Bladder Channel

Ganshu BL-18

Chinese: 肝俞

Pinyin: Gān Shū

Location

1.5 cun lateral to the lower border of the spinous process of the 9th thoracic vertebra (T9). 

How to locate

First locate the spinous process of the 7th cervical vertebra (C7), which is still palpable when the neck is being flexed and extended, while the 6th cervical vertebra (C6) starts to slide anteriorly and gradually disappears. 

The spinous process of the 9th thoracic vertebra (T9) is nine spinous process below C7.

Or first locate the spinous process of T7, which is level with the inferior angle of the scapula, when the patient is seated with their arms hanging down. T9 is two thoracic vertebra below. 

Ganshu BL-18 is 1.5 cun lateral to the lower border of T9. Hunmen BL-47 is at the same level but 3 cun lateral to T9.  

Points located between Fufen BL-41 and Zhibian BL-54 are in the lateral branch of the Bladder Channel, while these between Fengmen BL-12 and Baihuanshu BL-30 are in the medial branch.

Main actions

  1. Resolves Damp-Heat
  2. Invigorates Liver Qi and Blood
  3. Nourishes Liver Blood
  4. Extinguishes Interior Wind
  5. Benefits the eyes and sinews

Indications

Tetany Nausea Lockjaw Jaundice Red eyes Eye pain Neck pain Dizziness Sinew pain Stiff neck Tearfulness Eye itching Lumbar pain Muscle pain Bloody nose Opisthotonos Swollen eyes Shoulder pain Cholecystitis Abdominal pain Blurred vision Abdominal mass Coughing blood Epigastric pain Spine stiffness Hypogastric pain Floaters in eyes Vomiting of blood Hypochondriac pain Sour regurgitation Eye upper orbit pain Diminished night vision HypochondriaI distension

Needling

0.5–1 cun obliquely towards the spine.

Or 1 to 1.5 cun transversely towards the spine. This method applied more often as it allows the patients to lie in a supine position easily during needling retention. 

Caution: Pneumothorax.

Commentary for Ganshu BL-18

As the Back Transporting-Shu point of the Liver, Ganshu BL-18 is indicated for most Liver related patterns. 

Excess/Full patterns include Liver Qi Stagnation, Damp-Heat in the Liver and Gall Bladder, Liver Fire and Liver Blood Stagnation. 

It is widely used to invigorate Liver Qi, in order to ease distension and pain of the hypochondrium, epigastrium, abdomen and hypogastrium. Other symptoms include sour regurgitation, nausea and etc. 

By resolving Damp-Heat, Ganshu BL-18 treats jaundice and cholecystitis. By invigorate Liver Blood, it treats abdominal masses. 

This point also extinguish Interior Wind so as to ease stiff neck and spine, lockjaw, opisthotonos, or tetany. 

Since the Liver opens to the eyes and controls sinews, the point benefits the eyes and sinews in case of blurred vision, excessive lacrimation, upper orbit pain or redness, pain and itching of the eyes as well as pain in lumbar, neck, shoulder and etc. 

On the other hand, Ganshu BL-18 can also be used for Empty patterns such as Liver Blood Deficiency. Together with Geshu BL-17, it is able to treat symptoms such as dizziness and blurred vision. In this case, Tonifying Needling method or direct moxibustion should be applied.