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Diagram of the Hand-Shaoyang Sanjiao Meridian

The Hand-Shaoyang Sanjiao Meridian travels from the hand to the shoulder, and the shoulder connects back to this meridian. This meridian is rich in Qi and poor in Blood. It begins at Guanchong (TE1) and ends at Sizhukong (TE23), totaling twenty-three acupoints on each side, or forty-six acupoints bilaterally.

The Sanjiao (Triple Burner) is the pathway for water and grain, and the starting and ending point of Qi. The Upper Jiao is located below the heart, above the diaphragm, and at the upper opening of the stomach; its therapeutic area is at Danzhong (CV17), which is in the depression between the two nipples. The Middle Jiao is located at the middle of the stomach, specifically Zhongwan (CV12), four cun above the umbilicus, neither too high nor too low; its therapeutic area is beside the umbilicus. The Lower Jiao is located at the upper opening of the bladder; its therapeutic area is one cun below the umbilicus.

The Hand-Shaoyang Meridian corresponds to the Sanjiao: Guanchong (TE1), Yesmen (TE2), and Zhongzhu (TE3) are points of flow; Yangchi (TE4) is in the upper arm; Waiguan (TE5) penetrates and diverges to the Hand-Jueyin Pericardium Meridian; Zhigou (TE6) meets Huizong (TE7) in a hollow space; Sanyangluo (TE8) and Sidu (TE9) are anterior to the elbow. Chapter 10 of *Ling Shu* states: "The vessel of Hand-Shaoyang originates at the end of the fourth finger (ring finger), ascends out between the two fingers, follows the dorsal aspect of the wrist, emerges between the two bones of the forearm, ascends through the elbow." Master Hua notes that "two fingers" refers to the ring finger. Master Hua also states: "The end of the arm bone is called the wrist; beyond that is the elbow." The Hand-Shaoyang Meridian starts at Guanchong (TE1) at the tip of the fourth finger, ascends between the fingers, passes through Yesmen (TE2) and Zhongzhu (TE3), follows the dorsal aspect of the wrist to Yangchi (TE4), emerges between the two bones of the forearm, follows Waiguan (TE5), Zhigou (TE6), Huizong (TE7), Sanyangluo (TE8), and Sidu (TE9), then ascends through the elbow to reach Tianjing (TE10).

Guanchong (TE1): At the radial corner of the nail bed of the fourth finger, approximately the width of a leek leaf from the nail.
Yesmen (TE2): In the depression between the fourth and fifth fingers on the dorsal aspect of the hand.
Zhongzhu (TE3): In the depression distal to the metacarpophalangeal joint between the fourth and fifth fingers.
Yangchi (TE4): In the depression proximal to the dorsal wrist crease; moxibustion is contraindicated.
Waiguan (TE5): Two cun proximal to the dorsal wrist crease in the depression; it is the Luo-Connecting Vessel of Shaoyang, diverging to the Hand-Jueyin Pericardium Meridian.
Zhigou (TE6): Three cun proximal to the dorsal wrist crease in the depression between the two bones.
Huizong (TE7): One cun within the hollow space three cun proximal to the dorsal wrist crease.
Sanyangluo (TE8): On the arm, crossing the main pulse, one cun proximal to Zhigou (TE6).
Sidu (TE9): In the depression five cun proximal to the elbow on the lateral margin.
Tianjing (TE10): In the depression between two tendons, one cun posterior to the olecranon process on the lateral side of the elbow; take the point with the elbow flexed, or by pressing the hand against the knee, in the gap between the two bones and tendons.

Ascending: Qinglengyuan (SI10), Jianliao (TE14), Elbow, Axilla, Trapezius, Xiaoluo (SI11), ascending to the shoulder, meeting at Jianliao (TE14) and Tianliao (SI15); there is also Bingfeng (SI12) at the prominent bone, belonging to the intersection of the Hand and Foot Triple Yang meridians at the posterior Shoulderwell (GB21). Measuring horizontally three fingers, connecting the Yang Linking Vessel, the Hand and Foot Shaoyang meridians meet here, finally entering the Collarbone Depression (Quepen, ST12), dispersing in Chest Center (Dan Zhong, CV17), networking the Pericardium, traversing the body, and belonging to the Sanjiao. Shimén (CV5) is the Front-Mu point of the Sanjiao.

Chapter 10 of *Ling Shu* states: "Following Waiguan (TE5), it ascends to the shoulder, crosses behind the Foot-Shaoyang Gallbladder Meridian, enters the Collarbone Depression (ST12), spreads in Danzhong (CV17), networks the Pericardium, descends through the diaphragm, and successively belongs to the Sanjiao." Master Hua notes that there is no "and" character after "shoulder," changes "spread" to "cross," and "follow" to "traverse." Master Hua explains: "Between the shoulder and elbow, opposite the wrist on the arm, is Jianliao (TE14). Ascending from Tianjing (TE10), following the lateral aspect of the arm, passing Qinglengyuan (SI10) and Xiaoluo (SI11), running deep to the Hand-Taiyang Bladder Meridian and superficial to the Yangming Meridian, ascending to the shoulder, following Jianliao (TE14), meeting Jianliao (TE14) and Tianliao (SI15), crossing behind the Foot-Shaoyang Meridian, passing Bingfeng (SI12), descending into the Collarbone Depression (ST12) from Shoulderwell (GB21), then meeting at Danzhong (CV17) superficial to the Foot-Yangming Stomach Meridian, spreading and networking around the Pericardium, then descending through the diaphragm. At the upper opening of the stomach, it belongs to the Upper Jiao; at Zhongwan (CV12), it belongs to the Middle Jiao; at Yinjiao (CV7), it belongs to the Lower Jiao." Bingfeng (SI12) is seen in the Hand-Taiyang Bladder Meridian, a meeting point of the Hand and Foot Shaoyang, Hand-Taiyang, and Yangming meridians. Shoulderwell (GB21) is seen in the Foot-Shaoyang Gallbladder Meridian, a meeting point of the Hand and Foot Shaoyang and Yang Linking Vessels. Collarbone Depression (ST12) is an acupoint of the Foot-Yangming Stomach Meridian. Danzhong (CV17) is the area where the Ministerial Fire of the Pericardium governs. Zhongwan (CV12) and Yinjiao (CV7) are seen in the Conception Vessel (Ren Mai) and are the Front-Mu points of the Sanjiao, where the Qi of the Ren Mai issues.

Qinglengyuan (SI10): Two cun above the elbow; take the point with the arm extended and raised.
Xiaoluo (SI11): Below the shoulder on the lateral arm, descending from the axillary fold, located deep to the Hand-Taiyang Bladder Meridian and superficial to the Yangming Meridian.
Jianliao (TE14): On the anterior border of the shoulder, three cun from the shoulder head; it is the Luo-Connecting Vessel of the Hand-Yangming Large Intestine Meridian.
Naoshu (SI15): In the depression above the acromion on the shoulder end; take the point with the arm raised.
Tianliao (SI15): In the central depression at the junction of the supraclavicular fossa and the scapular spine; it is the Luo-Connecting Vessel of the Hand-Shaoyang Sanjiao Meridian and a meeting point of the Yang Linking Vessel.

A branch arises from Danzhong (CV17), moves to the Collarbone Depression (ST12), ascends the neck, arriving at Dazhui (GV14), which is the meeting point of the Hand and Foot Triple Yang and Du Vessels. It runs horizontally through Tianyou (TE16), passes Xuanli (GB37) and Hanyan (GB4), which are meeting points of the Hand and Foot Shaoyang meridians. It passes Yifeng (TE17), Maier (TE18), runs obliquely along the temporal region, Luxi (TE19), Qingjin, Shangjiaosun (TE20), Yangbai (GB14), Jingming (BL1), returning to Xinhui (GV22), which is the meeting point of the Hand and Foot Taiyang, Shaoyang, and Yangming meridians. It curves back along the side of the face, descending to the mandible, reaching Quanliao (SI18) in the depression of the cheekbone.

Chapter 10 of *Ling Shu* states: "A branch rises from Danzhong (CV17), emerges from the Collarbone Depression (ST12), ascends the neck, connects behind the ear, goes straight up to emerge above the upper angle of the ear, then curves down to the cheek to the chin." Master Hua interprets "connects" as "clutches." Master Hua explains: "Posterior to Naohu (GV17) is the neck region; inferior is the chin. A branch rises from Danzhong (CV17), emerges from the Collarbone Depression (ST12), ascends the neck over Dazhui (GV14), follows Tianyou (TE16) upward, clutches the ear, passes Yifeng (TE17), Maier (TE18), Luxi (TE19), goes straight up to emerge above the upper angle of the ear to Jiaosun (TE20), passes Xuanli (GB37), Hanyan (GB4), Yangbai (GB14), Jingming (BL1), curves down to the chin, meeting the area of Quanliao (SI18)." Dazhui (GV14) is seen in the Du Vessel, a meeting point of the Hand and Foot Triple Yang and Du Vessels. Xuanli (GB37) and Hanyan (GB4) are seen in the Foot-Shaoyang Gallbladder Meridian, a meeting point of the Hand and Foot Yangming and Shaoyang meridians. Yangbai (GB14) is seen in the Foot-Shaoyang Gallbladder Meridian, a meeting point of the Hand and Foot Yangming and Shaoyang meridians. Jingming (BL1) is seen in the Foot-Taiyang Bladder Meridian. Quanliao (SI18) is seen in the Hand-Taiyang Small Intestine Meridian, a meeting point of the Hand-Shaoyang and Taiyang meridians.

Tianyou (TE16): Outside the large tendon of the neck, above the Collarbone Depression (ST12), posterior to Tianchuang (SI16), anterior to Tianzhu (BL10), below the mastoid process, at the hairline above Tianchuang. *Zisheng Jing* calls it Tianrong (ST17).
Yifeng (TE17): In the depression at the posterior angle of the ear; pressing causes pain in the ear canal; it is a meeting point of the Hand and Foot Shaoyang meridians.
Maier (TE18): In the chicken-foot-shaped green collateral vessels posterior to the root of the ear.
Luxi (TE19): In the green vein posterior to the ear.
Jiaosun (TE20): In the middle of the auricle, superiorly open to the mouth with a hollow space; it is a meeting point of the Hand and Foot Shaoyang meridians.

Another branch arises from behind the ear, again passing through Yifeng (TE17) into the ear. Tinggong (SI19) is the pearl in the ear. The two Yang and Shaoyang three meridials gather at Ermen (TE21). Opposite the pupil is Heliao (SI19) and Tongziliao (GB1). All are five fen apart. Sizhukong (TE23) is located in the depression behind the eyebrow, intersecting with the Foot-Shaoyang Gallbladder Meridian.

Chapter 10 of *Ling Shu* states: "A branch enters the ear from behind the ear, exits the front of the ear, passes anterior to Guest Master (Zhusanli, LI10), crosses the cheek, and reaches the outer canthus." Master Hua notes that under "enters the ear," there is a "return" character, and the characters "exits the front of the ear, passes anterior to Guest Master, crosses the cheek" are absent. "Outer canthus" refers to the outer corner of the eye. Master Hua explains: "This branch enters the ear from Yifeng (TE17) behind the ear, passes Tinggong (SI19), experiences Ermen (TE21) and Heliao (SI19), returns to the outer canthus, meets Tongziliao (GB1), follows Sizhukong (TE23), and intersects with the Foot-Shaoyang Gallbladder Meridian." Tinggong (SI19) is seen in the Hand-Taiyang Small Intestine Meridian, a meeting point of the Hand and Foot Shaoyang and Hand-Taiyang meridians. Tongziliao (GB1) is seen in the Foot-Shaoyang Gallbladder Meridian, a meeting point of the Hand-Taiyang and Hand and Foot Shaoyang meridians.

Ermen (TE21): In the depression of the preauricular swelling corresponding to the ear notch.
Heliao (SI19): Under the temple hair anterior to the ear, at the transverse pulsating artery.
Sizhukong (TE23): Also known as Mukao, in the depression behind the eyebrow.

General Song:
Guanchong flows and circulates towards the wrist,
Passes the elbow, meets the shoulder, descends to the Collarbone Depression,
Networks the Pericardium, ascends the neck again,
Reaches the outer canthus, then returns to the source.

Commentary: The vessel of the Hand-Shaoyang Sanjiao originates at the dorsal end of the fourth finger and terminates at Sizhukong (TE23) in the depression behind the eyebrow. Its branch diverges from Heliao (SI19) to the outer canthus, measuring five chi in length, intersecting with the Foot-Shaoyang Gallbladder Meridian. Thus, the Foot-Shaoyang vessel begins at Tongziliao (GB1) in the outer canthus.

Acupoint Song:
Hand-Shaoyang is the Sanjiao,
Guanchong, Yesmen, Zhongzhu, Yangchi follow,
Waiguan leads to Huizong,
Sanyang, Sidu, Hao Tianjing,
Qinglengyuan, Xiaoluo, Jianliao,
Naoshu, Tianliao, each Tianyou,
Yifeng, Maier connect to Luxi,
Jiaosun, Ermen, Le Heliao,
Sizhukong completes the twenty-three acupoints without error.

Song of Alterations and Diseases:
This meridian has little blood but much Qi.
Alterations cause tinnitus, throat swelling, and bi-syndrome.
Diseases generated include spontaneous sweating,
Pain behind the ear and in the outer canthus,
Pain in Jianliao, elbow, and lateral arm,
And disability of the fourth and fifth fingers.

Chapter 10 of *Ling Shu* states: "Alterations cause deafness with a muffled sound, swelling of the pharynx and throat obstruction. Diseases governed by Qi include sweating, pain in the outer canthus, cheek pain, pain behind the ear, Jianliao, elbow, and lateral arm, and inability to use the fourth and fifth fingers. For these diseases, tonify deficiency, sedate excess, treat heat quickly, retain needle for cold, apply moxibustion for sinking/collapse, and treat according to the meridian if neither excess nor deficiency. In excess, the Renying (Carotid) pulse is larger than the Cunkou (Radial) pulse by one degree; in deficiency, the Renying pulse is smaller than the Cunkou pulse."

Phonetic Glossary:
Luo (泺), Yi (翳), Li (厘), Han (颔)