Emotions are complicated. Psychology is complicated. Humans, well, we’re complicated.
This season we’ve been diving deeply into emotional and psychological disorders on the blog. We started on Halloween with Sun Si Miao’s ghost points, the ancient treatment for conditions like addiction, bipolar, depression and anxiety.
Last week we talked about the shen, or how we understand spirit and consciousness in Chinese medicine.
But this week I thought we would get back to acupuncture and discuss an interesting group of points – the outer shu points – and tie them back to their impact on the shen.
The Points of the Back
There are over one hundred acupuncture points on the back. To put this in perspective, there are only about 300 regularly used acupuncture points. While some points belong to the channels that cross the shoulder or waist, the majority of the points fall into four groups:
- points that land on the governing vessel or Du channel
- Hua Tuo Jia Ji points
- Inner Shu points
- Outer Shu points
The Governing Vessel or Du Channel runs along the midline of the body, from the perineum, along the spine, over the top of the head and to the top lip. It is known as the Sea of Yang and is able to tonify kidney yang, nourish the brain, strengthen the shen and expel or calm wind.
Hua Tuo Jia Ji
The Hua Tuo Jia Ji points (HTJJ) are points used by the great doctor Hua Tuo of the Han dynasty. These points are the most medial, closest to the midline, of all the points on the back. These points are found a half inch from the spine and at the intervertebral space – the space between each of the bones of your spine.
Because of their location, they can have a direct impact on the spinal roots in the area. They treat local pain and reduce muscle tension in the area or treat anywhere along the pathway of that nerve.
Both inner shu and outer shu points are located along the urinary bladder or UB channel. Inner shu points are located along a line about one and a half inches from the spine. Outer shu points are found about 3 inches from the spine. Each shu point is located at the level of an intervertebral space – the space between each of the bones of your spine.
Inner and outer shu points are acupoints helpful for chronic diseases. There is at least one shu point per organ on the back as well as a shu point for the Du channel, the diaphragm, the sea of qi, the uterus or low back, the sacrum, and the anus. (Maciocia, 808).
The Inner Shu
While HTJJ points of the same intervertebral level can impact the organs and organ systems, inner shu points seem to be the best as directly impacting the organ system imbalances.
For instance, pi shu would be needled for someone who consistently has low energy and loose stool because it’s the shu point of the spleen. Shen shu would be needled for someone who has low energy with low back pain and arthritis because it’s the shu point of the kidneys.
The Outer Shu
The HTJJ points treated the simplest conditions, local and distal (away) from the acupoints themselves; they treated pain. The inner shu points treated more complex issues pertaining to the organ systems themselves. The outer shu points treat the most complex issues of all – issues of the psyche.
Outer shu points treat the emotional and psychological issues of the five yin organs – the heart, liver, spleen, lung and kidneys. As such, not only can they help support treatments for mania, bipolar and other conditions that ghost points are used for, but they can also treat more mundane issues such as anxiety and insomnia or more esoteric conditions such as a lack of direction in life.
Outer Shu points in detail
A quick reminder – a short hand for acupuncturists is to refer to a point by its channel name (in this case, urinary bladder – Ub), and the number of the point on the channel. I will be using both the short hand and the Traditional Chinese name as found in Peter Deadman’s A Manual of Acupuncture.
Ub 42 – Po hu, Door of the Corporeal Soul
At the most basic level, Po Hu nourishes and tonifies the lung. Because it is at the same level as Ub 13, Fei Shu (Lung Shu) it assists with all of the functions of the lung. It can support treatments for asthma, upper respiratory infections and traditionally it was used for chronic diseases such as tuberculosis and lung cancer.
Being an outer shu, Po Hu also helps treat disorders of emotional imbalance in the lung and disorders of the po. Po Hu be helpful in conditions of grief, but it may also help us get in touch with our gut instinct, our intuition and help us fulfill our destiny.
Ub 44 – Shen Tang, Hall of Spirit
Shen Tang lies at the same level as Xin Shu, the heart shu. As the outer shu of the heart, you would expect for there to be a litany of indications but according to Peter Deadman there are no clinical uses for Ub 44 in emotional or psychological issues related to the heart.
But according to Giovanni Maciocia, all of the outer shu points have an impact on the corresponding mental aspect of the yin organs, meaning this point must impact the shen. He states that this point can be used for anxiety or insomnia related to the heart, especially if they show signs of heat.
He also states that it can be used for any strong emotional state such as depression, mental restlessness and worry.
Ub 47 – Hun Men, Gate of the Ethereal soul
Hun Men lies at the same level as gan shu, the shu of the liver. Like Shen Tang, Peter Deadman states that “psychological and emotional indications for this point are notable by their absence in major classical texts.”
Again, Maciocia disagrees. He states that this point is indicated when a person is feeling confused and depressed, unable to plan their lives. If you remember from the last blog post, the hun is the source of our inspiration and drive. By opening this gate, we can potentially gain greater clarity in the direction of our lives.
Needling this point may be useful for those who are lacking inspiration, experiencing creative block or can’t move forward on a project.
Ub 49 – Yi She, Abode of Thought
Yi She is at the same level as Pi Shu, the spleen shu. This point is commonly used for conditions like diabetes, jaundice and vomiting because of it’s location – the bottom of the rib cage puts both Pi Shu and Yi She at the level of the digestive system, and more importantly the pancreas.
The emotion that most regularly impacts the spleen is worry and over-thinking and Yi She is a perfect point for people who feel mentally overworked and burnt out. It’s also a good point for people who are afraid to try new things, or those who tend to be withdrawn or wrapped up in their own thoughts.
Because the yi helps us to set boundaries, Yi She may also be needled in those who need help in setting stronger boundaries, who need help focusing or managing tasks, or even students trying to study.
Ub 52 – Zhi Shi, Residence of Will
Finally, Zhi Shi is found at the same level as Shen Shu. It is excellent for many of the same conditions as Shen Shu – tonifying the kidney system, supporting reproductive function and fertility and treating low back pain.
The kidneys store our yin, yang, and our jing making Zhi Shi an excellent point for extreme fatigue and exhaustion.
But in being an outer shu it is also a gateway for the zhi. The zhi is our willpower. This is a New Year’s Resolution point (that can be used all year round) to help support people trying to meet their goals, but finding themselves self-sabotaging.
This is an excellent point for people who’s depression manifests as a lack of interest in previous hobbies or an inability to complete tasks. It’s also an excellent point for people who feel powerless or hopeless.
Gateways to Spirit
These five points, Po Hu, Shen Tang, Hun Men, Yi She and Zhi Shi are excellent supplements for any emotional, psychological or spirit-focused treatments. When used in combination with inner shu points, an appropriate pattern diagnosis, lifestyle changes and Western treatments such as talk therapy or SSRIs, these five points can help support your journey through anxiety, depression and more.
Ready to add Chinese Medicine to your care plan?
Resources and Links
Peter Deadman – A Manual of Acupuncture
Giovanni Maciocia – The Foundations of Chinese Medicine
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul as well as doing home visits in the Twin Cities area. Check out the services page for more information!
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