Shi Xuan Ten Difusions, Ten Declarations, Ten Tips

What does Shi Xuan do?

Shi Xuan is an extra point — ten of them, one at each fingertip — belonging to no channel, so it carries no channel-theory actions, and everything below comes from documented clinical use rather than from channel mechanics. In that documented use it is a first-aid point set above all else: the classical response to sudden collapse, loss of consciousness, very high fever and convulsions in a child, applied by pricking the fingertips to bleed.

• Used to rouse a person from sudden collapse — the defining recorded use, and the reason the ten points were grouped and named at all. The reference literature places Shi Xuan among the small handful of classical emergency point sets, alongside DU-26 Shui Gou.
• Used in very high fever, including heat stroke and summer-heat collapse — the second great documented context, and the one that pairs the point set with bloodletting technique rather than with retained needling.
• Used in convulsions, including acute childhood fright wind — recorded in the paediatric emergency literature, and in epilepsy as a supporting measure.
• Used for severe swelling and pain of the throat — the classical "throat moth" presentations.
• Used locally for numbness, pain and spasm of the fingers — the one non-emergency use, and the only one that has been tested in a modern randomised trial (PMID 35712943).

Two corrections worth stating plainly. Our earlier record credited Shi Xuan with "regulating the Stomach and Intestines" and with "extinguishing wind and stopping convulsions". Both are organ and channel-theory phrases, and Shi Xuan is on no channel — it has no five-shu, yuan, luo, back-shu or front-mu classification, and no organ is connected to it. Those phrases have been removed. The points that genuinely carry the Stomach-and-Intestine regulating function are ST-36 Zu San Li, the Sea point of the Stomach channel, and ST-25 Tian Shu, the Front-Mu point of the Large Intestine; the point that genuinely carries the action of extinguishing interior wind is LIV-03 Tai Chong, with DU-26 Shui Gou as the channel point classically named for acute loss of consciousness. What the sources actually document for Shi Xuan is the clinical setting and the technique, not a channel mechanism — and that is how it is set out here.

Source: Sacred Lotus sources & references (existing action and indication record, corrected as described; ST-36, ST-25, LIV-03 and DU-26 records); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 577); Chinese Acupuncture & Moxibustion (p. 249); PubMed PMID 32394666, 35712943; cross-referenced against multiple online sources.

What is Shi Xuan used for?

Shi Xuan is a first-aid point set, and its recorded indications are dominated by emergencies — loss of consciousness, wind-stroke, heat stroke, and high fever with convulsions. The indications carried in Sacred Lotus sources & references are set out below. Loss of consciousness, stroke and heat stroke are medical emergencies requiring immediate emergency medical care; these are recorded here as the traditional literature records them, not as a course of action.

• Loss of consciousness and sudden collapse
• Wind-stroke — the classical term covering apoplexy and stroke presentations
• Summer-heat stroke
• Febrile disease with very high fever
• Acute childhood fright wind — convulsions in a young child with fever
• Clonic spasm and convulsion
• Epilepsy, as a supporting measure
• Mania and acute agitated mental states
• Severe swelling and pain of the throat, including "throat moth"
• Vomiting and diarrhoea, in the classical acute (sudden turmoil) presentations
• Numbness or pain of the fingers
• Finger spasm after stroke

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 577); Chinese Acupuncture & Moxibustion (p. 249); cross-referenced against multiple online sources.

How is Shi Xuan used in practice?

Shi Xuan is not one point but ten — one at the tip of each finger, a fraction of a cun beyond the free edge of the nail, at the very centre of the fingertip. The ten are defined and used together as a single set, which is unusual: almost no other entry in the point literature is a group in this way. Its documented role is also not the ordinary clinic role of a point. It belongs to the emergency literature, and the technique recorded with it is pricking to bleed rather than retained needling.

Which points is Shi Xuan combined with?

• With DU-26 Shui Gou — the classical partner. DU-26, in the philtrum above the upper lip, is the channel point recorded for restoring consciousness; Shi Xuan is the extra-point set named alongside it. Between them they make up the core of the traditional first-aid repertoire.
• With the twelve jing-well points — LU-11 Shao Shang, P-09 Zhong Chong and the rest, which sit at the nail corners a few millimetres away and are recorded for closely similar purposes. A review of their relationship concluded that jing-well points are generally the choice for internal disease, local disease and disease along a channel's course and can stand alone, while Shi Xuan is the first option in acute tense syndrome and syncope (PMID 32394666).
• With Qi Duan (EX-LE 12) — the corresponding set at the ten toe tips, which the same review notes is also called "foot Shi Xuan" and treats as the same category of point.
• With Ba Xie — the eight points at the web margins between the fingers, held in Sacred Lotus sources & references, used with Shi Xuan where the hand and fingers themselves are the problem rather than the whole person.
• With LI-11 Qu Chi and DU-14 Da Zhui — the standard heat-clearing channel points, where high fever is the presentation.

How does Shi Xuan differ from Si Feng?

The two are easily confused, because both are extra-point sets on the fingers. Si Feng ("Four Seams"), held in Sacred Lotus sources & references, sits on the palm side at the middle joint creases of the index, middle, ring and little fingers — four points, not ten — and its business is entirely paediatric digestion: childhood malnutrition, food accumulation and whooping cough. Shi Xuan sits at the tips of all ten fingers, and its business is emergencies. The same region of the body, different points, different purpose.

Source: Sacred Lotus sources & references (location, existing use record, and the Si Feng, Ba Xie, DU-26, LU-11, P-09, LI-11 and DU-14 records); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 577); Chinese Acupuncture & Moxibustion (p. 249); PubMed PMID 32394666; cross-referenced against multiple online sources.

Where is Shi Xuan located?

• A Manual of Acupuncture (p. 577): On the tips of the ten fingers, approximately 0.1 cun from the fingernail.

How is Shi Xuan needled in the textbooks?

Reference record only — this sets down what the standard texts document, not instruction for a reader, and nothing here is something to attempt. Sacred Lotus sources & references record the defining technique at Shi Xuan as pricking to bleed: each fingertip is cleansed and punctured superficially with a fine lancet or three-edged needle so that a few drops of blood are expressed, and our record notes that this may be followed by moxibustion. Shallow perpendicular insertion of about 0.1 cun is also recorded where needling rather than bleeding is described.

• Technique documented: pricking to bleed, a few drops per fingertip, across all ten points.
• Depth documented: superficial — approximately 0.1 cun, where insertion rather than bloodletting is recorded.
• Moxibustion: recorded in our own reference as a possible follow-on. A randomised controlled trial of 80 patients used wheat-grain moxibustion at Shi Xuan, eight to ten cones per point, as an addition to rehabilitation for finger spasm after stroke (PMID 35712943).
• Instruments: this is an invasive bloodletting procedure, and the literature describes sterile single-use instruments and standard clean-needle practice throughout.

What is the safety position on Shi Xuan?

The single most important thing to understand about this point set is the setting in which it is described. Loss of consciousness, stroke, cardiac arrest and heat stroke are medical emergencies. Anyone facing them needs emergency medical services immediately. The classical record of pricking the fingertips is documented here as a historical and reference fact about what the texts describe — it is neither a substitute for emergency care nor a reason to delay it. Where the technique appears in modern practice at all, it appears as an adjunct applied by a trained practitioner within a wider emergency response, never as a stand-alone measure and never as something for a bystander to attempt.

Beyond that, the anatomical hazard at Shi Xuan is small and local. The fingertips are among the most densely innervated sites on the body, so the procedure is sharply painful; the points are superficial, with no cavity, organ or major vessel beneath them. Bleeding technique anywhere carries the ordinary considerations of an invasive procedure — bloodborne infection where instruments are reused, local infection, and unwanted bleeding in a person with a clotting disorder or taking anticoagulant medication — and the reference literature treats those as the limiting factors. Acupuncture and bloodletting are carried out only by qualified, licensed practitioners; this record documents the literature and is not a technique guide.

Source: Sacred Lotus sources & references (existing needling and notes record); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 577); Chinese Acupuncture & Moxibustion (p. 249); PubMed PMID 35712943; cross-referenced against multiple online sources.

What does the name Shi Xuan mean?

Shi Xuan is usually rendered "Ten Diffusions", and also "Ten Declarations" or "Ten Tips". Shi is simply ten — one point for each finger. Xuan carries the sense of announcing, proclaiming or letting something out, and the reading is deliberate: at the very ends of the fingers, where the channels turn, something pent up is let out and diffused. Given that the point set's documented business is releasing a few drops of blood in collapse and high fever, "Ten Diffusions" states the technique and the intention in a single word. "Ten Tips" is the plain descriptive alternative, and simply says where they are.

Is Shi Xuan a channel point?

No. Shi Xuan is an extra point set — in the modern extra-point numbering, EX-UE 11. Extra points sit outside the fourteen channels: they were recorded for an observed clinical effect rather than derived from channel theory, so they carry no five-shu, yuan, luo, xi-cleft, back-shu or front-mu classification. That is why our record shows no channel and no point categories, and why the actions above are framed as documented uses. Any description of Shi Xuan "regulating" a named organ or "extinguishing" internal wind should be treated with caution; no channel runs through it, and our own record has been corrected accordingly.

How does Shi Xuan relate to the jing-well points?

This is the most interesting question about the point, and it has been examined directly in the literature. The twelve jing-well points — the first or last point of each of the twelve regular channels — sit at the nail corners of the fingers and toes, millimetres from Shi Xuan, and are used for strikingly similar emergency purposes, which is exactly why the two groups are so often confused. A review tracing the origin of both back to the Huangdi Neijing concluded that they are related but distinct: the jing-well points mark where the twelve regular channels begin or end, while Shi Xuan is described as lying at the crossing sites where paired yin and yang channels meet. The review's practical summary is that jing-well points are generally selected for internal disease, local disease and disease along a channel's course and can be used on their own, whereas Shi Xuan is the first choice — alone, or with Qi Duan (EX-LE 12) at the toes — in the emergency treatment of tense syndrome and syncope (Zhongguo Zhen Jiu 2020;40(5):553–556, PMID 32394666). In the review's own phrase, the two groups share the same source and supplement one another.

Is there research on Shi Xuan?

Point-specific research on Shi Xuan is very limited, and none of it concerns the emergency use for which the point set is famous — which is unsurprising, since collapse and heat stroke are not conditions in which fingertip bloodletting could ethically be trialled against emergency care. What exists that is genuinely about these points is the following.

• One randomised trial, on a non-emergency use. Eighty patients with finger spasm after stroke were randomised to rehabilitation training alone or to the same training plus wheat-grain moxibustion at Shi Xuan, eight to ten cones per point daily across four courses. The group receiving moxibustion showed greater gains in Fugl-Meyer motor and modified Barthel index scores, with lower surface-electromyography amplitudes in the wrist muscles (Zhongguo Zhen Jiu 2022;42(6):613–617, PMID 35712943). An unblinded 80-patient add-on trial is suggestive rather than conclusive — and it tested moxibustion, not the bloodletting the point set is known for.
• One retrospective clinical series. Seventy patients with haematological malignancy and chemotherapy-induced peripheral neuritis were compared retrospectively, one group receiving nutritional care alone and the other that care plus Shi Xuan and Qi Duan bloodletting with Master Tung's Five-tiger Point scraping (Am J Transl Res 2023;15(8):5304–5313, PMID 37692923, PMC10492046). A retrospective, non-randomised comparison of a combined intervention cannot isolate what Shi Xuan contributed.
• One animal model of heat stroke. Rats subjected to experimental heat stroke received gua sha along the governor and bladder channels, bloodletting at Shi Xuan (EX-UE 11) and BL-40 Wei Zhong, both, or neither. The combined treatment markedly extended survival time and attenuated markers of systemic inflammation, coagulation activation and tissue injury (Chin J Integr Med 2016;21(8):610–617, PMID 25098257). This is the closest the literature comes to testing the traditional heat-stroke indication, and it is a rat study of a combined therapy — it does not transfer to human practice.

No trial has tested fingertip bloodletting alone in a human emergency, and none is cited here as though it had.

Source: Sacred Lotus sources & references; Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 577); Chinese Acupuncture & Moxibustion (p. 249); PubMed PMID 32394666, 35712943, 37692923 (PMC10492046), 25098257 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.