LI4

Large Intestine Channel

Union Valley

合谷Hé Gǔ

Contraindicated during pregnancy

Moves Qi and Blood forcefully and directs them downward. Prohibited throughout pregnancy; in the tradition it is reserved for encouraging a labor that has already begun.

Anatomical location

On the back of the hand, between the first and second metacarpals, at the fleshiest part.

Main function

Disperses Wind-Heat, regulates Wei Qi (Defensive Qi), relieves pain.

  • Yuan (Source) point

Therapeutic indications

  • Headache
  • sore throat
  • fever
  • facial pain
  • frontal headache
  • sinusitis
  • rhinitis
  • conjunctivitis
  • common cold
  • fever without sweating or with excessive sweating
  • tonsillitis
  • trismus
  • deafness
  • hives
  • dysmenorrhea
  • constipation
  • abdominal pain
  • facial hemiplegia
  • pain in any location
  • insomnia due to pain
  • induction of labor at term
  • post-traumatic stress
  • depression
  • Parkinson's disease (tremor due to Internal Wind)
  • fibromyalgia
  • trigeminal neuralgia
  • tension headache
  • addictions and smoking cessation
  • bruxism
  • irritable bowel syndrome
  • allergic rhinitis
  • premenstrual syndrome
  • rheumatoid arthritis
  • psoriasis
  • atopic dermatitis
  • acne
  • herpes zoster and postherpetic neuralgia
  • chemotherapy-induced nausea and vomiting

Name and classical tradition

Hegu, 合谷, is probably the best-known acupuncture point, and its name describes exactly what you see and what you do. 合 means to join, bring together, close; 谷 is a valley, a hollow between two ridges. The valley is the depression between the first and second metacarpals, between two mountains of bone, and 合 alludes to the gesture of pressing the thumb and index finger together, which raises the muscle bulge where the point is found. It is a double geometric reading on which all the sources agree.

The Lingshu (Spiritual Pivot), chapter Ben Shu (本輸), locates it with a precise phrase: “過於合谷,合谷在大指歧骨之間,為原.” The qi passes through Hegu, which lies between the bones that fork off from the thumb; it is the Yuan-Source point. 歧骨, “forked bones,” is the classical way of naming the V formed by the two metacarpals. On the yang channels, the Yuan-Source point (原穴) is independent of the Shu-Stream point and occupies its own place in the sequence.

Its popular name is 虎口, “tiger's mouth”: when you open the thumb and index finger, the hand forms a pair of open jaws. The alias is well attested in the tradition. Another name, 容谷, “valley that receives,” circulates in modern references without a citation. In later literature, Hegu became one of the most frequently cited points, above all for the head and face, and the song of the four major points sums it up in a single line: “面口合谷收,” for the face and mouth, Hegu. The other three points in the song are ST36, BL40, and LU7.

Other names

  • 虎口Jiayi Jing
Location of point LI4, Union Valley
CC BY-ND 4.0 (opens in a new tab)
View point on the 3D modelLI4 on the anatomy
Needling techniquePerpendicular insertion 0.5-1 cun.
Depth0.5-1 cun
MoxibustionApplicable (5-10 minutes, indirect moxa)
PrecautionsAvoid in pregnancy due to the risk of inducing contractions.

Patterns that use it · 13

Classical combinations · 7

  • The Four Gates四关Sì GuānOpens the circulation of Qi and Blood throughout the body: LI4 governs Qi and the upper half, LR3 governs Blood and the lower half.
  • Four Command Points四总穴Sì Zǒng XuéEach point governs a region: ST36 the abdomen, BL40 the back and lumbar region, LU7 the head and nape of the neck, LI4 the face and mouth.
  • Release the exteriorOpens the exterior and expels the external factor before it penetrates deeper.
  • Clear the noseLocal point at the nasal ala, with the command point of the face and the Luo-Connecting point of the Lung.
  • Benefit the throatJing-Well point of the Lung for acute Heat, LI4 for pain, KI6 for dryness.
  • Painful shoulderLocal ring around the joint with the distal point of the Yangming.
  • Bring down feverMeeting of the Yang with the He-Sea point of the Large Intestine: disperses Heat throughout the body.

Basic formulas from the vademecum · 3

View the vademecum

Named functional sets from the school: here the point does not act on its own, but through the role it plays within the maneuver.

  • Regulate the Middle and the YangmingR.C.Y.PregnancyThe previous formula plus LI4, which brings the entire Yangming axis (Large Intestine and Stomach) into the governance of the Center. It opens the exterior and gives an outlet to what the Center mobilizes.
  • Clearing HeatPregnancyThe two great points of the hand Yangming—LI4 at the exterior and LI11 as the He-Sea point that sweeps Heat from the entire channel—supported by ST36 so that the dispersion does not deplete the Center.
  • Sweating-ReleasePregnancyOpens the exterior and expels the external factor through sweating: LU7 and LI4 are the Luo-Yuan pair of the Lung-Large Intestine axis, and GV14 commands all the Yang.
Cover of the guide “Protocols for the 20 most common patterns”

Free guide · PDF

Protocols for the 20 patterns you see most in practice

Each pattern with its tongue, its pulse, the treatment principle and the points to tonify and disperse. Made for the treatment table, not the bookshelf.

Do you use LI4 with your patients?

In the Clinic you record it in the patient's file, next to the tongue, the pulse and the measurements, so at the next session you know exactly what you used. The Atlas is built in.

See the Clinic