By Tom Kennedy
Learning acupuncture point location is a huge challenge for the student – how on earth do you go about internalising all that complex information? For those without a medical background, just learning the anatomical language is hard enough, let alone the point locations themselves.
The answer is multi-faceted, and will be to some extent individual. In this article, I’ll present a few different options which you can experiment with and discover what suits your own particular learning style. More than anything, it’s important to use the first method – working with partners – but all of these methods have their place and will help you through those tricky early months of study. Eventually, your favourite points will become like old friends, and you’ll hardly have to think about how to locate them at all.
Learning acupuncture point location with a partner
This is certainly the most important way of learning, because it’s the closest you can get to replicating the clinical situation. Palpating real bodies – and ideally a variety of bodies – is the only way to develop the requisite sensitivity and ‘muscle memory’. Using the acupuncture point location text and extra notes from A Manual of Acupuncture, get used to the feel of each anatomical landmark and step through the process slowly and deliberately to start with. Let’s take a common point like Zúsānlǐ Stomach 36 (ST-36) as an example.
Here’s the text from A Manual of Acupuncture:
Below the knee, 3 cun inferior to Dúbí ST-35, one finger-breadth lateral to the anterior crest of the tibia.
i. First locate Yánglíngquán GB-34. Zúsānlǐ ST-36 lies one cun inferior to Yánglíngquán GB-34 and one finger-breadth lateral to the anterior crest of the tibia; ii. Locate one handbreadth below Dúbí ST-35.
Of the location note options, point ii. is probably the easier to apply to start with. Dúbí Stomach 35 (ST-35) is immediately below the patella, so this is your first landmark. Feel around your partner’s patella, and get a sense of where its borders are. This will vary depending on build, but it’s one of the easier landmarks to define. As it says in the ‘Quick measurements’ section of the Manual, one hand-breadth is the same as 3 cun, but remember this refers to the patient’s hand, not yours. Measure your hand against theirs to see whether you need to slightly reduce or increase your measurement accordingly. Place your hand so that it buts up to the lower border of the patient’s patella, and taking into account your relative hand size, find the 3 cun level.
The next landmark is the anterior crest of the tibia. This is usually very easy to palpate. Just run your index finger up the sharp crest of this bone to define it, and lay it next to the crest to find the lateral measurement. See below for a video demonstrating this process.
Don’t forget, although the acupuncture point locations in A Manual of Acupuncture are very precise and carefully written, they are still just a guide, and sensitive palpation is still required to find the best point of entry. This only comes through experience, and many would argue that internal practices such as qigong can help to hone your sensitivity. Often there is a slight dip in the skin where the point is (more obvious at some points than others).
It may seem cumbersome and complicated going through this process to begin with, and it can certainly be daunting when you have many unique locations to memorise, but the more you practice the more natural it will become.
Learning acupuncture point location through self-palpation and treatment
This isn’t quite as ideal as the first method, but you can’t always have a willing partner at hand to prod about! Going through the same process but on your own body will at least allow you to familiarise yourself with anatomical landmarks, at least the ones that can be easily reached.
One benefit of this method is that you can get used to what points feel like when you stimulate them with various levels of pressure. This will help you gauge how your palpation will feel to your patients. When you are advanced enough to do so safely, needling yourself after palpation will also gradually help develop your ‘intuition’ about how different points and tissues will respond to needling.
Learning acupuncture point location by reading
Of course, simple reading through the acupuncture point location notes in A Manual of Acupuncture, and visualising the process of finding the points can also be useful. This is something that can be done almost anywhere and at any time, especially if you have access to digital membership.
Reading widely on the subject of acupuncture point location also has obvious benefits. For example, Paul Johnson raises some very interesting points (no pun intended) in his article ‘But where exactly is it? The pitfalls of teaching and learning point location’, published in the Journal of Chinese Medicine. He highlights how different practitioners will locate the same point quite differently at times. This can be disconcerting to the student, but it is simply an example of the dynamic nature of this medicine. The precise point locations in the Manual are somewhat misleading in this respect, when viewed in isolation. As stated in the Manual:
‘The precision of anatomical description however does not relieve the practitioner of the responsibility for careful observation and palpation of the area to be needled so that relevant underlying structures such as blood vessels are protected and the fundamental importance of the role of palpation in point location is not neglected.’
Learning acupuncture point location by drawing
Although this may not suit everyone, making sketches of various body areas and placing the points on them is another way to embed this knowledge. Using a body area such as the face, filling in as many points as possible, then checking your accuracy against the body area images in A Manual of Acupuncture is a useful exercise. You could trace the outline of the body area, make a few copies, and keep going until you have them all right. Mentally rehearsing the anatomical descriptions at the same time will be even more effective.
Learning acupuncture point location by using flash cards
Flash cards are an age-old method of memorising complex information. Simply write out the acupuncture point locations on one side of a card, maybe including a simple diagram, and write the name of the point on the other side. Shuffle the cards, and see how much you can remember without having to turn the card over.
Peter Deadman used this technique himself during his early training. He would take the cards with him on walks in nature, which he found beneficial to the process. He later produced a printed set of cards to save people the task of writing them all out!
Learning acupuncture point location with memory techniques
Going into detail about this area is beyond the scope of this article, but memory techniques such as ‘memory palaces’ can be extremely useful if you put the effort into learning them. There are lots of online courses available, so I’d suggest doing a search and seeing what resonates with you. You can learn some of the basic principles quite easily, but to find a method of memorising anatomical locations, point actions etc. will take considerable effort and practice, as you’re likely to need to master and combine several different techniques.
Learning acupuncture point location with digital resources
As I’ve said above, there is no real substitute for learning acupuncture point location on real bodies. However, modern technology can certainly be a useful helper, and we’ve spent many years developing digital versions of A Manual of Acupuncture. I first approached Peter Deadman with the basic idea of a digital point location test when I was studying for my own point location exams at Westminster University. I was struggling to take in all the information, and wrote myself a simple piece of software which would ask me to click a randomly selected point on a body.
The Online Edition of the Manual now contains several types of test, including a more elaborate version of the above (see example video below). You are asked to locate points either based on their channel, or from a customised group. You start by clicking the general area, then if you get this right, you have to place the point more precisely on a close-up image. You’re given a score out of 3 for each point depending on your accuracy.
Of course, this doesn’t take into account the importance of palpation, but it is a very useful and fun way to test your memory and challenge yourself. This can now be accessed on mobile phones and tablets, so as long as you have an internet connection, you can learn on the go. There are a number of other tests available too – follow the links on this site to try them for free. There’s also an accompanying offline phone app which features a simple multiple-choice test, for when you don’t have internet access.
I hope some of this information has been useful – I remember all too well how overwhelming point location exams can be! Please leave a comment below if you have your own methods of learning the acupuncture point locations that might be useful to others.