Acupuncture Points Notebook

: Fufen : Attached Branch

Bl-41 : Foot Taiyang Bladder 41

Classifications:
Master Tung's Nine Monkeys
Trigger point (Travell & Simons, 1998, Trigger Point Manual)
Master Tung's Five Mountain Ranges

Meetings:
Meeting of Bladder with Small Intestine

Location:
3 cun lateral to the midline, level with the lower border of the spinous process of the second thoracic vertebra (T2) and level with Fengmen Bl-12.

Needling:
Oblique insertion 0.3 - 0.5 cun

Warning:
Deep perpendicular or deep oblique needling in a medial direction carries a substantial risk of causing a pneumothorax.


TCM Actions:
Activates the channel and alleviates pain
Expels wind and cold

TCM Indications:
  • Contraction of the shoulder, scapula and back, pain and stiffness of the neck, back pain radiating to the head, numbness of the elbow and upper arm.
  • Wind-cold lodged in the interstices, wind-taxation.

    Neuroanatomy:
    Superficial Innervation: Posterior cutaneous thoracic nerves from T2
    Dermatome Segment: T2

    Trigger Point Associations:
    Muscle: Rhomboid minor
    Myotome Innervation: Dorsal scapular nerve (C5, with minor contribution from C4 and C6)
    Pain Referral Pattern: Local to point and around medial and superior border of scapula
    Indications: Shoulder pain remaining after other trigger points in the area have been deactivated

    Notes:
    In Master Tung's system this point is one of the five mountain ranges (Wu Ling). They consist of five sets of points in three lines representing the phases of the Wu Xing in a series of lines:

    The first set is along the midline, below each vertebrae from T2 to T11. From T2 to T8 relate to Fire, T9 to T11 relate to Earth.
    The second set is 3 cun from the midline. from T2 to T9. From T2 to T6 relate to Metal, T7 to T9 relate to Wood.
    The third set is 6 cun from the midline from T2 to T8. From T2 to T4 relate to Metal, T5 to T8 relate to Wood.

    They are indicated for fever, common cold, hypertension, headache, lumbar pain, numbness of the hands and feet, hemiplegia, acute stomachache, vomiting or acute enteritis by releasing heat, wind and stagnation from the organs relating to their phase and treated with a pricking method to release a drop of blood (McCann, 2014, Pricking the Vessels).

    This point is also one of the Nine Monkeys (Jiu Hou) in Tung Lineage acupuncture. They are located at 1.5 cun and 3 cun lateral from the midline level with T2, T3 and T4 and 6 cun from the midline, level with T1, T2 and T3. They are pricked to bleed in cases of scarlet fever phegm and stuck in the bronchia that cannot be expelled (McCann, 2014, Pricking the Vessels).

    This sort of technique may make greater sense than regular needles as shallow depth without retention may be safer over the spine and lungs.

    In Thai massage:
    Point along the outer Kalatharee sen line running from the lateral malleolus, up the sides of the leg, along the outer bladder channel, over the shoulder blade and down to the hands (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)


    Reference Notes: (click to display)