What Geshu does
Geshu is treated here as a practical point rather than a curiosity: where it sits, how it is needled, what the tradition says it does, and the skin conditions in this database that name it.
Actions
- Invigorates Blood
- Cools Blood Heat and stops bleeding
- Harmonises Qi in diaphragm and descends Rebellious Stomach Qi
- Nourishes Blood and tonifies Qi
Location
One and a half cun measured from the landmark shown in the diagram and the location text, lateral to the lower border of the spinous process of the 7th thoracic vertebra (T7).
How to find it
Find the bony landmark first, then feel for the hollow or tender spot the location describes. The point is usually sensitive when pressed. The seventh cervical vertebra is the starting landmark, since it can still be felt while the neck is flexed and extended, while the sixth slides forward and is lost. Seven spinous processes below C7 is T7. The level can also be found directly, because T7 sits level with the inferior angle of the scapula when the patient sits with the arms hanging. The point is 1.5 cun lateral to the lower border of the T7 spine. Geguan BL-46 lies at the same level but 3 cun out, and the stretch from Fengmen BL-12 to Baihuanshu BL-30 forms the inner branch of the Bladder channel.
Deqi
De qi at this point is felt as local distension, heaviness or aching, and may travel a short way along the channel.
A cun is a proportional body measurement, not a fixed length: one cun is about the width of the thumb at the knuckle, 1.5 cun about two finger widths, and 3 cun about the width of four fingers. On an average adult one cun is roughly one inch, but it scales with the person, which is why the texts measure in cun rather than centimetres.
Technique
Needling
Angle: 45 degrees, oblique Depth: Standard depth half a to one cun. Direction: Needle in the direction the location describes.
Moxibustion
Moxibustion is particularly recommended at this point, for 10 to 15 minutes or with 3 to 7 cones. The reference reserves moxa for deficiency: direct moxibustion warms and builds Qi and Blood, and it is the technique behind the Four Flowers combination with Danshu BL-19. Where the picture is excess, with stagnation or with bleeding driven by Heat, the record allows no moxibustion at all.
Skin uses
- Nausea Vomiting Belching Hiccuping Heart pain Chest pain Body aches Bloody nose Body swelling Coughing blood Epigastric pain Body distension Vomiting of blood Sour regurgitation Digestive difficulties
Point classifications
| Classification | Value |
|---|---|
| Channel | Meridian |
Classical record
The classical record summarises the classical use of this point without quoting a passage in full.
classical record
The first record of Geshu as a point on the back, placing it at the level of the seventh thoracic vertebra.
Lingshu (Spiritual Pivot), chapter Bei Shu, as recorded in the reference
血會膈俞. The text names Geshu as the meeting point of Blood and states that disorders of Blood should be treated at this point.
Nan Jing (Classic of Difficulties), chapter 45, as recorded in the reference
Lists vomiting, hiccup, difficulty in swallowing, fullness of the chest, pain in the hypochondrium and pain in the spine among the signs it governs.
Zhen Jiu Jia Yi Jing (Systematic Classic of Acupuncture and Moxibustion), as recorded in the reference
The text where the Four Flowers combination of Geshu BL-17 with Danshu BL-19 is first mentioned, used with moxibustion for consumption disorders.
Wai Tai Mi Yao (Secrets of a Frontier Official, 752 CE), as recorded in the reference
Safety
Who should treat this point
Acupuncture and moxibustion are practitioner procedures. This page is educational and is not a guide to self-treatment.
Caution
Safety flags: the reference marks it as a dangerous point. Needle with care, adjust depth to the patient's build, and modify or avoid the point where a flag applies. The point sits over the thoracic cavity, so a needle that is too deep, or one driven perpendicular, risks a pneumothorax. The reference asks for an oblique direction towards the spine or a transverse approach instead. Safe depth is given as roughly 1 cun, about 2.5 cm, and cadaver studies quoted in the record suggest a maximum of about 3 cm. Perpendicular insertion and any angle away from the midline are excluded, and deep needling is avoided altogether in thin or emaciated patients.
Deficiency and constitution
In a depleted patient the point is worked gently and briefly. Where the pattern is one of emptiness the reference warms the point rather than reducing it, using direct moxibustion, and it gives 3 to 7 cones as the range, so the technique is gentle and building rather than draining.
Before treatment
Educational reference only. Skin that is spreading, painful, blistering or accompanied by fever needs medical assessment.
Modern evidence and safety
General references for acupuncture safety and skin evidence. They are not specific to this point, and they are not a claim that needling it treats any condition.
- Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open, 2021. PMID: 34489268.
- Acupuncture for atopic dermatitis: a systematic review and meta-analysis. BMJ Open, 2024. PMID: 39638592.
- Manual acupuncture for the treatment of chronic spontaneous urticaria: a systematic review and meta-analysis. International Journal of Surgery, 2025. PMID: 40696933.
- Acupuncture in Dermatology: An Update to a Systematic Review. Journal of Alternative and Complementary Medicine, 2021. PMID: 32955916.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
What does Geshu do in skin practice?
It is used where the skin picture includes nausea vomiting belching hiccuping heart pain chest pain body aches bloody nose body swelling coughing blood epigastric pain body distension vomiting of blood sour regurgitation digestive difficulties, always as part of a combination chosen for the pattern.
How is it needled?
45° (Oblique) / 10-15° (Transverse). Standard depth 0.5 - 0.8 cun. De qi: Local distension and soreness spreading along the intercostal spaces. Sensation may radiate toward the spine or around the ribcage. Some patients may feel the sensation reach toward the epigastric region or chest.
Is it safe?
Dangerous point - requires extra caution Deep needling contraindicated - shallow insertion only Needle Depth 0.5 - 0.8 cun Needle Angle 45° (Oblique), 10-15° (Transverse) Body Area Back - Upper (Thoracic)
Why is Geshu called the meeting point of Blood?
The Nan Jing, in its forty-fifth chapter, identifies the point as the gathering place of Blood and says that disorders of Blood are treated here. In practice that gives the point three roles: it moves Blood where it has stagnated, it cools Blood where Heat is driving it out, and with moxibustion it builds Blood when the supply is low.
Why is moxibustion avoided at Geshu in some cases?
Because warming belongs to the deficiency side of the point and not to the excess side. Where Blood is stagnant, or where Heat is pushing blood out of the vessels, the reference uses a reducing method and allows no moxa, since heat would add to the problem. Direct moxibustion is kept for empty patterns, where it builds Qi and Blood.