Acupuncture
Point Profile for Reflux: Stomach 36
The first acupuncture point whose name I learned and was able to identify while my (first) acupuncturist was needling me was “Stomach 36”—”Zu San Li,” or “Three Leg Mile,” in reference to its alleged ability to help the patient walk three additional miles, as all transportation at the time of its discovery was obviously by foot.
“Li,” in Chinese, may also be used as a homonym for “to rectify,” in reference to the energy the point provides, either to our internal physiologies or our kneecaps it resides just inches below. (Yes, this is the point that should feel like a brief surge of shin splint down your tibia)
In modern times we are not as concerned with the need to walk a few extra miles, but the physiological intent holds relevant. Located along the anterior tibial nerve, Stomach 36 can be used to improve energy by its mechanism of increasing blood flow to the stomach, when indicated. That is, if someone is lethargic because they had five drinks the night before and only slept five hours it’s not because their organs are lacking blood. They probably need a different acu-point combination (and a nap).
Besides GERD or acid reflux, Stomach 36 is useful for treating numerous pathologies, including but not limited to diarrhea, bloating, pain of the abdomen, vomiting, belching, also conditions of the throat, chest, and lungs because of the gastrointestinal microbiome’s connection to the respiratory microbiome; finally anxiety, depression, and dizziness, because of the gut brain connection. This 2023 NCBI study concluded its ability to increase the length and mean basal pressure of the lower esophageal sphincter, of which both mechanisms reduce reflux.
According to Peter Deadman’s Manual of Acupuncture, “the great Han dynasty physician (and weren’t all great physicians from the Han??), Hua Tou, is said to have valued the use of ‘ST-36’ to treat the ‘five taxations’ and the ‘seven injuries.’”
The 5 Taxations:
- Excessive use of the eyes injures the blood (even before cell phones—imagine now!)
- Excessive lying down injures the qi (i.e. hypersomnia begets more hypersomnia)
- Excessive sitting injures the flesh (i.e. lack of exercise saps our energy)
- Excessive standing injures the bones (poor security guards)
- Excessive walking injures the sinews (any other New Yorkers remarkably inflexible?!)
Because everything starts and circulates out from the gut, if I had to choose one point to needle on every patient for the rest of my career it would be Zu San Li, Stomach 36. With appropriate metabolic fluids, we can optimize our production of nutrients, which in turn reaches all other systems of the body. Basic science.
Happy New Year, from DFA!
A quick re-cap on the year 2025 in the rearview, the “year-view,” if you will, otherwise “year in review” (clearly being a dad is impacting my jokes)!
A lot of business as usual in the way of business—my same schedule of 3 days a week in the office, plus one supervising in the school clinic at Pacific College, partially highlighted by our appearance on Ben Aaron’s PIX-11 News segment.
I also gladly welcomed my first ever part-time assistant, Kira Schneider, a great acupuncturist in her own right, with a private practice in Princeton, New Jersey.
This year’s continuing education was also more of the same, as Chinese medicine’s foundational text, the Shang Han Za Bing Lun, takes a lifetime to study and master. In addition to reading my nightly passages, I credit Genevieve Le Goff of California, with most of the knowledge I gained last year.
In the first week of this new year I’ve added to my repertoire, virtually lecturing 2 courses per week on Classical Chinese herbal medicine with the Virginia University of Integrative Medicine, which happens to have a New Jersey campus located just a few miles from my mom.
Speaking of which, Mom’s hangin’ in there, my wife, Dr. Jillian Cohen, just got the first ever fellowship at Hackensack Meridian Health’s Integrative Medicine department approved, and daughter Peyton has since turned 4 and 4 1/4, rapidly approaching 4 1/2, and has not been made aware that she’s about to have her second trip to Disney in two years (hopefully this time sans coronavirus). She remains infatuated with everything princesses and drawing (including occasional household furniture vandalism), and her bilingual Spanish abilities are improving, inevitably to surpass my own.
Curious to hear if anyone has any exciting news from last year and/or regarding the year to come—especially if it’s something I should be sharing on my newsletter to benefit fellow clients and friends.
T.J. Watt’s Dry Needling Injury: What Happened?
This past week, T.J. Watt of the Pittsburgh Steelers, suffered a pneumothorax (partial lung collapse) as reported by CBS SPORTS, after a dry needling accident at the team’s practice facility—the entire acupuncture community sighed in despondent frustration. For several years now, most licensed acupuncturists have taken exception to clinicians of other modalities appropriating from what we do, rebranding it as something new, and in some instances causing harm due to a lack of education.
As defined by the American Physical Therapy Association, dry needling is a modality that uses filiform needles to stimulate myofascial trigger points, muscular, and connective tissues, to treat pain and impaired range of motion.
Accoring to Theodore Levarda, sports medicine and dry needling acupuncturist of Morningside Acupuncture in New York, wrote: “Dry needling and acupuncture use the same acupuncture needle, but practitioner education, clinical training, and safety standards vary widely across professions. Licensed acupuncturists undergo extensive, formal training in needle-based procedures, anatomy, and safety protocols, while dry needling training for other professions is not standardized.”
To contrast licensed acupuncturists thousands of hours of education, plus national boards exams, nowadays there are many physical therapists, chiropractors, and MD’s taking 100-hour crash courses in acupuncture and/or “dry needling,” getting certified, and frankly, utilizing a medical modality they no little to nothing about. Pneumothorax is incredibly easy to avoid, as Watt’s is the first case of its kind I’ve heard of since beginning my own practice in 2013.
Linebacker, Patrick Queen, of the Steelers, cited two reasons why he prefers acupuncture to dry needling: “Kind of two different things: One [acupuncture], you got to go to school for a longer period of time. There’s a whole much more scientific thing that goes into it. I don’t do the whole dry needle thing. I’m actually scared of dry needling, so I kind of stay away from that stuff.”
While licensed acupuncturists appreciate Queen’s allegiance, what might be most interesting is the publicly accepted misconception of non-acupuncturists’ erroneous or even intentionally dishonest definition of the modality. It probably isn’t the dry needling that’s the problem but the practitioner behind the needle.
What you might find in an AI search and detailed on most web sites of non-licensed acupuncturists offering dry needling, and even WebMD and Cleveland Clinic, is an allegation that it is some uniquely modern approach to pain management, supposedly based on scientific evidence and western anatomy—whereas acupuncture is predicated on balancing some “energy,” or “life force” through “meridians” in the body. This stems from an old misinterpretation that is ripe for rectification—maybe we’ll have T.J. Watt to thank for his sacrifice to this end.
According to Donald Kendall’s book, The Dao of Chinese Medicine (2002, in 1901 George Soulie de Morant studied in China, then returned to Paris with a working understanding of the medicine, but several understandable gaps in comprehension. He mistranslated “Qi” as energy and “Jing” as meridian, the latter because of its applicability to almost anything longitudinal, including even agricultural fields. Whether due to the communication gap or geographic distance, over one hundred years later, most of us still operate under this same misguidance.
While the (Chinese) idea of “qi” might be broadened to refer colloquially to energies both within and outside of the body, in terms of medicine and physiology it is thought of as simply the systemic sum of our intake of air and food, which is exactly how its Chinese character reads. 氣
The food part is self-explanatory. The air, according to Kendall, as well as other scholars, such as Andrew Miles and Nigel Wiseman, encompasses oxygen and nitric oxide that travel within vessels (not “meridians”) or neurological pathways and carry blood and functional gases to our organs to either reduce inflammation or optimize functionality. Andrew Miles even outlines throughout his book, Enlighten Weight, the countless similarities between what nitric oxide does in the body and what Chinese medicine states are functions of qi, such as:
- Increasing body temperature
- Facilitating metabolism
- Capable of causing pain when stuck or trapped
In addition to “energy” and “meridians,” another term you can throw out with the bath water is “dry needling.” Dating back to the Han Dynasty thousands of years ago are medical texts that denote “ashi points” for needling. “Ashi” translates literally as “That’s the point,” in reference to local sites of pain, palpably taut bands, which ancient Chinese practitioners targeted with the intention of improving local perfusion and restoring normal muscular sarcomere length, precisely what supposedly distinguishes “dry needling.”
What’s more, there have been studies dating back as far as Ronald Melzack’s proving that 71% of the neuromuscular trigger points in the body correspond with acupuncture points, based on spatial distribution and associated pain patterns.
There is nothing wrong with dry needling, except for its name and prerequisites. Dry needling is local acupuncture. It’s been around for centuries. It is best administered by licensed acupuncturists who earned a master’s degree after four years of schooling, as opposed to clinicians of other modalities without ten percent the same education.
To Morning Exercise or Not to Morning Exercise
Patients (and students) can be good teachers, and one recently reminded me of an important premise, as she reported feeling much better since beginning to exercise in the morning upon waking, before breakfast, before doing anything else. For her, this made sense. For approximately the other half of the population it would not.
Sunrise in Chinese medicine is Shao Yang time, the time of day that corresponds, logically, with the body’s pivot, that is the system whose responsibility it is to use cortisol to bring vital substances, such as immunological or hormonal, upwards in the body. For those of us whose cortisol spikes too quickly or too early, exercise is one way to temper this surge. Interestingly, healthy food is another way. While physical movement can clear some of the inflammatory heat associated with morning cortisol, a proper breakfast of protein, unrefined sugars, and/or healthy fats can also act as an anchor to prevent it from spiking so much in the first place. For the types of people more prone to insomnia, hyperactivity, and fast metabolisms, it seems a moderate morning workout shortly followed by breakfast might be ideal.
For the opposite body type, prone to hypersomnia, chronic fatigue, and/or weight gain, a better time to exercise might be the time of day associated with the most “yang qi,” or warmth, closer to 12 noon, as these people tend to be more lacking in cortisol, as well as other excitatory chemicals, and therefore will benefit more by moving in accord with the environmental nature around them.
For those of us with small children at home, who cannot exercise upon waking, or those with jobs that preclude us from exercising just before lunch, I recommend doing what you can. Everyone is busy, but if you can find 15-30 minutes/day to get in your preferred form of movement, almost every scientific study on the subject since the beginning of scientific studies corroborate the benefit.
Black Friday & Raw Ginger
Friendly reminders for the next cold month of holiday season: To ward off cold weather most of the body’s excitatory and invigorating substances rush to the surface, thereby leaving our metabolic and endocrinological layer more vulnerable to cold and/or hypo-functionality. This can be the case even in places like Los Angeles, where the climate is relatively colder than what its inhabitants are used to.
A daily cup of ginger can warm our “more internal parts,” as to do with organs and hormones. I would recommend 3 slices, as depicted here, simmered in 3-4 cups of water for 30-40 minutes. If you’re dealing with sinus and/or respiratory issues you can use 4-5 slices, which changes the chemistry of the ginger to act more upon the lungs. If your physiological pattern includes “blood deficiency,” it is advisable to combine with a teaspoon or tablespoon of honey, or a few red dates, so as to not aggravate dryness.
Little known facts about raw ginger:
- can raise blood pressure and heart rate
- Increases stomach motility and acid secretion
- Evidenced to have an antibiotic effect against Salmonella typhi (Typhoid fever), Vibrio cholerae (Cholera), and Trichomanas vaginalis (an STD). Obviously, consult your physician. If used in such cases it should be within the context of a greater, targeted, customized formula
Second and final reminder: BLACK FRIDAY!
$50 OFF all follow up sessions and $100 off initial visits between now and New Year’s. Exclusions include those with 10 discounted session packages, those receiving superbills, and of course insurance patients.
