San Jiao channel and points

SJ primary channelRing finger dorsum of the hand between the radius and the ulna shoulder DU 14 GB 21ST 12 Pericardium (san jiao) UJ, MJ, LJ

separates around RN 17

ST12

Neck

Back of the ear

circles behind the ear

cheek (SI 18)

inferior aspect of the eye

separates behind the ear and enters the ear

emerges in front of the ear

terminate at the outer canthus of the eye at SJ23

linking with GB-1.

Entry point: SJ 1

Exit point: SJ 22

SJ Luo-connecting channel

SJ 5 along external of arm chest PC(no describe of goes to PC channel)

Excess: contraction of the elbows

Deficiency: flaccidity of the elbows

SJ divergent channelDiverge Head (DU20)

(not from SJ channel)

Enter Chest: PC & SJ(spreads at chest)

Exit Back of ear

Converges SJ 16

Most of the divergent channel distributed from lower to upper, SJ divergent channel is different.

When there is disharmony of SJ channel, most of the time show symptoms at ear, cheek, and chest area.

SJ muscular region

Start Finger

Bundle Big joints (wrist, elbow, shoulder)

Distributed External of upper arms

Unite GB 13

Indication of SJ channel

1. heat syndrome: 2. Shaoyang syndrome: hypochondriac

problems…3. problems along the pathway of SJ

channel: Finger, wrist, arm, shoulder…Side of head, ear, eyes…

SJ1 SJ2 SJ3 SJ4On the dorsal aspect of the ring finger, approximatel y 0.1 cun from the corner of the nail.

Between the ring and little fingers, 0.5 cun proximal to the margin of the web.

in the depression just proxi- mal to the fourth and fifth metacarpoph alangeal joints.

at the level of the wrist joint, in the depression between the tendons of extensor digitorum communis and extensor digiti minimi.

Perpendicula r or oblique insertion directed proximally 0.1 to 0.2 cun, or prick to bleed.

Perpendicula r insertion 0.3 to 0.5 cun.

Perpendicula r or oblique insertion directed proximally, 0.5 to 1 cun.

i. Slightly oblique proximal insertion 0.3 to 0.5 cun; ii.Transverse insertion towards the radial side of the wristbeneath the tendons, 0.5 to 1 cun.

SJ1Jing-well pt (metal)

SJ2Ying-spring pt (water):

SJ3Shu-

stream

SJ4Yuan- source

1. sense organs’ problems (SJ channel pass through): ear, eyes, mouth, throat: headache, red eyes, tinnitus, deafness, sore throat…2. finger, hand, arm problems: stiffness, numbness, painful of arms (esp. along SJ channel)1. Jing-well point (metal): 1) treat the uppermost reaches of the channels: tinnitus, deafness, earache, stiff mouth, dry lips, bitter taste in the mouth, headache, redness of the eyes, throat painful obstruction and pain of the submandibular region. 2) treat fullness below the Heart: congested heat of the upper jiao, oppression of the Heart with absence of sweating and Heart pain.3) clear heat: i. clearing heat from the channel, ii. treating febrile diseases.

GB44, BL67, SJ1 not for coma…

1. Ying-spring point (water): (clear heat) 1) clear heat from the upper reaches of the channel: ears (deafness, tinnitus, earache), eyes (redness, dryness, lacrimation) and gums and teeth (pain and bleeding). 2) clear heat from the Heart and spirit: manifesting as palpitations, fright, mania, raving and epilepsy. 3). malaria

2. treating local channel disorders affecting the wrist, hand and fingers.

(Shaoyang syndrome- next page)

See other page

See other page

Shaoyang syndrome• The Tai Yang stage involves Evil pathogens (Cold, Wind) on the exterior of the

body which need to be released or "sweated out." The Yang Ming stage involves pathogenic Heat in the Interior which need to be purged through the bowels. In between these two stages is the Shao Yang syndrome where the pathogen is between Internal and External.

• Although the Shao Yang symptoms include both chills and fever, these symptoms alternate from one to the other. The related channels of the Shao Yang syndrome are the San Jiao, Gallbladder, Pericardium, and Liver.

• Symptoms:1. Alternating chills and fever2. Bitter taste in mouth3. Blurred vision4. Nausea, vomiting, bloating, poor appetite, and stomach ache.5. Pain in the costal (hypochondriac) region6. Irritability, Heart Vexation, and irregular heart beat.

Tongue: Sides of the tongue are more red, mixed yellow and white coating (again reflecting the halfway characteristic of the Shao Yang syndrome).

• Pulse: Wiry pulse.

• Formula: Xiao Chai Hu Tang (Minor Bupleurum Decoction)

SJ 3Shu-stream pt (wood)

1. one of the most important distal points for treating ear disorders due to any pathology, particularly suited to exterior wind and Liver disharmony (especially when due to excess): tinnitus, deafness, inflammation of middle ear…Case: inflammation of middle ear w/ pus, pain around ear: reduce SI 3, pain in front of ear better, reduce SJ 3, pain behind ear disappeared

2. malaria: chronic malarial fever

3. Shu-stream point (wood):heaviness of the body and pain of the joints. pain of the shoulder and elbow, pain of the spine (at the level of the Heart), numbness of the four limbs and inability to flex and extend the fingers.

SJ 4Yuan-source pt

1. malaria2. wasting and thirsty

3. acute testitis 睾丸炎: middle size moxa on SJ4, 3 unit per day, treat for 1 week, 204 cases w/o symptoms relieved in 10hours to 7 days.

4. important point to strengthen the original qi in the treatment of diseases of deficiency (Japanese acupuncture)

SJ5 SJ6 SJ7 SJ8 SJ9 SJ10proximal to SJ4, in the depression between the radius and the ulna, on the radial side of the extensor digitorum communis tendons.

3 cun proximal to SJ4, on the ulnar side of SJ6

Same as SJ 5, SJ 6

on a line between SJ4 andthe lateral epicondyl e of the humerus

With the elbow flexed, this point is located in the depression cun proximal to the olecranon.

2 cun 3 cun 4 cun 7 cun

i. Slightly oblique insertion towards the ulnar side or oblique proximal or distal insertion towards the elbow or wrist respectively, 0.5 to 1.5 cun,

Perpendi cular or oblique 1 to 2 cun.

Perpendicular insertion 0.5 to 1 cun.

ii. Joined by threading to P 6. or P 5.

Caution: movement of the patient’s arm or hand after needling this point can result in a bent needle.

Note: according to some books this point is contraindi cated to needling.

SJ 5

SJ 6

SJ 7Xi-cleft

SJ 8 SJ 9 SJ 10He-sea point (earth)

1. problems along SJ channel pathway: 1) ear problems (tinnitus, deafness, blockage of ears, ear ache… )2) finger, arm, elbow, shoulder, upper back problems (pain, numbness, tingling, tremors, movement limited…)Next page

1. epilepsy2. acupuncture anesthesia for chest surgery

no relevant indications of Xi-cleft point

1. sudden loss of voice2. toothach e

1. sudden loss of voice2. toothache3. breathing problems: shortness of breath, plum pit Qi

1. migraine (Shaoyang area headache), hypochondriac pain, neck pain…2. transforming phlegm: scrofula, goiter, coughing of phlegm and psycho- emotional disorders. 3. pain, painful obstruction and atrophy disorder affecting the elbow, arm, shoulder, neck and upper back. (in classical sources to its use in the treatment of wind painful obstruction affecting the entire body)

SJ 51. Luo-connecting point 2. Opens to Yang wei channel

1. Luo-connecting point:1) Luo-connecting channel’s problems: Excess: contraction of the elbows Deficiency: flaccidity of the elbows 2) exterior-interior related channel’s problems: PC channel: oppression and tightness of the chest3) SJ channel’s problems:A. heat syndromes (shaoyang syndrome: SJ5+GB40…) B. problems along SJ channel: headache, eyes problems (red eyes, swollen and painful of eyes…), ear problems, finger problems, wrist problems, arm problems…)

2. opens to the Yang Linking vessel (Yang Wei channel): (SJ5+GB41) (Yang Wei links all the yang channels of the body, including the Governing vessel) 1) dispel pathogenic factors from the exterior (yang) portion of the body: exterior syndrome 2) headache: temporal, frontal, occipital and vertex headaches. (Yang Wei links all the yang channels)3) constipation4) Yang wei balance the yang qi of the whole body (yang deficiency, yin excess)5) problems along Yang wei channel pathway: 6) as couple point w/ GB41 treat Dai channel problems (GB41 + SJ5)

According to the Ode of the Obstructed River: SJ 5 for injury by cold to the exterior accompanied by headache.

Extra meridians Area supplied Connecting meridians

Yang Wei Lateral aspect of the lower extremities, shoulder and vertex

Hand and foot-taiyang, Du, hand and foot-shaoyang, foot-yangming

Yang Wei channel

Heel external malleolus

Along GB channel hip

posterior hypochondriac

costal region

axilla shoulder

Forehead

Neck

Meet DU channel

CAM (15 Points)BL 63GB 35SI 10SJ 15GB 21, 13, 14, 15, 16, 17, 18, 19, 20DU 16, 15

SJ 6Jing-river (fire)

upper jiao: 1) clear heat from the SJ channel, being indicated for febrile diseases, redness, pain and swelling of the eyes, tinnitus and deafness, lockjaw, swollen throat, scrofula etc. 2) resolve stagnation of qi in the chest giving rise to oppression of the chest and Heart pain3) stagnant qi transforms into fire and insults the Lung there may be cough with a red face.

middle jiao: SJ6 + GB34an essential point for treating pain of the lateral costal region, and distention due to qi stagnation or any other etiology

lower jiao:a major point for moving the qi of the intestines and treating constipation, whether due to stagnation of qi, heat or any other etiology

SJ 6 and SJ 5 are the only points on the three arm yang channels indicated for constipation

SJ11 SJ12 SJ13 SJ14this point is located1 cun proximal to SJ10.

on a line drawn betweenSJ10 and SJ14, 4 cun proximalto SJ10 and 6 cun distal to SJ14.

On a line drawn between SJ10 and SJ14, meets the posterior border of the deltoid muscle, approximately two thirds of the distance between these two points.

At the origin of the deltoid muscle, in the depression which lies posterior and inferior to the lateral extremity of the acromion.

Perpendicular insertion 0.5 to 1 cun.

Perpendicular or oblique insertion 1 to 2 cun.

Perpendicular or oblique insertion 1 to 2 cun.

i. With the arm abducted, perpendicular insertion directedtowards the centre of the axilla, 1 to 1.5 cun; ii. Transverse-oblique insertion directed distally towardsthe elbow, 1.5 to 2 cun.

SJ11 SJ12 SJ13Meeting point of SJ and LI

SJ14

1. local problems: shoulder and arm pain

1. headache2. jaundice (Shaoyang)

1. epilepsy2. problems along SJ channel pass way :HeadacheStiff neckToothache

1. red eyes2. goiter, scrofula (armpit)

1. common used for shoulder problems

SJ15 SJ16Midway between GB21 and SI13 (at the medial end of the suprascapular fossa).

On the posterior border of the sternocleidomastoid muscle, approximately 1 cun inferior to GB12, on a line drawn between BL10 and SI17.

Oblique insertion directed according to the clinical manifestations,0.5 to 1 cun.

Perpendicular insertion, 0.5 to 1 cun.

Caution: perpendicular insertion, especially in thin patients, carries a substantial risk of inducing a pneumothorax.

SJ15Meeting point of SJ and Yang Wei channel

SJ16Sky window point

Local problems:1. Shoulder and arm pain2. stiff neck3. fullness of chest

1. Problems of face and head:Headache, dizziness, puffy face, deafness…2. local problems: stiff neck3. insomnia, dream disturbed sleep

Window of the sky pointsLU-3 REN-22ST-9 SI-16LI-18 SI-17SJ-16 DU-16BL-10 P-1

SJ17 SJ18 SJ19 SJ20 SJ21Behind the earlobe, between the ramus of the mandible and the mastoid proces(tender spot)

Posterior to the ear, in a small depression on the mastoid bone, ?? of the distance along a curved line drawn from SJ17 to SJ20 following the line of the rim of the ear.

On the side of the head, directly level with the apex of the ear when the ear is folded forwards.

In the depression anterior to the supratragic notch and slightly superior to the condyloid process of the mandible.

1/3 2/3

Perpendicul ar towards the opposite ear, 0.5 to 1 cun.

Subcutaneous insertion along the course of the channel0.3 to 0.5 cun, or prick to bleed.

Transverse insertion 0.5- 1.5 cun.

Inferior oblique insertion, slightly posteriorly, 0.5 to 1cun.

Caution: No deep puncture. Deep puncture may cause

Note: according to severalclassical texts, this point is contraindicat ed to bleeding.

The needle should be inserted within the subcutaneous layers close to the bone of the skull, rather than more shallowly.

Note: many classical sources prohibit moxibustion atthis point in cases of discharge of pus from the ear.

SJ17 SJ18 SJ19 SJ20Meeting point of SJ, GB, SI

SJ21

1. local problems: ear problems: tinnitus, deafness, blockage of ear…1. facial problems: swollen on face, TMJ…2. scrofula, goiter3. hiccups4. expel wind: dizziness, bell’s palsy…5. ear problems

1. headache2. infantile epilepsy3. digestion problems: vomit, diarrhea…

1. eyes problems: red eyes, swollen eyes…2. mouth problems: toothache, dry lips, dry mouth3. headache, stiff neck…4. mumps (acupressure, moxa w/ Deng Xin Cao also works)

Emphasis on the ear problems

1. toothache2. stiff neck …3.TMJ…

Deng Xin Cao

SJ22 SJ23Approximately 0.5 cun anterior to the upper border of the root of the ear, in a slight depression on the posterior border of the hairline of the temple.

In the depression on the supraorbital margin, at the lateral end of the eyebrow.

Transverse insertion 0.3 to 0.5 cun.

Transverse insertion, medially along the eyebrow or posteriorly, 0.5 to 1 cun..

Note: according to several classical texts, this point is contraindicated to moxibustion

SJ22 SJ23Local problems: 1. heaviness of head or headache2. tinnitus3. TMJ

1. local problems: 1). headache, migraine…2). Eyes: blurred vision, red eyes, twitching of eyelids2. epilepsy