GB-24 (Ri Yue) Sun and Moon

What does GB-24 Ri Yue do?

Ri Yue GB-24 is the Front-Mu (alarm) point of the Gall Bladder — the place on the front of the body where the Gall Bladder's qi is said to gather — and everything it does follows from that. Sacred Lotus sources & references record that classification directly, and also classify GB-24 as a Meeting Point of the Gall Bladder and Spleen channels. The two facts together explain the point's odd double life: it is the Gall Bladder's own point on the chest, and it is simultaneously a middle-burner digestive point, because the Spleen channel meets it there.

• Benefits the Gall Bladder and spreads Liver qi — the primary recorded action. Constrained qi in the Liver and Gall Bladder is the pattern most associated with GB-24: distension and pain beneath the ribs, a tight, oppressed chest, irritability and sighing.
• Resolves damp-heat — the recorded action behind its classical use for jaundice and for the bitter taste in the mouth the tradition attributes to Gall Bladder heat. Damp-heat in the Liver and Gall Bladder is the pattern this point is named for in the reference literature.
• Lowers rebellious qi and harmonises the middle burner — the third recorded action, and the one the Spleen-channel meeting accounts for. Vomiting, acid regurgitation, belching and hiccup are the documented uses, and they belong to the Stomach and Spleen rather than to the Gall Bladder as such.
• Acts as the Gall Bladder's diagnostic point — as with all Front-Mu points, tenderness or a palpable change at GB-24 is read as a sign referring to its organ, so the point is palpated as well as needled. The Front-Mu points are sometimes called "alarm" points for exactly this reason.
• Benefits the breast — the recorded use in mastitis, consistent with the point's position on the chest wall below the nipple and with the tradition's attribution of breast distension to constrained qi in this region.

Source: Sacred Lotus sources & references (channel, Front-Mu and meeting-point classifications, existing action record, queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 441); Chinese Acupuncture & Moxibustion (p. 215); cross-referenced against multiple online sources.

What is GB-24 Ri Yue used for?

Ri Yue GB-24 is used above all for pain and distension beneath the ribs, and for the biliary and digestive complaints the tradition groups with it — jaundice, a bitter taste, vomiting and acid regurgitation. The indications carried in Sacred Lotus sources & references are pain in the hypochondriac region, vomiting, acid regurgitation, hiccup, jaundice and mastitis; the standard reference literature sets them out as below. They describe traditional use, not proven treatment, and this point carries the safety facts set out under needling.

• Hypochondriac pain — pain and distension beneath and between the ribs
• Fullness and oppression of the chest
• Jaundice
• Bitter taste in the mouth
• Vomiting and nausea
• Acid regurgitation and heartburn
• Belching and hiccup
• Epigastric pain and distension
• Poor appetite attributed to constrained qi
• Irritability, sighing and the sense of constrained emotion
• Mastitis and breast distension
• Biliary pain and the presentations grouped under gallstone disease
• Timidity and indecisiveness, in the classical framing of the Gall Bladder as the organ of judgement

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 441); Chinese Acupuncture & Moxibustion (p. 215).

Where is GB-24 Ri Yue, and how is it used in practice?

Ri Yue lies low on the front of the chest wall, directly below the nipple, in the seventh space between the ribs, four cun out from the midline of the body. Sacred Lotus sources & references give it in exactly those terms. That places it one intercostal space below Qi Men LIV-14, the Front-Mu point of the Liver, which sits in the sixth space on the same vertical line — and on the right side, both of them lie over the liver. The stacking of the two Front-Mu points, Liver above and Gall Bladder below, is one of the most memorable arrangements in the repertoire, and it is also the commonest source of confusion between them.

In practice GB-24 is reached for where a complaint is read as belonging to the Liver-and-Gall-Bladder pair and is felt beneath the ribs on the right. It is used less than LIV-14 and much less than the distal Gall Bladder points, which is the normal fate of a Front-Mu point on the thorax: the recorded angle is oblique and the depth shallow, so practitioners often prefer to reach the same organ from a safer position.

Which points is GB-24 combined with?

• With Dan Shu BL-19 — the Shu-Mu combination. BL-19, on the back one and a half cun lateral to the tenth thoracic vertebra, is the Back-Shu point of the Gall Bladder, confirmed by query in Sacred Lotus sources & references. Front-Mu with Back-Shu — the same organ approached from the front and from behind — is the oldest structured pairing in the medicine, and BL-19 with GB-24 is its Gall Bladder instance.
• With Qi Men LIV-14 — the Liver's Front-Mu point, one intercostal space above. The Liver and Gall Bladder are the paired zang and fu, and their Front-Mu points are needled together more often than either alone. The pairing is also the most-studied one involving GB-24: electroacupuncture at the right LIV-14 and GB-24 in cats altered the distribution of cholecystokinin- and vasoactive-intestinal-peptide-containing cells in the duodenum and the sphincter of Oddi (Acupunct Electrother Res 2005;30(1–2):15–25, PMID 16231629).
• With Yang Ling Quan GB-34 — the He-Sea point of the same channel and the Hui-Meeting point of the sinews, below the knee. Local point on the chest and distal point on the leg is the standard way this channel is treated for biliary complaints.
• With Dan Nang Xue — the modern extra point on the leg, held here as the Gallbladder Point, located by tenderness just below GB-34. Where GB-34 is the classical distal choice, Dan Nang Xue is the twentieth-century one, identified by palpation rather than by measurement, and the two are frequently used together with GB-24.
• With Ju Que REN-14 — the Heart's Front-Mu on the upper midline. A clinical report describes water injection for biliary colic performed at the most tender spot within the region bounded by Qimen LIV-14, Riyue GB-24 and Juque REN-14, reporting pain resolution in 32 of 56 cases (J Tradit Chin Med 1995;15(3):185–8, PMID 8569256). Note carefully that the treatment was applied to a region defined by those three points, not to GB-24 itself.
• In the documented gallstone protocols. A clinical study of frequency-varying electroacupuncture for gallstones used Qimen LIV-14, Liangmen ST-21, Riyue GB-24, Danshu BL-19, Ganshu BL-18, Yanglingquan GB-34 and Dannang EX-LE6 (Zhongguo Zhen Jiu 2006;26(11):772–4, PMID 17165496) — every one of those points is held here, which makes it a useful map of how GB-24 is actually prescribed. It is a multi-point protocol, so nothing in it is attributable to GB-24 alone.

Where does GB-24 sit among the Front-Mu points?

The Front-Mu points lie on the front of the trunk, one for each organ, at the place where that organ's qi is said to gather and where tenderness appears when it is disturbed. Sacred Lotus sources & references hold the complete set of twelve:

• Zhong Fu LU-01 — Lungs
• Shan Zhong REN-17 — Pericardium
• Ju Que REN-14 — Heart
• Qi Men LIV-14 — Liver
• Ri Yue GB-24 — Gall Bladder. This page.
• Zhang Men LIV-13 — Spleen
• Zhong Wan REN-12 — Stomach
• Shi Men REN-05 — San Jiao
• Jing Men GB-25 — Kidneys
• Tian Shu ST-25 — Large Intestine
• Guan Yuan REN-04 — Small Intestine
• Zhong Ji REN-03 — Bladder

Each Front-Mu point pairs with its organ's Back-Shu point on the inner Bladder line of the back, and Sacred Lotus sources & references hold that set complete too: Fei Shu BL-13 (Lungs), Jue Yin Shu BL-14 (Pericardium), Xin Shu BL-15 (Heart), Gan Shu BL-18 (Liver), Dan Shu BL-19 (Gallbladder), Pi Shu BL-20 (Spleen), Wei Shu BL-21 (Stomach), San Jiao Shu BL-22 (San Jiao), Shen Shu BL-23 (Kidneys), Da Chang Shu BL-25 (Large Intestine), Xiao Chang Shu BL-27 (Small Intestine) and Pang Guang Shu BL-28 (Bladder). Reading the Front-Mu list makes one thing plain: a Front-Mu point often sits on a different channel from its own organ — five of the twelve are on the Conception Vessel, and the Spleen's is on the Liver channel. GB-24 is one of only three that sit on their own organ's channel, along with LU-01 and LIV-14. That is not a rule; it is an accident of where each organ can be reached from the front.

Source: Sacred Lotus sources & references (location, Front-Mu and meeting-point classifications; the full twelve-point Front-Mu and Back-Shu sets, the BL-19, GB-34, REN-14 and Dan Nang Xue records all queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 441); Chinese Acupuncture & Moxibustion (p. 215); PMID 16231629; PMID 8569256; PMID 17165496; cross-referenced against multiple online sources.

Where is GB-24 located?

• A Manual of Acupuncture (p. 441): On the anterior chest wall, in the seventh intercostal space, directly below the nipple, 4 cun lateral to the midline.
• Chinese Acupuncture and Moxibustion (p. 215): Directly below the nipple, in the seventh intercostal space, 4 cun lateral to the anterior midline.

How is GB-24 Ri Yue needled, and why is it a safety-sensitive point?

Two anatomical facts have to come first. GB-24 lies in the seventh intercostal space on the chest wall — so the pleura and the lung lie beneath it, and pneumothorax is the documented complication of needling points in this band. And on the right side it lies over the liver, the largest solid organ in the body, which reaches up under the lower ribs. This is why every reference text records an oblique angle and a shallow depth at this point, and why the recorded depth is among the smallest given for any point on the body. Everything below is neutral reference data describing what the textbooks and the published studies state. It is not instruction, and this page does not teach technique. Needling is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record oblique insertion of 0.3 to 0.5 inch, with moxibustion applicable. The angle is recorded as oblique, not perpendicular, and that is the substance of the safety statement rather than a stylistic detail: an oblique needle travels along the chest wall, a perpendicular one travels toward what lies behind it.
• Deadman & Al-Khafaji (p. 441) and Chinese Acupuncture & Moxibustion (p. 215) both record oblique or transverse insertion at this point and both attach an explicit caution against deep or perpendicular insertion because of the structures beneath.
• For comparison within our own records: 0.3–0.5 inch at GB-24 is the same figure held here for Qi Men LIV-14 in the space above it, the same as for GB-21 over the apex of the lung, and roughly one-fifth of the 1.5–2.5 inches recorded for GB-30 in the buttock. Depth figures in this literature track the structure underneath, not the size of the region.
• A published clinical use of the transverse angle. A randomised trial of post-operative analgesia after laparoscopic cholecystectomy describes needles inserted transversely at Riyue GB-24, Qichong ST-30 and Yanglingquan GB-34 and fixed in place for electrical stimulation (Zhongguo Zhen Jiu 2014;34(2):169–72, PMID 24796057). Recorded here because it shows the angle the trial literature itself uses at this point.

The measured anatomy — and the honest limit of it

• No published study has measured needling depth at GB-24 itself. That is stated plainly rather than papered over. Searches of the safe-depth literature returned no study naming Riyue or GB-24 among its measured points, and none is claimed here.
• Chest-point depths have been measured by CT, and they vary with body size and sex. A computed-tomography study of 120 patients grouped by body weight, height and sex measured, for each commonly used chest point, the distance from the skin surface to the thoracic pleura and defined that distance as the point's safe depth; significant differences were found between body-size groups (Sheu CY, Lin JG, Zhonghua Yi Xue Za Zhi (Taipei) 1992;50(5):388–99, PMID 1338010). The same has been done in children, where the margins are smallest: a retrospective study of chest CT images in patients aged 4 to 18 found significant differences by sex at nine chest points and highly significant differences across age, weight and body-mass-index groups (Evid Based Complement Alternat Med 2015;2015:126028, PMID 26457105). Neither of these studies measured GB-24. They are cited for the principle they establish about the whole intercostal band in which GB-24 sits, and no measurement from either is attributed to this point.
• No single agreed safe depth exists for any point. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second, by MRI, CT, ultrasound and cadaveric dissection — both concluded that depths measured for the same point differ greatly between subject groups and measuring methods, and that the definition of "safe depth" has never been standardised (J Altern Complement Med 2011;17(3):199–206, PMID 21417806; Evid Based Complement Alternat Med 2013;2013:740508, PMID 23935678).

What is actually documented, and how often

Pneumothorax. A punctured lung is the second most frequently reported serious adverse event in acupuncture. A systematic review of the Chinese case-report literature from 1956 to 2010 identified 1,038 adverse-event cases across 167 articles, of which 307 were pneumothorax — behind only fainting — and attributed them chiefly to improper technique (He W et al., J Altern Complement Med 2012;18(10):892–901, PMID 22967282). Fatal cases exist: an autopsy report describes bilateral pneumothoraces following electroacupuncture, the authors noting that electrical pulses and the muscle contraction they cause may draw needles deeper than the depth at which they were inserted (J Forensic Sci 2022;67(1):377–383, PMID 34435369). The reference literature also records that a pneumothorax following needling over the thorax may not declare itself immediately, presenting hours later with sudden chest pain, breathlessness or a persistent dry cough; it is a medical emergency requiring immediate assessment.

Liver injury. Direct injury to the liver from an acupuncture needle is documented, though rare: a radiology case report describes acute haemoperitoneum — bleeding into the abdominal cavity — from direct liver injury caused by acupuncture, stating that it was the first such case reported (Seah EZ, J Radiol Case Rep 2023;17(8):15–20, PMID 37654899, PMC10435255). A separate forensic case report describes death from multiple organ injuries attributed to improper acupuncture practice (Forensic Sci Med Pathol 2026;22(2):463–468, PMID 41582237). Neither report names GB-24 as the point involved, and neither is presented here as having done so. The reference texts record that the risk of organ injury at points over the liver is greater where the liver is enlarged, and hepatomegaly is therefore specifically noted for points in this region — which for GB-24 means the right side in particular.

Risk in proportion. A meta-analysis of prospective clinical studies estimated serious adverse events at approximately 1 per 10,000 patients and about 8 per million treatments (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). The absolute risk is small and it concentrates in a small number of points; the points over the thorax and the liver, GB-24 among them, are where it concentrates.

Source: Sacred Lotus sources & references (existing needling record; the LIV-14, GB-21 and GB-30 depth figures queried directly for comparison); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 441); Chinese Acupuncture & Moxibustion (p. 215); PMID 24796057; PMID 1338010; PMID 26457105; PMID 21417806; PMID 23935678; PMID 22967282; PMID 34435369; PMID 37654899 (PMC10435255); PMID 41582237; PMID 34489268 — each verified resolvable and checked for retraction status before citation.

What does the name Ri Yue mean?

Ri Yue means "Sun and Moon" — ri, the sun, and yue, the moon. Sacred Lotus sources & references translate it exactly that way, and it is one of the few point names in the repertoire that is purely figurative rather than descriptive of a location. Two readings run through the commentaries, and both bear on how the point is used.

The first is about judgement. The classical texts describe the Gall Bladder as the "upright official who takes decisions" — the organ of clear judgement and of the courage to act on it. Sun and moon are the two lights by which anything can be seen clearly, so the name reads as the Gall Bladder's Front-Mu point being where clarity of decision is addressed. This is the reason indecisiveness and timidity appear in the classical indication lists for a point otherwise concerned with the ribs and the bile.

The second is about pairing. Sun and moon are the standard emblems of yang and yin, and GB-24 sits directly beneath Qi Men LIV-14, the Front-Mu point of the Liver — the yin organ to the Gall Bladder's yang. Two points, stacked in adjacent intercostal spaces, for the two halves of one paired system. Whether the namers intended that reading or not, it is how the name is taught, and it is a genuinely useful way to remember the two points' relationship.

Why does the Front-Mu classification matter?

Front-Mu points are the places on the front of the trunk where an organ's qi is said to gather. They carry two roles at once. They are used to treat the organ, and they are palpated in diagnosis — tenderness at a Front-Mu point is read as a sign that its organ is involved, which is why they are also called alarm points. Front-Mu points are classically weighted toward acute and excess conditions where their Back-Shu partners are weighted toward chronic and deficient ones, though the distinction is a tendency rather than a rule.

GB-24 carries a second classification as well: Sacred Lotus sources & references record it as a Meeting Point of the Gall Bladder and Spleen channels. Meeting points are where two or more channels cross, and they are chosen where one needle should influence more than one of them. This is what explains the digestive half of GB-24's indication list — the vomiting, the acid regurgitation, the belching. Without the Spleen channel meeting here, a Gall Bladder point on the chest would have no obvious claim on the Stomach.

Is there research on GB-24 Ri Yue?

The honest answer is that GB-24 has a small, old and largely preclinical literature, all of it about the biliary tract, and that no modern controlled trial has isolated this point. That should be said plainly rather than padded out with multi-point protocol studies.

• Preclinical work naming the point. In anaesthetised cats, electroacupuncture at the right Qimen LIV-14 and Riyue GB-24 was followed by a more numerous and more distinct distribution of cholecystokinin-labelled cells in the duodenum, gallbladder and sphincter of Oddi, and of vasoactive-intestinal-peptide-labelled cells in the duodenum and sphincter of Oddi but not the gallbladder; the authors concluded that electroacupuncture regulates biliary motility through those neuropeptides (Kuo YL et al., Acupunct Electrother Res 2005;30(1–2):15–25, PMID 16231629). An animal study with no control arm reported, and a two-point stimulation, so it does not separate GB-24 from LIV-14.
• A neuroanatomical tracing study — the most interesting of the set. Twenty-two rabbits received horseradish-peroxidase tracer injected either into the wall of the biliary ampulla or into the Riyue or the Qimen point area. Labelled cells from the Riyue area appeared in the spinal ganglia from T4 to T10 on the same side; those from the ampulla appeared from T3 to T11. The authors reported five to seven overlapping segments of sensory nerve projection between the Riyue and Qimen point areas and the common bile duct ampulla (Zhen Ci Yan Jiu 1990;15(1):13–7, PMID 2117999). This is a segmental-innervation finding in rabbits, not evidence of clinical effect — but it is the closest thing in the literature to a physical account of why a point on the lower right chest should have anything to do with the bile ducts.
• Clinical reports, all multi-point. Water injection at the most tender spot within the region bounded by Qimen LIV-14, Riyue GB-24 and Juque REN-14 was reported in 56 cases of biliary colic, with pain resolving in 32 (J Tradit Chin Med 1995;15(3):185–8, PMID 8569256) — a treatment applied to a region, not to the point. Frequency-varying electroacupuncture including GB-24 among seven points was compared with a combined lithagogue regimen in 120 cases of gallstones (Zhongguo Zhen Jiu 2006;26(11):772–4, PMID 17165496). And a three-arm randomised trial of post-operative analgesia after laparoscopic cholecystectomy used transversely inserted retained needles at GB-24, ST-30 and GB-34 with electrical stimulation (Zhongguo Zhen Jiu 2014;34(2):169–72, PMID 24796057).

What is missing should be said plainly: there is no sham-controlled trial of GB-24, no study isolating it from LIV-14 or from the rest of a biliary protocol, and no published measurement of needling depth at this point. Every clinical study located uses it alongside other points, so nothing in them is attributable to GB-24 itself.

How does GB-24 compare with the points around it?

Qi Men LIV-14 is the point most often confused with it and the one to learn alongside it: same vertical line below the nipple, one intercostal space higher, Front-Mu of the Liver rather than of the Gall Bladder. Where LIV-14 is weighted toward constrained Liver qi and blood stasis beneath the ribs, GB-24 is weighted toward damp-heat, jaundice and the bile. Zhe Jin GB-23 lies higher on the same channel in the fourth intercostal space and is a meeting point of the Gall Bladder and Bladder channels. Jing Men GB-25, the next Gall Bladder point down, sits on the flank at the free end of the twelfth rib and — confusingly for beginners — is the Front-Mu point of the Kidneys, not of anything gallbladder-related. Zhang Men LIV-13, just below and behind it, is the Front-Mu of the Spleen and the Hui-Meeting point of the zang. Dan Shu BL-19 on the back at T10 is GB-24's Back-Shu counterpart. And for the distal end of a Gall Bladder treatment, Yang Ling Quan GB-34 below the knee and the extra point Dan Nang Xue just below it are the two points held here that GB-24 is most often combined with.

Source: Sacred Lotus sources & references (name, translation, Front-Mu and meeting-point classifications, and the LIV-14, GB-23, GB-25, LIV-13, BL-19, GB-34 and Dan Nang Xue records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 441); Chinese Acupuncture & Moxibustion (p. 215); Su Wen, on the Gall Bladder as the official who takes decisions; PMID 16231629; PMID 2117999; PMID 8569256; PMID 17165496; PMID 24796057 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.