On your first visit, the practitioner will take notes on your lifestyle and medical history, and assess your condition using the "Four Examinations" of TCM - asking, observing, listening (and smelling), and finally touching, in which the most important test is taking the pulse. This is a skilled method of checking the rhythm and strength of all 12 meridian pulses (six on each wrist).

There are 28 descriptions, such as "wiry" or "choppy", to categorize the state of each pulse. To aid diagnosis, the practitioner may examine other parts of the body. She will then discuss treatment options, which, as well as acupuncture, often include advice on diet and lifestyle, and may involve herbs or acupressure. You will then be asked to lie on a treatment table, after removing any clothes covering needle sites (acupoints). The site depends on the disorder and whether the flow of chi is to be "warmed", reduced, or increased. Several acupoints may be used: those on the hands and feet are often treated, but sites on the back, abdomen, shoulders, and face are also widely used.


The practitioner generally inserts the acupuncture needles to a depth of 1/8 - 1 inch (4-25 mm) depending on the position of the acupoint being treated, although in some cases, practitioners may insert needles to a deeper level. Treatment often involves a combination of acupoints; usually 6 to 12 needles are used, varying according to the type of acupuncture and the condition of the individual patient. Acupuncture needles may be left in position for a few minutes, as little as a few seconds (especially along the back), or as long as an hour. At the end of the session they are withdrawn swiftly and gently, usually painlessly, without bleeding and leaving no trace on the skin
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