Stomach Meridian
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ST-4
Needle Depth
0.5–1.5 cun
Needle Angle
10-15° (Transverse)
Body Area
Face — Perioral, Face — Cheek
Location
Lateral to the corner of the mouth, directly below Juliao ST-3.
Main Actions
- Expels Wind
- Removes Obstructions from the Channel
Indications
Aphasia
Drooling
Toothache
Cheek pain
Wind-stroke
Eye deviation
Face numbness
Lips numbness
Blurred vision
Mouth deviation
Moving eyeballs
Facial paralysis
Eyelids twitching
Facial contraction
Trigeminal neuralgia
Commentary
Dicang ST-4 is one of the most used local points for expelling Exterior Wind of the face. For example, it is always used in case of mouth deviation.
Furthermore, it is also effective in expelling Interior Wind, characterized by post Wind-stroke symptoms such as facial paralysis, eye or mouth deviation, mouth drooling, inability to close eye.
It also opens the Channel by removing Obstructions on face. Typical manifestations are cheek pain or toothache.
Finally Dicang ST-4 has positive influence over facial muscles and can be used to treat aphasia.
Classical Sources
Zhenjiu Jiayi Jing (針灸甲乙經): "Foot paralysis with inability to collect [the foot], atrophy preventing walking, inability to speak, hands and feet atrophied and contracted unable to walk - Dicang governs these."
Zhenjiu Dacheng (針灸大成): "Governs: deviated mouth from wind stroke, eyes cannot close, swollen feet, loss of voice and inability to speak, drinking water without control, fluids leaking and dripping, incessant twitching of the eyelids, itching of the pupils, distant vision blurred, dim vision at night. Treat the right for disease on the left, treat the left for disease on the right. Frequent needling and moxibustion is appropriate to completely eliminate the wind pathogen. For deviation of mouth and eyes, correction is the standard."
Tongren Shuxue Zhenjiu Tujing (銅人腧穴針灸圖經): "Loss of voice, pain in the jaw and teeth, swelling of the jaw and cheeks, stiff neck unable to turn and look back."
How to Locate
The first four points of the Stomach Channel are located vertically in the central pupil line, when the patients look straight ahead. Dicang ST-4 is at the crossing point of the pupil line and a horizontal line originating at the corner of the mouth, about 0.4 cun lateral to the corner of the mouth. Ask the patient to smile so that nasolabial groove line become more obvious. Dicang ST-4 is located in the nasolabial groove.
Caution
When threading toward ST-6 (Jiache), insert subcutaneously along the skin surface to avoid damaging facial nerves and blood vessels. The facial artery and vein pass through this area - apply pressure after needle withdrawal if bleeding occurs. Use gentle technique on the face to prevent bruising. For facial paralysis, avoid overly strong stimulation in the acute phase.
Needle Angle
10-15° (Transverse)
Depth Category
Medium
Standard Depth
0.5–1.5 cun
Needling Directions
Obliquely in a lateral direction or vertically 0.3–0.5 cun. Or apply penetration method: transversely 1.5–2 cun in cases of facial paralysis towards Jiache ST-6. In case of trigeminal neuralgia needle towards Yingxiang LI-20. Caution: Facial artery/vein.
Expected Deqi Sensation
Distention and soreness locally around the mouth corner, or spreading sensation throughout the cheek. When threading toward ST-6 (Jiache), the sensation may radiate across the entire cheek area. Some patients experience a pulling sensation in the facial muscles.
Moxibustion
Recommended
Duration: 5–10 minutes
Cupping
Contraindicated
Bloodletting
N/A
Gua Sha
Questionable
Command Point
Commands region:
Face & Mouth
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