(285) Length of a Treatment Session

Started by HB KIM, Jun 30, 2009, 11:40 PM

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HB KIM

Overview
Acupuncture treatments are usually 15-45 minutes in length.  The 15-20 minute treatment length originated from The Classic of Difficulties (Nan Jing).  The 30 minute minimum length originated from the Spiritual Axis (Ling Shu).  The 45 minute suggested maximum length has evolved with some modern practitioner's experience.


Three Theories on Treatment Time

1. The Nan Jing, Chapter 23: 15-20 minutes
It was discovered through Daoist meditation practices that Qi and Blood move through the meridians at the rate of six cun* for each complete inhalation and exhalation.  The total length of the Meridians and Collaterals equals 1620 cun (Nan Jing, Chapter 23).  1620 divided by 6 equals 270, so it is said that 270 breaths are required for Qi to make one complete cycle through the body.  However, this number could vary based on a person's breath rate.  If a person breathes 14 times/minute, it will take 20 minutes (270/14) for Qi to make a complete cycle.  If a person breathes 18 times/minute, only 15 minutes (270/18) will be needed for Qi to make the complete cycle.  Therefore, according to  the  Nan Jing, treatment time can be calculated around 15-20 minutes. 
*Cun is a Chinese proportional unit of length; pronounced "chun".

2. The Ling Shu, Chapters 15 & 18: 30 minutes
There are two chapters in the Ling Shu that talk about Qi and Blood circulation.  In Chapter 15, it says that each circulation takes 2 units of the clock.  When the Ling Shu was written, one day was divided into 100 units of the clock, and therefore the Qi and Blood circulated through the channels 50 times per day. To calculate the time of one circulation, we calculate using the ratio of 2:100 = X:24 hours, and determine that X=0.46 hours.  Converted to minutes, this equals 28 minutes and 48 seconds.  Chapter 18 directly states that Qi and Blood flow through the meridians 50 times per day.  Since 24 hours equals 1440 minutes, you can divide 1440 by 50 to get the same calculation of 28 minutes and 48 seconds. This is where we get the guideline for approximately 30 minutes of treatment.

3. Modern Acupuncture: 45 minutes
In China, some practitioners report that the best results where achieved after 45 minutes of retaining the needles.  Master Tung style acupuncture also used a treatment time of 45 minutes, in which he stimulated the points every 15 minutes.  Sometimes Tung-style acupuncturists might leave the needles 60-90 minutes, such as is cases of Bell's palsy.


Factors that Influence Treatment Time
Treatment time may be altered based on a variety of factors.  The type of acupuncture theory used, body constitution of the patient, excess or deficiency condition, and hot or cold environment or season may influence the total treatment time.   In cases of pain, cold, or pain due to cold, it is better to leave the needles in for longer periods.  A treatment time of 45 minutes is recommended for these cases due to the hypofunction of the channel.  It may take time to activate the channels, so a longer treatment time is appropriate.  After 45 minutes, the Qi activation is less effective, so you do not want to leave a patient with needles in for longer than that.


HB's note
Although I accept all the theories from the Classics and clinical experience as true, I personally believe the location of the points are the most important factor for the treatment.  Locating acupuncture points can be compared to the hitting the target in archery.  The archery target is marked by different colors from the center out, for example: yellow, red, blue, black, white.  If you needle the target (yellow), the result is more dramatic and you don't have to retain the needle as long.  However, if you needle on "blue" or further out, you may have to retain the needle for a longer time or even stimulate the needles to reach the desired effect.  Precision of needling location is one of the most important factors in obtaining results with acupuncture.