STANDARD ACUPUNCTURE NOMENCLATURE PART 2REVISED EDITION Basic Technical Terms of Acupuncture Eight Extra Meridians Extra Points Scalp Acupuncture Acupuncture Needles Unit of Measurement
World Health Organization Regional Office for the Western Pacific Manila, Philippines
1991
Cover: one of the oldest "copperman" statues indicating the acupuncture points. Reproduced by the kind permission of the Tokyo National Museum.
First Edition 1988 Revised Edition 1991
NOTE The views expressed in this pamphlet are those of the members of the Regional Consultation Meeting on the Standardization of Acupuncture Nomenclature, held in May 1984. the Second WHO Regional Working Group on the Standardization of Acupuncture Nomenclature. held in July 1985. the Third WHO Regional Working Group on the Standardization of Acupuncture Nomenclature, held in June 1987. and the Scientific Group to Adopt a Standard Acupuncture Nomenclature. held in October-November 1989. and do not necessarily reflect the policies of the World Health Organization. For further information. please contact the WHO Regional Office for the Western Pacific. P. O. Box 2932. Manila. Philippines. TYPESET IN JAPAN PRINTED IN THE PHILIPPINES
CONTENTS
Page INTRODUCTION· ........................ ..... ............ ........ ..................................... 3 I. STANDARD NOMENCLATURE OF BASIC TECHNICAL TERMS OF ACUPUNCTURE ....... ..... ............... ............ .............................. 5 STANDARD NOMENCLATURE OF EIGHT EXTRA MERIDIANS .............................. .............................................. ......... ........ 6 STANDARD NOMENCLATURE OF EXTRA POINTS ................ ................. 8 STANDARD NOMENCLATURE OF SCALP ACUPUNCTURE .................................................................................... 11 SCALP ACUPUNCTURE LINES ............................................................... 14 STANDARD NOMENCLATURE OF ACUPUNCTURE NEEDLES··· .. ·· .. ········································ ............................................... 21 ST ANDARD NOMENCLATURE OF THE UNIT OF MEASUREMENT ....................................................................................
2.
3. 4.
5. 6.
7.
23
INTRODUCTION
With a view to achieving global agreement on a standard acupuncture nomenclature, the World Health Organization Regional Office for the Western Pacific has to date sponsored four regional meetings: (a) (b) (c) (d) Working Group on the Standardization of Acupuncture Nomenclature, Manila, December 1982; Regional Consultation Meeting on the Standardization of Acupuncture Nomenclature, Tokyo, May 1984; Second Working Group on the Standardization of Acupuncture Nomenclature, Hong Kong, July 1985; and Third Working Group on the Standardization of Acupuncture Nomenclature, Seoul, June 1987,
The Manila meeting in 1982 established the nomenclature structure of the meridians and acupuncture points, and reached a consensus on 361 classical Acupuncture points. The Tokyo meeting in 1984 approved the standard nomenclature of31 extra points and adopted brief explanations covering 361 classical acupuncture point names, the standard nomenclature of scalp acupuncture and the basic lines for locations of acupuncture points, except the Lateral Cranial Line and Lateral Abdominal Line. The Hong Kong meeting in 1985 approved 17 extra and new points, the standard nomenclature of the eight extra meridians, with the exception of "Chongmai", and the standard English nomenclature of the basic technical terms of acupuncture. The Seoul meeting in 1987 finalized the standard nomenclature of the eight extra meridians, developed the standard nomenclature of selected auricular points, acupuncture needles and unit for location of meridians and acupuncture points, finalized the standard nomenclature of forty-eight extra points, and adopted guidelines for development of the acupuncture chart. It was also decided to defer discussion on the basic lines for further study, After basic agreement at the Regional level, a Scientific Group to Adopt a Standard International Acupuncture Nomenclature was held in Geneva in October-November 1989, The meeting, together with the members from the WHO Regions other than the Western Pacific Region, reviewed the 361 classical acupuncture points, eight extra meridians, 48 extra points and scalp acupuncture and made minor modifications. A pamphlet entitled Standard Acupuncture Nomenclature which covers 361 classical
3
acupuncture points was published in 1984 and copies were distributed throughout the world. Its revised edition, which was adopted in the Geneva meeting in 1989, is being published with minor modifications. A booklet entitled Standard Acupuncture Nomenclature, gIVing a comparative multilingual list in English, French, Japanese. Korean and Vietnamese, was also published in 1984 as a WHO Regional Publication, Western Pacific Series No. I. This is now under revision. including the explanation of acupuncture point names. The present pamphlet consists of six sections: (I) Standard nomenclature of basic technical terms of acupuncture; (2) Standard nomenclature of the eight extra meridians; (3) Standard nomenclature of extra points; (4) Standard nomenclature of scalp acupuncture; (5) Standard nomenclature of acupuncture needles; (6) Standard nomenclature of the unit of measurement. At the Geneva meeting. eight extra meridians including the English nomenclature for "Chongmai" were adopted, 48 extra points were adopted based on Regional agreement and scalp acupuncture was adopted on the basis of Regional agreement with the inclusion of suitable diagrams. These are incorporated in this revised edition of the pamphlet.
4
STANDARD NOMENCLATURE OF BASIC TECHNICAL TERMS OF ACUPUNCTURE
There have been differences in the English nomenclature of basic technical terms of acupuncture. For instance. Jing (~~) was sometimes translated as "meridian", but at other times as "channel". Another example is Zhenjiuxue (~)(J'",:), which was translated as .. acupuncture point" or .. acupoint". The following standard nomenclature was adopted at the meeting held in Hong Kong in 1985 :
Meridian Collateral Meridian and Collateral Main Meridian Extra Meridian Meridian Point Extra Point Acupuncture Point
ling LUD JIngluD ZhengjIng QijIng JIngxue Qixue Zhenjiuxue
k~ (t.1:, ~,f.)
*W~i
~:'E (~?,~.£) *IH ~*
)
lHWf,m :tff~ ( tf:.
*1: )
~:'E U{, ~.£) A
~1/\:
~(fj.H))(J\:
5
STANDARD NOMENCLATURE OF EIGHT EXTRA MERIDIANS
At the meeting in Hong Kong in 1985, after a careful and detailed study and debate, the nomenclature for eight extra meridians was adopted with the exception of"Chongmai". The phrase "Eight Extra Meridians", which includes the Conception and Governor Vessel Meridians plus six extra meridians, was officially recognized as the corporate title of this group. It was unanimously decided to omit the term "meridian" after Conception Vessel and Governor Vessel in order to standardize the nomenclature of the eight extra meridians. The members were requested to find a suitable English equivalent for "Chongmai" and to report to the Third Regional Working Group. At the meeting in Seoul in 1987, "Chongmai" was again discussed. Various names were proposed such as Infusion Vessel, Sea Vessel, Gush Vessel, Flush Vessel, Charging Vessel and Ancestral Vessel. Most of the suggestions referred to the description in Neijing(pg~: Canon of Medicine), i. e. "sea of the blood and gas". Members from China, however, noted that it was impossible for them to find a suitable English equivalent. After a lengthy discussion, the terms Charging, Flush, Gush, Infusion were grouped as one with similar meanings and, considering the alphanumeric code, it was decided to use Flush Vessel and the abbreviation FV, with a footnote "Further investigation of a more suitable English nomenclature might be necessary". At the meeting in Geneva in 1989, ~Chongmai" was discussed again together with the participants from regions other than WHO Western Pacific Region. Thouroughfare Vessel and Thoroughway Vessel were proposed as possible English equivalents. After lively and careful discussion, it was finally decided to use Thoroughfare Vessel with the abbreviation TV. Th us, the nomenclature of the eight extra meridians is as follows:
6
STANDARD NOMENCLATURE OF EIGHT EXTRA MERIDIANS
GV CV TV BV YinHV YangHV YinLV YangLV
DOmai Renmai Ch6ngmai Daimai Ylnqiaomai Yangqiaomai Ylnweimai Yangweimai
'Pi ~I(c (I],k l H~IR(~,ki
Governor Vessel Conception Vessel Thoroughfare Vessel Belt Vessel
ffu ( itp ) ijl~ ( )j,k l ;;'Ii- ( 'ili , ,;t;; ) ijlWJAd
1;1: ( fill )~I.f, ( 1JW!iW],k) Yin Heel Vessel I:~(
fll:J l~l.iil ~11' lmr,(J],k 1 Yang Heel Vessel
I~ ( [:}j
Hit !t1n )jJ(, IIHd Yin Link Vessel
r.!!; ( [:llHU Uti )miWJ,id Yang Link Vessel
7
STANDARD NOMENCLATURE OF EXTRA POINTS
At the Tokyo meeting in 1984, 31 extra points were adopted, all of which are those recorded in the medical classics and are widely used. At the Hong Kong meeting in 1985, 5 extra points and 12 new points were adopted using the following criteria: (I) (2) (3) (4) (5)
The points should be in common use. They must be clinically effective. They must have a clear anatomical location. They must be at least 0.5 cun away from a classical acupuncture point. If an extra point has the same name as an existing point, a prefix must be added to it.
At the Seoul meeting in 1987, a suitable nomenclature for all the 48 acupuncture points was discussed. After careful consideration, it was unanimously agreed that all points outside the 361 classical acupuncture points should be called Extra Points. This should include all new points introduced after 1901 A.D., including 12 new points adopted in Hong Kong namely, QiCihou, ShangYl ngxiang, Ylmlng, Dlngchuan, YaoYI Xiazhlshl, Yaotongdian Wllilaogong, Lanwei, Dannang, Neixi'yan and Xlnei. Thus, all told, the Working Group adopted 48 extra points. The alphanumeric code of these 48 extra points was then discussed. The following principles were established and the alphanumeric code was adopted: (1)
(2)
head, neck and trunk regions, from the higher to the lower level; upper and lower extremities, from the proximal to the distal level and, if at the same level, from the medial to the lateraL
The following standard nomenclature was adopted for the 48 extra points. This was also adopted at the Geneva Meeting in 1989.
8
STANDARD NOMENCLATURE OF EXTRA POINTS
Points of Head and Neck, HN_ T6ujing xue ~!(I), m\i §~, W) J\ Ex-HNI *Ex-HN2 Ex-HN3 Ex-HN4 Ex-HN5 Ex-HN6 *Ex-HN7 *Ex-HN8 Ex-HN9 Ex-HNlO Ex-HNll Ex-HNI2 *Ex-HN13 *Ex-HNI4 *Ex-HNI5 Slshencong m'ingyang YlnUing YGyao Taiyang Erjian QiGhOu Shangyingxiang Neiyingxiang JUquan IHiiquan JinjIn Yuye Ylming Jingbailao ~LJ~lp(
f!11
)~.'ll(1l~\
'Il'i I ~~ )III!; ( lif]i flL<;f: .1\1.1. fiF. ) H'l:' ;U>I)jllifj)
If'k I:j(i~
(1;-;')
j
',iill (.if!! ) f,' f1-Lill (i!1! ) i'i'
~)R
.=f. au ~~IJ)j
~hHiJ. <Tr~ It
~il (J~i. }!l)
Fi'* (J;'. T;)
Points of Chest and Abdomen , CA. Xi5ngfu xue !~J!li 'A Ex-CAl Zigong Points of Back , B. Beibu xue ,"filiI/'( 'Ex-BI Ex-B2 *Ex-B3 Ex-B4 *Ex-B5 *Ex-B6 Ex-B7 Ex-B8 Ex-B9 Dlngchuan Jiaji Weiwanxiashil Pigen Xiazhlshl Yaoyi Yaoyan ShlqIzhuI Yaoqi
!J~II!(
~Uft
ali' (,r
9
Points of Upper Extremities, UE. ShangzhI xue J:J!i"/( Ex-UE1 Ex-UE2 Ex-UE3 Ex-UE4 Ex-UE5 Ex-UE6 *Ex-UE7 *Ex-UE8 Ex-UE9 Ex-UElO Ex-UEll Zhoujian Erbai Zh5ngquan Zh5ngku! m.gi:ik5ng Xiaogi:ik5ng YaotOngdian Wailaog5ng Baxie Slfeng Shixuan ijt'k
=8 rpJR rpM *1f('R")"~ 'H't ('ft j"!);: Jlf jj\J Jl1,1; ( }\ 1 jj-~H 11',
':iJ'l3m)
TI.;rlj 1lLI~;f(tl
)
+~
Points of Lower Extremities , LE. XiazhI xue TijiiJ'( 'Ex-LEI Ex-LE2 *Ex-LE3 *Ex-LE4 Ex-LE5 Ex-LE6 *Ex-LE7 Ex-LE8 Ex-LE9 Ex-LElO Ex-LEll *Ex-LE12 Kuangi:i Heding Xlnei Neixly{m Xlyan Dannang Lanwei Neihuaijian Waihuaijian Bafeng Duyln Qiduan t'lWlt ) ttl1t ) til( t% )
m(Triil
j*r"J I"Jj*HR ~i!1.
fjf!\'(ijH)ft loti] (ljjlJ ) I-f,
f"lM!I':'k jj-~!I':'k J\.J,pW~\)
)15 ( j~ lP1i ( i>JJ ) ~(\, ~\)t[1ffi
'Selected at the meeting in Hong Kong in 1985, the other 31 being selected at the meeting in Tokyo in 1984.
10
STANDARD NOMENCLATURE OF SCALP ACUPUNCTURE
Scalp acupuncture therapy, whereby diseases are treated by needling on certain areas of the head, has been employed in China since 1970. It is now becoming one of the therapeutic methods frequently used in many countries. ScalI' acupuncture has been developed on the basis of the traditional medicine system of acupuncture. Its points are closely related to the meridians, classical acupuncture points and the theory of internal organs. Thus its nomenclature should reflect the theory and characteristics of meridians and acupuncture points. This nomenclature is formulated on the principle of selecting points on the meridians decided by the locations in various regions of the head in combination with the classical method of through-needling (needling from one point to reach another point or more points) . Like the classical points, the nomenclature of scalp acupuncture consists of three essential elements, namely, alphanumeric code, Chinese phonetic alphabet (Pinyin) names and Han characters. The corresponding English equivalent is also given. The alphabetic code name of scalp acupuncture is MS, this code name being derived from the terms "micro-system" and "scalp points". This nomenclature was adopted at the meeting discussion. III
Tokyo
III
1984 after a lengthy
At the Geneva meeting, this nomenclature was also adopted with the inclusion of suitable diagrammes.
11
STANDARD NOMENCLATURE OF SCALP ACUPUNCTURE
MSI
Ezh6ngxian ~ii(~~l) crk,,\U H:) Middle Line of Forehead 1 cun long from GV24 Shenting iIi$ll$)/ff straight down along the meridian. Epangxian I Mj('~m)9; 1 *JIi.(~) Lateral Line I of Forehead 1 cun long from BL3 Meich6ng Ifliwf( i$) straight down along the meridian. EpangxianII ~ti(1im)~2**(~) Lateral Line 2 of Forehead I cun long from GBl5 T6ulinql ~J'i(:I;)Il.1i;(I/:;;)i,'[ along the meridian.
MS2
MS3
straight down
MS4
Epangxian Ill. '~ti('lim)~:; *g(tx) Lateral Line 3 of Forehead 1 cun long from the point 0.75 cun medial to ST8 T6uwei liIl (iI-: l*lWln straight down, DingzhOngxian fJ'i(Jnf)crWJ~x) Middle Line of Vertex From GV20 B<lihul (1~(~) to GV21 Qianding Mmmil along the midline of head. Dlngnie Qianxiexian fJ'i (Inilli\ Oj10 iiWMJit (ttl Anterior Oblique Line of Vertex-Temporal From Qianshenc6ng ~lJffi$(f$H!1!,(ff!€,) (one of acupuncture points of Ex-HNI Slshenc6ng ~Yffi$(./$)~!1!.(lf2,), 1 cun anterior to GV20 Baihul n*(~)) obliquely to GB6 Xuanli !!§(tJ;)t';(Jll[). Dingnie Houxiexian JJ\Uvillft(JJli)f!U!i):r.'/*Jll(tx) Posterior Oblique Line of Vertex-Temporal From GV20 Baihul Edt ( it) obliquely to GB7 Qubln
MS5
MS6
MS7
IlIl1f(~)'
12
MS8
Dingpangxian I TJl(J!ii)"81 ;jiJj(ti) Lateral Line 1 of Vertex 1.5 cun lateral to Middle Line of Vertex, 1.5 cun long from BL 7 T(lngtian jill), backward along the meridian. Dingpangxian II T):t(J!Jl)"8 2 ,j!!ll(ti) Lateral Line 2 of Vertex 2.25 cun lateral to Middle Line of Vertex l.5 cun long from GBl7 Zhengying j[.g(1\\ '3") backward along the meridian. Nieqianxian lli(lllOll1i**(til Anterior Temporal Line From GB4 Hanyan &!(SDl)/liWti:) to GB6 Xuanl! NiehOuxian II\(Jijjli~(I5)**(gi) Posterior Temporal Line From GB8 Shuaigii $B'- to GB7 Qubln !II!~(i}.i). Zhenshang ZhengzhOngxian ftJ:.lE<p*~(til Upper-Middle Line of Occiput From GV18 Qiangjian 5!1lr"9UB]) to GVl7 NaohO ij~~(lI~i, ijr;Jlp. Zhenshang Pangxian fLl:'%'k*( ti) Upper-Lateral Line of Occiput 0.5 cun lateral and parallel to Upper-Middle Line of Occiput. ftr"HJitWU Zhenxia Pangxian Lower-Lateral Line of Occiput 2 cun long from BL9 YOzhen clift straight down.
MS9
MSIO
~(~)t.;W!jl).
MSll
MSl2
MS13
MSl4
13
OV24
------~
, - - - - - - -- --- MSI I
BL3 -
- - ------..
~-......- - / I I I
I
r--------- MS2 / /
OBI5 - - -
I
/ ,---- -- //
ST8 --
}/ ~/ r-~----/
MS3
MS4
Fig. 1. Scalp acupuncture lines MSJ , MS2 , MS3 and MS4 (anterior view)
14
GV20 -~.....
_ MS5 GV21
Fig. 2. Scalp acupuncture line MS5 (vertex view)
15
qianshencong - - - - - - -"""""\ / /
/
~
- - - - - - - - MS6
GV20
- ------c GB6
MS7 - - - - -
GB7 - - -
Fig. 3. Scalp acupuncture lines MS6 and MS7 (lateral view)
16
BL7 qianshencong MS8 - - - - - GV20
GBl7
MS9 ---GB4 MSIO GB8 GB6
GB7
Fig. 4. Scalp acupuncture lines MS8, MS9, MSJO and MSJ J (lateral view)
17
GVI8----... /' /
,r- - - - - -
" /
" / ---_. / /
MSI2 MSI3
/ /
GVI7
/ /'
/' /
..-
/
..- ..-
..-
/
BL9 r---
MSI4
Fig . 5. Scalp acupuncture lines MSI2 , MSI3, and MSI4 (posterior view)
18
GV20
GV21 a aGBI?
GVI9
a
GVIS 0
nasion
visual area
GVI7 0 inion - -- ---. GVI6 Q
Fig. 6. Scalp acupuncture lines MS6 . MS7. MS8. MS9. MSIO and MSII superimposed on functional zones of the brain. *
'" These scalp acupunlure lines were formerly named in functional terms. The proposed standard international nomencl ature is based on surface anatomy so as to facilitate localization of the lines, but their relationship to the underlying functional structures has not changed.
19
GV20 0
GVI90
GV18 GV17 visual area
~
cerebelium
o atlas
GV16
inion
•
Fig. 7. Scalp acupuncture lines MSJ2 , MSl3 and MSJ4 superimposed on functiona l zones of the brain*
20
.. These scalp acupunture tines were formerly named in functional term s. The proposed standard international nomenclature is based on surface anatomy so as to facilitate locali zation of the lines . but their relationship 10 the underlying functional structures has not changed.
STANDARD NOMENCLATURE OF ACUPUNCTURE NEEDLES
At the meeting in Seoul in 1987, after a lively discussion, the standard nomenclature of filiform needles was adopted and the method of measurement was decided. The standard norr.enclature of the "nine classical needles·' and modern needles was also proposed as follows:
STANDARD NOMENCLATURE OF FILIFORM NEEDLES handle root body tip Zhenbing Zhengen Zhenti Zhenjian ~(it, ~mt,
'I'I·Hflj HHl{
~~( it,
'fl )im(i*)
r>l« *t, Hl;k (7t) IS
The diameter is measured at the root and the length of the needle measured from the root to the tip. The unit of measurement is the millimetre.
21
PROPOSED STANDARD NOMENCLATURE OF THE "NINE CLASSICAL NEEDLES"
(1)
Shear needle
Chiinzhen Yuiinzhen Chizhen Fengzhen Plzhen Yuiinllzhen Hiiozhen Changzhen Dil.zhen
it( ,ll: iill:(;frI, 'H)
(2) Round-point needle (3) Spoon needle (4) Lance needle (5) Stiletto needle (6) Round-sharp needle (7) Filiform needle (8) Long needle (9) Big needle
Iftl ([llU, fIl, H, bl
)~( H,
'H)
i£(,£)jjWH, Hl J~('(i")~(it, ~(',&:lill:(;frI, ~(lrnl, fIj,
ttl
'fr) HIJ~m,
H, &1
H)
~~(H,H)
tf:(
~ )lJil((
}I, H)
*~(}t,H)
PROPOSED STANDARD NOMENCLATURE OF MODERN NEEDLES (1)
Three-edged needle
Sanlengzhen
:=.ttt',
W~W,
'1'1)
(2) Ringheaded thumbtack QInzhen needle (3) Intradermal needle (4) Dermal needle Pineizhen Plfiizhen
liW\x)~(H,
H)
&:lj~lJil((H,
tI)
&)I1(~*)~(H,
H)
'These two Chinese characters are interchangeable.
22
STANDARD NOMENCLATURE OF THE UNIT OF MEASUREMENT
At the Seoul meeting in 1987, the Working Group discussed the unit for location of meridians and acupuncture points. It was reported that different units and systems were in use. Some countries used the term "inch" or other equivalent units in English. However, most of the countries used the cun/Cun, or tsun/Tsun. After a long discussion, it was decided to use the cun (non-italicized) as the standardized nomenclature for the unit. It was also noted that there were two different ways of defining the cun. Therefore, it was decided that the following standard nomenclature should be used in each measurement method:
B-cun F-cun
Glidli Fenclin Sh5uzhl T6ngshenclin Cfr.l"liilJr>t
bone proportional cun finger cun
23
The Working Group also discussed standardization of the measurement of parts of the body using the cun. Thirty-six parts of the body mentioned in Neijing(P'J~: Canon of Medicine) reviewed one by one. The following criteria were used: ( 1) (2) (3) (4) Commonly used Easy to measure Clearly defined anatomically Not controversial among the members were
Some controversial parts were left for further investigation. Standard measurements of six parts of the body were adopted as follows: (I)
from the upper border of the Manubrium to the end of the body of the Sternum = 9B-cun from the end of the body of the Sternum to the Umbilicus = 8B-cun from the Umbilicus to the upper border of the Symphysis pubis= 5B-cun from the Medial Malleol us to the ground = 3B-cun from the greater Trochanter to the knee joint= 19B-cun from the knee joint to the prominence of Lateral Malleolus= 16 B-cun
(2) (3) (4) (5) (6)
24
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