Dragon Classic of Acumoxa

The Zhenjiu yu long jing (The Jade and Dragon Classic of Acumoxa) was first
published in 1311 by Wang Guorui, and the latest version of the text was
edited by Li Ding, a famous professor of acupuncture (1), in 1994.
The book consists of three major parts: Yibai ershi yu long ge (The Jade and
Dragon Song on 120 Acumoxa Points), Tianxing shiyi xue gejue (Song of
Eleven Acumoxa Points that Resemble Heavenly Stars) and Liushiliu xue zhi
zheng (66 Points to Treat Syndromes).
The first part lists 83 diseases from different specialties (e.g. heart pain,
deafness, tinnitus, wheezing, abdominal pain, mastitis, oedema) and
suggests the respective acumoxa treatment. The second part is a list of
eleven extraordinarily effective acumoxa points. I will elaborate on this part
of the classic below. The third part consists of twelve chapters each of which
is dedicated to one channel and lists the main points with their respective
indications. Additionally the Zhenjiu yu long jing contains nine other texts
which are much shorter, most of them called "song" (ge, gejue) or
"rhapsody" (fu).
In the Qing dynasty the Siku quanshu zongmu tiyao (General Catalogue of
the Complete Texts of the Four Repositories with Descriptive Notes) (2)
describes the contents of the Zhenjiu yulong jing as "inclined to the mean
and involving the vulgar" and its style as "shallow and close [to ordinary
language]" (3) , furthermore it is "easy and clear to read, there is no essence
in the skill of its author, likewise one cannot say that it is close to what it
should [be close to]." (4)
This makes Li Ding ask the rhetoric question: "Although it is close to the
vulgar and not refined, its acumoxa technique is absolutely close to the
practice [of acumoxa], so how can the 'mean and vulgar' be an obstacle?"
(5) He continues: "It's absolutely justified to trace the great popularity of
Yuan and Ming acumoxa back to the mastership of this simple and essential
text" (6).
Below I recount one case of a patient suffering from post-herpetic pruritus.
The simple and straightforward treatment given in this case, which is familiar
to any acupuncturist working today, follows the guidelines for point selection
given in the Zhenjiu yu long jing, especially in the Tianxing shiyi xue gejue
(Song of Eleven Acumoxa Points that Resemble Heavenly Stars).
The patient
A male patient, age 64, presents with post-herpetic pruritus on the left
cheek, paresthesia and running of the nose. After he had obtained the usual
treatment for herpes zoster (aciclovir and antibiotics for bacterial
superinfection), the vesicles resolved but intense pruritus remained. This
woke him up several times a night so that he could not get enough sleep and
after about 10 days out of hospital he had developed further problems such
as restlessness and irritability. Physically the patient was in excellent shape
for his age (he was a long distance runner whose training consisted of about
40km running per week). He had mild hypertension, hypoacusis and benign
hyperplasia of the prostate; the only chronic ailment he suffered from was

stomach problems that had been diagnosed as gastritis 20 years before and
that usually became acute in the autumn. During the course of treatment he
told me that he easily got cold hands and feet, but had no chill sensations.
The tongue tip was slightly red; the areas of the tongue which represent the
middle and the lower burner were pale and normally had no coating, but if
they had it was thin, white and moist. The pulse was replete (shi mai) as well
as slippery (hua mai), in the left root (chi) position it was rather deep (chen)
and deficient (xu).
The diagnosis was heat poison (re du) in the yangming channels that
emerged in the face.
The chronic symptoms of gastritis and cold hands and feet together with the
tongue (except for the tip of the tongue) reflected a pre-existing problem
with coldness in the stomach.
Treatment
Great emphasis is placed in Chinese medicine on the importance of treating
herpes zoster in the acute phase, as soon as possible after its onset. This is
not only because acupuncture can be dramatically successful in resolving the
disease quickly, but because especially in the elderly there is a risk that,
untreated, herpes zoster can develop into post-herpetic neuralgia or neuritis.
Once this is established, it is difficult to cure and prolonged treatment over
years, which is not always successful, may be required.
Initially the patient could not bear to be touched in the affected area so that
local treatment was not suitable. I therefore concentrated on treating distally
and systemically. After the first treatment session the patient woke up only
once a night (as opposed to several times before acupuncture); after a
month his sleep had returned to normal. It took about 5 months to improve
the symptoms sufficiently to introduce local treatment.
The following points were selected:
* Hegu L.I.-4 on the right hand: "All problems of the face and mouth can be
tackled by Hegu L.I.-4." (7). The indications given for this point by the
Tianxing shiyi xue gejue (Song of eleven acumoxa points that resemble
heavenly stars) are "swollen face" and "heat disease without sweat coming
out" (8).
* Quchi L.I.-11 on the right arm: to cool qi as well as blood and to release
the exterior. The importance of combining it with Hegu L.I.-4 is stated by Li
Ding (9). Likewise the use of Quchi L.I.-11 as a necessary point for "dormant
papules due to one-sided wind" is emphasized in the Tian xing shiyi xue
gejue (Song of eleven acumoxa points that resemble heavenly stars) (10).
* Taiyuan LU-9: to strengthen the correct qi (zhengqi) of the lung and
thereby indirectly help driving the heat toxin out of the channels.
* Zusanli ST-36: to harmonize qi and blood as well as to cool blood (together
with Xuehai SP-10); at the same time it was used in this case to improve the
underlying condition of cold in the stomach, a treatment approach which is in
perfect accordance with the Tianxing shiyi xue gejue (Song of eleven

acumoxa points that resemble heavenly stars) (11). In the same paragraph
on ST-36 it also says that all kinds of diseases due to 'gu' in the qi level can
be treated very well by Zusanli ST-36. (12)
Under the influence of western patterns of pathophysiology 'gu' is understood
as a "poisonous condition" caused by parasites; in this case I took the liberty
of applying this concept to a "poisonous condition" caused by a virus. Both-parasites and viruses--have in common that they are physical entities (13)
that penetrate the human body so that herpes zoster and its sequelae could
also be understood as a gu-disease.
The treatment was completed with Xuehai SP-10 to cool blood and Sanyinjiao
SP-6 to nourish blood.
The areas of subcortex and shenmen in the left ear were needled during the
treatment session, and tiny magnetic balls were pasted onto the auricular
areas cheek and lung for 12 hours (14).
In the second sequence of the treatment--after five months--the focus was
placed on local points: This change from systemic to local was possible when
the side of the nose and the cheek were much less sensitive than at the
beginning. What remained was a very small hypoaesthetic area on the wing
of the nose ranging from Yingxiang L.I.-20 to a point lateral from Suliao DU25, an ahshi point. Xuehai SP-10 and Sanyinjiao SP-6 were omitted.
Treatment details
Duration of the treatment: 30 minutes per session.
Frequency: Once weekly.
Duration: 1 year (with a break of 1 month between the two sequences).
Needling technique: draining technique (xie fa): Quchi L.I.-11 and Hegu L.I.4; replenishing technique (bu fa): Taiyuan LU-9, Zusanli ST-36, Sanyinjiao
SP-6, Xuehai SP-10 (15). Needle size: 0.25 x 40 mm (with tube) for the body
points; 0.16 x 10 mm the face and ear.
Conclusion
In summary it can be said that the basis of treatment was the classical points
of the Zhenjiu yu long jing (The Jade and Dragon Classic of Acumoxa), which
are described by the text as having the potential of "melting snow with hot
water" (16) , a metaphor for "doing something easily".
Local treatment was started at a relatively late stage. In retrospect I regard
this long lasting first stage as a necessary preparation for the latter stage
which could not be entered earlier because of a strong aversion even to being
touched in the area involved.
Compared to the use of carbamazepin and other psychopharmacological
drugs that make up the standard treatment for postherpetic neuralgia and
pruritus in western medicine, the period of treatment described here
-although a whole year--is still shorter and the risk of side effects is lower.

References
(7) Mian kou hegu shou ("All problems of the face and mouth can be tackled
by Hegu L.I.-4"): According to Li Ding this famous sentence which can be
found in acupuncture textbooks today is an abbreviation of a thought that
was first expressed in the Zhenjiu yu long jing: "For any kind of illness in the
face or on the head once you needle Hegu L.I.-4 the result is absolutely
outstanding". (cf. Li Ding: Zhenjiu xue yi nan p. 182)
(8) cf. Li Ding: Zhenjiu yu long jing p.79.
(9) "Diseases of head, face, ear, eye, mouth and nose are all mastered by
Quchi L.I.-11 and Hegu L.I.-4." The author quotes Zabing xue fa ge (Song of
Acumoxa on Miscellaneous Diseases), a short text which was published after
the Zhenjiu yu long jing (Jade and Dragon Classic on Acumoxa). Although Li
Ding does not go into detail here, this text seems to stand in the tradition of
"songs on acumoxa points" just like the shorter texts in the Zhenjiu yu long
jing mentioned in the introduction. (cf. Li Ding: Zhenjiu xue yi nan. p. 182).
(10) Li Ding: Zhenjiu yu long jing. p. 79. On reading this passage of the text
carefully one can easily conclude that the author of the text describes what
we nowadays call "herpes zoster". Literally the passage translates as:
"Dormant papules due to wind on one half of the body can definitely be cured
by acumoxa [on quchi]".
(11) cf. Li Ding: Zhenjiu yu long jing. p.76.
(12) 'Gu' literally translates as "poisonous" or "poisonous insect"; it is a
concept that became extremely important with the Wenbing School (School
of Warm Diseases). See 'Gu Syndrome: Driving Out Demons and Snakes, A
Forgotten Clinical Approach to Chronic Parasitism' by Heiner Fruehauf,
Journal of Chinese Medicine, no. 57, May 1998.
(13) "Physical" as opposed to external pathogenic factors without a "body",
e. g. "liu qi" (six qi);
(14) The patient did not want to walk around with the plasters in public thus
I treated him in the evening and he removed them the next morning.
(15) Replenishing and draining techniques as defined in Zhenjiu xue p.170.
(16) Li Ding: Zhenjiu yu long jing. p.76.
Franz Zehentmayr studied sinology at the University of Vienna, Fudan
University Shanghai, and Cambridge University, western Medicine at the
University of Vienna, and acupuncture at Shanghai University of Traditional
Chinese Medicine. He is a general practitioner, presently working as a trainee
at the University of Salzburg, Institute of Radiotherapy and Radiooncology.