hey this is nicholas in this video we're going over the han tae yang small intestine channel as always we'll start by going over the general functions and characteristics of the small intestine then we'll go over the channel pathways including the primary channel lua connecting channel divergent channel and sinew channel and then we'll get into the functions and indications of the individual points so i'll go ahead and put time codes in the description below in case you want to jump around to the different sections the audio version of this lecture can be downloaded at tcm study.net under the acupuncture tab in case you want to listen to this lecture on the go there you can also find the handouts that go along with this video and there's also a practice test that you can take afterwards and before we get started i want to give a special thank you to the patreon members it's your support that makes videos like this possible so thank you for your contributions if you're not a member of the patreon and you want to join them in supporting this channel there's a link in the description below next to the red envelope but let's go ahead and get started so it turns out the small intestine is one of those organs that just doesn't really do a whole lot in chinese medicine and this is weird because in western medicine the small intestine plays an important role in digestion both in the breakdown of food and the absorption of nutrients but in tcm we tend to relegate those functions more to the spleen and stomach and even in fundamentals class we say that the small intestine separates the clear from the turbid and that sounds like it should be really important but honestly at least clinically doesn't really come up that much i mean let me put it this way when it comes to zhong fu diagnosis there are like 15 patterns for the spleen but they're only like three or four for the small intestine and it turns out that these patterns don't really have to do with digestion or the absorption of nutrients they're more about like urination problems due to heart heat pouring into the small intestine or lower abdominal pain with warboridness and those don't always come up a whole lot in the clinic and to make things even worse it turns out when we do want to treat these patterns it's actually unlikely that we would choose points on the small intestine channel for treatment for these patterns it's much more likely that we would choose points like stomach 39 the lower huh c point of the small intestine or ub27 the back shoe point of the small intestine so what does all this mean well for us it means that when we're trying to understand these points we're not going to look so much at the functions of the small intestine organ rather we're going to look at the characteristics of the small intestine channel itself in order to understand what these points can do for us for example when we look at the pathway of the small intestine channel it starts the little finger and goes up the arm so of course we're going to be able to treat issues in the fingers wrist and elbow but what really stands out is this zigzag pattern across the shoulder blade now it turns out that a lot of these points lie right on top of rotator cuff muscles like supraspinatus infraspinatus and teres minor so the small intestine channel is going to play an important role in treating shoulder issues things like shoulder pain frozen shoulder or problems with the rotator cuff the channel then goes to the neck so we're going to be able to use these points to treat neck and shoulder issues like stiffness of the neck inability to turn the head or occipital headache then the channel goes on to the face connecting to the eye and wrapping around the ear so we're going to be able to treat eye problems like red eyes or eye pain and ear problems like deafness and tinnitus but besides just the pathway of the channel we can also think about the general characteristics of the channel for example the si and ub make up the tai yang pair so if you remember in herb's class we talked about the shanghan loon and the six levels and there we said that the taiyong level was the most superficial level and the first to get hit by an exterior attack so we're going to see that there are points on the si channel that can release the exterior especially when we have an exterior attack with symptoms like stiff neck and shoulders because that's where the channel goes the small intestine is also paired with the heart through its interior exterior relationship and this is just a fancy way of saying that the heart and small intestine are yin yang pairs so we're going to see that there are certain points on the small intestine channel that have an action of calming the shen this is especially going to be for shen problems due to heat because the small intestine channel is a young channel and yang channels are good for clearing heat and finally this is maybe a little bit unusual but there is an internal pathway of the small intestine channel that goes to the chest and connects to ren17 so there are certain points on the small intestine channel that benefit the breast and promote lactation so this is maybe a little bit weird or unexpected so it's something that we want to pay attention to when it comes up i really need to stop gesturing like this when i say promote lactation but anyway so those are some of the things we can treat with the si channel let's go ahead and look at the functions and characteristics of the small intestine in more detail so whenever we talk about a channel i always like to start with chapter 8 of the su-n this is a section of the negin where each organ is assigned a government office here chapter 8 says the small intestine holds the office of abundant reception issuing material transformation so when we say the small intestine holds the office of abundant reception this is referring to the small intestine receiving food from the stomach the small intestine is like a stopping place between the stomach and the large intestine where food is further broken down and assimilated when we say that the small intestine issues material transformation this is referring to its function of separating the clear from the turbit so it's like the small intestine has a job of classifying or separating out the material that will be used by the rest of the body and it should be understood that this process of separating the clear from the turbid is a continuation of the process that was already begun by the spleen and stomach so this is the main function of the small intestine separating the clear from the turbit generally speaking the clear is sent back up to the spleen while the turbid is sent down to the large intestine where it's conducted out of the body so this is an interesting review of the small intestine organ but like we said these things just don't come up very much when we look at the small intestine channel and this is just a thing that happens the yang channels are generally less directly associated with the functions of the young organ than what you would see with the yin channels and the yin organs and this is particularly true of the yang channels on the arm so rather than looking at the organ it might be more helpful to look at some of the characteristics of the small intestine channel first we should maybe point out that this is a yang channel and it's associated with fire in terms of the five phases so that means that this channel is going to be good for clearing heat so we start looking at the points we'll see that many points are indicated for things like fever especially fever from malaria heat at various places along the channel including red eyes mouth ulcers swelling of the cheek neck and throat and then shen problems due to heat like mania and that brings us to the next one the small intestine channel has an interior exterior relationship with the heart channel so we'll see certain points that are indicated for heart issues or shen problems like mania depression fear and fright tongue thrusting and mad walking or mad talking then like we said before the small intestine is paired with the urinary bladder through its tai yang relationship so we might occasionally see some points that treat urination problems like dark scanty urine but more often we'll see points that release the exterior and expel wind heat because again the taiyon channel is the most exterior channel and then just to drive this point home one last time even deadman will say very directly even though the function of the small intestine is to separate the clear from the turbine and even though the primary channel connects to the stomach organ no points on the small intestine channel are indicated for disorders of the digestive system and again part of the reason we go over these functions and characteristics is so that we can better understand and remember the functions of the points and how they can be used clinically in treatment another way we can understand the functions of these points is by looking at the channel pathways starting with the primary channel the small intestine primary channel begins at si1 remember our linkage from the previous channel the heart channel ends at heart 9 on the radial side of the little finger and the small intestine channel begins at si1 on the ulnar side of the little finger so this is a pretty short linkage the channel then ascends the ulnar side of the arm to the shoulder so we'll be able to use points on the small intestine channel to treat pain and contraction of the fingers wrist pain elbow pain and arm pain and then the big one the channel zigzags across the shoulder blade so we can treat things like shoulder pain scapula pain and inability to raise the arm the channel connects to do 14 remember all the young channels connect to do 14 and then the channel goes to the neck so we'll see points that treat things like stiff neck neck and shoulder pain or inability to turn the head as well as things like sore throat then the channel goes to the face it travels across the cheek connects to both the inner and outer canthus of the eye loops around the ear and enters the ear at si19 so because this channel goes to the face we'll see that many of our points treat disorders of the face like red eyes eye pain nasal congestion and nosebleed swelling of the cheeks and deafness and tinnitus we have an internal pathway that starts at stomach 12 and descends through the heart stomach and small intestine so remember that each channel connects to its own organ and its yin-yang pair so it makes sense that the channel connects to the heart organ and the small intestine organ besides that the channel also connects to the stomach organ but like we said we're not really going to see this reflected in the point functions even though the channel connects to the stomach none of the points here treat stomach problems or digestive disorders and because this internal pathway goes through the chest and connects to ren 17 that's maybe how we can explain that certain points on the small intestine channel have the function of benefiting the breast treating things like swelling of the breast breast abscess and poor lactation and this internal pathway also goes down and connects to stomach 39 which is the lower c point of the small intestine so if we want to treat disorders of the small intestine organ like small intestine chi pain which is lower abdominal pain that radiates into the testicles or small intestine deficient and cold which is dull pain in the lower abdomen that improves with warmth then for those conditions you would use stomach 39 the lower huh c point of the small intestine and finally we also have this branch that goes from si18 to ub1 and that's just our linkage to the next channel so when we look at the channel pathologies all of these should make sense deafness yellow sclera sore throat and swelling of the cheeks because the channel goes to the face and connects to the ears eyes throat and cheeks distension and pain in the lower abdomen because the channel descends to the small intestine organ but like we said several times now this one is more characteristic of small intestine organ patterns like small intestine chi pain or small intestine deficient and cold like machioche says our key symptoms for small intestine organ patterns are lower abdominal pain and borborygmus but for those we would probably go to stomach 39 not necessarily points on the small intestine channel and finally pain in the posterior border of the lateral aspect of the shoulder and arm which is just pain along the channel next we can look at the small intestine dual connecting channel remember what we said about the general characteristics of the lull connecting channels number one each lull connecting channel begins at the lower connecting point so here we see the small intestine rule begins at si7 number two each lull connecting channel connects to its interior exterior related channel so here we see the small intestine bull connects to the heart channel and number three after connecting to its paired channel the dual connecting channel proceeds along its own pathway so here we see the small intestine rule goes up the arm and connects to li 15. so this is just telling us that the small intestine channel is really good at treating shoulder issues not only does the primary channel zigzag across the scapula the lua connecting channel also connects to the shoulder and then each lura connecting channel comes with excess and deficiency symptoms so for deficiency of the small intestine rule we have warts and here deadman just says warts but machioche specifically says long finger-shaped warts so i'm assuming when he says finger-shaped warts this is as opposed to flat warts which look different and i'm not going to show you pictures but you can google it now personally i've never really used this clinically but i have seen it show up on tests so if you ever see something about finger-shaped warts think small intestine wool and for deficiency symptoms we also have scabies which is a rash caused by mites burrowing into the skin but here i've seen some sources say scabies but machioche actually says itching scabs and i feel like that's not really the same thing so to try to clear this up i went and got my copy of the neijing paul unsholt's translation of chapter 11 of the ling shu says in the case of depletion warts grow the small ones resemble scabies at the fingers so i feel like here we're still talking about warts it's just that the warts look like scabies so it's either scabies warts that look like scabies or itching scabs take your pick for excess symptoms we have loose joints and inability to move the elbow the small intestine divergent channel looks fairly similar to the heart divergent channel it separates at the shoulder enters the axilla and connects to the heart and small intestine organs and finally the small intestine sinew channel looks pretty similar to the primary channel it starts at the little finger and goes up the arm binding at the wrist elbow and posterior aspect of the axilla then it spreads over the scapula again telling us that we can use the si channel to treat shoulder and scapula issues it goes to the neck and binds the mastoid process there's a branch that enters the ear allowing us to treat things like tinnitus and ear pain then it binds the mandible outer canthus and the corner of the head so those are the channel pathways now that we understand where the channels go and what tissues they connect to let's go ahead and look at the functions and indications of the individual points so we start with si1 si1 is a jingwell point and it does all the jingwell point things so remember what we said about the jingwell points number one jingwell points revive consciousness so si1 revives consciousness for loss of consciousness due to wind stroke number 2 jingwell points clear excess and treat the upper end of the channel so here we see si1 clears heat and benefits the sensory orifices clearing heat from the eyes ears nose tongue mouth and throat remember the upper end of the channel goes to these areas and that's why we're able to clear heat from those areas and as part of clearing heat si1 also expels wind heat treating febrile disease malaria and cough remember we said that the si channel is part of the tai yang pair and tai yang is the most superficial channel and the first to get hit by an exterior attack so we can use points on the si channel to release the exterior but because the si channel is a fire channel we're usually talking about expelling wind heat not when cold and especially when we have symptoms in the areas reached by the small intestine channel things like headache and stiff neck and finally according to the nan jing jingwell points are indicated for fullness below the heart so here we see si1 treating heart pain chest pain and pain in the lateral costal region so those are the functions related to the fact that si1 is a jing well point but i think what really stands out here is si1 promotes lactation and benefits the breasts treating insufficient lactation swelling of the breast or breast abscess so some people will say that this is an example of an empirical point meaning that we just know from experience that si1 treats poor lactation and there's really no theoretical reason why it should do that but other people will try to explain it by saying that the si channel connects to ren17 and that's how it can have an effect on this area and we might even combine these two points together in a treatment so i think that this function is a little bit more unusual and definitely stands out here so i definitely remember si1 promotes lactation si2 is a ying spring and water point remember the main function of yin spring points is to clear heat so because si2 is a ying spring point and because the small intestine channel is a fire channel that means that this point is really good at clearing heat especially again heat in the upper end of the channel eyes ears nose throat this again includes clearing wind heat and it also includes toxic heat like mumps it also treats pain along the channel and heat in the palms so si2 clears heat si3 is the shoe stream point remember according to the nan jing shoe stream points are indicated for heaviness of the body and pain in the joints so we see si3 treats neck pain headache and pain in the shoulder elbow and arm but what's really interesting here is si3 also opens the doom i or the governing vessel so we can say that si3 is the master point of the dumai the confluent point of the dumai or the opening point of the dumai those all mean the same thing so the dumai or governing vessel is one of the eight extraordinary vessels and it goes up the spine and enters the brain so that's maybe how we can explain most of the actions of this point si3 benefits the occiput neck and back including the lumbar area because that's where the dew channel goes you can maybe think that calming the shen and treating epilepsy are related to the fact that the dew channel enters the brain leisure gen said the brain is the residence of original spirit or you can think that the small intestine has an interior exterior relationship with the heart and it's the heart that houses the spirit and that's why si3 has these functions of calming the shun like the other points so far si3 also clears heat especially heat in the upper end of the channel this includes wind heat and we should probably pay attention to si3 treating night sweats this will come up later when we look at the point combinations in cam where we see si3 and heart 6 are used together to treat night sweats si4 is the yuan source point remember on yin channels the wan source points conify the organ but on yang channels the yuan source points clear excess and treat disorders along the pathway of the channel so for si4 its main action is treating pain along the channel including the fingers wrist elbow shoulder and neck like the other points so far si4 also treats the upper end of the channel for things like swelling of the neck pain and swelling of the cheek and tinnitus and kind of a strange one si4 has been found empirically to treat jaundice as well as pain in the lateral costal region with inability to catch the breath again there's really no theoretical reason as to why this point should work for treating either jaundice or hypochondrial pain it's just that through experience we found that it works so we can say that si4 is the empirical point for jaundice and we can add that to the list of empirical points that we've learned so far si5 is the jing river and fire point like the other points we've learned so far it clears heat from the upper end of the channel especially the eyes ears and jaw si5 also has an action of calming the shen treating things like mania and mad walking due to heat so maybe you can think that si5 is a fire point so it clears heat and our other fire organ is the heart so it clears heart fire to calm shun si6 is the she cleft point of the small intestine channel remember she cleft points treat acute conditions and pain so here we see si6 treating a lot of pain pain in the arm pain in the shoulder pain in the scapula pain so bad it feels like the arm is dislocated or broken the other thing that sticks out here is si6 brightens the eyes treating blurred vision and eye paint remember that the small intestine channel connects to both the inner and outer canthus so that's how we can explain that it treats eye problems or you can remember that si6 is located at the cleft of the ulnar styloid process and that ulnar styloid process kind of looks like an eye so si6 is the she cleft point and it's good for the eyes si7 has three main actions like many of the other points we've seen so far si7 releases the exterior treating external contraction of wind heat again the small intestine is part of the taiyong channel which is the most exterior channel and the first to get hit by an exterior attack so si7 can treat febrile diseases especially when there's neck pain because that's where the pathway of the channel goes number two si7 is the lull connecting point remember lower connecting points treat disorders of the yin yang pair which in this case is the heart so si7 calms the shen treating mania depression fear and fright sadness and anxiety and number three si7 treats disorders along the channel especially the elbow and fingers so if you have pain of the fingers and you want to choose a point that's not on the fingers si7 could be a good place to go then remember our excess and deficiency symptoms for the small intestine lull for excess we had inability to move the elbow so again elbow problems and for deficiency we had long finger shaped warts so if you see anything about finger-shaped warts think si7 and the wall connecting channel si8 is the hc point of the small intestine channel and even though that sounds like it should be important si8 isn't actually used all that much it's good for swelling at various places along the channel and like si7 it calms the shen and then just remember that normally we say that hussy points treat disorders of their respective organ but we don't really see anything like that here for si8 so if we wanted to treat disorders of the small intestine organ we would have to go to points like stomach 39 the lower hussy point of the small intestine after that we're on the shoulder with si9 10 11 12 13 and 14. these points are all located on the shoulder and scapula so they're pretty much all indicated for pain of the shoulder and scapula and we can maybe point out that many of these points are located right on top of rotator cuff muscles like supraspinatus infraspinatus and teres minor so that might be one of the ways they benefit the shoulder and when we look in deadman he'll say that a lot of these points have the action of expelling wind but here we're mainly talking about wind that is lodged in the muscles and is causing shoulder pain or shoulder stiffness as in b syndrome or painful obstruction syndrome but one of these points we should pay special attention to is si11 not only does it treat shoulder issues it also has the action of opening or unbinding the chest and it benefits the breast basically this point is right across from the chest so it can treat fullness in the chest and lateral costal region and it's right across from the breast so it can treat things like swelling of the breast breast abscess or insufficient lactation so so far we have two points on the small intestine channel that benefit the breast and promote lactation si1 and si11 si15 can also be used to treat shoulder and scapula pain but it's maybe less important than the previous points maybe what stands out more is that it has an action of descending lung chi treating cough and coughing up blood so the way i remember this one is kind of weird si15 is too soon lateral to c7 well it turns out we have an extra point right next to it called ding chuan which means stop wheezing so ding chuan is good for cough and wheezing and right next to it is si15 which is also good for descending lung chi and stop and cough so if you haven't learned the extraordinary points that might sound kind of weird but that's how i remember it si 16 is on the neck and it's one of our window of heaven points remember what we said about window of heaven points number one they treat disorders of the neck and throat so here we see goiter and throat pain given that they're usually located on the neck window of heaven points also regulate the flow of qi between the head and the rest of the body this is maybe a fancy way of saying that they treat rebellious chi in this case we have heat in the face and headache because the qi flows upward and got stuck window of heaven points treat disorders of the sense organs and disorders of sudden onset so here we have deafness tinnitus ear pain and sudden loss of voice and window of heaven points often treat psycho-emotional disorders so here we see si 16 calms the shen treating mania depression and talking with ghosts and pay attention to the location here si 16 is level with the learn geo prominence on the posterior border of the scm so we have three points located on the neck level with the laryngeal prominence stomach 9 is on the anterior border of the scm li-18 is between the two heads of the scm and si16 is on the posterior border of the scm so all three are leveled laryngeal prominence and all three are window of heaven points si17 is also a window of heaven point so it does a lot of the same things it treats disorders of the neck and throat like goiter scrofula and swelling of the throat it treats rebellious chi in this case rebellious lung and stomach gee like cough wheezing asthma and vomiting and it treats disorders of the sense organs like deafness and tinnitus si18 is on the face so it's good for the face this could be problems due to wind like facial paralysis trigeminal neuralgia or eye twitching or it could be problems due to heat like redness and swelling of the face si19 is right next to the ear so it's good for the ear treating things like deafness tinnitus and discharge so just review the first several points on the hand are all good for clearing heat from the upper end of the channel so eyes ears nose and throat remember we kind of saw the same thing happen with the large intestine channel with the points on the hand and a lot of these points have an action of releasing the exterior and expelling wind heat because the taiyon channel is the most exterior channel especially for exterior attacks with head and neck symptoms but if we wanted to differentiate these si1 is the jingwell point so it revives consciousness it also promotes lactation and benefits the breasts si2 is the ying spring point so it's good for clearing heat si3 is the shoe stream point so it treats pain in the joints but it's also the master point of the do my so it's good for the back neck and occiput basically the whole spine and because the do channel enters the brain si3 calms the spirit and treats epilepsy si4 is the yuan source point it treats pain along the channel including into the fingers then it's also the empirical point for jaundice si5 really just for heat in the upper end of the channel but it also clears heat and calms the spirit si6 is located on the cleft of the ulnar siloid process so it's the she cleft point meaning it treats acute conditions and pain also the ulnar styloid process looks like an eye so it benefits the eyes si7 is the lower connecting point so it treats disorders of the yin yang pair which is the heart channel so things like mania depression fear and fright or sadness and anxiety also remember elbow pain finger pain and warts si8 mostly for pain along the arm and shoulder and maybe not used super often si 9 through 14 are all near the shoulder and scapula so they're good for the shoulder and scapula but remember si11 is the one that unbinds the chest and promotes lactation si15 is next to ding chuan so it subdues rebellious lung chi and stops cough si 16 and 17 are both window of heaven points so they do the window of heaven point things si18 is on the face so it's good for the face especially facial disorders due to wind si19 is next to the ear so it's good for the ear so that is the han tai yang small intestine channel