Points of the Foot Taiyang Bladder Channel

Table of contents
  1. BL 1 (Jīng Míng, 睛明)
  2. BL 2 (Cuán Zhú, 攒竹)
  3. BL 3 (Méi Chōng, 眉冲)
  4. BL 4 (Qū Chā, 曲差)
  5. BL 5 (Wǔ Chù, 五处)
  6. BL 6 (Chéng Guāng, 承光)
  7. BL 7 (Tōng Tiān, 通天)
  8. BL 8 (Luò Què, 络却)
  9. BL 9 (Yù Zhěn, 玉枕)
  10. BL 10 (Tiān Zhù, 天柱)
  11. BL 11 (Dà Zhù, 大杼)
  12. BL 12 (Fēng Mén, 风门)
  13. BL 13 (Fèi Shù, 肺俞)
  14. BL 14 (Jué Yīn Shù, 厥阴俞)
  15. BL 15 (Xīn Shù, 心俞)
  16. BL 16 (Dū Shù, 督俞)
  17. BL 17 (Gé Shù, 膈俞)
  18. BL 18 (Gān Shù, 肝俞)
  19. BL 19 (Dǎn Shù, 胆俞)
  20. BL 20 (Pí Shù, 脾俞)
  21. BL 21 (Wèi Shù, 胃俞)
  22. BL 22 (Sān Jiāo Shù, 三焦俞)
  23. BL 23 (Shèn Shù, 肾俞)
  24. BL 24 (Qì Hǎi Shù, 气海俞)
  25. BL 25 (Dà Cháng Shù, 大肠俞)
  26. BL 26 (Guān Yuán Shù, 关元俞)
  27. BL 27 (Xiǎo Cháng Shù, 小肠俞)
  28. BL 28 (Páng Guāng Shù, 膀胱俞)
  29. BL 29 (Zhōn⁝ Lǚ Shù, 中膂俞)
  30. BL 30 (Bái Huán Shù, 白环俞)
  31. BL 31 (Shàn⁝ Liáo, 上髎)
  32. BL 32 (Cì Liáo, 次髎)
  33. BL 33 (Zhōng Liáo, 中髎)
  34. BL 34 (Xià Liáo, 下髎)
  35. BL 35 (Huì Yáng, 会阳)
  36. BL 36 (Chéng Fú, 承扶)
  37. BL 37 (Yīn Mén, 殷门)
  38. BL 38 (Fú Xì, 浮郄)
  39. BL 39 (Wěi Yáng, 委阳)
  40. BL 40 (Wěi Zhōng, 委中)
  41. BL 41 (Fù Fēn, 附分)
  42. BL 42 (Pò Hù, 魄户)
  43. BL 43 (Gāo Huāng, 膏肓)
  44. BL 44 (Shén Táng, 神堂)
  45. BL 45 (Yì Xǐ,)
  46. BL 46 (Gé Guān, 膈关)
  47. BL 47 (Hún Mén, 魂门)
  48. BL 48 (Yáng Gāng, 阳纲)
  49. BL 49 (Yì Shè, 意舍)
  50. BL 50 (Wèi Cāng, 胃仓)
  51. BL 51 (Huāng Mén, 肓门)
  52. BL 52 (Zhì Shì, 志室)
  53. BL 53 (Bāo Huāng, 胞肓)
  54. BL 54 (Zhì Biān, 秩边)
  55. BL 55 (Hé Yáng, 合阳)
  56. BL 56 (Chéng Jīn, 承筋)
  57. BL 57 (Chéng Shān, 承山)
  58. BL 58 (Fēi Yáng, 飞扬)
  59. BL 59 (Fū Yáng, 跗阳)
  60. BL 60 (Kūn Lún, 昆仑)
  61. BL 61 (Pú Cān, 仆参)
  62. BL 62 (Shēn Mài, 申脉)
  63. BL 63 (Jīn Mén, 金门)
  64. BL 64 (Jīng Gǔ, 京骨)
  65. BL 65 (Shù Gǔ, 束骨)
  66. BL 66 (Zú Tōng Gǔ, 足通谷)
  67. BL 67 (Zhì Yīn, 至阴)

There are 67 bilateral points on the foot taiyang bladder channel: 49 on the head, face, neck, back, and lumbar region; 18 on the posterior midline of the lower limbs and the lateral aspect of the foot. The first is on the face, BL 1 (jīng míng); the last is on the little toe, BL 67 (zhì yīn). Indications of these points include disorders of the urinary, reproductive, digestive, circulatory, and respiratory systems and the running course of the channel.

BL 1 (Jīng Míng, 睛明)

Intersecting point of the hand taiyang, foot taiyang, foot yangming, foot shaoyang channels, yinqiaoyangqiao and du mai

Location. On the face in the depression between the superomedial parts of the inner canthus of the eye and the medial wall of the orbit (Pic. 3-41).

Pic. 3-41 BL 1, BL 2 and BL 3
Pic. 3-41 BL 1, BL 2 and BL 3

Location method. When the eye is closed, BL 1 is in the depression 0.1 cun superior to the inner canthus.

Actions. Remove nebulae to improve vision, dispel wind, and clear heat.

Indications. Redness, pain, and swelling of the eyes, lacrimation due to wind, itching and pain of the inner canthus, pterygium, blurred vision, myopia, night blindness, color blindness, other eye disorders; acute lumbar sprain, sciatic pain.

Manipulation. Acupuncture: With the patient’s eyes closed, gently push the eyeball laterally. Needle slowly and perpendicularly along the orbital wall 0.3~0.5 cun with the other hand. Do not rotate, lift, or thrust. Local soreness and distending pain will spread to the eyeball and the surrounding area. When withdrawing the needle, press the site to avoid internal bleeding. Moxibustion is forbidden.

Precautions. Needle toward the outside to avoid puncturing the angular vein. Do not puncture the vein in the orbit; needle slowly and gently without rotating, lifting, or thrusting. Do not puncture the optic nerve; needle to a depth 0.2~0.3 cun, 0.5 cun at most.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经) and is especially effcient in improving vision. The brightness of the eyes, like yang shining brightly, is due to the refection of the essence of the fve zang and six fu organs, hence the name jīng míng, bright eyes.

Modern clinical observation and research. To control and stabilize intraocular pressure (IOP), 39 patients with glaucoma (75 eyes) received acupuncture at ST 2 (sì bái), BL 2 (cuán zhú), BL 1 (jīngmíng), and qiú hòu (EX-HN 7), among other points. After acupuncture, 24-hour diurnal IOP variation was 5.31 +/– 2.84 mmHg, significantly down from 7.06 +/– 3.86 mmHg (P<0.05). Acupuncture reduced and stabilized IOP in these patients.1

BL 2 (Cuán Zhú, 攒竹)

Location. On the head in the depression at the medial end of the eyebrow (Pic. 3-41).

Location method. A depression, the frontal notch, can often be palpated on the medial end of the eyebrow directly superior to BL 1 (jīng míng).

Actions. Clear heat, dissipate wind, and quicken collaterals to improve vision.

1 Liu W, Yang G, Zhao XJ, Song YG, Liu T, et al. Impact of acupuncture on 24 h intraocular pressure of glaucoma针刺对青光眼24小时眼压的影响. Chinese Acupuncture & Moxibustion. 2011; 31(6): 518-20.

Indications. Headache, pain of superciliary ridge, eyelid twitching, deviation of mouth and eyes, and other disorders of the nervous system; redness, pain and swelling of the eyes, lacrimation due to wind, myopia, blurred vision, other conditions of the fve sensory organs; lumbar sprain, spasm of the diaphragm.

Manipulation. Acupuncture: 1. Needle perpendicularly 0.1~0.3 cun or obliquely downward 0.5~1.0 cun to penetrate BL 1 (jīng míng); soreness and distending pain will be felt locally and around the orbit. 2. To treat pain of the superciliary ridge, needle transversely 1.0~1.5 cun toward yúyāo (EX-HN 4); numbness and distention will be felt locally and spread to the orbit. 3. Bleed with a three-edged needle. 4. All types of eye disorders can be prevented by pressing and kneading BL 2 30~50 times.

Precautions. Moxibustion is forbidden.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is located in the depression at the medial end of the eyebrow, which looks like a cluster of bamboo; hence the name cuán zhú, cluster of bamboo.

BL 3 (Méi Chōng, 眉冲)

Location. On the head superior to the frontal notch and 0.5 cun superior to the anterior hairline (Pic. 3-41).

Location method. With the patient sitting or supine, the point is midway between DU 24 (shéntíng) and BL 4 (qū chā) at the intersection of a horizontal line through DU 24 (shén tíng) and a vertical line through BL 2 (cuán zhú).

Actions. Improve vision, calm the mind, dispel wind, and unblock collaterals.

Indications. Dizziness, epilepsy, headache, stuffy nose, blurred vision.

Manipulation. Acupuncture: Needle transversely, 0.3~0.5 cun. Distending pain can be felt at the local area. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Chōng means upward. Foot taiyang bladder channel qi goes directly from the brow to this point, which was named méichōng, brow upward.

BL 4 (Qū Chā, 曲差)

Location. On the head 0.5 cun superior to the anterior hairline and 1.5 cun lateral to the anterior median line (Pic. 3-42).

Pic. 3-42 BL 4, BL 5, BL 6, BL 7 and BL 8
Pic. 3-42 BL 4, BL 5, BL 6, BL 7 and BL 8

Location method. The point is at the junction of the medial one third and lateral two thirds of a line connecting DU 24 (shéntíng) and ST 8 (tóu wéi).

Actions. Clear the head, improve vision, open the orifices, and calm the mind.

Indications. Headache, fever, stuffy nose, nosebleed, eye pain, blurred vision, other disorders of head and face.

Manipulation. Acupuncture: Needle transversely 0.3~ 0.5 cun. Distending pain can be felt at the local area. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classicof Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means curved; chā means separate. The bladder channel goes upward directly to BL 3 (méi chōng) where it separates laterally, so the point was named qū chā, curved separation.

BL 5 (Wǔ Chù, 五处)

Location. On the head 1 cun superior to the anterior hairline and 1.5 cun lateral to the anterior median line (Pic. 3-42).

Location method. The point is 0.5 cun superior to BL 4 (qū chā) and level with DU 23 (shàngxīng).

Actions. Clear head heat to improve vision, clear heat, and extinguish wind.

Indications. Epilepsy; infantile convulsion, headache, dizziness, blurred vision

Manipulation. Acupuncture: Needle transversely 0.3~0.5 cun. Distending pain can be felt locally. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Chù means Location. As the fifth point of the foot taiyang bladder channel, it is called wǔ chù, fifth point.

BL 6 (Chéng Guāng, 承光)

Location. On the head 2.5 cun superior to the anterior hairline and 1.5 cun lateral to the anterior median line (Pic. 3-42).

Location method. The point is 2 cun above BL 4 (qū chā), 1.5 cun above BL 5 (wŭ chù).

Actions. Clear heat, dispel wind, improve vision, and open the orifices.

Indications. Headache, stuffy nose, profuse nasal discharge, fever without sweating, eye pain, dizziness, blurred vision.

Manipulation. Acupuncture: Needle transversely 0.3~0.5 cun. Local distention can be felt. To treat headache, insert the needle 0.5~1.0 cun toward DU 20 (băi huì). Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. This point is forbidden when the scalp is infected.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经); it is named for its function: chéng means receive; guāng means brightness. It treats eye disorders and brightens the eyes, so it is called chéng guāng, receive brightness.

BL 7 (Tōng Tiān, 通天)

Location. On the head 4 cun superior to the anterior hairline and 1.5 cun lateral to the anterior median line (Pic. 3-42).

Location method. The point is midway between BL 6 (chéng guāng) and BL 8 (luò què).

Actions. Diffuse the lung and relieve stuffy nose, dissipate wind and clear heat.

Indications. Headache, heaviness of the head; stuffy nose, profuse and clear nasal discharge, nosebleed, sinusitis, other nasal disorders.

Manipulation. Acupuncture: Needle transversely 0.3~0.5 cun. Local distending pain can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Tōng means reaching; tiān means heaven. As the highest point on the bladder channel, it is called tōng tiān, reaching heaven.

BL 8 (Luò Què, 络却)

Location. On the head 5.5 cun superior to the anterior hairline and 1.5 cun lateral to the anterior median line (Pic. 3-42).

Location method. The point is 0.5 cun posterior and 1.5 cun lateral to DU 20 (băi huì).

Actions. Dispel wind, clear heat, improve vision, and open the orifices.

Indications. Deviation of the mouth, dizziness, depression and manic psychosis, epilepsy, stuffy nose, blurred vision, swelling of neck and goiter.

Manipulation. Acupuncture: Needle transversely 0.3~0.5 cun. Distending pain can be felt locally. Moxibustion: Use 3~5 cones of cone moxibustion, or a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经); it is located where the bladder channel connects with the brain and returns to the scalp. Luò means linking; què, return; its name means linking to return.

BL 9 (Yù Zhěn, 玉枕)

Location. On the head level with the superior border of the external occipital protuberance and 1.3 cun lateral to the posterior median line at the intersection of a vertical line from the lateral border of the trapezius and a horizontal line from the superior border of the external occipital protuberance (Pic. 3-43).

Pic. 3-43 BL 9 and BL 10
Pic. 3-43 BL 9 and BL 10

Location method. The point is lateral to the external occipital protuberance and 1.3 cun lateral to and level with DU 17 (năo hù).

Actions. Open the orifices and improve vision, unblock channels and quicken collaterals.

Indications. Headache, aversion to wind and cold, stuffy nose, eye pain, myopia.

Manipulation. Acupuncture: Needle transversely 0.3~0.5 cun. Local distending pain can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Located near the protuberance of the occipital bone, which is called yùzhěn gǔ (jade pillow bone), it was named yù zhěn, jade pillow.

BL 10 (Tiān Zhù, 天柱)

Location. In the posterior region of the neck in the depression lateral to the trapezius muscle at level of the superior border of the spinous process of the second cervical vertebra (C2) (Pic. 3-43).

Actions. Strengthen the sinews and bones, calm the mind, and clear heat of the head and eyes.

Indications. Headache, stiff neck, stuffy nose, loss of smell, redness, pain and swelling of the eyes, sore throat, shoulder and back pain, feet unable to support the body.

Manipulation. Acupuncture: Needle perpendicularly or obliquely 0.5~0.8 cun. Local soreness and distending pain spreads to the posterior of the head and sometimes to the eyes. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. Needle perpendicularly to avoid damaging the medulla or the spinal marrow. Needling deeply upward or anteriorly and medially is prohibited.

Annotation. The point appeared in The Spiritual Pivot-Fundamental Points (Líng Shū-Běn Shū,灵枢·本输). It is called tiān zhù, heaven’s pillar, for its lateral location on the neck. In the body, the head is heaven; the neck, the pillar of heaven.

BL 11 (Dà Zhù, 大杼)

influential point of the bone; intersecting point of the hand taiyang, foot taiyang

Location. On the upper back at the level of the inferior border of the spinous process of the first thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-44).

Pic. 3-44 BL 11, BL 12, BL 13, BL 14 and BL 15
Pic. 3-44 BL 11, BL 12, BL 13, BL 14 and BL 15

Actions. Clear heat and dissipate wind, and strengthen the sinews and bones.

Indications. Stiff neck, shoulder and back pain, low back pain, rigidity, cold pain of the bone and marrow, other neck and back disorders; cold, cough, asthma, fullness of the chest and hypochondrium, other chest and lung conditions; pharyngitis, nasal congestion, headache, dizziness, other head and facial disorders; stroke, epilepsy, deficiency due to overstrain.

Manipulation. Moxibustion: Needle medially 0.5~0.8 cun. Local soreness and distending pain can radiate to the intercostals or shoulders. Moxibustion: Use 5~7 cones of cone moxibustion, or a moxa stick for 10~20 minutes.

Precautions. Avoid puncturing the parietal pleura and the lungs. Insert the needle along the long axis of the neck of rib, not perpendicular to the axis.

Annotation. The point appeared in The Spiritual Pivot-The Needleing Criterions and Differencebetween Healthy and Pathogenic Qi (Líng Shū-Cì Jié Zhēn Xié, 灵枢·刺节真邪). Zhù means weaving shuttle; the transverse processes of the spinal column extrude on both sides like a shuttle, so the spinal column is called zhù gŭ, spinal column bone. As the point is at the top of spinal column, it was named dà zhù, large shuttle.

BL 12 (Fēng Mén, 风门)

Intersecting point of the foot taiyang channel and du mai

Location. On the upper back at the level of the inferior border of the spinous process of the second thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-44).

Actions. Boost qi to consolidate the exterior, dispel wind to release the exterior, and drain heat.

Indications. Cough due to common cold, fever and headache, thin nasal discharge, nose congestion, cough, asthma, other externally contracted disorders and lung diseases; neck pain and stiffiness, chest and back pain, carbuncle-abscess on the back, other neck and back conditions; vomiting, jaundice, edema, opisthotonos.

Manipulation. Acupuncture: Needle obliquely toward the spinal column 0.5~0.8 cun or insert 1~1.5 cun along the muscle layer. Local soreness and distending pain can radiate to the intercostal space. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes. Medicinal or ginger moxibustion may be used.

Precautions. See BL 11 (dà zhù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is the door through which pathogenic wind comes and goes and it treats wind disorders, so it is called fēng mén, wind door.

BL 13 (Fèi Shù, 肺俞)

Back-shu point of the lung

Location. On the upper back at the level of the inferior border of the spinous process of the third thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-44).

Actions. Clear heat to release the exterior, and diffuse the lung to regulate qi.

Indications. Cough, fullness of the chest and panting, coughing of blood, pharyngitis, spontaneous sweating, night sweats, steaming tidal fever, chest distress, palpitation, other chest and lung disorders; kyphosis, back pain, other back disorders; pruritus, urticaria, acne, itching, other skin disorders; vertigo, vomiting, jaundice, depression and manic psychosis, muscle pain.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun. Local soreness and distending pain can radiate to the intercostal space. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes. Medicinal or ginger moxibustion may be used.

Precautions. Insert along the long axis of the rib to avoid puncturing the lungs and causing hemothorax. Perpendicular insertion is forbidden.

Annotation. The point appeared in The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞). As the place where lung qi enters, it is called fèi shù, lung back-shu point, and treats lung disorders.

Modern clinical observation and research. In a study on clinical and immunomodulatory effects of acupuncture in allergic asthma, DU 14 (dà zhuī), BL 12 (fēng mén), and BL 13 (fèi shù) were needled every other day three times a week for fve weeks. The acupuncture regulated mucosal and cellular immunity: immunoglobulins, eosinophils, and nasal secretions significantly decreased; lymphocytes significantly increased. Plasma cortisol concentration did not change significantly. Overall treatment effective rate was 85%.1

BL 14 (Jué Yīn Shù, 厥阴俞)

Back-shu point of the pericardium

Location. On the upper back at the level of the inferior border of the spinous process of the fourth thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-44).

Actions. Invigorate blood, regulate qi, clear heart heat, and calm the mind.

Indications. Heart pain, palpitation, chest fullness, other heart disorders; chest and hypochondrial pain and fullness, cough, other chest and lung conditions; vomiting; scapula pain.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. See BL 13 (fèi shù).

1 Yang YQ, Chen HP, Wang Y, Yin LM, Xu YD,. Considerations for use of acupuncture as supplemental therapy for patients with allergic asthma. Clin Rev Allergy Immunol. 2013; 44(3): 254-61.

Annotation. The point appeared in Important Formulas Worth a Thousand Gold Pieces

(Qiān Jīn Yào Fāng, 千金要方). Called jué yīn shù, pericardium back-shu point, it was named for its function as the transportation and entry point of hand jueyin pericardium channel qi and its importance in treating heart and pericardium disorders.

BL 15 (Xīn Shù, 心俞)

Back-shu point of the heart

Location. On the upper back at the level of the inferior border of the spinous process of the fifth thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-44).

Actions. Regulate qi and blood, unblock heart collaterals, and calm the heart spirit.

Indications. Back pain due to chest pain, cardiac pain, palpitation, vexation, chest distress, other heart disorders; mania and depression, epilepsy, insomnia, amnesia, other brain disorders; nocturnal emissions, night sweats, turbid urine; asthma, cough, expectoration of blood; vomiting and dysphagia; shoulder and back pain; carbuncle-abscess on the back.

Manipulation. Acupuncture: 1. Insert obliquely and medially 0.5~0.8 cun. Local soreness and distention can radiate from hypochondrium to the anterior chest. 2. Insert transversely along the muscle layer upward or downward 1.0~2.0 cun. Local soreness and distention can be felt. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes. Medicinal moxibustion may be used.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞). Because it is located where heart qi infuses, it is important for heart disorders and was named xīn shū, heart back-shu point.

Modern clinical observation and research. To determine whether acupuncture prevents or reduces recurrence of arrhythmia in persistent atrial fibrillation (AF), amiodarone (n=26), acupuncture at PC 6 (nèi guān), HT 7 (shén mén), and BL 15 (xīn shù) once a week for 10 weeks (n=17), sham acupuncture (n=13), and no therapy (n=24) were compared. During a 12-month follow up, AF recurred respectively in 27%, 35%, 69%, and 54% of the patients. Recurrence was statistically similar in the drug and acupuncture groups, significantly higher in sham and control.1

BL 16 (Dū Shù, 督俞)

Location. On the upper back at the level of the inferior border of the spinous process of the sixth thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-45).

Pic. 3-45 BL 16, BL 17, BL 18, BL 19, BL 20 and BL 21
Pic. 3-45 BL 16, BL 17, BL 18, BL 19, BL 20 and BL 21

Actions. Regulate qi, invigorate blood, strengthen the heart, and unblock channels.

Indications. Cardiac pain, abdominal pain, abdominal distention, borborygmus, hiccup.

1 Lomuscio A, Belletti S, Battezzati PM, Lombardi F. Efficacy of acupuncture in preventing atrial fbrillation recurrences after electrical cardioversion. J Cardiovasc Electrophysiol. 2011; 22(3): 241-7.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun. Local soreness and distention can radiate to the muscle layer. Moxibustion: Use 5~7 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in Formulas from Benevolent Sages (Shèng Huì Fāng, 圣惠方).  refers to the du mai; because the point is located where the du mai channel qi infuses, it is called dū shū.

BL 17 (Gé Shù, 膈俞)

influential point of the blood

Location. On the upper back at the level of the inferior border of the spinous process of the seventh thoracic vertebra, 1.5 cun lateral to the posterior median line (Pic. 3-45).

Location method. Find the inferior angle of the scapula, which is level with the spinous process of the seventh thoracic vertebra.

Actions. Rectify qi and direct counterflow downward, invigorate blood and unblock the vessels.

Indications. Expectoration of blood, nosebleed, bloody stool, postpartum lochiostasis, other blood disorders; cardiac pain, palpitation, chest pain, chest distress, other heart and chest disorders; vomiting, hiccup, dysphagia, poor appetite, abdominal pain and masses, other spleen and stomach disorders; asthma, cough, spontaneous sweat, night sweats, phlegm-fluid retention, pharyngitis, other lung disorders; back pain, rigidity of the spine; hypochondrial pain; night blindness, reduced lactation, insomnia, other disorders of the running course.

Manipulation. See BL 16 (dū shù).

Precautions. See BL 16 (dū shù).

Annotation. The point appeared in The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞).  means diaphragm; since it corresponds interiorly to the diaphragm, this point was named gé shù.

Modern clinical application and research. Twenty-seven patients with intractable hiccup were cupped for 3~5 minutes; then BL 17 (gé shù) was pricked to bleed and cupped for 15 minutes. Treatment was given once a day in one or two three-day courses. At the three-month follow up, symptoms had subsided without recurrence in twenty-fve cases; hiccups had recurred in one; one showed no improvement.1

BL 18 (Gān Shù, 肝俞)

Back-shu point of the liver

Location. On the upper back at the level of the inferior border of the spinous process of the ninth thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-45).

Actions. Soothe the liver and rectify qi, promote gallbladder function and resolve constraint.

Indications. Distention and fullness of the stomach, abdomen, chest, and hypochondrium, jaundice, thoracic accumulation, acid refux, abdominal masses, other liver and gallbladder disorders; depression and manic psychosis, other mental disorders; epilepsy; redness, pain, and itching of the eyes; pterygium, white nebula of eye, profuse eye discharge, night blindness, glaucoma, blurred vision, other eye conditions; coughing blood, spitting blood, nosebleed, other blood disorders; neck rigidity and pain, low back pain, cold abdominal colic, other channel sinew disorders; irregular menstruation, amenorrhea, dysmenorrhea, other gynecological disorders; headache, vereigo.

1 Wang L, Shi YJ. Twenty-seven cases of intractable hiccup treated with fash cupping and collateral bloodletting at BL 17 (gé shù) 闪罐合膈俞刺络放血治疗顽固性呃逆27例. Chinese Acupuncture & Moxibustion. 2008; 28(2): 136.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun or transversely downward 1.0~1.5 cun. Local soreness and distention can radiate to the intercostal space. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes. Anemia and insomnia can be prevented using moxibustion at BL 18 (gān shù).

Precautions. See BL 16 (dū shù).

Annotation. The point appeared The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞). Gān means liver. The point, called gān shū, liver back-shu point, corresponds interiorly to the liver. As the place that liver qi infuses, it treats liver disorders.

BL 19 (Dǎn Shù, 胆俞)

Back-shu point of the gallbladder

Location. On the upper back at the level of the inferior border of the spinous process of the tenth thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-45).

Actions. Soothe the liver and promote gallbladder function, nourish yin and clear heat, harmonize the stomach and direct qi downward.

Indications. Distention and fullness of stomach and abdomen, indigestion, vomiting bile, bitter taste in the mouth, yellow eyes, regurgitation, dysphagia, jaundice; other disorders of liver, gallbladder, and stomach; chest and hypochondrial pain, swelling and pain of the armpit, other chest and hypochondrial disorders; pulmonary tuberculosis, tidal fever, headache, severe chills, palpitation due to fright, insomnia.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun. Local soreness and distention can radiate to the hypochondrium. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. Avoid puncturing the parietal pleura and internal organs. It is advisable to needle medially along the major axis of ribs and forbidden to needle deeply or perpendicular to that axis.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Dǎn means gallbladder. The point corresponds interiorly to the gallbladder. As the place where gallbladder qi infuses, it treats gallbladder disorders and is called dǎn shù, gallbladder back-shu point.

BL 20 (Pí Shù, 脾俞)

Back-shu point of the spleen

Location. On the upper back at the level of the inferior border of the spinous process of the 11th thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-45).

Actions. Fortify the spleen and control the blood, harmonize the stomach and boost qi.

Indications. Abdominal distention, vomiting, diarrhea, dysentery, undigested food in the stool, dysphagia, stomachache; other spleen, stomach, and intestinal disorders; spitting of blood, bloody stool, bloody urine, other blood disorders; jaundice, edema, emaciation, hypochondrial or abdominal masses, seminal emission, gonorrhea, panting, low back pain.

Manipulation. Acupuncture: Needle obliquely and medially 0.5~0.8 cun. Local soreness and distention can radiate to the lower back. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. See BL 19 (dǎn shù).

Annotation. The point appeared in The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞).  means spleen; as the place that spleen qi infuses, it is important in treating spleen disorders and is called pí shù, spleen back-shu point.

Modern clinical observation and research. In an RCT on acupuncture for chronic fatigue syndrome, 120 patients were equally divided into acupuncture and control groups. In the former, BL 15 (xīn shù), BL 20 (pí shù), and BL 43 (gāo huāng) were needled fve times a week for four weeks. In control, needles were inserted shallowly into non-acupoints on the gallbladder channel. Chalder fatigue scores decreased significantly (P<0.01) and physiological function and general health scores increased (P<0.05, P<0.01) from baseline in both groups after treatment. At four weeks and at three months, treatment group scores were significantly superior to those of control (P<0.05).1

BL 21 (Wèi Shù, 胃俞)

Back-shu point of the stomach

Location. On the upper back at the level of the inferior border of the spinous process of the 12th thoracic vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-45).

Actions. Harmonize the stomach, fortify the spleen, promote digestion, and drain dampness.

Indications. Stomachache, regurgitation, vomiting, borborygmus, undigested food in the stool, dysphagia, diarrhea, dysentery, infantile malnutrition; other spleen, stomach, and intestinal disorders; back and spinal column spasms and pain, atrophy, cough, amenorrhea, carbuncle.

Manipulation. Acupuncture: Needle perpendicularly 0.5~0.8 cun. Local soreness and distention can radiate to the waist and abdomen. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. To avoid injuring the parietal pleura and kidney, do not needle too deeply or anteriorly or laterally through the quadratus lumborum muscle.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Wèi refers to the stomach; because the point is located where the stomach qi transports, it is important in treating stomach disorders and is called wèi shù, stomach back-shu point.

BL 22 (Sān Jiāo Shù, 三焦俞)

Back-shu point of sanjiao

Location. In the lumbar region at the level of the inferior border of the spinous process of the first lumbar vertebra (L1) and 1.5 cun lateral to the posterior median line (Pic. 3-46).

Pic. 3-46 BL 22, BL 23, BL 24, BL 25 and BL 26
Pic. 3-46 BL 22, BL 23, BL 24, BL 25 and BL 26

Actions. Regulate the sanjiao, drain waterways, boost original qi, and strengthen the waist and knees.

Indications. Edema, difficult urination, enuresis, ascites, other sanjiao disorders; vomiting, hiccup, undigested food in the stool, borborygmus, diarrhea, jaundice, other spleen and stomach conditions; headache, dizziness, back and spinal column rigidity and pain, shoulder and back spasms, abdominal masses in women, seminal emissions.

1 Zhang W, Liu ZS, Xu HR, Liu YS. Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients针刺背俞穴治疗慢性疲劳综合征临床研究. Acupuncture Research. 2011; 36(6): 437-41, 448.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can radiate to the lower back and the abdomen. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Precautions. See BL 21 (wèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). The point is located where the sanjiao qi infuses. Used in treating sanjiao disorders, it is called sān jiāo shù, sanjiao back-shu point.

BL 23 (Shèn Shù, 肾俞)

Back-shu point of the kidney

Location. In the lumbar region at the level of the inferior border of the spinous process of the second lumbar vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-46).

Actions. Reinforce the kidney and strengthen the waist and yang, drain water and improve vision, sight, and hearing.

Indications. Dizziness, tinnitus, low back pain, other kidney deficiency disorders; enuresis, seminal emission, impotence, premature ejaculation, irregular menstruation, abnormal vaginal discharge, infertility, other genitourinary system conditions.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Soreness and distention can be felt at the lower back. Electric sensations and numbness can radiate to the lower limbs. To treat renal colic, one may use the dragon-tiger warming treatment. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes. Medicinal moxibustion or moxa with over 100 cones may be used; scarring moxibustion once a year for body building and health care is suggested; 5~7 cones of fù zĭ (Radix Aconiti Lateralis Praeparata) or warm moxibustion until the skin flushes may be used once a day, 20 times a month.

Precautions. See BL 21 (wèi shù).

Annotation. The point appeared in The Spiritual Pivot-Back-shu Points (Líng Shū-Bèi Shù, 灵枢·背俞). Shèn means kidney. Located where kidney qi infuses, the point is important in treating kidney disorders, so it is called shèn shù, kidney back-shu point.

Modern clinical observation and research. In a pilot study on wet cupping for persistent nonspecific low back pain, 21 patients were cupped six times in two weeks at two of the three points, BL 23 (shèn shù), BL 24 (qì hăi shù), and BL 25 (dà cháng shù); 11 were wait listed. Pain decreased 16.0 in NRS in both groups (P=0.52), but palliative prognostic scores were significantly better in the cupping group (P<0.01), which also used less acetaminophen (P=0.09).1

BL 24 (Qì Hǎi Shù, 气海俞)

Location. In the lumbar region 1.5 cun lateral to the posterior median line at the level of the inferior border of the spinous process of the third lumbar vertebra (Pic. 3-46).

Actions. Reinforce kidney yang, move qi, and invigorate blood.

Indications. Dysmenorrhea, anal fstula, lower back pain, inhibition of legs and knees.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt and an electric numbness can radiate to the buttocks and lower limbs. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in Formulas from Benevolent Sages (Shèng Huì Fāng, 圣惠方). It corresponds to RN 6 (qì hăi) and is where original qi infuses, so is called qì hǎi shù.

1 Kim JI, Kim TH, Lee MS, Kang JW, Kim KH, et al. Evaluation of wet-cupping therapy for persistent non-specific low back pain: A randomised, waiting-list controlled, open-label, parallel-group pilot trial. Trials. 2011; 12: 146.

Modern clinical observation and research. In a case series, ilioinguinal neuralgia was treated with BL 24 (qì hǎi shù), which was needled to produce an electric shock-like sensation that radiated from the groin to the the foot three times. The point was stimulated every 5 minutes; needles were retained for 20. Treatment was given once a day; three treatments constituted a course. Patients were treated at least once; six times at most. After treatment, 35 patients recovered; 4 could walk with less pain.1

BL 25 (Dà Cháng Shù, 大肠俞)

Back-shu point of the large intestine

Location. In the lumbar region at the level of the inferior border of the spinous process of the fourth lumbar vertebra and 1.5 cun lateral to the posterior median line (Pic. 3-46).

Location method. With the patient prone, fnd DU 3 (yāo yáng guān) at the midpoint of a line linking the highest points of the two iliac crests. The point is 1.5 cun lateral to DU 3.

Actions. Soothe and regulate the stomach and intestines, rectify qi, and resolve stagnation.

Indications. Abdominal pain, abdominal distention, diarrhea, borborygmus, constipation, dysentery, other stomach and intestinal disorders; rigidity and pain of low back and spine

Manipulation. Acupuncture: 1. Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt and an electric numbness can radiate to the buttocks and legs. 2. Needle transversely downward 2.0~2.5 cun toward BL 27 (xiǎo cháng shù). Local soreness and distention can spread to the sacroiliac joint. 3. Needle obliquely and laterally 2.0~2.5 cun to send an electric numbness to the buttocks and lower limbs. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes. Medicinal moxibustion may be used.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Dà cháng means large intestine. The point corresponds to the large intestine. It is where large intestine qi infuses and can treat disorders of the large intestine, so it is called dà cháng shù, large intestine back-shu point.

Modern clinical observation and research. See BL 23 (shèn shù).

BL 26 (Guān Yuán Shù, 关元俞)

Location. In the lumbar region at the level of the inferior border of the spinous process of the fifth lumbar vertebra (L5) and 1.5 cun lateral to the posterior median line (Pic. 3-46).

Actions. Cultivate original qi and consolidate the foundation to condition the lower jiao.

Indications. Abdominal distention, diarrhea, difficult urination, enuresis, low back pain.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt and an electric numbness can radiate to the lower limbs. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in Formulas from Benevolent Sages (Shèng Huì Fāng, 圣惠方). It corresponds to RN 4 (guān yuán) and is where original qi infuses, so it is called guān yuán shù.

BL 27 (Xiǎo Cháng Shù, 小肠俞)

Back-shu point of the small intestine

Location. In the sacral region at the level of the first posterior sacral foramen and 1.5 cun lateral to the median sacral crest (Pic. 3-47).

Location method. The point is level with BL 31 (shàng liáo).

Actions. Clear heat, drain dampness, and regulate urine and stool.

Pic. 3-47 BL 27, BL 28, BL 29 and BL 30
Pic. 3-47 BL 27, BL 28, BL 29 and BL 30

Indications. Dysentery, diarrhea, hernia, hemorrhoids, other intestinal disorders; seminal emission, enuresis, bloody urine, red urine and difficult urination, abnormal white vaginal discharge, distending pain of the lower abdomen, other urogenital system conditions; low back and leg pain, sacroiliitis.

Manipulation. Acupuncture: 1. Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt. 2. Needle obliquely downward 2.0~2.5 cun to make soreness and distention spread to the sacroiliac joint. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Xiǎo cháng means small intestine. The point corresponds to the small intestine, is located where small intestine qi infuses, and treats disorders of the small intestine. Therefore it is called xiǎo cháng shù, small intestine back-shu point.

BL 28 (Páng Guāng Shù, 膀胱俞)

Back-shu point of the bladder

Location. In the sacral region at the level of the second posterior sacral foramen and 1.5 cun lateral to the median sacral crest (Pic. 3-47).

Location method. The point is level with BL 32 (cì liáo).

Actions. Clear heat, promote urination, and cultivate and supplement kidney qi.

Indications. Red urine and difficult urination, retention of urine, enuresis, seminal emission; dampness, itching and distending pain of the external genitalia; sore external genitalia, other urogenital system disorders; abdominal pain, diarrhea, constipation, other intestinal disorders; rigidity and pain of the low back and spine, coldness and weakness of knee and foot.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can radiate downward to the buttocks or the popliteal space. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Pulse Classic (Mài Jīng, 脉经). Páng guāng means bladder. The point corresponds to the bladder, is located where bladder qi infuses, and can treat bladder disorders. Therefore it is called páng guāng shù, bladder back-shu point.

BL 29 (Zhōn⁝ Lǚ Shù, 中膂俞)

Location. In the sacral region at the level of the third posterior sacral foramen and 1.5 cun lateral to the median sacral crest (Pic. 3-47).

Location method. The point is level with BL 33 (zhōng liáo).

Actions. Warm yang and rectify qi, clear heat and dissipate cold.

Indications. Rigidity and pain of low back and spine, consumptive thirst, hernia, dysentery.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经) and in The Spiritual Pivot (Líng Shū-Cì Jié Zhēn Xié, 灵枢·刺节真邪).  refers to the muscles along the spine where the point is located, hence the name zhōn⁝ lǚ shù, middle muscle point.

BL 30 (Bái Huán Shù, 白环俞)

Location. In the sacral region at the level of the fourth posterior sacral foramen and 1.5 cun lateral to the median sacral crest (Pic. 3-47).

Location method. The point is level with BL 34 (xià liáo).

Actions. Regulate the lower jiao, warm channels, and quicken collaterals.

Indications. Abnormal white vaginal discharge, irregular menstruation, hernia, seminal emission, low back and leg pain.

Manipulation. Acupuncture: Needle perpendicularly 1.0~1.5 cun. Local soreness and distention can spread to the buttocks. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). The place where the body stores essence is called ‘bái huán’ or ‘yù huán’. The point corresponds to this essence house and is where the essence qi infuses. It treats profuse white leukorrhea, seminal emissions, and gonorrhea, so it is called bái huán shù, white circle point.

BL 31 (Shàn⁝ Liáo, 上髎)

Location. On the sacrum in the first posterior sacral foramen (Pic. 3-48).

Pic. 3-48 BL 31, BL 32, BL 33, BL 34 and BL 35
Pic. 3-48 BL 31, BL 32, BL 33, BL 34 and BL 35

Location method. The point is in the depression at the first posterior sacral foramen. Put the tip of the index fnger on the midpoint of a line linking BL 27 (xiǎo cháng shù) and the posterior midline, the little finger on the top of coccyx, and the middle and ring fingers spaced equally between them. BL 31 will be below the tip of the index fnger; BL 32 (cì liáo), the middle fnger; BL 33, the ring fnger; BL 34 (xià liáo), the little fnger.

Actions. Supplement and boost the lower jiao, clear heat, and drain dampness.

Indications. Irregular menstruation, abnormal vaginal discharge, other gynecologic disorders; difficult urination and defecation, seminal emission, impotence, prolapsed uterus, other genitourinary system conditions; low back and sacral pain, weak knees.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can be felt in the sacrum and will radiate to the lower limbs when the point is needled perpendicularly 1.0~2.0 cun to penetrate the posterior sacral foramen. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. Avoid injuring the sigmoid fexure. Do not exceed the depth of the first posterior sacral foramen when needling BL 31 (shàng liáo).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Liáo means sacrum; the point is in the first foramen of the sacrum, so it was named shàng liáo, upper sacral foramen.

BL 32 (Cì Liáo, 次髎)

Location. On the sacrum in the second posterior sacral foramen (Pic. 3-48).

Location method. The point is in the depression at the midpoint of a line connecting the posterior superior iliac spine and the spinous process of the second sacral vertebra.

Actions. Supplement and boost the lower jiao, clear heat, and drain dampness.

Indications. See BL 31 (shàng liáo).

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Soreness and distention can be felt in the sacrum. Needle 2.0 cun for menstrual disorders and leukorrhea; the patient should feel a warm sensation in the lower abdomen. The needling sensation should radiate to the perineum when one is treating strangury, seminal emission, and impotence; to the coccyx and sacrum for anorectal disorders. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. See BL 31 (shàng liáo).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Liáo means sacrum; the point is in the second foramen of the sacrum, so it was named cì liáo, second sacral foramen.

Modern clinical observation and research. In a case series on primary dysmenorrhea, treatment was given once a day during patients’ menstrual periods, starting a day or two days before menstruation began. BL 32 (cì liáo) was strongly needled for one minute; needles were withdrawn after qi was obtained. Other points were needled routinely, with needles retained for 30 minutes. During three menstrual cycles, 40 patients reported no pain and no recurrence; 17 reported reduced pain with recurrence; 3 had no relief.1

In a case series on urinary retention caused by cauda equina injury and refractory to conventional treatment, 15 patients received fve EA treatments a week at BL 32 (cì liáo), BL 33 (zhōng liáo), and BL 35 (huì yáng) for four weeks and three a week for the following two. Follow up was at six months. After the six-week treatment, 10 had regained self-voiding ability. At follow up, 8 of the 10 had maintained this ability; 2 had lost it again.2

BL 33 (Zhōng Liáo, 中髎)

Location. On the sacrum in the third posterior sacral foramen (Pic. 3-48).

Location method. The third posterior sacral foramen is the depression below BL 32 (cì liáo).

Actions. Supplement and nourish the lower jiao, clear heat, and drain dampness.

Indications. See BL 31 (shàng liáo).

1 Ye XY. Clinical observation of primary dysmenorrhea treatment using BL 32 (cì liáo) 针刺次髎穴为主治疗原发性痛经临床观察. Hubei Journal of Traditional Chinese Medicine. 2010; 32(10): 68.

2 Liu Z, Zhou K, Wang Y, Pan Y. Electroacupuncture improves voiding function in patients with neurogenic urinary retention secondary to cauda equina injury: Results from a prospective observational study. Acupunct Med. 2011; 29(3): 188-92.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Soreness and distention can be felt in the sacrum and can radiate to the lower limbs, external genitalia, and anus. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. See BL 31 (shàng liáo).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Liáo means sacrum. The point is in the third hole of sacrum, so it is called zhōng liáo, middle sacral foramen.

Modern clinical observation and research. See BL 32 (cì liáo).

BL 34 (Xià Liáo, 下髎)

Location. On the sacrum in the fourth posterior sacral foramen (Pic. 3-48).

Location method. The fourth posterior sacral foramen is the second depression down from BL 32 (cì liáo) at the level of the sacral hiatus.

Actions. Supplement and nourish the lower jiao, clear heat, and drain dampness.

Indications. See BL 31 (shàng liáo).

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Soreness and distention can be felt in the sacrum and can radiate to the external genitalia. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. See BL 31 (shàng liáo).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Liáo means sacrum. The point is in the fourth and last foramen of the sacrum, so it is called xià liáo, lower sacral foramen.

BL 35 (Huì Yáng, 会阳)

Intersecting point of the foot taiyang channel and the du mai

Location. On the buttock 0.5 cun lateral to the extremity of the coccyx (Pic. 3-48).

Location method. With the subject prone or in the knee-chest position, BL 35 (huì yáng) is in the soft depression lateral to the extremity of the coccyx.

Actions. Clear heat, drain dampness, rectify qi, and raise yang.

Indications. Diarrhea, dysentery, hemorrhoids, bloody stool; impotence; abnormal vaginal discharge.

Manipulation. Needle perpendicularly 0.8~1.0 cun. Soreness and distention can be felt locally and extend to the perineum area. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. Needle laterally-superiorly. To avoid piercing the rectum, do not angle inward or medially-superiorly.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经). Huì means meeting point. Because the foot taiyang channel and the du mai meet at this point, which is directly opposite RN 1 (huì yīn), the point is called huì yán, converging yang.

Modern clinical observation and research. See BL 32 (cì liáo).

BL 36 (Chéng Fú, 承扶)

Location. On the buttock at the midpoint of the gluteal fold (Pic. 3-49).

Actions. Relax sinews, quicken collaterals, and regulate urine and stool.

Pic. 3-49 BL 36, BL 37, BL 38, BL 39 and BL 40

Pic. 3-49 BL 36, BL 37, BL 38, BL 39 and BL 40
Pic. 3-49 BL 36, BL 37, BL 38, BL 39 and BL 40

 

Indications. Low back, sacrum, hip, and thigh pain; lower limb paralysis; hemorrhoids.

Manipulation. Acupuncture: Insert perpendicularly 1.5~2.5 cun. Local soreness and distention can be felt, and a lightning-like sensation can reach the feet. Moxibustion: Use 5~9 cones or of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Chéng means to bear;  means to support. The point is at the midpoint of the transverse gluteal crease in the region that supports the upper body and holds the lower limbs, so it is called chéng fú, bearing and supporting.

BL 37 (Yīn Mén, 殷门)

Location. On the posterior aspect of the thigh between the biceps femoris and the semitendinosus muscles, 6 cun inferior to the gluteal fold (Pic. 3-49).

Location method. With the patient prone, the semitendinosus and the biceps femoris are more distinct when the knee is fexed against resistance. The two muscles can be found by rotating the hip internally and externally. The point is 1 cun above the midpoint of a line linking BL 36 (chéng fú) and BL 40 (wěi zhōng).

Actions. Relax sinews, quicken collaterals, and strengthen the lower back and legs.

Indications. Low back, sacrum, hip, and thigh pain; lower limb paralysis.

Manipulation. Needle perpendicularly 1.0~2.5 cun; a lighting-like sensation should reach the feet. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Yīn means abundance. The point is 6 cun below BL 36 (chéng fú) in a wide area flled with muscle. It is located where bladder qi goes in and out, so it is called yīn mén (abundance gate).

BL 38 (Fú Xì, 浮郄)

Location. On the posterior aspect of the knee just medial to the biceps femoris tendon, 1 cun proximal to the popliteal crease (Pic. 3-49).

Location method. With the knee slightly fexed, BL 38 (fú xì) is medial to the biceps femoris tendon, 1 cun proximal to BL 39 (wĕi yáng).

Actions. Unblock channels, quicken collaterals, relax sinews, and lubricate the joints.

Indications. Low back, sacrum, hip, and thigh pain; numbness and spasms of the popliteal fossa, lower limb paralysis.

Manipulation. Acupuncture: Needle perpendicularly 0.5~1.0 cun; soreness and distention will be felt at the local area, and an electric numbness can reach the medial aspect of the leg. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means foating;  means seam. The point is 1 cun above BL 39 (wěiyáng) at the cleft of the medial aspect of the biceps femoris tendon, so it is called fú xì, foating seam.

BL 39 (Wěi Yáng, 委阳)

Lower he-sea point of the sanjiao

Location. On the posterolateral aspect of the knee just medial to the biceps femoris tendon in the popliteal crease (Pic. 3-49).

Location method. With the patient’s knees slightly fexed to reveal the biceps femoris tendon, the point is 1 cun lateral to BL 40 (wěi zhōng).

Actions. Promote the sanjiao, relax sinews, and quicken collaterals.

Indications. Waist and back pain, lower limb spasms and stiffiness; abdominal pain, difficulty in urinating.

Manipulation. Needle perpendicularly 1.0~1.5 cun; soreness and distention will be felt locally and can spread to the thighs and lower limbs. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Precautions. Scarring moxibustion is prohibited.

Annotation. The point appeared in The Spiritual Pivot-The Zang-fu Diseases Caused byPathogenic Qi (Líng Shū-Xié Qì Zàng Fǔ Bìng Xíng, 灵枢·邪气脏腑病形). Wěi means crook. The point is lateral to BL 40 (wěi zhōng), so it is called wěi yáng.

BL 40 (Wěi Zhōng, 委中)

He-sea point, lower he-sea point of the bladder

Location. On the posterior aspect of the knee at the midpoint of the popliteal crease (Pic. 3-49).

Actions. Clear summerheat, cool blood, resolve toxins, awaken the brain, calm the mind, unblock sinews, and quicken collaterals.

Indications. Lumbar pain; coldness of hip and thigh; cold, wind, and damp arthralgia; hemiplegia, spasms of the popliteal tendons, weakness or paralysis of the lower limbs, other disorders of the running course; erysipelas, boils, furuncles, itching; abdominal pain, vomiting, diarrhea, other intestinal and stomach disorders.

Manipulation. Acupuncture: 1. Puncture perpendicularly 0.5~1.0 cun; local numbness, soreness and distention can be felt and can spread to the feet. 2. Bleed with a three-edged needle. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Precautions. To avoid bleeding, do not needle deeply. Scarring moxibustion is prohibited.

Annotation. The point appeared The Spiritual Pivot-Fundamental Points (Líng Shū-Běn Shū,灵枢·本输). Wěi means crook; zhōng means center. The point is at the midpoint of the transverse crease of the popliteal fossa when the knees are bent, so it is called wěi zhōng, center of the crook.

BL 41 (Fù Fēn, 附分)

Intersecting point of the hand taiyang and foot taiyang channels

Location. On the upper back at the level of the inferior border of the spinous process of the second thoracic vertebra and BL 12 (fēng mén), 3 cun lateral to the posterior median line (Pic. 3-50).

Pic. 3-50 BL 41, BL 42, BL 43 and BL 44
Pic. 3-50 BL 41, BL 42, BL 43 and BL 44

Actions. Dispel wind, unblock channels, and quicken collaterals.

Indications. Neck and back stiffiness and pain, neck spasms, elbow and arm numbness and pain, other bi syndromes.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun; local soreness and distention can be felt. Moxibustion: Use 3~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. It is important to pay attention to the thickness of the chest wall and the depth of needle insertion. Perpendicular needling will injure the lungs and is prohibited.

Annotation. The point appeared The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means add; fēn means separate. The point is 3 cun lateral to the posterior midline at the lower border of the spinous process of the second thoracic vertebra, so it is called fù fēn, attached branch.

BL 42 (Pò Hù, 魄户)

Location. On the upper back at the level of the inferior border of the spinous process of the third thoracic vertebra, BL 13 (fèi shū), and DU 12 (shēn zhù) and 3 cun lateral to the posterior median line (Pic. 3-50).

Actions. Supplement the lung, enrich yin, and direct counterflow downward.

Indications. Pulmonary tuberculosis, cough, asthma, other lung disorders; stiff neck, shoulder and back pain.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun; local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Lateral to BL 13 (fèi shù), it corresponds to the lung, which store the corporeal soul, so it is called pò hù, door of the corporeal soul.

BL 43 (Gāo Huāng, 膏肓)

Location. On the upper back at the level of the inferior border of the spinous process of the fourth thoracic vertebra and BL 14 (jué yīn shù), 3 cun lateral to the posterior median line (Pic. 3-50).

Actions. Supplement the lung and rectify lung qi.

Indications. Deficiency, chronic syndromes; pulmonary tuberculosis, cough, asthma, night sweats, amnesia, seminal emissions, undigested food in the stool.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention sometimes will spread to the shoulder. Moxibustion: Use 7~15 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 20~30 minutes. Medicinal or scarring moxibustion may be used.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经). Gāo means below the heart; huāng means above the diaphragm. The point is located between the heart and diaphragm and is mainly used to treat difficult and serious disorders; thus it is called gāo huāng, vital region shu.

BL 44 (Shén Táng, 神堂)

Location. On the upper back at the level of the inferior border of the spinous process of the fifth thoracic vertebra, BL 15 (xīn shù), and DU 11 (shén dào) and 3 cun lateral to the posterior median line (Pic. 3-50).

Actions. Calm the mind and heart, invigorate blood, and quicken collaterals.

Indications. See BL 15 (xīn shù).

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 5~9 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Lateral to BL 15 (xīn shù), it corresponds interiorly to the heart and is used mainly for heart disorders. The heart is the keeper of the spirit, so the point is called shén táng, spirit hall.

BL 45 (Yì Xǐ,)

Location. On the upper back at the level of the inferior border of the spinous process of the sixth thoracic vertebra, BL 16 (dū shù), and DU 10 (líng tái) and 3 cun lateral to the posterior median line (Pic. 3-51).

Pic. 3-51 BL 45, BL 46, BL 47, BL 48, BL 49 and BL 50
Pic. 3-51 BL 45, BL 46, BL 47, BL 48, BL 49 and BL 50

Actions. Relieve cough, panting, and stuffy orifices, and quicken collaterals.

Indications. Cough, asthma, febrile diseases with no sweating, nosebleed, dizziness, malaria; shoulder, back, and hypochondrial pain.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in Basic Questions-Treatise on Bone Cavity (Sù Wèn-Gǔ KōngLùn, 素问·骨空论). Yì xǐ means sigh. Patients will sigh if pressure is put on the point.

BL 46 (Gé Guān, 膈关)

Location. On the upper back at the level of the inferior border of the spinous process of the seventh thoracic vertebra, BL 17 (gé shù), and DU 9 (zhì yáng) and 3 cun lateral to the posterior median line (Pic. 3-51).

Location method. The point is 3 cun lateral to DU 9 (zhì yáng), which is level with the inferior angle of the scapula.

Actions. Rectify qi and relieve chest stuffiness, harmonize the stomach, and direct qi downward.

Indications. Poor appetite, vomiting, hiccups, belching, distress, other qi counterflow disorders; back stiffiness and pain.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). As one of the main points for treating disorders of the diaphragm, it is called gé guān, diaphragm gate.

BL 47 (Hún Mén, 魂门)

Location. On the upper back at the level of the inferior border of the spinous process of the ninth thoracic vertebra, BL 18 (gān shù), and DU 8 (jīn suō) and 3 cun lateral to the posterior median line (Pic. 3-51).

Actions. Soothe the liver, rectify qi, fortify the spleen, and harmonize the stomach.

Indications. Distending pain of chest and hypochondrium, poor appetite, vomiting, borborygmus, diarrhea, back pain.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun Local soreness and distention can be felt. Moxibustion: Use 5~7 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It corresponds to the liver, which stores the ethereal soul. Because it is mainly used to treat liver disorders, it is called hún mén, gate of the ethereal soul.

BL 48 (Yáng Gāng, 阳纲)

Location. On the upper back at the level of the inferior border of the spinous process of the tenth thoracic vertebra, BL 19 (dăn shù), and DU 7 (zhōng shū) and 3 cun lateral to the posterior median line (Pic. 3-51).

Actions. Clear heat, promote gallbladder function, harmonize the middle jiao, and resolve food stagnation.

Indications. Diarrhea, jaundice, abdominal pain, borborygmus, consumptive thirst.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经). Yáng is the yang of yin/yang; gāng means key link. The point corresponds to the gallbladder, which belongs to yang wood, the element of ascending yang qi, so it is called yáng gāng, key yang link.

BL 49 (Yì Shè, 意舍)

Location. On the upper back at the level of the inferior border of the spinous process of the 11th thoracic vertebra, BL 20 (pí shù), and DU 6 (jĭ zhōng) and 3 cun lateral to the posterior median line (Pic. 3-51).

Actions. Fortify the spleen, harmonize the stomach, clear heat, and drain dampness.

Indications. Abdominal distention, borborygmus, vomiting, poor appetite, other stomach and intestinal disorders.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 5~7 cones of cone moxibustion, or use a moxa stick for 10~15 minutes.

Precautions. When one takes a deep breath, the lungs descend toward the subpleural line. The point is below the lungs but above this line; care must be taken not to puncture the lungs. See BL 13 (fèi shù).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is lateral to BL 20 (pí shù) and corresponds interiorly to the spleen, which houses the intelligence. Therefore, it is called yì shè, the residence of refection.

BL 50 (Wèi Cāng, 胃仓)

Location. On the upper back at the level of the inferior border of the spinous process of the 12th thoracic vertebra and BL 21 (wèi shù), 3 cun lateral to the posterior median line (Pic. 3-51).

Actions. Fortify the spleen, harmonize the stomach, resolve accumulation and food stagnation.

Indications. Abdominal pain, food accumulation in infants and children, abdominal distension, other spleen and stomach disorders; edema; back and spine pain.

Manipulation. Acupuncture: Needle obliquely 0.5~0.8 cun. Local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 10~30 minutes.

Precautions. To avoid penetrating the quadratus lumborum muscle and damaging the kidney, do not needle perpendicularly or too deeply.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经). Wèi means stomach; cāng means storehouse. The point is lateral to BL 21 (wèi shù), the back-shu point of the stomach, and is called wèi cāng, stomach storehouse.

BL 51 (Huāng Mén, 肓门)

Location. In the lumbar region at the level of the inferior border of the spinous process of the first lumbar vertebra, BL 22 (sān jiāo shù), and DU 5 (xuán shū) and 3 cun lateral to the posterior median line (Pic. 3-52).

Actions. Regulate the stomach and intestines, dissolve food stagnation, and disperse masses.

Indications. Abdominal masses, abdominal pain, constipation, other stomach disorders; breast disorders.

Manipulation. Acupuncture: Needle obliquely 0.8~1.0 cun. Local soreness and distention can spread to the lower back. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~30 minutes.

Precautions. See BL 50 (wèi cāng).

Annotation. The point appeared in The SystematicClassic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经) and is where sanjiao qi enters and exits. Huāng means the region between the heart and the diaphragm. The sanjiao is the father of yang qi, which is stored between the heart and the diaphragm, so the point is called huāng mén, gate of the region between heart and diaphragm.

Pic. 3-52 BL 51, BL 52, BL 53 and BL 54
Pic. 3-52 BL 51, BL 52, BL 53 and BL 54

BL 52 (Zhì Shì, 志室)

Location. In the lumbar region at the level of the inferior border of the spinous process of the second lumbar vertebra, BL 23 (shèn shù), and DU 4 (mìng mén) and 3 cun lateral to the posterior median line (Pic. 3-52).

Actions. Supplement kidney essence, regulate menstruation, arrest vaginal discharge, relieve dampness and strangury, and strengthen the waist and knees.

Indications. Seminal emission, impotence, other kidney deficiency disorders; vaginal pain, edema, difficulty urinating; back and spine stiffiness and pain.

Manipulation. Acupuncture: 1. Needle perpendicularly 0.8~1.0 cun. 2. Needle transversely toward BL 23 (shèn shù) 2.0~3.0 cun. Local soreness and distention can spread to the hip. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Precautions. See BL 50 (wèi cāng).

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is where kidney qi is stored. Lateral to BL 23 (shèn shù), it is mainly for kidney disorders. It is called zhì shì, storehouse of the will.

BL 53 (Bāo Huāng, 胞肓)

Location. On the buttock at the level of the second posterior sacral foramen, BL 28 (páng guāngshù), and BL 32 (cì liáo) and 3 cun lateral to the median sacral crest (Pic. 3-52).

Actions. Supplement the kidney, strengthen the waist, relax sinews, and quicken collaterals.

Indications. Abdominal distension, borborygmus, constipation, other stomach and intestinal disorders; difficulty urinating; low back and spine pain.

Manipulation. Acupuncture: Needle perpendicularly 0.8~1.0 cun. Local soreness and distention can spread to the lower abdomen and hip. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Bāo means urinary bladder; huāng means membrane of the bladder. Lateral to BL 28 (páng guāng shù), the point is mainly for bladder disorders and is called bāo huāng, bladder membrane.

BL 54 (Zhì Biān, 秩边)

Location. On the buttock at the level of the fourth posterior sacral foramen and BL 30 (bái huánshù), 3 cun lateral to the median sacral crest (Pic. 3-52).

Actions. Relax sinews, quicken collaterals, strengthen the waist and legs, and regulate the lower jiao.

Indications. Lumbar and leg pain, lower limb atrophy or paralysis, hemorrhoids, constipation, difficulty urinating.

Manipulation. Acupuncture: 1. Needle perpendicularly 1.5~3.0 cun. Local soreness and distention can be felt, and an electric numbness can spread to the lower limbs. 2. Needle obliquely at an angle of 80 degrees toward the external genitalia, 2.5~4.0 cun. The sensation can spread to the lower abdomen and the external genitalia. 3. Needle 1.5~2.0 cun obliquely toward the anus at an angle of 70 degrees; the sensation can spread to the anus. 4. Needle obliquely toward GB 30 (huántiào); local soreness and distention can be felt. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). Zhì means in order; biān means edge. The foot taiyang channel points are arranged from the top to bottom in an orderly manner; this one is the last on the second line, so it is called zhì biān, edge of the order.

Modern clinical observation and research. In an RCT comparing acupuncture at ashi points as the main ones to routine needling at GB 30 (huán tiào), BL 54 (zhì biān), and GB 34 (yáng líng quán) for piriformis syndrome, 80 patients were equally divided into two groups. Effective rates were 92.5% in the ashi group compared to 82.5% for the routine acupuncture (P<0.01); immediate analgesia was 75% in the former compared to 52.5% in the latter (P<0.01); VAS scores decreased in both groups but with a significant difference between the groups (P<0.05).1

Pic. 3-53 BL 55, BL 56, BL 57, BL 58 and BL 59
Pic. 3-53 BL 55, BL 56, BL 57, BL 58 and BL 59

BL 55 (Hé Yáng, 合阳)

Location. On the posterior aspect of the leg between the lateral and medial heads of the gastrocnemius muscle, 2 cun distal to the popliteal crease (Pic. 3-53).

Location method. The point is 2 cun distal to BL 40 (wĕi zhōng) on a line connecting BL 40 and BL 57 (chéng shān).

Actions. Invigorate blood, regulate menstruation, relax sinews, quicken collaterals, and strengthen the waist and knees.

1 Chen RN, Chen YB. Clinical observation on therapeutic effect and instant analgestic effect of inhibitory-needling at ashi point as major point for treatment of piriformis syndrome. 抑制法针刺阿是穴为主治疗梨状肌综合征即时止痛及疗效观察. Chinese Acupuncture & Moxibustion. 2009; 29(7): 550-2.

Indications. Low back and spine pain, soreness, lower limb atrophy or paralysis; fooding and spotting, abnormal vaginal discharge.

Manipulation. Acupuncture: Needle perpendicularly 0.5~1.0 cun; local soreness and distention can be felt, and an electric numbness can spread downward to the sole. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means converge; yáng means lateral or back of the lower leg. The point is where the medial and lateral heads of the gastrocnemius muscle converge, so it is called héyáng, confuent yang.

BL 56 (Chéng Jīn, 承筋)

Location. On the posterior aspect of the leg between the two muscle bellies of the gastrocnemius muscle, 5 cun distal to the popliteal crease (Pic. 3-53).

Location method. The point is at the midpoint of a line connecting BL 55 (hé yáng) and BL 57 (chéng shān).

Action. Relax sinews, quicken collaterals, strengthen the waist and knees, and regulate the large intestine.

Indications. Lumbar and leg spasms and pain; hemorrhoids.

Manipulation. Acupuncture: Needle perpendicularly 0.5~1.0 cun; local soreness and distention can spread downward to the sole. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经) and is at the junction of the foot taiyang channel sinew, which governs sinew disorders. Chéng means sustain; jīn means sinews; hence the name chéng jīn, sustain the sinews.

BL 57 (Chéng Shān, 承山)

Location. On the posterior aspect of the leg where the calcaneal tendon connects with the two muscle bellies of the gastrocnemius muscle (Pic. 3-53).

Location method. With the foot fexed, the point is in the sharp-angled depression inferior to the belly of the gastrocnemius muscle where the heads of the gastrocnemius muscle separate in a lambda shape.

Actions. Relax sinews, quicken collaterals, and regulate the intestines.

Indications. Hemorrhoids, constipation, prolapse of rectum, depression, nosebleed, hernia, lumbar and leg pain and spasms.

Manipulation. Acupuncture: Needle perpendicularly 1.0~1.5 cun; local soreness and distention can spread to the popliteal fossa; an electric numbness can spread to the sole. Moxibustion: Use 5~7 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Annotation. The point appeared in The Spiritual Pivot-Wei Qi (Líng Shū-Wèi Qì, 灵枢·卫气). Chéng means meet; shān means mountain. Because it is in the depression below the bellies of the gastrocnemius muscle, which looks like the meeting of mountains, the point is called chéng shān, sustain the mountain.

Modern clinical observation and research. Patients (n=60) with painful hemorrhoids received 3~12 mA, 2/100 Hz, dense-disperse EA for 30 minutes at BL 57 (chéng shān) and DU 1 (cháng qiáng) once a day for fve days. Pain levels dramatically decreased after the second treatment.1

BL 58 (Fēi Yáng, 飞扬)

Luo-connecting point

Location. On the posterolateral aspect of the leg 7 cun above BL 60 (kūn lún) at the level of BL 57 (chéng shān) and between the inferior border of the lateral head of the gastrocnemius muscle and the calcaneal tendon (Pic. 3-53).

Location method. The point is 1 cun distal to BL 57 (chéng shān).

Action. Relax sinews, quicken collaterals, clear heat, and alleviate swelling.

Indications. Headache, dizziness, nosebleed, stiff neck, other neck disorders; lumbar and leg pain, knee and leg weakness, atrophy of the foot, wind arthralgia, beriberi, other low back and leg disorders; cold malaria, hemorrhoids, depression, manic psychosis.

Manipulation. Acupuncture: Needle perpendicularly 0.7~1.0 cun; local soreness and distention can spread downward. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. Deep needling can puncture the posterior tibial artery and vein.

Annotation. The point appeared in The Spiritual Pivot-Channels (Líng Shū-Jīng Mài, 灵枢·经脉). From BL 57 (chéng shān), the channel follows the medial border of the lateral head of the gastrocnemius muscle and turns obliquely toward the point, which was named fēi yáng, fying and lifting.

BL 59 (Fū Yáng, 跗阳)

Xi-cleft point of the yangqiao mai

Location. On the posterolateral aspect of the leg 3 cun above BL 60 (kūn lún) between the fbula and the calcaneal tendon (Pic. 3-53).

Actions. Unblock channels, quicken collaterals, clear heat, and dissipate wind.

Indications. Lumbar, sacrum, hip, thigh, and leg pain; soreness and heaviness of knee and leg; cholera; spasms; cold and damp beriberi; swelling and pain of the external malleolus; foot ulcers; heaviness of the head as if pressed by stones, dizziness, other disorders of the running course.

Manipulation. Acupuncture: Needle perpendicularly 0.5~1.0 cun; local soreness and distention can be felt and can spread to the heel. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means dorsum of the foot; yáng refers to the yang of yin/yang.

BL 60 (Kūn Lún, 昆仑)

Jing-river point

Location. On the posterolateral aspect of the ankle in the depression between the prominence of the lateral malleolus and the calcaneal tendon (Pic. 3-54).

Action. Relax sinews, quicken collaterals, clear head heat, and improve vision.

Indications. Headache, dizziness, eye pain, nosebleed, other head and facial disorders; stiff neck, lumbar and sacrum pain, heel swelling and pain, other disorders of the running course; epilepsy from fright, delayed labor, malaria.

1 Li N, He HB, Wang CW, Yang CM. Observation of the therapeutic effects of electroacupuncture at BL 57 (chéng shān) and DU 1 (cháng qiáng) for hemorrhoid pain电针承山、长强穴治疗痔疮疼痛疗效观察. Chinese Acupuncture & Moxibustion. 2008; 28(11): 792-4.

Manipulation. Acupuncture: 1. Needle perpendicularly 0.5~1.5 cun; when threading to KI 3 (tài ), local soreness and distention can spread downward to the toe. 2. Puncture obliquely upward 2.0~3.0 cun, penetrating BL 59 (fū yáng); local soreness and distention can spread downward to the heel or the toe. Moxibustion: Use 5~9 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 10~20 minutes.

Pic. 3-54 BL 60, BL 61, BL 62, BL 63, BL 64, BL 65, BL 66 and BL 67
Pic. 3-54 BL 60, BL 61, BL 62, BL 63, BL 64, BL 65, BL 66 and BL 67

Precautions. This point is prohibited in pregnant women, as is scarring moxibustion.

Annotation. The point appeared in The SpiritualPivot-Fundamental Points (Líng Shū-Běn Shū, 灵枢·本输) and is named for its location posterior to the prominence of the external malleolus. Kūn Lún is the name of a mountain in western China; the name is a metaphor comparing the malleolus to the mountain.

BL 61 (Pú Cān, 仆参)

Intersecting point of the foot taiyang channel and yangqiao mai

Location. On the lateral aspect of the foot distal to BL 60 (kūn lún) and lateral to the calcaneus at the border between the red and white fesh (Pic. 3-54).

Actions. Relax the the sinews and bones, strengthen the waist and leg.

Indications. Atrophy or paralysis in the lower limbs, heel pain, pain, leg spasms, beriberi, swelling of the knee; epilepsy.

Manipulation. Acupuncture: Needle perpendicularly 0.3~0.5 cun; local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (Zhēn Jiŭ Jiă Yĭ Jīng, 针灸甲乙经).  means a servant; cān means paying respect. In the ancient times, servants had to kneel when seeing the master, thus showing the heels and revealing this point. Therefore it is called pú cān, a servant’s respect.

BL 62 (Shēn Mài, 申脉)

Confuence point of the yangqiao mai; intersecting point of the foot taiyang channel and yangqiao mai

Location. On the lateral aspect of the foot directly inferior to the prominence of the lateral malleolus in the depression between the inferior border of the lateral malleolus and the calcaneus (Pic. 3-54).

Location method. The point is in the depression distal to the inferior border of the lateral malleolus. Medially, the corresponding point is KI 6 (zhào hăi).

Actions. Invigorate blood, rectify qi, and calm the mind and spirit.

Indications. Insomnia, depression, manic psychosis, epilepsy, stroke, unconsciousness, other brain disorders; headache, migraine, eye swelling and pain, dizziness, pain of supra-orbital bone, nosebleed, deviation of mouth and eyes, and other head, face, and fve sensory organ disorders; waist and leg pain, sore lower limbs and joints, heel swelling and pain, foot and leg coldness, inability to sit for long periods, stiff neck, hemiplegia, other disorders of the running course.

Manipulation. Acupuncture: Needle perpendicularly or slightly obliquely 0.2~0.3 cun; local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. Scarring moxibustion is prohibited.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is mainly used to treat disorders of the fascia and inability to move freely. Shēn means to extend; mài refers to the yangqiao mai. This point links the bladder channel to the yangqiao mai, so it is called shēn mài.

Modern clinical observation and research. In 78 insomnia patients, acupuncture at KI 6 (zhào hăi) and BL 62 (shēn mài) plus acupoints based on syndrome differentiation (n=40) was compared to routine acupuncture at acupoints based only on syndrome differentiation (n=38). Adding KI 6 and BL 62 improved insomnia treatment significantly as compared to routine acupuncture only (P<0.01).1

BL 63 (Jīn Mén, 金门)

Xi-cleft point

Location. On the dorsum of the foot distal to the anterior border of the lateral malleolus and posterior to the tuberosity of the fifth metatarsal bone in the depression inferior to the cuboid bone (Pic. 3-54).

Actions. Unblock channels, quicken collaterals, clear the brain, and calm the spirit.

Indications. Headache, toothache, other head and face disorders; epilepsy, infantile convulsions, syncope, other brain disorders; shoulder and back pain, sore low back and knees, lower limb pain, multiple arthralgia, wind arthralgia, ankle sprain, cholera, spasms, other disorders of the running course.

Manipulation. Acupuncture: Needle perpendicularly 0.3~0.5 cun; local soreness and distention can be felt and can spread to the back of the dorsum of the foot. Moxibustion: Use 3~5 cones of cone moxibustion, or use warming needle moxibustion for 20 minutes, or use a moxa stick for 5~10 minutes.

Precautions. Scarring moxibustion is prohibited.

Annotation. The point appeared in The Systematic Classic of Acupuncture and Moxibustion (ZhēnJiŭ Jiă Yĭ Jīng, 针灸甲乙经). It is the xi-cleft point of the bladder channel and the starting point of the yangwei maiJīn means metal as well as place where water goes out; mén means gate. Bladder channel qi connects with that of the foot shaoyin kidney channel here; metaphorically the point is like a cold and killing September wind accompanied by cold rain, so it was named jīn mén, killing cold and metal gate.

BL 64 (Jīng Gǔ, 京骨)

Yuan-source point

Location. On the lateral aspect of the foot distal to the tuberosity of the fifth metatarsal bone at the border between the red and white fesh (Pic. 3-54).

Location method. The tuberosity of the fifth metatarsal bone is approximately midway between the heel and the fifth metatarsophalangeal joint; the point is below it.

Actions. Clear heat and dissipate wind, calm the heart and spirit.

1 Wang SG. Clinical observation on acupuncture at KI 6 (zhào hăi) and BL 62 (shēn mài) for treatment of insomnia针刺照海申脉为主治疗不寐症临床观察. Chinese Acupuncture & Moxibustion. 2005; 25(11): 771-2.

Indications. Headache, dizziness, red eyes, nebula, nasal congestion, nosebleed, other head and eye disorders; coldness of the back, stiff spine; lumbar, hip, thigh, and lower limb pain; low back sprain, other back and waist disorders; hemiplegia, sore knee and leg, beriberi due to cold and dampness, foot ulcers, other lower limb disorders; mania and depression, epilepsy, other brain disorders; cardiac pain, abdominal distention, diarrhea, bloody stool, malaria.

Manipulation. Acupuncture: Needle perpendicularly 0.3~0.5 cun; local soreness and distention can spread to the soles of the feet. Moxibustion: Use 3~7 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. Scarring moxibustion is prohibited.

Annotation. The point appeared in The Spiritual Pivot-Fundamental Points (Líng Shū-Běn Shū,灵枢·本输). Because it is proximal to the large fifth metatarsal bone, originally called jīng gǔjīng meaning large, the point was named jīng gǔ, tuberosity of the fifth metatarsal bone.

BL 65 (Shù Gǔ, 束骨)

Shu-stream point

Location. On the lateral aspect of the foot in the depression proximal to the fifth metatarsophalangeal joint at the border between the red and white fesh (Pic. 3-54).

Action. Unblock channels, quicken collaterals, clear heat, and dissipate wind.

Indications. Headache, red eyes, deafiness, dizziness, other head and facial disorders; psychosis, epilepsy from fright, other brain disorders; stiff neck, lumbar and back pain, furuncle of the back, pain of the back of the lower limbs, other running course disorders.

Manipulation. Acupuncture: Needle perpendicularly 0.3~0.5 cun; local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or a moxa stick for 5~10 minutes.

Precautions. Scarring moxibustion method is prohibited.

Annotation. The point appeared in The Spiritual Pivot-Fundamental Points (Líng Shū-Běn Shū,灵枢·本输). Shù means constraint. This point is at the distal part of the fifth metatarsal bone, which has a constrained shape, so it was named shù gǔ, head of the fifth metatarsus.

BL 66 (Zú Tōng Gǔ, 足通谷)

Ying-spring point

Location. On the little toe in the depression distal and lateral to the fifth metatarsophalangeal joint at the border between the red and white fesh (Pic. 3-54).

Actions. Unblock channel qi, calm the spirit, and improve intelligence.

Indications. Headache, stiff neck, dizziness, nosebleed, other head and neck disorders; depression and manic psychosis; knee pain; fever without sweat, asthma, cough, fullness of the chest.

Manipulation. Acupuncture: Needle perpendicularly 0.2~0.3 cun; local soreness and distention can be felt. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 5~10 minutes.

Precautions. Scarring moxibustion is prohibited.

Annotation. The point appeared in The Spiritual Pivot-Fundamental Points (Líng Shū-BěnShū, 灵枢·本输). Tōng means free-flowing channel qi;  means valley. Qi passes through a metaphorical valley near a yin channel here, so the point is called zú tōng gǔ, foot passing a valley.

BL 67 (Zhì Yīn, 至阴)

Jing-well point

Location. On the little toe lateral to the distal phalanx, 0.1 cun proximal to the lateral corner of the toenail at the intersection of a vertical line along the side of the nail and a horizontal line along its base (Pic. 3-54).

Actions. Invigorate blood, rectify qi, normalize fetal malposition, hasten delivery, clear head heat, and improve vision.

Indications. Headache, nasal congestion, nosebleed, eye pain, other head and facial disorders; retention of the placenta, fetal malposition, difficult delivery, other disorders of child birth; heat sensation on the sole of the foot.

Manipulation. Acupuncture: 1. Needle shallowly 0.1~0.2 cun; local soreness and distention can be felt. 2. Swiftly prick with a three-edged needle to bleed. Moxibustion: Use 3~5 cones of cone moxibustion, or use a moxa stick for 10~20 minutes.

Annotation. The point first appeared in The Spiritual Pivot-Fundamental Points (Líng Shū-BěnShū, 灵枢·本输). Zhì means extreme; yīn means foot shaoyin. It is at the side of the little toenail, where the foot taiyang channel qi flows into the foot shaoyin kidney channel.