上關 : Shangguan : Above the Joint

Location Guides:

Classifications:

Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Meetings:

Meeting of Gall Bladder with San Jiao and Stomach

Location:

Anterior to the ear, in a hollow above the upper border of the zygomatic arch, directly superior to Xiaguan St-7.

Needling:

Perpendicular insertion 0.3 - 0.5 cun

Warnings:

It is traditionally emphasised that deep needling should be avoided at this point.

Classical Needling:

"The Shaoyang usually has little Blood and much Qi" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Shaoyang is to be pierced 4 fen deep and remain inserted for five exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three 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:

Eliminates Wind and benefits the ears
Activates the channel and alleviates pain

TCM Indications:

• Deafness, tinnitus, purulent discharge from the ear, dimness of vision, pain of the face, toothache of the upper jaw, stiffness of the lips.
  
• Headache, aversion to wind and cold, chills and fever, hemiplegia, deviation of the mouth and eye, lockjaw, tetany leading to bone pain, clonic spasm.

Neuroanatomy:

Superficial Innervation: Auriculo-temporal nerve from posterior division of mandibular branch of trigeminal nerve (CN V3)

Dermatome Segment: CN V3 mandibular branch of trigeminal

Trigger Point Associations:

Muscle:
Temporalis

Pain Referral Pattern:
To temporal region and upper middle jaw and teeth

Indications:
Headache and toothache with no restriction in jaw opening ; Feeling teeth do not meet right

Martial Applications & Effects of Injury:

Listed in the Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621), Article 21: Delayed Death Touches with Twelve-Hour (Shichen 時辰) Diagrams. This point, along with Xingjian Liv-2, Tianrong SI-17 and Quanliao SI-18, are associated with Zi 子 Rat (11 pm - 1 am) and if struck during this time is said to cause death within 1 day from trauma to the temporal maxillary artery. In Article 24: Bronze Man Statue, which divides the body into zones associated with the Twelve-Hour branches (Shichen 時辰) going from top downwards, this point is the vital point of Chou 丑 Ox (1 - 3 am) and considered most vulnerable to a single knuckle thrust during this time (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

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

Major Combinations:

• Hemiplegia with deviation of the mouth and eye:
    Shangguan GB-3 and Xiaguan St-7
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Lockjaw:
    Shangguan GB-3 with Jiache St-6 and Ahshi points
    (Liao Runhong, 廖润鸿, 1874: Zhen Jiu Ji Cheng, 針灸集成, Compilation of Acupuncture and Moxibustion).
  
  
• Noises in the ears (tinnitus):
    Supplement Shangguan GB-3 and Shaoshang Lu-11
    (Anon, 400BC-260AD: Huang Di Nei Jing Ling Shu, 黃帝內經靈樞, Yellow Emperor's Inner Classic: Spiritual Pivot, Ch. 28, On Oral Inquiry).

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