Sometimes, it is difficult to practise the above mentioned standard manipulating manner of Dhyana-Thumb-Pushing in the clinical treatment for the different parts of the human body are different in their structures. Therefore, many variations have evolved in the Dhyana Thumb Pushing school．The frequently applied are as follows:

1. Thumb-Pushing with the Side Tip
When the standard manipulation is applied on the head, face, chest or hypochondriac regions, the manner that the manipulator fiexes his wrist and holds his fist may make the fingers bump against the body surface. So the manipulator should flex the wrist joint slightly, extend the fingers and put the radial side of the thumb tip on a certain part to swing forward and backward (Fig 68) when manipulating on these regions with Dhyana-thumb-pushing. In fact, this manipulative manner and the kneading with the radial side of the thumb are fairly alike．The moving route of the thumb pushing with the side tip on the head and face is regular. Click to learn TCM Treatment Evaluation for Diabetes.

2. Double Flying of Butterfly
Fengchi(GB 20)is an important acupoint in Tuina therapy. Generally speaking, the manipulator should use both thumbs to do Dhyana-Thumb-Pushing to stimulate the bilateral Fengchi(GB20) points at the same time. Therefore, it is vividly named as "Double Flying of Butterfly" (Fig 69)．

3. Pushing with the Flexed Thumb
It is not easy to keep the thumb tip fixed at a point when the Dhyana-Thumb．Pushing is done on the neck．Besides, the muscles on the neck of the cervical spondylopathy sufferers are rigid, so the pressing force is hard to penetrate into the deep tissues of the neck．The manipulator flexes the thumb, does Dhyana-Thumb-Pushing with the dorsal side of the interphalangeal joint of the flexed thumb, which is called pushing with the flexed thumb (Fig 70, Fig 71). Its pressing force is heavier,its stimulation is stronger,and its stability is better, so it is applicable to the neck,the occipital region, the places of joints and spaces of bones or joints. Click to learn Causes of Ulcerative Colitis in TCM.

4. Dhyana Thumb-Pushing Supported by the Hands
With fingers being extended and the part of the hand between the thumb and the index finger being open, the manipulator puts the abdomen of the two thumbs on bilateral sides of the patient’s cervical vertebrae and the rest fingers on the heterolateral sides of the neck to stabilize the hands, then swings the hands and moves the thumbs along the cervical vertebrae in the meantime. The manipulation is good in stability and high in efficiency (Fig 72)．

5. Thumb-Pushing Supported by Single Hand
Thumb-Pushing Supported by Single Hand is usually applied on the joints of the limbs (Fig 73). Click to learn Chinese Medicine Treatment for Ulcerative Colitis.

6. Dhyana-Thumb-Pushing and Circular-Rubbing
This manipulation is a compound manipulation which combines the Dhyana-Thumb-Pushing with the circular-rubbing. The manipulator keeps the thumb fixedly touching an acupoint, and makes the rest fingers circularly rub the abdomen wall. This manipulation is suitable for the abdominal region (Fig 74).

7. Twining
If the manipulating frequency of Dhyana-Thumb-Pushing is over 200 times per minute, it is named as twining．Generally speaking, the twining is required that the manipulator touches the body with the radial side of the thumb tip and swings in a narrow range-mitigative wave and high frequency．The twining is suitable for the local regions with a boil or a furuncle in its initiate stage or the injury with swelling and pain for it has a good dispersing effect．Click to learn TCM Treatment Evaluation for Ulcerative Colitis.