I wrote the following article for a winter issue of the British Acupuncture Council journal. The theme for the winter issue of the journal had the following keywords as its theme:
"Endings – ending a treatment, saying goodbye to a patient, end-of-life care – but also new beginnings – moving practice, big life changes, a new start in life."
“Suddenly I found the inspiration I had been looking for.“
As soon as I read the email from the editor, I immediately went to the bookshelf looking for point names that could somehow relate to the winter season or endings. I browsed for a long time. It was only after I had gone through the entire meridian system that my eyes fell on the very last point of the meridian cycle, Qimen, or as we know it, Liver 14.
Liver 14 or Gan mu?
Something resonated. The name Qimen, or in English, Qi-gate, refers to the point's position as the end of the qi cycle through the 12 regular meridians. Precisely because it is a cycle, the last point in the cycle is a gate and not a dead end. This is the inherent nature of a cycle.
“Just as winter marks the end of the year, winter will precisely thereby create the prelude to the start of a new life cycle.“
The end of a cycle will always precede the beginning of a new cycle. Just as winter marks the end of the year, winter will precisely thereby create the prelude to the start of a new life cycle. Similarly, Liver 14 is the last point in the qi cycle through the 12 meridians, but it is precisely from here that qi travels on and into the Lung meridian to start a new cycle of qi through the 12 meridians.
Already here we can see one of the situations where Liver 14 can be used in practice. Some acupuncturists use Liver 14 as a so-called "exit point". Here, the point will be used to treat symptoms that arise when there are blockages of qi, when qi needs to move from the Liver meridian to the Lung meridian. Typically, there will be symptoms and signs of Liver and Lung imbalances simultaneously.
Ellis, Wiseman and Boss mention Gan Mu as an alternative name for Liver 14[i]. Gan Mu refers to the fact that Liver 14 is the Liver's front-mu point. This means that Liver 14 can be used diagnostically, where visible or palpable changes in and around the point can indicate imbalances in the Liver itself, or it can be used therapeutically for the treatment of imbalances in the Liver.
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How I use Liver 14
Liver 14 is a point that I regularly use in my practice to treat problems caused by Liver qi imbalances. However, I would say that I almost exclusively use Liver 14 for the treatment of shi or excess conditions. I especially use Liver 14 when a stagnation of Liver qi affects one of the other organs that are near the point. In addition to using Liver 14 to regulate Liver qi when it disturbs the functionality of the Lungs, Stomach, or Heart, I also use Liver 14 to regulate and circulate qi in the chest and the upper abdomen. In addition to circulating and regulating qi, I will also use Liver 14 to drain Liver Fire and Liver and Gallbladder Damp-Heat. Precisely because these patterns are shi patterns, I will most often use a draining or dispersing needling technique.
When using these techniques, however, it is extremely important to pay attention to the depth and direction of the needle insertion to avoid the risk of causing a punctured lung.
When I choose to use Liver 14 in my point protocol, it will usually be a consequence of an intellectual analysis of the diagnostic situation or it will be due to how the point feels on palpation. However, I will often also choose to use the point when I can see that there are changes in the appearance of the skin in the area in and around the lower ribs. The skin in this area may be characterized by petechiae (indicating Heat in the Liver) or purplish nevi (indicating Liver qi and xue stagnation). A further decisive factor can be palpable tension in the area in and under the lower ribs.
While Liver 14 is not a point I use as often as Liver 2 or Liver 3, for example, it is a point that is invaluable and irreplaceable in certain situations, especially those described above.
