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THE EXTRAORDINARY POINTS

The Extra points 565

EXTRA POINTS OFTHE HEAD AND NECK

SISHENCONC (M-HN-1) COMMENTARY


Four Alert Spirit The four points Sishencong were first discussed in the
Sagelike Prescriptions from the Taiping Era. (10th century
LOCATION CE). As the name (Four Alert Spirit) implies, these four
Four points at the vertex of the scalp, I points are able to pacify interior wind which rises to
grouped around Baihui DU-20 and located harass the head and brain (windstroke, epilepsy, dizzi-
1 cun anterior, posterior and lateral to it. ness etc.) and to calm the spirit (mania-depression,
insomnia etc.). In clinical practice these points are either
used as a group, all four being needled together, or
through-needled from Baihui DU-20.

YINTANC (M-HN-3)
Hall of Impression

LOCATION
At the glabella, at the midpoint between the
medial extremities of the eyebrows.

Yintang (M-HN-3)

Baihui DU-20
a

LOCATION NOTE
The distance between Baihui DU-20 and the anterior
hairline is 5 cun. If the anterior hairline is indistinct, the
distance between Baihui DU-20 and the glabella is meas-
ured as 8 cun.

NEEDLING
Transverse insertion 0.5-1.5 cun.

ACTIONS
Calms the spirit NEEDLING
Pacifies wind With the fingers of one hand pinch up the skin over the
Benefits the eyes and ears point, and with the other hand needle transversely in an
inferior or lateral direction, 0.3-0.5 cun.
INDICATIONS
Windstroke, epilepsy, mania-depression, insomnia, ACTIONS
poor memory. Pacifies wind and calms the shen
One-sided and generalised headache, dizziness, Benefits the nose
deafness, disorders of the eyes. Activates the channel and alleviates pain
The Extra points

INDICATIONS Yuyao (M-HN-6)


Chronic and acute childhood fright wind, fright
spasm, frontal headache, dizziness, dizziness follow-
ing childbirth, insomnia, agitation and restlessness.
Nasal congestion and discharge, rhinitis, nosebleed,
disorders of the eyes, hypertension, pain of the face.

COMMENTARY
The extra point Yintang (M-HN-3)was first discussed in
the Essential Questions. It is curious however, that such an
important and commonly used point was not classified as
a point of the Governing vessel, on whose pathway it lies.
Lying between the eyebrows, in the area ascribed to the
'third eye' by many traditional cultures, Yintang (M-HN-3) NEEDLING
has been considered by some qigong authorities to be the Transverse insertion medially or laterally, 0.5 to 1cun.
location of the upper dantian.
Yintang (M-HN-3) is commonly used in four clinical ACTIONS
situations: i. as a powerful and effective point to calm the Benefits the eyes
spirit in the treatment of insomnia, anxiety and agitation; Relaxes the sinews and alleviates pain.
ii. to activate the channel and alleviate pain in the treat-
ment of frontal headache; iii. to benefit the nose in the INDICATIONS
treatment of nasal congestion and discharge, rhinitis, Redness, swelling and pain of the eyes, superficial
sinus pain, nosebleed etc. and iv. to pacify wind in the visual obstruction, twitching of the eyelids, drooping
treatment of chronic and acute childhood fright wind of the eyelid, frontal headache.
(infantile convulsions).
COMMENTARY
COMBINATIONS This point first appeared in the Classic of the Jade Dragon.
Head wind following intoxication: Yintang In clinical practice it is mostly selected in the treatment of
(M-HN-3), Zanzhu BL-2 and Zusanli ST-36 (Great supraorbital pain and diseases of the eyes and eyelids,
Compendium ). and is stimulated by through-needling from either Yang-
Insomnia: Yintang (M-HN-3), Shenmen HE-7 and bai GB-14 or Zanzhu BL-2.
Sanyinjiao SP-6.
Hypertension: Yintang (M-HN-3), Quchi L.1-11 and
Zusanli ST-36. QIUHOU (M-HN-8)
Headache: Yintang (M-HN-3), Fengchi GB-20, Behind the Ball
Taiyang (M-HN-9) and Hegu L.1-4.
Rhinitis: Yintang (M-HN-3), Yingxiang L.1.-20 and LOCATION
Hegu L.1-4. Along the inferior border of the orbit, at the
junction of the lateral one quarter and medial
three quarters of the infra-orbital margin.
YUYAO (M-HN-6)
Fish Waist NEEDLING
Ask the patient to close their eyes and look upwards. Use
LOCATION a finger to push the eyeball upwards and insert the needle,
In the centre of the eyebrow, in the depression first slightly inferiorly, then perpendicularly, between the
directly above the pupil when the eyes are eyeball and the inferior wall of the orbit, 0.5 to 1cun.
looking straight forwards. Caution: i. the needle should be inserted slowly without
lifting, thrusting or rotating; ii. immediately on with-
LOCATION NOTE drawal of the needle, press firmly with a cotton wool ball
Yuyao (M-HN-6) is traditionally located lateral to the for about a minute to prevent haematoma; iii. this nee-
supraorbital notch from which the supraorbital nerve dling method should not be attempted by those who have
emerges. not had appropriate clinical supervision.
The Extra points 567

u hou (M-HN-8) Disorders of the eyes, dimness of vision, redness and


swelling of the eyes, pain of the eyes, deviation of the
mouth and eye.

COMMENTARY
Taiyang (M-HN-9) is one of the most important and
commonly-used of the extra points. It was first discussed
in the Sagelike Prescriptions from the Taiping Era (10th
century CE), although considering its importance in the
martial arts tradition (as a vital spot where a blow may be
fatal) it was almost certainlyknownmuch earlier than this

I Taiyang (M-HN-9)is commonly needled or pricked to


Qiuhou (M-HN-8)
bleed in two clinical situations: i. in the treatment of one-
sided headache and dizziness, in which case it is frequently
ACTIONS joined to Shuaigu GB-8; and ii. in the treatment of diseases
Benefits the eyes of the eyes such as redness, swelling and pain. The Ode of
the Jade Dragon recommends bleeding bilateral Taiyang
INDICATIONS (M-HN-9) for dimness of vision, and also surprisingly
All eye diseases. needling it in combination with Shaoze SI-1 for swelling
of the breasts.
COMMENTARY
Qiuhou (M-HN-8)is a modern addition to the extra points
and is used in the treatment of a wide variety of eye Taiyang (M-HN-9)
diseases including short-sightedness, inflammation or
atrophy of the optic nerve, glaucoma, retinitis pigmen-
tosa and convergent strabismus.

TAlYANG (M-HN-9)
Sun (Supreme Yang)

LOCATION
At the temple, in the tender depression
approximately 1cunposterior to the mid-
point between the lateral extremity of the eyebrow and
the outer canthus of the eye.

NEEDLING
i. Perpendicular needling 0.5 to 0.8 cun; ii. Transverse
insertion posteriorly towards Shuaigu GB-8,l to 1.5 cun;
iii. Oblique insertion anteriorly 0.3 to 0.5 cun; iv. Prick to
bleed.

ACTIONS
Eliminates wind and clears heat
Reduces swelling and stops pain,
Activates the channel and alleviates pain

INDICATIONS
One-sided headache, dizziness, toothache, trigeminal
neuralgia.
The Extra points

COMBINATIONS INDICATIONS
Disorders of the eyes: Taiyang (M-HN-9), Jingming Redness, swelling and pain of the eyes, superficial
BL-1 and Yuwei (M-HN-7) (Ode of the Jade Dragon). visual obstruction, pain and swelling of the throat,
Redness, swelling and unbearable pain of both eyes mumps, one-sided headache, high fever.
with photophobia: needle Jingming BL-1 and Yuwei
(M-HN-7) and bleed Taiyang (M-HN-9) (Song of the COMMENTARY
]~deDrngon). This point was first discussed in the Great Compendizm of
Swelling of the breasts: Taiyang (M-HN-9) and Acupuncture and Moxibustion, which recommended the
Shaoze SI-1 (Ode of the Jade Dragon). application of five cones of moxa for the treatment of
superficial visual obstruction.

ERJIAN(M-HN-10)
Tip of the Ear BITONC (M-HN-14)
Penetrating the Nose
LOCATION
When the ear is folded forwards, this point lies LOCATION
at the apex of the ear. At the highest point of the naso-labial
groove.
LOCATION NOTE
Fold the ear so that the posterior part of the upper helix LOCATION NOTE
directly covers the anterior part of the upper helix. Take Run the finger along the naso-labial groove into the
care not to push the whole of the ear forwards. depression immediately below the nasal bone.

Erjian (M-HN-10) Bitong (M-HN-14)

I
Yingxiang L.1.-20

NEEDLING
i. Perpendicular insertion 0.1 cun or prick to bleed; ii. NEEDLING
moxibustion 3-5 cones. Transverse insertion towards the bridge of the nose 0.3 to
0.5 cun.
ACTIONS
Clears heat and dissipates swelling ACTIONS
Benefits the eyes and throat Benefits the nose
The Extra points

INDICATIONS INDICATIONS
Rhinitis, allergic rhinitis, nasal congestion and dis- Scrofula, cough, dyspnoea, Lung consumption, night
charge, nosebleed, nasal polyps. sweating, spontaneous sweating, steaming bone dis-
order with tidal fever, stiffness and pain of the neck.
COMMENTARY
Bitong (M-HN-14)is a modern addition to the extra points COMMENTARY
and is commonly used for the treatment of nose disorders, This point was first discussed in the Compilation of Acu-
especially by through-needling from Yingxiang L.1.-20. puncture and Moxibustion.Note that the name Bailao (One
Hundred Taxations)is also an alternative name for Dazhui
COMBINATIONS DU-14.
Chronic rhinitis: Bitong (M-HN-14), Hegu L.1-4,
Shangxing DU-23 and Tongtian BL-7. COMBINATIONS
Scrofula: Bailao (M-HN-30) and moxa Zhoujian
(M-UE-46) one hundred times (Compilation).
BAILAO (M-HN-30)
Hundred Taxations

LOCATION ANMIAN (N-HN-54)


At the back of the neck, 2 cun superior to Peacefu 1 Sleep
Dazhui DU-14,l cun lateral to the midline.
LOCATION
LOCATION NOTE Behind the ear, midway between Fengchi
The distance between the inferior border of the spinous GB-20 and Yifeng SJ-17.
process of C7 and the posterior hairline is 3 cun.
midway
-1I- ----_
I I I
I I !

I I Wangu GB-12
Anmian (N-HN-54)

NEEDLING LOCATION NOTE


Perpendicular insertion 0.5 to 0.8 cun. This point is found close to Wangu GB-12, but posterior
and slightly superior to it.
ACTIONS
Transforms phlegm and dissipates nodules NEEDLING
Stops cough and calms dyspnoea Perpendicular insertion 0.5 to 1 cun.
The Extra points

ACTIONS ACTIONS
Calms the spirit and pacifies the Liver Eliminates wind, activates the channel and alleviatespain

INDICATIONS INDICATIONS
Insomnia, agitation and restlessness, palpitations, Deviation of the mouth and eye, pain of the face,
epilepsy, dizziness, headache, tinnitus, hypertension. toothache, swelling of the gums, jaundice.

COMMENTARY COMMENTARY
Anrnian (N-HN-34) is a modern addition to the extra The point Jiachengqiang (M-HN-18)was first mentioned
points and is commonly used for the treatment of insom- in the Thousand Ducat Prescriptions. Clinically it is most
nia. It is located close to Wangu GB-12 which is similarly commonly used for facial paralysis and trigeminal
indicated for insomnia, as well as for mania and agitation neuralgia.
of the Heart.

COMBINATIONS JINJINYUYE (M-HN-20)


Insomnia: Anmian (M-HN-34), Neiguan P-6 and Golden Liquid &Jade Fluid
Sanyinjiao SP-6.
LOCATION
1

These paired points are located on the


JIACHENGJIANG(M-HN-18) veins either side of the frenulum of the
Adjacent to Container of Fluids tongue, Jinjinto the left and Yuye to the
right.
LOCATION
1 cun lateral to Chengqiang REN-24, LOCATION NOTE
over the mental foramen. The tongue should be rolled back to locate and treat these
points. If required the practitioner should roll the tongue
NEEDLING back using a gauze swab or wooden spatula.
i. Perpendicular-oblique insertion medially and inferiorly
into the mental foramen, 0.3 to 0.5 cun; ii. Transverse NEEDLING
insertion 0.5 to 1.5 cun. Prick to bleed.

1 cun
I-----
I I
Haiquan (M-HN-37)

I 1 Chengjiang REN-24
Yuye (M-HN-20)I I Jinjin (M-HN-20)
Jiachengjiang (M-HN-18)
The Extra points

ACTIONS Haiquan (M-HN-37)


Clears heat and reduces swelling
Generates fluids
Benefits the tongue

INDICATIONS
Lotus flower tongue, pain and swelling of the
tongue, mouth ulcers, throat painful obstruction, loss
of voice, loss of voice following windstroke.
Wasting and thirsting disorder, vomiting, nausea
and vomiting of pregnancy, diarrhoea.

COMMENTARY
These points were first mentioned in the Essential Ques-
tions. Several centuries later Sun Si-miao wrote in the
Thousand Ducat Prescriptions "Sudden swelling of the
tongue like an inflated pig's bladder obstructs the respira-
tion and can kill the patient if not treated promptly. Prick
the two large vessels on either side of the frenulum".
Although not commonly used in clinical practice due to Yuye (M-HN-20) I I Jinjin (M-HN-20)
their location beneath the tongue, these points may be
used in severe and recalcitrant disorders of the tongue,
including stiffness of the tongue and difficulty in speak-
ing following windstroke. Other disorders that these ACTIONS
points may be considered for are parched mouth associ- Clears heat and reduces swelling
ated with wasting and thirsting disorder, and severe and Generates fluids
unremitting nausea and vomiting of pregnancy. Benefits the tongue

COMBINATIONS INDICATIONS
Swelling of the tongue with difficulty speaking: Jinjin Heaviness, swelling and pain of the tongue, lotus
(M-HN-20), Yuye (M-HN-20) and Lianquan REN-23 flower tongue in children, facial paralysis.
(Great Compendium). Wasting and thirsting disorder, vomiting, abdominal
pain, diarrhoea, hiccup.

HAIQUAN (M-HN-37) COMMENTARY


Sea Spring This point, also known as Guifeng (Ghost Seal), was
included by Sun Si-miao among his 'thirteen ghost points'
LOCATION for the treatment of mania disorder and epilepsy. Although
In the centre of the frenulum of the tongue not commonly used in modern clinical practice due to its
between Jinjin and Yuye (M-HN-20). location, it is mainly indicated for acute or recalcitrant
disorders of the tongue and for facialparalysis. The Spiritual
LOCATION NOTE Pivot warns against needling this point "to excess" since it
The tongue should be rolled back to locate and treat this may lead to incessant bleeding and loss of voice.
point. If required the practitioner should roll the tongue
back using a gauze swab or wooden spatula. If the deeper COMBINATIONS
needling method is used, the tongue then rests on the Lotus flower tongue, swelling and distention,
needle with the mouth closed. extreme heat with difficulty in speaking: Haiquan
(M-HN-37), Shixuan (M-UE-I), Jinjin and Yuye
NEEDLING (M-HN-20) (Great Compendium).
i. 0.1 to 0.2 cun or prick to bleed; ii. 1.5 cun directed Throat moth: Haiquan (M-HN-37), Shaoshang LU-11
towards Yamen DU-15. and Hegu L.1.-4 (Great Compendium).
572 The Extra points

EXTRA POINTS OF THE BACK AND WAIST

DINCCHUAN (M-BW-1) COMBINATIONS


Calm Dyspnoea Acute asthma: Dingchuan (M-BW-I), Tiantu REN-22
and Kongzui LU-6.
aa &
"w
x r . A T~x n x T 4-
LWLrllL L U l Y

0.5 to 1cun lateral to the depression below the


spinous process of the seventh cervical vertebra (Dazhui HUANMEN M-BW-6
DU-14). Gate of Suffering

NEEDLING LOCATION
Perpendicular-oblique insertion towards the spine, 0.5 to 1.5 cun lateral to the prominence of the spinous
1 cun. process of the fifth thoracic vertebra (T5).

ACTIONS
Calms dyspnoea and wheezing and stops cough Huanmen M-BW-6
prominence of spinous
process of T5
INDICATIONS
Asthma, wheezing, cough, urticaria, pain of the
upper back.

Dingchuan (M-BW-1)

lower border of C7

Xinshu BL-15 I I .5cun

ACTIONS
Nourishes yin and clears heat
Tonifies qi

0.5 to 1 cun INDICATIONS


COMMENTARY The five taxations and the seven injuries, steaming
Dingchuan (M-BW-1) is a modern addition to the extra bone disorder, tidal fever, night sweating, agitation
points and is one of the primary points for the treatment and heat, poor appetite, heaviness of the limbs,
of acute wheezing, dyspnoea and asthma. fatigue, lack of strength, cough, dyspnoea.
The Extra points

COMBINATIONS INDICATIONS
The hundred syndromes of deficiency-taxation:moxa Wasting and thirsting disorder, dry throat, pain of
Huanmen (M-BW-6), Gaohuangshu BL-43 and the the chest and lateral costal region, epigastric pain,
four flowers [Geshu BL-17 and Danshu BL-191. vomiting.
(Compilation).
COMMENTARY
This point, nowadays known as Yishu (PancreasShu) was
WEIGUANXIASHU (M-BW-12) W first mentioned in the Thousand Ducat Formulas. It was
Stomach Controller Lower Shu f4 recommended by Sun Si-miao for wasting and thirsting
disorder (i.e. diabetes mellitus) and the accompanying
LOCATION symptoms of dryness of the throat.
1.5cunlateral to the lower border of the spinous
process of the eighth thoracic vertebra (T8). COMBINATIONS
Wasting and thirsting disorder and dry throat:
Weiguanxiashusanxue (i.e. Weiguanxiashu [M-BW-121
plus the point found inferior to the spinous process
of the eighth thoracic vertebra) 100 moxa cones
(Thousand Ducat Formulas).

YAOYAN (M-BW-24)
Lumbar Eyes

LOCATION
In the depression approximately 3.5 cun
lateral to the lower border of L4
(Yaoyangguan DU-3).

1 I
Dachangshu BL-25 Yaoyangguan DU-3
lower border of L4

NEEDLING
Oblique insertion towards the spine, 0.5 to 1 cun, or
transverse-oblique insertion 1to 1.5 cun.
Caution:perpendicular needling or oblique needling away
from the spine carries a substantial risk of causing a
pneumothorax.

ACTIONS
Clears heat and generates fluid
Yaoyan (M-BW-24) 3.5 cun
574 The Extra points

LOCATION NOTE Guanyuanshu BL-26


The 'eyes' referred to in the point name are the visible
hollows found in many people, just over one handbreadth
I Yaoyangguan DU-3

either side of the lumbar spine, below the level of the iliac lower border of L5

crest.
---.
NEEDLING
Perpendicular insertion, 1to 1.5 cun.

ACTIONS
Strengthens the Kidneys and benefits the lumbar region

INDICATIONS
Kidney deficiency lumbar pain, lumbar pain, con-
sumption.

COMMENTARY
This point was first mentioned in Song to Keep Up Your
Sleeve. It is commonly selected as a local point for acute or
chronic lumbar pain due to any aetiology.

COMBINATIONS
Lumbar pain: seven cones of moxa on Yaoyan
(M-BW-24) (Song to Keep Up Your Sleeve).

Shiqizhuixia (M-BW-25)

SHlQlZHUlXlA (M-BW-25)
Below the Seventeenth Vertebra COMMENTARY
Shqizhuixia (M-BW-25)was first mentioned in the Sup-
LOCATION plement to the Thousand Ducat Formulas. It is among the
On the midline of the lower back, in the
depression below the spinous process of the
-. most commonly used points for chronic back pain and is
very often found to be the focus of tenderness. It may be
fifth lumbar vertebra. used in both deficiency and excess patterns, and in the
frequently encountered clinical situation where the two
LOCATION NOTE are found in combination.
Slide a finger upwards along the midline of the sacrum
until it meets the significant depression inferior to the COMBINATIONS
lumbar spine. Chronic lumbar pain: Shiqizhuixia (M-BW-25), Guan-
yuanshu BL-26, Baohuang BL-53 and Weizhong BL-40.
NEEDLING
Perpendicular insertion 0.5 to 1 cun.
Caution: the spinal canal lies between 1.25 and 1.75 cun
deep to the skin surface,varying according to body build. HUATUOJIAJI(M-BW-35)
Hua Tuo's Paravertebral Points
ACTIONS
Tonifies the Kidneys and promotes urination LOCATION
Activates the channel and alleviates pain 0.5 to 1cun lateral to the depressions below
the spinous processes of the twelve thoracic
INDICATIONS and five lumbar vertebrae.
Pain of the lumbar region and legs, difficult
urination, foetus pressing on the bladder.
T h e Extra points 575

INDICATIONS
The points from the first to the fourth thoracic verte-
brae treat disorders of the Lung and upper limb.
The points from the fourth to the seventh thoracic
vertebrae treat disorders of the Heart.
The points from the seventh to the tenth thoracic ver-
tebrae treat disorders of the Liver and Gallbladder.
The points from the tenth to the twelfth thoracic
vertebrae treat disorders of the Spleen and Stomach.
The points from the first to the second lumbar
vertebrae treat disorders of the Kidneys.
The points from the third to the fifth lumbar
$ vertebrae treat disorders of the Bladder, Large and
Small Intestines, uterus and lower limbs.
2
B The points from the first to the seventh cervical
r
ul vertebrae treat local disorders of the neck.
All the Huatuojiaji (M-BW-35) points treat herpes
zoster at the level of the affected segmental nerve.
All the Huatuojiaji (M-BW-35) points treat pain and
stiffness of the local area.

COMMENTARY
The Huatuojiaji (M-BW-35)points were first mentioned
in Song to Keep U p Your Sleeve. Their discovery is attributed
to the great Han dynasty physician Hua Tuo who was said
to use them in preference to the back-shu points.

LOCATION NOTE
In clinical practice, the points located 0.5 to 1cun lateral to
the depressions below the spinous processes of the seven
cervical vertebrae are used as additional Huatuojiaji
points.

NEEDLING
Perpendicular-oblique insertion towards the spine, 0.5 to
1 cun. Note: the intention of needling these points is to
stimulatethe appropriate spinalnerve.The superficialloca-
tion of the point is chosen as 0.5 to 1cun lateral to the midline
according to depth and angle of needle insertion. In some
patients a more perpendicular, and in others a more ob-
lique, line of insertionwill give easier access to these points.

ACTIONS
Regulates and harmonises the five zang and six fu.
576 The Extra points

EXTRA POINTS O F THE CHEST A N D ABDOMEN

SANJIAOJIU(M-CA-23) INDICATIONS
Triangle Moxibustion Chronic diarrhoea, abdominal pain, pain around the
umbilicus, shan disorder, running piglet qi arising
LOCATION from the umbilicus.
On the lower abdomen. Construct an equi-
lateral triangle of which the apex is the COMMENTARY
umbilicus (Shenque REN-8), and the sides Sanjiaojiu (M-CA-23), also known as Qipang (Beside the
are equal to the length of the patient's Umbilicus)was first described in the Great Compendium of
smile. These points are located at the three points of the Acupuncture and Moxibustion which recommends this
triangle. point for the treatment of shan disorder, advising that the
bottom left point should be treated by moxibustion when
LOCATION NOTE the disorder is on the right side, and vice-versa. All three
It is helpful to describe this location to the patient. This will points may be treated for chronic diarrhoea.
invariably induce a smile which can then be measured.

Z l G O N G (M-CA-18)
Sanjiaojiu (M-CA-23) Palace of the Child (Uterus)

LOCATION
--
On the lower abdomen, 3 cun lateral to the
midline, level with Zhongji REN-3.

Zigong (M-CA-18)

Zhongji REN-3

NEEDLING
These points are treated by moxibustion only, whether
indirect, mediated by sliced ginger, crushed garlic, aco-
nite cake etc., or by cones placed directly on the skin.

ACTIONS
Regulates qi and alleviates pain
__________I
Stops diarrhoea 3 cun
The Extra points

LOCATION NOTE Tituo (N-CA-4)


Zhongji REN-3 lies on the midline of the lower abdomen,
4 cun inferior to the umbilicus and 1cun superior to the Guanyuan REN-4
pubic symphysis. Zigong (M-CA-18)is located one hand-
breadth lateral to this point.

NEEDLING
i. Perpendicular insertion 0.8 to 1.2 cun; ii. For prolapse of
the uterus, direct the needle from Zigong (M-CA-18)
towards Qugu REN-2 through the muscular layer. Then
rotate the needle until it wraps the muscle fibres, firmly
pull it upwards and outwards, and tape it to the skin in
this raised position for 20-30 minutes.

ACTIONS
Raises and regulates qi
Regulates menstruation and alleviates pain

INDICATIONS
Prolapse of the uterus, infertility, irregular menstrua-
tion, uterine bleeding.

COMMENTARY
Zigong (M-CA-18)was first mentioned in the Great Com-
pendium of Acupuncture and Moxibustion.
4 cun

COMBINATIONS
ployed. Direct the needle from Tituo (N-CA-4) towards
Infertility: Zigong (M-CA-18) and Zhongji REN-3
Qugu REN-2 through the muscular layer. Then rotate the
(Great Compendium).
needle until it wraps the muscle fibres, firmly pull it
Uterine bleeding: Zigong (M-CA-18) and Zhongji
upwards and outwards, and tape it to the skin in this
REN-3 (Great Compendium).
raised position for 20-30 minutes.
Ceaseless uterine bleeding: Zigong (M-CA-18),
Zhongji REN-3, Shimen REN-5 and Shenshu BL-23
(Great Compendium).
ACTIONS
Raises and regulates qi
TlTUO (N-CA-4)
INDICATIONS
Lift and Support
Prolapse of the uterus, dysmenorrhoea, abdominal
distention and pain.
LOCATION
On the lower abdomen, 4 cun lateral to the
COMMENTARY
midline, level with Guanyuan REN-4.
Tituo (N-CA-4)is a modern addition to the extra points
and is one of the primary points for the treatment of
LOCATION NOTE
uterine prolapse.
Guanyuan REN-4 lies on the midline of the lower abdo-
men, 3 cun inferior to the umbilicus and 2 cun superior
COMBINATIONS
to the pubic symphysis. Locate Tituo (N-CA-4) 4 cun
Prolapse of the uterus: Tituo (N-CA-4), Baihui
lateral to this point, medial to the anterior superior iliac
DU-20, Zusanli ST-36 and Sanyinjiao SP-6.
spine.

NEEDLING
i. Perpendicular insertion 0.8 to 1.2cun; ii. For prolapse of
the uterus, the following needling method may be em-
578 The Extra points

EXTRA POINTS OF THE UPPER EXTREMITY

SHIXUAN (M-UE-1) COMMENTARY


Ten Diffusions The points Shixuan (M-UE-I)were first discussed in the
~cziscrrzLo.ica~ FETrzLllas by p a t ?& cefikry physi-
LOCATION cian Sun Si-miao. They are almost exclusively used for
d
On the tips of the ten fingers, approximately acute conditions such as loss of consciousness (including
0.1 cun from the fingernail. the acute phase of windstroke), epilepsy, heat-stroke,
sunstroke etc. They are usually pricked to bleed, a proce-
NEEDLING dure which may occasionallybe followedby moxibustion.
Prick to bleed. This may be followed by moxibustion.

SIFENC (M-UE-9)
Four Seams

LOCATION
-
On the palmar surface of the hand, at the
midpoints of the transverse creases of the
proximal interphalangeal joints of the index, middle, ring
and little fingers.

LOCATION NOTE
In most subjects two creases will be found at the proximal
interphalangeal joints. In this case, Sifeng (M-UE-9) is
located on the crease which is more prominent on flexion
of these joints.

Shixuan (M-UE-1)

ACTIONS
Opens the portals and revives consciousness, drains heat
and pacifies wind.

INDICATIONS
Loss of consciousness, windstroke, summer-heat
stroke, febrile disease, swelling and pain of the
throat, throat moth, acute childhood fright wind,
clonic spasm, epilepsy, mania, vomiting, diarrhoea,
numbness or pain of the fingers Sifeng (M-UE-9)
The Extra points 579

NEEDLING
Prick to bleed, or prick and squeeze until a yellow-white
liquid appears.

ACTIONS
Fortifies the Spleen and dissipates accumulation

INDICATIONS
Chldhood nutritional impairment, childhood accumu-
lation disorder, cluldhood diarrhoea, whooping cough.

COMMENTARY
Sifeng (M-UE-9) is an important and commonly used
point grouping in the treatment of a wide range of child-
hood digestive disorders. It is indicated for two important
patterns known as chldhood nutritionalimpairment (shao
er gan) and childhood accumulation disorder (shao er ji
shi). The former refers to childhood malnutrition due to a
variety of aetiologies. Its symptoms include emaciation,

u
sallow complexion, impaired digestion, withered hair, Baxie (M-UE-22)
exhaustion and enlarged abdomen. The latter, childhood
accumulation disorder, more or less corresponds to the
pattern of food stagnation in adults and is regarded as a
major factor in such varied diseases as constipation, ab-
dominal pain, intestinal parasites, vomiting, diarrhoea,
cough and asthma.
The needling method used at these points is very spe-
cific, the points being pricked and squeezed to express a
few drops of clear yellow fluid.

BAXlE (M-UE-22)
Eight Pathogens
ACTIONS
LOCATION Clears heat and dissipates swelling
v
When the hand is made into a fist, six of
these points lie in the depressions between INDICATIONS
the metacarpal heads, proximal to the web margins. The Numbness, stiffness, redness, swelling, spasm and
remaining two points lie equidistant between the thumb pain of the fingers and hand, painful obstruction of
and index metacarpals, proximal to the web margins. the fingers.
Headache, toothache, pain and swelling of the throat,
LOCATION NOTE redness and swelling of the eyes, febrile disease.
To assist location of the first six points described above,
with the hand held in a fist draw an equilateral triangle COMMENTARY
between the prominences of the metacarpal heads and the These points were first discussed as far back as the Essen-
proximal end of the visible crease formed by the web tial Questions which recommended bleeding them for the
space. The points lie at the centre of these triangles. treatment of malaria. The name Baxie (Eight Pathogens),
however, did not appear until the Great Compendium of
NEEDLING Acupuncture and Moxibustion. In modern clinical practice
Perpendicular insertion along the line between the shafts they are almost always used for treating pain, swelling,
of the metacarpal bones, 0.5 to 1 cun. stiffness, numbness or spasm of the fingers and the sur-
The Extra points

rounding area. For disorders of the ring, middle and index INDICATIONS
fingers, the points either side of the finger are generally Acute lumbar sprain.
needled. For disorders of the little finger the point be-
tween the little and ring fingers is needled in combination COMMENTARY
with points such as Qiangu SI-2 and Houxi SI-3. For Yaotongxue (N-UE-19) is a commonly used point for
disorders of the thumb, the point between the thumb and acute lumbar sprain. It is usually selected when the pain
index finger is needled in combinationwith points such as is on either side of the midline and the paints on the
Lieque LU-7 and Yuji LU-10. affected side are manipulated whilst the patient is asked
to twist, turn and bend. Note that this point is also known
as Yaotongdian (Lumbar Pain Spot).
YAOTONCXUE (N-UE-19)
Lumbar Pain Point

LOCATION LUOZHEN (M-UE-24)


On the dorsum of the hand, two points located Stiff Neck
between the second and third and the fourth d7
and fifth metacarpal bones, in the depressions A LOCATION
lying immediately distal to the bases of the On the dorsum of the hand, in the depression
metacarpals. just proximal to the second and third
metacarpo-phalangeal joints.
LOCATION NOTE
Slide a finger proximally along the back of the hand LOCATION NOTE
towards the wrist, in the groove between the metacarpal i. Luozhen (M-UE-24)is usually located and needled with
bones until it reaches the tender depression just proximal the hand resting in a loose fist; ii. This point may be located
to the junction of the metacarpals. at the apex of an equilateral triangle formed by this point
and the prominences of the metacarpo-phalangeal joints
of the index and middle fingers; iii. The point is also
defined as lying on the dorsum.of the hand opposite
Laogong P-8.

Zhongzhu SJ-3

Luozhen (M-UE

NEEDLING
Perpendicular insertion 0.5 to 1 cun.

ACTIONS
Invigorates qi and blood in the lumbar region
The Extra points

NEEDLING LOCATION NOTE


Perpendicular or oblique insertion directed proximally, i. There are two points; one lies on the ulnar side of the
0.5 to 1cun. tendon of flexor carpi radialis, and between this tendon
and the tendon of palmaris longus if this is present, whilst
ACTIONS the other lies on the radial side of the tendon of flexor carpi
Invigorates qi and blood in the neck region radialis; ii. Divide the distance between the cubital crease
and Daling P-7 into thirds and locate this point at the
INDICATIONS junction of the proximal two thirds and the distal third.
Stiffness and pain of the neck, inability to turn the
head, headache, pain of the shoulder and arm. NEEDLING
Pain of the epigastrium, diarrhoea, acute and chronic Perpendicular insertion, 0.5 to 1cun or oblique proximal
childhood fright wind insertion 1to 1.5 cun.

COMMENTARY ACTIONS
Luozhen (M-UE-24)is commonly selected for acute pain Treats prolapse of the rectum and haemorrhoids
and stiffness of the neck. The point on the affected side is
manipulated whilst the patient is asked to flex, extend and INDICATIONS
rotate the neck. Haemorrhoids, prolapse of the rectum, itching of the
anus, blood in the stool, tenesmus.

ERBAl (M-UE-29) COMMENTARY


Two Whites This point first appeared in the Classic of the Jade Dragon
and has long been used for the treatment of haemorrhoids
LOCATION and rectal prolapse.
On the flexor aspect of the forearm, 4 cun
proximal to Daling P-7, either side of the tendon COMBINATIONS
of flexor carpi radialis. Chronic haemorrhoids: Erbai (M-UE-29), Chengshan
BL-57 and Changqiang DU-1 (Great Compendium).
Prolapse of the rectum and haemorrhoids: Erbai
(M-UE-29), Baihui DU-20, Zhishi BL-52 and
Changqiang DU-1 (Great Compendium).

ZHOUJIAN(M-UE-46)
Elbow Tip

LOCATION
On the tip of the olecranon process of the ulna.

NEEDLING
This point is treated by moxibustion only.

ACTIONS
Transforms phlegm and dissipates swelling

INDICATIONS
Scrofula, carbuncles and furuncles, deep-rooted ul-
cers, intestinal abscess.

COMMENTARY
This point was first discussed in the Thousand Ducat
Formulas, particularly in relation to the treatment of intes-
582 The Extra points

tinal abscess. It has also long been used for scrofula, a term
primarily used to describe nodules on the sides of the
Jianqian (M-UE-48)
neck, but also nodules in the axilla and inguinal region.
The text Introduction to Medicine recommends applying end of anterior axillary fold I
I
I
I 1)ianyuL.I.-15
moxibustion to right Zhoujian (M-UE-46) for left-sided
scrofula and vice-versa.

I I I
I Jianyu L.1.-15 I
I
1
!
i- midway --I
I
;

Zhoujian

I Jianqian (M-UE-48)

JIANQIAN(M-UE-48) INDICATIONS
Front of the Shoulder Stiffness and pain of the anterior aspect of the shoul-
der, numbness, paralysis and immobility of the
LOCATION shoulder joint.
On the anterior aspect of the shoulder joint,
midway between the anterior axillary crease COMMENTARY
and Jianyu L.1.-15. Jianqian (M-UE-48) also known as Jianneiling (Inner
Mound of the Shoulder) is frequently palpated, and nee-
LOCATION NOTE dled if tender, for pain in the front portion of the shoulder
This point is usually found to be tender on palpation. joint. In clinical practice it is commonly combined with
other important points for treating the shoulder such as
NEEDLING Jianyu L.1.-15, Juliao L.1.-16, Jianliao SJ-14 and Naoshu
i. Perpendicular insertion 1 to 1.5 cun; ii. Oblique or SI-10.
oblique-transverse insertion distally towards the elbow, 2
to 3 cun.

ACTIONS
Activates qi and blood and benefits the shoulder joint
The Extra points 583

EXTRA POINTS OF THE LOWER EXTREMITY

BAICHONCWO (M-LE-34) COMMENTARY


Hundred Insect Burrow This point was first discussed in the Great Compendium of
Acupuncture and Moxibustion. Lying close to Xuehai SP-10,
LOCATION an important point for the treatment of skin diseases,
3 cun proximal to the superior border of the Baichongwo (M-LE-34) is considered to have a special
patella, in a tender depression on the bulge of action on alleviating severe itching.
the vastus medialis muscle.

LOCATION NOTE HEDINC (M-LE-27)


This point lies 1 cun proximal to Xuehai SP-10. Crane's Summit

LOCATION
In the depression at the midpoint of the
superior border of the patella.

Heding (M-LE-27)

lateral Xiyan (MN-LE-16) medial Xiyan


also Dubi ST-35 (MN-LE-16)

vastus rnedialis

NEEDLING
Perpendicular or oblique insertion 1 to 1.5 cun.

ACTIONS
Clears heat from the blood
Eliminates wind and drains dampness NEEDLING
Perpendicular insertion 0.5 to 1 cun.
INDICATIONS
Sores of the lower region, wind rash, itching of the ACTIONS
skin. Activates qi and blood and benefits the knee joint.
The Extra points

INDICATIONS NEEDLING
Crane's knee wind, swelling and pain of the knee, leg With the knee flexed and supported by a rolled pillow, i.
qi, weakness of the knee and leg. Perpendicular insertion, directed towards Weizhong
BL-40, 1 to 2 cun; ii. Oblique insertion in a medial and
COMMENTARY superior direction, behind the patella 1 to 2 cun; iii.
Heding (M-LE-27) is a valuable secondary point in the Through-needling between lateral and medial Xiyan
treatment of disorders of the knee joint, and is often (MN-LE-16),behind the patellar ligament.
selected in combination with such points as Xiyan
(MN-LE-16),Xuehai SP-10,Liangqiu ST-34, Yanglingquan ACTIONS
GB-34 and Yinlingquan SP-9. Dispels wind-damp, reduces swelling and alleviatespain

INDICATIONS
XlYAN (MN-LE-16) Swelling and pain of the knee joint, difficulty in flex-
Eyes of the Knee ing and extending the knee, weakness of the knee
joint, numbness of the knee, numbness of the lower
LOCATION limb, atrophy disorder of the lower limb, leg qi.
On the knee, in the hollows formed when the
knee is flexed, immediately below the patella COMMENTARY
and both medial and lateral to the patellar ligament. The Xiyan (MN-LE-16)points were first discussed in the
eighth century text Necessities of a Frontier Official.Lateral
Xiyan (MN-LE-16) corresponds to Dubi ST-35, whilst
medial Xiyan (MN-LE-16) is a non-channel point. Used
together, these are essential points in the treatment of all
knee disorders, whether due to deficiency or excess, heat
or cold, and form the basis of any prescription for treating
disorders of the knee joint and surrounding tissues.
lateral Xiyan (MN-LE-16) medial Xiyan
also Dubi ST-35 (MN-LE-16)
COMBINATIONS
Redness, swelling and pain of the knees with inabil-
ity to walk: Xiyan (MN-LE-16) and Xiguan LIV-7
(Song of the Jade Dragon).

LANWEIXUE (M-LE-13)
Appendix Point

LOCATION
Approximately 2 cun distal to Zusanli ST-36
on the right leg.
R.
LOCATION NOTE
The exact location of this point is determined by careful
palpation to identify the point of maximum tenderness.

NEEDLING
Perpendicular insertion 1 to 1.5 cun.

ACTIONS
LOCATION NOTE Activates qi and blood and clears heat and fire poison
Lateral Xiyan (MN-LE-16)is identical with Dubi ST-35. from the Large Intestine
The Extra points 585

INDICATIONS DANNANGXUE (M-LE-23)


Acute and chronic appendicitis, paralysis of the Gal [bladder Point
lower limb, drop foot, indigestion.
LOCATION
COMMENTARY Between 1 and 2 cun distal to Yanglingquan
The point Lanweixue (M-LE-13)is famous for its applica-
tion in the treatment of both acute and chronic appendicitis.
In the majority of cases it becomes tender when the
GB-34 on the right leg.

LOCATION NOTE
K
appendix is inflamed, and indeed may perform a second- i. The exact location of this point is determined by careful
ary role in the diagnosis of this condition. Lanweixue palpation to identify the point of maximum tenderness; ii.
(M-LE-13)is one of the few acupuncture points that only Yanglingquan GB-34 is located below the lateral aspect of
exists on one side of the body. the knee, in the tender depression approximately 1 cun
anterior and inferior to the head of the fibula.
COMBINATIONS
Acute appendicitis: Lanweixue (M-LE-13), Shang- NEEDLING
juxu ST-37 (left), Tianshu ST-25, Quchi L.1.-11. Perpendicular insertion 1 to 1.5 cun.

ACTIONS
Clears heat and drains damp

INDICATIONS
0 Acute and chronic cholecystitis, acute and chronic
cholelithiasis, disease of the bile duct, biliary ascaria-
sis, distention and pain of the lateral costal region,
paralysis and numbness of the lower limb.
The Extra points

COMMENTARY LOCATION NOTE


The point Dannangxue (M-LE-23)is famous for its appli- These eight points include Xingjian LIV-2, Neiting ST-44
cation in the treatment of both acute and chronic and Xiaxi GB-43.
cholecystitis and cholelithiasis. In the majority of cases it
becomes tender when the gall bladder is inflamed, and NEEDLING
indeed may perform a secondary role in the diagnosis of Oblique insertion directed proximally, 0.5 to 1 cun.
these conditions. Dannangxue (M-LE-23)is one of the few
acupuncture points that only exists on one side of the ACTIONS
body. Clears heat and dissipates swelling

COMBINATIONS INDICATIONS
Acute pain of cholelithiasis: Dannangxue (M-LE-23), Leg qi, redness, swelling and pain of the dorsum of
Yanglingquan GB-34 (left), Qimen LIV-14 (right), the foot, malaria, headache, irregular menstruation.
Burong ST-19 (right), Zhongwan REN-12, Hegu L.1.-4
and Taichong LIV-3. COMMENTARY
The points that comprise Bafeng (M-LE-8)were first men-
tioned in Essential Questions1, although they were not
BAFENC (M-LE-8) named Bafeng (Eight Winds) until the Ming dynasty
Eight Winds classic The Great Compendium of Acupuncture and Moxibus-
tion. The Thousand Ducat Formulas of Sun Si-miao named
LOCATION them Bachong (Eight Rushing), reflecting the dynamic qi
On the dorsum of the foot, between the toes, sensation induced by needling these distal points of the
0.5 cun proximal to the margin of the web. foot. Although indicated for malaria in the Essential Ques-
tions, and for irregular menstruation in the Compilation of
Acupuncture and Moxibustion, this group of points is pri-
marily used for disorders of the toes in the same way that
the Baxie (M-UE-22)points are used for disorders of the
fingers. It should be noted, however, that three of the
Bafeng (M-LE-8) points do correspond to channel acu-
puncture points (Xiaxi GB-43, Neiting ST-44 and Xingjian
LIV-2).

NOTES
1 Essential Questions Chapter 36.