06/11/2019
Book Excerpt: Tonify the Qi and Warm the Yang
with 22.04 Great White and 22.05 Spirit Bone
Excerpted from the Upcoming Book,
Tung’s Magic Points: A Definitive Clinical Guide
Written in collaboration with Susan Johnson's colleague and student Eric Renaud, this long-awaited work will be the culmination of Susan's 30 years of intensive study, mentoring, classroom teaching, and successful clinical experience treating a broad range of disorders using Master Tung's points.
As an acupuncturist who has treated thousands of patients, taught thousands of students over three decades, and earned international recognition, Susan Johnson is a master practitioner and instructor. In this book, she shares selected case histories from her clinical experience as well as her studies with renowned teachers, Dr. Miriam Lee and Dr. Wei-Chieh Young. The book provides detailed theory to uncover the mechanics and magic of Tung’s points. All of the numerous point descriptions include detailed point locations, reaction areas, lists of indications, notes for accurate needling, cautions, point combinations, and comments.
Brief Summary: 22.04 Ling Gu (Great White) and 22.05 Da Bai (Spirit Bone) treat a wide variety of diseases by tonifying the qi and warming the yang. They are especially effective for lower back pain, sciatica, common cold, headache, hemiplegia, and toothache.
22.04 Great White Da Bai
with
22.05 Spirit Bone Ling Gu
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22.04-.05.jpg
Location:
This point is located on the back of the hand, just proximal and radial to the distal head of the second metacarpal bone. To find Da Bai (Great White) from the classic location of LI3 San Jian, move superior to the tendon and into the depression immediately inferior to the bone.
Meridian: Large Intestine
Reaction Area: Lung
Cautions:
Forbidden to needle during pregnancy.
Indications:
Lower back pain
Sciatica
Common cold
Headache
High fever
Hemiplegia
Facial twitch
Facial pain
Trigeminal neuralgia
Toothache (lower teeth)
Pediatric asthma with high fever
Pneumonia (acute)
Bronchitis
Asthma
Emphysema
Stomach prolapse (due to qi deficiency)
Poor absorption and digestion, difficult to gain weight
Diarrhea or constipation
Needling Notes:
Needling instruction: Da Bai is usually needled opposite the affected side, toward PC8 Lao Gong. The needle is wrapped around the second metacarpal bone in order to obtain an extra bone-treating-bone Kidney function. For sciatica, use a 1.0- to 1.5-cun needle; for other conditions, 1.0 cun is adequate. The point can also be needled perpendicularly.
Bleeding: Da Bai can be bled; however, I have had unfavorable experiences (hematoma) when bleeding this point, so I prefer to needle it. Upper back points are easily bled for high fever, pneumonia, and childhood asthma.
Needle depth: .05-1.5 cun
Comments:
Dao Ma combination: Da Bai (Great White) is occasionally needled on its own, but is more commonly used in combination, with 22.05 Ling Gu (Spirit Bone) as the Chief Point and Da Bai as the Auxiliary Point. Often in Master Tung’s Dao Ma patterns, one point is supporting the other, but what makes this combination unique is that both Ling Gu and Da Bai, when used individually, are Chief Points. They are needled together primarily to treat a wide variety of diseases by tonifying the qi and warming the yang.1
Energetic pathways:
Metal: White is the color of metal, indicating a connection to the metal element (Lung/Large Intestine). All “Bai/White” points (e.g., Da Bai, Shang Bai, Ci Bai, Zhong Bai, Xia Bai) treat the ears, eyes, nose and throat, as well as facial disorders. Da Bai (Great White) is also used in the treatment of high fever, bronchitis, pneumonia, emphysema, asthma, and headache due to common cold, for several reasons: it is located on the Large Intestine channel, which shares an internal/external connection to the Lung; it has the Reaction Area of the Lung; and it is found in the upper jiao portion of the hand.
Water: Acting as LI3 San Jian, Da Bai shares similar indications. Because Da Bai is needled closer to the bone – adding a bone-treating-bone, Kidney-tonifying function – it is superior to LI3 San Jian in the treatment of many Kidney-related diseases, such as lower back pain, sciatica, and weakness of the legs.
Wood: Da Bai shares the energetic effects of LI3 San Jian, the Shu-Stream and wood point of the Hand Yang Ming, so both points treat wind in the Lung channel; however, Da Bai is much more powerful than LI3. Because the Hand Yang Ming (LI) meridian shares a special relationship with Foot Jue Yin (LV), Da Bai is effective for both internal and external wind conditions.
Purplish vein near Da Bai in children: If there is a purplish vein in the area of Da Bai extending into the first phalange, always bleed it. This may appear with high fever, asthma or pneumonia; however, a dark vein here indicates a constitutional pathology of some kind. Bleeding LU11 Shao Shang and LI1 Shang Yang may be substituted when treating wind-heat conditions, though needling these points is more painful.
Additional commentary: See 22.05 Ling Gu (Spirit Bone).
When 22.04 Da Bai is combined with 22.05 Ling Gu, I always refer to this combination as “22.04-22.05 Ling Gu/Da Bai.” Ling Gu as the Chief Point is listed first, even though the point numbering is reversed.
Combinations:
Common cold headache: 22.04 Da Bai, A.04 San Cha Three.
Sciatica (UB, GB, SP and ST): 22.04-22.05 Ling Gu/Da Bai.
Groin pain: 22.04-22.05 Ling Gu/Da Bai, 33.12 Heart Gate.
Tennis elbow: 22.04-22.05 Ling Gu/Da Bai.
Dizziness: 22.04-22.05 Ling Gu/Da Bai.
Facial twitch: This is common after Bell’s palsy or excessive stress. Use 22.04 Da Bai, 77.22-77.23 Beside Three Miles.
Trigeminal neuralgia: The middle branch of the trigeminal nerve is the most commonly affected area and can be difficult to resolve. Use 22.04 Da Bai and 22.08 Wrist Prosperous One, because 22.08 links to SI18 Quan Liao and the middle branch of the trigeminal nerve, while 22.04 Da Bai goes to the Yang Ming area (LI/ST) – the middle and lower branches of the nerve. Stimulate one needle on each side, or use all four for a stronger treatment, while the patient simultaneously moves their face (Active Qi Moving). Use A.04 San Cha Three or 22.06 Zhong Bai to treat the upper branch of the trigeminal nerve, as Shao Yang relates to the side of the face. Additionally for Shao Yang type trigeminal neuralgia, use 77.22-77.23Beside Three Miles or 66.06-66.07 Wood Keep/Wood Scoop, adding 77.18Kidney Gate (Shen Guan) for chronic cases. You may also bleed the Tai Yang area, being careful to avoid the artery. Trigeminal neuralgia can be excruciatingly painful and may require narcotics. Wu Gong (centipede), Quan Xie (scorpion) and Jiang Can (silk worm) are all very useful in relieving severe pain due to wind, restoring normal flow of qi in all channels and collaterals, neutralizing toxins and dispersing nodules. Extremely small doses of each are used. 1.5 Quan Xie (scorpion) can be added to San Pien Tang in cases of unbearable pain.
Insomnia: 22.04 Da Bai, 66.03 Fire Hardness (Tung’s LV2); this is known as Anxiety Four Gates or Fire Four Gates.
Frequent urination: 22.04-22.05 Ling Gu/Da Bai, 77.18-77.21 Three Emperors.
Painful urination: 22.04-22.05 Ling Gu/Da Bai, 11.17 Wood (Anger), 1010.13-1010.14 Horse Fast Water/Horse Gold Water. Consider LI4/LV3Four Gates.
Spinal pain: 22.04-22.05 Ling Gu/Da Bai. Consider bleeding UB40 Wei Zhong.
Ischial nerve pain: 22.04-22.05 Ling Gu/Da Bai.
22.05 Spirit Bone Ling Gu
Location:
This point is located on the dorsum of the hand, immediately distal to the proximal junction of the first and second metacarpal bones. Slide down the bone.
Meridian: Large Intestine
Reaction Area: Lung
Cautions:
Forbidden to needle during pregnancy.
Indications:
Lower back pain
Sciatica
Leg pain or weakness
Common cold
Headache
Dizziness
Tinnitus
Deafness
Migraine
Bell’s palsy or facial paralysis
High fever
Hemiplegia
Facial twitch
Facial pain
Stye
Trigeminal neuralgia
Toothache (lower teeth)
Shoulder pain or frozen shoulder
Degenerative arthritis
Swelling of bone and surrounding tissue
Tennis elbow
Groin pain
Hip pain
Knee pain
Heel pain
Fatigue
Muscle atrophy
Asthma
Pediatric asthma with high fever
Acute or chronic cough
Bronchitis
Pneumonia (acute)
Emphysema
Weak digestion or poor appetite
Abdominal pain (Kidney deficient)
Navel pain
Stomach prolapse (qi deficient)
A**l prolapse
Diarrhea or constipation
Urinary incontinence (yang deficient)
Dysuria
Amenorrhea
Dysmenorrhea
Menstrual irregularity
Excessive or scanty menstruation
Labor induction or difficult labor
Needling Notes:
Needling instruction: Ling Gu is needled perpendicularly, as close as possible to the junction of the first and second metacarpal bones. A bone-treating-bone Kidney tonification function is obtained when the needle shaft contacts the bone.
Dao Ma: 22.05 Ling Gu (Spirit Bone) is almost always paired with 22.04 Da Bai (Great White). In this combination, Ling Gu is the Chief Point, and Da Bai is the Auxiliary Point.
Needle depth: .05-1.5 cun
Comments:
Energetic pathways: Ling Gu (Spirit Bone) is located on the Large Intestine meridian, anatomically between LU9 Tai Yuan (LU Yuan-Source/Shu-Stream point) and LI4 He Gu (LI Yuan-Source point). Ling Gu and Da Bai excel at tonifying qi deficiency anywhere in the body, primarily due to their location on either side of He Gu, a major Yuan-Source point. Da Bai links to the upper jiao, He Gu relates to the middle jiao, and Ling Gu relates to the lower jiao; therefore, indications are connected to all three jiao. The combination of Ling Gu/Da Bai nourishes and warms the yang, powerfully tonifies qi, and can be used to treat indications such as exhaustion, chronic cough or frequent urination due to yang deficiency. As explained below, Ling Gu and Da Bai regulate metal and water as well as wood and fire, and are internally/externally connected to the earth element (LI/ST), tonifying Stomach qi to treat insufficient digestion. The combination of these energetics makes Ling Gu and Da Bai among the most powerful acupuncture points on the entire body.
Harmonizing metal and water: Ling Gu (Spirit Bone) and Da Bai (Great White) represent the relationship between descending Lung qi and receiving Kidney qi. Da Bai is in the upper jiao area of the hand, representing the Lung, while Ling Gu is in the lower jiao area of the hand, representing the Kidneys. Lung and Kidney nourish the yin, regulate fluids and tonify qi. By harmonizing metal and water, they regulate breathing. When the Lung qi is not descending, people pant; if the Kidney qi is not properly receiving, breathing is long and labored. Large Intestine and Lung are externally/internally related, and Ling Gu and Da Bai both share the Reaction Area of the Lungs. Additionally, Ling Gu is located opposite 22.02 Double Fairy; deep needling of either point connects them to each other and enhances their potency. Double Fairy relates to Lung and treats pain of the upper back and scapula along the UB channel because it utilizes the special relationship between the Hand Tai Yin (LU) and Foot Tai Yang (UB). It is because both Lung and Urinary Bladder disperse fluids, and Large Intestine and Lung are connected, that Ling Gu and Da Bai are useful in the treatment of frequent or painful urination. This same relationship (LI/LU/UB) accounts for the points’ extraordinary usefulness in the treatment of Urinary Bladder sciatica.
Sciatica: Whether the sciatica is along the Urinary Bladder, Gallbladder, Spleen or Stomach channel, or a combination of these, Ling Gu and Da Bai can treat it. The special relationship between the Hand Tai Yin (LU) and Foot Tai Yang (UB), explained above, is one reason for these points’ unparalleled ability to strengthen the leg.
In TCM, the Kidney is said to govern the lower back and legs. Through the five-element relationship of metal (LU) as the mother of water (KD), the Lung and Kidney are connected. The points also strengthen the lower back due to the LU/UB special relationship (described above), as well as the internal/external relationship between the Kidney and Urinary Bladder, and the points’ Kidney tonification function that is activated when the needles contact the bone.Among these Kidney connections, an extremely important one is the special relationship between the Hand Shao Yang (SJ) and Foot Shao Yin (KD). Many patients experience sciatica that is primarily along the Gallbladder channel or is a combination of Urinary and Gallbladder types. Because Hand Shao Yang and Foot Shao Yang (SJ/GB) share a pathway, this powerful relationship between Shao Yang and Shao Yin (SJ/KD) enables Ling Gu and Da Bai to treat both channels.
Additionally, imaging systems reveal a correspondence between the fingers and the hips. There are further connections to lower back and Kidney: Ling Gu is located on the lower jiao segment of the hand, and the Kidney and Large Intestine channels are opposites on the Chinese clock (horary).
Because Yang Ming (LI/ST) and Tai Yin (LU/SP) both connect to the earth element, Ling Gu and Da Bai are also effective in the treatment of sciatica along the Spleen or Stomach channel.
Seventy percent of sciatica cases seen in the clinic are found along the Urinary Bladder channel and are related to the disc between the fifth lumbar vertebrae and the sacrum; twenty percent are connected to the L4-L5 disc and reflect on the Gallbladder channel. The remaining ten percent are L3-L4 disc related, affecting the Spleen or Stomach channel. If more than one disc is compromised, sciatica affects multiple channels. Ling Gu and Da Bai are the only Dao Ma combination found in Tung’s acupuncture that is capable of addressing all channels simultaneously.
Case histories: I remember a particular case in Dr. Lee’s clinic in which UB channel sciatica resolved quickly but returned the following day. This made Miriam suspect a lung condition, and so she ordered a chest x-ray that identified the patient’s lung cancer. Lung weakness may show up on the Urinary Bladder channel as either sciatica or scapular pain.
A patient in my practice was a heavy smoker with sciatica. After I needled Ling Gu and Da Bai, his sciatic pain completely disappeared. He went home and bench pressed to test the strength of his lower back after the treatment, as patients sometimes do. The pain immediately returned and was more severe than before, and I was not able to affect it with a second treatment the following day. It is best not to suggest to patients the possibility of cancer; however, I asked him to get a chest x-ray as soon as possible. Unfortunately, he never came back. It is always a good idea to remind patients to rest after their treatments.
Regulating wood and fire: Points such as Ling Gu and Da Bai, which treat earth, metal and water simultaneously, are the best points for tonifying qi. When there is blood deficiency, the yin and fluids are also weak. When there is yang deficiency, qi and fire are lacking. Da Bai (Tung’s LI3), which is activated by LI4 He Gu (Source Point) and is a wood Shu point, strongly relates to wood. Ling Gu, also activated by He Gu and LI5 Yang Xi (fire point), relates to fire. Together, they tonify qi, generating wood to build fire and thus warming the yang. By tonifying qi and warming the yang, these points are able to build the blood. Because the Yang Ming channel has more qi and more blood, Ling Gu and Da Bai are not only tonifying but also regulating for the qi and blood, and they can be very useful in the treatment of muscle atrophy and hemiplegia as well as digestive weakness, poor appetite, abdominal discomfort, diarrhea, constipation, and stomach or a**l prolapse.
Wood/wind/tendon diseases: Because the Hand Yang Ming (LI) meridian shares a special relationship with the Foot Jue Yin (LV), Ling Gu and Da Bai are effective in the treatment of wood, wind and tendon diseases, such as: migraines; tinnitus; dizziness; hemiplegia; facial paralysis; shoulder pain; tennis elbow; pain in the hip, groin, knee or heel; and urinary or menstrual disorders.
Brain connections: Through the special relationship of Large Intestine and Liver, Ling Gu and Da Bai connect with the brain. When combined with LV2 or LV3 and/or 11.17 Wood (Anger), they can be used for confused mental states, anxiety, depression or internalized rage. We find that classic, earth-type Four Gates LI4 He Gu with LV3 Tai Chong (22.05 Ling Gu/66.04 Fire Master Tung’s LV3) and alternatively, fire-type Anxiety Four Gates (22.04 Da Bai with 66.03 Fire Hardness, which is Tung’s LV2), all derive their strength from the main Source points and strongest qi points of the Liver and Large Intestine channels.
Combinations:
Confused mental state: 22.04-22.05 Ling Gu/Da Bai, LI11 Qu Chi, 77.18- 77.21 Three Emperors.
Dizziness: 22.04-22.05 Ling Gu/Da Bai, add LI11 Qu Chi (if due to Large Intestine/Liver connection) or PC6 Nei Guan if there is nausea.
Elbow pain: 22.04-22.05 Ling Gu/Da Bai.
Frozen Shoulder: 22.04-22.05 Ling Gu/Da Bai, 002 Fen Bai, a.k.a. Fan Hou Jue (found by making a triangle with Ling Gu and Da Bai, just proximal to the distal head of the first metacarpal bone).
Groin pain: 22.04-22.05 Ling Gu/Da Bai, 33.12 Heart Gate.
Heel pain: 22.04-22.05 Ling Gu/Da Bai, 11.27.5 Five Tiger (opposite), UB65 Guiding Point.
Hemiplegia: 22.04-22.05 Ling Gu/Da Bai, 88.25 Center Nine Miles (GB31), 77.18 Shen Guan. When blood pressure is still high, bleed DT.04 Five Mountain Range.
Inguinal crease pain: 22.04-22.05 Ling Gu/Da Bai.
Ischial nerve pain: 22.04-22.05 Ling Gu/Da Bai.
Meniere’s disease: 22.05 Ling Gu, PC6 Nei Guan (one side), LI11 Qu Chi (other side), 88.12-88.14 Three Yellows.
Frequent urination: 22.04-22.05 Ling Gu/Da Bai, 77.18-77.21 Three Emperors.
Painful urination: 22.04-22.05 Ling Gu/Da Bai, 11.17 Wood (Anger), 1010.13-1010.14 Horse Fast Water/Horse Gold Water. Consider 77.18-77.21 Three Emperors, LI4/LV3 Four Gates.
Paralysis: First use 11.10 Wood Fire, then add 22.04-22.05 Ling Gu/Da Bai, 88.25 Center Nine Miles (GB31), A.01 Qi Li (GB32).
Sciatica (Gallbladder): 22.04-22.05 Ling Gu/Da Bai, 22.06-22.07 Zhong Bai/Xia Bai or SJ5 Wai Guan (opposite side), 66.09 Water Curve (GB41) as a Guiding Point (same side).
Sciatica (thigh, Spleen, Stomach): 22.04-22.05 Ling Gu/Da Bai.
Sciatica (Urinary Bladder): Use opposite side SI3 Hou Xi with 22.04-22.05 Ling Gu/Da Bai, and UB65 Shu Gu on the same side as a Guiding Point; bleed UB40 Wei Zhong; 1010.22 Nose Wing (opposite side); 1010.25 State Water.
Spinal pain: 22.04-22.05 Ling Gu/Da Bai. Consider bleeding UB40 Wei Zhong.
Stroke: Opposite side: 22.04-22.05 Ling Gu/Da Bai, 88.25 Center Nine Miles (GB31), A.01 Qi Li (GB32), DU19 Hou Ding and DU21 Qian Ding (threaded over DU20 Bai Hui).
Stye: 22.05 Ling Gu, Ear Apex (bleed).
Tennis elbow (lateral pain): 33.07 Fire Bowels Sea (LI10) and LI11 Qu Chi (opposite side), close to the bone, 22.05 Ling Gu as a Guiding Point (same side).
Tinnitus: 22.05 Ling Gu, 77.18-77.21 Three Emperors (tonify qi & yang); 22.05 Ling Gu, 88.17-88.19 Four Horses, A.04 San Cha Three.
Tonify Kidney and Liver: 22.04-22.05 Ling Gu/Da Bai, 77.18-77.21 Three Emperors.
Excerpted from
Tung’s Magic Points: A Definitive Clinical Guide
All material copyright © 2019 Susan Johnson. All rights reserved.
