During troubled and turbulent times, it is not uncommon for acupuncturists to have patients enter the clinic presenting with issues such as depression and anxiety. In this installment, let's cover two acupuncture points often overlooked when dealing with issues such as emotional disturbance, life stress, anxiety and depression; and discuss some unique ways to use these points when creating patient-specific acupuncture point prescriptions for a wide array of potential expressions of emotional imbalances.
In my clinical experience, it is extremely common for patients suffering from a wide array of emotional challenges to also experience concomitant digestive disturbances. Whether patients present with "nervous stomachs" or a depleted appetite, emotional stress almost always affects the healthy harmony of the digestive system. Therefore, the use of St 23 and St 24 is not mysterious or odd, but rather extremely clinically relevant.
Stomach 23 (Supreme Unity)
The actions of St 23 include transforming phlegm, calming the spirit and harmonizing the middle jiao. When the spleen / stomach systems are not functioning efficiently, fluid disturbances occur, namely accumulation of damp and phlegm. Once this occurs, phlegm can rise and disturb the function of the heart organ, causing anxiety, depression and other issues.
St 23 Point Combinations
The following are some effective point combinations that include St 23 for patterns expressing as emotional disturbances:
St 23 + Sp 6 + Du 20 + Yin Tang: This point prescription is highly effective when a patient experiences anxiety / depression due to liver qi stagnation and phlegm misting the heart organ. In particular, this point prescription is important when stress / anxiety are coupled with digestive issues such as loose stool, flatulence, bloating, stress-induced eating or poor appetite.
While the three-point prescription of Sp 6 + Du 20 + Yin Tang is quite common, the addition of St 23 has a strong action to enhance the effectiveness of this point prescription, helping calm the mind and resolve phlegm.
If there are signs of heat such as a red tongue with yellow coating, racing pulse, and/or subjective feelings of heat, the point prescription can be enhanced as follows: St 23 + St 44 + Sp 6 + Du 20 + Yin Tang.
St 24 (Slippery Flesh Gate)
St 24 has many of the same actions as St 23, and functions to calm the spirit, transform phlegm, harmonize the stomach, and alleviate vomiting. St 23 and 24 are very close in location, and clinically I commonly common the two points in a combination that treats the two points as "one point."
St 24 Point Combinations
An effective three-point prescription using these two stomach points is St 23 + St 24 + St 25. St 25 is the front mu point of the large intestine and has the actions of regulating the intestines, regulating the spleen and stomach, resolving dampness / damp-heat, regulating qi / blood, and eliminating stagnation. This three-point prescription targets a wide range of disorders ranging from mental / emotional challenges, digestive disorders, and menstrual irregularities including anxiety / depression and gastric symptoms.
The following prescriptions are some examples of how these stomach points can be used:
- St 23 + St 24 + St 25 + Liv 3 for liver depression that causes gastric disturbances and mental / emotional challenges.
- St 23 + St 24 + St 25 + Ren 6 + Yin Tang for liver depression that causes mental / emotional challenges, along with gastric issues and/or menstrual imbalances.
- St 23 + St 24 + St 25 + Four Gates + St 44 for liver depression that causes mental / emotional challenges; along with phlegm misting the heart and a wide array of heat disorders such as heart fire, damp heat and/or depressive heat.
Clinical Takeaway
I hope you are inspired, particularly in these challenging times, to expand your clinical repertoire for helping patients to cope and recover from emotional challenges manifesting as anxiety, stress, and depression. Acupuncture can provide quick and effective relief from the symptoms of stress which affect each patient in unique ways.
Always remember that each patient is a unique expression of nature. We must take our time and find points that effectively target each patient's unique expression of disease and disharmony. Try to continually increase your clinical repertoire of acupuncture points to effectively provide patients shelter from the storms of life.
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