Pishu, Weishu and Zhiyang
Star脾俞、胃俞、至陽 (Píshū, Wèishū, Zhìyáng)
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 Spleen; strengthens the Spleen and resolves dampness.
Prone. 1.5 cun lateral to the lower border of the T11 spinous process. 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. The lung lies beneath — keep the insertion shallow.
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Back-Shu point of the Stomach; harmonises the Stomach and resolves food stagnation.
Prone. 1.5 cun lateral to the lower border of the T12 spinous process. Insert 0.5–0.8 cun, angled obliquely towards the spine (the source gives a perpendicular insertion; the oblique angle is used here because the pleural recess reaches this level), through the subcutaneous tissue into serratus posterior inferior and the erector spinae. The aching numbness should spread through to the abdomen.
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Du Mai point below T7; unbinds the chest, regulates the diaphragm and resolves damp-heat jaundice.
Prone with the arms at the sides; the point is level with the lower angles of the scapulae, in the hollow below the T7 spinous process. Insert 0.5–1.0 cun, straight in or obliquely (an upward oblique angle is standard). The needle crosses the subcutaneous tissue, the supraspinous and interspinous ligaments and reaches the ligamentum flavum (interarcuate ligament); the spinal canal lies immediately beyond, so that ligament marks the limit of insertion. An aching numbness should spread across the back and into the chest. Do not go deeper than stated, to protect the spinal cord.
- ⚠ Spinal cord / medulla
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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GV9 Zhiyang
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⚠ Spinal cord / medulla risk: deep or misdirected insertion can enter the spinal canal. World Health Organization 1999, Section II §5.2 (Central nervous system), p. 25
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No cited needling data yet for BL20, BL21. No flag here does not mean no risk.
Treatment Principle
Strengthen the Spleen and harmonise the Stomach, resolve dampness and promote digestion.
Indications
Method
Patient prone. BL20 is angled medially towards the spine to 0.5–0.8 cun until the sensation runs along the intercostal space; BL21 is needled 0.5–0.8 cun until it reaches the abdomen; GV9 is needled 0.5–1.0 cun until an aching numbness spreads over the back and chest.
⚠ Cautions
BL20 and BL21 overlie the lower lung and pleural recess: deep or perpendicular needling risks pneumothorax. At GV9 the spinal cord lies beneath — keep within the stated depth; the source warns against deep insertion there.
About
A back-of-the-body treatment for Spleen and Stomach disorders, used to strengthen the Spleen, settle the Stomach, resolve dampness and move food. Besides bloating, loose stools, dysentery, stomach pain, vomiting and undigested food in the stool, it reaches damp-heat jaundice, pain in the chest and flanks and low back pain.
Rationale
BL20 and BL21 are the Back-Shu points of the Spleen and Stomach, lying side by side at T11 and T12. GV9 on the Du Mai, level with the lower angles of the scapulae, regulates the diaphragm, unbinds the chest and clears damp-heat to resolve jaundice, which extends the combination from the digestive organs to the chest, flanks and Gallbladder picture.
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 11.
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