Koryo Hand Acupuncture: a Versatileand Potent Acupuncture Microsystem

This article is based an a papet Siven at tlle Twentieth Anniversary Farutn ol theAcupunclure Founclalion of Canada held in Toranto in lune 1994

SummaryKoryo Hand Acupunclure (KHA) is an acuput'tcturenicrcsystem analoBous ta eal acupuncturc. Unlikeother acLiputlcture m;crosystens, hov'ever, there is afull rteridian system inclu(tinB the ConceptiotlVessel and Coverning;Vessel and also the exltaardi'nary meridians. F-ach of the KHA microneridiansare lettered and corresportd la) one of the bodynctidi;1t1s (Figure 1 ).One can treat a witle range of ptoblens using this

modality and it is possible in nlany cases toadn|ninister Lreatment \^/ithout use ol needles

IntroductionThe origjnator ol l(oryo hand acupuncture (KHA),Dr Tae Woo Yoo OMD PhD, tel ls lhe story that, oncni8hL in the Autumn of 1971, he was awol<en by asevere pain in the back of his head and coll ld noiget back to sleep. He found himself staring at theback oi his middle i ingef with a premonit jon that hisheacl pain coulcl be rel ieved through a point on thchand. He palpated the back oi his midd e f ingerwith lhe t ip of a ballpoint pen and when he found apart icularly tendel alea inserted a needle into i t :suddenly his headache lvas 8one. Dr Yoo hadvisualised the distal phalanx of his index f inger asrepresenling the head of the body and he wondetedrvhether a similar correspondence existed betweenthe rest of the hand and varioLrs parts ol thc body-

Key wordsAcupuncture nicrosvstems, Karyoaau pLttictu re, Tt eatme nt protoco I s,

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FiEurc 1. The hend. sha||ing thc pathways end polntt atthe nictumeritia,s

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Further experiments revealed just such a correspon-dence, and so Koryo Sooji Chlm (Koryo handacupuncture) be8an (/).

Representation of the body on the handThere is a complete representation of the body oneach hand. The distal phalanx of the middle { ingerrepresents the head, the upper limbs are representedby the index and ring fingers and the t\,vo lowefl imbs are represented by the thumb and l i t t le f ingersfespectively. l f one stands wjth hands in front, palmsfacing forwards, the medial half of the left hand andthe lateral side of the right hand each represent theright side of the body. The left side of the body isrepresented by the left (medial) side of the r ighthand and the left ( lateral) side of the left hand(Fieurc 2). FiSure L Basic "Ihrce Heatet" thenpy.

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2. Basic thetapyThis approach is based on the primacy of the "ThteeHeaters" as one of the systems underlying humanphysiology in oriental medicine. The K Amicromeridian (corresponding to the ConceptionVessel) points are used in Basic therapy for the ThreeHeatets (Figure 4). The treatment of the LowerHeater is described below.

3. Formulary therapyThis is a symptomatic treatment method incorpo-rating tradii ional point combinations such as theFour Cates, Ll.4 and LR.3 (K D3 and K-N5fespectively in KHA), toBether with other pointcombinations found only in KHA. Points are thentreated as described in "Cotespondence therapy"above.

4. Microme dian therapyMicromeridian therapy uti l ises the physiology andpathology of the twelve zang /u organs of orientalmedicine. One wonld diagnose which organ(s) are

f$Me 2. Rep.esentatrcn of the bod) an the han.l

Thenpeutic apprcachesSeveral levels of treatment are possible using KHA,ranging from simple to more complex. The levelsinclude:

1 . Coftespondence therapyThis level of treatment is based on the somatoiopicmapping of the whole body on the hand, analogousto the mapping of the body on the ear. Whenexamining the area of the hand corresponding to thepainful body atea, one should be able either to el icittenderness in that area of the hand with a pressure-palpator, or else detect decreased electricalresistance usinS an acupuncture poini detector. Thepoints are then stimulated using needles, moxa,pellets, the ion electric beam apparatus, or magnets(Figure 3).

Figure 3. Trcahent paints according to sanatobpic mappin7

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Sedat on Ton i cano.

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Figurc 5. Mictometi.lia theraPY

in excess and which are deficient, and tonify or,pd - l * , J , r o rd rng \ . { ' dn a \ "mpr ' i n Kh \ l " r ra

l r t , . t i r p o \ F . , , i i \ i ) - ' q J d l ' d \ i l L r , r d r r ' 1 ' t . I

ST.25, lhe Alarm fMLl) point of LarBe lntestine, andLarse lntestine de{iciency is associated witht"nde,n".t at CV.4,5. To sedate or tonity amicromeridian one can use any oi the fol lowirlSthree methods with either needles, pellets or the ionelcctric beam apparatus (FiSure 5)..r. Using needles: insert the needle at appfoxirnately45 detsrees, with i ts t ip pointing against the directionof fkrw of the r. icfomeridian to sedate, or poLntlngin the direction of the micromeridian to tonifyb- Using si lver and gold coloured pel ets: put asi lver o-el let at a highernumbered point on ther. jcfomeridian and i gold pel et on a lower-nJ -b ts rcd po i r l r o . t sdJ l . . l l o i ' , u r ' o " * J t o tu' ' nm - I ' o i n - " . r i \F l u Eo d o .c : ' F ^ l " ' ed . r l t sone creates a countercurrent agalnst the dlrecl lon oTflow of the rnicromeridian and to toni ly one doesthe oDDosile.c. Ljsing t iny KHA magnets: the North polecorr".ou-ndt to negative and the South polecon'esponds to posit ive, using the rationaledescribed in b. above.d. Usins the "lan electic bearn apparatus"r

_fhis is a

small battery powered device that creates a polarisedbubble of air in a t iny plastic chamber directly overthe skin at both poles, thus stimLrlatinS the twopor r r . . Onc L r .e - . l ' e po . r ' ' r d . cB r i \ o po l * ' d 'on , r . p . l ne . i he r a rd : t 1 , , pn l l e r . r r b . abn r '

5. Five Elemetll theraP'/Five Element thefapy uti l ises the "Four Need/eiechrlque" for lonif lcai ion, sedation, Hcat_dispcll ingand Cold dispell ing, and is based on the Sherr andKo cycles of oriental rnediclne

6. EiEllt Extra Meridian theraPYThis"method of treatment is based on the diagnosticaooroach oi lhe "'fhree Constitutians theory" TheconstitLrt ional type is determined according to thehistory and a special physical examinalion whicho r imdr i l \ r r \ o , \ . . aodumrna and o ' I on lp l i o ' r :r r r , m - h i ' o r p i d r o . F ' m ' 1 . \ ^ \ , h o l l \ r . F b r ' '

Constitut ional Syndror.es is presentin€i Eachsvndrome is then lufther divided, on the basis of' , o |o d r . r ' o aJ pu l ' e l ' l o ' rB ' r l o d \ i n o ' ' ryang type of presentation and.lreatment ls l lrvenUsine the master and coupled pornts ot an-pp iop ' ' , t " ' . r rn rd i r r r r mp d i rn D ' l ' r i ad

o;-. u-- ep . \n1und l l_F - np. u I 'r ' ' o.rppr.

7. Biorhvthmic therapy'l his level of treatment is based on the seasons anclthe biological rhythms associated with anindividual 's t ir .e of bifth. when lf irsl heard rnentronof this treatment rationale I was sceptica, but thesuccess of this treatment is considefed to surpass al lthe other levels.

Su ggested the rape uti c a pPrca chI r i iommend to begin \ ' , i th Correspondence, Basicor Formulary therapy l leatrnent levels: the resullsobtainable are excellent. Furthermore the abil i ty totreat without using needles is a wonderfl l l boon'l-his

can be especial ly true in new or apprehensivepatienls, of those rvho have had a long-standingproblem with a paft jcular region of their body andas a result may have extreme anxiety associatedwith Lrsing needles in lhat area. These people ottenbenefit from having a seemingly more indirecttherarreutic approach, e.g. needling theCofiesDonding KHA poirrt What I consider a disadvantage is th;t in whole body acupunciLlre peoplecan be helped to becon]e more aware of the tensionDatterns thev hold in their bodies:what ls sometimesreferrecl to as an individual 's myofascial holdingpattern. When onc is using the KHA microsystem,bv virtlre of the fact that il is a "remote col1rol"typeoi aooroach, the treatment wi I not necessari ly helpto rnake a patient more aware of lhese myofascialtension-holding palterns.

EouiDdentt l ie io lowing equipment is helpful in canying outsimple treatment Protocols:

1. Auricular acupLtnctLtre point detectolIt would be best lc) use a device such as the "Polnter

Plus" body and auricLl lar acupLlncture pointdetector, which has two interchangeable t ips Usethe f ine ( i .e. alrr icular) t ip for KHA point detection.Also, the t jp of lh;s device is spring loaded, whichnrakes it a reasonably uselul palpalion device fotdetectints tender Corresponding points

KHA needles are very small and f ine, bLlt very lhins. u; ' h' . . , quar er- I ' h bod) nr at t ' Ll lJ r* ' d '] ' r . od' qL ' p ..rb.t. urc l l-a d\F dse 1-el in8depth is one to three mil l imetres.

Hand Moxa is speci{ ical ly designed ior use in KHAand shou d be placed directly on the skin. The t inymoxa Dieces come ready-lo use, mounted oncardboard with a hole punched throLlSh the centreso thal the heat can 8et through to the point. Usingbody moxa cigars to warm the needles in posit ion.ouid b" used as a short-term improvisation unti lone can obtain Hand Moxa

4. Cold atld Silver-colourecl pelletsThe only caveat here is lo use either al l goldcolourecl pel lets or al l si lver colourred pellets at any

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one treatment session when working at eitherCorrespondence, Basic or Formulary /evels, asotherwise one may unwitt ingly init iate meridianflow phenomena one did not quite intend.

5. Laset stimulationLaser st imulation is not mentioned in the l i teraturethat I have reviewed for this paper, but I have used jton KHA points and obtained some excellent results.

6. lon electric beam apparatusThe ion electr ic beam apparatus consists of posit iveand negative electrodes with the electrode tipseparated from the skin by a small plastic airchamber so that a small amount o{ air over the pointbecomes electr ical ly polarised. The metal port ion ofthe electrode does not actualJy touch themicromeridian point. At the r isk of stressin8 theobvious, one needs to apply both terminals to thehand, and if using Correspondence, Basic orFormulary therapy the points should al l bestimulated with one polarit , usually by placing thenon-point st imulating electrode at some neutfallocus on the hand where there is not an active KHApoint.

7. KHA magnetsKHA Magnets are small magnets specii ical lydesigned for use with hand acupuncture. They canbe used for point st imulation, with the North pole ofthe maBnet being considered negative and the Southpole posit ive. A small device to confirm which poleis being placed on the micromeridian point isavailable. ABain, when using Correspondence, Basicor FormLrlary therapies be sure to st imulate al l thepoints with the same polarity.

B. Needle insertelThis is a plastic Buide tube, pressed against the skin,through which the needle is tapped into the KHApoint. l t is very useful in minimising the pain ofneedle insert ion.

Some clinical protocols which may be useful1. Lower Heater basic prescriptionThe indications l isted for this are lack of energy,easy fatiguabil i ty, weakness, constant i l lness, loss otsexual desire, impotence, utefine bleeding, fr iSidity,urinary frequency or urgency, dysuria, al l lowerabdominal diseases and low back pain. (Where hasthis protocol been all my life?... I hear you asking.)Moxibustion is general ly more effective thanacupuncture for this type of energetic deficiency, soif needles are applied i t is considered advisable touse moxa both before and after their insertion.a.The prescript ion for men is K-A], K-A3, andK-A12 which corresponds to CV1,3 and 1 2.

It is said that for impotence and prematureejaculation, moxa for three to five days at these pointsfrequently produces remarkable results (Flgure 6).b. The prescription for women is moxa at K-Al, K-A4,K-A5, K-AB and K-Al2, except in the case ot uterinesurgery or bleeding when it is considered moreeffective to use magnets or pellets than moxa fFlgure 7).

FiEure 5. Lower Heater basic prcsctiplion lot nen.

It is ofien worthwhile to include the Lower Heaterbasic prescript ion for most other probtems as atprc-treatmentr when using KHA. l t is also worthconsidering using the appropriate Lower Heaterprotocol in association with body acupuncture, as abrief, energising treatment before commencingtreatment for the patient's presenting probtem.

2. Lumbar basic prescriptionThis formula may be used {or al l problems of thelow back area which are primari ly musculoskeletalin ofigin. When using this lumbar basic prescript ionit is especial ly important to add the Correspondingpoints, l .e. the appropriate tender hand acupuncture

FiSute 7. Lower Heater basic ptescription far women

Fi9ure 8. Lunbar basic prcsaiiption.

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filure 9. Upper Gl tta,.t / .totrach prcsctiption Figute 11. ct,naecological prcsctiption.

p o r r . . P o n t . l . L l q . K 1 2 l . - | . d K \ l l B * h i , l ^,6 ' p " .po rd to r . i - - , r l B l . doe r and ! " I b adde 'rneridian points) should be used, plus appropriateCorresponding points lFiSu,e B).3. Llpper C1 tract / stomach prcscriptionThis treatnrent is effective in upper Sastrointestinaltract disorders, paft icuiarly anorexia, nausea,hyperacidity and chronic dyspepsia. Points K-48,K-A]2, K-A]6, K F,1, and K K9 should be used withneedles, moxa or pellets lFisure 9).

1. Large iDtestine / elimination prescriptionThis protocol is useful for problems such asdiarrhoea, constjpation, peri-umbil ical pain, andabdominal bloating: symptoms often refened to as'irritable bowel syndrctne". Points K-A5, K-AB,K-Al2, K-A]6, K'E22 and K-F4 should be used(Figure I0).

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l . B " t - t A L p - t t ! ^ l i n i . t i o n p a ' i p t : o n .

5. Cynaecologt c a I p! e\( t i pl i onD"{'beo J.: i hp fout C\ naPcolo]i dl P. ' inl, l t"treatment is effective in a wide range of gynaecolog_ical disorders including pre-mensiral syndrome anddysmenorrhoea. I also found it remarkably effectivein a patient with very severe endometriosis ca!sinBalmost constant pelvic pain. Points K-A4 lCV4), K-A1 2 (CVl 2), K A1 6 (CVl'+), K-F6 (SP6) should beused; i t is also useful to add K-l l9 (81.23), l( 83(CV.2), K-A33 lcv.2a) (FiSure 11)

Acupuncturc in Medjcile

fi'urc 12. Resqiratoty PtetcnPtrcn

6. Respi r.ltory prescri ptiot)This is useful in Asthma and recurrent Bronchit is.Points K-A8,12,1 6,1 8,20,22, K-C1 and K CB shocrldbe used with needles ot moxa (Figure 12).

AcknowledgementsI thank Dr Tae Woo Yoo oi Seoul, Korea and theKoryo Hand Acupunctufe Insti tute of Arnerica toIpefmission to use diaSrams from the textbook KoryoHand Acupuncture (1) and ffom coufse material 12)I thank also Dr Peter Eckman MD PhD of SanFrancisco, Cali fornia, for permission to use hisdiagrams of the Micromeridian System of KHA.

Patrick MaSovem MB MICGP DObst(RCPI)Family Practice and Pain Management

Suite 20l Meh.,pointe, 16A3 Kingsway, BurnabyBritish Columbia, Canada v5H 1M4

1. Yoo TY 11988). Kotw hand acupunctute vol l Eum Ya g/vlek I n Publlshltrs C.,frpany, Scoul, Korea

2. KHA suPpl ies, eq!r lpment and lnformal ion ihoLr t .o ! rses:Koryo Hand Ac!pLrnct!re nstitlte of Amefica, 348 wardSlfeet, Neston Centet MA 02r59, USA. Tel/Frx (617)965 7224

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