Not over a breast lump, redness or warmth; have a doctor check it.
天溪 Tianxi
“Heavenly Stream” · SP18
Foot Taiyin · 18 of 21
Where. On the side of the chest, in the rib gap level with the nipple, about three finger-widths outside it.
For. Chest and side pain, cough, low milk supply.
Press. Gentle finger pads in the rib gap, one minute each side.
Caution. Not over a breast lump, redness or warmth; have a doctor check it.
天溪，在胸鄉下一寸六分陷者中按 · Press with me
Six slow breaths
About a minute. Press as you breathe out, ease as you breathe in.
鄰 · Neighbouring leaves
Where Tianxi Sits on the Lateral Chest
The dataset places Tianxi on the lateral chest, in the fourth intercostal space, six cun lateral to the anterior midline. Each clause is a small instruction. The intercostal spaces are the soft grooves between the ribs; counting down the chest, the fourth such groove lies roughly level with the nipple in the classical map. Lateral chest means the point sits out where the front wall of the torso curves around toward the side and the armpit — not on the shelf of bone beside the breastbone, and not hidden inside the armpit itself. And the six cun fix the horizontal line: a cun is the traditional measuring unit taken from the proportions of the person being examined rather than from a ruler, so the distance scales with the body. Six cun lands clearly beyond the vertical line that drops through the nipple — which the stomach-channel records place at four cun — leaving Tianxi about two thumb-widths farther out, on the outer curve of the chest.
The ground beneath this address argues for a light hand. Here the great fan of the pectoralis major thins toward its outer border, and beyond it the ribs curve round under coverings far slighter than the sturdy muscle of the front of the chest — soft tissue, then rib, then the space where the lung rides. Only a modest thickness of anything separates a fingertip here from the grooves between ribs. That thinness is precisely why the licensed record carries a professional caution at this site, and why every technique on this page stays strictly on the surface. Nothing about locating Tianxi requires force: the ribs and the grooves between them announce themselves through patient, feather-light touch, and the point rewards counting rather than pressing.
The neighbours turn the spot into a readable ladder. On the same vertical line six cun out from the midline, one groove below Tianxi, in the fifth intercostal space, stands Shidou (SP17); one groove above, in the third space, stands Xiongxiang (SP19); and a further groove up still, in the second, stands Zhourong (SP20). All three share Tianxi’s recorded rule — same line, different grooves — so once the line is found, the family finds itself. Fixing the neighbours confirms the middle one: if the finger rests a groove too low it has drifted onto Shidou’s ground, and if it climbs a groove high it reaches Xiongxiang’s station. Lower on the side of the trunk, off the shared line, the same catalogue records Dabao (SP21) on the midaxillary line in the sixth intercostal space — the twenty-first and final station of the spleen channel, closing its chest chapter.
Finding Tianxi by Touch
Sit or stand comfortably with the shoulders released, so the chest wall softens. Work on one side at a time. Begin by finding the nipple line: imagine a vertical line dropping straight down from the nipple, and recall that the classical map runs this line four cun out from the breastbone. Now find its height. The fourth intercostal space lies approximately at nipple height in most bodies — the very correspondence the stomach-channel records rely upon when they mark the centre of the nipple at the fourth groove. Rest a fingertip in the soft groove at that height, then walk outward along the same groove, past the nipple line, until the chest begins to curve away toward the side: about two thumb-widths beyond the line, in the yielding channel between two ribs, lies Tianxi. The sensation under the pad should be soft give between firmer ridges — never bare bone, and never the deep hollow of the armpit.
Two checks steady the result. First, compare sides: touch feather-light on each side in turn, and most people notice a faint, dull awareness at the true point and little sensation half a thumb-width away. Second, count. From your candidate spot slide one groove down — that is the fifth space, Shidou’s ground — and return upward past your start: the next groove up is the third, Xiongxiang’s station, and one further still the second, Zhourong’s. If the ladder reads smoothly in both directions, the count was true. Counting downward from the collarbone works poorly out here, where the collarbone’s guidance fades into the curve of the shoulder; the nipple-height method is the surer road.
The classic slips are gentle ones. Drifting inward puts you back on the nipple line among the stomach channel’s addresses; drifting outward walks you around the curve toward the armpit, where the ribs give way to soft tissue with no clear grooves to read. Dropping a groove low is the easiest error of all — the fifth space sits directly beneath and feels nearly identical, which is exactly why the neighbour-check matters. When in doubt, start again from nipple height and walk outward slowly one more time.
Reading the Name: Heavenly Stream
Point names in this tradition are often small landscapes, and this one paints water under open sky. Tian 天 means heaven — the sky overhead, the high and the open. Xi 溪 means mountain stream: a small watercourse running between banks, the kind of brook that threads a valley below the peaks. Together, Tianxi reads as the heavenly stream, or the stream beneath heaven. Traditional commentary connects the image to the geography of the site: high on the trunk where the body rises toward the shoulder, the point rests in the long groove between two ribs — a gully of flesh along which something was imagined to flow. Whether the water in question is qi, moisture, or simply the shape of the groove itself, the name teaches location by landscape.
There is a pleasing fit with the channel the point serves. The spleen belongs to earth in five-phase thinking — the element of soil, fields, and harvest — and earth is the very stuff that carves valleys and gives streams their banks. A stream named along an earth-element channel reads like the system describing itself: the terrain of the organ giving shape to the waterways that thread it. Classical lists place Tianxi amid the chest cluster of the spleen pathway, where the rising route finally gains the upper trunk; the watery name marks the moment the climb arrives at open heights.
Pinyin renders the name Tiānxī, and the dictionary agrees on both syllables: tian carries the first tone, and xi carries the first tone as well — the high, level tone held flat from beginning to end, like a sustained note or a road without gradient. Said slowly — a level tone, then the same level again — the name sounds the way a calm stretch of water looks. The hanzi pair 天溪 is compact enough to memorise at a glance, and like many channel points named for landscapes — valleys, ravines, streams, ponds — the metaphor doubles as a map reference.
Where the Spleen Channel Meets the Chest
The registry sums up the spleen channel in a single line: it ascends from the big toe up the inner leg to the chest. Classical texts unfold the journey in chapters. It begins at the inner edge of the big toe, crosses the inner ankle, climbs the inner leg and thigh, and passes through the abdomen — the territory where the tradition locates its work of digestion, blood, and women’s health. From the abdomen the visible pathway rises onto the trunk and turns outward, reaching the lateral chest along the line six cun from the midline, and there it commits to a climb: station by station up the rib gaps toward the shoulder region.
On the chest the numbering narrates the ascent from below. Shidou (SP17) holds the fifth intercostal space; Tianxi (SP18) the fourth; Xiongxiang (SP19) the third; Zhourong (SP20) the second. Four stations, evenly pitched, one anatomical step apart, all on the same vertical line six cun out — a staircase of grooves rising toward the collarbone region. Beyond them the channel’s twenty-first and final station, Dabao (SP21), swings out to the midaxillary line lower on the side of the trunk, closing the chest chapter at the sixth intercostal space. Tianxi sits near the heart of this staircase: high enough to overlook the whole climb, low enough to feel the ladder run beneath it.
Why does a channel rooted in digestion reach the chest at all? Classical physiology gave the spleen a directional duty — transforming nourishment and raising what the body needs upward — and drew the pathway to match: a route that gathers below and rises above. Whole regions of the body were written into each channel, and any station along a route could be consulted for complaints arising along it. That same logic explains the entries in Tianxi’s record that sit farthest from the dinner table: the point stands on the chest wall beside breast territory, and classical lists reached for stations near the breast in matters of the breast. The map, not modern anatomy, draws those lines — and learning to read the map is the point of this page.
The Traditional Record of Uses
The licensed dataset records five indications for Tianxi: chest and hypochondriac pain, cough, asthma, breast abscess, and insufficient lactation. Read as tradition rather than promise, the list paints a coherent picture. Chest and hypochondriac pain heads the record: the hypochondria are the flanks — the sides of the trunk below the armpits — and the traditional idea behind the phrase is constraint, a stuck, bound quality across the chest and ribs understood as qi failing to move freely. Cough and asthma follow the pattern seen across chest points in the old literature: wheezing, effortful, noisy breathing gathered under broad headings. For complaints like these, classical practice traditionally worked with points along the chest segment of whichever channel passed — and the spleen channel passes here.
The final two indications draw closer, physically and culturally. Breast abscess — inflammation and collection in breast tissue, long recognised and especially associated with nursing mothers — appears across the old literature as a matter addressed at points near the breast; insufficient lactation likewise sent practitioners to stations around the chest when milk ran short. These are historical entries, recorded for context. They are also the reason this page keeps its safety rails unusually firm: nothing here suggests massaging any actual breast complaint. A suspected abscess, any new lump, redness, warmth, fever, or pain calls for prompt medical assessment — such findings are never self-care material — and questions about milk supply belong with qualified clinicians and lactation specialists. What carries over into home practice from these old entries is not treatment but orientation: knowing this stretch of chest wall, and treating it gently.
It bears repeating plainly. These are the traditional uses recorded in a licensed dataset and classical literature, offered here for cultural and historical understanding. They are not claims that pressing this point treats disease. Where modern research has touched acupressure at all, reviews suggest effects are modest and context-dependent, and evidence specific to any single point remains thin. Hold the heritage with interest, and hold the boundaries firmly.
Self-Care Acupressure at Home
With the point found by the walkthrough above, settle in: seated or standing, shoulders heavy, breath unhurried. Curl the index and middle fingers together and rest the pads — not the tips — in the groove. Begin with contact alone for a few slow breaths, then add small circles, letting the skin glide over the tissue beneath rather than grinding against the ribs. Pressure should register as pleasant dullness or mild warmth, never sharpness; the intention stays in skin and superficial layer, never driving inward between the ribs. A common home rhythm is one to three minutes per side, once or twice daily, paired with slow exhales so each circle rides the breath out. Swap hands, find the mirror-image spot, and keep the two sides symmetrical.
Quality outranks duration. Light, patient, regularly repeated contact fits the wellness practice this page teaches; force teaches the body nothing and needlessly disturbs the thin coverings beneath. Warm cold hands first, since chilled muscle guards. Prefer a quiet corner to a screen, and let the minute of contact double as a breathing pause: inhale through the nose, feel the ribs widen under still fingertips, ease pressure on the long exhale. Anchoring the practice to an existing habit — after morning washing, before sleep — serves better than intensity ever has, because consistency is what self-care traditions actually request.
Treat the exercise as a small ceremony of attention rather than a treatment session. Perhaps the area feels less guarded afterward; perhaps breathing feels easier while you press; perhaps nothing changes except that you spent ninety seconds attending to your own body. Every one of those outcomes fits the honest scope of self-acupressure. What does not fit is escalation — pressing harder, longer, or deeper to force a result. When curiosity pulls that way, lighten the touch or simply stop for the day.
Cautions and Safe Practice
This address earns its caution honestly, and the licensed record states it in full: Keep insertion shallow, with an oblique or transverse angle. The directive governs trained professional hands, and it exists because of plain geography: the lateral chest wall is thin, and deep work at this site risks passing between the ribs toward the pleural space and the lung — the injury pattern classically associated with pneumothorax, a collapsed lung that is a medical emergency. Home self-care manages the same risk by a simpler rule: it never leaves the surface. Acupressure as taught on this page uses neither needles nor moxibustion anywhere, so the scenario behind the record’s warning never arises — provided pressure stays light, superficial, and brief.
For fingertip practice the practical rules follow. Use finger pads only — never elbows, knuckles, or tools — and keep pressure strictly superficial, resting on the groove rather than aiming between the ribs. Stop at once on sharp, electric, or radiating sensation, and do not resume that day. Skip the point entirely during acute breathing difficulty or feverish illness, over broken or irritated skin, and stay cautious for weeks after any chest injury or surgery until ordinary activity has been cleared. Pregnant readers, nursing mothers, and anyone living with lung or heart conditions should consult a qualified practitioner before adding any new point practice. And because two of the record’s traditional uses concern the breast, the matching modern rule is absolute: never press into a lump, an area of redness or warmth, or any unexplained change — bring such findings to a clinician promptly instead.
Above everything stands the wider rule. This page is educational, and acupressure is self-care, not diagnosis or therapy. Seek prompt medical care — not a longer pressing routine — for breathlessness at rest or on mild exertion, chest pain, coughing blood, a cough that will not settle, fever alongside breast pain or redness, or any symptom that frightens you; persistent symptoms belong with a licensed practitioner, physician or East Asian medicine provider as the complaint suits. The heavenly stream is a lovely image; the safest gift this station offers most people is a kindly acquaintance with their own chest wall.
Tianxi, the Heavenly Stream, climbs the lateral chest with the spleen channel, resting in the fourth intercostal space out toward the side of the torso. Classical practice reached for it when chest and flank felt bound and painful, when cough pressed, and in matters of the breast. This guide walks you to it by touch and shows how to keep any contact light, brief, and safe.
Cautions from the classical sources
- Keep insertion shallow, with an oblique or transverse angle.
Self-care limits
Frequently asked
- How do I find Tianxi without knowing anything about cun?
- Use the nipple as the anchor and the grooves as the stairs. Find the soft groove at roughly nipple height, walk outward along it about two thumb-widths past the vertical line dropping from the nipple, and settle where the chest curves toward the side. Then count one groove down and back up to greet the neighbours — fifth space, third space, second — and confirm the ladder. The six-cun figure simply names, in proportional language, the same walk your fingertip just took.
- Is pressing Tianxi myself actually safe?
- Gentle fingertip pressure held on the surface is generally reasonable self-care for healthy adults: it engages skin and the superficial layers, far short of the structures behind the ribs. The danger recorded at this site concerns deep professional techniques that reach toward the lung — a category home acupressure never approaches. Respect the stop signals: sharp or radiating sensation, worsening discomfort, or any change in breathing means finish immediately.
- What did classical practice use Tianxi for?
- The traditional record lists chest and hypochondriac pain, cough, asthma-style laboured breathing, breast abscess, and insufficient lactation. Its position on the chest explains the portfolio: classical practice reached for stations along a channel’s route for complaints arising in the regions that route crossed. Those are traditional frameworks for understanding the body, documented for context — not evidence-backed treatment claims, and never an invitation to self-treat a breast concern, which always belongs with a clinician.
- Why does a digestive channel reach up to the chest?
- Classical theory assigned the spleen the work of transforming nourishment and raising what the body needs upward — and drew the channel to match: born at the big toe, climbing the inner leg, crossing the abdomen, and rising at last to the lateral chest. Points along a route served complaints along it, which is how a digestive channel came to carry chest stations at all. The ascent is the theory made visible.
- When should I stop self-care and see a clinician instead?
- Whenever the body raises a proper flag: any new breast lump or skin change, redness, warmth, or fever; persistent chest or flank pain; breathlessness; a cough lasting beyond a few weeks; or anything that frightens you. None of these is ever a reason to press harder. Daily self-care and clinical medicine are different rooms in the same building — maintenance lives downstairs, diagnosis upstairs — and choosing the right door promptly is itself a health skill.
Sources
- 01WHO Standard Acupuncture Point Locations in the Western Pacific Region (2008), World Health Organization — nomenclature conventions.
- 02A Manual of Acupuncture, Peter Deadman, Mazin Al-Khafaji and Kevin Baker — point-name tradition and channel context.
- 03aijiu-mpvue (MIT License) licensed dataset, entry for SP18 Tianxi — location, actions, and caution record.
Last reviewed
牌記This leaf, for machines
Old books ended with a colophon saying who printed them. Every leaf here carries the same facts as structured data for agents and search, with no layout in the way.
- GET /en/points/sp18/leaf.json
- GET /zh-hant/points/sp18/leaf.json
- GET /zh-cn/points/sp18/leaf.json
- /llms.txt — the index of every leaf
- JSON-LD in the page: MedicalWebPage, MedicalEntity and FAQPage
{
"id": "SP18",
"name": {
"en": "Tianxi",
"gloss": "Heavenly Stream",
"zh-Hant": "天溪",
"zh-Hans": "天溪"
},
"channel": {
"id": "SP",
"order": 18,
"of": 21
},
"location": {
"text": "On the side of the chest, in the rib gap level with the nipple, about three finger-widths outside it."
},
"for": [
"chest and side pain",
"cough",
"low milk supply"
],
"press": {
"text": "Gentle finger pads in the rib gap, one minute each side.",
"seconds": 60,
"sides": "both"
},
"cautions": [
"Not over a breast lump, redness or warmth; have a doctor check it."
],
"source": "Zhenjiu Jiayi Jing, book 3",
"url": "https://acupoints.com/en/points/sp18",
"lastReviewed": "2026-08-24"
}