Before Practising the Dhyana-Thumb-Pushing, it is necessary to rectify the posture as follows．The manipulator sits uprightly with the thoracic and lumbar vertebrrae slightly flexed, the shoulder and arm relaxed, the scapula bone naturally descended, the elbow flexed and descended lower than the wrist, the wrist fully relaxed and flexed, and the fingers naturally flexed to make a empty fist, then puts the thumb tip, which is naturally extended, on a point, thus the palm side of the thumb just covers the" fist eye" and the interphalangeal joint being kept close to the radial side of the index finger (Fig 61, Fig 62 Fig 63)．
 
Then, the manipulator checks himself whether the upper limb is completely relaxed except the wrist(The begnner probably has the tight feeling on the wrist region). If he feels stiff and uncomfortable at any Dart of the upper limb, he must correct the Posture at anytime. Nimble moving, long manipulating duration, delivering force from the paim to the thumb, combining forcefulness and gentleness, and penetrating into muscles and tendons can only be achieved on the basis of completely relaxed condition．Otherwise, the moVement will become rigid and is probably not easy tobe correeted. Click to learn Chinese medicine Treatment for Gout.

The manipulator can practise the manipulation after completely relaxing the upper limb. First, he slightly extends the elbow join, swings forward and supinates the forearm, and moves forward the wrist region to drive the thumb to extend outward and straigtly with the Dart of the hand between the thumb and the index finger open touches the exercise bag with the whorl side of the thumb (Fig. 64), and then, flexes the elbow joint slightly, swings backward and Dronates the forearnl, moves the wrist backward to drive the thumb to move inward and flex(It is also allowed not to flex.), and touches the exercise bag with the tip of the thumb (Fig 65). The right manipulative manner of Dhyana-Thumb-Pushing is the combination of the above movements without any stop in manipulation. It should be noted that the ulnar side of the forearm should be lower than the radial side during the forward swinging, but at the same level when the wrist swings backward to its limit (Fig.66). Click to learn TCM Treatment Evaluation for Gout.

According to the requirements, the movements of the Dhyana-Thumb. Pushing should be harmonious and nimble, the pressing force should be uniform and gentle. Sometimes light and sometimes heavy as well as sometimes quick and sometimes slow are both notallowed. The Fig. 67 is a typical dynamic curve of the Dhyana-Thumb. Pushing in which the peak values, wave shapes and wave width are all very similar to each other. When you start practising the manipulation, you should keep the thumb tip on one point, but not make it slide during swinging the wrist and the forearm. When you are able to meet the above requirements, you can learn to move your thumb tip along some specificly selected lines(usually a meridian route) to and fro. You should swing the thumb with a high frequency but slide slowly. Besides, it is not permitted to press down deliberately. Its frequency is about 40 to 160 times per minute. Click to learn Causes of diabetes in TCM.

The touching area of the Dhyana-Thumb--Pushing is small and soft. It can stimulate the selected meridians and acupoints continuously, gently and forcefully, and is applicable to all of the acupoints and the meridian routes. It can relax muscles and tendons, dredge the blocked meridians, promote the flow of Qi and blood, regulating the functions of the viscera. It is especially suitable for treating internal, gynecological and pediatric diseases such as headache, insomnia, facial paralysis, diarrhea, constipation and irregular menstruation.