The Four Gates
Star四關 (Sì Guān)
Classical Chinese acupuncture; the pairing is recorded in the Ming-dynasty literature and is standard in every modern textbook.
Points
-
Yuan-Source of the Large Intestine; governs the upper body and the qi
Perpendicular, 0.5–1.0 cun, into the first dorsal interosseous; aim for an aching numbness that spreads into the fingers.
- Pregnancy: contraindicated
-
Yuan-Source of the Liver; governs the lower body and the blood
Oblique, angled proximally up the foot, 0.5–1.0 cun; the aching numbness may travel towards the sole. Patient seated with the foot flat, or supine.
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
Treatment Principle
Open the gates of qi and blood, above and below, so that stagnation anywhere in the body can move.
Indications
Method
Both points needled bilaterally, giving four needles. Even or reducing technique depending on the presentation; retain 20 to 30 minutes.
⚠ Cautions
Both points are contraindicated in pregnancy, which rules the combination out entirely for a pregnant patient. The strongly descending action that forbids it in pregnancy is the same one it is used for after delivery, when the placenta is retained — an obstetric emergency to be managed alongside, never instead of, medical care. Can be strongly moving; reduce stimulation in the depleted.
About
Perhaps the single most-used two-point combination in acupuncture. LI4 is the Yuan-Source of a hand yang channel and LV3 the Yuan-Source of a foot yin channel, so the pairing spans hand and foot, yin and yang, qi and blood.
Rationale
The four needles form a frame: two above and two below, two on yang channels and two on yin. Classical commentary describes them as the four gates through which qi and blood enter and leave the body, and their being opened together as the reason the combination moves stagnation wherever it sits rather than at any one location.
Clinical Notes
The default opening of a treatment for a tense, frustrated, physically knotted patient. Effective enough on its own that it is worth resisting the urge to add to it before seeing what it does.
Sources
- Deadman, Peter; Al-Khafaji, Mazin; Baker, Kevin. A Manual of Acupuncture. Journal of Chinese Medicine Publications.
- Guo Changqing (ed.). Acupuncture of Acupoint Combinations: Quick Lookups. Daylesford: Heart Space Publications, 2020 (English edition; © China Science and Technology Press). ISBN 978-0-6489215-5-4. Chapter 4, combination 16.
📝 Notes
Public notes from the community and your own private notes on The Four Gates.
No notes yet.