Gall Bladder Meridian
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GB-21
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
- Contraindicated during pregnancy
Needle Depth
0.3–0.5 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Shoulder, Neck — Lateral
Location
Midway between Dazhui DU-14 and the lateral extremity of the acromion, at the highest point of the shoulder.
Main Actions
- Removes Obstructions from the Channel
- Promotes lactation
- Descends Qi and promotes labor
Indications
Commentary
One of Jianjing GB-21's main function is to open the Channel by removing the Obstruction. It treats Painful Obstruction Syndrome on the shoulders and neck by relaxing the sinews and relieving stiffness there.
The second function is to benefit the breasts and promotes lactation for postpartum nursing mothers.
It helps descending Qi, so that it treats various childbirth issues such as retention of placenta, postpartum haemorrhage or threatened miscarriage. Therefore, this point is forbidden to needle during pregnancy.
Classical Sources
Zhenjiu Jiayi Jing (3rd Century): "It is needled to a depth of five fen and is moxaed with five cones."
Qian Jin Yi Fang (Thousand Gold Prescriptions): "For difficult labor, needle both Jianjing points one cun with reducing method; delivery will occur shortly. For upper qi cough and shortness of breath, wind-taxation and the hundred diseases, moxa Jianjing 200 cones."
Tong Ren Shu Xue Zhen Jiu Tu Jing (Bronze Man): "Meeting point of Hand and Foot Shaoyang and Yangwei. Treats the five taxations and seven injuries, inability to turn the neck to look behind, oppression of the upper back, inability to raise the hands to the head, or pain of the lumbar and hip from injury after falling."
Lei Jing Tu Yi (Ming Dynasty): Notes that Jianjing should not be used during pregnancy but is indicated for difficult labor.
How to Locate
Use Dazhui DU-14 below the 7th cervical vertebra (C7) and the lateral extremity of the acromion as the references. Draw an imaginary line between these two points and locate Jianjing GB-21 in the midway, on the highest point of the trapezius muscle on the sagittal plane.
Caution
CRITICAL SAFETY: Deep needling carries substantial risk of pneumothorax as the lung apex lies directly beneath this point. Perpendicular insertion should not exceed 0.3-0.5 cun, especially in thin patients. An alternative safer technique is to lift the trapezius muscle and needle horizontally 1 cun into the muscle belly. Use caution in patients with heart conditions as this point may cause fainting. This point has a very strong descending action on Qi and is strictly contraindicated during pregnancy (except to facilitate labor at term). The strong needle sensation at this point can cause fainting (needle shock) in sensitive patients.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
Vertically approximately 0.3–0.5 cun. An alternative and safer method: Lift the muscle and insert the needle approximately 1 cun anteriorly or posteriorly into the muscle belly. Caution: Contraindicated during pregnancy! Pneumothorax.
Expected Deqi Sensation
Strong distention and soreness radiating to the shoulder region and spreading in all directions. Some patients experience a numbing or buzzing sensation. This point typically produces strong needling sensation (deqi), which is why shallow insertion is advised to avoid fainting.
Moxibustion
Recommended
Duration: 5–15 minutes
Cupping
Particularly Recommended
Bloodletting
N/A
Gua Sha
Recommended
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