“Points located on the lower leg and thigh are extremely effective for adjusting the function of the entire body. They treat the organs and bowels and internal and external diseases. Their results are fast, accurate, and often astonishing. Most of these points are needled in groups that occur along the same line. For instance, there are the Four Horses, Four Flower points, Three Emperors, Three Yellows, etc. Some of these points are located in the same places as the regular fourteen channel points. However, because their usage and indications are different, so are their names.” – Dr. Lee, 1992

In keeping with Dr. Lee’s description, I find that when creating a treatment suited to each patient, I frequently build my protocol around Master Tung’s thigh points or calf points. Occasionally, I even carefully combine them:

• Thigh points, located in large muscle, have a vast nerve and blood supply, which accounts for their extremely powerful Dao Ma presentations. Most thigh points are Dao Ma combinations of a Chief Point and two Supporting Points. To those, we can choose to add a few specific distal points, to refine and complement the foundation upon which the treatment is based.
• Calf points are likewise powerful and can also be used as a base upon which to build and refine. However, their remarkable strength is less about their reserves of qi and blood, and more about their functions as Transporting Points, as we shall see once we delve into them individually.

Needling notes for Dao Ma patterns

Nearly all of Tung’s combinations on the thighs and calves are three-point Dao Ma patterns; we choose to needle one to three of these points. Generally, the middle point in the pattern is the Chief Point, the first one to be located and needled. We measure from the Chief Point to find the two Supporting Points. It is not important which Supporting Point is needled first, though typically we needle the more proximal point and then the distal one.

• Directional needling: Occasionally, the points are needled in the direction of the affected area. For example, we needle 77.05-77.07 Three Weights distal to proximal when treating diseases of the head and brain.
• Stimulation: When choosing protocols to treat the whole body or an organ system, we needle the middle point with strong stimulation, then add the Supporting Points on either side, again with strong stimulation; finally, we return to the Chief Point to restimulate, sending the energy in both directions. This form of needle stimulation is largely responsible for the phenomenal effects of Tung’s acupuncture.

Combining Dao Ma patterns in deficiency (more is not better)

We do not use multiple three-point Dao Ma patterns simultaneously, even when the patient is physically strong, because one bilateral three-point pattern is powerful enough to do just about any job. Tung’s practitioners understand that fewer needles usually provide a better treatment result, and that every needle needs to add and not unnecessarily disperse or detract from the overall treatment. If we are using points on the thigh and calf simultaneously, it is necessary to choose carefully, keeping the overall foundational treatment to a maximum of six needles.

For complicated cases, chronic or weak patients: We may wish to combine the functions of two Tung’s patterns. This is done by taking the Chief Point of one pattern and combining it with the Chief Point and one Supporting Point of another pattern. For example, when treating Parkinson’s disease, we are almost always treating an elderly and often frail patient, so we may choose to needle 88.12 Bright Yellow with 77.18-77.21 Two Emperors. Alternatively, we might choose Bright Yellow and 88.14 This Yellow, together with 77.18 Kidney Gate (Shen Guan). The patient will weaken if too many powerful points are needled simultaneously. Pay careful attention to this caution; otherwise patients will be tired and suffer the consequences after your treatments.

Needling with qi

Typically, practitioners in my classes have not been previously taught to use their qi in needling their patients, so their treatments are often less effective than they could be. The potency of a treatment has everything to do with the combination of the practitioner’s qi meeting the patient’s qi at the point being needled. Put some qi into your needles, and your treatments will be instantly effective; neglect to do so and your patients will look for help elsewhere. Occasionally, with needle-phobic, extremely weak, and/or elderly patients, I need to hold back my qi from the needle in order to avoid overwhelming them. Though it is my opinion that Tung’s points are exceptional, I believe that needling the correct points in their proper location, with qi, has much to do with the miraculous results I see in my clinic. The saying, “Every needle takes a little piece of your qi,” is true, and we want to build and protect our own qi so that we may provide powerful results without depleting ourselves.

Foot Yang Ming (ST)

TCM teaches that the Foot Yang Ming (ST) meridian has more qi and more blood, making bleeding techniques on the Stomach channel especially advantageous. In Tung’s acupuncture system, when needling for structural problems (bone, nerve, tendon, muscle or blood vessel), we use points on channels that are on the side opposite the affected area. There is one exception to this rule, however, as the Stomach channel can be used equally effectively on the same side or opposite side. This is only important when the opposite side is overloaded with needles, and it is helpful to “spill over” to the same side (affected side) using the Stomach channel. For example, because every pathway is involved when treating a frozen shoulder, the opposite side may be excessively needled while the affected side is scarcely needled. In this case, we can needle the points found on the Foot Yang Ming on the same side as the frozen shoulder, still utilizing distal needling technique.

Reaction Areas and Tung’s channels on the legs

Some of Tung’s Dao Ma combinations and points are located between two channels recognized in TCM, effectively meaning that they share some attributes of both channels. For example, 77.05-77.07 Three Weights and 77.22-77.23 Beside Three Miles are found between the Shao Yang and Yang Ming channels, as are many other Tung’s points patterns typically assigned to the Gallbladder. To select the appropriate points after identifying the affected zang/fu (often using face and palm diagnosis), Master Tung relied in part on his family’s knowledge of Reaction Areas. When we are choosing points, we may consider the Reaction Areas, in addition to their internal/external relationships, Hand and Foot channel connections, and the special relationships that utilize the I-Ching (absent in most TCM training). Do not necessarily expect to comprehend the relationships between the Reaction Areas and the meridians on which the points are located, as this takes further understanding of the energetic operations of the points themselves. This understanding develops as you use the points successfully and see their energetic connections for yourself.

The primary Dao Ma combinations on the legs, and their Reaction Areas, are as follows:

• Lower leg: 77.01-77.02 Correct Tendons, found between the Kidney meridian and the Urinary Bladder meridian, have the Reaction Areas of Brain and Spine. 77.05-77.07 Three Weights, found between the Stomach and Gallbladder meridians, have the Reaction Areas of Heart, Lung and Spleen. 77.08-77.09 Four Flower Upper/Four Flower Middle are found on the Stomach meridian and have the Reaction Areas of Heart and Lung. 77.18-77.21 Three Emperors, found on the Spleen meridian, have the Reaction Areas of Heart and Kidney. 77.22-77.23 Beside Three Miles are found between the Stomach and Gallbladder meridians, and they have the Reaction Areas of Teeth and Lungs.
• Upper leg: There are four primary Reaction Areas with associated Dao Ma combinations located on the thigh. Starting with the Liver meridian on the medial thigh, we find 88.12-88.14 Three Yellows, which have the Reaction Areas of Liver and Heart. Moving laterally, we arrive at the Spleen meridian and 88.09-88.11 Kidney Passing Points, which have the Reaction Area of the Kidney. On the midline of the thigh, near the Stomach meridian, are 88.01-88.03 Heart Passing Points, which have the Reaction Area of Heart. Finally, moving laterally to a line found between the Stomach and Gallbladder meridians, we find my favorite Dao Ma pattern, 88.17-88.19 Four Horses, which have the Reaction Areas of Lung and Liver.

Tension in the legs

Frequently, practitioners notice that their patients, especially women, are consciously or unconsciously holding their knees together or tensing their thighs. Patients who hold their knees together tightly may have a history of sexual abuse, although this certainly is not always the case (they may not remember whether they were abused, and there is no need to bring this possibility to their attention). It is very important, however, that the legs are completely relaxed before they are needled, as most of the needles used on the thighs, and many used on the calves, are inserted deeply. It is the practitioner’s responsibility to notice how the patient is holding their legs, because if the legs are not relaxed before needling, they cannot be relaxed after the needles are placed.

• Rocking the legs: Before needling the legs, always gently rock them. Either place your fingers on both sides of the knee joint (not the patella), or hold the foot or ankle, and gently rock back and forth. This will indicate to you where tension is being held. If the patient resists the rocking, usually it is because they are trying to keep their knees together. Rather than positioning their legs myself, as this might feel like a violation, I ask them to let their knees fall outward. This phrasing enables them to recognize the holding and to relax their legs.
• Blanketing for privacy: To give your patient the greatest possible privacy, avert your eyes while covering them with a blanket. Whether they need this consideration or not, it will help them to trust you more. Then, on the side you are about to needle, move the blanket to the middle. Once the needles are inserted, I always put a small box over them and then cover the box and the patient’s body with the blanket. The box keeps the blanket from pressing on the needles. This way the patient stays warm and relaxed during the treatment.

Pregnancy cautions

“Points on the lower limb relate to the abdomen so they are generally avoided during pregnancy. If there is a disease during pregnancy the qi will look for the disease. Use very gentle stimulation; if the stimulation is too strong the qi may look for the baby” (Dr. Lee, 1992). I felt that this beautiful statement by Dr. Lee had to be included here. However, please rest assured that throughout this book, all points that should be avoided in pregnancy are clearly designated as such, under the heading “Caution.” If the point description is silent regarding pregnancy, it is perfectly fine to include it in any treatment protocol. I am very careful not to over-needle a pregnant woman. If her pregnancy is stable and progressing nicely, one or two treatments per month are adequate. Typically, I use the following variation of Dr. Lee’s Ten Great Needles Treatment, dropping LI4 and SP6 altogether:

• Dr. Lee’s Ten Great Needles Treatment modified for pregnancy: Bilaterally needle 77.08 Four Flower Upper (ST36), 77.18 Kidney Gate (Shen Guan), LI11 Qu Chi, LU7 Lie Que; add left-side 11.17 Wood (Anger) if desirable. I use 30mm needles with only light stimulation for this treatment. This wonderful tune-up is safe for pregnant patients.

Specific channel and point relationships

Gallbladder points and the head, neck and shoulders

In Tung’s body of work, many points found between the Stomach and Gallbladder channels are loosely classified as “Gallbladder channel points.” All of them have a powerful effect on the head, neck, face, jaw and five senses. Therefore, it is important to determine the root cause of the pathology before choosing from the following points: 77.05-77.07 Three Weights, 77.22-77.23 Beside Three Miles, 77.24-77.25 Leg Five/One Thousand Gold, 77.27 Outer Three Gates, 88.17-88.19 Four Horses (with or without 88.25 Center Nine Miles [GB31]). All Gallbladder points deal with joints, tendons and wind, especially Beside Three Miles, but it is also helpful to think of bone and bone marrow as related to Shao Yang (blood and Sea of Marrow). All of these points can affect the Gallbladder channel on the head and neck, so when treating head and neck problems, it is important to determine the root cause of the pathology and to ascertain what else might be going on in the body that best relates to your choice of points from the above list. The following examples illustrate my meaning:

77.05-77.07 Three Weights (Tung’s GB39)

Because they fall between the Yang Ming (ST) and Shao Yang (GB) channels, Three Weights points are especially effective in disorders related to wind and phlegm, such as brain injuries or psychosis. But also, due to the relationship with GB39, they treat bone marrow and blood diseases. This idea is additionally supported by the fact that Three Weights points have the Reaction Area of Spleen, because according to TCM, the Spleen controls the blood. So, when Three Weights are used to treat head, neck and shoulder problems, they are most effective when the patient also has some kind of blood disease, a local circulatory issue such as a stroke or vascular occlusion, or any other kind of wind and phlegm disorder.

77.22-77.23 Beside Three Miles (Tung’s GB34)

Beside Three Miles points are most frequently used in the treatment of head, neck, shoulder and arm musculoskeletal issues because they are Tung’s version of TCM’s Sea of Sinews, and thus have a powerful effect on tendons and ligaments. Additionally, they are used for otitis media and headaches because of the correspondence between the Hand and Foot Shao Yang (SJ/GB) and the way this connects to the special relationship between the Hand Shao Yang (SJ) and Foot Shao Yin (KD).

77.24-77.25 Leg Five/One Thousand Gold

These points have the Reaction Areas of Lung and Thyroid and are particularly useful for any kind of throat problem. They are included in the frozen shoulder protocol because of their relationship to the Lungs, which governs the ability to move the shoulder forward and back (done by moving the arm behind the back, as if hooking a bra). 

77.27 Outer Three Gates

These points are primarily used to treat cancer anywhere in the body and would not be chosen for treatment of the head and neck unless there were also a cancer-related condition.

88.17-88.19 Four Horses

Because these points have the Reaction Areas of Lung and Liver, with a strong influence on the immune system and five senses, if I am using Four Horses to specifically treat the upper back, shoulder, neck or head, it is because the patient also has some kind of immune disorder that might involve the Lung, Liver or skin. For example, chest or rib pain related to pleurisy, emphysema, lung cancer, or even pneumonia usually responds well to Four Horses needled on the side opposite the indications.

Stomach channel

In Tung’s acupuncture, the Four Flower Line (77.08-77.14) is also known as the Stomach channel on the calf. Because of the special relationship between the Pericardium and Stomach, Four Flower points are terrific for coronary heart disease. For the same reason, Stomach channel points on the thigh have been given the name 88.01-88.03 Heart Passing Points.

Spleen channel

In Tung’s acupuncture, the Spleen channel houses very important Kidney points on both the calf and the thigh. They are not only used to treat kidney diseases such as nephritis, but also are highly effective in any situation where the TCM designation of Kidney deficiency is made.

77.18-77.21 Three Emperors

These magnificent points, including 77.18 Shen Guan (Kidney Gate), Master Tung’s Master Kidney point, are famous with every old-time Tung’s style acupuncturist for their outstanding ability to treat Kidney disorders ranging from hypertension and diabetes to hot flashes/night sweats or urinary tract disorders (including prostate). In all of Tung’s acupuncture, these might be the most frequently used points.

88.09-88.11 Kidney Passing points

These points are used for any kind of kidney organ issue; they are less used for hormonal, digestive or neurological disorders (these issues relate more to the Emperor points above). However, they can be used in pregnancy, while the Emperor points cannot.

Liver channel

Two absolutely fabulous point patterns, found on the medial thigh, are called 88.12-88.14 Three Yellows and 88.14-88.16 Gallbladder Points. For real liver disease or cholecystitis and gallstones, these unsurpassed point patterns are two of my favorites. Three Yellows, primarily used for hepatitis, are also an outstanding choice for many blood diseases, Parkinson’s disease, Meniere’s disease, and any type of exhaustion due to liver. These points are excellent for detoxification.