What Pishu does
Pishu 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
- Tonifies the Spleen Qi and Yang
- Resolves Dampness
- Nourishes Blood
- Lifts Spleen Qi and stop bleeding
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 11th thoracic vertebra (T11).
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. Start from the seventh cervical vertebra, which remains palpable as the neck is flexed and extended while the sixth slips forward out of reach. Eleven spinous processes below it is T11. A second route is to find T7, level with the inferior angle of the scapula when the patient sits with the arms hanging, then count four thoracic vertebrae down. A third is to locate the joint of the lowest rib at T12 and palpate upwards one level. The point is 1.5 cun lateral to the lower border of T11. Yishe BL-49 sits at the same level but 3 cun out, and the inner branch of the Bladder channel runs from Fengmen BL-12 to Baihuanshu BL-30.
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 here, for 10 to 15 minutes. The Spleen responds well to sustained warmth, and the reference uses direct moxibustion with Shenshu BL-23 when the aim is to build Blood in deficiency, so a warm and unhurried technique suits this point better than a brief one.
Skin uses
Pishu is the back-shu point of the Spleen, recorded to tonify Spleen Qi and Yang, resolve Dampness, nourish Blood and lift Qi. The traditional reasoning here is one of the clearest indirect links: the Spleen is described as the source of Dampness when its transforming function fails, and damp skin pictures are said to follow from that. The point is therefore considered where a damp pattern is thought to have an internal Spleen root, rather than for a named skin disease. With no skin-specific classical indication recorded for it, the rationale relies on traditional inference, not trial evidence.
No skin-specific classical indication is recorded for this point. The rationale above is an indirect, traditional reading of the point, not a promise of benefit.
Point classifications
| Classification | Value |
|---|---|
| Channel | Meridian |
Classical record
The text in which the point first appears, described as the place where the Qi of the Spleen infuses into the back.
Lingshu (Spiritual Pivot), chapter on the Back Transporting points, as recorded in the reference
Lists the point for chronic infantile convulsions arising from Spleen deficiency.
Yi Zong Jin Jian (Golden Mirror of the Medical Tradition), 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 lies over the thoracic cavity at the level of T11. Needling straight down, or angling the tip away from the midline, carries a substantial risk of pneumothorax. The reference asks for an oblique insertion towards the spine at roughly 45 degrees and a total depth of 0.5 to 0.8 cun, and it rules out deep insertion altogether. In thin patients the pleura sits closer to the surface, so the practitioner works with more caution and less depth, not more force.
Deficiency and constitution
In a depleted patient the point is worked gently and briefly. Where Spleen Yang is deficient the reference warms the point instead of draining it, using direct moxibustion, often together with Shenshu BL-23 when the aim is to build Blood.
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 Pishu do in skin practice?
It is used where the skin picture includes the conditions it is used with, always as part of a combination chosen for the pattern.
How is it needled?
45° (Oblique). Standard depth 0.5 - 0.8 cun. De qi: Local distension and soreness at the point, with sensation often spreading to the waist region. The deqi sensation may radiate along the intercostal space. Patients typically feel a deep, dull ache characteristic of Back-Shu points.
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) Body Area Back - Upper (Thoracic)
Is moxibustion preferred at Pishu?
The reference marks it as particularly recommended, for 10 to 15 minutes. Warmth suits a Spleen that has become cold and deficient, and direct moxibustion is named alongside Shenshu BL-23 when the aim is to build Blood, so moxa is often the main technique here while the needle works the same ground.
How does a Spleen point help with Dampness and Phlegm?
The Spleen governs how Body Fluids are transformed and moved on. When that work is weak the fluids gather as Dampness and later thicken into Phlegm, giving heaviness of the limbs, a sticky taste, gurgling in the abdomen and a sense of fullness. Pishu is used to restore the transforming function, so the fluid is moved rather than allowed to pool.