ALPHANUMERIC CODE, CHINESE NAME AND NUMBER FOR CHANNEL POINTS, "STRANGE POINTS", "NEW POINTS" AND "HAND POINTS"
The alphanumeric code varies between European and American authors. For instance Lung is coded LU, L, P (pulmon) etc by various authors. The code used here for the Channel points is that used by IVAS (International Vet AP Society). The codes for the "Strange Points" (Z, Y, X, A, L), "New Points" (NZ, NY, NX, NA, NL) and "Hand Points" (H) are my own).
Alphanumeric codes are very useful for rapid data storage and retrieval, for instance in prescriptions, in case history files and in computerised records.
Chinese point name is that used by Wu Wei Ping and the Hong Kong sources. However, European phonetic expression of the Chinese calligraphic symbols may vary between textbooks and the beginner must be aware of this. Thus, point Hoku may be called Rokou, HeGu (and other names!) in different textbooks. This causes great confusion to the beginner and makes computerization by point names (between multiple authors) difficult or impossible.
The Chinese point codes are those used in "The Newest Illustrations of the AP Points", Medicine and Health Publishing Co., Hong Kong (1973), the "Synopsis of Chinese AP" (1974) and the "Principles and practical use of AP Anaesthesia" (1974) and the same publishers. The "Strange", "New" and "Hand" points have no Chinese point codes.
Beginners should learn the location of the first and last point on each Channel. this helps to orient the course of the Channel in their minds and, also, the direction of flow of Qi. Students should also learn the position and functions of all the underlined points. These are the most important points, according to the Chinese AP Research Foundation (Taipei, Taiwan): "Basic AP - a scientific interpretation and application", (1977), C.A.R.F., Box 84-223 Taipei, Taiwan.
Students should validate the coding system used each new text. The codes used in this paper are not the same as those used in the prescriptions for common diseases (see Appendix 1 of the paper: The Choice of AP points for particular conditions).
AP CHANNELS
AP Channels are longitudinal lines connecting AP points with similar functional effects in humans. Traditional Vet AP texts do not describe Channels, probably because Vet AP theory was not as well developed as in humans.
TCM describes 12 pairs of Channels, which are bilaterally symmetrical in humans. These Channels are Lung (LU); Large Intestine (LI) (sometimes called the Colon (CO); Stomach (ST); Spleen/Pancreas (SP); Heart (HT); Small Intestine (SI); Bladder (BL); Kidney (KI); Pericardium (PC) (also called Heart Constrictor (HC) or Circulation-Sex (CS); Triple Heater (TH) (also called Triple Warmer or San Chiao); Gallbladder (GB); Liver (LV, sometimes written as LI or Liv).
Each of these Channels has a specified number of points along its course. In general, all the points on a Channel have some effect on the organ and its function e.g. any one of the BL points influences the bladder, but some are more effective than others.
The number of points is as follows:
| CHANNEL | LU | LI | ST | SP | HT | SI | BL | KI | PC | TH | GB | LV |
| No. Points | 11 | 20 | 45 | 21 | 9 | 19 | 67 | 27 | 9 | 23 | 44 | 14 |
Each of the points on the left Channels has its mirror opposite on the right side.
As well as the bilaterally symmetrical Channels, there are 2 midline (single) Channels - the Governor Vessel (GV) on the dorsal midline and the Conception Vessel (CV) on the ventral midline. There are 28 GV points and 24 CV points. Thus, the total number of Channel points = (2 x 309) + 52 = 670 points, or (309 + 52) = 361 positions (if one does not count mirror opposites).
Evidence for the physical existence of Channels: In sensitive humans, a stimulus (needling, pressure, electrical stimulus etc) applied to an AP point causes a sensation of paraesthesia (numbness, "pins-and-needles" sensation, "electric-shock" sensation) to radiate proximally or distally along the Channel. Very sensitive subjects can describe the superficial course of the entire channel and may also identify sensations in the related internal organ. TCM uses the term "Propagated Channel Effect" (PCE) to describe this effect.
The functional connection between AP points along the Channels has been demonstrated by application of sonic (sound) stimuli which can be measured along the course of the Channel by transducers which amplify and record the sound. More of the sound is detected along the Channel than at other places.
ANIMAL AP POINTS AND CHANNELS BY TRANSPOSITION FROM HUMANS
The vast majority of western Vets who use AP study, choose and locate the points for therapy by reference to the human system. Therefore, it is most important to learn this system properly. In this talk we will discuss briefly the human point and Channel system. Details of the course of the human Channels and the location of the AP points are in the paper "The study of AP: Sources and Study techniques" (Rogers 1990).
The Channel points: Each AP point has a Chinese name, a western alpha-numeric code (e.g. LI04; GB34; ST36), a position and a list of therapeutic indications, with some advice on methods of needling. We will see later that it is not necessary to memorise all the points. For general purposes a thorough knowledge of 60-90 points (in total) can give very valuable results. (These points are underlined in Appendix 1 of this paper). In this seminar, I will retain those codes (LU, LI, ST, SP, HT, SI, BL, KI, PC, TH, GB, LV, CV, GV) as the method of Channel point description. There are many other methods in use and one must adopt one convention to avoid confusion.
Other body points: As well as the Channel points, recent Chinese texts describe many other points off the Channels. These points have been proved to be of value in clinical practice and some of them should be studied. They include the "New Points", "Strange Points" and "Hand Points" as listed in the "Newest Illustrations of the AP Points (Hong Kong, 1975). Their names and codes (as used in the therapeutic prescriptions given in the paper on the Choice of points for therapy) are included in Appendix 1 of this paper.
Scalp points: There are zones on the scalp for motor and sensory function, speech area, reproductive function etc. These points are especially useful in treating the paralysis which often follows cerebrovascular accidents. Face points, Nose points and Foot Zone points are also described in recent texts.
The Chinese concept of the Macrocosm reflected in the Microcosm (the universe in the atom, the whole in the part (Hologram) find its expression also in the fact that every organ, joint, function and region of the body may "refer itself" to (i.e. influence and be influenced by) other parts of the body such as the face, scalp, nose, foot zones etc. However, by far the most well known (and best researched) example of this is in the Earpoints.
Earpoints: Nogier (France), discovered that certain specific points on the ear became sensitive to palpation or showed physical changes (vascular hyperaemia, anaemia, flaky/scaly skin, pustules or other reflex phenomena) in certain specific illnesses. He found that the distribution of these points resembled an inverted human foetus or homonculus, with the head downwards (at the ear lobe) and the back towards the posterior edge and the buttocks/feet at the upper part of the ear.
Intensive Chinese research in human clinical and experimental trials confirmed Nogier's findings. The result was the production of Ear maps which show the reflex earpoints for every major organ, joint, region and function of the body.
In a paper called "An experimental evaluation of auricular diagnosis: the somatotopic mapping of musculoskeletal pain" (1980), Oleson et al (Pain Management Clinic UCLA School of Medicine, Los Angeles) reported good diagnostic accuracy of human earpoints. The study was designed to evaluate the French and Chinese claims that the body is represented by a somatotopic map on the external ear. Forty patients with musculoskeletal pain were examined by one worker to determine the painful area. Each patient was then covered with a sheet to conceal any visible physical problems. The physician conducting the auricular diagnosis had no prior knowledge of the patient's medical history or condition. He simply examined the ear to locate areas which were sensitive to probe pressure and to DC (electric) current (increased conductivity). Using ear AP maps, he predicted the painful area. The agreement between the established medical assessment and the ear-point diagnosis was 75%. The results support the hypothesis that the body is represented by a somatotopic map on the external ear. A copy of the abstract of that article is attached at the end of this paper.
However, the Chinese make even further claims for ear-point sensitivity in diagnosis. Texts from Beijing (Outline of Chinese AP, 1975, Foreign Languages Press) and Hong Kong (Practical Ear Needling Therapy, 1980, Medicine and Health Publishing Co) claim that earpoint sensitivity can help in the diagnosis of the site of human cancer, inflammation and other lesions in the internal organs, such as the lung, liver, uterus, stomach, intestines etc.
This is a most astonishing and revolutionary concept to orthodox workers! The EAR may be used to assist in the diagnosis of the location of the condition (lesion, pain etc) and in the therapy of that condition. However, there is controversy over the exact position of the points: for instance, Nogier's ear charts are not identical to modern Chinese ear charts.
Kvirshishvili has already shown reflex points on the rabbit ear for the major joints. Still (Brno Vet School), Jeannot (France), Hill (USA) and others have described Ear AP points in animals but more work is needed to document the location and clinical uses of animal earpoints.
TRANSPOSITION FROM HUMANS TO ANIMALS
In animals, the transposition system has a number of difficulties and disadvantages:
a. Many of the important human AP points (the Command Points, see later) occur between the elbow and digit or knee (stifle) and digit. However, few of our animals have 5 digits. Thus, it can be difficult or impossible to locate anatomically comparable positions for these areas in animals. Where would one locate point Shang Yang (LI01) or Hoku (LI04) in the horse? Large animal Vet acupuncturists (Cain, Kothbauer, Thoresen, Westermayer etc) have described locations for these difficult points.
b. Bladder Shu points (organ-associated points) occur along the paravertebral line, in relation to intercostal spaces or the lumbar and sacral vertebrae. These are most important points for therapy in some diseases. Humans have 12 pairs of ribs, 12 thoracic vertebrae, 5 lumbar vertebrae and 5 sacral vertebrae, whereas few of our animal species fit this pattern. Thus, if point Pi Shu (BL20) (the spleen/pancreas associated point) lies between vertebrae T11-12 in man (with 12 pairs of ribs), where does it lie in the horse, with 18 pairs of ribs?
c. Other anatomical differences (for instance the absence of a clear umbilicus, the presence of a penis and sheath along the abdomen etc) can make it difficult to transpose points on the CV Channel.
d. Earpoints, which are extremely valuable points in man, are not as well researched in animals. Differences in ear anatomy make direct transposition very difficult.
How can we overcome these difficulties?
a. If one or more points can not be found, use other combinations. It is most important to know that many combinations of AP points can produce the same result. For instance, in man, headache might be treated by needling points Hoku (LI04). Lieh Chueh (LU07) and Tai Chung (LV03), points which could easily be found in the dog but difficult or impossible to find in the horse. However, points Feng Chih (GB20), Yin Tang (between the eyes), Tai Yang (in the temple, lateral to the eye) could produce good success also and could be located in most animals.
b. If there is doubt about the exact location of a transposed point, choose a number of points along the nerve trunk or in the same or nearby dermatomal areas. Research evidence most strongly suggests that AP effects are mediated via the nervous system and that nerve points in the same dermatome, along the same nerve trunk or in nearby dermatomes can exert very similar effects. Thus, although point Pi Shu (BL20) is nominally the associated point for the spleen-pancreas, points BL19 or 21 (Tan Shu, Wei Shu) would also have some effect. Similarly, although point BL13 (Fei Shu) is the Lung-associated SHU point (frequently used in treating asthma and bronchitis) points BL12 and 14 (Feng Men and Chueh Yin Shu or Pao Hsin Shu) would have similar effects. In fact, many of the massage, cupping, spooning and cautery techniques would be applied over the whole area of BL12,13,14.
c. If the penis is in the way, deflect it to one side. If the exact location of the umbilicus is not clear, make an estimate of its location and use this as the landmark to locate points above or below it.
d. In the next few years, research on the points (and especially the Earpoints) will help to define the position and functions of these points. Vet AP by the transposition method is a new art-science and we must expect changes and improvements to be made in the future. It is our privilege to be among the pioneers who will help to develop this most useful therapy in the West.
POINT NOMENCLATURE
In China, each point in medical and Vet AP has a name which (to a Chinese reader) is in some way descriptive of the function, location or character of the point. For instance point Hsin Shu (BL15) translates as SHU point for the Heart; point Tsu San Li (ST36) translates as Foot Three Miles (the point is 3 TSUN (Chinese inches) below the patella); point Lan Wei (Hsueh) translates as Appendix (Point) etc. These meanings are lost to most Western readers, as few texts give the translation of the point names.
AP texts in European languages may be based on originals from China, Korea, Japan, Taiwan, Hong Kong etc. The European phonetic spelling of the original characters (calligraphic figures) may vary widely for the same points. This may create great confusion for Western readers who are trying to index points under the point names. Therefore, Chinese and Western texts also give an alphanumeric or numeric code to each point. Even then, confusion may arise, as ST01 may be called M01 in Dutch and German texts, E01 in French texts, S01 in other English texts and ST08 or S08 in still more texts!
Therefore, it is essential that students should adopt one convention, based on one textbook which they will use as their basic reference work. Each new textbook or reference must be checked point by point against the reference text and, if necessary, the points in the new texts must be renamed and re-coded, if the student hopes to integrate the new material with the old.
The codes used in this paper are the IVAS codes, as follows:
| IVAS code | LU | LI | ST | SP | HT | SI | BL | KI | PC | TH | GB | LV | CV | GV |
| Rogers old code | LU | CO | ST | SP | HE | SI | BL | KI | HC | TH | GB | LI | VC | VG |
During this seminar and in all my papers, I will follow the IVAS convention. There is no guarantee that the IVAS convention is identical to that of the other lecturers. This is because there is no international standard of point coding and nomenclature established at this time. I can not alter the Appendix to Paper 3 (on the Choice of AP Points), as it is not on disk. That Appendix uses the old code (CO for Colon; HE for Heart, HC for Pericardium, LI for Liver etc).
TRADITIONAL AP POINTS IN ANIMALS
Chinese Vet texts and their translations into European languages show the points used in traditional Vet AP for the main domestic species: horse, ox, goat, pig, camel, duck and fowl. There are incomplete texts from other countries on the elephant. There are no texts available on small animals (dog, cat), laboratory animals (rats, mice, guinea-pigs), zoo animals or primates.
In the traditional Vet texts, AP points are shown as isolated positions, in relation to body landmarks, such as bones, joints, body cleavages, orifices or other anatomical landmarks. Each point has a name (denoted by a Chinese or Japanese symbol), an alpha-numeric code (e.g. FL 7) or a Chinese numeric code (81), a position, a list of its therapeutic functions, and advice on the method of stimulation.
For instance, in the ox, the Chinese text ("Chinese Vet Handbook", Anon 1972, Lan Chou Vet. Res., Institute, Ganshu, China), from which Klide and Kung prepared their section on the ox, shows the following points: (see Table 1).
There are many difficulties in learning the traditional vet AP system:
1. The points are isolated (not on Channels) and bear little relationship to each other in function. Thus, they have to be memorized in great detail. There is little possibility of busy practitioners learning this system properly.
2. Between species differences occur in the symbols, names, codes, positions, functions and method of stimulation. Thus, a Vet could know the points in the ox very well, yet not know the traditional system as applied to other species.
3. Within species differences occur. The Chinese name, symbol and translation for a particular point may vary between texts on the same species of animal. Even if the symbol is the same, the European alphabetic version and the codes may differ. Also, points in a precise position may have different therapeutic indications, depending on which reference text is being used. Part of this problem is due to the difficulty of translating Chinese into precise European equivalents. For instance, T 1 (Tan Tien) might be used for sunstroke (= hyperthermia) or exhaustion (= collapse = shock) depending on the skill of the translator! Similarly, Tan Tien (HN 1) might be used for cerebral congestion (= apoplexy?, collapse?) or epilepsy (= convulsions). HL 1 and FL 1 might be used for twisted pelvic and shoulder joints respectively but these might also translate as strained, sprained or painful joints. The fact is that little or no integration sources and translation has been done between (and even within species).
4. Unacceptable methods of stimulation are often recommended in the traditional texts. The use of thick or spear-like needles, hot irons and severe cautery would not be acceptable to Western Vet surgeons, their clients and their patients.
5. The system can not cater for many species because texts do not exist for them.
Over the next few years, Vets and scholars of the Chinese system will attempt to integrate the existing traditional texts. If this is done, a single authoritative text for each species (for which texts exist) may emerge. This should make it easier to study and use the traditional system. Until then, however, most Vets will have to follow one particular school or text of the traditional system. For those of you who wish to study the traditional AP system in animals, I recommend the texts of Klide and Kung; Westermayer; Rubin; Yu & Hwang and any other good translations of modern Chinese or Japanese Vet texts which may appear in the next year or so.
CONCLUSIONS
AP points and Channels are real physiological and physical entities. General properties of AP points and Channels and their association with peripheral nerves and other nervous structures are discussed.
AP points become reactive (hyper- or hypo-sensitive) in disease in their related Channels, organs, body functions on parts. They have diagnostic and therapeutic value.
Ear AP in animals is not as well developed at present as body AP but advances are expected.
Vet AP uses the traditional and/or transposition methods. Advantages and disadvantages of both are discussed. Beginners are advised to base their study on the human AP system and to include traditional Vet methods later.
Details of the course of the Channels and the location of the more important points in humans are in the paper "The study of AP: Sources and Study techniques" (Rogers 1990).
FURTHER READING MATERIAL
Anon (1980) Essentials of Chinese AP. Foreign Languages Press, Peking 432pp.
Anon (1977) Chinese AP Research Foundation, Taipei: Basic AP - a scientific interpretation and application. C.A.R.F., Box 84-223 Taipei, Taiwan 313pp.
Anon (1975) Newest illustrations of the AP points: booklet and charts. Medicine and Health Publishing Co., Hong Kong 105pp.
Brunner, F. (1980) Akupunktur fur Tierarzte - Akupunktur der Klientiere. WBV Biologisch Med. Verlag, Ipweg 5, D7060 Schorndorf, Germany 303pp.
Gilchrist, D. (1981) Manual of AP for small animals. Box 303, Redcliffe, Queensland 4020, Australia.
Oleson, T.D., Kroening, R.J. and Bresler, D.E. (1980) Experimental evaluation of auricular diagnosis: somatotopic mapping of musculo-skeletal pain at ear AP points. Report from Pain Control Unit, Dept. Anaesthesiology UCLA School of Med., Los Angeles, California 90024. (The UCLA group have valuable reports on AP research in many areas - clinical, experimental and theoretical).
Klide, A.M. and Kung, S.H. (1977) Vet AP. University of Pennsylvania Press, Philadelphia, 297pp.
Rubin, M. (1976) Manuel d'AP veterinaire pratique moderne en Rep. de Chine. Maloine Publishers, Paris. 85pp.
Schupbach, M. (1985) Thermographic proof of points with higher temperature after irritation of the uterus in minipigs & the influence of these points on the viscera. Inaugural Dissertation for the degree of DVM. Vet School, Zurich. 106pp.
Westermayer, E. (1978) Atlas of AP in horses. Health Science Press, Holsworthy, Devon, U.K. (This is the English version of the original German version, which had 40 pages of charts and text).
Westermayer, E. (1979) Atlas of AP in cattle. WBV Biologisch Med. Verlag, Ipweg 5, D7060 Schorndorf, Germany 62pp.
Yu Chuan & Hwang Yann-Ching (1990) Handbook on Chinese Veterinary AP and Moxibustion. FAO Office for Asia and the Pacific, Bangkok 193pp.