郄門 : Ximen : Xi-Cleft Gate

Location Guides:

Classifications:

Xi-Cleft point

Location:

On the flexor aspect of the forearm, 5 cun proximal to Daling P-7, on the line connecting Daling P-7 with Quze P-3, between the tendons of palmaris longus and flexor carpii radialis.

Needling:

Perpendicular insertion 0.5 - 1 cun, or oblique proximal insertion 1 - 1.5 cun, or transverse oblique distal insertion up to 5 cun connect all points up to Daling Pc-7 in Lingmeng opposite needling.

Classical Needling:

"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 moxaed with three cones. [The Wui Tui says five cones.]" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Invigorates Blood and dispels stasis
Cools Blood and stops bleeding
Calms the Shen
Moderates acute conditions

TCM Indications:

• Chest pain, Heart pain with vomiting, vomiting blood, coughing blood, nosebleed, five palms agitated and hot.
  
• Agitation, insomnia, melancholy, fear and fright of people, insufficiency of spirit qi, epilepsy.
  
• Chronic Malarial (瘧, Nue) Disorders, chronic haemorrhoids.

I Ching Hexagram:

䷸ Xun 巽 Gentle Wind

Shared with Huizhong SJ-7. Balanced by ䷲ (Dadun Liv-1 or Zulinqi GB-41).

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

Neuroanatomy:

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

Martial Applications & Effects of Injury:

Weakens the Heart, opening it to Pathogenic Invasion and making it tense, rapid and raising blood pressure. If there is pre-existing angina can even cause it to stop. It also has an effect upon the Shen (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Heart pain:
    Ximen Pc-4 with Quze Pc-3 and Daling Pc-7
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Heart pain with retching, agitation and fullness:
    Ximen Pc-4 with Jiquan He-1
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Coughing Blood:
    Ximen Pc-4 with Daling Pc-7
    (Haungfu Mi, 皇甫謐, 282: Zhen Jiu Jia Yi Jing, 針灸甲乙經, Systematic Classic of Acupuncture and Moxibustion).
  
  
• Fright and fear of people, Shen Qi insufficient:
    Ximen Pc-4 with Dazhong Kid-4
    (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 of the chest and lateral costal region:
    Ximen Pc-4 with Dabao Sp-21, Sanyangluo SJ-8, Yangfu GB-38 and Zulinqi GB-41 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).

Notes:

In Lingmen opposite needling for blood in urine due to Heat in Heart Blood one needle is inserted from Daling Pc-7 to Ximen Pc-4 while another is inserted in the opposite direction from Ximen Pc-4 to Daling Pc-7 (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.133).

In ayurvedic medicine:
Indravasti marma point
Size: 1/2 angula (cun)
Structure: Muscle
Effect of Injury: Premature death (kalantarprana marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

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