The Master Tung points known as the Seven Tigers (77.26) are in the region of UB 58 - UB 59 and between the tai yang and shao yang meridians. They are indicated for pain in the clavicle, scapula, occipital headaches, neck pain in the posterior and lateral regions, and tension at GB 21. Additionally, they may be used for pain in the sternum and costal regions, as well as for lung disorders, pleurisy, back pain, hemorrhoids, and channel-related symptoms.
These points are a three-point unit and all of them should be needled together for best results. The first point is located 2 cun above UB 60, the second point is 4 cun above UB 60, and the third point is 6 cun above UB 60.
Qi Propagation and Dao Ma's
In clinical practice, it is common to observe that patients will frequently feel de qi sensation radiate 2 or 3 cun along the meridian pathway. This is important to recognize because in Tung style needling we typically needle 2 or 3 points in close proximity and on the same meridian. A series of points done in this way are spaced 2 or 3 cun apart and are referred to as a dao ma.
By doing dao ma style needling it helps to propagate de qi further along the channel and myofascial lines. This has a synergistic effect and has many advantages over just needling one point on a single meridian. Using dao ma’s is essential to getting effects with distal needling, and when we needle points in close proximity it has a stronger influence on distant regions and structures. We will examine this in closer detail as it relates to Master Tung's points the 7 Tigers (77.26) and how they are used to treat pain in the scapula, neck, upper back, and shoulders.
Myofascial Lines - The Superficial Back Line and Lateral Line
The 7 Tigers (77.26) are located on the foot tai yang urinary bladder (UB) meridian and the superficial back line (SBL). However, some of the effects of these points also indicate that they affect the gallbladder (GB) meridian and lateral line (LL). This area from UB 58 - UB 60 is interesting because it is between the tai yang and shao yang meridians. A close look at the actions of these points shows they can be used for problems in the SI, UB, and GB meridians, as well as for kidney and lung disorders. Their ability to treat the clavicle and sternum is also interesting and we will explore the anatomical basis for this.
Tai Yang Meridians
The tai yang channels refer to the relationship between the UB and SI meridians, both of which are located in the posterior region of the body. When we needle points on the UB meridian it can affect the SI meridian and structures like the scapula. The small intestine points on the shoulder and scapula include SI 9, SI 10, SI 11, SI 12, and SI 13. For pain in the posterior shoulder, scapula, or at any of the above SI points, we can use the 7 Tigers with good benefits. One of the keys to getting results with the 7 Tigers is to needle them contralaterally to the scapular pain. It is also vital to have the client move their arm, shoulders, and scapula when using the 7 Tigers for these conditions. I will typically have a client move through a full series of shoulder and neck movements when I use these points for shoulder and neck pain.
The Shao Yang - Lateral Line Indications
The 7 Tigers are also indicated for lateral neck pain and other disorders that affect the lateral line or gallbladder meridian. For instance, they can be used for pain at GB 20 and GB 21, costal pain, and pain in the sternum. One of the muscles in the neck and on the lateral line is the splenius capitis, which originates on C7 - T3 and inserts on the mastoid process and occipital ridge. The point GB 20 is just posterior to the mastoid process, and it is possible that the 7 Tigers (77.26) affect the splenius capitis muscle via mechanical and neurological processes occurring through the LL and SBL.
The area of GB 20 is an interesting region because it is one of those areas where the shao yang (GB) meridian is meeting with the tai yang (UB) meridian. The points GB 20 and UB 10 are located next to each other and the 7 Tigers may be used to treat pain in this area. Remember that points like UB 58, UB 59, and UB 60 can also be used for occipital headaches and neck pain in this region. This would indicate that points in the UB 58 - UB 60 band, and the 7 Tigers, are affecting both the GB and UB meridians. The location of these points on the lower leg is also between the UB and GB meridians and the soleus and peroneus longus leg muscles.
Further exploring the anatomy of this region, we find that as the splenius capitis moves down from the occipital ridge and mastoid process it attaches to C7 - T3 which is in the area of the UB meridian. Once again we can see that the splenius capitis is transversing through the GB and UB meridians as it moves from the lateral neck to the spine and vertebrae of C7 - T3. There is a convergence between the GB and UB meridians happening in the splenius capitis muscle and at the points GB 20 and UB 10, as well as points like UB 12 and UB 13. Since the 7 Tigers can be used for both posterior and lateral neck pain, it seems that they may be influencing the splenius capitis and its origin and insertion points.
7 Tigers and the Sternal-Costal Region
The Seven Tigers are also indicated for pain in the ribs and sternum and this relates to its connections to the lateral line (GB meridian). The intercostal muscles are part of the lateral line, and as the ribs connect to the sternum, we find that points that treat the costal region can also be good for chest and sternal pain. For patients with chest pain, it is always essential to assess the ribs and intercostal muscles, as they may be causative or contributing factors to the chest pain.
In addition, the 7 Tigers (77.26) are indicated for pleurisy. I have also used these points for patterns such as liver overacting on the lungs, or with syndromes in which the intercostals (secondary respiratory muscles) are excessively tight or immobile and as a result are contributing to a respiratory disorder.
In pleurisy, there's a build-up of fluid in the pleural cavity, between the parietal pleura and the visceral pleura. Connective tissues also attach the lungs to the inner costal region, and it's possible that needling the 7 Tigers may affect not only the intercostal muscles but also the underlying connective tissues that attach to the parietal pleura and visceral pleura of the lungs.
7 Tigers for Clavicle Pain
The 7 Tigers are also indicated for clavicular pain and this is interesting because of the muscular attachments on the clavicle. On the lateral aspect of the clavicle the trapezius attaches, and on the medial sternal attachment, we find that the SCM muscle attaches. The SCM is also on the LL, so we can trace out LL line connections to both the medial and lateral aspects of the clavicle.
This is important because it helps us to understand the mechanism of how these points work. Since the 7 Tigers can treat pain at GB 20 and GB 21, we can also observe how the lateral attachment of the trapezius on the clavicle may be influenced by these points. Similarly, since the 7 Tigers (77.26) can treat sternal pain, they can also address medial clavicle pain because the clavicle attaches to the sternum. When using the 7 Tigers for sternoclavicular pain, it is often helpful to apply acupressure to the local area of pain and release any ashi points.
A Case Study
The patient's main complaint was chronic pain on the left side at SI 13. The pain also radiated up towards the cervical spine when it was most severe. On examination, trigger points were found in the levator scapulae muscle. The pain started after a fall from a sports-related activity and was worse with desk work and excessive sitting. A slight anterior head shift was noted and the patient spent excessive time looking down at work, thereby placing the neck in chronic flexion and placing strain on the posterior neck muscles. The SCM muscle on the left was noticeably tight and contracted when compared to the right SCM muscle. He also had pain between the fourth and fifth intercostal space on the left side, as well as occasional numbness and tingling on the left side in the region of the 7 Tigers.
I needled 77.26 on the left side, which was the same side as all of his symptoms. The ipsilateral side was selected because the pain in the cervical region was in the UB channel, as was the intercostal pain on the GB meridian and lateral myofascial line. If the pain was only at SI 13 or at other points in the scapula and SI meridian, I would have needled the contralateral side. However, since most of his symptoms were in the UB and GB channels I decided to needle the points ipsilateral to the pain.
Only the 7 Tigers were needled and the patient was asked to do a series of neck and shoulder movements with the needles being retained. After 10 minutes the client reported a 60 percent improvement. The needles were stimulated again and the patient was left for another 10 minutes with the needles. He noticed slightly more improvement after the second round. The patient was also taught a series of posture-correcting movements to assist in treating the pain, as were acupressure techniques using points on the lung meridian and in the region of LU 6 - LU 7.
In a follow-up visit, the client reported that the pain relief had lasted and that the exercises and movements gave noticeable improvement when he felt the pain returning. The same points were needled for the second session and the client reported 90% improvement following the second treatment. A couple weeks later the client came in for a third treatment after starting to feel the pain return. Overall he said the pain relief had a lasting effect, but that long work hours had caused him to have a flare-up. He also wanted to learn some additional exercises and movements that he could do while seated at a desk.
Happily, the patient returned a couple of months later reporting that the movements, exercises, and acupressure point protocols he was taught were maintaining the improvement. However, long work hours at a desk aggravated the problem and he felt he needed more acupuncture to reduce the pain. The client has become a long-term returning patient who uses acupuncture, acupressure, movements, and stretches to maintain his health.
I mention this case study because it demonstrates how Master Tung's points the 7 Tigers (77.26) can be used on the same side as the pain when the tai yang and shao yang meridians are involved. Although his primary complaint was pain at SI 13, with close examination we found that other painful areas and trigger points were present, that warranted the use of the 7 Tigers on the same side.
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