: Zhongliao : Middle Crevice

Bl-33 : Foot Taiyang Bladder 33

Location Guides:

Classifications:

Binding point of the foot Taiyang and foot Shaoyang Sinews

Meetings:

Meeting of Bladder with Gall Bladder,


Location:

Over the third posterior sacral foramen.

Needling:

Perpendicular insertion 0.5 - 1 cun, or 1.5 - 2 cun through the foramen.

Warnings:

Contraindicated during pregnancy.

Classical Needling:

It is needled to a depth of two cun, (the needle) is retained for a duration of ten 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:

Regulates the Lower Jiao and facilitates urination and defecation
Regulates menstruation and stops leucorrhoea
Benefits the lumbar region and legs

TCM Indications:

  • Difficult urination and defecation, constipation, diarrhoea containing undigested food, retention of urine, painful urinary dysfunction, abdominal distension.
  • Leucorrhoea, irregular menstruation, scanty menstruation, infertility.
  • Lumbar pain, pain and cold of the sacrum and coccyx, cold sensation of the buttocks, atrophy disorder and Painful Obstruction (痹, Bi) of the lower limb.
  • The Five Taxations (五勞, Wu Lao), the Seven Injuries (七傷, Qi Shang) and the six extremes.

Neuroanatomy:

Superficial Innervation: Dorsal rami of S1 - S3
Dermatome Segment: S3
Deeper Structures: Sacral nerve S1 emerging from foramen


Martial Applications & Effects of Injury:

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

Major Combinations:



Notes:

One of the Baliao or "eight crevices" located in the sacral foramen which all regulate urination, defecation, menstruation and benefit the lumbar region and legs.



Sacral Nerve Stimulation using an implanted device to electrostimulate this point has beeen adopted by modern surgeons to treat urinary urge incontinence and frequency (NICE guidelines). See also PTNS, a similar procedure at Sanyinjiao Sp-6.





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