Points Database

Location Guides:

: Fenglong : Abundant Bulge

St-40 : Foot Yangming Stomach 40

Classifications:
Luo-Connecting point

Location:
On the lower leg, midway between the tibiofemoral joint line (level with the popliteal crease) and the lateral malleolus, two fingerbreadths lateral to the anterior crest of the tibia (one fingerbreadth lateral to Tiaokou St-38)

Needling:
Perpendicular or oblique insertion 1 - 1.5 cun

TCM Actions:
Transforms phlegm and dampness
Benefits the chest
Clears phlegm from the lung and alleviates cough and wheezing
Clears phlegm from the heart and calms the spirit
Acvtivates the channel and alleviates pain

TCM Indications:
  • Copious phlegm, fullness, oppression and pain of the chest, stabbing pain of the chest, cutting pain of the abdomen, swelling of the face, dizziness, headache, wind-phlegm headache, plumstone qi (globus hystericus), swelling and pain of the throat, throat painful obstruction with sudden loss of voice.
  • Damp body, slackness and heaviness of the body.
  • Cough and shortness of breath, cough with copious phlegm, wheezing, dyspnoea, asthma.
  • Mania-depression, mad laughter, great happiness, desires to ascend to high places and sing, discards clothing and runs around, restlessness, seeing ghosts, indolence, epilepsy, hypertension.
  • Constipation, difficulty in passing urine and stools.
  • Atrophy disorder and painful obstruction of the lower limb, pain of the knee and leg, difficulty in flexing and extending the knee, lack of control of the legs, withering of the lower legs.

    Neuroanatomy:
    Superficial Innervation: Lateral femoral cutaneous nerve of the calf (L4 - S1)
    Dermatome Segment: L5
    Deeper Structures: Deep fibular (peroneal) nerve (L4 - S1)

    Notes:
    Main point in the body for transforming phlegm of all kinds.

    Yuen (2004, Luo Vessels, p.45-46) explains why this is such a popular point for Calming the Shen in China. The Stomach represents emotions ("gut feeling") and in a Confucian culture where the heart is supposed to be controlled by the head this point is considered useful for helping people keep their emotions to themselves.

    Ling Shu Ch. 6 suggests piercing the Luo points if a disease is in the Yang of the Yin realm (e.g. the Fu organs) implying this point for disorders of the Stomach.

    Ling Shu Ch. 10, On Channels, describes the diseases relating to the Luo emanating from this point as:
    Repletion: Madness
    Depletion: The feet can no longer be controlled
    (Unschuld, 2016).

    Ling Shu Ch. 19, On the Four Seasonal Qi, advises using the channels and Luo vessels for diseases which occur in spring. They are pierced deeply if severe and more shallow if mild. For the other seasons:
    - in summer choose the Yang channels and Luo located in the partings between the skin and flesh
    - in autumn choose the Shu-Stream points unless the disease in the Fu organs, then use the He-Sea points
    - in winter choose Jing-Well and Ying-Spring opening and retain the needle.

    Ling Shu Ch. 21, On Cold and Heat Diseases, repeats the advice to use Luo in spring but and adds that they can also treat diseases of the skin. For the other seasons it differs slightly from Ch. 19:
    - in summer choose the partings in skin structures which also treat the muscle and flesh
    - in autumn Taiyuan Lu-9 is chosen and can treat the sinews and vessels (this may also apply to other Shu-Stream points for this purpose, text is unclear)
    - in winter one chooses the main channel points which also treat the bones and marrow.

    Ling Shu Ch. 22, On Mania and Madness, advises to bleed this channel in instances of insanity. The original just states the division (eg. bleed foot Yangming) implying the main channel by omission but since it recommends bleeding the data is being entered under the Luo points unless a specific point is mentioned:
    - If a manic patient's back is stiff and bent in the adverse direction with pain in the spine then the hand and foot Taiyang (Wu and Wu, 2010), and the foot Yangming and Taiyin (Unshculd, 2016) are bled.
    - In the early stages of madness when sadness and hunger lead to the patient being grieved and forgetful, easily enraged with a tendency to be fearful, the foot Taiyin and Yangming can also be bled as an alternative (Unschuld, 2016) or as an addition (Wu & Wu, 2010) to bleeding the hand Taiyang and Yangming.
    - If a major delight causes a person to see demon-spirits and laugh inside but be unable to express it then blood is removed from the foot Taiyin, Taiyang and Yangming, and then from the hand Taiyin and Yangming.
    - If counterflow is causing the chest feels like it is about to burst, the intestines feel a sharp pain, the patient is vexed and cannot eat and the pulses are rough then this channel is bled and supplemented if the feet are cold and the foot Taiyin channel is bled and drained if they are warm.

    Ling Shu Ch. 23, On Heat Diseases, recommends that this point can reach the Qi in the Stomach in cases where there is Heat in the intestines with a feeling of a heavy body. It advises that the disease is removed from all the respective transport openings and all the Bafeng points too.


    Reference Notes: (click to display)