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Location Guides: |
He-Sea and Water point
Father point of the Pericardium channel
Binding point of the hand Jueyin Sinews
On the transverse cubital crease, in the depression immediately to the ulnar side of the aponeurosis of the biceps brachii muscle. Should be located and needles with the arm slightly bent.
Perpendicular insertion 0.5 - 1 cun, or prick to bleed, or transverse oblique distal insertion up to 6 cun to connect with Ximen Pc-4 in Ling Ze pointing to xi needling.
The brachial artery and veins lie deeply, just medial to this point
"The Jueyin usually has much Blood and little Qi" (Su Wen 素問 ch. 24) implying this channel should normally be 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, and (the needle) is retained for a duration of seven exhalations. It is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).
Clears Heat from the Qi, Ying-Nutritive and Blood levels
Harmonises the Stomach and Intestines and stops vomiting
Activates the channel and alleviates pain
Shared with Yemen SJ-2. Balanced by ䷶ (Xingjian Liv-2 or Yangfu GB-38).
Hexagram attributions are my own with an explanation given in the glossary.
Superficial Innervation: Border of lateral and medial cutaneous nerves of the forearm (C5 - C6 and C8 - T1)
Dermatome Segment: C6, T1 on ventral axial line
Deeper Structures: Median nerve from C5 - T1
Struck in a downwards direction, this point adds Heat to the Heart causing long term effects such as cold sores, excessive talking and gradually developing emotional imbalance. Struck upwards it affects the Lung/Large Intestine. If attacked with Shaohai He-3 and Chize Lu-5 with a knife edge it will cause extreme Qi drainage which could stop the Heart and Lungs (Montaigue, Dim Mak Locations, Taijiworld.com).
It seems unlikely that a strong strike could be achieved here as the elbow will simply fold. In fact, the main application of this point is in locks and throws when your aim is to do exactly that.
In five element acupuncture, as father point of the Pericardium channel this can control excesses in the Pericardium.
Ling Shu Ch. 44, On the Qi Moving in Accordance with the Norms, indicates that the He-Sea points should be pierced in autumn or when the disease is a result of immoderate diet. The seasonal aspect should not be interpreted literally as it describes the flavours as "controlled by autumn", probably referring to the mouth, nose and throat where the metal channels run. It also describes the morning, afternoon, evening and night cycle of the day to be like the four seasons of the year with evening corresponding to autumn. Perhaps the most likely interpretation is during middle age, the autumn period of life, when the effects immoderate diet are likely to start to show.
Only five channels are discussed so this point must have served the for the Heart too.
Ling Shu Ch. 71, On Evil Visitors, says that when a depletion evil is in the Lung and Heart it remains in two elbows. Yuen's theory of the Divergent meridians suggests that they store pathogens at the major joints, depleting our resources while they do, which would make this a potential point for for the Pericardium/San Jiao Divergent.
In Ling Ze pointing to xi needling for palpitations one needle one needle is inserted from Daling Pc-7 to Ximen Pc-4 while another is inserted in the opposite direction from Quze Pc-3 to Ximen Pc-4 (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.132).
Medieval phlebotomy point (Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov).
This was one of the most popular points for ancient phlebotomy, where the median cubital vein is located. In Greek and Roman times it was indicated for pleuritic pain above the diaphragm (Brain, 1986, Galen on Bloodletting, p.23).
Galen also advised it be bled in the case of unremitting nosebleed on the ipsilateral side of the body to the nostril that is bleeding (ibid., p.84) while applying bandages of "fillet-material" to the limbs and cupping the hypochondrium on the affected side. This is one of the few examples Galen gave of bleeding as a revulsive remedy rather than an evacuant.
The elbow is also mentioned for gouty patients (ibid.: 94) but in the context of evacuating areas adjacent to the affected parts probably applies to gout symptoms in the hands while the legs would be used for symptoms in the legs and anywhere for symptoms with no specific location.
See the similarities to the actions of Quchi Lu-5 located slightly radial to this point and still within the cubital fossa. It was also recommended as a replacement for Shaohai He-3 or Chize Lu-5 if the veins here are indistinct since it connects them both (ibid.: p.91).
In Hippocrates' On the Regimen in Acute Diseases it is recommended "If the pain causes a heavy feeling spreading about the breast or above the diaphragm". This is one of Hippocrates' more "heroic" bleeds as he advises us "not to be afraid of drawing a large quantity of blood until, instead of running clear and red, it becomes either much more redder or turns livid". If we assume the loss of blood was not actually therapeutic and quite possibly harmful then any therapeutic effect on pain would most likely be from the rather strong stimulation of this point.
In Hippocrates' Aphorisms, Section VI, 36, it is advised that "Venesection cures dysuria; open the internal veins of the arm" (trans. Adams, 1849, http://classics.mit.edu/Hippocrates/aphorisms.6.vi.html) which would suggest this point or Zhizheng SI-7.
Hippocrates in Epidemics V mentions "a patient with abdominal pain and rumbling who was bled from either arm alternately" (cited in Brain, 1986: p.113). This could have been any of the phlebotomy points in the arm but this seems to have been the most popular choice and has a curious similarity to the Chinese indication for this point to harmonise the Stomach and Intestines.
Further reference to bleeding from the elbow is made by Hippocrates in his Internal Diseases for jaundice, and possibly diseases of the lung (ibid.: 115).
Avicenna describes venesection at this point 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 median cubital vein has a function that is midway between the cephalic and the basilic vein. The basilic vein drains the trunk and below." (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).
Lad and Durve (2008) in Marma Points of Ayurveda call this point Ani and associate it with the doshas: Apana Vayu, Vyana Vayu, Kledaka Kapha and Shleshaka Kapha.
They give the following functions:
- Maintains bladder tone
- Regulates fluids and ambu vaha srotas
- Treats urinary dysfunction
- Promotes normal range of movement of upper extremities
- Relieves localised pain
They locate another point called Bahu Indrabasta 2 anguli below Ani which they associate with Apana Vayu, Vyana Vayu and Sadhaka Pitta.
They give the following functions:
- Relieves pain locally
- Regulates colon functions
- Stimulates agni and expels toxins
- Stabilises the mind
- Releases stagnant emotions
In Tibetan medicine:
Moxa point (AMNH, Tibetan Medical Paintings)
In Thai massage:
Acupressure point along the Kalatharee sen line running from the navel Shenque Ren-8 to the hands (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)
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
Steve Woodley Acupuncture & Traditional Medicine
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