(188) GB41 (Foot Falling Tears)

[HB KIM]

Clinical indication of GB41 (Zu Lin Qi)

1. Dry Eyes
From the name, you can use GB41 for Dry eyes. Apply GB41 for xeroma (or xerophthalmia). xerophthalmia is a dryness of the conjunctiva and cornea due to vitamin A deficiency. The condition begins with night blindness and conjunctival xerosis and progresses to corneal xerosis, and, in the late stages, to keratomalacia. You can also add ST1 (Tear Container), SP7 (Leaking Valley), DU26 (Water Trough), GB15 (Head Falling Tears) as well. As you see all of these points have body fluid related words in their names.

2. Allergic rhinitis
This point is one of the best points for allergic rhinitis. You can combine GB41, LU10 and DU23 together. You can also add DU17(Brain's door).  GB41 is also a good point for allergic rhinitis from the aspect of the Four needle technique. The Tonify SJ ( GB41,  SJ3, -UB66, -SJ2) treatment is good for allergic rhinitis and GB41 is in the prescription, so it's better to needle following the channel (tonifing direction).

3. Two "Falling Tears"
There are two "Falling Tears". One is GB15 (Head Falling Tears), the other one is GB41 (Foot Falling Tears). Clinically GB41 is more popular. For pain around GB15 (Head Falling Tears), you can use GB41; for coldness around GB41 (Foot Falling Tears), you can needle GB15.

4. Four Gate + GB41
When using the Four Gates (LI4, LV3) treatment, if the patient has a tendency to be easily irritable or angered, you can add GB41.  When there are symptoms of energy shooting up, GB41 is better than LV3.  In Korean constitutional theory, there are four constitutions:  Taiyang, Shaoyang, Taiyin and Shaoyin types.  For Shaoyang types, adding GB41 is good in addition to the Four Gates treatment.

5. Confluent point
GB41 is the confluent point for the Dai Mai.  With SJ5 combined, they can treat the sides of the body, i.e., ears, temporal head, hypochondriac, or Shaoyang syndrome (Xiao Chai Hu Tang).  A major dui-yao combination in Xiao Chai Hu Tang is Chai Hu with Huang Qin.  I think SJ5 is more like Chai Hu and GB41 is more like Huang Qin.  Chai Hu enters the SJ and Chai Hu and SJ5 both release Wind-Heat. Huang Qin enters the GB and Huang Qin and GB41 can both take care of Damp-Heat (Dai Mai).

6. GB41 vs. GB42
GB41 is located on the lateral side of the tendon of m.extensor digitorum longus, and GB42 is located on the medial side of the tendon of m.extensor digitorum longus. So, please don't confuse both points. GB42 is not a point to use in the clinic. That's why the GB is the only channel which skips the third distal point (GB42) as the Shu-Stream point.  Clinically, in general we don't use points which have "5 (five)" in it, ie, GB42 (Earth 5 convergence), LV10 (Foot 5 Mile), LI13 (Arm 5 Mile).  We use them sometimes in exceptional circumstances, if you don't know what's going on with the patient, but I don't recommend using them.

7. Techniques 
For the technique on this point, you can needle this point toward LV3. Generally speaking, we don't moxa on the top of the hand or foot. So, GB41 is for acupuncture only.