Ultimate filiform needle test 1)

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SP 5 Shang Mound/Shanqiu 商丘

medial of ankle, in dent @ the junction of straight lines drawn along the anterior and inferior borders of the medial malleolus. NEEDLING: 90º 0.2 to 0.3 cun; or 15º beneath the tendons towards, or to join with ST-41.

KD4 Great Bell/ Dazhong 大鐘

0.5 cun posterior to the midpoint of the line drawn between Taixi KID-3 and Shuiquan KID-5, on the anterior border of the Achilles tendon. Tip :Find KID-5, 1 cun directly inferior to KID-3, then locate KID-4 halfway between and 0.5 cun posterior to these two. NEEDLING :30-90º insertion directed anteriorly 0.5 cun.

Huatuojiaji 華佗夾脊

0.5 to 1 cun lateral to the depressions below the spinous processes of the 12 Ts & 5 Ls NEEDLING :30-90º insertion towards the spine, 0.5 to 1 cun. Note: the intention of needling these points is to stimulate the appropriate spinal nerve. patient dependent

ST 28 Water passage/ Shuidao 水道

2 cun lateral to the midline and 3 cun inferior to the umbili- cus, level with Guanyuan REN-4. Tip :2 cun line is located 1/2 between the midline and the palpable lateral border of the rectus abdominis muscle NEEDLING: 90º 1 to 1.5 cun Caution: X deep for thin or patient w full bladder

ST 21 Beam Gate / Lianmen 粱門

2 cun lateral to the midline and 4 cun superior to the umbilicus, level with REN-12. Tip :2 cun line is located 1/2 between the midline and the palpable lateral border of the rectus abdominis muscle NEEDLING: 90º 1 to 1.5 cun Caution: X deep for thin or patient with enlarge liv

ST 25 Heaven's Pivot/ Tianshu 天樞

2 cun lateral to the umbilicus Tip :2 cun line is located 1/2 between the midline and the palpable lateral border of the rectus abdominis muscle NEEDLING: 90º 1 to 1.5 cun or 30º inferior insertion towards the uterus for diseases of the uterus. Caution: X deep for thin patients

SJ 5 Outer pass/ Waiguan 外關

2 cun proximal to SJ-4, between the radius and the ulna, on the radial side of the extensor digitorum communis tendons. TIP: between the radius and the extensor digitorum communis tendons, close to the border of the radius. NEEDLING : 30 ̊ towards the ulnar side or proximal or distal insertion towards the elbow or wrist respectively, 0.5 to 1.5 cun, or longer to join PC 6 Caution: movement of the patient's arm or hand after needling this point can result in a bent needle.

SP 10 Sea of Blood/ Xuehai 血海

2 cun proximal to the superior border of the patella, in the tender depression on the bulge of the vastus medialis muscle, directly above SP-9. Tip : Loser hand on patient's opposite patella, with the fingers and thumb fully extended and the thumb at 45 ̊ to the index finger. point directly above Yinlingquan SP-9 NEEDLING:Perpendicular or oblique insertion 1 to 1.5 cun.

REN12 Middle Cavity/Zhongwan

@ Above the umbilicus Location: On the midline of the abdomen 4 cun above the umbilicus and midway between the umbilicus and the sternocostal angle Needling: Perpendicular insertion 0.8 - 1.5 cun Note:Deep needling may penetrate the perotineal cavity in thin patients

BL40 Middle of the Crook/ Weizhong

@ Back of the knee Location: On the popliteal crease in the depression midway between the tendons of biceps femoris and semiendinosus Tip: locate with the knee slightly flexed Needling: Perpendicular insertion 1 - 1.5 cun Note: popliteal artery and vein/tibial nerve all lay deep to this point

GB20 Wind Pool/ Fengchi 風池

@ Base of the skull Location:Below the occiput in the hollow between the origins of the sternomastoid and the trapezius muscles. Tip: Aim for the opposite eye or the tip of the nose. Needling: Slightly oblique inferior insertion 1 - 1.5 cun

REN4 Gate of Origin/Guanyuan

@ Below the umbilicus Location: 2cun above the pubic symphysis and 3 cun below the umbilicus on the midline. Needling: Perpendicular insertion 0.5 - 1 cun OR oblique insertion directed inferiorly 1 - 1.5 cun Note: Deep needling may penetrate a full bladder which should be emptied first.

REN6 Sea of Qi/Qihai

@ Below the umbilicus Location: 3.5 cun above the pubic symphysis and 1.5 cun below the umbilicus on the midline. Needling: Perpendicular insertion 0.8 - 1.5 cun Note:Deep needling may penetrate the perotineal cavity

REN14 Great Gateway/Juque

@ End of the Xiphoid process Location: On the midline of the abdomen 6 cun above the umbilicus and 2cun below the sternocostal angle Needling: Perpendicular insertion 0..5 - 1 cun OR oblique insertion directed inferiorly 1 - 1.5 cun. Note: Oblique superior insertion toward the heat is contraindicated in all cases. Thin patients with enlarged liver or heart may be at risk of damage with deep insertion.

GB41 Foot Governor of Tears/Zulinqi 足臨泣

@ Foot Location: In the depression distal to the junction of the 4th and 5th metatarsal bones. On the inner side of extensor digitorum longus muscle. Tip: Ask patient to abduct their little toe to make the depression more obvious. Needling: Perpendicular insertion 0.5 - 1 cun. Note: Incorrect needling won't allow needle to pass between the shafts of the bones

GB21 Shoulder Well/ Jianjing 肩井

@ High point of the Shoulder Location: Midway between Dazhui and Acromion at the high point of the trapezius muscle. On the posterior/anterior plane. Tip: Point is normally at most tender part Needling: Posterior Oblique Insertion 0.5-1 cun Caution: Perpendicular insertion may cause pneumothorax. Contraindicated in pregnancy.

BL23 Kidney Shu/Shenshu

@ Lower Back Location: 1.5 cun outwards from the middle of the spine on the lower border of the spinous process of the second lumbar vertebra (L2) Needling: Oblique or perpendicular oblique insertion towards the spine 1 - 1.5 cun. Note: Deep perpendicular needling may cause injury to the kidney

BL62 Exending Vessel/Shenmai

@ Outside of the foot Location: 0.5 cun below the bottom (inferior) border of the lateral malleolus in a depression behind the peroneal tendon Tip: directly below the malleolus prominence Needling: Oblique insertion inferiorly 0.3 - 0.5 cun

GB34 Yang Mound Spring/Yanglingquan 陽陵泉

@ Outside of the knee Location: Below the lateral aspect of the knee, in the tender depression 1 cun anterior and inferior to the head of the fibula Tip: Slide your fingers up the lateral aspect of the leg until the musculature gives way to the bony prominence of the head of the fibula Needling: Perpendicular or slightly oblique posterior needling 1-1.5 cun

BL31 Upper Crevice/Shangliao

@ Sacral Foramen Location: Over the first posterior sacral foramen (top of the sacrum) Needling: Perpendicular insertion 0.5 - 1 cun OR 1.5 - 2 cun through the foramen which requires slightly oblique medial and inferior insertion.

BL32 Second Crevice/Ciliao

@ Sacrum Location: Second posterior sacral foramen Needling: Perpendicular insertion 0.5 - 1 cun OR 1.5 - 2 cun through the foramen which requires slightly oblique medial and inferior insertion.

BL34 Lower Crevice/ Xialiao

@ Sacrum Location:Fourth posterior sacral foramen Needling:Perpendicular insertion 0.5 - 1 cun OR 1.5 - 2 cun through the foramen

BL33 Middle Crevice/Zhongliao

@ Sacrum Location:Third posterior sacral foramen Needling:Perpendicular insertion 0.5 - 1 cun OR 1.5 - 2 cun through the foramen

REN22 Heavenly Prominence/Tiantu

@ Sternal Notch Location: On the midline in the centre of the suprasternal fossa. 0.5 cun above the suprasternal notch. Needling: Perpendicular insertion 0.3 cun OR Perpendicular insertion 0.3 cun with the patients neck extended, and then direct the needle inferiorly behind the manubrium of the sternum 0.5 - 1 cun.

REN17 Chest Centre/Shanzhong

@ Sternum Location: On the midline of the sternum in the depression level with the 4th intercostal space. Tip: Locate the costal cartilage of the second rib which is level with the sternal angle then locate the second intercostal space below it and count down to the 4th space. In men this point can be located directly between the nipples. Needling: Inferior or Superior Transverse insertion along the channel 1 - 1.5 cun

REN 23 Corner Spring/Lianquan

@ Under the chin Location: On the anterior midline of the neck in the depression above the hyoid bone. Tip: Run your finger along the midline of the neck upwards until you fall into the depression infront of (above) the hyoid bone Needling: Oblique insertion 0.5 - 1.2 cun directed towards DU20 Baihui

BL13 Lung Shu/Feishu

@ Upper Back Location: 1.5 cun outwards from the middle of the spine on the lower border of the spinous process of T3 Needling: Oblique insertion toward the spine 0.5 - 1 cun OR transverse oblique insertion 1 - 1.5 cun Note: Perpendicular needling or needling away from the spine carries substantial risk of pneumothorax.

P6 Inner Pass/Neiguan

@ arm Location: On the flexor aspect of the arm (inside) 2 cun above P7 Daling between flexor carpi radialis and palmaris longus. Tip: can be found on the ulnar side of flexor carpi radialis Needling: Perpendicular insertion 0.5 - 1 cun Note: Median nerve lies under this point and therefore can create and electric shock type sensation. If this happens do not manipulate the needle further as it may cause nerve damage.

LU 7 Broken Seq. /Lieque 列缺

@ forearm radial side approx. 1.5 cun proximal to Yangxi L.I.-5 between brachioradialis & abductor pollicis longus tip: place 2nd finger @Yangxi LI5 /anatomical snuffbox, move directly proximally over the full extent of the styloid process of the radius, the finger falls into the cleft between the two tendons. Needling:pinch up the skin,15º proximal or distal direction, 0.5 to 1 cun, X cephalic vein.

GB14 Yang White/Yangbai 陽白

@ forehead Location: 1 cun above the midpoint of the eyebrow directly above the pupil when the eyes are looking forward Needle: Pinch the skin and needle transversely inferior direction 0.5 - 0.8 cun (toward the eyebrow)

GB30 Jumping Circle/Huantiao 環跳

@ lateral aspect of hip joint Location: Postero- Lateral aspect of the hip joint, one third of the distance between the prominence of the greater trochanter and the sacro-coccygeal hiatus. Tip: This point is readily located with the patient laying on their side. To accurately palpate the prominence of the greater of the greater trochanter place one hand over the lateral aspect of the hip joint at the level of the perineum and use the other hand to rotate the foot in order to feel the prominence of the greater trochanter. Needle: Perpendicular Needling 2 - 3.5 cun towards the genitals.

ST 7 Below the joint/ Xiaguan 下關

@ lower border of the zygomatic arch, anterior to the condyloid process of the mandible. TIP: ask the patient to open the mouth to better locate the condyloid process. Put finger on the condyloid process when the mouth is open, it will fall intoST-7 when closed. i. 90ºslightly inferiorly 0.5 to 1 cun; ii. 30º to join with such points as Tinggong SI-19, Jiache ST-6, Quanliao SI-18 etc. for diseases of the ear, teeth, face and jaw.

ST 2 four white/ Sibai 四白

@ the infraorbital foramen eyes looking forwards, 1 cun directly below the pupil tip: infraorbital foramen can be felt by palpating downwards from the edge of the orbital bone, about 0.3 cun below the edge NEEDLING 90º 0.2 to 0.4 cun or 15º to join with others eg Quanliao SI-18, Yingxiang L.I.-20 etc Caution:X deep insertion &. manipulation

GB2 Meeting of Hearing/Tinghui 聽會

@ the tragus of the ear Location; In the hollow between the intertragic notch (tragus) posteriorly and the condyloid process of the mandible anteriorly. tip: Locate this point with the mouth wide open. Needle: Slightly posterior insertion 0.5 to 1cun with mouth open, can close mouth after insertion.

SP 6 Three Yin crossing/ Sanyinjiao 三陰交

@1x handbreadth / 3 cun superior to the prominence of the medial malleolus.close to the media crest of tibia Needling: 90º 1 to 1.5 cun Caution: contraindicated in pregnancy.

LU 9 Supreme Abyss/ Taiyuan 太淵

@wrist joint between the radial artery & abductor pollicis longus Tip: locate Shenmen HE-7 at the lower border of the pisiform bone 1st Needling: 90º 0.3 - 0.5 cun, X radial artery .

YinTang Hall of impressions/ 印堂

At the glabella, at the midpoint between the medial extremities of the eyebrows. NEEDLING: pinch up the skin over the point, and with the other hand needle 15º in an inferior or lateral direction, 0.3-0.5 cun.

LIV 13 Completion Gate/ Zhangmen 章門

Directly anterior and inferior to the free end of the 11th rib. TIP: i. To locate the free end of the 11th rib, first place the entire hand on the upper abdomen and with gentle finger pressure palpate downwards along the costal margin, until the end of 11th rib found just above the level of the umbilicus; ii. This point usually lies on or near the mid-axillary line which is drawn vertically down from the apex of the axilla (Jiquan HE-1). NEEDLING: 15º or 30º medially or laterally (along the line of the rib) 0.5 to 1 cun. Caution: deep 90º may damage an enlarged LIV or SP

KD 22 Walking Corridor/ Bulan 步廊

In 5th IC, 2 cun lateral to the midline. TIP: Find 2th IC, then find 5thIC . in males the nipple lies in the 4th except Waihoe . The 2 cun line is located midway between the midline and the mamillary line. NEEDLING :15-30º insertion directed laterally along IC 0.5 to 1 cun. Caution: X deep 90º or 30º

LI 15 Should bone/ Jianyu 肩髃

In the depression anterior and inferior to the acromion, @ the origin of the deltoid. (Note: Jianliao SJ-14 is the other dent). TIP : abduct the arm NEEDLING i. arm abducted, 90º insertion towards HT1 1 to 1.5 cun; ii. 15-30º directed distally towards the elbow, 1.5 to 2 cun.

LI 20 Welcome Fragance/ Ying 迎香

In the naso-labial groove, at the level of the midpoint of the lateral border of the ala nasi NEEDLING:15 ̊ medio-superiorly 0.3 to 0.5 cun or join to Bitong (M-HN-14) at the highest point of the naso-labial groove. .

LU 5 Cubital March/ Chize 尺澤

On the cubital crease of the elbow, in the depression at the radial side of the tendon of biceps brachii. Tip: Locate and needle with the elbow slightly flexed, avoiding the cubital vein. Slightly lateral to the tendon instead of right next to it NEEDLING: 90º 0.5 to 1 cun

SP1 Hidden White/ Yin Bai 隱白

On the dorsal aspect of the big toe, at the junction of lines drawn along the medial border of the nail and the base of the nail, approximately 0.1 cun from the corner of the nail. Needling :90º or 30º 0.1 to 0.2 cun directed proximally or prick to bleed.

SI 1 Lesser Marsh / Shaoze 少澤

On the dorsal side little finger approx 0.1 cun from the corner of the nail. NEEDLING : 90 ̊ or 30 ̊ proximally 0.1 to 0.2 cun, or prick to bleed.

LIV 2 Moving Between/ XingJian 行間

On the dorsum of the foot, between the first and second toes, 0.5 cun proximal to the margin of the web NEEDLING : 0.5 to 1 cun 30º towards the heel, or 90º 0.5 cun to 0.8 cun.

LIV 3 Great Rushing/ Taichong 太衝

On the dorsum of the foot, in the hollow distal to the junction of the first and second metatarsal bones. TIP: Run a finger from LIV-2 along the interspace between 1st & 2nd metatarsal bones towards the ankle, into the pronounced depression before the junction of the bases of the 1st & 2nd metatarsals. NEEDLING : In the direction of KID-1, 0.5 to 1.5 cun.

ST 35 Calf's Nose/ Dubi 犢鼻

On the knee, in the hollow formed when the knee is flexed, immediately below the patella and lateral to the patellar ligament. NEEDLING: 90º 1 to 2 cun towards BL-40 or 30º 1 to 2cun medial and superior direction, behind the patella

LU 1 Central Palace / Zhong Fu 中府

On the lateral aspect of the chest, in the first intercostal space, 6 cun lateral to the midline, 1 cun inferior to Yunmen LU-2. Tip : play ' push hand ' to find delto-pectoral triangle. Yunmen LU-2 =centre top, then locate LU-1 in the IC approx 1 cun inferior and slightly lateral to it; NEEDLING Transverse-oblique insertion 0.5 to 1 cun medially along IC Caution: risk of pneumothorax.

LIV 14 Cycle Gate /Qimen 期門

On the mamillary line, in 6th IC, 4 cun lateral to the midline. TIP : First locate the costal cartilage of 2nd rib ( level with the sternal angle), then locate 2nd IC below it and count down to 6th . NEEDLING : 30 medial or lateral insertion 0.5 to 1 cun. Caution: deep º = poss pneumothorax.

SP3 Great White/ Tai Bai 太白

On the medial side of the foot in the depression proximal and inferior to the head of the first metatarsal bone. Tip: located by sliding the fingertip proximally over the side of the ball of the foot. Needling: 90º 0.5 to 1 cun

SP 21 Great wrapping/ Dabao 大包

On the mid-axillary line( vertically down from HT1) , in the 7th IC. Note: some sources locate this point in the 6th IC. TIP: count downwards from the 2nd IC s immediately below the sternal angle. In males, the nipple almost invariably lies in the 4th IC; NEEDLING: 15-30 ̊ along IC 0.5 to 1 cun. Caution: 90 ̊in thin patients= poss. pneumothorax.

LI 5 Yang Stream/ Yangxi 陽溪

On the radial side of the wrist, in the centre of the hollow formed by the tendons of extensor pollicis longus and brevis (anatomical snuffbox). TIP:extend the thumb to emphasise the hollow of the anatomical snuffbox, avoid cephalic vein NEEDLING: 90 ̊ 0.5 to 1 cun

SI 11 Heavenly gathering/ Tian Zhong 天宗

On the scapula, in a tender depression 1/3 distance from the midpoint of inferior border of the scapular spine to the inferior angle of the scapula. Tip: Alternately to draw an equilateral triangle with SI-9 and SI-10, WITH patient's shoulder relaxed. NEEDLING:90 ̊ or 30 ̊ 0.5 to 1.5 cun.

SI 3 Back stream/ Houxi 後溪

On ulnar border of the hand, in the dent proximal to the head of the 5th metacarpal bone. Tip: make loose fist NEEDLING : 90 ̊ 0.5 to 2 cun, towards LI3, with the hand in a loose fist position, i.e. with the metacarpal bones lying in the same plane

SJ 10 Heavenly Well/ Tianjing 天井

With the elbow flexed, located in the dent 1 cun proximal to the olecranon NEEDLING: 90 ̊ 0.5 to 1 cun

SI 19 Palace of Hearing / Tinggong 聽宮

With the mouth open,between the middle of the tragus and the condyloid process of the mandible. Tip: ask the patient to open the mouth so that the condyloid process of the mandible slides forwards to reveal the depression. NEEDLING i. 90 ̊ 0.5 to 1 cun; with mouth openpatient may close their mouth subsquently.


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