Point Synergies & Dao Ma's
One of the most significant breakthroughs I've had practicing acupuncture was to truly grasp what a Dao Ma is and how to use them. In his excellent book Advanced Tung Style Acupuncture: The Dao Ma Needling Technique of Master Tung Ching-Chang, James Mahar states, "The Dao Ma System utilizes three needles in different configurations (namely: Three Continuous, Three Transverse, and Three Triangular needles) to address a myriad of disorders..."
Adding to this, the three needles used are in close proximity to each other and in the same body region. As an example of a Triangular Configuration, the point combination of Ling Gu (22.05), Da Bai (22.04), and Xia Bai (22.07) constitutes one of the best-known Dao Ma's on the hand for treating lumbar pain. These points are featured in the image below.
Anyone that is familiar with this Dao Ma knows how effective it can be for treating various patterns of lumbar pain. Mahar also states in his book that Master Tung found that using three points was more effective than using two points. I have also found this true in the clinic, with a few exceptions of when two points are sufficient. If you know the above point combination well, you know that adding 22.07 is a must for getting superior results with lumbar pain, and this exemplifies the point of three needles being preferred in most Dao Ma point prescriptions.
Now consider treating a frontal headache with this combination. Is point 22.07 necessary for frontal headaches?
In many cases, 22.04 and 22.05 are enough for frontal headaches, but we can also add points like 66.05 (ST 43) and another point one cun distal to ST 43. Either of these two point groups (22.04 & 22.05 or ST 43 & ST 43.5) can often be sufficient for frontal headaches; however, when we combine them the effects become even stronger.
Three Point Dao Ma's
In most cases, I use three-point Dao Ma's but when using the points on the hands and feet I find that I can often get away with using only two points. This is especially true for sensitive patients and for those that are fast responders - meaning they respond quickly to needlework.
If you study Master Tung's points you will find that it is often suggested to use sets of three points. For instance, the Four Horses are a well-known point combination and are to be needled as a set of three. Similarly, the Four Flowers (77.08, 77.09, & 77.11), Lower Three Emperors (77.17, 77.19, 77.21), Upper Three Yellows, Three Scholars, and Hold Three Doors are all three point sets. These are also examples of what Mahar calls Three Continuous Dao Ma's, or three points on the same meridian line. These are the most common Dao Ma's using three points on the same meridian and in close proximity. Generally, the points on the legs, thighs, forearms and upper arms will use three points together and they are usually two or three cun apart of each other.
Now consider the typical needle response and how far needle sensation or de qi propagates. It's usually two or three cun in either direction, up or down the meridian. Sometimes patients may feel the qi travel further, and even to distant locations, but most of the time patients will describe that the electric feeling travels one or two inches up or down the meridian line.
When we use a Continuous Dao Ma it creates a synergistic effect that creates a stronger systematic reaction. This response can be so strong that many conditions can be treated with only three needles when a Dao Ma is used. To demonstrate my point, compare using Ling Gu, Da Bai, and Xia Bai for lumbar pain with another distal three-point combination that does not use points in close proximity. Pick any of your favorite points for lumbar pain - but the catch is - they can't be close to each other. If you like Ling Gu start with that as your first point. What is your second choice? We can pick from KI 7, UB points, Shen Guan (77.18), SI 3, etc. What three points do you choose?
Do you think they will produce such a good effect as Ling Gu, Da Bai, and Xia Bai? Probably not!
My point with the above demonstration is that a Dao Ma of three points in close proximity is more effective than using three points that are not close to each other.
The final Dao Ma that Mahar discusses is the Three Transverse Needles, and the most well-known combination that uses this is Thigh Nine Miles Three (88.25, 88.26, 88.27). The point 88.25 is the same as GB 31 and the other two points are 1.5 cun anterior and posterior to GB 31. This is a great point combination for back pain, hip pain, and conditions affecting the GB meridian and lateral line. I have used these points successfully for sciatica, lateral neck pain, temple headaches, tinnitus, and trigeminal neuralgia.
In the image above we see three different Dao Ma's used in the Tung system and the points in red are the transverse group known as Thigh Nine Miles 3. Also notice how the anterior and posterior points are at the intermuscular space between the tensor fascia latae, vastus lateralis, and the hamstrings. One advantage of using Thigh Nine Miles 3 over the other two groups (in green and blue) is that we are able to influence three myofascial lines (lateral line, superficial front line, and superficial back line). However, by needling 579 Miles (points in blue) or Thigh Three Springs (points in green) we are only needling the lateral line.
Knowing when to needle one Dao Ma over the others is an art and science and depends on each patient's unique presentations and the location of trigger points. If a patient presents with symptoms primarily in the foot shao yang channel then it is usually best to needle either 579 Miles or Thigh Three Springs. However, this should be verified by carefully palpating the client's lateral leg and comparing one point group over the others. For clients that present with symptoms in all leg yang lines or the LL, SFL, and SBL it is often best to needle Thigh Nine Miles 3, as this single Dao Ma can reach all three meridians / myofascial lines. However, if a client's symptoms are confined to the gallbladder meridian, or are a pure liver/gallbladder pattern, it may be best to use either 579 Miles or Thigh Three Springs.
Traditionally, we say that leg points on the gallbladder meridian can affect the gallbladder meridian in the head, neck, and face. While some of these effects may be mediated through the nerves, a myofascial model allows us to understand mechanical influences that may also be occurring through the myofascia.
One advantage of knowing the anatomy of myofascial lines is that they give us many insights into why acupuncture points work the way they do. For instance, many points on the thigh and on the lateral line are indicated for treating disorders of the head and face. Notice that the splenius capitis and SCM muscles in the neck are part of the lateral line and that these muscles attach to the mastoid process. This all may have something to do with why these points are used for such conditions as tinnitus, dizziness, facial paralysis, temporal headaches, and jaw pain.
Dao Ma's as a Key to More Effective Point Prescriptions
One thing that gave me a level of mastery using Dao Ma's (and using fewer points) was doing a lot of group acupuncture where I had to move fast and treat many patients per hour. When doing this kind of rapid-fire acupuncture I would limit myself to only using 3 - 6 needles per patient. To use these few needles and still get effective results requires knowing how to get maximum benefits from acupuncture. The Dao Ma's were the key that allowed me to produce fast and powerful results. While I was using Dao Ma's long before learning and teaching about myofascial anatomy, understanding the fascial lines gave me a whole new command of acupuncture and Dao Ma's.
To increase your clinical success rates I highly suggest using Dao Ma's and integrating those traditional practices with myofascial anatomy. The two systems complement each other very well and will greatly benefit all aspects of your practice. To learn more and take advantage of a special sale on my classes visit: Acupuncture Online Course Sale.