下巨虛 : Xiajuxu : Lower Great Void

Location Guides:

Classifications:

Lower He-Sea point of the small intestine
Point of the Sea of Blood
One of the "59 piercings" for clearing Heat in Su Wen Ch. 61

Location:

On the lower leg, 3 cun inferior to Shangjuxu St-37, and 1 cun inferior to Tiaokou St-38, one fingerbreadth lateral to the anterior crest of the tibia.

Needling:

Perpendicular or oblique insertion 1 - 1.5 cun

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@ and is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Moves Small Intestine Qi and transforms stagnation
Regulates and harmonises the Intestines and clears Damp-heat
Activates the channel and alleviates pain

TCM Indications:

• Lower abdominal pain, lumbar pain that radiates to the testicles.
  
• Diarrhoea, diarrhoea containing undigested food, Dysenteric Disorder (痢疾, Li Ji), pus and blood in the stool, insufficiency of the Small Intestine qi, dark urine.
  
• Breast abscess, manic raving, sudden fright, drooling, dry lips, Throat Painful Obstruction (喉痹, Hou Bi), absence of sweating, no pleasure in eating, pallor.
  
• Painful obstruction and atrophy disorder of the lower limb, hemiplegia of the leg, atrophy disorder of the foot, pain of the heel, extreme sensation of cold and heat in the shoulder, heat sensation in the area between the ring and little fingers, burning sensation in front of the ears.

Neuroanatomy:

Superficial Innervation: Lateral femoral cutaneous nerve of the calf (L4 - S1)

Dermatome Segment: L5

Deeper Structures: Deep fibular (peroneal) nerve (L4 - S1)

Martial Applications & Effects of Injury:

There is immediate great pain when this point is struck spot on but it also affects the Small Intestine and causes paralysis of the legs when struck hard. It will also have a later affect upon the Wei Qi and cause problems with the immune system as well (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Heat in the Stomach:
    Xiajuxu St-39 with Qichong St-30, Zushanli St-36 and Shanjuxu St-37
    (Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot, Ch. 23, On Heat Diseases).
  
  
• Diarrhoea and Dysenteric Disorder with pus and blood:
    Xiajuxu St-39 with Kid-21 and Taibai Sp-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).
  
  
• Manic raving:
    Xiajuxu St-39 with Qiuxu GB-40
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Fullness of the chest and lateral costal region radiating to the abdomen:
    Xiajuxu St-39 with Qiuxu GB-40, Xiaxi GB-43 and Shenshu Bl-23
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Breast abscess:
    Xiajuxu St-39 with Zusanli St-36, Xiaxi GB-43, Yuji Lu-10, Weizhong Bl-40, Zulinqi GB-41 and Shaoze SI-1
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).

Notes:

This point is also on the 5th trajectory of the Chong mai relating to digestive functions (Yuen, 2005, The Extraoridinary Vessels).

The "59 piercings" are named in the Su Wen Ch. 61 and mentioned in Su Wen Ch. 32 and Ling Shu Ch. 23 for treating Heat diseases.

Ling Shu Ch. 33, On the Four Seas, says the Chong Mai is the Sea of the 12 Meridians with its upper Shu-transport point at Dazhu Bl-11 point and lower Shu transport points at this point and Shangjuxu St-37.

In Tung acupuncture the Si Hua Zhong (77.09), Center Four Flowers, point is located in between this point and Shangjuxu St-37, 4.5 cun below Si Hua Shang (77.08) at Zusanli St-36, at the border of the tibia instead of one fingerbreadth lateral. It is indicated for problems of the Stomach channel including respiratory, cardiac and digestive illness as well as pain (Chu, 2015).

Si Hua Fu (77.10), Four Flowers Append, is located 2.5 cun below Si Hua Shang, just below this point, and has similar indications.

Si Hua Xia (77.11), Lower Four Flowers, is located 2.5 cun below Si Hua Fu and is indicated mainly for digestive disorders and Stomach channel issues.

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