ST45 Severe Exchange

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

ST45 (Lidui, “Severe Exchange”) is the Jing-Well Point point of the Stomach Meridian. It is located on the dorsal aspect of the second toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, approximately 0.1 cun from the corner. It clears heat from the Stomach channel, revives consciousness, calms the spirit, and harmonizes the Stomach and intestines.

Location

On the dorsal aspect of the second toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, approximately 0.1 cun from the corner.

Needling

Superficial, oblique insertion directed proximally, 0.1-0.2 cun, or prick to bleed.

TCM functions

Clears heat from the Stomach channel, revives consciousness, calms the spirit, and harmonizes the Stomach and intestines..

Indications

Shi-jue (corpse-like collapse), loss of consciousness, lockjaw, cessation of breath, states resembling spirit possession, abdominal fullness and distention, facial swelling, toothache of the upper jaw, aversion to cold, nasal congestion, nosebleed, yellow nasal discharge, nightmares, excessive dreaming, mania with desire to climb to high places and sing, mania with stripping off clothes and running, aversion to people and fire, fright upon hearing wooden sounds, cold feet, heat in the body, lack of sweating in febrile disease, jaundice, aversion to food, indigestion, pain along the course of the channel (chest, breast, inguinal region, thigh, shin, and dorsum of the foot), knee and patellar swelling and pain, foot coldness..

Jing-Well PointMetal Point

Clinical notes

As the Jing-Well and Metal point of the Stomach channel, ST45 is a primary point for clearing acute heat and resuscitating from collapse, especially with a presentation of mania or febrile disease. It is particularly effective for conditions like high fever, delirium, and fainting. Pricking to bleed is a common modern technique to powerfully clear heat, treat acute tonsillitis, or alleviate toothache. Its distal location on the channel also makes it useful for pain and swelling along the entire Stomach meridian.

On the Stomach channel

ST45 is one of 45 points on the Stomach Meridian. Nearby points:

Frequently asked questions

Where is ST45 located?

ST45 (Lidui) is located on the dorsal aspect of the second toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, approximately 0.1 cun from the corner.

What is ST45 used for?

ST45 clears heat from the Stomach channel, revives consciousness, calms the spirit, and harmonizes the Stomach and intestines. Common clinical indications include shi-jue (corpse-like collapse), loss of consciousness, lockjaw, cessation of breath, states resembling spirit possession, abdominal fullness and distention, facial swelling, toothache of the upper jaw, aversion to cold, nasal congestion, nosebleed, yellow nasal discharge, nightmares, excessive dreaming, mania with desire to climb to high places and sing, mania with stripping off clothes and running, aversion to people and fire, fright upon hearing wooden sounds, cold feet, heat in the body, lack of sweating in febrile disease, jaundice, aversion to food, indigestion, pain along the course of the channel (chest, breast, inguinal region, thigh, shin, and dorsum of the foot), knee and patellar swelling and pain, foot coldness.

How is ST45 needled?

Superficial, oblique insertion directed proximally, 0.1-0.2 cun, or prick to bleed.

Which meridian is ST45 on?

ST45 is a point on the Stomach Meridian (Zú Yángmíng Wèijīng).

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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.