Points Database

: Quchi : Pool at the Crook

LI-11 : Hand Yangming Large Intestine 11

Alternative Name(s): Guicheng, guitui
Translation: Ghost minister, ghost leg

Classifications:
He-Sea and Earth point

Sun Si-miao Ghost point (4th trinity)
Ma Dan-yang Heavenly Star point
Mother point of the Large Intestine channel

Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)
Homeostatic point 9 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

Location:
At the elbow, midway between Chize Lu-5 and the lateral epicondyle of the humerus at the lateral end of the transverse cubital crease

Needling:
Perpendicular insertion 1 - 1.5 cun, or joined by through needling to Shaohai He-3

TCM Actions:
Clears heat
Cools the blood, eliminates wind, drains damp and alleviates itching
Regulates qi and blood
Activates the channel and alleviates pain

TCM Indications:
  • High fever that does not recede, injury by cold with residual fever that does not recede, thirst with sweating on drinking and dry and hot skin when does not drink, malaria.
  • Throat painful obstruction, loss of voice, toothache, redness and pain of the eyes, lacrimation, pain in the front of the ear.
  • Agitation and oppression of the chest, manic disorders, poor memory, tongue thrusting, dizziness, hypertension, goitre, scofula.
  • Erysipelas (cinnabar toxin), urticaria, wind rash, dry skin, scaly skin, itching of the skin, shingles, pain and itching of the whole body as if bitten by insects, clove sores on the back.
  • Distension and pain of the abdomen, vomiting and diarrhoea, dysenteric disorder, amenorrhoea.
  • Numbness of the upper arm, painful obstruction, wind painful obstruction, hemiplegia, clonic spasm, contaction, immobility and pain of the elbow and shoulder, emaciation and weakness of the elbow, redness and swelling of the arm, atrophy disorder of the lower limbs, pain and swelling of the ankle.

    Neuroanatomy:
    Superficial Innervation: Posterior cutaneous nerve of the forearm (C6 - C8) and radial nerve (C5 - T1) at depth
    Dermatome Segment: C5

    Trigger Point Associations:
    Muscle: Supinators
    Myotome Innervation: Posterior interosseous nerve, a continuation of the deep branch of the radial nerve (C7 - C8)
    Location Notes: Extensor carpi radialis longus trigger point lies very close to this point, slightly distal and lateral, just off the brachioradialis muscle, and the aconeus trigger point should lie slightly distal and posterior still
    Pain Referral Pattern: Lateral aspect of the elbow and dorsal aspect of the hand over the adductor pollicis and first interosseous muscles (L.I.-4)
    Indications: Extensor tendonitis of the forearm ; Tennis elbow pain

    Notes:
    Main point for clearing Heat anywhere in the body.

    In five element acupuncture this point is reinforced to tonify Large Intestine deficiencies.

    Ling Shu Ch. 6 suggests piercing the He points of the Yang channels if a disease is in the Yang of the Yang realm (e.g. the skin). This would mean using this point to treat skin level disorders relating to this channel.

    Combining this with the needling techniques described in Chapter 7 we could suggest using either superficial needling here to influence pathogens in the skin, or leopard spot needling (three needles aimed at letting blood from each side) for pathogens in the Blood.

    Ling Shu Ch. 9, On Ends and Beginnings, advises that in the case of Heat associated with receding Yin Qi the Yang conduit should be pierced once and the Yin conduits twice. Based on other recommendation to use the He-Sea of the Yang conduits (Ch. 19) and the Yuan-Source with the Ying-Spring points (Chs. 6, 19 and 24) to clear Heat from the Zangfu, that would suggest this point, Taiyan Lu-9 and Yuji Lu-10 as a protocol to clear Heat in the Lung/Large Intestine. Next it advises that in Cold associated with receding Yang Qi the Yang should be pierced twice and the Yin once but no such obvious protocol is evident for this situation.

    Ling Shu Ch. 19, on the Four Seasonal Qi, advises using the He-Sea points in autumn when diseases are in the Fu organs.

    Ling Shu Ch. 71, On Evil Visitors, says that when a depletion evil is in the Lung and Heart it remains in two elbows. Yuen's theory of the Divergent meridians suggests that they store pathogens at the major joints, depleting our resources while they do, which would make this a potential point for for the Lung/Large Intestine Divergent.

    Ghost Points:
    The fourth trinity of Ghost Points, consisting of this point, Huiyin Ren-1, Shangxing Du-23 and Huiqian or Yintang, is concerned with self-destructive behaviour, self-harm and attempts at suicide.

    As a Heavenly Star point it is able to open us to Cosmic influences and so may counteract extreme states of despair. It is also indicated in difficulties doing the basic necessities of life.

    To "open" the point it should be needled very deeply towards the bone with no tonification or dispersal (Yuen, 2005, 3 Spirits & 7 Souls).

    One of the 18 tender spots used in the diagnosis of fibromyalgia (Wang, Acupuncture and Traditional Chinese Medical Approaches for Fibromyalgia, Acupuncture Today, vol.6 no.3, 2005).

    In Mayan medicine:
    Used to treat pain in the upper extremities (Garcia, Sierra, Balam, 1999: Wind in the Blood)

    Medieval phlebotomy point (John de Foxton, 1408: Liber Cosmographiae, maa.cam.ac.uk; Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov)

    Lad and Durve (2008) in Marma Points of Ayurveda locate a point near here at the body protuberance of the lateral epicondyle called Bahya Kurpara and associate it with Prana Vayu, Vyana Vayu and Shleshaka Kapha.

    They give the following functions:
    - Harmonises the movement of elbow and arm
    - Relieves pain locally
    - Improves circulation


    Reference Notes: (click to display)