Small Intestine Meridian
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SI-19
Exit Point
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.0 cun
Needle Angle
90° (Perpendicular)
Body Area
Ear, Face — Jaw
Location
Between the tragus and the mandibular joint, where a depression is formed when the mouth is slightly open.
Main Actions
- Benefits the ears
Indications
Commentary
There are three points anterior to the tragus of the ear, Tinghui GB-2 inferiorly, Ermen TB-21 superiorly and Tinggong SI-19 in the center. All three are frequently used to treat various ear problems, such as tinnitus, deafness, pain, itching and discharge in the ear. It is recommended to needle these three points alternately if frequent needling treatments are required.
Tonggong SI-9 is one of the most important local point for deafness and tinnitus, especially if they are called by certain Deficient patterns such as Lung and Heart Qi Deficiency. Often used together with Yifeng TB-17, they can be stimulated to invigorate Qi in the ears.
It is also said that Tinggong SI-19 can calm the Mind.
Classical Sources
Shi Si Jing Fa Hui (十四经发挥): States that SI-19 is the meeting point of Hand Taiyang (Small Intestine), Hand Shaoyang (San Jiao), and Foot Shaoyang (Gallbladder) channels. The text describes the channel pathway entering the ear at Tinggong.
Ling Shu: The Small Intestine channel branch ascends to the ear and terminates at Tinggong SI-19 anterior to the ear.
Zhen Jiu Jia Yi Jing: Lists the point's indications including deafness, tinnitus, and ear discharge (聤耳).
How to Locate
Locate and needle this point with the mouth open. This allows the condyloid process of the mandible to slide anteriorly and reveals the depression. Locate the vertical sulcus at the junction between the ear and the cheek. Then locate Tinggong SI-19 on the level of the tragus on the sulcus. It is located between Ermen TB-21 and Tinghui GB-2.
Caution
This point is located close to the superficial temporal artery and the auriculotemporal nerve. Care must be taken to avoid these structures. Always needle with the patient's mouth open to locate the depression properly. When retaining the needle, the patient should maintain a slightly open mouth position—placing a small object between the teeth can help. Avoid deep insertion as the temporomandibular joint structures are nearby. Due to proximity to blood vessels, check for pulsation before needling and apply pressure after needle withdrawal.
Needle Angle
90° (Perpendicular)
Depth Category
Medium
Standard Depth
0.5–1.0 cun
Needling Directions
0.5–1 cun vertically or slightly obliquely in an inferior direction. Caution: This point is located close to the superficial temporal artery and the auriculotemporal nerve
Expected Deqi Sensation
Distension and soreness in the ear region, with possible sensation radiating into the ear canal. The patient should keep their mouth open during needling for proper access and to ensure the needle enters the depression correctly. Deqi typically manifests as a dull ache or fullness around the temporomandibular joint area.
Moxibustion
Questionable
Duration: 5–10 minutes
Cupping
Contraindicated
Bloodletting
Contraindicated
Gua Sha
Contraindicated
Special Point Classifications
Exit Point
Related Resources
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