LIV-4 Zhongfeng - Middle Seal
More Spirit Names: Mound Center, Middle Barrier
| 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
- Resolves Dampness in the genitourinary system
Indications
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Combinations
Periumbilical pain | Pain of the umbilical region | Drum distention |
UB-44 | ||
Swelling of the throat with inability to swallow | Esophageal constriction | Jaundice with periodic low grade fever |
ST-36 | LIV-3 | |
Difficulty walking (moxa both points) | Difficulty walking | Inability to walk |
UB-18 | KI-14 | |
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.
- LIV-4 vs SP-5: LIV-4 is found from the anterior view, SP-5 from the side view.
Five Elements Spirit Perspective
| Spirit of the Point | Middle Seal is the transfer point from Metal, the Metal point on the Liver. Use it like a seal, to seal with wax: the patient gets the quality of 'this is me and who I am,' like putting a seal on who they are. It is for giving identity and recognition of self, and when the Liver lacks richness it enriches the quality of mind and spirit. Metal brings restraint and clarity to Wood and helps distinguish what is you from what is someone else. The seal stands for the individual, a signature that cannot be copied, the original: the part of Metal belonging to oneself alone and how one's uniqueness shows in the world. It hones a person toward what is most meaningful, refining the Wood so they can see the beauty and quality of what they have planned. Some people make so many plans they lose precision and cannot do them all; this point honors the ability to organize, telling the valuable from the rubbish, and brings air into Wood so it can circulate. It is a stamp of quality and royalty: the middle is the core essence, and this point brings richness to the core of Wood, so that our plans have quality and worthy goals that serve the highest good. |
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| Worsley | Location: At the front crease of the ankle, between the extensor hallucis longus and tibialis anterior tendons (occasionally found on the medial side of the tibialis anterior tendon instead). |
| When to Consider |
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| Notes |
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