肩中俞 : Jianzhongzhu : Middle Shoulder Shu

Location Guides:

Location:

2 cun lateral to the lower border of the spinous process of C7 (Dazhui Du-14)

Needling:

Oblique medial insertion towards the spine 0.5 - 1 cun

Warnings:

Deep insertion inferiorly, especially in thin patients, carries a substantial risk of inducing a pneumothorax

Classical Needling:

"The Taiyang 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, (the needle) is retained for a duration of seven 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:

Descends Lung Qi
Activates the channel and alleviates pain

TCM Indications:

• Cough, spitting blood, chills and fever, dimness of vision, pain of the shoulder and scapula.

Neuroanatomy:

Superficial Innervation: Dorsal rami of spinal nerves C3 - C5

Dermatome Segment: C5

Martial Applications & Effects of Injury:

Damage here will cause severe Qi drainage from the upper body, causing nausea and even knock out if the strike is quite hard. Nervous damage can occur as it is quite close to the backbone at the neck (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Rebellious Qi cough:
    Jianzhongshu SI-15 with Tianchi Pc-1, Tiantu Ren-22, Shanzhong Ren-17 and Jiexi St-41
    (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:

This point is part of a group of seven on the Small Intestine channel which trace the Big Dipper constellation over the shoulder (Kim, 2020). This point would be equivalent to Alkaid (摇光 Yaoguang, Fluctuating Light).

Alternatively, since there is already a point named 天樞 Tianshu St-25 on the front of the body, which may represent a set of points correlating to the Big Dipper, this set of points on the back may then correlate to the Little Dipper instead which was known in the Han dynasty as 勾陳七星 Gouchen Qixing, the seven stars of the god Gou Chen (Old Hook). This would make this point equivalent to Polaris (北極星 Beijixing, "North Pole Star" or 勾陳一 Gouchen Yi, "Old Hook One"), which seems appropriate for a point located next to Dazhui Du-14 where all Yang channels meet and creates a central Yin/Yang axis connecting this point with Shenque Ren-8 where Tianshu St-25 appears to be pointing to.

Of course, in the time of the Han dynasty, the position of Pole Star was not occupied by Polaris, but by Struve 1694, also called 天樞 Tianshu, which resides within the Northern Pole (北極 Beiji) asterism and remained in that position until the Song dynasty. This would still make sense as this acupuncture point is not exactly on Dazhui Du-14 but close to it.

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