by Hung Pui Yu
The Song of the KEYWORDS: ghost points, dian, cong, mental disorders, ABSTRACT: The song of the 13 Ghost Points of Sun Xi Miao is well known among Physicians of Traditional Chinese Medicine especially those specialising in Acupuncture. However, there has never been any in-depth study of these points and their functions within the context of mental disorders. As a result, these 13 Points are usually regarded 'as an historical relic rather than a proven clinical formula. Thus it is significant to investigall' the mechanisms of these 13 Ghost Points so that treatment can be properly evaluated. The aims of this study is to provide information on: I. The historical details on mental disorders based on TCM pathologies. 2. The author of the Song of the 13 Ghost Points, Sun Xi Miao. 3. The translations of different versions of the Song of the 13 Ghost Points. 4. An analysis of the treatment sequence of the 13 Ghost Points. The present study depends heavily on Traditional Classical Chinese Texts for historical details and Modem Acupuncture Texts are consulted in areas of point dynamics.
History of Mental Disorders Classical Chinese Medical Texts: Mental disorders are described in the earliest Chinese Medical Text - The Yellow Emperor's Classic of Internal Medicine. In Book 8 Chapter 30. it reads: The Yellow Emperor:
"Excellent! When the (mental) disease is serious, one discards ones clothings and runs around naked, climbing up high places, singing lOUdlyand even not eating for several days. Why is it that these people can climb to the top of nouses and high places when normal people cannot?" Chi Po:
"The 4 limbs are the extensions of the various Yang. When the Yang is excessive, the 4 limbs are strong. That is \"hy these people can climb to high places." The Yellow Emperor:
"Why does pne discard ones clothings and run around naked?" Chi Po:
"Because there is excessive heat in the body, one discards ones clothings and runs around naked." , In Book 22, Chapter 74 it reads: "Various Hot Madness, all are classified as Fire.'" In a latter medical text, the Nan Jing - The Classic of Difficulties, mental disorders are further described and classified. In question 20, it reads, "When the Yang is excessive, it is called Cong. When the Yin is excessive, it is called Dian." ,
Thirteen Ghost Points In Question 59, it reads: "Dian Cong diseases, how can one differentiate? When the Cong disease begins, one usually sleeps little, or is not hungry. One feels superior in virtues and intelligence. One laughs incessantly and loves to ~ing and dance. When the Dian disease begins, one feels sad and depressed. One stares vacantly straight ahead.'" Since these Classics, successive generations of physicians basically adhere to these concepts in their approaches to mental disorders. It is not until the later Dynasties of Yuan (1279-1368 AD), Ming (1368-1644 AD) and Ching (1644-1911 AD) when physicians begin to describe mental disorders in more complexity. In the Chuan Dynasty in Chapter 37 of his book, Chiao writes: " ... all these diseases originate from the deficiencies of Qi and Blood, and the invasion of Perverse Wind ... When the Perverse Wind invades the Yin, it causes Dian diseases. If the perverse Wind invades the Yang, it causes Cong diseases... '" In the Yuan Dynasty, in Book 4 Chapter 60. Chu writes: "Dian disease is classified as Yin and Cong disease is classified as Yang. Dian disease usually expresses as excessive joy while Cong disease usually expresses as excessive anger. ... most of these diseases are due to Phlegm accumulation within the area between the chest and the Heart.'" In another book in Chapter 62, Chu continues: "Cong disease can be seen as Blood stagnation... and Blood stagnation in the Lower Heater can also cause Cong disease... '" Since then, PhiegmlDamp begins to emerge as an important factor in mental disorders. In the Ming Dynasty, in Book'.5 of the Classic called The Authentic Transmission of Medical Knowledge, it reads: "Generally Cong disease is due to excessive Phlegm Fire, Dian disease is due to Heart Blood deficiency. All such diseases are due to high hopes not realised,'~ In Book 34 of his Complete works, Cheung writes: "Cong disease 1S usually due to Fire, or unfulfilled desires, or accumulated worries without outlet, or anger without outlet leading to Liver/Gall Bladder Qi stagnation, leading to the joining of Perverse Fire and Wood. If the Perverse Qi i~vades the Heart, it leads to the ShenlSpirit not residing. If the Perverse Qi invades the Stomach, it leads to excessive, ruthless, uncontrollable behaviour and movement.'" In the same period, another famous physician Wong, in Book 7 of his work, writes: -,. " ... the 2 diseases, each has its unique cause. It may be due to excessive anger which stirs the Liver Wind, or because of great fear which disturbs the Heart Fire, or due to accumulated Phlegm' which eventually leads to its rising by virtue of its heating up. It ascen<jsbut does not descend and subsequently blocks the Heart orifices. As a result, the Shen cannot communicate and loses control."路
The texts from these periods begin to emphasise emotions as an important aspect of mental disorder and the pathologies involved are described in more detail. In the Ching dynasty, in addition to the different aspects of mental disorders already described, Fu in his chapter on Madness, writes: " ... this disease generally arises from Cold deficiency of the Spleen/Stomach. When food and drink enter the Stomach, they are not transformed into JinglEssence but into Phlegm. The Phlegm then mists the Heart'orifices, thus causing the DianlCong diseases,''' Lastly a quote from the text - The Essentials of Confucian Physicians, it reads: , "When the Cong disease ... it belongs to Heat and Heat is Yang. The disease causes one to discard ones clothings and climb high places. Clothings are discarded because of the Heat. The ability to climb high places is due to the tendency of Yang to rise. It is this buoyancy which allows the body to feel light and reach high places ... Why does one feel so active and yet not hungry? This is because the excessive Yang causes excessive activities... Also one feels no hunger because the Perverse Yang accumulates within and fills the chest and abdominal areas".' In retrospect, strange as they seem, all these philosophical constructs have been applied and found effective at the clinical level.
Different Schools of Thought Basic Medical Classics such as The Yellow Emperor's Classic of Internal Medicine, The Classics of Difficulties and The Shang Lung Classic of Herbal Medicine provide the foundation for the later development of Chinese Medicine. In different dynasties, various schools of thoughts were established in which certain particular aspects were emphasised. In the Han Dynasty (206-220 AD), the Shang Han School (School of Cold Injury) became prominent and the Classic, Thesis of Cold Injury - Shang Han Lun, written by Cheung established the concept of the Six Divisions and their penetration by Perverse Qi in the disease process. Through successive generations of refinement, there are now well over 700 offshoots of this school. This school views mental disorders as pathologies in the 6 divisions as Yang Ming Fire invade the Heart and Jue Yin Heat rebels upwards. In the Sung and Gan Dynasties, the Ho Gan School (School of the Ho Gan District), became prominent. This school emphasises the Five Circulations and the Six Qi relating to the Stems and Branches. It believes that most diseases are due to FirelHeat and its practitioners are very proficient in the use of cold and cooling herbs. This school views mental disorders as FireIHeat related and pathologies such as Liver/Gall Bladder becoming Hot, Liver Yang Rising and Excess Fire/Heat invades the Heart are common. Anothet school, the I Shu School (School of the I Shu
District) places emphasis on the Cold/Hot, Excess/Deficient states of the ZanglFu. This school places great importance in maintaining the Spleen/Stomach. It believes 1hat emotions can cause internal injuries due to chronic deficiencies. This school views mental disorders as disharmony and deficiency related to Earth. Common pathologies are Deficiency of SpleenlKidney and Disharmony of Heart/Spleen. In the Gan Dynasty, the Gon Jue School (School of Attacking the Perverse Qi) maintains that if Perverse Qi remains within the body, it will injure the Upright Qi. Thus it is important to eliminate Perverse Qi from the body, so that the Upright Qi can be nursed back to health. This school approaches mental disorders by directly getting rid of the Perve~se Qi. In the Yuan Dynasty, the Dan Kue School (School of Chu Dan Kue) emphasises the importance of conserving the Yin. He maintains that the Yang is always in excess, whereas the Yin is quite often deficient. He also I revitalises the concept of Minister Fire (Liver/Kidney) and its vital role in maintaining life. The school views mental disorders in terms of Internal Fire, Phlegm and Obstructions. Some pathologies are Rebellious Minister Fire, Qi StagnationlPhlegm Obstruction, Yang Ming Fire leading to Phlegm Accumulation, Liver Fire leading to Phlegm, .Yin Deficiency resulting in Excess Fire and Stomach Yin Deficiency. In the Ming Dynasty, the Wan Bia School (School of Warming and Tonification) emphasises the warming and tonification of the Spleen/Stomach, Central Qi and the Ming Men Fire. This school places great importance in maintaining the balance between Qi of Pre-Heaven '(Kidney) and Later-Heaven (Spleen). Common pathologies are Obstruction of Heart/Spleen, Ming Men Fire Decline, Heart/Kidney Deficiency. [n the Ming and Ching Dynasties, the last major school is the Wan Bien School (School of Febrile Diseases). This school proposes a Four Divisional model of Wei, Qi, Ying and Blood to explain the penetration of Perverse heat into the body. Possible pathologies are Shao Yang Heat with Internal Phlegm Dartip, Perverse Heat invades the Blood affecting the
Sun Xi Miao, author of the 13 Ghost Points, lived around the period spaning the Chui (581-618 AD) and Tang Dynasties (618907 AD). This period is the most prosperous time in Chinese history, with stable government, extensive trades and cultural exchanges with many countries. In 589 AD the Chui Dyna!ty united China and undertook major reforms in government. The result was major advances in t9-efields of politics, economics, cultural and scientific achievements. Notable scientific advances were in paper making and printing. In medicine, the government established the Imperial Health Medical Ministry and the Imperial Herbal Ministry to collect, edit, print and research all fields of medicine. In 618 AD, with the beginning of the Tang Dynasty, the government continued to expand on the Imperial Medical ministry and the Imperial Herbal Ministry. The famous herbal text, The New Compilation of Herbs, was completed at this time. -.. With political and economic stability, the period provided fertile opportunities for the flourishing of cultural and religious activities. Culturally, there were various schools studying the I Ching, the Books of Lao Tse and Chuang Tse, the Four Books and the Five Classics, the Three Histories and the Hundred Schools of Thought. In areas of religions, there was harmony among the 3 dominant beliefs: Confucianism, Taoism and Buddhism. While Confucianism and Taoism were already finnly established within the Chinese psyche as their cultural heritages, Buddhism did not begin to spread to China until the end of the Western Han Dynasty and blossomed in the Tang Dynasty. As a result. there
It is' important to eliminate Perverse Qi from the body, so that the Upright Qi can be nursed back to health.
Heart/Shet;-l,
tlfiiJ
~.'
From various schools of though¢, the pathologies of mental disorders can be summarised generally as Full FirelHeat from ExcessYang, Empty HeatlFire from Yil;llBloodDeficiency, PhlegmlDamp of Hot and Cold types of ObsUuctions.(6)
were increased
cultural,
religious
and scientific
exchanges
between China and India, and the rest of the civilised world. [n terms of medicine, historical details suggest that Classics such as the Su Wen (The Yellow Emperor's Classic of Internal Medicine), the Ling Shu (The Classic of The Needle), the Shang Lung Ben Chia (The Shang Lung Classic of Herbal Medicine) and the Nan Jing (The Classic of Difficulties) from the period of the Warring States and beyond were available. The Classic, the Shan Han Lun (The Thesis on Cold Injury) from the Northern Han Dynasty was known to exist but was kept secret within families of physicians. Sun Xi Miao once lamented that even he did not get to read a "complete" copy of the Shan Han Lun until his advanced years. In the Jian Dynasty, Wong collected fragments of the Shan Han Lun and rearranged it. He also wrote the Muc Jing (The Classic of the Pulse). In acupuncture, the classic Jia I (Classic of Acupuncture and Moxibustion), was written. This acupuncture encyclopaedia
summarises all known knowledge and experiences of previous acupuncturists up to that time. In addition, the increase in contact with foreign countries such as India and Tibet suggests that there may have been exchanges in the fields of medicine. "
Thousand Gold Essential Emergency Prescriptions, which he finished around 652 AD. The Thousand Gold Prescriptions was comprised of 30 books, 232 sections and over 5,300 prescriptions. The Text covers Ethics, Clinical Diagnosis, Pulse Diagnosis, External Medicine, Internal Medicine, Gynaecology, Paediatrics, Emergency Medicine, Food Therapy, Mind Cultivation, Acupuncture, Herbal Medicine. Around 681 AD he His Life: Sun Xi Miao was born around 581 AD in the beginning of completed The Wings to the Thousand Gold Prescriptions the Chui Dynasty In the Yie district about 15 Ii (miles) from the which supplemented his original work. The Wings comprises 30 Sun family village. As a child, he was very intelligent but quite books. 198 sections and over 2,900 prescriptions. Together, The sick. He started school at 7 and was able to memorise over 1,000 Thousand Gold Prescriptions and The Wings is recognised as words per day from the Classics. In his time, he was regarded as the first Encyclopaedia of Chinese Medicine. In acupuncture, it was recorded that he found many mistakes a child prodigy. When he was still a youth, he could discuss in depth the Taoist philosophy of Lao and Chuang, the Classics and in acupuncture charts ·drawn before the Chui and Tang the Thoughts of The Hundred Schools. Around that period, the Dynasties. From many charts and his own experiences, he drew route to riches and power was through the Imperial Examination 3 colour acupuncture charts with points called The Chart of the and most youths spent their time studying the Classics for these Hall of Brilliance. The 12 Major Meridians were drawn in 5 different colours and the Eight examinations. However at the Extra meridians in green. There tender age of 18, Sun decided to were 282 front points, 194 back devote himself to the study of points and 174 points on the medicine. At the age of 20, he began his practise and his fame sides. A total of 349 acupuncture as a physician began to spread points were recorded. Even though the charts did not survive, far and wide. Throughout his medical career, his fame was the information was recorded in such that he was invited three Book 29 of The Thousand Gold Prescriptions. separate times to become the Imperial Physician to the Royal Family of three different Emperors - Chui Men Ti, Tang Tai In clinical practice, Sun emphasised that acupuncture Chun and Tan Gao Chun. Each time he declined the offer treaunent should be based on a correct and detailed diagnosis claimi~g ill health and instead continued to work among the and point selection should depend on that diagnosis. He also common people. Sun never sought.fame or riches and continued stressed the importance of using needles and moxa together. He throughout his life to teach the importance of medical virtues and recommended the use of moxa not only in Cold diseases but also ethics. I in Hot diseases. Besides medicine, Sun was also renowned for his knowledge In his Thousand Gold Prescriptions, there are 932 entries of practically everything worth knowing at the time. It was on acupuncture. In his other book, The Wings, there are 703 recorded that all the eminent scholars of the time regarded Sun as entries. Excerpts concerning mental disorders can be found in their teacher. During the reign of Tang Tai Chun, scholars were Book 13of The Thousand Gold Prescriptions, it reads: ordered to compile the Histories of the Five Dynasties - Chian, "Excess Heat in the Heart, ... one canoot eat, and ones chest Leung, Chan, Chou and Chui. After the Histories were feels full. The Qi is rebellious and presses against the diaphragm. completed, the scholars, afraid that they might have made some One feels suffocatingly hot. For such cases, the Heart Shu point • mistakes and omissions, went to consult Sun. It was reborded (BI15) should be moxaed 7 chong ... " Excerpts from Book 17of The Wings reads: that Sun gave an oral recitation of the Histories of the Five Dynasties without reference to any written material. "When the Perverse Madness m~nifests abnormally, one Sun died arou!1d682 AD at the age of 10I. Before his death, covers ones head and screams loudly. One wants to kill and has he willed that his funeral be as simple-as possible and that there no fear of water and fire. For such cases, the Gan Shi point (Pc 5) would be no animal sacrifices. After his death, he was should be moxaed, the left side for man and the right side for posthumously honoured as the King of Herbal Medicine. II.IW." woman. The duration of the moxa depends on the age... " His Work: For difficult cases of chronic diseases, he recommended the Throughout his life, Sun wrote many books. His general use of moxa on the Gao Huang point (BI 43) and Tsu San Li works included titles such as Commentaries nn Lao Tse, point (St 36). Sun also pioneered the use of the Ah Si points. In . Commentaries on Chuan Tse, Thesis on the Three Religions, Book 29 of the Thousand Gold Prescriptions, it reads: all of which were lost. His most important work is The "The use of Ah Shi points ... regardless of location of the
Sun Xi Miao - Author of the 13 Ghost Points
Sun never sought fame or riches and continued throughout his life to teach the importance of medical virtues and ethics
point, if there is pain, it is called Ah Shi point. . it can be needled and moxaed to effect a cure... " Lastly, he introduced the varying designations of body lengths to different parts of the body, thus advancing the art of point location. Besides pure medical knowledge, Sun also left us his view of the essential characteristics of a superior physician. Before all else, Sun pointed out that the superior physician must cultivate perfection in virtues and compassion. In this way, his medical skills could be applied, without any thoughts of financial gain and fame, for the service of all people. After this, the superior physician must know by heart the Su Wen (The Yellow Emperor's Classic of Internal Medicine), the Ling Shu (The Classic of the Needles), the Pei Chia (The Shang Lung Classic of Herbal Medicine), the Jia I (The Jia I Classic of Acupuncture and Moxibustion), the writings of Chang Chung Geng (Thesis on Cold Injury, Classic on the Pulse). He must also be experienced in the 3 positions and the 9 palpations in Pulse Diagnosis, the 12 Major Meridians and the acupuncture points, the' manifestations of the 5 Zimg and the 6 Fu. Then one must be proficient in the art of divination and the I Ching, Astrology, the 5 Classics, the 3 Histories, the Hundred Schools of Thoughts, Lao and Chuan Tse 11.l2.l3.l'.I~.16
Historical Aspects of the 13 Ghost Points There is very little information on the development of the 13 Ghost Points. Even though the Song of the 13 Ghost Points is attributed to Sun X: Miao, there are occasional short passages in other medical texts" to imply that these 13 points may have their origin as far back as Bien Chuen, the Bird Physician, who lived during the period of the Warring States (403-221 BC). In the Historical Records of Si Ma Chin, it was recorded that Bien Chuen could gauge the depth of disease penetration and the time of death of the Duke of Chai by visual diagnosis alone. He was also reputed to raise from the dead? (deep coma) the Prince of Fu by the use of acupuncture and moxibustion. His writings included Bien Chuen Classic of External Medicine (12 books), Bien Chuen Classic of Internal Medicine (9 books), and the Nan Jing Classic of Difficulties (81 Questions and Answers). Of all his writings, only the Nan Jing survived and the Ghost Points are not mentioned in it.••.n It is estimated that the Bien Chuen Classics of External Medicine and Internal Medicine were lost sometime after the Western Han Dynasty, but it is possible that fragments may survive in other medical texts and have been passed down that way. Another possibility is that some unknown physician from later periods attributed his work to Bien Chuen, a fairly common practice among the Chinese. The Song of the 13 Ghost Points first appeared in its complete form in the Thousand Gold Prescriptions" and The Wings" written by Sun Xi Miao in the Tang dynasty. Since then the Song is found in all notable acupuncture texts such as the Great Accomplishment of Acupuncture and Moxibustion by 12PACIFIC JOURNAL OF ORIENTAL MEDICINE f
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Yang Gue Chou and The Best Collection of Acupuncture and Moxibustion by Go Mao. Different versions of the Sonl1jof the 13 Ghost Points from various sources are basically similar in characters and meanings and any variations'are minimal."The Song is written in the poetic form of 7 characters per line and there is a total of 34 lines. Generally, the lines are paired to describe the location of the point, its Ghost Name and the technique used. The Song starts with a brief introduction to its clinical application and·then prpceeds to describe the 13 Points one at a time.
In the Sung Dynasty, the famous physician Chui Chou Fu composed his own Song of the 13 Ghost Points." Of the 13 points, 8 points are similar to Sun's original points and 4 points are completely different. The Song starts with 6 lines each con~istingof 7 characters. These 6 lines briefly summarise the 13 points. and is followed by 13 additional lines, each line naming the point and its Ghost Name. Modern versions of the Song of the 13 Ghost Points" are basically abbreviations of Sun's original Song, giving only the needle number and the name of the acupuncture point.
Translation of the Song of the 13 Ghost Points 1.
Bien Chuen Passage related to the 13 Ghost Points " Sun Xi Miao Song of the 13 Ghost Points'" Ill. Chui Chou Fu Song of 13 Points for Ghost Diseases" IV. Modem version of the Song of the 13Ghost Points" I. Bien Chuen Passage related to the 13 Ghost Points. Bien Chuen said: "For treating diseases due to the 100 Perverse Qi, there are 13 Points. Using the method of acupuncture, one starts by needling Ghost Palace, then Ghost Letterffrust, then Ghost Fortress and then Ghost Hean. One usually does not need to needle all the 13 Points and one should know whether it is effective after needling 5 to 6 Points. If Perverse Parasites (Spirit) speak voluntarily of its origin, then after detecting its actual presence, one can get hold of the Essence of the Spirit. One does not need to go all the way, just command and allow the Spirit to leave. One starts needling the man on his left side and the woman on her right side. If after needling several points and there is still no response (from the. Spirit), then one should needle allover the body according to the prescription." II. Sun Xi Miao - Song of the 13 Gbost Points. Line I. The 100 Perverse Qi causing diseases manifested as Madness. 2. There are 13 acupuncture points "meneeds to recognise. 3. Wherever one needles, one must start first at the point Ghost Palace. 4. Next, one needles the point Ghost Trust/Letter and these 2 points are always effective. 5. Let us start from the beginning and proceed step by step
n.
and pursue the aim (cure). 6. One should start on the left side for man and the right side for woman. 7. The 1st needle is inserted at Yin Chong (Du26J, also known as Ghost Palace until it cannot go in any further. 8. If one inserts the needles from the left side, then one takes them out from the right side. 9. - The 2nd needle one inserts underfbelow the nail of the thumb (Lu II?) , 10. The point is called Ghost Trust/Letter and the insertion should reach a depth of 3 fen. II. The 3rd needle one inserts underfbelow the nail of the big tow(Sp I?) 12. The point is called Ghost/Fortress and the insertion should reach a <Iepthof 2 fen. 13. The 4th needle one inserts at Da Ling (Pc 7), behind the palm. 14. The needle depth should be 5 fen and the point is called Ghost Heart. 15. The 5th needle one inserts at Shen Mai (BI 62), also known as Ghost Road. i6. The Fire Needle is inserted 3 times with 7 flashes. 17. The 6th needle one locates above Da Zhui (Dul4). 18. The point is 1 cun into the hairline and is called Ghost Pillow (Dul6J. 19. The 7th needle is located 5 fen under the ear (St 6?) 20. The point is called Ghost Bed; use warm needles. 21. The 8th needle is inserted at Cheng Jiang (Ren24), and is called Ghost Market. 22. One must remember that if one inserts the needles from the left side, one takes them out from the right side. 23.' The 9th needle one inserts at Jian Shi (Pc 5?), above Ghost Market. 14. The 10th needle one inserts at Shao Xing (Du23), and is called Ghost Hall. 25. The 11th point is located at the middle crease between the genitals (Renl), and is treated with 3 chong. 26. The Head of the Jade Gate in Women is called Ghost TreasurelHiding. 27. The 12th point is Qu Chi (LI 11) and is called Ghost Minister. 28. Here the Fire Needle also needs to have the 7 flashes. 29. The 13th point is located at the head of the tongue, and right in the middle of the tongue (extra point Ju Quan). 30. This point is also called Ghost Seal. 31. The needles are inserted in an opposite fashion on both sides of the hands and the feet. 32. If there is only I point, then only that point is needled. 33. This is the authentic oral teaching of Our Master. 34. Those Mad, Raging, Offensive Ghosts will all disappear without a trace.
III. Chui Chou Fu - Song of 13 Points for Ghost Diseases, Line
I. Start by needling Yin Chong (Du26J, Shen Ting (Du24), and F eng Fu (Dul6J. 2. Next needle the tongue crease, Cheng Jiang (Ren24), and Jia Che (St 6).
3. Then continue to needle Shao Shang (Lu 11), Da Ling (pc 7) and Jian Shi (pc 5). 4. And from reliable sources, needle Ru Zhong (St 17) and Yang Ling Quan (Gb 34).
5. And do not forget to needle Yin Bai (Sp I) and Xing Jian (Liv2). 6. These 13 Points are composed and arranged by Chou Fu. 7. The point Yin Chong is called Ghost Palace. 8. The point Shao Shang is called Ghost Room. 9. The point Yin Bai is called Ghost Festival. 10. The point Da Ling is called Ghost Heart. II. The point Xing Jian is called Ghost Road. 12. The point Feng Fu is called Ghost Wrist. 13. The point Jia Che is called Ghost Barrier. 14. The point Cheng Jiang is called Ghost Door. 15. The point Jian Shi is called Ghost Arm. 16. The point Shen Ting is called Ghost Light. 17. The point Ru Zhong is called Ghost Site. 18. The point Yang Ling is called Ghost Leg. 19. The point Tongue Crease is called Ghost Body. For people with Diseases)related to Ghosts/Spirits, one must first needle Yin Chong, and then the other 12 Ghost Points in that order. For men, one needles first the left side and for women, one needles first the right side. Treatment with these points guarantees miraculous cures. IV. Modern version of the Song of the 13 Ghost Points. Line
I. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
Xi Miao's cure for Madness. 13Points are recorded in detail. Ist needle Yin Chong. 2nd needle Shao Shang. 3rd needle Yin Bai. 4th needle Da Ling at the depression. 5th needle at Shen Mai. 6th needle at Feng Fll. 7th needle at Jia Che. 8th needle at Cheng Jiang. 9th needle at Jian Shi. 10th needle at Shang Xing. llthneedleatHlliYin. 12th needle at Qui Chi. 13th needle at the crease under the tongue. Use these points and health will be restored. PACIFIC JOURNAL OF ORIENTAL MEDICINE13
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Analysis of the Treatment Sequence The Song of the 13 Ghost Points of Sun Xi Miao begins by stating that the 13 Ghost Points are used for treatment of mental disorders. However, this is followed by the statement that by needling only the first 2 Ghost Points, Ghost Palace and Ghost Letter/Trust, a cure is assured. Perhaps this reflects Sun's experience that most mental disorders can be treated just by needling the first 2 Ghost Points. This view is supported by the Bien Chuen Passage on the 13 Ghost Points. It stated that it is usually not necessary to needle all 13 points and one should know if the treatment is effective after about 5 to 6 points. The Song then continues with the basic requirements that one should proceed from point to point in the prescribed order, and that one needles men first on their left side and women on their right side. After all these preliminaries, the treatment with the 13 Ghost Points begin. The I st Ghost Point, Ghost Palace, is stated as Yin Chong and can be confirmed as the point Shui Gou or Governor Vessel 26. Needling this point will activate the Yang Qi along the whole of Du Mai and will effectively clear any blockages, obstructions and Perverse Qi along the whole meridian especially the head. However, if one reads Line 7 carefully, it says the needle should be inserted until it cannot go in any deeper. This indicates that one is not needling just one point Yin ChOllg, but also Yin Jiao (Du28), the point in the mid upper gum. This is crucial because by needling both points simultaneously, one promotes the Yang Qi to move along Du Mai, unblocks any obstructions and clears any Heat from the meridian. And because Yill Jiao (Du28) is directly connected to Rell Mai (Conception Vessel), it will re-establish the continuous flow of Qi between the Du and Ren Mai, and the Yin and Yang in dynamic balance, Perverse Qi such as Heat can be handled with more effectiveness. Since one of the major features of the Eight Extra meridians is their ability to serve as Qi buffers, Perverse Qi can be diverted to various levels of the body where the least harm can be done. Conversely, because the Eight Extras meridians reach deep into the body, Perverse Qi residing deep within can be moved to the exterior where it will be disposed of effectively. The 2nd Ghost Point, Ghost LetterlTrust, is usually referred to as Shoo Shallg or Lung II. However, Line 9 refers to the location of the point as underlbelow the nail of he thumb only and no name for this point is given. It may be one of the 10 Extra Points for Emergency, but then as it is within the vicinity of the Lung meridian; it may be referred to as Shao Shang. By needling this point, it will activate Qi in the Lung meridian by drawing Qi from the MusclelTendino meridian. This activated Qi will increase movement along its Divergent
meridian which goes through the Heart. Since LUng is the Master of Qi, this increased Qi flow within its meridian will help the general Qi circulation of the whole body,. thus assisting in unblocking any obstructions. Because of its Divergent meridian, it will re-establish any YinlYang imbalance especially in the Upper Heater and the activated Qi flow can also have access to the Heart and clear any disharmonies there. As the Exit point of Hand Tai Yin, it can also move Qi down the meridian and effectively clear any Perverse Qi (Heat, Phlegm) in this way. As the Wood point of Lung, i't has the dynamic expanding and moving qualities of Wood to stimulate and move the Qi. As the Extra point, it can draw Perverse Qi (Heat) out of the body. The 3rd Ghost Point, Ghost Fortress, is usually referred as Yin Bai or Spleen I. However, Line II refers the location of the point as underlbelow the nail of the big toe and no name of the point is given. It may also be one of the extra points for Emergency. The point is located between Yin Bai and Da Dun (Li v I) and as such, the designation of this point as Yin Bai is uncertain. Probably the truth lies between these two points and their functions. By needling this point, it will draw Qi from the Muscle/Tendino meridian and activate the Qi in the Divergent meridian. As mentioned earlier, this will stimulate Qi circulation, balance Yin and Yallg, and affect the heart. The activated Qi in the Spleen meridian will promote its organ functions of clearing Damp and Phlegm and the feeding of the 4 sides. Also being the Earth Element, the Spleen will have a calming, neutralising and nourishing effect on the whole body. The activated Qi in the Liver meridian will promote Qi circulation and prevent any stagnation. It will promote its organ function so that it can better manage any of the Liver disharmonies. It is interesting to note how the points Shao Shang (Lu 11), Yin Bai (Sp 1) and Da Dun (Liv I) are used. These points correspond to the Upper Heater - Middle Heater - Lower Heater (Heaven-Earth-Man) sequence as Lu II, Sp I and Liv I. If these points are used together, they will effectively influence all the three Heaters and all their disharmonies. They will re-establish the harmony between the Heaters, and their QilBlood, ZangIFu and YinlYang balance. If they are used as Extra Points, they will clear perverse Qi (Heat) from all the three Heaters. Another interesting area is that Yin Bai is the Root Point of Tai Yin (Lung/Spleen) and Da Dun is the Root Point of Jue Yin (LiverlPericardium). By needling these points, one gains access deep into the Tai Yin and Jae Yin diversions. These points will remove any Perverse Qi within these 2 divisions, re-establish harmony and strengthen these divisions. It is obvious that the Root Point of Shoo Yin (Yong Quan or Kil) is not needled. It
It is usually not necessary to needle all 13 points and one should know if the treatment is effective after about 5 to 6 points
appears that this point is left out because the Shao Yin division contains the Heart and the Kidney, both of which should not be disturbed or accessed unnecessarily. Firstly, opening up the division may provide an opportunity for Perverse Qi to enter the Heart and the Kidney, causing further damage which can be fatal. Secondly, opening up the division may drain the Essence of the Heart and the Kidney, and should be avoided. The 4th Ghost Point. Ghost Heart, is named as Da Ling or Pericardium 7. Needling this point will have a calming and neutralising effect on the Fire Element because Da Ling is the Earth point and Shu point of Pericardium. Being an Earth point, it has the calming, neutralising and stable nature of the Earth Element and thus will calm any disturbances within the Pericardium. Being the Shu point, it will bring more Qi into the meridian to strengthen the Pericardium. In the Five Element Cycle, Pc 7 will move the Fire Element to earth and effectively reduces Fire in the Pericardium and Heart. The 5th Ghost Point, Ghost Road, is named as Shen Mai or BI 62. Shen t'!ai is the Master Point of Yang Qiao Mai (Yang Moving, VesseI),,~ne of the Eight Extra meridians. The main function of
circulation to the head. The point Shen Mai (BI 62) is used to regulate Yallg Qi to the head where it functions by absorbing or unblocking excess Yang Qi. The Fire Needle tonification technique is used to promote the movement of Yang Qi to the bead. It appears that the previous Ghost Points (I, 2, 3 and 4) are used mainly to unblock any obstructions and clears perverse Qi especially heat from the body. [f this is what has happened, then the removal of the Perverse Qi (heat) will mean that the body will be deficient in Yang Qi. It is probably that healthy Yang Qi is introduced back into the system by the Fire Needle technique through the point Shen Mai. This healthy Yang Qi is stimulated to move through the deep Eight Extra meridians especially the Yang Qiao Mai where it goes up to the head (brain) and ends at the point Feng Qi (Gb 20). The 6th Ghost Point, Ghost Pillow, is referred to as the point above Da Zhai (Dul4) and I cun into the hairline. The location corresponds exactly to the point
In Tra d't'IlOna IChi nese M ed"IClne, B one M arrow represents the .Bram, '
the Spmal Cord and the whole Nervous System
Yang Qiao Mai is to regulate Yang Qi in the head. In case of Madness where there is excessive Yang Fire in the head, Yang Qiao can absorb this excess Fire and return the body to its YinlYang balance. In Line 16, the Fire Needle is used. Line 16 reads: 'The Fire Needle is inserted 3 times with 7 flashes." The Fire Needle here probably refers to the needle tonification technique known as Burning Fire Mountain and not tile technique where actual red hot needles are used. The insertion performed 3 times corresponds well with the widely known Heaven-Earth-Man concept. The problem arises with the 7 flashes. The modern tonification technique specifies the use of 9 as the number for tonification and 6 as the number for sedation, and 7 is not mentioned. In the Concordances, 7 is the number of the Wood Element which represents the beginning of life, Spring, growth. In the I Ching, 7 is the number of new Yang and again represents birth, gentle growth. The word 'flashes' is a rare Classical Chinese word which conveys the brightness of a sharp metal (steel) blade when it is drawn out of its sheath. here it probably means the appearance of the needle as it is being manipulated in and out. The information provided by Line 16 suggests that a gentle tonification technique is used. This Fire Needle technique involves the manipulation (rotating) of the needle 7 times at the first level (heaven), then with further insertion and similar manipulations at the second level (Earth) and lastly, at the third level (Man). The major aim in Line IS and 16 is the promotion of Yang Qi
Feng Fu or Du6. This point is connected with Yang Wei Mai (Yang Protecting Vessel) at the point Feng Qi (Gb 20). Yang Wei Mai is one of the Eight Extra meridians and its main function is to protect the Yang.
By the connection of Feng Fu to Yang Wei Mai, protective Yang Qi can be provided to circulate to the head. Referring to the 5th Ghost Point, Shen Mai (HI 62) provides healthy Yang Qi to the head via Yang Qiao Mai. which ends at the point Feng Qi (Gb 20). [t becomes obvious that because of the connection of Feng Qi and Feng Fu, healthy Yang Qi will circulate upwards to the head by Yang Qiao Mai to Feng Qi and then into Yang Wei Mai through its connection with Feng Fu. In effect, healthy Yang Qi of Yang Qiao Mai and protective Yang Qi of Yang Qiao Mai are concentrated at the point Feng FII. Here another feature of Feng Fu becomes significant. Feng Fa and Bai Hui (Du20) together form the Sea of Bone Marrow. In Traditional Chinese Medicine, Bone Marrow represents the Brain, the Spinal Cord and the whole Nervous System. It is believed that Qi can circulate through the brain from Fen Fu, to Bai Hui (Da20). Thus with both healthy Yang Qi of the Yang Qiao Mai and the protective Yang Qi of Yang Wei Mai concentrated at Feng Fu, the logical sequence is that all this Yang Qi will circulate into the brain through Feng Fu. As a result, the Bone Marrow (Brain) will be nourished and mental balance will be strengthened. Another possibility relating to the points Feng Fu and Feng Qi is tbat both are very important points for eliminating Perverse Wind. The elimination of Wind will stop the fanning of the Perverse FirelHeat and effectively calm such mental disrurbances. The 7th Ghost Point, Ghost Bed, is stated as the point 5 Jen below the ear lobe. It is usually referred as the point Jai Che or
St 6. Even though there is no other point in the area that will fit the description, and the point is not named, Jai Che is a good compromise. The exact point is not known for certain. Jai Che is connected internally to the Small Intestine meridian at Quan Liao (SI 18); the Gall Bladder meridian at Tong Zi Liao (Gb I), the three Heater meridian through Ting Gong (SI 19), at Yi Feng (TH 17) which is also internally connected to Feng Qi (Gb 20). Indirectly, Jai Che connects to Jing Ming (Bl I), Yin Chong (Du26) and Cheng Jiang (Ren24). In short, Jia Cke connects to all the major meridians in the head especially to those on the sides. The technique stated in Line 20 specifies the use of warm needles. This indicates gentle tonification of Yang Qi. It is meaningful only if one assumes that the Perverse Yang Qi has been cleared and that healthy Yang Qi is being circulated back in its place. Through the connections at Jia Che, gentle Yang 'Qi can be introduced into the Small Intestine meridian, Gall Bladder meridian, Three Heater meridian and the Stomach meridian. It is important to note that the corresponding Yin partners of Small Intestine, Gall Bladder, Three Heater and Stomach are Heart, Liver,
Pericardium
and
I
It will also promote the smooth circulation of Qi between Du Mai and Ren Mai, and direct the downward movement of Yang and the upward movement of Yin. All the input of Yang Qi from Shen Mai (Bl 62), Feng Gu (Dul6) and Jia'Che (St 6) is being regulated at this point. As a result of Cheng Jiang, the Yin and Yang of the head is nicely balanced in tune with the rest of the body. The 9th Ghost Point is mentioned above as Ghost Market (Ren24) and does not .have it6 own Ghost Name. The point is stated as Jian Shi or Pericardium 5. The location of the point is stated above as Ghost Market and yet the point is named as Jian Shi (Pc 5). The conflicting information suggest that Jian Shi should be considered as the 9th Ghost Point in the absence of any other evidence to the contrary. The names of all the obvious points above Cheng Jian (Ren24) have been checked and none has a similar sound to Jian Shi (Pc 5). Besides, Jian /shi is a major point for mental disorders. Jian Shi is the Metal and Jing point of the Pericardium meridian. As the Metal point, it has the qualities of drying, contracting and dispersing and is used mainly to resolve Phlegm in the Heart. It is the major point for treating Phlegm related to mental disorders. (Phlegm causes mental disturbances when it clouds/ mists/blocks the HeartiPericardiumlShen in its communication with the other Zan'glFu and the outside world). Jian Shi will resolve the Phlegm and clear the mind and Shen, and restore normal mental functions. As a Jing point, it will assist in moving the Perverse Qi away from the Pericardium meridian and the HeartlPericardium. The 10th Ghost Point, Ghost Hall, is named as Sheng Xing or Governor Vessel 23. The major feature of this point is that it is the Concentration Point of Shao Yin (Heart, Kidney). It is also connected to the THlPc and BlIKi Divergent Meridians and Yin Wei Mai. This point will provide additional available Qi to the Shao Yin division of Heart and Kidney and help to strengthen both Zang. By virtue of its connection to the 2 divergent meridians and Yin Wei Mai, the Heart, KidneylPericardium and Yin are nourished and protected. It is at this stage that the fundamental Qi of the Heart and Kidney are involved. The II th Ghost Point, Ghost Treasure or Ghost Hiding, is located at the crease under the genitals. The name, Head of the Jade Gate refers to the female genital and is commonly referred to as the point Hui Yin or Conception Vessell. The last 3 words in Line 25 refers to the technique used. These words can mean crease/seam 3 chong, (The words for crease/seam is phonetically similar to the word moxa). The word chong is commonly used to denote the quantitynength of moxibustion. It appears that for the point Hui Yin, only moxibustion is used and there is no needling involved. It is important that this point is the General Luo Point
Phlegm causes mental disturbances when it clouds/mists/blocks the Heart/Pericardium/Shen in its communication with the other Zang/Fu and the outside world
Spleen, all of which features significantly in the pathologies of mental disorders. With the circulation of this gentle Yang Qi into all these meridians in the face, all the vital meridians and their related organs are nourished. One feature of JiaChe is its connection to the Gall Bladder meridian which will promote the circulation of Wei (Protective) Qi to the face and head. Another feature of this point is its ability to clear heat from Yang Ming, however, it probably is not as important here. There is a strong possibility that the internal connection of Feng Qi (Gb 20) to Yi Feng (TH 17) will allow the circulation of healthy Yang Qi of Yang Qiao Mai and protective Qi of Yang Wei Mai into the Small Intestine, Gall Bladder, Three Heater and Stomach meridians. This, in turn, will affect the Yin partners. This Yang Qi will assist in re-establishing the healthy Yang functions in the head. The 8th Ghost Point, Ghost Market, is named as Cheng Jiang or Conception Vessel 24. The point has direct connection with the Stomach meridian and the Governor Vessel. From the previous Ghost Point Jia Che (St 6), it is clear that the circulation of the Yang Qi at this point and the connection of the Stomach meridian to Cheng Jiang is significant. Apparently, the previous step only circulates the Yang Qi to the sides of the face, Cheng Jiang will help to regulate all these Qi movements to cover the whole face. Because of the connection of Cheng Jiang to Du Mai, it will harmonise the YinIYang activities of the whole body.
of all the Eight Extra meridians and the meeting Point of Du Mai, Ren Mai and Chong Mai (Penetrating Vessel). Applying gentle moxa at Hui Yin, will bring healthy Yang into the.Eight
Extra meridians deep within the body. It will remove any remaining perverse Qi in the Eight Extra meridians and fill them with healthy Yang. Its connections with Du Mai, Ren Mai and Chong Mai allows for this Yang Qi to circulate in the front (Ren) and b~ck (Du) and all other parts of the body (Chong). The 12th Ghost Point, Ghost Minister, is named as Qu Chi or Colon II. In Line 28, the Fire Needle technique of 7 flashes (refer Ghost Point 5) is again employed. Qu Chi is the Earth point and the He point of the Colon meridian. As the He point, it provides Qi. to the Colon and promotes its function of assimilating vital substances and fluids which will increase the Qi and Blood of the whole body. Because of its Five Element relationships, the Metal Element will feed the Water Element. In this way, Qu Chi can strengthen both the Kidney Yang and the Kidney Yin via this feeding pattern. As the Earth point, Qu Chi will have a balancing and neutralising effect on the whole system. The Earth' point of the Metal Element will be able to regulate the Earth and Wood Element through the five Element Cycle. As a result, Qu Chi is used for re-establishing the Sheng Cycle. Generally this point strengthens the Water Ele~ent (Kidney):--controlsthe Wood Element (Liver) and nourishes the Earth, Element (Spleen) resulting in great Harmony for all the Five Elements. The 13th Ghost Point, Ghost Seal, is located at the centre of the tongue. The extra point, Ju Quan, fits this location. The connection of this point to the Du Mai and Ren Mai is uncertain but highly probable. Also the internal connections of the Heart, Spleen and Kidney end at the tongue. Through these connections, it appears probably that the last Ghost Point is used to reconnect the Qi circulation of the Du Mai, Ren Mai, Heart, Sween and Kidney. The circulation of Qi into the Du Mai and Ren Mai will continuously regulate the dynamic YinlYang balance of the whole body. But through its connections with the Heart, Spleen and Kidney, Ju Quan will further make possible the balance of Heart YinIYang, Spleen YinIYang and Kidney YinIYang. This represents the Grand Harmony of the Heaven (Heart), Earth (Spleen) and Man (Kidney). . With the restoration of harmony, the treatment sequence of the 13 Ghost Points of Sun Xi Miao is concluded.
Brief Analysis of the 13 Ghost Points of ChuiChouFu The 13 Ghost Points of Chui Chou Fu will be discussed briefly here. It appears that Chui selected his points anatomically. His Ghost Points I to 6 are all located on the head. His Ghost Points 7 to 9 are located on the arrnIhand. His Ghost Point 10 is located at the middle of the chest and Ghost Points II to 13 are located on the leg/feet.
Since there is no information on needling technique. it is assumed that only needles are used. The needling of Ghost Point I, Yin Chong (Du26); Ghost Point 2, Shen Ting (Du24); Ghost Point 3, Feng Fu (Du/6); Ghost Point 4, Ju Quan (Extra PointTongue); Ghost Point 5, Cheng Jiang (Ren24) and Ghost Point 6, Jia Che (St 6) aim mainly at unblocking, eliminating and regulating perverse Qi in the head. The needling of Ghost Point 7, Shao Shang (Lu II); Ghost Point 8, Da Ling (Pc 7) and Ghost Point 9, Jian Shi (Pc 5) aim mainly at clearing Perverse Heat from the Upper Heater and the clearing of Phlegm. The needling of Ghost Point 10, Ru Zhong (St 17) probably aims at stimUlating the Middle Heater functions. This stimulation will increase Blood production, promote the feeding of the 4 sides, clearing of Phlegm and the regulating of Stomach Fire. Needling of Ghost Point II, Yang Ling Guan (Gb 34) promotes the smooth circulation of Qi by harmonising the Wood and the Earth Element. Ghost Point 12 Yin Bai (Sp I) and Ghost Point 13, Xing Jian (Liv 2) aim mainly to tonify Earth, resolve Damp and clear Heat from the system. ' A major concern of this 13 Ghost Point sequence is the universal p~ohibitionof needling Ghost Point 10, Ru Zhong (St 17).
Discussion Investigations into the rationale of the 13Ghost Points of Sun Xi Miao reveals a lot of subtle and interesting information that is not obvious at first glance. Since most of the details have already been discussed in the Analysis of the Treatment Sequence, a brief review of the 13 Points in the treatment of mental disorders will provide a beuer appreciation of the whole process, Ghost'Point 1 (Du26128) stimulates dynamic Yang Qi to move up the head via the Du meridian to clear any obstructions or Perverse Qi (Heat, Cold, Damp, Wind). It also reconnect.~the Ren - Du meridians allowing the smooth Qi circulation between the toplbottom, frontlback of the body and re-establishes the vital YinIYang balance. Ghost Point 2 (Lu 11) clears heat from the Upper Heater and promotes Qi circulation. Ghost Point 3 (Sp l/Liv 1) clears Heat from the Middle Heater (Spleen) and the Lower Heater (Liver), It promotes the smooth circulation of Qi, calms the Liver and clears PhlegmlDamp. I Ghost Point 4 (Pc 7) clears Heat from Pericardium and calms the Heart, Up to this stage, all 4 points aim mainly at clearing perverse Qi (Heat) from the body. Ghost Point 5 (BI 62) brings healthy Yang Qi to the head to replace the dispersed Perverse Qi, Ghost Point 6 (Du6) directs this Yang Qi into the Bone Marrow (Brain). Ghost Point 7 (St 6) directs Yang Qi to the sides of the face. Ghost Point 8 (Ren24) distributes this Yang Qi all over the face and head. It regulates the distribution of this Qi.
i
All lhe previous 4 Points aim at restoring heallhy Yang Qi to lhe head. Ghost Point 9 (Pc 5) clears Phlegm from the Pericardium and restores clarity to the mind. Ghost Point 10 (Du23) nourishes the Heart and Kidney. Ghost Point II (Renl) tonifies all the Eight Extra meridians. These two points tonify the whole body. Ghost Point 12 (Co 11) balances and regulates the 5 Elements. Ghost Point 13 (Tongue) establishes the Grand Harmony of Heaven (Heart) - Earth (Spleen) - Man (Kidney). In brief, it is my opinion that the 13 Ghost Points of Sun Xi Miao aim at first to get rid of Perverse Qi from the body and then proceed to replenish the weakened body with heallhy Qi which is then regulated and balanced. In terms of Perverse Qi, .the 13 Ghost Points are designed to treat Heat/Fire, Cold, PhlegmlDamp, Wind and Obstructions. Ghost Points I, 2; 3, 4, 5 will clear Fire/Heat. Ghost Points I, 5 (Fire Needle) will eliminate Cold. Ghost Points 3, 9, will resolve PhlegmlDamp.
Ghost Points 1,2, 10 and especially 5, 6 will clear Wind. Ghost Points 1,5, \] will clear Obstructions. There are still areas lhat need further attention. Starting with Ghost Point I, Yin Chong (Du26), Line 7 suggests that Yin Jiao (Du28) is also involved. Why is this point not clearly presented in lhe Song? Why is lhis fact merely hinted at? These questions are hard to answer but it may be that lhe number 13 has some mystical meaning in ancient Chinese culture. It is possible that 13, which represents darkn6Ss, misfortune, evil and ghosts in the West, may have similar meaning for the ancient Chinese. Since the Song is for the treatment of Ghost Diseases, it is reasonable to assume that the names of the 13 Ghost Points are restricted to 13 and additional points are merely hinted at. There is also the possibility lhat the 13 Ghost Points were known since the time of Bien Chuen, and Sun Xi Miao selected more than 13 points but then because of this historical restriction, he only named the 13 Ghost Points. This practice is not unusual because Chui Chou Fu selected his own 13 points and composed his own version of the 13 Ghost Points.
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Another difficulty regards the location of the points. Uncertainties related to Ghost Point 2 (?Lu 11), Ghost Point 3 (?Sp IlLiv 1), Ghost Point 7 (?St 6) and Ghost Point 9 (?Pc 5) have already been discussed and lhe points selected are the best compromises between locations and functions. As most of the above points may be Extra Points and information regarding their relationships to the 12 Major Meridians and the Eight Extra meridians are non-existent, it is almost impossible to discuss them within the TCM framework. Another interesting area is the Ghost Point II, Hui fin (Ren]). The location of this point near the genital makes it a point lhat is quite socially unacceptable to use, even in today's open modem Western societies. It is highly unlikely that this point was more socially acceptable for use in Sun Xi Miao's time. The question then is why Sun Xi Miao includes this point in his treatment sequence knowing full well that most physicians will be loathe to use it or avoid using it altogether. Perhaps, as Sun indicated early in his Song, most mental disorders can be treated with the first 2 points, and in very rare cases will points like Hui Yin (Renl) be necessary. This social barrier may explain why only selected Ghost Points were used by successive physicians to treat mental disorders and rarely the whole 13 points. It may also explain why Sun Xi Miaos' 13 Ghost Points is regarded more as a historical relic than a proven clinical formula, and is not widely used. It is interesting to see lhat Hui Yin (Renl) is not included in Chui Chou Fu's 13 Ghost Points, so it is debatable whether the point is absolutely necessary or can be replaced by other points. Lastly, there must be some criticisms about the modern versions of the 13 Ghost Points based on Sun Xi Miao. These Songs are brief and misleading. The problems stem from the fact that these modem authors assign modem known points to Ghost Points that are still debatable in terms of the locations. Another ~ of concern is their total disregard for techniques such as the use of Fire Needle and Moxa. These modern versions represent a gross distortion of the Song of the 13 Ghost Points of Sun Xi Miao, and a shallow understanding on the part of these authors. Worst of all, these Modern versions will be passed on to unsuspecting future generations and the spirit of the Original Song will be lost.
Conclusion The 13 Ghost Points of Sun Xi Miao represents a rational approach towards the treatment of mental disorders. The points are well chosen and sequenced in such a way that disharmony is gently restored back into harmony. Since lhese points are usually regarded as an Historical Relic rather than a Proven Clinical Formula, it is seldom used. Perhaps, against the spirit of Traditional Chinese Medicine, a standard modem clinical trial should be conducted to evaluate the effectiveness of the 13 Ghost Points Treatment for all mental disorders, regardless of their TCM pathologies.
The present analysis of lhe 13 Ghost Points represents only a limited, personal view of what may be happening. As always, insights into TCM depend on the depth and understanding of the one doing the interpreting. Perhaps, with this translation of the Song of the 13 Ghost Point~ of Sun Xi Miao, TCM practitioners of non-Chinese speaking backgrounds will be able to contribute fresh and exciting insights to this field of study ..
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This anicle ;s pr;nled by k,imJpetmission of UTS College of Acupuncture