三焦俞 : Sanjiaoshu : San Jiao Shu

Location Guides:

Classifications:

Back Shu point of the San Jiao
Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Meetings:

Meeting of Bladder with San Jiao Divergent

Location:

1.5 cun lateral to the lower border of the spinous process of the first lumbar vertebra (L1).

Needling:

Oblique or perpendicular-oblique insertion towards the spine 1 - 1.5 cun

Warnings:

Perpendicular needling carries a risk of injuring the kidney.

Classical Needling:

"The Taiyang usually has much Blood and little Qi" (Su Wen 素問 ch. 24) implying this channel should normally be bled.
"The foot Taiyang is to be pierced 5 fen deep and remain inserted for seven exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of five fen and moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Moves and regulates the San Jiao
Regulates the Spleen and Stomach and resolves Dampness
Regulates the water passages and promotes urination
Resolves masses

TCM Indications:

• Borborygmus, diarrhoea, undigested food in the stool, Dysenteric Disorder (痢疾, Li Ji), oeseophageal constriction, vomiting, difficult ingestion.
  
• Abdominal distension with emaciation, abdominal (zheng ju) masses and emaciation in women, zangdu (Ji Ju) masses, large and hard hypogastric (Ji Ju) masses.
  
• Oedema, difficult urination, white turbidity, blood in the urine, Deficiency Taxation.
  
• Headache, Visual Dizziness, alternating chills and fever, heat in the body, bitter taste in the outh and cracked lips, jaundice.
  
• Stiffness and pain of the lumbar spine, inflexibility and stiffness of the shoulder and back.

I Ching Hexagram:

䷫ Gou 姤 Coupling

Shared with Jueyinshu Bl-14 and with Baihui Du-20 in the Rising and Falling Hexagram sequence.

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

Neuroanatomy:

Superficial Innervation: Dorsal rami of L1 - L3

Dermatome Segment: L1

Deeper Structures: Dorsal rami of L1

Trigger Point Associations:

Muscle:
Longissimus thoracis

Pain Referral Pattern:
Inferior to posterior superior iliac spine

Indications:
Low back pain ; Myalgia of long extensors of back

Martial Applications & Effects of Injury:

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

Major Combinations:

• Borborygmus, abdominal distention and watery diarrhoea:
    Sanjiaoshu Bl-22 with Xiaochangshu Bl-27, Xiaoliao Bl-34, Yishe Bl-49 and Zhangmen Liv-13
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Borborygmus:
    Sanjiaoshu Bl-22 with Dachangshu Bl-25, Taibai Sp-3 and Gongsun Sp-4
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Undigested food in the stool:
    Sanjiaoshu Bl-22 with Zusanli Sp-36, Dachangshu Bl-25, Sanyinjiao Sp-6, Xiawan Ren-10, Xuanshu Du-5 and Liangmen St-21
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Hypogastric masses (Ji Ju) that are hard and big like a plate with epigastric distention and undigested food in the stool:
    Sanjiaoshu Bl-22 with Zhongwan Ren-12
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Notes:

One consideration of this point and its Ministerial Fire pair, Jueyinshu Bl-14, is that they sit just above the back Shu points for the Heart and Kidneys and so can be argued to represent the connecting pathways between the Heart and Kidneys, the two Shaoyin organs. One role of the Pericardium is to act as an envoy, transmitting the Sovereign Fire from the Heart via the San Jiao, the pathways of water, with the location of these points seeming to suggest this. Jueyinshu Bl-14 being above Xinshu Bl-15 enables it to capture Heat as it rises and then transmit to its pair, Sanjiaoshu Bl-22, which can then flow down to Sanjiaoshu Bl-23.

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

In Thai massage:
Acupressure point along the Itha (left) and Pingala (right) sen lines running from the navel Shenque Ren-8 to the knee and up the back to the neck and head.
Indicated for back, hip and sacroiliac joint pain/injury/arthritis, erectile dysfunction, gastrointestinal ailments, hypertension, indigestion, infertility, loss of libido, menstruation difficulties, PMS, reproductive system ailments, stomach ache and stress.
(Salguero & Roylance, 2011, Encyclopedia of Thai Massage)

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