Stomach Meridian
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ST-35
Needle Depth
0.5–1.0 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Knee
Location
In the depression below the patella and lateral to the patellar ligament.
Main Actions
- Removes Obstructions from the Channel
- Expels Cold-Damp and ease swelling
Indications
Commentary
Dubi ST-35 is a major point indicated for Painful Obstruction Syndrome, especially due to Damp-Cold invasion. It is always used when there are stiffness, pain, swelling or numbness of the knee.
In this case, moxa is especially recommended together with needling to expels Damp, Cold and Wind. Of course, this method is not recommended if the Painful Obstructions are of Heat features.
Classical Sources
Suwen (Simple Questions), Chapter on Qi Acupoints: First classical source mentioning Dubi, establishing it as a point of the Foot Yangming Stomach channel.
Lingshu (Spiritual Pivot), Ben Shu Chapter: "Needling Dubi causes the knee to be unable to extend" – a warning about improper needling technique causing joint dysfunction.
Zhenjiu Jiayi Jing (Systematic Classic of Acupuncture, 282 CE): "Dubi swollen, can needle above it. If hard, do not manipulate forcefully – forcing manipulation leads to immediate death."
Zhenjiu Dacheng (Great Compendium of Acupuncture, Ming Dynasty): "In the center of the kneecap, if ulcerated cannot be treated; if not ulcerated can be treated. If Dubi is hard, do not rush treatment; first wash and apply warmth, then gentle needling will cure."
Shengyu Ge (Victory Jade Song): "When both knees swell unexpectedly like buckets, apply moxa at Xiyan (knee eyes) and Zusanli."
Yulong Ge (Jade Dragon Song): "Hip bones can treat both legs' pain, knee red and swollen unable to walk – must needle Xiyan and Xiguan points, efficacy comes swiftly and disease will cease."
How to Locate
It is recommended to flex the knee slightly for the actual location. Dubi ST-35 is located in a depression on the lower lateral border of the patella, in a groove lateral to the patellar ligament. It projects onto the level of the knee joint space and more or less corresponds with the arthroscopic access to the joint. It is also known as the ‘lateral eye of the knee’ and is part of the extra point Xiyan Ex-LE-5.
Caution
Classical texts warn against aggressive manipulation when the knee area is hard or inflamed. The Zhenjiu Jiayi Jing specifically cautions that forcing manipulation when the point is hardened can be dangerous. If there is visible ulceration or infection at the site, needling is contraindicated. Care should be taken not to penetrate too deeply into the joint capsule, and the knee should be properly flexed during needling to access the point safely. The nearby lateral popliteal cutaneous nerve and common peroneal nerve branches warrant attention during deeper needling.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Medium
Standard Depth
0.5–1.0 cun
Needling Directions
0.5–1 cun slightly obliquely in a medial direction, towards Neixiyan Ex-LE-4 in the medial eye of the knee. Caution: Knee joint.
Expected Deqi Sensation
Distension, soreness, and heaviness around the knee joint. Deqi sensation may radiate within the joint capsule. Deep needling toward BL-40 may produce a sensation traveling through the knee. Patients often feel immediate relief of knee tension upon obtaining qi.
Moxibustion
Recommended
Duration: 5–10 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
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