合陽 : Heyang : Confluence of the Yang

Location Guides:

Classifications:

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

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Location:

On the lower leg, 2 cun inferior to Weizhong Bl-40, on the line connecting Weizhong Bl-40 and Chengshan Bl-57, in the depression between the two heads of the gastrocnemius muscle.

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Needling:

Perpendicular insertion 1 - 1.5 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 needled to a depth of six fen and moxaed with five cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

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TCM Actions:

Activates the channel and alleviates pain
Stops uterine bleeding and treats pain of the genitals

TCM Indications:

• Lumbar pain radiating to the abdomen, heat sensation of the inner thigh, pain, heat and heaviness of the knees, difficulty in walking.
  
• Uterine bleeding, leucorrhoea, pain of the genitals, sudden violent pain of the genitals, cold Shan (疝) Disorder.

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Neuroanatomy:

Superficial Innervation: Posterior cutaneous nerve of the thigh (S1 - S3)

Dermatome Segment: S2

Deeper Structures: Tibial nerve (L5 - S2)

Trigger Point Associations:

Muscle:
Gastrocnemius, soleus and popliteus (deep)

Myotome Innervation:
Gastrocnemius: Tibial nerve, specifically roots from S1 and S2; Soleus: Tibial nerve, specifically roots from L5 - S2; Popliteus: Tibial nerve from L5 and S1

Location Notes:
Gastrocnemus trigger points may be found all around this point in the upper part of the gastrocnemus muscle. For popliteus point it may be useful to locate slightly medial to make sure you are on the muscle.

Pain Referral Pattern:

Gastrocnemus: Around point and across posterior calf to sole of foot
Soleus: To medial calf
Popliteus: To back of knee

Indications:
Calf strain and cramps (gastrocnemus) ; Tenderness in the heel (soleus) ; Diseases of the knee (popliteus)

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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:

• Diminished Qi uterine bleeding:
    Heyang Bl-55 with Jiaoxin Kid-8
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).

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Notes:

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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