San Zhen Protocols Part II: Case Studies

By Craig Williams, LAc, AHG

In my last article, I presented a collection of three-point acupuncture combinations which can provide effective clinical
results. In this installment, I will share some case studies using these three-point combinations as well as discuss
needle technique and various ways to modify the point groups in relation to the unique pattern presentation of the
patient.
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I received excellent feedback on the initial installment of this series therefore I will continue case studies into part III as
well as discuss more three-point combinations which can expand a practitioner's repertoire and fine tune a diagnostic
plan.
Case Study for Ren 17 + Ren 6 + Du20
Patient was a 34-year-old Caucasian male with lingering dry cough, fatigue, low libido and orthostatic/postural
hypotension. The patient was referred from his primary care physician with normal blood work. The patient had no
other complaints. Tongue was red, dry, with cracks; pulse was deep, fast and thready. The TCM pattern differentiation
was Lung Yin Vacuity with Kidney Qi Vacuity; treatment protocol was to Nourish Yin and Supplement theQi. The points
Ren 17, Ren 6, and Du 20 were chosen with even stimulation. After three acupuncture sessions, the dry cough and
orthostatic hypotension were completely resolved. Patient also noted that sleep quality seemed improved and "deeper"
and within two weeks after receiving the three acupuncture sessions, his libido returned to his "normal." The
combination of Ren 17, the influential point of Qi with Ren 6, the "sea of Qi" is a powerful two-point therapy. By adding
Du 20, one is able to move stagnant qi from all areas of the body, upper Jiao, middle jiao and the lower jiao. Ren 6 also
has the ability to supplement as well as course the qi, therefore it's an excellent choice in conditions of qi vacuity.
Case Study for Ren 17 + Ren 6 + Sp 10
Patient was a 32-year-old Caucasian male with chronic prostatitis. This condition had been an ongoing issue for over six
months causing heavy dragging sensation in the pelvis area at night with chronic nighttime urination. Patient was
referred by his primary care physician and had no other presenting complaints. Tongue was slightly bluish with normal
coat and engorged purple sublingual veins. The pulse was choppy and slow. The TCM pattern diagnosis was Blood Stasis
in the Lower Jiao, treatment protocol was to invigorate Blood in the lower jiao. The point selection was Ren 17, Ren 6,
and Sp 10. Ren 17 was needled with an even technique, Ren 6 was needled with strong technique until the patient felt
the needle sensation radiate into the groin/pelvic area, Sp 10 was also needled with a strong technique until the patient
felt the needle sensation radiate up into the groin/pelvic area. After 6 treatments with this three point combination, the
patient was no longer experiencing the heavy dragging sensation in the pelvic area and was no longer waking at night
to urinate. After six more sessions of this combination, the patient was not experiencing any of the original complaints
and was referred back to his primary care physician for blood work and further evaluation. At a three month follow up,
the patient was no longer experiencing any discomfort and blood work was normal.
Ren 6 + GB 34 + Sp 9
Patient was a 24-year-old Caucasian female suffering from chronic yeast infections with incessant vaginal itching and
heavy discharge. She was referred by her gynecologist as standard treatment was not resolving the issue. All blood
work was normal and the patient was not suffering from any other issues. Tongue was red with a sticky yellow coat,
slight teeth marks; pulse was wiry and fast. The TCM pattern differentiation was Damp Heat in the Lower jiao,
treatment protocol was to Drain Damp and clear heat in the lower jiao. The patient was afraid of having needles in her
hands or feet, therefore I used this elegant three point combo. Ren 6 was needled until the patient felt a sensation
radiating into the groin area, GB 34 and Sp 9 were needled with strong reducing technique until the patient felt a
sensation radiate down the legs. After two acupuncture session of this combo, itching and discharge completely
resolved. After a total of six acupuncture sessions with this combo, the patient was no longer suffering from any
symptoms and was referred back to her gynecologist for evaluation. At a one month follow up, the patient was not
longer suffering from any yeast infections, itching or vaginal discharge. This case was interesting as the patient was not
willing to take any herbs or supplements and was not open to dietary modifications. However, the acupuncture alone
resolved her chronic condition.
Patient was a 35-year-old Caucasian male complaining of chronic knee pain with chronic fatigue. He was a long distance
runner who avidly followed a balanced diet and was concerned at being unable to continue to complete his races. The
patient's tongue was normal, healthy color with thin coat and no cracks in tongue body, engorged purple sublingual
veins; pulse was slow, wiry and slippery. The patient had no other complaints. TCM pattern differentiation
was Qi Vacuity with Blood Stasis, treatment protocol was to Supplement Qi and invigorate blood. I used Moxa on Ren 6
and needles on GB 34 and Sp 9. I used stick moxa on Ren 6 until the patient felt a warm comforting sensation
throughout the entire abdomen, and strong stimulation on GB 34/Sp 9 until the patient felt the needle sensation radiate
down the legs. After three treatments, patient reported a significant reduction in knee pain, deeper sleep and improved
energy levels. After six treatments with this three point protocol, the patient reported dramatically improved energy
levels with knee pain only on days of extreme running or track work. The patient continued to get one treatment a
month with this simple three point protocol and after six months reported no knee pain and no chronic fatigue.
Patient was a 29-year-old Hispanic female suffering from chronic urinary tract infections. She was referred by her
primary care physician after three rounds of antibiotics had failed to resolve the issue. Patient was currently not taking

any medications and was taking a probiotic as well as following a low sugar diet. Her tongue was red with normal body,
thin yellow coating; pulse was wiry and rapid. Her main complaints were burning upon urination and pelvic discomfort.
TCM pattern differentiation was Damp Heat in the Lower jiao with Qi Stagnation, treatment protocol was Drain Damp,
Clear heat and course the Qi. The point Ren 6 was needled with even technique for 1-2 minutes until patient felt a
warm sensation in the pelvic area, points GB 34/Sp 9 were needled with strong stimulation until the patient felt a warm
sensation in the radiating down the legs.
After three sessions of this protocol, the patient reported a 50 percent reduction in pelvic discomfort and minimal
burning upon urination. After a total of six sessions of this three point protocol, all urinary symptoms were resolved and
patient was not experiencing any pelvic discomfort. At this point, the patient was referred back to her primary care
physician for evaluation and blood work. At a three month follow up, all symptoms were completely resolved.
In part III of this series, I will continue to explore case studies on three point combinations presented in part 1, as well
as introduce more three point combinations for further clinical discussion.

Click here for more information about Craig Williams, LAc, AHG.

One of the most important aspects of using and learning

San Zhen therapy is that is allows the practitioner to refine
his/her knowledge of acupuncture points as well as fine
tune their diagnostic skills. Each point selected must have a
clear reason and must be supported by the
pattern/symptom presentation of the patient. Another
benefit for this streamlined approach is that patients who
are wary of needles experience less stress which allows the
treatment to work quickly and effectively. The following
three-point combinations are some which I have used
extensively in clinical practice with consistently positive
clinical results.
Ren 17 + Ren 6 + Du 20
This is a wonderful combination for moving
stagnant qi throughout the entire body and is extremely
effective in cases of chronic depression and chronic
insomnia. Ren 17 is the influential point of qi moving
stagnant qi from the Heart and Lung area in the Upper Jiao.
Ren 6 is the "sea ofqi" and moves stagnant qi from the
Middle and lower Jiao and has the ability to tonify qi as
well. The combination of Ren 17 with Ren 6 powerfully
moves stagnant qi throughout the entire body and gently
tonifies without causing any type of cloying.
Adding Du 20 allows the qi to flow up into the head area
and has the ability to calm and clear the mind as well as

clear pain the head region. I use this three point

combination as much or more often than the "Four Gates"
of LI4 and Liv3 and find that it works just as well if not
better for cases of depression or insomnia. I often combine
this three point combo with the three point combo of ear
points: Shen Men, Point Zero and Sympathetic point
to address recalcitrant cases of mental and emotional
origin.
Ren 17 + Ren 6 + Sp10
This is a wonderful three point combination in cases
of qi stagnation with concomitant Blood stasis. Sp 10,
"Blood Sea", has the unique ability to move and cool the
blood and works in elegant synergy with Ren 17 and Ren 6
to clear out qi stagnation/blood stasis with potential
stagnant heat. I often use this three-point combination in
cases of amenorrhea with painful cramps and also in
cases of menorrhagia due to deficiency.

Ren 6 + GB 34 + Sp9
This is a wonderful combination to clear Damp Heat in the
lower jiao. I use this combination extensively in cases of
vaginal/urinary issues due to Damp Heat. It's also
extremely effective in cases of Damp Heat seeping into the
lower jiao causing knee pain or leg pain. It also has the
ability to clear qi stagnation via the combination of Ren 6
and GB 34.

ST 23 + Ren 12 + Liv3
I use this three-point combination in cases of food
allergies, leaky gut or other gastric issues with signs
of depression, malaise or insomnia. ST23 has unique
indications for psychological or emotional issues, as well as
targeting the Stomach meridian and Stomach viscus
particularly in concert with Ren 12. This combination
is also effective in cases of "IBS" or other gastric

syndromes which present with pain or

aggravation during times of psychological

or emotional stress. In these cases I once again
use the three-point ear combo of Shen Men, Point
Zero , Sympathetic.

Du24 + Yin Tang + Du 20

This is an excellent three-point formula for disorders related
to stress, mental-emotional issues, insomnia, allergies,
migraine headaches or general headaches. Results can
often been seen within minutes with correct needle
manipulation.
Du24 + GB 14 + Liv 3
This is an excellent three-point formula for issues related to
the eyes, particularly in patterns of Depressive heat due to
Liver Qi Stagnation and Liver Yang Rising patterns. I have
also used this group of points in cases of insomnia and
computer related eye fatigue. It can also be used in cases
of acute and chronic sinusitis and allergies as the Liver
meridian and Liver viscus is frequently involved in these
clinical presentations. If heat signs are predominant,
substitute Liv 2 for Liv 3.
In part two of this article, I will discuss each of these point
combinations with case studies along with a discussion on
specific needle manipulation techniques for each threeneedle combination.

Click here for more information about Craig Williams, LAc, AHG.

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