36. The use of acupuncture points in Five Element Constitutional Acupuncture
Overview of the use of points278
The use of points according to traditional usage278
Other points with specific uses285
Overview of the use of points
Practitioners of Five Element Constitutional Acupuncture use points in three different ways.
1 According to the type of point. These uses were first laid down in the early classics. For example, different types of points are back shu points, yuan source points, Element points, tonification points, etc.
2 According to the qualities implied by the names given to them in antiquity, for example, using points such as Ht 7, Spirit Gate or Kid 25 Spirit Storehouse to treat a person at the level of the spirit. In some instances the location of the point is also considered.
3 Using a combination of points. Some points are used together to create a specific effect. For example, using Ren 15, St 25, St 32 and St 41 to clear possession or Exit and Entry points, such as Liv 14 and Lu 1, to clear a block.
This chapter will concentrate on how the different types of points described in the Chinese classics are used by a Five Element Constitutional Acupuncturist. Chapter 37 will discuss using points according to the qualities implied by the names, especially when they are used to treat a person’s spirit.
The use of points according to traditional usage
The Nei Jing and the Nan Jing outline several different classifications of points and give some indications as to how these points should be used. Much emphasis is placed on the use of ‘command’ points, the points situated below the elbow and knee.
The 360 points of the whole body have their command in the sixty-six points of the feet and hands.
(Yi Xue Ru Men by Li Chan, +157; quoted in Soulié de Morant, 1994, p. 145)
(In this quotation the number 66 comprises the five shu points of the 12 channels and the yuan source points of the yang channels, which are shu points.)
The command points are considered to be especially effective at enhancing the qi of the Organs. Giovanni Maciocia (1989, p. 335) describes them as being more ‘dynamic’ than points on other parts of the body for two reasons. Firstly, because they are more superficial in nature (for more on this see the Element points below), and secondly, because of the rapidly changing and relatively volatile yin/yang dynamics present at the beginning and end of the channel.
These points are commonly used to direct, enrich and ‘command’ the qi. The types of points discussed in this chapter are:
• Element points – especially the tonification and sedation points
• yuan source points
• horary points
• luo junction points
• xi cleft points
Other points with specific uses
Besides command points, there are a number of other points that are discussed in this chapter that are commonly used by Five Element Constitutional Acupuncturists. They are:
• back shu points
• Exit–Entry points
• points on the Ren and Du channels
• front mu points (these points are palpated for diagnosis only)
Although practitioners frequently use points on various parts of the body, they tend to complement them with command points. This usually enhances their effect. If a significant change has been effected in the patient’s colour, sound, odour, emotion or pulses by using only the body point then it may be unnecessary to use a command point as well.
Ling ShuChapter 1 compares the channels to rivers, starting with a ‘well’ at the tips of the toes or fingers and flowing into a ‘spring’, ‘stream’ and ‘river’ until it reaches a ‘sea’ at the knee or elbow. Here the qi travels deeper inside the body. This transformation is associated with particular points on the channel which are usually called the ‘Five Shu points’. 1 In the Nan Jing these points are linked with each of the Elements. These points are frequently used by Five Element Constitutional Acupuncturists. 2
1In the 1970s J. R. Worsley described these points and called them ‘Antique’ points. He recommended that they were used according to the season.
2Different passages in the Nei Jing and Nan Jing give different and even contradictory usages for these points. The use of these points in Five Element Constitutional Acupuncture is based, like much else, upon the Nan Jing.
Uses of Element points
1 They are most often used in the form of tonification or sedation points that are used to transfer qi around the sheng cycle.
2 They can be used to transfer qi between Organs across the ke cycle.
3 They can be used to treat a patient’s ‘Element within the Element’ (see Chapter 4, this volume). Element points are rarely used in this way and describing this use is not within the scope of this book.
The Element points are listed in Table 36.1.
|aJ. R. Worsley used a slightly different numbering system for some points on the Bladder channel to the one used by the Chinese. In that system it is Bladder 54.|
|Organ||Wood point||Fire point||Earth point||Metal point||Water point|
Position of Element points
The Element points are sited on the limbs. All nail points on the yin channels are Wood points, the second points are Fire points and the third points are Earth points. Points at the elbows or knees are Water points. Metal points vary slightly in their position but naturally lie between the Earth and Water points.
All nail points on the yang channels are Metal points, the second points are Water points and the third points (except GB) are Wood points. Points at the elbows or knees are Earth points. Fire points lie between the Wood and Earth points and can vary in their positions.
The concept of ‘transferring’ qi between Organs
The idea of transferring qi from an Organ that is in excess relative to another Organ is extremely old in Chinese medicine. The Maishu, recently excavated at the Zhangjiashan burial site, and probably the earliest extant treatise on acupuncture states:
Those who treat illness take the surplus and supplement the insufficiency.
(quoted in Lo, 2001, p. 29)
It is mentioned in Su WenChapter 5, that:
If there is a qi deficiency in a particular location or channel, the qi can be conducted or guided from other channels to supplement the weakness.
Su Wen, however, gives no specific treatment protocols for the process of ‘transferring’ qi. In the Ming dynasty, Xu Feng (+1439) and Gao Wu (+1529) set out the use of ‘tonification’ and ‘sedation’ points. This led to these treatment protocols becoming widely used, especially amongst Korean and Japanese acupuncturists. 3
3These treatment protocols are not used in contemporary TCM. It is interesting, however, to note that they were being taught at the Shanghai Military Medical College between 1964 and 1970. Entry/Exit protocols were also being taught; Eckman, 1996, p. 160.
The importance of harmonising the qi of the 12 Organs is fundamental in this style of acupuncture. This means that it is common practice to transfer qi between Organs even if the relatively stronger Organ is somewhat deficient in absolute terms. Pulse diagnosis is crucial in making this judgement.
The tonification point on a channel is the point associated with the preceding Element on the sheng cycle, the ‘mother’ of the Organ involved. Tonifying these points transfers qi from the mother Organ to the child. Qi can only be transferred from a yin Organ to another yin Organ or from a yang Organ to another yang Organ. For example, Bladder 67, the Metal point of the Bladder channel, can be used to pull qi from the Large Intestine into the Bladder or Kidney 7, the Metal point of the Kidney, to transfer qi from the Lung to the Kidney.
The tonification points are:
|•||Lung 9||•||Bladder 67|
|•||Large Intestine 11||•||Kidney 7|
|•||Stomach 41||•||Pericardium 9|
|•||Spleen 2||•||Triple Burner 3|
|•||Heart 9||•||Gall Bladder 43|
|•||Small Intestine 3||•||Liver 8|
The sedation point on a channel is the point associated with the following Element on the sheng cycle or the ‘child’ of the Organ involved. The sedation point on the channel is sedated if the qi in an Organ is in relative excess compared to that of the Organ that follows it on the sheng cycle. For example, St 45, the Metal point, can be sedated if the practitioner wishes to transfer qi to the Large Intestine.
The sedation points are:
|•||Lung 5||•||Bladder 65|
|•||Large Intestine 2||•||Kidney 1|
|•||Stomach 45||•||Pericardium 7|
|•||Spleen 5||•||Triple Burner 10|
|•||Heart 7||•||Gall Bladder 38|
|•||Small Intestine 8||•||Liver 2|
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