When I think of Four Horses, I think “immune system”

Four Horses are used to address all kinds of immune system reactions, from common cold and allergies to something as rare as the autoimmune disease known as pemphigoid/pemphigus. Allergic reactions usually involve some kind of trigger that pushes the liver beyond its capacity to detoxify the system when the Lung and Spleen are weak, and immunity is compromised. Four Horses have the Reaction Areas of the Lung and Liver. The Lung governs the surface (or Wei qi) and the Liver cleans the blood. When the Wei qi is weak, the body is vulnerable to external wind; when the Liver is weak, the blood is not clean and internal wind results. Found between the Shao Yang and Yang Ming channels, Four Horses relate to both wind and phlegm. Their extraordinary power comes from their ability to strengthen both the Lung and Liver through boosting the Spleen, cleaning the blood and expelling wind.

Energetic pathways:

Below is an explanation of the many different ways in which the energetics of Four Horses combine. We have done our best to tease out these relationships in a linear way in order that they might be more easily understood; however, they layer one upon another and are inextricably interwoven, interrelated, and not necessarily presented in order of importance. Their many overlapping energetic interactions make Four Horses extremely clinically useful:

Spleen/Stomach:

The Spleen governs the muscles, and together with the Stomach, it is responsible for postnatal qi. Four Horses points are located near the Stomach channel in the large quadriceps muscles of the thigh. Due to the abundant nerve and blood supply found there, needling these points provides ample tonification of qi and blood. Because of this earth element relationship, these points not only have a powerful influence over the immune system, but also are helpful in treating phlegm conditions such as hypothyroid and/or goiter. Muscle treats muscle, which enables us to use these points to treat muscle weakness or atrophy, multiple sclerosis and fibromyalgia. Because Four Horses points regulate the Spleen and Stomach, and the Stomach channel travels to the face, they are also used to treat diseases of the eyes, ears, nose and throat.

Lung/Spleen:

The Lung governs the Wei qi, which is responsible for the surface of the body and prevents the invasion of external pathogens. Because of the relationship of the Hand and Foot Tai Yin (LU/SP), Four Horses points tonify both Lung and Spleen qi. This makes them highly useful in the treatment of any kind of immune system deficiency, including autoimmune diseases, allergies, asthma, cough, colds or flus, phlegm, and skin diseases. The Spleen governs the muscles, and muscle treats muscle, but muscle also treats the skin. In most cases of Spleen deficiency, we see not only signs of internal dampness but also damp skin diseases, muscle weakness, loose stools and fatigue.

Lung/Large Intestine:

In addition to the above relationships, Tai Yin and Yang Ming are connected through the internal/external relationship of the Lung and Large Intestine, and both have a strong influence over external wind. We frequently add LI20 Welcome Fragrance as a Guiding Point for issues on the face, such as acne, but it is especially good for sinus infections or inflammation, sinus headaches, as well as other nasal problems, such as polyps or atrophy. Nasal atrophy is the loss of the ability to smell and therefore also taste. It frequently occurs after surgery as a side effect to anesthesia but also may be related to other kinds of drug interactions. See 1010.15 Welcome Fragrance (LI20) for my unique and detailed needling instructions.

Large Intestine/Liver:

In Tung’s acupuncture, we recognize a special relationship between the Hand Yang Ming (LI) and Foot Jue Yin (LV), which work together to detoxify the body. While the Large Intestine and Lungs are closely related (the Large Intestine expels toxins through the bowels, the Lungs through the skin), the Liver detoxifies the entire body by filtering the blood. Both the Liver and the Large Intestine expel wind – the Liver internally, and the Large Intestine externally. Four Horses Middle, the Chief Point, is located anterior to GB31 Wind Market, so Four Horses is associated with all kinds of wind diseases due to the internal/external relationship between the Liver and Gallbladder (wood and wind), making Four Horses very useful in the treatment of dizziness, vertigo, Meniere’s disease, Parkinson’s disease and hyperthyroidism.

Lung/Liver:

Four Horses points have the Reaction Areas of Lung and Liver; while the Lung governs the surface, the Liver cleans the blood. As previously discussed, one of the most common indications of a compromised immune system is an allergic skin reaction that happens when the surface is weak and the liver is overworked. Because Four Horses can be used to expel wind and move the blood, it is especially useful in treating allergic reactions that cause itching, rashes, psoriasis, eczema or fungal infections.

Lung/Urinary Bladder:

The Chinese have a saying: “The wind chill evil enters through the back of the neck.” Never is this more evident than in situations of wind chill lodging in the neck and upper back, causing not only muscle spasm but also the onset of most common colds and flu. There is a special relationship between the Hand Tai Yin (LU) and Foot Tai Yang (UB), characterized in part by the ability of both to disperse fluids. When the evil wind chill penetrates the Wei qi, governed by the Lungs, we use surface-dispersing herbs to open the exterior and induce sweating, thus relieving the Tai Yang upper back. The Tai Yin/Tai Yang relationship is also evident in the use of Four Horses for thorax pain (front or back), chest and rib pain, as well as Lung-deficient-type UB channel sciatica. However, I rarely use Four Horses for sciatica unless the patient also has another condition such as asthma, allergies or psoriasis, for which Four Horses points are indicated.

Cough and asthma:

Four Horses are my primary points and favorites for asthma and pneumonia, but they are also very good for any kind of cough, whether it is acute or chronic. If the wind chill has lodged in the upper back muscles, or if the lungs feel heavy or tight, cup the entire neck and upper back (with the patient sitting upright), then needle Four Horses, A.04 San Cha Three and 1010.19-1010.20 Water Gold/Water Through. Bleeding 33.16 Curve Mound (LU5) bilaterally is especially helpful in severe cases; it will open the lungs and immediately calm the breathing. If you are not comfortable bleeding LU5, it could be bilaterally needled. Water Gold/Water Through points tonify the Lungs and Kidneys and are great when a patient has been coughing or wheezing for an extended period of time. Because Water Gold/Water Through points are used for lower back pain and sexual dysfunction, they also can treat urinary incontinence that may arise toward the end of a severe upper respiratory infection. If the patient is experiencing allergic asthma, I am also likely to add 1010.15 Welcome Fragrance (LI20) to open the sinuses.

Common cold:

Illness may be avoided altogether if, within a few hours of being chilled, the patient takes an extremely hot shower with water beating upon the upper back and neck. This corresponds with the Chinese teaching, “The wind-chill evil enters through the back of the neck.” Often patients feel a shudder of cold coming out through the surface while they stand under the steaming hot water. They need to be careful not to get exposed to another chill after the hot shower (bring warm clothes into the bathroom). A good sweat, followed by a change of clothes, should relieve the chill.

Treatments:

Cupping:

When a patient has a wind-chill invasion, I immediately cup their entire upper back to remove it. This must be done within a few hours of the exposure for best results, although it may still be appropriate days later if the chill is still lodged in the body.

Cold/flu, sinusitis, allergies:

Bilaterally needle 88.17-88.19 Four Horses, A.04 San Cha Three and 1010.15 Welcome Fragrance (LI20) as Guiding Points; optional 11.17 Wood (Anger).

Optional: Dr. Miriam Lee’s Ten Great Needles Treatment:

Bilaterally needle ST36, SP6, LI11, LI4, LU7 in this order, tonifying the bottom and sedating the top), 1010.15 Welcome Fragrance (LI20).

For headache from a common cold:

Unilaterally needle 22.04 Da Bai and A.04 San Cha Three (one point on each side).

For sore throat:

Bleed VT.01 Throat Nine Moths or bleed LU11 and LI1.

To clear the sinuses:

Needle 1010.15 Welcome Fragrance (LI20) toward Yin Tang.

Optional:

To open the nose: Bilaterally needle proximal point 11.17 Wood (Anger). For nasal blockage with pain or headache: Unilaterally needle 66.05 Golden Gate (Tung’s ST43).

Allergy option:

Needle 11.17 Wood (Anger), 1010.15 Welcome Fragrance (LI20), LI4/LV3 Four Gates or 22.04 Da Bai.

For ear pain:

Bleed 77.22-77.23 Beside Three Miles.