Five Shu Points

Selection by Symptom Pattern: The Nan Jing Chapter 68 provides clear guidelines: 'Well points treat fullness below the heart; Spring points treat body heat; Stream points treat heaviness and joint pain; River points treat cough, asthma, and chills/fever; Sea points treat counterflow Qi and diarrhea.' In modern practice, Well points are commonly used for emergencies and mental disturbances; Spring points for febrile diseases and clearing heat; Stream points for arthritic and rheumatic conditions; and Sea points for digestive and internal organ disorders.

Mother-Child Method: Based on the Five Element correspondences, practitioners use 'tonify the mother for deficiency, sedate the child for excess.' For example, if the Lung (Metal) is deficient, tonify its 'mother' point (the Earth/Stream point Taiyuan LU-9); if excess, sedate its 'child' point (the Water/Sea point Chize LU-5). This method can be applied within a single meridian or across related meridians.

Seasonal Treatment: The Nan Jing Chapter 74 recommends: 'In spring needle the Well points, in summer needle the Spring points, in late summer needle the Stream points, in autumn needle the River points, in winter needle the Sea points.' This reflects the idea that Qi is more superficial in spring/summer (use distal points) and deeper in autumn/winter (use proximal points).

The Five Shu Points remain highly relevant in modern clinical practice. Research and clinical experience have validated many traditional applications: Well points are effective for emergency resuscitation—pricking the twelve Well points can help revive patients from loss of consciousness. Spring points like Neiting ST-44 effectively clear heat conditions such as stomach fire causing toothache. Stream points are valuable for treating intermittent and fluctuating conditions including various pain syndromes. Sea points like Zusanli ST-36 are among the most frequently used acupuncture points for treating digestive disorders, boosting immunity, and strengthening overall vitality.

Modern clinical studies have shown that combinations of Five Shu points can effectively treat diverse conditions. For example, research has demonstrated that needling the Five Shu points of the Spleen meridian can lower blood uric acid levels in patients with hyperuricemia. The Korean Sa-Ahm acupuncture system, which uses sophisticated Five Shu point combinations based on Five Element theory, has been studied for musculoskeletal pain and autonomic nervous system regulation with positive results.

The Five Shu Points are organized according to the progressive flow and deepening of Qi as it moves from the extremities toward the body's core. This is expressed through the water metaphor: Well points (fingertips/toes) are where Qi emerges like a spring; Spring points are where it begins to trickle; Stream points are where it gathers into a small stream; River points are where it flows freely; and Sea points (near elbows/knees) are where it enters deeply into the body like a river joining the sea.

Clinically, this system provides a framework for point selection based on: (1) the specific therapeutic properties of each point type (e.g., Well for emergencies, Spring for heat, Stream for joint pain, River for respiratory issues, Sea for organ disorders); (2) the Five Element correspondences that allow for Mother-Child tonification/sedation techniques; (3) seasonal treatment approaches where different point types are used in different seasons; and (4) time-based acupuncture methods such as Zi Wu Liu Zhu. The system allows practitioners to treat the same meridian in different ways depending on the nature of the pathology.