Tuesday, August 24, 2010

ST-40 Fenglong

The last Clinical Tip discussed the treatment of Dampness and Phlegm and it started with a reference to ST-40 Fenglong. It seems therefore appropriate now to discuss the clinical use of the point ST-40 Fenglong. As I said in the previous Clinical Tip, whenever I mention ST-40 in the course of my lectures, everybody associates it with resolving Phlegm. As we shall see, this point has many other extremely valuable actions.

ST-40's name Fenglong means "Abundant Bulge": this obviously refers to the bulge on the fibularis longus muscle where the point is situated. However, the word feng meaning "abundant" or "rich in" has also another meaning: it refers to the quality of the Yang Ming channels of being "rich in Qi and Blood".[i] Feng, therefore, refers to the quality of the Stomach channel of being rich in Qi and Blood and, because of this, to its use in invigorating the channels. ST-40 Fenglong is the Luo point of the Stomach channel and we shall see what relevance this has in the clinical use of the point.

The main actions of ST-40 Fenglong listed in modern Chinese books are:
a) Resolves Phlegm and Dampness
b) Opens the chest and subdues rebellious Qi
c) Promotes the descending of Lung-Qi and stops cough
d) Calms the Mind and opens the Mind's orifices
e) Invigorates the channels[ii]

The indications related to ST-40 grouped according to its function are as follows:
a) Feeling of oppression of the chest, profuse sputum, swelling of the face, dizziness, headache, swelling of the throat, feeling of heaviness of the body
b) and c) Cough with sputum, breathlessness, wheezing
d) Manic-depression [Dian Kuang], inappropriate laughter, inappropriate elation, desire to ascend to high places and sing, undress, and run around, mental restlessness, "seeing ghosts".
e) Loss of use of the lower legs, atrophy of muscles of the lower leg, difficulty in walking from Deficiency conditions.

This is a very important point since it is the point to resolve Phlegm in all its manifestations and in all parts of the body. However, as discussed in the previous Clinical Tip, this point would eliminate Phlegm only in combination with several other points.

It eliminates substantial Phlegm, such as profuse expectoration from the chest, Phlegm in the form of lumps, such as lumps under the skin, thyroid lumps and uterus lumps, and non-substantial Phlegm such as the one that clouds the Mind and obstructs the Mind's orifices causing mental disturbances or simply headache, dizziness and muzziness of the head. In all these cases this point should be needled with reducing method to resolve Phlegm.

I use the point ST-40 for asthma not so much for its Phlegm-eliminating effect but because it promotes the descending of Qi in the chest area: this point has a strong action on the chest and, for this reason, it has an effect on asthma together with points such as P-6 Neiguan and LU-7 Lieque.

This point's action on the chest is such that I use it also in muscular problems of the chest: for example, it is excellent to move Qi and make Qi descend when there is bruising of the chest and ribs from an accident: in such cases, I combine ST-40 with P-6 Neiguan. Another important action of this point is to calm the Mind, on which it has a profound effect. It can be used in all cases of anxiety, fears and phobias, not only if they are caused by misting of the Mind by Phlegm but also if they are caused by rebellious Qi. Indeed, in my opinion, the Phlegm-resolving effect of this point originally was specific in relation to mental illness, i.e. this point was used to eliminate Phlegm from the Heart's orifices causing mental illness.

Interestingly, the book "An Explanation of Acupuncture Points" (1624) does not make any mention of the effect of ST-40 in resolving Phlegm from the Lungs in Lung diseases, but it does mention the effect of this point in eliminating Phlegm from the Heart's orifices causing Kuang syndrome, i.e. the manic phase of bipolar disorder.

The Phlegm-resolving of this point should not be overemphasized overlooking its other functions. Apart from its use to resolve Phlegm, ST-40 can also be used to subdue rebellious Qi of the Stomach and Lungs when the person is very anxious, and the anxiety reflects on the Stomach function, with such symptoms as tightness of the epigastrium, a feeling of knot in the Stomach or, as some people say, a feeling of "butterflies in the stomach".
ST-40's quality of Luo point is important to understand some of its functions. It departs from ST-40 Fenglong 8 cun above the external malleolus, it flows up the leg and a branch joins with the Spleen channel, it then flows up the torso to the nape of the neck and head where it converges with the Qi of other channels, it then flows down to the throat.
The fact that the Luo channels flows to the neck where it "converges with the Qi of the other channels" makes it an important point to use for Bi Syndrome of the neck. If there is a Stomach disharmony and the patient suffers from chronic neckache, I use the point ST-40 bilaterally with reducing method.

Finally, some of ST-40's actions are also due to its being the Luo point that influences the Xu Li. Xu Li is the name for the Great Luo of the Stomach. The Great Luo of the Stomach is mentioned in chapter 18 of the Ling Shu: "The Great Luo channel of the Stomach is called Xu Li. It penetrates the diaphragm, it connects with the lungs and exits below the left breast. One can feel its pulsation by hand: it is the place where the Gathering Qi (Zong Qi) of the vessels [or channels] is situated."

Although the Ling Shu does not mention ST-40 in connection with the Xu Li channel, I do use ST-40 Fenglong to affect the Xu Li: as the Xu Li flows to lungs and heart and it influences the Zong Qi, I use ST-40 to affect the Xu Li and especially the heart when the pulse is irregular. In other words, ST-40 is an important point to affect the rate and rhythm of the heart.


[i] Yue Han Zhen 1990 An Explanation of the Acupuncture Points (Jing Xue Jie), People's Health Publishing Company, Beijing, p. 102. The book An Explanation of the Acupuncture Points was written in 1624.

[ii] Li Shi Zhen 1985 Clinical Application of Frequently-Used Acupuncture Points (Chang Yong Shu Xue Lin Chuang Fa Hui), People's Health Publishing Company, Beijing, p. 209.