Chapter 21 of the Lingshu, Hanre bing (寒熱病, cold and heat diseases), names five points, four on the neck and one below the armpit, gives each a sudden disorder, and closes by calling them the five regions of Tianyou (天牖五部). Tianyou, “window of heaven”, is the name of one of the five, now TB16 (Tianyou). Chapter 2 of the same text, Ben shu, lists ten points in order around the neck and below the armpit, with no indications. English-language textbooks call those ten the window of heaven or window of the sky points. The Lingshu, the half of the Huangdi Neijing that deals with needling, uses the name only for the five; the label for the ten is a twentieth-century one.
The five of chapter 21
Chapter 21 locates the five before it names their uses. The pulsing vessel at the side of the neck is Renying, on the foot yangming channel, in front of a neck sinew the text calls the ying sinew. Behind that sinew is Futu, on the hand yangming. The next vessel is Tianyou, which the Wikisource text puts on the foot shaoyang, and the next Tianzhu, on the foot taiyang. The pulsing vessel below the armpit, on the arm taiyin, is Tianfu.
| Point | Disorder the chapter assigns |
|---|---|
ST09 (Renying) | A headache it calls yang ying (陽迎), with fullness in the chest and no ability to catch the breath |
LI18 (Futu) | Sudden loss of voice with the qi hardened; the chapter adds letting blood at the tongue root (舌本) |
TB16 (Tianyou) | Sudden deafness with the qi clouded, and ears and eyes that do not see or hear clearly |
BL10 (Tianzhu) | Sudden spasm, epilepsy and dizziness, with legs that cannot bear the body |
LU03 (Tianfu) | Sudden dan (癉), a heat disorder, with qi running counter inside, the liver and lung striking each other, and blood spilling from the nose and mouth |
Four of the five entries open with bao (暴), sudden. A 2021 perspective in Medical Acupuncture by Michael Greenwood, a physician in Victoria, British Columbia, reads the group as points for sudden conditions in which qi rising the wrong way reaches the neck and is blocked there. The chapter does not say whether the tongue root is a place on the tongue or a point; the Zhenjiu jiayi jing, compiled by Huangfu Mi and dated by the WHO International Standard Terminologies on Traditional Medicine to 259, gives Shegen, tongue root, as another name for GV16 (Fengfu).
The ten of chapter 2
Chapter 2 starts at Tiantu, in the middle of the hollow above the collarbone on the conception vessel, and counts the vessels outward from it around the neck: the first vessel beside it is Renying, the second Futu, then Tianchuang, Tianrong, Tianyou and Tianzhu, and the seventh, in the centre of the back of the neck on the governing vessel, Fengfu. It then adds two points at the armpit: Tianfu at the pulsing vessel inside the armpit, and Tianchi three cun below the armpit on the hand heart-master channel, now the pericardium. The table gives the channel chapter 2 names for each and the location the Zhenjiu jiayi jing records.
| Code | Point | Channel in Lingshu chapter 2 | In chapter 21 | Location in the Zhenjiu jiayi jing |
|---|---|---|---|---|
CV22 | Tiantu 天突 | Conception vessel | No | On the midline 2 cun below the laryngeal prominence, in a hollow; taken with the head bowed |
ST09 | Renying 人迎 | Foot yangming | Yes | On the great pulsing vessel of the neck, beside the laryngeal prominence |
LI18 | Futu 扶突 | Hand yangming | Yes | 1.5 cun behind Renying |
SI16 | Tianchuang 天窗 | Hand taiyang | No | Below the angle of the jaw, behind Futu, in a depression where a pulse is felt |
SI17 | Tianrong 天容 | Foot shaoyang | No | Below the ear, behind the angle of the jaw |
TB16 | Tianyou 天牖 | Hand shaoyang | Yes | Between the neck sinews, behind Tianrong and in front of Tianzhu, behind the mastoid process |
BL10 | Tianzhu 天柱 | Foot taiyang | Yes | At the hairline on the back of the neck, in the depression at the outer edge of the large sinew |
GV16 | Fengfu 風府 | Governing vessel | No | 1 cun inside the hairline, in the hollow within the large sinews |
LU03 | Tianfu 天府 | Hand taiyin | Yes | 3 cun below the armpit on the inner edge of the upper arm, at a pulsing vessel |
PC01 | Tianchi 天池 | Hand heart-master | No | 1 cun behind the nipple, 3 cun below the armpit, between the ribs |
Seven of the ten names begin with tian (天), heaven; how such names are rendered into English is the subject of Point names in translation.
Where the channels disagree
The texts do not agree on which channel two of the points belong to. Chapter 2 puts Tianyou on the hand shaoyang, and the Zhenjiu jiayi jing agrees, but the Wikisource text of chapter 21 puts it on the foot shaoyang. Tianrong moves more: chapter 2 places it on the foot shaoyang, the Zhenjiu jiayi jing on the hand shaoyang, and AcuiQ’s catalogue, like Greenwood’s table, codes it to the small intestine channel, the hand taiyang, as SI17. Greenwood reports that Deadman and Al-Khafaji, writing in the Journal of Chinese Medicine in 1993, proposed reading the chapter’s Tianrong as GB09 (Tianchong), a foot shaoyang point, and that Jarrett, in The Clinical Practice of Chinese Medicine of 2003, proposed GB20 (Fengchi). Chapter 2 follows its list with a short guide to finding six of the vessels, from the foot yangming pulse beside the throat to the foot taiyang beside the large sinews of the nape at the hairline. The channels themselves are set out in The channel system.
How the ten got their name
Greenwood traces the English name to France. According to the paper, the French physician Chamfrault named the points window of the sky in 1954, apparently after Tianyou, and Chamfrault and Nguyen Van Nghi called the first five the great windows and the second five the little windows, before all ten came to share the one name. Chamfrault, a naval doctor sent to Tonkin in 1952, wrote a six-volume Traité de médecine chinoise that appeared between 1954 and 1969, according to a 2018 history of Chinese medicine in France by Marc Mezard. Greenwood notes that the historical texts discuss the group very little, that the set may be a modern conception rather than a traditional one, and that one writer, McDonald, called it a fanciful aberration of modern times with no historical justification.
Greenwood’s summary of the indications modern sources give is broader than chapter 21’s: an excess or deficiency of qi in the head with the opposite below the neck, qi of the lung or stomach rising the wrong way, headache and dizziness, swellings in the neck, and sudden disorders such as epilepsy and loss of voice. The paper also records a later shift in English writing from windows of the sky to windows to the sky, with authors treating the points as a link between mind and body, indications it says emerged in recent times.
Modern Chinese readings
Chinese scholarship works from chapter 21’s five. A 2021 analysis by Tong and colleagues at the Anhui University of Chinese Medicine compared the five regions with two other Neijing groupings, the roots and knots and the divergent channels, and concluded that they link each pair of interior and exterior channels. It reported that the points are used mainly for disorders of the nervous system, the sense organs and the motor system. A 2024 paper by Chen and colleagues at Xiyuan Hospital, Beijing, described the five as a window of the head and neck and set out a tuina method for acute pharyngitis built on them: pressing, plucking and smoothing at the five regions, with bloodletting at the apex of the ear.
Cautions in the sources
The Zhenjiu jiayi jing forbids moxa at three of the ten: Renying, Fengfu, where it says moxa makes a person mute, and Tianfu, where it says moxa sends the qi the wrong way. At Renying it adds that needling too deep can kill. Greenwood writes that some of the neck points carry anatomical risks to the lungs and blood vessels, including pneumothorax.
What these sources cannot tell you
Chapters 2 and 21 state a system and report no patients. Greenwood’s paper is a perspective with four case descriptions, and the two Chinese papers are textual and methodological, so none of the indications here is a measured result. The editions cited are transcriptions of particular printings, and a character can differ between printings. Which points belong in the ten, and whether the ten form a classical group at all, are questions the sources answer differently. How the Lingshu relates to the later compilations is covered in The classical texts, and the five-point lists that run along the limbs in Five transport points. A window of heaven point in one of AcuiQ’s protocols records that a study used it, not that the study chose it as one; What AcuiQ does not do sets out that limit.