Points Database

Location Guides:

: Renying : Man's Welcome

St-9 : Foot Yangming Stomach 9

Classifications:
Point of the Window of Heaven
Point of the Sea of Qi
Master Tung's Tonsilitis Nine

Meetings:
Meeting of Stomach with Gall Bladder, Yin Qiao Mai, Yang Qiao Mai, Stomach Divergent and Spleen Divergent

Location:
Level with the tip of and 1.5 cun lateral to the laryngeal prominance, in the depression between the anterior border of the sternocleidemastoid muscle and lateral border of the thyroid cartilage

Needling:
Perpendicular insertion 0.5 - 1 cun

Warning:
Care should be taken not to puncture the carotid artery which must be felt and held laterally during needling. According to several classical texts, this point is contraindicated to moxibustion


TCM Actions:
Regulates qi and blood and lowers rebellion
Benefits the throat and neck
Alleviates pain

TCM Indications:
  • Headache, dizziness, visual dizziness, red face, fullness of the chest, shortness of breath, asthma, sudden turmoil disorder, vomiting, pulseless syndrome, hypertension, hypotension.
  • Swelling and pain of the throat, scrofula, goitre, difficulty in swallowing.
  • Lumbar pain.

    Neuroanatomy:
    Superficial Innervation: Transverse cervical nerve (C2 - C3)
    Dermatome Segment: C2, C3

    Notes:
    Location of carotid pulse

    The Ling Shu Ch. 9, offers a different method of pulse diagnosis where this pulse measures the Yang and the radial pulse measures Yin. By comparing their strengths the location of a disease can be determined and the channel examined for pathology:
    - If the carotid pulse is 2x as strong as the radial the disease is in the Shaoyang. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the carotid pulse is 3x as strong as the radial the disease is in the Taiyang. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the carotid pulse is 4x as strong as the radial the disease is in the Yangming. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the carotid pulse is 5x as strong as the radial the disease and is massive and fast then Yang is overflowing and creating an external barrier that blocks Yin
    - If the radial pulse is 2x as strong as the carotid the disease is in the Jueyin. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the radial pulse is 3x as strong as the carotid the disease is in the Shaoyin. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the radial pulse is 4x as strong as the carotid the disease is in the Taiyin. If it races it is in the hand branch, otherwise it is in the foot branch
    - If the carotid pulse is 5x as strong as the radial the disease and is massive and fast then Yin is overflowing and creating a closed barrier that blocks Yang, shortening life.

    Ling Shu Ch, 21, On Cold and Heat Diseases, recommends releasing harmful Qi from this point in cases where Yang Qi rises rebelliously causing headache, fullness in the chest and inability to breathe.

    Ling Shu Ch. 26, On Miscellaneous Diseases, pressing on this point for pain in the cheeks when piercing the vessels at Jiache St-6 fails to work.

    Ling Shu Ch. 52, On the Wei Qi, considers this to be the tip of the foot Yangming meridian with the root being at Lidui St-45.

    Ling Shu Ch. 59, On Abnormal Wei Qi, advises this point, Tiantu Ren-22 and Lianquan Ren-23 (referred to as Houzhong) to drain accumulations in the chest. If there are accumulations in the chest and abdomen then these three points are coupled with Qichong St-30 and Zusanli St-36 used for draining accumulations below and Zhangmen Liv-13 in the middle. In severe cases a "chicken claw" technique, using three needles positioned like the character 个 Ge, are to be used. If the pulse is large and wiry and the the abdomen is tense it must not be pierced.

    Ling Shu Ch. 75, On Piercing to Regulate True and Evil Qi, recommends this point as part of the "Pushing and Dispersing" treatment. Its indications are when the body is hot and the patient has absurd visions, voices and speaks madly. The foot Yangming channel and the major Luo are observed and balanced. Then the patient lies on their back while the practitioner massages the SCM muscle at this point, gripping with his thumbs down to Qupen St-12 (the supraclavicular fossa in general rather than the specific point). CAUTION: although the text advises gripping for some time this can cut off the blood supply to the brain!

    This point would also be on the upper trajectory of the Chong mai in Jeffrey Yuen's descriptions (Yuen, 2005, The Extraordinary Vessels).

    This point, seen as symbolic of the air rushing down the infant's throat on its first breath and coming into contact with the world is indicated for difficulty in relating to the physical, material world along with Taiyuan Lu-9 or Lieque Lu-7, Zhongwan Ren-12 and Tainshu St-25.
    This set of points relates to the First Level of Manifestation of the Soul, roughly equivalent to the base or Muladhara chakra and basic consciousness, the awareness of being alive (Yuen, 2005, 3 Spirits & 7 Souls).

    When combined with Chongyang St-42 and Taixi Kid-3 (dispersing) it relates to the Fifth Level of Manifestation of the Soul or the Vishuddha throat chakra concerned with true expression of yourself as an Authentic Character or Realized Being (ibid.).

    In the Jade Purity tradition it would also make an appropriate addition to the first trinity of Ghost Points (ibid.).

    In Tung's acupuncture the Tonsilitis Nine (Hou E Jiu) points are located between these two points. The centre point is located at the superior notch of the thyroid cartilage with two more 1.5 cun lateral which would be approximately at the location of St-9. Two more points are located 1 cun above and 1 cun below each of these three. They are indicated for tonsilitis, throat pain, thyroiditis, throat itching and phlegm obstructing the throat. All are pricked to bleed. Due to their close proximity to the thyroid cartilage and blood vessels the skin must be pinched up and pricked to prevent unintended damage (McCann, 2014, Pricking the Vessels).

    This technique, properly performed, could be safer, avoiding the risk of patient's moving and pushing a retained needle deeper than intended.

    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).

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

    In ayurvedic medicine:
    Manya dhamni marma point
    Size: 4 angula (cun)
    Structure: Blood vessels
    Effect of Injury: Disability (vaikalyakar marma)
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, Marma Shastra)

    >Lad and Durve (2008) in Marma Points of Ayurveda call this point Mantha and associate it with Prana Vayu, Udana Vayu, Vyana Vayu, Sadhaka Pitta and Tarpaka Kapha.

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


    Reference Notes: (click to display)