Tsien-hueh, as dim-mak is often called, refers to the martial use of the acupuncture points to cause temporary or permanent damage to the Qi flow and to the body. On a pragmatic level, the value of striking, twisting, or applying pressure to ("sealing") these points often lies in affecting arterial blood flow, dislocating bones, tearing muscles and ligaments, and traumatising major nerves.
It is a legitimate aspect of learning the traditional internal martial arts, but was customary taught only to those long-term students who were trusted the most. In the old days, if you were a dim-mak expert, and everyone knew about it, you were less likely to be attacked (except by another expert who would presumably have developed the skills necessary to counteract yours).
However, if you struck a non-expert, then they would expect to develop severe side effects, even if you hadn't done them any real physical harm—and probably would. For example, if you are convinced that I will make your left earlobe fall off three weeks after touching or hitting you on the right nipple, then it would be surprising if you didn't feel a little nervous when hit or three weeks after the fact.
Having said this, I also think that there may well be more to this than meets the eye, at least on rare occasion. My instructor on the subject, Erle Montague, often points out that it is useless to attend seminars on death-point striking, to memorise a number of acupuncture points, and to practise striking them on a willing partner. No one on the street would stand around and let you hit them the way you probably practise in a martial school setting. In other words, such theoretical knowledge is useless unless you can keep the attacker from harming you first—that is, you have to know how to fight.
Similarly, many of the points work so well because attacking them also affects joints, organs, or blood and nervous systems—you don't want to fool around with these areas in an irre sponsible manner. Striking the many points that are particularly vulnerable to knockout, or can cause death in a training setting, is a stupid thing to do if you are a student—and irresponsible if you are a teacher! While such martial skills may have been necessary when created in lawless times, they have little place in modern life except as a curiosity.
Self-defence skills are an essential aspect of the traditional Chinese internal arts—but there is more to those arts than martial skill. However, in regards to dim-mak, life is too short to waste it developing knowledge that is the unarmed equivalent of nuclear weapons. If you train to automatically attack lethal points—which are often over internal organs that are rarely easy to rupture, causing peritonitis, or in the throat, or near the eyes—it would be astounding if you didn't reflexively overreact when frightened, if well trained at the methods but not in self-control.
Also, wishful thinking aside, hitting someone in a classroom setting is not the same as hitting them if they are attacking or defending with skill and aggression. Watch any Ultimate Fighting Match or mixed martial arts sporting match, and you will see fighters strike and be struck on supposedly vulnerable point after point without even looking crabby about it!
So, boys and girls, a little knowledge is a dangerous thing, and the use of Qi cultivation in the internal arts—no matter how you define and explore such knowledge—should promote good health, not destroy it. Dim-mak is a fascinating and legitimate aspect of the traditional internal arts, but you should think of it as being one aspect of your higher martial educa-tion—not the be-all and end-all of your training.
By the way, unlike many of those who have produced videos and books in the English language on point striking and dim-mak concepts, Erle Montague has gone out of his way to help debunk the myths and demonstrate how important it is to not practise such tactics in a haphazard manner.
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