3 Jiao

The three Jiao are the three divisions of the torso. The Jiao are also known as the three burning spaces. The three burning spaces are governed by the Triple Heater. The transformation that occurs in all organs does so within one of the Jiao. The Upper Jiao is the diaphragm to the sternum. The Heart, Heart Protector and Lungs are part of the Upper Jiao. The Middle Jiao is the umbilicus to the diaphragm and it includes the Gallbladder, Liver, Spleen and Stomach. The Lower Jiao is the pubis to the umbilicus and holds the Kidneys, Bladder, Large Intestine and Small Intestine.

The Triple Heater can be considered the heating engineer. Its’ job is to balance heat in all three burning spaces to make it safe and comfortable for all of the Officials to thrive in their roles. Imbalances among the Jiao are problematic. If the triple heater cannot maintain temperature among the three burning spaces, he will become ill and thus, so will the other Officials. When the Triple Heater's role is not being fulfilled, transformation cannot occur within the other Officials because they are trying to overcompensate and fulfill the role of the Triple Heater. The triple heater not only balances our physical temperature but rather the temperature of the body mind spirit. The three Jiao and the three levels of being, body mind spirit are correlated with each other.

We assess the three burning spaces for temperature imbalances. We consider the temperature of each of the burning spaces as well as the temperature in relation to the other burning spaces. In order to assess the three burning spaces, the clients must remove clothing from the abdomen. We like to allow the burning spaces to air out for 2 to 3 minutes before assessing their temperature. The assessment requires us to place I hand over each Jiao to determine its temperature. During this time, we can also get a sense of the client’s odor as well as the client’s level of comfort with touch. We will make notes with check, plus or minus for each of the burning spaces to note the temperature. We may also note any skin changes as well as moisture or dryness.  In classical fire elements acupuncture, there is no specific treatment done for him balances in the three burning spaces. However, we may recheck the temperature after several sessions to look for change based upon the treatment we implement. Imbalances can be stemming from the Three Heater or from one or more organs within the particular Jiao that presents off, based of course on the CF. Three Jiao can give us information overtime about how our treatments are working for the client. Treating the CF should over time create balance within the 3 Jiao as balancing the CF will cause the whole of the system to become more harmonious. 

To record our 3 Jiao Assessment:

3 Jiao


ITEA Personal Class Notes 2019

Japanese Abdominal Diagnosis

Also known as Hara Diagnosis, JAD is an abdominal palpatory technique used to determine the health of the 10 Organ Officials. Hara Diagnosis must not be used with pregnant women. The abdomen, like the pulse picture, is a template upon which life experiences are registered. In a healthy Hara, the practitioner should be able to palpate to the depth of one knuckle without eliciting pain. Pain, discomfort or odd sensations can indicate that there may be some imbalance in the Organ Official. The Heart palpated last and with only one finger, where the others may be palpated with the hands or fingers, in any order. Palpation should never be aggressive and comfort for the client should be emphasized. 

Japanese Abdominal Diagnosis

The palpation locations are as follows:

Heart - just below the xyphoid process

Stomach- at the level of the 8th ribs on the center line

Spleen - at the level of the 10th ribs on the center line

Gall Bladder - at the level of the 11th ribs, just medial to the nipple line

Lung - on the right in line with the umbilicus, just superior to the iliac crest and on the left just superior to the line of the umbilicus and superior to the iliac crest

Liver - on the left just superior to the line of the umbilicus and superior to the iliac crest

Kidney - just below the umbilicus, on the midline 

Bladder - just above the pubis, on the midline

Small Intestine - just inside the right iliacus

Large Intestine - just inside the left iliac

We record JAD by making notes within the Physical Exam on the JAD Form and additional notations about the client’s specific response.  

JAD gives us a subjective measure that we can use over time. Once we’ve collected the information from JAD, we can go back after a few treatments and re-assess. This will give us information about how the treatment is working related to the client’s subjective input. Thus if a client has a tender point, pain, or other odd sensation over the Large Intestine during evaluation, but it is not present in the re-assessment several treatments later, it can provide us with information that the treatments are supporting the person positively.


Personal Class Notes ITEA 2019

Hara Diagnosis - Graywolf

Agressive Energy

Qi is pure, life supporting, vital energy; even when blocked it is still all of these things. Essentially, Aggressive Energy is pollution of natural Qi. Qi becomes tainted in someway. When tainted energy is passed through the Sheng cycle and spread around system, it leads to premature organ failure and death. Generally, the polluted energy gets passed into the Ko cycle. Based upon the Law of Mother and Child, the mother refuses to give poor or polluted energy to its child. This shunting of energy into the Ko cycle means there's less energy within the Sheng cycle. However, if this polluted energy moves to all components of the Ko cycle, death is imminent. 

There are many causes of Aggressive Energy within the system. The presence of AE indicates that we are in someway living against the laws of nature and our body mind spirit is unable to bounce back. These include: trauma, surgery, dental work, anesthesia, living against one's own truth, overwhelmed by stressors, a weak constitution, cancer, emotional stress such as the death of a loved one, abuse on any level or any factor that causes nature to give up. Lifestyle in the modern-day world contributes to AE because we don't live in accordance with natural law. Living against natural law it's like a river that does not move, stagnant, not flowing, polluted and toxic; instead of moving freely it fosters disease and death.

It is most important to identify and remediate Aggressive Energy before beginning treatment. This assures that tainted energy will not be passed throughout the system. The presence of Aggressive Energy shows the natural law has broken down. Aggressive Energy does not show up lightly as it is not in accordance with the natural law. Aggressive Energy is held in the yin or solid mass organs. When the Organs present with Aggressive Energy, they do not want to pass on this polluted Qi, but its presence makes the Organ unable to heal itself. The Organ finds a way to rid this energy. Unfortunately, each organ retains some AE on. Classical five element acupuncture checks and drains Aggressive Energy in all clients. Only the presentation of Possession is treated before Aggressive Energy.

Why AE is present isn't as important as treating it, but often the client can offer insight into why it is present. There are some expressions of AE which include agitation, energetic chaos, lacking control of behaviors or emotions, depression, disconsolate, inability to Marshall own resources internally and externally, aggression or no particular symptoms but knowing that's something just doesn't feel right.

Aggressive Energy Associated Effect Points

To test for Aggressive Energy: Place needles, very superficially, just under the skin, with perpendicular insertion, in the bilateral Associated Effect Points (Back Shu) of all predominantly Yin organs, excepting the Heart. The insertion should be so shallow that, once inserted, a one-inch needle will hang at approximately a 45-degree angle to the skin.

Lung: UB 13

Heart Protector: UB 14

Liver: UB 18

Spleen: UB 20

Kidney: UB 23 

Needles should also be placed in the same fashion nearby the Associated Effect Points, but not in acupuncture points (i.e. at the same height relative to the spine and approximately one-inch lateral to the Associated Effect (Back Shu). Points. These are called "test" needles. The positioning of the "test" needles should be at sufficient distance from the actual points so that any redness on the skin from the actual points will not interfere with that of the "test" needle. The “test” needles provide a control to determine presence of AE.

The presence of Aggressive Energy is noted by erythema around the needles placed in the Yin Back Shu points, within 5-10 minutes of insertion. The Ko or control cycle, can become destructive when AE is present. We look to the coast cycle for correlations. Redness can present in the order of the Ko cycle and we can think of it like legs to a stool. Organs can go into failure according to the Ko cycle. To treat Aggressive Energy, we leave the needles in the Back Shu Points, which have tested, positive for AE until the redness completely disappears. As aggressive energy drains, redness dissipates. This can take minutes to hours. 

Normally, AE does not reach the Heart, as the Heart Protector bears the brunt of insults. In rare cases, this energy goes through the Heart Protector to the Heart. All other Yin organs should be drained first, then the Heart can be tested and drained. The Heart is checked last, and by itself, after all other organs have cleared of erythema. Even if all other organs test negative, check the Heart last, to be sure it is clear. After removing all other previously inserted needles, new needles are inserted into the Heart Back Shu point (UB15) with a new “test” needle nearby. If Aggressive Energy is not draining on the Heart Protector we can add a Heart at the same time to take the pressure off the Heart Protector. When Aggressive Energy is removed, nature and nature's healing abilities are back in control. After AE is checked and treated initially, it is not rechecked unless something outrageous happens. If no redness is present or there is no difference between the needles in the AEPs and the “test” points, then the test for Aggressive Energy is considered negative. The only way to determine presence of AE is to test for it, symptoms alone do not indicate Aggressive Energy.


Classical Five Element Acupuncture, Volume 3 by JR Worsley

Personal Class Notes ITEA 2019

Aggressive Energy by: Neil Gumenick

Entry Exit Points

The Wei Qi flows in the Law of Midday/Midnight. This Qi protects us from invasions. It flows just below the skin. The Entry Exit Points give us access to the Wei Qi level. Any Entry Exit Blocks occur on the Wei Qi level. The energy flows through the meridian and then from the Exit point of one meridian to the Entry point of the next, connecting a continuous cycle. 

Pulses Five Element Acupuncture

Entry Exit Blocks occur between Elements (within the Element, between the Officials are Junctions). Entry Exit Blocks are diagnosed only by the pulses. The Needle Technique is a Tonification Technique. The following sequence is used to clear an Entry Exit Block: Left Exit, R Exit, L Entry, R Entry where the block is occurring. Entry Exit Blocks could be due to weakness in the system, overload of toxins, transitions without flow. Blocks are part of the journey. We, as acupuncturists help to restore the continuous flow of energy by releasing these blocks. As with all Classical Five Elements Treatments, we must end the treatment with Command Points to ground the work. All Yang Entry Points and Yin Exit Points are Command Points.

It is important to note that with Entry Exit Block treatment, emotional release is possible. If we do not assist the client in clearing the block, it can limit the progression of the treatment. While the pulses are the only way we diagnose this particular block, the client may report the feeling of being stuck or blocked. This suggestion may lead us to look deeper at the possibility of an Entry Exit Block and further toward Husband Wife Imbalance or Possession. There is no harm in treating a Block, especially when in question. We can look to assess if after the treatment the Pulse Picture is improved. 

The most common blocks are Liver VIII / Lung IX, Spleen XII / Heart I, and Small Intestine II / Bladder III. Other possible blocks, though less common include: Triple Heater VI / Gall Bladder VII, Large Intestine X / Stomach XI, and Kidney IV / Heart Protector V. These are the only Entry Exit Blocks that are possible. It is, however possible that there is more than one Entry Exit Block occurring at the same time. It should be noted that Entry Exit Blocks can sometimes occur in the Conception and Governing Vessels. 

Entry Exit Points


II/III Entry Exit Block Pulse Picture 

Entry Exit Block

Treatment: Tonification Needle Technique: Left II19, Right II19, Left III1, Right III1

X/XI Entry Exit Block Pulse Picture 

Entry Exit Block

Treatment: Tonification Needle Technique: Left X20, Right X20, Left XI1, Right XI1


Personal Class Notes ITEA 2019

Law of Cure

Hering’s Law was formulated through the development of homeopathy, following the discoveries of Hahnemann, who is regarded as the Father of Homeopathy. Hering’s Law of Cure is the basis of healing in which the body heals itself. The states that symptoms of a chronic disease disappear in a definite order: 1. Reverse chronological order, 2. From within outward, and 3. From above downward. Reverse chronological order indicates that we will heal in reverse order of the symptom presentation or suppression through intervention. From within outward reflects that symptoms move from the more vital organs to the less vital organs, interior of the body toward the skin. From above downward means that we must heal from the head and trunk first, then toward the extremities.

Classical Five Element Acupuncture follows the principles of Law of Cure. JR Worsely describes that Law of Cure, “arises from the idea that the disease, which travels deeper as imbalance increases, reverses its path as Nature effects cure.” As Classical Five Element Acupuncturists, it is our job to assist Nature by treating the cause of the disease, rather than the symptoms, thus we must expect the presence of the Law of Cure within clients that we treat. Furthermore, we may expect that even though there is a brief and sometimes intense return of symptoms, that the client will acknowledge, ‘feeling better inside’. This presentation confirms that the body is in the process of healing itself on all levels of mind, body, and spirit.