耳門 : Ermen : Ear Gate

Location Guides:

Classifications:

One of the "59 piercings" for clearing Heat in Ling Shu Ch. 23
Shokanten Nine continents Pulse for Middle Jiao, Shaoyang and eyes and ears

Location:

In the depression anterior to the supratragic notch and slightly superior to the condyloid process of the mandible, just above Tinggong SI-19. Locate and needle with mouth open to slide the condyloid process forwards and reveal the depression. Once needled the patient can close their mouth.

Needling:

Inferior oblique insertion, slightly posteriorly 0.5 - 1 cun, or transverse inferior insertion to connect with Tinggong SI-19 and Tinghui GB-2 as part of "ear clearing technique".

Warnings:

Many classical sources prohibit moxibustion at this point in cases of discharge of pus from the ear.

Classical Needling:

"The Shaoyang usually has little Blood and much Qi" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"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 three exhalations, and it is moxaed with three cones. Moxibustion is forbidden when there is pus and earwax in the ear" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Benefits the ears
Clears Heat

TCM Indications:

• Tinnitus, deafness, impaired hearing, earache, discharge of pus from the ear, swelling of the ear, ear sores.
  
• Toothache, tooth decay, swelling and pain of the submandibular region, stiffness of the lips, headache, lockjaw, neck pain.

Neuroanatomy:

Superficial Innervation: Auriculo-temporal nerve from posterior division of mandibular branch of trigeminal nerve (CN V3)

Dermatome Segment: CN V3 mandibular branch of trigeminal

Martial Applications & Effects of Injury:

In seizing martial arts (Qin Na) this point is a cavity press point (Dian Xue, 點穴) which can be struck with the knuckle of the thumb causing fainting (Yang, 1995, Tai Chi Chin Na).

This is one of the eight striking points in Northern Praying Mantis Kung Fu. These are the nonfatal areas on an attacker's body that can be struck when just defending or wanting to defeat an attacker. Specifically associated with this point by Zhongwu Sports (2018, Chinese martial arts "eight hits and eight don't hits") and described as "The points under the ears on the jawbone hinge" (Olson, 2010, The Complete Guide to Northern Praying Mantis Kung Fu) and "the hollow between cheek and earlobe" by Wong Honfan (1946; in Ravenswood Academy, 2020, The Eight Forbidden Strikes of Praying Mantis Fist).

Major Combinations:

• Purulent ear sores with discharge:
    Ermen SJ-21 with Yifeng SJ-17 and Hegu LI-4
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Impaired hearing and deafness:
    Ermen SJ-21 with Fengchi GB-20, Xiaxi GB-43, Tinghui GB-2 and Tinggong SI-19
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Tinnitus with lumbar pain:
    First needle Renying St-9, then needle Ermen SJ-21 with Zusanli St-36
    (Anon, nd, Tian Xing Mi Jue, 天星秘訣, Secrets of the Celestial Star).
  
  
• Tinnitus:
    Ermen SJ-21 with Tinggong SI-19, Tinghui GB-2, Baihui Du-20, Luoque Bl-8, Yangxi LI-5, Qiangu SI-2, Houxi SI-3, Wangu SI-4, Zhongzhu SJ-3, Yemen SJ-2, Shangyang LI-1 and Shenshu Bl-23
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Stiffness of the lips and pain from tooth decay of the upper jaw:
    Ermen SJ-21 with Duiduan Du-27, Muchuang GB-16 and Zhengying BL-17
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Toothache:
    Ermen SJ-21 with Sizhukong SJ-23
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• "Ear clearing technique" for Heat in the ears:
    Thread one needle from Ermen SJ-21 to Tinghui GB-2 and another from Xiaguan St-7 to Tinggong SI-19
    (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.114).

Notes:

Ling Shu Ch. 23, On Heat Diseases, gives a different list of points for the "59 Piercings" to Su Wen Ch. 61 which includes a point in front of the ear that most likely means this point.

A Shokanten pulse is used to assist in diagnosis where the radial pulse is unclear, or in the comparative analysis of meridians in the upper and lower portions of the body. They are particularly used in psycho-emotional disorders. This point relates to the Middle Jiao, Shaoyang and eyes and ears.

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

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