: Dazhong : Great Bell

Kid-4 : Foot Shaoyin Kidney 4

Classifications:

Luo-Connecting point
Binding point of the foot Shaoyin Sinews


Location:

Approximately 0.5 cun posterior to the midpoint of the line drawn between Taixi Kid-3 and Shuiquan Kid-5, on the anterior border of the Achilles tendon

Needling:

Oblique-perpendicular insertion directed anteriorly 0.5 cun

Classical Needling:

It is needled to a depth of two fen, (the needle) is retained for a duration of seven exhalations, and it is moxaed with three cones. (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經)


TCM Actions:

Reinforces the Kidneys
Anchors the Qi and benefits the Lung
Strengthens the will and dispels fear

TCM Indications:

  • Coughing blood, dyspnoea due to diminished qi, asthma, wheezing, rattling sound in the throat, cough, shortness of breath, distension and oppression of the chest and abdomen, vomiting.
  • Heat in the mouth, dry tongue, painful throat with difficulty swallowing.
  • Palpitations, agitation of the Heart with fullness and vomiting, agitation, dementia, mental retardation, somnolence, propensity to anger, fright, fear and unhappiness, desire to close the door and remain at home.
  • Constipation with distended abdomen, difficult urination, dribbling and retention of urine, Malarial (瘧, Nue) Disorders with much cold and little heat, irregular menstruation.
  • Stiffness and pain of the lumbar region, pain and swelling of the heel.

Neuroanatomy:

Superficial Innervation: Medial calcaneal branches of tibial nerve (S1 - S2)
Dermatome Segment: S1


Martial Applications & Effects of Injury:

Can be a target for disabling an opponent with a sword or knife by severing the Achilles tendon and possibly causing large amounts of bleeding from the posterior tibial artery. Its location makes it most likely to be struck on an already immobilised opponent and was most often used as a punishment on a captive.

Impedes the flow of Yang Qi throughout the body causing instant weakness and feeling of fullness in the head like it will explode (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

  • Heat in the mouth:
    Dazhong Kid-4 with Shaochong He-9
      (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

  • Fright and fear of people, Shen Qi insufficient:
    Dazhong Kid-4 with Tongli He-5
      (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).

  • Somnolence:
    Dazhong Kid-4 with Taixi Kid-3, Shouwuli LI-13, Zhaohai Kid-6 and Erjian LI-2
      (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

  • Agitation of the Heart with fullness and vomiting:
    Dazhong Kid-4 with Taixi Kid-3
      (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

  • Difficulty in defecation:
    Dazhong Kid-4 with Shiguan Kid-18
      (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

  • Difficulty in defecation:
    Dazhong Kid-4 with Taixi Kid-3, Zhongliao Bl-33, Chengshan Bl-57, Chengjin Bl-56, Taichong Liv-3, Zhongwan Ren-12 and Guanyuan Ren-4
      (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

  • Emotional disturbance at the Yuan level (subconscious repression):
    Dazhong Kid-4 with Waiguan SJ-5, plus moxa on the Yin Source point and bleed the Yang Luo point related to the emotion involved
      (Yuen, 2004, The Luo Vessels, see notes below).


I Ching Hexagram:

Hexagram attributions are my own based with an explanation given in the notes below.



Notes:

Ling Shu Ch. 10, On Channels, describes the diseases relating to the Luo emanating from this point as:
Repletion: Closure with protuberance-illness (prostate hypertrophy)
Depletion: Lower back aches
(Unschuld, 2016).

Ling Shu Ch. 19, On the Four Seasonal Qi, advises using the channels and Luo vessels for diseases which occur in spring. They are pierced deeply if severe and more shallow if mild. For the other seasons:
- in summer choose the Yang channels and Luo located in the partings between the skin and flesh
- in autumn choose the Shu-Stream points unless the disease in the Fu organs, then use the He-Sea points
- in winter choose Jing-Well and Ying-Spring opening and retain the needle.

Ling Shu Ch. 21, On Cold and Heat Diseases, repeats the advice to use Luo in spring but and adds that they can also treat diseases of the skin.

For the other seasons it differs slightly from Ch. 19:
- in summer choose the partings in skin structures which also treat the muscle and flesh
- in autumn Taiyuan Lu-9 is chosen and can treat the sinews and vessels (this may also apply to other Shu-Stream points for this purpose, text is unclear)
- in winter one chooses the main channel points which also treat the bones and marrow.

The same chapter also says that if it is the bones which feel cold and heat sensations and the patient sweats ceaselessly it should be treated with the Foot Shaoyin Luo vessels on the inner thigh. If the teeth have dried up or the bones have ceasing Qi then no cure is possible.

Ling Shu Ch. 22, On Mania and Madness, advises that if the breath is shortened and brief and movement makes the Qi appear restrained then the foot Shaoyin channel is to be supplemented and the Luo are to be drained.

Ling Shu Ch. 26, On Miscellaneous Diseases, advises piercing the foot Shaoyin blood vessels in the hollow of the knee for lower back pain with heat in the centre and panting (probably Weizhong Bl-40 rather than here but this is the origin of the foot Shaoyin Luo).



Dazhong Kid-4 and Waiguan SJ-5 release emotions from the repressed (Yuan-Qi) level in Jeffrey Yuen's system of using the Luo to harmonise emotions.

The full protocol is to:
- Tonify the Yuan-Source point of the Yin meridian that relates to the emotional disposition being expressed.
- Bleed or plum blossom the Luo related to the level of expression (Waiguan SJ-5 and Dazhong Kid-4 in this example) in a figure 8 (e.g. Right arm -> Left leg -> Right leg -> Left arm) starting with the side with dominant symptoms. If unsure all levels can be released.
- Bleed or plum blossom the Luo of the Yang meridian connected to the Yuan-Source point tonified at the beginning (Yuen, 2004, The Luo Vessels lecture transcript, NESA; Chin, 2003, The Luo Vessels).

I think of it as tonifying the organ to bring the emotion up and then releasing it from the Luo via its transverse connection, like in a guest-host protocol, with the additional Luo being added to focus on the level of release.



鐘 translates as bell but has many connections to time, referring to bells that announce the passage of time. Bells were important ritual objects in Zhou and Han dynasty China (Landers, 2017), as were cycles of time. Much of classical medicine centres around maintaining harmony between the personal and cosmic temporal cycles suggesting that this point's name may have referred to the trajectory of the Luo which connects to the Heart, whose beating may have been compared to a ritual bell, keeping time during sacred ceremonies.

The etymology of 鐘 also reveals the characters 金 "gold" and 童 "child or servant boy". This may indicate that it was the role of a slave boy to keep time and strike the bells with a hammer at specific times. Clapperless bells were a feature of the Zhou and Han dynasties (The Met Museum, Six Niuzhong Bells).

----------------------------------------

There are no direct classical attributions of the points to I Ching hexagrams in the Nei Jing or other classical sources to my knowledge, but rather it is implied within the schema of the elements so the ones given are my own and a work in progress. Other sources may differ.

They are based on the channel having the outer trigram and the point having the inner as the point is internal to the channel itself.
  • Channels are assigned the trigram of their element and cardinal direction
  • Ren and Du are assigned ☰ Qian, Heaven and ☷ Kun, Earth respectively
  • Earth is assigned to ☶ Gen, Mountain
  • Pericardium and San Jiao are assigned to ☴ Xun, Wind
This places the regular channels associated with the four directions at their four cardinal points and means that every channel's complement is also its Six Division pair. It is almost identical to the I Ching Acupuncture arrangement by Dr Chen but with Shaoyang/Jueyin pairs reversed so that the Wood organs are in the cardinal east and Ministerial Fire is associated with Wind, as Wood turns to Fire.

The points themselves are arranged by:
  • Elemental points are assigned their element
  • Source points are attributed ☷ Kun, Earth, for Zang and ☰ Qian, Heaven, for Fu, as Yin and Yang are the Source of the Zang and Fu respectively
  • Luo points are attributed the opposite as they connect with their Yin-Yang opposite paired organ.
  • This leaves Xi-Cleft points which are assigned ☴ Xun, Wind, for their effect on acute disorders, with their complementary pairing being ☳ Zhen, Wood, the Jing-Well (Yin) and Shu-Stream point (Yang) which both deal with acute phases of disease.
  • Back-Shu and Front-Mu points are assigned Qian and Kun respectively on the top due to their close association with the Du and Ren and their organ element is placed at the bottom, making them naturally pair with each other, as in Su Wen, ch. 47 that suggests treating them together.
  • The gates of the Microcosmic Orbit on the Du and Ren follow the Waxing and Waning Hexagrams.
This enables them to be paired with points that share the same hexagram, their complementary opposite, or with its reverse which is the following or preceding hexagram in the King Wen sequence. Points can therefore be selected based on sharing a hexagram, their complementary opposite, or King Wen pairings in order to supplement or reduce a pathological state.

Reference Notes:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here