Points Database

Location Guides:

: Quze : Marsh at the Crook

Pc-3 : Hand Jueyin Pericardium 3

Classifications:
He-Sea and Water point

Location:
On the transverse cubital crease, in the depression immediately to the ulnar side of the aponeurosis of the biceps brachii muscle. Should be located and needles with the arm slightly bent.

Needling:
Perpendicular insertion 0.5 - 1 cun, or prick to bleed, or transverse oblique distal insertion up to 6 cun to connect with Ximen Pc-4 in Ling Ze pointing to xi needling.

Warning:
The brachial artery and veins lie deeply, just medial to this point


TCM Actions:
Clears heat from the qi, nutritive and blood levels
Harmonises the stomach and intestines and stops vomiting
Activates the channel and alleviates pain

TCM Indications:
  • Febrile disease, agitation and restlessness, agitation with thirst, dry mouth, dry tongue with pain of the lateral costal region, coughing blood, vomiting blood, summer-heat stroke.
  • Vomiting, diarrhoea, dysenteric disorder, sudden turmoil disorder.
  • Heart pain, palpitations, pounding sensation below the Heart, propensity to fright, counterflow qi, dyspnoea and cough, wind rash.
  • Tremor of the head, tremor of the hand and arm, pain and contraction of the elbow and arm, paralysis of the upper limb.

    Neuroanatomy:
    Superficial Innervation: Border of lateral and medial cutaneous nerves of the forearm (C5 - C6 and C8 - T1)
    Dermatome Segment: C6, T1 on ventral axial line
    Deeper Structures: Median nerve from C5 - T1

    Notes:
    Ling Shu Ch. 44, On the Qi Moving in Accordance with the Norms, indicates that the He-Sea points should be pierced in autumn or when the disease is a result of immoderate diet. The seasonal aspect should not be interpreted literally as it describes the flavours as "controlled by autumn". It also describes the morning, afternoon, evening and night cycle of the day to be like the four seasons of the year with evening corresponding to autumn. Only five channels are discussed so this point must have served the for the Heart too.

    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 Pericardium/San Jiao Divergent.

    In Ling Ze pointing to xi needling for palpitations one needle one needle is inserted from Daling Pc-7 to Ximen Pc-4 while another is inserted in the opposite direction from Quze Pc-3 to Ximen Pc-4 (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.132).

    Medieval phlebotomy point (Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov).

    This was one of the most popular points for ancient phlebotomy, where the median cubital vein is located. In Greek and Roman times it was indicated for pleuritic pain above the diaphragm (Brain, 1986, Galen on Bloodletting, p.23).

    Galen also advised it be bled in the case of unremitting nosebleed on the ipsilateral side of the body to the nostril that is bleeding (Brain, 1986, p.84) while applying bandages of "fillet-material" to the limbs and cupping the hypochondrium on the affected side. This is one of the few examples Galen gave of bleeding as a revulsive remedy rather than an evacuant.

    The elbow is also mentioned for gouty patients (ibid.: 94) but in the context of evacuating areas adjacent to the affected parts probably applies to gout symptoms in the hands while the legs would be used for symptoms in the legs and anywhere for symptoms with no specific location.

    See the similarities to the actions of Quchi Lu-5 located slightly radial to this point and still within the cubital fossa. It was also recommended as a replacement for Shaohai He-3 or Chize Lu-5 if the veins here are indistinct since it connects them both (ibid.: p.91).

    In Hippocrates' On the Regimen in Acute Diseases it is recommended "If the pain causes a heavy feeling spreading about the breast or above the diaphragm". This is one of Hippocrates' more "heroic" bleeds as he advises us "not to be afraid of drawing a large quantity of blood until, instead of running clear and red, it becomes either much more redder or turns livid". If we assume the loss of blood was not actually therapeutic and quite possibly harmful then any therapeutic effect on pain would most likely be from the rather strong stimulation of this point.

    In Hippocrates' Aphorisms, Section VI, 36, it is advised that "Venesection cures dysuria; open the internal veins of the arm" (trans. Adams, 1849, http://classics.mit.edu/Hippocrates/aphorisms.6.vi.html) which would suggest this point or Zhizheng SI-7.

    Hippocrates in Epidemics V mentions "a patient with abdominal pain and rumbling who was bled from either arm alternately" (cited in Brain, 1986: p.113). This could have been any of the phlebotomy points in the arm but this seems to have been the most popular choice and has a curious similarity to the Chinese indication for this point to harmonise the Stomach and Intestines.

    Further reference to bleeding from the elbow is made by Hippocrates in his Internal Diseases for jaundice, and possibly diseases of the lung (ibid.: 115).

    Lad and Durve (2008) in Marma Points of Ayurveda call this point Ani and associate it with Apana Vayu, Vyana Vayu, Kledaka Kapha and Shleshaka Kapha.

    They give the following functions:
    - Maintains bladder tone
    - Regulates fluids and ambu vaha srotas
    - Treats urinary dysfunction
    - Promotes normal range of movement of upper extremities
    - Relieves localised pain

    They locate another point called Bahu Indrabasta 2 anguli below Ani which they associate with Apana Vayu, Vyana Vayu and Sadhaka Pitta.

    They give the following functions:
    - Relieves pain locally
    - Regulates colon functions
    - Stimulates agni and expels toxins
    - Stabilises the mind
    - Releases stagnant emotions

    In Tibetan medicine:
    Moxa point (AMNH, Tibetan Medical Paintings)

    In Thai massage:
    Acupressure point along the Kalatharee sen line running from the navel Shenque Ren-8 to the hands (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)


    Reference Notes: (click to display)