Geguan BL-46

Chinese: 膈关

Pinyin: Gé Guān

Location

3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 7th thoracic vertebra (T7). 

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 7th thoracic vertebra (T7) is seven spinous process below C7.

Or directly 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. 

Geguan BL-46 is 3 cun lateral to the lower border of T7. Geshu BL-17 is at the same level but 1.5 cun lateral to T7.  

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. Regulates Qi in diaphragm and descends Rebellious Stomach Qi
  2. Removes obstructions from the Channel and eases pain

Needling

Obliquely 0.3–0.8 cun.

Caution: Pneumothorax.

Commentary for Geguan BL-46

Guguan BL-46 is at the same level as Geshu BL-17, which is the Gathering-Hui point of the Blood. Therefore, it has many actions similar to BL-17. 

Most importantly, it regulates Qi in diaphragm between the Upper and Middle Burner. To be more specifically, it removes Qi Stagnation in the Upper Burner, characterized by chest and diaphragm fullness and oppression. It also descends Rebellious Stomach Qi in the Middle Burner with typical symptoms such as vomiting, difficult ingestion and belching. 

On the other hand, it is used as a local point to remove obstructions from the Channel, so as to ease pain and stiffness in the spine, back and joint area.