The Curious Case of Qū Quán

On Point Functions and Historical Indications

I recently watched a video by Michael Brown, translator of Yuè Hánzhèn’s Explanation of Channels and Points. I saw it in a private social media group that I lurk on, but the video is also on a public site, linked above, so I’m going to assume it is okay to link to it. It is fairly brief and quite interesting, well worth a watch.

The topic is the development of what we learned in school as point function (or action). Brown makes some excellent points. Among these is that point functions are not that new, an earlier form of point function can be found in the point categories. For example, we know GB34 soothes the sinews because it is the huì point for the sinews. We know that LR14 courses the liver qì because it is the mù point for the liver, and so on. In light of this, the idea that the linking of functions to points constituted an “herbalization of acupuncture” is not entirely fair (one could argue that in the Sòng period herbal medicine underwent a process of “acupuncturization” in linking channels and systematic correspondence to medicinals, but that is another topic for another time), and that the more recent developments in acupuncture to bring it up to parity with herbal medicine are, on the whole, positive.

This led to a brief forum discussion in the comments on the place of functions vs historical indications that got me thinking, hence this post. I want to interject here that the forum I saw the post on is designated for scholars, and I personally do not consider myself a scholar. I am more a curious clinician. If something is working, I either leave it alone, or think more about why it is working so I can apply those notions to something that is not quite working. Historical indications are interesting, and comprise one set of data points among many regarding the applicability of a given point to a given situation (I explored some of those data points in past posts, like the one on acupuncture points for brain heat).

Sometimes, though, the historical indications bear very little resemblance to how I use a particular point in my practice. The first example that leaps to mind is LR8 (qū quán).

LR8 is a point I lean on. A lot. I can think of few other points I have more clinical experience with.

LR8: TCM functions and indications

The first I learned of it must have been back in 1993, when I gathered with some other students in the back room of Dr. Wu’s shop on Clark Street in Chicago. The book we used was the “Comprehensive” (Shanghai College, 1981), a translation of a 1974 PRC work that, from what Michael Brown says in the video, may have been one of the earliest textbooks to comprehensively incorporate point functions. In the text, the functions of LR8 are given as “Benefits the Bladder, clears and cools Damp Heat, relaxes the Muscle Channels.” Indications are given as “Prolapsed uterus, itching and distension of the genitals, pain in the penis, painful and rough urination, dysentery, knee pain.”

Ellis et al. (2004) add to this list “drains liver fire,” along with some related functions to the ones in the Shanghai book, and adds indications for some other conditions, such as “fright mania”, and “blood block infertility.”

And yet, when we teach Zàng-Fǔ patterns (as I am currently), LR8 is front and center as the go-to point to nourish liver blood (Maciocia, 2015). This idea, as far as I can tell, comes from Nán Jīng (Classic of Difficulties) chapter 69, and the “mother-child” principle which is a kind of bedrock of five-phase acupuncture theory. LR8 is the water point, and water is the mother of wood, thus use the water point of the wood channel to supplement it. The liver has two main functions, a yīn function of blood storage and a yáng function of qì coursing; supplementing the liver means improving its ability to store and portion out blood to the eyes, sinews, uterus, etc. Ergo, LR8 is the point to use in conditions of liver blood deficiency.

Yet that function didn’t make it into the translated material from Chinese sources. Funny, innit (sorry, just binge-watched the final season of Top Boy).

Deadman et al. (1998) sort of split the difference by listing nourishing yīn-blood as a “secondary function” of the point, and notes that historically it has “primarily been used for excess patterns.” Brown’s translation of Yuè Hánzhèn underscores this point. The extensive list of indications is likely a basis for the summary given in the translated modern textbooks. Though there are glimmers of blood deficiency such as “dizzy vision with generalised body pain,” and “blurred vision,” the clear majority of indications are for what we would think of as various patterns of damp-heat in the lower burner.

LR8 as I’ve known it

Now, to circle back to the use of LR8 in my clinic. Whatever my first impression of LR8 was, by 1995 I was immersed in Keiraku Chiryo, Japanese five phase acupuncture based heavily on Nán Jīng. LR8 was THE point for Liver deficiency patterns, and Liver deficiency – according to the majority of Japanese practitioners I asked – was the most common pattern to show up in clinic. Which means that, over the years, I have needled LR8 a lot. Like, on the daily, numerous patients every work day in clinic for over 28 years.

When I look at the functions and indications, both historical and modern, for LR8, I feel a sort of cognitive dissonance. The point is almost unrecognizable to me in many of the texts. If I could summarize how I most often use LR8 in the clinic, it would be two functions:

1)     Anchoring, settling, calming liver yáng/wind/fire conditions: dizziness, vertigo, headache, eye pain, agitation, etc. This is related to the category of hé-sea points, which in Nán Jīng 68 are indicated for downbearing counterflow and restraining leakage. This can also be seen as a restoration of tiáo dá, or orderly reaching. Also, LR8 is the water point, water corresponds to the salty flavor, and the salty flavor descends.

2)     Enriching water to moisten wood: in practice this means yīn-blood deficiency conditions of the sinews, eyes, uterus, and even to help nourish the root in essence deficiency, with problems of the sea of marrow and so forth. This is related to the mother-child principle in Nán Jīng 69, as discussed above. I also see it as a useful point in yíng-blood patterns, as a way to improve blood viscosity and mitigate stasis.

And, yeah… once in a great while, I suppose, I may use it for damp-heat prostatitis or something similar. But the vast majority of the time, I use LR8 in conditions reflecting yīn-blood deficiency as a root condition (in TCM terms) or simply for five-phase liver patterns.

As I mentioned earlier, I do not consider myself a scholar; I have taught for many years but I almost always teach from a standard textbook and add some color commentary. I actually haven’t taught point indication in the last ten years (good thing, maybe, considering this post). In my daily life as a clinician, 30-40 hours a week, I think I can say without reservation that, when I look back on cases that I would consider many of my most successful – quick resolutions to problems that had been years in the making – LR8, in the way I have always used it, figures as a key point in the prescription. Migraines, vertigo, musculoskeletal problems of various kinds, hormonal imbalances of different types, LR8 has always proved reliable for me in a way that few other points have. Swear down, bruv (sorry, Top Boy again).

Closing thoughts

To go back to my schooling, John Pirog, a teacher, friend and colleague, used to say, “if it works for you, it works.” I use LR8 in line with some very extensive training I received early in my career, based on classical ideas (Nán Jīng 68 and 69) that didn’t seem to hold much weight with later generations of acupuncturists, at least in China.  This brings up a host of other questions: why were these ideas largely ignored? Were they tried and judged ineffective? Or were other sources deemed more trustworthy? How is it that the point works so well for me in these sort of off-label situations? Is it because I learned it that way early on and kept using it?

Anyway, some thoughts on this topic. I need to go pull some needles from some LR8s. Thanks for reading. Bless.

Note: this newsletter is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.

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References

Deadman, P., Al-Khafaji, M., & Baker, K. (1998). A manual of acupuncture. Journal of Chinese Medicine Publications.

Ellis, A., Wiseman, N., Boss, K., & Cleaver, J. (2004). Fundamentals of Chinese acupuncture (Revised ed). Paradigm Publications.

Maciocia, G. (2015). Foundations of Chinese Medicine: A Comprehensive Text (3rd Edition). Elsevier Health Sciences (US).

Shanghai College of Traditional Medicine. (1981). Acupuncture: A comprehensive text (J. O’Connor, & D. Bensky, Trans.). Eastland Press. (Original work 1974).

Yue, H. (2021). Explanations of the channels and points, vol. 2 (M. Brown, Trans.). Purple Cloud Press.