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Alternate names: 含口 hán kǒu, Holding Mouth; 合骨 hé gǔ, Uniting Bones; 虎口 hǔ kǒu, Tiger's Mouth

Channel: LI, hand yáng brightness (yáng míng) large intestine channel

Modern location: An acupoint located on the dorsoradial aspect of the hand, on the radial side of the second metacarpal bone, inferior to the midpoint of the bone (i.e., under the bone).

Classical location: In the depression where the index finger and thumb bones part. From The Great Compendium of Acupuncture and Moxibustion (针灸大成 zhēn jiǔ dà chéng)

Local anatomy: The venous network of the dorsum of the hand; proximally, exactly on the radial artery piercing from the dorsum to the palm of the hand. The superficial ramus of the radial nerve; deeper, the palmar digital proprial nerve derived from the median nerve.

Action: Frees the channels and quickens the network vessels; courses wind and resolves the exterior; clears and discharges lung heat; frees gastrointestinal downbearing; relieves pain and quiets the spirit.

Modern indications: Headache; painful red swollen eyes; nosebleed; toothache; clenched jaw; deviated eyes and mouth; deafness; painful swollen throat; mumps; hypertonicity of the fingers; pain in the arm; febrile disease with absence of sweating or profuse sweating; abdominal pain; constipation; amenorrhea; difficult delivery.

Needle stimulus: Needling: 0.5‒0.8 cùn perpendicular insertion, i.e., toward the little finger. Moxa: 3 cones; pole 5‒15 min.

Needle sensation: Distension and numbness, spreading down to the fingers or up to the elbow, sometimes radiating into the shoulder or even the face.

Warning: Stimulation of this point is contraindicated during pregnancy.

Point groups: Source (yuán) point; command (sì zǒng) point of the face and mouth; one of Mǎ Dān-Yáng’s twelve heavenly star points; one of the nine needles for returning yáng.

Point name meaning:

• 合 hé: a union; to meet
• 谷 gǔ: valley

This point is found in a valley-like depression at the union of the first and second metacarpal bones. Because the Chinese words for valley (谷 gǔ) and bone (骨 gǔ) are homophonic, the name serves as a particularly poetic mnemonic device.

The name of this point is also the name of a mountain. The flesh that protrudes at LI-4 when the thumb and forefinger are pressed together resembles a mountain.

The alternate names applied to LI-4 are particularly illuminating:

• Tiger’s Mouth is a reference to the ability of the thumb and forefinger to open wide like a tiger’s mouth.
Holding Mouth is most likely a description of the point’s location in the Tiger’s Mouth, though it is possible that the character 含 (hán) to hold or contain, is a mistranscription of the character 合 (gǔ) because the two characters are so similar.The name 合骨, Uniting Bones, is an intentional or unintentional variation based on the similar pronunciation of the characters 谷 (gǔ) and 骨 (gǔ).

Note that the character 谷 gǔ means valley, and in the modern simplified script, it replaces 穀 gǔ meaning grain. See acupoint names: origins, meanings, and translations.

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