Point location is an important aspect of acupuncture, and acupuncture students spend hundreds of hours learning and practicing to find points. Not surprisingly therefore, this concern comes up whenever I teach. In learning Tung’s acupuncture there are lots of new points that are unfamiliar to most acupuncturists, so many students become concerned that they are not placing the needle in exactly the right place.
Sometimes I think this is a problem of how some teachers and practitioners talk about or otherwise present the material. For example, one of the most common questions I get is about the location of Tung’s point Huo Zhu 66.04. Acupuncturists have told me that elsewhere in books or classes they learn that Huo Zhu 66.04 is located just slightly proximal to Tai Chong LR-3. Thus these two points are approximately a few millimeters apart on the dorsal foot. These same acupuncturists also learn or read that this slight distance makes Huo Zhu 66.04 and Tai Chong LR-3 different points
But does it really? In my opinion this type of thinking is fundamentally flawed, and a gross misunderstanding of how acupuncture really works and how it is best applied clinically. In modern acupuncture textbooks points are usually described as precise anatomical loci. However, historically, this type of anatomical precision is more the result of the interaction of modern western anatomy with traditional medicine. For example, in Zhen Jiu Zi Sheng Jing 針灸資生經 (written in the Song dynasty, c. 1180) Tai Chong LR-3 is located either 1.5 or 2 cun posterior to the “base joint” (MTP joint) of the big toe (在足大指本節後二寸或寸半陷中). Looking at this type of point description we can arrive at two possible conclusions. First, ancient acupuncturists were sloppy in their point location. Why else would it be that in ancient times a point like Tai Chong LR-3 could be located in a relatively large space, but today we are precise enough to differentiate Huo Zhu 66.04 and Tai Chong LR-3 even though they are a mere millimeters apart? Second, point locations by their nature are simply not so precise that millimeters make a difference.
I do not believe the former to be true. But, I also do not believe the latter is true. I have seen that millimeters can make a difference in getting a point to work or not. How can this be reconciled? In classical acupuncture the precision of point location as described in the textbooks is not so important. That which is important is finding the real active point, or as described in Japanese as the “living” or “live” point (生きた壺). The live point is the one where some reaction can be palpated (e.g., pain or soreness), some tissue quality is evident (e.g., rough skin, spongy subcutaneous tissue, hard subcutaneous tissue), or some quality is visible (e.g., dark spider nevi, discolored skin). Thus, even though the location of a point can be large, the exact location that will be clinically useful can be small and must be found by touching or looking.
Some of the great modern practitioners of acupuncture agree. According to Dr. Wang Juyi, “...the actual location of any point is not necessarily where that point is located by techniques of proportional measurement. Rather, the point is the place where one can best get the Qi and facilitate the arrival of Qi. It is not fixed.” Shudo Denmei says, “Acupuncture points are hard to locate on healthy individuals. However, when Qi stagnates or pathological Qi invades from the outside, the point becomes depressed or protrudes. Qi, which is invisible, is thus transformed into a ‘quality’ that can be palpated and distinguished. This is what is known as an active point, which serves as both a point for diagnosis as well as treatment.” I couldn’t agree more with both of those statements!
Huo Zhu 66.04 and Tai Chong LR-3 are indeed the same point in the same location. Clinically however, we need to palpate or search for the active point in that area of the foot. If we practice any acupuncture, including Tung’s, with the idea that we just measure and then insert the needle, we will truly be missing the point.
References:
Denmei S, Brown S. Finding Effective Acupuncture Points. Seattle: Eastland Press, 2003; p. 5.
Wang JY, Roberson J. Applied Channel Theory in Chinese Medicine. Seattle: Eastland Press, 2008; p. 535.
Wang ZZ, Wilcox L. The Classic of Supporting Life with Acupuncture and Moxibusion: Zhen Jiu Zi Sheng Jing Vol I-III. Portland: The Chinese Medicine Database, 2014.