Acupuncture Points Notebook

: Geguan : Diaphragm Gate

Bl-46 : Foot Taiyang Bladder 46

Classifications:
Spirit point
Master Tung's Five Mountain Ranges
Master Tung's Capital points

Location:
3 cun lateral to the midline, level with the lower border of the spinous process of the seventh thoracic vertebra (T7) level with Geshu Bl-17.

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:
Regulates the diaphragm and descends counterflow qi
Harmonises the middle jiao

TCM Indications:
  • Belching, sighing, fullness and oppression of the chest and diaphragm, difficult ingestion, vomiting, vomiting blood, drooling, irregular defecation, dark urine.
  • Stiffness and pain of the spine, difficulty in bending and extending the spine, back pain with aversion to cold, pain of the body, stiffness of the joints.

    Neuroanatomy:
    Superficial Innervation: Posterior cutaneous thoracic nerves from T7
    Dermatome Segment: T7

    Notes:
    In five element acupuncture indicated for issues related to breathing, counterflow qi (hiccups).

    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).

    Tung's Capital (Ding Zhu) points are located 3 cun lateral to the midline from T4 to T9 and 6 cun lateral to the midline from T4 to T8 indicated for lumbar pain, especially when associated with arteriosclerosis, acute back sprain and chest pain upon breathing (ibid.)

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

    Lad and Durve (2008) in Marma Points of Ayurveda locate a point at the inferior angle of the scapula, slightly lateral to these points, called Bruhati and associate it with Prana Vayu, Vyana Vayu, Samana Vayu, Udana Vayu and Ranjaka Pitta.

    They give the following functions:
    - Regulates respiration
    - Acts on lower lobes of lungs and diaphragm
    - Enhances flow of prana
    - Benefits function of the liver, gallbladder, spleen
    - Relieves pain locally
    In Thai massage:
    Acupressure point (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)


    Reference Notes: (click to display)