JAS-II Root Treatment Strategies – Mixed Yin & Mixed Qiao

Differential Diagnosis Through Palpation

• Key symbols & their meanings
  • $X$ (uppercase): significant pressure pain/discomfort
  • $x$ (lowercase): less-severe pressure pain/discomfort
  • Arrow (→): direction of referred pain
  • $T$ (uppercase): strong tissue/fascial tension
  • $t$ (lowercase): slight tension
  • $O$ (blank circle): deficiency (empty, hollow palpatory finding)
  • $P$: palpable pulse/throbbing sensation at the reflex zone
• Hierarchy of findings
  • Pain findings override tension findings $(\text{Pain} > \text{Tension})$
  • When several painful zones are present, those located lower on the abdomen outrank those located higher.
• Routine sequence
  • Always palpate/confirm Mu-front collecting points related to each suspected Extraordinary Vessel (EV).

Extraordinary Channels – General Concepts

• Extraordinary treatments are constructed by combining two or more EVs into one therapeutic “root.”
• Protocols stem from decades of Japanese clinical observation & refinement.
• Classical texts (e.g.
  Chasing the Dragon’s Tail, Hara Diagnosis) mainly mention only Cross Syndrome & Four Gates; newer lines include Mixed Yin & Mixed Qiao protocols summarised here.

Root Treatment Strategy I – Mixed Yin (Stephen Birch)

Associated Vessels

• Chong Mai $\to$ SP/PC pair
• Ren Mai $\to$ LU/KD pair
• Collectively referred to as the “Mixed Yin” root.

Typical Clinical Pictures

• Cardiac complaints, neuroses, digestive & stomach disorders
• Cold feet, LV/GB disharmonies, perianal problems
• Respiratory issues: asthma, chronic LU patterns
• ENT problems, toothache
• Sub-groupings
  • Chong Mai-dominant: pronounced gyn disorders, digestive/intestinal problems
  • Ren Mai-dominant: lung/kidney axis issues, reproductive complaints

Diagnostic Reflexes

• Primary reflex: tension and/or pressure-pain at subcostals (esp. R side)
• Confirmatory reflex: R ST25–26–27 area (Mu line for LI & SI)
• Always re-assess Mu points for each implicated EV before needling.

Needle Prescription

1. Left $LU7$ (+)
2. Right $KD6$ (–)
3. Left $SP4$ (+)
4. Right $PC6$ (–)

• Needling order usually follows the list above; ensure cross-body polarity (∞ pattern): left = positive, right = negative.
• Retention: $10$–$30$ minutes.
• If no reflex change
  • Re-check point location & polarity.
  • Re-examine diagnosis; lack of change despite correct technique may suggest poor prognosis.

Supplementary Back-Shu Reinforcement

• Choose any two pairs (4 needles total) showing the strongest pain/tightness:
  • $BL13$ (T3) – Lung Shu
  • $BL18$ (T9) – Liver Shu
  • $BL20$ (T11) – Spleen Shu
  • $BL23$ (L2) – Kidney Shu
• Needle retention: up to $10$ minutes.
• Optional moxa at needle bases:
  • $3$–$5$ okyu cones OR
  • $1$–$3$ chinetsukyu contacts OR
  • $1$–$3$ ibuki pieces per needle
• Safety: avoid perpendicular needling above $BL25$.

Root Treatment Strategy II – Mixed Qiao (Yoshio Manaka)

Associated Vessels

• Du Mai $\to$ SI/BL pair (NOTE: polarity reversed compared with standard EV protocol)
• Ren Mai $\to$ LU/KD pair
• Fusion = “Mixed Qiao” root.

Typical Clinical Pictures

• Axial & lower-body musculoskeletal issues
  • Spinal arthritis, hip pain, sacro-iliac dysfunction, coccyx injury
  • General myalgia
• GYN disorders
• Respiratory complaints (asthma, LU patterns)
• ENT problems, toothache, neuroses

Diagnostic Reflexes

• Dominant sign: Ren-Mai abdominal reflex plus major complaint centred in the back (MC = back pain).
• Always cross-check relevant Mu points per EV.

Needle Prescription

1. Left $LU7$ (+)
2. Right $KD6$ (–)
3. Left $BL62$ (+)
4. Right $SI3$ (–) ← Du Mai pair uses reverse polarity compared with classical EV rule.

• Cross-body infinity pattern (left = positive, right = negative) still holds.
• Retention: $10$–$30$ minutes.
• If no change
  • Verify point precision, polarity orientation, diagnostic validity.
  • Persistent failure may indicate poor prognosis.

Supplementary Back-Shu Reinforcement

• Choose two points (not pairs) with maximal tenderness/tightness:
  • $BL13$ (T3) – LU
  • $BL23$ (L2) – KD
  • $BL27$ (level 1st Liao) – SI
  • $BL28$ (level 2nd Liao) – BL
• Also palpate adjacent Hua Tuo Jia Ji (HTJJ) for additional needling options.
• Needle retention: up to $10$ minutes.
• Optional moxa at each needle base (same dosing as Mixed Yin protocol).
• Safety reminder: no perpendicular needling above $BL25$.

Practical / Philosophical Notes & Clinical Tips

• The root treatment strives to correct the deepest layer (EV level) before addressing branch/local symptoms.
• Crossing polarities (left/right + / –) mirrors the infinity symbol, reinforcing systemic yin-yang communication.
• Re-testing palpatory reflex zones immediately after root insertion is mandatory; an immediate softening/pain reduction signals successful “switch-on” of the EV.
• Ethical practice: inform patients that lack of reflex change within two sessions may predict slower or limited recovery; consider referral or integrative consult.
• Keep meticulous charts using the symbol system—quick visual communication for any collaborating practitioner.