Classifications:
Front Mu of the Lung
Entry point from
Qimen Liv-14Front Shu of the Breast
Opening point of the Lung Divergent channel (Cecil-Sterman, 2012,
Advanced Acupuncture)
One of the "59 piercings" for clearing Heat in
Su Wen Ch. 61
Trigger point (Travell & Simons, 1998,
Trigger Point Therapy)
Meetings:
Meeting of Lung with Spleen, Large Intestine Divergent and Lung Divergent
Location:
On the lateral aspect of the chest, in the first intercostal space, 6 cun lateral to the midline, 1 cun inferior to Yunmen LU-2
Needling:
Transverse-oblique insertion 0.5 - 1 cun medially along the the intercostal space
Warnings:
Deep perpendicular needling or oblique insertion carries a substantial risk of causing a pneumothorax
Classical Needling:
Locate it with (the patient) lying supine. It is needled to a depth of three fen, (the needle) is retained for a duration of five exhalations, and it is moxaed with five cones. (Huangfu Mi 皇甫謐, 3rd Century,
Zhenjiu Jiayi Jing 針灸甲乙經)
TCM Actions:
Disseminates and descends Lung Qi and alleviates cough and wheezing
Transforms Phlegm, clears Heat and regulates the water passages
Descends Stomach Qi
TCM Indications:
- Cough, coughing turbid phlegm, coughing blood and pus, dyspnoea, wheezing, asthma, fullness of the chest, chest pain, breathing with raised shoulders, oppression of the chest and difficulty in breathing, diminshed qi with inability to lie down.
- Heat in the chest, aversion to cold, chills and fever, sweating.
- Throat Painful Obstruction (喉痹, Hou Bi), nasal congestion, swelling of the face.
- Difficult ingestion, vomiting, gall bladder heat vomiting, retching, abdominal distension.
- Skin pain, Running Piglet Qi (奔豚氣, Ben Tun Qi) with lumbar pain, goitre, pain of the upper back and shoulder.
Neuroanatomy:
Superficial Innervation: Lateral cutaneous branch of C3 - C4
Dermatome Segment: C4, T2
Trigger Point Associations:
Muscle:
Coracobrachialis and clavicular section of perctoralis major
Myotome Innervation:
Coracobrachialis: musculocutaneous nerve from anterior middle and upper divisions of brachial plexus (C5 - C7); pectoralis major: lateral pectoral nerve (C5 - C7)
Location Notes:
Travell & Simons' (1998) diagram shows this point slightly lateral at the base of delto-pectoral triangle, directing the needle lateral into the shoulder
Pain Referral Pattern:
To anterior shoulder and if coracobrachialis, down posterior and dorsal aspects of the arm and hand
Indications:
Upper limb pain, especially in the front of the shoulder and the posterior of the arm for coracobrachialis
; Intrascaupular and sternocleidomastoid pain and limited horizontal abduction of the arm
Martial Applications & Effects of Injury:
Listed in the
Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621), Article 9: Twelve-Hour (
Shichen 時辰) Vital Points Revealed as the vital point associated with the
Yin 寅 Tiger (3 - 5 am) and the Lung meridian (McCarthy, 2016,
Bubishi: The Classic Manual of Combat).
Struck with a smaller weapon such as a one-knuckle punch, this point causes great Qi drainage and thus great local pain which will slowly spread over the whole chest area due to this point's connection to SP 21. A strike here will hinder the progress of
Gu Qi causing a long term effect hindering nourishment to the body causing health and lifestyle to become slowly diminished (Montaigue,
Dim Mak Locations,
Taijiworld.com).
Major Combinations:
- Pathogens in the Lung:
Zhongfu Lu-1 with Yunmen Lu-2, Feishu Bl-13 and either Qupen St-12 or Tiantu Ren-22 (depending on how the location "in the middle of the Broken Basin" is interpreted)
(Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot, Ch. 20, On the Five Evils).
- Heat in the chest:
Zhongfu Lu-1 with Dazhu Bl-11, Qupen St-12 and Feishu Bl-13
(Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot Ch. 23, On Heat Diseases).
- Fullness of the chest with oesophageal constriction:
Zhongfu Lu-1 with Yishe Bl-49
(Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
- Chest pain:
Zhongfu Lu-1 with Yunmen Lu-2, Feishu Bl-13, Qimen Liv-14, Yinbai Sp-1, Hunmen Bl-47 and Daling Pc-7
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Swelling of the face and abdomen:
Zhongfu Lu-1 with Jianshi Pc-5 and Hegu LI-4
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Enuresis:
Zhongfu Lu-1 with Guanmen St-22 and Shenmen He-7
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Abdominal fullness, shortness of breath with a rattling sound:
Moxa on Zhongfu Lu-1, Shanzhong Ren-17 and Shenque Ren-8
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Difficult ingestion:
Zhongfu Lu-1 with Kunlun Bl-60, Chengman St-20, Yuji Lu-10 and Zhourong Sp-20
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
- Oesophageal constriction with difficult ingestion and vomiting:
Zhongfu Lu-1 with Zhongting Ren-16
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Throat Painful Obstruction:
Zhongmen Lu-1 with Yunmen Lu-2, Jianyu LI-15, Weizhong Bl-40, Fuliu Kid-7 and Fubai GB-10
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
I Ching Hexagram: ䷒
Hexagram attributions are my own based with an explanation given in the notes below.
Notes:
The "59 piercings" are named in the
Su Wen Ch. 61 and mentioned in
Su Wen Ch. 32 and
Ling Shu Ch. 23 for treating Heat diseases.
One of the twelve
Shu points of the breast mentioned in the
Su Wen Ch. 58 and identified by Wang Bing.
If the
Shu points of the Breast have elemental organ associations like the
Shu points of the Chest, then this imagery of a mansion or administrative centre, as contrasted against the villagers of
Xiongxiang Sp-19, would suggest this is the point of the Heart. If the theory is correct that these relate to the formation of bodily Qi from food and drink, then this point is where the
Kong Qi from the air and the
Gu Qi from food merge to become
Zong Qi, one of whose functions is to provide warmth, a function of the Fire element. In the formation of Blood, this connection to the Heart would allow the Blood that has gathered for circulation at
Zhourong Sp-20 to become infused with
Shen.
The imagery of an administrative centre or official residence, as opposed to a genuine imperial palace (宮
Gong), suggests Ministerial Fire rather than Sovereign Fire due to the relatively humble survival function of the Breast
Shu points.
The outer line of Tung's 12 Monkeys (Shi Er Hou) would be located slightly medial (5 fen) to this point.
The Front Mu points make likely locations for application of leeches to reduce fevers according to François Broussais' (1772-1838) philosophy who believed in placing them over the diseased organs to reduce inflammation (Greenstone, 2010,
The history of bloodletting, BCMJ, Vol. 52, No. 1, Pp 12-14).
In the case of the lung however any number of chest points could suffice.
Lad and Durve (2008) in
Marma Points of Ayurveda call this point
Kakshadhara or
Skandadhara and associate it with the
doshas: Prana Vayu, Vyana Vayu, Udana Vayu, Sadhaka Pitta, Ranjaka Pitta and Avalambaka Kapha.
They give the following functions:
- Enhances lung capacity and flow of prana
- Relieves tightness in chest and bronchospasm
- Relieves pulmonary congestion
- Relieves shoulder and arm pain
- Pacifies aches and soreness in breasts
In Thai massage:
Acupressure point (Salguero & Roylance, 2011,
Encyclopedia of Thai Massage)
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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