Copyright, 2007. Narda G. Robinson, DO, DVM, MS. All rights resered.

The Leg-Three-Miles Acupuncture Point for Internal Medicine

Problems 1 As early as 1000 BCE, physicians have recognized the value of
acupuncture for the treatment of internal medical disorders.2 Chinese acupuncturists
understood that harmonious interrelationships were vital to health, whether the focus of
this alance related to internal organs, family memers, society, or the universe as a
whole. !hese ancient healers oserved that stimulation of specific sites on the ody
was capale of influencing road restorative changes within the system, and they
ac"nowledged that these effects were mediated via the vasculature and associated with
nerves.# $odern medicine has achieved a deeper understanding of the
neurophysiologic networ"s that provide and control the delicate moment%to%moment
integration of impulses throughout the ody. &onetheless, acupuncture remains one of
the most powerful approaches availale to access these networ"s and therey help the
ody return to optimal functional capacity. 'hile the comprehensive repertoire of
acupuncture points includes hundreds of neurovascular sites around the ody,
acupuncture treatments most often incorporate only a fraction of these. A common ut
mista"en assumption is that the most effective acupuncture treatments, especially those
provided in China, result from comple( and elaorate diagnostic analyses, stemming
from mystical insights that westerners can only hope to achieve with long and concerted
effort. )n reality, according to Belgian physician *rancois Beyens, $+, ,ecretary
-eneral of the )nternational Council of $edical Acupuncture and .elated !echni/ues
0)C$A.!1, Chinese acupuncturists use only a handful of points and yet achieve highly
satisfactory results.2 'hen, during his training in China, he as"ed his mentors why
they chose only from this small suset of vital points, their reply was simply, 34Because
they wor"536 ,pecifically, a site on the pelvic lim called 347usanli36 0also "nown as
,tomach #8, or ,!%#81 is one of the most fre/uently used of all acupuncture points.
!he Chinese name 7usanli means 349eg !hree $iles36. :ral tradition has it that in
ancient times, most individuals traveled on foot, and stimulation of 7usanli would relieve
fatigue dramatically enough that the effects would allow one to travel another three
miles. )t was indeed common for people who were aout to emar" on a long ;ourney
to needle or mo(a this point 0which involves warming
1 <eith ). The Yellow Emperors Classic of Internal Medicine.
Ber"eley= >niversity of California ?ress, 1@2@. p. A. 2 Bendall +E. ?rolems with the Energy%$eridian
!heory. :tained at http=CCwww.ormed.eduCnewslettersCenergymeridian.htm on $arch 1A , 2002. #
Beyens, *. ?ersonal communication, at the 1@@@ Annual ,ymposium of the American Academy of
$edical Acupuncture. 2 Ellis A et al. Grasping the Wind. Broo"line= ?aradigm ?ulications, 1@D@. ?.
@1.

Copyright, 2007. Narda G. Robinson, DO, DVM, MS. All rights resered.
the area with a medicinal her such as mugwort1, in order to uild the necessary
strength and endurance for the trip.E8 7usanli is one of the four most important
acupuncture points on the ody, and indications for its use are myriad. A truncated
list of the indications for 7usanli in humans includes= epigastric pain, nausea,
vomiting, poor appetite, adominal distention, flatulence, diarrhea, edema,
shortness of reath, cough, chest pain, muscle pain, arthritis, and even loss of
consciousness. Fwang and 9imehouse cite the following indications for the use of
7usanli in canine patients= 34gastrointestinal disorders, general tonification point for
any wea" condition, paralysis of the pelvic lim, endocrine and metaolic
*igure 1. 9ateral view of the canine
pelvic lim
diseases, and acupuncture analgesia36.AD 0,ee *igure 1 for location of 7usanli in
dogs.1 *leming suggests 7usanli for e/uine patients with 34tiial and fiular pain,
stifle pain, upward fi(ation of the patella, arthritis of the tarsal ;oint, paralysis of
the tiial and fiular nerves, gastrointestinal disorders, acetylcholine effects,
fever, anore(ia, and lethargy36. *or avian patients, $cCluggage points to
7usanli E 9ade A. Acupuncture oints! Images and "unctions.
,eattle= Eastland ?ress, )nternational. 1@D@G pp. A2%#. 8 +eadman ? et al. A Manual of
Acupuncture. East ,usse(, England= Hournal of Chinese $edicine ?ulications., 1@@D. ?ages
1ED%181. And Fwang I%C and 9imehouse HB. Chapter @, Canine Acupuncture Atlas. )n ,choen
A$ 0ed.1= #eterinar$ Acupuncture! Ancient Art to Modern Medicine, 2 Edition. ,t. 9ouis= $osy,
)nc. 2001, p. 1#E. D *leming ?. Chapter #1, !ranspositional E/uine Acupuncture Atlas. )n
,choen A$ 0ed.1= #eterinar$ Acupuncture! Ancient Art to Modern Medicine. ,t. 9ouis= $osy,
)nc. 2001, pp. 202E.

Copyright, 2007. Narda G. Robinson, DO, DVM, MS. All rights resered.
for 34pathologic regurgitation, adominal pain, indigestion, diarrhea, any
digestive disorder, mental disorders, hemiplegia, pain in the "nee and leg36.@10 ,o
many conditions are treatale with this point that even a thousand years ago, Jin
Cheng%zu declared that y using 7usanli, 34all diseases can e treated36.11
.eaders can find this location on their own leg y placing the width of four fingers
eneath the ape( of the patella. $oving one finger%readth lateral to the midline
of the tiia, one arrives in a muscle groove etween the anterior tiialis and
e(tensor digitorum longus muscles. 0,ee *igure 2.1 +eep palpation of this point
often reveals tenderness, and strong pressure or needling at this site can create a
shoc"%li"e sensation accompanied y tingling or heaviness that radiates to the first
or second toe. )n fact, it is this spreading sensation, "nown as de %i! or 34the echo
of acupuncture36 that heralds significant widespread effects resulting from
stimulation of the point.12 9ocal neuroanatomic structures affected y needling
include= cutaneous ranches of the lateral sural cutaneous nerve and the
saphenous nerve, the recurrent articular nerve from the common peroneal nerve,
and motor ranches of the deep peroneal nerve. 9ocal vessels comprise the
anterior tiial recurrent artery and its companion vein.
*igure 2. Fuman ,!%#8
!he ma;ority of effects of acupuncture result primarily
from stimulation of vessels and nerves, yet many present%day acupuncturists
e(plain that needling 7usanli is eneficial ecause it 34tonifies Ji36, defining Ji as
34the force or energy that controls
11 @ $cCluggage +. Chapter 28, Acupuncture for the Avian
?atient. )n ,choen A$ 0ed.1= #eterinar$ Acupuncture! Ancient Art to Modern Medicine. ,t. 9ouis=
$osy, )nc. 2001, p. #1E. 10 +eadman, ?. :p. cit. :mura I. ?atho%physiology of acupuncture
treatment= effects of acupuncture on cardiovascular and nervous systems. Acupuncture &
Electro'Therapeutics (es. 1@AEG 1=E1%120. 12 Felms H$ et al. oint )ocations and "unctions.
Ber"eley= $edical Acupuncture ?ulishers. 2000, p. 182.

Copyright, 2007. Narda G. Robinson, DO, DVM, MS. All rights resered.
harmony in any living ody36.1#, 121E <ague terminology such as 34energy flow36,
34loc"ed energy36 and 34energy alancing36 is coming under increasing criticism,
in that it fails to provide satisfactory description of what is actually occurring in the
health, disease, and healing.th *urthermore, the notion that ancient Chinese
physicians considered Ji to e energy is li"ewise coming under fire, with critics
pointing to a 2018 century mistranslation 0y a *rench cler" wor"ing in China1 of the
Chinese character 34/i36 0vital air1 as 34energy36 34for lac" of a etter word36.1A
Additional errors in translation y the same individual shifted the focus of
acupuncture from its original emphasis on stimulation of significant locations along
lood vessels and nerves, to a modern concept of 34points36 along invisile
34meridians36.1D .estoring the study of acupuncture to its original premise as a
physiologic intervention will undoutedly allow scientists the est opportunity to
disentangle the comple( neurophysiologic reactions underlying whole ody enefit
from needling of 7usanli. .esearch has already shed light on some of the
mechanisms of action involved in the gloal actions of 7usanli. A common theme
is the recreation of autonomic alance throughout the organism, most often
achieved y reduction of unhealthful sympathetic nervous system over%stimulation
that arose following pain, stress, illness, or in;ury. $any of these studies include
the application of electrical stimulation to the needle inserted in 7usanli, which
helps augment the effects of the treatment. :ne study on the sympathetic effects
following manual and electrical acupuncture stimulation in humans showed a
generalized, longlasting warming, or sympathetic inhiition. Electroacupuncture
created a transient sympathetic activation that most li"ely reflected segmental
activation of vasomotor spinal refle(es.1@ Another study with electroacupuncture
stimulation showed enhanced splenic natural "iller cytoto(icity in rats possily
through inhiition of splenic sympathetic nerve function. Acupuncture lowered
lood pressure in dogs with e(perimentally%induced hypertension following
electrical stimulationG this reduction in lood pressure was accompanied y
increased
1E 1# 9imehouse HB and !aylor%9imehouse ?A. Chapter 8,
Eastern Concepts of Acupuncture. )n ,choen A$ 0ed.1= #eterinar$ Acupuncture! Ancient Art to
Modern Medicine. ,t. 9ouis= $osy, )nc. 2001, p. D0. 12 +eadman ?. :p. cit. +ossey 9. Fow
healing happens= E(ploring the nonlocal gap. Alternati*e Therapies. 2001G D021= 12%8, 10#%110.
18 7miews"i, ?aul, ed. -eorges ,ouliKL de $orant, Chinese Acupuncture 093Macuponcture
Chinoise1. trans. 9awrence -rinnell, Claudy Heanmougin, and $aurice 9eve/ue, Broo"line,
$ass.= ?aradigm ?ulications, 1@@2. .eferenced in Bendall +E= ?rolems with the
Energy$eridian !heory. :tained at http=CCwww.ormed.eduCnewslettersCenergymeridian.htm on
$arch 1A, 2002. 1A Bendall +E. ?rolems with the Energy%$eridian !heory. :tained at
http=CCwww.ormed.eduCnewslettersCenergymeridian.htm on $arch 1A , 2002. 1D Ernst $ and 9ee
$F$. ,ympathetic effects of manual and electrical acupuncture of the !susanli "nee point=
Comparison with the Fo"u hand point sympathetic effects. E+perimental ,eurolog$. 1@D8G @2=1%
10. 1@ Iu I et al. Enhancement of splenic interferon%LN , interleu"in%2, and &B cytoto(icity y ,#8
acupoint acupuncture in *#22 rats. -apanese -ournal of h$siolog$. 1@@AG 2A=1A#%1AD.

Copyright, 2007. Narda G. Robinson, DO, DVM, MS. All rights resered.
lood flow at the mesenteric artery.2021 ,imilarly, a study on human patients with
hypertension also demonstrated reduction of lood pressure, possily mediated y
a decrease in renin secretion.22 !ranscutaneous electrical nerve stimulation
0!E&,1 in rats delayed onset of e(perimental arthritis and reduced one erosion
and ;oint destruction following intradermal in;ection of ovine type )) collagen.2#
Electroacupuncture applied to 7usanli reduced alcohol%drin"ing ehavior in
restricted rats, and this was associated with an increase in striatal dopamine levels.
Beneficial alterations in "inetic function of the human pylorus occur,222E as does a
significant reduction in gastric acid secretion.28 A clinical review in the American
-ournal of Gastroenterolog$ provides further supporting evidence for the efficacy of
acupuncture on gastrointestinal function and in treating related disorders.
.esearching the neural and vascular influences of the entire collection of
acupuncture points as descried aove for 7usanli will e a prodigious tas". 'e
are fortunate to have access to the accumulated wisdom of thousands of years of
oservation of effects following acupuncture. Classical descriptions of effects
otained y stimulating certain acupuncture points help guide further research y
providing clues to remaining neural networ"s awaiting discovery. End note= *or
further information on +r. .oinson and medical acupuncture training at Colorado
,tate >niversity, consult her wesite at www.aavma.org .
20 ?eng 9 et al. !he effect of acupuncture on lood pressure=
the interrelation of sympathetic activity and endogenous opioid peptides. Acupuncture & Electro'
therapeutics (es.! Int. -. 1@D#G D=2E%E8. 21 Chiu IH et al. Cardiovascular and endocrine effects of
acupuncture in hypertensive patients. Clinical and E+perimental .$pertension. 1@@AG
1@0A1=102A%108#. 22 Hian/iao * et al. !herapeutic effects of !E&, at 347usanli36 on collagen%
induced arthritis in rats. Acupuncture (esearch. 2001G 28=21%22. 2# Ioshimoto B et al.
Electroacupuncture stimulation suppresses the increase in alcohol%drin"ing ehavior in restricted
rates. Alcoholism/ Clinical and E+perimental (esearch. 2001G 2E081= 8#,8D,. 22 9i%wei J et al.
Effect of electroneedling of 7usanli on "inetic function of human pylorus. International -ournal of
Clinical Acupuncture. 1@@2G E= 1#@%122. 2E 9u( - et al. Acupuncture inhiits vagal gastric acid
secretion stimulated y sham feeding in healthy su;ects. Gut. 1@@2G #E=1028%@. 28 9i I et al.
!he effect of acupuncture on gastrointestinal function and disorders. American -ournal of
Gastroenterolog$. 1@@2G DA=1#A2%1#D1. *igures= *igure 1= 7usanli location in dogs *igure 2=
7usanli location in humans