Just my point: DU 14

04 April 2024 | Practice
Peter Firebrace
BAcC Fellow: Denmark
Da zhui 大 椎 Big Hammer is the name of the seventh cervical vertebra – lowest and largest of the seven in the neck – leaving the twelve rib-bearing thoracic vertebrae behind on the way up to the head and brain.

With its strong hammer shape and prominent outcrop at the top of the back, the seventh cervical vertebra is easily found, so in ancient times all the vertebrae below were numbered from it. For example, DU 11 is described as ‘below the fifth vertebra’ down from it and DU 4 is ‘below the fourteenth vertebra’. It is then a definitive marker for the whole spine.

As with all important transition places on the body, there is an acupuncture point just below it, DU 14. Named Big Hammer after its vertebra, DU 14 is a striking and powerful point to repair, restructure and restore normality in extreme pathological situations that can be of immense danger even to life itself. DU 14, then, is a lifesaver.

In the Neijingtu 內 經 圖 Inner Landscape Map, the spinal cord is represented as a river that normally flows downward from the brain to the sea below. In the neidan 內 丹 inner alchemy tradition this depleting downward flow is reversed and made to ascend, so that the brain becomes nourished, restored and regenerated by the richness of the rising river.

Although this concept may appear strange to us, remember we are dealing with the proper functioning of brain and spinal cord, the nerve centres par excellence that govern the entire body – or to put it in Chinese medicine terms, the proper functioning of the du mai Governor vessel, the body’s unique Sea of Yang that rises from the coccyx below to the top of the head above.

We have seen the crucial importance of DU 4 below – ming men 命 門 Gate of Destiny, located between the yinyang foundation organs of the kidneys, at the turning point of the lumbar spine, L 2. This heat-restoring, jing-consolidating, youth-renewing point has been a blessing to many with crippling back pain and exhaustion. DU 14 above at the top of the back and the base of the neck that leads up to the head and brain is a point of similar stature and power. While the DU 4 ming men area is sensitive particularly to cold, DU 14 Big Hammer is a point that can be overcome and overwhelmed by heat. It is then a specific point for the tidal fever of malaria.

Peter Firebrace Article Pic

Here we see the river that flows down from the mountains of the head to the sea below – or which rises to the head in regenerative practice. The rocks are the vertebrae and the fire of ming men is clearly seen below. The large rock above is the Big Hammer. Detail from the Neijingtu, Inner Landscape Map

Let me share a case with you with unusual symptoms that I can remember very clearly, even though it was many years ago. An intense, sensitive man in his mid-twenties who had been living in Africa as a volunteer helper, had spent several months there and taken the anti-malarial drug Malarone throughout that time. He had unfortunately had malaria despite the treatment and was now affected by exhaustion, headaches, dizziness, intermittent fevers and strange and vivid dreams.

I had no previous experience of treating malaria, but presumed his symptoms were a kind of pathogenic factor remaining and that being sensitive he might well also be suffering from side effects from taking the malaria drug for an extended period of time. Checking the side effects confirmed this possibility: headaches four to seventeen per cent, dizziness two to five per cent, and strange or vivid dreams seven per cent.

Knowing DU 14’s reputation to disperse the heat and to help specifically in the tai yang shao yang chills and fever of malaria, I used this point each treatment. The young man had strong reactions in the acupuncture sessions, often feeling waves of heat with sweating and felt like he almost went into a trance, closing his eyes and entering another reality with occasional muscle twitching.

One treatment he felt he entered a strong dream state with very vivid images. He was on a high plateau in a desert landscape, just sand and large stones in front of him. Behind him he was aware of a powerful river that he could hear thundering far below. Suddenly from behind each of the large stones a man came out in a threatening pose and this group of men moved towards him menacingly. When they came closer, they in some way transformed into a very large snake that moved fast towards him and leapt to attack. Somehow he ducked and escaped its jaws and heard the giant snake whistle over his head and dive headlong into the river far, far below.

Drenched in sweat the young man woke with a start and after recounting the dream became very calm like he had lived through an extremely dangerous experience. That was the turning point in his treatment. He came twice more but after this unique dreamlike vision he became stronger with normal energy, no more headaches, fevers or dreams. Sun Simiao writes that DU 14 is for intense fevers, dizziness, nausea and injury by cold. In this case DU 14 da zhui 大 椎 Big Hammer was a major contributor to the patient’s dramatic and successful return to normal health.

With the alternative name of bai lao 百 勞 A Hundred Exhaustions, DU 14 is an excellent point to remember in all kinds of chronic fatigue, especially with a background of heat illness. In such cases of extreme depletion it combines well with BL 43 gao huang shu 高 肓 兪, particularly if there are respiratory or cardiac problems. In the Jiayijing – along with DU 15 ya men 啞 門 Gate of Dumbness and ST 9 ren ying 人 迎 Man Welcome – DU 14 is given as a point of the Sea of Qi, tan zhong 膻 中 Central Temple REN 17. This emphasises its function of regulating the qi of the chest and its use in all kinds of respiratory disorders.

DU 14 is also called hui shang 會 上 Meeting Above, indicating its important role as the crossing point of all the six yang meridians and the Governor vessel, which gives it such a strong effect to regulate and purify the yang before the du mai rises to the head and the brain itself.

This point then can both drain heat in fevers, but also warm the yang and disperse cold in deficiency. It also covers such serious symptoms as convulsions, epilepsy and madness, so including altered states of consciousness, like the vivid dreams mentioned above. For this DU 14 is often accompanied by either or both gui 鬼 demon or ghost points, DU 16 feng fu 風 府 Wind Storehouse above or P 5 jian shi 間 使 Intermediary Messenger below.

DU 14 is also an important point to remember in joint pain – of all the joints. I use it frequently for upper back, shoulder and neck problems, such as frozen shoulder, whiplash or tension preventing the proper movement of the neck and head. Zhang Zhong Jing emphasises its use in spinal rigidity, including trismus, arched back rigidity and contractures with the use of moxa on DU 12, DU 14 and DU 13.

Finally, this versatile point is useful in disorders of sweating. Both night sweating in yin deficiency – often with HT 6 yin xi 陰 郗 Yin Cleft – and also for spontaneous sweating when the defensive qi is weak and unable to close the pores – often with KID 7 fu liu 復 溜 Returning Current.

What a point, full of restorative and regenerative power at the crossroads of the trunk and head, a perfect prime position distributer of pure yang qi!