後谿 : Houxi : Back Stream

Classifications:

Shu-Stream and Wood point
Confluent point of the Du Mai, coupled with Shenmai Bl-62
Mother point of the Small Intestine channel

Location:

On the ulnar border of the hand, in the substantial depression proximal to the head of the fifth metacarpal bone.

Needling:

Perpendicular insertion 0.5 - 2 cun, directed towards Sanjian L.I.-3.
Needle with the hand in a loose fist so the metacarpal bones are lying in the same place, especially if needling towards the opposite side of the hand

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 two fen, (the needle) is retained for a duration of two exhalations, and it is moxaed with one cone" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Benefits the occiput, neck and back
Activates the channel and alleviates pain
Clears Wind and Heat and treats malaria
Calms the Shen and treats epilepsy
Clears Heat and benefits the sesory orifices
Regulates the Du Mai

TCM Indications:

• Stiffness and pain of the neck, difficulty in turning the neck, one-sided headache, bilateral headache, pain of the back and shoulder, pain of the shoulder, elbow and arm, contraction of the elbow, contraction and pain of the fingers, pain of the lumbar region and knees, hemiplegia.
  
• Malarial (瘧, Nue) Disorders, night sweating, cold shivering, chills and fever, febrile disease with absence of sweating, fullness of the chest, jaundice, dark hesitant urination.
  
• Epilepsy, Mania-Withdrawal (癲狂, Dian Kuang), disorders of the Governing vessel (Du Mai).
  
• Deafness, tinnitus, Superficial Visual Obstruction, redness and pain of the eyes, swelling of the eyes with lacrimation, nosebleed, toothache, swelling of the throat and cheek, redness, swelling and pain of both cheeks, loss of voice following Windstroke (中風, Zhong Feng).

I Ching Hexagram:

䷔ Shi Ke 噬嗑 Biting Through

Shared with Shaochong He-9 and balanced by ䷯ (Shuiquan Kid-5 or Jinmen Bl-63).

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

Neuroanatomy:

Superficial Innervation: Ulnar nerve (digital branch) from C8 and T1

Dermatome Segment: C8

Martial Applications & Effects of Injury:

Not easy to get at unless controlling the hand in a lock, a strike here will cause great pain and Qi drainage as well as non-communication between Heaven and Earth, the upper and lower body, causing confusion of the senses, tension in the body and an adverse effect on the Liver (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Stiffness of the neck with inability to turn the head:
    Houxi SI-3 with Tianyou SJ-16
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Headache:
    Houxi SI-3 with Tianzhu Bl-10, Taodao Du-13, Dazhu Bl-11 and Kongzui Lu-6
    (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 head and eyes:
    Houxi SI-3 with Waiguan SJ-5
    (Wu Yiding, 吳亦鼎, 1853: Shen Jiu Jing Lun, 神灸經論, Principles of Divine Moxibustion).
  
  
• Pain of the forearm:
    Houxi SI-3 with Shousanli LI-10 and Quchi LI-11
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Contraction of the elbow:
    Houxi SI-3 with Chize Lu-5, Jianyu LI-15, Xiaohai SI-8, Jianshi Pc-5, Daling Pc-7 and Yuji Lu-10
    (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:
    Houxi SI-3 with Wangu SI-4, Fengmen Bl-12, Jianjing GB-21, Zhongzhu SJ-3, Zhigou SJ-6 and Weizhong Bl-40
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Nue (Malaria) with much heat and little cold:
    Houxi SI-3 with Dazhui Du-14, Jianshi Pc-5 and Quchi LI-11
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Nue (Malaria) with much cold and little heat:
    Houxi SI-3 with Dazhui Du-14 and Quchi LI-11
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Profuse night sweating:
    Houxi SI-3 with Yinxi He-6
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• The five types of epilepsy:
    Houxi SI-3 with Jiuwen Ren-15 and Shenmen He-7
    (Shen Yu Ge, 勝玉歌, Song More Precious than Jade. First recorded in Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Epilepsy:
    Houxi SI-3 with Neiguan Pc-6, Shenmen He-7, Xinshu Bl-15 and Yinbai Sp-1
    (Xu Feng, 徐鳳, 1439: Zhen Jiu Da Quan, 針灸大全, Complete Collection of Acupuncture and Moxibustion).
  
  
• Epileptic convulsions, mad walking, inability to sleep, agitation of the Heart:
    Houxi SI-3 with Zanzhu Bl-2, Xiaohai SI-8 and Qiangjian Du-18
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Dian Kuang with desire to ascend to high places and sing, discard clothing and run around:
    Houxi SI-3 with Shenmen He-7 and Chongyang St-42
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Sudden mania:
    Houxi SI-3 with Jianshi Pc-5 and Hegu LI-4
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Deafness:
    Houxi SI-3 with Qiangu SI-2 and Pianli SI-6
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Nosebleed with stifled breathing:
    Houxi SI-3 with Chengling GB-18, Fengchi GB-20, Fengmen Bl-12 and Yixi Bl-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).
  
  
• Jaundice:
    Houxi SI-3 with Laogong Pc-8
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).

Notes:

One of the main distal points for neck and shoulder pain along with Tiaoku St-38 for shoulders and Luozhen (extra) for the neck.

In five element acupuncture this point is reinforced to tonify Small Intestine deficiencies.

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.

Ling Shu Ch. 23, On Heat Diseases, gives a different list of points for the "59 Piercings" to Su Wen Ch. 61. They include three on the outer and three on the inner side of the hands which most likely includes this point.

Cecil-Sterman explains that combining the Shu-Stream and Jing-Well points directed outwards is a method of expelling Pathogens from the Taiyang.

In Tung acupuncture the Wan Shu Yi, Wrist Flow One, point is located slightly proximal to this point. Its indications seem similar to this point echoing the Du and Taiyang channels (Back, neck, shoulder, arm, hip and side of foot pain, dizziness, vertigo, tinnitus and urinary disorders). It is often combined with Wan Shun Er, slightly distal to Wangu SI-4 (Chu, 2015).

Yuen (2005, The Eight Extraordinary Vessels) notes that this point, along with Zulinqi GB-41, is a Shu-Stream point instead of a Luo point like all the other extraordinary vessels because the Du, along with the Dai mai, are concerned with projecting out into the world while the other extraordinary vessels are about taking in from the outside world.

In the Maoshan Daoist tradition, when the 12 earthly branches, I Ching trigrams and elements are mapped onto the hand the knuckle of the little finger next to this point equates to the branch 亥 Hai and the element of Water with no Trigram association (Read, 2020, FB Post; 17QQ.com, 2020, Eight trigrams and twelve Branches of the earth palm).

In Mayan medicine:
Used to treat pain in the upper extremities (Garcia, Sierra, Balam, 1999: Wind in the Blood)

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

In ayurvedic medicine:
Kurchashira marma point
Size: 1 angula (cun)
Structure: Tendon
Effect of Injury: Pain (rujakar marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

In Tibetan medicine:
Bleeding point (AMNH, Tibetan Medical Paintings)

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