4-exam typesa note about the traditional ryodoraku points when dr. yoshio nakatani pioneered...

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Page 1: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

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Page 6: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

Jing-Well vs. Yuan Source: Which do I measure?By Adrian P. Larsen, D.C., F.A.S.A., C.Ac.

In the course of teaching meridian graphing techniques, I often get asked which set of points is the most valid to measure. The two standards are the Source (Yuan) points and the Jing-well points. Each set has specific purposes and applications, and each is useful in the clinical setting.

So, to shed more light on the subject, here is a quick primer on measurement point selection:

Source Point Graphs

Source (Yuan) points are the most energetically active points on the meridians, with 4-6 times more energetic activity than other points in the area. These points are most associated with the internal organs and with the general energetic state of the main meridian channels. For this reason, source point graphs tend to show greater variability than jing-well point graphs, and therefore tend to manifest imbalances more readily and sooner than jing-well point graphs.

This tendency toward higher variability makes the source point graph highly sensitive at locating meridian imbalances. In fact, this graph style is so sensitive, it’s rare to ever find a completely balanced graph. Therefore, the source point graph is both a blessing and a curse in clinical practice. The blessing is the strong tendency to locate even small imbalances, but the curse is the relative rarity of completely balanced graphs.

Page 7: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

In my practice, I generally start by taking a source point graph first to get an overall idea of the general state of the patient’s meridians. This graph serves as the starting point for further evaluations.

A Note About the Traditional Ryodoraku Points

When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of points now known as the Ryodorau points. This exam uses source points for 8 of the 12 meridians, but uses other points for the Small Intestine, Large Intestine, Kidney and Bladder meridians (SI 5, LI 5, KI 4, BL 65). Dr. Nakatani reportedly selected these points by measuring every point on every meridian on numerous patients and determining these points to be the most representative of the meridian averages.

Additionally, Dr. Nakatani used a different numbering system for the meridian measurement points. He labeled the meridians with H or F, denoting whether the point to be measured was on the hand or the foot. Then for each set of points, he numbered them 1-6, according to exam order. Therefore H1 is LU 9, H2 is PC 7, and so forth. The feet are labeled F1 (SP 3), F2 (LR 3) etc.

In modern practice, the traditional Ryodoraku exam and numbering system are all but extinct. Most practitioners opt to use the standard Yuan (Source) points representing all meridians.

Jing-well Graphs

Page 8: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

Jing-well points are the beginning and ending points of the 12 main meridians, and are the connection points between the main meridian channels and the tendino-musculo branches. Jing-well point graphs measure the general energetic balance of the meridians, as do source point graphs, but because they are the connection points to the tendino-musculo meridians, jing-well points tend to reveal imbalances associated with musculoskeletal complaints, as well as more chronic conditions. Jing-well graphs do not show as much variability as source point graphs, but the variability they show is clinically important. If the jing-well points show imbalances, these must be substantially corrected before the source point imbalances can be successfully addressed. Therefore, it is a good idea to, at least initially, take both types of measurements on patients.

In my practice, if I notice more than 6 imbalanced meridians in the Source point exam, I follow up with a jing-well point exam to determine the condition of the musculo-tendino meridians. If I find imbalances there, I address them first. My reasoning is that the musculo-tendino meridians serve as the reservoirs for the main channels, and that they must be corrected first before the main channels can fully return to balance.

Comparison

One of the most valuable ways to employ multiple exam types is by comparison. I regularly use this technique to compare jing-well exam results with source exam results. By doing so, I can quickly locate problem or chronic areas, because they will show as imbalances in both graphs. Take for example, the graph below. This 48 y.o. female presented in my office with severe mid-back pain and stiffness throughout her body. She moved very slowly, and complained of muscle pain in most movements.

Her graphs are illustrated below, with the source graph on the top and the jing-well graph on the bottom. As you can see, the source graph was a mess, without even one balanced meridian. The jing-well graph, on the other hand, is not so bad, with imbalances only seen in the Liver and Gallbladder meridians.

Page 9: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

I designed a treatment to address the imbalances in the Liver and Gallbladder meridians and she had excellent resolution of her pain within 3 treatments, as well as a much better source graph, as shown below.

Page 10: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

Choosing a Treatment when Comparing

When comparing source and jing-well graphs, the question of which graph should steer the treatment is very important. For any given meridian, the following three scenarios may apply:

1. The meridian is imbalanced in the source graph, and balanced in the jing-well.2. The meridian is imbalanced in the jing-well graph, and balanced in the source.3. The meridian is imbalanced in both graphs.

The following chart shows the proper treatment to use for each of the above scenarios, as well as the specific types of points to use, correlated with the specific types of imbalances.

Note: Splits always take priority and must be treated regardless of which exam type reveals them. Other types of imbalances do not necessarily have to be treated. Using the example graphs above, the imbalances in the Jing-well graph were splits and were treated. Because the jing-well graph seemed to be the root of the patient’s problem, I opted not to treat the many imbalances in the source point graph. Of course, once the jing-well point graph was balanced and the splits removed, I began treating based on the source point graph.

The chart below is employed on a meridian-by-meridian basis to select the best treatment points when comparing graphs.

Page 11: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

Treatment Point Selection Chart for Graph Comparisons:

Source Point ExamSource Point ExamSource Point ExamSource Point Exam

Balanced Excessive Deficient Split

Balanced None Sedation Point

Tonification Point Luo Point

Excessive Sedation Point

Sedation Point

Jing-well Point Luo Point

Deficient Tonification Point

Jing-well Point

Tonification Point Luo Point

Split Luo Point Luo Point Luo Point Luo Point

Summary

• Source point graphs are the most variable, the most sensitive, and reflect the condition of the main meridian channels.

• Jing-well point graphs are less sensitive and reflect the condition of the musculo-tendino branches.

• If you have patients who are not improving as quickly as you might expect, try comparing the source and jing-well graphs and looking for correlations you might have missed.

• When comparing source and jing-well graphs, give most emphasis to the meridians that are imbalanced in both graphs.

• For meridians that are imbalanced in both graph types simultaneously, splits take precedence over excess and deficiency.

• When a meridian is excessive in one graph type and deficient in the other, treat the jing well point on that meridian to open the musculo-tendino connection to the main meridian and balance the two systems.

• If a meridian is imbalanced in only one graph type, and is not split, you may or may not choose to treat it, depending on your treatment goals.

Jing

-Wel

l Exa

m

Page 12: 4-Exam TypesA Note About the Traditional Ryodoraku Points When Dr. Yoshio Nakatani pioneered Ryodoraku acupuncture in the early 1950’s, he performed his measurements on a set of

Apply Your Knowledge

Using the principles outlined in this article, design a treatment plan for the following graph comparison: