Traditional Chinese medicine (TCM) spans across two millennia, with its foundational text, the “Huang Di Nei Jing” (“The Yellow Emperor’s Inner Canon”), shaping how generations of physicians view the body and disease. However, not all acupoints enjoy equal treatment across time. Some gain fame, while others fade into footnotes.
One acupoint, the Lower Ridge (Xia Lian, LI8), located on the forearm, belongs to the latter group. While it once held a solid place in ancient protocols, its presence in current clinical practice is limited to supportive roles. However, limited attention doesn’t mean limited function.
Once Cited, Now Overlooked
Xia Lian first appeared in the “Yellow Emperor’s Inner Canon.” Its role is to clear the stomach and intestinal heat. In TCM, “heat” refers to a pathogenic state, not temperature. Heat can develop from eating too many “heaty” foods such as lamb, black pepper, chili peppers, mangoes, or durian fruit.
In line with the holistic nature of TCM, heat can also stem from emotions like anger or stress, both acute and chronic. To this day, Xia Lian often appears as a supportive point in protocols meant to address gastrointestinal symptoms caused by this type of pathogen.
In earlier times, though, Xia Lian was also used for conditions that can be loosely categorized as mental health issues. First, it was associated with treating “mania.” Unfortunately, this term and diagnosis don’t align with the modern framework of understanding mental health.
Xia Lian also played a role in treating sleep disorders like insomnia. As TCM evolved, however, treatment for such conditions shifted focus to points associated with the Heart meridian as it was seen as the home of the spirit (shen). Xia Lian, no longer central to these updated approaches, was left in conceptual limbo. Its decline came not because it failed to work, but because the conceptual framework around it changed.
Current Use
Today, Xia Lian finds its place as a supportive acupoint in treatment protocols. It supports the intestinal function and helps relieve abdominal pain and borborygmus—the gurgling sounds in the abdomen. From a local perspective, it helps manage pain and stiffness in the arms, aiding in the restoration of mobility.
Modern Findings
Modern acupuncture research rarely focuses on Xia Lian directly. However, one clinical study included it in a treatment protocol for cervical spondylotic radiculopathy, a degenerative condition in which the neck vertebrae compress or irritate the spinal nerves, leading to symptoms such as neck pain, stiffness, and nerve pain that can radiate down the arm.
Researchers compared three interventions: electroacupuncture with penetration needling, Jiaji electroacupuncture, and herbal granules. Xia Lian was used in the first group, paired with Shousanli (LI10) as part of a penetration needling pathway. This group showed the most significant improvement in pain scores across all tested measures. While Xia Lian wasn’t the primary treatment point, its inclusion underscores its potential value as part of a coordinated protocol.
How to Locate and Stimulate Xia Lian
To locate Xia Lian, start by bending your elbow and turning your forearm so the thumb side faces up. First, find the Yang Xi (LI5) acupoint on your wrist between two tendons that become visible when you flex your thumb. Next, identify the midpoint between the crease of your elbow and the prominent bone on the outer side of your elbow (Qu Chi, LI11 acupoint). Imagine a straight line connecting Yang Xi and Qu Chi. Xia Lian is found along this line, five finger-widths down from Qu Chi. Press gently around this area to identify a sore or tender spot. These sensations mark the exact point.
Ways to Stimulate Xia Lian
Firm pressure: Press firmly for three to five seconds, then relax for three seconds. Repeat for one to three minutes on each side.
Circular massage: Massage in small circles with your index finger or thumb for one to three minutes on each side.
Herbal patch: Apply an herbal patch overnight for longer activation.
Advanced methods: Acupuncture, moxibustion, a gentle heat therapy using dried mugwort, or gua sha or scraping, by a trained professional, can deepen the therapeutic effects.
Precautions
Avoid stimulating Xia Lian if the area is still recovering from an injury. When using herbal patches, check the ingredient lists to avoid synthetic additives, especially if you have sensitive skin.
Don’t Underestimate the Underused
Whether you connect more with Xia Lian’s earlier use for mental health purposes or today’s focus on digestion and arm mobility, it still holds value. Even if you’re unsure about its exact location, gently patting along the outer side of your forearm can engage the whole Large Intestine meridian. Save this trick for after a spicy barbecue or an indulgent meal. Your digestive system might appreciate the gesture.
TCM expert Shihhsiang Hung reviewed this article for accuracy and clarity.
