四滿 : Siman : Four Fullnesses

Location Guides:

Classifications:

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

Meetings:

Meeting of Kidney with Chong Mai

Location:

On the lower abdomen, 2 cun below the umbilicus, 3 cun superior to the superior border of the symphysis pubis, 0.5 cun lateral to the midline (Shimen Ren-5). Note: The Great Compendium of Acupuncture and Moxibustion locates this 1 cun from the midline.

Needling:

Perpendicular insertion 1 - 1.5 cun

Warnings:

Deep needling may penetrate the peritoneal cavity.

Classical Needling:

"The Shaoyin usually has little Blood and much Qi" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Shaoyin is to be pierced 2 fen deep and remain inserted for three exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of one cun and is moxaed with five cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Regulates the Lower Jiao
Regulates Qi and moves Blood stasis
Regualates the water passages promotes urination

TCM Indications:

• Lower abdominal pain, abdominal distension, Shan (疝) Disorder, cutting pain below the umbilicus, stone oedema of the upper abdomen, oedema, Running Piglet Qi (奔豚氣, Ben Tun Qi), pain of the Kidneys.
  
• Irregular menstruation, uterine bleeding, malign blood with acute pain, accumulated cold in the uterus, infertility, leucorrhoea, retention of lochia, seminal emission, white and turbid urethral discharge.
  
• Dysenteric disorder, diarrhoea, water in the Large Intestine, constipation, cold shivering, pain of both lateral costal regions, redness and pain of the inner canthus.

Neuroanatomy:

Superficial Innervation: Anterior cutaneous thoracic nerve from T12

Dermatome Segment: T12

Trigger Point Associations:

Muscle:
Rectus abdominis dysmenorrhoea points

Location Notes:
These points are closer to the midline

Pain Referral Pattern:
Local around point

Indications:
Dysmenorrhoea

Martial Applications & Effects of Injury:

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

Major Combinations:

• Stone oedema of the upper abdomen:
    Moxa Siman Kid-14, Rangu Kid-2, Qichong St-30 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).
  
  
• Stone oedema of the upper abdomen:
    Siman Kid-14 with Rangu Kid-2
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Malign blood in the uterus, internal Counterflow fullness and pain:
    Siman Kid-14 with Shiguan Kid-18
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

Notes:

In Tung lineage acupuncture the Bowel Nest 23 (Fu Chao Er Shi San) are a group of points located in a line at 1 cun intervals between Ren-2 and Ren-10. An additional eight points on either side form a 4x5 grid at the levels of Ren-9 to Ren-5, also at 1 cun intervals. This would match with the alternative location for this point given in the Great Compendium. Ren-8, on the navel, is not included.

They are pricked using Tung's method in local disorders of pain, stagnation and heat in the abdomen such as uteritis, nephritis, umbilical area pain, enteritis, appendicitis and intestinal cancers (McCann, 2014, Pricking the Vessels).

In nine palaces abdominal acupuncture, this point is located in the region associated with ☵ Kan, Water, the north and the Kidneys and Bladder organs (Schelbert, 2014, Ryan, 2009).

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