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[From *Ling Shu*] The Ren Mai (Conception Vessel) at the center of the clavicular fossa is named Tian Tu (Heavenly Protrusion). (This corresponds to the arterial pulse at the center of the clavicular fossa.) The first pulse on the lateral side of the Ren Mai belongs to the Foot-Yangming Stomach Channel, named Ying Sang (Human Well). (This corresponds to the arterial pulse on both sides of the throat.) The second pulse is in the Hand-Yangming Large Intestine Channel, named Futu (Supporting Prominence). (Located one cun posterior to the anterior border of the mandible, behind the arterial pulse of the throat.) The third pulse is in the Hand-Taiyang Small Intestine Channel, named Tian Chuang (Heavenly Window). (Posterior to the Hand-Yangming channel, directly below the angle of the mandible.) The fourth pulse is in the Foot-Shaoyang Gallbladder Channel, named Tian Rong (Heavenly Reception). (Posterior to the angle of the mandible, directly below the ear.) The fifth pulse is in the Hand-Shaoyang Sanjiao Channel, named Tian You (Heavenly Aperture). (Above the Wang Gu point behind the ear.) The sixth pulse is in the Foot-Taiyang Bladder Channel, named Tian Zhu (Heavenly Pillar). (In the middle of the large tendons of the nape.) The seventh pulse is in the Du Mai (Governing Vessel) at the center of the neck, named Feng Fu (Wind Palace). The Foot-Yangming Stomach Channel has an arterial pulse flanking the throat, located in the chest. The Hand-Yangming Large Intestine Channel is next, lateral to it, one cun from the angle of the mandible. The Foot-Taiyang Bladder Channel is at the angle of the mandible. The Foot-Shaoyang Gallbladder Channel is below the ear, posterior to the angle of the mandible. The Hand-Shaoyang Sanjiao Channel emerges behind the ear and ascends above the Wang Gu point. The Foot-Taiyang Bladder Channel flanks the nape, within the large tendons. (All based on the *Ben Shu* chapter of *Ling Shu*).

[From *Nei Jing*] There are two methods for acupuncture and moxibustion treatment of neck and nape pain.
The first involves selecting the Hand-Taiyang Small Intestine Channel and Foot-Taiyang Bladder Channel to treat pain at the back of the neck. The classic states: When the Foot-Taiyang Bladder Channel is disturbed, the symptom is a sensation as if the neck is being pulled out; treat according to deficiency, excess, cold, heat, or sunken points. It also states: For neck pain with inability to flex or extend, puncture the Foot-Taiyang Bladder Channel; for inability to turn the head, puncture the Hand-Taiyang Small Intestine Channel. It further states: For wind-induced neck and nape pain, puncture Feng Fu, which is located at the upper vertebra. Additionally: If pathogenic factors lodge in the collaterals of the Foot-Taiyang Bladder Channel, causing pain in the head, neck, and shoulder, puncture the area where the nail meets the flesh at the tip of the little toe, one point on each side, and relief will be immediate. If not relieved, puncture three cun below the lateral malleolus, treating the left side for right-sided symptoms and vice versa, within the time it takes to eat a meal.
The second involves selecting the Hand-Yangming Large Intestine Channel and Foot-Yangming Stomach Channel to treat pain at the front of the neck. The classic states: Diseases generated by the Foot-Yangming Stomach Channel include neck swelling. It also states: When the Hand-Yangming Large Intestine Channel is disturbed, the symptom is neck swelling; treat all such cases according to deficiency, excess, cold, heat, or sunken points.

[From Acupuncture Classics] Neck and nape pain: Select Hou Xi (SI3).
[Nape stiffness]: Select Cheng Jiang (CV24), Feng Fu (GV16).
[From *Zhen Jiu Jia Yi Jing*] Head and neck pain with heaviness, sudden stiffening and falling upon rising, nasal obstruction, epistaxis, and dyspnea: Treated by Tong Tian (BL31). Head wind pain, heavy head, eyes feeling as if protruding, inability to look left or right: Treated by Bai Hui (GV20). Neck pain with inability to turn the head, tearing, excessive saliva, rhinorrhea or epistaxis, redness and pain in the inner canthus, Qi rebellion, deafness and blindness, throat spasm pulling on neck tendons: Treated by Feng Chi (GB20). Neck swelling with inability to flex/extend, cheek swelling pulling to the ear: Treated by Wan Gu (GB12). Nape stiffness: Puncture Yin Men (TE18). Neck and nape pain with inability to flex/extend, headache, chills, convulsions, fullness in hypochondrium due to excess Qi, combined Qi along the spine, fever without sweat, lower back pain: Treated by Da Shu (BL11).
East wind arises in spring, disease affects the Liver, manifesting in the neck and nape. (Full text see Five Zang Organs.)

[From *Ben Cao Gang Mu*] To treat tendon tightness and inability to turn the neck, use Qu Gua Decoction.
Qu Gua (Papaya, two fruits, remove lid and pulp) Moyao (Myrrh, ground, 2 liang) Ruxiang (Frankincense, ground, 2 fen)
Place the latter two herbs inside the Qu Gua, replace the lid, secure with bamboo pins, and steam over rice three to four times until soft. Grind into a paste. Take 3-5 spoons per dose, dissolved in Di Huang Jiu (Rehmannia Wine), mixed with Ban Zhan (half cup) of Sheng Di Huang Zhi (Fresh Rehmannia Juice) and Er Zhan (two cups) of Wu Hui Jiu (Unadulterated Wine). Take one-eighth of a cup, warmed and dissolved, taken warm.
A patient suffered from this condition, starting in the afternoon and resolving at dusk. I said: This patient likely started with foot symptoms. The classic states that the twelve Foot channels have tendons, but only the Foot-Taiyang tendon extends from the foot to the nape. Generally, tendons are the exterior correspondence of the Liver. From midday to dusk is the Yang time of heaven, specifically Yin within Yang. Also, Yin within Yang corresponds to the Lung. From Li (Wu hour, noon) to Dui (You hour, 5-7 PM) is the time when Yin is prosperous and Yang is weak. Thus, *Ling Bao Bi Fa* states: From Li to Qian, Kidney Qi is exhausted and Liver Qi is weak; the Liver and Kidney organs receive Yin Qi, so the attack occurs at this time. I prescribed this formula, and after three doses, the patient recovered.

[Li Dongyuan] In men with nape stiffness and inability to look back, with slight pain upon movement, the pulse is wiry, rapid, and excess, more pronounced on the right hand. I treated this as Phlegm-Heat lodging in the Taiyang Channel. Used Er Chen Tang (Two-Cured Decoction) plus Jiu Xi Huang Qin (Alcohol-washed Scutellaria Root), Qiang Huo (Notopterygium Rhizome), and Hong Hua (Carthamus Flower). The patient recovered after two days.

[Li Gao] Yang Shen Tang (Spirit-Nourishing Decoction) treats shortness of spirit, insomnia, and swollen/tight neck tendons difficult to extend. Avoid sweet-warm herbs; prefer bitter-cold herbs.
Huang Qi (Astragalus Root, 1 qian) Ren Shen (Ginseng Radix, 3 fen) Gan Cao (Licorice Root, 7 fen) Cang Zhu (Atractylodis Rhizoma, 5 fen) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 fen) Chai Hu (Bupleuri Radix, 4 qian) Sheng Ma (Cimicifugae Rhizoma, 4 qian) Dang Gui Shen (Angelica Sinensis Root Heart, 5 fen) Mai Ya (Hordei Fructus Germinatus, 5 fen) Mu Xiang (Aucklandiae Radix, 1 fen) Chuan Xiong (Ligusticum Chuanxiong Rhizome, 3 fen) Ban Xia (Pinelliae Rhizoma, 7 fen) Ju Pi (Citri Reticulatae Pericarpium, 1 qian) Huang Lian (Coptidis Rhizoma, 5 fen) Huang Qin (Scutellariae Radix, alcohol-soaked 2 fen) Huang Bo (Phellodendri Cortex, 1 fen)
Coarsely powder. Take 5 qian per dose, decoct in two zhan of water, strain, and take slightly warm, at any time.

[From *Ben Cao Gang Mu*] To treat Kidney Qi attacking the nape and back with immobility, use Jiao Fu San (Pepper and Aconite Powder).
Da Fu Zi (Prepared Aconite Lateral Root, one piece, weighing 6 qian or more. Processed, skin and umbilicus removed, powdered)
Powder the Aconite. Take two large qian per dose, with 20 grains of Hao Chuan Jiao (Sichuan Pepper), filled with white flour. Decoct with one and a half zhan of water and seven slices of fresh ginger until reduced to seven parts. Remove the pepper, add salt, and take on an empty stomach.
A relative of mine suffered from neck tendon pain radiating to the back and thighs, unable to move. Various wind-dispelling herbs were ineffective. I recalled a syndrome in *Qian Jin Fang* of Kidney Qi attacking the back causing stiffness, so I prescribed this formula. One dose brought immediate recovery. Since then, it has been effective for others. Generally, Kidney Qi ascends from the waist along the spine to the Cao Xi point, then enters the Ni Wan Palace. The Cao Xi point cannot be penetrated unless one is skilled in Dao Yin exercises. Now, Qi rebels and stops here. Using Pepper guides the Qi back to its channel, bringing peace. Qi reaches the upper part, Pepper descends, hence recovery.

[From *Qian Jin Fang*] To treat wind-induced nape stiffness with inability to look back: Dig a pit, heat it until red, sprinkle water to cool it. Place fresh peach leaves under the mat for lying down. Position the neck over the herbs, cover the edges with clothing to trap the vapor. Allow the patient to sweat; after a long time, the condition resolves.
Another prescription for head and nape stiffness with inability to look back: Steam one sheng of soybeans until they change color, place them in a bag, and use as a pillow.
All spasmodic conditions with nape stiffness belong to Dampness. (Full text see Diagnosis Methods; treatment see Spastic Nape Stiffness section in Shang Han.)