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  Wai Tak Cheung: How Does the Acupuncturist Decide Which Meridian or Points to Use?  
  Because patients are different; the points chosen for each patient vary. In addition, as a patient's condition improves, the meridian or points used will vary with the improvement. When
deciding what meridian or points to use, the acupuncturist must first assess the patient's condition through diagnosis.

There are eight ancient classifications for all diseases that are still valid for assessing a patient's condition today. Disease must be either yin or yang, cold or hot, internal or external, hypo-functional or hyper-functional. The acupuncturist uses four traditional Chinese methods to help decide which condition exists and what must be done to bring the body into balance.

1. Observing: The acupuncturist looks at the patient. How is the patient's coloring? How does the patient walk? What are the patient's facial expressions? For example, does the patient look tired or does the patient seem alert and energetic? Some acupuncturists examine the patient's eyes, tongue, and fingernails as well. Because these observations guide the acupuncturist, it is important that the patient come for appointments in a natural state-no makeup, no chewing gum or food that might discolor the tongue, no alcohol which discolors facial skin. Smoking also influences the skin.

2. Listening: The acupuncturist listens to the patient. Is the voice too loud or too soft? Is the breath regular, is it rough or difficult?

3. Questioning: The acupuncturist asks questions about how the patient feels, what ails them. It is important for the patient to be honest and tell the acupuncturist everything of concern; the answers to these questions help the acupuncturist determine the best treatment. Acupuncturists tend to treat the whole body, not just the specific areas where the symptoms are expressed. Accordingly, they are interested in all areas of the patient's experience because physiologically everything relates.

4. Palpitating: The acupuncturist checks by touch in two ways, first for painful points on the body and then by feeling different parts of the radial artery. Unusual qualities in the pulse may indicate an abnormal internal condition. Classically, this is called "taking the pulses."

Sometimes the patient may be confused by the asking of questions or the answers given, but all the information from these methods are combined to determine which acupuncture points are used.

Sometimes it is not necessary or desirable to directly stimulate an organ to get good results, as in the case of severe stomach spasms when the affected area is too sensitive to even touch. In this case, the acupuncturist will not put needles in the stomach area, but in the area on the outside of the shin bone below the knee-a point called St 36. If a patient comes in with neck pain, generally speaking, the acupuncturist will treat a point on the gall bladder meridian, GB 20, because this meridian goes directly to the neck area. If the patient has severe pain, we use GB 39 on the outside of the ankle. Do not be surprised by the placement of the needles when you visit the acupuncturist.
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