下廉 : Xianlian : Lower Angle

Location:

On the radial side of the forearm, 4 cun distal to Quchi L.I.-11 on the line connecting Yangxi L.I.-5 with Quchi L.I.-11

Needling:

Perpendicular or oblique insertion 0.5 - 1.5 cun

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 five fen, (the needle) is retained for a duration of five 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:

Harmonises the Small Intestine
Expels Wind and clears Heat
Clears Yangming Fire and calms the Shen

TCM Indications:

• Abdominal pain, lower abdominal distension, fullness and pain of the abdomen and lateral costal region, periumbilical pain, insufficiency of Small Intestine qi, diarrhoea containing undigested food, blood in the stool, dark urine.
  
• Headache, head wind dizziness, pain of the eye, dry lips with drooling, breast abscess, dysponoea.
  
• Manic raving, mad walking.
  
• Hemiplegia, wind-damp Painful Obstruction (痹, Bi), cold Painful Obstruction (痹, Bi), pain of the elbow and arm.

Neuroanatomy:

Superficial Innervation: Posterior cutaneous nerve of the forearm from C5 - C8

Dermatome Segment: C6

Martial Applications & Effects of Injury:

Similar to Wenliu LI-7, this point causes Qi drainage and pain along the entire channel, even knock out, if struck hard enough. Often used with Zhongfu Lu-1 to drain the power from the whole body, Lu-1 being struck first (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Hot Stomach with no pleasure in eating:
    Xialian LI-8 with Xuanzhong GB-39
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Diarrhoea due to injury by food:
    Xialian LI-8 with Shanglian LI-9
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Manic raving:
    Xialian LI-8 with Taiyuan Lu-9, Yangxi LI-5 and Kunlun Bl-60
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Wind-Damp Painful Obstruction:
    Xialian LI-8 with Weizhong Bl-40
    (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 and Cold of the arm:
    Xialian LI-8 with Quchi LI-11 and Jianjing GB-21
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Difficult and dark urination:
    Xialian LI-8 with Shanglian LI-9
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Notes:

Avicenna describes venesection along the accessory cephalic vein that runs approximately along the course of the arm Yangming Large Intestine channel in his treatise On Venesection:

"The cephalic vein drains more blood from the neck and above, and little from below the neck, but it does not exceed the epigastrium, and it does not significantly cleanse the lower parts... The accessory cephalic vein is similar to the cephalic." (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).

The median cubital or basilic veins are used for the lower body.

Medieval phlebotomy point (Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov)

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