While hiking, you come across a truly beautiful waterfall. The area seems untouched by humans, and you're confident that you are the first to discover this place. As you excitedly explore the surroundings, you stumble upon stepping stones resembling the ones shown in the picture below. They are placed at equal intervals of 2 feet. Do you think these stepping stones were created naturally?
Now, look at the acupoints from the navel to the xiphoid process in the picture below. The acupoints are arranged at equal intervals. Therefore, when locating acupoints, we use references such as the 1/2 and 2/3 points. However, does this arrangement of acupoints feel natural? Take a look at the ribs next to it. They are all placed at different intervals and have slightly different shapes. So why do we assume that acupoints are all placed at the same intervals? It doesn't make sense when you think about it. It seems like people who couldn't feel the acupoints made up this assumption to make it easier to find them.
So, the famous acupuncturist 'Heo Im' from the Joseon Dynasty said the following in his book "Experiences in Acupuncture and Moxibustion":
"自古用手之法이 非不詳盡이로대 後人이 未達其意하고 徒務量穴之分寸하며 不曉動脉之應手"
It is a shame that the doctors in these days search the point only based on measurement, though doctors in the past explained the feelings on hand in detail.
We rely on measurements because we cannot feel the acupuncture points and don't receive such training. It seems that even in the Joseon Dynasty, doctors were not much different. The ancient acupuncturist Sun Simiao said this in his book "Essential Prescriptions Worth a Thousand Gold":
又以肌肉文理, 節解縫會, 宛陷之中, 及以手按之, 病者快然, 如此子細安詳用心者, 乃得眞穴耳. 《千金》
살 위의 금과 뼈짬, 자개미, 마디, 우묵한 곳 등에 손으로 누르면 환자가 시원해 하는 곳들이 있으므로 이런 곳들을 자세하고도 세밀하게 살펴야 침혈을 바로잡을 수 있다[천금].
"Through observing muscle definition, the splitting of joints, meeting points, and the unique depressions, and by pressing them with the hand, the patient feels relief. Only those who examine these intricate details with care and attention can truly find the true acupoints."
To find the correct acupuncture points, you must rely on the sense of touch at your fingertips. By examining the details of the skin, muscles, flow of Qi, pulse of blood vessels, and the shape of bones, you can locate the acupoints. Sun Simiao called these true acupoints (真穴). Recently, modern acupuncturists have been referring to these points as live points, true points or active points.
These points refers to an active, sensitive, or reactive point on the body. These points, also known as acupuncture points or acupoints, are specific locations on the body's surface where energy or "Qi" (pronounced "chee") flows through a network of channels, called meridians. The concept of live points is based on the belief that stimulating these points can help to balance the flow of energy, thereby promoting healing and overall well-being.
A live point can be identified by its heightened sensitivity to touch or pressure, its palpable change in tissue texture, or a noticeable change in the patient's response when the point is pressed or needled. In some cases, a live point may also be warmer than the surrounding tissue, indicating increased blood flow and energy concentration in that area.
In classical texts, when describing acupuncture points, emphasis was placed on feelings rather than relying on measurements. Some commonly used words when describing these points are:
- 陷中 (xiàn zhōng): indentation, A sunken area, where the finger goes in when pressed. Among the 361 acupuncture points, as many as 144 are described as 陷.
- 動脈應手 (dòngmài yìng shǒu): It means the area where the pulse movement is felt by the hand. The pulse could refer to the anatomical artery or the flow of Qi. In ancient times, there was no distinction between the pathway of Qi and the pathway of blood in the pulse.
- 宛宛中 (wǎn wǎn zhōng): It means a gently protruding area. In Chinese dictionary (尹喜伯. 前揭書 : p.203.), it is referred to as 'mild heel' which means 'the middle part is protruding and bulging.' When two 宛 characters are combined into 宛宛中 (wǎn wǎn zhōng), it means 'a soft and gentle bulging.'
- 罅 (xià): A crack, gap, or split area.
- 起肉 (qǐ ròu): It means the point where muscle is raised.
이준무; 김택률. 절순문안과 취혈의 관계에 대한 고찰- 침구대성을 중심으로 -. Korean Journal of Acupuncture. 2005; 22(4) 175-185.
For example, when explaining the acupuncture point LI 4, all documents throughout the ages describe it as being between the thumb and index finger, along with words above.
- 靈樞 在大指岐骨之間
- Ling Shu : Between the large finger's branch bones
- 鍼灸甲乙經 手大指次指間
- Jia Yi Jing : Between the thumb and index finger
- 太平聖惠方 在手大指兩骨罅間 宛宛中
- Taiping Sheng Hui Fang : Between the thumb's two bones, in wǎn wǎn zhōng
- 十四經發揮 在手大指次指歧骨間陷中
- Fourteen Meridians Elucidated : Between the thumb and index finger's branch bones, in xiàn zhōng
- 針灸大全 在虎口歧骨之間陷中
- Complete Collection of Acupuncture and Moxibustion : Between the base of the thumb and index finger's branch bones, in xiàn zhōng
- 針灸集書 在手大指次指歧骨間陷中 又云 手大指骨罅間宛宛中
- Collection of Acupuncture and Moxibustion Books : Between the thumb and index finger's branch bones, in the indentation; also, between the thumb's bone crevices, in wǎn wǎn zhōng
- 鍼灸聚英 手大指次指歧骨間陷中
- Acupuncture and Moxibustion Collection : Between the thumb and index finger's branch bones, in xiàn zhōng
- 鍼灸大成 手大指次指歧骨間陷中
- Great Compendium of Acupuncture and Moxibustion : Between the thumb and index finger's branch bones, in xiàn zhōng
- 針方六集 在手大指次指歧骨間 動脈應手
- Six Collections of Acupuncture Prescriptions : Between the thumb and index finger's branch bones, where the artery corresponds to the hand
In other words, any place between the thumb and index finger can be an acupuncture point. There are commonly three cases:
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| 1. The most common acupuncture point is the highest protruding area, which is located in the center between the thumb and index finger. |
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| 2. The proximal area between the thumb and index finger, which is called Ling Gu in Master Tung acupuncture. It is close to the radial artery and nerve, causing pain and a strong sensation from the acupuncture needle. |
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| 3. The area right next to the index finger's metacarpal bone, where the large intestine meridian connecting LI3 and LI4. |
None of these acupuncture points are right or wrong. They can all be correct or incorrect. In the following paper, research was conducted on the different effects of different parts of LI4. From the perspective of true acupuncture points, the effective location for each patient may vary each time acupuncture is applied.
- Point 1 had a better therapeutic effect for toothache relief and analgesia-anesthesia effect than for headache relief, location
- Point 2 was better for headache than toothache relief; locations
- Point 3 and Point 4 had a mixed effect whereas,
- Point 5 seems to have a better chance to get bioenergy (De Qi) as manifested by tingling and numbing sensation at the acupunctured site.
(Lu DP, Lu GP, Gabriel PL. Comparing the clinical effect of five varying locations of LI.4 acupoint. Acupunct Electrother Res. 2008;33(3-4):135-43.)
All above points are right LI4 point. They can be different based on patients or diseases. What really matter is not the location, but 'how to locate the point by sensation'. In acupuncture practice, you need to find the true acupuncture point by palpating, feeling, and grasping the flow of Qi(Mai).
These are the sensations and feedback in process of searching the point with your fingers. Based on these sensation you can get TRUE points.
- Feeling relief of pain when pressed
- Feeling intense pain when pressed
- The pain in the painful area decreases after pressing
- Small nodules or hard areas can be felt
- The area is soft or distinctly different from the surroundings when touched
- The area is sunken or swollen compared to the surroundings
- The temperature or texture is different from the surroundings during palpation
Japanese people have a unique way of finding and inserting acupuncture points, which is also a method to find true acupuncture points. I will introduce this method next post