BL20

Pishu

Star

脾俞 (Píshū) — Spleen Shu

Bladder channel · point 20

Not yet clinically reviewed

Back-Shu point of the Spleen

Traditionally used for

Digestion
Urinary & fluids
Menstrual & women's health
Energy & fatigue
Liver & jaundice

Cautions & contraindications

No deep needling

Location

On the back, 1.5 cun lateral to the lower border of the spinous process of T11.

How to locate: With the patient prone, trace the twelfth rib back to T12 and count up one spinous process to T11 (or down four from T7 at the inferior angle of the scapula); the point is 1.5 cun lateral to the lower edge of the T11 process.

Regional anatomy: Skin and subcutaneous tissue, then latissimus dorsi, serratus posterior inferior and erector spinae; the lower edge of the pleura still reaches this level, so the needle is kept shallow and angled toward the spine.

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

Body map, back: BL20 · Upper back — Fig. — BL20 · Upper back After Albinus, 1747

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

Needling

Cited needling

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

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 (1)

Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 278 Supports: techniques (names this point)

Site notes · not cited

No deep needling

Depth: 0.5–0.8 cun

Angle: Oblique, directed medially

Moxibustion: Moxibustion at BL20 with BL21 is the classical treatment for chronic Spleen yang deficiency with cold and loose stools.

⚠ Cautions: Pneumothorax risk on deep perpendicular insertion.

Functions

Tonifies Spleen qi and yang and resolves dampness
Nourishes blood and controls the blood
Raises the yang and lifts prolapse
Harmonises the middle burner

Indications

Poor appetite, abdominal distension and loose stoolschronic fatigue and weakness of the limbsoedema and heavinessblood in the stool and uterine bleedingprolapse of the uterus or rectumjaundiceanaemia

Combinations Using This Point

Pishu, Weishu and Zhiyang

BL20, BL21 and GV9 on the mid and lower back — strengthens the Spleen, settles the Stomach, resolves dampness and aids digestion.

Similar Points

Ranked by shared patterns and conditions

Zusanli how are these connected? Zhongwan how are these connected? Sanyinjiao how are these connected? Qihai how are these connected? Taibai how are these connected? Guanyuan how are these connected?

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.)

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