imbalanced
Acupuncture Techniques

The Four Needle Technique: A Follow-Up to the Husband/Wife Imbalance

Neil Gumenick, MAc, LAc, Dipl. Ac.

Editor's Note: The author realizes that there are a number of traditions that employ the "Four Needle Technique" and that there may be variations, in theory and practice, of what is described below.


In my previous article on the Husband/Wife Imbalance (Nov 2018), I made mention that successful clearing of this lethal block may require treatment stronger than the first two protocols explained. Here, I will review the first two protocols and explain the use of the final protocol, the Four Needle Technique, rarely needed, but essential when required.

Additionally, the Four Needle technique may be employed in instances other than a stubborn Husband/Wife Imbalance. In the Classical Five-Element tradition, this technique can be used when any Element or organ/function (AKA "Official") is resistant and unresponsive to treatment by more conventional means.

The Husband/Wife Imbalance

In this situation, detected only by pulse diagnosis, the Officials corresponding to the Wife (those read on the right hand side) will be read as quantitatively and qualitatively more pushy, dominant, overbearing, and excessive than those corresponding to the Husband (those read on the left hand side). The Husband Officials will be, by comparison, weak, yielding, and deficient.

The first protocol involves transferring from the excess to the deficiency. The term "transfer" refers to the movement of energy from one place to another, with the aim of restoring balance. In a Husband/Wife imbalance tonify:

  • UB 67, the Metal Point to pull excess from LI along the Sheng (creating) cycle
  • KI 7, the Metal Point to pull excess from LU along the Sheng (creating) cycle
  • KI 3, the Earth Point to pull excess from SP across the K'e (controlling) cycle
  • LIV 4, the Metal point to pull excess from LU across the K'e (controlling) cycle

Then, to strengthen the Husband side of the Fire Element, tonify:

  • SI 4, the Source Point
  • HT 7, the Source Point

The technique for tonification is as follows, each point is fully needled on the left side first, then the right. Before insertion, position the needle tip on the point, needle angled slightly in the direction of flow of the meridian; insert and turn 180 degrees clockwise; quickly withdraw, and briefly press the point immediately, sealing the hole.

If the pulses do not indicate that the block has broken (i.e. the entire right side still has excess while the left is still deficient and weak), then employ stronger means. The second protocol utilizes the Associated Effect Points (AKA "Back Shu" or "AEPs") of the predominantly Yin Officials. AEPs provide a very strong, powerful, and direct influence on the organ or function to which they correspond.

First, sedate (bilaterally) the AEPs corresponding to the Wife (can be done in any order):

  • UB 13 (AEP of LU)
  • UB 14 (AEP of PC)
  • UB 20 (AEP of SP)

The technique for sedation is as follows—position the needle tip on the point, right side first, the needle angled slightly against the flow of the meridian (upwards, as the UB channel flows downward). Insert to depth and turn 180 degrees counter-clockwise. Leave the needle in place. Repeat the technique on the same point on the left side. Continue until needles of the above points are in place. All are retained until the Wife pulses begin to soften – usually within a few minutes.

Then, leaving the sedation needles in place, tonify the predominantly yin Officials of the Husband:

  • UB 15 (AEP of HT)
  • UB 18 (AEP of LIV)
  • UB 23 (AEP of KI)

The technique for tonification is the same as described in the first protocol. In this case, position the needle on the AEP, angled slightly downward, insert, and give 180 degree turn clockwise. Remove immediately and press the hole. With tonification, treat the left side first, followed by the right. The points may be done in any order. As an example, going from above to below, tonify UB 15 left side, then right side, followed by UB 18 and 23 in the same fashion.

Then, remove the sedation needles. Check the pulses. If the block has broken, the change will be the softening and lessening of all of the Wife side pulses and a significant increase in strength of all of the Husband side pulses as described above.

Four Needle Tonification with a Husband/Wife Imbalance

If the above protocol is still unsuccessful, then use the third protocol—the Four Needle Technique. Basically, this technique utilizes four points to either powerfully tonify (supply) an Official that is deeply deficient, or sedate (drain) an Official that is significantly and stubbornly in excess. It is a very strong treatment, and in this tradition is used (albeit rarely) when Officials are otherwise unresponsive. Four Needle Technique, in such cases, may be the only way to get the energy to move.

In this third protocol, our first action will be to tonify KI, the predominantly yin Official of the Water Element, thereby strengthening the Husband side. To do this, we employ four points that have the effect of strengthening KI by supplying it with the energy that creates it, while sedating that which controls it. Thus, the points are:

  • KI 7, the Metal point of the deficient Official, tonified, to pull energy from its "mother" on the Sheng or Creative cycle.
  • LU 8, the Metal Point on the "mother" on the Sheng cycle, tonified, to ensure that the mother has an ample supply of energy to keep feeding the "child."
  • KI 3, the Earth point – the controlling influence on the K'e cycle, sedated, to diminish that which controls or inhibits KI within itself.
  • SP 3, the Earth Point – the con-trolling influence on the K'e cycle, sedated, to diminish control in the Official which controls KI at its origin.

The recommended needling method is as follows:

Insert KI 7 and LU 8, left side first, then right, angled slightly in the direction of flow and give each a hint of tonification – a very slight turn clockwise and retain.

Then, insert KI 3 and SP 3, right side first, then left, angled slightly against the direction of flow, giving each a full 180 degree turn counterclockwise and retain. Wait until the Wife (right hand side) pulses have softened. This could take 15-20 minutes.

Next, fully tonify KI 7 and LU 8 with a full 180 degree clockwise turn, remove, and press the holes to seal. Then, remove KI 3 and SP 3, with no additional turn, and leave the holes open.

Check the pulses to see if the Husband/Wife Imbalance is broken. If it has not, the next recommended step would be to sedate LU, with Four Needle Technique, strongly sedating the predominantly yin Official of the Metal element, belonging to the Wife (or right side). It is very rare to have to continue this far to successfully break this block, but as you are fighting for the patient's life, this protocol must be considered.

Four Needle Sedation with a Husband/Wife Imbalance

To employ Four Needle sedation of LU, utilize four points that have the effect of first pushing the excess out of the Official into its child, creating a large vacuity in the child into which the excess can drain, and then increasing that which controls or inhibits the Official in excess. Thus, the points are:

  • LU 5, the Water point, sedated, to push the excess via the Sheng cycle to its child, KI.
  • KI 10, the Water point, sedated, to create a vacuity in KI into which the excess can drain.
  • LU 10, the Fire point, tonified, to provide greater control of Metal within LU itself.
  • PC 8, the Fire point, tonified, to provide greater control of Metal from its origin of control.

The recommended needling method is as follows:

Insert LU 5 and KI 10 right side first, then left, angled slightly against the direction of flow, giving each a full 180 degree turn counterclockwise and retain. Wait until the Wife (right hand side) pulses have softened. This could take 15-20 minutes. Then, insert LU 10, left side then right, angled slightly in the direction of flow, turn a full 180 degrees clockwise, immediately withdraw and press the hole to seal. Next, insert PC 8, left side then right, angled slightly in the direction of flow, turn a full 180 degrees clockwise, immediately withdraw and press the hole to seal. Then, remove the sedation needles with no additional turn, and leave the holes open.

Finally, check the pulses. If the block remains, we may have to continue the process of alternately tonifying the predominantly yin Officials of the Husband and sedating those of the Wife until the block has cleared. If it were necessary to continue in this fashion (extremely rare), the recommended order after the above would be to tonify LIV and check pulses. If still unbroken, sedate SP and check pulses. If still unbroken, tonify HT and check pulses. If unbroken, sedate PC and check pulses. If, at any stage, there is improvement, but not a complete clearing, it is advisable to repeat the transfer protocol.

If, at any stage, the block has been successfully broken, no further action regarding a Husband/Wife Block is needed. If the block has cleared, there will be a softening and lessening of the pushy, dominant qualities of the Wife side, and a significant increase in strength of the Husband side.

In the Classical Five-Element tradition, once the block has cleared, assuming there are no other blocks present, support the patient at the core. You may need to use an appropriate point (or points) to support the patient's spirit, and follow with appropriate points on the meridians that, by means of traditional diagnosis, were determined to be those of the patient's primary elemental imbalance – the Causative Factor (AKA "CF").

I recommend having the patient come back for a checkup within 1-3 days to make sure the block has not returned and, perhaps, to reinforce core support. If the block has returned, start the process from the beginning.

Additional Uses of Four Needle Technique

There may be occasions, other than in a Husband/Wife Imbalance, where we find that an Official, or an Element, is simply unresponsive despite your efforts to create balance and harmony by such actions as removing blocks, energy transfers, command points, spirit points, even AEPs (AKA "Back Shu Points"). Nothing seems to work. In such cases, resort to the Four Needle Technique. Following the same logic as discussed above, based on pulse diagnosis, you can powerfully tonify or sedate any Official. If the entire Element is affected, start by treating the predominantly yin Official, adding the predominantly yang if needed.

To Tonify

A key to remembering this protocol is simply to tonify:

  • The first two needles summon the energy into the deficient Official from its "mother" and provide the mother a continual supply of energy to feed the child.
  • The second two needles serve to diminish the controlling influence, first in the Official concerned and then in the origin of control.

For example, to tonify PC, you will want to add Wood and diminish Water, so the Fire will blaze. Thus, the points are:

  • PC 9, the Wood point, to summon energy from Wood (LIV), the mother of Fire.
  • LIV 1, the Wood point of LIV, to ensure an abundant supply of energy to feed the child. These are inserted and retained with a hint of tonification, as described above.
  • PC 3, the Water point of PC, sedated, to diminish the controlling influence in the Official itself.
  • KI 10, the Water point of KI, sedated, to diminish the controlling influence at its origin.

These are sedated fully and retained. Once you feel the Water pulses diminishing and PC increasing, fully tonify and remove the first 2 needles, pressing the hole to seal, and remove the last 2 needles with no further action, leaving the holes open.

To Sedate

A key to remembering this protocol is simply to sedate:

  • The first 2 needles push the energy out of the excess Official into its "child" and make room for that excess by creating a big vacuity in the child into which the excess can drain.
  • The second 2 needles increase the influence of control in the excess Official itself and provide a greater supply of the controlling element at its origin.

For example, to sedate SP, you will want to push the excess into Metal while adding Wood, which controls Earth. Thus, the points are:

  • SP 5, the Metal point, sedated, to push the excess into the child LU.
  • LU 8, the Metal point, sedated, to create the vacuity in LU to receive the excess.

These are sedated fully and retained. Once you feel on the pulses that Earth has sedated, add:

  • SP 1, the Wood point, tonified, to increase the element of control in the excess Official itself.
  • LIV 1, the Wood point, tonified, to increase the element of control at its origin.

Tonify these points as described above, remove and press the holes to seal. Then remove the sedation needles with no additional turn and leave the holes open.

January 2019
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