Acupunct Med 1996 Schnorrenberger 89 103

Morphological Foundations of Acupuncture:An Anatomical Nomenclature of Acupuncture

Structuresclaus C schnorrenberger

SummaryELlropean mistranslations of oriSinal Ch/nese texishave not merely intrcduced incorrecl concepts toWestern acupunctutists, but have adversely affectedtreatment methods. The French diplomaL Soulie cleMoran t pub l i shed an impor tan t t rea t i se ,"L'acuponcture Chinoise", in 1939; this has fomedthe basis ol Westernised "tradit ional" chineseacupunc tu re . Because he hac l no med ica lbackground, he was unable to interpret the medical,tEnil i , dn, e ol tr"di l ionrl ahina'e ' on cpt- in thlLerL, th.t he had ,e"d. Ure hc, oulcl not \cp lhat afirm basis ol medical knowledge is necessary tor thercliable practise of acupuncture, thus unwittinglyinttoducin7 acupuncturc as a playgrcund for laytheraptsts.The two most important mistranslations were: i the

use of "point" lor Xue wei, which would be bettertranslated as "foramen" to give fhe impressian of athree dimensional slructure; and ii. Qi, which is apart icularly diff iculL concept to translate, but isce r ta in l y no t equ iva len t t a t he Wes te rn te rm"energy". These erros have now been accepted intostandard usage through their transcript ion intomodern, western laDBuage, Chinese LextbaoksWestern aa:upuncturists are mainly unaware at' the

substantial anatomical basis for the nomenclaturc inacupunc tu te t and i n r i eed o i t he ana tomica lknowledge ol the ancient Chinese physicians asexp ressed i n a r i g ina l Ch inese ned ica l t ex t s ,examples ol which are Bivetl in this paper.

Key wordsAcupuncture, Acupoints, Anatony, Nomenclature,Trad iti on a I Ch i nese med i ci ne.

IntroductionThe typjcal Chinese expression lor the acupuncturepoint is Xue Wei which correctly translated means"pit-place", "hale-spo|" or in some contexts rhesl'1 Inthe language of classical acupunctufe this term iscommonly designaied to al l the therapeutic "points",which are by definit ion and in reali ty not points ata l l bu t bod i l y s t ruc tu res . These s t ruc tu res a redescribed three dimensionally in classica chinesetexts. Accordingly, "poirts" of acupuncture do notexist because they are not one- or two dimensionalco o rd ina tes on the su r face o f t he sk in as mos t

A. u p u ncLu re i n Med l( i n,"

Western textbooks try lo make us bel'eve. Correctlyunderstood, acupuncture "points" ate anatomicaland morpholo:l ical structures which in most casesc a n e a s i l y b e d e l e c t e d w i t h t h e n a k e d e y e(e .g . S l .1B , AP1B, S i .19 , CB.20 , LU .s , 11 .4 , C I l 34 ,and many more). In fact these structures are visi l l lehollows or elevations on the exter'or of the humanorgan ism, exp la in ing the l og i ca l de r j va t i on o t t heoriginal term "Foramen" (Xue'wei)- Most westerna n d m a n y C h i n e s e p u b l i c a t i o n s c o n c e a l t h L simportant fact. And in part icular i t is not rnentionedin the foreign languaBe texts on acupuncture byC h i n e s e p u b l i s h i n g h o u s e s , a s f o r i n s t a n c e i n"Outline ol Chinese Acupuncture" ot "Essentials olCh i nese Acu pu nctu re" ( 1,2 ).

S u r p r i s i n B l y , m o d e r n C h i n e s e a u t h o r s o facLrpuncture textbooks when wfit ing in Westernlanguages tend to tac i t l y copy ou t t he Wes te rnacupLrncture terminology without naming iG oriSin;the results are, as a mattel oi course, erroneousWestern trans ations of the oriSinal Chinese terms.Western readers are mislead in their assumplion thatthese works refer to genuine soulces. They cannotperceive the above mentioned impl'cations and aretherefore defrauded of the opponunity to understandthe essence of Chinese acupuncture. The authentjcsources are st i l l the oriSinal classical Chinese works,whjch to a Sreat extent have not yet been translatedinto Western langua8es- During the I960s, '70s andod ' \ ' 80 . , r l - r e - . medr , . l , o l " ; e ' r r t r e Ppoo lp .Repuo l r n f I h in . pLb l i . hcd ' ompr la r o r ' u f ' nmcancient texts in modern Chinese characters (Mao_ fse tung ' s

re fo rma t ion o f t he Ch inese cha rac te rsintroduced a so called short form, which howeverdoes not contain the ful l information of the classicalcharacters.) These revised texts contain valuableinformation because they integrate recent cl inicalexperience in China as well as new technlques andaddit ional or new foramina (polr l is)-The problem with acupuncture in Europe is to be

seen in a lack of general medical knowledge of earlyE u r o p e a n t r a n s l a t o r s o f t h e C h i n e s e c l a s s i c sNLrrferous uncorrected errors are contained in thewo tk "L 'acuponc tu re Ch ino i se " , pub l i shed i n2 vo lumes by the F rench nove l i s t and d ip lomatCeorges Soulie de Morant. His work appeared inPar i s i n 1939 and s t i l l i s t he bas i s o f many fa l seassumpt ions i n Wes te rn acupunc tu re l oday (3 )S o L r l i e , w h o p r o b a b l y s p o k e a n d u n d e r s t o o d

89 Novenbet 1996 Vol 14 No.2

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Ch inese qu i te we l l , i n t roduced fo r examp le theincorrect translation "poirt" instead of the generalChinese term Xue-Wei although he was welt awareo f t he th ree -d imens iona l na tu re o f t he c lass i ca lacupunctlrre structures. ln his book he quite stressesthe cha rac te r i s t i c f ea tu re o f t he po in t s as ho les(foramina) or as hollows, but nevertheless chose theword point as his translation. ln part icular he is theoriginator of the ambiguous term "energy" for theChinese Qi as he himself admits "faute de mieux".The latter has lead to endless misunderstandings inEuropean acupuncture. Furthefmore, Soulie did nothave co r rec t unde fs tand ing o f t he na tu re o f t hemetidiarc (Jing-Luo) which are t ime orientated aswell as anatomical and topographicai by definit ion.As a resu l t Sou l i e cou ld be ca l l ed the fa the r o f"Euro-Puncturc", the playground of many laymen asw e l l a s p h y s i c i a n s , b e c a u s e i t s e e m e d t h a taccording to SouJie, sol id medical knowledge wasnot absolutely necessary for the rel iable practice oiacupuncture,

Anatomical and topographical informa onconlained in original acupunclurc le.msThe o ldes t t rad i t i ona l t ex t re la t i nB to Ch inesemedicine, entit led Huang-Di Nei-JinB Su-Wen, isquilc ' l .dr in : ls r l . l( . \ o1l t l^rmdl on , or(err rB lheanatomical structures of acupuncture loramina (4).

Plate 2. LinB Shu, Chapte.3l.

"The hunan latynx is 1A Lian1 lapTox. 1|Ad heary and2.5 Cun (apprcx. 5cn) r,ide, to the stona.h the distance1.6 Chi" (apprcx.25cm).

Plate 1.5u Wen. Chaptet 64.

middle: "Ihis totunen @)nment:rcfe6 ta Stamach 12,Que Pen)lies between the tupafthe shouldet antl thchot z . - ' t 'h . " tdq bo", \ , nrp ' t . t . - |d \ r : lleft:"lt is possible (comment: fq back pain and tenicular pain)Io puncturc lhe E sa.Jal foramina (Chin: Ba Liaa) and the pointsofpain.Ihe 8 saualforanina lie in depr$sions between thclunbar and sactat rcBbns."

For instance, the B sacral fofamina (Ba l/ao) as welJas seveTa l o the r ana tomica l bone o r i f i ces a rereferred to in the 16th Fascicle, Chapter 60, section"Cu-Kong-Lun" which rneans "Essay on the BoneOrifices" lsee P/are /, original pag of the su-Wen,Chapter 60, containing the Chinese characters fort l - e B -a , r " l l o rdm indJ r5 / . rhe \d , a l f o r "m i rd d reknown to modern European acupuncturists as thepo in ts B ladder 31 , 32 , 33 and J4 . They a re ,however, not in lact "points" but well describedbone structures.The same chapter of the su-We, is also concerned

with the anatomical structures of numerous otherbones o f t he he rman body . l t i s no l onger j us tassumed , bu t has been h i s to r i ca l l y p roven , t ha tmedical practi l ioners in ancient China carried outex tens i ve ana tomica l s tud ies f6 l . Th i s f ac t i s s t i l lwidely unknown in Western countries, neither non-p h y s i c i a n e n t h u s i a s t s n o r m a n y m e d i c a lacupuncturists with special ised training are aware ofthe exact historical context.Moreover, the second part of the Huang-Dl Nei

JinB, Ihe Ling-Shu-Jing, sometimes referred to as the"B ib le o f Acupunc tu re " , con ta ins documen ta ryevidence of anatomical studies in ancient China. Forexample Chapter 31, Chang Wei-Lun, which means"Essay on the lntestines and Stor?ach" Bives an exactaccount of the length and structure of the differentsections of the digestive system which coulcl nothave been achieved without previous and thoroughd issec t i on o f t he a reas conce rned (7 ) (P la te 2 loriginal page of lhe LinB-Shu-JinB, Chapter 31, seealso Table I) (8, 9).

II,'J

(tu .:Ji:Eri 9e#r.ffi

w>-;il;t 1^E

4ffi#itrthr,tr *E4F'iffillLl \ t r3 r n)2rE

Navenber 1996 Val 11 No.2 9A \.upun.tLne tn MedLne


I Ht MIAsURTMT\ IS OF IHI DIGESIIVI \YsTEMfrom Lins-Shu l in8, ChaPler 3 lMeasurements: Chinese1 . Pharyfx to enbance oi slonrach l5Chin.lect lcht) o 25-|.

5.80m

1.60m(Duoden!m ,nd Jej !num)

( l eum wi th ascen. l inBand tr)nsve6e colon)

l3 Chin. teet

2 l Chin. lec l

2.8 Chin. ieetlDcscendins and s iEmoid

Comparison ofancient Chinse io modern measurementsRatio ofOelophaSus : Intest nes1 . 6 : 5 6 . 8 C h i n . t e e t = I r J 60 . 2 5 : 9 . 2 5 m = 1 : : t 7

t F i ) t l , E + - + t + + E + +Trl^=44' 3 \ , * ,1,=*r .g : ,2 ,n, q^=*, * t

aiigirO ":4" (+:lq) firili'FH=i'1f "--l', (fa)

i6r!IJE=i "=i'.

(i&iEr X?,EH:!iiElL+, it6*2, r!+1tE=ItrT-5Ein:+.F. Afilt6'=-ii.

t F ' l l d E . 1 i f : : G 4 c 6 r , i , l\- i . 'J+E. {= E .,E,.r- ,='"

(iE+r ,.81.(Si:l F9iEF=i{rd}LF, riE.lxz, + +E:A-5

e&IzrA. eFtt4'=-i,

Plate 3. Zhen Jiu lia YiJinS, Fas.icle 3

Contains antoni.atdetaik an the position ofthc I sactallotamina CiLiao lBladder i2), zhans Liao lBtact.let 3J),Xla Liao (Bla.lclet 34).

Plate 4.Iane Ren 'hu Xue Zlen liu Tu 1i18, Fasci.tF 1Iftnslatian lftun left to riSht):a) "The Shang Liaa (Bladder 31) caDsists af 2 fotamina bathsi.les af the centte of the sPine, which lie in depresstans ot thehilhest bane .njfices, 1 Cun beiav'the bone proje.tions" ltetetsta the latuet nedial naryins ofthc ilia..rest)b)"The Ci Liaa (Eladder 32) consi'ts ai 2 to nina both sidesof the cente of the spine Thev lie in deptessions af lhe secandbane arifice" (of the Os sactun)c) "The Zhon| Liao (Biadde. 33) consktt of 2 fotanina bothsides of the centte al the spine lhey lie ln.lepresslans ot thethid bane arifice" (of the Os sacrun)d) "The Xia Liao lBladdet 34) cansists of 2 fatanina bdh sidesb the centre af the spine.Ihey lie in depressians ofth foutlhbone orifice" bf the Os sac.un)

Plate 5. Tong Ren Shu Xoe Zhen liu Tu ling, Fasci.lP 1

"Ihe Yans Lins Quan (Callbladdet 31).onsins af 2 Fadminaand tier 1 Cun belaw each knee in Ihe nid.lle of thc.Jeptessions ofthc wai Lian" (= head offibula)

I i II l'4&W

_',ii,\'xXi;i$ffi;frtr,l.lEE R,r,4t4tfr.,1

t.ffi8tE,{ f t 1i+i It l

1 r it t tl L I

EvEM'Wl.rttr-iltl4liXtEfre ft4f6r1.f lt ir,tD$+i1Et r-r$,^\trfr,1ft*r6'rI r+ri 1!

Acupu rctLre I n M e.l i c i ne 91 No\etnbet 199b Val l1 No ./


l n add i t i on , t he work o f t he famous phys i c ianHuang Fu-Mi, entitled Zhen,Jiu lia-Yi-ling which hecomp i led i n 259 AD, con ta ins an abundance o fexact descript ions of the anatomical structures ofacupuncture loci (Plate 3) (10).The p r imary sou rce o f i n fo rma t ion and exac t

anatomical accounts is however the classic lon6Rer, the Copper Man f: i 7) (see also Plates 4, 5,6and 14). Plate l provides documentary evidence oft o p o E r a p h i c a l a n d a n a t o r n i c a l i n t o r m a t t o nconcerning the foramina Bladder 31, 32, 33 and 31,found in this text in classical Chinese characters_ Aclassical japanese work of acupuncture dating fromthe middle of the '19th century, which was wflt ten lnChinese and therefore read in China, contains anana tomica l l y accu ra te i l l us t ra t i on o f t ne sac ra tf o r a m i n a . T h i s w o r k m a y a l r e a d y h a v e b e e ninfluenced by early Western anatomy, but i t standsL o - p d r ' \ o r \ ^ r l h a 1 ) ^ o d c r ' l d ' 1 d l o r r i t , J r l , a s a s ' a ras i t s p rec i s ion i s conce rned (P la tes 7 , 8 ) (12 ) .

Plate 6. TonE Ren Shu Xue Zhen Jiu Tu line, fascicle 1.

"The YanE Lins Quan (Callbladder 31).onsist; af 2 Fotaninaand lies 1 Cun below each knee in the mitldle af uEdepresstans ofthewai Lian" (= head offtbula).

This issue is proven by comparing it to an almostidenticaJ i l lustration of the sacral foramina whichhas been taken from a well known anatomical at lasof our day (Plate g). Ovet and above many otherstructures, which cannot possibly be referrecl to hefein ful l , the / lng-Xue Huil ie describes the foraminaYanB Ling Quan (Gallbladder 34) and Yin LingQuan (Spleen 9/ with great competence (Plates 10/2). The author Soulie de Morant was aware of

Novenber 1996 Vol 14 Na.2

Ptate 7. OtiEinal page fran rhe classicalwark Jins Xue Hui-lie.

these i l lustrations in the l ing-Xue Hui-Jie, as hep u b l i s h e d t h e m i n h i s v , t o r k ( 1 3 ) . ^ s d n o n -physician, however, and without suff icient medicalknowledge and understanding, he was not capableo f i n t e r p r e t i n B t h e i r m e d i c a l a n d a b o v e a l lmorphological si8nif icance, and just added to theconluston-Also, in his predicament, he sought refuge jn the

term "erer8y'for the Chinese Qi. ln rcality, "enetgy"explains nothing but only repJaces one unknowntactor by anothef, result ing in lhe ' ,energetic"acupunc tu re theo ry , popu la r i n t he Europeanacupuncture scene of today. The medical essenceand foundations of the important classical textsremained out of Soulie's reach-

F. ,g t n f4 *'i!r31.

: F fi- 6 E" J,iz * ^ t p r y

4,3 i {4$i. f+ r*

3 # .f

t

t1,1 -

'F

4E

dt + t Ft l f i '

A E-{h

Al*

, \B.uPl

Oti9lnal paqe fron the classi.al work Jing-Xue

92 Acu pu nctu re i n Med ici ne


How great the suggestive element of the false, eaf yEuropean translations of Chinese acupunctlrre textsactuaily was, is i l lustrated by the fact that the authofo f t h i s a r t i c l e h imse l f adop ted many amb iguousFrench te rms du r ing h i s ea r l y days as a r . ed i caau tho r - He was , i n f ac t , f o rced to do so as heo the rw ise wou ld no t have been unders tood i nacuplrncture circles. This appJies for example to theincorrect use of the term "ener1y" lot the Chineseexpression Qi which he sti l l used in his translationof the work Huang-Dl Nei JinB Ling-Shu in 1974 (14).

Piate 9. Venttaland daBalvie\r ofthe os sactunt

Plate 11. Otder af the rJetidiars and fotamina in theinterc%talspa.es lfrcm the "ling Xuc Hurlie").

j * g * t r

Plate 12. Vertebral stt uclures, scapula, humetus ancttapollaphy of sone fotamlna lfrcn the "ling Xue llui lie")

(C((

t:E

fg

PlaE 1a. 1he fotamen vin LinEQuan (Spleen 9)ftom the "Jing Xue Hurlie.

European Acupuncturc: Discrepancies and RisksIt fol lows that i t is not only a rnatter of unquali f iedcontrovers, but can to sorne degree explain why\ \p r l p rn o t i i r . r ' . d ro Jn r \e r . . i e \ r i l l o re ' c ,8 l i ' "acu pu nc tu re . Eu ropean acupunc tu re so . re i l esthernselves, with their thousands of members, rnakeErave mistakes pertaining to Chinese medicine andacupuncture. In addit ion they olten pass on falsein {o rma t jon to the i n te fes ted pub l j c , t o . . ed l ca lo o ( o r \ d - . u r i a l i o r s r r d m ' d i , J l i , l . L r r d 1 ' Fcompanies. The errors oi Western authors evenspread as far as China, the cradle oi acupuncture-While the Chinese sti l l correctly refer to "holes",

"nests" and "pi is" (original ter.a: Xue Wel) whenspeaking of needle and rnoxa therapy (Zhen-Jiu) inthe i r mo the r t onBUe, these same spec ia l i s t s t a l kabout "poinis" of acupuncture when dealinB $' i thinterested Western patties (1,2). The onLy relatlvelyinsignif icant exceptions are a few points on the earand the 18 'hew" acupuncture points of the hand,wh ich even i n modern Ch inese a re a l so ca l l ed"points" (Dian).

Acupun.tLrc h Medicine 93 Navenbet 1996 Val 11 Na.2


In the author's opinion, an acupuncturist who is:L not acquainted with the histofical and anaromrcat-topograph ica l , t h ree d imens iona l bas i s o { t heforamina, who:ri . perhaps out of misguided tradit ional perceptionneglects the thorough anatomical foundation of hisdaily work, and who:i / r ' . canno t recogn ise the morpho log i ca l ,t opograph ica l and ana tomica l s i gn i f i cance o facupunc tu re s t ruc tu res , shou ld bes t d i sca rd h i sneedles and close his practice. He is certainly a r iskto his patients health. This applies as much today asit did during the period of the classic book l ing-ShuJ ing 2000 yea rs ago , where expe r ience warnsaga ins t unschoo led the rap i s t s and the resu l t i ngdangerous injuries caused by poor acopuncture.Ev idence o f t h i s f ac t can read i l y be found i nhistorical as well as in contemporary literature f/5 26).The Thrce'dimensional Orientation ofChinese Medicine in the Human BodvBes ides the th ree -d imens iona l o r i en ta t i on i n t heworld and environment, the correct structural orderof the human body also plays an important role inthe ancient Chinese acupuncture texts. The classicalC h i n e s e o r d e r o f s p a c e i s d e r i v e d f r o m t h ecorrelatjon between heaven, mankind ano eartn,Man i s seen as be tween heaven and ea r th .The Chinese charactefs "Tiar" (heaven), "Ren" (man)and "D/" (earth) ar therefore often found in thenames o f acupunc tu re fo ramina (Tab le 2 ) . I heyse rve the th ree d imens iona l o r i en ta t i on on the

human body in the sense of upper (superior), middle(med ia l ) and l ower ( i n fe r i o r ) . The Ch inese te rms"Shang" (uppetl, "Zhong" (middle) and ,X/a,,(lower)have the same meaning. These terms can neatly betranslated into a Latin anatomical nomenclaturewh ich i s i l l us t ra ted i n Tab le 2 . The on l y twoexceptions here are the basic terms yin and yarg,which are of a pre-categorial character, i .e. theyhave no equivalent in ouf occidental Aristotel iant rad i t i on o f t h ink ing and speak ing i n t e rms o fcategories. The integration of t ime and space thaty l r - yang imp l i es has no equ iva len t i n modernWestefn languages at al l f2Z.Due to the cons ide rab le and comprehens ive

d i f f e r e n t i a t i o n o f m e d i c a l a n a t o m y , m o d e r nanatomical nomenclattrre goes as a matter ot courseinto Ereat detail, as the contemporary standard work"Nomina Anatomicaf i l lustrates (28). The tradit ional,d n a l o m , c . a h n e r e " , u p u n r l u e t e r m \ d r e i ncomparison more simple, but often a great dealniore graphic. Neveftheless, the conformity in manycases, the objective and logical paral lels, and theanalogies of our anatomical nomenclature with thetradit ional Chinese names are not only evident, but toa large degree anatomically and toposraphicalJy proved.Iab le 3 summar i ses the Ch inese topograph ica l

synonyrns tor the generic term rxue Wel" ( l i teral ly:hole spot, pit-place) on the human body as we

asother topographical names with their translationsa n d c o m p a r e s , w h e r e v e r p o s s i b l e , t h e L a t i nequ iva len t , wh ich may usua l l y be found i n ou rmodern anatomical nomenclature.

CENERAT TOPOGRAPHICAT TIRMS OF CHINESE MTDICINE FOR THREE.DIMENSIONAL ORtINIAfION ON THE BODYTraditional Chinese ropographi.al Terms Latin Anatomical Trandation

DiZhong

1O (Earth) Ca!dal is

t

T= Medianus Centra l is

Crania is

TraditionalChineseYanB [EYin FXQian Ei

EnglishManing

fraditionalChinesewai tl

You E

English

nSnr

Meaning

Sin is ter

ObliquusDorsalis

HenB .ffiBei Hru BE

Ial Yans ,t[E

Mian F

jinc tnxions l@

Bei ?fRegiones abdominales

tu Yin ::Pff

HuiYin AFA

Reglo per ineahs

tr

Navenbet 1996 Val 14 No.2 94 Acupuncturc n Medi.ine


Table 3cHfNESE TOPOCRAPHICAL AND ANATOMICAT SYNoNYMS FOR THE BAslc IERM Xue'Weiwilh eramples of some ilpiel acupunclure fonmina

Traditional English Latin anatomicalExamples

1stcRoUP: meaning "hole, hollow"

Tang

DinBCongCanE

,\fit*

ft

d

pi t

halJ

lcatinusllDomusltHorreuml

K t . 1 3 , N P l 3st.18, 81.31-34, AP 160

st11, BL_49LU.1L l . 1 7PC.8st4, 81.50

2nd GROUP:

Chuang

meanin8 "gate, door. opening"ll door, gate

tr mouth, estuary

f, bowl IScutulal

tu.2, Hr.7 , AP 11 2sT_11, cv17st38s t .16 ,5116sl12

3rd CROUP:,n8ZeZhuchi

auanauCou

Q'

Chong

tstagnuml

ILacud

IFonsl

CanalistRivrsltAbundantialReceptaculum aquaeIMarelIVortexl

TE.10, C8.211U,5, PC.3K t . t 51 I . 1 1TE.11KL1, Kt .5LU.81R.5, CV261t .5, SPlSK t . 1 45t lsP.10, cv6BL,3Kt.7

meaning "body of water, watrcourse"

r+ poot, pudote

it pondis ve,

ra groove, channel14 't,"u-ffi abundantwaterii receipt of waterE sea, oceani$ risinc whirlpool

4th GROUP: meaning "depression, vall, path"cu t;xi t4

11.4, K1.201t.5, Kl .3st28, c8.28

Rivus

5rh GROUP: meaning "hill, elevalion"shan drLins [n)ian +

8L.57, AP 4PC.7, G8.34, SP.9A P 1 4 6 , 8 7 , 8 8 , 1 0 6 , 1 5 1

mound, h i l l Caput

6th GROUP: meanine "bone. bone structure"C U F

Jian lEl

Os

Spatium

Ll. t6, AP 1s7sT.3, 8t.31-34Lt.2,3

7rh GRoUP: meaning "boundar, dgeCuan ;

MargoPC.6,1R.7, TE.51 t . 8 , 9LR,4

1t

II

Acupu ncture i n Med ici ne 95 Novenber 1996 vol 14 No-2


Traditional English

8th CROUP: meaningDlrtantia 1t.13, St35

9th GROUPT meaning ",unction, meeting place, distribution"

{ crosslngJi distribution IDistr ibut iol

C8.42SP681.41

1oth GROUP: meaning "tendon, blood vessel"[;i. veselE tendon

81.62CV8, AP 147, B1.56, CB.2]

11th GROUP:

Ting

meaning "place, plainfi (niarket) p ace

IE inner court

51t3, cB.3lN P 7 7 , A P 9 5 , ] ] 9st44

12th GRoUP: meaninS 'crevice, cleft, splitx i (Aj ) c lef t PC 4, HT613th GROUP: meaning poinlDian N P 4 1 , 5 0 , H a n d l - 1 8 , E . r l

14th CROUP: meaning "body parts and organs"

ErBi

, yaro, eroowlF abdomen

l@ chestE ear

ffi upper abdomenF lumbar resion^fl8[6 inner orsans

Cap!t

Epiganri!m

L U . 55 P 1 6 . 1 45 1 . 9 , 1 4 , 1 5 , T E . ] 4S P 1 9T E . 2 1 , A P ] OA P 1 5 , 1 6 , N P 1 2sr8

cv ]0 , r 2 , 13CV281.12-2A

15th GRoUP: Poini names refeftinS to tems oftradilional chinese medicine or indicaiionsFeng l i l wind lventur l 8L.12, AP 137,C8.2O,CV.16

Qi

Zhong

Ian,n8

wt4n

lvis vitalisl

L iq!of tSuc! t

s t . t2 , AsP 28, 68,89cv6, AP 59, St t t , I3 , Kt . t 3 , AP 41sl t0, Kt .5L U . t , K t . 1 5 , 2 6Kl_7,81.44, CV.24IE-2AP 33

CV1, SI33, CV7, BL.6Z,K t . 1 0 , 1 1 , A P 1 6 6 - r 6 8 , C B . l t , 1 t . 9 , 1 1cv9, cB. . l5 , 34, 33, CV 38, AP 9,11.5, ST.42, S1.5, 81.48, 55, 59, C8.14sP t lK1.25

nlght, darkness, lower etc. cannot be translated

day, briSh(ness, upper, etc. cannot be translated

(ZanB)fll

Novenber 1996 vol 11No.2 96


on the meaning of the original "point" nafiesin classical acupunctureThe maiority of the European acupuncturists are nota w a r e t h a t t h e o r i g i n a n a m e s o f t h e C h i n e s eforamina are derived either from the anatomicaltopography of the human body, or in rare cases fromthe i r e f fec t , i n t he sense o f t rad i t i ona l Ch inesem e d i c i n e . I n a d d i t i o n , t h e c o n c e p t o f m o d e r nWestern medicine is at best incorporated in thea c u p u n c t u r e " p o i n f " n a r a e s o f e a r a n d s c a l pacupuncture. In some cases the Addil ional Points( A P ) a n d N e w P o i n t s ( N P ) a r e n a m e d o u t o fconceptions of tradit ional Chinese medical thoriesMore o f ten , however , t he i r names con ta ininformation pertaining to the anatomy, topography,therapeutic effect or iradit ional physiology of theseforamina.A maiority of the names of the 361 well-known

classical meridian points make expJicit reference toanatomical topo8raphy. Iable 4 shows how theoriginal names of the foramina on the 14 so_calledMain Meridians may be classif ied jnto the fol lowingA oup ' : d . ropo8 . oh r b . e f fe , r . , . ph rs o ogv o fr . o . t i on r l L l ' r e .e ^ co r , i ne . . rd d . o lhe r , r i p r ta lis cJear that anatomical and topographical namesDredorrinate, as 259 of the 361 are thus named.Th is i us t i f i es the t ransc r ip t i on o f t he t rad i t i ona lCh inese names in to the te rm ino logy o t modernWestern anatomy (29). Only 51 of the 361 meridianpoints are named after their effect, '14 after theircha rac te r i s t i cs i n t he sense o f t he teach ings o ftradit ional Chinese medicine and only 7 have theirofiental ion in other tradit ional aspects (e8. lung 77= L i t t l e 5 th no te o f t he Ch inese mus ica l sca le ;Large lntesline 1 = 5th note of Yang; Spleen 5 = Htllof the 5th note; Sma// /ttestine 6 = Care of Old Age;Pericardium 8 = Palace of Work; Conception Vessel2? = Ro ta t i ng Ax le , re fe r t i ng to an as t ronomicconste lat ion). I n sho r t , i n t he o r i g ina l Ch inese the names o f

almosr T2ok of the 361 meridian points are derivedfrom topographical or anatomical structures Of theAddit ional Points (or PaM) there are 71'k (Table 5),of the New Points 537" lkble 6) in this cateSory.The nomenclature of the foramina of the ear ls iroma d;fferent source. Some o{ them bear the originalname 'bolnr". The .najority, i .e. 1 86 out ot 192foramina of the ear, relate to an inner ofgan or anaffected part of the body or to their therapeuticetrect (Table 7). Only 6 of the 192 ear tofamLna arenamed a f te r ana tomica l t opography and i t i si n te res t i nB to no te tha t t hese 6 o r iS ina le f ro rnc lass i ca l t ex t s . The p laus ib le reason fo r t h i s i s ,amonS other things, that the outer struciure oi theear offers only a few mofphological characterlst lcs:that is few differentiating criteria in the anatomy ofthe ear cornpared to the relatively large number olknown eaf foramina,I t shou ld a l so b taken i n to cons ide ra t i on tha t

au r i cu lo the rapy i n i t s p resen t f o rm has beendeveloped only recently, mainly through the work ofthe renowned French physician PFM Nogier f30)a n d s e v e r a l o l h e r m o d e r n c h i n e s e d o c t o r s .

NOMENCTATURE ORIGINOF TH[ 203 ADDTfIONAT fORAMINA (%)croup Topo- Effect Physiology Other Total

graphy (chin Med)l - lead a id 20 13 0 I l4

Th.r rax and 23 12 I 1 39

Backand 25 l0 0 I 38

U p p e r 4 0 8 0 l 4 e

L o w e r 3 6 7 0 0 4 3

Totaf 144 50 3 6 2O3% 7 1 2 5 1 3 l o o

NOMENCLATURE ORICINof THE 118 NIW TORAMINA e/ . )croup Topo_

Siaphy

Back and 6

Total 62o/. 53

tffect Physiology Other Total(chin Med)

2 0 0 I J 3 7

3 0 0 6

1 2 4 0 1 8

6 0 0 2 1

1 5 0 0 l r r

5 6 04 7 0

0 1 1 80 1 0 0

NOMENCTATURE ORIGINOT THE 36I MERIDIAN FORAMINA (%)

5TS PHTS1B LKIPCTEC B

CV lDM)cv (RM)folal

grapnyl 01 7 24 0 4

3 )6 25l t l1 5 5

1 7 32 8 91 1 |2 0 51 2 1259 517 2 1 4

Physiology Oiher Total(Chin Med)

1I

I37235

1 2

l l2l)4 52 1

2 792 )

28253611 0 02

Acu puncturc in Med icin 97 Novenbet 1996 Vol 1.1No.2


NOMENCTAfURE ORICINOF fHE 197 EAR FORAMINA (%)Croup Topo-

grapny

Tra8us l

AntitraSus 0

Crus in f .anth. 0Triangular

Crus hel ic is 1Crus hel . fe8ion 0

Total 17

Effect Physiolo8y Other Total(chin Med)

1 3 0 0 1 l9 0 0 1 02 0 0 2: 0 0 11 8 0 0 1 8t l 0 0 1 37 0 0 7,1 0 0 1

1 3 01 7 0 05 0t 2 01 2 08 03 9 01 8 6 09 4 0

0 1 3o 1 70 t 80 6a 1 2o 1 20 80 4 10 t970 100

tr

mmE

This fesulted in the effects of the ear fofamina beingexpressed in terms of Western medicine, whichexplains why the concepts of tradjt ional Chinese

Plate 13. NeNe distribution ofthe eaL

medicine were taken into account only in a fewexceptions (eg. Ear 35, 55, 76, 77, and 159). A new,m o d e r n . a a a r o m i c a l l r a n o t o p o g r a p h i t a l l lo l | e r l d lad 10me1 . l J tu .e see . l \ , l he re lo re , n o r "s! i table for auriculothefapy as well, part icularly asthe effect of the nerves which supply the ear andI a l -m ' l r he resu l l . o f a , upunr tu re on the o rgan isma n d t h e i n n e r o r g a n s c a n b e m o r e c l e a r l ydist inguished fPlate /J). Examples of anatomicalnames of the acupuncture foramina of the primarympr id idn ro la l i on r l , i 1g to 5p lee l \ 4e . i o .dn . md)be seetl in Table B t31-2).

ACUPUNCTURE FORAMTNA OF fHE PRIMARY MERIDIAN CIRCULATTON(Lung Meridian io Spleen Meridian)LUNC MIRIDIANLU. Shou TaiYin Fei l ing

Great Yin ofthe Arm - Lung Meridian {Lu)LU.1 Zhong F!

. . . . . . . . . . . . . . . . . . . . .A. axjllarts, V axi aris IR. ventralis n. rhoraciciUPalace of the Middle Eurner(the Lung and Spleen Meridians meet to fom the lal-ytn)L U . 2 Y u n M e n . . . . - . . .

. . . . . . . . . . . . . . . V c e p h a t i c a 1 p e c t o r a t i sClold gate lrefeu to topography of rhe ,,uppea, thorax)

t U . 3 T i a n F u . . . . . . . . . . . . . . . . . . . . . . . V c e p h a t i c a 2 d e h o i d e s s u p e r i o r

Heaven s house (refe6 to locatjon on upper arm)LU.4 Xia gai

. .V cephatica 3 dehojdes inrefiorOn both s ides of the lunss(colour of the lunss - whi te, Chin. Bat

LU.5 Chi Ze . .Tendo m. bicipitk Iarratis (art. cubiti |)

Ell puddle (or Ell pond) (toposraphy and anaromy)Lu.6 Kong zui

. . .A. radiatis proximatis l, Vv. radiates proximales lDepen hole kefe6 to topography and effect) IR.supedicialis n. radialit, M. bra.hioradiatis distalisLU.7 Lie Que .procersus stytoides radii iN. radia|r, R. supe.ftciatislA4aneeme.r i. a depie$ion tropo8raphy)LU 8 linq Gu A. radialts proximatis 2, W. radiales prox. 2Croove ofthe meridian s course (topography) tR superficiatis N. radialis, C5_ThtltU.9 Tai yuan

.A. radiatis distalis, Vu radiates dEtaresDeep pond (topography) IR. super{iciatjs n. radia|s, C5_Thtl

t u . 1 a v u J i . . . . . . . . . . . . . . . . . . . M . a b d u c r o r p o l t i c i s b r e v i ;

Flank of a fish kefers to firhlike appearanceof the bal l o f the hand)

L U . 1 1 S h a o S h a n g ( s e e a l s o L l . l ) . . . . . . . . V a u m u n B u k p o l l i c j s r a d i a t i s ( A . e r V p a l m a r i s

polJ ic is radia lh)Little 5ih nore (5,5ana is the 5th note ofrhe chinese musical scale, correspondinS ro metal= LundlarSe Inrestine)

PulmonaFPectoral-BrachialRadial-Proiction

Novenber 1996 Vol 11 No.2 98 Acupuncture in Meclcine


LARCI INTESTINE MERIDIANLt. Shou vang Ming Da chang Iing Radial-Brachial"Ceivical-lnfraorbital'Proiection

Bright Yang ofthe Arm - Large Intestine Meridian (Ll)L l . l s r ' a ' A v a n g ( s e e a s o L U . l l ) . . . . . . V a l l u m u n g u i s i n d i c i s r a d i a i s l N d i s i t a l i s d o 6 a l i s l b ,

R. s !per f ic ia l is n. medianusl

5th note of YaDa (Sharg is the 5th noie of rhe Ch inese scale, corcspond ing to meta I = L! ng/Lae IntestineLt .2 l ian N d ig i ta l isdonal is la tN radia l is et R superf ic ia l is

2nd space hefers to topography n medjanusl (Art. metacarpophalangea 2 dist )distal metacalpophalanseal joint)

t t \ tan tDn3rd space (iopography proxima

L . 1 H e G uMeer ing point in the val ley (or rather 'Bone Val ley")

I L Yanp XiYan! vally (or ransdepresion;refers to structure and lopoEraphy)

I b Pian LiBranchins ofi paih (ruoVessel branches offhere)

L).7 Wen Liu N cutanels aniebrachii posterior 2 lN fadialGlCirc ! la t ion of wamth

Ll.8 Xia Lian N cutaneus antebrachii posterjor 3 tN radialisl

Ll.g shang Li;n . .. . . N. cutaneus antebrach ii poneior 4 tN radjalisl

L l . l0 Sl 'ou san I i . . . . . . . . . . . M extensor carp i radia l is longus (M s lp inator)Three measlrfements ot the arms tN. radia , , r profu.dus; C5-Thl l(ri= Cun, ;.e. 3 Cun below the elbow when arm is extended)

1 r . 1 1 Q u C r , i . . . . . . . . . . . . . . . . . . . . M b r a c h i o r a d i a l i s 1 ( a ' 1 . c u b t i l ) t N r a d i a l i s ,Arched basin r r muscl lares; c5 Thl l

L t . 1 2 Z h o u L i a o . . . . . . . . . . . . . . N . c u t a n e u s b r a c h i i l a t e r a l i s i n f e r i o r I I N . r a d i a l j s lCroove of the elbow (toposraphY)

L1.13 Wu Li .N. cutaneus brachi i la tera l is in fer io .2 tN radia l is lF ive path measl res ( t l= Cun, te. a Cun beiow LU. l )

L l . l4 a i Nao M del to ideus 3 in fer iorShoulder nruscle

Lt.15 Jian Yu . M de loideus 1 superior [N axillaris (N cutanelsshoulder bone {or :corner of the shoulder) brachi i la tera l is super iof ) l

L t . 1 6 t u c u . . . . . . . . . . . . . N n s u p r a c l a v i c u l a r e s l a t e r a l e s I C 3 - C ' UCiant bone (1.e. c lav ic le)

L1.17 TianDing. . . . . . . . . .N t ransversu, co l l i tP exus cerv ica l is lHeavenly sauce pan{refe$ to position ofthe neck: "uppef', "heaven )

L l . l8 Neck-F! Iu . . . . . . N. a l r cu lar is magnus 1 lP lexus ceNical ls lLateral overhang (Prominentia aryngea)

1t.19 Nose-He Ltao . . . . . N. infnobiialis et rr buccale, 1 tTriseminls/FacialislGrai i d i tch ( topoSraphy)

L))a v in l ^ ian l . . . . . . . . . . . . . . . . . . . . . . . . . . . N in f raorb i ta l is et r r . buccales 2 tTr i8em in us/Facia is lGreet ne ofthe scent lrefers to eilect)

metacarpopha anseal joini)N. d ig i ta l is do|sal is 1b tN. radia l is et R. super t ic ia lGn. medianusl (Art. metacarpophalansea 2 prox.)M.adductorpol l c is 1 tN. radia l is 'C5 Thl , N.u lnar is - C8-Th1; N. medianus - C6 Thl lFo$a radialis (articulatio carpometacarpea po licis)

N. curaneus antebrachii posterior 1 [N. radialis]

STOMACH MERIDIANsT. zu Yang MinB wei JinB

BriSht Y.ng of the leB - slomach Merididn i51)sI.1 Cheng Qi . . . . Sutura zvsomaticomaxillar s

Reception ot tearsS L 2 S i B a i - . . . . . . . . . . . . F o r a m e . i n f m o r b i t a l e

Br lght v iew in a l l four d i rect ionsSL3 )u iiao Fossa canina

Enormou5 ditch (topography)SL4 Dicans M. buccinator l

Eadh g;nary (for the five cereals) l.e. mouthsT.s Da vig Nn buccales a Rr.buccales (sensorv IN triseminus

Creat g;eting (refers lo function) Vl and motoric tN facialis Vlll anastomos6)5I.6 Jia Che M masseter IN ma$etericLrs (motor')

cart ofthe cheek N mandibularis, Triseminus Vl(refers to shape ofthe two mandib!lar bones topo8raphv)

Facial-lniercostal-Femoral-Tibial-Proiection

ST.7 Xia Cuan N. aur icu lotempola is 1 tN. mandibular i r ,N. t r igeminus VlLower bader (Arcus zygomaticus inlerior refers to topographyl

rAcupunctu.e in Med icine 99 November 1996 val 1,1 No.2


5 T . 8 I o ! W e i . . . . . . . . . . . . N . z f 8 o m . r r i c l s , R . z l S o n r a r c o r e n r p o r a t j s

I lc .d b i i rJ , , re lor :a ig e o i i rc head - rereE to lop.) .qtuphyr LN m.x 1. . s , N. r i i8 ;mtr , r vrSi l t l Ren y i rg Me,nbrara rhyfeoic l ;a aref , r lsa 'eetrDE oi lhe l )eop . l rcreB ro r rynr a i . l the !o i .e l

5 T l 0 . t f i u i I ! . . . . . i \ 4 . s e m o c . r . t o m a r t o i d c l s r a ^ r e r o r

Pis.ge o i n! t f l lor ro wate. , rc ieu io ph, , ,s io loEl i5 l l l Qt the .C a! ] . ! t r : terna is

I om. oa re bicath tseJr oi brcal|i.fN eir (r.i-"rs to ,-iicc|sY.r 2 Que Pcn . . .Clrvic! a fr-..1i.,1 s

r f comp ct . ke! i i . . , . [o isa supac]a! ] . ! la . is : topogr.ph\ ,15T l : l Qi Hu .N te. torat s la l - . ra is tp tc \ ls br , r .h ia l s lC.r le o i thc bre; lh (o .nrran.e. idrc a?i : .e ier to c f ic . pa6 j r i r ! . lav i . !

. r 5 l5I .11 Ku Fang

. . . N. rLe,co(a l is | l n jedi r sLaLer, r ls tor .gc roo.r n i a i r : fd Qr l

S T l 5 W u y t . . . . . . . . . . . N . i f l - " r c o s t a i s 0 2 n r e l i t ,F l id i iE p . r (e l rbr . l f end Qr l

SLlr yinltchuang . . .N. ir(er.ona|s 0l mcdia i\ ! rn . low oi the.hen l iopo8ra| l ry l

5I 1/ Ru zhory . . . .Ccfr . ! . ) nrrnr .e LN i i lo .osLj i 0 t nrc. t ra i i lCenLre o idrc brer i l

5 r l 8 R ! C e ' i r r o . a e d X ! L i r . . . . . . . . . . . . . N i i l . f . o s r . , l s 0 5 m e . t i i 5 1 = \ . l u b f , n m r . r s lRoot o i rhe brcasi r r e . owcrnars i , ro i thcmafrmrvElandl

S r . r 9 a u f o r g . . . . . . . N n t c i . o ( a t i s t j 6 r n c d i a i .

CJnfot f i r i i i e . bo! i . l i r .v ra i th . absorr ion. i r rDd n lhe r lo n ichr

5 I . 2 0 C h e r y M a D . . . . N i i l e . c o s t a t s 0 T m e a J l i ,

F! l l cor ta i i . r / r ro, r rch is I ! l when conren s rea.hcs rh s poinLl5I )1 L iang Men

. .N. nLe(onr l is 07 medir is nrpe r lDoo. o i thc ioo. l

\ 1 2 2 C u a D M e n . . . . . . N i n r o . o s L . r l s 0 8 m c d a i t \ r f r e r o r

Eoundar) doo (bcr i .er iLonrach an. l i r (enncr5T. l i la t y i . N , j rcr .osta l ts 0. r t r redia G s lper orVe,r arg. y l (con$pofdr ro s l r tcc i rhe t , , ) r r )5 I 2 4 H u a R o u M e n

. . . . . . . N . i . t e r c o n a i J 0 ( r , r j e c l i . t s i n i e r o r

SDr.oLr m!s. le r loor

tT.25

5f .26

s l . t t

5T2I ]5r29

lsep.n i t ron or l le c car and ! i ( lcar . l ! r r r d j ! .s t onT i a n ' h u . .

. . . . . . N . n r e ( o n r l i s t { l m e . t i r i : n i p . n . .Tlnr i! r)oiii oi h.a!e, lboun.l.ry betwccr )irr!=hcalen, uppfr ; a .d ) r , , L=car th. orer l n thc l jorJy lwai Littg

. . . . . N. inl.rcona s r0 nuj a|! irter !,Ol io h i l Lr l rpograph! lD a l u . .

. . . . . N D t c r . o < t a i s t n r . . J a | sCir , -atcn i . r r .e$ ( thc ab. l . rnen protr !de! rere mosl lShuiDao . . .

.N r lh(ostn is . t l= N r tcr .on. i .Wnler r ' . ry 1rcfere, , !e ro ena i .est i icafdb,xJde,rCt i Lai

. . . . .N. iohyposJnr . ls j i l j . lon Dal sRct !nr r 'e iers to c l i - . . lh is po nr b. i .8s orSan

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