What is the Point of Acupuncture?

Background: Acupuncture skeptics consider The Yellow Emperor's Internal Medicine—a classic that is important to the theory and practice of acupuncture—as a work based on metaphysics. This claim is one of the factors preventing the mainstream biomedical community from accepting the clinical merit of acupuncture. Objective: The goal of this research was to test the hypothesis that needle theory and acupoint locations described in the classics are based on anatomy and physiology, not on metaphysics. Methods: Passages from the Ling Shu (Spiritual Pivot) relevant to the properties of acupoints were translated and then interpreted using biomedical science. Acupoint locations described in the Jia Yi Jing (Systematic Classic) were transliterated, and their anatomical significance was determined by literature review, dissection, and/or electrostimulation. Finally, acupoint anatomy was compared to descriptions in a traditional Chinese acupuncture textbook. Results: Biomedical interpretation of the Ling Shu revealed a detailed appreciation of the peripheral nervous system, including observations, such as nerve depolarization, mechanical transduction, antidromic/orthodromic conduction, and segmental organization of the nervous system. Using the 11 acupoints of the Lung meridian as an illustration, 4 acupoints (LU 1, LU 2, LU 6, and LU 10) missed the verified neuroanatomical target, 5 acupoints (LU 3, LU 4, LU 7, LU 8, and LU 9) lacked anatomical precision, and only 2 acupoints (LU 5, LU 11) were neuroanatomically precise, compared to textbook descriptions. Conclusions: This study demonstrated that acupuncture classics have a biomedical basis and that each acupoint has distinct neuroanatomical specificity. Understanding precise acupoint anatomy has direct clinical advantages in verifying acupoint locations and evoking the correct De Qi response for each acupoint.