Classical Perspectives on Treatment of Luo(Connecting) VesselsBy Kia Sinay LAc

IntroductionI uo Mai, or connecting, vessels, areLknown for their influence on thesuppression of pathogens. These vesselsbecome active as holding vessels forexternal and internal pathogenic factorsin the body when the body's resources areinsufficient and incapable of eradicatingpathogens. If wei qi or ying qi are insuffi-cient to eradicate pathogens, the pathogenis diverted to and held in a state of latencyin the luo vessels.

The luo vessels only become activeunder unresolved pathogenic influences.There are two known states of the luovessels: fullness of the luo or emptinessof the luo. Fullness of the luo presentsas broken blood vessels or varicositiesalong the luo trajectory. According to theHuang Di Nei Jing—otherwise known asthe Yellow Emperor's Classic On Internal

Medicine—these broken blood vessels mayindicate cold (blue vessels) or heat (redvessels) in the vessels. Emptiness of the luooccurs after the ying or blood is exhausted

from fighting pathogens, resulting in theuse of other dense fluids (hormonal fluids,dampness or phlegm) to hold pathogensin latency, resulting in the formation ofnodules, lipomas, or cysts.

Luo Vessels in Expression,Suppression or Repression ofEmotionsMood: Expression is a function of the weienergy to bring the pathogenic factor fromthe ying or blood level up to the wei level inan attempt to eradicate the pathogen. Thislevel of expression is more of a mood than atargeted emotion. A mood is a feeling withno causative factor. Mood is representedby the relationship of the Lung and Liver towe/energy. To therapeutically express themood, use the Lung and Liver luo points,LÜ-7 (lie que. Broken Sequence) and LIV-5 (//gou, Woodworm Canal).

Emotion: Suppression is a function ofying energy, which acts as a fluid mediumholding the pathogenic factor in a relativestate of latency. The Spleen and Pericardium

Table of Luo Vessels Symptoms:¿uo Vessels, Symptoms of Fullness, Symptoms of Emptiness

are responsible for manifesting this latency.Use the luo of the Spleen and Pericardiumchannels, SP-4 and P-6, to bring emotionsout of suppression.

Psychological Armoring: Repression is

a function of yuan energy—it is a densermedium, and holds the pathogenic factor atthe deepest level of the body. The develop-ment of psychological armoring occurs atthis level. Repression is represented by theyuan energy of the Kidney and San ¡iao. Tobring emotions out of a repressed state, usethe tuo points of the Kidney and San ¡iaochannels, KID-4 and S|-5.

Treatment: Differentiate the level ordepth of involvement based on three states:mood, emotion, or psychological armoring.Additionally, determine the five-elementrelationship to the mood, emotion orarmoring, and treat the yang luo vesselpoint associated with the mood, emotion orarmored state's element, For example, if themood is fear, associated with the elementof water, choose the yang of water. Bladderluo point BL-58.

Continued on page 28

Lung

• Gesturing with hands, hot palms• Constant need for stimulation, need to

touch everything• Hyperactive need for contact• Highly spirited• Constant need to be doing things• No interest in making contact• Lack of interest in engaging in life• Lack of motivation to make contact, or

stimulation• Boredom, yav/ning, lack of interest

targe Intestine

• Tightness in jaw, neck and shoulders• Inability to digest or to sense the world• Inability to separate from the situation,

or to handle and process the situation

Stomach

• Madness, dementia• Inability to control emotions• Insomnia, irritability, insanity• Lack of motivation or interest; lack of

connection• Paralysis in lower limbs

Spleen

• Habituation, constant repetitivepatterning, obsessing

• Habituation to point of addictivebehaviors

Heart

• Rigidity, stubbomness, closed toother possibilities

• Lack of assertiveness, doubt,unsure of self, inability to besatiated

Small Intestine

• Failure to grasp new information• Stiffness, rigidity in arms• Heaviness in head• Accumulation of thoughts

causing confusion; lack of abilityto sort

• Constant need for approval, lackcertainty when have approval

• Lack notion of "enough isenough"

• Lack ability to discem what toeliminate

Bladder

• Panic attacks• Hyper-stimulated adrenals• Easily overwhelmed by too much

information• Inability to determine satiation• Fetishes• Incessant needs

Kidney

• Phobias, fear, paranoia• Inability to let go of deep traumas• Habituated emotional responses

regardless of stimuli• Feelings of impending doom• Lack of any hope, fears of no resolu-

tion, leading to a shutting down

Pericardium

• Heart pain• Lack of faith or hope, lack of spirit• Inability to control emotions• Sense of numbness in perceptions

or sensations• Loss of insight• Stiff neck, decline in sensory orifices• Can't sense others' emotions

San ¡iao

• Notion of double personality• Stubbom• Indifference about life• Inappropriate behavior

Call Bladder

• Incessantly lamenting aspects of life• Inability to see new possibilities• Pseudo-suicidal tendencies• Overburdened by regrets• Paralysis of legs, buckled knees• Lack of urge to live life, suicidal tendencies• Can't stand up to the world

Liver

• Sense that there is more to be done in lifecausing anxiousness about mortality

• Sense that there is constantly more to bedone, but never achieve completion

Great tuo of Spleen

• Physical pain all over body• Emotional pain, intense agony and

suffering• Depression• Melancholy, depression that causes

immobility• Hopelessness

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Treatment Application of the LuoVessels:

First, select the luo vessels of the yangelemental and emotional association to helpfacilitate the release through the yang vessel.

Emotion/Mood - ElementalAssociation - Yang Luo Vessel Point

Anger - Wood - CB-37 Bright Light,(Cuang Ming)Anxiety - Fire - SI-7 Branch to the Correct,{Zhi Zheng)Worry - Earth - ST-40 Bountiful Bulge,{Feng Long)Grief - Metal - LI-6 Veering Passage, {Pian Li)Fear -Water - BL-58 Taking Flight, (Fei Yang)

Second, determine the emotionalcomponent and the level of involvement, i.e.expression, repression, or suppression. Addthese points to facilitate the release of theunderlying pattern.• Expression {wei level): Related to a mood

or feeling. To encourage release of theexpressed mood or emotion use the iuopoint of the Lung and Liver, LU-7 {Heque, Broken Sequence) and llV-5 (Ii gou.Woodworm Canal).

• Suppression (ying level): Related to theemotional disposition influenced by one'stemperament. To encourage expressionof suppressed emotions use the luo pointof the Spleen and Pericardium, SP-4{gong sun, Yellow Emperor) and P-6 {neiguan, Inner Pass).

• Repression {yuan level): Related toone's temperament and psychologicalarmoring. To encourage release ofrepressed emotions, use the luo point ofthe Kidney and San fiao channels, KID-4{da zhong, Large Goblet) and S)-5 {waiguan, Outer Pass).

Check the pulses to ensure there isenough wei, ying or yuan at the respec-tive organ systems to provide for a fullrelease. If insubstantial, bring more yangenergy to the luo vessel point by scraping{gua sha) the luo point itself with flint,prior to lancing or plum blossoming. Tofurther encourage a complete release andharmonize the blood, follow the bleedingvs/ith moxa over the luo point, or needlingone point proximal to the he-sea point.

Treatment of Fullness of Luo Vessels

Open the treatment with the respective luovessels point. The classical needling tech-nique for luo vessels is bloodletting. Using a

28 C A L I F O R N I A | O U R N A L O F O R I E N T A L M E D I C I N E

lancet or plum blossom at the luo point. Ifbroken capillaries or blood vessels are founddirectly over the point or along the trajec-tory, prick these varicosities to bleed. If thearea lanced or plum blossomed does notrespond with a blood release, bring we/andying to the surface by scraping igua sha)the area, then use bloodletting techniques(plum blossom or lancet). Second, examinethe luo trajectory for broken blood vessels,and prick to bleed. Classically, luo vesseltreatments are used every other day.

Treatment of Emptiness of theLuo Vessels

Open the treatment with the respective luopoint with lancet or plum biossom. Lookfor any phlegm or fluid accumulations(nodules, lipomas, or fatty cysts) alongthe trajectory. To break up the phlegm orfluid accumulations, scrape {gua sha) thelocation, and use a five-star needle tech-nique to surround the accumulation fromeach of four directions, and at the center ofaccumulation. Check the pulses followingthe bloodletting, if the pulse is blooddeficient (represented by a weak/xu, thin/xi,or short/duon pulse at the moderate level),the treatment needs to be harmonized.Harmonize with moxabustion over the luo,source or shu points. Using moxa followingthe bloodletting provides warmth and yangto encourage the release to the exterior.

Luo Vessel Needle Techniques

Classically luo vessel points are bled witha lancet, one of the nine classic needles.Consideration of the seasonal correspon-dence may influence the response to luovessels treatment. The winter—whenthe energetic Intention of the body is tostore—may not be an appropriate time tobleed acupuncture points. Disregarding theseasonal correspondence In this mannerwill risk disrupting the individual's seasonalbalance.

Luo Vessels Treatment PrinciplesTreatment frequency: According to theclassics, treatment of luo vessels is everyother day.

Harmonize following bloodletting on luovessels based on pulse examination. If thepulse is found to be deficient at the yinglevel, use one point proximal to the he-seapoint to harmonize the blood. An alterna-tive technique may be to use moxa overthe luo vessel point itself in addition to useof the point proximal to the he-sea pointon the respective channel. For example,following a luo vessels treatment of the

large intestine, take the pulse at the cunposition on the right hand at the moderatelevel to determine the quality and quantityof b\oodlying at this level. If the pulseis found to be weak or deficient in thisposition, then it is recommended to moxathe luo point, LI-6 (pian Ii, Veering Passage)and tonify one point proximal to the he-seapoint, LI-12 (zhou liao, Elbow Bone-Hole).It may also be beneficial to use SP-10 (xuehai. Sea of Blood) to assist in the productionof blood. If blood stagnation is present, useSP-11 0/ 'T'̂ n, Winnower Gate) to assist ininvigoration of the movement of the blood.

To invigorate the blood with theheart's pumping action, use the Heart orPericardium source points, HE-7 (shen men.Spirit Cate) or P-7 (do ling, Creat Mound).When needling, it is important to use atechnique such as Burning Mountain Fireto activate all three levels of the body: wei(superficial level), ying (moderate level), andyuan (deep level).

It is important to note that classicallythe luo points are needled contra-laterallyrespective to the position of the right or leftpulses. The Lung, Large Intestine, Spleen,Stomach, Kidney and Bladder luo pointsare needled on the left side (correlatingto pulses found on the right), and theHeart, Small Intestine, Liver, Gall Bladder,Pericardium and San jiao luo points areneedled on the right side (correlating topulses found on the left).

The Ling Shu (Spiritual Axis) states theCreat Luo controls all the luos. SP-21 (dobao. Great Embracement) is responsible forthe production and management of blood,and ensures that the luo vessels are movingthe blood. The Great Luo of the Spleenproduces the red substance and ascendsit to the Heart where the red substance istransformed into blood. From the Heart,the blood descends to the Liver for storage,and the Spleen banks the blood. This isrepresented by the trajectory of SP-21 toHE-1 (Ji quan. Highest Spring) to LIV-13(zhang men, Camphorwood Cate), knownas the axis responsible for the productionof blood.

If the condition involves an underlyingblood deficiency with respect to the luovessels, you must nourish and move blood.Below are methods to nourish and moveblood.• Axis of Blood: Needle SP-21 (do bao,

Creat Embracement) angled toward HE-1(Ji quan. Highest Spring). Needle HE-1 toLIV-13 (zhang men, Camphorwood Cate)to bank blood.

• Tonify either or both the Ren and Du luopoints, REN-15 (jui wei. Turtledove Tail) andDU-1 (chang qiang. Long Strong).

• Tonify one point proximal to the he-seapoint on the affected channel.

ConclusionThe tuo vessels can be used to treat manyconditions, and should not be limited topsycho-emotional uses. Blood is an essentialcommodity and resource for the body. Thepathogens of luo vessels afflict the ying oryuan levels to facilitate holding pathogens ina state of latency. Maintaining latency erodesa deeper foundation of longevity and healthby utilizing the body's resources. Should thepatient and clinician determine that a releaseis not appropriate, it is paramount to continuenourishing the blood through techniquesoutlined above to keep the body's resourcesavailable as holding vessels. However, if thepatient and clinician determine to releasethe pathogen from the luo vessels, carefulconsideration must be made to follow theclassical treatment guidelines for luo vessels,working closely with the patient every otherday for a cycle of three treatments every otherday; and maintaining a close dialogue withthe patient to assure their treatment progress.Additionally, therapy may be useful concurrentto the luo treatment as another means ofsupport for the patient.

Kia Sinay is currently completing her Ph.D.

in Classical Chinese Medicine at American

University of Complimentary Medicine.

She has been in clinical practice since 1995.

Sinay has completed three certificate programs

withjefrey Yuen in New York: Advanced

Herbology, Advanced Acupuncture, and

Application of Gems in Classical Chinese

Medicine.

ReferencesEllis E. fundamenials of Chlneie Acupuncture. Masschusetts:Paradigm Pubiicalions, BrooWine; 1991.

George S. "Luo Vesseis," Lecture/Ciass. American University ofComplimentary Medicine, California; Los Angeles; September27-28, 2003.Georges, "tuo Vessels," Lecture/Class, American University ofComplimentary Medicine, California Los Angeles; November1 -2, 2003-George S. "Luo ¡ing (Connecting Vessels) & Their ClinicalApplication," Lecture/Class, New York; New York, April! 6-17,2005.

Unschuld P. The Nan Ching, the Chssk of Difficuit Issues.California; University of California Press, Berkeley and LosAngeles; 1986,Wu N. Yeiiow Empero's (sic) Canon Internal Medicine. China: ChinaScience Technology Press; 1997.Yuen |, "Luo Vessels," Lecture/Class, New Mexico: Santa Fe;August 7, 2004.Yuen ). "Neuroendocrinology and luo Mai," Lecture/Class,American University of Complimentary Medicine, California: LosAngeles; November S, 2004.

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