As practitioners of Oriental medicine, we know that acupuncture points are a nexus of physiological activities that govern certain body parts. These points may have certain elemental energies, such as "water" points that regulate water, or they may have domain over the zang fu organs or essential substances.

These functions are not automatically activated simply by sticking needles into a point. It could involve active twirling of the needle (a typical Chinese technique), or simply the subtle but equally effective positioning of a needle in relation to the flow of qi in the meridian (a common Japanese method).

In this article, I will illustrate these concepts by explaining the use of a particular point, ST36 (zusanli), and how it can achieve varied clinical effects in two ways: first, by the specific needle technique employed; second, by its combination with other points. I've chosen zusanli specifically because of its multiple clinical energetics and its importance in the clinician's repertoire of treatment points.

In the Chinese selection of points, ST36 is perhaps the most renowned. From a classical standpoint, we know it as the he-sea point of the stomach meridian. He-sea points are those in which the qi of the channel is deeply converged. Because of this, they have a direct effect upon the organ, in this case the stomach. Likewise, on a yang meridian, he-sea points correspond to earth points elementally. As such, this means these points can regulate earth energy be adding to or taking away that energy, for instance, dampness. The way to achieve this, however, is by way of needle technique. A tonification technique can strengthen the earth element; a dispersion technique can disperse excess earth energy. Therefore, we can appreciate the critical relationship of needle technique to point selection. Point selection, of course, is contingent upon the treatment in plan, which in turn is constructed in coordination with the diagnosis.

Returning specifically to ST36, as an earth point on an earth meridian, confers its additional status as an horary point. Horary points have the same elemental energy as the meridian on which they are located. Possessing this unique quality is analogous to a "double dose," so to speak, of that elemental energy. In the case of ST36, this makes it a very "earthy" point, but again, it is through needle technique that we decide what to do with that earth energy.

In terms of indications (clinical conditions that are a direct function of the classical energetics discussed above), ST36 is known for its use in treating the following conditions: gastric pain; vomiting; abdominal distention; indigestion; borborygamus; diarrhea; constipation; dysentery; mastitis; dizziness; mental disorders; hemiplegia; beriberi; aching of the knee joint; abscessed breast; edema of the limbs; difficult urination; incontinence; paralysis; seizures; asthma (lung or kidney type); duodenal ulcers; depression; and abdominal and gastric illness.

Now let us turn our attention to the use of ST36 with other acupuncture points, to see how they work synergistically, and to see which needle technique needs to be chosen to accomplish those results. Source materials for this discussion were obtained in a lecture I attended in 1988 at the International Training Center of the Academy of Traditional Chinese Medicine in Beijing, China, entitled "Very Famous Old Prescriptions for ST36." In lieu of a lengthy discussion, and for clinician convenience, this information is summarized in the table that follows. The practitioner may select any tonification (reinforcement) or dispersion (reduction) technique that he/she prefers. Standard point locations and depths of insertion should be used and, if required, can be consulted.

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