膈關 : Geguan : Diaphragm Gate

Classifications:

Spirit point
Master Tung's Five Mountain Ranges
Master Tung's Capital points

Location:

3 cun lateral to the midline, level with the lower border of the spinous process of the seventh thoracic vertebra (T7) level with Geshu Bl-17.

Needling:

Oblique insertion 0.3 - 0.5 cun

Warnings:

Deep perpendicular or deep oblique needling in a medial direction carries a substantial risk of causing a pneumothorax.

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).
"Locate it with the" (patient) seated upright, shoulders extended. It is needled to a depth of five fen and moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Regulates the diaphragm and descends counterflow Qi
Harmonises the Middle Jiao

TCM Indications:

• Belching, sighing, fullness and oppression of the chest and diaphragm, difficult ingestion, vomiting, vomiting blood, drooling, irregular defecation, dark urine.
  
• Stiffness and pain of the spine, difficulty in bending and extending the spine, back pain with aversion to cold, pain of the body, stiffness of the joints.

Neuroanatomy:

Superficial Innervation: Posterior cutaneous thoracic nerves from T7

Dermatome Segment: T7

Martial Applications & Effects of Injury:

Considered by Zhongwu Sports to be one of the eight striking points in Northern Praying Mantis Kung Fu (Zhongwu Sports, 2018, Chinese martial arts "eight hits and eight don't hits") instead of the points on the spine as other sources claim (Olson, 2010, The Complete Guide to Northern Praying Mantis Kung Fu; 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:

• Aversion to cold in the back and stiffness of the spine with difficulty bending:
    Geguan Bl-46 with Zhibian B-54 and Jinggu Bl-64
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Notes:

In five element acupuncture indicated for issues related to breathing, counterflow qi (hiccups).

In Master Tung's system this point is one of the five mountain ranges (Wu Ling). They consist of five sets of points in three lines representing the phases of the Wu Xing in a series of lines:

The first set is along the midline, below each vertebrae from T2 to T11. From T2 to T8 relate to Fire, T9 to T11 relate to Earth.
The second set is 3 cun from the midline. from T2 to T9. From T2 to T6 relate to Metal, T7 to T9 relate to Wood.
The third set is 6 cun from the midline from T2 to T8. From T2 to T4 relate to Metal, T5 to T8 relate to Wood.

They are indicated for fever, common cold, hypertension, headache, lumbar pain, numbness of the hands and feet, hemiplegia, acute stomachache, vomiting or acute enteritis by releasing heat, wind and stagnation from the organs relating to their phase and treated with a pricking method to release a drop of blood (McCann, 2014, Pricking the Vessels).

Tung's Capital (Ding Zhu) points are located 3 cun lateral to the midline from T4 to T9 and 6 cun lateral to the midline from T4 to T8 indicated for lumbar pain, especially when associated with arteriosclerosis, acute back sprain and chest pain upon breathing (ibid.)

This sort of technique may make greater sense than regular needles as shallow depth without retention may be safer over the spine and lungs.

Lad and Durve (2008) in Marma Points of Ayurveda locate a point at the inferior angle of the scapula, slightly lateral to these points, called Bruhati and associate it with the doshas: Prana Vayu, Vyana Vayu, Samana Vayu, Udana Vayu and Ranjaka Pitta.

They give the following functions:
- Regulates respiration
- Acts on lower lobes of lungs and diaphragm
- Enhances flow of prana
- Benefits function of the liver, gallbladder, spleen
- Relieves pain locally

In Thai massage:
Acupressure point (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)

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