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POINT: LIV-4 (LIVER-4)  

NAME: ZHONGFENG

English: Middle Seal
Also Known As: Middle Barrier
Central Blockade

LOCATION:

  • On the ankle, anterior to the prominence of the medial malleolus, in the significant depression just medial to the tendon of the tibialis anterior when the ankle is extended (dorsiflexed).
    Note: it is important to dorsiflex the ankle by drawing the toes upward towards the shin before locating this point.
  • Midway between SP-5 Shangqiu and ST-41 Jiexi.
    Note: the distance of this point from the prominence of the medial malleolus is variously given as 1 or 1.5 cun.
  • One cun anterior to the inferior margin of the medial malleolus of the ankle, midway between SP-5 Shangqiu and ST-41 Jiexi.
  • Located on the medial side of the tendon of the tibialis anterior muscles, level with the vertex of the medial malleolus.

NEEDLING:

  • Perpendicular insertion 0.3 to 0.5 cun.
  • Oblique insertion medially towards SP-5 Shangqiu or laterally towards ST-41 Jiexi.
  • Slanted insertion 0.5 to 1 cun causing local distention and soreness.
  • Moxibustion is applicable.

COMMAND FUNCTIONS:

  • Jing-River point
  • Metal point

ACTIONS:

  • Spreads Liver Qi
  • Regulates the Lower Jiao
  • Clears Stagnant Heat from the Liver channel

INDICATIONS:

  • Pain and retraction of the genitals
  • Hypogastric pain
  • Shan disorder
  • Cold Shan disorder
  • Seminal emission
  • Seminal emission due to Deficiency-taxation
  • Seminal emission with dreams
  • Nocturnal emission
  • Difficult urination
  • The five types of painful urinary dysfunction
  • Retention of urine
  • Ischuria
  • Contracted sinews
  • Numbness of the body (paresthesia)
  • Pain of the medial aspect of the knee
  • Pain of the knee and ankle
  • Cold inversion of the feet
  • Pain in the penis
  • Hepatitis
  • Hernia
  • Yin hernia
  • Hernia pain
  • Conjunctivitis
  • Cold ankles and feet
  • Paralysis
  • Vaginal pain
  • Anorexia
  • Fever and chills
  • Penis retracted
  • Difficulty walking due to muscular atrophy
  • Paludism with pain during crises
  • Lack of sperm
  • Pain and swelling of the lower abdomen
  • Abdominal discomfort after eating
  • Periumbilical pain
  • Difficult defecation
  • No pleasure in eating
  • A green complexion
  • Sighing
  • Jaundice
  • Yellow body with a low grade fever
  • Malaria
  • Goiter
  • Dry throat
  • Lumbar pain
  • Diminished Qi
  • Heaviness of the body
  • Pain and swelling of the medial malleolus
  • Abdominal pain
  • Dripping urine
  • Colic
  • Distending pain in the hypochondrium
  • Muscular wasting
  • Impotence
  • Penis retracted causing pain radiating to the lower abdomen
  • Lack of sperm
  • Cystitis with lower abdominal pain
  • Pain and distention of the lower abdomen
  • Beriberi
  • Bilateral paralysis (diplegia)
  • Swollen vulva
  • Chills
  • Malaise after eating

COMBINATIONS:

REN-9
Shuifen
REN-8
Shenque

LIV-8
Ququan
REN-9
Shuifen

KI-7
Fuliu
SP-4
Gongsun
SP-3
Taibai
REN-9
Shuifen

Periumbilical pain

Pain of the umbilical region

Drum distention

SI-2
Qiangu
KI-6
Zhaohai

UB-44
Shentang

LIV-10
Zuwuli

Swelling of the throat with inability to swallow

Esophageal constriction

Jaundice with periodic low grade fever

ST-36
Zusanli

LIV-3
Taichong

LIV-3
Taichong
ST-36
Zusanli

Difficulty walking (moxa both points)

Difficulty walking

Inability to walk

UB-18
Ganshu
M-HN-13
Yintang

KI-14
Siman

 

Acute infectious hepatitis

Drumlike abdomen

 

CONTRAINDICATIONS:

NOTES:

  • The main function of this point is to regulate Qi in the Lower Jiao portion of the Liver channel, specifically the genitals, urinary system and region around and below the umbilicus.
  • Use this point if the condition neither gets worse or improves after eating.
  • This point can be used for detoxifying the Liver.