Yang Jizhou ' s Twelve Manipulations

Yang Jizhou, an acupuncturist of the Ming Dynasty, summarized the twelve kinds of manipulations, of which all but the warming technique in the mouth are adopted in today ' s acupuncture treatment.

• Needle insertion assisted by the thumb nail. Before the needle is inserted, press heavily on the point with the thumb nail to disperse qi and blood. In this way puncturing does not damage the defensive qi. This approach functions in four aspects : fixing the point to be needled ; dispersing qi and blood to avoid injuring the defensive qi ; distracting the patient ' s attention to reduce pain ; avoiding bleeding
• Attentive insertion and manipulation. Hold the needle handle with the right hand, thrust and rotate it deep into the muscles with force. After three breathings, lift the needle to the part just below the skin. After another three breathing, the needling sensation may appear. Then other manipulations may be followed
• Warming the needle in the mouth ( omitted )
• Entering of the needle. a ) Before needling, the patient and practitioner should keep even breath to calm the mind. b ) The point should be located accurately, for example, points of the yang meridians on the four extremities should be located between the tendons and bones, while those of the yin meridians on the four extremities located at the place with the fingers responding to the arteries
• Pressing. After the insertion and manipulation of the needle, but the patient does not feel the needling sensation, lightly press the skin with fingers along the course of the meridian on which the point is located, both above and below. The purpose is to make smooth flow of qi and blood and to facilitate the arrival of qi
• Scratching. If an inserted needle is difficult to lift, thrust or even withdraw, the needle is stuck by the pathogenic factors. Scratch the needle with the thumb nail up and down along the course of the meridian to dispel the pathogenic factors from the meridians
• Withdrawing. On withdrawal of the needle, the practitioner should concentrate his mind and pull the needle slowly to the three levels. For reinforcing, heavy thrusting is applied, while for reducing, forceful withdrawal is used
• Twisting. A needle should not be twisted too tight, otherwise, it will be entangled by the muscles, causing sharp pain. In stagnation of qi twist the needle to promote smooth flow of qi and blood, and to disperse the defensive qi
• Turning. To treat the disease in the upper region, turn the needle forth ward to make qi ascend, and to treat the disease in the lower region, turn the needle backward to make qi descend. Lifting the needle to the middle level, and turning the needle backward is the reinforcing method, and vice versa. The purpose is to promote smooth flow of qi
• Retaining. Before withdrawing the needle, keep the needle subcutaneously for a while, then withdraw it. The purpose is to keep the qi stable at the punctured part
• Shaking. When the needle is withdrawn in the level, shake the needle twice at each level to enlarge the punctured hole
• Pulling. On withdrawal of the needle, be sure that it is not stuck tightly. Then use the fingers to lift the needle out carefully - as if " pulling a tiger ' s tail.