PC 4 — Xī Mén (郄门) — Cleft Gate

PC 4 (Xi Men, “Cleft Gate”) is the Xi-cleft point of the Pericardium channel — reserved by classical doctrine for acute conditions of the channel. Located 5 cun above the wrist crease on the anterior forearm, it is the principal acupuncture point for acute heart pain, palpitations and chest oppression, particularly when these are sudden or severe.

On this page

1. Overview
2. Location
3. Actions
4. Indications
5. Needling
6. Clinical notes
7. Treatment at my clinic

1. About PC 4 (Xi Men)

PC 4 — Xī Mén — is the Xi-cleft (accumulation) point of the Pericardium channel. In classical theory, Xi-cleft points are used for acute conditions of their channel and Zang-Fu, as they are where Qi and Blood gather and where stagnation manifests most acutely. PC 4 is therefore the point of choice for acute cardiac symptoms, chest oppression and bleeding disorders relating to the Heart.

2. PC 4 location

5 cun proximal to the wrist crease, on the line between PC 3 (Qu Ze) and PC 7 (Da Ling), between the tendons of palmaris longus and flexor carpi radialis.

3. Actions

1. Invigorates Blood and stops pain in the chest
2. Calms the Shen
3. Stops bleeding (haemoptysis, haematemesis)
4. Clears Heat from the Heart

4. Indications

1. Acute heart pain, angina pectoris
2. Palpitations, anxiety, tachycardia
3. Chest oppression, fullness in the chest
4. Acute panic attacks
5. Haemoptysis (blood in sputum), haematemesis (vomiting blood)
6. Acute mastitis
7. Pleurisy and chest pain

5. Needling

Perpendicular insertion 0.5–1.0 cun. Strong De Qi often radiates along the channel to the chest. Acupuncture should only be performed by a fully qualified practitioner.

6. Clinical notes

PC 4 is a key emergency-style point on the Pericardium channel. While PC 6 (Nei Guan) is used for chronic and general Heart and chest conditions, PC 4 is reserved for acute presentations — the sharp chest pain, sudden palpitations or panic attack. The Xi-cleft point’s special function in stopping bleeding makes it useful in haemoptysis from Heat in the chest. Often combined with PC 6, HT 7 (Shen Men) and CV 17 (Shan Zhong).

7. Treatment at my clinic

I use PC 4 as part of tailored acupuncture prescriptions for acute anxiety and panic attacks, palpitations and chest tightness. I see patients at my clinic in Wokingham, Berkshire.

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