Points Database

: Shenshu : Kidney Shu

Bl-23 : Foot Taiyang Bladder 23

Classifications:
Back-Shu of the kidneys

Homeostatic point 15 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)
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 Huatuo location) and Kidney Divergent

Location:
1.5 cun lateral to the lower border of the spinous process of the second lumbar vertebra (L2).

Needling:
Oblique or perpendicular-oblique insertion towards the spine 1 - 1.5 cun

Warning:
Deep perpendicular needling carries a risk of injuring the kidney.


TCM Actions:
Tonifies the kidneys and fortifies yang
Benefits essence
Nourishes kidney yin
Firms kidney qi
Regulates teh water passages and benefits urination
Benefits and warms the uterus
Benefits the ears and eyes
Strengthens the lumbar region

TCM Indications:
  • Oedema, deficiency-taxation oedema, difficult urination, turbid urine, deficiency exhaustion white turbidity, enuresis, frequent urination, dripping urination, wasting and thirsting disorder with frequent urination, blood in the urine.
  • Seminal emission, seminal emission with dreams, urine containing semen, impotence, premature ejaculation, pain of the genitals, acute hypogastric pain.
  • Irregular menstruation, accumulation of cold in women giving rise to taxation, chronic cold of the uterus, emaciation in women due to sexual intercourse during menstruation, leucorrhoea, red and white leucorrhoea.
  • Cold or damp (dong) diarrhoea, borborygmus, undigested food in the stools, eats a lot but remains thin, pain of the lateral costal region, cold and distension of the Stomach, cold vomiting.
  • Chronic dyspnoea and cough, asthma, diminished qi.
  • Kidney deficiency deafness, tinnitus, visual dizziness, night blindness, blurred vision.
  • The five taxations and the seven injuries, taxation of the five zang, chronic cold of the water (Kidney) zang, deficiency-taxation emaciation.
  • Heavy head with heat in the body, redness and heat of the face, redness of the head and body, yellow-black complexion, wind headache, alternating chills and fever, rebellious qi Heart pain.
  • Pain and soreness of the lumbar region and knees, icy cold sensation of the lumbar region, cold legs, hot and cold sensations of the bones, windstroke, hemiplegia.

    Neuroanatomy:
    Superficial Innervation: Dorsal rami of L1 - L3
    Dermatome Segment: L2
    Deeper Structures: Dorsal rami of spinal nerves from L2

    Trigger Point Associations:
    Muscle: Multifidus
    Myotome Innervation: Posterior branches of dorsal rami from L3
    Pain Referral Pattern: Around the point and radiating down the back. Also to the abdomen directly anterior to the point.
    Indications: Myalgia of the long extensors of the back ; Paraumbilical pain

    Notes:
    This is the main points for treating lumbar pain. As the back-shu point of the kidneys it is also the most important back point for all disorders of water and reproductive functions.

    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 point or Lianquan Ren-23 to be the tip of the foot Shaoyin meridian with the root being at Zhaohai Kid-6, Fuliu Kid-7 or Jiaoxin Kid-8 (the text is vague and says 3 cun above or below the inner ankle).

    One of the points in the External Dragons protocol in five element acupuncture, along with Baihui Du-20, Dazhu Bl-11 and Pucan Bl-61, for eliminating a blockage between the therapist and patient, or a disconnection from themselves, with the additional presence of external symptoms or trauma.

    Also one of the Aggressive Energy Drain points in five element acupuncture, along with Feishu Bl-13, Jueyinshu Bl-14, Xinshu Bl-15, Ganshu Bl-18 and Pishu Bl-20, 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.

    Jeffrey Yuen (2005, The Eight Extraordinary Vessels) says this point is where the third and fourth trajectories of the Du mai (from Jingming Bl-1 over the head, through the Brain and down the Huatuojiaji, and from the lower Dantian to the coccyx Changqiang Du-1 via the genitals, Huiyin Ren-1 and the buttocks, to the lower spine) enter the Kidneys.

    Classical texts such as the Nei Jing and Ling Shu which considered the Dai mai as simple a circle around the waist would also include this a point on the Dai mai along with others level to Shenque Ren-8 and Mingmen Du-4 instead of the traditional points (Ibid.).

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


    Reference Notes: (click to display)