Bi Zhong Arm Middle

What does Bi Zhong do?

Bi Zhong is a purely local point of the forearm — everything documented about it concerns the arm it sits on, and nothing else. It is an extra point, belonging to no channel, so it carries no channel-theory action; what the reference literature records is a mid-forearm point used directly for a limb that has stopped working properly — paralysis, spasm, contracture, numbness and pain of the forearm, wrist and hand. Its whole clinical identity is that it reaches deep into the middle of the forearm, between the two bones, from a spot that is easy to find on any arm.

• Relieves pain and numbness of the forearm — the defining documented use, and the one our own record lists first.
• Eases spasm and contracture of the upper limb — recorded for the arm that has drawn up and will not release, whether after stroke or after long disuse.
• Used for paralysis and hemiplegia of the arm and wrist — the indication that gives the point its place in the repertoire. It belongs to the small group of extra points recorded specifically for a limb that will not move.
• Used for restricted movement of the wrist and fingers — an extension of the same use rather than a separate one, and the reason the point is reached for in wrist drop and weak grip.
• Used for pain at the outer elbow and for compression complaints of the wrist — our own record carries tennis elbow and carpal tunnel syndrome here, both of them modern applications of a point recorded for the forearm as a whole.

A correction worth stating plainly. Our own earlier record opened by saying that Bi Zhong "frees the local channels and vessels of the forearm" and went on to "relaxes the sinews". Those are channel-theory phrases, and Bi Zhong lies on no channel — queried directly, it holds no five-shu, yuan, luo, xi-cleft, back-shu, front-mu or confluent classification, no element, and no channel affiliation at all, being recorded under the extra points. There is no channel running through it that could be freed. The claim has been removed, and the points that genuinely carry it are all held in this library and were all queried:

• Wai Guan SJ-05 — the Luo-Connecting point of the Sanjiao channel and the Confluent point of the Yang Linking Vessel, on the back of the forearm between the radius and the ulna. This is the channel point for opening the outer aspect of the arm and relieving pain and stiffness along it, and it lies on the same line as Bi Zhong, lower down.
• Nei Guan P-06 — the Luo-Connecting point of the Pericardium channel and the Confluent point of the Yin Linking Vessel, on the front of the forearm. It is the corresponding point on the flexor side and the one that genuinely carries the channel action for the inner arm, the wrist and the hand.
• Shou San Li LI-10 and Qu Chi LI-11 — on the outer forearm below the elbow. LI-11 is held here as a Sun Si-miao Ghost Point and a Ma Dan-yang Heavenly Star Point, and the pair is the classical channel treatment for a paralysed or painful arm.
• Yang Ling Quan GB-34 — the Hui-Meeting Point of the Sinews, held here, and the point in the whole repertoire that genuinely carries "relaxes the sinews" as a general action, for any limb.

What the sources actually document at Bi Zhong is a local effect on a forearm, arrived at empirically, and that is what is set out above. The reader is not left with less by the correction — they are pointed at the points that do the thing that was wrongly claimed here.

Source: Sacred Lotus sources & references (existing action and indication records, corrected as described; the extra-point status, absence of channel and absence of all point categories queried directly; the SJ-05, P-06, P-07, LI-10, LI-11 and GB-34 records queried directly); Chinese Acupuncture & Moxibustion (p. 251); cross-referenced against multiple online sources.

What is Bi Zhong used for?

Bi Zhong is used for the forearm and the hand, and for very little else — above all for a limb that has lost movement or drawn up: paralysis, spasm and contracture of the upper extremity, with pain and numbness of the forearm alongside them. The indications carried in Sacred Lotus sources & references are paralysis, spasm and contracture of the upper extremities, pain of the forearm, and carpal tunnel; the reference literature adds only closely related presentations of the same limb. This is an unusually short indication list, and keeping it short is the accurate thing to do.

• Paralysis of the upper limb — the defining indication
• Hemiplegia of the arm and wrist following stroke
• Spasm and contracture of the forearm and hand
• Pain of the forearm
• Numbness of the forearm, wrist and hand
• Weakness of the wrist and grip, and difficulty extending the wrist
• Carpal tunnel syndrome
• Pain at the outer elbow, including tennis elbow
• Restricted movement of the wrist and fingers
• Tremor of the hand

What it is not used for. The reference literature does not record Bi Zhong for internal-organ disorders, for systemic complaints or for anything above the shoulder or below the hand. Where an arm problem is part of a wider pattern — wind-stroke, deficiency, blood stasis — the points that carry that reasoning are on the channels: LI-11 Qu Chi and LI-10 Shou San Li for the yang aspect of the arm, P-06 Nei Guan and SJ-05 Wai Guan for the two paired Extraordinary Vessels that govern the limb's inner and outer sides, GB-34 Yang Ling Quan for the sinews of the body as a whole, and LI-15 Jian Yu and LI-14 Bi Nao further up the arm. All are held here and all were queried. Bi Zhong's contribution is the local one at the middle of the forearm, and it is used alongside those rather than in place of them.

Source: Sacred Lotus sources & references (existing indication record, reformatted here as a list from a bare comma-run; the LI-10, LI-11, LI-14, LI-15, P-06, SJ-05 and GB-34 records queried directly); Chinese Acupuncture & Moxibustion (p. 251); cross-referenced against multiple online sources.

Where is Bi Zhong, and how is it used in practice?

Bi Zhong lies at the middle of the forearm, halfway between the crease of the wrist and the crease of the elbow, in the gap between the two bones of the forearm. In our own words: find the crease at the wrist and the crease at the elbow and take the midpoint of the line between them; the forearm is conventionally measured as twelve cun between those two creases, so the midpoint falls at about six cun from either end. The point lies in the soft gap between the radius and the ulna at that level. Sacred Lotus sources & references hold one location record for it, from Chinese Acupuncture & Moxibustion, placing it on the lateral aspect of the forearm between the two bones; no Deadman & Al-Khafaji location or needling record is held for this point, which was confirmed by direct query and is consistent with its not being catalogued there.

A real and unresolved discrepancy is flagged here rather than smoothed over, and it is the single most important thing to know about locating this point. Published sources disagree about which aspect of the forearm Bi Zhong is on — it is variously described as lateral, as dorsal (the back of the forearm) and as palmar (the front). Our own record follows Chinese Acupuncture & Moxibustion, which gives the lateral aspect, and that is kept here unchanged. The wording itself contains a small tension worth naming: the space "between the radius and the ulna" is most readily approached from the back of the forearm, where the two bones are separated by the interosseous membrane under a relatively thin muscle layer, rather than from the outer edge where the radius itself lies directly under the hand. Our location is kept and nothing is overwritten; the disagreement is recorded because it changes what lies under the needle, as set out under needling, and because a reader comparing sources will meet it immediately.

Which points is Bi Zhong combined with?

• With Wai Guan SJ-05 — held here, on the back of the forearm two cun above the wrist crease, on the line from Yang Chi SJ-04 to the tip of the elbow, between the radius and the ulna. Our own location records for SJ-05 and for Bi Zhong use almost the same anatomical phrase, which places the two points on the same line at different heights: SJ-05 low near the wrist, Bi Zhong at the midpoint of the forearm. SJ-05 is the Luo-Connecting point of the Sanjiao channel and the Confluent point of the Yang Linking Vessel, and it is the channel point of that line. Zhi Gou SJ-06, three cun above the wrist and also described in our records as lying between the radius and the ulna, sits between them.
• With Nei Guan P-06 — held here, on the front of the forearm two cun above the wrist between two tendons, the Luo-Connecting point of the Pericardium channel and the Confluent point of the Yin Linking Vessel. P-06 is the flexor-side counterpart to the whole of this territory, and pairing a point on one side of the forearm with one on the other — needled through toward it, in some documented techniques — is the standard structure for numbness and pain of the hand.
• With Da Ling P-07 — at the middle of the wrist crease between the same two tendons, held here as the Yuan-Source point of the Pericardium channel and a Sun Si-miao Ghost Point. Where the complaint is carpal tunnel syndrome specifically, P-07 at the wrist and P-06 just above it are the channel points of that region, and Bi Zhong is used further up the same limb.
• With Shou San Li LI-10 and Qu Chi LI-11 — on the outer forearm below the elbow, both held here. LI-11 is at the outer end of the elbow crease and is one of the most used points in the repertoire; LI-10 is two cun below it on the line to Yang Xi LI-05, and is the classical point for an arm that will not lift or grip. For pain at the outer elbow, LI-10 and LI-11 are the local points and Bi Zhong the point further down the forearm.
• With Jian Yu LI-15 and Bi Nao LI-14 — on the shoulder and upper arm, both held here; LI-15 is a Meeting Point of the Large Intestine channel with the Yang Motility Vessel and LI-14 a Meeting Point of the Large Intestine channel with the Small Intestine and Bladder channels. In treatment of a paralysed arm the whole limb is usually addressed at once, from shoulder to hand, and Bi Zhong contributes the mid-forearm level of that sequence.
• With Tian Jing SJ-10 — at the elbow on the same outer line, held here, where a treatment wants the upper end of the Sanjiao channel's course down the arm.
• With the extra point Er Bai — held here, and the forearm's other extra point: our record places it on the flexor aspect, four cun proximal to Da Ling P-07, either side of the tendon of flexor carpi radialis. Er Bai and Bi Zhong are the two extra points of the mid-forearm on opposite sides of the same limb, though their uses have nothing in common — Er Bai's recorded indications are haemorrhoidal rather than musculoskeletal, which is a useful reminder that the extra points are grouped by position and not by function.
• With the extra points Zhong Quan and Zhou Jian — both held here, at the dorsal wrist crease and at the tip of the elbow respectively. They complete the arm's extra-point set, and like Er Bai their documented uses are largely internal rather than local.

Why use an extra point here at all when channel points are nearby?

Because the extra points of the limbs were recorded for an observed effect at a particular spot rather than derived from the channel map, and because the middle of the forearm is a stretch the channel points do not densely cover. On the outer forearm our own records place SJ-04 at the wrist, SJ-05 at two cun and SJ-06 at three cun, and then the next named point on that line is at the elbow — leaving the middle of the forearm comparatively bare. Bi Zhong fills it. That is an honest and sufficient reason for a point to exist, and it is the same reason most extra points exist. It is not a claim that Bi Zhong does something the channel points cannot: where a channel action is wanted, the channel points named above are the ones that carry it.

Source: Sacred Lotus sources & references (the single location record, and the confirmed absence of a Deadman location record; the SJ-04, SJ-05, SJ-06, SJ-10, P-06, P-07, LI-05, LI-10, LI-11, LI-14, LI-15, GB-34, Er Bai, Zhong Quan and Zhou Jian records queried directly); Chinese Acupuncture & Moxibustion (p. 251); cross-referenced against multiple online sources.

Where is Bi Zhong located?

• Chinese Acupuncture and Moxibustion (p. 251): On lateral aspect of the forearm, midway between the transverse wrist crease and elbow crease, between the radius and the ulna.

How is Bi Zhong needled, and what lies beneath it?

Stated plainly: Bi Zhong is a low-hazard point. It is on the forearm — there is no body cavity, no lung, no internal organ and no great vessel anywhere near it, and the limbs are among the safest regions in the whole repertoire. What the anatomy does put beneath it is a nerve, and which nerve depends on which aspect of the forearm the point is taken to be on — which our own sources disagree about. Everything below is recorded as neutral reference data describing what the textbooks and the anatomical literature state. It is not instruction, this page does not teach technique, and needling is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record perpendicular insertion of 1 to 1.2 cun. That is a deep figure by the standards of this library — deeper than most points on the trunk — and it is a straightforward consequence of where the point is: the mid-forearm is thick with muscle and the needle is travelling toward the membrane between the two bones rather than toward anything hollow.
• No moxibustion figure is carried in our own needling record for this point, and no Deadman & Al-Khafaji needling record is held for it — the point is not catalogued there. Where our sources are silent, we say so rather than supplying a figure from elsewhere.
• For comparison within our own holdings. Queried directly, the neighbouring channel points of the forearm carry comparable perpendicular depths. Depth figures in this literature track the structure underneath, and on a limb the structure underneath is muscle and then bone.

The anatomy — and why the aspect disagreement changes it

This is the one place where the discrepancy flagged under practice has a practical consequence, so it is set out precisely rather than as a general caution.

• If the point is taken on the dorsal (back) aspect between the bones, as the phrase "between the radius and the ulna" most naturally describes, the structure of interest is the posterior interosseous nerve with the accompanying posterior interosseous vessels, running down the back of the forearm on the interosseous membrane deep to the extensor muscles. That nerve is purely motor to the extensor muscles of the forearm and carries no skin sensation.
• If the point is taken on the palmar (front) aspect, as some sources describe it, the structures in the middle of the forearm are the median nerve, running between the two layers of the finger flexors, and the anterior interosseous nerve and vessels on the front of the interosseous membrane. Our own earlier note for this point raised the median nerve, and this is why: it is a real structure of the mid-forearm, but it belongs to the flexor side, not to the aspect our location record gives.
• If the point is taken on the strict lateral edge, as our own location record has it, the radius itself lies immediately beneath, with the mobile wad of muscles — brachioradialis and the radial wrist extensors — over it, and the superficial branch of the radial nerve running beneath brachioradialis in the upper forearm before becoming subcutaneous lower down.
• The honest summary is that a reader cannot know from our sources alone which of those three sets of structures lies under this point, because our sources do not agree on the aspect. That is a far more useful thing to record than a general warning, and it is recorded here instead of one.
• Bruising and local soreness are the ordinary events at a mid-forearm point, as they are anywhere on a limb. A transient electric or radiating sensation toward the hand is described in the reference literature at deep forearm points and is a local nerve response rather than an injury.

What the published safety literature says

• No imaging or cadaveric study measuring a needling depth at Bi Zhong could be located, and no published case report of injury at this point could be sourced. Neither is asserted.
• Two general facts about depth. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second, by MRI, CT, ultrasound and cadaveric dissection — both concluded that measured depths for the same point vary greatly between subject groups and measuring methods, and that "safe depth" has never been standardised (J Altern Complement Med 2011;17(3):199–206, PMID 21417806; Evid Based Complement Alternat Med 2013;2013:740508, PMID 23935678). Neither reports a figure for this point.
• Where the serious events of acupuncture actually cluster. Systematic reviews of the Chinese case literature place them over the chest, the abdomen, the neck and the orbit, attributed chiefly to improper technique (He W et al., PMID 22967282; Zhang J et al., Bull World Health Organ 2010;88(12):915–921C, PMID 21124716, PMC2995190). The forearm is in none of those groups.
• Risk in proportion. A meta-analysis of prospective clinical studies estimated serious adverse events in acupuncture at approximately 1 per 10,000 patients and about 8 per million treatments, with roughly half of all recorded events being bleeding, pain or flare at the needle site (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). A 2024 review of acupuncture safety reaches the same conclusion, adding that the small number of genuinely serious events involving infection are attributable to contaminated needles and inadequate skin disinfection rather than to needling as such (Am J Chin Med 2024;52(6):1555–1587, PMID 39460372). Standard clean-needle practice applies here as everywhere.
• Where a point is low-hazard, we say so plainly. Bi Zhong is one of the straightforward points of the limbs, and the useful information here is anatomical precision about a disputed location rather than a warning imported from a different part of the body.

Source: Sacred Lotus sources & references (existing needling record and the single location record; the confirmed absence of a Deadman needling record; the SJ-05, SJ-06, P-06 and P-07 needling records queried directly for comparison); Chinese Acupuncture & Moxibustion (p. 251); PMID 21417806; PMID 23935678; PMID 22967282; PMID 21124716 (PMC2995190); PMID 34489268; PMID 39460372 — each verified resolvable and checked for retraction status before citation.

What does the name Bi Zhong mean?

Bi Zhong means "Arm Middle" — bi, the arm and specifically the forearm, and zhong, the middle or centre. Sacred Lotus sources & references translate it exactly that way. It is one of the plainest names in the whole repertoire: the point is at the middle of the forearm, and the name says so and nothing more. That bluntness is characteristic of the extra points, which were named for where they are or what they do rather than by the poetic and cosmological vocabulary of the channel points — compare Zan Zhu BL-02 ("Bamboo Gathering") or Tian Chuang SI-16 ("Celestial Window") among the channel points against extra points such as Yao Yan ("Lumbar Eyes"), Xi Yan ("Eyes of the Knee") and Zhou Jian ("Elbow Tip"), all held here. A plain name is often the mark of a point recorded from observation rather than derived from theory.

What are Bi Zhong's other codes?

The point is also catalogued as Ex-UE12 in the standard extra-point numbering, and as M-UE-30 in some references — the same point under alternate classification schemes, not three different points. The older "M" codes belong to a numbering system that many texts have since replaced with the "EX" scheme, and both are still in print. Extra-point coding is genuinely inconsistent across the literature: our Xi Yan record documents a case in which one location appears as EX-LE 4, as EX-LE 5 and as ST-35 across published trials of a single condition. A reader comparing point lists between sources should expect the codes to disagree, and should match on the name and the location rather than on the code.

Is Bi Zhong a channel point?

No. Bi Zhong is an extra point, and this is the fact that governs how everything else on this page is written. Queried directly, our record places it under the extra points with no channel affiliation, no five-shu, yuan, luo, xi-cleft, back-shu, front-mu or confluent classification and no element. Extra points sit outside the fourteen channels: they were recorded because needling a particular spot was observed to do something, not because a channel was reasoned to pass through it. That is why the actions on this page are framed as documented clinical use, and why the channel-theory phrasing that had accumulated in our earlier record — "frees the local channels and vessels", "relaxes the sinews" — was removed rather than kept. Any claim that Bi Zhong "opens", "frees" or "regulates" a named channel should be treated with caution: no channel runs through it. The genuine carriers of those actions are named in full under Actions above, and every one is held in this library: SJ-05 Wai Guan and P-06 Nei Guan for the outer and inner forearm, LI-10 Shou San Li and LI-11 Qu Chi for the arm and its movement, and GB-34 Yang Ling Quan, the Hui-Meeting Point of the Sinews, for the sinews of the body as a whole.

How does Bi Zhong compare with the points around it?

Wai Guan SJ-05 is its nearest and most instructive neighbour: our own location records describe both as lying between the radius and the ulna — SJ-05 at two cun above the wrist and Bi Zhong at the midpoint of the forearm, the same line at different heights. SJ-05 is a channel point carrying two classifications and a wide systemic range; Bi Zhong is a local point carrying none. Zhi Gou SJ-06 at three cun sits between them on the same line, and Yang Chi SJ-04, the Yuan-Source point of that channel, is at the wrist below. Nei Guan P-06 and Da Ling P-07 are the corresponding points on the flexor side, and are the ones to read for carpal tunnel complaints approached from the channel side. Shou San Li LI-10 and Qu Chi LI-11 are higher, near the elbow, on the outer aspect. Among the extra points, Er Bai is the forearm's other one — on the flexor aspect four cun proximal to Da Ling P-07, either side of the flexor carpi radialis tendon, with entirely different indications — and Zhong Quan at the dorsal wrist crease and Zhou Jian at the elbow tip complete the arm's extra-point set. All are held here and all were queried.

Is there research on Bi Zhong?

Almost none, and saying so plainly is more useful than filling the section. A search of the indexed literature under this point's romanised name returns exactly two items, and neither is a trial of the point for the conditions it is actually used for.

• A single-page clinical note, on an indication not otherwise recorded for this point. An item titled "Acupuncture at Bizhong (Extra) for treatment of breast pain in premenstrual period" appeared in the Chinese acupuncture literature (Zhongguo Zhen Jiu 2011;31(2):180, PMID 21442834). The limits could hardly be more severe: it occupies a single page, there is no indexed abstract, no patient numbers are available, and there is no control group. Nothing is claimed from it — and, importantly, premenstrual breast pain is not an indication carried for this point in our own record or in the standard reference literature, so it is recorded here as an isolated published report rather than added to the indication list. It is included because it is one of only two indexed items naming the point, and because a reader who finds it should know exactly what it is.
• A rat study, labelled as a rat study. An experimental study in female Sprague-Dawley rats compared the effect of needling a large number of channel points and extra points on the electrical activity of gonadotropin-releasing hormone neurons in the hypothalamus, and ranked them. Among the extra points tested, Bizhong was grouped in the middle of the ranking with Jingbi and Tai Yang — below Zi Gong, Dan Nang and Yao Yan, above Er Bai and Ding Chuan — and by region the upper-limb and thoracodorsal extra points ranked lowest while the lower-abdominal ones ranked highest (Wang SJ et al., J Tradit Chin Med 2010;30(1):30–39, PMID 20397460). This is an animal experiment about reproductive endocrine physiology, not a study of arm paralysis, and it says nothing about clinical effect in people. It is recorded so a reader meeting it knows what it is. Its one genuinely relevant observation for this page is that the forearm extra points were among the least active in that model — consistent with Bi Zhong being a local point rather than a systemic one.
• What is not here. There is no randomised trial of Bi Zhong, no sham-controlled study, no case series for the indications it is actually used for — paralysis, contracture, forearm pain or carpal tunnel syndrome — and no imaging or cadaveric measurement at it. Its indications rest entirely on the reference literature and accumulated clinical practice. That is a legitimate basis, and it is how much of the extra-point repertoire stands; it is simply not the same thing as clinical evidence, and this record does not blur the two.
• A search caution. Romanised-name searches in this field return a great deal that is not about acupoints at all. Both items above were read rather than counted, and each names Bizhong as a point.

Source: Sacred Lotus sources & references (name, translation, extra-point status, absence of channel and absence of all point categories queried directly; the SJ-04, SJ-05, SJ-06, P-06, P-07, LI-10, LI-11, GB-34, Er Bai, Zhong Quan, Zhou Jian, Yao Yan, Xi Yan, Ding Chuan, Tai Yang, Dan Nang Xue and Zi Gong Xue records queried directly); Chinese Acupuncture & Moxibustion (p. 251); PMID 21442834; PMID 20397460 (rat study) — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.