孔最 : Kongzui : Maximum Opening

Location Guides:

Classifications:

Xi-Cleft point

Location:

On the flexor aspect of the forearm, 7 cun proximal to Taiyuan LU-9, on the line connecting Taiyuan LU-9 with Chize LU-5

Needling:

Perpendicular or oblique insertion 0.5 - 1 cun

Classical Needling:

"The Taiyin usually has much Qi and little Blood" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The hand Yin and Yang receive their Qi via nearby paths so their Qi arrive swiftly. The depth of piercing must not exceed 2 fen and must not remain inserted for longer than one exhalation" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three fen deep and (the needle) is retained for a duration of three exhalations. 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
Clears Heat and moistens the Lung
Clears Heat and stops bleeding
Moderates acute conditions

TCM Indications:

• Cough, wheezing, asthma, chest pain, swelling and pain of the throat, loss of voice, febrile disease with absence of sweating.
  
• Coughing blood, spitting blood, vomiting blood, hiccup.
  
• Severe pain of the elbow and upper arm, inability to raise the arm above the head, difficulty in flexing and extending the fingers, epigastric pain, haemorrhoids, headache, clonic spasm.

I Ching Hexagram:

䷛ Da Guo 大過 Great Undertaking

Shared with Wenliu LI-7. Balanced by ䷚ (Xiangu St-43 or Yinbai Sp-1).

Hexagram attributions are my own with an explanation given in the glossary.

Neuroanatomy:

Superficial Innervation: Lateral cutaneous nerve of the forearm from C5 - C6

Dermatome Segment: C6

Martial Applications & Effects of Injury:

A slashing strike deeper that 2 inches to this point may sever the radial artery causing unconsciousness from blood loss in 30 seconds and death in death in as little as 2 minutes (Kaiser, 2019, The Dangers from Knife and Weapon Slashing).

Lower arm paralysis is immediate with a hard strike. The recipient will feel like he has been struck in the lungs. As a Xi-cleft point, a strike here causes the reverse effect of healing using this point, so instead of releasing much needed Qi to the lungs it draws it away. Therefore it can be massaged or needled to heal a lung strike, or struck to exacerbate a previous lung strike with potentially lethal results (Montaigue, Dim Mak Locations, Taijiworld.com).

In seizing martial arts (Qin Na) this point is a cavity pressing point (Dian Xue, 點穴). Pressing this area can cause the lungs to contract and the opponent to pass out. Pressing with lesser power can cause pain and numbness in the arm (Yang, 2004, Analysis of Shaolin Chin Na, 2nd Edition)

Major Combinations:

• Febrile Disease with absence of sweating:
    Kongzui Lu-6 with Shangliao Bl-31
    (Haungfu Mi, 皇甫謐, 282: Zhen Jiu Jia Yi Jing, 針灸甲乙經, Systematic Classic of Acupuncture and Moxibustion).
  
  
• Loss of voice:
    Kongzui Lu-6 with Yamen Du-15
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Spitting blood:
    Kongzui Lu-6 with Quze Pc-3 and Feishu Bl-13
    (Classic of Supplementing Life).
  
  
• Headache:
    Kongzui Lu-6 with Houxi SI-3, Tianzhu Bl-10, Taodao Du-13 and Dazhu Bl-11
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Acute asthma:
    Kongzui Lu-6 with Dingchaun Ex-BW-1 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).

Notes:

In Tung acupuncture this is the location of the Di Shi, Earth Scholar, point. Two others, Ren Shi, Human Scholar, and Tian Shi, Heavenly Scholar, are located 3 cun proximal and distal to this point along the Lung channel. They are often used as a combination for all Lung channel issues (Chu, 2015).

Points on the forearm were recommended for bleeding by Galen when the veins at the elbow crease were not visible (Brain, 1986, Galen on Bloodletting, p.91). This point would probably equate to Chize Lu-5 for disorders of the upper neck and head.

Avicenna describes venesection at this point or Lieque Lu-7 in his treatise On Venesection:

"The cephalic vein drains more blood from the neck and above, and little from below the neck, but it does not exceed the epigastrium, and it does not significantly cleanse the lower parts." (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).

The median cubital or basilic veins are used for the lower body while the accessory cephalic vein (following the arm Yangming Large Intestine channel) has a similar function to the cephalic.

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