曲池 : Quchi : Pool at the Crook

Classifications:

He-Sea and Earth point
Sun Si-miao Ghost point (4th trinity)
Xu Qiufu Ghost point
Ma Dan-yang Heavenly Star point
Mother point of the Large Intestine channel

Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977)
Homeostatic point 9 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

---

Location:

At the elbow, midway between Chize Lu-5 and the lateral epicondyle of the humerus at the lateral end of the transverse cubital crease

---

Needling:

Perpendicular insertion 1 - 1.5 cun, or joined by through needling to Shaohai He-3

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 hand Yin and Yang receive their Qi via nearby paths so their Qi arrive swiftly. The depth of piercing must not exceed 2 fen and must not remain inserted for longer than one exhalation" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of five fen, (the needle) is retained for a duration of seven 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
Cools the Blood, eliminates Wind, drains Damp and alleviates itching
Regulates Qi and Blood
Activates the channel and alleviates pain

TCM Indications:

• High fever that does not recede, injury by cold with residual fever that does not recede, thirst with sweating on drinking and dry and hot skin when does not drink, Malarial (瘧, Nue) Disorders.
  
• Throat Painful Obstruction (喉痹, Hou Bi), loss of voice, toothache, redness and pain of the eyes, lacrimation, pain in the front of the ear.
  
• Agitation and oppression of the chest, manic disorders, poor memory, tongue thrusting, dizziness, hypertension, goitre, scofula.
  
• Erysipelas (cinnabar toxin), urticaria, wind rash, dry skin, scaly skin, itching of the skin, shingles, pain and itching of the whole body as if bitten by insects, clove sores on the back.
  
• Distension and pain of the abdomen, vomiting and diarrhoea, Dysenteric Disorder (痢疾, Li Ji), amenorrhoea.
  
• Numbness of the upper arm, Painful Obstruction (痹, Bi), wind Painful Obstruction (痹, Bi), hemiplegia, clonic spasm, contaction, immobility and pain of the elbow and shoulder, emaciation and weakness of the elbow, redness and swelling of the arm, atrophy disorder of the lower limbs, pain and swelling of the ankle.

---

I Ching Hexagram:

䷞ Xian 咸 Accord

Shared with Taiyuan Lu-9. Balanced by ䷨ (Lidui St-45 or Shangqiu Sp-5).

Hexagram attributions are my own with an explanation given in the glossary.

---

Neuroanatomy:

Superficial Innervation: Posterior cutaneous nerve of the forearm (C6 - C8) and radial nerve (C5 - T1) at depth

Dermatome Segment: C5

Trigger Point Associations:

Muscle:
Supinators

Myotome Innervation:
Posterior interosseous nerve, a continuation of the deep branch of the radial nerve (C7 - C8)

Location Notes:
Extensor carpi radialis longus trigger point lies very close to this point, slightly distal and lateral, just off the brachioradialis muscle, and the aconeus trigger point should lie slightly distal and posterior still

Pain Referral Pattern:
Lateral aspect of the elbow and dorsal aspect of the hand over the adductor pollicis and first interosseous muscles (L.I.-4)

Indications:
Extensor tendonitis of the forearm ; Tennis elbow pain

---

Martial Applications & Effects of Injury:

This point is where pressure is applied in bent elbow locks that twist the arm backwards.

Listed in the Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621), Article 24: Bronze Man Statue, which divides the body into zones associated with the Twelve-Hour branches (Shichen 時辰) going from top downwards, the lower bicep and elbow (He-3, SJ-10, SI 8, LI 10, LI 11, LI 12 & Lu 5) and the xiphoid process (Juque Ren-14) are the vital points of Wu 午 Horse (11 am - 1 pm) and considered most vulnerable to a palm thrust during this time (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

When struck this may damage the elbow joint and weaken the joint system of the entire body. It can also cause diarrhoea and vomiting and upset the Shen. Due to its proximity to the lateral epicondyle of the humerus, it may also be possible to damage your own hand if not careful so usually struck with the palm (Montaigue, Dim Mak Locations, Taijiworld.com).

In seizing martial arts (Qin Na) this point is a dividing muscle/tendon point (fen jin, 分筋) and cavity press point (Dian Xue, 點穴) gripped with the fingers and may be combined with Shaohai He-3 causing pain of the arm or numbness (Yang, 1995, Tai Chi Chin Na; Yang, 2004, Analysis of Shaolin Chin Na, 2nd Edition).

---

Major Combinations:

• Fever:
    Quchi LI-11 with Shaochong He-9
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• Cold Damage with great Heat which does not recede:
    Quchi LI-11 with Xuanzhong GB-39, ZUsanli St-36, Dazhui Du-14, Yongquan Kid-1 and Hegu LI-4
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Nue (Malaria) with strong fever and few chills:
    Quchi LI-11 with Dazhui Du-14, Houxi SI-3 and Jianshi Pc-5
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Nue (Malaria) with strong chills and mild fever:
    Quchi LI-11 with Dazhui Du-14 and Houxi SI-3
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Wasting and Thirsting Disorder:
    Quchi LI-11 with Chengjaing Ren-24, Jinyin/Yuyue Ex-HN-20, Renzhong Du-26, Lianquan Ren-23, Yinbai Sp-1, Laogong Pc-8, Taichong Liv-3, Xingjian Liv-2, Ranggu Kid-2 and Shangqiu Sp-5
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Diseases of the head, face, ears, eyes, mouth and nose:
    Quchi LI-11 with Hegu LI-4
    (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).
  
  
• Toothache with aversion to cold:
    Quchi LI-11 with Daying St-5, Quanliao SI-18 and Tinghui GB-2
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Manic raving, fear and fright:
    Quchi LI-11 with Yuji Lu-10, Zhizheng SI-7, Hegu LI-4, Shaohai He-3 and Wangu SI-4
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Hemiplegia:
    Quchi LI-11 with Yanglingquan GB-34
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• One-sided Wind (hemiplegia):
    Quchi LI-11 with Yanglingquan GB-34 and Huantiao GB-30
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Windstroke with one-sided withering and incessant pain:
    Quchi LI-11 with Jianyu LI-15, Xuanzhong GB-39, Taixi Kid-3, Zusanli St-36 and Kunlin Bl-60
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Atrophy disorder and numbness of the arm:
    Quchi LI-11 with Waiguan SJ-5 and Tianjing SJ-10
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Pain of the elbow, at times cold:
    Quchi LI-11 with Guanchong SJ-1, Shousanli LI-10, Zhongzhu SJ-3, Yanggu SI-5 and Chize Lu-5
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Pain and Cold of the arm:
    Quchi LI-11 with Xialian LI-8 and Jianjing GB-21
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Pain and heaviness of the shoulder with inability to raise the arm:
    Quchi LI-11 with Tianliao SJ-15
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Inability to bend the elbows and fingers:
    Quchi LI-11 with Shousanli LI-10, Waiguan SJ-5 and Zhongzhu SJ-3
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Contraction of the arm with tightness of the sinews of both hands resulting in inability to open the hands:
    Quchi LI-11 with Chize Lu-5, Yangchi SJ-4, Hegu LI-4 and Zhongzhu SJ-5
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Contraction of the elbow with pain:
    Chize Lu-5 joined to Quchi LI-11
    (Yu Long Fu, 玉龍賦, Ode of the Jade Dragon. First recorded in Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Pain of the forearm:
    Quchi LI-11 with Jianjing GB-21
    (Biao You Fu, 標幽賦, Ode to Elucidate Mysteries. First recoreded in Shi Guitang, 施桂堂. 1241: Zhen Jiu Zhi Nan, 針灸指南, Guide to Acupuncture and Moxibustion).
  
  
• Pain of the forearm:
    Quchi LI-11 with Shousanli LI-10 and Houxi SI-3
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Yangming Channel exhaustion from long term unsuccessful treatment: Quchi LI-11 with Zusanli St-36 (Wang & Robertson, 2008, Applied Channel Theory, see notes below).
  
  
• Self-harm, suicidal or self-destructive behaviour during the fourth stage of Ghost Possession:
    Needle Quchi LI-11, bleed Shangxing Du-23 and Yintang Ex-HN-3 or Haiquan Ex-HN-11 and moxa Huiyin Ren-1
    (Yuen, 2005, 3 Spirits & 7 Souls, see notes below).
  
  
• Hypertension:
    Quchi LI-11 with Zusanli St-36 (Deadman, Al-Khafaji & Baker, 2001, A Manual of Acupuncture).
  
  
• Hypertension:
    Quchi LI-11 with Renying St-9, Baihui Du-20 and Taichong Liv-3 (Deadman, Al-Khafaji & Baker, 2001, A Manual of Acupuncture).
  
  
• Bacillary dysentery:
    Quchi LI-11 with Shangjuxu St-37 and Tianshu St-25 (Deadman, Al-Khafaji & Baker, 2001, A Manual of Acupuncture).

---

Notes:

Main point for clearing Heat anywhere in the body.

There are several reasons for this:

1. It is on the Arm Yangming channel, being the upper limb section (and hence most Yang) of one of the hottest divisions, often associated with mania disorders.
2. It is also the Earth point, belonging to the central element, bringing extremes back into harmony. Earth is also the Child of Fire among the Five Phases, so Earth points can reduce Heat.
3. Earth is the Mother of Metal, so the Earth point of the Metal channel can reinforce this Fu Organs function of clearing Heat through the stool.
4. Its elemental pairing with the Lung gives it influence over Exterior Heat patterns and Wei Qi.
5. Its Yangming pairing with the Stomach, and being the Earth point of this channel, gives it an influence over the central level and Ying Qi Heat
6. In the 12 Earthly Branches system from which the Chinese Clock is derived, the Large Intestine and Kidney are opposite one another suggesting that they balance or complement each other. Both are located in the Lower Jiao and Metal is the mother of Water while Earth controls Water, making the Earth point of the Metal channel point strongly indicated for Kidney Deficiency Heat disorders.
7. Its Earthly Branch pair in the King Wen Sequence is the Small Intestine, which belongs to Sovereign Fire and is the Yang counterpart of the Heart, suggesting that the Large Intestine can also regulate Full Heat and Heart Heat conditions.

It is probably these associations that earned this its attributions as a Ghost Point and Heavenly Star Point by Sun Si-Miao and Ma Dan-Yang.

---

In five element acupuncture this point is reinforced to tonify Large Intestine deficiencies.

---

Often combined with Zusanli St-36 to strengthen Yangming function and re-establish proper Qi transformation in cases where long term unsuccessful treatment has caused the channel to become exhausted and unresponsive (Wang & Robertson, 2008, Applied Channel Theory).

See also Yangchi SJ-4 for a similar application from Jeffrey Yuen when Back-Shu and Yuan-Source points stop working.

---

Ling Shu Ch. 6 suggests piercing the He points of the Yang channels if a disease is in the Yang of the Yang realm (e.g. the skin). This would mean using this point to treat skin level disorders relating to this channel.

Combining this with the needling techniques described in Chapter 7 we could suggest using either superficial needling here to influence pathogens in the skin, or leopard spot needling (three needles aimed at letting blood from each side) for pathogens in the Blood.

Ling Shu Ch. 9, On Ends and Beginnings, advises that in the case of Heat associated with receding Yin Qi the Yang conduit should be pierced once and the Yin conduits twice. Based on other recommendation to use the He-Sea of the Yang conduits (Ch. 19) and the Yuan-Source with the Ying-Spring points (Chs. 6, 19 and 24) to clear Heat from the Zangfu, that would suggest this point, Taiyan Lu-9 and Yuji Lu-10 as a protocol to clear Heat in the Lung/Large Intestine. Next it advises that in Cold associated with receding Yang Qi the Yang should be pierced twice and the Yin once but no such obvious protocol is evident for this situation. Another interpretation that would match with common practice today, based on the idea of odd numbers being Yang/moving/clearing while even numbers are Yin/tonifying/reinforcing, is that the points on the channel to be cleared are pierced on one side only while those on the channel to be tonified are pierced bilaterally.

Ling Shu Ch. 19, on the Four Seasonal Qi, advises using the He-Sea points in autumn when diseases are in the Fu organs.

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 Lung/Large Intestine Divergent.

---

Ghost Points:
The fourth trinity of Ghost Points relates to the separation of Heaven and Earth. It consists of this point, Huiyin Ren-1, Shangxing Du-23 and Huiqian or Yintang and is concerned with self-destructive behaviour, self-harm and attempts at suicide.

As a Heavenly Star point it is able to open us to Cosmic influences and so may counteract extreme states of despair. It is also indicated in difficulties doing the basic necessities of life.

To "open" the point it should be needled very deeply towards the bone with no tonification or dispersal (Yuen, 2005, 3 Spirits & 7 Souls).

In the separation of Heaven and Earth, this point acts as the central pivot to harmonise the other two, being a He-Sea and Earth point of a Yangming channel. In the Twelve Branches the Ghost Points follow a cycle from top to bottom with this point representing You, 酉 and the Kidney channel (Ayal, 2021, The 13 Ghost Points 十三鬼穴).

---

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).

---

In Mayan medicine:
Used to treat pain in the upper extremities (Garcia, Sierra, Balam, 1999: Wind in the Blood)

---

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

---

Lad and Durve (2008) in Marma Points of Ayurveda locate a point near here at the body protuberance of the lateral epicondyle called Bahya Kurpara and associate it with the doshas: Prana Vayu, Vyana Vayu and Shleshaka Kapha.

They give the following functions:
- Harmonises the movement of elbow and arm
- Relieves pain locally
- Improves circulation

---

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

---