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Si Ma 駟馬 Three Horses (MTA)

Updated: Jul 20, 2023

Location of Si Ma

Si Ma Zhong 駟馬中 Middle Three Horses: 3 cun anterior to Feng Shi - GB31 in a standing position

Si Ma Shang 駟馬上 Upper Three Horses: 2 cun superior to Si Ma Zhong

Si Ma Xia 駟馬下 Lower Three Horses: 2 cun inferior to Shi Ma Zhong

Manipulation of Si Ma

Insert perpendicularly 0.5-2 cun.

Category of Si Ma

Lung and Liver

Indications of Si Ma

(1) Lung and chest: chest pain, upper back pain, rib-side pain, lung diseases e.g. pneumonia, cough, and asthma (2) Head: allergic rhinitis, sudden deafness, tinnitus, and otitis (3) Skin diseases: acne, pigmentation, scabies, and eczema (4) Liver: stroke sequelae, pains, facial paralysis, red eyes, and sciatica


These acupoints are located between the gallbladder and stomach channels. Thus they can be used to balance Yangming and Shaoyang. Yangming belongs to metal; therefore, it is categorized as the lung. On the other hand, the Shaoyang gallbladder pairs with Jueyin liver; therefore, it is categorized as the liver.

Si 駟 refers to Heavenly Horse in Chinese astrology's East Azure Dragon division. The horse belongs to the Qian trigram in Bagua or Eight Trigrams, which also relates to metal. The Qian trigram covers heaven and head in Yi Jing (易經 I Ching, Book of Change). In TCM, heaven refers to the external pathogens raised from abnormal climatic changes e.g. wind, cold, heat, damp, dryness, and summer heat. It is the lung that protects the body from those external pathogens. When external pathogens attack the body, symptoms on the head are commonly seen, e.g. headache, running nose, tinnitus, itching eyes, sore throat, etc.

In the five elements theory, metal controls wood. When there is excess in the liver e.g. liver Qi stagnation (pain), liver wind (stroke, paralysis), lung metal acupoints can be selected to balance the excessive liver wood. In general, lung-metal acupoints can be chosen to treat various pain syndromes due to stagnation. Another representative metal acupoint is Ling Gu (Z2.1) in MTA.

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