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  Vital Point Striking – Part 1

Tom Bisio

Posted on October 30, 2014

Vital points are not a myth. The secret knowledge of vital points has been known for 2,500 years. Bian Que, a legendary physician from China’s Spring and Autumn Period (around 500 BC), was a traveling physician who was perhaps the first known acupuncturist. When passing through the kingdom of Guo, he encountered a group of people mourning the death of the king’s son, who had been dead for half a day. After inquiring into the circumstances of the prince’s death, Bian Que suspected that he was not dead but in a coma-like state induced by shock. Upon examining the body, he detected minute signs of life. Needling a single point (some say the Bai Hui,  “Hundred Meetingsacu-point on the head), he revived the prince, literally bringing him back from the dead.

Not only physicians, but warriors and martial artists from many cultures knew that blows to specific areas or points on the human body could interrupt the processes of life by stopping the breath, interrupting cardiac function, or directly damaging the central and peripheral nervous system. Attacking the vital points of the human body is therefore an important aspect of Chinese martial arts. Vital point striking and seizing is variously known as dian xue (tien-hsueh) 点 穴, or dim mak in Cantonese. This term literally means “dotting holes” or “dotting caves/cavities” (ie: striking acupuncture points), hence its translation into English as “spotting” or “dotting.”  However, dian xue methods are also used to block veins and arteries (dian mai 点脉), and to twist and displace bones and muscles.

Vital point attacks are not unique to the Chinese martial arts. Kalaripayit, the martial art of Southern India, contains secret point striking techniques known as marma-adi,[1] and Okinawan karate employs vital point striking in its kata and self-defense techniques.[2] In the Japanese martial arts, kyusho-jitsu (“vital point art”) refers to systems or methods of attacking vital points. Vital point striking techniques in arts like Judo and Aikido are referred to as atemi-waza or atemi-jutsu. Traditionally the study of vital points also included methods of resuscitating those struck on these points, as well as herbal therapies to counteract the damage to the internal organs, nerves, blood vessels and meridians, which is often a by-product of these strikes.

The Hsi Yuan Lu, a 13th century Chinese text on forensic medicine, was written for government appointed officials who held inquests into homicides and accidental deaths.[3] These men were versed in the location of the 32 vital points that could cause death, even if struck with a relatively light blow. They employed many ingenious means of discovering the true cause of violent deaths. One official held an inquest into a death resulting from a fight in which a man was struck and stopped breathing. However, no mark was seen on the body. As it was cold at the time, the official had the corpse covered in cloth and put in a pit with burning wood. When the body was warm he sprinkled paper with wine and vinegar and placed the paper on the body so that the injuries would become visible.[4]

Vital point striking is built into the training methods of the Chinese internal martial arts. The kata of Okinawan Karate, and the forms in Xing Yi and Ba Gua, contain sequences of strikes to vital points which display an understanding of how the opponent’s body will react to each strike. Qin na, seizing and locking techniques, also rely heavily on knowledge of the body’s vulnerable areas. Many of the stances or “guard positions” employed in these arts are designed to habituate the practitioner to closing off vital areas. For example, in both the santi posture in Xing Yi and the millstone pushing posture in Ba Gua, the elbow sinks to protect the ribs and the zhangmen and qimen acu-points (Liv 13 and Liv 14). The chest is hollowed or softened slightly, to protect vital points related to the heart and lungs, and the legs are aligned so as to protect the groin and strengthen the knee and lower leg.

Knowledge of vital point striking was not limited to Asia. Ancient Olympic competitors in the vicious no-holds barred sport of Pankration also had knowledge of the body’s weak points. One famous tale involves two Greek fighters, Creugas and Damoxenus, who struggled till dusk with neither conceding defeat. They agreed to settle the contest by trading blows without defending. Cruegas went first, striking Damoxenus a powerful blow to the head. Damoxenus was able to weather the blow. He had Cruegas raise his arm and hit him in the armpit with a piercing fingertip strike, a fatal blow.[5]

The body’s vital areas include, but are not confined to meridians and acupuncture points. Methods of striking the vital points include:

  1. Attacks to points that also act as revival points in order to cause unconsciousness. For example, neiguan (P 6) and renzhong (DU 26).

  1. Attacks to areas where the force penetrates into the brain to cause unconsciousness: the mastoid process, base of the skull, yamen and fengfu (DU 15 and 16), etc.

  1. Attacking points that relate to the organs such as zhangmen and qimen (LIV 13 and LIV 14), tanzhong (REN 17), or riyue and jingmen (GB 24 and GB 25).

  1. Attacking points on meridians that weaken the meridian and the muscles and fascia it travels through. For example, yinlian (LIV 11) and shousanli (LI 10).

  1. Attacking the veins and arteries. For example, seizing the radial artery or closing off the carotid artery.

  1. Seizing or striking tendons and ligaments: kicking the hamstring tendons behind the knee, striking or shearing the tricep tendon to cause pain and weaken the arm, splitting the bicep muscle to damage and weaken it.

  1. Attacking a nerve plexus like the carotid sinus, brachial plexus, ulnar nerve (“funny bone”) or solar plexus.

  1. Twisting and displacing bones: clawing and pulling quepen (ST 12) to attack the nerve plexus and displace the collarbone.

  1. “Sealing the breath” by striking points that cause the muscles and fascia around the lung to contract suddenly.

  1.  Striking and breaking bones that are vulnerable such as the collarbone or the arch of the foot.

Knowledge of vital points can help to equalize differences in size and strength. To this end, many martial arts employ short, easily concealable weapons that amplify the effects of vital point striking and seizing. The kongo or yawara, a short stick with knobs on the ends, is found in many styles of Jiu-Jitsu. The kongo is thought to be derived from the Buddhist vajra, a scepter or weapon which symbolizes thunderbolts or lightning. Kalaripayit also uses a short stick to attack the marmas (vital points) and Okinawan martial arts sometimes employ the tekko, which originally may have been a kind of brass knuckles thought to be derived from stirrups or horseshoes. Held in the fist, this effectively weighted the hand for striking. Modern tekko’s can have a variety of designs, making them suitable for striking points.






2 types of tekko

In Xing Yi, the “iron finger” is employed as a concealed weapon for striking vital points. The equivalent Ba Gua weapon is the “judge’s or scholar’s pen,” also known as “bagua needles” or “Emei needles”. Both the iron finger and the scholar’s pen have a ring that goes around one finger to facilitate control and rotation of the weapon as well as weapon retention. The scholar’s pen is longer than the iron finger and often has sharpened ends, while the iron finger has a small spike opposite the ring that facilitates seizing. Another weapon, called the point-striking stick, is an adaptation of the yawara and Xing Yi Iron Finger. It has a knob on one end for chopping, while the other end is tapered for poking. A cord or leather ring goes around one finger so the grip can be shifted without losing the weapon. While these weapons can help a smaller person deliver more effective blows in a self-defense situation, they can also concentrate the force and striking power so as to make strikes lethal. The original Ba Gua “Deer Antler Knife” is actually the polished antler of a small deer. The tips of the antlers are used to attack vital points.


Xing Yi “iron finger”


Ba Gua “scholar’s pen”


Ba Gua point-striking stick


Deer Antler Knife

In the modern era, where martial techniques are studied for self-defense and self-development rather than for life and death combat, vital point striking methods are usually taught to advanced students who have demonstrated both control and accuracy in striking, as well as mature emotional development as martial arts practitioners. These techniques are dangerous to practice without knowledge of traditional Chinese medicine or the equivalent (eg: Ayurvedic medicine in the Indian martial arts). Heavy blows to vital areas, or lighter repeated blows to these areas over time, can do incalculable damage to one’s health.

Some examples of possible side effects of these kinds of blows witnessed in classes and in the clinic are:

  • Repeated blows to renying (ST 9), the carotid sinus, can cause spontaneous blackouts, blood clots and nerve damage.

  • Strikes to zhongji (REN 3), just above the pubic bone, can cause blood in the urine and stasis of qi and blood leading to body weakness.

  • Repeated strikes to the base of the skull: headaches, blackouts, damage to the brain or the vision.

  • Strikes to neiguan (P 6): heart problems and nausea, as well as nerve damage in the arm.

  • Strikes to qimen (LIV 14) can cause problems with the liver and diaphragm and blood stasis under the heart.

  • Strikes that seal the lungs, can cause nausea, vomiting and damage to the lung.

  • Kicks to the lower legs can damage the meridians that pass through the leg  and destabilize the knee.

In most cases, Chinese medicine is effective in reversing the effects of strikes to vital points. However, just using a die da jiu (hit-fall liniment) is often not enough. It is important for the teacher and the students to be familiar with the correct revival methods for different types of blows, chokes, and seizing techniques. In Japanese  jiu-jitsu and kempo systems, attacking the vital points is referred to as sappo, while revival methods are often collectively referred to as kappo or kuatsu.

Revival techniques can be effective in cases of fainting, unconsciousness, and drowning as well as martial art injuries from falls, blows, attacks to the vital points and chokes. These techniques involve manipulation as well as pressing and striking vital points to quickly disperse blockages of qi or stimulate the sensory-motor systems. For example, a controlled blow with the palm to  the DU 4 (mingmen) acupoint and using the knuckle to strike SP 4 (gongsun) are effective methods for revival from a blow to the groin, while striking just below the 7th Cervical vertebrae in an upward direction with the palm can resuscitate a person who has been choked unconscious, or has stopped breathing from a blow to the chest or solar plexus.

Revival techniques alone may not be enough to fully recover from a vital point attack. Herbal formulas containing envoy herbs that guide the formula’s action to specific areas are often necessary to heal these kinds of injuries. For example, for a strike to the point yintang (an extra point between the eyebrows), herbs like bai zhi, and man jing zi are added to direct the action of the formula  to the injured area. Similarly niu xi and du zhong are common components in formulas that treat injuries to the low back and tailbone.

Acupuncture and tui na (Chinese massage) are also useful in treating the after-effects of blows to vital areas. Treatment is usually more effective if performed soon after the injury, as long-term damage is not always reversible. Many martial arts experts have shortened their lives learning vital point striking techniques in pursuit of attaining martial prowess and many teachers have severely damaged students by striking vital points indiscriminately. Chinese martial systems such as Shaolin recognized this problem long ago, and created formulas that specifically treat spotting attacks to individual points.[6] Traditionally infant urine was one of the ingredients included in these kinds of formulas.

[1] The Fighting Arts, Howard Reid & Michael Croucher. New York: Simon and Schuster, 1983.

[2] The Bible of Karate: Bubishi, trans. and commentary by Patrick McCarthy. Tokyo: Charles Tuttle Co. 1995.

[3] Celestial Lancets: A History and Rationale of Acupuncure and Moxabustion, by Joseph Needham and Lu Gwei Djen, Cambridge University Press, 1980, p. 307-308.

[4] The Washing Away of Wrongs, Sung Tz’u, trans. By Brian E. McKnight. Ann Arbor: Center for Chinese Studies University of Michigan, 1981. pp. 81-82.

[5] Pankration: The Traditional Greek Combat Sport & Modern Martial Art, by Jim Arvanitis, Boulder, CO: Paladin Press, 2003, p. 8d

[6] Shaolin Secret Formulas, transmitted by Patriarch De Chan and trans. By Zhang Ting-liang and Bob Flaws. Boulder, CO: Blue Poppy Press, 1995.



Vital Point Striking – Part 2

Posted on November 28, 2014

Contents [show] [show]

This is Part 2 of a 2-part article on Vital Point Striking. Read Part 1 HERE.

Simultaneous with the development of the lethal techniques discussed in Part I of Vital Point Striking, were the creation of strategies which could undue the damage. These resuscitation, or “reanimation” techniques, use pressure, vibration and percussion or even heating of acu-points to re-activate or “jumpstart” the vital processes which have been short-circuited by deadly blows. Revival techniques that employ percussion or striking use much the same principle as the attacking method: the healing blow creates a a shock that re-activates what has been disrupted. The difference between the attacking and healing blow is one of intention, force and direction. It is no surprise then, that many of the same points that are used to attack and disrupt vital function can also be used to revive and restore normal functioning.

Because of their effectiveness, revival techniques are still used today. Jigoro Kano, the founder of Judo, included revival methods when he created judo from traditional ju-jitsu styles. Many Judo and Ju-jitsu schools still teach some of the old revival techniques known as kappo, or kuatsu, as an antidote to vital point strikes, chokes, fainting, and syncope. Acupuncturists and Chinese martial artists are familiar with some of the revival points which are a part of Chinese medicine, and Auyervedic healers and martial artists from India have their own methods of reversing the effects of attacks to the marmas. More recently, physicians and veterinarians have begun to study some of these revival points and testify to their efficacy.

Chinese physicians have long known that Ren Zhong, DU 26 (“Human Center”), a point between the nose and upper lip, is effective for reviving people, yet in the West this phenomenon has only recently been studied. When we hear the story of Bian Que and the Prince of Guo, it seems impossible that a single acu-point could bring someone out of a coma, but experiments with rats showed that acupuncture at DU 26 caused an immediate rise in the oxygen levels of tissue in the frontal cortex of the brain and sudden vaso-dilation with increased capillary perfusion.[1] One effect of stimulating DU 26 with a needle is the rapid release of epinephrine, which results in  revival.

Numerous studies on animals have confirmed the effectiveness of this point. In studies with dogs, in which a large amount of blood was rapidly removed (simulating traumatic injury), 75% of those animals who received stimulation at DU 26 survived. In the control group, where no acu-point stimulation was provided, all the animals died. Acupuncture at DU 26 also reversed cardiovascular depression induced by morphine. DU 26 resuscitated neonatal kittens delivered by cesarean section, a demonstrated success following unproductive cardiopulmonary resuscitation attempts.[2] DU 26 has also been employed as the primary emergency revival method for sea turtles trapped in fishing nets that have been subjected to prolonged submergence. The turtles appear to be dead, without signs of respiration or normal reflexes. Often they are not dead, but in a comatose state. Inserting a needle at DU 26 is effective at reviving them.[3]

DU 26 has other uses as well. Firm pressure with a pencil eraser or one’s thumbnail can relieve acute back pain, and increase mental alertness and energy. It can be used as an emergency point for a drowsy driver, or any situation when one is tired and immediate mental focus is required.

Another acu-point that has been the subject of numerous scientific studies is Inner Gate: P 6 (Nei Guan).  Inner Gate has been shown to significantly reduce nausea during pregnancy[4] and motion sickness.[5] P 6 also relieved post-operative nausea and vomiting from anesthesia[6], as well as nausea and vomiting resulting from chemotherapy, particularly when combined with Leg Three Mile, ST 36 (Zu San Li), the most powerful acu-point for stomach problems.[7] Additionally, in chemotherapy patients who had arterial catheters, P 6 alleviated chest pain very rapidly.

P 6 is also known to stabilize the cardiac rhythm and increase coronary blood flow. Studies in China showed that in patients with heart disease, regular acupuncture at P 6 reduced chest pain, relieved fatigue and edema, and helped them to reduce their dosage of medication, while improving cardiac function. Animal experiments have confirmed that stimulation of P 6 improves oxygen supply to the heart.[8]

Great Thoroughfare, LIV 3 (Tai Chong), has been shown to moderate sympathetic activity in the body. Research has shown that stimulating LIV 3 for 20 minutes can significantly reduce high blood pressure. It is also a useful point for headaches, calf cramps and is very effective in relieving pain and discomfort in cases of traumatic injury.

Revival methods do not always employ points in a direct manner. Sometimes percussive strikes are delivered to an area or over an organ, as in the so-called “pre-cordial thump” used by physicians and emergency medical personnel when defibrillation equipment  is unavailable. In the martial arts, an upward blow with the palm to the upper back is used to revive people who have been struck at the carotid sinus or choked unconscious. Other techniques of revival stimulate the tendons by plucking them. This activates the liver and powerfully opens blocked energy in the local area.

Revival Method for a Blow to the Carotid Sinus (ST 9 Acu-point)

When someone is hit in the carotid sinus and passes out, the main mechanism of the knockout involves baro-recepters that maintain blood pressure through autonomic control of heart and blood vessels. Stimulation of these receptors is what causes the immediate dizziness and loss of consciousness. It is important to stimulate the body to restore blood pressure quickly. The quickest method of revival is to slap the kidney area 2x with a cupped palm and then sit the person up and give them two or three cupped palm slaps between the shoulder blades in and upward direction. These slaps can be at the level of T7 or T-3/T-5. This quickly sends a wave of qi and blood to the head, restoring blood pressure and consciousness. The force must not penetrate inward toward the spine but rather upward, the cupped palm creating a focal point for this movement. It this fails, push Du 26 between the nose and upper lip in the philtrum very hard, even digging in with a fingernail.

After the person is conscious, use the back of the hand to gently and rhythmically knock at the spine at the level of the top of the scapula. While knocking, direct the force and intention toward the front of the throat. The person should feel a vibration in the front of their throat. It should be comfortable and pleasant. Make sure you round the  knocking hand slightly so that your knuckles do not hit the spinous processes. Performed correctly, this “knocking” will relax the tissues and vessels in the carotid sinus area. Make sure the person rests and drinks warm liquids. Keep them under observation.

This method of revival is for healthy people engaged in rigorous martial arts or sports activities, not for elderly, debilitated people. One problem with repeated strikes to the carotid sinus is that it is an area prone to atherosclerotic plaque which if dislodged, can cause blood clots and strokes. There is speculation that such strikes can also cause cardiac arrest.


Striking Upward Between the Shoulder Blades[9]

Herbal Formula for a Dian Xue Strike to Nei Guan (P 6)

Strikes to P 6 are often combined with a follow-up blow to ST 9 – the first strike weakens the heart and body thereby making the second strike more effective. A strong penetrating blow to P 6 can numb or damage  the medial nerve of the forearm and cause nausea and an irregular heartbeat. In Shaolin Secret Formulas for the Treatment of External Injury, Monk De Chan[10] gives the following herbal formula to treat a blow to this acu-point:

Base Formula – Shaolin General Emergency Formula for Dian Xue
  • 6 gm Chuan Xiong

  • 9         Dan Gui

  • 6         Yan Hu Suo

  • 3         Mu Xiang

  • 9         Qing Pi

  • 6         Wu Yao

  • 6         Tao Ren

  • 6         Yuan Zhi

  • 4.5      San Leng

  • 6         E Zhu

  • 6         Gu Sui Bu

  • 6         Chi Shao

  • 6         Su Mu

The following additions are added to the base formula for a blow to P 6:

  • 4.5      Qiang Huo

  • 4.5      Gui Zhi

  • 9         Niu Xi

This should be followed by taking Qi Li San with Yellow wine. Resinall K (Health Concerns) can be substituted for traditional Qi Li San, which contains toxic ingredients. Resinall K comes in an alcohol base, so the yellow wine can be omitted.

Case Study: Martial Artist Kicked at Ren 3/Ren4

I treated a 25 year old patient engaged in martial arts. He was student of mine who had been sparring outside the school with others and received a hard kick just above the pubic bone a day and half before I saw him. When he entered the clinic, this normally energetic and upbeat young man was pale, his voice was weak and there was a slight ashen color on his cheeks. His limbs also felt weak and his pulse was a little erratic. He told me had blood in his urine.

Aside from the blood in the urine this seemed to be a classic case of “qi shock.” In the martial arts, qi shock occurs when a sudden blow disrupts the normal circulation of qi creating stasis of qi. As a result qi and fluids begin to back up behind this stasis. As qi and fluids back up over time, from minutes to hours – there is a decrease in circulation to the limbs. This in turn creates a feeling of weakness and fatigue. The person becomes pale because there is less qi circulating to bring blood to the face. Often after receiving a hard blow to the body that shocks or stops the qi, the person initially feels okay. Then over the next few minutes they begin to feel weak and faint, their face becomes pale and then they sometimes pass out. If treated immediately – by restoring the free-flow of qi with simple tui na revival techniques – there are usually no residual symptoms. If left untreated for a day or more the person can get weaker and qi stasis can turn into blood stasis creating more serious problems. In the case of the patient in question it was clear that he was proceeding along this trajectory and in addition, blood vessels in the area of the injury had ruptured so that their was blood passing with his urine.

I laid him down and needled LIV 3 (Tai Chong) and LI 4 (He Gu), called the “Four Gates” when needled bilaterally. The four gates are said to move blood and qi through the 12 meridians. The young man immediately broke into a cold sweat and passed out – so called “needle shock.” In this case, it was a result of the stasis of qi in the interior being abruptly dispelled and the qi moving quickly to the exterior and to the four limbs, away from the blocked area. This can cause momentary unconsciousness until the even distribution of qi is restored. I used the technique above – striking between the shoulder blades – to revive him and then gave him something warm to drink. He immediately felt better and his color returned.

I gave then him the following formula to deal with the blood in the urine.  Three days of herbs sufficed to complete the treatment.

  • Xiao Ji

  • Bai Mao Gen

  • San Qi

  • Qu Mai

  • Dong Kui Zi

  • Xue Yu Tan 

[1] Celestial Lancets: A History and Rationale of Acupuncure and Moxabustion, by Joseph Needham and Lu Gwei Djen, Cambridge University Press, 1980, p. 83.

[2] Skarda RT. Anesthesia case of the month. JAVMA. 1999;214(1):37-39, from: The One Acupuncture Point Everyone Should Know:  GV 26 by Narda G. Robinson, DO, DVM, MS, FAAMA .

[3] www.seaturtle.org/ists/PDF/final/2703.pdf

[4] Effect of Acupressure on Nausea and Vomiting During Pregnancy: A Randomized, Placebo-controlled Pilot Study by  Werntoft E, Dykes AK and Slotnick RN. J Reprod Med 2001;46(9):835-839.

Safe, Successful Nausea Suppression in Early Pregnancy With P-6 Acustimulation. J Reprod Med 2001;Sep, 46(9):811-814. Comment in: J Reprod Med 2001;Dec, 46(12):1079.

[5] P6 Acupressure Reduces Symptoms of Vection Induced Motion Sickness by Hu S, Stritzel R, Chandler A,  and Stern RM.. Aviat Space Environ Med, July 1, 1995 ; 66(7): 631-4.

[6] Perioperative Acupuncture and Related Techniques, Chernyak, Grigory V. M.D. and  Sessler, Daniel I. M.D. Anesthesiology:Volume 102(5)May 2005, pp 1031-1049.

[7] Dibble SL, Chapman J, Mack KA, Shih AS. Acupressure for nausea: results of a pilot study. Oncol Nurs Forum 2000;Jan-Feb, 27(1):41-47.

[8] Neiguan (Pericardium -6) by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon.www.medaku.com/images/NEIGUAN_Pericardium-6_.pdf

[9] Drawing adapted from Complete Kano Jiu-Jitsu (Judo), by H. Irving Hancock and Katsukuma Higashi. Dover Publications: New edition (February 1950).

[10] Shaolin Secret Formulas for the Treatment of External Injury Transmitted by Patriarch De Chan Translated by Zhang Ting-Liang and Bob Flaws. Boulder CO: Blue Poppy Press, 1995, pp. 117-19.



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