LR4 Middle Seal

Reviewed by · Licensed Acupuncturist & TCM Physician · Last reviewed June 2026

LR4 (Zhōng Fēng, “Middle Seal”) is the Jing-River point point of the Liver Channel of Foot Jueyin Meridian. It is located on the anterior aspect of the ankle, in the depression 1 cun anterior to the prominence of the medial malleolus, medial to the tendon of the tibialis anterior muscle. The point is located by dorsiflexing the foot to reveal the depression. It spreads Liver Qi, regulates the lower jiao, clears Liver channel damp-heat, soothes the sinews.

Location

On the anterior aspect of the ankle, in the depression 1 cun anterior to the prominence of the medial malleolus, medial to the tendon of the tibialis anterior muscle. The point is located by dorsiflexing the foot to reveal the depression.

Needling

Perpendicular insertion 0.5 to 1.0 cun, medial to the anterior tibial artery.

TCM functions

Spreads Liver Qi, regulates the lower jiao, clears Liver channel damp-heat, soothes the sinews..

Indications

Genital retraction into the abdomen with pulling pain in the sinews, seminal emission, flaccidity and reversal (wei jue), five types of urinary strangury (lin), inability to urinate, coldness of the feet, jaundice with slight fever, poor appetite, numbness of the body, cold hernia, pain in the waist, throat swelling, reversal counterflow, abdominal distension from the five zang, enlarged lower abdomen in women, difficult childbirth, dry throat, excessive thirst, hernia near the navel in women, pale and wan complexion as if about to die, difficulty breathing, difficult defecation, small lower abdomen swelling and pain, pain around the navel, loss of sensation in the body..

Jing-River pointMetal point

Clinical notes

As the Jing-River and Metal point on the Liver channel, Zhongfeng is adept at clearing damp-heat from the lower jiao and Liver channel, making it a key point for urinary and genital disorders like urinary strangury, genital pain, and seminal emission. Its ability to soothe the sinews is highlighted in its use for pain and contraction in the lower abdomen and genitals. It also treats psycho-emotional states associated with Liver Qi constraint, such as a deathly pale complexion and sighing.

On the Liver Channel of Foot Jueyin channel

LR4 is one of 14 points on the Liver Channel of Foot Jueyin Meridian. Nearby points:

Frequently asked questions

Where is LR4 located?

LR4 (Zhōng Fēng) is located on the anterior aspect of the ankle, in the depression 1 cun anterior to the prominence of the medial malleolus, medial to the tendon of the tibialis anterior muscle. The point is located by dorsiflexing the foot to reveal the depression.

What is LR4 used for?

LR4 spreads Liver Qi, regulates the lower jiao, clears Liver channel damp-heat, soothes the sinews. Common clinical indications include genital retraction into the abdomen with pulling pain in the sinews, seminal emission, flaccidity and reversal (wei jue), five types of urinary strangury (lin), inability to urinate, coldness of the feet, jaundice with slight fever, poor appetite, numbness of the body, cold hernia, pain in the waist, throat swelling, reversal counterflow, abdominal distension from the five zang, enlarged lower abdomen in women, difficult childbirth, dry throat, excessive thirst, hernia near the navel in women, pale and wan complexion as if about to die, difficulty breathing, difficult defecation, small lower abdomen swelling and pain, pain around the navel, loss of sensation in the body.

How is LR4 needled?

Perpendicular insertion 0.5 to 1.0 cun, medial to the anterior tibial artery.

Which meridian is LR4 on?

LR4 is a point on the Liver Channel of Foot Jueyin Meridian (Zú Juéyīn Gānjīng).

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⚠️ This page is for general education and is not medical advice. Acupuncture is a traditional practice; evidence varies by condition and study quality, and individual results differ. It does not replace diagnosis or treatment by a licensed professional. Always consult a qualified acupuncturist or physician.