JOURNAL OF CHINESE MEDICINE NUMBER 42 MAY 1993 ii. According to Symptomatology:


• When the disease is at the Zang, needle the Jing-Well point.


• If manifesting as a change in the colour, needle the Ying-Spring point.


• When the disease attacks intermittently, needle the Shu-Stream point.


• When the disease manifests as changes in the patient’s voice, needle the Jing-River point1


.


• If there is disease of the stomach and irregular appetite, needle the He-sea point.


The Spiritual Axis Chapter 4 (‘Disease Patterns of Zangfu as Caused by Pathogenic Qi’) also says:


The Divergent branches of the Yang channels reach into the interior and connect with the Fu ... the Ying- Spring and Shu-Stream points treat the channel, the He-Sea points treat the Fu.


The Ling Shu Chapter 6 (‘Longevity, Premature Death, Strength and Weakness’) distinguishes when to needle particular Shu points depending on the site/depth of the disease:


There is Yin within Yin and Yang within Yang ... Internally the five zang are Yin whilst the six Fu are Yang. Externally the sinews and bones are Yin whilst the skin is Yang. Thus it is said: • When the disease is at the Yin within Yin (zang), needle the Ying-Spring and the Shu-Stream points of the Yin channels.


• When the disease is at the Yang within Yang (skin), needle the He-Sea points of the Yang channels. • When the disease is at the Yin within Yang (sinews and bones), needle the Jing-River points of the Yin channels.


• When the disease is at the Yang within Yin (fu), needle the Luo points.”


Clinical Application with Reference to Classical Indications


It is a commonplace that Chinese medicine allows and indeed even embraces contradiction much more readily than Western scientific thought. It is perhaps an inevita- ble feature of a system that has developed over such a long period of time, and in which no theory, if it offers something of clinical or philosophical interest, necessar- ily need be abandoned in the light of a new and appar- ently contradictory one. Some of the classical theories on the use of the 5 Shu points are contradictory, some are barely borne out by clinical practice, and in some cases important clinical uses of these points are not referred to in the classical theories.


Jing-Well


The Jing-Well points all lie on the extremities and are the first or last points of their respective channels. With the exception of Yongquan KID-1, all are located on the tips of the fingers or toes. According to the classical sources


1. The Chinese text which continues here is unclear, literally saying “channel full and blood”. The Systematic Classic of Acupuncture and Moxibustion changed this to “Luo full and blood”, implying blood stasis, but it is not clear whether this refers to the Jing-River points or the He-Sea points.


discussed above, the Jing-Well points are indicated for: i. fullness below the heart ii. diseases of the zang iii. channel disorders.


In the light of traditional and modern clinical use, the following observations may be made.


i. As far as “fullness below the Heart” is concerned, ‘below the Heart’ normally refers to the epigastric area. Examination of the indications of the Jing-Well points, however, show that many specifically treat fullness and pain of the heart region itself. Thus Shaoshang LU-11 is indicated for fullness of the heart with sweating and fullness below the heart; Shangyang L.I.-1 for Qi fullness of the chest radiating to the flank etc.


Jing-Well Points Effect on "fullness below the Heart"


Shaoshang LU-11 Fullness of the heart with sweating, fullness below the heart.


Shangyang L.I.-1 Qi fullness of the chest radiating to the flank.


Lidui ST-45 Yinbai SP-1


Fullness and distention of the chest and abdomen.


Agitated heart, heat in the middle of the chest.


Shaochong HE-9 Heart pain, pain of the chest and flank.


Shaoze SI-1


Cold sensation below the heart, agitation with heart pain, oppression and pain of the chest and diaphragm.


Zhongchong P-9 Heart pain, epigastric pain.


ii. The Jing-Well points, situated at the extremities, are in the main powerful points to clear heat and fullness from the uppermost end of their respective channel, particu- larly in acute syndromes. Thus Shaoshang LU-11 is indicated for swelling and pain of the throat and mumps; Shangyang L.I.-1 for throat pain, deafness, tinnitus and toothache; Lidui ST-45 for swelling of the face, tooth- ache, lockjaw, throat Bi, cracked lips, deviation of the mouth, nosebleed and yellow nasal discharge; Shaochong HE-9 for pain at the root of the tongue, swollen tongue, throat Bi, dry throat, heat in the mouth, eye pain, red eyes, yellow eyes; and so on. This confirms the statement in the Spiritual Axis (Chap- ter 4) that Jing-Well points treat channel disorders, and demonstrates clearly the principle that the most distal points on any channel are the strongest to clear excess and heat from the opposite end of the channel. It should be stressed that treating channel disorders, in this con- text, does not mean that these are important points for stiffness, pain and discomfort along the course of the channel as a whole, and thus the Jing-Well points are not indicated for Bi or Wei syndromes, or traumatic injury. A careful examination of the indications of the Jing-Well points, however, clearly contradicts the statement in Chapter 44 of the Spiritual Axis that the Jing-Well points treat disorders of the zang.


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