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Scientific Proof of Five Transporting Points Selection in Acupuncture

One of the things that has always bothered me as a practitioner trained in both western medicine and Chinese medicine is how to explain some of the less savory aspects of acupuncture theory to skeptics.  Previous research done in the 70s has shown the physiological effects of inserting an acupuncture needle per se into the body.  Part of the critique however, is in point selection.

Even some acupuncturists are starting to claim just inserting the needles into points chosen due purely to western standards, such as so-called dry needling or segmental acupuncture, is the only “scientific” acupuncture, and such ideas such as the Five Elements and Five Transporting Points are not “modern” enough.

The Five Elements in Chinese philosophy and medicine are Wood, Fire, Earth, Metal and Water.  Traditional Chinese Medicine believes that there are special “Five Transporting Points” or “Five Shu Points” on each of the 12 paired meridians that correspond to these five elements.  It also believes that needling different elemental points has a different effect on the body.  The skeptic might grudgingly say that while science has proven that inserting a needle has a biological effect, surely it won’t make much difference if one inserts a needle on the wrist as opposed to the elbow just because the points are of different “elements”?

Let us acknowledge that the ancient Chinese obviously did not have the technological know-how that we do now.  Obviously they made observations and recorded their observations using the language and culture that they had at the time.  Hence, as we call certain physiologic phenomena “inflammation” because it looks like fire (it’s red, painful, warm, etc…) the Chinese would call a particular physiologic phenomena “cold” because it feels tight, is cool to the touch, etc.

Hence what probably happened was that the ancient doctors observed similar physiological reactions on similarly grouped points.  These became the basis for assigning them relationships according to five element philosophy.

Anyhow, here is proof that there are indeed physiologic differences between needling points traditionally assigned different “element” roles.

A disclaimer, the article made a mistake in saying PC5 is a wood point – it is a metal point; and that TE3 is a metal point when it is a wood point.  The article corrects itself in the later sentences, though.

J Altern Complement Med. 2012 Oct;18(10):959-64. doi: 10.1089/acm.2010.0751. Epub 2012 Aug 23. Differential autonomic response to acupuncture at wood and metal of five-shu acupoints. Choi W, Lee S, Cho S, Park K.


1 Department of Neuropsychiatry, College of Oriental Medicine, Sangji University , Wonju, South Korea .


Abstract Objectives: The study examined differential autonomic nervous responses to acupuncture stimulation at the wood points ([Formula: see text]) and the metal points ([Formula: see text]) among the five-shu points of the Pericardium and Triple Energizer Meridian. Design: This was a crossover study of different acupuncture points with randomized order. Subjects: The study subjects were 30 healthy female volunteers (22.8±2.6 years old). Interventions: The acupuncture sessions were carried out over four sessions at 2-5-day intervals at the same time of day with one of the four acupoints: the wood distal point (Zhongchong, PC9), metal distal point (Zhongzhu, TE3), wood proximal point (Jianshi, PC5), and metal proximal point (Guanchong, TE1) on the left hand. After 5 minutes’ rest (Pre-Acup), acupuncture needles were inserted, manipulated promptly, and were retained for 20 minutes followed by 5 minutes’ rest (Post-Acup). Main outcome measures: Heart rate variability, skin conductance response, respiration rate, and peripheral skin temperature were measured. Results: For the normalized low-frequency band of heart rate variability, there was a statistically significant increase during Acup and Post-Acup at the PC9 and TE3 wood points compared with Pre-Acup. Statistically significant decreases for PC5 and TE1 were evident at the metal points. Skin conductance response and peripheral skin temperature, which are indicative of sympathetic activity and blood flow, respectively, were significantly induced at PC9 during Acup compared to Pre-Acup. Conclusions: The wood points PC9 and TE3 increase sympathetic activity; and the metal points TE1 and PC5 increase the parasympathetic activity. The effect of acupuncture on the autonomic nervous system differs between the wood and the metal points.

The body is regulated by the autonomic nervous system.  This is composed of the parasympathetic and the sympathetic systems.  Parasympathetics are for everyday regulation, while sympathetics are for “fight or flight” responses. What is significant in this study is that PC9 (wood) and TE1 (metal) are located on fingertips, while TE3 (wood) is located in the palm and PC5 (metal) is located near the wrist.  In theory, being anatomically closer to each other, TE1 and PC9 should have similar effects when needled.  Yet, the observed effects match the “elemental” assignment more than the anatomic proximity.

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