氣戶 : Qihu : Qi Door

Classifications:

Master Tung's Twelve Monkeys
Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)

Location:

At the top of the chest, directly below Quepen ST-12, on the inferior border of the clavicle, 4 cun lateral to the midline, on the mamillary line.

Needling:

Transverse-oblique insertion laterally of medially, 0.5 - 0.8 cun, or transverse insertion inferiorly along the channel

Warnings:

Deep or perpendicular needling insertion carries a substantial rist of puncturing the lung or injuring the subclavian vessels

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).
"Locate it with (the patient) lying supine. It is needled to a depth of four fen and is moxaed with five cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Descends rebellious Qi and unbinds the chest

TCM Indications:

• Fullness and distension of the chest and lateral costal region, pain of the chest and upper back, cough, dyspnoea, asthma, wheezing, vomiting blood, hiccup, inability to taste food, stiffness of the neck with inability to turn the head.

Neuroanatomy:

Superficial Innervation: Supraclavicular nerve from C3 - C4

Dermatome Segment: C3, C4

Trigger Point Associations:

Muscle:
Pectoralis major (clavicular head)

Pain Referral Pattern:
From point across top of chest inferior to clavicle

Indications:
Strain of pectorals ; Cardiac syndromes

Martial Applications & Effects of Injury:

This point adds Yang Qi to the head causing loss of balance to the point of falling down and will also cause great nausea. Qi is said to enter the meridian through this point, so a strike here also unbalances the Yin and Yang in the whole body (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Chronic pain of the lateral costal region:
    Qihu St-13 with Huagai Ren-20
    (One Hundred Symtpoms).
  
  
• Dyspnoea with Rebellious Qi, breathing with raised shoulders, inability to taste food:
    Qihu St-13 with Yunmen Lu-2, Tianfu Lu-3 and Shenmen He-7
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Notes:

Tung's 12 Monkeys (Shi Er Hou) are a group of six points in two lines on each side just below the clavicle. The centre point is at the midline of the clavicle, approximately at the location of this point with two more located 1.5 cun to the left and right. The second line is located 1.3 cun below the first. They are indicated for scarlet fever, asthma, severe common cold, sudden turmoil and incessant diarrhoea (McCann, 2014, Pricking the Vessels).

Tung's prick to bleed method may be a safer method to employ over the lungs as it uses shallow insertion with no retention making the risk of pneumothorax smaller. It may also provide stronger stimulation to this relatively insensitive region.

The Stomach Shu are a proposed set of points that complement the Breast Shu. They are level with the Chest Shu and Front Mu points on the abdomen and receive the Blood and Ying Qi created through the action of the Spleen and Lung, via the Breast Shu, to distribute among the Zangfu. Whereas the Back Shu and Chest Shu deliver Yang and Yin Yuan Qi through the Bladder and Kidney Channels to the Zangfu, these points are focused specifically on postnatal Qi.

This point is the Master Point of the Stomach Shu and represents the place where the Ying Qi and Blood, generated by the Breast Shu, is received and directed along the Stomach Channel to nourish the various Zangfu represented on its trajectory. This is indicated by the point's name, "Qi Door".

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