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Location Guides: |
Jing-River and Metal point
Child point of the Spleen channel
Binding point of the foot Taiyin Sinews
On the medial side of the ankle, in the depression which lies at the junction of straight lines drawn along the anterior and inferior borders of the medial malleolus.
Perpendicular insertion 0.2 - 0.3 cun
Transverse insertion beneath the tendons, or to join with Jiexi St-41
"The Taiyin usually has much Qi and little Blood" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Taiyin is to be pierced 3 fen deep and remain inserted for four exhalations" (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).
Fortifies the Spleen and resolves Dampness
Benefits the sinews and bones
Calms the Shen
Shared with Lidui St-45. Balanced by ䷞ (Quchi LI-11 or Taiyaun Lu-9).
Hexagram attributions are my own with an explanation given in the glossary.
Superficial Innervation: Saphenous nerve, from femoral nerve (L2 - L4)
Dermatome Segment: L4
Striking this point results in great local pain, Qi drainage and immediate power loss. Normally strong joints give way immediately under mild pressure, making it a good set up for a joint lock (Montaigue, Dim Mak Locations, Taijiworld.com).
In five element acupuncture this point is reduced to drain excess in the Spleen.
The word 商 Shang in the name of this point translates as many things including relating to the Shang Dynasty; trade, commerce or business; a businessman or dealer; to consult or discuss; a quotient in mathematics and the second (metal) note of the pentatonic musical scale. Many of these related to the reputation of the Shang who first begun trading with neighbouring people in their capital Shangqiu. This recalls the idea in the Yellow Court Classic of the Spleen as a marketplace where transactions with the outside world are made, exchanging goods and labour. This may explain it's action on the musculoskeletal system as it assists the marketplace of the Spleen to turn food (currency) into actions (services). Its action on calming the Shen is because integrity and trust are required for effective trade relations (Yang Zhenhai, 2020, Yellow Emperor's Inner Needling).
Ling Shu Ch. 6 suggests piercing the Jing points of the Yin channels if a disease is in the Yin of the Yang realm (e.g. the sinews and bones). This would mean using this point to treat disorders of the hip, knee and ankle.
Ch. 7 then suggests using paired needles either side of the tendon to remove a tendon blockage illness, and straight needling to the bone for bone blockage illness. This could be interpreted as using these technique on this point, on either side of the tibialis anterior in incidences of injury to this tendon or straight in cases of ankle injury, or using them as local techniques while Ch. 6 is a distal point suggestion.
Ling Shu Ch. 44, On the Qi Moving in Accordance with the Norms, indicates that the Jing-River points should be pierced in late summer or when the disease affects the voice. The seasonal aspect should not be interpreted literally as it describes the voice and musical notes as "controlled by late summer". It also describes the morning, afternoon, evening and night cycle of the day to be like the four seasons of the year although late summer is not included in this comparison but presumably has some correlate (maybe late afternoon).
In reflexology the band across the ankle, including this point, relates to the lymph and groin.
Avicenna describes venesection at this point in his treatise On Venesection:
"Among the veins in the great saphenous vein, which is on the inner side of the heel. It is more obvious than the sciatic vein. It is venesected to drain the blood from the organs below the liver and to bring the blood from the upper parts to the lower parts; for this reason, its venesection brings on menstruation and opes up the tips of haemorrhoids. By analogy the venesection of the sciatic vein and the great saphenous vein should have similar effects; however, experience has shown that the sciatic vein is much more effective in treating the pain of sciatica, which may be is close proximity. The best way to venesect the great saphenous vein is to use oblique to cross incisions." (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).
In the 22nd section, On Cupping, he says:
"Cupping on the leg is similar to venesection in its effectiveness. It cleases the blood and induces menstruation. For white women with loose bodies and thin blood, it is better to cup the legs than to venesect the great saphenous vein." (ibid.)
It does not give a specific location for cupping on the legs but since it compares it to venesection of the great saphenous it is included here.
Medieval phlebotomy point (John de Foxton, 1408: Liber Cosmographiae, maa.cam.ac.uk).
Most likely location for phlebotomy point mentioned in ancient Greek and Roman medicine when after giving birth: "the cervix uteri was retroverted; pain in the hip and leg, relieved by venesection alongside the ankle" (Brain, 1986, Galen on Bloodletting, p.23) as this is approximately where the saphenous vein runs.
This point was also mentioned by Galen along with Bl-40 to be scarified or bled in the case of suppression of menses (ibid. p.83). According to him scarification at the ankles was more suitable for those of fair skin, while those of darker skin were more suited to bleeding at the knees.
Hippocrates mentions bleeding from the ankle in the case of a woman who "had no lochial discharge after childbirth; although she had tremor of the whole body" in Epidemics II (Ibid. p.113).
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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