膈俞 : Geshu : Diaphragm Shu

Location Guides:

Classifications:

Hui-Meeting point of Blood
Master Tung's Double Phoenixes
Master Tung's Behind the Heart points

Location:

1.5 cun lateral to the lower border of the spinous process of the seventh thoracic vertebra (T7).

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:

Invigorates Blood and dispels stasis
Cools Blood Heat and stops bleeding
Nourishes and harmonises the Blood
Harmonises the diaphragm and descends rebellious Qi

TCM Indications:

• Oppression of the chest, Heart pain, stabbing pain of the Heart, Mania-Withdrawal (癲狂, Dian Kuang), coughing and dyspnoea, Throat Painful Obstruction (喉痹, Hou Bi).
  
• Epigastric pain, fullness of the abdomen and lateral costal region, vomiting, vomiting of food eaten the day before, hiccup, oesophageal constriction, difficult ingestion, Stomach reflux, inability to eat, Heart pain on eating, jaundice.
  
• Coughing blood, vomiting blood, spitting blood, nosebleed, blood in the stool, all blood diseases, urticaria.
  
• Dizziness, Tidal Fever, night sweating, Steaming Bone Disorder, spontaneous sweating, fever with absence of sweating, aversion to cold.
  
• Painful obstruction of the whole body, pain in the whole body, pain of the skin, flesh and bones, frequent stretching and yawning, heaviness of the body, swelling, distension and pain of the body, weariness of the four limbs, lethargy with no desire to move, somnolence, back pain, rigidity of the spine.

Neuroanatomy:

Superficial Innervation: Posterior cutaneous thoracic nerves from T7

Dermatome Segment: T7

Deeper Structures: Dorsal rami of spinal nerves from T7

Martial Applications & Effects of Injury:

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

Major Combinations:

• The hundred syndromes of Deficiency Taxation:
    Moxa the four flowers (Geshu Bl-17 and Danshu Bl-19), Gaohuangshu Bl-43 and Huanmen Ex-BW-6
    (Liao Runhong, 廖润鸿, 1874: Zhen Jiu Ji Cheng, 針灸集成, Compilation of Acupuncture and Moxibustion).
  
  
• Vomiting:
    Geshu Bl-17 with moxa on Zhangmen Liv-13 and Zhongwan Ren-12
    (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 Phlegm in the diaphragm:
    Geshu Bl-17 with Shuaigu GB-8
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Contraction and Cold of the shoulder and back with pain of the inner aspect of the scapula:
    Geshu Bl-17 with Yixi Bl-45, Jinmen Bl-63 and Chize Lu-5
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Throat Painful Obstruction:
    Geshu Bl-17 with Jingqu Lu-8
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Bone pain:
    Geshu Bl-17 with Zigong Ren-19 and Yutang Ren-18
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).

Notes:

As the hui-meeting point of blood this is the main back point for the treatment of all blood disorders.

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.

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).

Tung's Behind the Heart (Hou Xin or Bei Xin) points are located under spinous processes from T4 to T9, 1.5 cun laterally to T4 to T7 and 3 cun laterally from T4 to T6. They are indicated for "wool like furuncles", clove sores, weakness and debility of the Heart zang, Stomach diseases, acute heart disease leading to numbness and paralysis, wind-cold entering the interior, severe wind-cold, stroke, externally contracted diseases that manifest with papules. They clear heat from the Heart and Lung and release the exterior so are useful in dermatological disorders (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