What Tianshu does
Tianshu is treated here as a practical point rather than a curiosity: where it sits, how it is needled, what the tradition says it does, and the skin conditions in this database that name it.
Actions
- Regulates the Intestines, Stomach and Spleen
- Invigorates Qi and Blood in the Uterus
- Resolves Dampness
- Expels Wind-Heat
- Calms the Mind
Location
Two cun measured from the landmark shown in the diagram and the location text, lateral to the centre of the umbilicus.
How to find it
Find the bony landmark first, then feel for the hollow or tender spot the location describes. The point is usually sensitive when pressed. The abdomen is measured in cun from the umbilicus, and two cun is the width of three fingers laid side by side, or half the distance from the navel to the midclavicular line. Have the patient lie flat with the arms by the sides so the abdominal wall is not pulled, find the centre of the umbilicus, then measure horizontally and press gently into the soft tissue. The point is usually tender in anyone with a bowel complaint, and in a thin patient the edge of the rectus abdominis can be felt beneath the finger, which is a useful guide to depth.
Deqi
De qi at this point is felt as local distension, heaviness or aching, and may travel a short way along the channel.
A cun is a proportional body measurement, not a fixed length: one cun is about the width of the thumb at the knuckle, 1.5 cun about two finger widths, and 3 cun about the width of four fingers. On an average adult one cun is roughly one inch, but it scales with the person, which is why the texts measure in cun rather than centimetres.
Technique
Needling
Angle: 90 degrees, perpendicular Depth: Standard depth half a to one and a half cun. Direction: Needle in the direction the location describes.
Moxibustion
Particularly recommended, ten to fifteen minutes with a stick or an equivalent number of cones. Warmth is what turns the point from a regulator of excess into a tonic for the Spleen and Intestines, and the reference uses it for chronic diarrhoea and for undigested food in the stools. It is applied with the abdomen relaxed and the bladder empty, and it is not used where the abdomen is hot and tender.
Gua sha
Questionable. The abdomen over the intestines is soft tissue with viscera beneath, and scraping across it is not part of standard care; where surface heat needs releasing, gua sha is worked on the back or the neck.
Skin uses
- Mania Oedema Anxiety Borborygmi Leukorrhea Infertility Constipation Turbid urine Schizophrenia Abdominal pain Umbilical pain Painful period Chronic diarrhoea Abdominal distension Swelling of the face Irregular menstruation Undigested food in the stools
Point classifications
| Classification | Value |
|---|---|
| Channel | Meridian |
Classical record
The Ling Shu is the first text to place Tianshu, fixing it level with the umbilicus. Every later description keeps that anchor, and the point has been the abdominal point for the Intestines ever since.
Ling Shu (Divine Pivot)
Tian (天) is heaven and shu (枢) is a pivot or hinge. The region above the navel was read as heaven and the region below as earth, so a point at the level of the navel is the axis between them, the place where digestion turns.
The name and its meaning
Safety
Who should treat this point
Acupuncture and moxibustion are practitioner procedures. This page is educational and is not a guide to self-treatment.
Caution
Safety flags: contraindicated or restricted in pregnancy; the reference marks it as a dangerous point. Needle with care, adjust depth to the patient's build, and modify or avoid the point where a flag applies. Depth is the main issue at Tianshu. In a thin patient a perpendicular needle pushed past the stated range can pass the peritoneum and reach the small intestine, so the abdomen is palpated first to judge the thickness of the wall and the needle is kept shallow. Pregnancy is a contraindication, particularly after the first trimester, because strong stimulation near the Uterus is not worth the risk, and menstruation with a heavy flow is treated with caution for the same reason. An empty bladder and a settled stomach are both sensible before treatment.
Deficiency and constitution
In a depleted patient the point is worked gently and briefly. Here that means tonification rather than reduction, and warmth rather than needle work. Where Spleen yang is weak and the stools are loose, the abdomen is warmed in short sessions and the point is supported by Qihai REN-6 plus Shangjuxu ST-37, so qi is supplied from below while the Intestines are regulated. In a very thin or very weak patient the depth is reduced further, and the patient is watched for dizziness during treatment.
Before treatment
Educational reference only. Skin that is spreading, painful, blistering or accompanied by fever needs medical assessment.
Modern evidence and safety
General references for acupuncture safety and skin evidence. They are not specific to this point, and they are not a claim that needling it treats any condition.
- Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open, 2021. PMID: 34489268.
- Acupuncture for atopic dermatitis: a systematic review and meta-analysis. BMJ Open, 2024. PMID: 39638592.
- Manual acupuncture for the treatment of chronic spontaneous urticaria: a systematic review and meta-analysis. International Journal of Surgery, 2025. PMID: 40696933.
- Acupuncture in Dermatology: An Update to a Systematic Review. Journal of Alternative and Complementary Medicine, 2021. PMID: 32955916.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
What does Tianshu do in skin practice?
It is used where the skin picture includes mania oedema anxiety borborygmi leukorrhea infertility constipation turbid urine schizophrenia abdominal pain umbilical pain painful period chronic diarrhoea abdominal distension swelling of the face irregular menstruation undigested food in the stools, always as part of a combination chosen for the pattern.
What does the name mean?
Heaven and pivot. Above the navel the body was mapped to heaven and below it to earth, so a point level with the navel is the hinge between the two, the axis around which digestion turns. The name describes a function rather than an anatomical structure.
Why is Tianshu used for both constipation and diarrhoea?
Because it regulates the Intestines rather than driving them in one direction. The reference treats it as the point for bowel disorders whichever way they run, and the technique decides the effect: a reducing needle for the constipated, hot case, moxibustion and a gentler approach for the cold, loose one.
Is it safe to needle deeply here?
Only within limits, and the limits depend on the patient. In a thin person a deep perpendicular needle can reach the peritoneum and the small intestine, so the abdomen is palpated first and the depth adjusted. It is also avoided in pregnancy and used with care during a heavy period.
Why is moxibustion particularly used at Tianshu?
Warmth is what turns the point from a regulator of excess into a tonic for the Spleen and Intestines. The reference recommends it for chronic diarrhoea and for undigested food in the stools, where yang is too weak to transform, and records ten to fifteen minutes as the usual session.