ST-12 (Que Pen) Empty Basin

What does ST-12 Que Pen do?

Que Pen ST-12 is the point in the hollow above the collarbone where five of the six yang channels converge, and its recorded actions follow the two things that lie beneath it — the lung and the passage of the channels into the chest. Sacred Lotus sources & references record that it descends Lung qi and clears heat from the chest, and that it activates the channel and alleviates pain. Its classification is unusual and it is the key to the point: our records hold ST-12 as a Meeting Point of the Stomach, Large Intestine, Small Intestine, Sanjiao and Gallbladder Channels. Five yang channels pass through this one small fossa on their way from the head and arm into the trunk.

• Descends Lung qi — the primary recorded action. Qi that should fall is rising: this is the basis for the point's use in cough, in wheezing and in breathlessness. The action is a literal one at this location, since the dome of the lung sits immediately below the fossa.
• Clears heat from the chest — for the sense of heat, fullness and oppression above the diaphragm that the tradition reads as heat lodged in the chest.
• Activates the channel and alleviates pain — the local and channel action, for pain in the supraclavicular fossa itself and for pain referred along the shoulder and into the arm.
• Benefits the throat — recorded alongside its neighbours on the neck. ST-12 is the lowest of the Stomach-channel neck points, below Ren Ying ST-09, Shui Tu ST-10 and Qi She ST-11, and it shares their throat range.
• Serves as a crossing of the yang channels — the action its classification implies rather than a separate function. A point where five channels meet is described in the classical literature as able to influence all of them, which is why the point appears in treatments aimed at the shoulder, the arm and the side of the neck as well as at the chest.

One thing should be said plainly about how these actions are used. ST-12 is a little-used point in modern practice despite an impressive classification, and the reason is anatomical rather than theoretical: the structures beneath it are unforgiving, and safer points a short distance away cover most of the same clinical ground. That is set out under needling.

Source: Sacred Lotus sources & references (channel, the five-channel meeting classification, and the existing action record — whose broken list markup is corrected here); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 139; Chinese Acupuncture & Moxibustion, p. 148; cross-referenced against multiple online sources.

What is ST-12 Que Pen used for?

Que Pen ST-12 is used for the chest and the throat, and for pain in the hollow above the collarbone where it sits. The indications carried in Sacred Lotus sources & references are cough, asthma, sore throat and pain in the supraclavicular fossa; the standard reference literature sets the range out as follows. These describe traditional use, not proven treatment, and this point carries the significant safety cautions recorded under needling.

• Cough
• Asthma, wheezing and shortness of breath
• Fullness and oppression of the chest
• Sore and painful throat
• Pain in the supraclavicular fossa
• Pain and rigidity of the neck
• Pain in the shoulder and referred pain into the arm
• Swelling and nodules of the neck, including the presentation the classics call scrofula
• Numbness or weakness of the upper limb

Two of these deserve a note. The supraclavicular pain indication is the one most specific to this point rather than shared with its neighbours — the fossa is a real anatomical space with its own local complaints. And the upper-limb indications reflect the anatomy directly: the nerves of the arm pass through this region on their way out of the neck, which is why a point named for a hollow above the collarbone appears in treatments for the arm at all.

Source: Sacred Lotus sources & references (existing indication record, reformatted here as a list); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 139; Chinese Acupuncture & Moxibustion, p. 148.

Where is ST-12 Que Pen, and how is it used in practice?

Que Pen sits in the middle of the supraclavicular fossa — the soft hollow you can feel just above the collarbone, roughly a hand's breadth out from the midline of the throat, in line with the nipple. It is the fourth and lowest of the Stomach-channel points on the neck, directly below Qi She ST-11 at the inner end of the collarbone, and the point immediately above Qi Hu ST-13, which lies below the collarbone where the chest begins. Our own records place it four cun lateral to the anterior midline, on the mamillary line, behind the upper border of the clavicle at its midpoint.

The name is a description of that hollow, and it is the single most useful thing to know when learning the point: que pen, "empty basin" — the depression above the collarbone read as a broken or incomplete bowl. Find the basin and you have found the point.

Which points is ST-12 combined with?

• For cough and wheezing — with Tian Tu REN-22 in the suprasternal notch and Shan Zhong REN-17 in the centre of the chest, the two midline points for the breath; with Fei Shu BL-13, the Lung Back-Shu point, on the back at the same general level; and with the distal Lung-channel points Chi Ze LU-05 and Lie Que LU-07. All are held in Sacred Lotus sources & references.
• For throat disorders — with Tian Tu REN-22, with its channel neighbours Ren Ying ST-09 and Qi She ST-11, and with the distal pairing He Gu LI-04 and Shao Shang LU-11 that is standard for a blocked and painful throat.
• For neck and shoulder pain — with Jian Jing GB-21 on the top of the shoulder, Tian Ding LI-17 on the side of the neck and Feng Chi GB-20 below the occiput. It is worth noting that GB-21 lies in the same hazardous band above the lung apex and carries the same caution.
• For nodules and swellings of the neck — with Tian Tu REN-22, Tian Ding LI-17, Tian Rong SI-17 and the distal point Tian Jing SJ-10, the classical grouping for dissolving neck nodules.
• Along its own channel — ST-09, ST-10, ST-11 and ST-12 descend the neck in sequence and are treated as a functional group for the throat and the breath. Que Pen is the end of that run and the transition into the chest points.

Why does the five-channel meeting classification matter?

Because it records something anatomical in channel language. Sacred Lotus sources & references classify ST-12 as a Meeting Point of the Stomach, Large Intestine, Small Intestine, Sanjiao and Gallbladder channels — five of the six yang channels of the body. In the channel descriptions of the classical literature, the supraclavicular fossa is the doorway through which the yang channels of the arm and the head pass down into the trunk to reach their organs. Que Pen is the name of that doorway, and several channel pathways in the Ling Shu are described as passing through it. The clinical consequence is that this point is regarded as able to reach any of those five channels — but in practice the reach is used sparingly, for the reason given under needling.

A related observation from the modern literature is worth recording because it makes the classical picture concrete rather than mystical. A Chinese review essay took as its starting point that the supraclavicular fossa — the location of Que Pen — is the site at which cancers of many different primary organs deposit their first palpable secondary node, and argued that the pattern of channels running through this one fossa is what the classical writers were describing when they routed so many pathways through it (Zhongguo Zhen Jiu 2012;32(12):1099–102, PMID 23301480). It is a theoretical essay, not a study, and it is recorded here as an observation about why so much converges at this small hollow, not as a claim about treatment.

Source: Sacred Lotus sources & references (location, the five-channel meeting classification, and the ST-09, ST-10, ST-11, ST-13, REN-17, REN-22, BL-13, GB-20, GB-21, LI-04, LI-17, LU-05, LU-07, LU-11, SI-17 and SJ-10 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 139; Chinese Acupuncture & Moxibustion, p. 148; Ling Shu (Spiritual Pivot), on the yang channel pathways through the supraclavicular fossa; PMID 23301480; cross-referenced against multiple online sources.

Where is ST-12 located?

• A Manual of Acupuncture (p. 139): In the supraclavicular area, posterior to the superior border of the clavicle and at its midpoint, 4 cun lateral to the midline, on the mamillary line.
• Chinese Acupuncture and Moxibustion (p. 148): In the midpoint of the supraclavicular fossa, 4 cun lateral to the anterior midline.

How is ST-12 Que Pen needled, and what is the risk?

Stated plainly: ST-12 is one of the most anatomically hazardous points on the body. It lies in the supraclavicular fossa directly over the apex of the lung, and pneumothorax — a punctured lung — is the documented hazard of needling in this region. The subclavian artery and vein and the nerves of the brachial plexus also pass through this fossa. Our own reference record does something it does for very few points: it states in terms that deep puncture is not advisable. 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 perpendicular insertion of 0.3 to 0.5 inch, with the explicit rider that deep puncture is not advisable, and moxibustion applicable. Three to five tenths of an inch is among the shallowest figures our records carry for any point on the trunk.
• Deadman & Al-Khafaji (p. 139) and Chinese Acupuncture & Moxibustion (p. 148) record shallow insertion at this point and both attach an explicit caution naming the lung beneath. The recorded emphasis in the reference literature is on depth rather than on angle: the fossa has no bony floor, and there is nothing to stop a needle that travels too far.
• Moxibustion is recorded as applicable, and it is worth noting that moxa at this point involves no depth at all.
• For comparison within our own records: the 0.3–0.5 inch at ST-12 is the same bounded figure our records give for Qi She ST-11 immediately above it and for Jian Jing GB-21 over the lung apex on the shoulder, and it is shallower than the 0.5–0.7 inch recorded for Fei Shu BL-13 on the back. Depth figures in this literature track what lies underneath, not the size of the region.

The measured anatomy — and exactly which point each study measured

This is where precision matters most, because the anatomical literature for this region is real, detailed and easy to misattribute.

• Honest limit, stated first. No imaging or dissection study measuring a needling depth at ST-12 specifically could be located. The points on either side of it have been measured; this one has not. Rather than borrow a figure taken elsewhere and attach it to Que Pen, what is recorded here is the bounded depth the reference texts give, together with the measured anatomy of the immediate region — with every measurement attributed to the point at which it was actually made.
• The cadaveric needle-path study measured ST-11 and REN-22, not ST-12. A clinical anatomy study dissected 92 sides in 46 adult bodies, marking the needle paths with steel needles and dissecting layer by layer. The two points examined were Tian Tu REN-22 and Qi She ST-11. At Qi She the internal jugular vein was pierced on 68 of 92 sides (73.9 per cent), the left common carotid artery on 24 sides (26.1 per cent), and the vagus nerve was contacted on 50 sides (54.3 per cent); the authors concluded that needling at these points can injure the upper pleural cavity, the great vessels of the mediastinum and cervical root, and the vagus nerve (Chen Y et al., Zhongguo Zhen Jiu 2007;27(2):120–2, PMID 17370496). Que Pen ST-12 was not one of the points dissected in that study, and none of those percentages belongs to it. It is cited because ST-11 is Que Pen's immediate neighbour at the inner end of the same collarbone and the study is the clearest published statement of what lies at the root of the neck.
• The pleural-dome dissection did not name ST-12 either. A companion study of 46 adult bodies mapped the dome of the pleura against the commonly used points around it, naming Tian Tu REN-22, Qi She ST-11, Jian Jing GB-21, Ding Chuan EX-B1 and Da Zhu BL-11 explicitly. The dome's projection varied widely between individuals, extending beyond the medial third of the clavicle in almost 60 per cent of bodies. The authors concluded that when a point is located and angled as the standard describes the pleura is not reached, but that exceeding the recorded depth breaches the pleural membrane (Chen Y et al., Zhongguo Zhen Jiu 2006;26(5):346–8, PMID 16739850). ST-12 is not in that list — but the finding is directly relevant to it, because the dome of the pleura extending beyond the medial third of the clavicle in six bodies out of ten is the anatomy of the supraclavicular fossa in which Que Pen sits.
• How thin the margin is in this region, measured at a named point. Ultrasonography in 101 adults measured the vertical distance from the skin to the pleural line at Jian Jing GB-21: 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 figure is GB-21's, not Que Pen's. It is offered as the measured scale of the shoulder-girdle region rather than as a number for this point, and it makes the essential fact concrete: over the lung apex, a centimetre and a half can be the entire margin.
• Children have been measured across the chest, but ST-12 was not among the points. A retrospective CT study measured the distance from skin to pleura at 28 chest acupoints in 319 patients aged 4 to 18, including the whole upper Kidney-channel run and LU-01, LU-02 and ST-13 (Ma YC et al., Evid Based Complement Alternat Med 2015;2015:126028, PMID 26457105, PMC4592721). Que Pen ST-12 is not in that point list.
• 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 — both concluded that measured depths for the same point differ greatly between subject groups and between 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). A textbook depth describes an average body, not a constant.
• What lies beneath, in plain terms. Below the skin and the platysma of the supraclavicular fossa lie the omohyoid muscle, the trunks of the brachial plexus travelling out toward the arm, and the subclavian artery and vein crossing over the first rib. Behind and below all of these is the cupola of the pleura and the apex of the upper lobe of the lung. There is no bone between the needle and the lung.

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 — behind only fainting — with 35 deaths recorded across the whole series; the authors attributed the events chiefly to improper technique and judged most avoidable through standardised training (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 about traumatic complications (Zhang J et al., Bull World Health Organ 2010;88(12):915–921C, PMID 21124716, PMC2995190). An emergency-department series from a tertiary hospital in Seoul over five years recorded 12 mechanical complications of thoraco-abdominal needling — ten pneumothoraces, eight requiring a chest drain — with a mean interval of 1.6 days between the treatment and arrival at the emergency department (Lee HJ et al., Pain Med 2017;18(12):2504–2508, PMID 28431130). Fatal cases exist: an autopsy report describes bilateral pneumothoraces following electroacupuncture, the authors noting that electrical pulses and the muscle contraction they cause may draw needles deeper than the depth at which they were inserted (J Forensic Sci 2022;67(1):377–383, PMID 34435369).

What we will not claim. None of the systematic reviews above identifies the individual points involved in its cases, and no published case report naming Que Pen ST-12 specifically as the point at which a pneumothorax or other injury occurred was located. No such claim is made here. The honest statement is the one the anatomy already makes, and which our own reference record makes for us: the apex of the lung is directly beneath this point, and deep puncture is recorded as not advisable for that reason.

Delayed presentation. The reference literature records that a pneumothorax following needling at the root of the neck may declare itself hours later with sudden chest pain, breathlessness or a persistent dry cough. The Seoul series makes the point better than any warning: the average patient arrived more than a day afterwards. 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, placing it among the safer treatments in medicine (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). Both things are true together: the overall rate is low, and the events that do occur cluster at a small number of points over the lung, of which Que Pen is one.

Pregnancy — what we actually hold

Our own records were queried directly for this, and the answer is precise: Sacred Lotus sources & references carry pregnancy language on 51 point records, and ST-12 is not one of them. No pregnancy contraindication is recorded here for Que Pen, and none is added. Readers meeting ST-12 on circulating lists of points to avoid in pregnancy should know that the modern review literature on the so-called forbidden points does not include it: the historically forbidden group identified in a systematic narrative review of randomised trials is SP-6, LI-4, GB-21, BL-60, BL-67, BL-32 and BL-33 (Med Acupunct 2019;31(6):346–360, PMID 31871522, PMC6918516), and a review of the scientific evidence for those points found no objective evidence of harm across 15 clinical trials (823 women), a cohort of 5,885 pregnant women, and animal work (Carr DJ, Acupunct Med 2015;33(5):413–9, PMID 26362792). What can be said without guessing is this: the caution that governs ST-12 in every source we hold is the lung beneath it, and that caution applies to everyone.

Source: Sacred Lotus sources & references (existing needling record; pregnancy fields across the point records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 139; Chinese Acupuncture & Moxibustion, p. 148; PMID 17370496; PMID 16739850; PMID 29936338; PMID 26457105 (PMC4592721); PMID 21417806; PMID 23935678; PMID 22967282; PMID 21124716 (PMC2995190); PMID 28431130; PMID 34435369; PMID 34489268; PMID 31871522 (PMC6918516); PMID 26362792 — each verified resolvable and checked for retraction status before citation.

What does the name Que Pen mean?

Que Pen means "Empty Basin" or "Broken Bowl" — que, lacking, incomplete or broken, and pen, a basin or shallow bowl. The name is anatomical description rather than metaphor: the hollow above the collarbone, bounded by the clavicle in front and the muscles of the neck behind, read as a bowl with a piece missing. Sacred Lotus sources & references translate it as Empty Basin.

What is unusual about this name is that que pen was a name for the body part before it was the name of a point. A study in the Chinese history-of-medicine literature traced the term through archaeological and documentary sources — including its use for a constellation and, separately, for the pelvis — and argued that in the Huangdi Neijing and related texts the word describes a region of the body, with the acupuncture point taking its name from the region afterwards. The paper uses Que Pen and Tian Shu ST-25 as its two worked examples of the ancient habit of transferring body-part names to point names (Son JR, Zhonghua Yi Shi Za Zhi 2023;53(5):313–317, PMID 37935515). That is a real and useful piece of context: when the classics say a channel "enters the que pen", they are naming a place in the body, and the point sits in that place.

Why is ST-12 a meeting point of five channels?

Because the supraclavicular fossa is where the yang channels of the arm and head turn downward into the trunk. Sacred Lotus sources & references classify ST-12 as a Meeting Point of the Stomach, Large Intestine, Small Intestine, Sanjiao and Gallbladder channels — five of the six yang channels; only the Bladder channel, which runs down the back, does not pass through. In the channel descriptions of the Ling Shu these pathways are repeatedly said to descend through the que pen to reach their organs in the chest and abdomen. The point therefore carries a classification most points never achieve, and it is worth understanding what that classification is describing: not five separate therapeutic powers, but one crowded doorway.

Is there research on ST-12 Que Pen?

The honest answer is that there is no clinical trial of this point, and the small published literature that names it is either theoretical or uses it as a measurement site. That should be said plainly rather than filled in with studies about other things.

• Infrared thermal imaging at Que Pen in asthma. The most directly point-specific finding available. Body-surface temperature was imaged in 60 patients meeting bronchial asthma criteria and 60 healthy controls, at a set of sites the authors treat as "intermediate structures" of the Lung and Large Intestine interior-exterior relationship — the throat, Quepen, the elbow, the nose, Lie Que LU-07 and Pian Li LI-06 — each compared with a control area 0.2 cm to one side. In the healthy group the two sides matched at every site except Quepen, and in the asthma group the left-right difference at Quepen, and the difference between Quepen and its control area, were both statistically significant, as was the difference between the groups (Fu Y et al., Chin J Integr Med 2016;22(11):855–860, PMID 27286712). This is an observational imaging study, not a treatment trial, and it says nothing about whether needling the point helps — but it measured Que Pen itself, and it found a measurable asymmetry there in people with asthma.
• A theoretical essay on the channels through the fossa. The review discussed under practice above, which reasons from the supraclavicular node's role in cancer spread to the classical routing of five channels through Que Pen (Zhongguo Zhen Jiu 2012;32(12):1099–102, PMID 23301480). Argument, not evidence.
• Que Pen as a measurement site in manual therapy. A quantitative study of manipulation for atlantoaxial joint disorder in 18 patients instrumented the practitioner's hands and measured the force applied at Feng Chi GB-20 and at Quepen ST-12, reporting a maximum force at Quepen of 14.44 ± 3.27 N on the affected side against 9.41 ± 1.38 N on the other (Zhongguo Gu Shang 2024;37(6), PMID 38910379). This measures pressure applied during manipulation, not needling, and the point is a landmark in it rather than a treatment.
• Que Pen inside an acupressure protocol. A trial of 400 patients with nerve-root cervical spondylosis compared digital acupoint pressure — at Quepen, Jian Jing and other points — against an oral herbal medicine, reporting better outcomes in the pressure group (Zhongguo Zhen Jiu 2009;29(8):659–62, PMID 19947274). This tests a protocol using pressure rather than needles, and ST-12 is one component of it.

A point-code caution, recorded because it was met while assembling this. The English abstract of that last paper lists the points as "Quepen (ST 12), Jianjing (GB 21) and Tianzong (ST 11)" — but Tianzong is SI-11 on the Small Intestine channel over the shoulder blade, while ST-11 is Qi She on the neck. Two point codes have been transposed in the published abstract. Every record used on this page was read rather than counted, and this is exactly why.

What is missing: no randomised trial isolates ST-12, and none of the cough, asthma, throat or supraclavicular-pain indications recorded for it has been tested at this point specifically. Its clinical standing rests on the classical record, and this site does not claim otherwise.

How does ST-12 compare with the points around it?

Qi She ST-11 lies directly above it at the inner end of the collarbone, between the two heads of the sternocleidomastoid, and is the point the cadaveric needle-path study actually measured; the two share both their throat range and their hazard. Ren Ying ST-09 and Shui Tu ST-10 continue the same channel up the neck, ST-09 being the best known of the four and carrying its own caution at the carotid pulse. Qi Hu ST-13 is the next point down, below the collarbone, where the Stomach channel begins its descent over the chest. Tian Tu REN-22 lies medially in the suprasternal notch and is the other classically high-hazard point of this region. Jian Jing GB-21 sits laterally on the top of the shoulder in the same band above the lung apex, and is the point in this region for which the measured skin-to-pleura depth is published. Yun Men LU-02 and Zhong Fu LU-01 lie below and lateral, in the hollow beneath the outer end of the collarbone, and cover much of the same chest and cough territory from the Lung channel — LU-01 being the Front-Mu point of the Lungs. Shu Fu KI-27 sits below the inner end of the collarbone, two cun from the midline, and is the Kidney channel's contribution to the same clinical ground. All of these are held in Sacred Lotus sources & references.

Source: Sacred Lotus sources & references (name, channel, categories, and the ST-09, ST-10, ST-11, ST-13, REN-22, GB-21, LU-01, LU-02 and KI-27 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 139; Chinese Acupuncture & Moxibustion, p. 148; Huangdi Neijing and Ling Shu on the channel pathways through the supraclavicular fossa; PMID 37935515; PMID 27286712; PMID 23301480; PMID 38910379; PMID 19947274; PMID 17370496 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.