Three-edged needles are instruments for bleeding therapy, in which bleeding at certain selected points or certain blood vessels is done to promote circulation, clear evil heat, and relieve swelling. There are three basic methods in use: spot pricking, scattered pricking, and bleeding at vessels.The technique was first started by Bao Xiang-Yang, the second affiliated hospital of Heilongjiang College of TCM, China. According to The Miraculous Pivot, the oldest classic on acupuncture, one of the nine kinds of needles, the lance needle, “is mainly used to bleed and clear heat”. In the plain questions, we find the observation, “While treating diseases, one should first remove the excess blood.”
The Miraculous Pivot went further to propose the principle: “It is important to remove stagnant evil blood.” Moreover, it described ‘Collateral Puncture (Luo Ci)’, ‘Complementary Puncture (Zan Ci)’, and ‘Leopard Pattern Puncture (Bao Wen Ci)’—all of which are basically the same as the scattered pricks in modern practice. The classic text also provided indications: only in the presence of apparent stagnancy of blood, one can safely conduct bleeding. As seen from these passages, a great amount of clinical experience had already been accumulated at the time of composition. The practice has confirmed the book’s enduring value in resuscitation, heat clearing, circulation promotion, and detumescence.
Made of stainless steel, the three-edged needle is about 6 cm long. The long handle is cylindrical. They were designed after the model of the lance needle used in antiquity. It should be thoroughly sterilised before use, and the skin should also be disinfected with iodine tincture and alcohol before the procedure.
The medical acupuncturist massages the site for a while so that some blood is accumulated there, before disinfecting the area. He then fixes the site to be punctured with the first three fingers of his left hand and uses the right hand to conduct the puncture.
The needle should be handled with right thumb and index finger while stabilising the anterior part with the middle finger so that only 1-2 fen of the tip is exposed. The needle should be inserted quickly to a depth of 1-2 fen and quickly withdraw it. The surrounding skin should be gently pressed to extract 3-5 drops of blood before stopping the bleeding with a cotton ball. This method is mainly applied to points located over finger tips. Bleeding should be done by a medical acupuncture practitioner.
After disinfection, the acupuncturist ties a tourniquet tightly around the arm proximal to the puncture site. With the left thumb pressing on the vein distal to the site of puncture, he punctures the vein with the three-edged needle held by his right hand to a depth of 0.5-1 cun and withdraws it very quickly. In case the blood does not come out freely, one may push the proximal vein downward to aid the flow. After loosening the tourniquet, a cotton ball is kept to stop any bleeding. Bleeding is conducted every 3-4 days (or every 1-2 weeks if a larger amount is bled at each session.)Bleeding is helpful in fever, coma, throat pain, tonsillitis, fever, acute vomiting, swelling, pain in foot, headache, vertigo, and hypertension etc.
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi