Governing Vessel
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DU-9
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.0 cun
Needle Angle
45° (Oblique), 90° (Perpendicular)
Body Area
Back — Upper (Thoracic)
Location
On the back midline, in the depression below the spinous process of the 7th thoracic vertebra (T7).
Main Actions
- Resolves Damp-Heat
- Opens the chest
- Regulate Middle Burner
Indications
Commentary
Zhiyang DU-9 is mainly used to treat jaundice and Hypochondrial and epigastric fullness. It can remove Damp-Heat from the Liver and the Gall Bladder.
It also open the chests by resolving Qi Stagnation there, so as to treat symptoms such as feeling of distension or oppression, hiccups and sighing.
Classical Sources
《针灸甲乙经》(Zhenjiu Jiayijing - The Systematic Classic of Acupuncture and Moxibustion): First documented this point as belonging to the Du Mai (Governing Vessel), located below the 7th thoracic vertebra.
《针灸大成》(Zhenjiu Dacheng - The Great Compendium of Acupuncture and Moxibustion): "第七椎下" (Below the seventh vertebra). Lists its indications including jaundice, chest and hypochondriac fullness, and spinal stiffness.
Name Etymology: 至 (zhì) means "extreme" or "reaching"; 阳 (yáng) means "yang." The point is named because it is located at the level of T7, where the back (yang region) and the Du Mai (yang vessel) converge with the number seven (a yang number representing the extreme of yang), making this the point where yang energy reaches its peak.
How to Locate
Locate the Tufffier's line, which connects the two most superior points on the iliac crest. It generally intersects with the spinous process of the 4th lumbar vertebra (L4). Then locate the 7th thoracic vertebra by counting up 9. Locate Zhiyang DU-9 below the spinous process of the 7th thoracic vertebra (T7) on the midline. Or identify the inferior angle of the scapula, which is normally at the same level as Zhongyang DU-9 in the posterior midline.
Caution
This point lies directly over the spinal canal. In smaller individuals, the spinal canal may be reached after only 1.25 cun regardless of body weight. Oblique inferior insertion is preferred over perpendicular needling to reduce risk. Always needle with the patient's back straight or slightly flexed. Deep perpendicular insertion is contraindicated. Only experienced practitioners should attempt oblique insertions at this location.
Needle Angle
45° (Oblique) / 90° (Perpendicular)
Depth Category
Shallow
Standard Depth
0.5–1.0 cun
Needling Directions
0.5–1 cun strictly vertically to the skin or obliquely in an inferior direction, with the patient’s back straight or flexed in order to avoid puncturing the spinal canal. Oblique insertions should only be carried out by experienced practitioners, as in small persons, irrespective of their body weight, the spinal canal may be reached after only 1.25 cun.
Expected Deqi Sensation
Local distension and soreness at the point, which may radiate bilaterally across the thoracic region or along the spine. Some patients experience a spreading warm sensation in the upper back area.
Moxibustion
Recommended
Duration: 5–10 minutes, or 3–5 moxa cones
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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