Acupoint · SJ-5

Waiguan

外关 wài guān also known as Outer Pass, Outer Gate, Wai Kuan, 外关

3Actions
1Skin uses
Triple Burner Meridian (Hand Shaoyang)Expels Wind-HeatRemoves Obstructions from the ChannelBenefits the ears

What Waiguan does

Waiguan is a Triple Burner point on the forearm, two cun above the wrist. This page covers its position, its needling, its traditional actions, and the skin cases here that call on it.

Actions

  • Expels Wind-Heat
  • Removes Obstructions from the Channel
  • Benefits the ears

Location

Two cun proximal to Yangchi, between the radius and ulna, in the joint space on the dorsum of the wrist.

How to find it

Find the wrist landmark, then follow the distance described in the location and feel for the depression; the spot is usually tender when pressed.

Deqi

De qi is a soreness and distension at the point that often runs down to the fingertips or up the arm to the elbow; needled through to PC-6, it can reach both the back and the palm side of the forearm.

A cun is a proportional body measurement, not a fixed length: one cun is about the width of the thumb at the knuckle, 1.5 cun about two finger widths, and 3 cun about the width of four fingers. On an average adult one cun is roughly one inch, but it scales with the person, which is why the texts measure in cun rather than centimetres.


Technique

Needling

Angle: 90 degrees, perpendicular Depth: Standard depth half a to one and a half cun. Direction: Needle in the direction the location describes.

Moxibustion

Moxibustion suits cold or deficient patterns, and is given in short sessions.


Skin uses

  • Fever Mumps Ear pain Tinnitus Deafness Red eyes Eye pain Arm pain Headaches Dizziness Neck pain Stiff neck Elbow pain Wrist pain Ear itching Bloody nose Finger pain Hand tremor Sore throat Eye swelling Mouth ulcers Cracked lips Arm swelling Irritability Shoulder pain Arm paralysis Blurred vision Aversion to cold Tongue stiffness Elbow contraction Fingers stiffness Migraine headache Hypochondriac pain Swelling in the ears Bitter taste in the mouth Alternation of hot and cold feeling

Point classifications

ClassificationValue
Classical groupsLuo-Connecting Point

Safety

Who should treat this point

Acupuncture and moxibustion are practitioner procedures. The material here is educational, not a self-treatment guide.

Caution

Nothing marks this point out as hazardous. Use standard care for the region and set the depth by the patient's build.

Deficiency and constitution

Where the patient is depleted, work the point gently and briefly.

Before treatment

Educational material only. Skin that is spreading, painful or blistering, or that comes with a fever, needs medical assessment.


Modern evidence and safety

Traditional use

General references for acupuncture safety and skin evidence. They are not specific to this point, and they are not a claim that needling it treats any condition.

Evidence note

No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.

Common questions

What does Waiguan do in skin practice?

In this skin collection it appears where wind-heat sits on the surface and where the channel is blocked: fever with aversion to cold, a sore throat, red or painful eyes, a swollen face, mumps, ear pain with tinnitus or deafness, and pain through the arm, wrist, fingers or neck. It is always one part of a combination chosen for the pattern.

How is it needled?

Needled perpendicular at 90 degrees or obliquely at 45 degrees, to a standard depth of 0.5 to 1.5 cun. The response is a local distension and soreness that often runs down towards the fingertips or up the arm towards the elbow. Needled through to PC-6, the sensation can reach both the back and the palm side of the forearm.

Is it safe?

If the patient's hand or arm is moved after the needle is in place, the needle can bend, because the point lies between the radius and ulna. Needling straight into the extensor digitorum communis tendon is avoided, since it gives a sharp pain rather than a proper de qi response.