The lungs lie beneath: gentle pressure only, never hard or sharp.
譩譆 Yixi
“A Sigh” · BL45
Foot Taiyang · 45 of 67
Where. Below the sixth bump under the neck bone (C7), four finger-widths from the spine, by the shoulder blade.
For. Cough; shortness of breath; shoulder and back ache.
Press. Ask a partner to press gently with a thumb, about a minute each side.
Caution. The lungs lie beneath: gentle pressure only, never hard or sharp.
噫嘻，在肩髆內廉，俠第六椎下，兩傍各三寸按 · Press with me
Six slow breaths
About a minute. Press as you breathe out, ease as you breathe in.
鄰 · Neighbouring leaves
Where Yixi Sits on the Upper Back
Yixi belongs to the upper back, in the band of layered muscle between the spine and the shoulder blade. The dataset places it below the spinous process of the sixth thoracic vertebra, three cun lateral to the posterior midline. A cun is the traditional measuring unit of Chinese point-location: proportional lengths taken from the person being examined rather than from a ruler, so a cun across the back of a broad-framed adult differs from a cun on a slight teenager. For this stretch of points there is a friendly shortcut — three cun is roughly the width of four fingers held flat together, measured outward from the groove that runs down the middle of the back.
The bladder channel travels down the back in two parallel lines. The inner line, running about one-and-a-half cun from the midline, gathers most of the classical back-shu points; the outer line, three cun out, carries a series of companion points, and Yixi belongs to this outer line. At the very same vertebral level, directly inward halfway to the spine, sits Dushu (BL16), so the two can be learned together as an inner-and-outer couplet. Under the fingertips lies the territory of the trapezius and rhomboid group — the layered muscles that move and steady the shoulder blade — spread over the rib cage that shelters the chest.
The vertical neighbours are equally clear-cut. One level up, below the spinous process of the fifth thoracic vertebra, rests Shentang (BL44); one level down, below the seventh, sits Geguan (BL46); all three share the same three-cun line, stacked like rungs of a ladder. Counting the levels correctly matters, because one step up or down is already a different point with its own entry in the old books. Move patiently, count the spinous processes aloud if it helps, and remember that slouching can blur how clearly the levels are felt.
A Self-Palpation Walkthrough
Sit upright on a firm chair with both feet down and shoulders released, so the back muscles soften. First find the prominent knob of bone at the base of your neck where the spine meets the collar-line — the seventh cervical vertebra, the classic starting peg for counting downward. A widely taught landmark comes next: with the arms hanging loose, the lower angles of the two shoulder blades sit roughly level with the seventh thoracic vertebra. From there count up one spinous process to the sixth thoracic level, settle a fingertip on the lower edge of that process, then measure four flat finger-widths outward from the midline groove onto the thick muscle. That is the neighbourhood of Yixi.
A few confirmations help before any pressing begins. Touch feather-light and compare sides: many people notice a faint, dull awareness near the true spot and little sensation a finger-width away. Check the horizontal distance against the inner line too: at the same vertebral level, halfway in toward the spine, you should be able to find Dushu (BL16). If instead your finger lands on the hard border of the shoulder blade or on bare rib, ease back toward the muscular band between spine and scapula. Both sides deserve the same careful survey, since the two points ought to mirror each other.
Two classic mistakes account for most misses. The first is losing count of the vertebrae: the prominent bump at the neck base is occasionally ambiguous, so anchor on the shoulder-blade angles as well and cross-check before settling. The second is measuring outward from the edge of the shoulder blade rather than from the central groove, which throws the distance off from the very start. Posture matters too — a rounded, hunched back changes where the blades ride. When in doubt, relax the shoulders, return to the base of the neck, and walk down the spine one process at a time, slowly.
Reading the Name: A Sigh Made into a Map Reference
The name is a small oddity worth savouring, because it is built from sound rather than scenery. Yi and xi both belong to the old written family of exclamations — sighs, gasps, cries of surprise or relief. Joined together they read like one long exhalation, often rendered as a weary or comforted sigh voiced half-aloud. On a map where points are named for valleys, gates, courtyards and storehouses, a point named for a noise stands out, and the choice tells you something about how attentively the old practitioners listened to the people in front of them.
Tradition preserves the story behind the sound. As the old accounts describe it, practitioners working along the back during episodes of chills and fever pressed point after point, and when their fingers found the tender spot the patient voiced this exclamation — the sigh was heard, noted, and kept. Classical texts describe confirming the location by exactly that response, the cry answering the press. Read this way, the name is a set of instructions in miniature: touch, listen, confirm. It also explains why the story attaches naturally to this stretch of the back, where the recorded indications include precisely those chill-and-fever complaints.
Pinyin writes the name Yìxǐ: a falling fourth tone on Yi, and a dipping third tone on xi that sinks before lifting again. The dataset records the name in older variant script (譩譆), characters formed with the speech radical, while modern writing often renders the same sounds with the more familiar 噫嘻. However it is spelled, the meaning holds steady. A point named for a sigh reminds whoever hunts for it that the body speaks — and that part of the craft has always been paying attention to what answers back.
Traditional Indications, Explained
The recorded indications read: cough, shortness of breath, shoulder and back pain, malaria, and febrile disease. Framed as tradition rather than promise, the breathing entries come first: classical practice understood smooth, easy breath as qi moving and descending properly, and a stubborn cough or laboured breathing as that movement disturbed. Points along the upper-back stretch of the bladder channel figured in such discussions, and Yixi belonged to that company. These are frameworks for reading the body from within a pre-modern system, offered here for cultural and historical understanding.
Malaria and febrile disease need history around them. Before modern medicine identified parasites and infections, old records gathered under malaria a whole family of illnesses marked by chills and fever arriving in waves, and under febrile disease the many conditions dominated by heat. Practitioners of that era discussed such episodes alongside the bladder channel points of the upper back, and tradition links the naming story of this very point to scenes of exactly that kind of illness. Old categories do not map cleanly onto modern diagnoses, and nothing here suggests pressure at this point influences any infection — the connection is literary and historical, not clinical.
Shoulder and back pain, the remaining indication, follows straight from the channel map. Classical descriptions trace the bladder pathway beginning at the inner corner of the eye, sweeping over the head, then descending the back in two parallel lines through the very territory where Yixi sits, continuing down the back of the leg to the outer side of the little toe — the longest channel in the traditional anatomy. Discomfort along that course was approached at points along the route. And the standing caveat bears repeating: these are the traditional uses recorded in a licensed dataset, not claims that pressing this point treats disease. Where modern research touches self-applied pressure at all, reviews suggest effects are modest and context-dependent, and evidence specific to any single point remains thin.
Self-Care Acupressure at Home
An upper-back point asks for a little creativity of position. Reach across your chest with the opposite hand and let your index and middle fingertips settle into the muscular band inside the border of the shoulder blade; swap hands for the far side. If the reach strains, stack both hands behind your back and lean gently into the backrest of a chair or a firm cushion, letting steady light contact do the work, or invite a household partner to apply fingertip pressure while you guide them. Whichever way you choose, the rules hold: pads of the fingers, never tips; contact alone for a few breaths first; then small, slow circles, letting the skin glide over the tissue beneath. Pressure should register as pleasant dullness or mild warmth, never sharpness. A common home rhythm is one to three minutes per side, once or twice daily, riding slow exhales.
Quality matters more than duration. Light, patient, regularly repeated contact fits the wellness register this page practises; hard jabbing teaches the body nothing and merely irritates the tissues. Warm cold hands before you begin, because chilled muscle guards. Choose a quiet corner over a screen, since the practice doubles as a breathing pause: inhale through the nose, feel the back widen slightly under still fingers, press gently on the long exhale. People who keep a routine often anchor these minutes to an existing habit — after making the bed, before an evening shower — because consistency, not intensity, is what self-care traditions actually ask for.
Treat the exercise as a small ceremony of attention rather than a treatment session. Notice what changes across weeks: perhaps the band of muscle feels less guarded, perhaps your breath settles while you press, perhaps nothing shifts except that you spend ninety seconds attending to your own back. Every one of those outcomes fits the honest scope of self-acupressure. What does not fit is escalation — pressing harder, longer, or deeper to force a result. When curiosity pulls that way, return to gentleness or simply stop for the day.
Cautions and Safe Practice
The licensed entry for Yixi records no special caution note, but a quiet record is not permission for force. Plain geography explains why: beneath this stretch of upper back lie the ribs and the lungs they shelter, and no home practice needs to approach them. The universal rule therefore governs everything here — self-care means gentle, purely superficial contact, and the intention never travels past the skin and the first layer of muscle. That boundary holds whether or not any individual entry carries its own warning; it is simply the ground rule every upper-back practice shares.
The practical rules follow. Use finger pads only — no elbows, knuckles, or tools — and never grind through clothing or drag across skin. Skip the point over broken or irritated skin, during a feverish illness while the body rests, and after any recent injury or surgery in the area until ordinary activity has been cleared. Sharp, electric, or radiating sensation means stop at once and do not try again that day. Pregnant readers, and anyone living with a chronic condition, should consult a qualified practitioner before adding any new point practice, however gentle it may seem.
And the wider rule stands over everything: this page is educational, and acupressure is self-care, not diagnosis or therapy. Seek prompt medical care — not a pressure routine — for a cough lasting beyond a few weeks, breathlessness, chest or back pain without clear cause, fevers or night sweats that persist, or any symptom that frightens you. Persistent symptoms belong with a licensed practitioner, medical or East Asian medical as suits the complaint. The old story gives this point the loveliest name on the back; the kindest thing it can offer most people today is a slower, warmer acquaintance with their own shoulders.
Yixi — a name that means a sigh — sits high on the back beside the spine, level with the sixth thoracic vertebra and three cun out from the midline. Classical practice reached for it in cough, shortness of breath, shoulder and back pain, and episodes of chills and fever; tradition even says the point is named for the sound patients made when it was pressed.
Self-care limits
Frequently asked
- How do I find Yixi without knowing anything about cun?
- Use the shoulder blades as your rulers. With the arms hanging loose, the lower tip of each shoulder blade sits roughly level with the seventh thoracic vertebra; count up one spinous process to the sixth thoracic level, then measure four flat finger-widths outward from the central groove. That is the same ground the cun measurements encode — the traditional numbers and the body landmarks are two languages describing one spot.
- Why does this point have such a strange name?
- Because it began life as a sound. Yi and xi are old written exclamations, and tradition says patients voiced this sigh when a practitioner pressing along the back found the tender spot during chill-and-fever episodes; classical texts describe the cry itself as confirmation of the location. Most point names borrow landscapes — valleys, gates, markets — but this one borrowed a voice, which makes it one of the more memorable entries in the whole atlas.
- Is it safe to press my own upper back like this?
- Gentle fingertip pressure held on the surface is generally reasonable self-care for healthy adults. The sensible limits are the ones described throughout this page: pads only, light and slow, purely superficial, nothing driven inward with force, and immediate stopping on any sharp or radiating sensation. Difficulty arises only when people escalate — digging with knuckles, using gadgets, or pressing through pain — none of which belongs to home practice.
- What did classical practice use Yixi for?
- The traditional record lists cough, shortness of breath, shoulder and back pain, malaria, and febrile disease. The breathing and back entries fit the channel thinking of the era; the malaria and fever entries belong to a pre-modern world of illness classification and connect to the sighing-naming story. Those are traditional frameworks documented for cultural context — not evidence-backed claims that pressing the point treats any of them.
- When should I skip acupressure and see a professional instead?
- Whenever a symptom persists, worsens, or frightens you. A cough outlasting a few weeks, breathlessness, unexplained chest or back pain, recurring fever, night sweats — these call for prompt professional assessment, not a longer pressing routine. Think of the two as neighbours: daily self-care keeps house downstairs, and clinical medicine holds the consulting room upstairs that you visit when symptoms will not settle. Neither substitutes for the other.
Sources
- 01WHO Standard Acupuncture Point Locations in the Western Pacific Region (2008), World Health Organization — nomenclature conventions.
- 02A Manual of Acupuncture, Peter Deadman, Mazin Al-Khafaji and Kevin Baker — point-name tradition, the sighing-name account, and channel context.
- 03aijiu-mpvue (MIT License) licensed dataset, entry for BL45 Yixi — location, actions, and empty caution record.
Last reviewed
牌記This leaf, for machines
Old books ended with a colophon saying who printed them. Every leaf here carries the same facts as structured data for agents and search, with no layout in the way.
- GET /en/points/bl45/leaf.json
- GET /zh-hant/points/bl45/leaf.json
- GET /zh-cn/points/bl45/leaf.json
- /llms.txt — the index of every leaf
- JSON-LD in the page: MedicalWebPage, MedicalEntity and FAQPage
{
"id": "BL45",
"name": {
"en": "Yixi",
"gloss": "A Sigh",
"zh-Hant": "譩譆",
"zh-Hans": "譩譆"
},
"channel": {
"id": "BL",
"order": 45,
"of": 67
},
"location": {
"text": "Below the sixth bump under the neck bone (C7), four finger-widths from the spine, by the shoulder blade."
},
"for": [
"cough",
"shortness of breath",
"shoulder and back ache"
],
"press": {
"text": "Ask a partner to press gently with a thumb, about a minute each side.",
"seconds": 60,
"sides": "both"
},
"cautions": [
"The lungs lie beneath: gentle pressure only, never hard or sharp."
],
"source": "Zhenjiu Jiayi Jing, book 3",
"url": "https://acupoints.com/en/points/bl45",
"lastReviewed": "2026-08-24"
}