Session 17

Lecture – Microsystems Needling

Techniques – Scalp
Chinese Medicine
SCALP ACUPUNCTURE SYSTEMS
International Standard of Nomenclature for Scalp Acupuncture
(ISNSA)
Stimulation area of the cerebral cortex (Jiao)*
Shangxi head imaging scalp acupuncture (Fang)*
Therapeutic Zone scalp acupuncture (Zhu)
Yin Yang scalp acupuncture (Tang)
New stimulation area for cerebral cortex functions (Lin)
Experimental scalp acupuncture
Ba Gua scalp acupuncture (Liu)
Japanese scalp acupuncture (Yamamoto) (YNSA)
Head meridians and acupoints
*Session focus (Bomzon & Amir, 2020; Wang, 2009)
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JIAO SCALP ACUPUNCTURE

1970s – Dr Shun Fa Jiao – stimulation of the cerebral cortex scalp

acupuncture is based on cerebral cortex function and mapping
areas of the brain to the corresponding areas of the skull.
Dr Shun Fa Jiao published a book titled ‘Scalp Acupuncture’
Originally, Jiao identified 16 areas for stimulation – technique
involves fast needle insertion, fast rotation/manipulation, followed
by fast withdrawal.
Scalp acupuncture can be used for a variety of neurological
conditions including stroke, multiple sclerosis, and Parkinson’s
disease.
It is often combined with instructed movements or exercises
simultaneously with needle stimulation

(Bomzon & Amir, 2020; Wang, 2009)

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 JIAO SCALP ACUPUNCTURE
Figure 1

Jiao Scalp Acupuncture Imaging The feet are located towards the
vertex of the head.

The head is located towards the

lower temple.

Much of this system was

originally used to treat stroke –
particularly the sensory and
motor lines.

Other reference lines are the

anterior to posterior midline, and
the eyebrow to occiput line.

Note. Adapted from Micro-Acupuncture in Practice (p. 56), by

Y. Wang, 2009, Churchill Livingstone Elsevier. Copyright 2009
by the Churchill Livingstone Elsevier. (Wang, 2009)

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JIAO SCALP ACUPUNCTURE
Standard lines: Figure 2

Jiao Scalp Acupuncture Standard lines

Anterior-posterior midline:
Midline running across the vertex
connecting the midpoint between the
eyebrows with the lower border of the
tip of the external occipital
protuberance.
Eyebrow-occiput line:
The line running horizontally across the
lateral side of the head connecting the
midpoint of the superior border of the Note. Adapted from Micro-Acupuncture in
Practice (p. 57) by Y. Wang, 2009, Churchill
eyebrow with the tip of the external Livingstone Elsevier. Copyright 2009 Churchill
occipital protuberance. Livingstone Elsevier.
(Wang, 2009)

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CORTICAL HOMUNCULUS
Figure 3
The sensory and motor
Cortical Homunculus homunculus are
graphical
representations of the
human body with the
size of each body part
scaled according to the
amount of sensory or
motor cortex dedicated
to that part. It looks like
a distorted humanoid
figure.
Larger portion = larger
sensory processing
and larger degree of
motor control (hands,
face etc.).

Note. From Principles of Anatomy & Physiology (p. 721), by G.J. Tortora et al., (Tortora et al., 2022)
2022, Wiley. Copyright 2022 by Wiley.
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JIAO SCALP ACUPUNCTURE
Figure 4 The upper fifth represents foot and
trunk.
Scalp
Acupuncture
The middle two fifths represent the
Areas arm and hand.
The lower two fifths represent face
and head.
The spaces are relative to the amount
of nervous tissue associated with
each area. (Hecker et al., 2006)

Note. Adapted from Micro-acupuncture in practice (p.59) by Y. Wang, 2009, Churchill Livingstone Elsevier.
Copyright 2009 Churchill Livingstone Elsevier. 8

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JIAO SCALP ACUPUNCTURE
Figure 5

Anterior and Posterior

Stimulation areas

Note. From Micro-Acupuncture in Practice (p. 59), by Y. Wang, 2009, Churchill Livingstone Elsevier.
Copyright 2009 Churchill Livingstone Elsevier.
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FANG SCALP ACUPUNCTURE
Created by Dr Yun-Peng Fang in 1976
Uses the image of a human body lying prone over the scalp.
The head of the image sits at the anterior of the scalp.
The midpoint of the anterior hairline across to the corner of the
hairline corresponds to the organs of the upper, middle and
lower Jiao.
Commonly used for: pain relief, stop spasms, calm the Shen,
reduce high blood pressure, relieve itching.
Used in combination with body movement techniques.
4 types of imaging: Prone imaging, prone organs, inverted
imaging and inverted organs, functional regions imaging.
(Wang, 2009)
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FANG SCALP ACUPUNCTURE
Figure 6

Fang Scalp
Acupuncture Mapping

Note. From Micro-Acupuncture in Practice (p. 60), by Y. Wang, 2009, Churchill Livingstone Elsevier.
Copyright 2009 by Churchill Livingstone Elsevier. 11

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FANG SCALP ACUPUNCTURE

Standard lines: Figure 7

Fang Scalp Acupuncture: Standard lines

Eyebrow – vertex – occipital line:

Midline 33cm length or 33 portions

Eyebrow – ear – occipital line:

26.4 portions – horizontal along lateral
portion of the head from midpoint of
eyebrow to tip of external occipital
protuberance. Cerebrum above,
Note. Adapted from Micro-Acupuncture in
cerebellum below. Practice (p. 60), by Y. Wang, 2009, Churchill
Livingstone Elsevier. Copyright 2009 by
Churchill Livingstone Elsevier.

(Wang, 2009)

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FANG SCALP ACUPUNCTURE
Figure 8
Prone imaging:
Sutures
The system uses the coronal suture
(left and right upper arms),
sagittal suture (trunk area) and
lambdoid suture (left and right
legs) for correspondence.
Bregma corresponds to the area
between the neck and cervical
vertebrae.
Anterior bregma corresponds to the
neck and head.
Lambda area corresponds to the
sacral tip. Note. Adapted from Micro-Acupuncture in Practice (p. 61), by
Y. Wang, 2009, Churchill Livingstone Elsevier. Copyright 2009
(Wang, 2009) by Churchill Livingstone Elsevier.

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FANG SCALP ACUPUNCTURE

Prone organ: Figure 9

Sensory centre
Reflects sensory nerves of the body
(sensory centre).
Used to treat internal organs or skin
and muscle sensory disorders such
as pain, touch, cold, heat,
numbness or itching.
The area from the anterior midline,
along the anterior hairline to the Note. Adapted from Micro-Acupuncture in Practice
(p. 61), by Y. Wang, 2009, Churchill Livingstone
corner of the forehead (total 6.5cm) Elsevier. Copyright 2009 by Churchill Livingstone
is divided into three parts to reflect Elsevier.

the upper jiao (3cm), middle jiao

(1.5cm) and lower jiao (2cm).

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FANG SCALP ACUPUNCTURE
Figure 10
Inverted imaging (motor
Inverted imaging
region) and inverted organ
(sensory region).
Based on functional location
of cerebral cortex.
Precentral gyrus of the frontal
lobe and the post central
gyrus of the parietal lobe
reflect an image onto the
scalp.
Note. Adapted from Micro-Acupuncture in Practice (p. 62), by
Y. Wang, 2009, Churchill Livingstone Elsevier. Copyright 2009
Churchill Livingstone Elsevier.

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FANG SCALP ACUPUNCTURE Figure 11

Functional Regions Imaging

Functional regions imaging:

The cerebral cortex – control and
management of other organs
and tissues of the body.
Scalp acupuncture developed
many stimulation areas based
on cerebral cortex functional
centre distribution areas.
These include thought, speech,
signal, written, memory, auditory,
smell & taste, balance, usage,
breathing and circulation, and Note. Adapted from Micro-Acupuncture in Practice
(p. 64) by Y. Wang, 2009, Churchill Livingstone
vision. Elsevier. Copyright 2009 by Churchill Livingstone

(Wang, 2009) Elsevier.

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SELECTING AN AREA TO TREAT

If the condition is unilateral, needle the opposite side. Nerves

that control the left side of the body are on the right side of
the brain (and vice versa).
Select the area according to the presenting disease pattern.
Zang Fu pathologies can be needled bilaterally.
Support with other relevant areas. For example, the sensory,
motor and speech regions may be necessary to stimulate
when treating someone who has had a stroke.

(Wang, 2009)

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FANG SCALP ACUPUNCTURE: INDICATIONS

Respiratory, vascular, digestive, reproductive, endocrine,

immune and neurological systems can be targeted.
Central Nervous System disorders – pain, acute conditions.
Scalp acupuncture can adjust the function of the cerebral
cortex, thus improving the circulation of the brain vascular
system.
Scalp acupuncture can regulate the excitatory state and
inhibitory functions of the cerebral cortex.

(Wang, 2009)
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TISSUE LAYERS OF THE SCALP

Figure 12

Tissue layers of the scalp

(Wang, 2009)
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SCALP NEEDLING
Needles 40-50mm x .25 or 0.30 gauge
Shorter needles for children 13-15mm
Patient should always be lying down.
Initial insertion – rapid, freehand or using a guide tube, 15–20-
degree angle to the skin. Pain on insertion may indicate that the
needle has made contact with a hair follicle, blood vessel or nerve.
Insertion should feel smooth and painless.
Threading – follow the selected stimulation area and use the
flexibility of the needle to help get the needle to the required
length of the area.
General threading advice – swab large area around needle site to
maintain sterility.
(Wang, 2009)
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NEEDLE MANIPULATION AND REMOVAL
Traditionally, scalp acupuncture technique is heavy and strong.
The needle is twirled and rotated 200 times per minute for 2-3 minutes at a
time (not with the scalp image system).
This technique should elicit a Qi sensation, possibly only for 5-10 minutes,
at which time the technique should be repeated.
Common response – hot sensation on limbs opposite to needling site,
sometimes a tightening sensation rather than heat.
False lifting and false thrusting (gentle and small movement) to stimulate the
area.
The scalp area is highly vascular and prone to bleeding (fast and copious!).
Always wear a glove on the non-dominant hand holding a cotton ball
ready when removing needles and apply pressure for as long as needed
to ensure bleeding has stopped.
See Chinese Medicine Clinic Handbook (p. 8)
(Wang, 2009)
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TREATMENT DURATION AND FREQUENCY

Determined by severity of patient’s condition.

Shorter duration for children, psychological conditions, mild
conditions, weak constitution.
Long history of disease but mild symptoms - may require
treatments one or two times per week for 10 to 12
treatments.
Treatment period can be 3-5 days (severe and acute conditions
once daily) or up to 7-10 days (maintenance)
One course of treatment = daily for 7-10 days.
May need up to 3 courses of treatment for some conditions.

(Wang, 2009)
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OTHER SCALP TREATMENTS

Electro-acupuncture can be used in combination with scalp

acupuncture.
Blood-letting can be used on scalp points.
Dermal-hammer can be used on the scalp – mild and medium
pressure.
Moxa can be used on scalp points – especially GV20.

(Wang, 2009)
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CONTRAINDICATIONS

Do not treat infants under 1 year old – fontanelle not yet

closed. Posterior fontanelle closes at approximately 2
months old. Anterior fontanelle closes between 4-26 months
old.
Cerebral haemorrhage – fever and coma.
High fever, acute inflammation, heart failure.
Caution: pregnancy – do not use strong manipulation.
Needle shock is possible – observe Chinese Medicine Clinic
Handbook (p. 38-39) protocol

(Wang, 2009)

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NEEDLE METHODS FOR SI SHEN CONG
Figure 13
Yang Ci technique – group of
Needle Methods
needles inserted into one
specific area, commonly
GV20. First, needle with
perpendicular insertion at
GV20. The other four needles
are inserted obliquely at Si
Shen Cong directed towards
GV20.

Special square insertion –

oblique insertion anti-
clockwise threading towards
each of the Si Shen Cong
points to create a square
Note. Adapted from Micro-Acupuncture in Practice (p. 90) by Y. Wang,
2009, Churchill Livingstone Elsevier. Copyright 2009 by Churchill shape around GV20.
Livingstone Elsevier.
(Wang, 2009)

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Case study

A 61-year-old male suffered a stroke 1 year ago and has come

to you for assistance with rehabilitation. He is coherent but
has a slight stutter with his speech. His memory is poor, and
he has lost the use of his left arm and hand.
Which scalp acupuncture treatments would be appropriate?
State the location, appropriate needle size and stimulation
technique.

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PRACTICAL WORKSHOP

Lecturer demonstration and student practice locating sensory

and motor pathways, three jiaos, scalp measurements,
acupoints on the scalp.
Lecturer demonstration and student practice using Fan system
of scalp acupuncture to treat areas of pain.
Lecturer demonstration and student practice using shencong
stimulation methods.

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 Chinese Medicine Library Resource Links

APA 7th Edition Referencing Guide reference tips with examples

APA 7 FAQs questions submitted by students with examples provided by librarians
Chinese Medicine Library Guides

Databases, Journals & Web Links:

Anatomy TV
Natural Medicines
Journal of Chinese Medicine Article Archive
A Manual of Acupuncture [App]
Chinese Medicine Formula Image Database

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References
Adrigu. (2009). The sensory homunculus [Image]. Flickr.

https://www.flickr.com/photos/97793800@N00/3824405836

Bomzon, D. & Amir, A. (2020). Clinical handbook of Yamamoto new scalp acupuncture. Singing Dragon.

Hecker, H., Steveling, A., & Peuker, E. (2006). Microsystems acupuncture the complete guide: ear-scalp-

mouth-hand. Thieme.

Tortora, G. J., Derrickson, B., Burkett, B., Cooke, J., DiPietro F., Diversi, T., Dye, D., Engel, A., Green, H.,

Macartney, M., McKean, M., Peoples, ,G., & Summers, S. (2022). Principles of anatomy & physiology (3rd

ed.). Wiley.

Wang, Y. (2009). Micro-Acupuncture in practice. Churchill Livingstone Elsevier.

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