SJ-09 (Si Du) Four Rivers

What does SJ-09 Si Du do?

SJ-09 benefits the throat and ears — a focused San Jiao forearm point, its recorded action reaching the head the channel serves.

• Benefits the throat — behind its use for sudden voice loss
• Benefits the ears — the San Jiao channel’s classical connection to hearing, behind its use for deafness

A distal point working the head from the upper forearm. Si Du sits high on the back of the forearm, yet its action is throat and ears — the San Jiao channel ascending the arm, over the shoulder and up the neck to the ear and side of the head. Treating the ear and throat from a point below the elbow is the channel logic the whole system runs on. It has no five-shu element and no special classification; it is used for what its action names.

On the name. “Si Du” means Four Rivers — the si du being the four great rivers of classical China (the Yangtze, Yellow, Huai and Ji), which received state sacrifices. Several San Jiao points carry water names (the channel governs the body’s waterways), and the “four rivers” image places this point among them — our neighbouring SJ-10 Tian Jing is the “Celestial Well”, another water name a little higher up.

Source: Sacred Lotus sources & references (channel, action and translation records; the SJ-10 record queried against our own data), cross-referenced against multiple online sources.

What is SJ-09 Si Du used for?

SJ-09 is used for deafness, toothache, migraine, sudden hoarseness or loss of voice, and pain in the forearm. Our own indication record is reproduced here in full.

• Deafness
• Toothache
• Migraine (one-sided headache)
• Sudden hoarseness of the voice
• Pain in the forearm

Head-and-face above, forearm below. Deafness, toothache, migraine and voice loss are the throat-and-ear action reaching the head; the one-sided (migraine) headache is the shao yang signature, the San Jiao and Gall Bladder channels running over the temple and side of the head; forearm pain is local, the point sitting there.

An honest note. Deafness of sudden onset is a medical emergency — sudden sensorineural hearing loss needs same-week specialist care. Sudden or persistent hoarseness (more than three weeks) requires assessment. A new, severe, or changed headache pattern requires assessment — “migraine” should be a diagnosis a clinician has made, not an assumption, since some sudden severe headaches are emergencies. Toothache with facial swelling and fever is a medical emergency. This record documents classical use only.

How it is combined. With SJ-17 Yi Feng and GB-02 Ting Hui for the ear, with SJ-5 Wai Guan and GB-20 Feng Chi for the one-sided headache, and with SJ-10 Tian Jing just above for the arm. All held here.

Source: Sacred Lotus sources & references (indication and action records; the GB-02, GB-20, SJ-05, SJ-10 and SJ-17 records queried from our own data), cross-referenced against multiple online sources.

Where is SJ-09 Si Du located?

SJ-09 is on the back of the forearm, five cun below the point of the elbow, in the gap between the two forearm bones.

• 5 cun below the olecranon — the bony point of the elbow at the back
• On the lateral (outer) aspect of the back of the forearm
• Between the radius and the ulna, in the interosseous space — the same midline gap the lower San Jiao forearm points use

Measured from the elbow, not the wrist. Where SJ-05, SJ-06 and SJ-08 are placed by distance up from the wrist crease, SJ-09 is placed by distance down from the elbow — 5 cun below the olecranon. It sits in the upper third of the forearm, above SJ-08 (which is 4 cun above the wrist), all of them threading the same interbone space. SJ-10 Tian Jing lies higher still, just above the elbow.

On the name. “Si Du” — Four Rivers, one of the channel’s water names, as noted above.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; the SJ-08 and SJ-10 records queried from our own data).

• A Manual of Acupuncture (p. 401): In the depression between the radius and the ulna, on a line drawn between Yangchi SJ-4 and the lateral epicondyle of the humerus, 7 cun proximal to Yangchi SJ-4.
• Chinese Acupuncture and Moxibustion (p. 205): On the lateral side of the forearm, 5 cun below the olecranon, between the radius and ulna.

How is SJ-09 Si Du needled?

Our own record states perpendicular insertion of 0.5–1.0 inch, with moxibustion applicable. What follows is a neutral record of what the reference literature documents. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: perpendicular, 0.5–1.0 inch, into the interosseous space between the forearm bones.
• Moxibustion: recorded as applicable.
• Regional anatomy: the point lies between the radius and ulna over the interosseous membrane, among the deep forearm extensors; the posterior interosseous nerve and vessels run in the region; the two bones flank the needle path.

Hazard, stated proportionately. This is a low-hazard point: no body cavity, no pleura, no organ, bones flanking the needle. Our record carries no arterial caution at SJ-09, and it is not among the nine points that do. The posterior interosseous nerve nearby can make the sensation carry.

What is not claimed. No study measuring a safe depth at SJ-09 could be located, and none is borrowed. No case report naming SJ-09 was located.

Source: Sacred Lotus sources & references (needling record, retained unchanged; the nine arterial cautions queried from our own data), cross-referenced against multiple online sources; regional anatomy from standard anatomical description.

Is there research on SJ-09, and what should a reader know?

No trial isolates SJ-09. Where the point appears it is one component of an ear, headache or arm protocol, and a study that includes a point in a protocol is not evidence about that point.

What this page can state with confidence. SJ-09 Si Du (“Four Rivers”) is a San Jiao forearm point that benefits the throat and ears, treating the head from the upper forearm the way the channel connects them; its migraine indication is the shao yang side-of-head signature. It carries no five-shu element and no special classification, and is located 5 cun below the elbow — measured from the elbow, unlike its wrist-referenced lower neighbours — between the two forearm bones.

A note on searching for it. “SJ 9”, “TE 9”, “TW 9” and “Sidu” searches return protocol trials and unrelated material — and “Sidu” is a common Chinese place and personal name. Any claim attached to this point should be checked against what a study actually used.

Source: Sacred Lotus sources & references (action, indication and location records; the SJ-08 and SJ-10 records and the nine arterial cautions queried, against our own data).