Large Intestine Channel

Hegu LI-4

Chinese: 合谷

Pinyin: Hé Gǔ

Location

Between the 1st and 2nd metacarpal bones, approximately in the middle of the 2nd metacarpal bone on the radial side. 

How to locate

When pressing the thumb and index finger together, the adductor pollicis and the interosseus dorsalis muscles will form a bulge. Locate Hegu LI-4 at the highest point of the bulge and push it further towards the inferior aspect of the second metacarpal bone. 

Or: Insertion on the angle bisector between the 1st and 2nd metacarpal bones, needling in the direction of the midpoint of the second metacarpal bone. 

Or: Spread the thumb and forefinger and place the distal phalanx of the thumb of the other hand on the webbed border. When flexing the thumb, its tip will point to LI-4. 

Main actions

  1. Expels Exterior Wind
  2. Regulates Defensive Qi
  3. Benefits the face, eyes, nose, ears and mouth.
  4. Removes Painful Obstruction from the Channel
  5. Harmonizes the Yang ascending and Yin descending

Indications

Fever Styes Asthma Lockjaw Sneezing Sweating Arm pain Tinnitus Deafness Red eyes Eye pain Coughing Headaches Toothache Sinusitis Epistaxis Hemiplegia Runny nose Amenorrhea Throat pain Bloody nose Eye swelling Blocked nose Mouth ulcers Eye deviation Delayed labor Blurred vision Conjunctivitis Mouth deviation Prolonged labor Epigastric pain Aversion to cold Facial paralysis Fingers stiffness Allergic rhinitis Absence of sweating Swelling of the face Trigeminal neuralgia Retention of dead fetus

Needling

0.5–1 cun vertically or slightly obliquely towards the palmar aspect of the hand.

Caution: Reducing Needle techniques are contraindicated during pregnancy, except being used for inducing labor. 

Commentary for Hegu LI-4

Hegu LI-4 is one of the most important point to expel Wind-Heat and release the Exterior by stimulating the diffusing of Lung Qi. Therefore, it is widely used in the starting stages of a common cold, influenza, allergic rhinitis or other Exterior diseases. The typical manifestations are blocked nose, sneezing, burning eyes, coughing, stiff neck or aversion to cold. 

Due to its strong function of extinguishing Wind from the head, some practitioners use the combination of LI-4 and Taichong LIV-3 for stopping headache. Actually the combined bilateral needling of these two points is called 'Si Guan' (Four Gate). They strongly regulate Qi and Blood, stop pain and relieve spasms. 

Furthermore, when used together with Taichong LIV-3, Shenting DU-24 and Benshen GB-13, LI-4 is said to be also effective in calming the Mind and reducing anxiety. It is commonly practiced in the Western countries. 

It also regulates sweating by regulating Defensive Qi in the space between the skin and muscles. Therefore, in case of Wind invasion, it is effective in both occasions of excessive or absence sweating. Tonifying Hegu LI-4 and reducing Fuliu KI-7 to stimulate sweating. Vice versa to stop sweating. 

When combined with Zusanli ST-36 and Qihai REN-6, it is able to treat chronic allergic rhinitis due to Lung Qi Deficiency or just general weak Defensive Qi.  The patients are more likely to be effected by Exterior Wind Invasion. 

Due to its direct influence on face, it is often used as a distal point to treat diseases related to mouth, nose, ears and eyes. Typical symptoms are allergic rhinitis, conjunctivitis, mouth ulcers, styes, sinusitis, epistaxis, toothache, trigeminal neuralgia or frontal headaches. It is also used for facial problems after Wind-stroke, such as deviation of eye and mouth or peripheral facial paralysis. 

It is also a powerful distal point in treating Painful Obstruction Syndrome in the finger, arm or shoulder as it opens the Channel. In additional to that, it also eases pain in Organs, especially in the Stomach, Small and Large Intestine and Uterus due to its calming and antispasmodic function. 

Another important function of LI-4 is to harmonize the Yang ascending and Yin descending. Therefore, it can subdue uprising Rebellious Qi or lift sinking Qi. For example, Rebellious Stomach Qi causes epigastric pain, Liver Yang rising causes migraine while Rebellious Lung Qi leads to asthma. When used together with Qihai REN-6, it can raise sinking Spleen Qi. 

Finally, Hegu LI-4 is said to be powerful in inducing labor. Thus it can be used for prolonged or delayed labor as well as retention of dead fetus. Therefore, it is forbidden to use during pregnancy.