Students new to Tung's system of acupuncture often struggle with learning new point locations, actions, and indications. However, an easy way to learn the Tung method is to compare his points with the standard TCM points. In this post I will compare the Four Flowers (77.08, 77.09, 77.11) with stomach 36 (ST 36), ST 37, and ST 38. We will also discuss how these points relate to the superficial front myofascial line.
The first thing to recognize with the Tung points is that they are located next to the tibia and in the small space between the edge of the bone and the tibialis anterior muscle. This is significant because there is dense connective tissue and fascia there, and this likely plays a role in some of the actions of these points. I will discuss this more below in relation to the Superficial Front Line (SFL). First though, let's compare the location of the Four Flowers to the points ST 36, ST 37, and ST 38.
The location of the three points known as the Four Flowers is directly on the edge of the tibia 3 cun, 7.5 cun, and 12.5 cun below ST 35. Therefore, 77.08 and ST 36 are both located three cun below ST 35, but 77.08 is on the edge of the tibia, while ST 36 is one cun lateral and in the tibialis anterior muscle. Both these points have similar functions in treating digestive, respiratory, and heart conditions.
The Master Tung point 77.09 is located 7.5 cun below ST 35 and on the edge of the tibia. Stomach 37 is three cun below ST 36, and ST 38 is 8 cun below ST 35. This places 77.09 between ST 37 and ST 38. All of these points treat digestive problems, and ST 38 is also known to be an empirical point for the shoulder.
With all of these points in close proximity and with similar functions, how do we know which ones are best to needle? Do we stick with the TCM text book locations, or should we venture into the Tung points and hope for better results?
The answer to these questions depends in who you're treating and the unique ways in which they hold tension (qi stagnation) in their bodies.
To get familiar with the Tung points and understand when you should needle them over ST 36, ST 37, or ST 38 simply palpate these points. Do this on yourself now, and on your next 10 patients. That should be sufficient to demonstrate the point I want to make.
Palpation of the Four Flower Line
To palpate the Four Flowers simple place the tip of your thumb on the edge of the tibia and press down the line. When doing this correctly your thumb should glide between the narrow space between the tibia and the anterior tibialis muscle. Be observant of any sensitive ashi points and note if there are any nodules or trigger points. (Remember that trigger points are defined as painful nodules in a band of tension.)
If you find a trigger point that is an ideal place to put a needle.
The next exercise is to find ST 36 in tibialis anterior and then slide your thumb or fingers down the stomach meridian. Notice the overall level of sensitivity and note if you find any trigger points.
Which line is most sensitive on you? Which line is more sensitive on your clients? What line has more nodules or trigger points?
You may notice that most people are more sensitive on the Four Flower Line, while fewer people hold tension on the ST meridian.
The nodules that you can often feel on the Four Flower line are equivalent to micro areas of qi stagnation. When you needle those nodules along the Four Flower line you can expect a strong needle reaction.
In my experience I have found that most people are more sensitive on the Four Flower line and that more nodules are located along this line. However, after needling them a few times the points decrease in sensitivity, and then the stomach meridian points can become more sensitive. When the regular stomach points are more sensitive then I will needle them.
The Four Flowers and the Myofascial Lines
The tibialis anterior and fascia between this muscle and the bone is part of the Superficial Front Line (SFL). The SFL includes the tibialis anterior, quadriceps, rectus abdominis, sternal fascia, and SCM muscles. This myofascial line is very similar to the stomach meridian and explains many things about how the Four Flowers and stomach meridian points work.
Remember that the points ST 36, ST 37, and the Four Flowers all benefit the respiratory and digestive system. If we follow the SFL up we find that the rectus abdominis is part of this myofascial chain. On the internal side of the rectus abdominis muscle are extensive fascial connections to the internal organs and digestive system. Similarly, the sternal fascia and SCM are part of the SFL and both relate to the functional activities of the lungs. The SCM are secondary respiratory muscles, and the sternal fascia connect internally to the parietal pleura and lungs.
This provides an anatomical and mechanical basis for understanding how points on the stomach meridian and leg can modulate lung and digestive functions.
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In light,
Jim
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