三間 : Sanjian : Third Space

Location Guides:

Classifications:

Shu-Stream and Wood point

Location:

On the radial side of the index finger, in the substantial depression proximal to the head of the second metacarpal bone

Needling:

Perpendicular insertion 0.5 - 2 cun, directed towards Houxi SI-3, or transverse insertion to Hegu LI-4 as part of "Jian Xi to Gu Needling".

Classical Needling:

"The Yangming usually has much Qi and much Blood" (Su Wen 素問 ch. 24) implying this channel can normally be needled or bled.
"The hand Yin and Yang receive their Qi via nearby paths so their Qi arrive swiftly. The depth of piercing must not exceed 2 fen and must not remain inserted for longer than one exhalation" (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:

Expels Wind and Heat
Clears Heat and benefits the throat and teeth
Dispels fullness and treats diarrhoea

TCM Indications:

• Throat Painful Obstruction (喉痹, Hou Bi), obstruction of the throat, toothache of the lower jaw, pain from decaying teeth, tongue thrusting, acute eye pain, dry scorched lips and mouth, nosebleed, rhinitis, tinnitus, chills and fever.
  
• Cold or damp (dong) diarrhoea, borborygmus, somnolence, injury by cold with water binding the chest and lateral costal region, fright, fullness of the chest, Malarial (瘧, Nue) Disorders.
  
• Acute stiff neck, redness and swelling of the dorsum of the hand, difficulty in flexing and extending the fingers.

I Ching Hexagram:

䷐ Sui 隨 Following

Shared with Shaoshang Lu-11. Balanced by ䷑ (Liangqiu St-34 or Diji Sp-8).

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

Neuroanatomy:

Superficial Innervation: Superficial branch of radial nerve from C6 - C8

Dermatome Segment: C7

Martial Applications & Effects of Injury:

Combined with Erjian LI-2, a strike at this point can cause temporary blindness but is very difficult to achieve (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Pain from tooth decay:
    Sanjian LI-3 with Daying St-5 and Zhengying GB-17
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Erosion, heat and dryness of the mouth:
    Sanjian LI-3 with Laogong Pc-8, Shaoze SI-1 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).
  
  
• Obstruction of the throat:
    Sanjian LI-3 with Jianshi Pc-5
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Somnolence:
    Sanjian LI-3 with Erjian LI-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).
  
  
• Somnolence with no desire to move the four limbs:
    Sanjian LI-3 with Sanyanluo SJ-8, Tianjing SJ-10, Zuwuli Liv-10 and Lidui St-45
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Borborygmus and diarrhoea:
    Sanjian LI-3 with Shenque Ren-8 and Shuifen Ren-9
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Pain of the shoulder and back, Wind Taxation:
    Sanjian LI-3 with Shenshu Bl-23
    (Xi-Hong Fu, 席弘賦, Ode of Xi-Hong. First recorded in: Xu Feng, 徐鳳, 1439: Zhen Jiu Da Quan, 針灸大全, Complete Collection of Acupuncture and Moxibustion).

Notes:

Ling Shu Ch. 19, on the Four Seasonal Qi, advises using the Shu-Stream points, unless the diseases are in the Fu organs, in which case the He-Sea points are chosen.

In Tung acupuncture this equates to the Da Bai, Big White, point (22.04) and is often combined with Ling Gu at the other end of the bone, between the first and second metacarpals, slightly proximal to LI-4. Their location on the arm Yangming which controls Qi and Blood in the entire body together with their ability to move Qi and Blood make them applicable for most diseases (Chu, 2015).

In "Jian Xi to Gu Needling" Sanjian LI-3 and Yangxi LI-5 are needled transversely to meet at Hegu LI-4 in treatment of pain and heat in the upper body. Electro-stimulation can be applied too (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.136).

In the Maoshan Daoist tradition, when the 12 earthly branches, I Ching trigrams and elements are mapped onto the hand the knuckle of the index finger next to this point equates to the branch 寅 Yin, the Trigram ☵ Kan, Water and the element of Wood (Read, 2020, FB Post; 17QQ.com, 2020, Eight trigrams and twelve Branches of the earth palm).

In ayurvedic medicine:
Kshipra marma point
Size: 1/2 angula (cun)
Structure: Tendon
Effect of Injury: Belatedly fatal (kalantarpranahar marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

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