前頂 : Qianding : In Front of the Crown

Location Guides:

Classifications:

One of the "59 piercings" for clearing Heat in Su Wen Ch. 61
One of the Greater Four Alert Spirits (Da Sishencong) along with Houding Du-19 and Luoque Bl-8

Location:

At the top of the head on the midline, 1.5 cun directly anterior to Baihui Du-20 and 3.5 cun posterior to the anterior hairline.

Needling:

Transverse insertion 0.5 - 1 cun

Warnings:

This point should not be needled in infants whose fontanelle has not yet closed.

Classical Needling:

"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:

Eliminates Wind and treats convulsions
Benefits the head

TCM Indications:

• Head wind, Visual Dizziness, wind epilepsy, childhood fright epilepsy, acute and chronic Childhood Fright Wind, clonic spasm.
  
• Pain and swelling of the vertex, swelling and redness of the face, oedema, aversion to wind-cold, copious clear nasal discharge.

Neuroanatomy:

Superficial Innervation: Ophthalamic branch of trigeminal nerve (CN V1)

Dermatome Segment: CN V1 ophthalamic branch of trigeminal

Martial Applications & Effects of Injury:

One of the Shichen 時辰 (long hours) vital points associated with the 12 Branches in the Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621). This point along with Shaohai He-3, Shenque Ren-8 and Huangshu Kid-16 are associated with Wei 未 Ram (1-3 pm) and if struck during this time is said to cause death within one year from trauma to the coronal suture (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

See Montaigue, Dim Mak Locations, Taijiworld.com for explanation of effects.

Major Combinations:

• Childhood Fright Wind:
    Qianding Du-21 with Xinhui Du-22, Benshen GB-13 and Tianzhu Bl-10
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Wind Dizziness and one-sided headache:
    Qianding Du-21 with Houding Du-19 and Hanyan GB-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).
  
  
• One-sided or generalised Head Wind:
    Qianding Du-21 with Baihui Du-20, Shangxing Du-23, Shenting Du-24, Sizhukong SJ-23, Fengchi GB-20, Zanzhu Bl-2, Touwei St-8 and LI-4
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Inability to speak following Windstroke:
    Qianding Du-21 with Shenting Du-24 (Song of the Jade Dragon).
  
  
• Sudden swelling of the face:
    Qianding Du-21 with Xinhui Du-22, Shangxing Du-23, Xiangu St-43 and Gongsun Sp-4
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Redness and swelling of the face:
    Qianding Du-21 with Xinhui Du-22, Shangxing Du-23, Naohu Du-17 and Fengchi GB-20
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Deficiency swelling of the face:
    Qianding Du-21 with Renzhong Du-26
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).

Notes:

The "59 piercings" are named in the Su Wen Ch. 61 and mentioned in Su Wen Ch. 32 for treating Heat diseases. This point along with Shangxing Du-23, Xinhui Du-22, Baihui Du-20 and Houding Du-19 clear Heat from counterflow in the Du channel.
Ling Shu Ch. 23, On Heat Diseases, gives a different set of "59 Piercings but includes 5 points on either side 3 or 4 cun above the hairline which would be to either side of this point.

Ling Shu Ch. 24, On Counterflow Diseases, seems to employs this set of points in treating headache, dizziness and heaviness of the head. It advises draining from the five points on each of the five channels on the top of the head, including this point, followed by the hand Shaoyin and then foot Shaoyin.

This point along with Baihui Du-20, Xinhui Du-22, Shangxing Du-23, Shenting Du-24 and Yintang connect with the frontal brain concerned with differentiation of experiences and is associated with the Liver, Pericardium and Yang channels (Yuen, 1995, The Curious Organs, taken from class notes by Avi Magidoff).

In Tung acupuncture this point is called Qian Hui (1010.05), Anterior Meeting, and indicated for headache, dizziness, unconsciousness, blurry vision and nerve degeneration (Chu, 2015).

Location of the Yin Wei Mai in Zhang Boduan's Book of the Eight Vessels on alchemical working (Wang Mu, 2011, Foundations of Internal Alchemy)

Among the Du Mai points of the head, this point has a particular association with the convulsions that implies stirring of Internal Wind, and hence the Wood element and Liver/Gall Bladder Zangfu.

In Mayan medicine:
Combined with Houding Du-19 and Luoque Bl-8 to form a cross used to treat asthma and late closure of the fontanel (Garcia, Sierra, Balam, 1999: Wind in the Blood).

Lad and Durve (2008) in Marma Points of Ayurveda call this point Brahmarandhra and associate it with the doshas: Sadhaka Pitta, Prana Vayu, Tarpaka Kapha and Udana Vayu.

They give the following actions:
- Regularizes sadhaka pitta functions
- Relieves headaches
- Facilitates optimal pituitary gland functions
- Regulates frontal lobe activity
- Improves cerebral circulation and CSF circulation
- Promotes creativity and intelligence, stimulates memory
- Calms the mind, transforms feelings and emotions into pure consciousness

In Tibetan medicine:
Moxa point (AMNH, Tibetan Medical Paintings).

Venesection point, called Mtshogs Gsang (Fontanelle Point) measured by finding the vena temporalis superficialis approx. 4 cun posterior to the hairline. Its is indicated for:

- Headache, especially from chronic Mkrhis Pa (Bile) disorder
- Hangover
- Vertigo
- Fever headache
- Droopy eyelids
- Nausea
- Combined Bad Kan (Phlegm) and Mkhris Pa (Bile) disorders
- Pain in the front of the head
- Pain behind the eyes

(Chenagtsang & Nguyen, 2017, Sowa Rigpa Points).

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