In nature, there are distinctions between heaven, earth, sun, and moon; in the human body, there are differences between qi, blood, yin, and yang; wellness vary in deficiency, excess, mildness, and severity. Regulating manipulation techniques have the functions of harmonizing qi and blood, regulating zang-fu organs, smoothing the flow of qi, and balancing yin and yang. They are mainly used for conditions such as insufficient qi and blood nourishment, dysfunction of zang-fu organs, impaired flow of qi, and imbalances of yin and yang in the human body, including excess or deficiency.
Regulating manipulation techniques are divided into six types: tonifying, purging, harmonizing, dispersing, mild, and spinal pinching method.
1. Tonifying method
Tonification means “support and assistance.” For the principle of “tonifying deficiency,” different massage techniques can be used for supports according to the various types of deficiency syndromes.
Gently massaging the epigastrium and abdomen, pressing and stimulating BL 20 (Pishu) and BL 21 (Weishu), applying pressure to the Spleen and stomach area, and kneading ST 36 (Zusanli) have the effects of invigorating the Spleen and harmonizing the stomach, as well as improving appetite.
Using the index and middle fingers, press respectively on the shu points on both sides of the patient’s back in accordance with the patient’s respiration (from Dazhu BL-11 to Weishu BL-21) for 10 to 20 times. This has the effect of replenishing central qi.
At the Baihui (GV20) acupoint at the top center of the head, use the thumb to perform pressing and lifting manipulation in accordance with the patient’s breathing to supports visceroptosis.
Press both palms respectively on the Shenshu (BL23) acupoint on both sides, and perform a perpendicular pressing action from the surface to the inside according to the patient’s breathing. Repeat this action in a pattern of one breath, one press, one relaxation, and one tightening to nourish the primordial qi.
Rub both palms together until they are warm, then press them onto the bilateral Shenshu (BL23) and Mingmen (GV4) acupoints, repeating several times. Next, rub the palms together again until warm and place them on the left waist. Rub repeatedly from left to right until the skin in that area feels warm and a sense of penetration is experienced. This method has the effect of warming and tonifying the Kidney yang and assisting the fire of Mingmen. It can supports conditions caused by the decline of Mingmen fire, such as cold pain in the waist and knees, cold limbs, spermatorrhea, impotence, and premature ejaculation in men, as well as uterine coldness and infertility in women.
2.Purgative method
Purgation implies “downward elimination,” hence it is also called the downward elimination method. “Eliminate when there is excess” is its guiding principle, primarily used for all excess syndromes and phlegm syndromes, such as constipation, abdominal distension and pain, and excessive accumulation of phlegm and saliva. Purgation methods are divided into mild purgation and strong purgation.
Mild purgation: Use the palm and fingers to make circular friction on the abdomen. It has the effect of invigorating the Spleen and harmonizing the stomach, and is suitable for mild epigastric and abdominal wellness.
Heavy purgation: Place the index, middle, and ring fingers of the right hand flat on the cardia at the upper part of the stomach. Then, perform relatively deep pressing and rubbing movements along the pathway from the cardia to the gastric fundus, gastric body, pylorus, duodenal region, left transverse colon, left colic flexure, descending colon, sigmoid colon, rectum, and anus. This is the heavy purgation technique, also known as the “food-dissipating and stagnation-relieving method” or “food accumulation-eliminating method”. The heavy purgation method has the function of promoting digestion and relieving stagnation, and is mainly used for signs of imbalance such as food accumulation in the epigastrium and constipation.
Regarding reinforcing and reducing methods in massage, special attention should be paid to the following six aspects during the manipulation techniques; otherwise, the reinforcing and reducing effects will not be achieved.
(1) Duration of manipulation time: Manipulation with a shorter duration and a shallower stimulating effect that excites muscle cells is considered tonifying. Manipulation with a longer duration and a deeper stimulating effect that inhibits muscle tissue is considered purging. However, manipulation with a relatively long duration but light force that activates and excites the physiological functions of the internal organs is considered tonifying. Conversely, manipulation with a relatively short duration but heavy force that slows down and inhibits the physiological functions of the internal organs is considered purging.
(2) Intensity of manipulation force: Light stimulation is for tonification, but it should be noted that deep stimulation is not necessarily heavy stimulation, such as using relatively light pressing methods; heavy stimulation is for purgation, but it should be noted that superficial stimulation is not necessarily light stimulation, such as using relatively heavy patting methods.
(3) Proximity to the body: Pushing from the distal end of the limb toward the proximal end of the body is tonifying; pushing from the proximal end of the body toward the distal end of the limb is purging.
(4) Direction of the manipulation site: When performing manipulation on the epigastrium and abdomen, the direction of massage techniques is counterclockwise, while the direction of movement of the techniques on the supports site is clockwise, which has the effect of invigorating the Spleen and harmonizing the stomach, significantly enhancing the digestive and absorptive functions of the gastrointestinal tract; this is considered tonification. If both the technique operation and the direction of movement of the techniques on the supports site are clockwise, this method has a purgative and cathartic effect; this is considered purgation. If both the technique operation and the direction of movement of the techniques on the supports site are counterclockwise, it has an astringent and antidiarrheal effect, and is mainly used to supports diarrhea, rectal prolapse, etc.
(5) Speed during manipulation: Slow manipulation techniques are for tonification, while fast manipulation techniques are for purgation.
(6) Meridian Pathway Pushing along the meridian in the direction of its flow is tonifying, while pushing against the direction of its flow is purging.
3.Harmonizing Method
“He” means reconciliation and harmonization. “Kneading for harmonization” is mainly used when pathogenic factors are in the semi-exterior and semi-interior stage; or after using strong stimulation techniques, such as relatively strong acupoint pressing and relatively strong pressing, kneading is then applied to helps with occasional the pain. The manipulation techniques mainly used for the harmonization method are kneading and rubbing.
Have the patient lie supine with both lower limbs bent and raised. The masseur’s right hand palm adheres to the patient’s epigastric region and performs clockwise circular rubbing. This has the effect of invigorating the Spleen and harmonizing the stomach, and is used to supports signs of imbalance such as nausea, vomiting, and loss of appetite.
Rubbing and pressing both sides under the costal region with both hands respectively, and coordinating with pressing Qimen (LR14), Riyue (GB24), and Zhangmen (LR13), as well as separating and pushing Shanzhong (CV17), can supports the syndrome of Liver Qi Stagnation.
Pushing and rubbing the upper abdomen from top to bottom (from the xiphoid process to the navel), and pressing simultaneously on Neiguan (PC6) and Waiguan (SJ5) can supports belching, acid reflux, and abdominal discomfort caused by upward counterflow of stomach qi.
4.Dispersing method
The term “dispersion” implies the meaning of digestion, guidance, and dispersion. “Massaging to disperse” can be applied to supports both tangible and intangible conditions. The main techniques of the dispersion method primarily include pressing, kneading, rubbing, and friction. The techniques should be performed with a light, rapid, gentle, and rhythmic manner.
Kneading and rubbing the upper abdomen, pressing and stimulating Qimen (LR14), Riyue (GB24), and Zhangmen (LR13), pushing apart Tanzhong (CV17), and using both thumbs to push apart the areas below the bilateral hypochondria can soothe the Liver and regulate qi. It is used to supports costal and hypochondriac distending pain caused by Liver Qi Stagnation, abdominal distension and pain, breast distending pain in women, and Qi Stagnation-type dysmenorrhea.
Place the eight fingers of both hands (excluding the thumbs) on the chest, and repeatedly comb and massage from the chest to the intercostal spaces at the back, moving from top to bottom. This has the effect of purging the Lung and descending rebellious qi, and is used to supports cough, asthma, and other conditions caused by upward rebellious Lung qi.
5. Evenness Method
Also known as “dividing method”. “Ping” means balance and peace. As stated in “Su Wen · Zhi Zhen Yao Da Lun”: “supports yin for yang wellness and supports yang for yin wellness”, “Carefully observe the location of yin and yang and adjust them with the goal of achieving balance”. This indicates that the purpose of supports wellness is to correct the imbalance of yin and yang. In traditional Chinese medicine, commonly used supports methods such as supports cold with heat, supports heat with cold, tonifying deficiency, purging excess, dispersing stagnation, and reducing hardness are all aimed at achieving balance. For example, using both thumbs to push apart the forehead can expel wind and dispel cold; pinching the Renzhong (GV26) acupoint can restore yang and rescue from syncope; using both thumbs to push apart the back and waist can dispel wind and helps with occasional exterior syndromes; pushing apart the transverse wrinkles on the wrist can balance yin and yang and supports insomnia or hypersomnia; pushing apart the chest can widen the chest and regulate qi; pushing apart the abdomen can promote intestinal peristalsis and helps with occasional constipation, etc.
6. Chiropractic Spinal Pinching Method
Its main functions are to dispel wind and dissipate cold, harmonize qi and blood, regulate the zang-fu organs, and promote digestion to eliminate food stagnation. It is suitable for both adults and children. The specific details will be discussed in detail later.