Verscienta
GV9

Zhiyang

Star

至陽 (Zhìyáng) — Extremity of Yang

Du (Governing) channel · point 9

Not yet clinically reviewed

Traditionally used for

  • Cough & breathing
  • Heart & circulation
  • Liver & jaundice

Location

On the back, on the posterior midline, in the depression below the spinous process of T7.

How to locate: With the patient prone and the arms at the sides, the spinous process of T7 lies level with the inferior angles of the scapulae; the point is in the depression just below it, level with BL17.

Regional anatomy: Beneath the skin and subcutaneous tissue the needle passes through the supraspinous and interspinous ligaments toward the ligamentum flavum; the spinal canal and cord lie beyond it.

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

Body map, back: GV9 · Upper back
Fig. — GV9 · Upper back After Albinus, 1747
Body map, back: GV9 · Upper back

GV9 · Upper back · Albinus, Tabulae sceleti et musculorum, 1747

The vertebral column — Gray's Anatomy plate Needling hazard — see Needling safety
The vertebral column Gray's Anatomy, 1918
The vertebral column — Gray's Anatomy plate Needling hazard — see Needling safety

The vertebral column · Gray's Anatomy, 1918

3D view

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
  1. Oblique (45° to the skin), 0.5–1 cun, superior. Deadman P, Al-Khafaji M, Baker K, p. 541
  • The spinal cord 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 spinal cord / medulla risk above still applies.

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.

Needling

Cited needling

  • ⚠ Spinal cord / medulla
  1. Oblique insertion — superior
    Depth 0.5–1 cun
    skindeeper
Reported mean safe needling depth, mm — Taiwanese adults (CT)
UnderweightNormalOverweight
Men 34.7 42.0 48.6
Women 33.7 38.6 49.0

CT-measured mean safe needling depths from Taiwanese adults, by sex and body size (Lin et al. 2013); population-specific and a guide only — adjust to the patient in front of you.

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)
  1. Lin JG, Chou PC, Chu HY. An exploration of the needling depth in acupuncture: the safe needling depth and the needling depth of clinical efficacy. Evid Based Complement Alternat Med. 2013;2013:740508 — Tables 9 (male) and 10 (female), back acupoints Supports: safe depth (measured)
  2. World Health Organization. Guidelines on basic training and safety in acupuncture. Geneva: WHO; 1999. WHO/EDM/TRM/99.1 — Section II §5.2 (Central nervous system), p. 25 Supports: spinal cord / medulla (names this region)
  3. Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 541 Supports: techniques (names this point)

Site notes · not cited

Depth: 0.5–1.0 cun
Angle: Oblique, directed superiorly

Functions

  • Clears damp-heat from the middle burner and resolves jaundice
  • Strengthens the Spleen and resolves dampness
  • Regulates the diaphragm, unbinds the chest and harmonises the upper burner
  • Strengthens the back

Indications

Jaundice and hepatitischest and hypochondriac paincough and asthmaback stiffness and paincardiac pain

Clinical Notes

A well-known point for angina and for jaundice; strong pressure here is a traditional first-aid measure in cardiac pain.

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

Danshu how are these connected? (Danshu) Qimen how are these connected? (Qimen) Riyue how are these connected? (Riyue) Yanglingquan how are these connected? (Yanglingquan)

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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