Acupuncture
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EX-B-4
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.0 cun
Needle Angle
90° (Perpendicular)
Body Area
Back — Lower (Lumbar)
Location
3.5 cun lateral to the lower border of the spinous process of the 1st lumbar vertebra (L1).
Main Actions
- Circulates Qi in the Upper and Middle burner
- Resolves Qi and Blood Stagnation
Indications
Hepatosplenomegaly (enlarged liver and spleen)
Abdominal masses (pi kuai)
Lumbar pain
Lumbago
Lumbar muscle strain
Gastric spasm
Stomach pain
Gastritis
Gastric dilation
Hepatitis
Regurgitation
Enteritis
Nephroptosia (kidney prolapse)
Hernia pain
Commentary
Pigen EX-B-4 is not a major point. Its main function is to circulate Qi in the Upper and Middle burner as well as resolve Qi and Blood Stagnation.
Classical Sources
The name Pigen (痞根) translates as "Root of the Glomus" or "Root of the Lump." The character 痞 (pì) refers to a mass or lump in the abdomen, particularly referring to enlarged organs such as liver and spleen enlargement. This point is named for its ability to treat hepatosplenomegaly, "as if cutting off the root of the mass."
According to Danxi Xiansheng Xinfa (丹溪先生心法, Master Danxi's Methods of the Heart): "Masses in the center are from phlegm-damp; masses on the right are from food stagnation; masses on the left are from blood stasis." The action of this point is likened to severing the root of such masses.
The point derives from Huangmen (肓門 BL-51), indicating its relationship to the Bladder channel region and its influence on the internal organs.
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 1st spinous process of the 1st lumber vertebra (L1) by counting up three. Pigen EX-B-4 is 3.5 cun lateral to the lower border of L1.
Caution
Caution: Risk of kidney injury with improper or excessively deep needling. This point lies in close proximity to the kidneys, and deep perpendicular needling can potentially puncture the renal capsule. Always use appropriate needle depth (0.5-1.0 cun) and avoid inserting medially. Practitioners should palpate carefully to locate the point, as there can be slight variations in position. The point is often found at or near trigger points of the quadratus lumborum muscle.
Needle Angle
90° (Perpendicular)
Depth Category
Medium
Standard Depth
0.5–1.0 cun
Needling Directions
0.8–1 cun obliquely in a medial direction. Caution: Injury to the kidneys!
Expected Deqi Sensation
Local aching and distension sensation at the point, often radiating to the lumbar region. The point frequently presents as a tender or ashi point, particularly in patients with lower back pain or quadratus lumborum involvement.
Moxibustion
Recommended
Duration: 10–15 minutes; or 3–7 moxa cones
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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