In the marketplace, we hear of dry needling being talked about more and more. As professional practitioners of Chinese medicine and acupuncture, it is important that we do not lose sight of our passion, purpose and belief in what we are doing, both for the sake of preserving the full practice of acupuncture and Chinese medicine, and for the sake of our patients.
Professional acupuncture involves skillful needling at five depths: Xing (structure), Qi (energy), Yi (intention), Shen (spirit), Kong (space). Dry needling is performed at the Xing (structure) level only.
The Significance of Differentiating Qi Under the Needle
The ultimate goal of acupuncture treatment is to reconcile Qi and Blood and to balance Yin and Yang. The classic Ling Shu states: "Acupuncture is effective only if the Qi has arrived. Its effect, as one would describe, is as if the winds blow away the clouds and clear the azure sky. These all are the Dao of acupuncture." This writing speaks to the importance of achieving "De Qi" (get qi) when needling.
Achieving De Qi enables us to apply tonifying or dispersing needling techniques so that we may fill deficiency and disperse excess, which is the general principle of acupuncture. The general principle of acupuncture treatments is to fill deficiency and disperse excess. The Ling Shu states, "Empty or full, the nine needles are exceedingly wondrous. To tonify or disperse, results will be achieved through needling."
When it comes to performing tonifying or dispersing, we must not only know the needling techniques, but we must be able to discern whether it is evil qi or good qi under the needle. Ling Shu described very clearly that during needling, "When the Evil Qi comes out, it is tight and urgent. When the Grain Qi comes, it is slow and harmonious." In clinical practice, more than simply knowing this, we need to further differentiate the Qi under the needle.
The following quotes from the classics relate to grasping Qi movement, having an understanding of Qi while needling, and communicating with Qi:
- The essence of needling lies in the regulation of Qi."
- Follow the rules of Yin-Yang and embrace the laws of nature."
- The principles of using these fine needles are easy to say but difficult to master. Ordinary skills of acupuncture maintain the physical body; advanced skills maintain the spirit."
- Ordinary techniques guard the gates; advanced techniques control the moving power. At the core of this moving power, it is quiet and subtle. Its coming cannot be hurried; its going cannot be chased."
All of these quotes from the classics are related to grasping Qi movement, understanding of Qi while needling, and the communication with Qi. This communication happens at the Qi level or even at the spirit level. It is a communication between the acupuncturist and the patient. Simply put in modern language, it is a matter of finding a way to grasp the Qi and balance Yin-Yang by implementing the traditional methods of rationale, principle, formula, point, and technique. Doing so unifies Heaven and Man in the communication between the acupuncturist and patient at the various levels.
Five Steps of Qi Differentiation
During needling, Qi differentiation is crucial in order to obtain De Qi, hold Qi, and guide Qi. The Ancients called it "listening to the needle." In fact, it is similar to a kind of Qi differentiation method used by ancient acupuncturists in which the patient's Qi-Blood and flow of Qi can be sensed through the needles while doing vipassana meditation.
Step 1: Probing the Point
Here, "probing" carries a similar meaning just like knocking on doors, saying hello to the owner and seeking the owner's permission. In this step, the assisting hand and point palpation techniques are applied. Next, lifting-thrusting and twirling techniques are performed to sense the Qi-Blood under the needle within the same level and at different levels.
Step 2: Entering the Subconscious
This step emphasizes the importance of entering a "selfless" state, an in-between stage of the conscious and unconscious mind. The acupuncturist should synchronize with the patient's respiratory rhythm.
Step 3: Visualizing
This step requires the practitioner's exclusive attention and unified mind. It is a state of meditative contemplation, visualizing the energy traveling through the meridians.
Step 4: Gathering Qi
Having skills to gather Qi is an essential step of this process. These skills are learned in advanced study of needling techniques. We will not delve into those details within this discussion.
Step 5: Becoming Tranquil and Transcendent
Taoism has a saying: "a person has six roots (eyes, ears, nose, tongue, body, and intention) with intention as the leader." This suggests that we need to use our intention to mediate the induction and control of physiological perceptions.
When we utilize our imaginative power while in a state of absolute focus and tranquility, our mind can become one with the needle. In this state, our fingers will become extremely sensitive. As a result, the sensation of Qi, the texture of the skin, flesh, and internal organs will become highly differentiated under the needle. At this moment, we have to manipulate the needle naturally, intuitively, attentively, and yet not intentionally.
Editor's Note: The conclusion of this article, including the Four Sensations Under the Needle will be published in next month's issue.
Professor Wei Liu graduated from Tianjin University of Traditional Chinese Medicine majoring in acupuncture and orthopedics. Dr. Liu, a licensed acupuncturist, practices in Minneapolis, Minnesota. He is the founder of East Wind Acupuncture and Tuina Healing Center, Inc. and is a well known clinician and professor of acupuncture across the U.S.
Dr. Liu co-founded the Department of Acupuncture at Northwestern Health Sciences University (NWHSU) in 2000. He continued as a professor of TCM at NWHSU until 2017. In 2004, Dr. Liu was invited to be the visiting professor for the first cohort of the Doctor of Acupuncture and Oriental Medicine (DAOM) program at Oregon College of Oriental Medicine (OCOM), and currently continues to function in that capacity. Dr. Liu has been welcomed as a prominent and beloved speaker at different TCM conferences and programs, such as the Pacific Symposium, Great River Symposium and the international acupuncture courses at Harvard Medical School.
In June 2016, he was appointed as the guest professor and committee member of the Experts Committee by China-America Acupuncture Rehabilitation Institute and established the “Dr. Liu’s Acupuncture Workshop.” In April 2017, Dr. Liu was also appointed as the guest professor by Guangzhou University of Chinese Medicine. In May 2017, he was selected by the Chinese 100 Overseas Projects as one of the first ten TCM experts abroad.
Dr. Wei Liu’s profound knowledge of acupuncture was passed down through his family. His acupuncture methods and techniques adhere to the ancient classical style, yet are also innovative. He has formed his own style, the Dr. Liu Style, and created several sets of acupuncture needling series, methods and techniques, such as Liu’s Scalp Acupuncture, Liu’s Abdominal Acupuncture, Kite-Needling, and Liu’s Structural Energy Acupuncture.
Dr. Liu has been a coveted instructor from coast to coast on variety of topics of acupuncture. His teaching style is straightforward, lively, and full of humor, expressing profound meanings with simple words. Dr. Liu’s acupuncture style has won the most applause from his colleagues in the field, and earned him the reputation as a grandmaster in acupuncture.
Wei (Vivien) Zhang, licensed acupuncturist and certified Chinese herbalist, is the first acupuncturist at the Department of Anesthesia, Critical Care and Pain Medicine of Mass. General Hospital; and also serves as a medical staff member of Emerson Hospital. As her new endeavor, she is working on integrative treatments for autism and other brain development-related conditions with Dr. Martha Herbert, a pediatric neurologist and brain development researcher, and Dr. June Kong, a primary care physician. Wei was a professor of New England School of Acupuncture from 1999-2008 before dedicating herself to full-time clinical care. She received her medical degree from Beijing University of Traditional Chinese Medicine, and master's degree in nutrition and health promotion from Simmons College.
Ruth Tongen owns Synergy Health, LLC, a private practice in Edina, Minnesota. She received her master's degree in Oriental medicine from Northwestern Health Sciences University. She is licensed as an acupuncturist by the Minnesota Board of Medical Practice. Ruth also has a bachelor's of science in nursing from the University of North Dakota and has held staff, executive and consulting roles in acute care, long-term care, research, and employee health. She is also credentialed in human resources and combines her backgrounds to serve people moving through major transitions and living with chronic conditions.