Classifications:
Nine Points for Returning Yang (First Trinity: Separation)
Group Luo Point for the Three Arm Yin (Spleen, Liver & Kidney)
Homeostatic point 6 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)
Meetings:
Meeting of Spleen with Liver and Kidney
Location:
On the medial side of the lower leg, 3 cun superior to the prominence of the medial malleolus, in a depression close to the medial crest of the tibia.
Needling:
Perpendicular or oblique proximal insertion 1 - 1.5 cun
Warnings:
Contraindicated in pregnancy
Classical Needling:
"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).
TCM Actions:
Tonifies the Spleen and Stomach
Resolves Dampness
Harmonises the Liver and tonifies the Kidneys
Regulates menstruation and induces labour
Harmonises the Lower Jiao
Regulates unination and benefits the genitals
Calms the Shen
Invigorates Blood
Activates the channel and alleviates pain
TCM Indications:
- Spleen and Stomach deficiency, Spleen deficiency with heavy body, heavy body with heaviness of the four limbs, oedema, borborygmus, diarrhoea, undigested food in the stool, abdominal distension, cold abdomen, unbearable pain below the umbilicus, pain of the Spleen, fullness and distension of the Heart and abdomen, no desire to eat and drink, vomiting of fluid after eating, Sudden Turmoil (霍亂, Huo Luan) Disorder.
- Irregular menstruation, uterine bleeding, uterine bleeding with dizziness, menorrhagia, amenorrhoea, dysmenorrhoea, abdominal (Zheng Jia) masses in women, leucorrhoea, uterine prolapse.
- Infertility, restless foetus syndrome, transverse presentation, delayed labour, prolonged or difficult labour, retention of lochia, retention of dead foetus, post-partum dizziness.
- Seminal emission, seminal emission with dreaming, sexual hyperactivity in men, impotence, pain of the genitals, pain of the penis, contracted testicles, Shan (疝) Disorder, pain due to Shan (疝) Disorder.
- Difficult urination, enuresis, the five types of painful urinary dysfunction, cloudy urine, white turbidity.
- Pailpitations, insomnia, Gall Bladder deficiency, sudden fright disorder in children.
- Dizziness, blurred vision, tinnitus, yawning, hypertension.
- Leg pain, Crane's Knee, damp Painful Obstruction (痹, Bi), atrophy disorder and Painful Obstruction (痹, Bi) of the lower limbs, hemiplegia, heat in the soles of the feet, shin pain, eczema, urticaria, counterflow cold of the foot and hand.
Neuroanatomy:
Superficial Innervation: Tibial nerve from sciatic nerve (L4 - S3)
Dermatome Segment: L4
Martial Applications & Effects of Injury:
As the meeting of Yin, immediate great pain is felt with a dropping feeling from waist downwards, great nausea and even possible defecation when struck (Montaigue, Dim Mak Locations, Taijiworld.com).
Major Combinations:
- Diarrhoea, containing undigested food:
Reinforce Sanyinjiao Sp-6 and Yinlingquan Sp-9
(Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot).
- Diarrhoea with thin stools:
Sanyinjiao Sp-6 with Shenque Ren-8 and Taichong Liv-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Undigested food in the stool:
Sanyinjiao Sp-6 with Zhongwan Ren-12
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
- Undigested food in the stool:
Sanyinjiao Sp-6 with Liangmen St-21, Zusanli St-36, Dachangshu Bl-25, Xiawan Ren-10, Sanjiaoshu Bl-22 and Xuanshu Du-5
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
- Sudden Turmoil Disorder, headache, chest pain and dyspnoeic rales:
Sanyinjiao Sp-6 with Renying St-9, Neiguan Pc-6, Guanchong SJ-1 and Zusanli St-36
(Liao Runhong, 廖润鸿, 1874: Zhen Jiu Ji Cheng, 針灸集成, Compilation of Acupuncture and Moxibustion).
- Spleen deficiency constipation:
Sanyinjiao Sp-6 with Shangqiu Sp-5
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Irregular menstruation:
Sanyinjiao Sp-6 with Daimai GB-26, Qihai Ren-6, Zhongji Ren-3 and SHenshu Bl-23
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Inhibited menstruation:
Sanyinjiao Sp-6 with Zulinqi GB-41 and Zhongji Ren-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Profuse and ceaseless uterine bleeding:
Sanyinjiao Sp-6 with Jiaoxin Kid-8, Yingu Kid-10 and Taichong Liv-3
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
- Profuse and ceaseless uterine bleeding:
Sanyinjiao Sp-6 with Taichong Liv-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Women who have had too many children:
Sanyinjiao Sp-6 with Shimen Ren-5
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Difficult delivery:
Reduce Sanyinjiao Sp-6 and Taichong Liv-3, reinforce LI-4
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Retention of lochia:
Reduce Sanyinjiao Sp-6 and Zhongji Ren-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Retention of lochia:
Sanyinjiao Sp-6 with Jianjing GB-21 and Zhongji Ren-3
(Li Xuechuan, 李學川: Zhen Jiu Feng Yuan, 針灸逢源, Meeting the Source of Acupuncture and Moxibustion).
- Post-partum dizziness:
Sanyinjiao Sp-6 with Zusanli St-36 and Zhigou SJ-6
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Post-partum pain from Blood Stasis:
Sanyinjiao Sp-6 with Qihai Ren-6
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Sudden swelling, redness and pain of the vagina:
Sanyinjiao Sp-6 with Huiyin Ren-1 and Zhongji Ren-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Red and white leucorrhoea:
Sanyinjiao Sp-6 with Baihuanshu Bl-30, Daimai GB-26, Guanyuan Ren-4, Qihai Ren-6 and Jianshi Pc-5
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Pain of the penis:
Sanyinjiao Sp-6 with Yuji Lu-10, Taixi Kid-3 and Zhongji Ren-3
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Sagging and swollen testicle without pain:
Sanyinjiao Sp-6 with Guilai St-29 and Dadun Liv-1
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- White turbidity and chronic seminal emission:
Sanyinjiao Sp-6 with Qihai Ren-6
(Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
- Lower abdominal pain from the seven kinds of Shan Disorder:
Sanyinjiao Sp-6 with Zhaohai Kid-6 and Ququan Liv-8
(Xi-Hong Fu, 席弘賦, Ode of Xi-Hong. First recorded in: Xu Feng, 徐鳳, 1439: Zhen Jiu Da Quan, 針灸大全, Complete Collection of Acupuncture and Moxibustion).
- Obstructed urination:
Sanyinjiao Sp-6 with Yinlingquan Sp-9 and Qihai Ren-6, followed by Yingu Kid-10 and Daling Pc-7
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Inability to urinate:
Sanyinjiao Sp-6 with Shimen Ren-5, Guanyuan Ren-4, Zhongji Ren-3 and Qugu Ren-2
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion)
- Oedema of the four limbs:
Sanyinjiao Sp-6 with Zhongdu Liv-6, Hegu LI-4, Quchi LI-11, Zhongzhu SJ-3, Yemen SJ-2, Xingjian Liv-2, Neiting St-44 and Yinlingquan Sp-9
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Running Piglet Qi in women:
Sanyinjiao Sp-6 with Qimen Liv-14, Guanyuan Ren-4, Zhongji Ren-3, Shimen Ren-5 and Xuehai Sp-10
(Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
- Running Piglet Qi:
Sanyinjiao Sp-6 with Zhangmen Liv-13 and Shimen Ren-5
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Palpitations and insomnia:
Sanyinjiao Sp-6 with Daju St-27 and Qihai Ren-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).
- Insomnia:
Sanyinjiao Sp-6 with Yinlingquan Sp-9, Yinbai Sp-1, Gongsun Sp-4, Feishu Bl-13 and Taiyuan Lu-9
(Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
- Cold-Damp Leg Qi:
Sanyinjiao Sp-6 with Zusanli St-36
(Yu Long Ge, 玉龍賦, Song of the Jade Dragon. First recorded in Wang Guorui, 王國瑞, 1329: Bian Que Shen Ying Zhen Jiu, Yu Long Jing, 扁鵲神應針灸玉龍經, Bian Que's Spiritual Guide to Acupuncture and Moxibustion, Classic of the Jade Dragon).
- Hip pain:
Sanyinjiao Sp-6 with Huantiao GB-30, Shugu Bl-65, Jiaoxin Kid-8 and Yingu Kid-10
(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 hip with difficulty walking and pain of the skin of the lateral aspect of the leg:
Sanyinjiao Sp-6 with Zulinqi GB-41
(Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
- Leg Qi:
Sanyinjiao Sp-6 with Zusanli Sp-36 and Xuanzhong GB-39
(Yu Long Fu, 玉龍賦, Ode of the Jade Dragon. First recorded in Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
- Insomnia due to Heart and Spleen deficiency:
Sanyinjiao Sp-6 with Shenmen He-7, Zusanli St-36 and Yintang Ex-HN-3 (Deadman, Al-Khafaji & Baker, A Manual of Acupuncture).
- Insomnia due to disharmony of the Heart and Kidneys:
Sanyinjiao Sp-6 with Shenmen He-7 and Zhaohai Kid-6 (Deadman, Al-Khafaji & Baker, A Manual of Acupuncture).
- Insomnia due to Liver Fire:
Sanyinjiao Sp-6 with Shenmen He-7, Anmian Ex-HN-14, Ganshu Bl-18 and Danshu Bl-19 (Deadman, Al-Khafaji & Baker, A Manual of Acupuncture).
- Overactive Bladder Syndrome:
Electro at Sanyinjiao Sp-6 and Shuiquan Kid-5 (NICE Guidelines).
Notes:
One of the most important points for regulating the Yin aspects of the body, being able to both tonify the Spleen, Liver and Kidneys and clear Yin pathogens such as Dampness and Blood stasis. Since Spleen, Liver and Kidney all have strong influence over the Blood and reproductive cycle it is a very common point for menstrual issues.
Its ability to regulate urination has seen electro-acupuncture at this point approved by NICE as "percutaneous tibial nerve stimulation" (PTNS), with the second electrode being a pad applied to the foot (probably Shuiquan Kid-5). See also Sacral Nerve Stimulation for a similar form of modern treatment at Zhongliao Bl-33 over the third sacral foramen.
Ling Shu Ch. 23, On Heat Diseases, recommends using this point to stop an extreme sweat brought by treatment. Neighbouring Fuliu Kid-7 is more commonly mentioned for this purpose.
Ling Shu Ch. 52, On the Wei Qi, considers this to be the root of the foot Taiyin meridian with the tip being at Pishu Bl-20 and the root of the tongue.
Ling Shu Ch. 52, On the Wei Qi, also considers this point or Rangu Kid-2 (the text is vague and says 3 cun above or below the inner ankle) to be the root of the foot Shaoyin meridian with the tip being at Shenshu Bl-23 and Lianquan Ren-23.
The contraindication for pregnancy seems to be from its use in protocols for difficult labour to stimulate contractions and not an absolute contraindication if used appropriately in conjunction with other points (Betts & Budd, 2011). A review of trials where "forbidden points" were used in pregnancy found no objective evidence of harm (Carr, 2015).
In Tung acupuncture this point is known as Ren Huang, Human Emperor (77.21) and is often combined with Di Huang, Earth Emperor (77.19), 4 cun above, 1 cun above Lougu Sp-7, and Tian Huang, Heavenly Emperor (77.17), at Yinlingquan Sp-9 to make Xia San Huang, the Lower Three Emperors. They all treat many disorders of the Spleen, Liver and Kidney, this one especially focuses on the Liver (Chu, 2015).
The Nine Points for Returning Yang are used for assisting those close to death. They may be used to resuscitate collapse from deserted Yang, or if it is their time, to assist them in their passage. They are divided into three trinities, related to separation, transition and reunion.
This point belongs to the first trinity, related to separation. They open the orifices, restrain Yang, calm the Shen, strengthen the Middle Burner and establish Heart/Kidney communication. Symptoms include:
- Separation from physical sustenance: food, air, sleep
- Breathing becomes laboured and slows down
- Appetite goes down
- Wants to sleep more but sleep becomes restless with tossing and turning.
Moxa on this point strengthens the Middle Burner to stop vomiting and enable us to take in water and reinforce the post-natal Qi.
J. Yuen lectures on death/dying and the spirit of points, posted as Facebook comments, 19 Dec 2020.
There is little written about the Group Luo except that they are used in cases where 3 related meridians are imbalanced. The only detailed protocol that could be found was from Pialoux (2008), Guide to Acupuncture and Moxibustion, where it states that they can "switch the energies from one side to the other by tonifying deficiencies and dispersing excesses".
To do this, the Group Luo relating to the type of energy (Yin or Yang) in excess is reduced on the affected side after the opposite Group Luo is tonified on the opposite side. Alternatively a trauma affecting all three channels on one limb could be resolved tonifying all its paired opposites - arm/leg and yin/yang on the same side, the same point on the opposite side, and then reducing the affected Group Luo point (i.e. an injury causing swelling affecting all three leg Yang channels can be resolved by tonifying the Group Yang Luo on the affected side arm and opposite leg, and the Group Yin Luo on the affected side, then reducing the the Group Yang Luo on the affected side).
Principle Point of the Xing Nao Kai Qiao (醒脑开窍, activating the brain and opening the orifices) method of Dr. Shi Xue-Min for post-stroke sequalae along with Renzhong Du-26, Neiguan Pc-6, Jiquan He-1, Chize Lu-5 and Weizhong Bl-40.
The aim of these points are to use the Yin meridians and the Du meridian to activate the brain and open the orifices and nourish the liver and kidney. This point supplements the three Yin channels, boosts Marrow, regulates Qi and Blood, and quiets the Spirit. Each point is usually manipulated for 1-3 minutes with one treatment course constituting 10 days of twice daily treatments 3-6 hours apart; 3-5 treatment courses are used continuously.
Liu, J. & Liu, K. (2012). Dr. Shi Xue-Min and the Xing Nao Kai Qiao Legacy. Acupuncture Today 13(3).
Jin's Three Needles for Cholesterol are located at this point, Zusanli St-36 and Neiguan Pc-6. They are indicated for high cholesterol (eLotus, 2021).
In Tibetan medicine:
Moxa 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
