Course: Point Locations I Date: 11/9/07

Class #: 7

General pathway notes:

St lateral side nose, inner canthus (meets bladder chanel here), interorbital, to mouth corner, oblique to
mandible, up on anterior ear along gb channel, up along gb to corner hair, across to middle at du 24.
facial branch terminates here.

Neck branch splits out at about ST 5 (which is closer to ST 9..)

One branch lateral to superclav fossa, 2 branches

1 to body cavity – thoracic then to stomach/spleen. Lower abdomen, emerges goes to st 30?
1 banch along mammillary to midline to lower ab to meet interior branch above. Down lateral thigh to
ant/lat knee, down, to top of foot, to 2nd/3rd metatars bones to lat aspect of 2nd toe.

1 – lower legs splits from primary at st 36

2 – split from main at ST 42 to center/bottom foot, oblique to big toe, cnx to SP 1

Highlights:
1. ST channel doesn’t originate at ST 1! Originates at LI 20!!! (lateral to nose)
2. ST channel, ST 8 doesn’t directly connect to ST 9, but ST 5 is more closely connected.
Remember where those facial branches are!!
3. Peter Deadman book says neck splits from facial at ST 5… other books say it splits out around
ST 5, not exactly at it.
4. ST channel goes to the upper gums (while LI goes to lower gums.) Clinical significance: if
numbness/pain/swelling on upper, use lower limbs. If pain/swelling/numb on upper gums, use
upper limb points.
5. 3 branches of ST channel located on lower limbs. Know where those branches split out from
main trunk, where they terminate.
a. First branch on lower ant aspect to midline on top of foot to term at ST 45 at lateral
aspect 2nd toe.
b. Second branch splits from ST 36 lat aspect lower leg, term at lat aspect of 3rd toe.
c. Third branch is located on lower leg splits at ST 42, up to meet SP channel on medial big
toe at SP 1.

ST 1
2 methods for finding the point:
1. Have patient look straight forward, find center of pupil as your landmark. Go down to
intraorbital ridge.
2. Find the inner and outer canthus, find midline of these 2.
Location is between the eyeball and the bone. Use a dry cottonball to move the eyeball up and away
from the insertion point.

Needling notes about needling around the eyes in general, ST 1 in specific:

1. Communication with patients
When you needle around eyes, you must have good communic with pt, tell them the risks as well
as asking for their cooperation. Hematoma is a real possibility. Pt needs to know this. You want
to avoid lawsuits as well as causing problems for the patient.

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 (Same applies to the cupping treatments – make the patient part of the healing team, not just a
passive recipient!)

2. CNT practices
Strict clean needle tech shd be applied prior to needling. Alcohol cannot get into the eye—won’t
damage, but does hurt a lot!

3. Selection of needle
Use thin and short needles around the eyes.
a. Why? Don’t need a long needle—depths are less than 0.5. Short also gives you better
control of the motion of the needle. Thin is important because a thick one can cause more
soft tissue damage, including higher risk of inner bleeding. (thicker gives stronger stim,
but more pain, maybe too much stim) Guages 36 or 38, ½ cun -1 cun needle. ½ is the
best. 36=0.18mm 38=0.20 but that’s really a little too thick. Don’t’ use thinner than 0.14.
Too hard to insert, manipulate. Need to find a balance between convenience for you and
pt.

4. Push eyeball away

Ask pt to close eyes during entire process of needling, not just insertion—retention and
withdrawl too. Have a dry cotton ball ready when you insert because it doesn’t stay in long at all.
Put ball on acu point, push eyeball away from insertion point. (Much like moving a vessel or
tendon away when you insert)

5. Direction of insertion
When you insert you first insert slightly downward after needle penetrates. Insert slightly
downwards, then penetrate perpendicularly into the space.

6. Depth
recommended depth = 0.2-0.5cun.

7. Manip/retention
in general, manip/reten is not recommended for any points around eyes. Put to desired depth, get
stim feeling without manipulating, pull it out. Not recommended, but not
prohibited/contraindicated either. (Shen sometimes retains them a little bit.)

8. Withdrawl
immed upon withdrawl, roll cottonball over hole, press for 1 minute, ask patient to press for
another 2-3 minutes.
a. Why? You don’t know if you’ve hit a blood vessel/artery or not. Cannot tell…though if
you needle the eyeball the patient will tell you very vocally. This prevents
hematoma/stasis. If you needle a vessel:
i. Vein: hold 1 minute to stop bleeding.
ii. Artery: hold 5 minutes minimum.

9. Bruises
If there IS hematoma at any point around eyes, remain calm for heaven’s sake. Not a big health
problem like it is in trunk or neck. Doesn’t cause damage, but it affects the appearance of the
face which can really piss your patient off. Further medical attention not necessary. Have them
apply ice first 24-48 hours, then switch to heat—hot water on towel, towel to bruises. This will

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 accellerate healing and absorption of leakage of blood.

10. Moxa
ST 1 and all eye points are contraindicated with Moxa per the classics
a. Moxa around eye, puts vision at high risk of injury.
Note: Moxa sticks weren’t invented until 17th C. Books written prior to this assumed
moxa cones applied directly to skin, size of grain of rice to olive size. Moxa directly
burned on skin. Sometimes ginger or herb below it. Much higher risk of damage.
b. Smoke. Gives negative stim to eye. Same is true of smokeless moxa.

ST 2
Not commonly used.

Locate by landmark. Just below ST 1, feel on the orbital ridge for the divot, which is the infraorbital
foramen.

Note: If you were using a long ass needle and were able to wiggle that puppy around you might hit the
eyeball, so there’s a cautionary note here.

Insertion: Perp insertion 0.2-0.4 cun

Contraindicated for moxa (smoke gets in your eyes) and lift/thrust (damage to infraorbital nerve in
foramen)

Indicated for eye problems, facial paralysis such as Bell’s Palsy. Peripheral facial paralysis is Bell’s
Palsy, central facial paralysis is due to cranial nerve damage. Can be used for parasites in the abdomen
along with LI 20.

This point also used for facial rejuvenation along with yangming channel points, which are rich in Qi
and Blood.

Bell’s Palsy: see deviation of both mouth and eye

Central facial paralysis: deviation of mouth only.

ST1-ST3 are usually inline)

ST 3
Directly below ST 1 and level with lower border of the ala nasi (wing of the nose) on the lateral side of
the naso-labial groove. Have your patient smile to find the groove.

Insertion: Perp 0.5-0.8 cun.

Indicated for facial paralysis and cosmetic rejuvenation (along with yangming channel points mentioned
above).

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ST 4
Usually inline with ST 1, but on some people the mouth is wider. Better: locate by finding the corner of
the mouth, go 0.4 cun out, should be in the naso-labial groove.

Needle:
Perpendicular 0.2-0.3 cun.
Transverse/oblique toward other manifestation (such as ST 6) 0.5-0.8 cun.

Used for facial paralysis quite commonly as well as drooling (elderly ppl and young kids).

ST 5
Located on anterior angle of the jaw at anterior edge of the masseter muscle. Find the bottom of the
jawbone. Find the masseter muscle edge located here—pt may need to clench/unclench teeth so you can
find the anterior edge. Go ½ cun up from bottom edge of jawbone to the anterior edge of the masseter.

Don’t go too high! Only ½ cun up from bottom edge of mandible! Also, there’s an artery here to avoid.

Needle:
Oblique insertion 0.3-0.5 cun

Treats problems of jaw and mouth

ST 6
Ghost point category

Most common mistake is getting this one too high. Also, located close to ST 5.
Located 1 fingerbreadth anterior and superior to angle of the jaw (corner) on the highest point on the
masseter muscle. (Abt 45 º from corner). Have patient clench teeth to find it, but relax to needle it.

Needle:
Perpendicular 0.3-0.5 cun
Transverse toward another feature/point.

Indicated for facial problems, tooth problems, TMJ, clenching problems, and trigeminal neuralgia.

ST 7
Often used for TMJ

This is located in the zygomatic arch. When the jaw is closed, there’s a depression there just in front of
the condyloid process of the mandible. When the jaw is open the condyloid process slides into the hole.
Hold your finger here and have the patient open and close the jaw to find it. Should be just anterior to
the hole in the ear.

Needle:
Perpendicular, slightly inferiorly, 0.5-1cun

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Used for TMJ, hearing and ear problems, trigeminal neuralgia.

ST 8
Technically located at the corner of the forehead, 0.5cun within the anterior hairline. 3 ways to find it:
1. Find the corner of the hairline, go back about 0.5 cun at a bit of an angle laterally. Should be a
small depression here.
2. Double the distance from GB 15 (in hairline directly over midline of eye) to DU 24 (centerline,
0.5 cun into hairline) and into the hairline by 0.5cun.
Find the distance between Du 24 (is also the yintang) and GB 15 (above the pupil when pt is
looking directly forward. Make note of this distance. Go up from GB 15 into the hairline by .5
cun. Measure over laterally the length of the distance from GB 15 to DU 24.
3. 4.5cun over from midline and .5 cun toward posterior.

Needle:
Oblique/transverse 0.5-1 cun into the 4th layer of the scalp in the loose connective tissue (the first 3
layers are tightly bound together).

Indicated for headache, vision problems, hairloss (with little effect, actually).

ST 9
This point is more closely related to ST 5 than to ST 8. This one is on the neck. ST 8 is above the
hairline. Not commonly used.

Have your patient turn her head. Find the Adam’s apple—most prominent tip—then go lateral just
anterior to the anterior border of the sternal head of the SCL muscle (find it by locating the muscle
attach point just lateral to the sternal notch).

Needle:
Perpendicular insertion 0.5-1cun
Moxa is contraindicated. Moxa burns can infect, carotid will move them thru body. Boo.
Caution: Carotid arter is here—palpate to find. Hold laterally with one hand using your index and thumb
on either side of the point to hold the artery away from the point. Puncturing this artery can be a very
bad scene!

Indicated for throat problems, wheezing, voice problems…..and there are others that are far safer!

ST 11
Not a misprint. Find ST 11 before you do ST 10!

ST 11 is located at the root of the neck. Have patient turn head to side. Find the sternal head and the
clavicular head of the SCL muscle. There’s a triangle shaped depression between the two. Point is
located in this depression. There’s a small artery here.

Needle:
Perpendicular 0.3-0.5cun.
Caution: Don’t deep needle!! Lung puncture danger.

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ST 10
Find ST 11 and ST 9 first!

Have pt turn head to side. Find the sternal head of the SCL muscle. ST 10 is located on the anterior
border of the sternal head of the SCL muscle, ½ way between ST 9 and ST 11, but is not inline with
them. Forms a shallow triangle when the 3 points are used together.

Needle: 0.3-0.5 cun.

Caution: carotid artery!

ST 12

Know this—
Meeting point of the following channels:
 Stomach
 Large Intestine
 Small intestine
 Sanjiao
 Gall Bladder
Can therefore stimulate a lot of channels without adding yet more points to the mix.

To locate, find the midline of the clavicle. Measure from sternal notch to the junction with the acromion
process. Find ½ way mark. Point is in the supraclavicular fossa just above the upper border of the
clavicle.

Needle:
Safest—needle transverse, angling posterior into the trapezius 0.5-1cun in depth
Not so safe—needle perpendicular 0.3-0.5cun.
Contraindicated in preggers.

Use for cough and wheeze due to lung qi rebellion. Local pain too.

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