Bladder Meridian
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BL-45
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.3–0.5 cun
Needle Angle
45° (Oblique)
Body Area
Back — Upper (Thoracic)
Location
3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 6th thoracic vertebra (T6).
Main Actions
- Expels Wind-Heat
- Subdues Rebellious Lung Qi
- Invigorates Qi and Blood
Indications
Cough
Fever
Malaria
Dyspnoea
Eye pain
Dizziness
Back pain
Chest pain
No sweating
Bloody nose
Scapula pain
Shoulder pain
Five palm heat
Hypogastrium pain
Axilla contraction
Abdominal distention
Hypogastrium fullness
Lateral costal region pain
Commentary
Yixi BL-45 is at the same level as Dushu BL-16, which is the Back Transporting-Shu point of the Governing Vessel.
Both points share some similar actions and indicated for disharmony of the Vessel.
Classical Sources
Zhenjiu Jiayi Jing (Systematic Classic of Acupuncture and Moxibustion): Lists Yixi among the Bladder channel points on the second lateral line of the back, indicating its use for shoulder and back pain, cough, and respiratory disorders.
Name Origin: The name "譩譆" (Yì Xǐ) literally means an exclamation of surprise or a sighing sound. According to classical sources, when locating this point and applying pressure, patients often involuntarily exclaim "yi xi" due to the sensitivity of the area—hence the name. This reflects the point's location in a tender area near the scapula.
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 6th thoracic vertebra (T6) is six spinous process below C7. Or locate the spinous process of T7, which is level with the inferior angle of the scapula, when the patient is seated with their arms hanging down. T6 is one thoracic vertebra above. Yixi BL-45 is 3 cun lateral to the lower border of T6. Dushu BL-16 is at the same level but 1.5 cun lateral to T6. 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.
Caution
This point overlies the thoracic cavity. Deep perpendicular needling or incorrect angle carries substantial risk of pneumothorax (collapsed lung). Always needle obliquely toward the spine or laterally along the rib, using shallow insertion depth (0.3–0.5 cun). Practitioners should be well-trained in proper technique before needling points in this region. If patient experiences sudden sharp chest pain, difficulty breathing, or coughing after needling, discontinue treatment and monitor for pneumothorax symptoms.
Needle Angle
45° (Oblique)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
Obliquely 0.3–0.8 cun. Caution: Pneumothorax.
Expected Deqi Sensation
Soreness and distension locally, with possible radiation toward the shoulder blade or lateral chest wall. Some patients may experience a sensation spreading along the intercostal space toward the anterior chest.
Moxibustion
Recommended
Duration: 5–15 minutes
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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