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(302) 24 Gate Openings

Started by HB KIM, Apr 27, 2010, 02:19 PM

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The point combination LI4 (union valley) + LV3 (great surging) is well known as the "four gates".  However, it is only one possible combination out of 12 four gate pairs.  If needling order is considered, it can be expanded to 24 pairs.

"24 Gate Opening" is one of the essential acupuncture theories in Korean medicine.  Gate opening exhibits the unique function of synchronizing the body in time and space, and aligning the body with the environment.  It is an excellent choice for the first treatment in a course, as it increases the body's receptiveness to acupuncture's benefits.


A) Order of insertion:  According to the theory, the order of needling has a significant impact on the treatment.  The needling order should be modified according to the time of day.  (Refer to p.360 of Minibook of Oriental Medicine).  Otherwise, 4 gates → Yintang → DU20 can be used as a universal order anytime of the day.   

B) Combination principle:  Yuan source points are used in the practice of Tong Gi Chim.  Yuan source points are paired by opposite polarity of both yin and yang channels as well as hand and foot channels.  For example: LI4 (E), a hand yang channel, is combined with LV3 (M) or KD3 (H), which are foot yin channels. Points within the same circuits (Heaven, Earth, HuMan) cannot be combined. (Channels in the Earth (E) circuit are LU, LI, ST, and SP. Channels in the Heaven (H) circuit are HT, SI, UB, and KD. Channels in the  Human (M) circuit are PC, SJ, GB, and LV.) 2 possible combinations for each point x 12 Yuan source points = 24 Gate Opening treatments.  While there is some overlap of pair combinations, the treatment is considered different depending on which point is used as the primary or secondary point.

C) Clinical application:  Gate Opening is not limited to the use of LI4+LV3.  Depending on the presenting symptoms, different Gate Opening pairs may be more appropriate.  For example, HT7+GB40 targets the HT and GB for Wen Dan Tang (warm the gallbladder decoction) type conditions.  KD3+LI4 should be used for Si Shen Wan (four miracle pill) type conditions. 


Some basic indications of the 12 gate opening pairs are listed below but are not limited to these.  Gate opening has a wide range of actions.  The best Gate Opening combo is chosen based on Zang-Fu theory.  If uncertain, the use of LI4+LV3 is never a bad choice.  (Refer to the HB's forum article - (228) Four Gates)

1   LU9 + GB40:   Cough, asthma, shortness of breath, gallstone
2   LI4 + LV3:   Yin-yang imbalance, pain, internal wind, dysmenorrhea
3   ST42 + PC7:   Disorders in the chest, diaphragm, epigastric area
4   SP3 + SJ4:   Fatigue, tiredness due to overwork, diabetes
5   HT7 + GB40:   Insomnia, palpitations, anxiety, lack of courage
6   SI4 + LV3:   Liver disorders, hepatitis, cirrhosis, blood stasis
7   UB64 + PC7:   Urinary tract infection, dribbling urination, poor memory
8   KD3 + SJ4:   Essence deficiency, KD Yang deficiency, adrenaline deficiency
9   LU9 + UB64:   Lower back pain, external wind, skin disorders
10   LI4 + KD3:   Diarrhea, constipation, irritable bowel syndrome, colitis
11   ST42 + HT7:   Indigestion from emotional imbalance, gastritis, gastric ulcers
12   SP3 + SI4:   Blood deficiency, nutrition deficiency, amenorrhea


A treatment called Great Gate Opening is used in addition to a Gate Opening treatment for more severe conditions.  Two more needles are added: PC9 on one side, and SJ1 on the other.  Note that both the PC and SJ exist only as functions, not as true physical organs.  Therefore, the PC/SJ primary channels are more closely related to the eight extra vessels while the other ten primary channels are closely related to the organs.

Great gate opening  =  Gate opening + PC9, SJ1