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‘Why Are You Doing That Point?’ Liver 3 and Large Intestine 4

By Sara Calabro

Acupuncture devotees are dying to know: Why are you doing that point? It is one of the most common questions that acupuncturists receive during treatments.

This is the first installment of an ongoing series that explains popular acupuncture points.

The logic behind choosing points varies. Certain acupuncture styles recommend points for unique reasons. Even within the same style, many points have more than one indication. Some points can substitute for others in cases where, for example, a needle-sensitive person prefers being stuck elsewhere. Other points can be left out or added based on the overall combination.

Recognizing that there are variations and exceptions, certain acupuncture points are used with a relative amount of uniformity. Across styles, they are known to be especially powerful in their effects. As a result, acupuncturists use them a lot. If you’re a regular acupuncture goer, you’ll probably recognize them.

This inaugural article of the “Why Are You Doing That Point?” series is a twofer. We’ll look at Liver 3 and Large Intestine 4, two points that are popular in their own right and also frequently needled together in a combination called Four Gates.

Liver 3 Gets Things Moving

Liver 3—also known as Taichong (Chinese name), Great Rushing (English translation) and LV3 (acupuncturist lingo)—is located on the foot, between the first and second toes.

Liver 3 is what’s known as a source point. Every meridian has one. Source points behave sort of like central stations on subway lines. They are hubs where internal and external energies gather and transform. They are single, high-concentration points that grant access to the larger system.

Because Liver 3 has such far-reaching effects, it is indicated for a very wide variety of conditions. John Pirog, in The Practical Application of Meridian Style Acupuncture, says Liver 3 is “probably the most important point for stagnation of the inner body.”

Liver 3 is used for menstrual cramps, headaches, vision problems, coastal-region pain and shortness of breath, low back pain, insomnia, and more. The list truly goes on and on. Feeling stuck? Hello, Liver 3. This point gets things moving.

Liver 3’s extensive effects are palpable. Needling it usually causes a strong achy sensation, either locally at the site of insertion, throughout the entire foot, or sometimes even up into the leg along the Liver meridian.

If you’ve had acupuncture, you’ve probably had Liver 3. If you haven’t yet, consider it inevitable.

Large Intestine 4 Is a Great Bang for Your Buck

Large Intestine 4—also known as Hegu (Chinese name), Joining Valley (English Translation) and LI4 (acupunk lingo)—is located on the hand, in the web between the thumb and index finger.

Large Intestine 4, like Liver 3, is a fantastic bang for your buck. If you think about the location, between the first and second fingers, it’s basically the upper-body version of Liver 3, which is located between the first and second “fingers” on the lower body.

Large Intestine 4 is a source point as well. It is indicated for a wide variety of conditions and also tends to cause a strong needling sensation.

Probably the best-known use of Large Intestine 4 is to release the exterior. This refers to treating what are known as Wind conditions—chills and fever, runny nose, headaches, stiff upper back and neck, too much or too little sweating, sore throat, dizziness, etc. Large Intestine 4 is the go-to point for these types of symptoms. It is thought to disperse the Wind and also bolster the body’s defenses against recurrence.

Other common indications for Large Intestine 4 include toothache, sinusitis, rhinitis, nosebleeds and Bell’s Palsy. This is because the Large Intestine meridian travels up to the face, so almost any symptom related to that region calls for the point.

In addition to these common uses, Large Intestine 4 is used in treatments for everything from constipation to skin disease to low back pain.

Note: Large Intestine 4 is contraindicated during pregnancy.
Another note: Here’s a great product for applying acupressure to Large Intestine 4.

Four Acupuncture Points Are Better Than One

Liver 3 and Large Intestine 4 are often used together. Each point is done on both sides of the body, creating a four-point combination known as Four Gates. This is one of the most frequently used point combinations in all of acupuncture.

There are many theories associated with Four Gates but the prevailing idea is that the combination opens up circulation throughout the entire body. Liver 3 handles the lower half while Large Intestine 4 addresses the upper. Together, they pack a powerful punch.

Four Gates usually tackles symptoms caused by stagnation. This includes pain as well as menstrual irregularities, constipation, or feelings of frustration—basically anything that suggests things aren’t flowing as smoothly as they should be.

The next installment of “Why Are You Doing That Point?” is on Stomach 36. Read it now.

Featured photo by Sara Calabro
LV3 and LI4 infographics from A Manual of Acupuncture


Eddie Young

As always, beautifully written piece…. a reminder of the power of the gates for sure.


Mr. Young,

Reminds me of the time you suggested we do just these four points. I protested. You convinced me. I shut up :)



I just read about double four gates- Lv2,3 + LI3,4. I’m dying to use it! I know just the patient too. :)

Great book to refer patients to is Andy Wegman’s “why did you put that there?”


Thanks for the recommendation, Ariel. I will definitely check out Andy’s book.



Sweet, thank you, Tatyana!


Eric Grey

It’s interesting, tailoring the explanation of “why do you do that point ‘to the invidiual patient. To student-patients, I give one explanation, to 60+ year old lifelong housewives, I give another.

I am wondering, do you ever use the imagery from the point names and stuff from the classics to explain points to patients? I’m always very surprised at how well this turns out…

Thanks for the great post!


Hey Eric. Definitely, with people who seem interested, I will certainly share point names as a way of explaining a point’s function. Although I am sure you, with all your classics knowledge, do it much much better than I. I smell a contributed-article opportunity… :)

Thanks for the feedback.



I love using these 4 gates to nourish and move qi and blood. According to Wang Ju-Yi, they can also be used as a ‘reset’ button to regulate channel flow for patients who have had treatments from multiple practitioners -or as a place to start with new patients. He also considers Lung 5 and Spleen 9 as ‘the other 4 gates’. They are He-Sea points-imaging one another again. Setting the rhythm of the Lung and Spleen, this pair regulates TaiYin qi transformation to reestablish healthy fluid metabolism, and are great for regulating counterflow qi and transforming dampness… You can do these together, unilaterally (for females: LI4 on left, LIV 3 right, LU 5 right SP 9 left) during treatment to nourish qi and blood production, fluid metabolism, and movement.

[…] Located on the back of the hand, between the thumb and index finger, Large Intestine 4 is one of the most important acupuncture points for anything having to do with the head and face. It is a great point for alleviating headaches and sinus pressure. (Note: This point is contraindicated during pregnancy.) Learn more about this point’s uses and location here. […]

Maruti Shanbhag

CAUTION While using Liv 3.

The Liv 3 occasionally defies homeostasis and can bring up sudden myoclonous jerks in the patient being treated. The reason for this is it has strong influence on the ANS and can suddenly bring down the BP. Hence Dr Jaysuriya always advised his acupuncture students to verify if the patient has high BP before needling Liv3. Thought of sharing this as I too have encountered this.

[…] it ends just outside the nostril. The bulk of the channel resides on the arm. With the exception of Large Intestine 4, Large Intestine 11 is considered the most powerful point for resolving issues along the Large […]

[…] If your Valentine isn’t experiencing any specific aches and pains, Four Gates is a great addition to your acupressure massage. It will circulate energy and help ease any stagnation, physical or emotional, that may have gone unmentioned. Learn more about the benefits and exact location of Four Gates here. […]

[…] I’ve found that this most commonly occurs with points in the hands and feet, especially Large Intestine 4, an acupuncture point located between the thumb and index finger. You also may experience muscle […]

[…] removed. I’ve found that this most commonly occurs with points in the hands and feet, especially Large Intestine 4, an acupuncture point located between the thumb and index finger. You also may experience muscle […]

Erik Carlson

Hi Sara,
I just stumbled into your web site via a google search. I’m a massage therapist I use the Hegu point during chair massages. I also use point protocols when using Acutonic(R) tuning forks on points, but I also like to show folks how to use basic points with acupressure. Enjoy the imagery and context you’re providing.


dear sara, acupoint Liv 3 can”t bring down BP. this is my own experience.but not only my experience my colleague also experienced the same.and i am one of the student of prof.dr. anton jayasuriya.



Hi Sara Li-4,Tw-5 beautiful points to headach.

Maruti Shanbhag

Hi Sara
I suggest that the book, Clinical Acupuncture Ed 2008 be read by people to understand Dr Anton’s experiences with Acupuncture. The Page # 517 last paragraph has following:
“Liv 3. This is a good homeostatic point, being most effective in treating hypertension. However, caution must be exercised as it could cause sudden drop in BP. It’s advisable to have the patient in supine position while using this point. Acupuncture normally causes homeostasis, this however, is an exceptional instance when homeostasis can be overshot.

Page # 517
“If the BP is very high do not use points on the Liver channel, especially Taichong ( Liv. 3) as an abrupt fall in BP may occur. This may cause stroke .”

In my experience I have seen that the over stimulation of Liv 3 has brought in Tachycardia in one patient. I am suspecting Tachycardia must have happened because of over stimulation of Liver.
This however, happens occasionally, but one needs to be aware of this. There is a small clip of YouTube video on Dr Anton’s training and Dr Anton mentions this in this video too. I have mentioned this because no one should think that Liv 3 is a safe point to needle. It has very powerful influence on the ANS and can cure hundreds of illnesses, if used correctly at the same time bring in unwanted effects also.


Bad side-effect of acupuncture? May be. Read on…looking to receive some comments.

I started acupuncture treatment for my right side of my body – neck, shoulder, and leg for 4 consecutive weeks. Four weeks after I stopped, I noticed rectal bleeding and some fecal stains. Two weeks after I noticed it, it stopped.

I have stopped the treatment and as of now, no bleeding or staining.

Is this bad effect due to acupuncture? I wonder….

Vanessa Foteu


I wanted to know if you have any more hints for remembering the points, like the one “pool of the cool”?

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