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Acupuncture Points Notebook

Location Guides:

: Tianding : Heaven's Tripod

LI-17 : Hand Yangming Large Intestine 17

Classifications:
Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)

Location:
On the lateral side of the neck, 1 cun inferior to Futu L.I.-18, on the posterior border of the sternocleidomastoid muscle

Needling:
Perpendicular insertion 0.3 - 0.5 cun or oblique insertion 0.5 - 0.8 cun

Warning:
Deeper needling may puncture the carotid artery or jugular vein


TCM Actions:
Benefits the voice and throat

TCM Indications:
  • Sudden loss of voice, throat painful obstruction, rattling sound in the throat, goitre, scrofula, difficulty in breathing, difficult ingestion.

    Neuroanatomy:
    Superficial Innervation: C4 - C8 via cervical plexus
    Dermatome Segment: C3

    Trigger Point Associations:
    Muscle: Scalenus medius
    Myotome Innervation: Spinal nerves C4 - C6
    Pain Referral Pattern: To zones of the chest, along the medial aspect of the scapula, and all down the lateral aspect of the upper arm and radial side of the forearm to the dorsal aspect of the hand
    Indications: Pain in neck, shoulder and upper arm

    Notes:
    Avicenna describes cupping at this point in his treatise On Cupping:

    "Cupping on the two veins along the neck is second to venesection of the cephalic vein. Their cupping is beneficial in cases of head trembling and to the organs of the head, such as the face, teeth, ears, eyes, throat and nose... Cupping the veins of the neck may cause head trembling." (Aspects of Treatment According to General Diseases, 22nd section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine)

    Any point along the path of the jugular could be indicated by this point but the proximity of LI-18 to the carotid would make it even riskier than cupping the jugular alone. Given that Avicenna generally refers to wet cupping (Hijama) this would be a risky procedure anyway.

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    In ayurvedic medicine:
    Siramatrika marma point
    Size: 4 angula (cun)
    Structure: Blood vessels.
    Effect of Injury: Fatal (sadhyapranahat marma).
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

    Lad and Durve (2008) in Marma Points of Ayurveda locate Siramantha anterior to the this point on the anterior of the SCM and associate it with the doshas: Prana Vayu, Udana Vayu, Vyana Vayu, Ranajaka Pitta and Sadhaka Pitta.

    They give the following functions:
    - Regulates thyroid and parathyroid functions
    - Enhances cervical lymphatic circulation
    - Regulates blood pressure and cardiac functions
    - Relieves neck tension
    - Benefits pharynx and larynx


    Reference Notes: (click to display)