Directing Vessel
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REN-18
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.3–0.5 cun
Needle Angle
10-15° (Transverse)
Body Area
Chest
Location
On the midline of the chest, on the level of the 3rd intercostal space.
Main Actions
- Opens the chest and regulates Qi
- Descends rebellious Qi
Indications
Wheezing
Dyspnoea
Vomiting
Chest pain
Throat pain
Breast pain
Chest fullness
Swollen throat
Breast swelling
Shortness of breath
Difficulty swallowing
Lateral costal region pain
Commentary
Yutang REN-18 can be used to open the chest and remove Qi Stagnation there, so as to treat symptoms like pain, fullness and swelling in the chest, breast, throat and lateral costal region.
It is also applied to regulate and descend Rebellious Qi, especially the Rebellious Lung Qi. Therefore it treats shortness of breath, vomiting, and wheezing.
Classical Sources
Zhenjiu Jiayi Jing (針灸甲乙經 - Systematic Classic of Acupuncture and Moxibustion): "Chest fullness, inability to breathe, rib pain, bone pain, wheezing with rebellious Qi rising, vomiting with vexation of the heart - Yutang governs these."
Name Etymology: Yu (玉) means "jade" and Tang (堂) means "hall" or "palace." The point lies at the level of the Heart, considered a jade palace - a precious dwelling place for the sovereign Heart and its spirit (Shen). The nearby points REN-16 (Central Palace), REN-17 (Central Altar), and REN-19 (Purple Palace) all share this theme of royal residence, emphasizing this region's importance for the Heart and spirit.
How to Locate
Identify Shangzhong REN-17 in the middle of the two nipples, on the level of the 4th intercostal space. Locate the 3rd intercostal space by counting one space up. Or locate the 3rd intercostal space by palpation or counting down from the clavicle. Yutang REN-18 is on the midline of the sternum.
Caution
Located directly over the sternum with potential risk of pneumothorax or cardiac injury. Some individuals have a sternal foramen (congenital opening in the sternum) which creates a direct pathway to vital structures. Only transverse (horizontal) needling is recommended - never needle perpendicularly. Keep needling shallow (0.3-0.5 cun) and subcutaneous.
Needle Angle
10-15° (Transverse)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
0.5–1 cun transversely in a superior or inferior direction along the Channel. Caution: only transverse needling is recommended in order not to injure the Heart or the pleura, especially for patients with a sternal foramen.
Expected Deqi Sensation
Due to its location on the sternum, deqi sensation at this point is typically subtle and may be difficult to obtain. Patients may feel a mild local distension or warmth spreading across the chest. A dull, heavy sensation may radiate laterally toward the ribs or upward toward the throat.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
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