The Chinese name for Liver 5, Li Gou, translates into English as “Woodworm Channel” or “Woodworm Ditch”. It can be further translated into Danish as “Træorm grøft” or “Træorm rille”.
Liver 5 is not a point that I constantly use, but it is a point that I regularly use. By regularly, I mean that Liver 5 is a point I use three or four times a week, rather than three or four times a day.
The difference between Liver 3 & Liver 5
“Liver 5 suffers the fate of being a point often overshadowed by many acupuncturists’ favorite point, Liver 3.”
This is clearly seen when I supervise students or discuss cases with colleagues. For many, Liver 3 is “the point” for treating stagnant Liver qi or stagnant Liver xue. However, many times they could just as well have chosen to use Liver 5 instead. If we look at the actions and indications attributed to Liver 3 and Liver 5, there is indeed a significant overlap.
Both Liver 3 and Liver 5 are important points for dispersing and regulating Liver qi – and thereby qi generally in the body. However, there are still differences between the two points. These differences will make one point more suitable than the other in specific situations.
The essential differences
Firstly, Liver 3 is a yuan-source point, and Liver 5 is a luo-connecting point. The difference in point categories will in itself affect the situations where I might choose one point over the other. The difference will also affect the way I stimulate the point. For example, with Liver 3, I not only use needling techniques to move Liver qi and xue, but precisely because Liver 3 is a yuan-source point, I will often use reinforcing needling techniques. I will do this to nourish Liver yin and Liver xue. However, Liver 5 is a point that I will almost always use either an even or a draining needling technique on. I will do this because my purpose with stimulating Liver 5 will either be to regulate qi, move stagnant qi, or to drain Damp-Heat from the lower jiao or from the genitals, an area of the body that Liver 5 has a special relationship with.
Another significant difference between the two points is that Liver 5 is physically more proximal than Liver 3. The points' relative positions on the meridian will influence where on the meridian their effect will be most pronounced. While the more distal Liver 3 is more often used for problems affecting the head and eyes, Liver 5 will have less effect here because it is more proximal. Instead, Liver 5 is more relevant for treating the groin, genitals, and for treating qi stagnation in the throat, the not-so-uncommon “plum-pit qi”. Liver 3 can of course also be used in these situations, but Liver 5 will, all else being equal, be more obvious. Overall, Liver 5 has a special relationship to the groin and genitals, not only because it is more proximal than Liver 3, but especially because Liver 5 is where the Liver's luo-connecting vessel originates. Both points are often used for treating emotional disorders, but again there are differences between the two points.
Personal preference
Personally, I use Liver 3 more to release stagnant qi that inhibits the movement of Shen and Hun, while I find that Liver 5 can both move Liver qi, but is also more calming, especially when Hun and Shen are agitated or restless. Again, this differentiation is far from unambiguous, and there are many situations where I would choose the opposite, but for me, this differentiation is a guideline. Finally, Liver 3 also calms Liver yang and internal wind, something I do not use Liver 5 for.
A technique one can use when choosing between points that largely have similar actions is to palpate the points and choose the point that is most tender or active. Unfortunately, my experience is that Liver 3 is often tender in most patients, when there is also tenderness or meridian changes present at Liver 5.
A guideline and compass
Liver 5 can in some ways be a challenging point for some, as different books have slightly inconsistent descriptions of the point's precise location. Although all books locate Liver 5 as being 5 cun above the inner ankle bone, some sources describe Liver 5 as being on the shin itself, while most books I have read locate the point right next to the bone, in the depression between the shin bone and the calf muscle. In practice, I find this point, as I do with all points, by lightly gliding my fingertip over the surface of the skin, to feel for physical and energetic changes in the area.
My understanding is that acupuncture points are dynamic, and descriptions of point locations are merely guidelines. The descriptions in the point books tell one where in the body's landscape one expects to find the point, but the exact localization of the point will depend on the individual itself and on how the person's qi moves through the body's superficial structures. Usually, palpating the skin in this way results in me finding Liver 5 in the depression behind the bone.
This location also best fits Nigel Wiseman's alternative explanations for the point's characters Li and Gou. Although the standard translation of Li Gou is “Woodworm Ditch”, the term Li can also be translated as “ladle”. Wiseman says that this may indicate that the point is found in the depression or in the “ladle” between the muscle and the bone. Another translation Wiseman gives for Li is “calabash”, which he relates to the shape of the gastrocnemius muscle, and that the point is located in the gou, i.e., the ditch between the muscle and the bone. There is general agreement in most books that the standard interpretation of Li Gou as Woodworm Ditch or Woodworm Channel in English, relates to the fact that Liver 5 is a luo-connecting point that connects two Wood meridians.
A versatile point
“I find Liver 5 to be a very effective point for treating many ailments and problems”
In addition to being a useful point in treating patients, Liver 5 is also useful when diagnosing. The late Professor Wang specifies that when palpating the Liver meridian and feeling nodules or tenderness at Liver 5, it can be an indication of menstrual irregularities or qi and xue stagnations along the meridian's course, often in the groin, as well as problems in the hand's Jueyin meridian (Pericardium meridian). The latter could for example be carpal tunnel syndrome. Later in the book, Professor Wang also recommends the use of Liver 5 for the treatment of herpes zoster, testicular pain, metritis, and vaginal discharge. This is certainly confirmed by my own experience using the point. I find Liver 5 to be a very effective point for treating many ailments and problems in and around the genitals, especially fungal infections, vaginismus and vulvodynia, as well as testicular pain and testicular swelling in men.
