( or , Japanese
: つぼ tsubo
), also called
, are locations on the body that are the
focus of acupuncture
acupuncture treatment. Several hundred acupuncture points are
located, it is considered, along meridians
across the anatomy which affect a specific organ or other part of
the body). There are also numerous "extra points" not associated
with a particular meridian.
current research into acupuncture points and mechanisms takes place
's acupuncture theory predates scientific method
. There is no known
basis for the existence of
acupuncture points or meridians. Acupuncturists tend to perceive
traditional Chinese medicine in functional rather than structural
terms, i.e. as being useful in guiding evaluation and care of
patients. The findings of a 2005 systematic review
of the effects of
acupuncture on brain activation as measured by functional magnetic
and positron emission tomography
were summarized as follows: "These studies show that specific and
largely predictable areas of brain activation and deactivation
occur when considering the traditional Chinese functions
attributable to certain specific acupuncture points. For example,
points associated with hearing and vision stimulates the visual and
auditory cerebral areas respectively."
Acupoints used in treatment may or may not be in the same area of
the body as the targeted symptom. The Traditional Chinese Medicine
(TCM) theory for the selection of such points and their
effectiveness is that they work by stimulating the meridian system
to bring about
relief by rebalancing yin
"chi" or "ki"). This theory is based on the paradigm of TCM and has
no analogue in western medicine.
Body acupoints are generally located using a measurement unit,
called the cun
, that is calibrated
according to their proportional distances from various landmark
points on the body. Acupoint location usually depends on specific
anatomical landmarks that can be palpated. There are nearly 400
basic acupoints recognized by the WHO
on the meridians
. Many of these basic
points are rarely used. Some points are considered more
therapeutically valuable than others, and are used very frequently
for a wide array of health conditions.
Location by palpation for tenderness is also a common way of
locating acupoints (see also trigger
). Points may also be located by feeling for subtle
differences in temperature on the skin surface or over the skin
surface, as well as changes in the tension or "stickiness" of the
skin and tissue. There is no scientific proof that this method
works and some practitioners disagree with the method.
Body acupoints are referred to either by their traditional name, or
by the name of the meridian on which they are located, followed by
a number to indicate what order the point is in on the meridian. A
common point on the hand, for example, is named Hegu
referred to as LI 4 which means that it is the fourth point on the
Large Intestine meridian.
Categories of body acupuncture points
Certain acupuncture points are ascribed different functions
according to different systems within the TCM framework.
- *Five Transporting Points system describes the
flow of qi in the channels using a river analogy, and ascribes
function to points along this flowline according to their location.
This system describes qi bubbling up from a spring and gradually
growing in depth and breadth like a river flowing down from a
mountain to the sea horse.
- :*Jing-well points represent the place where
the qi "bubbles" up. These points are always the first points on
the yin channels or last points on the yang channels and with
exception of Kid-1 YongQuan all points are located on the tips of
fingers and toes. The Nan Jing and Nei Jing described jing-well
points as indicated for "fullness below the heart" (feeling of
fullness in the epigastric or hypochondrium regions) and disorders
of the zang organs (yin organs).
- :*Ying-spring points are where the qi "glides"
down the channel. The Nan Jing and Nei Jing described ying-spring
points as indicated for heat in the body and change in
- :*Shu-stream points are where the qi "pours"
down the channel. Shu-stream points are indicated for heaviness in
the body and pain in the joints, and for intermittent
- :*Jing-river points are where the qi "flows"
down the channel. Jing-river points are indicated for cough and
dyspnoea, chills and fever, diseases manifesting as changes in
voice, and for diseases of the sinews and bones.
- :*He-sea points are where the qi collects and
begins to head deeper into the body. He-sea points are indicated
for counterflow qi and diarrhea, and for disorders resulting from
irregular eating and drinking.
- *Five Phase Points ascribe each of the five
phases - wood, fire, earth, metal and water - to one of the Five
Transporting points. On the yin channels, the jing-well points are
wood points, the ying-spring points are fire, shu-stream points are
earth, jing-river points are metal, he-sea points are water points.
On the yang channels, the jing-well points are metal, ying-spring
are water, shu-stream are wood, jing-river points are fire and
he-sea points are earth points. These point categories are then
implemented according to Five Phase theory in order to approach the
treatment of disease.
- *Xi-cleft points are the point on the channel
where the qi and blood gather and plunge more deeply. These points
are indicated in acute situations and for painful conditions.
- *Yuan-source points are points on the channel
from where the yuan qi can be accessed.
- *Luo-connecting points are located at the
point on the channel where the luo meridian diverges. Each of the
twelve meridians have a luo point that diverges from the main
meridian. There are also three extra luo channels that diverge at
Sp-21, Ren-15 and Du-1.
- *Back-shu points lie on the paraspinal muscles
either side of the spine. Theory says that the qi of each organ is
transported to and from these points, and can be influenced by
- *Front-mu points are located in close
proximity to the respective organ. They have a direct effect on the
organ itself but not on the associated channel.
- *Hui-meeting points are a category of points
that are considered to have a "special effect" on certain tissues
and organs. The hui-meeting points are:
- :*zang organs - Liv-13 Zhang Men
- :*fu organs - Ren-12 Zhong Fu
- :*qi - Ren-17 Shang Fu
- :*blood - Bl-17 Ge Shu
- :*sinews - GB-34 Yang Ling Quan
- :*vessels - Lu-9 Tai Yuan
- :*bone - Bl11 Da Zhu
- :*marrow - GB-39 Xuan Zhong
Listing of points
- :Location: outside of the lower leg, a few inches
below the kneecap on the tibialis anterior muscle (the shin
muscle, not the shin bone).
- :Effect: Contributes to digestion and overall
Additionally, there are microsystems
acupoints that are typically not located on the meridians. For
external ear microsystem exclusively, utilizing thousands of points
that are not on a meridian, but located on the surface of the
external ear. The Korean system of
hand acupuncture is a microsystem
that utilizes acupoints on the hand.
There are other common
and uncommon acupoints that are called extra points
meaning that they are neither on a meridian nor part of a
microsystem. Extra points are referred to more often by name,
though some of the more commonly known have a letter/number
combination for reference. A popular extra point is
, located at the midpoint between the eyebrows
Evidence from neuroimaging studies
Acupuncture appears to have distinct effects on cortical activity,
as demonstrated by MRI (magnetic resonance imaging) and PET
(positron emission tomography). Researchers from the University
of Southampton, UK and Purpan Hospital of Toulouse, France,
summarize the literature:
- Investigating Acupuncture Using Brain Imaging Techniques:
The Current State of Play: George T. Lewith, Peter J. White
and Jeremie Pariente. "We have systematically researched and
reviewed the literature looking at the effect of acupuncture on
brain activation as measured by functional magnetic resonance
imaging and positron emission tomography. These studies show that
specific and largely predictable areas of brain activation and
deactivation occur when considering the traditional Chinese
functions attributable to certain specific acupuncture points. For
example, points associated with hearing and vision stimulates the
visual and auditory cerebral areas respectively."
Efficacy of specific distal points
This section focuses on the efficacy of specific distal
, i.e. body acupoints that according to TCM theory are
indicated for treating conditions whose symptoms manifest in areas
of the body that are distant from the acupoint's location. Current
biomedical knowledge does not predict that such points should be
efficacious. An example is P6, located near the wrist and used to
The Cochrane Collaboration
group of evidence-based
(EBM) reviewers, reviewed the use of P6 for nausea and
vomiting, and found it to be effective for reducing post-operative
nausea (RR 0.71, 95% CI 0.61 to 0.83), vomiting (RR 0.70, 95% CI
0.59 to 0.83), and the need for rescue antiemetics (RR 0.69, 95% CI
0.57 to 0.83). The Cochrane review included various means of
stimulating P6, including acupuncture, electro-acupuncture,
transcutaneous nerve stimulation, laser stimulation, acustimulation
device and acupressure; it did not comment on whether one or more
forms of stimulation were more effective. EBM reviewer Bandolier
said that P6 acupressure
in two studies showed 52% of patients with control having a
success, compared with 75% with P6 acupressure
. One author of
an article published in the Scientific Review of Alternative
Medicine disagreed .
One randomized controlled trial studied a classical TCM treatment
for breech birth
orientation of the baby, which is much riskier than head-first).
The study showed that moxibustion
acupoint BL 67 (aka UB 67), located at the tip of the fifth toe,
was more effective than placebo at reducing the incidence of breech
birth. An EBM review by Cochrane said that that more data were
needed before recommendations on clinical effectiveness could be
Criticism of TCM theory
Clinical use of acupuncture points frequently relies on the
conceptual framework of Traditional Chinese Medicine
(TCM), which some scholars have characterized as pseudoscientific
. Proponents reply that TCM is
a prescientific system
continues to have practical relevance.
Martial arts applications
There are several types of pressure points, each of which is
applied differently, and each one creates different effects. Some
of the principles are discussed below:
- Pain: Some points are painful, because of the
prevalence of nerves in the area. For example, being prodded in the
throat is painful. The body has a pain withdrawal reflex, whereby it
reacts to pain by moving away from it. Martial artists make use of
this, sometimes without being aware of it. Applying pressure next
to the collar bone, from above, will cause the person to move
downwards (away from the pain), whereas poking them in the gap
between the jaw and neck (just below the ear) will make their body
want to move upwards. Pressure to the shoulder causes that side of
the body to move back. A rub to the back down will cause the body
to move forth. Some points react more violently to pain from
changes in the pressure (rubbing) rather than constant pressure.
All pressure points can cause pain but that may not be their true
- Muscular: Here a direct attack is made on a
muscle, which will contract. Examples include: (I) a punch to the
solar plexus, which impacts the
diaphragm and thus affects the person's breathing ("getting the
wind knocked out of you"); and (II) an attack to the outer thigh,
which could cause the person to fall as their leg loses power (a
"dead leg" or "charley horse").
- Pressure: The baroreceptor in the carotid artery is pressure-sensitive,
allowing the body to control the bloodflow into the brain. Pressure
against this region will 'trick' the body into thinking that blood
pressure is too high, and thus will constrict and lower blood
pressure - which can cause blackout. Striking veins and arteries
can also cause them to shut or tear, both of which will definitely
cause black-out and possible death if not treated immediately.
- Break: There are certain areas which are
likely to lead to a break if struck properly. This includes the
"loose rib", the philtrum and the top of
the skull (soft-spot).
- Hyper-Extension There are joints that, when
struck, can be hyper-extended and even completely torn apart. This
is a technique which can cause permanent damage and disfiguration
to one's opponent, usually focusing on the elbow and the knee.
There are two types:
- brute force: This takes advantage of the vulnerability of the
strike point, thereby causing the damage; and
- Golgi organs: A relatively gentle
strike to the Golgi tendon at the back of the elbow, for example,
causes a reflex which immediately relaxes that tendon, allowing the
elbow to more easily bend in the wrong direction. If this is
immediately followed by a solid strike to the elbow joint, the
elbow can be broken with significantly less effort than through
- Brain shake: The brain is actually a very
vulnerable organ, which is why it is
encased in the skull. The brain floats in
fluid and balances on a very flexible spine. Certain techniques can actually
shake the brain in a way which causes black out. The most commonly
taught technique involves a strike just below the occipital ridge, at the correct angle in the
correct direction. Other areas that are susceptible to such
techniques are the temples and the top of the skull.
- Energy: Some believe that there are energy
channels which flow around the body through acupuncture meridians, and an attack will
impact the flows, and thus impact the body. This is called "chi",
"ki" or "qi" in East Asian cultures. These
techniques are said to be capable of causing blackout, serious
injuries or death when used by a sufficiently skilled martial
Currently, there are two standards available. One is published by
Chinese authority and another by WHO ,
. A semi-official
version by Chinese authority can be found at the website of
Federation of Acupuncture-Moxibustion Societies
Notes & References
- Felix Mann:
"...acupuncture points are no more real than the black spots that a
drunkard sees in front of his eyes." (Mann F. Reinventing
Acupuncture: A New Concept of Ancient Medicine. Butterworth
Heinemann, London, 1996,14.) Quoted by Matthew Bauer in
Chinese Medicine Times, Vol 1 Issue 4 -
Aug 2006, "The Final Days of Traditional Beliefs? - Part One"
- Kaptchuk, 1983, pp. 34-35
- "Despite considerable efforts to understand the anatomy and
physiology of the "acupuncture points", the definition and
characterization of these points remains controversial. Even more
elusive is the basis of some of the key traditional Eastern medical
concepts such as the circulation of Qi, the meridian system, and
the five phases theory, which are difficult to reconcile with
contemporary biomedical information but continue to play an
important role in the evaluation of patients and the formulation of
treatment in acupuncture." Acupuncture. National Institutes of
Health: Consensus Development Conference Statement, November 3-5,
1997. Available online at consensus.nih.gov/1997/1997Acupuncture107html.htm.
Retrieved 30 January 2007.
- The Complete Guide to Sensible Eating: Third
Edition, by Gary Null, ISBN 1-888363-61-4.
- Cited from an excerpt from Acupressure's Potent Points by Michael Reed Gach, Ph.
- Investigating Acupuncture Using Brain Imaging Techniques:
The Current State of Play - Lewith et al. 2 (3): 315 -
Evidence-based Complementary and Alternative Medicine
- Stimulation of the wrist acupuncture point P6 for
preventing postoperative nausea and vomiting
- Nausea and vomiting in early pregnancy [Jan 1999;