Understanding the Upper and Lower He Points in TCM

In Traditional Chinese Medicine (TCM), He-Sea points are among the Five Shu points found along the channel pathways. They are traditionally described as places where the qi of a channel gathers and moves more deeply, making them especially relevant to disorders associated with the zang-fu organs, digestive function, fluid movement and changes in qi direction. Many of these points are located around the elbows and knees, where needling can influence both local tissues and the broader channel network. Learn more about Three Reel Klassieke Slots.html.

The phrase “upper and lower He points” can be confusing because it is used differently across textbooks, teaching traditions and clinical conversations. Usually, it distinguishes the regular He-Sea points on the limbs from the Lower He-Sea points, a special group of points on the lower limb that correspond to the Yang Fu organs. Understanding their locations, functions and limits helps students read acupuncture charts more accurately and apply theory with appropriate clinical judgement.

The Place of He-Sea Points Within the Five Shu

The Five Shu points are located on the channels between the fingertips or toes and the elbows or knees. They are named Jing-Well, Ying-Spring, Shu-Stream, Jing-River and He-Sea. This sequence is traditionally understood as a movement from a more superficial, narrow flow at the extremities towards a deeper and broader gathering near the joints.

A He-Sea point is therefore not simply a point chosen because it sits near an elbow or knee. In classical theory, it represents a stage at which channel qi enters more deeply and connects with the zang or fu system. This is why He-Sea points are often selected for internal disorders, particularly those involving the stomach, intestines, bladder, gallbladder, or the transformation and transportation of fluids.

The regular He-Sea points occur on all twelve primary channels. Examples include LU5 on the Lung channel, LI11 on the Large Intestine channel, ST36 on the Stomach channel, SP9 on the Spleen channel, HT3 on the Heart channel, SI8 on the Small Intestine channel, BL40 on the Bladder channel, KI10 on the Kidney channel, PC3 on the Pericardium channel, SJ10 on the San Jiao channel, GB34 on the Gallbladder channel and LR8 on the Liver channel.

What “Upper” He Points Usually Means

“Upper He points” is not a universally standard category in the same way as the Lower He-Sea points. In many teaching settings, the term is used informally to describe the ordinary He-Sea points located around the elbow or knee, distinguishing them from the special Lower He-Sea group. Some practitioners simply call these points He-Sea points and reserve “Lower He-Sea” for the additional points on the lower leg.

This distinction matters because the regular He-Sea point belongs to its own channel. For example, LI11 is the He-Sea point of the Large Intestine channel, while ST36 is the He-Sea point of the Stomach channel. Their actions are interpreted through channel theory, Five Phase relationships, zang-fu physiology and the individual presentation rather than through location alone.

Several regular He-Sea points are widely used in clinical education. LU5 may be considered when Lung qi fails to descend and there is cough, wheezing or a feeling of fullness in the chest. LI11 is commonly discussed for heat patterns and disorders affecting the Large Intestine channel. ST36 has broad applications involving the Stomach and Spleen systems, qi and blood support, digestion and general vitality. GB34 is associated with the Gallbladder channel and is often taught for sinew disorders and constrained Liver-Gallbladder qi.

The Lower He-Sea Group

Lower He-Sea points are a special set of points on the lower leg that relate to the Yang Fu organs. The classic pairing is generally taught as follows: ST36 for the Stomach, ST37 for the Large Intestine, ST39 for the Small Intestine, BL39 for the San Jiao, BL40 for the Bladder and GB34 for the Gallbladder. Some lists and translations vary slightly in wording, but these six correspondences are the standard framework used in contemporary TCM education.

The concentration of these points below the knee is clinically significant. It gives practitioners a way to affect the Yang Fu organs from the leg while working through a channel region that is often accessible, especially when local abdominal tenderness or acute sensitivity makes direct abdominal needling less suitable. The points are not mechanical switches for individual organs; their use is based on pattern diagnosis, channel relationships, symptom quality and the person’s overall constitution.

ST37, known as Shangjuxu, is frequently associated with Large Intestine functions such as intestinal regulation and the movement of qi and fluids. ST39, Xiajuxu, is linked with the Small Intestine and may be considered in presentations involving separation and transformation. BL39, Weiyang, is associated with the San Jiao and fluid pathways. BL40, Weizhong, is both the regular Bladder He-Sea point and the Lower He-Sea point of the Bladder, making it an important example of overlapping categories.

How Practitioners Choose Between Them

Point selection begins with a diagnosis rather than with the name of a point category. A practitioner may assess the presenting symptoms, tongue, pulse, constitution, channel tenderness and relevant medical history. Someone with loose stools, fatigue and a pale tongue may require a different strategy from someone with abdominal pain, irritability, thirst and signs of heat, even if both are being considered for an intestinal complaint.

The regular He-Sea point may be selected when the channel itself, its associated zang-fu system or a Five Phase relationship is central to the presentation. A Lower He-Sea point may be especially relevant when the clinical picture relates to a Yang Fu organ, intestinal movement, bladder function, gallbladder disorders or the San Jiao’s role in fluid transformation. In practice, the two approaches can be combined with yuan-source points, luo-connecting points, alarm points, back-shu points or local treatment.

Needling technique also requires care. Points around the knee and lower leg have important vessels, nerves, tendons and other structures nearby. Depth, angle and stimulation should be based on formal training, current anatomy knowledge and the person’s body type. In Australia, acupuncture is regulated under the national registration scheme, so patients should check that a practitioner is registered with the Chinese Medicine Board of Australia through AHPRA rather than relying on a point list alone.

Applying the Theory In Australian Practice

A patient in Sydney who spends long hours at a desk may describe neck tension, digestive discomfort and poor sleep in the same consultation. A person in Melbourne might seek treatment during a cold, damp winter for recurrent aches and sluggish digestion, while someone in Brisbane may present with heat, thirst and irritability during a humid summer. These descriptions can be clinically useful, but seasonal weather and lifestyle do not replace an individual TCM assessment.

Australian practice also operates within a modern health system. Routine acupuncture is generally not covered by Medicare, although some private health insurance extras policies may provide benefits depending on the policy and provider requirements. Registered Chinese medicine practitioners may work in private clinics, multidisciplinary centres and community settings, and they may need to coordinate care with a GP, physiotherapist or specialist when symptoms suggest a condition requiring biomedical investigation.

Lifestyle discussion often forms part of a broader treatment plan. A practitioner may talk about regular meals, hydration, sleep, movement and the person’s tolerance for heat or cold. Food therapy can be culturally adaptable: a warming soup may suit one patient in a Melbourne winter but be unsuitable for someone with signs of internal heat. A practical example of this approach appears in guidance on warming herbal soup, where ingredients are considered in relation to season and intended effect rather than treated as universal remedies.

Clinical learning can also be shaped by travel and observation. Students attending workshops or visiting Chinese medicine institutions overseas may compare terminology, point locations and local teaching styles, much as travellers collect visual impressions in an inspiring travel photo. For Australian practitioners, this perspective can be valuable when treating patients from diverse cultural backgrounds while remaining consistent with professional standards.

Common Misunderstandings About He Points

One frequent misunderstanding is that every symptom connected with an organ requires its matching Lower He-Sea point. TCM diagnosis is more nuanced. A bowel complaint may involve Spleen qi deficiency, Liver qi stagnation, damp-heat, cold, blood deficiency or a biomedical condition outside the scope of acupuncture treatment. The same point can have different significance in different patterns, and the correct treatment may not include a He-Sea point at all.

Another error is assuming that “lower” means stronger, deeper or automatically better. The label describes the category and location of the point, not a ranking of clinical power. ST37 is not inherently superior to LI11 for every Large Intestine-related presentation, and BL40 is not chosen merely because it is a Lower He-Sea point. The practitioner must consider whether the problem is primarily channel-based, organ-based, acute, chronic, excess, deficiency, hot, cold or mixed.

Students can also confuse the Lower He-Sea correspondences with the regular Five Shu sequence. For example, ST36 is the Stomach channel’s He-Sea point and also the Lower He-Sea point of the Stomach. GB34 is the Gallbladder channel’s He-Sea point and the Lower He-Sea point of the Gallbladder. By contrast, ST37 is not the regular He-Sea point of the Stomach; it is the Lower He-Sea point associated with the Large Intestine.

Terminology should be checked against the lineage or curriculum being used. Classical sources, English translations and modern acupuncture schools may explain the same relationships with slightly different wording. Even apparently simple charts should be read alongside anatomy, contraindications, needling safety and the wider diagnostic framework.

A Practical Reference For Study

The following summary separates the regular He-Sea points from the Lower He-Sea correspondences. It is a study aid rather than a treatment prescription, and point functions can be described differently depending on the textbook or teaching lineage.

Category	Point	Channel or Fu association	Common study themes
Regular He-Sea	LU5	Lung channel	Descending Lung qi, cough, wheezing, channel disorders
Regular He-Sea	LI11	Large Intestine channel	Heat patterns, channel pain, skin-related presentations
Regular and Lower He-Sea	ST36	Stomach channel; Stomach Fu	Digestion, qi and blood support, abdominal disorders
Regular He-Sea	SP9	Spleen channel	Dampness, fluid transformation, lower-limb swelling
Regular He-Sea	HT3	Heart channel	Heart channel disorders and spirit-related patterns
Regular He-Sea	SI8	Small Intestine channel	Channel pain and heat-related presentations
Regular and Lower He-Sea	BL40	Bladder channel; Bladder Fu	Lumbar pain, channel disorders, Bladder-related patterns
Regular He-Sea	KI10	Kidney channel	Kidney water metabolism and heat-related patterns
Regular He-Sea	PC3	Pericardium channel	Chest and Heart-shen-related presentations
Regular He-Sea	SJ10	San Jiao channel	Channel pain and San Jiao-related patterns
Regular and Lower He-Sea	GB34	Gallbladder channel; Gallbladder Fu	Sinews, lateral body pain, Gallbladder disorders
Lower He-Sea	ST37	Large Intestine Fu	Intestinal regulation and abdominal presentations
Lower He-Sea	ST39	Small Intestine Fu	Small Intestine functions and lower abdominal patterns
Lower He-Sea	BL39	San Jiao Fu	Fluid pathways and lower burner presentations

The distinction becomes easier to remember when the two systems are studied together: regular He-Sea points belong to each of the twelve primary channels, while the Lower He-Sea points provide a separate set of lower-limb correspondences for the six Yang Fu organs. Clinical reasoning then determines whether either group is appropriate.

A sound understanding of these points combines classical theory with anatomy, safety, communication and referral awareness. A registered practitioner may use He-Sea points as part of a carefully individualised treatment, while patients should seek medical assessment for severe, persistent or unexplained symptoms. For learners, the most reliable approach is to memorise the correspondences, understand the underlying channel logic and keep each point within the context of whole-person diagnosis.