Bladder Channel

Question 1

Describe the path of the bladder channel

Answer 1

The urinary bladder channel begins from UB-1 (jing ming) at the inner canthus of the eye and then ascends to the fore- head. It continues upward where it meets up with the gov- erning vessel at DU-20 (bai hui) at the vertex of the head. It then subdivides and a branch runs into the temple.
● Starting from the vertex of the head, the main portion of the urinary bladder channel enters the brain. Then it emerges at the posterior region of the neck and bifur- cates into two different branches:
● The first branch runs all the way down the posterior aspect of the neck. It descends laterally 1.5 cun lat- eral to the posterior midline and parallel to the ver- tebrae, where it meets up with the lumbar region of the back. In this area, the pathway enters the body cavity to connect with the kidney and urinary blad- der, its pertaining organ. The lumbar branch then descends through the gluteal region to the popliteal fossa, where it ends at UB-40 (wei zhong).
● The second branch flows downward from the poste- rior aspect of the neck along the vertebral column. It descends straight downward, 3 cun lateral to the posterior midline, along the medial border of the scapula. It runs downward through the lumbar region into the gluteal region at GB-30 (huan tiao) and then continues along the posterior aspect of the thigh on the lateral side.
● Then this branch reconnects with the first branch at the popliteal fossa. From there, a single branch now flows down to the lower leg and descends to the poste- rior aspect of the external malleolus. Finally, running along the lateral aspect of the fifth metatarsal bone, it meets the lateral side of the tip of the little toe at UB-67 (zhi yin).

Question 2

Bl1: Jing ming

Answer 2

Eyes Bright, Meeting Pt of Bl, SI, and St, Entry Pt, Pt of the Yin and Yang
Qiao Mai

LOCATION
In the slight depression on the margin of the medial eye orbit, 0.1 cun superior and medial to the inner canthus.

LOCATION GUIDE
Have the patient sit while looking upward or lie in the supine position. Locate the point on his or her face, in the depres- sion between the superomedial part of the inner canthus of the eye and the medial wall of the orbit.

Question 3

Bl 2: Zan zhu

Answer 3

Collecting Bamboo

LOCATION
At the medial end of the eyebrow, on the supraorbital notch (foramen).

LOCATION GUIDE
Have the patient sit or lie in the supine position. Locate the point on the forehead, on the supraorbital foramen, superior to the inner canthus. This point is located in the depression at the medial end of the eyebrow.

Question 4

Bl 3: Mei chong

Answer 4

LOCATION
On the forehead, directly above the medial end of the eye- brow at UB-2 (zan zhu). The point is located 0.5 cun above the natural anterior hairline, midway between DU-24 (shen ting) and UB-4 (qu chai).

LOCATION GUIDE
Have the patient sit or lie in the supine position. Locate the point on the forehead, superior to the supraorbital notch at UB-2 (zan zhu), 0.5 cun superior to the anterior hairline. The distance between anterior and posterior hairlines is 12 cun. If the anterior hairline is not very discernible, the distance is measured as 15 cun from the glabella to the posterior hair- line, making the anterior hairline at about one-fifth of this distance.

Question 5

Bl 4 Qu chai

Answer 5

LOCATION
On the frontal region of the head, 0.5 cun directly above the anterior hairline, 1.5 cun lateral to the midline. It is at the junction of the medial one-third and lateral two-thirds of the line connecting DU-24 (shen ting) and ST-8 (tou wei).

LOCATION GUIDE
Have the patient sit or lie in the supine position. Locate the point on his or her forehead, 0.5 cun superior to the anterior hairline and 1.5 cun lateral to the anterior midline. The distance between anterior and posterior hairlines is 12 cun.
If the anterior hairline is not very discernible, the distance is measured as 15 cun from the glabella to the posterior hairline, making the anterior hairline at about one-fifth of this distance. The distance from DU-24 (shen ting) to ST-8 (tou wei)
is 4.5 cun.

Question 6

Bl 10: Tian zhu

Answer 6

Heavenly Pillar

The point lies in a depression in the trapezius muscle, about 1.3 cun lateral to Du 15 and just inferior to the occiput. Start with your finger on Du 15. (Du 15 lies on the mid-line of the neck, between C 1 and C 2, at about ½ cun below Du 16 and roughly ½ cun above the natural hair line.)
Roll your finger out onto the trapezius.
On a person with a well-defined hairline, it lies roughly 1/2 cun superior to the natural hairline of the neck, and 1.3 cun lateral to the mid-line.

Question 7

Bl 11: Da zhu

Answer 7

Hui Pt for Bones, Meeting Pt of Bl and SI, Pt to Release External
Dragons. Pt of Sea of Blood

Between 1st and 2nd
thoracic vertebrae. 1.5 cun lateral to posterior midline, level with Du 13.

Question 8

Bl 12: Fengmen

Answer 8

Bl 12 Fengmen Wind Gate Meeting Pt of Bl and Du Mai

Between 2nd and 3rd thoracic vertebrae. 1.5 cun from posterior midline.

Question 9

Bl- 13: Fei shu

Answer 9

Bl- 13 Back Shu pt. of the Lung

Between 3rd and 4th thoracic vertebrae. 1.5 cun lateral to posterior midline level with Du 12 and Bl 42.

Question 10

Bl 14: Jue yin shu

Answer 10

Back Shu pt. of the Pericardium

Between 4th and 5th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Bl 43.

Question 11

Bl 15 XINSHU

Answer 11

Heart Back Shu Point

Between 5th and 6th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 11 and Bl 44.

Question 12

Bl 16 DUSHU

Answer 12

Governor Back Shu Point

Between 6th and 7th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 10 and Bl 45.

Question 13

Bl 17 GESHU

Answer 13

Diaphragm Back Shu Point

Between 7th and 8th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 9 and Bl 46.

Question 14

Bl 18 GANSHU

Answer 14

Liver Back Shu Point

Between 9th and 10th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 8 and Bl 47.

Question 15

Bl 19 DANSHU

Answer 15

Gall Bladder Back Shu Point

Between 10th and 11th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 7 and Bl 48.

Question 16

Bl 20 PISHU

Answer 16

Spleen Back Shu Point

Between 11th and 12th thoracic vertebrae. 1.5 cun lateral to posterior midline. Level with Du 6 and Bl 49.

Question 17

Bl 21 WEISHU

Answer 17

Stomach Back Shu Point

12th thoracic and 1st lumbar vertebrae. 1.5 cun lateral to posterior midline. Level with Bl 50.

Question 18

Bl 22 SANJIAOSHU

Answer 18

Triple Burner Back Shu Point

1st and 2nd lumbar vertebrae. 1.5 cun lateral to posterior midline. Level with Du 5 and Bl 51.

Question 19

Bl 23 SHENSHU

Answer 19

Kidney Back Shu Point

2nd and 3rd lumbar vertebrae. 1.5 cun lateral to posterior midline. Level with Du 4 and Bl 52.

Question 20

Bl 24 QIHAISHU

Answer 20

Sea of Qi Back Shu Point

3rd and 4th lumbar vertebrae. 1.5 cun lateral to posterior midline.

Question 21

Bl 25 DACHANGSHU

Answer 21

Large Intestine Back Shu Point

4th and 5th lumbar vertebrae. 1.5 cun lateral to posterior midline. Level with Du 3.

Question 22

Bl 26 GUANYUANSHUQI

Answer 22

Gate of Yuan Qi Back Shu Point

5th lumbar and sacrum. 1.5 cun lateral to posterior midline.

Question 23

Bl 27: XIAOCHANGSHU

Answer 23

Small Intestine Back Shu Point

From Bl 28, feel halfway up the ridge of the medial edge of the sacro-iliac joint. The ridge feels quite straight, but at this halfway place you will find a little kink, and this indicates the level of Bl 27.
The point is in the gap between the ilium and the sacrum, at the level of the 1st sacral foramen.
(On many women this will be 11/2 cun from the mid-line of the spine, but on a man this is likely to be a
smaller distance.)

Question 24

Bl 28: PANGGUANSHU

Answer 24

Bladder Back Shu Point

The point lies just medial to the inferior corner of the sacro-iliac joint. The point is in the gap
between the ilium and the sacrum, at the level of the 2nd sacral foramen.
(On many women this will be 11/2 cun from the mid-line of the spine, but on a man this is likely to
be a smaller distance.)

Question 25

Bl 32: CILIAO

Answer 25

Second Foramen In the 2nd sacral foramen, on a level with Bl 28.

Question 26

Bl 36: CHENGFU

Answer 26

Receiving Support Find the crease between her buttock and her thigh, the gluteal fold. The point is at the mid-point of this crease, or the mid-point of the posterior surface of her thigh, directly below Bl 54. To find the mid-point, either trace up the line that lies between the bellies of her biceps femoris muscle, or trace a line down from Bl 54. (Bl 54 is approximately 3 cun lateral to the mid-line, in line with Bl 53, or the Outer Bladder Line, on a level with the 4th sacral foramen.)

Question 27

Bl 37: YINMEN

Answer 27

Thigh Gate This point is on an imaginary line connecting Bl 36 – Bl 40, whose length is 14 cun. The point lies at 8 cun superior to the popliteal crease (or 6 cun below Bl 36) on the mid-line of the back of the thigh, between the biceps femoris and the semitendinosus muscles.

Question 28

Bl 38: FUXI

Answer 28

Superficial Cleft Find the lateral end of the popliteal crease, and the large tendon of the biceps muscle of the thigh (biceps femoris). This point lies 1 cun superior to the popliteal crease, just medial to the tendon.

Question 29

Bl 39: WEIYANG

Answer 29

Crooked Yang Find the lateral end of the popliteal crease, and the large tendon of the biceps muscle of the thigh (biceps femoris). This point lies just medial to the tendon, on the crease. It is roughly 1 cun lateral to Bl 40.

Question 30

Bl 40: WEIZHONG

Answer 30

Crooked Middle On the midpoint of the popliteal crease, between the two large tendons (of the biceps femoris and the semitendinosus muscles). Bend the knee to establish the principal crease at the flexure of the knee. Feel the seam of the centre of the gastrocnemius from Bl 57, through Bl 56 and 55, and extend this line to the knee crease. This will bring you to the mid-point between the two large tendons. Feel for the hollow of the point. This is called a ‘vagabond’ point, in that occasionally one may have to move it a little lateral, in order to avoid the popliteal vein or popliteal lymphatic glands if any of these have become prominent at the centre of the crease.

Question 31

Bl 42 POHU

Answer 31

Door of Po 3rd and 4th thoracic vertebrae, medial border of scapula. Level with Du 12 and Bl 13.

Question 32

Bl 43 GAOHUANGSHU

Answer 32

Vitals Back Shu Point 4th and 5th thoracic vertebrae, medial border of scapula. Level with Bl 14.

Question 33

Bl 44 SHENTANG

Answer 33

Shen Hall 5th and 6th thoracic vertebrae, medial border of scapula. Level with Du 11 and Bl 15.

Question 34

Bl 45 YIXI

Answer 34

Cry of Pain 6th and 7th thoracic vertebrae, medial border of scapula. Level with Du 10 and Bl 16.

Question 35

Bl 46 GEGUAN

Answer 35

Diaphragm Pass 7th and 8th thoracic vertebrae, roughly at the level of the inferior tip of the scapula. Level with Du 9 and Bl 17.

Question 36

Bl 47 HUNMEN

Answer 36

Hun Gate 9th and 10th thoracic vertebrae. 3 cun lateral to posterior midline. Level with Du 8 and Bl 18.

Question 37

Bl 48 YANGGANG

Answer 37

Yang Essence 10th and 11th thoracic vertebrae. 3 cun lateral to posterior midline. Level with Du 7 and Bl 19.

Question 38

Bl 49 YISHE

Answer 38

Yi Dwelling 11th and 12th thoracic vertebrae. 3 cun lateral to posterior midline. Level with Du 7 and Bl 20.

Question 39

Bl 50 WEICANG

Answer 39

Stomach Granary 12th thoracic and 1st lumbar vertebrae. 3 cun lateral to posterior midline. Level with Bl 21.

Question 40

Bl 51 HUANGMEN

Answer 40

Vitals Gate 1st and 2nd lumbar vertebrae. 3 cun lateral to posterior midline. Level with Du 5 and Bl 22.

Question 41

Bl 52 ZHISHI

Answer 41

Zhi Dwelling 2nd and 3rd lumbar vertebrae. 3 cun lateral to posterior midline. Level with Du 4 and Bl 23.

Question 42

Bl 53: BAOHUANG

Answer 42

Womb Vitals On the Outer Bladder Line, 3 cun lateral to the mid-line of the spine, on a level with the 2nd sacral foramen and Bl 28. Double the distance from Bl28.

Question 43

Bl 54: ZHIBIAN

Answer 43

Lowermost Edge On the Outer Bladder Line, 3 cun lateral to the mid-line of the spine, on a level with the 4th sacral foramen and Bl 30.

Question 44

Bl 55: HEYANG

Answer 44

Yang Union On the posterior mid-line of the leg, 2 cun below Bl 40, between the two heads of the gastrocnemius muscle.

Question 45

Bl 56: CHENGJIN

Answer 45

Sinew Support On the posterior midline of the leg, 5 cun below Bl 40, in the centre of the belly of the gastrocnemius muscle.

Question 46

Bl 57: CHENGSHAN

Answer 46

Supporting Mountain The point lies approximately 8 cun inferior to Bl 40 on the posterior mid-line of the leg. It is at the apex of the ‘V’ where the two heads of the gastrocnemius muscles separate. To expose this ‘V’, with the patient lying on their front (prone), ask them to lift their heel. Then, with their foot still in the air, ask them to pull up their toes towards their knee as far as they can. The more the stretch, the more the inverted ‘V’ of the muscle will show. Finally, with the patient’s leg relaxed, feel for the hollow of the point. (When the cun measurement and the anatomy appear to be in conflict for the above point, it is the anatomy that determines where the point lies.)

Question 47

Bl 58: FEIYANG

Answer 47

Fly and Scatter 7 cun superior to Bl 60, posterior to the posterior border of the fibula, between the gastrocnemius and soleus muscles. To highlight the soleus muscle, ask the patient to push the ball of their foot into your hand while you resist. Run you finger proximally up from Bl 60 to where you feel the lateral border of the gastrocnemius muscle and feel for the point. The point is lateral to and approximately 1 cun inferior to Bl 57.

Question 48

Bl 59: FUYANG

Answer 48

Instep Yang 3 cun superior to Bl 60, in the groove between the Achilles tendon and the posterior border of the fibula. Hold the person’s foot at a right angle to make this groove easier to feel.

Question 49

Bl 60: KUNLUN

Answer 49

Kunlun Mountain The point lies midway between the posterior border of lateral malleolus and the anterior border of the Achilles tendon. Holding the foot at a right angle reveals a groove between the lateral malleolus and the Achilles tendon. The point lies in this groove level with the highest point of the lateral malleolus.

Question 50

Bl 61: PUCAN

Answer 50

Subservient Visitor Bl 63 – 61: These vary a little according to the position of the foot. For accuracy, find them with the foot at a right angle to the leg. In order to needle, the patient's foot must be relaxed – either support their foot in this position, or, if you gently let it fall to rest, re-mark the point according to the new presentation. The point lies 11/2 cun directly inferior to Bl 60, in a depression in the middle of the calcaneum. From Bl 60 to the bottom of the foot is 3 cun. Holding the foot a right angle Bl 61 is found halfway between these two landmarks.

Question 51

Bl 62: SHENMAI

Answer 51

Extending Vessel Bl 63 – 61: These vary a little according to the position of the foot. For accuracy, find them with the foot at a right angle to the leg. In order to needle, the patient's foot must be relaxed – either support their foot in this position, or, if you gently let it fall to rest, re-mark the point according to the new presentation. The point lies 1/2 cun below the inferior border of the lateral malleolus. Holding the foot at a right angle, draw an imaginary line from the tip of the lateral malleolus towards the sole of the foot. The point lies on this line, in a depression roughly 1/2 cun inferior to the inferior edge of the malleolus bone.

Question 52

Bl 63: JINMEN

Answer 52

Golden Gate Bl 63 – 61: These vary a little according to the position of the foot. For accuracy, find them with the foot at a right angle to the leg. In order to needle, the patient's foot must be relaxed – either support their foot in this position, or, if you gently let it fall to rest, re-mark the point according to the new presentation. The point is found in the hollow that lies proximal to the tuberosity of the 5th MT bone, inferior to the lateral edge of the cuboid bone. Roll your finger off the 5th MT tuberosity into the hollow. You will feel the cuboid bone immediately above (superior to) your finger. The point lies at a height that is a little superior to the line of Bl 65 and Bl 64.

Question 53

Bl 64: JINGGU

Answer 53

Capital Bone Distal and inferior to the tuberosity of the 5th MT bone. Slide your finger proximally from BL 65 along the 5th MT until you come to the bulge of the tuberosity: also slide your finger distally from the height of the bulge to clarify the beginning of the flare of the tuberosity. The point lies here, just inferior to the bone and just above the muscle that spreads open the little toe (abductor digiti minimi). (At the change in skin tone and texture.)

Question 54

Bl 65: SHUGU

Answer 54

Binding Bone Proximal to the 5th MTP joint, proximal and inferior to the flare of the head of the 5th MT bone. Pull down the toes to expose the head of the 5th MT more clearly. (At the change in skin tone and texture.)

Question 55

Bl 66: ZUTONGGU

Answer 55

Foot Passing Valley On the lateral side of the little toe, distal and inferior to the 5th MTP joint, where the base of the proximal phalanx begins to flare out. Pushing up the 5th MTP joint can make this point a little easier to feel.

Question 56

Bl 67: ZHIYIN

Answer 56

Reaching Yin Lateral nail point of the little toe.