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Acupuncture - Points
Points   |   Channels


Acupuncture Points Overview

In Latin "acus" means needle and "punctura" means penetration or prick.

acupuncture points Acupuncture is the art and science of stimulating specific points on the body to mobilize the body's internal healing mechanisms. From ancient times it was discovered that, by stimulating distinct sites on the body's surface, diseases in both the superficial tissues and internal organs could be treated, and that pathology in an internal organ will often manifest itself in certain external or systemic symptoms.

Conjecture has it that thousands of years B.C., when man suffered from an ailment, or injury, or felt pain in some part of his body, it was observed that his natural tendency was to massage the tender area with his hands. Over time, this observation in the relationship between pain and its relief, through stimulation at the tender area, led to the systematic identification of points, their cause-and-effect relationships, diversification and sophistication in the correlation of points to diseases, and their integration by function within the larger scope of acupuncture Channel theory.

Stimulation (massage) of pain points first began by using the hands. Then stimulation (pressure) with a blunt stone became the early basis for acupuncture. Today, stimulation (needling) of acupuncture points is accomplished with very fine stainless steel needles.

There are approximately 1,000 acupuncture points (also called acupoints). An acupoint may be thought of as places where the energy of a Channel converges and accumulates, like a vortex, and gets transported to the body surface. Because of the converging, accumulating and surfacing behavior, these points are particularly conducive to manipulation.

The vast majority of acupoints have both local and distal effects. For example, a point on the hand may be used to treat local symptoms of hand pain or it can be used to treat a symptom farther along the Channel, such as eye pain or nasal congestion. It may also treat an area not directly supplied by the Channel, such as ankle pain, based on the interrelationships between the Channels.

Of the approximately 1,000 acupoints, 361 to 365 are located on Channels that have a relationship with the Internal Organ systems. (The difference in the above number reflects differences in interpretation and source.) The concept of Channels is integral to acupuncture practice and theory. It is through the Channel functions and Channel relationships with the Internal Organs and tissues that the points are given systemic integration. One aspect of this integration is the fact that points along a Channel share many of the same therapeutic properties. Without the integrating and systemic networking of Channels, acupoints may be limited in scope and deemed to be random phenomenon.



Classification of Acupuncture Points


There are four classifications of acupuncture points as follows:

A. Channel Points
  • 14 Primary Channels: There are 12 Organ Channels each connected with one of the 12 Internal Organs. These 12 occur bilaterally on each side of the vertical midline of the body to make up a total of 24 channels. Each of the 12 Organ Channels has its own set of points. These 12 Channels, along with the Ren and Du Vessels comprise the 14 Primary Channels. According to Chinese texts there are 361 to 365 of the Primary Channel points.
  • Eight Extraordinary Vessels: There are eight Extraordinary Vessels (also referred to as Eight Extra Vessels or Eight Miscellaneous Channels). Only two of these have their own specific points. These two are the Ren Vessel, traversing the front midline of he body, and the Du Vessel, traversing the back midline along the spine. The remaining six Extra Vessels are accessed by a few specific points belonging to the 14 Primary Channels.
  • The 12 Divergent Channels, 15 Connecting Collateral Channels, 12 Muscle Regions, and 12 Cutaneous Regions all utilize and share a few points belonging to one of the 14 Primary Channels.
For additional information about Channels, please see the section on Channels.

B. Miscellaneous (Extra) Points
  • The majority of Miscellaneous Points (also referred to as Extra Points) do not belong to any specific Channel. However, a few of these 'points' are groups or clusters of points that may or may not belong to Channels. There may be hundreds of these points but only about 40 are commonly noted in classical Chinese texts.
C. Pain ('Ashi') Points
  • Pain point or 'Ashi' is a general term referring to points on the patient's body that become tender (painful, sensitive to the touch) during illness or injury. They are not fixed points but are unique to the individual. Ashi points may remain fixed for a period of time, or come and go, and can move around the body. These points are located simply by the spontaneous tenderness the patient feels or by palpating (pressing, touching) affected areas.
D. Modern Points
  • Modern points are those that have been recently discovered and added to the practice of acupuncture. Many of these points were discovered in conjunction with the practice of modern allopathic medicine. For example, by comparing the anatomical pathways of the nervous system with traditional Channel theory or through the use of electrical probes, new points located along major nerve trunks and branches were discovered.


Category of Points


There are numerous groupings of points regarded as special because of their anatomical locations and functional characteristics. A few of the major categories are listed below.

A. Five Shu (Transporting) Points
  • A group of five points on each of the 12 Primary Organ Channels are collectively named Shu points. These five points exist bilaterally on each of the 12 Channels. Each group is located on the limbs below the elbow on the arm channels, and below the knees on the leg channels.
  • The Five Shu points on each of the 12 Channels are designated as Well, Gushing, Transporting, Traversing and Uniting points. They are named sequentially so that the Well points are the most distal at the fingers and toes, and the Uniting points are most proximal being located near the elbows and knees.
  • Together, the Five Shu points represent the growth of Qi in the channels from its shallow and distant beginnings (Well points at the fingers and toes) to its deep, swelling and accumulating presence (Uniting points at the elbows and knees) before the Qi goes more deeply interior into the body.
  • Because of their locations near the superficial areas of the body, some of these points can be a bit sensitive on needling. But because of their special properties they are extremely effective.
B. Six Lower He Sea (Lower Uniting) Points
  • The six Yang Channels each have a Lower He Sea point used to treat disorders of their respective Yang organs.
  • The six Yang organs are the Stomach, Large Intestines, Small Intestines, Bladder, Gall Bladder and San Jiao (Triple Burner).
C. Sixteen Xi Cleft (Accumulating) Points
  • The 16 Xi Cleft points are thought of as holes or clefts at the site where Qi and Blood in the channels converge and accumulate as they circulate through the body.
  • Xi Cleft points are used primarily in the treatment of acute diseases or as diagnostics tools when palpating.
D. Twelve Back Shu Points
  • The 12 Back Shu points are all located along the Bladder Channel on each side of the spine. There is one Back Shu point for each of the 12 Primary Organs.
  • Back Shu points are points through which the circulating Qi of their respective Organs passes. They are used primarily to treat chronic disorders of the Organs and for diagnostics purposes.
  • They are more commonly used to treat disorders of the six Yin organs which are the Lungs, Spleen, Heart, Pericardium, Liver and Kidneys.
E. Twelve Front Mu Points
  • Like the Back Shu points there are 12 Front Mu points located on the chest and abdomen corresponding to the 12 Internal Organs.
  • Front Mu points are also used to treat diseases of the Internal Organs and for diagnostics purposes.
F. Eight Influential (Meeting) Points
  • There are eight points deemed to have a special normalizing effect on Organs, tissues, Blood and Qi.
  • An Influential Point exists affecting one of the following areas:
    • Yin Organs
    • Yang Organs
    • Qi
    • Blood
    • Muscles and Tendons
    • Blood Vessels
    • Bones
    • Marrow


Acupuncture Modalities


Within the practice of Acupuncture, there are different techniques or modalities. It is at the personal discretion of the practitioner to utilize one mode in favor of another. In my practice, several of the following modalities may be combined in a treatment session according to the patient's individual needs and requirements.

A. Body Acupuncture
  • Body acupuncture simply consist of utilizing the various different classification of points discussed above. These include the Primary Points, Miscellaneous Points, Pain Points and Modern Points. Body points cover a wide region including the head, face, trunk, limbs, hands, and feet.
B. Scalp Acupuncture
  • Scalp acupuncture consists of using points located on the scalp. Similar to body points, points on the scalp have been associated with the Internal Organs as well as the neurological aspects of physiology.
  • In most instances, scalp points are utilized for neurological, sensory and motor disorders such as paralysis, tremors, shaking, numbness, tingling, etc., resulting from stroke, Parkinson's disease, Multiple Sclerosis, and other nervous system disorders.
  • Various regions throughout Asia may use different theoretical and topographical constructs of scalp therapy. Dr. T. Yamamoto of Japan is renowned for developing a modern topography of scalp points that are somewhat different from classical Asian scalp acupuncture.
C. Auricular (Ear) Acupuncture
  • Of the 12 Primary Organ Channels, all six of the Yang Channels traverse the ear either directly or through connecting channels. The six Yin Channels do not have direct connections but are indirectly linked through their Internal-External relationships with the Yang Channels.
  • In conjunction with the Internal Organs theory, points on the front and back of the external ear are associated with Internal Organs such that diseases of the organs can be treated with direct stimulation of ear. However, as a comprehensive system of diagnosis and treatment, ear acupuncture as a modality is a newer theory. In the 1950's, Dr. Nogier of France extensively studied the behavior of ear points and developed a slightly modified topographical view of the ear.
  • Ear points can be needled to treat a wide range of disorders from musculoskeletal to addiction related disorders.
D. Korean 4-Needle (Sa-am) Theory
  • Korean 4-Needle (also referred to as Sa-am) theory is a complex and comprehensive theory of diagnosis and acupuncture treatment emphasizing the interrelationships between the Five Elements. It was developed by Master Sa-Am, a physician and monk of the Chosun Dynasty in Korea. For over 400 years the art and science of this technique remained lost and hidden until recent discovery enabled its recovery and study.
  • Sa-am theory utilizes a special category of points known as Shu Points and applies these points according to the Generating and Controlling Sequences of the Five Elements theory. Only four points are chosen. For example, two points are from the primary Channel being treated, and two from the Grandmother channel according to a tonifying (strengthening) and sedating (lessening) technique.
  • In Korea, Korean Oriental Medicine (KOM), known as Hanbang, is the primary health care system for more than 20% of the population. KOM is widely integrated with Western allopathic medicine throughout many hospitals in Korea. There, KOM modalities including Sa-am 4-Needle technique, Sasang Korean Constitutional medicine, and Korean Hand acupuncture are equally relied upon along with classical methods.
E. Master Tong (Tung) Acupuncture
  • Master Tong (Tung) was a modern practitioner who is said to have passed down his family's secrets prior to his death. His acupuncture consists of using the existing Channel Points and Extra Points in ways not commonly utilized under the Channel theory. The technique involves selecting only a few discrete points according to specific ailments and symptoms. It is commonly applied in cases of pain syndromes.


Functions and Indications of Acupoints


The majority of the Channel Points are known to have multiple functions and indications. The differences between a function and indication can be explained as follows:

Function:
  • A function may be thought of as a Treatment Strategy or Treatment Principle.
  • A Treatment Strategy/Principle can be thought of as a summarization and general principle, or mechanism of action.
  • Examples include: Clear Heat; Disperse Cold, Drain Dampness; Resolve Phlegm; Descend Rebellious Qi; Cool the Blood; Remove Obstruction, Expel Wind, Calm the Mind, Tonify Qi; Harmonize Blood, Nourish Yin; Supplement Yang; etc.
Indications:
  • Indications refer to the discrete symptoms for which a point is effective.
  • Examples include: cough; abdominal pain; insomnia; headache; dizziness; spasms; blurred vision; skin itch; etc.

An example is given below on the functions and indications of an important acupoint, Large Intestine 4 (LI4)
, located on the hand near the junction of the thumb and index finger:

Functions of LI4:
  • Expels Exterior Wind and releases the Exterior
  • Promotes distribution of Lung-Qi
  • Regulates Defensive Qi and sweating
  • Stops pain
  • Removes obstruction from the Channel
  • Tonifies Qi and consolidates the Exterior
  • Harmonizes the ascending and descending of Qi
  • Benefits the eyes, nose, ears and mouth
  • Promotes labor
  • Calms the Mind
Indications of LI4:

Chills, fever, sneezing, headache, sweating, absence of sweating, toothache, painful obstruction of the throat, facial swelling, lockjaw, deviation of the eye, hemiplegia, arm pain, tinnitus, deafness, redness/swelling/pain of the eye, blurred vision, nosebleed, nasal congestion and discharge, sneezing, amenorrhea, prolonged labor, delayed labor, and retention of dead fetus.

In applying the point LI4, or any acupoint, to any of its indications, it is most effective when used on pathology resulting from one of the scenarios addressed by its Function. For example, if eye pain and blurred vision are caused by Blood Deficiency requiring the treatment principle of Nourishing the Blood, LI4 by itself is not adequate as Nourishing the Blood is not one of its Functions. In this case, it must be combined with other points that Nourish the Blood in order to treat both the indication (eye pain and blurred vision) as well as the underlying condition (Blood Deficiency-induced eye symptoms).



Manipulation: Even, Tonify, Sedate


Some acupoints are homeostatic. This means that it has a regulating function to bring the body back to balance regardless of the manifested symptom. For example, a point that regulates the bowels can be used whether the patient is experiencing diarrhea or constipation. The degree of efficacy, however, is affected by combining the regulating point with other points that are more specific in treating either the diarrhea or the constipation aspect.

In many cases, however, the practitioner must 'tell' a point which Treatment Principle to take - either tonify to astringe the diarrhea or sedate to promote bowel movement. Two of the more common ways this is done are:

Direction of insertion
  • When the needle is slanted along the Qi flow of the channel, this produces a tonifying effect.
  • When the needle is slanted against the Qi flow of the channel, this produces a sedating effect.
  • When the needle is pointed perpendicular to the channel, this results in an even effect.
Twirling of the needle after insertion
  • If the needle is twirled back and forth in a clockwise direction, this produces a tonifying or even effect.
  • If the needle is twirled back and forth in a counterclockwise direction, this produces a sedating effect.
An Even method allows the acupoint to manifest its effects without any particular constraints. A Tonifying method tells the point to use a strengthening principle in the case of a Deficient condition. And a Sedating method tells the point to subdue an Excess condition and expel a pathogen which may have invaded the body.



Art and Science of Acupuncture


The science of acupuncture is evidenced by predictability. An acupoint needled with a specified method (even, tonify, sedate) will produce an expected outcome based on its known properties and Channel relationships. Mastery of the science involves knowledge of the points' location, functions, indications, applications, contraindications, needling technique, interactions with other points, and more.

The artisty of acupuncture is more elusive. Artistry applies to the way a practitioner selects a particular group of points, among similarly behaving points, that will not only produce a desired effect, but do so in a way that will address the patient's underlying condition in an harmonious way. At the heart of the Medicine is the philosophy of balance and harmony. Therefore, the artistry entails selection of points uniquely appropriate to each patient with the attempt to balance the following aspects at each treatment:
  • Yin and Yang polarities
  • Upper body and Lower body potential energies
  • Left and Right hemisphere energetics
  • Distal and Local points interactions
Remaining true to this philosophy, for each patient at each session, requires the labor of thought and the burden of thinking. In addition to balancing the four aspects listed above, one must also ensure combining points to marry the function with the indications, and to pair Channels not only based on Yin-Yang and External-Internal relationships but also by their supportive and related functions and areas of effect.

How easy it is to gather a discrete group of points designed to ameliorate symptoms but leave the underlying condition largely untouched. The patient would not be any wiser for it. Yet, to disregard this fundamental principle of balance and harmony, however strenuous the application, is to sacrifice long-term healing over short-term gains, and to compromise efficacy for efficiency.

In truth, artistry begins with knowledge. Knowledge must be flavored by creativity. And creativity must evolve through failures and mature through successes. Only then can art support the practice and the practice promote the art.


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