MEDICAL ACUPUNCTURE FOR VETERINARIANS

Canine Point Mini-Manual

2013 Canine Mini Manual

Table of Contents
Lung (LU) Large Intestine (LI) Stomach (ST) Spleen (SP) Heart (HT) Small Intestine (SI) Bladder (BL) Kidney (KI) Pericardium (PC) Triple Heater (TH) Gallbladder (GB) Liver (LR) Conception Vessel (CV) Governor Vessel (GV) Extra Points Canine-Equine Shu Point Comparison Canine-Equine Mu Point Comparison 2-3 4-5 6-8 10-11 12-13 14-15 16-21 22-23 24-25 26-27 28-33 34-36 38-40 42-44 46-58 49-50 51-52

2013 IAVMA, Inc. and Narda G. Robinson, DO, DVM, MS. All rights reserved. 1

Lung (LU)

Point Name & Location LU 1 (Zhong Fu, Central Treasury) On the chest, medial to the greater tubercle of the humerus, in the 1st intercostal space. LU 5 (Chi Ze, Cubit Marsh) On the lateral aspect of the biceps brachii tendon at the level of the cubital crease. Locate with elbow slightly flexed. LU 7 (Lie Que, Divergent Branch) In the nook proximal to the radial styloid process. LU 9 (Tai Yuan, Great Abyss) Distal to the radial styloid process, level with the carpal joint, radial to the radial a (i.e., toward the dew claw side).

Relevant Anatomy Cervicothoracic spinal nn

Indications & Point Combinations Local pain (LU-1, local points); reduced shoulder mobility (LU-1, restricted locations); respiratory disorders (LU-1, BL-13, BL-12) Local elbow pain; distal bicipital tendon pain (palpate to localize tender points); epistaxis (LU-5, LU-9)

Radial n Musculocutaneous n

Superficial radial n Nervi vasorum

Superficial radial n Nervi vasorum

Skin disorders (LU-7, LI-4, ST-36, SP-10); neck pain (LU-7, SI-3, local neck points); carpal pain (palpate for tender points); dental pain (LU-7, LI-4) Arrhythmias (LU-9, PC-6), hemoptysis (LU-9, LU-5); carpal pain (palpate for tender points)

Large Intestine Large Intestine (LI)

Point Name & Location LI 4 (He Gu, Union Valley) Midway along the shaft of the 2nd metacarpal bone on its radial (dew claw) side. Alternate location in the web space between the dewclaw and digit II. LI 10 (Shou San Li, Arm Three Li) 2 cun distal to LI 11, between the extensor carpi radialis and common digital extensor mm. LI 11 (Qu Chi, Pool at the Bend) At the lateral end of the cubital crease of the flexed elbow.

Relevant Anatomy Radial n Nervi vasorum in carpal arterial arch

Indications & Point Combinations Pain or skin irritation along the trajectory of the LI channel (palpate, observe); headache (LI-4, palpate for pain and source of head pain); sinus discomfort (LI-4, local sinus points) sympathetic regulation (LI-4, ST-36, LR-3, GV-20)

Radial n

Lateral elbow pain (palpate for extensor trigger points & sources of local or referred pain); radial n injury (LI-10, LI-11, LI-4, caudal cervical spinal n roots) Lateral elbow pain (palpate for extensor trigger points & sources of local or referred pain); radial n injury (LI-10, LI-11, LI-4, caudal cervical spinal n roots); immune modulation and anti-inflammation (LI-11, LI-4, GV-14, ST-36) Shoulder joint pain (LI-15, TH-14, trigger points); suprascapular n injury (LI-15, cervicothoracic spinal nn roots, SI-11, SI-12) Rhinitis (LI-20, Yintang), sinusitis, local nasal disorders, trigeminal neuritis affecting infraorbital n and branches and thereby reducing nasal discomfort and stuffiness

Radial n

LI 15 (Jian Yu, Shoulder Bone) Just cranial and distal to the acromion process. LI 20 (Ying Xiang, Welcome Fragrance) Lateral to midpoint of the ala nasi.

Suprascapular n Axillary n

Trigeminal n Facial n

Stomach (ST)

Point Name & Location ST 2 (Si Bai, Four Whites) At the infraorbital foramen. ST 4 (Di Cang, Earth Granary) Lateral to the labial commissure. ST 6 (Jia Che, Cheek Carriage) In the belly of the masseter m. ST 25 (Tian Shu, Celestial Pivot) Approximately 2 cun lateral to the center of the umbilicus, in the belly of the rectus abdominis m. ST 34 (Liang Qiu, Ridge Mound) 2 cun proximal to the patella in the vastus lateralis m, opposite SP 10. ST 35 (Du Bi, Calfs Nose) Lateral to the patellar ligament. ST 36 (Zu San Li, Leg 3 Miles) 2 cun distal to the tibial plateau, 1 cun lateral to the tibia crest in the belly of the cranial tibialis m.

Relevant Anatomy Trigeminal n Facial n Trigeminal n Facial n Trigeminal n Facial n L1 spinal n

Indications & Point Combinations Maxillofacial pain (ST-2); nasal congestion (ST-2, LI-20); trigeminal neuritis (ST-2, other affected branches of CN V) Facial n injury affecting labial or platysma m function (ST-4, TH-17); orofacial pain (ST-4, ST-2) Masticatory pain (ST-6); trigeminal n dysfunction leading to hypo- or hyper-tonic masseter m Abdominal discomfort, diarrhea, intestinal cramping (ST-25, ST-36, BL-20, BL-21)

Femoral n

Femoral n

Fibular n

Stifle pain, instability, and/or dysfunction (ST-34, ST-36, SP-9, SP-10); femoral n injury (ST-34, spinal segmental input to L4-L6 spinal nn) Stifle pain (ST-35, ST-34, ST-36, SP-10, SP-9); patellar tendinitis (Xiyan= lateral (ST 35) plus its opposite on the medial aspect of the patellar tendon) Stifle pain (ST-35, ST-34, ST-36, SP-10, SP-9); GI problems and motility issues (ST-36), immune or inflammatory problems (ST-36, LI-4, LI-11, GV-14); pelvic limb dysfunction (ST-36, relevant neuromuscular, peripheral nn, and spinal segments)

ST 40 (Feng Long, Bountiful Bulge) Midway between the lateral malleolus and the stifle joint between the cranial tibialis and long digital extensor mm. ST 41 (Jie Xi, Stream Divide) On the dorsal hock, between the tendons of the long digital extensor and cranial tibialis mm, level with the lateral malleolus.

Fibular n

Fibular n

Gastrointestinal disorders involving fluid retention or swelling (ST-40, ST-36, SP-6); lateral crus myofascial dysfunction or hock instability (ST-40, palpate for trigger points in the lateral extensors and peroneal mm/tendons) Tarsal pain and restricted motion (ST-41, ST-36, KI-3, BL-60)

Spleen (SP)

10

Point Name & Location

Relevant Indications & Point Combinations Anatomy SP 4 (Gong Sun, Grandfather Grandson) Medial plantar Reproductive dysfunction (SP-4, PC-6, lumbosacral Just distal to the base of the 2nd n spinal segments); medial pedal pain (SP-4, palpate for metatarsal bone. tenderness) SP 6 (San Yin Jiao, Three Yin Tibial n Pelvic problems, voiding dysfunction, or reproductive Intersection) dysfunction (SP-6, KI-3, relevant lumbosacral spinal 3 cun proximal to the medial malleolus segments); pelvic limb edema (SP-6, SP-9; add manual along the caudal border of the tibia. lymphatic drainage) SP 9 (Yin Ling Quan, Yin Mound Spring) Saphenous n Stifle pain (SP-9, ST-34, ST-36, SP-10); edema of the Just distal to the medial tibial condyle. hind limb (SP-9, SP-6); genital pain (SP-6, SP-9, BL-23, BL-31, BL-32, BL33, Bai Hui); pelvic limb edema (SP-9, SP-6; add manual lymphatic drainage) SP 10 (Xue Hai, Sea of Blood) Femoral n Stifle pain (SP-9, ST-34, ST-36, SP-10); reproductive On the medial side of the thigh, in the disorders (SP-6, SP-10, BL-23, BL-31, BL-32, BL-33, vastus medialis m, 2 cun above the Bai Hui); erythematous and/or pruritic skin conditions craniomedial border of the patella. (SP-10, LI-4, LI-11, ST-36, GV-14) Opposite ST 34, which is in the vastus lateralis m.

11

Heart Heart (HT)

(HT)

12

Point Name & Location

HT 3 (Shao Hai, Lesser Sea) At the medial end of the crease of the flexed elbow, cranial to the medial humeral epicondyle.

Relevant Anatom y Ulnar n

Indications & Point Combinations

HT 7 (Shen Men, Spirit Gate) On the lateral carpus, lateral to the flexor carpi ulnaris and superficial digital flexor tendons. HT 8 (Shao Fu, Lesser Palace) Enter caudal to the metacarpal pad between the 4th and 5th metacarpals; thread under the pad. HT 9 (Shao Chong, Lesser Rushing) On the radial aspect of the nail bed of the 5th (most lateral) digit of the manus.

Ulnar n

Emotional stress/anxiety (HT-3, HT-7, ST-36, GV-20); epilepsy that worsens with stress (HT-3, LR-3, ST-36, GV-20, other vagal neuromodulatory points); medial elbow pain (HT-3, relevant trigger points or pain sites); ulnar neuropathy (HT-3, HT-7, GV-14; palpate for myofascial regions of nerve entrapment) Emotional stress/anxiety (HT-7, ST-36, GV-20)

Ulnar n

Thoracic limb neurologic dysfunction (HT-8, Baxie, caudal cervical ventral spinal nerve points); degenerative joint disease in the manus (HT-8, local tender points) Fever (HT-9, GV-14, GV-20); coma (HT-9, GV-20)

Ulnar n

13

Small Intestine (SI) Small Intestine (SI)

14

Point Name & Location SI 3 (Hou Xi, Back Stream) On the ulnar manus, just proximal to the 5th metacarpophalangeal joint. SI 8 (Xiao Hai, Small Sea) Over the ulnar nerve groove between the medial humeral epicondyle and the olecranon process of the ulna. SI 9 (Jian Zhen, True Shoulder) In a depression on the caudal border of the deltoid m, between the long and lateral heads of the triceps brachii m. SI 11 (Tian Zong, Celestial Gathering) In the middle of the belly of the infraspinatus m, in the infraspinous fossa. SI 12 (Bing Feng, Grasping the Wind) In the middle of the belly of the supraspinatus m, in the supraspinous fossa. SI 19 (Ting Gong, Palace of Hearing) On the caudal zygomatic region, in a depression rostral to the tragus, dorsal to the condylar process of the mandible (palpated readily with the mouth open).

Relevant Anatomy Ulnar n

Indications & Point Combinations Cervicothoracic pain or nerve injury (SI-3, BL-10, local tender points); local pain (SI-3, palpate for tender points); ulnar neuropathy (SI-3, SI-8, myofascial restriction entrapping ulnar n brr) Medial epicondylitis/elbow pain (SI-8, HT-3, local points, trigger points); ulnar neuropathy (SI-8, SI-3, HT-7, caudal spinal nns exit points on lateral neck) Shoulder or thoracic limb pain (SI-9, treat source of pain (TH-14, LI-15 for joint pain; trigger points for soft tissue pain, consider spinal n contribution) Myofascial dysfunction (SI-11, check for trigger points in the triceps, digital extensors, etc.) Myofascial dysfunction (SI-12, other local trigger points related to shoulder function) Otitis media and externa (SI-19, TH-17, TH-20); temporomandibular joint (TMJ) pain (SI-19, SI-18, temporalis trigger points, BL-10)

Ulnar n

Axillary n Radial n

Suprascapular n Suprascapular n Trigeminal n Facial n

15

Bladder (BL) B(BL)

16

Point Name & Location BL 1 (Jing Ming, Bright Eyes) Immediately dorsal to the medial canthus. BL 2 (Zan Zhu, Gathered Bamboo) Directly above BL 1 along the orbital rim. BL 10 (Tian Zhu, Celestial Pillar) Just caudal to the wing of the atlas on the dorsolateral neck region.

Relevant Anatomy Trigeminal n Facial n Trigeminal n Facial n Greater occipital n (C2)

Indications & Point Combinations Epiphora, lacrimal duct dysfunction (BL-1, ST-2). Needle cautiously. Eye pain and keratoconjunctivitis sicca (BL-2, TH-23, GB-1); frontal sinusitis (BL-2, tender facial points) Cervical pain, tension (BL-10, local trigger points, GV-14, tense inner Bladder line points along the back, ST-36); headache (BL-10, GV-20, local trigger and tender points); vertigo (BL-10, GB-20, TH-20, GB-34, GV-20, local tender points); nasal obstruction (BL-10, LI-20, Yintang) Tension and pain locally or regionally (BL-11 and local tender/trigger points)

BL 11 (Da Zhu, Great Shuttle) Lateral to the caudal border of the spinous process of the 1st thoracic vertebra, mid-way from the spinous process to the medial border of the scapula. BL 12 (Feng Men, Wind Gate) Lateral to the caudal border of the spinous process of the 2nd thoracic vertebra, midway between the spinous process and the medial border of the scapula. BL 13 (Fei Shu, Lung Shu) Same as BL 12 but lateral to T3.

Cervicothoracic spinal nn

Cervicothoracic spinal nn

Early upper respiratory illness or lung problem (BL-12, BL-13, LU-1, LU-7); tracheal irritation (BL-12, CV-22)

Upper thoracic spinal nn

Lung problems (BL-13, LU-1, GV-14, ST-36); local pain

17

BL 14 (Jue Yin Shu, Reverting Yin Shu) Same as BL 12 but lateral to T4. BL 15 (Xin Shu, Heart Shu) Lateral to the caudal border of the spinous process of the 5th thoracic vertebra, between the longissimus and iliocostalis mm. BL 17 (Ge Shu, Diaphragm Shu) Lateral to the caudal border of the spinous process of the 7th thoracic vertebra, between the longissimus and iliocostalis mm. BL 18 (Gan Shu, Liver Shu) Lateral to the caudal border of the spinous process of the 10th thoracic vertebra, between the longissimus and iliocostalis mm. BL 19 (Dan Shu, Gall Bladder Shu) Lateral to the caudal border of the spinous process of the 11th thoracic vertebra, between the longissimus and iliocostalis mm. BL 20 (Pi Shu, Spleen Shu) Lateral to the caudal border of the spinous process of the 12th thoracic vertebra, between the longissimus and iliocostalis mm. BL 21 (Wei Shu, Stomach Shu) Lateral to the caudal border of the spinous process of the 13th thoracic vertebra, between the longissimus and iliocostalis mm.

Upper thoracic spinal nn Upper thoracic spinal nn

Heart palpitations (BL-14, BL-15, PC-6, ST-36); local pain Heart problems (BL-14, BL-15, PC-6, ST-36); local pain; anxiety (BL-15, CV-17, HT-7, GV-20, LR-3) Hiccoughs, spasmodic coughs (BL-17, CV-15, CV-22); local pain

Midthoracic spinal nn

Midthoracic spinal nn

Liver problems (BL-18, LR-14, ST-36); local pain

Midthoracic spinal nn

Hepatobiliary problems (BL-19, GB-24, GB-34); local pain

Caudal thoracic spinal nn

Digestive problems, poor appetite, or diarrhea (BL-20, BL-21, BL-25, ST-36, CV-12)

Caudal thoracic spinal nn

Digestive problems, poor appetite, or diarrhea (BL-20, BL-21, ST-25, ST-36, CV-12)

18

BL 22 (San Jiao Shu, Triple Burner Shu) Lateral to the caudal border of the spinous process of the 1st lumbar vertebra, between the longissimus and iliocostalis mm. BL 23 (Shen Shu, Kidney Shu) Lateral to the caudal border of the spinous process of the 2nd lumbar vertebra, between the longissimus and iliocostalis mm.

Thoracolumbar spinal nn

Abdominal distension with fluid accumulation (BL-22, CV-5, KI-16); adrenal problems (BL-22, BL-23, BL-52)

Thoracolumbar spinal nn

BL 25 (Da Chang Shu, Large Intestine Shu) Lateral to the caudal border of the spinous process of the 5th umbar vertebra, between the longissimus and iliocostalis mm. BL 27 (Xiao Chang Shu, Small Intestine Shu) Lateral to the 1st sacral foramen, between the medial border of the cranial dorsal iliac spine and the sacrum. BL 28 (Pang Guang Shu, Bladder Shu) Lateral to the 2nd sacral foramen, between the medial border of the cranial dorsal iliac spine and the sacrum.

Kidney problems (BL-23, GB-25, KI-3, GV-4); genitourinary disorders (BL-23, Bai Hui, BL-28, CV-3, KI-3, SP-6, GV-20); lumbar and pelvic pain (BL-23, BL-25, Bai Hui, SP-6, local pain or trigger points, BL-60, KI-3) Cranial lumbar nn Intestinal pain, distension, poor digestion, constipation, diarrhea (BL-21, BL-20, BL-25, ST-25, ST-36) S1 spinal n Genitourinary problems, including incontinence, cystitis, prostatitis, impotence (BL-27, BL-28, BL-23, Bai Hui, KI-3, SP-6, CV-3); small intestine issues (BL-27, CV-4, ST-36); sacroiliac dysfunction Genitourinary problems, including incontinence, cystitis, feline urologic syndrome, prostatitis, impotence (BL-27, BL-28, BL-23, Bai Hui, KI-3, SP-6, CV-3); sacroiliac dysfunction

S2 spinal n

19

BL 35 (Hui Yang, Meeting of Yang) In the skin fold lateral to the base of the tail.

Sacral spinal nn

BL 36 (Cheng Fu, Hold and Support) Ventral to the tuber ischii, at the attachments of the semitendinosus and semimembranosus mm. BL 39 (Wei Yang, Outside of the Crook) On the lateral end of the popliteal crease, just medial to the tendon of the biceps femoris m (Note: Location differs from equine). BL 40 (Wei Zhong, Middle of the Crook) In the center of the popliteal fossa.

Sciatic n

Common fibular n

Tibial n

BL 52 (Zhi Shi, Residence of the Will) 3 cun lateral to the caudal border of the spinous process of L2, at the lateral border of the iliocostalis m, level with BL 23.

Thoracolumbar spinal nn

Sacral pain, tail dysfunction (BL-35, GV-2, local points); anorectal disorders (BL-35, GV-1, BL-57, Bai Hui), priapism (BL-35, BL-31, BL-33, Bai Hui) Sciatic neuralgia or nerve injury (BL-36, BL-26, BL-27, BL-40, BL-39, KI-3); hamstring mm tension/myofascial restriction (BL-36, myofascial tender points) Pelvic limb pain or paresis (BL-39, relevant trigger points or points related to the neurologic or spinal cord injury); urinary retention or incontinence (BL-39, KI-3, SP-6, BL-28, BL-23) Pelvic limb pain/paresis (BL-40, relevant trigger points related to the neurologic or spinal cord injury); urinary retention (BL-40, KI-3, SP-6, BL-28, BL-23); stifle pain (BL-40, ST-36, ST-34, SP-9, SP-10) Kidney problems (BL-23, BL-52, GB-25, KI-3, GV-4); genitourinary disorders (BL-23, BL-28, BL-31, BL-33, CV-3, KI-3, SP-6); lumbar or pelvic pain (BL-23, BL-52, Bai Hui, SP-6, local pain or trigger points, BL-60, KI-3)

20

BL 54 (Zhi Bian, Sequential Limit) Just dorsal to the greater trochanter. BL 60 (Kun Lun, Kunlun Mountains) Between the lateral malleolus and the calcaneal tendon. BL 62 (Shen Mai, Extending Vessel) Just caudodistal to the lateral malleolus. BL 67 (Zhi Yin, Reaching Yin) Lateral to the nail bed of the most lateral (5th) digit of the pes.

Sciatic n

Fibular n Tibial n Fibular n Tibial n Fibular n Tibial n

Hip or gluteal pain (BL-54, GB-29, GB-30); sciatic n dysfunction (BL-54, GB-30, BL-36, BL-40, BL-39, BL-60, KI-3) Spinal or pelvic limb pain (BL-60, local/myofascial trigger points related to the pain problem) Tarsal pain (BL-62, local points and myofascial trigger points related to the pain problem) Malposition of the fetus (BL-67); placental retention (BL-67, BL-31, BL-33, Bai Hui); distal stimulation of digital nn for pelvic limb neuropraxia

21

Kidney (KI)

22

Point Name & Location KI 1 (Yong Quan, Gushing Spring) Between the 2nd and 3rd metatarsal bones, under the metatarsal pad. KI 3 (Tai Xi, Supreme Stream) In the depression between the medial malleolus and the calcaneal tendon. KI 6 (Zhao Hai, Shining Sea) Just craniodistal to the medial malleolus. KI 7 (Fu Liu, Returning Current") 2 cun proximal to the tip of the medial malleolus just cranial to the calcaneal tendon.

Relevant Anatomy Tibial n

Indications & Point Combinations Shock (KI-1, HT-9, GV-26); coma (KI-1, GV-20, Yintang); pain or swelling of the pes (KI-1, Bafeng); neuropraxia of the pelvic limb (KI-1, ST-36, Bafeng, related peripheral nerves, spinal segments); status epilepticus Urinary problems (KI-3, SP-6, BL-23, BL-28, CV-3, Bai Hui); reproductive problems (KI-3, SP-6, SP-10, Bai Hui, BL-27, BL-28, GV-20); voiding dysfunction in general Tarsal pain (KI-6, BL-62, relevant painful points)

Tibial n

Tibial n

Tibial n

Calcaneal tendinitis/pain (KI-7, relevant local points)

23

Pericardium (PC)

24

Point Name & Location PC 3 (Qu Ze, Marsh at the Crook) In the cubital crease, on the medial side of the biceps brachii tendon. PC 6 (Nei Guan, Inner Pass) 2 cun proximal to the carpal joint, between the tendons of the flexor digitorum superficialis and flexor carpi radialis. PC 8 (Lao Gong, Palace of Toil) Between the 2nd and 3rd metacarpal bones, under the pad.

Relevant Anatomy Median n

Indications & Point Combinations Bicipital tendon pain (PC-3, LU-5); median n injury (PC-3, PC-6) Nausea and vomiting (PC-6); cardiac arrhythmias (PC-6, HT-7); disorders of the cranial GI tract (PC-6, ST-36); agitation (PC-6, HT-7, LR-3, GV-20) Thoracic limb neurologic dysfunction (PC-8, Baxie, relevant neural pathways); thermoregulation disorders of the manus; palmar pain

Median n

Median n

25

Triple Heater (TH)

26

Point Name & Location TH 3 (Zhong Zhu, Central Islet) On the dorsal manus, proximal to the 4th and 5th metacarpophalangeal joints. TH 5 (Wai Guan, Outer Pass) 2 cun proximal to the carpus between the radius and ulna. TH 10 (Tian Jing, Celestial Well) 1 cun proximal to the olecranon at the tendinomuscular intersection of the long head of the triceps brachii m. TH 14 (Jian Liao, Shoulder Crevice) Caudodistal to the acromion.

Relevant Anatomy Radial n Ulnar n Radial n

Indications & Point Combinations Local pain in the manus, digits

Local pain, distal antebrachium; myofascial restriction of the extensors of the antebrachium Elbow pain related to triceps restriction, triceps tendinopathy at the olecranon process, or enthesiopathy (TH-10, local points) Shoulder pain (TH-14, LI-15, local tension or pain points); suprascapular n injury (TH-14, LI-15, SI-11, SI-12, caudal cervical ventral nerve root points) Facial n injury (TH-17; add points along involved facial n brr) TMJ dysfunction (TH-21, SI-19, SI-18); facial n injury involving auriculopalpebral br of CN VII (TH-21, GB-2, TH-17) Eye pain, dry eye (TH-23, GB-1, BL-2, BL-10, ST-36)

Ulnar n

Suprascapular n

TH 17 (Yi Feng, Wind Screen) Ventral to the ear, between the wing of the atlas and the mandibular process. TH 21 (Er Men, Ear Gate) Rostroventral to the pretragic notch, dorsal to the condylar process when the mouth is open. TH 23 (Si Zhu Kong, Silken Bamboo Hollow) Lateral to the zygomatic process of the frontal bone.

Facial n

Trigeminal n Facial n CN V, CN VII

27

Gallbladder (GB)

28

29

30

Point Name & Location GB 1 (Tong Zi Liao, Pupil Crevice) Near the lateral canthus, dorsal to the frontal process of the zygomatic bone. GB 2 (Ting Hui, Auditory Convergence) Ventral to the intertragic incisure, at the caudal border of the condylar process of the mandible, located with mouth open. GB 14 (Yang Bai, Whiteness of Yang) 1 cun above the orbital rim in line with the pupil.

Relevant Anatomy Trigeminal n Facial n Trigeminal n Facial n C2 spinal n

Indications & Point Combinations Eye pain, dry eye (TH-23, GB-1, BL-2, BL-10, ST-36); facial n injury (TH-17, GB-1, relevant facial n branches/associated points) Ear problems, including otitis media (GB-2, TH-17, TH-21, BL-10, GV-14); facial numbness and paralysis (GB-2, relevant facial n branches/associated points); TMJ dysfunction (TH-21, SI-19, GB-2, SI-18) Frontal sinusitis and headaches (GB-14, BL-2, BL-10, GV-20); eye pain (GB-14, local eye points); epilepsy (GB-14, GV-20, ST-36, BL-10, other pertinent points for patient stress or cervicocephalic myofascial dysfunction) Early upper respiratory infection (GB-20, GV-14, LI-4, LU-7); head and neck pain (GB-20, BL-10, tender and local points), eye problems (GB-20, GV-20, local eye points), vertigo (GB-20, BL-10, GV-20, GB-34, TH-17, Yintang)

Trigeminal n Facial n

GB 20 (Feng Chi, Wind Pool) Craniolateral to BL-10, between the attachments of the sterno-occipitalis portion of the sternocephalicus and the cleidocervical portion of the brachiocephalicus m; caudal to the base of the ear. GB 21 (Jian Jing, Shoulder Well) Midpoint of the cranial border of the scapula.

Facial n C2 spinal n

Caudal Local or regional muscle tension (GB-21, local cervical spinal tender or trigger points); thoracic limb nn dysfunction (involvement of local mm identified by palpation)

31

GB 24 (Ri Yue, Sun and Moon) In a depression ventral to the costochondral junction at the 9th intercostal space, caudodorsal to LR-14. GB 25 (Jing Men, Capital Gate) On the lateral side of the abdomen, at the tip of the 13th rib. GB 29 (Ju Liao, Squatting Bone-Hole) One-third the distance from the greater trochanter to the cranial dorsal iliac spine. GB 30 (Huan Tiao, Jumping Round) Midway between the greater trochanter and the tuber ischii.

Midthoracic spinal nn

Caudal thoracic spinal nn Cranial gluteal n Sciatic n

Hepatobiliary problems (GB-24, LR-14, ST-36, LR-3); intercostal neuralgia (GB-24, tender local points); regional pain (GB-24, local tender or trigger points) Kidney problems (GB-25, BL-23, BL-52, GV-4); regional pain (GB-25, local points) Hip problems (GB-29, GB-30, BL-54, local tender or trigger points) Hip problems (GB-29, GB-30, BL-54, local tender or trigger points); sciatic n dysfunction (GB-30, BL-54, BL-36, BL-37, BL-39, BL-40, Bafeng); sciatic pain (GB-30, BL-26 BL-27, Bai Hui, BL-37, ST-36, BL-60) Hip or pelvic limb pain or neurologic dysfunction (use as local point in addition to GB-29, GB-30, BL-54, local tender or trigger points) Pain, arthritis, and/or edema of the stifle (GB-33, local stifle points, palpate for tender points)

GB 31 (Feng Shi, Wind Market) On the midline of the lateral aspect of the thigh, 7 cun above the popliteal crease. GB 33 (Xi Yang Guan, Knee Yang Joint) On the lateral stifle, proximal to the joint line, in a depression caudal to the femur in the biceps femoris m.

Femoral n Sciatic n Fibular n

32

GB 34 (Yang Ling Quan, Yang Mound Spring) Fibular n In the depression cranial and distal to the fibular head.

GB 39 (Jue Gu, Severed Bone) 3 cun proximal to the lateral malleolus in the depression between the caudal border of the fibula and the tendons of the peroneus (fibularis) longus and brevis mm. GB 41 (Zu Lin Qi, Foot Governor of Tears) In the depression distal to the junction of the 4th and 5th metatarsals, lateral to the extensor digitorum longus tendon.

Fibular n

Stifle pain (GB-34, GB-33, ST-36, SP-9, SP-10); musculotendinous pain or tension (GB-34 plus local tender points); hepatobiliary disorders (GB-34, GB-24, LR-14, BL-19, BL-18); lateral pelvic limb or hip discomfort (GB-34, regional points) Pelvic limb pain, movement problems and/or stiffness (GB-39, local points, regional points, tender points); bone marrow disorders (GB-39, ST-36, BL-17) Local foot pain (GB-41 plus local or tender points); eye problems (GB-41 plus local eye points)

Fibular n

33

Liver (LR)

34

Point Name & Location LR 2 (Xing Jian, Moving Between) Between the 2nd and 3rd digit of the pelvic limb, distal to the metatarsophalangeal joint. LR 3 (Tai Chong, Great Rushing) Midway along the groove between the 2nd and 3rd metatarsal bones.

Relevant Anatomy Deep fibular n

Indications & Point Combinations Pelvic limb paresis (LR-2 as part of the Bafeng points, ST-36, relevant spinal segments); agitation (LR-2, HT-7, GV-20)

Deep fibular n

LR 8 (Qu Quan, Spring at the Crook) On the medial side of the stifle joint, caudodistal to medial condyle of the femur, at the level of the joint line.

Saphenous n Tibial n (to joint capsule)

Seizures (LR-3, ST-36, HT-3, GV-20, Sishencong, BL-10); anxiety (LR-3, HT-3, GV-20); foot pain (LR-3, local pain problems); hepatobiliary disorders (LR-3, ST-36, LR-14, GB-24, BL-18, BL-19); headaches (LR-3, LI-4, GV-20, local painful points on the head); genital pain or inflammation (LR-3, SP-6, BL-25, BL-27, Bai Hui); endocrine and metabolic disorders (LR-3, LI-4, ST-36, appropriate visceral spinal segmental points) Reproductive disorders (genital pain or inflammation (LR-8, SP-6, BL-25, BL-27, Bai Hui); respiratory allergies (LR-8, LI-4, LU-7, LI-11), urticaria (LR-8, SP-10, LI-4, ST-36); stifle problems and pain (GB-34, GB-33, ST-36, SP-9, SP-10, LR-8)

35

LR 13 (Zhang Men, Screen Gate) On the lateral side of the abdomen, just ventral and cranial to the tip of the 12th rib. LR 14 (Qi Men, Cycle Gate) On the mammary line, at the level of the 8th intercostal space.

Caudal thoracic spinal nn

Digestive problems, vomiting, abdominal swelling, diarrhea (LR-13, ST-36, SP-6, CV-12)

Midthoracic spinal nn

Digestive problems, vomiting, abdominal swelling, diarrhea (LR-14, ST-36, SP-6, CV-12); hiccups (LR-14, CV-15, CV-22, BL-17 (consider firm acupressure at these sites)

36

37

Conception Vessel (CV)

38

Point Name & Location CV 1 (Hui Yin, Meeting of Yin) On the perineal region, in the depression between the anus and the caudal border of the scrotum in males, or caudal labial commissure in females. CV 3 (Zhong Ji, Central Pole) 4 cun caudal to the umbilicus = 1 cun cranial to the symphysis pubis, on the midline. CV 4 (Guan Yuan, Gate of Origin) 3 cun caudal to the umbilicus = 2 cun cranial to the symphysis pubis, on the midline. CV 5 (Shi Men, Stone Gate) 2 cun caudal to the umbilicus = 3 cun cranial to the symphysis pubis, on the midline. CV 6 (Qi Hai, Sea of Qi) 1.5 cun caudal to the umbilicus = 3.5 cun cranial to the symphysis pubis, on the midline. CV 8 (Shen Que, Spirit Gateway) In the center of the umbilicus. CV 12 (Zhong Guan, Middle Cavity) Halfway between the umbilicus and the xiphisternal synchondrosis, on the midline.

Relevant Anatomy Sacral spinal nn

Indications & Point Combinations Emergency resuscitation of a drowned patient (CV-1, GV-26); genitourinary problems (CV-1, CV-3, BL-23, BL-28, KI-3, SP-6) Genitourinary, especially bladder, problems (CV-1, CV-3, BL-23, BL-28, KI-3, SP-6) Uterine problems (CV-4, BL-31 to BL-33, SP-6, LR-8) Caudal abdominal pain (CV-5, ST-36), ascites (CV-5, BL-22, ST-25, SP-9) Periumbilical abdominal pain (CV-6, ST-25, ST-36), ascites (CV-6, BL-22, ST-25, SP-9) Avoid needling here; warm with moxa or laser; diarrhea (CV-8, ST-25, ST-36) Abdominal problems, including processes of food absorption and assimilation (CV-12, BL-21, ST-36, SP-6)

Cranial lumbar spinal nn Cranial lumbar spinal nn Cranial lumbar spinal nn Cranial lumbar spinal nn L1 spinal n

Midthoracic spinal nn

39

CV 14 (Ju Que, Great Tower Gate) Halfway between CV 12 and the xiphisternal synchondrosis, on the midline. CV 17 (Shan Zhong, Chest Center) On the ventral midline, at the level of the fourth intercostal space. CV 22 (Tian Tu, Celestial Chimney) At the cranial tip of the manubrium.

Midthoracic spinal nn

Cranial thoracic spinal nn

Cervicothoracic spinal nn

Anxiety (CV-14, HT-7, LR-3, GV-20), palpitations, emesis, or emotional problems upsetting the stomach (CV-14, PC-6, LR-3) Anxiety, stress, or cardiac problems (CV-17, BL-14, BL-15, GV-20, HT-7); coughing, chest discomfort (CV-17, LU-1, BL-13, LU-7; consider LI-4, LU-5) Thyroid, throat, and tongue issues (CV-22, CV-23, ST-9, LI-4); cough, asthma, other respiratory problems (CV-22, LU-7, BL-23, BL-13, LU-1); hiccups (CV-22, BL-17)

40

41

Governor Vessel (GV)

42

Point Name & Location GV 1 (Chang Qiang, Long Strong In the depression between the anus and base of the tail. GV 2 (Yao Shu, Lumbar Shu) Sacrocaudal junction. GV 3 (Yao Yang Guan, Lumbar Yang Gate) Along the dorsal midline in the depression caudal to the spinous process of L4. GV 4 (Ming Men, Life Gate) Along the dorsal midline in the depression caudal to the spinous process of L2. GV 14 (Daz Hui, Great Vertebra On the midline, between the dorsal spinous processes of the last cervical and first thoracic vertebrae.

Relevant Anatomy Sacral nn

Indications & Point Combinations Diarrhea (GV-1), fecal incontinence (GV-1, BL-39, GVT), rectal prolapse (GV-1, Bai Hui), ejaculatory problems (GV-1, Bai Hui, BL-27, BL-28) Anal dysfunction (GV-2 +/- GV-1, BL-35, sacral nn points)

Sacral nn

Midlumbar spinal nn

Lumbar pain (GV-3, BL-23, BL-25)

Thoracolumbar Lumbar pain (GV-4, BL-23, local lumbar tender and trigger points, spinal nn BL-40, BL-60), pelvic analgesia (GV-4, BL-23, BL-25, SP-6), genitourinary dysfunction (GV-4, BL-27, BL-28, SP-6) Cervicothoracic Neck and back pain (GV-14, spinal segmental and tender or spinal nn trigger points), thoracic limb pain and weakness (GV-14, pertinent points according to neurologic injury or pain), respiratory problems (GV-14, BL-13, LU-1, LU-7, ST-36), epilepsy (GV-14, GV-20, ST-36, LR-3, HT-3), fever (GV-14, LI-4, LI-11, GV-20), immunologic dysfunction (GV-14, LI-4, ST-36, SP-10)

43

GV 20 (Bai Hui, 100 Convergences) On the dorsal midline of the skull, in a notch at the rostral end of the external sagittal crest (a.k.a., parietal crest). GV 26 (Shui Gou, Water Trough) In the intersection of the T formed below the nose, in the philtrum.

Trigeminal n Cranial cervical spinal nn

Agitation (GV-20, HT-7, LR-2), epilepsy (GV-20, ST-36, HT-7, PC-6, local head and neck points), headaches (GV-20, local points), dizziness (GV-20, BL-10 or GB-20, GB-34, LR-3), cerebrovascular accident (GV-20, pertinent points related to neurologic dysfunction and brain area(s) affected) Cardiopulmonary collapse (vigorous stimulation of GV-26), status epilepticus (GV-26)

Trigeminal n Facial n

44

45

Extra Points

46

Point Name & Location Bai Hui (100 Convergences) A depression on the dorsal midline in the lumbosacral space.

Relevant Anatomy Mid- to caudal lumbar spinal nn

Indications & Point Combinations Lumbosacral pain (Bai Hui, local tender or trigger points, BL-40, BL-60), pelvic limb pain or neurologic dysfunction (Bai Hui, relevant points for pain or neurologic dysfunction), pelvic organ or reproductive problems (Bai Hui, BL-27, BL-28, SP-6, KI-3) Frontal sinusitis (Yintang, BL-2, GB-14, GV-20, BL-10), frontal headache (Yintang, trigger points, BL-10, LI-4), epilepsy (Yintang, GV-20, LR-3, ST-36, GV-14) Cervical intervertebral disk disease, neck pain (add relevant trigger points)

Yintang (Hall of Impression) On the dorsal midline of the head, between the eyebrow equivalents.

Trigeminal n Facial n

Cervical spinal nerve points (not shown) In the groove at the lateral aspect of the neck along the course of the omotransversarius m. Xiyan (Eyes of the Knee) A pair of points in the depressions medial and lateral to the patellar ligament; the lateral point = ST-35. Baxie (Eight Evils) Points located on the dorsum of the front paw, distal to the metacarpophalangeal

Cervical spinal nn

Saphenous n

Stifle joint pain (Xiyan, ST-36, ST-34, SP-9, SP-10); patellar tendinitis (Xiyan)

Digital nn

Thoracic limb neuropraxia (Baxie, relevant neurologic pathways and spinal segments), manus discomfort (Baxie,

47

joints, proximal to the web margins. Bafeng (Eight Winds) Points located on the dorsum of the hind paw, distal to the metatarsophalangeal joints, proximal to the web margins. GVT or Weijian (Tip of Tail) At the tip of the tail. Digital nn

tender points) Pelvic limb neuropraxia (Bafeng, relevant neurologic pathways and spinal segments), pedal discomfort (Bafeng, tender points) Fecal incontinence (GVT or points at lateral aspect of tail where spinal nn exit); tail neuropraxia. Often, a more productive point is found on the lateral aspects of the tail at the junction of the most proximal and middle thirds.

Caudal spinal nn

48

Canine Shu Points BL 13 Lateral to the caudal border of the spinous process of the T3 vertebra, midway between the spinous process and the medial border of the scapula. BL 14 Same as BL 13, but lateral to T4.

Equine Shu Points BL 13 3 cun lateral to the dorsal midline, at the caudal edge of the scapular cartilage in the 8th intercostal space, between the longissimus and iliocostalis mm. BL 14 3 cun lateral to the dorsal midline, in the 9th intercostal space, between the longissimus and iliocostalis mm. BL 15 In line with BL 14, lateral to T10.

Associated Organ Lung

Pericardium

BL 15 Lateral to the caudal border of the spinous process of the 5th thoracic vertebra, between the longissimus and iliocostalis mm, lateral to T5. BL 18 In line with BL 15, lateral to T10. BL 19 BL 20 BL 21 T13. BL 22 BL 23 In line with BL 15, lateral to T11. In line with BL 15, lateral to T12. In line with BL 15, but lateral to In line with BL 15, lateral to L1. In line with BL 15, lateral to L2.

Heart

BL 18 T14. BL 19 BL 20 BL 21 BL 22 L2. BL 23 L3.

In line with BL 14, lateral to T13 and In line with BL 14, lateral to T15. In line with BL 14, lateral to T17. In line with BL 14, lateral to T18. In line with BL 14, between L1 and In line with BL 14, between L2 and

Liver Gallbladder Spleen Stomach Triple Heater Kidney

49

BL 25

In line with BL 15, lateral to L5.

BL 27 Lateral to the S1 foramen, between the medial border of the dorsal sacral iliac spine and the sacrum. BL 28 Lateral to the S2 foramen, between the medial border of the dorsal iliac spine and the sacrum.

BL 25 In line with BL 14, between L5 and L6, or between L4 and L5 if the horse lacks an L6. BL 27 3 cun lateral to the dorsal midline, between the spinous processes of S1 and S2. BL 28 3 cun lateral to the dorsal midline, between the spinous processes of S2 and S3.

Large Intestine

Small Intestine

Urinary Bladder

50

Canine Mu Points LU 1 On the chest, medial to the greater tubercle of the humerus, in the 1st intercostal space.

Equine Mu Points LU 1 In the center of the descending pectoral m, medial to the humerus, directly medial to the cephalic vein, in the 1st intercostal space. CV 17 On the ventral midline, in a large depression, at the level of the caudal border of the olecranon. CV 14 On the ventral midline at about the level of the xiphoid. LR 14 In the 13th intercostal space at the level of the elbow, between the external abdominal oblique m and the internal and external intercostal mm. GB 24 In the 14th intercostal space, just caudodorsal to LR 14. LR 13 At the distal end of the 17th rib. CV 12 On the ventral midline, midway between the xiphoid process and the umbilicus. CV 5 On the ventral midline, halfway between the pubic symphysis and the umbilicus.

Associated Organ Lung

CV 17 On the ventral midline, at the level of the 4th intercostal space. CV 14 Midway between CV-12 and the xiphisternal synchondrosis, on the midline. LR 14 On the mammary line, at the level of the 8th intercostal space.

Pericardium

Heart Liver

GB 24 In a depression ventral to the costochondral junction at the 9th intercostal space, caudodorsal to LR 14. LR 13 On the lateral abdomen, just cranioventral to the tip of the 12th rib. CV 12 Midway between the umbilicus and the xiphisternal synchondrosis, on the midline. CV 5 2 cun caudal to the umbilicus, 3 cun cranial to the symphysis pubis, on the midline.

Gallbladder

Spleen Stomach

Triple Heater

51

GB 25 On the lateral abdomen, at the tip of the 13th rib.

ST 25 Approximately 2 cun lateral to the center of the umbilicus, in the rectus abdominis m, midway between its lateral border (linea semilunaris) and the linea alba. CV 4 3 cun caudal to the umbilicus, 2 cun cranial to the symphysis pubis, on the midline. CV 3 4 cun caudal to the umbilicus, 1 cun cranial to the symphysis pubis, on the midline.

GB 25 Midway on a vertical line drawn from the caudal border of the costochondral junction of the 18th rib to the ventral border of the iliocostalis m. ST 25 1.5 cun lateral to the umbilicus.

Kidney

Large Intestine

CV 4 3 cun caudal to the umbilicus, 2 cun cranial to the symphysis pubis, on the midline. CV 3 4 cun caudal to the umbilicus on the ventral midline.

Small Intestine

Urinary Bladder

52

53

54