L. Intestine CONTENTS CONTENTS CONTENTS CONTENTS CONTENTS CONTENTS Stomach Bladder Channel Spleen Heart S.

Intestine GANSHU BL-18

General Index Indications Index Point Names Index Glossary Points Index General General General Index Index Index Indications Indications Indications Index Index Index Point Point Point Names Names Names Index Index Index Glossary Glossary Glossary Points Points Points Index Index Index Index Index Names Index Points Index General Index Indications Indications Index Point Point Names Index Glossary Glossary Points Index General Previous Point Next Point Combinations Index Previous Previous Previous Point Point Point Next Next Next Point Point Point Combinations Combinations Combinations Index Index Index 1 See Notes Previous Point Point Combinations Index Previous Point Next Next Point Combinations Index

INDICATIONS

LiverBladder Shu Kidney Back-Shu point of the Liver Pericardium

Gall Bladder 1.5 cun lateral to the lower border of the spinous process Liver of the ninth thoracic vertebra (T9). Conception Governing Extra Points
1.5 cun

Distention and pain of the lateral costal region, epigastric pain, abdominal (ji ju) masses, focal distention, hypogastric fullness and pain, lower abdominal pain, abdominal cramps, shan disorder. Fullness of the chest, cough with chest pain, cough with fullness of the lateral costal region and inability to catch the breath, shortness of breath, jaundice, dry mouth. Much anger, mania-depression, epilepsy. Coughing blood, spitting blood, vomiting blood, nosebleed. Blurred vision, redness of the eyes, night blindness, excessive lacrimation, redness pain and itching of the inner canthus, superficial visual obstruction, upward staring eyes, dizziness, visual dizziness, pain of the nose, pain of the supraorbital region. Rigidity of the neck and spine, pain of the spine, lumbar pain, pain of the neck and shoulders, lockjaw, opisthotonos, cramps, pain of the sinews, tetany.
COMMENTARY

Jinsuo DU-8
lower border of T9

Ganshu BL-18

LOCATION NOTE

Locate at the visible highest point of the paraspinal muscles.

Oblique insertion towards the spine, 0.5 to 1 cun, or transverse-oblique insertion 1 to 1.5 cun. Caution: perpendicular needling or oblique needling away from the spine carries a substantial risk of causing a pneumothorax.
ACTIONS

Spreads Liver qi Regulates and nourishes Liver blood Pacifies wind Cools fire and clears damp-heat Benefits the eyes and sinews

Ganshu BL-18 is the back-shu point of the Liver, where the qi of the Liver emanates from the interior to the body surface, and like all the back-shu points (especially those of the yin zang) Ganshu BL-18 has a strong action on regulating and tonifying its corresponding zangfu at the deepest level. The principal functions of the Liver are to maintain the free flow of qi, store blood, dominate the sinews and open into the eyes. By spreading Liver qi, nourishing and cooling Liver blood, clearing damp-heat and pacifying wind, Ganshu BL-18 is able to regulate all these aspects of the Liver function. According to Master Dan-xi of the Jin-Yuan dynasty The Liver governs spreading. This refers to the Liver's function of ensuring the free and easy flow of qi throughout the body and assisting the normal qi movement of all the zangfu, for example the descending of the Lung and Stomach qi and the ascending of the Spleen qi. Stagnation of Liver qi is considered the pre-eminent pathological pattern of the Liver since it is frequently the starting point of other Liver patterns (for example the transformation of Liver qi into fire) and it commonly accompanies any other pattern of Liver disharmony. The ability of Ganshu BL-18 to promote the free flow of Liver qi is reflected in various ways. Stagnant qi in the upper, middle or lower jiao may give rise to distention and pain of the chest, lateral costal region, epigastrium and hypogastrium as well as to shan disorder. According to the Spiritual Pivot20 with anger the qi rebels upwards and accumulates in the chest. If Liver qi or Liver fire invade the Lung there will be cough with chest pain, coughing of blood, cough with fullness of the

L. Intestine CONTENTS CONTENTS CONTENTS CONTENTS CONTENTS CONTENTS CONTENTS Stomach 2 Spleen Heart

Index Indications Index Point Names Index Glossary Points Index General General General Index Index Index Indications Indications Indications Index Index Index Point Point Point Names Names Names Index Index Index Glossary Glossary Glossary Points Points Points Index Index IndexGeneral General Index Indications Index Point Names Index Glossary General Index Indications Index Point Names Index Glossary Points Index Points Index General Index Indications Index Point Names Index Glossary Points Index Previous Point Next Point Combinations Index Previous Previous Previous Point Point Point Next Next Next Point Point Point Channel Combinations Combinations Combinations Index Index Index Previous Point Next Point Previous Point Next Point Combinations Index Combinations Index Previous Point Next Point Combinations Index Bladder See Notes

S. Intestine lateral costal region and inability to catch the breath, or Bladder shortness of breath. According to Correcting Errors in Kidney Medicine by Wang Qing-ren of the Qing dynasty qi is without form and thus unable to congeal into masses; the Pericardium development Sanjiao of masses requires form in the shape of blood. If stagnation of qi leads to blood stasis, therefore, Gall Bladder there will be abdominal masses. If Liver qi stagnation Liverthe function of the Gall Bladder in secreting bile inhibits Conception there will be damp-heat of the Liver and Gall Bladder and consequent jaundice. According to the Spiritual Pivot21 Governing The Liver stores blood, the blood is the residence of the Extra Points ethereal soul (hun); when Liver qi is deficient there is fear, when excess there is anger. If stagnation of qi is pronounced, and especially if it transforms to fire, there will be emotional manifestations such as anger, mania-depression, and even epilepsy. The increasing pressure of prolonged qi stagnation may easily transform to fire. According to the Essential Questions22 Anger will cause the qi to surge upwards; if it is extreme there is vomiting of blood. Since the Liver stores the blood, the heat of Liver fire or Liver yang may easily transmit to the blood and, given the tendency of the Liver qi to rise excessively, cause reckless upward movement of blood leading to symptoms such as vomiting blood, nosebleed, and spitting and coughing blood. When Liver blood or Liver yin are insufficient, they will be unable to nourish and moisten those regions of the body dominated by the Liver and irrigated by Liver blood, principally the eyes and the sinews. It is a special property of the back-shu points of the zang that they nourish and regulate their corresponding sense organs. According to the Spiritual Pivot23 Liver qi opens into the eyes; when the Liver is in harmony, the eyes are able to distinguish the five colours, whilst the Essential Questions24 says The Liver receives blood so there is sight. Insufficiency of Liver blood or Liver yin may lead to disorders such as blurred vision, night blindness, lacrimation and dizziness. If heat from Liver fire or Liver yang rises to disrupt the eyes, there will be redness, itching and pain. If Liver fire leads to the stirring of wind, there will be upward staring of the eyes. The Investigation into Points Along the Channels therefore states that Ganshu BL-18 is indicated for all diseases of the eyes pertaining to the Liver. According to the Essential Questions The Liver dominates the sinews of the entire body25, and When a person sleeps the blood returns to the Liver26. If Liver blood or Liver yin fail to nourish the sinews and thus maintain their softness and flexibility, there may be chronic stiffness and contraction, cramps or pain of the sinews. These symptoms may be especially pronounced both when the body is exhausted and the blood is less effective at nourishing, or during or following sleep or inactivity

when the blood returns to the Liver and less is available to circulate throughout the body. This kind of stiffness, contraction, cramping or pain will be even more pronounced when there is concurrent stagnation of Liver qi, or when deficiency of yin or blood leads to stirring up of Liver wind. According to sayings of Chinese medicine The Liver governs uprising and Anger makes the Liver qi rise to the neck and shoulders. Stagnation of Liver qi or uprising of Liver yang therefore easily lead to stiffness and pain of the neck and shoulders. If Liver fire or high fever consume Liver yin and generate wind there may be such acute spasmodic symptoms as opisthotonos, lockjaw, rigidity of the neck and spine and tetany. Ganshu BL-18 is indicated for all of these symptoms. Finally the Illustrated Supplement to the Classic of Categories states that Ganshu BL-18 is one of five points (Feishu BL-13, Xinshu BL-15, Ganshu BL-18, Pishu BL-20 and Shenshu BL-23) which drain heat from the five zang.
COMBINATIONS

Fullness of the hypogastrium: Ganshu BL-18 and Baohuang BL-53 (Thousand Ducat Formulas). Acute pain of both lateral costal regions: Ganshu BL-18, Pishu BL-20 and Zhishi BL-52 (Thousand Ducat Formulas). Coughing and spitting blood: Ganshu BL-18, Quepen ST-12, Xinshu BL-15, Juque REN-14 and Jiuwei REN-15 (Supplementing Life). Vomiting blood and spontaneous external bleeding: Ganshu BL-18, Yinbai SP-1, Pishu BL-20 and Shangwan REN-13 (Great Compendium). Liver blood deficiency with cloudy vision: reinforce Ganshu BL-18 and reduce Zusanli ST-36 (Song of the Jade Dragon). Superficial visual obstruction: Ganshu BL-18 and Toulinqi GB-15 (Great Compendium). Somnolence: Ganshu BL-18, Taixi KID-3, Zhaohai KID-6, Baihui DU-20, Tianjing GB-21, Erjian L.I.-2, Sanjian L.I.-3 and Lidui ST-45 (Great Compendium). Cold abdominal shan disorder: Ganshu BL-18, Yinshi ST-33 and Taixi KID-3 (Great Compendium).