Classical Points Combinations and Clusters of Points, in Acupuncture Therapy

Shmuel Halevi Ph.D
P.O.Box 159 Kfar Veradim
Telfax: 972-4-9973480
25147 ISRAEL
e-mail :



1. The Shu-Mu Law (8)

This technique of points-combination is based on two specific points groupings, one on the front of the body and one on the back, i.e., the Associated and Alarm points. The concept is that both sets have a direct influence on the organ with which they are associated, like Feishu (B-13) and Zhongfu (L-1) on the Lung, or Pishsu (B-20) and Zhangmen (LIV-13) on the Spleen etc. Furthermore, if each point alone has a strong influence on its organ, combining it with Its vis - a - vis point, will boost its effect and enhance the therapy.

Clinical experience has shown that this combination principle usually has a better effect in Shiconditions when a sedating and soothing action is needed. It is used less in Xu conditions, where other techniques are applied. Both Shu and Mu Points are chosen when an internal organ is afflicted, thus combining these two points together has a strong effect on the organ, most frequently, a sedating one.


Points-combinations - general rules

The various laws for combining points

Formula building in acupuncture therapy utilizing points combinations

Survey of classical and effective points-combinations


The principle of Shu-Nu is based on an even more basic law, the law of the "opposites".


2. The Law of the Opposites

The use of the "law of the opposites" suggests that a disease located In one part of the body should be treated on the opposite part. For Instance, a disease located in the right part of the body should be treated on the left side. A disease located in the back should be treated in the front, and vice versa. A disease located in the upper part, should be treated in the lower part of the body, and so on.

Practical examples of this law are treating Weizhong (B-54) for back pain (lower-upper), or treating Hegu (LI-4) left - for toothache in the right mandible, etc.

An extension of this law gave birth to many sets of points combinations, using two effective points from each of the opposites. Thus, in the case of lower back pain, the use of the point below - Weizhong (B-54), is happily "married" with the most effective point in the upper part, i.e. - Shenshu (B-23). These two points together form the very basis for any lumbago problem treatment, taking advantage of the law of the opposites.


3. Combining Yin Channel Points with Yang Channel Points

This law is another example of how Chinese thinking makes use of the philosophy of duality, or rather, contrasting and complementary phenomena - such as Yin-Yang etc.

The Comprehensive Text of Shanghai College states:

"As we know the primary Yang channels are connected with the primary Yin channels in a Yin/Yang relationship. By combining a point on a Yang channel with another on its paired Yin channel, the cumulative effect is greater than needling either point separately. Examples: combining S-36 (Zusanli) on the Stomach channel (Yang) with SP-4 (Gongsun) on the Spleen channel (Yin) for stomach disease. Or combining L-9 (Taiyuan) on the Lung channel (Yin) with LI-4 (Hequ) on the Large-Intestine channel (Yang) for coughing. The most well known combinations of this kind are between the Source points on the channel primarily affected by a disease, and the Connecting point on the channel paired with the first, in the Yin-Yang relationship. In this combination the Source point is called the "host" and the Connecting point the "guest"."(p.58).

This principle of combining points has created renowned combinations such as Hegu (LI-4) with Liehchueh (L-7), for upper respiratory tract ailments. Taichong (LIV-3) with Guangming (G37) for eye disorders, Taiyuan (L-9) with Pianli (LI-6) for cough from phlegm aetiology, etc.

The idea behind this form of combination is to divert excess energy from the diseased organ to its parallel Yin/Yang related channel. Thus, by puncturing the "host" point which is a Source point, one directly drains an overactive organ (Source points are in close relation with their organ (9)). The stimulation of the Luo point of the parallel meridian, ensures that the excess Qi would thus leave by the closest possible gate. (Luo points form a passage between two Yin/Yang meridians). (10)


4. Master and Coupled Points of Extra Meridians

The master and coupled points of the eight extra meridians form eight pairs of points each attributed to one extra meridian. Each pair is said to "open" its extra meridian, thus enabling it to absorb extra energy, like a "sea" or "reservoir" of energy. (11)

Two techniques exist by which these combinations are used. one way stimulates the two master points and then the two coupled points. The second advocates puncturing right master point and left coupled point in women, and vice-versa in men. (12)

Many of the eight pairs have been found so helpful in clinical practice that they are often used with no regard to their original assignment as master and coupled points of an extra meridian. A good example would be the pair Neiguan (P-6) and Gongsun (SP-4). This couple with the addition of Zusanli (ST-36) form the best points-combination to treat morning sickness, or any nausea, of different etiologies.

Another couple: Liehchueh (L-7) and Shaohai (K-6), which is also used quite frequently, has already been discussed in the previous chapter.

More of these couples will be discussed later in our last chapter.


5. Combining Local with Distant Points

This is a general law for combining points in acupuncture. The law takes advantage of the experience gained from the use of various points, and binds together effective points in the vicinity of the disease, with other effective points from distant parts of the body.

It has been found, for instance, that Ligou (LIV-5) is an effective point to treat maladies of the external sex organs (by virtue of its task as a Luo point of the meridian that encircles these organs). Zhongii (CV-3) is also an effective point for treating such problems (13). Thus, binding the two together, one close to the disease focus, and one from afar, makes a good combination in any formula for this purpose.

This law also has a deep root in the concept of "Root and Branch" and "Origin and End".

This concept is an ancient observation that all primary meridians have reciprocal relationships between points situated on the upper and lower reaches of the body, respectively.

Thus, the Bladder meridian has its root area in the vicinity of Fuyang (B-59), and branch area around Jingming (B-1).

or, the Spleen channel makes its root around Sanyiniiao (SP-6), and its branch in Pishu (B-20) as well as Lianchuan (CV23). (Acupuncture - A Comprehensive Text, p. 61)


6. One Point Above. Two Points Below

An extension of the previous law, this extraordinary law achieves wonders in acute processes, if applied correctly.

This law makes use of the previous law: "combining local with distant points", with two additions. One is that all the points should be on the same meridian segment (i.e. Shaoyang, Yangming, Taiyin etc.). The second, emphasizes that only one needle should be planted near the disease, while far from it two needles. This may, at first, sound bizarre, but the logic is clear.

Taking, once more, the example of sinusitis, the points combination which is the outcome of this law would be: Hegu (LI-4), Yingxiang (LI-20), Zusanly (ST-36), Nelting (ST-44).

Hegu, as the strongest point in the hand-Yangming, will set the whole Yang-Ming energy in motion. Yingxiang serves as the local point to cause a dispersion effect In the area, and Zusanli, together with Neiting, are "the two points below". These two points below provide a strong stimulation to the other end of the meridian, thus accelerating its energy and flow, while eliminating the stagnation in its upper part.

This same law formulates another very important points combination, used to effect Damp elimination from the intestines (purgation of the intestines).

The combination is: Tianshu (ST-25), Zusanli (ST-36), Shangjuxu (ST-37)and Xiajuxu (ST-39).

Tianshu is the local strong point for the intestines (Mu point of the colon), the other three points being situated on the same stomach meridian, and creating the weight to cause a strong downward flow of the stomach meridian energy (15).


7. Empirical Points-Combinations

There are dozens of points-combinations in acupuncture which have emerged through sheer clinical

experience. Every practitioner, who has spent a considerable length of time in clinical work, has probably noticed that some points yield better results when combined with certain points.

It is only logical that after so many generations of accumulated experience in the field of acupuncture, such empirical combinations have become the inheritance of the majority of practitioners.

In comparison with the other forms of points-combinations that have so far been detailed, this form lacks their theoretical background in most cases.

Nevertheless, clinical success is, after all, the ultimate judge, and thus, these combinations have earned their position in clinical work.

Here are a few examples of points-combinations whose source is entirely empirical:

  1. The addition of Sibai (ST-2) to the combination of Dannangxue (extra), Tianshsu (ST-25) and Guanyuan (CV-4), have a great soothing effect on biliary ascariasis. Manipulating Sibai in a sedative fashion, usually eliminates the very sharp pain which this illness causes (16). There is no theoretical explanation for this phenomenon.
  2. Hegu (LI-4) on the opposite side, combined with Liangqiu(ST-34) on the affected side, is a quick relief for strained muscles or tendons of the knee Joint (usually due to sport injury). In order to obtain the full effect of this combination, one should first puncture Hegu, at an oblique angle towards the metacarpal bones, two Cun deep, and then manipulate Liangqiu to cause numbness or distension around the knee (17).
  3. Shaoze (SI-1) has an undeniable influence on the breasts. Hence, all breast diseases, including agalactia (lack of milk), are treated with the aid of this point. When combining Taiyang (extra) to Shaoze (SI-1), we make an effective points-combination for swollen breasts. This formula's source is also classical (Song of the Jade Dragon Ca. 1500) (18).

It is worthwhile mentioning, in this connection, that many empirical combinations include extra points, and there are a few that are composed entirely of extra points.

The reason for this is clear. Since extra points themselves have originated from clinical experience, and in many cases as Ahshi points, they lack the theoretical basis that most of the meridians' points have.

It is no wonder then, that many empirical combinations include extra points, for they too have originated from clinical observation.

Example No. 3 (above) may illustrate this phenomenon, or this very popular combination:

Yintang (extra), Shenmen (H-7), Sanyinjiao (SP-6).

This formula is often used to calm the mind, especially in cases of insomnia (19), or mental anxiety.

Shenmen and SanyinJiao harmonize Fire and Water elements, or Heart and Kidney functions, while Yintang places an emphasis on calming the mind. Thus, an extra point (Yintang) contributes to the principal effect of the two meridian points, with its empirically-found soothing properties.


7. Points Clusters

A Points cluster is a grouping of a few points in the same area of the body, whose mutual effect on this area is beneficial.

In many cases these clusters are formed from extra points, like Sishencong on the vertex, or from Ahshi points (tender points) in the vicinity of the disease focus.

An example of a points-cluster would be "Three needles at the ankle". i.e. Kunlun (B-60), Jiexi (ST-41), Taixi (K-3). This cluster serves as a local treatment to disperse any blood stagnation caused by trauma in the ankle joint, or paraplegia (20).

Another "Three needles at the ankle" serves the same purpose, and is a combination of three different points: Qiuxu (G-40), Jiexi (ST-41), and Shangqiu (SP-5). This is indeed a very effective trio for sprained ankle, etc.

The majority of the points clusters, though not all of them, are concerned with localized influence. Making use of the T.C.M. principle that any pain, swelling etc. is caused by stagnant energy or blood, or both, (21) the use of powerful local points in conjunction, is supposed to resolve this stagnation, and dislodge the barrier.

Needless to mention, the utilization of such a combination would need a special dispersing technique, one that would enhance the flow of energy in the region, and disperse blood or fluid from the joint.

Other points clusters serve the same purpose as regular points-combinations, i.e. to cause any precalculated therapeutic effect, with the difference, as we mentioned above, that they are located in close vicinity.

The articulations of the body, such as: shoulder Joint, ankle, knee or elbow Joint, are considered the most vulnerable parts of the body, in relation to the smooth flow of Qi (22). Rheumatic pain which is caused by weather Influences, according to T.C.M. thinking, is usually lodged in the joints, thus hindering the smooth flow of Qi.

It is not surprising, therefore, that many clusters of points have originated in the vicinity of the joints, for the purpose of removing the stagnant pernicious influence that has lodged there.

Such clusters are the "three ankle points", that we have already mentioned, or "the three shoulder points" and the "three knee points", some of which will be discussed later.


9. Balancing and mutual assistance

This very traditional principle of Chinese medicine Is responsible for dozens of points combinations, which have been formulated over the millenia.

The idea of balancing is, after all, the core of Chinese thought, originating from the basic conception of Yin and Yang (23).

All phenomena in our body can actually be attributed to Yin and Yang, and its balanced or imbalanced state.

Without pondering too deeply upon this subject's philosophy, which is beyond the scope of this work, it is sufficient to say that balancing of Yin and Yang, Hot and Cold, Shi and Xu, is the ultimate goal of Chinese medicine (24).

Therefore, besides the various rules of points-combinations that we have summarized above, there is the principle of balancing Yin and Yang activities, which dictates what points to use in each case of imbalance.

one of the most frequently encountered imbalances in clinical practice is that of the Fire and Water elements. Most often symptoms such as heart palpitations, insomnia, dream disturbed sleep, anxiety etc., are the outcome of this imbalance. According to the poetic imaginative Chinese physiology, Kidney Water is Insufficient and unable to control Heart-Fire, which blazes upward.

This may cause palpitations and restless Heart, as well as disturbed Shen (spirit), since Shen resides In the heart organ.

To rectify this, the Chinese have originated many combinations, formulated from points having the ability to restrain or dredge the heart activity on the one hand, and to strengthen or supplement Kidney-Water, on the other hand.

Such combinations are:

1. Shenmen (H-7) and Sanyinjiao (SP-6)

2. Tongli (H-5) and Dazhong (K-4)

3. Tongli (H-5) and Zhaohai (K-6). (26)

Another frequently encountered balancing method is to harmonize activities, either of organs or of functions. This is also based on the concept of deficiency or excess of specific activities. A good illustration for this would be the combination of Hequ (LI-4) and Fuliu (K-7).

This combination Is used primarily to treat cases of either excessive, or lack of, perspiration.

In case of excessive perspiration, Wei Qi is deficient, so Hegu has to be tonified in order to fortify the protective abilities of Wei Qi. (Please note that Wei Qi is responsible for the tonus of the sweat-pores, thus controlling perspiration). At the same time Fuliu has to be reduced, since its activities are closely linked to "water" movements in the body.

In the case of absence of perspiration, one should use these very points, only with reversed manipulation. For example: Hegu sedated, In order to release tightness of the sweat-pores which are controlled by Wei Qi. Fuliu tonified, In order to increase "Water" movement In the body (27).

Another principle of points-combination, which was included under this heading, is the principle of mutual assistance.

In the same way that herbs are frequently chosen to assist and strengthen one another's action, so are points, by this principle of combination.

This method is often relevant In cases where elimination of a pathogenic factor is needed, much like herbal treatment.

For instance, where elimination of a Wind-Heat factor in the head region is needed (i.e. tonsillitis), Hegu LI-4) is of major importance. To strengthen its action we shall most probably choose Quchi (LI-11), a point quite powerful by itself, for eliminating Wind-Heat. Clinical observaton has verified, that this couple of points has a much better impact on the head region than each of them alone (28).

By the same logic, Sanyinjiao (SP-6) and Yinlingquan (SP-9) are often combined together, for the purpose of eliminating Damp-Heat pathogen from the Lower Burner.

SanyinJIao is indicated, among many other qualities, to resolve Damp and Damp-Heat from the Lower Burner, mostly by facilitating urination (29). Yinlingquan is also iIndicated to resolve Damp and Damp-Heat from the Lower Jiao, and it treats: edema, ascites, retention of urine, urinary tract infection, diarrhea, etc. (30).

Again, clinical experience has shown that putting together these two points, enhances the therapeutic effect of each of them, and this combination has become a valuable asset of Traditional Chinese medicine (31).