1. Anatomy of the foot:

Following the differentiation of the hand and foot through human development, the feet bear the responsibility of support-tag the body, and so the foot is, of course, far inferior to the hand in performing skillful movements. The anatomy of the foot, as that of the hand, has drawn the attention of scholarly investigation, although its responsibilities are simpler and less abstruse.

The feet are the lowest part of the body. When people stand and walk they must keep the body stable. For accomplishing their specific functions, the feet have a unique anatomic structure and a complicated blood supply and nervous system to regulate the body's repeated movements and constant change of posture. Mankind achieved the ability to stand up and walk on two feet through exercise over the millennia, as individuals obtain their ability to walk after exercise beginning in early child-hood. Therefore, exercise was essential to the development of the foot, and remains so. The foot is the stablizing part of the body, just as the hand is the skillful member.

In normal people, the foot is composed of 26 bones. Among them are the 7 tarsal bones: the calcaneous, talus, cuboid, navicular and 1st, 2nd and 3rd cuneiform bones; they are connected by the articular ligaments to perform dorsiflexion, plantar flexion, and rotation of the ankle joint. The 5 metatarsal bones are arranged in a parallel pattern from the big toe to the

Fig. 2-20 Bones of foot

1-distal phalanx 2-middle phalanx 3-proximal phalanx 4-1st metacarpal bone 5-1st cuneiform bone 6-2nd cuneiform bone 7-3rd cuneiform bone 8-navicular bone 9-talus bone 10-trochlea ll-body 12-base 13-caput 14-5th metatarsal bone 15-cuboid bone 16-calcaneous bone 17-calcaneous tuberosity 18-sesamoid bone.

little toe and are numbered from 1 st to 5th. The toes contain 14 phalanges, 2 in the big toe and 3 in each of other toes, and they are numbered as 1st (proximal), 2nd (middle) and 3rd (distal) phalanx from the proximal end to distal end of a toe. The bones of the foot are connected by muscles, tendons, and fibrous bundles to perform different foot movements. (Fig. 2-20).

There are also numerous blood vessels (Fig. 2-21 ) and

Fig. 2-21 Distribution of blood vessels in foot

1-posterior tibial artery 2-plantar artery 3-anterior tibial artery 4-dorsal foot artery 5-arcuate artery 6-dorsal metatarsal artery 7-anterior tibial vein 8-dorsal venous rete of foot

Fig. 2-22 Distribution of nerves in foot

1-saphenous nerve 2-superficial peroneal nerve 3-deep peroneal nerve 4-lateral dorsal cutaneous foot nerve 5-intermediate dorsal cutaneous foot nerve

nerve branches with nerve endings and receptors distributed in the foot (Fig. 2-22) to conduct nerve impulses to and from the brain for fast adjustments to bodily conditions and changes in the external environment. The eyes and balance organs in the inner ear also contribute to these adjustments. There is a thick plantar cushion in the sole of the foot covered with a dense layer of epithelium and laid over a thick pad of fat. The arch of the foot (Fig. 2-23) is a unique construction in human beings, an evolutional product of the human body allowing it to stand erect and

Fig. 2-23 Diagram of foot arch

1-gravity line 2-transverse arch of foot 3-plantar arch (lateral and medial longitudinal arches of foot)

walk. The bones, joints, and ligaments of the foot are arranged in a bow-like arch with an upward convex curvature to form the elastic structure of the arch. The rebound force from the ground when walking, jumping or bearing heavy weight is thereby diverted and reduced by the arch of the foot to protect the internal organs and tissues from injury. It also protects the nerves and blood vessels in the sole when standing or bearing weight for a long time. The arch consists of the longitudinal arch, anteroposteriorly arranged, and the transverse arch, mediolaterally arranged. To protect the arch of the foot, physical exercise is recommended to strengthen the foot muscles, ligaments and bones. Standing in a static posture over a long time should be avoided. Walking, running and jumping capability may be severely impaired in patients with flat feet.

The foot has been called a "second heart" or "third eye" of the human body because it can play a role in adjusting essential body organs such as the heart and eye through the close connection between the foot and the internal organs. As with the hand, the electrical activity of the foot is very similar to that of the head. The foot is sensitive to changes in temperature and can rapidly affect the functioning of the respiratory, circulatory, and digestive systems. There is a folk proverb: "The whole body feels warm if the foot is warm, and the whole body feels cool if the foot is cool." The aging process, bodily instability, and many diseases often start in the lower limbs. The head, hands and feet are similarly distant from the anatomical and gravitational center of the body. Therefore, an important function is particularly committed to these "periperal structures" of the body.

2. General principles of acupoints and reflecting areas on foot:

According to the meridian theory of traditional Chinese medicine, 6 regular meridians, including--the foot Yangming stomach, foot Taiyang uninary bladder, foot Shaoyang gallbladder, foot Shaoyin kidney, foot Jueyin liver, and foot Taiyin spleen meridians are connected with the foot, and 33 regular acupoints having important therapeutic functions are located at the original or terminal parts of these 6 meridians.

Through continuous clinical practice, 74 extra foot acupoints were discovered and put into therapeutic use.

These holographic points and reflecting areas are widely distributed on the foot, produce stable therapeutic effects, and are not difficult to remember and use in clinical practice.

The acupoints and reflecting areas on the hand and foot can be used independently or in combination to produce an adjusting effect anywhere in the body depending on the time and place of treatment, the nature of the disease, and the experience of the practioner.

3. Distribution of acupoints and reflecting areas on plantar side of foot:

The plantar side of the foot has 1 regular acupoint, 43 extra acupoints, and 32 holographic points and reflecting areas as follows:

1) Regular acupoint:

Yongquan (KI 1 ) :

Location: On the longitudinal midline and at the junction of anterior one-third and posterior two-thirds of the sole, at the tip of a V-shaped crease (Fig. 2-24).

Indications: Fainting, psychosis, convulsions, sore throat,

dryness in mouth, diarrhea, dryness and rhagades of foot, shock, hypertension, stroke, heat stroke, insomnia, heart palpitations, heart pain, vertigo, parietal headache, pro-lapse of uterus, infertility, aphonia, dysurination, constipation, and spasms due to cholera.

2) Extra acupoints:

(1) Insomnia (Anmian) acupoint (EX-PF 1) :

Location: At the center of the sole (Fig. 2-25).

Fig. 2-25 Extra acupoints on plantar side of foot

Indication: Insomnia.

(2) Lineiting (inner Neiting) acupoint (EX-PF 2) :

Location: On the plantar side of foot and in the interosseous space between 2nd and 3rd metatarsal bones, and opposite to Neiting (ST 44) on dorsal side of foot (Fig. 2-25).

Indications: Pain of toes, convulsions in children, indigestion, and epilepsy.

(3) Nuxi acupoint (EX-PF 3) :

Location: At the midpoim of posterior heel border and on the dorsoplantar boundary of the foot (Fig. 2-25).

Indications: Alveolitis, alveolar abscess, convulsions, epilepsy, nasal bleeding, and nasal obstruction.

(4) No. 1 acupoint (EX-PF 4) :

Location: This is 1 cun anterior to the midpoint of posterior heel border (Fig. 2-26).

Fig. 2-26 No. 1 to No. 14 extra acupoints on plantar side of foot

Indications: Common cold, headache, maxillary sinusitis, and rhinitis.

(5) No. 2 acupoint (EX-PF 5) :

Location: This is 3 tun anterior to the posterior heel border and 1 tun medial to the midline of sole (Fig. 2-26).

Indication: Trigeminal neuralgia.

(6) No. 3 acupoint (EX-PF 6):

Location: This is 3 cun anterior to the posterior heel border (Fig. 2-26).

Indications: Neurasthenia, hysteria, insomnia, hypotension, and coma.

(7) No. 4 acupoint (EX-PF 7):

Location: This is 3 cun anterior to the posterior heel border and 1 cun lateral to the midline of sole (Fig. 2-26).

Indications: Intercostal neuralgia, chest pain, and chest distress.

(8) No. 5 acupoint (EX-PF 8):

Location: This is 4 cun anterior to the posterior heel border and 1.5 cun lateral to the midline of sole (Fig. 2-26).

Indications: Sciatic neuralgia, appendicitis, and chest pain.

(9) No. 6 acupoint (EX-PF 9):

Location: This is 5 curl anterior to the posterior heel border and 1 cun medial to the midline of sole (Fig. 2-26).

Indications: Dysentery, diarrhea, and duodenal peptic ulcer.

(10) No. 7 acupoint (EX-PF 10) :

Location: This is 5 cun anterior to the posterior heel border (Fig. 2-26).

Indications: Asthma and maldevelopment of brain.

(11) No. 8 acupoint (EX-PF 11) :

Location: This is 1 cun lateral to No. 7 acupoint (Fig. 2-26).

Indications: Neurasthenia, epilepsy, and psychoneurosis.

(12) No. 9 acupoint (EX-PF 12) :

Location: This is 4 cun posterior to the junction of big and second toes (Fig. 2-26).

Indications: Dysentery, diarrhea, and uteritis.

(13) No. 10 acupoint (EX-PF 13) :

Location: This is 1 cun medial to Yongquan (KI 1) acupoint (Fig. 2-26).

Indications: Chronic gastroenteritis and stomach spasms.

(14) No. 11 acupoint (EX-PF 14) :

Location: This is 2 cun lateral to Yongquan (KI 1) acupoint (Fig. 2-26).

Indications: Shoulder pain and urticaria.

(15) No. 12 acupoint (EX-PF 15) :

Location : This is 1 cun posterior to the junction of big and second toes (Fig. 2-26).

Indication: Toothache.

(16) No. 13 acupoint (EX-PF 16) :

Location : This is 1 cun posterior to the midpoint of plantar of little toe (Fig. 2-26).

Indication: Toothache.

(17) No. 14 acupoint (EX-PF 17) :

Location: This is at the midpoint of plantar crease of little toe (Fig. 2-26).

Indications: Frequent urination and incontinence of urine.

Notice: The midline of the sole is a line between the junction of 2rid and 3rd toes and the midpoint of posterior heel border, and it is divided into 10 proportional cun of the patient's body. Three lines are drawn from each junction of 2 neighboring toes and parallel to the midline to a distance of 1 cun between each of the 2 neighboring lines. The horizontal lines are drawn to a distance of 1 cun between 2 neighboring lines to form a network. There are also other acupoints on this network.

(18) Regeneration acupoint (EX-PF 18):

Location: This is 5 fen posterior to No. 3 acupoint (Fig. 2-27).

Indications: Malignant brain tumors, nasal bleeding, and nasal obstruction.

ye acupoint (EX-PF 19):

Location: This is 5 fen anterior to No. 2 acupoint (Fig. 2-27).

Indications: Redness, swelling, and pain of eye.

(20) Head acupoint (EX-PF 20) :

Location: This is 5 fen anterior to No. 3 acupoint (Fig. 2-27).

Indications: Headache and insomnia.

Fig. 2-27 Extra acupoints on plantar side of foot

l-liver, kidney and gallbladder 2-pain-controlling 3-lung, heart and urinary bladder 4-spleen, pericardium and triple energizer 5-colon, stomach and small intestine 6-eye, head and ear 7-regeneration 8-mouth

(21) Ear acupoint (EX-PF 21) :

Location: This is 5 fen anterior to No. 4 acupoint (Fig. 2-27).

Indications: Nervousness and pain.

(22) Colon acupoint (EX-PF 22) :

Location: This is 5 fen posterior to No. 6 acupoint and 1 cun anterior to eye acupoint (Fig. 2-27).

Indications: Abdominal pain, diarrhea, appendicitis, and acute stomachache.

(23) Stomach acupoint (EX-PF 28) :

Location: This is 1 cun lateral to colon acupoint (Fig. 2-27).

Indications: Psychosis, acute stomachache, abdominal pain, diarrhea, appendicitis, toothache, and ostcomyclitis of maxillary bone.

(24) Small intestine acupoint (EX-PF 24):

Location: This is 1 cun lateral to stomach acupoint (Fig. 2-27).

Indications: Abdominal pain, diarrhea, appendicitis, and retention of urine.

(25) Spleen acupoint (EX-PF 25) :

Location: This is 1 cun anterior to colon acupoint (Fig. 2-27).

Indications : Hernia with pain, testitis, convulsions in children, stroke with aphasia, acute stomachache, and emission of sperm.

(26) Pericardium acupoint (EX-PF 26) :

Location: This is 1 cun anterior to stomach acupoint (Fig. 2-27).

Indications: Psychosis and insomnia.

(27) Triple energizer acupoint (EX-PF 27):

Location: This is 1 cun anterior to small intestine acupoint (Fig. 2-27).

Indications: Cough, chest pain, retention of urine, and tinnitus.

(28) Lung acupoint (EX-PF 28) :

Location: This is 1 cun anterior to spleen acupoint (Fig. 2-27).

Indications: Cough and chest pain.

(29) Heart acupoint (EX-PF 29) :

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