This three-hour lecture will utilize classical anatomical concepts to facilitate more precise point locations. Despite the impression of many modern practitioners, classical anatomical knowledge was highly developed in some respects. In particular, an often overlooked anatomical concept in classical literature is 節 (jié- joint; section; node). This term, one of a few often translated as 'acupuncture point' has implications for precise point location in the modern clinic. In this seminar, select acupuncture points will be considered in the context of the classical context of finding points in 節 (jié)/joints. To that end, the concept of 'joints' within the skin (皮 pí), vessels (脈 mài), sinews (筋 jīn), bones (骨 gǔ) and flesh (肉 ròu) will be considered in precise demonstrations of optimal location for some commonly used points.

Introduction to meridian palpation; Jing Luo: The significance of energy meridians; The “Six Layers” during treatment; Tai Yin (Lung & Spleen meridians)

Introduction to meridian palpation; Jing Luo: The significance of energy meridians; The “Six Layers” during treatment; Tai Yin (Lung & Spleen meridians)

01.07.2010
Einführung in das Palpieren von Leitbahnen
Bedeutung der Jing Luo
Die Sechs Schichten in der Behandlung, Tai Yin

02.07.2010
San Jiao, Shao Yin, Jue Yin, Tai Yang, Shao Yang
Knoten und Schwellungen und tastbare Veränderungen auf den Leitbahnen
Praktische Übungen

03.07.2010
Yang Ming, Brunnen-Jing Punkte, Rücken-Shu-Punkte, Punktekombinationen
Praktische Übungen

04.07.2010
Kategorien Luo Punkte, Xi-Cleft Punkte, Punktekombinationen
Punkte der Milz-Leitbahn und Ihre Bedeutung, Punkte der Dickdarm Leitbahn und Ihre Bedeutung, Punkte der Magen Leitbahn und Ihre Bedeutung, Balancieren der Schichten
Praktische Übungen

05.07.2010
Ren Mai/Du Mai, Punkte der Herz und Nieren Leitbahn und Ihre Bedeutung, Shao Yi
Praktische Übungen
Patientengespräch und –behandlung, Fälle

The direction of qi flow in the channels has been a subject of debate from the earliest period of Chinese medicine. This short presentation will discuss the possible physiological implication of the direction of qi circulation outlined in two chapters of the Inner Classic.

Each of the twelve channels includes a point often referred to in English as the ‘cleft’ or ‘xi-cleft’ point. Most often, modern acupuncture textbooks refer to these points as being particularly useful in cases of acute pain. While this is certainly true, a brief analysis of commonly found patterns of palpated changes at these points will reveal other applications for these particularly useful points. This short article will review the functions of the cleft points in the channel system and provide some ideas for broadening their clinical application.
The character郗 (xī) generally refers to a narrow opening or pathway. Consequently, many modern texts describe the cleft points as being in areas where the channel pathway narrows and has a tendency to blockage and accumulation of qi and blood. A more clinically useful conception is of the cleft points as areas where channel qi is filtered (過濾guò lǜ) and flow is controlled. They are like sluice gates (閘門zhá mén) or toll booths regulating the nature and rate of channel flow. As might be expected, these points are often found in areas of the body where an opening or clear separation can be readily palpated. Sometimes, these palpable openings are between the bodies of muscles or, in many cases, they can be palpated as spaces on or near bones.
In general, one might summarize the functions of the cleft points as follows:
1. Facilitate qi movement so as to alleviate pain and eliminate swelling (利氣止痛消腫lì qì zhǐ tòng xiāo zhǒng)
This is the most common use of the cleft points and involves opening up channel circulation in cases where ‘lack of free and open circulation has led to pain’ (不通則痛bú tòng zé tōng). This function of the cleft points is especially relevant on the yang channels as those channels and organs require constant movement for optimum function.
2. Redirect counterflow to control bleeding (降逆止血jiàng nì zhǐ xuè)
These are cases where counterflow qi in the channel has led to a kind of stagnation. The qi stagnation, in turn has led to a stasis of blood. Palpation of the cleft points can be quite helpful for indicating the presence of blood stasis not only in the channel but also in the associated organs. It is on the yin channels where this aspect of the cleft points seems particularly relevant. As yin channels and organs produce and accumulate the core substances of the body, their tendency to the yin-natured condition of blood stasis is relatively greater.
When palpating the cleft points, especially on the yin channels, one often finds small hard nodules. These are indicative of a condition involving counterflow accumulation of blood. When palpating the yin channel cleft points it is important to consider the nature of the palpated change. In general, changes felt with very little pressure as one moves the thumb along the channel are considered ‘shallow’ and indicate a relatively acute condition. Conversely, deeper changes indicate a more long-standing condition in the channel and/or organ. In addition, the texture of palpated changes can help refine one’s understanding of the nature of a given palpated change. Sometimes one feels ‘bubble-like’ changes that disappear with multiple passes along the channel. These types of hollow, soft nodules are usually more indicative of qi stagnation and are less commonly found at the yin channel cleft points. In contrast, slightly harder and more fixed changes indicate the involvement of blood stasis and thus what might be termed ‘hard nodules’ are more common at and around the yin channel cleft points.
The clinical relevance of hard nodules found at the cleft points of yin channels will vary. The experience of Professor Wang Ju-yi provides a helpful starting place for analyzing these changes. Drawing from years of careful observation in Beijing hospitals, Dr. Wang’s experience with yin channel cleft points can be summarized as follows:
Hard, fixed nodules on the spleen channel at the cleft point SP-8 (dì jī) indicate a relatively longstanding compromise in the spleen function of holding blood in the vessels; often in cases of gynecological stasis due to ‘overholding’. On the other hand, a small line of soft nodules palpated at and around the liver cleft point LR-6 (zhōng dū) is more common in cases of counterflow qi leading to blood stasis and cold in the Jueyin channel (either liver or pericardium aspect). Most commonly, this involves cold accumulation in the liver channel as it passes though the groin or in the medial forearm along the pericardium channel. On the pericardium channel, one very often finds a fairly deep hard nodule in the area proximal to PC-4 (xī mén) when there is blood stasis in the chest. This might be stasis due to a deep-seated, unresolved issue involving the lungs or even the more serious case of stasis in the coronary arteries. LU-6 (kǒng zuì), in contrast, also often indicates blood stasis in the chest but is less often as deep and serious as that found on the pericardium channel. Consequently, the changes palpated around LU-6 are often less deep and are softer to the touch. One exception would be the interesting tendency of LU-6 to hold ‘memories’ of past lung conditions such as pneumonia- often verified by the presence of a very deep hard, fixed nodule at the point. Although sometimes difficult to differentiate from other nearby points, the heart cleft point HT-6 (yīn xī) will often have hard nodules in cases where there is blood stasis either in the heart or brain; symptoms will vary. Finally, the cleft point of the kidney channel KI-5 (shuǐ quán) has a tendency to feel as if there is a thickening of the underlying fascia which is adhered to the calcaneus in cases of stasis in the prostate or urinary system.
All of the previous examples are commonly associated with stasis of blood in either the yin organs or the pathways of their associated channels. For the clinician, palpation of the channel can thus add another diagnostic parameter when blood stasis is suspected. This can influence not only the choice of acupuncture points but may also shape thinking when creating an appropriate herbal formula. For example, a patient with a chronic cough who has hard fixed nodules around PC-4 might benefit from the addition of herbs which move blood to a formula designed to resolve cough and phlegm. For acupuncture, cleft points may be added into point prescriptions so as to facilitate open channel flow and resolve blood stasis. For example, when the cleft point LU-6 has palpable nodules, a patient with a chronic cough may benefit from the combination of LU-6 with the more strengthening source point LU-9 (tài yuǎn).
Obviously, the previous examples point towards a very useful clinical reality which Dr. Wang elucidates. Namely, practitioners can benefit from considering the physiological implications of palpated changes not only at cleft points, but other important points throughout the body. The key to gleaning this information lies in considering the functions of the points and how changes in channel conductivity at those points can influence the functioning of the organs. It is hoped that others will join in carefully noting the texture, shape and depth of palpated changes in the channels so as to further broaden this useful diagnostic technique.