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Reply To: Acupuncture Bootcamp

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Answers interspersed:

On exam #2:
-A patient with a history of hernia comes to the clinic because of acute distending pain in the lower abdomen, borborygmus, and bearing-down sensation in the testes, which refers to the lower back. The tongue is normal, and the pulse is string-taut. According to the theory of Zang-Fu organs, which is the most likely diagnosis?
A: Disturbance of Qi in the Small Intestine
–> I thought anytime there was “bearing down” that that would automatically be sinking of Qi. What am I missing?

The bearing down is definitely in there to throw you for a loop. However, everything else is right out of the textbook: Small Intestine Qi Pain from Foundations of Chinese Medicine by Maciocia.

-The main etiology of facial paralysis is the invasion of Wind and/or Cold, attacking the:
A: Bright Yang (Yang Ming) and Lesser Yang (Shao Yang)
These meridians are the two superficial meridians, and are subject to the invasion of Wind and/or Cold.
–> I have in my notes from our learnings in the bootcamp, that the 6 level order goes: Tai Yang, Yang Ming, Shao Yang, etc… Wouldn’t that mean that Tai Yang and Yang Ming are most superficial?

The answer is clear because when you think of the acupoints involved in facial paralysis, it’s the Yangming and Shaoyang. That being said, I don’t like the wording here regarding ‘most superficial.’ I will make a note to go in and change this wording. I believe ‘most susceptible’ to Wind would be a better choice of words.

-A patient has insomnia, mental restlessness, ulcerations in the mouth and on the tongue, and hot, deep yellow urine with painful urination. The tongue is red with yellow coating, and the pulse is deep and rapid. According to the theory of Zang-Fu organs, the diagnosis would be:
A: Heart-Fire Transmitted to the Small Intestine
–> Why not HT-Fire transmitted to the BL, since the symptoms seem to be more BL related?

This is the mechanism we all learn in school due to the Interior/Exterior organ relationship between Heart and Small Intestine. Heart-Fire is not transmitted directly to the Bladder. I don’t make up the rules. I just follow them.

On exam #3:
-There is a question about the crossing point of the Hand Shao Yang and Foot Shao Yang meridian being SJ17. Is there a central place where I can find these crossing points?

A Manual of Acupuncture by Peter Deadman, pages 52-55

On exam #1 & 3:
There have also been a couple questions about gauge of an acupuncture needle. I thought that the smaller the gauge, the smaller the needle (ie. 0.25 x 30mm needle is thicker than a 0.15 x 30mm needle), but the exams seem to say otherwise? I’m confused. Is gauge not the diameter?
–ie. on Exam 1 it said: “What gauge of an acupuncture needle has the smallest diameter?
A: No.34 (not No.26) – the larger the gauge of an acupuncture needle, the smaller the diameter of the needle”

This follows western medical needles, which have holes and states, “The higher the gauge number, the smaller the hole.” Therefore in acupuncture, the larger a gauge number is, the smaller the needle in diameter.