Zhongwan, Neiguan and Zusanli
Star中脘、內關、足三里 (Zhōngwǎn, Nèiguān, Zúsānlǐ)
Modern Chinese point-pair (对穴) teaching, as compiled by Guo Changqing and colleagues at the School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine.
Points
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Front-Mu point of the Stomach and Hui-Meeting point of the fu organs; harmonises the Stomach from the front.
Patient supine: on the anterior midline of the upper abdomen, 4 cun above the umbilicus. Insert perpendicularly 0.5–1.0 cun through the subcutaneous layer and the deep abdominal fascia to the fascia just outside the peritoneum, seeking an aching distension that spreads into the stomach.
- ⚠ Organ
- Pregnancy: caution
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Luo-Connecting point of the Pericardium and confluent point of the Yin Wei Mai; stops nausea and vomiting.
Palm up, wrist slightly flexed: 2 cun above the midpoint of the wrist crease on the PC3–PC7 line, between palmaris longus and flexor carpi radialis. Insert perpendicularly 0.5–1.5 cun through the deep fascia and the finger flexors to pronator quadratus, seeking local aching and numbness with an electric sensation to the fingertips.
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He-Sea point of the Stomach; strengthens the Spleen and Stomach and descends Stomach qi.
Seated with the knee bent: 3 cun below ST35, one finger-breadth lateral to the anterior crest of the tibia; alternatively, 1 cun below the lower outer margin of the upper tibia. Insert perpendicularly 0.5–1.5 cun through tibialis anterior toward extensor hallucis longus, seeking a sensation that spreads to the ankle, dorsum of the foot and toes.
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
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CV12 Zhongwan
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⚠ Organ injury has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 4 (Organ injury associated with acupuncture)
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No cited needling data yet for PC6, ST36. No flag here does not mean no risk.
Treatment Principle
Regulate qi and harmonise the Stomach; descend rebellious qi to stop nausea and vomiting.
Indications
Method
CV12 is needled on the midline with the patient supine, perpendicularly 0.5–1.0 cun; PC6 perpendicularly 0.5–1.5 cun and ST36 perpendicularly 0.5–1.5 cun on both sides. The book gives no retention time or moxibustion instructions for this set.
⚠ Cautions
At CV12 the needle ends at the fascia immediately outside the peritoneum: stay within the stated depth, especially in thin patients. The median nerve lies beneath PC6 — stop manipulating once the electric sensation is obtained.
About
A three-point prescription for the Stomach — a point over the organ, one on the forearm and one on the leg — for nausea and vomiting, abdominal pain and distension, disordered bowels and poor appetite.
Rationale
CV12 is the Front-Mu point of the Stomach and the Hui-Meeting point of the fu organs, treating the Stomach directly from above. ST36 is the He-Sea point of the Stomach, which strengthens the middle burner and brings Stomach qi downward from below. PC6, the Luo point of the Pericardium and confluent point of the Yin Wei Mai, governs the chest and epigastrium and is the chief point for stopping nausea. A local point, an upper-limb distal point and a lower-limb distal point thus surround the middle burner.
Sources
- Guo Changqing (ed.). Acupuncture of Acupoint Combinations: Quick Lookups. Daylesford: Heart Space Publications, 2020 (English edition; © China Science and Technology Press). ISBN 978-0-6489215-5-4. Chapter 5, combination 1.
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