Spleen Meridian
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SP-18
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–0.8 cun
Needle Angle
45° (Oblique), 10-15° (Transverse)
Body Area
Chest
Location
2 cun lateral to the nipple, in the 4th intercostal space.
Main Actions
- Regulates Qi and descends Rebellious Qi
- Benefits the breasts and promotes lactation
Indications
Cough
Hiccuping
Chest pain
Breast lumps
Chest fullness
Breathlessness
Low milk supply
Clogged milk ducts
Difficult breastfeeding
Lateral costal region pain
Rattling sound in the throat
Lateral costal region fullness
Commentary
Tianxi SP-18 is not a major point of the Spleen Channel.
Its main function is to regulate Qi in the chest and lateral costal region, so as to release pain and distension there. It also descends the Rebellious Qi to stop shortness of breath, coughing, hiccup and rattling sound in the throat.
Another important function of Tianxi SP-18 is that it promotes lactation by removing breast lumps and clear the clogged milk ducts.
Classical Sources
Zhenjiu Jiayi Jing (Systematic Classic of Acupuncture and Moxibustion): Records Tianxi for chest fullness, cough, and breast disorders. The point was documented as one of the chest points of the Spleen channel with actions to regulate Qi flow in the thorax.
Name Interpretation: "Tian" (天) means heaven or upper region, referring to its location in the upper chest. "Xi" (溪) means stream or ravine, describing the intercostal space where the point lies, like a path through which Qi flows upward along the Spleen channel.
How to Locate
The nipples usually falls into the 4th intercostal space, which is the same level at Tianxi SP-18. Measure 2 cun lateral from the nipple by following the course of the intercostal space and locate SP-18.
Caution
Located over the 4th intercostal space with risk of pneumothorax (collapsed lung) if needled too deeply. Perpendicular insertion is contraindicated, especially in thin patients. Always use oblique or transverse needling along the intercostal space. Avoid deep insertion—shallow technique is essential for safety.
Needle Angle
45° (Oblique) / 10-15° (Transverse)
Depth Category
Shallow
Standard Depth
0.5–0.8 cun
Needling Directions
0.5–0.8 cun obliquely or transversely, parallel to the intercostal space or with or against the channel pathway. Caution: Pneumothorax.
Expected Deqi Sensation
Local distension and soreness spreading through the intercostal space. The sensation may radiate toward the breast or along the rib area. Deqi is typically mild due to shallow needling requirements.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
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