Acupressure applied to Gall Bladder 20.

According to the World Health Organization (WHO) there are 361 charted acupuncture points on the body. Acupuncturists generally recognize any active point on the body that is particularly sensitive as an acupuncture point, so understood in this way, the number of actual points are limitless.

Within the medical tradition of Indian Ayurvedic medicine, there is a comparable number of points on the body that can be treated called marmas. Like Chinese acupuncture the science of marmani developed in India about 5,000 years ago in Vedic times. Ayurvedic texts describe 117 major marma points. Located at anatomical sites where veins, arteries, tendons, bones or joints intersect, they are similar to the more numerous Chinese acupoints as today they are also stimulated by palpation for both diagnosis and healing. Interestingly, about 75 of the 117 principal marma points exactly correspond to principle acupoints used in Chinese medicine.

Many of the points on the Chinese Gall Bladder meridian, especially on the head and shoulders, treat the condition known in Traditional Chinese Medicine as “Wind.” There are broadly two types of wind: “External Wind,” which includes inflammations on the surface layers of the body including allergic reactions affecting the skin, eyes, ears and nasal sinuses as well as viral and bacterial conditions such as colds, flu, headaches and other common afflictions. “Internal Wind” is completely different and includes more chronic diseases such as epilepsy and Parkinson’s. In both cases, the description “Wind” denotes diseases that represent some fundamental instability.

While not exactly corresponding in location, the Chinese acupoint called feng chi or “Wind Palace,” also less poetically known as Gall Bladder 20 (GB 20), seems closely related in action to the Ayurvedic point Krikatika Marma. These points are located within an inch of each other at the occipital base of the skull can be stimulated to treat allergies, itchy eyes and all kinds of headaches. With effective 4- to 5-second stimulation, one can experience a feeling of immediate clearing in the head which caused one of my acupoint students to dub the point/s a “brain cooler.”

Locating GB20 and Krikatika Marma

Feng Chi (GB20) is in a natural groove located behind the ear at the base of the posterior mastoid (ear) bone where the muscles of the neck attach to the skull. Krikatika marma is on both sides of the central axis leading into the skull at the juncture of the 2nd cervical vertebra.

Fortunately both these points are easy to find and easy to massage even on oneself. To locate GB 20, simply interlock the fingers of both hands palms facing inward and cradle the occiput on the back of the skull. Both your thumbs should naturally fall to the grove connecting the neck and the skull on your neck.  Krikatika marma is one inch towards the center on either side of the cervical spine.

These both connect to the brain and are very powerful. Until you become more familiar with their effect you should stimulate them deeply but probably not more than 4 to 5 seconds each.

  • Both points benefit the head, neck, eyes and ears
  • Relieve local pains such as headaches
  • Relieves tension and both physical and emotional stress
  • Treats respiratory conditions such as colds, flu and asthma

They can be used to immediately relieve allergy symptoms especially of the eyes, ears and nasal passages. Neck pain and stiffness with a decrease in range of motion, stress-related emotional disturbance, middle ear infections, tinnitus, Meniere’s syndrome, and asthma.

I sometimes think of GB 20 as a “lobelia” point because like the herb Lobelia inflata, it has such powerful antispasmodic (Wind-relieving) properties. Similarly, stimulating Krikatika affects the upper lobes of the lung, stimulating bronchodilation and the relief of asthma.

GB 20 and Krikatika marma offer instant relief of Meniere's disease which is a disorder of the inner ear that causes episodes of spinning vertigo, feeling of fullness in the ear and fluctuating hearing loss which is progressive, ultimately leading to permanent loss of hearing and ringing in the ear (tinnitus).

Meniere's disease affects only one ear and can occur at any age but usually starts between the ages of 20 and 50. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life. There is no known cure for Meniere’s disease and there are a variety of Western drugs usually with varying degrees of undesirable side effects, ranging from anti-nausea drugs and valium to steroids and even surgical intervention to cut off neurological response. Certainly for this disease alone, GB 20 and krikatika marma, with no side effects, are worth trying.

GB 20 and Krikatika marma are also useful for those who may experience brain fog and eyestrain from study or working with a computer for long hours. It seems quite natural that one might raise their finger-clasped hands above and behind their head occasionally not only to stretch and take in more oxygen but also to drop down as they take a deep inhale and maintaining a brief inhaled breath allow their thumbs to stimulate these two acupoints points for the price of one. One can easily extend the benefit of these points by massaging back and forth between these two points.

Note: this can be a very powerful experiential treatment.  Start out cautiously massaging no more the 4 or 5 seconds on each side and wait an hour or so before repeating.

Itchy, Severely Inflamed Eye

One of the common problems associated with aging is dry eyes. This can be complicated with an increased allergic sensitivity to airborne allergens. One randomized, placebo-controlled study showed that stimulation of GB 20 in dry-eye patients was significantly improved after 4-weeks of treatment.

I recently had a patient with a severe eye inflammation exhibiting symptoms of severe itchiness, redness, and swelling which caused him to go to his ophthalmologist for a remedy.

The ophthalmologist diagnosed it as inflammation caused by allergy and prescribed some exorbitantly expensive cortisone-based eye drops for relief. It was at this point that my patient sought alternative treatment. Because he would be traveling and it would not be convenient to make an herbal eyewash, I showed him how to massage GB 20.

This point worked like a charm, making it unfortunate that he had already spent nearly $200 for a tiny container of no more than a tablespoon of cortisone eyedrops which he never used. (Believe it or not, it was a cheaper brand from the original prescription which with even Medicare would have cost over $600!)

The first treatment priority was to allay the itching. Each time he felt an urge to rub his eyes he would massage GB 20 for 4 to 5 seconds as described. The itching completely stopped, lasting at first for an hour and after a few times, each time longer until the itching was completely gone.


  1. Shin MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10
  2. MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10.
  3. Takayama S, Seki T, Nakazawa T, et al. N. Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: additional therapy to standard medication. Evid Based Complement Alternat Med. 2011;2011:157090. Epub 2011 Mar 7. PubMed PMID: 21437193

In my previous blog, I discussed the little-known use of ragweed for allergies. Another herb that can give over-the-counter antihistamines a run for their money is butterbur (Petasites hybridus). About 20 percent of Americans complain of allergies each year, often interfering with normal work and recreational activities. Butterbur, like ragweed, is a member of the Asteraceae family whose abundant pollen wreaks annual havoc on those who are sensitive to them.

ButterburA study published in August 2005 in Phytotherapy Research looked at 330 patients who suffered from sporadic hay fever. The study divided the participants into three groups: the first took 8 mg of butterbur extract three times a day; the second took 180 mg of fexofenadine (Allegra), a common antihistamine, each morning, and the last took a placebo.

At the end of the study, both groups receiving active treatment reported a significant reduction in the nasal congestion and itchy, watery eyes most commonly experienced with hay fever. Most strikingly, there was almost no difference between taking an antihistamine or the butterbur extract, except that some taking the antihistamine complained of drowsiness.

Since antihistamines and butterbur work in different ways, study author Dr. Andreas Schapowal of the Allergy Clinic in Landquart, Switzerland, feels that combining the two drugs would be effective. However, no study has investigated how butterbur works in combination with any other drug.


Butterbur: Antispasmodic and anti-inflammatory properties find use in migraines, allergies

The active ingredients in butterbur extracts are petasin and isopetasin. Petasin reduces spasms in smooth muscle and vascular walls, while isopetasin acts on the system that reduces inflammation. Together, the two act as an effective anti-inflammatory drug with potential in treating many ailments. These anti-spasmodic and anti-inflammatory properties have been demonstrated in pharmacological and experimental systems. Butterbur regulates calcium channels and inhibits the synthesis of the enzymes lipoxygenase and cyclooxygenase.

 Efficacy and tolerability of butterbur was demonstrated in two randomized, double-blind and placebo-controlled clinical trials with more than 300 adult patients and in one open trial in 108 children and adolescents.

Petasin also provides an inhibitory action on the leukotriene and histamine. The former is responsible for the allergic reactions in human body, when the blood vessels are dilated and get permeable causing such symptoms as rhinitis and sneezing. The latter causes inflammation and provokes the symptoms of asthma and hay fever. Therapeutic effects of petasin are applicable for such conditions as kidney stones, menstrual cramps, urinary disorders, and gastrointestinal problems (ulcers in particular) associated with muscle spasms and inflammation. In addition, petasin is known to provide hypotensive actions and strenghthen cardiac tissue.

Medical studies have proved that butterbur extract helps both in prevention and treatment of migraine, especially in severe cases and with fewer side effects (e.g. sedative) than in typical headache preparations. This action is supposedly achieved by relieving pressure on blood vessels and affecting calcium channels. An important feature of the herb's anti-migraine action is that it can be used in adolescents and even children. A study published in January 2005 showed that butterbur extract could help to prevent and reduce migraine symptoms better than placebo.

A few studies have implied that the extract may also be useful in treating asthma, bronchitis, and other respiratory disorders. "Three randomized, placebo-controlled studies of the butterbur extract, Ze 339, in peer-reviewed journals should convince anybody of the efficacy and safety of the medication in allergic rhinitis," said Schapowal.

Astralagin and isoquercitrin are flavonoid glycosides found among the other important chemicals in the herb. They provide anti-depressant properties for the human central nervous system.

Also, anti-oxidant and properties associated with butterbur have been noted in several studies.

The most common pharmaceutical form butterbur is being released in is the supplement called Petadolex. These are the butterbur gelcaps produced for relieving migraine symptoms. There are no recorded adverse reactions to the use of butterbur. However, older studies that have not been duplicated showed that butterbur leaf extract may have caused cancer in animals. Therefore it has gradually faded from human use. The compound responsible for this toxic effect, the pyrrolizidine alkaloid, has since been identified, and newer butterbur supplements are made from only the leaves of a plant (roots contain higher levels of the alkaloid) specially developed to be low in the compound. Now experts say that the herb is safe for use. Due to the risk of PA toxicity, butterbur should only be consumed processed and purchased from the authorized dealers. The raw extract should be avoided.

Historical use of butterbur

Butterbur has a long history of use, possibly dating back to ancient times. Related to comfrey and coltsfoot, it was used to treat asthma and sinus infections. In the 16th century it was described as a "plague flower," presumably because it may have been found effective in treating this disease. Native Americans used butterbur root for inflammation, hay fever and headaches, much as it is used today.

The size of the leaves made it useful as a head cover, which gave the butterbur its derived generic name. Petasus is a Greek word for a broad felt hat worn by shepherds, hence Petasites is the name of the genus. The plant's common name "butterbur" refers to another function of the leaves: they were used to wrap butter for preserving it and keeping it cool. In some cultures seeds of butterbur are believed to have love divination properties and are used for rituals by young women.

Butterbur is native to Europe as far north as Scandinavia, and is also naturally found in some parts of Asia and North America. It is considered invasive and due to its space and light-consuming habits, butterbur grows with no other plants around its leaves. Favoring clay and sandy loam, it is found in meadows, shades by the waterways, flood plains, marshes, and other damp areas.

The rhizome of the plant is considered to possess most of the beneficial properties associated with butterbur.  It contains bitter resinous juice and has an unpleasant taste. Leaves are used for herbal extracts intended to manage allergies.

Useful links 

The cold and flu season is still upon us. While Michael wrote about treating flu last fall, especially the swine flu, I want to address a different approach here. Cold/flu treatment usually falls into two main categories: wind-chill and wind-heat. Most flu formulas commonly available, western and Chinese, address wind-heat conditions as their symptoms are the most common: slight chills, stronger fever, thirst, sweating, restless, desire for cool drinks, mucus and phlegm that's yellow and a yellow-coated tongue with a redder body, especially the front third. A great Chinese patent equivalent that clears the chill but also treats the wind component beautifully (manifesting in the stuffy nose, tight neck and shoulders and body aches) is Chuan Xiong Cha Tiao Wan. It contains, mint (bo he), ligusticum (chuan xiong), schizonepeta (jing jie), notopterygium (qiang huo), licorice (gan cao), angelica (bai zhi), ledebourilla (fang feng) and asarum (xi xin). If taken at the first signs of chills and body aches, dull headache and tingly-ache along the nape of the neck and shoulders it can knock it right out. If a virus invades along with the wind chill, take the above with a lower dosage of any cooling anti-viral herbs such as elderberry, isatis or olive leaf. The combination is quite effective and quickly knocks out these nasty conditions. If there are signs of both heat and cold it's possible to take the typical western herbs for colds and flu along with adding strong ginger tea (or a smaller dosage of Ginger Warming Compound). Be sure to add in an anti-viral herb, as that is often the key to quickly knocking out any cold or flu.

Kudzu lobata flower by MiyaIf you or someone you know is one of the unfortunate 0.1% of the population who suffers from cluster headaches, take heart:an herb commonly used in Traditional Chinese Medicine and in Asian cooking may help manage the frequency of attacks and severity of pain.

A recent study completed by Yale University Doctor R. Andrew Sewell and his team shows that the herb Kudzu may be effective for treating cluster headaches. (Read the full text of Sewell's study here.)

My readers in the southern United States may do a double take on that one. "Kudzu? The 'vine that ate the South'?" they may ask. Yes, that dreaded vine which can advance at a rate of about 10 feet a day, covering all in its path, has a root (a giant one, I might add) that could be a godsend for sufferers of cluster headaches, whose pain is said to surpass all other human pain.

So named because they occur in clusters either classified as episodic or chronic, cluster headaches are also known as "suicide headaches" because of the excruciating severity of their pain. Episodic cluster headaches will have a remission period of a month or longer. Chronic cluster headaches occur continuously without any remission period between cycles. The condition can change from chronic to episodic or vice versa with remission periods lasting decades being known to occur.

In his report in the January 2009 edition of Headache Journal, Dr. Sewell describes how the rhizome of Kudzu (Pueraria lobata, also known in Chinese as ge gen) is detailed in classical Chinese medical texts as indicated for many conditions, including symptoms of cold, flu and fever with stiff neck, as well as alcoholism, diarrhea, hypertension and angina pectoris. Sewell's research suggests that Kudzu also has among its effects the ability to increase cerebral flow to the brain, thus relieving headaches -- including the dreaded cluster headache. The next step is a randomized clinical trial using standardized extracts to determine whether kudzu may have a role in the management of cluster headaches, as reported by many who have already found relief using this herb.

Traditional Chinese medicine (TCM) distinguishes different types of headaches as follows:

1. Acute headaches caused by external factors including

  • Wind and Cold with symptoms of chills and cold sensitivity
  • Wind and Heat with symptoms of chills, fever, inflammation
  • Wind and dampness with symptoms of dampness (edema)

2. Chronic headaches caused by internal factors including:

  • Liver Yang syndrome with symptoms of hypertension, aggressive irritability
  • Kidney (adrenal and hormonal) imbalance
  • Qi (energy) and Blood deficiency. Associated with a person who is nutritionally weak and run down.
  • Turbid Phlegm with symptoms of dampness, phlegm, possible cough and excessive sputum.
  • Blood stagnation with symptoms of fixed stabbing pain

The severity of pain in cluster headaches places this condition prominently in the category of Blood stagnation, but individual patients may exhibit more than a single syndrome and treatment is adjusted accordingly with corresponding acupuncture/acupressure and traditional Chinese herbal formulas.


The use of OTC drugs for headaches

Over-the-counter drugs such as aspirin or acetaminophen are classified as effective for mild pain and inflammation and may have a very limited use for severe migraines or cluster headaches. However the therapeutic principle is consistent with TCM theory, which states "no blockage, no pain" -- in other words, aspirin's blood-thinning properties relieve pain by releasing stagnant Blood which blocks free flow of Qi.

Aspirin, the first "wonder drug" is pure acetylsalicylic acid and was originally derived from the common herb for rheumatic pains and fever, Meadowsweet (Asperea ulmaria - thus the name "aspirin"). Acetylsalicylic acid is found in several plants with similar properties, including willow, rosemary, white poplar and wintergreen.

The significant difference between herbs containing acetylsalicylic acid and the drug aspirin is that the drug is synthesized to be the pure chemical while the herbs contain many other cofactors that may play a broader and more vital role in treatment with less chance of adverse reactions.

I've seen it happen many times before. An herb is found in its whole form to be effective for a specific disease but in its synthesized single chemical form it is not so effective. Because drug companies spend millions to bring a drug to market, there is no incentive to invest in an herb that can be freely found as a common noxious weed.

Mississippi kudzu by GsmithIn the meantime, Kudzu is commonly available in powdered form as a sauce thickening condiment in Japanese cooking. As stated, Kudzu, also known as Pueraria Montana, is a spreading vine with a gigantic root. It is native to Asia and was introduced in the Southeastern United States, where it encountered no natural ecological limiting growth factors. Kudzu took off, engulfing huge swaths of that part of the country, climbing telephone poles and overrunning deserted homesteads. It's nearly impossible to eradicate.

We will have to see whether Kudzu, reported to be effective by scores of patients in Dr. Sewell's study, finds its way through the costly pharmaceutical red tape market as well it can find its way over and through anything in its path on the Southeastern U.S. landscape. For the sake of cluster headache sufferers all over the world, I hope it does.

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