
Channels and Acupoints: An Overview
In recent times, considerable research has been done with respect to the anatomical relationships between Channels and acupuncture points. Presently, most research is directed at establishing the relationship between the points and anatomical structures.
The Relationship Between the Acupuncture Points and Peripheral Nerves:
According
to numerous reports, the closest relationship exists between the
peripheral nerves in the tissues and the acupuncture points.
Anatomical
dissections performed at 309 traditional acupuncture points by the
Anatomical Teaching and Research Group of the Shanghai College of
Traditional Medicine in 1959, found that 152 points could be stimulated
directly over nerves, while 73 additional points could be stimulated
within 0.5 cm. of a nerve. Another study of 324 acupuncture points by
the Anatomical Teaching and Research Group of Shanghai No. 1 Medical
School in 1960, found that 323 were supplied by nerves. Among these,
304 were associated with superficial cutaneous nerves, 155 with deep
nerves and 137 points were found to have both superficial and deep
neural involvement. Microscope observation showed that all layers of
the skin and muscle tissues at acupuncture sites contained numerous and
varied nerve branches, plexi and endings.
The Relationship Between the Channels and the Peripheral Nervous System:
There
is a particularly close relationship between the paths of the channels
on the limbs and the pathways of peripheral nerves.
Anatomical
investigations by the Shanghai College of Traditional Medicine, found
that the course of the Lung channel on the upper limb was similar to
the path of the musculocutaneous nerve, the Pericardium channel similar
to the median nerve, and the Heart channel similar to the paths of the
ulnar and medial cutaneous nerves of the arm.
The channels and
points are the foundation of acupuncture and moxibustion. In the
historical development of acupuncture, the actual utilisation of points
in the treatment of disease has contributed to the formation of channel
theory. This theory has, in turn, provided a framework for the
selection of points in the clinic.
The words ' acupuncture
point' are derived from the Chinese characters meaning hole or orifice,
and position, the 'position of the hole'.
The development and
classification of the points: Traditionally, the word hole was combined
with other terms such as hollow, passageway, transport, and Qi. This
suggests that the holes on the surface of the body were regarded as
routes of access to the body's internal cavities.
It is
conjectured that from very early times, man, suffering from one ailment
or another, and was fortuitously cured by a sharp blow, burn or other
accident or that, feeling pain in some part of his body, he massaged
the tender area with his hands and felt better. Over a period of time,
this experience was recognised as more than coincidental, and these
random observations were then recorded in a more systematic fashion.
Gradually, a methodical system of needling and moxibustion to treat
disease emerged. In the beginning, the unnamed acupuncture points were
generally referred to as "stone and burning places," a sharp stone
being the original needle, and "burning' a reference to the earliest
form of moxibustion.
Three Phases Have Been Discerned In The Historical Development Of The Concept Of The Acupuncture Point
The
first was that of unspecified location. In this earliest phase, people
would needle or cauterise whatever area on their body was
uncomfortable, ie., "Whatever Hurts Is The Point." Such points of pain
included those which were spontaneously tender, as well as those which
were painful only when pressed with the hand. Because there were no
specific locations for the points, they had no names.
The second
phase, after a long period of practice and experience, certain points
became identified with specific diseases. The capacity of distinct
points to affect and be affected by local or distant pain and disease,
was perceived as a predictable, physiological feature of the body. As
the correlation between point and disease became established names were
assigned to certain points to distinguish them from other, random
points of pain.
In the final phase, what were previously
isolated, localised points, each with a singular function, became
integrated into a larger system which related and grouped diverse
points systematically according to similar functions. The vehicle of
integration was the channel system. It is difficult to grasp the
concept of the channels without referring to the points. On the other
hand, to look at the points independently of the channel system would
be to return acupuncture to the first stage of its development, when
each of the points was regarded as a random, isolated phenomenon. The
two concepts must be considered together, the points being an important
basis upon which channel theory was formulated.
The Classification Of The Four Types Of Points
The
earliest exposition of the channels, points and methodology of
acupuncture is found in the Yellow Emperor's Classic (2nd century, BC).
In this book, many points were assigned to one or another of the
channels according to their similar curative properties. The names of
the twelve Primary channels, six of which traverse the arms, and six
the legs, are derived in part from the twelve traditional Organs with
which they are joined. Thus, the name of each channel reflects those
parts of the body with which the channel, and its constituent points,
is therapeutically linked. In the Inner Classic, usually only the name
of the channel is mentioned in connection with treating a certain
disease, since it was known that the points along the channel shared
the same therapeutic properties. This illustrates how systematised
acupuncture had become by this time.
The channel points include
all those on the twelve Primary channels, bilaterally, as well as the
points on the Conception and Governing channels which follow the median
line of the body in front and back. Although an occasional point was
added during later dynasties, more than 95% of the channel points had
been identified by the 3rd century.
Among these points there
are differences between those which are important or less important,
and between those which are commonly or rarely used. In order to
emphasise the importance of certain channel points, ancient physicians
further differentiated among them.
Miscellaneous or 'off-channel' points.
(Extra meridian points)
The
channel points are so named because they are located along the paths of
the twelve Primary channels plus the Conception and Governing channels
(the so called Fourteen channels).As time passed, new points were
discovered or confusion arose when one name was used to designate two
or more distinct points, only one of which was situated along a
channel. In this manner, a new category of points emerged called
miscellaneous or off-channel points. The evolution of these points was
similar to that of the channel points. In the beginning, a site on the
body was needled or cauterised according to the traditional principle
of "whatever hurts is the point". Then, as the effectiveness of a
particular point became established, it was given a name. Later
generations of practitioners, familiar with the location and curative
properties of a miscellaneous point, might then add it to the list of
channel points.
Some miscellaneous points like M-HN-9 (Taiyang),
because of their proximity to convenient physical landmarks, are more
easily located than neighbouring channel points. For this reason, they
are preferred in the clinic. Other miscellaneous points, however, are
more difficult to locate. Finally, there are some miscellaneous points
which are not individual points at all, but are groupings or clusters
of channel and off-channel points.
Points of Pain
(AhShi points)
Includes Trigger Points.
This
general name is given to those sites on the body that become
spontaneously tender when disease or injury occurs,. Their locations
are not fixed. A physician may find a point of tenderness when,
palpating for other conventional points, the patient winces or suddenly
starts. (The Chinese call these "Aah! is the point")
New Points
Traditionally,
all acupuncture points were distributed among the three categories
discussed; Since the establishment of the People's Republic of China in
1949, however, and particularly during the period from the Cultural
Revolution to the present, many new and effective points were
discovered, both by professional medical personnel as well as
paramedics ("barefoot doctors") and by others who have been encouraged
to experiment on themselves in order to further the knowledge of
acupuncture. The discovery of new points has closely paralleled the
development of medical practice. For example, the use of acupuncture in
recent years to treat deaf-mutism, eye diseases, sequelae of infantile
paralysis, etc. has focused attention upon the discovery of new points
around the ears, eyes and lower limbs.
Many of the new points
were discovered by combining Western and Chinese medicine, for example,
by comparing the anatomical description of the nervous system with
traditional channel theory. Because acupuncture points are presently
understood to be surface projections of distinct internal structures,
including nerves and other tissues, it was suspected, and later
confirmed, that new points might be found along major nerve trunks or
at those places where nerve branches converged with the main trunk.
Another method of exploration utilises an electric probe that measures
the electrical conductivity of the skin to identify certain 'reactive
points'. This method has been particularly useful in charting the
points on the ear. Similarly, the probe can be used to measure
electrically excitable 'motor points' in the nerves and muscles. For
example, when using the 'embedding thread' method to treat sequelae of
infantile paralysis, the most important point for stimulation may be
selected from among those in the paralysed muscle which best responds
to the probe.
Using a combined Chinese and Western approach to discover new points has opened new vistas for traditional acupuncture.
Locating The Points
When locating the precise position of an acupuncture point, the most important single guide is sensitivity.
Generally
speaking, acupuncture points are found in depressions in the muscles or
joints, and are often sensitive to finger pressure, particularly where
an illness or symptom with which a certain point is associated is
present in the body.
For gross measurements, the muscle and bone
structures provide useful landmarks. The ancients devised a system
called 'bone measurement', whereby the length of certain bones provided
a standard of measurement relative to the body proportions of the
individual patient.