Zusanli Point (ST-36 / Leg Three Li, also known as Xialing and Guixie)
Dredges the meridians and unblocks the collaterals, ascends the clear and descends the turbid, regulates the spleen and harmonizes the stomach, tonifies qi and blood, strengthens the body and cultivates the root. Based on its properties, this point has a wide range of indications and is clinically used for gastrointestinal system disorders, various chronic disease management, and is a key point for health preservation.
Indications
Stomach pain, vomiting, abdominal distension, borborygmus, indigestion, acute and chronic gastritis, gastric ulcer, and neuralgia. (1) Digestive disorders: Stomach pain, abdominal distension, belching, hiccups, vomiting, food stagnation, diarrhea, constipation, dysentery, acute and chronic pancreatitis, appendicitis, acute and chronic gastroenteritis, hepatitis, biliary disorders. (2) Various chronic diseases and deficiency syndromes: Consumptive disease with emaciation, palpitations and shortness of breath, dizziness, cough and wheezing, visceral prolapse, recovery period after severe illness. (3) Skin disorders: Acne, melasma, rubella, neurodermatitis, urticaria. (4) Head, face and orificial disorders: Facial paralysis, facial spasm, trigeminal neuralgia, tinnitus, deafness, eye diseases, nasal diseases. (5) Lower limb flaccidity/bi-syndrome: Post-stroke hemiplegia sequelae, numbness of hands and feet, knee joint disorders, sciatica, difficulty lifting the limbs. (6) Key point for health preservation: Enhances immunity, strengthens the body, and delays aging. (7) Others: Insomnia, manic disorders, hypertension, hypotension, irregular menstruation, infertility, lumbar pain, edema, beriberi, mastitis, fibrocystic breast disease, heart disease, respiratory disorders, leukopenia, arteriosclerosis, etc.
Precise Location
Located on the Stomach Meridian, on the anterolateral side of the lower leg, 3 cun below Dubi (ST-35), one middle finger-width lateral to the anterior crest of the tibia.
Location Method
Sit upright with the knee flexed at 90°. Place the palm on the patella (left hand on left leg, right hand on right leg) with the fingers pointing downward – the point is below the tip of the ring finger, parallel to the middle finger.
Massage Method
Press vertically into the point with the middle finger pad – a sore, distending, and numb sensation will occur. Knead once each morning and evening for 1–3 minutes per session. Therapeutic actions: Dredges the meridians and unblocks the collaterals, ascends the clear and descends the turbid, regulates the spleen and harmonizes the stomach, tonifies qi and blood, strengthens the body and cultivates the root.
Compatibility
Stomach pain: Combine with Zusanli (ST-36) and Huaroumen (ST-24). Disease overview: Stomach pain is a common clinical symptom seen in acute and chronic gastritis, gastric and duodenal ulcers, gastric neurosis, as well as gastric mucosal prolapse, gastroptosis, pancreatitis, cholecystitis, and cholelithiasis. Massage sequence: Sit on a chair. Place the right palm on the center of the kneecap and lightly grasp the knee – extend the middle finger along the tibia; the intersection of the horizontal line at the middle fingertip and the extension of the index finger direction is Zusanli – press for 1 minute, then massage Huaroumen for 3 minutes. Note: Hiccups, flatulence, bowel movement, or mild diarrhea during massage are normal reactions. Vomiting: Combine with Zhongwan (RN-12), Quepen (ST-12), Tiantu (RN-22), Neiguan (PC-6), Yangbai (GB-14), and Taichong (LR-3). Goiter: Combine with Hegu (LI-4), Qishe (ST-11), Lieque (LU-7), Fengchi (GB-20), and Tianchong (GB-9). Various stomach disorders: Combine with Zhongwan (RN-12) and Neiguan (PC-6). Various flaccidity/bi-syndrome: Combine with Yanglingquan (GB-34). Qi-blood deficiency and skin disorders: Combine with Xuehai (SP-10). Stomach pain with chest impediment: Combine with Juque (RN-14). Perianal disorders: Combine with Chengshan (BL-57). Supplement qi, control blood, health preservation: Combine with Qihai (RN-6). Edema and urinary retention: Combine with Yinlingquan (SP-9). Post-illness deficiency: Combine with Gaohuang (BL-43). Facial disorders: Combine with Hegu (LI-4). Supplement qi and blood, unblock meridians, prevent stroke: Combine with Xuanzhong (GB-39) with moxibustion. Regulate intestines, strengthen spleen, stop diarrhea: Combine with Shangjuxu (ST-37), Tianshu (ST-25), and Pishu (BL-20). Prevent colds: Combine with Fengmen (BL-12) and Dazhui (GV-14) with moxibustion. Visceral prolapse due to spleen deficiency: Combine with Baihui (GV-20), Qihai (RN-6), Zhongwan (RN-12), and Pishu (BL-20). Anemia and debility: Combine with Dazhui (GV-14), Qihai (RN-6), Ganshu (BL-18), Pishu (BL-20), and Sanyinjiao (SP-6). Vertigo due to phlegm-damp obstruction: Combine with Fenglong (ST-40), Sanyinjiao (SP-6), Yinlingquan (SP-9), Neiguan (PC-6), and Zhongwan (RN-12). Palpitations due to heart-spleen deficiency: Combine with Pishu (BL-20), Sanyinjiao (SP-6), Shenmen (HT-7), and Xinshu (BL-15). Acute mastitis: Combine with Liangqiu (ST-34), Jianjing (GB-21), Taichong (LR-3), Hegu (LI-4), and Tanzhong (RN-17).
Efficacy & Actions
Zusanli belongs to the Foot Yangming Stomach Meridian and is the He-Sea point of the meridian, the Lower He-Sea point of the Stomach organ, one of the "Four General Points," one of the "Ma Danyang Twelve Heavenly Star Points," one of the "Nine Points for Returning Yang," the primary point for abdominal disorders, and an important point for strengthening and health preservation. It regulates the spleen and stomach, tonifies the middle and supplements qi, unblocks the meridians and collaterals, dispels dampness and wind, strengthens the body and dispels pathogens. The reinforcing or even reinforcing-reducing technique is commonly used. Moxibustion is applicable and is one of the commonly moxibusted points. First documented in Lingshu · Wuxie. "Zu" means lower limb; "Sanli" means three cun below Dubi (ST-35). The Suwen · Zhenjie states: "Sanli means three cun, the same meaning as Shousanli – Zusanli is three cun below the knee." It is also known as "Xialing" and "Guixie." The Lingshu states: "When pathogens invade the spleen and stomach, there is muscle pain. If yang qi is excessive and yin qi deficient, there is heat in the middle with polyphagia; if yang qi deficient and yin qi excessive, there is cold in the middle with borborygmus and abdominal pain. If both yin and yang are excessive or both deficient, there is both cold and heat. All are regulated by Zusanli." When sudden stomach cramping, abdominal distension, acid regurgitation, vomiting, diarrhea, or constipation occurs, regular massage of Zusanli can achieve therapeutic and health-preserving effects. (1) Key Point for Treating Digestive System Disorders: As the He-Sea point of the Stomach Meridian and the Lower He-Sea point of the Stomach organ, according to the principle "He treats internal organs," it is commonly used for stomach disorders. It strengthens the spleen and benefits the stomach, harmonizes the middle and supplements qi, warms the middle and disperses cold, moves qi and reduces distension, descends rebellion and stops vomiting, promotes digestion and resolves stagnation, regulates the intestines and stops diarrhea. Clinically used for stomach pain, vomiting, dysphagia, abdominal distension, abdominal pain, borborygmus, poor appetite, food stagnation, constipation, diarrhea, dysentery, hepatitis, cholecystitis, and various digestive disorders. The Four General Point Song states: "For abdominal disorders, retain Zusanli." The Lingshu · Jiuzhen Shier Yuan states: "When yin organs have yang disorders, use Xialing (Zusanli)" – meaning Zusanli can be used for all six fu-organ disorders. (2) Important Point for Lower Limb Flaccidity/Bi-Syndrome: The principle "treat flaccidity by treating Yangming alone" has long been applied. Zusanli as the He-Sea point of the Stomach Meridian regulates Yangming qi and blood. The Huangdi Neijing states: "Yangming is the sea of the five zang and six fu, governing the moistening of the tendons; the tendons bind the bones and facilitate the joints... when Yangming is deficient, the tendons relax and the Belt Vessel fails to guide, resulting in flaccidity and inability to use the legs." Thus Zusanli is an important point for treating flaccidity syndrome. (3) Key Point for Health Preservation: This point regulates the body's overall functions and enhances immunity. The Great Compendium states: "If you want to be at ease, keep Zusanli frequently moist." Hua Tuo said: "Zusanli treats five types of fatigue with emaciation and deficiency due to the seven emotions." A common saying goes: "Regular moxibustion at Zusanli is better than eating old hen soup." In Japanese folk tradition: "Do not travel with anyone who does not moxibust Zusanli; moxibust Zusanli when traveling, and walk briskly as if flying." Regular moxibustion at Zusanli strengthens the body and prevents disease. (4) Application for Various Other Disorders: The Zhenjiu Zisheng Jing states it "treats all diseases," and clinical practice calls it a "point for all diseases." Zusanli is also used for head and facial disorders (especially eye and nasal diseases), prevention and treatment of colds (especially recurrent colds and gastrointestinal-type colds), breast disorders, mental conditions, vertigo, manic disorders, edema, respiratory disorders, heart disease, skin diseases, and urogenital disorders.
Contraindications
This point has wide therapeutic applications. Based on the condition, it may be needled or moxibusted, and needled deeply or shallowly – deep needling for heart disease and facial disorders; shallow needling for limb and digestive disorders; moderate depth for respiratory disorders; health preservation and deficiency conditions primarily use moxibustion.
