Class #: 8
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.
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.
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.
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.
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.
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.
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.
Stomach 20
Location: 1 unit below ST 19.
Stomach 21
Location: see location note for ST 21 in intro to this section.
Stomach 22
Location: 1 unit below ST 21.
Stomach 23
Location: see location note above for ST 23.
Stomach 24:
Location: 1 unit below ST 23.
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.
Needling: 1 – 1.5 cun perpendicular insertion. Be aware there is a danger of peritoneal puncture in a thin
patient.
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!!!
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