THE JOURNAL OF
BIOELECTROMAGNETIC
MEDICINE

Volume Twenty-Two
July 2010

Low-Level Laser Acupuncture Treatment
In The Clinical Application
Of The Five Shu Points

E. F. Block

Introduction - Traditional Acupuncture

The Classical Definition of the 5 Shu Points

The Classical definition of the acupuncture points comes from the Ling Shu (Miraculous Pivot, 1st century BCE). Acupuncture points are classified by categories according to clinical practice - Five Shu Points, Five Element Points, Lower He Sea Points, Xi Cleft Points, Yuan Source Points, Luo Connecting Points, Back Shu Points & Front Mu Points, Hui Meeting Points, Extraordinary Vessel Master Coupled Points, Command Points, Four Seas Points, Sky Window Points, Thirteen Ghost Points, Entry Exit Points and the Shokanten Points. Please refer here to learn more. The individual points located linearly on the meridians are grouped according to patient diagnosis and intent of treatment in order to return the body to balance.

The 5 shu or transporting points are located below the elbows and knees on the extremities. Since the Qi flowing in these portions of the channels is passing through a particularly high rate of change in dynamic quality, the five Shu points play an important role in the formation of many acupuncture prescriptions. The 12 meridians are categorized as to Yin/Yang and the 5 Elements (Metal [Air], Water, Wood, Fire, Earth). The flow of Qi in the meridians is said to originate in the body center and move to the hands and out of the body proper into the environment in the first movement. Then the energy comes into the hand from the environment and flows across the body to the head in the second movement. From the head the flow is across the body to the feet and out into the environment for the third movement. The forth and last movement of the cycle is from the environment into the feet, across the body and into the body center. Three complete cycles through the meridians are accomplished in approximately every 28 minutes.

Being able to influence the movement of Qi within, into and out of the body is of paramount importance. Thus, the 5 Shu points may be likened to gates controlling the flow of Qi within, into and out of the body. A description of the 3 rounds of Qi flow to make a complete cycle may be found here. If the body is not in balance, one may influence the quantity of flow within a meridian by filling or draining a point on either side of the specific point that is defined as the namesake of that meridian. Yin meridians have the ultimate point labeled as Wood, while Yang meridians have the ultimate point labeled as Metal. The namesake of the Lung meridian is the Metal point in the series as Lu8. For the Large Intestine meridian it is the Metal point in the series as LI1. See the tables below for an explanation. The namesake point is also known as the hourly point, see below. Namesake points are in red.

Yin/Zang
Meridian Wood Fire Earth Metal Water
Lung 11 10 9 8 5
Spleen 1 2 3 5 9
Heart 9 8 7 4 3
Kidney 1 2 3 7 10
Pericardium 9 8 7 5 3
Liver 1 2 3 4 8

Yang/Fu
Meridian Metal Water Wood Fire Earth
Large Intestine 1 2 3 5 11
Stomach 45 44 43 41 36
Small Intestine 1 2 3 5 8
Urinary Bladder 67 66 65 60 40
SanJiao 1 2 3 6 10
Gall Bladder 44 43 41 38 34

In addition to being labeled with an Element, each of the 5 Shu points are labeled with a description of each acupuncture point from the tip of the finger/toe to the elbow/knee. The Qi flow in the meridians is likened as to the flow of water from the ground. The ultimate point is likened as to a well (jing) with a deep reservoir. The second point is likened as to a spring (ying) issuing from the ground. The third point is likened as to a stream (shu). The fourth point is likened as to a river (jing) and the fifth as to the sea (he). There is a definite ideation of Qi being more available the closer to the body center. The difference in Element nomenclature beginning in the ultimate point as per Yin/Yang meridian was not stated.

Clinical Application of the 5 Shu Points According to TCM Theory

According to the Classical Difficulties (68th Difficulty)

  1. Jing-Well points for fullness below the heart
  2. Ying-Spring points for heat in the body
  3. Shu-Stream points for heaviness of the body and pain in the joints
  4. Jing-River points for shortness of breath, cough, chills and fever
  5. He-Sea points for rebellious Qi (vomiting) and diarrhea

According to the Spiritual Axis (Chapter 44)

  1. According to the Season
    • In the winter needle the Jing-Well points
    • In the spring needle the Ying-Spring points
    • In the summer needle the Shu-Stream points
    • In the late summer needle the Jing-River points
    • In the winter needle the He-Sea points
  2. According to Symptomology
    • Diseases in the Zang, needle the Jing-Well points
    • Manifesting as a change in color, needle the Ying-Spring points
    • When the disease manifests intermittenty, needle the Shu-Stream points
    • When the disease manifests in the patient's voice, needle the Jing-River points
    • If there is disease of the stomach and irregular appetite, needle the He-Sea points
  3. According to the Spiritual Axis (Chapter 4)
    • The Divergent branches of the Yang channels reach into the interior and connect with the Fu organs
    • The Ying-Spring and Shu-Stream points treat the channel
    • The He-Sea-points treat the Fu organs

Clinical Application of the 5 Shu Points According to the 5 Element Theory of Zi Wu Liu Zhu (Midnight - Noon Circadian Clock)

In case of Deficiency

  • Stimulate the Mother point at the time period just after the corresponding organ time period
  • Stimulate the Mother point at the opposite time period of the corresponding organ time period
  • For example, stimulate Lu9 at 5-7 AM or at 3-5 PM for Lung Deficiency

In case of Excess

  • Reduce the Son point at the time period of the organ
  • Reduce the Son point at the opposite time period of the organ
  • For example, reduce Lu5 at 3-5 PM or at 3-5 AM for Lung Excess

Introduction to Low-Level
or Cold Laser Aupuncture

Low-Level or Cold Laser acupuncture relies upon the same dosage principles as needling, and a knowledge of acupuncture theory & practice is required. The applied laser dosage is determined by the manner of the intended effect, which is generally characterized as to stimulate or to sedate acupuncture points, Ashi Points, and Trigger Points. According to the Arndt-Schultz Rule, it can be understood that low dosages will stimulate and that higher dosages will sedate. Dosages of 0.5 to 2.5 J/cm2 are reported to be effective in the stimulation of superficial acupuncture points, with 2.5 to 5.0 J/cm2 being effective for deeper points and myofascial trigger points. Higher dosages (8 - 12 J/cm2) are effective for the sedation of points.

LEDs and lasers both generate biomodulatory effects within living tissue, however, most published research relates to lasers. The therapeutic effects of lasers are both wavelength and dosage dependent. Low dosages stimulate, high dosages inhibit and thus both have therapeutic applications. The optimal therapeutic window for photobiostimulation is 0.5 to 5.0 Joules/cm2. For optimal biostimulation, lower dosages per point with more treatment points and for optimal bioinhibition, higher dosages per point with less treatment points as stated above. Visible red wavelengths (~620-690 nanometers) have shallow penetration and are used for superficial treatment such as facial rejuvenation, acne, scars and other skin blemishes. Infrared wavelengths (~760-1260 nanometers) penetrate deeper for subdermal tissue treatment in musculoskeletal injuries, sports therapy and wound healing. Laser therapy works on the principle of inducing a biological response through energy transfer, in that the photon energy delivered into the tissue by the laser will modulate the biological processes within that tissue, and those within the biological system of which that tissue is a part. Laser energy at or near 800 nanometers is particularly effective as this is close to the biophotonic emissions of cells. Again, the Arndt-Schultz Rule infers that low dosages of photonic energy will stimulate those biological processes while higher dosages will inhibit them.

Treatment Protocol

The intent of the traditional acupuncture protocol is to stimulate the Mother point of the namesake point of the meridian for a deficiency in that meridian or conversely to reduce the Son for an excess. The Spleen Meridian will be used as an example, for instance as if there was an excess condition in the Spleen Meridian. Since the namesake Shu point on the Spleen meridian is the Earth/Shu-Stream point Sp3, the Metal/Jing-River point Sp5 is to be reduced. Sp5 is the Son of the namesake point Sp3. If there is a deficiency, the Mother of the Sp3 point is to be stimulated, Sp2.

Using the laser to reduce means to apply a dosage of 8-12 Joules/cm2. Conversely, a stimulatory dosage would be 0.5 to 5.0 Joules/cm2. Thus to stimulate the Mother point of the namesake in the meridian treated, apply a dosage of 4 Joules/cm2. In order to reduce the Son point of the namesake point in the meridian treated, apply a dosage of 10 Joules/cm2. This protocol is in accordance with the Arndt-Schultz Rule.

Conclusions

While it is the Qi of the practitioner that enters the patient upon needle insertion, it is the intent of the practitioner and the manner of needle manipulation that determines the quality of the treatment. The use of the Cold Laser to stimulate or to reduce any particular point is readily applied to the theory of Shu Point acupuncture. Laser acupuncture is much faster that traditional needle treatment, approximately 5 to12 seconds. The quality of the treatment is very sure and may be consistently applied at any time. Many years of laser acupuncture experience have shown the effectivtness of this means of clinical treatment.

References

  1. The 5 Shu Points
  2. The TCM Theory of the 5 Shu Points
  3. Ling Shu Acupuncture
  4. Acupuncture As Informational Medicine
  5. Effects of electroacupuncture at shu-points of the five zang-organs on electrophysiologic function of sciatic nerve in the rabbit of Guillain-Barre syndrome

Index