Points Database

: Wangu : Wrist Bone

SI-4 : Hand Taiyang Small Intestine 4

Classifications:
Yuan-Source point

Location:
On the ulnar border of the hand, in the depression between the base of the fifth metacarpal bone and the triquetral bone.

Needling:
Perpendicular insertion 0.3 - 5 cun

TCM Actions:
Activates the channel and alleviates pain
Clears heat and reduces swelling
Clears damp-heat and treats jaundice

TCM Indications:
  • Contraction of the five fingers with difficulty in flexing and extending, weakness and pain of the wrist, contraction of the arm and elbow with difficulty in flexing and extending, stiffness and swelling of the neck, headache, pain of the shoulder, coldness and pain of the shoulder and back, pain of the lateral costal region with inability to catch the breath, lumbar pain radiating to the leg, hemiplegia, clonic spasm.
  • Pain and swelling of the cheek radiating to the ear, swelling of the neck, submandibular region and jaw, throat painful obstruction, tinnitus, superficial visual obstruction, lacrimation, loss of sense of taste.
  • Jaundice, Spleen deficiency jaundice, febrile disease with absence of sweating, chills and fever, malaria, wasting and thirsting disorder, agitation and fullness.

    Neuroanatomy:
    Superficial Innervation: Ulnar nerve (palmar branch) from C8 and T1
    Dermatome Segment: C8

    Notes:
    Abductor digiti minimi trigger point lies close to this point, just distal to the head of the fifth metacarpal and on the belly of the muscle (Travell & Simons, 1998, Trigger Point Manual)

    Ling Shu Ch. 26, On Miscellaneous Diseases, advises this point is pierced in case of a nosebleed. If it does not end it advises to bleed Weizhong Bl-40.

    In Tung acupuncture the Wan Shu Er, Wrist Flow Two, point is located slightly distal to this point. Its indications seem similar to this point echoing the Du and Taiyang channels (Back, neck, shoulder, arm, hip and side of foot pain, dizziness, vertigo, tinnitus and urinary disorders). It is often combined with Wan Shun Yi, slightly proximal to Houxi SI-3 (Chu, 2015).

    In Mayan medicine:
    Used to treat pain in the upper extremities (Garcia, Sierra, Balam, 1999: Wind in the Blood)


    Reference Notes: (click to display)