Verscienta
LI4

Hegu

Star

合谷 (Hégǔ) — Union Valley

Large Intestine channel · point 4

Not yet clinically reviewed

Yuan-Source pointCommand point of the face and mouth

Traditionally used for

  • Headaches
  • Eye health
  • Nose & throat
  • Teeth & mouth
  • Colds & fever
  • Menstrual & women's health
  • Nerves & recovery

Cautions & contraindications

  • Pregnancy

Location

On the dorsum of the hand, between the first and second metacarpal bones, at the midpoint of the radial side of the second metacarpal.

How to locate: Adduct the thumb and index finger; the point lies at the highest point of the muscle that bulges up. Alternatively, place the crease of the opposite thumb web against the web margin — the point is beneath the thumb tip.

Regional anatomy: Beneath the skin and subcutaneous tissue the needle enters the first dorsal interosseous and then adductor pollicis; the dorsal venous network is superficial and the radial artery passes deep to the point into the palm.

Distances are in cun, a proportional unit — how to measure.

Body map, front: LI4 · Hand
Fig. — LI4 · Hand After Albinus, 1747
Body map, front: LI4 · Hand

LI4 · Hand · Albinus, Tabulae sceleti et musculorum, 1747

Bones of the hand, dorsal — Gray's Anatomy plate
Bones of the hand, dorsal Gray's Anatomy, 1918
Bones of the hand, dorsal — Gray's Anatomy plate

Bones of the hand, dorsal · Gray's Anatomy, 1918

Needling

Cited needling

  • Pregnancy: contraindicated

Techniques — the source gives these as alternatives:

  1. Perpendicular insertion
    Depth 0.5–1 cun
    skindeeper
  2. Oblique insertion — directed proximally
    Depth 1–1.5 cun
    skindeeper

Traditionally forbidden in pregnancy (at least before 37 weeks). Carr (2015) reviewed the trials and found no objective evidence of harm from needling these points; the prohibition is traditional, not evidence-based.

Depths describe average adult habitus in the cited population, never a single safe number for the patient in front of you. Palpate and adjust.

Sources (2)
  1. Carr DJ. The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med. 2015;33(5):413-419 — Identifying sources of concern and relevant outcomes Supports: pregnancy (names this point)
  2. Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove: Journal of Chinese Medicine Publications; 1998 — p. 103 Supports: techniques (names this point)

Site notes · not cited

  • Pregnancy
Depth: 0.5–1.0 cun
Angle: Perpendicular
⚠ Cautions: Contraindicated in pregnancy — its strong descending and blood-moving action is classically held to promote labour.

Functions

  • Releases the exterior and expels wind
  • Regulates the defensive qi and the sweat pores
  • Benefits the face, nose, mouth, teeth and eyes
  • Moves qi and blood and stops pain
  • Induces labour and promotes delivery

Indications

Common cold, fever and headachetoothache, facial pain and facial paralysisnasal congestion and nosebleedsore throatany pain in the head and faceabsence of sweating or excessive sweatingdelayed labouramenorrhoea

Balance Method partners

Under Dr. Tan's six systems, LI4 at the hand balances these channels at the regions its segment images.

Classical calendar method · 子午流注

When the tables open LI4

The hours Zi Wu Liu Zhu names this point at, by method. Times are the double-hour's start in UTC.

  • 甲申 15:00–17:00 Na Jia Fa, 庚-day sequence · Yuan-Source (原), returning to the source

    「合谷金原返本歸」

    Next: Tue 13 Oct, 15:00

A classical reference, not a recommendation: the tables say when the method opens this point, not that it is the point to needle. Open points by the hour →

Clinical Notes

One of the four Command points: "for the face and mouth, seek Hegu." With LV3 it forms the Four Gates, the standard combination for moving qi and blood throughout the body.

Combinations Using This Point

Miriam Lee's Ten Points

Five points needled bilaterally — LI4, LI11, ST36, SP6 and LU7 — as a single restorative prescription for the depleted, overworked patient.

The Four Gates

LI4 and LV3 needled bilaterally — the standard combination for moving stagnant qi and blood throughout the body.

Quchi and Hegu

LI11 and LI4 on the yang-ming channel — for headache, facial and throat complaints, skin itch and urticaria, abdominal disorders and arm paralysis.

Similar Points

Ranked by shared patterns and conditions

Lieque how are these connected? (Lieque) Fengchi how are these connected? (Fengchi) Fengmen how are these connected? (Fengmen) Dazhui how are these connected? (Dazhui) Waiguan how are these connected? (Waiguan) Taichong how are these connected? (Taichong)

Sources

  • World Health Organization. WHO Standard Acupuncture Point Locations in the Western Pacific Region. Manila: WHO Regional Office for the Western Pacific, 2008. (Location.)

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