Command points: 4 Junction points

Junction points provide a link between the yin and yang officials of an element, and in this way help maintain an element's balance.  They are also used as part of the procedure for transferring energy from element to element around the circle of the elements.

Yin and yang officials are usually happy to share their energy so to that there is no need for us to interfere with their naturally balanced communication with one another.  Very occasionally, though, one or other official is under greater stress than its companion.  This will appear as a discrepancy between the pulse pictures between them, with either the yin or yang aspect having less energy.  In this case the junction point of the weaker official should be tonified, encouraging it to draw increased energy to itself from its stronger partner.

 

Some pairings of junction points have very evocative names, such as those for the Outer Fire officials, Inner and Outer Frontier Gates.  Gates are always important points, helping energy move smoothly around the body, as needling these two junction points would do.

 

If a command point on either an element's yin or yang official is selected, treatment can then be completed by tonifying the junction point of the untreated official so that both of the element's officials benefit.  For example, you might choose HP (V) 8, Palace of Weariness, for its spirit, and add the Three Heater junction point TH (VI) 5 to finish the treatment.

 

Junction points are also used as part of the routine balancing of energy which forms part of our Akabane procedure.  Where an Akabane imbalance is detected on one official on one side of the body, the junction point of the weaker yin or yang official is stimulated to help it draw energy from the stronger official on the other side of the body.

Command points: 3 Element points: horary and seasonal treatment

Each set of command points also contains points which have a specific association with the five elements, creating a subsidiary circle of the elements. These points lie along the arm and leg in the order of the five element circle.  One of the points will be a Metal point, another a Wood point, and so on.  On yin officials the order of the elements on the arms and legs starts at the nail or first point with the first command points being Wood points and the final command points being Water points, whilst on yang officials the order starts with Metal points at the nail or first point, and finishes with  Earth at the elbow or knee.  The element points add the quality of their particular element to the official they form part of.  A Fire point on the Gall Bladder will therefore add some Fire quality to the Wood of the Gall Bladder.  

The element point of a patient's guardian element (Earth points on Stomach and Spleen for an Earth patient, for example) are the most frequently used of these elements points, because they are selected according to a specific time of day or season.  Treatment for the time of day is called horary treatment (from the Latin word for "hour"), and is based on the 24-hour Chinese clock.  Treatment chosen for a particular season is called seasonal treatment.

 

An element's element point has a particular resonance, as it emphasizes that element's qualities.  A Metal point on Lung or Large Intestine therefore increases the power of the Metal element.  This is particularly so when the element points of that person's guardian element are selected for horary or seasonal treatment in Metal's horary time or Metal's season, autumn, and doubly so if these points can be needled at the same time both in Metal horary time and in the right season.

 

For horary treatment, the twinned horary points of the yin and yang officials are needled to time exactly to correspond to that particular official's horary time according to the 24-hour clock by the sun.  It will therefore be impractical to choose horary points for some of the officials whose horary times are at unsocial hours during the night, such as those for Wood and Metal patients. It is much easier to arrange for Earth, Fire and Water patients whose horary times are during practice hours.  For these patients, the time of treatment has to be during both officials' horary times.  For an Earth patient, with Stomach's horary time from 7- 9 am, and Spleen's from 9 - 11 am, XI (St) 36 must be needled before 9 am by the sun (in other words around 8.45), and then there will be a slight wait until XII (Sp) 3 can be needled after 9 am. 

 

There is much discussion and some disagreement among five element practitioners as to whether we should consider giving horary/seasonal treatments to people whose element has no particular relationship to that time of day or season.  In other words, should we give a Fire person a Wood seasonal treatment in spring.  I have not myself included this as part of my treatment protocol over the many years of my practice, but I know many other practitioners who do.  I think my decision was based on one example of a Fire patient who I gave a Water seasonal treatment to in winter and who told me that she had felt a bit odd after the treatment, but this might have had nothing to do with the Water points but instead related to what was going on in her life.  Perhaps practitioners should do their own research on this to discover how far giving seasonal treatments for any season which is not that of their patient's guardian element appears to support their patients.  The problem here is that I believe that the positive effect of treatment is based on the cumulative effect of a number of treatments on their element, rather than on the effect of a single treatment.   

 

Apart from horary and seasonal treatments, we enter a complex area of five element treatment when we consider whether we should select other element points, such as a Metal point on a Water patient, or an Earth point on a Fire point.  Leaving aside the fact that some element points are chosen as part of tonification or sedation treatment, I think it is not advisable to think that it might be useful to add some Metal to Water points for the Water patient, or more Earth to Fire for the Fire patient.  This requires great insight to pinpoint whether the Water patient would indeed benefit from more Metal, or the Fire patient would benefit from more Earth, because this is a very subtle area of diagnosis.   During our training we were strongly advised just to use the element points for tonification or sedation and for seasonal or horary treatment, and for no other reason.  This is the advice I am therefore passing on here as it is what I have always done.

Command points: 2. Tonification and sedation points

Element points are used both to tonify and to sedate the energy of a patient's guardian element, and are chosen as a frequent alternative to source points.  Tonification is selected as treatment when our pulse-reading tells us that there is more energy in the mother element of our patient's element than in the element itself.  It is then preferable to draw energy from the mother element to the guardian element by needling its tonification points rather than its source points, since this is a way of spreading energy evenly between mother and child.  We should remember that the aim of all five element treatment is to balance the energy so that it flows smoothly from element to element.¬

When we decide to use a tonification point, we select the element point of the mother element.  For example, the tonification points for an Earth patient will be St (XI) 41 and Sp (XII) 2, the Fire points on Stomach and Spleen.

 

It is much more usual for the guardian element to reveal its imbalance as weakness rather than by showing an excess of energy, which is why tonification rather than sedation is overwhelmingly used in five element acupuncture.  If there is any excess energy in the guardian element it is also likely to be dispersed through the standard procedures that we use to clear blocks.  The initial check for Aggressive Energy may show that some pulses seem to have excess energy, but the AE procedure encourages this excess to disperse through the needles to the outside air.  A Husband-Wife block may reveal excess pulses on one hand, and in the case of Entry-Exit blocks the exit points of one meridian may show that they are retaining a build-up of excess energy which is prevented from releasing itself by passing it on to the adjacent entry point.  These are just temporary signs of blocked energy, and each of these blocks can be cleared, not by using an element's sedation points, but through specific procedures.

 

For the the purposes of five element treatment, I think we need to ignore the category of sedation points, and concentrate instead on the frequent use of tonification points.

 

 

 

Command points: 1 Source points

Source points are probably the most important group of points of all those we call command points (see Chapter 6, pages 84 - 98 of my Handbook of Five Element Practice).  These all lie on the arm, between the fingers and the elbow, and on the leg, between the toes and the knee.  If we were to stretch our arms and our legs out, as in the Leonardo da Vinci cartoon, these points would be on the two extremities of the body, on our legs tethering us to the ground beneath our feet, and on our arms as we reach up to the heavens above our head.  We can see them as forming a protective ring around us, sheltering our energy, before the meridians draw their energy to the main area of our body.

Each set of points contains the following: a source point, a tonification point, a sedation point, a junction point, and five different element points.  Some of the officials also have other points such as entry or exit points which are not considered to be command points.

 

All points other than command points can be regarded as in some senses interfering with a patient's energy by manipulating it in some way.  The most important feature of command points is that they are regarded as being the safest points of all, because they have what is described as their own in-built safety factor.  They are therefore selected to complete each treatment and bring energy back under the patient's control.  They are always used together in their paired yin/yang relationship. 

 

The most important points of all these very important command points are what are known as source points.  For the six yin officials, these are the Earth points within the circle of element points, whilst the six yang officials have no equivalent association with an element point.  A yin source point can therefore be seen as drawing upon some of the energy Earth adds to whatever guardian element treatment is directed at.  In other words, this additional Earth quality provides some of the centring which is Earth's particular quality. It is probably also the reason why I choose to needle a yang command point first, before a yin command point, starting with the left side and then the right.  It is as though yang command points offer the external support which all yang officials bring before we delve deeper within to access the deeper, more internal qualities yin officials provide.

My favourite acupuncture points: Conclusion

Many people may wonder why I don't include my own descriptions of acupuncture points, but only list them.  There are many reasons why I am reluctant to do this, the main one being that I don't think that I can explain the reasons for my choice clearly in words.  I have developed these choices after many years of practice, and mainly through something I call my "feel".  I find it very difficult if not impossible to describe how today I might feel that CV 14 is a good point for one patient, whilst III 38 might be the one for another patient.

One day I decided to look back at the treatments I gave to my first patients as part of my initial training, and was amazed at just how few points there were on this list.  And they were all such simple treatments, mostly consisting of command points plus the very occasional additional point, ones we called "spirit points" (although as I often say, all points have their spirit, command points included).  Of course we always started with an AE drain, and were on the look-out for blocks.  The main emphasis of treatment was the simple requirement to confirm a patient's element and then strengthen it in any way we could by choosing points on its two meridians, or points relating to them, such as AEPs or Windows.

I have often talked about the magical day towards the end of my postgraduate study with JR Worsley when he picked up his "brown chart", the well-known bible of acupuncture points all us five element acupuncturists have at our side, and started reading out the names of one point after another, starting with the first, Heart 1, Utmost Source, and ending with GV 28, Mouth Crossing.  He did not tell us how we should use these points, except occasionally murmuring, almost to himself, "this is a lovely point", or "only the most experienced practitioners must use this point", or "this is a forbidden point to needle".  But he spoke each point's name as though he was addressing his beloved.

 

I knew I had heard a master at work, with an understanding of what points meant to him that I would never acquire, but which had touched me at different times to help illuminate my own understanding of my craft.  Perhaps, too, I like to think that he was passing on to the few of us in his class some hint of his mastery to help us develop our own approaches to the points.  Or at least that is what I like to say to myself.

My favourite CV/GV (Ren Mai/Du Mai) points

I have now reached the final selection of my favourite points, those which are on Conception and Governor Vessels.  I have left these to the last because I think they should be viewed as a very special group, to be used always with care.  These two great meridians form the trunk of the great five element tree, from which each element branches out.  Unless there is the major blockage which we know of as a CV/GV block, where the energy from this trunk is unable to feed its branches as it should, I regard these points as adding something very special to the main body of a five element approach to treatment, to be drawn on only where necessary. 

One great distinction between these two series of points is that Conception Vessel runs over the front of the body, its yin aspect, and Governor Vessel over the back, its yang aspect.  In deciding which of these points I might consider adding to an element's points, my first thought is therefore whether my patient needs strengthening from a yin or a yang aspect.   Simply stated, do I think that he/she needs more backbone (yang) or more inner strength (yin)?

 

I also base my selection on a point's anatomical position, and on the name it has been given over the thousands of years of its use.

 

But I turn to CV or GV points only when I feel that all the good work I am doing to strengthen a patient's guardian element is somehow lacking something, and I need to add a deeper layer to my treatment.

 

 

CONCEPTION VESSEL (CV)

 

CV 1                Meeting of Yin             (5 points)

CV 8                Spirit Deficiency

CV 12              Middle Duct

CV 14              Great Deficiency

CV 22              Heaven Rushing Out

 

In addition, there are many CV points which have a special connection to individual officials, and are together known as the Alarm Points.  These points have a special relationship to each official, and on being palpated can provide information about the health of the official.    

     

 

GOVERNOR VESSEL (GV)

 

GV 1                Long Strength             (6 points)

GV 4                Gate of Life                 

GV 12              Body Pillar

GV 14              Great Hammer

GV 19              Posterior Summit

GV 20              One Hundred Meetings

 

 

 

My favourite Water points

(In addition to Command Points)

KIDNEY (IV)             (7 points)

IV 16   Vitals Correspondence

IV 22   Walking on the Verandah

IV 23   Spirit Seal

IV 24   Spirit Burial Ground

IV 25   Spirit Storehouse

IV 26   Amidst Elegance

IV 27   Storehouse

 

BLADDER (III)         (19 points)

III 10   Heavenly Pillar

 

Inner Bladder Line

III 13   Lungs Correspondence

III 14   Heart Protector Correspondence

III 15   Heart Correspondence

III 18   Liver Correspondence

III 19   Gall Bladder Correspondence

III 20   Spleen Correspondence

III 21   Stomach Correspondence

III 22   Three Heater Correspondence

III 23   Kidney Correspondence

III 25   Large Intestine Correspondence

III 27   Small Intestine Correspondence

III 28   Bladder Correspondence

 

Outer Bladder Line

III 37   Soul Door

III 38   Rich for the Vitals Correspondence

III 39   Spirit Hall

III 42   Spiritual Soul Gate

III 44   Thought Dwelling

III 45   Stomach Granary

III 47   Ambition Room

 

It has been a most illuminating exercise for me to gather together the list of my favourite Water points, and realise so clearly for the first time the very unique position the Water element occupies.  For unlike its fellow elements, its points can be used to treat all elements, and are not limited to treating only itself.

 

The Kidney chest points and Inner and Outer Bladder points are routinely added to reinforce the effect of points on the other elements.  This gives it a very special place in the hierarchy of the elements.  It helps us understand that it is in many ways our core element, the original element from which all the other elements spring and from which all life emerges.

  

My favourite Metal points

 (In addition to Command Points)                  

LUNG (IX)                     (3 (4) points)

IX 1     Middle Palace           

IX 2     Cloud Gate

IX 6     Greatest Hole

(IX 10    Fish Region)

LARGE INTESTINE (X)     (3 points)

X 7      Warm Current

X 15    Shoulder Joint

X 20    Welcome Fragrance

 

AEPs

III 13   Lung Correspondence  

III 25   Large Intestine Correspondence

 

WINDOWS OF THE SKY

IX 3     Heavenly Palace

X 18    Support and Rush Out

 

It is interesting to compare the fact that I have selected fewer points for the Metal element (6 in total, apart from the AEPs and the Windows) than those for the Wood and Earth elements.   I expect the same will be true of the Water element, again with its two officials having far more points than either the Fire or the Metal elements. 

It may also be significant that I have chosen only three points for the Large Intestine out of a total of 20, the same number as for its yin companion, the Lung, which only has 11 points.  This may be because I like to concentrate my attention on the Lung, the receiver of Qi from the heavens, rather than on the Large Intestine, in charge of drainage and dregs.   Perhaps this is because I may tend to regard it , wrongly, as a less important official.

There is one further point on the Lung, IX 10 Fish Region, which is a command point, but also has a special position when treating the Metal element.  I was told by JR Worsley that it is "the most spiritual point on the body", and that has resonated strongly with me since then.  It is a point which Metal people love to be told about, because at a deep level they understand the point's significance.  We would all like to have our most spiritual point needled, whatever our element, but it is only Metal people who appear to understand how important this point is for them.

 

 

 

 

My favourite Earth points

In addition to Command Points

 

SPLEEN (XII)           (3 points)

XII 8    Earth Motivator

XII 15  Great Horizontal

XII 20  Encircling Glory

 

STOMACH (XI)        (8 points)

XI 4     Earth Granary

XI 8     Head Tied

XI 12   Broken Bowl

XI 19   Not at Ease

XI 24   Lubrication Food Gate

XI 25   Heavenly Pivot

XI 37   Upper Great Void

XI 39   Lower Great Void

 

AEPs

III 20   Spleen Correspondence  

III 21   Stomach Correspondence

 

WINDOW OF THE SKY

XI 9     People Welcome

In addition to the above, there are two sets of Earth points which we were told as students that we could needle as paired points.  The first is a combination of two command points, St (XI) 40, Abundant Splendour and Sp (XII) 3, Prince's Grandson.  Abundant Splendour's name is enough encouragement for us to select it, but it becomes a more powerful point when it is used at the same time as Prince's Grandson.  An Emperor's grandson was regarded as a very special person, since he ensured that the Emperor's legacy would continue to further generations.

 

The second set of points is the combination of St (XI) 25, Heavenly Pivot with Sp (XII) 15, Great Horizontal, which are on the same level of the mid-abdomen as CV 8, Spirit Deficiency.  They can therefore be seen as strengthening the centring effect which CV 8 brings to the spirit.

 

 

 

 

 

 

My favourite Outer Fire points

 (In addition to Command Points)

 

HEART PROTECTOR (V)  (1 point)

V 4      Gate of Ch'i Reserve

 

THREE HEATER (VI)         (4 points)

VI 7     Assembly of Ancestors  

VI 12   Relax and Joy

VI 18   Feeding Meridians

VI 23   Silk Bamboo Hollow

AEPs

III 14   Heart Protector Correspondence  

III 22   Three Heater Correspondence

 

WINDOWS OF THE SKY

V1       Heavenly Pond (for men)

V 2      Heavenly Spring (for women)

IV 16   Heavenly Window

This completes the list of my favourite points for both sides of the Fire element and for the Wood element.  

It's noticeable how few points I have listed.  I realise that when I move on to Earth and Water there will be a much greater choice of points available.  And when I reach Metal, another element with its yin official in the Upper Jiao, I expect my list also to contain only a few favourite points.  This is because the number of points on the front of the Upper Jiao is far fewer than those on the Middle and Lower Jiao.

This made me look at the range of points available for all the elements, and try and see if there is a pattern here which relates to the number of points on different officials and in different areas of the body.  Totalling all the points on all the elements, including CV and GV, I have counted 115 points on all yin officials and more than double the number, at 246, for the total of all yang officials.  

It is also noticeable that the three Upper Jiao yin officials, Heart, Heart Protector and Lung, have the least number of points of all officials. This is reflected in my selection of only a total of 3 favourite points for Heart and Heart Protector officials, and only 2 for the Liver, although this is in the Middle Jiao.  

It will be interesting to compare this number with the total of my favourite points for all the other elements and their officials once I have completed these lists.

 

 

 

My favourite Inner Fire points

(In addition to Command Points)

 

HEART (I)     (2 points)

I 1        Utmost Source

I 5        Penetrating Inside

 

SMALL INTESTINE (II)      (8 points)      

II 9      Upright Shoulder

II 10    Shoulder Blade

II 11    Heavenly Ancestor

II 12    Grasping the Wind

II 13    Crooked Wall

II 14    Outside the Shoulder Correspondence

II 15    Middle of the Shoulder Correspondence

II 19    Listening Palace (also Exit point (for Entry-Exit block)

 

AEPs

III 15   Heart Correspondence (to be used with care, and usually only after AE is found on the other yin AEPs)

III 27   Small Intestine Correspondence

 

WINDOWS OF THE SKY

II 16    Heavenly Window

II 17    Heavenly Appearance

(Small Intestine is the only official with two Windows of the Sky)

There are a group of very important Small Intestine points on the back, which lie over the scapula and lead up from the armpit to the neck from II 9 to II 15.  It is clear from this how much this official contributes to holding us upright.  Apart from the Inner and Outer Bladder pathways and of course Governor Vessel, it is the only official with points on the back.

 

 

 

  

My favourite Wood points

Following on from my blog of 10 April: Acupuncture points:  helping our skeleton dance, I am drawing up a list of my favourite points for each element.  These will form handouts to accompany another set of videos for my Chinese students in which I talk through my choice of points.  

Here is the first list, which is of my favourite Wood points.  I have always been encouraged to use the least number of points possible, so you will see how few there are in this list.    

I am sure each acupuncturist will have assembled their own list, which may well include other points.  As I always say, each five element practitioner has the right, and I think the duty, to develop their own practice in ways which feel comfortable to them, so my list may well be very different from other practitioners' lists.  The most important thing is that we should always be open to input from others, provided that we are satisfied that this input is based on good clinical experience, not on trawling through the kind of acupuncture books listing points which, as you know, I am very wary of.

NORA'S FAVOURITE WOOD POINTS

(in addition, of course, to Command Points)

 

 

LIVER  (VIII)  (2 POINTS)

VIII 13 Chapter Gate

VIII 14 Gate of Hope

 

 

GALL BLADDER (VII)    (7 POINTS)

VII 1    Orbit Bone

VII 14 Yang White

VII 15  Head Above Tears

VII 16 Eye Window

VII 20  Wind Pond

VII 24 Sun and Moon

VII 25  Capital Gate

 

 

AEPs

III 18    Liver Correspondence            

III 19    Gall Bladder Correspondence 

 

 

WINDOWS OF THE SKY

The Wood element has no points which are listed as Windows of the Sky.  This is probably because Wood is all to do with vision, with looking forward into the future.  Every Wood point therefore gives us vision.  Partly because of its name, I like to think that VII 16 Eye Window can be used as an alternative Window of the Sky.

 

ALSO:  

III 42 Spiritual Soul Gate has a particular relevance for the Wood element because it is at the level of the Liver AEP (III 18).