Meridians and collaterals Lecturer: Qu Hongyan

Acupuncture or needling, is a type of therapy that stimulates certain locations or points of the body, by manipulating needles or other similar instrument.

Moxibustion refers to a therapy utilizing ignited moxa wool to heat or cauterize the surface of the human body.

Cupping is a therapy in which a jar is attached to the skin surface using negative pressure created by introducing a flame into the cup or some other means of suction so as to form a localized congestion or blood stagnation to prevent or treat diseases.

Preface The meridian theory, which is taken as an important component of the theoretical system of traditional Chinese medicine, concentrates on the study of the distributions, physiological functions, pathological changes of the meridians as well as their relationships with the viscera, body constituents, sense organs and orifices, qi, blood and body fluids. It is the core of acupuncture theory.

Development of needles Bian-stone needles Stainless steel filiform needles Bone needles

Effects and Clinical application of meridian theories Twelve regular meridians 1 2 Eight extra meridians 3 Twelve divergent meridians 4 The branch-foundation, tip-root, qi thoroughfare and four seas Effects and Clinical application of meridian theories 5

Jing, meridians, means “go through” or “a path”. They are strong and trunk branches Jing, meridians, means “go through” or “a path”. They are strong and large. They run longitudinally and interiorly within the body. Luo, that is collaterals, means “something that connects” or “a net”. They are the branches of the meridians, thin and small. They run transversely and superficially, and crisscross and net the whole body.

Meridian system Fifteen connecting collaterals Superficial collaterals Twelve regular meridians Meridians Eight extra meridians Meridian system Twelve divergent meridians Fifteen connecting collaterals Superficial collaterals Tertiary collaterals Collaterals

Twelve regular meridians

Nomenclature The nomenclature of the twelve regular meridians is based on three factors, which are hand or foot, yin or yang, and zang or fu organs. e.g. Lung meridian of hand-taiyin Large intestine meridian of hand-yangming Gallbladder meridian of foot-shaoyang

Nomenclature of the Twelve Regular Meridians Hand/Foot Yin/Yang Three yang/Three yin The Twelve Meridians Hand Yin Taiyin Lung Meridian Shaoyin Heart Meridian Jueyin Pericardium Meridian Yang Yangming Large Intestine Meridian Shaoyang Sanjiao Meridian Taiyang Small Intestine Meridian Foot Spleen Meridian Kidney Meridian Liver Meridian Stomach Meridian Gall Bladder Meridian Bladder Meridian

Six meridians of hand

Six meridians of foot

Pathways and flow of qi Hand Foot Head Chest or Abdomen Three yin meridians of hand Lung meridian of hand taiyin Pericardium meridian of hand jueyi Heart meridian of hand shaoyin Chest or Abdomen Hand Three yin meridians of foot Spleen meridian of foot taiyin Liver meridian of foot jueyi Kidney meridian of foot shaoyin Three yang meridians of hand Large intestine meridian of hand yangming Triple energizer meridian of hand shaoyang Small intestine meridian of hand taiyang Foot Head Three yang meridians of foot Stomach meridian of foot yangming Gallbladder meridian of foot shaoyang Bladder meridian of foot taiyang

Head three yang meridian three yin meridian Chest Hand of hand Abdomen of foot of foot Foot

Directions of twelve regular meridians Three yin meridians of hand run from chest to hand Three yang meridians of hand run from hand to head Three yang meridians of foot run from head to foot Three yin meridians of foot run from foot to abdomen and chest. If we extend our arms overhead, the yin meridians run upward while yang ones run downward

Distribution of the twelve regular meridians The Twelve Regular Meridians have lateral and symmetrical distribution on the head, face, trunk and limbs. The six yin meridians are distributed on the medial side of the limbs and on the chest and abdomen. The six yang meridians are distributed on the lateral side of the limbs and on the head, face and trunk.

Distribution in the trunk Location The first lateral line The second lateral line The third lateral line Head 1.5cun（ bladder meridian Waist and back 1.5cun（ bladder meridian ） 3cun（bladder meridian） Abdomen 0.5cun（kidney meridian） 2cun (stomach meridian） 4cun（spleen meridian） Chest 2cun（kidney meridian） 4cun (stomach meridian） 6cun（spleen meridian）

Chest Tip of index finger Beside the nose Tip of great toe External canthus Beside the nose Chest Tip of great toe Tip of ring finger In the chest In the chest Tip of small toe Tip of small finger Inner canthus

Connections Yin meridians and yang meridians connect in the hand or the foot. Two yang meridians with the same name connect in the head or facial region. Hand yin meridians and foot yin meridians connect in the chest.

Exterior-interior relationship Yin meridians, which are considered relatively inner, belong to zang organs and interact with fu organs. Yang meridians, which run relatively superficially, belong to fu organs and connect to zang organs. The heart meridian belongs to the heart and connect to the small intestine The small intestine meridian belongs to the small intestine and interact with the heart. i.e.

Lung meridian of hand-taiyin

Large intestine meridian of hand-yangming

Stomach meridian of foot-yangming

Spleen meridian of foot-taiyin

Heart meridian of hand-shaoyin

Small intestine meridian of hand-taiyang

Bladder meridian of foot-taiyang

Kidney meridian of foot-shaoyin

Pericardium meridian of hand-jueyin

Triple energizer meridian of hand-shaoyang

Gallbladder meridian of foot-shaoyang

Liver meridian of foot-jueyin

The Eight Extra Meridians Eight Extra Meridians are the meridians whose courses are different from the twelve regular meridians, eight in all, namely Governor Vessel, Conception Vessel, Thoroughfare Vessel, Belt Vessel, Yin Link Vessel, Yang Link Vessel, Yin Heel Vessel and Yang Heel Vessel.

Differences compared with twelve regular meridians They do not belong to any zang-fu organs directly; They have no exterior-interior relationship amongst themselves They travel in an extraordinary way compared to the twelve regular meridians Apart from GV and CV which have their own points, the other meridians share the points with the twelve regular meridians.

Functions of Eight Extra Meridians They distributed longitudinally and horizontally among the twelve regular meridians, working not only as strengthening the association between the twelve regular meridians, but also as dominating and controlling qi and blood, as well as balancing yin and yang. They regulate the qi and blood of the regular meridians, such as in storage, drainage of the qi and blood. If the twelve regular meridians were likened to the rivers and great rivers, the eight extra meridians would be likened to the lakes and reserviors.

Physiological functions ： （1）regulates qi and blood of yang meridians and be named as sea of yang meridians ； （2）reflects the function of brain, kidney and spinal cord； （3） governs reproduction Governor Vessel

Physiological functions: （1）regulates qi and blood of yin meridians and be named as sea of yin meridians； （2）regulates menstruation and pregnant fetus. Conception Vessel governs uterus and gestation Conception Vessel

Physiological functions: （1）regulates qi and blood of twelve regular meridians； （2） governs reproduction； “the sea of twelve regular meridians” “the sea of five zang organs and six fu organs” Thoroughfare Vessels

Physiological functions: Restrains the other meridians like a belt Belt Vessel

Twelve divergent meridians Twelve divergent meridians are branches departing from the twelve regular meridians and traveling deeply into the body cavity. Twelve divergent meridians have four distribution characteristics, namely “separating”，“entering”，“resurfacing” and “joining” By the distribution of separating, entering, resurfacing and joining, the divergent meridians strengthening the bonds between the interior and exterior-paired regular meridians as well as with their zang-fu organs.

Twelve divergent meridians The yang divergent meridians then join their own regular meridians again, while yin ones join their internally-externally related yang meridians Resurfacing usually at neck or the face Joining Resurfacing Yin divergent meridians Yang meridian Yang divergent meridians Yin meridian Entering Separating usually at Popliteal fossa Yang meridians Separating

The branch-foundation, tip-root, qi thoroughfare, and four seas in the meridian theory

Four roots and three tips Root-tip theory Root and tip refer to the originating and terminating points of qi in the twelve regular meridians. The word “Gen”, means root or originating, and it refers to the Jing-well point of the individual meridian in the extremities. The word “Jie” means tip or gathering, and it lies on the head, chest and abdomen. Twelve regular meridians take four extremities as root, the head, chest and abdomen as the tip. Four roots and three tips

Branch-foundation theory Branch and foundation, or “Biao Ben”in Chinese, refers to the up and down corresponding relationship in the meridians. Branch upper part of the body foundation lower part The limbs are the foundation, trunk, head and face are the branch

Qi thoroughfare Qi thoroughfare is the direct pathway where the meridian qi spreads in the trunk, head and face transversely and obliquely. Qi thoroughfare theory shows that regions like the head, chest, abdomen and shank are the common pathways for circulation of the meridian qi, and it provides an explanation for the horizontal relationship of various meridians.

Four seas The four seas include the sea of marrow, the sea of blood, the sea of qi and the sea of grain and water. In Ling Shu, Hai Lun (Spiritual Pivot, Chapter 33), it points out that the stomach is the sea of grain and water, Penetrating is the sea of twelve regular meridians, Danzhong is the sea of qi, brain is the sea of marrow The four seas generalize the four locations in which the meridian qi generates, distribute and gathers.

Physiological functions of meridians Circulating qi and blood Linking zang and fu organs and communicating the internal with the external Resisting evil qi Inducing and transmitting information Regulating the balance of the body functions

Circulating qi and blood All zang-fu organs and tissues conduct their normal physiological functions, relying on the nourishment provided by qi and blood, which are transmitted by meridians. As stated in the Ling Shu, Ben Zang (Spiritual Pivot, Chapter 47 ) “the meridians have the function of moving qi and blood, nourishing yin and yang, lubricating joints and tendons.”

Linking zang and fu organs and communicating the internal with the external Human body is a complicated organism consisting of five zang organs and six fu organs, four limbs and bones, five sensory organs and nine orifices, tendons, muscles, etc. Each of them has its own special functions and all of them make the body an organic whole. Such interrelation or coordination between them is accomplished through the communicating function of meridians.

Resisting evil qi In Ling Shu, Ben Zang (Spiritual Pivot, Chapter 47 ) it was recorded that “the meridians have the function of moving qi and blood, nourishing yin and yang, lubricating joints and tendons.” This sentence shows that the meridians and collaterals can ”transport blood and qi to adjust yin and yang”, and since the “nutritive qi flows inside the meridians and defensive qi runs outside the meridians”. The defensive qi is disperse to the skin thereby strengthening the function of defending the surface of the body.

Inducing and transmitting information The phenomenon of arrival of qi, normal sensation felt by the patient treated with acupuncture, is a specified manifestation of inducing and transmitting functions of the meridians.

Regulating the balance of the body functions Meridians function to promote the circulation of qi and blood and harmonize yin and yang, thus maintaining the functional activities of the body in a state of a relative balance.

Clinical application of meridian theories Explaining the pathological changes Guiding the diagnosis of disease Guiding the treatment of disease

Explaining the pathological changes Meridians function to transport qi and blood, induce and transmit information. Pathologically, they serve as the passages for transmitting pathogenic qi and manifesting disorders. pain in hypochondrium and lower abdomen Stagnation of liver qi

Guiding the diagnosis of disease Each meridian runs along certain routes and pertains to one viscus. Under pathological conditions, some morbid phenomena may frequently occur along a meridian and the viscus that it pertains to. e.g. Frontal headache indicates a disease of yangming meridian Headache of the temporal region is a disease of shaoyang meridian pain in the nape and occipital region can be the clue to a disease of taiyang meridian

Guiding the treatment of disease The theory of meridians has been extensively applied to direct the treatment in all clinical specialties, and particularly to the treatment with acupuncture, moxibustion and massage when locating acupoints along the meridians, and to the treatment with drugs when selecting drugs according to meridian tropism.

Thank you!