: Tiantu : Heavenly Prominence

Ren-22 : Extraordinary Conception Vessel 22

Alternative Name: Yuhu 玉戶
Translations: Jade Door
Location Guides:

Classifications:

Window of Heaven point
Master Tung's Metal Five

Meetings:

Meeting of Conception Vessel with Yin Wei Mai, Gall Bladder Divergent, Liver Divergent, Stomach Divergent, Spleen Divergent, Heart Divergent and Pericardium Divergent


Location:

On the midline, in the centre of the suprasternal fossa 0.5 cun superior to the suprasternal notch.

Needling:

Perpendicular insertion 0.3 cun, or with the neck extended (remove head pillow) needle first perpendicularly 0.2 - 0.3 cun, then direct the needle inferiorly along the posterior border of the manubrium of the sternum 0.5 - 1 cun.

Warnings:

This second method should not be attempted by practitioners without clinical experience under supervision.

Classical Needling:

Locate it with the (patient’s) head bent down. It is needled to a depth of one cun, (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:

Descends rebellious Qi and alleviates cough and wheezing
Benefits the throat and voice

TCM Indications:

  • Obstruction in the chest, fullness of the chest, obstruction of qi with Heart pain, pain of the Heart and back, rebellious qi with cough, asthma, sudden dyspnoea, inability to breathe, abscess of the Lung with purulent bloody coughing.
  • Rattling sound in the throat, accumulation of phlegm in the throat, Plumstone Qi, ulceration of the throat which prevents eating, swelling of the throat, cold sensation of the throat, dry throat, much spittle, Throat Painful Obstruction (喉痹, Hou Bi), cracked voice, inability, swelling of the neck, goitre.
  • Oesophageal constriction, vomiting, jaundice.
  • Purple-green veins beneath the tongue, nosebleed, heat sensation of the skin of the face, red face, swelling of the back of the neck and shoulder, chills and fever, heat sensation of the skin of the abdomen, urticaria, numbness of the flesh of the body.

Neuroanatomy:

Superficial Innervation: Transverse (superficial or cutaneous) cervical nerve (C2, C3)
Dermatome Segment: C3


Martial Applications & Effects of Injury:

In seizing martial arts (Qin Na) this point is a cavity press point (Dian Xue, 點穴) which can be struck with the thumb or Secret Sword technique causing sealing of the breath (Bi Qi, 閉氣) (Yang, 1995, Tai Chi Chin Na).

One of the 36 vital points of Feng Yiyuan 馮一元 listed in the Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621) (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

This is one of the eight non-striking or forbidden points in Northern Praying Mantis Kung Fu. Described as "The throat" by Olson (2010, The Complete Guide to Northern Praying Mantis Kung Fu) and "the windpipe" by Wong Honfan (1946; in Ravenswood Academy, 2020, The Eight Forbidden Strikes of Praying Mantis Fist).

See Montaigue, Dim Mak Locations, Taijiworld.com for explanation of effects.

Major Combinations:



Notes:

Important point for treating all Lung and throat disorders.



Ling Shu Ch. 2, The Roots of the Acupuncture Points, lists this point along with 9 others, with no indications for their use. This chapter later became the origin of the "Window of Heaven" points, although this name was not given until modern times.

Ling Shu Ch. 20, On the Five Evils, advises piercing either this point or Qupen St-12 (depending on how the location "in the middle of the Broken Basin" is interpreted) along with Zhongfu Lu-1, Yunmen Lu-2 and Feishu Bl-13 for pathogens in the Lung.

Ling Shu Ch. 59, On Abnormal Wei Qi, advises this point, Renying St-9 and Lianquan Ren-23 (referred to as Houzhong) to drain accumulations in the chest. If there are accumulations in the chest and abdomen then these three points are coupled with Qichong St-30 and Zusanli St-36 used for draining accumulations below and Zhangmen Liv-13 in the middle. In severe cases a "chicken claw" technique, using three needles positioned like the character 个 Ge, are to be used. If the pulse is large and wiry and the the abdomen is tense it must not be pierced.

Ling Shu Ch. 69, On Grief, Rage and Loss of Voice, advises removing Cold from this point if the patient has lost their voice.



In Tung's acupuncture this point is called Jin Gan and forms one of the Metal Five (Jin Wu), a series of five points that start at the upper border of the manubrium and descend at 1 cun intervals, approximately overlapping with Ren-18 to Ren-22. They are all indicated for difficultly breathing as well as their traditional indications for each point (McCann, 2014, Pricking the Vessels).



Jin's Three Needles for Protrusion are located at this point, Shuitu St-10 and Futu LI-18. They are indicated for goiter and thyroid nodules (eLotus, 2021).



In Mayan medicine:
Punctured quickly from above, below, left and right, then rubbed with deer fat to treat chronic asthma, cough and flu.
Sometimes combined with Xuanji Ren-21 to strengthen effect and Shufu Kid-27 to form a cross representing the 4 cardinal directions. May also be combined with a cross on the top of the head (Houding Du-19, Qianding Du-21 and Luoque Bl-8) or points between each of the ribs beside the sternum (Kid-22 to Kid-26) (Garcia, Sierra, Balam, 1999: Wind in the Blood).



In the Vedic tradition the Vishuddha Chakra would be located between this point and Dazhui Du-14.

In Ayurvedic medicine:
Lad and Durve (2008) in Marma Points of Ayurveda call this point Kanthanadi and associate it with the doshas: Prana Vayu, Udana Vayu, Vyana Vayu, Sadhaka Pitta and Avalambaka Kapha.

They give the following functions:
- Benefits lungs, pharynx, larynx, trachea
- Calms respiration, stimulates bronchodilation
- Benefits speech
- Regulates thyroid and parathyroid functions
- Improves metabolism
- Regulates cardiac functions
- Releases suppressed emotions



In Tibetan medicine:
Can be treated by burning cones of dried edelweiss flowers (Trah-wah) over crushed garlic at this point for hiccups, blockages of the throat and dislocation of the heart (Bradley, 2000: Principles of Tibetan Medicine).

Venesection point, called Thong Rtsa (Throat Vein) measured by finding the arcus venosus jugularis approx. 2 cun superior to the incisura jugularis (suprasternal notch). Its is indicated for:

- Tsha Ba (Heat) in the Heart
- Delusions and hallucinations
- Panic disorder
- Breathing problems
- Coughing
- Hoarse voice
- Pressure on the back, neck and shoulders

(Chenagtsang & Nguyen, 2017, Sowa Rigpa Points).

This point is also one of the "Six Wind Points" which can be stimulated with warmth from oils, hands, compresses or hot stones to treat disorders of Wind, seen in Tibetan medicine as problems of anxiety, insomnia, nervousness, mood swings, irritability, stiffness, memory loss, and trembling as well as discomfort and pain in the lower back, hips and joints. The other Wind Points are Dazhui Du-14, Baihui Du-20, Shanzhong Ren-17, Laogong Pc-8 and Yongquan Kid-1 (Tibet House US, https://tibethouse.us/stress-tibetan-medicine/, Accessed 18th May 2019).




In Thai massage:
Acupressure point along the Sumana sen line running from the navel Shenque Ren-8 to this point.
Indicated for asthma, breathing difficulties, hiccups, mouth disorders and respiratory ailments.
(Salguero & Roylance, 2011, Encyclopedia of Thai Massage).



In the Qabalah this point along with Xuanji Ren-21 would be the location of Chesed (Farrow, 2007, The Psychology of the Body). He also relates the other Window of Heaven points Renyin St-9, Futu LI-18, Tianrong SI-17 and Tianfu Lu-3 with Chesed.



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