Basic Theory of Acupuncture and Moxibustion Contents Studying progress (total time 220 hrs, 15 weeks, about three

months) A brief introduction to meridians & colloterals and acupoints(16 hrs) 1. What are the means of meridians and collaterals? 2. What is the composition of the meridian system? 3. What are the acupoints? Part 1 Fourteen Meridians and Acupoints (104 hrs) Lecture 1 The Lung Meridian of Hand-Taiyin(LU) Lecture 2 The Large intestine Meridian of Hand-Yangming (LI) Lecture 3 The Stomach Meridian of Foot-Yangming (ST) Lecture 4 The Spleen Meridian of Foot-Taiyin (SP) Lecture 5 The Heart Meridian of Hand-Shaoyin (HT) Lecture 6 The Small intestine Meridian of Hand-Taiyang (SI) Lecture 7 The Bladder Meridian of Foot-Taiyang (BL) Lecture 8 The Kidney Meridian of Foot-shaoyin (KI) Lecture 9 The Pericardium Meridian of Hand-Jueyin (PC) Lecture 10 The Sanjiao (Triple Energizer) Meridian of Hand-Shaoyang (SJ) Lecture 11 The Gallbladder Meridian of Foot-Shaoyang (GB) Lecture 12 The Liver Meridian of Foot-Jueyin (LR) Lecture 13 The Ren Meridian (Conception Vessel) (RN) Lecture 14 The Du Meridian (Governor Vessel) (DU) Take the middle Exam for Course C (4 hrs) When you finish the above contents and prepare to take the middle exam, please contact with your tutor to send you the middle exam paper for course C by e-mail. After you finish the exam, please send back the finished exam paper to your tutor, he/she will check your answers and give you the score. Part 2 Acupuncture and Moxibustion Techniques (92 hrs) Lecture 1. Acupuncture 1. Filiform needle 2. Needling methods 3. Precautions, Contraindications and Management of Possible Accidents in Acupuncture Treatment Lecture 2. Moxibustion 1. What is Moxibustion 2. What are the effects of moxibustion? 3. What is the classification of moxibustion 4. How to apply the moxibustion? Take the final exam for course C (4hrs) When you finish all of the contents and prepare to take the final exam, please contact with your tutor to send you the final exam paper for course C by e-mail. After you finish the exam, please send back the finished exam paper to your tutor, he/she will check your answers and give you the score. Basic Theories of Acupuncture and Moxibustion

A brief introduction to meridians & collaterals and acupoints 1. What are the means of meridians and collaterals? 2. What is the composition of the meridian system? 3. What are the acupoints? 4. How to locate the acupoints? Part 1 Fourteen Meridians and Acupoints Lecture 1 The Lung Meridian of Hand-Taiyin(LU) Lecture 2 The Large intestine Meridian of Hand-Yangming (LI) Lecture 3 The Stomach Meridian of Foot-Yangming (ST)

Lecture 4 The Spleen Meridian of Foot-Taiyin (SP) Lecture 5 The Heart Meridian of Hand-Shaoyin (HT) Lecture 6 The Small intestine Meridian of Hand-Taiyang (SI) Lecture 7 The Bladder Meridian of Foot-Taiyang (BL) Lecture 8 The Kidney Meridian of Foot-shaoyin (KI) Lecture 9 The Pericardium Meridian of Hand-Jueyin (PC) Lecture 10 The Sanjiao (Triple Energizer) Meridian of Hand-Shaoyang (SJ) Lecture 11 The Gallbladder Meridian of Foot-Shaoyang (GB) Lecture 12 The Liver Meridian of Foot-Jueyin (LR) Lecture 13 The Ren Meridian (Conception Vessel) (RN) (or CV) Lecture 14 The Du Meridian (Governor Vessel) (DU) (or GV) Appendix: Standard Location of the Extra Points (EX) Part 2 Acupuncture and Moxibustion Techniques Lecture 1 Acupuncture 1. Filiform needle 2. Needling methods 3. Precautions, Contraindications and Management of Possible Accidents in Acupuncture Treatment Lecture 2 Moxibustion 1. What is Moxibustion 2. What are the actions of moxibustion? 3. What is the classification of moxibustion 4. How to apply the moxibustion?

Basic Theories of Acupuncture and Moxibustion A Brief Introduction to Meridians & Collaterals and Acupoints
1. What is it meant by meridians and collaterals? In terms of traditional Chinese medicine, the meridians (Jing) and collaterals (Luo) are pathways in human body through which the Qi and blood circulate. They form a specific network which communicates with the internal organs and limbs and connects the upper to the lower and the exterior to the interior portions of the body. The meridians are the main body of the system and they run lengthwise inside the body while the collaterals, being as the branches of the meridians run crosswise from the meridians either on or just below the body surface. Since they are distributed over the entire body, the meridians and collaterals link altogether the Zang-Fu (internal organs of human body) and other organs, the orifices of the body, then the skin, muscles and bones, bringing the body into an organic whole, hence to carry on the systematic activities in coordination. The theory of the meridians and collaterals is the one which focus on studying the physiological functions and pathological changes of the meridian system, as well as the relationship between the system and the Zang-Fu organs (internal organs), thus is an important component of the theoretical system of traditional Chinese medicine (TCM). Despite the apparent fact that this theory is closely related to acupuncture therapy, it provides the theoretical foundation not only for acupuncture, moxibustion, massage and Qigong which have something in common, but also guides the clinical practice of other fields of TCM.

2. What is the composition of the meridian system? The meridian system consists of three parts: the regular meridians, the eight extra meridians and the twelve divergent meridians. There are altogether twelve regular meridians, namely the three Yang meridians of the hand, the three Yang meridians of the foot, the three Yin meridians of the hand and the three Yin meridians of the foot. Why they are called "twelve regular meridians"? It is because these meridians are the chief pathways of Qi and blood. The twelve regular meridians start and terminate at given parts, run along regular routes and meet in a specified sequence. They are moreover, associate with the Zang-Fu organs. There are also eight extra meridians: the Du (governor vessel), Ren (conception vessel), Chong, Dai, Yinqiao, Yangqiao, Yinwei, and Yangwei meridians. The eight extra meridians interlace the twelve regular meridians, helping reinforce the communication between and adjustment of the twelve regular meridians. The eight extra meridians are not directly related to any of the internal organs. The twelve divergent meridians are the divergent parts of the twelve regular meridians moving mainly deep inside the body. They usually start from the limbs, then run deep into the body, and finally emerge from the body at the back of the neck. These meridians are also distributed symmetrically in both sides of the body. There are Yang and Yin divergent meridians. The Yang divergent meridians start from the six regular Yang meridians and, after traveling through the body, rejoin the regular meridians while the Yin ones give off from the six Yin regular meridians, however, after traveling through the body, they join the Yang regular meridians with which they are exteriorly-interiorly related. Among the meridians mentioned above, the twelve regular meridians plus Du meridian (governor vessel meridian) and Ren meridian (conception vessel meridian) are the most useful thus most important parts for clinical practice. Therefore, they are illustrated in detail in the following. 3. What are the acupoints? Acupoints (an abbreviation for acupuncture points) are the specific sites where the Qi of ZangFu organs (internal organs) and meridians spreads to the body surface. Acupoints are not only the pathways for the circulation of Qi and blood, but also the loci of response to diseases. In acupuncture and moxibustion treatment, proper technique are used on the acupoints to regulate the functional activities of the body, strengthen the body resistance so as to prevent and treat diseases. Medical practitioners in ancient China have left plentiful recordings describing the locations and indications of acupoints, forming a systematical theory. 4. How to locate the acupoints? There are three methods for locating the acupoints, i.e. surface anatomical landmarks, bone proportional measurement and finger measurement. They are often used in combination, but the first one is the fundamental and the other two the supplemental ones. 4.1. Surface anatomical landmarks This method is used to determine the location of acupoints on the basis of the anatomical landmarks on the body surface, which are divided into two ways, the fixed landmarks and the movable ones. The fixed landmarks include the prominence and depressions formed by the joints and muscles, the configuration of the five sense organs, hairline, fingernails and toenails, nipples and

umbilicus. For instance, Yanglingquan (GB 34) is in the depression anterior and inferior to the head of fibula and Binao (LI 14) is at the center of the insertion of the deltoid muscle, etc. The moveable landmarks refer to the clefts, depressions, wrinkles or prominences appearing on the joints, muscles, tendons and skin when the body is in certain postures with motion. For example, Tinggong (SI 19) is between the tragus and the mandibular joint, where a depression is formed when the mouth is slightly open and Quchi (LI 11) is in the depression at the lateral end of the cubital crease when the elbow is flexed. The major anatomical landmarks on the surface of human body are listed as follows: On the head are: 1). the midpoint of the anterior hairline; 2). the midpoint of the posterior hairline; 3). the corner of the forehead (at the corner of the anterior hairline); 4). the mastoid process. On the face are: 1). Yintang (EX-HN 3) (at the midpoint between the eyebrows); 2). the pupil (in the sitting position and looking straight forward), or the center of the eye (at the midpoint of the line between the inner and outer canthi). On the neck is: 1). the laryngeal protuberance. On the chest are: 1). the suprasternal fossa (in the depression above the suprasternal notch); 2). the midpoint of the sternoxyphoid symphysis (at the conjunction of the sternum and xyphoid process); 3). the nipple (the center of the nipple). On the abdomen are: 1). the umbilicus (Shenque RN 8) (the center of the umbilicus); 2). the upper border of the pubic symphysis at the crossing point of the upper border of the pubic symphysis and the anterior midline); 3). the anterior superior iliac spine. On the lateral side of the chest and abdomen are: 1). apex of the axilla (the highest point of the axillary fossa); 2). the free end of the 11th rib. On the back, lower back and sacrum are: 1). the spinous process of the 7th cervical vertebra; 2). The spinous processes from the 1st to the 12th thoracic vertebrae and from the 1st to the 5th lumbar vertebra, the median sacral crest and the coccyx; 3). The medial and the scapular spine (on the medial border of the scapula); 4). The acromial angle; 5). The posterior superior iliac spine. On the upper limbs are: 1). the anterior axillary fold (the anterior end of the axillary crease); 2). the posterior axillary fold (the posterior end of the axillary crease); 3). the cubital crease; 4). the tip of the elbow (olecranon); 5). the dorsal and palmer creases of the wrist (styloid crease between the distal ends of the styloid processes of the ulna and radius). On the lower limbs are: 1). the greater trochanter of the femur; 2). the medial epicondyle of the femur; 3). the medial epicondyle of the tibia; 4). the inferior gluteal crease (the border between the buttocks and thigh)

5). Dubi (ST 35) (in the center of the depression lateral to the patella ligament); 6). the popliteal crease; 7). the tip of the medial malleolus; 8). the tip of the lateral malleolus. 4.2. Bone proportional measurement In this method the joints are taken as the main landmarks of the length and width of various portions of the human body. The proportional measurement of various portions of the human body defined in the "Miraculous Pivot" (Ling Shu) is taken as the basis for the location of acupoints in combination with the modified methods introduced by the acupuncturists through the ages. The length between two joints is divided into several equal portions, each portion as one cun and 10 portions as one chi. The main bone proportional measurements are listed in the following table. The Table of Bone Measurement
Position origin and end points Head and face Portion method of measurement (cun) Remarks

From the midpoint of the anterior hairline to the posterior hairline

12, longitudinal measurement

Used for measuring the longitudinal distance of the acupoints on the head Used for measuring the longitudinal distance of the acupoints on the anterior and posterior hairline and the head

From Yintang (EX3, longitudinal HN3) to the midpoint of measurement the anterior hairline From the point below the spinous process of the 7th cervical vertebra 3, longitudinal (Dazhui, DU 14) to the measurement midpoint of the posterior hairline From Yintang (EXHN3) to the midpoint of the posterior hairline 18, longitudinal and then to the point below the spinous measurement process of the 7th cervical vertebra (Dazhui, DU 14) Between the corner of the forehead (Touwei ST 8)
Chest, abdomen and

9, transverse measurement

Used for measuring the transverse distance of the acupoints on the anterior part of the head

hypochondrium

From the suprasternal fossa (Tiantu, RN 22) to the midpoint of the sternoxyphoid symphysis

9, longitudinal measurement

Used for measuring the longitudinal distance of the acupoints of Ren meridian (Conception Vessel) on the chest Used for measuring the longitudinal distance of the acupoints on the upper abdomen Used for measuring the longitudinal distance of the acupoints on the lower abdomen Used for measuring the transverse distance of the acupoints on the chest and abdomen Used for measuring the longitudinal distance of the acupoints on the hypochondrium

From the midpoint of 8, longitudinal the sternoxyphoid symphysis to the center measurement of the umbilicus From the center of the umbilicus to the upper border of the pubic symphysis (Qugu, RN 2) Between the two nipples 5, longitudinal measurement

8, transverse measurement

From the apex of the axilla to the free end of 12, longitudinal the 11th rib (Zhangmen, measurement LR 13)
Back and lower back

From the medial border 3, transverse of the scapula to the measurement posterior midline From the acromial angle to the posterior midline
Upper limbs

Used for measuring the transverse distance of the acupoints on the back Used for measuring the transverse distance of the acupoints on the shoulder and back

8, transverse measurement

From the anterior and posterior axilla folds to the cubital crease

9, longitudinal measurement

Used for measuring the longitudinal distance of the acupoints on the arm Used for measuring the longitudinal distance of the acupoints on the forearm

From the cubital crease 12, longitudinal to the dorsal crease of measurement the wrist

Lower limbs

From the upper border of the pubic symphysis 18, longitudinal to the upper border of measurement the medial epicondyle of the femur

Used for measuring the longitudinal distance of the acupoints on the three Yin meridians of the foot on the medial side of the lower limbs Used for measuring the longitudinal distance of the acupoints on the three Yang meridians of the foot on the latero-posterior side of the lower limbs (the distance from the gluteal groove to the popliteal crease is equivalent to 14 cun)

From the lower border of the medial epicondyle of the tibia to the tip of the medial malleolus

13, longitudinal measurement

From the great trochanter to the popliteal crease From the popliteal crease to the tip of the lateral malleolus

19, longitudinal measurement Used for measuring the longitudinal distance of the acupoints on the three Yang meridians of the foot on the latero-posterior side of the lower limbs

16, longitudinal measurement

4.3 Finger measurement This is a method to locate the acupoints by measuring the distance with either the length or the width of the patients' finger (s). 1). Middle finger measurement: When the middle finger is flexed, the distance between the radial ends of the two interphalangeal creases of the patient's middle finger is taken as 1 cun. 2). Thumb measurement: The width of the interphalangeal joint of the patient's thumb is taken as 1 cun 3). Four-finger measurement: When the four fingers (index, middle, ring, and little fingers) keep close, their width on the level of the proximal interphalangeal crease of the middle finger is taken as 3 cun. This method is mainly used for locating the acupoints of the lower limbs. When locating the acupoints, this method should be used in combination with some simple movable landmarks on the basis of the bone proportional measurement.

Part 1 Fourteen Meridians and Acupoints

Lecture 1. The Lung Meridian of Hand-Taiyin(LU) 1. Traveling route a) The meridian starts from the middle Jiao (energizer), the portion between the diaphragm and the umbilicus of the body activity, and runs downward to connect with the large intestine. Then it

ascends along the upper orifice of the stomach and crosses the diaphragm before pertaining to the Lung. b) It emerges from the Lung system transversely (at point Zhongfu, LU l) and runs down along the medial aspect of the upper arm and on the radial side of the Heart Meridian of HandShaoyin and the Pericardium Meridian of Hand-Jueyin. Then it goes through the cubital fossa and enters cunkou (on the wrist over the radial artery where the artery is palpable) along the radial border of the medial aspect of the forearm. It continues to run along the thenar eminence and the thenar border and arrives at the radial side of the thumb tip (point Shaoshang, LU 11). c) A branch starts from Lieque (LU 7) and runs along the radial side to the tip of the index finger. 2. Symptoms:

Cough, asthma, shortness of breath, hemoptysis, common cold, fullness in the chest, sore throat, and other disorders (e.g. pain) along the course of the meridian.
3. Acupoints Zhongfu (Front-Mu Point, LU l) Location: 6 cun lateral to the anterior midline and at the same level of the first intercostal space. Indications: Cough, asthma, sore throat, fullness in the chest, and pain in the shoulders and back. Method: Insert the needle obliquely toward the lateral side of the chest, 0.5-0.8 cun deep. Note: Do not insert the needle too deep lest the lung should be injured. Regional anatomy: Vasculature: The axillary artery and vein and the thoracoacromial artery and vein. Innervation: The intermediate supraclavicular nerve, the branches of thoracic nerves, and the lateral cord of the brachial plexus. Yunmen (LU 2) Location: 6 cun lateral to the anterior midline and in the depression of the infraclavicular fossa. Indications: Cough, asthma, sore throat, and hot sensation and pain in the chest. Method: Insert the needle obliquely into the lateral side of the chest, 0.5-0.8 cun deep. Note: Do not insert the needle too deep lest the lung should be injured. Regional anatomy: Vasculature: The cephalic vein, the thoracoacromial artery and vein, and the axillary artery. Innervation: The intermediate and posterior supraclavicular nerves, the branches of the thoracic nerves and the brachial plexus.

Tianfu (LU 3) Location: On the medial aspect of the upper arm, 3 cun below the anterior end of the axillary fold and on the radial side of biceps muscle of arm. Indications: Cough, asthma, epistaxis, and pain in the shoulders and medial aspect of the upper arm. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Notes: a) Simple measurement: Raise the arm horizontally forward and bend neck towards the arm. The place on the medial side where the tip of nose touches is the Tianfu acupoint. b) Tianfu (LU 3) and Hegu (LI 4) are effective in treating epistaxis. Regional anatomy: Vasculature: The cephalic vein and the branches of the brachial artery and vein. Innervation: The lateral cutaneous nerve of arm and the musculocutaneous nerve. Xiabai (LU 4) Location: One cun below Tianfu (LU 3), 5 cun above the cubital crease and on the radial border of biceps muscle of arm. Indications: Cough, shortness of breath, pain and fullness in the chest, pain in the medial aspect of the upper arm, and retching. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Tianfu (LU 3).

Chize (He-Sea Point, LU 5) Location: Above the cubital crease and on the radial border of the tendon of the biceps. Indications: Cough, asthma, afternoon fever, hemoptysis, epistaxis, sore throat, pain and fullness in the chest, pain in the elbow and arm, infantile convulsion, and acute mastitis. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Notes: a) Chize is a He-Sea point of the meridian, belonging to water of the Five Elements. According to the principle of treating excess syndrome by purgation and reduction, this acupoint is indicated for the excess syndromes of lung diseases .

b) Use the point together with Zhongfu (LU 1), Danzhong (RN 17), Feishu (BL 13) and Dingchuan (EX-BL 1) to cure cough and asthma, and in cooperation with Jianyu (LI 15) and Quchi (LI 11) to cure pain in the elbow and arm c) Chize (LU 5) can also be used to relieve spasmodic pain in the elbow. Regional anatomy: Vasculature: The branches of the radial recurrent artery and vein and the cephalic vein. Innervation: The antebrachial lateral cutaneous nerve and the radial nerve. Kongzui (Xi-Cleft Point, LU 6) Location: On the medial aspect of the forearm and the line joining Chize (LU 5) and Taiyuan (LU 9), and 7 cun above the transverse crease of the wrist. Indications: Cough, asthma, hemoptysis, sore throat, aphonia, and spasmodic pain in the elbow and arm. Method: Insert the needle perpendicularly, 0.5-l cun deep. Note: Use the point together with Hegu (LI 4) to treat fever without sweating. Regional anatomy: Vasculature: The cephalic vein and the radial artery and vein. Innervation: The antebrachial lateral cutaneous nerve and the superficial ramus of the radial nerve. Lieque (Lou-Connecting Point and one of the Eight Confluent Points, LU 7)

Location: On the radial side of the forearm, superior to the styloid process of the radius and 1.5 cun above the transverse crease of the wrist. Indications: Cough, asthma, sore throat, pain in the wrist, rigidity of nape with headache, facial paralysis, and toothache. Method: Insert the needle obliquely upward, 0.3- 0.5 cun deep. Notes: a) Simple measurement: Cross the inter-space between the index finger and thumb of both hands, with the index finger of one hand on the styloid process of the radius of the other, and the point is at the depression under the tip of the index finger. b) Since this acupoint is one of the eight confluent points, it can be used together with Zhaohai (KI 6) to treat sore throat. c) Lieque (LU 7) and Wangu (GB 12) are indicated for facial paralysis. Regional anatomy: Vasculature: The cephalic vein and the branches of the radial artery and vein. Innervation. The antebrachial lateral cutaneous nerve and the superficial ramus of the radial nerve.

Jing-riverqu (Jing-River Point, LU 8)

Location: On the palmar side of the forearm, 1 cun above the transverse crease of the wrist and on the radial side of artery. Indications: Cough, asthma, sore throat, chest pain, and pain in the wrist. Method: Keep away from radial artery and insert the needle perpendicularly, 0.3-0.5 cun deep. Moxibustion is contraindicated. Regional anatomy: Vasculature: The radial artery and vein. Innervation: The antebrachial lateral cutaneous nerve and the superficial ramus of the radial nerve.
Taiyuan (Shu-Stream Point, Yuan-Primary Point, and Influential Point of Vessels, LU 9)

Location: On the transverse crease of the wrist and in the depression on the side of radial artery. Indications: Cough, asthma, hemoptysis, sore throat, chest pain, acrotism, and pain in the wrist. Method: Keep away from artery and insert the needle perpendicularly, 0.3-0.5 cun deep. Notes: a) It is the Shu-Stream point of the meridian, belonging to earth of the Five Elements. According to the principle of adopting the reinforcing and replenishing method for a deficiency syndrome, this acupoint is indicated for Lung diseases of the deficiency type. b) Use the point together with Neiguan (PC 6) and Shenmen (HT 7) to treat chest pain and palpitation. c) It is advisable to puncture Taiyuan (LU 9) and Lieque (LU 7) to treat wind-phlegm syndrome of cough. d) It is said that Taiyuan and Renying (ST 9) can be used as the chief prescription to treat acrotism. Regional anatomy: Vasculature: The radial artery and vein. Innervation: The antebrachial lateral cutaneous nerve and the superficial ramus of the radial nerve.

Yuji (Ying-Spring Point, LU 10)

Location: On the radial side of the midpoint of the first metacarpal bone and the dorso-ventral boundary of the hand. Indications: Cough, asthma, hemoptysis, sore throat, aphonia, fever, and a hot sensation in the palm. Method: Insert the needle perpendicularly, 0.5-0. 8 cun deep. Note: It is said that when treating bronchial asthma, needling Yuji together with Dazhui (DU 14), Zusanli (ST 36) and Guanyuan (RN 4) will help improve pulmonary function, relieve bronchial spasm, reduce airway resistance, promote ventilation function and alleviate the wheezing sound. Regional anatomy: Vasculature: The venules linking the thumb with the cephalic vein. Innervation: The superficial ramus of the radial nerve.
Shaoshang (Jing-Well Point, LU 11)

Location: On the radial side of the thumb and about 0.1 cun posterior to the corner of the fingernail. Indications: Cough, sore throat, epistaxis, fever, and syncope. Method: Insert the needle obliquely upward, 0.l -0.2 cun deep or make bleeding by prompt prick. Notes: a) Renzhong (DU 26) and Zusanli (ST 36) may be used together to treat syncope and shock. b) According to "Epitome of Acupuncture and Moxibustion", the combination of Shaoshang, Tiantu (RN 22) and Hegu (LI 4) is indicated for treating sore throat. Regional anatomy: Vasculature: The arterial and venous network formed by the palmar and the digital proprial arteries and veins. Innervation: The mixed branches of the antebrachial lateral cutaneous nerve, the superficial ramus of the radial nerve, and the peripheral nerve network formed by the palmar and the digital proprial nerve of the median nerve.

Lecture 2 The Large intestine Meridian of Hand-Yangming (LI) 1.Traveling route

a) The meridian starts from the tip of the index finger (point Shangyang, LI 1). Then it runs upward along the radial side of the index finger, passing the interspace of the first and second metacarpal bones and the tendons of long and short extensor muscle of the wrist. It continues to rise further along the radial side of the forearm and elbow, and the radial side of the dorsal aspect of the upper arm, and arrives at the shoulder. It runs along anterior border of the acromion, then meets Dazhui (DU 14) and enters the body cavity through the supraclavicular fossa. b) It runs down from the supraclavicular fossa to connect with the lung; further down it crosses the diaphragm and pertains to the large intestine. c) Starting from the supraclavicular fossa, it passes the neck, cheek, and the gums of the lower teeth; then exiting the mouth cavity, it runs around the upper lip, crosses at the philtrum, and ends at the alae nasi (point Yingxiang, LI 20)
2. Symptoms:

Abdominal pain, borborygmus, diarrhea, constipation, dysentery, toothache, sore throat, stuffy nose, and the other disorders (e.g. pain) along the course of the meridian.
3. Acupoints Shangyang (Jing -Well Point, LI l)

Location: On the radial side of the index finger and about 0.1 cun posterior to the corner of the fingernail. Indications: Toothache, swollen cheek, and sore throat, numb fingers, febrile disease without sweating, and syncope. Method: Insert the needle 0.1 cun deep into the skin, or prompt prick so that a little blood comes out. Regional anatomy: Vasculature: The network of digit dorsal arteries and veins. Innervation: The palmar digital proprial nerve and the intrinsic nerve derived from the median nerve.
Erjian (Ying-Spring Point, LI 2)

Location: In the depression of the radial side and distal to the second metacarpophalangeal joint. Indications: Toothache, dry mouth, sore throat, red and swollen eyes, and pain in the interphalangeal joints. Method: Insert the needle perpendicularly, 0.2-0.3 cun deep. Regional anatomy: Vasculature: The dorsal digital and the palmar digital proprial arteries and veins. Innervation: The dorsal digital nerve of the radial nerve and the palmar digital proprial nerve of median nerve.
Sanjian (Shu-Stream Point, LI 3)

Location: In the depression of the radial side and proximal to the second metacarpophalangeal joint. Indications: Toothache, sore throat, red and swollen eyes, and pain in the interphalangeal joints. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy:

Vasculature: The dorsal venous network of hand and the branch of the first dorsal metacarpal arteries. Innervation: The superficial ramus of the radial nerve.
Hegu (Yuan- Primary Point, LI 4)

Location: Between the first and second metacarpal bones and approximately on the radial side of the midpoint of the second metacarpal bone. Indications: Toothache, trismus, facial paralysis, facial swelling, sore throat, red and swollen eyes, fever, anhidrosis and hyperhidrosis, cough, numbness and paralysis of upper limbs, amenorrhea, prolonged labor, infantile convulsion, and urticaria. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep, acupuncture and moxibustion are contraindicated to pregnant women. Note: Simple measurement: place the transverse crease of the interphalangeal joint of the thumb on the web-space between the thumb and index finger of the other hand, the acupoint locates at the place where the tip of the thumb rests. Regional anatomy: Vasculature: The dorsal venous network of hand. Innervation: The superficial ramus of the radial nerve.
Yangxi (Jing-River Point, LI 5)

Location: On the radial side of the wrist crease and in the depression between the tendons of the long and short exterior muscles of the thumb. Indications: Red and swollen eyes, sore throat, headache, tinnitus, and pain in the wrist. Method: Insert the needle perpendicularly, 0.3- 0.5 cun deep. Regional anatomy: Vasculature: The cephalic vein, the radial artery and its dorsal carpal branch. Innervation: The superficial ramus of the radial nerve.
PianLi (Luo-Connecting Point, LI 6)

Location: On the radial side of the dorsal surface of the forearm and 3 cun above the crease of the wrist. Indications: Facial paralysis, red and swollen eyes, sore throat, and pain in the arm. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The cephalic vein. Innervation: The lateral cutaneous nerve of forearm, and the superficial ramus of the radial nerve on the radial side, the dorsal cutaneous nerve and the dorsal interosseous nerve of the forearm on the ulnar side.

Wenliu (Xi-Cleft Point, LI 7)

Location: On the radial side of the dorsal surface of the forearm and 5 cun above the crease of the wrist. Indications: Facial paralysis, facial swelling, sore throat, headache, swollen mouth and tongue, and pain in the arm. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The muscular branch of the radial artery, and the cephalic vein. Innervation: The dorsal cutaneous nerve of the forearm and the deep ramus of the radial nerve.
Xialian (LI 8)

Location: On the radial side of the dorsal surface of the forearm and 4 cun below the cubital crease. Indications: Red and swollen eyes, headache, vertigo, and pain in the elbow and arm. Method: Insert the needle perpendicularly, 0.51cun deep. Regional anatomy: Vasculature and innervation: The same as those of Wenliu (LI 7).
Shanglian (LI 9)

Location: On the radial side of the dorsal surface of the forearm and 3 cun below the cubital crease. Indications: Hemiplegia, headache, and numbness and pain in the arm. Method: Insert the needle perpendicularly, 0.5-1cun deep. Regional anatomy: Vasculature and innervation: The same as those of Wenliu (LI 7).
Shousanli (LI 10)

Location: On the radial side of the dorsal surface of the forearm and 2 cun below the cubital crease. Indications: Toothache, swollen cheek, aphonia, numbness and motor impairment of the upper limbs, and pain in the shoulder and arm. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Note: Shousanli, in the anterior cubital region, is indicated for pains in shoulder and back. This point may be used together with Jianyu (LI 15) and Waiguan (SJ 5) to treat motoring impairment of the upper limbs and pain in the shoulder Regional anatomy: Vasculature: The branches of the radial recurrent artery and vein.

Innervation: The same as that of Wenliu (Ll 7).

Quchi (He-Sea Point, LI 11)

Location: At the lateral end of the cubital crease with the elbow flexed. Indications: Toothache, red and swollen eyes, sore throat, motor impairment of the upper limbs, febrile diseases, scrofula, urticaria, and vertigo. Method: Insert the needle perpendicularly, l- l.5 cun deep. Notes: a) It is the He-Sea point of the meridian and belongs to earth in terms of the Five Elements. It is indicated for febrile diseases and mania. b) It can be used together with Dazhui (DU 14) and Fengchi (GB20) to treat fever; with Dazhui and Xuehai (ST 10) to treat urticaria; and with Zusanli (ST 36) and Renying (ST 9) to treat vertigo. c) Studies show that it is also effective for simple appendicitis. Regional anatomy: Vasculature: The branches of the radial recurrent artery and vein. Innervation: The dorsal cutaneous nerve of the forearm and the radial nerve.
Zhouliao (LI 12)

Location: On the lateral side of the upper arm, 1 cun above Quchi (LI 11) and on the medial border of the humerus. Indications: Numbness and pain in the arm, elbow and shoulder Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The radial collateral artery and vein. Innervation: The dorsal cutaneous nerve of the forearm and the radial nerve.
Shouwuli (LI 13)

Location: On the lateral side of the upper arm and 3 cun above Quchi. Indications: Spasmodic pain in the elbow and arm, and scrofula. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The radial collateral artery and vein. Innervation: The dorsal cutaneous nerve of the forearm and the radial nerve.

Binao ( LI 14)

Location: On the lateral side of the arm, at the insertion of the deltoid muscle and 7 cun above Quchi (LI 11). Indications: Eye diseases, and pain in the shoulder and arm, and scrofula. Method: Insert the needle perpendicularly or obliquely upward, 0.8-1cun deep. Note: It is often used together with Jianyu (LI 15) for acupuncture anesthesia in pneumonectomy. Regional anatomy: Vasculature: The branches of the posterior humeral circumflex artery and vein, and the deep brachial artery and vein. Innervation: The dorsal cutaneous nerve of the arm and the radial nerve.
Jianyu (LI 15)

Location: On the shoulder and in the depression anterior and inferior to the acromion when the arm is abducted. Indications: Toothache, motor impairment of the upper limbs, and pain in the shoulder and arm. Method: Insert the needle perpendicularly or obliquely, 0.8-l.5 cun deep. Note: According to Basic Questions, Yunmen (LU 2), Jianyu (LI 15), Weizhong (BL 40) and Yaoshu (DU 2) can be combined to reduce heat in the limbs. Regional anatomy: Vasculature: The posterior humeral circumflex artery and vein. Innervation: The supraclavicular nerve and the axillary nerve.
Jugu (LI 16)

Location: In the depression between the acromial extremity of the clavicle and the scapular spine. Indications: Pain in the shoulder, arm and back, scrofula, and goiter Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Note: Do not insert the needle too deep lest the lung should be harmed. Regional anatomy: Vasculature: The suprascapular artery and vein. Innervation: The posterior supraclavicular nerve, the branch of the accessory nerve, and the suprascapular nerve.

Tianding (LI 17)

Location: On the posterior border of sternocleidomastoid muscle, 3 cun lateral to and 1cun below the tip of Adam's apple. Indications: Sore throat, sudden loss of voice, scrofula, and goiter Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The external jugular vein. Innervation: The supraclavicular nerves and the phrenic nerve at the posterior border of the sternocleidomastoid muscle where the cutaneous nerve of neck just emerges.

Futu(LI 18)

Location: 3 cun lateral to the tip of Adam's apple and between the sternal head and clavicular head of sternocleidomastoid muscle. Indications: Cough, asthma, sore throat, sudden loss of voice, scrofula, and goiter. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The ascending cervical artery and vein. Innervation: The great auricular nerve, the cutaneous nerve of neck, the lesser occipital nerve and the accessory nerve.

Kouheliao (LI 19)

Location: 0.5 cun lateral to Shuigou (DU 26) Indications: Facial paralysis, trismus, nasal stuffiness, and epistaxis. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Moxibustion is contraindicated. Regional anatomy:

Vasculature: The superior labial branches of the facial artery and vein. Innervation: The anastomotic branch of the facial nerve and the infraorbital nerve.
Yingxiang (LI 20)

Location: In the nasolabial groove and beside the midpoint of the lateral border of ala nasi. Indications: Nasal stuffiness, epistaxis, rhinorrhea with turbid discharge, and facial paralysis and itching. Method: Insert the needle perpendicularly, 0.1 - 0.2 cun deep, or insert obliquely upward, 0.5-0.8 cun deep. Moxibustion is contraindicated. Note: If there is a feeling of a warm wriggling on the face, this point can be used for the treatment. Regional anatomy: Vasculature: The facial artery and vein, and the infraorbital artery and vein. Innervation: The anastomotic branch of the facial and the infraorbital nerves.
Lecture 3. The Stomach Meridian of Foot-Yangming (ST) 1. Traveling route

a) The meridian starts at the lateral side of ala nasi, runs up to the root of the nose and meets the Bladder Meridian of Foot-Taiyang. Then it descends along the lateral side of the nose (point Chengqi, ST l), enters the upper gum, curves around the lips goes down to meet Chengjiang (RN 24) at the mentolabial groove, and then runs along the posterior and lower part of the cheek to the acupoint Daying (ST 5). It continues to travel along the angle of the mandible, passing the front of the ear (Xiaguan, ST 7), ascends to the anterior hairline and finally reaches the forehead. b) One of its branches descends from Daying (ST 5) to Renying (ST 9) and then running along the throat, reaches Quepen (ST 12), at the center of the supraclavicular fossa. It continues to go downward, through the diaphragm and then connects with the stomach and spleen. c) A straight branch starts from the supraclavicular fossa, crosses the nipple and reaches Qichong (ST 30), at the lateral side of the abdomen. d) Another branch starts from the lower orifice of the stomach, through the abdomen, and descends to Qichong (ST 30) where it joins the straight branch. Then it passes Biguan (ST 3l), running along the anterior border of the thigh, Futu (ST 32), and then descends to the lateral side of the knee. It continues to travel along the lateral side of the crural tibia, reaches the dorsum of the foot and then enters the lateral side of the tip of the second toe. e) The tibial branch starts from Zusanli (ST 36), 3 cun below the knee and goes down to the lateral side of the lip of the middle toe. f) The dorsal foot branch starts from the dorsum of the foot and ends at the medial side of the tip of the great toe.
2. Symptoms:

Borborygmus, abdominal distention, edema, stomachache, vomiting, polyorexia, facial paralysis, sore throat, febrile diseases, mania, pain in the chest, and other disorders (e.g. pain) along the course of the meridian.
3. Acupoints Chengqi (ST 1)

Location: On the face, directly below the pupil and between the eyeball and the inferior border of the orbit. Indications: Red and swollen eyes, night blindness, lacrimation in exposure of wind, twitching eyelids, facial paralysis, and myopia. Method: When the eyeball is fixed, insert the needle perpendicularly and slowly along the infraorbital ridge, 0.5-0.8 cun deep. Do not use lifting and thrusting methods lest the blood vessel be injured, resulting in edema due to blood stasis. Regional anatomy: Vasculature: The branches of infraorbital and ophthalmic arteries and veins. Innervation: The branch of infraorbital nerve, the inferior branch of oculomotor nerve and the muscular branch of facial nerve.
Sibai (ST 2)

Location: On the face, directly below the pupil and in the depression of the infraorbital foramen. Indications: Red and swollen eyes, corneal nebula, twitching eyelids, facial paralysis, headache, and vertigo. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Take care not to injure the eyeball while puncturing. Regional anatomy: Vasculature: The branches of facial artery and vein, the infraorbital artery and vein. Innervation: The branches of facial nerve and infraorbital nerve.
Juliao (ST 3)

Location: On the face, directly below the pupil and at the level of the lower border of ala nasi. Indications: Facial paralysis, twitching eyelids, epistaxis, and toothache. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of facial and infraorbital arteries and veins. Innervation: The facial and infraorbital nerves.

Dicang (ST 4)

Location: 0.4 cun lateral to the corner of the mouth. Indications: Facial paralysis, salivation, toothache, and swollen cheek. Method: Insert the needle perpendicularly, 0.2 cun deep or horizontally towards Jiache (ST 6), 0.8-1 cun deep. Note: In clinic, Dicang (ST 4) is effective in treating facial paralysis when used together with Jiache (ST 6). When needled together with Yingxiang (LI 20), Quanliao (SI l 8), Qianzheng (EX-HN), and Hegu (LI 4), it can be used to treat facial paralysis and trigeminal neuralgia. Regional anatomy: Vasculature: The facial artery and vein. Innervation: The branches of facial and infraorbital nerves and the terminal branch of buccal nerve.
Daying (ST 5)

Location: l.3 cun anterior to the mandibular angle and on the anterior border of the masseter muscle where the pulsation of facial artery is palpable. Indications: Facial paralysis, trismus, toothache, and swollen cheek. Method: Insert the needle perpendicularly or horizontally, 0.2-0.5 cun deep. Regional anatomy: Vasculature: The facial artery and vein. Innervation: The facial and buccal nerves.
Jiache (ST 6)

Location: On the cheek, one finger-breadth anterior and superior to the mandibular angle and at the prominence of the masseter muscle when the jaw is clenched. Indications: Facial paralysis, trismus, toothache, swollen face, and cheek. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep or insert the needle horizontally, 0.5-1 cun deep. Regional anatomy: Vasculature: The masseteric artery. Innervation: The great auricular nerve, facial nerve and masseteric nerve.

Xiaguan (ST 7)

Location: In the depression below the zygomatic arch anterior to the mandibular condyloid process. Indications: Toothache, trismus, facial paralysis, deafness, and tinnitus. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature. The transverse facial artery and vein and maxillary artery and vein. Innervation: The zygomatic branch of facial nerve and branches of auriculotemporal nerve.

and

the

Touwei (ST 8)

Location: On the lateral side of the head and 0.5 cun above the anterior hairline at the corner of the forehead. Indications: Red and swollen eyes, twitching eyelids, headache, and dizziness. Method: Insert the needle horizontally, 0.5-l cun deep. Moxibustion is contraindicated. Note: Touwei and Daling (PC 7) could be used together to treat severe headache and ophthalmalgia. It is also an effective point in treating migraine in combination with Shuaigu (GB 8) and Fengchi (GB 20). Regional anatomy: Vasculature: The frontal branches of superficial temporal artery and vein. Innervation: The branch of auriculotemporal nerve and the temporal branch of facial nerve.
Renying (ST 9)

Location: l .5 cun lateral to the tip of Adam's apple and on the anterior border of sternocleidomastoid muscle. Indications: Sore throat, fullness in the chest, dyspnea, scrofula, goiter, headache, vertigo, and hemiplegia. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Do not injure the artery. Moxibustion is contraindicated. Note: It is effective in treating hypertension when combined with Zusanli (ST 36) and Quchi (LI 11); and treating hyperthyroidism in combination with Neiguan (PC 6), Zusanli (ST 36), Shenmen (HT 7), and Sanyinjiao (ST 6).

Regional anatomy: Vasculature: The superior thyroid artery, internal and external carotid artery. Innervation: The cutaneous nerve of neck, the cervical branch of facial nerve, sympathetic trunk and the descending branch of hypoglossal nerve and the vagus nerve.

Shuitu (ST 10)

Location: At the midpoint of the line connecting Renying 9) and Qishe (ST 11) and on the anterior border of sternocleidomastoid muscle. Indications: Sore throat, cough, asthma, and goiter Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The common carotid artery. Innervation: The cutaneous nerve of neck, the superior cardiac nerve stemming from sympathetic nerve and sympathetic trunk.

(ST

Qishe (ST 11)

Location: Directly below Renying (ST 9) and on the upper border of the medial end of the clavicle. Indications: Sore throat, asthma, rigid neck, and goiter Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Avoid to make deep insertion. Regional anatomy: Vasculature: The anterior jugular vein and common carotid artery. Innervation: The anterior branch of the supraclavicular nerve and the muscular branch of ansa hypoglossi.

Quepen (ST 12)

Location: At the center of the supraclavicular fossa and 4 cun lateral to the anterior midline. Indications: Cough, asthma, sore throat, pain in the supraclavicular fossa, and scrofula. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Acupuncture is contraindicated for pregnant women. Regional anatomy: Vasculature: The transverse cervical artery. Innervation: The intermediate supraclavicular nerve and the supraclavicular portion of brachial plexus.

Qihu (ST 13)

Location: At the lower border of the clavicle and 4 cun lateral to the anterior midline. Indications: Cough, asthma, and fullness and pain in the chest. Method: Insert the needle perpendicularly, 0.2-0.5 cun deep. Regional anatomy: Vasculature: The branches of thoracoacromial artery and vein and sub-clavicular vein. Innervation: The branches of supraclavicular nerve and anterior thoracic nerve.
Kufang (ST 14)

Location: In the first intercostal space and 4 cun lateral to the anterior midline. Indications: Cough, asthma, and distending pain in the chest and hypochondriac region. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: Thoracoacromial artery and vein, and the branches of the lateral thoracic artery and vein. Innervation: The branch of the anterior thoracic nerve.

Wuyi (ST 15)

Location:In the second intercostal space and 4 cun lateral to the anterior midline. Indications: Cough, asthma, distending pain in the chest and hypochondriac region, and mastitis. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Kufang (ST 14). Innervation: The branch of greater pectoral muscle stemming from the anterior thoracic nerve.
Yingchuang (ST 16)

Location: In the third intercostal space and 4 cun lateral to the anterior midline. Indications: Cough, asthma, distending pain in the chest and hypochondriac region, and mastitis. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Notes. Vasculature: Lateral thoracic artery and vein. Innervation: The branches of the anterior thoracic nerve.
Ruzhong (ST 17)

Location: At the center of the nipple. Note: This point is not used for acupuncture or moxibustion, but rather serves as a landmark for locating the other acupoints. The distance between two nipples is 8 cun.

Rugen (ST 18)

Location: In the fifth intercostal space and 4 cun lateral to the anterior midline. Indications: Cough, asthma, chest pain, mastitis, and hypogalactia. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of intercostal artery and vein. Innervation: The fifth intercostal nerve.

Burong (ST 19)

Location: 6 cun above the umbilicus and 2 cun lateral to the anterior midline. Indications: Stomachache, vomiting, abdominal distention and pain, and anorexia. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of the seventh intercostal artery and vein, and the branches of superior epigastric artery and vein. Innervation: The branches of the seventh intercostal nerve.

Chengman (ST 20)

Location: 5 cun above the umbilicus and 2 cun lateral to anterior midline. Indications: Stomachache, vomiting, abdominal distention, borborygmus, and pain in the hypochondriac region. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Burong (ST 19).

the

Liangmen (ST 21)

Location: 4 cun above the umbilicus and 2 cun lateral to the anterior midline. Indications: Stomachache, vomiting, abdominal distention, diarrhea, and anorexia. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of the eight intercostal arteries and veins, and the branches of the superior epigastric arteries and veins. Innervation: The branch of the eight intercostal nerve.

Guanmen (ST 22)

Location: 3 cun above the umbilicus and 2 cun lateral to the anterior midline. Indications: Abdominal distention and pain, borborygmus, diarrhea, and edema. Method: Insert the needle Perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Liangmen (ST 21).

Taiyi (ST 23)

Location: 2 cun above the umbilicus and 2 cun lateral to the anterior midline. Indications: Stomachache, abdominal pain, indigestion, irritability, and mania. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The branches of the eight and ninth intercostal arteries and veins, and the branches of the inferior epigastric arteries and veins. Innervation: The branches of the eight and ninth intercostal nerves.

Huaroumen (ST 24)

Location: 1 cun above the umbilicus and 2 cun lateral to the anterior midline. Indications: Stomachache, vomiting, and mania. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The branches of the ninth intercostal arteries and veins, and the branches of inferior epigastric arteries and veins. Innervation: The branch of the ninth intercostal nerve.

Tianshu (Front-Mu point of the Large Intestine, ST 25)

Location: 2 cun lateral to the center of the umbilicus. Indications: Pain around the umbilicus, abdominal distention, borborygmus, diarrhea, constipation, dysentery, appendicitis, dysmenorrhea, irregular menstruation, and abdominal mass. Method: Insert the needle perpendicularly, 0.8-1 .2 cun deep. Note: a) It is the Front-Mu point of the large intestine and usually used to treat abdominal distention and pain, diarrhea and constipation together with Dachangshu (BL 25). b) It is also effective in treating irregular menstruation and dysmenorrhea together with Sanyinjiao (ST 6) and Ciliao (BL 32). c) This acupoint can be also used to treat abdominal masses and lumps, blood stasis, metrorrhagia and irregular menstruation Regional anatomy: Vasculature: The branches of the tenth intercostal arteries and veins, and branches of the inferior epigastric arteries and veins. Innervation: The branches of the tenth intercostal nerve.

Wailing (ST 26)

Location: 1 cun below the umbilicus and 2 cun lateral to the anterior midline. Indications: Abdominal pain, dysmenorrhea, and hernia. Method: Insert the needle perpendicularly, 0.8l .2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Tianshu (ST 25).

Daju (ST 27)

Location: 2 cun below the umbilicus and 2 cun lateral to the anterior midline. Indications: Lower abdominal distention, dysuria, hernia, and seminal emission. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The branches of the eleventh intercostal arteries and veins, and inferior epigastric arteries and veins. Innervation: The eleventh intercostal nerve.
Shuidao (ST 28)

Location: 3 cun below the umbilicus and 2 cun lateral to the anterior midline. Indications: Lower abdominal distention, dysuria, and dysmenorrhea. Method: Insert the needle perpendicularly, 0.8- l.2 cun deep. Regional anatomy: Vasculature: The branches of subcostal arteries and veins, and inferior epigastric arteries and veins. Innervation: The branches of subcostal nerve.
Guilai (ST 29)

Location: 4 cun below the umbilicus and 2 cun lateral to the anterior midline. Indications: Lower abdominal distention, dysmenorrhea, irregular menstruation, impotence, seminal emission, and hernia. Method: Insert the needle Perpendicularly, 0.8- l.2 cun deep. Regional anatomy: Vasculature: The inferior epigastric artery and vein. Innervation: The iliohypogastric nerve.

Qichong (ST 30)

Location: 5 cun below the umbilicus and 2 cun lateral to the anterior midline. Indications: Lower abdominal pain, hernia, irregular menstruation, dysmenorrhea, impotence, and swollen vulva. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of superficial epigastric artery and vein, and inferior epigastric artery and vein. Innervation: The ilio-inguinal nerve.

Biguan (ST 31)

Location: On the anterior side of the upper thigh, at the level of the inferior border of symphysis pubis and in the depression lateral to the sartorius muscle. Indication: abdominal pain, motor impairment of the lower limbs, and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, l-l.5 cun deep. Regional anatomy: Vasculature: The branches of lateral femoral circumflex artery and vein. Innervation: The lateral cutaneous nerve of thigh.

Futu (ST 32)

Location: On the line connecting the anterior superior iliac Spine and lateral border of the patella and 6 cun above the superolateral corner of the patella. Indications: Motor impairment and pain in the lower limbs, and pain in the knees and lumbar region. Method: Insert the needle perpendicularly, 1-2 cun deep. Regional anatomy: Vasculature: The branches of lateral femoral circumflex artery and vein. Innervation: The anterior and lateral cutaneous nerves of thigh.

Yinshi (ST 33)

Location: On the line connecting the anterior superior iliac Spine and lateral border of the patella and 3 cun above the superolateral corner of the patella. Indications: Motor impairment of the lower limbs, numbness and pain in the lower limbs, pain and stiffness in the knees, and hernia. Method: Insert the needle perpendicularly, 0.8-l.5 cun deep. Regional anatomy: Vasculature: The descending branch of the lateral femoral circumflex artery. Innervation: The anterior and lateral cutaneous nerves of thigh.

Liangqiu (Xi-Cleft Point, ST 34)

Location: On the line connecting the anterior superior iliac Spine and lateral border of the patella and 2 cun above the superolateral corner of the patella. Indications: Stomachache, swollen knees, motor impairment of the lower limbs, and mastitis. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Yinshi (ST 33).

Dubi (ST 35)

Location: On the knee, in the depression lateral to the patella and its ligament when the knee is flexed. Indications: Pain in the knee joint. Method: Insert the needle slightly towards the ligament, 0.8l.2 cun deep. Regional anatomy: Vasculature: The network of arteries and veins of the knee joint. Innervation: The lateral cutaneous nerve of calf and the articular branch of the common peroneal nerve.

Zusanli (He-Sea Point and Lower He-Sea Point of the Stomach, ST 36)

Location: 3 cun below Dubi (ST 35) and one finger breadth from the anterior crest of the tibia. Indications: Stomachache, abdominal distention, vomiting, diarrhea, dysentery, indigestion, edema, appendicitis, mastitis, mania, epilepsy, flaccidity and numbness of the lower limbs, dyspneic cough, vertigo, palpitation, and emaciation due to consumptive disease. Method: Insert the needle perpendicularly, Regional anatomy: Vasculature: The anterior tibial artery and vein. Innervation: The branches of the lateral cutaneous nerve of calf and the saphenous nerve, and deep peroneal nerve.
Shangjuxu (Lower He-Sea Point of the Large Intestine, ST 37)

Location: 3 cun below Zusanli (ST 36). Indications: Abdominal pain, borborygmus, diarrhea, dysentery, appendicitis, and motor impairment of the lower limbs. Method: Insert the needle perpendicularly, 1-l.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zusanli (ST 36).

Tiaokou (ST 38)

Location: 8 cun below Dubi (ST 35) and one finger breadth from the anterior crest of the tibia. Indications: Motor impairment, numbness and spasmodic pain in the lower limbs, and pain in the shoulder. Method: Insert the needle perpendicularly, l-l.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zusanli (ST 36)

.
Xiajuxu (Lower He-Sea Point of the Small Intestine, ST 39)

Location: 9 cun below Dubi (ST 35) and one finger breadth from the anterior crest of the tibia. Indications: Lower abdominal distention and pain, diarrhea, dysentery, motor impairment of the lower limbs, and testalgia. Method: Insert the needle perpendicularly, l-l.5 cun deep. Regional anatomy: Vasculature: The anterior tibial artery and vein. Innervation: The branches of the superficial peroneal nerve and deep peroneal nerve.

Fenglong (Luo-Connecting Point, ST 40)

Location: One finger breadth from Tiaokou (ST 38). Indications: Cough, asthma, mania, epilepsy, headache, vertigo, and motor impairment of the lower limbs. Method: Insert the needle perpendicularly, 1- l.5 cun deep. Regional anatomy: Vasculature: The anterior tibial artery and vein. Innervation: The superficial peroneal nerve.

Jiexi (Jing-River Point, ST 41) Location: On the dorsum of the foot, at the midpoint of the transverse crease of the ankle joint, and between the tendons of long extensor muscle of thumb and long extensor muscle of toe. Indication: Abdominal distention, constipation, mania, motor impairment, numbness and pain in the lower limbs, and headache and vertigo. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The anterior tibial artery and vein. Innervation: The superficial and deep peroneal nerves.
Chongyang (Yuan-Primary Point, ST 42)

Location: At the prominence of the instep, where the pulsation of the dorsal artery of the foot is palpable, and 3 cun above Xiangu (ST 43). Indications: Stomachache, abdominal distention, facial paralysis, facial swelling, toothache, and swollen instep. Method: Keep the needle away from the artery and insert it perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal artery and vein of foot and dorsal venous network of foot. Innervation: The medial dorsal cutaneous nerve of foot stemming from the superficial peroneal nerve.

Xiangu (Shu-Stream Point, ST 43)

Location: In the depression distal to the commissure of the second and third metatarsal bones. Indications: Abdominal pain, borborygmus, swollen face, general edema, and swollen instep. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot. Innervation: The medial dorsal cutaneous nerve of foot.

Neiting (Ying-Spring Point, ST 44)

Location: On the instep and at the proximal end of the skin crease of the web between the second and third toes. Indications: Abdominal distention, stomachache, diarrhea, dysentery, toothache, and facial paralysis, sore throat, and swollen instep. Method: Insert the needle obliquely upward, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot. Innervation: The dorsal digital nerves, and the lateral branch of medial dorsal cutaneous nerve of foot.

Lidui (Jing-Well Point, ST 45)

Location: On the lateral side of the second toe and about 0.1 cun posterior to the corner of the toenail. Indications: Abdominal distention, swollen face, facial paralysis, and toothache, sore throat, epistaxis, mania, and cold legs and feet. Method: Insert the needle perpendicularly, 0.1-0.2 cun deep. Regional anatomy: Vasculature: The arterial and venous network formed by dorsal digital arteries and veins of foot. Innervation: The dorsal digital nerves of foot stemming from the superficial peroneal nerve.

Lecture 4. The Spleen Meridian of Foot-Taiyin (SP) 1.Traveling route

a) The meridian starts from the medial side of the great toe, along the dorso-ventral boundary of the foot and passing the first phalanx and metatarsal joint, then reaches the anterior border of medial malleolus. It continues to ascend along the posterior border of the medial side of the tibia, emerges from the place 8 cun above the medial malleolus, and runs in front of the Liver Meridian of Foot-Jueyin. Then passing through the knee and the inner side of the thigh, it enters the abdomen, pertaining to the spleen and connecting with the stomach. Finally, it goes through the diaphragm and the pharynx, reaches the root of the tongue and further spreads under the tongue. b) A branch starts from the stomach, passes the diaphragm and enters the heart.
2. Symptoms:

Abdominal distention, stomachache, diarrhea, dysentery, edema, jaundice, dysuria, lassitude, stiffness and pain in the tongue, pain in the inner side of the thigh and irritability.
3. Acupoints Yinbai (Jing-Well Point, Sp l)

Location: On the medial side of the great toe and about 0.1 cun lateral to the corner of the toenail. Indications: Abdominal distention, diarrhea, vomiting, menorrhagia, metrorrhagia, hematuria, irritability, and mania. Method: Insert the needle 0.1 cun into the skin, or prick to make a small amount of bleeding. Regional anatomy: Vasculature: The dorsal digital arteries of foot. Innervation: The dorsal digital nerve of foot deriving from the superficial peroneal nerve, and plantar digital proprial nerve.
Dadu (Ying-Spring Point, Sp 2)

Location: On the medial side of the great toe and in the depression just distal to the metatarsodigital joint. Indications: Stomachache, vomiting, abdominal distention, diarrhea, constipation, and irritability. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of the medial plantar artery and vein. Innervation: The plantar digital proprial nerve deriving from the medial plantar nerve.

Taibai (Shu-Stream Point and Yuan-Primary Point, Sp 3)

Location: On the medial border of the foot and in the depression on the medial side of the distal end of the first metatarsal. Indications: Stomachache, abdominal distention and pain, diarrhea, dysentery, constipation, lassitude and heavy sensation in the limbs, and cardiodynia. Method: Insert the needle perpendicularly, 0.30.5 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot, the medial plantar artery and the branches of the medial tarsal artery. Innervation: The branches of saphenous nerve and the superficial peroneal nerve .
Gongsun (Luo-Connecting Point and one of the Eight Confluent Points, Sp 4)

Location: On the medial border of the foot, anterior and inferior to the proximal end of the first metatarsal. Indications: Stomachache, vomiting, abdominal pain, diarrhea, dysentery, irritability, and insomnia. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The medial tarsal artery and the dorsal venous network of foot. Innervation: The saphenous nerve and the branch of the superficial peroneal nerve.
Shangqiu (Jing-River Point, Sp 5)

Location: on the medial side of the ankle and in the depression anterior and inferior to the medial malleolus. Indications: Abdominal distention, diarrhea, constipation, indigestion, jaundice, and pain in the foot and ankle. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The medial tarsal artery and the great saphenous vein. Innervation: The medial cutaneous nerve of leg and the branch of the superficial peroneal nerve.

Sanyinjiao (Sp 6)

Location: On the medial side of the leg, 3 cun above the tip of the medial malleolus and just posterior to the tibia. Indications: Abdominal distention, borborygmus, diarrhea, dysentery seminal emission, dysuria, enuresis, edema, insomnia, motor impairment, and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The great saphenous vein, and the posterior tibial artery and vein. Innervation: The medial cutaneous nerve of leg and the tibial nerve.

Lougu (Sp 7)

Location: On the medial side of the leg, 6 cun above the tip of the medial malleolus and just posterior to the tibia. Indications: Abdominal distention, borborygmus, dysuria, enuresis, and numbness in the lower limbs. Method: Insert the needle perpendicularly, 0.5- l cun deep. Regional anatomy: Vasculature and innervation: The same as those of Sanyinjiao (Sp 6).

Diji (Xi-Cleft Point, Sp 8)

Location: On the medial side of the leg and 3 cun below Yinlingquan (Sp 9). Indications: Abdominal distention, abdominal pain, diarrhea, dysentery, irregular menstruation, dysmenorrhea, and dysuria. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The great saphenous vein, the branch of the supreme genicular artery, and the posterior tibial artery and vein. Innervation: The same as that of Sanyinjiao (Sp 6).

Yinlingquan (He-Sea Point, Sp 9)

Location: On the medial side of the leg and in the depression posterior and inferior to the medial condyle of the tibia. Indications: Abdominal distention, diarrhea, dysentery, edema, jaundice, dysuria, dyspnea, and pain in the medial side of the knee and thigh. Method: Insert the needle perpendicularly, l - l.5 cun deep. Regional anatomy: Vasculature: The great saphenous vein, the supreme genicular artery and the posterior tibial artery and vein. Innervation: The medial cutaneous nerve of leg and the tibial nerve.
Xuehai (Sp 10)

Location: On the medial side of the thigh, 2 cun above the superior medial corner of the patella and on the prominence of the medial head of the quadriceps muscle. Indications: Irregular menstruation, dysmenorrhea, metrorrhagia, pain in the medial side of the knee and thigh, urticaria, eczema, and pruritus. Method: Insert the needle perpendicularly, l - l.2 cun deep. Note: Simple measurement: First, the patient flexes his knee. Then the doctor places his left palm on the upper border of the patient's right knee cap, with his four fingers extending upward and the thumb held at an angle of 45 degrees. The acupoint is right under the tip oft he thumb. The one on the other leg can be located in the same way. Regional anatomy: Vasculature: The muscular branches of the femoral artery and vein. Innervation: The anterior cutaneous nerve of thigh and the muscular branch of the femoral nerve.
Jimen (Sp 11)

Location: On the medial side of the thigh and 6 cun above Xuehai. Indications: Dysuria, enuresis, and pain in the medial side of the thigh. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The great saphenous vein and the femoral artery and vein. Innervation: The anterior cutaneous nerve of thigh and the saphenous nerve.

Chongmen (Sp 12)

Location: In the inguinal region, 3.5 cun lateral to the midpoint (Qugu, RN 2) of the upper border of the symphysis pubis and lateral to the pulsating external iliac artery. Indication: Abdominal pain, diarrhea, leukorrhagia, and hernia. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The femoral artery and vein. Innervation: The femoral nerve.

Fushe (Sp 13)

Location: On the lower abdomen, 4 cun below the center of the umbilicus and 4 cun lateral to the anterior midline. Indications: Abdominal pain and masses in the abdomen, and hernia. Method: Insert the needle perpendicularly, 0.5-1cun deep. Regional anatomy: Vasculature: The superficial epigastric artery and the intercostal artery and vein. Innervation: The ilioinguinal nerve.
Fujie (Sp 14)

Location: On the lower abdomen, 4 cun lateral to the anterior midline and 3 cun above Fushe (Sp 13). Indications: Pain around the umbilicus, diarrhea, and hernia. Method: Insert the needle perpendicularly, 1-1.2 cun deep. Regional anatomy: Vasculature: The eleventh intercostal artery and vein. Innervation: The eleventh intercostal nerve.
Daheng (Sp 15)

Location: On the middle abdomen and 4 cun lateral to the center of the umbilicus. Indications: Abdominal pain, diarrhea, and constipation. Method: Insert the needle perpendicularly, l - l .2 cun deep. Regional anatomy: Vasculature: The tenth intercostal artery and vein. Innervation: The tenth intercostal nerve.

Fuai (Sp 16)

Location: On the upper abdomen, 3 cun above the umbilicus and 4 cun lateral to the anterior midline. Indications: Abdominal pain, diarrhea, and constipation. Method: Insert the needle perpendicularly, 0.5-1cun deep. Regional anatomy: Vasculature: The eighth intercostal artery and vein. Innervation: The eighth intercostal nerve.

Shidou (Sp 17)

Location: On the lateral side of the chest, in the fifth intercostal space and 6 cun lateral to the anterior midline. Indications: Fullness and pain in the chest and hypochondriac region, and edema. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The thoracoepigastric vein. Innervation: The lateral cutaneous branch of the fifth intercostal nerve.

Tianxi (Sp 18)

Location: On the lateral side of the chest, in the fourth intercostal space and 6 cun lateral to the anterior midline. Indications: Chest pain, cough, and mastitis. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of lateral thoracic artery and vein, the thoracoepigastric artery and vein, and the fourth intercostal artery and vein. Innervation: The lateral cutaneous branch of the fourth intercostal nerve.

Xiongxiang (Sp 19)

Location: On the lateral side of the chest, in the third intercostal space and 6 cun lateral to the anterior midline. Indications: Fullness and pain in the chest and hypochondriac region. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The lateral thoracic artery and vein, and the third intercostal artery and vein. Innervation: The lateral cutaneous branch of the third intercostal nerve.
Zhourong (Sp 20)

Location: On the lateral side of the chest, in the second intercostal space and 6 cun lateral to the anterior midline. Indications: Fullness and pain in the chest and hypochondriac region and cough with dyspnea. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The lateral thoracic artery and vein, the second intercostal artery and vein. Innervation: The muscular branch of the anterior thoracic nerve, and the lateral cutaneous branch of the second intercostal nerve.
Dabao (Major Lou-Connecting Point of the Spleen, Sp 2 l)

Location: On the lateral side of the chest, in the sixth intercostal space and on the middle axillary line. Indications: Fullness and pain in the chest and hypochondriac region, cough, and asthma. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The thoracodorsal artery and vein and the sixth intercostal artery and vein. Innervation: The sixth intercostal nerve and the terminal branch of the long thoracic nerve.

Lecture 5. The Heart Meridian of Hand-Shaoyin (HT) l. Traveling route

a) The meridian originates in the heart, spreading over the "heart system". It descends internally passing the diaphragm to connect with the small intestine. b) The straight portion starts from the "heart system", running along the esophagus and terminates in the "eye system". c) The main branch traverses the lung, then runs downward and emerges in the mid of the axilla (Jiquan, HT l). Then it goes along the posterior (the ulnar) border of the medial aspect of the upper arm (behind the Lung Meridian of Hand-Taiyin and Pericardium Meridian of Hand-Jueyin) and reaches the elbow. It runs further down along the posterior border of the medial side of the forearm to the pisiform bone proximal to the palm, and enters the palm. It descends along the radial side of the palm, terminating at Shaochong (HT 9).
2. Symptoms:

Cardialgia, dry throat, thirst with a desire to drink, yellowish eyeballs, pain in the hypochondriac region and along the meridian.
3. Acupoints Jiquan (HT 1)

Location: At the apex of the axillary fossa, where the pulsation of the axillary artery is palpable. Indications: Palpitation, cardialgia, dry throat, fullness in the chest, and cold-pain or motor impairment of the elbow and arm. Method: Keep the needle away from the artery and insert it perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The axillary artery. Innervation: The ulnar nerve, median nerve and medial cutaneous nerve of arm.
Qingling (HT 2)

Location: On the medial side of the arm, 3 cun above the cubital crease and in the groove medial to the biceps muscle. Indications: Yellowish eyeballs, pain in the hypochondriac region, pain in the elbow and arm, and headache. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The basilic vein and superior ulnar collateral artery. Innervation: Themedial cutaneous nerve of forearm, medial cutaneous nerve of arm and ulnar nerve.

Shaohai (He-Sea Point, HT 3)

Location: At the midpoint of the line connecting the medial end of the cubital crease and the medial epicondyle of the humerus when the elbow is flexed. Indications: Cardialgia, pain in the hypochondriac region, pain in the elbow and arm, headache, and scrofula. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The basilic vein, inferior ulnar collateral artery, and ulnar recurrent artery and vein. Innervation: Themedial cutaneous nerve of forearm.
Lingdao (Jing-River Point, HT 4)

Location: On the palmar side of the forearm and on the radial side of the tendon of the ulnar flexor muscle of the wrist, and 1.5 cun proximal to the crease of the wrist. Indications: Palpitation, cardialgia, aphasia with stiff tongue, sudden loss of voice, and pain in the elbow and arm. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The ulnar artery. Innervation: The medial cutaneous nerve of forearm and ulnar nerve.
Tongli (Lou-Connecting Point, HT 5)

Location: On the palmar side of the forearm and on the radial side of the tendon of the ulnar flexor muscle of the wrist, and 1 cun proximal to the crease of the wrist. Indications: Palpitation, cardialgia, sore throat, sudden loss of voice, aphasia with stiff tongue, and pain in the wrist and arm. Method: Insert the needle perpendicularly, 0.3~0.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Lingdao (HT 4).
Yinxi (Xi-Cleft Point, HT 6)

Location: On the palmar side of the forearm and on the radial side of the tendon of the ulnar flexor muscle of the wrist, and 0.5 cun proximal to the crease of the wrist. Indications: Cardialgia, palpitation, night sweat, and aphasia. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy:

Vasculature and innervation: The same as those of Lingdao (HT 4).

Shenmen (Shu-Stream Point and Yuan-Primary Point, HT 7)

Location: On the transverse crease of the wrist and at the radial side of the tendon of the ulnar flexor muscle of the wrist. Indications: Cardialgia, palpitation, insomnia, mania, epilepsy, aphonia, and pain in the wrist and forearm. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Notes: Shenmen is an effective point for dementia and it is also effectively used for cardialgia when combined with Neiguan (PC 6) and Xinshu (BL 15). To treat insomnia it is combined with Fengchi (GB 20), Neiguan (PC 6) and Sanyinjiao (ST 6). Regional anatomy: Vasculature and innervation: The same as those of Lingdao (HT 4).
Shaofu (Ying-Sring Point, HT 8)

Location: On the palmar surface, between the fourth and fifth metacarpal bones, and in the depression proximal to the metacarpophalangeal joint. Indications: Palpitation, chest pain, feverish sensation in the palm, and spasmodic pain in the little finger Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The common palmar digital arteries and veins. Innervation: The fourth common palmar digital nerve derived from the ulnar nerve.
Shaochong (Jing-Well Point, HT 9)

Location: On the radial side of the little finger and 0.1 cun proximal to the corner of the nail. Indications: Coma, palpitation, cardialgia, and pain in the finger-joint and febrile diseases. Method: Insert the needle 0.1 cun into the skin, or prick so that a little blood comes out. Regional anatomy: Vasculature: The arterial and venous network formed by the proper palmar digital artery and vein. Innervation: The palmar digital proprial nerve derived from the ulnar nerve.

Lecture 6. The Small intestine Meridian of Hand-Taiyang (SI) l. Traveling route

a) The meridian starts at the ulnar side of the little finger (Shaoze, SI l), running along the ulnar side of the dorsum of hand, then enters the wrist. Passing the styloid process of ulna, it ascends along the posterior border of ulnar side of the forearm and emerges from between the olecranon and the medial epicondyle of humerus. It continues to travel along the ulnar border side of dorsal aspect of the upper arm, comes out from the shoulder joint, circles around the scapular region, and then meets the Du Meridian on the shoulder. After that, it enters the supraclavicular fossa (Quepen, ST 12), connects with the heart, descends along the esophagus, passes the diaphragm, reaches the stomach and finally goes into the small intestine, its pertaining organ. b) Another branch starts from the supraclavicular fossa (Quepen, ST 12), running along the neck and past the cheek, and reaches the outer canthus. It terminates in the ear (Tinggong, SI 19). c) The third branch starts at the cheek, ascends to the infraorbital region, passes the lateral side of the nose, and finally enters the medial canthus of the eyes.
2. Symptoms:

Sore throat, deafness, yellowish eyeballs, swollen cheek, pain in the neck, shoulder, arm and elbow, and other disorders along the running course of the meridian.
3. Acupoints Shaoze (Jing-Well Point, SI 1)

Location: On the ulnar side of the little finger and about 0.1cun lateral to the corner of the nail. Indications: Tinnitus, ophthalmalgia, headache, sore throat, pain in the lateral side of the shoulder and arm, hypogalactia, mastitis, apoplexy, and coma. Method: Insert the needle 0.1 cun into the skin, or prick so that a little blood comes out. Notes: Shaoze, Hegu (LI 4), and Danzhong (RN 17) can be used together for hypogalactia. Regional anatomy: Vasculature: The arterial and venous network formed by proper palmar digital artery and vein and dorsal digital artery and vein. Innervation: The palmar digital proprial nerve and dorsal digital nerve stemming from the ulnar nerve.
Qiangu (Ying-Spring Point, SI 2)

Location: At the intersection of the dorsoventral border of the hand and the ulnar end of the crease of the fifth metacarpophalangeal joint. Indications: Headache, tinnitus, deafness, sore throat, ophthalmalgia, malaria, mania, and pain in the elbow, wrist and arm. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy:

Vasculature: The dorsal digital artery and vein stemming from the ulnar artery and vein. Innervation: The dorsal digital nerve and palmar digital proprial nerve stemming from the ulnar nerve.
Houxi (Shu-Stream Point and one of the Eight Confluent Points, SI 3)

Location: At the intersection of the dorsoventral boundary of the hand and the ulnar end of the distal palmar crease. Indications: Rigid nape with headache, conjunctival congestion, corneal nebula, deafness, tinnitus, sore throat, pain in the wrist, elbow and arm, malaria, mania, and febrile diseases. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Notes: This is one of the eight confluent points communicating with the Du Meridian. It is combined with Fengchi (GBL 20) and Jianjing (GBL 21) to treat the rigid nape with headache. If combined with Hegu (LI 4), Jianshi (P 5), and Dazhui (DU 14), it can treat malaria. When combined with Shenmen (HT 7), Neiguan (P 6), Dazhui and Fengu (DU 16), it can treat mania and epilepsy. Clinical practice shows that needling at Houxi and Huantiao (GB 30) may help relieve pain in the legs. Regional anatomy: Vasculature: The dorsal digital artery and vein, and dorsal venous network of hand. Innervation: The dorsal branch stemming from the ulnar nerve.
Wangu (Yuan-Primary Point, SI 4)

Location: On the ulnar border of the hand and in the depression between the proximal end of the fifth metacarpal bone and hamate bone. Indications: Rigid nape with headache, and tinnitus, corneal nebula, jaundice, and pain in the shoulder, arm and wrist, febrile diseases with anhidrosis. Method: Insert the needle perpendicularly, 0.3- 0.5 cun deep Regional anatomy: Vasculature: The dorsal carpal artery (branch of the ulnar artery) and dorsal venous network of hand. Innervation: The dorsal branch of the ulnar nerve.
Yanggu (Jing-River Point, SI 5)

Location: On the ulnar border of the wrist and in and triangular bone. Indications: Rigid nape with headache, deafness, tinnitus, ophthalmalgia, swollen jaw, and pain in the arm and wrist. Method: Insert the needle perpendicularly, 0.3-0.5 cun Regional anatomy: Vasculature: The dorsal carpal artery. Innervation: The dorsal branch of the ulnar nerve.

Yanglao (Xi-Cleft Point, SI 6)

Location: On the ulnar side of the posterior surface of the forearm, and in the depression proximal to and on the radial side of the head of the ulna. Indications: Blurred vision and pain in the shoulder, arm, and lumbar region. Method: Insert the needle obliquely upward, 0.50.8 cun deep. Regional anatomy: Vasculature: The terminal branches of interosseous dorsal artery and vein of forearm and the venous network of the wrist. Innervation: The anastomotic branches of dorsal cutaneous nerve of forearm and the dorsal branch of the ulnar nerve.
Zhizheng (Lou-Connecting Point, SI 7)

Location: On the ulnar side of the posterior surface of the forearm and 5 cun proximal to the dorsal crease of the wrist. Indications: Rigid nape with headache, pain in the elbow, forearm and fingers, febrile diseases, and mania. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The terminal branches of interosseous dorsal artery and vein of forearm. Innervation: The branch of the medial cutaneous nerve of forearm and interosseous dorsal nerve of forearm at the radial side.

Xiaohai (He-Sea Point, SI 8)

Location: On the medial side of the elbow and in the depression between the olecranon of the ulna and the medial epicondyle of the humerus. Indications: Headache, pain in the neck, swollen jaw, and spasmodic pain and motoring impairment of the elbow and arms. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The superior and inferior ulnar collateral arteries and veins, and ulnar recurrent artery and vein. Innervation: The branches of medial cutaneous nerve of forearm, and the ulnar nerve.

Jianzhen (SI 9)

Location: Posterior and inferior to the shoulder joint and 1cun above the posterior end of the axillary fold when the arm is adducted. Indications: Tinnitus, deafness, and pain and motoring impairment of the shoulder and arms. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The circumflex artery and vein of scapula. Innervation: The branch of axillary nerve and radial nerve.
Naoshu (SI 10)

Location: On the shoulder, above the posterior end of the axillary fold and in the depression below the lower border of the scapular spine. Indications: Pain in the shoulder and arms and scrofula. Method: Insert the needle perpendicularly or obliquely outward, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior humeral circumflex artery and vein, and suprascapular artery and vein. Innervation: The axillary nerve and suprascapular nerve.
Tianzong (SI 11)

Location: In the depression of the center of the subscapular fossa. Indications: Pain in the scapular region and the latero-posterior side of the elbow and arms. Method: Insert the needle perpendicularly, 0.51 cun deep. Regional anatomy: Vasculature: The muscular branches of circumflex artery and vein of scapula. Innervation: The suprascapular nerve.
Bingfeng (SI 12)

Location: Directly above Tianzong (SI 11) and in the center of the suprascapular fossa. Indications: Pain in the scapular region and aching in the shoulder and arms. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy:

Vasculature: The suprascapular artery and vein. Innervation: The posterior branch of the supraclavicular nerve and accessory nerve, and suprascapular nerve.
Quyuan (SI 13)

Location: In the depression at the medial side of the suprascapular fossa. Indications: Spasmodic pain in the shoulder and scapular region. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The descending branch of the transverse cervical artery and vein, and the muscular branch of the suprascapular artery and vein. Innervation: The lateral branch of the second rami posteriores nervorum thoracalium and accessory nerve, and the muscular branch of the suprascapular nerve.
Jianwaishu (SI 14)

Location: 3 cun lateral to the lower border of the spinous process of the first thoracic vertebrae. Indications: Stiffness of nape and back, pain in the shoulder and back, and cold-pain in the upper limbs. Method: Insert the needle perpendicularly, 0.5-0. 8 cun deep. Regional anatomy: Vasculature: The transverse cervical artery and vein. Innervation: The medial cutaneous branch of the first rami posteriores nervorum thoracalium and accessory nerve, and dorsal nerve of scapula.
Jianzhongshu (SI 15)

Location: On the back and 2 cun lateral to the lower border of the spinous process of the seventh cervical vertebrae (Dazhui, DU 14). Indications: Pain in the shoulder and back, cough, dyspnea, and chills and fever. Method: Insert the needle perpendicularly, 0.50. 8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Jianwaishu (SI 14).

Tianchuang (SI 16)

Location: On the lateral side of the neck, 3.5 cun lateral to the tip of Adam's apple, and on the posterior border of the sternocleidomastoid muscle. Indications: Tinnitus, deafness, sore throat, swollen cheek, and sudden loss of voice. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The ascending cervical artery. Innervation: The cutaneous nerve of neck at the place where the great auricular nerve plexus generates.

Tianrong (SI 17)

Location: On the lateral side of the neck, posterior to the mandibular angle and in the depression of the anterior border of the stemocleidomastoid muscle. Indications: Tinnitus, deafness, sore throat, swollen neck and nape, and goiter. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The external jugular vein, the internal carotid artery and the internal jugular vein. Innervation: The anterior branch of the great auricular nerve, the cervical branch of the facial nerve and the sympathetic nerve.
Quanliao (SI 1 8)

Location: On the face, directly below the outer canthus and in the depression below the zygomatic bone. Indications: Facial paralysis, twitching eyelids, and toothache. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of transverse facial artery and vein. Innervation: The facial and infraorbital nerves.

Tinggong (SI 19)

Location: On the face, anterior to the tragus and posterior to the mandibular condyloid process and in the depression found when the mouth is open. Indications: Deafness, tinnitus, otorrhea, toothache, and pain in the mandibular joint. Method: Insert the needle perpendicularly, 1-1.2 cun deep. Regional anatomy: Vasculature: The rami auriculares anteriores of the superficial temporal artery and vein. Innervation: The branch of the facial nerve, and auriculotemporal nerve.

Lecture 7. The Bladder Meridian of Foot-Taiyang (BL) l. Traveling route

a) The meridian starts at the medial canthus of the eye (Jingming, BL l), ascends to the forehead and then arrives at the vertex. b) The cephalic branch descends from the vertex to the upper corner of the ear. c) The straight cephalic branch descends from the vertex to the brain, exits along the nape and the medial side of the scapula, moves down along the spine, and then reaches the lumbar region. It enters the abdomen and connects with the kidney and the urinary bladder. a) The lumbar branch starts at the lumbar and gluteal region and runs to the popliteal fossa. e) Another branch starts at the medial side of the scapula, running along the spine, and reaches the greater trochanter of femur in the gluteal region. Then it descends along the latero-posterior side of the thigh and meets the lumbar branch at the popliteal fossa. It continues to descend along the posterior side of the calf and emerges from the posterior side of the external malleolus. After passing the tuberosity of the fifth metatarsal bone, it reaches the lateral side of the tip of the little toe (Zhiyin, BL 67).
2. Symptoms

Dysuria, enuresis, yellowish eyeballs, epistaxis, headache, mania, pain in the nape, back, lumbar region and along the meridian.
3. Acupoints Jingming (BL1)

Location: On the face and in the depression slightly medial to the inner canthus. Indications: Eye disorders (red and swollen eyes, corneal nebula, and blurred vision) and trichiasis. Method: With the patient's eyes closed and eyeballs fixed on the lateral side of the orbit, insert the needle slowly along the orbit, 0.5-1 cun deep. Do not twirl, lift or thrust the needle forcefully. Withdraw the needle slowly at the end of the treatment and press the point for a while to avoid bleeding. In addition, moxibustion is contraindicated. Regional anatomy: Vasculature: The angular artery and vein, and ophthalmic artery and vein. Innervation: The supratrochlear and infratrochlear nerves, oculomotor nerve, and ophthalmic nerve.
Zanzhu (BL 2)

Location: On the face, in the depression of the medial end of the eyebrow and at the supraorbital notch. Indications: Frontal headache, pain in the supraorbital region, red and swollen eyes, blurred vision, and twitching eyelids. Method: Insert the needle horizontally toward Yuyao (EX-HN 4, on the forehead and in the eyebrow, directly above the pupil), 0.3-0.5 cun deep. Moxibustion is contraindicated. Regional anatomy:

Vasculature: The frontal artery and vein. Innervation: The medial branch of the frontal nerve.
Meichong (BL 3)

Location: On the head, directly above the medial end of the eyebrow and 0.5 cun above the anterior hairline. Indications: Headache, nasal stuffiness, vertigo, and epilepsy. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Moxibustion is contraindicated. Regional anatomy: Vasculature and innervation: The same as those of Zanzhu (BL 2).
Quchai (BL 4)

Location: On the head, 1.5 cun lateral to the anterior midline, 0.5 cun above the anterior hairline and 1.5 cun lateral to Shenting (DU 24). Indications: Headache, nasal stuffiness, epistaxis, and blurred vision. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The frontal artery and vein. Innervation: The lateral branch of the frontal nerve.
Wuchu (BL 5)

Location: On the head, 0.5 cun above Quchai (BL 4) and 1.5 cun lateral to Shangxing (DU 23). Indications: Headache, dizziness, and epilepsy. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature and innervation: the same as those of Quchai (BL 4).
Chengguang (BL 6)

Location: 1.5 cun above Wuchu (BL 5). Indications: Headache, dizziness, nasal stuffiness, and febrile diseases with anhidrosis. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The anastomotic network of the frontal artery and vein, temporal artery and vein. Innervation: The anastomotic branch of the lateral branch of the frontal nerve and the great occipital

nerve.
Tongtian (BL 7)

Location: l .5 cun above Chengguang (BL 6) Indications: Headache, dizziness, nasal stuffiness, and epistaxis. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The anastomotic network of the superficial temporal artery and vein and occipital artery and vein. Innervation: The branch of the greater occipital nerve.
Luoque (BL 8)

Location: l .5 cun posterior to Tongtian (BL 7). Indications: Vertigo, tinnitus, blurred vision, swollen nape, mania, and epilepsy. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of the occipital artery and vein. Innervation: The branch of the greater occipital nerve.
Yuzhen (BL 9)

Location: l .3 cun lateral to Naohu (DU 17) and on the lateral side of the upper border of the external occipital protuberance. Indications: Pain in the head and nape, red and swollen eyes, and nasal stuffiness. Method: Insert the needle horizontally downward, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The occipital artery and vein. Innervation: The branch of the greater occipital nerve.

Tianzhu (BL 10)

Location: On the nape and in the depression on the lateral side of trapezius muscle, l.3 cun lateral to Yamen (DU 15). Indications: Rigid nape with headache, sore throat, nasal stuffiness, and mania. Method: Insert the needle obliquely, 0.5- I cun deep. Do not insert deep. Regional anatomy: Vasculature: The occipital artery and vein. Innervation: The greater occipital nerve.

Dazhu (Influential Point of Bones, BL 11)

Location: On the back, l.5 cun lateral to the midpoint between the spinous processes of the first and second thoracic vertebrae. Indications: Rigid nape with headache, back rigidity, fever, nasal stuffiness, and cough. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Do not insert deep. Regional anatomy: Vasculature: The medial branches of the posterior intercostal artery and vein. Innervation: The medial cutaneous branches of the first rami posteriores nervorum thoracalium and its lateral branches.
Fengmen (BL 12)

Location: On the back, l.5 cun lateral to the midpoint between the spinous processes of the second and third thoracic vertebrae. Indications: Common cold, cough, fever, rigid nape with headache, and pain in the chest and back. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the second and third rami posteriores nervorum thoracalium, and their lateral branches.
Feishu (Back-Shu Point of the Lung, BL 13)

Location: On the back and l.5 cun lateral to the midpoint between the spinous processes of the third and fourth thoracic vertebrae. Indications: Cough, asthma, afternoon fever, night sweat, hematemesis, and pain in the chest and back. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the third and fourth rami posteriores nervorum thoracalium, and their lateral branches.
Jueyinshu (Back-Shu Point of the Pericardium, BL 14)

Location: On the back and 1.5 cun lateral to the midpoint between the spinous processes of the fourth and fifth thoracic vertebrae. Indications: Cough, palpitation, cardialgia, and stuffiness and pain in the chest. Method: Insert the needle obliquely, 0.5-0.8 cun deep.

Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the fourth and fifth rami posteriores nervorum thoracalium and their lateral branches.
Xinshu (Back-Shu Point of the Heart, BL 15)

Location: On the back and 1.5 cun lateral to the midpoint between the spinous processes of the fifth and sixth thoracic vertebrae. Indications: Palpitation, cardialgia, irritability, insomnia, pain, and oppressed feeling in the chest, mania, and epilepsy. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the fifth and sixth rami posteriores nervorum thoracalium, and their lateral branches.
Dushu (BL 16)

Location: On the back and 1.5 cun lateral to the midpoint between the spinous processes of the sixth and seventh thoracic vertebrae. Indications: Fever, chills, cardialgia, stomachache, abdominal pain, borborygmus, and hiccup. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The medial branches of the posterior intercostal artery and vein, and the descending branch of the transverse cervical artery. Innervation: The medial cutaneous branches of the sixth and seventh rami posteriores nervorum thoracalium, and their lateral branches.
Geshu (Influential Point of Blood, BL 17)

Location: On the back and 1.5 cun lateral to the midpoint between the spinous processes of the seventh and eighth thoracic vertebrae. Indications: Vomiting, hiccup, dysphagia, cough, asthma, afternoon fever, night sweat, dizziness, and palpitation. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial branches of the seventh and eighth rami posteriores nervorum thoracalium and their lateral branches.

Ganshu (Back-Shu Point of the Liver, BL 1 8)

Location: On the back and l.5 cun lateral to the midpoint between the spinous processes of the seventh and tenth thoracic vertebrae. Indications: Pain in the hypochondriac region, jaundice, hematemesis, eye diseases, and mania. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the ninth and tenth rami posteriores nervorum thoracalium, and their lateral branches.
Danshu (Back-Shu Point of the Gallbladder, BL 19)

Location: On the back and l.5 cun lateral to the midpoint between the spinous processes of the tenth and eleventh thoracic vertebrae. Indications: Pain in the hypochondriac region, jaundice, bitter taste, and afternoon fever Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL l l). Innervation: The medial cutaneous branches of the tenth and eleventh rami posteriores nervorum thoracalium, and their lateral branches.
Pishu (Back-Shu Point of the Spleen, BL 20)

Location: On the back and l.5 cun lateral to the midpoint between the spinous processes of the eleventh and twelfth thoracic vertebrae. Indications: Abdominal distention, diarrhea, jaundice, dysentery, edema, vomiting, hematochezia, and week spleen and stomach. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Dazhu (BL 11). Innervation: The medial cutaneous branches of the eleventh and twelfth rami posteriores nervorum thoracalium, and their lateral branches.
Weishu (Back-Shu Point of the Stomach, BL 21)

Location: On the back and 1.5 cun lateral to the midpoint between the spinous processes of the twelfth and the first Lumbar vertebrae. Indications: Stomachache, abdominal distention, borborygmus, vomiting, and weak spleen and stomach.

Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The medial rami of the posterior branches of subcostal artery and vein. Innervation: The medial cutaneous branch of twelfth rami posteriores nervorum thoracalium, and its lateral branches.
Sanjiaoshu (Back-Shu Point of Sanjiao, BL 22)

Location: On the lower back and 1.5 cun lateral to the midpoint between the spinous processes of the first and second lumbar vertebrae. Indications: Abdominal distention, borborygmus, diarrhea, dysentery, dysuria, edema, and lumbago and upper back pain. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior rami of the first lumbar artery and vein. Innervation: The lateral cutaneous branch of the tenth rami posteriores nervorum thoracalium, and the lateral ramus of the posterior branch of the first lumbar nerve.
Shenshu (Back-Shu Point of the Kidney, BL 23)

Location: On the lower back and 1.5 cun lateral to the midpoint between the spinous processes of the second and third lumbar vertebrae. Indications: Impotence, seminal emission, irregular menstruation, leukorrhagia, sterility, dysuria, enuresis, edema, tinnitus, deafness, and pain in the knee and lumbar region. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior rami of the second lumbar artery and vein. Innervation: The lateral cutaneous branch of the posterior ramus of the first lumbar nerve, and its lateral branch.
Qihaishu (BL 24)

Location: On the lower back and 1.5 cun lateral to the midpoint between the spinous processes of the third and fourth lumbar vertebrae. Indications: Pain in the back and lumbar region, dysmenorrhea, hemorrhoid, and pain and weakness of the lower limbs. Method: Insert the needle perpendicularly, 0.5- I cun deep. Regional anatomy: Vasculature: The posterior rami of the third lumbar artery and vein.

Innervation: The lateral cutaneous branch of the posterior ramus of the second lumbar nerve.
Dachangshu (Back-Shu Point of the Large Intestine, BL 25)

Location: On the lower back and 1.5 cun lateral to the midpoint between the spinous processes of the fourth and fifth lumbar vertebrae. Indications: Abdominal distention, borborygmus, diarrhea, dysentery, lumbago, numbness and pain in the lower limbs, and hemorrhoids. Method: Insert the needle perpendicularly, l l.2 cun deep. Note: It is often combined with Tianshu (ST 25) to treat borborygnius, diarrhea, and dysentery. Regional anatomy: Vasculature: The posterior rami of the fourth lumbar artery and vein. Innervation: The posterior ramus of the third lumbar nerve.
Guanyuanshu (BL 26)

Location: On the lower back and 1.5 cun lateral to the midpoint between the spinous processes of the fifth lumbar and first sacral vertebrae. Indications: Abdominal distention, diarrhea, dysuria, and lumbago. Method: Insert the needle perpendicularly, l l.2 cun deep. Regional anatomy: Vasculature: The posterior rami of the lowest lumbar artery and vein. Innervation: The posterior ramus of the fifth lumbar nerve.
Xiaochangshu (Back-Shu Point of the Small Intestine, BL 27)

Location: On the sacrum, at the level of the first posterior sacral foramen and 1.5 cun lateral to the medial sacral crest. Indications: Distention and pain in the lower abdomen, dysuria, enuresis, seminal emission, leukorrhagia, and lumbago. Method: Insert the needle perpendicularly, l-l.2 cun deep. Regional anatomy: Vasculature: The posterior branches of the lateral sacral artery and vein. Innervation: The lateral ramus of the posterior branch of the first sacral nerve.

Pangguangshu (Back-Shu Point of the Bladder, BL 28)

Location: On the sacrum, at the level of the second posterior sacral foramen and 1.5 cun lateral to the medial sacral crest. Indications: Stranguria, retention of urine, enuresis, seminal emission, stiffness and pain along the spinal column, and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature: The posterior branches of the lateral sacral artery and vein. Innervation: The lateral rami of the posterior branches of the first and second sacral nerves.
Zhonglushu (BL 29)

Location: On the sacrum, at the level of the third posterior sacral foramen and1.5 cun lateral to the medial sacral crest. Indications: Dysentery, hernia, stiffness and pain along the spinal column, and diabetes. Method: Insert the needle perpendicularly, l l.2 cun deep. Regional anatomy: Vasculature: The posterior branches of the lateral sacral artery and vein, and the branches of the inferior gluteal artery and vein. Innervation: The lateral rami of the posterior branches of the third and fourth sacral nerves.
Baihuanshu (BL 30)

Location: On the sacrum, at the level of the fourth posterior sacral foramen and 1.5 cun lateral to the medial sacral crest. Indications: Enuresis, hernia, leukorrhagia, and irregular menstruation. Method: Insert the needle perpendicularly, l l.2 cun deep. Regional anatomy: Vasculature: The inferior gluteal artery and vein, and internal pudendal artery and vein. Innervation: The inferior clunial nerve, the lateral rami of the posterior branches of the third and fourth sacral nerves, and inferior gluteal nerve.

Shangliao (BL 3 l)

Location: On the sacrum, at the midpoint between the posterosuperior iliac spine and the posterior midline, just at the first posterior sacral foramen. Indications: Lumbosacral pain, irregular menstruation, leukorrhagia, seminal emission, and dysuria, Method: Insert the needle perpendicularly, l - l .2 cun deep. Regional anatomy: Vasculature: The posterior branches of the lateral sacral artery and vein. Innervation: The posterior ramus of the first sacral nerve.
Ciliao (BL 32)

Location: On the sacrum, medial and inferior to the posterosuperior iliac spine, just at the second posterior sacral foramen. Indications: Lumbosacral pain, irregular menstruation, leukorrhagia, impotence, seminal emission, hernia, and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, l - 1.2 cun deep. Regional anatomy: Vasculature: The same as that of Shangliao (BL 31). Innervation: The posterior ramus of the second sacral nerve.
Zhongliao (BL 33)

Location: On the sacrum, medial and inferior to Ciliao, just at the third posterior sacral foramen. Indications: Lumbosacral pain, irregular menstruation, leukorrhagia, and dysuria. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature: The same as that of Shangliao (BL 31). Innervation: The posterior ramus of the third sacral nerve.
Xialiao (BL 34)

Location: On the sacrum, medial and inferior to Zhongliao, just at the fourth posterior sacral foramen. Indications: Lumbago, abdominal pain, borborygmus, diarrhea, and dysuria. Method: Insert the needle perpendicularly, 1 - 1.2 cun deep. Regional anatomy: Vasculature: The branches of the inferior gluteal artery and vein. Innervation: The posterior ramus of the fourth sacral nerve.

Huiyang (BL 35)

Location: On the sacrum and 0.5 cun lateral to the tip of the coccyx. Indications: Dysentery, diarrhea, hemafecia, hemorrhoids, and impotence. Method: Insert the needle perpendicularly, l - 1.2 cun deep. Regional anatomy: Vasculature: The branches of the inferior gluteal artery and vein. Innervation: The coccygeal nerve.

Chengfu (BL 36)

Location: On the posterior side of the thigh and at the midpoint of the inferior gluteal crease. Indications: Lumbago, numbness and pain in the lower limbs, and hemorrhoids. Method: Insert the needle perpendicularly, l -2.5 cun deep. Regional anatomy: Vasculature: The companion artery and vein of sciatic nerve. Innervation: The cutaneous nerve of thigh, and sciatic nerve.
Yinmen (BL 37)

Location: On the posterior side of the thigh and on the line connecting Chengfu (BL 36) and Weizhong (BL 40), and 6 cun below Chengfu (BL 36). (Fig. 2-48) Indications: Stiffness and pain along the spinal column and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, l -2 cun deep. Regional anatomy: Vasculature: The third perforating branch of the deep femoral artery and vein. Innervation: The posterior cutaneous nerve of thigh and sciatic nerve.
Fuxi (BL 38)

Location: At the lateral end of the popliteal crease, 1cun above Weiyang (BL 39) and medial to the tendon of the biceps muscle of the thigh. Indications: Numbness and pain in the gluteal and femoral region and pain in the popliteal fossa. Method: Insert the needle perpendicularly, l-l .2 cun deep. Regional anatomy: Vasculature: The superolateral genicular artery and vein.

Innervation: The posterior cutaneous nerve of thigh and common poroneal nerve.
Weiyang (Lower He-Sea Point of Sanjiao, BL 39)

Location: At the lateral end of the popliteal crease and medial to the tendon of the biceps muscle of the thigh. Indications: Dysuria, lower abdominal distention, stiffness and pain along the spinal column, and spasmodic pain in the lower limbs. Method: Insert the needle perpendicularly, l- l.2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Fuxi (BL 38).

Weizhong (He-Sea Point, and Lower He-Sea Point of the Bladder, BL 40)

Location: At the midpoint of the popliteal crease and between the tendon of the biceps muscle of the thigh and the semitendinous muscle. Indications: Abdominal pain, vomiting, diarrhea, dysuria, pain in the leg, lumbar and popliteal regions, motor impairment of the lower limbs, and sunstroke. Method: Insert the needle perpendicularly, l- l.2 cun deep or prick the acupoint so that a little blood comes out. Moxibustion can be used except the scarring moxibustion. Note: a) As the He-Sea point of the meridian, it can help disperse heat, activate the circulation of Qi, resolve stasis, and stop vomiting. b) Acupoints on the popliteal region can be used to treat lumbar disorders. Weizhong is therefore often used together with Shenshu (BL 23) and Huantiao (GBL 30) to treat pain in the lumbar region and legs. Regional anatomy: Vasculature: The vena femoropoplitea, and popliteal vein and artery. Innervation: The posterior cutaneous nerve of thigh and tibial nerve.

Fufen (BL 41)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the second and third thoracic vertebrae. Indications: Spasmodic pain in the nape, shoulder and back, and numbness in the upper limbs. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The descending branch of the transverse cervical artery, and the lateral rami of the posterior branches of the intercostal artery and vein. Innervation: The lateral cutaneous branches of the first and second rami posteriores nervornm thoracalium, and dorsal nerve of scapula.
Pohu (BL 42)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the third and fourth thoracic vertebrae. Indications: Cough, asthma, and stiffness and pain in the nape and back. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The posterior branch of the intercostal artery, and the descending branch of the transverse cervical artery Innervation: The medial cutaneous branches of the second and third rami posteriores nervorum thoracalium and their lateral branches, the dorsal nerve of scapula.
Gaohuang (BL 43)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the fourth and fifth thoracic vertebrae. Indications: Pulmonary tuberculosis, cough, asthma, seminal emission, night sweat, weak spleen and stomach, and pain in the shoulder and back. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The posterior branch of the intercostal artery and the descending branch of the transverse cervical artery. Innervation: The medial cutaneous branches of the third and fourth rami posteriores nervorum thoracalium and their lateral branches, and the dorsal nerve of scapula.
Shentang (BL 44)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the fifth and sixth thoracic vertebrae. Indications: Cough, asthma, pain in the shoulder and back, and chest pain. Method: Insert the needle obliquely, 0.5-0.8 cun deep.

Regional anatomy: Vasculature: The posterior branches of the intercostal artery and vein, and the descending branch of the transverse cervical artery. Innervation: The medial cutaneous branches of the fourth and fifth rami posteriores nervorum thoracalium and their lateral branches, and the dorsal nerve of scapula.
Yixi (BL 45)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the sixth and seventh thoracic vertebrae. Indications: Cough, asthma, malaria, and pain in the shoulder and back. Method: Insert the needle obliquely, 0.50.8 cun deep. Regional anatomy: Vasculature: The posterior branches of the intercostal artery and vein. Innervation: The medial cutaneous branches of the fifth and sixth rami posteriores nervorum thoracalium and their lateral branches.
Geguan (BL 46)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the seventh and eighth thoracic vertebrae. Indications: Vomiting, belching, and dysphagia. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Yixi (BL 45). Innervation: The medial cutaneous branches of the sixth and seventh rami posteriores nervorum thoracalium and their lateral branches.
Hunmen (BL 47)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the ninth and tenth thoracic vertebrae. Indications: Distention and pain in the chest and hypochondriac region, vomiting, and dysphagia. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Yixi (BL 45). Innervation: The medial cutaneous branches of the eighth and ninth rami posteriores nervorum thoracalium.
Yanggang (BL 48)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the tenth and eleventh thoracic vertebrae. Indications: Jaundice, abdominal pain, borborygmus, diarrhea, and diabetes.

Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Yixi (BL 45). Innervation: The lateral branches of the ninth and tenth rami posteriores nervorum thoracalium.
Yishe (BL 49)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the eleventh and twelfth thoracic vertebrae. Indications: Abdominal distention, borborygmus, diarrhea, vomiting, and dysphagia. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Yixi (BL 45). Innervation: The lateral branches of the tenth and eleventh rami posteriores nervorum thoracalium.
Weicang (BL 50)

Location: On the back and 3 cun lateral to the midpoint between the spinous processes of the twelfth thoracic and first lumbar vertebrae. Indications: Abdominal distention, stomachache, edema, and infantile indigestion with food retention. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The posterior branches of the subcostal artery and vein. Innervation: The lateral branch of the eleventh rami posteriores nervorum thoracalium.
Huangmen (BL 51)

Location: On the lower back and 3 cun lateral to the midpoint between the spinous processes of the first and second lumbar vertebrae. Indications: Abdominal pain, mass in the abdomen, constipation, and breast disorders of women. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The posterior branches of the first lumbar artery and vein. Innervation: The lateral branch of the twelfth rami posteriores nervorum thoracalium.
Zhishi (BL 52)

Location: On the lower back and 3 cun lateral to the midpoint between the spinous processes of the second and third Lumbar vertebrae. Indications: Seminal emission, impotence, dysuria, edema, and lumbago. Method: Insert the needle perpendicularly, l - l .2 cun deep. Regional anatomy:

Vasculature: The posterior branches of the second lumbar artery and vein. Innervation: The lateral branch of the 12th and the lateral branch of the first lumbar nerve.
Baohuang (BL 53)

Location: On the buttock, at the level of the second posterior sacral foramen and 3 cun lateral to the median sacral crest. Indications: Borborygmus, abdominal distention, dyschesia, dysuria, and pain along the spinal column and swollen vulva. Method: Insert the needle perpendicularly, 1 - 1.2 cun deep. Regional anatomy: Vasculature: The superior gluteal artery and vein. Innervation: The superior clunial nerve, and superior gluteal nerve.
Zhibian (BL 54)

Location: On the buttock, at the level of the fourth posterior sacral foramen and 3 cun lateral to the median sacral crest. Indications: Dysuria, dyschesia, pain in the lumbar and sacral region, numbness and pain with motoring impairment of the lower limbs, and hemorrhoids. Method: Insert the needle perpendicularly, l-2 cun deep. Regional anatomy: Vasculature: The inferior gluteal artery and vein. Innervation: The inferior gluteal nerve, posterior cutaneous nerve of thigh, and sciatic nerve.
Heyang (BL 55)

Location: On the posterior side of the leg and 2 cun below Weizhong (BL 40). Indications: Stiffness and pain along the spinal column, numbness and pain in the lower limbs, hernia, and metrorrhagia. Method: Insert the needle perpendicularly, 1- l.5 cun deep. Regional anatomy: Vasculature: The small saphenous vein, and popliteal artery and vein. Innervation: The medial cutaneous nerve of calf, and tibial nerve.

Chengjin (BL 56)

Location: On the posterior side of the leg and between Heyang (BL 55) and Chengshan (BL 57), at the center of the gastrocnemius muscle belly and 5 cun below Weizhong (BL 40). Indications: Pain in the back and lumbar region, pain in the leg, spasm of gastrocnemius muscle, and hemorrhoids. Method: Insert the needle perpendicularly, l - l.5 cun deep. Regional anatomy: Vasculature: The small saphenous vein, and posterior tibial artery and vein. Innervation: The medial cutaneous nerve of calf, and tibial nerve.

Chengshan (BL 57)

Location: On the posterior midline of the leg, between Weizhong (BL 40) and Kunlun (BL 60), 8 cun below Weizhong, and in the depression formed below the gastrocnemius muscle belly when the leg is stretched or the heel is lifted. Indications: Lumbago, pain in the leg and spasm of the gastrocnemius muscle, hemorrhoids, and constipation. Method: Insert the needle perpendicularly, l- l.5 cun deep. Note: a) Simple measurement: When the leg is stretched the acupoint is in the depression below the gastrocnemius muscle belly. b) It is usually used together with Changqiang (DU 1), Erbai (Ex-ue 2) and Dachangshu (BL 25) in treating hemorrhoids. Regional anatomy: Vasculature and innervation: The same as those of Chengjin (BL 56).
Feiyang (Luo-Connecting Point, BL 58)

Location: On the posterior side of the leg, 7 cun directly above Kunlun (BL 60) and 1cun lateral and inferior to Chengshan (BL 57). Indications: Pain in the back and lumbar region, weakness and numbness of the lower limbs, headache, dizziness, and hemorrhoids. Method: Insert the needle perpendicularly, l- 1.5 cun deep. Regional anatomy: Vasculature: The posterior tibial artery.

Innervation: The lateral cutaneous nerve of calf.

Fuyang (Xi-Cleft Point of the Yangqiao Meridian, BL 59)

Location: On the posterior side of the leg, posterior to the lateral malleolus and 3 cun directly above Kunlun (BL 60). Indications: Pain in the lower limbs and lumbar region, motor impairment of the lower limbs, pain and swelling in the ankle, and headache. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The small saphenous vein and the terminal branch of the peroneal artery. Innervation: The sural nerve.

Kunlun (Jing-River Point, BL 60)

Location: posterior to the lateral malleolus and in the depression between the tip of the external malleolus and Achilles tendon. Indications: Rigid nape with headache, dizziness, mania, lumbago, swollen ankle, infantile epilepsy, and difficult labor Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The small saphenous vein and posterior artery and vein of lateral malleolus. Innervation: The sural nerve.
Pucan (BL 61 )

Location: On the lateral side of the foot, in the depression posterior and inferior to the external malleolus and I .5 cun directly below Kunlun (BL 60). Indications: Weakness and numbness of the lower limbs, swollen heel, and epilepsy. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The lateral calcaneus branches of the peroneal artery and vein. Innervation: The lateral calcaneus branch of the sural nerve.
Shenmai (one of the Eight Confluent Points, BL 62)

Location: On the lateral side of the foot and in the depression directly below the external malleolus.

Indications: Rigid nape with headache, vertigo, insomnia, epilepsy, and numbness and pain in the lower limbs. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Note: a) This is one of the Eight Confluent points communicating with the Yangqiao Meridian. It can treat disorders of the inner canthus and the neck, nape, ear and shoulder when used together with Houxi (SI 3). b) When used together with Zhaohai (K 6), it can treat insomnia. Regional anatomy: Vasculature: The lateral malleolus arterial network. Innervation: The sural nerve.
Jinmen (Xi-Cleft Point, BL 63)

Location: On the lateral side of the foot, directly below the anterior border of the external malleolus and in the depression lateral to the cuboid bone. Indications: Lumbago, stranguria, numbness and pain in the lower limbs, pain in the foot and ankle, epilepsy, and infantile convulsion. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Note: As a Xi-Cleft point of the meridian, it is especially effective for lumbago and stranguria. Regional anatomy: Vasculature: The lateral plantar artery and vein. Innervation: The lateral dorsal cutaneous nerve of foot and lateral plantar nerve.
Jinggu (Yuan-Primary Point, BL 64)

Location: On the lateral side of the foot and in the depression below the tuberosity of the fifth metatarsal bone. Indications: Epilepsy, headache, rigid nape, corneal nebula and pain in the legs, and lumbar region. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Jinmen (BL 63).
Shugu (Shu-Stream Point, BL 65)

Location: On the lateral side of the foot and in the depression posterior to the fifth metatarsophalangeal joint. Indications: Epilepsy, rigid nape with headache, dizziness, and pain in the legs and lumbar region. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The fourth common plantar digital artery and vein. Innervation: The fourth common digital plantar nerve and lateral dorsal cutaneous nerve of foot.
Zutonggu (Ying-Spring Point, BL 66)

Location: On the lateral side of the foot and in the depression anterior to the fifth metatarsophalangeal joint. Indications: Rigid nape with headache, dizziness, mania, and epilepsy. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The plantar digital artery and vein. Innervation: The proprial digital plantar nerve and lateral dorsal cutaneous nerve of foot.
Zhiyin (Jing-Well Point, BL 67)

Location: On the lateral side of the small toe, about 0.1 cun to the corner of the toenail. Indications: Headache, nasal stuffiness, ophthalmalgia, abnormal fetal position, and difficult labor and retention of placenta. Method: Insert the needle 0.1 cun into the skin. Note: Zhiyin (BL 67) is often used for abnormal fetal position, either with acupuncture or moxibustion. Clinical reports show that using laser onto Zhiyin (BL 67) can help treat abnormal fetal position with a success rate of 76.26%. Some scholars believe that acupuncture and moxibustion promote uterine and fetal activities and relax abdominal muscle, which help the fetal position becomes normal. Regional anatomy: Vasculature: The arterial network formed by dorsal digital artery of foot and proper digital plantar artery. Innervation: The proprial digital plantar nerve and lateral dorsal cutaneous nerve of foot.

Lecture 8. The Kidney Meridian of Foot-Shaoyin (KI) l. Traveling route a) The meridian starts at the plantar tip of the small toe and runs obliquely towards Yongquan (KI l) in the center of the sole. Passing Rangu (KI 2) which locates in front of the medial malleolus, it circles the posterior medial malleolus and runs in the heel. Then it ascends along the medial side of the calf, and emerges from between the semitendinous and semimembranous muscles in the popliteal fossa. It further ascends along the medial side of the thigh, enters the spinal column and terminates in the kidneys, connecting with the urinary bladder. b) The kidney branch starts from the kidney, passes the liver and diaphragm, enters the lung, runs through the throat and finally reaches the root of the tongue. c) Another branch starts from the lung, links with the heart and enters the chest. 2. Symptoms Hemoptysis, asthma, dry tongue and swollen pharynx, pain in the lumbar region, spinal column and medial side of the thigh, diarrhea, palpitation, and feverish sensation in the center of the sole. 3. Acupoints Yongquan (Jing-Well Point, KI l) Location: On the sole, in the depression where appears on the anterior part of the sole. When the foot is in the plantar flexion and approximately at the junction of the anterior third and posterior twothirds of the line connecting the base of the second and third toes and the heel. Indications: Coma, headache, and vertigo, dry tongue, swollen pharynx, aphonia, dysuria, infantile convulsion, and epilepsy. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Note: This acupoint is often used for coma together with Shuigou (DU 26) and Zusanli (ST 36). Regional anatomy: Vasculature: The plantar arch of the anterior tibial artery. Innervation: The second common plantar digital nerve. Rangu (Ying-Spring Point, KI 2) Location: On the medial border of the foot and in the depression below the tuberosity of the navicular bone. Indications: Seminal emission, diabetes, jaundice, irregular menstruation, and pruritus vulvae, prolapse of uterus, and swollen instep. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of the medial plantar artery and medial tarsal arteries. Innervation: The terminal branch of the medial cutaneous nerve of leg and medial plantar nerve.

Taixi (Shu-Stream Point and Yuan-Primary Point, KI 3) Location: On the medial side of the foot, posterior to the medial malleolus and in the depression between the tip of the medial malleolus and Achilles tendon. Indications: Impotence, seminal emission, frequent micturition, diabetes, irregular menstruation, headache, vertigo, insomnia, deafness, asthma, sore throat, lumbago, toothache, and swollen ankle. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Note: As the Shu-Stream and Yuan-Primary points of the meridian, this acupoint can help replenish the kidney and strengthen the loins and knees. It is effective for lumbago, impotence, seminal emission, and irregular menstruation when used together with Shenshu (BL 23), Guanyuan (RN 4), and Sanyinjiao (ST 6). If used together with Shenmen (HT 7) and Sanyinjiao it can treat insomnia. Regional anatomy: Vasculature: The posterior tibial artery and vein. Innervation: The medial cutaneous nerve of leg and tibial nerve. Dazhong (Luo-Connecting Point, KI 4) Location: On the medial side of the foot, posterior and inferior to the medial malleolus and in the depression medial to the attachment of the Achilles tendon. Indications: Hemoptysis, asthma, dysuria, lumbago, dementia, irregular menstruation, and swollen ankle. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The medial calcaneal branch of posterior tibial artery. Innervation: The medial cutaneous nerve of leg, and the medial calcaneal ramus stemming from the tibial nerve. Shuiquan (Xi-Cleft Point, KI 5) Location: On the medial side of the foot, 1cun directly below Taixi (KI 3) and in the depression of the medial side of the tuberosity of the calcaneum. Indications: Dysuria, amenorrhea, dysmenorrhea, irregular menstruation, prolapse of uterus, and blurred vision. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Dazhong (KI 4). Zhaohai (one of the Eight Confluent Points, KI 6) Location: On the medial side of the foot and in the depression below the tip of the medial malleolus. Indications: Sore throat, insomnia, irregular menstruation, dysmenorrhea, leukorrhagia, frequent micturition, dysuria, red and swollen eyes, and epilepsy. Method: Insert the needle perpendicularly, 0.5-1cun deep. Note:

a) As one of the Eight Confluent Points communicating with the Yinqiao Meridian, it is often used to treat disorders of the lung, throat, chest and diaphragm together with Lieque (LU 7). b) The point is effective for constipation when used together with Zhigou (SJ 6), and effective for insomnia when combined with Shenmai (BL 62). Regional anatomy: Vasculature: The posterior tibial artery and vein. Innervation: The medial cutaneous nerve of leg and tibial nerve. Fuliu (Jjing-River Point, KI 7) Location: On the medial side of the leg, 2 cun directly above Taixi (KI 3) and anterior to the Achilles tendon. Indications: abdominal distention, diarrhea, edema, swollen foot, night sweat, and febrile diseases with anhidrosis or hyperhydrosis. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Note: It is often used together with Hegu (LI 4) to treat anhidrosis and hyperhydrosis. Regional anatomy: Vasculature: The posterior tibial artery and vein. Innervation: The medial cutaneous nerve of calf and medial cutaneous ramus of leg, and tibial nerve.

Jiaoxin (KI 8) Location: On the medial side of the leg, 2 cun above Taixi (KI 3), 0.5 cun anterior to Fuliu (KI 7) and posterior to the medial border of the tibia. Indications: Irregular menstruation, metrorrhagia, prolapse of uterus, diarrhea, hernia, and swollen testis. Method: Insert the needle perpendicularly, 0.5-l cun deep. Regional anatomy: Vasculature: The posterior tibial artery and vein. Innervation: The medial cutaneous nerve of leg and tibial nerve. Zhubin (KI 9) Location: On the medial side of the leg and 5 cun above Taixi (KI 3). Indications: Mania, epilepsy, hernia, and pain in the calf. Method: Insert the needle perpendicularly, 0.5-l cun deep. Regional anatomy: Vasculature: The posterior tibial artery and vein. Innervation: The medial cutaneous nerve of calf, medial cutaneous nerve of leg and tibial nerve.

Yingu (He-Sea Point, KI 10) Location: On the medial side of the popliteal fossa semimembranous muscles when the knee is flexed. Indications: Impotence, seminal emission, irregular menstruation, metrorrhagia, dysuria, and pain in the knee and popliteal fossa. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature: The medial superior genicular artery and vein. Innervation: The medial cutaneous nerve of thigh.

Henggu (KI 11 ) Location: On the lower abdomen, 5 cun below the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Distending pain in the lower abdomen, impotence, seminal emission, dysuria, enuresis, and hernia. Method: Insert the needle perpendicularly, 1-1.2 cun deep. Regional anatomy: Vasculature: The inferior epigastric artery and vein, and external pudendal artery. Innervation: The branch of iliohypogastric nerve. Dahe (KI 12) Location: On the lower abdomen, 4 cun below the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Seminal emission, impotence, irregular menstruation, leukorrhagia, and pain in the pudendal region, hysteroptosis, and diarrhea. Method: Insert the needle perpendicularly, l - l .2 cun deep. Regional anatomy: Vasculature: The muscular branches of the inferior epigastric artery and vein. Innervation: The intercostal nerve and iliohypogastric nerve. Qixue (KI 13) Location: On the lower abdomen, 3 cun below the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Amenorrhea, irregular menstruation, leukorrhagia, dysuria, diarrhea, and impotence.

Method: Insert the needle perpendicularly, 1- l .2 cun deep. Regional anatomy: Vasculature: The same as that of Dahe (KI 12). Innervation: The twelfth intercostal nerve. Siman (KI 14) Location: On the lower abdomen, 2 cun below the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal pain, diarrhea, edema, hernia, irregular menstruation, and seminal emission. Method: Insert the needle perpendicularly, l- l.2 cun deep. Regional anatomy: Vasculature: The same as that of Dahe (KI 12). Innervation: The eleventh intercostal nerve.

Zhongzhu (KI 15) Location: On the lower abdomen, 1 cun below the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal pain, diarrhea, constipation, and irregular menstruation. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature: The same as that of Dahe (KI 12). Innervation: The tenth intercostal nerve. Huangshu (KI 16) Location: On the middle abdomen and 0.5 cun lateral to the center of the umbilicus. Indications: Abdominal pain and distention, constipation, diarrhea, hernia, and irregular menstruation. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zhongzhu (KI 15). Shangqu (KI 17) Location: On the upper abdomen, 2 cun above the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal pain and distention, diarrhea, and constipation. Method: Insert the needle perpendicularly, l- l.2 cun deep. Regional anatomy: Vasculature: The superior and inferior epigastric arteries and veins. Innervation: The ninth intercostal nerve.

Shiguan (KI 18) Location: On the upper abdomen, 3 cun above the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal pain, constipation, vomiting, and sterility. Method: Insert the needle perpendicularly, l- l.2 cun deep. Regional anatomy: Vasculature: The branches of the superior epigastric artery and vein. Innervation: The eighth intercostal nerve.

Yindu (KI 19) Location: On the upper abdomen, 4 cun above the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal distention and pain, diarrhea, constipation, and sterility. Method: Insert the needle perpendicularly, l - l.2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Shiguan (KI 18). Futonggu (KI 20) Location: On the upper abdomen, 5 cun above the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal distention and pain, vomiting, and weak spleen and stomach. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Shiguan (KI 18). Youmen (KI 21) Location: On the upper abdomen, 6 cun above the center of the umbilicus and 0.5 cun lateral to the anterior midline. Indications: Abdominal pain, vomiting, diarrhea, dysentery, pain in the chest and hypochondriac region, and irritability. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The same as that of Shiguan (KI 18). Innervation: The seventh intercostal nerve.

Bulang (KI 22) Location: On the chest, in the fifth intercostal space and 2 cun lateral to the anterior midline. Indications: Chest pain, cough, asthma, and vomiting. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The fifth intercostal artery and vein. Innervation: The anterior cutaneous branch of the fifth intercostal nerve, and the fifth intercostal nerve. Shenfeng (KI 23) Location: On the chest, in the fourth intercostal space and 2 cun lateral to the anterior midline. Indications: Cough, chest pain, asthma, vomiting, and mastitis. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The fourth intercostal artery and vein. Innervation: The anterior cutaneous branch of the fourth intercostal nerve, and the fourth intercostal nerve. Lingxu (KI 24) Location: On the chest, in the third intercostal space and 2 cun lateral to the anterior midline. Indications: Cough, asthma, chest pain, and mastitis. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The third intercostal artery and vein. Innervation: The intercostal nerve, and the third intercostal nerve. Shencang (KI 25) Location: On the chest, in the second intercostal space and 2 cun lateral to the anterior midline. Indications: Cough, asthma, chest pain, and irritability. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The second intercostal artery and vein. Innervation: The anterior cutaneous branch of the second intercostal nerve, and the second intercostal nerve. Yuzhong (KI 26) Location: On the chest, in the first intercostal space and 2 cun lateral to the anterior midline. Indications: Cough, asthma, distending pain in the chest, and anorexia. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The first intercostal artery and vein. Innervation: The anterior cutaneous branch of the first intercostal nerve, the anterior branch of the supraclavicular nerve and the first intercostal nerve.

Shufu (KI 27) Location: On the chest, below the lower border of the clavicle and 2 cun lateral to the midline. Indications: Cough, asthma, chest pain, and anorexia. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The anterior perforating branches of the internal mammary artery and vein. Innervation: The anterior branch of the supraclavicular nerve.

Lecture 9.The Pericardium Meridian of Hand-Jueyin (PC) 1.Traveling route a) The meridian starts from the chest and connects with the pericardium. Then it passes through the diaphragm and connects with Sanjiao. b) The thoracic branch starts from the chest and hypochondriac region and exits at Tianchi (PC l), 3 cun below the axilla. Then it ascends to the axillary fossa, runs along the medial side of the upper arm and between the Hand-Taiyin and Hand-Shaoyin meridians, and enters the cubital fossa. Finally, it goes between the tendons of the long palmar muscle and radial flexor muscle, enters the palm and terminates at the tip of the middle finger (Zhongchong, PC 9). c) The palmar branch originates from the palm and runs to the tip of the ring finger. 2. Symptoms Cardialgia, palpitation, irritability, mania, epilepsy, fullness in the chest and hypochondriac region, swollen axilla, spasmodic pain in the elbow and arm, and feverish sensation in the palm. 3. Acupoints Tianchi (PC 1) Location: On the chest, in the fourth intercostal space and 1 cun lateral to the nipple. Indications: Irritability, swollen axilla, distending pain in the chest and hypochondriac region, cough, asthma and, scrofula. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The thoraco-epigastric vein and the branches of the lateral thoracic artery and vein. Innervation: The muscular branch of the anterior thoracic nerve and the fourth intercostal nerve. Tianquan (PC 2) Location: On the medial side of the arm, 2 cun below the anterior end of the axillary fold and between the long and short heads of the biceps muscle of the arm. Indications: Cardialgia, distension pain in the chest and hypochondriac region, pain in the elbow and arm, and cough. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The muscular branches of brachial artery and vein. Innervation: The medial cutaneous nerve of arm and musculocutaneous nerve.

Quze (He-Sea Point, PC 3) Location: At the midpoint of the cubital crease and on the ulnar side of the tendon of the biceps muscle of the arm. Indications: Palpitation, cardialgia, irritability, pain in the elbow and arm, febrile diseases, and vomiting. Method: Insert the needle perpendicularly, 0.8-l cun deep. Or prick the acupoint so that a little blood comes out. Regional anatomy:

Vasculature: The brachial artery and vein. Innervation: The median nerve. Ximen (Xi-Cleft Point, PC 4) Location: On the palmar side of the forearm and on the line connecting Quze (PC 3) and Daling (PC 7), and 5 cun above the crease of the wrist. Indications: Cardialgia, palpitation, irritability, epilepsy, and epistaxis. Method: Insert the needle perpendicularly, 0.51 cun deep. Note: a) As the Xi-Cleft point of the meridian, Ximen can be used to relieve acute pain. It can be needled together with Geshu (BL 17) and Neiguan (PC 6) to relieve pain in the heart and chest. b) Ximen is frequently used for acupuncture anesthesia in pulmonary operation. Regional anatomy: Vasculature: The median antebrachial artery and vein, and the palmar interosseous artery and vein of forearm. Innervation: The medial cutaneous nerve of forearm, median nerve and palmar interosseous nerve of forearm. Jianshi (Jing-River Point PC 5) Location: On the palmar side of the forearm, 3 cun above the crease of the wrist and between the tendons of the long palmar muscle and radial flexor muscle of the wrist. Indications: Palpitation, cardialgia, mania, epilepsy, and pain in the chest and hypochondriac region, stomachache, and malaria. Method: Insert the needle perpendicularly, 0.5-l cun deep. Regional anatomy: Vasculature: The same as that of Ximen (PC 4). Innervation: The medial and lateral cutaneous nerves of forearm, the palmar cutaneous branch of median nerve, and the palmar interosseous nerve of forearm. Neiguan (Luo-Connecting Point and one of the Eight Confluent Points, PC 6) Location: On the palmar side of the forearm, 2 cun above the crease of the wrist and between the tendons of the long palmar muscle and radial flexor muscle of the wrist. Indications: Cardialgia, palpitation, epilepsy, insomnia, and pain in the elbow and arm, as well as pain in the chest and hypochondriac region, stomachache, and vomiting. Method: Insert the needle perpendicularly, 0.5-l cun deep. Note: a) As one of the eight confluent points communicating with the yinwei Meridian, Gongsun (ST 4), it can treat stomachache, with Ximen (PC 4), Xinshu (BL 15) and Geshu (BL 17), it can treat cardialgia. b) Clinical reports show that Neiguan, Shuigou (DU 26) and Sanyinjiao (Sp 6) can be used to treat apoplexy. Regional anatomy: Vasculature and innervation: The same as those of Jianshi (PC 5).

Daling (Shu-Stream Point and Yuan-Primary Point, PC 7) Location: At the midpoint of the crease of the wrist and between the tendons of the long palmar muscle and radial flexor muscle of the wrist. Indications: Cardialgia, palpitation, mania, epilepsy, and pain the chest and hypochondriac region, and stomachache. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The palmar carpometacarpal arterial and venous network. Innervation: The medial nerve.

in

Laogong (Ying-Spring Point, PC 8) Location: At the center of the palm, between the second and third metacarpal bones but close to the latter, and where the tip of the middle finger touches when the hand is clenched. Indications: Cardialgia, apoplexy, coma, sunstroke, mania, epilepsy, stomatitis, and foul breath. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Note: Simple measurement: Clench the hand, the acupoint locates at the place where the tip of the middle finger touches. Regional anatomy: Vasculature: The common palmar digital artery. Innervation: The second common palmar digital nerve of median nerve. Zhongchong (Jing-Well Point, PC 9) Location: At the center of the middle fingertip. Indications: Coma, sunstroke, cardialgia, irritability, dysphasia, and sublingual pain and swelling. Method: Insert the needle 0.1 cun into the skin, or prick so that a little blood comes out. Regional anatomy: Vasculature: The arterial and venous network formed by the proprial palmar digital artery and vein. Innervation: The proprial palmar digital nerve of median nerve

Lecture 10. The Sanjiao (Triple Energizer) Meridian of Hand-Shaoyang (SJ) 1. Traveling route a) The meridian starts at the end of the ring finger on the ulnar side (point Guanchong, SJ l), goes along the ulnar side of the ring finger and reaches the wrist through the dorsum of the hand. Then it ascends along the lateral side of the forearm and between the ulna and radius. Passing through the posterior cubitus and the lateral side of the upper arm, it arrives at the shoulder. Traveling behind the Gallbladder Meridian, it then enters the supraclavicular fossa and spreads in the chest to connect with the pericardium. Finally, it crosses the diaphragm and pertains to Sanjiao. b) One branch starts from the chest and comes out of the supraclavicular fossa. Then it goes along the nape and reaches the back of the ear. Passing the upper corner of the ear and the cheek, it terminates at the infraorbital region. c) The other branch enters the ear from behind. Passing the front of the ear (Shangguan, GB 3), it meets the above branch on the cheek and terminates at lateral canthus (Sizhukong, SJ 23). 2. Symptoms Deafness, sweating, sore throat, and other disorders (e.g. pain) in the lateral canthus, cheek, retro-auricular region, shoulder, arm, elbow, and fingers. 3. Acupoints Guanchong (Jing-Well Point, SJ l) Location: On the ulnar side of the ring finger and about 0.1 cun lateral to the corner of the nail. Indications: Headache, red and swollen eyes, deafness, tinnitus, sore throat, irritability, and stiff tongue. Method: Insert the needle 0.1 cun into the skin. Or prick the acupoint so that a little blood comes out. Regional anatomy: Vasculature: The arterial and venous network formed by proper palmar digital artery and vein. Innervation: The proprial palmar digital nerve stemming from ulnar nerve. Yemen (Ying-Spring Point, SJ 2) Location: On the dorsum of the hand, between the ring and little fingers and 0.5 cun proximal to the margin of the web. Indications: Headache, red and swollen eyes, tinnitus, deafness, sore throat, malaria, and pain in the finger joints. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal digital artery of ulnar artery. Innervation: The dorsal branch of ulnar nerve.

Zhongzhu (Shu-Stream Point, SJ 3) Location: On the dorsum of the hand, proximal to the fourth metacarpophalangeal joint and in the depression between the fourth and fifth metacarpal bones. Indications: Headache, red and swollen eyes, tinnitus, deafness, sore throat, malaria, and pain in the arm, wrist and finger joints. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The dorsal venous network of hand and the fourth dorsal metacarpal artery. Innervation: The dorsal branch of ulnar nerve. Yangchi (Yuan-Primary Point, SJ 4) Location: At the midpoint of the dorsal crease of the wrist and in depression on the ulnar side of the tendon of the common extensor muscle of the fingers. Indications: Deafness, malaria, sore throat, and pain in the arm wrist. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal venous network of wrist and dorsal carpal artery. Innervation: The dorsal branch of ulnar nerve and the terminal branch of the dorsal cutaneous nerve of forearm. the and

Waiguan (Luo-Connecting Point and one of the Eight Confluent Points, SJ 5) Location: On the dorsal side of the forearm, 2 cun proximal to the dorsal crease of the wrist and between the radius and ulna. Indications: Headache, red and swollen eyes, tinnitus, deafness, and pain in the hypochondriac region, pain in the shoulder and back, febrile diseases, and scrofula. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Notes: As one of the eight confluent points communicating with the Yangwei Meridian, Waiguan can help disperse wind-heat. If used together with Hegu (LI 4) and Dazhui (DU 14), it can treat fever with swollen eyes caused by exogenous affection. Regional anatomy: Vasculature: The dorsal and palmar interosseous arteries and veins of forearm. Innervation: The dorsal cutaneous nerve of forearm, dorsal interosseous nerve of forearm of the radial nerve and volar interosseous nerve of median nerve. Zhigou (Jing-River Point, SJ 6) Location: On the dorsal side of the forearm, 3 cun proximal to the dorsal crease of the wrist and between the radius and ulna.

Indications: Tinnitus, deafness, sudden loss of voice, pain in the hypochondriac region, pain in the shoulder and back, febrile diseases, and constipation. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Notes: Zhigou can be needled with reducing method to treat hyperactive ministerial fire in Sanjiao, constipation and pain in the hypochondriac region. Needled together with Yanglingquan (GB 34), it can treat pain in the hypochondriac region; combined with Zhaohai (KI 6) or Tianshu (ST 25) and Daheng (ST 15), it can treat constipation. Regional anatomy: Vasculature and innervation: The same as those of Waiguan (SJ 5). Huizong (Xi-Cleft Point, SJ 7) Location: On the dorsal side of the forearm, 3 cun proximal to the dorsal crease of the wrist, and on the ulnar side of Zhigou (SJ 6) and on the radial side of the ulna. Indications: Deafness, tinnitus, and pain in the arm and epilepsy. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The dorsal interosseous artery and vein of the forearm. Innervation: The dorsal cutaneous nerve and dorsal interosseous nerve of the forearm and volar interosseous nerve. Sanyangluo (SJ 8) Location: On the dorsal side of the forearm, 4 cun proximal to the dorsal crease of the wrist and between the radius and ulna. Indications: Sudden deafness, toothache, sudden loss of voice, and pain in the arm. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Huizong (SJ 7). Sidu (SJ 9) Location: On the dorsal side of the forearm, 5 cun distal to the tip of the olecranon and between the radius and ulna. Indications: Tinnitus, deafness, sore throat, sudden loss of voice, and pain in the arm. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Huizong (SJ 7).

Tianjing (He-Sea Point, SJ 10) Location: On the lateral side of the upper arm and in the depression 1 cun proximal to the tip of the olecranon. Indications: Tinnitus, deafness, migraine, and pain in the hypochondriac region, nape, shoulder and arm. Method: Insert the needle perpendicularly, 0.5-l cun deep. Regional anatomy: Vasculature: The arterial and venous network of elbow. Innervation: The dorsal cutaneous nerve of the arm and the muscular branch of the radial nerve.

Qinglengyuan (SJ 11) Location: On the lateral side of the upper arm, 2 cun above the tip of the olecranon and 1 cun above Tianjing (SJ 10). Indications: Headache, yellowish eyeballs, and pain and motor impairment of the shoulder and arm. Method: Insert the needle perpendicularly, 0.5- l cun deep. Regional anatomy. Vasculature: The terminal branches of the median accessory artery and vein. Innervation: The dorsal cutaneous nerve of arm and the muscular branch of radial nerve. Xiaoluo (SJ 12) Location: On the lateral side of the upper arm and at the midpoint of the line connecting Qinglengyuan (SJ 11) and Naohui (SJ 1 3). Indications: Headache, rigid nape, toothache, and pain in the shoulder, back and arm. Method: Insert the needle perpendicularly, 1- l .2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Qinglengyuan (SJ 11). Naohui (SJ 13) Location: On the lateral side of the upper arm and on the line connecting the tip of the olecranon and Jianliao (SJ 14), and on the postero-inferior border of the deltoid muscle. Indications: Pain in the shoulder and arm, goiter, and scrofula. Method: Insert the needle perpendicularly, 0.5- 1.2 cun deep. Regional anatomy: Vasculature: The same as those of Qinglengyuan (SJ 11). Innervation: The dorsal cutaneous nerve of the arm and the muscular branch of radial nerve and radial nerve.

Jianliao (SJ 14) Location: On the shoulder, posterior to Jianyu (LI 15) and in the depression inferior and posterior to the acromion when the arm is abducted. Indications: Pain and motor impairment of the shoulder and arm. Method: Insert the needle into the shoulder joints perpendicularly, l - l.5 cun deep. Regional anatomy: Vasculature: The muscular branch of the posterior humeral circumflex artery. Innervation: The muscular branch of axillary nerve. Tianliao (SJ 15) Location: On the scapula, at the midpoint between fianjing (GBL 21) and Quyuan (SI 13) and at the superior angle of the scapula. Indications: Pain in the shoulder and arm and stiffness and pain in the nape and back. Method: Insert the needle perpendicularly, 0.5- 0.8 cun deep. Regional anatomy: Vasculature: The descending branch of the transverse cervical artery, and the muscular branch of suprascapular artery. Innervation: The accessory nerve and the branch of suprascapular nerve. Tianyou (SJ 16) Location: On the lateral side of the neck, directly below the posterior border of the mastoid process, on the level of the mandibular angle and on the posterior border of the sternocleidomastoid muscle. Indications: Headache, stiff nape, sudden loss of voice, and vertigo. Method: Insert the needle perpendicularly, 0.5- l cun deep. Regional anatomy: Vasculature: The posterior auricular artery. Innervation: The lesser occipital nerve.

Yifeng (SJ 17) Location: Posterior to the ear lobe and in the depression between the mastoid process and mandibular angle. Indications: Tinnitus, deafness, facial paralysis and swollen cheeks. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy:

Vasculature: The posterior auricular artery and vein. Innervation: The great auricular nerve and facial nerve perforating from stylomastoid foramen. Chimai (SJ 18) Location: On the head, at the center of the mastoid process and at the junction of the middle third and lower third of the line connecting Yifeng (SJ 17) and Jiaosun (SJ 20) along the curve of the ear helix. Indications: Headache, tinnitus, deafness, and epilepsy induced by fright. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The posterior auricular artery and vein. Innervation: The posterior auricular branch of great auricular nerve.

Luxi (SJ 19) Location: On the head and at the junction of the upper third and middle third of the line connecting Yifeng (SJ 17) and Jiaosun (SJ 20) along the curve of the ear helix. Indications: Headache, tinnitus, earache, and infantile convulsion. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The posterior auricular artery and vein. Innervation: The anastomotic branch of great auricular nerve and lesser occipital nerve Jiaosun (SJ 20) Location: On the head and directly above the ear apex Just within the hairline. Indications: Tinnitus, deafness, red and swollen eyes, corneal nebula, swollen gum, and rigid nape. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of superficial temporal artery and vein. Innervation: The branches of auriculotemporal nerve.

Ermen (SJ 21) Location: On the face, anterior to the supratragic notch and in the depression behind the posterior border of the condyloid process of the mandible. Indications: Deafness, tinnitus, earache, and toothache. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The superficial temporal artery and vein. Innervation: The branches of auriculotemporal nerve and facial nerve.

Erheliao (SJ 22) Location: On the posterior margin of the temples, anterior to the root of the ear auricle at hairline and posterior to the superficial temporal artery. Indications: Headache, tinnitus, lockjaw, and paralysis. Method: Insert the needle obliquely, 0.3-0.5 cun Regional anatomy: Vasculature: The superficial temporal artery and Innervation: The branch of auriculotemporal and the temporal branch of facial nerve. Sizhukong (SJ 23) Location: On the face and in the depression at lateral end of the eyebrow. Indications: Headache, red and swollen eyes, vertigo, and twitching eyelids. Method: Insert the needle horizontally, 0.5-1 cun Regional anatomy: Vasculature: The frontal branches of superficial temporal artery and vein. Innervation: The zygomatic branch of facial nerve and the branch auriculotemporal nerve.

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Lecture 11. The Gallbladder Meridian of Foot-Shaoyang (GB) 1. Traveling route a) The meridian starts at the outer canthus (Tongziliao, GB l), ascends to the corner of the forehead (2) and reaches the retro-auricular region. Then it runs along the neck in front of the Sanjiao meridian. After arriving at the shoulder, it runs behind the Sanjiao meridian and enters the supraclavicular fossa. b) The auricle portion arises from the retro-auricular region, enters the ear, comes out in front of the ear and arrives at the posterior side of the outer canthus. c) The canthus branch starts at the outer canthus and runs downward to the area near Daying (ST 5). After meeting the Hand-Shaoyang meridian, it goes upward to the infraorbital region. Passing Jiache (ST 6) in its downward movement, it reaches the neck and meets the auricle branch in the supraclavicular fossa. Then it further descends into the chest, crosses the diaphragm, and connects with the liver and gallbladder. Running through the hypochondriac region, it comes out from both sides of the lower abdomen (Qichong, ST 30) and runs along the margin of the pubic hair. Finally, it reaches Huantiao (GB 30). d) The straight branch starts at the supraclavicular fossa, passes the axilla, the lateral side of the chest and the hypochondriac region, and meets the canthus branch at Huantiao (GB 30). Then it travels along the lateral side of the thigh and the knee, passes the anterior side of the fibula and runs directly downward to the lower end of the fibula and above the external malleolus. Finally, it goes along the anterior border of the external malleolus and the dorsum of the foot and enters the lateral side of the tip of the fourth toe. e) The dorsal branch starts from between the first and second metatarsal bones, enters the tip of the great too, turns back and penetrates the nail, and terminates in the hairy region proximal to the nail. 2. Symptoms Bitter taste in mouth, headache, malaria, dizziness, scrofula, swelling in the axillary region, and pain or other disorders in the outer canthus, mandible, supraclavicular fossa, chest, hypochondriac region, thigh and knee. 3. Acupoints Tongziliao (GB l) Location: On the face, 0.5 cun lateral to the outer canthus and on the lateral border of the orbit. Indications: Headache, red and swollen eyes, corneal nebula, and optic atrophy. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: Zygomaticoorbital artery and vein. Innervation: Zygomaticofacial and zygomaticotemporal nerve and the temporal branch of the facial nerve.

Tinghui (GB 2) Location: On the face, anterior to the intertragic notch and in the depression posterior to the condyloid process of the mandible when the mouth is open. Indications: Tinnitus, deafness, facial paralysis, headache, and pain in the face. Method: With the patient's mouth open, insert the needle perpendicularly, 0.51 cun deep.

Regional anatomy: Vasculature: Superficial temporal artery. Innervation: Great auricular nerve and facial nerve. Shangguan (GB 3) Location: Anterior to the ear, directly above Xiaguan (ST 7) and in the depression above the upper border of the zygomatic arch. Indications: Headache, tinnitus, deafness, toothache, facial paralysis, pain in the face, and epilepsy induced by terror. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The zygomaticoorbital artery and vein. Innervation: The zygomatic branch of facial nerve.

Hanyan (GB 4) Location: On head, in the hair above the temple and at the junction of the upper fourth and lower three-fourths of the curved line connecting Touwei (ST 8) and Qubin (GB 7). Indications: Migraine, vertigo, and toothache. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature The parietal branches of superficial temporal artery and vein. Innervation: The temporal branch of auriculotemporal nerve.

Xuanlu (GB 5) Location: On the head, in the hair above the temple and at the midpoint of the curved line connecting Touwei (ST 8) and Qubin (GB 7). Indications: Migraine, pain in the outer canthus, and tinnitus. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Hanyan (GB 4). Xuanli (GB 6) Location: On the heed, in the hair above the temple and at the junction of the upper three-fourths and lower fourth of the curved line connecting Touwei (ST 8) and Qubin (GB 7). Indications: Migraine, pain in the outer canthus, tinnitus, and toothache. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Hanyan (GB 4). Qubin (GB 7) Location: On the heed, and at the crossing point of the vertical posterior hairline of the temple and horizontal line through the ear apex. Indications: Headache, red and swollen eyes, swelling and pain in the cheek and

jaw, trismus, and sudden loss of voice. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Hanyan (GB 4). Shuaigu (GB 8) Location: On the head, directly above the ear apex and 1 .5 cun above the hairline. Indications: Migraine, vertigo, vomiting, and infantile convulsion. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The parietal branches of superficial temporal artery and vein. Innervation: The anastomotic branch of auriculotemporal nerve and great occipital nerve.

Tianchong (GB 9) Location: On the head, directly above the posterior border of the ear root and 2 cun above the hairline. Indications: Headache, tinnitus, deafness, convulsion, palpitation and epilepsy. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The posterior auricular artery and vein. Innervation: The branch of great occipital nerve. Fubai (GB 10) Location: On the head, posterior and superior to the mastoid process and at the junction of the middle third and upper third of the curved line connecting Tianchong (GB 9) and Wangu (GB 12). Indications: Headache, tinnitus, deafness, rigid nape, scrofula, and goiter Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Tianchong (GB 9). Touqiaoyin (GB 11) Location: On the head, posterior and superior to the mastoid process and at the junction of the middle third and lower third of the curved line connecting Tianchong (GB 9) and Wangu (GB 12). Indications: Headache, vertigo, tinnitus, and deafness. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of posterior auricular artery and vein. Innervation: The anastomotic branch of great and lesser occipital nerves. Wangu (GB 12) Location: On the head and in the depression posterior and inferior to the mastoid process. Indications: Headache, rigid nape, and deafness, facial paralysis, and swollen cheeks. Method: Insert the needle obliquely, 0.5-0.8 cun deep.

Regional anatomy: Vasculature: The posterior auricular artery and vein. Innervation: The lesser occipital nerve. Benshen (GB 13) Location: On the head, 3 cun lateral to Shenting (DU 24), 0.5 cun above the anterior hairline and 3 cun lateral to the anterior midline. Indications: Headache, dizziness, epilepsy, and infantile convulsion. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The frontal branches of the superficial temporal artery and vein, and the lateral branches of the frontal artery and vein. Innervation: The lateral branch of the frontal nerve. Yangbai (GB 14) Location: On the forehead, directly above the pupil and 1 cun above the eyebrow. Indications: Headache, dizziness, and pain in the orbital ridge, facial paralysis, and twitching eyelids. Method: Insert the needle horizontally downward, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The lateral branches of frontal artery and vein. Innervation: The lateral branch of frontal nerve.

Toulinqi (GB 15) Location: On the head, directly above the pupil and 0.5 cun above the anterior hairline. Indications: Headache, dizziness, red and swollen eyes, nasal obstruction, and infantile convulsion. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The frontal artery and vein. Innervation: The anastomotic branch of the medial and lateral branches of frontal nerve. Muchuang (GB 16) Location: On the head, 1.5 cun above the anterior hairline and on the line connecting Toulinqi (GB l 5) and Fengchi (GB 20). Indications: Headache, dizziness, and optic atrophy, red and swollen eyes, and

swollen head and face. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The frontal branches of superficial temporal artery and vein. Innervation: The anastomotic branch of the medial and lateral branches of frontal nerve. Zhengying (GB 17) Location: On the head, 2.5 cun above the anterior hairline and on the line connecting Toulinqi (GB l 5) and Fengchi (GB 20). Indications: Headache, vertigo, and toothache. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: the anastomotic plexus formed by the parietal branches of superficial temporal artery and vein, and occipital artery and vein. Innervation: The anastomotic branch of the frontal and great occipital nerves. Chengling (GB 1 8) Location: On the head, 4 cun above the anterior hairline and on the line connecting Toulinqi (GB 15) and Fengchi (GB 20). Indications: Headache, vertigo, nasal obstruction, and ophthalmalgia. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of occipital artery and vein. Innervation: The branch of great occipital nerve. Naokong (GB 19) Location: On the head, directly above Fengchi (GB 20) and at the level of the upper border of the external occipital protuberance. Indications: Headache, rigid nape, and vertigo, red and swollen eyes, and epilepsy. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Chengling (GB 18).

Fengchi (GB 20) Location: On the nape, below the occipital bone, at the level of Fengfu (DU 16) and in the depression between the upper ends of the stemocleidomastoid and trapezius muscles. Indications: Headache, vertigo, red and swollen eyes, rigidity and pain in the nape and back, apoplexy, facial paralysis, febrile diseases, common cold,

malaria, and goiter. Method: Insert the needle obliquely towards the medial orbit of the opposite eye or the tip of the nose, 0.8-l cun deep. Regional anatomy: Vasculature: The branches of occipital artery and vein. Innervation: The branch of lesser occipital nerve Jianjing (GB 21) Location: On the shoulder, at the midpoint of the line connecting Dazhui (DU 14) and the acromion. Indications: Rigidity and pain in the nape and back, pain and motor impairment of the shoulder and arm, mastitis, lack of lactation, and scrofula. Method: Insert the needle perpendicularly, 0.50.8 cun deep. Do not insert the needle too deep. Acupuncture is contraindicated for pregnant women. Regional anatomy: Vasculature: The transverse cervical artery and vein. Innervation: The lateral branch of supraclavicular nerve, and accessory nerve. Yuanye (GB 22) Location: On the lateral side of the chest, on the mid-axillary line when the arm is raised, 3 cun below the axilla and in the fourth intercostal space. Indications: Fullness and pain in the chest and hypochondriac regions, swollen axillary region, and pain and motor impairment of the upper limbs. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The thoraco-epigastric vein, lateral thoracic artery and vein, and the fourth intercostal artery and vein. Innervation: The lateral cutaneous branch of the fourth intercostal nerve and the branch of long thoracic nerve.

Zhejin (GB 23) Location: On the lateral side of the chest, 1cun anterior to Yuanye (GB 22), at the level of the nipple and in the fourth intercostal space. Indications: Pain in the chest and hypochondriac region, asthma, swollen axillary region, and pain in the shoulder and arm. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The lateral thoracic artery and vein. Innervation: The lateral cutaneous branch of fourth intercostal space.

Riyue (Front-Mu Point of the Gallbladder, GB 24) Location: On the upper abdomen, directly below the nipple, in the seventh intercostal space and 4 cun lateral to the anterior midline. Indications: Jaundice, vomiting, abdominal distention, and pain in the chest and hypochondriac region. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The seventh intercostal artery and vein. Innervation: The seventh intercostal nerve. Jingmen (Front-Mu Point of the Kidney, GB 25) Location: On the lateral side of the waist and just below the free end of the twelfth rib. Indications: Abdominal distention, borborygmus, diarrhea, pain in the lumbar and hypochondriac regions, and dysuria. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The eleventh intercostal artery and vein. Innervation: The eleventh intercostal nerve. Daimai (GB 26) Location: On the lateral side of the abdomen, at the crossing point of a vertical line through the free end of the eleventh rib and a horizontal line through the umbilicus. Indications: Irregular menstruation, amenorrhea, leukorrhagia, and pain in the lumbar and hypochondriac regions. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy:

Vasculature: The intercostal artery and vein. Innervation: The intercostal nerve. Wushu (GB 27) Location: On the lateral side of the abdomen, anterior to the anterosuperior iliac spine and 3 cun below the level of the umbilicus. Indications: Metroptosis, leukorrhagia, hemia, and pain in the lower abdomen. Method: Insert the needle perpendicularly, 0.5-l cun deep. Regional anatomy: Vasculature: The superficial and deep circumflex iliac arteries and veins. Innervation: The Iliohypogastric nerve.

Weidao (GB 28) Location: On the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine and 0.5 cun anterior and inferior to Wushu (GB 27). Method: Insert the needle perpendicularly or obliquely to the anteroinferior side, l - l.5 cun deep. Regional anatomy: Vasculature: The same as that of Wushu (GB 27). Innervation: The Ilioinguinal nerve. Juliao (GB 29) Location: On the hip, and at the midpoint of the line connecting the anterosuperior iliac spine and the prominence of the great trochanter Indications: Hernia, pain in the lumbar region and lower limbs, and weakness of the lower limbs. Method: Insert the needle perpendicularly, 1- l.5 cun deep. Regional anatomy: Vasculature: The branches of superficial circumflex iliac artery and vein; the ascending branches of lateral circumflex femoral artery and vein. Innervation: The lateral femoral cutaneous nerve.

Huantiao (GB 30) Location: At the junction of the middle third and lateral third of the line connecting the prominence of the great trochanter and the sacral hiatus when the patient is in a lateral recumbent position with the thigh flexed. Indications: Flaccidity, weakness and motor impairment of the lower limbs. Method: Insert the needle perpendicularly, 23 cun deep. Regional anatomy: Vasculature: The inferior gluteal artery and vein. Innervation: The inferior gluteal cutaneous nerve, inferior gluteal nerve and sciatic nerve. Fengshi (GB 31 ) Location: On the lateral midline of the thigh, 7 cun above the popliteal crease, or at the place touching the tip of the middle finger, when the patient stands erect with the arms hanging down freely. Indications: Flaccidity, weakness and motor impairment of the lower limbs, general pruritus, and beriberi. Method: Insert the needle perpendicularly, l -2 cun deep. Regional anatomy: Vasculature: The muscular branches of lateral circumflex femoral artery and vein. Innervation: The lateral femoral cutaneous nerve, and the muscular branch of femoral nerve.

Zhongdu (GB 32) Location: On the lateral side of the thigh and 2 cun below Fengshi (GB 3 l). Indications: Flaccidity, weakness and motor impairment of the lower limbs. Method: Insert the needle perpendicularly, l- l .5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Fengshi (GB 3 l).

Xiyangguan (GB 33) Location: on the lateral side of thigh and 2 cun below Fengshi (GB 31). Indications: Pain in the knee, spasmodic pain in the popliteal fossa, and pain and numbness in the lower limbs. Method: Insert the needle perpendicularly, 0.8-1 cun deep. Regional anatomy: Vasculature: The lateral superior genicular artery and vein. Innervation: The terminal branch of lateral femoral cutaneous nerve.

Yanglingquan (He-Sea Point, Lower He-Sea Point of the Gallbladder, and Influential Point of Tendons GB 34) Location: On the lateral side of the leg and in the depression anteroinferior to the capitulum of the fibula. Indications: Jaundice, bitter taste, vomiting, pain in the chest, hypochondriac region and knee, and weakness and flaccidity of the lower limbs. Method: Insert the needle perpendicularly, l~ l.5 cun deep. Regional anatomy: Vasculature: The inferior lateral genicular artery and vein. Innervation: The common peroneal nerve bifurcating into superficial and deep peroneal nerves. Yangjiao (GB 35) Location: On the lateral side of the leg, 7 cun above the tip of the external malleolus and 1 cun posterior to Waiqiu (GB 36). Indications: Distending pain in the chest and hypochondriac region, and weakness and flaccidity of the lower limbs, depression, and sore throat. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of peroneal artery and vein. Innervation: The lateral cutaneous nerve of calf.

Waiqiu (Xi-Cleft Point, GB 36) Location: On the lateral side of the leg, 7 cun above the tip of the external malleolus and on the anterior border of the fibula. Indications: Distending pain in the chest and hypochondriac region, weakness and flaccidity of the lower limbs, and depression. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The muscular branches of anterior tibial artery and vein. Innervation: The superficial peroneal nerve.

Guangming (Luo-Connecting Point, GB 37) Location: On the lateral side of the leg, 5 cun above the tip of the external malleolus and on the anterior border of the fibula. Indications: Ophthalmalgia, blurred vision, night blindness, distension pain in the breast, and weakness and flaccidity of the lower limbs. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Waiqiu (GB 36). Yangfu (Jing-River Point, GB 38) Location: On the lateral side of the leg, 4 cun above the tip of the external malleolus and slightly anterior to the anterior border of the fibula. Indications: Pain in the chest and hypochondriac region, swollen axillary region, pain in the outer canthus, and weakness and flaccidity of the lower limbs. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Waiqiu (GB 36). Xuanzhong (Influential Point of Marrow, GB 39) Location: On the lateral side of the leg, 3 cun above the tip of the external malleolus and on the posterior border of the fibula. Indications: Distension pain in the chest, abdomen and hypochondriac region, weakness and motor impairment of the lower limbs, and hemorrhoid bleeding. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Waiqiu (GB 36).

Qiuxu (Yuan-Primary Point, GB 40) Location: Anteroinferior to the external malleolus and in the depression lateral to the tendon of the long extensor muscle of the toes. Indications: Red and swollen eyes, malaria, distension pain in the chest and hypochondriac region, swollen axillary region, and pain and swelling in the malleolus and foot. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of anterolateral malleolar artery and vein. Innervation: The branches of intermediate dorsal cutaneous nerve and superficial peroneal nerve. Zulinqi (Shu-Stream Point and one of the Eight Confluent Points, GB 41) Location: On the lateral side of the instep of the foot, and in the depression lateral to the junction of the fourth and fifth metatarsal bones. Indications: Migraine, malaria, dizziness, and pain in the outer canthus, scrofula, and swollen instep. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal arterial and venous network of foot and the fourth dorsal metatarsal artery and vein. Innervation: The branch of intermediate dorsal cutaneous nerve of foot. Diwuhui (GB 42) Location: On the lateral side of the instep, between the fourth and fifth metatarsal bones and on the medial side of the tendon of the extensor muscle of the little toe. Indications: Headache, tinnitus, deafness, swollen breast, fullness and pain in the chest and hypochondriac region, and swollen instep. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zulinqi (GB 41). Xiaxi (Ying-Spring Point, GB 43) Location: On the lateral side of the instep, between the fourth and fifth toes and proximal to the margin of the web. Indications: Headache, vertigo, tinnitus, deafness, and pain in the outer canthus, distending pain in the chest and hypochondriac region, and swollen instep. Method: Insert the needle perpendicularly, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The dorsal digital artery and vein. Innervation: The dorsal digital nerve. Zuqiaoyin (Jing-Well Point, GB 44) Location: On the lateral side of the fourth toe and about 0.1 cun lateral to the corner of the toe nail. Indications: Headache, dizziness, red and swollen eyes, tinnitus, deafness, distending pain in the chest and hypochondriac region, and irritability Method: Insert the needle 0.1 cun into the skin. Regional anatomy:

Vasculature: The arterial and venous network formed by dorsal digital artery and vein and plantar digital artery and vein. Innervation: The dorsal digital nerve.

Lecture 12 The Liver Meridian of Foot-Jueyin (LR) l. Traveling route a) The meridian starts at the hairy region posterior to the nail of the great toe (Dadun, LR l), goes upward along the dorsum of foot and passes through the area 1 cun in front of the medial malleolus. It ascends along the medial side of the leg and in front of the Spleen meridian of Foot-Taiyin. Then it emerges from behind the Foot-Taiyin Meridian at the level 8 cun above the medial malleolus. Passing the medial side of the knee and the thigh, it enters the pubes and curves around the external genitals before arriving at the lower abdomen. Continuing to run along the stomach on both sides, it pertains to the liver and connects with the gallbladder. Further on it passes through the diaphragm and spreads in the chest and hypochondriac region. Finally it ascends along the posterior side of the throat, enters the nasopharynx, connects with the eye system, emerges from forehead, and meets the Du Meridian at the vertex. b) One branch arises from the eye system, descends to the cheek, and curves around the lips. c) Another branch arises from the liver, goes through the diaphragm, and enters the lung. 2. Symptoms Diarrhea, vomiting, hernia, and enuresis, dysuria, fullness in the chest, swollen lower abdomen, and lumbago. 3. Acupoints Dadun (Jing-Well Point, LR 1) Location: On the lateral side of the great too and 0.1 cun lateral to the corner of the toe nail. Indications: Hernia, enuresis, dysuria, irregular menstruation, metrorrhagia, mania, and swollen vulva. Method: Insert the needle 0.1 cun into the skin. Regional anatomy: Vasculature: The dorsal digital artery and vein. Innervation: The dorsal digital nerve stemming from the deep peroneal nerve. Xingjian (Ying-Spring Point, LR 2) Location: On the instep and at the end of the web between the first and second toes. Indications: Headache, vertigo, red and swollen eyes, optic atrophy, hernia, dysuria, irregular menstruation, and epilepsy. Method: Insert the needle obliquely upward, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot, and the first dorsal digital artery and vein. Innervation: The dorsal digital nerve stemming from the deep peroneal nerve. Taichong (Shu-Stream Point and Yuan-Primary Point, LR 3) Location: On the dorsum of foot and in the depression distal to the junction of the first and second metatarsal bones. Indications: Headache, vertigo, hernia, irregular menstruation, jaundice, red and swollen eyes, optic atrophy, epilepsy, facial paralysis, pain in the chest and hypochondriac region, and weakness and flaccidity of the lower limbs. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot and the first dorsal metatarsal artery. Innervation: The branch of the deep peroneal nerve.

Zhongfeng (Jing-River Point, LR 4) Location: On the instep, 1 cun anterior to the medial malleolus, in the depression on the medial side of the tendon of the anterior tibial muscle, and on the line connecting Shangqiu (SP 5) and Jiexi(ST 41) Indications: Seminal emission, dysuria, hernia, jaundice, swollen lower abdomen, and pain in the chest and hypochondriac region. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The dorsal venous network of foot and anterior medial malleolar artery. Innervation: The branch of medial dorsal cutaneous nerve of foot, and saphenous nerve.

Ligou (Luo-Connecting Point, LR 5) Location: On the medial side of the leg, 5 cun above the tip of the medial malleolus and on the medial border of the tibia. Indications: Irregular menstruation, leukorrhagia, hernia, dysuria, and tibial pain. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The great saphenous vein. Innervation: The branch of saphenous nerve. Zhongdu (Xi-Cleft Point, LR 6) Location: On the medial side of the leg, 7 cun above the tip of the medial malleolus and on the medial border of the tibia. Indications: Diarrhea, abdominal distention, hernia, and pain in the hypochondriac region, and metrorrhagia. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The great saphenous vein. Innervation: The branch of saphenous nerve.

Xiguan (LR 7) Location: Posteroinferior to the medial condyle of the tibia and 1 cun posterior to Yinlingquan (SP 9). Indications: Sore throat, weakness and flaccidity in the lower limbs, and swollen knee. Method: Insert the needle perpendicularly, 0.8-1 cun deep. Regional anatomy: Vasculature: The posterior tibial artery. Innervation: The branch of medial sural cutaneous nerve and the tibial nerve.

Ququan (He-Sea Point, LR 8) Location: On the medial side of the knee, at the medial end of the popliteal crease when the knee is flexed, posterior to the medial epicondyle of the tibia and in the depression of the anterior border of the insertions of the semimembranous and semitendinous muscles. Indications: Dysuria, pain in the lower abdomen, headache, vertigo, irregular menstruation, prolapse of uterus, and pain in the knee. Method: Insert the needle perpendicularly, 0.8-1 cun deep. Regional anatomy: Vasculature: The great saphenous vein and supreme genicular artery. Innervation: The saphenous nerve. Yinbao (LR 9) Location: On the medial side of the thigh, 4 cun above the medial epicondyle of the femur and between the medial vastus and sartorius muscles. Indications: Dysuria, enuresis, irregular menstruation, and pain in the lumbosacral region. Method: Insert the needle perpendicularly, 0.8- l.5 cun deep. Regional anatomy: Vasculature: The femoral artery and vein, and the superficial branch of medial circumflex femoral artery. Innervation: The anterior femoral cutaneous nerve on the pathway of the anterior branch of obturator nerve.

Zuwuli (LR 10) Location: On the medial side of the thigh, 2 cun lateral to and 3 cun directly below Qugu (RN 2). Indications: Dysuria, metroptosis, and distention and fullness in the lower abdomen. Method: Insert the needle perpendicularly, 0.8- l.5 cun deep. Regional anatomy: Vasculature: The superficial branches of medial circumflex femoral artery and vein. Innervation: The genitofemoral nerve, anterior femoral cutaneous nerve and the anterior branch of obturator nerve. Yinlian(LR 11 ) Location: On the medial side of the thigh, and 2 cun lateral to and 2 cun directly below Qugu (RN 2). Indications: Irregular menstruation, leukorrhagia, and pain in the lower abdomen and medial side of the thigh. Method: Insert the needle perpendicularly, 0.8- l.5 cun deep. Regional anatomy: Vasculature: The branches of medial circumflex femoral artery and vein. Innervation: The genitofemoral nerve, the branch of medial femoral cutaneous nerve and the anterior branch of obturator nerve. Jimai (LR 12) Location: Lateral to the pubic tubercle, lateral and inferior to Qichong (ST 30) and 2.5 cun lateral to the anterior midline. Indications: Hernia, metroptosis, and pain in the penis and lower abdomen. Method: Insert the needle perpendicularly, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of external pudendal artery and vein, the pubic branches of inferior epigastric artery and vein and femoral vein. Innervation: The ilioinguinal nerve and the anterior branch of obturator nerve. Zhangmen(Front-Mu Point of the Spleen and Influent Point of Zang organs, LR 13) Location: Below the free end of the eleventh rib. Indications: Abdominal distention, diarrhea, jaundice, vomiting, abdominal mass, and pain in the chest and hypochondriac region. Method: Insert the needle obliquely, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The terminal branch of the tenth intercostal artery. Innervation: The tenth and eleventh intercostal nerves.

Qimen (Front-Mu Point of the Liver, LR 14) Location: On the chest, directly below the nipple and in the sixth intercostal space, 4 cun lateral to the anterior midline. Indications: Abdominal distention, diarrhea, and vomiting, abdominal mass, and distending pain in the chest and hypochondriac region. Method: Insert the needle obliquely or horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The sixth intercostal artery and vein. Innervation: The sixth intercostal nerve.

Lecture 13 The Ren Meridian (Conception Vessel) (RN,CV) l. Traveling route The meridian starts at the lower abdomen and emerges from the perineum (Huiyin, RN l). Passing the pubes, it ascends along the midline of the abdomen and chest. Then it reaches the throat and curves around the lips. After running through the face, it enters the infraorbital region. 2. Symptoms Hernia, leukorrhagia, and masses and lumps in the abdomen . 3. Acupoints Huiyin (RN 1) Location: On the perineum, at the midpoint between the posterior border of the scrotum and anus in male. Indications: Dysuria, dyschesia, seminal emission, metroptosis, hemorrhoids, prolapse of anus, epilepsy, and asphyxia due to drowning. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Be careful when needling at pregnant women. Regional anatomy: Vasculature: The branches of perineal artery and vein. Innervation: The branch of perineal nerve. Qugu (RN 2) Location: On the anterior midline of the abdomen and at the midpoint of the upper border of the symphysis pubis. Indications: Stranguria, enuresis, seminal emission, impotence, and fullness of the lower abdomen, hernia, irregular menstruation, and leukorrhagia. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of inferior epigastric artery and obturator artery. Innervation: The branch of iliohypogastric nerve.

Zhongji (Front-Mu Point of the Urinary Bladder, RN 3) Location: On the anterior midline of the abdomen and 4 cun below the umbilicus. Indications: Dysuria, enuresis, seminal emission, impotence, hernia, irregular menstruation, and metroptosis. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of superficial epigastric and inferior epigastric arteries and veins. Innervation: The branch of iliohypogastric nerve. Guanyuan (Front-Mu Point of the Small Intestine, RN 4) Location: On the anterior midline of the abdomen and 3 cun below the umbilicus. Indications: Impotence, seminal emission, enuresis, irregular menstruation, leukorrhagia, metroptosis, apoplexy and prostration syndrome, as well as general debility. Method: Insert the needle perpendicularly, 0.8- 1.2 cun deep. Regional anatomy:

Vasculature: The same as that of Zhongji (RN 3). Innervation: The medial branch of the anterior cutaneous branch of the twelfth intercostal nerve. Shimen (Front-Mu Point of the Sanjiao, RN 5) Location: On the anterior midline of the abdomen and 2 cun below the umbilicus. Indications: Dysuria, edema, diarrhea, abdominal pain, hernia, seminal emission, and irregular menstruation. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The same as that of Zhongji (RN 3). Innervation: The anterior cutaneous branch of the eleventh intercostal nerve.

Qihai (RN 6) Location: On the anterior midline of the abdomen and 1.5 cun below the umbilicus. Indications: Pain in the lower abdomen, enuresis, incontinence of urine, dysuria, diarrhea, impotence, seminal emission, hernia, irregular menstruation, metroptosis, apoplexy, and general debility. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Shimen (RN 5). Yinjiao (RN 7) Location: On the anterior midline of the abdomen and 1 cun below the umbilicus. Indications: Pain and distention in the abdomen, dysuria, edema, diarrhea, amenorrhea, and leukorrhagia. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The same as that of Zhongji (RN 3). Innervation: The anterior cutaneous branch of the tenth intercostal nerve. Shenque (RN 8) Location: In the center of the umbilicus. Indications: Apoplexy, abdominal pain with cold limbs, diarrhea, and edema. Method: Acupuncture is prohibited and moxibustion is applicable. Regional anatomy: Vasculature: The inferior epigastric artery and vein. Innervation: The anterior cutaneous branch of the tenth intercostal nerve.

Shuifen (RN 9) Location: On the anterior midline of the abdomen and 1 cun above the umbilicus. Indications: Pain and distention of the abdomen, edema, diarrhea, regurgitation, and vomiting. Method: Insert the needle perpendicularly, 0.8- l.2 cun deep. Regional anatomy: Vasculature: The same as that of Shenque (RN 8). Innervation: The anterior cutaneous branches of the eighth and ninth intercostal nerves.

Xiawan (RN 10) Location: On the anterior midline of the upper abdomen, 2 cun above the umbilicus. Indications: Stomachache, abdominal pain and distention, vomiting, regurgitation, and hiccup. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The same as that of Shenque (RN 8). Innervation: The anterior cutaneous branch of the eighth intercostal nerve. Jianli (RN 11) Location: On the anterior midline of the abdomen, 3 cun above the umbilicus. Indications: Stomachache, abdominal pain and distention, diarrhea, and vomiting. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The branches of superior and inferior epigastric arteries and veins. Innervation: The anterior cutaneous branch of the eighth intercostal nerve. Zhongwan (Front-Mu Point of the Stomach and Influential Point of Fu Organs, RN 12) Location: On the anterior midline of the upper abdomen and 4 cun above the umbilicus. Indications: Stomachache, abdominal pain and distention, vomiting, hiccup, diarrhea, jaundice, cough, asthma, excess sputum, and weak spleen and stomach. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature: The superior epigastric artery and vein. Innervation: The anterior cutaneous branch of the seventh intercostal nerve.

Shangwan (RN 13) Location: On the anterior midline of the upper abdomen and 5 cun above the umbilicus. Indications: Abdominal distention, stomachache, vomiting, and epilepsy. Method: Insert the needle perpendicularly, 0.8- l .2 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zhongwan (RN 12).

Juque (Front-Mu Point of the Heart, RN 14) Location: On the anterior midline of the upper abdomen and 6 cun above the umbilicus. Indications: Cardialgia, palpitation, epilepsy, chest pain, stomachache, and vomiting. Method: Insert the needle obliquely downward, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zhongwan (RN 12). Jiuwei (Luo-Connecting Point, RN 15) Location: On the anterior midline of the upper abdomen and 7 cun above the umbilicus. Indications: Cardialgia, palpitation, chest pain, mania, and epilepsy. Method: Insert the needle obliquely downward, 0.5- 1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Zhongwan (RN 12). Zhongting (RN 16) Location: On the anterior midline of the sternum and at the junction of the gladiolus and xiphoid process. Indications: Fullness in the chest and hypochondriac region, vomiting, dysphagia anorexia, and globus hystericus. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The perforating branches of internal mammary artery and vein. Innervation: The anterior cutaneous branch of the fifth intercostal nerve.

Danzhong (Front-Mu Point of the Pericardium and Influential Point of Qi, RN 17) Location: On the mid-sternal line and at the level of the fourth intercostal space. Indications: Palpitation, chest pain, cough, asthma, and lack of lactation. Method: insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The same as that of Zhongting (RN 16). Innervation: The anterior cutaneous branch of the fourth intercostal nerve. Yutang (RN 18) Location: On the mid-sternal line and at the level of the third intercostal space. Indications: Cough, asthma, chest pain, sore throat, and swollen breasts. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The same as that of Zhongting (RN 16). Innervation: The anterior cutaneous branch of the third intercostal nerve. Zigong (RN 19) Location: On the mid-sternal line and at the level of the second intercostal space. Indications: Cough, asthma, chest pain, sore throat, and vomiting. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The same as that of Zhongting (RN 16). Innervation: The anterior cutaneous branch of the second intercostal nerve. Huagai( RN 20) Location: On the mid-sternal line and at the level of the first intercostal space. Indications: Cough, asthma, chest pain, and sore throat. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature. The same as that of Zhongting (RN 1 6). Innervation: The anterior cutaneous branch of the first intercostal nerve. Xuanji (RN 21) Location: On the mid-sternal line and at the midpoint of the sternal manubrium. Indications: Cough, asthma, and sore throat. Method: Insert the needle horizontally, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The same as that of Zhongting (RN 16). Innervation: The anterior branch of the supraclavicular nerve and the anterior cutaneous branch of the first intercostal nerve.

Tiantu (RN 22) Location: On the anterior midline of the neck and in the center of the suprasternal fossa. Indications: Cough, asthma, sore throat, sudden loss of voice, goiter, and globus hystericus. Method: First, insert the needle perpendicularly, 0.2 cun deep. Then turn the needle tip downward and insert it between the posterior side of the sternum and the trachea slowly, 0.5-1 cun deep. Pay attention to the accuracy of insertion. Regional anatomy: Vasculature: The jugular venous arch and the branch of inferior thyroid artery innominate vein and aortic arch. Innervation: The anterior branch of the supraclavicular nerve.

Lianquan (RN 23) Location: On the anterior midline of the neck and at the midpoint of the upper border of the hyoid bone. Indications: Swollen sublingual region, aphasia with stiff tongue, sudden loss of voice, dysphagia, and sore throat. Method: Insert the needle obliquely towards the root of the tongue, 0.5-1 cun deep. Regional anatomy: Vasculature: The anterior jugular vein. Innervation: The branch of cutaneous cervical nerve, hypoglossal nerve, and the branch of glossopharyngeal nerve. Chengjiang (RN 24) Location: On the face and in the depression at the midpoint of the mentolabial sulcus. Indications: Facial paralysis, swollen gums, and sudden loss of voice, salivation, epilepsy, and swollen face. Method: Insert the needle obliquely, 0.3-0.5 cun deep. Regional anatomy: Vasculature: The branches of inferior labial artery and vein. Innervation: The branch of facial nerve.

Lecture 14 The Du Meridian (Governor Vessel) (DU) 1. Traveling route The meridian starts from the lower abdomen and emerges at the perineum. Then it ascends along the spinal column and reaches Fengfu (DU 16) on the nape. It then enters the brain and reaches the vertex. Finally, it winds along the forehead to the nose bridge. 2. Symptoms Pain and stiffness in the spinal column, and opisthotonos. 3. Acupoints Changqiang (Luo-Connecting Point, DU l) Location: 0.5 cun below the tip of the coccyx. Indications: Hemorrhoids, prolapse of anus, mania, epilepsy, diarrhea, and constipation. Method: Insert the needle obliquely towards the anterior side of the coccyx, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of anal artery and vein. Innervation: The posterior ramus of coccygeal nerve, and anal nerve.

Yaoshu (DU 2) Location: At the hiatus of the sacrum. Indications: Mania, epilepsy, hemorrhoids, irregular menstruation, and weakness and pain in the lower limbs. Method: Insert the needle slightly upwards, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of middle sacral artery and vein. Innervation: The branch of coccygeal nerve. Yaoyangguan (DU 3) Location: Below the spinous process of the fourth lumbar vertebra. Indications: Impotence, seminal emission, irregular menstruation, and pain in the lumbosacral region. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of lumbar artery. Innervation: The medial branch of the posterior ramus of lumbar nerve. Mingmen (DU 4) Location: Below the spinous process of the second lumbar vertebra. Indications: Impotence, seminal emission, irregular menstruation, leukorrhagia,

sterility, and lumbago. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Yaoyangguan (DU 3). Xuanshu (DU 5) Location: Below the spinous process of the first lumbar vertebra. Indications: Lumbago, abdominal distention, diarrhea, and dysentery. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Yaoyangguan (DU 3).

Jizhong (DU 6) Location: Below the spinous process of the eleventh thoracic vertebra. Indications: Diarrhea, jaundice, hemorrhoids, epilepsy, and stiffness and pain in the spinal column. Method: Insert the needle perpendicularly, 0.5- 1 cun deep. Regional anatomy: Vasculature: The posterior branch of the eleventh intercostal artery. Innervation: The medial branch of the posterior ramus of the eleventh thoracic nerve. Zhongshu ( DU 7) Location: Below the spinous process of the tenth thoracic vertebra. Indications: Fullness in the abdomen, jaundice, and lumbago. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the tenth intercostal artery. Innervation: The medial branch of the posterior ramus of the tenth thoracic nerve. Jinsuo (DU 8) Location: Below the spinous process of the ninth thoracic vertebra. Indications: Epilepsy, stomachache, and stiffness of the spine. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the ninth intercostal artery. Innervation: The medial branch of the posterior ramus of the ninth thoracic nerve.

Zhiyang (DU 9) Location: Below the spinous process of the seventh thoracic vertebra. Indications: Jaundice, cough, asthma, and distending pain in the chest and hypochondriac region. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the seventh intercostal artery. Innervation: The medial branch of the posterior ramus of the seventh thoracic nerve.

Lingtai( DU 10) Location: Below the spinous process of the sixth thoracic vertebra. Indications: Cough, asthma, furuncles, and stiffness and pain in the back. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the sixth intercostal artery. Innervation: The medial branch of the posterior ramus of the sixth thoracic nerve. Shendao (DU 11) Location: Below the spinous process of the fifth thoracic vertebra. Indications: Palpitation, cardialgia, apoplexy with aphasia, epilepsy, cough, and stiffness and pain in the back. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the fifth intercostal artery. Innervation: The medial branch of the posterior ramus of the fifth thoracic nerve. Shenzhu (DU 12) Location: Below the spinous process of the third thoracic vertebra. Indications: Cough, asthma, epilepsy, and stiffness and pain in the back. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the third intercostal artery. Innervation: The medial branch of the posterior ramus of the third thoracic nerve. Taodao (DU 13) Location: Below the spinous process of the first thoracic vertebra. Indications: Headache, malaria, fever, and stiffness and pain in the nape and back. Method: Insert the needle perpendicularly, 0.5-1 cun deep. Regional anatomy: Vasculature: The posterior branch of the first intercostal artery. Innervation: The medial branch of the posterior ramus of the first thoracic nerve. Dazhui (DU 14) Location: Below the spinous process of the seventh cervical vertebra.

Indications: Febrile diseases, common cold, malaria, cough, asthma, epilepsy, rubella, and stiffness and pain in the nape and back. Method: Insert the needle perpendicularly, 0.51cun deep. Regional anatomy: Vasculature: The branch of transverse cervical artery. Innervation: The posterior ramus of the eighth cervical nerve, and the medial branch of the posterior ramus of the first thoracic nerve. Yamen (DU 15) Location: On the nape and 0.5 cun directly above the midpoint of the posterior hairline. Indications: Mutism, aphasia with stiff tongue, sudden loss of voice, mania, and epilepsy Method: Insert the needle perpendicularly or obliquely downward, 0.5-1 cun deep. Regional anatomy: Vasculature: The branches of occipital artery and vein. Innervation: The third occipital nerve. Fengfu (DU 16) Location: On the nape and 1 cun directly above the midpoint of the posterior hairline. Indications: aphasia, hemiplegia, and rigid nape with headache, mania, and epilepsy. Method: Insert the needle perpendicularly or obliquely downward, 0.5-1 cun deep. Regional anatomy: Vasculature: The branch of occipital artery. Innervation: The branches of the third occipital nerve and great occipital nerve. Naohu (DU 17) Location: On the head and 1.5 cun directly above Fengfu (DU 16). Indications: Headache, vertigo, mutism, epilepsy, and rigid nape. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of left and right occipital arteries and veins. Innervation: The branch of great occipital nerve. Qiangjian (DU 18) Location: On the head and 1.5 cun directly above Naohu (DU 17). Indications: Headache, vertigo, rigidity and pain in the nape and back, insomnia, and epilepsy. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Naohu (DU 17). Houding( DU 19) Location: On the head and 1.5 cun directly above Qiangjian (DU 18). Indications: Headache, vertigo, rigid nape, insomnia, and epilepsy. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature and innervation: The same as those of Naohu (DU 17).

Baihui (DU 20) Location: On the head and 7 cun directly above the midpoint of the posterior hairline. Indications: Headache, vertigo, apoplexy with aphasia, mania, epilepsy, prolapse of anus, metroptosis, and syncope. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The anastomotic network formed by superficial temporal arteries and veins, and occipital arteries and veins on both sides. Innervation: The branch of great occipital nerve.

Qianding (DU 21) Location: On the head and 1.5 cun anterior to Baihui (DU 20). Indications: Headache, vertigo, epilepsy, red and swollen eyes, and rhinorrhea. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: the anastomotic network formed by right and left superficial temporal arteries and veins. Innervation: The branch of frontal nerve and the branch of great occipital nerve. Xinhui (DU 22) Location: On the head and 1.5 cun anterior to Qianding (DU 21). Indications: Headache, vertigo, epilepsy, infantile convulsion, rhinorrhea, and epistaxis. Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The anastomotic network formed by superficial temporal artery and vein, and frontal artery and vein. Innervation: The branch of frontal nerve. Shangxing( DU 23) Location: On the heed and 1 cun above the midpoint of the anterior hairline. Indications: Headache, vertigo, red and swollen eyes, mania, rhinorrhea, epistaxis, and febrile diseases. . Method: Insert the needle horizontally, 0.5-0.8 cun deep. Regional anatomy: Vasculature: The branches of frontal artery and vein, and the branches of superficial temporal artery and vein. Innervation: The branch of frontal nerve. Shenting (DU 24) Location: On the head and 0.5 cun above the midpoint of the anterior hairline. Indications: Headache, vertigo, mania, insomnia, epistaxis, and rhinorrhea. Method: Insert the needle horizontally, 0.5-0.8 cun deep.

Regional anatomy: Vasculature: The branches of frontal artery and vein. Innervation: The branch of frontal nerve. Suliao (DU 25) Location: On the face and at the center of the tip of the nose. Indications: Nose disorders (such as nasal stuffiness, epistaxis, and rhinorrhea) and syncope. Method: Insert the needle obliquely upward, 0.3-0.5 cun deep. Or prick so that a little blood comes out. Moxibustion is contraindicated. Regional anatomy: Vasculature: The dorsal nasal branches of facial artery and vein. Innervation: The lateral nasal branch of anterior ethmoidal nerve.

Shuigou (DU 26) Location: On the face and at the junction of the upper third and middle third of the philtrum. Indications: Coma, syncope, trismus, epilepsy, facial paralysis, and swollen lips and face. Method: Insert the needle obliquely upward, 0.3-0.5 cun deep. Moxibustion is contraindicated. Regional anatomy: Vasculature: The superior labial artery and vein. Innervation: The buccal branch of facial nerve, and the branch of infraorbital nerve. Duiduan (DU 27) Location: On the labial tubercle of the upper lip and at the junction of the philtrum and the upper lip. Indications: Mania, facial paralysis, and swollen lips and gums. Method: Insert the needle obliquely upward, 0.2-0.3 cun deep. Moxibostion is contraindicated. Regional anatomy: Vasculature and innervation: The same as those of Shuigou (DU 26). Yinjiao (DU 28) Location: At the junction of the upper gum and the frenulum of the upper lip. Indications: Red and swollen gums, mania, and rhinorrhea. Method: Insert the needle obliquely upward, 0.2-0.3 cun deep. Moxibustion is contraindicated. Regional anatomy: Vasculature: The superior labial artery and vein. Innervation: The branch of superior alveolar nerve.

Appendix: Standard Location of the Extra Points (EX) 1. Extra Points of the Head and Neck, (EX-HN) Sishencong (EX-HN 1) Location: Four points on the vertex of the head, 1 cun anterior, posterior and lateral to Baihui (DU20). Indications: Headache, vertigo, insomnia, poor memory, and epilepsy. Method: Puncture horizontally for 0.5-0.8 cun. Regional anatomy: Vasculature: The network anastomosed by the occipital artery and vein, the parietal branches of the superficial temporal artery and vein with the supraorbital artery and vein. Innovation: The branches of the greater occipital, auriculotemporal and supraorbital nerves. Yintang (EX-HN 3) Location: On the forehead, at the midpoint between the eyebrows. Indications: Headache, vertigo, epistaxis, sinusitis, infantile convulsion, and insomnia. Method: Puncture horizontally 0.3-0.5 cun. Regional anatomy: Vasculature: The frontal artery from the ophthalmic artery and the accompanying vein. Innovation: The supratrochlear branch of the frontal nerve. Yuyao (EX-HN 4) Location: On the fore head, directly above the pupil, in the eyebrow. Indications: Pain in the supraorbital region, tic of the eyelid, ptosis of the eyelid, red painful swelling of the eyes, and cloudiness of the cornea. Method: Puncture horizontally 0.3-0.5 cun. Regional anatomy: Vasculature: The lateral branches of the supraorbital artery and vein. Innovation: The lateral branches of the supraorbital nerve, the branches of the facial nerve. Taiyang (EX-HN 5) Location: At the temporal part of the head, between the lateral end of the eyebrow and the outer canthus, in the depression one finger breadth behind them. Indications: Headache, eye diseases, and deviation of the eyes and mouth. Method: Puncture perpendicularly 0.3- 0.5 cun, or prick for bleeding. Regional anatomy: Vasculature: The branches or tributaries of the superficial temporal artery and vein. Innovation: The zygomaticofacial branch of the zygomatic nerve, the temporal and zygomatic branches of the facial nerve, the temporal nerve of the mandibular nerve. Erjian (EX-HN 6) Locations: Above the apex of the ear auricle, at the tip of the auricle when the ear is folded forward. Indications: Red painful swelling of the eyes, febrile diseases, and nebula. Method: Puncture perpendicularly 0.1-0.2 cun, or prick for bleeding. Regional anatomy: Vasculature: The anterior auricular branches of the superficial temporal artery and vein, the posterior auricular branches of the posterior auricular artery and vein. Innovation: The anterior auricular branches of the auriculotemporal nerve, the posterior auricular branches of the lesser occipital nerve, and the auricular branches of the facial nerve. Qiuhou (EX-HN 7) Locations: On the face, at the junction of the lateral fourth and the medial three fourths of the infraorbital margin. Indications: Eye diseases. Method: Push the eyeball gently upward, then puncture perpendicularly 0.5-1.2 cun along the

orbital margin slowly without manipulation of lifting, thrusting, twisting and rotating. Regional anatomy: Vasculature: The branches or tributaries of the infraorbital artery and vein, the branches or tributaries of the ophthalmic artery and vein, and the infraorbital artery and vein. Innovation: The branches of the infraorbital and facial nerves and the inferior branches of the oculomotor nerve. Shangyingxiang (EX-HN 8) Location: On the face, at the junction of the alar cartilage of the nose and the nasal concha, near the upper end of the nasolabial groove. Indications: Rhinitis, nasal obstruction, and boils in the nasal area. Method: Puncture horizontally upward to medial side 0.3-0.5 cun. Regional anatomy: Vasculature: The angular artery and vein. Innovation: The branches of the infraorbital and infratrochlear nerves, and the buccal branches of the facial nerve. Jinjin (EX-HN 12) Location: In the mouth, on the vein in the left side of the frenulum of the tongue. Indications: Swelling of the tongue, vomiting, aphasia with stiffness of the tongue, and ulceration in the mouth. Method: Prick for bleeding. Regional anatomy: Vasculature: The deep lingual artery from the lingual artery, and the deep lingual veins to the lingual vein. Innovation: The gnathic nerve from the mandibular nerve, the hypoglossal nerve, and the nervous fibers of the tympanic cord from the facial nerve. Yuye (EX-HN 13) Location: In the mouth, on the vein in the right side of the frenulum of the tongue. Indications: The same as those of Jinjin (EX-HN12). Method: The same as that of Jinjin (EX-HN12). Regional anatomy: The same as those of Jinjin. 2. Extra Points of the Chest and Abdomen (EX-CA) Zigong (EX-CA 1) Location: On the lower abdomen, 4 cun below the center of the umbilicus and 3 cun lateral to Zhongji (RN 3). Indications: Prolapse of the uterus, irregular menstruation, and infertility. Method: Puncture perpendicularly 0.8-1.2 cun. Regional anatomy: Vasculature: The superficial epigastric vein and the branches or tributaries of the inferior epigastric artery and vein. Innovation: The lateral cutaneous branches of the iliohypogastric nerve in the superficial layer and and the branches of the iliohypogastric nerve in the deep layer. 3. Extra Points of the Back (EX-B) Dingchuan (EX-B 1) Location: On the back, below the spinous process of the 7th cervical vertebra, 0.5 cun lateral to the posterior midline. Indications: Asthma, cough, neck rigidity, pain in the shoulder and back, and rubella. Method: Puncture perpendicularly 0.5-0.8 cun. Regional anatomy: Vasculature: The branches or tributaries of the deep cervical artery and vein and the transverse

cervical artery and vein. Innovation: The medial cutaneous branches as well as the muscular branches of the posterior branch of the 8th cervical nerve and the posterior branch of the 1st thoracic nerve. Jiaji (EX-B 2) Location: On the back and low back, 17 points on each side, below the spinous processes from the 1st thoracic to the 5th lumbar vertebrae, 0.5 cun lateral to the posterior midline. Indications: Those from the spinous process of the 1st to the 3rd thoracic vertebrae are indicated to the disorders of the upper limbs; those from the spinous process of the 1st to the 8th thoracic vertebrae are indicated to the disorders in the thoracic region; those from the spinous process of the 6th thoracic vertebra to the 5th lumbar vertebra are indicated to the disorders in the abdominal region; and those from the 1st to the 5th lumbar vertebrae are indicated to the disorders of the lower limbs. Method: Puncture perpendicularly 0.5-1cun in the cervical and thoracic region and puncture 1.01.5 cun in the lumbar region. Note: Or it is also said that all the points could be punctured obliquely to the medial side (toward the spine) 0.5-1 cun. Regional anatomy: The medial cutaneous branches of the posterior branches of the 1st thoracic nerve to the 5th lumbar nerve and the accompanying arteries and veins in the superficial layer, and the muscular branches of the posterior branches of the 1st thoracic nerve to the 5th lumbar nerve, the branches or tributaries of the dorsal branches of the posterior intercostal arteries and veins or lumbar arteries and veins in the deep layer respectively. Yaoyan (EX-B 7) Location: On the lower back, below the spinous process of the 4th lumbar vertebra, 3 cun lateral to the posterior midline. Indications: Lumbago, irregular menstruation, leukorrhea, and frequent urination. Method: Puncture perpendicularly 1-1.5 cun. Regional anatomy: Vasculature: The branches of or tributaries of the 4th lumbar artery and vein. Innovation: The superior clunial nerve and the cutaneous branches as well as the muscular branches of the posterior branch of the 4th lumbar nerve. Shiqizhui (EX-B 8) Location: On the lower back and on the posterior midline, below the spinous process of the 5th lumbar vertebra. Indications: Lumbago, leg pain, paralysis of the lower limbs, dysfunctional uterine bleeding, irregular menstruation, and dysmenorrhea. Method: Puncture perpendicularly 0.8-1.2 cun. Note: It is also said that the point is punctured obliquely upward 1-1.5 cun. Regional anatomy: The cutaneous branches of the posterior branch of the 5th lumbar nerve and the accompanying artery and vein in the superficial layer and the branches of the posterior branch of the 5th lumbar nerve and the external (posterior) vertebral venous plexus between the adjacent spinous processes in the deep layer. Yaoqi (EX-B 9) Location: On the lower back, 2 cun directly below the tip of the coccyx, in the depression between the sacral horns. Indications: Epilepsy, headache, insomnia, and constipation. Method: Puncture horizontally 1-2 cun. Regional anatomy: The branches of the posterior branches of the 2nd and 3rd sacral nerves and the accompanying artery and vein. 4. Extra Points of the Upper Extremities (EX-UE) Zhoujian (EX-UE 1)

Location: On the posterior side of the elbow, at the tip of the olecranon when the elbow is flexed. Indications: Scrofula. Method: Moxibustion for 7-15 moxa cones. Regional anatomy: Vasculature: The arteriovenous network around the elbow joint. Innovation: The posterior cutaneous nerve of the forearm. Erbai (EX-UE 2) Location: Two points on the palmer side of each forearm, 4 cun proximal to the crease of the wrist, on each side of the tendon of the radial flexor muscle of the wrist. Indications: Hemorrhoids and prolapse of rectum. Method: Puncture perpendicularly 0.5-1 cun. Regional anatomy: Vasculature: 1). The medial point: The tributaries of the median brachial vein and the median artery. 2). The lateral point: The tributaries of the cephalic vein and the radial artery and vein. Innovation: 1). The medial point: The lateral cutaneous nerve of the forearm and the median nerve. 2). The lateral point: The lateral cutaneous nerve of the forearm. Zhongkui (EX-UE 4) Location: On the dorsal side of the middle finger, at the tip center of the proximal interphalangeal joint. Indications: Nausea, vomiting, hiccup, and poor digestion. Method: Moxibustion for 3-5 moxa cones, or puncture perpendicularly 0.2-0.3 cun. Regional anatomy: Vasculature: The dorsal digital artery from the dorsal palmar artery and the dorsal digital vein to the dorsal venous network of the palm. Innovation: The dorsal digital nerve with its radial branch originating from the radial nerve and its ulnar branch originating from the ulnar nerve. Yaotongdian (EX-UE 7) Location: Two point on the dorsum of each hand, between the 1st and 2nd and between the 3rd and 4th metacarpal bones, and at the midpoint between the dorsal crease of the wrist and the metacarpophalangeal joint. Indications: Acute lumbar sprain. Method: Puncture obliquely 0.5-0.8 cun toward the center of the metacarpus from both sides. Regional anatomy: Vasculature: Innovation: Baxie (EX-UE 9) Location: Four points on the dorsum of each hand, at the junction of the red and white skin proximal to the margin of the webs between each two of the five fingers of a hand. Indications: Fever, irritability, pain of eyes, redness and swelling of the dorsum of the hand, finger numbness, and spasm and contracture of the fingers . Method: Puncture obliquely 0.3-0.8 cun, or prick for bleeding. Regional anatomy: Vasculature: The dorsal metacarpal artery and vein or the dorsal digital artery and vein, the common digital palmer artery and vein or the proper palmer digital artery and vein. Innovation: The dorsal digital nerve and the proper palmer digital nerve. Sifeng (EX-UE 10) Location: Four points on each hand, on palmer side of the 2nd and 5th fingers and at the center of the proximal interphalangeal joints.

Indications: Malnutrition and indigestion in children, and whooping cough. Method: Prick for bleeding or squeeze out a small amount of yellowish viscous fluid locally. Regional anatomy: Vasculature: The branches or tributaries of the proper palmer digital artery and vein and the subcutaneous digital vein. Innovation: The proper palmer digital nerve from the median nerve, the proper palmer digital nerve from the median nerve for the radial side and from the ulnar nerve from the ulnar side, and the proper palmer digital nerve from the ulnar nerve. Shixuan (EX-UE 11) Location: Ten points on both hands, at the tips of the 10 fingers, 0.1 cun from the free margin of the nail. Indications: Apoplexy, coma, epilepsy, high fever, acute tonsillitis or acute sore throat due to other causes, infantile convulsion, numbness of the finger tips. Method: Puncture 0.1-0.2 cun superficially or prick for bleeding. Regional anatomy: Innovation: The median nerve and ulnar nerve. 5. Extra Points of the Lower Extremities (EX-LE) Heding (EX-LE 2) Location: Above the knee, in the depression of the midpoint of the upper border of the patella. Indications: Knee pain, weakness or paralysis of the foot and leg. Method: Puncture perpendicularly 0.5-1 cun. Regional anatomy: Vasculature: The tributaries of the great saphenous vein and the arteriovenous network of the knee joint. Innovation: The anterior cutaneous branches of the femoral nerve. Baichongwo (EX-LE 3) Location: 3 cun above the medial superior corner of the patella of the thigh with the knee flexed, i.e. 1 cun above Xuehai (SP 10). Indications: Rubella, eczema, boils or carbuncles in the lower part of the body, and gastrointestinal parasitic diseases. Method: Puncture 1.0-1.5 cun. Regional anatomy: Vasculature: The great saphenous vein and the muscular branch of the femoral artery and vein. Innovation: The anterior cutaneous branch of the femoral nerve and deeper, the femoral nerve. Neixiyan (EX-LE 4) Location: In the depression medial to the patellar ligament when the knee is flexed. Indications: Knee pain, weakness of the lower limbs, and heaviness and pain of the leg and foot. Method: Puncture perpendicularly 0.5-0.8 cun. Regional anatomy: Vasculature: The arteriovenous network of the knee joint. Innovation: The infrapatellar branches of the saphenous nerve and the anterior cutaneous branches of the femoral nerve. Xiyan (EX-LE 5) Location: In the depression on both sides of the patellar ligament when the knee is flexed. The medial and lateral points are named "Neixiyan" and "Waixiyan" respectively. Indications: The same as those of Neixiyan (EX-LE 4). Method: The same as that of Neixiyan (EX-LE 4). Regional anatomy:

1). The medial point: The same as those of Neixiyan (EX-LE 4) 2). The lateral point: The same as those of Dubi (ST 35) Dannang (EX-LE 6) Location: At the upper part of the lateral surface of the leg, 2 cun directly below the depression anterior and inferior to the head of the fibula [Yanglingquan (GB 34)]. Indications: Acute and chronic cholecystitis, gallstones, biliary ascariasis, and muscle atrophy and numbness of the lower limbs. Method: Puncture 1-1.5 cun. Regional anatomy: Vasculature: The anterior tibial artery and vein. Innovation: The lateral sural cutaneous nerve and the superficial peroneal nerve and the deep peroneal nerve. Lanwei (EX-LE 7) Location: At the upper part of the anterior surface of the leg, 5 cun below Dubi (ST35), one finger breadth lateral to the anterior crest of the tibia. Indications: Acute and chronic appendicitis, indigestion, and paralysis of the lower limbs. Method: Puncture 1-1.5 cun. Regional anatomy: Vasculature: The superficial veins and the anterior tibial artery and vein. Innovation: The lateral sural cutaneous nerve and the deep peroneal nerve. Bafeng (EX-LE 10) Location: Eight points on the instep of both feet, at the junction of the red and white skin proximal to the margin of the webs between each two neighboring toes. Indications: Beriberi, pain of the toes, and red painful swelling of the dorsum of the foot. Method: Puncture obliquely 0.5-0.8 cun or prick for bleeding. Regional anatomy: Vasculature: The superficial venous network of the foot the dorsal digital artery from the dorsal metatarsal artery, and the dorsal digital veins to the dorsal metatarsal vein. Innovation: The dorsal digital nerve of the intermediate dorsal cutaneous nerve of the foot.

Part 2. Acupuncture and Moxibustion Techniques Lecture1. Acupuncture Acupuncture is a procedure by which diseases can be prevented and treated through proper insertion of needles into certain points with various manipulating techniques performed. Today, those commonly used in acupuncture clinic are filiform needle, cutaneous needle, and threeedged needle, among which the filiform needle is mostly popularly used. In this chapter the information will focus on the acupuncture therapy main performed with filiform needles. See the following. 1. Filiform needle 1.1. The Structure and Specification The filiform needles are popularly used at present in clinic. The needles could be made of gold, silver, alloy, etc., but most of all are made of stainless steel. A filiform needle may be divided into five parts: a) Handle: the part wrapped with filigree either of copper or stainless steel, b) ) Tail: the part at the end of the handle, c) ) Tip: the sharp point of the needle, d) Body (Shaft): the part between the handle and the tip, and e) Root: the demarcation line between the body and the handle. The length and gauge refer to the dimension of the needle body and the common filiform needles vary in length and diameter. Needles from Nos. 26-32 in diameter and l -3 cun in length are most frequently used in clinic. In general, if a needle has a tip as sharp as a pine needle and the round, smooth, flexible, and resilient body, it is valued as the best quality. The filiform needles should be well stored to avoid damage. The damaged needles may cause discomfort to patient or bring about accidents. The needle tip should be preserved with special care by observing the following instructions. a) Unused needles are suggested to store in a box with layers of gauze or in a tube with dry cotton balls placed at the both ends to protect the needle tip. b) On boiling water sterilization, needles should be bound steadily by gauze in case the needle tip hits against the wall of the container. c) On manipulation, insertion of the needle should be neither too forceful nor too fast to prevent it from getting bent. If the needle tip touches bones, the needle should be withdrawn a little to avoid bending. 1.2. Needling practice As the filiform needle is fine and flexible, it is very difficult to insert it into the skin without some special force exerted by the fingers, say nothing of conducting the needling manipulations. It is apparent that an appropriate finger force is the guarantee to minimize the pain and optimize the therapeutic effects. The training of fingers may start with a short and thick filiform needle, progressing to a finer and longer one before clinical application. 1) Practice with sheets of paper Fold fine and soft tissues into a small packet about 5 8 centimeters in size and 1centimeter in thickness, then bind the packet with gauze thread. Hold the paper packet in the left hand and the needle handle with the right hand. Insert the needle into the packet and rotate in and out clockwise and counter-clockwise. At the beginning, if you feel the needle stuck or difficult to rotate, take it easy and continue the exercise until you feel it easy to insert and rotate the needle. As your finger force grows stronger, the thickness of the paper packet should be increased. 2) Practice with a cotton ball Make a cotton ball of about 5-6 centimeter in diameter wrapped in gauze. Hold the ball with the left hand and needle handle with the right hand. Insert the needle into it and practise a rotating,

lifting, and thrusting procedure. According to the required postures during acupuncture and the reinforcing and reducing approach, practise the basic manipulation techniques. The purpose of this method is to practise the different manipulating techniques in acupuncture. 3) Practise on the practitioners' own body This procedure usually follows the practice on the paper packet and the cotton ball so as to have personal experience of the needling sensation in clinical practice. The method will only possess and produce the beneficial results in acupuncture treatment. 1.3. Preparations prior to treatment 1) Inspection of the instruments Needles of various size, trays, forceps, moxa wool, jars, sterilized cotton ball, 75% alcohol or 1.5% iodine tincture, or 2% gentian violet, etc. should be carefully prepared and inspected before use. 2) Posture of the patients In order to have correct location of points, to make effective manipulating techniques of acupuncture and moxibustion, to retain needle for a prolonged period of time, and to prevent the accidents of needle fainting, bent needle, stuck needle or broken needle, it is essential for a patient to be in an appropriate posture. Therefore it is of great importance clinically to select a proper posture for the patients. Generally speaking, it must be ensured that the practitioners must be able to work without hindrance and the patients feel comfortable and are well relaxed. The commonly-used postures adopted in the clinic are: a) Sitting in flexion: applicable to performing the techniques on the points on the head, neck and back. b) Sitting erect with elbows resting on a table: suitable for needling the points on the head, arm and shoulder. c) ) Lateral recumbent: suitable for needling the points at the lateral side of the body. d) Supine posture: suitable for needling the points on the head and face, chest and abdominal region, and the four limbs. e) Prone posture: suitable for the points on the head, neck, back, lumbar and buttock regions, and the posterior region of the lower limbs. 3) Sterilization: a) Needle sterilization: Autoclave sterilization: Needles should be sterilized in an autoclave at l.5 atmospheric pressure and 125 C for 30 minutes. Boiling sterilization: Needles and other instruments are boiled in water for 30 minutes. This method is easy and effective without any special equipment. Medicinal sterilization : Soak the needles in 75% alcohol from 30-60 minutes. Then take them out and wipe off the liquid from the needles with a piece of dry cloth. At the same time, the needle tray and forceps which have directly contacted with the filiform needles should also be sterilized in the same way. Besides, needles used to treat some infectious cases should be sterilized and stored in separate place. b) Skin disinfection: The area on the body surface selected for needling must be sterilized. Generally, points on the local area must be sterilized with 75% alcohol, or first with 2.5% iodine and then it is removed by a 70% alcohol cotton ball. If the disinfected area is accidentally polluted, it is imperative to repeat the sterilization. The practitioner's fingers should be sterilized routinely. 2. Needling methods

Various needling techniques and manipulations, which attach importance to the insertion and withdrawal of the needle, have been summarized by practitioners based on their experience in the past generations. 2.1. Insertion The needle should be inserted coordinately with the help of both hands. The posture for insertion should be correct so that the manipulation can be smoothly done. Usually the needle is held with the right hand, which is known as the puncturing hand while the left hand (known as the pressing hand) pushes firmly against the area beside the point. In the first chapter of "Miraculous Pivot", it says: "Needle must be inserted into the body with the right hand under the assistance by the left hand.'' In the book "Classic on Medical Problems", it is said that "an inexperienced acupuncturist believes in only the importance of the right hand, while an experienced believes in the importance of the left hand likewise''. It is further stated in "Lyrics of Standard Profundities" that "press heavily with the left hand to disperse Qi and insert the needle gently and slowly to avoid pain''. These points of view have illustrated the importance of the coordination between the right and left hands on inserting the needles. According to the length of the needle and the location of the point, different inserting methods are employed. 2.1.l. Inserting the needle aided by the pressure of the finger of the pressing hand Press beside the acupuncture point with the nail of the thumb or of the index finger of the left hand, hold the needle with the right hand and keep the needle tip closely against the nail, and then insert the needle into the point. This method is suitable for puncturing with short needles such as those used in needling Neiguan (PC 6), Zhaohai (KI 6), etc. 2.1.2. Inserting the needle with the help of the puncturing and pressing hands Hold the needle tip with the thumb and the index finger of the left hand, leaving 0.2-0.3 centimeters of its tip exposed, and hold the needle handle with the thumb and index finger of the right hand. As the needle tip is directly over the selected point, insert the needle swiftly into the skin with the left hand, meanwhile the right hand presses the needle downward to the required depth. This method is suitable for puncturing with long needles, such as those used in needling Huantiao (GB 30), Zhibian (BL 54), etc. 2.1.3. Inserting the needle with the fingers stretching the skin Stretch the skin where the point is located with the thumb and index finger of the left hand, hold the needle with the right hand and insert it into the point rapidly to a required depth. This method is suitable for the points located on the abdomen where the skin is loose, such as Tianshu (ST 25), Guanyuan (RN 4), etc. 2.1.4. Inserting the needle by pinching the skin Pinch the skin up around the point with the thumb and index finger of the left hand, insert the needle rapidly into the point with the right hand. This method is suitable for puncturing the points on the head and face, where the muscle and skin are thin, such as Zanzhu (BL 2), Dicang (ST 4), Yintang (EX-HN3), etc. 2.2. Angle and depth of insertion In the process of insertion, angle and depth are especially important in acupuncture. Correct angle and depth help to induce the needling sensation, bring about the desired therapeutic results and guarantee safety. Different angles and depth at the same point punctured could produce varied needling sensation and therapeutic effects. Appropriate angle and depth depends upon the location of the points, the therapeutic purpose, the patient's constitution and the body size, a bulky person or a slim one. 2.2.l. The angle formed between the needle and the skin surface Generally speaking, the points are needled in three angles, perpendicular, oblique and horizontal. a) Perpendicular In this way the needle is inserted perpendicularly, forming a 90 angle with the skin surface. Most points on the body can be punctured in this angle.

b) Oblique This method is used for the points close to the important viscera or in the loci where the muscle is thinner. Generally speaking, the needle is inserted obliquely to form an angle of approximately 45 with the skin surface. Points such as Lieque (LU 7) in the upper extremity, Jiuwei (RN 15) in the abdominal region, Qimen (LR 14) on the chest, and the points on the back, are often needled in this angle. c) Horizontal (also known as transverse insertion) This method is commonly used in the areas where the muscle is thin such as Baihui (DU 20) and Touwei (ST 8) on the head, Zanzhu (BL 2) and Yangbai (BL 14) on the face, Tanzhong (RN 17) on the chest, etc. 2.2.2. Depth of needle insertion Generally speaking, a proper depth of needling induces better needling sensation without hurting the important viscera. In clinic the depth of insertion mostly depends upon the constitution of the patient, the location of points and the pathological condition. For the elderly often suffering from deficiency of Qi and blood, or for infants with delicate constitution, and such areas as the head, face and back region, shallow insertion is advisable. For the young and middle-aged with strong or obese constitutions, or for the points on the four limbs, buttocks and abdominal region, deep insertion is applicable. 2.3. Manipulations and "De Qi" (Arrival of Qi---needling sensation) Manipulations: The manipulation of needles may give rise to certain needling reaction, to obtain which several methods should be applied. The "Arrival of Qi" refers to the sensation of soreness, numbness or distention around the points after the needle is inserted to a certain depth. At the same time the operator may feel the tenseness around the needles. 2.3.l. The fundamental manipulating techniques a) Lifting and thrusting: After the needle tip penetrating the skin surface, the needle body is perpendicularly lifted and thrust in the point. This, known as lifting and thrusting, is applied only when the needle is inserted to a certain depth. But it is inappropriate not to lift and thrust the needles too much, otherwise local pain or the damage of the local tissues may take place. b) Twirling or rotating: After the needle has reached its required depth, twirl and rotate the needle backward and forward continuously. Generally, the needle is rotated with an amplitude from l80 to 360 . Rotating either clockwise or counter-clockwise alone may twine the muscle fibers and cause pain. 2.3.2. Waiting for and promoting Qi If Qi fails to arrive after certain manipulating techniques are given, some measures have to be taken, such as temporarily retaining the needle and then rotating again until Qi is obtained. This is called "waiting for Qi". If, after the insertion and manipulation of the needle, the patient does not feel or only has little needling sensation, the method of promoting Qi should be used. The six auxiliary manipulating methods are seen below. a) Pressing: Slightly press the skin along the course of the meridian. It is described in Compendium of Acupuncture and Moxibustion that "the target meridian is pushed up and down to promote the circulation of Qi and blood''. The major purpose of this method is to facilitate the movement of Qi through the target meridian and strengthen its sensation at the point. The method is used in patients whose needling sensation is delayed. b) Plucking: Pluck the handle of the needle lightly, causing it to tremble and strengthening the stimulation to obtain Qi. In "Compendium of Acupuncture and Moxibustion", it says: "First, pluck the handle of the needle, after the arrival of Qi, insert the needle a bit deeper. This is the reinforcing method.'' It is also pointed out in "Questions and Answers on Acupuncture and Moxibustion" that "if Qi

does not flow smoothly, pluck the needle lightly and make Qi travel faster.'' The plucking method used to promote Qi flow is for patients with retarded Qi sensation due to Qi deficiency. c) Scraping: When the needle is retained, the thumb and index finger of the left hand support the body of the needle where it enters the skin. The thumb of the right hand is placed on the tail end to hold the needle steady, then scrap the handle with the nail of the index or middle finger of the right hand upward from the bottom or vice versa. Scraping is used to spread the needling sensation to a larger area or to propagating along the meridians. d) Shaking: Shaking of the needle can strengthen the needling sensation. In the book "Questions and Answers on Acupuncture and Moxibustion", it is said that "shaking is an aid for Qi flow.'' Moreover, shaking the needle may be used as an auxiliary method for reducing i.e., before withdrawal of the needle, shake the needle to drive the pathogenic factors out. In "Compendium of Acupuncture and Moxibustion", it says: "First, shake the handle of the needle to cause arrival of Qi . When Qi arrives, withdraw the needle a little, which is known as the reducing method.'' e) Flying: In the book "Introduction to Medicine", it says: "Twirling the needle quickly for three times is known as "flying". Twirl the needle and separate the thumb and index finger from it for several times until the needling sensation is strengthened. f) Trembling: Hold the needle with the fingers of the right hand and apply quick lift-thrust movement in small amplitude to cause vibration. It is stated in "Classic of Divine Resonance" that "hold the needle with the thumb and index finger of the right hand, lift and thrust it in rapid frequency but small amplitude as if trembling to promote Qi.'' Therefore it is applied to strengthen the needling sensation and activate the flow of Qi and blood. 2.3.3.Arrival of Qi In the process of acupuncture, no matter what manipulation it is, the arrival of Qi must be achieved. In the first chapter of "Miraculous Pivot", it is described that "Acupuncture therapy does not take effect until the arrival of Qi. In "Ode of Golden Needle" it is said: "Quick arrival of Qi suggests quick and good effects in treatment, slow arrival of Qi shows retarded effects in treatment.'' It is apparently indicated that the arrival of Qi is especially important in acupuncture treatment. a) Signs of the arrival of Qi When the patient feels soreness, numbness, heaviness and distension around the point, or their transmission upward and downward along the meridians, it is a sign of the arrival of Qi. Meanwhile, the operator should feel the tenseness around the needle. "Lyrics of Standard Profundities" says: "It seems a fish bites on fishing pulling the line downward.'' This is a vivid description to whether the arrival of Qi is obtained or not. b) Factors influencing the arrival of Qi i) Inaccurate location of the points: It is very important to locate points correctly in acupuncture treatment. In case of inaccurate location, it would be affected to obtain the required needling sensations. ii) Improper depth of the needle insertion: A given depth of insertion to each point is required. Either too deep or too shallow would affect the arrival of Qi. iii) Imperfect manipulation: The needling manipulation is requisite for the arrival of Qi. The operator should practise it correctly or perfectly, otherwise, the expected effects can not be achieved. iv) Weak constitution and dull sensation: In the "Miraculous Pivot", it describes: "An individual with abundant Yang Qi may have a quick needling sensation, a healthy person responds with a normal rate to acupuncture, neither quick nor slow, and a man with excessive Yin and deficient Yang, (i.e. delicate constitution and dull sensation) may have a slow needling sensation''. For

severe cases there may not appear the needling sensation, and the therapeutic results will be no doubt unsatisfactory. Acupuncturists in the past attached importance not only to the arrival of Qi, but also to the activity of the "spirit Qi'' in the meridians. In "Compendium of Acupuncture and Moxibustion" it is said: "In case of arrival of the spirit Qi, a tense feeling appears under the needle.'' The first chapter of "Miraculous Pivot" says: "A point is the place where the spirit Qi enters and flows out.'' The function of acupuncture is to regulate the meridian Qi. The arrival of Qi is a manifestation of the normal activity of the spirit Qi. Therefore, it is important in observing the therapeutic effects. 2.4. Retaining and withdrawing the needle 2.4.l. Retaining "Retaining'' means to hold the needle in place after it is inserted to a given depth below the skin. Pathological conditions decide the retaining and its duration. In general, the needle is retained for fifteen to twenty minutes after the arrival of Qi. But for some chronic, intractable, painful and spastic cases, the time for retaining of the needle may be appropriately prolonged. Meanwhile, manipulations may be given at intervals in order to strengthen the therapeutic effects. For some diseases the duration may last for several hours. For patients with a dull needling sensation, retaining the needle serves as a method of waiting for Qi. 2.4.2. Withdrawing On withdrawing the needle, press the skin around the point with the thumb and index finger of the pressing hand, rotate the needle gently and lift it slowly to the subcutaneous level, then withdraw it quickly and press the punctured point for a while to prevent bleeding. 2.5. Reinforcing and Reducing Methods Reinforcing (also translated as tonifying) and reducing (also known as sedating) are two corresponding methods based on the guide line set in "Internal Classic", i.e. reinforcing for the deficiency-syndromes and reducing for the excess-syndromes. The method which is able to invigorate the body resistance and to strengthen the weakened physiological functions is called reinforcing, while that which is able to eliminate the pathogenic factors and to harmonize the hyperactive physiological functions is known as the reducing. Clinically, reinforcing or reducing method is applied according to the functional conditions of the patient. Under different pathological conditions acupuncture may exercise different therapeutic functions, or the effects of the reinforcing and reducing. If an individual is subject to a collapsed condition, acupuncture functions to rescue Yang from the collapse and when an individual is under a condition of internal pathogenic heat, acupuncture functions to expel the heat outwards. Acupuncture can not only relieve the stomach and intestine spasms, but also strengthen the stomach and intestine peristalsis. This dual regulating function is closely related to the condition of the antipathogenic factors of the body. If they are vigorous, it is easy to activate the meridian Qi and the regulating function of acupuncture is good; on the contrary, if they are forceless, it is difficult to excite the meridian Qi and the regulating function is poor. Acupuncture is an approach able to promote the alteration of the internal environment of the body. For this purpose certain manipulating techniques have been created. Acupuncturists in past ages have developed and summarized a number of reinforcing and reducing methods which are still commonly used in clinic today. 2.5.l. The basic reinforcing and reducing methods a) Reinforcing and reducing by lifting and thrusting the needle In "Classic on Medical Problems", it states: "Heavy pressing of the needle to a deep region is known as reinforcing, while forceful lifting of the needle to the superficial region is known as reducing." It tells the reinforcing from the reducing by the force and speed used in manipulation. After the needle is inserted to a given depth and the needling sensation appears, the reinforcing is obtained by lifting the needle gently and slowly but thrusting it heavily and rapidly; while the reducing is achieved by lifting the needle forcefully and rapidly but thrusting it gently and slowly.

b) Reinforcing and reducing by twirling and rotating the needle: The reinforcing and reducing of this kind can be differentiated by the amplitude and speed used for the manipulation. When the needle is inserted to a certain depth, rotating the needle gently and slowly with small amplitude is called the reinforcing; on the contrary, rotating the needle rapidly with large amplitude is known as the reducing. In the seventy-third chapter of "Miraculous Pivot", it says: "Twirling the needle slowly is the reinforcing and twirling the needle rapidly to promote the flow of Qi is the reducing method.'' In addition, the reinforcing and reducing methods are distinguished by clockwise or counter-clockwise rotation of the needle. To be more exact, the right rotation is the reducing method and the left rotation is the reinforcing method. In "Guide to Acupuncture", it describes: "Rotating the needle forward with the thumb means the reinforcing, rotating the needle backward with the thumb means the reducing.'' Of course, twirling of the needle doesn't follow on direction. There is a difference only between the speed of rotation and the force used. For example, in forth turning, the needle is rotated forcefully and rapidly by the thumb, however, in back turning, the needle is rotated gently and slowly by the thumb. The right rotation is just in the opposite way. c) The reinforcing and reducing achieved by rapid and slow insertion and withdrawal of the needle: This is another kind of reinforcing and reducing methods distinguished by the speed of insertion and withdrawal of the needle. In the first chapter of "Miraculous Pivot", it says that "inserting the needle slowly and withdrawing it rapidly is the reinforcing method, and inserting the needle rapidly and withdrawing it slowly is the reducing method.'' In the third chapter of "Miraculous Pivot" the same explanation is given. During the manipulation, the reinforcing method is performed by inserting the needle to a given depth slowly and lifting it rapidly just beneath the skin, and a moment later withdraw it. The reducing method is performed just in a opposite procedure. d) The reinforcing and reducing achieved by keeping the hole open or close: In "Plain Questions", it says that "excess is due to the entrance of the pathogenic factor into the human body whereas deficiency is due to the exit of the vital Qi.'' On withdrawing of the needle, shake it to enlarge the hole and allow the pathogenic factor going out. This is called the reducing method. Conversely, pressing the hole quickly to close it and preventing the vital Qi from escaping is called the reinforcing method. e) The reinforcing and reducing achieved by the direction the needle lip pointing to: In "Compendium of Acupuncture and Moxibustion", it says: "The three Yang meridians of hand run from the hand up to the head. The needle tip pointing downwards, i.e. against the meridian course, is known as the reducing method. The opposite direction of the needle tip pointing to i.e., following the running course of the meridian. is known as the reinforcing method." f) The reinforcing and reducing achieved by means of respiration: In "Plain Questions", it states: "The reinforcing is achieved by inserting the needle when the patient breathes in and withdrawing the needle when the patient breathes out. The reducing is achieved in an opposite way." In addition to the above-mentioned methods, even reinforcing and reducing movement is also used in clinic. This method is used to treat diseases which are atypical to deficiency or excess in nature. Lift, thrust and rotate the needle evenly and gently at moderate speed to cause a mild sensation and withdraw the needle at moderate speed as well. 3. Precautions, Contraindications and Management of Possible Accidents in Acupuncture Treatment 3.1. Precautions and Contraindications in Acupuncture Treatment 3.1.1. It is advisable to apply few needles or to delay giving acupuncture treatment to the patients who are either famished or overeaten, intoxicated, over-fatigued or very weak.

3.1.2. It is contraindicated to puncture points on the lower abdomen and lumbosacral region for women pregnant under three months. After three months pregnancy it is contraindicated to needle the points on the upper abdomen and lumbosacral region, and those points causing strong sensation such as Hegu (LI 4), Sanyinjiao (SP 6), Kunlun (BL 60) and Zhiyin (BL 67). 3.1.3. Points on the vertex of infants should not be needled when the fontanel is not closed. In addition, retaining of needles is forbidden since the infants are unable to cooperate with the practitioner. 3.1.4. Needling should avoid the blood vessels to prevent bleeding. Points of the chest and back should be carefully needled to avoid injury of the vital organs. In "Plain Questions", it says: "If you puncture the points at the chest and abdominal region, you should avoid hurting the five Zang organs.'' 3.1.5. Historic medical literature of the past contraindicates certain points on the human body for puncture or deep puncture. Most of these points are located close to the vital organs or large blood vessels, such as Chengqi (ST l) located below the eyeball, Jiuwei (RN 15) near the important viscera, Jimen (SP 1l) near the femoral artery, etc.. These points should generally be punctured obliquely or horizontally to avoid accidents. 3.2. Management of Possible Accidents Although acupuncture is safe and free from side effects, some accidents may take place owing to negligence of the contraindications, imperfect manipulations, or want of the anatomical knowledge. If an accident really occurs, the practitioner should keep calm. As long as he solves the problem in time, serious consequences can be avoided. The possible accidents are seen as follows: 3.2.l. Fainting Cause: This is often due to nervous tension, delicate constitution, hunger, fatigue, improper position of the patients, or the fierce needling manipulation. Manifestations: During acupuncture treatment, there may appear dizziness, vertigo, palpitation, short breath, fidgets, nausea, pallor, cold sweating, weak pulse. In severe cases, there may be cold extremities, drop of blood pressure, and loss of consciousness. Management: When fainting aurae such as dizziness, vertigo, fidgets and nausea appear, stop needling immediately and withdraw all the needles. Then help the patient to lie down, and offer him some warm or sweet water. The symptoms will disappear after a short rest. In severe cases, in addition to the above management, press hard with the fingernail or needle Shuigou (DU 26), Zhongchong (PC 9), Suliao (DU 25), Neiguan (PC 6) and Zusanli (ST 36), or apply moxibustion to Baihui (DU 20), Qihai (RN 6), and Guanyuan (RN 4). Generally, the patient will respond, but if not, other emergency measures should be taken. 3.2.2. Stuck needle Cause: It may arise from nervousness, strong spasm of the local muscles after the insertion of the needle, or from twirling the needle with improper amplitude or in one direction only, causing muscle fibers to bind the needle, or from the change of position by the patient after the insertion of the needles. Manifestations: After the insertion of the needle, it is found at times difficult or impossible to rotate, lift and thrust them. This situation is known as stuck needle. Management: Ask the patient to relax. If the needle is stuck due to excessive rotation in one direction, the condition will release when the needle is twirled in the opposite direction. If the stuck needle is caused by the tension of the muscles temporarily, leave the needle in the place for a while, then withdraw it by rotating, or by massaging the muscle near the point, or even by inserting another needle nearby to transfer the patient's attention and to ease the muscle tension. If the stuck needle is caused by the changed position of the patient, the original posture should be resumed and then withdraw the needle. Prevention: Sensitive patients should be encouraged to release their tensions. Avoid the muscle

tendons during the insertion of needles. Twirling the needle with excessive amplitude or in one direction only shall in no case be allowed. In the process of manipulation, the posture of the patient should remain unchanged. 3.2.3. Bent needle Cause: This may result from unskillful or fierce manipulation, or the needle striking the hard tissues inside, or a sudden change of the patient's posture due to various reasons, or from an improper management of the stuck needle. Manifestations: It is difficult to lift, thrust, rotate and withdraw the needle. At the same time, the patient feels pain. Management: When the needle is bent, lifting, thrusting, and rotating shall in no case be applied. The needle should be removed slowly and withdrawn by following the course of the bending. In case the bent needle is caused by the change of the patient's posture, move him/her to his/her original position to relax the local muscles and then remove the needle. Never try to withdraw the needle with force. Prevention: Perfect insertion and gentle manipulation are required. The patient should have a proper and comfortable position and it is not allowed to change the position when the needles are retained. The needling area shall in no case be impacted or pressed by an external force. 3.2.4. Broken needle Cause: This may arise from the poor quality of the needle or eroded base of the needle, from too strong manipulation of the needle, from strong muscle spasm, or a sudden movement of the patient when the needle is in place, or from withdrawing a stuck needle. Manifestations: The needle body is broken during manipulation and the broken part is below the skin surface. Management: When it happens, the patient should be asked to keep calm and remain unmoved so as to prevent the broken needle from going deeper into the body. If the broken part protrudes from the skin, remove it with forceps or fingers. If the broken part is at the same level of the skin, press the tissue around the needle until the broken end is exposed, then remove it. If it is completely under the skin, surgery should be resorted to. Prevention: To prevent accidents, careful inspection of the quality of the needle should be made prior to the treatment to reject the needles which are not in conformity with the requirements specified. The needle body should not be inserted completely into the body and a little part should be exposed outside the skin. On needle insertion, if it is bent, the needle should be withdrawn immediately. Never try to insert a needle with too much force. 3.2.5. Hematoma Cause: This may result from injury of the blood vessels during insertion, or from absent pressing of the point after withdrawing the needle. Manifestations: Local swelling, distension and pain after withdrawal of the needle. Management: Generally, a mild hematoma will disappear by itself. If the local swelling and pain are serious, apply local pressing, or light massage, or warming moxibustion to help disperse the hematoma. Prevention: Avoid injuring the blood vessels. 3.2.6. After-effect Cause: It is mostly due to the unskilled manipulation and fierce stimulation. Manifestations: After withdrawal of the needle, there may remain an uncomfortable feeling of soreness and pain, which may persist for a long period. Management: For the mild cases, press the local area, and for severe cases, in addition to pressing, moxibustion is applied to the local area. Prevention: Fierce manipulation shall in no case be applied. Lecture 2. Moxibustion

1. The Concept of Moxibustion Moxibustion is a commonly-used method of treatment in TCM, which is usually combined with acupuncture in clinical practice. It is said: When a disease fails to be respond to medication and acupuncture, moxibustion is suggested.To do moxibustion, the moxa wool, which is made into a cone or a stick, is used as the chief material. Moxa wool is burned in a specially made container on or above the points or certain loci of the body. In this way, the meridians are warmed and dredged, the circulation of Qi and blood promoted, the patient's resistance to diseases strengthened and the invading pathogenic factors dispelled. Generally speaking, moxibustion is used to treat the diseases of cold and deficiency type. 2. The Actions of Moxibustion 2.1. Warm and dredge the meridians, promote the circulation of Qi and blood, and expel cold and dampness. It can be used for arthralgia due to wind, cold, and dampness; vertigo, anemia and amenorrhea due to deficiency of Qi and blood; and the syndromes of deficiency of Yang. 2.2. Warm the middle energizer, recuperate the depleted Yang and relieve collapse. It is effective for such manifestations as profuse perspiration, cold limbs and faint pulse caused by the collapse of Yang-Qi; and it is also effective for protracted diarrhea and dysentery, prolapse of anus, metrorrhagia, prolapse of anus and enuresis. In addition, moxibustion performed with the assistance of ginger is effective for vomiting, diarrhea and abdominal pain of the cold-deficiency type, while that with the aconite helps warm the kidney and strengthen Yang so is effective for seminal emission and impotence. 2.3. Remove blood stasis and dissipate masses. It is indicated for mastitis, furuncles, scrofula and cellulitis. 2.4. Prevent diseases and keep healthy. Burning a moxa stick on Dazhui (DU 14), Guanyuan( RN 4), Gaohuang(BL43) and Zusanli (ST 36) regularly can enhance the patient's resistance, prevent diseases and keep healthy. 3. The Classification of Moxibustion From the ancient times until now rich clinical experience has been gained in the moxibustion therapy. At first only the moxa cones were used. But now various approaches have been developed and used clinically, i.e. moxibustion with moxa cones, with moxa sticks, and with warming needle. 3.1. Moxibustion with moxa cones Moxibustion with moxa cones is divided into the direct one and the indirect one. The direct moxibustion is performed by placing a moxa cone directly on the skin and ignite it, while the indirect one is made by placing a moxa cone indirectly on the skin, insulated with different assisting materials, such as ginger, salt and garlic, etc. 3.1.1. Direct moxibustion A moxa cone placed directly on the point and ignited is called direct moxibustion, and is also known as open moxibustion,which was widely used in the ancient times with satisfactory therapeutic effect. This type of moxibustion is subdivided into the scarring moxibustion and the non-scarring moxibustion according to whether the local scar is formed or not after moxibustion. a) Scarring moxibustion (also known as festering moxibustion: Prior to moxibustion, apply some onion or garlic juice to the site in order to make an easy adhesion of the moxa cone to the skin, then put the moxa cone on the point and ignite it until it completely burns out. Repeat this procedure for burning five or ten moxa cones. This method may lead to a local burn, blister, festering and scar after healing. Indications are certain chronic diseases such as asthma. b) Non-scarring moxibustion: A moxa cone is placed on a point and ignited. When half or two thirds of it is burnt or the patient

feels discomfort from the burning, remove it and renew the cone. No blister should be formed and there should be no festering and scarring. Indications are diseases of chronic, deficient and cold nature such as asthma, chronic diarrhea, indigestion, etc. 3.1.2. Indirect moxibustion The ignited moxa cone does not rest on the skin directly but is insulated from the skin by one of the following four types of materials. a). Moxibustion with ginger Cut a slice of ginger about 0.5 cm thick, punch numerous holes on it and place it on the point selected. On top of it, a large moxa cone is placed and ignited. When the patient feels it scorching, remove it and renew the cone. This method is indicated in symptoms caused by weakness of the stomach and spleen such as diarrhea, abdominal pain, painful joints and other symptoms due to Yang deficiency. b) Moxibustion with garlic Cut a slice of garlic about 0.5 cm thick (a large single clove of garlic more is desirable), punch holes in it, put it on the selected point with the ignited moxa cone above. Renew the cone when the patient feels it scorching. This method is indicated in scrofula, tuberculosis, the early stage of skin ulcer with boils, poisonous insect bite, etc. c) Moxibustion with salt This is usually applied at the umbilicus, so it is also called moxibustion at Shenque point.Fill the umbilicus with salt to the level of the skin, place a large moxa cone on the top of salt and then ignite it. (If the patient's umbilicus is not concave in shape, a piece of wet noodle can be put around the umbilicus then fill salt in it. The moxa cone can be placed and ignited on the top of the salt.) This method is effective in cases of abdominal pain, vomiting and diarrhea, pain around the umbilicus, pain caused by hernia, prolonged dysentery, etc. In addition, moxibustion with salt has the function to restore Yang from collapse, e.g. symptoms of excessive sweating, cold limbs and impalpable pulse. Large moxa cones must be used successively until sweating stops, pulse restores and the four extremities get warm. d) Moxibustion with monkshood cake A coin-sized cake made of monkshood powder mixed with alcohol is punched with numerous holes in it, and placed on the site of the moxibustion with the moxa cone ignited and burnt on the top of it. Since it is of heat nature, the monkshood may warm Yang and expel cold. This method is only suitable to treat deficient syndromes, such as impotence and ejaculatio precox caused by declination of the Mingmen (Vital Gate) fire. 3.2. Moxibustion with moxa sticks Apply a lighted moxa stick over the selected point. It is easy to control the heat and the length of the moxibustion, and the therapeutic effect is good, so it is often used nowadays. This method includes two kinds: mild-warm moxibustion and sparrow-pecking moxibustion. 3.2.1. Mild-warm moxibustion Apply an ignited moxa stick over the point to bring mild warmth to the local area for five to ten minutes until the local area is red. 3.2.2. Sparrow-pecking, moxibustionbr />When this method is applied, the ignited moxa stick is rapidly pecked over the point, paying attention not to burning the skin. In addition, the ignited moxa stick may be evenly moved from left to right or in circular movement. 3.2.3. Moxibustion with warming needle Moxibustion with warming needle is a combining method of acupuncture with moxibustion, and is used for conditions in which both the retaining of the needle and moxibustion are needed. The manipulation is as follows: After the arrival of Qi and with the needle retained in the point, wrap the needle handle with a unit of moxa wool and ignite it to cause a mild heat sensation around the point. This method

functions to warm the meridians and promotes the free flow of Qi and blood so as to treat painful joints caused by cold-damp, numbness with cold sensation and paralysis. 4. The Application of Moxibustion 4.l. The process and dosage for moxibustion The Precious Prescriptionspoints out that Moxibustion is generally applied to Yang portion first, then Yin portion; clinically it is applied to the upper part first and then the lower part.Treat the back first, the abdominal region second; the head and body first and the four extremities second. But the sequence should be given according to the pathological conditions. The dosage of moxibustion, including the size of moxa cone or duration of the moxa stick application should be in parallel to the patients' pathological conditions, general constitution, age and the loci where moxibustion is to be applied. Generally, three to seven moxa cones are used for each point, and ten to fifteen minutes for the application of moxa stick. 4.2. The contraindications of moxibustion a) Both excess and heat syndromes (including high fever caused by common cold or heat due to Yin deficiency, etc) are not indicated to the treatment with moxibustion. b) Scarring moxibustion should not be applied to the face and head, and the area in the vicinity of the large blood vessels. According to the recordings of ancient literatures, there are certain points which are advisable to acupuncture but not suitable for moxibustion, because most of them are close to the vital organs or arteries. Examples are Jingming (BL l), which close to the eyeball, and Renying (ST 9), above a large artery. c) Moxibustion is not allowed to done on the abdominal and lumbosacral regions of the pregnant women. 4.3. Management after moxibustion After moxibustion, different degrees of burns may remain in the local region, or there is only a slight red sign of burning, which will disappear soon. But sometimes, a few blisters result on the skin surface. Take care not to let small blisters break, they can be healed by themselves. Large blisters should be punctured and drained. If pus is formed, the blister should be dressed to prevent further infection.

Acupuncture Facts
tutor posted on June 18, 2009 17:38 Acupuncture Facts
California State Oriental Medicine Association What is Acupuncture? The intent of acupuncture therapy is to promote health and alleviate pain and suffering. The method by which this is accomplished, though it may seem strange and mysterious to many, has been time tested over thousands of years and continues to be validated today. The perspective from which an acupuncturist views health and sickness hinges on concepts of "vital energy," "energetic balance" and "energetic imbalance." Just as the Western medical doctor monitors the blood flowing through blood vessels and the messages traveling via the nervous system, the acupuncturist assesses the flow and distribution of this "vital energy" within its pathways, known as "meridians and channels". The acupuncturist is able to influence health and sickness by stimulating certain areas along these "meridians". Traditionally these areas or "acupoints" were stimulated by fine, slender needles. Today, many additional forms of stimulation are incorporated, including herbs, electricity, magnets and lasers.

Still, the aim remains the same - adjust the "vital energy" so the proper amount reaches the proper place at the proper time. This helps your body heal itself. Acupuncture is just one form of therapy used within the coherent system of healing known as Oriental Medicine. Oriental Medicine includes herbology, physical therapy, dietetics and special exercises (such as Tai Chi and Qi Gong), and is a complete medical system unto itself and is not another branch of modern Western medicine. Acupuncture evolved from principles and philosophies unique to Oriental thinking and Oriental Medicine, and is most effectively applied when done in accordance with those principles. What is the history? Most experts would say that acupuncture is at least 2000 years old. The exact age is less important than the fact that Oriental Medicine is the most widely utilized healing system on this planet. Its roots are in China, but the fruits of its potential to help the sick and injured are apparent in many places, including all of Asia, Europe and America. Today, the art and science of Acupuncture / Oriental Medicine is still not understood by many, yet it continues to gain popularity and acceptance because of one fact - IT WORKS. How does acupuncture work? For millennia, the acupuncturist has been engaging subtle human energies, otherwise known as "Qi". According to time-tested principles unique to Oriental Medicine, the acupuncturist would assess and adjust the flow and distribution of "Qi" in order to promote health and healing. So far, modern research has described various physiological shifts following acupuncture, such as beneficial changes in the body's own natural painkillers, anti-inflammatory agents, immune system functions and hormonal activity. Despite the powerful technology available today, even the modern physicists cannot explain exactly how this ancient healing therapy works. Perhaps in the near future, the actual chemical and electromagnetic events that occur during acupuncture will be described. Why use Acupuncture and Oriental Medicine? In addition to being effective for many acute and chronic common illnesses, Oriental Medicine has much to offer those who wish to raise the quality of health and vitality. Practitioners of Oriental Medicine operate with prevention in mind, attempting to correct small energetic imbalances before they become big health problems. Current health trends emphasizing exercise, proper nutrition, stress reduction and immune system strengthening all validate the life-styles and methods that have always been promoted by practitioners and advocates of Acupuncture / Oriental Medicine. Are there side effects? When performed by a properly trained and licensed practitioner, acupuncture is safe and effective, free fromadverse or addictive side effects. Quite often, a sense of relaxation and well-being occurs during and after treatments. While undergoing therapy for one ailment, other problems may resolve concurrently. This is a common side benefit that again demonstrates the value of balancing the quality and quantity of "vital energy" within the entire person. What are the limits of Oriental Medicine and Acupuncture? Oriental Medicine and acupuncture are powerful healing tools, but they are not panaceas nor the solution to every health care problem. Both Western and Oriental Medicine have their respective strengths and weaknesses, which is why in modern China, the two systems are used together. When appropriately combined, the patient is well served.

Generally speaking, acute, life threatening conditions are best handled by Western medical doctors. Routine health problems and chronic conditions, for which drug therapy and surgery have not been effective, often benefit from Acupuncture / Oriental Medicine. How do I choose an acupuncturist? For over 12 years, the Medical Board of California has been licensing acupuncturists. At present, one is allowed to practice only after successfully completing four years of training at an approved college of Oriental Medicine, and passing a rigorous written and practical exam given by the California Acupuncture Committee. The title "Licensed Acupuncturist" or "L.Ac." means that these criteria have been met. Always look for a copy of the license, which should be clearly displayed in the practitioner's office. Organizations such as the California Acupuncture & Oriental Medicine Association can help you locate a qualified practitioner. Call them at: (800) 477-4564 to find the name of a licensed CAA member in your area. What should I ask the practitioner I'm considering? Always ask any practitioner about the extent of his or her training. Have them explain the differences between Oriental Medicine and Western Medicine in language that you can understand. Oriental medicine has its limitations just as Western Medicine does. Look for practitioners who know their limitations and have referral networks to take care of your health in ways they cannot. Ask them about previous experience with conditions similar to your own. Although it is difficult to forecast response to treatments, ask about the signs and changes that the practitioner looks for to confirm that treatments are progressing well. Inquire about what therapies will be used and why. Practitioners should be able to explain any procedure they perform. What does the examination/consultation involve? An exam/consultation includes what you tell the practitioner about your medical history and what your body says: The appearance of the face and body build, the shape and color of the tongue, the quality of the pulses, the feel of diagnostic areas such as the abdomen and back. An acupuncturist may test for weaknesses along the "meridians" and weaknesses in the muscles. Sometimes devices that measure electrical activity of acupoints may be used. How long is the visit? Usually the first visit is the longest in order to allow for a complete history taking and exam - typically an hour. Follow-up visits are shorter, usually 15 to 45 minutes, depending on practitioner and patient needs. Sometimes other therapies, such as moxabustion, acupressure/massage and exercises are incorporated with the acupuncture treatment. Don't the needles hurt? Most people who have had acupuncture would describe it as virtually painless or far less painful than plucking out a hair. The sensations that follow range from nothing at all, to mild tingling, to slight numbness/achiness, to electrical pulsations in areas distant from the site of insertion. All these sensations usually subside once the needles are removed. The needles used for acupuncture are much smaller that the standard hypodermic needle, do not draw blood and are solid, not hollow. What is treatment like? Most patients would say, "relaxing." Usually patients leave in less discomfort and are more functional than when they walked in. Sometimes the effects are too subtle to perceive, especially in the beginning of treatment. Yet after 5 to 10 treatments the improvements become more and more apparent. Is it safe?

If performed by a qualified, conscientious practitioner, yes. Licensed Acupuncturists know the human anatomy well, and insert needles in a safe fashion. The instruments used to penetrate the skin are either pre-sterilized and disposable after a single use, or disinfected and sterilized in an autoclave, as surgical and dental instruments are, after each use. The practitioner is well aware of the concern over infectious diseases, and takes every measure to insure cleanliness as all health care professional do. Bleeding rarely occurs, unless done so on purpose in specific situations. Even then the amount is minimal and in no way dangerous. What services can a practitioner of Oriental Medicine/Acupuncture provide? Acupuncture, Acupressure/Massage, Therapeutic Exercises, Herbal Medicine, Diet therapy, Breathing Exercises, Referrals, Oriental Medical Diagnosis.

Acupuncture----Stomach meridian
host posted on May 15, 2009 11:01

Acupuncture----Large intestine meridian

host posted on May 15, 2009 11:00

Acupuncture--Lung meridain
host posted on May 15, 2009 10:57