BL32

Ciliao

Star

次髎 (Cìliáo) — Second Bone-Hole

Bladder channel · point 32

Not yet clinically reviewed

Ba Liao (Eight Bone-Holes) group

Traditionally used for

Urinary & fluids
Menstrual & women's health
Fertility & vitality
Pain & joints

Location

On the sacrum, in the second posterior sacral foramen, in the depression midway between the posterior superior iliac spine and the spinous process of S2.

How to locate: With the patient prone, find the posterior superior iliac spine; the point is in the depression of the second posterior sacral foramen, midway between the iliac spine and the S2 spinous tubercle. To confirm, rest the little finger on the fourth posterior sacral foramen, usually level with the top of the gluteal cleft (and with the sacral hiatus), then lay the ring, middle and index fingers upwards in a slight V over the depressions of the other foramina; the middle finger falls on the second foramen.

Regional anatomy: Skin and subcutaneous tissue, then the tendinous sacral origin of erector spinae, with the needle entering the second posterior sacral foramen.

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

Body map, back: BL32 · Sacrum — Fig. — BL32 · Sacrum After Albinus, 1747

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

3D view

3D view not available for this point: its position on the 3D model couldn't be checked against its location text, so it is not shown. The 2D maps above show it.

Needling

Cited needling

Pregnancy: contraindicated

Techniques — the source gives these as alternatives:

Perpendicular insertion

Depth 0.5–1 cun

skindeeper
Perpendicular insertion — through the foramen

Depth 1.5–2 cun

skindeeper

Needling through the foramen is easier with a slightly oblique medial and inferior insertion.

Traditionally forbidden in pregnancy (at least before 37 weeks). Carr (2015) reviewed the trials and found no objective evidence of harm from needling these points; the prohibition is traditional, not evidence-based.

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 (3)

Carr DJ. The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med. 2015;33(5):413-419 — Identifying sources of concern and relevant outcomes Supports: pregnancy (names this point)
World Health Organization. Guidelines on basic training and safety in acupuncture. Geneva: WHO; 1999. WHO/EDM/TRM/99.1 — Section II §2.1 (Pregnancy), p. 20 Supports: pregnancy (names this region)
Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 293 Supports: techniques (names this point)

Site notes · not cited

Depth: 1.0–1.5 cun

Angle: Perpendicular into the foramen

Functions

Regulates the uterus and menstruation
Regulates the lower burner and promotes urination
Clears damp-heat from the lower burner
Strengthens the Kidneys and the essence
Promotes labour
Strengthens the lumbosacral region and relieves sciatica

Indications

Dysmenorrhoea and irregular menstruationinfertilitydifficult labour — used to promote and regulate contractionsvaginal dischargeimpotence and seminal emissiondifficult urinationlumbosacral pain and sciatica

Clinical Notes

The most-used of the eight sacral foramen points, and the principal point for period pain and for labour. Moxibustion here is a standard obstetric technique.

Combinations Using This Point

Ciliao and Baohuang

BL32 with BL53 at the level of the second sacral foramen — supports original qi, clears damp-heat and frees the channel.

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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