KLLP: A Variation on the K3L Pattern in Manaka System Acupuncture
One of the joys of working with Manaka System Acupuncture is that while the four-step protocol gives us structure, it doesn’t lock us into rigidity. Each step has a specific goal. The goal of Step 1 is to release the abdomen. Once you have figured out the pattern, the point selection is usually clear. But with MSA, there’s always room for refinement and careful variation.
A good example is the K3L pattern.

The K3L pattern manifests as a Cross Syndrome with the co-presentation of Yin Qiao Ren. If we treated each channel pair separately with one ion pumping cord, we would need three cords. Stephen Birch developed a more economical way by combining the Yin Qiao Ren pair with LI 4 and LIV 3.
The standard K3L point combination is:
| Point | Side | Colour |
| LU 7 | Left | Red |
| KID 6 | Right | Black |
| LI 4 | Right | Black |
| LIV 3 | Left | Red |
The pattern gets its name from the first letters of the four points. One begins with the letter K and the other three with the letter L: K3L.
LI 4 and LIV 3 are the component points of the famous Four Gates, or Si Guan treatment. Traditionally, these points, when needled bilaterally, are thought to move qi and blood strongly, releasing physical tension and relieving generalised pain. They’re also thought to calm the nervous system and relieve stress and anxiety.
Perhaps this was part of Stephen’s thinking, but he was also thinking structurally. LI 4 is needled on the right hand and thus affects the upper right quadrant (the tight subcostals on the right), and LIV 3 is needled on the left foot, affecting the lower left quadrant. Thus, these two points address the Cross Syndrome part of the K3L pattern.
In practice, I have found a small variation useful in some patients. I call it KLLP. The KLLP variation substitutes P 7 for LI 4, giving us P 7 and LIV 3, together with KID 6 and LU 7.
The point combination is:
| Point | Side | Colour |
| LU 7 | Left | Red |
| KID 6 | Right | Black |
| P 7 | Right | Black |
| LIV 3 | Left | Red |
I use this variation when the standard K3L pattern fails to release the Cross Syndrome component, especially when the patient is less angry/uptight and more anxious/worried.
When the presentation has more of the familiar stress, frustration, or anger quality, LI 4 and LIV 3 may still be the better match, especially if the pulse is wiry.
The rationale for the KLLP variation is the jue yin connection between the pericardium and liver channels. Manaka used these two points on the same side for his hepatitis treatment. But just like LI 4 on the right hand, P 7 on the right affects the upper right quadrant. Contralaterally with LIV 3, they treat the Cross Syndrome. In some patients, P 7 seems to provide a stronger release than LI 4.
This combination is not a replacement for the standard K3L pattern, but an option to consider when the K3L abdominal finding is present. If the patient is more anxious than angry or if the subcostal reaction only partially releases, then this variation can be very helpful.
As always in MSA, the real test is what happens under our hands. Do the abdominal reactions change? When KLLP is well matched, I find that the hara changes rapidly.
This is one of the reasons I enjoy teaching Manaka System Acupuncture. The four-step protocol gives us a clear framework, but within it we are still observing, testing, and adjusting.
KLLP is a small clinical variation on an existing pattern, offered in the same spirit in which I received the work: as a practical tool for thoughtful practitioners.
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