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.