Lianquan and Yamen

Star

廉泉、啞門 (Liánquán, Yǎmén)

Point Pairs (对穴) Throat

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

  1. CV23 Lianquan midline

    Conception Vessel–Yin Wei meeting point above the larynx; frees the tongue and restores the voice from the front.

    Patient seated or supine. On the anterior midline above the laryngeal prominence, in the hollow over the upper border of the hyoid. Insert 0.5–0.8 cun toward the root of the tongue, then draw the needle back under the skin and redirect it obliquely to the left and to the right, until a local ache with distension is felt. The needle passes skin and subcutaneous tissue into the muscles above the hyoid toward the tongue root.

    • ⚠ Major vessel
  2. GV15 Yamen midline

    Governor Vessel–Yang Wei meeting point, the 'gate of muteness'; restores speech from the back of the neck.

    Patient seated with the head bent slightly forward. On the posterior midline 0.5 cun within the hairline, in the hollow above the spinous process of C2. Insert perpendicularly or angled slightly down toward the mandible, 0.5–0.8 cun, through the subcutaneous tissue and nuchal ligament toward the interarcuate ligament, until a local ache with numbness is felt. Do not go deeper — the spinal cord lies beneath.

    • ⚠ Spinal cord / medulla

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

  • CV23 Lianquan
    • ⚠ Vascular injury or haematoma has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 4 (Organ injury) and Table 8 (Hemorrhage)
  • GV15 Yamen
    • ⚠ Spinal cord / medulla risk: deep or misdirected insertion can enter the spinal canal. World Health Organization 1999, Section II §5.2 (Central nervous system), p. 25; Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 2 (Central nervous system injury associated with acupuncture)

Treatment Principle

Clear the Heart, benefit the throat and tongue, and restore speech.

Indications

Deaf-mutismsudden loss of voiceswelling and pain of the tongueulcers of the mouth and tongue

Method

Needle Lianquan with the patient seated or supine, redirecting the needle to either side after the first insertion; needle Yamen with the patient seated and the head slightly flexed, with no deeper insertion than 0.8 cun.

⚠ Cautions

Yamen is a high-risk point: the medulla oblongata and spinal cord lie directly deep. Never angle upward, keep strictly within 0.8 cun, and do not use moxibustion there. At Lianquan, keep the needle above the hyoid and directed toward the tongue root.

About

A front-and-back pairing across the neck at the level of the tongue root: Lianquan above the larynx and Yamen below the occiput. The source uses it for loss of speech in its various forms and for a swollen, painful or ulcerated tongue.

Rationale

Lianquan is on the Conception Vessel and meets the Yin Wei Mai; Yamen is on the Governor Vessel and meets the Yang Wei Mai, and its name means 'gate of muteness'. The two therefore join the front and back midline channels, and the yin and yang linking vessels, around the tongue. In Chinese medicine the tongue is the outward sprout of the Heart, which is why clearing the Heart appears in the principle alongside the throat and speech.

Clinical Notes

The source describes Lianquan's needle as passing through the thyroid gland and hyoid bone; that is not the path of a correctly placed needle, which lies above the hyoid in the suprahyoid muscles on its way to the tongue root.

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 2, combination 9.

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