Gaohuangshu BL-43

Chinese: 膏肓俞

Pinyin: Gāo Huāng Shū

Location

3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 4th thoracic vertebra (T4). 

How to locate

First locate the spinous process of the 7th cervical vertebra (C7), which is still palpable when the neck is being flexed and extended, while the 6th cervical vertebra (C6) starts to slide anteriorly and gradually disappears. 

The spinous process of the 4th thoracic vertebra (T4) is four spinous process below C7.

Or locate the spinous process of the 3th thoracic vertebra (T3), which is generally on the level of the medial end of the scapular spine, when the patient is seated with their arms hanging down. T4 is one thoracic vertebra below. 

Gaohuangshu BL-43 is 3 cun lateral to the lower border of T4. Jueyinshu BL-14 is at the same level but 1.5 cun lateral to T4. 

Points located between Fufen BL-41 and Zhibian BL-54 are in the lateral branch of the Bladder Channel, while these between Fengmen BL-12 and Baihuanshu BL-30 are in the medial branch.

Main actions

  1. Nourishes Lung Yin
  2. Tonifies Qi
  3. Nourishes the Heart
  4. Nourishes the Essence
  5. Tonifies the Stomach and Spleen

Needling

Obliquely 0.3–0.5 cun.

Moxibustion is often used on this point.

Caution: Pneumothorax.

Commentary for Gaohuangshu BL-43

'Gaohuang' refers to the space between the Heart and diaphragm, and it is supposed to be the most difficult part of the body any medical treatments can reach. Thus Gaohuangshu BL-43 is often used in chronic diseases with great debility. 

First of all, it tonifies the Original Qi and general Qi of the whole body and is indicated for patients after a long-term illness. Direct moxibustion with moxa cones is more recommended in this case. 

Secondly, it strongly nourishes the Lung Yin, that is depleted after chronic Lung disease. The patient normally suffers from chronic dry cough, wheezing, coughing of blood, exhaustion, night sweating, consumption and weight loss. In this case, moxa is not recommended. 

Thirdly, it nourishes the Essence in case of Kidney Deficiency, especially after a long-term disease, characterized by symptoms such as nocturnal emissions, seminal emissions, impotence, low sexual energy or poor memory. 

Fourthly, it nourishes the Heart and invigorates the Mind. It achieves so by promoting the Essence's function of benefiting the Brain. Therefore, BL-43 is able to improve memory and lift the general spirit.

Finally BL-43 tonifies the Stomach and Spleen in case of Stomach and Spleen Deficiency. Typical manifestations include weak limbs and undigested food in the stools.