BL43 (Gaohuangshu, “Vital Region Shu”) is an acupuncture point on the Bladder Meridian. It is located on the upper back, at the level of the lower border of the spinous process of the fourth thoracic vertebra (T4), 3 cun lateral to the posterior midline. It powerfully tonifies all forms of vacuity, nourishes yin and blood, supplements the Kidneys and secures the essence, calms the spirit and settles the mind, descends rebellious Lung qi and stops cough.
On the upper back, at the level of the lower border of the spinous process of the fourth thoracic vertebra (T4), 3 cun lateral to the posterior midline.
Oblique insertion medially, 0.5 to 1.0 cun. Deep perpendicular or oblique lateral insertion carries a substantial risk of causing a pneumothorax.
Powerfully tonifies all forms of vacuity, nourishes yin and blood, supplements the Kidneys and secures the essence, calms the spirit and settles the mind, descends rebellious Lung qi and stops cough.
All diseases, emaciation and vacuity detriment, consumptive disease (chuan shi), bone-steaming disorder, nocturnal emissions during dreams, upwardly surging qi, cough and counterflow, madness and delusion, forgetfulness, phlegm diseases, shoulder and back pain, elbow numbness, neck stiffness and pain, inability to turn the head, vomiting, fullness and vexation.
Gaohuangshu is one of the most important tonifying points in the classical literature, famed for treating deep-seated, chronic, and difficult diseases arising from vacuity, especially Lung and Kidney yin deficiency. Its reputation comes from the story of the Duke of Jin, whose illness was deemed incurable because it was lodged in the 'Gao Huang' region; this point is said to access that very area. Moxibustion is the traditional method of choice to treat conditions like tuberculosis, chronic fatigue, night sweats, and seminal emission.
Classical text; the translation was prepared with AI and is not clinical advice.
《針灸大成》 Zhēnjiǔ Dàchéng — Great Compendium of Acupuncture & Moxibustion, 1601 · 卷十 · Source: Wikisource ↗
膏肓 在四椎下一分，五椎上二分，兩旁各三寸半，四肋之間去胛骨容側指許， 灸百壯，止千壯It is located 1 fen below the fourth vertebra and 2 fen above the fifth, 3.5 cun to each side, between the ribs about a finger's width from the shoulder blade, according to this text; BL43 is moxibusted with 100 cones, up to 1000.
《針方六集》 Zhēnfāng Liùjí — Six Collections on Needling, Wu Kun, 1618 · 卷之一·神照集 · 足太陽膀胱經圖穴十四 · 足太陽膀胱經所發六十三穴 · Source: jicheng.tw ↗
又曰：人言二十以上不宜灸膏肓，恐致虛火上炎The text reports a view that BL43 should not be moxibusted in people over twenty, for fear of causing deficiency fire to flare upward.
《醫學入門》 Yīxué Rùmén — Introduction to Medicine, Li Chan, 1575 · 诸虫 · Source: Wikisource ↗
正所谓膏之上，肓之下，针之不到，药之不行，只宜早灸膏肓、四花为佳The text records that for a condition lodged "above the gao and below the huang", where needles and drugs cannot reach, early moxibustion at BL43 and the Sihua points was considered best.
《醫宗金鑑·刺灸心法要訣》 Yīzōng Jīnjiàn · Cìjiǔ Xīnfǎ Yàojué — Golden Mirror of Medicine: Essential Teachings on Acupuncture & Moxibustion, Wu Qian et al., 1742 · 卷七 · 背部主病針灸要穴歌 · Source: jicheng.tw ↗
膏肓穴，主治諸虛百損，五勞七傷，身形羸瘦，夢遺失精，上氣咳逆，痰火發狂，健忘，怔忡The text records that BL43 was used for all kinds of deficiency and damage, the five taxations and seven damages, emaciation, nocturnal emission and seminal loss, rising qi with cough, phlegm-fire mania, forgetfulness and palpitations.
BL43 is one of 67 points on the Bladder Meridian. Nearby points:
BL43 (Gaohuangshu) is located on the upper back, at the level of the lower border of the spinous process of the fourth thoracic vertebra (T4), 3 cun lateral to the posterior midline.
BL43 powerfully tonifies all forms of vacuity, nourishes yin and blood, supplements the Kidneys and secures the essence, calms the spirit and settles the mind, descends rebellious Lung qi and stops cough. Common clinical indications include all diseases, emaciation and vacuity detriment, consumptive disease (chuan shi), bone-steaming disorder, nocturnal emissions during dreams, upwardly surging qi, cough and counterflow, madness and delusion, forgetfulness, phlegm diseases, shoulder and back pain, elbow numbness, neck stiffness and pain, inability to turn the head, vomiting, fullness and vexation.
Oblique insertion medially, 0.5 to 1.0 cun. Deep perpendicular or oblique lateral insertion carries a substantial risk of causing a pneumothorax. Caution: The classical texts do not list specific contraindications but emphasize the difficulty in locating the point correctly, noting that if the scapula covers the point, treatment will be ineffective. Modern anatomy dictates extreme caution to avoid pneumothorax.
BL43 is a point on the Bladder Meridian (Zú Tài Yáng Páng Guāng Jīng).