ST-45 (Li Dui) Severe Mouth

What does ST-45 Li Dui do?

ST-45 clears heat from the Stomach channel, and clears heat, calms the spirit and restores consciousness — and it is the Jing-Well and Metal point of the Stomach channel, which makes it the channel’s SEDATION point.

• Clears heat from the Stomach channel — applied to the face, gums and throat, where the channel runs
• Clears heat, calms the spirit and restores consciousness — the Jing-Well emergency and spirit-calming functions

Its five-shu role, derived from our own element records. The Stomach is a yang Earth channel, and ST-45 is its Metal point — and Metal is Earth’s child, so ST-45 is the sedation point. The full Stomach series, from our data: ST-41 Jie Xi Jing-River & Fire (tonification, Fire generates Earth), ST-45 Jing-Well & Metal (sedation, this point), ST-36 Zu San Li He-Sea & Earth (horary), ST-43 Wood and ST-44 Water carrying no named role. Our ST-43 record sets out the same series from the controlling-element side.

Why a Jing-Well point calms the spirit. The twelve Jing-Well points sit at the fingertips and toe-tips, and the classical texts group them for reviving consciousness, for acute febrile states, and for disturbances of the spirit — agitation, mania, disordered dreaming. ST-45 carries all three, and its mania and dream indications belong to that shared Jing-Well character, sharpened by the Stomach channel’s relationship with the spirit in classical thought (“when the stomach is disharmonious, sleep is disturbed”).

On the name. “Li Dui” is rendered in our data as Severe Mouth, sometimes Sick Mouth or Cruel Exchange — one of the more contested names in the system, and our record does not settle it. The Stomach channel serves the mouth and the face, and several readings tie the name to that.

Source: Sacred Lotus sources & references (channel, element, action and translation records; the full Stomach five-shu series queried and ST-45 confirmed the Metal/sedation point, against our own data), cross-referenced against multiple online sources.

What is ST-45 Li Dui used for?

ST-45 is used for facial swelling, deviation of the mouth, nosebleed, toothache and sore throat, abdominal distension, coldness of the leg and foot, febrile disease, and mental and sleep disturbance. Our own indication record is reproduced here in full.

• Facial swelling
• Deviation of the mouth
• Epistaxis (nosebleed)
• Toothache, sore throat and hoarse voice
• Abdominal distension
• Coldness in the leg and foot
• Febrile disease
• Dream-disturbed sleep and mental restlessness (the spirit indications of the recorded action)

The face-and-mouth cluster is the channel’s far end reaching its start. The Stomach channel begins below the eye and runs down the face through the jaw and teeth — so a point on the second toe carrying facial swelling, mouth deviation, nosebleed and toothache is treating the head from the foot, the distal logic our ST-42 record sets out. Abdominal distension is the organ; coldness of the foot is local.

An honest note, and several entries need one. A NEW FACIAL DROOP OR DEVIATION OF THE MOUTH REQUIRES URGENT ASSESSMENT — stroke and Bell’s palsy both need same-day care; our ST-04 and GB-12 records carry the same warning. Sore throat with difficulty swallowing or breathing is a medical emergency, and a hoarse voice lasting more than three weeks needs assessment. Fever with confusion or loss of consciousness is a medical emergency. A nosebleed that will not stop needs care. This record documents classical use only.

The mental entries in context. ST-45 is one of five Stomach points our data records for mania (with ST-23, ST-24, ST-36, ST-40) — the spirit-calming action being the shared thread. Persistent sleep disturbance or mental restlessness deserves proper assessment, and an acute manic state is a matter for psychiatric care. This record documents a classical indication, not a treatment claim.

How it is combined. With ST-44 Nei Ting, the Ying-Spring point, above it — the two toe points used together for Stomach-channel heat in the face and gums. With ST-40 Feng Long for the mental symptoms, and LI-04 He Gu for the face and teeth. All held here.

Source: Sacred Lotus sources & references (indication and action records; every Stomach mania indication queried, and the GB-12, LI-04, ST-04, ST-40, ST-42 and ST-44 records checked, against our own data), cross-referenced against multiple online sources.

Where is ST-45 Li Dui located?

ST-45 is at the outer corner of the second toenail — the last point of the Stomach channel.

• On the second toe, at the junction of the lateral (outer) nail border and the base of the nail
• Located by the standard two-line method: one line along the outer edge of the nail, one along its base; the point is where they meet
• ST-44 Nei Ting lies proximal, in the web between the second and third toes

The Jing-Well points sit at nail corners, and ST-45 is a textbook case. Eleven of the twelve are at a fingernail or toenail corner, located this same way; our LU-11 and P-09 records note that KI-01, on the sole, is the one exception. The two-line construction — nail-edge line meeting nail-base line — is the standard for all of them, and it fixes a point about 0.1 cun from the nail.

Which corner of the second toe. Our record specifies the lateral border — the side away from the big toe. That is not a detail to drop: the second toe has two nail corners, and the Stomach channel takes the outer one, leaving the inner corner to the classical extra points of the toe.

On the name. “Li Dui” — Severe Mouth in our record, with the sense genuinely disputed, as noted above.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged including the lateral-border specification; the LU-11, P-09 and ST-44 records queried from our own data).

• A Manual of Acupuncture (p. 172): 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 of the nail.
• Chinese Acupuncture and Moxibustion (p. 157): On the lateral side of the 2nd toe, 0.1 cun posterior to the corner of the nail.

How is ST-45 Li Dui needled?

Our own record states SUBCUTANEOUS insertion to about 0.1 inch, with moxibustion applicable — the shallow depth every Jing-Well point carries, there being almost no tissue at a toe-tip. What follows is a neutral record of what the reference literature documents. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: subcutaneous, about 0.1 inch. For the collapse and heat indications the classical method is often to prick to bleed rather than to retain a needle — our data records a three-edged-needle bleeding technique at several Jing-Well points, and our SJ-18 record sets out that the library holds fourteen such points.
• Moxibustion: recorded as applicable.
• Regional anatomy: the nail bed and the tip of the distal phalanx lie beneath thin skin; dorsal digital nerves and the small digital vessels run along the toe’s margins; the bone is immediately deep.

Hazard, stated proportionately. This is a low-hazard point: no cavity, no organ, no major vessel, and bone a fraction of an inch beneath. Toe-tips are densely innervated and needling here is sharply felt — a matter of tolerability rather than danger. Where blood is drawn the ordinary considerations of any skin puncture apply.

What is not claimed. No study measuring a safe depth at ST-45 could be located, and none is needed at a depth of a tenth of an inch. No case report naming ST-45 was located.

Source: Sacred Lotus sources & references (needling record, retained unchanged; the SJ-18 record and the Jing-Well bleeding-technique set queried from our own data), cross-referenced against multiple online sources; regional anatomy from standard anatomical description.

Is there research on ST-45, and what should a reader know?

No trial isolates ST-45. Where the point appears it is one component of a protocol — often a resuscitation or heat protocol using several Jing-Well points together — and a study that includes a point in a protocol is not evidence about that point.

What this page can state with confidence. ST-45 is the Jing-Well and Metal point of the Stomach channel, and because the Stomach is a yang Earth channel, Metal is Earth’s child, which makes it the sedation point — checkable against our own element records and consistent with ST-41 as tonification and ST-36 as horary. It is the channel’s last point, at the outer corner of the second toenail. Its facial and mouth indications are the channel’s far end treating its own start. And it is one of five Stomach points recording mania, its spirit-calming action being the Jing-Well character shared across the twelve.

A note on searching for it. “ST 45”, “S 45” and “Lidui” searches return protocol trials and unrelated material — “Lidui” matches personal and place names, and the point’s English name varies between sources. Any claim attached to this point should be checked against what a study actually used.

Source: Sacred Lotus sources & references (element, action and indication records; the Stomach five-shu series and the Stomach mania indications queried, against our own data).