BL34

Xialiao

Star

下髎 (Xiàliáo) — Lower Bone-Hole

Bladder channel · point 34

Not yet clinically reviewed

Ba Liao (Eight Bone-Holes) group

Traditionally used for

Digestion
Bowel health
Urinary & fluids

Location

On the sacrum, in the fourth posterior sacral foramen, level with the sacral hiatus.

How to locate: With the patient prone, 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 point is under the little finger, in the fourth foramen, level with the sacral hiatus and the second depression below BL32.

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

Body map, back: BL34 · Sacrum — Fig. — BL34 · 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. 295 Supports: techniques (names this point)

Site notes · not cited

Depth: 1.0–1.5 cun

Angle: Perpendicular into the foramen

Functions

Regulates the lower burner and the intestines
Promotes urination and benefits the genitals
Strengthens the Kidneys and the essence
Benefits the anus and the lumbosacral region

Indications

Lower abdominal painconstipation and blood in the stoolhaemorrhoidsdifficult urinationlumbosacral pain

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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