Effect of Reflex Points on the Gallbladder Meridian and Vision by Kimberly Burnham, PhD (Integrative Medicine)

            This next section is meant for you to look up the image and work with each of the points outlined. The research abstracts are just for information. If there are things you don't understand—don't worry about it.
            The gallbladder meridian runs from the side of the eye, near the temple (at the outer canthus of the eye. It loops down and up to the forehead within the hairline and descends behind the ear to the corner of the skull. This wood meridian returns to the forehead arcing across the side of the head and descends to the back of the head, then down the side of the body. It meets the Bladder Meridian (water element) at the sacrum and runs down the outside of the leg and ends on the 4th toe.
 
[Images at https://theory.yinyanghouse.com/acupuncturepoints/gallbladder_meridian_graphic]
 
Gallbladder 
            "Under the strict control of experimental conditions and fixation of electrical acupuncture stimulation parameters, the changes of hepatic bile output were observed in five different stages before, during and after acupuncture, and compared with those in control group not treated by acupuncture. The results showed that electrical acupuncture of Ganshu (Back-Shu point) (GB 18) and Qimen (Front-Mu point) (LI 14) could obviously promote the secretion of hepatic bile. The immediate effect was superior to that in other groups. In a group not treated by acupuncture, hepatic bile output gradually decreased as time went on. In animal experiment, a model of bile pigment lithogenesis was made in guinea pig. The animals were randomly divided into five groups of control, simultaneous acupuncture, simultaneous moxibustion, re-acupuncture after one week and re-acupuncture after two weeks. The results indicated that electrical acupuncture or moxibustion of relevant acupoints such as Ganshu (GB 18) and Qimen (LI 14) could really very effectively inhibit the animal lithogenesis caused by lithogenesis food. A tendency was observed towards that the earlier acupuncture was performed, the better the preventive effect on lithogenesis. In the influence on lithogenesis bile, both acupuncture and moxibustion could reduce the contents of biliary total bilirubin and free bilirubin and the activity of biliary beta-glucuronidase. Acupuncture also produced an effect in lowering hepatic beta-glucuronidase but moxibustion didn't. Hepatohistological observation showed that lithogenous food could also cause fatty degeneration of liver, and moxibustion could markedly inhibit its progress. Both acupuncture and moxibustion didn't remarkably influence the content of serum cholesterol." Zhang, S., H. Chen, et al. (1995). "[Clinical and experimental researches in the inhibition of bile pigment lithogenesis by acupuncture and moxibustion]." Zhen Ci Yan Jiu 20(3): 40-45.
 
Gallbladder (GB) 18 Located on the top of the head straight back from each eye, just in front of a line crossing the top of the head from ear tip to ear tip. In the parietal region, on a curved line drawn between Toulinqi GB-15 and Fengchi GB-20, following the contour of the cranium, 1.5 cun posterior to Zhengying GB-19, directly lateral to Baihui Du-20. 
 
            In a study to observe the effect of acupuncture of Jianjing (GB 21) and non-acupoint on gallbladder volume and clinical symptoms of chronic cholecystitis patients, researchers noted, "After acupuncture intervention, the remission rates of shoulder-back pain and stomachache in non-acupoint and GB 21 groups were 56.67% and 90.00% respectively, while the effective rates of the patients' gastric distention and nausea in non-acupoint and GB 21 groups were 16.67% and 23.33%, respectively. The therapeutic effect of Jianjing (GB 21) was apparently superior to that of non-acupoint in pain relief. Acupuncture stimulation of Jianjing (GB 21) can effectively relieve shoulder-back pain and stomachache, and regulate the volume of the deflated and expanded gallbladder in cholecystitis patients. The effect of acupuncture of non-acupoint is relatively poorer in relieving the cholecystitis patients' symptoms and regulating the gallbladder volume. Wen, F. Y., S. C. Li, et al. (2012). "[Effects of acupuncture of Jianjing (GB 21) on gallbladder volume and symptoms of cholecystitis patients]." Zhen Ci Yan Jiu 37(5): 398-402.
 
Gallbladder (GB) 21 is located at the top of the shoulders half way between the rotator cuff (outer edge of the shoulder) and the vertebrae column (spine).
 
            In an electroacupuncture study of the effect on the gallbladder of two points (Yanglingquan (Gallbladder 34)  and Yinlingquan (Spleen 9) acupoint on white blood cell (WBC) count and gallbladder wall thickness in rabbits with acute cholecystitis, Researchers noted, "Compared with the control group,WBC count and gallbladder wall thickness of the model group were significantly increased, and those changes were reversed by EA intervention at either GB 34 or SP 9 acupoints. As to WBC count, there was no significant difference between EA-GB 34 and EA-SP 9 groups (P>0. 05), whereas for reducing gallbladder wall thickness, EA stimulation at GB 34 acupoint resulted in a better effect than that of EA at SP 9 acupoint. EA produces positive therapeutic benefits on acute cholecystitis in rabbits. It seems that stimulation at "Yan - glingquan" acupoint gives rise to a better effect than that of "Yinlingquan" acupoint in particular for the reduction of gallbladder wall thickhess."  Zhou, M. L., W. R. Jia, et al. (2015). "[Effect of Electroacupuncture at "Yanglingquan" (GB 34) Acupoint on White Blood Cell Count and Gallbladder Wall Thickness in Rabbits with Acute Cholecystitis]." Zhen Ci Yan Jiu 40(3): 233-237.
 
Gallbladder (GB) 34 is located near the outer side of the knee in a depression anterior (in front of)  and inferior (below) the head of the fibula (thinner bone on the outer side of the lower leg).

Head Symptoms 
            In a study to observe and evaluate the clinical effect of acupuncture at "Siguan" combined with the Gallbladder Meridian acupoints on migraine, researchers noted, "The observation group was treated with acupuncture at "Siguan" including Hegu (LI 4) and Taichong (LR 3), combined with the Gallbladder Meridian acupoints including Fengchi (GB 20), Shuaigu (GB 8), Qiuxu (GB 40) and Zulinqi (GB 41), while the control group was treated with acupuncture at the Gallbladder Meridian acupoints, including Fengchi (GB 20), Shuaigu (GB 8), Qiuxu (GB 40), Zulinqi (GB 41), Yanglingquan (GB 34) and Hanyan (GB 4). At the end of the treatment, the total effective rate was 95.2% (40/42) in the observation group and 80.0% (36/45) in the control group, which had statistical difference (P<0.05). After 3-month follow-up, the total effective rate was 88.1% (37/42) in the observation group and 75.6% (34/45) in the control group, which had no statistical difference. The "Siguan" combined with the Gallbladder Meridian acupoints could significantly relieve the migraine intensity, frequency and lasting time, and its improvement of symptoms and short-term efficacy are superior to those of the Gallbladder Meridian acupoints alone. Lin, X. M., X. Yao, et al. (2014). "[Acupuncture at "Siguan" combined with Gallbladder Meridian acupoints for migraine: a randomized controlled trial]." Zhongguo Zhen Jiu 34(10): 947-950.
 
Gallbladder (GB) 20 is located near the base of the skull behind the ear in a depression between the upper portion of the sternocleidomastoid muscle and the trapezius.
 
Gallbladder (GB) 8 Superior to the apex of the auricle, 1.5 cun within the hairline (1/2 ear length from the apex).
 
Gallbladder (GB) 40 At the outside of the ankle, anterior and inferior to the external malleolus (big bump on outside of ankle) in a depression on the lateral side of the tendon of extensor digitorum longus
 
Gallbladder (GB) 41 Top of the foot near the fourth toe, posterior to the 4th metatarsophalangeal joint in a depression lateral to the tendon of extensor digiti minimi
 
Gallbladder (GB) 34 is located near the outer side of the knee in a depression anterior (in front of)  and inferior (below) the head of the fibula (thinner bone on the outer side of the lower leg).
 
Gallbladder (GB) 4 Side of the forehead in front of the ear, within the hairline of the temporal region at the junction of the upper 1/4 and lower 3/4 distance between ST 8 and GB 7.
 
Vision 
            In a study to investigate the dynamics underlying the sustained effect of acupuncture as a possible explanation of earlier findings that acupuncture stimulation at the vision-related acupuncture point, GB37, researcher's findings from this study suggest that "acupuncture at GB37 can induce complex brain activity in the vision cortex. The state-related neural signal may reflect one of the significant characteristics underlying acupuncture." Liu, J., J. Nan, et al. (2013). "Additional evidence for the sustained effect of acupuncture at the vision-related acupuncture point, GB37." Acupunct Med 31(2): 185-194.
 
Gallbladder (GB) 37 Near the outer ankle, on the lateral aspect of the lower leg, 5 cun (finger widths) above the tip of the external malleolus (bony bump on the outside of the ankle), on the anterior border of the fibula (smaller outer bone in the lower leg).
 
"Acupoint specificity is one of the central issues of functional magnetic resonance imaging (fMRI) studies of acupuncture and has been under discussed. However, strong and consistent proof has not been provided for the existence of acupoint specificity, and unsuitable analysis approach applied could be the reason. We observed that previous researches of acupoint specificity were mostly based on model-based methods which were limited to make exploration of acupoint specificity because of the inaccurate specified prior. Here we applied multi-voxel pattern analysis (MVPA) to investigate the specificity of brain activation patterns induced by acupuncture stimulations at a vision-related acupoint (GB37) and a nearby nonacupoint (NAP). Results showed that multiple brain areas could differentiate the central neural response patterns induced by acupuncture stimulation at these two sites with higher accuracy above the chance level. These regions included occipital cortex, limbic-cerebellar areas and somatosensory cortex. Our results support that the characteristic neural response patterns of brain cortex to the acupuncture stimulation at GB37 and a nearby NAP could differ from each other effectively with the application of MVPA approach." Li, L., W. Qin, et al. (2010). "Exploring vision-related acupuncture point specificity with multivoxel pattern analysis." Magn Reson Imaging 28(3): 380-387.
 
            Another study compared the differences in the efficacy on distant version of naked eye in the patients of juvenile myopia between rotating manipulation and lifting-thrusting manipulation of acupuncture neddling. The points worked with included: Cuanzhu (BL 2),Yuyao (EX-HN 4), Sizhukong (TE 23), Taiyang (EX-HN 5), Fengchi (GB 20), Zusanli (ST 36), Guangming (GB 37) and Sanyinjiao (SP 6). Researchers noted, "Acupuncture achieves the positive and sustainable clinical effect on juvenile myopia, and the results of rotating manipulation are superior to that of lifting-thrusting manipulation. Age, basic vision and duration of sickness impact the clinical efficacy. Tao, X. Y., B. Y. Zhao, et al. (2014). "[Impacts of rotating or lifting-thrusting manipulation on distant vision of naked eye in patients of juvenile myopia: a randomized controlled trial]." Zhongguo Zhen Jiu 34(5): 465-468.
 
Gallbladder (GB) 20 is located near the base of the skull behind the ear in a depression between the upper portion of the sternocleidomastoid muscle and the trapezius.
 
Gallbladder (GB) 37 Near the outer ankle, on the lateral aspect of the lower leg, 5 cun (finger widths) above the tip of the external malleolus (bony bump on the outside of the ankle), on the anterior border of the fibula (smaller outer bone in the lower leg).
 
Zheng H, Chen M, Wu X, Li Y, Liang FR. Manage migraine with acupuncture: a review of acupuncture protocols in randomized controlled trials. Am J Chin Med. 2010;38(4):639-50.
 
Shin MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10.
 
Takayama S, Seki T, Nakazawa T, et al. N. Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: additional therapy to standard medication. Evid Based Complement Alternat Med. 2011;2011:157090. Epub 2011 Mar 7. PubMed PMID: 21437193