ST-41 (Jie Xi) Ravine Divide

What does ST-41 Jie Xi do?

Jie Xi ST-41 is the Jing-River and Fire point of the Stomach channel of Foot Yang Ming, at the front of the ankle — and because the Stomach is a yang Earth channel and Fire is the mother of Earth, it is also the classical tonification point of the whole Stomach channel. That single fact organises everything else about it. Where ST-44 Nei Ting, the Water point, is the place the tradition goes to drain heat out of the Stomach, ST-41 is the place it goes to add warmth and strength to a channel that is cold, weak or slow.

• Clears heat from the Stomach channel and the Stomach fu — the action recorded in our own sources, directed at the channel's course over the face and at the digestive presentations of Stomach heat. It sits alongside, not against, the tonification role: the Jing-River points as a group are also recorded for febrile and respiratory presentations.
• Tonifies the Stomach channel — the mother-point action. Where the Stomach channel itself is deficient, the classical mother-child rule directs reinforcement at its Fire point, which is ST-41.
• Activates the channel and alleviates pain — its principal everyday use, and a local one: ST-41 is the ankle point of the Stomach channel, used for pain, swelling and restricted movement of the ankle and for weakness of the foot.
• Calms the spirit — a recorded action shared with several Stomach-channel points, applied to agitation, disturbed sleep and the classical mania presentations attributed to Yang Ming heat rising.
• Benefits the head — for headache and dizziness, following the Stomach channel's ascent over the face and forehead. Frontal headache is Yang Ming territory, and ST-41 is one of the distal points chosen for it.
• Regulates the intestines — the recorded use in abdominal distension and constipation, which follows from the channel's relationship with the Stomach fu rather than from any local action.

Source: Sacred Lotus sources & references (channel, Jing-River and Fire classification, and the existing action record); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 167; Chinese Acupuncture & Moxibustion, p. 155; Nan Jing (Classic of Difficulties), chapter 68, on the five-shu indications; cross-referenced against multiple online sources.

What is ST-41 Jie Xi used for?

ST-41 is used most of all for the ankle itself — pain, swelling and restricted movement — and for weakness or paralysis of the lower leg and foot; secondarily for frontal headache and dizziness, and for abdominal fullness and constipation. The indications carried in Sacred Lotus sources & references are set out below. They describe traditional use, not proven treatment.

• Pain and swelling of the ankle joint
• Weakness and muscular atrophy of the lower limb
• Motor impairment of the leg and foot
• Foot drop and difficulty raising the front of the foot
• Pain and paralysis of the lower extremities
• Headache, particularly frontal
• Dizziness and vertigo
• Redness of the face and eyes
• Abdominal distension
• Constipation
• Febrile disease
• Epilepsy
• Agitation and disturbed sleep

Where the emphasis actually falls. Of these, the ankle indications are by a wide margin the ones ST-41 is used for in daily practice — a point at the front of the ankle joint is, unsurprisingly, an ankle point first. The published prescribing literature bears this out: an analysis of 236 acupuncture prescriptions for ankle sprain drawn from 201 clinical studies found ST-41 to be the third most frequently used point of all, behind only Ashi (tender) points and BL-60 Kun Lun (PMID 36858419). The head and digestive indications are genuine and classically recorded, but they are the distal use of a Yang Ming point rather than what brings the point into a treatment.

Source: Sacred Lotus sources & references (existing indication record); Chinese Acupuncture & Moxibustion, p. 155; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 167; PubMed PMID 36858419; cross-referenced against multiple online sources.

Where is ST-41 Jie Xi, and how is it used in practice?

Jie Xi sits on the front of the ankle, on the crease that appears when the foot is drawn upward, in the hollow between the two prominent tendons that stand out there — roughly level with the tip of the bony knob on the outer side of the ankle. The two tendons are those that lift the big toe and the other toes; the point is in the gully between them, on the midline of the front of the ankle. It is a comparatively easy point to find, because the tendons appear clearly when the foot is flexed upward and the depression between them is unmistakable. Sacred Lotus sources & references hold two location records for it, one taking the midpoint of the ankle crease and the other taking the level of the outer ankle bone; they describe the same hollow and neither has been altered here.

Which points is ST-41 combined with?

• With BL-60 Kun Lun — the most strongly associated pairing in the published ankle literature. The complex-network analysis of 236 ankle-sprain prescriptions found "BL-60 with ST-41" to be the single most closely associated point combination in the whole set, ahead of "BL-60 with KI-03" (PMID 36858419). Anatomically the logic is plain: BL-60 is behind the outer ankle, ST-41 in front on the midline, and the two bracket the joint.
• With GB-40 Qiu Xu and KI-03 Tai Xi — the rest of the ring of points around the ankle, completing the encirclement for sprain, swelling and restricted movement. All are held in Sacred Lotus sources & references.
• With GB-34 Yang Ling Quan, ST-36 Zu San Li and GB-39 Xuan Zhong — the standard combination for weakness, atrophy and foot drop in the lower limb, where ST-41 is the ankle-level point and the others work higher up the leg. This is the conventional protocol used as the control arm in modern foot-drop trials (PMID 39943752).
• With ST-36 Zu San Li — for the tonification role. ST-36 is the He-Sea and Earth point and the Stomach channel's principal tonifying point overall; ST-41 is the mother point by the five-element rule. The two are used together where the intention is to strengthen the channel rather than to treat the ankle.
• With ST-44 Nei Ting and LI-04 He Gu — for the Yang Ming head and face indications, where ST-41 is a supporting distal point rather than the lead.
• With LIV-03 Tai Chong — one web-space away on the top of the foot, frequently paired with ST-41 in modern lower-limb protocols.
• Among its category peers — every channel has a Jing-River point, and on the yang channels they are the Fire points. Its counterpart on the arm Yang Ming channel is LI-05 Yang Xi, whose name ("Yang Ravine") is built on the same image and which occupies the corresponding hollow at the front of the wrist.

Source: Sacred Lotus sources & references (both location records, point categories, and the BL-60, GB-40, KI-03, GB-34, GB-39, ST-36, ST-44, LI-04, LI-05 and LIV-03 records); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 167; Chinese Acupuncture & Moxibustion, p. 155; PubMed PMID 36858419, 39943752; cross-referenced against multiple online sources.

Where is ST-41 located?

• A Manual of Acupuncture (p. 167): On the ankle, level with the prominence of the lateral malleolus, in a depression between the tendons of extensor hallucis longus and extensor digitorum longus.
• Chinese Acupuncture and Moxibustion (p. 155): On the dorsum of the foot, at the midpoint of the transverse crease of the ankle joint, in the depression between the tendons of m. extensor digitorum longus and hallucis longus, approximately at the level of the tip of the external malleolus.

How is ST-41 Jie Xi needled, and what lies beneath it?

Reference record only — this sets out what the standard texts document, not instruction for a reader. Sacred Lotus sources & references record perpendicular insertion of 0.5 to 0.7 inch at ST-41, with moxibustion noted as applicable. Deadman & Al-Khafaji record a comparable perpendicular range at the ankle crease. The figures are modest, and the reason is anatomical rather than conventional: this is one of the few points on the foot where a named artery and a named nerve lie directly within the region.

• Angle documented: perpendicular, into the depression between the two extensor tendons at the front of the ankle.
• Depth documented: approximately 0.5 to 0.7 cun in our own record; a comparable range in the reference literature.
• Moxibustion: documented as applicable — and more relevant here than at most Stomach points, since ST-41 is the channel's tonification point and moxa is the classical warming method.

Safety reference — the measured anatomy. ST-41 carries no cavity or organ hazard: it is at the ankle, far from the chest, abdomen and skull, and none of the pneumothorax caution that governs points over the thorax and upper back applies. What bounds it is entirely local, and it is worth stating precisely because it is more than most foot points carry.

• The point lies between the tendons of extensor hallucis longus (medially, the tendon to the great toe) and extensor digitorum longus (laterally, the tendons to the other toes), held down at this level by the extensor retinaculum.
• The anterior tibial artery, with its accompanying veins, descends through this interval at the front of the ankle and becomes the dorsalis pedis artery just distal to the point — the vessel whose pulse is felt on the top of the foot. It is documented as running in the region of ST-41.
• The deep fibular (deep peroneal) nerve accompanies the artery through the same interval. It supplies the muscles that lift the foot and a small patch of skin between the first and second toes.
• The floor of the region is the ankle joint capsule and the front of the tibia and talus.

The events the reference literature records at points of this kind follow directly from that list: bleeding and bruising where a vessel is contacted, a sharp radiating sensation toward the toes where a nerve is contacted, and pain on striking the joint capsule or periosteum. One published measurement bears on this directly. A musculoskeletal-ultrasound validation study examined what actually lies within the documented insertion-depth ranges of the five-phase points, and identified a group of points at which needles need to be inserted carefully because a vessel, nerve or joint structure lies within the stated range. ST-41 was in that group, alongside ST-36, SI-03, LU-09, KI-03, GB-34 and LIV-03 (Complement Ther Med 2013;21(6):641–8, PMID 24280473). That is a statement about anatomy rather than a report of harm — no injury occurred in the study — but it is the reason the recorded depths at this point deserve to be read as limits rather than as suggestions. Standard clean-needle practice applies. Acupuncture is carried out only by a qualified, licensed practitioner; this record documents the literature and is not a technique guide.

Pregnancy. Our sources record no pregnancy contraindication for ST-41. That caution attaches to LI-04 He Gu, SP-06 San Yin Jiao, GB-21 Jian Jing, BL-60 Kun Lun and the lower-abdominal and sacral points, and should not be transferred here by assumption.

Source: Sacred Lotus sources & references (existing needling record); Chinese Acupuncture & Moxibustion, p. 155; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 167 (surface and deep anatomy of the anterior ankle); PubMed PMID 24280473 — verified resolvable and checked for retraction status before citation.

What does the name Jie Xi mean?

Jie Xi means "Ravine Divide" — xi, a mountain stream or the ravine it runs in, and jie, to loosen, untie, separate or divide. The xi half is the same word used at SI-03 Hou Xi ("Back Ravine"), KI-03 Tai Xi ("Great Ravine") and LI-05 Yang Xi ("Yang Ravine"), all held in Sacred Lotus sources & references, and in every case it names the same thing: a narrow depression between two raised structures. Here the raised structures are the two tendons that stand out at the front of the ankle when the foot is drawn up, and the ravine is the gully between them.

Jie is the interesting half, and the commentaries read it in more than one way. The literal reading is anatomical — this is where the foot divides from the leg, the dividing line of the ankle. A second traditional reading takes jie in its sense of loosening or untying, and points out that this is where a shoe or a boot is fastened and unfastened: the place where the strap is tied, and the place where it is loosened at the end of the day. A third takes the same word in its clinical sense, since jie is the verb used for releasing the exterior and loosening what is bound, and ST-41's recorded actions include relieving obstruction of the channel. All three readings are traditional; none is decisive, and the site does not choose between them. The point is also rendered "Ravine Divide", "Stream Divide" and "Dispersing Stream" in different translations.

Why is ST-41 the tonification point of the Stomach channel?

Because it is the Fire point on an Earth channel, and Fire is the mother of Earth. This is the clearest worked example of the five-shu mother-child rule anywhere on the body, and it is worth setting out step by step.

The five-shu points run from the tip of each limb inward, and the classics assign each a stage in the flow of channel qi: Jing-Well where it begins, Ying-Spring where it glides, Shu-Stream where it pours, Jing-River where it flows freely, He-Sea where it enters the deep. Jing here is the character for a river channel or watercourse; the image is of the stream, having gathered, now running in a defined bed. The Nan Jing attaches an indication to each stage, and the Jing-River point's is cough and wheezing with chills and fever — which is why several of the Jing-River points carry respiratory and febrile indications that look out of place on their channels.

Each five-shu point also carries an element. On the yang channels the sequence runs Metal, Water, Wood, Fire, Earth from the toes or fingers inward. The Stomach channel is yang and its own element is Earth; in the generating cycle Fire generates Earth, so the Fire point of the Stomach channel is its mother point — the place to reinforce when the channel is deficient. Sacred Lotus sources & references record ST-41's classification as Jing-River & Fire, and the Fire point on this channel is ST-41. Its opposite number is the sedation or child point, ST-45 Li Dui, the Metal point at the second toe, since Earth generates Metal.

The complete Stomach five-shu series held here, running inward from the toes: ST-45 Li Dui (Jing-Well, Metal), ST-44 Nei Ting (Ying-Spring, Water), ST-43 Xian Gu (Shu-Stream, Wood), ST-41 Jie Xi (Jing-River, Fire) and ST-36 Zu San Li (He-Sea, Earth), with ST-42 Chong Yang between ST-41 and ST-43 as the channel's Source point. Read as a set they show the logic clearly: ST-44, the Water point, is where the tradition drains Stomach heat; ST-41, the Fire point, is where it warms and reinforces; ST-36, the Earth point, is the channel's own element and its great general tonic.

Is there research on ST-41 Jie Xi?

There is no clinical trial that isolates ST-41, and this site does not claim otherwise. What exists is prescribing-pattern research showing how heavily the point is actually used for the ankle, plus multi-point protocols in which ST-41 appears as one component, plus one anatomical study of its insertion depth. That is worth stating plainly rather than dressing up whole-protocol trials as though they were about this point.

• Prescribing patterns for ankle sprain — the most informative finding. A complex-network and association-rule analysis of the acupuncture literature for ankle sprain drew 236 prescriptions from 201 clinical studies published between 2011 and 2021, covering 61 points and 846 point-uses. The ten most frequently used were Ashi points (109 uses), BL-60 Kun Lun (79), ST-41 Jie Xi (70), GB-40 Qiu Xu (68), BL-62 Shen Mai (63), GB-34 Yang Ling Quan (59), KI-03 Tai Xi (53), KI-06 Zhao Hai (52), GB-39 Xuan Zhong (37) and SP-05 Shang Qiu (34). Association-rule analysis identified "BL-60 with ST-41" as the most closely related point combination in the whole dataset (support 34.83%), ahead of "BL-60 with KI-03" (26.37%) (Zhen Ci Yan Jiu 2023;48(2):204–10, PMID 36858419). This documents what practitioners do, not whether it works — but it is the clearest evidence available that ST-41's ankle role is real and current rather than merely textual.
• Post-stroke foot drop — ST-41 in the conventional protocol. Sixty patients with foot drop after stroke were randomised across three arms; the control arm received conventional acupuncture at GB-34 Yang Ling Quan, ST-41 Jie Xi, LIV-03 Tai Chong, ST-36 Zu San Li, GB-39 Xuan Zhong and GB-40 Qiu Xu, while the two observation arms added needling of myofascial trigger points in the tibialis anterior and gastrocnemius, one of them under ultrasound guidance. Both observation arms improved walking speed and Holden scale grade more than the control arm (Zhongguo Zhen Jiu 2025;45(2), PMID 39943752). ST-41 sits in the comparator here, not in the tested variable, and the trial's result is about trigger-point needling. It is named only so that a reader is not left thinking it supports this point.
• Insertion depth, anatomical. The musculoskeletal-ultrasound validation study of the five-phase points identified ST-41 among the points requiring careful insertion because of what lies within the recorded depth range (PMID 24280473). This is described in full under needling.

There is no randomised trial of ST-41 alone for ankle pain, foot drop, headache or any other indication, and the site does not claim that ST-41 treats any condition. Its standing rests on the classical five-shu logic set out above and on long clinical use.

How does ST-41 differ from the points near it?

ST-41 sits at the top of a crowded stretch of the Stomach channel, and its neighbours are easily confused with it. ST-42 Chong Yang lies a short distance distal, on the highest part of the top of the foot, and is the channel's Source point — it sits directly over the dorsalis pedis pulse and is the point at which the classics took the Stomach pulse. ST-43 Xian Gu is further forward again between the second and third foot bones, the Shu-Stream and Wood point, weighted toward oedema and facial swelling. ST-44 Nei Ting is at the toe web, the Ying-Spring and Water point and the channel's great heat-clearer. Moving up the leg, ST-40 Feng Long is the Connecting point, the tradition's principal point for resolving phlegm, and has nothing to do with the ankle. Around the joint itself, GB-40 Qiu Xu lies in front of and below the outer ankle bone, BL-60 Kun Lun behind it, KI-03 Tai Xi behind the inner ankle bone and SP-05 Shang Qiu in front of and below it — with ST-41 on the midline at the front, completing the ring. All are held in Sacred Lotus sources & references.

Source: Sacred Lotus sources & references (name, both location records, point categories, the Stomach five-shu series, and the ST-36, ST-40, ST-42, ST-43, ST-44, ST-45, BL-60, GB-40, KI-03, SP-05, GB-34, GB-39, LI-05, SI-03 and LIV-03 records); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 167; Chinese Acupuncture & Moxibustion, p. 155; Nan Jing (Classic of Difficulties) on the five-shu indications and the mother-child rule; PubMed PMID 36858419, 39943752, 24280473 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.