ST36

足三里 (Zú Sān Lǐ)

ST36  (足三里, Zú Sān Lǐ)

English Name:

Leg Three Miles
 

Meridian:

Stomach Meridian of Foot-Yangming (足阳明胃经)
 

Acupoint Code:

ST36

Functions

• Drains dampness from the Spleen.
• Stimulates the generation of Stomach qi.

Location

On the lateral side of the lower leg, 3 cun below Dú Bí (犊鼻, ST35), one finger-breadth lateral to the anterior crest of the tibia, along the line connecting Dú Bí (ST35) and Jiě Xī (解溪, ST41).

Anatomy

1. Superficial Layer: Contains the lateral cutaneous nerve of the calf.
2. Subcutaneous Layer: Includes branches of the superficial peroneal nerve and small veins.
3. Deep Fascia: Covers the tibialis anterior muscle, creating palpable tension upon penetration.
4. Tibialis Anterior Muscle: Beneath the deep fascia, hugging the tibia. This layer is key for effective stimulation.
5. Interosseous Membrane: Below the tibialis anterior muscle; home to the anterior tibial artery, vein, and deep peroneal nerve.
6. Tibialis Posterior Muscle: Behind the interosseous membrane, located between flexor digitorum longus and flexor hallucis longus.
7. Posterior Leg Neurovascular Bundle: Includes the posterior tibial artery, vein, and tibial nerve (contacted only when inserted beyond 2 cun).

Indications

1. Digestive Disorders: Stomach pain, vomiting, hiccups, abdominal distension, diarrhea, constipation, and dysentery.
2. Respiratory Conditions: Cough, asthma, and palpitations.
3. Mental and Neurological Issues: Insomnia, mania, and dizziness.
4. Chronic Illnesses: Fatigue, edema, and malnutrition.
5. Musculoskeletal Issues: Knee pain, paralysis, leg weakness, and beriberi.

Needling Technique

• Insertion Depth: 1–2 cun vertically.
• Insertion Layers:
  1. Skin: Contains the lateral cutaneous nerve.
  2. Subcutaneous Tissue: Superficial nerves and veins.
  3. Deep Fascia: Generates a "breakthrough" sensation.
  4. Tibialis Anterior Muscle: Effective layer for stimulation.
  5. Interosseous Membrane: Pierced at ~1.3 cun; creates a distinct sensation upon crossing.

Clinical Applications

Modern Acupuncture Uses:

• Gastrointestinal Disorders: Acute and chronic gastritis, duodenal ulcers, dysentery, and intestinal obstruction.
• Hepatic Issues: Hepatitis and toxic hepatitis.
• Cardiovascular Conditions: Hypertension, hyperlipidemia, coronary heart disease, and angina.
• Respiratory Disorders: Bronchitis and asthma.
• Genitourinary Issues: Nephritis, renal colic, and bladder inflammation.
• Mental Health: Insomnia and stress disorders.
• Musculoskeletal Complaints: Rheumatic fever, paralysis, and knee pain.

Point Combinations

• For weak legs/paralysis: Combine with Chōng Yáng (ST42), Pū Cān (BL67), Fēi Yáng (BL58), and Fù Liū (KI7).
• For excessive menstrual bleeding: Use with Tiān Shū (ST25), Sān Yīn Jiāo (SP6), Shèn Shū (BL23), and Xíng Jiān (LR2).
• For dizziness: Combine with Qū Chí (LI11), Fēng Lóng (ST40), and Sān Yīn Jiāo (SP6).
• For breast abscesses: Pair with Liáng Qiū (ST34), Qī Mén (LR14), Nèi Guān (PC6), and Jiān Jǐng (GB21).
• For stomach pain (post-gastrectomy): Combine with Shàng Jù Xū (ST37), Sān Yīn Jiāo (SP6), and points near the incision.
• For acute toxic hepatitis: Use with Yáng Líng Quán (GB34) and Xíng Jiān (LR2).

Effects

• Boosts Stomach qi and digestive function.
• Drains dampness to strengthen the Spleen.

Additional Notes

1. This point is classified as the "He-Sea" point of the Stomach Meridian.
2. Known for its tonic effects, Zú Sān Lǐ (ST36) is one of the most widely used points for health preservation.