tonification in japanese acupuncture

Gathering the Ki

TONIFICATION

  If we are to adhere to the Nan Jing’s basic tenant that all diseases start from a deficiency of the Essential Ki; then it follows that “tonification” will be our most frequently used needle technique. Almost every patient will receive a tonification technique on their most deficient meridians, and deficient areas, found during palpation.

  The question of what exactly is the correct tonification technique becomes very important at this junction. Almost every acupuncturist I know, and the techniques of those whom I have read, vary from practitioner to practitioner. Some employ techniques for tonification that are the same as those that other practitioners use for “dispersing”. Some practitioners retain needles for 20 minutes or more, other practitioners do contact needling and move on. So at this point, anything I might say is obviously my own opinion and approach, based on my own experiences.

The most important thing to know about tonification has nothing to do with the particular needle technique you will use, or whether you are using direct moxa instead of needles. The most essential elements of tonification are ‘intention’ and ‘focus’. Without these, your techniques will bring mediocre results, at best. With ‘intention’ and ‘focus’, almost any technique will work that is appropriate for the situation.

Intention and focus do not necessarily require a deep serious attitude, but rather a relaxed mind that comes from knowing what we are doing is going to help the patient. The focus part comes in performing our technique, where we pay close attention to forming the oshide, placing the needle and sensing the ki. At the same time, our intention is formed. Ki and intention are brought to the point of the needle at the same time.

The Nan Jing says that when the ki departs, it is time to remove the needle. Basically, tonification at that point is then complete. Move to the next point.

The next most important thing in tonification is to use appropriate techniques. Tonification techniques can be separated into those that are more appropriate for patients with cold syndromes or for patients with hot syndromes. The pulse is usually clearly fast or slow, when one of these syndromes is present. Patients with pulses that are neither fast nor slow and have good strength, can be tonified using techniques closer to those used for warmer patients.

Patients that display cold pulses and symptoms, perhaps, with flaccid abdomens and pale color, are best treated with techniques such as shōnishin (stroking technique), sesshokushin (contact needling), tonetsukyū (direct moxa), or kyūtōshin (needle handle moxa).

All the techniques are used to stimulate the defensive ki at the surface layer of the skin. Needles are not normally retained. The biggest exception to these surface -stimulating techniques is when kyūtōshin is used on cold and deficient patients. The needle must be inserted deep enough to support the moxa, and the needle must remain while the moxa burns. The relatively broad area warmed by the burning moxa, and the warm needle are very tonifying to internally chilled patients. However, the needles should be removed as soon as the moxa starts to cool. The patient can then be covered with a towel, to retain the heat.

If you want to retain needles, they should be very shallow, or “skin” needles, which are covered with a towel, and then a TDP lamp or other source of heat is applied broadly over the towel.

Direct moxa can be used instead, or along with, needles for deep tonification. At the very least, ST-36 should be treated with direct moxa for all your cold patients. Many of these are elderly. ST-36 and Shitsumin (at the center of the heel) alone can do wonders for the problems of aging.

Retaining needles will release heat from the body, and for this reason are more appropriate for patients with heat signs and symptoms. The hibiki or redness that
spreads out from a few “skin” needles in warm patients can be remarkable, covering the entire upper back from as few as 3 or 4 needles.

Retained needles and vigorous sanshin techniques can be applied to them. The retained needles should be shallow for deficient areas, and slightly inserted in hard and tense areas. Just clearing heat in this manner will give your patients a lot of relief.

Cold patients should have short warming treatments, warm patients can have longer cooling treatments.

Patients with primarily emotional issues, depression, anxiety, insomnia, etc., are usually treated with the techniques used on cold patients. Treating the surface reorganizes the central nervous system and can bring about an energy shift. Exceptions will, of course, be patients exhibiting excess heat signs, red face, tongue, palms, load voice, etc. For these patients you can start out releasing heat, and finish the treatment with shōnishin and sanshin in the neck and shoulder area. After clearing the heat, shōnishin can create a sense of calm and tranquility.