Bladder Point 67
Zhiyin: Reaching Yin
Extremity of Yin/Utmost Yin

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Bladder point 67 is an acupuncture point on the small toe. In Chinese medicine it has certain properties which make it very useful:

  • Exit point of the Bladder channel. (The Entry point for the Bladder channel is Bladder point 1, also a great point.)
  • The Jing-Well point on the Bladder channel
  • The Metal point on the channel
  • Its Tonification point

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Location of Bladder Point 67

On the dorsal (upper) surface of the small toe (the fifth toe, digitus minimus) lateral and proximal to the nail.

The usual way of locating Bladder point 67 is to draw lines along the lateral border of the toenail and along the base of the toenail. Where they meet is the point.

However, people's toes vary, and as you age, your toenail can change along with the shape of your toe. Often the point is about 0.1 cun proximal to the lateral corner at the base of the nail.

And sometimes it's somewhere else! Best tip? With a sharp finger nail, press gently into the area where you expect the point to be and round about it, and when there is soreness (or the most soreness), mark the point by making a cross in the skin with your finger nail.

Needling Zhiyin

Bladder Point 67 can be needled, bled, pressed and moxa'ed. However, it can be sore, especially in healthy young people so if being needled, use a very thin needle and press the area with your fingernail adjacent to the point (to provide a counter sensation), as you needle it.

If using a moxa stick, don't hold it steadily over the point but pass it back and forth over the point. If using moxa cones, use small ones and replace them rapidly. For many people sensations at this point are attenuated either by skin thickness or age and holding a moxa stick over the point can lead to a burn before the patient reports a burning sensation.

Needling depth and direction
0.1cun to 0.2cun either obliquely upwards, or vertically. Swift insertion is recommended: the skin may be thick and the nerves on its surface less effective, but most people have nerves underneath, which may feel the needle perfectly clearly.

Needle Sensation for Bladder Point 67
Local sensation and pain. Yes: there's really no other way to describe it: this point does hurt a bit. Tell your patient to take a deep breath and exhale strongly as the needle is inserted.

He or she may wish to exclaim vigorously too: a good strong swear-word is a proven way to dissipate pain! (Why? Because acute pain occurs, according to Chinese medicine, when Qi is unable to move, so builds up and stagnates. Swearing vigorously moves Qi, so dissipates the stagnation, reducing the pain. Read more about this and other ways to deal with pain under Qi stagnation.)

Actually, it's not that bad and the benefits can be great - think of that!

Actions of Bladder Point 67

1. Yang area symptoms
To understand the action of Bladder Point 67, think first of where it is and the experience of acupuncturists using it over at least 2000 years.

Points on one end of a meridian often strongly affect the area at the other end of the meridian. If so, you would expect this point to affect the head, the forehead and particularly the eyes and the area around them.

So ... the point clears the head and the eyes of energy trapped there, including Wind. So it helps to clear neck pain, headaches especially at the vertex (although consider whether there is a deficiency of Liver Blood aspect to this as well), fuddled thinking ('clears the brain'), heaviness in the head, blocked nose, sinus congestion, epistaxis, eye problems such as pain, inflammation and itching and visual blurring (film over the eyes) and pain at the inner canthus. Also used for infantile convulsions.

In this regard, it is not so much acting to tonify but to clear and descend excess yang and qi in the area due to acute rather than chronic pathogenic factors.

If used to clear exterior pathogenic factors one would expect the pulse to be superficial. But even if there is no exterior pathogenic factor at work but the pulses are still very superficial, use of this point can take energy (and the pulses) deeper towards normality.

So it can be a useful point for traumatic injuries at the vertex. The top of the body, the Head, is at the Yang extreme of the body and this point is excellent for problems there. Another very Yang area of the body is the skin and indeed, this point is excellent for burns and scalds, and itching of the whole body.

2. Bladder and Kidney Qi symptoms
Bladder Point 67 lies on the Bladder channel and being the Exit point of the meridian, its Well point and its tonification point, can help many problems associated with the meridian itself and the areas it passes over, and the Kidney meridian, which lies next in line in the movement of Qi through the 24 hour clock. It therefore moves Qi from the Bladder meridian to the Kidney meridian.

So, for example, it helps hearing and deafness, tinnitus and ear problems; back and lumbar pain (though one might expect it to be more effective in upper back pain than lower back pain); urinary problems such as difficulty urinating, or pain when urinating, seminal emissions and problems such as cystitis. All these conditions are often indications of Bladder or Kidney zangfu syndromes, and if so, they can usually be helped with Chinese medicine and acupuncture.

Here the point is acting both to tonify the meridian ('tonify' is probably not quite the right way of explaining its action: what it does is help to move qi along the channel) and regulate symptoms lying along its path. However, in practice, it must be said, this is not the first point one would think of when treating acute dysuria.

3. The Kidney meridian which, because this point feeds directly into it, (because Zhiyin is the Exit point on the Bladder channel, from where Qi transfers to the first point or Entry point on the Kidney channel) may almost be said to be part of the Bladder meridian, covers many other problems including yin deficiency heat and sweating, pain or heat in the soles of the foot, cramps and spasms, knee problems, and Kidney yang problems such as over-cooling in malaria with lack of sweating.

Here its action seems to be regulating Kidney Qi and doing some tonifying. In relation to this, the point is sometimes used to correct endocrine gland imbalances.

4. Chest area

The Kidney channel (of which this point may, along with Kidney point 1, be said to be the beginning) ends in the chest, and this point helps pain in the chest and sides of the chest, and turbulence, agitation and anxiety of the Heart.

Bladder Point 67 is also a special point for breast problems, along with other points mainly on the Spleen and Gallbladder meridians.

Here it is acting so as to descend excess.

5. Malposition of the foetus
Now think of its name ' Extremity of Yin' or 'Reaching Yin'.

From a mother's point of view, as the foetus in her womb grows, it becomes an increasing impediment to movement, energy and comfort.

In other words it is a large lump of Yin, growing steadily over nine months. The mother's body, particularly her Kidney Qi, Jing-essence and Blood go to form the baby. In health, of course, the baby eventually presents head down facing the right way and proceeds through the birth canal at the appropriate time.

However, all that Yin takes Yang to make - the mother's Yang; so not surprisingly she gets tired - she's at the limit of her endurance: she's completely fed up with it all!

And eventually, the Yin lump has to start moving itself, first in positioning itself and then moving - in other words the Yin lump becomes more Yang. (After birth of course, all being well, the lump is very definitely Yang, not least in exercising its lungs and demanding attention.)

But if that lump of Yin fails to develop Yang qualities, this point's name shows its purpose. Under the rules of yin and yang, when yin reaches its maximum it becomes yang, and vice versa. Treating this point with Yang energy, moxa, stimulates the 'lump' to get a move on: to turn, to push.

Ideally then, from about 34 weeks, if there is mal-position of the foetus, start using moxa over this point - the mother or her partner can do this when shown how, until the baby has turned. (Then stop, otherwise, it may continue spinning like a top and end up where it started!)

Equally, too much moxa for a mother whose Spleen Yang energy is very weak just might, conceivably, promote labour too early.

So it's regarded as being very safe but in a mother who is disturbed, very anxious or exhausted, it is perhaps better if done by someone else or the acupuncturist.

6. Inducing Labour
Along with other points, Bladder point 67 is renowned for being able to induce labour. Usually for this purpose both acupuncture and moxa may be used, depending on how warm the mother feels.

When used for inducing labour, Bladder Point 67 stimulates the uterus and its contents. Used with other energy points, such as Stomach 36 (Zusanli), Spleen 6 (Sanyinjiao) and Large Intestine 4 (Hegu), it can help birth proceed.

How much moxa to use for this? Moxa stick for at least five minutes every hour (but be careful not to burn the skin) and acupuncture that stimulates the point. However, as with all acupuncture, it is sensible to adjust treatments according to the overall symptom picture of the mother, including her pulses and tongue.

7. Undischarged placenta
Used as for labour when the placenta fails to appear: moxa and acupuncture.

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Bladder point 67 
It can help the embryo to attach to the wall of the uterus so is helpful when trying to conceive.

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