GB-41 (Zu Lin Qi) Foot Overlooking Tears

What does GB-41 Zu Lin Qi do?

Zu Lin Qi GB-41 is the point on the foot that opens the Girdling vessel — the Dai Mai — and it is the Shu-Stream point of the Gall Bladder channel. Those two classifications, both carried in Sacred Lotus sources & references, account for the whole of its clinical range, and they pull in two different directions: as a Shu-Stream point it belongs to the everyday five-shu machinery of its own channel, and as a Confluent point it reaches an extraordinary vessel that encircles the waist and binds every vertical channel passing through it.

• Opens and regulates the Girdling vessel — the classification that matters most. GB-41 is the distal point through which the Dai Mai is accessed, and it is paired with Wai Guan SJ-05 in the standard confluent-point couple.
• Spreads Liver qi — the recorded action behind its use in constrained qi presentations, and the reason a Gall Bladder point on the foot is reached for in a pattern named for the Liver. The two channels are an interior-exterior pair.
• Benefits the chest, the lateral costal region and the breasts — for distending pain beneath the ribs and in the breasts, particularly the premenstrual kind. Sacred Lotus sources & references also record the more unusual action of stopping lactation.
• Clears the head and benefits the eyes — the Gall Bladder channel runs over the side of the head and begins at the outer corner of the eye, and GB-41 is the distal point that treats along it: one-sided headache, dizziness and pain at the outer canthus.
• Transforms phlegm and dissipates nodules — the recorded action behind its long-documented use for scrofula, the chains of hard nodules in the neck described in the classics.
• Activates the channel and alleviates pain locally — for pain and swelling of the top of the foot and spasm of the foot and toes, the ordinary local use of any point in this position.

Source: Sacred Lotus sources & references (channel, Shu-Stream and Confluent classifications, existing action and use records); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 460); Chinese Acupuncture & Moxibustion (p. 220); cross-referenced against multiple online sources.

What is GB-41 Zu Lin Qi used for?

Zu Lin Qi GB-41 is used for one-sided headache and eye complaints along the Gall Bladder channel, for distending pain in the breasts and beneath the ribs, and — through the Girdling vessel — for menstrual disorders and vaginal discharge. The indications below are those carried in Sacred Lotus sources & references and set out in the standard reference literature. They describe traditional use, not proven treatment.

• Headache, particularly one-sided headache along the side of the head
• Dizziness and vertigo
• Pain of the outer corner of the eye (outer canthus)
• Red, painful or watering eyes
• Scrofula — chains of hard nodules in the neck and armpit
• Pain and distension in the hypochondriac region
• Distending pain of the breasts
• Mastitis
• Irregular menstruation
• Excessive vaginal discharge, through the Girdling vessel
• Pain and swelling of the dorsum (top) of the foot
• Spastic pain of the foot and toes
• Pain along the shoulder, arm and side of the body treated through the Dai Mai and Yang Wei pairing

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 460); Chinese Acupuncture & Moxibustion (p. 220).

Where is GB-41 Zu Lin Qi, and how is it used in practice?

Zu Lin Qi lies on the top of the foot, in the hollow just beyond the point where the fourth and fifth long foot bones meet, on the outer side of the tendon running to the little toe. It is found by sliding a finger back along the groove between the fourth and fifth toes until it drops into a depression. Sacred Lotus sources & references record its practical role in two lines: it stops lactation, and it spreads Liver qi stagnation along the course of the Gall Bladder channel — which is a precise description of what practitioners actually use it for.

Which points is GB-41 combined with?

• With Wai Guan SJ-05 — the essential pairing. The eight Confluent points work in four couples, each opening one vessel and supporting a partner vessel. GB-41 opens the Girdling vessel and SJ-05 opens the Yang Linking (Yang Wei) vessel, and Sacred Lotus sources & references carry both classifications. When a practitioner intends to open the Dai Mai, this is the pair that does it — and by convention GB-41 is needled on one side and SJ-05 on the opposite side.
• With Dai Mai GB-26 — the complementary approach. GB-26 is where the Gall Bladder channel meets the Girdling vessel on the trunk; GB-41 is the distal point that opens the vessel. Opening the vessel from the foot and treating it locally at the waist is the standard combination, and it is the one used in the published trials on abdominal obesity described below.
• With Tai Chong LIV-03 — the Yuan-Source point of the paired Liver channel, on the other side of the same foot. The pair is the standard choice for constrained qi presenting as headache, irritability and breast distension.
• With Feng Chi GB-20 and Shuai Gu GB-08 — the local head points of the same channel, with GB-41 as the distal point. This proximal-and-distal arrangement along the Gall Bladder channel is the classical structure for one-sided headache.
• With Tian Jing SJ-10 — the point most associated with dissolving nodules, used with GB-41 for scrofula. The ancient prescriptions place these two together (see the research section).
• With Qiu Xu GB-40 — the Yuan-Source point of the same channel, immediately proximal at the ankle; the two are often used together for the ankle, the foot and the channel as a whole.
• Method — Sacred Lotus sources & references record moxibustion as applicable at this point.

Where does GB-41 sit among its category peers?

GB-41 carries two classifications, and they place it in two quite different groups.

• The eight Confluent points. Each of the eight extraordinary vessels is opened by a Confluent point on the limbs, and the eight work as four couples. Sacred Lotus sources & references carry the complete set: LU-07 Lie Que for the Conception Vessel with KI-06 Zhao Hai for the Yin Motility vessel; SI-03 Hou Xi for the Governing Vessel with BL-62 Shen Mai for the Yang Motility vessel; P-06 Nei Guan for the Yin Linking vessel with SP-04 Gong Sun for the Penetrating vessel; and GB-41 Zu Lin Qi for the Girdling vessel with SJ-05 Wai Guan for the Yang Linking vessel. GB-41 is the only point in the entire system classified as the Confluent point of the Dai Mai.
• The five Shu-Transporting points of the Gall Bladder channel. GB-41 is the Shu-Stream and Wood point of its channel. On a yang channel the five-shu points run Metal, Water, Wood, Fire, Earth from the toe upward, and Sacred Lotus sources & references carry the full Gall Bladder series: GB-44 Zu Qiao Yin (Jing-Well, Metal), GB-43 Xia Xi (Ying-Spring, Water), GB-41 Zu Lin Qi (Shu-Stream, Wood), GB-38 Yang Fu (Jing-River, Fire) and GB-34 Yang Ling Quan (He-Sea, Earth). Because the Gall Bladder is itself a Wood organ, GB-41 is the Wood point on the Wood channel — the channel's own horary point, the one that resonates with its own element. Classically, Shu-Stream points are the ones indicated for heaviness of the body and painful joints.

Source: Sacred Lotus sources & references (location, categories, full Confluent-point set, full Gall Bladder five-shu series); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 460); Chinese Acupuncture & Moxibustion (p. 220); cross-referenced against multiple online sources.

Where is GB-41 located?

• A Manual of Acupuncture (p. 460): In the depression distal to the junction of the 4th and 5th metatarsal bones, on the lateral side of the tendon of m. extensor digitorum longus (branch to little toe).
• Chinese Acupuncture and Moxibustion (p. 220): Posterior to the fourth metatarsophalangeal joint, in the depression lateral to the tendon of m. extensor digiti minimi of the foot.

How is GB-41 Zu Lin Qi needled?

Reference fact: GB-41 is a small point on the top of the foot, and it is among the lower-hazard points on the body — there is no body cavity, no major nerve trunk and no large vessel beneath it. Sacred Lotus sources & references record perpendicular insertion of 0.3 to 0.5 inch, with moxibustion applicable. The figures below are recorded as neutral reference data describing what the textbooks state, not as instructions for performing a technique. Needling is carried out only by a qualified, licensed practitioner.

• Angle and depth — perpendicular, 0.3 to 0.5 inch in the record held here. Chinese Acupuncture & Moxibustion (p. 220) and Deadman & Al-Khafaji (p. 460) record insertion in the same shallow range at this point; the depth is limited by the anatomy itself, since the point lies in a narrow hollow between two foot bones.
• What lies beneath — skin, the fourth dorsal interosseous muscle in the space between the fourth and fifth long foot bones, and the dorsal metatarsal artery and vein with their accompanying nerves. These are small vessels, and the ordinary consequence of contacting one is a bruise. Bleeding and bruising at the needle site are the most frequently recorded acupuncture adverse events of any kind: a meta-analysis of prospective clinical studies found that roughly half of all recorded events were bleeding, pain or flare at the site, and estimated serious adverse events at approximately 1 per 10,000 patients (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268).
• Moxibustion — recorded as applicable.
• One traditional-use consideration worth recording. Sacred Lotus sources & references list stopping lactation among this point's uses. That recorded action is a reason the point is noted in the reference literature in connection with breastfeeding — the same fact seen from the other side. It is stated here as reference information about what the sources record, not as advice.
• No single agreed safe depth exists for any acupuncture point. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second — both concluded that depths measured for the same point vary greatly with the subject group and the measuring method, 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). At a foot point the practical consequence is minor; the principle is worth carrying across the whole set of records.

Source: Sacred Lotus sources & references (existing needling and use records); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 460); Chinese Acupuncture & Moxibustion (p. 220); PMID 34489268; PMID 21417806; PMID 23935678 — each record checked as active and not retracted.

What does the name Zu Lin Qi mean?

Zu Lin Qi means "Foot Overlooking Tears" — zu, the foot; lin, to look down upon or overlook; qi, tears. The name records the point's action on the eyes: the Gall Bladder channel begins at the outer corner of the eye, and this distal point on the foot is credited with clearing the eyes and stopping excessive watering. The word zu — foot — is in the name for a reason. There is a matching point on the head, Tou Lin Qi GB-15, "Head Overlooking Tears", which sits above the eye on the same channel and which Sacred Lotus sources & references classify as a Meeting Point of the Gall Bladder and Bladder channels with the Yang Linking vessel. The two share a name and an action on the eye and are constantly confused; "Zu" and "Tou" are what separate them.

What is the Girdling vessel, and why does GB-41 open it?

The Girdling vessel — Dai Mai — is one of the eight extraordinary vessels, and it is the only one in the entire system that runs horizontally: it encircles the waist like a belt while every other channel and vessel travels lengthwise along the body. Its described function is to bind — to gather and restrain the vertical channels as they pass through the waist, in the way a sash gathers a robe. When it fails to bind, the classical picture is of things falling or leaking downward: vaginal discharge, prolapse, dragging heaviness, weak and flaccid legs.

• GB-41 is the Confluent point of that vessel — the distal point on the foot through which it is opened, and the only point carrying that classification.
• SJ-05 Wai Guan is its coupled partner, opening the Yang Linking vessel; the two are used together when the Girdling vessel is being opened.
• GB-26 Dai Mai, GB-27 Wu Shu and GB-28 Wei Dao are the three Gall Bladder-channel points on the trunk that Sacred Lotus sources & references record as meeting points with the Girdling vessel — the vessel's local territory on the body. A reader who wants the vessel treated locally rather than opened wants those; the full account of the vessel is held with GB-26.
• Note the name trap: Dai Mai is both a point (GB-26, on the trunk) and a vessel (the Girdling vessel). GB-41 is neither — it is the point that opens the vessel from a distance.

Is there research on GB-41 Zu Lin Qi?

There is no randomised controlled trial isolating GB-41, and it would be misleading to suggest otherwise. Every clinical study located uses the point inside a multi-point prescription, so the results belong to the prescription and not to this point. What the literature does provide is one unusually good piece of documentary evidence about the point's classical standing:

• Historical corroboration of the scrofula indication — the strongest finding for this point. A data-mining study extracted every acupuncture and moxibustion prescription for scrofula from the Chinese Medical Code, a large compilation of classical medical texts: 314 prescriptions, 54 points, 530 total point occurrences. The three most frequently used points across the whole historical corpus were Tian Jing SJ-10, Zu Lin Qi GB-41 and Tai Chong LIV-03, and the most-used channels were the hand and foot Shao Yang — the Sanjiao and Gall Bladder. The most-used categories of special point were the He-Sea and the Shu-Stream points (Zhongguo Zhen Jiu 2023;43(2):233–8, PMID 36808521). This is worth dwelling on: our own indication record lists scrofula for GB-41, and an independent analysis of the classical corpus finds it to be the second most-used point for that condition in the whole of the historical literature, chosen from the category to which it belongs. The record and the corpus agree.
• The Girdling-vessel prescriptions, clinical. Two Chinese trials tested a "Dai Mai regulating" approach in which GB-41 appears alongside GB-26. In the first, 35 patients with abdominal obesity were treated for eight weeks with a prescription built around Dai Mai GB-26 and Zu Lin Qi GB-41 together with eight other points; weight, body-mass index, waist circumference and ultrasound-measured visceral fat all fell (Zhen Ci Yan Jiu 2012;37(6):493–6, PMID 23383460). In the second, a randomised trial in 58 patients with polycystic ovarian syndrome and abdominal obesity used electroacupuncture at GB-26 and ST-25 with needling at six further points including Zu Lin Qi GB-41 and Wai Guan SJ-05 — the confluent pair — against diet and exercise alone, reporting greater reductions in fasting insulin, insulin resistance and waist circumference in the acupuncture group (Zhen Ci Yan Jiu 2018;43(4):255–9, PMID 29888581). With ten points in the first prescription and eight in the second, neither can show what GB-41 contributed.
• The confluent points as a set, clinical. A randomised trial in 42 patients with chronic pharyngitis needled all eight Confluent points together — P-06, SJ-05, LU-07, SI-03, SP-04, BL-62, KI-06 and GB-41 — with an extra point, against an oral Chinese patent medicine, reporting better symptom scores and inflammatory-marker changes in the acupuncture group (Zhongguo Zhen Jiu 2019;39(12):1285–8, PMID 31820603). It is a small unblinded trial of the whole eight-point group, not of GB-41.
• Migraine, clinical. A randomised trial of 87 patients with migraine included Zu Lin Qi GB-41 in the Gall Bladder-channel prescription given to both arms; the arms differed in whether LI-04 and LIV-03 — the classical Siguan or "four gates" pair — were added to that base (Zhongguo Zhen Jiu 2014;34(10):947–50, PMID 25543418). Because GB-41 was given to everyone, the trial says nothing about it.

The honest summary: GB-41's evidential support is classical and documentary rather than clinical. That is worth stating plainly rather than dressing multi-point trials up as point-specific findings.

How does GB-41 compare with the points around it?

Qiu Xu GB-40, the Yuan-Source point of the same channel, lies proximal to it in front of the outer ankle and is the more general channel point; where GB-41 is chosen for the Dai Mai and for the head and breast, GB-40 is chosen for the ankle and for the channel as a whole. Di Wu Hui GB-42 lies immediately distal in the same intermetatarsal space and covers much the same local territory without the special classifications. Xia Xi GB-43, the Ying-Spring and Water point, sits between the fourth and fifth toes and is weighted to clearing heat from the head and ears. Tou Lin Qi GB-15 is the head point of the same name, described above. Tai Chong LIV-03, on the other side of the same foot, is the Shu-Stream point of the paired Liver channel — the direct counterpart of GB-41 on the yin side, and its most frequent partner. And Dai Mai GB-26 on the trunk is the local point of the vessel GB-41 opens; the two are the distal and local halves of the same treatment.

Source: Deadman & Al-Khafaji, A Manual of Acupuncture (p. 460); Chinese Acupuncture & Moxibustion (p. 220); Sacred Lotus sources & references (categories, full Confluent-point set, Girdling-vessel points, neighbouring points held here); PMID 36808521; PMID 23383460; PMID 29888581; PMID 31820603; PMID 25543418 — each checked as active and not retracted; cross-referenced against multiple online sources.