Acupuncture - Textbook and Atlas - Gabriel Stux, Bruce Pomeranz - 1987 - 3642717446

Gabriel Stux Bruce Pomeranz
Acupuncture
Textbook and Atlas
Translations of Chinese Terms by Karl Alfried Sahm

Illustrations prepared by Petra Kofen
With 98 Figures and an Acupuncture Selector
Springer-Verlag
Berlin Heidelberg New York Tokyo
Dr. med. Gabriel Stux
Acupuncture Center
GoltsteinstraBe 26, 4000 Dusseldorf
Federal Republic of Germany
Prof. Bruce Pomeranz

25. Governor's Road
Toronto, M4W 2F9
Canada
This book is based on the following books published by Springer-Verlag:

Lehrbuch der klinischen Akupunktur Akupunktur: Lehrbuch und Atlas
Atlas der Akupunktur Grundlagen der Akupunktur
ISBN-13: 978-3-642-71744-4 e-ISBN-13: 978-3-642-71742-0

DOl: 10.1007/978-3-642-71742-0
This work is subject to copyright. All rights are reserved, whether the whole or part ofthe material is concerned, specifically the rights of
translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data
banks. Duplication of this publication or parts thereofis only permitted under the provisions ofthe German Copyright Law of September
9,1965, in its version of June 24,1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German
Copyright Law.
© Springer-Verlag Berlin Heidelberg 1987
Softcover reprint ofthe hardcover I sl edition 1987
The use of registered names, trademarks, etc. in the publication does not imply, even in the absence of a specific statement, that such
names are exempt from the relevant protective laws and regulations and therefore free for general use.
2119/3140-543210
Preface
Acupuncture: Textbook and Atlas is a fundamental textbook based on different books

published in German by the first author. It is intended to meet the needs of western
acupuncturists by providing a basic treatment of all the main fields of acupuncture.
The chapter on the scientific basis of acupuncture has been written by Prof. Bruce
Pomeranz, an eminent neurophysiologist who is in the vanguard of basic research into
acupuncture.
Following an introduction to the philosophical and theoretical background of tradi-
tional Chinese medicine, the traditional diagnostic system is presented. This is funda-
mentally different from western medical diagnosis. The Chinese system of channels
and functional organs and the significance of points and point categories are described
in detail in Chap. 5, the 14 main channels and about 150 acupuncture points important
in daily practice being presented with the didactic emphasis on morphology and clini-
cal application. The Chinese point names are given in the Pin Yin transcription accord-
ing to the latest standardized system of the World Health Organization and have been
translated into English by Karl Alfried Sahm.
The most important acupuncture points in the different regions of the body are listed
after the description of channels and points. The methods of needling and moxibustion
are described with reference to their historical origins and development and presented
in detail with their clinical applications. The treatment of adjunctive methods (laser
therapy and acupressure) and the different microsystems, such as scalp, hand and ear
acupuncture, is brief but comprehensive.
The chapter on treatment is based on western modes of diagnosis, which is discussed
in relation to Chinese diagnostic categories, and the major principles of therapy. The
most important acupuncture points are given for the different diagnoses. They should
not be used as "recipes", but as hints to underlying rules on the selection of points.
Thanks are due to my first acupuncture teachers, Prof. Anton Jayasuriya from Sri Lan-
ka and Dr. Maria Vinnemeier from Velbert, West Germany. Many stimulating lectures
given by eminent scholars, for example Prof. Zhang Jin from Harbin and Prof. Cheng
Xingnong from Beijing, have had positive influences on this book.
Thanks to Janet Dodsworth and Britta Severin for translation work and for correction
of the manuscript.
Autumn, 1986 Gabriel Stux

Table of Contents
1 Scientific Basis of Acupuncture (B. Pomeranz) . 1

1.1 Acupuncture Analgesia (Basis Research) 1
1.2 Acupuncture Analgesia for Chronic Pain . . . 17
1.3 Drug Addiction . . . . . . . . . . . . . . . . . 18
1.4 Asthma, Nerve Regeneration and Cardiovascular Effects of Acupuncture 19
1.5 Acupuncture Points (Do They Really Exist?) . . . . . . . . . . . . . . .. 20
2 History of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . .. 35
3 Background and Theory of Traditional Chinese Medicine (G. Stux) .. 37

3.1 Tao, Yin and Yang. . . . . . 37
3.2 The Cosmic Vital Energy: Qi . 39
3.3 Jing, the Life Essence . . 40
3.4 Shen, or Psychic Energy. . 40
3.5 Disturbances of Qi . . . . 41
3.6 The System of Five Phases 43
3.7 External Climatic Factors . 44
3.7.1 Description of the Climatic Factors 45
3.8 Internal Emotional Factors . . . . . 46
4 Diagnosis in Traditional Chinese Medicine (G. Stux) . 47

4.1 Eight Diagnostic Criteria, Ba gang . 47
4.2 Interior and Exterior Li, Biao . 48
4.3 Excess and Deficiency Shi, Xu 48
4.4 Heat and Cold Re, Han . . . 49
4.5 Yin and Yang . . . . . . . . . 50
4.6 Four Examinations Si zhen . . 50
4.7 Visual Observation Wang zhen . 51
4.8 Listening and Smelling Wen zhen 52
4.9 Questioning Wtm zhen . . . . . 52
4.10 Physical Examination Qie zhen . 54
5 Chinese System of Channels, Organs and Points (G. Stux) . 55

5.1 Channels and Organs . . . . . . . . 55
5.2 Presentation of the Point Categories 60
5.2.1 Shu Points or Transport Points 60
5.2.2 M u or Alarm Points . . . . . 60
5.2.3 Influential Points, Hui Xue . 62
5.2.4 Xi-Cleft Points. . . 62
5.2.5 Five Shu Points .. 63
5.2.6 Tonification Point . 63
5.2.7 Sedative Point . . . 64
VIII Table of Contents
5.2.8 Jing Well Point. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64

5.2.9 Ying Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64
5.2.10 Yuan Source Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
5.2.11 Jing Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
5.2.12 He Sea Point . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 66
5.2.13 Luo Connecting Point. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 66
5.2.14 Confluent Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
5.3. Methods of Point Location . . . . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.1 Anatomical Landmarks . . . . . . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.2 Proportional Cun Measurement . . . . . . . . . . . . . . . . . . . . . .. 70
5.3.3 Proportional Measurement . . . . . . . . . . . . . . . . . . . . . . . . .. 72
5.3.4 Location by Means of Specific Posture . . . . . . . . . . . . . . . . . . . 72
5.3.5 Location by Measurement of Skin Resistance. . . . . . . . . . . . . . .. 74
5.3.6 Location with the Aid of Other Points . . . . . . . . . . . . . . . . . . .. 74
5.3.7 Combination of Different Methods . . . . . . . . . . . . . . . . . . . .. 74
5.3.8 Location of Painful, Sensitive or Tender Points . . . . . . . . . . . . . .. 74
6 Systematic Description of Channels and Points (G. Stux) . . . . . . . . . . 77

6.1 Lung Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 77
6.2 Large Intestine Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
6.3 Stomach Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 92
6.4 Spleen Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
6.5 Heart Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
6.6 Small Intestine Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
6.7 Urinary Bladder Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
6.8 Kidney Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
6.9 Pericardium Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
6.10 Sanjiao Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
6.11 Gallbladder Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
6.12 Liver Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
6.13 DuMai . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
6.14 RenMai . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
6.15 Chong Mai . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 198
6.16 DaiMai . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
6.17 Yangqiao . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
6.18 Yinqiao . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
6.19 Yangwei . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
6.20 Yinwei . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
6.21 Extra Points . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
7 Regions with Important Acupuncture Points (G. Stux) . . . . . . . . . . . . 212

7.1 Face . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
7.1.1 Points Around the Orbita . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
7.1.2 Points Around the Ear . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
7.1.3 Points Around the Nose . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
7.2 NeckArea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
7.3 Dorsal Side of the Trunk .. . . . . . . . . . . . . . . . . . . . . . . . . . 216
7.4 Abdominal Area. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
7.4.1 Epigastrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
7.4.2 Middle and Lower Parts of the Abdominal Area . . . . . . . . . . . . . . 218
7.5 Shoulder Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
7.6 Points Around the Knee Joint . . . . . . . . . . . . . . . . . . . . . . . . 220
Table of Contents IX
8 Technique of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . . 223

8.1 Acupuncture Needles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
8.2 Technique ofInsertion and Stimulation of the Needles . . . . . . . . . . . 224
8.3 De Qi Sensation . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 225
8.4 Tonifying and Sedating Methods of Stimulation . . . . . . . . 225
8.5 Electroacupuncture, Electrostimulation . . . . .. . . . . . . . . . . . . 226
8.6 Sterilization of the Needles . . . . . . . . . . . . . . 227
8.7 Complications of Acupuncture Treatment. . . . . . . . . . . . . . . . . . 227
9 Moxibustion (G. Stux) . . . .... . · .229

9.1 Indications and Methods. ... . . · .229
9.2 Direct Moxibustion . . .. .... . .230
9.3 Indirect Moxibustion with Ginger Slice Isolation . . . . . . · . . . . . . . 230
9.4 Moxibustion with "Moxa Cigars" . . . . . . . . . . . . .. · . . . . . . . 231
9.5 Moxibustion by Heating Acupuncture Needles .. · . . . . . . . 231
9.6 Infrared Moxibustion . . . . . . . . . . . . · . . . . . . . 231
10 Laser Acupuncture (G. Stux) . . . . . . 233
11 Acupressure(G.Stux) ... . . . . . . 235
12 Ear Acupuncture (G. Stux) . ..... . ... 237

12.1 Technique of Ear Acupuncture . . . . . . .238
12.2. Representation of the Body on the Auricle .238
12.3 Numbering of Ear Points . . . . . . . .242
12.4 Rules for Selection of Ear Points . . .246
13 Scalp Acupuncture (G. Stux) . .249

13.1 Fourteen Lines for Treatment. .249
13.2 Method of Needling . . . . . . · .252
14 Hand Acupuncture (G. Stux) . . . .253

14.1 Points of the Dorsum of the Hand .253
14.2 Points on the Palm. . . . . . . . .256
15 Acupuncture Treatment (G. Stux) . . . . . . . . . . . . . . . . . . . . . . . 261

15.1 Principles of Acupuncture and Major Rules of Point Selection .. 261
15.2 Locomotor Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270

15.2.1 Arthrosis of the Jaw Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
15.2.2 Cervical Spondylitis, Torticollis, Rheumatoid Arthritis . . . . . . . . . . . 271
15.2.3 Intercostal Neuralgia, Trauma of the Thorax, Ankylosing Spondylitis,
Zoster Neuralgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
15.2.4 Sciatica, Lumbar Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
15.2.5 Periarthritis Humeroscapularis, Frozen Shoulder . . . . . . . . . . . . . . 273
15.2.6 Epicondylitis, Tennis Elbow . . . . . . . . . . . . . . . . . . . . . . . . . 273
15.2.7 Pain in the WristJoint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
15.2.8 Pain in the Hand, Rheumatoid Arthritis, Dupuytren's Contraction . . . . 274
15.2.9 Coxarthrosis, Coxarthritis . . . . . . . . . . ...... 274
15.2.10 Gonarthrosis, Pain in the Knee Joint. . .. 275
15.2.11 Pain in the Ankle Joint .. 275
15.2.12 Pain in the Toes . . . . . . 275
15.2.13 Rheumatoid Arthritis . . . 276
X Table of Contents
15.3 Respiratory Disorders .277

15.3.1 Common Cold. . . . .278
15.3.2 Tonsillitis, Laryngitis .278
15.3.3 Maxillary Sinusitis .278
15.3.4 Frontal Sinusitis . . .279
15.3.5 Chronic Bronchitis .279
15.3.6 Bronchial Asthma . .279
15.4 Cardiovascular Disorders . . . . . . . . . . . . . . . . . 280

15.4.1 Coronary Heart Disease with Angina Pectoris .. . . . 280
15.4.2 Cardiac Neurosis . . . . . . . . . . . . . · . 281
15.4.3 Cardiac Arrhythmia . . . . . . . . . . . . · . 281
15.4.4 Exhaustion Conditions in Heart Disease · . 281
15.4.5 Hypertension . . . . . . . . . . . . . . . · .282
15.4.6 Hypotension . . . . . . . . . . . . . . . . · .282
15.4.7 Disturbances of Peripheral Blood Supply .282
15.5 Gastroenterological Disorders . . 283

15.5.1 Esophagitis, Dysphagia . . . .283
15.5.2 Gastritis, Gastroenteritis .. .284
15.5.3 Gastric and Duodenal Ulcer .284
15.5.4 Diarrhea . . . . . . . . .284
15.5.5 Irritable Bowel Disease . . . .285
15.5.6 Constipation . . . . . . . . . .286
15.5.7 Hemorrhoids, Anal Fissure . .286
15.5.8 Cholangitis, Cholecystitis, Biliary Dyskinesia, Biliary Colic . . . . . . · . 286
15.5.9 Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . · .287
15.6 Mental Disturbances and Illnesses .287

15.6.1 Depression . . . . . . . .288
15.6.2 Exhaustion Conditions .289
15.6.3 Agitation . . . . . . .289
15.6.4 Sleep Disturbances .289
15.6.5 Schizophrenia . . . .290
15.6.6 Drug Addiction . . .290
15.6.7 Alcohol Addiction. .290
15.6.8 Nicotine Addiction .290
15.6.9 Overweight, Weight Loss .291
15.6.10 Sexual Disturbances . 291
15.7 Neurologic Disorders .292

15.7.1 Headache and Migraine .292
15.7.2 Trigeminal Neuralgia .294
15.7.3 Hemiparesis . .295
15.7.4 Facial Paresis .296
15.7.5 Epilepsy . . . .296
15.8 Gynecological Disorders . .297

15.8.1 Dysmenorrhea. . . . .297
15.8.2 Amenorrhea . . . . . . . · .297
15.8.3 Adnexitis, Salpingitis . . .298
15.8.4 Pain caused by Gynecological Tumors . .298
15.8.5 Pruritus Vulvae . . . . . . . . . . . . . .298
Table of Contents XI
15.8.6 Hyperemesis Gravidarum . . 299

15.8.7 Analgesia During Childbirth . 299
15.8.8 Deficient Lactation . . 300
15.9 Urological Disorders . .300

15.9.1 Pyelonephritis, Urinary Infections, Chronic Glomerulonephritis . . . . 301
15.9.2 Renal Colic . . . . . . . . . . . . . . . . . . . .... . . . . 301
15.9.3 Prostatitis, Psychogenic Urological Symptoms · 301
15.9.4 Impotence and Male Fertility Disorders . . · 302
15.9.5 Enuresis . . . . .302
15.10 Skin Disorders . · 303

15.10.1 Acne Vulgaris . · 303
15.10.2 Leg Ulcers, Deficient Wound Healing .304
15.10.3 Eczema, N eurodermitis . . . . . .304
15.10.4 Psoriasis . . . . . . . . . . . . . .304
15.10.5 Herpes Zoster, Zoster Neuralgia .304
15.10.6 Herpes Simplex . . . . . . . . · 305
15.11 Disorders of the Sense Organs . · 305

15.11.1 Deafness . . . . . . . . . . . . · 305
15.11.2 Tinnitus . . . . . . . . . . . . · 305
15.11.3 Meniere's Syndrome, Dizziness, Motion Sickness, Labyrinthitis. . · . 306
15.11.4 Chronic Conjunctivitis .306
15.11.5 Glaucoma Simplex · 306
15.11.6 Visual Deficiency . . . .307
15.12 Acute Disorders and Emergencies . .307

15.12.1 Fainting, Collapse . . . . . . .307
15.12.2 Epileptic Fits, Grand Mal. . .307
15.12.3 Acutely Painful Conditions . .307
Appendixes A - H . . . . . . . . . . . .308
A. World Health Organization List ofIndications for Acupuncture · . 309
B. Nomenclature and Abbreviations for Channels and Points · . 310
C. Glossary of Chinese Terms . . . . . . . . . . . . . . . · . 311
D. Translation of Chinese Ideograms and Point Names. · 315
E. Alphabetic List of Chinese Point Names . . . . . . . · 326
F. Index ofIndications for Acupuncture . . . . . . . . . .329
G. Historical Illustrations from the Golden Mirror of Medicine · 331
H. System of the Five Phases .334
Literature . . · 335
Subject Index · 339

1 Scientific Basis of Acupuncture
B.Pomeranz
In this chapter we review 228 of modem scientific studies on acupuncture. As most

research has focused on acupuncture analgesia (AA) this will be the major topic. Two
main conclusions are drawn: first that AA is effective in treating chronic pain (working
better than placebo), and second that the neurological mechanisms of AA are rapidly
becoming apparent. We conclude that acupuncture activates small myelinated nerve
fibres in the muscle, which send impulses to the spinal cord, and then activates three
centres (spinal cord, midbrain and pituitary-hypothalamus) to cause analgesia. The
spinal cord centre uses enkephalin and dynorphin to block incoming painful informa-
tion. The midbrain centre uses enkephalin to activate the raphe descending system
which inhibits spinal cord pain transmission using the monoamines (serotonin and
norepinephrine). The third centre is the hypothalamus-pituitary, which releases beta
endorphin into the blood and cerebrospinal fluid to cause analgesia at a distance. Thus
all three endorphins (enkephalin, beta endorphin, and dynorphin) have a role in AA,
and two monamines (serotonin and norepinephrine) are also involved. When high fre-
quency low intensity stimulation is used a non-endorphin type of analgesia occurs.
Unfortunately, much less research has been done into the other claims made in addi-
tion for acupuncture, and these will be given less coverage (Sects. 1.3 and 1.4). Finally,
the specificity of acupuncture points will be discussed in Section 1.5.
1.1 Acupuncture Analgesia (Basic Research)
Western scientists only began to take acupuncture seriously in 1972 after diplomatic
visits to China increased in frequency. In the ensuing years delegations of American
physicians were especially impressed by major surgery performed in China on awake
patients, in whom pain was greatly reduced by acupuncture analgesia (AA). Instead of
twirling the acupuncture needles by hand according to the ancient methods, needles
were electrically stimulated at approximately the same low frequency (2-4 Hz). This is
much more convenient than having acupuncturists reach under the sheets on the
operating table to manipulate the needles manually for 3 h during surgery. The new
method is called electro acupuncture (EA). Visitors were told that over 400,000 major
surgical procedures had been done in China in the 1960s using AA. Now that chemical
anaesthetics are more readily available in China, fewer than 10% of patients continue
to get AA, because it is rather difficult to administer, is more time consuming and is not
100% reliable, failing to work in many cases. In addition, AA is not used for abdominal
surgery because muscle relaxation is not possible. AA requires that patients be care-
fully selected and trained to ensure that they will not become squeamish during sur-
gery. Even when AA abolishes most of the pain, many conscious patients cannot toler-
ate the emotional stress of the operation. For this reason many operations were done
on medicated patients (given tranquillizers, opiates etc.), and this has raised consider-
able controversy as to how effective AA is for surgical procedures. Recent statements
from China suggest that some deception was used during the Mao regime to exagger-
ate the claims of AA for surgery: supplementary drugs were often used when they
claimed that no drugs were administered.
In recent years in the west, AA has been restricted mainly to the treatment of chronic
pain and has not been used for surgical procedures except for demonstration purposes.
In some western countries, however, AA is used in combination with nitrous oxide
(sufficient N 20 being given to render the patient unconscious, but not enough for
analgesia) [76]. However, even for the treatment of chronic pain, many western physi-
cians were sceptical at first, despite a vast body of anecdotal evidence from both China
and Europe.
How could a needle in the hand possibly relieve a toothache? Because such phenom-
ena did not fit into the existing knowledge of physiology, scientists were puzzled and
sceptical. Many explained it by the well-known placebo effect which works through
suggestion, distraction or even hypnosis [199, 200]. Indeed, in 1945 Beecher [11] had
shown that morphine relieved pain in 70% of patients, while sugar injections (placebo)
reduced pain in 35% of patients who believed they were receiving morphine. Thus,
many medical scientists in the early 1970s assumed that AA worked by the placebo
(psychological) effect. However, there were several problems with this idea. How does
one explain its use in veterinary medicine over the past 1000 years in China and for
approximately 100 years in Europe, and its growing use on animals in America? Ani-
mals are not suggestible and only a very few species are capable of the still reaction (so-
called animal hypnosis). Similarly, small children respond to AA. Moreover, several
studies in which patients were given psychological tests for suggestibility did not show
a good correlation between AA and suggestibility [98]. Hypnosis has also been ruled
out as an explanation, as there have been two studies [7, 61] showing that hypnosis and
AA respond differently to naloxone, AA being blocked and the hypnosis being unaf-
fected by this endorphin antagonist.
Up to 1973 the evidence for AA was mainly anecdotal, with a huge collection of case
histories from one quarter of the world's population. Unfortunately, there were few
scientifically controlled experiments to convince the sceptics. In the past 13 years, how-
ever, the situation has changed considerably. Scientists have been asking two impor-
tant questions. First, does AA really work (that is by a physiological rather than a
placebo/psychological effect)? Second, if it does work, what is the mechanism?
The first question (does it work?) had to be approached by way of controlled experi-
ments to factor out placebo effects, spontaneous remissions, etc. These have been car-
ried out in clinical practice on patients with chronic pain (see Sect. 1.2), in the labora-
tory on humans, studying acute laboratory-induced pain (see Sect. 1.5), and in animals
(see Sect. 1.5). From numerous studies it can be concluded that AA works much better
than placebo.
Hence AA must have some physiological basis. But what are the possible mechanisms?
Only the answer to the second question (how does AA work) could possibly dispel the
deep scepticism toward acupuncture.
1.1.1 Neural Mechanisms of Acupuncture Analgesia
Ten years of research in our laboratory, coupled with over a hundred papers from the
western scientific literature led to a compelling hypothesis. (With the exception of
16 studies, very few papers published in China are cited, as this is a review of the west-
ern literature.) Figures 1-3 summarize various aspects of the hypothesis of the neural
mechanism of AA. First we will explain the figures, and then present the detailed evi-
dence for the hypothesis. Figure 1 shows how pain messages are transmitted from the
skin to the cerebral cortex. First we will explain the schematics. On the left is skin with
a muscle beneath it in the lower left comer. An acupuncture needle penetrates the mus-
cle. The next rectangle is spinal cord, and to the right are rectangles depicting various
Acupuncture Analgesia (Basic Research) 3
Painful
Stimulus
Skin
Muscle
Acu H---+I- 1-1--.---+( I

Needle
legend:
--+ ...
Painful Direction of lene
Excitatory
Synapse
~
Inllibitory
Synapse
~o
I
StillU1us IIIPU1ses Cell sensory lene Blood
ST1=$pinotlla1aic Tract
Acupuncture
Ieed1e
D
sensor, Receptor
Vessel
Fig.1. Pain Transmission
brain structures: midbrain, thalamus, pituitary-hypothalamus and cerebral cortex. As

shown in the legend to Fig. 1, open triangles show excitatory terminals (exciting at the
synapse) and closed triangles, inhibitory terminals. Large arrows indicate the direction
of flow of impulses in the axons, small arrows, the painful stimulus.
In order to understand the pain transmission shown in Fig. 1, follow the thick arrows at
the top. An injury to the skin activates the sensory receptors (squares) of small afferent
nerve fibres (labelled 1) of A delta and C axon size. (Nerve fibres are classified by size
according to whether they originate in skin or muscle: large myelinated nerves A beta
[skin] or type I [muscle] carry "touch" and proprioception, respectively. Small myeli-
nated A delta [skin] or types II and III [muscle] carry "pain"; the smallest unmyeli-
nated C [skin] and type IV [muscle] carry "pain". Types II, III, IV and C also carry non-
painful messages.) Cell 1 synapses onto the SIT (spinothalamic tract) cell in the spinal
cord (labelled 2). The SIT (cell 2) projects its axon to the thalamus to synapse onto
cell 3, which sends impulses to the cortex to activate cell 4 (probably in the primary
somatosensory cortex). We must point out that this diagram is oversimplified, since
there are at least six possible pathways carrying painful messages from the spinal cord
to the cortex, but for the sake of clarity only the SIT is shown.
For the other cells (cells 5-14) it is best to go to Fig. 2 to see how they operate. In Fig. 2,
the acupuncture needle is shown activating a sensory receptor (square) inside the mus-
cle, and this sends impulses to the spinal cord via the cell labelled 5, which represents
type II and III muscle afferent nerves (small myelinated afferents). Type II afferents
are thought to signal the numbness of "de qi" needling sensations and type III, the full-
ness (heaviness) sensation [201]. If soreness is also felt that is carried by unmyelinated
type IV afferents from the muscle (but soreness is not usually part of the "de qi" sensa-
tions). In some acupuncture points there are no muscles (e.g. at finger tips, over major
nerve trunks), and here different fibres are involved. (If cutaneous nerves are activated
the A delta fibres are the relevant ones.) Cell number 5 synapses in the spinal cord onto
an ALT (anterolateral tract) cell (labelled 6) which projects to one to three centres; to
the spinal cord, to the midbrain~ and to the pituitary-hypothalamic complex.
Painful
Stimulus
Skin
Muscle
Acu
Needle
O-<l -<] ~
~9
~d; Excitatory Inhibitory
Synapse Synapse
o
Horlone lIerve
Release Cell lIerve Vessel
~
Direction of Ilpuises I Acu lIeedle Sensory
Receptor
--..
Painful Stillulus
ALT=Anterolateral Tract DLT =Dorsolateral Tract
STT=Spinothalallic Tract "="onoallines E=Endorphins
Fig. 2. Acupuncture (Low Frequency High Intensity)
Within the spinal cord, cell 6 sends a short segmental branch to cell 7, which is an
endorphinergic cell. This cell releases either enkephalin or dynorphin, but not beta
endorphin. There are three families of endorphins: enkephalin, beta endorphin and
dynorphin, and these are all labelled E in Fig. 2. The receptors for en kephalin, beta
endorphin and dynorphin are delta, mu and kappa, respectively. The spinal cord
endorphins cause presynaptic inhibition of cell 1 (preventing transmission of the pain-
ful message from 1 to 2). As there are very few axo-axonal synapses between cell 7 and
cell 1, it is thought that the endorphin peptides merely diffuse to the receptors located
on the terminals of cell 1. There are also postsynaptic endorphin synapses acting
directly onto cell 2 from cell 7, though these are not shown. Thus, enkephalins and
dynorphins block pain transmission at the spinal cord level. (Note further that cell 7
can also be activated by descending activity from cell 11 via the dorsolateral tract [D L1]
to be described below.) The presynaptic inhibition probably works by reducing calcium
current inflow during the action potential in the terminals of cell 1, resulting in reduced
release of the pain transmitter. (The pain transmitter which connects cells 1 and 2 is not
known: glutamate, substance P and ATP have been suggested but the evidence is not
clear on this matter; it is known that endorphins reduce the release of substance P.)
What the diagram does not show are the numerous peptides present in the terminals of
cell 1, (among these are cholecystokinin, somatostatin, neurotensin, bombesin, calci-
tonin gene-related peptide, angiotensin, substance P, and vasoactive intestinal
peptide). So far only cholecystokinin (CCK) has been shown to playa role in AA [71],
acting like naloxone, the opiate antagonist, to block endorphin-mediated AA (perhaps
the ratio of CCK and endorphins is the important variable in producing analgesia).
The roles of the other peptides in pain and analgesia are not known, partly because
good antagonists are not available.
Cell 6 also projects to the midbrain, ascending the spinal cord in the ALT. Here it
excites cells in the periaqueductal grey (PAG; cells 8 and 9), which releases enkephalin
to disinhibit cell 10 (which is thus excited) and in tum activates the raphe nucleus (the
raphe nucleus is located in the caudal end of the medulla oblongata [cell 11]) causing it
to send impulses down the DLT to release monoamines (serotonin and norepineph-
rine; labelled M) onto the spinal cord cells [67]. Cell 2 is inhibited by postsynaptic inhi-
bition, while cell 1 is presynaptically inhibited via cell 7 (cell 7 is excited while cell 2 is
inhibited by the monoamines). Either of the two monoamine mechanisms can suppress
the pain transmission. In addition to the raphe magnus, which releases serotonin onto
the cord, there is the adjacent reticularis paragigantocellularis (not shown), which may
release norepinephrine via the DLT onto the spinal cord (norepinephrine binds to an
alpha receptor in the cord to block pain transmission). Some believe that serotonin and
norepinephrine act synergistically in this regard [65]. There is some evidence that the
peptide neurotensin may be the excitatory transmitter between cells 10 and 11 [9]. The
precise relationship of these descending monoamine effects to AA is not clear at pre-
sent, and results suggest that some of the raphe serotonin effect in AA may be me-
diated by ascending fibres from the raphe to the forebrain (not shown). More work is
needed on the role of the monoamine system in AA.
Even less well understood is the action of cell 6 onto cells 12 and 13 (the pituitary hypo-
thalamic complex), where cell 12 in the arcuate nucleus may activate the raphe via beta
endorphin and cell 13 in the hypothalamus may release beta endorphin from the pitu-
itary gland. While there is some agreement that AA is accompanied by elevated beta
endorphin in the CSF (and blood) and that pituitary lesions suppress AA, there is no
agreement on how the beta endorphin from the pituitary reaches the brain to cause
analgesia. Too little reaches the blood to cross the blood-brain barrier in sufficient
quantities to produce analgesia. Some evidence suggests that the pituitary-portal
venous system can carry hormones in a retrograde direction directly to the brain [13].
Perhaps cell 14 can influence cell 9 as shown by the thin arrows, without having to
cross the blood-brain barrier. If so, the role of circulating endorphins in the blood is
unclear. However there is an important correlate of pituitary beta endorphin release:
ACTH and beta endorphin are both coreleased on an equimolar basis into the circula-
tion [161] (they are both made from a common precursor). The ACTH travels to the
adrenal cortex, where cortisol is released into the blood, which may explain why acu-
puncture is helpful in blocking the inflammation of arthritis and the bronchospasms of
asthma (the doses of cortisol released by acupuncture are small and finely regulated,
thus avoiding the side effects of cortisol drug therapy).
Figures 2 and 3 show the importance of the parameters of stimulation. During EA,
stimulation at low frequency and high intensity is thought to activate all three centres
(Fig. 2) and to use all the endorphin mechanisms in them [30]. Hence it is antagonized
by naloxone. On the other hand, high-frequency (low-intensity) stimulation activates
only two centres in Fig. 3 : the midbrain (it bypasses the endorphin synapses there) and
the spinal cord. In the rest of this chapter low frequency is given with high intensity
and high frequency with low intensity stimulation. High-frequency AA is not blocked
by naloxone, but is sensitive to manipulations of monoamines [33]. In addition, high-
frequency acupuncture has a strong segmental effect, which is not antagonized by
naloxone, suggesting that cell 7 uses non-endorphinergic transmitters (e. g. GABA,
gamma aminobutyric acid). (Because of insufficient data we have left out other centres
implicated by some experiments in the AA-endorphin effects: these include the
nucleus accumbens, amygdala, habenula, and anterior caudate [75, 224].) In Fig. 2 the
axon from the SIT cell (cell 2) can be seen to have a collateral fibre dropping down to
excite cell 8 in the midbrain to cause analgesia. In 1979, Le Bars et al. [90 a] discovered
a phenomenon called DNIC (diffuse noxious inhibitory control), in which one pain
inhibits another. Its role in AA is not established.
In summary, acupuncture activates nerve fibres in the muscle, which send impulses to
Painful
Stimulus
Skin
Pituitary
Hypothal
@
0
Muscle
Acu I-+---+-+- 1tI.......--I~'k'(

@~
legend: n --<1 ~
~9
A
--+ ~ Excitatory Inhibitory
Horlone llerve Synapse Synapse
Release Cell
D lerve Vessel
Dlrec~ lipuises I Icu leedle Sensory
Receptor
----...
Painful Stillulus
ALl=Anterolateral Tract DLl =Dorsolateral Tract
ST1=Sp1nothaI8lic Tract "="onoalines E=Endorphins
Fig. 3. Acupuncture (High Frequency, Low Intensity)
the spinal cord and activate three centres (spinal cord, midbrain, and hypothalamus-
pituitary) to cause analgesia. The spinal site uses enkephalin and dynorphin to block
incoming messages with stimulation at low frequency, and other transmitters (perhaps
GABA) with high-frequency stimulation. The midbrain uses enkephalin to activate the
raphe descending system, which inhibits spinal cord pain transmission by a synergistic
effect of the monoamines, serotonin and norepinephrine. The midbrain also has a cir-
cuit which bypasses the endorphinergic links at high-frequency stimulation. Finally, at
the third centre, the hypothalamus-pituitary, the pituitary releases beta endorphin into
the blood and CSF to cause analgesia at a distance (e. g. the midbrain). Also the hypo-
thalamus sends long axons to the midbrain and via beta endorphin activates the des-
cending analgesia system. This third centre is not activated at high-frequency, only at
low-frequency stimulation.
What is the practical significance of this three-level system? When needles are placed
close to the site of pain, or in the tender (trigger, or ah shi) points they are maximizing
the segmental circuits operating at cell 7 within the spinal cord, while also bringing in
cells 11 and 14 in the other two centres (Fig. 2). When needles are placed in distal
points far away from the painful region they activate the midbrain and hypothalamus-
pituitary (cells 11 and 14) without the benefit of local segmental effects at cell 7.
(Cells 11 and 14 produce analgesia throughout the body, while cell 7 produces analge-
sia locally.)
Local segmental needling usually gives a more intensive analgesia than distal non seg-
mental needling, because it uses all three centres. Generally the two kinds of needling
(local and distal) are used together, to enhance one another. Another important practi-
cal consequence of this system is the frequency/intensity effect. As shown in Fig.2,
low-frequency (2-4 Hz), high-intensity needling works through the endorphin system
and acts in all three centres, while a high frequency (50-200 Hz) and a low intensity
only activates cells 7 and 11, bypassing the endorphin system, as seen in Fig. 3. Numer-
ous studies have shown that the types of analgesia produced by these two approaches
are quite different [3]: the low frequency produces an analgesia of slower onset, and
more importantly, of long duration, outlasting the 20-min stimulation session by
30 min to many hours. Also, its effects are cumulative, becoming increasingly better
after several treatments. The high-frequency analgesia, in contrast, is rapid in onset but
is very short lasting, with no cumulative effects. Many authors have arbitrarily
described the low-frequency type of analgesia as "acupuncture-like" TENS, when it is
produced with TENS (transcutaneous electrical nerve stimulation) and the high-fre-
quency analgesia as true TENS. This arises from the history of TENS based on the
"gate" theory of pain [122], which stated that: large-diameter touch fibres inhibit small-
diameter pain inputs to the spinal cord: high frequency would optimize the "closing of
the gate", as it increases the presynaptic inhibition caused by GABA. Low intensity
would also activate the large diameter fibres that are so important in the gate theory.
Segmental effects in the spinal cord were originally thought to predominate, so that
TENS electrodes were usually placed close to the site of pain. The short onset and
short duration of TENS fit well with the known time-course of presynaptic inhibition
(subsequent work has shown that the midbrain also plays a role in high-frequency
analgesia, as shown in Fig. 3). In contrast, low-frequency, high-intensity AA was desig-
nated acupuncture-like because manual needle twirling was at a low frequency
(2-4 Hz) and was aimed at producing the de qi sensation, thus requiring intense stimu-
lation which activates small fibers (type II and III). When TENS electrodes are used
(instead of needles) at low frequency, a very strong current must be used (> 20 mA) to
achieve this form of analgesia (i. e. low frequency, high intensity). For low-frequency
acupuncture-like TENS acupuncture points are frequently used, often at a distance
from the segment serving the painful site. Obviously the distinction between TENS
and EA is arbitrary, as EA can be given at either low or high frequency, segmentally or
nonsegmentally, and at high or low intensity. The same is true for TENS. The impor-
tant fact to emphasize here is that both methods stimulate nerve fibers. Hence,
throughout this chapter we will draw on the two data bases for information about
mechanisms involved (however, with a greater emphasis on needles for those purists
who want to keep a distinction between EA and TENS). Perhaps the major difference
between TENS with pads and acupuncture with needles is not in the frequencies used
but rather in the intensities delivered, and hence in the particular nerve fibers activated.
AA depends on deqi sensations, but TENS does not. Recent evidence has shown that
type II and III muscle afferents are activated during de qi sensations [201], with numb-
ness caused by type II and heaviness by type III (occasionally soreness occurs, which is
mediated by type IV). This will be dealt with more fully in Section 1.5, but for now it is
sufficient to note that TENS electrodes rarely achieve de qi sensations and hence prob-
ably activate only large diameter afferents. Recently we helped to develop a TENS
device which can produce de qi sensations, and have achieved more long-lasting anal-
gesic effects than with other TENS devices [33]. This has reduced the difference
between TENS and acupuncture.
As mentioned above, it appears that low-frequency analgesia produces a cumulative
effect, so that repeated treatments produce more and more benefit to the patient [111,
156, 198] or laboratory animal [152]. This could be due to long-lasting effects of endor-
phins in the low-frequency system. Most TENS high-frequency devices must be worn
continuously by the patients, as the effect is of short duration, and in over 70% of cases
the effectiveness wears off after some months of continuous use because tolerance
develops [211]. In contrast, low-frequency acupuncture need only be given daily (or
twice a week), because of its long-term cumulative effects [156]. Indeed, too-frequent
application of low frequency acupuncture produces tolerance; for example, if applied
continuously for 6 h, acupuncture causes the analgesia to weaken and disappear [70].
This effect is cross tolerant with morphine tolerance [70] and the mechanisms involved
may be those of addiction to endorphins. Hence spacing the acupuncture treatments
with long enough intervals may prevent tolerance while promoting the cumulative
effects. Perhaps the failure of some western clinics to achieve success is due to the use
of very infrequent treatment (e. g. l/week) and the termination of treatment after five
to ten sessions. In some clinics in Asia patients are treated daily for a month then
weekly for 6 months, and the results reported anecdotally are excellent. Of course,
some patients will never respond to acupuncture for various reasons: non-responders
may be genetically deficient in opiate receptors; we have shown that mice genetically
lacking endorphin receptors respond poorly to acupuncture [138]. Others may be defi-
cient in endorphin molecules: rats lacking endorphin compounds responded poorly to
acupuncture [126]. Hence in clinical practice a strategy must be developed to allow
non-responders to be recognized while not aborting therapy too soon for potential
responders who might show delayed cumulative effects. (One way is to decide after
5 treatments: if there is no benefit whatsoever, abort; if mild to moderate effects occur
continue and reassess after 10-15 treatments.) Often the cost of repeated office visits is
prohibitive. Hence we have developed a home TENS device (which gives de qi sensa-
tions): this can be used over acupuncture points by the patient at home for 30 min a
day for several months [33]. However, among 3000 patients anecdotally observed,
10%-20% did not benefit from these devices, as they could not tolerate sufficiently
strong stimulation to obtain de qi.
Most textbooks might have ended this discussion of AA right here. However, because
acupuncture is so controversial, and relatively new to western medicine, more data are
needed to convince the student that the acupuncture mechanisms outlined in Figs. 1-3
are well established. Those who are in a hurry can skim or skip the next few pages, but
should nonetheless scrutinize the reference list (this omits a huge literature from China
which, if included, would double the number of citations). It should be apparent that
we know more about AA than about many chemical drugs in routine use (for example,
we know very little about the mechanisms of action of most anaesthetic gases, but we
continue to use them regularly). The reader is also referred to recent reviews [67, 120,
143, 146].
1.1.2 Evidence for Endorphins and Acupuncture Analgesia
Perhaps the most exciting experiments, which opened up the field of AA to scientific
research, were those in which endorphin antagonists (e. g. naloxone, naltrexone) were
used. That naloxone could antagonize AA was reported initially by two groups:
Mayer et al. [116], studying acute laboratory-induced tooth pain in human volunteers,
produced AA by manual twirling of needles in LI. 4 (first dorsal interosseus muscle of
the hand). In a double-blind design they gave one group of subjects i. v. naloxone and
another group received i. v. saline. The saline group showed AA with a time-course
typical of clinical reports (30 min to onset of analgesia and effects lasting for over 1 h).
The naloxone-treated group showed no AA. As there were no controls receiving nalox-
one alone, one might argue that naloxone hyperalgesia simply subtracted from the
analgesia of AA. However, this is probably not the case, since numerous studies on
acute laboratory-induced pain have shown that naloxone alone rarely produces hyper-
algesia [60]. (This suggests that endorphins do not have a basal tone during acute pain.)
Mayer et al. [116] did have a control group of subjects receiving placebo injections. The
placebo subjects were told to expect a strong analgesic effect, and none was observed
(as predicted from Beecher's work on acute pain, where only 3% of subjects reported
placebo analgesia [11]).
The other early naloxone study was by Pomeranz and Chiu [149] in awake mice; they
used the mouse squeak latency paradigm and electroacupuncture (EA) at LI. 4.
Numerous control groups were used in this experiment in an attempt to pick out some
of the possible artifacts. Each group received one of the following: EA alone; EA plus
saline; EA plus i. v. naloxone; sham EA in a non-acupuncture point; naloxone alone;
saline alone; and no treatment at all Gust handling, restraint and repeated pain testing).
The results were unequivocal: naloxone completely blocked AA; sham EA produced
no effect; and naloxone alone produced very little hyperalgesia (not enough to explain
reduction of AA by subtraction). Moreover, the results in mice and in humans indi-
cated, first, that AA was not a psychological effect and secondly, that AA was truly
blocked by naloxone. In another study, Cheng and Pomeranz [29] plotted a dose-
response curve for naloxone and found that increasing doses produced increasing
blockade. In a third study in anaesthetized cats, Pomeranz and Cheng [148], recording
from layer-5 cells in the spinal cord (cell 2 in Fig.l), completely prevented the EA
effects with i. v. naloxone.
Since these early papers there have been numerous studies in which systemically
administered endorphin antagonists have been used to test the endorphin AA hypothe-
sis. Although most researchers reported naloxone antagonism [17, 21, 25, 29, 30, 31,
39,53,63,88,92,136,138,148,149,152,166,172,173, 176, 177, 181, 189, 194,210,213,
224,225], a few did not find any effects of naloxone [1, 23, 24, 140, 187, 198, 214]. Three
of these seven naloxone failures were recorded with high-frequency, low-intensity
stimulation, which is probably not endorphinergic [1, 198, 214]. In one of the failures
[24] low-intensity stimulation was used, which did not lead to de qi sensations: in spite
of this four of seven subjects in that study showed naloxone antagonism. While the rea-
sons for the other three negative papers are not entirely clear, a possible explanation
has recently emerged. Antagonists work best when given before the treatment [147,
202], and fail to reverse analgesia that has already been initiated. Thus, naloxone can
prevent but often cannot reverse AA. (In the three failed experiments researchers tried
to reverse AA, giving the endorphin antagonist after, not before, the acupuncture treat-
ments.) There may be a good reason for this failure of naloxone to reverse AA:
naloxone binds poorly to kappa receptors, which might explain the difficulty in over-
coming dynorphin-mediated AA with it. The evidence for this statement is the follow-
ing: as noted in Fig. 2, dynorphin acts in the spinal cord to mediate AA. In an elegant
experiment, Han et al. [68] showed that intrathecal administration of dynorphin anti-
serum blocked AA in rabbits. This proves that spinal cord dynorphin mediates AA. In
the same paper they showed that dynorphin given intrathecally caused a similar anal-
gesic effect, but that it was difficult to reverse the analgesia with naloxone given after
dynorphin, though naloxone could block it when given before dynorphin administra-
tion [68]. A similar result was reported by Basbaum et al. [9], who gave dynorphin
intrathecally and found they could prevent the analgesia, but not reverse it, with nalox-
one. Another explanation for this failure of naloxone to reverse endorphinergic
analgesia is put forward by Watkins and Mayer [202]: perhaps the endorphins set up a
cascade effect whereby the subsequent events use other neurotransmitters and endor-
phins are no longer required. (Watkins and Mayer [202] proposed a modulatory effect
of endorphins on synapses using other transmitters.) Since the naloxone effect (even
on kappa receptors) is one of competitive inhibition, by raising the dose of naloxone
one should be able to displace dynorphin and hence reverse the AA. In our study we
used 28 l!g naltrexone intrathecally (14 times the usual dose) and still could only pre-
vent, not reverse, the AA [147]. Taken together, the overwhelming weight of evidence
shows that naloxone antagonizes AA and that the few negative results may be due to
poor timing of the naloxone administration.
A few weeks after the first naloxone results were announced in the research news sec-
tion of Science [112], a letter to the editor in the same journal justifiably criticized the
use of naloxone as the sole proof of the acupuncture-endorphin hypothesis [74]. This
criticism is based mainly on the argument that naloxone is a drug that might possess
unknown side effects (unrelated to opiate receptor blocking). Small doses which were
effective in reversing AA (in man 5 x 10- 8 M, in mice and cats 10- 6 M) would tend to
implicate receptor effects: but the effectiveness of small doses of naloxone is clearly
not enough evidence to prove specificity [168]. However, since that letter was written
nine different lines of experimentation have emerged which have independently
provided support for the AA-endorphin hypothesis:
1. Four different opiate antagonists block AA.
2. Naloxone has a stereospecific effect.
3. Microinjection of naloxone (or antibodies to endorphins) blocks AA only if given
into analgesic sites.
4. Mice genetically deficient in opiate receptors show poor AA.
5. Rats deficient in endorphin show poor AA.
6. Endorphin levels rise in blood and CSF during AA, and fall in specific brain regions
duringAA.
7. AA is enhanced by protecting endorphins from enzyme degradation.
8. AA can be transmitted to a second animal by CSF transfer or by cross-circulation,
and this effect is blocked by naloxone.
9. Reduction of pituitary endorphins suppresses AA.
Details of the nine lines of evidence supporting the AA-endorphin hypothesis are as
follows:
1. Using a battery of different endorphin blocking agents, Cheng and Pomeranz [29] in
the mouse squeak paradigm observed that small doses of cyclazocine, diprenor-
phine or naltrexone all blocked AA in the same manner as naloxone. This helps to
rule out non-specific naloxone actions, since it is highly unlikely that all four endor-
phin antagonists have the same side effects.
2. Using the same mouse paradigm, Cheng and Pomeranz [29] showed that stereospe-
cific receptors are involved in AA. When they injected dextronaloxone, an inactive
stereoisomer (in vitro it is 1000times weaker than naloxone), it was shown to be
completely ineffective. Since the most likely side effects of naloxone would probably
stem from (non-receptor) membrane fluidization, the stereospecificity of naloxone
rules out most of the possible side effects. This result suggests that a stereospecific
endorphin receptor mediates AA, and hence endorphins must be involved.
3. It has been reported from several laboratories that microinjection of naloxone into
the midbrain periaqueductal grey (PAG) [224] or intrathecally over the spinal cord
[136] decreases AA in rats and rabbits; other sites which do not contain endorphins
show no naloxone effects. This further proves the mediation by endorphins of AA
and also gives some idea of the brain regions involved.
Perhaps more convincing is the blockade of AA by microinjection of antisera con-
taining antibodies targeted to one of the three major endorphin peptides. When mi-
c roinjected, the antibody helps to specify the site of action of each endorphin pep-
tide (while also confirming the AA-endorphin hypothesis). Thus, antidynorphin [68]
or antienkephalin [72] (but not anti-beta endorphin) blocks AA when given intrathe-
cally onto the spinal cord of rabbits, whereas microinjection into the PAG of
antienkephalin and anti-beta endorphin (but not antidynorphin) blocks AA [68, 72,
217]. These results are extremely important, as they fit perfectly with the known dis-
tribution of these compounds and their physiological effects. Thus, the spinal cord
has enkephalin and dynorphin, but very little beta endorphin, while the PAG has
enkephalin and beta endorphin but little dynorphin. Moreover, microinjection of
dynorphin only causes analgesia in the spinal cord, and not in the PAG [68]. Also, it
is now agreed that much of the endorphin released during AA into spinal cord lum-
bar CSF of humans is dynorphin [175]. These antisera experiments are very costly
owing to the large amounts of high-strength purified antisera needed, and they are
among the most elegant reported in the AA literature. Han did them in collaboration
with Lars Terenius and Avrum Goldstein, who provided the antisera. This also
underscores the priorities given to this AA work by these eminent endorphin scien-
tists.
In our own experiments with intrathecal naltrexone (a long-acting endorphin antag-
onist), we confirmed the importance of prevention rather than reversal of AA (as
mentioned above) [147]. Moreover, we found a new phenomenon, that of potentia-
tion of AA by repeated EA treatment (EA was given twice in succession, with a
90-min interval). This AA could only be prevented by giving intrathecal naltrexone
before the first EA treatment [152]. This potentiation must not be confused with tol-
erance, which arose when EA was given continuously over 6 h, ultimately leading to
suppressed AA [70]; this suppression lasted for 24 h.
Another result obtained with intrathecal injections and lending support for the AA-
endorphin hypothesis was that recorded with cholecystokinin (CCK), a peptide in
spinal cord that is thought to behave like naloxone, blocking morphine analgesia
and footshock analgesia [115]. Han et al. [71] showed that intrathecal CCK blocked
AA in the rat, further supporting the endorphin hypothesis. Moreover, they found
that antisera containing CCK antibodies reversed the tolerance to repeated AA, sug-
gesting that tolerant rats may release CCK, leading to weakened responsiveness to
the endorphins released by AA. Finally, CCK antisera converted non-responders to
responders in the AA paradigm [71]. Perhaps non-responders release too much CCK
along with endorphins.
Another study of microinjection in the PAG implicated a metenkephalin precursor
(metenkephalin-arg 6-phe 7) (MEAP) in AA in rabbits: when captopril (an enzyme
inhibitor preventing degradation of this peptide) was injected it enhanced AA [38].
This captopril effect was abolished by antisera to MEAP, microinjected into the
PAG. MEAP is 3 times more potent than enkephalin and 3 times less potent than
morphine, but the question of whether it is the major transmitter in the PAG needs
further study. In another intrathecal study of AA the enzyme inhibitors captopril
and bestatin both enhanced the analgesia by preventing enzyme degradation of
endorphins. The authors argued that captopril enhanced the met-enkephalin-arg-
phe molecules and bestatin enhanced the shorter met-enkephalin peptides [38].
4. Peets and Pomeranz [138] designed an experiment to test the AA-endorphin hypoth-
esis without injecting any drugs by using genetic tools (hence side effects of nalox-
one cannot be implicated). They bred a strain of mice, CXBK, which had previously
been shown to respond poorly to morphine because of a congenital deficiency of
endorphin receptors [8]. As these mice have only 50% of the usual endorphin recep-
tor activity, they gave less than half the usual EA analgesia, proving the necessity for
endorphin receptors. Moreover, the after-effect (prolonged time course) of AA was
much shorter than normal. Roy et al. [162] showed that these CXBK mice have nor-
mal brain endorphin levels, suggesting that the entire deficiency is located at the
receptors. Peets and Pomeranz [138] speculated that the 30% of humans who do not
experience morphine analgesia or AA might have some genetic deficiency in the
endorphin system.
5. Another reason was found to explain the failure of AA in some subjects. Takeshige
et al. [126] studied EA analgesia in rats and observed that 40% of rats failed to de-
monstrate AA. These same animals were then sacrificed (2 weeks later) and were
found to be deficient in endorphins measured by receptor-binding assay. This corre-
lation of AA and endorphin brain levels further supports the AA-endorphin hypo-
thesis. Moreover, Takeshige was able to convert non-responders into responders by
giving them D amino acids to enhance endorphin effects by preventing enzyme
degredation from peptidase [181].
6. Important evidence w)1ich confirms the AA hypothesis comes from measurement of
endorphins in brain, cerebrospinal fluid (CSF) or blood before and after acupunc-
ture. In the first such study, Sjolund et al. [175] collected CSF by lumbar puncture
from patients with chronic pain treated with acupuncture-like TENS of acupoints.
They measured CSF endorphin levels before and immediately after treatment.
When treating backache by segmental acupoints (segmental AA) in the lumbar
region, they observed doubling of CSF levels of endorphins immediately after
30 min of treatment. However, when they treated face pain by acupoints in the hand
(LI. 4) they observed no changes in lumbar CSF endorphin levels. This result sug-
gested that a local (segmental) release of endorphins occurred in the backache
patients (since lumbar acupoints were used and lumbar CSF was measured); in the
LI. 4 study the hand stimulation did not elevate endorphins in lumbar CSF, since
remote segments were stimulated (cervical 8 rather than lumbar 5). The CSF endor-
phins were measured by receptor-binding assays which did not reveal which peptide
was involved. Using Sephadex columns to characterize the endorphins, they noted
that only fraction 1 was changed by AA. It is very likely that much of fraction 1 was
dynorphin. In another study CSF metenkephalin was measured by radioimmuno-
assay (RIA) in awake rabbits after acute cisternal punctures: Zou et al. [225]
observed this rise in metenkephalin secretion after 30 min of AA only when they
protected peptides from peptidase destruction using bacitracin. More recently a
group working at NIH in Bethesda has confirmed these results: using push-pull can-
nulae in awake rats given EA in the ears, they observed a rise in fraction 1 measured
by receptor binding assay and in beta endorphin measured by RIA of the CSF. They
also observed a drop in brain endorphin levels in the hypothalamus, medial thala-
mus and PAG when the rats were sacrificed, suggesting release from these sites.
There were no changes in blood levels [139]. With a cannula in the lateral brain ven-
tricle, He et al. [75] used a receptor-binding assay and showed release of endorphins
during AA. Recent studies on rat spinal cord showed elevated metenkephalin levels
(which correlated with the degree of success achieved) during AA [196]. Also during
AA enkephalin were released into lumbar CSF in rats if they were protected from
enzyme attack by peptidase [38]. However, unlike CSF and tissue results, blood mea-
surements of endorphins have been more confusing: in one study beta endorphins
were unchanged but metenkephalin went up in the blood, and this rise correlated
with alleviation of pain in chronic pain patients [85]. Perhaps this could reflect
release of metenkephalin from the adrenal medulla; some studies of footshock
analgesia have implicated this system. In contrast, in two human studies both ACTH
and beta endorphin in the blood were markedly elevated [109, 129]. Also EA pro-
duced a rise in blood cortisol in horses [16, 35] and rabbits [99], while sham EA in
non-acupoints gave no cortisol rise ruling out stress as the cause [35]. In horses Bos-
sut et al. noted a rise in blood beta endorphin and cortisol with EA, but these rises
did not correlate with the AA observed [16]. In patients receiving ear EA for surgery,
plasma ACTH and beta endorphin were elevated: moreover, pretreatment with
hydrocortisone suppressed this response [113] owing to negative feedback suppres-
sion of pituitary function. In normal volunteers blood cortisol increased by 50%, and
when these same subjects were needled at non-acupoints no changes were noted
[94]. It is interesting to note that patients with chronic headache had low plasma beta
endorphins, but failed to show a rise with needling, while normals showed a rise in
plasma beta endorphins with acupuncture [50]. The authors suggested that headache
patients have a poorly reactive pituitary endorphin system.
Until endorphin turnover studies become possible, it is difficult to be certain about
the exact interpretation of all the above endorphin biochemical results. Does a
decreased brain level mean a decreased synthesis, increased release, or increased
breakdown? Do increased CSF levels mean more release or less reuptake? Never-
theless, consideration of all the results together reveals a significant pattern: an ele-
vated CSF level and a decreased brain level at the same time suggest an increased
release during AA.
7. Even more impressive than blocking AA by naloxone is its enhancement by aug-
mentation of the endorphin system (it is always easier to block than enhance a bio-
logical process). A strong piece of evidence for the AA-endorphin hypothesis arises
from using enzyme blockers which protect the endorphin peptides from degrada-
tion. The first to be used were the o-amino acids o-leucine and o-phenylalanine
(normally amino acids are L-isomers). Both Ehrenpreis et al. [49] and our own group
[28] had shown that these compounds caused analgesia which is antagonized by nal-
oxone. This led us to test whether o-amino acids could enhance AA in our mouse
paradigm, and we found that they did [31]. Subsequently Ehrenpreis et al. [49]
showed that o-phenylalanine enhanced AA in humans. Since o-phenylalanine is a
safe drug that has been in use since 1940 (FDA-USA approved) this could become a
useful clinical adjunct to EA. In a recent series of elegang experiments Takeshige et
al. in Japan have shown the following effects of o-phenylalanine in rats:
(a) nonresponders (rats with low brain endorphin levels, who have poor AA
responses) [126] are converted to responders [64], an effect that is antagonized by
naloxone [181]. Thus, when the endorphin system is enhanced with o-phenylalanine
all rats become responsive to AA.
(b) In rats, use of sham (non-acupuncture) points does not normally produce analge-
sia, but these points can become effective if lesions of the centromedian nucleus of
the thalamus (the so-called analgesic inhibitory system are induced. o-phenylala-
nine seems to inhibit this system, as it enables non-acupoints to produce AA [54, 78,
181].
There are some experiments suggesting that d-amino acids are not potent inhibitors
of endorphin degradation in vitro [184]. Other compounds which seem to be more
potent have been used to potentiate AA. For example, intracerebroventricular injec-
tions of bacitracin potentiated AA in rabbits in a naloxone, reversible manner [225].
The same study showed that enkephalin was raised in the CSF only if bacitracin was
used to protect it from enzyme degradation [225]. Another study used intrathecal
antienzymes and found that both captopril and bestatin were effective in enhancing
AA [38]. By perfusing the intrathecal CSF these authors were able to show that cap-
t opril protects enkephalin-arg-phe while bestatin protects regular enkephalin from
enzyme degradation, and thus they proposed that both these forms of the enke-
phalin family are involved in AA [38]. Dynorphin and beta endorphin are less sus-
ceptible to rapid enzyme degradation, and they have not been affected in the
enhancement experiments.
8. At this point a few historically important experiments carried out in China before
endorphins were discovered and which, in retrospect, support the AA endorphin
hypothesis should be mentioned. In one experiment, rabbits were given finger acu-
puncture (massage of acupoints or acupressure) on UB. 60 (Achilles tendon) to pro-
duce analgesia. When CSF was taken from an awake rabbit with AA and transferred
to an awake naive recipient, the non-acupunctured rabbit obviously experienced
analgesia. Both rabbits showed the same time course of AA (delayed onset and pro-
longed effect) [159]. In another experiment in China [105], rats were joined by the
common carotid artery and vein. One rat in each pair was given 70 min of EA. In
recipient (untreated) rats there was also analgesia, with the typical time course. After
the discovery of endorphins and of their possible connection to AA, a more modem
version of the cross-circulation experiment was done using naloxone. Pairs of rab-
bits were joined at the femoral artery and vein. EA was applied to St. 36 (tibialis ante-
rior) and St. 7 (facial nerve). When i. v. naloxone was given prior to EA treatment,
both groups of rabbits showed a complete blockade of AA [92]. This paper suggests
that endorphins from the pituitary, circulating through the bloodstream, may medi-
ate the AA.
9. Another line of evidence suggesting the importance of pituitary endorphins was
gathered from mouse squeak experiments. Pomeranz et al. [153] and Cheng et al. [34]
showed that reduction of pituitary endorphins reduced AA. In one paper they
showed that pituitary removal abolished AA (but see [53]), while sham hypophysec-
tomy did not. In another study they suppressed beta endorphin release by injecting
the steroid dexamethasone (this used the negative feedback effect of steroids on to
ACTH: since ACTH and endorphin are released into the blood together, dexameth-
asone injections suppressed release of both compounds by negative feedback).
Dexamethasone injections 4 h before EA suppressed AA in mice. In humans, ste-
roid injections suppressed a rise in plasma beta endorphin due to EA [113]. In a third
experiment these authors chemically suppressed beta endorphin by another method,
that is by feeding mice 2% saline in the drinking water for 3 days; when this was
done, AA was completely abolished. As stated above, evidence shows that AA is
often accompanied by a rise in blood cortisol ACTH and beta endorphin which
must come from the pituitary.
In summary, ten different lines of research have just been reviewed (the 9 listed plus
the naloxone studies), which cumulate in confirmation of the AA-endorphin
hypothesis. With so much convergent evidence for the AA-endorphin hypothesis, why
are there still sceptics?
1. Some sceptics cite the few failures of naloxone to reverse AA. We have already sug-
gested (above) that naloxone reversal experiments are prone to difficulty because of
dynorphin and the kappa receptor (naloxone prevents but does not reverse AA).
Moreover, the number of successfull naloxone antagonisms of AA far exceed the
number of failures.
2. Sceptics state that naloxone antagonism is necessary but not sufficient evidence.
That is why we have spent several pages presenting ten different lines of evidence
(only one line of evidence depends on naloxone).
3. Some sceptics attack animal studies of AA as being unrelated to AA in humans.
First, there have been numerous experiments in humans which have had the same
AA-endorphin outcome as in lower animals. Secondly, the similarity of results
across many species proves the generality of the phenomenon. Thirdly, there is no
proper objective measure of pain in man. Fourthly, if sceptics are correct, then the
entire animal "pain" literature should be discarded, a literature which gave us our
initial insights into endorphins, brain stimulation analgesia, TENS, and other results
that have proved to be highly applicable to human pain.
4. Some sceptics are concerned that AA in animals may merely be stress-induced
analgesia (which also releases endorphins) and hence have nothing to do with acu-
puncture in humans. At a recent conference on stress-induced analgesia at the
New York Academy of Sciences we gave a lecture entitled: "Relation of stress-
induced analgesia to acupuncture analgesia". Some of the points made in that paper
[144] were:
1. Sham EA on nearby non-acupuncture points in animals induces no AA, thus con-

trolling for stress.
2. AA elicited in anaesthetized rats and cats, or decerebrate cats, does not involve
psychological stress.
3. AA at one frequency is endorphin mediated, while at another it is serotonin medi-
ated; yet both give the same levels of stress.
4. Many mechanisms of stress analgesia are very different from those of AA.
5. Results in mice and rats were obtained with mild stimulation activating A beta
nerve fibres, a non-painful procedure which is no more stressful than sham point
stimulation.
In conclusion, the objections raised by sceptics are easily refuted. The overwhelming
evidence supports the AA-endorphin hypothesis.
1.1.3 Evidence for Midbrain Monoamines and Acupuncture Analgesia
There are numerous papers implicating the midbrain monoamines in AA (especially

serotonin and norepinephrine). As the raphe magnus in the brainstem contains most of
the serotonin cells in the brain, lesions which destroy these cells (or their axons in the
DLT) would presumably impair AA if serotonin were involved (such lesions usually
abolish morphine analgesia, which is mediated by descending inhibition via the raphe-
DLT-serotonin system [9]. Numerous experiments show that lesions to this system
block AA: Lesions of the medial medulla oblongata abolish AA, while lesions of the
raphe magnus or DLT reduce AA [171]. Similarly, electrolytic lesions of the raphe [83]
or chemical lesions induced in this nucleus with 5,6-dihydroxytryptamine [119] decrease
AA. PCPA (parachlorophenylalanine), which blocks biosynthesis of serotonin blocks
AA in the rabbit [119] and in mice [32], and blocks segmental nerve stimulation analgesia
in rats [215]. Methysergide, which blocks serotonin receptors, suppresses peripheral
nerve stimulation analgesia in mice [173], and cinancerin (another serotonin receptor
blocker) blocks AA in mice [32]. In all the above chemical tests of the serotonin-AA
hypothesis, the drugs were given systemically (usually i. p.). Local microinjection
studies, however, produced surprising results, suggesting that the descending serotonin
DLT-inhibitory system may not be as important as the raphe projections to the fore-
brain: intrathecal cinancerin injections over the spinal cord produced no blockade of
AA in rats [136], while lesions of the ascending raphe tracts induced by microinjection of
5,6-dihydrotryptamine into the medial forebrain bundles caused a selective decrease of
cerebral serotonin and a correlated decrease of AA in the rat [66].
Microinjection of cinanserin into the various brain regions confirmed the importance of
ascending serotonin pathways; AA was blocked by injections into the limbic system and
the midbrain PAG [66]. Enhancement of AA is observed in mice [32] and rats [66] when
serotonin is increased by giving 5HTP systemically or intracerebroventricularly [66], the
latter route being more effective than the intrathecal route. Measurements of serotonin
turnover rates were made during AA in rats: the spinal cord/brainstem regions showed
different results than the upper brain. There was a marked increase in utilization in the
upper brain [66]. As utilization is a better index of activity, Han et al. [66] concluded that
the forebrain serotonin was more important for AA than spinal cord serotonin. AA also
causes increased release of radioactive serotonin into the cerebral ventricles, which sup-
ports the impression that the ascending serotonin systems are important.
All this leaves us with the questions: why does lesion of the D LT in the spinal cord
inhibit AA if spinal cord serotonin does not mediate AA effects? Does the DLT con-
tain other transmitters which mediate AA? Mayer and Watkins suggest that a syner-
gism between descending serotonin and norepinephrine is the important factor [115].
Indeed, Hammond [65] showed recently that combined intrathecal antagonists
(methysergide for serotonin, and phentolamine for norepinephrine) produced the best
antagonism of descending analgesia produced by brainstem stimulation. Perhaps this
should be tried for AA (combined intrathecal antagonists should block AA more effec-
tively than single antagonists).
There have been a number of studies on the effects of norepinephrine (alone without
serotonin) on AA. Yohimbine (an a-2-norepinephrine antagonist) blocked AA in mice
when given systemically [32]. Intrathecal phentolamine (an a-2 blocker) blocked AA,
showing the importance of descending norepinephrine pathways [67]. A recent study
[220] showed that lesioning the descending norepinephrine tracts with 6-hydroxydopa-
mine micro injected into the tracts decreased AA in rats. Similar experiments with
serotonin lesions using 5,6-dihydroxytryptamine produced less clear-cut results. How-
ever, combined lesions made by using both toxins produced the best blockade of AA,
indicating that synergism of the two 11l0noamines is important [220]. It should be men-
tioned that ascending norepinephrine effects in AA are inhibitory rather than excit-
atory in nature: thus, stimulation of the locus ceruleus in the midbrain inhibited AA,
and AA is potentiated by electrolytic lesions of locus ceruleus [46]. This is consistent

with the inhibitory effect of locus ceruleus norepinephrine on the raphe magnus [9].
Since norepinephrine has opposite effects centrally as compared to the spinal cord, it is
best to dissect them out by microinjection experiments. Norepinephrine turnover
studies have shown an increased utilization, leading to a decreased brain content con-
sistent with increased activity during AA [69]. Clearly the monoamine story needs more
work. If synergism of descending serotonin and norepinephrine is important, then
combined intrathecal blockers should be used in all future studies of monoamines in
AA. The relative roles of ascending and descending tracts needs to be clarified.
An important parameter of EA (or TENS) is the frequency of stimulation, as this deter-
mines which neurotransmitters are released. Several authors have shown that low-fre-
quency-produced AA is endorphinergic, as it is antagonized by naloxone [30,176].
High-frequency-produced AA is not affected by naloxone [30,176], but is monoamin-
ergic, being antagonized by the serotonin-receptor blocker cinancerin and the synthe-
sis blocker PCPA; high-frequency AA is enhanced by the serotonin precursor, 5HTP
[32]. These frequency effects have been summarized in Section 1.1 in Figs. 2, 3.
In conclusion, there is no doubt that the monoamines (serotonin and norepinephrine)
playa role in AA. Serotonin projections from the raphe to higher centres may mediate
AA. Descending projections to the spinal cord (via DLT) may work in synergism with
descending norepinephrine effects to block pain transmission in the spinal cord.
1.1.4 Evidence for Pituitary Hypothalamic System and Acupuncture Analgesia

The third possible centre of low frequency endorphin analgesia is the pituitary-hypo-
thalamic system. The arcuate nucleus of the ventromedial hypothalamus and the pitu-
itary gland contain all the beta endorphin cells in the brain [14]. As the arcuate cells
have long axons, beta endorphin is found in other brain loci, but this all originates
from the hypothalamic cells [203]. The arcuate cells can produce analgesia via these
long axons (stimulating the PAG, for example). Lesions of the arcuate nucleus abolish
AA in rats [167].
There is a good deal of confusion regarding the possible relationship of the pituitary
(hormonal) beta endorphins to pain modulation. We have already outlined the evi-
dence (lesions and blood biochemistry studies) implicating pituitary endorphins in
AA. Involvement of the pituitary in other forms of analgesia has been studied. For
example, ablation of the pituitary abolishes stress-produced analgesia: naloxone par-
tially reverses this stress analgesia: brain and blood levels of beta endorphins are ele-
vated by stress [161] and every mole of ACTH released to the blood is accompanied by
a mole of beta endorphin during stress [161]. These results suggest that stress analgesia
is at least partly mediated by pituitary beta endorphins. However pituitary ablation is a
very unreliable technique: moreover, injection of the drug naloxone could have side
effects. To make matters worse, in some species (e. g., rat) the blood-brain barrier for
beta endorphin is quite tight [161], although mice, rabbits and man have less of a bar-
rier [193]. Recently, a new route for the pituitary endorphins to reach the brain (bypass-
ing the barrier) has been discovered [13, 124] in the hypothalamic pituitary portal sys-
tem (reverse flow). Perhaps the endorphins can reach the 3rd ventricles and, via the
CSF, influence such structures as the caudate, thalamus and PAG. AA and the pitu-
itary system needs more research.
1.1.5 Conclusions
In conclusion, the evidence for the mediation of AA by endorphins is very strong,
while that for the involvement of monoamines needs more work to verify the possible
synergism of serotonin and norepinephrine. Moreover, the circuits depicted in
Figs. 1-3 are quite well established, although there is some uncertainty about the role
of the pituitary.
Acupuncture Analgesia for Chronic Pain 17
1.2 Acupuncture Analgesia for Chronic Pain
This section leads up to two important conclusions: First we conclude that AA is very
effective in treating chronic pain, helping from 55%-85% of patients, which compares
favourably with the effects of potent drugs (e. g., morphine helps in 70% of cases) [11].
Secondly, we conclude that AA is more effective than placebo, indicating a real physi-
cal effect.
These conclusions are based on evidence collected in three classes of studies (see
recent reviews: [160, 197]). We omitted all studies in which fewer than two treatment
sessions were given to each patient:
Class A: studies in which there was no control group for comparison with the acupunc-
tured group or in which there was a control group in which the subjects received no
treatment whatsoever.
Class B: studies in which there was a control group receiving percutaneous acupunc-
ture but at the wrong location (called sham acupuncture). The sham-acupunctured
group was compared with a group that received true acupuncture.
Class C: studies using a placebo control group (usually a disconnected TENS device,
or acupuncture needles taped to the skin) and in which this group was compared with
the group receiving true acupuncture. It is important to note that needles were not
inserted percutaneously in the control group for class C studies and hence this is not
considered to be sham acupuncture.
In classes Band C the experiments were usually single blind (the patient did not know
about the sham or placebo but the therapist did know). We will show below that the
quality of the experiments, in descending order, is class C, class B, class A. Initially it
was thought that class B studies were similar in quality to those of class C; it was hoped
that sham acupuncture was a good control for placebo effects, and hence many studies
were based on this approach [160,197]. Unfortunately, experience has since shown that
sham acupuncture (needles inserted in wrong locations in class B) helps about
33%-50% of chronic pain patients [160, 197], while placebo in class C helps only
30%-35% of patients [160, 197] ("true" acupuncture helps 55%-85% of patients) [160,
197]. In the review by Lewith and Machin [96] it was argued convincingly that the sta-
tistical problems inherent in class B experiments, in which one group shows a 40% suc-
cess rate (sham acupuncture) and another one shows a 70% success rate (true acupunc-
ture), make the burden of proof unrealistic, requiring at least 122 patients in the study
to find a difference between the two groups. Restated in statistical terms, to avoid mak-
ing a type II error and hence missing a difference between groups, for 80% power an
N of 61 per group or a total of 122 per study is necessary, while for 95% power an N of
90 per group, or a total of 180 patients in the study is necessary [96].
As stated above, placebo benefits only 30%-35% of patients with chronic pain. Hence
the burden of proof is more realistic for class C experiments: to compare 30% in
placebo controls with 70% in true acupuncture requires only 70 patients (an N of 35
per group, 70 total, for 80% power; or an N of 51 patients per group, 102 total, for 95%
power). Hence, it is not surprising that two out of two class C experiments showed sig-
nificant differences between treated and controls [107, 141], while four of six class B
experiments did not [48, 57, 58, 222] (but see [73, 114]). (AA failed in the treatment of
post-herpetic neuralgia and migraines in class C studies.) We can conclude from
class C studies that acupuncture helps 55%-85% of chronic pain patients, and this is
significantly better than placebo controls, only 30%-35% of whom have been helped
[107, 141]. In class B, despite the failures to observe significant differences between
sham and true acupuncture groups [48, 57-59, 222; but see 73, 114], perhaps the
33%-50% success rates observed with sham acupuncture were not placebo effects as
these rates were in excess of the 30%-35% seen in placebo studies. Moreover, the
class B results suggest but do not prove that acupuncture points may not be very spe-
cific in their ability to produce analgesia. To avoid statistical problems, class B studies
with larger sample sizes (122 patients) are needed, for thorough testing of the specific-
ity of acupuncture points versus sham points for treatment of chronic pain.
Normally we would completely ignore class A experiments, as they are poorly con-
trolled studies. Perhaps this is too severe, as many of these studies showed the
55%-85% success rate [26, 27, 42, 43,84,89,93,95, 155, 178, 223] that we now know
from class C experiments to be far above the placebo level of 30%-35%. Strictly speak-
ing, comparison across experiments is not permissible, but one cannot help but be
impressed with the consistency of all the results in each of classes A, Band C.
In addition to the three classes of studies outlined above, there have been several
experiments in which the acupuncture group was compared with a group receiving
standard treatments for chronic pain. These studies suffered from the same problems
as class B experiments (placing too strong a burden of proof on the small sample size).
Nevertheless, several of these studies did show AA to outperform the standard medical
treatment [62, 101, 103, 180], while another [2] showed no differences between AA and
conventional therapies (the latter result may be due to a type II error because of small
sample sizes). However, even if the analgesic effects of acupuncture and of a chemical
analgesic are equivalent this is also a victory for AA, given the many side effects of
analgesic drugs (in comparison to drugs AA has very few side effects; see Chap. 8). In
two studies in which acupuncture has been compared with TENS, acupuncture was
slightly more effective, but the differences were not statistically significant [52, 90]
because of a type II error.
In conclusion, we see that AA works better than placebo (class C) for most pains
(except neuralgias or migraines) [44, 97] and helps 55%-85% of patients, which is a
remarkable efficacy rate; morphine only helps 70% of patients with chronic pain [11].
If AA is better than or equal to conventional methods in relieving chronic pain, and if
AA is safer than drugs, then AA should become the method of choice for treating cer-
tain chronic pains. More studies in class C would make these conclusions even more
convincing. Experiments in class B and A are poorly designed, but the success rate of
AA in them seems too high to be merely a placebo effect.
1.3 Drug Addiction
Wen, a well-known Hong Kong neurosurgeon, discovered serendipitously that EA

produced relief of the withdrawal symptoms of opium addiction. He found this when
he gave acupuncture for postsurgical pain to his patients, some of whom turned out to
be closet opium addicts. In his first paper on this subject he reported that prolonged
daily treatments for 8 days helped patients withdraw from opium [205], but in a later
paper he reported that a more rapid and effective method of treatment was to combine
the antagonist naloxone with EA of the ear given for 30 min a day for 3 days [204]. Of
50 cases, 41 responded well and 9 did not. After a 1-year follow-up 51 % of cases
remained drug free [206], which is a much better proportion than can be obtained with
conventional methods. Unfortunately, he had no placebo control group. But Wen did
not claim a cure: "The treatment was not a cure because craving for the drug, even
without any abstinence symptoms, still persisted in these patients. Therefore it should
be said that a patient has been detoxified but that he still needs rehabilitation, espe-
cially on the psychosocial side" [204]. Other studies have shown lower success rates,
perhaps due to motivation problems and high dropout rates before a complete course
of treatment [110]. Other researchers have shown good initial results. Excluding papers
Asthma, Nerve Regeneration and Cardiovascular Effects of Acupuncture 19
in acupuncture journals, we counted five successful replications of Wen's work [87,

102, 135, 163, 170). In one study [170] in patients addicted to analgesics, 12 out of
14 patients were successfully withdrawn [170] using ear points for 60 min a day.
Several authors speculated that endorphin release mediated this effect [170). In a study
of 30 heroin addicts, the blood and CSF beta endorphin levels did not show any
changes with acupuncture, suggesting a different responsiveness in the opiate addict
than in normal subjects [209]. This suggests that the endorphin system is shut off by
negative feedback onto its autoreceptors from the heroin in the blood. Moreover,
blood ACTH and cortisol levels are reduced by acupuncture in addicts during with-
drawal, reflecting the suppression of stress levels and withdrawal symptoms by acu-
puncture [207]. In mice [208] it was possible to assay the total brain beta endorphin,
which was elevated by acupuncture in withdrawing mice (plasma beta endorphins
were unaffected by acupuncture). Moreover, withdrawal symptoms were decreased by
acupuncture in these mice, a result also reported by our own team [36] and by Ng et al.
for rats [127]. However, in other studies EA has been shown to raise the CSF level of
metenkephalin in human addicts [40 a]. Thus, the picture is confusing, perhaps because
of the complex nature of addiction. Finally, suppression of symptoms by the auto-
nomic nervous system should not be ignored.
Extrapolation of these results to acupuncture treatment of smoking, alcoholism and
overeating is dangerous. In these other areas claims are often made without the long-
term follow-up needed to check for recurrences due to unsolved psychological prob-
lems. Controlled studies to rule out placebo effects are urgently needed (in addition to
long-term follow-up reports) before firm conclusions are possible regarding the effi-
cacy of acupuncture in treating addiction.
1.4 Asthma, Nerve Regeneration and Cardiovascular Effects of

Acupuncture
These topics are all covered under one heading because very little controlled research
has been done in any of these areas. In a careful study on asthmatic patients Tashkin et
al. [185] showed that bronchospasms induced by catecholamines could be reduced by
acupuncture whereas placebo was ineffective. Bronchospasms were measured by spi-
rometry. Similar results have also been reported by others [12, 183]. However, in con-
trast to the positive results in these acute studies, Tashkin et al. were unable to show
any efficacy of acupuncture in the long-term treatment of asthmatic patients [186]. This
failure occurred in an elegant experiment using a double-blind crossover design (with a
4-week interval between the placebo and true acupuncture to avoid carry-over effects)
where they failed to see any benefit over placebo. Outcomes were scored by subjective
scoring, spirometry and whole-body plethysmography [186]. Perhaps daily treatments
might have produced better results, but this awaits future studies.
Nerve regeneration in humans has not been subjected to proper double blind clinical
studies. In China there have been anecdotal reports of over 100,000 cases of Bell's
palsy (paralysis of the 7th nerve) treated with acupuncture, with a success rate of92%.
However, Bell's palsy shows spontaneous remission in over 80% of cases, so we cannot
draw any conclusions without a placebo control group. R. Cheng (1981, personal com-
munication) has collected reports of 1500 patients with retinal blindness whose sight
has been restored by acupuncture, but again no controls were used (in this condition
spontaneous remission is less of a problem in interpretation). Wen is currently doing a
controlled study on blind patients, and preliminary results indicate that the placebo
group showed no improvements while the acupuncture group showed marked
enhancement of sight (H. L. Wen 1986, personal communication). It is important to
note that the claim is made that only partially blind patients are helped by acupunc-
ture, while totally blind patients are beyond help. In laboratory experiments, Pomer-
anz's group showed that EA markedly enhanced motor-nerve regeneration and sen-
sory nerve sprouting in adult rats after sciatic nerve injury [118,145,154] (see Sect. loS).
There is currently an experiment in progress at the Boston Veterans Hospital to study
the effect of acupuncture on patients with cerebrovascular accidents, with positive pre-
liminary results (M. Naesser 1986, personal communication).
Many cardiovascular experiments have been done on animals. In one elegant experi-
ment Yao et al. [219] used acupuncture-like stimulation of the sciatic nerve to lower
blood pressure for prolonged periods in awake spontaneously hypertensive rats. These
effects were naloxone reversible and had a serotonin component [219] much like AA.
Recently Hoffman and Thoren showed that there was a circadian rhythm to the effi-
cacy of acupuncture in lowering blood pressure, working only if acupuncture was
given during the daytime and not during the night [79]. Also, there was no effect in
renal hypertensive rats [79]. In another study Thoren showed that prolonged "jogging"
in spontaneously hypertensive rats produced exactly the same effects as acupuncture
(analgesia and lowered blood pressure via serotonin and endorphin mechanisms), sug-
gesting that type III muscle afferents may function normally to induce analgesia dur-
ing severe exercise [189]. (Incidentally, the jogger's high and analgesia from running
are both antagonized by naloxone in humans.) Perhaps this phenomenon can explain
the normal physiological (and teleological) role of the acupuncture system.
Conversely, anaesthetized dogs stimulated at Du 26 (the upper lip) showed a rise in
blood pressure which was not antagonized by naloxone [91]. Moreover, in haemor-
rhagic shock in dogs, stimulation of this point helped to restore the blood pressure by
increasing cardiac output [41]. The same authors working in dogs observed that the
lowering of cardiac output that could be obtained by stimulating St. 36 was blocked by
atropine, suggesting a parasympathetic effect. Recent studies in anaesthetized cats and
rats showed that low-intensity stimulation lowered the secretion of catecholamines
from the adrenal medulla, while high-intensity activation of peripheral nerve increased
secretion. In tum, these lowered or increased secretions lower or raise blood pressure,
respectively [6]. Work in humans is needed to verify these powerful cardiovascular
effects seen in animals. More studies on the autonomic effects of acupuncture are also
desirable.
1.5 Acupuncture Points (Do They Really Exist?)
The question of the existence of acupuncture points has been explored in several ways:
1. By comparing the effects of needling at true points versus sham points;
2. By studying the unique anatomical structures at acupoints;
3. By studying the electrical properties of skin at acupoints;
4. By studying the nerves being activated by acupuncture at acupoints.
1.5.1 Does Needling at True Points Work Better than Needling at Sham Points?
Several experimenters have shown, for acute laboratory-induced pain in human sub-
jects, that needling of true points produces marked analgesia while needling of sham
points produces very weak effects [22, 179]. These results were clear-cut because effects
elicited by sham-point stimulation are nonexistent in acute laboratory pain (placebo
pills also have poor efficacy in acute pain, causing analgesia in only 3% of cases). In
contrast to these clear-cut results, the work on chronic pain patients has been less con-
Acupuncture Points 21
vincing. As mentioned in Section 1.2, placebo analgesia in chronic pain has a strong
effect, working in 30%-35% of patients. Moreover, needling in sham points seems to
work in about 33%-50% of patients, while true points are effective in about 55%-85%
of cases [197]. Therefore, to show statistical significance in the differences between
sham-point needling and true-point needling requires huge numbers of patients (at
least 122 per study) so that experiments that would allow definitive conclusions have
not yet been done [197] (see Sect. 1.2). It is puzzling that sham acupuncture works in
33%-50% of patients with chronic pain, while not working at all in acute laboratory-
induced pain. Because of these problems the specificity of acupoints has only been
shown in acute pain studies in humans, but has yet to be properly studied in patients
with chronic pain, where the number of patients studied has never exceeded the
required 122.
In animal studies in mouse [149], cat [19, 56], horse [35], rat [182, 188], and rabbit [55,
99], many researchers have shown that true acupuncture works better than sham need-
ling in acute pain studies. These results are consistent with the research on acute pain
in humans. It is important in such studies on animals to use mild stimulation in awake
animals to avoid inducing stress; strong stimulation of sham sites could cause stress-
induced analgesia [144]. Stress analgesia is a well-documented phenomenon [108] and
is mediated by endorphins. If the stimulation used is very strong, animals are highly
stressed by both true- and sham-point needling. In studies done during anaesthesia
these problems of psychological stress are reduced [19, 55, 56, 137, 147, 148, 150, 152,
153, 188].
1.5.2 Are There Unique Anatomical Structures at Acupuncture Points?
Despite several histological studies of the skin and subcutaneous structures under acu-
points, no unique structures have been found. However, several authors [62, 123] have
made the astute observation that the majority of acupuncture points coincide with trig-
ger points: for example, Melzack et al. found that 71 % of acupuncture points corre-
spond to trigger points [123]. This suggests that needles activate the sensory nerves
which arise in muscles. This agrees with findings that stimulation of muscle afferents is
important for producing analgesia [37, 104, 201]. The work of Travell on trigger points,
beginning in 1952 [190] and culminating in a large book published in 1983 [191], shows
that there are small hypersensitive loci in the myofascial structures, which when
touched or probed give rise to a larger area of pain in an adjacent or distant (referred)
area. She observed that "dry needling" (with needles containing no drugs) of these trig-
ger points produced pain relief. When acupoints are tender the Chinese call them ah
shi points, and needling of them is recommended.
In a recent review on the subject of the anatomy of acupuncture points, Dung [47]
listed ten structures which are found in the vicinity of acupoints (see especially num-
bers 5, 6 and 9 regarding trigger points). In decreasing order of importance, he found:
1. Large peripheral nerves. The larger the nerve the better.
2. Nerves emerging from a deep to a more superficial location.
3. Cutaneous nerves emerging from deep fascia.
4. Nerves emerging from bone foramina.
5. Motor points of neuromuscular attachments: a neuromuscular attachment is the
site where a nerve enters the muscle mass. This is not always the actual neuromus-
cular synapse, which may occur a few centimeters further along the nerve and after
it has divided into smaller branches. The pathophysiological significance of this
neuromuscular attachment is unknown.
6. Blood vessels in the vicinity of neuromuscular attachments.
7. Along a nerve which is composed of fibres of varying sizes (diameters). This is more
likely on muscular nerves than on cutaneous nerves.
8. Bifurcation point of peripheral nerve.

9. Ligaments (muscle tendons, joint capsules, fascial sheets, collateral ligaments), as
they are rich in nerve endings.
10. Suture lines of the skull.
It is obvious from this list that no particular structure dominates at acupuncture points.
Perhaps the major correlate is the presence of nerves, be they in large nerve bundles
(items 1-8) or nerve endings (items 9 and 10). The abolition of AA by injection of local
anaesthetics into an acupoint before stimulation begins [37, 151] strongly suggests that
nerves are important for this phenomenon (see Sect. 1.5.4). However, we should not
rule out other mechanisms to explain effects of acupuncture in immunological, aller-
gic, and other non-AA phenomena. One can speculate on the possible release of ara-
chidonic acid from lesioned membranes during needling, giving rise to leukatrienes
and prostaglandins, which could affect immunity. Also currents of injury might be
important for nerve regeneration (see Sect. 1.5.3). Do local anaesthetics prevent all acu-
puncture effects, as they do for AA? It would be easy to find out, but few experiments
have been done on non-analgesic effects.
1.5.3 Do Acupuncture Points Have Unique Physiological Features

(e.g., Low Skin Resistance, High Skin Potentials, Current Flows)?
There have been a number of reports that the skin resistance (impedance) over acu-
puncture points is lower than that of surrounding skin [10, 18], but this result has often
been attributed to pressure artifacts from electrodes [117, 131, 192]. Normally dry skin
has a DC resistance in the order of 200,000 ohms to 2 million ohms. At acupuncture
points this is down to 50,000 ohms in the studies claiming unique properties of acu-
points. These observations have led to the marketing of "point finders", pencil-shaped
metal-tipped probes attached by wires to an ohmmeter. The circuit is completed by a
second electrode in a hand-held metal cylinder (with large skin contact on the sweaty
palm and hence with a low resistance in the order of 1000 ohms). The point finder gen-
erally measures DC resistance based on Ohm's law (E = IR): a constant voltage is
applied to the wires, and the resultant current (I) is measured, from which resistance
(R) is instantly computed. This can be read out on a meter directly or a wheat stone
bridge. Most devices produce a beeping tone whose frequency (or intensity) is propor-
tional to the resistance being measured. This allows the clinician to move the roving
pencil probe around the body surface while listening to the tones. Anecdotal reports
suggest that these devices work best in certain regions (e.g., hands, face, ears) in which
acupuncture points and low resistance often coincide (but see [121] for negative results
on the ear). It is further claimed that during disease of particular organs the resistances
at acupoints are abnormally low (even lower than the usual low resistance at acu-
points; but see [121]). Indeed, the Japanese (Ryodoraku) method of measuring the acu-
point skin resistance on the body has been in widespread use in Japan since it was
introduced by Nakatani in 1950 [128], while Nogier and the French school [130] have
made observations at ear acupoints (but see also [121]). In Germany, the Voll and Vega
machine has concentrated on another skin electrical phenomenon, whereby the initial
peak resistance reading is ignored, while the capacitative "fall-back" of the reading to a
steady-state (higher resistance) value is considered diagnostic. In the USSR, Gaikin
developed the toboscope as a point finder, which was shown at the World Fair in Mon-
treal in 1967 (Expo '67).
There have been two careful experiments to validate the claims of ear "point finders"
[121, 133]. Oleson et al. [133] took 40 patients, and in a "blind" design compared diag-
noses made by using a point finder (9 V DC, 50 IlA) on the ear with diagnoses made on
the same patients by means of a western medical work-up. The researchers were blind
as to the western diagnosis, to ensure that no clues were available to them. Amazingly,
the correlation between ear diagnosis and western diagnosis was 72.5%, which was
highly significant [133]. Recently, Melzack and Katz [121] could find no difference in
conductance between acupuncture points and nearby control points in patients with
chronic pain [121] when they measured skin resistances in the ear. Unfortunately, nei-
ther Ryodoraku nor the Voll machine has been validated by similar controlled studies.
Moreover, the further claims for the Voll machine that homeopathic remedies placed
in parallel with the measuring wires can modify the readings, and thereby be used to
select appropriate treatments for the diagnosed ailment, have never been scientifically
tested.
Until recently we were quite sceptical of the entire skin resistance phenomenon. This
was because the measurements were not made in accordance with established biophys-
ical practice. Neither published reports [10, 18, 157, 158] ,nor clinical anecdotal obser-
vations had been based on properly conducted studies, as pointed out by others [18,
117, 131, 192]. Recently we have improved the methodology. To avoid electrochemical
potentials we used Ag/ AgCl electrodes with a salt bridge; to avoid polarization from
DC currents we used biphasic pulses; to avoid electrical damage of skin we applied
small (microampere) currents; to avoid mechanical injury of the skin we used spring-
loaded probes; and to overcome skin moisture variations we supplied very small
amounts of saline through a millipore filter from the salt bridge. When these precau-
tions were taken a highly reliable technique was developed [174]. Preliminary results to
date suggest that acupuncture points sometimes do have a lower impedance (resis-
tance) than surrounding skin. Whether or not acupoints will tum out to have a lower
skin resistance than surrounding skin, the point finders on the market are very
unreliable [174].
We have no idea what the physiological significance (if any) could be of low resistance
at acupoints. It is known that sweating has a profound effect on skin resistance; this
forms the basis of lie detector tests. Stress, which activates the sympathetics, causes
sweating and a drop in skin resistance. In a preliminary study we have determined that
sweating occurs uniformly over the skin surface (equally at acupoints and over the sur-
rounding skin). Moreover, the ear lobe is practically devoid of sweat glands, yet resis-
tance phenomena are claimed to occur there as well [133] (but see [120]). We have not
yet validated the claims that there is a drop in resistance during disease; if this latter
phenomenon proves to be true, the pathophysiological mechanism is unclear. Can
sympathetics affect local sweating during disease? Why should this be localized to acu-
points, when sweating normally appears to be diffusely organized? It is also unclear
why, in normal people, the acupoint should have a low resistance. Could the presence
of a large nerve, emerging from deep tissues to more superficial layers, induce skin
changes?
Another finding at acupuncture points is the presence of a voltage source [10] (i. e.,
there is reported to be a potential difference between acupoints and the neighbouring
skin), with the points being 5 mV further in the positive direction than the non-points.
Unfortunately (as mentioned above for resistance), most of these voltage measure-
ments did not use state-of-the-art biophysical methodology. This is particularly unfor-
tunate as electrochemical potential artifacts produced at the electrode-to-skin interface
are large compared with the millivolts being generated by the body. Recently an out-
standing study was published by Jaffe et al. [81], showing that the human skin has a
resting potential across its epidermal layer of 90 mV (outside negative, inside positive).
This paper paid no attention to acupuncture points. Nevertheless, one can speculate
that acupuncture points, having low resistance, tend to short-circuit this battery across
the skin, and hence give rise to a source of current in a source-sink map of the skin. In
other words, acupuncture points provide a path of least resistance for currents driven
by the 90-m V resting potential which exists across the entire skin, and is consistent with
the 5 mV readings mentioned above [10].
An important measurement in the same paper by Jaffe et al. [81] showed that a lesion (a
cut) in the skin produces a current of injury which is due to short-circuiting of the skin
battery. Perhaps insertion of acupuncture needles into the skin might also produce a
current of injury which has biological influences on the underlying tissues. Indeed, our
team has recently reported that weak currents (only 1-1 0 ~A) promote nerve growth in
the leg of an adult rat when applied through acupuncture needles [118, 145, 154]. In
China over 100,000 patients with Bell's palsy of the 7th nerve have been reported (anec-
dotically) to benefit from EA and plain needling (see Sect. 1.4 above) [216]. Perhaps the
current of injury caused by needling (and generated by the 90-mV resting potential
across the intact skin) promotes nerve regeneration in these cases. It is important to
note that nerves grown in cell cultures will grow branches toward the electrodes in a
weak DC electric field [134]. Moreover, this growth is maximal in the direction of the
negative pole [134]. The papers from our laboratory also show enhanced nerve growth
towards the negative pole of the applied DC field [118, 145, 154]. Holes made by nee-
dles would also cause a negativity at the site of injury, due to the current of injury.
Regeneration of amputated amphibian limbs has been shown to be enhanced by
applied electric fields (and currents) in the direction of the negative pole [15]. Although
this has not been shown in adult mammals, there is indirect evidence of its effects in
humans. If children suffer accidental amputation of the distal phalanx it will com-
pletely regenerate (with nail, fingerprint, etc.) provided the tissue is kept moist. The lat-
ter allows a current of injury which is negative distally, and about 1 ~A in amplitude
[80].
DC fields and currents have also been implicated in bone healing, plant growth,
embryology, and spinal cord regeneration in paraplegic guinea pigs [132].
Preliminary studies on normal human volunteers in our laboratory indicate that need-
ling the skin produces a prolonged decrease of local skin resistance. A simple calcula-
tion using Ohm's law suggests to us that a small hole created by an acupuncture needle
can create a sufficient current of injury to be of possible benefit to tissue growth and
regeneration. Ohm's law states that E = IR. Given that E is 90 m V (skin potential), if
acupuncture creates a long-lasting shunt in the skin, dropping the resistance (R) to
9000 ohms, that would produce a current of injury (I) of 10 ~A. This is precisely the
amount of current which can promote nerve growth [145] and limb regeneration [15].
1.5.4 What Nerves Are Activated by Acupuncture?
Electrophysiological evidence (given below) indicates that stimulation of muscle affer-

ent fibres (type II and III) produces de qi sensations [201], which in tum send messages
to the brain to release neurochemicals (endorphins, monoamines, cortisol). Perhaps
acupoints are the loci of type II and III fibres.
One of the earliest and most clear-cut papers on the subject was published by the emi-
nent Chinese physiologist, Chiang, in 1973 [37]; in this paper he showed that the essen-
tial correlate of analgesia was a de qi sensation: the feeling of numbness, fullness, and
sometimes soreness [37]. By injecting procaine (2%) into the acupoints (LI. 4 and
LI. 10) in humans he determined that subcutaneous injections did not block de qi,
while intramuscular procaine abolished the de qi sensations. Moreover, whenever the
de qi was blocked, so was the AA. (Experiments have been done in animals [19, 55, 151]
showing that procaine injections also abolish AA.) To rule out the role of circulating
compounds released by acupuncture, he also repeated these experiments with a tour-
niquet on the arm: as the de qi persisted, so did the AA. Another important finding
recorded in Chiang's paper was the lack of target specificity: acupuncture of points in
the arm produced equal AA in all parts of the body as measured by skin analgesia tests
(he did not test the arm itself or he would have seen a stronger segmental effect there)
[3]. Two other studies showed the same lack of target specificity in humans in acute lab-
oratory-induced pain [100, 106]. These results are consistent with mechanisms in Fig.2.
It must be strongly emphasized here that the authors of the last two papers mentioned
may have drawn the wrong conclusions from their otherwise excellent studies: they
concluded that all the relief experienced was purely a placebo effect, since there was
no targeting of the treatment effects to specific pain locations. Yet there is no way that
60% of patients could have benefited from placebo: as stated previously, Beecher
reports that in acute laboratory-induced pain, placebo only works in 3% of volunteers
[11], and hence the 60% effect in the acute pain studies [106] could not have been me-
diated by placebo. Since they stimulated true acupoints they observed widespread AA
effects with specific targets. We interpret all these findings as follows: the acupoint
maps are essential for localizing the sites where the best de qi can be achieved (i. e.,
location of type II and III muscle afferents). In that sense, the points are specific. How-
ever, the further claim of traditional Chinese medicine, that the points are also target-
specific, may not be true. The conclusion that point specificity is not total nonsense
comes from the many studies on acute pain (both in humans and animals) in which
sham acupuncture produces no analgesia. Here 'sham' is used to mean placement of
needles in non-acupuncture points (see Sect. 1.2). Remember that Lynn and Perl [106]
placed needles in true acupoints, but they were merely inappropriate for the pain tar-
gets. Their points were not truly sham, in that they did not use non-acupuncture points.
In contrast, there are human studies in which acupuncturing the first dorsal interosseus
muscle (LI.4) produced a rise in tooth pain threshold (using signal detection theory),
while acupuncture of the fourth dorsal interosseus muscle (sham) produced no analge-
sia [22]. Another study of the pain threshold of the neck produced similar results [179]
in humans. Numerous animal studies have shown the same specificity: in mice [149],
cats [19, 56], horses [35], rats [188] and rabbits [55, 99], the sham points showed no AA
while real points gave AA. But the most extensive series of experiments on sham acu-
puncture was performed by Takeshige et al. in Japan, on rats. Not only did this group
find that non-acupuncture (sham) points failed to produce AA (in contrast to true
points in the same animals), but they proceeded to find a plausible explanation [54, 77,
78,86, 125, 142, 167, 181, 182, 195]. In a series of elegant experiments (far too complex
to give in detail here) they mapped out an AA-inhibitory system in the brain which is
activated by stimulation of non-acupuncture points: this system is activated from non-
acupoints via nerves to the posterior hypothalamus then to the lateral contromedian
nucleus of the thalamus and finally to lateral PAG (where it inhibits the midbrain AA
system). (For a review of this extensive research project, see [182].) Lesioning of this
inhibitory system releases the suppressed AA, so that non-acupoints become effective
in producing AA. Finally, Toda and Ichioka did an elegant experiment to show, in the
rat, that lesioning of the ulnar nerve had no effect in blocking AA from LI. 4 stimu-
lation, but lesions of radial and median nerves abolished AA [188]; conversely, electri-
cal stimulation of radial and median nerves produced AA but ulnar stimulation did not
[188]. It appears that the ulnar nerve does not reach the analgesia sites of the brain, or it
may perhaps activate Takeshige's inhibitory system.
This brings us to the most direct experiments of all: the recording of impulses from the
nerves involved in producing AA. Pomeranz and Paley [151], recording from afferents
from LI. 4 (first dorsal interosseus muscle) in mice, found that type II afferents were
sufficient to produce AA. But they deliberately avoided activating pain fibres (III and
IV) in awake mice, to avoid causing stress analgesia. Similar results were reported by
Toda and Ichioka, showing that type II afferents were sufficient for AA in the rat [188],
as recruiting type III and type IV did not augment the AA.
In a recent paper, Lu [104] showed that type II and III afferents were important in rab-
bits and cats for AA: dilute procaine (0.1 %) blocked type IV fibres and had no effect on
AA, while ischaemic blockade (or anodal blockade) of type II and III fibres abolished
AA. Thus, types II and III mediate AA in these two species (all blockades were verified
with direct electrical recordings from the blocked nerves).
Perhaps the best experiment of all was recently done on humans with direct microelec-
trode recordings from single fibres in the median nerve while acupuncture was per-
formed distally [201]. When de qi was achieved the following was observed: type II
muscle afferents produced numbness, type III gave sensations of heaviness and disten-
sion, and type IV (unmyelinated fibres), soreness. As soreness is an uncommon aspect
of de qi, we conclude that the main components of de qi are carried by type II and III
afferents (small myelinated afferents from muscle).
Finally, mention should be made of the sensation sometimes felt by the acupuncturist:
the "grab" of the needle by the muscle when proper de qi is achieved. Recordings of
electromyograms around acupoints during de qi have shown pronounced muscle acti-
vation, accompanied by the therapist's noting the grab of the needle [5].
The practical importance of all this could be summarized as follows: for AA it is
important to use strong stimulation to achieve de qi sensations; the acupuncture maps
are specific in the sense of helping us find type II and III fibres needed to obtain de qi.
However, acupoints may not be target specific as claimed according to meridian the-
ory; the only target specificity occurs from segmental effects of ah shi (tender) point
stimulation, in which there is an additional benefit from spinal segmental endorphins
(see Fig. 2 cell 7), added to the total-body effect of midbrain and pituitary endorphins
(see Fig. 2 cells 11 and 14). Thus, of the three acupuncture effects: local, meridian, and
total-body, we have evidence for local (Fig.2 cell 7) and total-body (Fig. 2 cells 11 and
14), but none (so far) for meridian effects.
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2 History of Acupuncture
G.Stux
It is quite certain that acupuncture with the help of sharpened stones was already being
practiced during the Stone Age. The earliest mentions of "stone needles," called Pien
in Chinese, date from about 500 B. C.
Decisive impulses that led to the development of the philosophical concepts of acu-
puncture came from the Shamans and from the early Taoist philosophers. Basic knowl-
edge of the natural processes in the irrigation of the fields influenced the development
of the concepts of the flow of life energy, Qi, in the human body. The legendary en-
gineer and founder of the Xia Dynasty (2140-1711 B. C.) created the basis for a suc-
cessful agriculture. Floods were minimized, and regular harvests were made possible
by watering the fields. The regulation of water flow in the irrigation systems, not too
much and not too little, brought good crops, and in this way harmony to the communi-
ty, providing the basis of adequate nourishment. Probably the system of polarities of
Yin and Yang also derived from these concepts during the period of the warring states
(Zhanguo) in 481- 221 B. C. The original meaning of Yang was the sunny side of the
mountain and that of Yin, the shady side.
At the beginning of the Han Dynasty (207 B. C.-221 A. D.) the classic text of medicine,
the Huang Di Nei Jing, was written in two parts: Su Wen (2nd century B. C.) and Ling
Shu (1st century B. C.). In this "Classic Textbook of Physical Medicine of the Yellow
Emperor," the major theories of traditional Chinese medicine were developed and
clearly conceptualized in a dialogue between the Yellow Emperor and his physician
Chi Po. Excavations of tombs from the period of the Han Dynasty revealed acupunc-
ture needles made of gold and iron.
During later periods acupuncture developed and flourished, as seen in many classic
textbooks dealing with the major fields of Chinese medicine. Just a few of these classic
texts will be enumerated here, to show the wide range of themes:
- Classic Text on Difficulties - Nan Jing - from the time of the Han Dynasty
- Classic Text on Pulses - Mai ling - and Emergency Prescriptions - Zhou-hou Bei ji
Fang - from the time of the Jin Dynasty
- Thousand Ducant Prescriptions - Qian jin Yao fang - from the time of the Tang
Dynasty
- Illustrated Classic Text on Acupuncture Points from the time of the Song Dynasty
- Great Compendium of Acupuncture and Moxibustion - Zhen jin Dacheng - and
the Great Pharmacopeia - Be cao Gang mu - from the time of the Ming Dynasty
- Golden Mirror of Medicine - Yi zong Jin jian - from the time of the Qing Dynasty
Even in 758 A. D., during the Tang Dynasty, academic medical examinations were car-
ried out in newly established medical colleges. The further development of Chinese
medicine was also affected by Buddhist influences, and its finest period was in the
Ming and early Qing Dynasties. But by the end of the Qing Dynasty in the nineteenth
century, western influence and the degeneration of Chinese culture as a result of the
foreign Manchu rule had brought about a decline in traditional Chinese medicine.
Mter 1949, when the People's Republic of China was founded, a new renaissance
started for acupuncture. In the 1950s Academies of Traditional Chinese Medicine
were established in Beijing, Shanghai, Nanjing, and other major cities. Much effort
36 History of Acupuncture
was invested in scientific research into the major effects of acupuncture. In particular,
the development of acupuncture anesthesia for surgical operations enhanced interest
in research into the analgesic effects of acupuncture. Spectacular documentary films
showing surgical operations with acupuncture anesthesia awakened the interest of the
western medical world also. For acupuncture anesthesia it was necessary to stimulate
the points continuously, so that electro stimulation of acupuncture needles was de-
vised. This method was also introduced in the therapeutic field. Further methods of
stimulating acupuncture points were discovered and introduced into daily practice,
such as laser treatment and infrared moxibustion. New fields of application, such as
scalp, hand and, especially, ear acupuncture were developed and were also introduced
into clinical practice in the west.
3 Background and Theory of Traditional Chinese Medicine
G.Stux
Following the scientific aspects of acupuncture that have already been described, in
this chapter the background of acupuncture and the philosophical theories behind it
are introduced. Some of these theories are difficult for a European to understand, not
least because it is so difficult for us to adapt to the holistic pattern of thought on which
it is based; this does not, for example, recognize the division of the human organism
into body and soul. The terms used in any work on acupuncture are very rich and com-
plex in meaning. In many cases their meaning can only be conveyed and delimited by
description in various ways. A detailed discussion of parallels to western thinking
would go beyond the scope of this textbook, and we shall therefore confine ourselves
in this section to a presentation of the traditional ideas, without further comment.
3.1 Tao, Yin and Yang
The Bronze Age in China began around 1500B.C., at the beginning of the Shang
Dynasty. During this time the roots of Taoism and of Chinese medicine evolved from
the primitive Shamanism embracing good and evil spirits and ancestor worship. Even
as early as 200 years B. C. the basic tenets of Chinese medicine were recorded in detail
in a classic work. These first basic explanations in the Huang Di Nei Jing, the Yellow
Emperor's textbook of physical medicine, are presented in the form of a dialogue be-
tween Huang Di, the Yellow Emperor, and his doctor, Chi Po. The Emperor asks ques-
tions about health and about the causes and treatment of illness. Chi Po explains to the
Emperor the principles of a healthy way of life that will lead to longevity. The func-
tions of the various organ systems and meridians and their harmonious interaction in
the healthy human being are presented in detail in the course of the dialogue, as are the
disturbances that are present in illnesses.
The Chinese doctors of ancient times had a· weltanschauung that was based on a
philosophical view of nature. They saw man as an integral part of nature and in a state
of intensive interaction with his environment. Nature is in a constant state of change
and continuous development. Thus, the vegetation changes in recurring dynamic cy-
cles as a function of seasons. In a similar way, man passes through different phases of
development during his life, from birth through growth and maturation to death.
The Chinese did not regard these developments as the work of a divine creator, but as
the expression of inherent conformity with a natural law, which they called Tao
(pronounced Dao). The essential nature of the Tao was described by Laotse in the
Tao Te King (Dao De ling in the new Pin Yin script) in the fifth century B. C. This begins:
The Tao that can be described
is not the real Tao.
The Tao is the Ultimate that creates and unites all things. It is the unstructured continu-
um from which everything has emanated and which persists in the structured universe.
The essence of the Ultimate cannot be more clearly defined conceptually. Various ren-
derings of "Tao" are encountered in the numerous translations of the Tao Te King: "the
Way," "the One," "the Absolute." The Tao is the source and the motive power of
creation:
The Tao creates the One
The One creates the Two
The Two generates the Three;
But the Three
generates all things.
The Tao brings out the polarity between Yin (pronounced "inn") and Yang from an
unstructured primal state (the One). All things in nature then develop within this field
of tension between Yin and Yang. Tao remains as the creative force of nature, the basis
of all dynamic transformation of matter and of living beings:
The Tao is an endless stream, always active,
But without overflowing.
It is profound and the origin of all things.
All pairs of opposites in nature are subject to this dynamic polarity between Yin and
Yang:
Yang is the heaven, Yin is the earth;
Yang is the male, Yin the female;
Yang is warm, Yin is cold;
Yang is active, Yin is passive.
The original meaning of Yang is reflected in old Chinese ideograms; it is the sunny side
of the hill, while Yin symbolizes the shady side.
The opposites complement each other in a dynamic process. Neither can exist without
the other. Laotse says on this point:
All things bear the Yin within themselves
and the Yang in their arms.
The power of emptiness generates its harmony.
Thus, the universe is regarded as a complex network of intricately related processes
played upon by opposing forces. Yin cannot exist without Yang; the two forces always
combine to make up the whole, Tai ji in Chinese.
This polar system pervades every part of the universe and has an important role in
medicine, in the description of life processes in the human body and of their distur-
bances (Table 3.1).
Table3.1 System of Yin and Yang counterparts

Yin Yang
Receptive Creative
Earth Heaven
Negative Positive
Body
Ventral Dorsal
Internal External
Lower Upper
Inside Surface
Internal organs Skin
Functions
Hypofunction Hyperfunction
Deficiency Energy Excess
Inadequate blood flow Hyperemia
Cold Heat
Degeneration Infection
The Cosmic Vital Energy 39
Chinese ideas about physiology are heavily influenced by the fact that autopsies and
anatomical sections were forbidden in Ancient China because the human body was
regarded as holy. Certainly we can assume that some insight into the anatomical rela-
tionships had at least been gained from observations of severe injuries sustained in ac-
cidents and from other more or less chance happenings, so that the ancient Chinese
would have an idea of the position of each organ in the body. But on the whole, Chi-
nese ideas of physiology and pathology are based on extremely precise external obser-
vations linked up by systems of hypotheses. Some parts of this system of Chinese medi-
cine seem incomprehensible at first when considered in light of our present-day
knowledge, but obviously it was precisely the concentration on observation of func-
tions that led to useful therapeutic guidelines.
3.2 The Cosmic Vital Energy: Qi
The interaction of the opposing forces Yin and Yang gives rise to the flow of vital ener-
gy, or "Qi." This life force is fundamental to the description of nature for the Chinese.
Qi, or Chi as it was written in the Wade-Giles transskription, is omnipresent in nature,
and is apparent in all life in the form of change and movement.
The Chinese concept of Qi goes beyond the western idea of energy in physical terms,
and for this reason its translation as vital energy is not completely satisfactory.
As we have seen, Tao cannot be directly described, and in the same way there is no di-
rect definition of Qi. The constantly flowing vital energy Qi can only be described in a
roundabout way, and its nature can only be grasped from its effects. Any stagnation
leads to an impairment of the life processes. Complete standstill means death. Accord-
ing to the traditional concept, the cosmic Qi flows everywhere in nature, for example in
river water. In the human body Qi accumulates in the organs and flows in courses that
are called Jing and Luo. The polar arrangement of the "Qi channels" led European
doctors to compare them to the geographical system of meridians, so that they referred
to them initially as meridians, and then later also as channels.
The Qi governs the functions of the organs and their manifold interaction. Every life
process, every organic function, is an expression of the action and movement of Qi.
There are various forms of Qi in the human body: In the lung Qi is taken up from the
respiratory air. This "respiratory Qi" is called "Yang Qi" or "Kong Qi," because it
comes from above, from the sky (Yang). Indian Ayurvedic medicine embraces similar
ideas; this respiratory Qi is known in this discipline as Prana, but it has a wider signifi-
cance.
The digestive process transforms food into "food Qi" or "Yin Qi," known in Chinese
as "Gu Qi." The third important source of Qi in the body is the "hereditary Qi," which
is also referred to as "Yuan Qi," the vital energy each person inherits from his or her
parents and which brings about the person's growth and development. This basic or
ancestral Qi is traditionally believed to be stored in the renal system.
These three forms of Qi combine in the body to give the "fundamental Qi" that flows
through the entire body. The functions of the organs and their various outputs are
brought out by the Qi inherent in each. Respiration, as a function of the lungs, and
digestion of the food, as a function of the stomach and intestine, are expressions of the
Qi of each of these organs. The specificity of the functions is determined by the Qi of
the corresponding organs. Qi regulates the functions from the quantitative aspect. If
the Qi of an organ is weakened the function of this organ will be incomplete or faulty,
but if Qi is present in excess the result is excessive function.
According to the traditional idea, Qi flows through the body in a manner reminiscent
of the way in which the water in the rivers flows through the continents. The channels,
the body's "rivers of energy," carry the "channel Qi," the so-called "ling Qi," or per-
vading Qi. There are two Chinese ideograms that are transcribed as ling: one is ling in
the sense of the essence oflife, and the other ling means the channels that extend to all
parts of the body. ling Qi is the Qi that flows through the channels and must be distin-
guished from ling, the life essence. The main functions of Qi in the body are:
- It is the source of movements; not only of voluntary movements, however, but also
of the movement processes involved in respiration, circulatory function, and intesti-
nal motility.
- The generation of warmth in the body is a further function of Qi.
- Psychic activity and vitality are an expression of Qi, and are known collectively as
"Shen."
- A further function of Qi is the conversion of food to blood and other body fluids.
- It is with the aid of Qi that the body excretes the toxic waste products. Its function
also includes the accumulation of important nutriments, however.
- In addition, however, Qi also has the function of protecting the body from external
noxious influences, e. g. climatic influences that might lead to illness. This protective
function is particularly important in the prevention of illnesses. This "protective Qi"
is known as "Wei Qi" and is concentrated mainly at the body surface. It also flows
between the muscles and the skin in the peripheral regions and in the outer parts of
the body cavities. Since this "resistance Qi" is concentrated mainly at the body sur-
face it is classed as a component of Yang ("Yang Qi"), because the body surface
corresponds to Yang, in contrast to the internal organs.
3.3 Jing, the Life Essence
Jing, the life essence also has an important role in the description of the life processes.
The life essence is regarded as the material basis of Qi. ling is also designated "super-
refined material," the "seed of life," and the "elementary reproductive force." The
evolutive processes in the body, differentiation of the organs and growth, are also tra-
ditionally considered to reflect the action of Jing. The primary or congenital Jing arises
from the union of the parental life essences, and it is this that determines the develop-
ment of each individual and the nature of his or her particular constitution. According
to traditional ideas this primary ling is nourished by the acquired ling, which is de-
rived from the "food following refinement." ling does not increase as life proceeds;
rather it declines continuously in the senescent phase, until it is completely exhausted
at the point of death.
3.4 Shen, or Psychic Energy
Shen is another important concept in traditional Chinese medicine. It is the force of

consciousness and is often translated as "spirit." Shen gives birth to our thoughts. The
capacity for reasoning and the differentiation of the personality are further functions
of Shen. It is traditionally believed to be stored in the heart and revealed in the eyes.
When the Shen is disturbed the eyes become clouded, colorless and dull; the patient
becomes forgetful and retarded, and the sleep pattern is upset. If the disturbance of
Shen is very marked there are also changes in the conscious state, which can extend to
unconsciousness. Both Shen and Qi are considered to be Yang forces of the body,
while ling is classed as part of Yin.
Disturbances of Qi 41
The concept of the "three treasures" (San Bao) arose during the time of the Ming
Dynasty (1368-1644). This term is derived from Taoism and embraces the vital energy,
Qi, the psychic energy, Shen, and ling, the essence of life. According to traditional
thinking only a harmonious interaction of these three life forces can ensure perfect
health. If ling, the life essence, and the vital energy, Qi, are present in adequate
amounts the spiritual force, or Shen, can also come into its own. Any weakness of one
of these basic forces leads to physical or mental disharmony, that is, to sickness.
3.5 Disturbances of Qi
According to Chinese tradition most illnesses and disturbances are rooted in the flow
of Qi; there is either an excess or a deficiency of the vital energy in the organ systems
and the channels. A blockage or stagnation of the Qi in the channels is another possible
cause of illness.
Deficiency conditions (Table 3.2) are characterized by a weakness of Qi and therefore
by inadequate functioning of the corresponding organs. In such circumstances the in-
testine's digestive action is incomplete, and undigested food is eliminated.
As Qi corresponds to the Yang polarity, a weakness of Qi is described as a Yin condi-
tion. The Chinese called deficiency-type disharmonies "Xu conditions." If there is a
general weakness of the vital energy throughout the entire body many different cardi-
nal symptoms occur, such as pallor, cold hands and feet, immoderate coldness, low
blood pressure, lack of drive, lowered activity, lack of energy. Retarded movements
and slack muscles are further frequent signs of illness due to weakness. Inadequate
blood flow and coldness in the extremities, like immoderate coldness, are the most pro-
nounced symptoms.
Typical illnesses that arise with disturbances involving deficiency are:
- Degenerative illnesses
- Diseases of old age
- Depression
In Chinese medicine, the therapy of choice for deficiency conditions is moxibustion,
which is the application of heat at acupuncture points.
An excess of vital energy is the second important disturbance of Qi. This is referred to
as a Yang condition. It leads to excessive function of the organ systems concerned. Ill-
nesses resulting from an excess of Qi are referred to as "Shi" conditions. Heat, as one
of the main symptoms, can be restricted to one joint, or it can become manifest as gen-
eralized fever throughout the body. Other important symptoms in conditions of excess
are plethora, flushing, and acute shooting or cramp-type pain. Inner uneasiness, ner-
vousness, and overexcitement are the psychological effects of this Yang-type condition
ofQi.
When the vital energy is blocked, or stagnated, the flow of Qi is disturbed, primarily in
the peripheral areas of the body. The usual result of this blockage (Qi Zhi Zheng) ofvi-
tal energy is a state of excess. Inappropriately high muscle tone, muscle pains, myoge-
losis and restricted movement are typical features of such conditions. A stagnation of
this kind is often present in the case of headaches, together with an excess of Qi leading
to feelings of tension and acute pain. In the internal organs blockage of Qi can lead to a
reversal of the usual direction of flow of the body fluids. When Qi is blocked in the
area of the stomach, for example, vomiting results, that is the contents of the stomach
move in the opposite direction to usual ("rebellious Qi"). Constipation is also frequent-
ly the result of a blockage of vital energy and is characterized by typical symptoms,
ranging from a feeling of fullness and pain to cramps.
Table 3.2 Disturbances involving deficiency and excess

Deficiency of Qi; Xu Excess of Qi; Shi
Yin condition Yang condition
Symptoms of coldness Symptoms of heat
Pallor Flushing
Inadequate blood flow Plethora
Feeling cold Feeling hot
Slack muscles Tense muscles
Hypofunction Hyperfunction
Depressive illnesses Agitation
Hypoactivity Hyperactivity
Dull pains Acute pains
Degenerative illnesses Inflammatory illnesses
Traditionally, illnesses are divided according as whether they have "internal" or

"external" causes:
- Illnesses are externally caused when the "energy" of nature round about, e. g., in the
form of climatic influences, acts on the weakened body, thus leading to disturbances
of Qi in the channels and organs. External climatic factors are heat, cold, dryness,
damp, wind, or a combination of such factors, e. g., a cold dry wind. In ancient Chi-
na people were much more susceptible to climatic influences than they are now, in
the modern industrialized society. Nonetheless, illnesses attributable to climatic in-
fluences still occur, e. g., colds and chills, especially when there is a change in the
weather. The external causes of illnesses are traditionally believed to affect the pe-
ripheral regions and the superficial layers of the body first, particularly when the
normal protective function of Qi is inadequate.
Once they have acted on the weakened body for some time, external climatic influ-
ences can also precipitate disturbances of the internal organs. The external disturb-
ing factors are allotted to the internal organs according to the correspondence sys-
tem of the five phases. Cold, for example, damages the kidney; dryness, the lung;
and heat, the heart and the circulation.
- Internal causes of disturbances of the vital energy, such as faulty nutrition or psycho-
logical stress, can also lead to illness. Excessive emotions, such as fear, rage, anger,
brooding, agitation and sadness, leads to a disturbance of the energy in individual
organs. Disturbances of internal organs owing to deficiency or excess occur particu-
larly when feelings arise suddenly and are especially intense and inadequately pro-
cessed. Fear, for example, is traditionally believed to harm the kidney; rage and an-
ger, to lead to disharmony of the liver; sadness, to weaken the energy in the lungs;
excessive excitement, to be harmful to the heart; and brooding, to lead to stomach
upsets. Any disturbance in the internal organs is caused partly by emotional factors
in accordance with the system of the five elements.
Too little or too much food, and especially mistaken combinations of food, have a
decisive effect on the energy distribution in the organs and on disturbances of the or-
gans. The ancient Chinese divided foodstuffs too into Yin and Yang categories:
Potatoes, white bread and sugar are considered as "Yin food," while vegetables, sa-
lads and grains are "Yang food." According to Chinese thinking the diet should con-
sist of a balanced mixture of Yin and Yang foodstuffs.
The System of Five Phases 43
3.6 The System of Five Phases
In addition to the system of Yin and Yang, which made it possible to understand polar
processes and polar forces, the system of the "five elements" or "five phases", in
Chinese Wu Xing, was introduced in the third century B. C. to allow categorization of
processes with a phasic course. The five element system is one of correspondences, ac-
cording to which physical processes or phenomena are classified in five phases. This
system was an essential standardization of the ancient natural philosophers' view of
the world. The traditional system of Chinese medicine classed widely varying natural
processes and evolutionary events in this system of five basic factors. The five phases
are wood, fire, earth, metal, water. These five basic phases are intimately interlinked, in
such a way that they stimulate, but also inhibit or control; each is controlled by an-
other, while itself simultaneously controlling another.
The sequence in the promoting cycle or "Sheng cycle" is:

Wood, fire, earth, metal, water;
The sequence in the inhibition cycle or "Ko cycle" is:

Wood, earth, water, fire, metal.
Needham (1956) relates the five elements to the properties

of materials, rather than to materials as such.
Wood - Stability and slight malleability
Fire - Flammability, development of heat
Earth - Fertility
Metal - Fusibility
Water - Fluidity
Metal Earth
~
Five Phases, Sheng and Ko cycles Sheng
The relations of these five phases cannot be taken literally in a substantial way; they
are rather a sort of abstract symbols comparable to those used in algebra, such as A, B,
C, or x and y, which are structured to give a logical system of equivalents. Needham's
interpretation already contains an abstraction compared with the original concepts -
but it obviously does not go far enough to make their significance for the human body
easily comprehensible.
Table 3.3 The five-phase system of equivalents

Phases Directions Seasons Climatic Colors Stages of
factors development
Wood East Spring Wind Green Birth
Fire South Summer Heat Red Growth
Earth Center Late summer Damp Yellow Change
Metal West Autumn Dryness White Harvest
Water North Winter Cold Black Composure
What this system does allow, however, is the classification of empirical findings and
observations in very different fields (Table 3.3).
A great many of the facts and processes in medicine, for example the functions of inter-
nal organs, tissues, and sensory organs, are classified in this way according to the five
phases (Table 3.4).
Table 3.4 Classification by the five phases

Phase Internal Hollow Sensory Body layer Emotion Taste
organ organ organ
Wood Liver Gallbladder Eye Muscle Anger Sour
Fire Heart Small intestine Tongue Blood vessels Joy Bitter
Earth Spleen Stomach Mouth Connective tissue Brooding Sweet
"flesh"
Metal Lung Large intestine Nose Skin Sadness Spicy
Water Kidney Urinary bladder Ear Bone, joints Fear Salty
3.7 External Climatic Factors
According to the traditional theory of Chinese medicine there are five climatic factors
corresponding to the five phases (in addition to other series of five factors): Heat, cold,
damp, dryness and wind. These five "weather factors," or six, if heat and summer heat
are treated as separate concepts, have a dual significance for Chinese medicine: First
as climatic influences that can lead to illness (e. g., cold - chills, heat - heat stroke), and
then also as aids to description and characterization of physical symptoms. Fever is a
heat symptom, while shifting pain is described as "internal wind"; cold extremities and
stiff joints are described as a reflection of the "cold" factor. Thus, the system of five ele-
ments is used to describe external climatic influences and to characterize physical
symptoms.
The climatic influences are traditionally believed to get into the body from outside,
e. g., through the mouth, the face, or the skin, and especially when the temperature
changes or during the transition from one season to the next. The intensity of the
body's own defense reaction is extremely significant for the development of illnesses
and their multiplicity of symptoms. The symptoms can be very variable and pass from
one factor to another: cold symptoms, for example, can give way to feverish heat
symptoms. In addition, different factors are often present together, as in the case of
cold, damp and wind in rheumatic illnesses (Chinese Bi syndrome).
External Climatic Factors 45
3.7.1 Description of the Climatic Factors
Wind Feng
As a characteristic major factor, wind has an active nature, which is to say that it is a
Yang factor, and is classed with the spring. It moves the body as the wind moves the
boughs of the tree.
A distinction is made between the wind in nature, as a pathogenic external climatic fac-
tor, and wind as an aid to describing physical symptoms. The wind that is a climatic
factor influences the upper part of the body, the face, the nape, the upper respiratory
tract, and the skin. It leads to disharmony in the body and usually occurs in association
with other factors, e. g., cold or damp.
Wind symptoms are typified by sudden onset and constant changes. Sudden-onset
pain occurring at different sites and with definite changes in intensity is a wind symp-
tom, but so also is variable fever in the presence of infectious diseases. "Internal wind"
is characterized by dizziness, ringing in the ears, trembling, or inappropriate sensa-
tions. It is traditionally believed that strong wind continuing over a long time leads to a
"disharmony" of the liver if the body is in a weakened state, and thus in tum to hepatic
damage.
Heat Re
The heat factor varies in intensity and form: "heat," "fire," and "moderate heat."
"Summer heat" is regarded as a pathogenic external influence, which leads, for exam-
ple, to heat stroke. Fire and moderate heat are used to describe physical symptoms
(e. g., "heat fire").
Heat symptoms are swelling, redness, rise in temperature, plethora, and pain, that is to
say typical symptoms of inflammation. Heat uses up the body's Qi and Yin, thus lead-
ing to symptoms of Yin deficiency and excess of Yang. Internal heat can lead to a
"standstill of Qi and blood." It damages the vessels and thus leads to the accumulation
of fluids outside the vessels. The damage to Yin, or consumption of Yin fluid, leads to
thirst, dry mouth and throat, and concentrated urine.
Heat and fire have a rising tendency in the body. If their influence is of a long duration
they lead to impairment of the "heart." According to the traditional way of thinking,
however, the heart signifies emotional functions rather than any others, and thus the
influence of heat brings about disturbances of consciousness - extending to uncon-
sciousness (heat stroke). Milder symptoms are excessive tiredness, dizziness, physical
sluggishness, and breathing difficulties.
Damp Shi
Damp symbolizes sluggishness, heaviness, rigidity and standstill, thus corresponding
to the Yin pole. In the seasonal cycle damp corresponds to late summer. Nonetheless,
"damp air" can exert its effect as a pathogenic factor in any season. This external cli-
matic influence brings about a standstill of the vital energy in the body, Qi, with symp-
toms of feelings of heaviness, dullness, and rigidity. Rheumatism is typical for the ill-
nesses in which damp plays a major part.
Damp as a characteristic of physical symptoms has a falling tendency in the body. The
lower part of the body is disturbed. Heavy extremities, dull pain, tiredness, fatigue,
sluggishness, restricted movements, rigidity, and a rough sore feeling are typical symp-
toms. Damp-type symptoms are the ones most frequently complained of in the elderly.
The organ system most frequently damaged by damp is the spleen system.
Cold Han
Cold is diametrically opposed to heat, and is therefore classed as belonging to the Yin
pole; it corresponds to winter. However, the effects of the cold can lead to illness in
any season if the body is impaired or weakened. A sudden onset of the symptoms is
characteristic of the external influence of cold. Like the wind, cold has a particular
pathogenic significance as an external climatic factor.
Typical "cold symptoms" occur: feeling cold and shivery, desire for warmth, cold ex-
tremities or cold body areas, pallor, gooseflesh. Movements are retarded, psychic activ-
ity is sluggish, the mood depressed, actions inhibited. These cold symptoms can
change into fever, however, a typical heat symptom, which reflects a strong Yang reac-
tion of the body.
Cold, as a Yin symptom, nonetheless typically leads to a deficiency of Yang. The flow
ofQi and blood in the channels is slowed down or blocked; this is expressed as intense,
stabbing, cramping pain and as slowing down or inhibition of movement. Degenera-
tive and/or arthrotic illnesses are typical "cold Yin" illnesses: The most effective thera-
py is moxibustion. Cold has a damaging effect on the kidneys and on the bones and
joints in particular; the kidney, the source of the Yang energy in the body, is weakened
by it.
Dryness Zao
In comparison with the other climatic factors dryness has only a subordinate role. It of-
ten occurs in association with heat and leads to "desiccation" and to heat symptoms
such as redness and a feeling of hotness. Dryness of the mucous membranes of the
nose, the lips, the mouth, or the skin are the most frequent symptoms described under
this expression. External dryness leads to disturbance of the lung function with a dry
unproductive cough.
3.8 Internal Emotional Factors
According to the system of the five phases five emotions are allocated to the Yin and
Yang organs or channels. The emotional factors are regarded as "internal" causes of
organic disturbances. According to this idea, too much grief affects the function of the
lung, while too much rage influences the normal function of the liver and, particularly,
that of the gallbladder. Fear weakens the renal system; brooding causes stomach up-
sets. Excitement and excessive pleasure lead to disharmony of the heart and in turn to
an unbalanced psychic state. The internal emotional factors affect both the Yin organs
and the Yang organs, in keeping with the system of the five elements (Table 3.5).
Table 3.5 Internal emotional factors in the system of the five phases
Emotional factors Yin organs Yang organs Phases
Anger, rage Liver Gallbladder Wood
Excitement, pleasure Heart and pericardium Small intestine and Sanjiao Fire
Brooding Spleen Stomach Earth
Sadness, depression Lung Large intestine Metal
Fear, alarm, anxiety Kidney Urinary bladder Water
4 Diagnosis in Traditional Chinese Medicine
G.Stux
Diagnostic categories crystallized out very early in the development of Chinese medi-
cine, on the basis of the philosophical system of the Yin-Yang polarity. The natural
philosophical ideas of Taoism and the equivalence system of the five phases also
played a part in the refinement of diagnostic technique in traditional Chinese medi-
cine. The development of this system of diagnosis went hand in hand with that of the
range of therapies that Chinese medicine embraced. At first only the therapy with nee-
dles became known in the west; it is only in recent years that more attention has also
been paid to the system of diagnosis in Chinese medicine, although the systems of di-
agnosis and therapy are intimately interlinked.
4.1 Eight Diagnostic Criteria, Ba gang
The traditional system of Chinese medicine classes the individual signs and symptoms
of illness according to diametrically opposed diagnostic criteria. Eight diagnostic crite-
ria are known, four couples made up of polar extremes, called Ba gang in Chinese:
- Yin and Yang

- Interior and exterior (Li and Biao in Chinese)
- Deficiency and excess (Xu and Shi in Chinese)
- Cold and heat (Han and Re in Chinese)
The symptoms of a functional disturbance or an illness are analyzed with reference to

these eight diagnostic criteria. Disharmonies of Qi, the vital energy, in the channels or
organs and the effects of such disturbances are all described with reference to these
eight polar criteria. This is the way a diagnosis is made in the Chinese sense.
The Chinese doctor assesses the individual symptoms and signs in categories referred
to disharmony of Yin and Yang in the organs or channels, thus ascertaining "distur-
bance patterns," which are called "syndromes" in the traditional western sense of this
word. In the Chinese sense, a syndrome is not only the total cluster of symptoms, but
also the cause of the symptoms and their interpretation according to the concepts upon
which the traditional system of medicine rests.
Yin and Yang are universal diagnostic criteria, and therefore they are generally valid
and applicable to all phenomena. They constitute the primary criteria of a diagnosis in
the Chinese sense; Yin or Yang disturbances at different levels are referred to. The four
couples of opposites used in the Chinese system of diagnosis are explained below.
4.2 Interior and Exterior Li, Biao
Internal disturbances, called Li in Chinese, are disharmonious states of the five Zang
organs and the six Fu organs. The disturbances of these internal organs are frequently
chronic in nature, being characterized by pains in the area of the rib cage or abdomen,
raised body temperature, and disturbances of the gastrointestinal function, such as
retching, diarrhea, and nausea. Pain can also radiate along the channels. Internal ill-
nesses usually have causes that are also classed in Chinese medicine as internal: distur-
bances of the organ complexes, for example, are caused by an excess of such feelings
as anxiety, fear, sadness, or excitement or by inadequate or contaminated food.
External illnesses, called Biao in Chinese, are characterized by disturbances of the
channels and collaterals, especially in the peripheral regions and at the surface of the
body. The external disturbance is usually characterized by acute pain in the extremi-
ties, the joints, or the head, and by susceptibility to climatic factors. Typical external
disturbances are peripheral neuralgia or localized joint disease. Chinese medicine con-
siders that these are caused by external pathogenic climatic influences, such as cold,
heat, damp, wind, or dryness. The treatment of external and internal disturbances ac-
cording to Chinese concepts of medicine is fundamentally different, so that the diag-
nostic classification is of decisive importance for the planning of therapy.
4.3 Excess and Deficiency Shi, Xu
Deficiency disturbances, or Xu conditions in Chinese, are characterized by a deficiency

of vital energy, Qi, of blood, or of Jing, the elementary substance. Deficiency-induced
disturbances lead to hypofunction of organ systems. Typical symptoms of such distur-
bances are excessive tiredness, exhaustion, dizziness, motor retardation, pallor of the
skin, tongue and mucous membranes, low blood pressure, tendency to syncope, inade-
quate blood perfusion, sudden profuse sweating, dry mouth, oliguria, and deficiency
of body fluids (Table 4.1). In addition, retarded intestinal passage and impaired diges-
tion are typical deficiency-induced disturbances of the intestinal organs. A pale tongue
and a weak pulse are important signs for the diagnosis. Degenerative illnesses are
counted as deficiency diseases.
Table4.1 Typical symptoms of excess and deficiency

Excess, Shi Deficiency, Xu
Powerful muscular movements Feeble, slow muscular movements
Agitation, hyperactivity Tiredness, exhaustion
Loud voice Faint voice
Upright posture Stooping posture
Quick, vigorous way of walking Slow gait
Hypertension Hypotension
Hyperemia Deficient blood perfusion
Psychologically active attitude Psychological passivity
Excitement, mania Depression, subdued mood
Excessive activity Deficient activity
Short sleep period, Long sleep period with disturbed sleep
difficulty in falling asleep
Coated tongue Little coating of tongue
Strong pulse Weak pulse
Heat and Cold 49
The deficiency diseases are usually chronic and are often characterized by locally or
generally inadequate blood flow. The most usual cause of deficiency diseases is
exhaustion of Qi following the action of internal pathogenic influences over a long
period.
Disturbances caused by excess, or Shi in Chinese, are characterized by an excessive
amount of Qi or blood in organs and channels. Blockages of channels are also often
preceded by a state of excess. Typical symptoms are acute pain, cramps, hypertension,
plethora, increased muscle tone, and increased secretion of body fluids (Table 4.1). The
most important signs are reddening of the tongue, redness of the face, and a strong
pulse. In the psychological sector agitation, nervousness, overexcitement, restlessness,
aimless activity and, often, sleeplessness are observed.
4.4 Heat and Cold Re, Han
Cold disturbances, or Han in Chinese, occur when external pathogenic cold takes effect
on a body in which Qi is weakened. In these circumstances typical cold symptoms
manifest themselves, such as immoderate feelings of cold, cold extremities, and pallor
(Table 4.2). If these persist for a fairly long time cold illnesses, psychic retardation, or
watery diarrhea arise. Cold disturbances are usually chronic. The active Yang Qi in the
body becomes continuously weaker. Cold-type disturbances can often be changed into
fever, a heat-type symptom, by the body's Yang activity.
Heat disturbances, or Re in Chinese, are caused basically by increased Yang activity of
the Qi in the body. Qi is responsible for the generation of heat in the body. The hyper-
activity of Yang leads to exhaustion of the Yin forces and of the Yin fluids ifit persists,
and as a result the Yang system develops heat. Typical heat-type symptoms are high
body temperature, redness, hyperemia, pain, and agitation (Table 4.2). Obstinate con-
stipation, dark urine (exhaustion of the Yin fluid), a red tongue, and a fast pulse can
also occur.
Cold- and heat-type symptoms can occur simultaneously if the disturbance of Qi in the
body is extreme. For example, even if a high fever is present the extremities can be cold
because of the centralization of the circulation. In traditional Chinese medical jargon
this is described as heat symptoms in the presence of "illusionary" cold. It is also possi-
ble for "false" heat symptoms to arise in some parts of the body when generalized cold
symptoms are present.
Table4.2 Typical heat- and cold-type symptoms

Heat, Re Cold, Han
Red face Pale face
Redness of skin and mucous membranes Pale mucous membranes
Warmness/burning of the extremities Cold extremities
Fever Hypothermia
Feeling hot Feeling cold
Exacerbation of the symptoms Exacerbation of the symptoms
by heat (e. g., in bath) by cold
Thirst for cold drinks Feeling need for warm drinks
Quick movements Slow movements
Dark, scanty urine Dilute urine
Obstinate constipation Watery stool
Fast pulse Slow pulse
Red tongue Pale tongue
4.5 Yin and Yang
Yin and Yang are the categories within Chinese thought that have universal validity
and are applicable to all phenomena. Thus, the diagnostic criteria discussed above,
interior - exterior, excess - deficiency, heat - cold, should be regarded as shadings of
the generally valid criteria of Yin and Yang. Exterior, excess, and heat are Yang crite-
ria, while interior, deficiency, and cold are Yin criteria. The eight diagnostic criteria are
helpful in that they make it possible to describe the disturbances of Qi in the organs
and channels in a more vivid way. These patterns of disturbances, or syndromes in the
Chinese sense, are individually shaded pictures from which the experienced doctor
can derive precisely the correct therapy with needles, moxa, or medicinal herbs.
The eight diagnostic criteria seldom occur in isolation as described, but rather in
various combinations. Thus, excess and heat, two Yang criteria, often occur together.
The classic phrase for a phenomenon of this kind is Yang in Yang. Typical Yang symp-
toms predominate, such as vigorous, quick body movements, acute pain exacerbated
by pressure or heat, strong, quick pulse, hyperemia, restlessness, and fever. Excess and
cold can also occur simultaneously, or deficiency and heat. Such circumstances are de-
scribed as Yin in Yang or Yang in Yin. Thus, Yin-type and Yang-type symptoms occur
at the same time; for example fever, burning, and an urge to pass water, as Yang symp-
toms, occur together with generalized weakness, tiredness, and cold feet (Yin symp-
toms) in the presence of urinary tract infections. According to traditional ideas this
phenomenon would be described as a Yang condition of the urinary bladder and a
Yin, or weakened, state of the kidney. Often therefore, it is necessary to apply the eight
diagnostic categories to the symptoms of illness and functional disturbances of the
individual organs.
4.6 Four Examinations, Si zhen
The steps necessary for a diagnosis to be reached in traditional Chinese medicine are
fundamentally different from the process current in present-day western medicine. The
doctor uses his senses to determine a pattern of disturbance of Qi in the organs and
channels according to the eight diagnostic criteria, referring to the symptoms, the
patient's external appearance, and an external examination.
Since the time of the Han Dynasty (202 B. C. to 220 A. D.), Chinese doctors have been
using four classic methods of examination. These are:
1. Visual observation, looking (Wang zhen)
2. Listening and/or smelling (Wen zhen)
3. Questioning (Wen zhen)
4. Examination, palpation (Qie zhen)
Attention has centered on a few methods of examination since ancient times, such as
observation of the skin color, examination of the tongue, and feeling the pulse. The
allocation of specific signs and symptoms to the classic categories of disharmony has
also been subject to a continuous process of refinement. The holistic manner of obser-
vation and the intuitive ascertainment of patterns of disturbances also received a great
deal of attention in the diagnostic process.
Visual Observation Wang 51
4.7 Visual Observation Wang zhen
First of all the doctor observes the patient's overall appearance, behavior, and move-
ments. A robust, powerful constitution suggests strong organs; the patient usually
reacts with disturbances of the excess and Yang type. A feeble appearance indicates a
weakness of Qi and ling; such patients are inclined to weakness and Yin-type distur-
bances. Overweight is generally an indication that Qi is weak. An underweight, slim,
leptosomatic constitution suggests a weakness of Yin and of the blood. These patients
are inclined to active Yang behavior.
Movement is traditionally ascribed to Yang and passivity to Yin. Patients with active,
vigorous movements, an extravert, emotional nature, and a powerful, loud voice in-
cline to Yang- and excess-type disturbances. Slow, uncertain and feeble body move-
ments indicate a tendency to deficiency or Yin, with an inclination to cold-type distur-
bances. Observation of the patient's way of walking plays an important part in the
assessment of muscular movements.
During observation, the traditional Chinese doctor places particular value on the
assessment of the patient's Shen. Shen, the spiritual strength and psychic energy, is
manifest mainly in the shining of the eyes. The facial expression and the degree of
clarity in thinking also constitute an important indication of the state of the Shen. The
patient is said to "have Shen." If the Shen is weak the eyes are lackluster, the facial
expression unappealing, and the patient's thoughts disconnected and illogical. As
Shen is dependent on Qi and the blood, weakness of Shen indicates a disturbance of Qi
and the blood.
The next thing to be assessed is the color in the face. This gives important information
about Qi and the blood. It also allows decisive conclusions about the condition of the
internal organs. Colors are allocated to the Yin and Yang organs according to the
theory of the five phases (Table 4.3).
Table 4.3 Allocation of colors to organs and climatic factors

Color Yin organ Yang organ Climatic factors
Green Liver Gallbladder Wind
Red Heart Small intestine Heat, fire
Brown Spleen Stomach Damp
White Lung Large intestine Dryness
Black/gray Kidney Urinary bladder Cold
A "white face," i. e., pallor, indicates a general tendency to cold-type disturbances, or a

deficiency or Yin disturbance. In chronic pulmonary illness, too, extreme pallor and
lack of color in the face are frequent findings. A gray("black")-looking face indicates a
grave weakness of the energy in the kidneys. A yellowish/greenish color in the face in-
dicates hepatic diseases, while a yellowish/brownish color suggests a disturbance of
the digestive function of the spleen. A red face is typical in cardiac disease and can also
occur in the presence of heat-type disturbances.
Traditional Chinese medicine paid particular attention to observation of the tongue. In
addition to the size and consistency, importance also attaches to the color of the tongue
and to any coating.
A pale tongue indicates a deficiency or cold-type disturbance, while an exaggeratedly
red tongue suggests a heat-type disturbance of the internal organs. A dry tongue is an
indication of deficiency of heat or Yin, while a very moist tongue reflects a cold-type
disturbance. The functional system of spleen and stomach determines the quality of
the coating of the tongue. A slight coating can be completely normal. A thick coating
reflects a state of excess, and if it is very dry it indicates excess of Yang or heat, with
resultant loss of Yin fluid. A yellowish coating shows that a heat-type disturbance is
present. A white, watery coating is found with fullness of or heat in the stomach. Swell-
ing or enlargement of the tongue is characteristic for a deficiency of Qi and excess of
fluid.
Changes to the tongue can be restricted to particular parts. The tip of the tongue
reflects cardiac disturbances, the root shows renal disturbances, and the sides, distur-
bances ofliver and gallbladder; the middle part of the tongue undergoes changes when
disturbances of the stomach and spleen are present. Although diagnosis based on
observation of the tongue has a long tradition in Chinese medicine it now has little sig-
nificance and is just one small element of the traditional method of diagnosis.
The secretion from the nose and throat used also to be assessed with reference to the
eight traditional criteria. A clear thin secretion, for example, reflects a cold- and defi-
ciency-type disturbance, while a thick, cloudy or yellowish secretion shows a heat- or
excess-type disturbance. Blood-stained sputum shows heat-induced pulmonary dam-
age and a large volume of secretion, a damp-induced disturbance.
4.8 Listening and Smelling Wen zhen
Examinations in this category are performed to assess breathing, speech, coughing,

body odor, and the odor of the excreta. Loud agitated speech indicates a Yang-type
disturbance, while faint, slow, shy speech suggests deficiency and Yin-oriented distur-
bance. Deep, powerful breathing is an indication of an excess-type disturbance, while
fast superficial breathing usually indicates a deficiency. Vigorous coughing is evaluat-
ed as a Yang disturbance, while chronic superficial throat-clearing shows a deficiency-
type disturbance.
When assessment is made by smell a distinction is made between heat-type and cold-
or deficiency-type disturbances. A foul evil-smelling secretion or stool indicates a heat
disturbance, while a sharp acrid or fishy smell indicates a cold or deficiency distur-
bance.
4.9 Questioning Wen zhen
In this part of the examination, the traditional Chinese doctor asks the patient about
his medical history and the course of earlier and present disturbances, and assesses the
accounts supplied with reference to the eight diagnostic criteria. Illnesses with a
chronic course indicate deficiency states in the organs, while acute illnesses indicate
excesses. The medical history frequently reveals a repeated occurrence of certain or-
ganic deficiencies. Thus, the same disturbance patterns can keep on recurring. The
patient is also asked about his or her reactions to cold and/or heat and about the
nature and precise location of any pains.
Fever and feeling hot are extreme signs of a heat or Yang disturbance. If the patient
avoids warmth or the symptoms are exacerbated by warmth a heat-type disturbance is
also present. Ague, cold shudders, avoidance of cold, immoderate sensitivity to cold,
and exacerbation of symptoms by cold are typical signs of cold- or Yin-type distur-
bances. In these circumstances the Yang Qi is then decisively weakened, and the
patient is inactive and withdraws from the world around.
Sudden pronounced sweating even after only slight exertion indicates a deficiency of
Yang. Night sweats indicate a deficiency of Yin with concomitant excess of Yang.
Questioning Wen 53
Immoderate thirst is a typical heat or Yang symptom, and in its presence the Yin fluid
is exhausted. Excessive hunger or immoderate appetite expresses a deficiency of Qi.
Lack of appetite with a feeling of fullness in the abdomen shows a weakness of the
functional system made up of the spleen and the stomach. In elderly people or after
long illnesses obstinate constipation occurs when there is a deficiency of Qi and the
body fluids are used up. Spastic constipation is an excess-type or Yang-type distur-
bance of the digestive system.
According to the traditional Chinese concept, pain is a sign ofdisturbances in the flow of
Qi. Acute pain and cramps are attributed to an excess of Qi or to a blockage or stagna-
tion of Qi. Dull, oppressive or nagging pain is often caused by a deficiency of Qi. Since
pain is often the symptom that causes the patient most distress, analysis of the pain
with reference to the criteria used in Chinese medicine is of decisive importance for
selection of the therapeutic procedure to be adopted later.
Pain often radiates along channels; for example pain radiates along the heart channel
during an attack of angina pectoris. External illnesses caused by cold, such as sciatica,
also run along certain channels. In these circumstances the energy of the channel is
said to be disturbed. Allocation of pain to the corresponding channels is of decisive im-
portance later for the selection of points to be used in the therapy. For example, if a
headache is localized in the area of the gallbladder channel in the head the points used
in treatment are distal points along the gallbladder channel in the leg and foot and
points along the Sanjiao channel in the arm (channel axis).
As well as the site of pain, its quality and changes in the way it is perceived are funda-
mental to the diagnosis in the traditional sense.
Acute, sharp, shooting pains and cramps are found in excess-type disturbances or when
Qi is blocked in the channels, that is to say in the presence of Yang conditions. These
"Yang pains" are exacerbated by pressure, massage or heat. It often happens that such
Yang pains are caused by external pathogenic climatic factors, such as wind, heat, or
damp, and lead to a stagnation of Qi and blood with a consequent state of excess in the
peripheral areas of the body.
Dull, oppressive, deep pains accompanied by a feeling of fullness or by tiredness are
characteristic of deficiency-type disturbances, and they are relieved by massage, pres-
sure, or heat. These "Yin pains" are attributable to disturbances of the internal Zang
and Fu organs and are often chronic in nature. In the treatment of such pains it is of
decisive importance that the internal organs are strengthened, for example by means of
moxibustion.
In the traditional diagnosis of headache and migraine, in addition to assessment of the
nature of the pain, determination of its localization and the way it radiates also plays a
large part when the controlled acupuncture therapy to be applied is selected. Head-
aches felt in the temples are ascribed to the stomach and large intestine channel, and
parietal headaches (gallbladder course) to the gallbladder and sanjiao channel; treat-
ment is applied at the corresponding points. Acute headaches are mostly attributable
to external pathogenic climatic factors, while chronic headaches have their roots in dis-
harmonies of the internal organs and their channels.
In the presence of sleep disturbances with internal agitation, nervosity, and chaotic
thought processes Chinese doctors refer to hyperactivity of the fire in the heart, which
is caused by an excess of the heart's Yang. In the case of an excessive need for sleep, or
too much sleep with restricted activity during the day, there is a deficiency of Yang or
of the vital energy Qi.
4.10 Physical Examination Qie zhen
The last means of diagnosis is the physical examination, which is of great importance
for the diagnosis in Chinese medicine. On palpation the temperature and the tone in
the tissues and muscles are assessed and classed according to the eight diagnostic crite-
ria. Sites with severe pains are allocated to the courses of the channels and the specific
local points are ascertained. In this way points that are not acupuncture points within
the system of channels are also selected for the application of needles. These nonspe-
cific pressure pain points are called Ah-Shi points in Chinese. Overtense muscles are al-
so sought out by palpation, allocated to the channels, and then treated by way of local
and distal points. Overtense muscles and myogelosis are classed as Yang-type distur-
bances, or more specifically as states of excess with blockage of Qi. Slack muscles and
soft oily skin with no tension are regarded as a Yin condition.
The method of taking the pulse was described in detail as long ago as 200 B. C. in the
Huang Di Nei Jing. Many of the later works in the Chinese acupuncture literature give
the classic diagnostic method of taking the pulse an important place. The radial pulse is
felt with three fingers on each side. This gives six pulse points, and at these the condi-
tion of each of the five Yin organs (Table 4.4) and the six Yang organs is assessed from
the aspect of energy. The classic pulse points are called Cun, Guan, and Chi in
Chinese.
Table4.4 Allocation of the pulse points of the Yin organs

Cun (distal) Guan Chi (proximal)
Right Lung Spleen Yang kidney
Left Heart Liver Yin kidney
5 Chinese System of Channels, Organs and Points
G.Stux
5.1 Channels and Organs
Traditional Chinese medicine recognizes a system of lines covering the human body
like an orderly network. These lines follow a polar course longitudinally round the
body; European doctors compared them to the meridian system of the earth and for
this reason called them meridians (and later channels in English). As early as 200 years
B. C. the channels and their acupuncture points were described in minute detail in the
classic ancient work on acupuncture, the Huang Di Nei Jing. In this work they were
compared to the great rivers in China, which extend to all parts of the country and keep
it alive by providing the essential water.
According to traditional ideas the vital energy Qi flows through this system of channels
and regulates the body functions. It is possible to exert a direct therapeutic effect on
the channels and organs, and thus in tum on the body functions, by way of the acu-
puncture points. Points where therapeutic stimulation had similar effects were con-
nected, and this is probably how the concept of channels arose in ancient times.
The 11 organs recognized by Chinese medicine interact intimately with the channels. The
old idea of the organs is not limited to the anatomical structure of the organs, as it is in
western medicine; "organs" in the Chinese sense has much more the meaning of the
functions of organ systems. This is why the term "functional systems" is also used. The
structure and topography of the organs was subordinate in Chinese medicine, because
precise anatomical examination of the body was forbidden in ancient China. The func-
tional system of the lung, for example, means the entire respiratory function, including
the olfactory function. The functional system of the large intestine embraces the excre-
tory function. Thus, a concept of functional continua that were equated with the or-
gans arose. This ancient system of medicine was not so much morphologically oriented
as functionally, and in this way it is the opposite of western medicine, which was ini-
tially based heavily on anatomical and pathomorphological findings.
The 11 organs or functional systems were divided into 6 Yang organs and 5 Yin organs.
The 6 Yang organs are called Fu organs in Chinese; they are the hollow organs large in-
testine, small intestine, stomach, urinary bladder, gallbladder and "Sanjiao." The
5 Yin organs are the Zang organs: lung, heart (pericardium), spleen, kidney and liver.
Heart and pericardium are regarded as a single functional system, although there are
separate cardiac and pericardial channels. The Zang organs are parenchymatous or-
gans, which are referred to as storage organs because the Qi is traditionally believed to
accumulate in them.
One Yin and one Yang organ form a functional unit, e.g., large intestine (Yang) and
lung (Yin). This also involves a particular tissue, in this case the skin, and the corre-
sponding channels, i. e., the large intestine channel and the lung channel. The channel
can be compared to a branch deriving from the tree represented by the organ. The acu-
puncture points are situated along the channel like buds. By way of these points a thera-
peutic influence can be exerted on the organ function by the application of
needles, heat, or massage.
A pair of channels consists of a Yin and a Yang channel (e. g., lung and large intestine
channels), which run parallel to one another in the limbs. They are also called coupled
channels, because in the peripheral areas they are coupled with connecting vessels, the
Luo connections. Yang channels run laterally or on the dorsal side of the body, while
Yin channels run medially or on the ventral side.
The 12 channels belonging to the 11 organs are termed main channels or "Master meri-
dians." Together with the Luo connections, which connect each Yin-Yang couple of
the channels, they are referred to collectively by the Chinese as the Jing-Luo system.
ling means channel and Luo means collateral. The original meaning of the character
for ling is warp threads, i. e., the longitudinal threads in a silken fabric, which give the
fabric its longitudinal structure. The main channels play an important part in the treat-
ment of disease. Most of the acupuncture points are situated on these main channels.
In addition to the 12 coupled main channels there are other channel systems, which
can only be described briefly in this textbook.
Among the eight channels that make up the system of extraordinary channels
(Qi Jingbamai in Chinese), also called "irregular or marvellous channels," there are
two, those with their courses on the ventral and dorsal midlines of the body, that are
particularly important. The one at the front, the Ren Mai, is also referred to as the con-
ceptional vessel. The one in the midline of the back, the Du Mai, is the governing vessel,
which counts as a Yang channel. These 2 extraordinary channels and the 12coupled
main channels together make up the system of 14 channels on which the 361 classic acu-
puncture points are situated. The other channel systems do not have any points of their
own; some of them are flat, while others are linked to the main channels like a net-
work. These are the system of the
12 Jingbie, known in the European system of nomenclature as divergent or distinct
channels;
12 Jingjing, the tendinomuscular channels;
12Pibu, the cutaneous sections of the main channels; and
15 Luomai, the collaterals of the main channels.
The 12 Jingbie, divergent or distinct channels, are intimately connected with the main
channels. They promote the connection between the peripheral regions of the body
and the internal organs. The special channels link the extremities with the center of the
body, i. e., the heart. They reinforce the connection between the main channels and the
corresponding internal organs, and in particular they reinforce the central function of
the heart as the seat of mental activity ("the heart housing the mind"). The connection
of the six Yin channels to the face and head is also provided by the Jingbie, since there
are no Yin channels in the head region. The Jingbie do not have any points of their
own; they are also dependent on the points on the main channels.
The 12 Jingjing, or tendinomuscular channels, involve the muscles and tendons along
the courses of the main channels. They always originate at the extremities and take a
centripetal course towards the trunk and the head. They connect areas traversed by
muscles and tendons with the main channels, thus playing an important part in supply-
ing vital energy, Qi, to the extremities. Thus, the tendinomuscular channels are very im-
portant for movement processes in the peripheral regions. Many external illnesses are
treated by way of the system of tendinomuscular channels.
The 12 Pibu are the cutaneous surfaces parallel to the 12 main channels and run at the
surface of the body like a fine-spun network in the skin. They bring the protective Qi,
or Wei Qi, into the skin from the main channels, thus protecting the surface of the body
against the penetration of pathogenic external climatic influences. The Pibu make up
the uppermost layer in the system of resistance to pathogenic influences. The Pibu are
treated with superficial application of needles, with the aid of plum blossom needles,
with massage, cold or hot poultices, or cupping; recently laser acupuncture has also
been used.
Channels and Organs 57
DuMai
Governing Vessel RenMai

Conceptional Vessel
Yang Yin
Ren Mai und Du Mai
The 12 main channels make up a system of 3 courses or cycles of channels at the body
surface. One course of channels is made up of 4 main channels, 2 Yin and 2 Yang chan-
nels.
One Yin-Yang couple runs in parallel course along the arm, and one along the leg. An
internal branch of the channel derives from the main channel running to the corre-
sponding Yin or Yang organ. Thus, a coupled Yin-Yang channel and the correspond-
ing Zang and Fu organs together make up a functional and morphological unit.
Yin-Channel
Yin-Organ
Luo -Connections
_------1 Yang-Organ
Yang-Channel
The Zang and Fu organs thus belong together as a functional system, while the corre-
sponding Yin-Yang channels running in parallel are linked in the peripheral regions by
way of the Luo connections. For this reason, references are found to internal and exter-
nallinkage of the organs and channels.
The topography of the three channel courses and their connections are described below.
The first course is located at the ventral side of the body, the second at the dorsal side,
and the third, laterally.
The first course is made up of the lung, large intestine, stomach and spleen channels
(see adjacent figure).
The lung channel starts at the chest wall and runs along the arm to the corner of the
thumbnail. Its course is on the volar side of the arm, i. e., the inside, and it is considered
to belong to the Yin polarity. The large intestine channel starts from the index finger
and runs on the dorsal, or outer, side of the arm to the face; this channel is classed as
part of the Yang polarity.
The face is the starting point of the stomach channel, which runs ventrally down the
body to the second toe. It corresponds to the Yang polarity. The spleen channel, final-
ly, runs from the foot back to the chest wall, thus completing the first course of the
channels. The course of the spleen channel is along the inside of the leg and corre-
sponds to the Yin polarity. A simple rule emerges from all this:
Yin channels run on inner surfaces, i. e., ventral or medial ones, while Yang channels
run along outer, i. e., dorsal or lateral, surfaces.
The arrangement of the second and third courses of channels is similar to that of the
first. The second course is sited on the dorsal side of the body and is made up of the
heart, small intestine, urinary bladder, and kidney channels. The third course is made
up of the channels relating to the pericardium, Sanjiao, gallbladder, and liver, and is
situated laterally on the body. The third course passes laterally around the middle of
the body and the extremities, between the first course on the ventral side and the sec-
ond course on the dorsal side.
The three Yin channels for the lung (radial), heart (ulnar), and pericardium start from
the lateral chest wall and run distally along the inside of the arm, ending at the corners
of the fingernails. The three Yang channels for the large intestine (radial), small intes-
tine (ulnar), and Sanjiao start from the hand and run along the outside of the arm to the
face. The three Yang channels for the stomach (ventral), urinary bladder (dorsal), and
gallbladder (lateral) start from the face and pass to the foot. The course of the channels
is completed with the three Yin channels of the leg: those for spleen, kidney and
liver.
It appears to be particularly important to make oneself familiar with the "map" of
channels and understand how they are systematically interrelated, and not merely
learn where the points are (Table 5.1).
Table 5.1. Three courses of channels

Yin Yang Yang Yin
1st course Lung Large intestine Stomach Spleen
2nd course Heart Small intestine Urinary bladder Kidney
3rd course Pericardium Sanjiao Gallbladder Liver
Two adjacent Yang channels or two adjacent Yin channels in the same course of chan-
nels combine to make up a Yin or Yang channel axis, in Chinese Chiao. The Yang
channel axes pass from the arm to the leg by way of the head and trunk, that is to say,
basically downwards. The Yin channel axes have an upward direction, from the feet to
the arms by way of the trunk. The Yang channel axis made up of the large intestine and
the stomach channels is called the Yang-Ming channel axis. In Chinese sources the
large intestine channel is often referred to as the Hand Yang-Ming, and the stomach
Channels and Organs 59
I. Course of Channels. ventral

Sp. Lu.
r
Yin
l
)
Thorax
Foot Hand
t St.
(
U J
Yang Face
2. Course of Channels. dorsal
Yin Ki. He.
r )
Thorax
l
Foot Hand
tYang
UB.
(
Face
SI. J
3. Course of Channels. lateral
Yin Uv. Pe.
l
)
r Thorax
Foot Hand
tYang
GB.
Face
(
SJ. J
Table 5.2 Channel axes

Tai-Yin Major Yin Spleen and lung channels
Shao-Yin Minor Yin Kidney and heart channels
Jue-Yin Absolute Yin Liver and pericardium channels
Yang-Ming Brilliant Yang Large intestine and stomach channels
Tai-Yang Major Yang Small intestine and urinary bladder channels
Shao-Yang Minor Yang Sanjiao and gallbladder channels
channel, by analogy, as the Foot Yang-Mingo All the channel axes have Chinese
names, and the meanings of these reveal interesting link-ups (Table 5.2).
The channel axes are important for diagnosis as well as for treatment. Thus, pain
localized along the path of a particular channel is often treated by stimulation of points
on the channel axis; in the syndrome with painful shoulder and pain in the area of the
large intestine channel, for example, acupuncture needles are often applied at point
St.38 Tiaokou on the Yang-Ming channel axis.
5.2 Presentation of the Point Categories
A large number of classic acupuncture points can be allocated to point categories.

Points with particular functions are grouped in these categories. The Mu or alarm
points, for example, are useful in the diagnosis and treatment of illnesses affecting a
particular organ, while the ling points are used in acute emergencies. The points be-
longing in one category are usually situated on different channels. (The Shu points are
an exception to this; they are all on the urinary bladder channel.) The localization can
be inferred from the category of points. Thus, Mu points are found on the ventral side
of the trunk, while ling points are found at the corners of the finger- and toenails. The
five "Shu points" are on the individual channels distal to the elbow and knee and the
Luo points, proximal to the wrist or ankle; the Shu points are on the back beside the
vertebral column along the urinary bladder channel.
Thirteen categories of points are known in traditional Chinese medicine, and about
128 points can be classed in these. The separate point categories are presented below
with reference to their semantic origin, functional significance, and localization, and
the links between the separate categories. Illustrations are used to facilitate the
explanation.
5.2.1 Shu Points or Transport Points
The Chinese word "Shu" means to conveyor transport. A distinction is made between
two groups of Shu points:
The 12 Shu points on the urinary bladder channel (Table 5.3) are also referred to as
Beishuxue or Back Shu points. They are traditionally believed to convey the vital
energy Qi to the corresponding organs. One Shu point on the urinary bladder channel
is allocated to each of the five Yin or storage organs and to the six Yang or hollow
organs. These points are situated 1.5 cun lateral to the center of the vertebral column,
under the vertebral spine in each segment.
In view of their direct influence on the corresponding organ systems, treatment of these
Beishu points is indicated in organic illnesses. Their significance from the aspect of
diagnosis is based on the fact that they become sensitive to pressure when the organs
corresponding to them are diseased. Moxibustion is often applied at the Shu points.
In addition to the 12 Beishu points on the medial branch of the urinary bladder chan-
nel, there are the 5 Shu points also known as ancient points on each channel; these
points are discussed later.
5.2.2 Mu or Alarm Points
"Mu" means collect. The Mu, or alarm, points (Table 5.3) are situated ventrally on the
trunk and are also known as Mu front points. One Mu front point is attributed to each
internal organ. These points have a similar function to the Back Shu points, that is to
say, the treatment of organic disorders, and are often used together with the Shu points
in therapies. When the organs corresponding to these points are diseased they also be-
come sensitive to pressure, so that they are important in diagnosis, as alarm points, as
well as in treatment.
Shu and Mu Points 61
_Lu. _ _ _ Lu.1.
• US. 13 Feishu-
• US. 14 Jueyinshu pe.~

• US. 15 Xinshu -------He.
Ren 17 Shanzhong •
• US. 18 Ganshu-- Liv. ----Liv.14 •
• US. 19 Danshu_GB. - - - - G S . 24 •
Ren 14 Jujue •
• US. 20 Pishu - Sp.
·US. 21 ~ Ma·-------_ _ _ _ _ _ Ren 12 •
• US. 22~ 1_ .
• • • Liv. 13 Zhangmen
US. 23 GS.25
Ki.
St.25.
• US. 25 DaChangShu_---'-:-~--L I . - - - -
SJ.- - - - - Ren 5 Shimen •

• US. 27 Xiaochangshu____ SI.--______ Ren 4 Guanyuan •
• US. 28 Pangguangshu ~
US.-_ _ __ Ren 3 Zhongji •
Table 5.3 Back Shu and Mu front points

Organ Back Shu point Mu point
Lung UB.13 Feishu T-3 Lu.l Zhongfu
Pericardium UB.14 Jueyinshu T-4 Ren 17 Shanzhong
Heart UB.15 Xinshu T-5 Ren 14 Juque
Liver UB.18 Ganshu T-9 Liv.14 Qimen
Gallbladder UB.19 Danshu T-l0 GB.24 Riyue
Spleen UB.20 Pishu T-ll Liv.13 Zhangmen
Stomach UB.21 Weishu T-12 Ren 12 Zhongwan
Sanjiao UB.22 Sanjiaoshu L-l Ren5 Shimen
Kidney UB.23 Shenshu L-2 GB.25 Jingmen
Large intestine UB.25 Dachangshu L-4 St.25 Tianshu
Small intestine UB.27 Xiaochangshu S-l Ren4 Guanyuan
Urinary bladder UB.28 Pangguangshu S-2 Ren3 Zhongji
5.2.3 Influential Points, Hui Xue
Apart from their other effects, the eight influential points have a specific influence on
the tissues and/or organs corresponding to them (Table 5.4). "Hui" means to assemble
or collect. They are traditionally believed to be the points at which Qi for the corre-
sponding organs or tissues is concentrated. There are five influential points in the trunk
region, two (GB.34, GB.39) in the leg, and one, Lu. 9 Taiyuan, at the wrist.
Table 5.4 Influential points

Organ, tissues Influential points
Zang hui Yin organs Liv.13 Zhangmen
Fuhui Yang organs Ren 12 Zhongwan
Qi hui Respiratory organs Ren 17 Shanzhong
Xue hui Blood UB.17 Geshu
Guhui Bone UB.l1 Dashu
Sui hui Bone marrow GB.39 Xuanzhong
Jiu hui Muscles, tendons GB.34 Yanglingquan
Mai hui Vascular system Lu.9 Taiyuan
5.2.4 Xi-Cleft Points
"Xi" means cleft or space. It is traditionally believed that each Xi-cleft point is the
place where the Qi is accumulated for the corresponding channel. Treatment of the Xi-
cleft points (Tsri according to the Wade-Giles system) is indicated in the case of acute
illnesses of the corresponding organs or channels (Table 5.5). Following acupuncture
they are stimulated by firm manual pressure.
Presentation of the Point Categories 63
Table S.S Xi-cleft points of the organs

Organs Xi-cleft points
Lung Lu.6 Kongzui
Large intestine Ll.7 Wenliu
Stomach St.34 Lianqiu
Spleen Sp.8 Diji
Heart He.6 Yinxi
Small intestine SI.6 Yanglao
Urinary bladder UB.63 Jinmen
Kidney Ki.5 Shuiquan
Pericardium Pe.4 Ximen
Sanjiao SJ.7 Huizong
Gallbladder GB.36 Waiqiu
Liver Liv.6 Zhongdu
5.2.5 Five Shu Points
The five Shu (ancient) points are situated in the peripheral part of each channel, distal
to the elbow or knee. The peripheral position of each channel is traditionally believed
to be subject to external climatic influences such as cold, heat, dryness, damp, and
wind. These climatic factors are referred to as biopathogenic forces. According to the
traditional correspondence system of Chinese medicine each of the five Shu points
corresponds to one of the five elements. These points are therefore also known as ele-
mental points. The relative positions of the five elements are different on the Yin and
the Yang channels (see Table 5.6). Thus, on the Yang channels the ling points corre-
spond to the element metal, while on the Yin channels they correspond to the wood. In
addition, one Shu point on each channel corresponds to the same element as the chan-
nel as a whole. This point is referred to in English as the hourly point. According to the
traditional mother-and-son ruling there is a tonification point and a sedative point for
each channel.
TableS.6 Allocation of the elements to the Yin and Yang channels

Jing Ying Shu, Yuan Jing He
Yang channels Metal Water Wood Fire Earth
Dryness Cold Wind Heat Damp
Yin channels Wood Fire Earth Metal Water

Wind Heat Damp Dryness Cold
5.2.6 Tonification Point
In each case, the tonification point of the channel is the point preceding the hourly
point, the "mother point" on the Sheng cycle (Sect. 3.6). In the case of the lung channel
metal is the hourly point, and is preceded by the element earth (Yuan point, Table 5.6),
which is the tonification point. The Yuan point of the lung channel is Lu.9 Taiyuan
(Table 5.7).
TableS.7 Tonification and sedative points on the lung channel

Jing Ying Yuan Jing He
Lu.ll Lu.l0 Lu.9 Lu.8 Lu.5
Wood Fire Earth Metal is related Water
Tonification point to the lung Sedative point
5.2.7 Sedative Point
In contrast, the sedative point is the point following the hourly point; it is the "son
point." In the case of the lung channel (Table 5.7) the sedative point corresponds to the
element water and is the He point, Lu.5 Chize.
5.2.8 Jing Well Point
The ling well point (Ting in the Wade-Giles transcription) is the most distally situated
point on any channel (Table 5.8). ling means well. The ling point is the source of the
"river" that carries the Qi energy.
Eleven ling points are situated at the comers of fingernails and toenails, while the ling
point of the kidney channel is on the sole of the foot.
Table 5.8. ling well points of different channels

Channel Lu. LI. St. Sp. He. SI. UB. Ki. Sl. GB. Liv.
ling well point Lu.11 LI.1 St.45 Sp.1 He.9 SI.1 UB.67 Ki.1 Sl.1 GB.44 Liv.1
5.2.9 Ying Point
The Ying point (transcribed according to the Wade-Giles system as Yong or long) is
the second of the five Shu points and is situated proximal to the ling point in the area
of the metacarpal bones or on the top of the foot (Table 5.9). The English translation of
Ying is the name of an old lake. The word has more the meaning of a slow-flowing
river passing through a lake, because at this point the Qi coming from the source flows
along slowly and is distributed over a wider area. The energy of each channel is tradi-
tionally believed to be activated or accelerated at this point, and thus it is reinforced be-
fore flowing on further to the Yuan or Shu point. In addition, cold is stimulated in the
case of the Yang channels and heat in the case of the Yin channels (see allocation of
the five points to the elements and climatic factors).
Table 5.9 Ying points of the different channels

Channel Lu. LI. St. Sp. He. SI. UB. Ki. Pe. Sl. GB. Liv.
Ying points Lu.10 LI.2 St.44 Sp.2 He.8 SI.2 UB.66 Ki.2 Pe.8 Sl.2 GB.43 Liv.2
5.2.10 Yuan Source Point
The Yuan (transcribed as Yunn according to the Wade-Giles system) point is also
called the source point and is situated in the area of the wrist or the ankle.
Yuan means origin, source, beginning. The Yuan point is the marshalling point, the
source of Qi from the coupled channel. Puncture of the Yuan source point attracts the
energy of the coupled channel, because the transverse Luo vessel coming from the Luo
point of the coupled channel ends at this point. For this reason there is an intimate con-
nection between the Yuan points and the Luo points. The Yuan and Luo points are
credited with an important function when the energy in the two coupled channels is
disturbed.
The Yang channels have a further point, the Shu point (Yu according to the Wade-
Giles system of transcription), which corresponds to the element wood. Shu means to
transport. The Qi begins to flow more rapidly at this point.
Five Shu Points on the Leg 65
Sp. 10 Xuehai
K i. 10
Sp. 9 Y inling~uan
Sp. 6 Sanyinjiao
~~~_"_I Jing
Sp. I Yinbai
On the Yin channels, the Yuan and Shu points are the same (Table 5.10).
Table 5.10. Shu and Yuan points on the channels

Shu point L1.3 St.43 S1.3 UB.65 Sl.3 GB.41
Yuan point Lu.9 Ll.4 St.42 Sp.3 He.7 SI.4 UB.64 Ki.3 Pe.7 Sl.4 GB.40 Liv.3
5.2.11 Jing Point

The ling point (or King according to the Wade-Giles transcription system) is the fourth
of the five Shu points, Shu IV, and is situated proximal to the wrist or ankle (Table
5.11). ling means to pass through, and signifies that the stream ofQi becomes a river at
this point.
Table 5.11. ling points on the channels

ling point Lu.8 LI.5 St.41 Sp.5 He.4 Sl.5 UB.60 Ki.7 Pe.5 Sl.6 GB.38 Liv.4
5.2.12 He Sea Point

The He points (He is transcribed in the Wade-Giles system as Ho) are the most proxi-
mally situated of the five Shu points and are found in the areas of the elbow and knee
(Table 5.12). "He" means oneness, and this term thus implies that at this point the river
of Qi flows into the ocean of the body. This is where the superficial, distal course of the
channel ends, giving way to the deep, proximal course. Thus, the He sea point provides
the connection between the peripheral and the proximal parts of the channel. The He
sea points are of decisive importance in the treatment of diseases of the internal organs.
Many of the most frequently used acupuncture points are He sea points, for example
St. 36 Zusanli, LI. 11 Quchi, GB. 34 Yanglingquan.
Table 5.12. He sea points on the channels

He sea points Lu.5 LI.11 St.36 Sp.9 He.3 SI.8 UB.40 Ki.10 Pe.3 Sl.10 GB.34 Liv.8
5.2.13 Luo Connecting Point

The Luo or connecting point (transcribed as Lo in the Wade-Giles system) is situated
proximal to the Yuan point. It is the starting point for the Luo connecting vessel, a
communicating vessel that combines with the Yuan point of the other channel in the
couple (Table 5.13). The longitudinal Luo vessel arises beside it at the Luo point, and
running parallel to the channel passes from here at a deep level directly to the chan-
nel's internal Zang or Fu organ. The Luo point is not counted as one of the five Shu
points, but is a point category in its own right (Table 5.14).
Table 5.13. Luo connections between the Yin and Yang channels
Lu. LI. St. Sp. He. SI. UB. Ki. Pe. Sl. GB. Liv.
Luo Lu.7 Ll.6 St.40 Sp.4 He.5 SI. 7 UB.58 Ki.4 Pe.6 Sl.5 GB.37 Liv.5
Yuan
t t
Di.4
t
Sp.3
t t t t
St.42 SI.4 He.7 Ki.3
t t
UB.64 Sl.4 Pe.7 Liv.3
t t GB.40
Lu.9
Sp. 10 Xuehai
Ki. 10
Sp. 9 Yinling~uan
Sp. 6 Sanyinjiao
;---.._...._ ..._......., Jing

Sp. 1 Yinbai
Table 5.14. Luo and Yuan points

Channel Luo point Yuan point
Large intestine Ll.6 Pianli Ll.4 Hegu
Sanjiao SJ.5 Waiguan SJ.4 Yangchi
Small intestine SI. 7 Zhizheng SI.4 Hand Wangu
Stomach St.40 Fenglong St.42 Changyang
Gallbladder GB.37 Guangming GB.40 Qiuxu
Urinary bladder UB.58 Feiyang UB.64 Jinggu
Lung Lu.7 Lieque Lu.9 Taiyuan
Pericardium Pe.6 Neiguan Pe.7 Daling
Heart He.5 Tongli He.7 Shenmen
Spleen Sp.4 Gongsun Sp.3 Taibai
Sp.21 Dabao
Liver Liv.5 Ligou Liv.3 Taichong
Kidney Ki.4 Dazhong Ki.3 Taixi
DuMai Du 1 Changqiang
Ren Mai Ren 15 Jiuwei
5.2.14 Confluent Points
The confluent points (Table 5.15) are on the main channels in the area of the wrist or
ankle and form a link between the main channels and the extraordinary channels.
These key points are traditionally believed to bring the extraordinary channels into
play. They are used in the treatment of disturbances of the extraordinary channels.
Most of the key points are Luo or Yuan points.
Table 5.15 Extraordinary channels and their confluent points

Extraordinary channels Confluent points
Chong Mai (Tchong Mo) Sp.4 Gongsun
Yinwei (Yin Oe) Pe.6 Neiguan
Du Mai (Tou Mo) S1.3 Houxi
Yangqiao (Yang Keo) UB.62 Shenmai
Dai Mai (Tae Mo) GB.41 Foot Linqi
Yangwei (Yang Oe) SJ.5 Waiguan
Ren Mai (Jenn Mo) Lu.7 Lieque
Yinqiao (Yin Keo) Ki.6 Zhaohai
Sp. 10 Xuehai
Ki. 10
Sp. 9 Ynli ing!=juan
Sp. 6 Sanyinjiao
.......---,......._ .._~ Jing

Sp. 1 Y ni bai
5.3 Methods of Point Location
Several methods of locating acupuncture points are used. Every acupuncture point is
located with its own specific method. Some points can be located with the aid of more
than one method. Accurate location of the acupuncture points is very important for the
success of the treatment. Palpation of the area concerned is important, because acu-
puncture points mostly become increasingly sensitive to palpation. Especially in the
area of painful disorders of the locomotor system, but also in neurological disorders,
points that are tender on pressure are found. These points are also needled if they do
not correspond to classic acupuncture points in their location. Such tender points are
called Ah Shi points in Chinese and are indicated as local points in addition to the spe-
cific distal points.
Mter needling acupuncture points it is useful to check the correct position of the nee-
dle and in the event of excessive divergence to needle once more. This supplementary
checking of the location is didactically very important and is especially advisable for
the beginner.
5.3.1 Anatomical Landmarks
Acupuncture points are located with the help of anatomical landmarks of the body,
such as eyebrow, hairline, transverse crease of a joint, spinous processes of the verte-
brae, mamillae, navel, and upper border of the symphysis.
Examples:
Ren 12 Zhongwan is located midway between the tip of the xiphoid and the umbilicus.
Du 13 Taodao is located between the spinous processes of the 1st and 2nd thoracic
vertebrae.
Ex.1 Yintang is located between the eyebrows.
5.3.2 Proportional Cun Measurement
The Chinese use the cun or "body inch" to measure the distances on the body. The cun
is a relative body measure. It is the distance between the transverse creases of the inter-
phalangeal bone of the middle finger when the patient's finger is slightly flexed (see
diagram below). The breadth of the distal phalanx of the thumb is also equal to 1 cun.
The hand has a breadth of 3 cun at the level of the proximal finger joints (4 finger
breadths = 3 cun). The breadth of the index and middle fingers together is equal to 1.5
cun. The distance of the acupuncture points from transverse creases or joint clefts is
measured in cun.
If the proportions of the physician and the patient are identical measurement in the
physician's cun is permissible. When there is an obvious discrepancy, for example in
the treatment of children, it is difficult to size up the proportions. In Sri Lanka a new
device, the cunometer, has been developed to measure exactly in cun. It is a scissors-
type instrument with four pairs of arms, their lengths in a fixed relative proportion of
1 : 2 : 3 : 4. In dependence on the pair of arms used to measure off the cun, lengths of
0.25-4 cun can be set and used for measurement. A cunometer makes exact measure-
ment of the individual cun possible, which is especially helpful in the treatment of chil-
dren and for the beginner.
Cun measurement with the Hand 71
1,5 (un
1 (un
2 (un 3 (un
72 Methods of Point Location
i
2Cun
1
1
1Cun Cunometer
Examples of Cun measurement:
Ren 5 Shimen is located 2 cun below the navel, on the midline.
The points on the stomach channel in the area of the abdomen are located 2 cun para-
medially, whereby the points of the kidney channel are located 0.5 cun laterally to the
midline. The points of the medial branch of the urinary bladder channel are located 1.5
cun (2 finger breadths) to the side of the vertebral column.
5.3.3 Proportional Measurement
The lengths of the various parts of the body, e.g., forearm, upper arm, thigh, are gener-
ally in fixed proportions to each other that can be expressed in cun (see diagram
below).
From the anterior to the posterior hairline, on the midline 12cun
Between the eyebrow line and the anterior hairline 3cun
Dorsal hairline to the prominence 3cun
Between the two mamillae 8cun
Between two ribs lcun
Between the umbilicus and the tip of the xiphoid 8cun
Between the navel and the upper border of the symphysis 5cun
Between the axillary fold and the transverse crease of the elbow 9cun
Between the transverse creases of elbow and wrist 12cun
Between the greater trochanter of the femur and the middle of the patella 19cun
Between the middle of the patella and the tip of the lateral malleolus 16cun
5.3.4 Location by Means of Specific Posture
The patient is asked to adopt a specific posture that is helpful for point location.
Examples:
LI.4 Hegu is located when the thumb is adducted, at the highest point of the resultant
muscular ridge.
LI. 11 Quchi is located at the lateral end of the transverse crease when the elbow is
flexed to a right angle.
Sp. 10 Xuehai is located when the knee is flexed, at the middle of the m. vastus
medialis.
Cun proportions on the Body 73
19Cun
,
16 Cun
74 Methods of Point Location
5.3.5 Location by Measurement of Skin Resistance
Many acupuncture points, especially peripheral ones, have a lower skin resistance than
the surrounding area. Instruments designed to measure skin resistance for the purpose
of locating acupuncture points give acoustic or visual signals indicating points at
which skin resistance is lowered. About 80 acupuncture points with reduced skin resis-
tance can be accurately located with this method, most of them distal ones. Measure-
ment of skin resistance is advisable for the beginner, and especially for location of
points on the ear. On the ear this method is of significant importance because areas on
the ear corresponding to disturbed organs or body regions develop reduced skin resis-
tance. Therefore, this method is also important as an additional diagnostic method for
ear acupuncture.
5.3.6 Location with the Aid of Other Points
Examples:
Ex.6 Sishencong is located 1 cun in front of, lateral and dorsal to Ou 20 Baihui.
St. 40 Fenglong and St. 38 Tiaokou are located 5 cun below St. 36 Zusanli.
5.3.7 Combination of Different Methods
Examples:
St. 36 Zusanli is found one finger breadth lateral to the tuberositas tibiae.
GB.14 Yangbai is located 1 cun above the middle of the eyebrow.
5.3.8 Location of Painful, Sensitive or Tender Points
These points are called Ah Shi points (locus dolendi) and are not necessarily classic
acupuncture points. Needling of these sensitive or tender points is important in loco-
motor disorders.
Cun proportions on the Body 75
19Cun
( ,
16 Cun
6 Systematic Description of Channels and Points
G.Stux
6.1 Lung Channel Lu.
The lung channel is a Yin channel. The lung channel and the spleen channel together
make up the Tai Yin axis.
Course: According to the traditional theory each channel has an internal course, which
connects the peripheral and superficial course with the corresponding organ (lung)
and with its connected organ (large intestine). The internal course of the lung channel
originates from the "middle burner" (Jiao) in the epigastric region and first runs
downward to the large intestine, then back upward to the stomach and on to the cardia,
subsequently passing through the lung to the neck and from here sideways to the point
Lu. 1 Zhongfu. The superficial course of the lung channel starts on the lateral side of
the thorax in the 1st intercostal space, then descends along the radial side of the upper
arm, along the radial side of the forearm to the wrist joint and ends on the radial comer
of the thumb nail.
Clinical Applications: Treatment of respiratory disorders, disorders of throat and nose;

skin disorders and painful disturbances along the channel.
Element: Metal
Coupled organ: Large intestine
Tissue: Skin
Sense organ: Nose, sense of smell
Maximal time: 3-5a.m.
Alarm point, Mu: Lu.1 Zhongfu
Back Shu point: UB.i3 Feishu (lateral to T-3)
He Xi Luo Jing Yuan Ying Jing
Lu 5 6 7 8 9 10 11
• • • •
TaiYin
LI
+
Yang Ming
•
11
•7 •3 •2 •
Important points Point categories, clinical applications
Lu.1 Zhongfu Mu point, alarm point

Lu.5 Chize He point, sedative point
Lu.6 Kongzui Xi-cleft point
Lu.7 Lieque Luo connecting point to LI.4 Hegu
Confluent point for Ren Mai
Lu.9 Taiyuan Yuan source point,
Tonification point
Influential point for the vascular system
Lu.10 Yuji Ying point
Lu.11 Shaoshang Jing well point
Lu. 1 Zhongfu Center of the prefecture Mu (alarm) point of the lung
Location: On the lateral side of the anterior wall of the thorax in the 1st intercostal
space. This point is located 6 cun lateral to the midline and in relaxed shoulder girdle
1 cun below the clavicle, below Lu.2 Yunmen.
Indications: As the alarm point of the lung this point is painful or tender on pressure in
respiratory disorders. It is often used in disorders of the respiratory organs, such as
bronchial asthma, bronchitis, bronchiectasis, and their symptoms, such as cough, dysp-
nea and thorax pain.
Local point needling is performed here for pain in the shoulder girdle and pain on the
lateral side of the thorax.
Needling method: Tangential and lateral, ca. 1 cm. Oblique direction to avoid injury of
the pleura (pneumothorax).
Some acupuncture points are called "dangerous" points owing to their anatomicalloca-
tion, because dangerous injuries can be caused by careless needling, e. g., pneumo-
thorax. No manual stimulation should be carried out at dangerous points.
Lu. 5 Chize Pond of the elbow He point Sedative point
Location: At the elbow crease, lateral to the biceps tendon.

Indications: Arthritis of the elbow joint, lung disorders, paralysis of the arm. In psoria-
sis and other skin disorders bleeding of this point may be effective. For this purpose
relatively thick needles are used (0.5-1.0 mm).
According to traditional medicine, the bleeding of points has an additional sedative
effect for the Qi, the vital energy.
Lu.5 Chize is the He point of the lung channel and is one of the five Shu points, thus
corresponding to the element water.
Needling method: Perpendicular, 1-2 cm.
Lu. 6 Kongzui Pronounced cleft Xi-cleft point
Location: On the radial side of the forearm, 7 cun proximal to the wrist joint crease, on
the connection line between Lu. 5 and Lu.9
Indications: According to traditional theory this point is a Xi-cleft point, and stimu-
lation of it is indicated in acute disorders of the corresponding organ, the lung, in acute
bronchial asthma, for example. A further indication is acupuncture anesthesia.
Needling method: Perpendicular, 1-2 cm, strong stimulation.
Lung Channel Internal Course 79
\
Lu.1 Zhongfu
\
.. ,
Lu.
I
I
/
I
I
I
I
I
I
I
,
I
I
I
I Lu.5 Chize
I
I
Lu.6 Kongzui
Lu.7 lieque
Lu. 7 Lieque Mistake in row Luo connecting point to LI. 4,

confluent point of Ren Mai
Location: On the radial side of the forearm on the border of the radius, 1.5 cun proxi-
mal to the transverse crease of the wrist.
Indications: Disorders of the respiratory organs, such as bronchitis, bronchial asthma,
bronchiectases. Pain in the neck, back of the head, cervical spondylosis, tension and
myogelosis of the neck muscles, headache, toothache and facial paralysis, paralysis
and restricted movement of the upper extremity, Parkinson's disease, skin disorders,
local disorders such as arthritis of the wrist or tendovaginitis.
Lu.7 Lieque is the Luo point of the lung channel, and therefore the starting point
for the transverse and longitudinal Luo vessel. The transverse Luo vessel connects
Lu.7 Lieque with the coupled large intestine channel, with the Yuan point LI. 4 Hegu.
Consequently, disturbances along the large intestine channel, e. g., toothache and
facial paralysis, can be treated with stimulation of Lu. 7 Lieque.
Lieque is one of the important distal points.
The course of the longitudinal vessel leads to the lung and directly influences this or-
gan. Therefore, this point is very important in the treatment of lung disorders. As con-
fluent point, Lu.7 Lieque brings the extraordinary channel Ren Mai into play.
Needling method: Oblique, 1-2 cm.
Lu. 8 Jingqu Channel ditch Jing point
Location: On the radial side of the radial artery, 1 cun proximal to the transverse crease
of the wrist measuring from the point Lu.9 Taiyuan.
Indications: The location of this point corresponds to the 2nd pulse Guan of traditional
pulse diagnosis. On the right side the spleen pulse (deep) and stomach pulse (superfi-
cial) are palpated here; on the left side, the liver (deep) and the gallbladder pulse
(superficial).
Besides this diagnostic significance, Lu.8 Jingqu is also important in the treatment of
wrist and throat disorders.
Needling method: Perpendicular, 0.5 cm.
Lu. 9 Taiyuan Large deep abyss Yuan source point from LI. 6
Tonification point
Influential point for blood vessels
Location: On the radial side of the wrist joint crease, lateral to the radial artery.
Indications: Disorders of the respiratory organs; arteriosclerosis and further blood ves-
sel disorders (influential point of blood vessels), wrist pain, polyneuropathy of the
upper extremity.
According to traditional Chinese theory Lu.9 Taiyuan is one of the 8 influential points.
Influential points have a specific effect in disorders of certain tissues and organs. Tai-
yuan is the influential point for disorders of the vessels, for example in arteriosclerosis,
intermittent claudication, endarteritis and varicosis.
Lu.9 Taiyuan is also the Yuan source point of the lung channel; this is where the trans-
verse Luo vessel, coming from the Luo point LI. 6 of the large intestine channel, ends.
It is also the tonification point of the channel. Tonification points, according to the tra-
ditional mother-and-son law, increase the energy of the corresponding organ. Moxi-
bustion at tonification points has a very intensive effect.
Needling method: Perpendicular, 0.5-1 cm.
Caution with needling: Avoid the radial artery.
Lung Channel Internal Course 81
\
Lu.1 Zhongfu
,
\
"
Lu.
I
I
/
I
I
I
I
,,,
I
I
I
I
I Lu.5 Chize
I
I
Lu.6 Kongzui
Lu.7 lieque
Lu. 10 Yuji Fishlike border Ying point
Location: On the palm of the hand, above the middle of the 1st metacarpal bone, at the
junction between the skin of palm and dorsum of the hand.
Indications: Pain, numbness of the hand as a consequence of peripheral vascular disor-
ders, arthrosis of the thumb joint, polyneuropathy, respiratory disorders.
Points on the hand are seldom used as hand acupuncture is very painful.
Lu. 11 Shaoshang Minor 2nd tone (Shang) Jing well point
The Chinese differentiate five tones (a pentatonic scale). The five tones are related to
the five phases. The 2nd tone, Shang, corresponds to the element metal, and thus to the
lung. The meaning is weak lung Qi.
Location: On the radial side of the thumb nail, ca. 3 mm proximal to the nail comer.
Indications:Treatment of acute emergencies such as fainting, collapse, epileptic attack,
high fever, fever convulsions, cardiac and respiratory emergencies. Acupuncture
should be combined with other emergency measures.
Jing well points are reserved for acute emergencies and other serious disorders, be-
cause needling at these is very painful.
Needling method: Oblique in proximal direction, ca. 2 mm.
Further points on the lung channel with translations
Lu.2 Yunmen Gate of clouds

Lu.3 Tianfu Heavenly prefecture
Lu.4 Xiabai Noble white
Lung Channel 83
Lu. 1 Zhongfu
6.2 Large Intestine Channel LI.
The large intestine channel is a Yang channel. The large intestine channel and the
stomach channel together make up the Yang Ming axis.
Course: The channel course runs from the radial comer of the index finger nail along
the tabatiere to the radial and dorsal side of the forearm, then to the radial side of the
elbow crease. Along the lateral side of the upper arm it ascends to the shoulder, where
it forms a connection with Du 14 Dazhui below the prominence, returns to the fossa su-
praclavicularis, where the internal branch originates, passing to the lung and on to the
large intestine. An internal connection runs to the lower He point St. 37 Shangjuxu.
From the fossa supraclavicularis the external course of the channel continues along the
side of the neck to the face and ends lateral to the nose at the opposite side, with LI. 20
Yingxiang.
Clinical applications: The large intestine channel is coupled with the lung channel, and
the two together constitute a functional unity; distal points of the large intestine chan-
nel are stimulated in disorders of the related organ, the lung, and in skin disorders.
Stimulation of large intestine points is also indicated in disorders along the channel
course.
LI.4 Hegu is the most important analgesic point in the body and is stimulated in all
painful conditions. LI.11 Quchi, because of its homeostatic and immune-enhancing
effects, is one of the most frequently used acupuncture points.
Element: Metal
Coupled organ: Lung
Tissue: Skin
Sense organ: Nose, sense of smell
Maximal time: 5-7 a. m.
Alarm point, Mu: St. 25 Tianshu (2 cun lateral to the navel)
Back Shu point: UB.25 Dachangshu (lateral to L-4)
Luo connection: LI. 6 to Lu. 9
He Xi Luo Jing Yuan Ying Jing
Lu 5 6 7 8 9 10 11
• • • •
Tai Yin
LI
+
Yang Ming
•
11
•7 •
3
•2 •
Coupled channels: Lung and large intestine channel

Large Intestine Channel Internal Course 85
LI.1S Jianyu
\ LI. 11 Quchi
I
I
I
1 LI.7Wenliu
,
I
I
I
11. 6 Pian Ii
I
I
I
I
LI.4 Hegu
I
I
I
I
I
I
I
I
I
I
I
I
,I
I
I
, '1;:;
\
'-
I
I
\
I
\
\
\
~
St. 37 Shangjuxu
LI.1 Shangyang Jing well point

LI.4 Hego Yuan source point from Lu.7
LI.6 Pianli Luo connecting point to Lu.9
LI.7 Wenliu Xi-cleft point
LI.11 Quchi He point and tonification point
LI.1 Shangyang Yang of the 2nd tone (Shang) Jing well point
Shang, the 2nd tone of the Chinese five tone scale (pentatonic), corresponds to the ele-
ment metal. The organ with which the Yang part of the "metal" according to the five
phases is associated is the large intestine.
Location: On the radial side of the index finger, 3 mm proximal to the nail corner.
It can also be situated at the point of intersection of the radial and proximal border
lines of the nail.
Indications: Acute emergencies such as fainting, collapse, epileptic attack, high fever,
apoplexy, acute pain and swelling of the throat.
Needling method: Perpendicular or oblique, 1-2 mm.
LI. 3 Sanjian Three spaces between Shu point
Location: On the radial side of the index finger, proximal to the head of the os metacar-
pale II.
Indications: For acupuncture anesthesia in tooth extraction and toothache.
Needling method: Perpendicular, 0.5-1 cm, or in direction to LI. 4 Hegu.
LI. 4 Hegu Closed valley Yuan source point from Lu. 7
Location: There are three possible ways oflocating this important point:
1. At the highest point of the m. adductor pollicis with the thumb and index finger
adducted. This method is the one most often used.
2. At the midpoint of the line bisecting the angle between the 1st and 2nd metacarpal
bones when the thumb is fully extended.
3. Same level on the radial side of the 2nd metacarpal bone, above the 1st m. interos-
seus. This location is different from the first and second, and is often used for acu-
puncture anesthesia.
Indications: Painful conditions; stimulation relieves pain in all parts of the body.
LI. 4 Hegu is the most important analgesic point. Treatment of disorders of the head
area, especially of the face, the neck, and the teeth; sweating, fever, abdominal pain,
painfree childbirth. The specific effect on the head has been verified by clinical re-
search. Stimulation of this point, owing to its good analgesic effect, is nearly always in-
dicated in anesthesia. LI. 4 Hegu is one of the most frequently used acupuncture
points.
Needling method: Perpendicular, 1-2 cm, directed toward Pe.8 Laogong.
Large Intestine Channel 87
LI. 20 Yingxiang
LI.19 Nasen-Heliao
LI.14 Binao
)
LI. 4 Hegu
LI.,3 Sanjian
-'""-""'-
~~~t-=:;:::;i::!::=~LI.1 Shangyang
LI. 5 Yangxi Yang brook Jing point
Location: Between the tendons of the m. extensor pollicis longus and of the m. extensor
pollicis brevis, in the tabatiere, at the radial end of the dorsal side of the wrist. This
point should be located with the wrist in extension.
Indications: Arthritis of the wrist, eye disorders, excessive sweating, headache.
LI. 6 Pianli Lateral course Luo connecting point to Lu. 9
Location: On the radial and dorsal side of the forearm, 3 cun proximal to the dorsal
crease of the wrist, from LI. 5 Yangxi.
Indications: As a Luo point it is the Luo connecting point to the lung channel (Lu.9
Taiyuan) and suitable for treatment of disturbances of both related channels lung and
large intestine (e. g., tonsillitis and nose bleeding).
Needling method: Perpendicular or oblique, 0.5-2 cm.
LI. 7 Wenliu Warm sliding Xi-cleft point
Location: On the radial and dorsal side of the forearm, on the line connecting the
points LI. 5 Yangxi and LI. 11 Quchi, 5 cun proximal to the dorsal crease of the wrist,
from LI. 5 Yangxi.
Indications: Acute abdominal pain, flatulence, acute pain of the face, and headache.
Xi-cleft points are used in acute disorders of the corresponding organ or channel and
are stimulated strongly.
Needling method: Perpendicular, 1-1.5 cm.
LI. 10 Shousanli Three units on the arm
Location: On the forearm 2cun distal to LI.11 Quchi.

Indications: Paralyses, tremor, epicondylitis, tennis elbow. Arthrosis of the elbow joint.
Abdominal pain, diarrhea. LI. 10 Shousanli is an important general tonification point.
Therefore, moxibustion is often indicated.
LI. 11 Quchi Pond on the curve He point Tonification point

Location: On the end of the lateral transverse elbow crease, when the forearm is flexed
at a right angle to the upper arm. Also to be located on the transverse crease at the mid-
dle of the connection between biceps tendon and the lateral epicondylus of the
humerus.
Indications: Homeostatic and immune-enhancing point. Therefore this point is often
used in allergic and infectious disorders, furthermore in skin disorders, endocrine dis-
turbances, hypotension, hypertension, states of weakness, elbow disorders. LI. 11
Quchi, because of its tonifying effect, is also very often heated with moxa.
LI.14 Binao Upper arm
Location: On the lateral side of the upper arm, on the front border of the V-shaped
middle side of the m. deltoideus; on the line connecting LI. 11 Quchi and LI. 15 Jianyu.
LI. 20 Yingxiang
LI. 19 Nasen-Heliao
LI.14 Binao
)
LI.4 Hegu
--
LI .. 3 Sanjian
~~~.....:::;:::;::!::::;:~LI.1 Shangyang
Indications: Neuralgia of the arm, periarthritis of the shoulder.

LI. 15 Jianyu Shoulder clavicle
Location: With the arm abducted, on the shoulder in the anterior depression, palpable
anterior to the tendon of the m. biceps.
Indications: Periarthritis of the shoulder, paralysis of the arm, periarthritis humero-
scapularis.
LI. 17 Tianding Celestial kettle
Location: Above the middle of the fossa supraclavicularis, on the posterior side of the
m.stemocleidomastoideus, 1 cun below LI. 18 neck Futu.
Indications: Angina, tonsillitis, cough.
Needling method: Perpendicular, 0.5 cm. A dangerous point.
LI. 18 Neck Futu Assistance for outlet
Location: 3 cun lateral to the prominence of the thyroid cartilage, between the two bel-
lies of the m. stemocleidomastoideus.
Indications: Goiter, sore throat, cough, dysphagia, bronchial asthma.
Needling method: Perpendicular, 0.5 cm. A dangerous point.
LI. 19 Nose Heliao Small and long bone cleft
Location: Below the nose, 0.5 cun lateral from Du 26 Renzhong. Du 26 is located on
the midline, on the border between the upper and middle third of the distance between
nose and upper lip.
Indications: Rhinitis, common cold, nose bleeding, facial paralysis, trigeminal neural-
gia, toothache.
Needling method: Oblique, 0.2-0.5 cm.
LI. 20 Yingxiang Welcome the smell
Location: Between ala nasi and nasolabial groove.

Indications: Rhinitis, blocked nose, common cold, nose bleeding, facial paralysis,
trigeminal neuralgia, toothache.
Further points on the large intestine channel with translations
LI.2 Erjian Two spaces

between Ying
U.8 Xialian Below the edge
LI.9 Shanglian Above the edge
LI.12 Zhouliao Elbow bone cleft
LI.13 Hand Wuli Five units on the arm
LI.16 Jugu Large bone
LI. 20 Yingxiang
LI.19 Nasen-Heliao
LI.14 Binao
)
LI.4 Hegu
LI..3 Sanjian
.,..~"-
~~~~;::;:~~L~1.1 S angyang
6.3 Stomach Channel St.
The stomach channel is a Yang channel. The stomach channel and the large intestine
channel (also Yang) together make up the Yang Ming axis.
Course: The stomach channel starts below the middle of the eye with point St. 1 Cheng-
qi and courses in a V tum to the temple to St. 8 Touwei. From St. 1 Chengqi, an internal
connection runs first to the bridge of the nose (VB. 1 Jingming) and then to point LI. 20
Yingxiang at the ala nasi. A further internal branch turns downward from point St. 1 to
the upper gums, circles around the lips, connects to the Ren Mai below the mouth, and
continues to the cheek. From St. 5 Daying on the cheek the external branch runs
downward along the throat to the fossa supraclavicularis, descending to point St. 12
Quepen. From here, the internal branch passes through the thorax to the stomach and
then to the spleen. The superficial course follows the mamillary line along the thorax to
the abdomen, where 2 cun lateral to the midline it continues on the anterior side of the
thigh to the lateral side of the knee and lateral border of the tibia to the dorsum of the
foot. The channel ends at the lateral comer of the 2nd toenail in point St.45 Lidui.
Clinical applications: The points of the face (St.1-8) are used in disorders of this area,
e. g., eye disorders, migraine, facial paralysis, trigeminal neuralgia, and toothache. The
points of the thoracic area are indicated in chest pain and in disorders of the mammary
gland. Abdominal points (St. 21,25,29) are selected in gastrointestinal disorders and in
pelvic disorders. Points of the lower extremity are used in the treatment of paralysis
and joint disorders. Stimulation of points below the knee, as distal points, is indicated
in abdominal disorders (St.36, 40) and in disorders of the shoulder joint (St.38) and of
the face (St. 44).
Element: Earth
Coupled organ: Spleen
Tissue: Fatty tissue, muscle, "flesh"
Sense organ: Mouth
Maximal time: 7 -9 a. m.
Alarm point, Mu: Ren 12Zhongwan (middle navel xiphoid)
Back Shu point: UB.21 Weishu (lateral to T-12)
Jing Ying Yuan Luo Jing Xi He

1 2 4 5 8 9 TaiYin
• •+ • • •
Sp.
St.
•
45
•
44
•
43
•• •
40 36 34 Yang Ming
Coupled channels: Spleen and stomach channel

Stomach Channel Internal Course 93
St.1 Chengqi
St. 17 Ruzhong
St. 21 liangmen
St. 25 Tianshu
St. 32 Femur-Futu
St.34 liangqiu
St. 36 Zusanli
St. 38 Tiaokou
St. 40 Fenglong
St. 44 Neiting
St.1 to St.8 Disorders ofthe face

St. 12 Quepen Disorders of the thorax
St. 21, St. 25, St. 29 Abdominal disorders
St. 29 Guilai Urogenital disorders
St. 30, St. 36, St. 38, St.41 Paralysis of the leg
St. 34 Liangqiu Xi-cleft point
St. 36 Zusanli He point, general tonification point
St. 40 Fenglong Luo connecting point to Sp. 3
St.42 Chongyang Yuan source point from Sp.4
St. 44 Neiting Ying point, important analgesic point
St. 45 Lidui Jing well point
St. 1 Chengqi Receive tears
Location: Directly below the middle of the eyeball, just above the lower border of the
orbit.
Indications: Eye disorders, trigeminal neuralgia.
Needling method: This point is a dangerous acupuncture point owing to its location
near the eye. Needling should be carried out only by experienced acupuncturists: per-
pendicular, 0.1-0.8 cm, along the lower border of the orbita.
GB.1 Tongziliao, UB.1 lingming, St.1 Chengqi and Ex.4 Qiuhou are located around
the orbita. The three Yang channels coursing from the head to the feet originate around
the eye: the stomach channel below the eye passes ventrally down the body; the uri-
nary bladder channel medial to and above the eye, dorsally along the body; and the
gallbladder channel lateral to the eye has a lateral course.
St. 2 Sibai Four white, In all directions clear
Location: On the infraorbital foramen, 0.7 cun directly below St.1 Chengqi.
Indications: Trigeminal neuralgia, eye disorders, facial paralysis.
Needling method: Perpendicular, 0.2-0.5 cm.
The first four stomach points St. 1. St. 2, St. 3, and St. 4 are located on the vertical line
below St. 1 Chengqi.
St. 3 Juliao Large bone cleft
Location: Directly below St. 2 Sibai at the level of the lower border of the ala nasi.
Indications: Trigeminal neuralgia, sinusitis, rhinitis, toothache, facial paralysis.
Needling method: Oblique or perpendicular, 0.5 cm.
St. 4 Dicang Storage in the earth
Location: 0.5 cun lateral to the comer of the mouth, on the vertical line below the mid-
dle of the eyeball.
Indications: Trigeminal neuralgia, facial paralysis, hypersalivation, aphasia, disorders
of the upper jaw, sinusitis. For anesthesia in tooth extraction from the upper jaw.
Needling method: Oblique, in lateral direction, 1 cm.
Stomach Channel Internal Course 95
St.1 Chengqi
St.17 Ruzhong
St. 21 Liangmen
\
St. 25 Tianshu
St. 32 Femur-Futu
St. 34 Liangqiu
St. 36 Zusanli
St. 38 Tiaokou
St. 40 Fenglong
St. 44 Neiting
St. 5 Daying Great welcome
Location: At the lowest point of the anterior border of the masseter muscle.
Indications: Trigeminal neuralgia, toothache, parotitis, facial paralysis.
St. 6 Jiache Cheek mechanism
Location: At the midpoint of the masseter muscle, when the jaw is closed.
Indications: Trigeminal neuralgia, toothache, parotitis, trismus, facial paralysis.
In trigeminal neuralgia the local points St. 2 Sibai, St. 3 Juliao, St. 4 Dicang,
St. 5 Daying, St. 6 Jiache, St. 7 Xiaguan, and SI.18 Quanliao are very important.
St. 7 Xiaguan Below the pass
Location: In the depression below the middle of the lateral arch of the os zygomaticum
in the palpable groove formed above the mandibula.
Indications: Trigeminal neuralgia, toothache, arthritis of the mandibular joint, facial
paralysis.
St. 8 Touwei Head binding
Location: 0.5 cun dorsal to the comer of the hairline on the forehead, just above
St. 7 Xiaguan. This point is located 4.5 cun lateral to the midline and 3 cun above the
level of the eyebrows.
Indications: Migraine, frontal and parietal headache, excessive lacrimation.
Needling method: Horizontal, 1 cm, posterior direction for headache, anterior direction
for eye disorders. AIl points of the scalp are needled in a tangential direction.
St. 12 Quepen Imperfect basin
Location: On the mamillary line, at the midpoint of the supraclavicular fossa, 4 cun lat-
eral to the midline.
Indications: Thorax pain, bronchial asthma, cough, sore throat.
Needling method: Perpendicular, 0.5-1 cm. A dangerous point.
St.17 Ruzhong Breast center
This is a forbidden point for acupuncture and moxibustion and is only used for orien-
tation, to locate other acupuncture points.
Location: Center of the nipple, in the 4th intercostal space, 4cun lateral to the midline.
Stomach Channel, Head and Trunk 97
St. 1 Chengqi
St. 2 Sibai
St. 3 Juliao
St. 4 Dicang
St. 17 Ruzhong
St. 21 liangmen t
St. 25 Tianshu
"
St. 29 Guilai
St. 18 Rugen Base of the breast
Location: Just below the nipple in the 5th intercostal space.

Indications: Mastitis, lactational deficiency, chest pain, cough, dyspnea, angina
pectoris, intercostal neuralgia.
Needling method: Oblique, 1 cm, lateral outward direction.
Dangerous point (pneumothorax).
St.13, St.14, S1.15, S1.16 are located on the mamillary line, 4cun lateral to the midline,
and are rarely used.
St. 21 Liangmen Beam gate
Location: 2 cun lateral to the midline, 4 cun above the umbilicus. S1. 21 is located lateral
to Ren 12 Zhongwan, and the two points are often stimulated together.
Indications: Acute and chronic gastritis, gastric and duodenal ulcer, gallbladder disor-
ders, vomiting, and nausea.
Needling method: Perpendicular, 1-2 cm. A dangerous point.
St. 25 Tianshu Celestial pivot Mu point of large intestine
Location: 2cun lateral to the umbilicus.

Indications: Acute and chronic gastroenteritis, diarrhea, constipation, vomiting, nau-
sea, gastric and duodenal ulcers. As an alarm (Mu) point, important in diagnosis of dis-
orders of the large intestine.
Needling method: Perpendicular, 1-2 cm. In weakness conditions, moxibustion of
St. 21 Liangmen, St. 25 Tianshu and Ren 12 Zhongwan is indicated.
St. 29 Guilai Coming back
Location: 4 cun directly below S1. 25.

Indications: Constipation, diarrhea, irritable bowel disease, pelvic disorders, urogenital
disorders, impotence.
St. 30 Qichong Vital energy impulse
Location: 5 cun directly below S1. 25, 2 cun lateral to the midline (Ren 3), above the
symphysis.
Indications: Constipation, diarrhea, urogenital disease, impotence.
St. 31 Biguan Thigh joint
Location: At the point of intersection of the vertical line from the anterior superior iliac
spine and the horizontal line on the level of the lower border of the symphysis.
Indications: Paralysis of the lower extremities, coxarthrosis.
Needling method: Perpendicular, 2-3 cm. In treatment of paralysis electrostimulation
of the stomach points is applied.
Stomach Channel, Head and Trunk 99
St. 1 Chengqi
St. 2 Sibai
St. 3 Juliao
St. 4 Dicang
St. 17 Ruzhong
St. 21 liangmen
St. 25 Tianshu
1f
St. 29 Guilai
St. 32 Femur Futu Hidden rabbit
Location: 6 cun above the middle of the upper border of the patella, between m. rectus
femoris and m. vastus lateralis. On the connection line between St. 35 Dubi and the an-
terior superior iliac spine.
Indications: Paralysis of the lower extremities, hemiplegia, disorders of the knee joint.
Needling method: Perpendicular, 2-4 cm, or oblique in proximal direction, 3-6 cm.
Electrostimulation.
St. 34 Liangqiu Beam hill Xi-cleft point
Location: 2 cun above the lateral and superficial border of the patella.
Indications: Disorders of the knee joint, acute gastrointestinal disorders.
Xi-cleft points are used in the treatment of acute disorders of the corresponding organ.
St.35 Dubi Calf's nose (also called Lateral Xiyan)
Location: In the depression lateral to the lower border of the patella when the knee is
slightly bent.
Indications: Painful disorders of the knee joint.
Needling method: Oblique towards the middle of the patella, 2 cm. On the medial side
of the patella Ex. 32 Xiyan is located. The two points together are called calf's nose and
are used together with Ex.31 Heding, on the superficial border of the patella, as local
points for treatment of knee joint disorders.
St. 36 Zusanli Three units on the leg He point
Location: One finger breadth lateral to the lower border of the tuberositas tibiae, 3 cun
below the knee joint.
Indications: Most important distal point for abdominal disorders: gastritis, stomach
and duodenal ulcer, vomiting, nausea, diarrhea, constipation. General tonification
point in weakness conditions and hypotension. Homeostatic effects in diabetes melli-
tus and metabolic diseases, weakness and paralysis of the legs, and in neuropathy.
St. 36 Zusanli is one of the most effective acupuncture points, with a wide range of
effects: spasmolytic and analgesic effect for the gastrointestinal tract, general toni fica-
tionpoint, homeostatic effect in endocrine and metabolic diseases. Many scientific
studies have verified the effectiveness of stimulation of this point.
St. 37 Shangjuxu Above the large earth hill Lower He point of the large intestine
Location: 3 cun below St. 36 Zusanli and one finger breadth lateral to the anterior
border of the tibia.
Indications: Diarrhea, disorders of the large intestine, paralysis of the lower extremi-
ties. This point is the lower He point of the large intestine.
Stomach Channel on the Leg 101
St. 31 Biguan
St. 32 Femur-Futu
St. 34 liangqiu
\ St. 35 Dubi
St. 36 Zusanli
St. 38 Tiaokou St. 40 Fenglong

St. 39 Xiajuxu
St. 43 Xiangu
St. 44 Neiting
St. 38 Tiaokou Long opening
Location: 5 cun below St. 36 Zusanli, one finger breadth lateral to the anterior border of
the tibia.
Indications: Frozen shoulder, periarthritis of the shoulder. This point is highly specific
for the shoulder.
Needling method: Perpendicular, 2-3 cm, toward VB. 57 Chengshan.
Manual stimulation to provoke a De Qi sensation.
St. 39 Xiajuxu Below the large earth hill Lower He point of the small intestine
Location: 6 cun below St. 36 Zusanli, one finger breadth lateral to the anterior border of
the tibia.
Indications: Paralysis of the lower extremities, polyneuropathy, disorders of the small
intestine, acute diarrhea.
This point is the lower He point of the small intestine.
St. 40 Fenglong Flourishing Luo connecting point to Sp. 3
Location: One finger breadth lateral to St. 38 Tiaokou, 2 cun lateral to the border of the
tibia, 5 cun below St. 36 Zusanli.
Indications: Excessive sputum, bronchitis and bronchial asthma, epilepsy, gastrointe-
stinal disorders.
From the Luo point a direct connection runs to the spleen channel to Sp. 3; therefore it
is stimulated for the treatment of gastroenterological disorders.
Needling method: Perpendicular, 3 cm.
St. 41 Jiexi Relax cramp Jing point, tonification point
Location: In the middle between the two malleoli on the ankle joint. The point is
located between the tendons of the m. extensor digitorum longus and the m. extensor
hallucis longus.
Indications: Disorders of the ankle joint, paralysis of the leg, abdominal disorders, con-
stipation, depression, headache.
St.42 Chongyang Yang impulse Yuan source point from Sp. 4
Location: On the dorsum of the foot, between the 2nd and 3rd metatarsal bones, proxi-
mal to their base.
Indications: Gastrointestinal disorders.
St. 31 Biguan
St. 32 Femur-Futu
St. 34 liangqiu
\ St. 35 Dubi
St. 36 Zusanli

St. 39 Xiajuxu
St. 43 Xiangu
St. 44 Neiting
St.43 Xiangu Falling into the valley Shu point
Location: In the depression distal to the base of the 2nd and 3rd metatarsal bones.
Indications: Headache, abdominal pain.
One of the best analgesic points in the leg.
Needling method: Perpendicular, 1 cm, vigorous stimulation.
St. 44 Neiting Interior hall Ying point
Location: 0.5 cun proximal to the margin of the web between the 2nd and 3rd metatar-
sal bones.
Indications: Distal point for toothache, headache, abdominal pain, diarrhea. Used to-
gether with St.43 as general analgesic point; also for acupuncture anesthesia and in
fever.
Needling method: Perpendicular, 1 cm or oblique. Electrostimulation in severe pain
and for anesthesia.
St. 45 Lidui Sliding exchange Jing well point
Location: On the lateral side of the 2nd toe, 2mm proximal to the comer of the nail.
Indications: Acute emergencies, like all other Jing points.
Further points on the stomach channel with translations
St.9 Renying Welcome to the people

St.10 Shuitu Sparkling water
St.ll Qishe Dwelling of vital energy
St.13 Qihu Door of vital energy
St. 14 Kufang Storeroom
St.15 Wuyi Room curtain
St.16 Yingchuang Breast window
St. 19 Burong Not allow
St.20 Chengman Completely full
St.22 Guanmen Pass gate
St.23 Taiyi Origin of the universe
St.24 Huaroumen Smooth flesh gate
St.26 Wailing Exterior grave hill
St.27 Daju Very large
St.28 Shuidao Waterway
St.33 Yinshi Yin city
St. 31 Biguan
St. 32 Femur-Futu
St. 34 Liangqiu
\
,-(
\ St. 35 Dubi
St. 36 Zusanli

St. 39 Xiajuxu
St. 43 Xiangu
St. 44 Neiting
6.4 Spleen Channel Sp.
The spleen channel is a Yin channel. The spleen channel and the lung channel together
make up the Tai Yin axis (Tai Yin = Large Yin).
Course: The spleen channel starts on the medial side of the great toe nail, then runs
along the medial side of the foot to the medial side of the leg and along here to the lat-
eral side of the abdomen. From here an internal connection passes through the spleen
and pancreas, then through the stomach and esophagus to reach the root of the tongue.
In the thoracic area an internal branch is traditionally believed to connect with the
heart. The superficial course runs from the abdomen to the lateral and upper side of
the thorax. It turns in a downward and lateral direction to end, at the axillary line in the
6th intercostal space, in Sp. 21 Dabao. Sp.21 Dabao is called the major Luo. From here
connections radiate into the rest of this area like spokes of a wheel.
Clinical applications: According to traditional ideas the functions of the spleen system
include the functions of the pancreas, i.e. the humoral part of the digestive function
(Yin part), and also the functions of the spleen, with the reticuloendothelial system.
The spleen system is traditionally believed to regulate water and blood metabolism, to
influence the skeletal muscles, and to nourish the lips and the tongue. Points of the
spleen channel are indicated in disorders of the digestive system, urogenital disorders,
and skin disorders in edema and ascites.
Coupled organ: Stomach

Element: Earth
Tissue: Connective tissue, fatty tissue, "flesh"
Sense organ: Mouth
Alarm point, Mu: Liv.13 Zhangmen (11th rib)
Back Shu point: UB.20 Pishu (lateral to T-11)
Jing Ying Yuan Luo Jing Xi He

1 2 4 5 8 9 TaiYin
• •+ • • •
Sp.
St.
•
45
•
44
•
43
••
40 36 34
• Yang Ming
Coupled channels: Spleen and stomach channel

Spleen Channel Internal Course 107
\
\
\
Y
/1
1\
I I
I I
, 8·
/ I
/ I
~
Sp. 21 Dabao
~
~ Sp.~
Sp. 10 Xuehai
Sp. 9 Yinlingquan
Sp. 1 Yinbai u---'-....."

Important points Point categories, clinical application
Sp.1 Yinbai Jing well point, acute emergencies

Sp.2 Dadu Ying point, tonification point
Sp.3 Taibai Yuan source point (of St. 40)
Sp.4 Gongsun Luo connecting point to St. 42
Confluent point of Chong Mai
Sp.5 Shangqiu Jing point, sedative point
Sp.6 Sanyinjiao Junction of the three Yin channels:
Sp., Ki., Liv.
Sp.8 Diji Xi-cleft point, acute organ disorders
Sp.9 Yinlingquan He point
Sp.10 Xuehai Immune-enhancing effect (sea of blood)
Sp.15 Daheng Abdominal disorders
Sp.21 Dabao Major Luo, thoracic disorders
Sp. 1 Yinbai Hidden white Jing well point
Location: On the medial side of the great toe, 3 mm proximal to the corner of the nail.
Indications: In acute emergencies such as fainting, collapse; also in abdominal pain
and convulsions, nausea.
Needling method: Perpendicular, 1-2 mm.
Sp. 2 Dadu Big city Ying point, tonification point
Location: On the medial side of the great toe, distal to the 1st metatarsophalangeal
joint, at the junction of the skin of the dorsum and that of the sole of the foot.
Indications: Abdominal pain, feeling of repletion, hyperhidrosis, fever.
Needling method: Perpendicular, 0.5 em.
Sp. 3 Taibai Great white Yuan source point from St. 40
Location: On the medial side of the foot, proximal to the head of the 1st metatarsal
bone.
Indications: Pain in the upper abdomen, abdominal distention, diarrhea, vomiting,
constipation.
Needling method: Perpendicular, 0.5-1 em.
Sp. 4 Gongsun Grandson of the duke Luo connecting point to St. 42
Location: On the medial side ofthe foot, in the depression distal to the base of the 1st
metatarsal bone.
Indications: From this point the transverse Luo vessel passes to the stomach channel;
therefore Sp.4 is indicated in gastric disorders, such as gastritis and dyspepsia, but also
in diarrhea and constipation.
Spleen Channel on the Leg 109
Sp. 10 Xuehai
Sp. 9Yinlingquan
Sp. 6Sanyinjiao
Sp. 5 Shangqiu Shang Hill (Shang = 2nd tone) Jing point, sedative point
Shang corresponds to metal. Sp.5 is the Shu point corresponding to metal.

Location: At the point of intersection of the two lines drawn tangential to the distal and
inferior sides of the malleolus medialis.
Indications: Arthritis, distortion of the ankle joint, gastritis, enteritis, diarrhea, consti-
pation.
Sp.6 Sanyinjiao Meeting of the three Yin (San = 3, Yin = Yin channel,
Jiao = junction)
Location: On the medial side of the lower leg, 3 cun above the medial malleolus, dorsal
to the posterior border of the tibia.
Indications: Urogenital disorders and disturbances such as dysuria, frequent urination,
retention of urine, impotence, orchitis, dysmenorrhea, amenorrhea.
Gastrointestinal disturbances such as diarrhea, abdominal distention.
Important general tonification point for chronic fatigue, convalescence, and hypo-
tension. Allergic and immunological disorders, endocrine disorders, such as diabetes
mellitus; skin disorders.
As it is the junction point of the three Yin channels of the leg (Sp., Ki., Liv.), stimu-
lation of Sp. 6 is also indicated in disorders of the kidney and liver.
Disorders of the lower extremities, such as polyneuropathy, paralysis, disturbances of
blood flow, phlebitis, lymphangitis, chronic lower leg ulcers.
For acupuncture anesthesia during surgical operations in the pelvic region and for
painfree childbirth.
Moxibustion is indicated in general deficiency conditions.
Sp. 8 Diji Power of the earth Xi-cleft point
Location: On the medial side of the leg, 3 cun below the medial condyle, on the poste-
rior border of the tibia.
Indications: Menorrhagia, dysmenorrhea, other urogenital disorders. As it is a Xi-cleft
point, stimulation of Sp. 8 Diji is indicated in acute disorders of the digestive system.
Sp.9 Yinlingquan Spring at the Yin grave hill He point
Location: On the medial side of the leg, in the depression below the lower border of the
medial condyle, at the level of the tuberositas tibiae.
Indications: Edema, ascites and swelling of the lower extremities.
Spleen Channel on the Leg 111
Sp. 10 Xuehai
Sp. 9 Yinlingquan
Sp. 6 Sanyinjiao
Sp.10 Xuehai Sea of blood
Location: The highest point of the m. vastus medialis, 2 cun proximal to the upper bor-
der of the patella.
Indications: Important immune-enhancing point. Skin disorders, allergies, infectious
disorders, blood diseases, urogenital disorders.
Sp. 15 Daheng Large horizontal
Location:4cun lateral to the umbilicus, lateral to St.25.

Indications: Gastrointestinal disorders, diarrhea, constipation, dyspepsia.
Sp. 21 Dabao Large envelope
Location: On the midaxillary line, in the 6th intercostal space.

Indications: According to traditional theory this point is called the "Major Luo." There
are many ramifications from it. Pain in the chest, lung disorders, dyspnea, digestive dis-
orders.
Needling method: Oblique, 1-2 cm. Dangerous point.
Further points on the spleen channel with translations
Sp.7 Lougu Groove

Sp.ll Jimen Arch gate
Sp.12 Chongmen Gate of the impulse
Sp.13 Fushe Storage house of the prefecture
Sp.14 Fujie Abdominal node, constipation
Sp.16 Fuai Abdominal pain
Sp.17 Shidou Nutrition cavity
Sp.18 Tianxi Celestial brook
Sp.19 Xiongxiang Land of the chest
Sp.20 Zhourong Surrounded with glory
Spleen Channel, Trunk 113
Sp. 21 Dabao
Sp. 15 Daheng
6.5 Heart Channel He.
The heart channel is a Yin channel. The heart channel and the small intestine channel
together make up the Shao-Yin axis.
Course: The internal course starts from the heart and passes through the diaphragm to
connect with its coupled organ, the small intestine. A further internal branch connects
the heart with the eye. The third internal branch runs from the heart to the axilla, and
emerges in He. 1 Jiquan to the surface. The peripheral and superficial course descends
from the axilla along the medial and posterior side of the arm ulnar to the palm and
ends on the radial side of the little finger at the nail comer in He.9 Shaochong.
Clinical applications: The functional system of the heart, according to traditional

theory, includes the function of the circulation system and its regulation besides the
function of the heart, and also the function of the brain, especially the consciousness.
The activity of the mind and the feelings are associated with the heart. Thus, points on
the heart channel are psychologically effective. The heart "opens to the mouth" and
thus determines the color of the tongue.
Stimulation of points on the heart channel is indicated in heart disorders, psychologi-
cal disorders such as insomnia, agitation, speech disturbances; furthermore in mental
disorders such as schizophrenia and epilepsy and in painful disorders along the chan-
nel, e.g., epicondylitis and tendovaginitis. Heart points are also effective in the treat-
ment of psychosomatic illness.
Element: Fire
Coupled organ: Small intestine
Tissue: Blood and blood vessels
Sense organ: Tongue
Maximal time: 11 a. m.-1 p. m.
Alarm point, Mu: Ren 14Juque
Back Shu point: VB. 15 Xinshu (lateral to T-5)
He Jing Luo Xi Yuan Ying Jing
Shao Yin 3 4 5 6 7 8 9
• • • •
He
SI
• •7 •3 •2 •
TaiYang 8
Coupled channels: Heart and small intestine channel

Heart Channel Internal Course 115
I
I
I
1
I
( 1
I
1
I
I
4
I
I
,I
I
~
He.3 Shaohai He point

He. 4 Lingdao Jing point
He.S Tongli Luo connecting point to SI. 4
He. 6 Yinxi Xi-cleft point
He. 7 Shenmen Yuan source point from SI.7, sedative point
He.S Shaofu Ying point
He. 9 Shaochong Jing well point, tonification point
He. 1 Jiquan Peak spring
Location: In the middle of the axilla, medial to the axillary artery.

Indications: Pain in the arm, paralysis of the upper extremities, cardiac pain, lactation
disorders, excessive sweating.
Avoid the axillary artery.
He. 3 Shaohai Smal Sea He point
Location: On the ulnar side of the elbow, at the end of the transverse cubital crease,
0.5 cun radial to the epicondylus ulnaris.
Indications: Arthritis of the elbow joint, angina pectoris, tremor.
He. 4 Lingdao Miraculous way Jing point
Location: On the palmar side of the forearm, 1.5 cun proximal to the transverse crease
of the wrist, toward He.7 Shenmen.
Indications: Angina pectoris, neuralgia of the nervus ulnaris.
He. S Tongli Internal connection Luo connecting point to SI. 4
Location: 1 cun proximal to He.7 Shenmen, radial to the tendon of the m. flexor carpi
ulnaris.
Indications: Speech disturbances, aphasia, hoarseness, pain in the wrist, mental distur-
bances, vision disorders.
He. 6 Yinxi Yin cleft Xi-cleft point
Location: 0.5 cun proximal to He.7 Shenmen.

Indications: Angina pectoris, night sweating, acute cardiac disorders.
Heart Channel 117
He.S Tongli
\
He.7 Shenmen
He.7 Shenmen Gate of spirit Yuan source point from SI. 7, sedative point
Location: On the transverse crease of the wrist, radial to the tendon of the m.flexor car-
pi ulnaris. Needling is also possible from the ulnar side of the wrist, ulnar to the tendon
of the m. flexor carpi ulnaris.
Indications: Mental disturbances, insomnia, anxiety states, epilepsy, cardiac pain, angi-
na pectoris.
Needling method: Perpendicular, 0.5 cm. From the ulnar side 1 cm.
He. 8 Shaofu Minor palace Ying point
Location: On the palm between the 4th and 5th metacarpal bones. When the fist is
clenched the point is located between the tips of the ring and little fingers.
Indications: Pain in the hand, Raynaud's syndrome, enuresis, dysuria, increased sweat-
ing of the hand.
Needling method: Perpendicular, 0.5-1 cm; painful point.
He. 9 Shaochong Minor impulse Jing well point, tonification point
Location: On the radial side of the little finger, 2mm proximal to the nail corner.
Indications: As a ling well point, in acute emergencies of heart and circulation, and
also in apoplexy and coma. Mental disturbances, fever, acute chest pain.
Further point on the heart channel with translation
He.2 Qingling Lively spirit

Heart Channel 119
He. 5 Tongli
\
He.7 Shenmen
6.6 Small Intestine Channel SI.
The small intestine channel is a Yang channel. The small intestine channel and the uri-
nary bladder channel together make up the Tai Yang axis.
Course: The small intestine channel starts from the ulnar nail comer of the little finger
and passes upward along the ulnar and dorsal side of the arm to the dorsal side of the
shoulder. Here it forms a connection with Du Mai 14 Dazhui, which is located below
the prominent vertebra. The internal branch originates from the dorsal side of the
shoulder and runs to the heart, stomach, and small intestine. The channel runs along
the shoulder in a zigzag line and continues on the lateral side of the neck and cheek to
the ear. A connecting branch runs from the cheek along the nose to the urinary bladder
channel to UB.1 Jingming.
Clinical applications: Treatment of painful disorders along the channel, e. g., epicondy-
litis, periarthritis of the shoulder, torticollis, cervical spondylosis, toothache, trigeminal
neuralgia, and ear disorders.
Element: Fire
Coupled organ: Heart
Sense organ: Tongue
Maximal time: 1-3p.m.
Alarm point, Mu: Ren 4 Guanyuan
Back Shu point: UB.27 Xiaochangshu (lateral to S-1)
He Jing Luo Xi Yuan Ying Jing
Shao Yin 3 4 5 6 7 8 9
• • • •
He
SI
Tai Yang
•
8
•7 •3 •2 •1
Coupled channels: Heart and small intestine channel
SI.3 Houxi Tonification point, confluent point Du Mai

SI.6 Yanglao Xi-cleft point
SI. 7 Zhizheng Luo connecting point to He. 7
SI.8 Xiaohai He point
SI.17 Tianrong Ear disorders
SI.18 Quanliao Trigeminal neuralgia
SI.19 Tinggong Ear disorders
Small Intestine Channel Internal Course 121
51. 9 Jianzhen
I
I
I
I
I
I
I
I
51 :
51. 6j"nglaO
51. 3 Houxi
I
SI. 1 Shaoze Minor pond Jing well point
Location: On the ulnar side of the little finger, 2mm proximal to the nail corner.
Indications: Acute emergencies, fever and lactation disorders.
SI. 3 Houxi Posterior brook Tonification point Confluence point of Du Mai

Shu point
Location: On the ulnar border of the hand with the fist clenched, at the ulnar end of the
main transverse crease of the palm. This point is located proximal to the head of the os
metacarpale toward the ulna.
Indications: Pain, tense muscles and restricted movement of the neck and of the shoul-
der area, e. g., torticollis, cervical spondylosis. In painful restricted movements of the
neck vigorous manual stimulation is indicated.
Tinnitus, deafness, headache, fever; paralysis and peripheral neuropathies of the arm.
Needling method: Perpendicular, 1-2 cm, vigorous stimulation; this point may be pain-
ful.
SI. 6 Yanglao Age cherishing Xi-cleft point
Location: In the depression on the radial side of the styloid process of the ulna. In supi-
nation or pronation a cleft radial to the styloid process is palpable.
Indications: As a Xi-cleft point, in acute painful disorders along the channel, e. g., pain-
ful restricted movement of the neck or shoulder (vigorous manual stimulation).
In cases of status asthmaticus, if Ren 22 Tiantu is ineffective, SI. 6 should be stimulated
together with Ren 17 Shanzhong.
Needling method: Oblique, 1 cm, toward Pe.6.
SI. 7 Zhizheng Branching off from the channel Luo connecting point to He. 7
Location: On the ulnar and dorsal side of the forearm, 5cun proximal to the wrist.
Indications: Restricted movement of the neck, pain in the forearm, mental disorders.
SI. 8 Xiaohai Little sea He point
Location: With the elbow flexed, between the olecranon and the medial epicondyle of
the humerus.
Indications: Pain in elbow and shoulder.
SI. 9 Jianzhen Steadfast shoulder
Location: When the arm is adducted, 1 cun above the dorsal crease of the axilla.
Small Intestine Channel 123
SI. 18 Quanliao
SI. 9 Jianzhen
) SI. 8 Xiaohai
SI. 6 Yanglao
SI. 3 Houxi
Indications: Periarthritis of the shoulder, paralysis of the arm.

The points Sl.l0-13 are located on the scapula and indicated as local points for disor-
ders and disturbances of the shoulder area.
SI. 10 Naoshu Transport point to the upper arm muscle
Location: When the arm is adducted, the point is located below the spina scapulae,
directly above SI. 9 Jianzhen.
Indications: Periarthritis of the shoulder.
SI. 11 Tianzong Celestial ancestor
Location: In the fossa infrascapularis, on the connection line between spina scapulae
and the lower tip of the scapula, at the border between the upper and middle thirds of
this distance.
Indications: Pain in the shoulder girdle.
SI. 14 Jianwaishu Transport point of the external shoulder
Location: 3 cun lateral to lower border of the spinous process of the 1st thoracic verte-
bra, lateral to Du 13 Taodao.
Indications: Pain in the shoulder, cervical spondylosis, restricted movement of the
neck.
Needling method: Oblique, 1-2 cm. A dangerous point.
SI.1S Jianzhongshu Transport point (Shu) in the middle of the shoulder
Location: 2 cun lateral to the lower border of the spinous process of the 7th cervical
vertebra, lateral to Du 14 Dazhui.
Indications: Pain in the shoulder, cervical spondylosis, restricted movement of the
neck, bronchitis, bronchial asthma.
SI. 17 Tianrong Celestial view
Location: Dorsal to the angle of the jaw, anterior to the m. sternocleidomastoideus.

Indications: Tonsillitis, sore throat, arthrosis of the mandibular joint.
Needling method: Perpendicular, 1 cm. A dangerous point.
) SI. 8 Xiaohai
SI. 6 Yanglao
SI. 3 Houxi
Sf. 18 Quanliao Zygomatic bone cleft
Location: Caudal to the arcus zygomaticus, directly below the outer canthus of the eye.
Indications:Toothache of the upper jaw, trigeminal neuralgia, facial paralysis. For acu-
puncture anesthesia in brain surgery and in tooth extraction.
Sf. 19 Tinggong Palace of hearing
Location: With the mouth slightly open, in the depression anterior to the tragus.
Indications: Ear disorders, e.g., deafness, tinnitus, ear infections, Meniere's disease,
trigeminal neuralgia.
This point is usually punctured together with Sl.21 Ermen and GB. 2 Tinghui. It is pos-
sible to needle from Sl.21 subcutaneously, parallel to the surface of the skin, vertically
downward through all these three points.
Further points on the small intestine channel with translations
SI.2 Qiangu Anterior valley Ying point

SI.4 Hand Wangu Wrist bone Yuan point of He. 5
SI.5 Yanggu Yang valley ling point
SI.12 Bingfeng Vent hole
SI.13 Quyuan Curved wall
SI.16 Tianchuang Heaven's window
) SI. 8 Xiaohai
SI. 6 Yanglao
SI. 3 Houxi
6.7 Urinary Bladder Channel UB.
The urinary bladder channel is a Yang channel. The urinary bladder channel and the
small intestine channel together make up the Tai Yang axis.
Course: The urinary bladder channel starts from the inner canthus of the eye and as-
cends parallel to the midline (Du Mai) over the forehead to the neck. At the vertex the
channel forms a connection to Du 20 Baihui (100 connections). At the neck the channel
bifurcates into two branches; the more important medial branch descends 1.5 cun
lateral and parallel along the midline to the level of the 4th sacral foramen, where it
turns back upward to the 1st sacral foramen and then continues caudal to the dorsal
side of the thigh to the hollow of the knee, to connect with the lateral branch. In the
lumbar region an internal branch ramifies first to the kidney and then to the urinary
bladder. From the hollow of the knee the channel descends along the dorsal side of the
lower leg to the malleolus lateralis to the lateral aspect of the foot and ends on the later-
al comer of little toe nail. The urinary bladder channel, with 67 points, is the longest
channel.
Clinical applications: In disorders along the channel:
- Points on the face are used for eye disorders and for headache.
Points on the neck are selected for occipital headache and cervical spondylosis.
The Shu points on the medial branch are located segmentally. These paravertebrally
located points have a direct influence on the segmentally corresponding internal or-
gan. In acute and chronic disorders of the corresponding organs the Back Shu points
become tender on pressure or painful. The Back Shu points are important for
diagnosis and treatment.
The Back Shu points are also indicated, as local points, in chest pain, lumbago, and
sciatica.
- The points of the lumbar and sacral area are stimulated for the treatment of kidney
and urogenital disorders.
- The points located peripherally are indicated as distal points in lumbago, sciatica
and urogenital disorders.
Element: Water
Coupled organ: Kidney
Tissue: Bones and joints
Sense organ: Ear
Alarm point, Mu: Ren 3 Zhongji
Back Shu point: UB.28 Pangguangshu
Jing Ying Yuan Luo Jing He
2 3 4 5 6 7 10 Shao Yin
• • • • +• •
Ki.
+ UB.
•
67
••
66 65 64
•
63
•
62 60 58 40 TaiYang
Coupled channels: Kidney and urinary bladder channel

Urinary Channel Internal Course 129
~;-- UB.23 SHenshu)

~.
I
I·-..J
US.40 Weizhong
\ US.60 Kunlun
UB.2 Zanzhu Eye disorders, headache

UB.10 Tianzhu Cervical spondylosis, occipital headache
UB.11 Dashu Influential point for bone (lateral to T-l)
UB.13 Feishu Shu point of the lung (lateral to T-3)
UB.14 Jueyinshu Shu point of the pericardium (lateral to T-4)
UB.15 Xinshu Shu point of the heart (lateral to T-5)
UB.17 Geshu Shu point of the diaphragm (lateral to T -7)
Influential point for blood
UB.18 Ganshu Shu point of the liver (lateral to T-9)
UB.19 Danshu Shu point of the gallbladder (lateral to T-10)
UB.20 Pishu Shu point of the spleen (lateral to T -11)
UB.21 Weishu Shu point of the stomach (lateral to T -12)
UB.22 Sanjiaoshu Shu point of the Sanjiao (lateral to L-1)
UB.23 Shenshu Shu point of the kidney (lateral to L-2)
UB.25 Dachangshu Shu point of the large intestine (lateral to L-4)
UB.27 Xiaochangshu Shu point of the small intestine (lateral to S-l)
UB.28 Pangguangshu Shu point of the urinary bladder (lateral to S-2)
UB.40 Weizhong He point
UB.58 Feiyang Luo connecting point to Ki. 3
UB.60 Kunlun Jing point
UB.62 Shenmai Psychologically effective
UB.63 Jinmen Xi-cleft point
UB.64 Jinggu Yuan source point from Ki.4
UB.65 Shugu Shu point, sedative point
UB.66 Tonggu Ying point
UB.67 Zhiyin Jing well point, tonification point
UB. 1 Jingming Bright eyes
Location:0.1 cun medial to and above the inner canthus of the eye.
Indications: Disorders of the eye, lacrimal gland and the eyelid.
Dangerous point owing to its location; avoid the eye.
UB. 2 Zanzhu Covered with bamboo
Location: On the medial end of the eyebrow, directly above the inner canthus of the
eye.
Indications: Eye disorders, frontal sinusitis, frontal headache, migraine.
UB. 3 Meichong Impulse to the eyebrow
Location: On the extension of a line from the inner canthus in cranial direction, 0.5 cun
behind the hairline, 3.5 cun directly above the eyebrow.
Indications: Eye disorders, frontal headache and migraine.
Urinary Channel Internal Course 131
n·/
~; UB.23 S~ensh" j
,
l--..J J
UBAO Weizhong
~ UB.60 Kunlun
The points UB.4-9 are located 1.5 cun lateral to the midline and are seldom used.
Mostly the important points of this area Du 20 Baihui and Ex.6 Sishencong are nee-
dled because they are closely related to the urinary bladder points.
UB. 10 Tianzhu Celestial pillar
Location: 1.3 cun lateral to Du 15 Yamen (C-112), 0.5 cun above the posterior hairline.
Indications: Headache, migraine, dizziness, vision disorders, cervical spondylosis,
common cold.
Needling method: Perpendicular or oblique, 0.5-1 cm.
UB. 11 Dashu Big shuttle Influential point for bone
The thoracic vertebra has the form of a shuttle.

Location: 1.5 cun lateral to the lower border of the spinous process of the 1st thoracic
vertebra; 1.5 cun lateral to Du 13 Taodao.
Indications: Bone and joint disorders, rheumatoid arthritis, occipital headache, cervi-
cal spondylosis, bronchial asthma, cough, fever.
The points of the medial branch are often used in accordance with the indications.
UB. 13 Feishu Transport point to the lung Shu point of the lung
Location: 1.5 cun lateral to the lower border of the spinous process of the 3rd thoracic
vertebra (Table 6.1).
Indications: Lung disorders, such as bronchial asthma, chronic bronchitis; also in
cough and excessive sputum. The Shu points of the corresponding organ are often
combined with the Mu or alarm points (the Mu point of the lung is Lu.1 Zhongfu).
In chronic lung disorders moxibustion of this Shu point is applied.
UB. 14 Jueyinshu Transport point to the weakened Yin Shu point of the
pericardium
Location: 1.5 cun lateral to the lower border of the spinous process of the 4th thoracic
vertebra.
Indications: Heart and circulatory disorders.
UB. 15 Xinshu Transport point to the heart Shu point of the heart
vertebra.
Indications: Heart diseases such as angina pectoris, mental disorders.
Moxibustion of the points UB.13-15 is often used in chronic disorders of the chest or-
gans.
Urinary Channel Medial Branch 133
UB.3 Meichong
UB.2 Zanzhu
UB.1 Jingming
UB.11 Dashu
\
UB.13 Feishu
UB~4 Jueyinshu
UBt7G~h" I
UB.15 Xinshu
UB.18 Ganshu
I •
UB.19 Danshu
UB:20 Pishu.l
UB.21 Weishu
I W•
UB.22 Saniiaoshu )
UYJShe,"
I ,
UB.25 Dachangshu
I \
UB.27 Xiaochangshu
I •
UB.28 Pangguangshu
\UB.54
UB.30 Baihuanshu
VB. 16 Dushu Transport point to the governing vessel Shu point of the Du Mai
vertebra.
Indications: Chest pain.
VB.17 Geshu Transport point to the diaphragm Shu point of the diaphragm,
influential point for blood
Location: 1.5 cun lateral to the spinous process of the 7th thoracic vertebra.
Indications: Hiccough, nausea, bronchial asthma, dyspnea, blood disorders.
VB. 18 Ganshu Transport point to the liver Shu point of the liver
vertebra.
Indications: Liver and gallbladder disorders, eye disorders.
VB. 19 Danshu Transport point to the gallbladder Shu point of the gallbladder
vertebra.
Indications: Disorders of the biliary duct.
VB. 20 Pishu Transport point to the spleen Shu point of the spleen
Location: 1.5 cun lateral to the lower border of the spinous process of the 11 th thoracic
vertebra.
Indications: Digestive disorders, pain in the upper abdomen, diarrhea, pancreas disor-
ders.
Needling method: Perpendicular, 1-2 cm. Dangerous point.
VB. 21 Weishu Transport point to the stomach Shu point of the stomach
vertebra.
Indications: Gastric disorders such as stomach and duodenal ulcers, chronic gastritis.
The points VB.18-21, the Back Shu points of liver, gallbladder, spleen and stomach,
are used in disorders of the upper abdomen, and in conditions caused by weakness of
organs, with moxibustion.
Urinary Channel Medial Branch 135
UB. 3 Meichong
UB. 2 Zanzhu
UB.1 Jingming
UB.11 Dashu
\
UB.13 Feishu
UB:14 Jueyinshu
UBt7G~h" I
UB.15 Xinshu
UB.18 Ganshu
I ,
UB.19 Danshu
UB:20 Pishuj
UB.21
I
Weishu
,.
UB.I 22 Saniiaoshu )
UB(3Sh,"
,
UB.25 Dachangshu
I \
UB.27 Xiaochangshu
I •
UB.28 Pangguangshu
\UB.54
UB.30 Baihuanshu
UB. 22 Sanjiaoshu Transport point to the Sanjiao Shu point of the Sanjiao
Location: 1.5 cun lateral to the spinous process of the 1st lumbar vertebra.
Indications: Abdominal disorders, gastric disorders, lumbago.
UB. 23 Shenshu Transport point to the kidney Shu point of the kidney
Location: 1.5 cun lateral to the lower border of the spinous process of the 2nd lumbar
vertebra.
Indications: Renal disorders, urogenital disorders, dysmenorrhea, lumbago, sciatica,
ear disorders.
Needling method: Perpendicular, 1- 2 cm.
In deficiency conditions of the kidney moxibustion is often applied.
UB. 24 Qihaishu Transport point to the sea of vital energy Shu of the sea of
vital energy
Location: 1.5 cun lateral to the lower border of the spinous process of the 3rd lumbar
vertebra.
Indications: Lumbago, sciatica, deficient tonification of internal organs.
Needling method: Perpendicular, 1- 2 cm.
Table 6.1 Back Shu points with their functions

Points Location Name Function Translation
UB.13 T3 Feishu Shu of the lung Transport point to the lung
UB.14 T4 Jueyinshu Shu of the pericardium Transport point to the Yin
UB.1S TS Xinshu Shu of the heart Transport point to the heart
UB.16 T6 Dushu Shu oftheDu Transport point to the
governing vessel (Du)
UB.17 T7 Geshu Shu of the diaphragm Transport point to the
diaphragm,
influential point for blood
UB.1S T9 Ganshu Shu of the liver Transport point to the liver
UB.19 T10 Danshu Shu of the gallbladder Transport point to the
gallbladder
UB.20 T11 Pishu Shu of the spleen Transport point to the spleen
UB.21 T12 Weishu Shu of the stomach Transport point to the stomach
UB.22 L1 Sanjiaoshu Shu of the Sanjiao Transport point to the Sanjiao
UB.23 L2 Shenshu Shu of the kidney Transport point to the kidney
UB.24 L3 Qihaishu Transport point to the sea of
vital energy
UB.2S L4 Dachangshu Shu of large intestine Transport point to the
large intestine
UB.27 S1 Xiaochangshu Shu of small intestine Transport point to the
small intestine
UB.2S S2 Pangguangshu Shu of the urinary bladder Transport point to the
urinary bladder
Urinary Bladder Channel, Leg 137
UB. 23 Shenshu
UB. 24 Qihaishu
UB. 25 Dachangshu
UB. 26 Guanyuanshu
UB. 53 ~aohuang
Zhibian
UB. 36 Chengfu
) UB. 39 Weiyang
UB. 40 Weizhong
UB. 63 Jinmen
J l UB.60
UB. 62
Kunlun
Shenmai
UB.64
UB.65
UB.66
Jinggu
Shugu
Tonggu
UB. 67 Zhiyin
VB. 25 Dachangshu Transport point to the large intestine Shu point of the
large intestine
Location: 1.5 cun lateral to the lower border of the spinous process of the 4th lumbay
vertebra.
Indications: Diarrhea, constipation, abdominal distention, large intestine disorders,
lumbago, sciatica.
VB. 26 Guanyuanshu Transport point to the enclosed original energy
Location: 1.5 cun lateral to the lower border of the spinous process of the 5th lumbar
vertebra.
Indications: Abdominal pain, lumbago, sciatica.
VB. 27 Xiaochangshu Transport point to the small intestine Shu point of the
small intestine
Location: 1.5 cun lateral to the midline, at the level of the 1st posterior sacral foramen.
Indications: Intestinal disorders, urogenital disorders, lumbago, sciatica.
In lumbago and sciatica the points UB. 27 -30 (S-1 to SA) are needled together. These
points are also used with moxibustion of the sacral area.
VB. 28 Pangguangshu Transport point to the urinary bladder Shu point of the
urinary bladder
Location: 1.5 cun lateral to the midline, at the level of the 2nd posterior sacral foramen.
Indications: Urogenital disorders, dysmenorrhea, lumbago, sciatica.
VB. 29 Zhonglushu Transport point to the spine
Location: 1.5 cun lateral to the midline, at the level of the 3rd posterior sacral foramen.
Indications: Lumbago, sciatica.
VB. 30 Baihuanshu Transport point at the white ring
Location: 1.5 cun lateral to the midline, at the level of the 4th posterior sacral foramen.
Indications: Urogenital disorders, lumbago, sciatica.
Urinary Bladder Channel, Medial Branch 139
UB. 3 Meichong
UB.2 Zanzhu
UB.1 Jingming
UB.11 Dashu
\
UB.13 Feishu
UB~14 Jueyinshu
I
UB.15 Xinshu
UBt7G~hU
UB.18 Ganshu
I ,
UB:l9 Danshu
UB:20 Pishuj
UB.21 Weishu
Uyl She,u
I ••
UB.I 22 Sanjiaoshu
,
)
UB.25 Dachangshu
I \
UB.27 Xiaochangshu
I •
UB.28 Pangguangshu
\UB.54
UB.30 Baihuanshu
UB. 31 Shangliao Upper bone cleft
Location: On the 1st posterior sacral foramen.

Indications: Lumbago, urogenital disorders, dysmenorrhea, constipation.
UB. 32 Ciliao Second bone cleft
Location: On the 2nd posterior sacral foramen.

Indications: As for UB.31.
UB. 33 Zhongliao Middle bone cleft
Location: On the 3rd posterior sacral foramen.

UB. 34 Xialiao Lower bone cleft
Location: On the 4th posterior sacral foramen.

UB. 35 Huiyang Meeting of the Yang
Location: At the tip of the coccyx, 0.5 cun lateral to Du Mai.

Indications: Hemorrhoids, anal fissure, impotence.
UB. 36 Chengfu Support
Location: At the midpoint of the gluteal fold.

Indications: Sciatica, hemorrhoids, paralysis of the lower limb.
UB. 37 Yinmen Flourishing gate
Location: On the connection line between UB. 36 and UB. 40. 6 cun distal to UB. 36.
Indications: Sciatica, paralysis of the lower extremities.
Urinary Bladder Channel, Medial Branch 141
UB. 2 Zanzhu
UB. 1 Jingming
UB.11 Dashu
\
UB.13 Feishu
•
UB;14 Jueyinshu
UB.1S Xinshu
UBl7GeShU /
UB.18 Ganshu
I •
UB.19 Danshu
UB;20 Pishuj
UB.21 Weishu
Uyl She,u
t , "
UB.I 22 Saniiaoshu
,
)
UB.25 Dachangshu
I l
UB.27 Xiaochangshu
I I
UB.28 Pangguangshu
\UB.54
UB.30 Baihuanshu
VB. 39 Weiyang Yang in the bend
Location: On the lateral end of the popliteal transverse crease, medial to the tendon of
the m. biceps femoris.
Indications: Backache, cramps of the calf muscles.
VB.40 Weizhong Center of the bend He point
Location: At the midpoint of the popliteal transverse crease.

Indications: Lumbago, sciatica, pelvic disorders, impotence, enuresis. UB.40 is one of
the important distal points of the lower extremities and influences the lower area of the
back.
The points UB.41 Fufen to UB. 54 Zhibian are located on the lateral branch of the uri-
nary bladder channel, 3 cun lateral to the lower border of the spinous process (Table
6.2). They are used in the treatment of psychosomatic disorders. The translation of
these point names shows their psychic relevance. The points are perpendicularly
needled, 0.5-2 cm, but since they overlie the lung care must be taken in leptosomatic
patients to avoid injuring the lung.
Table 6.2 Points of the lateral branch of the urinary bladder channel
Point Location Name Translation Lateral to
UB.41 T2 Fufen Adjacent point UB.12
UB.42 T3 Pohu Door of vitality UB.13
UB.43 T4 Gaohuang Residence of the noble organs UB.14
UB.44 T5 Shentang Hall of the spirit UB.15
UB.45 T6 Yixi Joyful excitement UB.16
UB.46 T7 Geguan Gate of the diaphragm UB.17
UB.47 T9 Hunmen Gate of the spirit soul UB.18
UB.48 T10 Yanggang Yang rule UB.19
UB.49 T 11 Yishe Hut of thoughts UB.20
UB.50 T12 Weicang Storage of the stomach UB.21
UB.51 L1 Huangmen Gate to the noble organs UB.22
UB.52 L2 Zhishi Room of the will UB.23
UB.53 S2 Baohuang Placenta UB.28
UB.54 S4 Zhibian Lateral succession UB.30
VB. 54 Zhibian Lateral succession
Location: 3 cun lateral to the midline, at the level of the 4th posterior sacral foramen.
Indications: Lumbago, sciatica, disorders of the hip joint, paralysis of the lower
extremities, urogenital disorders.
Urinary Channel, Lateral Branch 143
UB.41
UB.42
UB.43
UB.44
UB.4S Yixi
UB.46 Geguan
UB.47
I
Hunmen
UB.48 Yanggang
UB.49 Yishe
UB.SO Weicang
UB.S1 Huangmen
UB.S2 Zhishi I
UB.S3 Baohuang
UB.S4
I
Zhibian
UB. 57 Chengshan Mountain holding
Location: 8 cun distal to UB. 40, between the two bellies of the m. gastrocnemius.
Indications: Cramps of calf muscles, sciatica, pain in the lower extremities,
hemorrhoids, frontal headache.
UB. 58 Feiyang Blowing in the wind Luo connecting point to Ki. 3
Location: 7 cun directly proximal UB. 60.

Indications: Eye disorders, lumbago, sciatica, urinary tract infection.
UB. 60 Kunlun Kunlun mountain Jing point
The Kunlun mountain is regarded as supporting the heavens.

Location: At the middle of the connecting line drawn between the malleolus lateralis
and the Achilles tendon.
Indications: Sciatica, lumbago, distortions and pain of the ankle joint, tendinitis of the
Achilles tendon, paralysis of the lower extremities.
UB. 61 Pushen Kneeling bow
The point can be felt during a genuflexed bow, which was common when a servant
approached his master.
Location: Inferior and dorsal to the malleolus lateralis, directly below UB. 60 Kunlun.
Indications: Distortion of the ankle joint, Achilles tendon distortion.
UB. 62 Shenmai Announcing the pulse Confluent point for Yangqiao
Location: 0.5 cun directly below the malleolus lateralis.

Indications: Mental disorders, convulsions, epilepsy, apoplexy, addictions, sleep
disturbances.
UB. 67 Zhiyin Outer Yin Jing well point, tonification point
Location: On the lateral side of the little toe, 0.1 cun proximal to the nail comer.
Indications: As ling well point, for acute emergencies. Specifically indicated for pain-
free childbirth.
UB. 23 Shenshu
UB. 24 Qihaishu
UB. 25 Dachangshu
UB. 26 Guanyuanshu
UB. 53 ~aohuang
Zhibian
UB. 36 Chengfu
UB. 39 Weiyang
UB. 40 Weizhong
UB.63 Jinmen
) l UB. 60
UB.62
Kunlun
Shenmai
UB. 64
UB. 65
UB.66
Jinggu
Shugu
Tonggu
UB. 67 Zhiyin
Further points on the urinary bladder channel with translations
UB.4 Quchai Angular deviation

UB.5 Wuchu Fifth place
UB.6 Chengguang Receiving the light
UB.7 Tongtian Entrance to heaven, The highest
UB.8 Luoque Connection to the back side
UB.9 Yuzhen Jade occiput
UB.12 Fengmen Gate of the wind
UB.38 Fuxi Superficial cleft
UB.55 Heyang Common Yang
UB.56 Chengjin Muscle holding
UB.59 Fuyang Step Yang
UB.63 Jinmen Golden gate
UB.64 Jinggu Yuan source point from Ki.4, bone of the capital
UB.65 Shugu Sedative point, bone bundle
UB.66 Tonggu Ying point, valley passage
UB. 23 Shenshu
UB. 24 Qihaishu
UB. 25 Dachangshu
UB. 26 Guanyuanshu
~aohuang
Zhibian
UB. 36 Chengfu
) UB. 39 Weiyang
UB. 40 Weizhong
UB.63 Jinmen
) I UB.60
UB.62
Kunlun
Shenmai
UB.64
UB.65
UB.66
Jinggu
Shugu
Tonggu
UB.67 Zhiyin
6.8 Kidney Channel Ki.
The kidney channel is a Yin channel. The kidney channel and the heart channel
together make up the Shao Yin axis.
Course: The kidney channel is the only one that originates on the sole of the foot. It
runs to the medial side of the leg, then along to the abdomen, where the channel is
located 0.5 cun lateral to the midline. In the thoracic area the distance from the midline
is 2 cun. The channel ends below the depression of the clavicle with point Ki.27 Shufu.
From the lower abdomen the internal course ramifies in the dorsal direction, courses
along the spine toward cranium, passes through the kidney, then ascending through
the liver and lung to the throat and ending at the root of the tongue. From the kidney a
further connection passes to the urinary bladder, the coupled Yang organ. A further
branch connects the starting point Ki.1 Yongquan with the medial side of the little toe,
at the corner eof the nail. This branch connects with the urinary bladder channel,
which ends at the lateral nail corner of the little toe in VB. 67 Zhiyin.
Clinical applications: The kidney channel is coupled with the urinary bladder channel
and together they form a functional system. This includes the excretory function of the
kidney and of the urinary tract and also the reproductory functions of the external gen-
italia. According to traditional theory the system of the fire or Yang kidney describes
the humoral functions of the adrenals.
The Chinese kidney system influences the willpower. Therefore renal deficiency is
relevant to the lack of willpower and thus also to mental depression.
The points on the kidney channel are mainly indicated in urogenital disorders, rheu-
matoid arthritis and mental depression.
Element: Water
Coupled organ: Urinary bladder
Tissue: Bone
Sense organ: Ear
Maximal time: 5-7 p. m.
Alarm point, Mu: GB.25 Jingmen
Back Shu point: UB.23 Shenshu
Jing Ying Yuan Luo Jing He
1 2 3 4 5 6 7 10 Shao Yin
• • • • • +• •
Ki.
UB.
+
•
67
••
66 65 64
•
63
•
62
• ••
60 58 40 TaiYang
Coupled channels: Kidney and urinary bladder channel

Kidney Channel Internal Course 149
Du 1 Changqiang
Ki.1 Yongquan Jing well point, sedative point

Ki.3 Taixi Yuan source point from UB. 58
Ki.4 Dazhong Luo connecting point to UB.64
Ki.5 Shuiquan Xi-cleft point
Ki.6 Zhaohai Urogenital disorders
Ki.7 Fuliu Jing point, tonification point
Ki.10 Yingu He point
Ki. 1 Yongquan Bubbling spring Jing well point, sedative point
Location: On the sole at the border between the anterior and middle thirds of the foot,
proximal to the 2nd and 3rd metatarsophalangeal joints.
Indications: Ki.1 is one of the most important ling well points in the body: it is speci-
fically indicated in epileptic attacks and other acute emergencies, when vigorous stim-
ulation should be applied. Otherwise this point is seldom used, because it is painful.
Ki. 3 Taixi Highest brook Yuan sourche point from UB. 58
Location: Midway between the most prominent point of the malleolus medialis and
the superior border of the Achilles tendon.
Indications: Urogenital disorders, enuresis, dysmenorrhea, impotence, cystitis, disor-
ders of the upper ankle joint.
Ki. 4 Dazhong Big bell Luo connecting point to UB. 64
Location: Dorsal to the malleolus medialis, above the insertion of the Achilles tendon,
ventral to the tendon.
Indications: Pain of the ankle joint, achillodynia, lumbago, kidney and urinary bladder
disorders.
Ki. 5 Shuiquan Water spring Xi-cleft point
Location: Above the calcaneus, 1 cun below Ki.3 Taixi, dorsal to and below the malleo-
lus medialis.
Indications: Analgesia and spasmolysis for nephrolithiasis, dysmenorrhea, hyper-
menorrhea, acute renal colic.
Kidney Channel, Leg 151
Ki. 10 Yingu
Ki.7 Fuliu Ki. 8 Jiaoxin
Ki.3 Taixi
Ki. 4 Dazhong
Ki. I Yongquan
Ki. 6 Zhaohai Direction to the sea
Location: 1 cun directly below the inferior border of the malleolus medialis.
Indications: Dysmenorrhea, disorders of the ankle joint.
Ki. 7 Fuliu Reestablished flow Jing point, tonification point
Location: On the anterior border of the Achilles tendon, 2 cun above the malleolus
medialis.
Indications: Cystitis, nephritis, night sweats, diarrhea, lumbago; moxibustion in weak-
ness conditions.
Ki. 8 Jiaoxin Presents the message
Location: On the posterior border of the tibia, 2cun above the malleolus medialis,
0.5 cun anterior to Ki.7 Fuliu.
Indications: Kidney and urinary bladder disorders.
Ki.7 Fuliu, Ki.8 Jiaoxin and Sp.6 Sanyinjiao are often used for moxibustion in uro-
genital disorders with Yin symptoms.
Further points on the kidney channel with translations
Ki.2 Rangu Natural valley, Ying point

Ki.9 Zhubin Build for the guest
Ki.l0 Yingu Yin valley, He point
Ki.11 Henggu Horizontal bone
Ki.12 Dahe Especially influential
Ki.13 Qixue Point of vital energy
Ki.14 Siman Full everywhere
Ki.15 Abdomen Zhongzhu Flowing in
Ki.16 Huangshu Transport point to the noble organs
Ki.17 Shangqu Large intestine arch - Shang - arch (Shang the
2nd tone, corresponds to metal and so to the large
intestine)
Ki.18 Shiguan Stone pass
Ki.19 Yindu Yin capital
Ki.20 Abdomen Tonggu Valley passage
Ki.21 Youmen Exit gate of the Stomach
The points Ki. 22- 27 are located in the thoracic area, 2 cun lateral to the midline.
Ki.22 Bulang Cross the corridor
Ki.23 Shenfeng Altar of the spirit
Ki.24 Lingxu Divine hill
Ki.25 Shencang Hidden spirit
Ki.26 Yuzhong Opulent appearance
Ki.27 Shufu Transport point to the prefecture
Kidney Channel on the Trunk 153
Ki. 27 Shufu
Ki.16 Huangshu
Ki.11
6.9 Pericardium Channel Pee
The pericardium channel is a Yin channel. The pericardium channel and the liver
channel together make up the Jue Yin axis.
The pericardium channel has a marked effect on the regulation of the circulation.
Course: The pericardium channel starts from the middle of the thorax in the area of the
pericardium. An internal branch passes in the caudal direction through the upper, mid-
dle and lower "warmers" to the stomach region. The major branch runs laterally from
the pericardium and emerges lateral to the mamilla in Pe.1 Tianchi, then passes to the
axilla, descending along the medial aspect of the arm to end in the palm at the tip of the
middle finger.
Clinical applications: According to Chinese theory the heart and pericardium channels
are associated with the brain and its mental functions. Heart and pericardium form a
functional unit according to this idea, and this corresponds to the element fire.
The pericardium is considered to protect and regulate the cardiac function. The heart
is related more to the mental functions. Points of the pericardium channel have a
strong effect on the circulation and are therefore indicated in cardiac and circulatory
disorders.
Mental and psychosomatic disorders and gastroenterological disorders are also indica-
tions for stimulation of points on the pericardium channel.
Element: Fire
Coupled organ: Sanjiao
Sense organ: Tongue
Alarm point, Mu: Ren 17Shanzhong
Back Shu point: UB.14 Jueyinshu
He Xi Jing Luo Yuan Ying Jing
Jue Yin 3 4 5 6 7 8 9
• • • • •
Pee
SJ.
Shao Yang
•
10
•
7
•
6
• •
3 2
•
Coupled channels: Pericardium and Sanjiao channel
Pericardium Channel Internal Course 155
--- ...... Pe.1 Tianchi

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Pe. 9 Zhongchong
Pe.3 Quze He point

Pe.4 Ximen Xi-cleft point
Pe.5 Jianshi Jing point
Pe.6 Neiguan Luo connecting point to SJ.4
Confluent point Yinwei
Pe.7 Daling Shu point, Yuan point, sedative point
Pe.9 Zhongchong Jing well point, tonification point
Pe. 1 Tianchi Celestial pond
Location: 1 cun lateral to the mamilla, in the 4th intercostal space.

Indications: Angina pectoris, intercostal neuralgia.
Needling method: Oblique in lateral direction, 1-2 cm. A dangerous point.
Pe. 3 Quze Curved marsh He point
Location: On the transverse cubital crease, medial to the biceps tendon.

Indications: Arthritis of the elbow joint, angina pectoris.
Pe. 4 Ximen Cleft gate Xi-cleft point
Location: Between the tendons of the m. palmaris longus and flexor carpi radialis,
5 cun proximal to the transverse crease of the wrist.
Indications: As Xi-cleft point, in acute disorders of the cardiac and circulation system,
such as angina pectoris, cardiac arrhythmia, tachycardia, pleuritis, mastitis, mental
lability. Acupuncture anesthesia.
Pe. 5 Jianshi Messenger Jing point
Location: Between the tendons of the m. palmaris longus and flexor carpi radialis,
3 cun proximal to the transverse crease of the wrist.
Indications: Schizophrenia and other psychiatric disorders, epilepsy, angina pectoris,
tachycardia.
Pe. 6 Neiguan Inner pass Luo connecting point to SJ. 4, confluent point of Yinwei
Location: Between the tendons the m. palmaris longus and flexor carpi radialis, 2 cun
proximal to the transverse crease of the wrist.
Indications: Cardiac disorders, disorders of the chest area: angina pectoris.
Disorders of the upper abdomen: Gastric and duodenal ulcers, gastritis, nausea, hic-
cough, vomiting, heartburn.
Pericardium Channel 157
Pe. 5 Jianshe
Pe. 6 Neiguan
Pe.7 Daling
Pe. 9 Zhongchong
Pe.6 is the most important distal point for disorders of the epigastrium and the anterior
chest wall.
Mental disorders and psychiatric diseases: Vegetative dysregulatiom, agitation,
epilepsy.
For acupuncture anesthesia in chest and upper abdominal surgery. As Luo connecting
point of the pericardium channel (to Sl.4 Yangchi) and as confluent point of the extra
channel Yinwei, Pe.6 Neiguan is indicated in many cases.
Needling method: Perpendicular, 1-2 cm. For acupuncture anesthesia deep needling in
direction of Sl. 5 Waiguan.
Pe. 7 Daling Big tomb Shu point, Yuan source point from SJ. 5, sedative point
Location: On the transverse crease of the wrist, between the tendons of m. palmaris
longus and flexor carpi radialis.
Indications: Wrist disorders, tendovaginitis, polyneuropathy, paralysis. Mental distur-
bances and psychiatric disorders, schizophrenia, insomnia, epilepsy.
Pe.8 Laogong Working palace Ying point
Location: On the palm of the hand, between the tips of the middle and ring fingers
when they are flexed. On the "head line" at the junction of the third metacarpal bone.
Indications: Paralysis, polyneuropathy, skin disorders on the hand, Dupuytren's
contracture.
Points on the hand are very painful.
Pe. 9 Zhongchong Middle impulse Jing well point, tonification point
Location: At the midpoint of the tip of the middle finger. Medial nail comer of the mid-
dle finger (both locations given in the literature).
Indications: As ling well point, in acute emergencies such as collapse, fainting, shock.
Further point on the pericardium channel with translation
Pe.2 Tianquan Celestial spring

Pericardium Channel 159
.,
Pe.5 Jianshe
Pe.6 Neiguan
Pe.7 Daling
Pe. 9 Zhongchong
6.10 Sanjiao Channel SJ.
The name of this channel is translated as "triple burner" or "triple heater."

The Sanjiao channel is a Yang channel. The Sanjiao channel and the gallbladder chan-
nel together make up the Shao Yang axis.
Course: The Sanjiao channel starts on the ulnar comer of the nail of the ring finger,
ascends along the dorsal side of the hand and arm to the shoulder, circles around the
auricle, and runs to the lateral side of the eyebrow. From the shoulder an internal
branch originates, passing to the pericardium and then in a caudal direction to the
Sanjiao to the stomach area. On the face a branch curves along the cheek to end below
the orbita.
Clinical applications: The Huang Di Nei ling and further ancient literature describe
the Sanjiao as "burning, heating three cavities." There are no anatomical descriptions,
and therefore the Sanjiao is regarded as the three body cavities. The upper "warmer"
corresponds to the thorax and controls the respiration; the middle one corresponds to
the abdominal cavity and controls the digestive function, and the lower warmer is
related to the pelvic region and rules the urogenital functions.
Although it is impossible to give the exact location of the Sanjiao, physiological func-
tions and disorders are related to the channel. Points of the Sanjiao channel are
selected:
- In deafness, tinnitus, dizziness.
- In gastrointestinal disorders, such as constipation.
- In chest and shoulder pain.
- In headache and eye disorders.
Element: Fire
Connected organ: Pericardium
Sense organ: Tongue
Alarm point, Mu: Ren 5 Shimen
Back Shu point, Shu: UB. 22 Sanjiaoshu
He Xi Jing Luo Yuan Ying Jing

Jue Yin 3 4 5 6 7 8 9
• • • • •
Pe.
5J.
• • •6 • • •
5hao Yang 10 7 3 2
Coupled channels: Pericardium and Sanjiao channel

Sanjiao-Channel Internal Course 161
SJ.23 Sizhukong
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SJ.3 Zhongzhu Shu point, tonification point,

distal point for ear disorders
SJ.5 Waiguan Luo connecting point to Pe. 7,
distal point for the head
SJ.6 Zhigou Jing point, for constipation
SJ.8 Sanyangluo Connection of the three Yang channels,
distal point for the chest wall
SJ.14 Jianliao Disorders of the shoulder
SJ.17 Yifeng Ear disorders
SJ.21 Ermen Ear disorders
SJ. 3 Zhongzhu Center of the small island Shu point, tonification point
Location: On the back of the hand between the 4th and 5th metacarpal bones, proximal
to the metacarpophalangeal joint.
Indications: Deafness, tinnitus, dizziness and other ear disorders, pain, paralysis and
polyneuropathies of the hands.
SJ.4 Yangchi Yang pond Yuan source point from Pe. 6
Location: Radial to the tendon of m. extensor digitorum communis, on the dorsal side
of the wrist, directly above the joint cleft.
Indication: Distortion of the wrist.
SJ. 5 Waiguan Outer pass Luo connecting point to Pe. 7
Location: At the midpoint between ulna and radius, 2 cun proximal to the dorsal crease
of the wrist.
Indications: Torticollis, temporal headache, common cold, fever; paralysis, pain and
polyneuropathy of the arm, arthritis of the wrist and finger joints.
SJ.6 Zhigou Lateral groove Jing point
Location: At the midpoint between ulna and radius, 3 cun proximal to the dorsal crease
of the wrist.
Indications: Constipation, irritable bowel disease. For acupuncture anesthesia in chest
surgery.
SJ.8 Sanyangluo Connection of the three Yang channels
The three Yang channels of the arms connect at this point

(San = three, Yang, Luo = vessel).
Sanjiao Channel 163
Location: Between ulna and radius, 4 cun proximal to the dorsal crease of the wrist.
Indications: Disorders and pain in the chest wall. Intercostal neuralgia, herpes zoster,
deafness, aphasia. For acupuncture anesthesia in thoracotomy.
SJ. 14 Jianliao Shoulder bone cleft
Location: In the more dorsally situated of the two depressions palpable on the shoul-
der when the arm is abducted. The depression is dorsal to the biceps tendon.
Indications: Painful disorders of the shoulder, periarthritis humeroscapularis, paralysis
of the arm.
Needling method: Perpendicular, 1-2 cm, in direction of He. 1 Jiquan.
SJ. 15 Tianliao Celestial bone cleft
Location: At the midpoint of the line drawn between acromion and prominent verte-
bra, Du 14 Dazhui; 1 cun below GB.21 Jianjing.
Indications: Cervical spondylosis, periarthritis of the shoulder, torticollis.
SJ.17 Yifeng Curtain in the wind
Location: In the depression posterior to the ear lobe, anterior to the mastoid process.
Indications: Deafness, tinnitus, otitis media, parotitis, facial paralysis, acupuncture
anesthesia.
SJ.21 Ermen Gate of the ear
Location: When the mouth is opened, in the depression anterior to the intratragic
notch, above the condyloid process of the mandible.
Indications: Deafness, tinnitus, otitis media, dizziness, disorders of the mandibular
joint.
Needling method: Perpendicular, 1-2 cm, with the mouth slightly open; also in down-
ward needling direction parallel to surface of the skin, through the points SI.19 Ting-
gong and GB.2 Tinghui.
SJ.23 Sizhukong Free from fine bamboo
Location: At the lateral end of the eyebrow.

Indications: Eye disorders, frontal and temporal headache, migraine.
Needling method: Oblique in dorsal direction, 1-2 cm.
Sanjiao Channel 165
Further points on the Sanjiao channel with translations
SJ.1 Guanchong Impulse pass

SJ.2 Yemen Gate of the body fluids, Ying point
SJ.7 Huizong Meeting of the kin, Xi-cleft point
SJ.9 Sidu Four drains
SJ.10 Tianjing Celestial well, He point
SJ.11 Qinglengyuan Cool deep
SJ.12 Xiaoluo Shallow river
SJ.13 Naohui Meeting of the upper arm muscles
SJ.16 Tianyou Celestial window
SJ.18 Qimai Crazy pulse
SJ.19 Luxi Skull reposing
SJ.20 Jiaosun Small corner
SJ.22 Ear Heliao Soft bone cleft
Sanjiao Channel 167
6.11 Gallbladder Channel GB.
The gallbladder channel is a Yang channel. The gallbladder channel and the Sanjiao
channel together make up the Shao Yang axis.
Course: The gallbladder channel originates from the outer canthus of the eye and runs
to the ear, circling around it and then curving downward to the occipital region. From
here the channel runs back to the forehead and then returns backward parallel to the
midline to the neck, passing further along the shoulder to the side of the chest and de-
scending on the lateral side of the trunk along the lateral side of the abdomen along the
lateral side of the leg and foot. In the neck area the internal branch ramifies from the
superficial course, and passes through the thorax to the liver and gallbladder, conti-
nuing on in a caudal direction until it reaches the major channel course again in the hip
area. From the temple an internal connection passes to the ear and then in the ventral
direction to the stomach channel.
Clinical applications: The gallbladder channel is closely related functionally with the
liver. Both channels influence the metabolic functions and, according to traditional
theory, are responsible for the circulation of the vital energy, Qi. Stimulation of points
on the gallbladder channel of the trunk region and of important distal points is indi-
cated in liver and gallbladder disorders, low back pain, sciatica, paralysis, and disor-
ders of the mamma. Points on the head and in the neck area are used in eye and ear
disorders, headache, and migraine and for cervical spondylosis.
Element: Wood
Coupled organ: Liver
Tissue: Muscle and tendon
Sense organ: Eye
Maximal time: 11 p. m. - 1 a. m.
Alarm point, Mu: GB.24 Riyue (7th intercostal space)
Back Shu point, Shu: UB.19 Danshu (T-10)
jing Ying Yuan jing Luo Xi He

1 2 3 4 5 6 8 jue Yin
• • • •
+ Liv.
+ GB .
• • • • •
44 . 43 41 40 38 37 36 34 Shao Yang
Coupled channels: Liver and gallbladder channel

Gallbladder Channel Internal Course 169
GB.14 Yangbai
GB.1 Tongziliao
... GB. 2 Tinghui
GB.20
GB. 21 Jianjing
GB.24 Riyue
GB. 25 Jingmen
GB.30 Huantiao
, GB. 34 Yanglingquan
GB.37 Guangming
Xuanzhong
GB.1 Tongziliao Eye disorders

GB.2 Tinghui Ear disorders
GB.14 Yangbai Migraine, frontal headache
GB.20 Fengchi Cervical spondylosis; occipital headache
GB.21 Jianjing Additional alarm point of the gallbladder
GB.24 Riyue Alarm point, Mu point of the gallbladder
GB.25 Jingmen Alarm point, Mu point of the kidney
GB.30 Huantiao Sciatica
GB.34 Yanglingquan He point
Influential point for muscle and tendon
GB.36 Waiqiu Xi-cleft point
GB.37 Guangming Luo connecting point to Liv.3
GB.39 Xuanzhong Influential point for marrow
GB.40 Qiuxu Yuan source point from Liv.5
GB.41 Foot Linqi Confluent point of Dai Mai, Shu point
GB. 1 Tongziliao Pupillar bone cleft
Location: 0.5 cun lateral to the outer canthus of the eye.

Indications: Eye disorders, frontal and occipital headache, trigeminal neuralgia, tics.
Needling method: Oblique, 1-2 cm in lateral direction.
GB. 2 Tinghui Can hear
Location: When the mouth is opened, the point is palpable in a depression, behind the
condyle of the mandible.
Indications: Deafness, tinnitus, otitis media.
GB. 8 Shuaigu Following the valley
Location: 1 cun above the highest point of the auricle, 2cun above the upper fold of the
ear.
Indications: Parietal and temporal headache, migraine, dizziness.
Needling method: Oblique, 1-2 cm in ventral or dorsal direction.
GB. 14 Yangbai Clear Yang
Location: On the forehead 1 cun above the midpoint of the eyebrow.

Indications: Eye disorders, night blindness, glaucoma, frontal headache, migraine,
trigeminal neuralgia.
Needling method: Oblique, 0.5-1 cm.
Gallbladder Channel, Head and Trunk 171
.-..-_G....B~. 8 Shuaigu
Tongziliao
GB. 12
GB. 2 Tinghui
GB.20
GB. 24 Riyue
GB.25 Jingmen
GB. 26 Daimai
GB. 30 Huantiao
GB. 15 Head Linqi Nearly weeping
Location: Above GB.14 Yangbai, 0.5 cun behind the hairline (the anterior hairline is
located 3 cun cranial to the eyebrows).
Indications: Frontal headache, migraine.
Needling method: Oblique, 0.5-1 cm.
GB. 20 Fengchi Wind pond
Location: Between the origins of the m. sternocleidomastoid and m. trapezius.

Indications: Pain of the neck, torticollis, cervical spondylosis, occipital headache, com-
mon cold, dizziness, hypertension.
GB. 21 Jianjing Shoulder well Additional alarm point of the gallbladder
Location: At the highest point on the shoulder between the prominence (Du 14Da-
zhui) and the acromion.
Indications: Gallbladder and liver disorders, periarthritis of the shoulder, myogelosis.
GB. 21 Jianjing is an additional alarm point on this channel (besides GB.24 Riyue and
Ex.35 Dannang) and is also important for diagnosis. In gallbladder disorders the pain
is projected to the area of this point; this is also known in western medicine.
GB. 24 Riyue Sun and moon Mu point of the gallbladder
Location: On the mamillary line in the 7th intercostal space.

Indications: Liver disorders, hepatitis, cholecystitis, gastritis, hiccough.
GB. 25 Jingmen Gate of the capital Mu point of the kidney
Location: At the lower border of the free end of the 12th rib.
Indications: Disorders of liver and gallbladder, intercostal neuralgia. In kidney disor-
ders together with VB.23 Shenshu, the Shu point of the kidney. Moxibustion of both
points is often used in deficiency conditions of the kidney.
GB. 26 Daimai Belt vessel
Location: Midway between the free ends of the 11th and 12th ribs, at the level of the
navel.
Indications: Disorders of liver and gallbladder, intercostal neuralgia, lumbago, back-
ache, menstrual disorders, cystitis, endometritis, bowel disease, feeling of distention in
the abdomen, acupuncture anesthesia.
Gallbladder Channel, Head and Trunk 173
GB.12
GB. 2 Tinghui
GB.20
GB. 24 Riyue
GB. 25 Jingmen
GB. 26 Daimai
GB. 30 Huantiao
GB. 30 Huantiao Circular jump
Location: On the line from the trochanter major to the lower border of the sacral bone,
at the border between the outer and middle thirds of this distance.
Indications: Sciatica, low back pain, coxarthrosis, paralysis, polyneuropathy of the leg.
With slow insertion at precisely the correct location a sensation like an electric current
or a sharp pain can be felt.
GB. 31 Fengshi City of the wind
Location: On the lateral side of the thigh, between the m. vastus lateralis and biceps
femoris, 7 cun above the joint cleft of the knee. When the arm is adducted, the tip of the
middle finger indicates this point.
Indications: Low back pain, sciatica, paralysis, neurodermatitis.
GB.34 Yanglingquan Yang grave spring He point

Influential point for tendons and muscles
Location: At the point of intersection of the lines from the anterior and inferior borders
to the head of the fibula.
Indications: Disorders of muscles and tendons, influential point; tendovaginitis, myo-
dystrophies, myopathy, mental disorders, disorders of the knee joint, rheumatoid
arthritis.
Needling method: Perpendicular, 2-3 cm. Also oblique, in downward and anterior
direction. Vigorous stimulation in paralysis.
GB. 36 Waiqiu Exterior hill Xi-cleft point
Location: On the anterior border of the fibula, 7 cun above the malleolus lateralis.
Indications: Acute biliary colic, acute liver disorders, torticollis, cervical spondylosis.
GB. 37 Guangming Bright light Luo connecting point to Liv. 3
Location: On the anterior side of the fibula, 5 cun proximal to the malleolus lateralis.
Indications: Eye disorders, mental disorders.
This Luo point is also indicated in disorders of the coupled organs liver and
gallbladder.
GB. 39 Xuanzhong Hanging of the bell Influential point for marrow
Location: Between the posterior border of the fibula and the tendons of m. peronaeus
longus and brevis, 3 cun proximal to the malleolus lateralis.
Indications: As influential point, in disorders of the marrow in blood disorders.
Important distal point for torticollis.
Gallbladder Channel, Leg 175
GB. 26 Daimai
GB. 30 Huantiao
GB. 31 Fengshi
GB. 34 Yangl ingquan
GB. 37 Guangming
Xuanzhong
GB.40 Qiuxu Barren hill Yuan source point from Liv. 5
Location: Anterior and inferior to the malleolus lateralis; at the intersection of the line
drawn from anterior and inferior malleoli laterale.
Indications: Arthritis, distortion of the ankle joint, lower leg ulcers, chest pain, mastitis.
GB.41 Foot Linqi On the foot nearly weeping Confluent point of Dai Mai
Shu point
Location: Distal to the base of the 4th and 5th metatarsal bones.
Indications: Important distal point for deafness, mastitis, lactation disorders and dys-
menorrhea. Confluent point of the Dai Mai.
GB.44 Foot Qiaoyin Yin cave on the foot Jing well point
Location: On the lateral comer of the 4th toe nail.

Indications: As ling point in acute emergencies, headache, pleuritis, bronchial asthma.
The extra point 35 Dannang is located on the gallbladder channell cun distal to GB. 34
and is an additional alarm point for the gallbladder (in addition to GB.21). In disor-
ders of the gallbladder and liver this point becomes tender or painful.
Further points on the gallbladder channel with translations
GB.3 Shangguan On the pass

GB.4 Hanyan Tired lower jaw
GB.5 Xuanlu Hanging on the scalp
GB.6 Xuanli Little hung up
GB.7 Qubin Curve at the temple hair
GB.9 Tianchong Celestial impulse
GB.l0 Fubai Passing white
GB.ll Head Qiaoyin Yin cavity of the head
GB.12 Head Wangu End of the scalp bone
GB.13 Benshen Origin of the spirit
GB.16 Muchuang Eye window
GB.17 Zhengying Ordered camp
GB.18 Chengling Welcome the spirit
GB.19 Naokong Brain arch
GB.22 Yuanye Depression of the axilla
GB.23 Zhejin Lateral to the muscles
GB.27 Wushu Fifth axis
GB.28 Weidao Connecting the pass
GB.29 Femur luliao Lying in the bone cleft
GB.32 Femur Zhongdu Middle of the trench
GB.33 Xiyangguan Yang pass on the knee
GB.35 Yangjiao Crossing of Yang
GB.38 Yangfu Yang helps
GB.42 Diwuhui Five meetings on the earth
GB.43 Xiaxi Intermediate brook
Gallbladder Channel, Leg 177
GB. 26 Daimai
GB. 30 Huantiao
GB. 31 Fengshi
GB. 34 Yanglingquan
GB. 37 Guangming
Xuanzhong
6.12 Liver Channel Liv.
The liver channel is a Yin channel. The liver channel and the pericardium channel
together make up the Jue Yin axis.
Course: The liver channel runs from the great toe along the medial side of the leg and
thigh to the external genitalia, then ascending to the abdomen, to end at the lateral
chest wall in the 6th intercostal space below the mamilla.
In the genital region an internal branch ramifies in the cranial direction through the
stomach to the liver and gallbladder, subsequently crossing the chest and throat to the
face and eyes to end in the area of Du 20 Baihui.
Clinical applications: The liver channel is closely related to the genitalia and their func-
tions and also to the eye. The distal points of the liver channel are indicated in eye dis-
orders, liver and gallbladder disorders, and headache. The points of the lower extremi-
ties are selected in disturbances of the urogenital functions and in hepatic and
metabolic disorders. Points on the trunk are used in hepatic, cholecystic and metabolic
disorders.
Element: Wood
Coupled organ: Gallbladder
Tissue: Muscle and tendon
Sense organ: Eye
Alarm point, Mu: Liv.14 Qimen
Back Shu point, Shu: VB. 18 Ganshu
Jing Ying Yuan Jing Luo Xi He

1 2 3 4 5 6 8 Jue Yin
• • • •
+ Liv.
+ GB.
• • • • •
44 43 41 40 38 37 36 34 Shao Yang
Coupled channels: Liver and gallbladder channel
Liv.3 Taichong Yuan source point from GB.37

Liv.6 Zhongdu Xi-cleft point, extra alarm point
Liv.8 Ququan He point, tonification point
Liv.13 Zhangmen Mu point of the spleen
Influential point of the Zang organs
Liv.14 Qimen Mu point of the liver
Liver Channel Internal Course 179
Liv. 14 Qlmen
Liv. 13 Zhangmen
Liv.1 Dadun
Liv. 1 Dadun Large wall Jing well point
Location: Proximal to the lateral comer of the great toe nail.

Indications: As a ling well point, in acute emergencies, especially in metabolic distur-
bances.
Needling method: Oblique, 2-3 mm.
Liv. 2 Xingjian Going into the space Ying point, sedative point
Location: On the margin of the web between 1st and 2nd toes.
Indications: Dysmenorrhea, hypermenorrhea, enuresis, conjunctivitis, burning of the
eyes, headache, epilepsy, insomnia.
Liv. 3 Taichong Large impulse Yuan source point from GB. 37
Location: Between the 1st and 2nd metatarsal bones, 2cun proximal to the margin of
the web.
Indications: Liver and gallbladder disorders, epilepsy, concussion of the brain, hyper-
tension. Distal point for eye disorders, pain of the head and chest, endocrine disorders
and metabolic disorders, such as diabetes mellitus. In mental agitation, this point and
LI. 4 Hegu are needled together.
Liv. 5 Ligou Shell groove Luo connecting point to GB. 40
Location: On the medial border of the tibia, 5 cun above the medial malleolus.
Indications: Dysmenorrhea, hepatitis.
Liv.6 Zhongdu In the center of the capital Xi-cleft point,

Additional alarm point of the liver
Location: On the posterior border of the tibia, 7 cun above the medial malleolus.
Indications: As the alarm point of the liver, this point becomes sensitive to pressure in
hepatic disorders. This point is used for diagnosis and treatment in hepatic disorders.
Anesthesia for surgical procedures involving the genital organs.
Needling method: Perpendicular or oblique, 1-3 cm.
Liv. 8 Ququan Spring in the curve He point, tonification point
Location: At the medial end of the transverse popliteal crease, at the anterior border of
m. semimembranosus and semitendinosus.
Indications: Urinary tract infections, disorders of the knee joint, impotence, dysmenor-
rhea.
Liver Channel, Leg 181
Liv. 8 Ququan
Liv. 6 Zhongdu
Liv. 3 Taichong
Dadun
Liv. 13 Zhangmen Item gate Mu point of the spleen

Influential point of Zang organs
Location: At the free end of the 11th rib.

Indications: Disorders of liver and gallbladder, metabolic diseases; influential point of
Zang organs (lung, heart, spleen, kidney, liver).
Liv.14 Qimen Last gate Mu point of the liver
Location: On the mamillary line in the 6th intercostal space.

Indications: Liver disorders, pain of the upper abdomen and chest, heart disorders,
bronchial asthma, intercostal neuralgia, mastitis, lactation disorders.
Further points on the liver channel with translations
Liv.4 Zhongfeng At the middle of the altar, ling point

Liv.7 Xiguan Knee pass
Liv.9 Yinbao Yin envelope
Liv.l0 Wuli Five Chinese units
Liv.ll Yinlian Yin comer
Liv.12 limai Speedy pulse
Liver Channel, Trunk 183
Liv. 14 Qimen
Liv. 13 Zhangmen
\.
6.13 Du Mai
This channel is also called Du (Wade-Giles: Tou Mo) governing vessel (GV.). Du
means to govern. The Du Mai, together with the Ren channel and the 12 paired (regu-
lar, main) channels, is one of the "14 channels." The Du Mai and the Ren channels are
classed among the eight "extraordinary channels," Qi Jingba Mai.
No internal organ is related to the Du channel, but the Du Mai is closely related to the
central nervous system. The Du Mai is considered to be the governor of the 6 Yang
channels, with an important controlling and governing role. The Du Mai has signifi-
cant influences on the functions of the central nervous system, the mental functions
especially.
Course: The Du Mai starts at the os coccygis and passes upward along the dorsal mid-
line to the neck, then runs along the midline of the head to the forehead and nose, to
end below the upper lip in the mouth.
Clinical applications: Governing the six Yang channels, the Du Mai has an important
coordinating and harmonizing effect on all regions of the body and all organs. Points
in the lumbar and sacral region are indicated in urogenital disorders and in lumbago.
Points in the chest and neck regions are selected in chest pain, cervical spondylosis, in-
tercostal neuralgia, immune deficiency, fever and infectious disorders. Points on the
cranial course are important in mental, psychosomatic and neurologic disorders, and
in headache and migraine. The point Du 20 Baihui, located on the vertex of the skull, is
the most important governing and harmonizing point, and is therefore indicated for
every acupuncture treatment.
Du 1 Changqiang Perpetual and continuous
Location: Midway between the anus and the tip of the coccyx.
Indications: Anorectal diseases, diarrhea.
Du 2 Yaoshu Transport point to the loin
Location: At the border between the os coccygis and the os sacrum.

Indications: Urogenital disorders, lumbago. In treatment of spastic paralysis electro-
stimulation together with Du 6Jizhong is applied.
Du 3 Yaoyangguan Yang pass of the loin L-4/5
Location: On the middle between the 4th and 5th lumbar vertebrae.
Indications: Lumbar pain, sciatica, urogenital disorders.
Du Mai 185
Du 23 Shangxing
Du)Y.JI aohu
Du 16 ;lengJu
• ( -'I,
Du 15 Yamen
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Du 26 Renzhong
Du 14
Du 13
Du 11 Shendao
Du 6 Jlzhong
Du 4 Mlngme )
Du 3 Yaoyangguan
Du 2 Yaoshu
Du 1 Changqlang
Du 4 Mingmen Gate of life L-213
Location: Between the spinous processes of the 2nd and 3rd lumbar vertebrae.
Indications: Lumbago, sciatica, urogenital disorders, acupuncture anesthesia.
Du 6 Jizhong Center of spine T-11/12
Location: Below the spinous process of the 11th thoracic vertebra.

Indications: Lumbago, sciatica, epilepsy. In the treatment of spastic paralysis electro-
stimulation is also applied at Du 2 or Ex. 20.
Needling method: Oblique, 1 cm.
The electrostimulation of Du 2 Yaoshu and Du 6 Jizhong in spastic paralysis is verified
by clinical studies. The extra point 20 can be stimulated instead of Du 2.
Du 11 Shendao Way of the spirit T-5/6
Location: Below the spinous process of the 5th thoracic vertebra.

Indications: Weakness of the memory, anxiety states, mental disorders.
Du 12 Shenzhu Support of the personality T-3/4
Location: Below the spinous process of the 3rd thoracic vertebra.

Indications: Mental disorders, anxiety states, insomnia.
Du 13 Taodao Content way T-112
Location: Below the spinous process of the 1st thoracic vertebra.

Indications: Cervical spondylosis, pain in the neck, occipital headache, fever,
infectious disease.
Du 14 Dazhui Large vertebra C-71T-1
Location: Below the spinous process of the vertebra prominens (C-7).

Indications: Fever, infectious disease, immune-enhancing effect. Psychiatric disorders
such as epilepsy, schizophrenia. Bronchial asthma, eczema, occipital headache, cervi-
cal spondylosis, torticollis. Du 14Dazhui is the meeting point of many Yang channel
connections in the neck and upper chest region, and is therefore an important
governing and coordinating point.
Du Mai 187
Du 23 Shangxing
Du 17/ aohu
//?
Du 16 ;s,"Fengfu
• ( "'I,
Du 15 Yamen
1'('
Du 26 Renzhong
Du14
Du 13 Taodao
Du 11 Shendao
Du 6 Jizhong
Du 4 Mingme
)
Du 2 Yaoshu
Du 1 Changqiang
Dn 15 Yarnen Mute gate C-112
Location: Between C-1 and C-2; (suboccipital punction place).

Indications: Deafness, aphasia, speech disturbances.
Occipital headache, cervical spondylosis, torticollis. Psychiatric disorders.
Needling method: Perpendicular, not deeper than 1 cm, no stimulation, a dangerous
point.
Dn 16 Fengfn Prefecture in the wind
Location: Directly below the protuberantia occipitalis.

Indications: Occipital headache, migraine, common cold, apoplexy, psychiatric
disorders.
Dn 20 Baihni Hundred meetings
Location: On the continuation of the line connecting the lowest and highest points of
the ear lobe, on the median line of the head; 7 cun above the posterior hairline, 5 cun
behind the anterior hairline.
Indications: Psychologically effective point, general sedative and harmonizing effect.
Headache, apoplexy, weakness of memory, distal point for anorectal disorders. This
point can be used for every acupuncture treatment because of its general psychological
and coordinating effect. In rare cases needling of this point can cause headache. Other
general harmonizing points like Du 14 Dazhui should be used. No stimulation by hand
and no electrostimulation.
Needling method: Oblique, in general needling in posterior direction, 0.5 cm.
Dn 23 Shangxing Upper star
Location: 1 cun above the anterior hairline (4 cun above the eyebrow line).
Indications: Frontal headache, frontal sinusitis, rhinitis, common cold, insomnia,
anxiety, mental disorders.
Needling method: Oblique, 0.5 cm.
Dn 24 Shenting Court of the spirit
Location: 0.5 cun above the anterior hairline.

Indications: Frontal headache, dizziness, insomnia, rhinitis, common cold, sinusitis
frontalis, mental disorders.
Needling method: Oblique, in posterior direction, 0.5 cm.
Dn 25 Snliao Simple bone cleft
Location: On the tip of the nose.

Indications: Rhinitis, nose bleeding, mental disorders.
Needling method: Perpendicular, 0.5 cm; very painful point.
Du Mai 189
Du 23 Shangxing
Du)y~aohu
Du 16 ;l"engfu
4 ( ''I,
Du 1S Yamen
1'"
Du 26 Renzhong
Du14
Du 13 Taodao
Du 11 Shendao
Du 6 Jizhong
Du 4 Mingme )
Du 3 Yaoyangguan
Du 2 Yaoshu
Du 1 Changqiang
Du 26 Renzhong Center of upper lip
Location: At the border of the middle and upper thirds of the distance between nose
and upper lip.
Indications: Du 26is the ling well point (last point on the skin) of the Du Mai and one
of the most important ling well points of the body. Specific effective in acute emergen-
cies, such as collapse, shock and epileptic attack.
It is the most important point in acute emergencies. Epileptic attacks can be directly
interrupted.
Needling method: Oblique in upward direction, 0.5 cm. Strong stimulation in epileptic
attack. If no acupuncture needle is available the nail of the index finger or a disposable
cannula should be used.
The last two points on the Du Mai, Du 27 and Du 28, are located in the mouth and are
indicated in toothache, gum disorders, and hemorrhoids.
Further points on the Du Mai with translations
Du5 Xuanshu Hanging turning point (L-1/2)

Du7 Zhongshu Middle of the center (T-1 0/11)
Du8 linsuo Muscle contraction (T-9/10)
Du9 Zhiyang In direction to the Yang (T-7/8)
Du10 Lingtai Hill of spirit (T-6/7)
Du 17 Naohu Brain door
Du18 Qiangjian Strong interval
Du19 Houding Backward vertex
Du21 Qianding Anterior vertex
Du22 Xinhui Meeting at the anterior fontanel
Du27 Duiduan At the border of the cave
Du28 Yinjiao Gum crossing
Du Mai 191
Du 23 Shangxing
Du 17/~NaOhU
.",
.//70
Du 16 /1, engfu
' (
Du 15 Yamen
~'r.
Du 26 Renzhong
Du14
Du 13 Taodao
Du 11 Shendao
Du 6 Jizhong
Du 4 Mingme )
Du 3 Yaoyangguan
Du 2 Yaoshu
Du 1 Changqiang
6.14 ReD Mai
The Wade-Giles nomenclature refers to the Ren channel as lenn Mo; in the western
literature it is called the conceptional vessel (CV.).
The Ren and the Du channels do not correspond directly to an internal organ. The Ren
Mai controls the six Yin channels and the alarm points. The Ren Mai influences the
genital organs and is therefore also called the conceptional vessel.
Course: The Ren channel starts from the perineum, ascending along the front midline
over the abdomen and thorax to end below the mouth.
Clinical applications: The Ren Mai, controlling the six Yin channels, has a coordi-
nating effect in disorders of the Yin organs, e. g., spleen, liver, kidney, lung, and heart.
The points of the Ren Mai are therefore often indicated in gastrointestinal disorders
and in disorders of the heart and lung. The Ren Mai is the site of many alarm points:
Ren 12 Zhongwan, the alarm point of the stomach; Ren 14 luque, that of the heart;
and Ren 17 Shanzhong, that of the pericardium. There are also many tonification
points on the Ren channel, such as Ren 6 Qihai, sea of energy, and Ren 8 Shenque, the
navel (only for moxibustion).
Ren 1 Huiyin United Yin
Location: At the middle of the perineum.

Indications: Hemorrhoids, pelvic inflammation.
Ren 2 Qugu Curved bone
Location: On the midline directly above the upper border of the symphysis, 5 cun
below the navel.
Indications: Urogenital disorders, incontinence and retention of urine, chronic pelvic
inflammation, enuresis, impotence, spermatorrhea, premature ejaculation, dysme-
norrhea.
Ren 3 Zhongji In the middle between the poles Mu point of the urinary bladder
Location: On the midline, 1 cun above Ren 2 Qugu or symphysis.

Indications: Same as Ren 2 Qugu.
Ren 4 Guanyuan Surrounded source energy Mu point of the small intestine
Location: On the midline, 2 cun above Ren 2 Qugu, 3 cun below the umbilicus.
Indications: Same as Ren 1 and 2.
Ren Mai Internal Course 193
Ren 17 Shanzhong
.;)
(
Ren 12 Zhongwan
)
Ren 8 Shenjue
Ren 6 Qihai
Ren 5 Shimen Stony gate Mu point of the Sanjiao
Location: On the midline, 2cun below the umbilicus.

Indications: Edema and ascites.
General tonification point - moxibustion.
Ren 6 Qihai Sea of vital energy
Location: On the midline, 1.5 cun below the umbilicus.

Indications: States of weakness. This is a general tonification point and is indicated to-
gether with S1. 36 Zusanli and Sp.6 Sanyinjiao in chronic fatigue and hypotension.
Moxibustion should be used.
Ren 8 Shenque Palace gate of the spirit
Location: Umbilicus.
Indications: This point is a forbidden point for acupuncture. Moxibustion is useful in
abdominal pain and diarrhea. The umbilicus is an important general tonification
point, like Ren 6 Qihai.
Ren 9 Shuifen Water separation
Location: On the midline, 1.0 cun above the umbilicus.

Indications: Diarrhea, edema, ascites.
Ren 12 Zhongwan In the middle of the stomach pit Influential point

for the Fu organs
Mu point of the stomach
Location: On the midline, midway between the xiphoid process and the umbilicus,
4 cun above the umbilicus.
Indications: Gastric and duodenal ulcer, gastritis, nausea, vomiting, abdominal disten-
tion, digestive disorders, liver disorders.
Ren 14 Juque Large palace gate Mu point of the heart
Location: On the midline, 6cun above the umbilicus.

Indications: Stomach disorders, heart diseases such as angina pectoris, mental disor-
ders such as insomnia and agitation.
Ren 15 Jiuwei Wild pigeontail Luo connecting point to the Du channel
Location: Immediately below the sternum.

Indications: Cardiac pain, hiccuping, vomiting, ulcer pain, mental disorders.
Ren Mai 195
Ren 15 Jiuwei
Ren 14 Jujue
l )
Ren 8 Shenjue
Ren 6 Qihai
Ren 5 Shimen
Ren 4 Guanyuan
Ren 3 Zhongji
Ren 2 Qugu
Ren 17 Shanzhong Middle of the chest Mu point of the pericardium

Influential point for the respiratory system
Location: In the middle of the sternum between the nipples, at the level of the 4th inter-
costal space.
Indications: Heart and lung disorders, bronchial asthma, disorders of the chest wall.
Needling method: Oblique, in downward direction, 2-3 cm.
Ren 22 Tiantu Standing out from heaven
Location: In the jugular fossa.

Indications: Acute bronchial asthma attacks, hiccuping, dysphagia, pharyngitis.
Needling method: The patient must sit for needling of this point. First of all the needle
is inserted 0.5 cun in a backward direction, after which the patient is asked to lean his
or her head right back, and the needle can then be advanced parallel to the posterior
border of the sternum 3-4 cm in the caudal direction. This point should be used only
by the experienced acupuncturist. Incorrect insertion endangers the great vessels and
other vital organs in the mediastinum.
Ren 23 Lianquan Modest spring
Location: Midway between the upper border of the cricoid cartilage and the lower bor-
der of the mandible.
Indications: Aphasia, mutism, dysphagia, speech disorders following stroke, stuttering,
hypersalivation, pharyngitis, laryngitis.
Needling method: Oblique toward the root of the tongue or toward Du 20 Baihui,
2-3 cm.
Ren 24 Chengjiang Pap receiving
Location: In the groove on the middle between the lower lip and tip of chin.
Indications: Facial paralysis, trigeminal neuralgia, toothache in the region of the lower
incisors, swellings of the lower jaw, hypersalivation, anesthesia point for tooth
extraction.
Further points on the Ren channel with translations
Ren 7 Abdomen Yinjiao Yin crossing

Ren 10 Xiawan Lower stomach pit
Ren 11 Jianli Interior construction
Ren 13 Shangwan Superior stomach pit
Ren 16 Zhongting In the middle of the hall
Ren 18 Yutang Jade hall
Ren 19 Thorax Zigong Purple palace
Ren20 Huagai Pompous cover
Ren 21 Xuanji Main star (Great Bear)
Reo Mai 197
Ren 15 Jiuwei
Ren 14 Jujue
l
Ren 8 Shenjue
Ren 6 Qihai
Ren 5 Shimen
Ren 4 Guanyuan
Ren 3 Zhongji
Ren 2 Qugu
6.15 Chong Mai
The other 6 extraordinary channels, Chong Mai, Dai Mai, Yangqiao, Yinqiao, Yang-
wei, and Yinwei, do not have points of their own, but they constitute collaterals to the
12 main channels and use their points. These 6 channels, according to traditional
theory, transport and distribute the "ancestral," source, or hereditary energy all over
the body. The eight extraordinary channels can be divided into two groups:
- The primary extraordinary channels are the Du Mai, Ren Mai, Chong Mai, and Dai
Mai channels, all with their origin in the pelvic region. They are closely related to the
Chinese functional system of the kidney.
- The four secondary extraordinary channels are the Yangqiao, Yinqiao, Yangwei and
Yinwei channels, which run from the feet toward the head and are closely related to
the urinary bladder channel.
The extraordinary channels each have a confluent point that "opens" the specific ex-
traordinary channel. Confluent points are located on the main channels, mostly in the
region of the wrist or ankle joint.
The Chong Mai is also called the vital vessel; Chong means impulse, or to give an im-
pulse. The Chong Mai starts in the lower abdomen, in the uterus, and runs to the peri-
neum (Ren 1), where the deep branch ascends to the kidney and to the spine. The su-
perficial branch passes ventrally to the kidney channel and they ascend together
parallel to the midline as far as the throat, then on to the mouth and circle around the
lips.
The points of the Chong Mai are: Ren 1 Huiyin, Ki.11 Henggu, Ki.12 Dahe,
Ki.13 Qixue, Ki.14 Siman, Ki.15 Zhongshu, Ki.16 Huangshu, Ki.17 Shangqu,
Ki.18 Shiguan, Ki.19 Yindu, Ki.20 Tonggu, Ki.21 Youmen.
Sp.4 Gongsun is the confluent point.
6.16 Dai Mai
Dai means belt or girdle, and Mai means vessel. Dai Mai, the belt vessel, runs like a
belt from the spine along the hypochondrium in the ventral direction.
The points for the Dai Mai are: GB.26 Daimai, GB.27 Wushu, and GB.28 Weidao.
There are close relationships with points VB. 23 Shenshu and Ren 8 Shenque, the
navel. GB.41 Foot Linqi is the confluent point.
6.17 Yangqiao
The Yangqiao channel starts below the heel in the point VB. 62 Shenmai. Qiao means
to stand on tiptoe. The channel ascends on the lateral side of the leg, along the lateral
side of the abdomen and thorax to the shoulder, passing to the neck and mouth. From
the mouth an internal connection passes to the inner canthus of the eye, following
along the urinary bladder channel in the dorsal direction, to end in the point GB.20
Fengchi.
The points on the Yangqiao are: VB.62 Shenmai, VB.61 Pushen, VB.59 Fuyang,
GB.29 Juliao, SI.10 Naoshu, LI.15 Jianyu, LI.16 Jugu, St.4 Dicang, St.3 Juliao,
St. 1 Chengqi, VB.1 Jingming, and GB.20 Fengchi.
VB. 62 Shenmai is the confluent point.
Chong Mai and Yangqiao 199
St. 1
St. 3
St. 4
Ki. 21
Ki. 20
Ki.18
Ki. 17
Ki.16
J
J
I
I Ki.13
I
\ /' Ki. 11
\
' -_
I
...... ...
-'
Ren 1 Huiyin
UB.59
UB. 62 Shenmai
UB.61
6.18 Yinqiao
The Yinqiao channel starts on the inner side of the foot with point Ki.6 Zhaohai, the
confluent point. From here the channel ascends along the inner side of the leg to the
genital region, then follows a course parallel to the midline along the trunk to the neck,
to end at the inner canthus of the eye in point UB.1, where it connects with the Yang-
qiao channel.
The points are: Ki.6 Zhaohai, Ki.8 Jiaoxin, and UB. 1 Jingming.
Ki.6 Zhaohai is the confluent point.
6.19 Yangwei
Wei means the outer twines of a net, but it also means to hold together, to bind, to con-
nect. The Yangwei, according to traditional theory, connects the Yangwei and the Yang
channels and controls the exterior body layers, the skin and the subcutis. This ex-
traordinary channel is especially important in treatment of disorders caused by exter-
nal climatic factors, such as wind and cold. SJ.5 Waiguan is the confluent point and is
effective in the case of climatic influences acting on the head.
The Yangwei channel starts from the lateral malleolus in the point UB. 63, ascends on
the lateral side of the body via the knee and hip to the shoulder continuing to the fore-
head and then along the gallbladder channel to the neck.
The points on the Yangwei are: UB. 63Jinmen, GB.35 Yangjiao, SI.10 Naoshu,
SJ.15 Tianliao, GB. 21 Jianjing, St. 8 Touwei, GB.13 Benshen, GB.14 Yangbai, GB. 15
Linqi, GB.16 Muchuang, GB.17 Zhengying, GB.18 Chengling, GB.19 Naokong,
GB.20 Fengchi, Du 16 Fengfu, and Du 15Yamen.
SJ.5 Waiguan is the confluent point.
6.20 Yinwei
The Yinwei channel according to traditional ideas, connects all the Yin channels and
has an important influence on the heart and on the Yang organs stomach, large intes-
tine, and gallbladder.
The course of the Yinwei channel is from the medial side of the lower leg along the
knee, ascending on the lateral side of the abdomen to the thorax to end on the neck.
The points on the Yinwei channel are: Ki.9 Zhubin, Sp.13 Fushe, Sp.15 Daheng,
Sp.16 Fuai, Liv.14 Qimen, Ren 22 Tiantu, and Ren 23 Lianquan.
Pe.8 Neiguan is the confluent point of Yinwei.
Dai Mai 201
UB. 23 Shenshu L+----e.. GB.26 Daimai
GB.27
GB. 28
202 Yinqiao and Yinwei Channels
UB.1 Jingming
1\
•• Liv. 14 Qimen
!I
Sp. 15 Daheng
Ki. 8 Jiaoxin
Ki. 6 Zhaohai
Yangwei 203
---GB.17
GB.16
GB.15
St. 8 Touwei
SJ.15 Tianliao
SI. 10 Naoshu
\.
GB.35
6.21 Extra Points Ex.
Mter the categorization of the 361 classic acupuncture points located on the 14 chan-
nels, new points were found and introduced as extra points (Ex.). In this book the
terminology of the Academy of Traditional Chinese Medicine is used. Every point has
a Chinese name, which shows its location or function, e. g., Ex.2 Taiyang = temple,
Ex.8 Anmian = silent sleep. Most of the extra points are not located on any of the
14channels, but a few are found along the courses of the main channels, e.g., Ex.35
Dannang distal to GB. 34 Yanglingquan.
The acupuncture literature published in recent years differs widely in the numbering
systems used for the extra points. In 1984 the World Health Organization established
an international standard for acupuncture point names, including the 31 commonly
used extra points. The extra points were not numbered by the organization committee,
which means that use of their Chinese names is particularly important. In this textbook
we also give the numbering system published by the Academy of Traditional Chinese
Medicine in 1975 in the book Outlines, because it is widely used.
The regions in which the extra points are found are abbreviated by the WHO
standardization committee as follows:
Extra points on the head and neck - Ex-HN

Extra points on the chest and abdomen - Ex-CA
Extra points on the back of the trunk - Ex -B
Extra points on the upper extremities - Ex-UE
Extra points on the lower extremities - Ex-LE
Only the most important extra points are described here.
Extra points on the head and neck Ex-HN
Ex. 1 Yintang Stamp hall Ex-HN
Location: Between the eyebrows on the midline at the root of the nose.
Indications: Rhinitis, frontal headache, frontal sinusitis, eye disorders.
Needling method: Oblique, in caudal direction, 0.5 cm.
Ex. 2 Taiyang Temple Ex-HN
Location: At the point of intersection of the continuations of the eyebrow and the
lower eyelid in the lateral direction, on the lateral border of the orb ita.
Indications: Headache, migraine, eye disorders, facial paralysis, trigeminal neuralgia,
frontal sinusitis, toothache.
Needling method: Perpendicular or oblique, 1 cm.
A dangerous point.
Extrapoints of the Head Region 205
Ex. 2 Taiyang
Ex.4 Qiuhou
Ex.5 Jiachengjiang
Ex. 6 Sishencong
If
~~
(ff ~ Ex. 3 Yuyao
~
Ex.1 Yintang
/
~
~ -a--
l
'/~
• Ex.2 Taiyang
Ex. 7 Y·Immg
.
, Ex.4 Qiuhou
Ex. 9 Anmian II • • • ~ ~
~\\~\\\I) --
Ex.8 Anml.n I ~
~---'
Ex. 3 Yuyao Fish back Ex-HN
Location: In the middle of the eyebrow, directly above the pupil.

Indications: Frontal sinusitis, eye disorders, headache.
Needling method: Oblique, 0.5 cun, in medial direction for frontal sinusitis, in ventral
direction for eye disorders.
Ex. 4 Qiuhou Behind the eyeball
Location: On the lower border of the orbita, at the junction of the lateral fourth and the
medial three-fourths of the lower border of the orbita.
Indications: Myopia, disorders of the N. opticus, glaucoma, and other eye disorders.
Needling method: Perpendicular, slightly downward, 1 cm, with the patient looking
upwards. The needle should be directed toward the lower border of the orbita. This is a
dangerous point, which should be used only by the experienced acupuncturist. It is
important to avoid the eye.
Ex.5 Jiachengjiang Framing the point "pap receiving"
Location: In the foramen mentale, about 1 cun lateral to Ren 24 Chengjiang.

Indications: Facial paralysis, trigeminal neuralgia, toothache.
Ex. 6 Sishencong The four spiritual wise men Ex-HN
Location: Four points, located 1 cun anterior, posterior, and lateral to Du 20 Baihui.
Indications: Headache, apoplexy, epilepsy, agitation, insomnia.
Needling method: Oblique, 0.5 em toward Baihui.
These four points are usually needled together with the point Baihui.
Ex. 7 Yiming Healing to the bright light
Location: This point is located on a straight line between SJ.17 Yifeng and GB.20
Fengchi, 1 cun dorsal to SJ. 17. The points SJ. 17, Ex.8, Ex. 9, and G B. 20 are located
on a horizontal line behind the ear lobe.
Indications: Ear and eye disorders.
Ex. 8 Anmian I Calm sleep
Location: Between SJ.17, Yifeng and Ex.7 Yiming, 0.5 cun dorsal to SJ.17.
Indication: Insomnia.
Needling method: Perpendicular, 1 cm. Anmian I and II are used together.
Extrapoints of the Head Region 207
Ex. 2 Taiyang
Ex.4 Qiuhou
Ex. 5 Jiachengjiang
Ex. 6 Sishencong
!r
fr·
(f Ex. 3 Yuyao
~
~ Ex. 1 Yintang
~
/ l .'~ Ex.2 Taiyang
Ex.7 Yiming
\
~ '.-:" Ex.4 Qiuhou
Ex. 9 Anmian II • • • ~ ~
~\\~\\\I) --
Ex.B Anml.n I ~
Ex. 9 Anmian II Calm sleep
Location: Midway between Ex.7 Yiming and GB.20 Fengchi.

Indication: Insomnia.
Extra points on the back Ex-B
Ex. 17 Dingchuan Calming asthma
Location: 0.5 cun lateral to Du 14 Dazhui.

Indication: Important point for bronchial asthma.
Needling method: In slightly medial direction, 1 cm.
Ex. 20 Yaoqi Miracle point at the sacrum Ex-B
Location: On the dorsal midline 2cun above the os coccygis.

Indications: Muscle relaxation in spastic paralysis and for acupuncture anesthesia.
Epilepsy.
Needling method: Oblique, in upward direction, 1 cm.
Ex. 21 Huatuojiaji Huatuo points bind the spine
This point is named for the famous Chinese surgeon Hua Tuo;
Huatuo means wonderful son.
Location: This is a series of 28 point pairs, located 0.5 cun lateral to the lower border of
the processus spino sus, between the 1st cervical and the 4th sacral vertebrae.
Indications: Pain along the spine, segmental pain radiation, disorders of the internal
organs corresponding to the segmental innervation.
Needling method: 1 cm in the cervical and thoracic region. The needles should be in-
serted in a slightly medial direction. Three to five Huatuo points are used in one
acupuncture treatment session.
Extra points on the upper extremity Ex-UE
Ex. 28 Baxie Eight obliquities Ex-UE
Location: On the back of the hand, at the midpoints of the webs (8 points). The patient
should form a fist for needling at these points.
Indications: Disorders and pain in the fingers, rheumatoid arthritis.
Needling method: Oblique, in proximal direction, 1 cm.
Extrapoints of the Back 209
Ex. 21 Huatuojiaji
• Ex.20 Yaoqi
Extra points on the lower extremities Ex-LE
Ex. 31 Heding Crane crest Ex-LE
Location: At the middle of the upper border of the patella.

Indication: Disorders of the knee joint.
Ex. 32 Xiyan Knee gap Ex-LE
Location: At the level of the lower border of the patella, medial to the ligamentum
patellae.
Indication: Disorders of the knee joint.
Needling method: Perpendicular or oblique, in medial direction, 0.5-2 cm. The point
St. 35 Dubi, located on the lateral side of the lower border of the patella, is also called
lateral Xiyan. These points together with Ex. 31 are indicated for treatment of disorders
of the knee joint.
Ex. 33 Lanwei Appendix Alarm point of appendix
Lanwei in Chinese means wormlike appendix.

Location: 2 CUll below St. 36 Zusanli.
Indications: Appendicitis, postoperative pain after appendectomy.
Needling method: Perpendicular, 2 cm. This point can be painful in acute appendicitis.
Ex. 35 Dannang Gallbladder Additional alarm point of the gallbladder
Location: 1 cun distal to G B. 34 Yanglingquan on the course of the gallbladder channel.

Indications: Gallbladder and liver disorders.
Ex. 36 Bafeng Eight winds Ex-LE
Location: On the dorsum of the foot in the middle of the webs, 8 points.
Indications: Arthritis of the toes, pain and paresthesia offoot and toes.
Needling method: Oblique in proximal direction, 1 cm. Liv.2 Xingjian, St. 44 Neiting,
and GB.43 Xiaxi coincide in location with the Bafeng points.
Neima (Nei means medial and Ma anesthesia)
Location: On the posterior border of the tibia midway between the medial malleolus
and the knee joint. This point corresponds to the location of Liv. 6 Zhongdu.
Indications: Analgesic point for surgery in the lower abdominal and urogenital areas.
This point is indicated for pain relief during childbirth, together with Sp. 6 Sanyinjiao.
Extra Points 211
Waima (Wai means lateral, Ma anesthesia)
Location: At the same level as Neima on the lateral side of the leg, 8 cun above the lat-
eral malleolus.
Indications: Acupuncture anesthesia for the pelvic and abdominal region.
The 31 standard extra points listed with the Chinese names
Head and neck

Ex-HN Sishencong
Ex-HN Taiyang
Ex-HN Jinjin
Ex-HN Juquan
Ex-HN Erjian
Ex-HN Yintang
Ex-HN Neiyingxiang
Ex-HN Yuye
Ex-HN Haiquan
Ex-HN Yuyao
Chest and abdomen

Ex-CA Zigong
Back of trunk
Ex-B Jiaji
Ex-B Pigen
Ex-B Yaoyan
Ex-B Shiqizhui
Ex-B Yaoqi
Upper extremities
Ex-UE Zhoujian
Ex-UE Erbai
Ex-UE Zhongquan
Ex-UE Zhongkui
Ex-UE Dagukong
Ex-UE Xiaogukong
Ex-UE Baxie
Ex-UE Sifeng
Ex-UE Shixuan
Lower extremities
Ex-LE Heding
Ex-LE Xiyan
Ex-LE Neihuaijian
Ex-LE Waihuaijian
Ex-LE Bafeng
Ex-LE Duyin
7 Regions with Important Acupuncture Points
G.Stux
7.1 Face
Three Yang channels of the ann end in the face, the large intestine, the Sanjiao, and the
small intestine channels. The three Yang channels originating in the eye area pass to
the foot: Stomach, gallbladder and urinary bladder channels. The stomach channel
starts directly below the eyeball and runs along the ventral side of the body to the foot;
the gallbladder channel starts lateral to the eye and also runs along the lateral side of
the body; the urinary bladder channel originates medial to and above the eye and de-
scends along the dorsal side of the body to the foot. There are no Yin channels in the
face area.
Acupuncture points of the face are indicated as local points in disorders of the eye and
ear, and also in trigeminal neuralgia, facial paralysis, rhinitis, and toothache. The most
important points are:
7.1.1 Points Around the Orbita
St. 1 Chengqi Directly below the middle of the eyeball, just above the
lower border of the orbita
GB.1 Tongziliao 0.5 cun lateral to the outer canthus of the eye
UB. 1 1ingming 0.1 cun medial to and above the inner canthus of the eye
UB.2 Zanzhu On the medial end of the eyebrow, directly above the inner
canthus of the eye
Ex.4 Qiuhou At the lower border of the orbita, lateral to its middle
Ex.3 Yuyao On the eyebrow, directly above the midpoint of the pupil
Ex.1 Yintang Midway between the two eyebrows
GB.14 Yangbai On the forehead 1 cun above the midpoint of the eyebrow
The major indications for these points are disorders of the eye and frontal headache.
The most important distal points for this region are LI. 4 Hegu, GB. 37 Guangming and
St. 44 N eiting.
7.1.2 Points Around the Ear
S1.21 Ennen Above the condyloid process of the mandible, in the

depression anterior to the tragus
SI.19 Tinggong In the depression anterior to the tragus, below S1.21
Ennen
GB.2 Tinghui Anterior to the ear, below SI. 19 Tinggong
S1.17 Yifeng Posterior to the ear lobe, anterior to the mastoid process
These points are indicated mainly in disorders of the ear. The most important distal
points for the ear are S1.3 Zhongzhu and GB.41 Foot Linqi.
Acupuncture Points in the Face 213
~__ St. 2 Sibai

iSt. 3 Juliao
214 Neck Area
7.1.3 Points Around the Nose
Ex.l Yintang Midway between the two eyebrows

LI.20 Yingxiang Lateral to the ala nasi
St.2 Sibai On the infraorbital foramen
St.3 luliao Directly below St. 2 Sibai, lateral to the ala nasi
St.6 liache At the highest point of the masseter muscle
St. 7 Xiaguan Below the middle of the os zygomaticum, in the depression
below the middle of the lateral branch of the os
zygomaticum in the palpable groove formed above the
mandibula
SI.18 Quanliao Directly below the outer canthus of the eye below the
zygomatic arch
The main indications for these points are rhinitis, sinusitis maxillaris, trigeminal neu-
ralgia, and facial paralysis.
7.2 Neck Area
In the region of the neck the Du Mai passes along the dorsal midline, while lateral to
this line the course of the urinary bladder channel and, more laterally, that of the gall-
bladder channel are situated. The points in the neck area are indicated in occipital
headache, cervical spondylosis and torticollis.
Du 15 Yamen Between the 1st and 2nd cervical vertebrae

Du 16 Fengfu Directly below the external occipital protuberance
UB.l0 Tianzhu 1.3 cun lateral to Du 15Yamen
GB.20 Fengchi Between the origins of the m. sternocleidomastoid and
m. trapezius
Du 14 Dazhui Below the spinous process of the vertebra prominens
Du 13 Taodao Below the spinous process of the 1st thoracic vertebra
UB.11 Dashu 1.5 cun lateral to Du 13 Taodao
GB. 21 lianjing At the highest point of the shoulder
The main indications for these local points are occipital headache and cervical spondy-
losis. The important distal points for the neck region are Lu.7 Lieque, SI. 3 Houxi,
GB.39 Xuanzhong, and UB.60 Kunlun.
Acupuncture Points in the Neck Region 215
Du 20 Baihui
Du 16 Fengfu
Yamen
Dazhui
Taodao
216 Dorsal Side of the Trunk
7.3 Dorsal Side of the Trunk
On the back the channels are situated parallel to the midline. The Du Mai, the govern-
ing vessel, ascends in the middle of the spinous processes, and the medial branch of the
urinary bladder channel (UB. 11- UB. 31), with its important Back Shu points influenc-
ing the internal organs, runs 1.5 cun to the side of it. The lateral branch of the urinary
bladder channel is located 3cun lateral to the midline (UB.41 to UB.54). A group of
28 extra points, named by the surgeon Hua Tuo, is located paravertebrally 0.5 cun from
the vertebral column. In a short part of the back the gallbladder channel descends
along the lateral side of the trunk. Acupuncture points on the back are indicated in
painful disorders of the spine, sciatica, and disorders of the internal organs.
The important points are:

Du 14 Dazhui Below the spinous process of the vertebra prominens
Du 13 Taodao Below the spinous process of the 1st thoracic vertebra
Du 11 Shendao Below the spinous process of the 5th thoracic vertebra
Du 6 Jizhong Below the spinous process of the 11 th thoracic vertebra
Du 4 Mingmen Below the spinous process of the 2nd lumbar vertebra
Du 2 Yaoshu At the border between the coccyx and the sacrum
UB.11-UB.28 Back Shu points (p. 136)
UB.41- UB. 54 On the lateral branch of the urinary bladder channel
(p.142)
Ex.21 Huatuojiaji 0.5 cun lateral to the lower border of the spinous process of
the vertebra
GB.25 Jingmen At the free end of the 12th rib
G B. 26 Daimai Midway between the 11th and 12th ribs, at the level of the
navel
Acupuncture Points on the Back 217
Ex. 21
UB.11 Dashu
T~l UB~13 Feishu
I
Du 11 Shendao UB.15 Xinshu
UB.17 Geshu
.,
UB.19 Danshu
Du 6 Jizhong UB.20 PiSh~
GB.25 Jingming
u4 Mingmen UB.23 Shen\U

)
UB.25 Dachangshu
I \
UB\ Xiaochangshu
Du 2 Yaoshu
UB.30 Baihuanshu
218 Abdominal Area
7.4 Abdominal Area
In the abdominal area the Ren Mai, the conceptional vessel, runs along the midline;
the kidney channel follows a paramedian course 0.5 cun away; the stomach channel
has a paramedian course 2 cun away. The spleen, liver, and gallbladder channels are
located laterally. The points in the abdominal area are used as local points for gastro-
enterological and urogenital disorders. Points of the Ren Mai, stomach channel, liver
channel, and gallbladder channel are especially important in these disorders. The
points on the kidney and spleen channels are rarely used in this area.
7.4.1 Epigastrium
Ren 12 Zhongwan On the midline, midway between the xiphoid process and
the umbilicus
St.21 Liangmen 2 cun lateral to Ren 12
Liv.13 Zhangmen At the free end of the 11 th rib
Liv.14 Qimen On the mamillary line in the 6th intercostal space
GB.24 Riyue On the mamillary line in the 7th intercostal space
The points in the epigastrium are used as local points in stomach disorders, such as
gastric ulcer and gastritis, and also in liver and gallbladder disorders. The important
distal points are Pe.6 Neiguan and St.36 Zusanli.
7.4.2 Middle and Lower Parts of the Abdominal Area
St. 25 Tianshu 2 cun lateral to the umbilicus

Sp.15 Daheng 4 cun lateral to the umbilicus
G B. 26 Daimai Midway between the free ends of the 11th
and 12th ribs, at the level of the umbilicus
Ren 6 Qihai 1.5 cun below the umbilicus
Ren 3 Zhongji 4 cun below the umbilicus
St. 29 Guilai 4 cun directly below the umbilicus, 2 cun
lateral to the midline
The main indications of these points are gastrointestinal disorders and urological and
urogenital disorders. Distal points for this region are St. 36 Zusanli and Sp.6 Sanyin-
jiao.
Acupuncture Points in the Abdominal Region 219
Liv.14 Qimen
•
i \ iyue • t
l 1
GB.2
(
Ren 12 Zhongwal"! I
St. 21 liangmen
GB. 25 Jingmen·
GB.2 DaimJ Sp.15St. 25 Tianshu
Ren 6 Qihai
St. 29 Guilai Ren 3 Zhongj

220 Points in the Shoulder Area and Around the Knee Joint
7.5 Shoulder Area
The Yang channels relating to large intestine and Sanjiao and the small intestine chan-
nel pass over the shoulder.

LI. 15 Jianyu In the anterior depression with the arm abducted
SJ. 14 Jianliao In the further back of the two depressions palpable on the
shoulder with the arm abducted
SI. 9 Jianzhen 1 cun above the dorsal crease of the axilla with the arm
adducted
LI.14 Binao At the frontal border of the V-shaped middle side of the
m. deltoideus
SJ.15 Tianliao At the midpoint of the line between acromion and
prominence, Du 14 Dazhui, 1 cun below GB. 21 Jianjing
SI.10 Naoshu Below the acromion, above SI. 9
Acupuncture points on the shoulder are indicated in periarthritis humeroscapularis.

The distal points S1. 38 Tiaokou and LI. 4 Hegu are important for the shoulder.
7.6 Points Around the Knee Joint
The three Yang channels stomach, gallbladder, and urinary bladder channel pass
across the knee, and on the medial side the three Yin channels spleen, liver and kidney.
Extra points are also located in the knee area.
The important points at the knee joint:

St.35 Dubi Lateral to and below the patella
S1. 36 Zusanli 1 cun lateral to the tuberositas tibiae
Ex.31 Heding On the midpoint of the upper border of the patella
Ex.32 Xiyan In the depression on the medial side of the ligamentum
patellae
GB.34 Yanglingquan Anterior and inferior to the head of the fibula
VB.40 Weizhong At the midpoint of the popliteal transverse crease
Sp.9 Yinlingquan In the depression below the lower border of the medial
condyle
Liv.8 Ququan At the medial end of the transverse popliteal crease,
at the anterior border of m. semimembranosus and
m. semitendinosus
Most points of the knee are Shu points, proximally located He points (S1.36, GB.34,
VB. 40, Sp.9, Liv.8). These knee points are indicated mainly as local points for gonar-
throsis and gonarthritis. Distal points are S1.44 Neiting and VB. 60 Kunlun.
Acupuncture Points of the Shoulder and Knee 221
U.14 Binao
51.. 9 Jlanzhen I
\
Ex,31 Heding-.--_
t
EX.J2) Xi~n_
I
St. 35 Dubi
Sp. 9 Yinglingquan
St. 36 Zusanli
8 Technique of Acupuncture
G.Stux
8.1 Acupuncture Needles
Already in prehistoric times, sharpened stones ("Bian" in Chinese) were applied in

massage of certain parts of the body. Later bone or bamboo "needles" were used. Gold
and steel needles have been found in Han Dynasty tombs (206 B. C. to 221 A. D.).
In the Huang Di Nei Jing classic needles were mentioned for different applications.
An illustration in the Zhen Jiu Da Cheng of 1601 shows the nine classic needles and
describes their clinical use:
Chanzhen, arrow head needle, for skin diseases. The later plum blossom needles were devel-
oped from these Chanzhen needles.
Yuanzhen, round headed "needles" for massage.
Dizhen, fine round needles sharp in the same way as a millet grain, to press onto the skin.
Fengzhen, lancets triangular in section; needles with three faces, for needling of the Luo con-
nections in chronic disease.
Pizhen, sword lancets for surgical use.
Yuanlizhen, sharp, short filiform needles for use in rheumatoid arthritis.
Haozhen, most often used, thin filiform needles, for tonifying method of needling.
Chongzhen, long filiform needles for deep insertion.
Dazhen, also called Haozhen, large thick needles used for edematous tissues around the
joints, also for cauterization by fire treatment.
The filiform needles, Yuanlizhen and Haozhen, were applied most often when the
Zhen Jiu Da Cheng was being written. Today mostly filiform steel needles are used for
acupuncture. The steel used is flexible and is not breakable. Gold and silver needles
are applied only very rarely and only in ear acupuncture. The diameter of the needles
varies from 0.2 to 0.6 mm and is given often as the Gauge (26-32):
Gauge 34 32 30 28 26
mm 0.22 0.26 0.32 0.38 0.45
In most cases needles 0.3-0.4 mm thick are used. The length varies from 1 to 10cm and
is often given in inches, the 1-in., 1Yz-in., and 2-in. needles being most common.
Filiform needles consist of a tip, a body, and a handle. The length of the needles refers
to the body. Often the wire webbing handle is made of silver. Double-webbed needles
are better for easy manual stimulation and are called dragon head needles.
During acupuncture the patient should be lying comfortably in the supine position.
This is the best position for relaxation of the patient during acupuncture treatment and
also the best way of preventing fainting. The patient should not move during treatment,
because it can be painful if the needles bend in the muscle. For treatment of points on
the back, e. g., in low back pain, patients should lie prone or in a lateral position. This
position should also be comfortable for the patient. Fainting is seen in 5%-10% of pat-
ients treated in the sitting position, especially at the beginning of the treatment.
8.2 Technique of Insertion and Stimulation of the Needles
Yangjizhou, a physician from the Ming times (1368-1644), describes eight common
needling techniques. In China today 24 modem needling techniques are common. The
8 techniques of Yangjizhou are described here to demonstrate their relevance for daily
practice:
Chuai is searching by palpation with the finger. Acupuncture points are the most sensitive parts
of the skin and often tender on pressure or painful.
Zhao is the exertion of pressure on the skin with the nail before insertion of the needle. This is a
frequently used needling technique, which can significantly reduce the pain of insertion.
Chuo is rotation of the needles in one direction. The needle is twisted in the same direction until
resistance is felt.
Tan is vibration of the handle after insertion. With the help of the nail the handle is mani-
pulated up and down to cause vibration of the inserted needle. Tan is an important meth-
od of tonification with needles.
Yao is deep insertion of the needles followed by withdrawal with concomitant rotation.
Men is closure of the acupuncture point with the finger after withdrawal of the needles.
Xun is tapping along the channel with the finger after insertion to enhance the needling
sensation.
Nian is rotation of the needle between thumb and index finger.
Acupuncture needles are held vertically between the thumb on one side and the index
and middle fingers on the other. The middle finger guides the needle and prevents
bending of the needle during insertion. The needles are mostly held perpendicular to
the fingers, seldom parallel. The tip of the needle extends 1-5 cm from the point of
contact with the fingers, especially with long needles, which are more liable to bending.
Insertion of the needle, especially the perforation of the skin, should be fast. Fast inser-
tion clearly reduces the pain. In the slow method of insertion the skin is penetrated
slowly during rotation of the needle. The skin can be pressed simultaneously with the
nail of the thumb of the free hand. The slow method may be painful, and therefore the
fast method is preferred by most Chinese doctors.
Beginners can practice the different methods of insertion on a cork, or by needling
layers of paper fixed in a frame. When the fast method is practiced the number of lay-
ers of paper in the frame should be increased to enhance the resistance. Points should
be marked on the paper so that precise insertion of needles can be practiced.
During insertion of the needle attention should be focused on its tip. The Chinese say
that Qi should be concentrated in the needle.
The insertion can be perpendicular (90°) or oblique (30° _60°), or occasionally also
tangential (10°). The depth of insertion and the direction are given with the specific
acupuncture point, but they are aproximate values, which can vary, depending on the
constitution of the patient. In children the depth of insertion is significantly less than in
adults, in keeping with their size. In the chapter describing the acupuncture points the
depth of insertion is given in centimeters or millimeters and not in cun, because the
metric values can be remembered better and are easier to judge. The depth of insertion
varies between some millimeters and 5 cm or more.
The Chinese call the superficial insertion layer "Heaven," the middle one "Men," and
the deep one "Earth." First of all the needle is quickly inserted superficially (Heaven)
through the skin and then it is slowly advanced into the deep layer (earth); thus, inser-
tion is usually achieved in two phases. But fast insertion into the deep layer in one step
is also possible. Mter insertion the acupuncture needles are retained in place for
10-30 min. They must not lead to any pain. The patient should not move during this
time, because this might cause pain.
Tonifying and Sedating Methods of Stimulation 225
8.3 De Qi Sensation
When the needles are inserted and retained in place, patients feel a typical sensation
called De Qi by the Chinese. This sensation is subjective and is described as numbness,
pressure sensation, heaviness, soreness, or distension. A feeling of heat or of coldness
can also be present.
The De Qi sensation differs from patient to patient and is also dependent on the place
of needling. It is more pronounced when the point is located in peripheral muscles or
when distal points of the hand offeet are needled. De Qi sensations are associated with
the pain of insertion, which is generally felt in deep layers of the tissue. Sometimes it
can be similar to an electric shock.
Often the De Qi sensation radiates along the channel, especially when distal points are
needled. This phenomenon is called "propagated sensation along the channel" (PSC).
In recent years much research work has been done in China on this phenomenon,
which generally occurs in 5%-10% of patients. Different methods of stimulation of
needles can evoke propagated sensations along the channels, which have a positive ef-
fect on the prognosis of a disease.
8.4 Tonifying and Sedating Methods of Stimulation
Manipulation of the needles is essential for classic acupuncture treatment. There are
three major techniques for this:
- Lifting and thrusting
- Rotation, clockwise and counterclockwise, at an amplitude of 90° -180°
- Combination of rotation with lifting and thrusting
The effect of acupuncture treatment depends essentially on the stimulation of the nee-
dles and a clear De Qi sensation experienced by the patient. But if the patient finds it
painful manual stimulation should be discontinued. Therefore, the patient is asked to
say if pain is experienced during manual stimulation.
According to traditional theories there are three major methods of stimulation:
1. Tonifying method, Chinese Bu, also called strengthening; this is applied in defi-
ciency-type disturbances, Yin type, Xu in Chinese.
Xu disturbances are characterized by a deficiency of vital energy and involve such
symptoms as coldness, reduced blood supply, weak pulse, hypofunction of organs.
The tonifying method is characterized by careful, painfree needling with thin nee-
dles inserted in the direction of flow in the channel, gentle manipulation or none at
all, and long retention of the needles. Quick insertion and slow withdrawal of the
needle is also tonifying. Gentle manipulation of the needles is the essential factor.
Moxibustion, the heating of acupuncture points, is another major method of toni-
fying.
2. Sedating method, in Chinese Xie, also called the draining, dispersing, or reducing
method; this is applied in excess-type conditions (Yang type or Shi in Chinese).
Shi disturbances are characterized by an excess of vital energy and such symptoms
as heat, increased blood supply, strong pulse, and hyperfunctioning of organs.
For the sedating method the needles are manipulated vigorously following insertion
against the direction of flow in the channel, and the retention period is short. Slow
insertion followed by quick withdrawal is sedating. Generally, thicker needles are
used for sedation than for tonification. The intensive manipulation of the needles in
particular, is essential for the sedating method.
3. The even method of needling is technically between the tonifying and sedating
methods. The spectrum ranges from markedly sedating to intensely tonifying
methods.
Table8.1 Sedating and tonifying methods

Sedation, Xie Tonifying, Bu
Reducing, dispersing method Reinforcing, strengthening method
Vigorous, intensive manipulation Weak stimulation
Thick needles (0.3-0.6 mm) Thin needles (0.1-0.3 mm)
Brief retention (5-15 min) Protracted retention (15-30 min)
Against the channel flow With the channel flow
Counterclockwise Clockwise
Slow insertion Quick insertion
Quick withdrawal Slow withdrawal
Insertion during inhalation Insertion during exhalation
"Son" sedating point "Mother" tonifying point
Moxibustion
8.5 Electroacupuncture, Electrostimulation
Electroacupuncture (EA) was introduced in the 1950s in connection with the develop-
ment of acupuncture anesthesia in China. During acupuncture anesthesia it is neces-
sary to stimulate the acupuncture points for a long period, so stimulation with electric
current was tried. This method was developed and introduced in the subsequent years
not only for anesthesia but also for the daily practice of therapeutic acupuncture. Elec-
troacupuncture is now considered a routine method of stimulation, although manual
stimulation is superior in its therapeutic effect. The advantages of electro acupuncture
are the milder traumatization of the tissue and the time saving.
The main indications for electrostimulation of the needles are:
- Paralysis
- Severe and chronic pain conditions, e. g., pain in carcinoma
- Painful conditions not reacting to manual stimulation
- Acupuncture anesthesia
Contraindications to electrostimulation:
- Presence of a pacemaker
- Cardiac arrhythmia
- Epilepsy and shock
- Fever
- Weakness and hypotension
- Pregnancy
Relative contraindications are anxiety, nervosity, and agitation; in small children it
should also be used only with reservations.
In acutely painful conditions, such as trigeminal neuralgia, migraine or other acute
neuralgic pain, electrical manipulation of the needles should be avoided.
In electro acupuncture electrodes are attached to the needles and connected to an elec-
trostimulator (also called electropulse stimulator). Many such electro stimulators have
been developed in recent years, with frequencies generally ranging from 2 to 200 Hz.
The wave form can be spike-like or right-angled. In these electrostimulation devices
the current intensity and the frequency can be adjusted for the needs of treatment.
Some apparatuses have been developed with high frequencies up to 2000 Hz for
acupuncture anesthesia.
Complications of Acupuncture Treatment 227
High frequencies and high current intensity seem to have a sedating effect, whereas
low frequencies and low current intensity have a tonifying effect. Generally two or
three pairs of electrodes (4-6 needles) are connected. About the same numbers of dis-
tal and local points are used for electrostimulation. The most important distal points
for electrostimulation are L1.4, LI.11, SJ.5, St.36, St.38, St.44, UB.40, UB.60, and
GB.34. The points Du 20 Baihui, He.7 Shenmen, and Pe.6 Neiguan are not electro-
stimulated (danger of circulatory reactions, such as fainting). Complications of electro-
acupuncture are lowering of blood pressure, fainting, and agitation.
8.6 Sterilization of the Needles
Acupuncture needles are generally sterilized with a hot air sterilizer at 180 DC or in an
autoclave. Especially because of the danger of contamination with hepatitis or AIDS vi-
ruses needles must be sterilized with the utmost care, and the exact time and temperature
during sterilization should be carefully controlled.
Disinfection or boiling of needles is totally inadequate. In the recent years disposable
needles have been introduced.
8.7 Complications of Acupuncture Treatment
Acupuncture is a safe method with no side effects when the general precautions are
observed. Nonetheless, complications can occur, as documented in the literature:
1. Fainting during acupuncture treatment occurs mainly in nervous, tense, or tired
patients. When acupuncture is performed with the patients in a sitting position,
fainting, the most common complication, is seen in about 5%-10% of patients. To
avoid fainting, patients should be treated while lying down.
2. Local infections are a very rare complication, because the subcutaneous tissues have
a high resistance against a thin acupuncture needle. Local infections are caused by
inadequate sterilization or by overtraumatizing of the tissue when acupuncture is
carried out by an inexperienced therapist. In over 10000 personal cases no abscesses
or other evidence of local infections have been seen. But in ear acupuncture, espe-
cially when long-term pressure needles are used, local infections of the auricle are re-
ported more often.
3. Pain during insertion of the needles is due to clumsy insertion technique or to blunt
or hooked needles. If a patient moves during acupuncture treatment this can cause
pain, and therefore patients should lie in a stable position and should have the op-
portunity of communicating any discomfort during the period of needle retention.
Tense or anxious patients feel more pain. Needling at points on the face and at Jing
points is more painful than elsewhere.
4. Injuries to internal organs have been reported in the literature, but such complica-
tions are very rare and are caused by insufficient anatomical knowledge. In particu-
lar, injury to the lung could be caused by deep needling of points on the chest wall,
and therefore the dangerous points in this region should be needled obliquely and to
a depth of no more than 1 cm.
9 Moxibustion
G.Stux
9.1 Indications and Methods
Zhen Jiu, the Chinese name for acupuncture, meaning needling and burning, also em-
braces the application of moxibustion. Like "needle acupuncture," moxibustion has a
tradition going back many thousands of years. The Huang Di Nei Jing recommends
moxibustion for diseases caused by coldness or damp and for weakness conditions.
Often acupuncture and moxibustion are practiced together as complementary forms of
treatment in the same session.
The indications for moxibustion include a wide range of weakness (Xu) diseases, most-
ly of a chronic character, such as bronchitis, asthma or diarrhea (Table 9.1). Moxibus-
tion is especially effective in weakness after convalescence and in depression.
Table 9.1 Indications for moxibustion

Chronic bronchitis Hypotension
Bronchial asthma Exhaustion
Chronic diarrhea Feeling of coldness in the body
Depression Chronic disease
Bowel disease
Moxibustion is contraindicated in fever, in acute infectious diseases, in the presence of

hypertension, hemorrhage and during menstruation, and also in nervousness with
sleep disturbances, that is to say in Yang conditions (Table 9.2).
Table 9.2 Contraindications for moxibustion

Fever Acute and chronic hemorrhage
Acute infections During menstruation
Hyperemia Nervousness and overexcitement
Hypertension Sleep disturbances
Selection of points for moxibustion depends on the individual symptoms of the

disease. The principles used in selection of points for moxibustion are similar to those
followed for acupuncture, but some special points are favored: general tonification
points play an important role (Table 9.3).
Table 9.3. General tonification points

Ren6 Qihai
Ren8 Shenque
Sp.6 Sanyinjiao
St.36 Zusanli
Moxibustion directly influences the internal organs, and therefore Shu and Mu points
of the related organs are selected (Table 9.4).
230 Moxibustion
Table9.4. Shu and Mu points for moxibustion

Organ Shu point Mu point
Lung VB.13 Feishu Lu.1 Zhongfu
Spleen VB.20 Pishu Liv.13 Zhangmen
Stomach VB.21 Weishu Ren 12 Zhongwan
Sanjiao VB. 22 Sanjiaoshu Ren5 Shimen
Kidney VB.23 Shenshu GB.25 Jingmen
Moxibustion is also applied at specific tonification points ("mother points") and to

Yuan points.
Moxibustion is not applied on the head, in the face or near to mucous membranes. The
navel, a forbidden point for acupuncture, is an important tonification point for moxi-
bustion.
In moxibustion acupuncture points are heated by burning dried leaves of the Artemisia
vulgaris plant. Artemisia vulgaris is a medical herb that is common in both Asia and
Europe. The leaves are dried and prepared to give a similar consistency to that of cot-
ton wool. There are many methods of applying moxibustion:
1. Direct moxibustion
2. Indirect moxibustion - With ginger slice isolation
- With moxa cigars
- By heating acupuncture needles
- Infrared moxibustion
9.2 Direct Moxibustion
In this method small cones of moxa are burned directly on the skin causing burning.
This method is very painful and leads to scars; it is therefore also called scarring moxi-
bustion. Today this method is very seldom used.
9.3 Indirect Moxibustion with Ginger Slice Isolation
In this method of moxibustion fresh ginger slices 1-2 mm thick are used to isolate the
direct heat of the burning moxa leaves. Fresh ginger roots are cut into slices 1-2 cm in
diameter, then placed on the skin at specific acupuncture points. A cone of moxa wool
is placed on each ginger slice and then ignited. The heat penetrates slowly to the deep
layers of the skin. When the patient feels a sensation of heat at one point, the ginger
slice with the moxa cone is moved away and placed on the next point, subsequently be-
ing returned to the first. In this way every point is heated six to eight times, until a slight
redness is observed.
This method is very effective, but it should be applied with care so as not to burn the
skin, especially when the ginger slice with the burning moxa cone is moved to the next
point.
This method can be applied by the patient at home. The physician marks the chosen
acupuncture points with a permanent felt pen. Then the method is explained in detail
to the patient. This can be also done with the help of a video film produced by the
author. Instead of ginger slices, garlic can also be used as isolator, as it was in China
especially for tuberculosis.
Infrared Moxibustion 231
9.4 Indirect Moxibustion with "Moxa Cigars"
For this method moxa wands are rolled in thin paper; these are called moxa cigars or
moxa rolls. A moxa cigar is ignited in a similar way to an ordinary cigar, at one end,
and then brought up to only 0.5-1 cm away from the chosen acupuncture point until
the patient feels a sensation of heat. The moxa cigar is then removed (3-4 cm), and is
brought nearer again after a few seconds. This is repeated six to eight times until slight
redness is observed. In this way, every acupuncture point is heated for about
30-40 s. But care must be taken not to bum the skin. This method has been in wide use
since the time of the Ming Dynasty (1368-1644).
9.5 Moxibustion by Heating Acupuncture Needles
A small ball of moxa is fixed on the free end of an acupuncture needle and ignited. The
heat is conducted through the needle to the deeper layers of the subcutis and muscle.
This method is used especially for the Back Shu points and GB.30 Huantiao.
9.6 Infrared Moxibustion
In recent years electrical instruments have been developed to heat acupuncture points.
In China an extract of the Artemisia vulgaris plant is applied to the acupuncture point
before heating. Most instruments on the market use infrared radiation directly or indi-
rectly on the skin.
In general the traditional methods seem to be more effective than infrared moxibus-
tion. But some patients do not like the smell of burning moxa leaves and in this case it
is advisable to use infrared moxibustion.
10 Laser Acupuncture
G.Stux
At the end of the 1960s Mester, in Hungary, began to use low-intensity laser light to
treat wounds that were not healing. Mester also found activation of collagen fibers, en-
hanced vascularization, and fast healing in skin ulcers that had not responded to clas-
sic and long-term treatment, including plastic surgery. Kovinskii observed an increase
in the tissue granulation rate when irradiating bum wounds with helium neon laser
light.
Some years later, probably 1973, laser light of low intensity was first applied to acu-
puncture points by Ploog. When these trials were first started laser light with a wave-
length of 632 nm in the red visible range, produced by neon helium lasers, was used.
A therapeutic effect similar to that of classic acupuncture was observed in some, espe-
cially chronic, disorders. This method of irradiating acupuncture points with laser light
of low intensity was introduced into the everyday practice of acupuncture in western
Europe at the end of the 1970s.
It is characteristic for laser light that it is monochromatic with a very narrow wave-
length and a high wave coherence, so that nondivergent light radiation is formed. The
wavelength and frequency of laser waves are identical, causing light of particular puri-
ty that does not diffuse in the same way as ordinary light. Therefore, the biological ac-
tion of this coherent light, even at low intensity (1-2 mW), has a significant stimulating
effect on the tissue and thus a high therapeutic value.
In 1975 the first helium neon laser device was introduced into West Germany; it had an
intensity of 1 mW and a wavelength of 632 nm. Later infrared lasers with 904 nm wave-
length and 5-10 mW intensity generated from gallium arsenide diodes were also manu-
factured. The latest development is a diode laser device with 780 nm wavelength and
10-15 mW intensity. These low-energy laser systems are also called soft lasers. The
originally introduced red light helium neon lasers with 632 nm are the most widely
used, penetrating about 1 mm directly and 8-10 mm indirectly into the skin tissue. In
many of the laser appliances on the market the coherent laser wave can be modulated,
with frequencies ranging from 1 to 2000 Hz, by mechanical partial interruption of the
original radiation.
The main indications for laser acupuncture are skin diseases and chronic pain condi-
tions, but Meniere's syndrome and mental disorders are also treated by this technique.
Especially in children and in oversensitive patients laser acupuncture has clear advan-
tages. On the other hand, clinical studies show that in acute painful conditions laser
acupuncture has a significantly inferior effect to classic acupuncture.
In clinical use laser acupuncture has many similarities with classic body acupuncture.
The points are selected for laser treatment in the same way as for classic acupuncture,
with 10-20 points irradiated for 10-60 s each per treatment session. Two to three
sessions of laser acupuncture are administered per week. Laser irradiation can also be
applied to the common points of the ear.
In skin diseases, in addition to the radiation of acupuncture points the skin lesions
themselves are irradiated, generally for 2min per cm2, with lasers of 2mW intensity.
The method of irradiating the affected skin area has recently also started to be used by
cosmeticians to enhance skin regeneration and improve wrinkles.
234 Laser Acupuncture
The major advantages of laser acupuncture are that the treatment is painless and that
asepsis is assured because the laser handle is usually not touching the skin surface dur-
ing irradiation. In many acute disorders, however, the action of laser irradiation has an
inadequate therapeutic effect. Laser treatment is therefore generally limited to chronic
diseases.
Dangers of Laser Acupuncture
Special care must be taken, when laser treatment is applied to points near the eye,
not to radiate directly into the pupil. Serious harm can be caused to the retina, because
the lens of the eye concentrates the laser light many thousand times and it is then fo-
cused on the retina. This can also happen with the invisible infrared lasers (780 nm or
904 nm), if the laser is directed into the pupil. Therefore, the handle should be brought
close to the skin before the laser light is turned on.
The patient's eyes must be closed when laser treatment is applied in the face.
11 Acupressure
G.Stux
Acupressure is the massage of acupuncture points. It is indicated in mild disturbances

and diseases. Since ancient times acupressure has been used as a method of self-care
by patients. Today in China schoolchildren learn to use this method to treat mild symp-
toms such as headaches or toothache. The major indications for acupressure are pain-
ful conditions such as headache, toothache, cervical spondylitis, and shoulder and
lumbar pain. Many psychosomatic disturbances can also be positively influenced by
acupressure, e.g., sleep disturbances, nervousness, nausea, feeling that vomiting is im-
minent, seasickness, constipation, or menstrual problems.
Indications for acupressure

Headache
Cervical spondylosis
Shoulder pain
Toothache
Lumbago and sciatica
Nausea, vomiting, seasickness
Constipation
Menstrual problems
Nervousness
Common cold, rhinitis, sore throat
Acute emergencies, fainting, collapse
In acute painful conditions light massage with the pads of the index finger or the
thumb is advisable. In chronic diseases moderately vigorous massage is applied. The
finger should remain at the same point whether massage is performed with a circular
motion or to and fro along the channel. In the case of massage to and fro the pressure
in the direction of the channel flow is pronounced: on the Yin channels of the arm on
the proximal-to-distal movement and on the Yang channels of the arm from distal to
proximal. The stomach, urinary bladder and gallbladder channels run from the head to
the feet, and the three Yin channels from the leg to the chest. When the channels are
massaged the finger used is applied with increasing pressure as it is moved along the
channel. Massage along the channel in its direction of flow is especially effective when
the pain is felt along the channel. The pressure exerted by the finger should be light
when points over nerves around sensory organs or on the frontal side of the neck are
massaged and at the beginning of the treatment. The time of acupressure should be
30-60 s at local points and 1- 2 min at distal points. Acupressure can be also used to
complement a course of acupuncture treatment in the free interval. But as in any form
of self-treatment by a patient, before acupressure a clear western diagnosis should be
made.
12 Ear Acupuncture
G.Stux
Even in antique times in China, acupuncture was carried out at points on the auricle.
In the Huang Di Nei ling it says: "The ear is the place where all the channels meet." It
is not known how widespread or how common the use of ear acupuncture was in an-
cient times. In Arabian medicine certain parts of the auricle were cauterized to treat
such illnesses as sciatica. In France ear acupuncture was introduced by Paul Nogier in
the 1950s and supplemented by new findings, such as the "auriculocardial reflex." Ear
acupuncture now has a prominent place in Chinese textbooks of acupuncture. The de-
velopment of acupuncture anesthesia also yielded new results relevant to ear acupunc-
ture. Analgesic effects in certain parts of the body were found to be caused by stimu-
lation of corresponding areas on the auricle. In many centers acupuncture anesthesia
has been carried out with the help of ear acupuncture points.
More than 200 points are described on the auricle today, 70 of which are used more
often than the others. Owing to the small size of the auricle the exact location of ear
points is very important. The anatomical structures of the auricle help to locate the
points: Helix, antihelix, fossa triangularis, tragus, antitragus, lobus and cavum con-
chae. The ear is richly innervated from the branches of the following brain nerves:
Vagus, glossopharyngeus, trigeminus, facialis, and the 2nd and 3rd branches of the
cervical spinal nerves. In addition, the sympathetic fibers reach the ear along the
vessels.
Ear acupuncture is based on the theory that all parts of the whole body are represented
on the auricle, just as each is known to be represented in a specific brain area. The pro-
jection corresponds to the shape of a fetus in the uterus with the head directed down-
ward. The specifity of the projection was demonstrated by the physiological institute in
Shanghai in animal experiments: After an artificial lesion had been induced in the
stomach of a rabbit, reduced electric skin resistance was found at the corresponding
"stomach point" of the animal's auricle. After healing of this ulcerous lesion the
change in skin resistance disappeared. These electrical reactions of the auricle are elim-
inated by the injection of a local anesthetic agent.
The specific representation of organs is also important for diagnosis. In certain disor-
ders the skin resistance is changed at the corresponding parts of the auricle. This is
advantageous for the specific auricular diagnosis that has to precede every ear acu-
puncture treatment, as a point detector can be used to search for auricular points with
reduced skin resistance. Skin changes on the auricle are also often found, e. g., redness
or scaling, corresponding to the diseased organs. In this context Nogier found the
"auriculocardial reflex." During scanning of the affected region on the ear, changes in
the radial pulse are felt and are evaluated diagnostically. The radial pulse is felt with
the left hand and simultaneously the auricle is explored with a blunt probe. If the auri-
culocardial reflex is positive the pulse changes after palpation of the areas correspond-
ing to the diseased organs.
238 Ear Acupuncture
12.1 Technique of Ear Acupuncture
While in body acupuncture the metal of the needles is not important, according to tra-
ditional ideas and also to Nogier, when applied at the ear different metals have differ-
ent effects: gold has a tonifying, and silver and steel a sedative effect.
At the auricle shorter and thicker needles are applied than in body acupuncture. To
avoid infections, the cartilage should not be injured. It is also advisable to disinfect the
auricle before needling. Needles for ear acupuncture are 0.5 cm long and 0.6-1.2 mm
thick. Needling of the ear is more painful than body acupuncture. The depth of inser-
tion is 1 mm, and in general insertion is vertical. Sometimes several points are punc-
tured with one thin needle inserted subcutaneously in a tangential direction.
The needles are rotated manually, as in body acupuncture. They are retained in place
for 15-30 min. During this time the needles should be manipulated two or three times.
In acute and very painful disorders vigorous stimulation is indicated. The cartilage
must be avoided in manual stimulation. Especially at the beginning, until an improve-
ment is achieved, daily treatment is advisable. Ear acupuncture is later performed two
or three times per week. In chronic disorders permanent needles are also used. They
look like small thumbtacks and are fixed in place with sticking plaster. Due to the risk
of infection, and especially of purulent and long-term perichondritis of the ear, perma-
nent needles should be used only when strictly indicated. Recently small ear balls have
started to be used. These are small steel or gold balls fixed with a small plaster to the
ear points. The ear balls remain on the ear for 3 - 6 days and have the advantage of not
injuring the skin. Three or four times a day the patient presses the ear ball with a pul-
sating movement of the index finger for 1-3 min, thus exerting acupressure. These ear
balls are used especially in psychogenic disturbances and in drug addiction, in addi-
tion to the common acupuncture treatment.
In China ear acupuncture is mostly combined with body acupuncture, but in some
centers only ear acupuncture is carried out. Ear acupuncture is advantageous in drug
addiction, but also in acute and very painful disorders, mostly having an immediate
effect. In my experience ear acupuncture does not have a comparable long-term effect
to body acupuncture and it should therefore be combined with body acupuncture.
12.2 Representation of the Body on the Auricle
As body parts have corresponding brain areas, cranial body regions have correspond-
ing areas in the caudal part of the ear. The lobe is related to the facial region, the an-
tihelix to the spine, and the cavum conchae to the internal organs. The upper and lower
extremities are projected between helix and antihelix. Some points with specific effects
are located independently of this projection scheme, e.g., ear point Shenmen, which
has a general sedative and analgesic effect. The lobe is divided by three horizontal and
two vertical lines into nine areas. Their representation on the body is listed here:
Region 1: Teeth of the lower jaw

Region 2: Tongue in the middle of this region, lower jaw in the upper part
Region 3: Upper jaw in the lower part, lower jaw in the upper part of this region
Region 4: Teeth of the upper jaw
Region 5: Eye; this region is located in the middle of the lobe and is the point
for earrings. Avoid inflammations of this point.
Region 6: Internal ear; dizziness and tinnitus are also influenced from this
region
Ear 239
FO~$a triangularis
Crus antihelicis inferior
Antihelix
Crus helicis
- ,
/
Cavum conchae
Meatus acusticus extern us
(
Incisura intertragica
Lobus auriculae
240 Ear Acupuncture
Region 8: Tonsil and pharynx

Regions 7 and 9 are not specifically represented on the body
The spine is represented on the antihelix: The point for the cervical spine is located
caudally, at the border to the ear lobe; then, proceeding in a cranial direction, come the
points for the thoracic spine and the chest wall, and just in front of the beginning of the
fossa triangularis the lumbar spine. On the ventral course of the crus anthelicis inferior
the pelvis is represented, with the sciatic nerve, and on the cranial course of the crus an-
tihelix superior are the points for the hip joints, knees, and feet. Between antihelix and
helix, from caudal to cranial the shoulder girdle, then the elbow, and finally the hand
are projected.
In the cavum conchae the internal organs are represented. These are arranged in a
semicircle around the crus helicis. In the middle of the cavum conchae below the crus
helicis the heart point is located, surrounded by those for the pulmonary lobes and the
trachea. The tips of the lung points are situated ventral to those for the pulmonary
lobes.
In the cavum conchae an inner and an outer semicircle surround the crus helicis. The
inner semicircle is formed by the gastrointestinal tract, the esophagus point being
located caudally and the stomach point, in the middle of this semicircle. The small in-
testine and finally the large intestine points are located in the cranial arch above the
crus helicis. The outer semicircle is made up of points for the parenchymatous organs
(spleen, liver, kidney) of the abdomen, the Chinese Yin organs. The spleen point is
located dorsal to the stomach point, and the liver is cranial, linking to the spleen; then
the pancreas point cranial to the small intestine above the crus helicis, and finally the
kidney and urinary bladder points at the upper and ventral end of the semicircle. In the
middle of the fossa triangularis the uterus is represented and in the lower part the ear
Shenmen, a sedative and analgesic point, is found.
The Chinese usually specify the ear acupuncture points with the designation of the
organs concerned supplemented by ear, e. g., ear lung, ear stomach, or ear Shenmen.
Ear with Representations 241
Lumbal region
Region 1 Region 2 Region 3
Lower jJW
\i '
I ·i
iTongue
Region 4 Region 5 Region 6

~
Eye Ear
Region 8
Tonsills
242 Ear Acupuncture
12.3 Numbering of Ear Points
In Chinese ear acupuncture charts and also in European ear acupuncture books, the
regions corresponding to the organs are described and a numbering system for the ear
points is also given. Bachmann and Bischko numbered the ear points in the 1960s. The
numbering in this book is taken from Chinese sources. Due to the small size of the ear
clarity is difficult, so a numbering system allows exact categorization of these points
and has advantages especially for documentation.
Ear points 1-11 are located on the lobule

Ear point 1 Analgesia for the lower teeth
Ear point 2 Palate
Ear point 3 Floor of the mouth
Ear point 4 Tongue
Ear point 5 Upper jaw
Ear point 6 Lower jaw
Ear point 7 Analgesia for the upper teeth
Ear point 8 Eye
Ear point 9 Internal ear
Ear point 10 Tonsils
Ear point 11 Cheek
Ear points 12-21 are located on the tragus

Ear point 12 Analgesia
Ear point 13 Adrenal gland
Ear point 14 Nose
Ear point 15 Larynx and pharynx
Ear point 16 Mucous membranes of the nose (rhinitis, sinusitis)
Ear point 17 Thirst quenching
Ear point 18 Appetite reduction
Ear point 19 Hypertension
Ear point 20 Ear (location of SJ. 21 Ermen)
Ear point 21 Heart (arrhythmia)
Ear points 22-36 are located on the antitragus

Ear point 22 Endocrine gland
Ear point 23 Ovary
Ear point 24 Eye
Ear point 25 Brainstem
Ear point 26 Analgesia for tooth extraction
Ear point 27 Larynx
Ear point 28 Hypophysis
Ear point 29 Analgesia for the head, treatment of hypertension
Ear point 30 Parotid gland
Ear point 31 Dingchuan (Chinese: calming asthma) in bronchial asthma
Ear point 32 Testes, ovary
Ear point 33 Forehead
Ear point 34 Brain, neurological disorders
Ear point 35 "Sun" headache, sleep disturbances
Ear point 36 Headache
Ear, Numbering 243
50
56
54
53
89 88 69 65
87
15 101
17
100
·14
101
18
16
37
27
29
36
3
1 4
2
9
8 11
7
244 Ear Acupuncture
Ear points 37 -54 are located on the antitragus

Ear point 37 Cervical spondylitis
Ear point 38 Os sacrum
Ear point 39 Chest pain
Ear point 40 Lumbar pain
Ear point 41 Neck
Ear point 42 Thorax
Ear point 43 Abdomen
Ear point 44 Mamma
Ear point 45 Thyroid gland
Ear point 46 Toe
Ear point 47 Heel
Ear point 48 Malleolus
Ear point 49 Knee joint
Ear point 50 Hip joint
Ear point 51 Autonomic nervous system (and endocrine disturbances)
Ear point 52 Sciatic nerve
Ear point 53 Buttocks
Ear point 54 Lumbosacral region
Ear points 55-61 are located in the fossa triangularis
Ear point 55 Shenmen - gate of the spirit
Ear point 56 Pelvic region
Ear point 57 Hip joint
Ear point 58 Uterus
Ear point 60 Asthma, dyspnea
Ear point 61 Hepatitis
Ear points 62-71 are located between helix and anthelix in the so-called scapha
Ear point 62
Ear point 63 Clavicle
Ear point 64 Shoulder joint
Ear point 65 Shoulder girdle
Ear point 66 Elbow
Ear point 67 Hand
Ear point 68 Appendix
Ear point 71 Skin disorders, urticaria
Ear points 72-78 are located on the helix
Ear point 72
Ear point 76 Liver
Ear point 77 Liver
Ear point 78 Ear
Ear points 79-83 are located on the crus helicis
Ear point 79 External genitalia
Ear point 80 Urethra
Ear point 81 Rectum
Ear point 82 Diaphragm
Ear point 83
Ear, Numbering 245
50
56
54 38
89 88 69 65
20
87
15 101
17
100
14
101
18
16
37
27
29
36 6
3
1 4
2
9
8 11
7
246 Ear Acupuncture
Ear points 84-104 are located in a semicircle around the crus helicis
Ear point 84 Mouth
Ear point 85 Esophagus
Ear point 86 Cardia
Ear point 87 Stomach
Ear point 88 Duodenum
Ear point 89 Small intestine
Ear point 90
Ear point 91 Colon
Ear point 92 Urinary bladder
Ear point 93 Prostata
Ear point 94 Ureter
Ear point 95 Kidney
Ear point 96 Pancreas and gallbladder
Ear point 97 Spleen
Ear point 98 Liver
Ear point 99 Ascites
Ear point 100 Heart
Ear point 101 Lung
Ear point 102 Bronchial system
Ear point 103 Trachea
Ear point 104 Sanjiao
Ear points 105-108 are located on the dorsal side of the auricle
Ear point 106 Analgesia for the thorax
Ear point 107 Analgesia for the sacral region
Ear point 108 Analgesia for the lower back
The presentation of points 105 -1 07 is given here as in the Chinese literature. European
sources often differ.
12.4 Rules for Selection of Ear Points
- Application of points corresponding to the body projection, e. g., the ear point of the
lung to treat bronchial asthma.
- Use of points according to traditional Chinese principles, e.g., allocation of skin to
the lung, the eye to the liver.
- Use of points which are mentally harmonious, e.g., ear Shenmen.
- Use of points which produce noticeable reactions in certain disorders:
- Visual observation: Change of color, especially of the affected region.
- Measurement of the skin resistance: In disorders of an organ the skin resistance
of the corresponding ear region is reduced. This is measured with a skin resistance
measuring apparatus and the points found are then acupunctured.
- Sensitivity on pressure: With searching instruments, e. g., with spring suspension
of the key button, points are searched for that are more sensitive than others on
pressure.
Ear, Numbering 247
40
___
89.- 88 69 65
83 87
15
17
14
37
27
19
6
14
3
4
1 1
9
8 11
7
13 Scalp Acupuncture
G.Stux
The early 1970s saw the development of scalp acupuncture on a basis of empirical
research in China. First of all the indications were limited to paralysis, tremor and
paresthesia; further indications have since been added. In scalp acupuncture areas
which correspond to the location of the important brain areas are needled, e. g., gyrus
precentralis or postcentralis. Initially 15 specific areas of the scalp were described.
These areas used in scalp acupuncture have been intensively investigated in recent
years. New results have led to various changes, so that the definition of these areas now
used is almost completely new. In 1984 Chinese acupuncture centers together with the
World Health Organization developed new standards for scalp acupuncture. The new
areas, now called lines, have been freshly defined with the aid of classic acupuncture
points of the head area.
Today 14lines with new names are described. The Chinese names are also listed below,
but at the moment it is possible to give the indications for only the important new
lines. MS stands for scalp acupuncture, M indicating microsystem and the S indicating
scalp acupuncture.
13.1 Fourteen Lines for Treatment
Line MS 1 Middle line of forehead Ezhongxian
Location:This line is 1 cun long and runs from Ou 24 Shenting straight down along the
Ou Mai, that is on the midline. Ou 24 Shenting is located 0.5 cun behind the anterior
hairline. The hairline is by definition 3 cun above the eyebrow.
Line MS 2 Line 1 lateral to forehead Epangxian 1
Location: This line is 1 cun long and runs from UB.3 Meichong straight down along
the urinary bladder channel, parallel to the midline. UB. 3 Meichong is located 0.5 cun
dorsal to the anterior hairline and directly above the inner canthus of the eye.
Indications: This line is equivalent to the former thoracic area (former zone 13) and is
indicated in bronchial asthma, chronic bronchitis and further pulmonary disorders.
Location: This line is 1 cun long and runs from GB.15 Head Linqi straight down along
the gallbladder channel. GB. 15 Head Linqi is located 0.5 cun dorsal to the hairline, di-
rectly above the the middle of the eyeball.
Indication: This line corresponds to the former gastric area (12) and is indicated in
stomach disorders.
Location: This line is 1 cun long and runs 0.5 cun medial to St.8 Touwei straight down.
Indication: This line, formerly called the genital area (14), is indicated in dysmenorrhea
and hypermenorrhea, and for acupuncture anesthesia in hysterectomy and cesarian
section.
Line MS 5 Middle line of vertex Dingzhongxian
Location: This line courses from Du 20 Baihui to Du 21 Qianding along the midline of
the head. Du 21 Qianding is located 1.5 cun ventral to Du 20 Baihui.
Indications: Mental disturbances and psychosomatic disorders.
Line MS 6 Anterior oblique line of vertex-temporal Dingnie Qianxiexian
Location:This line runs from Sishencong (located 1 cun anterior to Baihui, on the mid-
line) obliquely to GB. 6 Xuanli. Its course is parallel to the posterior oblique line of ver-
tex-temporal.
Indication: This line corresponds to the former motor area (1) and is indicated in para-
lysis and motor aphasia.
Line MS 7 Posterior oblique line of vertex-temporal Houxiexian
Location: This line connects Du 20 Baihui with GB. 7 Qubin.

GB. 7 Qubin is located one finger breadth anterior to and above the highest point of the
auricle.
Indications: The former sensory area (2) is indicated in painful conditions and in sen-
sory disturbances.
Line MS 8 Line 1 lateral to vertex Dingpangxian 1
Location: This line is 1.5 cun long and runs from VB. 7 Tongtian backward along the
urinary bladder channel, 1.5 cun parallel to the midline. VB. 7 Tongtian is located 4 cun
dorsal to the anterior hairline. The urinary bladder channel runs 1.5 cun lateral to the
midline.
Line MS 9 Line 2 lateral to vertex Dingpangxian 2
Location: This line is 1.5 cun long and runs from GB.17 Zhengying backward along
the gallbladder channel, parallel to the midline. GB.17 Zhengying is located 3.5 cun
dorsal to the anterior hairline.
Line MS 10 Anterior temporal line Nieqianxian
Location: This line connects GBA Hanyan and GB.6 Xuanli. GBA Hanyan is located
halfway between St. 8 Touwei and GB.7 Qubin.
Lines of Scalp Acupuncture 251
~ Line 3
~~~
Line MS 11 Posterior temporal line Niehouxian
Location: This line connects GB.7 Qubin and GB. 8 Shuaigu. GB. 8 Shuaigu is located
above the highest point of the auricle, 1.5 cun above the anterior hairline.
Line MS 12 Upper middle line of occiput Zhenshan Zhengzhongxian
Location: This line connects Du 17Naohu and Du 18 Qiangjian. Du 17Naohu is

located 1.5 cun above Du 16 Fengfu, directly below the protuberantia occipitalis.
Du 18 Qiangjian is located 1.5 cun above Du 17 Naohu.
Line MS 13 Upper lateral line of occiput Zhenshang Pangxian
Location: This line runs 1 cun lateral to and parallel to the upper middle line of the
occiput.
Indication: This line corresponds to the former visual area (10) and is indicated in
central visual disturbances.
Line MS 14 Lower lateral line of occiput Zhenxia Pangxian
Location: This line is 2cun long and runs from UB.9 Yuzhen straight down parallel to
the midline.
13.2 Method of Needling
Thick acupuncture needles with a diameter of 0.4-0.6 mm and a length of 25-50 mm

are used. The direction of insertion is mostly tangential to the scalp and in general
centrifugal. An exception is made in the case of the horizontal lines, from which the
needles are inserted in a ventral to dorsal direction. Several needles are applied in
series along a distance of 5-10 mm on the appropriate line. To intensify the treatment
several needles can be inserted in a bunch at one point. The depth of insertion is up to
0.5-1 cm.
In paralysis and in resistant cases to treatment the needles are vigorously stimulated by
hand with rotation as usual. Electrostimulation is applied also. The time of treatment is
10-20 min, as in body acupuncture. In recent years homolateral treatment has been
preferred.
14 Hand Acupuncture
G.Stux
The points that can be used for hand acupuncture are considered to be extra points.
Many body regions, and also some internal organs, are represented on the hand as they
are on the ear. The disadvantage of hand acupuncture is that needling is painful.
Therefore, in chronic cases stimulation of hand acupuncture points is combined with
that of points used in classic body acupuncture. Mostly one hand acupuncture point is
used in addition to the body acupuncture combination. Although we have less experi-
ence in Europe, this method is described here for the sake of completeness.
In all 34 hand acupuncture points are known, 18 of which are located on the dorsal
side and 16 on the palmar side of the hand. The effect of hand acupuncture can be in-
creased by vigorous manual stimulation or electric stimulation with frequencies of
3-12 Hz. A treatment will take 10-20 min, as in body acupuncture. Depending on the
location, the depth of insertion varies between 2 and 10 mm.
14.1 Points on the Dorsum of the Hand
Hand point 1 (Lumbar region, leg)
Location: There are two hand points numbered one; these are located at the proximal
end of the metacarpal bone between the small and ring fingers and between the index
and middle fingers.
Indications: Lumbago, sciatica, especially in acute cases. These two points are needled
together and vigorously stimulated. They are used very often in addition to local points
in the lumbar region.
Hand point 2 (Foot)
Location: On the radial side of the metacarpophalangeal joint of the thumb, at the end
of the transverse crease. The hand points are located at the finger joints, at the radial
and ulnar ends of the related transverse crease, and are needled with the joint in a
flexed position.
Indications: Pain in the joints.
Hand point 3 (Thorax)
Location: On the radial side of the interphalangeal joint of the thumb.

Indications: Intercostal neuralgia, nausea, vomiting.
254 Hand Acupuncture
Hand point 4 (Eye)
Location: On the ulnar side of the interphalangeal joint of the thumb.

Indications: Eye disorders, conjunctivitis.
Hand point 5 (Shoulder)
Location: On the radial side of the metacarpophalangeal joint of the index finger.
Indications: Pain in and stiffness of the shoulder, e. g., in periarthritis humeroscapula-
ris.
Hand point 6 (Forehead)
Location: On the radial side of the interphalangeal joint of the index finger.
Indications: Frontal headache, sinusitis.
Hand point 7 (Vertex)
Location: On the radial side of the interphalangeal joint of the middle finger.
Indications: Headache, migraine.
Hand point 8 (Right or left side of the head)
Location: On the ulnar side of the interphalangeal joint of the ring finger.
Indications: Unilateral headache, migraine, chest pain, biliary colic.
Hand point 9 (Perineum)
Location: On the radial side of the interphalangeal joint of the small finger.
Indications: Perianal pain, hemorrhoids.
Hand point 10 (Back of the head)
Location: On the ulnar side of the interphalangeal joint of the small finger, along the
course of the small intestine channel.
Indication: Occipital headache.
Hand point 11 (Vertebral column)
Location: On the ulnar side of the metacarpophalangeal joint of the small finger.
Indications: Backache, tinnitus.
Hand point 12 (Sciatic nerve)
Location: On the ulnar side of the metacarpophalangeal joint of the ring finger.
Indications: Sciatica, hip pain.
Points of Hand Acupuncture 255
23 "-
22~\;25
, 1.20
21
•
Hand point 13 (Larynx pharynx)
Location: On the ulnar side of the metacarpophalangeal joint of the middle finger.
Indications: Tonsillitis, pharyngitis, laryngitis, toothache, trigeminal neuralgia.
Hand point 14 (Neck)
Location: At the level of the metacarpophalangeal joint of the index finger, on the ul-
nar side.
Indications: Cervical syndromes.
Hand point 15 (Nose bleeding)
Location:0.1 cun proximal to the border of the margin of the web between index finger
and thumb.
Indication: Nose bleeding.
Hand point 16 (Head)
Location: On the ulnar side of the metacarpophalangeal joint of the thumb.

Indication: Headache.
Hand point 17 (Nose)
Location: In the angle formed by the 1st and 2nd metacarpal bones, 1 cun proximal to
LI.4 Hegu.
Indications: Rhinitis, sinusitis.
Hand point 18 (Wrist joint)
Location: At the wrist joint crease between the tendons of extensor of the index finger
and thumb.
Indications: Pain in the wrist joint.
14.2 Points on the Palm
Hand point 19 (Upper abdomen)
Location: 0.1 cun proximal to Pe.8.

Indications: Pain in the upper abdomen after gastroenteritis, gastritis etc.
Hand point 20 (Foot joint)
Location: 0.5 cun proximal to Pe.8.

Indications: Pain of the foot joint, e. g., in rheumatoid disorders.
11
23 "-
22~~25
\ 1. 20
21
•
Hand point 21 (Common cold)
Location: At the level of point 28, 0.5 cun lateral to the thenar eminence.
Indications: Common cold.
Hand point 22 (Hysteria)
Location: At the level of the metacarpophalangeal joint of the thumb, when the thumb
is abducted on the middle of the margin of the web.
Indications: Depression.
Hand point 23 (Bronchitis)
Location: Between index and middle finger; if the distance from the margin of the web
to the "head line" is divided into three the point is located on the border of the proxi-
mal and middle thirds.
Indications: Cough and fever in acute and chronic bronchitis.
Hand point 24 (Mouth)
Location: In the middle of the crease of the metacarpophalangeal joint of the middle
finger.
Indication: Stomatitis.
Hand point 25 (Heart)
Location: Between ring and small fingers, 0.2 cun distal to the so-called heart line.
Indications: Palpitations, tachycardia.
Hand point 26 (Kidney)
Location: In the middle of the crease of the distal interphalangeal joint of the small
finger.
Indications: Disorders of the kidney.
Hand point 27 (Enuresis)
Location: In the middle of the crease of the proximal interphalangeal joint of the small
finger.
Indications: Enuresis and incontinence.
Hand point 28 (Increased sweating)
Location: On a straight line, 0.5 cun distal to point 19.

Indication: Hyperhidrosis.
Hand point 29 (Large intestine)
Location: In the middle of the crease of the distal interphalangeal joint of the index
finger.
Indications: Nausea, meteorism.
Hand point 30 (Small intestine)
Location: In the middle of the crease of the proximal interphalangeal joint of the index
finger.
Indication: Diarrhea.
Hand point 31 (Heart)
Location: In the middle of the crease of the distal interphalangeal joint of the middle
finger.
Indication: Tachycardia.
Hand point 32 (Sanjiao, triple warmer)
Location: In the middle of the crease of the proximal interphalangeal joint of the mid-
dle finger.
Indications: Lymphatic disorders, lymphangitis.
Hand point 33 (Spleen)
Location: In the middle of the crease of distal interphalangeal joint of the ring finger.
Indications: Blood disorders, such as anemia, polycythemia.
Hand point 34 (Liver)
Location: In the middle of the crease of the proximal interphalangeal joint of the ring
finger.
Indications: Loss of appetite; disorders of the liver.
15 Acupuncture Treatment
G.Stux
The character of an illness, according to the traditional view, is believed to lie in a dis-
turbance of the vital energy, Qi, of organs and channels, that is, in a disharmony of Yin
and Yang. Therefore the primary aim of the treatment is to balance Yin and Yang, thus
harmonizing the flow of Qi. In the Huang Di Nei ling much attention is devoted to the
prophylaxis of illnesses. In this work a harmonious way of life that strengthens the
body and its resistance (Wei Qi) is recommended. This includes balanced nutrition,
regular physical exercise and breathing exercises (e. g., Qi Gong, later Tai Ji Quan), and
psychic harmony in social life according to the thinking of Confucianism, Taoism, or
Buddhism. A long life in harmony with surrounding nature and society was aspired
to.
When illnesses occurred, first the body was strengthened. Then the disturbances of the
channels and organs concerned were systematically combated to harmonize the excess
or deficiency conditions. Apart from acupuncture and moxibustion, herbs were used in
treatment.
The harmonizing of Qi influences not only the disturbed parts of the body, but in-
cludes the psychic and physical aspects of the whole human being. According to Chi-
nese medicine no separation of psyche and soma was known. The human being was
considered in its wholeness, in association with the rest of nature and the social milieu.
15.1 Principles of Acupuncture and Major Rules of Point Selection
Important bases for a successful acupuncture treatment are:

- Comprehensive diagnosis with the methods of western medicine, with particular em-
phasis on the exclusion of malignant illnesses.
Exact analysis of the symptoms and, especially in chronic and complicated cases,
classification of them according to the system of traditional diagnosis. The differentia-
tion with the most bearing on therapy is that into excess or deficiency conditions.
Disturbances caused by excess, Shi in Chinese, are treated with sedative methods,
while deficiency disturbances, Xu, are treated with tonifying methods. Moxibustion
is an important tonifying method. Points should be selected from the point catego-
ries with careful reference to these diagnostic categories, especially in organic disor-
ders.
- Examination and allocation of pain to channels and organs.
- Knowledge of the 12 main channels, and of the Ren Mai and Du Mai, their courses,
their relations, and the distribution of specific points. Knowledge of the point cate-
gories, their indications and meanings.
- Exact location of the points, precisely correct technique of insertion, an adequate
depth of needle insertion, and appropriate stimulation (sedative or tonifying
method).
In acupuncture point selection for treatment, major empirical principles and rules
based on the traditional knowledge of Chinese medicine are used. They have been ex-
tended through the findings of modem scientific research over the last 30years.
1. Every acupuncture point has a local effect on the surrounding area. For example,
St. 8 Touwei is a local point selected for the treatment of temporal headache.
2. Painful, indurated (e. g., myogelosis), and tender points with no relation to a channel
are also used as local acupuncture points. They are also called locus dolendi points, in
Chinese Ah-Shi points.
The trigger points should not be needled in acute conditions, e.g., trigeminal neural-
gia, because this can increase the pain.
3. Every acupuncture point has an effect on disturbances of the corresponding channel,
the coupled channel, and on illnesses of the corresponding organ and allocated tis-
sues and sensory organs (Table 15.1).
These principles of acupuncture are basic to point selection.
Table 15.1 Relation of organ, tissue, sensory organ, element

Zang organs Fu organs Tissue Sensory organs Phases
Lung Large intestine Skin, body hair Nose Metal
Kidney Bladder Bone, joints Ear Water
Liver Gallbladder Muscle, tendon Eye Wood
Heart Small intestine Blood, Tongue Fire
Pericardium Sanjiao blood vessels
Spleen Stomach Connective Mouth Earth
tissue,
adipose tissue,
"flesh"
4. Acupuncture points have an effect on the related channel axis, for example
St.38 Tiaokou along the Yang-Ming (stomach-large intestine) on the shoulder.
5. Points located distal to elbow and knee are called distal points and have an influence
on proximal areas. The six distal points listed in Table 15.2 are particularly signifi-
cant. These six distal points are chosen frequently. Apart from their distal effects on
the head, neck, face, and epigastrium they also have important general effects, e. g.,
analgesia.
Table 15.2 Six important distal points

Points Location Proximal area
Arm LI.4 Hegu Between thumb and Face, neck
index finger Sensory organs
Lu.7 Lieque 1.5 cun proximal to the wrist Neck, lung
joint on the radial border
Pe.6 Neiguan On the inner side of the Epigastrium, front of chest
forearm, 2 cun proximal to
the wrist joint
Leg St.36 Zusanli Lateral to the shinbone Organs of the abdomen
below the knee
UB.40 Weizhong In the middle of the patella Low back,
urogenital organs
Sp.6 Sanyinjiao 3 cun above the inner Pelvic organs, perineum
malleolus
Apart from these six distal points, numerous points located distal to the elbow and
knee have a specific effect on proximal regions. These distal points each have an in-
fluence on the corresponding channel. Local and distal points on the same channel
Principles of Acupuncture and Major Rules of Point Selection 263
are selected, for example St.8 Touwei and St.44 Neiting in temporal headache. The
number of distal points selected is approximately equal to the number of local
points.
6. According to actual scientific findings some acupuncture points have pronounced
analgesic, sedative, immune-enhancing, tonifying or homeostatic effects (Table 15.3).
Table 15.3 Specific points

Points with analgesic effect LI. 4 Hegu
St. 44 Neiting
St. 43 Xiangu
Points with sedative effect Du 20 Baihui
Ex. 6 Sishencong
He. 7 Shenmen
UB.62 Shenmai
Points with tonifying effect Ren 6 Qihai
Ren 8 Shenque
St. 36 Zusanli
Sp. 6 Sanyinjiao
Points with immune-enhancing effect LI. 11 Quchi
Du 14 Dazhui
Du 13 Taodao
Points with homeostatic effect LI. 11 Quchi
Sp. 6 Sanyinjiao
St. 36 Zusanli
7. Some acupuncture points with specific effects are used for symptomatic treatment
and are listed in Table 15.4.
Table 15.4 Symptomatic points

Symptom Points
Hiccuping St. 36, Pe. 6, UB.17
Nausea Pe. 6, St. 36
Sweating He. 6, Ki. 7, LI. 4
Sneezing LI. 20, Ex. 1, Pe. 6
Edema Sp. 9, Ren 5, Ren 9
Insomnia Du 20, He. 7, Ex. 8, Ex. 9
Fever Du 14, LI. 11, LI. 4
Impotence Ren 6, Sp. 6, St. 36, Liv.8
Constipation SJ. 6, St. 25
Diarrhea Sp. 4, St. 36, Ren 6
Speech disturbance Ren 22, He. 5, Ren 23
8. The 5 Shu points distal to elbow and knee correspond to the five phases and are used
in treatment according to the traditional Chinese rules. The 5 Shu points ling, Ying,
Yuan, ling and He are also applied individually. They have different effects and in-
dications:
Jing points (Wade-Giles: Ting) is the most distal situated point and is located at the
comers of fingernails and toenails. They are selected in acute emergencies (e. g., col-
lapse, shock, nausea). According to Chinese thinking, in extremely Yin-type condi-
tions, for example collapse, the Yang energy returns to the channels affected when
ling points are needled. The point Du 26 Renzhong, located below the nose, is the
most important ling point. Needling of ling points is mostly painful. In acute emer-
gencies, if no needle is on hand, the ling points should be pressed with the fingernail.
9. The Luo connection ends at the Yuan point, which comes from the Luo point of the
coupled channel. According to the traditional view, most of the organ energy along
the channel course is concentrated at this Yuan point. The Luo and Yuan points are
chosen in disturbances of the coupled Zang and Fu organs. Many important and fre-
quently used acupuncture points are Yuan points; for example LI. 4 Hegu is the
most important analgesic point, He.7 Shenmen one of the most effective psychic
harmonizing points; Liv.3 Taichong and GB.41 Foot Linqi are also Yuan points
(Table 15.5).
Table 15.5 Luo and Yuan points

Channel Luo point Yuan point
Large intestine LI. 6 Pianli LI. 4 Hegu
Sanjiao SJ. 5 Waiguan SJ. 4 Yangchi
Small intestine SI. 7 Zhizheng SI. 4 Hand Wangu
Stomach St. 40 Fenglong St. 42 Changyang
Gallbladder GB.37 Guangming GB.40 Qiuxu
Urinary bladder UB. 58 Feiyang UB. 64 Jinggu
Lung Lu. 7 Lieque Lu. 9 Taiyuan
Pericardium Pe. 6 Neiguan Pe. 7 Daling
Heart He. 5 Tongli He. 7 Shenmen
Spleen Sp. 4 Gongsun Sp. 3 Taibai
Sp. 21 Dabao
Liver Liv. 5 Ligou Liv. 3 Taichong
Kidney Ki. 4 Dazhong Ki. 3 Taixi
DuMai Du 1 Changqiang
Ren Mai Ren 15 Jiuwei
10. The He points are the most proximally situated Shu points and are found in the area
of the elbow or knee. According to Chinese medicine, it is believed that at this point
the river ofQi flows from the periphery into the ocean of the body. The He point is
located at the border between the superficial and distal course of the channel and
the deep, proximal part. Thus, the He point connects both important segments of
one channel. The distal course of the channel is traditionally thought to be influ-
enced by external climatic factors, while the proximal part is closely related to the
internal organs. Therefore the He points are significantly important in the treat-
ment of illnesses caused by external factors. Many of the most frequently used acu-
puncture points are He points, e. g., LI. 11 Quchi, St. 36 Zusanli, Sp.9 Yinlingquan,
VB.40 Weizhong, GB. 34 Yanglingquan and Liv.8 Ququan.
11. According to traditional rules, the five Shu points include a tonification point and a
sedative point. The tonification point corresponds to the "mother element" accord-
ing to the law of the five phases and tonifies the energy of the corresponding chan-
nel and organ. Therefore, the tonification points are selected in deficiency condi-
tions of organs and channels. Moxibustion is often applied at these tonification
points.
12. The sedative point that is also one of the five Shu points corresponds to the "son ele-
ment" according to the law of five phases. The Qi of channels and organs can be
sedated by stimulation of this point. Therefore, the sedative points are mostly
needled in excess conditions and are stimulated with sedative methods.
13. The Luo connecting point is the starting point for the transverse Luo connection that
combines this point with the Yuan point of the coupled channel, e. g. Lu.7 Lieque
(Luo) with LI.4 Hegu (Yuan). A deep connection also has its source at the Luo
point, the longitudinal Luo vessel, that runs to the corresponding internal organ.
Thus, the Luo point is directly connected to the corresponding internal organ and
has a strong effect on this organ. The Luo points are frequently selected for treat-
ment of the internal Zang and Fu organs, for example Lu.7 Lieque in lung, St. 40
Fenglong in stomach, and He.5 Tongli and Pe.6 Neiguan in cardiovascular disor-
ders. The spleen channel has two Luo points: Sp.4 Gongsun and Sp.21 Dabao.
Sp.21 Dabao is called "Major Luo." The two extraordinary channels Du Mai and
Ren Mai also each have one Luo point, Du 1 Changqiang and Ren 15 Jiuwei
(Table 15.5).
14. Xi-cleft points (Wade-Giles: Trsi) are chosen in acute illnesses of the corresponding
internal organs (e.g., in acute gastritis, acute bronchitis) (Table 15.6). According to
traditional ideas the Xi-cleft points activate the energy of the channels, and thus al-
so of the organs. Therefore Xi-cleft points are selected in acute disturbances of the
channels, e.g., in acute painful conditions or neuralgia. The Xi-cleft points are reg-
ularly located distal to elbow and knee. They are vigorously stimulated.
Table 15.6 Xi-cleft points of the organs

Organs Xi-cleft points
Lung Lu. 6 Kongzui
Large intestine LI. 7 Wenliu
Stomach St. 34 Lianqiu
Spleen Sp. 8 Diji
Heart He. 6 Yinxi
Small intestine SI. 6 Yanglao
Urinary bladder UB. 63 Jinmen
Kidney Ki. 5 Shuiquan
Pericardium Pe. 4 Ximen
Sanjiao SJ. 7 Huizong
Gallbladder GB.36 Waiqiu
Liver Liv. 6 Zhongdu
15. Apart from their other effects, the eight influential points have a specific influence
on the tissues and organ systems and the functions corresponding to them
(Table 15.7).
Table 15.7 Influential points

Tissues, organs Influential points
Zang organs, storage organs Liv. 13 Zhangmen
Fu organs, hollow organs Ren 12 Zhongwan
Respiratory system Ren 17 Shanzhong
Blood UB.17 Geshu
Bone UB.ll Dashu
Bone marrow GB. 39 Xuanzhong
Muscle, tendon GB. 34 Yanglingquan
Vascular system Lu. 9 Taiyuan
16. Mu points or alarm points (Wade-Giles: Mo), are sensitive to pain and vary in con-
sistency in acute and chronic disturbances of the pertaining organs. They are im-
portant in diagnosis as well as in treatment. The Mu points are situated ventrally on
the trunk. One Mu point is attributed to each Yin and Yang organ (Table 15.8).
They have a similar function to the Back Shu points.
Table 15.8 Mu or alarm points

Organs Mu points
Lung Lu. 1 Zhongfu
Pericardium Ren 17 Shanzhong
Heart Ren 14 Juque
Liver Liv. 14 Qimen
Gallbladder GB. 24 Riyue
Spleen Liv. 13 Zhangmen
Stomach Ren 12 Zhongwan
Sanjiao Ren 5 Shimen
Kidney GB. 25 Jingmen
Large intestine St. 25 Tianshu
Small intestine Ren 4 Guanyuan
Urinary bladder Ren 3 Zhongji
17. The Shu points or transport points (Wade-Giles: Yti) are located segmentally on the
medial branch of the urinary bladder channel. Like the alarm points, which are lo-
cated frontally, the Shu points become sensitive to pressure in disturbances of the
pertaining organ. Apart from their diagnostic relevance, the Shu points are impor-
tant for the treatment of organ disorders. According to traditional ideas the Shu
points transport the vital energy, Qi, to the related internal organs. The Shu points
of the organs are situated under and lateral to the vertebral spine in each segment.
They correspond in location to the sympathetic ganglion. The Shu points are often
used together with the Mu points in treatment of illnesses of the internal organs,
particularly in chronic conditions (Table 15.9). In deficiency conditions of the or-
gans, moxibustion of the Shu and Mu points is very effective.
Table 15.9 Back Shu points

Organs Back Shu points Location
Lung UB.13 Feishu T-3
Pericardium UB.14 Jueyinshu T-4
Heart UB.15 Xinshu T-5
Liver UB.18 Ganshu T-9
Gallbladder UB.19 Danshu T-10
Spleen UB. 20 Pishu T-11
Stomach UB. 21 Weishu T-12
Sanjiao UB. 22 Sanjiaoshu L-1
Kidney UB.23 Shenshu L-2
Large intestine UB. 25 Dachangshu L-4
Small intestine UB. 27 Xiaochangshu S-1
Urinary bladder UB. 28 Pangguangshu S-2
18. The eight extraordinary channels can be brought into play by the confluent points
(Table 15.10). The confluent points of the Du Mai, Ren Mai, and Chong Mai are
especially significant. The Du Mai comes into play with SI. 3 Houxi, Ren Mai with
Lu.7 Lieque, and the Chong Mai with Sp.4 Gongsun.
Table 15.10 Confluent points

Extraordinary channels Confluent points
Chong Mai (Tchong Mo) Sp. 4 Oongsun
Yinwei (Yin Oe) Pe. 6 Neiguan
Du Mai (Tou Mo) SI. 3 Houxi
Yangqiao (Yang Keo) UB. 62 Shenmai
Dai Mai (Tae Mo) OB. 41 Foot Linqi
Yangwei (Yang Oe) SJ. 5 Waiguan
Ren Mai (Jenn Mo) Lu. 7 Lieque
Yinqiao (Yin Keo) Ki. 6 Zhaohai
19. Points are selected with reference to the innervation of the dermatome or myotome or
to the corresponding peripheral nerves in neuralgia and neurological disorders.
The Huatuojiaji points (Ex. 21) situated 0.5 cun lateral to the vertebral column un-
der the vertebral spine in each segment and the points on both branches of the uri-
nary bladder channel are especially effective.
20. Unilateral disorders can also be treated with points on both sides of the body. This
is effective and should be borne in mind in selection of the distal points that are reg-
ularly needled on both sides. In acute pain, e. g., trigeminal neuralgia, only local
points on the contralateral side are used at the beginning of treatment, while distal
points on both sides are stimulated.
Many principles of acupuncture treatment are based on traditional ideas of pathology

and diagnosis. This basic textbook describes only the important rules of point
selection.
The next part of this chapter deals with the point combinations that are used in impor-
tant disorders and have been confirmed in daily practice. In 1979 the World Health Or-
ganization drew up an indication list of the important disorders for which acupuncture
treatment seems promising (Appendix A). The spectrum of acupuncture indications
treated in this textbook goes beyond the WHO list and includes the most disorders that
are treated with acupuncture in western countries.
The point combinations listed below should not be uncritically followed, but should help
the beginner to get a "feel" for point selection. An analysis of the point combinations
with reference to the principles of acupuncture presented, is especially instructive. The
selection of points for a particular disorder must take account of the individual
symptoms. The following system of treatment is based on western diagnosis. Study of
the complicated traditional syndromes of Chinese medicine is recommended for the
advanced acupuncturist.
A holistic concept of acupuncture should be maintained. The combination of dietary
advice, physical therapy, and psychotherapy can be of decisive importance in healing.
Drug treatment, if necessary and indicated, should be slowly reduced.
Du 20 Baihui, the "governor" of the Du Mai, the governing vessel, is the point that ef-
fects central coordination of all Yang points. In addition, Du 20 Baihui is an effective
sedative point. Therefore, this point can be used in every acupuncture treatment. In sel-
dom cases, needling of Du 20 Baihui can cause headache. Than instead of this point
Du 14 Dazhui should be used.
Generally two or three treatments are carried out per week. In acutely painful condi-
tions, such as trigeminal neuralgia, acute migraine or pain in carcinoma, daily treat-
ment can be useful. A pause of 7 -1 0 days is mostly inserted after 8-12 sessions.
In general the needles are retained in place for 10- 25 min and then removed; but reten-
tion for up to 1 h can be necessary in trigeminal neuralgia, migraine or pain in
carcinoma.
In the displayed list of indications below the acupuncture points are listed in this way:
1st column, local points; 2nd column, distal points on the arms; and 3rd column, distal
points on the legs. The important points are always listed first. According to the indi-
vidual symptoms, 10-15 of the listed points are selected, so that a maximum of 20
needles per acupuncture treatment are used. These points can be varied individually.
Before every acupuncture treatment, points that are painful or sensitive to pressure in
the appropriate region, the so-called Ah-Shi points, are searched for and used as local
acupuncture points.
For easy reference, the indications are listed here alphabetically:
Acne vulgaris 15.10.1 Eczema 15.10.3

Acute emergencies 15.12 Enuresis 15.9.5
Acutely painful conditions 15.12.3 Epicondylitis 15.2.6
Adnexitis 15.8.3 Epilepsy 15.7.5
Agitation 15.6.3 Epileptic fits 15.12.2
Alcohol addiction 15.6.7 Esophagitis 15.5.1
Amenorrhea 15.8.2 Exhaustion conditions 15.4.4
Anal fissure 15.5.7 15.6.2
Analgesia during childbirth 15.8.7
Angina pectoris 15.4.1 Facial paralysis 15.7.4
Ankle joint, pain in 15.2.11 Fainting 15.12.1
Arthrosis of jaw joint 15.2.1 Fertility, disturbances in men 15.9.4
Asthma, bronchial 15.3.6 Frozen shoulder 15.2.5
Biliary colic 15.5.8 Gastric and duodenal ulcer 15.5.3

Biliary dyskinesia 15.5.8 Gastritis 15.5.2
Bronchitis, chronic 15.3.5 Gastroenteritis 15.5.2
Gastroenterological disorders 15.5
Cardiac arrhythmia 15.4.3 Glaucoma simplex 15.11.5
Cardiac neurosis 15.4.2 Gonarthrosis 15.2.10
Cardiovascular disorders 15.4 Grand mal 15.12.2
Cholangitis 15.5.8 Gynecological disorders 15.8
Cholecystitis 15.5.8 Gynecological tumors 15.8.4
Collapse 15.12.1
Common cold 15.3.1 Hand, pain in 15.2.8
Conjunctivitis, chronic 15.11.4 Headache 15.7.1
Constipation 15.5.6 Hemorrhoid 15.5.7
Coronary heart disease 15.4.1 Hemiparesis 15.7.3
Coxarthritis 15.2.9 Hepatitis 15.5.9
Coxarthrosis 15.2.9 Herpes simplex 15.10.6
Herpes zoster 15.10.5
Deafness 15.11.1 Hyperemesis gravidarum 15.8.6
Depression 15.6.1 Hypertension 15.4.5
Diarrhea 15.5.4 Hypotension 15.4.6
Dizziness 15.11.3
Drug addiction 15.6.6 Impotence 15.9.4
Dupuytren's contraction 15.2.8 Intercostal neuralgia 15.2.3
Dysmenorrhea 15.8.1 Irritable bowel disease 15.5.5
Dysphagia 15.5.1
Knee joint, pain in 15.2.10
Labyrinthitis 15.11.3 Salpingitis 15.8.3

Lactation, deficient 15.8.8 Schizophrenia 15.6.5
Laryngitis 15.3.2 Sciatica 15.2.4
Leg ulcers 15.10.2 Sense organs, disorders of 15.11
Locomotor disorders 15.2 Sexual disturbances 15.6.10
Lumbar Pain 15.2.4 Skin disorders 15.10
Sleep disturbances 15.6.4
Mental disturbances and Spondylitis, ankylosing 15.2.3
illnesses 15.6 Spondylitis, cervical 15.2.2
Meniere's syndrome 15.11.3 Sinusitis, frontal 15.3.4
Migraine 15.7.1 Sinusitis, maxillary 15.3.3
Motion sickness 15.11.3
Tennis elbow 15.2.6
N eurodermitis 15.10.3 Thorax, trauma of 15.2.3
Neurologic disorders 15.7 Tinnitus 15.11.2
Nicotine addiction 15.6.8 Toe, pain in 15.2.12
Tonsillitis 15.3.2
Overweight 15.6.9 Torticollis 15.2.2
Trigeminal neuralgia 15.7.2
Periarthritis humeroscapularis 15.2.5
Peripheral blood supply, Urological disorders 15.9
disturbances 15.4.7 Urological symptoms,
Prostatitis 15.9.3 psychogenic 15.9.3
Pruritus vulvae 15.8.5
Psoriasis 15.10.4 Visual deficiency 15.11.6
Renal colic 15.9.2 Weight Loss 15.6.9

Respiratory disorders 15.3 Wound healing, deficient 15.10.2
Rheumatoid arthritis 15.2.2 Wrist joint, pain in 15.2.7
15.2.8
15.2.13 Zoster neuralgia 15.2.3
15.10.5
15.2 Locomotor Disorders
Locomotor disorders are mainly characterized by restricted movements of the joints

and acute or chronic pain. The treatment of such chronic pain conditions with physical
exercises, or chiropractic is often unsatisfactory. Long-term drug treatment is limited
by gastrointestinal side effects and by disturbances of hematopoiesis.
The effect of acupuncture treatment in these disorders has been verified by many con-
trolled studies. The often surprising results of acupuncture treatment in such chronic
pain conditions are also verified in daily practice. The good patient acceptance of this
treatment combined with its effectiveness accounts for the claim that acupuncture
should not be used in treatment only as a last resort. The use of acupuncture treatment
in the early stages of disease prevents a disadvantageous course. Many crippling defor-
mities can be avoided in this way. Suffering or pain of some years' duration can be dra-
matically alleviated.
Principles of Treatment in Locomotor Disorders

- In the treatment of locomotor disorders points in the affected area - local points -
are combined with important distal points.
- Points that are painful and sensitive to pressure, Ah-Shi points, are systematically
selected and needled.
- The location of pain and its radiation must be related to the channels, to allow treat-
ment by stimulation of specific local and distal points of the appropriate channel.
For example, pain in the shoulder along the large intestine channel is treated with
stimulation of local points on the large intestine channel and of important distal
points, such as LI.4 Hegu, LI. 11 Quchi.
- In pain along a channel, points ofthe corresponding axis are also selected; for exam-
ple, in pain along the large intestine channel, points of the stomach channel, of the
Yang-Ming (e.g. S1.38 Tiaokou) are used.
- The influential point for muscles and tendons GB.34 Yanglingquan is indicated in all
disorders of muscles and tendons.
- In degenerative disorders of joints, bone, and cartilage the influential point
VB. 11 Dashu is selected.
- Analgesic points, such as LI.4 Hegu, St.44 Neiting, are often additionally used in
pain treatment.
- The most important homeostatic point, LI. 11 Quchi, can be successfully used to-
gether with St. 36 Zusanli and Sp.6 Sanyinjiao.
- Important sedative points, such as He.7 Shenmen and UB. 62 Shenmai, are indicated
in many cases when nervousness and sleep disturbances are present.
15.2.1 Arthrosis of the Jaw Joint

Pain in the jaw joint often goes together with tense mastoid muscles, which can be re-
laxed effectively by needle treatment. Psychogenic factors are important for the etiolo-
gy and chronicity of disease. Pain in the area of the jaw joint is positively influenced by
acupuncture.
Du 20 Baihui
St. 7 Xiaguan LI. 4 Hegu St. 44 Neiting
SI. 19 Tinggong He. 7 Shenmen
GB. 2 Tinghui S1. 5 Waiguan
S1. 21 Ermen
SI. 18 Quanliao
Ah-Shi points
Locomotor Disorders 271
15.2.2 Cervical Spondylitis, Torticollis, Rheumatoid Arthritis
According to Chinese classification cervical spondylitis is differentiated into two forms

according to pain location:
- In the first type the pain occurs near the midline, indicating that it is related to the
small intestine channel. Pain is characterized by restricted movements and pain in
tilting the head forward or backward. Corresponding local points and distal points
on the small intestine and urinary bladder channels, e. g. Tai Yang are selected for
treatment.
- When there is pain along the lateral side of the neck, and restricted movements and
pain on turning the head, cervical spondylitis is treated with the Sanjiao and gall-
bladder channel, e. g. Shao Yang.
In acute cervical spondylitis and torticollis stimulation with a sedative method is neces-
sary, that is, vigorous manipulation of the needle. In chronic cases moxibustion is indi-
cated in addition.
Cervical spondylitis medial type (small intestine and urinary bladder channels - Tai
Yang axis)
Du 20 Baihui
UB. 10 Zhongfu SI. 3 Houxi UB. 60 Kunlun
Du 14 Dazhui SI. 6 Yanglao
UB. 11 Dashu Lu. 7 Lieque
Ex. 21 Huatuojiaji LI. 4 Hegu
Ah-Shi points
In the case of acute onset of disease and severe pain with severely restricted move-
ments of the neck, intensive manual stimulation of SI. 3 Houxi and SI. 6 Yanglao
brings a speedy recovery.
Cervical spondylitis lateral type (Sanjiao and gallbladder channel - Shao Yang axis)
Du 20 Baihui
GB. 20 Fengchi SJ. 5 Waiguan GB. 39 Xuanzhong
GB. 21 Jianjing LI. 4 Hegu GB. 34 Yanglingquan
Du 14 Dazhui
Ah-Shi points
15.2.3 Intercostal Neuralgia, Trauma of the Thorax, Ankylosing Spondylitis,

Zoster Neuralgia
Du 20 Baihui
Ex. 21 Huatuojiaji SJ. 8 Sanyangluo GB. 40 Qiuxu
Segmental urinary bladder points LI. 4 Hegu
UB.11 - UB.21
Ah-Shi points
In severe cases acupuncture treatment should be continued over 20-30 sessions. In

such long-term cases with typical deficiency symptoms moxibustion is indicated in ad-
dition. Even in chronic and severe zoster neuralgia good degrees of success are
achieved.
15.2.4 Sciatica, Lumbar Pain
Exact allocation of pain to the channels is necessary for specific and successful treat-
ment. Sciatic pain is related either to the urinary bladder channel (dorsal) or to the gall-
bladder channel (lateral). Differentiation into acute types with Yang character or
chronic types with deficiency symptoms is indispensable for treatment to be effective.
In the cases of acute onset of disease and severe pain, vigorous manipulation of the
acupuncture needles is applied. Electrical stimulation can be helpful. In chronic cases
with dull pain, deficiency symptoms, and sensitivity to cold, in addition to needling
moxibustion is indicated. According to Chinese ideas there is a deficiency of the kid-
ney Yang in such cases. Moxibustion of the corresponding specific points (VB. 23,
VB. 25, Ki. 7, Ki.8, Sp.6) is then applied.
Pain along the urinary bladder channel

Du 20 Baihui
Du 3 Yaoyangguan LI. 4 Hegu VB. 40 Weizhong
Du 4 Mingmen Hand point 1 VB. 60 Kunlun
VB. 23 Shenshu VB. 58 Feiyang
VB. 25 Dachangshu VB. 57 Chengshan
VB. 26 Guanyuanshu
VB. 27 Xiaochangshu
VB. 32 Ciliao
VB. 54 Zhibian
VB. 36 Chengfu
VB. 37 Yinmen
Ah-Shi points
Three or four of the listed local points are selected, being those located in the area of
the most severe pain. VB.23 Shenshu is an important local point with a pronounced
general effect.
Pain along the gallbladder channel

Du 20 Baihui
GB.30 Huantiao LI. 4 Hegu GB. 34 Yanglingquan
GB. 31 Fengchi GB. 39 Xuanzhong
Du 3 Yaoyangguan
Du 4 Mingmen
Points for moxibustion

VB. 23 Shenshu Ki. 7 Fuliu
VB. 25 Dachangshu Ki. 3 Taixi
Du 3 Yaoyangguan Sp. 6 Sanyinjiao
VB. 26 to UB.30 Paravertebral line connecting sacral urinary bladder points
15.2.5 Periarthritis Humeroscapularis, Frozen Shoulder
Local points in the area of the shoulder girdle are selected according to the location of
the most severe pain:
- In pain located on the anterior side of the shoulder, points on the large intestine
channel (LI.15, L1.16) on the shoulder are needled together with distal points of this
channel (LI. 4, LI. 11) and with the important distal point at the leg (St. 38) of the
Yang-Ming (LI. and St.).
If pain is located on the dorsal side of the shoulder joint, local points on the small
intestine channel (SI. 9, SI. 10, SI. 11) are used in combination with distal points of
the small intestine channel (SI. 6).
In the case of pain in the middle of the shoulder local and distal points of the San-
jiao channel are selected. An additional point of reference in selection of the appro-
priate channel is yielded by differentiation of the symptoms into restricted and pain-
ful movement of the shoulder joint:
Anteversion - large intestine channel (Yang Ming)
Abduction - Sanjiao channel (Shao Yang)
Retroversion - small intestine channel (rai Yang)
In painful restricted movements of the shoulder joint (frozen shoulder) stimulation of
St. 38 Tiaokou is very effective. In a personal study 40% of the patients had recovered
after the first session and 80% after two or three treatments.
Pain on the frontal side of the shoulder (Yang Ming)
Du 20 Baihui
LI. 15 Jianyu LI. 4 Hegu St. 38 Tiaokou
LI. 16 Tianding LI. 11 Quchi
LI. 14 Binao
Pain in the middle of the shoulder (Shao Yang)

Du 20 Baihui
SJ. 14 Jianliao SJ. 5 Waiguan
SJ. 13 Naohui LI. 4 Hegu St. 38 Tiaokou
Pain on the dorsal side of the shoulder (rai Yang)

Du 20 Baihui
SI. 9 Jianzhen SI. 6 Yanglao
Du 14 Dazhui SI. 3 Houxi
15.2.6 Epicondylitis, Tennis Elbow
In preparation for treatment of the very painful condition of epicondylitis great care
must be devoted to the selection of points that are painful or tender on pressure. Distal
points of the corresponding channel are added. Vigorous stimulation, especially of the
distal points, is very effective. During the course of treatment the elbow joint should be
spared. Sudden movements of the joint and heavy carrying must be avoided.
Du 20 Baihui
LI. 11 Quchi LI. 4 Hegu
Lu. 5 Chize SJ. 5 Waiguan
Pe. 3 Quze
He. 3 Shaohai
Ah-Shi points
15.2.7 Pain in the Wrist Joint
In pain in the wrist joint, local points in the area of the maximal pain are primarily
selected, and these are combined with the two analgesic points LI. 4 Hegu and St. 44
Neiting.
Du 20 Baihui
Pe. 7 Daling LI. 4 Hegu St. 44 N eiting
He. 7 Shenmen
Lu. 9 Taiyuan
LI. 5 Yangxi
SJ. 4 Yangchi
Ah-Shi points
15.2.8 Pain in the Hand, Rheumatoid Arthritis, Dupuytren's Contraction
For the treatment of painful hand conditions points in the region of most severe pain
are combined with the two main analgesic points. Vigorous stimulation is necessary.
The eight extra points Ex. 28 Baxie (Ba = eight) are very effective.
Du 20 Baihui
Ex. 28 Baxie LI.4 Hegu St. 44 Neiting
Lu. 10 Yuji
Pe. 8 Laogong
He. 8 Shaofu
15.2.9 Coxarthrosis, Coxarthritis
According to traditional ideas coxarthrosis is mostly caused by a deficiency-type

disturbance. Treatment with a tonifying method is indicated. Especially in predomi-
nantly dull and numbing pain, needling and moxibustion of the tonification points is
successful.
Du 20 Baihui
OB.30 Huantiao LI. 4 Hegu OB. 34 Yanglingquan
VB. 54 Zhibian VB. 40 Weizhong
VB. 32 Ciliao VB. 60 Kunlun
VB. 36 Chengfu St. 44 Neiting
Ah-Shi points

VB. 23 Shenshu VB. 40 Weizhong
VB. 54 Zhibian Ki. 3 Taixi
Ki. 7 Fuliu
15.2.10 Gonarthrosis, Pain in the Knee Joint
Acupuncture treatment is very effective in the relief of pain of the knee joint. Even in
severe joint deformations durable pain relief is often achieved. The three local points
Ex.31 Heding, Ex. 32 Xiyan and St.35 Dubi, which are also called knee eyes, are cen-
tral to the treatment, and painful local points and points tender to pressure are also se-
lected. Distal points on the appropriate channels related to the local points are vigor-
ously stimulated. The general analgesic points St.44 Neiting and LI.4 Hegu are also
useful.
Du 20 Baihui
Ex. 31 Heding LI. 4 Hegu St. 44 Neiting
Ex. 32 Xiyan VB. 11 Dashu VB. 60 Kunlun
St. 35 Dubi
St. 36 Zusanli
GB. 34 Yanglingquan
VB. 40 Weizhong
Ah-Shi points
Swelling of the joints

Sp. 9 Yinlingquan
15.2.11 Pain in the Ankle Joint
In the case of pain in the ankle joint local points sensitive to pressure are selected.
Important general points, such as Sp.9 Yinlingquan for swelling and LI. 4 Hegu and
St. 44 Neiting for severe pain, complete the spectrum of points.
Du 20 Baihui
St. 41 Jiexi LI. 4 Hegu St. 44 N eiting
GB. 40 Qiuxu VB. 11 Dashu
VB. 60 Kunlun
Ki. 3 Taixi
Ki. 6 Zhaohai
Ah-Shi points
In swelling
Sp. 9 Yinlingquan
15.2.12 Pain in the Toes
In pain in the toes the eight extra points Ex. 36 Bafeng (Ba = eight) are very effective.
Du 20 Baihui
Ex. 36 Bafeng LI. 4 Hegu GB. 34 Yanglingquan
St. 44 Neiting
Ah-Shi points
15.2.13 Rheumatoid Arthritis
According to traditional medicine there is a traditional syndrome, "Bi" in Chinese, that

is similar in its symptoms to rheumatoid arthritis. The Bi syndrome is caused by a
disturbance of the Qi and blood flow. Pathogenic influences such as wind, cold and
damp and a deficiency of the protecting Qi (Wei-Qi) provoke this disease. Several
forms of the Bi syndrome are differentiated:
1. Bi syndrome with severe pain that is relieved by heat. The cause is pathogenic cold.
2. Bi syndrome with vagrant pain sensations and restricted movements, caused by
pathogenic wind influence.
3. Bi syndrome with long-lasting pain, heaviness and physical sluggishness, caused by
pathogenic damp.
4. Bi syndrome with acutely inflamed joints (swelling, redness, heat), caused by a com-
bination of pathogenic cold, dampness, and wind.
The different types of the Bi syndrome are caused by a deficiency of the protective Qi.
The traditional therapy eliminates the pathogenic influences of cold, damp, and wind
and enhances the body's resistance.
Because primarily a deficiency is concerned the treatment is based on activation and
tonification of the Qi by means of moxibustion at tonification points. Needling of the
appropriate channels and joints eliminates the pathogenic influence. Moxibustion of
general and specific tonification points is carried out daily:
Ren 6 Qihai LI. 11 Quchi St. 36 Zusanli
Ren 8 Shenque LI. 10 Shousanli Ki. 7 Fuliu
Ren 12 Zhongwan Sp. 6 Sanyinjiao
UB. 20 Pishu
UB. 22 Sanjiaoshu
UB.23 Shenshu
Ou 4 Mingmen
Ou 13 Taodao
Ou 14 Oazhui
Needle treatment in combination with moxibustion is indicated for quite a long period.
For needling, local and distal points are selected from those listed above. Antirheu-
matic drugs should be reduced slowly, in keeping with the pain relief achieved with
acupuncture.
In addition to tonification therapy, analgesic points are used with vigorous stimu-
lation:
LI. 4 Hegu
St. 44 Neiting
St. 43 Xiangu
The influential point for muscles and tendons, GB.34 Yanglingquan, is very effective
in rheumatic illnesses. UB.11 Oashu, the influential point for bone and cartilage, is of-
ten needled. In acute inflammations Ou 14 Oazhui is indicated.
Long-term treatment often not only reduce the pain, but also improves the movement
in the affected joints.
Respiratory Disorders 277
15.3 Respiratory Disorders

Many respiratory disorders are successfully influenced by acupuncture. Especially in
chronic conditions, such as chronic sinusitis, bronchitis, or bronchial asthma, acupunc-
ture is more effective than other forms of treatment. Long-term success can be fre-
quently achieved even in therapy-resistant cases. In acute infections of the upper respi-
ratory system the acute symptoms can usually be alleviated in a short time.
According to traditional medicine, external climatic influences such as cold, wind,
dryness, and occasionally heat, are considered to be causal factors, together with a
weakened defense system (Wei Qi). Depending on the course, excess- or deficiency-
type disturbances (Shi and Xu forms) can occur. Their differentiation is important
for point selection and for the technique of stimulation.
Principles of treatment
- Local points in the area of the disorder, e. g.:
Nose: LI. 20 Yingxiang, Ex.1 Yintang
Paranasal sinus: LI.20 Yingxiang, St.2 Sibai, St.3 Juliao, SI.18 Quanliao
Frontal sinus: UB.2 Zanzhu, GB.14 Yangbai, Ex.3 Yuyao, Ex.1 Yintang
Tonsils: Ren 23 Lianquan, LI.18 Neck-Futu, SI.17 Tianrong
- Important distal points for respiratory disorders:
Lu. 7 Lieque Luo point of the lung with a marked effect on the respiratory sys-
tem.
LI.4 Hegu with a marked effect on the head and neck; decreases the fever
and increases sweating; as Yuan point of the large intestine, it con-
nects with the Luo vessel to the lung channel (Lu.7).
Lu. 6 Kongzui Xi-cleft point of the lung, indicated in acute cases of bronchitis or
asthma.
SJ. 5 Waiguan removes the heat-type symptoms and the wind influence, similar
to L1.4.
- Local points in the area of the disorder, with a specific effect on disturbances caused
by wind (Feng), such as GB. 20 Fengchi, Du 16 Fengfu, UB. 12 Fengmen in common
cold.
- The Shu and Mu points of the lung, UB.13 Feishu and Lu.1 Zhongfu, are selected in
deficiency disturbances (Xu) of the lung and are stimulated with a tonifying method.
In this case moxibustion of these points is also indicated.
- Ren 17Shanzhong, the influential point for the respiratory system, is selected espe-
cially in bronchitis and asthma.
- Ex. 17 Dingchuan is a specific extra point for relief of asthma.
- Ren 22 Tiantu is effective in acute attacks of asthma.
- UB.17 Geshu has a relaxing effect on the diaphragm and stimulation of this point is
indicated in cough and dyspnea caused by asthma.
- Du 14 Dazhui, LI. 11 Quchi and LI. 4 Hegu are effective in relief of fever.
- St. 40 Fenglong increases expectoration of persistent and viscous mucus.
- He. 7 Shenmen and Pe.6 Neiguan are useful if psychogenic factors are predominant.
15.3.1 Common Cold
According to traditional ideas the common cold is caused by external pathogenic cli-
matic factors such as cold and wind, and occasionally heat, in association with weak-
ened defense. The typical general symptoms, such as headache, pains in the limbs, ex-
haustion, and tiredness, are an expression of the external factors. Symptoms like fever,
thirst, and dryness of the mucous membranes are present in heat-type disturbances,
when the fluid (Yin) is exhausted.
Du 20 Baihui
GB.20 Fengchi Lu. 7 Lieque Sp. 10 Xuehai
Du 14 Dazhui LI. 4 Hegu
Du 16 Fengfu LI. 11 Quchi
SJ. 5 Waiguan
The treatment is aimed at expelling the external pathogenic factors and especially at
activating the protective forces of the lung.
In the second phase of the disorder, when the acute symptoms have been attenuated,
moxibustion of the points listed below is advisable. Moxibustion can be carried out
daily by the patient.
LI. 11 Quchi
Ren 6 Qihai
St. 36 Zusanli
Ki. 7 Fuliu
VB. 12 Fengmen
15.3.2 Tonsillitis, Laryngitis
The acute symptoms of this disorder can be relieved very effectively with acupuncture.
In suppurative, febrile tonsillitis an antibiotic therapy should be considered.
Du 20 Baihui
SI. 17 Tianrong LI. 4 Hegu
LI. 18 Neck Futu Lu. 11 Shaoshang
Ren 23 Lianquan He. 5 Tongli in hoarseness
For fever Du 14 Dazhui and LI.11 Quchi are used in addition.
15.3.3 Maxillary Sinusitis
Acupuncture is especially effective in a chronic course of this disease. The relapse rate
can be significantly reduced.
Du 20 Baihui
LI. 20 Yingxiang LI. 4 Hegu Sp.10 Xuehai
St. 2 Sibai LI. 11 Quchi
St. 3 Juliao
SI. 18 Quanliao
Respiratory Disorders 279
15.3.4 Frontal Sinusitis
In frontal sinusitis such symptoms as frontal headache and a sensation of pressure be-
tween the eyes are corrected. After a few treatment sessions the swelling of the mucous
membranes has started to abate and the blocked mucus is dissolved.
Du 20 Baihui
UB. 2 Zanzhu LI. 4 Hegu UB. 60 Kunlun
Ex. 3 Yuyao LI. 11 Quchi
Ex. 1 Yintang
GB. 14 Yangbai
15.3.5 Chronic Bronchitis
This disease is characterized by chronic irritation and the inability to expectorate bron-
chial mucus. Chronic inflammatory reactions maintain this state.
According to traditional ideas a deficiency-type disturbance of the lung is accompa-
nied by a deficiency of the kidney or spleen. The treatment is based on activation of the
organ systems and on a harmonizing influence on the lung function.
Du 20 Baihui
Lu. 1 Zhongfu Lu. 9 Taiyuan St. 40 Fenglong
UB. 13 Feishu Lu. 7 Lieque St. 36 Zusanli
Du 14 Dazhui
Ren 17 Shanzhong
UB. 17 Geshu has a sedative effect in chronic cough.
If deficiency symptoms caused by a chronic course are predominant moxibustion is

useful.
UB. 13 Feishu Lu. 9 Taiyuan
UB. 20 Pishu LI. 11 Quchi
UB. 23 Shenshu
Du 4 Mingmen
Ren 6 Qihai
According to traditional ideas acute bronchitis is caused by an external wind or cold

influence, and it is therefore considered an excess-type disturbance of the lung. The
treatment is similar to that of common cold.
15.3.6 Bronchial Asthma
Bronchial asthma is one of the major indications for acupuncture in disorders of inter-
nal organs. In acute forms lasting success can be achieved. Following a chronic course
over some decades with pathologic changes in the lung the spasm can be reduced. The
corticoids are slowly reduced as acupuncture treatment proceeds during the first
weeks. The success rates quoted in the literature are 60%-70%.
Asthma is traditionally divided into excess and deficiency types (Shi and Xu form).
Asthma of the excess type is caused by external wind and cold influences, or by heat, in
which case it is characterized by accumulation of sputum. In asthma of the deficiency
type, besides the lung the kidney is also often in a deficiency state. The differentiation
of excess and deficiency types according to traditional diagnostic categories is essential
for treatment.
Asthma of excess type

Du 20 Baihui
Ren 17 Shanzhong Lu. 7 Lieque St. 40 Fenglong
VB. 13 Feishu LI. 4 Hegu (in the case of blocked
mucus)
Lu. 1 Zhongfu Lu. 5 Chize (in heat-type disturbance)
Ex. 17 Dingchuan Lu. 6 Kongzui (in acute shortness of breath)
Ren 22 Tiantu (in acute shortness of breath)
Du 14 Dazhui (in acute infection)
Asthma of deficiency type

Du 20 Baihui
Ren 17 Shanzhong Lu. 9 Taiyuan
VB. 13 Feishu Lu. 7 Lieque
Ex. 17 Dingchuan
In asthma of deficiency type, in addition to needling with tonifying stimulation (mild

stimulation) moxibustion is very important for the success of treatment. Moxibustion
of the important following tonification points is applied daily:
VB. 13 Feishu Lu. 9 Taiyuan St. 36 Zusanli
VB. 23 Shenshu LI. 11 Quchi Ki. 3 Taixi
Du 4 Mingmen
Ren 6 Qihai
VB. 20 Pishu in deficiency disturbances of the spleen together with
Ren 12 Zhongwan
15.4 Cardiovascular Disorders
In cardiovascular disorders acupuncture is used very effectively. An exact diagnosis

must be made before acupuncture treatment. Other possible therapies should be
used in addition to acupuncture if indicated. Acupuncture is especially appropriate
for the treatment of psychosomatic heart disorders. In hypotension and hyperten-
sion and in exhaustion conAditions resulting from chronic heart disorders a combi-
nation of acupuncture and moxibustion is effective.
15.4.1 Coronary Heart Disease with Angina Pectoris
In coronary heart disease acupuncture should be carried out in association with

drug treatment. Acupuncture has a sedative and harmonizing effect on the heart. Ac-
cording to traditional ideas an excess-type disturbance of the heart is present. Stag-
nation of Qi and blood is another possible explanation.
Du 20 Baihui
VB. 15 Xinshu Pe. 6 Neiguan
Ren 14 Juque He. 7 Shenmen
Ren 17 Shanzhong Pe. 4 Ximen (in acute conditions)
Cardiovascular Disorders 281
15.4.2 Cardiac Neurosis
In cardiac neurosis the psychogenic character is predominant. The patients suffer from
anxiety, internal agitation, nervousness, palpitation, and tachycardia, and have pains
along the inner side of the left arm (heart channel). According to the concepts of tradi-
tional medicine an excess-type disturbance of the heart is present in such cases. After a
few acupuncture sessions the physical symptoms are significantly reduced and the
patient's anxiety is attenuated.
Du 20 Baihui
Ex. 6 Sishencong He. 7 Shenmen
Ren 14 Juque He. 5 Tongli
Pe. 1 Tianchi Pe. 6 Neiguan
15.4.3 Cardiac Arrhythmia
Acupuncture treatment should be tried in cardiac arrhythmia. In psychogenic distur-

bances success is achieved with a short course of treatment.
Tachycardia Bradycardia
Du 20 Baihui Du 20 Baihui
He. 7 Shenmen He. 5 Tongli
Pe. 7 Daling Du 25 Suliao
Pe. 6 Neiguan Du 26 Renzhong
Pe. 4 Ximen
In tachycardia the treatment is sedative, while in bradycardia it is tonifying.

Moxibustion can be useful for concomitant deficiency symptoms.
15.4.4 Exhaustion Conditions in Heart Disease
Weakness symptoms such as tiredness, exhaustion, dyspnea on exertion, different

heart sensations, and depressive or anxious mood disorder are predominant in these
conditions. According to traditional ideas a disturbance of the heart is present. Defi-
ciency of other organ systems, e. g., the kidney or spleen system, is often diagnosed.
In these deficiencies of the organs moxibustion of important Shu and Mu points has a
tonifying effect. General tonification points are also helpful in such cases. Needling of
important points of the heart and pericardium channels has a harmonizing effect on
the psyche.

UB. 15 Xinshu
UB. 20 Pishu
UB. 21 Weishu
UB. 23 Shenshu
Ren 6 Qihai
St. 36 Zusanli
Ren 14 Juque
Ren 12 Zhongwan
GB. 25 Jingmen
Points for acupuncture

Du 20 Baihui
Ren 17 Shanzhong He. 7 Shenmen
Ren 14 Juque Pe. 6 Neiguan
15.4.5 Hypertension
According to traditional ideas an excess-type disturbance of the liver with a deficiency

of the kidney Yin and an excess of the kidney Yang is present in hypertension. Stimu-
lation of Liv. 3 Taichong, the Yuan point of the liver, balances this disturbance very ef-
fectively; since it causes a pronounced reduction in blood pressure patients should be
treated only in a lying position. Vigorous stimulation enhances the effect of the antihy-
pertensive treatment. During acupuncture treatment medication should be reduced
according to the blood pressure.
Du 20 Baihui
UB. 15 Xinshu LI. 11 Quchi Liv. 3 Taichong
GB. 20 Fengchi He. 7 Shenshu St. 36 Zusanli
Liv. 2 Xingjian
15.4.6 Hypotension
In hypotension many typical deficiency symptoms are present: dizziness, tiredness,

feeling of weakness, shivering, and cold feet and hands. The treatment is mostly based
on moxibustion of important tonification points.
UB. 23 Shenshu LI. 11 Quchi St. 36 Zusanli
Ren 6 Qihai LI. 10 Shousanli Ki. 7 Fuliu
Du. 12 Shenzhu
Du. 11 Shendao
Besides moxibustion needling of these points with a tonifying method is also indicated.
15.4.7 Disturbances of Peripheral Blood Supply
According to traditional medicine a stagnation of Qi and blood is present. There are a

number of possible reasons. Acupuncture treatment re-establishes the disturbed flow
of Qi and blood. Important homeostatic points, such as LI. 11 Quchi and St. 36 Zusanli,
together with the influential point for blood vessels Lu.9 Taiyuan and the extra points
28 and 36, Baxie and Bafeng, are effective. Vigorous manual stimulation is necessary.
Moxibustion can be useful, but burning, made more likely by reduced sensation, must
be avoided.
Du 20 Baihui
UB. 15 Xinshu Lu. 9 Taiyuan GB. 34 Yanglingquan
LI. 11 Quchi St. 36 Zusanli
He. 3 Shaohai Ex. 36 Bafeng
Ex. 28 Baxie
LI. 4 Hegu
Gastroenterological Disorders 283
15.5 Gastroenterological Disorders
Numerous gastroenterological disorders are successfully treated with acupuncture.

Especially in functional and psychosomatic disorders the treatment is very successful.
Because many functional systems include the digestive organs the possibilities of in-
fluencing the corresponding channels are very good. In gastroenterological disorders
too, the traditional diagnostic categories of excess and deficiency disturbances must be
differentiated. This differentiation is especially important for treatment. Excess-type
disturbances, e. g., gastritis or ulcers, are treated with vigorous needle manipulation
(sedative), while in deficiency-type disturbances moxibustion is indicated.
The following points are very effective in the treatment of gastrointestinal disorders:
1. St.36 Zusanli is the most important distal point for gastrointestinal disorders.
Personal studies have verified the spasmolytic effecIt of this point by gastroscopic
monitoring.
2. Pe.6 Neiguan has a specific effect on the upper digestive tract and is effective in
nausea, hiccup, and vomiting.
3. Alarm points are often used
Ren 12 Zhongwan for stomach
St. 25 Tianshu for large intestine
Ren 4 Guanyuan for small intestine
Liv. 6 Zhongdu for liver
Ex. 35 Dannang for gallbladder
Ex. 33 Lanwei for appendix
4. Shu points are useful in chronic disorders
UB. 21 Weishu stomach
UB. 20 Pishu spleen
UB.22 Sanjiaoshu Sanjiao
UB.18 Ganshu liver
UB. 19 Danshu gallbladder
Moxibustion is applied to the Shu and Mu points for the corresponding functional
systems.
15.5.1 Esophagitis, Dysphagia
In this disorder the excess-type symptoms such as burning, pain in the epigastrium and
dysphagia are predominant.
Du 20 Baihui
Ren 12 Zhongwan Pe. 6 Neiguan St. 36 Zusanli
Ren 14 Juque LI. 4 Hegu St. 44 Neiting
Ren 15 Jiuwei LI. 11 Quchi
Ren 22 Tiantu
UB.17 Geshu
15.5.2 Gastritis, Gastroenteritis
In acute gastritis, according to traditional criteria such excess-type symptoms as heart-

burn, feeling offullness, and acute pain in the epigastrium are predominant. In gastro-
enteritis fulminant intestinal symptoms often occur in addition. Sedative acupuncture
treatment harmonizes the stomach and digestive organs in a short time. In chronic gas-
tritis a deficiency-type disturbance with symptoms such as loss of appetite, general
tiredness, and a sensation of emptiness in the stomach area are present. In addition to
needling (tonification method) moxibustion is also indicated, especially at Shu and Mu
points on the stomach and spleen channels.
Du 20 Baihui
St. 21 Liangmen St. 34 Liangqiu
St. 25 Tianshu
UB. 21 Wei shu
Liv. 13 Zhangmen
Points for moxibustion in chronic deficiency-type disturbances of the digestive tract:

Shu points Mu points
UB. 21 Weishu Ren 12 Zhongwan St. 36 Zusanli
UB. 20 Pishu Liv. 13 Zhangmen
15.5.3 Gastric and Duodenal Ulcer
As in gastritis, differentiation of excess-type from deficiency-type symptoms according

to traditional criteria must precede treatment with a sedative or a tonifying method.
If there is acute and cramp-type pain in the hypochondriac area a disturbance of the
liver may be present; treatment should be at points Liv.14 Qimen and Liv.3 Taichong,
to harmonize the Qi of the liver.
Acute ulcer pain is generally attenuated after some hours. Acute pain is treated daily,
and two treatment sessions per week are then given until the ulcer is healed.
Du 20 Baihui
St. 21 Liangmen Pe. 6 Neiguan St. 36 Zusanli
St. 25 Tianshu Sp. 4 Gongsun
Ren 12 Zhongwan St. 44 Neiting
UB. 21 Weishu Liv. 3 Taichong
UB. 20 Pishu
Sp. 15 Daheng
Liv. 14 Qimen
Ren 6 Qihai
15.5.4 Diarrhea
The treatment of diarrhea has a long tradition in China. In early times it was known
that nutrition was one of the important causes. Diarrhea can also reflect either an
excess-type or a deficiency-type disturbance. In acute gastroenteritis (15.5.2) the diar-
rhea is of an excess type with a feeling of fullness and acute, sometimes cramping pain.
Vigorous manipulation of the needles, i. e., sedative treatment, brings about fast im-
provement.
Gastroenterological Disorders 285
In chronic diarrhea a deficiency-type disturbance of the spleen, and occasionally of the

kidney, is present. Moxibustion and tonifying treatment are indicated.
Important points for diarrhea are St. 37 Shangjuxu, the lower He point of the large in-
testine, St. 25 Tianshu, the Mu point of the large intestine, and Sp.4 Gongsun, the Luo
point of the spleen channel.
Du 20 Baihui
St. 25 Tianshu Pe. 6 Neiguan Sp. 4 Gongsun
UB. 25 Dachangshu LI. 11 Quchi St. 37 Shangjuxu
St. 29 Guilai LI. 4 Hegu St. 36 Zusanli
Ren 6 Qihai Sp. 6 Sanyinjiao
Ren 4 Guanyuan St. 39 Xiajuxu
Moxibustion in diarrhea with deficiency-type symptoms

St. 25 Tianshu LI. 11 Quchi Sp. 4 Gongsun
UB. 20 Pishu Sp. 6 Sanyinjiao
Liv. 13 Zhangmen St. 36 Zusanli
Ren 6 Qihai
Ren 4 Guanyuan
UB.23 Shenshu (in kidney-Yang deficiency)
Du 4 Mingmen
15.5.5 Irritable Bowel Disease
The symptoms vary and are characterized by various combinations of constipation

and/ or diarrhea, abdominal pain, sometimes mucus in the stool, flatulence, and vege-
tative symptoms. According to the symptoms three groups are differentiated: Spastic
colon with constipation, "emotional" diarrhea, and irritable bowel disease with alter-
nating constipation and diarrhea. Mental stress is very significant in the etiology of this
psychosomatic disorder.
As in other disorders of the digestive organs, the symptoms are differentiated accord-
ing to traditional diagnostic categories: Excess-type disturbances are apparent in acute
cramping pain, acute diarrhea, or spastic constipation.
Deficiency-type disturbances are characterized by chronic constipation or chronic di-
arrhea with weakness symptoms, such as dull pain, lack of appetite, tiredness, depres-
sive mood or anxiety state. Moxibustion is advisable in such cases, while in distur-
bances of the excess-type vigorous needling is indicated.
It is mostly the large intestine that is affected and therefore St. 37 Shangjuxu, the lower
He point of the large intestine, and St. 25 Tianshu, the Mu point of the large intestine,
are very important.
Du 20 Baihui
St. 25 Tianshu LI. 4 Hegu St. 37 Shangjuxu
St. 29 Guilai LI. 11 Quchi St. 36 Zusanli
Sp. 15 Daheng Sp. 4 Gongsun
UB. 25 Dachangshu
UB. 20 Pishu
Liv. 13 Zhangmen
In deficiency-type disturbances moxibustion of Mu and Shu points of the large intes-

tine, spleen, and sometimes stomach channels is indicated.
15.5.6 Constipation
As in irritable bowel disease, the points are selected according to the individual excess
or deficiency symptoms. The large intestine channel is also important for treatment.
SJ.6 Zhigou is a very effective point in chronic constipation.
Du 20 Baihui
St. 25 Tianshu SJ. 6 Zhigou St. 37 Shangjuxu
Sp. 15 Daheng LI. 11 Quchi St. 36 Zusanli
St. 29 Guilai Sp. 4 Gongsun
UB. 25 Dachangshu
In chronic deficiency-type disturbances moxibustion is indispensable in addition.
15.5.7 Hemorrhoids, Anal Fissure
Acupuncture is indicated for treatment of the acute physical symptoms in these disor-
ders. Vigorous stimulation, especially of the distal points, is very effective.
Du 20 Baihui
Du 1 Changqiang Du 26 Renzhong St. 36 Zusanli
Ren 1 Huiyin LI. 4 Hegu Sp. 6 Sanyinjiao
UB.32 Ciliao Du 28 Yinjiao St. 44 Neiting
UB. 54 Zhibian
UB.24 Qihaishu
15.5.8 Cholangitis, Cholecystitis, Biliary Dyskinesia, Biliary Colic
Disorders of the biliary ducts are effectively treated with acupuncture, which is indi-
cated especially in chronic and functional disorders. An excess-type disturbance of the
liver and gallbladder is usually present. In treatment important points on these chan-
nels are used together with the appropriate Shu and Mu points.
Du 20 Baihui
GB.24 Riyue LI. 4 Hegu GB. 34 Yanglingquan
Liv. 14 Qimen Pe. 6 Neiguan GB.37 Guangming
UB.19 Danshu Sp. 6 Sanyinjiao
UB. 18 Ganshu Liv. 3 Taichong
St. 21 Liangmen Ex. 35 Dannang
GB. 21 Jianjing St. 36 Zusanli
Liv. 6 Zhongdu
Mental Disturbances and Illnesses 287
15.5.9 Hepatitis
Hepatitis is treated in China with acupuncture and moxibustion. In western medicine

the therapeutic options are very limited, so that acupuncture treatment is advisable.
The transaminases drop significantly after 2-3 weeks in many cases. Disposable nee-
dles should be used for the treatment of hepatitis.
The Mu and Shu points of the digestive organs are important. According whether
excess or deficiency symptoms are present sedative or tonifying treatment is indicated.
Du 20 Baihui
Mu points Shu points

Liv. 14 Qimen UB. 18 Ganshu
GB. 24 Riyue UB. 19 Danshu
Liv. 13 Zhangmen UB.20 Pishu
Ren 12 Zhongwan UB. 21 Weishu
Additional points
St. 21 Liangmen Liv. 3 Taichong
Sp. 6 Sanyinjiao
St. 36 Zusanli
Liv. 6 Zhongdu
Ex. 35 Dannang
15.6 Mental Disturbances and Illnesses
In psychiatric centers in the People's Republic of China and also in western Europe
and America acupuncture treatment is increasingly being applied in mental illnesses.
Together with psychotherapy, acupuncture, with its various psychic and somatic ef-
fects, replaces medication.
Acupuncture has a mental harmonizing, sedative or tonifying effect. Especially acu-
puncture points of the Du Mai, heart, pericardium and gallbladder channels have psy-
chological effects.
In many mental disturbances additional organ systems are affected. These organs are
treated by stimulation of the points of the corresponding channels together with im-
portant points for mental disturbances.
The following points are selected most frequently:
Du 20 Baihui the governing point of the Du Mai.
Ex. 6 Sishencong with pronounced psychological effect.
He. 7 Shenmen Yuan and sedative point of the heart channel.
Pe.6 Neiguan Luo point of the pericardium channel.
VB.62 Shenmai with harmonizing effect.
VB.15 Xinshu the Shu point of the heart channel.
Acupuncture treatment is very effective in a large number of psychosomatic disorders,
such as agitation or exhaustion conditions, insomnia, sexual disturbances, drug addic-
tions, obesity and headache; this has been documented by many clinical trials.
15.6.1 Depression
In western medicine the spectrum of depressive illness extends from reactive to en-
dogenous depression. According to the diagnosis, treatment with psychotherapy or an-
tidepressive drugs is possible. The number of depressive patients is increasing.
In Chinese medicine depressive disorders are described as a disturbance of the kidney
Qi, and thus as a deficiency (Xie) of the kidney Yang. The Chinese understanding of
the kidney is mainly based on its function and includes the function of the urogenital
system in general, but also the function of the adrenal gland. The function of the will is
the psychological correlate. The forces of the "ego" are determined by the kidney Qi.
Deficiency of the kidney Yang means a weakened ego.
The symptoms of a kidney Yang deficiency are characterized by pallor, excessive feel-
ing of cold, cold feet and hands, tiredness, reduced activity, lack of energy, and de-
pressed mood. In the case of more severe deficiency disturbances somatic symptoms
are predominant, such as pronounced feelings of cold in the lumbar region, rigidity of
the lower back, lumbar pain and sciatica, and reduced libido or impotence. Often
chronic urinary infections occur, caused by a reduced immune response. Diminished
energy, lack of drive, and withdrawal from the environment are additional mental
symptoms.
Moxibustion is the major treatment method, and the indirect methods with moxa ci-
gars or with moxa cones on slices of ginger are preferred. Moxibustion can be carried
out by the patients following demonstration of the method by the doctor. This gives the
patients the feeling that they are able to do something for their own health rather than
passively having treatment administered by the physician, and this in itself has a posi-
tive influence.
The selection of points for moxibustion is dependent on the individual symptoms. The
following points have shown their effectiveness in daily practice:
VB. 23 Shenshu Shu point of the kidney
GB. 25 Jingmen Mu point of the kidney
Ren 6 Qihai "Sea of energy," important general tonification point
Ren 4 Guanyuan "Enclosed source energy," important tonification point
Ren 8 Shenque Navel, important tonification point for moxibustion
Ki. 7 Fuliu Tonification point of the kidney channel
Ki. 8 Jiaoxin Enhances the effect of Ki. 7 Fuliu
Sp. 6 Sanyinjiao "Junction of the 3 Yin channels," spleen, kidney and liver,
important general tonification point
In some cases with a pronounced deficiency-type disturbance the following additional

points are useful:
St. 36 Zusanli general tonification point
Liv. 8 Ququan tonification point of the liver channel
Lu. 9 Taiyuan tonification point of the lung channel
LI. 11 Quchi tonification point of the large intestine channel
Agitated patients with nervousness and restlessness are sedated by stimulation of

points on the heart channel. Further harmonizing points of the Du Mai and pericar-
dium channel are added.
Acupuncture of the following points

Du 20 Baihui
He. 5 Tongli
Pe. 6 Neiguan
15.6.2 Exhaustion Conditions
Typical somatic weakness symptoms such as lack of energy, tiredness, reduced activity,
dizziness, and sensitivity to cold are predominant in this disorder. Since they dictate
the basic disorder, the weakened organs should be determined. As in depressive illness,
the kidney Yang is often weakened. Other organs are also often affected by deficiency
states. The basic treatment is moxibustion, which could be combined with acu-
puncture.
Moxibustion
UB.23 Shenshu LI. 11 Quchi Ki. 7 Fuliu
UB. 22 Sanjiaoshu SJ. 3 Zhongzhu Sp. 6 Sanyinjiao
GB. 25 Jingmen Lu. 9 Taiyuan St. 36 Zusanli
Ren 6 Qihai
Du 4 Mingmen
Acupuncture
Du 20 Baihui
Du 14 Dazhui He. 7 Shenmen St. 36 Zusanli
UB. 15 Xinshu Pe. 6 Neiguan Sp. 6 Sanyinjiao
Ren 6 Qihai
15.6.3 Agitation
Agitation, according to traditional criteria, is interpreted as an excess-type disturbance
of the heart, or sometimes of the liver. Acupuncture can have a significant sedative ef-
fect even after only one session. Only a few treatments are necessary for the achieve-
ment of a lasting harmonizing effect with no side effects.
Du 20 Baihui
Ex. 6 Sishencong He. 7 Shenmen Liv. 3 Taichong
UB. 15 Xinshu Pe. 6 Neiguan UB. 62 Shenmai
15.6.4 Sleep Disturbances
Sleep disturbances may have various causes and occur in different types. According to
traditional criteria of diagnosis an excess-type disturbance of the heart is present. Defi-
ciency-type conditions, for example of the kidney, can also cause sleep disturbances.
The additional symptoms, such as internal agitation, nervousness, lack of concentra-
tion, tiredness, and various vegetative physical symptoms, are related to other dis-
turbed organ systems. They are treated with acupuncture or, in the case of a deficiency,
with moxibustion. The major points for sleep disturbance are completed with two spe-
cific extra points, Ex.8 Anmian I and Ex.9 Anmian II. Anmian in Chinese means
"sleep well."
Mter a few acupuncture sessions the hypnotics taken by most of these patients can be
discontinued.
Du 20 Baihui
Ex. 6 Sishencong He. 7 Shenmen UB. 62 Shenmai
Ex. 8 Anmian I Pe. 6 Neiguan Sp. 6 Sanyinjiao
Ex. 9 Anmian II
Ex. 1 Yintang
Moxibustion in deficiency-type disturbances
UB. 23 Shenshu LI. 11 Quchi Sp. 6 Sanyinjiao
UB. 22 Sanjiaoshu Ki. 7 Fuliu
Ren 6 Qihai Ki. 8 Jiaoxin
15.6.5 Schizophrenia
In China, psychoses, e. g., schizophrenia, are treated with acupuncture. Sedative or

tonifying treatment is emphasized depending on whether agitation/anxiety or depres-
sion is more prominent. At the center of treatment are the heart channel and the Du
Mai, the governing vessel, with its harmonizing effect.
Du 20 Baihui
Ex. 6 Sishencong He. 7 Shenmen UB. 62 Shenmai
Du 26 Renzhong He. 5 Tongli GB. 34 Yanglingquan
Du 13 Taodao Pe. 6 Neiguan
Du 14 Dazhui
15.6.6 Drug Addiction
Acupuncture treatment for patients addicted to opiates was started in Hong Kong in
the 1960s. Surprisingly, these patients had no withdrawal symptoms in the acute phase.
At first no explanation could be found for this. Then, in 1979, raised levels of endor-
phins were demonstrated in heroin addicts treated with acupuncture. Acupuncture
treatment in drug addiction, besides not causing withdrawal symptoms, also has a psy-
chologically harmonizing and stabilizing effect. Nevertheless, the success of treatment
is dependent on the therapeutic circumstances, the attendant psychotherapeutic mea-
sures, and the social conditions.
Both body acupuncture and specific ear acupuncture points are used for drug addic-
tion. In particular, the points Ear Shenmen, Ear lung, and Ear heart are very effective.
In deficiency-type disturbances moxibustion is indicated in addition.
Du 20 Baihui
Du 14 Dazhui He. 7 Shenmen St. 36 Zusanli
Ear point 55 Shenmen Pe. 6 Neiguan GB. 34 Yanglingquan
Ear point 101 lung LI. 4 Hegu Liv. 3 Taichong
Ear point 100 heart SJ. 5 Waiguan
15.6.7 Alcohol Addiction

Acupuncture treatment is successful in alcoholism, owing to its psychologically stabi-
lizing effect. Especially in addictions, the therapeutic circumstances and the social con-
ditions are very important for the success of treatment. It is mostly the organ systems
stomach-spleen and liver-gallbladder that are disturbed. Points on the heart channel
have a sedative effect, and the specific ear points relieve the withdrawal symptoms.
Du 20 Baihui
Ren 12 Zhongwan He. 7 Shenmen St. 36 Zusanli
Liv. 13 Zhangmen Pe. 6 Neiguan GB. 34 Yanglingquan
Liv. 14 Qimen Liv. 3 Taichong
Ear point 55 Shenmen
Ear point 84 mouth
Ear point 87 stomach
Ear point 98 liver
15.6.8 Nicotine Addiction
Acupuncture treatment is also very effective in patients who wish to discontinue smok-
ing. The withdrawal symptoms, such as internal agitation, nervousness, excessive
appetite, desire for cigarettes, but also sweating, palpitation, and further vegetative
physical symptoms, are relieved by acupuncture. As in all drug addictions patient mo-
tivation is important for the success of treatment. Mter patients have discontinued
smoking, they are treated two or three times per week, for four or five sessions. During
this time a surprising mental stabilization often occurs. In treatment aimed at discon-
tinuation of smoking stimulation of a combination of points, with special emphasis on
ear points, is indicated.
Du 20 Baihui
Du 14 Dazhui Pe. 6 Neiguan
Ear point 55 Shenmen
Ear point 101 lung
Ear point 87 stomach and
Ear point 91 large intestine (in excessive appetite or constipation)
15.6.9 Overweight, Weight Loss

Acupuncture regulates the appetite and thus reduces excessive appetite. According to
traditional criteria overweight patients are always characterized by deficiency-type dis-
turbances, most frequently of the stomach-spleen system but in some cases even of the
kidney. Excessive appetite is an expression of a weakened spleen-stomach system.
Therefore, moxibustion is indicated in weight loss in addition.
Treatment of overweight is most effective when accompanied by a course of fasting for
1-2 weeks. During this time the patient should drink 3-4 liters of fluids per day. Mter
fasting the patient can change his or her nutritional habits and adopt a healthy diet
much more easily. An individual dietetic consultation is of decisive importance for
long-term success of the treatment. Acupuncture treatment should be given two or
three times per week, and six to eight times altogether. The specific ear points abre es-
pecially effective.
Du 20 Baihui
Ren 12 Zhongwan He. 7 Shenmen St. 36 Zusanli
Ear point 55 Shenmen Pe. 6 Neiguan Liv. 3 Taichong
Ear point 87 stomach
Ear point 84 mouth
Moxibustion in weakness symptoms
Shu points Mu points Additional points
UB. 20 Pishu Liv. 13 Zhangmen LI. 11 Quchi
UB. 21 Wei shu Ren 12 Zhongwan St. 36 Zusanli
UB. 23 Shenshu GB. 25 Jingmen Ki. 7 Fuliu
Sp. 6 Sanyinjiao
15.6.10 Sexual Disturbances

According to traditional ideas most sexual disturbances result from a weakness of the
kidney Yang. Kidney Yang also used to be called "Gate of Life," and the ancient Chi-
nese therefore referred to weakness of the "Fire at the Gate of Life." There are some-
times concomitant disturbances of the liver and spleen. Typical symptoms, such as ner-
vousness, internal agitation, and restlessness, which indicate a disturbance of the heart
are often found.
Du 20 Baihui
Ren 3 Zhongji He. 7 Shenmen Sp. 6 Sanyinjiao
Ren 4 Guanyuan Liv. 8 Ququan
Ren 6 Qihai Liv. 3 Taichong
UB. 23 Shenshu Ki. 7 Fuliu
Du 4 Mingmen
15.7 Neurologic Disorders
Acupuncture shows a good effect especially in migraine, chronic headache, and

trigeminal neuralgia. In these illnesses acupuncture is significantly more beneficial
than other therapeutic measures. In patients with migraine and trigeminal neuralgia,
even of some decades' duration, acupuncture treatment relieves the pain for years. The
sensational successes achieved in these conditions have enhanced the spread of acu-
puncture in the west. Even in paralyses acupuncture treatment improves the function
of movement, which cannot be achieved with other forms of treatment. In epilepsy
acupuncture has a surprising anticonvulsive effect in acute attacks. It is even possible
to reduce the relapse rate.
15.7.1 Headache and Migraine
Headache and migraine are the main neurologic indications for therapeutic acupunc-
ture. According to traditional ideas chronic headache and migraine are attributed to a
blockage ofQi in the Yang channels of the head. The blockages and therefore the pain
are mostly caused by an internal disturbance of organs and channels, and rarely by ex-
ternal influences caused by weather factors. According to the character of the pain,
excess- or deficiency-type disturbances may be present. The location of pain is very im-
portant for the planning of an individual acupuncture treatment. According to the tra-
ditional concept of Chinese medicine the location and radiation of pain can be divided
into four major groups depending on the channels affected:
- Pain along the gallbladder channel, with most pain in the area of GB.14 Yangbai
above the eyes or GB.20 Fengchi in the neck. Because the pain is localized on the
Sanjiao-gallbladder axis this headache is called Shao-Yang type headache.
Accounting for 40%-50% of headaches, the Shao-Yang type is the most frequent.
Stimulation of distal points on the Sanjiao and gallbladder channels is indicated.
Headache of Shao-Yang type

Du 20 Baihui
GB. 14 Yangbai SJ. 5 Waiguan GB. 41 Foot Linqi
GB. 20 Fengchi LI. 4 Hegu
- Pain in the area of the temple, with most pain in the region of St. 8 Touwei, is related
to the stomach channel. Such headaches are called Yang-Ming type headaches and
are treated with distal points of the large intestine and stomach channels.
Headache of Yang-Ming type

Du 20 Baihui
St. 8 Touwei LI. 4 Hegu St. 44 Neiting
GB. 4 Hanyan LI. 11 Quchi St. 36 Zusanli
- Pain along the urinary bladder channel, with most pain in the area of UB. 2 Zanzhu
between the eyebrows or UB.10 Tianzhu in the neck is called Tai-Yang type head-
ache. Stimulation of distal points on the small intestine and urinary bladder chan-
nels is indicated.
Neurologic Disorders 293
Headache of Tai-Yang type

Du 20 Baihui
UB. 2 Zanzhu SI. 3 Houxi UB. 60 Kunlun
UB. 10 Tianshu LI. 4 Hegu UB. 67 Zhiyin
Pain in the area of vertex Du 20 Baihui is related to the liver channel. According to
traditional ideas an internal connection passes from the liver channel to the point
Du 20 Baihui at the vertex. Treatment at distal points of the liver channel is
indicated.
Headache in disturbance of the liver functions
Du 20 Baihui
Ex. 6 Sishencong LI. 4 Hegu Liv. 3 Taichong
Liv. 2 Xingjian
GB. 34 Yanglingquan
Head pains in different regions are also divided into frontal, temporal, parietal, and
occipital headaches by many authors. Then the following points are selected:
Frontal headache
Du 20 Baihui
Du 23 Shangxing LI. 4 Hegu S1. 44 N eiting
S1. 8 Touwei GB. 34 Yanglingquan
GB. 14 Yangbai
Ex. 1 Yintang
Ex. 2 Taiyang
Ah-Shi points
Ternporalheadache
Du 20 Baihui
Ex. 6 Sishencong SJ. 5 Waiguan S1. 44 Neiting
S1. 8 Touwei LI. 4 Hegu GB. 41 Foot Linqi
GB. 8 Shuaigu GB. 34 Yanglingquan
SJ. 23 Sizhukong
Ah-Shi points
Parietal headache
Du 20 Baihui
Ex. 6 Sishencong LI. 4 Hegu
S1. 8 Touwei SJ. 3 Zhongzhu
GB. 8 Shuaigu SJ. 5 Waiguan
Ah-Shi points
Occipital headache
Du 20 Baihui
Ex. 6 Sishencong Lu. 7 Lieque UB. 60 Kunlun
GB. 20 Fengchi LI. 4 Hegu
UB. 10 Tianzhu
Ah-Shi points
15.7.2 Trigeminal Neuralgia
Trigeminal neuralgia is one of the disorders with the most severe pain. The results with
medication are often unsatisfactory. According to traditional ideas trigeminal neural-
gia is the result of a blockage of Qi caused by wind, cold, or heat, together with pro-
nounced internal disturbances of the liver and stomach energy. These organs may be
either in an excess state, with heat symptoms and acute burning pain, or in a deficiency
state, with dull nagging pain. If periodic or moving pains occur in attacks, a wind dis-
turbance is present. The weather factors, such as heat and wind, also describe the quali-
ties of pain. In the treatment of trigeminal neuralgia a large number of points in the
face (10-12) are needled; they should be manually stimulated over and over again, for
sedative or, rarely, tonifying stimulation. Distal points, especially LI.4 Hegu, are vigor-
ously stimulated by hand. At first severe cases are treated daily and the needles are left
in for 30-60 min. In severe acute pain only the contralateral side of the face should be
needled, because the pain might be increased by needling on the painful side. After the
acute pain has abated, usually after three or four sessions, the painful side can be
needled, first of all with a few needles and then with a gradually increasing number of
needles. The intensity of stimulus given by manual needle manipulation is also slowly
increased. In the majority of the cases the first alleviation of pain is experienced after
four to six sessions. From this time onward drug treatment can be slowly reduced. For
a significant pain reduction it is generally necessary to treat for a further 15-20 ses-
sions. After a course of treatment the patients are mostly painfree for several years.
When trigeminal pain recurs a new course of treatment with fewer sessions should be
administered. According to the location of pain the following points are selected:
Pain in the area of N.ophthalmicus V 1

Du 20 Baihui
GB. 14 Yangbai LI. 4 Hegu St. 44 Neiting
Ex. 2 Taiyang SJ. 5 Waiguan Liv. 3 Taichong
UB. 2 Zanzhu St. 36 Zusanli
Pain in the area of N. maxillaris V 2

Du 20 Baihui
St. 2 Sibai LI. 4 Hegu St. 44 Neiting
St. 3 Juliao SJ. 5 Waiguan Liv. 3 Taichong
SI. 18 Quanliao St. 36 Zusanli
Du 26 Renzhong
St. 7 Xiaguan
LI. 20 Yingxiang
Pain in the area of N. mandibularis V 3

Du 20 Baihui
St. 4 Dicang LI. 4 Hegu St. 44 Neiting
St. 6 Jiache SJ. 5 Waiguan Liv. 3 Taichong
St. 7 Xiaguan St. 36 Zusanli
Ren 24 Chengjiang
Ex. 5 Jiachengjiang
Neurologic Disorders 295
15.7.3 Hemiparesis
The treatment of hemiparesis occupies a major place in acupuncture clinics in China.

Hemiparesis after a cerebral insult has a better prognosis than does posttraumatic
hemiparesis. According to Chinese doctors paresis after poliomyelitis can also be treat-
ed successfully. My own experience in the treatment of spastic paresis shows a signifi-
cant reduction of the spasm in 30% of patients. Most treatment of paresis with physio-
therapy is unsatisfactory, and therefore primary acupuncture treatment is advisable.
Early treatment of paresis after cerebral palsy has especially good results. Even in pa-
resis of a long duration amazing improvements are often achieved.
In paresis, according to Chinese ideas a pronounced weakness disturbance is present,
accompanied by a blockage of Qi and blood. The large intestine and stomach channels
are primarily affected, i.e., the Yang-Ming, so that points on the large intestine and
stomnach channels are mostly indicated, with deep needling into the muscles. To in-
crease the level of stimulus, the needles are manipulated at low frequencies. Electrical
stimulation intensifies the effect of acupuncture and counteracts muscular athropy.
Moxibustion is also useful in pronounced cold and weakness symptoms, and provides
supplementary tonification for the weakened patient.
In the treatment of paresis acupuncture is carried out for two to three cycles of treat-
ment, each of 10-12 sessions. If there is no success of treatment after this, 10-15
sessions of scalp acupuncture should be tried. Acupuncture treatment is combined
with physiotherapy, which strengthens the muscles and avoids contraction.
Hemiparesis of the arms

Du 20 Baihui
Ex. 6 Sishencong GB. 34 Yanglingquan
LI. 15 Jianyu
LI. 11 Quchi
LI. 10 Shousanli
LI. 4 Hegu
Ex. 28 Baxie
SJ. 14 Jianliao
SJ. 5 Waiguan
SJ. 3 Zhongzhu
Hemiparesis of the legs

Du 20 Baihui
Ex. 6 Sishencong GB. 30 Huantiao
St. 31 Biguan GB. 34 Yanglingquan
St. 32 Femur Futu GB. 37 Guangming
St. 36 Zusanli GB. 40 Qiuxu
St. 37 Shangjuxu
St. 40 Fenglong
St. 41 Jiexi
St. 44 Neiting
Ex. 36 Bafeng

Ren 6 Qihai LI. 10 Shousanli St. 36 Zusanli
Ren 4 Guanyuan LI. 11 Quchi Sp. 6 Sanyinjiao
UB. 23 Shenshu SJ. 5 Waiguan St. 41 Jiexi
UB. 25 Dachangshu
15.7.4 Facial Paresis
In acupuncture treatment of facial paresis remissions have been achieved in many

cases. Electrical stimulation with low frequencies of 3-10 Hz intensifies the effect of
needling. The local points are selected only on the affected side, while the distal points
are needled on both.
Du 20 Baihui
Ex. 6 Sishencong LI. 4 Hegu GB.34 Yanglingquan
GB.14 Yangbai LI. 11 Quchi St. 36 Zusanli
Ex. 2 Taiyang St. 44 Neiting
St. 2 Sibai
St. 3 Jupliao
St. 4 Dicang
St. 5 Daying
St. 7 Xiaguan
SI. 18 Quanliao
Ex. 5 Jiachengjiang
15.7.5 Epilepsy
In the west, epilepsy is seldom treated with acupuncture, although acupuncture treat-
ment has good anticonvulsive effects. In the treatment of acute attacks, especially the
anticonvulsive effect is distinct. Needling or pronounced acupressure with the finger-
nail leads to interruption of the convulsion within seconds in a high percentage of
cases. Especially in acute attacks the point Dn 26 Renzhong on the upper lip is effective
in 80%-90% of patients, which is verified by research results. If there is no needle on
hand, heavy pressure with the nail of index finger or thumb brings the epileptic fit to an
end. In emergency a thin disposable cannula can be also used.
Besides the treatment of acute attacks a long-term treatment is effective in the interval
between epileptic attacks. Medication should first be continued until constant freedom
from attacks is obtained, and then slowly reduced in consultation with the attending
neurologist.
Treatment of attacks
Dn 26 Renzhong
Treatment in interval between epileptic attacks

Du 20 Baihui
Ex. 6 Sishencong He. 7 Shenmen Ki. 1 Yongquan
Ex. 1 Yintang Pe. 6 Neiguan VB. 62 Shenmai
Du 26 Renzhong GB.34 Yanglingquan
Gynecological Disorders 297
15.8 Gynecological Disorders
The major indications in the field of gynecology are painful disorders of the pelvic or-
gans and functional physical symptoms. According to traditional medicine the genital
organs are related to the kidney system. The liver channel is also important, because it
passes along the genital area. The Ren Mai, also called conceptional vessel, is closely
related to the genital organs. Therefore gynecological disorders are treated with stimu-
lation of points on the kidney and liver channels, Ren Mai, and Du Mai. The differen-
tiation into excess- or deficiency-type disturbances is very important for the success of
treatment, determining whether the emphasis should be on needle treatment or moxi-
bustion. Many disorders are caused by deficiency-type disturbances, of the kidney sys-
tem for example, so that moxibustion is often indicated.
15.8.1 Dysmenorrhea
According to traditional ideas either an excess-type disturbance with cramp-type pain

is present, which increases on pressure or warmth and radiates into the legs or the back,
or a deficiency-type disturbance. A deficiency disturbance is characterized by dull pain
during or after menstruation, which is relieved by warmth and pressure. Dizziness,
tiredness, or sensitivity to cold may also be present. In excess-type disturbances the
blockage of Qi and blood is treated with strong stimulation, i. e., a sedative method. In
the deficiency-type disturbance, besides needling, moxibustion of Mu and Shu points
of the kidney is indicated, but not during heavy menstrual bleeding.
Du 20 Baihui
Ren 3 Zhongji LI. 4 Hegu Sp. 6 Sanyinjiao
Ren 6 Qihai Sp. 10 Xuehai
Ren 4 Guanyuan Liv. 3 Taichong
St. 36 Zusanli
Moxibustion in deficiency disturbance
VB. 23 Shenshu GB. 25 Jingmen Sp. 6 Sanyinjiao
VB.20 Pishu Liv. 13 Zhangmen Ki. 7 Fuliu
Ren 4 Guanyuan St. 36 Zusanli
Ren 6 Qihai
15.8.2 Amenorrhea
In China amenorrhea is also treated with acupuncture and moxibustion. The amenor-
rhea is regarded as rigidity or "exhaustion" of the blood due to a weakness of the liver,
spleen, or kidney. Therefore moxibustion should be applied.

VB. 23 Shenshu Sp. 6 Sanyinjiao
VB. 20 Pishu St. 36 Zusanli
VB. 18 Ganshu
Ren 3 Zhongji
Ren 2 Qugu
St. 29 Guilai
Additional points
Ren 3 Zhongji Sp. 6 Sanyinjiao
St. 29 Guilai Liv.2 Xingjian
Du 4 Mingmen St. 36 Zusanli
15.8.3 Adnexitis, Salpingitis
In this disorder, besides chemotherapy, acupuncture relieves the pain and shortens the
course of the illness.
Du 20 Baihui
Ren 4 Ouanyuan LI. 11 Quchi Sp. 6 Sanyinjiao
St. 29 Ouilai LI. 4 Hegu Sp.10 Xuehai
UB. 23 Shenshu St. 36 Zusanli
OB. 26 Daimai
UB. 31 Shangliao
UB. 32 Ciliao
In chronic inflammations of the pelvic organs with typical weakness symptoms with-
out distinct and acute inflammatory signs moxibustion is applied.
Moxibustion in chronic weakness symptoms
UB. 23 Shenshu Sp. 6 Sanyinjiao
OB. 25 Jingmen Ki. 7 Fuliu
UB. 18 Oanshu St. 36 Zusanli
Ren 6 Qihai
Ren 4 Ouanyuan
15.8.4 Pain Caused by Gynecological Tumors
Acupuncture, because of its good analgesic effects, is indicated in tumor pain of the
pelvic region. Acupuncture is especially advisable, because the general condition is
mostly poor and acupuncture has no side effects as strong analgesic drugs do. In severe
pain electrical stimulation with changing impulses is very effective.
Du 20 Baihui
Ren 4 Ouanyuan LI. 4 Hegu Sp. 6 Sanyinjiao
Du 3 Yaoyangguan LI. 11 Quchi St. 44 N eiting
VB. 23 Shenshu
UB. 25 Dachangshu
Tonifying with moxibustion in poor general condition
UB. 23 Shenshu Sp. 6 Sanyinjiao
OB. 25 Jingmen St. 36 Zusanli
UB. 26- UB. 30 UB. 40 Weizhong
Ren 6 Qihai
15.8.5 Pruritus Vulvae
According to traditional medicine an excess-type disturbance of the liver is the reason

for this condition. Vigorous stimulation, a sedative method, alleviates the itching very
effectively.
Du 20 Baihui
Ex. 6 Sishencong LI. 11 Quchi Liv. 2 Xingjian
Ren 2 Qugu LI. 4 Hegu Sp. 6 Sanyinjiao
Ren 1 Huiyin Sp. 10 Xuehai
Du 1 Changqiang
Du 26 Renzhong
UB. 16 Dushu
Gynecological Disorders 299
In skin disorders of the genital area laser radiation of the affected area is very effective.
In the case of a psychological genesis of the pruritus stimulation of He. 7 Shenmen or
UB. 62 Shenmai is indicated in addition.
15.8.6 Hyperemesis Gravidarum
In pregnancy acupuncture is only used after consideration of important principles, be-

cause stimulation of certain acupuncture points can cause abortion. Points on the
spleen, liver, and kidney channels on the leg and points in the area of the middle and
lower abdomen must on no account be needled. Treatment of other illnesses in preg-
nancy should also take account of contraindications. During pregnancy the nOeedles are
manipulated only gently.
In hyperemesis, according to traditional ideas, a deficiency-type disturbance of the
stomach energy is present. Stimulation of St. 36 Zusanli calms the "rising Qi of the
stomach."
Acupuncture Points in Hyperemesis

Du 20 Baihui
Ren 16 Zhongting He. 7 Shenmen
Moxibustion of important tonification points is indicated in addition for cold or

weakness symptoms.
15.8.7 Analgesia During Childbirth
Acupuncture significantly relieves the pain of childbirth. The duration of labor is also
significantly reduced. In the case of weakness of uterine contractions acupuncture in-
creases the activity of the uterus. Episiostomy and subsequent suture of the perineum
can also be carried out with acupuncture analgesia. Besides the analgesic and mentally
relaxing effect improved cooperation of the mother frequently seen. The reduced use
of narcotics is advantageous for the newborn.
In acupuncture for analgesia during childbirth local points in the area of the lower ab-
domen or back are combined with important distal points. The distal points Sp.6
Sanyinjiao and Neima, on the inner side of the leg, are needled unilaterally, which
does not obstruct the obstetrician. LI. 4 Hegu, on the hand, is repeatedly stimulated by
hand. The distal points of the leg are also used, and in severe low back pain electrical
stimulation is also applied at these points. Electrical stimulation increases the analgesic
effect of acupuncture.
Du 20 Baihui
St. 29 Guilai LI. 4 Hegu Sp. 6 Sanyinjiao
Ren 4 Guanyuan He. 7 Shenmen Extra-Neima
Du 2 Yaoshu Liv. 3 Taichong
Du 6 Jizhong St. 36 Zusanli
GB.21 Jianjing UB. 67 Zhiyin
Generally two local points and two distal points on the arms and on the legs are
selected. In severe pain the stimulation can be more intense and more needles can be
used.
15.8.8 Deficient Lactation
There are many possible causes of deficient lactation. According to traditional ideas a
deficiency of Qi and blood is present, and also a deficiency of the liver, mostly in the
presence of mental lability or depression. Moxibustion is often indicated.
Du 20 Baihui
Ren 17 Shanzhong SI. 1 Shaoze GB. 41 Foot Linqi
St. 18 Rugen LI. 4 Hegu St. 36 Zusanli
UB. 18 Ganshu Sp. 6 Sanyinjiao
UB. 20 Pishu
Moxibustion in deficient lactation

UB. 18 Ganshu LI. 11 Quchi St. 36 Zusanli
UB. 20 Pishu Sp. 6 Sanyinjiao
15.9 Urological Disorders
A wide spectrum of urological disorders constitute indications for acupuncture. Espe-

cially in chronic inflammation with skin irritation and in functional disturbances of the
urogenital area acupuncture treatment is very effective.
According to traditional ideas the kidney system, besides the renal functions, includes
the urogenital functions. In urological disorders a deficiency of the kidney system is
usually present, accompanied by reduced activity, tiredness, lack of energy, cold feet,
feeling cold in the lumbar region, low resistance, and lack oflibido. In some cases there
are infections of the urogenital region. In the psychic field weakness of willpower and
withdrawal from the environment caused by fear are predominant.
Urological disorders are treated with points on the urinary bladder channel. At the
same time points on the Ren Mai, spleen channel, and Du Mai are selected.
Important points for urological disorders:

- Sp. 6 Sanyinjiao, the meeting point of the three Yin channels, spleen, kidney and
liver, is the most important distal point for the urogenital system.
- Liv.3 Taichong, the Yuan point, is a further distal point, because the liver channel
passes through the genital region.
- UB.23 Shenshu is the Shu point of the kidney. In kidney disturbances the organ can
be directly influenced by way of this point.
- Ren 3 Zhongji is the Mu point, or alarm point, of the urinary bladder, and as a local
point very important in treatment of the urinary bladder.
- Ren 6 Qihai is a important general tonification point, affecting the urogenital system
in particular. Moxibustion is very effective in deficiency disturbances.
Urological Disorders 301
15.9.1 Pyelonephritis, Urinary Infections, Chronic Glomerulonephritis
In these disorders, according to the traditional classification of symptoms, a kidney

Yang deficiency is present. The symptoms caused by inflammation, such as burning,
acute pain, and fever are an expression of an excess or heat disturbance of the urinary
bladder. During treatment the kidney must be strengthened with moxibustion. Needle
treatment is used in addition to alleviate the acute excess-type symptoms of the urinary
bladder channel. In urinary infections acupuncture is combined with the appropriate
medication, to control the acute inflammation. Acupuncture and moxibustion, be-
cause of their immune-enhancing effect, abolish the relapsing character of urinary in-
fections, so that a chronic course can often be avoided.
UB. 23 Shenshu LI. 11 Quchi Ki. 7 Fuliu
GB.25 Jingmen Ki. 8 Jiaoxin
Du 4 Mingmen Sp. 6 Sanyinjiao
UB. 28 Pangguangshu Liv. 8 Ququan
UB. 25 Dachangshu
Ren 4 Guanyuan
Ren 6 Qihai
Points for acupuncture

Du 20 Baihui
Ren 3 Zhongji LI. 4 Hegu Ki. 3 Taixi
UB. 23 Shenshu LI. 11 Quchi Liv. 3 Taichong
In oliguria too, according to traditional diagnosis, a pronounced deficiency distur-

bance of the kidney system is present. Acupuncture treatment and moxibustion should
be tried.
15.9.2 Renal Colic
The acute pain of colic is significantly relieved by acupuncture. According to tradi-

tional ideas an excess-type state with a blockage of Qi is present. Sedative treatment,
with vigorous stimulation especially of the distal points, is indicated.
Du 20 Baihui
UB. 23 Shenshu LI. 4 Hegu Ki. 5 Shuiquan
UB. 28 Pangguangshu Ki. 3 Taixi
UB. 32 Ciliao UB. 40 Weizhong
UB. 54 Zhibian
15.9.3 Prostatitis, Psychogenic Urological Symptoms
In these chronic irritations, according to traditional ideas, a heat and damp distur-
bance of the kidney and urinary bladder system is present. Differentiation into excess-
or deficiency-type categories dictates whether sedative or tonifying treatment is indi-
cated. Acupuncture treatment is especially successful in predominantly psychosomatic
conditions, which are resistant to other forms of treatment.
Du 20 Baihui
Ren 3 Zhongji LI. 4 Hegu Sp. 6 Sanyinjiao
Ren 4 Guanyuan Ki. 5 Shuiquan

VB. 23 Shenshu VB.63 Jinmen
VB. 28 Pangguangshu
In weakness symptoms moxibustion is indicated in addition.
15.9.4 Impotence and Male Fertility Disorders
Impotence has been treated with acupuncture since ancient times in China. Impotence
is interpreted as a weakness of the kidney Yang, and also as "faded Yang"; the Chinese
call it a deficiency of "Fire at the Gate of Life." Disturbances of the heart and spleen
may be present in addition, if patients complain of nervousness, sleep disturbance, and
gastrointestinal symptoms.
In China male fertility disorders are also treated with acupuncture. Recent research
studies from Vienna show a significant increase in the number and in the basic and
subsequent motility of spermatozoa in sub fertile men.
Du 20 Baihui
Ren 3 Zhongji He. 7 Shenmen Sp. 6 Sanyinjiao
Ren 4 Guanyuan LI. 5 Yangxi Ki. 3 Taixi
Ren 6 Qihai Liv. 8 Ququan
Du 4 Mingmen St. 36 Zusanli
VB. 23 Shenshu
St. 30 Qichong
VB. 15 Xinshu
Moxibustion
VB. 23 Shenshu Liv. 8 Ququan
Du 4 Mingmen Sp. 6 Sanyinjiao
Ren 6 Qihai Ki. 7 Fuliu
15.9.5 Enuresis
Enuresis is traditionally ascribed to a weakness of the kidney Qi. There are many possi-
ble causes, mostly psychogenic, e. g., anxiety. Treatment with moxibustion strengthens
the kidney Qi. Acupuncture with a tonifying technique is indicated in older children or
adolescents. In infants moxibustion and laser treatment should be tried.

VB. 23 Shenshu Ki. 3 Taixi
VB. 28 Pangguangshu Liv. 3 Taichong
Ren 3 Zhongji Sp. 6 Sanyinjiao
Ren 4 Guanyilan St. 36 Zusanli
Ren 6 Qihai VB. 40 Weizhong
VB. 32 Ciliao VB. 67 Zhiyin
Acupuncture
Du 20 Baihui
He. 7 Shenmen Sp. 6 Sanyinjiao
Ren 3 Zhongji Ki. 3 Taixi
VB. 23 Shenshu
Skin Disorders 303
15.10 Skin Disorders
In many skin disorders, such as acne, herpes zoster, psoriasis, and eczema, acupunc-
ture treatment is effective. According to traditional ideas the skin is related to the lung
and the large intestine, and therefore skin disorders are treated with points on these
channels. Both excess- and deficiency-type conditions should be considered for needle
stimulation.
Principles of treatment
- Local points are combined with specific points:
- Points surrounding the disorder: The diseased skin area should not be needled,
especially the ulcerated region.
- Points on the lung channel, because the skin is related to the lung.
- Sp.10 Xuehai because of its antiallergic properties.
- Du 14 Dazhui and Sp.6 Sanyinjiao because of their anti-infective and immune-
enhancing effects.
- LI.11 Quchi, as a homeostatic point.
- Lu.9 Taiyuan is the influential point for the vascular system, and is needled in
disturbances of blood supply.
Besides needling, laser treatment has a major role in the therapy of skin disorders. The
laser ray can be used to radiate skin lesions, for example in herpes simplex and in defi-
cient wound healing. Local and specific distal acupuncture points are also radiated.
The exposure time for radiation treatment applied to whole areas of skin is 2 mini cm2
with a laser power of 2mW. Each acupuncture point is radiated for 15-30s.
15.10.1 Acne Vulgaris
In the treatment of acne important acupuncture points in the affected area are selected,
for example on the face and back. In addition the specific distal points on these chan-
nels passing through the affected region are treated. In acne laser treatment of the af-
fected area is also effective.
Acne of the face

Du 20 Baihui
St. 3 luliao LI. 4 Hegu St. 36 Zusanli
St. 5 Daying LI. 11 Quchi Sp. 10 Xuehai
St. 6 liache Lu. 7 Lieque Sp. 6 Sanyinjiao
St. 7 Xiaguan Pe. 4 Ximen
Further local points
Acne of the back

Du 20 Baihui
Du 14 Dazhui LI. 11 Quchi UB.40 Weizhong
Du 12 Shenzhu Lu. 7 Lieque UB.60 Kunlun
UB. 13 Feishu Sp. 10 Xuehai
Further local points
15.10.2 Leg Ulcers, Deficient Wound Healing
In this case radiation of the skin lesions concerned is surprisingly effective. Within a
few days new granulation tissue forms and lesions that have been present for years
start to heal. Besides laser treatment acupuncture is also effective.
Local points: Points proximal and distal to the ulcer. Points on channels passing
through the affected area. Points corresponding to the location of the ulcer on the con-
tralateral side of the body.
General points
Du 20 Baihui
Lu. 9 Taiyuan
Lu. 7 Lieque
Du 14 Dazhui
LI. 11 Quchi
Sp. 6 Sanyinjiao
15.10.3 Eczema, Neurodermitis
According to traditional ideas a Yin deficiency of the lung is present in these condi-
tions. In the treatment of eczema stimulation of the points on the lung and large intes-
tine channels is effective. Moxibustion of important distal points can also be useful.
Changed nutritional habits are very important for the success of treatment.
Du 20 Baihui
Du 14 Dazhui LI. 11 Quchi Sp. 10 Xuehai
Points of the He. 7 Shenmen Sp. 6 Sanyinjiao
affected region LI. 4 Hegu St. 36 Zusanli
15.10.4 Psoriasis
In psoriasis success can be achieved only with long-term treatment. In most cases two
to four cycles of treatment, each with 10-12 sessions, are required. Laser treatment of
the affected skin area is very successful.
Du 20 Baihui
Points of the LI. 11 Quchi Sp. 10 Xuehai
affected area Lu. 5 Chize Sp. 6 Sanyinjiao
Lu. 7 Lieque St. 36 Zusanli
15.10.5 Herpes Zoster, Zoster Neuralgia

Acupuncture treatment is appropriate for analgesia in the acute phase. Even in chronic
zoster neuralgia of some years' duration significant alleviation of pain is attained.
Du 20 Baihui
Du 14 Dazhui SJ. 8 Sanyangluo VB. 60 Kunlun
urinary bladder channel LI. 4 Hegu St. 44 Neiting
points of the affected LI. 11 Quchi
area
In the acute phase only local needles above and below the affected segment are
inserted. Laser radiation of the affected area is indicated. Vigorous manual stimulation
of the distal points is useful.
Disorders of the Sense Organs 305
15.10.6 Herpes Simplex
If possible the skin lesions should be radiated by laser when the first pustules occur.
The exposure time should be 2min/cm2 with a laser power of2mW. The distal points
for the face, such as LI. 4 Hegu and LI. 11 Quchi, are indicated in addition. In genital
herpes Sp.6 Sanyinjiao and Sp.l0 Xuehai are radiated or needled. After daily treat-
ment for 3-4 days the lesions are usually cured. Laser treatment reduces the relapse
rate.
15.11 Disorders of the Sense Organs
In disorders of the sense organs deafness, tinnitus, vertigo, conjunctivitis, and visual
deficiency are the major indications. Clinical research from China verifies the high ef-
fectiveness of acupuncture treatment in disorders of the sense organs, although the
mechanism of effect is still unknown. According to traditional ideas the ear is related
to the functional system of the kidney and urinary bladder, while the eye corresponds
to the functional system of the liver and gallbladder. In addition there are close con-
nections between the ear and the Sanjiao channel, which circles round the ear, and
stimulation of the distal points is highly effective in ear disorders.
15.11.1 Deafness
In congenital deafness, sudden hearing loss, and deafness of old age it is advisable to
try acupuncture treatment. According to traditional criteria weakness symptoms of the
kidney and Sanjiao are generally predominant. Therefore, in addition to acupuncture
treatment moxibustion is also indicated.
Du 20 Baihui
SJ. 21 Ermen SJ. 3 Zhongzhu GB. 41 Foot Linqi
SI. 19 Tinggong SJ. 5 Waiguan
GB. 2 Tinghui LI. 4 Hegu
SJ. 17 Yifeng SI. 6 Yanglao
GB. 20 Fengchi SI. 3 Houxi
Du 15 Yamen
Moxibustion
VB. 23 Shenshu SJ. 3 Zhongzhu Ki. 3 Taixi
VB. 22 Sanjiaoshu Ki. 7 Fuliu
15.11.2 Tinnitus
In various types of ringing in the ears acupuncture treatment is effective. Acupuncture

is especially indicated when earlier medication has been ineffective.
According to traditional ideas either an excess-type disturbance of the liver or gallblad-
der with a heavy sensation in the head or headache, or a deficiency-type disturbance of
the kidney system with typical cold symptoms is present. An excess-type disturbance is
sedated with vigorous needle stimulation, whereas moxibustion is effective in deficien-
cy of the kidney.
Du 20 Baihui
SJ. 21 Ermen SJ. 3 Zhongzhu Liv. 3 Taichong
SJ. 17 Yifeng Liv. 2 Xingjian
GB. 2 Tinghui GB. 41 Foot Linqi
Moxibustion
UB. 23 Shenshu Ki. 3 Taixi
Du 4 Mingmen Ki. 7 Fuliu
Sp. 6 Sanyinjiao
15.11.3 Meniere's Syndrome, Dizziness, Motion Sickness, Labyrinthitis
Acupuncture is effective in various types of dizziness. According to traditional ideas a

disharmony of Yin and Yang is present, and often also a weakness disturbance of the
Sanjiao or the kidney system.
Du 20 Baihui
SJ. 21 Ermen SJ. 3 Zhongzhu GB. 41 Foot Linqi
SI. 19 Tinggong SJ. 5 Waiguan Liv. 3 Taichong
GB. 2 Tinghui LI. 4 Hegu
SI. 6 Yanglao
Moxibustion is indicated in pronounced weakness symptoms.
15.11.4 Chronic Conjunctivitis
In chronic conjunctivitis and in other sorts of irritation of the eye, e. g., intolerance to
contact lenses, acupuncture treatment has a good result.
In Chinese medicine describes these states of irritation as "ascending fire of the liver."
External climatic influences, such as wind or heat, may also contribute to them.
When points in the area of the orbit are needled great care must be taken not to injure
the eye. Beginners should not needle these points. Distal points on the liver and gall-
bladder channels, GB.37 Guangming, the Luo point, and Liv.3 Taichong, the Yuan
point, are very important. Stimulation of LI.4 Hegu is also very effective in eye
disorders.
Du 20 Baihui
Ex. 2 Taiyang LI. 4 Hegu Liv. 3 Taichong
UB. 1 Jingming LI. 11 Quchi GB. 37 Guangming
SJ. 23 Sizhukong Sp. 6 Sanyinjiao
St. 1 Chengqi
GB. 1 Tongziliao
GB.20 Fengchi
Du 14 Dazhui
15.11.5 Glaucoma Simplex
In glaucoma simplex acupuncture brings about a significant decrease in the intraocu-

lar pressure, which must be continuously monitored during the course of treatment.
Du 20 Baihui
St. 1 Chengqi LI. 4 Hegu Liv. 3 Taichong
Ex. 4 Qiuhou GB. 37 Guangming
Acute Disorders and Emergencies 307
15.11.6 Visual Deficiency
A visual deficiency can be caused by many eye disorders. After exhaustion of the stan-
dard ophthalmologic treatments it is advisable to try acupuncture, because sometimes
significant improvements in vision can be achieved.
Du 20 Baihui
St. 1 Chengqi LI. 4 Hegu GB. 37 Guangming
Ex. 4 Qiuhou SI. 6 Yanglao UB.18 Ganshu
UB. 2 Zanzhu LI. 5 Yangxi Sp. 6 Sanyinjiao
GB. 14 Yangbai LI. 11 Quchi Liv. 3 Taichong
GB. 20 Fengchi St. 36 Zusanli
Ex. 2 Taiyang
15.12 Acute Disorders and Emergencies

In many acute disorders, such as fainting, collapse, grand mal, and acute pain, acu-
puncture in addition to the usual emergency treatment is often very effective. For ex-
ample a patient in an acute attack can be needled while a syringe is prepared for injec-
tion of the appropriate drug. In a circulatory collapse the circulation can be stabilized
within seconds. Usually only ling points that have a direct effect are needled. In acute
emergencies, if no needles are available, exceptionally thin disposable cannulae can be
used. Acupuncture is also useful for diagnosis in acute emergencies. If a comatose pat-
ient does not react to needling the coma is deep and dangerous.
Basic elements of treatment

- Needling and stimulation of Jing points.
- Needling of specific distal points for fast relief of pain and other symptoms.
- Needling oflocal, spontaneously sensitive or pressure-sensitive Ah Shi points.
- Needling of Xi-cleft points corresponding to the affected organs.
- Needling of Du 20 Baihui with sedative effect.
15.12.1 Fainting, Collapse
Du 26 Renzhong
Vigorous manual stimulation of the needles. If no acupuncture needles are available
acupressure with the thumbnail should be also tried.
15.12.2 Epileptic Fits, Grand Mal
In an acute attack Du 26 Renzhong is needled and vigorously stimulated. Often the

attacks are aborted immediately.
15.12.3 Acutely Painful Conditions
Acutely painful conditions, e. g., renal or gallbladder colic, cardiac infarction, or acute
abdominal pain, needling of important analgesic points reduces the pain in a short
time. Further diagnostic and therapeutic procedures are eased.
These points are vigorously stimulated by hand.
Important points for acute pain conditions:
LI. 4 Hegu on the hand,
St.44 Neiting on the foot.
Appendixes
Appendix A. World Health Organization

List of Indications for Acupuncture
Appendix B. Nomenclature and Abbrevations for Channels and
Points
Appendix C. Glossary of Chinese Terms
Appendix D. Translation of Chinese Ideograms and Point Names
Appendix E. Alphabetic List of Chinese Point Names
Appendix F. Index of Indications for Acupuncture
Appendix G. Historical Illustrations from the Golden Mirror of
Medicine
Appendix H. System of Five Phases

Appendix A
World Health Organization
List of Indications for Acupuncture
Respiratory Tract Gastrointestinal Disorders
Acute sinusitis Spasm of the esophagus and cardia

Acute rhinitis Hiccups
Common cold Gastroptosis
Acute tonsillitis Acute and chronic gastritis
Gastric hyperacidity
Chronic duodenal ulcer
Bronchopulmonary Disorders Acute and chronic colitis
Acute bacterial dysentery
Acute bronchitis Constipation
Bronchial asthma Diarrhea
(most effective in children and in patients Paralytic ileus
without concomitant diseases)
Neurologic and Orthopedic Disorders

Disorders of the Eye
Headache
Acute conjunctivitis Migraine
Central retinitis Trigeminal neuralgia
Myopia (in children) Facial paralysis
Cataract (without complications) Paralysis after apoplectic fit
Peripheral neuropathy
Paralysis caused by poliomyelitis
Disorders of the Mouth Cavity Meniere's syndrome
Neurogenic bladder dysfunction
Toothache Nocturnal enuresis
Pain after tooth extraction Intercostal neuralgia
Gingivitis Periarthritis humeroscapularis
Acute and chronic pharyngitis Tennis elbow
Sciatica, lumbar pain
Rheumatoid arthritis
Appendix B
Nomenclature and Abbreviations
for Channels and Points
Main Channels (Jing) Abbreviations used

In this Elsewhere in
volume the literature
Lung channel, Shou Tai Yin Lu. LU,P
Large intestine channel, Shou Yang Ming LI. L.I., Co, IG
Stomach channel, Zu Yang Ming St. S,ST,V
Spleen channel, Zu Tai Yin Sp. LP
Heart channel, Shou Shao Yin He. H., Ht,C
Small intestine channel, Shou Tai Yang SI. S.I., IT
Urinary bladder channel, Zu Tai Yang UB. U. B., B, Bl, VU
Kidney channel, Zu Shao Yin Ki. K., KID, R
Pericardium channel, Shou lue Yin Pe. P.,HC,TW
Sanjiao channel, Shou Shao Yang SJ. S.l., TB, TH, SC
Gallbladder channel, Zu Shao Yang GB. G.B.,VF
Liver channel, Zu lue Yin Liv. Li,LIV,H
8 Extraordinary channels, Qi Jingba Mai "irregular or marvellous channels"

Du Mai, governing vessel (To Mo) Du Gv, GV, TM
Ren Mai, conceptional vessel (len Mo) Ren Co, CV, 1M
Chong Mai (Chung Mo)
Dai Mai (Tai Mo)
Yangqiao, Yang Chiao, (Yang Keo), Yang motility, or ankle vessel
Yinqiao, Yin Chiao, (Yin Keo), Yin motility, or ankle vessel
Yangwei, Yang regulating or reuniting channel
Yinwei, Yin regulating, or reuniting channel
12 Jingbie, distinct or divergent channels (separate master meridian)

Points: Shu point, Beishu, or transport point, Back Shu point (Yu)
Mu or alarm point (Mo)
Influential point, Hui Xue
Xi-cleft point (Tsri)
Five Shu point, Wushu, Shu I-V (Yu)
Tonification point
Sedative point
ling well point, Shu I (Ting)
Ying point, Ying spring point, Shu II (Yong, Rong)
Shu stream point, Shu III (Yu)
Yuan source point (Yunn)
ling point, ling river point, Shu IV (King)
He point, He Sea point, Shu V (He)
Luo connecting point (Lo)
Confluent point, key point
Wade-Giles transcription is given in parentheses in each case.
Appendix C
Glossary of Chinese Terms
a
1 Philosophical Terms
The ideogram for Dao is composed of two parts:
.. shoo means head and
~s L ChDO togo.
Dao is translated as way, path, universal order, universal law. A path in a

landscape creates a unique structure. Dao is the universal order, the crea-
tive universal law. It is the basic principle of nature. Dao creates the
relativity of the universe, tai ji.
:* tii Taiji consists of two ideograms:
:* tai is the greatness, the highest,
:tJ! ji is the peak, also the ridge of a roof. Ji consists of the ideogram
for
* tree as a symbol standing between heaven and earth and of an

upper and a lower horizontal stroke, between which
1 is also the ancient sign for man.
o to the left of this is the ideogram for mouth (kou) and to the right,
J{ the ancient ideogram for hand.
Mouth and hand are two important attributes of the human being, symbo-
lizing speech and action.
Tai ji is the highest universal law in Chinese philosophy: "Endless, eternal,
without any boundaries; infinity and therefore the universal law." This is
the origin of the field of tension in the world in Yin and Yang.
Yang consists of the two ideograms:
fD for hill and
yang for brightness, expansiveness;

Yang is the light side of the hill, the sunny side.
312 Glossary of Chinese Terms
Yin consists of two ideograms
jin now or present and
yun for clouds.
Yin is the shady side (cloudy side) of the hill. Yin and Yang are the com-
plementary polar forces, which are continuously transformed.
According to Chinese philosophy the transformation is accomplished in
five phases, wu xing.
Wu is the ideogram for 5.
Xing means to go, the journey, the change, to take place and
consists of two ideograms:
chi means small step and
f chu to go to.
According to Chinese philosophy the five phases make up a complex sys-
tem which explains the phases of phenomena and the correlations of the
physical world. In medicine the five phases classify the physiological and
pathological relations of the internal organs, tissues, and sense organs.
The five phases comprise all aspects of nature,

wan wu.
wan means 10000, large number, or countless.
wu are living beings, objects, things.
Wanwu is translated as 10000 things - the universe.
2 Medical Terms
Qi consists of two ideograms:
qi for air, vapor or breathing, and the ideogram
?IE mi for rice or grain.

Qi is the vital energy and is symbolized by two parts of the ideogram: air,
for breathing, and grain as the origin of nutrition. These are the basis of
vital energy:
- breathing and nutrition.
mi, the grain, also symbolizes the vital energy latent in a grain of seed.
In the ancient literature qi is also written as fire - luo - instead of grain.
Shen consists of two ideograms
shi to make known, to point at, to show and
shen to report.
Shen means spirit, psychic energy, reasoning ability to clearness of
consciousness. The original meaning of shen, certainly originating from
the time of ancestor worship, was the communication between man and
gods by way of the spirits.
Glossary of Chinese Terms 313
Jing consists of the two ideograms:

mi for grain and
qing for fresh or young.
Jing is the life essence, the subtile material, the material basis of qi,
the vital energy. The "young" grain here symbolizes the
essence of life.
Xue means blood. The ideogram is composed of two ideograms:

chu for drop or point and
JlIZ. min for vessel.
Jin and ye are the body fluids, such as saliva, sweat, gastric juice, or
urine:
jin means the light and clear fluids and ye, the cloudy and
thick liquids.
Jin consists of two parts:

shui water and
yu for brush.
Ye consists of the two basic ideograms:
shui water and

ye for night or darkness.
Zang and fu designate the Chinese internal organs.

Fu are the Yang organs, such as stomach, large intestine,
gallbladder etc. The ideogram consists of two parts
rou for flesh and
fu for prefecture, official residence.
The ideogram for rou is found in the character used for all internal organs.
Fu organs, as governing authorities, influence the connected Yin organs.
W Zang consists of the two ideograms
)iJ rou flesh and

zang to hide, to preserve, to store.
~
The Zang organs are the Yin organs, such as lung, liver, and spleen.
According to traditional Chinese thinking the Zang organs store the vital
energy. These organs are hidden deep within the body.
314 Glossary of Chinese Terms
Jing luo is the Chinese designation for the system of channels and
collaterals (ling are the channels, Luo are the collaterals).
The original meaning of the ideogram jing is the warp threads in weaving.
The longitudinal threads provide the structure of the woven fabric as the
channels are the structural elements of the body.
Luo means to connect, to knot. The Luo vessels connect the
coupled channels (ling) with each other.
3 Point Categories
The ideogram shu means to transport. In the Chinese literature (cihai)

there are two other ideograms that have the same meaning:
Two different groups of Shu points are known:

1. The Bei shu points are located on the urinary bladder channel. They are
called transport points. Bei means back (Back Shu points).
2. The Wu shu points, the five Shu points, are known as the five antique
points in the Western literature. They are located distal to the elbow or
knee and transport the vital energy. They were imagined as the changing
course of a river from its source to the sea. The five Shu points (Wu shu
points) are:
# Jing meaning the wellspring, the source of the river.
Xing is the second stage of the river, also called ying or rong. Xingze
or Xingsea is an old sea in the Henan Province in the middle
course of the Yellow River. In the Han Dynasty this sea be-
came silted up. The ideogram for xing consists of an upper
part, with the sign for fire twice, and a lower part, with the
sign for water, and the sign for to cover with between the two.
According to the theory of five phases, the Xing point is relat-
ed to the fire in the Yang channels and the water in the Yin
channels.
Shu is the third antique point. Here the ideogram shu means to
flow (transport).
Jing has the original meaning of warp threads and signifies here
that the Qi stream flows through.
He means a flowing together or delta and implies in this connec-
tion that the streams flow from the extremities into the sea of
the internal organs.
Mu means to collect, knot together. Mu points are also called the

meeting points of the vital energy of the Zang Fu organs. Be-
cause of their diagnostic function they are called alarm points.
Xi means cleft. These are collecting points of vital energy. Need-
ling of Xi points activates the flow of Qi in the channel.
Ah shi Ah is an interjection. Shi means correct or yes; "Ah" also
means right.
Appendix D
Translation of Chinese Ideograms and
Point Names
m dao The way, universal principle, Taoism
~iJ yin Northern side of a mountain, the shady, cloudy side, neg~tive,
dark, female
~8 yang Southern side of a mountain, the sunny side, positive, light,

male
e;. qi Air, vapor or breathing, vital energy
~. shim Spirit, psychic energy, effective
*A jing Life essence, subtile material, the material basis ofQi
t~
'"'
guqi Nutrition energy
1\ ~ daqi Cosmic energy
IP. ~ yuanqi Origin energy
iA '=t jingqi Life essence
J! '=t weiqi Defence energy
tf ~ jingqi Vital energy of the channels
~f jing Warp threads in weaving
~ IUD Collateral
1~ ~ jingluo Network of channels in which the vital energy and blood flow
Vfl* dumai Governing channel on the dorsal midline
if ft* renmai Conceptional channel on the ventral midline

1~ sanjiao Triple warmer
","
t: ben Root, origin or cause (of disease)
fJ biao Symptom (of disease)
J! xu Deficiency, weakness
~ shi Excess
:,~ btl Strengthen, to reinforce, to tonify
r!) xie Reduce, to sedate

316 Translation of Chinese Ideograms and Point Names
B
~iiJ }f: a-shi Correct or yes, locus dolendi point
*8
bing Hold, a handful grain
bai White, clear, light, simple
8 bai Hundred, many, all
~ btl No, not
iii cang Hide, storage, to store
JJ~ chang Intestine, internal

,~ chong Impulse
i'tfi chong Active
if chuang Window
* da Large, important, very
1ff dai Belt, girdle, area
fl~ diin Gallbladder
t! di Earth
V du Govern, to control
tP du Capital, big city
er Two, both
Jt: er Ear, lateral
fl~ fei Lung
}Xl feng Wind, vent
t;J- feng Close, to enclose, envelop, cover
m fii Prefecture, residence, palace
Ht gan Liver
~ gil Valley, nutrition
1t gil Bone, character
*
guan Pass
llf hai Sea, ocean
* han Coldness, poorness
Fa hou Backward, posterior

p hu Door, opening, family
itt hila Beautiful, China, Chinese, glory

Translation of Chinese Ideograms and Point Names 317
A hui Meeting, unite, society

Z;;
&. ji Illness
*~ ji Peak, tip, outermost end
~ ji Spine, back
~ jla Press, to carry by yourself
m jian Shoulder, to carry
~ jiao Crossing, to unite
~ jin Gold, metal

~;:{ jing
~I Pass, warp threads in weaving, rule
~
J1. jing Capital, large, numerous
ft jing Well
:rL kong Hole, hollow, cave
~ liflO Bone cleft, joint cleft
IJi ling Hill, grave, tomb
m mai Pulse
fl men Gate, door
8~ ming Bright, clear
iji; nao Brain
J*1 nei Internal
~ pi Spleen, stomach
.
1M qian Anterior
rm qUlin Spring
qu Curve, curved, angle, angular
lW que Palace gate
A. ren Human beings, people
if ren Responsible
~ rong Contents, face, permission
san Three, often

/1'
y sMo Little, seldom
J: shang Above, peak, best
jfij shang 2nd tone of the ancient Chinese pentatonic scale,

corresponds to the element metal
$ shen Announce
'R shen Kidney
*+ shen Spirit, soul, God
7]{ shiii Water, fluidity
75 shi Stone, stony, infertile
1lr shi City, market
1m si Four, everywhere
IJM shu Transport point, to transport
~ tai Very, major
::tc ~B tai yang Major yang, sun
7C tilin Heaven, celestial, day, nature, weather
Jfl ting Hall, court, house
off ting Listen, to hear
jj tong Passage
tJj[ wan Stomach cavity, channel in the body
"
wei Stomach
E. wu Five
l~ xi Cleft
"~
Xl Knee
r1 Xl Brook
IlJ xln Heart, center
M xing Star
~ xii Empty
.dn xue Blood, bloody
/1' xiao Small, young
~ xii Ancient tomb
11 yao Kidney, hip, lumbar region
O~ ya Mute, sore
ril ye Secret, body fluids, fluidity
~ yI Physician, to heal, medicine
~ yu Fish, fishlike
3i yu Jade, precious, precious stone
7t yuan Source
7* ze Pond
~ zhii Small island
11 zhu Injection
*it zhiii Spine
$ zhong Center, Chinese
cp IE zhong guo Middle empire, China
fr zhu Bamboo
Lung Channel LI. 11 Quchi Curved pond

LI.12 Zhouliao Elbow bone cleft
Lu.l Zhongfu Center of the pre- LI.13 Hand Wuli Five units on the
fecture arm
Lu.2 Yunmen Gate of the clouds LI.14 Binao Upper arm
Lu.3 Tianfu Heavenly prefec- LI. 15 Jianyu Shoulder clavicle
ture LI.16 Jugu Large bone
Lu.4 Xiabai Noble white LI.17 Tianding Celestial kettle
Lu.5 Chize Pond of the elbow LI. 18 Neck Futu Assistance for out-
Lu.6 Kongzui Pronounced cleft let
Lu.7 Lieque Mistake in row LI.19 Nose Small and long
Lu.8 Jingqu Channel ditch Heliao bone cleft
Lu.9 Taiyuan Large deep abyss LI. 20 Yingxiang Welcome the smell
Lu.l0 Yuji Fishlike border
Lu.l1 Shaoshang Minor 2nd tone
(Shang)
Stomach Channel
Large Intestine Channel St. 1 Chengqi Receive tears

St.2 Sibai Four white, In all
U.l Shangyang Yang of the 2nd directions clear
tone (Shang) St. 3 Juliao Large bone cleft
LI. 2 Erjian Two spaces St.4 Dicang Storage in the earth
between St. 5 Daying Great welcome
LI. 3 Sanjian Three spaces St. 6 Jiache Cheek mechanism
between St. 7 Xiaguan Below the pass
LI. 4 Hegu Closed valley St. 8 Touwei Head binding
U.5 Yangxi Yang brook St. 9 Renying Welcome to the
LI.6 Pianli Lateral course people
LI. 7 Wenliu Warm sliding St. 10 Shuitu Sparkling water
U.8 Xialian Below the edge St. 11 Qishe Dwelling of vital
LI. 9 Shanglian Above the edge energy
LI.l0 Shousanli Three units on the St. 12 Quepen Imperfect basin
arm St.13 Qihu Door of vital energy
St. 14 Kufang Storeroom Sp.7 Lougu Groove

St. 15 Wuyi Room curtain Sp.8 Diji Power of earth
St. 16 Ying- Breast window Sp.9 Yinling- Spring at the Yin
chuang quan grave hill
St.17 Ruzhong Breast center Sp.10 Xuehai Sea of blood
St. 18 Rugen Base of the breast Sp.11 limen Arch gate
St. 19 Burong Not allow Sp.12 Chongmen Gate of the impulse
St.20 Chengman Completely full Sp.13 Fushe Storage house of
St. 21 Liangmen Beam gate the prefecture
St. 22 Guanmen Pass gate Sp.14 Fujie Constipation (Ab-
St. 23 Taiyi Origin of universe dominal node)
St. 24 Huarou- Smooth flesh gate Sp.15 Daheng Large horizontal
men Sp.16 Fuai Abdominal pain
St. 25 Tianshu Celestial pivot Sp.17 Shidou Nutrition cavity
St. 26 Wailing Exterior grave hill Sp.18 Tianxi Celestial brook
St. 27 Daju Very large Sp.19 Xiong- Land of the chest
St. 28 Shuidao Waterway xiang
St.29 Guilai Coming back Sp.20 Zhourong Surrounded with
St.30 Qichong Vital energy im- glory
pulse Sp.21 Dabao Large envelope
St. 31 Biguan Tighjoint
St. 32 Femur Hidden rabbit
Futu
St. 33 Yinshi Yin city Heart Channel
St.34 Liangqiu Beam hill
St. 35 Dubi Calfs nose He.1 liquan Peak spring
St.36 Zusanli Three units on the He.2 Qingling Lively spirit
leg He.3 Shaohai Minor sea
St. 37 Shangjuxu Above the large He.4 Lingdao Miraculous way
earth hill He.5 Tongli Internal connection
St. 38 Tiaokou Long opening He.6 Yinxi Yin cleft
St. 39 Xiajuxu Below the large He.7 Shenmen Gate of spirit
earth hill He.8 Shaofu Minor palace
St. 40 Fenglong Flourishing He.9 Shaochong Minor impulse
St. 41 liexi Relax the cramp
St.42 Chong- Yang impulse
yang
St.43 Xiangu Falling into the Small Intestine Channel
valley
St. 44 Neiting Interior hall SI.1 Shaoze Small pond
St.45 Lidui Sliding exchange SI.2 Qiangu Anterior valley
SI. 3 Houxi Posterior brook
SI.4 Wangu Wrist bone
SI. 5 Yanggu Yang valley
Spleen Channel SI. 6 Yanglao Age cherishing
SI. 7 Zhizheng Branching off from
Sp.1 Yinbai Hidden white the channel
Sp.2 Dadu Big city SI. 8 Xiaohai Little sea
Sp.3 Taibai Great white SI. 9 lianzhen Steadfast shoulder
Sp.4 Gongsun Grandson of the SI.10 Naoshu Transport point to
duke the upper arm
Sp.5 Shangqiu Shang hill muscle
Sp.6 Sanyinjiao Meeting of the SI.11 Tianzong Celestial ancestor
three Yin SI.12 Bingfeng Vent hole
SI.13 Quyuan Curved wall UB.22 Sanjiaoshu Transport point to

SI.14 Jianwaishu Transport point of the Sanjiao
the external shoul- UB.23 Shenshu Transport point to
der the kidney
SI.15 Jianzhong- Transport point in TJB.24 Qihaishu Transport point to
shu the middle of the the sea of vital
shoulder energy
SI. 16 Tian- Heaven's window UB.25 Dachang- Transport point to
chuang shu large intestine
SI.17 Tianrong Celestial view UB.26 Guan- Transport point to
SI. 18 Quanliao Zygomatic bone yuanshu the enclosed origin
cleft energy
SI.19 Tinggong Palace of hearing UB.27 Xiao- Transport point to
changshu the small intestine
UB.28 Pang- Transport point to
guangshu the urinary bladder
Urinary Bladder Channel UB.29 Zhonglu- Transport point at
shu the spine
UB.1 Jingming Bright eyes UB.30 Baihuan- Transport point at
UB.2 Zanzhu Covered with shu the white ring
bamboo UB.31 Shangliao Upper bone cleft
UB.3 Meichong Impulse to the UB.32 Ciliao Second bone cleft
eyebrow UB.33 Zhongliao Middle bone cleft
UB.4 Quchai Angular type UB.34 Xialiao Lower bone cleft
deviation UB.35 Huiyang Meeting of the
UB.5 Wuchu Fifth place Yang
UB.6 Cheng- Receiving the light UB.36 Chengfu Support
guang UB.37 Yinmen Flourishing gate
UB.7 Tongtian Entrance to heaven, UB.38 Fuxi Superficial cleft
The highest UB.39 Weiyang Yang in the bend
UB.8 Luoque Connection to the UB.40 Weizhong Center of the bend
back side UB.41 Fufen Adjacent point
UB.9 Yuzhen Jade occiput UB.42 Pohu Door of vitality
UB.10 Tianzhu Celestial pillar UB.43 Gaohuang Residence of the
UB.11 Dashu Big shuttle noble organs
UB.12 Fengmen Gate of the wind UB.44 Shentang Hall of the spirit
UB.13 Feishu Transport point to UB.45 Yixi Joyful excitement
the lung UB.46 Geguan Gate of the
UB.14 Jueyinshu Transport point to diaphragm
the weakened Yin UB.47 Hunmen Gate of the spirit
UB.15 Xinshu Transport point to soul
the heart UB.48 Yanggang Yang rule
UB.16 Dushu Transport point to UB.49 Yishe Hut of thoughts
the governing vessel UB.50 Weicang Storage of the
UB.17 Geshu Transport point to stomach
the diaphragm UB.51 Huangmen Gate to the noble
UB.18 Ganshu Transport point to organs
the liver UB.52 Zhishi Room of the will
UB.19 Danshu Transport point to UB.53 Baohuang Placenta
the gallbladder UB.54 Zhibian Lateral succession
UB.20 Pishu Transport point to UB.55 Heyang Common Yang
the spleen UB.56 Chengjin Muscle holding
UB.21 Weishu Transport point to UB.57 Chengshan Mountain holding
the stomach UB.58 Feiyang Blowing in the wind
UB.59 Fuyang Step Yang Pericardium Channel

UB.60 Kunlun Kunlun mountain
UB.61 Pushen Kneeling bow Pe.1 Tianchi Celestial pond
UB.62 Shenmai Announcing the Pe.2 Tianquan Celestial spring
pulse Pe.3 Quze Curved marsh
UB.63 linmen Golden gate Pe.4 Ximen Cleft gate
UB.64 linggu Bone of the capital Pe.5 lianshi Messenger
UB.65 Shugu Bone bundle Pe.6 Neiguan Inner pass
UB.66 Tonggu Valley passage Pe.7 Daling Big tomb
UB.67 Zhiyin Outer Yin Pe.8 Laogong Working palace
Pe.9 Zhong- Middle impulse
chong
Kidney Channel
Ki.1 Yongquan Bubbling spring Sanjiao Channel

Ki.2 Rangu Natural valley
Ki.3 Taixi Highest brook Sl.1 Guan- Impulse pass
Ki.4 Dazhong Big bell chong
Ki.5 Shuiquan Water spring Sl.2 Yemen Gate of the body
Ki.6 Zhaohai Direction to the sea fluids
Ki.7 Fuliu Reestablished flow Sl.3 Zhongzhu Center of the small
Ki.8 liaoxin Presents the mes- island
sage Sl.4 Yangchi Yang pond
Ki.9 Zhubin Build for the guest Sl.5 Waiguan Outer pass
Ki.10 Yingu Yin valley Sl.6 Zhigou Lateral groove
Ki.11 Henggu Horizontal bone Sl.7 Huizong Meeting of the kin
Ki.12 Dahe Especially influen- Sl.8 Sanyang- Connection of the
tial luo three Yang chan-
Ki.13 Qixue Point of vital energy nels
Ki.14 Siman Full everywhere Sl.9 Sidu Four drains
Ki.15 Zhongzhu Flowing in Sl. 10 Tianjing Celestial well
Ki.16 Huangshu Transport point to Sl.11 Qingleng- Cool deep
the noble organs yuan
Ki.17 Shangqu Large intestine arch Sl. 12 Xiaoluo Shallow river
Ki.18 Shiguan Stone pass Sl.13 Naohui Meeting of the
Ki.19 Yindu Yin capital upper arm muscles
Ki.20 Tonggu Valley passage Sl.14 lianliao Shoulder bone cleft
Ki.21 Youmen Exit gate of the Sl.15 Tianliao Celestial bone cleft
stomach Sl. 16 Tianyou Celestial window
Ki.22 Bulang Cross the corridor Sl.17 Yifeng Curtain in the wind
Ki.23 Shenfeng Altar of the spirit Sl.18 Qimai Crazy pulse
Ki.24 Lingxu Divine hill Sl. 19 Luxi Skull reposing
Ki.25 Shencang Hidden spirit Sl.20 liaosun Small corner
Ki.26 Yuzhong Opulent appear- Sl.21 Ermen Gate ofthe ear
ance Sl.22 Heliao Soft bone cleft
Ki.27 Shufu Transport point to Sl.23 Sizhukong Free from fine bam-
the prefecture boo
Gallbladder Channel GB.40 Qiuxu Barren hill

GB.41 Foot Linqi On the foot nearly
GB.1 Tongziliao Pupillar bone cleft weeping
GB.2 Tinghui Can hear GB.42 Diwuhui Five meetings on
GB.3 Shangguan On the pass the earth
GB.4 Hanyan Tired lower jaw GB.43 Xiaxi Intermediate brook
GB.5 Xuanlu Hanging on the GB.44 Qiaoyin Yin cave on the foot
scalp
GB.6 Xuanli Little hung up
GB.7 Qubin Curve at the temple Liver Channel
hair
GB.8 Shuaigu Following the val- Liv.1 Dadun Large wall
ley Liv.2 Xingjian Going into the
GB.9 Tianchong Celestial impulse space
GB.10 Fubai Passing white Liv.3 Taichong Large impulse
GB.11 Qiaoyin Yin cavity of the Liv.4 Zhongfeng At the middle of the
head altar
GB.12 Wangu End of the scalp Liv.5 Ligou Shell groove
bone Liv.6 Zhongdu In the center of the
GB.13 Benshen Origin of the spirit capital
GB.14 Yangbai Clear Yang Liv.7 Xiguan Knee pass
GB.15 Head Linqi Nearly weeping Liv.8 Ququan Spring in the curve
GB.16 Muchuang Eye window Liv.9 Yinbao Yin envelope
GB.17 Zhengying Ordered camp Liv.10 Wuli Five units
GB.18 Chengling Welcome the spirit Liv.11 Yinlian Yin comer
GB.19 Naokong Brain arch Liv.12 Jimai Speedy pulse
GB.20 Fengchi Wind pond Liv. 13 Zhangmen Item gate
GB.21 Jianjing Shoulder well Liv.14 Qimen Last gate
GB.22 Yuanye Depression of the
axilla
GB.23 Zhejin Lateral to the DuMai
muscle
GB.24 Riyue Sun and moon Du1 Chang- Perpetual and con-
GB.25 Jingmen Gate of the capital qiang tinuous
GB.26 Daimai Belt vessel Du2 Yaoshu Transport point to
GB.27 Wushu Fifth axis the loin
GB.28 Weidao Connecting the Du3 Yaoyang- Yang pass of the
path guan loin
GB.29 Juliao Lying in the bone Du4 Mingmen Portal oflife
cleft Du5 Xuanshu Hanging turning
GB.30 Huantiao Circular jump point
GB.31 Fengshi City of the wind Du6 Jizhong Center of the spine
GB.32 Zhongdu Middle of the Du7 Zhongshu Middle of the
trench center
GB.33 Xiyang- Yang pass on the Du8 Jinsuo Muscle contraction
guan knee Du9 Zhiyang In direction to the
GB.34 Yangling- Yang grave spring Yang
quan Du10 Lingtai Hill of spirit
GB.35 Yangjiao Crossing of Yang Du 11 Shendao Way of the spirit
GB.36 Waiqiu Exterior hill Du 12 Shenzhu Support of the per-
GB.37 Guang- Bright light sonality
ming DuB Taodao Content way
GB.38 Yangfu Yang helps Du14 Dazhui Large vertebra
GB.39 Xuan- Hanging of the bell Du 15 Yamen Mute gate
zhong
Du16 Fengfu Prefecture in the Ren 17 Shanzhong

Middle of the chest
wind Ren 18 Yutang Jade hall
Du17 Naohu Brain door Ren 19 Zigong Purple palace
Du18 Qiangjian Strong interval Ren20 Huagai Pompous cover
Du19 Houding Backward vertex Ren21 Xuanji Main star (Great
Du20 Baihui 100 meetings Bear)
Du21 Qianding Anterior vertex Ren22 Tiantu Standing out from
Du22 Xinhui Meeting at the heaven
anterior fontanel Ren23 Lianquan Modest spring
Du23 Shangxing Upper star Ren24 Chengjiang Pap receiving
Du24 Shenting Court of the spirit
Du25 Suliao Simple bone cleft
Du26 Renzhong Center of the upper
lip
Du27 Duiduan At the border of the Extra Points
cave
Du28 Yinjiao Gum crossing Ex. 1 Yintang Stamp hall
Ex.2 Taiyang Temple
Ex.3 Yuyao Fish back
RenMai Ex.4 Qiuhou Behind the eyeball
Ex. 5 Jiacheng- Framing the point
Ren 1 Huiyin United Yin jiang "pap receiving"
Ren2 Qugu Curved bone Ex. 6 Sis hen- The four spiritual
Ren3 Zhongji In the middie be- cong wise men
tween the poles Ex. 7 Yiming Healing to the
Ren4 Guanyuan Surrounded source bright light
energy Ex. 8 Anmian I Calm sleep
Ren5 Shimen Stony gate Ex. 9 Anmian II Calm sleep
Ren6 Qihai Sea of vital energy Ex. 17 Dingchuan Calming asthma
Ren7 Yinjiao Yin crossing Ex. 20 Yaoqi Miracle point at the
Ren8 Shenque Palace gate of the sacrum
spirit Ex. 21 Huatuo- Huatuo points bind
Ren9 Shuifen Water separation jiaji the spine
Ren 10 Xiawan Lower stomach pit Ex. 28 Baxie Eight obliquities
Ren 11 Jianli Interior construc- Ex. 31 Heding Crane crest
tion Ex. 32 Xiyan Knee gap
Ren 12 Zhongwan In the middle of the Ex. 33 Lanwei Appendix
stomach pit Ex. 35 Dannang Gallbladder
Ren13 Shangwan Superior stomach Ex. 36 Bafeng Eight winds
pit
Ren 14 Juque Large palace gate Neima (Nei means medial and Ma
Ren 15 Jiuwei Wild pigeontail anesthesia)
Ren 16 Zhongting In the middle of the Waima (Wai means lateral, Ma anesthe-
hall sia)
The 31 standard extra points listed with the

Chinese names
Head and neck

Ex-HN Sishencong
Ex-HN Taiyang
Ex-HN Jinjin
Ex-HN Juquan
Ex-HN Erjian
Ex-HN Yintang
Ex-HN Neiyingxiang
Ex-HN Yuye
Ex-HN Haiquan
Ex-HN Yuyao
Chest and abdomen
Ex-CA Zigong
Back of trunk
Ex-B Jiaji
Ex-B Pigen
Ex-B Yaoyan
Ex-B Shiqizhui
Ex-B Yaoqi
Upper extremities
Ex-UE Zhoujian
Ex-UE Erbai
Ex-UE Zhongquan
Ex-UE Zhongkui
Ex-UE Dagukong
Ex-UE Xiaogukong
Ex-UE Baxie
Ex-UE Sifeng
Ex-UE Shixuan
Lower extremities
Ex-LE Heding
Ex-LE Xiyan
Ex-LE Neihuaijian
Ex-LE Weihuaijian
Ex-LE Bating
Ex-LE Duyin
Appendix E
Alphabetic List of Chinese Point Names
Anmian I Ex. 8 Dazhui Du 14 Hanyan GB. 4

Anmian II Ex. 9 Dicang St. 4 Heding Ex. 31
Diji Sp. 8 Hegu LI. 4
Bafeng Ex. 36 Dingchuan Ex. 17 Heliao (ear) Sl. 22
Baihuanshu UB. 30 Diwuhui GB. 42 Heliao (nose) LI. 19
Baihui Du 20 Dubi St. 35 Henggu Ki. 11
Baohuang VB. 53 Duiduan Du 27 Heyang VB. 55
Baxie Ex. 28 Dushu VB. 16 Houding Du 19
Benshen GB. 13 Houxi SI. 3
Biguan St. 31 Erbai Ex. 24 Huagai Ren 20
Binao LI. 14 Erjian LI. 2 Huangmen VB. 51
Bingfeng SI. 12 Ermen Sl. 21 Huangshu Ki. 16
Bizhong Ex. 23 Huantiao GB.30
Bulang Ki. 22 Feishu VB. 13 Huaroumen St. 24
Burong St. 19 Feiyang VB. 58 Huatuo liaji Ex. 21
Fengchi GB. 20 Huiyang VB. 35
Changqiang Du 1 Fengfu Du 16 Huiyin Ren 1
Chengfu VB. 36 Fenglong St. 40 Huizong Sl. 7
Chengguang VB. 6 Fengmen VB. 12 Hunmen VB. 47
Chengjiang Ren 24 Fengshi GB. 31
Chengjin VB. 56 Fuai Sp. 16 liache St. 6
Chengling GB.18 Fubai GB. 10 liachengjiang Ex. 5
Chengman St. 20 Fufen VB. 41 lianjing GB. 21
Chengqi St. 1 Fujie Sp. 14 lianli Ren 11
Chengshan VB. 57 Fuliu Ki. 7 lianliao Sl. 14
Chize Lu. 5 Fushe Sp. 13 lianshi Pe. 5
Chongmen Sp. 12 Fuxi VB. 38 lianwaishu SI. 14
Chongyang St. 42 Futu (femur) St. 32 lianyu LI. 15
Ciliao VB. 32 Futu(neck) LI. 18 lianzhen SI. 9
Fuyang UB. 59 lianzhong Ex. 22
Dabao Sp. 21 lianzhongshu SI. 15
Dachangshu VB. 25 Ganshu VB. 18 liaosun Sl. 20
Dadu Sp. 2 Gaohuang VB. 43 liaoxin Ki. 8
Dadun Liv. 1 Geguan VB. 46 liexi St. 41
Dahe Ki. 12 Geshu VB. 17 limai Liv. 12
Daheng Sp. 15 Gongsun Sp. 4 limen Sp. 11
Daimai GB.26 Guanchong Sl. 1 lingbi Ex. 13
Daju St. 27 Guangming GB.37 linggu VB. 64
Daling Pe. 7 Guanmen St. 22 lingmen GB. 25
Dannang Ex. 35 Guanyuan Ren 4 lingming UB. 1
Danshu VB. 19 Guanyuanshu VB. 26 lingqu Lu. 8
Dashu VB. 11 Guilai St. 29 linjin, Yuye Ex. 10
Daying St. 5 linmen VB. 63
Dazhong Ki. 4 linsuo Du 8
Alphabetic List of Chinese Point Names 327
1iquan He. 1 Qichong St. 30 Shenque Ren 8

1iuwei Ren 15 Qihai Ren 6 Shenshu UB. 23
1izhong Du 6 Qihaishu UB.24 Shentang UB.44
1ueyinshu UB. 14 Qihu St. 13 Shenting Du 24
1uliao (femur) GB. 29 Qimai S1. 18 Shenzhu Du 12
1uliao (nose) St. 3 Qimen Liv. 14 Shidou Sp. 17
1ugu LI. 16 Qinglengyuan S1. 11 Shiqizhui Ex. 19
1uque Ren 14 Qingling He. 2 Shiguan Ki. 18
Qishe St. 11 Shimen Ren 5
Kongzui Lu. 6 Qiuhou Ex. 4 Shixuan Ex. 30
Kufang St. 14 Qiuxu GB. 40 Shousanli LI. 10
Kunlun UB. 60 Qixue Ki. 13 Shuaigu GB. 8
Quanliao SI. 18 Shufu Ki. 27
Lanwei Ex. 33 Qubin GB. 7 Shugu UB. 65
Laogong Pe. 8 Quchai UB. 4 Shuidao St. 28
Liangmen St. 21 Quchi LI. 11 Shuifen Ren 9
Liangqiu St. 34 Quepen St. 12 Shuiquan Ki. 5
Lianquan Ren 23 Qugu Ren 2 Shuitu St. 10
Lidui St. 45 Ququan Liv. 8 Sibai St. 2
Lieque Lu. 7 Quyuan SI. 13 Sidu S1. 9
Ligou Liv. 5 Quze Pe. 3 Sifeng Ex. 29
Lingdao He. 4 Siman Ki. 14
Linghou Ex. 34 Rangu Ki. 2 Sishencong Ex. 6
Lingtai Du 10 Renying St. 9 Sizhukong S1. 23
Lingxu Ki. 24 Renzhong Du 26 Suliao Du 25
Linqi (foot) GB. 41 Riyue GB. 24
Linqi (head) GB.15 Rugen St. 18 Taibai Sp. 3
Lougu Sp. 7 Ruzhong St. 17 Taichong Liv. 3
Luoque UB. 8 Taixi Ki. 3
Luozhen Ex. 26 Sanjian LI. 3 Taiyang Ex. 2
Luxi S1. 19 Sanjiaoshu UB. 22 Taiyi St. 23
Sanyangluo S1. 8 Taiyuan Lu. 9
Meichong UB. 3 Sanyinjiao Sp. 6 Taodao Du 13
Mingmen Du 4 Shangguan GB. 3 Tianchi Pe. 1
Muchuang GB. 16 Shangjuxu St. 37 Tianchong GB. 9
Shanglian LI. 9 Tianchuang SI. 16
Naohu Du 17 Shanglianquan Ex. 12 Tianding LI. 17
Naohui S1. 13 Shangliao UB. 31 Tianfu Lu. 3
Naokong GB. 19 Shangqiu Sp. 5 Tianjing S1. 10
Naoshu SI. 10 Shangqu Ki. 17 Tianliao S1. 15
Neiguan Pe. 6 Shangwan Ren 13 Tianquan Pe. 2
Neiting St. 44 Shangxing Du 23 Tianrong SI. 17
Shangyang LI. 1 Tianshu St. 25
Pangguangshu UB. 28 Shanzhong Ren 17 Tiantu Ren 22
Pianli LI. 6 Shaochong He. 9 Tianxi St. 18
Pishu UB.20 Shaofu He. 8 Tianyou S1. 16
Pohu UB. 42 Shaohai He. 3 Tianzhu UB. 10
Pushen UB. 61 Shaoshang Lu. 11 Tianzong SI. 11
Shaoze SI. 1 Tiaokou St. 38
Qianding Du 21 Shencang Ki. 25 Tinggong SI. 19
Qiangjian Du 18 Shendao Du 11 Tinghui GB. 2
Qiangu SI. 2 Shenfeng Ki. 23 Tonggu (foot) UB. 66
Qiaoyin (foot) GB. 44 Shenmai UB.62 Tonggu Ki. 20
Qiaoyin (head) G B. 11 Shenmen He. 7 (thorax)
328 Alphabetic List of Chinese Point Names
Tongli He. 5 Yamen Du 15 Zhengying GB. 17

Tongtian UB. 7 Yangbai GB. 14 Zhibian UB. 54
Tongziliao GB. 1 Yangchi SJ. 4 Zhigou SJ. 6
Touwei St. 8 Yangfu GB. 38 Zhishi UB. 52
Yanggang UB.48 Zhiyang Du 9
Waiguan SJ. 5 Yanggu SI. 5 Zhiyin UB. 67
Wailing St. 26 Yangjiao GB. 35 Zhizheng SI. 7
Waiqiu GB. 36 Yanglao SI. 6 Zhongchong Pe. 9
Wangu (hand) SI. 4 Yanglingquan GB. 34 Zhongdu GB. 32
Wangu (head) GB. 12 Yangxi. LI. 5 (femur)
Weicang UB.50 Yaoqi Ex. 20 Zhongdu (foot) Liv. 6
Weibao Ex. 15 Yaoshu Du 2 Zhongfeng Liv. 4
Weidao GB. 28 Yaoyangguan Du 3 Zhongfu Lu. 1
Weishang Ex. 14 Yatong Ex. 27 Zhongji Ren 3
Weishu UB. 21 Yemen SJ. 2 Zhongliao UB. 33
Weiyang UB. 39 Yifeng SJ. 17 Zhonglushu UB. 29
Weizhong UB. 40 Yiming Ex. 7 Zhongquan Ex. 25
Wenliu LI. 7 Yinbai Sp. 1 Zhongshu Du 7
Wuchu UB. 5 Yinbao Liv. 9 Zhongting Ren 16
Wuli(hand) LI. 13 Yindu Ki. 19 Zhongwan Ren 12
Wuli (femur) Liv. 10 Yingchuang St. 16 Zhongzhu Ki. 15
Wuming Ex. 18 Yingu Ki. 10 (abdomen)
Wushu GB. 27 Yingxiang LI. 20 Zhongzhu SJ. 3
Wuyi St. 15 Yinjiao Ren 7 (hand)
(abdomen) Zhouliao LI. 12
Xiabai Lu. 4 Yinjiao Du 28 Zhourong Sp. 20
Xiaguan St. 7 (mouth) Zhubin Ki. 9
Xiajuxu St. 39 Yinlian Liv. 11 Zigong Ex. 16
Xialian LI. 8 Yinlingquan Sp. 9 (abdomen)
Xialiao UB. 34 Yinmen UB.37 Zigong (thorax) Ren 19
Xiangu St. 43 Yinshi St. 33 Zusanli St. 36
Xiaochangshu UB.27 Yintang Ex. 1
Xiaohai SI. 8 Yinxi He. 6
Xiaoluo SJ. 12 Yishe UB. 49
Xiawan Ren 10 Yixi UB.45
Xiaxi GB. 43 Yongquan Ki. 1
Xiguan Liv. 7 Youmen Ki. 21
Ximen Pe. 4 Yuanye GB. 22
Xingjian Liv. 2 Yuji Lu. 10
Xinhui Du 22 Yunmen Lu. 2
Xinshu UB.15 Yutang Ren 18
Xiongxiang Sp. 19 Yuyao Ex. 3
Xiyan Ex. 32 Yuzhen UB. 9
Xiyangguan GB. 33 Yuzhong Ki. 26
Xuanji Ren 21
Xuanli GB. 6 Zanzhu UB. 2
Xuanlu GB. 5 Zengyin Ex. 11
Xuanshu Du 5 Zhangmen Liv. 13
Xuanzhong GB. 39 Zhaohai Ki. 6
Xuehai Sp. 10 Zhejin GB. 23
Appendix F
Index of Indications for Acupuncture
Acne vulgaris 15.10.1 Epileptic fits 15.12.2

Acute emergencies 15.12 Esophagitis 15.5.1
Acutely painful conditions 15.12.3 Exhaustion conditions 15.4.4
Adnexitis 15.8.3 15.6.2
Agitation 15.6.3
Alcohol addiction 15.6.7 Facial paralysis 15.7.4
Amenorrhea 15.8.2 Fainting 15.12.1
Anal fissure 15.5.7 Fertility, male 15.9.4
Analgesia during childbirth 15.8.7 Frozen shoulder 15.2.5
Angina pectoris 15.4.1
Ankle joint, pain in 15.2.11
Gastric and duodenal ulcer 15.5.3
Arthrosis of jaw joint 15.2.1
Gastritis 15.5.2
Asthma, bronchial 15.3.6
Gastroenteritis 15.5.2
Gastroenterological disorders 15.5
Biliary colic 15.5.8
Glaucoma simplex 15.11.5
Biliary dyskinesia 15.5.8
Gonarthrosis 15.2.10
Bronchitis, chronic 15.3.5
Grand mal 15.12.2
Gynecological disorders 15.8
Cardiac arrhythmia 15.4.3
Gynecological tumors 15.8.4
Cardiac neurosis 15.4.2
Cardiovascular disorders 15.4
Hand, pain in 15.2.8
Cholangitis 15.5.8
Headache 15.7.1
Cholecystitis 15.5.8
Hemorrhoid 15.5.7
Collapse 15.12.1
Hemiparesis 15.7.3
Common cold 15.3.1
Hepatitis 15.5.9
Conjunctivitis, chronic 15.11.4
Herpes simplex 15.10.6
Constipation 15.5.6
Herpes zoster 15.10.5
Coronary heart disease 15.4.1
Hyperemesis gravidarum 15.8.6
Coxarthritis 15.2.9
Hypertension 15.4.5
Coxarthrosis 15.2.9
Hypotension 15.4.6
Deafness 15.11.1
Depression 15.6.1 Impotence 15.9.4
Diarrhea 15.5.4 Intercostal neuralgia 15.2.3
Dizziness 15.11.3 Irritable bowel disease 15.5.5
Drug addiction 15.6.6
Dupuytren's contraction 15.2.8 Knee joint, pain in 15.2.10
Dysmenorrhea 15.8.1
Dysphagia 15.5.1 Labyrinthitis 15.11.3
Lactation, deficient 15.8.8
Eczema 15.10.3 Laryngitis 15.3.2
Enuresis 15.9.5 Leg ulcers 15.10.2
Epicondylitis 15.2.6 Locomotor disorders 15.2
Epilepsy 15.7.5 Lumbar pain 15.2.4
330 Alphabetic List of Chinese Point Names
Mental disturbances and Sexual disturbances 15.6.10

illnesses 15.6 Skin disorders 15.10
Meniere's syndrome 15.11.3 Sleep disturbances 15.6.4
Migraine 15.7.1 Spondylitis, ankylosing 15.2.3
Motion sickness 15.11.3 Spondylitis, cervical 15.2.2
Sinusitis, frontal 15.3.4
Neurodermitis 15.10.3 Sinusitis, maxillary 15.3.3
Neurologic disorders 15.7
Nicotine addiction 15.6.8 Tennis elbow 15.2.6
Thorax, trauma of 15.2.3
Overweight 15.6.9 Tinnitus 15.11.2
Toe, pain in 15.2.12
Periarthritis humeroscapularis 15.2.5 Tonsillitis 15.3.2
Peripheral blood supply, Torticollis 15.2.2
disturbances 15.4.7 Trigeminal neuralgia 15.7.2
Prostatitis 15.9.3
Pruritus vulvae 15.8.5 Urological disorders 15.9
Psoriasis 15.10.4
Urological symptoms, 15.9.3
psychogenic
Renal colic 15.9.2
Respiratory disorders 15.3
Rheumatoid arthritis 15.2.2 Visual deficiency 15.11.6
15.2.8
15.2.13 Weight loss 15.6.9
Wound healing, deficient 15.10.2
Salpingitis 15.8.3 Wrist joint, pain in 15.2.7
Schizophrenia 15.6.5
Sciatica 15.2.4 Zoster neuralgia 15.2.3
Sense organs, disorders of 15.11 15.10.5
AppendixG
Historical Illustrations from the
Golden Mirror of Medicine
The Golden Mirror of Medicine was published in the Qianlong era (1736-1796).
The government compiled this book, which contained everything known about
traditional Chinese medicine at the time.
I ·,
I.
Top left: Historical illustration showing the channels

on the face
Top right: Lung channel with its internal course
Bottom left: Acupuncture points on the lung channel
Right-hand page
Top left: Spleen channel
Top right: Sanjiao channel
Bottom left: Three Yang channels on the arm: large

intestine, Sanjiao and small intestine
Bottom right: Three Yang channels on the leg: stomach,

gallbladder and urinary bladder
ii
Appendix H. System of Five Phases
Classification into five Phases wil xing guI lei billo
Human body Nature
A.1:.$- rimti fJ l~\:ti-- zirimjie
Yin Yang Sense Tissue Emotion Taste Season Climatic Stages Color
Organ Organ Organ factor
AJt M1 '-g' 1;f>- +t;t, "i *-t -"l1~ ~~
zailg fii guan ti qing zhi wei ji jie qihOu
1:.*
shong zhang yan
Wood Liver Gallbladder Eye Muscle Anger Sour Spring Wind Birth green
;t ~t Jbt I~ ~$ tt. ~ )4, .'i. -t
mil gan dan mil jin nil suan chun
* feng sheng qIng
Fire Heart Small Tongue Blood Joy bitter Summer Heat Growth red
intestine vessel
;J( Il:.,' ,J'R~ 1;:- 4- -l -:t ~ -:It
l -*-
hilo xIn xiao chang she mai xi kii xia re chang chi
Earth Spleen Stomach Mouth Flesh Brooding sweet Late Damp Development yellow
summer
T!]
± !If 'H t:J ~ I~'" -tt *l: ~ -I{"
-*
til pi wei kou rou sI gan chang chiin shI hila huang
Metal Lung Large Nose Skin Sadness hot, spicy Autumn Dryness Harvest white
intestine
1:- Jtr1i AfWJ ! )t~ ~,:t.t 1 :V\. jJ *i:. ~
jIn fei da chang bi pimilO bili, you xin qiu zao shou bai
Water Kidney Bladder Ear Bone Fear salty Winter Coldness Storage black
'1;<.
~ A-?Et :If t ~i,f& foX. ~ ~ ~ ~
*-
shui shen pimg-guan er gu jing, kong xiim dong han dmg hili
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88. Pothmann R, Yeh HL (1982) The effects of treatment with antibiotics, laser and acupuncture
upon chronic maxillary sinusitis in children. Am Chin Med 10: 55-58
89. Pothmann R, Stux G (1982) Zur Behandlung der spastischen Bewegungsstorung mit Aku-
punktur unter besonderer Berucksichtigung des Kindesalters. Orthopad Praxis 18/6:
457-458
90. Richardson PH, Vincent CA (1986) Acupuncture for the Treatment of Pain: a Review of
Evaluative Research. Pain 24: 15-40
91. Riederer P, Tenk H, Werner H, Bischko J, Rett A, Krisper H (1975) Manipulation ofneuro-
transmitters by acupuncture? J Neural Transm 37: 81-94
92. Schmidt H (1979) Akupunkturtherapie nach der chinesischen Typenlehre. Hippokrates,
Stuttgart
93. Schnorrenberger CC (1976) Stechen und Brennen. Hippokrates, Stuttgart
94. Schnorrenberger CC (1979) Lehrbuch der chinesischen Medizin fUr westliche Arzte. Hip-
pokrates, Stuttgart
95. Schnorrenberger CC, Ching-Lien K (1974) Klassische Akupunktur Chinas Ling Kti King.
Hippokrates, Stuttgart
96. Second National Symposium of Acupuncture and Moxibustion and Acupuncture Anaeste-
sia (1984). All-China Society of Acupuncture and Moxibustion. Beijing, China
97. Sjolund B, Eriksson M (1976) Electro-acupuncture and endogenous morphins. Lancet
217994: 1085
98. SjOlund B, Eriksson M (1979) The influence of naloxone on analgesia produced by periph-
eral conditionary stimulation. Brain Res 17312: 295-301
99. Sjolund B, Terenius L, Eriksson M (1977) Increased cerebrospinal fluid levels of endorphins
after electro-acupuncture. Acta Physiol Scand 100/3: 382-384
100. Stiefvater EW (1978) Praxis der Akupunktur. Fischer, Heidelberg
101. Stux G (1983) Akupressur zur Selbsthilfe. Videolehrprogramm in 3 Lektionen. Akumed,
Augsburg
102. Stux G (1984) Treatment of migraine with acupuncture and moxibustion, pilot study on
50 patients. Second national Symposium, Beijing
103. Stux G (1985) Akupressur und Moxibustion. J. F. Bergmann, Miinchen
338 Literature
104. Stux G (1986) Grundlagen der Akupunktur. Springer, Berlin Heidelberg New York Tokyo
105. Stux G, Fernando F, Pothmann R, Jayasuriya A (1979) Verminderung des Muskeltonus
durch Akupunktur bei spastischen Erkrankungen und bei Operationen. Akupunktur-Theo-
rie und Praxis 7/3: 127-131
106. Stux G, Fernando F, Jayasuriya A (1979) Efficacy of acupuncture in spastic disorders of
skeletal muscle. Am J Acupunct 712: 167 -169
107. Stux G, Jayasuriya A (1981) Grundlagen der Akupunktur. Video-Lehrfilmprogramm in
8 Lektionen, Akumed, Munchen
108. Stux G, Stiller N, Pothmann R, Jayasuriya A (1981) Lehrbuch der klinischen Akupunktur.
Springer, Berlin Heidelberg New York
109. Stux G, Jayasuriya A (1982) Atlas der Akupunktur. Springer, Berlin Heidelberg New York
110. Stux G, Mannheimer JS (1982) Therapie-Atlas Tenzcare. Optimale Stimulationsstellen fUr
TENS-Elektroden.3 M Deutschland GmbH, Neuss
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Springer, Berlin Heidelberg New York Tokyo
112. Stux G, Sahm KA (1986) Chinese Ideograms. A survey of terms in TCM. BritJ Acu 9/2: 4-6
113. Tashkin DP, Bresler DE, Kroeming RJ, Kerschner H, Katz RL, Coulson A(1977) Compari-
son of real und simulated acupuncture and isoproterenol in metacholine-induced asthma.
(UCLA Acupunctur Project). Ann Allergy 39/6: 379-387
114. Tenk H (1978) Problematik der Akupunktur in der Kinderheilkunde. Haug, Heidelberg
115. Toda K (1979) Effects of electroacupuncture on thalamic evoked responses. Exp Neurol
66/2:419-422
116. Unschuld PU (1980) Medizin in China. Eine Ideengeschichte. Beck, Munchen
117. Van Nghi N (1975) Pathogenese und Pathologie der Energetik in der chinesischen Medizin.
M. L. Verlag, Uelzen
118. Vincent CA, Richardson PH (1986) The Evaluation of Therapeutic Acupuncture: Concepts
and Methods. Pain 24: 1-13
119. Vinnemeier M (1978) Arbeitsmaterial zur Akupunktur. Eigenverlag, Velbert
120. Wall PD (1978) The gate control theory of pain mechanism, a reexamination and restate-
ment. Brain 101: 1-18
121. Wu CC (1976) Preliminary report on effects of acupuncture on hyperlipidemia in man.
Artery 212: 181-195
122. Wu CC, Hsu CJ (1979) Neurogenetic regulation of lipid metabolism in rabbits: A mecha-
nism for cholesterol-lowering effect of acupuncture. Atherosclerosis 3312: 153-164
123. Yau PS (1975) Scalp-needling therapy. Medicine & Health, Hong Kong
124. Zhang Xiangtong, HT Chang (1986) Research on Acupuncture, Moxibustion, and Acu-
puncture Anestesia. Science Press, Beijing, Springer, Berlin Heidelberg New York Tokyo
Subject Index
AA 1-18 Childbirth, analgesia 299

Acne vulgaris 303 Chinese terms, glossary 311-314
ACTH 4-6 Cholangitis 286
Acupressure 235 Cholecystitis 286
Acupuncture Analgesia 1-18 Cholecystokinin 4
Acupuncture points 20-26 Chong Mai 198
Addiction 290 Chronic pain 17-21
Adnexitis 298 Climatic factors 44
Agitation 289 Colic, renal 301
Ah-Shi 262 Collapse 307
Ah-Shi points 54,314 Cold 46,49
Alcohol addiction 290 Common cold 278
Allocation of pain 261 Complications of acupuncture treatment 227
Amenorrhea Conceptional vessel 192
Anal fissure 286 Confluent point 68, 266
Analgesia 1-18 Conjunctivitis 306
Analgesic effect 263 Constipation 286
Angina pectoris 280 Coronary heart disease 280
Angiotensin 4 Course of channels 58-59
Ankle joint, pain 275 Coxarthritis 274
Ankylosing spondylitis 271 Coxarthrosis 274
Anterolateral tract 4-6 Cun measurement 70
Arrhythmia 281 Cunometer 70
Artemisia vulgaris 230-231 CXBKmice 11
Arthrosis of the jaw joint 270
Asthma 19-20, 279
Auricular diagnose 237
Dai Mai 198
Auriculocardial reflex 237
Damp 45
Axis 262
Dangers of laser 234
Dao 311
Deafness 305
Back Shu 62 Deficiency 41, 48
Ba Gang 47-49 Deficient lactation 300
Basic research 1-25 Depression 288
Bell's pulsy 19,24 De Qi sensation 225
Biao 48 Diagnosis 47
Biliary colic 286 Diagnostic criteria 47
Biliary diskinesia 286 Diarrhea 284
Bombesin 4 Dizziness 306
Bronchial asthma 279 DNIC 5
Bronchitis 279 Dorsolateral tract 4
Bu 225 Drug addiction 18-19,290
Dryness 46
Du Mai 56-57, 184-191
Calcitonin 4 Dupuytren's contraction 274
Cardiac neurosis 281 Dysmenorrhea 297
Cardiovascular disorders 280- 282 Dysphagia 283
Cardiovascular effects 19-20
CCK 4,11
Cervical spondylitis 271 EA 1,5-7
Channel 39, 55 EA, high frequency 6-7
Chi 39 EA, low frequency 5-7
340 Subject Index
Ear acupuncture 237-246 History 35

Earth 44 Homeostatic effect 263
Eczema 304 Huang Di Nei ling 37
Electroacupuncture 1,5-7,226 Hui Xue 62
Electrostimulation 226 Hyperemesis gravidarum 299
Emergencies 307 Hypertension 282
Emotional factors 46
Endorphin 4-16
Enuresis 302 Ideograms 315-325
Epicondylitis 273 Immune-enhancing effect 263
Epilepsy 296 Impotence 302
Epileptic fits 307 Infections 227
Esophagitis 283 Influential points 62, 265
Essence 40,313 Infrared lasers 233
Even method 226 Infrared moxibastion 231
Examinations 50-54 Injuries 227
Excess 41,48 Insertion of needles 224
Exhaustion 281 Interior 48
Exhaustion condition 289 Irritable bowel disease 285
Exterior 48 Intercostal neuralgia 271
Extraordinary channels 56
Extra point 204- 211
law joint 270
ling 39,40,313
Facial paresis 296 ling Luo 314
Fainting 227,307 lingbamai 56
Feng 45 lingbie 56
Fertility disorders in male 302 lingjing 56
Fire 44 ling point 66
Five phases 43-44,334 ling Well point 64, 263
Five Shu points 63, 263 lue-Yin 59
Frontal sinusitis 279
Frozen shoulder 273
Fu organs 55,313 Kidney channel 148-153
Knee joint, pain 275
Ko cycle 43
GABA 5-6
Gallbladder channel 168-177
Gastritis 284 Labyrinthitis 306
Gastroenteritis 284 Large intestine channel 84-91
Gastroentero!ogica! disorders 283 - 287 Laryngitis 278
Glaucoma simplex 306 Laser acupuncture 223-224
Glomerulonephritis 301 Li 48
Gonarthrosis 275 Life essence 40,313
Goverring vessel 184 Listening 52
Grand mal 307 Liver channel 178-183
Gu Qi 39 Locomotor disorders 270-276
Gynecological disorders 297-300 Low frequency EA 5-6
Gynecological tumors, pain caused by 298 Lumbar pain 272
Lung channel 77 - 83
Luo connecting point 66, 265
Han 46,49 Luo connections 56-57
Hand acupuncture 253 Luomai 56
Hand, pain 274
Headache 292
Heat 45,49 Maxillary sinusitis 278
Heat channel 114-119 MEAP 11
Helium neon laser 233 Meniere's syndrome 306
Hemiparesis 295 Mental disturbances and illnesses 287-292
Hemorrhoids 286 Metal 44
Hepatitis 287 Metenkephalin 12-15
Herpes simplex 305 Metenkephalin precursor 11
Herpes zoster 304 Migraine 292
He Sea point 66, 264 Monoamines 1-8,15-16
High frequency EA 6- 7 Motion sickness 306
Subject Index 341
Moxa cigars 230-231 - point 64, 264

Moxibustion 229-231 Sense organs, disorders 305-307
Mu points 60,266 Sensory receptors 3
Muscle relaxation 1 Sexual disturbances 291
Shao-Yang 59
Shao-Yin 59
Naloxone 4-7 Shen 40,312
Needles 223 Sheng cycle 43
Nerve regeneration 19-20 Shi 41-42,45,48
Neurodermitis 304 Shu points 60, 266
Neurological disorders 292 Sinusitis 278
Neuronal mechanism 2-8 Skin disorders 303-305
Neurotensin 4 Skin resistance 22-24,74
Nicotine addiction 290 Sleep disturbances 289
Nogier 237 Small intestine channel 120-127
Nomenclature 310 Smelling 52
Numbering of ear points 242-248 Soft lasers 233
Somatostatin 4
Spleen channel 106-113
Opiate antagonist 9-14 Spinothalamic tract 3-4
Organs 55 Sterilization of needles 227
Overweight 291 Stimulation 224-226
Stomach channel 92-105
Substance P 4
PAG 4-7 Surgical procedure 1-2
Pain diagnose 53
- during insertion 227
- transmission 3-5 Tai Ji 311
Periarthritis humeroscapularis 273 Tai-Yang 59
Pericardium channel 154-159 Tai-Yin 59
Pibu 56 Tao 37,311
Pin Yin 37 Tao Te King 37-38
Pituitary hypothalamus 16 Tendinomuscular channels 56
Point categories 60 Tennis ellbow 273
Point location 70 TENS 7-8
Point names, alphabetic 326-330 Thorax, trauma 271
Prostatitis 301 Tinnitus 305
Pruritus vulvae 298 Toes, pain 275
Psoriasis 304 Tonification point 63
Psychic energy 40 Tonifying effect 263
Pulse diagnose 54 - method 225
Pyelonephritis 301 Tonsillitis 278
Torticollis 271
Treatment 261- 307
Qi 39,312 Trigeminal neuralgia 294
Questioning 52
VIP 4
Re 45,49 Visual deficiency 307
Renal colic 301 - observation 51
Ren Mai 56,192 Vital energy 39
Respiratory disorders 277 - 280
Retinal blindness 19
Rheumatoid arthritis 271,276 Water 44
Rules of point selection 261-267 Weight Loss 291
WHO 267
- list of indications for acupuncture 309
Salpingitis 298 Wind 45
San Bao 41 Wood 44
Sanjiao channel 160-167 Wound healing, deficient 304
Scalp acupuncture 249-252 Wrist joint, pain 274
Schizophrenia 290
Sciatica 272
Sedating method 225 Xi-Cleft points 62, 265
Sedative effect 263 Xie 225
342 Subject Index
Xu 41-42,48 Yang-Ming 59
Xue 313 Yangwei 200
Yin 38,312
Ying point 64
Ulcer, duodenal 284 Yinqiao 200
-, gastric 284 Yinwei 200
Ulcers of the leg 304 Yuan Qi 39
Urinary bladder channel 128-146 - source point 64, 264
- infections 301
Urological disorders 300-302
Zang organs 55,313
Zao 46
Yang 38,311 Zoster neuralgia 271,304

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Gabriel Stux Bruce Pomeranz

Translations of Chinese Terms by Karl Alfried Sahm

With 98 Figures and an Acupuncture Selector

Prof. Bruce Pomeranz

This book is based on the following books published by Springer-Verlag:

Atlas der Akupunktur Grundlagen der Akupunktur

ISBN-13: 978-3-642-71744-4 e-ISBN-13: 978-3-642-71742-0

Acupuncture: Textbook and Atlas is a fundamental textbook based on different books

Autumn, 1986 Gabriel Stux

1 Scientific Basis of Acupuncture (B. Pomeranz) . 1

2 History of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . .. 35

3 Background and Theory of Traditional Chinese Medicine (G. Stux) .. 37

4 Diagnosis in Traditional Chinese Medicine (G. Stux) . 47

5 Chinese System of Channels, Organs and Points (G. Stux) . 55

5.2.8 Jing Well Point. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 64

6 Systematic Description of Channels and Points (G. Stux) . . . . . . . . . . 77

7 Regions with Important Acupuncture Points (G. Stux) . . . . . . . . . . . . 212

8 Technique of Acupuncture (G. Stux) . . . . . . . . . . . . . . . . . . . . . . 223

9 Moxibustion (G. Stux) . . . .... . · .229

10 Laser Acupuncture (G. Stux) . . . . . . 233

11 Acupressure(G.Stux) ... . . . . . . 235

12 Ear Acupuncture (G. Stux) . ..... . ... 237

13 Scalp Acupuncture (G. Stux) . .249

14 Hand Acupuncture (G. Stux) . . . .253

15 Acupuncture Treatment (G. Stux) . . . . . . . . . . . . . . . . . . . . . . . 261

15.2 Locomotor Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270

15.3 Respiratory Disorders .277

15.4 Cardiovascular Disorders . . . . . . . . . . . . . . . . . 280

15.5 Gastroenterological Disorders . . 283

15.6 Mental Disturbances and Illnesses .287

15.7 Neurologic Disorders .292

15.8 Gynecological Disorders . .297

15.8.6 Hyperemesis Gravidarum . . 299

15.9 Urological Disorders . .300

15.10 Skin Disorders . · 303

15.11 Disorders of the Sense Organs . · 305

15.12 Acute Disorders and Emergencies . .307

Subject Index · 339

In this chapter we review 228 of modem scientific studies on acupuncture. As most

1.1 Acupuncture Analgesia (Basic Research)

1.1.1 Neural Mechanisms of Acupuncture Analgesia

Acu H---+I- 1-1--.---+( I

Fig.1. Pain Transmission

brain structures: midbrain, thalamus, pituitary-hypothalamus and cerebral cortex. As

Fig. 2. Acupuncture (Low Frequency High Intensity)

Acu I-+---+-+- 1tI.......--I~'k'(

Fig. 3. Acupuncture (High Frequency, Low Intensity)

1.1.2 Evidence for Endorphins and Acupuncture Analgesia

1. Sham EA on nearby non-acupuncture points in animals induces no AA, thus con-

1.1.3 Evidence for Midbrain Monoamines and Acupuncture Analgesia

There are numerous papers implicating the midbrain monoamines in AA (especially

and AA is potentiated by electrolytic lesions of locus ceruleus [46]. This is consistent

1.1.4 Evidence for Pituitary Hypothalamic System and Acupuncture Analgesia

1.2 Acupuncture Analgesia for Chronic Pain

1.3 Drug Addiction

Wen, a well-known Hong Kong neurosurgeon, discovered serendipitously that EA

in acupuncture journals, we counted five successful replications of Wen's work [87,

1.4 Asthma, Nerve Regeneration and Cardiovascular Effects of

1.5 Acupuncture Points (Do They Really Exist?)

1.5.2 Are There Unique Anatomical Structures at Acupuncture Points?

8. Bifurcation point of peripheral nerve.

1.5.3 Do Acupuncture Points Have Unique Physiological Features

1.5.4 What Nerves Are Activated by Acupuncture?

Electrophysiological evidence (given below) indicates that stimulation of muscle affer-