Neiguan and Ximen

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內關、郄門 (Nèiguān, Xìmén)

Point Pairs (对穴) Cardiac

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. PC6 Neiguan bilateral

    Luo-Connecting point of the Pericardium; regulates the Heart, harmonises the Stomach and calms the spirit.

    Palm up with the wrist slightly flexed: 2 cun above the midpoint of the wrist crease on the line from PC3 to PC7, between the tendons of palmaris longus and flexor carpi radialis. Insert perpendicularly 0.5–1.5 cun through the deep fascia into flexor digitorum superficialis, then flexor digitorum profundus and pronator quadratus. Seek local aching and numbness with an electric sensation running to the fingertips.

  2. PC4 Ximen bilateral

    Xi-Cleft point of the Pericardium; relieves acute pain of the heart and chest.

    Arm stretched forward, palm up, elbow slightly flexed: 5 cun above the midpoint of the wrist crease on the PC3–PC7 line, between the same two tendons. Insert perpendicularly 0.5–0.8 cun through the deep fascia and muscle layer to the interosseous membrane. Local aching and numbness spreading to the fingertips is sought.

Treatment Principle

Regulate qi and relieve pain, descend rebellious qi and harmonise the Stomach, and calm the spirit.

Indications

Cardiac painPalpitationsInsomniaStomach acheVomitingHiccupContracture and pain of the elbow and arm

Method

Both points lie on the Pericardium channel between the palmaris longus and flexor carpi radialis tendons and are needled perpendicularly with the forearm supinated — PC6 0.5–1.5 cun, PC4 0.5–0.8 cun — until the sensation travels toward the fingers. The book gives no retention time or moxibustion instructions for this pair.

⚠ Cautions

The median nerve lies directly beneath PC6; once the electric sensation to the fingertips has been obtained, do not keep lifting and thrusting, and keep to the lower end of the depth range in a slender forearm.

About

Two points on the Pericardium channel of the forearm, used for chest and heart pain, palpitations and poor sleep, for nausea, vomiting and hiccup, and for tightness of the arm.

Rationale

PC4 is the Xi-Cleft point of the Pericardium, where the channel's qi and blood gather deeply and which is used for acute, painful conditions of its organ. PC6 is the Luo-Connecting point and the confluent point of the Yin Wei Mai, which governs the chest, Heart and Stomach. The Xi-Cleft point relieves the acute pain while the Luo point regulates the qi of the chest and descends rebellious Stomach qi; both calm the spirit.

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 4, combination 5.

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