REN-21 (Xuan Ji) Jade Pivot

What does REN-21 Xuan Ji do?

REN-21 descends Stomach qi and dispels food accumulation, unbinds the chest and descends Lung qi, and benefits the throat — the highest of the sternal Conception-vessel points, just below the throat.

• Descends Stomach qi and dispels food accumulation — settling the stomach and clearing stuck food, an action reaching down to the digestive tract
• Unbinds the chest and descends Lung qi — the chest-and-lung action, behind cough and asthma
• Benefits the throat — the throat action, fitting its high position just below the throat notch

The broadest action of the sternal run, and position explains it. REN-21 sits at the top of the breastbone, one cun below REN-22 Tian Tu at the throat notch — so it reaches upward to the throat, outward to the chest and lung, and downward (along the oesophagus) to the stomach. That three-way reach — throat, chest, stomach — is wider than the other sternal points, and follows from its position at the junction of neck and chest.

On the name. “Xuan Ji” is rendered Jade Pivot — and xuan ji is the name of a star of the Big Dipper (and, in old Chinese astronomy, a jade sighting-instrument for the heavens). The reading casts the point as a pivot at the top of the chest, echoing the celestial names of the region (the neighbouring REN-22 is “Celestial Chimney”).

Source: Sacred Lotus sources & references (channel, action, location and translation records; the REN-20 and REN-22 records queried against our own data), cross-referenced against multiple online sources.

What is REN-21 Xuan Ji used for?

REN-21 is used for chest pain, cough, and asthma. Our own indication record is reproduced here in full.

• Pain in the chest
• Cough
• Asthma (wheezing, laboured breathing)

The chest-and-breath core. The recorded indications are the chest-and-lung picture — chest pain, cough, asthma — matching the chest-unbinding and descend-Lung-qi actions. The throat and stomach actions widen where the point is used in combination (for a lump-in-the-throat sensation, or for stuck food with chest oppression), though the primary listed indications are respiratory.

An honest and important note. Chest pain must never be assumed muscular — it requires medical assessment to exclude cardiac and other serious causes. Asthma is a serious condition needing medical management; a severe attack is life-threatening. A cough lasting more than three weeks, or with blood or breathlessness, requires assessment; and difficulty swallowing warrants assessment. This record documents classical use only.

How it is combined. With REN-22 Tian Tu just above for the throat and cough, the sternal Ren points for the chest, and LU-07 Lie Que distally. All held here.

Source: Sacred Lotus sources & references (indication and action records; the LU-07 and REN-22 records queried from our own data), cross-referenced against multiple online sources.

Where is REN-21 Xuan Ji located?

REN-21 is on the midline of the upper breastbone, in the centre of the manubrium, one cun below the throat-notch point REN-22.

• On the anterior midline, in the centre of the manubrium (the upper segment of the breastbone)
• 1 cun below REN-22 Tian Tu, which sits in the hollow at the top of the breastbone (the suprasternal notch)
• The highest of the sternal Ren points, above REN-20 Hua Gai at the sternal angle

Found from the throat notch. REN-22 sits in the soft hollow at the very top of the breastbone (the jugular notch); REN-21 is one cun below it, on the bone of the manubrium. Both the notch above and the sternal angle below (REN-20) bracket it. It is on bone, not in the soft notch.

On the name. “Xuan Ji” — Jade Pivot, the Big Dipper star, as noted above.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; the REN-20 and REN-22 records queried from our own data).

• A Manual of Acupuncture (p. 521): On the midline of the manubrium of the sternum, midway between Huagai REN-20 and Tiantu REN-22.
• Chinese Acupuncture and Moxibustion (p. 240): On the anterior midline, in the centre of the sternal manubrium, 1 cun below Tiantu (REN-22).

How is REN-21 Xuan Ji needled?

Our own record states subcutaneous insertion of 0.3–0.5 inch, with moxibustion applicable — the flat technique the breastbone calls for. What follows is a neutral record of what the reference literature documents. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: subcutaneous, 0.3–0.5 inch, threaded flat along the manubrium.
• Moxibustion: recorded as applicable.
• Why flat, not perpendicular: the manubrium lies immediately beneath; and a possible sternal foramen means a deep perpendicular needle could pass through toward the structures behind. The subcutaneous technique avoids both.
• Regional anatomy: the point lies over the manubrium; behind it lie the aortic arch and the great vessels of the upper chest, and the trachea; the internal thoracic vessels run behind the sternum to each side.

Hazard, stated proportionately. With subcutaneous needling over bone this is a low-hazard point — the manubrium shields the great vessels behind it, so there is no route to them at the recorded depth. The sternal foramen is why the needling is kept flat. Our record carries no arterial caution at REN-21, and it is not among the nine points that do; the vessels behind the manubrium are the reason deep perpendicular needling is not used.

What is not claimed. No study measuring a safe depth at REN-21 could be located, and none is needed at a subcutaneous depth over bone. No case report naming REN-21 was located.

Source: Sacred Lotus sources & references (needling record, retained unchanged; the nine arterial cautions queried from our own data), cross-referenced against multiple online sources; regional anatomy, including the sternal foramen note, from standard anatomical description.

Is there research on REN-21, and what should a reader know?

No trial isolates REN-21. Where the point appears it is one component of a chest, throat or respiratory protocol, and a study that includes a point in a protocol is not evidence about that point.

What this page can state with confidence. REN-21 Xuan Ji (“Jade Pivot”) is the highest of the sternal Conception-vessel points, in the centre of the manubrium just below the throat-notch point REN-22. Its position gives it the widest action of the sternal run — reaching up to the throat, out to the chest and lung, and down to the stomach. Its listed indications are respiratory (chest pain, cough, asthma). It is needled subcutaneously over the breastbone, with no pneumothorax risk.

A safety note. Chest pain, asthma and difficulty swallowing are matters for medical care; this page records classical use and says so.

A note on searching for it. “REN 21”, “CV 21” and “Xuanji” searches return protocol trials and unrelated material — and “Xuanji” is a star name and a common personal name. Any claim attached to this point should be checked against what a study actually used.

Source: Sacred Lotus sources & references (action, indication and location records; the REN-20 and REN-22 records queried, against our own data).