Spleen 4 (SP4, SP4, or SP 4), also known as “Gong Sun” (Grandchild or minute connected channel according to Maciocia), is a vital point often utilized for conditions that involve digestive dysfunction, emotional well-being, and gynecological disorders.
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Spleen 4 Point Location
Spleen 4 is located on the medial side of the foot, proximal to Spleen 3, and distal and inferior to the base of the 1st metatarsalphalangeal (MTP) joint (various sources).
Functions of Spleen 4
Spleen 4 is known to have a deeper connection to Yin energies. In TCM theory, Yin is associated with nourishment, cooling, and grounding – all essential for blood regulation and emotional balance. This is why Spleen 4 is often selected for conditions where there’s a need to harmonize the blood and emotions.
TCM Functions
According to Giovanni2:
- Harmonizes the middle burners
- Regulates the Intestines
- Regulates the Chong Mai
- Calms the mind
- Benefits the feet and toes
Biomedical Function
- Fullness, digestion
- Dysmenorrhea
- Anxiety, mental restlessness
Clinical Applications
Since Yin is traditionally associated with blood and fluids, Spleen 4 is commonly used in TCM for conditions that involve blood deficiencies or stagnation. This makes it highly relevant for addressing:
Gynecological issues
Spleen 4 is effective for menstrual irregularities, dysmenorrhea (painful periods), and other gynecological conditions where blood flow needs to be regulated or supported. This point helps move stagnant blood and aids in balancing reproductive health, aligning with its role in nourishing Yin and blood.
Digestive support
Although more subtle than Spleen 3 in digestive actions, Spleen 4 plays a supportive role in the digestion and absorption process by ensuring that nutrients are transported effectively within the body.
Emotional well-being
This point is also selected for emotional or psychological conditions, particularly those stemming from blood or Yin imbalances. Spleen 4, through its regulation of blood and connection to the Penetrating (Chong) Vessel, can help alleviate emotional distress, making it beneficial in treating conditions like anxiety and restlessness.
Connection to the Chong (Penetrating) Vessel
Spleen 4 is the Master Point of the Chong Mai, or Penetrating Vessel. This is a major vessel in TCM that plays a significant role in regulating the blood, linking directly to both reproductive and digestive functions. Through its connection to the Chong Mai, Spleen 4 can mobilize and balance the flow of Qi and blood, particularly in the abdomen and reproductive organs.
Practical Application and Considerations
When using Spleen 4 in clinical practice, practitioners might consider it for:
- Menstrual and gynecological treatments: For cases where menstrual flow is scant or irregular, Spleen 4 can be paired with other points to support the balance of blood flow.
- Pain relief: Due to its action on blood circulation, it’s useful for alleviating pain that arises from blood stagnation.
- Emotional and psychological symptoms: When combined with other points, Spleen 4 can address emotional symptoms that stem from blood or Yin imbalances.
Research on Spleen 4
Research on spleen 4 is available, however most of the research seems to examine it’s use in conjunction with other acupuncture points, in particular Pericardium 6 (PC6). However, the literature is still available and more rigorous testing is always welcomed.
Effects on the Autonomic Nervous System
A study published in 2006 in The Journal of Internal Korean Medicine looked at points Pericardium 6 (PC6) and Spleen 4 (SP4) and their effects on the the autonomic nervous system in healthy adults. 22 healthy adults were recruited and randomized into a study and control group (sham acupuncture). The control group received acupuncture superficially near PC6 and SP4 but not at the exact locations. The subjects rested for 10 minutes, received acupuncture, then had the needles removed after resting 15 minutes. Heart rate variability (HRV) was measured consistently.
HRV was analyzed in terms of:
- Low Frequency (LF): Often associated with sympathetic activity.
- High Frequency (HF): Linked to parasympathetic (vagal) activity.
- LF/HF Ratio: Used as an indicator of the balance between sympathetic and parasympathetic functions
The Low frequency significantly decreased during the acupuncture period in the study group, while it significantly increased in the sham acupuncture group. The low frequency (LF) / high frequency (HF) ratio had also significantly decreased during the the period and had sustained post treatment. The sham control group had no significant changes. The authors postulate that PC6 and SP4 could “increase parasympathetic activity and balance the autonomic nervous system.”3
Gastroesophageal Reflux Diseases (GERD)
A study published in a 2023 journal of Gastroenterology Research and Practice looked at 68 patients with refractory gastroesophageal reflux diseases (GERD). The points used were Stomach 36 (ST36), Percaridium 6 (PC6), and Spleen 4 (SP4). The acupuncture group received acupuncture for 30 minutes, with intervention every 5 minutes to achieve a “de qi” sensation. The shame control group received superficial needle with no manipulation for the same time period.
The percentages of normal contraction improved in the acupuncture group while in the control group showed no significant changes after intervention.4
The authors concluded that acupuncture may has short-term efficacy in patients with symptoms of refractory gastroesophageal reflux disease.
Electro-Acupuncture and Spleen 4
Research has shown that electro-acupuncture SP4 and PC6 can “regulate organ index, promote gastric emptying, improve immune function, reduce inflammatory response, and improve gastrointestinal motility disorders.”5
To Summarize: Spleen 4 A Harmonizing Point
In essence, Spleen 4 is a powerful point for harmonizing the body’s blood and Yin aspects, especially in cases where blood-related conditions are present. Its association with the Chong Mai gives it a broad application range, from gynecological and emotional support to digestive health.
This information is for educational purposes only. Please consult with a healthcare provider for any diagnosis or treatment.
- Xing, Liwei & Xu, Jinlong & Zhang, Qiong & Li, Li & Li, Yunxiu & Zhuang, Haina & Yuan, Zhuojun & Zhao, Rong & Ma, Yanping. (2020). Pregnancy outcome treated with stage-by-stage acupuncture and moxibustion therapy based on the chong channel being sea of blood theory in repeated IVF-ET failure patients: A randomized controlled trial. Medicine. 99. e23234. 10.1097/MD.0000000000023234. ↩︎
- Maciocia G. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. 2nd ed. Elsevier Churchill Livingstone; 2005:942-943. ↩︎
- Rheu KH, Im IH, Kim DH, Na BJ, Lee BJ, Park SU, Ko CN. Effect of acupuncture at PC6 (Neiguan) and SP4 (Gongsun) points on autonomic nervous system in healthy adults. Korean J Orient Int Med. 2006;27(3):703-710. ↩︎
- Yuming T, Yuping Z, Yihan L, et al. Acupuncture Improved the Function of the Lower Esophageal Sphincter and Esophageal Motility in Chinese Patients with Refractory Gastroesophageal Reflux Disease Symptoms: A Randomized Trial. Gastroenterol Res Pract. 2023;2023:4645715. Published 2023 May 24. doi:10.1155/2023/4645715 ↩︎
- Zi Ke, Hongruyu Chen, Yong Zhao, Jixian Ke, Youqiong Xie, Runxin Zeng, Yini Hua, Zhihao Xiong, Xuanxuan Wang; Acupuncture Point Selection Patterns for Chemotherapy-Induced Nausea and Vomiting: A Data Mining Analysis. Complement Med Res 22 August 2024; 31 (4): 343–358. https://doi.org/10.1159/000538839 ↩︎
Carlo St. Juste II, MAOM has a background in acupuncture with over 10 years of clinical experience, published author, and over 16 years in the Martial Arts. He has worked with various organizations to implement employee wellness programs and workshops including The City of West Covina, The City of Brea, Broadcom, University of Southern California (USC), American Suzuki, and Pomona College. He is dedicated to promoting integrative health and has seen the benefits of knowledge and implementation first hand.