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Journal of Chinese Medicine | Issue 133 | October 2023
Renzhong DU-26 and Somatised Distress: A Case Study
Carme Martorell
Abstract
The subject of this study was a young woman diagnosed with fibromyalgia, whose physical pain had been
unresponsive to six months of various medical interventions, including acupuncture. As a last resort the single
point Renzhong DU-26 was needled based on the patient’s symptoms and their psychological context. The
significant positive outcome of this treatment prompted an investigation into the fundamental mechanisms
associated with this particular acupoint. Its specific location on the face, strategically positioned between areas
associated with heaven (yang) and earth (yin), aligns this point with the human level of Chinese cosmology; its
established function as a resuscitation point may be intricately connected to this symbolic significance. This case
report thereby advocates for incorporating both a symbolic and a personalised approach in acupuncture diagnostics.
Keywords
Acupuncture, acupuncture point, Renzhong DU-26, Du Mai, symbolic, fibromyalgia, Governing vessel
Case history
Sandra, a 39-year-old woman, presented with fibromyalgia that had started at the age of 31, and which coincided
with her beloved mother’s recovery from a stroke. She initially experienced paravertebral pain from the cervical
region to the coccyx, which gradually spread to affect her entire body. The pain occurred together with anxiety,
insomnia and fatigue. Having previously received analgesic medications (paracetamol and non-steroidal anti-
inflammatories) and antidepressants (amitriptyline), all of which yielded negligible ameliorative effects, she was
subsequently referred to the author by a fellow acupuncturist who had been treating her for some months without
success, with the aim of exploring an alternative strategy for her condition.
Sandra, who had been extremely shy as a child, was an emotional yet reserved individual. Her medical history
included childhood otitis, acute tinnitus (predominantly nocturnal) and two episodes of vertigo. She was of
medium height and slender build, with the only notable feature being a kyphosis-lordosis posture. Her primary
zangfu diagnosis included patterns of Heart yindeficiency and Spleen qi vacuity generating dampness, although
these did not account for the localisation of her pain.
Treatment began on a weekly basis. She received the following series of treatments (with each bullet point listing
the points needled at each treatment; note that at some treatments just one point was used):
• Shanzhong REN-17
• Yunmen LU-203/01/2024, 12:12A Case Study Using the Single Point Renzhong DU-26 – Qiological Community
https://forum.qiological.com/t/a-case-study-using-the-single-point-renzhong-du-26/1985/print2/5
• Juque REN-14
• Lieque LU-7, Hegu LI-4, Dadu SP-2
Kunlun BL-60, Dazhong KID-4, Yaoshu DU-2, Dazhu BL-11
Tongli HE-5
Zulinqi GB-41, Daimai GB-26
Changiang DU-1
LiequeLU-7,ZhongwanREN-12
Qihai REN-6, Chize LU-5
YaoyangguanDU-3
Qihai REN-6, Chize LU-5
Hegu LI-4, Fuliu KID-7
Taibai SP-3
Waiguan SJ-5, Baihui DU-20, Fengfu DU-16
Yaoshu DU-2
Yamen DU-15
Yamen DU-15, Naoshu SI-10
Zhongwan REN-12, Jianjing GB-21
Zhaohai KID-6, Jiaoxin KID-8
By the end of this series of treatments, Sandra’s fatigue, anxiety and insomnia had improved, but the pain
remained, especially in the coccyx. At the next session, Renzhong DU-26, Weizhong BL-40, Dazhong KID-4,
Sanyinjiao SP-6 were needled with five ashi points in the area of the coccyx, resulting in a 50 per cent reduction in
pain. This treatment was repeated a week later, leading to 65 per cent relief of the coccyx pain and disappearance
of the lower back pain, although the neck pain remained.1 At the next session, based on these recent improvements,
a last attempt was made to help her by needling Renzhong DU-26 on its own,for reasons that will be discussed
below. A half inch, 0.14 millimetre thick needle was used, without any specific needle technique or manipulation.I
then did not see or hear of Sandra for five years. My clinical boundaries dictate that I do not call up patients
unsolicited to ask for feedback. Nor do I enquire from their friends – should I be treating them – for any details.
Renzhong DU-26 and Somatised Distress: A Case Study
As it happened, five years later a friend whom Sandra had recommended come to me for treatment conveyed to me
Sandra’s recollection of that final treatment at Renzhong DU-26: ‘After placing that tiny needle beneath my nose,
all my pains vanished forever and ever.’
Discussion
Renzhong DU-26 lies at the convergence of Ren Mai (Conception Vessel, associated with yin) and Du Mai
(Governing Vessel, associated with yang). According to the framework of Chinese medicine, these vessels
represent the utmost expressions of the yin-yang principle, the separation of which leads to death. Acupuncturists
are well-acquainted with the revitalising capacity of this acupoint,2 although it is judicious to acknowledge its
efficacy in the treatment of facial3 and spinal4 pathologies as well. Additionally, prior to thepersonal experience
described in this article, the author was already acquainted with Cygler’s scholarly work pertaining to the facial
pain encountered by three women aged between 60 and 70 who had recently been widowed (Cygler, 1985). In all
three instances, Cygler needled Renzhong DU-26 exclusively, with a notable level of efficacy.03/01/2024, 12:12A Case Study Using the Single Point Renzhong DU-26 – Qiological Community
https://forum.qiological.com/t/a-case-study-using-the-single-point-renzhong-du-26/1985/print3/5
The choice to select Renzhong DU-26 in Sandra’s case was based on the following considerations. Firstly, Sandra’s
history of kypholordosis and vertigo were consistent with Du Mai pathology. Moreover, her original pain was
localised in the spinal region. Additionally, the clinical experiences recounted by Cygler suggest that the pathology
treated by Renzhong DU-26 is associated with emotional somatisation triggered by a confrontation with death. In
the present case, this involved the fear Sandra harboured following hermother’s stroke. Finally, based on the
author’s firsthand experience, when a patient’s entire symptomatology converges upon a single acupoint, its
isolated stimulation provides the best results.5
Journal of Chinese Medicine | Issue 133 | October 2023
Renzhong DU-26 and Somatised Distress: A Case Study
Renzhong DU-26 is located beneath the nose, at the meeting point between the middle-third of the face (associated
with the human in Chinese medicine) and the lower third (associated with earth), as illustrated in Image 1. This
location implies a unique facial reference. Thus, while the point Yintang M-HN-3 connects the human to heaven,
Renzhong DU-26 establishes a connection between human and earth. However, when considering the particular
location of this point within the nasal-labial furrow, Renzhong DU-26 precisely straddles the boundary between the
middle third, signifying the human level, and the upper third, representing the heavenly realm, as depicted in Image
2. In this context, Renzhong DU-26 connects the human with heaven. This dual perspective is further underscored
by Renzhong DU-26 being an intersection point between the Du Mai and Ren Mai. These associations mean that
Renzhong DU-26 is a point intricately linked to the human being, and serves as a conduit for the qi that sustains
life.
The location of Renzhong DU-26 on the head and its placement along the Du Mai provide valuable insights into
the specific life-and-death situation represented by this point. Firstly, the head is symbolically linked to the celestial
realm in ancient Chinese medical texts6 and thereby the transcendental aspect of human existence and the
individual’s journey towards unity after passing. Secondly, Renzhong DU-26 lies along the Du Mai, which
represents the governing mental faculties (associated with yang, as opposed to the receptive, earthly, physical
associations of the Ren Mai) and self-control (‘control’ being one of the primary meanings of the ideogram ? du).
The danger of yin-yang separation in this context means that these patients may have difficulties with acceptance
(a yin quality symbolised by Ren Mai, which intersects with Renzhong DU-26). Thus patients who stand to benefit
from treatment involving Renzhong DU-26 may experience a heightened mental awareness of the reality of death.
Within this framework, the patient’s suffering, unable to find complete expression on an emotional level, may
manifest as somatic symptoms. The core issue here extends beyond mere preservation of a patient’s life. Given the
multifaceted nature of energetic dynamics spanning physical, functional and psychological dimensions, the
efficacy of Renzhong DU-26 transcends simple physical revitalisation. It encompasses the point’s profound
capacity to provide solace during critical moments, particularly when individuals wrestle with the inexorable fact
of mortality.
To bring the discussion back to the current case, Sandra’s ailment seems to have been triggered by the trauma of a
life-and-death situation involving a loved one. The resulting distress appears to have been expressed through
fibromyalgia. The positive outcome suggests that, in this specific scenario, the entire pathology resonated at just
one acupoint: Renzhong DU-26.
Dr. Carme Martorell, a committed practitioner from Barcelona, has devoted 34 years to practising acupuncture and
18 years to teaching it. Her deep exploration of acupuncture, drawing from English and French sources, as well as
insights gained from her clinical practice, led her to explore the resonances within different meridian categories, in
order to investigate the specific dynamics of each acupoint – notably in the realm of psychological pathology.03/01/2024, 12:12A Case Study Using the Single Point Renzhong DU-26 – Qiological Community
https://forum.qiological.com/t/a-case-study-using-the-single-point-renzhong-du-26/1985/print4/5
Beyond her clinical work in this field, she is driven by the opportunity to connect French and English knowledge
sources, believing that they have untapped potential for synergy. She may be contacted at
.
References
AGMA (Association Génevoise des Médecins Acupuncteurs) (2003). Punctologie Generale. Gutenberg: Géneve.
Cygler, B. (1985). Le 26 Du Mo, Révue Française d’Acupuncture, 41: 37-44. Deadman, P., Al-Khafaji, M. &
Baker, K. (1998). A Manual of Acupuncture.
Journal of Chinese Medicine Publications: Hove.
Guillaume, G., Chieu, M. (1995). Dictionnaire des points d’Acupuncture. Guy Trédaniel: Paris.
Martorell, C. (2014). The Psychological Dimension of Ren Mai, Journal of Chinese Medicine, 150: 56-66.
Milsky, C. & Andrès, G. (2009). Lingshu: Le Pivot Merveilleux. La Tisserande: Paris.
Sionneau,P. (2000).Acupuncture.LesPointsEssentiels.GuyTrédaniel:Paris. Soulié De Morant, G. (1982).
L’Acuponcture Chinoise. Maloine: París. Van Nghi, N. (1984). Médecine Traditionelle Chinoise. IBB: Barcelona.
Endnotes
1. In cases of chronic functional pathology, my therapeutic intention extends beyond mere temporary relief; I
aspire to bring about lasting solutions. In my experience, the use of ashi points often yields little more than
local and transitory relief. Thus, this specific treatment choice says something about the level of
demoralisation I had reached at this stage of the treatment course. I was aware that Sandra had already
received this kind of treatment from my colleague, which is why I do not consider their use to be the
foundation of the turning point in this case. On the flip side, this marked the first instance in which
Renzhong DU-26 was incorporated into her treatment protocol.
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Journal of Chinese Medicine | Issue 133 | October 2023
Renzhong DU-26 and Somatised Distress: A Case Study
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2. I.e. its function to restore consciousness – see Deadman et al. (1998).
3. Such as facial oedema, dentalgia (Guillaume & Chiu, 1995); mouth spasms, jaw contraction, trismus (Soulié
De Morant, 1982); amblyopia, oral conditions (Van Nghi, 1984); dental conditions, spasms or atony of the
eye muscles (AGMA, 2003); peripheral facial paralysis, blindness, serous rhinorrhoea (which hinders03/01/2024, 12:12A Case Study Using the Single Point Renzhong DU-26 – Qiological Community
https://forum.qiological.com/t/a-case-study-using-the-single-point-renzhong-du-26/1985/print5/5
breathing); anosmia, epistaxis, lip tremor, blurry vision, oedema of the upper lip,dead skin on the lips
(Sionneau, 2000).
4. For instance, paralysis or deviation of the spine, pain and stiffnessof all vertebral bodies, acute pain from the
lower back down to the feet (Soulié De Morant, 1982); pathology in the lumbar vertebrae, acute central low
back pain (especially traumatic) with inability to flex-extend (Van Nghi, 1984); lumbar sprain (Deadman et
al., 1998); lumbar stiffness, lumbar hyperlordosis (AGMA, 2003).
5. See Martorell (2014).
6. This concept is eloquently articulated in Lingshu (71): ‘The sky is round,the earth is square. The man has a
round head and square feet. This is how they correspond to each other.’ (translation by the author based on
Milsky & Andrès, 2009)