Acupuncture Points Notebook

Location Guides:

: Futu : Support the Prominence

LI-18 : Hand Yangming Large Intestine 18

Point of the Window of Heaven
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)
Confluent point of the Large Intestine and Lung Divergent channels (Cecil-Sterman, 2012, Advanced Acupuncture)

Meeting of Large Intestine with Large Intestine Divergent and Lung Divergent

On the lateral side of the neck, level with the tip of the lanyngeal prominence, between the sternal and clavicular bellies of the sternocleidomastoid muscle

Perpendicular insertion 0.3 - 0.5 cun or oblique insertion 0.5 - 0.8 cun

Deeper needling mayb puncture the carotid artery or jugular vein

TCM Actions:
Benefits the nose and throat
Alleviates cough and wheezing

TCM Indications:
  • Swelling and pain of the throat, sudden loss of voice, rattling sound in the throat, goitre, scrofula, difficulty in swallowing.
  • Cough, coughing with much spittle, wheezing, asthma, hypotension.

    Superficial Innervation: Greater auricular nerve (C2 - C3)
    Dermatome Segment: C3

    Trigger Point Associations:
    Muscle: Sternomastoid
    Myotome Innervation: Motor functions supplied by ipsilateral accessory nerve (CN XI); Sensation provided by dorsal rami of C2 - C3
    Location Notes: The trigger point location should be on the belly of the sternomastoid
    Pain Referral Pattern: To back of head and from top of cheek to temple, to the forehead above the eyebrow and into the inner canthus of the eye. Some spillover onto cheek, top of head and front of throat
    Indications: Torticollis ; Myalgia of neck muscles ; Head and facial pains

    Ling Shu Ch. 21, On Cold and Heat Diseases, recommends using this point and bleeding from the under the tongue (probably Jinjin/Yuye) in cases of sudden loss of voice and stiffness of the throat and tongue muscles.


    Avicenna describes venesection at this point in his treatise On Venesection:

    "Among the head veins are the jugulars, which are venesected at the beginning of leprosy, pharyngitis, shortness of breath, severe asthma, voice hoarseness, and vitiligo due to an excess of hot blood, as well as diseases of the spleen and the sides of the body [such as pleurisy]. As we have explained before, the vein should be punctured with a very fine blade. As to the method of restricting the vein, the head should be tilted to the opposite side of the venesected side, and select an area of the vein that is stable. As in the saphenous and sciatic veins, the clamping should be horizontal, while the incision should be longitudinal." (Aspects of Treatment According to General Diseases, 21st section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine).


    In ayurvedic medicine:
    Siramatrika marma point
    Size: 4 angula (cun)
    Structure: Blood vessels.
    Effect of Injury: Fatal (sadhyapranahat marma).
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society)

    Lad and Durve (2008) in Marma Points of Ayurveda locate Siramantha slightly inferior to the this point, level with LI-17 but on the anterior of the SCM, and associate it with the doshas: Prana Vayu, Udana Vayu, Vyana Vayu, Ranajaka Pitta and Sadhaka Pitta.

    They give the following functions:
    - Regulates thyroid and parathyroid functions
    - Enhances cervical lymphatic circulation
    - Regulates blood pressure and cardiac functions
    - Relieves neck tension
    - Benefits pharynx and larynx

    Reference Notes: (click to display)