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Introduction: In this article, Wang Juyu shares a medical case involving tooth pain. The patient initially intended to perform bloodletting at Lidui (ST 45), but upon examination, Wang found no tenderness at Lidui, nor at Xiangu (ST 43) or Neiting (ST 44). Instead, a distinct tender point was identified between the two acupoints, and acupuncture at this site yielded excellent therapeutic results. This illustrates that acupoints can shift, and palpation should be the definitive guide for locating them.

Trust Palpation: Understanding the Phenomenon of Acupoint Shift

Wang Juyi

On one occasion, a student had swelling and tenderness in the upper right gum for over a week. He intended to perform bloodletting at the right Lidui (ST45), as pain in the upper gums is often attributed to pathology of the Foot Yangming Meridian. Just as he was about to needle the Jing-well point of the Foot Yangming Meridian, I stopped him.

I applied pressure to his right Lidui (ST45) but did not find any soreness or pain. Therefore, I continued tracing upward along the meridian. No soreness was detected at Neiting (ST44) or Xiangu (ST43). Then, I returned to the area between Neiting (ST44) and Xiangu (ST43) and discovered a spot with intense soreness that could alleviate the gum pain.

Thus, I inserted a needle at this "Ashi point," achieved the needling sensation (deqi), and performed lifting, thrusting, twisting, and rotating manipulations. I also flicked and scraped the needle handle with my fingernail while instructing the student to massage the painful gum area with his tongue. Throughout this process, I continued manipulating the needle. Within one minute, the gum pain significantly subsided (reduced by 80%). The pain completely disappeared the following day.

From this, it can be seen that in order to accurately locate acupoints, the doctor must palpate along the area to identify the site with the strongest response. The area pressed should elicit the following sensations:

1. There is a gap or depression;

2. There is a sense of Qi (the doctor can feel the presence of Qi);

3. The patient can feel abnormal sensations such as soreness, numbness, or pain.

The best outcome is when the practitioner's tactile sensation aligns with the patient's perception.

The author often finds that acupoint locations differ from textbook descriptions and can vary from person to person. Multiple factors can cause acupoints to shift, and practitioners can only determine their precise locations through careful palpation; otherwise, acupuncture may be ineffective.

There are two main reasons for acupoint displacement:

① It may be a congenital phenomenon, appearing bilaterally, and can be confirmed through palpation; ② Displacement due to pathological abnormalities. For example, an earthquake may destroy a dock, but a new one often appears nearby afterward. Similarly, damage to the body's meridians can cause an acupoint to shift to an adjacent location.

Many people mistakenly consider shifted acupoints as new ones, such as some acupuncture schools having numerous "newly discovered" points. In reality, some "extra-meridian points" might actually be displaced regular meridian points.

Because acupoint positions often shift, when locating them, doctors must use their own fingers to feel and search for the appropriate gaps, rather than relying solely on the patient's soreness as a basis for confirming the acupoint location.