Extra points

An extra point is a named point that sits outside the 361 points of the fourteen channels. The WHO International Standard Terminologies on Traditional Medicine of 2007 defines it, under the Chinese terms jingwai qixue (經外奇穴) and qixue (奇穴), as an acupuncture point not located on the meridians, also called a non-meridian point. The definition is by exclusion, so which points count depends on which list a source follows. The WHO list has 48, China’s national standards have their own, and AcuiQ’s catalogue holds more than the WHO’s 48. This page sets out how the WHO chose its list, where the lists part company, and how a reader can carry an extra point from one source to another. The codes themselves, and the two places where AcuiQ’s numbering departs from the WHO’s, are in Reading a point code.

How the WHO chose 48

Part 2 of the WHO Standard Acupuncture Nomenclature, the revised edition of 1991, records how a working group of the WHO Regional Office for the Western Pacific built the list over three meetings. In Tokyo in 1984 it adopted 31 extra points, all recorded in the medical classics and in wide use. In Hong Kong in 1985 it added 5 more extra points and 12 new ones, on five criteria:

1. the point is in common use;
2. it is clinically effective;
3. it has a clear anatomical location;
4. it lies at least 0.5 cun from a classical point;
5. if it shares a name with an existing point, its name takes a prefix.

In Seoul in 1987 the group agreed unanimously that every point outside the 361 classical ones should be called an extra point, including every new point introduced after 1901. The twelve new points it named are Qiuhou, Shangyingxiang, Yiming, Dingchuan, Yaoyi, Xiazhishi, Yaotongdian, Wailaogong, Lanwei, Dannang, Neixiyan and Xinei. A WHO scientific group in Geneva adopted the 48 in 1989. The codes run down the head, neck and trunk from top to bottom, and along each limb from the trunk outwards, medial before lateral where two points share a level. Part 2 gives each point a code, a pinyin name and its Chinese characters, and no location.

Extra points often seen in protocols

The table gives the AcuiQ code, the catalogue’s pinyin and English names, and the WHO code where there is one. A code with a lettered range covers a set of sites rather than a single one: Shixuan is the tips of the ten fingers, and Bafeng eight sites between the toes on the top of the foot.

Anmian, behind the ear midway between GB20 (Fengchi) and TB17 (Yifeng), is one of the points in the catalogue that the WHO list does not contain, so a paper that names it has no WHO code to give.

Yintang: one point, three homes

The point between the eyebrows shows how far the lists can drift. The WHO list of 1991 makes it EX-HN3, an extra point. The WHO location standard of 2008 covers only the 361 channel points, and its Governor Vessel ends at GV28 (Yinjiao), so it has no entry for Yintang at all. China’s national standard moved it onto the channel. According to the foreword of GB/T 12346-2021, the 2006 edition listed Yintang as the 29th point of the Governor Vessel, and the 2021 edition renumbered it, placing it between Shenting (GV24) and Suliao (GV25) under the code GV24+. Papers follow whichever they learned: a 2015 trial protocol by Zhang and colleagues on allergic rhinitis lists the point as Yintang (GV29). AcuiQ files it as an extra point, XH03, so a GV29 or GV24+ in a paper means Yintang, not a Governor Vessel point this catalogue numbers.

A second code for the same digits

Some papers use an older English-language scheme with an M- prefix. A 2018 article by Tong-zheng on extra points writes Yintang as M-HN-3 and Taiyang as M-HN-9. The digits do not carry across: in the WHO list EX-HN9 is Neiyingxiang, inside the nasal cavity, and Taiyang is EX-HN5. A converter that swaps one prefix for the other moves a needle from the temple to the nostril, and nothing in the code warns that it has. The general case, a code that resolves to the wrong real point, is measured in TF4 Is Not a Point.

China’s separate list

The 2021 revision of GB/T 12346 removed the names and locations of 46 extra points that its 2006 edition had carried in a chapter of their own, and renamed the standard to cover meridian points only. The revision also dropped Zhoujian, the elbow tip, which the 2006 edition had kept as a reference point. Its introduction says the extra points would get a national standard of their own, and the State Administration for Market Regulation issued GB/T 40997-2021, Nomenclature and location of extra points in common use, on 26 November 2021, the same day as the revision. China therefore has a location standard for extra points where the WHO has only names.

Extra points and ashi points

The WHO terminology keeps a separate entry for the ashi point, which it calls an ouch point (阿是穴): a point with no specific name and no fixed location, found by tenderness or other pathological responses. An extra point has both a name and a location, and the 1985 criteria require the location to be clear. The two are easy to confuse in English because both sit off the channels. Trigger points, which Dry needling covers, are a third idea again.

What the lists cannot tell you

The second of the 1985 criteria, clinical effectiveness, was a judgement made by a working group, and part 2 cites no trial behind it; neither list is a ranking of evidence. Neither WHO publication fixes where an extra point is, so two sources can agree on a name and a code and still needle different spots, the problem Measuring in cun describes for channel points. On AcuiQ, each extra point carries the catalogue’s written location on its point page, and the regional groupings are browsable from the atlas.