Liver Meridian
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LR-4
Metal-Jin
River-Jing Point
Needle Depth
0.3–0.5 cun
Needle Angle
90° (Perpendicular)
Body Area
Ankle, Foot — Dorsum
Location
1 cun anterior to the tip of medial malleolus, in the depression on the medial side of the tendon of the tibialis anterior.
Main Actions
- Invigorates Liver Qi in the Lower Burner
- Clears Dampness in the genitourinary system
Indications
Turbid urine
Umbilical pain
Genitalia pain
Painful urination
Urinary retention
Urinary difficulty
Genitals retraction
Abdominal distension
Hypogastric distention
Lower abdominal swelling
Commentary
Zhongfeng LIV-4 is mainly used to treat Liver Qi Stagnation that causes distension in the Lower Burner, especially in the genitourinary system. The main symptoms are hypogastric and abdominal distension as well as umbilical pain.
Like Dadun LIV-1 and Taichong LIV-3, it also clears Dampness so as to treats Shan disorder (Hernial and Genitourinary Disorders). Other main manifestations are difficult and painful urination, turbid or retention of urine as well as lower abdomen swelling.
Classical Sources
Ling Shu (Spiritual Pivot), Chapter 2 - Ben Shu: This is the original text where Zhongfeng first appears as an acupuncture point. It establishes the point's location as "anterior to the medial malleolus, in the depression" and identifies it as the Jing-River point of the Liver channel.
Yizong Jinjian (Golden Mirror of Medicine): "Treats nocturnal emission, seminal loss, retraction of the genitals, the five types of painful urinary dysfunction, inability to urinate, abdominal distension, and goiter qi. This point combined with Zusanli and moxa treats difficulty walking."
Zhen Jiu Jia Yi Jing (Systematic Classic of Acupuncture): Records indications including hernia, pain around the umbilicus, penile pain, and urinary disorders, establishing its primary use for lower jiao conditions.
How to Locate
With slight ankle dorsiflexion, the tendon of the tibialis anterior muscles becomes more pronounced on the medial aspect of the ankle. Zhongfeng LIV-4 is located in the depression between the tendon and the tip of the medial malleolus.
Caution
The point lies near the anterior tibial artery and dorsal venous network. Avoid the visible veins on the ankle. The saphenous nerve and medial dorsal cutaneous nerve branches are in this area - gentle needling technique is recommended to minimize discomfort. Ensure proper dorsiflexion of the ankle to accurately locate the depression medial to the tibialis anterior tendon.
Needle Angle
90° (Perpendicular)
Depth Category
Shallow
Standard Depth
0.3–0.5 cun
Needling Directions
Puncture vertically 0.3-0.5 cun.
Expected Deqi Sensation
Local distension and soreness around the ankle. Deqi may radiate along the medial aspect of the leg or toward the dorsum of the foot. Some patients experience a spreading sensation toward the lower leg or the big toe following the Liver channel pathway.
Moxibustion
Recommended
Duration: 5–10 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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