Huagai

What is CV20?

CV20 (Huagai) is a point on the Conception Vessel channel, sitting on the midline of the breastbone at the level of the first rib space.

The Conception Vessel runs up the front midline of the body, from the pubic bone to the lower lip. CV20 is one of a short ladder of points spaced down the sternum, between CV21 above it and CV19 below it. Its pinyin name, Huagai, means "flowery canopy", an old Chinese anatomical term for the lungs, which sit on either side of the breastbone.

Because of that name and that location, tradition links CV20 to the chest and breathing. Classical texts list it for cough, wheezing, a tight or full feeling in the chest, and throat discomfort. In modern practice it is a minor point; most practitioners reach for CV17 or CV22 before they reach for CV20, though every standard point curriculum still teaches it.

Two things are worth saying once, clearly, before the rest of this page. A point having centuries of traditional use is not evidence that it does anything, and it is not evidence that it is safe. Those are separate questions, and this page keeps them separate.

The honest verdict on the evidence: there are no human trials testing CV20 on its own for any condition. What research exists on acupressure for breathlessness or cough uses multi-point protocols that may or may not include this point, so nothing can be credited to CV20 specifically. Acupressure research as a whole tends to be small, short, and hard to blind, which makes placebo effects difficult to rule out.

Finger pressure here is low-risk for most healthy adults, because you are pressing on a flat, solid bone with nothing fragile directly underneath. The real cautions are about that bone itself — surgery, fracture, thinning — and about not using a pressure point in place of care for chest symptoms that need a doctor.

Where is CV20 and how do you find it?

CV20 sits on the midline of your breastbone, just above the bony ridge where the upper and lower parts of the sternum meet.

• Start at the neck hollow. Put a fingertip in the soft U-shaped dip at the base of your throat, between the two collarbone ends. That hollow is the suprasternal notch, and the point CV22 sits in it.
• Slide straight down the bone. Move your finger downward along the hard midline of the breastbone, staying exactly in the centre. You will feel bone the whole way.
• Measure about two thumb-widths. CV20 is roughly 2 cun below the neck hollow. One cun is about the width of your own thumb at the knuckle, so two thumb-widths — around 4 to 5 cm in most adults — lands you in the right area.
• Check against the sternal ridge. Keep sliding down and you will meet a slight raised ridge across the bone, where the breastbone changes angle. CV20 sits just above that ridge, at the level of the first rib space on either side.
• Confirm with the rib spaces. Walk your other hand sideways from the point. You should be level with the gap between the first and second ribs, close under the collarbone.

Everything you are feeling for here is bone and midline, which makes CV20 easier to locate than most points. If the two methods disagree slightly, stay on the midline and accept the approximate level — small differences in body size move the point by a centimetre or so, and precision at that scale is not something finger pressure requires.

Do not confuse CV20 with CV17, which is much lower down, level with the fourth rib space and roughly between the nipples. And do not drift up into the soft throat hollow of CV22; that area is not flat bone and should not be pressed hard.

How do you apply pressure to CV20?

1. Sit upright and settle. Sit or stand with your back straight and shoulders relaxed. Slumping flattens the chest and makes the breastbone harder to read with your fingers.
2. Use a clean, flat fingertip. Wash your hands. Use the soft pad of your index or middle finger, not the nail and not a knuckle or tool.
3. Find the spot and rest the finger there. Place the pad on the midline of the breastbone, about two thumb-widths below the neck hollow, just above the sternal ridge.
4. Press straight in, gently. Push perpendicular to the bone with light to moderate force. You are pressing on bone with a thin skin covering, so it will feel firm quickly. Aim for a 3 or 4 out of 10 — noticeable, never sharp.
5. Hold or circle for 30 to 60 seconds. Either hold steady pressure or make small, slow circles roughly the size of a pea. Keep the finger in contact with the skin rather than rubbing across it.
6. Breathe out slowly as you press. Long, unhurried exhales are the part of this routine most likely to change how your chest feels.
7. Release and repeat. Lift off for a few seconds, then repeat two or three times. A whole session takes two to three minutes.
8. Use it once or twice a day at most. There is no benefit to grinding at the same patch of bone for long stretches.

Stop immediately if the pressure causes sharp pain, if the skin bruises or stays red, if you feel lightheaded, or if any chest symptom gets worse while you press. Persistent tenderness over the breastbone after gentle pressure is a reason to leave the area alone and ask a doctor about it.

This is self-applied finger pressure only. Nothing on this page involves needles, heat, suction, scraping or anything that breaks the skin, and none of those should be attempted on yourself.

What is CV20 traditionally used for?

• Cough. Classical sources list CV20 for cough, and the point's name links it to the lungs. No trial has tested finger pressure at CV20 for cough, so this rests on tradition alone.
• Wheezing and laboured breathing. Tradition uses the sternal points for asthma-type breathlessness. Some small studies of acupressure for breathlessness in COPD (a long-term lung disease) report modest improvement, but they use several points together, are mostly unblinded, and cannot tell you what CV20 contributed.
• Chest tightness or fullness. A congested, pressed-upon feeling in the upper chest is a classic CV20 indication. Here the plausible mechanism is simple: slow breathing plus steady touch tends to ease the sensation of tightness, whichever point you touch.
• Sore or constricted throat. Older texts mention throat discomfort and hoarseness. There is no human evidence for CV20 in throat conditions, and a sore throat that lasts beyond a week needs a proper look.
• Chest pain of the gripping or stuck type. Tradition describes CV20 for chest oppression. This is the claim to treat most cautiously — new, severe or exertional chest pain is a medical question, never a pressure-point question.
• Calming before sleep or during stress. Not a classical use, but many people find midline chest pressure with slow exhales settling. Any benefit here is likely from the breathing and the self-soothing touch rather than the specific point.

Put plainly: the traditional list for CV20 is consistent and old, but the human evidence for this particular point is absent. That does not mean pressing it is pointless or harmful for most people — it means nobody can honestly promise you a result.

If you want to try it, treat it as a comfort measure alongside proper treatment, not as a replacement. Inhalers, antibiotics and investigations exist for reasons that finger pressure does not cover.

Are there tips for using CV20 effectively?

• Let the breath lead. Press gently as you breathe out, slowly, through slightly pursed lips. The exhale does more for a tight chest than the pressure does, and the two work better together.
• Respect the bone. There is almost no padding over the breastbone, so moderate force feels harder here than elsewhere. Back off well before anything stings.
• Keep sessions short and regular. Two or three minutes once or twice a day beats one long session. Repeated gentle contact is also less likely to leave the skin sore.
• Use a flat finger pad. A broad contact spreads the force. A fingernail or a hard tool concentrates it on a sliver of skin over bone and can bruise.
• Try it sitting, not lying. Upright posture opens the ribcage and makes the sternal ridge easier to feel, so you find CV20 faster.
• Pair it with CV17 if you like. CV17, lower on the same midline between the nipples, is the better-known chest point. Working both down the breastbone takes under five minutes.
• Keep a simple diary. Note your symptom on a 0 to 10 scale before and after, for two weeks. Self-applied techniques are heavily influenced by expectation, and a written record is the only way you will see a real pattern.
• Warm hands help. Cold fingers on bare chest skin make people tense up and breathe shallowly, which defeats the purpose.
• Do it over thin clothing if you prefer. A t-shirt layer is fine and makes no practical difference to a gentle hold.
• Know what you are testing. Give it a fair, short trial for a mild everyday complaint. If nothing changes in a couple of weeks, stop; it is not a technique that needs months to show up.

None of these tips make CV20 more powerful. They make the attempt safer, more comfortable and easier to judge honestly.

What do people get wrong with CV20?

• Expecting a cure. The most common error by far. CV20 is not a treatment for asthma, a chest infection, heart disease or anything else, and nobody can promise it will change a symptom.
• Digging into the bone. Hard, grinding pressure on the breastbone bruises the thin skin and tender periosteum over it, without adding any benefit. Firm but kind is the whole technique.
• Confusing CV20 with CV17. CV17 is much lower, level with the fourth rib space, roughly between the nipples. CV20 is high on the manubrium, about two thumb-widths below the neck hollow.
• Drifting up into the throat hollow. The soft dip at the base of the neck is CV22, not CV20, and it sits over the windpipe. That area should never be pressed hard or poked.
• Using it on undiagnosed chest pain. Pressing a point while chest pain builds wastes the minutes that matter. New, severe, crushing or spreading chest pain means emergency help, not self-treatment.
• Replacing an inhaler or medication. Some videos imply chest points can substitute for asthma or COPD treatment. They cannot, and skipping prescribed medicine is genuinely dangerous.
• Ignoring a healing breastbone. People who have had heart surgery through the sternum sometimes press the scar area far too early. That bone takes months to knit.
• Treating tradition as proof. "It has been used for 2,000 years" tells you about history, not about effect. Both can be interesting at once.
• Overdoing the frequency. Pressing the same patch of bone many times a day leaves it tender, which then gets misread as the point "working".
• Skipping the breath. People hold their breath while concentrating on the point, which tightens the chest — the opposite of what they came for.

What does the research on CV20 actually say?

No useful human research on CV20 specifically was found. There are no controlled trials, and no published case series that isolate this point for cough, asthma, chest tightness or any other complaint. That is the honest starting position, and it is the same position most individual acupoints are in.

What does exist is research on acupressure applied to groups of points. Small trials have looked at acupressure protocols for breathlessness in chronic obstructive pulmonary disease (a long-term lung disease) and for symptom relief in cancer care. These studies generally report modest short-term improvements in how breathless or anxious people feel. They are also typically small, run for a few weeks, and nearly impossible to blind, because the person being touched knows they are being touched. When sham acupressure is compared against real acupressure, the gap often narrows considerably.

Even where such a trial includes a chest midline point, the design cannot tell you what any single point contributed. A protocol using six points that produces a small benefit does not demonstrate that CV20 did anything at all.

It is worth contrasting this with the one acupressure claim that does have reasonable human evidence: PC6 at the wrist for nausea and vomiting, including in pregnancy and after surgery. That has been tested in many randomised trials and remains the clearest case in the field. CV20 has nothing comparable, and pretending otherwise would be dishonest.

What this means for you in practice: treat CV20 as a low-risk comfort technique with an unproven effect. If gentle pressure and slow breathing make your chest feel easier for a while, that is a real experience and worth having. It is not evidence that the point treated a condition, and it is not a reason to delay seeing a doctor about a cough, a breathing problem or chest pain.