腎俞 : Shenshu : Kidney Shu

Classifications:

Back Shu point 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)

Meetings:

Meeting of Bladder with Bladder Divergent 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

Warnings:

Deep perpendicular needling carries a risk of injuring the kidney.

Classical Needling:

"The Taiyang usually has much Blood and little Qi" (Su Wen 素問 ch. 24) implying this channel should normally be bled.
"The foot Taiyang is to be pierced 5 fen deep and remain inserted for seven exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of three fen, (the needle) is retained for a duration of seven exhalations, and it is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Tonifies the Kidneys and fortifies Yang
Benefits essence
Nourishes Kidney Yin
Firms Kidney Qi
Regulates the 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 (五勞, Wu Lao) and the Seven Injuries (七傷, Qi Shang), 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 (中風, Zhong Feng), 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

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

Martial Applications & Effects of Injury:

In seizing martial arts (Qin Na) striking the lower back at approximately at this point is a method of striking the organs (Da Qi Guan, 打器官) in order to injure the kidneys (Yang, 2004, Analysis of Shaolin Chin Na, 2nd Edition).

This is one of the eight non-striking or forbidden points in Northern Praying Mantis Kung Fu. Described as "The kidneys" by both Olson (2010, The Complete Guide to Northern Praying Mantis Kung Fu) and Wong Honfan (1946; in Ravenswood Academy, 2020, The Eight Forbidden Strikes of Praying Mantis Fist).

See Montaigue, Dim Mak Locations, Taijiworld.com for explanation of effects.

Major Combinations:

• Cold of the lower extremities:
    Shenshu Bl-23 with Jinggu Bl-64 and Rangu Kid-2
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Cold and pain of the bone marrow:
    Shenshu Bl-23 with Dazhu Bl-11, Xuanzhong GB-39, Fuliu Kid-7, Lidui St-45 and Shenmai Bl-62
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Weakness of the Kidneys and lumbar region accompanied by seminal emission:
    Shenshu Bl-23 with Xinshu Bl-15
    (Yu Long Fu, 玉龍賦, Ode of the Jade Dragon. First recorded in Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Lumbar pain:
    Shenshu Bl-23 with Qihaishu Bl-24 and Zhonglushu Bl-29
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Lumbar pain due to Kidney deficiency:
    Shenshu Bl-23 with Baihuanshu Bl-30, Weizhong Bl-40 and Taixi Kid-3
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Lumbar pain in the elderly:
    Shenshu Bl-23 with Mingmen Du-4
    (Yu Long Fu, 玉龍賦, Ode of the Jade Dragon. First recorded in Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Incontinence of urine and faeces in the elderly:
    Moxa Shenshu Bl-23 and Mingmen Du-4
    (Yu Long Fu, 玉龍賦, Ode of the Jade Dragon. First recorded in Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Invasion by Cold or Damp diarrhoea containing undigested food:
    Shenshu Bl-23 with Zhangmen Liv-13
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Cold or Damp diarrhoea with undigested food in the stool:
    Shenshu Bl-23 with Dachangshu Bl-25
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Vomiting or Cold in the Stomach with distention, much eating but remains thin:
    Shenshu Bl-23 with Weishu Bl-21
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Zhou Yi Hexagram:

䷅ Song 訟 Conflict.

Trigrams: Kan (Water) below, Qian (Heaven) above.

Danger within, strength without — the inner situation is perilous, and the outer environment is forceful. Conflict arises when the inner danger meets outer pressure.

Nuclear Trigrams: Lines 2-3-4 form Li (Fire). Lines 3-4-5 form Xun (Wind). Beneath the conflict, there is clarity (Li) and gentle penetration (Xun). The hidden message: conflict can be resolved through understanding and patient influence, not through force.

Judgement:
有孚窒惕，
Possessing captives, in stifling dread.
Xie Qi contained at this point has reached the Kidneys, the source of life. The situation is dire.
中吉，終凶。
The middle is auspicious, but it ends in failure.
Treat cautiously, but be aware that it might still end in failure.
利見大人，不利涉大川。
It is favourable to see the great man. It is not favourable to cross the great river.
Professional help should be sought as great danger is present, although even this may not help.

Overall: Conflict has arisen in the Kidney and Bladder, the source of Yin and Yang and the location of the Ming Men. The situation is dire and help should be sought before it is too late. Treatment needs to be cautious to avoid harm, but it must be done.

Lines:

Image:
天與水違行，訟。君子以作事謀始。
Heaven and water move in opposite directions: Song. Thus the gentleman, in doing things, considers the beginning.

Heaven (Qian) rises, water (Kan) flows down. They move apart — this is the structure of conflict. The gentleman prevents conflict by considering the beginning carefully. If you plan well at the start, you avoid disputes later. The image is preventive, not reactive.

Acupuncture Point Connections:
Shared with Pangguangshu Bl-28.
Inverted into ䷅ (Dazhong Kid-4 or Jinggu Bl-64).
Opposed by ䷣ (Juque Ren-14 or Guanyuan Ren-4).

Hexagram attributions are my own with an explanation given in the glossary.
Translations are my own, assisted by DSeek and compared to Richard Rutt's interpretion (2002).

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:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here