Category Archives: Planning

The Three Gates of Qimen

In 1988 I travelled to southern California to study Jin Shin Do® Bodymind Acupressure™ with Iona Teeguarden. While there I helped to type the JSD Foundation newsletter and was invited to reply to a letter from a reader enquiring about Iona’s non-standard location of Liver 14. In those early days of my studies and with internet research a thing of the future, I was unable to respond. Here then, 35 years late, is my reply.

Qimen ~ Cycle Gate/Gate of Hope ~ Liver 14

The last point of the Liver meridian is a significant one. Here the Qi completes the cycle of the 12 meridians before flowing through to Lung 1 whence it started. It is a place where Qi can become blocked, causing congestion in the chest, and reflecting stagnation in the Liver organ, or pent-up feelings of frustration and anger. Its location, however, is not straightforward, and I have encountered three different locations that derive from different traditions. What follows is something of a detective story as I try to unravel the historical origins of each location. Please forgive me, reader, for my attention to such arcane detail. It seems my Metal Element is showing through.

Standard Qimen

The standard location in Traditional Chinese Medicine (TCM) of Qimen – Cycle Gate – Liver 14 is in the chest, in the 6th intercostal space and 4 cun lateral to the midline, on what is known as the mammillary line (in line with the nipple). This is the location that is most widely used and became the standard with the codification of acupuncture in China in the 1950s. Here is the location from Peter Deadman’s A Manual of Acupuncture.

Lower Qimen

A minority of practitioners locate Liver 14 much lower, on the border of the ribcage, also on the mammillary line. This location became standard for students of JR Worsley’s Five Element Acupuncture method which became especially widespread in England and the USA. Here is the location from Worsley’s Traditional Chinese Acupuncture Vol 1 which is known affectionately in his community as “the big red book”.

This alternative location has become widely enough known that it is acknowledged by Deadman, and by Jarmey in his Practical Guide to Acupoints, as “Lower Qimen”:

As a keen student of history and of lineage, I had always wondered about the origin of Worsley’s deviation. I found a possible answer earlier this year when I obtained a copy of the book Chinese Acupuncture by the Taiwanese acupuncturist Dr Wu Wei-Ping. Published in 1962, his work was translated into French by Jacques Lavier which was in turn translated into English by Philip Chancellor. It is known that Worsley studied with Wu Wei-Ping in Taiwan. Peter Eckman in his book, In the Footsteps of the Yellow Emperor, shows photos of Worsley with Wu in 1966. Wu’s location is clearly at “Lower Qimen”:

Where did Wu get his alternative location? One possible source is Japan which ruled Taiwan from 1895-1945 and had strong cultural influences over the island. In my searches I discovered at least one Japanese luminary who made use of the lower location. That is Dr Yoshio Manaka (1911-89).

Eckman describes Manaka as having good relationships with many of the Japanese schools of acupuncture but never became identified with any one. He also had numerous contacts among the French and German schools which were being established and he made several teaching trips to Europe. It’s possible that Worsley had direct contact with Manaka. Here is the location from Manaka’s book, Chasing the Dragon’s Tail. (Mislabelled as LV 4)

Acupuncturists of the Worsley lineage consider Lower Qimen to have greater psycho-emotional and spirit associations that are not ascribed to the standard location by TCM practitioners. Indeed, Worsley gave the name Gate of Hope to this lower point rather than the usual translation Cycle Gate. This suggests its power to support a person to face the future with clarity and enthusiasm, alleviating depression caused by stagnation of Liver Qi.

Several years ago, I received an email from Peter Borten, an acupuncturist in Portland, Oregon, in response to my original blog on this point. His comments made an impact on my view of of the two different locations. Peter said,

“As I went first to a TCM school and then a Five Element school under J.R. Worsley, I see the TCM and Five Element locations of this point as having distinctly different energetics. When I’m needling this point for its Five Element “spirit of the point” properties, or to clear an entry-exit block, I always go with the Five Element location at the bottom of the ribcage.”

I now follow this advice in clinic, using Lower Qimen as a “spirit” point and when I detect an entry-exit block between Liver 14 and Lung 1.

One other thing to note before we leave Gate of Hope, is that Worsley-trained acupuncturists often needle Liver 13 (Chapter Gate) and Liver 14 (Gate of Hope) together: a new chapter of life heralds the hope of moving forward.

Inner Qimen

Now we come to the third and most obscure of the three locations, the one that was subject of the letter to the Jin Shin Do Foundation. We might call this “Inner Qimen”. Iona Teeguarden located Liver 14 at the bottom of the ribcage but more medially to the Worsley location. (Number 5 in the JSD system.) In her 1978 book Acupressure Way of Health, she located it on the ribcage at the junction of the ninth rib cartilage to the eighth rib, in a little indentation inside the nipple line. This places it about 1 cun medial and superior to the Lower Qimen. In her later book Joy of Feeling, Teeguarden calls this point Gate of Hope, so clearly there was a Worsley connection.

I used this location for many years until I moved to the standard location in the 6th intercostal space. However, I do return to it from time to time. I find it very helpful in releasing points in the neck. When Small Intestine 16 is not releasing, I will hold it in combination with the opposite “Inner Qimen” and find that usually opens the neck wonderfully.

According to a biography on the Jin Shin Do Foundation website, Iona learned Jin Shin Jytsu with Mary Burmeister who was a student of the founder of that method, Jiro Murai. Iona travelled to Japan in 1976 and studied with Dr Haruki Kato, also a student of Jiro Murai.  She states that “some of the JSJ points were in different locations than I had learned from Mary.” One of Burmeister’s “safety energy locks” (SEL 14) was in the location of Lower Qimen; I infer that this was one of those points which varied and that Inner Qimen is from Kato. The following illustration is from Alice Burmeister’s book The Touch of Healing.

While researching for this blog. I stumbled upon a graphic produced by Shohaku Honma (1904-1962) which shows Liver 14 on the ribcage but clearly more medial to Lower Qimen. I have not seen this location anywhere else, but here it is being used by a famous Japanese acupuncturist with whom Worsley studied. What could be the connection between Teeguarden and Honma? Could it be Kato? As part of his studies, Kato became a licensed acupuncturist so he could have professional and legal standing. Perhaps here is a connection to Honma.

Clinical Implications

Well, dear reader, if you are still with me after this deep dive into history, congratulations! I salute your perseverance.

Let me finish by summarising the clinical implications of these three different locations of Qimen Liver 14, for it is the clinical outcomes that are of greatest importance.

Standard Qimen is the mu point of Liver and so treats acute conditions that relate to the Liver organ. It also treats local congestion in the chest and ribcage. It can have an effect on the emotion of anger which, when out of balance, is stored in the Liver.

Lower Qimen is the Worsley location. It is also a mu point and treats at the physical level. But more significantly it treats psycho-emotional disharmony in the Wood Element and at the level of spirit. It helps lift depression, enabling a person to see clearly the way forward and make plans with hope for the future. It also is useful when there is an entry-exit block between Liver and Lung.

Inner Qimen is a useful alternative for both physical and psycho-emotional issues, for suppressed anger and frustration, for releasing the diaphragm and the associated neck segment.

As in all cases, the point is not on the chart, it is where you feel the Qi.

Staying Flexible

Liver 6 ~ Zhongdu ~ Central Capital

Boy, what a spring it’s been in southern Australia: powerful forces blowing through, upending the calm serenity, unexpected gusts shaking things loose. I’m not just referring to the weather here, though it has been very windy and stormy of late; I’m also talking about the uprising, often jerky energies of the Wood Element that create a surging force, putting pressure upon any of our Wood issues that are unresolved.

I mentioned last time my unexpected gall bladder protestations. In response I’ve begun taking some supplements that cleanse and support the liver and gall bladder, only to find that my dreams have been unusually frequent and vivid. Sleep sometimes feels like a long-running Netflix drama series. This is because the liver houses the hun, spirit of Wood, which organises our dreams at night. Flushing the liver can affect the dream life.

Anger has also been prominent for many people this spring as the rising tide of Wood energy lets us know how balanced is this Wood emotion within us. I’ve had many clients comment on their frustration levels recently. And I’ve noticed that these emotions are spilling over into angry public protests over the Covid lockdowns.

Which brings us to an acupoint that can address some of these issues, the xi-cleft point of the Liver channel: Liver 6, Zhongdu, Central Capital. Its name refers to its location in the centre of the shin bone, to the cleft or hollow in which it is located, and perhaps because the xi-cleft point is where Qi accumulates as does the population of a capital city.

As a xi-cleft point, it is very good for clearing stagnation along the whole length of the Liver channel, starting at the big toe, travelling up the inside of the leg, around the groin, into the abdomen and through the diaphragm before finishing below the breast. It is particularly known for treating acute conditions of the genital area, urinary pain, uterine pain, and lower abdominal pain. It can also address numbness in the hands and feet and emaciation of the legs.

An overarching function of the point is that it spreads and smooths Liver Qi. One of the main functions of the Liver official is to promote smooth flow of blood and Qi throughout the body. Central Capital is a significant point to support this function. One of the ways that stagnant Liver Qi can present is in constant sighing, brought on by tightness in the diaphragm which prevents Liver Qi from ascending. Another point we’ve looked at in the past, Liver 14 in the chest , can be paired with Liver 6 to address this condition.

Zhongdu can also treat stagnation at the psycho-emotional level which might present outwardly as frustration, irritability, anger and judgement of others; or internally as collapse, hopelessness, despair, and judgement and criticism of oneself. For some, there is a flipping back and forth between the two responses. In both scenarios, the Liver Qi is not moving smoothly up the body as it needs to.

One of the major issues that the Wood Element presents us is about how we manage the limits and boundaries we encounter. How we deal with the inevitable roadblocks we meet in life will tell us much about the health of our Wood. When you meet an obstacle to your forward movement, how do you tend to respond? A healthy Wood will be flexible and adapt to changing circumstances. If plan A isn’t working, we look around, make wise assessments, change the plan, and move forward. If you collapse at hurdles or try to crash through them, consider alternatives and work around the barriers. Working with Liver points will support your adaptability and flexibility, and Central Capital can be central to this support.

Location of Liver 6

The point lies 7 cun above the prominence of the inner ankle bone. As there are 15 cun from the knee crease to the ankle on the inside of the lower leg, the point is slightly less than halfway up. It lies on the back border of the tibia bone in a hollow between the tibia and the gastrocnemius muscle.

It makes for a nice pairing with Gall Bladder 36 which we looked at last time. GB 36 is at the same level as Liver 6 but on the outside of the leg.