Hegu LI-4 location
LI-4

Hegu LI-4

Joining Valley · 合谷 · Hé Gǔ
Large Intestine Meridian
Yuan-Source Point Ma Dan Yang Heavenly Star

Safety Warnings

  • Contraindicated during pregnancy

Needle Depth

0.5–1.0 cun

Needle Angle

90° (Perpendicular), 45° (Oblique)

Body Area

Hand — Dorsum

Location

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

Main Actions

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

Commentary

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. 

Classical Sources

Ling Shu (Spiritual Pivot): First mentions Hegu as the Yuan-Source point of the Large Intestine channel.

Zhen Jiu Jia Yi Jing (Systematic Classic of Acupuncture): "Hegu, also called Hukou (Tiger's Mouth), is located between the thumb and index finger, in the depression between the bones. It is where the Hand Yangming passes and is the Yuan point."

Zhen Jiu Da Cheng (Great Compendium of Acupuncture): "Needle 3 fen, retain for 6 breaths, moxa 3 cones. For pregnant women, reducing is acceptable but tonification should not be used - tonification will cause miscarriage."

Si Zong Xue Ge (Ode to the Four Command Points): "For the face and mouth, seek Hegu" (面口合谷收).

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.

Caution

Strong stimulation is contraindicated during pregnancy as LI-4 can stimulate uterine contractions and potentially induce labor. Only use during pregnancy under qualified professional supervision specifically for labor induction. The point lies near the dorsal venous network and the radial artery passes nearby at depth - avoid directing the needle toward the wrist to prevent puncturing these vessels. Use smaller amplitude lifting-thrusting techniques to avoid hematoma formation.

Needle Angle

90° (Perpendicular) / 45° (Oblique)

Depth Category

Medium

Standard Depth

0.5–1.0 cun

Needling Directions

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.

Expected Deqi Sensation

Local aching, distension and soreness that may radiate to the elbow, shoulder, or face. When needled deeply toward Laogong PC-8, sensation may spread to the palm and fingertips with numbness and tingling.

Moxibustion

Recommended

Duration: 10–15 minutes

Cupping

Questionable

Bloodletting

Recommended

Gua Sha

Recommended

Special Point Classifications

Yuan-Source Point Ma Dan Yang Heavenly Star

Command Point

Commands region:

Face & Mouth

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