ST-43 (Xian Gu) Sunken Valley

What does ST-43 Xian Gu do?

ST-43 is the Shu-Stream and Wood point of the Stomach channel, and its recorded actions are about fluid — it regulates the Spleen and dispels edema, and it harmonises the Stomach and intestines. Swelling, not pain, is what this point is known for.

• Regulates the Spleen and dispels edema — the action the indications are built around
• Regulates and harmonises the Stomach and intestines — the fu-organ action

Its five-shu role is the one that has no special name, and that is worth stating plainly. The Stomach is a yang Earth channel and ST-43 is its Wood point — and Wood controls Earth rather than generating or being generated by it. That means ST-43 is none of the three named roles. Derived from our own element records, the Stomach series runs: ST-41 Jie Xi Jing-River & Fire, ST-43 Shu-Stream & Wood, ST-44 Nei Ting Ying-Spring & Water, ST-45 Li Dui Jing-Well & Metal, ST-36 Zu San Li He-Sea & Earth. So:

• Tonification (mother) point — ST-41 (Fire generates Earth)
• Sedation (child) point — ST-45 (Metal is Earth’s child)
• Horary point — ST-36 (Earth on an Earth channel)
• Controlling element — ST-43 — this point, and no named role attaches to it

ST-43 also completes a rule from the yang side. On yang channels the Yuan-Source point and the Shu-Stream point are separate points; on yin channels they coincide. Our ST-42 record carries the Yuan classification alone with no five-shu element, and the Shu-Stream sits here at ST-43 — the two halves of the same rule, one point apart.

Source: Sacred Lotus sources & references (channel, element and action records; the full Stomach five-shu series and ST-42's classification queried and tested against our own data), cross-referenced against multiple online sources.

What is ST-43 Xian Gu used for?

ST-43 is used for facial or general edema, for abdominal pain and rumbling, and for swelling and pain of the top of the foot. Our own indication record is reproduced here in full.

• Facial or general edema
• Abdominal pain
• Borborygmus (abdominal rumbling)
• Swelling and pain of the dorsum of the foot

Three of the four entries are swelling. Facial edema, general edema, and local swelling of the foot — a strikingly consistent list, and consistent with the recorded action. Few points in this library have indications this tightly themed; most carry a spread across several systems.

An honest note. Edema — swelling of the face, limbs or body — requires medical assessment. Its causes include cardiac, renal, hepatic and venous disease, and generalised swelling of new onset is a reason to seek care promptly. This record describes classical use; it is not a suggestion that assessment be delayed. The same framing is applied to the edema indications on SP-09, KI-07 and REN-09 in this library.

How it is combined. With ST-44 Nei Ting, immediately distal, the Ying-Spring and Water point and the classical Stomach-heat point. With ST-42 Chong Yang, immediately proximal, the Yuan-Source point — three consecutive points on the foot carrying three different classifications. With ST-36 Zu San Li and SP-09 Yin Ling Quan for fluid. All held here.

Source: Sacred Lotus sources & references (indication record; ST-36, ST-42, ST-44, SP-09, KI-07 and REN-09 classifications queried from our own data), cross-referenced against multiple online sources.

Where is ST-43 Xian Gu located?

ST-43 is on the top of the foot, in the hollow between the second and third metatarsal bones, one cun back from ST-44 Nei Ting.

• Between the second and third metatarsals, in a depression
• 1 cun proximal to ST-44 Nei Ting, which sits at the web margin
• ST-42 Chong Yang lies further proximal, where the metatarsals meet the cuneiforms

Three points, one line, three categories. ST-42, ST-43 and ST-44 sit in sequence along the second-and-third metatarsal interval, separated by measurement alone — and they are the Yuan-Source point, the Shu-Stream point and the Ying-Spring point respectively. As with the four Pericardium points between the forearm tendons, substituting one for a neighbour substitutes a category, not just a location.

On the name. “Xian Gu” means Sunken Valley — the valley being the groove between the two metatarsal bones, and sunken the depression you feel in it. Purely positional, and among the more literal names in the system: the point is named for the hollow it sits in, exactly as SP-05 Shang Qiu and LIV-04 Zhong Feng are named for their own bony surroundings.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; ST-42, ST-44, SP-05 and LIV-04 records queried from our own data).

• A Manual of Acupuncture (p. 170): On the dorsum of the foot, between the second and third metatarsal bones, in a depression 1 cun proximal to Neiting ST-44.
• Chinese Acupuncture and Moxibustion (p. 156): In the depression distal to the junction of the 2nd and 3rd metatarsal bones.

How is ST-43 Xian Gu needled?

The standard texts record perpendicular insertion to roughly 0.3–0.5 inch, with moxibustion applicable. What follows is a neutral record of what the reference literature documents, not instruction for a reader.

• Angle and depth as recorded: perpendicular, 0.3–0.5 inch.
• Moxibustion: recorded as applicable.
• Regional anatomy: the dorsal interosseous muscle lies between the metatarsals; the dorsal metatarsal artery and the dorsal digital branches of the superficial fibular nerve run in the interval; the metatarsal shafts form the walls.

Hazard, stated proportionately. This is a low-hazard point: no body cavity, no major vessel, no large nerve trunk. It is worth noting the contrast with its immediate proximal neighbour — our ST-42 record opens with an explicit “avoid puncturing the artery” caution because the dorsalis pedis crosses it. That caution belongs to ST-42. One cun distal, the artery has divided into its smaller dorsal metatarsal branches, and our own ST-43 record carries no such warning. The distinction is real and is stated here rather than carried over.

What is not claimed. No study measuring a safe depth at ST-43 could be located, and none is borrowed. No case report naming ST-43 was located, and none is asserted.

Source: Sacred Lotus sources & references (needling record, retained unchanged; ST-42's arterial caution queried from our own data and attributed to ST-42), cross-referenced against multiple online sources; regional anatomy from standard anatomical description.

Is there research on ST-43, and what should a reader know?

No trial isolates ST-43. Where the point appears it is one component of a protocol, and a study that includes a point in a protocol is not evidence about that point.

Where this channel’s attention has gone. Overwhelmingly to ST-36 Zu San Li, and our record for it is deliberately deflationary — post-operative ileus is the only substantial evidence base, the nausea evidence is graded low to very low certainty, and the immunity and longevity claims are explicitly rejected. A distal point on the same channel should not be presented as having more.

What this page can state with confidence. Two checkable things, both derived from our own element records. ST-43 is the Wood point of a yang Earth channel, which makes it the controlling-element point and therefore none of tonification, sedation or horary — those are ST-41, ST-45 and ST-36. And its position as the Shu-Stream point one cun from the separate Yuan-Source point at ST-42 confirms the yang-channel half of a rule that holds twelve out of twelve across this library.

A note on searching for it. “ST 43” and “Xiangu” searches return protocol trials and a large volume of unrelated material — Xiangu is a place name and a personal name, and also transliterates a mushroom used in cooking. This library has discarded comparable matches throughout. Any claim attached to this point should be checked against what a study actually used.

Source: Sacred Lotus sources & references (element and classification records; the Stomach five-shu series and ST-36's research findings queried from our own data).