GB-40 (Qiu Xu) Hill Ruins

What does GB-40 Qiu Xu do?

GB-40 Qiu Xu is the Yuan (Source) point of the Gall Bladder channel of Foot Shao Yang — the point at which the original qi of that channel is said to surface and settle — and it sits in the hollow at the front and underside of the outer ankle bone. Source points are the channel's own regulating point: they are used to treat the organ directly, to balance a channel that is either full or empty, and diagnostically by palpation. That classification, plus its position at the ankle joint, gives GB-40 its two working faces — a Gall Bladder point and a local ankle point.

• Spreads Liver qi and clears Gall Bladder heat and damp-heat — the Source-point action on the organ, applied to hypochondriac pain, bitter taste, vomiting and acid regurgitation, and to the presentations older sources group under jaundice and malaria.
• Activates the channel, alleviates pain and benefits the joints — its local and channel role, and the reason it is the ankle's own Gall Bladder point.
• Regulates Shao Yang — used where the pattern is described as neither fully exterior nor fully interior, with alternating or shifting presentation along the sides of the body.
• Serves as a diagnostic point — like all Source points, tenderness or a change in the hollow at GB-40 is read as referring to its channel and organ, so the point is palpated before it is chosen.

Source: Sacred Lotus sources & references (channel and Yuan Source classification, existing action record); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 458; Chinese Acupuncture & Moxibustion, p. 220; Source-point scheme per Ling Shu (Spiritual Pivot), Chapter 1; cross-referenced against multiple online sources.

What is GB-40 Qiu Xu used for?

GB-40 is used for two distinct groups of complaints: local disorders of the ankle, and Gall Bladder and Shao Yang patterns affecting the flanks, the neck and the digestion. The indications recorded in Sacred Lotus sources & references are set out below.

• Pain and swelling of the outer ankle (external malleolus)
• Pain in the neck
• Pain in the hypochondriac (flank and rib-side) region
• Swelling in the axillary region
• Vomiting and acid regurgitation
• Muscular atrophy and weakness of the lower limbs
• Malaria (the alternating-fever presentation of the classical literature)
• Ankle sprain and restricted ankle movement
• Bitter taste in the mouth and other Gall Bladder signs

Source: Sacred Lotus sources & references (existing indication record); Chinese Acupuncture & Moxibustion, p. 220; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 458; cross-referenced against multiple online sources.

How is GB-40 Qiu Xu used in practice?

GB-40 lies at the ankle, in the hollow just in front of and below the bony knob on the outside of the ankle, on the outer side of the tendon that runs to the toes. The depression is easy to find with a fingertip and is often tender, which is why the point is palpated as a matter of course in both ankle complaints and Gall Bladder patterns.

• With GB-34 Yang Ling Quan — the standard within-channel pairing: the Source point at the ankle with the He-Sea point below the knee, one channel treated at two levels.
• With LIV-03 Tai Chong — Source point with Source point across the interior–exterior paired channels, the classic Liver-and-Gall-Bladder combination for constraint, flank pain and irritability.
• With GB-24 Ri Yue and LIV-14 Qi Men — the Source point joined to the two Front-Mu points on the flank, for hypochondriac pain and biliary presentations.
• With BL-60 Kun Lun, BL-62 Shen Mai and ST-41 Jie Xi — the local ring of points around the ankle joint, used together for sprain, swelling and restricted movement. Analysis of the published ankle-sprain literature shows this is exactly the grouping practitioners actually select (PMID 36858419).
• With SJ-05 Wai Guan — the hand and foot Shao Yang points used together to open the channel along its length.
• Threaded toward KI-06 Zhao Hai — a penetrating-needle technique from the outer ankle through to the inner, recorded in a small Chinese case series for palpitation (PMID 25509733). A 30-case series is an observation, not evidence of effect, and is noted here only because the technique is documented.

How does GB-40 differ from GB-34?

These are the two Gall Bladder channel workhorses, and they do different jobs. GB-34 Yang Ling Quan is the He-Sea point of the channel and the Hui-Meeting point of the Sinews — a whole-body point for tendons, ligaments and soft tissue anywhere, from the jaw to the hip, plus the He-Sea point's action on the fu organ. GB-40 Qiu Xu is the Source point — the channel's own balancing and diagnostic point, and the local point for the ankle it sits on. Put plainly: reach for GB-34 when the problem is the sinews or the organ; reach for GB-40 when the problem is the channel itself, the ankle, or when you want the Source point for a Shu-Yuan or Yuan-Luo pairing. The two are frequently used together, which is a combination rather than a redundancy.

Where does GB-40 sit among the Source points?

Sacred Lotus sources & references hold the full set of twelve Yuan Source points — LU-09 Tai Yuan, LI-04 He Gu, ST-42 Chong Yang, SP-03 Tai Bai, HT-07 Shen Men, SI-04 Wan Gu, BL-64 Jing Gu, KI-03 Tai Xi, P-07 Da Ling, SJ-04 Yang Chi, GB-40 Qiu Xu and LIV-03 Tai Chong. Every one of them lies at or just beyond the wrist or the ankle, and on the yin channels the Source point doubles as the Earth and Shu-Stream point, while on the yang channels — GB-40 among them — it is a separate point in its own right. That distinction is worth holding: on a yang channel the Source point is an addition to the five-shu series, not one of its members.

Source: Sacred Lotus sources & references (location, Yuan Source classification, full Source-point set); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 458; Chinese Acupuncture & Moxibustion, p. 220; PubMed PMID 36858419, 25509733; cross-referenced against multiple online sources.

Where is GB-40 located?

• A Manual of Acupuncture (p. 458): At the ankle joint, in the depression anterior and inferior to the lateral malleolus.
• Chinese Acupuncture and Moxibustion (p. 220): Anterior and inferior to the external malleolus, in the depression on the lateral side of the tendon of m. extensor digitorum longus.

How is GB-40 Qiu Xu needled in the textbooks?

Reference record only — this describes what the standard texts document, not instruction for a reader. Sacred Lotus sources & references record perpendicular insertion of 0.5–0.8 cun at GB-40, with moxibustion noted as applicable. Deadman & Al-Khafaji record a comparable perpendicular range and additionally describe oblique insertion directed toward the inner ankle for particular applications.

• Angle documented: perpendicular into the depression; oblique toward the medial side of the ankle in the threading variant.
• Depth documented: approximately 0.5–0.8 cun perpendicular; deeper for the threading technique.
• Moxibustion: documented as applicable.

Safety reference. GB-40 carries no cavity or organ hazard — there is no thoracic, abdominal or cranial structure anywhere near it, which is one reason the point is so freely used. The anatomy that does bound the recorded depth is local and superficial: the point lies in a hollow directly over the ankle joint capsule and the tendon of extensor digitorum longus, with the branches of the superficial fibular (peroneal) nerve and the small vessels of the ankle in the immediate area. The documented depth range is therefore short, and the reference texts locate the point in the depression lateral to the tendon rather than on it. Local bruising and transient tenderness are the events most often recorded at ankle points. Where an ankle is acutely swollen after injury, the reference literature treats the region as one to be handled conservatively. Standard clean-needle practice applies. Acupuncture is performed by qualified, licensed practitioners; this record documents the literature and is not a technique guide.

Source: Sacred Lotus sources & references (existing needling record); Chinese Acupuncture & Moxibustion, p. 220; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 458.

What does the name Qiu Xu mean?

Qiu Xu translates as "Hill Ruins" — qiu for a hill or mound, xu for a ruin, a mound of rubble, or an old settlement gone to earth. The name is topographical and describes exactly what a finger finds there: the outer ankle bone is the hill, and the point sits in the broken, uneven hollow at its foot. Chinese point names of this kind are location aids first — the image tells the practitioner where to press. Some translations render it "Mound of Ruins" or "Hill Wastes"; they describe the same landmark.

Why does the Yuan (Source) classification matter?

The Source points are set out in the first chapter of the Ling Shu, where they are described as the places where the original (yuan) qi of each channel lingers and collects. Three practical consequences follow. First, a Source point can be used in either excess or deficiency — it regulates rather than only tonifying or only draining, which makes it a safe general choice when the diagnosis is a channel or organ rather than a precise pattern. Second, Source points are diagnostic: they are palpated for tenderness, slackness or change, and the finding refers to their own channel. Third, they anchor two structured combinations — the Yuan-Luo pairing, which joins a channel's Source point to the Connecting point of its partner channel, and the Shu-Yuan pairing, which joins the Source point to the organ's Back-Shu point (here BL-19 Dan Shu, the Back-Shu point of the Gall Bladder, held in Sacred Lotus sources & references). Knowing GB-40 is the Source point is what makes those combinations available.

Is there research on GB-40?

The point-specific research on GB-40 is thin, and it would be misleading to suggest otherwise — but it is not absent, and one trial is unusual in testing the point on its own.

• A single-point clinical trial. A three-centre randomised controlled study in 275 migraine patients compared electroacupuncture at GB-40 Qiuxu against electroacupuncture at ST-25 Tianshu as the control point, and reported better visual analogue pain scores in the GB-40 group across all three centres after four weeks, with the advantage persisting at six months (J Tradit Chin Med 2009;29(1):43–49, PMID 19514188). This is genuine point-level evidence and is worth knowing about. It is also a single-country, single-blind study from 2009 with limited outcome reporting, and migraine is not a leading indication for GB-40 in the classical record — so it should be read as one result, not as a foundation.
• Ankle sprain — the point is chosen, but not isolated. A complex-network analysis of 201 published reports on acupuncture for ankle sprain found Qiuxu (GB-40) the fourth most frequently used point in the whole literature, after the tender Ashi point, BL-60 Kun Lun and ST-41 Jie Xi, with GB-34 also in the top ten (PMID 36858419). That establishes what practitioners actually do, not whether it works. On whether it works, the honest answer is that the evidence is weak: the Cochrane review of acupuncture for acute ankle sprain in adults included 20 heterogeneous trials and 2,012 participants and concluded that the available evidence was insufficient, with high risk of bias throughout (PMID 24953665); an earlier systematic review of 17 trials and 1,820 participants reached a similar verdict (PMID 23496981). Neither review isolates GB-40.
• Imaging. GB-40 has been used repeatedly as a test point in acupoint-specificity brain imaging, compared against KI-03 Tai Xi — a point in the same nerve segment on the opposite side of the ankle. Those studies report differing brain-network responses to the two points (PMID 21531109; PMID 22069078; PMID 22931977). This is mechanistic imaging in small samples of healthy volunteers, not evidence of clinical benefit.

GB-40's standing rests principally on its classification as the Source point of the Gall Bladder channel and on long clinical use, not on modern trial evidence. We hold no credible point-specific research on GB-40 for hypochondriac pain, jaundice or the other classical Gall Bladder indications, and we do not cite whole-protocol studies as though we did.

How does GB-40 compare with the points around it?

Directly across the ankle, KI-03 Tai Xi is the Source point of the Kidney channel and the point most often used as GB-40's experimental comparator; BL-60 Kun Lun sits behind the outer ankle bone rather than in front of it, on the Bladder channel, and is the other main ankle point for local pain; BL-62 Shen Mai lies just below the outer ankle bone and is the Confluent point of the Yang Motility Vessel. Further up the same channel, GB-41 Zu Lin Qi on the foot is the Confluent point of the Girdling Vessel and GB-39 Xuan Zhong above the ankle is the Hui-Meeting point of Marrow. Each of these has a classification GB-40 does not, and vice versa — which is the whole reason the set exists.

Source: Sacred Lotus sources & references; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 458; Chinese Acupuncture & Moxibustion, p. 220; Ling Shu (Spiritual Pivot), Chapter 1; PubMed PMID 19514188, 36858419, 24953665, 23496981, 21531109, 22069078, 22931977, 25509733 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.