Researchers from Shandong University of Traditional Chinese Medicine, Professors Liu Yutan, Jia Hongling, and Zhang Yongchen, have provided groundbreaking insights into the understanding of Huatuo Jiaji points, shedding light on their historical origins, clinical applications, and integration into modern acupuncture techniques.
Huatuo Jiaji points, a cornerstone of acupuncture practice, are known by various names, including Jiaji (夹脊), paravertebrals (脊旁), Tuoji (佗脊), Huatuo points (华佗穴), and elbow vertebra (肘椎). These acupoints are located bilaterally along the spine and are lauded for their efficacy in addressing visceral, limb, trunk, and channel diseases. Despite their widespread use, there has been significant debate surrounding their naming, location, and standardized application [1].
To address these inconsistencies, Professor Liu Yutan, a seasoned researcher with over 30 years of experience, has meticulously documented his understanding of Huatuo Jiaji points. His analysis emphasizes their historical evolution, anatomical positioning, and therapeutic compatibility with various acupuncture techniques.
Historical Context of Jiaji Points
The origins of Jiaji points can be traced back to classical Chinese medical texts, with references appearing as early as the Su Wen. In the chapter on acupuncture for malaria, it is stated:
“Twelve malaria patients, each presents variously at different times… they must be needled at the Xiaji below the nape of the neck” [1].
This description highlights the importance of tender points located along both sides of the spine, often identified through palpation. Such tender points, termed ashi points, serve as a guiding principle for Jiaji point selection and treatment.
Key Historical Milestones
1. Sui Dynasty: Yang Shangshan’s Nei Jing Tai Su elaborates on Jiaji points as being closely associated with ashi points along the 21 vertebrae of the spine [2].
2. Jin Dynasty: In Ge Hong’s Emergency Standby Remedies, a cholera treatment using moxibustion at 1 cun from the second lumbar vertebra is detailed. This account underscores the use of specific Jiaji points for life-saving interventions [3].
3. Ming and Qing Dynasties: Texts like Zhang Jingyue’s Illustrated Wings of the Classified Canon and Yue Hanzhen’s Explanation of Channels and Points further standardize the placement and therapeutic scope of Jiaji points [5][6].
4. Japanese Edo Period: Acupuncturist Ishizaka Sotetsu expands the Jiaji point system to include 34 points, spanning from the 7th cervical vertebra to the 5th lumbar vertebra [7].
5. 20th Century Standardization: Cheng Dan’an introduces the modern terminology “Huatuo Jiaji Points,” categorizing them as extra points and providing detailed anatomical and clinical descriptions [11].
Modern Understanding and Clinical Applications
Huatuo Jiaji points are now classified as extra points (EX-B2) and have been standardized by the International Standard for Acupoints to be located 0.5–1 cun lateral to the depressions below spinous processes from the 1st thoracic vertebra to the 5th lumbar vertebra [14]. Many other sources list the points lateral to the cervical spine to include the Jiaji points. Professor Liu’s contributions refine this understanding by emphasizing the anatomical, clinical, and safety considerations in their application.
1. Local Point Selection
Huatuo Jiaji points are used for diseases of the spine, such as lumbar bone hyperplasia and ankylosing spondylitis. For multiple vertebral pathologies, points are alternated or combined for maximum effect. They are also used for the treatment of endogenous and exogenous disorders.
2. Nerve Distribution
Points are often selected based on spinal nerve innervation. For example:
• C2–C4: Head-related conditions.
• C3–C7: Neck-related conditions.
• T11–L5: Lumbosacral and pelvic disorders [19].
3. Zang-Fu Theory
For liver dysfunction, Jiaji points corresponding to the liver’s back shu point (T9) are combined with additional acupoints, such as Taichong (LV3) and Taixi (KD3), to address organ-related pathologies [24]. The same is true for other back shu points. For example, the heart back shu point’s corresponding Jiaji point benefits patients with heart conditions.
4. Tender Points
Tenderness at specific Jiaji points often indicates related visceral pathologies. For example, tenderness at T6–T8 may suggest biliary colic, guiding targeted treatment [25].
5. Compatibility with Other Acupoints
Jiaji points are often effectively combined with:
• Mu points: Regulating organ function.
• Shu points: Enhancing qi flow along channels.
• Xiahe (Lower Uniting) points: Treating fu-organ diseases like cholecystitis [26][27].
Implications for Modern Acupuncture Practice
The comprehensive analysis by Professor Liu and his colleagues has reinforced the significance of Huatuo Jiaji points as a versatile tool in acupuncture. Their unique positioning along the du mai and bladder meridian allows for the regulation of qi and blood, making them effective for systemic diseases and difficult-to-treat conditions.
Sources:
[1] Yang Shangshan. Huangdi Neijing Taisu. Beijing: People’s Medical Publishing House, 1955: 145.
[2] Ge Hong. Emergency Standby Remedies. Beijing: People’s Medical Publishing House, 1983: 29.
[3] Sun Simiao. A Thousand Gold Pieces Emergency Formulary. Beijing: People’s Medical Publishing House, 1955: 369.
[5] Zhang Jingyue. Illustrated Wings of the Classified Canon. Beijing: Xueyuan Press, 1993: 430.
[6] Yue Hanzhen. Explanation of Channels and Points. Beijing: People’s Medical Publishing House, 1990: 237.
[7] Ishizaka Sotetsu. Treatise on Acupuncture and Moxibustion. Japanese Toto Bookstore, 1812: 67.
[11] Cheng Dan’an. Chinese Acupuncture and Moxibustion. Beijing: People’s Medical Publishing House, 1955: 209.
[14] Wang Deshen. International Standard for Acupoints. Beijing: Higher Education Press, 1992: 104.
[19] Beijing College of Traditional Chinese Medicine. Golden Needle, Wang Leting. Beijing: People’s Medical Publishing House, 1984: 66.
[24] Guo Jing. Clinical Research on Acupuncture Treatment of Hyperlipidemia Guided by the Theory of Qi Street. Jinan: Shandong University of Traditional Chinese Medicine, 1996: 12-16.
[25] Tian Dequan. Clinical Study on Acupuncture Treatment of Idiopathic Prolactinemia. Jinan: Shandong University of Traditional Chinese Medicine, 1994: 11-14.
[26] Liu Rongfen. Acupuncture Case of Refractory Insomnia. Shandong Journal of Traditional Chinese Medicine, 2000, 19(10): 632-633.
[27] Liu Yutan, Zhang Yongchen, Xiao Fei, et al. Comparison Between Acupuncture Prescriptions for the Treatment of Cholecystitis: A Report on 71 Cases. American Journal of Acupuncture, 1996, 24(2/3): 115-121.
