KI-27 (Shu Fu) Shu Mansion

What does KI-27 Shu Fu do?

Shu Fu KI-27 is the twenty-seventh and final point of the Kidney channel, sitting in the hollow just below the inner end of the collarbone, and it is the classic point of that channel for cough and for a tight, oppressed chest. Sacred Lotus sources & references record three actions for it: it unbinds the chest, it transforms phlegm and alleviates cough and wheezing, and it harmonises the Stomach and lowers rebellious qi. All three describe the same movement from different angles — something that should be descending is instead pressing upward, and this point is where the Kidney channel's ascent through the chest ends.

• Unbinds the chest — the core action, and the one the point is chosen for. The tradition's phrase for the sensation is oppression: a fullness, tightness or constriction in the chest that is not pain and not breathlessness alone. KI-27 is the Kidney channel's answer to it.
• Transforms phlegm and alleviates cough and wheezing — the respiratory action proper, for productive cough, for phlegm that will not clear, and for wheezing and breathlessness.
• Harmonises the Stomach and lowers rebellious qi — the reason a Kidney-channel point on the chest carries digestive indications. Rebellious qi is qi rising when it should fall, and it presents as belching, hiccup, nausea and vomiting as readily as it does as cough. The Kidney channel is described in the classics as passing through the diaphragm on its way into the chest, and this action follows that route.
• Benefits the Kidneys' grasp of the breath — the theoretical link that ties the point's channel to its indications. The Kidneys are held to receive and anchor the qi drawn in by the Lungs, and a failure of that anchoring is the classical explanation for breathlessness on exertion. KI-27 is the Kidney channel's terminal point in the chest and is used within that reasoning.

Source: Sacred Lotus sources & references (channel and the existing action record — whose broken list markup is corrected here); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 362; Chinese Acupuncture & Moxibustion, p. 198; cross-referenced against multiple online sources.

What is KI-27 Shu Fu used for?

Shu Fu KI-27 is used for cough, wheezing and chest oppression — a narrow, consistent and entirely respiratory core, with a second smaller group of indications concerning rebellious Stomach qi. The indications carried in Sacred Lotus sources & references are cough, asthma and chest pain; the standard reference literature sets the range out as follows. These describe traditional use, not proven treatment, and this point carries the safety considerations recorded under needling.

• Cough, including chronic and productive cough
• Asthma, wheezing and shortness of breath
• Chest pain
• Fullness and oppression of the chest
• Difficulty breathing when lying flat
• Nausea and vomiting
• Belching and hiccup
• Inability to eat, or reduced appetite accompanying chest fullness
• Pain and soreness below the collarbone at the point itself

The pattern is worth reading as a whole. Every one of these is a symptom of something rising or refusing to settle — the breath, the phlegm, the stomach contents, the sense of pressure in the chest. That is what a point recorded as unbinding the chest and lowering rebellious qi is for.

Source: Sacred Lotus sources & references (existing indication record, reformatted here as a list); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 362; Chinese Acupuncture & Moxibustion, p. 198.

Where is KI-27 Shu Fu, and how is it used in practice?

Shu Fu sits in the depression on the lower border of the collarbone, two cun out from the midline of the breastbone — roughly two thumb-widths to the side of the notch at the top of the sternum, tucked up under the bone. It is the highest and last point of the Kidney channel, and the easiest of the whole Kidney chest run to find, because the collarbone gives it a hard landmark that the points below it lack.

Those points below it are the key to using KI-27 well. The Kidney channel crosses the chest as a vertical column of six points, all two cun lateral to the midline, one in each of the upper intercostal spaces: Bu Lang KI-22, Shen Feng KI-23, Ling Xu KI-24, Shen Cang KI-25, Yu Zhong KI-26 and then Shu Fu KI-27 under the clavicle. All six are held in Sacred Lotus sources & references, all six carry chest and cough indications, and in practice they are counted upward from a palpable rib space or downward from the collarbone. KI-27 is the reference point of the column.

Which points is KI-27 combined with?

• For cough and wheezing — with Fei Shu BL-13, the Lung Back-Shu point on the upper back, which is the standard partner for any respiratory treatment; with Shan Zhong REN-17 in the centre of the chest, the Hui-Meeting point of qi; and with Tian Tu REN-22 in the suprasternal notch for the acute, tight, unproductive cough.
• For phlegm — with Feng Long ST-40, the Luo-Connecting point of the Stomach channel and the tradition's principal point for resolving phlegm, and with Chi Ze LU-05, the He-Sea point of the Lung channel.
• For chest oppression and fullness — with Shan Zhong REN-17 and Nei Guan P-06, the pairing used across the whole of the chest region for constriction and for a chest that will not open. Both are held here. (Note that our library codes the Pericardium channel P-06, P-07, P-08.)
• For breathlessness on exertion attributed to the Kidneys — with Shen Shu BL-23, the Kidney Back-Shu point, and Tai Xi KI-03, the Yuan-Source point of its own channel at the ankle, which is the standard distal partner for anything on the Kidney channel.
• For nausea, belching and hiccup — with Zhong Wan REN-12, the Front-Mu point of the Stomach, and Zu San Li ST-36.
• With the neighbouring chest points of other channels — Zhong Fu LU-01, the Front-Mu point of the Lungs, and Yun Men LU-02 sit laterally under the outer part of the same collarbone and cover overlapping ground from the Lung channel.

Where does KI-27 sit among its peers?

KI-27 carries no special-point classification in Sacred Lotus sources & references — it is not a five-shu, yuan, luo, xi-cleft, back-shu, front-mu or confluent point, and no such role has been invented for it here. What gives it standing is position: it is the point at which the Kidney channel, which begins on the sole of the foot at Yong Quan KI-01, finally stops. A channel that starts at the lowest point on the body ends at the highest point it reaches, immediately below the collarbone, and the tradition treats that terminus as significant in itself. Among the six Kidney chest points it is the most used, both because it is the easiest to locate accurately and because it is the highest — closest to the throat and the top of the lungs, where the complaints it addresses are felt.

Source: Sacred Lotus sources & references (location, channel, and the KI-01, KI-03, KI-22, KI-23, KI-24, KI-25, KI-26, BL-13, BL-23, REN-12, REN-17, REN-22, LU-01, LU-02, LU-05, ST-36, ST-40 and P-06 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 362; Chinese Acupuncture & Moxibustion, p. 198; cross-referenced against multiple online sources.

Where is KI-27 located?

• A Manual of Acupuncture (p. 362): In the depression on the lower border of the clavicle, 2 cun lateral to the midline.
• Chinese Acupuncture and Moxibustion (p. 198): In the depression on the lower border of the clavicle, 2 cun lateral to the anterior midline.

How is KI-27 Shu Fu needled, and what is the risk?

Stated plainly: KI-27 lies below the collarbone over the apex of the lung, and pneumothorax — a punctured lung — is the documented hazard of needling in this region. The reference texts do not record a perpendicular insertion here. Sacred Lotus sources & references specify oblique insertion of 0.3 to 0.5 inch, and the angle is the substance of that record rather than a stylistic detail. Everything below is recorded as neutral reference data describing what the textbooks and the published anatomical studies 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 oblique insertion of 0.3 to 0.5 inch, with moxibustion applicable. Three to five tenths of an inch, obliquely, is among the most bounded figures our records carry.
• Deadman & Al-Khafaji (p. 362) and Chinese Acupuncture & Moxibustion (p. 198) record oblique or transverse insertion at this point and both attach an explicit caution against deep or perpendicular insertion, naming the lung beneath. The reason the angle matters is geometric: an oblique needle travels along the chest wall, a perpendicular one travels toward it.
• Moxibustion is recorded as applicable, and involves no depth at all.
• For comparison within our own records: the same bounded 0.3–0.5 inch is recorded for Que Pen ST-12 in the hollow above the collarbone and for Jian Jing GB-21 on the top of the shoulder — the two other points of this library that sit directly over the lung apex. Depth figures in this literature track what lies underneath, not the size of the region.

What has actually been measured at this point

• A CT study that measured KI-27 itself. This is the useful finding, and it is genuinely point-specific. A retrospective study measured, directly from chest CT images, the distance from the skin surface to the pleura at 28 chest acupoints in 319 patients aged 4 to 18 (205 boys, 114 girls). The point list runs the full Conception Vessel chest sequence REN-16 to REN-22, the whole upper Kidney run KI-22 to KI-27, ST-13 to ST-18, SP-17 to SP-20, GB-22, GB-23, LU-01, LU-02 and the first point of the Pericardium channel. The measured depth at Shu Fu KI-27 was 27.50 ± 10.08 mm in boys and 27.67 ± 9.56 mm in girls — the difference between the sexes at this point was not significant, though it was at several others. Depth differed significantly by age group (P < 0.001), by weight group (P < 0.05) and by body mass index group (P < 0.05), and the authors' conclusion was that clinicians should attend to the wide variation in needle depth (Ma YC et al., Evid Based Complement Alternat Med 2015;2015:126028, PMID 26457105, PMC4592721). State the limits precisely: these are children and adolescents, all from a single Taiwanese hospital population, and the figure is the distance to the pleura — the depth at which the lung is reached, not a recommended depth. The standard deviation is the striking part: ten millimetres of scatter around a mean of twenty-seven means individual children differed from one another by more than the whole textbook insertion range.
• What the point-specific figure does and does not license. It establishes that KI-27 has been measured, that the margin at it is on the order of two to three centimetres in children, and that the margin varies enormously between individuals. It does not establish an adult figure, and none is quoted here because none measuring this point was located.
• The nearest measured adult figure in this region belongs to a different point. Ultrasonography in 101 adults measured the vertical distance from skin to pleural line at Jian Jing GB-21 as a mean of 17.4 mm in men and 14.6 mm in women, increasing with weight, height and body mass index (Lin S-K et al., J Acupunct Meridian Stud 2018;11(6):355–360, PMID 29936338). That is GB-21's figure, not Shu Fu's, and it is offered only as the measured scale of the shoulder-girdle region.
• The cadaveric studies of this region did not include KI-27. The dissection of 92 sides in 46 adult bodies measured the needle paths at Tian Tu REN-22 and Qi She ST-11 (PMID 17370496), and the companion pleural-dome mapping named REN-22, ST-11, GB-21, Ding Chuan EX-B1 and Da Zhu BL-11 (PMID 16739850). Shu Fu is in neither list. The pleural-dome finding is nonetheless the relevant background: the dome extended beyond the medial third of the clavicle in almost 60 per cent of bodies, and the medial end of the clavicle is exactly where KI-27 sits.
• No single agreed safe depth exists for any point. Two systematic reviews of the safe-depth literature — 33 studies in one, 47 in the other, using MRI, CT, ultrasound and cadaveric dissection — concluded that measured depths for the same point differ 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).
• What lies beneath, in plain terms. Below the skin at KI-27 lie the fibres of pectoralis major, then the first rib and the first intercostal space, and behind those the cupola of the pleura and the apex of the upper lobe of the lung. The clavicle itself is above and in front of the point, not beneath it, so it provides no protection to a needle angled downward.

What is documented, and in what proportion

Pneumothorax is the second most frequently reported serious adverse event in acupuncture. A systematic review of the Chinese case-report literature from 1956 to 2010 identified 1,038 adverse-event cases across 167 articles, of which 307 were pneumothorax, with 35 deaths across the whole series; the authors attributed the events chiefly to improper technique and judged most avoidable (He W et al., J Altern Complement Med 2012;18(10):892–901, PMID 22967282). A separate systematic review of 115 Chinese-language articles reporting 479 adverse events including 14 deaths reached the same conclusion (Zhang J et al., Bull World Health Organ 2010;88(12):915–921C, PMID 21124716, PMC2995190). An emergency-department series from Seoul recorded 12 mechanical complications of thoraco-abdominal needling over five years, ten of them pneumothoraces, with a mean of 1.6 days between the treatment and the patient's arrival (Lee HJ et al., Pain Med 2017;18(12):2504–2508, PMID 28431130).

What we will not claim. No published case report naming Shu Fu KI-27 specifically as the point at which a pneumothorax occurred was located, and no such claim is made. The recorded oblique angle and bounded depth exist because of what is underneath, and that is the whole of the honest statement.

Delayed presentation. The reference literature records that a pneumothorax following needling over the chest or the root of the neck may declare itself hours later with sudden chest pain, breathlessness or a persistent dry cough. It is a medical emergency requiring immediate assessment.

Risk in proportion. A meta-analysis of prospective clinical studies estimated serious adverse events in acupuncture at approximately 1 per 10,000 patients and around 8 per million treatments (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). The overall rate is low; the events that do occur cluster at a small number of points over the lung, and KI-27 is in that band.

Source: Sacred Lotus sources & references (existing needling record); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 362; Chinese Acupuncture & Moxibustion, p. 198; PMID 26457105 (PMC4592721); PMID 29936338; PMID 17370496; PMID 16739850; PMID 21417806; PMID 23935678; PMID 22967282; PMID 21124716 (PMC2995190); PMID 28431130; PMID 34489268 — each verified resolvable and checked for retraction status before citation.

What does the name Shu Fu mean?

Shu Fu means "Shu Mansion" or "Transport Mansion" — shu, the character used throughout acupuncture for a transport or conveying point, and fu, a mansion, official residence or storehouse. Sacred Lotus sources & references translate it as Shu Mansion. The name is read as the great house at the end of the road: the Kidney channel has carried qi upward from the sole of the foot through twenty-six points, and this is the residence in which that transported qi finally arrives.

The choice of fu is worth noticing because it is the grandest of the dwelling-words used in point names. Where other points are given a door, a gate, an abode or a chamber, this one is given a mansion — the residence of an official, a building with authority attached to it. It sits at the top of a run of Kidney chest names that is unusually poetic even by the standards of the repertoire: Shen Feng KI-23 "Spirit Seal", Ling Xu KI-24 "Spirit Ruins", Shen Cang KI-25 "Spirit Storehouse", Yu Zhong KI-26 "Lively Centre" and then Shu Fu KI-27. Read together they describe the chest as a series of inhabited rooms, and the reader can see the classical writers reaching for architecture to describe the interior of the trunk.

Why does it matter that KI-27 is the last point of the Kidney channel?

Because a channel's terminal point marks where its influence stops, and the Kidney channel's stopping place is high — below the collarbone, at the top of the chest. That single fact explains most of what the point does. A channel usually associated with the lower back, the reproductive system and the constitutional reserve has its final station immediately below the throat, and the indications recorded for that station are cough, wheezing and a tight chest rather than anything lumbar or reproductive at all. The tradition's own explanation for why a Kidney point should govern the breath is the doctrine that the Kidneys grasp and anchor the qi the Lungs draw in; KI-27 sits where those two territories meet.

It should also be said what KI-27 is not. It carries no five-shu, yuan-source, luo-connecting, xi-cleft, back-shu, front-mu or confluent classification in Sacred Lotus sources & references, and none has been invented for it. It is a plain channel point in an important place.

Is there research on KI-27 Shu Fu?

The honest answer is that there is no clinical trial of this point, and the only genuinely point-specific published work on it is anatomical. That should be said plainly rather than filled in with studies of protocols that happen to contain it.

• The CT depth study measured this point. The chest-acupoint imaging work described under needling above (PMID 26457105, PMC4592721) included Shu Fu KI-27 among the 28 points measured in 319 children and adolescents, and published a figure for it. It is anatomical rather than clinical, and it is the single most useful published finding about this point.
• KI-27 inside a treatment protocol. A case series of ten consecutive patients with large- or small-fibre peripheral neuropathy applied a standardised protocol built around the anatomical relationship between points and peripheral nerves; the protocol included bilateral KI-27 alongside LI-11, ST-36, GB-34, SP-06, SP-09, LI-04 and the Sanjiao point our records code SJ-05, with electroacupuncture at KI-03 to KI-01 and ST-41 to the Liver point our records code LIV-03. All ten patients reported improvement on a visual analogue scale (Dimitrova A, Med Acupunct 2017;29(6):352–365, PMID 29279730, PMC5733739). This is an uncontrolled case series of a whole protocol; KI-27 is one of a dozen points in it, and the study says nothing about what this point does on its own.

A point-name caution, recorded because it was met while assembling this. Searching the published literature for "Shu Fu" is unreliable: the string is also part of the name of the herbal formula Gui Zhi Jia Shu Fu Tang, and a search on the name alone returns clinical trials of that formula for knee osteoarthritis and similar work that has nothing to do with this acupuncture point (for example Trials 2019;20(1):140, PMID 30782208). Searching "Shufu" as a single word returns a still larger and entirely unrelated literature — surnames and institutional names. Every record used above was read to confirm it concerns the acupuncture point below the clavicle. Nothing was counted; the small number of results is the honest total.

What is missing: no randomised trial isolates KI-27, and none of the cough, wheezing or chest-oppression indications recorded for it has been tested at this point specifically. Its clinical standing rests on the classical record and on its place at the end of the Kidney channel, and this site does not claim otherwise.

How does KI-27 compare with the points around it?

Yu Zhong KI-26 lies directly below it in the first intercostal space and is the next point down the same column; KI-25 Shen Cang, KI-24 Ling Xu, KI-23 Shen Feng and KI-22 Bu Lang continue it downward, all two cun from the midline, all carrying chest and cough indications, and all easily miscounted since the rib spaces must be palpated rather than measured. Zhong Fu LU-01, the Front-Mu point of the Lungs, and Yun Men LU-02 sit laterally beneath the outer part of the same collarbone and are the Lung channel's points for the same territory — LU-01 being the stronger choice where the complaint is squarely a Lung one. Que Pen ST-12 lies above the collarbone in the supraclavicular fossa and shares KI-27's position over the lung apex and its cautions. Tian Tu REN-22 and Xuan Ji REN-21 lie on the midline two cun medially, REN-22 in the notch above the breastbone and REN-21 on the manubrium below it. Shan Zhong REN-17 in the centre of the chest is the point most often paired with KI-27 for chest oppression, and it is the Hui-Meeting point of qi. All of these are held in Sacred Lotus sources & references.

Source: Sacred Lotus sources & references (name, channel, and the KI-01, KI-22, KI-23, KI-24, KI-25, KI-26, LU-01, LU-02, ST-12, REN-17, REN-21 and REN-22 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 362; Chinese Acupuncture & Moxibustion, p. 198; PMID 26457105 (PMC4592721); PMID 29279730 (PMC5733739); PMID 30782208 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.