Points Database

Location Guides:

: Riyue : Sun and Moon

GB-24 : Foot Shaoyang Gall Bladder 24

Classifications:
Front Mu point of the gall bladder
Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Meetings:
Meeting of Gall Bladder with Spleen, Gall Bladder Divergent and Liver Divergent

Location:
On the anterior chest wall, in the seventh intercostal space, directly below the nipple, 4 cun lateral to the midline.

Needling:
Transverse-oblique insertion along the intercostal space 0.5 - 1 cun

Warning:
Deep or perpendicular needling may induce a pneumothorax.


TCM Actions:
Benefits the gall bladder and spreads liver qi
Lowers rebellious qi and harmonises the middle jiao
Resolves damp heat

TCM Indications:
  • Distension, fullness and pain of the lateral costal region, pain of the ribs, epigastric pain, abdominal distension, jaundice.
  • Vomiting, much spittle, acid regurgitation, hiccup.
  • Sighing with tendency to sadness, heat of the lower abdomen, heat of the hypogastrium, loss of use of the four limbs.

    Neuroanatomy:
    Superficial Innervation: Lateral cutaneous thoracic nerve from T8
    Dermatome Segment: T8

    Trigger Point Associations:
    Muscle: External oblique and intercostals
    Myotome Innervation: External oblique: Thoracoabdominal nerves (T7 - 11) and subcostal nerve (T12); Intercostals: Intercostal nerve from T11
    Location Notes: Intercostals can produce trigger points anywhere in the intercostal space. See other Liv-14 for details.
    Pain Referral Pattern: To the area medial to the ribcage and under the sternum (Zhongwan Ren-12 and Liangmen St-21) with spillover across the inferior aspect of the ribs and sternum and radiating to opposite flank
    Indications: Abdominal pain and digestive discomfort

    Notes:
    Near to this point, just below the costal margin on the right side, is where to elicit Murphy's sign as a test for gallstones. Placing a hand here during exhalation and asking the patient to inhale will push the gallbladder against the examiners fingers and elicit a reaction if tender. To confirm pain must not be elicited on the left side too.

    The Front Mu points make likely locations for application of leeches to reduce fevers according to François Broussais' (1772–1838) philosophy who believed in placing them over the diseased organs to reduce inflammation (Greenstone, 2010, The history of bloodletting, BCMJ, Vol. 52, No. 1, Pp 12-14).

    Lad and Durve (2008) in Marma Points of Ayurveda locate two point with different names and functions on the left and right between here and Fuhai Sp-16, directly below the nipple on the costal margin. Both are associated with Ranjaka Pitta, Pachaka Pitta, Samana Vayu, Apana Vayu and Kledaka Kapha.

    The point on the right side is called Yakrut has the following functions:
    - Regulates the function of the liver and gallbladder
    - Stimulates bhuti agni (liver metabolism) and detoxifies ama
    - Regulates digestion and metabolism of all seven dhatus (tissues)
    - Regulates functions of small intestine and colon
    - Relieves pain locally
    - Pacifies fiery emotions

    The point on the left side is called Pliha and has the following functions:
    - Regulates spleen functions
    - Regulates and detoxifies blood
    - Enhances immunity
    - Enhances lymphatic circulation
    - Regulates functions of small intestine and colon
    - Relieves pain locally
    - Balances emotions


    Reference Notes: (click to display)