When we go to bed, according to traditional acupuncture theory, it is normal for blood (or fluid) to move from the body’s yang system (which is associated with the outside, brightness, activity, heat and daytime) into its yin system (associated with the interior, darkness, quietness, cold and night‑time).
In the morning, blood flows back out to the yang system and the external body surface and we wake up. The idea of yin being dominant at night is reflected in the fact that things which promote yang – such as being too active (either mentally or physically) or too hot – will keep you awake.
The major organs that have a strong association with blood in the Chinese system are the Spleen, Heart and Liver. (These are given capital letters because they relate as much to the energy of these organs as to the physical organs themselves.)
One of these B the Heart B is associated with the mind and controls the emotions. This means that emotional problems (including things such as stress and overwork) can interfere with the normal flow of blood. As a result, the blood won’t flow into yin at night and sleep will be disrupted.
Because acupuncture is a holistic therapy which takes account of the whole patient, any treatment will be tailor‑made for that particular patient. But to illustrate how a diagnosis is made and treatment decided upon, we can look at the treatment likely to be used when certain combinations of symptoms are present:
! Sleep which is disturbed by dreams, headaches, discomfort in the upper part of the abdomen, a bitter taste in the mouth, and a tendency to get upset or angry very easily are all symptoms of stagnation in the Liver. The stagnation results in Heat arising and this, in turn, attacks the Heart (or mind). The diagnosis would be confirmed if the acupuncturist found that your tongue was red with a yellow coating and that your pulse was wiry and rapid. The treatment is to needle points which will expel the Heat, soothe the Liver and calm the mind.
! If you tend to be irritable and, as well as having insomnia, you suffer from dizziness and low back pain, and if you have a rapid, weak pulse, a diagnosis may be made of disharmony of the Heart and Kidney. Treatment will use acupuncture points that restore harmony.
! When, as well as insomnia, you have a feeling of fullness or bloating and belching and you also have a history of eating an irregular diet, and if, on examination, the acupuncturist finds a slippery rapid pulse and a red tongue with a yellow greasy coat, the diagnosis is likely to be that of Phlegm and Heat attacking the Heart. The treatment consists of needling point to expel the Phlegm and Heat and calm the mind.
! Light sleep, disturbing dreams, palpitations, poor memory, listlessness and a poor appetite are all symptoms of a deficiency of Qi and of Blood in the Heart and Spleen. The tongue is pale with a thin coating and the pulse is thin and weak. Here it is necessary use points which will nourish the Qi and the Blood and will calm the Heart.
The combination of needles used in any one case will depend on the type of insomnia which has been diagnosed. However, there are two points which are frequently used in a variety of cases. These are the seventh point on the Heart meridian (known as H 7 and also called the ADoor of the Mind@) which lies on the wrist, and the sixth point along the Spleen meridian (Sp 6) which is situated on the inside of the leg just above the ankle. The first of these points calms the mind while the second stimulates yin which, as was mentioned above, needs to be dominant at night if you=re going to get a good night=s sleep.
In addition to these two, other points will be used according to the diagnosis:
! A point on the Liver meridian, Liver 2 (usually abbreviated to Liv 2), which lies between the first and second toes can be used to reduce Heat and clear stagnation.
! Stagnation can also be cleared by two points on the Bladder meridian (Bl 18 and Bl 19), which are situated on the back a little way above the waist.
! Two other Bladder points, Bl 15 and Bl 23 used together will balance the Qi between the Heart and Kidney. Both are on the back, lying along a line that runs parallel to the spinal column, one at around waist level and the other a little higher than armpit level.
! Bl 15 can also be used to strengthen the Qi of the Heart when there is a deficiency, while Bl 20, lying on the same line parallel to the spinal column and a little above the waist, will stimulate the Spleen and promote the circulation of Qi.
! To dispel Phlegm, a point on the Stomach meridian (St 40), on the side of the leg immediately below the calf, may be used.
The acupuncturist will choose the combination of points that seem to offer the most appropriate treatment for the individual patient. This may include other points on the arms, legs or trunk in addition to, or instead of, those mentioned above. Every patient is different and so every patient will be treated differently. However, it is unusual for more than six or eight needles to be used at any one time.