Xian-Bing Hou ,Shu-Yan Liu ,Chun-Sheng Jia＊

1Hebei Cangzhou Integrated TCM&Western Medicine Hospital,Cangzhou City,Hebei,China;2Hebei College of Traditional Chinese Medicine,Shijiazhuang,Hebei,China.

Professor Jia Chunsheng is one of the sixth of old traditional Chinese medicine experts,and often instructs students in ordinary clinics to attach importance to learning and clinical practices of classic works.Now Professor Jia Chunsheng selects a poet—Song to Elucidate Mysteries in the Guidelines of Acupuncture Classic by Dou Hanqing in the Jin and Yuan Dynasties,and requires the students to read carefully,investigate deeply,and apply at times;Moreover,Professor Jia Chunsheng discusses the "important factors to achieve good clinical therapeutic effects by acupuncture" contained in the Song to Elucidate Mysteries,in many aspects of understanding acupoint characteristics,defining clearly acupoint compatibility,selecting appropriate needling manipulation,how to determine needling depth,how to determine needling direction,how to determine needle retention time,and how to select acupuncture &moxibustion method,etc.Now they are discussed as follows,to discover and spread Dou's acupuncture technique and to increase clinical therapeutic effects.

Key words:Jia Chunsheng,Apprentice,Classics,Dou Hanqing, Song to Elucidate Mysteries,Therapeutic dose of acupuncture

Background

The author is the academic inheritor of Professor Jia Chunsheng,one of the sixth national batch of old traditional Chinese medicine experts.Professor Jia Chunsheng has instructed the students in ordinary clinics that,"the development and innovation of acupuncture are important of course;however,if innovation is not established on the basis of heritage,it would become a castle in the air;many academic schools have emerged during development of acupuncture produced hundreds of schools of thought contend and each has its merits;during heritage,attention must be paid to learning widely from multiple recipes,drawing on others' successful experiences,and achieving mastery through a comprehensive study of the subject,and then it can increase greatly clinical efficacies------".

TheSong to Elucidate Mysteriesis a poet in the Guideline of Acupuncture Classis by Dou Hanqing,and means indication and elucidation of subtle and profound acupuncture mechanisms.TheSong to Elucidate Mysterieshas discussed important problems in acupuncture science,with respect to the acupuncture mechanisms,distribution of meridians and collaterals,andqiand blood,selection method of acupoints for acupuncture,needling reinforcing and reducing manipulations,application of special acupoints,opportunity for acupuncture therapy,differentiation and treatment of the root and branch by acupuncture,and acupuncture compatibility and incompatibility;it is very close to acupuncture clinical practices,and has been with important clinical guidance significance,and is attached with importance by many acupuncture doctors.Moreover,theSong to Elucidate Mysteriesis of euphuistic and beautiful language and is easy to read,to Professor Jia Chunsheng advise us to read carefully,investigate deeply,and apply at times.Professor Jia Chunsheng applies often the acupuncture mechanisms in theSong to Elucidate Mysteries,and also understands thoroughly its truth and brings into play and develops in clinical practices.Can learning acupuncture certainly achieve good clinical therapeutic effects?Professor Jia Chunsheng points out that theSong to Elucidate Mysteriescontains many discussions for"important factors to achieve good clinical therapeutic effects by acupuncture",and instructs students to learn theSong to Elucidate Mysteriesin the following aspects:

First learn the Song to Elucidate Mysteries:The importance for the "wonder" of acupuncture is in"application"

Professor Jia Chunsheng points out:To achieve good therapeutic effects from learning acupuncture,it is first to apply acupuncture in clinical practices.Acupuncture is convenient and efficient to use,and is not restricted by environmental factors;moreover,the rational of acupuncture is to regulate human function,and does not introduce any exogenous chemical substances.Being safe,effective,and efficient,acupuncture is the method of first choice for treatment of diseases.The author saw previously that Professor Jia Chunsheng treated a student with intense pain with jet-like vomiting (later diagnosed with renal colic).At that time,the study paid a visit to a Grade 3A Hospital and could not be diagnosed definitely due to pain reasons.The hospital did not give any analgesic drug,while the student was very painful at that time;through diagnosis and examination,Professor Jia Chunsheng conducted acupuncture at ear acupoint kidney，ureter,andthree energizer;the student's pain was relieved obviously 5 min later.Professor Jia Chunsheng also conducted once scar acupuncture at Zúsānl?,an interpretation for the "wonder" application of acupuncture by first-hand experiences.Professor Jia Chunsheng further points out:To become a good acupuncture doctor,acupuncture must be applied in practices.It should be used in healthcare and self-protection against disease,and should be first considered in clinical diagnosis and treatment.Acupuncture therapy has obvious advantages and has more extensive application scope.The "application" word is to bring its advantages into full play,integrate the acupuncture into life,and allow it to become one integral part of life.The more you use,then the more experiences you may bet,and the more you may understand the"wonder"of acupuncture.

Then learn the analysis of the Song to Elucidate Mysteries on the basic knowledge of acupuncture

Professor Jia Chunsheng points out that,only good master of the basic knowledge of acupuncture can further do with skill and ease in clinical practices of acupuncture.TheSong to Elucidate Mysteriesanalyzes the basic knowledge of acupuncture in the following aspects:

Understand acupoint characteristics

Professor Jia Chunsheng points out:The first step of acupuncture therapy is to determine precisely the treatment target.For diagnosis and treatment by acupuncture,more stress is laid on diagnostic examination.After the affected meridians and collaterals are determined,the most important step is to determine the immediate state of acupoint;in this way,the treatment target of acupuncture therapy may be discovered [1].This paragraph of the Song makes it clearly;to master the method for selection of acupoints,it must first get the knowledge of the characteristics and laws for distribution of acupoints;the proportional unit of the body is the scaling laws for distribution of acupoints;then you should observe the patient's sinew and bone sizes and muscle thickness,thereby to determine needling depth site and depth.Meanwhile,it also suggests that different body position may also impact needling method of acupoints;the acupoints ofyangmeridians are mostly distributed in the depression area beside the sinews and bones of theyangside;the acupoints ofyinmeridians are mostly distributed in the gap between the sinews and bones of theyinside and beside the arteries of popliteal fossa;for selection of meridians and collaterals,it must consider the two adjacent meridians and collaterals;for selection of acupoints,it must consider the acupoints on all sides to further position the target acupoints.In total,to use well acupoints,it must understand and analyze acupoints.For example,Mr.Yang Jiasan has concluded the rules for selection of acupoints [2],based on the distribution characteristics of acupoints.

Precise combination of acupoints

Professor Jia Chunsheng points out:The first step to learn well acupuncture is to understand the characteristics of acupoints,and the next step is how to select and combine acupoints.It is somewhat similar to command an army to fight battle.Even for a powerful arm,it cannot still win a war without the leadership of a good general.The Song to Elucidate Mysteriesdiscusses detailedly selection of proximal acupoints,selection of distal acupoints,selection of acupoints by contralateral shallow collateral needling,and selection of exterior-interior related meridian acupoints,etc.Mastery of such selection rules of acupoints is like mastery of the book on the art of war,to direct military operations with miraculous skill.

Gather together on needling

Professor Jia Chunsheng points out:A doctor must concentrate attention,gather together,and be absorbed on needling,as calm as with the tiger-shaped tally in hand;be empty mind,as waiting respected guests.In this way,the doctor can feel accurately the sense delivered by needle,as fish to swallow the hook.

Selection of appropriate needling manipulation

Professor Jia Chunsheng points out:In theSong to Elucidate Mysteries,Dou also proposed the tips for needling manipulation,i.e.,the manipulation acting on the acupuncture needle by fingers,to achieve the purpose of movingqiand regulatingqi,to realize reinforcing-reducing effects.

Finally learn mastery on therapeutic dose of Acupuncture in the Song to Elucidate Mysteries,this is critical to increase clinical therapeutic effects of acupuncture

Professor Jia Chunsheng points out:Whether the acupuncture is clinically effective,and how fast what degree the acupuncture is effective,are related with the selected acupoints,as well as needling depth,needle retention time,and selected acupuncture &moxibustion method.Professor Jia Chunsheng has emphasized that,similar to prescription,acupuncture is also particular to "dose".Some experts have said,the critical issue that is not disclosed of traditional Chinese medicine is in dose;so does acupuncture.In recent years,the results from some high quality randomized,controlled clinical trials conducted on foreign countries have raised questions for clinical therapeutic effects of acupuncture,and considered that acupuncture has the same therapeutic effects as placebo [3].To figure out why,it is related with that some scientific researcher of acupuncture do not master well the"dose"of acupuncture,so they obtain inaccurate conclusions.Giving a not quite appropriate examine,an apprentice who has just learned Kungfu for one month,without any practical experiences,contests with a ruffian who has never learned Kungfu,and both of them may be equally matched;however,the students would not conclude that "Kungfu is just placebo",as the difference of combat powers between a martial artist who has practiced Kungfu for many years and a common person is quite obvious.The introduction of acupuncture is relatively simple.However,to become a skilled acupuncture doctor,it has to consider repeatedly,weigh,and master proficiently the elements needling direction,depth,angle,layer,manipulation,opportunity,needle retention time,and selected acupuncture &moxibustion method.Needle withdrawal seems a very simple matter.Professor Jia Chunsheng points out,needle withdrawal is actually the most important basic skill for learning acupuncture,as during needle withdrawal,the student may feel the needling sense,and the needling angle and depth of treatment by the teacher.The Song to Elucidate Mysteriesmainly discusses the contents of the therapeutic dose of acupuncture in the following 4 aspects:

How to determine needling depth

Professor Jia Chunsheng inspire the studies that,while reading,it must draw differences about other cases from one instance.Why it requires shallow needling in spring and summer,and deep needling in autumn and winter?Asyang qiexpands outwards in spring and summer,acupuncture is intended to dredge meridianqi,andqiis in exterior area and so it requires shallow needling.Therefore,the key for depth of needling is in depth ofqi,and then for the same reasons:A thin person requires shallow needling,while a fat person with much phlegm requires deep needling;febrile disease requires shallow needling or point bloodletting to bleed,while cold disease requires deep needling;mild disease requires shallow needling,while severe disease requires deep needling;upperjiaodisease requires shallow needling,while lowerjiaodisease requires deep needling;acupoints in threeyangmeridians of the hand require shallow needling,while acupoints in the threeyinmeridians of the hand require deep needling,etc.Of course,those rules are relative and are important reference information;the specific needling depth still depends on the patient's condition.

How to determine needling direction

Professor Jia Chunsheng points out:The overall direction of meridians isyangdescending andyinascending,consistent with "Tai" hexagram in the sixty-four hexagrams.Human body has such taiji mode of endless loop and also radial direction of meridian sinews;both of them must be discriminated in clinical practices.In fact,neck,shoulder,waist,and leg pains commonly seen in clinical practices are mostly diseases of both meridian sinews and meridians;in regulating meridian sinews,radial is forward and counter-radial is reverse.

How to determine needle retention time

Professor Jia Chunsheng points out:Cold pattern requires extended needle retention,while heat pattern requires rapid needle withdrawal;of course,the premise is that acupuncture has achieveddeqi(arrival ofqi).Needle retention time must consider cold and heat factors.Additionally,exterior patten requires short retention time of needle and interior pattern requires long retention time of needle;yangpatten requires short retention time of needle andyinpattern requires long retention time of needle;children require short retention time of needle;and so on.Professor Jia Chunsheng has also found that,whiling adopting the subcutaneous penetration needling method of ear acupuncture,the longer the needle retention time is,the better the therapeutic effects is[4];the needle may be retained for 30 to 60 min,or even 2 to 3h in severe cases.

How to select acupuncture&moxibustion method

For selection of acupuncture &moxibustion method,Professor Jia Chunsheng adopts mainly filiform needle.However,through clinical observation of many years,it is discovered that each kind of needle tools has its own unique,irreplaceable properties and therapeutic effects.Professor Jia Chunsheng has first proposed the concept of"specific effect specificity of acupuncture &moxibustion method" [5];that is to say,different acupuncture &moxibustion methods have their own optimal indications or corresponding disease stages due to their different clinical effects.Moreover,commencing from the relationship between different acupuncture &moxibustion methods and specific effect specificity against the syndromes,the literatures for the required acupuncture &moxibustion methods are collected,and the information is extracted and analyzed to form a standardized format;a database for literatures of acupuncture &moxibustion methods is established and the application platform for literature data is designed.Finally,the data are analyzed and tested,to reveal knowledge and laws for application of potential acupuncture &moxibustion methods in mass of fuzzy,incomplete literatures data for acupuncture &moxibustion methods [6].Presently,the big data have been used to complete analysis on specificity of acupuncture &moxibustion methods,such as fire needling,acupoint injection therapy,and acupoint application therapy[7?9].

Conclusion

Professor Jia Chunsheng recommends the students to learn a classic work,theSong to Elucidate Mysteries,so that the students untangle the academic ideas of Dou's acupuncture and conduct further induction and summarization,to extract "important factors to achieve good clinical therapeutic effects by acupuncture".In this way,Professor Jia Chunsheng applies the academic ideas of ancient sages in clinical practices of modern acupuncture,inherits Dou's acupuncture theory,and innovates the acupuncture techniques,to increase clinical therapeutic effects of acupuncture.In total,in academic heritage of acupuncture and moxibustion of traditional Chinese medicine acupuncture,importance must be attached on learning of ancient literatures,and the integration of classic theories and modern clinical practices can only realize innovation.