Points Database

Location Guides:

: Xin Shu : Heart Shu

Bl-15 : Foot Taiyang Bladder 15

Classifications:
Back-Shu point of the heart
Master Tung's Double Phoenixes
Master Tung's Behind the Heart points

Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)

Meetings:
Meeting of Bladder with Bladder Divergent (at the regular and Huatuo location)

Location:
1.5 cun lateral to the lower border of the spinous process of the fifth thoracic vertebra (T5).

Needling:
Oblique insertion towards the spine 0.5 - 1 cun, or transverse-oblique insertion 1 - 1.5 cun

Warning:
Perpendicular needling or oblique needling away from the spine carries a substantial risk of causing a pneumothorax.


TCM Actions:
Tonifies and nourishes the heart
Regulates heart qi
Calms the spirit
Unbinds the chest and resolves blood stasis
Clears heart fire

TCM Indications:
  • Heart pain, oppression of the chest with restlessness, chest pain extending to the back, worried and oppressive sensation of the chest with inability to catch the breath, palpitations, fright palpitations, irregular pulse, Heart qi deficiency in children.
  • Poor memory, anxiety, weeping with grief, frightened and cautious with Heart deficiency, insomnia, excessive dreaming, disorientation, delayed speech development, mania-depression, epilepsy, dementia, mad walking, seminal emission.
  • Cough, coughing blood, vomiting, vomiting blood, abdominal distension, difficult ingestion, night sweating, rednes of the lips accompanied by sweating.
  • Lack of strength in the root of the tongue, lacrimation, eye pain, windstroke, hemiplegia, jaundice, nosebleed, white turbidity.

    Neuroanatomy:
    Superficial Innervation: Posterior cutaneous thoracic nerves from T5
    Dermatome Segment: T5
    Deeper Structures: Dorsal rami of spinal nerves from T5 if directed inward and accessory nerve (CN XI) if directed into trapezius and dorsal scapular (C5) if directed into rhombus major

    Trigger Point Associations:
    Muscle: Trapezius, rhomboid major or multifidus at deep levels
    Myotome Innervation: Trapezius: Motor - accessory nerve (CN XI), Sensation - dorsal rami of C2 - C3; Rhomboid major: Dorsal scapular nerve (C4 - C5); Multifidus: Dorsal rami of spinal nerves from T5
    Pain Referral Pattern:
    \nTrapezius and rhomboid major: Across back and to chest
    \nMultifidus: local to point and to the midline
    Indications: Back and shoulder pain ; Back pain ; Cardiac syndromes

    Notes:
    As the back shu point of the Heart this point is the main back point for dealing with all disorders of the heart, including spiritual and psychological issues. It is often combined with Jueyinshu Bl-14 for physical heart symptoms.

    Ling Shu Ch. 51, On the Back Transport Points, advises that the back Shu points of the Yin organs should be pressed. If this elicits a response, either pain or the relief of a existing pain, then these points should be supplemented or drained with moxa and not pierced. To supplement with moxa the cone is to be left to burn down naturally, to drain it is to be blown on to make it burn more fiercely.

    Ling Shu Ch. 52, On the Wei Qi, considers this to be the tip of the hand Shaoyin meridian with the root being at Shenmen He-7.

    One of the Aggressive Energy Drain points in five element acupuncture, along with Feishu Bl-13, Jueyinshu Bl-14, Ganshu Bl-18, Pishu Bl-20 and Shenshu Bl-23, indicated where psychological or emotional issues are blocking treatment. They are needled from left to right, top to bottom, with the exception of Xinshu Bl-15 that is needled last, along with controls outside the Bladder channel at the same levels. If aggressive energy is present the points should become redder than the test points and are left until the redness disappears. If not then needles can be removed and treatment continued.

    When using the Bladder or Small Intestine Divergent meridians to expel a pathogen a band around the chest at this point, including Shendao Du-11, Shentang Bl-44 and Shanzhong Ren-17, should be treated with Gua Sha before commencing needling (Cecil-Sterman, 2012, Advanced Acupuncture).

    In Master Tung's system a line of points corresponding to the inner back Shu points from T2 to T8, known as the double phoenix points (Shuang Feng), can be pricked to release a drop of blood in cases of pain or numbness in the extremities or arteriosclerosis.
    They all relate to the Fire element and the Heart and so have the function of quickening the Blood in the Heart and the extremities (McCann, 2014, Pricking the Vessels).

    Tung's Behind the Heart (Hou Xin or Bei Xin) points are located under spinous processes from T4 to T9, 1.5 cun laterally to T4 to T7 and 3 cun laterally from T4 to T6. They are indicated for "wool like furuncles", clove sores, weakness and debility of the Heart zang, Stomach diseases, acute heart disease leading to numbness and paralysis, wind-cold entering the interior, severe wind-cold, stroke, externally contracted diseases that manifest with papules. They clear heat from the Heart and Lung and release the exterior so are useful in dermatological disorders (ibid.).

    In ayurvedic medicine:
    Vrihati marma point
    Size: 1/2 angula (cun)
    Structure: Blood vessels
    Effect of Injury: Premature death (kalantarpranahar marma)
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, Marma Shastra)

    In Tibetan medicine:
    Moxa point (AMNH, Tibetan Medical Paintings)


    Reference Notes: (click to display)