How many acupuncture points are listed in the Neijing?

Contemporary TCM teaches that there are 361 canonical acupuncture points. However, the Neijing describes in several chapters that the human body correlates both to 365, 360, and possibly 354, so let’s explore where those numbers originate.

Calendar Systems in Early China

The solar calendar is one of several used in the Warring State’s period of the Neijng. Looking to the Huainanzi for context we find that in “early China no distinction was made between astronomy and astrology,”[1] and that efforts were made to portend the significance of both periodical and occasional phenomena. The regularities of the five visible planets were tied to the mechanisms of the cosmos and of yinyang; Jupiter for example, with its 12 year orbit around the sun, was correlated to the twelve earthly branches di zhi which in turn were associated with twelve animal names as early as the 4th c. BCE. The 28 lunar lodges likewise predate the written record and extend back in history perhaps as late as the 3rd millennium BCE.  Periodic time was tracked by “means of a cycle of sixty quasinumerals, the ganzhi sexagenary cycle.” This cycle was calculated from two sets of ordinals: “the ten heavenly stems tian gan and the the twelve earthly branches di zhi.[2] During the Shang period the ten stems were used to track appropriate timing for sacrifices, whereas the twelve branches were likely used to keep track of “the lunar months and perhaps also the twelve years of the Jupiter cycle.”[3]  By the early imperial period this system combined to “produce a sequence of sixty binomes used to keep track of years that repeat in sixty year intervals.” These years are defined by the waxing and waning of yin and yang and thus are not tied to either the agricultural or solar calendar, which were used for other purposes.

When the Neijing was compiled sometime between the 4th and 2nd c. BCE there were three primary calendars used: the astronomical (solar-lunar) calendar introduced above, along with the agricultural calendar of twenty-four solar nodes, as well as the civil calendar (also called the Xia calendar). Each tracked a “year” of activity, though that year was measured and equipped in distinct ways.[4] In early China it was well-known that the lunar calendar was 354 days whereas the solar year totaled 365.25 days, and the solar-lunar calendar system was developed to reconcile these differences. This calendar was used primarily for ritual purposes, whereas a separate solar calendar was equipped by farmers that was keyed to solstices and equinoxes, regular metrological phenomena, and other agricultural actives.  

These systems help establish relevant context concerning the possible calendar systems utilized in the Neijing. Of principle relation to this essay are the solar and lunar years (Qi Xue Lun and Qi Fu Lun)[5] of approximately 365 and 354 days, as well as the yinyang year of 360. A yinyang year has five seasons, compared to four earthly seasons. We will find that 354, 365 and 360 are all numbers potentially given as the “total number of acupuncture points” in various chapters of the Neijing.

Yinyang Body: Timing of Heaven, Form of Earth

It is useful to understand that the Neijing has a habit of differentiating two systems, heaven tian as the triagram qian and earth di as kun. Tian is the creation, function, yang, flow (timing) of heaven, whereas di is parallel to the form, yin, flow (form) of earth. As we found in Lingshu chapter 81, Qi Bo uses the phrase yu tian dong du, yu di he ji 與天同度, 與地合紀 to describe how the body’s circulation passes through the same measurements as heaven and its setup is the same as earth. This statement is used to convey that both heavenly and human circulation pass through/flow/liu dong 流动 the same “units of measurement as heaven,” which is the 28 constellations passing through 365 units, and that the body’s waterways have the same physical structure as those on earth.[6] For example, in the human body this takes the form as the twelve primary channels that parallel the 12 months of a year, 365 days of a solar year and 365 joints, and 28 vessels corresponding to 28 constellations. There are 36 divisions in each constellation, and thus 1008 divisions in a day and in a human body. 10 is the perfect number of heaven and earth, and 360 is the number of heaven as well as the total degrees in a sphere. This ends up as relevant context that we have two systems at play, heaven and earth, function and form. Humans communicate with both heaven and earth and thus 360 and 365, leading to disequilibrium and multivarious currents of flow within the body’s jingluo system.   

Beginning with 360 we take this as the length of a yinyang year with 30 days as one month and 60 days as a full cycle due to the months alternating their position as yin or yang. 30 x 12 = 360. 6 stages of qi transformation (the six qi) x 60 days (one cycle of yinyang) equals 360. There are 360 degrees in a circle, and we should keep in mind that yinyang is a logarithmic spiral of spacetime and that the cosmos and the human body are reflections of one another. Ultimately all things coalesce and disperse according to the changes bian 變 and transformations hua 化 of yinyang that unfold according to this cosmic cycle. It is important to understand that the human body, in terms of its quintessential nature, was conceived of as a yinyang body.

Whereas the body takes its timing and function set from heaven, in terms of its physical form the human body correlates to earth and its set of correspondences. At its most fundamental level the body is a structure ti that hosts function yong, a landscape of rivers and mountains whose actions must be synchronized with the movement of the sun and moon. The body as a cosmorphic hologram of nature itself is fundamental to the Neijing as well as the Huainanzi. In both sources it is the number of joints that correlate to the solar days of a year; Lingshu chapter 1 for example states that “The twelve origin openings are the venues through which the five long-term depots supply the 365 joints with qi and flavors.”[7] This compares to the Huainanzi, which states that heaven correlates to the 366 joints. In both cases it is the body’s physical appearance that correlates to 365, not the its internal qi dynamic or number of qi holes 氣穴. Physical appearance and qi dynamic are two separate systems fundamental to the Lingshu’s model of the human body. The physical appearance is the function and form given by heaven and earth, whereas the yinyang body of qi transformation partakes in a universal sequence of six that permeates the cosmos. Thus five phases and six segments of a day/six lines of a hexagram.

Totaling the Points in the Lingshu and Suwen

The Lingshu ultimately names 160 acupuncture points. In the Suwen it is perhaps impossible to reach consensus of the number of points. As we know from the Mawangdui silk manuscripts the identification of specific points on a meridian with certain functions evolved from more basic treatment principles such as “cauterize vessel xxx.”[8] The Suwen contains older material than the Lingshu[9] and it often refers to locations of acupuncture points but does not mention specific names. Vessel theory and point utilization matured over time, and even in reviewing commentary in Suwen chapters 58 and 59 we see there has been disagreement throughout its history as to how many points are being described therein. That said there is important discourse in both chapters that can help provide context.

But first let us examine Suwen chapter 9. Here Qi Bo states explicitly that one year in heaven constitutes six times the jia zi (jia zi refers to a yinyang cycle of 60 days/one period). One “revolution of heaven” is 360 days. However, on earth this eternal cycle expresses ephemerally with a variable solar-lunar cycle that results in 365- and 366-day years as well as longer and shorter months. Therefore one “year” on earth is more accurately understood as the “the 365 degrees of heaven.”[10] It then repeats what we learned in Lingshu chapter 1, that “counting man, he, too, has 365 joints.”[11] It is not altogether clear what was considered to be a “joint” in the body: commentary considers it a possible reference to locations where spirit qi leaves and enters during its travels. This would seem to conform to Suwen chapter 58, where the word hole can indicate “all locations of qi within the body.”[12] Another possibility is that it refers to the number of sections of the skeleton.[13] However, what is clear is that the human body corresponds to both heaven and earth, and therefore to the heavenly eternal yinyang year-cycle of 360 that never changes as well as the earthly ephemeral solar-lunar system of a variable and approximate 365. There are at once fixed within the body two different distinct calendars: yang heaven (360) and yin earth (365). This is likewise the division in the body between internal qi transformation (the circle/heaven/head) and external physical appearance (the square/earth/feet), which are the two primary categorical realms of human physiology. This is consistent with the commonly expressed belief in the Neijing that the human body is a hologram of both the timing of heaven and structure of the earth.

Qi Bo states that “In heaven one takes six (times) six (ten day terms) to arrive at the number of its terms. Heaven has ten days terms, and when the ten day terms have been completed six times the cycle returns to jia. When jia has been completed six times one year is completed. (This is a pattern of 360 days.)”[14] Because all life is based in yinyang humans too adhere to this calendar. The chapter goes on to explain that 365 correlates to the 365 sections of a human’s physical appearance and is used to correlate the structure of the human body to that of the earth. 365 is one celestial cycle and is referred to as “the degrees of heaven,” or “that by which the passage of sun and moon is determined.” This makes for 365 days as one celestial year, separate from the 360 days of the actual yinyang year, “with an accumulation of qi that results in intercalations.” Qi Bo further explains in chapter 9 that the six units of 15 days makes for one 90 day season and four seasons constitute one year, or 360 day cycle of yinyang. Each day of the year is a microcosm of one of the five agents, and therefore the imperfect solar year results varies which phase ends the year which in turn is tied to the surplus accumulation of qi that results in intercalations.[15] Intercalations can be understood in this context as an intrusive inserting of something in an existing series or sequence. Because of this variability, Qi Bo explains, a year contributes to a human’s state of health and explain why qi “abounds and weakens, and why repletion and depletion occur.”[16] Thus we find that the variances between the 360/365 days of a “year” are integral to human physiology and pathomechanics. 

Qi Bo told us in the beginning of Suwen chapter 9 that six times six calculates the numbers of heaven, whereas “on earth one takes nine times nine (geographic sections) to set up a calculation.” In short, humans contain nine orifices and nine depots that communicate with the qi of heaven, whose revolutions number 360. Both Suwen chapters 6 and 20 restate this concept of nine depots- 4 physical depots (temples, eyes and nose, mouth and teeth, heart and chest) vs 5 spirit depots (liver, heart, spleen, lung, kidneys). This system of 6×6 and 9×9 are then tied together when Qi Bo states that the temporal intercalations between 360 and 365 play out in the spatial geography (5 depots, later expanded to 12) of the human body.[17] He then teaches how the five zang organs, which store the intangible transformative shen qi of the earth/five phases, are parallel to and communicate with the qi of each of the five yinyang seasons. He also lists how the five qi of heaven and qi flavors of earth enter and interact with the body, as well as how to recognize phenomena associated with each of the depots, such as designated function, color, and body tissue.   

On then to Suwen chapter 58, which opens with Huang Di stating to Qi Bo that he has heard that there are 365 qi holes that correspond to the days of a year. Qi Bo bangs his head on the ground a couple times and seems to offer a snarky reply to Huang Di implying that was an embarrassing question[18], to which Huang Di responds by asking Qi Bo to release him from such ignorance. This is where things start to get particularly interesting. Qi Bo is implying that it is naïve to believe that there are 365 acupuncture points conforming to the days of a year, and as chapter 58 unfolds we see that there are in fact two sets of acupuncture points, 360 and 365. How can this be?

Firstly, we shouldn’t be surprised to find two primary sets of correspondences used to analyze the number of qi holes. As we’ve learned a year is both 360 AND 365 depending on if we are referring to yinyang or the solar calendar. 360 represents the degrees of heaven and a year in this system refers to the full cycle of “qi generation and completion,” and 365 refers to the number of degrees “passed by the circular movements of the sun.”[19] Whereas in the Lingshu heaven’s circulation is ascribed to the solar cycle of 365, in Suwen 9 the chapter begins by establishing that heaven is correlated to the 360 and earth to 365. This becomes important because it helps establish the likelihood in Suwen chapter 58 that Qi Bo is clarifying between these two sets numbers as they relate to qi holes.

Secondly, there is disagreement as to the correct content of chapter 58. Qi Bo does not reply to Huang Di directly with “no, it’s ACTUALLY xxx number of qi holes.” Reading through the commentary here and in chapter 59 we see there is disagreement as to how many points are being described since all are not named. To further complicate the matter, Lin Yi et al. and Hu Tianxiong both believe that Qi Bo’s commentary in section 58-292-72 through 58-293-2 were erroneously moved to chapter 58 from chapter 60. Lin Yi et al. further comment that if we disregard this section and beginning counting at “Depot transporters: 50 holes”[20] Qi Bo lists 360 acupuncture points in this section. If we add the points above and below the Celestial Chimney (Ren 22) then this increases to 365. If one disregards repeated entries this number is 313.[21] 360 is consistent both with the conformation of heaven as well as Qi Bo’s earlier commentary that implied Huang Di was mistaken in simply associating qi holes to 365. It also follows the rest of the chapter’s theme, where Huang Di proceeds to thank Qi Bo for teaching him the correct number of points and then ask if there is something that the “tertiary network vessels, the ravines and valleys” too have something to which they correspond. Taken in context this further implies a different system of correspondence at play. In the beginning of the chapter Huang Di asked about qi holes 氣穴, which are all locations in the body that contain qi. To this Qi Bo seems to have replied that there are 360. In reference to the tertiary network the text speaks of “meeting points of the holes,” 穴會, which also number 365 and correspond to one year. Huang Di then asks about the meeting points of the valleys and ravines, which Qi Bo states also number 365 and correspond to a year.

In Chapter 59 we find the term qi “palace” 氣府 to describe locations where qi effuses from the vessel, and that these locations are not to be confused with transporter and qi holes.[22] From the chapter as a whole this is reference to a body segment associated with one of the 365 degrees/days of the year. At the end of the chapter the speaker, who is unnamed, states that when the qi holes are combined with the palaces (places where the qi of the vessels are effused) there are altogether 365 holes. However, Wang Bing disagrees in the commentary saying that there are 365 qi palaces (which conforms to the idea that 365 is a reference to regions of the body) but the conduits contain an additional 19 points, making a total of 385. Whereas Zhang Jiebin attempts to clarify here that there are 365 qi holes and that the qi palaces serve as the “basic line”  that unites all the conduits.[23] To further confound the matter, Jean-sylvain Prot asserts that chapter 59 names 354 locations, not 365. If 354 were intended here it would align with the Neijing’s correlation of the human form to that of earth (and moon by categorical extension), and thus I find it plausible to find that the moon was perhaps considered in relationship to the ordering and layout of the meridian system. The sun brings things into being, the moon completes. Wang Bing’s commentary regarding 19 additional acupuncture points also strongly suggests efforts were made here to relate the numbering of points both to the solar and the lunar months of a year. 19 represents the Metonic cycle of 19 years and 235 lunations, after which the Moon’s phases recur on the same days of the solar year. If such were the case we find now three possible sets of calendric importance used to correlate the body and it points of qi effusion to the rhythmic cycles of yinyang, the sun, and the moon.

Conclusion

In Suwen chapter 9 we learned that each day of the year corresponds to one of the five phases, and that every five days (5 degrees of the sun) is a microcosmic year of the five phases. This cycle repeats three times (heaven, earth, humanity) for a unit of 15 days, and multiplied times 6, the qi of heaven, makes for one yinyang season of 90 days. Four seasons in a year make 360 days. Because the eternal cycle of heaven is not quite the same as the ephemeral seasons of earth we are left with a variable amount of remaining/surplus qi each solar year; some years by “5” days and every fourth as “6”.  This surplus results in intercalations in both the macrocosm of the yearly weather cycles as well as the qi mechanics of the human body. It is precisely this regularity or irregularity in the jie zou 節奏 cycles of changes and transformations cycles between 5 and 6 that produce the reality in which we exist: years repeat but each year is distinct unto itself—that is the logarithmic spiral of timespace yu zhuo 宇宙, of yinyang itself. If there were no irregularity in our timing vs that of heaven, we would be heaven itself and the myriad things would not exist.

Discourse between Qi Bo and Huang Di in Suwen chapters 58 and 59 suggest more than one system was used to tabulate acupuncture points. Qi Bo makes such a display about setting the record straight regarding 365 points that one assumes this was a rather critical distinction. Perhaps his answer was explicitly understood in its day, only to become muddied by the many pens of history. How the systems of 360, 365, and possibly 354 are similar and dissimilar remain obscure. Perhaps 354 and 365 were more of an attribute of the manifest earth body, conceived as the meeting points of ravines and valleys that were somehow distinct from but interconnected to an internal system of qi transformation that flows through 360 locations. It was known that the earth, moon, and sun come into alignment exactly every 19 years and there is textual evidence that this Metonic cycle was considered in tabulating qi hole locations. The allocation and naming of acupuncture points evolved in early history and with the fragmentation and editing of the original text I am not sure these differences will ever be cemented or teased apart. I believe there are multiple possible answers that stem from different correlative systems such as heaven and earth, as well as interpretations such as what is defined as a qi “hole” and how this location differs from that which “effuses qi” but is not a qi hole.

It is characteristic of the syncretic Huang-Lao thinkers to bridge together competing streams of thought into one grand coherent system. Principles of ganying were not yet established during the early Warring State’s period, and ultimately I suspect that we find in the Neijing attempts to rectify multiple models of resonant correspondence linking the points and channels of the body to the celestial movements of the macrocosmic world.  


[1] Huainanzi, page 921

[2] Huainanzi, page 923.

[3] Ibid.

[4] Refer to Appendix B in the Huainanzi trans. by Columbia Press.

[5] Credit to Jean-sylvain Prot

[6] Lingshu Chapter 81, p. 765

[7] Lingshu Chapter 1, p. 49.

[8] Suwen Chapter 59, p. 65

[9] Harper, Mawangdui Manuscripts, p. 89

[10] Suwen Chapter 9, p. 166

[11] Suwen Chapter 9, p. 163

[12] Suwen Chapter 58, p. 47

[13] Ibid

[14] Suwen Chapter 9, p. 166

[15] Suwen Chapter 9, pp. 165, 169

[16] Suwen Chapter 9, p. 170

[17] Suwen Chapter 9, p. 174: “The qi unite and assume (the) physical appearance.”

[18] Pual Unschuld spoke about the at-times disrespectful attitude toward Huang Di that we occasionally encounter in the Neijing, stating that this is one reason why the work may have been unpopular in its time. Lecture at Maryland University of Integrative Health, Oct. 2019.

[19] Suwen Chapter 9, p. 164

[20] Suwen Chapter 58, p. 50

[21] Suwen Chapter 58, p. 53-54

[22] Suwen Chapter 59, p. 61

[23] Suwen Chapter 59, p. 72

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