Goiter
StarEssentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.
Points
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San Jiao point; disperses stagnant qi and phlegm in the swelling
Reduce.
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Local neck point of the Large Intestine; moves qi and blood at the site
Reduce.
- ⚠ Pneumothorax
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Local neck point of the Small Intestine; moves qi and blood at the site
Reduce.
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Local Conception Vessel point at the base of the throat; moves stagnation
Reduce.
- ⚠ Pneumothorax
- ⚠ Airway
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Distal hand-yangming point; directs qi and blood along the channel through the neck
Reduce.
- Pregnancy: contraindicated
-
Distal foot-yangming point; directs qi and blood along the channel through the neck
Reduce.
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
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LI17 Tianding
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⚠ Pneumothorax has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 1 (Pneumothorax associated with acupuncture)
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CV22 Tiantu
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⚠ Pneumothorax has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 1 (Pneumothorax associated with acupuncture)
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⚠ In front of the trachea: risk of airway injury. World Health Organization 1999, Section II §5.2 (Other points), p. 25
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Treatment Principle
Move qi and blood and break up stasis and masses with reducing technique at San Jiao, Large Intestine and Stomach points.
Indications
Method
Reducing technique throughout.
⚠ Cautions
Any neck swelling needs medical investigation (thyroid function, ultrasound) to exclude malignancy, and hyperthyroidism needs medical management; thyroid storm is an emergency. Do not needle into the goiter itself. LI17 and SI17 lie near the carotid artery and jugular vein; needle shallowly. CV22 must be needled with care: the needle goes down behind the sternum, never posteriorly towards the trachea or deep into the mediastinum. LI4 is contraindicated in pregnancy.
About
The college prescription for goiter, explained as qi obstruction from anger, worry or depression producing phlegm and blood stasis, or as qi stagnating in the neck from external factors and failure to adapt to the environment.
Rationale
TE13 disperses stagnant qi and phlegm in the swelling, since the San Jiao governs the qi of the whole body. LI17, SI17 and CV22 sit on the neck and move qi and blood locally to scatter the stagnation. LI4 and ST36, distal points on the hand and foot yangming channels that pass through the neck, steer the flow of qi and blood towards the site.
Clinical Notes
For depressed liver qi add CV17 and LV3. The book equates this goiter with simple goiter and hyperthyroidism. It also gives an ear-acupuncture option.
Sources
- Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Goiter, p. 388–389.
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