Si Ma — The Four Horses

Star

駟馬 (Sì Mǎ)

Master Tung — Dao Ma Groups Dermatology

Master Tung Ching Chang, Tung's Extraordinary Points.

Points

  1. T.88.18 Si Ma Shang bilateral

    Upper

  2. T.88.17 Si Ma Zhong bilateral

    Middle; the principal point

  3. T.88.19 Si Ma Xia bilateral

    Lower

Treatment Principle

Regulate the Lung, which governs the skin, and open the surface — treating dermatological disease from the interior rather than the lesion.

Indications

Eczema, psoriasis and dermatitisacneurticaria and chronic itchingallergic rhinitis and sinusitisasthma and chronic coughshingles and post-herpetic neuralgiarib and flank painlymphadenopathytinnitus

Method

Needle all three, perpendicular, 1.5 to 2.5 cun, bilaterally. Retain 30 to 45 minutes. Treat twice weekly at first for chronic skin disease.

Needle order: Si Ma Zhong first as the principal point, then Shang and Xia.

⚠ Cautions

Deep lateral thigh needling — straightforward, but observe depth in thin patients.

About

The Four Horses are the group most Tung practitioners reach for in dermatology, and the clearest expression of the system's reliance on the Lung–skin relationship.

Rationale

Tung placed the Lung correspondence on the lateral thigh. Because the Lung governs the skin and the body hair in classical physiology, a group that regulates the Lung reaches skin disease anywhere on the body — which is why the same three points are used for eczema on the hands and psoriasis on the scalp alike.

Clinical Notes

Chronic skin disease needs a course measured in months, not visits. The Si Ma group is often combined with bleeding at the ear apex or in the Wu Ling field on the back where heat is prominent.

Sources

  • Young, Wei-Chieh. Lectures on Tung's Acupuncture: Points Study. Blue Poppy Press.

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