中膂俞 : Zhonglushu : Mid-Spine Shu

Location Guides:

Classifications:

Trigger point (Travell & Simons, 1998, Trigger Point Manual)

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Location:

1.5 cun later to the midline, at the level of the third posterior sacral foramen.

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Needling:

Perpendicular insertion 0.5 - 1 cun

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 located on the prominent muscle running parallel to the spine. It is needled to a depth of three fen, (the needle) is retained for a duration of ten exhalations, and it is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

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TCM Actions:

Benefits the lumbar region
Dispels Cold and stops diarrhoea

TCM Indications:

• Dysenteric disorder, cold in the intestines, Shan (疝) Disorder, abdominal distension, pain of the lateral costal region, Kidney deficiency wasting and thirsting disorder, absence of sweating.
  
• Stiffness and pain of the lumbar spine, inability to turn the spine.

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Neuroanatomy:

Superficial Innervation: Dorsal rami of S1 - S3

Dermatome Segment: S3

Deeper Structures: Dorsal rami of S3

Trigger Point Associations:

Muscle:
Piriformis and gluteus maximus

Myotome Innervation:
Piriformis: nerve to the piriformis (L5 - S2); Gluteus maximus: Inferior gluteal nerve (L5 - S2)

Pain Referral Pattern:
Pirifomris: To the greater trochanter of the humerus and down the posterior of the thigh
Gluteus maximus: To the buttock

Indications:
Sciatica ; Pain in the buttocks

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Martial Applications & Effects of Injury:

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

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Major Combinations:

• Dysenteric disorder:
    Hegu LI-4 and Zusanli St-36; if severe add Zhonglushu Bl-29
    (Anon, nd, Shi Si Jing Yao Xue Zhu Zhi Ge, 十四經要穴主治歌, Song of the Points of the Fourteen Primary Channels).
  
  
• Lumbar pain:
    Zhonglushu Bl-29 with Shenshu Bl-23 and Qihaishu Bl-24
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

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Notes:

Ling Shu Ch. 75, On Piercing to Regulate True and Evil Qi, recommends this point as part of the "Undressing" treatment. Its indications are when there is a surplus of Yang and insufficiency of Yin Qi causing Heat in the interior and exterior. The two heats combine to become hot like burning coal and they cannot bear to have clothes touch the skin or to lie on a mattress, the pores are closed and there is no sweating, the tongue is scorched, the lips are desiccated, the flesh dries up, the throat is parched and they cannot tell good from bad food. It is treated by removing the Heat from this point, Tianfu Lu-3 and Dazhu Bl-11, then supplementing the Taiyin channels of hand and foot, Lung and Spleen, to diminish the sweat. Presumably the initial piercings are supposed to induce the sweat or this contradicts the earlier symptom of the pores being closed and the sweat not leaving.

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

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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

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