Course: Point Location I
Class #: 8
Date:
11-16-07
Exam on Week 10
Will cover Lung, Large Intestine and Stomach channel. No practicum, just words.
Final on Week 12
Comprehensive: overview of channels, collaterals, points, LU, LI, ST. Will be a practicum on this one.
Stomach 13-18
Not commonly used.
All located on the mamillary line. This is the midmark from the sternal notch to the end of the clavicle
or 4 cun from the midline of the body. Two methods for locating the mamillary line:
1. Finger cun measurement: 4 cun from the midline.
2. (More accurate), find the midpoint of the clavicle.
The nipple may or may not be on the mamillary line.
St 13 and 14 are both located in the first intercostal space. 13 is at the top of the space just on the lower
margin of the clavicle. Stomach 14 is in the center of the intercostal space.
Find the first intercostal with your index finger then use successive fingers to locate 2nd, 3rd, 4th
intercostal spaces. Stomach 13-18 are all located in a line below ST 12, 4 cun from the midline of the
body in the intercostal spaces.
Needling for ST 13-ST 18: depth = 0.3-0.5 cun, transverse insertion.
The further you get toward the umbilicus and distal from that the deeper you can go. Deeper penetration
such as perpendicular inserts carry high risk of pneumothorax.
Note about pneumothorax:
Symptoms:
Cough
Dyspnea
Cannot lie flat w/o discomfort
Lung collapse
Deviated trachea toward affected side
May happen significantly after treatment, may happen right away. There is a question on the
boards about a patient who calls w/these symptoms and asks what you should do. The proper
answer is seek medical attention. This is generally not life threatening and doesn’t necessarily
require EMS, but it is damn uncomfortable for the patient. Often treated with office visit or
outpatient visit, then meds and bed rest. Expect to be sued.
A note about being sued: Shen says the key is not to try not to be sued, but not to be sued
successfully. Sure isn’t easy being a healer…
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Stomach 13
Location: top of the first intercostal space at the bottom margin of the clavicle, directly below ST 12.
1. Find the midline of the clavicle or measure 4 cun lateral from the midline.
2. Find the bottom margin of the clavicle and this is ST 13
Needling: Transverse insertion, 0.3 – 0.5 cun in depth. Aim the needle in the direction of the problem –
i.e., lung problems, aim toward lung.
Used for sore throat and hiccups to descend the Qi. Because of proximity to the area, can be used for
fullness in the chst and rib area, chest pain, upper back pain, couth, dyspnea, asthma, wheezing, etc.
Stomach 14
Location: middle of the first intercostal space in a line with Stomach 12/13.
Needling: Transverse insertion, 0.3 – 0.5 cun in depth. Aim the needle in the direction of the problem –
i.e., lung problems, aim toward lung.
Stomach 15
Location: in the middle of the 2nd intercostal space on the mamillary line.
Needling: Transverse insertion, 0.3 – 0.5 cun in depth. Aim the needle in the direction of the problem –
i.e., lung problems, aim toward lung.
Used for coughing, wheezing, chest tightness, mastitis.
Note about mastitis:
Definition: inflammation in the breast tissue milk ducts. Most people treat w/western
meds/antibiotics. If using non-western, herbal meds are better than acupuncture. Use the meds
both internally and externally (creams or herbal washes applied to the area of inflamation)
Stomach 16
Location: in the middle of the 3rd intercostal space on the mamillary line.
Needling: Transverse insertion, 0.3 – 0.5 cun in depth. Aim the needle in the direction of the problem –
i.e., lung problems, aim toward lung.
Used for chest tightness, cough, fullness of chest w/sob, restless sleep, fever/chills, and more.
Stomach 17
Location: right in the center of the nipple, which may or may not be in the 4th intercostal space. The
more important point is the “Nip Center” location.
This point is only a reference point! It is unique in that it has no clinical application at all and is actually
contraindicated for acupuncture, cupping or moxa.
Stomach 18
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Location: in the middle of the 5th intercostal space, 4 cun from the midline on the mamillary line. (In a
perfect world this is just below the nipple, but not generally true). You might need to push the breast
upward (ask the patient to do this) to find the 5th intercostal space.
Needling: Transverse insertion, 0.3 – 0.5 cun in depth. Aim the needle in the direction of the problem –
i.e., lung problems, aim toward lung.
In truth, none of the points above are much used…
Stomach 19-25, the Upper Abdomen points of the Stomach Channel
These points are located in a line 2 cun from the midline. The points are not so much located with cun as
they are divided into 8 equal parts from the sternocostal angle to the center of the umbilicus.
To locate these points:
1. Find the sternocostal angle to either side of the top of the xyphoid process. Alternately, you can
find the xyphoid process and palpate to find the top of it. The sternocostal angle should be just
lateral to this.
2. Find the center of the umbilicus.
Sternocostal angle to umbilicus is 8 units (possibly 8 cun, perhaps give or take a little.
3. Divide the distance
a. Stomach 25: 2 cun lateral from the center of the umbilicus
b. Stomach 21: Divide the distance between the sternocostal angle and Stomach 25.
Remember this is 2 cun from the midline, as are all the following points.
c. Stomach 19: Divide the distance between Stomach 21 and the sternocostal angle in half.
d. Stomach 23: Divide the distance between Stomach 21 and Stomach 25.
e. To locate 20, 22, and 24, just place them between the points above.
The closer toward the umbilicus you are the more deeply you can needle. The further you are from the
umbilicus, the shallower you needle.
Depths:
 Stomach 18-24 = 0.5 – 1 cun. Adjust this by the weight of the patient – the thinner, the
shallower, the heavier the deeper you can go.
 Stomach 25 = 1 – 1.5 cun, perpendicular insertion.
To find 2 Cun from the midline:
1. Finger cun measurement
2. Measure ½ way between mamillary line to mid body line
3. Look for the ridge, middle of 6-pack abs…which you generally won’t see because most patients
don’t have that!
Stomach 19-25 traditionally used to boost a poor appetite, but in reality they will all increase the
effectiveness of digestion.
Constipation in TCM and western med will cause toxins and such to be reabsorbed into the
tissues, affecting the skin, organs and brain. This is part of the tie between LI and LU in TCM,
aspiration of waste, waste dump of LI.
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Overweight in TCM is a retention of water and waste. Increase digestive effectiveness and
decrease weight. In other words these are bidirectionally effective points.
Stomach 19
Location: 2 cun lateral to midline and 6 units from center of umbilicus. See the location note above to
locate ST 19-25.
Needling: 0.5 – 1 cun, perpendicular.
Used for ab distention, poor appetite, vomiting.
Stomach 20
Location: 1 unit below ST 19.
Needling: 0.5 – 1 cun, perpendicular.
Poor appetite, abdominal distention.
Stomach 21
Location: see location note for ST 21 in intro to this section.
Needling: 0.5 – 1 cun, perpendicular.
Used for ab distention, poor appetite.
Stomach 22
Location: 1 unit below ST 21.
Needling: 0.5 – 1 cun, perpendicular.
Used for ab distention, poor appetite
Stomach 23
Location: see location note above for ST 23.
Needling: 0.5 – 1 cun, perpendicular.
Used for ab distention, poor appetite.
Stomach 24:
Location: 1 unit below ST 23.
Needling: 0.5 – 1 cun, perpendicular.
Used for ab distention, poor appetite and more. Also, mania-depression, stiff tongue and such.
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Stomach 25
Category: Front Mu point of the Large Intestine
Bidirectional regulatory function, meaning it will treat both constipation and diarrhea (including spleen
diarrhea with undigested food, unformed stool.) Can also be used for ab pain, shan disorder, pain of the
uterus, dysmenorrhea, irregular menstruation.
Location: 2 cun lateral to the center of the umbilicus
Needling: 1 – 1.5 cun perpendicular insertion. Be aware there is a danger of peritoneal puncture in a thin
patient.
Lower abdominal points: ST 26-ST30
1 unit here is not the same as 1 unit for the upper ab points, nor is it likely to equal 1 cun thumb
measurement. Use proximal measurement.
1. Palpate for top margin of the pubic bone.
Be sure you communicate well with your patient, telling them what you’re palpating for, what
these points will do for them, etc. They may be more comfortable finding this for you. More on
that in a minute.
2. Find the center of the umbilicus
ST 26 through ST 30 are located 2 cun lateral to this line on both sides of the body.
3. Find the location by dividing the distance
a. Divide the distance between the umbilicus mark and the top margin of the pubic bone in
half. This is a reference point
b. ST 27: Go ½ cun above the middle mark in 3a.
c. ST 26: Go ½ way between ST 27 and ST 25.
d. ST 28: Go ½ cun below the middle mark in 3a.
e. ST 30: Top margin of the pubic bone, 2 cun lateral from the midline.
f. ST 29: Go ½ way between ST 30 and ST 28.
All of these points are used for Shan disorder and then some. Re shan disorder, don’t want to needle into
hernia because intestine tends to protrude into it. Needle at these points in order to encourage the body
to pull the intestine back to where it should be.
Needle depths:

ST 25-29: 1 – 1.5 cun, perpendicular insertion.

ST 30: 0.5 – 1 cun, perpendicular insertion. No moxa!!!
Moxa is always contraindicated where there is hair!
Special to know: Stomach 28 is indicated for abdominal edema.
Most important indication for Stomach 29: irregular menstruation.
A note about patient communication and the genital or breast area:
Ask patients to locate sensitive stuff for you and you tell them how. Many are not comfortable with you
doing it. Communicate well!! Let them know what you are doing and why. Ask them if you can move
their underwear. They don’t need to remove it or bras either. Tell them what is happening. This gives
them a sense of control.
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