Wei syndrome — upper limb

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Textbook Prescriptions Musculoskeletal

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

LI15 Jianyu affected side

Large Intestine point at the shoulder; opens yangming at the top of the arm
LI11 Quchi affected side

He-Sea of the Large Intestine; moves qi and blood through the arm
LI4 Hegu affected side

Yuan-Source of the Large Intestine; distal point that carries yangming to the hand
- Pregnancy: contraindicated
TE5 Waiguan affected side

Luo-Connecting point of the Sanjiao; supports the yangming points on the forearm

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

Treatment Principle

Promote the flow of qi in the yangming channels so the sinews and bones are nourished, clearing heat or tonifying according to the type.

Indications

flaccid weakness or wasting of the arm with loss of movementlung heat: arises in or after a febrile illness, with cough, irritability, thirst, scanty dark urine, red tongue with yellow coat, thin rapid pulsedamp-heat: sallow face, listlessness, turbid urine, hot soles the patient wants to cool, yellow sticky coat, forceful pulseliver and kidney essence deficiency: sore weak lower back, seminal emission, premature ejaculation, leukorrhoea, dizziness, blurred vision, red tongue, thin rapid pulse

Method

Reduce for lung heat and damp-heat, without moxibustion; reinforce for liver and kidney deficiency. Usually only the affected side is needled, but because the course is long the book allows needling both sides in turn, the healthy side before the affected one.

⚠ Cautions

Acute flaccid weakness is a medical emergency until shown otherwise (Guillain-Barré syndrome, transverse myelitis, spinal cord compression, stroke): it needs urgent diagnosis before or alongside acupuncture. Moxibustion is contraindicated while heat is present. LI4 is contraindicated in pregnancy.

About

The book's prescription for wei (flaccid paralysis or atrophy) affecting the arm, built on the classical rule of treating wei through yangming.

Rationale

Three yangming points run from shoulder to hand, following the Neijing teaching that wei is treated by selecting from yangming alone, the channel rich in qi and blood that nourishes the sinews. TE5 adds a shaoyang point on the forearm to help the arm points carry through to the wrist.

Clinical Notes

Add points by type: LU5 and BL13 to clear lung heat; BL20 and SP9 for damp-heat; BL18 and BL23 to tonify the liver and kidney. Moxibustion, alone or with needles, is brought in only once heat has cleared. Treatment is long, so the book stresses winning the patient's trust; tapping-needle work along the channels or over the weak area is an option. It lists myasthenia gravis, acute myelitis, hysterical and periodic paralysis, and progressive muscular atrophy as Western equivalents. For infantile paralysis (poliomyelitis) the same approach applies, with the matching Huatuo Jiaji points added; for weak extensors use yang-channel points on the extensor aspect and for weak flexors yin-channel points on the flexor aspect, with light, shallow needling in convalescence and moxa if wished.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Wei Syndrome (Paralysis), p. 371–373.

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