GB-19 (Nao Kong) Brain Hollow

What does GB-19 Nao Kong do?

GB-19 benefits the head and alleviates pain, and it pacifies wind and clears the sense organs. Its name means Brain Hollow, and it sits on the occiput directly above GB-20.

• Benefits the head and alleviates pain — shared with GB-17 and GB-18 on the same run
• Pacifies wind and clears the sense organs — the action its eye, ear and epilepsy indications rest on

It carries the fullest indication list of the five points on this run — six entries against GB-15’s six, GB-16’s four, GB-18’s four and GB-17’s two — and it is the only one of them recording tinnitus, neck stiffness or epilepsy. Being the lowest and most posterior of the five, closest to the neck and the ear, its list reflects its position.

It is a Meeting Point of the Gallbladder Channel with the Yang Linking Vessel (Yang Wei Mai), as are all five points of this run — GB-15 through GB-19. Five consecutive points on one vessel is what makes the group cohere.

On the name, and the point it shares it with. “Nao Kong” means Brain Hollow. Nao here is the brain — and our record fixes this point’s level by reference to DU-17 Nao Hu, Brain Door, on the midline. Two points named for the brain, at the same level, on different lines, one used to locate the other. Take care not to confuse this nao with the one meaning upper arm, which our SJ-13 Nao Hui and SI-10 Nao Shu records carry — a different character, identical in toneless pinyin.

Source: Sacred Lotus sources & references (channel, category, action, location and translation records; the GB-15 to GB-18 indication lists counted, and the DU-17, SI-10 and SJ-13 records queried, against our own data), cross-referenced against multiple online sources.

What is GB-19 Nao Kong used for?

GB-19 is used for headache and neck stiffness, vertigo, painful eyes, tinnitus and epilepsy. Our own indication record is reproduced here in full — six entries.

• Headache
• Stiffness of the neck
• Vertigo
• Painful eyes
• Tinnitus
• Epilepsy

An honest note, and several of these need one.

• EPILEPSY REQUIRES MEDICAL DIAGNOSIS AND PRESCRIBED MANAGEMENT, and a first seizure, a prolonged seizure, or a seizure in a child is a MEDICAL EMERGENCY. This record documents a classical indication and makes no claim that acupuncture treats epilepsy or seizures.
• HEADACHE WITH NECK STIFFNESS AND FEVER REQUIRES URGENT ASSESSMENT — and a sudden severe headache unlike any before is an emergency in its own right. That combination sits in this indication list, which is why it is stated here.
• Sudden vertigo with headache, double vision, weakness, slurred speech or unsteadiness is a MEDICAL EMERGENCY, since those can indicate a stroke affecting the balance centres — which lie in the part of the brain this region overlies.
• A red or painful eye requires assessment; some causes are sight-threatening. New or one-sided tinnitus requires assessment.

Why this list is the fullest of its run. GB-19 is the lowest and most posterior of the five, sitting where the scalp meets the neck, close to the ear and above the occiput. Neck, ear and eye indications follow from that position — and the four points in front of it, further onto the crown, carry none of the neck or ear entries.

How it is combined. With GB-20 Feng Chi directly below — but see the needling section, because the two are anatomically quite different. With GB-18 in front on the same curve. With DU-17 Nao Hu on the midline at the same level, and BL-09 Yu Zhen between them at 1.3 cun. With BL-10 Tian Zhu for the neck. All held here.

Source: Sacred Lotus sources & references (indication record, with the GB-15 to GB-19 lists counted and compared; the BL-09, BL-10, DU-17, GB-18 and GB-20 records queried from our own data), cross-referenced against multiple online sources.

Where is GB-19 Nao Kong located?

GB-19 is on the back of the head, directly above GB-20, level with DU-17 on the midline.

• Directly above GB-20 Feng Chi, in the occipital region
• Level with DU-17 Nao Hu, which sits on the midline just above the external occipital protuberance
• BL-09 Yu Zhen lies between them, 1.3 cun lateral to DU-17

Two references, and both are firm — which sets this point apart from the rest of its run. GB-16, GB-17 and GB-18 are placed by equal 1.5-cun steps measured from one another along a curve, a chain in which error accumulates. GB-19 is not part of that chain: it is fixed independently, by a vertical from GB-20 and a level from DU-17, both of which rest on the external occipital protuberance — a definite, palpable bony landmark. Our GB-16 record sets out why that difference matters.

Three points across one level. DU-17 on the midline, BL-09 at 1.3 cun, GB-19 further out — three channels at the occiput, and our records hold all three. Note that BL-09 sits at 1.3 cun, one of only three points in this library using that unusual measure; a reader assuming the familiar 1.5-cun line will place it wrongly, as our BL-09 record explains.

On the name. “Nao Kong” — Brain Hollow. Kong is a hole or hollow, and nao the brain, shared with DU-17 Nao Hu at the same level. The name is anatomical in a way few point names are — and the needling section explains why that makes the distinction from GB-20 below worth stating carefully.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; the BL-09, DU-17, GB-16, GB-17, GB-18 and GB-20 records queried and the equal-step chain compared against our own data).

• A Manual of Acupuncture (p. 435): In the occipital region, directly above Fengchi GB-20, level with Naohu DU-17.
• Chinese Acupuncture and Moxibustion (p. 213): On the head and on the level of the upper border of external occipital protuberance or Naohu (DU-17), 2.25 cun lateral to the midline of the head.

How is GB-19 Nao Kong needled, and how does it differ from GB-20 below it?

Our own record states subcutaneous insertion to roughly 0.3–0.5 inch, with moxibustion applicable — and the single most useful fact on this page is that GB-19 is ON the occipital bone while GB-20, directly below it, is BELOW that bone. What follows is a neutral record of what the reference literature documents. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: subcutaneous (transverse), 0.3–0.5 inch — identical across all five points of this run, and identical again to every other scalp point in this library.
• Moxibustion: recorded as applicable.
• Regional anatomy: the occipitalis muscle and the epicranial aponeurosis lie beneath thin skin; the occipital artery and the greater occipital nerve run in the region; the occipital bone lies directly beneath, and the cerebellum and the posterior cranial fossa lie within it.

The boundary, stated precisely, because the name invites exactly the wrong inference. This point is called Brain Hollow and it sits on the back of the head — but the skull is closed here in an adult, bone lies immediately beneath the scalp, and the recorded insertion is transverse. That makes GB-19 a low-hazard point: no cavity within reach, no organ, no major vessel at the point itself.

GB-20 Feng Chi, directly below it, is a different situation entirely. Our GB-20 record carries an explicit caution because that point sits in the soft hollow beneath the occipital bone, where there is no bone to stop a needle and the brainstem lies deep — and our DU-16 Feng Fu record carries the same caution for the same reason on the midline. The line between them is the lower edge of the occipital bone, and GB-19 is above it. This page neither imports GB-20’s caution nor exports GB-19’s safety downward: our BL-09 record draws the same boundary from the middle of the same level, and the distinction is anatomical and exact.

What is not claimed. No study measuring a safe depth at GB-19 could be located, and none is borrowed. Neither measured-depth study this library uses reaches the head. No case report naming GB-19 was located.

Source: Sacred Lotus sources & references (needling record, retained unchanged, and the recorded insertions across GB-15 to GB-19 compared; the BL-09, DU-16 and GB-20 records queried from our own data and their cautions attributed to those points), cross-referenced against multiple online sources; regional anatomy from standard anatomical description.

Is there research on GB-19, and what should a reader know?

No trial isolates GB-19. Where the point appears it is one component of a headache or neck protocol, and a study that includes a point in a protocol is not evidence about that point.

Its neighbour below is one of the most-used points in acupuncture. GB-20 Feng Chi appears in most headache, neck and dizziness protocols, and a great deal of the literature a reader will find near GB-19 is really about GB-20. Evidence about GB-20 is evidence about GB-20 — and given that the two points differ in the one respect that matters most anatomically, the distinction is worth more here than usual.

What this page can state with confidence. GB-19 sits directly above GB-20, level with DU-17, and — unlike GB-16, GB-17 and GB-18 — it is not part of the equal-step chain: it is fixed by two independent references, both resting on the external occipital protuberance. It carries the fullest indication list of the five points on its run, and is the only one recording tinnitus, neck stiffness or epilepsy. And its name says Brain Hollow while the anatomy says solid bone — the hazard in this region belongs to GB-20 one point below, where the bone ends.

A note on searching for it. “GB 19”, “G 19” and “Naokong” searches return protocol trials and unrelated material — and note that nao transliterates at least two different characters in the point system: the brain, as here and at DU-17, and the upper arm, as at SJ-13 Nao Hui and SI-10 Nao Shu. Any claim attached to this point should be checked against what a study actually used.

Source: Sacred Lotus sources & references (action, indication, location and needling records; the GB-15 to GB-19 run compared, and the BL-09, DU-16, DU-17, GB-20, SI-10 and SJ-13 records queried, against our own data).