次髎 : Ciliao : Second Crevice

Location Guides:

Classifications:

Binding point of the foot Taiyang and foot Shaoyang Sinews

Meetings:

Meeting of Bladder with Gall Bladder

Location:

Over the second posterior sacral foramen.

Needling:

Perpendicular insertion 0.5 - 1 cun, or 1.5 - 2 cun through the foramen using a slightly oblique medial and inferior insertion.

Warnings:

Contraindicated during pregnancy.

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 three cun, (the needle) is retained for a duration of seven exhalations, and is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Regulates the Lower Jiao and facilitates urination and defecation
Regulates menstruation and stops leucorrhoea
Benefits the lumbar region and legs

TCM Indications:

• Painful urinary dysfunction, dark urine, retention of urine, difficulty in urination and defecation, constipation, borborygmus, watery diarrhoea, Shan (疝) Disorder, hardness and distension below the Heart.
  
• Red and white leucorrhoea, dysmenorrhoea, irregular menstruation, infertility, pain of childbirth.
  
• Lumbar pain, sacral pain, numbness of the lumbar region extending down to the feet, lumbar pain radiating to the genitals, sciatica, pain and Painful Obstruction (痹, Bi) of the lower limb, hemiplegia.

Neuroanatomy:

Superficial Innervation: Dorsal rami of S1 - S3

Dermatome Segment: S3

Deeper Structures: Sacral nerve S1 emerging from foramen

Martial Applications & Effects of Injury:

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

Major Combinations:

• Difficult urination and defecation:
    Moxa Shangliao Bl-31, Ciliao Bl-32, Zhongliao Bl-33 and Xiaoliao Bl-34 with one hundred cones
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Infertility:
    Ciliao Bl-32 with Yongquan Kid-1 and Shangqiu Sp-5
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Pain of the lumber region and aversion to cold:
    Ciliao Bl-32 with Baohuang Bl-53 and Chengjin Bl-56
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Rigidity of the lumbar spine with inability to turn:
    Ciliao Bl-32 with Zhangmen Liv-13
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Sciatica:
    Ciliao Bl-32, Chengfu Bl-36, Zhibian Bl-54, Weizhong Bl-40 and Kunlun Bl-60 (Deadman, Al-Khafaji & Baker, A Manual of Acupuncture).

Notes:

As one of the Baliao or "eight crevices" located in the sacral foramen which all regulate urination, defecation, menstruation and lumbar region, and being at the same level as the bladder-shu Pangguangshu Bl-28 this point is the strongest of the Baliao for regulating urination.

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