BL43 Gaohuangshu means 'Vital Region Shu'

Reviewed by · Licensed Acupuncturist & TCM Physician · Last reviewed June 2026

BL43 (Gaohuangshu, “Gaohuangshu means '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.

Location

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.

Needling

Oblique insertion medially, 0.5 to 1.0 cun. Deep perpendicular or oblique lateral insertion carries a substantial risk of causing a pneumothorax.

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TCM functions

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..

Indications

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..

Clinical notes

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.

On the Bladder channel

BL43 is one of 67 points on the Bladder Meridian. Nearby points:

BL39BL40BL41BL42BL44BL45BL46BL47

Frequently asked questions

Where is BL43 located?

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.

What is BL43 used for?

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.

How is BL43 needled?

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.

Which meridian is BL43 on?

BL43 is a point on the Bladder Meridian (Zú Tài Yáng Páng Guāng Jīng).

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⚠️ This page is for general education and is not medical advice. Acupuncture is a traditional practice; evidence varies by condition and study quality, and individual results differ. It does not replace diagnosis or treatment by a licensed professional. Always consult a qualified acupuncturist or physician.