If we observe the Chinese characters the classical acupuncturists used to depict ‘Gao’ in Gao Huang Shu BL 43, we find that it is drawn as a height or pavilion that is raised and elevated above, along with ‘flesh’. Thus, ‘Gao’ has a relationship to the concept of elevation or great height & the concept of flesh. Whist the character used to depict ‘Huang’ shows again the radical for ‘flesh’ and the concept of entering an empty space or hiding place. Hence, concepts of ‘hidden’, ‘secret’, or even ‘missing’ can be related to Huang.
It is important to note that the character ‘Gao’ has been popularly interpreted as relating to ‘fat & greasy’, as well as the region that is said to be ‘below the heart’. The concept of ‘below the heart’ may relate to the character ‘Gao’ representing the height of heights within the ‘flesh’ or body, which would be the ‘heart’. In acupuncture philosophy the ‘heart’ is seen as the ‘emperor’ and the ‘heart’ houses the ‘spirit’, thus what can be higher than the concept of the emperor or spirit? So, if something cannot be higher it must be ‘below’ & this is a plausible reason as to why ‘Gao’ represents below the highest point, ‘below the Heart’.
Now, ‘Huang’ can be interpreted as the description above, however popularly many acupuncturists and scholars have related it to the space ‘above the diaphragm’. Regardless of this, what the concept of ‘Gao Huang’ seems to relate to is the notion of somewhere very deep, vital & important within the body & it is for this reason that the famous acupuncturist of the Tan dynasty Sun Si-miao declared that there is no disease that this acupuncture point (Gao Huang Shu) cannot treat.
In regards to the clinical application and utilisation of this acupuncture point it is important to note that it is primarily a Moxabustion point. In Sun Si-miao’s book ‘the Thousand Ducat Formulas’ he states that moxa cones should be burned directly onto this point. Furthermore, it is important that the acupuncture point’s location is open and well accessed. This is managed by having the patient lying abdomen down on the acupuncture table with their arms hanging off the lateral edges of the acupuncture table. This splays open the shoulder blades and ‘presents’ the hidden area of the Gao Huang Shu BL 43. I personally then palpate the inner region of the scapula and feel for tightness and pressure pain, testing the possible various acupuncture point locations for Gao Haung Shu BL 43 on the body & selecting the appropriate acupuncture point to Moxa. Generally using anywhere from the 15 to 30 rice grain moxa cones (okyu) per acupuncture visit, or alternatively tiger warmer for those who are too sensitive to direct Moxabustion.
As always, please feel free to contact me with any questions you may have.
Giancarlo Nerini - Acupuncturist (Melbourne & Safety Beach)