L.

Intestine
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Spleen
Heart
S. Intestine
JIANJING GB-21 INDICATIONS
Bladder
Shoulder Well • Stiffness and pain of the neck, pain of the shoulder and
Kidney back, inability to raise the hand and arm, hemiplegia.
Meeting point of the Gall Bladder,
Pericardium • Loss of speech following windstroke, windstroke,
Sanjiao and Stomach channels
Sanjiao wind-taxation, the five taxations and the seven inju-
with the Yang Linking vessel ries, steaming bone disorder, Kidney deficiency
Gall Bladder
lumbar pain.
Liver
LOCATION • Cough and dyspnoea, rebellion of qi, mania-depres-
Conception
Midway between Dazhui DU-14 and the tip of the ac- sion, redness of the face.
romion, at the crest of the trapezius muscle.
Governing • Scrofula, goitre, leg qi ascending to attack the Heart,
Extra Points pain of the Spleen.
tip of acromion Jianjing GB-21 Dazhui DU-14 • Difficult or prolonged labour, inversion counterflow
of the arms and legs following miscarriage, retention
of the placenta, uterine bleeding.
• Breast pain, breast abscess, breast milk does not flow,
furuncles and carbuncles.
COMMENTARY
The region of Jianjing GB-21, at the crest of the trapezius
muscle, is particularly prone to symptoms of contraction,
tightness and pain due to a variety of aetiologies. The Gall
Bladder is interiorly-exteriorly coupled with the Liver.
Stagnation of Liver qi or uprising of Liver yang due to
anger, frustration, resentment etc. commonly vent up-
wards along the Gall Bladder channel, and readily
accumulate in and below the neck, especially when tight-
ness and restriction in the relatively narrow neck region
prevent their upward flow. The close relationship be-
tween the upper body and anger was emphasised in
many texts, for example the Essential Questions4 which
stated “anger will cause the qi to surge upwards”. Alter-
natively, the region of Jianjing GB-21 may be injured by
sprain, penetration by wind-cold (especially after sleep-
ing in a cold draught), prolonged poor posture or
occupational strain. Jianjing GB-21 may be needled in all
midway
such cases of stiffness of the neck and shoulders, which
may extend to the back or arm.
Jianjing GB-21 is indicated for a variety of phlegm
LOCATION NOTE disorders. Phlegm may involve Liver or Gall Bladder
i. The crest refers to the highest point of the trapezius muscle pathology in the following three ways: i. Liver qi stagna-
on the sagittal (anterior-posterior) plane; ii. This point is tion leads to stagnation of fluids which condense into
normally located at the point of maximum tenderness. phlegm, summed up in the statement in the Treatise on
Disorders of Blood “When qi flows, water also flows”, ii.
NEEDLING Liver wind ascends carrying phlegm with it (this is one of
Posterior oblique insertion, 0.5-1 cun. the main pathological features of windstroke), and iii.
Caution: i. perpendicular insertion, especially in thin Liver or Gall Bladder fire steams and condenses fluids
patients, carries a substantial risk of inducing a pneumo- into phlegm. By virtue of its actions of regulating qi,
thorax; ii. contraindicated in pregnancy. lowering and transforming phlegm and dissipating nod-
ules, Jianjing GB-21 is used in the treatment of such
ACTIONS phlegm disorders as hemiplegia, loss of speech following
Regulates qi, activates the channel and alleviates pain windstroke, windstroke, scrofula and goitre
Transforms and lowers phlegm and dissipates nodules Jianjing GB-21 also has a strong qi descending action
Benefits the breasts and expedites delivery and is indicated in various disorders of rebellious qi such
 L. Intestine
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Bladder
Spleen
Heart
S. Intestine
as cough and dyspnoea, rebellion of qi, and leg qi ascend- (Ode to Elucidate Mysteries).
ing Bladder
to attack the Heart. Leg qi is a disorder characterised • Pain and cold of the arm: Jianjing GB-21, Quchi L.I-11
Kidney
by numbness, pain, weakness, spasm, swelling, redness and Xialian L.I-8 (Great Compendium).
andPericardium
heat sensations of the feet and legs. In severe cases the • Scrofula: Jianjing GB-21, Shaohai HE-3, Tianchi P-1,
pathogen
Sanjiaoattacks more deeply affecting the abdomen and Zhangmen LIV-13, Zulinqi GB-41, Zhigou SJ-6, Yangfu
Heart. GB-38 and Shousanli L.I.-10 (Great Compendium).
Gall Bladder
Difficult labour may be due to stagnation or deficiency • Retention of the placenta: Jianjing GB-21 and Zhongji
of qiLiver
and blood. In either case, due to its strong descending REN-3 (Great Compendium).
Conception
action, Jianjing GB-21 has long been used to expedite • Retention of the placenta: Jianjing GB-21, Zhongji
delivery and promote the descent of the placenta, and for
Governing REN-3 and Sanyinjiao SP-6 (Meeting the Source).
thisExtra
reason is contraindicated in pregnancy. Jianjing GB-21
Points • Pain and soreness of leg qi: first needle Jianjing
is also specifically indicated by the Classic of Supplement- GB-21, then needle Zusanli ST-36 and Yanglingquan
ing Life with Acupuncture and Moxibustion for “Inversion GB-34 (Celestial Star).
counterflow coldness of the arms and legs following • Prolapse of the rectum: Jianjing GB-21, Baihui DU-20,
miscarriage”. A similar condition in post-partum women Changqiang DU-1, Dachangshu BL-25, Hegu L.I.-4
is described by the famous Qing dynasty gynaecologist and Qichong ST-30 (Compilation).
Fu Qing-zhu who says “In the course of delivery, some
women overexert themselves with taxation and fatigue
injuring the Spleen. As a result, there occurs inversion
with counterflow chilling of the limbs, qi ascends to fill up
the chest, the pulse departs, and form deserts”5. The
implied ability of Jianjing GB-21 to tonify deficiency fol-
lowing miscarriage, is surprisingly mirrored in its
indications for a variety of deficiency patterns including
wind-taxation, the five taxations and seven injuries, Kid-
ney deficiency lumbar pain and steaming bone disorder.
So strong is the action of Jianjing GB-21 in descending qi
that Gao Wu, in the Ode of Xi-hong, says “When you needle
Jianjing GB-21 you must needle Zusanli ST-36. If this is not
done, the qi will not be regulated”. In other words, the
action of Zusanli ST-36 on tonifying and raising the qi will
help to counter any excessive descent of the qi resulting
from needling Jianjing GB-21.
Jianjing GB-21 is also indicated for breast disorders. The
Gall Bladder primary channel penetrates the chest and the
Gall Bladder sinew channel connects with the breast,
whilst Jianjing GB-21 is a meeting point of the Gall Blad-
der channel with the Stomach channel which descends
through the nipple. Excessive worry, anger, frustration,
resentment or depression may lead to stagnation and
knotting of Liver qi, or accumulated heat in the Stomach
channel may gather at the breast, leading to breast pain,
breast abscess, and failure of the breast milk to flow.
Jianjing GB-21 may be selected in all these situations.

COMBINATIONS
• Inability to turn the neck: Jianjing GB-21 and Pohu
BL-42 (Supplementing Life).
• Pain of the shoulder and back: Jianjing GB-21, Fengmen
BL-12, Zhongzhu SJ-3, Zhigou SJ-6, Houxi SI-3, Wangu
SI-4 and Weizhong BL-40 (Great Compendium).
• Pain of the forearm: Jianjing GB-21 and Quchi L.I.-11