Heart Meridian
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HT-4
Metal-Jin
River-Jing Point
Needle Depth
0.3–0.5 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Forearm, Wrist
Location
On the radial side of the tendon of flexor carpi ulnaris, 1.5 cun above the transverse crease of the wrist when the palm faces upward.
Main Actions
- Calms the Mind
- Relaxes the sinews
- Benefits the voice
Indications
Fear
Spasm
sSadness
Red eyes
Retching
Cold bones
Swollen eyes
Loss of voice
Restlnessness
Throat abscess
Arm contraction
Elbow contraction
Forearm neuralgia
Commentary
Lingdao HE-4 is the River point of the Heart Channel. It is mostly used to treat channel disorders and it has a special action on joints and bones. For examples, it can be stimulated to ease spasm and forearm neuralgia.
It can also treat Painful Obstruction Syndrome (Bi Syndrome) of elbow and wrist, especially if the obstruction is in the Heart or Small Intestine Channels.
On the other hand, Lingdao HE-4 is also able to subdues Rebellious Qi. Therefore it can treat symptoms such as retching as well as redness and swelling of the eyes.
Finally, it treats mental issues such as sadness, fear, anxiety, mental restlessness due to its calming effect on the Mind.
Classical Sources
Zhenjiu Jiayi Jing (针灸甲乙经 - Systematic Classic of Acupuncture): Describes Lingdao's indications including heart pain, grief, fright, sudden loss of voice, retching, throat abscess, redness and swelling of the eyes, cold sensation in bones and marrow, spasm, contraction of the elbow and arm.
Ling Shu (灵枢 - Spiritual Pivot): The River-Jing points are indicated for "diseases manifesting in the patient's voice" and "diseases of the sinews and bones" - explaining Lingdao's special effect on aphonia and musculoskeletal conditions.
Name Interpretation: Ling (灵) means spirit or soul; Dao (道) means pathway or road. The point name suggests it serves as a pathway for the Heart spirit (Shen) to flow freely, reflecting its action on emotional and mental conditions.
How to Locate
The flexor carpi radialis muscle has a distinct tendon which can be easily palpated ulnar and proximal to the wrist crease. It attaches to the pisiform bone. Lingdao HE-4 is located directly on the radial side of the tendon, 1.5 cun above the transverse crease of the wrist when the palm faces upward. Shenmen He-7, Yinxi HE-6, Tongli HE-5 and Lingdao HE-4 are all located on a line on the radial aspect of the tendon at 0.5 cun intervals.
Caution
The ulnar artery and ulnar nerve pass through this area. Needle carefully on the radial side of the flexor carpi ulnaris tendon to avoid these structures. Use gentle technique as the area can be sensitive. Avoid aggressive manipulation in patients with bleeding disorders or those on anticoagulant therapy.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
0.3–1 cun vertically or obliquely in a proximal or distal direction.
Expected Deqi Sensation
Localized aching, distension, or soreness at the point. Deqi may radiate along the medial aspect of the forearm toward the wrist or up toward the elbow. Some patients may experience a sensation traveling toward the chest or heart region, particularly when treating cardiac or emotional conditions.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Questionable
Bloodletting
N/A
Gua Sha
Questionable
Five Element & Transporting Classification
Five Phase
Metal-Jin
Transporting Type
River-Jing Point
Mother-Child Role
Child (Reducing)
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