: Lidui : Strict Exchange

St-45 : Foot Yangming Stomach 45

Classifications:

Jing-Well and Metal point
Child point of the Stomach channel


Location:

On the dorsal aspect of the second toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, approximately 0.1 cun from the corner of the nail.

Needling:

Perpendicular or oblique insertion directed proximally 0.1 to 0.2 cun, or prick to bleed.

Classical Needling:

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


TCM Actions:

Clears Heat from the Stomach channel
Clears Heat, calms the Shen and restores consciousness.

TCM Indications:

  • Swelling of the face, heat in the head, nosebleed, yellow nasal discharge, rhinitis with nosebleed, toothache, lockjaw, Throat Painful Obstruction (喉痹, Hou Bi), cracked lips, deviation of the mouth.
  • Fullness and distension of the chest and abdomen, excessive hunger, lack of appetite, inversion counterflow, Malarial (瘧, Nue) Disorders, febrile disease, febrile disease with absence of sweating, yellow urine, jaundice.
  • Loss of consciousness.
  • Excessive dreaming, easily frightened with desire to sleep, insomnia, dizziness, Mania-Withdrawal (癲狂, Dian Kuang), desires to ascend to high places and sing, discards clothing and runs around.
  • Sensation of cold int he shin, cold of the lower limbs and feet, swelling and pain of the knee.

Neuroanatomy:

Superficial Innervation: Superficial peroneal nerve from L4 - S1
Dermatome Segment: L5


Martial Applications & Effects of Injury:

As a Metal and Jing-Well point it has a great affect upon the muscles and tendons, so it can be used as a set up point for a joint lock where the tendons and muscles are being attacked. It will
cause mind confusion and has been known to cause the nose to bleed
profusely (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:



I Ching Hexagram:

Shared with Shangqiu Sp-5. Balanced by (Quchi LI-11 or Taiyaun Lu-9).

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



Notes:

In five element acupuncture this point is reduced to drain excess in the Stomach.



Ling Shu Ch. 19, on the Four Seasonal Qi, advises opening the Jing-Well and Ying-Spring openings in winter, piercing deeply and retaining the needle for a while.

Ling Shu Ch. 22, On Mania and Madness, advises that when Wind invasion and counterflow causes the limbs to become swollen, profuse sweating, a feeling of cold and to be irritated when hungry, then blood is removed from the outer and inner sections of the hand Taiyin and foot Shaoyin and Yangming. If the flesh is cool then it is be done through the Ying-Spring points and if the bones are cold it is to be done through the Jing-Well and Jing-River points.

Ling Shu Ch. 52, On the Wei Qi, considers this to be the root of the foot Yangming meridian with the tip being at Renying St-9.



In Maoshan Daoism the character for Jing 井 is used to trap disease, ghosts and demons. It is drawn in the air invoking the "three mountains" mudra (index, middle and ring finger extended) with the bent line continuing in a circle (usually clockwise), or with ash and sprayed on with water held in the mouth, and sometimes on talismans (Read, 2020, FB Post, 1 Sep 2020). This may explain why the Jing-Well points are so often used to expel pathogens.



In Tibetan medicine:
Moxa point (AMNH, Tibetan Medical Paintings)

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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