Volume 6, Number 1 | Spring 2011

Medical History in Japan"Historical Significance of the Standardization of Acupoint
Locations“, the Second Japanese Acupoint Committee (1)Makoto Mayanagi

Graduate School of Humanities
Ibaraki University

Makoto Mayanagi "Historical Significance of theStandardization of Acupoint Locations", thesecond Japanese acupoint committee "Detailed
Guide to the Location of Acupoints" from theclassics to the WHO standardization", pp 411-422,
Tokyo, Ishiyaku Publishing, June 2009 (partiallyrevised)
The historical significance of the present day
will only be known in the future. Nevertheless bygoing back into history it should be possible tocatch a bird's eye view of the historical role of thestandardization of acupoint locations made on thisoccasion.
In the past acupoints were standardized threetimes. The first time was approximately during
the first century and constituted standardization
on a "conceptual level". This had the common
purpose of a conceptual clarification of themeaning of meridians (channels) as prerequisite
for acupoints and the very nature of acupoints
themselves. The second standardization in thesecond century represented a unification andstandardization of various ideas about meridians
and acupoints that hat sprouted from the firststandardization on a "theoretical level". The third
standardization occurred after acupuncture andmoxibustion therapy has spread all over China in
the 11th century and the Chinese government
realized the necessity of a support for this usefultherapy,leadingtoaunification
andstandardization on a "national level".
These first to third implementations werestandardizations based on the subjective views of
one or several scholars. And today, at a time when
acupuncture and moxibustion is about to assume28

a role in the medical care worldwide, based onmodern scientific views, a standardization
allowing an objective verification was needed. And
that is precisely the nature of the current
standardization. Historically the fourth of its kind
it probably can be designated as an objective
standardization on a "global level".
Based on the above I would like to trace thehistory of the discovery of meridians, acupoints
and their changes, as well as the standardization
process.
1 Meridian concepts and moxibustion treatment
prior to the second century BC[text excavated from the Mawangdui tomb]

Figure 1 足臂十一脈灸経 Zubi Shiyi (11) mai Jiujing

The oldest firmly established text pertaining
to meridians is not a text that has been handed
down above ground, but has slept under ground
until its excavation. The tomb No. 3 site of
Mawangdui in Hunan province in China, in theoutskirts of Changshayao is the site of theexcavation of a group of medical texts. One ofthese has been written on a silk cloth and named
after its excavation the "『足臂十一脈灸経』. Figure
1 shows that it was written in the seal-engravingstyle of writing Chinese characters and is a textdealingwithmoxibustion

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 1 | Spring 2011

meridians on the arms and legs, but its content

have been transcribed sometime between the Qin

antedates

dynasty and the early Han dynasty, so that thethecontentsofthechapteron

inception of the content probably goes back to pre-meridians (jing mai) in the Ling Shu.
Thesecharacters

aretodaycompletelydeciphered [1]. For example, the first line in

Qin times.
These Mawangdui medical texts offered theFigure 1 can be interpreted as "The greater yangfollowing

warm (meridian) begins at the hollow of thecorresponding to the five viscera and six bowels of

external malleolus ...". However, in the underlined

later generations were recognized, but no vessels

character "warm" the portion meaning "speak"corresponding

may actually represent "eye" and therefore

meridian, conception and governor vessels areinterpreted as the character for (blood) vessels ormentioned. In other words, the twelve meridians

meridian (mai). This section corresponds to thefor six viscera and six bowels described in the"The greater yang meridian ... (and its branching

chapter on meridians in the "Ling Shu" arevessels) ... behind the external malleolus ..." part

apparently a concept of later ages. While there areappearing in the chapter on jing mai in the Ling

many entries pertaining to moxibustion treatment,

Shu.

Further, line 5 shown in Figure 1 denotes

indicating "use moxibustion on the greater yin"The lesser yang (warm) meridian of the footmeridian of the foot for all kinds of diseases", nooriginates in front of the malleolus ..." and thisacupoint locations are given. Moxibustion wascorresponds to the "The lesser yang gallbladderapplied mainly on the hands and feet only, but

meridian ... (and its branching vessels) ...

seemingly not on the torso. Needling methods

originates in front of the malleolus ..." partwere not mentioned either.

appearing in the chapter on jing mai in the Ling

insights.

toFirst,the11

modernmeridians

pericardium

In other words, the meridian concept wasShu. The "Ling Shu" was thought to be a forgedpresumably

text from the later period of the Qing dynasty, but

discovered later. These texts also suggest that

this example here clearly provides its firmly

moxibustion treatment based on this meridian

established evidence.

concept had been developed first and acupuncture

Moreover, not only the 『足臂十一脈灸経』, butdeveloped

firstandacupoints

only later.

also the texts named the first and second volumeof the "Yin-yang shih-yi mo-chiu ching" and[Origin of moxibustion treatment]materials of similar contents have been unearthedWhy has moxibustion been developed firstsimultaneously with aforementioned silk texts [2].

and has mugwort (Artemisia princeps) been used?

These Mawangdui medical texts have been burial

Professor Jianmin Li from the Academia Sinica inaccessories for a woman who died a few years

Taiwan has focused on the employed ignition

before 168 BC. The woman's body had not been

method [3]. In other words, in China mugwort has

decomposed and was unearthed as a still moist

customarily been used since ancient times as acorpse, suggesting that it had been buried

fumigation smoke to drive away evil qi and since

immediately after death and therefore themugwort contains a lot of essential oils, it easily

Mawangdui medical texts also had remainedignites. For that reason the focus of round carved

buried since the second century BC. Yet, theice lenses has been used to ignite the mugwort.

characteristics of the ideograph form used in theThis ignition technique has been used since

Mawangdui medical texts suggests, that theyancient times.

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Adding the authors own conjectures, amongexcavated, the body of which is painted in black

the various ignition methods since ancient times

lacquer [4]. Judging from the coins excavated at

this method was probably considered to be

the same time allows to infer that the burial took

strongest in its yang nature, since the sunplace between 179 and 141 BC. As Figure 2 shows,provided the source of the ignition. On the other

there are on the body surface 9 pairs ofhand,

gradually

symmetrical lines running up- and downward as

decreases over time and at the end of this process

well as a midline on the back drawn in red

death is recognized. This was considered to belacquer. However, no markings or characters thatcaused by evil qi. In other words, because evil qi

might denote acupoints are found. Althoughdeprives the body of its temperature, it has beeninterpretation of these red lines as blood vessels

thought since ancient times to be a form of yin qi.

may not be impossible, there is no vessel in theI

thecenter of the back, so that these lines indicate

interpretation that mugwort was ignited by themore likely meridians than blood vessels. If thatsun to expel the evil qi and the elimination of yin

is so, the central line on the back conceivably

qi using this yang qi led to the development of

indicates the governor vessel and the other 9

moxibustion treatment.

lines the three yin and three yang vessels of thehumanbelievebodytherefore

temperaturethat

thisjustifies

hand and the three yang vessels of the feet. It[Excavation of dolls in Mianyang]should be noted then, that there are no three yin
vessels of the feet.
The above mentioned Professor Jianmin Li
also directed his attention to the drawn governor
vessel that is not correlated to the viscera andbowel concept and discussed in detail the originof this governor vessel. I can add my own
speculations to this. The part of the body surface
most resistant when exposed to cold is the face,
so that the face was envisioned as of an area
where yang qi accumulates. For this reason all
the yang meridians gather on the face, whileconversely the yin meridians follow a course
gathering in yin areas. On the other hand,human (male) external secretions apart from theexcretions are saliva from the mainly yang mouthand semen form the mainly yin reproductive
organs. For that reason the concept that large

Figure 2 Wooden black lacquer doll (early Han period)

On the other hand, from a grave dating backto the early Han period in the city of Mianyang of
Szechuan province a wooden doll has been
30

amounts of secreted saliva flow via the spinal
cord, that is the governor vessel, into yin regions
to supplement semen has also been formed inancient times. The concept that the governor
vessel is the route for the circulation of saliva andThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 1 | Spring 2011

semen is correlated to the origin of thedevelopment of Taoist sex practices (fang shi) or
the gymnastic breathing exercises called "guidingand pulling" (Tao yin) and later the governor
vessel was considered to be of great importancefor the Taoist sex practices and the guiding andpulling exercises.
Moreover, on this figure no lines were drawn
for the conception vessel and the three yin
meridians of the foot. The conception vessel is ameridian also related to pregnancy and sinceancient times there seem to have been the conceptthat viewed the conception vessel as a meridian ofwomen. And since all of the six yang meridians,
the governor vessel and the three yin meridians on
this figure are strongly yang in nature, Professor
Jiro Endo of Tokyo University of Science suggested,that the figure probably represents a male.

iKasper D. L., Braunwald E., Hauser S., Longo D., Jameson
J. L., Fauci A.S. : Harrison's Principles of InternalMedicine, 16/e, n.p. : McGraw-Hill Professional, 2004.
p.1335.
ii
Rubenstein J.J., Schulman C.L., Yurchak P.M.,. DeSanctis
R.W. : Clinical spectrum of the sinus syndrome. Circulation,.
1972; 46 : 5-13.
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Peters R. W., Vijayaraman P., Ellenbogen K.A. :Indications for permanent and temporary cardiac pacing.
(Edited by Ellenbogen K.A. and Wood M. A. : Cardiac
Pacing and ICDs, 5th edition.), n.p. : Blackwell Publishing,[Development and fusion of the meridian
concepts]
Based on the above description it seems that
there have been different concepts regarding theorigin of the conception vessel, governor vesseland 12 regular meridians of the six viscera and sixbowels. The 11 meridians recorded in the medical
texts of the Mawangdui correspond to five visceraand six bowels and are considered to be a concept
designed for therapy. Thus, the 12 regularmeridians of the six viscera and six bowels havedeveloped during later ages. On the other hand,the figure from Mianyang reveals the initialstages of a combination of the concepts pertaining
to the conception vessel and governor vessel
through the Taoist sex practices in correlation toreproduction and birth with the yin and yang
meridians. In the various chapters of the "Su Wen"and "Ling Shu" the main differences in the dialog
represent differences among schools and since
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