Directing Vessel
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REN-19
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 2nd intercostal space.
Main Actions
- Opens the chest and regulates Qi
- Descends rebellious Qi
Indications
Commentary
The main function of this point is to open the chest and remove Qi Stagnation, so as to relieve pain in the chest and sternum. Together with Yutang REN-18 and Geshu BL-17, it also treats bone pain.
Like Yutang REN-18, it can be stimulated to descend Rebellious Qi so as to treat coughing, vomiting and difficulties to swollen foods.
Classical Sources
Zhenjiu Jiayi Jing (针灸甲乙经 - Systematic Classic of Acupuncture and Moxibustion, 282 CE): Records Zigong as treating chest and hypochondriac fullness, vomiting and retching, and vexation of the heart.
Lei Jing Tu Yi (类经图翼 - Illustrated Supplement to the Classic of Categories): Documents its therapeutic effect on throat obstruction (喉痹) and throat blockage (咽塞).
Regarding the name: 'Zi' (紫, purple) corresponds to the color of fire and royalty; 'Gong' (宫) means palace. The heart was anciently called the 'Purple Palace' as the sovereign organ, and the Ren Mai at this level corresponds internally to the Heart. Hence the point was named Zigong - the palace of the sovereign organ.
How to Locate
Identify Shangzhong REN-17 in the middle of the two nipples, on the level of the 4th intercostal space. Locate the 2nd intercostal space by counting two space up. Or locate the 2nd intercostal space by palpation or counting down from the clavicle. Zigong REN-19 is on the midline of the sternum.
Caution
Located directly over the sternum. Only transverse (horizontal) needling is recommended to avoid injuring the mediastinum or pleura. Exercise particular caution in patients who may have a sternal foramen (a congenital opening in the sternum), which could allow the needle to penetrate into the chest cavity. Deep perpendicular needling is strictly contraindicated.
Needle Angle
10-15° (Transverse)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
0.5 cun transversely in a superior or inferior direction along the Channel. Caution: only transverse needling is recommended in order not to injure the mediastinum or the pleura, especially for patients with a sternal foramen.
Expected Deqi Sensation
A local distending or heavy sensation over the sternum. Deqi may be subtle at this location due to the thin subcutaneous tissue over bone. Some practitioners note sensation may radiate slightly superiorly or inferiorly along the midline.
Moxibustion
Recommended
Duration: 5–15 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
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