膝眼 : Xiyan : Eyes of the Knee

Location:

On the knee, in the hollows formed when the knee is flexed, immediately below the patella and both medial and lateral to the patellar ligament.

Needling:

With the knee flexed and supported by a rolled pillow: Perpendicular insertion, directed towards Weizhong Bl-40, 1 - 2 cun, or oblique insertion ins a medial and superior direction behind the patella 1 - 2 cun, or through needling, between lateral and medial Xiyan (M-LE-16) behind the the patellar ligament.

TCM Actions:

Dispels Wind Damp, reduces swelling and alleviates pain

TCM Indications:

• Swelling and pain of the knee joint, difficulty in the flexing and extending the knee, weakness of the knee joint, numbness of the knee, numbness of the lower limb, atrophy disorder of the lower limb, Leg Qi (腳氣, Jiao Qi).

Neuroanatomy:

Superficial Innervation: Saphenous nerve (L3 - L4), medial, and lateral cutaneous nerve of the calf (L5 - S2), lateral

Dermatome Segment: L4 (medial), L5 (lateral)

Martial Applications & Effects of Injury:

This is one of the eight striking points in Northern Praying Mantis Kung Fu. These are the nonfatal areas on an attacker's body that can be struck when just defending or wanting to defeat an attacker. Wong Honfan (1946) describes as "the soft tissue just below the kneecap" suggesting the Xiyan (Ravenswood Academy, 2020, The Eight Forbidden Strikes of Praying Mantis Fist). Olson describes as "The points on top of the kneecaps" suggesting Heding (Olson, 2010, The Complete Guide to Northern Praying Mantis Kung Fu) although a literal translation is "Crane's Knee Tiger Head" implying the whole knee joint and it's surrounding structures.

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

Major Combinations:

• Redness, swelling and pain of the knees with inability to walk:
    Xiyan Ex-LE-5 with Xiguan Liv-7
    (Yu Long Ge, 玉龍賦, Song of the Jade Dragon. First recorded in Wang Guorui, 王國瑞, 1329: Bian Que Shen Ying Zhen Jiu, Yu Long Jing, 扁鵲神應針灸玉龍經, Bian Que's Spiritual Guide to Acupuncture and Moxibustion, Classic of the Jade Dragon).

Notes:

Essential points in the treatment of all knee disorders, whether due to deficiency or excess.

Medieval phlebotomy point (Hans von Gersdorff, 1517: Feldtbüch der Wundartzney, www.nlm.nih.gov)

In ayurvedic medicine:
Janu marma point (medial only)
Size: 1 angula (cun)
Structure: Tendon
Effect of Injury: Disability (vaikalyakar marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

Lad and Durve (2008) in Marma Points of Ayurveda locate a point called the anterior Janu in the centre of the kneecap, between these points and Heding. They associate it with the doshas: Vyana Vayu, Prana Vayu, Apana Vayu, Udana Vayu, Shleshaka Kapha, Kledaka Kapha and Avalambaka Kapha.

They give the following functions:
- Benefits the knees
- Promotes circulation
- Relieves pain locally

Another posterior Janu is located at Weizhong Bl-40.

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

In Thai massage:
Acupressure points (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