Class #: / 4
Dr. Luo substituting – so some of this is review…
Special Points
1)5 Shu Points – gotta know for boards!!
2)Yuan points
3)Luo points and yuan points
4)Back shu points and front mu points
5)Eight influential points
6)The xi-cleft points
7)The lower he-sea points
8)Eight confluent points and the intersecting points
Indications of 5 Shu points.
Stress = fire. Gotta reduce the fire. 5 shu points!
Jing-well points: fullness below the heart, diseases of the zang
Ying-spring points: clear heat
Shu-stream: joint probs, heaviness
Jing-River: cough, fever, chills.
He-Sea: very deep area: qi and diarrhea
This is another system of energy, this jing ying shu jing he. Holding energy in dan-tian is one way—holding source of energy. But not only deep area that holds energy—flows from outside into the body. In the 5 shu system flows into the body thru the extremeties distal areas.
Yuan points
For yang channel: distinct points between Shu-Stream and Jing-River.
For yin channel: shares the same point as the shu-stream point. Lung 9, for example is shu and yuan point.
Example: 4 gates = LI 4 (yang yuan source), Liv-3 (yin shu/yuan source) located between 1st and 2nd metatarsal. This balances the yin and the yang and happens to be the strongest combination.
Very important to know.
LU 9, LI 4, ST 42, SP 3, HT 7, SI 4, BL 64, KI 3, PC 7, TB 4, GB 40, LV 3
Indications: tonification and regulation. (Not good points to reduce! Use Ying points for that.)
Example, H7 to tonify heart/heartblood to help insomnia and fatigue. PC however, better for Shen related problems.
Order: jing-well, ying-spring, shu-stream, yuan source (yins = shu), jing-river, he-sea
Special points very important on board exam!
Luo Connecting points
Luo means connecting in Chinese. Connects exterior/interior channels. Each primary has a Luo point. Ren has one, Du has one, Great Spleen has one. Grand total of 15. Ren in front, Du in back. Spleen are on the sides.
Indications:
- treat disorders of int/ext related channel or zangfu
Lung 7, for instance, commonly used in common cold. - treat disorders in reaching regions reached by the luo connecting channel.
- treat psycho-emo disorders.
Yuan and Luo points
Use them together in host-guest combination. These have a deep meaning. Here’s a Dr. Luo example.
Yuan / LuoLung / Lung 9 / Lung 7
LI / LI 4 / LI 6
Patient starts with cough … later gets constipation. Cough is a lung problem (yin). Constipation comes later because lung qi cannot go down and disperse the moisture to LI (the yang paired channel for Lung).
Treatment: host-guest combination.
Host is the Yuan and is associated with the disease that expressed first—the lung/cough.
Guest is the Luo and is associated with the disease that expressed afterward as a result—LI/constipation.
Use Lung-9 and LI-6 to treat.
Suggestion: memorize the locations of the special points such as yuan and luo.
Back-shu and Front-Mu points
Back-shu’s and Front-mu’s are all located on trunk.
Back-shu Points
All located on Bladder channel. One line runs on the transverse points of the spine, one runs between that and border of the scapula—3 cun between these 2 borders, Back shu points are located 1.5 cun from spinal ridge.
Indications: tonify zangfu.
Lung Back-shu, for instance. Cough, tonify the lung back-shu—UB 13.
The back-shu points of the twelve zangfuLung / Feishu BL-13 / Bladder / Pangguangshu BL-28
L. Intestine / Dachangshu BL-25 / Kidney / Shenshu BL-23
Stomach / Weishu BL-21 / Pericardium / Jueyinshu BL-14
Spleen / Pishu BL-20 / Sanjiao / Sanjiaoshu BL-22
Heart / Xinshu BL-15 / Gall Bladder / Danshu BL-19
S. Intestine / Xiaochangshu BL-27 / Liver / Ganshu BL-18
Can combine Front with Back for front/back association. Called shu/mu assoc or front/back assoc.
Front Mu points
The front-mu points of the twelve zangfuLung / Zhongfu LU-1 / Bladder / Zhongji REN-3
L. Intestine / Tianshu ST-25 / Kidney / Jingmen GB-25
Stomach / Zhongwan REN-12 / Pericardium / Shanzhong REN-17
Spleen / Zhangmen LIV-13 / Sanjiao / Shimen REN-5
Heart / Juque REN-14 / Gall Bladder / Riyue GB-24
S. Intestine / Guanyuan REN-4 / Liver / Qimen LIV-14
Mostpoints for Front-mu are on Ren channel. Also, Liver, GB, Lung.
Eight Influential Points
AKA: Hui-Meeting Points
Very large concept. Very basic components of the body: zang, fu, qi, blood, sinews, vessels, bone, marrow.
The hui-meeting pointsZang / Zhangmen LIV-13 / Sinews / Yanglingquan GB-34
Fu / Zhongwan REN-12 / Vessels / Taiyuan LU-9
Qi / Shanzhong REN-17 / Bone / Dazhu BL-11
Blood / Geshu BL-17 / Marrow / Xuanzhong GB-39
Look at Lung, the controller of the 100 vessels: Lung 9, the Yuan source point is the Hui-Meeting or Influential point.
Cough: might use the yuan/luo combination of Lu 9 and LI 6, but add Ren-17 for Qi since cough is related to qi. Also, if you have trouble breathing, stimulate Ren 17 (use acupressure!!)
These points are where the xconverges. Zang converges at Liv-13. Blood converges at BL-17. Etc.
Xi-Cleft Points
Yang Xi-cleft points: usually used to stop pain
Yin xi-cleft points: usually used to stop bleeding
Most Xi-cleft points are around elbow and knee joints and below. Use them for emergency situations.
Example: cough with blood or epistaxis—could use LU 6.
Gallbladder stones with pain and sweating—use GB 36
The xi-cleft points of the twelve channelsLung / Kongzui LU-6 / Bladder / Jinmen BL-63
Large Intestine / Wenliu L.I.-7 / Kidney / Shuiquan KID-5
Stomach / Liangqiu ST-34 / Pericardium / Ximen P-4
Spleen / Diji SP-8 / Sanjiao / Huizong SJ-7
Heart / Yinxi HE-6 / Gall Bladder / Waiqiu GB-36
Small Intestine / Yanglao SI-6 / Liver / Zhongdu LIV-6
The xi-cleft points of the extraordinary channels
Yang Motility / Fuyang BL-59 / Yang Linking / Yangjiao GB-35
Yin Motility / Jiaoxin KID-8 / Yin Linking / Zhubin KID-9
Xi-cleft, per textbook = acute conditions and pain. Xi-cleft of Yin are both, plus blood problems, like bleeding.
Chronic diseases can use this, but generally speaking these are the choice for emergency situations.
The Lower He-Sea Points
Yang organ energy converges here. These are also called the Lower He Uniting Points. Each of the 6 Fu organs have another he-sea point on yang meridians of the lower extremeties.
Stomach / ST 36Large Intestine / ST 37
Small Intestine / ST 39
Gall Bladder / GB 34
Bladder / BL 40
San Jiao / BL 39
ST, LI, SI all use Stomach channel as the functions are related to Stomach. Water/heat/diarrhea = St 39 treatment. Clear heat = UB/BL 40.
Used in clinic to treat disease of the 6 Fu organs.
Eight Confluent Points of the Eight Extraordinary Channels.
Use when regular treatment is not so effective.
Eight extraordinary channels are connected to the 12 regular channels via these points. Ren connected to LU-7, for instance.
Used in combination to treat various problems.
The confluent points of the extraordinary channelsConception / Lieque LU-7 / Yin Motility / Zhaohai KID-6
Governing / Houxi SI-3 / Yang Motility / Shenmai BL-62
Penetrating / Gongsun SP-4 / Yin Linking / Neiguan P-6
Girdling / Zulinqi GB-41 / Yang Linking / Waiguan SJ-5
Intersecting Points
Know there are connecting points for every channel where they intersect with other channels.
Four command points:
By tradition (pre-Ming dynasty), were 4 points. 2 were added later in history. These were considered most important and useful points:
For exam purposes, just memorize the 4.
Disorders of: / Point:Abdomen / ST 36
Lumbar Region and back / UB 40
Head and nape of neck / LU 7
Face and mouth / LI 4
Added later in history….
Chest/lateral costal region / P-6
Resuscitation / Du-26
Windows of Heaven/Sky Window
Most of these are around/above the neck, some not. Can be used to treat problems of the head, the “heaven” area. Examples: unclearness or congestion in the head. Yang Qi disturbance will be felt in the head. See Pg 49—cough/wheezing with qi rebellion, face and eye swelling, throat problems, emotional problems, 5 sense organs.
The window of heaven pointsTianfu LU-3 / Tiantu REN-22
Renying ST-9 / Tianchuang SI-16
Futu L.I.-18 / Tianrong SI-17
Tianyou SJ-16 / Fengfu DU-16
Tianzhu BL-10 / Tianchi P-1
Locating an Acupoint
Summary:
- Anatomical Landmarks and Position
- Measuring Methods
- Porportional measurement
- Using landmarks
- Finger measurement
- Convenient measurement
Landmarks and Positions
Landmarks don’t move—bones such as the metatarsal bones or the mastoid process. Positioning often in a depression next to a bone or between muscles.
Gallbladder 34, for instance: find the head of the fibula, is on interior of the fib, then inferior to this location in the depression. (this is near ST 36)
Du 14: just below C7 vertebra. (hint: C7 still moves a little when you twist your head. T1 does not.)
Some landmarks move! There are other methods of location.
Examples.
Du 24: anterior hairline + .5cun…but some people’s have receded! Start at Yintang, go up 3 cun.
LI 11: This is in the cubital crease. Usually the lateral end of the crease is the point. Flex the arm to find it.
ST 35: in the knee depression—you have to flex the knee, find the 2 depressions at the head of the tibia on medial and lateral side. Lateral side depression is the point.
Measuring Methods
Proportional Measurement
Metacarpal Phalangeal joint: knuckles
Proximal phalangeal joint: mid joints of flexed finger from index to pinkie finger.
Please note: this proportion measurement is the proportion of the patient!
So “cun” is based on the person you are treating. For human beings this is not a fixed measurement.
(This is the same for pulse positions!)
Pg 63 (See Point Location and Needling)
Example of basic measurements:
9 cun from anatomical neck of humerus (axillary crease) to the elbow crease.
9 cun from lateral-lateral hairline.
9 cun from mastoid process to mastoid process
12 cun from front hairline to back hairline
12 cun from cubital crease to wrist crease
8 cun from sternal notch to acromion process
8 cun from Sternal angle (just above xyphoid process) to umbilicus
8 cun from nip to nip (on females, mid-clavicular line to mid-clavicular line)
5 cun from umbilicus to pubic symphysis.
14 cun from gluteal fold to popliteal crease
16 cun from popliteal crease to lateral malleolus
15 cun from popliteal crease to medial malleolus
19 cun from great trochanter to popliteal crease (anterior)
Pay attention to the finger/hand measurements also
Du 20 = 5 cun from front hairline, 7 cun from back hairline. This is the highest point on the body. What is due has no hair? 3 cun from Yintang, then 5 more to Du 20.
How many cun from Yintang to Du 14? 3 from yinting to hairline, 12 to the back hairline + 3 more. Grand total: 18.
Point Locations 1 – Fall 2007
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