ADVANCED CLINICAL ACUPUNCTURE

Lecture 4
Meridian and Acupoint 4 - Spleen

Dr. Brian Chi Yan Cheng

鄭智仁中醫博士
November 2022

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HKU School of Professional and Continuing Education
4 Leg Tai Yin Spleen Meridian
• 21 acupoints on one side
• 11: anterio-medial side of the lower
limbs
• 10: sides of the chest and abdomen
• Begins at the Yinbai Hidden White (SP1)
• Ends at Dabao Great Embracement
(SP21)
4.2 Main indications
• Disorders of spleen and stomach: Abdominal
pain and distension, poor appetite, vomiting,
diarrhoea, dysentery, borborygmus, jaundice and
oedema
• Kidney or gynaecological disorder:
Dysmenorrhoea, irregular menstruation, uterine
bleeding, morbid leucorrhoea, prolapse of the
uterus, sterility, delayed labour, nocturnal
emission, impotence, enuresis, dysuria
• Disorders in the regions along the course of
the meridian
4.3 Acupuncture Points
SP1 Yinbai Hidden White (隱白)
• Location: On the medial side of the distal segment of the hallux (big toe), at
approximately 1 fen from the nail, and level with the corner of the toenail.
• Acupoint anatomy: Skin - subcutaneous tissue – dorsal digital nerve and vein of the
medial side of the hallux - crural fascia - dorsal digital branches of the superficial fibular
nerve and the dorsal digital artery – distal phalanx of the hallux.
• Locating the acupoint: On the medial side of the distal segment of the hallux, locate the
acupoint at approximately 1 fen from the corner of the nail.
• Indications: Abdominal distention, retching without appetite, menstrual disorders,
children easily frightened by strangers or becoming ill because of strangers, and chronic
fright wind
• Method: Puncture perpendicularly 0.2-0.3cun. Moxibustion applicable
• Application: Together with SP6 and SP8 to treat bleeding
• Treatment of functional uterine bleeding, upper gastrointestinal bleeding, acute enteritis,
schizophrenia, neurasthenia and so on.
3.3 Acupuncture Points
3.3 Acupuncture Points
SP2 Dadu Great Metropolis (大都)
• Location: On the medial side of the hallux, along the border between the red and white
flesh in the depression in front of the base joint.
• Acupoint anatomy: Skin - subcutaneous tissue – dorsal digital nerve and vein of the
medial side of the hallux - crural fascia - dorsal digital branches of the superficial fibular
nerve and the dorsal digital artery – proximal phalanx of the hallux.
• Locating the acupoint: On the medial side of the hallux, in the joint between the bones
anterior and inferior to the metatarsophalangeal joint, and along the border between the
red and white flesh. Here, the dorsal side is fleshy, and, thus, called Dadu Great
Metropolis (SP-2).
• Indications: Epigastric pain, abdominal fullness and vomiting, diarrhea, febrile disease
without sweating, heaviness of the body and pain in the bones, painful swelling of the
toe joints, and counterflow cold of the extremities.
• Method: Puncture perpendicularly 0.3-0.5cun. Moxibustion applicable
• Application: Together with ST36 to treat bloating
3.3 Acupuncture Points
3.3 Acupuncture Points
SP4 Gongsun Yellow Emperor (公孫)
• Location: At 1 cun behind the base joint of the hallux and in the depression in front of the
in inner ankle.
• Acupoint anatomy: Skin - subcutaneous tissue - dorsal digital nerve and vein of the
medial side of the hallux - crural fascia - medial crural cutaneous branches of the
saphenous nerve - dorsal digital branches of the superficial fibular nerve and the dorsal
digital artery - medial head of the flexor hallucis brevis and the abductor hallucis - first
metatarsal bone.
• Locating the acupoint: At 1 cun behind the metatarsophalangeal joint of the hallux,
where the proximal end of the first metatarsal bone joins with the cuneiform, locate the
acupoint in the depression along the border between the red and white flesh below the
arch of the foot. When sitting upright, if the bottoms of the patient’s feet face each other,
the acupoint is located where the arches of the feet are furthest apart.
• Indications: Abdominal deficiency and distention, abdominal pain, vomiting, spleen
deficiency with edema, and jaundice.
• Method: Puncture perpendicularly 0.5-0.8cun. Moxibustion applicable
• Application: Together with ST41, RN12, ST36 to treat food stagnation
3.3 Acupuncture Points
SP5 Shangqiu Shang Hill (商丘)
• Location: In the depression inferior and slightly anterior to the inner ankle.
• Acupoint anatomy: Skin - subcutaneous tissue – medial dorsal cutaneous nerve of the
superficial fibular nerve and branches of the great saphenous vein - crural fascia - medial
crural cutaneous branches of the saphenous nerve – inferior extensor retinaculum –
between the tendons of the tibialis anterior and the extensor hallucis longus - anterior
medial malleolar artery and branches of the deep fibular nerve – the talus.
• Locating the acupoint: In the depression slightly in front of the inferior border of the
medial malleolus and at the end of the transverse ankle crease. After locating the acupoint,
pull back the hallux, and the depression will appear. An alternative method for locating
the acupoint: Measure 8 fen medially (horizontally) from the jiexi Ravine Divide (ST-41)
acupoint in the middle of the ankle to arrive at zhongfeng Mound Center (LV-4). Then,
measure 8 fen from zhongfeng Mound Center (LV-4) to the inferior border of the medial
malleus to reach shangqiu Shang Hill (SP-5).
• Indications: Epigastric pain, abdominal distention, abdominal pain, borborygmus,
panting and retching, coldness in the body, the heaviness of the body and joint pain,
edema, listlessness with drowsiness, and a propensity to sigh.
• Method: Puncture perpendicularly 0.5-0.8cun. Moxibustion applicable
3.3 Acupuncture Points
SP6 Sanyinjiao Three Yin Intersection (三陰交)
• Location: At 3 cun above the inner ankle, in the depression along the posterior border of
the tibia.
• Acupoint anatomy: Skin - subcutaneous tissue - great saphenous vein and the medial
cutaneous branch of the saphenous nerve - crural fascia - medial crural cutaneous
branches of the saphenous nerve - soleus muscle and flexor digitorum longus - tibial
nerve and the posterior tibial artery and vein – the tibia.
• Locating the acupoint: On the medial side of the calf, along the posterior border of the
tibia, measure 3 cun upward from the point of the inner ankle; the acupoint is level with
xuanzhong Suspended Bell (GB-39) on the lateral side.
• Indications: Abdominal distention, abdominal pain, diarrhea, enuresis, difficulty
urinating, impotence, dysmenorrhea, metrostaxis, heaviness and pain in the body, swelling
and pain in the dorsum of the feet and ankles, uticaria, jaundice, edema, and visceral
agitation.
• Method: Puncture perpendicularly 0.5~1.0 cun. Moxibustion is applicable. Needling is
contraindicated in pregnancy women.
3.3 Acupuncture Points
SP9 Yinlingquan Yin Mound Spring (陰陵泉)
• Location: On the medial side of the calf near the knee, in a depression along the medial
border of the tibia below the knee, and opposite and 1 cun higher than yanglingquan Yang
Mound Spring (GB-34).
• Acupoint anatomy: Skin - subcutaneous tissue - great saphenous vein and the medial
cutaneous branch of the saphenous nerve - crural fascia - medial crural cutaneous
branches of the saphenous nerve - fibularis longus - tibial nerve, saphenous nerve, and the
posterior tibial artery and vein – the tibia.
• Locating the acupoint: With the patient sitting upright and their knees bent, first locate
the medial head of the popliteal crease, then find the depression below the head of the
crease and under the medial condyle of the tibia, and apply pressure and hold. Extend the
patient’s leg to locate the acupoint in this position. (The patient should be lying in a
supine position, with their knees slightly bent. The needle should be inserted from the
medial side to the lateral side horizontally.)
• Indications: Abdominal fullness, poor appetite, oedema, urinary difficulty, leucorrhoea,
bi-syndrome, and redness and swelling in the legs and knees.
• Method: Puncture perpendicularly 0.5-1.0cun. Moxibustion applicable
3.3 Acupuncture Points
3.3 Acupuncture Points
SP10 Xuehai Sea of Blood (血海)
• Location: On the medial side of the knee at 2 cun above the patella.
• Acupoint anatomy: Skin - subcutaneous tissue - great saphenous vein, cutaneous
branches of the obturator nerve, and cutaneous branches of the femoral nerve - crural
fascia – sartorius and medial border of the quadriceps femoris - femoral artery – the
femur.
• Locating the acupoint: With the patient sitting upright, their legs hanging down, and
their knees bent, hold the left patella with the center of the right palm, the four fingers
should be held together with the thumb opened. The acupoint is located under the thumb
position at the distal bulge of the vastus medialis of the quadriceps femoris. The patient
should experience unbearable soreness and distention when the acupoint is pressed.
Indications: Metrostaxis, menstrual disorders, dysmenorrhea, leucorrhea, eczema,
urticaria, and anemia.
• Method: Puncture perpendicularly 0.5-1.2cun. Moxibustion applicable
3.3 Acupuncture Points
3.3 Acupuncture Points
3.3 Acupuncture Points
3.3 Acupuncture Points
3.3 Acupuncture Points
SP21 Dabao Great Embracement (大包)
• Location: On the lateral side of the chest, at 6 cun below the armpit, and 3 cun below
yuanye Abyss Humor (GB-22).
• Acupoint anatomy: Skin - subcutaneous tissue – long thoracic nerve, lateral thoracic
artery, and anterior cutaneous branches and lateral cutaneous branches of intercostal
nerves - latissimus dorsi and serratus anterior - intercostal muscle - excessive insertion
depths can penetrate the lungs and cause pneumothorax.
• Locating the acupoint: With the patient lying sideways, proceed from zhourong All-
Round Flourishing (SP-20) in a lateral, oblique, and inferior direction. Instruct the patient
to extend their arms straight and hold them close to the side. Measure 3 cun below the end
of the axillary crease (underarm crease) of yuanye Abyss Humor (GB-22) on the
gallbladder meridian channel and a further 3 cun below yuanye Abyss Humor (GB-22) to
reach dabao Great Embracement (SP-21). When the area is palpated, the sixth rib should
be felt underneath.
• Indications: Chest pain, watery qi in the chest, and an inability to catch one’s breath.
3.3 Acupuncture Points
SP1 0.1 cun posterior to the corner of the nail, on the medial side of the great
toe.
SP2 On medial side of the great toe, distal and inferior to the 1st
metatarsophalangeal joint in a depression at the juncture of the red and
white skin.
SP3 Proximal and inferior to the head of the 1st metatarsal bone in a depression
at the junction of the red and white skin.
SP4 In a depression distal and inferior to the 1st metatarsal bone at the junction
of the red and white skin.
SP5 In a depression distal and inferior to the medial malleolus, midway between
the tuberosity of the navicular bone and the tip of the medial malleolus.
SP6 3 cun directly above the tip of the medial malleolus on the posterior border
of the tibia. Contraindicated to needle during pregnancy.
SP7 6 cun from the tip of the medial malleolus on line connecting tip of medial
malleolus and SP9 on the posterior border of the tibia (3 cun above SP6)
SP8 3 cun below SP9 on line connecting SP9 and medial malleolus
SP9 On the lower border of the medial condyle of the tibia, in the depression
between the posterior border of the tibia and gastrocnemius muscle.
SP10 With the knee in flexion, 2 cun superior to the superior border of the
patella, on the bulge of the medial portion of the quadriceps femoris
muscle.
SP11 6 cun above SP10 on the line connecting SP12 and SP10.
SP12 3.5 cun lateral to the midline at CV2, in the inguinal region, on the lateral
side of the femoral artery. Avoid femoral artery when needling!
SP13 0.7 cun laterosuperior to SP12 and 4 cun lateral to the anterior midline.
SP14 1.3 cun below SP15 and 4 cun lateral to the anterior midline, on lateral side
of rectus abdominis muscle.
SP15 4 cun lateral to the center of the umbilicus, lateral to rectus abdominus
muscle.
SP16 3 cun above SP15 and 4 cun lateral to the anterior midline at CV11
SP17 6 cun lateral to the anterior midline in the 5th intercostal space.
SP18 6 cun lateral to the anterior midline in the 4th intercostal space.
SP19 6 cun lateral to the anterior midline in the 3rd intercostal space.
SP20 6 cun lateral to the anterior midline in the 2nd intercostal space.
SP21 On the midaxillary line, 6 cun inferior to the anterior axillary crease.
Midway between the axilla and the free end of the eleventh rib.