四白 : Sibai : Four Whites

Location Guides:

Classifications:

Shokanten Nine continents Pulse for Lower Jiao, Yangming and the mouth and teeth
Homeostatic point 19 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

Meetings:

Meeting of Stomach with Stomach Divergent

Location:

With the eyes looking directly forwards, this point is located 1 cun directly below the pupil, in the depression at the infraorbital foramen

Needling:

Perpendicular insertion 0.2 - 0.4 cun
Transverse insertion to join with such points and Quanliao S.I.-18, Yingxiang L.I.-20, etc.
Oblique insertion supero-laterally, along the infraorbital foramen 0.3 - 0.5 cun

Warnings:

According to several classical texts this point is contraindicated to moxibustion

Classical Needling:

"The Yangming usually has much Qi and much Blood" (Su Wen 素問 ch. 24) implying this channel can normally be needled or bled.
"The foot Yangming is to be pierced 6 fen deep and remain inserted for ten exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three fen and moxaed with seven cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Eliminates Wind, clears Heat and benefits the eyes

TCM Indications:

• Redness and pain of the eyes, Superficial Visual Obstruction, dimness of vision, Visual Dizziness, itching eyes, excessive lacrimation, deviation of the mouth and eye, twitching of the eyelids, headache.
  
• Round worms in the bile duct.

Neuroanatomy:

Superficial Innervation: Infraorbital nerve, from maxillary branch of trigeminal nerve (V2)

Dermatome Segment: CN V2 maxillary branch of trigeminal

Martial Applications & Effects of Injury:

This point is quite sensitive and will cause considerable local pain
and Qi drainage resulting in knock out and severe nervous damage. When struck one feels a moving down sensation into the chest and then into the legs which will become weak as a result of the downward draining Qi (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Superficial Visual Obstruction:
    Sibai St-2 with Jingming Bl-1 and Hegu LI-4
    (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 and Visual Dizziness:
    Sibai St-2, Yongquan Kid-1 and Dazhu Bl-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).

Notes:

This point would also be on the upper trajectory of the Chong mai in Jeffrey Yuen's descriptions (Yuen, 2005, The Extraordinary Vessels).

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 Lower Jiao, Yangming and the mouth and teeth.

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