📍 BL-43: The point for chronic, untreatable diseases...

published 4 MONTHS AGO | 4 MINS READ

This week I thought I'd share an interesting story about BL-43 (gāo huāng shū) and how it was used to treat chronic (or even incurable) diseases...

BL-43: The Vital Region Transport Point

The name of BL-43 (膏肓俞 gāo huāng shū) is Vital Region Shu, and it kind of tonifies everything.

BL-43 is located 3 cun lateral to T4
(level with UB-14).

According to Deadman, it: tonifies and nourishes the Lung, Heart, Kidneys, Spleen and Stomach; nourishes yin and clears heat; calms the spirit; fosters original qi, and resolves phlegm.

Is there anything it can't do? What is going on here?

WTF is a Vital Region?

Individually, the character 膏 gāo means "fat", and the character 肓 huāng means membrane. But as a compound term, 膏肓 gāohuāng refers to the area between Heart and diaphragm. This is often translated as Vital Region.

This is a very deep region where chronic pathogens get stuck. Once a pathogen enters this area, needles cannot reach it, herbs cannot penetrate it, and nothing can be done.

Deadman tells the story of when it was first mentioned in Master Zuo-jiu's Tradition of the Spring and Autumn Annals (580 BCE):

The Prince of Jin who was gravely ill sent for the famous Doctor Yi Huan. After examining the patient, Doctor Huan declared that the disease had settled in the gaohuang region (between the Heart and the diaphragm) and hence "it cannot be purged, it cannot be reached [by needling], herbs will not penetrate it, there is nothing to be done".

So because BL-43 is the Back-Shu point of this Gao Huang region, it is able to treat these chronic, "incurable" diseases.

BL-43 in the Classics

What kind of diseases was gāo huāng shū used for?

In 1128, Zhuang Zhuo was inspired to write a text called Method of Moxibustion at Gaohuangshu after being cured of various diseases -- such as beri-beri and malaria -- by burning 300 cones of moxa on BL-43.

In the Thousand Ducat Formulas by Sun Si-miao, he writes, "Gaohuangshu BL-43, there is no [disorder] that it cannot treat" and "once moxibustion is completed, it causes a person's yang qi to be healthy and full."

Most texts emphasized using moxa BL-43 (as much as 100 to 300 cones). Some even went as far as to say the point was contraindicated to needling.

Others recommend that, after moxa on BL-43, moxa should be done on other points below the umbilicus (REN-6, REN-4) in order to guide down the heat that was generated.

Modern Uses of BL-43

Like we said, BL-43 tonifies pretty much everything. But it is most commonly used in chronic, stubborn diseases:

Lung (especially Lung yin): consumption, cough, coughing blood, steaming bone disorder, night sweating, emaciation
Heart: poor memory, palpitation, insomnia, phlegm-fire mania
Kidney: seminal emission and impotence
Spleen/Stomach: deficiency, undigested food in the stool, weakness of the four limbs
Original Qi: deficiency, five types of taxation, the seven injuries
Phlegm: phlegm is often a factor in chronic disease

However, when we look at Macioica’s point prescriptions, he tends to use BL-43 primarily for Lung patterns, especially when the condition is chronic (which makes sense, since this point is close to BL-13).

He also notes:

In a broader sense, 'Gaohuang' also indicates the site of any disease that is chronic and very difficult, if not impossible, to treat. This point is therefore used in very chronic diseases, particularly of the Lungs, and especially Lung-Yin deficiency. Historically, it was used for tuberculosis of the Lungs.

For patterns of Lung Yin deficiency, Maciocia recommends needling BL-43 rather than burning moxa.

What about you?