Hegu Point (LI-4, Tiger Mouth)
Dispels wind and releases the exterior, clears heat and opens the orifices, alleviates pain and calms the spirit, and regulates and descends the stomach and intestines. Based on its properties, it is clinically used for colds, fever, pain, gynecological disorders, mental conditions, and diseases of the head, face, and facial orifices.
Indications
Febrile disease without sweating, headache and dizziness, nasal congestion, sinusitis, deafness, tinnitus, red and painful eyes, toothache. (1) Head, face and orificial diseases: Headache, vertigo, toothache, eye diseases, ear disorders (tinnitus, deafness), nasal diseases (sinusitis, allergic rhinitis, epistaxis), facial paralysis, trigeminal neuralgia, facial spasm, temporomandibular joint disorder. (2) Exogenous diseases: Common cold, fever, cough, anhidrosis, hyperhidrosis, sore throat. (3) Pain syndromes: Headache, trigeminal neuralgia, toothache, stomachache, abdominal pain, dysmenorrhea, shoulder and arm pain, wrist pain, finger pain. (4) Gynecological diseases: Amenorrhea, dysmenorrhea, difficult labor, abortion, miscarriage prevention, irregular menstruation. (5) Skin diseases: Rash, urticaria, melasma, acne, etc. (6) Intestinal diseases: Dysentery, constipation, intestinal spasm. (7) Others: Surgical anesthesia, malaria, flaccidity syndrome, bi-syndrome, stroke, hiccups, and mental disorders.
Precise Location
On the dorsum of the hand, between the 1st and 2nd metacarpal bones, at the midpoint of the radial side of the 2nd metacarpal bone. For needling, keep the hand in a semi-closed fist, insert perpendicularly 0.5–1 cun. Moxibustion is applicable.
Location Method
(1) Spread the thumb and index finger of one hand to tighten the web. Place the transverse crease of the interphalangeal joint of the opposite thumb on the web margin between the thumb and index finger – the point is where the tip of the thumb falls. (2) Bring the thumb and index finger together. Locate the highest point of the muscle bulge between the 1st and 2nd metacarpal bones on the dorsum of the hand.
Massage Method
① Massage: Firmly press and knead with the thumb tip. ② Moxibustion: Apply mild-warm moxa stick. Bend the thumb vertically and press on Hegu with a rhythm of pressing and releasing once every 2 seconds (about 30 times per minute).
Compatibility
Headache: Combine with Taiyang (EX-HN5). Toothache, facial pain, facial paralysis: Combine with Jiache (ST-6) and Yingxiang (LI-20). Cold, headache, fever, nasal congestion: Combine with Jiache and Yingxiang to dispel wind, release exterior, and open the lung orifices. Yuan-Luo combination: Combine with Lieque (LU-7). Epilepsy/mania, headache, vertigo, hypertension (Four Gates): Combine with Taichong (LR-3) to calm the spirit and calm liver wind. Head, face and orificial diseases: Combine with Quchi (LI-11). Anhidrosis (no sweating): Reinforce Hegu, reduce Fuliu (KI-7). Hyperhidrosis (excessive sweating): Reinforce Hegu, reinforce Fuliu. Prolonged labor: Reinforce Hegu, reduce Sanyinjiao (SP-6). Prevent miscarriage: Reduce Hegu, reinforce Sanyinjiao. Common cold: Combine with Waiguan (TE-5), Quchi (LI-11), and Fengchi (GB-20). Exogenous fever: Combine with Dazhui (GV-14), Quchi (LI-11), and Shaoshang (LU-11). Gastrointestinal disorders: Combine with Zusanli (ST-36). Nasal diseases: Combine with Yingxiang (LI-20), Yintang (EX-HN3), and Zusanli (ST-36). Depletion of vital qi or sudden yang collapse (collapse/prostration syndromes): Combine with Guanyuan (RN-4), Qihai (RN-6), and Zusanli (ST-36). Facial spasm: Combine with Fengchi (GB-20). Acupuncture anesthesia for neck and facial surgeries: Combine with Neiguan (PC-6). Limited finger flexion/extension: Combine with Laogong (PC-8). Upper limb flaccidity/bi-syndrome: Combine with Jianyu (LI-15), Quchi (LI-11), Shousanli (LI-10), and Waiguan (TE-5). Various pain and depression disorders (Four Gates): Combine with Taichong (LR-3).
Efficacy & Actions
Hegu is the Yuan-Source point of the Large Intestine meridian, where the primordial qi passes and lodges. It was first documented in Lingshu · Benshu. "He" means to close or converge; "Gu" means valley, also referring to the depression where muscles meet. Located at the junction of Taiyin and Yangming, open like a valley, closed like a mountain – hence the name Hegu. As it lies between the thumb and index finger, resembling a wide-open tiger's mouth, it is also called "Tiger Mouth." (1) Key Point for Facial, Head and Orificial Disorders: The Large Intestine meridian runs from the hand up to the head and face, encircling the face. As the Yuan-Source point, it is rich in qi and blood, making it highly effective for disorders of the head, face, and orifices. The ancient saying states: "Facial and oral disorders are treated with Hegu." It treats headache, eye diseases, sore throat, toothache, facial deviation, ear disorders, mumps, nasal diseases, facial spasm, trigeminal neuralgia, trismus, temporomandibular joint disorder, aphonia, drooling, etc. Often combined with Quchi, another classic principle states: "For disorders of the head, face, ears, eyes, mouth and nose, Quchi and Hegu are the primary points." (2) Excellent for Various Pain Syndromes: Its analgesic effect has been praised by generations of physicians. The Biaoyou Fu states: "For cold, heat, pain and bi-syndrome, open the four gates." It is widely used for headache, toothache, red and painful eyes, sore throat, trigeminal neuralgia, chest pain, stomach pain, abdominal pain, dysmenorrhea, uterine contraction pain, finger pain, wrist pain, elbow and arm pain, neck pain, and lower limb bi-syndrome. Often combined with Taichong and Neiguan to enhance the analgesic effect. (3) Common Point for Exogenous Febrile Diseases: The Large Intestine is internally-externally related to the Lung. Its nature is ascending and dispersing, light and clear, moving to the exterior. It releases the exterior, reduces fever, disperses wind pathogens, and clears lung qi. It is effective for exogenous fever and wind pathogens invading the lung-defense system, often combined with Waiguan, Quchi, and Fengchi. (4) Effective for Gynecological and Obstetric Conditions: It strongly promotes qi circulation and blood activation, and unblocks the meridians. Used for irregular menstruation, dysmenorrhea, difficult labor, retained placenta, and insufficient lactation – especially effective for amenorrhea and prolonged labor. The History of the Southern Dynasties documented reinforcing Hegu and reducing Sanyinjiao to induce abortion. (5) Special Bidirectional Regulation and Combinations: Inducing/Stopping Sweating (with Fuliu): To induce sweating when there is no sweat, reinforce Hegu and reduce Fuliu. To stop excessive sweating, reinforce both Hegu and Fuliu. Abortion/Preventing Miscarriage (with Sanyinjiao): Reinforcing Hegu and reducing Sanyinjiao can induce abortion; reducing Hegu and reinforcing Sanyinjiao can prevent miscarriage. Four Gates (with Taichong): One Yang, one Yin; one Fu-organ, one Zang-organ; one upper, one lower; one qi, one blood. They harmonize qi and blood, providing calming, anticonvulsant, and analgesic effects for various diseases.
Contraindications
Hegu can cause uterine contractions and may induce miscarriage; therefore, pregnant women should use this point with caution or avoid needling entirely. The Illustrated Manual of Acupoints on the Bronze Figure states: "Pregnant women should not be needled here, as it damages fetal qi." The Shenying Jing also says: "It is not suitable for pregnant women." This point has strong stimulation; needling intensity must be carefully controlled.