Regional Anatomy:
Skin-subcutaneous tissue-trapezius muscle-levator muscle of scapula.
In the superficial layer, there are the supraclavicular nerve and the branches or tributaries of the superficial cervical artery and vein. In the deep layer, there are the branches or tributaries of the trandverse cervical artery and vein and the branches of the dorsal scapular nerve.
Location:
1. Sit upright; midpoint of the line connecting the highest spot of spinous process of the 7th cervical vertebrae and the acromial extremity of clavicle, perpendicular to the nipple. 2. Press the inferior border of spina scapulae of the patient with the 1st transverse stria posterior to the palm of the doctor, press the spot below the 7th cervical vertebrae with his or her thumb, press the shoulder with his or her other four fingers juxtaposed together, nearby the neck prop the index finger against the neck with the middle finger flexed, the spot where the tip of middle finger reaches is JianjingGB21(Jianjing (GB21) [3]).
Function:
Lowering the adverse flow of qi, and resolving masses, nourishing the deficiency, and activating the channels and collaterals.
Indications:
Pain and rigidity of the neck, pain in the shoulder and back, motor impairment of the arm, mastitis, scrofula, apoplexy, difficult labor.
Prescription:
Combined use with HeguLI4 (Hegu (LI4) Yuan-Source Point [4]) and SanyinjiaoSP6 (Sanyinjiao (SP6) [5]) for treatment of dystocia and retention of placenta; with TianzongSI11 (Tianzong (SI11) [6]) and RugenST18 (Rugen (ST18) [7]) for treatment of mastitis; with QuchiLI11 (Quchi (LI11) He-Sea Point [8]) for treatment of tuberculosis of cervical lymph nodes; and with DazhuiGV14 (Dazhui (GV14) [9]), GaohuangBL43 (Gaohuang (BL43) [10]), PishuBL20 (Pishu (BL20) [11]), WeishuBL21 (Weishu (BL21) [12]), XiawanCV10 (Xiawan (CV10) [13]), and ZusanliST36 (Zusanli (ST36) He-Sea Point [14]) for treatment of asthenic diseases.
Methods:
Insert the needle subcutaneously to 1-1.5 cun depth; needling response: local numbness and distention; moxibustion: using 3-7 moxa-cones, or mild moxibustion for 15 min.
Note:
Don`t puncture deeply, or else the needle would penetrate the external intercostal muscles-the internal intercostal muscles-the costal pleura-the pleural cavity-the visceral pleura and the lung by its tip, and cause an injury to lung, leading to pneumatothorax.
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