肺俞 : Feishu : Lung Shu

Location Guides:

Classifications:

Back Shu point of the Lung
One of the "59 piercings" for clearing Heat in Su Wen Ch. 61
Master Tung's Double Phoenixes
Master Tung's Nine Monkeys

Meetings:

Meeting of Bladder with Large Intestine Divergent and Lung Divergent

Location:

1.5 cun lateral to the lower border of the spinous process of the third thoracic vertebra (T3).

Needling:

Oblique insertion towards the spine 0.5 - 1 cun, or transverse-oblique insertion 1 - 1.5 cun

Warnings:

Perpendicular needling or oblique needling away from the spine 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).
"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 Lung Qi and nourishes Lung Yin
Descends and disseminates Lung Qi
Clears Heat from the Lung
Releases the Exterior

TCM Indications:

• Cough, dyspnoea, asthma, fullness of the chest, shortness of breath with no desire to speak, persistnet cough in children, cold Lung, heat sensation in the chest, chest pain, difficult breathing on lying down, coughing of phlegm, Lung abscess, attack of the Lung by wind, rapid pulse, fever, night sweating with chills and fever and aversion to cold, cold shivering, absence of sweating, Throat Painful Obstruction (喉痹, Hou Bi).
  
• Lung atrophy, consumption, consumption with Steaming Bone Disorder, Deficiency Taxation Fever, Tidal Fever, night sweating, spiting blood, wasting and thirsting disorder, dryness of the mouth and tongue, deficiency agitation.
  
• Mania, heat in the body, mad walking with desire to commit suicide, epilepsy.
  
• Fullness with no pleasure in eating, vomiting, vomiting fluid after eating, vomiting of foam, goitre, jaundice, pain of the flesh and itching of the skin, urticaria.
  
• Pain of the upper back and shoulder, crooked spine, turtle back in children, lumbar pain and stiffness.

I Ching Hexagram:

䷉ Lu 履 Treading

Hexagram attributions are my own with an explanation given in the glossary.

Neuroanatomy:

Superficial Innervation: Posterior cutaneous thoracic nerves from T3

Dermatome Segment: T3

Deeper Structures: Dorsal rami of spinal nerves from T3

Martial Applications & Effects of Injury:

Damage to this point with cause the Lungs to be damage greatly reducing the power of their Qi and causing them to buckle over, gasping for air. The Kidneys and Wei Qi are also affected making them more vulnerable to External Pathogenic Invasions (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Cough with phlegm:
    Feishu Bl-13 with Fenglong St-40
    (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).
  
  
• Cough that reaches the voice:
    Feishu Bl-13 with Tantu Ren-22
    (Gao Wu, 高武, 1529: Bai Zheng Fu, 百症賦, Ode of a Hundred Symptoms).
  
  
• Lung distention:
    Feishu Bl-13 with Taiyuan Lu-9
    (Haungfu Mi, 皇甫謐, 282: Zhen Jiu Jia Yi Jing, 針灸甲乙經, Systematic Classic of Acupuncture and Moxibustion).
  
  
• Chest pain:
    Feishu Bl-13 with Yunmen Lu-2, Zhongfu Lu-1, Yinbai Sp-1, Qimen Luv-14, Hunmen Bl-47 and Daling Pc-7
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Spitting blood:
    Feishu Bl-13 with Kongzui Lu-6 and Quze Pc-5
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Seasonal fever:
    Feishu Bl-13 with Taodao Du-13
    (Gao Wu, 高武, 1529: Zhen Jiu Yu Jing, 針灸聚英, Glorious Anthology of Acupuncture and Moxibustion).
  
  
• Mad walking with desire to commit suicide:
    Feishu Bl-13 with Fengfu Du-16
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Stiffness of the lumbar region and back with inability to bend to the side:
    Feishu Bl-13 with Yaoshu Du-2
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• For Gu Poison:
    Apply moxibustion to Feishu BL-13, Zusanli ST-36 and Guikuxie (Demon Wailing Point) located at Shaoshang Lu-11 when the thumbs are tied together so moxa can be applied to both simultaneously.
    (Qugu Ranxi Lu, Master Ranxi’s Treatise on Expelling Gu Toxins, 1893, in Fruehauf, 1998, Driving Out the Demons and Snakes).

Notes:

As back shu point of the lungs this is the main point on the back for treating all lung disorders.

The "59 piercings" are named in the Su Wen Ch. 61 and mentioned in Su Wen Ch. 32 and Ling Shu Ch. 23 for treating Heat diseases. This point along with Dazhu Bl-11, Zhongfu Lu-1 and Qupen St-12 clear Heat from the chest. The Su Wen Ch. 61 and Wang Bing only describe this as the "Back Transporter" so could refer to any of the upper Back-Shu points but given the indication of Heat in the chest and all the other points in this group relating to the Lung rather than the Heart or Pericardium then this point seems most likely.

Ling Shu Ch. 20, On the Five Evils, advises piercing this point, Zhongfu Lu-1, Yunmen Lu-2 and either Qupen St-12 or Tiantu Ren-22 (depending on how the location "in the middle of the Broken Basin" is interpreted) for pathogens in the Lung.

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, suggests this point and some unspecified points on the sides of the chest to release evil Qi in the chest. It advises to press the point for a time until there is a reaction and then pierce with the fine needle and apply a draining technique. Conditions treated are headache, dizziness and falling to the ground, abdominal pain, fullness, distension and accumulation. If it is painful and the pain moves it can be cured easily; if is is a painless fixed accumulation it is difficult.

In the Shang Han Lun, line 171, Zhang Zhong-Jing recommends using this point along with Dazhui Du-14 and Ganshu Bl-18 for the dragover of Taiyang and Shaoyang disease. This is because Feishu Bl-13 can eliminate pathogens from the Taiyang while Ganshu Bl-18 can eliminate pathogens from the Shaoyang (Liu, 2016, Shang Han Lun, p. 500). This explanation uses the different ways of pairing the channels: one using the connection between both Tai stages while the other uses the internal-external relationship of the Liver-Gallbladder. Dazhui Du-14 meanwhile simply releases the exterior from all Yang channels.

One of the Aggressive Energy Drain points in five element acupuncture, along with Jueyinshu Bl-14, Xinshu Bl-15, Ganshu Bl-18, Pishu Bl-20 and Shenshu Bl-23, 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.

In Master Tung's system a line of points corresponding to the inner back Shu points from T2 to T8, known as the double phoenix points (Shuang Feng), can be pricked to release a drop of blood in cases of pain or numbness in the extremities or arteriosclerosis.
They all relate to the Fire element and the Heart and so have the function of quickening the Blood in the Heart and the extremities (McCann, 2014, Pricking the Vessels).

This point is also one of the Nine Monkeys (Jiu Hou) in Tung Lineage acupuncture. They are located at 1.5 cun and 3 cun lateral from the midline level with T2, T3 and T4 and 6 cun from the midline, level with T1, T2 and T3. They are pricked to bleed in cases of scarlet fever phegm and stuck in the bronchia that cannot be expelled (McCann, 2014, Pricking the Vessels).

Avicenna describes cupping at this point in his treatise On Cupping:

"Cupping on the back [between the shoulders] is second in effectiveness to venesecting the basilic vein. It is beneficial in relieving shoulder and throat pain... Also, cupping the upper back weakens the mouth of the stomach." (Aspects of Treatment According to General Diseases, 22nd section in Abu-Asab, Amri & Micozzi, 2013, Avicenna's Medicine)

Any point from Bl-11 to Bl-17 could be indicated by this point but the indications of throat and shoulder pain suggest this one matching Chinese indications best, plus his comment that to avoid side effects "cupping on the upper back should be done slightly higher, unless the reason is to treat the bleeding and coughing, then it should moved lower and not higher".

He also adds that "Cupping on the upper back and inner sides of the thighs is beneficial in bloody chest disease (hemoptysis) and bloody asthma; however it weakened the stomach and causes heart palpitations."

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