It's the kidney time of year and we can expect to see people who have not been protecting their Kidney qi, haven't been storing it, don't even know about it, and who may be suffering through symptoms related to its decline.
In this case, you might next compare the strength of the out of balance liver qi with the weakness of the kidney qi. When the liver has been under chronic stress it can be one of the most difficult movements to adjust to the normal wave. Spreading, rising liver qi would need to be rooted or otherwise addressed prior to tonifying the weak kidneys at any rate. It would be unpleasant for the patient if we tonifed the weak kidneys too early thereby strengthening rising Liver yang or Liver fire leading to exacerbated symptoms. If the patient is under very severe stress I will check the back shu points to see if the liver stress has been sent back there. Quickly needling them to open them can be a way to begin a treatment and I recommend aerobic exercise since that will move Liver qi.
It is not that uncommon for really stressed patients to report that aerobic exercise elicits tears sometimes. Their stress has built up so much that exercise acts almost like a pressure valve in that it opens up a pathway for the qi to escape. Further, liver, gallbladder, and stomach channels may be adversely affected by liver stress. When this is the case the person may have a tight jaw or other areas of their face might be tight or experience spasms. Even the root of TMJ can be Liver qi stagnation.
My goal in cases like this is to take the "nervous" qi, the imbalanced qi, that was probably keeping the person going and settle it down or manage it to help tonify the kidneys. It's time to get their digestion working better so that it will make good quality qi, and maybe even give them the opportunity to start building a qi reserve.
One approach is to balance each phase in the creation cycle: wood, fire, earth, metal and water. Start with Gallbladder 34 and Heart 8, which is one of my favorite point combinations for taking stress away from the liver, heart and brain. Gallbladder 34 controls and relaxes muscles so the liver has somewhere to shoot the stress; muscles can be used as a sort of buffer for stress rather than the liver throwing the stress to the Spleen or kidneys. Naturally, we wouldn't want that situation to continue because then the back shu points and other muscles will get tight and suffer from reduced qi and blood flow.
But, needling Gallbladder 34 at least gives the liver a pathway for its stress. Add Heart 8 and you can relax the diaphragm and reduce the fire of fire. It will help disperse the liver stress that is going toward the heart. Now we can work with earth, needle Spleen 9, Stomach 36 and Ren 12. This combination will help balance the earth element and balance the activity of the spleen and stomach organ pair. All of the systems work through earth as a central connecting point so balancing the earth phase is of particular importance. Wood, fire, and earth balanced; next come metal and water. Lung 7 and Lung 1 will open the lungs and help metal control wood as well as enhance the movement from metal to water. In fact, use both Lung 1 and Kidney 27 to open the chest. Now, it is safe to tonify the kidneys. You may use the water of water point Kidney 10 or Kidney 6 plus Kidney 7 to nourish kidney Yin and Yang.
Getting the organ systems/elements to communicate for optimum health is a balancing act. Huang Di said, "The principles of using the needles, one must know the physical form and qi and their positions: left and right, top and bottom, yin and yang, external and internal, whether blood and qi are plentiful or sparse, whether movement is in counterflow or smooth flowing. Then one can plan to attack the excessive. Know how to untie knots. Know how to tonify the hollow and to disperse the solid. Know the upper and lower qi doors. ... Carefully harmonize the qi, ... have the ability to tune and harmonize."
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