Bladder Meridian
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BL-22
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.0 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Back — Lower (Lumbar)
Location
1.5 cun lateral to the lower border of the spinous process of the 1st lumbar vertebra.
Main Actions
- Regulates the Triple Burner and the Lessor Yang
- Regulates the water passages and resolves Dampness
Indications
Commentary
Sanjiaoshu BL-22 is a very important point.
First of all, as the Back Transporting-Shu point of the Triple Burner, it helps regulating Qi and Body Fluids in the Upper, Middle and Lower Burner. BL-22 is locate right above Shenshu BL-23, the Back Transporting-Shu point of the Kidneys. It promotes the emerging of the Original Qi from the space between the Kidneys and its dispersing to the five Yin and six Yang Organs as well as their Channels through the Triple Burner.
The Triple Burner Channel belongs to Lesser Yang. Thus BL-22 is indicated for Lessor Yang Patterns according to the Six Stage Theory. Typical symptoms include alternation of hot and cold feeling, headaches, dizziness and bitter taste.
Secondly, it is a major point to regulate water passages in the Lower Burner. It helps to transform and transport Body Fluids properly and excrete dirty Fluids. Thus it also resolves Dampness in the Lower Burner by regulating the Water Passage. When this function is impaired, the patients tend to suffer from Oedema and various urinary issues.
Finally, it invigorates the Blood in the Lower Burner as well, since Blood is part of Body Fluids. From this point of view, BL-22's action is quite similar to the herb Ze Lan.
Classical Sources
Jia Yi Jing (The Systematic Classic of Acupuncture, 282 CE): Lists indications including abdominal distension, borborygmus, vomiting, diarrhea, and dysentery.
An Explanation of Acupuncture Points (Xue Wei Shi Yi, 1654): Breaks down actions by Burner: Upper Burner treats headache from Wind-Cold invasion, vomiting with dizziness; Middle Burner treats masses, distension, no appetite, shoulder and back pain; Lower Burner treats turbidity, diarrhea, abdominal distension, borborygmus.
Su Wen Chapter 8: States that the Triple Burner is "the official in charge of irrigation and controls the Water passages," explaining why BL-22 is essential for fluid metabolism.
How to Locate
First identify the Tuffier's line which connects the highest points of the iliac crest. The spinous process of the 4th lumber vertebra (L4) mostly falls on this line. Then identify the spinous process of the first lumber vertebra (L1) by counting three up. Locate Sanjiaoshu BL-22 1.5 cun lateral to the lower border of L1. Huangmen BL-51 is at the same level but 3 cun lateral to L1. 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.
Caution
Due to proximity to the kidney, deep perpendicular needling is contraindicated. Use oblique insertion directed toward the spine at a depth of 0.5–1.0 cun. In thin patients, take extra precaution with needle depth. Anatomically, the point overlies the thoracolumbar fascia, erector spinae muscles, and the kidney lies deep to this region at L1 level.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Medium
Standard Depth
0.5–1.0 cun
Needling Directions
Obliquely 0.5–1.5 cun. Caution: Kidneys.
Expected Deqi Sensation
Distending, aching sensation locally in the lower back, often radiating bilaterally or toward the spine. May produce a sensation of warmth spreading into the abdomen, reflecting activation of the San Jiao's water metabolism function.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
Organ & Tissue Associations
Back-Shu Point for:
San Jiao (Triple Burner)
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