Zhourong

What is SP20?

SP20, or Zhourong, is an acupressure point on the upper chest, in the second gap between the ribs, well out to the side of the breastbone.

It is the twentieth point of the Spleen channel, one of a short row of Spleen points that run up the side of the chest. The name Zhourong is usually translated as "encircling glory" or "all-round flourishing". Classical texts group it with its neighbours for chest fullness, cough and wheezing, and it is taught in standard point curricula as part of that set.

In practice it is a minor point. Most practitioners reach for chest and lung points on other channels first, and SP20 appears far more often in point lists than in treatment notes.

Two things are worth saying once, clearly, before the rest of the page. First, the fact that a point has been used for centuries is not evidence that it works; tradition records what people did, not what it achieved. Second, long use is not evidence that it is safe for you in particular, because the chest wall holds ribs, breast tissue, surgical scars and implanted devices that the classical authors were not thinking about.

The honest verdict on the evidence: there is essentially no human research on SP20 on its own. No controlled trial has tested finger pressure here for cough, breathlessness, chest tightness or digestion. What exists is tradition plus a small amount of general acupressure research that does not isolate this point.

That does not make it harmful. Gentle self-applied pressure on intact skin over the ribs is low-risk for most people. It does mean you should treat SP20 as a comfort measure you are trialling, not as a treatment for a chest or breathing problem. Everything described here is finger pressure only. Nothing on this page involves needles, heat, suction or anything that breaks the skin.

Where is SP20 and how do you find it?

SP20 sits in the second rib space, roughly 6 cun (about 15 cm in an average adult) out from the midline of the breastbone, towards the front of the armpit.

• Find the bump on your breastbone. Run a finger down from the notch at the base of your throat. About 5 cm down you will feel a slight ridge where the upper and lower parts of the breastbone meet. This is the sternal angle.
• Slide out to the second rib. The rib that joins the breastbone at that ridge is the second rib. Move your fingertip sideways onto it.
• Drop into the gap below it. The soft hollow directly under the second rib is the second intercostal space (the gap between two ribs). SP20 lies along this gap.
• Travel out to the side. Follow that gap outwards, past the line of the nipple, towards the fold at the front of your armpit. SP20 is around the level of that fold, roughly two thumb-widths further out than the nipple line.
• Settle in the soft spot. You want the springy hollow between two ribs, not the hard rib itself. A light press should feel slightly tender or dull rather than sharp.

A rough shortcut: raise your arm, find the crease at the front of the armpit, then slide down a short way onto the chest wall and feel for the second rib gap. Bodies differ, so the point may sit a finger-width either way.

On a woman, the point is above most breast tissue, on the upper chest wall. If you find yourself pressing into soft breast tissue, you have gone too low. Classical sources agree on the second intercostal space and on the distance from the midline; anything more precise than that is guesswork. If you cannot find a clear hollow, press gently over the general area rather than digging for a spot.

How do you apply pressure to SP20?

1. Sit upright and get comfortable. A chair with back support works well. Wash your hands and work on bare skin or a thin layer of clothing so you can feel the ribs.
2. Locate the gap first. Walk your fingertip along the second rib space until you feel the soft hollow rather than hard bone. Confirm it before you add any force.
3. Use the flat pad of one or two fingers. The index and middle fingertips are ideal. Avoid nails, knuckles and massage tools; the chest wall is thinly padded.
4. Press lightly and straight in. Aim for about 3 or 4 out of 10 on a discomfort scale — a dull, present pressure. The chest tolerates far less force than a shoulder or a calf.
5. Hold for 30 to 60 seconds. Breathe slowly and evenly while you hold. Many people find it easier to ease the pressure in as they breathe out.
6. Add small circles if you prefer. Slow circular rubbing over the same spot, for the same length of time, is an equally reasonable approach.
7. Do both sides. SP20 exists on the left and the right. Treat them one after the other for balance.
8. Repeat sparingly. Two or three rounds per side, once or twice a day, is plenty. More pressure or more repetitions does not buy more benefit.

Stop straight away if the pressure causes sharp pain, a pinching sensation, any change in your breathing, dizziness, or pain that spreads into the arm, neck or jaw. Stop also if the skin stays red or sore afterwards, or if an area that was tender becomes more tender over several days.

Give any self-care routine a fair trial of a week or two and judge it honestly. If nothing has changed, SP20 is probably not doing anything for you, and that is a normal result. Never press this point instead of using prescribed medication such as an inhaler, and never use it to talk yourself out of getting chest symptoms checked.

What is SP20 traditionally used for?

• Cough and wheezing. Classical sources list SP20 for cough, wheeze and "rebellious" upward movement of qi. No controlled human trial has tested pressure on this point for any breathing symptom, so this remains a traditional indication only. It is not a substitute for asthma or COPD treatment.
• Chest fullness and tightness. The commonest traditional use is a sense of congestion or oppression across the upper chest. Gentle pressure on a tight chest wall may feel pleasant, and slow breathing during the hold can settle a stress response, but neither effect is specific to SP20 and neither has been measured here.
• Rib-side and chest-wall soreness. Practitioners sometimes use this row of Spleen points for aching along the side of the chest. Light massage over sore muscle plausibly eases local tenderness; that is ordinary soft-tissue comfort rather than a channel-specific result.
• Hiccup and belching. Older texts mention SP20 for hiccup and for food or air coming back up. Human evidence for acupressure and hiccup is thin overall, and nothing points at SP20 in particular.
• Poor appetite and sluggish digestion. Because it belongs to the Spleen channel, which tradition links with digestion, SP20 is sometimes listed for loss of appetite or difficulty swallowing. This is channel reasoning, not a tested effect, and there is no trial behind it.
• A short calming ritual. Many people use chest points simply as a cue to sit still and breathe slowly for a minute. That calming effect is real and well described for slow breathing generally, though it belongs to the breathing, not to the point.

The overall picture: SP20 has a clear place in tradition and almost no place in the research literature. If you want a point where human trials genuinely support a specific effect, PC6 for nausea and vomiting is the standard example, and SP20 is nowhere near that level of support.

Are there tips for using SP20 effectively?

• Count ribs rather than guess. Finding the ridge on the breastbone and counting down to the second gap takes ten seconds and puts you far closer than eyeballing it.
• Let the breath set the rhythm. Ease pressure in as you breathe out and soften as you breathe in. It keeps the force low and makes the minute pass more calmly.
• Go lighter than you think. The chest wall has little padding over bone. If you can feel the rib edge pushing back hard, reduce the pressure rather than shifting your position.
• Use a warm shower first. Warm skin and relaxed chest muscles make the rib gaps easier to feel, especially if you are slim or very muscular.
• Keep sessions short and regular. A minute per side, once or twice a day, beats one long session. Long heavy pressing just leaves the area sore.
• Work both sides. Treating only one side often leaves the chest feeling uneven. The point is paired, so treat it as a pair.
• Write down what happens. Note your symptom out of ten before and after, for a week or two. Self-care is easy to over-credit from memory, and a simple record keeps you honest.
• Pair it with the obvious basics. For a persistent cough or chest tightness, hydration, humidified air, upright posture and prescribed inhalers do far more than any point. Use SP20 alongside them, never instead.
• Stop at the first sharp signal. Sharp, electric or spreading pain means move your finger or stop entirely. Acupressure sensation should be dull and tolerable, never piercing.
• Set a realistic trial period. Decide in advance that you will try it for two weeks. If nothing shifts, drop it without guilt rather than pressing harder and longer.

What do people get wrong with SP20?

• Pressing on the rib. Landing on hard bone instead of the springy gap between the second and third ribs. It is uncomfortable and misses the point entirely.
• Confusing it with its neighbours. SP19 sits one rib space lower and SP21 is far down on the side of the chest near the armpit. Lung points LU1 and LU2 sit higher, close to the collarbone and shoulder joint. Counting from the breastbone ridge sorts this out.
• Starting at the nipple line. SP20 is further out than the nipple line, towards the front of the armpit fold, and in the second rib space rather than down level with the nipple.
• Expecting a cure. No acupressure point cures asthma, bronchitis, reflux or a chest infection, and SP20 has no trial evidence behind any of those uses. Treat it as a comfort routine with an uncertain payoff.
• Replacing real treatment. Skipping an inhaler, antibiotic or follow-up appointment because the point feels soothing is the genuinely dangerous mistake on this page.
• Using it on undiagnosed chest pain. Pressing a sore chest can delay getting heart or lung symptoms assessed. Pain that feels crushing or heavy, or spreads to arm, neck or jaw, needs urgent medical help, not finger pressure.
• Digging in with a tool. Knuckles, pens, massage sticks and hard balls concentrate force onto ribs and bruise easily. Use fingertips only.
• Working through a scar or implant. Pressing over recent surgery, a pacemaker, a port or a tender lump is a real risk, not an abstract caution. Leave those areas alone.
• Treating tradition as proof. Seeing SP20 on a classical point list tells you people used it, not that it worked. Both claims deserve separate evidence.

What does the research on SP20 actually say?

There is no useful human research on SP20 specifically. A search of the acupuncture and acupressure literature turns up no controlled trial, no case series and no imaging study that isolates this point for cough, breathlessness, chest tightness, hiccup or appetite.

What exists instead is indirect. Trials of acupuncture and acupressure for respiratory symptoms generally use multi-point prescriptions, so even where a study reports a benefit, you cannot attribute it to any single point in the combination. Many of those studies are also small, short and unblinded, which makes placebo and expectation effects hard to separate from the treatment.

Chest points in the published literature are almost always needled by clinicians, not pressed by patients. That matters twice over: the procedure being tested is not the one described on this page, and the needling risk discussed in those papers, chiefly lung puncture, simply does not apply to a fingertip resting on the chest wall.

For contrast, it is worth knowing what decent evidence looks like. PC6 at the wrist has been tested in many randomised trials for nausea and vomiting, with repeated reviews finding a modest but real effect. SP20 has nothing remotely comparable.

What should you take from that? Absence of evidence is not proof of uselessness. It does mean no one can tell you how often SP20 helps, how much, or for whom. If gentle pressure here feels good and you use it alongside proper medical care, that is a reasonable personal choice. If you are deciding whether to rely on it for a breathing or digestive problem, the honest answer is that the research gives you no grounds to do so.