Moxibustion of Yong quan, added to hypertensive drugs, could be a simple and helpful adjunct to reduce blood pressure, though perhaps just systolic blood pressure and not diastolic (3).

Yong quan is also the most commonly used acupoint for hypertension, followed by Qu chi (LI11), Tai chong (LR3), Shen que (REN8), San yin jiao (SP6) and Nei guan (PC6) and often combined with San yin jiao, Shen que, or Nei guan (4).

Electroacupuncture at Ji quan (HT1), Tian quan (PC2), Qu quan (LR8), Yin ling quan (SP9), and Yong quan (KI1) could be more beneficial than a conventional acupuncture protocol for post stroke flaccid paralysis (5). 

Electroacupuncture with low frequency stimulation (10 Hz) at Fenglong (ST 40) and  Yongquan was more effective than other common point combinations for reducing the frequency and intensity of epileptic seizures (6). This could be due to acupuctures ability to regulate endogenous opioid receptors which can then go on to control sodium channels and prevent overexcitability leading to seizures (7). 

Electroacupuncture at Bai hui (DU20) and Yong quan, every other day for 6 weeks, was able to benefit mice with Alzheimer’s disease, remarkably reducing the levels of amyloid beta 1-40 and 1-42 as well as the ratio between them. There was also some evidence of improving learning memory and upregulation of low density lipoprotein receptor-related protein-1, the main carrier protein of amyloid beta, though neither reached statistical significance (7). 

Further studies on Bai hui and Yong quan in Alzheimer’s disease mice, additionally, show:

• Improved memory and learning, possibly via up-regulating hippocampal lipoprotein receptor-related protein 1 expression and, again, down-regulating hippocampal amyloid beta (1-42) expression (8) 
• Inhibition of the overexpression of activated Caspase-3 and Bax proteins in the hippocampus (pro-apoptosis biomarkers) (9)
• The number of the apoptotic neurons in the striate cortex (10)
• Alleviating the pathological changes of neurons of the hippocampal CA 1 region; disappearance of the mitochondrial cristae, degeneration of the synapses, breakage and vague outline of the basement membrane of the blood capillaries (11)
• Reduction in the expression levels of autophagy-related proteins LC3 and p62 (12)
• Increased the production of acetylcholine and lowering the levels of amyloid precursor protein (13)
• Increased mitochondria COX activity, protecting the structure and function, and improving energy metabolism (14)

Electroacupuncture of Zhong Chong (PC9) and Yong quan (KI1) can significantly improve the ability of learning and memory and the latency and amplitude of P 300 in rats with vascular dementia, to a similar effect level as intragastric perfusion of Nimodipine (15)

Electroacupuncture at the jing well points Shao Chong (HT9), Zhong Chong (PC9), Yong quan (KI1) and Shao Shang (LU11) also benefit rats with vascular dementia, remarkably improving memory impairment, decreasing the overproduction of nitric oxide and increasing the output of superoxide dismutase – a potent antioxidant (16)

Three days of daily electroacupuncture at Bai hui and Yong quan can inhibit the decline of learning and memory in Alzheimer’s disease mice; suppressing the overexpression of APP-C99 and reducing the production and accumulation of amyloid-beta, thereby alleviating the neuroapoptosis (17).

Acupuncture at Bai hui (DU20), left nieⅠ (extra), Da zhui (DU14), Ji zhong (extra), Qu chi (LI 11), Yong quan (KI1), He gu (LI4), Zhou jie (extra) and Xi qian xue (extra) combined with nerve growth factor could improve the neurobehavioral ability of cerebral palsy infant rats, inhibit the nerve cell apoptosis (regulating Bax, Casp3 and Bcl-2) and improve the brain tissue injury and energy metabolism by up-regulating the expressions of GAP-43 and MCT 1. All of these effects were stronger when acupuncture was confined with the nerve growth factor than with nerve growth factor on its own (18).

Electroacupuncture at Bai hui (DU20), Da zhui (DU14), Qu chi (LI11) and Yong quan (KI1) could ameliorate neurologic damage of the first somatic sensory area and alleviate the degenerative changes of ultrastructure of cortical neurons in rats subjected to hypoxic-ischemic encephalopathy. The longer acupuncture treatment lasted, the better its therapeutic effect was. This was accompanied by gradually increased expression of glial cell line-derived neurotrophic factor family receptor rearranged during transfection at the mRNA level and its downstream signaling Akt at the protein level in the ischemic cortex (19).

Electroacupuncture at Bai hui, Shen men (HT7) and Yong quan helped rats suffering with Rett syndrome, a rare progressive neuro-developemental disorder that predominantly affects girls and leads to severe cognitive, motor and social impacts. Neural activation was observed in the substantia nigra of the midbrain, corpus striatum, and cerebral cortex with a corresponding increase in the c-Fos protein. Body weight was significantly improved, compared to control and normal groups and brain weight improved. Motor and social tests also showed improvements after acupuncture, there was corresponding reductions in oxytocin levels, higher can lead to anxiety. It also extended life expectancy by 44% (20). 

Three sessions of acupuncture at Yong quan (KI1) (with reducing and slightly heavy manipulation), Ting gong (SI19), Ting hui (GB2) and Er men (SJ21), with suspending moxibustion for thermal sensitization on Yong quan (KI1) led to better outcomes for sudden hearing loss than ‘routine medication’ (21).

Electroacupuncture at Yong quan, alongside antiemetics can help patients with hepatic cancer experiencing nausea and vomiting from the chemotherapy cisplatin, to a greater extent than antiemetics alone (22). 

Acupuncture, combined with medication and education, at Shen que (REN8), Yong quan (KI1), Ye shi, and ashi point could help patients with Hashimoto’s thyroiditis, leading to improvements in thyroglobulin antibody, thyroid peroxidase antibody as well as alleviating thyroid enlargement, improving TCM symptoms and anxiety, and improve quality of life scores (23).

Transelectrical stimulation of Yong quan improves premenstrual syndrome reducing symptoms as well as catecholamine, noradrenaline, and adrenaline levels. Progesterone levels increased and follicle-stimulating hormone, prolactin, and estradiol levels decreased significantly (24).

Adding moxibustion to a point protocol for osteoarthritic knee pain could at 6% to the effectiveness rate. This was also shown in a stronger benefit to pain scores, stiffness scores, physical function scores, the amount of joint effusion and the contents of interleukin-1β, tumor necrosis factor-α and high-sensitivity C-reactive protein (25). 

Similarly, adding moxibustion at Yong quan can improve the cognitive function and motor and balance function of lower limbs in patients with post-stroke cognitive impairment, reduce the risk of falls and improve the quality of life’ (26).

Acupuncture at Shui gou (DU26), Lao gong (PC8) and Yong quan (KI1) as well as matrix needling around Feng chi (GB20) is as effective as Botox injection for Cervical dystonia (spasmodic torticollis), albeit a bit slower acting (27).

Acupuncture at the Jing well points [Shao shang (LU11), Shang yang (LI1), Li dui (ST45), Yin bai (SP1), Shao chong (HT9), Shao ze (SI1), Zhi yin (BL67), Yong quan (KI1), Zhong chong (PC9), Guan chong (SJ1), Zu qiao yin (GB44) and Da dun (LR1)] as well as standard care (medication and rehabilitation therapy), daily for 20 days, inserting the points following the qi flow benefited patients with post-stroke urine retention leading to better results, at urine retention, than without the application of acupuncture (28).

Yong quan, since 1987, has been consistently performed in sudden death and cardiac arrest situations as an option in both basic and advanced CPR failure, though it can also be applied in traumatic or vascular brain injury, with the biomechanisms evidenced above. Below is the initial letter published in 2010, but the originator of the manoeuvre, it describes the technique and some of the patients it saved: 

“Since 1993, 30 in-hospital patients (13 male; mean age 49.2±17.4 years) with life-threatening conditions have been treated by the author using K1 point stimulation (stroke-hypotensive ischemia [6 patients—1 died]; severe arterial hypertension [8 patients, no deaths]; electrocution [1 patient who died]; crushed chest [2 patients—1 died]; skull fracture+chest trauma+bilateral femur fracture [1 patient who died]; post-surgical shock [4 patients—1 died]; pulseless electrical activity [2 patients—1 died]; ventricular fibrillation [3 patients—1 died]; gas embolism [1 patient who survived]; sepsis-induced renal failure [2 patients—1 died]).

All patients were pulseless, had a Glasgow Coma Scale score of 3, and had no other vital signs. In all patients, cardiopulmonary resuscitation (CPR) with defibrillation if indicated, was undertaken before the manoeuvre was applied. In the 6 stroke patients the technique was applied before arrival of the emergency team and recovery occurred after a few minutes.

It is convenient to do the manoeuvre with both hands over the same foot, as a considerable amount of pressure over the sole is needed. In such cases, one thumb compresses over the K1 point and the other reinforces pressure over its distal joint.

A strong thumb can apply a force of 10–15kg. A pen or the end of a toothbrush, for example, can be used to achieve more pressure over a smaller area.

The manoeuvre increases the heart rate (confirmed in normal volunteers). The ECG could not be monitored in patients out of the intensive care unit, but vital signs and consciousness were recovered at the same time. The average K1 stimulation time was 3.8min and the most persistent symptom after the manoeuvre was blurred vision.

Bray coined the term “Lazarus phenomenon” to name the unexpected recovery of native circulation in apparently dead patients. The cases presented in this letter are a particular type of Lazarus phenomenon, where a planned manoeuvre may reverse impending death.

The aim of this paper is to raise the issue of this simple emergency resource to be used by ER physicians, nurses, paramedics and rescuers and to be considered in any CPR protocol for the improvement of survival and recovery of such critically ill patients, with the additional advantage of zero cost.

A word of caution: in conscious patients, the manoeuvre is quite painful and should not be applied during training.” (29)

A review, from two years later, of the evidence of the resuscitation manoeuvre showed that 58 patients have survived, yielding an 84.48% survival rate (30). This result indicates a consequent improvement of the survival tendency. The paper provides the statistic that 95% of patients undergoing cardiac arrest die, though it is more likely to be 90% without treatment, 75-80% with CRP, and 60% or lower with a defib all outside of the hospital. Inside a hospital it can be 25-50%+ depending if the patient is ‘shockable’. Needless to say, Yong quan appears to provide a safe, simple, free and potentially effective addition that could be applied to cardiac arrest, cerebral event, environmental catastrophe, or adult or infant sudden death syndrome. 

A more recent systematic and metaanalysis of acupuncture in cardiopulmonary cerebral resuscitation, with the main points being Nei guan (PC6), Shui gou (DU26), Bai hui (DU20), Yong quan (KI1), and San yin jiao (SP6), i.e. not using the acupuncture resuscitation manoeuvre and not applying acupuncture until after resuscitation, still found some interesting benefits. Reducing or preventing cerebral reperfusion injury and potentially preventing brain death at day 3, though with less certainty (31). This is most definitely an area that needs more research, although models of research are tricky with resuscitation, absolutely ethically, but also determining what should be the control and null hypothesis in such research, best we could say at this point is that if there is an extra pair of hands, use them. 

Another study found Shui gou (DU26), Yin tang (EX-HN 3), Shi xuan (EX-UE 11), Ya men (DU15), Yong quan (KI1) and moxibustion to be useful for preventing degradation of the mind with patients in a persistent vegetative state, again quite a small study however (32). 

Another, with 30 mins of electroacupuncture daily, primarily at electroacupuncture at Baihui (GV 20), Shuigou (GV 26), Yongquan (KI 1) as well as medication, for patients in coma for 3 weeks or more showed significant improvements in wakening  40.1 days and 73.3% (11/15) respectively in the observation group, which were higher than 51.8 days and 28.6% (4/14) in the control group (33).

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