Five transport points

The first chapter of the Lingshu, the half of the Huangdi Neijing that deals with needling, describes the qi of each channel as water moving from a source to the sea. It emerges at the well (jing 井), flows at the spring (ying 滎), pours at the stream (shu 輸), moves at the river (jing 經) and enters at the sea (he 合). Each of the twelve organ channels has one point at each of the five positions, all of them at or below the elbow or the knee, so the twelve channels carry 60. The WHO International Standard Terminologies on Traditional Medicine of 2007 calls the set the five transport points and renders the five as well, brook, stream, river and sea points; this page uses the hyphenated forms jing-well, ying-spring, shu-stream, jing-river and he-sea, which keep the pinyin beside the English. The classical texts built two further rules on the set: a five-phase assignment that differs between yin and yang channels, and a rule for choosing which point to supplement and which to drain.

Where each point sits

The WHO terminology defines each position by its place on the limb. The jing-well point is at the tip of a finger or toe, where the qi of the channel starts to bubble. The ying-spring point lies mostly just beyond the joint at the base of a finger or toe, the shu-stream point mostly just behind that joint, and the jing-river point on the forearm or lower leg. The he-sea point lies mostly near the elbow or knee, where the channel’s qi goes deep into the body. The Lingshu counts 25 such points for the five zang organs and 36 for the six fu organs: each yang channel carries a sixth point between the stream and the river, the yuan-source point, which Source, connecting and cleft points covers.

Chapter 2 of the Lingshu, Ben shu, walks each channel from its well to its sea and locates every point in words. The Zhenjiu jiayi jing, compiled by Huangfu Mi and dated by the WHO terminology to 259, repeats the five positions for every channel and adds the phase of each point. The table gives the points as those two texts assign them, under AcuiQ’s codes.

The heart channel

The Lingshu’s list has one gap. Under the heart, chapter 2 names Zhongchong, Laogong, Daling, Jianshi and Quze, the five points now coded to the pericardium channel. Chapter 71 gives the reason: the heart is the ruler of the organs and lets no pathogen in, so any pathogen aimed at it lodges in the pericardium, and the heart’s own channel alone has no transport points. The same chapter allows one place on it, at the end of the sharp bone behind the palm. The Zhenjiu jiayi jing fills the gap with the five heart-channel points in the table, from Shaochong to Shaohai, and notes that one of the channel’s points has no indications of its own because the heart admits no pathogen. A 2021 review of the he-sea point in the Neijing and the Nanjing by Yan and colleagues at Shandong University of Traditional Chinese Medicine found the names, locations and ways of locating the he-sea points of eleven channels recorded in those two texts.

The five phases on yin and yang channels

Chapter 2 of the Lingshu already labels the wells: every yin-channel well is wood and every yang-channel well is metal. Difficulty 64 of the Nanjing, the Classic of Difficult Issues, which the WHO terminology dates to the Han dynasty and whose 81 chapters are numbered as difficulties, completes the pattern for all five positions.

Both columns follow the generating cycle, and at every position the yang phase is the one that restrains the yin phase: metal restrains wood, water restrains fire, and so on down the table. The Nanjing explains the pairing through the heavenly stems: the yin well is yi wood, the yang well is geng metal, and geng is the hard partner of the soft yi, the same pairing repeated at every position. The Zhenjiu jiayi jing writes the phase into the entry for each of the 60 points, so LU09 (Taiyuan) is earth and LI03 (Sanjian) is wood. The cycles themselves are set out in The five phases.

What each position was said to treat

Three passages of the Nanjing tie the positions to disorders and to times of year. Difficulty 68 gives each position a group of complaints: the well governs fullness below the heart, the spring heat in the body, the stream heaviness of the body and pain in the joints, the river panting, cough, chills and fever, and the sea qi rising the wrong way and diarrhoea. Difficulty 74 matches the positions to the seasons and the zang organs: wells in spring for the liver, springs in summer for the heart, streams in late summer for the spleen, rivers in autumn for the lung and seas in winter for the kidney. Difficulty 65 explains the two ends of the sequence: the well is east and spring, where things begin; the sea is north and winter, where the yang qi goes in to be stored.

The Lingshu divides the positions differently. In chapter 4 the spring and stream points treat the outer course of a channel and the sea points treat the fu organs inside, which leads to the lower he-sea points of the six fu set out in Influential and confluent points.

Supplementing the mother, draining the child

In the generating cycle each phase is the mother of the next and the child of the one before. Difficulty 69 of the Nanjing states the rule built on that: where there is deficiency, supplement the mother; where there is excess, drain the child; and where there is neither, because the channel itself is ill and no other pathogen is involved, take the channel itself. Difficulty 79 works one case on the transport points of a single channel. For a disease of the heart it drains the shu-stream point of the hand heart-master channel, now the pericardium channel, which is earth, the child of fire, and supplements its jing-well point, which is wood, the mother of fire: PC07 (Daling) and PC09 (Zhongchong) in AcuiQ’s codes.

Two other difficulties qualify the rule. Difficulty 73 notes that the wells sit where the flesh is thin and the qi scant, and where a well should be needled, the spring is drained in its place, because fire is the child of wood. Difficulty 75 applies the cycle across channels: when the liver (east) is in excess and the lung (west) deficient, it drains fire (south) and supplements water (north).

A 2009 review by Ahn Chang-beohm and colleagues at Dongeui University, Busan, credits Gao Wu, a Ming-dynasty author whose Zhenjiu juying the WHO terminology dates to 1529, with first using the five transport points along the generating cycle as a supplementing and draining treatment of a channel’s own points. The review traces the later Korean Sa-am method, which adds the controlling cycle, to the same base. The Zhenjiu dacheng, compiled by Yang Jizhou and dated to 1601, prints the method channel by channel in its seventh volume, citing the Nanjing’s rule at each entry and timing the draining to the two-hour period of the day when the channel’s qi was held to peak and the supplementing to the period after it.

The dacheng adds the gallbladder’s yuan-source point, GB40 (Qiuxu), to the points for supplementing that channel.

What these sources cannot tell you

The Lingshu, the Nanjing and their successors state a system; they report no counts of patients, so none of the indications above is a measured result. The texts also disagree with each other in places: chapter 2 of the Lingshu files the pericardium points under the heart, and the later compilations add points and rules the earlier ones lack. The editions cited here are transcriptions of particular printings, and a phrase can differ between printings. Ahn and colleagues note that the Sa-am method still needs guidelines for how it should be practised.

A transport point in one of AcuiQ’s protocols records that a study used it, not that the study chose it by any of these rules; What AcuiQ does not do sets out that limit. How the texts relate to each other is covered in The classical texts, and the jing-well points’ use for letting a few drops of blood in Bloodletting.