上巨虛 : Shangjuxu : Upper Great Void

Location Guides:

Classifications:

Lower He-Sea point of the Large Intestine
Point of the Sea of Blood
One of the "59 piercings" for clearing Heat in Su Wen Ch. 61

Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977)

Location:

On the lower leg, 3 cun inferior to Zusanli St-36, one fingerbreadth lateral to the anterior crest of the tibia

Needling:

Perpendicular or oblique insertion 1 - 1.5 cun

Classical Needling:

"The Yangming usually has much Qi and much Blood" (Su Wen 素問 ch. 24) implying this channel can normally be needled or bled.
"The foot Yangming is to be pierced 6 fen deep and remain inserted for ten exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of eight fen and is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Reuglates the Intestines and transforms stagnation
Clears Damp Heat and alleviates diarrhoea and dysenteric disorder
Regulates the Spleen and Stomach
Activates the channel and alleviates pain

TCM Indications:

• Borborygmus, diarrhoea, diarrhoea containing undigested food, diarrhoea due to attack of cold in the winter, Dysenteric Disorder (痢疾, Li Ji), heat in the Large Intestine, cold of the Large Intestine, deficiency of the Large Intestine qi, intestinal abscess, cutting pain of the intestines, constipation, abdominal pain, abdominal distension, periumbilical pain with inability to stand for long, dark urine.
  
• Heat in the Stomach, deficiency and weakness of the Spleen and Stomach, insufficiency of zang qi, consumption, shortness of breath, dyspnoea with difficulty in walking, qi rushes up to the chest, fullness of the chest and lateral costal region, swelling of the face.
  
• Mania, aversion to the sound of people talking.
  
• Hemiplegia, Leg Qi (腳氣, Jiao Qi), numbness and Painful Obstruction (痹, Bi) of the lower limb, coldness and pain of the bone marrow, weakness of the lower leg, contraction and pain of the front of the shin, swelling of the knee.

Neuroanatomy:

Superficial Innervation: Lateral femoral cutaneous nerve of the calf (L4 - S1)

Dermatome Segment: L5

Deeper Structures: Common fibular (peroneal) nerve (L4 - S1)

Trigger Point Associations:

Muscle:
Extensor digitorum longus

Pain Referral Pattern:
On the lateral anterior aspect of the lower half of the lower leg and ankle, and concentrating on the lateral aspect of the dorsum of the foot, possibly extending to the 4 lateral toes.

Indications:
Strain of toe extensors

Martial Applications & Effects of Injury:

Besides obvious immediate pain and Qi drainage, striking this point damages the colon function and can cause defecation immediately if struck hard enough. It will also drag too much Qi into the legs causing an imbalance in the whole system. This strike will also have an adverse affect on the flow of Wei Qi reducing our resistance to External Pathogenic invasion (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Yellow and difficult urination:
    Shangjuxu St-37 with and Xiajuxu St-39
    (Supplementing Classic).
  
  
• Bacillary dysentery:
    Shangjuxu St-37 with Tianshu St-25 and Quchi LI-11 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).

Notes:

This point is also on the 5th trajectory of the Chong mai relating to digestive functions (Yuen, 2005, The Extraordinary Vessels).

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. This point along with Qichong St-30, Zusanli St-36 and Xiajuxu St-39 clear Heat from the stomach.

Ling Shu Ch. 19, on the Four Seasonal Qi, recommends this point for disease in the Large Intestine with borborygmus and rushing against the chest, use this hole, Zusanli St-36 and either the diaphragm (Unschuld, 2016) or Qihai Ren-6 (Wu & Wu, 2010)

Ling Shu Ch. 33, On the Four Seas, says the Chong Mai is the Sea of the 12 Meridians with its upper Shu-transport point at Dazhu Bl-11 point and lower Shu transport points at this point and Xiajuxu St-39.

In Tung acupuncture the Si Hua Zhong (77.09), Center Four Flowers, point is located in between this point and Xiajuxu St-39, 4.5 cun below Si Hua Shang (77.08) at Zusanli St-36, at the border of the tibia instead of one fingerbreadth lateral. It is indicated for problems of the Stomach channel including respiratory, cardiac and digestive illness as well as pain (Chu, 2015).

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