When using acupuncture to treat patients with complex, multi-pattern presentations, I prefer to use contralateral circuit needling. This is because I can address most, if not all of the symptoms and patterns in a holistic way and with fewer needles. It’s like “feeding three birds with one crumb” or finding one herb that treats three or four different patterns simultaneously. Complicated cases demand thoughtful and thorough treatment planning and point selection. And when the selected points are the correct, appropriate ones and, the point combinations are the most elegant for a given group of disharmony patterns, setting them up in a perfectly balanced contralateral sequence frequently expedites a breakthrough! When a patient experiences this major shift towards harmony and the alleviation of his or her symptoms, he or she is often inspired to return and commit to further healing work with acupuncture.

Contralateral circuit needling strategies make use of points on the corresponding but opposite side of the body from the affected area of pain or dysfunction. This is in contrast to ipsilateral treatment — treating the same side of the body as the affected area and bilateral needling — using the same points on both sides of the same meridians in a symmetrical, geometric way. Contralateral treatments make use of the transport points of the extremities (the Shu points and Five Phase points) and the other power points: Yuan-Source, Luo-Connecting, Xi-Cleft Points, the Confluent Points of the 8 Extraordinary Vessels and any “active” non-meridian trigger (ashi) points.

Contralateral needling also takes into account the directions of yinyang Qi flow for organ meridians: upwards for Yin meridians and downwards for the Yang meridians (viewing the body in the correct Chinese anatomical position with arms held overhead, thumbs positioned medially like the big toes). As an example of contralateral treatment, if there is a painful case of frozen shoulder with a strong stabbing pain on the left LI 15 (Jianyu) point, I would look for a corresponding ashi pain point on the opposite LI 15 area and treat there instead of the left (affected) side. Mostly, however, I would instead prefer to go to the anatomically analogous area at or near the right St. 31 (Biguan) on the opposite side. This contralateral technique is called mirroring (Miu Ci in Chinese): the right hip mirrors the left shoulder like the right knee mirrors the left elbow. Then I’d be using more opposites (arm/leg, left/right) and thus more opposition and “friction” to trigger an energy and myofascial release. I’d use a draining (xie fa) technique on the right St 31 to release and relieve the left LI 15 pain. In this example, the site of pain is on the Yangming (Stomach/Large Intestine) thus I’m using both an arm and opposite leg yangming circuit to treat the painful frozen left shoulder and release the chronic holding pattern found in the rotator cuff muscles or at the Biceps tendon on the left shoulder.

If the frozen shoulder was a “branch” symptom and the “root” was a Spleen vacuity, I would bolster the treatment by supplementing the Spleen meridian on the left limb (searching for a sensitive or “active” Spleen point and then connecting that Spleen point to a corresponding Lung point on the upper right limb). This then creates a Yangming/Tai Yin flowing figure eight circuit — the Spleen meridian as Yin is ascending Qi up the left inner leg and then, attracted to the upper Taiyin ,— the Lung point (used to target the Lung meridian on the contralateral right side) — Qi moves up the inner right arm towards the hand. The Lung point polarity being Yin is now attracted to its biao-li connected meridian on the left arm, the Large Intestine which is Yang polarity. Needling, for example, Hegu, LI 4 on the left limb (since it’s such a great pain-relieving point) would balance and enhance the effects of the Lung Point chosen on the right limb while also relieving some of the LI 15 pain above. And because Yang descends, the Yangming Large Intestine meridian in the troubled upper left (LI 15 area) would be attracted downwards to the yangming Stomach 31 point already needled on the right side. Finally, the Stomach meridian is biao-li attracted to its internal partner, the Spleen meridian — now needled on the left leg. Thus, we facilitate a circuitous flow of Qi in a figure 8 moving up with the Yin, then switching polarities to Yang and being directed downwards with the Yang! Hopefully, the frozen shoulder pain would vanish at this point! (“Where there is free flow there is no pain.”) An example of a point choice for this kind of treatment: Left side: Hegu, Sp 4 or Sp 5/Right side: Lu 9, St 31, St 36.

I don’t only use contralateral circuit needling in my practice but it’s especially effective for pain problems and also for chronic multi-pattern, emotionally-based syndromes affecting the organ systems. Contralateral needling is the style recommended by many Taiwanese and Japanese acupuncture masters who have preserved various ancient classical methods and secrets of acupuncture treatment not usually found in the new TCM acupuncture practiced in the People’s Republic of China. Unlike bilateral acupuncture treatment which can be appropriate for somatically-caused Zangfu (organ) imbalances, or for bilateral meridian problems or even for inducing groundedness and a spiritual calm in people not disturbed by medical problems, the contralateral meridian style treatments create a friction, a movement like a wave that ripples through the body releasing stagnant Qi and Blood in the meridians which in turn, can correct deep internal imbalances. This style of treatment is the preferred style of such notable practitioners as Master Tung, Miriam Lee, Richard Tan and Yitian Ni. It was also the first style I learned in my acupuncture training from students of Taiwanese acupuncture master Wu Wei-P’ing in 1974.

With the following treatment examples of successful contralateral circuit needling, my aim is not that readers should copy the exact, literal point protocols for these different problems but instead my goal is to explain and share my treatment strategies. Hopefully, by doing so, the reader will get a sense of the principles underlying point choices set up in a contralateral meridian-oriented way which opens circuits that facilitate a breakthrough movement toward balance and cure. Each case is based on individualized pattern diagnoses.


Tinnitus is hard to treat—especially if chronic. If acupuncture and/or herbal treatment are employed within a year of the onset of tinnitus, it can sometimes be amazingly effective! A 66-year old woman came to me with the following symptoms: a loud tinnitus of three-month duration felt mostly in her right ear. She also suffered from neck pain, stiffness and occasional right-sided headache especially felt at her right Bl 10 (Tianzhu) point, malaise, lack of stamina, insomnia, a touch of rosacea on her upper cheeks, tiny red facial lesions which were new, and occasional dizziness. I viewed her constitution as a xiao yin bodymind type—ectomorphic (thin), malnourished, sensitive, yin vacuous type. She had rapid, thready, fine and floating pulses with both cubit (3rd position) Kidney pulses empty. Her Spleen/Stomach pulse was also flat and empty. She had a thin, wiry, quick pulse in her right wrist inch position (Lung, upper chest or right-side of head?). Her left wrist pulses were all rapid, fine and wiry in the bar (Liver/Gall Bladder) position. Her tongue body was thin and red with a redder tip. I diagnosed her as having Kidney Yin vacuity with effulgent vacuity heat rising, complicated by a Spleen Qi vacuity causing a Liver Blood vacuity and that, in turn, leading to Liver Depression/Qi Stagnation with a resultant Liver heat which had been shunted to the Gall Bladder resulting in a Gall Bladder meridian stagnation in the head and neck. (Like most people with multi-pattern presentations, she manifested a mixture of vacuity and excess patterns.)

Upon palpating her neck, I found that the right side neck pain and stiffness at Bladder 10 actually also referred over to GB 20 and down to GB 21. I interpreted this tension and pain as the meaning and reason for her right inch pulse being wiry and rapid. However, I was also open to the possibility of Depressive Liver heat from the chronic Qi stagnation invading the Lungs and aggravating the rising vacuity heat causing chest oppression leading to the Heart-Spirit disquietude and insomnia.This patient had been to many practitioners and two different ENT doctors who both basically told her there was nothing she could do about the irritating sizzling sounds in her right ear.

Since this woman was very fragile and effete, I decided to be extra gentle and nourishing to her — especially for her initial treatment session. I used 10 points and they led to a breakthrough— by the end of the first treatment, her neck pain subsided! Moreover, the ringing in her ears had ceased! Here is the point formula I used: Right side: Ht 5, LU 7, GB 39, Bl 62/ Left side: SI 4, TW 5, Ki 2, SP 6. I also needled Ren 4 and Yin Tang (M-HN-3) between the eyebrows. I burned moxa to heat the needle at Ren 4 to help build vitality and then connected Ren 4 to Yin Tang to create a yin-yang balance and to target the head (the seat of her most disturbing symptoms). To create a powerful contralateral circuit, I first palpated both Ki 2 points (Rangu, the Kidney Fire points) and found the left one was most sensitive and thus I started there by needling first with a xie fa (draining) technique and later with a bu fa (supplementing) technique. (Shudo Denmai suggests Ki 2 , the Ying-Spring point and Fire point of the Kidney meridian for tinnitus and other ear problems. Needling Ki 2 drains vacuity heat from Kidney Yin vacuity). Keeping in mind what the Chinese classics state about the ear and the sense of hearing being the “flower” and “portal” of the Kidney system, it’s easy to understand how hyperactive yang (ministerial fire) could ascend to one or another ear due to a major yin vacuity of the Kidneys!

After needling Ki 2 on the left side and also adding the left ankle Spleen 6 point as an “assistant” to support the yin supplementation, and, thinking of balancing the Kidneys through the biao-li (external/internal), I then needed to find the correct and appropriate Bladder point on the right side. Since her neck pain was mostly located at right Bl 10, I decided on the right side Bl 62 using the principle of treating opposite ends of the body (head to feet). And further, if we image her right foot as her head and her right ankle as her neck, Bl 62 must (ipso facto) be one of the correct and best points to release the tension causing the neck pain which in turn was due to the rising vacuity heat. (I found her right Bl 62 to be very sensitive and ashi and needled there with a draining (xie fa) technique. Bl 62 is also the Confluent (or opening) point of the Yang Qiao Mai which is indicated for clearing heat from the head and also used for tinnitus and dizziness! Since she also suffered from insomnia caused, most likely, by her Kidney Yin vacuity (Water not controlling Fire) and thus causing Vacuity Heat Harassing the Heart-Spirit, I chose Ht 5 on her right wrist. This opened a contralateral Shaoyin (Ht/Ki) circuit ascending from Ki 2 on the left with Qi being attracted to the Ht 5 on the right. Ht 5 is also in the imaged microsystem area of the neck — if you imagine the hand as the head and the wrist as the neck. It is also the Luo-Connecting point of the Heart meridian connecting to the Heart’s partner, the Small Intestine meridian.

The Small Intestine meridian is connected to the Bladder meridian through the Taiyang. Therefore, it also drains some of the Taiyang (Bladder) vacuity heat away from the head and heart. Since I needed a Small Intestine point on the left side to balance (through biao-li) the Heart 5 and, by extension, the Bl 62 on the right, I chose to drain the SI 4, the Source point — both because it was the most sensitive/painful (Ashi) point on her Small Intestine meridian and because it is highly indicated for tinnitus and neck pain! At this stage of the treatment, I had two diagonal circuits opened: Shaoyin (Ki/Ht) traversing upwards contralaterally from the left foot to right hand and Taiyang (SI/Bl) traversing downwards contralaterally from the left hand to the right foot.

Also, remember, I had needled Sp 6 on the left ankle to boost more Yin in the Kidneys? To balance the Sp 6, I added Lung 7 on the right wrist which opened a further Taiyin diagonal circuit from left foot to right hand. Lu 7 is the Confluent point of the Conception Vessel which is the most Yin channel of the entire body — the “Sea of Yin!” Lu 7 is also indicated for head and neck pain and headaches, especially one-sided headaches. Moreover, being on the wrist, Lu 7 also has the potential to target or image the neck Bl 10 pain. Furthermore, the Bladder and the Lungs are connected and balanced through the Chinese Clock (Midday/Midnight Law). Both organ channels are at 3:00 o’clock in this schema. Bladder and Lungs are also balanced through the Bei Tong system of “same name” — Taiyang and Taiyin! Also, the tissue of the Lungs is the skin and remember, this patient had tiny red lesions on her face! (There were many reasons to add the Lung meridian to the treatment protocol).

Finally, I added two more points: Right GB 39 and left TW 5 and used a draining technique. Again, another circuit opens as both points are connected through the Shaoyang and both points are located a bit up from the ankle and wrist respectively—imaging the neck pain that referred from Bl 10 to GB 20 and downwards to GB 21! By the time all needles were in place and I was burning moxa on the needle at CV 4 to draw the vacuity heat downward from the head/neck, she was already feeling ebullient! Her headache/neck pain had vanished, and she entered an exquisite deep relaxation!

The circuits I opened were: shaoyin, taiyang, taiyin and shaoyang. On her right side, her Ht 5 point balanced her GB 39 through the Chinese Clock (noon/midnight), and, as mentioned above, her Lu 7 point balanced her Bl 62 point also through the Chinese Clock (3 am and 3 pm). On her left side, her SI 4 point balanced her Sp 6 point through the Bei Tong system (same name: SI = taiyang and Sp = taiyin). Likewise, her left TW 5 point balanced her Ki 2 point through the Bei Tong (same name: Ki = shaoyin and TW = shaoyang) and further, her TW 5 point also balanced her Sp 6 through the Chinese Clock (9 pm/ 9 am). Notice also that all meridians that go to the ear were used in this treatment: Kidney — which “opens” to the ear, Gall Bladder, Triple Warmer, Small Intestine and the Small Intestine sinew channel which enters the ear!

Her tinnitus was relieved by a breakthrough triggered by balancing the affected organ meridians treated contra-laterally in their “six meridian partner divisions” and biao-li circuits through their appropriate connecting points and well-known point combinations. The opened circuits corrected all flows causing Qi movement which calmed (or leveled) the hyperactive yang while supplementing the insufficient yin resulting in balance and thus higher functioning. In subsequent treatments I used a similar reasoning but made slight adjustments: e.g. using Ki 6 instead of Ki 2 thus bringing in the Yin Chiao Mai to balance the Yang Qiao Mai. Alternatively, I used SI 3 instead of SI 4 to balance the Yin and Yang Qiao Mai with the Central Channels: Du Mai and Ren Mai.


Bedwetting is also a difficult problem to treat! The subject was a 10 year-old boy who had been wetting his bed since birth! His parents desperately sought help from many healing disciplines: psychiatric as well as bladder and kidney specialists and ultrasound. He was prescribed Oxybutonin pills and used them for the two months prior to seeing me. But there was no change in his bedwetting! Finally, they decided to try acupuncture.

I found him to be a good-natured boy slightly overweight with a distended lower abdomen. His parents told me he had a ravenous appetite, would eat anything, anytime. His pulses revealed a dual Kidney-Spleen Qi vacuity — possibly a “former heaven natural endowment”— his “weak link”. Further, he had a rapid Stomach pulse showing Stomach Fire which explained for me the rapid hungering and his hearty appetite. I used two statements of fact from the Nei Jing to help guide me in understanding this case: “The Kidney is the Bar of the Stomach. If this bar gate is {weakened}, water will gather, causing a variety of conditions.” and “The Kidneys govern sealing and storing.” Other phrases from the classics that amplified the meanings of these two statements: “Kidney Qi vacuity leads to sealing and storing losing their command.” And, concerning “The Kidneys are the bar of the Stomach” an addendum states, “If the Kidney diffusion and movement is diminished, this leads to the grasping of food and its transportation being slow.” And further, “Kidneys not securing and managing leads to urinary incontinence.”

Although this boy could have suffered an early life trauma that had affected his Kidney function while remaining unconscious and repressed, he probably also had a congenital deficiency of Kidney Qi. And, as acupuncturists, we know that it is the Kidney Qi that stores and seals up both the “treasuries” (seminal and menstrual fluid, Jing/Essence) and “holds and secures” the urine in the Bladder. Both of his Kidney pulses were deficient as well as his Spleen pulse. Since his “weak link” was the Kidney Qi, the Kidney couldn’t function as the “bar” to the Stomach thus causing excessive fluid to accumulate in his Middle Jiao. This fluid accumulation probably caused the evil heat in the Stomach by blocking or displacing the healthy warm Qi that normally flows in that area for proper digestion. His Stomach was excessive because the weak Kidneys couldn’t act as a “bar” to keep the Stomach functioning within its healthy boundaries. His Stomach pulse was replete and fast and all pulses were slippery.

My diagnosis: Dual Spleen/Kidney Qi Vacuity with Dampness accumulating in the Middle Jiao and Heat in the Stomach. For his first treatment, I started by first using gentle pole moxibustion on his Du 4 and Ren 4 points to warm his Kidney Yang and strengthen his Kidney Qi and Essence. Setting up a contralateral circuit needling pattern in the subsequent sessions looked like this: Right side: TW 5, LI 4, Sp 9, Ki 6/Left side: Lu 5, Lu 7, St 36, Bl 40. Additionally, I added Ren 6 to strengthen his Kidney Yang. In later treatments I initially needled Bl 23 bilaterally and then had him turn over where I also used St 22 (Guanmen) bilaterally before lining up the contralateral sequence of points.

I used St 36 to strengthen the Spleen and the Middle Jiao while also resolving dampness. Bl 40 was chosen to help regulate water metabolism and this was bolstered by combining with Lu 5 (found in the anatomically analogous “mirrored” area) famous (as the Water point of the Lungs) for regulating the “water passages”. Moreover, using Bl 40, the Earth point of the Bladder helped shore up or “dam” the overflow of unrestrained fluid. And remember, the Lung and Bladder are closely related through the Chinese Clock (Midday/Midnight Law) and so, for most of the acupuncture sessions, I booked only at 3 pm to make optimal use of this law of treatment! Having now understood more about the strategy of creating and opening interacting circuits in this contralateral manner of treatment, can you —the reader — find how many other circuits were opened using the above point protocols?

After his second treatment, his parents happily announced that he had two dry nights (! ) — for the first time in possibly 10 years! For each treatment after that — while using contralateral circuit needling and continuing to refine my point choices — this boy had more and more dry nights each week! Eventually, with continuing improvement, a possible psychosomatic cause which had been suppressed for years might finally come to the forefront to be healed. Then, I may use the simple, ancient bedwetting formula: St 22, Bl 40 with Ht 7 (Shenmen)—the “Gate of the Spirit” while helping support him in a psychotherapeutic way to release possible painful images and any repressed memories and feelings.

Justin Pomeroy Lic. Ac., NCCAOM. AOBTA , has been practicing Chinese medicine for 36 years and was a founder of the Midwest College for Oriental Medicine. He practices and teaches at Life gate Center in Chicago. Go to: justinpomeroy.com for more information.