BL18

Ganshu

Star

肝俞 (Gānshū) — Liver Shu

Bladder channel · point 18

Not yet clinically reviewed

Back-Shu point of the Liver

Traditionally used for

Dizziness
Eye health
Menstrual & women's health
Mood & calm
Liver & jaundice

Cautions & contraindications

No deep needling

Location

On the back, 1.5 cun lateral to the lower border of the spinous process of T9.

How to locate: With the patient prone, find T7 level with the inferior angle of the scapula and count down two spinous processes to T9; the point is 1.5 cun lateral to the lower edge of that process.

Regional anatomy: Skin and subcutaneous tissue, then latissimus dorsi and erector spinae; the pleura and lung lie beneath, so deep needling risks pneumothorax.

Distances are in cun, a proportional unit — how to measure.

Body map, back: BL18 · Upper back — Fig. — BL18 · Upper back After Albinus, 1747

The vertebral column — Gray's Anatomy plate — The vertebral column Gray's Anatomy, 1918

3D view

Drag, or focus the model and use the arrow keys, to rotate; + and − to zoom; 0 to reset; Esc to close.

Skin Skeleton

Needle diagram for the marked point — a schematic section through the skin, not the model.

Technique 1: Oblique (45° to the skin), 0.5–1 cun Direction (source's words): “towards the spine” Scale: 1 cun as WHO 2008 defines it here — Between the bilateral medial borders of the scapula: 6 B-cun; this scale is half of the 6 B-cun between the two medial borders (posterior midline to one border), 3 B-cun. Deadman gives depth in cun, conventionally the patient's own finger-cun. It is drawn here to this region's proportional (B-)cun, so the bar approximates an approximation. Not a depth in millimetres.

Technique 2: Transverse-oblique (about 20° to the skin), 1–1.5 cun Scale: 1 cun as WHO 2008 defines it here — Between the bilateral medial borders of the scapula: 6 B-cun; this scale is half of the 6 B-cun between the two medial borders (posterior midline to one border), 3 B-cun. Deadman gives depth in cun, conventionally the patient's own finger-cun. It is drawn here to this region's proportional (B-)cun, so the bar approximates an approximation. Not a depth in millimetres.

3D anatomy: BodyParts3D, © The Database Center for Life Science licensed under CC Attribution 4.0 International (licence). Subset, simplified and recoloured by Verscienta — changes and licence details.

Approximate placement, carried over from our 2D body map onto a single adult male model (BodyParts3D) and checked against the point's location text. Shown on one side of the body. Locate the point on your patient by the location text and palpation, not by this model.

Cun on this part of the body: Between the bilateral medial borders of the scapula: 6 B-cun; this scale is half of the 6 B-cun between the two medial borders (posterior midline to one border), 3 B-cun (WHO 2008, General Guidelines, Proportional Bone (Skeletal) Measurements, p. 12).
Needle angle and depth: Oblique (45° to the skin), 0.5–1 cun, towards the spine. Deadman P, Al-Khafaji M, Baker K, p. 275
Transverse-oblique (about 20° to the skin), 1–1.5 cun. Deadman P, Al-Khafaji M, Baker K, p. 275

The lung is not drawn: the anatomical model used here does not include it as a surface. This is a limit of the model, not of the anatomy. The pneumothorax risk above still applies.

Needling

Cited needling

⚠ Pneumothorax

Techniques — the source gives these as alternatives:

Oblique insertion — towards the spine

Depth 0.5–1 cun

skindeeper
Transverse-oblique insertion

Depth 1–1.5 cun

skindeeper

Case reports: pneumothorax after needling at this point (1 case in Wu et al. 2015).

Depths describe average adult habitus in the cited population, never a single safe number for the patient in front of you. Palpate and adjust.

Sources (2)

Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S. Systematic review of adverse effects: a further step towards modernization of acupuncture in China. Evid Based Complement Alternat Med. 2015;2015:432467 — Table 1 (Pneumothorax associated with acupuncture) Supports: pneumothorax (case report)
Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 275 Supports: techniques (names this point)

Site notes · not cited

No deep needling

Depth: 0.5–0.8 cun

Angle: Oblique, directed medially

⚠ Cautions: Pneumothorax risk on deep perpendicular insertion.

Functions

Spreads Liver qi and relieves constraint
Nourishes Liver blood and benefits the eyes
Clears Liver heat and damp-heat
Extinguishes wind
Benefits the sinews

Indications

Hypochondriac pain and irritabilitydepression and emotional constraintred, dry or painful eyes and blurred visiondizzinessjaundiceirregular menstruationnight blindnessmuscle cramps and spasms

Combinations Using This Point

Ganshu and Mingmen

BL18 with GV4 — strengthens yang, supports essence and original qi and tonifies the Kidney, with the Liver's link to the eyes.

Jinsuo and Ganshu

GV8 with BL18 at the T9 level — soothes the Liver, strengthens yang, regulates qi and settles spasm and the spirit.

Sources

World Health Organization. WHO Standard Acupuncture Point Locations in the Western Pacific Region. Manila: WHO Regional Office for the Western Pacific, 2008. (Location.)
Focks C, ed. Atlas of Acupuncture. Edinburgh: Churchill Livingstone Elsevier, 2008. (Locating method and actions.)

📝 Notes

Public notes from the community and your own private notes on BL18 Ganshu.

No notes yet.

Back to Points