ST-44 (Nei Ting) Inner Court

What does ST-44 Nei Ting do?

Nei Ting ST-44 is the Ying-Spring and Water point of the Stomach channel of Foot Yang Ming, and the tradition's principal point for clearing heat from the Stomach. The classification is the explanation: Ying-Spring points are the heat-clearing members of the five-shu set, and because the Stomach is a yang Earth channel, its Ying-Spring point falls on Water — the element that controls Fire. A water point on a fire-prone channel is exactly what the tradition wants for burning, hyperacid, toothache-and-mouth-ulcer heat. Sacred Lotus sources & references also record ST-44 as one of Ma Dan-yang's Heavenly Star points.

• Clears heat from the Stomach channel and alleviates pain — its defining action, directed at the part of the channel that crosses the face: toothache in the upper jaw, mouth ulcers, swollen gums, sore throat, nosebleed and frontal headache.
• Harmonises the intestines and clears damp-heat — for dysentery-type diarrhoea, urgency, foul stool and abdominal distension.
• Calms the spirit — recorded for the restlessness, irritability and disturbed sleep the tradition attributes to Stomach heat rising, on the principle that "when the Stomach is disharmonious, sleep is disturbed".

Because Yang Ming is described as the channel most abundant in both qi and blood, heat in it tends to be florid — strong appetite, thirst, bad breath, constipation, a red face — and ST-44 is the distal point used to drain it downward and away from the head.

Source: Sacred Lotus sources & references (channel, five-shu and Heavenly Star classifications, and the recorded actions above); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 171; Chinese Acupuncture & Moxibustion, p. 156; cross-referenced against multiple online sources.

What is ST-44 Nei Ting used for?

Nei Ting ST-44 is used above all for toothache, mouth and throat complaints, and for heat in the digestive tract — acid regurgitation, burning stomach pain and foul-smelling diarrhoea. The indications recorded in our sources divide into a facial and oral group, a digestive group, a febrile group, and a small local group at the foot. These describe traditional use, not proven treatment.

• Toothache
• Pain in the face
• Deviation of the mouth
• Sore throat
• Epistaxis (nosebleed)
• Gastric pain
• Acid regurgitation
• Abdominal distension
• Diarrhoea
• Dysentery
• Constipation
• Febrile disease
• Swelling and pain of the top of the foot

Source: Sacred Lotus sources & references (existing indication record); Chinese Acupuncture & Moxibustion, p. 156; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 171.

How is ST-44 Nei Ting used in practice?

Nei Ting lies on the top of the foot, in the hollow just behind the web between the second and third toes — about half a cun back from the edge of the web, on the far side of the joint at the base of the second toe. It is a small, distinctly tender point and one of the most reliably found on the foot.

• With LI-04 He Gu — the classic distal pairing for toothache and facial pain, joining the Yang Ming points of the hand and foot. Both channels cross the face, so the tradition treats the jaw from both ends of the body at once.
• With ST-06 Jia Che and ST-07 Xia Guan — the local points at the jaw, added to ST-44 and LI-04 to make the standard four-point toothache treatment.
• With ST-45 Li Dui — the Jing-Well point at the tip of the second toe, used with ST-44 for the more acute or spirit-disturbing presentations of Stomach heat.
• With ST-36 Zu San Li and ST-25 Tian Shu — for the digestive presentations, where ST-44 clears the heat and the other two regulate the Stomach and intestines.
• With ST-43 Xian Gu — the Shu-Stream and Wood point immediately proximal on the same channel; the pairing of Shu-Stream and Ying-Spring points is a recognised classical selection method in its own right.
• Among its category peers — every channel has a Ying-Spring point, and as a group they are the heat-clearers of the five-shu scheme. LI-02 Er Jian is the arm Yang Ming equivalent and is chosen for the same toothache-and-throat territory from the hand.

Source: Sacred Lotus sources & references (location and point categories); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 171; Chinese Acupuncture & Moxibustion, p. 156; cross-referenced against multiple online sources.

Where is ST-44 located?

• A Manual of Acupuncture (p. 171): On the dorsum of the foot, between the second and third toes, 0.5 cun proximal to the margin of the web.
• Chinese Acupuncture and Moxibustion (p. 156): Proximal to the web margin between the 2nd and 3rd toes, in the depression distal and lateral to the 2nd metatarsodigital joint.

How is ST-44 Nei Ting needled in the textbooks?

Reference record only — this documents what the standard texts state, not instruction for a reader. Chinese Acupuncture & Moxibustion records perpendicular insertion of 0.3–0.5 cun at ST-44, with moxibustion noted as applicable. Deadman & Al-Khafaji record a comparable shallow perpendicular range, and additionally describe oblique insertion directed proximally along the channel for disorders of the foot.

• Angle documented: perpendicular; oblique proximal variant recorded for local foot problems.
• Depth documented: approximately 0.3–0.5 cun — a shallow point, as the five-shu points of the extremities generally are.
• Moxibustion: documented as applicable, though for a heat-clearing point it is used sparingly in practice.

Safety reference. ST-44 lies between the long bones of the foot, well away from any body cavity or major vessel, and carries no organ or pneumothorax hazard; the shallow depth the texts record is set by the anatomy rather than by risk. The dorsal digital vessels and nerves run in the space, so bleeding and a sharp local sensation are the ordinarily documented occurrences — the point is characteristically tender. Our sources record no pregnancy contraindication for ST-44; that caution attaches to LI-04 and SP-06. Standard clean-needle practice applies. Acupuncture is performed by qualified practitioners; this record documents the literature and is not a technique guide.

Source: Chinese Acupuncture & Moxibustion, p. 156; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 171; Sacred Lotus sources & references (existing needling record).

What does the name Nei Ting mean?

Nei Ting means "Inner Court" — nei, inner, and ting, a courtyard. The classical reading is architectural: the web between the toes is the gateway, and the depression just inside it is the courtyard beyond the gate, the first sheltered space a visitor reaches. A second reading in the commentaries plays on the same image in reverse, the point being where a patient who dislikes noise and disturbance — a recorded symptom of Stomach heat — retreats to the quiet of an inner court. Both readings are traditional; neither is decisive, and the site does not choose between them.

Why does the Ying-Spring classification matter at ST-44?

The five-shu points run from the tip of each limb inward, and the classics assign each a stage in the flow of channel qi: Jing-Well where it begins, Ying-Spring where it "glides", Shu-Stream where it pours, Jing-River where it flows, He-Sea where it enters the deep. The Nan Jing attaches an indication to each, and the Ying-Spring point's is heat and febrile disease. That is why the Ying-Spring point of a channel is the standard place to go when the presenting problem is heat in that channel, and why ST-44 rather than any other Stomach point is the toothache-and-mouth-ulcer choice.

The element assignment sharpens it further. On yang channels the Ying-Spring point is a Water point; the Stomach is a yang Earth channel, so ST-44 is a Water point on an Earth channel whose characteristic pathology is Fire. Sacred Lotus sources & references record ST-44's element classification as Ying-Spring & Water. The Stomach channel's other five-shu points held here — ST-45 Li Dui (Jing-Well, Metal), ST-43 Xian Gu (Shu-Stream, Wood), ST-41 Jie Xi (Jing-River, Fire) and ST-36 Zu San Li (He-Sea, Earth) — complete the set, with ST-42 Chong Yang as the channel's Source point.

Is there research on ST-44 Nei Ting?

ST-44 has very little point-specific clinical research. What exists is mostly experimental work using the point to test whether acupuncture points are physiologically distinguishable at all, plus one clinical trial in which it appears as part of a comparator protocol. That is worth stating plainly rather than filling the gap with whole-protocol studies.

• Point specificity, human imaging. A functional MRI study in 33 healthy volunteers compared needling ST-44 with the immediately adjacent LIV-03 and with a nearby non-point. Both real points activated the contralateral primary somatosensory area and the same-side cerebellum, but ST-44 selectively activated a different set of regions from LIV-03 — including the secondary somatosensory area, middle and inferior frontal gyri, lingual gyrus and posterior cingulate cortex. The authors concluded that two adjacent points elicit distinct cortical patterns (PMID 23762172). This is one of the better-designed point-specificity studies, and ST-44 is one of its two named points.
• Stomach-channel specificity, animal. A rat study recording neuron discharge and c-Fos expression in the nucleus of the solitary tract — a brainstem relay for visceral input — found response rates of 65% for ST-02, 51% for ST-36 and 47% for ST-44, against 35% for a point off the Stomach channel and 31% for a non-point, with electroacupuncture at both ST-36 and ST-44 raising c-Fos counts significantly above the off-channel comparators (PMID 23591003). Animal mechanism work, but directly relevant to the traditional claim that ST-44 reaches the Stomach.
• Toothache, clinical. A randomised controlled study of 85 patients with toothache compared a five-shu-based selection — Shu-Stream and Ying-Spring points of the channel corresponding to the affected tooth — against a routine protocol containing ST-06, ST-07, LI-04, LI-02 and ST-44. The five-shu arm reported a higher cure rate (88.4% against 69.0%) and a lower six-month recurrence rate (PMID 23227682). ST-44 sits in the comparator arm rather than being the tested variable, and the trial is small and single-centre — but it is one of the few clinical studies in which the point appears by name in its own classical territory.

There is no well-powered clinical trial isolating ST-44, and the site does not claim otherwise.

How does Nei Ting differ from the points near it?

ST-44 sits in a crowded part of the foot and is easily confused with its neighbours, all of which are held in this library. ST-43 Xian Gu lies proximal to it in the same intermetatarsal space and is the Shu-Stream and Wood point, weighted toward oedema, facial swelling and channel obstruction rather than heat. ST-45 Li Dui is the Jing-Well and Metal point at the corner of the second toenail, the more acute and spirit-directed choice. LIV-03 Tai Chong lies one web over, between the first and second toes, and is a Source and Shu-Stream point on a yin channel — a different point with different actions, despite the two being within a finger's width of each other, and the pair the imaging study above used precisely to test whether that difference is real. The extra point group Ba Feng, held here, occupies all four toe webs including the one ST-44 sits behind, but is a local point group for the foot rather than a distal point for the head and digestion.

Source: Sacred Lotus sources & references (name, categories and cross-referenced point records); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 171; Chinese Acupuncture & Moxibustion, p. 156; Nan Jing (Classic of Difficulties), on the five-shu indications; PubMed PMID 23762172, 23591003, 23227682, each checked as active and not retracted; cross-referenced against multiple online sources.