"Zhi" (至), extreme or ultimate; "yang" (陽), yang aspect. Back is associated yang, and the number "seven" is considered a yang number. This acupoint is located at 7th thoracic vertebra, making it the "ultimate yang within yang." Additionally, the spinous processes of 6th and 7th thoracic vertebrae are the most prominent points of thoracic curvature of spine. Hence the name.

bubble_chart Location

Zhiyang (GV9) acupoint
(adapted from "Meridians and Acupoints")

On the midline of back, in the depression below the spinous process of 7th thoracic vertebra, approximately level with the inferior angle of scapula.

• Zhenjiu Jiayi Jing: "Located in the space below 7th vertebral joint." It can also be located at the prominence of the spinous process.
• Leijing Tuyi : "When selecting acupoints along governor vessel on spine, they should be located at the prominent points of vertebral joints".

bubble_chart Anatomy

• Muscles: thoracolumbar fascia, supraspinous ligament, and interspinous ligament.
• Nerve: medial branch of posterior branch of 7th thoracic nerve. Within spinal canal lies spinal cord.
• Vessels: posterior branch of 7th intercostal artery, interspinous subcutaneous venous plexus.

bubble_chart Manipulation

Insert obliquely 0.5~1 cun, but avoid deep insertion. Alternatively, insert at the prominence of the spinous process and direct it downward subcutaneously for 1~2 cun. Moxibustion with moxa cone 3 to 5 times, moxibustion with moxa stick for 15 to 20 minutes.

bubble_chart Efficacy

Tonify qi, discharge heat, benefit chest and diaphragm, clear liver and gallbladder.

• Classical: chills and fever with laziness, fatigue and soreness of legs, heaviness and pain in limbs, shortness of breath and difficulty speaking, jaundice, stomach pain, cold in stomach, or appetite, fullness in chest and hypochondrium, pain in chest and back.
• Modern: angina pectoris, arrhythmia, hepatitis, cholecystitis, biliary ascariasis, stomach pain, abdominal pain, malaria, pleurisy, intercostal neuralgia, psoriasis.

bubble_chart Combinations

• Biliary ascariasis: Zhiyang (GV9) penetrates Danshu (BL19).
• Viral hepatitis: Zhiyang (GV9), Ganshu (BL18), Pishu (BL20), Zusanli (ST36) , Yanglingquan (GB34).
• Arrhythmia: Zhiyang (GV9), Xinshu (BL15), Neiguan (PC6).