Liver 13: Zhangmen Gate of the System

Liver 13 is the Alarm or ‘Mu’ point for the Spleen. Useful for many problems, especially abdominal.
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Liver 13
Liver 13

Liver 13 is the thirteenth point along the main acupuncture channel of the Liver and is:

 

Location of Liver 13

Zhangmen lies at the tip of the 11th rib, or just inferior and anterior to it.

 

Liver 13 location

 

Needling Liver 13

1/ Perpendicular to the skin. Recommended depth of needle is no more or less than that required to reach the point. In thin people this may be only a quarter of an inch, whereas in fat people it could be two inches or even more. With that in mind, beware of needling too deeply.

The way I reach it is to palpate the point which, if it needs treatment, is usually sensitive if not actually sore, and assess how deeply I have to press the skin inwards to reach it.

Then I insert the needle with the skin pressed inwards on either side of the point, so that the actual depth from the surface of the skin to the point is less.

Once I have deqi, I slowly release the flesh with the other hand and as it springs back to normal I allow it to ride up the sides of the shaft of the needle which I’m keeping stationery so as to remain in contact with the point.

This means that in fat people you must start with a longer needle, otherwise the flesh as it rises will eventually drag the needle’s point away from the point.

2/ Parallel to the rib either medially or laterally, but in this case you must insert the needle from either further forward (if needling laterally) or further back (if needling medially). This increases the difficulty of finding the point, I find.

 

Sensation

Local to the area, but frequently extends across the abdomen, or upwards or downwards, depending on the disharmony being treated.

 

Moxibustion on Zhangmen

Moxa: 5 – 10 cones

 

ACTIONS of Liver 13

  • Regulates interaction between Liver and Spleen
  • Releases Qi stagnation, including that caused by the Liver
  • Harmonises the middle and lower jiao
  • Strengthens the Spleen
 

Regulates interaction between Liver and Spleen

  • That the Spleen Alarm point is on the Liver channel shows how closely together these two zang interact. Moreover, it suggests that most Spleen problems are related to the Liver, or at least that they are in so far as problems exist in the trunk.
  • Abdominal distension
  • Circulation of Qi and Blood
  • Resolves Damp where indicated by TCM for eg ascites
  • Sore ribs, tender even to lie on
  • Cardiac area pain

 

ReleaseQi stagnation, including that caused by the Liver

  • Indigestion
  • Vomiting
  • Enlargement of Spleen and Liver
  • Chest pain
  • Lumps and distension in the chest from stagnant qi
  • Suppressed anger or tendency to get angry too easily
  • Pain in the abdomen from stagnant qi
  • Oesophageal spasm or constrictoin

 

Harmonises the middle and lower jiao where for example in:

  • Enteritis
  • Hepatitis
  • Diarrhoea from cold in middle jiao
  • Hypochondriacal pain
  • Pain on the flanks
  • Pain in the right upper abdomen area and under the right ribs for liver and gallbladder disease. Also in the left upper abdomen area and under the left ribs for stomach and spleen-pancreas conditions.  Use the Liver 13 point on the side of the pain.
  • Its name translates as the ‘Chapter Gate’, or ‘Gate of the System’, or ‘Gate of Order’, which therefore suggests how important to our health is this ability to harmonise the middle and lower jiao.

 

Note: ‘Jiao’ means ‘burning space’ and in Chinese medicine your trunk has three: above the diaphragm, below the diaphragm but above the umbilicus, and below the umbilicus. You could say this means the chest, the upper and the lower abdomen, but the word ‘jiao’ – ‘burning space’ describes not just the place but the activity: it tells you more about the function.

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Strengthens the Spleen

The Spleen is said to be the assembly point for the 5 Zang. I’ve always taken this to mean that it enables the zang organs to function properly. Therefore if all 5 are diseased, this point becomes particularly important.

  • Cold and pain in the lumbar area, causing spasm or rigidity.
  • Chronic Tiredness in the limbs
  • Diarrhoea

 

COMMENT on Liver 13, Zhangmen

Liver 13 is both a Spleen point and a Liver point and can almost be used for either one or the other, as well as both, so often does the desired outcome require the same treatment for both.

Partly because Liver 13 is a meeting or ‘Assembly’ point with the Gallbladder, I’ve used this point for thigh and leg pain, including sciatica (along with other points) when it seemed indicated, such as when the pain was either along the Spleen meridian or the Gallbladder or Liver meridian.

I don’t see why it shouldn’t also be used for shoulder or arm pain along the Lung, Pericardium or Three-heater channels because of those channels’ respective relationships with the Spleen, Liver and Gallbladder.

The name of the point – ‘Gate of the System’ is suggestive. I don’t read or speak Chinese, so hope someone will enlighten me, but the suffix ‘-men’ appears to be the same as that used in the other points with the same suffix, where it is usually translated as a gate, or portal. ‘Zhang’ on the other hand, may be the same as ‘zang’ in which case the point literally becomes the gate of the 5 Zang, making it an enormously important point for harmonising them. Whether this is the case, it certainly does seem to harmonise them.

Cupping this point can be very effective for Liver Wind conditions as well for other excess conditions arising from Liver invading Spleen.

 

What my lecturers told me, and what I do …

Many of my lecturers suggested I always use it with Liver 14 (which is the Alarm or Mu point of the Liver, and a meeting point of the Liver and Spleen channels with the Yin Linking vessel) to strengthen its effect, but I have seldom found this necessary.

Besides, Liver 14 is also the Exit point of the Liver channel, making it a kind of entry point of the Lung channel. Using it might temporarily change the Lung or other pulses, changing the dynamic between all the pulses and reducing the real feedback to me of the outcome of my treatment on Liver 13.

I belong to the minimalist school! I prefer to do the least possible to help the body change positively. If I do too much, I may upset something.

This is a great point for treating irritable bowel pain and for enabling the faeces to move. If someone habitually gets pain of this sort, you can show them where to massage over the point. Do emphasise, however, that such massage will be palliative only unless other points are treated properly after a considered diagnosis in Chinese Medicine.

Don’t self treat with Liver 13!

Please don’t be tempted to use this point on yourself! It can be quite deep on fat people and just under the skin on thin people. In both cases it is easy to go too deep and prick something better left alone. See an acupuncturist!

Click here to get back from Liver 13 to Point Categories

Click to find out more about the Liver in Chinese medicine

For what WESTERN medicine says about the liver, click here!

 

For points along the Liver channel, click below:

Liver-1DadunGreat Clarity
Liver-2XingjianWalk Between
Liver-3TaichongGreat Pouring
Liver-4ZhongfengMiddle Seal
Liver-5LigouWoodworm Groove
Liver-6ZhongduCentral Capital
Liver-7XiguanKnee Joint
Liver-8QuquanSpring at the Bend
Liver-9YinBaoYin Wrapping
Liver-10ZuwuliLeg Five Miles
Liver-11YinlianYin Angle
Liver-12JimaiUrgent Pulse
Liver-13ZhangmenSystem Gate
Liver-14QimenCycle Gate
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