食竇 : Shidou : Food Cavity

Location Guides:

Classifications:

Front Shu of the Breast

Trigger point (Melzack, Stillwell & Fox, 1977)

Location:

On the lateral side of the chest, in the fifth intercostal space, 6 cun lateral to the midline.

Needling:

Transverse-oblique insertion along the intercostal space 0.5 - 1 cun

Warnings:

Perpendicular insertion, especially in thin patients, carries a substanstial risk of inducing a pneumothorax.

Classical Needling:

"The Taiyin usually has much Qi and little Blood" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Taiyin is to be pierced 3 fen deep and remain inserted for four exhalations" (Ling Shu 靈樞 ch. 12).
"Locate it with the" (patient’s) arm raised. It is needled to a depth of four fen and moxaed with five cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Dissipates accumulation of food and promotes digestion

TCM Indications:

• Fullness of the chest and lateral costal region, ceaseless pain of the lateral costal region, abdominal distension, water swelling of the abdomen, oesophageal pain, pain of the diaphragm, belching, vomiting immediately after eating, undigested food in the stool, borborygmus. Cough, swelling of the breasts, chronic Spleen Malarial (瘧, Nue) Disorders, jaundice.

Neuroanatomy:

Superficial Innervation: Lateral cutaneous thoracic nerve from T6

Dermatome Segment: T6

Deeper Structures: Neuromuscular junction of long thoracic nerve (C5 - C7) to the serratus anterior muscle

Trigger Point Associations:

Muscle:
Serratus anterior

Location Notes:
Although Melzack (1977) locates the serratus anterior here, Travell & Simons' (1998) diagrams show Dabao Sp-21 to be a better location

Pain Referral Pattern:
Around the point on the lateral aspect of the chest and on the back at the medial-inferior border of the scapula

Indications:
Costal vertebral sprain ; Scapular fractures

Martial Applications & Effects of Injury:

Must be struck from the side, towards the pectoral, usually with an elbow or palm, to cause great local pain lasting for some hours and Qi drainage so severe they will wish to lie down. It is even possible to have a percussive effect to the heart, causing it to stop, but is difficult to reach as the arm must be raised first (Montaigue, Dim Mak Locations, Taijiworld.com).

Notes:

One of the twelve Shu points of the breast mentioned in the Su Wen Ch. 58 and identified by Wang Bing.

The Qing dynasty commentator Yue Hanzhen noted that this is the beginning of the Spleen channel entering the chest and the Spleen Qi receives food and drink and transforms it (Yue, Explanation of Channels and Points, trans. Brown, 2019, p. 191). This may suggest that the twelve Shu points of the breast are connected with the transformation of food and drink into Qi.

According to the Book of Bian Que's Secrets this point "connects real Spleen Qi and cures 36 types of Spleen disease. In severe disease, when life is hanging by a thread, 200-300 cones of moxibustion at this point will assure survival. Use this point in any major Spleen disease" (quoted in Deadman and Al-Khafaji, 2001, A Manual of Acupuncture, p.202).

This would also lend support to the idea that the front Shu of the breast, and this point in particular, are concerned with the transformation of food and drink into bodily Qi since a disruption in this process would lead to starvation and death.

Reference Notes:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here