Five Elements

Five Element Philosophy

Five Element acupuncture in the Worsley tradition treats the person, not the disease. Its aim is to bring body, mind and spirit back into balance so that nature can do the healing. The teachings below set out the outlook behind every diagnosis and every point choice.

Treat the person, not the disease

We are not chasing symptoms. We are bringing a person into body, mind and spirit balance so that nature can heal them. When the root imbalance is addressed, symptoms that seemed unrelated often resolve by themselves, because they were only the branches of one tree.

Body, mind and spirit are one

In Chinese, body, mind and spirit are one word. Our medicine acknowledges the spirit: if we don't affect the spirit we won't affect the disease, because the spirit is part of our illness. As long as we are alive, spirit lives in the body the way Qi lives in the Blood, so the levels cannot be pulled apart, and every point touches every level to a greater or lesser degree.

Nature heals; the practitioner is a humble instrument

Be a very humble instrument, and truly hear the patient's soul and spirit. The practitioner does not heal anyone. We put the Officials back in order and get out of the way, so that the person's own nature can restore their health, their autonomy and their rightful destiny.

The Causative Factor is the root

Each person has one element whose imbalance is the root of their difficulties: the Causative Factor (CF). It is found by the traditional signs of color, sound, odor and emotion, together with a detailed case history. Treatment centers on that element and its Officials, because when the root is strengthened the whole kingdom of the Officials can come back into order.

The elements as seasons and stages of life

The five elements are the movements of nature: Wood is spring, birth and growth; Fire is summer, maturity and full expression; Earth is late summer, harvest and nourishment; Metal is autumn, letting go and the gathering of what has value; Water is winter, storage, rest and the seed of the next beginning. Yin and Yang cycle through every day and every season, and we greet them in the elements. The same cycle runs through a human life, which is why a person's imbalance shows itself in the way they meet each season.

Most illness is at the spirit level

About 95% of the people we see are ill at the level of the spirit, and about 5% at the mental level, partly because our culture has lost touch with spiritual life, which indigenous cultures still recognize. Accordingly, about 80% of our work is the spirit of the points. When we see the presence of the person, we decide which spirit level points they need.

Seeing, not looking

We know how to look and to project, but we have forgotten how to see: we filter out what we don't want to see, and we have been conditioned not to see. We must look at the patient with new eyes every time, the way a child sees, and listen to more than the story. True seeing of the patient and of their potential is what tells us what is really needed.

Rapport and the sacred container

Treatment happens within a privileged and sacred container. Once you see who the person really is and you vibrate in unison with them, the question becomes where to go from there. Many of the deepest spirit points (Windows of the Sky, DU-16 Wind Palace and others) should be used only once trust has been built and the person is ready.

Why the point names matter

The name of a point describes its spirit and comes close to its essence; each point is unique in what it offers. The names carried specific images for the people who gave them, so we try to understand each point as it truly is (its name, its element and Official, its place on the body and its energetic role) rather than reading our own modern meanings into it. Holding a clear image of what a point is meant to do also focuses the practitioner's intention when needling.

The beauty of the points

The meridians have their own beauty and symmetry, like a kimono with the seasons painted on and woven through it. Draw the meridians from point to point, and use meditation, introspection and creativity to get a sense of each point's spirit, so you can use it when you feel that energy before you.

The Five Elements and the Twelve Officials

Each element governs two or four Officials, the 'ministers' of an imperial court ruled by the Heart, the Supreme Controller. When every Official does its job the kingdom is at peace; when one fails, the others are thrown into disorder. Each Official is described below with its gifts in balance and the signs of its imbalance.

Fire: Heart (Supreme Controller)

The sovereign, who harmonizes and orders, moves the Blood and houses the Shen. The Heart carries who a person is and what they are here for: their purpose, mission, identity and destiny, along with long-term memory, especially of emotional content. It is consciousness itself, presence and wakefulness, the light you see in someone's eyes, and it holds court over all the Officials. Out of balance there can be befuddlement and disorientation, being very up around others and then crashing into chaos when alone, and being easily startled. The Heart does not want to be out of control, so it may wear a mask to hold everything together; for the Heart, control can matter more than the need to be loved. A Heart CF can be stoic, a martyr, unemotional, yet they have suffered; there may have been issues with control when young, and a need to do everything themselves. Points especially connected with a Fire CF include REN-5, REN-7, REN-12, REN-14, REN-15, REN-17, UB-15, UB-43, UB-44, UB-51, KI-25 with KI-27, and DU-8, which makes things solid and secure and gives strength.

The mask comes from not feeling in control inside, so the Heart strains to hold everything together.

Fire: Small Intestine (Separator of Pure from Impure)

The sorter, the alchemist, which discriminates what is pure from what is impure and decides what to accept and what to turn away. Its chief task is to keep our insight clean, so that the Heart's passion and compassion can come out into the world. The sorter needs its work to be fun; when impurity gets through it appears as negativity, sarcasm and cynicism, or a joke with a slight barb (polluted joy). Its range runs from the true eclectic to the scattered: confusion, murkiness, trouble with priorities and with knowing what is good for you, a lack of discrimination in what is let into the Heart, sometimes difficult sexual issues or many relationships. A person may have a good Heart that never shows itself in the world, and may take on challenge after challenge or be frozen into doing nothing, and on the spirit level lack a sense of purpose. The Small Intestine meridian affects the neck and shoulders. A Small Intestine CF who is muddled and confused may just need to feel settled and comfortable within themselves.

Life needs to be fun for the Sorter, or fun starts to sound like a groan, and a joke with a slight barb is a sign that the Fire is not clear or clean. Out of balance it cannot draw out the pure essence; there may be excess sexuality and many relationships drawn by charisma, or the kind of confusion seen in someone who asks others to order for them in a restaurant.

In health it lets us put ourselves in the proper 'garden' and by the proper window, transforms how we see and how we are, clarifies our needs, and sorts out what to accept and what to refuse.

Fire: Heart Protector (Circulation-Sex)

The Heart's cushion and protective envelope, absorbing shocks before they reach it, which moves the Blood through the kingdom. It circulates pleasure and the emotions and guides us in taking joy in and spreading it; it is the charismatic Official whose attraction works like magnetism, and it governs intimacy, sexuality and connection with the Heart. Out of balance a person may feel dead inside, with no feeling moving; flat, disconnected, unable to get inside or to connect; vulnerable and fragile; sad, withdrawn, or playing the clown. Its special points are much the same as for the Heart: REN-5, REN-7, REN-12, REN-14, REN-15, UB-43, UB-44, UB-51, KI-25 with KI-27, and DU-8.

It governs the circulation of emotion and the capacity for expression. When a person feels dead inside, neither blood nor emotion is moving, and they can seem unreachable. DU-8 makes things solid and secure and gives strength.

Fire: Three Heater (Official of Balance and Harmony)

Carries the passion and exuberance within out into the world around us, circulating warmth and joy and bringing Fire to each of the Officials. It is the thermostat of the three Jiao, regulating hot and cold so the organs can function, and it regulates the waterways: the sluices and ditches that carry fluids. Its meridians run through the eyes and ears, so it attunes us to our environment through the senses; it is the facilitator of engagement and of being comfortable in our surroundings, and it gets joy from others and from social warmth. In balance it brings lightness and lets us hold things lightly; out of balance there is a flatness, with no brightness coming through. It is often missed as a CF.

It has a quality of total playfulness, and as the thermostat it keeps hot and cold evenly distributed. Out of balance there is a lack of joy, and the person comes to depend on others for joy and social warmth.

Earth: Stomach (Official of Rotting and Ripening)

The great granary: a hollow, Yang Fu organ through which things move, it receives and holds the grain, beginning the breakdown of whatever is taken in on the body, mind and spirit levels so that we can nourish and support ourselves. It rots and ripens food to prepare it for the Spleen, grants the five tastes and transforms nourishment into Blood, Qi and flesh. It should be filled, and its energy should move downward; when it doesn't, there may be rebellious Qi, regurgitation or reflux. It raises our appetite for food and for life. When Earth is out of balance a person may not allow themselves what they really want, depriving themselves of their own fullness: 'I don't have what I need; I am abandoned.' Disappointment is the sadness of Earth, and there may be trouble asking for help, rejection of sympathy, and difficulty finding the center. There can be a wound that seems beyond changing, the sorrow of never having been heard, understood or fed. When the Stomach is depleted it takes from the Spleen's Yin reserves. In balance the self is nourished and abundant, and giving to others comes into balance too; the goal is to help people nourish themselves. ST-19, ST-20, ST-24 and ST-25 get Qi moving through the middle Jiao; REN-3, REN-4, REN-10, REN-12, UB-49 and UB-50 also relate.

A useful question: is there fullness and bounty in this person's life? Rejecting sympathy shows someone who cannot take anything in and is struggling to find their center.

Earth: Spleen (Official of Transportation and Distribution)

In charge of distribution throughout body, mind and spirit. It transforms food in the Stomach into Qi and Blood, turning nourishment into energy, grants the five tastes, creates flesh, transforms fluids, and supports and holds up and in (the uterus and bladder held up, the Blood held in its vessels). It has much to do with pregnancy, with sensuality and fullness of the senses, and it gives us an inner residence, a deep feeling of being at home within. Maldistribution can look like a person who is thin above and heavy below; Damp can show as lack of motivation and sluggishness. Out of balance there is an emptiness, an empty basket, deeper and more profound than that of the Stomach. Compulsions are about actions and belong to Wood; obsessions are about thoughts and belong to Earth.

Metal: Lung (Receiver of Qi from the Heavens)

Brings inspiration and lets tasks reach completion, giving life a rhythm and room to receive it; without air things become stale, still and void. With each breath we affirm that we deserve to exist and have value. The Lung takes the spirit of the Heavens and brings it down into the human body, and in doing so makes something of value both for ourselves and for others. Pride and humility matter greatly; out of balance the person is forever trying to prove their own worth, cannot breathe in their own brilliance, never feels complete, and carries a deep longing for the father, for spirit, for honor and for completion. Energy and tears may be held up in the chest instead of coming down into the body. Points related to Metal include REN-12, REN-17, DU-3, DU-12, UB-42 and KI-24. A Metal CF may look as though they are not really there, but somewhere else.

Out of balance there is an empty feeling inside, and in treatment the aim is to bring the held-up energy down.

Metal: Large Intestine (Drainer of Dregs)

Gives us the ability to let go and to change; it is where unfinished business can finally close. Letting go means many things: an attitude, a stance, a way of being stuck in a situation that stops us from meeting life fully, and allowing things to be imperfect. Metal also governs the skin, where the world outside meets the world inside, the pores breathing so that life can flow in. When it is out of balance the negativity polluting body, mind and spirit is immense: nothing is ever good enough, and there is a refusal to accept situations as they are. Loss is the distance between what was, or what might have been, and what is now. Guilt is stagnation, energy that does not move; its healthy form is regret, which by being acknowledged lets us move on and release what was inadequate. When loss is not let go, there may be a lack of self-respect, feeling broken, empty and weighed down. Autumn is no time to hurry toward answers; often no action at all is the best action, and things will happen when their time arrives.

Often nothing is good enough, and that includes the person themselves; the Colon relates to self-worth. The no-action of autumn is wu wei.

Water: Bladder (Official of Storage of Water)

Controls the reservoir that holds the Kidneys' power, and sets our pace, so we don't spend more than we have; it is about setting limits and resting appropriately so that energy is there from day to day. It separates out the pure fluids and is a source of cleverness and resourcefulness. Imbalance shows as pushing to exhaustion, overexertion, and being unable to sustain anything begun or see it through for lack of reserves; there may be a fear that one can't go on, that the floor will drop away ('I just want peace'). A Bladder CF may struggle to choose a direction because of many talents, bend over backwards to please, and have a stiff neck; rest is primary for their health. Its gift is acknowledging fear and stepping forward into it. REN-3, REN-4 and UB-52 have a relationship to a Water CF.

Imbalance can also show as excessive urination, and lifestyle choices affect the Bladder.

Water: Kidney (Controller of Water)

The storehouse of vital essence, Jing, where power and potential arise: the root of both Yin and Yang. The Kidney governs growth, development and reproduction through time, sexuality and desire, creates and distributes fluids to body, mind and spirit, and anchors the Qi that the Lungs breathe in. It provides resilience, cushioning, will, resourcefulness and motivation. Everything in body, mind and spirit comes from the Kidneys, even what was laid down before conception, which is why some teachers use the Kidney chest points on any CF.

Sexuality here covers both reproduction and physical desire, while intimacy belongs to the Heart Protector. The Kidney transforms and circulates the fluids as well as creating them.

The Will has to be kept in proper balance. When it is weak, a person lacks drive and ambition and has trouble starting and finishing tasks; when it is too strong, they turn ruthless toward others and themselves, and may drain their energy and harm their health and relationships. Fear is necessary too, since without it a person acts recklessly and foolishly, yet too much fear paralyzes action because danger and difficulty are seen everywhere. Constant fearful stress, and the anger that grows from it, can harm the Heart and in the end can even cost a life.

Wood: Liver (Official of Planning)

The planner and the general: assessing circumstances, aware of the details, anticipating what may happen, and giving direction; it brings the smooth flow of Qi that moves around obstacles, and the ability to organize your life. It stores the Blood that nourishes ligaments, tendons and eyes, and houses the Hun. Its virtue is benevolence: 'I can grant you your space.' It regulates the emotions, which should move like a wave, up and then down. Out of balance a person may wander aimlessly or be bogged down in details and compulsions, take up too much space and encroach on others' time; in balance they allow other perspectives to show up. A Wood CF needs structure.

Out of balance the person may also complain. Benevolence here is participative rather than autocratic, with boundaries that allow freedom. To tell Wood from Earth: with Wood the compulsions concern actions, while with Earth the obsessions concern thoughts.

Wood: Gallbladder (Official of Decision and Judgment)

Effective action: the strategist of day-to-day operations, punctual and exact in timing, who implements our goals in the world, makes decisions and gets the job done. It provides vision and the broad, 360-degree perspective that sees to the edges, wise and just judgment, and the ability to rise above the details, choose a path and take the steps to make it happen, rooting creative juices in a course of action. Out of balance a person cannot stay rooted in one thing, judges harshly how things should be, never has clarity, cannot see in the dark or know what step to take; symptoms are often one-sided, and narrow vision obstructs wise judgment.

The Gallbladder puts you on your track when you have a general idea but do not know the path, and it collects the details for the Planner.

Conception Vessel (Ren)

The response to the call to life, for all things begin with Yin: the Sea of Yin. It is the front, receptivity, matter and substance; supporting, nourishing, moist, interior and deep, earth in relation to heaven, the feminine. Deficiency shows as being unable to rest in one's own being calmly: wobbly and collapsed inside. Roughly, REN-1 to REN-3 relate to structure and vital energy in the lower Jiao, REN-4 and REN-5 to passion, REN-6 to lifting up and adding, REN-8 to REN-15 to Wood and Earth issues (how the self is fleshed out in the world, mental processes and ego development), and the upper points to nourishment of the spirit.

Governor Vessel (Du)

The call to life itself: strength, direction and guidance, the support of the Yang. It is the back and the backbone, activating, uplifting, motivating and expansive; it receives orders from Heaven about life and brings those orders to the Officials, giving support from behind and the ability to stand on one's own feet and act in the world. Deficiency shows as a person who cannot do or express, with weakness, coldness, tiredness and holding back. Roughly, DU-1 to DU-3 relate to survival and DU-4 to sexuality and passion.

Worsley's Teachings on the Elements and Officials

Worsley's own explanations of the Elements, the Officials and the laws behind Five Element treatment, retold in my own words.

The Elements as phases of the one Qi

Worsley begins from a point he says is easy to forget: everything is One rather than Many. The ancient Chinese never thought of the five Elements as five separate substances or colored building bricks, because in the end there is a single Qi and a single Dao. Qi, the vital force, makes and shapes everything on earth and is always changing, and the Elements are names for the phases of that movement, each with its own character. Studying one Element on its own therefore means looking at a fragment of a far bigger picture, which a practitioner who treats the whole person must never lose sight of.

The patterns are not our invention but our discovery: they exist already in Nature and in us, and the tables and labels are no more than an alphabet compared with the living poetry of Nature. He hopes students will look with the eyes of body, mind and spirit and see the Elements at work all around them, and will learn from children, who would never settle for a grid on paper but would want to go and find these five wonderful things for themselves.

The seasons and the Elements

Worsley calls the cycle of the seasons the best possible window onto the essence of each Element, and he objects to treating the seasons as just one more item to slice into five in the tables. Spring shows Wood: birth, regeneration and upward thrust, but growth that follows an inner plan with the flexibility to reach its goal, and with it hope and vision. Summer shows Fire: ripening, flowering, color, warmth and the love that Fire pours into everything, given in proper measure so it nourishes rather than scorches.

Late summer shows Earth: the harvest, the mother who feeds every child equally, and the security of a full storehouse, together with the movement and distribution that carry nourishment everywhere. Autumn shows Metal: letting go and decay, yet also the return of essence to the soil and the taking in of pure quality from Heaven. Winter shows Water: an apparently lifeless surface beneath which reserves, endurance and the will to survive carry life through to the next spring. Because the cycle has no beginning or end, it also reminds us that Qi never stops, only transforms, whatever our calendars say.

Wood

For Worsley the single word that captures Wood on every level is vision. Physically it gives sight, and the Chinese linked Wood with the eyes, with tendons and sinews, and through its meridians with the reproductive organs. Its movement is purposeful, forward, flexible and quick, like a seedling forcing its way past a stone, and the tree, an upright link between heaven and earth, is its image. In the mind it gives the power to plan, decide, judge, imagine and reason: the step-by-step building of ideas, and the foresight needed simply to cross a big city on time.

In the spirit, which he calls the most important level, it gives hope and a sense of purpose, the dreams of the next hour, day and year that keep us alive. The key words that return again and again are birth, growth, regeneration, hope, vision, activity and exuberance. He adds that the Chinese believed the part of the spirit linked with Wood rose upward and survived the body at death, a natural extension of the direction it gives us in life.

Wood in imbalance

When Wood is disturbed Worsley looks for loss of flexibility and purpose on every level. Like an old tree whose sap no longer rises, tendons stiffen, sprain or snap, or lose all tone so that a person shambles along without aim; eyes may dim or ache, or when the sap rises too hard there is pressure and headache. Some people race endlessly after distant targets without enjoying what they have earned, while others are rooted to the spot and cannot move.

The mind may either ramble on without direction or harden into rigid order, so that the consultation becomes either a chaotic monologue or something like a military briefing. In the spirit the loss is gravest of all: a person with no spring in their year, who sees no future and falls into the deepest despair and resignation. Beneath the aches and the anguish Worsley hears a lost voice pleading for direction and hope, and what such a person most needs is structure, a plan and a vision so that the strength and suppleness of Wood can return.

Anger, the shout and looking beyond labels

Worsley uses anger to show why a label must never replace the senses. Anger, or an abnormal lack of it, is the emotion of Wood, but people grow angry from outrage, from hurt, from being ignored, from not being respected, or from sheer terror, and each kind has a different root and a different feel. A cold, cutting anger, or the hostility of someone frozen in panic, may belong to quite another Element; the anger of terror might better be called a fear-anger or Water-anger. Wood's own anger is noisy, vigorous and forceful, and when it is blocked it shows as frustration, resentment and hostility.

He suggests picturing the five emotions as five segments of a circle rather than five points of a compass, so that each Element sets a prevailing tone within which other feelings still occur, just as spring has its deaths and harvests colored by spring's optimism. The same applies to the shout: a person may be loud without shouting in the diagnostic sense, while another can carry all the emphasis and telling quality of a shout at ordinary volume. A marked lack of appropriate force is as much a distress signal as too much.

Fire

Worsley describes Fire as the summit of the whole cycle: the hopes and plans of Wood becoming real in the present, when time seems to stand still in the summer heat. Its gifts are love and joy, the greatest a person can receive, and the energy we take in at this peak warms us through the rest of the year. Its image is the sun, an inner sun that gives the body warmth, speeds circulation, digestion and growth, and works through the blood and vessels that carry heat, food, air and messengers everywhere.

The Chinese read the state of Fire's spirit in the complexion and gave it the tongue and the power of speech. In the mind Fire brings brightness, lively intelligence and enthusiasm; its central gift he sums up as understanding, the equal giving and receiving that lets people really hear one another and from which kindness and generosity grow. In the spirit it gives communion with the universal spirit, and the love that lets us feel warmth for strangers passing in the street. He urges practitioners to find this love in themselves and to trust that it lives at some level in even the most unlovable patient.

Fire in imbalance

Worsley pictures a Fire imbalance as either a summer that will not end, bringing drought and burning up the harvest and the winter reserves, or a sun that barely appears. Too much heat shows as redness, thirst, drying of secretions, a racing system and inflammation; too little leaves a person cold, damp, pale and bloodless, with cold hands and feet. Speech falters, stammers or races on, and the voice either bubbles with excitement in the wrong places or stays flat when it should rise to warmth.

He describes Fire as governing gates between people: when they work, openness and trust come easily; when they jam, people become over-defended or defenceless, over-trusting or suspicious. Some open up even when it is dangerous and scorch everyone around them; others have so little fire that they hide away in case the little they have is put out. Asking about relationships, social and sexual, reveals a great deal. In the spirit, losing the inner sun makes life cold, dark, flat and joyless, ending in defeat, resignation or bitterness, and such people may chase physical heat, demand impossible intensity from lovers, or above all long for a love that can rekindle the spirit.

Earth

Worsley sees Earth as a mother's love and the harvest that guarantees survival. Like a good mother, Earth feeds without conditions and without favorites, making sure each child gets a fair share wherever it is, so movement and distribution belong to Earth as much as solid ground does. Being grounded means the security and stability that come from touching the earth's spirit, which renews its promise of food each year. Physically its Officials take in, digest and distribute nourishment, and it rules the flesh, meaning muscle bulk and reserve rather than fat, an internal harvest kept as store, warmth and protection.

He insists there is no such thing as merely eating: food must appeal to mind and spirit too, which he illustrated with English cream cakes set against a joyless diet of brown rice, while still urging moderation. We also digest, chew over and swallow ideas, and learning we love goes in easily. In the spirit Earth gives a home, a feeling of belonging, and the centering that holds the other Elements' gifts, which is why some Chinese traditions placed Earth in the middle. He adds that soils are as varied as trees, and the practitioner must learn what kind of soil each person is.

Earth in imbalance

When Earth falters Worsley sees the same failure of digestion in body and mind: food or ideas go in and sit there churning, the stomach swells and ferments, there is little energy to send to the limbs, and the patient may stare blankly and need things said several times. Worry and anxiety arise naturally when the harvest cannot be trusted. Size may go to extremes, with some harvesting fat on fat and others refusing any harvest, more often for emotional than physical reasons, and comfort eating is really a search for emotional and spiritual comfort.

He traces the behaviors to the unmothered child: some crave sympathy without limit and turn every ache into a reason to receive it, while others reject sympathy outright so that offering it feels like a slap. The balance of caring for self and others can tip into the exhausted martyr who gives a harvest in every season, or into extremes of fussing or neglect over appearance. In the spirit a damaged Earth leaves a person uprooted and unprotected, like a family that has lost its mother, showing the agitation of a small child who cannot find her.

Metal

Worsley sees two movements in Metal: letting go of what has finished and taking in pure essence. Autumn leaves rot, but their minerals return to the soil and keep it fertile, and without that return the earth would become barren. In us the Colon lets go of waste in body, mind and spirit, and the Lungs take in Qi from the heavens, along with new ideas and inspiration. Just as Earth is the Mother, Metal is the Father, the link with Heaven, which need not mean a particular deity, only the meeting of heavenly and earthly Qi that sustains life.

Metal is the divine spark, like the molten metals glowing at the earth's core, and the word that fits it best is quality: everything is enriched by it. Its gifts are those of a good father: authority, wisdom, guidance and above all respect, both for others and for oneself, giving self-esteem and a sense of one's own worth and place in the universe. He notes how our language of value draws on precious metals and stones, given as medals and tokens of honor.

Metal in imbalance

Worsley describes grief as releasing what is over, and a Metal imbalance as letting go too early or not at all, in body, mind and spirit alike, mirrored physically in diarrhea and constipation. Some ignore loss entirely, while others carry regret for decades and go through life facing backwards, wishing things had been different. The deepest grief, though, needs no loss at all: it comes from being cut off from the Heavenly Father and the spark within, leaving a cold, empty void that nothing seems able to fill. Such people may chase from teacher to teacher across the world, fanatical for a time, and the emptiness remains.

Without self-respect some neglect themselves completely, while others hide the void behind immaculate grooming, ostentatious wealth or fastidious precision. He compares people to metal at different temperatures: workable when warm, molten when overheated, and in our age most often cold, rigid and brittle, shattering under pressure. The skin, the third lung, may lose its bloom, and the eyes may look hollow, cast down to the ground or fixed upward in search of something higher. Deep down these patients ask to be taken by the hand and guided, and above all to be respected.

Water

Worsley calls Water the most elusive and impenetrable Element: it takes any shape, slips round every dam, gives nothing away on its surface, and yet makes up most of every living thing. Its season, winter, looks dead, but beneath the snow seeds and sleeping animals are living on stored reserves. He names three aspects: reserves, flow, and the cleansing power of flow. Reserves are the inheritance passed from generation to generation, and the farmer's reservoirs and ditches show why they must be gathered and kept clear.

Flow carries nutrients and hormones, removes waste through the Bladder and Kidney, and lubricates every joint and moving part. Cleansing applies to mind and spirit as much as to the body, which is why so many faiths baptize in holy water and sacred rivers. Deeper still lies the essence of Water, the will and determination to see the winter through, like the ocean wearing away cliffs over millennia, and the drive of each seed toward its destiny. That inner resolve, not physical strength, is what keeps the young and the weak going in disasters when the strong freeze, and it carries us along the hard road toward health, understanding and truth.

Water in imbalance

When Water is out of balance Worsley expects effects in every cell: swelling and edema, or dryness that lets Fire run wild, stiff joints that have lost their lubrication, and a weak flow that lets impurities settle as stones or gout. The mind and spirit grow stagnant like a brackish stream, unable to wash away old ideas. Fear is Water's emotion, and he describes it as the unthinkable fear of drought, war or catastrophe, the dread of an unknown future. Physically fear dries the mouth, brings cold sweats and can loosen the bladder; mentally it makes people either babble or freeze.

Some dash about in panic, others distract themselves, and the eyes may dart about or sit blank and unreadable. Those who have long held huge inner terrors at bay may show a lack of fear, taking up reckless sports because no ordinary danger can register. Patients with Water imbalances often ask for reassurance again and again, like children who still fear what is behind the cupboard door after the light is on, and words alone cannot reach a fear lodged in the spirit. He warns that burning through reserves, living fast without an inner winter of rest, ends in exhaustion on every level, and a spirit run down to nothing makes a person as good as dead while the body carries on.

Elements within Elements

Worsley teaches that each Element contains all five, which explains why two people with the same Causative Factor can be so different: the difference is one of quality, not only of degree. A tree lives in earth, drinks water, is warmed by the sun and enriched by minerals and air, and within its own growth it also needs rising, warmth, nourishment, letting go and reserves. Growth itself must contain all five. If the Fire within someone's Wood is weak, their growth may be stiff even though their Fire overall is fine, and the treatment belongs to Wood, perhaps with points chosen for the Element within; treating Fire would miss the mark.

Each Element within has its own Element within, so there are no fixed first causes. This is what the senses can detect: the green of a Wood Causative Factor is never plain green but blue-green, yellow-green and so on, laughter can be shouting-laughter or weeping-laughter, and each odor has five variants with five more inside each. An Element may even be deprived of its own essence, like a starving mother trying to nurse her child. Emotions within emotions are hardest, because they must be drawn out and judged for appropriateness, and here only all four diagnostic signs and supervised clinical practice can keep us from serious errors.

Color, sound, odor and emotion

Worsley lists twelve main correspondences for each Element: color, sound, odor, emotion, season, climate, taste, power, direction, part of the body, sense organ and external physical manifestation, though hundreds more exist. Only the first four are used to establish the Causative Factor, and these he treats as the basis of diagnosis; the rest are second-grade information, useful to confirm a diagnosis but never to found one, because a problem in one Element, such as dry eyes from depleted Water, can show up anywhere. For Wood: green, shouting, rancid, anger, spring, wind, sour, birth, east, eyes, tendons and ligaments, nails.

For Fire: red (often seen as a lack of red, like a washed-out color print), laughing, scorched, joy, summer, heat, bitter, maturity, south, tongue, blood vessels, complexion. For Earth: yellow, singing, fragrant, sympathy, late summer, humidity, sweet, center. Metal is linked with grief, weeping and the rotten odor, and Water with fear, the groan and the putrid odor. He stresses that these signs belong to Nature in health as well; the green of spring is everywhere, and a correspondence becomes diagnostic only when it becomes dominant, or out of place or season.

Reading the secondary correspondences

Worsley explains several correspondences through the character of their Element. Green and sour both belong to unripeness, like an unformed apple, which is why we call an inexperienced person green. Rancid is the smell of fat gone off, linked to the Wood Officials' part in breaking down fats. Wind is changeable and volatile like Wood, and some people find it makes them irritable or unusually invigorated; a Wood imbalance may also bring a craving for sour foods, a strong liking or dislike of green, and poor, brittle or ridged nails. Scorched can be appealing in moderation, like roasting coffee, but turns unpleasant when inappropriate.

The Earth singing voice is not a regional lilt but a mother soothing her child, cooing and falling away within each word, appealing for sympathy and drawing us in. Earth's yellow recalls the fertile loess of northern China. Fragrant is not a pleasant smell but the cloying sweetness of overblown blooms in a humid late-summer greenhouse. The Water groan is a monotone without variation, like a drone heard through a wall, giving nothing away, just as a person rigid with fear may look still on the surface. Directions follow the sun's course and once guided where Chinese emperors lived each season, but matter little in a modern insulated life.

The Sheng cycle and the Law of Mother–Child

Worsley describes the Sheng cycle diagram as saying a great deal by itself: equal circles evenly spaced show that no Element is greater than another and each has an equal share of the flow, and the arrows show a natural order that has no start or finish, just as spring always follows winter and never the reverse. The cycle both creates and nourishes, though creation here does not mean making from nothing: wood feeds and creates a blaze, but only if there is already a spark, so a weak spring means a summer that never quite arrives rather than none at all.

Each Element relates to the next as mother to child. A poor spring gives a poor summer crop, which gives a thin harvest, a barren autumn, low winter reserves and weak seeds in spring, so an imbalance in one Element spreads round the cycle, most of all to its child. Signs of distress in Fire may therefore come from Fire itself or from Wood, Water or Metal behind it. The child cries loudest while the mother suffers quietly, so the loudest complaint is not the root, and a mother can overwhelm her child as well, as endless winter rain drowns the spring growth.

Yin and Yang Officials on the Sheng cycle

Worsley explains that in the Sheng cycle diagram each Element's circle is cut by the main circle into an inner and an outer half: the predominantly Yin Official sits inside (Liver, Kidney) and the predominantly Yang Official outside (Gallbladder, Bladder). The zang, solid Yin organs, produce, transform and regulate Qi; the fu, hollow Yang organs, store and excrete raw materials and waste and are sometimes empty.

Mother–Child therefore runs Official to Official: the Stomach is mother to the Large Intestine, and the Lung is fed by the Spleen. If the Lung is the main source of trouble, the Spleen as its mother or the Kidney as its child may show the most distress, and symptoms in the Lung or skin may send us looking to them. He is firm that the Yang Officials must never be treated as less important: in a family where the father earns and the mother keeps house, everyone still worries when the youngest baby is ill.

The Ko cycle among the Officials

Worsley describes the Ko cycle as the cycle of control by which the Elements hold one another in check, Earth damming Water, Water quenching Fire and so on. Among the Officials only the Yin Official controls the Yin Official across the cycle: the Liver controls the Spleen, Heart and Heart Protector control the Lung, the Spleen controls the Kidney, the Lung controls the Liver, and the Kidney controls Heart and Heart Protector.

Some traditions build syndromes such as Liver invading the Spleen on these links, which he finds rich and evocative but liable to become formula diagnosis done with the head instead of the senses. An overstrong Liver strains its child, its mother, the Spleen it controls and the Lung that must restrain it, and the real cause may lie elsewhere entirely: a sick Heart Protector can leave its mother the Liver hyperactive and its child the Spleen weak, producing the picture of Liver invading Spleen with the root in the Heart Protector.

The meridians, their Elements and command points

The Qi travels along set pathways called meridians. In places they run close to the skin (the superficial pathways) and in places deep inside the body (the deep pathways), and they run on both sides of the body. There are twelve main meridians, each with a name and a Roman numeral; the numbering follows the order in which the Qi passes through them in one full circuit.

Six carry mainly Yang qualities of energy and six mainly Yin: I Heart (Lesser Yin), II Small Intestine (Greater Yang), III Bladder (Greater Yang), IV Kidney (Lesser Yin), V Circulation-Sex (Absolute Yin), VI Three Heater (Lesser Yang), VII Gallbladder (Lesser Yang), VIII Liver (Absolute Yin), IX Lung (Greater Yin), X Colon (Sunlight Yang), XI Stomach (Sunlight Yang) and XII Spleen (Greater Yin). Two special meridians follow: XIII, the Conception Vessel, and XIV, the Governor Vessel. Points along the pathways are the places where the energy can be regulated effectively; their numbers rise in the direction the energy flows, so point 1 is where the meridian begins.

Every meridian is either Yin or Yang and belongs to one of the five Elements, each with its color: Fire (red) for Heart, Small Intestine, Circulation-Sex and Three Heater; Earth (yellow) for Stomach and Spleen; Metal (white) for Lung and Colon; Water (blue) for Bladder and Kidney; Wood (green) for Gallbladder and Liver. On top of its own Element, each meridian carries a command point for each of the five Elements. The Heart meridian, for example, is a Fire meridian as a whole, yet its third point is its Water point, the fourth its Metal point, the seventh its Earth point, the eighth its Fire point and the ninth its Wood point.

The Wei cycle

Worsley describes the Wei cycle as a relatively superficial flow that follows the numbering of the Officials, from Heart as I to Small Intestine as II, Bladder as III, Kidney as IV and onward. It is chiefly a protective layer that defends us against harmful influences from the environment, both the classic climatic causes of Wind, Cold, Heat, Fire, Damp, Humidity and Dryness and the pollution of modern life. Its main problems are blocks, where energy cannot pass from one meridian to the next. He stresses that superficial means nearer the surface, not less important: a blocked meridian is the Official's own residence, and an Official starved of energy at this level can suffer as badly as one deprived of nourishment from its mother on the Sheng cycle. He notes that one branch of Japanese acupuncture builds its whole diagnosis and treatment on this level.

The spirit of the Officials

Worsley explains that where the Elements give a broad picture, the Officials lead us directly to what is real inside, much as a children's book showing two little men working bellows taught him more about the lungs than any diagram. The Chinese saw the person as a small kingdom with twelve ministers of an imperial court, and the vital word is function: each Official must be understood by what it does, not what organ it resembles. Proof of this is that the Gallbladder or Spleen Officials go on working after the physical organ is removed, needing extra help after the shock but still functioning on every level.

The Officials are simply the Elements alive inside us, and each works in body, mind and spirit. Like any court they can cooperate peacefully or clash, which helps explain why people neglect their own wellbeing and why we speak of a part of us that would not let us do something. He asks students to stop asking how the patient's Liver is and to ask instead how the Planner's work is going, and he warns against using these descriptions as a lookup from symptom to Official, because a struggling Official may be ill itself or simply starved, clogged, parched, overheated or left without help from the others.

The Officials depend on one another

Worsley compares meeting the twelve Officials one by one to being introduced to a big family at a party: we may recall names and faces, but we do not know them until we see them working and playing together, changing and squabbling. Two simple statements carry the whole idea: no Official can do another's job, and every Official needs all the others to do its own. The Planner, for example, gives the whole court its direction, but each Official also needs its own plan: the Stomach for the right blend, the Spleen for a delivery schedule as precise as a military operation, the Colon to extract water and pass waste, the Lung to coordinate breathing.

Without the Planner the Stomach may simply vomit food out of confusion. Likewise if the Separator fails, poisoned information flows on to the plans, boundaries, memory, inspiration and resolve of every other Official. A person who feels they have no future may therefore have any Official at the root, not necessarily Wood. Disease is a process: in the end every Official cries out, but those closest in function, above all the partner in the same Element, show it first. His conclusion is that the goal is better knowing rather than more knowing, and that no template of symptoms can be laid over a patient like a grid.

The paired Officials of an Element

Worsley uses Liver and Gallbladder as the clearest example of how the two Officials of an Element depend on each other. They are like an architect and a site foreman: without a plan the foreman faces a bare plot and can only improvise, risking doors where windows should be; without a foreman the architect's plans never leave the armchair, and the plastering is done before the wiring. The two are blood brothers of the same stock, so what harms one harms the other: when the Planner is ill the decision maker is the first to panic, and the Planner grows frustrated and hopeless with no one to carry out its work. The same holds for every pair, Heart and Small Intestine, Stomach and Spleen, Colon and Lung, Bladder and Kidney, and it is between partners that signs of weakness usually show first, since an imbalance in one Official is in truth an imbalance of the whole Element.

Liver: the Planner

Worsley calls the Liver the architect of the individual. Its blueprints are more than drawings: they carry the vision and hope that give every part of us an aim, so that each Official knows where it is going and what it should be doing. A good planner also makes contingency plans, which lets us stay relaxed and flexible whatever comes up. When the Planner fails, the body's rhythms go astray: menstrual cycles become irregular, food turns up where and when it should not, and movement loses its grace, becoming clumsy or dizzy.

In the mind some people cannot plan at all and drift with the wind; others start projects everywhere and finish none; others plan so rigidly that every other option is closed off. Some cannot organize themselves yet insist on organizing everyone else. In the consultation the Planner shows itself either in a muddle or in a prepared list delivered point by point. He also notes that long courses of drugs tax the Liver, which must clear them from the system.

Gallbladder: the Decision Maker

For Worsley the Gallbladder excels above all in the mind: deciding, judging, evaluating and coordinating, the constant choices about what to say and what things mean as we compare where we are with where the plan says we should be. Arriving where we need to be, when we need to be there, is its gift. Its judgment matters just as much for our deeper goals, since no plan is flawless and not every aim deserves pursuit; the Gallbladder alone can weigh the worth of the goals we set.

He thinks this power is especially precious now, when so many people press their beliefs and spiritual teachings on us, because a healthy Official of Judgment lets us see to the heart of ideas and tell right from wrong. He points out that the physical gallbladder merely stores bile and can be removed without great loss, which makes any literal equation between organ and Official absurd. Together the two Wood Officials bring growth, purpose and hope to the whole person and to every other Official.

Heart: the Supreme Controller

Worsley stresses that the Chinese did not call anything supreme lightly. The Heart is like an emperor who delegates tasks to his ministers yet depends on them for everything; his commands succeed only when they agree with what his people want. It is the dwelling of the Shen, the spirit, whose strength a Chinese doctor reads in the complexion and the sparkle of the eyes. Physically it produces the blood and drives it out, and the blood is its line of communication to every Official. It sets limits and boundaries, fixes priorities and judges disputes impartially, and what makes the court welcome its rule is the unconditional love and warmth it gives in return.

A contented king means a contented kingdom, and the Heart shows itself only through the love and joy flowing among its subjects. Yet it depends entirely on the others to plan, decide, regulate and sort. When it is ill the boundaries dissolve into fear, panic, insomnia, palpitations, vivid dreams and joyless depression, and every other Official suffers. A frightened Heart may also grab control of everything, issuing what feel like imperial commands, until the others resentfully hand over all their work and the Heart collapses under the load, which Worsley sees summed up in the term cardiac arrest.

Approaching the Heart through its ministers

Worsley teaches that the Small Intestine, the Three Heater and the Heart Protector all protect the Supreme Controller, and that none of them is a lesser Official, since a ruler is only as strong as the love and respect his rule earns. Because the Heart points are so powerful and touch the whole being, he usually approached the Heart through its ambassadors and protectors, so that the ministers could veto what was offered, and went to the Heart Official itself only when that route failed. He describes the Heart and its three ministers in Fire as what keeps the spirit's light and warmth burning in us, and remarks that each Official in turn seems to be the most important one, which should teach us respect for functions we take for granted every day.

Small Intestine: the Separator

Worsley calls this Official the Separator or the Sorter, the one who separates pure from impure. It takes the rotted and ripened food from the Stomach, keeps the clean Qi for body, mind and spirit and passes the dirty Qi to the Colon, and by keeping only what is pure it lets our warmth and love stay untainted. It is remarkable how much goodness it extracts even from a diet of burgers and cola, but it still needs respect, and if it is ill no change of diet or supplements will help, since it will keep the rubbish as readily as the nourishment.

In the mind it sorts the useful from a flood of trivia and filth, and it is the seat of our sense of natural justice, the shared feeling for right and wrong behind our moral codes. Like a private secretary it sifts everything so that only matters worth the minister's time reach the Supreme Controller, another layer of protection. Its active sorting comes before any decision can be made. When it fails the body clogs with thick, dirty energy, lumps, skin eruptions, inflamed boils and gummed-up joints, the mind becomes confused and unstable, and trapped fire can produce hysteria or mania.

Three Heater: the regulator of Fire

Worsley sees the Three Heater as the regulator and harmonizer of Fire, adjusting our inner heat to our surroundings and to the people around us, like an emotional and social thermostat. When it works erratically people blow hot and cold: overwhelming one moment, indifferent the next, with a volcanic temper that is forgotten ten minutes later. Relationships suffer, because closeness depends on constantly adjusting to each other, and give and take is impossible without regulation. It may instead get stuck too hot or too cold, giving one inappropriate response to every situation.

He warns that a person may take up new paths and relationships with great intensity and then drop them two weeks later, not by rejecting them but because the interest simply dies, as a disturbed fire flares and fails. Since following the Dao means meeting each situation appropriately, this Official is crucial to the spirit too. Its meridian's point names speak of controlling water: frontier gates, fluid gates, a pond, a heavenly well, a branch ditch, a crossing of the Yang and a gutter, the whole apparatus of an irrigation system for spreading heat and energy in measured flow. The Heart Protector lends us self-protection, while the Three Heater lends the power of regulation.

Stomach: the Official of Rotting and Ripening

Worsley says we are more disrespectful to the Stomach than to any other Official, treating it as a sack into which we pour food. Its job is not only to break food down but to blend it, like mortar that must be neither too wet nor too dry, or a cake that can be delicious or inedible from the very same ingredients, into something palatable to body, mind and spirit. Putting someone with long-standing stomach trouble on the purest bland diet can make the Official lazy, so that it no longer knows what to do with ordinary food; a normal mix of good and less good is what it expects.

It feeds every other Official and is their direct link with the Earth, giving the security of a baby at its mother's breast, and its downward movement grounds us in the mind and spirit of the Earth as well. When it is ill, badly prepared Qi leaves mucus and phlegm blocking the channels, the Officials reject their food, and there is weakness, distension, reflux and vomiting. Mentally, information does not go in, so a person may look blank and forget instructions a minute later, feeling the confusion of a child who has lost its mother. Underneath lies a hunger that shows as craving for sympathy and sweetness, or later as bitter rejection of anything the mother offers.

Spleen: the Official of Transportation and Distribution

Worsley compares the Spleen to a transport manager running a haulage fleet day and night, every day of the year, carrying Qi to every corner of body, mind and spirit, and he does not think the image unworthy of the medicine. However good the diet and the Stomach, if transport fails the food never arrives and starts to rot where it lies. Without delivery the limbs, hands and feet go cold and the whole body becomes weak and lethargic; what little moves thickens into phlegm, lumps and stones, blood stagnates into varicose veins and hemorrhoids, and menstrual blood fails to arrive or comes thick and painful.

In the mind the loss of movement shows as poor concentration, a feeling of being stuck, and the worry and anxiety of Earth, which he calls coagulation of thought. Uneven delivery leaves some parts of the mind and spirit well fed and others starving, bringing the jealousy, spite and attention-seeking of children cared for unequally. He also warns against assuming every Spleen patient deserves sympathy: some are simply lazy, solving the world's problems from the armchair without moving. The ancients called the Spleen the granter of the five tastes, through its pathway to the tongue.

Lung: the Receiver of Pure Qi from the Heavens

Worsley reminds us that we can last weeks without food and days without water, but only minutes without air. Mother Earth and Father Heaven do not feed us equally in quantity; it is the quality of the air, its small kernel of value, that unlocks the food we eat, as a spark unlocks petrol or tinder lights wood. Many of the oldest religions center their prayer and meditation on the breath and begin each day with breathing practice. The Lung also clears rubbish of its own, but its chief work is inspiration on every level: the flash in which the pieces of a problem suddenly come alive with meaning, and above all the link with the Heavens that gives life quality and higher purpose. When it fails we feel the great chasm, the void left when this connection has not been tended, and accounts of sudden religious conversion show what it is like when such a void is filled at once.

Colon: the Drainer of Dregs

Worsley treats Lung and Colon as the easiest Officials to understand, and as so interdependent that imbalance usually shows in both: we must let go of rubbish to take in fresh Qi, and take in fresh Qi before we can let go. The Colon, the drainage ditch in the Lower Jiao, clears waste from all of body, mind and spirit, including the waste of every other Official, so when it falters they all slowly choke on their own pollution. Holding on can be emotional as well as physical: wanting to let go of the past but being unable to, and people who let themselves go after a bereavement often neglect cleanliness too.

He insists that the Yang Officials can be the source of deep spiritual distress, and that pollution of the spirit, showing as cynicism, negativity, gloom and dismissiveness, is the worst thing this Official's illness can cause. A constipated spirit stays locked in old beliefs and cannot move on; with no autumn no spring can follow, and last year's growth hangs on looking ever more tattered. The stubbornness that results can feel like trying to bend solid metal.

Bladder: the Official of Storage of Water

Worsley explains that the Bladder Official stores water and decides, not merely automatically but by choice, how much to keep and how much to expel, setting aside impurities and holding the clean water the reservoir needs. When it pours water away too fast there is dryness of skin and hair and a parched, cracked surface; when the reservoir overflows there is swelling and waterlogging; when impurities are kept they travel in the fluids to every cell. Its meridian is the longest in the body with the most points, which alone should remind us of its importance.

In the mind good irrigation lets thoughts flow and grow, and its reserves give every other Official movement, security and a future; in the spirit it underlies endurance, ambition and determination. Imbalance may leave minds arid and stagnant, or so flooded that thoughts burst their banks and the person seems impossible to pin down. At root lies the fear, or lack of fear, of an empty well, and the even worse terror of drowning, the despair of being beyond anyone's help.

Kidney: the Controller of the Waterways

Worsley calls on scripture and the stories of saints to describe the resolve and inner strength the Kidney gives, which deserve the deepest respect. It creates bone and marrow, the brain being a sea of marrow, and gives long-term memory; when strong it opens the ears, and it governs the sexual organs and the inherited seed passed from parents to child as ancestral energy. Fear moves energy downward, which is why terror loosens bowels and bladder, dries the mouth and brings sweat. Its cleverness is the cunning of water finding its way round any barrier.

Because our inherited reserves are finite and spent from cradle to grave, many signs of Kidney weakness look like ageing, and young people who burn the candle at both ends, or take drugs long term, can become old before their time. A truly excess Kidney is rare; apparent excess is usually a cry of distress. When the spirit's reserves are gone a person may live in constant dread, deny all danger, or sink into total resignation. The Chinese counted ancestral energy, spirit and Qi as the Three Treasures, and the Kidney's links with the Governor Vessel and the Extraordinary Meridians, the seas and oceans of the body, show that it is the root of life.

The Kidney chest points

Worsley singles out the points on the upper chest that he calls the Kidney Chest Points: Spirit Seal, then Spirit Burial Ground, then Spirit Storehouse, then Amidst Elegance and finally Storehouse. Every one of them reaches deep into the spirit, taps the person's vital reserves and restores their link with the inner strength required when their spirit has sunk low after long suffering. He says a short paragraph could never convey their beauty or the many lives they have transformed among people who were quietly slipping away, and that, used at the right moment and with the right intention, they let the practitioner revive a person at a level far beyond bare physical survival.

The Causative Factor

Worsley defines the Causative Factor as the one Element whose weakness, whether present from birth or arising early in childhood, holds the key to every pattern of disharmony in body, mind and spirit. Every patient has one major weakness that stands out above the rest, as obvious and as damaging as a missing season would be; with no summer, everyone would hunt for warmth, and a person lacking the inner sun of Fire goes looking for missing warmth and love in the same way.

It can create such chaos in the system that only trained senses can find it, revealed through the inappropriate color, sound, odor and emotion, and then the pattern in the chaos can be traced through the relationships between the Elements. At the deepest level the practitioner meets people without reserves, without purpose, without a vital spark, without nourishment, or with no warmth of love and joy, and understanding the Elements this way lets us reach the heart of their distress. Treatment aims to restore balance in the Causative Factor so that the whole system can find its way back.

The legs of the stool and the golden key

Worsley uses the image of a stool to insist on enough evidence before reaching a diagnosis: its four legs are color, sound, odor and emotion, and one or two legs cannot support a conclusion, while three are only just enough. He also speaks of a golden key, a moment when a patient says or does something that confirms the Causative Factor, sometimes in words that echo the correspondences themselves, as with a voice groaning that its worst fear is the deep blue sea, but more often in a turn of phrase that shows the person without the mask.

Treating the cause, not the symptom

Worsley calls Classical Five Element Acupuncture, when it is practiced properly according to the natural laws, one of the loveliest systems of medicine people have ever had: an art and a science at once. Its guiding principle is steady attention to finding and treating what causes an illness, not what the illness looks like on the surface. Acupuncture aimed only at named diseases or at the symptoms of the moment he calls 'local doctor', symptomatic or formula acupuncture. In the East it is mostly given right at the start of an illness, because people there see their local doctor at the first sign of trouble, and its job is to bring comfort for a while until a fully trained physician can diagnose and treat any serious cause underneath.

Sometimes that early relief even lets the body throw off the cause by itself, so he does not dismiss it entirely. In the West, though, people usually come to acupuncture only after Western medicine has failed, when the illness has been there a long time and is often chronic. Using symptomatic techniques then can at best ease things for a time by pushing away the obvious symptoms; at worst it is dangerous, because the real cause stays hidden and goes on unchecked. Making symptoms disappear for a while is not a cure. First aid can be taught to a local doctor within months, but training a Five Element practitioner takes many years, because it is a complete system of medicine that takes in all of a person (body, mind and spirit together) and rests on a philosophy that must be understood as well.

He uses the Small Intestine meridian to show the danger of local, symptomatic needling. Shoulder, elbow, neck and ear trouble often accompanies imbalance in this Official, and many formula treatments use its points to free the flow. But if the problem is a blockage of impure energy, like silt in a river, stirring it locally is like poking a muddy stream with a stick: instead of letting the mud settle so some clean water can be drawn, we cloud the whole river and spread poison everywhere.

This is why he will never accept local doctor or symptomatic points chosen outside a Traditional Diagnosis and a treatment plan built on it. The same reasoning runs through all his teaching: lower back pain does not automatically mean Kidney, nor cold hands and feet Spleen, because where a symptom appears is often not where its cause lies. Students are given an exercise of taking one physical symptom and explaining how an imbalance in each of the twelve Officials could produce it, and the real cause can be found only through the imbalanced color, sound, odor and emotion.

Every patient is unique

In every part of Chinese medicine, Worsley says, the practitioner keeps the individual in view. This system cannot treat everyone the same way. Each person is a one-off, a being the Creator has not made before and will not make again, and people differ from one another enormously. So the cause of illness has to be looked for afresh in each person in our care, which is why the personal relationship and rapport between practitioner and patient matter so much.

Appropriateness

Worsley calls appropriate a key word for this medicine and for the Daoist philosophy behind it. The Elements create all the faculties and attributes of a human being, and when the flow is good and they are in balance a person meets each situation with a fitting response: afraid when there is danger, grieving when there is loss. With a poor flow and unbalanced Elements, responses go astray, such as laughing off a loss or flaring into anger when offered warmth. Following the Dao, in his view, comes down to doing and saying what is appropriate, and the correspondences only become diagnostic when they appear out of proportion or out of place.

Body, mind and spirit as one

Worsley explains why he almost always says body, mind and spirit together when discussing symptoms, treatment and change: no body, mind or spirit exists apart from the whole, only one flow of energy moving through all three. A blockage anywhere affects everywhere, so a mental or spiritual problem can surface as a physical complaint, and a physical problem can arise from the mind or spirit. He adds that our age gives little care to the spirit and lacks words for it, so much disease begins there unrecognized, and there is now more illness arising from the mind and spirit than from physical causes alone. When any part of body, mind or spirit falls, the other two are never far behind.

The Dao: health, illness and cure

Dao means roughly 'The Way'. An ancient Daoist sage said it cannot be talked about, only lived. To follow the Way is to walk with Nature through all its changes and to recognize the essence, the true spirit, in every living thing. It is the road we travel from birth to death, and walking it lets us know who we really are and see all creatures living together in harmony. Classical Five Element Acupuncture tries to bring a person back into harmony with the Dao. The practitioner trusts that Nature, when nothing blocks it, carries the patient toward health in body, mind and spirit, the way rivers run easily down to the ocean. As another Chinese sage put it, 'Easy is right.' Illness comes from breaking natural laws and falling out of step with the Dao.

When we lose the Way we lose our built-in ability to adapt to a changing world and changing circumstances; tightness and blockage then interrupt the flow of vital, healing energy and leave us open to disease. The body sickens, the mind grows uneasy and the spirit draws back, and if the spirit draws back completely, death follows. So the practitioner is trained in the laws of Nature and treats by them, so that the Qi itself can cure the causative factor. Worsley stresses that no healer, ancient Chinese or modern Western, can actually cure disease. The most anyone can do is help Nature do the curing, supporting the body's own defenses in the most natural way possible. Treatment should help the patient come to see this for themselves, and so really value living in harmony with Nature.

Yin and Yang of the Qi

Qi is the life force that makes and sustains every living form, and Yin and Yang are its two aspects. Both are always there, each defined by the other, so neither can ever be cut off or stand alone, and nothing alive is ever purely one or the other. They complete each other like night and day, winter and summer, woman and man, moon and sun. Balance between them is essential: as long as the two stay in harmony, disease cannot arise, while serious imbalance disturbs body, mind and spirit and illness follows. Yin rises out of the earth and gives rise to Yang; Yang comes down from heaven, enters the earth and gives rise to Yin again, and between them they keep every cycle of life turning.

Picture the body standing with the arms raised: Yin flows up the inner legs and the trunk and then out along the front of the arms toward the sky, while Yang flows down the back of the arms into the chest or the back, then on down the outer legs into the earth. This is why the classical stance for describing the body has the arms up, showing Yin moving from earth to heaven and Yang from heaven to earth. When Yin and Yang are balanced the energy moves freely and steadily and body, mind and spirit stay whole; when the pathways become narrowed or blocked, disease takes hold where the system is weakest, and in the end the whole energy system fails.

The Law of Cure

Worsley describes the Law of Cure as a Five Element law: as body, mind and spirit come back into balance, symptoms tend to return in the reverse order in which they arrived, to clear from above downward, and to leave from inside outward. Disease travels deeper as imbalance grows, and it retraces its path as Nature brings about a cure. Patients often report a brief return of old symptoms, sometimes stronger than the first time, yet carrying a sense of feeling better inside.

Other laws and conditions

Worsley also outlines several further laws and conditions. The Law of Midday–Midnight, the Chinese Clock, gives each Official a two-hour peak in the day, its horary time, when treating it is most effective, and can guide patients' habits, for instance that food eaten when the Stomach peaks in early morning is best digested. The Law of Husband–Wife describes a serious disturbance in which the pulses of one side outweigh the other in a way that must be corrected before ordinary treatment. Aggressive Energy is energy that has become polluted, often after severe shock or repeated battering of a Yin Official, and spreads across the Ko cycle, destroying the creative work of the Elements.

Possession is a deep disturbance acting like an invading force, ranging from complete insanity to something barely visible that still blocks any therapy, and it is cleared with the Internal or External Dragons: the 7 External Demons are released with DU-20, UB-11, UB-23 and UB-61, and the 7 Internal Demons with a Master Point just below REN-15, together with ST-25, ST-32 and ST-41. The Conception and Governor Vessels he likens to seas compared with the rivers of the twelve meridians, with points of profound power. He also notes that the Chinese saw disease as arising from climatic extremes (external causes) or from extreme or prolonged emotion (internal causes), with the internal causes usually more relevant in modern practice.

Each point has its own character

Worsley wrote that every point has a character of its own and its own way of expressing itself. Chosen with real sensitivity, and used at the right moment and in an effective way, a point brings precisely its own function, character and expression into the healing process. In his point book he deliberately left out any explanation of the natural laws, and any specific teaching on patrons, pulses, treatment techniques, traditional diagnosis, the Officials or the spirits of the points, warning that using such material without proper training can be dangerous.

Point groups outside the classical system

Besides the classical categories, Worsley's point book also lists Antique Points, Assembling Points, the Eight Extra Meridians and their points, points for the Endocrine Glands, and the Meeting and Reunion Points. These are not used in Classical Five Element Acupuncture; he included them because other styles of acupuncture use them. In the Antique Point scheme each command point is tied to a season: Cheng to Winter, Yung to Spring, Yu to Summer, Ching to late Summer and Ho to Autumn. First Aid points are included too, but are meant for use only in particular circumstances and according to certain criteria.

Meridian Pathways

How each meridian travels through the body, with the internal branches that link it to its Official and its partners.

Heart

The Heart meridian has its origin deep inside the substance of the heart. From there one internal channel runs downward along the midline, passes through the diaphragm into the belly and links with the small intestine. A second internal branch rises beside the esophagus, crosses the pharynx, curves around the corner of the mouth and reaches upward as far as the optic foramen. Yet a third internal route climbs along the aorta, enters the lungs and then follows the subclavian artery outward to the armpit, where the meridian surfaces at its entry point, HT-1. On the surface it runs down along the inner edge of the biceps to the elbow crease, in front of the humerus's medial epicondyle, then follows the inner edge of the ulna to the outer side of the pisiform bone. After crossing the wrist it passes through the palm between the fourth and fifth metacarpals and along the thumb side of the little finger, finishing at the nail point on that side, HT-9, which is the exit point. From HT-9 it passes its energy on to SI-1, the first Small Intestine point, at the nail point on the outer (ulnar) side of the little finger.

Small Intestine

The Small Intestine meridian starts on the surface at its entry point, SI-1, the nail point on the outer (ulnar) side of the little finger. It follows the inner edge of the little finger and of the fifth metacarpal, curves slightly backward across the ulna's styloid process, and climbs along the ulnar edge of extensor carpi ulnaris up to the elbow, where it passes between olecranon and medial epicondyle. It goes on up the back of the upper arm on its inner side to the acromion's lower border, drops onto the shoulder blade, rises again and travels inward above the scapular spine until it meets the midline beneath the seventh cervical vertebra at DU-14. From DU-14 it goes deep, passes forward across the shoulder into the supraclavicular fossa at ST-12, and there it splits in two. The internal branch goes first to the heart at REN-17, then down along the esophagus, through the diaphragm at the midline and through the stomach at REN-13 and REN-12, and links with the small intestine. The surface branch climbs the neck beside the sternocleidomastoid through SI-16, crosses the jaw, rises over the cheek to SI-18 and then bends outward to finish in front of the tragus at the exit point, SI-19. From SI-18 one internal offshoot runs up to the outer corner of the eye at GB-1 and then finishes at SI-19; another leaves the surface channel at SI-18, rises beside the nose to the inner corner of the eye at UB-1 and links there with the Bladder meridian.

Bladder

The Bladder meridian starts on the surface at the inner corner of the eye, its entry point UB-1. It rises past the inner end of the eyebrow at UB-2 to the midpoint at DU-24, then runs over the forehead bone just to the side of the midline up to the crown at UB-7. At this point an internal offshoot goes across to the midline at DU-20 and then outward and down behind the ear, linking with GB-8, GB-9, GB-10, GB-11 and GB-12. A second offshoot enters the brain from UB-7 and comes out again to rejoin the surface channel at the nape. The surface channel carries on over the head beside the midline, links from UB-9 to DU-17 on the midline at the occiput, and then slants outward to the occipital protuberance's base at UB-10. Here it splits into two lines that run down the back on either side of the spine. The inner line first passes through DU-14 on the midline beneath the seventh cervical vertebra, then descends level with the outer tips of the transverse processes, which is 2 ACI out from the midline, widening to 2½ ACI from the midline across the lumbar area. At UB-23, between lumbar vertebrae two and three, an internal branch goes in to the kidney and on to the bladder itself. The inner surface line keeps descending beside the midline over the sacrum down to where the fourth sacral foramen lies, then climbs back inward into the first sacral foramen and comes down again through each foramen in turn to a spot just beside the coccyx, UB-35. It then crosses gluteus maximus to the buttock crease at UB-36, slants outward down the back of the thigh to the outer side of the back of the knee, and joins the other line in the middle of the popliteal fossa. The outer line runs down the back level with the inner edge of the shoulder blade, 4 ACI from the midline, widening to 4½ ACI from the midline in the lumbar area, down to the level of sacral foramen four at UB-54. It turns outward into gluteus maximus to GB-30, behind the greater trochanter, and from there slants inward down the back of the thigh, meeting the inner line in the middle of the popliteal fossa at UB-40. Now a single surface channel, it passes over the back of the gastrocnemius to the lower edge of the muscle belly, shifts outward and then down to run behind the outer ankle bone, across the heel bone and along the fifth metatarsal's edge, ending at the nail point on the outer side of the little toe, UB-67, the exit point. From there it links with the Kidney meridian.

Kidney

The Kidney meridian has its origin deep on the underside of the little toe and runs internally until it surfaces at the entry point, KI-1, on the sole between the second and third metatarsals, just behind their heads. It then runs inward beneath the navicular bone, climbs over the inner ankle bone to where the posterior tibial artery runs, and from there loops downward in front of the Achilles tendon to the heel bone and the lower tip of the inner ankle bone. From there it climbs the back inner surface of the lower leg and on up the gastrocnemius to the inner edge of the popliteal fossa; an internal offshoot runs from KI-8 to SP-6 and comes back to the surface channel at KI-9. Above the knee it passes over the back inner thigh and the adductors to the groin, where it goes deep, joins the coccyx tip at DU-1, and rises up the spine to the gap between lumbar vertebrae two and three before entering the kidney. One branch goes from the kidney to the bladder; from the bladder it reaches the midline at REN-4, drops to REN-3 and then moves 1½ ACI outward, level with the pubic symphysis's upper edge, to KI-11. Here it surfaces again and climbs the abdomen beside the midline through the rectus abdominis. Once it reaches the chest at intercostal space five, it rises 2 ACI out from the midline to the exit point, KI-22, and finishes just under the collarbone at its final point, KI-27. A second internal branch rises from the kidney up the abdomen into the liver, passes through the diaphragm into the lungs, and then climbs through trachea and larynx up to the tongue's root. From the lungs a further offshoot links with the heart and runs to the midline of the chest level with the nipples, REN-17, where it joins the Circulation-Sex (Pericardium) meridian.

Circulation-Sex (Pericardium)

The Circulation-Sex meridian has its origin deep in the chest, inside the pericardium. It comes out at the midline level with the nipples, at REN-17, in the area of the Upper Heater, and runs down the midline, through the diaphragm and past REN-12 in the Middle Heater, to a spot just under the navel, REN-7, in the Lower Heater. Another branch goes outward from the pericardium and surfaces just outside the nipple, in intercostal space four, which is the entry point, PC-1. From there it curves over the chest muscles to the center of the front of the upper arm and runs down to the hollow on the inner side of the biceps tendon at the elbow crease. It continues along the front of the forearm between the palmaris longus and flexor carpi radialis tendons to the middle of the wrist crease, crosses the palm between metacarpals three and four, and runs along the middle finger's thumb side to the nail point on that side, its final point, PC-9. From the palm's center, at the exit point PC-8, an internal offshoot travels along the ring finger to the nail point on its outer (ulnar) side, where it links with the Three Heater meridian.

Three Heater

The Three Heater meridian starts on the surface at the nail point on the outer (ulnar) side of the ring finger. It follows the ring finger's outer side to the back of the hand, between metacarpals four and five, crosses the wrist, and climbs the back of the forearm between ulna and radius to the elbow. It carries on up the center of the triceps and the rear part of the deltoid to the hollow beneath the acromion, then bends inward over the back of the shoulder to SJ-15; from SJ-14 an internal offshoot goes to SI-12 and then links with SJ-15. At SJ-15 the channel goes deep, crosses the shoulder, meets the Gallbladder meridian at GB-21 and reaches the supraclavicular fossa at ST-12. Still deep, it runs down and inward through the Upper Heater to the midline at REN-17, linking with the pericardium, then passes through the diaphragm and descends the midline to the Middle Heater at REN-12 and on to the Lower Heater at REN-7. From REN-17 an internal branch climbs to the supraclavicular fossa at ST-12, goes back over the shoulder to the midline beneath the seventh cervical vertebra at DU-14, and returns to the shoulder, surfacing again just under SJ-16. It rises up the neck beside the sternocleidomastoid as far as the mastoid process, then follows the back edge of the ear along the hairline to SJ-20. There it goes deep once more, passes to the forehead bone crossing GB-5 and GB-4, travels across the forehead through GB-14 to the inner corner of the eye at UB-1, descends the nasolabial groove to the jaw and curves onto the cheek, finishing at the lower edge of the zygomatic arch, SI-18. Another branch leaves the surface channel at the mastoid process at SJ-17, goes into the ear canal and comes out on the surface in front of the tragus at SI-19. From there it rises upward and inward through SJ-21 to the exit point, SJ-22, and on to the outer end of the eyebrow, its final point SJ-23, where it links with the Gallbladder meridian.

Gallbladder

The Gallbladder meridian starts on the surface level with the eye's outer corner, at the entry point GB-1. It runs down and outward to a spot in front of the earlobe, climbs the temple up to the fronto-parietal fissure, curves down behind the ear onto the mastoid process, and after that comes forward again over the head to the brow ridge at GB-14. Turning back once more, it crosses the head to the occipital area and descends the back of the neck beside the trapezius's edge to the shoulder at GB-21. From GB-21 an internal branch crosses the back of the shoulder to the midline beneath the seventh cervical vertebra at DU-14, then goes outward and down to UB-11, and finally descends outward by way of SI-12 to the shoulder and into the supraclavicular fossa at ST-12, where the meridian surfaces again. On the head there are four internal offshoots. The first leaves GB-1, drops down the cheek to the jaw at ST-5, rises to the lower edge of the cheekbone at SI-18, comes down outward to the jaw's angle at ST-6, and runs down the side of the neck into the supraclavicular fossa at ST-12. The second leaves GB-7, at the top of the ear, and joins SJ-20, which lies just behind GB-7. The third leaves GB-14 on the forehead and runs down to the inner corner of the eye at UB-1. The fourth leaves GB-20, goes forward to SJ-17 on the mastoid process, then into the ear, coming out in front of it at SI-19. From the supraclavicular fossa two channels, one surface and one deep, run down the body. The surface channel descends outward to intercostal space four on the front axillary line at GB-22, moves forward by way of GB-23 to intercostal space seven in the nipple line at GB-24, then turns outward again to the twelfth rib's tip. It travels on to the ASIS (anterior superior iliac spine) and descends the outer hip to GB-29. There it goes deep, passing backward and inward down the sacrum by way of UB-31 and UB-33 to the coccyx tip at DU-1, and comes back to rejoin the surface channel in the hollow behind the greater trochanter at GB-30. The deep channel descends from the supraclavicular fossa through the chest, passes the surface channel at GB-24, goes through the diaphragm, links with LIV-13, and enters both liver and gallbladder. From there it drops to the pubic bone's upper edge at ST-30, turns outward through the pelvis and joins the surface channel in the hollow behind the greater trochanter at GB-30. The surface channel then runs down the outer edge of the thigh to the outer side of the knee, down the outer calf in front of the fibula, in front of the outer ankle bone and over the top of the foot between metatarsals four and five, ending at its final point, the nail point on the outer side of the fourth toe. An internal offshoot runs from the angle where metatarsals four and five meet, at the exit point GB-41, to the gap between the first and second metatarsals and on to the top of the big toe, and there it links with the Liver meridian at LIV-1.

Liver

The Liver meridian starts on the surface at the nail point on the outer side of the big toe. It crosses the top of the foot between metatarsals one and two and passes in front of the inner ankle bone, then climbs the inner surface of the lower leg behind the tibia, passing SP-6 at 4 ACI above the inner ankle bone. It crosses the inner side of the knee area to the inner thigh and follows adductor longus through LIV-10, LIV-11 and LIV-12. One internal offshoot climbs from LIV-11 through SP-12 and SP-13. Another runs inward from LIV-12, circles the genitals, rises up the midline of the lower abdomen to REN-2, REN-3 and REN-4, and then travels upward and outward to the eleventh rib's tip at LIV-13. The last stretch of the surface channel goes on to a point on the lower border of the ribcage in the nipple line, the exit point LIV-14. From LIV-13 an internal branch runs beside the stomach into the liver, links with the gallbladder and comes back to LIV-14. It then passes through the diaphragm, spreads out along the ribs, and climbs behind trachea, larynx and pharynx, reaching the nasal cavities and nasolacrimal canal. It links with the eye, then rises over the forehead, crosses from frontal to parietal bone on the crown, and ends at DU-20. From the eye an offshoot runs down to the jaw and rings the mouth on the inner side of the lips, within orbicularis oris. A further internal branch leaves the liver, goes through the diaphragm into the lungs, and there links with the Lung meridian at LU-1.

Lung

The Lung meridian has its origin deep in the area of the stomach, at REN-12. It drops down to circle the transverse colon at REN-9, then rises up the midline past the stomach and through the diaphragm, where it branches into every lobe of the lungs. Above the lungs it runs alongside the midline and climbs in paired branches, one on each side of the trachea, as high as the larynx. Each branch then comes down and outward to the collarbone's lower border and surfaces at a point outside the second rib, which is the entry point, LU-1. The surface channel curves over the front of the shoulder, runs down along the outer side of the biceps to the elbow crease, continues over the front of the forearm on its thumb side to the area of the pulse, crosses the wrist onto the thenar eminence, and follows the thumb's outer front edge to its final point, the nail point on the outer side, LU-11. Just above the radial styloid process an internal offshoot leaves from the exit point, LU-7, crosses to the back of the hand and runs between metacarpals one and two, where it links with the Large Intestine (Colon) meridian at LI-4.

Large Intestine (Colon)

The Colon meridian starts on the surface at the nail point on the thumb side of the index finger, LI-1. It runs along the back of the index finger on its outer side, passes through the angle formed by metacarpals one and two at the entry point, LI-4, goes through the anatomical snuffbox, and climbs the thumb edge of the forearm to the outer side of the elbow, just outside the humeral epicondyle. It then rises along the outer edge of the biceps to where the deltoid inserts; from this point, LI-14, a short internal offshoot reaches back to SJ-13. The main channel continues to the shoulder through the gap between the acromion and the collarbone to LI-16. From LI-16 an internal section crosses the trapezius to the midline at the seventh cervical vertebra's base, DU-14, and comes back forward across the shoulder into the supraclavicular fossa at ST-12, where the meridian splits. The internal branch goes down through the chest into the lungs, through the diaphragm, and on through the abdomen to link with the large intestine at ST-25. The surface branch runs inward to the neck's base at LI-17, climbs part of the sternocleidomastoid to the back part of the jaw, and from there goes to the upper jaw and upper lip. At the philtrum, DU-26, it crosses to the other side of the face to LI-19 and finishes at the lower edge of the wing of the nose, the exit point LI-20, from which it links with the Stomach meridian at ST-1. An internal offshoot leaves the channel in the upper jaw, passes through the lower jaw's gum and rings the mouth.

Stomach

The Stomach meridian has its origin deep near the wing of the nose at LI-20. It rises beside the nose to the middle of the nasal bridge, turns to the inner corner of the eye at UB-1, and then runs outward to the middle of the lower rim of the eye socket, where it surfaces at ST-1. On the surface it descends the cheek, lined up with the pupil, through ST-2, ST-3 and ST-4. From ST-3 an internal channel crosses to the philtrum at DU-26, follows the contour of the mouth through ST-4 to the lower lip's center at REN-24, and then rejoins the surface channel. The meridian then moves outward to ST-5 at the masseter near the angle of the jaw, climbs through ST-6 in front of the ear to ST-7, then to the temple hairline and up across the forehead bone past GB-3, GB-6, GB-5 and GB-4, and through ST-8 to the middle of the hairline above the forehead at DU-24. The first branch leaves at the jaw and carries the surface channel down beside the trachea to the inner end of the collarbone, then outward to the supraclavicular fossa at ST-12, where it splits into a surface and a deep channel. The surface channel descends the chest in the nipple line; at intercostal space five it shifts inward and runs down the abdomen beside the midline to the inguinal ligament at ST-30. The deep channel goes from ST-12 inward and downward through the chest, passes through the diaphragm and goes into the stomach on the midline at REN-13, and an offshoot from here links with the spleen. The deep channel goes on down the midline to REN-12, then runs downward and outward to meet the surface channel at ST-30. From here it is a single surface channel, descending the front of the thigh along the outer edge of rectus femoris, past the kneecap's outer border and down the tibia's outer edge. At 9 ACI below the kneecap it makes a detour upward and outward to ST-40, then goes on to the middle of the ankle joint, along the midline of the top of the foot between metatarsals two and three, and ends at its final point, ST-45, the nail point on the outer side of the second toe. One internal offshoot leaves at ST-36, 3 ACI below the kneecap, runs outside the surface channel and ends at the nail point on the outer side of the middle toe. Another leaves from the middle of the top of the foot at the exit point, ST-42, and goes to the nail point on the big toe's inner side, and there it links with the Spleen meridian at SP-1.

Spleen

The Spleen meridian starts on the surface at the nail point on the big toe's inner side. From there it runs along the inner edge of the foot, where the skin of the sole meets the skin of the top of the foot, to the first metatarsal's head, passes in front of the inner ankle bone, and climbs the inner lower leg to meet the Kidney and Liver meridians at SP-6, 4 ACI above the inner ankle bone. It goes on up the tibia's back edge to the gastrocnemius, past the inner side of the kneecap to vastus medialis, and on up to the groin area of the abdomen at SP-12 and SP-13. Here it goes deep and joins the midline at REN-3 and REN-4, then comes back outward and surfaces briefly as it climbs the abdomen in the nipple line through SP-14 and SP-15. Going deep again, it passes to the midline at REN-10, and from that point it enters spleen, pancreas and stomach. From REN-10 it returns to the nipple line at SP-16 and surfaces, climbs the chest past LIV-14 and GB-24, angles outward to SP-17, and rises on the surface to the second intercostal space. There it turns down and outward, to a spot on the mid-axillary line in intercostal space six, finishing at the exit point, SP-21. From SP-21 it goes deep, crosses the inside of the chest wall past LU-1, climbs the esophagus and spreads throughout the tongue; an internal offshoot also links SP-21 with HT-1. A further branch leaves REN-10, passes through the diaphragm into the heart, and links there with the Heart meridian.

Conception Vessel (Ren)

The Conception Vessel starts on the perineum at REN-1 and climbs the front midline of the abdomen, chest and neck, passing over the chin to the lower lip, finishing there at REN-24. From REN-24 paired internal branches curve around the mouth's corners to the gums and beneath the upper lip, and from the gums paired branches climb the cheeks up to the optic foramen, meeting ST-1 there. Another internal branch connects REN-24 with DU-1.

Governor Vessel (Du)

The Governor Vessel starts at the coccyx tip, DU-1, and an internal branch reaches from there to the perineum to meet REN-1. The main channel climbs the spinal midline up to the atlas, continues over the top of the head along the midline, and comes down over forehead and nose to the upper lip, finishing at the middle of the upper gum, DU-28. An internal branch runs down to the lower lip, meeting REN-24 and the Stomach meridian. At DU-12, in the hollow beneath the third thoracic vertebra, paired internal branches rise outward to UB-12 and then curve back inward to the hollow beneath the first thoracic vertebra, rejoining the main channel at DU-13. At DU-16, between atlas and occiput, a branch leaves the main channel and enters the brain, coming out again to rejoin it at the midpoint of the sagittal fissure, DU-20.

Causative Factor (CF)

The Causative Factor is the element whose imbalance lies at the root of a person's difficulties. It is the center of Five Element diagnosis and treatment.

How the CF is found

The CF is diagnosed by the traditional signs of color, sound, odor and emotion, together with a detailed case history and ongoing observation of the state of all five elements and twelve Officials. A Water point such as UB-66, for example, belongs only to someone diagnosed with a Water CF.

Treating on the CF

Apart from the points that can be used on any CF and the points needed to clear a specific block, the points of the twelve regular meridians are used only on the meridians of the patient's own CF element. When working with Windows of the Sky, do both Officials of the CF element.

Confirming the CF

The Associated Effect Points (AEPs) go directly to the Officials and reach their deepest reserves, so they help confirm the CF: on the wrong CF the patient may have an aggravation, while on the right CF you get results. Xi-Cleft points can also be used to test the CF.

The signs of each element

Fire: red color, laughing voice, scorched odor, joy. Earth: yellow color, singing voice, fragrant odor, sympathy. Metal: white color, weeping voice, rotten odor, grief. Water: blue-black color, groaning voice, putrid odor, fear. Wood: green color, shouting voice, rancid odor, anger.

The Spirit of the Points

Each point has a unique spirit, drawn from the meaning of its Chinese name and deepened by long clinical use, and placed in context by its Official, meridian, element, location and energetic role.

What a point's spirit is

A point's spirit comes from the meaning of its name and from generations of clinical experience. The name describes the spirit and is close to its essence, and each point is unique in what it offers. A spirit point gives about 70% of its effect to the spirit, 20% to the mind and 10% to the body; a Command point is the reverse, about 70% to the body, 20% to the mind and 10% to the spirit.

What the spirit is

Spirit is our essence and the quality of our lives, right to the end. If the spirit is well, whatever troubles we have won't be as intense, and we are able to be okay with changes. Spirit is the light within us, so that we feel the light instead of the weight of our karma, and it is the part of us that follows our guidance. It is the only part of us that deals with symbols rather than language; symbols speak to our dreams, and we dream in elements (houses, a stove with three burners, metal things).

Seeing the health of the spirit

We can see the health of the spirit by looking into someone's eyes: sparkling or dull, in or out of balance. When deciding which spirit points to do, listen deeply; the Officials will tell us how they are doing.

Spirit level and mental level illness

A person ill at the mental level doesn't take the illness personally; there is a shining light no matter how sick they are, and life's traumas don't leave deep wounds, rather like an elephant's skin. They move through difficulty, heartache and pain by analyzing it and taking a practical approach: 'My heart is broken; what am I going to do about it? Step a, step b, step c.' The scar heals and you hardly see it. They may still be deeply spiritual; they simply deal with things differently. When out of balance, though, things can become very difficult mentally, may not even make sense, and you might even think they are possessed. A person ill at the spirit level takes it personally: the events of life leave trauma that wounds the Heart and always leaves scars, and the wound affects how they move in life. They may reflect great health at times, particularly after great treatments, yet still ignore the signs of the spirit. Mental or spirit level illness strikes at the same moment, the first domino; the question is which direction it comes from.

Spirit and the skin

In traditional Chinese medicine, all skin problems are considered to be at the spirit level.

The spirit of the Kidney points

Kidney points are about resurrecting the spirit. Their spirit is mysterious, calming, soothing and reassuring; it carries will, strength, reserves and power, pulling up from the depths and from the ancestors with a down-and-up kind of energy, along with the cleansing quality of Water and how we use it.

The spirit of the Earth points

The emphasis of Earth points is nurturance, grounding, receptivity and fullness: receiving, abundance and a sense of satisfaction; the harvest of food, children and projects, producing what we want to be and to produce; and the feeling of being held and supported, knowing what would let us feel fully nurtured.

Point Names and What They Mean

Many point names fall into families. Knowing what a Gate, a Palace or a Window does helps us understand any point that carries that word.

Gates

Gates are all about opening and closing, and they need to swing both ways. In the Chinese empire it mattered greatly who opened and closed the gates: open for a good messenger, closed to the enemy. Our conditioning confuses us about whom to let in and whom to keep out, so it is important to know when to open and when to close. With the Outer Frontier Gate (SJ-5), love is let in; when it gets stuck, a person can't receive the love all around them. The Inner Frontier Gate (PC-6) opens appropriately, allows a person to take things in and connect with themselves, and restores balance in body, mind and spirit. Many more points would carry 'gate' in a full translation of their names.

Ditches and Gutters

These drain away. They sweep out the ditches and gutters where things sometimes get clogged, and get rid of what we don't need.

Valleys

Valleys are about walking between emotional states: they move a person through the valley, out of the cold, sharp wind, to the place they need to be. They may help soften the emotional place a person is in.

Heavenly points

These concern where the spirit resides. They are found high on the body and on the head and help connect the person with the Heavenly Father.

Windows

At the appropriate time, a Window lets us see what we need to see. There is one for each Official. A person usually needs to have been in treatment for a while; when someone can't see something clearly, we may need to open a window. Use them only on the CF and do both Officials of the element, and take care to do them at the right time.

Ducts

Ducts carry cables, wires and lines of communication, and so it is in us: upper, middle and lower. The Ducts on the Conception Vessel connect the three Jiao, so they help when the upper, middle and lower parts of the body need to communicate.

Palaces

A Palace takes a person to a palace for replenishment, to that place within themselves. A weary Fire CF can go to the Palace of Weariness (PC-8), where they can be loved and taken care of.

Ponds

A small resource of water, which in us is the life essence. A Pond gives access to the life essence, a small amount of the person's Qi.

Mounds

An accumulation.

Seas, Springs and Marshes

In China every source of water is a holy place, with a shrine beside it, and any store of water has great significance. A Sea is a great accumulation of Qi that can be tapped and drawn to wherever it is needed; a Marsh is a place of fertility and nourishment.

Spirit and Soul points

Points named for the spirit or soul, such as Spirit Burial Ground (KI-24), Spirit Storehouse (KI-25), Soul Door (UB-42), Spirit Hall (UB-44) and Spiritual Soul Gate (UB-47), speak directly to the spirit and are among the most powerful points we have.

Types of Points

Besides its name, each point has an energetic role on the meridian. These roles tell us how strongly and at what level a point acts.

Command points

The points from the elbows and knees down to the fingers and toes. They command the energy and move it in a particular way, strongly and holistically through the whole body. They include the Element points, Source points, Horary points and Junction points, as well as the Tonification and Sedation points. About 70% of their effect goes to the body, 20% to the mind and 10% to the spirit.

Element points

Each meridian has a point for each of the five elements. An Element point invigorates that element within the Official, for example Water within Fire. A Water point can add illumination and brightness, since Water's power is to emphasize; use it when a point or a person is dull, low or needs brightening.

Tonification and Sedation points

The Tonification point is the Element point of the mother element (for example the Wood point on a Fire meridian) and draws energy into the meridian along the Sheng cycle. The Sedation point is the Element point of the child element and moves energy on to the following element on the Sheng cycle.

Source points

There is one Source point for each of the twelve Officials. A Source point invigorates all the energy within the Official and is a more general and safer point to use; it is grounding and harmonizing, a well that brings up the energy within the meridian and the person. On the Yin meridians it is the third point in from the nail and is always the Earth point; on the Yang meridians it is the fourth point in from the nail and has no element of its own. Source points are often Gates and Pathways.

Horary points

The Horary point is the Element point of the meridian's own element (for example the Metal point on the Lung), and it is strongest during the Official's two-hour period on the Chinese clock. Horary points have two uses: needled in their own two-hour window they clear accumulated debris, so the true state of the Official and its pulse can be read before deciding how to treat (some practitioners do the Horary points in the first couple of treatments and then once a year); used for their spirit, they can be chosen at any hour.

Junction points

The Junction point connects the two Officials of an element. It opens the deficient meridian and shares energy with its sister or brother Official, like a gate opening and moving the energy along, because the siblings want to have equal energy. Always treat the Junction point on the deficient side.

Xi-Cleft points

Safe points, good for creating movement when someone is stuck; secondary Source points, places where the Qi swirls, gathers and circles like a river rather than simply flowing outward. Use them when you want more movement than a Source point gives, for an added boost, or to test the CF. They free up energy that has become stagnant.

Also called Accumulation points, they can build up both the quality and the volume of energy on their meridian, drawing on the reserve that has collected there to give a small stimulus. They lift a person and give them the perspective to see where they are heading. They also show whether Command points will be enough: if an Accumulation point brings change, Command point treatment may be enough; if not, the patient may need spirit points.

The pairs are HT-6 and SI-6, UB-63 and KI-5, PC-4 and SJ-7, GB-36 and LIV-6, LU-6 and LI-7, ST-34 and SP-8.

Entry and Exit points

These connect one meridian to the next in the order of the Chinese clock. Energy enters each meridian at its Entry point and leaves at its Exit point. In an entry-exit block, you treat the Exit point of the first meridian and the Entry point of the next.

Associated Effect Points (AEPs): inner Bladder line

The inner Bladder line points on the back give each Official immediate, direct and unrestricted access to the reservoir of energy stored by the Bladder. On the CF they go directly to the Officials and reach the deepest reserves, which is why they help confirm the CF. Use them when you want to touch the Official, shake it up or make strong contact with it, usually after the person has been treated for a while and only on the CF.

Outer Bladder line points

The outer Bladder line points (UB-42 to UB-52; in the old numbering 37 to 47, so the class notes and the national exam use different numbers for the same points) lie beside the AEPs, each opposite the AEP of an Official. They are used for the spirit of the points on any CF, both for their energy and for their names. A few of them, Soul Door (UB-42), Spirit Hall (UB-44), Spiritual Soul Gate (UB-47) and Ambition Room (UB-52), are among the most used spirit points of all.

In practice they are perhaps used more often than the Kidney chest points.

Upper Kidney chest points

KI-22 to KI-27 lie on the upper chest, close to the Lung and Heart and to the Earth points of the Stomach. They carry Water's willpower, continuing and moving forward without exhaustion, and they concern exposure: where we are and who we are. All of them give something extra, a spirit charge; they help the breath come in as a gift from Heaven, and since it is the Kidney's job to keep us moving and connected to our ancestors, they bring ancestral Qi into the person. They are calming and revive the spirit, which makes them good for insomnia and anxiety (especially KI-24), and they support both the spirit and the treatment. They can be used on any CF.

Spirit Seal, Spirit Burial Ground and Spirit Storehouse address the Shen, the Ling and the Shen in turn: Yang, Yin, Yang. Read as the lines of an I Ching trigram, two Yang lines holding a Yin line, they form Li, the trigram of Fire, lying on the Water meridian over the Heart in the upper burner, the region of Heaven. Together they speak to the spiritual alchemy between Water and Fire and to the most basic balance between the Yin and Yang of the Heart spirit, which life needs if it is to unfold spontaneously and well.

Windows of the Sky

Deep spirit points, like washing the windows of the soul so that wisdom can come in. They also remove blocks to the flow of Qi between the head and the body. Most lie on the neck, some on the upper arm. Commonly listed are LU-3, LI-18, ST-9, SI-16, SI-17, UB-10, PC-1, SJ-16, REN-22 and DU-16; the class notes and handouts also name others, such as LI-17, GB-9 and GB-16. See the guidelines on Windows of the Sky under Treatment Guidelines.

Reunion points

Points where meridians meet, used to bring the meridians together once the person is getting healthier and healthier: when the pulses are close together and of similar quality, all the Officials are close, and the person has been in treatment for a while. If the quality is not similar, don't use them. They harmonize the three Jiao, bring more power, and help the person move to the next level of their soul's development; with these points you are going deeper.

Ghost points

Thirteen classical points, among them PC-5, PC-7, PC-8, ST-6, LU-11, LI-11, SP-1, UB-62, REN-1, REN-24, DU-16, DU-23 and DU-26, were traditionally used for disturbances of the spirit, including possession by earthly spirits. Points with 'ghost' among their names are usually points that can restore the spirit.

Trauma points

HT-7 calms someone down after an accident or trauma, and can be used after a big treatment, such as the Dragons or a Ren–Du treatment, to anchor it, especially when the Dragons were chosen from the patient's history, to bring the spirit into the treatment. LU-7 brings back the rhythm of the breath when someone can't breathe after a trauma, or in hysteria. ST-36 stabilizes and centers; it is considered a second Source point on Earth.

The five transporting points as a stream of water

The transporting points picture the meridian's energy as water rising and growing. At the Well point the stream bubbles up from under the ground like a small, shallow fountain. At the Spring point it begins to flow freely, a little brook getting bigger. At the Stream point it pours into a still pool, swirling as it enters a lake that keeps filling. At the River point it runs on as a long stream heading somewhere, and the Qi grows fuller the further it travels from its source. At the Sea point it joins the sea of energy, the converging waters becoming deeper and broader.

Source, Associated Effect and Alarm points together

Source (Starting) points help the five Yin Organs and six Yang Organs do their work and keep the internal Officials regulated. The Associated Effect Points (AEPs), also called Back Shu or posterior points, are where each Organ's energy reaches the back; they all lie on the Bladder meridian, near the Organ they serve. The Alarm (Front Mu, Gathering) points are on the chest and abdomen, where the energy of the meridian and of its Organ gathers; they too sit near their Organ and help in diagnosing what is wrong with the inner Officials.

Which Points Can Be Used on Any CF

Most points belong only to the CF's own meridians, but some groups can be added to any treatment.

Points for any CF

The upper Kidney chest points (KI-22 to KI-27), the outer Bladder line points (UB-42 to UB-52), the points of the Ren and Du vessels, and HT-1 Utmost Source can be added to treatment whatever the patient's elemental CF. The class notes also include Windows of the Sky, though they are best done on the CF where possible, and the Kidney and Stomach points on the chest.

All other points

Every other point on the twelve regular meridians is kept for the meridians of the patient's own CF element; the one exception is a point needed to clear a specific energy block, such as an entry-exit block.

Exceptions in practice

Some points marked for one element may be used on any CF when that element's issues are present. Thought Dwelling (UB-49) can be used on any CF with Earth issues, and Ambition Room (UB-52) on any CF when Water is out of balance. Spirit Hall (UB-44) is kept for a Fire CF unless the Heart has taken a hit or there is a major crisis.

Points that reach beyond the CF

Besides the points already listed, DU-19 with DU-20 can be added on any CF. The Associated Effect Points can also be used on any CF (Secondary source).

The outer Bladder line is sometimes taken to run from Soul Door (UB-42) to Womb and Heart Diaphragm (UB-53), all of it usable on any CF for its spirit meaning (Secondary source). In the same way, the Kidney points KI-21 through KI-27 are open to every CF for their spirit meaning (Secondary source).

Points with a special bond to an Element or CF

Besides the points on its own meridians, each Causative Factor (CF) has other points with which it has a particular affinity.

Fire: REN-5, REN-7, REN-12, REN-14, REN-15 and REN-17, UB-15, UB-43, UB-44 and UB-51; KI-25 and KI-27 work well together for a Fire CF; DU-8 makes things solid and secure and gives strength. Water: REN-3, DU-4 and UB-52 (Secondary source). Wood: REN-2, DU-8, DU-20, UB-47 and UB-48. Metal: REN-12, REN-17, DU-1, DU-3, UB-42 and KI-24 (Secondary source). Earth: REN-3, REN-4, REN-10, REN-12, UB-49 and UB-50.

(The outer Bladder line numbers here have been converted to the numbering used on this site.)

Entry–Exit Blocks

Energy flows from one meridian to the next in the order of the Chinese clock, leaving each by its Exit point and entering the next by its Entry point. When the flow is obstructed at one of these junctions, energy backs up in the meridians before the block, which feel full on the pulses, while the meridians after it are left deficient, and treatment on the CF will not hold until the block is cleared. People tend to get the same entry-exit blocks again, and a block may or may not be related to their CF. To clear one, treat the Exit point of the meridian before the block and then the Entry point of the meridian after it.

The Entry and Exit points

Lung: entry LU-1, exit LU-7. Large Intestine: entry LI-4, exit LI-20. Stomach: entry ST-1, exit ST-42. Spleen: entry SP-1, exit SP-21. Heart: entry HT-1, exit HT-9. Small Intestine: entry SI-1, exit SI-19. Bladder: entry UB-1, exit UB-67. Kidney: entry KI-1, exit KI-22. Heart Protector: entry PC-1, exit PC-8. Three Heater: entry SJ-1, exit SJ-22. Gallbladder: entry GB-1, exit GB-41. Liver: entry LIV-1, exit LIV-14, which flows back into LU-1.

People tend to develop the same Entry–Exit blocks again and again, and whether a block relates to their CF varies from person to person.

Spleen to Heart (SP-21 to HT-1)

These people long to be cared for, yet find it hard to let anything into their Heart. There may be a lot of crying, losing emotional control and obsession, and the practitioner may feel a strong urge to take care of them: they pull at the heartstrings. HT-1 Utmost Source links us with the Heart of the Universe; here the person is spinning out of control, has lost touch with the universe's love, and nothing gets in. You can see it in whether nourishment is allowed all the way down into the Heart. A weak, unyielding Heart is overpowered by the compulsion of the Spleen, and no amount of nourishment satisfies it; eating disorders may be the Heart crying out for love. There may be bulimia, anorexia, oral compulsions or insomnia. An unbalanced relationship with the mother in the formative years often contributes to this block. HT-1 is the point used when the spirit is cut off from the Heart and the person can't feel their own Heart.

A troubled relationship with intimacy can affect the part of the self that receives nourishment.

Small Intestine to Bladder (SI-19 to UB-1)

Fear makes it hard for the person to let themselves hear what their own Heart, or anyone else's, is saying. They can't accept life as it happens from moment to moment and keep refusing what is actually in front of them, so their hearing and seeing may be affected; they may seem completely unable to hear what you say, and often feel unheard and misunderstood themselves. Physically there may be jaw (TMJ) problems, tinnitus, ear infections, dizziness, and bladder or urinary problems. SI-19 Listening Palace, as the Exit point, naturally connects to the Bladder, and after sorting things out, UB-1 Eyes Bright lets a person see clearly and take in all that the Universe offers.

Kidney to Heart Protector (KI-22 to PC-1)

The person can't look others in the eye: extreme shyness, terror of letting anyone see them, as though badly burned in a relationship and now living behind a wall. It may worsen whenever intimacy threatens. The fear of intimacy can keep putting out the Heart's fire, so the person seems emotionally cold and joyless; or the perceived threat can make the Heart Protector's fire blaze out of control, with tendencies to mania and hypersexuality. Symptoms may include palpitations, chest pain, breast problems, anxiety, insomnia and depression. KI-22 is the Kidney's Exit point and passes into the Heart Protector, so there is a big connection between this point and Fire: Water is the pilot light, and without it there is no Fire.

Three Heater to Gallbladder (SJ-22 to GB-1)

Uptight, judgmental and bitter, with no warmth to soften the judgment; there is frustration because compassion is not getting in. The Gallbladder empowers vision, and the Three Heater is the thermostat to the inner and outer world, the outer frontier. When this block is present, stagnation and the loss of clear vision undermine the Three Heater, and the person, working from incomplete information, projects judgment onto themselves and the world, which tends to turn into anger, bitterness and resentment. Symptoms include migraines, jaw problems, cataracts, and teeth grinding or jaw clenching.

Liver to Lung (LIV-14 to LU-1)

A hard block, from Wood to Metal. Wood is jammed and frustrated and clings to its anger and resentment, and Metal is not controlling Wood (even if you give Metal energy, it still won't). The person feels terrible about themselves, carries unresolved anger, and cannot reach the loss that lies underneath a chronically frustrating situation or let go of the grief; there is often a longing or emptiness deeper than the frustration. Clearing it can remove the stagnation of repressed anger and free the Lung to grieve and process tender feelings, so that the loss, for example of a relationship, can be worked through. When the diaphragm position on the pulse feels puffed up, it can point to stagnant Qi, heat or both, as when tender feelings are pushed down while anger rises, as often happens in a divorce. Physically there may be tender breasts, sighing, gas pains and breathlessness.

The stagnation it leaves sits in the upper and middle burners.

Large Intestine to Stomach (LI-20 to ST-1)

There has been a loss that hasn't been grieved, and emotional material that was never digested is being held on to: tears not yet cried (ST-1 is Receive Tears). The task is to release the old and open to the new; when this is stuck, the person isn't letting anything in, there is sadness beneath, and they want nourishment but can't yet receive it. Its hallmark is being unable to let go of undigested parts of the past and being unable to cry. Physically there may be chronic sinusitis, nasal polyps, facial rashes, allergies, and a wide range of eye or digestive symptoms.

Ren–Du (Conception Vessel–Governor Vessel) block

The two great vessels meet at the mouth, and a block between them is cleared through REN-24 and DU-28, the last point on the Du vessel. The person is not present in life and can't function well in it, and needs an extra push. If you suspect a Ren–Du block, REN-4 First Gate with DU-4 Gate of Life can be done beforehand, and if someone is like that in life but the block isn't there, try REN-4 with DU-4 before doing a Ren–Du treatment. They can also be done afterward to support the treatment, stabilizing, allowing movement and bringing the person down to earth. A Ren–Du block can also be treated together with an upper Kidney point and HT-1. HT-7 can anchor the treatment afterward.

Blocks within an element

Blocks can also occur between the two Officials of one element: LU-7 to LI-4, ST-42 to SP-1, HT-9 to SI-1, UB-67 to KI-1, PC-8 to SJ-1 and GB-41 to LIV-1. They are cleared the same way, with the Exit point first and then the Entry point.

Spiritual Afflictions

Much of Five Element work concerns conditions of the spirit itself. Each is described below: what it looks like, and the Five Element approach and points the teachings give for it. These conditions often need to be addressed before the Officials can respond to treatment on the CF.

Possession

A person may feel, or seem, as though something has taken them over. They may look out of vacant eyes with 'no one at home', say they are not themselves, behave in ways that make no sense, or simply fail to respond to treatment that should be working. Mental-level imbalance can look so strange that you might think the person is possessed. In the Worsley tradition possession is cleared before any other treatment, with the Seven Dragons: the Internal Dragons when the possession has arisen from within, and the External Dragons when it has come from outside. Points: ST-25, ST-32, ST-41, DU-20, UB-11, UB-23, UB-61

Internal possession

The possession arises from within, often from overwhelming emotion, trauma or long-held inner turmoil that has taken the person over. It is treated with the Seven Internal Dragons: a point just below the tip of the sternum (the Master point), then ST-25, ST-32 and ST-41 on both sides. When it releases, you may feel it go from head to toe, a sense of movement through the whole meridian. Points: ST-25, ST-32, ST-41

External possession

The possession comes from outside the person. It is treated with the Seven External Dragons: DU-20, then UB-11, UB-23 and UB-61 on both sides. UB-61 Servant's Aide also helps with sciatica and back pain. Points: DU-20, UB-11, UB-23, UB-61

Earthly spirits and after a possession treatment

The classical texts describe earthly spirits that have not yet moved on toward heaven and can become malevolent; a patient troubled by them may feel possessed. PC-5 The Intermediary, one of the classical Ghost points, is very calming; it settles and cleanses a possessed spirit and turns chaos into peace, easing fears, panics, phobias and terrors; it can be used after possession treatments. HT-7 Spirit Gate is also used after a possession treatment, to bring the person back into who they are as a spirit. Do not use KI-23 Spirit Seal straight after a possession treatment; it would be far too soon. Points: PC-5, HT-7, KI-23

Buried spirit (spiritual death)

When life has weighed on someone so heavily, or hurt them so badly, that they have all but given up, the spirit lies buried where we cannot reach it. Some become loud and uncontrolled, others silent and resigned; they can move, talk and reason, and determination may even make them seem fine, but there is no core and no spark, an empty shell going through the motions. A person can go on existing without spirit, but that is not living. KI-24 Spirit Burial Ground stands in a class by itself here: it breaks open the ground where the spirit lies and brings it back to life. We have to unbury the spirit before we can treat it, and we must support the person afterward or they go right back into the grave. If KI-24 or REN-1 has had no effect, UB-42 Soul Door can open the eyes of a patient who has given up; UB-47 Spiritual Soul Gate follows after these. KI-22 Walking on the Veranda helps a person who has been resurrected take the first step back among people. Points: KI-24, REN-1, UB-42, UB-47, KI-22

Loss of connection to the Source

When shock or trauma breaks through the Heart's defenses, the bond with the source of love, both inside and outside us, can be torn. The person feels lonely and cut off, without inspiration, afraid and hollow, unable to love, without compassion, warmth or joy; the other Officials become unruly and panic stricken; or the person stands at the edge of the grave, and it looks inviting. The Heart is cut off, or their heart just isn't in it anymore. HT-1 Utmost Source reconnects the person with the Source, a hotline to God, the Emperor; it revitalizes and resurrects, but the person has to be ready. It is also used in the Spleen–Heart block, when the spirit is cut off from the Heart. HT-4 Spirit Path guides a person who has lost their way back to the path. Points: HT-1, SP-21, HT-4

Shock and trauma closing the gates

A shock, physical or emotional, can slam shut the gates of the spirit and leave a person in perpetual darkness, unable to take in inspiration or spiritual nourishment however much of it surrounds them. HT-7 Spirit Gate restores the free opening and closing of the gate and brings the person back into who they are as a spirit; it calms after an accident or trauma. UB-42 Soul Door is for those shut off after something unbearable. LU-7 brings back the breath after trauma, ST-36 stabilizes, and DU-12 Body Pillar is for trauma that has weakened the inner pillar and left a person fragile and unable to carry on. HT-7 is very safe and can be used on any CF for a broken heart, anxiety, insomnia, shock, or any strain on the Heart. Points: HT-7, UB-42, LU-7, ST-36, DU-12

Spirit locked in or locked out

When the spirit is shut out of its home, or the gate is jammed open, it can never settle; the person is always restless, unsteady and uneasy, or very talkative and out of control, high spirited but with nothing to say. When the spirit is shut in, the person can't reach the love, joy, inspiration and fun inside them, and hungering for contact with the spirit may drive them to destructive substitutes such as drugs, alcohol, overeating and promiscuity. HT-7 Spirit Gate restores a gate that opens and closes properly. Points: HT-7

The homeless spirit

The spirit is unsettled and out of control and cannot find its way back home; it seems to cry out for direction. The Emperor has been jarred and displaced, and chaos spreads through the kingdom. Sometimes the spirit is present within but cannot express itself outwardly. UB-44 Spirit Hall gives the spirit a home where it can live in peace, security and warmth, and restores order; a person whose spirit is at home is at home wherever they are. Points: UB-44

Spirit depletion

Daily demands and occasional traumatic events can drain the spirit's tank. Each Official runs on spirit; with too little, its work loses its joy, the smallest job feels like too much, and the person meets life with apathy, resistance or stubbornness. The person may improve physically yet still not feel better in themselves. REN-8 Spirit Deficiency, moxa only on salt in the navel (from 3 to 30 cones, depending on the degree of deficiency), fills the tank; with high blood pressure or a protruding navel use REN-14 Great Deficiency instead. When the spirit is alive but undernourished, KI-25 Spirit Storehouse fills the reserves before it becomes buried. The upper Kidney points all give an extra spirit charge. Points: REN-8, REN-14, KI-25, KI-22, KI-23, KI-24, KI-26, KI-27

Heartbreak

The Heart is broken: a partner has died or left, there has been a divorce or a death, and the person can't go on; there's no sparkle left, only a palpable joylessness. Heartbreak treatments include REN-15 Dove Tail; REN-14 Great Deficiency with UB-44 Spirit Hall; REN-8 Spirit Deficiency; and REN-8 with REN-14. REN-15 is closer to the Heart Protector, when the hurt comes from loss or deception; REN-14 reaches the Heart itself, when things have been so painful that the person begins to withdraw from their Heart. Points: REN-15, REN-14, UB-44, REN-8

Grief that won't move

Grief can be held in the chest and never come down; there may be uncried tears, an inability to cry, and undigested loss. Sadness and grief may affect the Lungs, and some people cannot function at all. UB-42 Soul Door is a great point for deep grief. The Large Intestine–Stomach block holds unmourned loss, and the Liver–Lung block holds anger that keeps the person from grieving. KI-21 Dark Gate, done first, with KI-20 Through the Valley, is a combination for grief. Points: UB-42, LI-20, ST-1, LIV-14, LU-1, KI-21, KI-20

Despair and darkness

The person lives in the dark: no joy, unable to see that there is light or to come out, having given up hope, perhaps feeling suicidal. A person cannot thrive in the sun alone, and part of healing may mean going into the darkness. KI-21 Dark Gate works either way: it takes a person into the darkness they are avoiding, or brings light into the darkness they live in. UB-47 Spiritual Soul Gate is for hopelessness and depression, DU-20 One Hundred Meetings is for deep depression, and DU points can be combined (DU-20 with DU-19) for deep depression. Points: KI-21, UB-47, DU-20, DU-19

Broken will

The will is broken: the person says they no longer have the spirit for things. In people who have been ill for a long time the spirit is worn down and a wall stands between them and life; they are no longer light of heart, and the spirit needs reawakening. There may be futility, speechlessness and no laughter, with the senses paralyzed. HT-7 Spirit Gate and HT-4 Spirit Path both address this, and UB-52 Ambition Room powerfully lifts the spirit of the will for someone with no drive and nothing to aim at. Points: HT-7, HT-4, UB-52

Fragmentation and loss of identity

The person cannot see or feel who they really are; the self is in fragments. Water CFs in particular can feel disconnected and disempowered. KI-23 Spirit Seal brings the fragments together and gives the spirit its seal of approval, and DU-20 One Hundred Meetings pulls everything together when a person is fragmented and scattered. Points: KI-23, DU-20

A spirit stuck in old patterns

Even with the right CF, the Officials can dig in, turn stubborn and refuse their duties, until nothing in the kingdom moves. DU-14 Great Hammer wakes them up and breaks old patterns, but only when the person is truly ready. UB-47 Spiritual Soul Gate is used for stuckness of spirit. Points: DU-14, UB-47

Restless spirit and insomnia

When the spirit is restless, sleep is disturbed. When we sleep we are in our most trusting space, so insomnia can reflect issues with trust. HT-7 Spirit Gate strengthens the spirit, and the upper Kidney points, especially KI-24, calm and revive it. Points: HT-7, KI-24, KI-25

Shut behind a wall

The person stays out of sight, terrified of being seen, like someone who was badly hurt in love; or they have been afraid and cold for so long that they have contracted and can't even tell you who they are. The Kidney–Heart Protector block is the classic picture. UB-60 Kunlun Mountain warms all of that up, for like Water, Fire can be very purifying; KI-22 Walking on the Veranda helps the person feel they can be in the world with their Heart again. Points: KI-22, PC-1, UB-60

Seeing what was buried

Something pushed deep down may need to be seen at the right point in healing. Windows of the Sky can bring buried memories, dreams or trauma to the surface; what the person sees may be traumatic, or beautiful and deeply healing. The patient must be ready and strong enough, and the right support is critical. Points: LU-3, LI-18, ST-9, SI-16, SI-17, UB-10, PC-1, SJ-16, REN-22, DU-16

The Ren and Du Vessels

The Conception Vessel (Ren) and Governor Vessel (Du) are the first two of the eight Extraordinary Meridians. Their points can be used on any CF.

Vessels, not meridians

Ren and Du are vessels rather than meridians, more powerful and dynamic than what the meridians hold. They are the oceans that hold the vital Qi and feed the other meridians, which are the streams. Ren is nourishment and who we are in life, where everything begins: the Yin energy. Du moves us forward in life: the Yang energy. Many times it is good to combine the two. In treatment they used to be added only after the Command points; now they are used more often. In health there should be a continuum between them, and their Entry and Exit points matter greatly: clearing the Entry–Exit between Ren and Du rejuvenates all the Officials.

Between Earth and Heaven

The Conception Vessel connects us to the earth and the cosmos at the same time, our raw connection with the different elements of the universe: picture a person grounded on the earth and reaching toward heaven. In meditation we can work with its points: REN-2 Crooked Bone, REN-4 First Gate, REN-8 Spirit Deficiency, REN-12 Middle Duct (the Alarm point of the Stomach and a meeting point for many meridians), REN-17 Within the Breast, REN-22 and the throat center, and REN-24 Receiving Fluid. Keep in mind the vertical quality of the Conception Vessel.

Yin and Yang

Yin and Yang are the dynamism of expansion and contraction, rest and action, dark and light, present in everything and every moment, cycling through the day and the seasons. Ren and Du form a continuum like Yin and Yang, with orbits within orbits and endless interconnections; REN-4, for example, starts something that moves something else. Keep watching how they flow. As you come to know your patients you will see whether they are Yin or Yang deficient, and you can balance Yin and Yang through Ren and Du.

Three reasons to use Ren points

For the spirit of the points; as Reunion points; and to bring harmony and balance between Yin and Yang.

The main clinical points

REN-3, REN-4, REN-6, REN-8, REN-12, REN-14 and REN-15 are the Ren points used most in clinic. They are deeply transformative and healing, and spiritual openings occur in the Heart through them.

Pairs of Ren and Du points

REN-1 Meeting of Yin with DU-1 Long Strength joins extreme Yin and extreme Yang. REN-4 First Gate with DU-4 Gate of Life is used around a Ren–Du block, before or after it, and for the person who is not present in life and needs an extra push. DU-20 with DU-19 is a combination for deep depression.

Caution with Du and moxa

If a person is manic, don't use moxa on the Governor Vessel; it adds too much energy.

Using the Conception Vessel

The Conception Vessel flows up the front midline and nourishes the Yin aspect. When it is deficient a person is restless, agitated, always on the go and driven, unable to settle into peace; if someone is very wobbly inside and has collapsed internally, support their Yin with Conception Vessel points.

Many Conception Vessel points are meeting points of several meridians, so they act on several at once and give less precision and control than channel points. Use them only when indicated: used early, a patient may improve without your knowing why or where to go next, and forcing balance between two badly imbalanced Officials before the groundwork is done can cause confusion and undo the benefits of earlier treatments.

Using the Governor Vessel

The Governor Vessel flows up the midline of the back and has everything to do with the brain, the skull and the spinal cord. Its main work is strength: directing, guiding and supporting the Yang aspect. When it is deficient a person struggles to act and express themselves; there may be weakness, cold, fatigue and holding back. Someone can be solid in their Yin yet unable to act in their Yang, collapsing under heavy stress, and it is their Yang that needs support.

Don't use Governor Vessel points on their own for low back ache, and if there is a lack with real pain, supply the lack from the Conception Vessel first. Once the Command points have supported the Officials, Governor Vessel points with moxa can bring strength and warmth to a sacrum that is still cold, and the Command points will then work better.

Choosing between Ren and Du points

If you are unsure which vessel a patient needs, ask whether DU-12 Body Pillar would serve them better, for support and strength from behind, or REN-8 Spirit Deficiency, for support from the middle. Then look at the body's structure: where is the vitality, which part has gone short because energy has piled up elsewhere, which part stands out, and is the imbalance one of excess or of absence?

Treatment Guidelines

These are the practical principles for planning and giving treatment in the Worsley tradition.

Clear the obstacles first

Before treatment on the CF can take hold, anything that stands in the way of it is cleared: possession (with the Dragons), Aggressive Energy (with the AE drain), entry-exit blocks and the Ren–Du block, and a Husband–Wife imbalance. Only then is the CF treated.

Build up the Officials first

When doing spirit points, build up the Officials first: do the AEPs and strengthen the Officials, then do the spirit points. A spirit point given to Officials with nothing in reserve has little to work with.

Things to consider when choosing a point

Its location: which organs and Officials lie in that area. Its geography: what lies in relationship to it. Its name and its spirit. Its element and Official, and what that element and Official do. The direction of the meridian, up or down, and its Yin or Yang nature, including Ren and Du. Where the point is physically: for someone in a 'hard place', hard-to-reach points can be good. The location of the other elements. Above all, it is important to see what the patient really needs.

Shift or hold?

Ask whether the person needs an energetic shift, to move, or needs to be held and embraced. Get a sense of the spirit of the points and use them when you feel that energy before you, letting yourself stay open to the spirit of the points.

Plan ahead

Keep a list of future points for treatment planning. Think about the person and what their soul needs at every level.

Horary points in the treatment plan

Horary points can be used as diagnostic tools: give them in the first couple of treatments, or once a year.

Windows of the Sky: use with care

These are very powerful points, not to be taken lightly. The patient may suddenly see the beauty of the world, the birds and the sky, after living in a cave inside themselves; but all the light arriving at once can be shocking. Buried memories or hidden trauma may come up, and the person may have to go through it; what they see might be difficult, traumatic or beautiful, and it can unfold in dreams or in life. Done at the wrong time, a Window can set a person back by several months. Let the patient tell you, at some level, that there is something they need to see; make sure they are ready and strong enough to face it, give the right support, and do the Windows on the CF wherever possible. Done well, they can be awakening, letting the person see something from the past clearly because now they are ready.

Junction and Reunion points

Always treat the Junction point on the deficient side. Keep Reunion points for later in treatment, when the pulses are close together and of similar quality.

Order and timing of the spirit points

Some spirit points prepare the way for others. KI-24 Spirit Burial Ground or REN-1 comes first when the spirit is buried; if they have had no effect, UB-42 Soul Door; and UB-47 Spiritual Soul Gate after these, because used too soon it can open up too much. After KI-24 the person must be supported, or they will go back into the grave. HT-1 and DU-14 are used only when the person is ready.

Anchor a big treatment

HT-7 Spirit Gate can be used after a big treatment, such as the Dragons or a Ren–Du treatment, to anchor it and bring spirit into it.

When to retain the needles

When doing combinations of points, leave the needles in. Retain them too when a person is in their head rather than their body, or for anxiety and thinking too much.

Moxa

Moxa warms and tonifies and works beautifully on many spirit points, but avoid it where there are heat signs or high blood pressure, and on the Governor Vessel in a manic person. REN-8 is moxa only, on salt in the navel. Some points are forbidden to needle and are only moxaed, such as HT-2 Blue Green Spirit.

First aid

HT-1 is a first aid point for drowning, whether the body or the spirit is drowning, and for heart attack. HT-7 calms after an accident or trauma, LU-7 restores the breath, and ST-36 stabilizes. UB-17 is the emergency point for hiccups.

Treating an active cold

When a person has an active cold, the Metal and Earth pulses are usually high, because the protective Qi is fighting the cold. Sedate LU-7 and LI-4 and leave the needles in for 20 minutes; add LI-11 if the person is hot.

Order of priorities in a treatment plan

A common order of priorities: clear possession first; then Aggressive Energy; then a Husband–Wife imbalance; then Entry–Exit blocks, with a Ren–Du block taking precedence; then spirit-level blocks (such as KI-24, HT-1 or REN-1); then the umbilical pulse and Akabane imbalances.

After that, engage the level the patient needs with points on the CF for mind and spirit, the outer Bladder line and Kidney chest points, Windows of the Sky, or Governor and Conception Vessel points; then transfers; and usually finish on Command points, or occasionally a different point below elbow or knee, which can also engage the level.

The practitioner's attention while needling

A classical text advises that while needling, the practitioner should think of nothing else: concentrating as if alone in a quiet, secluded room with the doors and windows shut, hearing no noise from outside and undistracted by passing thoughts, attending only to the needle.

Five Element Terms

A glossary of the Five Element terms used throughout this section, in alphabetical order.

AE drain

The treatment that clears Aggressive Energy. Needles are placed shallowly in the inner Bladder line AEPs of the Yin Officials (UB-13 Lung, UB-14 Heart Protector, UB-15 Heart, UB-18 Liver, UB-20 Spleen, UB-23 Kidney), with control needles nearby. Redness spreading around a needle shows AE in that Official, and the needles stay in until the redness fades.

Aggressive Energy (AE)

Polluted, harmful energy that has crossed from one Official to another along the Ko (control) cycle, so that it damages rather than nourishes. Present AE would undermine any treatment, so it is checked for and drained early in treatment.

Akabane test

A test of heat sensitivity at the Well points of the fingers and toes, made by passing a lit incense stick over each point and counting until the patient feels the heat. A marked difference between the left and right sides of a meridian shows an imbalance in that meridian.

Alarm points

Points on the front of the trunk (also called Front Mu points), each closely linked with one Official; for example REN-14 for the Heart and REN-15 for the Heart Protector.

Ancestral Qi

The Qi we inherit and draw from our ancestors. The upper Kidney chest points bring ancestral Qi into the person and help the breath come in as a gift from Heaven.

Associated Effect Points (AEPs)

Points on the inner Bladder line of the back, one for each Official, that give that Official immediate, direct and unrestricted access to the energy reserves stored by the Bladder. On the CF they reach the Officials' deepest reserves and help confirm the diagnosis.

Blocks

Obstructions to the free flow of energy that stop treatment from holding until they are cleared. The main kinds are entry-exit blocks, the Ren–Du block, Aggressive Energy, Husband–Wife imbalance and possession.

Body, Mind and Spirit

The three levels of a human being, which are one word in Chinese and cannot be separated while we live. Every point affects all three levels, in different proportions.

Buried spirit

A spirit so burdened or traumatized that it has gone under and can't be reached: the person goes through the motions with no spark. KI-24 Spirit Burial Ground is the classic point for it.

Causative Factor (CF)

The element whose imbalance is the root of a person's difficulties. It is diagnosed by color, sound, odor and emotion, and treatment is centered on its Officials.

Chinese clock

The twenty-four-hour cycle in which each Official has a two-hour period of peak energy: Lung 3–5 am, Large Intestine 5–7 am, Stomach 7–9 am, Spleen 9–11 am, Heart 11 am–1 pm, Small Intestine 1–3 pm, Bladder 3–5 pm, Kidney 5–7 pm, Heart Protector 7–9 pm, Three Heater 9–11 pm, Gallbladder 11 pm–1 am, Liver 1–3 am.

Color, Sound, Odor, Emotion (CSOE)

The four traditional diagnostic signs used to find the CF: the color seen on the face, the sound of the voice, the odor of the body, and the emotion that is out of balance.

Command points

The points from the elbows and knees down, which command and move the energy strongly through the whole person: Element, Tonification, Sedation, Source, Horary and Junction points. They act mostly on the body (about 70%).

Conception Vessel (Ren)

The Extraordinary vessel running up the front midline, the Sea of Yin: receptivity, nourishment and substance, where everything begins. Its points can be used on any CF.

Controller of Water (Kidney)

The Kidney Official, the storehouse of Jing: the source of Yin and Yang, of will, resilience and motivation, and of growth, development and reproduction.

Dragons, Internal and External

The Worsley treatments for possession. The Seven Internal Dragons are a point just below the tip of the sternum (the Master point), then ST-25, ST-32 and ST-41 on both sides; the Seven External Dragons are DU-20, then UB-11, UB-23 and UB-61 on both sides.

Drainer of Dregs (Large Intestine)

The Large Intestine Official, which lets go of what is no longer needed and allows unfinished business its closure.

Earth

The element of late summer, harvest and nourishment, with the Stomach and Spleen as its Officials. Its color is yellow, its sound singing, its odor fragrant and its emotion sympathy.

Element points

The five points on every meridian that correspond to the five elements; each invigorates that element within the Official.

Entry and Exit points

The points where energy enters a meridian and leaves it for the next meridian in the order of the Chinese clock.

Entry–Exit block

An obstruction where energy should pass from one meridian's Exit point to the next meridian's Entry point. Energy backs up before the block and is deficient after it; it is cleared by treating the Exit point and then the Entry point.

Extraordinary Meridians

Eight vessels that hold reserves of Qi like oceans feeding the regular meridians. The Conception and Governor Vessels are the first two.

Fire

The element of summer, maturity, warmth and joy, with four Officials: the Heart, Small Intestine, Heart Protector and Three Heater. Its color is red, its sound laughing, its odor scorched and its emotion joy.

Ghost points

Thirteen classical points traditionally used for severe disturbances of the spirit, including possession by earthly spirits.

Governor Vessel (Du)

The Extraordinary vessel running up the spine, the support of Yang: strength, direction and the ability to stand on one's own feet and act in the world. Its points can be used on any CF.

Heart Protector (Circulation-Sex)

The Fire Official that protects and buffers the Heart, circulates joy and the emotions, and governs intimacy and connection.

Horary points

On each meridian, the Element point of the meridian's own element. Needled in its two-hour period on the Chinese clock it clears the Official so that its true state can be read; for its spirit it can be used at any time.

Hun

The ethereal, spiritual soul housed by the Liver, linked with intuition, imagination, vision and a higher consciousness: a Yang movement toward the heavens.

Husband–Wife imbalance

A serious imbalance in which the pulses of the left wrist (the Husband side) are markedly weaker than those of the right (the Wife side), a sign that the person's life force is giving way. It is treated before the CF; in the class notes the sequence begins with UB-67 and includes KI-7, the Metal Tonification points of Water.

Jing

Essence, stored in the Kidneys: the inherited foundation of growth, development, reproduction and vitality.

Junction points

Points that connect the two Officials of an element, letting energy pass from the fuller sibling to the deficient one. Treat the Junction point on the deficient side.

Ko cycle

The control cycle of the elements, which keeps each one in check: Fire controls Metal, Metal controls Wood, Wood controls Earth, Earth controls Water, and Water controls Fire. Aggressive Energy travels along this cycle.

Law of Midday–Midnight

On the Chinese clock, each Official is opposite another twelve hours away; when one is at its peak, its partner is at its lowest. Energy can be drawn from an Official to its opposite, which is used both in diagnosis and in timing treatment.

Law of Mother–Child

Along the Sheng cycle each element is the mother of the next and feeds it. A deficient child can be strengthened by tonifying its mother, and a weak mother will in turn leave the child undernourished.

Ling

The Yin aspect of the spirit: being quiet enough to hear the Heart's insight, so that Heaven can descend into the Heart. KI-24 connects a person with their Ling.

Mental level

A way of being ill in which a person processes life's trauma through the mind and does not take illness personally. Fewer than one in twenty patients are ill mainly at this level.

Metal

The element of autumn, letting go and the gathering of value, with the Lung and Large Intestine as its Officials. Its color is white, its sound weeping, its odor rotten and its emotion grief.

Moxa cones

Small cones of dried mugwort placed on a point and lit, then removed as soon as the patient feels the heat. They warm and tonify; the number of cones is set for each point, and moxa is avoided with heat signs, high blood pressure, or on the Governor Vessel in a manic person.

Official of Balance and Harmony (Three Heater)

The Fire Official that spreads warmth and joy outward, regulates the temperature of the three Jiao and the waterways, and attunes us to our environment.

Official of Decision and Judgment (Gallbladder)

The Wood Official of vision, strategy, wise judgment and effective action.

Official of Planning (Liver)

The Wood Official, the general and planner, who brings the smooth flow of Qi, organizes, gives direction and houses the Hun.

Official of Rotting and Ripening (Stomach)

The Earth Official that receives food, holds the grain, and rots and ripens it so it can become Qi, Blood and flesh, and that raises our appetite for life.

Official of Storage of Water (Bladder)

The Water Official that holds the reservoir of energy, paces us, sets limits and supplies every Official through the AEPs.

Official of Transportation and Distribution (Spleen)

The Earth Official that turns nourishment into energy and distributes it through body, mind and spirit, and that holds things up and in.

Officials

The twelve functions of body, mind and spirit, pictured as ministers of an imperial court ruled by the Heart: two for each element, and four for Fire.

Outer Bladder line points

Points on the outer Bladder line of the back (UB-42 to UB-52; old numbering 37 to 47), each lying opposite an Official's AEP. They are spirit points that can be used on any CF.

Po

The corporeal soul, housed by the Lung, tied to the body and the breath. UB-42 Soul Door lies opposite the Lung's AEP.

Possession

A state in which a person seems, or feels, taken over by something not their own, with vacant eyes and treatment that does not hold. Internal possession arises from within, external possession from outside; each is cleared with its set of Dragons before other treatment.

Pulse taking (the twelve pulses)

Reading the state of all twelve Officials at the wrists, each position having a superficial and a deep level. Left wrist, from the hand toward the elbow: Small Intestine and Heart, Gallbladder and Liver, Bladder and Kidney. Right wrist: Large Intestine and Lung, Stomach and Spleen, Three Heater and Heart Protector.

Qi

The vital energy that flows through the meridians and animates body, mind and spirit.

Receiver of Qi from the Heavens (Lung)

The Metal Official that takes in the breath and the spirit of the Heavens, gives rhythm and inspiration, and gives us a sense of our own worth.

Ren–Du block

A block between the Conception and Governor Vessels, cleared through REN-24 and DU-28 where the vessels meet at the mouth. The person is not present in life and needs an extra push.

Reunion points

Points where meridians meet, used later in treatment, when the pulses are close and similar, to harmonize the three Jiao and take the person deeper.

Sedation

Needling that drains excess energy from a point or Official, usually turning the needle counterclockwise and leaving it in for a time.

Sedation points

On each meridian, the Element point of the child element, which moves energy on to the next element on the Sheng cycle.

Separator of Pure from Impure (Small Intestine)

The Fire Official that sorts what is pure from what is impure, in food, ideas and feelings, and keeps the Heart's insight clear.

Shen

The spirit housed by the Heart: consciousness, presence and the light behind the eyes.

Sheng cycle

The creation cycle of the elements, in which each one feeds the next: Wood feeds Fire, Fire feeds Earth, Earth feeds Metal, Metal feeds Water, and Water feeds Wood.

Shock

A sudden physical or emotional blow that can slam the gates of the spirit shut and cut a person off from the Heart. HT-7, HT-1 and UB-42 are among the points used for it.

Source points

One for each Official: a general, safe and grounding point that invigorates all the energy within the Official.

Spirit

Our essence and the quality of our lives: the light within us that follows our guidance and speaks through symbols and dreams.

Spirit depletion

A spirit whose reserves have run low, so that the Officials have no fuel and even small tasks feel overwhelming. REN-8 and KI-25 are classic points for it.

Spirit level

A way of being ill in which life's wounds go to the Heart and leave scars that affect how the person moves through life. About 95% of patients are ill at this level.

Spirit of the point

The unique identity of a point, drawn from the meaning of its Chinese name and from long clinical use, and set in context by its Official, element, location and energetic role.

Spirit points

Points used mainly for their spirit, which give about 70% of their effect to the spirit, 20% to the mind and 10% to the body.

Supreme Controller (Heart)

The Heart Official, the emperor within, who houses the Shen, holds our purpose and identity, and brings order and cohesion to all the other Officials.

Three Jiao

The three 'burning spaces' of the body (upper, middle and lower), regulated by the Three Heater.

Tonification

Needling that adds energy to a point or Official. In the Worsley tradition the needle is turned clockwise and withdrawn promptly.

Tonification points

On each meridian, the Element point of the mother element, which draws energy into the meridian along the Sheng cycle.

Upper Kidney chest points

KI-22 to KI-27 on the upper chest. They give an extra spirit charge, bring in ancestral Qi, calm and revive the spirit, and can be used on any CF.

Water

The element of winter, storage and the seed of new life, with the Bladder and Kidney as its Officials. Its color is blue-black, its sound groaning, its odor putrid and its emotion fear.

Windows of the Sky

Deep spirit points, mostly on the neck, that open the windows of the soul so a person can see what they need to see, and that free the flow of Qi between head and body. Use them only when the person is ready, preferably on the CF.

Wood

The element of spring, birth and growth, with the Gallbladder and Liver as its Officials. Its color is green, its sound shouting, its odor rancid and its emotion anger.

Xi-Cleft points

Points where the Qi gathers and swirls, used as secondary Source points to create movement when someone is stuck and to test the CF.

Yi

Intellect and thought, housed by the Spleen. UB-49 Thought Dwelling lies opposite the Spleen's AEP, the seat of the intellect.

Yin and Yang

The two complementary forces present in everything: expansion and contraction, rest and action, dark and light, cycling through every day and season.

Zhi

Will, housed by the Kidney, associated with Essence, intention, ambition and aspiration. UB-52 Ambition Room governs it.