SJ-23 (Si Zhu Kong) Silk Bamboo Hole

What does SJ-23 Si Zhu Kong do?

Si Zhu Kong SJ-23 is the last point of the San Jiao channel of Hand Shao Yang, sitting in the small hollow at the outer end of the eyebrow, and its recorded work is to eliminate wind and alleviate pain, and to benefit the eyes. Sacred Lotus sources & references record those two actions directly. It carries no five-shu, yuan, luo, xi-cleft, back-shu or front-mu classification — it is a plain channel point, and what gives it its clinical weight is position rather than category: it is where the San Jiao channel finishes, at the outer corner of the brow, in the territory the tradition assigns to one-sided headache and to the eye.

• Eliminates wind and alleviates pain — the first recorded action, and the busiest. "Wind" in this literature covers the sudden, moving and one-sided: the temple headache that shifts, the eyelid that twitches, the face that will not move on one side. SJ-23 is the local point of the outer brow for all three.
• Benefits the eyes — the second recorded action, and the reason SJ-23 appears in almost every modern eye protocol. It is one of the ring of points surrounding the orbit, holding the outer-upper corner of that ring.
• Clears heat from the head and eyes — an extension of the two actions above rather than a separate claim, and the recorded basis for its use in redness and pain of the eye and in one-sided headache attributed to yang rising.
• Activates the local channel and benefits the face — the action behind its recorded use in facial paralysis and in the twitching of the eyelid and eyebrow. The San Jiao channel's described course arrives here after passing around the ear, which is also why the point appears in prescriptions that reach toward the temple and the ear rather than only the eye.

The point's position at the end of a channel is worth a sentence, because it is not incidental. The San Jiao channel begins at the ring finger, runs up the back of the arm, over the shoulder, around the ear, and terminates here at the outer end of the eyebrow. That whole course is why a channel most associated with the arm and the ear delivers a point of the eyebrow — and why SJ-23 is chosen in company with the channel's distal points when a treatment intends the channel rather than only the local complaint.

Source: Sacred Lotus sources & references (channel and existing action record; absence of any point category confirmed by direct query); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 412); Chinese Acupuncture & Moxibustion (p. 208); cross-referenced against multiple online sources.

What is SJ-23 Si Zhu Kong used for?

Si Zhu Kong SJ-23 is used above all for one-sided headache at the temple and outer brow, and for the eye — redness, pain, blurred vision and twitching of the eyelid. The indications carried in Sacred Lotus sources & references are headache, redness and pain of the eye, blurring of vision, twitching of the eyelid, toothache and facial paralysis; the standard reference literature sets them out more fully below. They describe traditional use, not proven treatment, and this point carries the periorbital reference facts set out under needling.

• One-sided headache and migraine at the temple
• Frontal and supraorbital headache
• Pain in the outer corner of the eye and in the eyebrow
• Redness, swelling and pain of the eye
• Blurred or failing vision
• Twitching of the eyelid and eyebrow
• Drooping eyelid
• Excessive tearing and eyes that water in the wind
• Dry, tired or aching eyes
• Facial paralysis and deviation of the mouth and eye
• Toothache, particularly of the upper teeth
• Dizziness
• Epilepsy and mania recorded in the classical texts

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 412); Chinese Acupuncture & Moxibustion (p. 208).

Where is SJ-23 Si Zhu Kong, and how is it used in practice?

Si Zhu Kong lies in the small depression at the outer end of the eyebrow — the hollow you can feel by running a finger along the brow from the nose outward until the bone dips just before the temple. Sacred Lotus sources & references give it as the depression at the lateral end of the eyebrow; Deadman & Al-Khafaji place the same hollow on the supraorbital margin at that lateral end. It is on the bony rim, outside the orbit, not inside it — a distinction that governs everything under needling below.

In practice SJ-23 is used in two ways. It is a local point of the brow, threaded along the eyebrow toward its neighbours, and in that role it is one of the most-used points on the face: it appears in almost every modern eye protocol and in a great many headache prescriptions. It is also the terminal point of the San Jiao channel, so it is chosen when a treatment intends that channel — added to Wai Guan SJ-05 or Zhong Zhu SJ-03 at the arm where a Shao Yang pattern is being treated from both ends. Sacred Lotus sources & references record subcutaneous needling here and record no moxibustion, which is discussed under needling.

Which points is SJ-23 combined with?

• With Zan Zhu BL-02 — the point at the inner end of the same eyebrow. BL-02 and SJ-23 are the two ends of the brow, and threading a needle from one toward the other along the eyebrow is the classic local technique of this region. The pair appears together in the modern dry-eye trial literature: a randomised trial in 156 patients (312 eyes) added penetrating needling at Zan Zhu BL-02, Si Zhu Kong SJ-23, Si Bai ST-02 and Jing Ming BL-01 to sodium hyaluronate eye drops for four weeks and reported better symptom scores, tear break-up time, Schirmer test, tear meniscus height and lower tear interleukin-6 and tumour necrosis factor alpha than drops alone (Zhongguo Zhen Jiu 2025;45(5):633–637, PMID 40369920). Our BL-01 record cites the same trial from its own side.
• With Yu Yao — the extra point in the middle of the eyebrow, between BL-02 and SJ-23. Our Yu Yao record notes the oddity that the middle of the brow belongs to no channel while both its ends do; SJ-23 is the outer end of that trio.
• With Tai Yang — the extra point at the temple, a short distance laterally. SJ-23 threaded toward Tai Yang is a standard arrangement for one-sided headache and for visual fatigue, and it was used in exactly that form — "Sizhukong TE-23 to Taiyang EX-HN5" — in a randomised study of a triple-needling method for presbyopia with visual fatigue (Zhongguo Zhen Jiu 2022;42(6):625–628, PMID 35712945).
• With Tong Zi Liao GB-01 — half a cun lateral to the outer corner of the eye, just below SJ-23 on the orbital rim. The two are the outer-corner pair, and both appear in the dry-eye and eye-fatigue protocols.
• With Shuai Gu GB-08 and Feng Chi GB-20 — the temporal and occipital points, added for one-sided headache. A randomised trial in 76 patients with migraine used a shallow-puncture, more-twirling technique at Sizhukong SJ-23, Tou Lin Qi GB-15, Shuai Gu GB-08, Xuan Lu GB-05, Feng Chi GB-20, Wai Guan SJ-05 and Zu Lin Qi GB-41, reporting greater reduction in pain scores and higher serum 5-HT and beta-endorphin than flunarizine (Technol Health Care 2023;31(S1):533–540, PMID 37038799, PMC10200134). SJ-23 is listed first in that prescription — but it is one of seven points, and the result belongs to the prescription.
• With Wai Guan SJ-05 and Zhong Zhu SJ-03 — the distal points of its own channel at the wrist and hand, used with SJ-23 as a local-and-distal arrangement along the San Jiao.
• With Yang Bai GB-14 and Si Bai ST-02 — the points above and below the eye, added in facial paralysis and where the whole orbit is being surrounded.

Where does SJ-23 sit among the points around the eye?

Sacred Lotus sources & references hold a full set of points around the orbit, and knowing which does what is the most practically useful thing about the region. BL-01 Jing Ming at the inner corner and the extra point Qiu Hou at the lower rim are the deep points needled inside the orbital rim, reserved for serious disorders of vision, and they are in a stricter safety class than everything else here. BL-02 Zan Zhu, Yu Yao and SJ-23 Si Zhu Kong form the brow line — inner, middle and outer. GB-14 Yang Bai sits a cun above the brow on the forehead; ST-02 Si Bai and ST-01 Cheng Qi lie below the eye; GB-01 Tong Zi Liao is at the outer corner just below SJ-23; and Tai Yang is at the temple, outside the orbit altogether. SJ-23 is the outer-upper corner of that ring, and it is the one weighted most clearly toward one-sided complaints — headache at the temple, twitching of one eyebrow — because of the channel it terminates.

Source: Sacred Lotus sources & references (both location records, channel, and the BL-01, BL-02, Yu Yao, Qiu Hou, GB-01, GB-14, ST-01, ST-02, Tai Yang, SJ-03 and SJ-05 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 412); Chinese Acupuncture & Moxibustion (p. 208); PMID 40369920; PMID 35712945; PMID 37038799 (PMC10200134); cross-referenced against multiple online sources.

Where is SJ-23 located?

• A Manual of Acupuncture (p. 412): In the depression on the supraorbital margin, at the lateral end of the eyebrow.
• Chinese Acupuncture and Moxibustion (p. 208): In the depression at the lateral end of the eyebrow.

How is SJ-23 Si Zhu Kong needled, and how hazardous is it?

Stated plainly, and stated first because the region invites over-warning: SJ-23 is a periorbital point, not an intra-orbital one. It lies on the bony rim at the outer end of the eyebrow, the recorded technique is shallow subcutaneous insertion of 0.3 to 0.5 inch under the skin, and the frontal bone is directly behind it. It is not in the same safety class as Jing Ming BL-01 or the extra point Qiu Hou, which are needled inside the orbit against its wall. The events actually documented at points of SJ-23's kind are bruising and periorbital haematoma — a bruise at the brow spreads visibly into the eyelid — and those are cosmetic and self-limiting rather than dangerous. Everything below is recorded as neutral reference data describing what the textbooks and the published case literature state. It is not instruction, and this page does not teach technique. Needling anywhere near the eye is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record subcutaneous insertion of 0.3 to 0.5 inch — that is, the needle laid flat under the skin along the brow, not driven in at right angles. The transverse angle is the substance of the record, not a stylistic detail: it keeps the needle in the skin of the eyebrow with bone beneath, travelling away from the orbit rather than toward it.
• Deadman & Al-Khafaji (p. 412) and Chinese Acupuncture & Moxibustion (p. 208) record comparable transverse insertion along the eyebrow, directed either laterally toward Tai Yang or medially along the brow toward Yu Yao and Zan Zhu BL-02 — the threading technique described under practice above.
• Our own record carries no moxibustion at this point. That is worth stating as a fact about the record rather than passing over: three of the San Jiao channel's other head points — Jiao Sun SJ-20, Er Men SJ-21 and He Liao SJ-22 — all carry "moxibustion is applicable" in Sacred Lotus sources & references, and SJ-23 does not. The reference literature records a long-standing classical prohibition on moxibustion at Si Zhu Kong, and the silence in our own record is consistent with it. What is documented here is needling, transversely and shallowly.
• Where the ordinary depth figures sit. The 0.3–0.5 inch recorded at SJ-23 is the same figure our records carry for BL-02 Zan Zhu and GB-01 Tong Zi Liao — the other periorbital points needled subcutaneously outside the rim — and is markedly shallower than the perpendicular depths recorded at limb points. Depth figures in this literature track the structure underneath.

Which safety class this point belongs to

• The distinction that matters in this region. Our Yu Yao and Qiu Hou records place BL-01 Jing Ming and Qiu Hou in a stricter safety class than the periorbital brow and cheek points — BL-02, Yu Yao, SJ-23, GB-14 and ST-02 — precisely because those two are needled inside the orbital rim, against the bone, with the eye and its muscles in the same small space, and carry an explicit prohibition on lifting, thrusting and rotating the needle. SJ-23 is needled transversely under the skin outside the rim. Our BL-01 record calls this "the most useful single thing to carry away about this region", and it applies here in the reader's favour: the deep-orbit hazard is not SJ-23's hazard, and it is not imported onto this page.
• What is actually beneath. Skin, the fibres of orbicularis oculi at the outer brow, and then the frontal bone at the lateral part of the supraorbital margin, with the zygomatic process of the frontal bone laterally. The zygomaticotemporal nerve and small branches of the superficial temporal vessels run in this area, which is why bruising is common and why a small radiating sensation toward the temple is sometimes reported. There is bone behind a transversely laid needle throughout.
• Why bruising is the characteristic event. The eyelid skin is the thinnest on the body and its tissue planes are loose, so blood released at the brow tracks downward into the lid under gravity. A bruise from a brow point therefore looks far worse than the bleed that caused it. Firm pressure with a sterile swab after withdrawal is the ordinary precaution the references record, and it is a bigger factor in someone taking an anticoagulant or antiplatelet medicine.
• No imaging study measuring a safe needling depth at SJ-23 could be located, and none is quoted. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second, by MRI, CT, ultrasound and cadaveric dissection — concluded in any case that measured depths for the same point differ greatly between subject groups and 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 the periocular case literature documents — and what it attributes to which point

• The systematic review, and the finding it actually reports. The only published review of severe adverse events from periocular acupuncture collected 14 case reports covering 15 eyes in 14 patients, published between 1982 and 2020. Events included globe perforation, vitreous haemorrhage, retinal detachment, endophthalmitis, cataract and optic nerve injury; vitrectomy was performed in six of ten perforated eyes; at least three of the procedures were carried out in unlicensed premises. The review concluded that "no specific periocular area was identified as more prone to eyeball injury", and of twelve eyes with penetrating injury only three reported the acupuncture site at all — those three being Cheng Qi ST-01, Yu Yao and Tong Zi Liao GB-01 (Lee SM et al., Korean J Ophthalmol 2023;37(3):255–265, PMID 37068839, PMC10270772). Si Zhu Kong SJ-23 was not among the named sites, and no injury is attributed to it here. Our BL-01 record makes the identical statement about BL-01, and the two pages are consistent.
• Orbital haemorrhage and bruising are documented for the region. A 2025 ophthalmology case report describes bilateral orbital haemorrhages following periocular acupuncture (Davidson AE et al., Orbit 2025;44(5):633–637, PMID 40116367). Two women aged 61 and 86 presented with painless bruising around the eye three and ten days after acupuncture for dry eye; one was taking daily low-dose aspirin, and for her it was the second such episode in twenty sessions. Neither had globe perforation and both resolved over some weeks without visual consequence (Tsai JHJ et al., J Surg Case Rep 2025;2025(1):rjae783, PMID 39895879, PMC11784745). Neither report names SJ-23; both are cited for the region and for the point about blood-thinning medication.
• Honest limit. We could not source any published case report of injury at SJ-23, and none is asserted. Where a point is comparatively low-hazard, the useful thing is to say so plainly and to keep the attribution exact rather than to borrow a warning from a point in a different class.

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, 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). Systematic reviews of the Chinese case literature place the orbit among the regions where serious events concentrate and attribute them chiefly to improper technique (PMID 22967282; PMID 21124716, PMC2995190). The accurate summary for SJ-23 is that it sits at the edge of a region that deserves respect, on the safe side of the line that divides it — and that the event a reader will actually encounter here is a bruise.

Source: Sacred Lotus sources & references (existing needling record; the SJ-20, SJ-21 and SJ-22 moxibustion records and the Yu Yao, Qiu Hou and BL-01 orbital-class records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 412); Chinese Acupuncture & Moxibustion (p. 208); PMID 37068839 (PMC10270772); PMID 40116367; PMID 39895879 (PMC11784745); PMID 21417806; PMID 23935678; PMID 34489268; PMID 22967282; PMID 21124716 (PMC2995190) — each verified resolvable and checked for retraction status before citation.

What does the name Si Zhu Kong mean?

Si Zhu Kong means "Silk Bamboo Hole" — si, silk or fine thread; zhu, bamboo; and kong, a hole or hollow. Sacred Lotus sources & references translate it exactly that way. The image is of the eyebrow itself: fine hairs lying in a tapering line, which classical Chinese likens to the slender leaves of bamboo, and "silk bamboo" is the poetic name for the brow. The kong is the small depression at the outer end of that brow — the hollow the finger drops into just before the temple. The name is therefore a location instruction in three characters: the hollow at the end of the eyebrow. It is one of the more transparent names in the repertoire once the bamboo image is known, and it is worth knowing because the brow's other point names use the same visual vocabulary — Zan Zhu BL-02 at the inner end means "Gathered Bamboo", and the extra point Yu Yao in the middle means "Fish Spine" or "Fish Waist". Three points along one eyebrow, three pictures of the same shape.

Does SJ-23 carry a point classification?

No — and that is worth stating rather than leaving as an absence. Sacred Lotus sources & references record no five-shu, yuan, luo, xi-cleft, back-shu, front-mu, confluent or meeting-point classification for SJ-23, and no element. It is a plain channel point. What it has instead is a structural position: it is the twenty-third and final point of the San Jiao channel, the place where a channel that began at the ring finger comes to an end at the outer brow. Terminal points of channels tend to be locally weighted and this one is no exception — its indications are overwhelmingly those of the brow, the eye and the temple rather than those of the San Jiao as an organ. The channel's organ-level and regulating work is carried elsewhere: at Yang Chi SJ-04, the Yuan-Source point at the wrist, and at San Jiao Shu BL-22, the organ's Back-Shu point, both held here.

Is there research on SJ-23 Si Zhu Kong?

SJ-23 has no trial of its own, but it is one of the most frequently included points in the modern eye-protocol literature, and it appears in migraine trials as well. The honest summary is that every study naming it tests a prescription of which it is one member.

• Dry eye — the largest body of work. A randomised trial allocated 156 patients (312 eyes) to sodium hyaluronate eye drops alone or to the same drops plus penetrating needling of four eye points — Zan Zhu BL-02, Si Zhu Kong SJ-23, Si Bai ST-02 and Jing Ming BL-01 — for four weeks. The combined group did better on subjective symptom scores, the ocular surface disease index, corneal staining, tear break-up time, Schirmer test and tear meniscus height, and showed lower tear interleukin-6 and tumour necrosis factor alpha (Zhongguo Zhen Jiu 2025;45(5):633–637, PMID 40369920). A second randomised trial in 60 patients (120 eyes) with aqueous-deficiency dry eye compared acupuncture at Shang Jing Ming (extra), Zan Zhu BL-02, Si Zhu Kong SJ-23, Tai Yang and Tong Zi Liao GB-01 against sodium hyaluronate drops alone, and reported greater improvement in tear meniscus height, basic tear secretion and subjective symptom score, with no adverse events in either group (Zhongguo Zhen Jiu 2023;43(11):1235–1238, PMID 37986246). Both are single-centre, unblinded designs testing multi-point protocols.
• Migraine. A randomised trial in 76 patients used a shallow-puncture, more-twirling needling method at seven points beginning with Sizhukong SJ-23 and reported greater reduction in pain scores and higher serum 5-HT and beta-endorphin than oral flunarizine (Technol Health Care 2023;31(S1):533–540, PMID 37038799, PMC10200134). Worth noting the other side of the ledger: in a separate randomised trial of migraine prophylaxis, SJ-23 was part of the control arm — the "conventional acupuncture" comparison of Ashi points, Sizhukong SJ-23, Shuai Gu GB-08 and Tai Yang — against a neck-based method that outperformed it on episode frequency and pain intensity at follow-up (Zhongguo Zhen Jiu 2024;44(6):611–617, PMID 38867620). Both groups improved; the point here is that SJ-23's inclusion in a prescription is not evidence of its individual effect in either direction.
• Eye fatigue and myopia. A randomised study of a triple-needling method for presbyopia with visual fatigue threaded Sizhukong TE-23 toward Taiyang as one of its components (Zhongguo Zhen Jiu 2022;42(6):625–628, PMID 35712945). A randomised trial in 170 pre-myopic children aged 6 to 12 applied transcutaneous electrical stimulation — not needling — at six orbital points including SJ-23, against a sham device (Zhongguo Zhen Jiu 2025;45(2):173–178, PMID 39943758); our Yu Yao and BL-01 records cite the same trial from their own sides. Six points and no needle insertion, so it says nothing about SJ-23 individually.
• An honest absence in facial paralysis. Our own indication record carries facial paralysis for this point. It is worth recording that the review which analysed the treatments used in 33 higher-quality randomised trials of peripheral facial paralysis named the consistently selected points as ST-04, ST-07, ST-06, REN-24, LI-20, SI-18, SJ-17, GB-14, ST-02, GB-20, DU-26, Yu Yao and LI-04 — and did not include SJ-23 (Zheng H et al., Am J Chin Med 2009;37(1):35–43, PMID 19222110). The traditional indication stands as a traditional indication; the modern trial consensus for that condition centres on the mouth, cheek and forehead points rather than on the outer brow.

What is missing should be said plainly: there is no sham-controlled randomised trial of SJ-23 alone for dry eye, headache, eyelid twitching or any other of its uses. Its standing rests on the classical record and on how consistently practitioners include it, not on point-specific evidence.

How does SJ-23 compare with the points around it?

Zan Zhu BL-02 is at the opposite, inner end of the same eyebrow and is the Bladder-channel brow point — reached for in frontal headache and lacrimation, and the point SJ-23 is most often threaded toward. Yu Yao sits between them in the middle of the brow and belongs to no channel at all; it is the extra point of the three and is weighted toward the eyelid. Tong Zi Liao GB-01 lies just below and lateral to SJ-23 at the outer corner of the eye, is a meeting point of the Gall Bladder, Small Intestine and Sanjiao channels, and is its closest neighbour and constant partner. Tai Yang, further laterally at the temple, is outside the orbit altogether and is the one-sided-headache point proper. Yang Bai GB-14 is a cun above the brow on the forehead. BL-01 Jing Ming at the inner corner and Qiu Hou at the lower rim are the deep vision points and are in a different and stricter safety class, as set out above. On its own channel, He Liao SJ-22 is the previous point, in front of the ear at the hairline, and — unlike SJ-23 — our record for it carries an explicit instruction to avoid the artery there. All are held in Sacred Lotus sources & references.

Source: Sacred Lotus sources & references (name, translation, channel, absence of point categories, and the BL-01, BL-02, Yu Yao, Qiu Hou, GB-01, GB-14, ST-01, ST-02, Tai Yang, SJ-04, SJ-20, SJ-21, SJ-22 and BL-22 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 412); Chinese Acupuncture & Moxibustion (p. 208); PMID 40369920; PMID 37986246; PMID 37038799 (PMC10200134); PMID 38867620; PMID 35712945; PMID 39943758; PMID 19222110; PMID 37068839 (PMC10270772) — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.