One of the most important things in True Acupuncture is point location. Even if you are able to correctly diagnose the patient the treatment will fail or give only short term results if proper acupoint location isn't done. This may seem obvious to you however, if you went to a Traditional Chinese Medicine (TCM) school then you may have picked up the idea that point location is easy. My impressions as a new student were always that the acupoints were about one centimeter in size and you can fish your way to acquire Qi. . . well, that is not accurate. The reality is, there are several levels of acupoints with True Acupoints giving the strongest and longest lasting effects. Other points (secondary acupoints) often give little to no effect even when needled dead center.
Modern Chinese Medicine does not put a strong emphasis on point location. If you watch a modern TCM practitioner from China needle you will often witness a blur of needle insertion. I was always amazed at how quickly 20 needles could be placed into a person, literally within 60 seconds. The problem here is, acupoints are 1-2 millimeters in diameter. Being more than a couple millimeters away from the center of an acupuncture point will often result in minimal effect, and if any effect takes place it is usually of short duration. There simply is no possible way to locate the center of a true acupoint within seconds. . . well, unless you are enlightened, maybe.
This explains why most patients have some relief from the treatment but within a few days the symptoms have returned. This has raised the belief in acupuncturists around the world that more frequent visits to the acupuncturist are required. If the truth be told, less visits are needed with proper point location. A patient treated properly with a True Acupoint needled dead center rarely will need to be treated within a week and usually two plus weeks or more should be taken. It is often the case that the effects of such a point only begin showing maximal impression one week after treatment.
What is noticed when a True Acupuncture Point is needled dead on is something very different than the typical response patients have to treatment — decreased effect immediately following the treatment, instead what is seen is, increased physiologic response over time. In other words, the patient continues to get better and better as time increased from the point of treatment. This is verified via the radial pulses. What is seen in the pulses is an increased movement toward the direction of the treatment as time from the treatment increases. This will often continue for two or more weeks.
This is a unique phenomenon to needling a True Acupoint. No other acupuncture body points respond with this type of physiological change. Having now outlined their uniqueness I hope that you will take it to heart just how important it is to properly differentiate primary from secondary and other acupoints.
This is THE most important topic in True Acupuncture and it is very very important that you become aware that 99.99% of the time you needle you are not hitting the center of a True Acupoint. Being more than 2 mm off greatly reduces the effects and only major points have influence that ranges to a centimeter in size and that influence is minimal compared to the center. Furthermore, many of these points are not located where Traditional Chinese Medicine currently locates them.
Morant gives the necessary information for us as practitioners, and clients, to know when True Acupuncture is being applied:
When touched, the point awakens a response, an echo: a) in the pulse of the organ; b) along the meridian of the organ; c) in the organ itself; d) in the point's own pulse; e) in the part of the brain and nervous centers concerned; f) more weakly, in the overall pulses, the meridians, the organs in relation to it; g) in certain parts of the organ or the body, either along the meridian on the same side of the body or along other meridians in relation to it and often on the opposite side to the point touched; and h) in the point upstream and downstream along the channel of the meridian. "False" points on the meridian awaken some of these sensations, but never the last, which provides an important verification of the location. (emphasis added)
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Recognizing the Point
Each meridian has an important point for the energy itself, among those which command the functions of its associated organ and the energy of its related regions.
1) The exact location of the points: They are not easy to find; we must learn to recognize them. As many true points as there are on the meridians, there are also points that give some, but never as many, analogous effects: those which are neither all the same nor of equal strength; and those which are the wrong points. And then again there are points of limited effect which are the points "off the meridians," or "new points;" and finally, there are purely local points of command, the "local points."
. . .
2) The true points: These are determined from several indications and must exhibit all of them.
a. A sensitivity to pressure, a kind of bruising, like a "black and blue mark" . . .
b. An awakening in the meridian of "something that passes," an "electric flow."
c. A response in the related organ, like a wave, which mostly comes by moving the finger on the point.
d. A response on the pulse of this organ.
e. A response of the same sort in the related nervous center and always on the opposite side (contralateral).
f. A (sense of) puncture in the true point upstream and downstream on the meridian. (emphasis added)
g. A response in the organs in relation to the principal organ.
h. A response in the pulses of the related organs.
i. A response, finally, in the part of the body commanded by the point . . .
j. On themselves, sensitive people perceive a warm pressure on the point . . .
Finally, the true points have something special that all sensitive people and those accustomed to "reading" and "listening" to the sensations of their organs and the parts of their bodies can perceive without error. By pressing on a true point a slight sensitivity awakens in the preceding and following point on the meridian; only the true points respond. (emphasis added)
3) The false points: on each meridian there are some points other than the true ones. Inexperienced and inattentive people might mistake these for the true points.
Their effects are not comparable to those of the true points in intensity of reaction, in the duration of the desired effect, or in the number of effects produced.
Pain under pressure is their single trait in common with the true points. So we must never base ourselves on this single sign.
4) The new points, or those outside the meridians. In addition to the true points all located on meridians or the median lines, there are points on the body with fixed places having exact effects. Some of them are located on meridians and, in addition to their own strength, they have in part the strength of the whole line of the meridian. Others are clearly outside the meridians. A list of them is given following the meridians.
It is possible to recognize them by the sensation in the part of the body which they command and from the pain awakened under the pressure of the finger.
5) Center of pain points: Local neuralgias, contusions, weakness or contractures of muscles, etc. sometimes awaken at the center of the pain, a particularly painful point under the pressure of the finger which often has no relation with any of the points described above.
Only used in "reaction-acupuncture" (local) they give good results when the pains are recent, but in fact they do not remove the cause, the functional trouble or more deeply, the energetic problem which is the true cause.
The above quotes from Morant give acupuncturists and clients clear clues to know when a True Acupuncture point is being needed. From my experience, the most obviouse is the reaction in an adjacent True Acupoint "up stream" or "down stream" from the True Acupoint being needled. When a True Acupoint is needled the sensation felt at the point being needled can generally be described as "nervy" or "prickly." However, significantly more "sensation" is felt at a True Acupoint "up stream" or "down stream" of the point being needled. The sensation at this adjacent True Acupoint is usueally significantly more intense than that felt at the point being needled. This sensation can often be described as a "bursting" or "explosion" of sensation/energy, "like a small sun exploding" within the adjacent acupoint. This sensation can be very intense especially when needling a very "large/powerful" Acupoint such as Pc-6. This response and sensation is totally unique to True Acupoints & True Acupuncture.