DU-26 (Shui Gou) Water Trough

What does DU-26 Shui Gou do?

Shui Gou DU-26 is the classical revival point of Chinese medicine: its first and defining recorded action is to restore consciousness and open the orifices in sudden collapse. It sits on the Governing Vessel in the philtrum, the groove between the nose and the upper lip, where Sacred Lotus sources & references record the Large Intestine and Stomach channels meeting the Du Mai. That triple meeting is the classical explanation for a range that covers both the mind and the face.

• Restores consciousness and opens the orifices — the primary recorded action, and the reason the point exists in the emergency literature at all. It is the first-named point in the classical repertoire for sudden loss of consciousness, collapse, windstroke and fainting. Collapse and loss of consciousness are medical emergencies requiring emergency medical care; this describes what the tradition records, not a course of action.
• Calms the spirit and settles wind — the recorded basis for its classical use in convulsion, epilepsy, childhood fright wind, mania and severe agitation. It is one of Sun Si-miao's Ghost Points, the group assembled for exactly these presentations.
• Benefits the face, nose and mouth and expels wind — the local action, following the Large Intestine and Stomach channels that cross the philtrum: deviation of the mouth and eye, facial swelling and puffiness, nasal congestion and nosebleed, toothache and clenched jaw.
• Benefits the spine and treats acute lumbar sprain — the Governing Vessel runs the length of the spine, and DU-26 is its most used distal point for a back that has locked acutely. This is the one everyday, non-emergency use of the point.
• Clears heat and settles the interior — recorded in febrile disease with disturbed consciousness, and in the classical management of summerheat collapse.

Source: Sacred Lotus sources & references (channel, meeting-point and Ghost Point classifications; existing action record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 559); Chinese Acupuncture & Moxibustion (p. 234); cross-referenced against multiple online sources.

What is DU-26 Shui Gou used for?

Shui Gou DU-26 is used for two very different things: the emergency management of collapse and loss of consciousness in classical practice, and — in ordinary clinic use — acute lumbar sprain and disorders of the face. The indications carried in Sacred Lotus sources & references are set out below. Loss of consciousness, collapse, stroke, shock and seizure are medical emergencies requiring immediate emergency medical care. The list records traditional use, not proven treatment, and nothing here is an alternative to calling for emergency help.

• Loss of consciousness, coma and fainting (recorded as a first-aid point in Chinese practice)
• Windstroke and collapse with sudden loss of awareness
• Shock and collapse, including summerheat collapse and heat stroke
• Epilepsy and seizure
• Infantile convulsion and childhood fright wind
• Mania, withdrawal, severe agitation and disturbed mental states
• Acute lumbar sprain and sudden locking of the lower back
• Stiffness and pain of the spine, with difficulty bending or turning
• Deviation of the mouth and eye, and facial paralysis
• Trismus — clenched jaw with inability to open the mouth
• Puffiness and swelling of the face; oedema of the face
• Nasal congestion, nasal discharge, loss of smell and nosebleed
• Toothache and pain of the gums
• Febrile disease with disturbed consciousness
• Motion sickness, nausea and dizziness (recorded in modern practice)

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 559); Chinese Acupuncture & Moxibustion (p. 234).

Where is DU-26 Shui Gou, and how is it used in practice?

Shui Gou lies in the philtrum — the vertical groove running from the base of the nasal septum down to the upper lip — at the junction of its upper third with the rest. Both of our location records place it there: one describes the junction of the upper third with the middle third, the other the junction of the upper third with the lower two thirds, which is the same landmark expressed two ways. It is one of the easiest points on the body to find and one of the most tender, and both facts explain its role: in a person who has collapsed, no measurement or landmark-hunting is needed, and the stimulus is unmissable.

Which points is DU-26 combined with?

• For collapse and loss of consciousness — with the extra point Shi Xuan at the ten fingertips, with Yong Quan KI-01 on the sole and Zhong Chong P-09 at the tip of the middle finger. These are the classical revival group. Every one of these presentations is a medical emergency requiring emergency medical services; the grouping is recorded here as reference, not as a response to an emergency.
• For windstroke — DU-26 is the opening point of the modern Xing Nao Kai Qiao (“awaken the brain, open the orifices”) protocol associated with Shi Xue-min, in which it is combined with Nei Guan P-06 and San Yin Jiao SP-06. That combination is the most studied use of this point in the modern literature.
• For acute lumbar sprain — with Hou Xi SI-03, the confluent point of the Governing Vessel, with Wei Zhong BL-40 and Kun Lun BL-60 on the Bladder channel behind the leg, and with the extra point Yao Tong Xue on the back of the hand. The reference literature records the point being stimulated while the person gently moves the back, a pattern the modern literature calls movement or “dynamic qi” acupuncture.
• For deviation of the mouth and facial paralysis — with Di Cang ST-04 at the corner of the mouth, Ying Xiang LI-20 beside the nostril, Jia Che ST-06 at the jaw and He Gu LI-04 as the distal point. The extra point Qian Zheng, held here on the cheek, belongs to the same group.
• For nasal disorders — with Ying Xiang LI-20 and the extra point Bi Tong beside the nose, and with Su Liao DU-25 on the nose tip immediately above it on the same vessel.
• With its mirror below the mouth — Cheng Jiang REN-24 sits in the corresponding hollow below the lower lip on the Conception Vessel. DU-26 and REN-24 are paired for facial disorders and are both Ghost Points, the pairing above and below the mouth being an old one.

Where does DU-26 sit among its category peers?

DU-26 is one of Sun Si-miao's Ghost Points — the thirteen points assembled in the Tang dynasty for mania, seizure and disordered mind, in which it is recorded first, under the name Gui Gong, “Ghost Palace”. Sacred Lotus sources & references hold this group with DU-26 alongside Shao Shang LU-11, Yin Bai SP-01, Da Ling P-07, Lao Gong P-08, Shen Mai BL-62, Feng Fu DU-16, Shang Xing DU-23, Cheng Jiang REN-24, Jia Che ST-06, Qu Chi LI-11 and Hui Yin REN-01. It is also the Governing Vessel's meeting with the Large Intestine and Stomach channels, which is the theoretical basis for its facial range.

Source: Sacred Lotus sources & references (location, category and grouping records); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 559); Chinese Acupuncture & Moxibustion (p. 234); cross-referenced against multiple online sources.

Where is DU-26 located?

• A Manual of Acupuncture (p. 559): Above the upper lip on the midline, at the junction of the upper third and lower two thirds of the philtrum.
• Chinese Acupuncture and Moxibustion (p. 234): At the junction of the upper third and middle third of the philtrum.

How is DU-26 Shui Gou needled, and what does a reader most need to know?

The single most important fact about this point is not a needling fact at all: loss of consciousness, collapse, stroke, shock and seizure are medical emergencies that require emergency medical care immediately. Nothing recorded below is an alternative to that, and nothing here should delay it. With that stated, the technique the standard texts record is set out as neutral reference data. It is not instruction, and this page does not teach technique. Needling is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record oblique insertion directed upward, 0.3 to 0.5 inch. The upward direction — toward the nasal septum, following the run of the philtrum — is the recorded trajectory at this point.
• Deadman & Al-Khafaji (p. 559) and Chinese Acupuncture & Moxibustion (p. 234) both record oblique superior insertion and both record that the stimulation given here is strong. This is one of a small number of points where vigorous stimulation is part of the recorded description rather than an option.
• Moxibustion is generally not recorded for this point in the standard references, which is unsurprising given its position on the face.
• Pain. The reference literature is explicit that DU-26 is among the most painful points on the body. That is not incidental to its recorded use — the intensity of sensation is the mechanism the classical texts describe.

Fingernail pressure — the non-needle technique

The texts record that DU-26 is very often stimulated without a needle at all, by pressing hard into the philtrum with a fingernail or thumbnail. This is the form in which the point is most widely known in China, where it is a piece of common first-aid knowledge rather than a specialist procedure — the manoeuvre a bystander is taught for someone who has fainted. It is recorded here because it is what the sources document, and because a reader encountering “ren zhong” in a Chinese context will meet it in this form. It is a record of practice, not a recommendation: a person who has lost consciousness needs emergency medical assessment, and pressing a point is not a treatment for the cause of a collapse.

Where the real hazard lies at this point

DU-26 carries no significant anatomical hazard of its own. It sits over the maxilla with bone immediately beneath, well away from the great vessels, the pleura and the brain — nothing like the anatomical exposure of points such as Feng Fu DU-16 at the skull base or Jian Jing GB-21 over the lung apex. Set in proportion, a meta-analysis of prospective clinical studies estimated serious adverse events from acupuncture at roughly 1 per 10,000 patients and about 8 per million treatments, with about 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). The recorded hazard at DU-26 is of a different kind entirely, and it is worth naming plainly: the risk is that a person in a genuine emergency is stimulated at this point instead of being taken to emergency care. The largest review of the Chinese adverse-event literature — 1,038 cases across 167 articles, with 35 deaths across the series — concluded that most serious events followed improper technique and were avoidable (He W et al., J Altern Complement Med 2012;18(10):892–901, PMID 22967282); the same principle of not substituting for necessary care applies here.

Source: Sacred Lotus sources & references (existing needling record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 559); Chinese Acupuncture & Moxibustion (p. 234); PMID 34489268; PMID 22967282 — each record checked as active and not retracted.

What does the name Shui Gou mean, and why is it also called Ren Zhong?

Shui Gou means “Water Trough” or “Water Ditch” — shui, water, and gou, a channel, gutter or drainage ditch. The name is literal and anatomical: the philtrum is the groove down which nasal fluid runs, and the classics named the point for the channel it sits in. The point is at least as widely known by its other name, Ren Zhong (人中), “Middle of Man” or “Centre of the Person”. That name carries the classical cosmology of the face: the upper half of the face was assigned to heaven, the lower half to earth, and the philtrum is the meeting line between them — the human middle. In Chinese usage ren zhong is the ordinary word for the philtrum itself, which is why the point and the anatomy share a name.

Why does the Ghost Point classification matter?

Sacred Lotus sources & references classify DU-26 as a Sun Si-miao Ghost Point. The thirteen Ghost Points were assembled by the Tang-dynasty physician Sun Si-miao (581–682) for what the medicine of the time described as possession — the presentations a modern reader would recognise as mania, psychosis, seizure and delirium. DU-26 is recorded as the first of the series, under the name Gui Gong, “Ghost Palace”, and the order was itself part of the method. The classification is not decoration: it tells you the point was assembled into a group specifically for disturbances of consciousness and mind, which is precisely the territory its indications still occupy. It is also a Meeting Point of the Governing Vessel with the Large Intestine and Stomach channels, which accounts for everything on its list that concerns the face, nose, mouth and teeth.

Is there research on DU-26 Shui Gou?

Yes — DU-26 has one of the larger point-specific research literatures of any acupuncture point, concentrated in resuscitation, shock and acute brain injury. It should be read carefully: the clinical studies test the point as an addition to conventional emergency and intensive care, never as a replacement for it, and the strongest and most numerous studies are in animals.

• Shock — the largest point-specific clinical trial. A three-centre randomised controlled trial in 276 patients with mild to moderate shock compared conventional Western medical treatment alone against the same treatment plus electroacupuncture at Shuigou GV26. Blood pressure rose sooner in the group receiving electroacupuncture, and the markedly-effective rate was 52.9 per cent against 18.1 per cent in the medication-only group (Zhongguo Zhen Jiu 2008;28(7):473–6, PMID 18678155). The design is the important detail: electroacupuncture was an addition to medical treatment of shock, and the trial says nothing about using the point instead of it.
• Sepsis-associated encephalopathy. Seventy patients in intensive care were randomised to routine Western treatment or the same plus electroacupuncture at Bai Hui GV20 and Shuigou GV26 for one week. The acupuncture group showed larger falls in C-reactive protein, interleukin-6 and neuron-specific enolase and larger gains in Montreal Cognitive Assessment and Glasgow Coma Scale scores, with a total effective rate of 88.6 per cent against 57.1 per cent (Zhen Ci Yan Jiu 2020;45(5):402–6, PMID 32447856). Again an add-on to intensive care, unblinded, and small.
• Refractory status epilepticus — a single case. A 67-year-old woman with varicella-zoster encephalitis and non-convulsive status epilepticus persisting despite continuous midazolam infusion received ten minutes of electroacupuncture at Shuigou; the authors reported immediate EEG suppression lasting nine minutes, after which prolonged epileptic discharges and clinical seizures were not seen again (Front Neurol 2020;11:580777, PMID 33329323, PMC7734353). One case report is a hypothesis, not evidence of effect.
• Animal work on arousal and brain injury — the bulk of the literature. Electroacupuncture at Shuigou has been studied in rodent models of cerebral ischaemia and traumatic brain injury with reported effects on infarct size and neuronal necrosis and on the specificity of the point against controls (Zhongguo Zhen Jiu 2010;30(3):221–5, PMID 20496739), on large-conductance calcium-activated potassium channels after ischaemia-reperfusion (Neural Regen Res 2016;11(6):957–62, PMID 27482225), on arousal from disordered consciousness after traumatic brain injury (Evid Based Complement Alternat Med 2021;2021:6611461, PMID 33959185, PMC8075666), and on motor recovery at different stimulation frequencies (J Tradit Chin Med 2012;32(1):99–104, PMID 22594111). This is preclinical mechanism work and does not establish clinical effect in people.
• What is not there. No randomised trial isolates DU-26 for acute lumbar sprain, despite that being one of its best-known clinical uses; the acute-sprain trial literature that does exist tests other points, such as Hou Xi SI-03 (Zhongguo Zhen Jiu 2007;27(1), PMID 17378192). A small clinical series reported acupuncture at Shuigou combined with antagonistic movement in 26 cases of coccygodynia (Zhongguo Zhen Jiu 2014;34(7):717, PMID 25233669), which is a report rather than a trial. And no study has tested — or could ethically test — fingernail pressure at this point against emergency medical care in a real collapse.

How does DU-26 compare with the points around it?

Su Liao DU-25 sits immediately above it on the tip of the nose, on the same vessel, and shares its recorded use in collapse and shock but not its spinal or mental range. Cheng Jiang REN-24 is its mirror below the mouth on the Conception Vessel, also a Ghost Point, and the two are paired for the face. Shi Xuan, the extra point set at the ten fingertips held here, is the other great classical first-aid point group, and the reference literature places the two together as the core of the emergency repertoire — Shi Xuan pricked to bleed, DU-26 stimulated strongly. Zhong Chong P-09 at the tip of the middle finger and Yong Quan KI-01 on the sole complete that group. Among the Ghost Points, Shen Mai BL-62 and Feng Fu DU-16 are the other members with a substantial independent reputation. It is worth saying plainly what distinguishes DU-26 from all of them: it is the only one that has become general public knowledge in China rather than practitioner knowledge.

Source: Sacred Lotus sources & references; Deadman & Al-Khafaji, A Manual of Acupuncture (p. 559); Chinese Acupuncture & Moxibustion (p. 234); PMID 18678155; PMID 32447856; PMID 33329323; PMID 20496739; PMID 27482225; PMID 33959185; PMID 22594111; PMID 25233669; PMID 17378192 — each record checked as active and not retracted; cross-referenced against multiple online sources.