Introduction: Xia Shouren’s profound understanding of a single acupoint is akin to Zhang Xichun’s meticulous exploration of medicinal substances. Using herbs is like deploying troops, and using acupoints is similarly strategic. This article discusses the Weizhong (BL40) acupoint from various perspectives, particularly highlighting several commonly used acupoint combinations introduced by Mr. Xia in the third section. These combinations are valuable summaries of his clinical experience.

Profile: Xia Shouren, born in Jin County, Liaoning Province (1906–1986). In his youth, he worked at the Liaodong Bank and East Asia Bookstore in Pulandian, Dalian. From 1938 to 1939, he studied at the Tokyo Advanced Acupuncture School in Japan. After graduation, he returned to China, moving from Tianjin to Beiping (now Beijing). He established his practice in Beiping in 1942. From 1958 to 1966, he taught at the Beijing Traditional Chinese Medicine School. In 1966, he joined the Acupuncture Department of Beijing Hospital of Traditional Chinese Medicine.

Clinical Experience of Dr. Xia Shouren: Insights on the Six Shu Acupoints in Acupuncture—Weizhong

Author/Beijing Hospital of Traditional Chinese Medicine

Acupoint Location: Slightly lateral to the center of the popliteal crease, located in the prone position.

Acupoint Characteristics: Weizhong is the He-Sea point of the Foot Taiyang Meridian and also the Xi-Cleft point for blood.

Indications: Stiffness and pain in the lumbar spine, difficulty in flexion and extension of the hip, thigh, and knee joints, wind-cold-dampness impediment, febrile diseases with absence of sweating, malaria, persistent epistaxis, wind stroke with loss of consciousness, cholera with severe abdominal pain, furuncles, enuresis, spontaneous sweating, and night sweats.

I. Analysis of the Therapeutic Functions of Weizhong (BL40)

1. Analysis of the Therapeutic Functions of Weizhong from the Perspective of Acupoint Characteristics:

Weizhong (BL40) is an acupoint of the Bladder Meridian of Foot-Taiyang. Taiyang governs the qi of all yang meridians and dominates the exterior. If defensive yang is not consolidated, pathogenic factors such as wind, cold, and dampness may invade the muscular exterior, leading to stagnation and obstruction of the Taiyang meridian qi, which fails to descend properly. This results in a series of exterior syndromes and pain syndromes, such as fever, aversion to cold, headache, lumbar and spinal pain, and joint pain.

The Taiyang meridian governs the exterior and opening functions, with the ability to disperse yang and release the exterior, descend counterflow and activate blood circulation to treat headaches, febrile diseases without sweating, stiffness and pain in the lumbar spine, restricted flexion and extension of the hip joint, wind-cold-dampness impediment, malaria, and other conditions. The Xuexi point excels in activating blood circulation and dispelling stasis, such as in cases of epistaxis, furuncles, cholera, and gripping pain in the heart and abdomen (often caused by fire stagnation, qi stagnation, and blood stasis). Selecting the Weizhong point has the effect of draining fire, descending counterflow, activating blood circulation, dispelling stasis, and relieving pain. Particularly for cholera and gripping pain in the heart and abdomen, bloodletting at Weizhong is more effective than acupuncture.

Spontaneous sweating is due to qi deficiency and insecurity of the exterior, while night sweats result from yin deficiency and heat forcing fluids outward. Selecting the Weizhong point can boost qi and secure the exterior to treat spontaneous sweating, and clear heat and nourish yin to treat night sweats.

2. Examining the therapeutic functions of Weizhong from the perspective of meridian circulation and disease manifestations:

The Foot Taiyang meridian circulates through the head, neck, back, waist, sacrum, buttocks, and passes along the posterior aspect of the lower limb to the little toe. The disease manifestations of the Foot Taiyang meridian: It governs diseases related to tendons—headache, vertex pain, ... pain in the neck, back, waist, sacrum, popliteal fossa, calf, and foot, and inability to use the little toe.

These symptoms manifest along the pathway of the Foot Taiyang Meridian from head to foot, inevitably leading to stagnation and reversal of Taiyang meridian qi, resulting in pain. Weizhong (BL40) is the He-Sea point of the Foot Taiyang Meridian and also a Xi-Cleft point for blood. The He-Sea point governs counterflow qi and drainage, while the Xi-Cleft point for blood promotes blood circulation. Thus, it is understood that its function is to unblock yang, descend counterflow, activate blood, and dispel stasis, thereby treating various pain syndromes of the Taiyang Meridian.

II. Relationship Between Needle Sensation and Nerve Distribution

The deep layer of the Weizhong point is precisely where the tibial nerve passes. The tibial nerve descends behind the popliteal artery and vein to the posterior aspect of the medial malleolus, where it divides into the medial and lateral plantar nerves, extending forward to the five toes. Therefore, in terms of needle sensation and therapeutic effect, needling Weizhong to achieve a sensation that reaches the five toes yields significant results.

III. The Combined Effects and Explanations of Weizhong

1. Weizhong (BL40) paired with Renzhong (GV26) treats lumbar spine sprain pain ("Jade Dragon Ode")

Renzhong is the meeting point of the Hand and Foot Yangming Meridians and the Governor Vessel. The Governor Vessel is the sea of all yang meridians, and yang governs movement. The Hand and Foot Yangming Meridians are meridians abundant in qi and blood. In the formation of sprain-induced low back pain, qi must be stagnant and blood must be stagnant, leading to impaired motor function.

The lumbar spine is traversed by the Governor Vessel, so selecting Renzhong can disperse and unblock the yang of the Governor Vessel to move stagnant qi and blood, promoting the recovery of motor function. This is also a method of treating lower disorders from above. Additionally, selecting the He-Sea point Weizhong, which is also the Xi-Cleft point for blood, can descend counterflow, activate blood, and dispel stasis to relieve pain. This is a method of treating upper disorders from below.

2. Weizhong (BL40) paired with Fuliu (KI7) treats lumbago and back pain ("Great Compendium of Acupuncture and Moxibustion")

The foot-taiyang meridian courses along the back and waist, and the waist is also the residence of the kidneys. The bladder and kidneys are externally-internally related. If external pathogenic factors such as wind, cold, and dampness invade from the exterior of the bladder foot-taiyang into the interior of the kidney foot-shaoyin, the kidney qi in the interior will inevitably become deficient.

Therefore, the jing-river point of the kidney meridian, Fuliu (KI 7), is selected. The jing-river points are indicated for panting, cough, cold, and heat, and can invigorate kidney yang to expel interior pathogenic factors. Weizhong (BL 40) is selected to disperse the qi of taiyang to dissipate exterior pathogenic factors. By resolving both the exterior and interior, the wind, cold, and damp pathogenic factors will naturally be eliminated.

3. Weizhong (BL 40) paired with Taichong (LR 3) for treating dizziness and distending pain (personal experience)

Taichong (LR 3) is the shu-stream point of the liver meridian and also its yuan-source point. The liver meridian ascends from the big toe to meet the governor vessel at the vertex. The liver stores blood, and its zang-organ pertains to jueyin and governs wind. If kidney yin is deficient below, liver yang becomes hyperactive above, transforming into heat and generating wind. The wind and heat force qi and blood to rebel upward, resulting in symptoms such as dizziness or distending pain, which is the so-called dizziness due to water failing to nourish wood.

According to the principle of treating upper disorders by selecting lower points, the Shu and Yuan point of the Liver Meridian, Taichong (LR 3), is selected. The Yuan point treats both deficiency and excess patterns, functioning to calm the liver and extinguish wind. Weizhong (BL 40, also the Xi-Cleft point for blood) is selected to drain heat, direct rebellious qi downward, and guide blood to descend. It can be combined with Fuliu (KI 7) of the Kidney Meridian to nourish water (kidney) and support wood (liver), yielding a certain therapeutic effect. However, for cases with more severe yin deficiency, if herbs that nourish yin and subdue yang are not concurrently used, the therapeutic effect may be difficult to consolidate.

4. Weizhong (BL 40) Paired with Yanglingquan (GB 34) for Treating Migraine (Personal Experience)

Weizhong (BL 40) belongs to the Foot Taiyang (Bladder) Meridian; Yanglingquan (GB 34) belongs to the Foot Shaoyang (Gallbladder) Meridian. According to the theory of Opening, Closing, and Pivoting: Taiyang governs opening and the exterior, Yangming governs closing and the interior, and Shaoyang governs pivoting and the half-exterior half-interior. Therefore, the ability of Taiyang to open and Yangming to close both rely on Shaoyang to pivot and facilitate.

For example, when wind pathogen invades the Taiyang exterior, causing headache, selecting Weizhong (BL 40), the He-Sea point and Xi-Cleft point for blood of the Foot Taiyang Meridian, functions to diffuse yang, release the exterior, direct rebellious qi downward, and activate blood to disperse wind. Pairing it with Yanglingquan (GB 34), the He-Sea point and Influential point for tendons of the Foot Shaoyang Meridian, can direct rebellious qi downward to relax the sinews. Furthermore, it can pivot the Shaoyang mechanism to assist the opening of Taiyang, thereby enhancing the efficacy of Weizhong (BL 40) in releasing the exterior, dispersing wind, directing rebellious qi downward, and alleviating pain.

IV. Case Studies

1. Migraine

An elderly woman in her sixties. While enjoying the cool air in the courtyard during summer, she sweated and was exposed to wind, leading to left-sided migraine. Tongue coating thin and yellow, pulse wiry and slippery. After 1 a.m., due to severe headache, she was unable to sleep, and her eyes were difficult to open. Thus, the method of dispelling wind and releasing the exterior was applied, needling Fengchi (GB20) and Waiguan (TE5) on the affected side, and Hegu (LI4) and Lieque (LU7) on the healthy side, but it proved ineffective. The needles were then removed.

Have the patient lie on their side, and needle the affected side's Weizhong point (He-sea point and blood cleft point) to activate blood circulation and dispel wind, lower adverse qi flow and relieve pain. Additionally, pair it with the He-sea point of the Foot Shaoyang Gallbladder Meridian and the tendon convergence point, Yanglingquan, to pivot the Shaoyang pivot to assist the Taiyang opening and resolve external pathogens. The patient fell asleep within ten minutes of needle retention, and there was no recurrence the following day.

This case demonstrates that using only the He-Sea points of the Foot-Taiyang and Foot-Shaoyang meridians achieved the effect of descending counterflow and relieving pain.

2. Traumatic Headache

A male high school student came from Tianjin for consultation. During sports activities, he was struck on the back of the head by a medicine ball and was hospitalized in Tianjin for three months, diagnosed with "concussion." He experienced dizziness and persistent headache without improvement. The tongue coating was thin and white, and the pulse was slightly wiry and slow.

The headache from "concussion" is caused by the injury to the brain's collaterals due to the impact, leading to stagnation of qi and blood stasis. The head is the meeting point of all yang meridians, and the qi of the three yang meridians becomes stagnant and counterflows, obstructing smooth circulation. The treatment should focus on unblocking yang, regulating qi, descending counterflow, and dispelling stasis.

Therefore, selecting Weizhong (BL 40) of the Foot-Taiyang Meridian to unblock yang and descend counterflow, promote blood circulation and dispel stasis; paired with Taichong (LR 3) of the Liver Meridian (Shu-Stream point and Yuan-Primary point), as the liver stores blood and its meridian ascends to the vertex, it can assist Weizhong in descending counterflow qi and promoting blood stasis. Acupuncture was performed every other day, with a total of four sessions resulting in complete recovery.

3. Amenorrhea

Patient Wang, female, 15 years old. Amenorrhea for nine months, with normal diet, sleep, and bowel and urinary functions, without prominent symptoms, moderate nutrition, and a relatively weak constitution. Tongue coating thin and white, tongue body pale, pulse moderate, with slight choppiness at both chi regions.

The causes of amenorrhea vary. Although the patient had amenorrhea for nine months, there were no specific discomforts, only slight discomfort upon heavy pressure at the three points of Tianshu (ST 25) and Qihai (CV 6) in the lower abdomen. When lying prone, a hard nodule about the size of a pea was discovered approximately two cun above the left Weizhong (BL 40) point of the Foot-Taiyang Meridian, neither red nor swollen, but painful upon heavy pressure.

The patient reported being prone to catching colds. The Taiyang (Greater Yang) channel governs the exterior, and frequent colds led to lingering wind-cold pathogens that stagnated in the Foot Taiyang channel, causing qi and blood stasis and the formation of a hard nodule. Internally, the Foot Taiyang Bladder channel is connected to the Foot Shaoyin Kidney channel. In women, the uterus (zǐgōng) is linked to the kidneys. The lingering wind-cold pathogens transmitted from the exterior to the interior, invaded the uterus, and obstructed the vessels (evidenced by a faint and choppy pulse at the chi position), resulting in amenorrhea.

The treatment principle was to unblock the channels, dispel wind, regulate qi, and promote blood circulation.

Based on the location of the hard nodule above the left Weizhong (BL40) point, only the left Foot Taiyang channel's Weizhong point (He-Sea point and Xi-Cleft point for blood) was needled to observe its effect in unblocking the channels, dispelling wind, activating blood, and removing stasis. After a single needling session at this point alone, menstruation resumed on the third day.