SI-15 (Jian Zhong Shu) Central Shoulder Shu

What does SI-15 Jian Zhong Shu do?

SI-15 descends Lung qi, and it activates the channel and alleviates pain — and it is the only point on the Small Intestine channel’s upper back stretch whose recorded action names an organ.

• Descends Lung qi — the respiratory action, and the reason for the cough and asthma indications
• Activates the channel and alleviates pain — the local action

A Lung action on a Small Intestine point is worth pausing on, and the explanation is position rather than channel theory. SI-15 sits 2 cun lateral to C7, at the very top of the back where the lung apex rises into the root of the neck. Points in that band carry respiratory indications regardless of which channel they belong to — our BL-13 Fei Shu, BL-12 Feng Men and BL-42 Po Hu records all sit a few levels below on the Bladder channel and do the same. The back’s segmental logic overrides channel membership here.

Its neighbour and its name. SI-14 Jian Wai Shu — Outer Shoulder Shu — sits one level below at T1 and 3 cun lateral. SI-15 is Jian Zhong Shu, Central Shoulder Shu: zhong, central, marks it as the more medial of the pair at 2 cun, and wai, outer, marks SI-14 at 3 cun. The two names describe their relationship to each other, which is unusual and genuinely helpful.

A naming caution. Both end in -shu, and neither is a Back-Shu point. Those all sit on the inner Bladder line at 1.5 cun; our BL-26 record sets out the same trap on that channel, where seven of nineteen -shu names are not organ Back-Shu points, and our DU-02 record documents it on the Governing Vessel.

Source: Sacred Lotus sources & references (channel, action, location and translation records; the SI-14, BL-12, BL-13, BL-26, BL-42 and DU-02 records queried against our own data), cross-referenced against multiple online sources.

What is SI-15 Jian Zhong Shu used for?

SI-15 is used for cough, asthma, coughing of blood, and pain in the shoulder and back. Our own indication record is reproduced here in full.

• Cough
• Asthma
• Haemoptysis (coughing of blood)
• Pain in the shoulder and back

Three of the four are respiratory, and only one is local — unusual for a point whose name is about the shoulder. It matches the recorded action exactly: the Lung action comes first in our record and dominates the indication list. Compare its neighbour SI-14, one level below, whose indications are entirely musculoskeletal with no respiratory entry at all. Two points a level apart, and the split between them is clean.

An honest note, and the third entry is the urgent one. COUGHING BLOOD REQUIRES PROMPT MEDICAL ASSESSMENT, ALWAYS. It is a sign of lung, airway or cardiac disease, and some causes are serious and treatable when found early. There is no circumstance in which it should be managed by a classical indication rather than investigated. Asthma is a condition that can be fatal and requires medical diagnosis and prescribed management; worsening breathlessness or an attack not responding to reliever medication is a medical emergency. A cough lasting more than three weeks, or with weight loss or fever, requires assessment. This record documents classical use only.

How it is combined. With DU-14 Da Zhui at the same level on the midline. With SI-14 Jian Wai Shu below and laterally, and BL-11 Da Zhu at T1 on the inner line. With BL-13 Fei Shu, the Lung’s Back-Shu point, and LU-07 Lie Que distally for the respiratory indications. With GB-21 Jian Jing laterally on the shoulder. All held here.

Source: Sacred Lotus sources & references (indication and action records; the SI-14, BL-11, BL-13, DU-14, GB-21 and LU-07 records queried and compared from our own data), cross-referenced against multiple online sources.

Where is SI-15 Jian Zhong Shu located?

SI-15 is on the upper back, two cun out from the midline, level with the lower edge of the seventh cervical spinous process — the same level as DU-14 Da Zhui.

• 2 cun lateral to the midline, level with C7
• Level with DU-14 Da Zhui on the midline
• SI-14 Jian Wai Shu lies one level below at T1, and further out at 3 cun

A 2-cun line, which is rare on the back. Almost every point on the upper back sits on the 1.5-cun inner Bladder line or the 3-cun outer line, and this library has flagged the exceptions where they occur — BL-35 at 0.5 cun, BL-09 and BL-10 at 1.3 cun. SI-15 at 2 cun is another. A reader who assumes the familiar lines apply to every back point will place it wrongly, and the distance is small enough that the error is easy to make and hard to notice.

C7 is where the whole back is counted from, and our DU-13 and BL-11 records set out the complication: C7 and T1 can both be prominent, and in some people T1 is the more prominent, so the starting vertebra is not always self-evident. SI-15 is at the very top of that chain, which makes it as exposed to a starting error as any point on the body.

On the name. “Jian Zhong Shu” — Central Shoulder Shu. Jian is the shoulder, shared with SI-14 Jian Wai Shu and GB-21 Jian Jing; zhong, central, distinguishes it from its outer neighbour. As noted above, the -shu ending is not a Back-Shu designation.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; the BL-09, BL-10, BL-11, BL-35, DU-13, DU-14, GB-21 and SI-14 records queried from our own data).

• A Manual of Acupuncture (p. 244): 2 cun lateral to the lower border of the spinous process of C7 (Dazhui DU-14).
• Chinese Acupuncture and Moxibustion (p. 172): 2 cun lateral to the lower border of the spinous process of the 7th cervical vertebra Dazhui (DU-14).

How is SI-15 Jian Zhong Shu needled, and what is the pneumothorax risk?

Stated plainly: SI-15 lies over the top of the thorax with the lung apex beneath, pneumothorax is the documented hazard of this band — and of the 23 points measured in the study covering this region, SI-15 HAS THE THICKEST MARGIN OF ALL. What follows is a neutral record of what the reference literature and the published measurements document. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: oblique, 0.3–0.6 inch. The obliquity is the safety feature, not a stylistic detail.
• Moxibustion: recorded as applicable. It carries no pneumothorax hazard.
• Regional anatomy: the thick upper fibres of trapezius overlie levator scapulae and the rhomboids; the first rib and the apex of the lung lie deep, with the pleural dome rising above the level of the first rib into the root of the neck.

The measurement, attributed precisely. A study measuring safe needling depth at 23 back and shoulder points on paediatric chest CT gives SI-15 as 38.75 mm in boys and 34.74 mm in girls on average. For off-midline points such as this one the measure is skin to the pleura; the Governing Vessel points in the same study are measured skin to the epidural layer, a different definition entirely. These are paediatric figures and are not adult values (Wang J et al., PMID 26922245, PMC4769822).

Comparing all 23 figures, SI-15 is the thickest margin in the table — in both sexes — and the range is worth seeing whole. From SI-15’s 38.75 mm in boys down to BL-46’s 18.16 mm, the thinnest, is more than a twofold difference across points in the same study, on the same backs. Our BL-45 and BL-46 records hold the thin end; SI-15 and its neighbour SI-14 (36.82 mm) hold the thick end. The bulk of trapezius over the shoulder girdle is what separates them from the outer-line points down over the lower ribs.

What that does and does not license. A thicker margin is not permission for a deeper needle — our record’s bound is 0.3–0.6 inch regardless, and the figure explains why that bound is comfortable rather than tight. The pleural dome is still directly beneath. Our BL-11 record cites an adult cadaveric study finding the dome extended beyond the medial third of the clavicle in almost 60 per cent of 46 bodies — that variation applies to this region too, and no adult figure for SI-15 could be located.

Source: Sacred Lotus sources & references (needling record, retained unchanged); PMID 26922245 / PMC4769822 (paediatric chest CT; SI-15 among the 23 measured points, skin-to-pleura, all 23 figures compared and SI-15 confirmed the highest in both sexes); PMID 16739850 via our BL-11 record for the adult pleural-dome variation; regional anatomy from standard anatomical description.

Is there research on SI-15, and what should a reader know?

No trial isolates SI-15. Where the point appears it is one component of a neck, shoulder or respiratory protocol, and a study that includes a point in a protocol is not evidence about that point.

The research that names SI-15 is anatomical, and it defines one end of a scale. The paediatric CT study measures this point by name and, compared across all 23 points it covers, gives it the thickest margin above the pleura of any of them — the mirror image of BL-46, which holds the thinnest. Having both ends of that range documented, from the same study and the same subjects, is more useful than either figure alone: it shows that “a point on the upper back” is not a single anatomical situation.

What this page can state with confidence. SI-15 sits 2 cun from the midline at C7 — an uncommon lateral distance that a reader used to the 1.5-cun and 3-cun lines can easily mistake. Three of its four recorded indications are respiratory, matching its recorded Lung action, where its neighbour SI-14 one level below is entirely musculoskeletal. And its measured margin is the largest in the table, at more than double the thinnest.

A note on searching for it. “SI 15”, “SI-15” and “Jianzhongshu” searches return protocol trials and unrelated material, and there is a specific trap: “SI” also abbreviates the International System of Units and is a common word fragment, so the code alone is a poor search term. Note too that Jian Zhong Shu and Jian Wai Shu differ by one syllable and name adjacent points. Any claim attached to this point should be checked against what a study actually used, and to which layer it measured.

Source: Sacred Lotus sources & references (action, indication and location records; the SI-14, BL-45 and BL-46 records compared against our own data); PMID 26922245 for the measured depths and the 23-point comparison.