chapter 4_meridians and collaterals
TRANSCRIPT
Chapter 4_Meridians and Collaterals
Section 1. Concept and Formation of the Meridian System1. The Concept of Meridians2. The Composition of the Meridian System
Section 2. The twelve principal meridians1. The courses, connections and distributions of the twelve principal meridians2. The relationships between the twelve principal meridians and cyclical flow of qi and blood in them3. The routes of the principal meridians
Section 3 The eight extra meridians
Section 4 The functions of meridians and their Application1. Functions of meridians2. Clinical Significance of the theory of meridians
Chapter 4. Meridians and CollateralsThe meridian-collateral theory focuses on studying the physiological functions and pathological changes of the meridian-collateral system, as well as the relationship between the system and the Zang-Fu organs. It is an important component of the theoretical system of traditional Chinese medicine. The development of the meridian-collateral theory is closely related to acupuncture therapy. It provides not only the theoretical foundation for acupuncture, massage and Qigong, but also guides the clinical practice of other related fields of traditional Chinese medicine. Section 1. Concept and Formation of the Meridian-Collateral System1. The concept of meridians and collateralsThe meridians (Jing) and collaterals (Luo) are pathways in which Qi and blood circulates. They form a specific network which communicates with the internal organs and limbs and connects the upper to the lower and the exterior to the interior of the body. The meridians are the major channels of the system and they run lengthwise within the interior of the body. The collaterals are the branches of the meridians and they run crosswise from the meridians either on or just below the body surface. Since they are distributed over the entire body, the meridians and collaterals link together the Zang-Fu and other organs, the orifices of the body, the skin, muscles and bones. They bring the body into an organic whole to carry on the systematic activities.2. The composition of the meridian-collateral systemThe meridian system consists of the regular meridians, the eight extra meridians, as well as the affiliated parts i.e. the twelve divergent meridians, the twelve tendon-muscle meridians and the twelve cutaneous regions.There are twelve regular meridians: the three Yin meridians of the hand, the three Yin meridians of the foot, the three Yang meridians of the hand and the three Yang meridians of the foot. They are called the twelve regular meridians, because they are the chief pathways of Qi and blood. The twelve regular meridians start and terminate at given parts, run along the regular routes and meet in a specified sequence. They are, moreover, associated with the Zang-Fu organs. Though we say
there are twelve regular meridians, in fact these twelve meridians are doubled when counting symmetrically on both the left and right sides of the body.There are eight extra meridians: namely Du, Ren, Chong, Dai, Yinqiao, Yangqiao, Yinwei and Yangwei meridians. The eight extra meridians are interlaced with the twelve regular meridians, helping reinforce the communication between and adjustment of the twelve regular meridians. The eight extra meridians are not directly related to any of the internal organs.There are twelve tendon-muscle meridians and twelve cutaneous regions. The former is the system affiliated to the twelve regular meridians connecting with the tendons and muscles and they are basically coincident with the superficial routes of the twelve regular meridians and their function is to connect all the bones and joints of the body and to maintain the normal motor functions of the joints. The latter are the superficial portions of the body that respond to the distribution of the twelve regular meridians and their collaterals. As their courses are similar to that of the twelve regular meridians, they derive their names from the meridians.As the collaterals are concerned, the big and small branches of meridians are known as collaterals, including the major collaterals, superficial collaterals and tertiary collaterals. The major collaterals are the bigger and chief collaterals. They extend directly from the twelve regular meridians and the Du and Ren Meridians. Together with the "major collateral of the spleen" they are called the "Fifteen Major Collaterals" the principal function of which is to maintain the communication between the exterior-interior paired meridians. The superficial collaterals lie just beneath the skin and the tertiary collaterals are the smallest and finest of all.
Section 2. The twelve principal meridiansThe twelve regular meridians are symmetrically distributed on both sides of the body. They run along the medial or lateral aspects of the upper and lower limbs, each corresponding to either a Zang or a Fu organ. Their names are given on the basis of three factors, hand or foot, Yin or Yang, and pertaining to a Zang or Fu organ. Those that run on the upper limbs are hand meridians, while those that run on the lower limbs are foot meridians. Those that run on the medial aspects of the limbs are Yin meridians and they pertain to Zang organs, while those that run on the lateral aspects are Yang meridians and they pertain to Fu organs.1. The courses, connection and distribution of the twelve regular meridians1.1. The linking connection among the twelve regular meridiansThe three hand Yin meridians start in the chest and run to the end of fingers where they meet the three hand Yang meridians. The three hand Yang meridians start from the end of the fingers and ascend to the head where they meet the three foot Yang meridians. The three foot Yang meridians start from the head and run down to the toes where they meet the three foot Yin meridians. The three foot Yin meridians start from the toes and ascend to the abdomen or chest where they meet the three hand Yin meridians. Thus, a closed Yin and Yang circuit is formed. The three hand Yang meridians terminate at the head where the three foot Yang meridians start. This reflects the ancient saying that "the head is the juncture of all the Yang meridians."1.2. The running and distribution of the twelve regular meridiansOn the limbs, the three Yin meridians are distributed along the medial aspects while the three Yang meridians along the lateral aspects. The Taiyin and Yangming meridians run along the front fringe of the limbs, the Shaoyin and Taiyang
meridians run along the back edge, and the Jueyin and Shaoyang meridians run in between.On the head, the Yangming meridians are distributed on the face and forehead, the Taiyang meridians are on the cheeks and on the top and back of the head; and the Shaoyang meridians are on the lateral side of the head.With regard to the body trunk, the three hand Yang meridians travel in the shoulders and scapular region; among the three foot Yang meridians: the Yangming runs in the front (the chest and abdomen), the Taiyang in the back, and the Shaoyang in the lateral side; the three hand Yin meridians all come out of the armpits; and the three foot Yin meridians run on the abdominal or the thoracic region where the meridians run lengthwise from the medial to the lateral in such order as Foot-Shaoyin, Foot-Yangming, Foot-Taiyin, and Foot-Jueyin.2. The exterior-interior relationships between the twelve regular meridians and cyclical flow of Qi and blood in them2.1. The exterior-interior relationshipsThe three Yin and three Yang meridians of the hand and foot form six exterior-interior pairs through the divergent meridians and major collaterals. The six pairs of the meridians with exterior-interior relationships are as follows: the Bladder Meridian of Foot-Taiyang and the Kidney Meridian of Foot-Shaoyin; the Gallbladder Meridian of Foot-Shaoyang and the Liver Meridian of Foot-Jueyin; the Stomach Meridian of Foot-Yangming and the Spleen Meridian of Foot-Taiyin; the Small intestine Meridian of Hand-Taiyang and the Heart Meridian of Hand-Shaoyin; the Triple Jiao Meridian of Hand-Shaoyang and the Pericardium Meridian of Hand-Jueyin; and the Large Intestine Meridian of Hand-Yangming and the Lung Meridian of Hand-Taiyin. These meridians, which are exteriorly-interiorly related, meet at the ends of the four Limbs, run lengthwise side by side in the medial and lateral aspects of the limbs (except the Liver Meridian of Foot-Jueyin and the Spleen Meridian of Foot-Taiyin which cross each other at the place 8 cun above the internal malleolus, switch courses, and finally go to pertain to their respective Zang-Fu organs).The general exterior-interior relationship of the twelve regular meridians is strengthened not only through the exterior-interior relationship of each specific pair, but also through their pairing with the Zang-Fu organs. As a result of this system, related Zang and Fu organs work harmoniously when healthy and affect each other pathologically when diseased. In treatment, acupoints on the exteriorly-interiorly related meridians could be alternately used. For example, points of the Lung Meridian could be used to treat the disorders of large intestine, vice versa.2.2. Cyclical flow of q and blood in the twelve regular meridiansThe twelve regular meridians link one another in a fixed order and the circulation of Qi and blood in the meridians is cyclical. It is usually said that the circulation starts from the Lung Meridian of Hand-Taiyin, travels to the Liver Meridian of Foot-Jueyin, and finally flows back to the Lung Meridian of Hand-Taiyin.3. The routes of the twelve regular meridians
3.1. The Lung Meridian of Hand-Taiyin (LU) (see fig. 1)a) The meridian starts from the middle Jiao (energizer), the portion between the diaphragm and the umbilicus of the body activity, and runs downward to connect with the large intestine. Then it ascends along the upper orifice of the stomach and crosses the diaphragm before pertaining to the Lung.b) It emerges from the Lung system transversely (at point Zhongfu, LU l) and runs down along the medial aspect of the upper arm and on the radial side of the Heart Meridian of Hand-Shaoyin and the Pericardium Meridian of Hand-Jueyin. Then it
goes through the cubital fossa and enters Cunkou (on the wrist over the radial artery where the artery is palpable) along the radial border of the medial aspect of the forearm. It continues to run along the thenar eminence and the thenar border and arrives at the radial side of the thumb tip (point Shaoshang, LU 11).c) A branch starts from Lieque (LU 7) and runs along the radial side to the tip of the index finger.
3.2. The Large Intestine Meridian of Hand-Yangming (LI) (see fig. 2)
a) The meridian starts from the tip of the index finger (point Shangyang, LI 1). Then it runs upward along the radial side of the index finger, passing the interspace of the first and second metacarpal bones and the tendons of long and short extensor muscle of the wrist. It continues to rise further along the radial side of the forearm and elbow, and the radial side of the dorsal aspect of the upper arm, and arrives at the shoulder. It runs along the anterior border of the acromion, then meets Dazhui (DU 14) and enters the body cavity through the supraclavicular fossa.b) It runs down from the supraclavicular fossa to connect with the lung; further down it crosses the diaphragm and pertains to the large intestine.c) Starting from the supraclavicular fossa, it passes the neck, cheek, and the gums of the lower teeth; then exiting the mouth cavity, it runs around the upper lip, crosses at the philtrum, and ends at the alae nasi (point Yingxiang, LI 20)
3.3.The Stomach
Meridian of Foot-Yangming (ST) (see fig. 3 and fig. 4)
a) The meridian starts at the lateral side of ala nasi, runs up to the root of the nose and meets the Bladder Meridian of Foot-Taiyang. Then it descends along the lateral side of the nose (point Chengqi, ST l), enters the upper gum, curves around the lips goes down to meet Chengjiang (RN 24) at the mentolabial groove, and then runs along the posterior and lower part of the cheek to the acupoint Daying (ST 5). It continues to travel along the angle of the mandible, passing the front of the ear (Xiaguan, ST 7), ascends to the anterior hairline and finally reaches the forehead.b) One of its branches descends from Daying (ST 5) to Renying (ST 9) and then running along the throat, reaches Quepen (ST 12), at the center of the supraclavicular fossa. It continues to go downward, through the diaphragm and then pertains to the stomach and connects with the spleen.c) A straight branch starts from the supraclavicular fossa, crosses the nipple and reaches Qichong (ST 30), at the lateral side of the abdomen.d) Another branch starts from the lower orifice of the stomach, through the abdomen, and descends to Qichong (ST 30) where it joins the straight branch. Then it passes Biguan (ST 3l), running along the anterior border of the thigh, Futu (ST 32), and then descends to the lateral side of the knee. It continues to travel along the lateral side of the crural tibia, reaches the dorsum of the foot and then enters the lateral side of the tip of the second toe.e) The tibial branch starts from Zusanli (ST 36), 3 cun below the knee and goes down to the lateral side of the lip of the middle toe.f) The dorsal foot branch starts from the dorsum of the foot and ends at the medial side of the tip of the great toe.
3.4. The Spleen Meridian of Foot-Taiyin (SP) (see fig. 5 and fig. 6)a) The meridian starts from the medial side of the great toe, along the dorso-ventral boundary of the foot and passing the first phalanx and metatarsal joint, then reaches the anterior border of the medial malleolus. It continues to ascend along the posterior border of the medial side of the tibia, emerges from the place 8 cun above the medial malleolus, and runs in front of
the Liver Meridian of Foot-Jueyin. Then passing through the knee and the inner side of the thigh, it enters the abdomen, pertaining to the spleen and connecting with the stomach. Finally, it goes through the diaphragm and the pharynx, reaches the root of the tongue and further spreads under the tongue.b) A branch starts from the stomach, passes the diaphragm and enters the heart.
3.5.The Heart Meridian of Hand-Shaoyin (HT) (see fig. 7)a) The meridian originates in the heart, spreading over the "heart system". It descends internally passing the diaphragm to connect with the small intestine.
b) The ascending portion starts from the "heart system", running along the esophagus to connect with the "eye system".c) The straight portion go upward to traverse the lung, then runs downward and emerges in the mid of the axilla (Jiquan, HT l). Then it goes along the posterior (the ulnar) border of the medial aspect of the upper arm (behind the Lung Meridian of Hand-Taiyin and the Pericardium Meridian of Hand-Jueyin) and reaches the elbow. It runs further down along the posterior border of the medial side of the forearm to the pisiform bone proximal to the palm, and enters the palm. It descends along the radial side of the palm, terminating at the finger tip ( Shaochong , HT 9).
3.6. The Small intestine Meridian of Hand-Taiyang (SI) (see fig. 8)
a) The meridian starts at the ulnar side of the little finger (Shaoze, SI l), running along the ulnar side of the dorsum of hand, then enters the wrist. Passing the styloid process of ulna, it ascends along the posterior border of ulnar side of the forearm and emerges from between the olecranon and the medial epicondyle of humerus. It continues to travel along the ulnar border side of dorsal aspect of the upper arm, comes out from the shoulder joint, circles around the scapular region, and then meets the Du Meridian on the shoulder. After that, it enters the supraclavicular fossa (Quepen, ST 12), connects with the heart, descends along the esophagus, passes the diaphragm, reaches the stomach and finally goes into the small intestine, its pertaining organ.
b) Another branch starts from the supraclavicular fossa (Quepen, ST 12), running along the neck and past the cheek, and reaches the outer canthus. It terminates in the ear (Tinggong, SI 19).
c) The third branch starts at the cheek, ascends to the infraorbital region, passes the lateral side of the nose, and finally enters the medial canthus of the eye.
3.7. The Bladder Meridian of Foot-Taiyang (BL) (see fig. 9 and fig. 10)a) The meridian starts at the medial canthus of the eye (Jingming, BL l), ascends to the forehead and then arrives at the vertex.b) The cephalic branch descends from the vertex to the upper corner of the ear.c) The straight cephalic branch descends from the vertex to the brain, exits along the nape and the medial side of the scapula, moves down along the spine, and then reaches the lumbar region. It enters the abdomen and connects with the kidney and pertains to the urinary bladder.a) The lumbar branch starts at the lumbar and gluteal region and runs to the popliteal fossa.e) Another branch starts at the medial side of the scapula, running along the spine, and reaches the greater trochanter of femur in the gluteal region. Then it descends along the latero-posterior side of the thigh and meets the lumbar branch at the popliteal fossa. It continues to descend along the posterior side of the calf and emerges from the posterior side of the external malleolus. After passing the tuberosity of the fifth metatarsal bone, it reaches the lateral side of the tip of the little toe(Zhiyin, BL 67).
The Kidney Meridian of Foot-Shaoyin (KI) (see fig. 11 and fig.12)a) The meridian starts at the plantar tip of the small toe and runs obliquely towards Yongquan (KI l) in the center of the sole. Emerging from Rangu (KI 2) which locates at the medial aspect of the tuberosity of the navicular bone, it circles behind the medial malleolus and runs in the heel. Then it ascends along the medial side of the calf, and emerges from between the semitendinous and semimembranous muscles in the popliteal fossa. It further ascends along the medial side of the thigh, enters the spinal column, terminates in the kidneys, its pertaining organ, and connects with the urinary bladder.b) The kidney branch starts from the kidney, passes the liver and diaphragm, enters the lung, runs through the throat and finally reaches the root of the tongue.c) Another branch starts from the lung, links with the heart and enters the chest.
3.9. The Pericardium Meridian of Hand-Jueyin (PC) (see fig. 13)a) The meridian starts from the chest where it pertains to the pericardium. Then it passes through the diaphragm and moves down to connect with San Jiao (triple energizer).b) The thoracic branch starts from the chest and hypochondriac region and exits at Tianchi (PC l), 3 cun below the axilla. Then it ascends to the axillary fossa, runs along the medial side of the upper arm and between the Hand-Taiyin and Hand-
Shaoyin meridians, and enters the cubital fossa. Finally, it goes between the tendons of the long palmar muscle and radial flexor muscle, enters the palm and terminates at the tip of the middle finger (Zhongchong, PC 9).c) The palmar branch originates from the palm and runs to the tip of the ring finger.
3.10. The Sanjiao (Triple Energizer) Meridian of Hand-Shaoyang (SJ, TE) (see fig.14)a) The meridian starts at the end of the ring finger on the ulnar side (point Guanchong, SJ l), goes along the ulnar side of the ring finger and reaches the wrist through the dorsum of the hand. Then it ascends along the lateral side of the forearm and between the ulna and radius. Passing through the posterior cubitus and the lateral side of the upper arm, it arrives at the shoulder. Traveling behind the Gallbladder Meridian, it then enters the supraclavicular fossa and spreads in the chest to connect with the pericardium. Finally, it crosses the diaphragm and pertains to Sanjiao.b) One branch starts from the chest and comes out of the supraclavicular fossa. Then it goes along the nape and reaches the back of the ear. Passing the upper corner of the ear and the cheek, it terminates at the infraorbital region.c) The other branch enters the ear from behind. Passing the front of the ear (Shangguan, GB 3), it meets the above branch on the cheek and terminates at lateral canthus (Sizhukong, SJ 23).3.11. The Gallbladder Meridian of Foot-Shaoyang (GB) (see fig. 15 and fig. 16)a) The meridian starts at the outer canthus (Tongziliao, GB l), ascends to the corner of the forehead (2) and reaches the retro-auricular region. Then it runs along the neck in front of the Sanjiao meridian. After arriving at the shoulder, it runs behind the Sanjiao meridian and enters the supraclavicular fossa.b) The auricle portion arises from the retro-auricular region, enters the ear, comes out in front of the ear and arrives at the posterior side of the outer canthus.c) The canthus branch starts at the outer canthus and runs downward to the area near the point Daying (ST 5). After meeting the Hand-Shaoyang meridian, it goes upward to the infraorbital region. Passing Jiache (ST 6) in its descending course, it reaches the neck and meets the auricle branch in the supraclavicular fossa. Then it further descends into the chest, crosses the diaphragm, and connects with the liver and pertains to the gallbladder. Running through the hypochondriac region, it comes out from both sides of the lower abdomen (Qichong, ST 30) and runs along the margin of the pubic hair. Finally, it reaches Huantiao (GB 30).d) The straight portion starts at the supraclavicular fossa, passes the axilla, the lateral side of the chest and the hypochondriac region, and meets the canthus branch at Huantiao (GB 30). Then it travels along the lateral side of the thigh and the knee, passes the anterior side of the fibula and runs directly downward to the lower end of the fibula and above the external malleolus. Finally, it goes along the anterior border of the external malleolus and the dorsum of the foot and enters the lateral side of the tip of the fourth toe.e) The dorsal branch starts from between the first and second metatarsal bones, enters the tip of the great toe, turns back and penetrates the nail, and terminates in the hairy region proximal to the nail.
3.12.The Liver Meridian of Foot-Jueyin (LR) (see fig. 17 and fig. 18)a) The meridian starts at the hairy region posterior to the nail of the great toe (Dadun, LR l), goes upward along the dorsum of foot and passes through the area 1 cun in front of the medial malleolus. It ascends along the medial side of the leg and in front of the Spleen Meridian of Foot-Taiyin. Then it emerges from behind the Foot-Taiyin Meridian at the level 8 cun above the medial malleolus. Passing the medial side of the knee and the thigh, it enters the pubes and curves around the external genitals before arriving at the lower abdomen. Continuing to run along the stomach on both sides, it pertains to the liver and connects with the gallbladder. Further on it passes through the diaphragm and spreads in the chest and hypochondriac region. Finally it ascends along the posterior side of the throat, enters the nasopharynx, connects with the eye system, emerges from forehead, and meets the Du Meridian at the vertex.b) One branch arises from the eye system, descends to the cheek, and curves around the lips.c) Another branch arises from the liver, goes through the diaphragm, and enters the lung.
Section 3 The eight extra meridians The eight extra meridians are the Du (Governor Vessel Meridian), Ren (Conception Vessel Meridian), Chong, Dai, Yangqiao, Yinqiao, Yangwei and Yinwei meridians. They are different from the twelve regular meridians in that none of them pertains to or connects with any specific Zang or Fu organ and they are not exterior-interior related. The eight extra meridians are distributed in between the twelve regular meridians in a complex pattern and their major functions are to strengthen the links between the regular meridians and to regulate their Qi and blood circulation. For example, the Dai Meridian "control all the meridians" and strengthens the communication between the meridians at the waist. The Chong Meridian connects with the three Yin and three Yang meridians, thus is termed as the "sea of all the twelve regular meridians " or "the sea of bloos". The Du Meridian meets all the Yang meridians, so is described as the "sea of all the Yang meridians", while the Ren Meridian is the "sea of all the Yin meridians". The surplus Qi and blood of the twelve regular meridians flow into the eight extra meridians and are stored there. When the Qi and blood in the twelve regular meridians are insufficient, the Qi and blood stored in the eight extra meridians flow out to supplement them. Furthermore, the eight extra meridians are closely related to the liver, kidney, uterus, brain and marrow. They influence one another physiologically and pathologically.1. The Du Meridian (DU, or GV) (see fig. 19)The Du Meridian (Governor Vessel Meridian) originates in the perineum. It ascends along the midline of the spine to Fengfu (DU 16), where it enters the skull and connects with the brain. From the nape of the neck, it continues to go up along the midline to the vertex, then down along the midline of the
forehead to the tip of the nose and the upper lip. It terminates in the labial frenulum at a point between the upper lip and upper gums.One branch comes out from the spine, enters the abdomen and terminates in the kidney.Another branch originates in the lower abdomen, goes straight upward to the umbilicus and heart, from where it runs to the throat and the chin. Curving around the lips, it travels upward to just below the eyes.Physiological Functions: Because the Du Meridian communicates with and governs all the Yang meridians and the Yangwei Meridians, it is called the "sea of Yang meridians". Moreover, because it runs along the midline of the spine and enters the brain and its branches connect with the kidney, it is closely related to the brain, spinal cord and kidney.2. The Ren Meridian (RN, or CV) (see fig. 20)The Ren meridian starts from inside the lower abdomen and emerges from the perineum. It goes anteriorly to the pubic region and ascends along the interior of the abdomen and chest to the throat. Ascending further, it curves around the lips, passes through the cheek, and enters the infraorbital region.Physiological Functions: The Ren Meridian is known as the "sea of Yin meridians, because it connects with all the Yin meridians of the body. The word "ren" also has the meaning of "pregnancy" in Chinese. In women, this meridian is thought to originate in the uterus where the fetus is nourished. Consequently, traditional Chinese medicine states, "The Ren Meridian governs the development of the fetus."3. The Chong MeridianThe Chong meridian starts within the lower abdomen and emerges at the perineum, where its superficial portion communicates with the Kidney Meridian of Foot-Shaoyin at Qichong (ST 30). Running along both sides of the abdomen, it goes up to the throat, encircles the lips and ends in the infraorbital area.One branch emerges at Qichong (ST 30), descends along the medial side of the thigh, enters the popliteal fossa and continues to run along the medial border of the tibia to terminate in the sole of the foot. Another one extends from behind the internal malleolus, runs obliquely into the dorsum of the foot and ends in the big toe.The third branch ascends along the spinal column and communicates with the Du Meridian.Physiological Functions: Running from foot to head, the Chong Meridian is to serve as the hub for Qi and blood of the entire body. Since it controls Qi and blood circulation of the twelve regular meridians, it is called the "sea of the twelve regular meridians". It is also called "sea of blood" because it is closely related to menstruation.4. The Dai MeridianThe Dai meridian starts just below the rib cage and appears as a belt, it runs around the waist.Physiological Function: to control and regulate all the longitudinal-running meridians.5. The Yinqiao Meridian and the Yangqiao MeridianThe Yinqiao Meridian and Yangqiao Meridian originate from below the malleoli, on the left and right symmetrically.
The Yinqiao Meridian starts from the posterior aspect of the navicular bone at Zhaohai (KI 6). It ascends behind the medial malleolus, then travels straight up along the posterior side of the medial aspect of the leg to the external genitals. Traveling along the surface of the abdomen, it reaches up into the supraclavicular fossa, then further ascends to a point adjacent to the Adam' s apple and in front of Renying (ST 9). From there, it reaches the inner canthus and communicates with the Yangqiao Meridian and the Hand and Foot Taiyang Meridians.The Yangqino Meridian originates under the external malleolus at Shenmai (BL 62) and travels upward along the back of the body. It runs up along the external malleolus and the lateral side of the leg and passes through the waist to travel along the postero-lateral side of the rib cage. Running up to the shoulder and supraclavicular fossa, it travels to the side of the neck and the corner of the mouth. At the inner canthus, it communicates with the Yinqiao Meridian and the Hand and Foot Taiyang Meridians. From there going upward into the hairline, it runs to the back of the ear where it meets the Gallbladder Meridian of Foot-Shaoyang.Physiological Functions: Both the Yinqiao Meridian and Yangqiao Meridian nourish the eyes and control their opening and closing, and govern the movement of the lower limbs. The ancients believed they "control Yin and Yang on the left and right of the body".6. The Yinwei Meridian and the Yangwei MeridianThe Yinwei Meridian originates on the medial side of the leg where the three Yin meridians meet. Then it ascends along the medial side of the leg to the abdomen where it runs parallel to the Spleen Meridian of Foot-Taiyin. It continues to ascend to the hypochondrium to join the Liver Meridian of Foot-Jueyin. Then it terminates in the pharynx and communicates with the Ren Meridian.The Yangwei Meridian originates in the external malleolus. Running parallel to the Gallbladder Meridian of Foot-Shaoyang, it ascends along the posterolateral side of the trunk and the back of the axillary fold to the shoulder. It passes the neck and the back of the ear and travels to the forehead and then returns to the nape where it terminates by meeting the Du Meridian.Physiological functions: The Yangwei meridian is connected with all the Yang meridians and dominates the exterior of the body; the Yinwei meridian is connected with all the Yin meridians and dominates the interior of the body. The two regulates the flow of Qi in the Yin and Yang meridians and help maintain coordination and equilibrium between the Yin and Yang.
Section 4 The functions of meridians and their Application1. The functions of meridiansEven though the five Zang and six Fu organs, and all the tissues and orifices each perform their own physiological activities, they need another structure to integrate their functions to maintain the body as an organic whole. The integration is accomplished mainly by the network of meridians, of which the four functions are involved with the meridian Qi.1.1. Linking the exterior with the interior and the upper with the lower, and linking up with the Zang-Fu organs.The twelve meridians and their branches form a communicating network between the internal organs. It connects the upper with the lower as well as the interior with the exterior parts of the body. The eight extra meridians link with the twelve regular meridians, while the twelve tendon-muscle meridians and the twelve cutaneous regions link with the muscular portions and superficial portions of the
body respectively. These linkages ultimately integrate the body into an organic whole.a) Communication of the Zang-Fu organs with the tendons, muscles and skinThe twelve regular meridians connect with the Zang-Fu organs. Meridian Qi spreads to the tendons, muscles and the cutaneous regions, linking the skin and muscles to the internal organs.b) Communication of the Zang-Fu organs with the five sense organs and nine body orificesMeridians run through the eyes, ears, nostrils, mouth, tongue, genitals and anus, in addition, they connect with the Zang-Fu organs. Thus, the five sense organs and nine orifices are linked up with the internal organs via meridians. For instance, the Heart Meridian of Hand-Shaoyin is connected with the small intestine, it links, moreover, with the eye system, and one of its branches travels upward to the tongue. The Liver Meridian of Foot- Jueyin is connected with the gallbladder and the eye system. The Stomach Meridian of Foot-Yangming is connected with the spleen and it curves around the lips. The Spleen Meridian of Foot-Taiyin links with the tongue and spreads under it. The Kidney Meridian of Foot-Shaoyin and the Liver Meridian of Foot-Jueyin both connect with the root of the tongue.c) Communication among the Zang-Fu organsEach of the twelve meridians links with a particular Zang or Fu organ, which strengthens the relationship between the exteriorly-interiorly related Zang-Fu organs. Some meridians communicate with several Zang-Fu organs, e.g., the stomach meridian corresponds to the stomach and links with the spleen, and its branch runs to the heart. The spleen meridian links the spleen with the stomach and connects with heart. The gallbladder meridian links the gallbladder with the liver and its branch runs to the heart. The kidney meridian links the kidney with urinary bladder, heart, lung and liver. The small intestine meridian links the small intestine with the heart and stomach.d) Communication among the meridiansCommunication among the twelve regular meridians follows a regular pattern. The convergences of the twelve regular meridians and the eight extra meridians, and the communication among the latter, ensure the linkage of all of them. For instance, the three Yang meridians of the hand and those of the foot all meet at Dazhui (DU 14) and the Yangqiao Meridian and Du Meridian meet at Fengfu (DU 16), and so the Du Meridian is called the "sea of Yang meridians." Because the Ren Meridian is where the three Yin meridians of the foot meet the Yinwei Meridian and the Chong Meridian, and the three Yin meridians of the foot link with the three Yin meridians of the hand, the Ren Meridian is known as the "sea of Yin meridians". The Chong Meridian meets the Ren Meridian in the chest. It also links with the Du Meridian in the back. The Du and Ren meridians also connect with the twelve regular meridians. The Chong Meridian runs to the nasopharynx, linking with the three Yin and Yang meridians and collecting the Qi and blood of the twelve regular meridians. Thus, the Chong Meridian is called the "sea of blood". The Du, Ren, and Chong meridians all originate in the uterus or the pelvis.1.2. Transporting Q and blood, and nourishing the Zang-Fu organs and tissuesQi and blood are two materials that ensure the functional activities of the Zang-Fu organs and tissues. The meridians and collaterals are passages in which Qi and blood circulate through the whole body, nourishing the organs and tissues, and protecting them against the attack by the pathogenic factors.
1.3. Transmitting needling responseThe meridian-collateral system can transmit the needling response and other sensations. The phenomenon of the arrival of Qi is a manifestation of this function.1.4. Regulating functional balanceThe meridians and collaterals transport Qi and blood and regulate the balance between Yin and Yang of the body, thus, bringing the relative balance of life activities. When one falls ill, a disharmony of Qi and blood will be present as well as an excess or a deficiency of Yin and Yang. Acupuncture therapy, through the mode of "the removal of the excess and the reinforcement of the deficiency", is applied to regulate the functions of the meridians and restore the balance of Yin and Yang. It has been verified that placing needles on acupoints of the meridians can regulate the relevant Zang-Fu organs by suppressing the hyperactivity or exciting the hypoactivity.2. Clinical significance of the theory of meridians2.1. Indicating pathological changesIn terms of pathology, the meridians and collaterals are the transmission routes of exogenous pathogenic factors. For example, exogenous pathogenic factors are transmitted from the interstitial space between the skin and flesh to the five Zang and six Fu organs through the meridian system. Since it provides the functional link between the organs, the meridian system also becomes the route for the transmission of diseases among them. For instance, liver disorders may affect the stomach and lung, for the liver meridian curves around the former and runs into the latter. The Kidney Meridian of Foot-Shaoyin runs into the lung and connects with the heart, and so water retention due to deficiency of kidney Qi may affect the heart and lung. Disorders of two exteriorly-interiorly related meridians may often affect the exteriorly-interiorly related Zang and Fu organs. For instance, the heart fire may be transmitted to the small intestine; and the excessive heat with a resultant obstruction in the large intestine may bring about the impeded Qi flow in the lung, leading to asthma coughing or stuffiness in the chest.2.2. Serving as a guidance to diagnosis and treatmenta) Guiding diagnosisThe meridians have regular routes and connect with given organs, thus, they can reflect the disorders of those particular organs. From a clinical perspective, when the loci of the abnormality are considered in the light of the running courses of the meridians, the physician can often tell which meridian and which Zang-Fu has been affected. For example, hypochondriac pain suggests the disorders of the liver or the gallbladder. Pain in the supraclavicular fossa indicates the disorders of lung. As for headaches, pain in the forehead implies a morbid state in the Yangming Meridians; pain on both sides of the head indicates the pathological changes in the Shaoyang Meridians; pain in the occipital part of the head or the nape signifies the abnormality in the Taiyang Meridians, while pain in the vertex of the head refers to the pathological changes in the Jueyin Meridians. Furthermore, in some pathological conditions, tenderness, node or cord like reactions may be found in the superficial portion of the body through which the meridians run, or in places where meridian Qi accumulates. Sometimes, morphological changes in the skin are helpful in diagnosis. With a lung disease, for example, nodes may be found at Feishu (BL 13) and tenderness may appear at Zhongfu (LU l). With appendicitis or appendiceal abscess, tenderness will be found at Lanwei points (2 cun below Zusanli ST 36). Abnormal changes could be found at Pishu (B 20) in patients with prolonged indigestion.
b) Guiding treatmentThe meridian-collateral theory has been widely used to guide treatment of various diseases, especially in acupuncture, massage and herbal medicine. For instance, the selection of the acupoints for the acupuncture and massage treatment are determined by the theory. If a meridian is affected, the practitioner may choose local or distant points on the diseased meridian to administer acupuncture or massage. Before selecting the points, however, it is first necessary to differentiate the syndromes so as to decide which meridian is in trouble. Points are then selected according to the meridian routes and the scope of their connections.The transmitting function of the meridians also determines the efficacy of a particular drug, that is, through the transmitting function of the meridians, the curative elements of the drug can be sent to the site of the disease promptly and thus cure it. Based on the long-term observation of the affinity of certain drugs for particular Zang or Fu organs, ancient practitioners developed a theory of "home meridians for medicines", meaning that certain drugs in certain quantities are beneficial to the meridians of certain organs.Furthermore, the more recent practices of acupuncture anesthesia and ear and electric acupuncture are all developed under the guidance of the theory of meridians. Successful results have frequently been obtained in all of these therapeutic methods.