi “Kidney Qi”. The Daheng points on both sides and the Zhongji point form a triangle on the lower abdomen. The area inside the triangle includes spleen, stomach, kidney channels, and overlaps with points on the chong, ren, and dai vessels. There are both yin meridians and yang meridians, including the three of the eight extraordinary vessels. The spleen and stomach are the foundation of the acquired constitution, and the kidney is the foundation of the innate constitution. The Daheng SP15 acupoint is needled towards Zhongji CV3, which can also play a role in the harmony of the acquired constitution.
Tianshu ST25: Direct puncture to open the stomach and intestines and mobilize the qi of the triple burner.
Zusanli ST36: It is the lower He-sea point of the stomach, where the qi of the stomach channel converges into the sea. This point is used to strengthen the spleen and stomach and regulate the qi of the viscera.
2.3 Special acupuncture methods for abdominal threading
● Penetrating acupoints: Zhongzhu KD15 + Siman KD14 + Qixue KD13 wiht one needle
● Daheng through Zhongji
Threading technique: Before acupuncture, the patient is instructed to empty the bladder, lie flat, and expose the abdomen. The doctor massages the patient’s abdomen clockwise with his hands, with the force gradually increasing from light to heavy. The needle can be used only when the acupoints are opened and there is no resistance under the fingers. Needle insertion: The needling hand holds the handle of a 5-inch (125mm) needle, and the pressing hand holds the lower end of the needle body, which is against the Zhongzhu KD15 acupoint or Daheng SP15 acupoint at a shallow angle, with the needle tip facing the Qixue KD13 or Zhongji CV 3 point. Both hands cooperate to apply force at the same time, combining piercing and twisting, gently twisting and slowly advancing, and the needle is inserted to a depth of 4 inches (100mm). Needle sensation: After the needle is inserted to a certain depth, a sinking, tight, and coarse or rough sensation will appear under the needle. To strengthen the qi sensation, the needle should be moved continuously. When moving the needle, the needle handle is held between the thumb, middle, and index finger of the needling hand. While gently shaking the needle handle, the needle body is withdrawn and thrust lightly in and out while it is twisted back and forth quickly with low amplitude (160-200 times/minute). The index finger of the other hand gently presses the needle body downward, like a bird pecking. To expand the sensation, the lifting and thrusting movement can be slightly larger. The movements of both hands should be coordinated, frequently and finely, gently and softly, so as not to cause discomfort to the patient. While moving the needle, the patient may feel a slight achy and bloated feeling in the lower abdomen, or possibly a more comfortable feeling of heat. The needle sensation of some patients can even be transmitted to the lower limbs and groin. Needle removal: After the acupuncture point is penetrated, the needle can be left in place for 20-30 minutes. When removing the needle, the piercing hand and the pressing hand must cooperate to slowly withdraw the needle, and press the needle hole with a sterilized cotton ball for a while. After the needle is removed, gently massage the patient’s abdomen again, and let the patient rest for a few minutes before leaving.
3. Clinical application examples
3.1 Diarrhea Patient, male, 89 years old, consultation date: June 5, 2024. Chief complaint: occult blood in stool for nearly 2 years, intermittent purulent blood, watery stool for half a month. Current medical history: The patient was found to have positive occult blood in stool during a physical examination nearly 2 years ago. Later, a pelvic CT scan at the Third Hospital of Beijing University showed a malignant tumor of the rectum. Because the patient and his family requested conservative treatment, no surgery, radiotherapy, chemotherapy or other related treatments were given. Half a month ago, the patient had intermittent watery stools, which occasionally had a small amount of mucus and purulent blood and was admitted to the undergraduate department for follow-up treatment. The patient is now sleepy, sleeping 12-15 hours/day, with a pale face, physical fatigue, shortness of breath, laziness, low appetite, normal food intake, normal urination, intermittent watery stools sometimes with mucus or purulent blood, 6-8 bowel movements/day, 20-50ml/time. The tongue is pale with thin fur, and the pulse is deep and weak. History: hyperlipidemia for 5 years, regular use of atorvastatin, denial of other chronic diseases such as hypertension, coronary heart disease, diabetes, etc. Personal history: denial of a history of smoking and drinking, has 2 sons, and the spouse is healthy. Diagnosis: diarrhea (Qi and blood deficiency syndrome). Treatment principle: replenish Qi and nourish the blood. Acupoints: Adding Yinbai SP1 to the main points Zhongwan CV12, Liangmen ST21, Tianshu ST25, Zhongzhu KD15 and Siman KD14 with Qixue KD13 (three acupoints with one needle), Daheng SP15, Zhongji CV3, and Zusanli ST36, and treat twice a week. Follow-up: After 2 and a half weeks of treatment, the patient’s watery stool became firmer as loose stool, 5-6 times/day, 20-50ml/time, occasionally having a small amount of mucus in the stool, but no visible blood. His poor appetite slightly improved. Although he was still quite tired, the total time he was sleeping was shortened to 10-12 hours/day. Note: According to Jing Yue Quan Shu•by Zhang Jingyue, it says: “The root of diarrhea is all due to the spleen and stomach”. Long-term diarrhea is mainly caused by spleen deficiency. The spleen and stomach are the source of qi and blood production. The patient has long-term occult blood loss, and diarrhea, and the qi is consumed along with the blood, resulting in qi and blood deficiency. Therefore, the author’s acupoint prescription is used to start from the spleen and stomach in the middle jiao, protect the spleen and stomach, replenish the upright qi, and achieve the purpose of replenishing qi and nourishing blood. In addition, Yinbai SP1 is the well point of the spleen channel, which strengthens the spleen and stomach, replenishes qi and regulates blood, warming yang and reviving from fainting. It is effective for all kinds of abnormal bleeding. The book Zhenjiu Zisheng Jing written by Wang Zhizhong in Song Dynasty said: “If a woman’s menstruation is overflow and does not stop, acupuncture will heal it immediately.” Professor Wang Yin also cited the example of moxibustion on Yinbai to treat women with continuous uterine bleeding. Therefore, acupuncture of Yinbai was added to treat blood in the stool, and the effect was significant.
3.2 Insomnia
The patient is a 49-year-old female nurse. Date of consultation: October 15, 2024. Main complaint: Difficulty falling asleep for half a year. Current medical history: The patient had irregular sleep due to fatigue half a year ago, and then had difficulty falling asleep, and occasional panicked feelings, but did not take it seriously. Later, the symptoms gradually worsened, and the local hospital treated her with 2mg qn of estazolam (benzodiazepine type sedative medication). Current symptoms: fatigue, difficulty falling asleep, need to take estazolam every night to fall asleep, easy to wake up, difficulty falling asleep again after waking, typically only getting 3-4 hours of sleep per night, dizziness in the morning, no headache, nausea or other symptoms. When she’s tired, she is prone to palpitations. She has a poor appetite, unformed stool, with one bowel movement per day, normal urination, a pale tongue with thin white fur, and a weak pulse. History: 3 years of arrhythmia, no regular medication, deny other chronic diseases such as hypertension, coronary heart disease, and diabetes. Personal history: denies the history of smoking and drinking, has 1 son and 1 daughter, healthy spouse, and is in menopause. Diagnosis: Insomnia (Qi and blood deficiency syndrome). Treatment principle: Strengthen the spleen and replenish Qi, nourish blood, and calm the mind. Acupoints: Add scalp acupuncture to the stomach area, Baihui GV20, and Anmian (extra point under mastoid process) along with the root treatment of Zhongwan CV12, Liangmen ST21, Tianshu ST25, Zhongzhu KD15 + Siman KD14 + Qixue KD13 (one needle and three acupoints), Dahengtou SP15 Zhongji CV3, and Zusanli ST36 points, and treat 3 times a week. Follow-up: After 3 weeks of treatment, the patient’s difficulty falling asleep significantly improved. When she did not have to get up at night to work, she no longer needed to take estazolam. She had dreamless sleep 5-6 hours per night, and her fatigue and loss of appetite improved.
Comment: This patient worked hard, had an irregular life, and was worried a lot. Over time, this damaged the heart and spleen. The heart governs the blood vessels, and the spleen is the source of qi and blood production. If both the heart and spleen are deficient, the qi and blood production will be insufficient. Therefore, Professor Wang Yin’s acupuncture point selection scheme was used to start with the spleen and stomach in the middle jiao, protect the spleen and stomach, replenish the positive qi, and achieve the purpose of replenishing qi and nourishing blood. The head is the place where all yang and channels gather. Scalp acupuncture in the stomach area can regulate the spleen and stomach. Baihui GV20 boosts the yang and benefits the qi and Anmian (extra point) can be used together to calm and stabilize the mind.
4. Summary
The spleen and stomach acupuncture method is one of the point prescriptions most used by Professor Wang Yin in clinical practice. It is often used to treat digestive diseases such as chronic gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis, functional dyspepsia, hiccups, diarrhea, etc. It is also used for sleep disorders, dizziness, obesity, irregular menstruation, tinnitus, skin diseases, etc., with significant clinical efficacy. Professor Wang Yin uses the method of “regulating the middle jiao” to smooth the qi, harmonize qi and blood, and regulate the various organs. It focuses on the patient as a whole, and uses the cultivation of positive energy to adjust the balance of yin and yang, qi and blood, and internal organs, thereby mobilizing the body’s functions to resist pathogenic factors and drive them out. This is also the specific manifestation of the connotation of “positive energy is inside, and evil cannot be interfered with.”
