Stomach Meridian
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ST-18
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.3–0.5 cun
Needle Angle
45° (Oblique)
Body Area
Chest
Location
In the 5nd intercostal space, on the mammillary line, 4 cun lateral to the anterior midline.
Main Actions
- Benefits the breasts
- Regulates Qi in the chest
Indications
Commentary
Rugen ST-18 is a widely used local point for breast issues for women, especially for postpartum mothers. Typical symptoms are mastitis, clogged milk duck, difficult breastfeeding, or low milk supply.
It can also be used to regulate Stomach Qi so as to benefit the breasts and chest. Manifestations includes coughing, short of breath, chest oppression or difficulty swallowing.
Classical Sources
Zhenjiu Jiayijing (The Systematic Classic of Acupuncture and Moxibustion, 282 CE): First classical text to document this point, listing its indications for chest fullness, difficulty swallowing, breast pain, and cough.
Qianjin Yaofang (Essential Prescriptions Worth a Thousand Gold, 652 CE): Sun Simiao noted its use for breast disorders, chest pain, and respiratory conditions. The text emphasizes its role in treating lactation problems.
How to Locate
Rugeng ST-18 is locate on the mamillary line, which is 4 cun lateral to the anterior midline. The nipple (Ruzhong ST -17) is mostly located on the 4th intercostal space, while ST-18 is one intercostal space directly below the nipple. In women, ST-18 is normally found at the root of the breast.
Caution
CRITICAL: Risk of pneumothorax with deep or improper needling. The pleural cavity and lung tissue lie beneath this point. On the left side, the heart and pericardium are directly medial to this location. On the right side, the liver edge may be affected. Always needle obliquely along the intercostal space, never perpendicular or deep. This point should be needled by experienced practitioners only. Avoid in patients with emphysema or other lung conditions that increase pneumothorax risk.
Needle Angle
45° (Oblique)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
0.5–0.8 cun obliquely or transversely, parallel to the course of the intercostal space or with or against the channel pathway. Caution: Pneumothorax.
Expected Deqi Sensation
Local distension and soreness radiating around the breast area. Some patients may feel the sensation spreading toward the nipple or into the chest cavity. Due to the shallow needling depth required, strong deqi manipulation should be avoided.
Moxibustion
Recommended
Duration: 5–10 minutes
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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