Geshu and Danshu
Star膈俞、膽俞 (Géshū, Dǎnshū)
Modern Chinese point-pair (对穴) teaching, as compiled by Guo Changqing and colleagues at the School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine.
Points
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Back-Shu point of the diaphragm and Hui-Meeting point of blood; invigorates blood and descends rebellious qi.
Prone. 1.5 cun lateral to GV9, at the lower border of the T7 spinous process and level with the lower angle of the scapula. Angle the needle medially towards the spine, 0.5–0.8 cun deep, through the subcutaneous tissue into serratus posterior inferior and the erector spinae (sacrospinalis). An aching numbness should run out along the intercostal space. Keep the insertion shallow: deep needling risks pneumothorax.
- ⚠ Pneumothorax
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Back-Shu point of the Gallbladder; clears the Liver and Gallbladder and regulates the Shao Yang.
Prone. 1.5 cun lateral to the lower border of the T10 spinous process. Angle the needle medially towards the spine, 0.5–0.8 cun deep, through the subcutaneous tissue into latissimus dorsi and the erector spinae (sacrospinalis). An aching numbness should run out along the intercostal space. Keep the insertion shallow: deep needling risks pneumothorax.
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
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BL17 Geshu
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⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. World Health Organization 1999, Section II §5.2 (Lung and pleura), p. 25
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No cited needling data yet for BL19. No flag here does not mean no risk.
Treatment Principle
Regulate qi and send rebellious qi downwards, invigorate the blood and free the collaterals, soothe the Liver and regulate the Gallbladder.
Indications
Method
Patient prone. Both points are needled bilaterally, angled medially towards the spine to 0.5–0.8 cun, until an aching numbness spreads along the intercostal spaces. In the classical Four Flowers tradition the four points are treated with moxibustion.
⚠ Cautions
All four points overlie the lung: deep or perpendicular insertion risks pneumothorax, and the source warns against deep insertion at both. Direct moxibustion leaves scars and needs the patient's informed consent.
About
Two Back-Shu points of the mid back, needled on both sides to make four points. The book gives this pairing a function heading — regulating and descending qi, invigorating blood and the collaterals, soothing the Liver and regulating the Gallbladder — but no list of conditions. The same four points are the classical Four Flowers (四花) moxibustion set of the Tang-dynasty physician Cui Zhidi, which later authors located at bilateral BL17 and BL19.
Rationale
BL17 is the Back-Shu point of the diaphragm and the Hui-Meeting point of blood; BL19 is the Back-Shu point of the Gallbladder. Paired, they join blood with the Liver–Gallbladder axis, which fits the book's emphasis on moving blood and qi and regulating the Liver and Gallbladder. In the Four Flowers tradition the same four points are used to nourish blood and yin in wasting, feverish consumptive disease.
Clinical Notes
The indications listed here are not from Guo; they are the standard textbook uses of the classical Four Flowers moxibustion set and have been supplied so that the record is usable. For conditions matching the book's own function heading, such as hiccup or hypochondriac pain, the individual actions of BL17 (descends rebellious qi) and BL19 (clears the Liver and Gallbladder) are the guide.
Sources
- Guo Changqing (ed.). Acupuncture of Acupoint Combinations: Quick Lookups. Daylesford: Heart Space Publications, 2020 (English edition; © China Science and Technology Press). ISBN 978-0-6489215-5-4. Chapter 3, combination 12.
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