An Acupuncture Case History
by
Zhou Zhi Jie

From: Shi Yong Zhen Jiu Yi An Xuan
(An Anthology of Practical Acupuncture Case Histories)

Example #4, pp. 78-80

Min XX XX, Female, Age 25. Worker at the Xi An Municipality Plastics Factory. On 25 March 1974 she came to our hospital for treatment.

Patient’s Remarks: (The father’s explanation [for the daughter]) For more than two weeks the patient had been ceaselessly crying and laughing, cussing and cursing (even at relatives), and maniacally, chaotically running around.

Disease History: Since very young the patient was shy, hesitant, and fearful [1]. About a month earlier she had an argument with her sister-in-law, and for a long time thereafter was depressed, unhappy, and unable to sleep at night. Half a month before [coming for treatment] she suddenly had agitation, a red face, dizziness, headache, and from time to time laughed or cried. She cussed and cursed—even at relatives—and both eyes stared angrily. She would run around maniacally, or lie down by the road side, and had gone for several days without food. She had extraordinary qi and bodily strength. Her stools were dry.

Investigation: The patient’s face was flooded red, and she had a pallid expression. The tongue body was red, the fur was yellow and slimy, and the pulse was surging, large, and rapid. (The stools were like sheep stool.)

Diagnosis: Mania pattern.

Pattern Identification: Liver depression transforming to heat, and phlegm and fire harassing the upper [burner], clouding and closing the clear portals.

Treatment Principles: Calm the liver and drain fire, dispel phlegm and open portals, and quiet the heart and settle the spirit.

Point Selection: Da Zhui (GV-14), Tao Dao (GV-13), bilateral Jue Gu (GB-39) joined to San Yin Jiao (SP-6), bilateral Hou Xi (SI-3), bilateral Lao Gong (PC-8), bilateral Ling Dao (HT-4), and bilateral Feng Chi (GB-20). The above points were used with application of strong draining hand methods. Treatments were once each day with needles retained for thirty minutes and needles moved to obtain qi every five minutes. After three treatments the stool moved freely, the patient’s essence-spirit was slightly calmer, and there were no more frightful or fearful manic delusions. The patient was still agitated, and could not sit or lie down quietly.

Proceeding with the point combination above, even supplementing, even draining hand method was applied. Treatment was done once every day with the needles retained for thirty minutes and moved every five minutes to obtain qi. After the needles were withdrawn dotting [2] technique was applied to each point for three minutes. After two treatments like this the patient’s mental condition was normal, she slept peacefully, and her intake of food and drink was self regulated. She could even do household chores.

At that point acupuncture was discontinued, but each day dotting technique was applied on all points from the same point combination for three minutes. After five more sessions, all symptoms were eliminated. Follow-up inquiries after two years showed that the patient had no discernible discomforts.

Comment: Nan Jing: “Er Shi Nan” says: “With heavy yin there is withdrawal, with heavy yang there is mania. Su Wen “Zhi Zhen Yao Da Lun” says “Excessive agitation and mania is all ascribed to fire.” Zhu Dan Xi says “Kuang ascribes to yang…mostly it is from phlegm binding in the heart and thoracic spaces.” In clinic one also sees that with this disease there are sudden outbursts, cussing and cursing (even at relatives), as well as ascending to a high place and singing out, casting off one’s clothes and running around, jumping over walls and climbing onto roofs; this ascribes to abrupt anger and binding heat of the yang brightness [channel], which results in phlegm and fire internally brewing. The primary emphasis of treatment is to clear heat and drain fire, settle the heart and dispel phlegm. In this example it was necessary to calm the liver and drain fire, dispel phlegm and open the portals, quiet the heart and settle the spirit to cure the illness. Therefore, the above points were selected for the following reasons: Point Da Zhui is the intersection point of the governing vessel and the three yang channels of the hands and feet; its application can perfuse and free depressed fire. Point Tao Dao is the intersection point of the urinary bladder channel and the governing vessel; its application can discharge heat and settle tranquility. Needling Hou Xi joined to Lao Gong frees the governing vessel and drains heart fire. Jue Gu joined to San Yin Jiao, with suitable hand technique, can drain gallbladder fire and regulate the liver and spleen. Point Ling Dao is the river point of the heart channel, and its application regulates and outthrusts heart qi. Point Feng Chi is the intersection point of the hand and foot minor yang channel with the yang linking vessel; its application can clear and drain wind and yang. The points above in combination, with manipulation techniques [suitable] for the symptoms, can reap a rapid result.

Da Zhui Tao Dao Feng Chi Qiao

Jue Gu Tou Zhi San Yin Jiao

Hou Xi Zhi Tou Lao Gong Xue

Ling Dao Shi Shu Xu Ji Lao

[1] The text literally says that she had a narrow heart and chest. Can someone correct my interpretation of this as “fearful”?

[2] Dotting is my translation of “dian xue.” Dian is the dian from yi dian zhong (1 o’clock), while xue means the acupoint. I am checking with others for an explanation of this method, or a preferred translation.