LIV-13 (Zhang Men) Camphorwood Gate

What does LIV-13 Zhang Men do?

Zhang Men LIV-13 carries two of the most significant classifications in the repertoire at once: it is the Front-Mu (alarm) point of the Spleen, and it is the Hui-Meeting (influential) point of the zang — the yin organs as a group. Sacred Lotus sources & references record both, together with a third designation as a Meeting Point of the Liver and Gallbladder channels. It sits on the Liver channel at the free end of the eleventh rib, and almost everything it does follows from the fact that a Liver-channel point governs the Spleen: this is the point at which the Liver–Spleen relationship is treated directly.

• Fortifies the Spleen and harmonises the middle burner — the Front-Mu action and the defining one. Used for the poor appetite, abdominal distension, loose stools, borborygmus and undigested food the tradition attributes to a Spleen that is not transforming.
• Harmonises the Liver and the Spleen — the pattern in which constrained Liver qi "overacts on" the Spleen, giving distension that comes and goes with mood, alternating bowels, and pain beneath the ribs with digestive upset. LIV-13's position on one channel and service to the other organ makes it the anatomical expression of that pattern.
• Spreads the Liver and regulates qi — for the constrained, stuck, distending presentation: hypochondriac pain, a tight chest, sighing and irritability.
• Regulates the middle and lower burners — the recorded action behind its use in abdominal distension, vomiting, diarrhoea and disorders of urination and water metabolism below the diaphragm.
• Influences the zang organs as a whole — the Hui-Meeting action, and the one that makes LIV-13 more than a Spleen point. Where a treatment addresses the solid organs collectively rather than one of them, this is the point classically reached for.
• Disperses accumulations and masses — the classical use for palpable accumulations beneath the ribs and in the abdomen, and for the hard nodules the classics call scrofula.
• Acts as the Spleen's diagnostic point — as with all Front-Mu points, tenderness or a palpable change at LIV-13 is read as a sign referring to its organ, and the point is palpated as well as needled.

Source: Sacred Lotus sources & references (existing action record; Front-Mu, Hui-Meeting and channel-meeting classifications queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 488); Chinese Acupuncture & Moxibustion (p. 226); cross-referenced against multiple online sources.

What is LIV-13 Zhang Men used for?

Zhang Men LIV-13 is used above all for abdominal distension and the digestive complaints the tradition attributes to a Spleen disturbed by a constrained Liver. The indications carried in Sacred Lotus sources & references are abdominal distension, borborygmus, hypochondriac pain, vomiting, diarrhoea and indigestion; the standard reference literature sets them out more fully as follows. They describe traditional use, not proven treatment, and this point carries the safety facts set out under needling.

• Abdominal distension and fullness
• Borborygmus — rumbling and gurgling of the abdomen
• Pain and distension in the hypochondriac region, beneath and between the lower ribs
• Indigestion and undigested food in the stool
• Poor appetite
• Vomiting
• Diarrhoea, and alternating loose and dry stools
• Fatigue and heaviness of the limbs attributed to Spleen deficiency
• Palpable masses and accumulations in the abdomen
• Jaundice
• Difficult urination and oedema
• Pain of the lower back and inability to turn the trunk
• Scrofula — chains of hard nodules

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 488); Chinese Acupuncture & Moxibustion (p. 226).

Where is LIV-13 Zhang Men, and how is it used in practice?

Zhang Men lies on the side of the trunk at the free end of the eleventh rib — the lower of the two short "floating" ribs that end in the muscle of the flank rather than joining the ribcage in front. Sacred Lotus sources & references place it below that free end, and directly anterior and inferior to the rib tip. A common way of finding it is that the tip of the elbow reaches it when the arm is folded across the chest. It is the thirteenth of the fourteen Liver-channel points, one below Qi Men LIV-14, the last point of the whole twelve-channel circuit.

In practice LIV-13 is used where digestion and emotion are tangled together, which is the presentation its two classifications describe from opposite directions: a Spleen point sitting on the Liver channel. It is very commonly treated with moxibustion, since most of what it is used for is deficiency of the middle burner.

Which points is LIV-13 combined with?

• With Pi Shu BL-20 — the Shu-Mu combination. BL-20, on the back beside the eleventh thoracic vertebra, is the Spleen's Back-Shu point; LIV-13 is its Front-Mu. Front and back of the same organ, treated together, is the oldest structured pairing in the medicine, and our BL-20 record names LIV-13 as its counterpart from the other side.
• With Qi Men LIV-14 — the point immediately above it on the same channel and the Front-Mu of the Liver. The pair covers the Liver-and-Spleen relationship from both of its ends and is the standard local treatment of the lateral costal region.
• With Tai Chong LIV-03 and Zu San Li ST-36 — the Yuan-Source point of the Liver channel and the great point of the Stomach and Spleen. Local point on the flank with distal points on the leg is how the Liver channel is normally treated, and this trio is the standard structure for constrained Liver qi disturbing digestion.
• With Zhong Wan REN-12 — the Front-Mu of the Stomach and the Hui-Meeting point of the fu organs. Pairing the influential point of the yin organs with the influential point of the yang organs is a deliberate and classical construction.
• With San Yin Jiao SP-06 and Yin Ling Quan SP-09 — added where dampness and fluid accumulation dominate.
• The full Shu-Mu set for the three organs of the middle. A controlled study of 90 women with endometriosis used the Shu-Mu combination of Ganshu BL-18, Pishu BL-20, Shenshu BL-23 with Qimen LIV-14, Zhangmen LIV-13 and Jingmen GB-25 — the Back-Shu and Front-Mu pairs of the Liver, Spleen and Kidneys together — against routine needling and against oral danazol (Zhongguo Zhen Jiu 2006;26(12):863–5, PMID 17313008). The same six-point Shu-Mu construction has been used in animal work on uric acid (Zhen Ci Yan Jiu 2021;46(5):411–5, PMID 34085465). Both are named for the combination they illustrate; neither is evidence about this point alone.
• For nodules and scrofula — data-mining of the ancient acupuncture literature on scrofula extracted 314 prescriptions from the classical corpus and found that the core prescription for the chest-and-armpit region comprised Daling P-07, Yang Ling Quan GB-34, Danzhong REN-17, Jianjing GB-21, Waiguan SJ-05, Zhigou SJ-06, Yuanye GB-22 and Zhangmen LIV-13 (Zhongguo Zhen Jiu 2023;43(2):233–8, PMID 36808521). Note that our library codes the Pericardium channel P-07, not PC-07.

Where does LIV-13 sit among the Front-Mu and the Hui-Meeting points?

The Front-Mu or alarm points are the twelve places on the chest, abdomen and flanks where each organ's qi is held to collect. Sacred Lotus sources & references carry the full set: LU-01 Zhong Fu for the Lungs, REN-17 Shan Zhong for the Pericardium, REN-14 Ju Que for the Heart, REN-12 Zhong Wan for the Stomach, LIV-14 Qi Men for the Liver, LIV-13 Zhang Men for the Spleen, GB-24 Ri Yue for the Gall Bladder, GB-25 Jing Men for the Kidneys, REN-05 Shi Men for the San Jiao, REN-04 Guan Yuan for the Small Intestine, REN-03 Zhong Ji for the Bladder and ST-25 Tian Shu for the Large Intestine. LIV-13 is the sharpest illustration of a rule readers routinely get wrong: a Front-Mu point need not sit on its own organ's channel. The Spleen's alarm point is on the Liver channel. Only three of the twelve match their organ's channel — LU-01, GB-24 and LIV-14 — and the other nine, LIV-13 most conspicuously, are assigned by anatomy rather than by channel.

The eight Hui-Meeting or influential points, set out in the Nan Jing, each govern one tissue or category across the whole body rather than one channel. All eight are held in Sacred Lotus sources & references:

• Zang organs — Zhang Men LIV-13. This page.
• Fu organs — Zhong Wan REN-12
• Qi — Shan Zhong REN-17
• Blood — Ge Shu BL-17
• Sinews — Yang Ling Quan GB-34
• Vessels — Tai Yuan LU-09
• Bones — Da Zhu BL-11
• Marrow — Xuan Zhong GB-39

LIV-13 and REN-12 form the natural pair within that set — the yin organs and the yang organs — and they are the two of the eight that are also Front-Mu points, which is why they carry more weight in general internal treatment than the other six.

Source: Sacred Lotus sources & references (location, Front-Mu and Hui-Meeting classifications; the full twelve-point Front-Mu set and the full eight-point Hui-Meeting set queried directly; BL-20 confirmed as the Spleen Back-Shu counterpart); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 488); Chinese Acupuncture & Moxibustion (p. 226); Nan Jing, Difficulty 45; PMID 17313008; PMID 34085465; PMID 36808521; cross-referenced against multiple online sources.

Where is LIV-13 located?

• A Manual of Acupuncture (p. 488): Directly anterior and inferior to the free end of the eleventh rib.
• Chinese Acupuncture and Moxibustion (p. 226): On the lateral side of the abdomen, below the free end of the eleventh rib.

How is LIV-13 Zhang Men needled, and what lies beneath it?

Stated plainly: LIV-13 lies at the free end of the eleventh rib, and what sits deep to that landmark differs by side. On the left the spleen lies beneath the lower ribs; on the right the liver does. The point is also within the band of the trunk in which pneumothorax is the documented complication of needling. This is why every reference text records a shallow depth here, and why the standard cautions name organ enlargement specifically. Everything below is neutral reference data describing what the textbooks and the published literature state. It is not instruction, and this page does not teach technique. Needling is carried out only by a qualified, licensed practitioner.

The angle and depth the texts record

• Sacred Lotus sources & references record perpendicular insertion of 0.5 to 0.8 inch, with moxibustion applicable. That is a bounded figure and an unusually precise one — most points in our records carry a rounder range.
• Deadman & Al-Khafaji (p. 488) and Chinese Acupuncture & Moxibustion (p. 226) record a comparable shallow perpendicular range, with oblique insertion directed posteriorly along the rib margin also recorded, and both attach an explicit caution against deep insertion because of the organs beneath. The recorded caution names enlargement of the spleen or the liver as the circumstance in which the margin narrows, since an enlarged organ extends below the rib margin and closer to the surface.
• For comparison within our own records: 0.5–0.8 inch at LIV-13 sits between the 0.3–0.5 inch held here for LIV-14 directly above it on the chest wall and the 1–1.2 inch held for BL-23 in the lumbar muscle mass. The figures track what is underneath, not the size of the region.
• Moxibustion is recorded as applicable and is heavily associated with this point, since most of what it is used for is deficiency of the middle burner.

The measured anatomy — and an honest statement of its limits

• What has been measured, and what has not. Safe needling depths on the trunk have been quantified by imaging. A computed-tomography study of 120 patients, grouped by weight, height and sex, measured for each commonly used chest point the distance from skin to pleura and defined that as the point's safe depth, finding significant differences between body-size groups (Sheu CY, Lin JG, Zhonghua Yi Xue Za Zhi (Taipei) 1992;50(5):388–99, PMID 1338010). A retrospective study of chest CT in patients aged 4 to 18 measured skin-to-organ depths at chest acupoints and found significant differences by sex at nine of them and highly significant differences across age, weight and body-mass-index groups (Evid Based Complement Alternat Med 2015;2015:126028, PMID 26457105). Neither study measured LIV-13. They are cited for the principle they establish — that depth to a deep structure varies substantially with body build — and no measurement is attributed here to this point that has not been made at it.
• No single agreed safe depth exists for any point. Two systematic reviews of the safe-depth literature — 33 studies in the first, 47 in the second, using MRI, CT, ultrasound and cadaveric dissection — both concluded that depths measured for the same point differ greatly between subject groups and measuring methods, and that the definition of "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).
• Where the organs actually are. The spleen normally lies under the ninth to eleventh ribs on the left, behind the mid-axillary line, and is not palpable unless enlarged. The liver occupies the right upper abdomen under the lower ribs and is the largest solid organ in the body. LIV-13 is at the tip of the eleventh rib, at the lower margin of that span rather than in the middle of it — which is the honest statement, and the reason the reference cautions attach the greatest weight to the enlarged-organ case.

What is documented in the case literature

Liver injury. Direct injury to the liver from an acupuncture needle is documented, though rare. A radiology case report describes acute haemoperitoneum — bleeding into the abdominal cavity — from direct liver injury caused by acupuncture, and states that it was the first such case reported (Seah EZ, J Radiol Case Rep 2023;17(8):15–20, PMID 37654899, PMC10435255). A forensic case report describes death from multiple organ injuries attributed to improper acupuncture practice (Forensic Sci Med Pathol 2026;22(2):463–468, PMID 41582237), and an earlier autopsy report of a sudden death after acupuncture found trivial injuries to the liver and stomach with mild bleeding into the abdominal cavity as incidental findings, the death itself being caused by undiagnosed leukaemia (Am J Forensic Med Pathol 2012;33(1):102–4, PMID 20890170).

Injury through the trunk wall. A retrospective emergency-department series from a tertiary hospital in Seoul over five years recorded 12 mechanical complications of needling in the thoraco-abdominal region: ten pneumothoraces, one with air also in the mediastinum, and two cases of air in the abdominal cavity, one of which required emergency total colectomy. Eight patients needed a chest drain and were admitted for a median of eleven days, and the mean interval between the treatment and arrival at hospital was 1.6 days (Lee HJ et al., Pain Med 2017;18(12):2504–2508, PMID 28431130). Pneumothorax is the second most frequently reported serious adverse event in acupuncture: a systematic review of the Chinese case literature from 1956 to 2010 found 307 pneumothoraces among 1,038 adverse-event cases, attributed chiefly to improper technique (He W et al., J Altern Complement Med 2012;18(10):892–901, PMID 22967282).

What we will not claim. We could not source a published case report naming LIV-13 specifically as the point at which a spleen or liver injury occurred, and none is asserted here. What is recorded instead is what is documented: a bounded shallow depth in every reference text, an explicit caution naming organ enlargement, the anatomical position of the spleen and the liver relative to the eleventh rib, and a published record of liver injury and of pneumothorax and bowel perforation from needling over the trunk.

Risk in proportion. A meta-analysis of prospective clinical studies estimated serious adverse events in acupuncture at approximately 1 per 10,000 patients and around 8 per million treatments, placing it among the safer treatments in medicine (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). The absolute risk is small and it is concentrated at a small number of points over the trunk; LIV-13 is one of them.

Source: Sacred Lotus sources & references (existing needling record); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 488); Chinese Acupuncture & Moxibustion (p. 226); PMID 1338010; PMID 26457105; PMID 21417806; PMID 23935678; PMID 37654899 (PMC10435255); PMID 41582237; PMID 20890170; PMID 28431130; PMID 22967282; PMID 34489268 — each verified resolvable and checked for retraction status before citation.

What does the name Zhang Men mean?

Zhang Men means "Camphorwood Gate" — zhang, the camphor tree, and men, a gate or door. Sacred Lotus sources & references translate it exactly that way. Zhang also carries the sense of a screen, a barrier or something that obstructs, and both readings are used: the camphor tree is large, aromatic and used for building, so a camphorwood gate is a substantial one; and a gate that screens marks a boundary. The point sits at the free end of the eleventh rib, at the boundary between the ribcage and the soft flank — a real anatomical threshold. The name is also read as "Completion Gate" or "System's Door", pointing at the same idea: a passage into the interior. It belongs to a run of men ("gate") names on the trunk that mark transitions, of which Qi Men LIV-14 immediately above it is the next.

Why does a point on the Liver channel govern the Spleen?

This is the question readers arrive at LIV-13 with, and the answer is worth stating clearly. Front-Mu points are assigned by where an organ's qi is held to gather on the body surface — by anatomy — not by which channel runs over that spot. Nine of the twelve Front-Mu points sit on a channel other than their own organ's, and LIV-13 is the clearest case: the Spleen's alarm point lies on the Liver channel, at the tip of the eleventh rib on the left flank, in the region the spleen actually occupies.

That accident of anatomy turned into a piece of theory. Because the Spleen's alarm point sits on the Liver channel, the point became the natural place to treat the relationship between the two organs — the pattern the tradition calls Liver overacting on the Spleen, in which constrained emotion disturbs digestion. A great deal of what LIV-13 is used for in modern practice is that single pattern. The point's second classification reinforces it: as Hui-Meeting point of the zang, LIV-13 is held to influence all five yin organs, so it is reached for wherever the interior organs are being addressed as a system rather than singly.

Is there research on LIV-13 Zhang Men?

The honest answer is that LIV-13 has almost no research isolating it, and what exists tests combinations in which it is one component. That should be said plainly rather than dressed up.

• A placebo-controlled trial that used LIV-13 for its Hui-Meeting classification. One hundred women with iron-deficiency anaemia were randomised to needling at GB-39, BL-17 and LR-13 for 30 minutes daily for two weeks, or to needling at non-acupuncture points. Haemoglobin rose from 10.39 to 11.38 g/dl in the acupuncture group against 10.58 to 10.40 g/dl in the control (P < 0.001), with changes also in mean corpuscular haemoglobin and red cell distribution width (Devi KG et al., J Acupunct Meridian Stud 2023;16(6):263–267, PMID 38115592). The point selection is a pure Hui-Meeting construction — marrow (GB-39), blood (BL-17) and the yin organs (LIV-13) — which makes it an unusually direct test of the classification, but it is a three-point protocol, so nothing in it is attributable to LIV-13 alone.
• Shu-Mu combination studies. The controlled endometriosis study of 90 women (PMID 17313008) and the animal uric-acid work (PMID 34085465) both used LIV-13 paired with BL-20 inside a six-point Back-Shu-with-Front-Mu construction. They demonstrate how the point is used, not what it does by itself.
• Classical-literature data mining. The analysis of 314 ancient prescriptions for scrofula found Zhangmen LIV-13 in the core prescription for the chest-and-armpit region (PMID 36808521). This is evidence about the historical record rather than about clinical effect, and it is worth having for exactly that reason: it confirms that the scrofula indication our own record carries is genuinely classical.

What is missing: there is no randomised trial of LIV-13 alone, no sham-controlled study of it, and none of its digestive indications has been tested at this point specifically. Where a reader encounters strong claims about this point, they rest on classical authority and clinical tradition, not on trial evidence.

How does LIV-13 compare with the points around it?

Qi Men LIV-14 lies just above it on the same channel in the sixth intercostal space, is the Front-Mu of the Liver, and is the last point of the twelve-channel circuit; where LIV-13 leans toward the Spleen and the middle burner, LIV-14 leans toward the Liver, the chest and the emotions, and the two are routinely used together. Pi Shu BL-20 on the back at T11 is LIV-13's Back-Shu counterpart and its constant partner. Jing Men GB-25 sits behind and below on the flank at the free end of the twelfth rib — one rib down, and the Kidneys' Front-Mu point; the two floating-rib tips carry the two most counter-intuitive Front-Mu assignments in the set, and confusing them is the commonest error in this region. Dai Mai GB-26 lies below LIV-13 on the same vertical line and is the point of the Girdling Vessel. Zhong Wan REN-12 on the front midline is its opposite number among the Hui-Meeting points, governing the yang organs where LIV-13 governs the yin. And Tai Bai SP-03 at the foot is the Spleen channel's own Yuan-Source point — the distal Spleen point to LIV-13's proximal one, for readers looking for a Spleen point that is actually on the Spleen channel.

Source: Sacred Lotus sources & references (name, translation, Front-Mu and Hui-Meeting classifications, and the neighbouring point records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture (p. 488); Chinese Acupuncture & Moxibustion (p. 226); Nan Jing, Difficulty 45; PMID 38115592; PMID 17313008; PMID 34085465; PMID 36808521 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.