Points Database

: Yishe : Abode of Thought

Bl-49 : Foot Taiyang Bladder 49

Classifications:
Spirit point

Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Location:
3 cun lateral to the midline, level with the lower border of the spinous process of the eleventh thoracic vertebra (T11) and level with Pishu Bl-20.

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:
Clears damp-heat
Regulates the spleen and stomach

TCM Indications:
  • Distension and fullness of the abdomen, distension and pain of the chest and lateral costal region, slippery diarrhoea, difficult ingestion, vomiting, reddish-yellow urine, heat in the body with yellow face and eyes.
  • Back pain, wasting and thirsting disorder, aversion to wind and cold.

    Neuroanatomy:
    Superficial Innervation: Posterior cutaneous thoracic nerves from T11
    Dermatome Segment: T11

    Trigger Point Associations:
    Muscle: Serratus posterior inferior and iliocostalis thoracis
    Myotome Innervation: Serratus posterior inferior: Intercostal nerves from T9 - T12; Iliocostalis: Dorsal rami of T11
    Pain Referral Pattern:
    \nSerratus posterior inferior: Around point
    \nIliocostalis thoracis: Along intercostal space and to lower lateral quadrant of abdomen. Some spillover along back and shoulder
    Indications: Nagging ache in lower thoracic region after other points have been deactivated ; Back pain

    Notes:
    Like the other outer bladder points of the five zang, despite being named after their spiritual aspect they have little indication for treatment of psychological disorders in the classical literature but are mainly used for draining heat from their corresponding zang (Deadman et al, 2001).

    In five element acupuncture indicated for an earth cf, obsessive thoughts, overthinking, eating disorders.

    The "59 piercings" are named in the Su Wen Ch. 61 and mentioned in Su Wen Ch. 32 and Ling Shu Ch. 23 for treating Heat diseases. This point along with Pohu Bl-42, Shentang Bl-44, Hunmen Bl-47 and Zhishi Bl-52 clear Heat from the five Zang.

    Jeffrey Yuen (2005, 3 Spirits & 7 Souls) suggests for inability to express worry and pensiveness we can direct the Yuan qi to here for expression by needling Pishu Bl-20 outwards and then this point relatively perpedicularly.
    For excessive worry or pensiveness we can direct it back to the Zang by needling this point obliquely towards the inner Bladder line and then needling Pishu Bl-20 downards.


    Reference Notes: (click to display)