内庭 : Neiting : Inner Courtyard

Location Guides:

Classifications:

Ying-Spring and Water point
Ma Dan-yang Heavenly Star point

Location:

On the dorsum of the foot, between the second and third toes, 0.5 cun proximal to the margin of the web.

Needling:

Perpendicular insertion 0.5 cun or oblique insertion directed proximally inserted 0.5 - 1 cun

Classical Needling:

"The Yangming usually has much Qi and much Blood" (Su Wen 素問 ch. 24) implying this channel can normally be needled or bled.
"The foot Yangming is to be pierced 6 fen deep and remain inserted for ten exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three fen, (the needle) is retained for a duration of twenty exhalations, and it is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Clears Heat from the Stomach channel and alleviates pain
Harmonises the Intestines and clears Damp Heat
Calms the Shen

TCM Indications:

• Toothache, pain of the lower teeth, pain of the upper teeth, pain of the face, deviation of the mouth and eye, nosebleed, Throat Painful Obstruction (喉痹, Hou Bi), tinnitus, thirst.
  
• Abdominal pain, distension of the lower abdomen, borborygmus, diarrhoea, Dysenteric Disorder (痢疾, Li Ji), blood in the stool, constipation.
  
• Febrile disease with absence of sweating, Malarial (瘧, Nue) Disorders with no pleasure in eating, cold shivering, aversion to cold, hand and feet counterflow cold, hot inversion, urticaria, pain of the skin of the chest, blood in the urine.
  
• Aversion to the sound of people talking, desire for silence, frequent yawning.
  
• Pain and swelling of the dorsum of the foot.

Neuroanatomy:

Superficial Innervation: Superficial peroneal nerve from L4 - S1

Dermatome Segment: L5

Martial Applications & Effects of Injury:

A strike here will cause power loss, great local pain and a strange affect in that it causes the recipient to feel as if he has been struck in the jaw. This could
cause the brain to think that the jaw has been struck and cause knock out. If left unchecked, this strike will cause all kinds of Qi balance problems that will only get worse (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Counterflow Qi in the limbs:
    Bleed stagnant blood in the vessels, then needle Neiting St-44 with Xiangu St-43, Zulinqi GB-41 and Xiaxi GB-43
    (Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot, Ch. 34, On the Five Disturbances).
  
  
• Pain of the eyeball:
    Neiting St-44 with Shangxing Du-23
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Throat Pain:
    Neiting St-44 with Zhongzhu SJ-3 and Zhigou SJ-6
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Cold Damage with absence of sweating:
    Reduce Neiting St-44 and Fuliu Kid-7, reinforce Hegu LI-4, even technique on Bailiao Ex-HN-15
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Cold Damage with sweating:
    Reduce Neiting St-44 and Hegu LI-4, reinforce Fuliu Kid-7, even technique on Bailiao Ex-HN-15
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Loss of consciousness from Summerheat stroke:
    Neiting St-44 with Renzhong Du-26, Hegu LI-4, Baihui Du-20, Zhongji Ren-3 and Qihai Ren-6
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Red (bloody) Dysenteric_Disorder:
    Neiting St-44 with Tianshu St-25, Yinbai Sp-1, Qihai Ren-6, Zhaohai Kid-6 and Neiguan Pc-6
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• All types of diarrhoea and abdominal disorders:
    Neiting St-44 with Zusanli St-36
    (Za Bing Xue Fa Ge, 雜病穴法歌, Song of Points for Miscellaneous Diseases. First recoreded in Gao Wu, 高武. 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Undigested food in the stool, no pleasure in eating, periumbilical pain:
    Neiting St-44 with Lidui St-45 and Tianshu St-25
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Chronic Nue (Malaria) with no pleasure in eating:
    Neiting St-44 with Gongsun Sp-4 and Lidui St-45
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Oedema of the four limbs:
    Neiting St-44 with Sanyinjiao Sp-6, Zhongdu Liv-6, Hegu LI-4, Quchi LI-11, Zhongzhu SJ-3, Yemen SJ-2, Xingjian Liv-2 and Yinlingquan Sp-9
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).

Zhou Yi Hexagram:

䷃ Meng 蒙 Youthful Folly, Ignorance.

Trigrams: Kan (Water) below, Gen (Mountain) above.

Danger within, stillness without — a spring blocked by a mountain. This is ignorance, inexperience, the folly of youth. The water wants to flow but cannot find its way out.

Nuclear Trigrams: Lines 2-3-4 form Zhen (Thunder). Lines 3-4-5 form Kun (Earth). Beneath the ignorance, there is movement (Zhen) and receptivity (Kun). The hidden message: the fool is not static — there is a stirring within. If properly guided, the movement will find its ground.

Judgement:

亨。匪我求童蒙，童蒙求我。
Opening.
The channel can be opened here and stagnation guided out.

匪我求童蒙，童蒙求我。
I do not seek the young and foolish; the young and foolish seek me.
The treatment must be sought with genuine intent and not imposed. Those not ready for serious engagement will not respond well.

初笨告，再三漄，漄則不告。
At the first divination, I inform him. If he asks two or three times, it is importunity. If he is importunate, I do not inform him.
Dampness is a stubborn condition that requires lifestyle change. The patient should be informed of this at the first treatment. If they are unhappy about this and continue to ask for alternatives, they are not ready for steady change and treatment should not be given.

利貞。
Burning is beneficial.
Fortification with moxa is appropriate for this point.

Overall: Ignorance is not a permanent condition, but it can be a very stubborn condition. Damp-Heat and Shen disturbance are also very stubborn conditions that often stem from ignorance of their causes in lifestyle factors. Treatment can help guide Damp-Heat out, but it must be coupled with lifestyle advice that requires patience and discipline. If they are unable or unwilling to accept that, it should not be forced, but nor should treatment be pursued as acupuncture alone cannot reverse a lifestyle that refuses to change.

Lines:

Image:
山下出泉，蒙。君子以果行育德。
A spring beneath a mountain: Meng. Thus the gentleman cultivates character through thoroughness.

The image is of water emerging from a mountain — clear, fresh, but uncertain of its path. The gentleman nourishes his virtue — he does not rush the process. He lets the spring find its course through patient cultivation.

Acupuncture Point Connections:
Shared with Yinlingquan Sp-9. Their commentaries are slightly different because Yinlingquan Sp-9 deals more with Dampness, while this point treats Damp-Heat and Shen disturbance but the principles are the same.
Inverted into ䷃ (Yongquan Kid-1 or Shugu Bl-65).
Opposed by ䷱ (Yinxi He-6 or Yanglao SI-6).

Hexagram attributions are my own with an explanation given in the glossary.
Translations are my own, assisted by DSeek and compared to Richard Rutt's interpretion (2002).

Notes:

Important point for clearing Heat from the Stomach and Yangming.

Ling Shu Ch. 19, on the Four Seasonal Qi, advises selecting the Jing-Well and Ying-Spring openings in winter, piercing deeply and retaining for a while. However, the character for "retain" 留 is a combination of 田 "a field," possibly referring to the idea of waiting for things to grow, and 卯 which is the 4^th Earthly Branch (Mao, Rabbit, ䷡, 5-7 am, Large Intestine) and said to derive from a Shang Dynasty glyph, originally referring to a blood sacrifice (a person or animal cut in half) before coming to mean bloodletting and "pouring out" (Smith, 2011). This might suggest it was actually referring to bleeding these points, and maybe even letting the points bleed for a time rather than retaining the needle.

Ling Shu Ch. 22, On Mania and Madness, advises that when Wind invasion and counterflow causes the limbs to become swollen, profuse sweating, a feeling of cold and to be irritated when hungry, then blood is removed from the outer and inner sections of the hand Taiyin and foot Shaoyin and Yangming. If the flesh is cool then it is be done through the Ying-Spring points and if the bones are cold it is to be done through the Jing-Well and Jing-River points.

Nei Ting is also a homonym for 內聽 "Inner Hearing", an important aspect of Neidan inner alchemy (Brine, 2020, The Taoist Alchemy of Wang Liping, p.63). See also Neiguan Pc-6 which is a homonym for 內觀 "Inner Observation", a complementary Neidan technique (ibid. p.51).

In reflexology this point relates to the tops of the shoulders.

In Mayan medicine:
Pinched and pulled in cases of pain and inflammation of the foot and toes (Garcia, Sierra, Balam, 1999: Wind in the Blood)

In Thai massage:
Acupressure point (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)

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