Distal points are the points on the arms below the elbows and on the legs below the knees; local
points are those on the head and trunk. As explained above, the distal points, being on the lower
arm and leg, are more dynamic than the local points on the trunk. Whilst distal points should
always be used in both acute and chronic cases, local points need not be used in every case. The
most common approach, however, is to combine distal with local points.
In acute cases, the distal points have the effect of removing obstructions from the channel and
expelling pathogenic factors and they are therefore usually needled with reducing method. The
local points have the function of supporting the eliminating action of the distal points and
focusing it on the desired area: they are usually needled with even method. For example, in
treating an acute sprain of the lower back with bilateral pain on the lower back, one might
choose BL-40 Weizhong as a distal point (needled with reducing method) and BL-26
Guanyuanshu as a local point (needled with even method). Sometimes distal points are needled
before inserting the local ones. The example of ST-38 Tiaokou for acute sprain of the shoulder
has already been given above. To give another example, in acute sprain of the lower back with
pain on the midline, the distal point Du-26 Renzhong is selected and manipulated vigorously
before inserting the local points.
In chronic cases, distal and local points simply reinforce each other's function.
The following is a list of the main distal and local points according to areas (Table I.1Table I.1).
This table lists points from different channels and the choice of which point to use has to be
guided by other factors, chiefly a proper identification of the channel involved.
As mentioned above, the points in Table I.1Table I.1 are from different channels and their
choice has to be further guided by the identification of patterns and channel involved. For
example, two of the distal points indicated for the throat are LU-11 Shaoshang and KI-6
Zhaohai: LU-11 would be selected in sore throat from acute invasions of Wind-Heat, while KI-6
would be chosen for a dry throat from Yin deficiency. As another example, the distal points
indicated in the table for the Heart are P-4 Ximen, P-5 Jianshi, P-6 Neiguan and HE-7 Shenmen:
P-4 would be chosen if there were an irregular heart beat, P-5 if Phlegm were obstructing the
Heart, P-6 in Heart-Qi deficiency, and HE-7 for Heart-Blood deficiency.
Rising and Descending of Qi
An awareness of the rising and descending movement of Qi in the channels is essential to give a
balanced acupuncture treatment. Many pathological conditions are due to a derangement in the
direction of movement of Qi. The Qi of certain organs naturally descends while that of others
naturally ascends.
Organs whose Qi descends are the Stomach, Lungs, Heart and Kidneys; the only organ whose Qi
normally ascends is the Spleen. The Liver is different in so far as its Qi spreads in all directions.