俠谿 : Xiaxi : Clamped Stream

Location Guides:

Classifications:

Ying-Spring and Water point
Mother point of the Gall Bladder channel

Location:

Between the fourth toe and the little toe, 0.5 cun proximal to the web margin.

Needling:

Perpendicular insertion 0.3 - 0.5 cun, or oblique insertion directed proximally 0.5 - 1 cun

Classical Needling:

"The Shaoyang usually has little Blood and much Qi" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Shaoyang is to be pierced 4 fen deep and remain inserted for five exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three fen, (the needle) is retained for a duration of three exhalations, and it is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Clears Heat and benefits the head, ears and eyes
Clears Damp-heat from the channel and reduces swelling

TCM Indications:

• Headache, dizziness, Visual Dizziness, hypertension, redness and pain of the outer canthus, itching of the eyes, deafness, tinnitus, pain of the ears, pain and swelling of the cheek and submandibular region.
  
• Fullness and pain of the chest and lateral costal region, pain of the chest with inability to turn to the side, breast abscess, discharging breast abscess.
  
• Amenorrhoea, hardness and pain of the hypogastrium, swelling of the four limbs, pain of the whole body, febrile disease with absence of sweating, copious sweating, Malarial (瘧, Nue) Disorders, mania.
  
• Wandering pain, pain of the knee and thigh, swelling and pain of the lateral aspect of the knee, redness, swelling and pain of the dorsum of the foot, heat in the soles of the feet, damp erosion and cracks between the toes, contraction of the five toes.

I Ching Hexagram:

䷧ Jie 解 Release, untie

Shared with Ququan Liv-8. Balanced by ䷤ (Laogong Pc-8 or Zhigou SJ-6).

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

Neuroanatomy:

Superficial Innervation: Superficial fibular (peroneal) nerve (L4 - S1)

Dermatome Segment: L5, S1

Martial Applications & Effects of Injury:

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

Major Combinations:

• Head Wind:
    Xiaxi GB-43 with Shangxing Du-23, Qianding Du-21, Baihui Du-20, Yanggu SI-5, Hegu LI-4, Guanchong SJ-1 and Kunlun Bl-60
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Impaired hearing and deafness:
    Xiaxi GB-43 with Fengchi GB-20, Tinghui GB-2, Ermen SJ-21 and TInggong SI-19
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Pain of the submandibular region giving rise to tinnitus and difficulty hearing:
    Xiaxi GB-43 with Wangu SI-4, Yanggu SI-5, Jianzhen SI-9 and Zuqiaoyin GB-44
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Swelling of the submandibular region with lockjaw:
    Xiaxi GB-43 with Yanggu SI-5
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• Swelling and sabre lumps of the axilla:
    Xiaxi GB-43 with Yangfu GB-38 and Taichong Liv-3
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Abscess, ulceration and swelling of the breast:
    Xiaxi GB-43 with Tianxi Sp-18
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Pain and hardness of the hypogastrium:
    Xiaxi GB-43 with Yanglingquan GB-34
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• The five types of haemorrhoids:
    Xiaxi GB-43 with Weizhong Bl-40, Chengshan Bl-57, Feiyang Bl-58, Yangfu GB-38, Fuliu Kid-7, Taichong Liv-3, Qihai Ren-6, Huiyin Ren-1 and Changqiang Du-1
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).

Notes:

In five element acupuncture this point, as the mother point (water point on a wood channel) is reinforced to tonify Gall Bladder deficiencies. In TCM and classical sources its actions are mainly draining Damp-Heat.

Ling Shu Ch. 19, on the Four Seasonal Qi, advises selecting the Jing-Well and Ying-Spring openings in winter, piercing deeply and retaining for a while. However, the character for "retain" 留 is a combination of 田 "a field," possibly referring to the idea of waiting for things to grow, and 卯 which is the 4^th Earthly Branch (Mao, Rabbit, ䷡, 5-7 am, Large Intestine) and said to derive from a Shang Dynasty glyph, originally referring to a blood sacrifice (a person or animal cut in half) before coming to mean bloodletting and "pouring out" (Smith, 2011). This might suggest it was actually referring to bleeding these points, and maybe even letting the points bleed for a time rather than retaining the needle.

Ling Shu Ch. 34, On the Five Disturbances, advises piercing this point with Zulingqi GB-41, Xiangu St-42 and Neiting St-44 after bleeding stagnant blood in the vessels to remove disturbing Qi in the limbs causing counterflow.

In Tung acupuncture this is the location of the Liu Wan, Six Ends, point. It is indicated for traumatic injury where it is often combined with Shui Qu (1 cun proximal, at Diwushi GB-42), and Gall Bladder channel problems such as headache, migraine, tinnitus and pain (Chu, 2015).

The Tung point Mu Dou, Wood Combat, is located at the same level as this point between the 3rd and 4th metatarsal bones and indicated Shaoyang patterns including indigestion, fatigue and poor circulation, often combined with Mu Liu, Wood Remains, 1 cun proximal (Chu, 2015).

In reflexology this area relates to the top of the shoulders.

Avicenna describes venesection at this point in his treatise On Venesection:

"Among the leg vessels is the sciatic vein (inferior gluteal), which can be venesected at the outer side of the heel or below, or above, between the hip and the heel. It should be wrapped or strapped with strong bandages. It is better to bathe before venesecting the sciatic vein. Its incision should be longitudinal. If the vein in the hidden the the branch between the two smallest toes (the fourth and the small toe) is the one to venesect. There is a great benefit in venetecting the sciatic vein in cases of sciatica as well as in gout, varicose veins, and elephantiasis. It is difficult to carry out a second venesection on the sciatic vein" (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).

Although this point is described quite specifically it seems to indicate that any point along the foot Shaoyang Gall Bladder channel up to the hip where the vein can be accessed is acceptable. It may also be noteworthy that the Luo pathway of Gall Bladder channel goes across the dorsum of the foot.

Medieval phlebotomy point (John de Foxton, 1408: Liber Cosmographiae, maa.cam.ac.uk; Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov)

In Thai massage:
Acupressure point (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