That's It, FolksThat's It, Folks - A brief catalogue of needling sensations from the Yin Fu Ba Gua System

By David Miller. L.Ac. MSTOM

During the year long training course specializing in Orthopedics at the Tri-State College of Acupuncture taught by Andrew Nugent-Head, a significant amount of time was dedicated to interactive needling sensations. Andrew Nugent-Head is the current authority on the Yin Fu Ba Gua medical system handed down from Yin Fu to Men Bao Zhen, then to Dr. Xie Pei Qi, which was taught to Mr. Nugent-Head. During Andrew's lectures, a catalogue of reliable needling sensations was identified and discussed, in conjunction with the Eight Functions of Qi daily exercises designed to cultivate Tangible Qi. The exercises are not discussed here. Instead, the half dozen or so sensations that are so commonly produced in patients are explained and it is suggested that each of the sensations is the result of a specific strategy that an acupuncturist initiates through the use of Tangible Qi.

The described sensations that follow can each be achieved by following a skill set found in the Yin Fu Ba Gua medical system. Admittedly, most authentic cultivation methods contain the same qualities. The Qi Gong factory is not the issue. The focus here is on the use of Ah Shi needling to treat physical injury of any stage, and getting the correct De Qi response for each needle. This in turn, also activates the desired point function. Look in Deadman and read all of the point functions. It is silly to think a needle can be inserted using random stimulation and automatically kick start the variety of functions listed. It's like pointing at a dish in a menu written all in Chinese, and hoping you don't get squid ink soup.

It is not necessary for a practitioner to cultivate Tangible Qi to bring about needling sensations in the patient, but there is a difference in the ability to successfully repeat those sensations consistently if there is "Good Qi" in the hands of the one holding the needle. It may be time for all those aspiring to perform acupuncture to cultivate Tangible Qi, in order to be able to take part in this conversation. The days of point and pray may be over as fewer in the profession just turn the lights out and hope something happens. Instead, they pull Qi to where it needs to go and fulfill the point functions with judicious expertise. This is something Andrew Nugent-Head routinely does and is able to pass on those skills to his students.

For Ah-Shi (That's It!) needling, the patient must be prepared for strong stimulation and painful aftershock of the effective and dynamic tendino-muscular responses found in Ah Shi work. From a patient's perspective, a vital aspect of treatment with acupuncture is being able to predict and vocalize what the needle will feel like, what sensations will be produced, and how sensations may increase or change from moment to moment, and that only the desired sensation will succeed. To be gently communicating what desired needling sensation is being sought, while actively listening to the patient's spontaneous responses, is the sign of a competent and compassionate acupuncturist. Patients will be more open to stronger needling of Ah Shi points and Tendino-Muscular channels when the person holding the needle can tell them what it should feel like beforehand. That can turn an "Ow! I want to punch you in the face!" response into an "Ow! It hurts but don't take it out!" reaction. It is not possible to compare styles that do not seek to illicit powerful De Qi responses, so that dialogue is avoided here. The following notes were taken in class concerning the various sensations that can be procured during needling, according to Andrew Nugent-Head and the Yin Fu System, which I modified with respect to my own experiences in the clinic. This is not a Wiseman-esque attempt at uniformity. Many practitioners may use different terminology for the same sensations, however it is suggested that each experience has a unique clinical significance.

1. Distal or Satellite Response: A sensation of awareness or awakening at a location other than where the patient is being needled. The practitioner and patient are often pleased or surprised at the 'magic of acupuncture' when this happens; particularly if the location of the sensation is unexpected; far away from the injury; and apparently unrelated to it. While this certainly occurs during Ah Shi treatment, and is often felt in the area perceived to be injured, Andrew says, "Be aware that this can give false information. A distal sensation can be due to proper awakening of the channel and tendino-muscular channel, but it can also be the patient involuntarily tensing, shifting or holding themselves in awkward ways, causing them to be aware of other areas of their body."

2. Spiderweb: This is a sensation emanating from the epicenter of the Ah Shi point outwards in all directions. This is useful, especially when treating the upper back, shoulders, scapula or anywhere a large number of tendons and muscles connect, overlap, or intertwine. In this way, successfully needling an Ah Shi point can awaken and reinvigorate the Qi and Blood, particularly those that are small but very painful or hard upon palpation.

3. Electricity: A sensation felt up or down a specific pathway can be very important in certain situations. Not only does this fully awaken the Qi along the pathway, but it is also the most important tool in chasing secondary stagnation out of the pathway– i.e. cold or damp blockage, wei or bi syndromes that happen opportunistically due to an injury. However, an electric sensation by itself without also creating throbbing, aching, or fasciculation is unlikely to cure the problem and may only provide temporary relief that then disappears after a few days. This sensation is not to be confused with inadvertently puncturing a nerve

4. Throbbing: This sensation that occurs at the point means that the flow of blood has been increased in the area. This can be very important in large muscles and thicker parts of the tendino- muscular channels, or when the Ah Shi point is a small lump within a specific layer of a tendon or muscle bunch but is not affecting all of its layers. This needle sensation is often then retained for a few minutes with further stimulation in order to maximize circulation in the area.

5. Fullness: This is always a good sign, and often the best strategy when dealing with patients who require gentle treatment. However, with stronger patients or when treating serious injuries, eliciting a sensation of fullness is rarely successful by itself, even with significant retention.

6. Heaviness: Like Fullness, it is always a good sign but again is rarely enough with stronger patients or with serious injuries. The most important result of heaviness is that it means that the area is no longer stuck in what Andrew refers to as "a holding pattern of tension and resistance," but has relaxed to a place where healthy Qi and Blood flow are now possible.

7. Achy: Also like Fullness and Heaviness, it indicates a low level of Qi and blood flow that is important in terms of healing weaker patients, but rarely enough for stronger ones. The point combination of Shou San Li and Zu San Li for elderly Qi Deficiency comes to mind. The greatest function of Qi that achy represents is that it forces the body and mind to acknowledge a particular area, and thus begin repairs.

8. Fasciculation: This is frequently the most important treatment method in Ah Shi work. The twitch and spasm of muscle fibers literally pushes and courses the Qi and Blood through the point and along the pathway. While it is tempting for the practitioner to see fasciculation as a validation of correct needling, it is worth it to caution against the belief that it is necessary to achieve at every insertion and with every patient. In a situation where bi or wei have settled in, fasciculating the Ah Shi point without also producing a traveling sensation down the pathway to create flow from and through the injury, often produces a painful treatment with low success. This is because Ah Shi needling does not necessarily address the numerous secondary problems that happen as a result of Qi and Blood no longer flowing smoothly along a pathway. Fasciculation primarily addresses the blood aspect of an injury and physically lengthens the pathway to release the tension vectors involved. The work of Janet Trevell was dedicated to this sort of concept. This illustrates the point that Ah Shi needling must be included in the context of a correct Chinese medical diagnosis in order for treatment to be truly successful.

There are a handful of sensations that are never okay. A burning sensation usually means that a point has been located too close to a blood vessel. Even if the burning subsides, clear the point, put pressure on the hole, and use an alternate location. I consider the true fairfield of an acupuncture energy point to the size of a large freckle. Therefore, missing the point by small fraction can also result in a painful insertion. If nothing is felt at an insertion site, then appropriate stimulation is required to activate the point. If a needle is correctly positioned and the patient describes the Qi flowing towards the opposite direction of the channel and that was not the intended direction, it should be corrected. Sharpness, burning, pinching, pain, should all be differentiated from a desired De Qi. How to achieve control of the point using Tangible Qi, hand techniques, needle direction, etc. is another subject.

There are other needle sensations: warming, cooling, up, down, spiraling, vibration, and probably many variations as well. What is crucial in any TCM Orthopedic treatment is the accurate staging of an injury, addressing the correct combination of tonification and sedation, point selection, patient constitution, current illness script, and the use of classic traumatology tools found in every Shi Fu's handbag. But once the sword is drawn from the sheath and the needle inserted, the Yin Fu Ba Gua System can be counted on to provide a skill set that will change point and pray needle styles for good. The sensations brought up here introduce a talking point for interested practitioners to cultivate Tangible Qi and engage in authentic Chinese medical styles that are time tested, pre-packaged, and ready to go. That's it!

Many acupuncturists already have a system of Tangible Qi cultivation. But if the reader would like more information on the Yin Fu Ba Gua Style, on-going classes are taking place with Andrew Nugent- Head in London, New York, South Carolina, and more. Simply go to www.traditionalstudies.org.


David A. Miller graduated from Pacific College of Chinese Medicine and has been in private practice for eight years. He currently resides in Salisbury, Ct. He has studied the Gao Family Bu Di Zhen system in Yang Shuo, China and attended the Beijing Martial Arts University in 1997 as well as the Beijing Economic Management Institute. He specializes in Tui Na, Qi Gong Out-Going Therapy, practices Acupuncture and Herbs, and is an associate professor at PCOMNY. He is currently pursuing a doctorate at Tri-State College of Acupuncture with an Orthopedic specialty. He can be contacted at: youandiacupuncture@icloud.com



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