Acupuncture Points

The Pacific College of Oriental Medicine publishes a newspaper entitled Oriental Medicine, that carries a great many interesting articles mainly written by practicing acupuncturists. In the current issue there is a nice article entitled “What are Meridians and Points?” by Iona Marsaa Teeguarden a therapist who has developed some very interesting acupressure techniques for dealing with an array of problems. This is a very interesting topic to me: you may have seen some of those pictures of acupuncture points that look like tramlines traversing the body.

Over the last few years I’ve read everything about the acupuncture points that I could get my hands on. If it’s in one of the ten or twelve languages that I can read, then I’ve probably got a reprint of the paper, and people have been kind enough to send me translations of at least parts of papers in Chinese, Japanese and Korean. Some of the research has been excellent, and some less so.

The first point (ha ha…), often controversial when I am talking to classically trained acupuncturists, is that although some of the large well-known acupuncture points are usually in the same place in different individuals, many of the lesser known points are not. Of the 361 main named acupuncture points only a couple of dozen seem to be fixed on the body. Most of the rest can be some way off from the pictures in books. I learned that first when I was an apprentice in London, and then during my studies in China. The top Chinese acupuncturists search for the right points to use. It’s one of the reasons why modern Chinese acupuncturists have identified over a thousand “extra points.”

Although people usually talk about “meridians” joining the acupuncture points together, the Chinese usually refer to them as “channels and collaterals.”

There does not seem to be any neurological or vascular structure at the site of an acupuncture point. Taken together with he fact that acupuncture points tend to be tender and to have characteristic electrical properties, both of which get better with treatment, suggests that they are functional rather than structural entities. Most experienced acupuncturists have noticed that the points vary not just with treatment, but also with mood, the weather and in women, during the menstrual cycle.

In the late 1930s, a French physician named Niboyet was probably the first to find indications that the main acupuncture points have lowered electrical resistance compared with surrounding skin. Some other studies (1, 2, 3, 4, 5.)have provided some support for these findings, although it is difficult to known precisely what to make of the finding that these areas of reduced electrical resistance can also be located on fresh but not dried cadavers. Some people have invoked some mechanism involving electrolytic fluxes along connective tissue or fascial planes of the body. But that’s all just speculation backed by some research correlating acupuncture points and fascial planes.

An additional problem for simple electrical models is that some of the acupuncture points also respond to polarized light, which would be odd if the primary mechanisms of acupuncture points were electrical.

Another set of experiments sought to exploit the phenomenon of “propagated needle sensation.” If acupuncture is done well, then this happens very frequently. It is a subjective sensation of warmth, heaviness, numbness or bursting, that moves at between 1 and 10 centimeters per second, which is much slower than a nerve impulse. This sensation moves along the proposed channels along which the Qi is supposed to flow. But this is the interesting bit: the sensations are not related to any known neurological pathways. The precise nature of this propagated needle sensation remains elusive, with reports of it being interrupted by chilling, local anesthetics and mechanical pressure, whilst it has also been shown to travel to phantom limbs in amputees.

Attempts have been made to trace out acupuncture points and their associated channels by the use of radioactive tracers and by measuring electrical propagation along the channels. 99-Technetium has been the most widely used, and it has been claimed that the tracers diffuse from acupuncture points along the classical acupuncture channels, whilst tracer injected at non acupuncture points diffuses without showing any such linear pattern. The speed of the linear migration of the tracer injected into acupuncture points was accelerated by the use stimulation of appropriate acupuncture points.

If we cannot find anything anatomical at acupuncture points, and they clearly change place and character as the person changes. Then what do the Chinese have to say about the points and the channels?

They say that the channels are there to distribute Qi, and that the acupuncture points are the control points of the channels. The traditional theory is that Qi flows in response to thoughts and emotions. Perhaps thoughts and emotions have effects on muscle contraction and that pushes the Qi along, but I thin that we have to step away from the physical body. I can well remember one of the first people whom I ever treated. I gently needled a “Liver point” on her foot, and she felt the sensation in her eye on the same side of the body. There is no known neurological connection between the foot and the eye on the same side. But in Chinese medicine, the Liver channel terminates in the eye on the same side of the body. The theory of fascial planes can also not explain that. Neither can the observation that many of us have made in the clinic. In some people, acupuncture reveals their entire acupuncture system: the channels become red.

Even when acupressure is used in the subtle systems around the body. I have seen a Chinese Qigong Master demonstrate this phenomenon in a paraplegic patient.

While the Master’s hands were three feet away for the body.

And that will be the topic of yet another research study.