note: The following article is one I wrote a couple of years ago for the Illinois State Acupuncture Association.
In Japan, the concept of living and functioning points is often ascribed to Takeshi Sawada, one of the greats in 20th century acumoxa. Acupuncture points are more than anatomical landmarks, they are manifestations of a functional problem in the body. As such, they are normally dormant, becoming active when a pathological condition begins to form. It goes without saying that acupuncture point location based solely on anatomical knowledge will be less effective than point location based on skilled palpation.
The anatomical location is, of course, necessary when seeking the live point. One of my teachers, Mr. Murakami (who, like most of the senior teachers in the Toyo Hari Association, is blind), likens it to mail delivery. The anatomical location is the address that is printed on the letter. But you, as the letter carrier, need to know where the mailbox is. It could be near the street, or on the side of the house, in the back, in a slot on the door. For this you need to search once you arrive at the correct address.
Complicating this is the idea that live points move, often some distance away from their anatomical location. This is frequently seen with connecting (luo) points. The same live point on different sides of the body, for example SP4, may be in very different locations. By the time the client returns for their next visit, the particular live point will likely have have moved or may even have disappeared.
Precision is extremely important in point location, especially when one considers the size of the tip of a needle compared to the tip of one's finger. Once one has located the live point, if the needle placement is accurate, one needs only to apply a small stimulus in order to obtain satifactory results. Very often the needle does not need to be inserted, or needs only to be inserted very shallowly. Sometimes the needle tip is held against the point and penetrates with no pressure whatsoever, just goes in painlessly.
Try this exercise: take a tiny (about 1 mm square) piece of Micropore tape, and place it on your skin, either on your lower limbs or abdomen. It doesn't have to be on any particular point. Prepare a needle in your right hand. Close your eyes. With your left index finger, palpate lightly for the piece of tape. When you find it, turn your left index finger over and with your right hand place the tip of the needle on the center of the piece of tape. Open your eyes and see where the tip of the needle has landed. You may be surprised at how difficult this exercise can be.
In the Toyo Hari Association, the pulse is used not only in diagnosis, but also as feedback. That is, the pulse quality should improve when the proper live point has been found. A typical group exercise in Toyo Hari for point location uses one person as a model, and several others palpating for the live point, each in turn. Each one has a fine-point marker of a different color. Once the live point has been located, the student marks it, and then steps aside for the next student. Once each person has marked their live point, the teacher or senior student touches each mark in turn while the students check the model's pulses. It is often remarkable to feel the difference in pulse quality merely by lightly touching different points, some only a millimeter or two apart.
The above two exercises are very helpful in developing subtle palpation skills. They are usually used to refine one's ability to find deficient points for tonification during the first stage of treatment. In addition, there are other ways to find live points for dispersion, local treatment, moxibustion, intradermals, bloodletting, and other methods. Since we use acupuncture meridians and points to gain access into the deepest processes of the human body, it is crucial to keep studying and refining our ability to locate and treat these amazing phenomena that live on and below the surface of the body.