Directing Vessel
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REN-22
Window of Heaven
Safety Warnings
- Dangerous point - requires extra caution
Needle Depth
0.2–1.5 cun
Needle Angle
45° (Oblique), 10-15° (Transverse)
Body Area
Neck — Anterior
Location
In the centre of the suprasternal fossa. 0.5 cun superior to the sternum.
Main Actions
- Descends Lung Qi
- Benefits the throat and voice
- Resolves Phlegm
Indications
Goitre
Coughing
Wheezing
Dry throat
Hoarse voice
Throat ulcers
Loss of voice
Swollen throat
Phlegm in throat
Shortness of breath
Rattling sound in the throat
Commentary
Tiantu REN-22 is often used to treat both chronic and acute cough and asthma due to its ability to descend Rebellious Lung Qi.
It can also expel Phlegm from the throat and Lungs. Therefore, it can be applied in acute bronchitis with profuse sputum or chronic retention of Phlegm in the throat.
It is also widely used to treat various throat and voice related symptoms such as throat dryness, swelling and ulcers as well as loss of voice.
Classical Sources
Ling Shu (Spiritual Pivot), Chapter 2: Lists Tiantu among the important points in the neck region that connect the body with the head, considered among the Window of Heaven points for descending rebellious Qi.
Zhen Jiu Jia Yi Jing (Systematic Classic of Acupuncture): "Coughing with Qi rushing upward, wheezing, sudden loss of voice and inability to speak... throat obstruction with dryness and acute difficulty breathing, rattling in the throat." This classic establishes Tiantu's primary indications for throat and respiratory disorders.
Jia Yi Jing: Identifies Tiantu as the meeting point (Hui point) of the Yin Wei Mai and Ren Mai, establishing its role in connecting the Yin Linking Vessel with the Conception Vessel.
How to Locate
Locate Tiantu REN-22 in the centre of the suprasternal fossa, about 0.5 cun superior to the sternum. The patients are recommended to lie on their back with a pillow under the shoulders or sit with a comfortable and safe head support.
Caution
This is a DANGEROUS point requiring strict attention to needling technique. The needle must first be inserted perpendicularly 0.2 cun, then directed inferiorly to slide behind the sternum. NEVER needle straight down or at an angle into the thorax. Risk of injury to: (1) Brachiocephalic (innominate) artery and vein behind the sternum, (2) Aortic arch in the superior mediastinum, (3) Trachea directly beneath the point, (4) Lung apex and pleura which could cause pneumothorax. Only experienced practitioners should needle this point. Avoid in patients with bleeding disorders or those on anticoagulants. Use gentle stimulation only.
Needle Angle
45° (Oblique) / 10-15° (Transverse)
Depth Category
Medium
Standard Depth
0.2–1.5 cun
Needling Directions
Initial vertical insertion 0.2 cun in order to penetrate the skin, then direct the tip of the needle inferiorly and continue to insert the needle parallel to the posterior aspect of the sternum up to 0.5–1 cun. Caution: Dangerous point and should only be needled by experienced practitioners. Wrong insertion technique (for example, vertical or oblique retrosternal needling) may injure the big Vessels and Organs inside the mediastinum.
Expected Deqi Sensation
Local distension and soreness at the point site. A characteristic constricting or tight sensation around the pharynx and throat area is common. Some patients report a sensation extending downward into the chest or a feeling of the throat opening. Due to the sensitive location, needling should be gentle and patients may experience a transient coughing or swallowing reflex.
Moxibustion
Recommended
Duration: 5–10 minutes
Cupping
Questionable
Bloodletting
Contraindicated
Gua Sha
Contraindicated
Special Point Classifications
Window of Heaven
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