🌸 Do you know the point combination Four Flowers?

You've probably heard of the point combination Four Gates (LV-3 + LI-4), but have you heard of a point combination called Four Flowers (BL-17 + BL-19)?

This is an interesting combination I came across while looking up some things about BL-17, so I thought you might be interested in hearing about it...

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The "four flowers" is a point combination made up of BL-17 (膈俞 gé shū) and BL-19 (膽俞 dǎn shū).

This combination was first mentioned in Secrets of a Frontier Official in 752 CE, but that book didn't actually name the points -- it just described the point locations in a rather roundabout way.

Later, in the 13th century, the Classic of Supplementing Life with Acupuncture and Moxibustion defined the "four flowers" as BL-17 and BL-19. It said that these points dominate blood, and moxa on these points can treat taxation consumption disorder.

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The Gathering Point of the Blood

The name of BL-17 is gé shū ("diaphragm shu"), and it's the Hui-Meeting point of the Blood.

(This category of points can be called the Eight Hui-Meeting Points, Eight Gathering Points, or Eight Influential Points depending on which book you're reading.)

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The Hui-Meeting points come to us from chapter 45 of the Nan Jing. These are points where the qi of certain tissues gathers or assembles. And when we needle these points, we can influence the respective entity.

So in chapter 45 it says, the qi of the blood gathers at Ge Shu.

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Unfortunately, the Nan Jing doesn't give us any reasons as to why each point is chosen as a gathering point. But later scholars have tried to come up with explanations.

One explanation for BL-17 goes something like this:

Blood is generated in the Heart and stored in the Liver. The Heart is above the diaphragm, and the Liver is below the diaphragm. Therefore, all blood must pass through the diaphragm at some point, and therefore the qi of the blood gathers at the Diaphragm Shu point (BL-17).

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Moving Blood, Cooling Blood, and Tonifying Blood

So because BL-17 is the Hui-Meeting point of the Blood, it has a great influence on disorders of the blood.

Most classical point indications for BL-17 focus on two areas: invigorating blood to dispel stasis, and cooling the blood to stop bleeding.

So in this way, it has very similar actions to SP-10 (血海 xuè hǎi). However, because BL-17 is in the upper body, it is better for conditions of the upper and middle jiao. SP-10 is better for conditions is the lower jiao (like menstruation issues).

If you're looking through Maciocia point prescriptions, you may notice that he often uses both BL-17 and SP-10 for blood stasis. Since BL-17 is better for the upper body and SP-10 is better for the lower body, this combination will treat blood stasis anywhere in the body.

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But BL-17 can also be used to tonify blood (and yin) as well. For this application, moxibustion is typically used.

In tonifying blood, BL-17 has three areas of specialty:

• night sweating and steaming bone disorder due to severe blood and yin deficiency
• taxation consumption disorder
• blood deficiency + blood stasis

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It's for the second condition, taxation consumption disorder, that the Four Flowers combination is used.

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But why add BL-19?

So it makes sense that BL-17 is used for blood deficiency, but why add BL-19?

After all, BL-19 is the Back-Shu point of the Gallbladder. It's typically used for heat and damp-heat in the Gallbladder. Wouldn't BL-18 (the Back-Shu of the Liver) make more sense?

I'm actually not sure, and I haven't been able to find any explanation.

If we look at Maciocia point prescriptions, he often uses BL-17 plus BL-18 (needle only) for blood stasis. But then he'll sometime use BL-17 with BL-18 or BL-20 to tonify blood, but in these cases, one should use direct moxa on BL-17.

So I would remember: if you want to use BL-17 to tonify blood, make sure you use moxa. If you want to move blood or clear blood heat, use a needle only.