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Female Case Study: Wood Element

The Liver Meridian Pathway

ďBeginning by the inside of the big toenail, the liver channel crosses the top of the foot, passes in front of the inside ankle and up the inner aspect of the leg through SP-6 close behind the edge of the bone. It continues past the knee along the inner thigh to the groin and pubic region, where it circulates the external genitals. It connects with the conception vessel in the lower abdomen and continues up around the stomach to enter both the liver and gallbladder. Connecting with two surface points on the ribs, the channel then dips into the ribcage, runs up through the throat, opening to the eye, and ends at the crown of the head where it connects with the governing vessel. A branch circles the mouth.

Internal Trajectories:

The liver meridian rises up the medial sides of the legs from the big toes.

[It then] comes into the yin organs [sexual organs] and circles around the yin organs. Then it passes through the small abdomen; then up to and surrounding the stomach; then it permeates the liver. and spirally wraps the gallbladder. It comes up and passes through the diaphragm, up the sides of the ribs, up behind the trachea, to behind the throat. Then it rises up the cheeks, comes into the eyes, passes up the forehead and meets the du mai at the top of the head. . . . A branch separates from the liver, passes up through the diaphragm and goes to the lungsĒ2

Case History:
This client comes for a treatment due to her being a migraine sufferer. While preparing her feet for a treatment and doing general observations, you note that her big toes are turning upwards, the 4th toes have an abnormal shape and her spine reflex is very curvy.  All her toes look like ďclawsĒ, and most of the skin on her heels is cracked.  Her clothing is mostly green and she speaks with a high pitched voice.  She is generally displeased with her life and her family members.

List the type of questions you will ask the client as well as the answers

Q Have you had any gallbladder or liver disorders such as gallstones, inability to digest fats properly, ie indigestion after eating a fatty meal, or do you suffer from gout, or had jaundice, or hepatitis?
A Yes, I have had gallstones removed and I donít digest rich meals very well.

Q Do you have any digestive complaints?
A  I sometimes get heartburn and acid reflux.

Q  At what time, and where about on your head to you get your migraines?
A I get my migraines mainly late, before going to bed and they are located on my temples, or after I have eaten chocolate or something rich.

Q Do you suffer from neck tension, shoulder pain?
A  Yes, neck tension seems to accompany my migraine, but I seem to get more shoulder pain now that itís winter.

Q  Do you have any sleep disorders? (gallbladder influences quality and length of sleep2)
A  I often wake up suddenly, early in the morning and canít get back to sleep.

Q  Do you suffer from eye pain, eye disorders or have dry/watery eyes?
A  I get shooting pains on the side of my eyes, I have occasional blurry vision and dry eyes

How is the quality of your nails
A  They are all very weak, break easily and have ridges.

Q  Do you suffer from any muscular pain or have abnormalities in posture or difficulty bending?
A Yes, I get pain in my knee occasionally

Q Where about is your knee pain
A  On the inner sides of my knees

Q  Have you had any problems in your reproductive area?
A  Yes, I had an ovarian cyst on my right side

Q Do you suffer from Premenstrual Tension or pain?
A Yes, I do seem to be more irritable prior to my periods and I do get very tender breasts before hand

Where about are your breasts tender?
A  on the outside

How is your libido?
A Nonexistent!

Q Do you tend to get facial pigmentation marks on cheek bones?
A  Yes, it is a little darker than the rest of my skin

Q Do you have suffer from depression, memory loss, mood swings?
A  I have mood swings and can be very irritable with my family

Do you have a craving or perhaps a dislike for sour?
A  Yes, I am crazy about pickled gerkins, onions and those sour ball sweets.

Q   In order to determine the wood chi you are taking in Ė what and when do you eat, do you go into the sun occasionally, how often do you drink alcohol?
A I grab a cup of coffee in the morning and drink more coffee until lunch, I might have a sandwhich, sometimes I donít, and at dinner we normally have meat and veggies with a carbohydrate.  Occasionally we eat convenient or fast foods for dinner.  I hardly ever go into the sun -  itís bad for you! and I have at least 2 glasses of wine daily. 

Q What do you drink besides coffee and wine during the day?
A  Nothing else, occasionally a Coke or Fanta.

Q Are your meat and vegetables fresh and organic?
A  No, I buy my meat for the month at the grocery shop and vegetables are generally tinned or frozen and I deep freeze most of what we need for the month ahead.

Q Do you ever check labels for additives?
A No, I donít

Q Do you eat any fresh fruit, nuts, seeds, fish?
A  Very rarely eat fruit, nuts, or seeds; and my family arenít very fond of fish.

Do you do anything special to relax?
A We go to a movie or restaurant.


1. Chinese Herbal Medicine by Dr Guang Xu, Vermillion London, Published 1996 ISBN 0-0980-944-4
2. www.lieske.com/5e.html downloaded in April 2003
4. International School of Reflexology & Meridian Therapy, Study Notes 2003

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