LIV-05 (Li Gou) Woodworm Canal

What does LIV-05 Li Gou do?

Li Gou LIV-05 is the Luo-Connecting point of the Liver channel, and its recorded work is to spread the Liver, regulate qi and benefit the genitals, to clear damp and heat from the lower jiao, to regulate menstruation and to treat plumstone qi. Sacred Lotus sources & references record those four actions and that classification directly. Two things follow from the classification. A Connecting point is where a channel sends a branch across to its paired partner — here from the Liver to the Gall Bladder — so LIV-05 can address both channels from one place. And because the Liver channel's own course curves around the external genitalia, this is the point on the lower leg through which that region is most directly reached.

• Spreads the Liver, regulates qi and benefits the genitals — the first and defining action, and the one that separates this point from every other on the channel. The Liver channel of Foot Jue Yin runs up the inside of the leg, passes through the genital region and encircles the external genitalia before continuing to the abdomen. LIV-05 is the Connecting point on that channel, and genital complaints — itching, pain, swelling, hernia and dragging pain in the groin — are its signature territory.
• Clears damp and heat from the lower jiao — the "lower burner", the pelvic compartment. This is the recorded basis for the point's use in genital itching and abnormal vaginal discharge, both of which our own indication record carries, and for painful, burning or turbid urination. Damp-heat sinking into the lower body is one of the tradition's central patterns, and LIV-05 is one of the small number of points named for it on the Liver channel.
• Regulates menstruation — the third recorded action, following from the Liver's classical role in storing and moving the blood. Irregular periods are carried in our own indication record for this point.
• Treats plumstone qi — the fourth recorded action, and the one that will be unfamiliar. Plumstone qi (mei he qi) is the classical name for the persistent sensation of a lump or obstruction in the throat that cannot be swallowed away and is not found on examination. The tradition attributes it to qi constraint with phlegm, and constrained qi is the Liver's own pathology. That a point on the shin should be named for a sensation in the throat is characteristic of how the Connecting points work: the Liver channel's own course reaches the throat, and the Connecting point acts along the whole of it.
• Connects to the Gall Bladder channel — recorded in the classification rather than as a separate action, but it is the mechanism behind the rest. The Liver and Gall Bladder are interior-exterior partners, and the Connecting point is the crossing place between them.

What the classical Connecting-vessel description adds. The Ling Shu's account of the fifteen Connecting vessels gives each one a pair of disorders — one for excess and one for deficiency — and the Liver's is unusually specific: repletion of the Liver's Connecting vessel produces prolonged erection, while depletion produces intense itching. Both belong to the genital region, and both are recognisable in this point's surviving indication list.

Source: Sacred Lotus sources & references (existing action record, reformatted here as a list; channel confirmed as the Liver Channel of Foot Jue Yin and the Luo (Connecting) Point classification queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 482); Chinese Acupuncture & Moxibustion (p. 223); Ling Shu (Spiritual Pivot), on the fifteen Connecting vessels; cross-referenced against multiple online sources.

What is LIV-05 Li Gou used for?

Li Gou LIV-05 is used above all for genital itching and genital complaints, for abnormal vaginal discharge and urinary difficulty, for irregular menstruation, and for the sensation of a lump in the throat the tradition calls plumstone qi. The indications below are those carried in Sacred Lotus sources & references together with those set out in the standard reference literature. They describe traditional use, not proven treatment. This is a low-hazard point, for the reasons set out under needling.

• Itching of the genitals — the point's signature indication
• Pain and swelling of the external genitalia
• Hernia and dragging pain in the groin
• Retention of urine and difficulty passing urine
• Bed-wetting and urinary incontinence
• Abnormal or profuse vaginal discharge
• Irregular menstruation
• Lower abdominal pain and distension
• Plumstone qi — a persistent sensation of a lump in the throat
• Prolonged erection
• Depression, irritability and constrained mood
• Weakness, wasting and atrophy of the leg
• Pain and coldness along the inner side of the lower leg
• Fear, fright and palpitations, as recorded in the classical literature for this Connecting point

Where LIV-05's indications overlap with the points around it, and where they do not. Genital itching and damp-heat in the lower burner are shared with San Yin Jiao SP-06, the Three Yin Intersection held here as a Meeting Point of the Spleen, Liver and Kidney channels, and with Yin Ling Quan SP-09, the Spleen's He-Sea and Water point and the tradition's principal damp-draining point — both queried. What LIV-05 adds that neither of those carries is the channel relationship: it is the Liver channel's own Connecting point, and the Liver channel is the one that encircles the genitals. That is why it appears in genital and lower-burner prescriptions even where a Spleen point is doing the damp-clearing.

Source: Sacred Lotus sources & references (existing indication record, reformatted here as a list; the SP-06 and SP-09 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 482); Chinese Acupuncture & Moxibustion (p. 223); cross-referenced against multiple online sources.

Where is LIV-05 Li Gou, and how is it used in practice?

Li Gou lies on the inner side of the lower leg, five cun above the tip of the inner ankle bone, on the flat surface of the shin bone. In our own words: find the bony knob on the inside of the ankle, measure about a third of the way up the lower leg toward the knee, and settle on the smooth flat face of the shin bone on its inner side. It is one of the easiest points on the body to locate, because the whole medial surface of the tibia lies directly under the skin with no muscle over it — the bone is right there under the fingertip.

Our two location records differ slightly and both are kept. The Chinese Acupuncture & Moxibustion record held here places the point "on the midline of the medial surface of the tibia" — that is, on the flat face of the bone itself. The Deadman & Al-Khafaji record places it "immediately posterior to the medial crest of the tibia, in the depression between the medial crest of the tibia and the gastrocnemius muscle" — that is, just behind the sharp front edge of the shin, in the hollow where the flat bone gives way to the calf. The two descriptions bracket a narrow strip perhaps a finger's breadth wide, and the difference is a real one in the literature rather than an error by either source. Neither location record has been altered. Both agree on the level — five cun above the tip of the inner ankle bone — and both place the point on the subcutaneous inner face of the shin, which is what governs the needling record.

Which points is LIV-05 combined with?

• With Qiu Xu GB-40 — the Yuan-Source point of the Gall Bladder channel, queried here. This is the classical Yuan-Luo combination for the Liver: a channel's Connecting point paired with the Source point of its partner channel. It is the structure that makes the Connecting classification useful rather than decorative, and it works in both directions — conversely Guang Ming GB-37, the Gall Bladder's Connecting point, pairs with Tai Chong LIV-03, the Liver's Source point. Both of those records are held here and set out the same rule from their own side.
• With Tai Chong LIV-03 — the Liver channel's own Yuan-Source point on the foot, a Shu-Stream and Earth point and a Ma Dan-yang Heavenly Star Point, queried here. Needling a channel's Source and Connecting points together is the everyday same-channel pairing, and LIV-03 with LIV-05 is among the commonest of them: LIV-03 for the Liver as an organ and for constrained qi, LIV-05 for the channel's course through the genitals.
• With San Yin Jiao SP-06 and Yin Ling Quan SP-09 — for genital itching, abnormal discharge and damp-heat in the lower burner. Both are on the same inner lower leg within a hand's breadth of LIV-05, and both are held here.
• With Qu Gu REN-02 and Zhong Ji REN-03 — the local points on the lower midline, held here. REN-02 is classified in our own records as a Meeting Point of the Conception Vessel with the Liver Channel and REN-03 as a Meeting Point with the Spleen, Liver and Kidney channels — so the distal Liver point and the local midline points are joined by the same channel reasoning, not merely by proximity.
• With Qu Quan LIV-08 and Zhong Feng LIV-04 — its immediate neighbours on the channel, both queried. LIV-08 is the Liver's He-Sea and Water point at the knee and, because Water is the mother of Wood, the channel's tonification point; LIV-04 is the Jing-River and Metal point at the ankle.
• For eczema and stubborn itching of the skin — a randomised trial in chronic eczema of the "blood deficiency stirring wind" pattern used bilateral BL-62, SI-03, SP-09, LI-11, Ligou LR-05, SP-06 and SP-10 against a topical steroid, and reported greater reductions in eczema severity, itch score and quality-of-life score in the acupuncture arm, with no difference in relapse at follow-up (Zhongguo Zhen Jiu 2025;45(11):1582–1586, PMID 41261543). It is a seven-point protocol in 48 patients, so nothing in it belongs to LIV-05 alone; it is cited because it shows the point in a modern itching prescription, which is its classical territory.

Why does LIV-05 become tender, and what has been measured?

Two studies have examined this point as a place the body reports something, rather than as a place to needle — and both found it reactive. This is unusual: most points have no measurement of any kind attached to them.

• In dysmenorrhoea. Thirty-five women with primary period pain, 34 with secondary period pain and 35 healthy controls had the lower-leg segments of the Spleen, Liver and Kidney channels examined by pressure for palpable changes — cords, nodules and depressions — and for tenderness scored on a visual analogue scale. Positive findings clustered at SP-09, SP-08 and SP-06 on the Spleen channel and at Xi Guan LIV-07 and Li Gou LIV-05 on the Liver channel. The rate of positive findings, tenderness and pain score at LIV-05 was significantly higher in the secondary group than in the primary group (Zhen Ci Yan Jiu 2023;48(7):686–93, PMID 37518963). The Spleen channel reacted most often overall; the point is that LIV-05 discriminated between the two kinds of period pain.
• In chronic prostatitis. Thirty-two men with type-III chronic prostatitis and 30 healthy men had the same three channels examined by palpation and by tenderness meter. Positive reaction rates at SP-06, SP-09, KI-03, Ligou LR-05, SP-08, LIV-08, SP-05 and LIV-04 were all significantly higher in the patients, and tenderness thresholds along the three channels were lower (Zhongguo Zhen Jiu 2022;42(10):1131–5, PMID 37199204). Every one of those points is held in this library.

Neither study tested treating the point. What they establish is narrower and more interesting: that in two conditions of the lower burner, LIV-05 is among the sites at which the body's surface changes measurably — which is the empirical shadow of what the tradition means when it says a channel reflects its organ.

Source: Sacred Lotus sources & references (both location records; existing use record; the GB-37, GB-40, LIV-03, LIV-04, LIV-07, LIV-08, SP-05, SP-06, SP-08, SP-09, SP-10, KI-03, REN-02, REN-03, BL-62, SI-03 and LI-11 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 482); Chinese Acupuncture & Moxibustion (p. 223); PMID 41261543; PMID 37518963; PMID 37199204 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.

Where is LIV-05 located?

• A Manual of Acupuncture (p. 482): 5 cun above the prominence of the medial malleolus, immediately posterior to the medial crest of the tibia, in the depression between the medial crest of the tibia and the gastrocnemius muscle.
• Chinese Acupuncture and Moxibustion (p. 223): 5 cun above the tip of the medial malleolus, on the midline of the medial surface of the tibia.

How is LIV-05 Li Gou needled, and is it a hazardous point?

Stated plainly: LIV-05 is a low-hazard point, and the anatomy is unusually simple. It lies on the flat inner face of the shin bone, where the tibia is covered by nothing but skin — no muscle, no cavity, no organ, no great vessel. That is why our own record specifies subcutaneous insertion of 0.3 to 0.5 inch rather than a perpendicular depth: at this point there is essentially nothing to go into. A needle here travels under the skin along the surface of a bone. Everything below is recorded as neutral reference data describing what the textbooks and the published literature state. It is not instruction, this page does not teach technique, and needling is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record subcutaneous insertion of 0.3 to 0.5 inch, with moxibustion applicable. The word "subcutaneous" is the substance of that record, not a stylistic choice — it describes a needle laid along beneath the skin rather than driven into tissue, and it is prescribed by the anatomy rather than by any hazard.
• Deadman & Al-Khafaji (p. 482) and Chinese Acupuncture & Moxibustion (p. 223) record comparable transverse or oblique insertion along the medial surface of the tibia, in a similar range. Neither attaches a hazard caution of the kind both attach to the thoracic, abdominal, orbital and occipital points.
• Why the depth is small here and larger elsewhere on the same leg. Queried directly, our records give 1 to 1.5 cun perpendicular at the extra points on the front and outer calf, where thick muscle covers the bone. At LIV-05 there is no such muscle. Depth figures in this literature track the structure underneath, and here the structure is bone at almost zero depth.
• Moxibustion is recorded as applicable and is common at this point, particularly where the lower leg is cold or the complaint is one of depletion. The thin covering that limits needling depth is the same thing that makes the point convenient for heat.

What actually lies beneath

• The tibia. The inner face of the shin bone is one of the few large areas of the skeleton that lies directly under the skin. There is no muscle belly between skin and bone on that surface, which is why the shin bruises so easily and why a knock there hurts as it does. A needle at LIV-05 has bone immediately beneath it at every angle.
• The great saphenous vein is the one structure of consequence in this territory. It is the long superficial vein that runs up the inside of the leg from the ankle, and it lies in the fat just under the skin on this surface — the same layer a subcutaneous needle occupies. Bruising is the expected consequence of catching it, not injury, and bruising at leg points is among the most commonly recorded acupuncture events of any kind.
• The saphenous nerve accompanies that vein and supplies sensation to the skin of the inner leg. A sudden electric or radiating sensation is a recognised warning of direct needle contact with a nerve rather than a sign of correct technique: a review tracing the history of the recognised needling sensations concluded that the electric shock is caused by the needle entering a nerve and should be treated as a warning of possible peripheral nerve injury (Guo Y et al., Neural Plast 2020;2020:8834573, PMID 33204248, PMC7655260).
• There is no body cavity, no lung and no internal organ anywhere near this point. The hazards that govern the points of the thorax, the upper back and the abdomen simply do not arise on the inner shin. Compare the record held here for Da Bao SP-21 on the lateral chest wall, where pneumothorax is the documented hazard and the recorded depth is bounded because of it; nothing of that kind applies here.
• No imaging or cadaveric study measuring a safe depth at LIV-05 could be located, and none is required in the way it is over the trunk: the depth is limited by bone at the surface. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second, by MRI, CT, ultrasound and cadaveric dissection — both concluded that measured depths for the same point vary greatly and that "safe depth" has never been standardised (J Altern Complement Med 2011;17(3):199–206, PMID 21417806; Evid Based Complement Alternat Med 2013;2013:740508, PMID 23935678). Neither reports a figure for this point.

What the literature documents here

• The ordinary events are minor. Bruising over the shin, brief local soreness and occasional bleeding are what the reference literature records at points of this kind. A meta-analysis of prospective clinical studies found that about half of all recorded acupuncture adverse events across the whole repertoire were bleeding, pain or flare at the needle site, and estimated serious adverse events at approximately 1 per 10,000 patients and around 8 per million treatments (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268).
• Where the serious events actually occur. Systematic reviews of the Chinese case literature find them concentrated at points over the chest, the abdomen, the neck and the orbit, attributed chiefly to improper technique (He W et al., PMID 22967282; Zhang J et al., Bull World Health Organ 2010;88(12):915–921C, PMID 21124716, PMC2995190). LIV-05 is not in that group.
• Honest limit. We could not source any published case report of injury at LIV-05, and none is asserted. Where a point is genuinely low-hazard the useful thing is to say so plainly rather than import a warning from elsewhere.

Source: Sacred Lotus sources & references (existing needling record; both location records; the SP-21 record and the extra-point leg records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 482); Chinese Acupuncture & Moxibustion (p. 223); PMID 33204248 (PMC7655260); PMID 21417806; PMID 23935678; PMID 34489268; PMID 22967282; PMID 21124716 (PMC2995190) — each verified resolvable and checked for retraction status before citation.

What does the name Li Gou mean?

Li Gou means "Woodworm Canal" — li, a wood-boring insect or the channel it eats through timber, and gou, a ditch, groove or canal. Sacred Lotus sources & references translate it exactly that way; it is also met as "Insect Ditch" and "Termite Ditch". The image is worth unpacking, because it is doing two things at once.

The first is anatomical. The point lies in the long shallow groove on the inner side of the shin, where the flat face of the bone meets the soft flesh of the calf — a channel running the length of the leg, like the tunnel a boring insect leaves behind it in wood. The second is a pun on the channel itself. The Liver belongs to the Wood phase in five-element theory, so a "woodworm" on the Liver channel is a worm in the Liver's own element. And the sensation the point is most used for — persistent, maddening genital itching — is exactly what a burrowing insect suggests. Classical point names often carry a location, an element and an indication in three syllables, and this is one of the clearer examples.

What is a Luo-Connecting point, and what does it mean that LIV-05 is one?

A Connecting point is where a channel sends a branch across to its interior-exterior partner, so that one needle can reach both. Each of the twelve regular channels has one, and there are fifteen in total. Sacred Lotus sources & references hold the complete set, queried directly: the twelve channel Luo points — LU-07 Lie Que, LI-06 Pian Li, ST-40 Feng Long, SP-04 Gong Sun, HT-05 Tong Li, SI-07 Zhi Zheng, BL-58 Fei Yang, KI-04 Da Zhong, P-06 Nei Guan, SJ-05 Wai Guan, GB-37 Guang Ming and LIV-05 Li Gou — together with REN-15 Jiu Wei, the Connecting point of the Conception Vessel, DU-01 Chang Qiang, the Connecting point of the Governing Vessel, and SP-21 Da Bao, the Great Connecting point of the Spleen. Four of the twelve — LU-07, P-06, SJ-05 and SP-04 — also carry a Confluent-point classification for an extraordinary vessel. LIV-05 does not; it is a Connecting point and nothing else, which makes it one of the cleaner illustrations of what the classification does on its own.

Each of the twelve is paired in use with the Source point of its partner channel, a structure called the Yuan-Luo combination. For LIV-05 the partner is Qiu Xu GB-40, the Source point of the Gall Bladder — queried here. Conversely GB-37 Guang Ming, the Gall Bladder's Connecting point, pairs with Tai Chong LIV-03, the Source point of the Liver. Reading those two pairs side by side is the clearest way to see how the structure works, and both records are held here.

One distinction worth keeping straight. LIV-03 Tai Chong is the Liver's own Source point, and needling LIV-03 with LIV-05 is a same-channel Source-and-Connecting pairing — extremely common in practice, and a different structure from the cross-channel Yuan-Luo combination described above. Both pairings are legitimate and both are used; they are simply not the same thing, and the classical Yuan-Luo rule is the cross-channel one.

How is LIV-05 different from the points around it?

Queried directly from our own records, the Liver channel's lower-leg run is: Tai Chong LIV-03 on the foot, the Yuan-Source point, a Shu-Stream and Earth point and a Ma Dan-yang Heavenly Star Point; Zhong Feng LIV-04 at the ankle, the Jing-River and Metal point; Li Gou LIV-05, the Connecting point, five cun above the inner ankle bone; Zhong Du LIV-06, the Cleft point, two cun higher on the same surface; Xi Guan LIV-07 below the knee; and Qu Quan LIV-08 at the knee, the He-Sea and Water point and — because Water is the mother of Wood — this channel's tonification point. The two that are most easily confused are LIV-05 and LIV-06, because they sit on the same flat face of the shin two cun apart and neither has an obvious landmark of its own. The difference is functional and clean: LIV-05 is the Connecting point, used for chronic complaints of the genitals and the lower burner and for reaching the Gall Bladder channel; LIV-06 is the Cleft point, and Cleft points are classically the choice for acute and painful conditions and, on yin channels, for bleeding. Chronic and connecting below, acute and blood above.

Is there research on LIV-05 Li Gou?

There is a small point-specific literature — and the most rigorous piece of it is a negative result, which is worth reporting in full rather than passing over.

• The trial in which LIV-05 was the whole treatment — and did not beat the alternative. Fifty-seven patients with cervical spondylosis were treated with acupuncture at Ligou LR-05 plus movement therapy and compared with 65 patients of the same disease types treated with conventional acupuncture over the same period. Cure rates were 52.6 per cent against 46.2 per cent and total effective rates 98.2 per cent against 96.9 per cent, and the difference between the groups was not statistically significant. The authors' conclusion was that the two approaches were similarly effective, with the single-point approach requiring a shorter course and fewer points (J Tradit Chin Med 2010;30(2):113–7, PMID 20653167). Two things are true at once here: a single distal point on the shin performed no worse than a full conventional prescription for a neck condition, and the study did not show it performed better. The design has real limits — the comparison group was assembled in parallel rather than by randomisation, and there was no sham arm. It is nonetheless one of very few studies in which this point is the variable, and it is cited for what it actually found.
• The point as a diagnostic site. The two channel-examination studies described under how the point is used — in primary and secondary period pain (PMID 37518963) and in type-III chronic prostatitis (PMID 37199204) — both found LIV-05 significantly more reactive in patients than in controls, and the first found it discriminated between two kinds of period pain. These measure the point rather than treat it, and that is precisely why they are useful.
• Where it appears in protocols without being isolated. A randomised trial of electroacupuncture at four Liver-channel points — LIV-03, LIV-05, LIV-08 and LIV-12, all held here — against hormone therapy in 62 women with diminished ovarian reserve reported comparable overall effectiveness, with better anxiety and depression scores in the acupuncture arm (Zhongguo Zhen Jiu 2024;44(11):1261–6, PMID 39532442). The chronic-eczema trial described under uses (PMID 41261543) is a seven-point protocol. A short clinical report describes finger pressure at Ligou LR-05 combined with exercise for low back pain (Zhongguo Zhen Jiu 2013;33(2):155, PMID 23620946), and an older paper sets out clinical experience in applying the point (J Tradit Chin Med 2009;29(2):104–6, PMID 19663095); neither is a controlled study and no abstract is indexed for either.
• What is not here, and it matters. There is no controlled trial of LIV-05 for genital itching, for damp-heat in the lower burner, for abnormal vaginal discharge or for plumstone qi — that is, for any of the indications the point is actually known for. The one trial that isolates it tested it on a neck condition. That gap is worth naming plainly rather than filling with protocol studies in which the point happens to appear.
• What was discarded. A bare search on the syllables "Ligou" returns a plant-pathology paper on a fungal disease of bagged apples, a structural-biology paper on a kinase, and two French cardiology papers from 1994 — none of which concerns this point or any acupoint. They were read and rejected rather than counted, and they are mentioned because the same false hits will meet anyone searching this point by name.

Source: Sacred Lotus sources & references (name, translation, channel and Luo (Connecting) Point classification queried directly; the complete fifteen-point Connecting set queried directly; the LIV-03, LIV-04, LIV-06, LIV-07, LIV-08, LIV-12 and GB-40 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 482); Chinese Acupuncture & Moxibustion (p. 223); Ling Shu (Spiritual Pivot), on the fifteen Connecting vessels; PMID 20653167; PMID 37518963; PMID 37199204; PMID 39532442; PMID 41261543; PMID 23620946; PMID 19663095 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.