Point location & needle direction: PC9, LI11, SJ2, BL40

Ryan_Gallagher: April 15, 2019, 6:05pm
Hi folks,
I have a few questions on point location and needle direction:
• In Sa’am, do you use the version of PC9 on the tip of the 3rd digit, or at the radial base of the nail bed?
• With a point like LI11, would you use the direction of the needle to tonify/reduce, or would you just use
forward/backward twisting to tonify/reduce? (LI11 is a point that seems to warrant perpendicular insertion.)
Relatedly: If you’re reducing SJ2, do you direct the needle against the channel, or do you needle into the knuckle
and use backward twisting to reduce?
• How do you needle BL40? Do you let the person lie face-up and needle from the lateral knee, or do you place the
person in a side-lying position?
Thanks!
Ryan

dcvalley: April 15, 2019, 3:46pm
Here is my method, I do not warrant the information
pc9 radial base of nail is what I have used
li11, find point start a quarter of an inch away from point and needle toward li15
sj2 against the channel and counterclockwise rotation
ub40, I have done either position also face up, whatever fits patient comfort/other needle needs

dcantor: April 15, 2019, 8:04pm
I would answer the same as @dcvalley and can confirm that Toby stated Pc9 should be needled at the radial
corner of the nail bed. All points should be angled with or against the channel, including LI 11 and SJ 2, but the
angle is less severe on he-sea points like LI 11 and Lv 8. I usually needle BL 40 face up, with the patient’s leg
angled out to the side a bit. However, if you can just feel for the point and insert the needle, the leg can lie directly
on a bolster since the needle will be resting transversely against the skin.
1 Like24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print2/8

KristinWisgirda: April 16, 2019, 9:44pm
Hi Ryan,
I’ve heard Toby say explicitly say several times that we want to give each point a clear direction/intention so we
use as many methods as we can to reinforce the message.
Tonify: needle with the channel, thumb forward/clockwise rotation, close point
Sedate/drain: needle against channel, heavy counterclockwise/thumb back, leave point open
A number of times, I’ve seen Toby tonify St36 and then stroke the Stomach channel distally.
I’ve seen Toby needle LI 11 at the traditional location but strongly angled proximally.
Toby emphasizes watching the face for changes during and after needling. That would be hard to do if the patient is
side lying. For Ub40, you can have the patient laterally rotate their leg for insertion and then rotate it back to
neutral because the needle angle will be pretty flat. This is how I’ve seen Toby do it. I’ve also done it as
@dcantor suggests- feeling for the point under the knee but I get better qi with the lateral rotation method.
Hope that helps.

ngmatthews: October 4, 2021, 5:15pm
Toby clearly told us in Seattle that we are to use the traditional PC 9 in corner of nail.
For LI 11 I do a transverse insertion either up- or downstream as indicated, fairly shallow. For SJ 2 I needle away
from the knuckle and do counterclockwise twisting.
For Bl 40 face up, I needle transversely either upstream or downstream with strong stimulation. I have them lift up
their knee from the bolster for this. Then I place their knee back onto the bolster with the needle flat against the
skin. They need reassurance, but they are always comfortable.

Ryan_Gallagher: April 19, 2019, 5:48pm
Thanks for these pointers, everyone. I’ve yet to do a class with Toby—I’ll do the online class if/when it becomes
available (or one in the northeast if it manifests!), so these tips are much appreciated in the meantime.
It’s taken some time to get comfortable with needling the jing-well points and with using stronger stimulation
(binding the tissue), but, like many of you have said, if the practitioner is confident and at ease, the patient’s system
will register that.
Using this system has also given me the opportunity to explore points that I had been neglecting—like LI5, for
which I’m finding I need to adjust the wrist to create the proper opening for the needle. Good stuff!
1 Like24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print3/8

haunani: April 20, 2019, 1:09pm
I love the encouragement we are all getting as practitioners in these posts to really step into our medicine by
stepping into the comfort of EACH point.
As an intern, I remember a patient telling me how she “loooooved” to brag to her friends when we (her team) did
“cool shit” to her in clinic. “Cool shit” translated to moxa, cupping, bleeding, and jing well points. As long as she
felt better/saw improvement (and had cool stories to tell her friends) she wanted us to do whatever it took.
I know not all patients will be like her but I also do believe that most of our patients are coming to us wanting to
step, or knowing they are stepping, into the unknown/mystery. Part of that mystery includes doing things that
they’d never expect or consider…like shoving a needle and twisting near the nail bed. Hahaha.

ngmatthews: October 4, 2021, 5:15pm
Not sure what Toby would say here, but I find when needling LI 5 and SI 5, I want to do a very transverse needling
so yes, you might need to move the wrist a bit to get that done.

ngmatthews: October 4, 2021, 5:15pm
Hi, I made a photo yesterday of how I needle BL 40. This one is of tonification. I have the patient supine and they
lift their knee to expose the back side. Then I insert flat to the skin and they can lower their leg back down either
onto the bolster or flat because the needle is flat against the skin. After this photo I inserted the needle a bit more
deeply and angled it even flatter against the back of the calf.24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print4/8

ngmatthews: October 4, 2021, 5:15pm
Here is a pic of my H8 tonification. Purple Seirin threaded about 1/2″ toward H 9.24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print5/8

amyjenner: April 24, 2019, 12:17am
Thanks so much for the photos, it really helps.
Would like to support the manifestation of a Northeast class too

michaelmax: April 25, 2019, 3:20am
That HT8 can be tricky as it does easily move when the patient relaxes their hand. I’ll try going in at a more acute
angle like you have here. thanks!
KristinWisgirda #13April 25, 2019, 11:52am24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print6/8
Yesterday I thought I threaded H8 properly and it still shifted when the patient moved her hand! Gotta find a way
to prevent this.

lauramcgraw: April 25, 2019, 7:21pm
Loving the photos of point direction and location. I hear Toby needles Liver 8 slightly superior, wondering if that is
your experience kwisgirda?

KristinWisgirda: April 25, 2019, 7:44pm
lauramcgraw:
I hear Toby needles Liver 8 slightly superior, wondering if that is your experience kwisgirda?
Yes, his Liv8 location looks like it is in the notch where the shaft of the femur meets the medial epicondyle. Gotta
confirm this one.

sweiz: April 29, 2019, 12:27pm
Thanks for the pictures, Anyone have a good picture of Toby’s liver 8?

KristinWisgirda: April 29, 2019, 8:11pm
I’ve sent Toby a list of questions from the forum including Liver 8 location. He will be getting back to us.

Tobydaly1: April 30, 2019, 8:02pm

AJSClaussen: December 4, 2019, 6:47pm
I am a little unclear on how to needle UB40 to go with or against the channel. To go against the channel do you
needle towards UB39? To go with the channel do you needle proximally towards UB41 or distally towards UB55?
Thank you in advance for the clarification.

KristinWisgirda: December 4, 2019, 10:07pm
Thanks for your question.
When draining UB40 as part of the UB supplementing treatment, you needle against the channel proximally
toward UB37, not laterally toward Ub39.
The only time you would be supplementing UB40 in Saam is if you were draining the UB channel system. You
should not be draining any channel system at this time. Toby very, very strongly cautions against draining until you
are a much more experienced practitioner and have received proper training in draining. Inappropriate draining can
cause irreparable harm to a patient.

AJSClaussen: December 4, 2019, 10:33pm

24/01/2024, 12:11Point location & needle direction: PC9, LI11, SJ2, BL40 – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/point-location-needle-direction-pc9-li11-sj2-bl40/99/print8/8
No worries, I am not draining any channel systems. Supplementing is giving me plenty of material to work with all
by itself. Unfortunately I chose to be literal with my treatment and needled UB40 towards UB39. Live and learn.
Thank you for the quick response.