Acupuncture
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EX-CA4
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
- Contraindicated during pregnancy
Needle Depth
0.5–1.5 cun
Needle Angle
90° (Perpendicular)
Body Area
Abdomen — Middle, Abdomen — Lower
Location
On the anterior midline, 2.5 cun inferior to the umbilicus.
Main Actions
- Stop diarrhoea
Indications
Commentary
This is a modern point, mainly used to stop diarrhoea.
Classical Sources
Classical references to this extra point are found in empirical acupuncture traditions rather than the foundational classical texts. The point appears in modern compilations of extra points where it is noted for its specific effect on stopping diarrhea, hence its name 止泻 (zhǐ xiè) meaning "stop diarrhea." It is also recorded under alternative names including Xueqing (血清) and Guanyuanshang (关元上), indicating its location just above the Guanyuan REN-4 point.
How to Locate
The distance between the upper border of the pubic symphysis and the center of the umbilicus is 5 cun. Zhixie EX-CA is in the midpoint of these two reference points.
Caution
Located on the anterior midline of the abdomen at 2.5 cun below the umbilicus, this point requires careful needling depth control to avoid penetrating the peritoneum. Deep insertion is contraindicated. Do not needle in patients with full bladder or during pregnancy. In thin patients, extra caution is needed as abdominal wall thickness varies significantly. Always use proper needle angle (perpendicular) and moderate depth (0.5-1 cun for safety). The bladder should be emptied before needling.
Needle Angle
90° (Perpendicular)
Depth Category
Medium
Standard Depth
0.5–1.5 cun
Needling Directions
Vertically 0.5–1 cun. Caution: Peritoneum, full bladder, pregnancy
Expected Deqi Sensation
Local distension and soreness spreading through the lower abdomen. The deqi sensation may radiate toward the umbilicus or down toward the pubic region. Patients typically feel a deep, dull ache characteristic of abdominal point needling.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
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