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THE CHANNELS AND COLLATERALS

It is by virtue of the twelve channels that human life exists, that disease arises, that human beings can be treated and illness cured. The twelve channels are where beginners start and masters end. To beginners it seems easy; the masters know how difficult it is. Spiritual Pivot Chapter 17.

Qi cannot travel without a path, just as water flows or the sun and moon orbit without rest. So do the yin vessels nourish the zang and the yang vessels nourish the fu. Spiritual Pivot Chapter 17.

INTRODUCTION
'Channels and collaterals' is a translation of the Chinese term 'jingluo'. Jing has a geographical connotation and means a channel (e.g. a water channel) or longitude. In this book it is translated as channels, elsewhere as meridians. Using the image of a tree, the jing are like the trunk and main branches of the channel network. They generally run longitudinally through the body at a relatively deep level, and connect with the internal zangfu. Specifically they comprise the twelve primary channels, the eight extraordinary vessels and the twelve divergent channels. Luo means to attach or a net, and refers to the finer branches of the channel network which are more superficial and interconnect the trunk and main branches (jing), the connective tissues and cutaneous regions. In this book they are referred to in general as the collaterals, and more specifically as the luo-connecting channels. There are fifteen luo-connecting channels, the twelve that belong to the twelve primary channels, the luo-connecting channels of the Conception and Governing vessels, and the great luo-connecting channel of the Spleen. The general category of the collaterals also includes the myriad minute collaterals that are distributed throughout the body. In addition to the jing and luo, there are twelve sinew channels and twelve cutaneous regions. Whilst a typical chart of the acupuncture channels, therefore, illustrates only the superficial pathways of the twelve primary channels, we should remember that the channel network is considerably more complex than this, and there is no part of the body, no kind of tissue, no single cell, that is not supplied by the channels. Like a tree, the trunk and main branches define the main structure, whilst ever finer branches, twigs and leaves spread out to every part. The study of the channels in traditional Chinese medicine can be said to be the equivalent of the study of anatomy in Western medicine. Chinese medicine paid scant attention to the physical structure of the interior of the body, and references to the shape and location of the internal zangfu in classical texts are few and very brief. Furthermore there was no study of the distribution of the nerves, or the origin and insertion of the muscles. Traditional Chinese medicine did, however, describe in minute detail the pathways of the wide variety of channels that serve to circulate the qi and blood to every part of the body. The channels penetrate the zangfu and the extraordinary fu in the deepest levels of the body and connect with the skin, muscles, flesh, tendons, and bones, the head, body and limbs, and the sense organs, linking all the tissues and structures of the body into an integrated whole.
HISTORY OF CHANNEL THEORY

Different theories have been advanced to explain the discovery of the channels. These theories may be summarised as being of two main kinds: i. points first, channels second, and ii. channels first, points second. According to the first theory, centuries of observation of the existence of tender spots on the body during the course of disease, and the alleviation of symptoms when they were stimulated by massage or heat, led to the gradual discovery of the acupuncture points. When sufficient points were known, they were linked into groups with common characteristics and effects, and aided by the observation of propagated sensation when they were stimulated, understanding of channel pathways followed. According to the second theory, propagated sensation during the course of massage and more especially the exploration of the internal landscape of the body through mediation and qigong practice, led to the discovery of the channel pathways, with the knowledge of specific points coming later. This second theory received strong confirmation from the significant discovery of a silk book during excavation of the Western Han tomb at Mawangdui1, which describes the pathways of eleven channels but does not refer to any specific points.

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THE FUNCTIONS OF THE CHANNELS

1 Transporting qi and blood throughout the body and rendering the body an integrated whole It is by virtue of the complex interweaving network of the channels that the qi and blood is transported to every part of the body. All the organs, sense organs and tissues are nourished, energised and warmed by the qi and blood circulating through the channel network. Using the analogy of a plant, the zangfu may be perceived as the roots of the channels, the channels themselves as the stems, and the different body tissues, and especially the sense organs, as the flowers. Thus the Heart, for example, is said to flower into the tongue. The zangfu, the channels passing through the limbs and body, and the tissues and sense organs which they nourish therefore constitute an integrated whole. At the same time, by virtue of the interconnections between the channels, the zangfu themselves are linked with each other. For example, the primary channel of the Lung originates in the Stomach, and passes through the Large Intestine and diaphragm, whilst the primary channel of the Heart connects with the Small Intestine and Lung. By virtue of their origin in the depths of the body and their emergence at the surface, the channels also link the interior with the exterior. Since they run bilaterally, or in the case of the Girdling vessel encircle the body, the primary, divergent, connecting and sinew channels as well as six of the extraordinary vessels, link the two sides of the body, and since they run vertically, the various channels link above with below. The theory of the channels, therefore, underlies one of the most significant discoveries of Chinese medicine; they form the physiological interconnections that render the body an integrated whole rather than a series of independent units. 2 Protecting the body When the pathogen comes to dwell as a guest, first it resides in the skin and body hair. If it remains and does not leave it will enter the minute connecting channels. If it remains and does not leave it will enter the luo-connecting channels. If it remains and does not leave it will enter the channels, reaching the five zang and spreading into the intestines and Stomach Essential Questions2. The various kinds of channels occupy different depths within the body. As well as nourishing and energising these different layers of the body, the channels serve to prevent the penetration of pathogenic factors that may

Most superficial
Cutaneous regions Minute collaterals Sinew channels Luo-connecting channels Primary channels Divergent channels Extraordinary channels Deep pathways of the primary and divergent channels

Deepest

attack the body from the outside. Wind, cold, damp, heat, fire and dryness are important causes of disease according to Chinese medicine. When extreme, or when the body resistance is lowered, they can attack the body and easily penetrate to the deeper levels such as the zangfu and the bones and joints. The deeper the penetration towards the zangfu, the more serious the disease becomes. Part of the function of the channel network is to contain and repel these pathogenic factors, and prevent deeper penetration. Thus, for example, a person who sleeps in a draught may wake with a stiff and painful neck. The wind and cold will usually in this instance have injured only the more superficial portions of the channel network, i.e. the sinew channels, causing local stagnation of qi and blood. Treatment, whether by acupuncture, cupping or massage will relatively easily eliminate the pathogenic factor. If, however, a person is frequently exposed to wind, cold and damp, then over time the pathogenic factors will not be contained at the level of the superficial channels, but may penetrate deeper into the body, injuring the joints, sinews and bones. If even more prolonged, the pathogens may injure and weaken the zangfu, most commonly the Liver and Kidneys. Alternatively, an acute attack of wind and cold may induce the typical symptoms of chills, slight fever, headache, body aches, runny nose etc. Here, the pathogenic factors have injured and caused stagnation of the defensive and nutritive qi in the relatively superficial portion of the body. The treatment principle is to release the exterior. If, however, the pathogenic factors are not contained at the superficial level, but penetrate deeper, they may injure the zangfu, most commonly the Lung, Stomach, Spleen or intestines. To summarise, the entire channel network serves as a series of barriers to prevent the deeper penetration of pathogenic factors from the exterior. When contained at the exterior, the disease is relatively less serious and easier to eliminate. When the body resistance is lowered, or the

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pathogenic factor is exceptionally strong or prolonged, and the channels cannot contain the pathogenic factors at the exterior, the disease is relatively more serious and harder to cure. 3 Responding to dysfunction in the body When the harmony of the body is disrupted by any of the causes of disease, the channels can respond in a number of ways: i. Disease of the channels themselves The channels themselves can be diseased giving rise to local tenderness, pain, weakness, distention, numbness, tingling etc. Disease of the channels means impaired flow of qi and blood (i.e. stagnation) or insufficiency of qi and blood leading to malnourishment. For example: back sprain due to traumatic injury can give rise to pain, aching, tingling etc. in the channels in the lumbar region and leg. attack by pathogenic wind and cold into the muscle layers can give rise to stiffness, soreness and aching with points of local tenderness, whether acupuncture points or ahshi3 points. prolonged exposure to wind-cold-damp may give rise to chronic pain and aching in the limbs and joints. previous injury or prolonged over-use of any part of the body may give rise either to stagnation or deficiency in the channels in a local area resulting in aching and pain. ii. Disease of the zangfu reflecting onto the channels When the zangfu are in disharmony internally, their related channels may also show signs of disorder, for example: stasis of Heart blood can give rise to pain which descends along the Heart channel in the arm, or ascends along the Heart channel to the throat. stagnation of Liver qi can lead to distention and pain in any portion of the Liver channel, or its interiorlyexteriorly related Gall Bladder channel, for example the genitals, lateral costal region, breasts, throat or head. Heat in the Stomach fu may give rise to symptoms such as excessive hunger and vomiting as well as transmitting to the Stomach channel in the head, giving rise to tooth abscess, bleeding gums, ulcers on the tongue etc. Liver fire can transmit via the Liver channel to the eyes and manifest as redness, soreness and pain.

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iii. Disease transmitting via the channels Disease can pass from one zangfu to another via the channels, or from one channel to another, for example: Heart fire can transmit from the Heart channel to its interiorly-exteriorly related hand Small Intestine channel, from the hand taiyang Small Intestine channel to the foot taiyang Bladder channel and thence to the Bladder fu. severe deficiency of Kidney yang and impaired transformation of body fluids can cause excessive water to overflow to the Lung and/or Heart, both linked to the Kidney via the internal pathway of its primary channel. iv. Visibly showing disease In some cases, the course of a diseased channel can be discoloured and therefore visible, whether purple showing stasis of blood, red indicating heat, or pale as a result of deficiency of qi and blood. 4 The channels serve to transmit qi to the diseased area The channels serve to transmit acupuncture stimulation from the acupuncture point to the diseased area of the body, rendering acupuncture treatment effective. By stimulating an acupuncture point by some means, whether by needling, application of heat, pressure, massage or cupping, the qi and blood of the whole course of the channel may be regulated.

THE TWELVE PRIMARY CHANNELS

GENERAL DESCRIPTION

There are twelve primary channels running vertically, bilaterally, and symmetrically. Each channel corresponds to, and connects internally with, one of the twelve zangfu. The channels corresponding to the zang are yin, and the channels corresponding to the fu are yang. There are therefore six yin and six yang channels, three yin channels and three yang channels on the arm, and three yin channels and three yang channels on the leg. To understand the pathways of the channels it is helpful to visualise a person standing with their arms by their sides, the palms facing the legs, rather than in the conventional anatomical position. The yang channels then traverse the outer surface of the arm or leg, travel to the head, and with the exception of the Stomach channel , the back. The yin channels traverse the inner surface of the limbs, and the abdomen and chest. More specifically:

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the three yin channels of the hand (Lung, Pericardium and Heart) begin on the chest and travel along the inner surface of the arm to the hand. the three yang channels of the hand (Large Intestine, Sanjiao and Small Intestine) begin on the hand and travel along the outer surface of the arm to the head. the three yang channels of the foot (Stomach, Gall Bladder and Bladder) begin on the face, in the region of the eye, and travel down the body and along the outer surface of the leg to the foot.

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the three yin channels of the foot (Spleen, Liver and Kidney) begin on the foot and travel along the inner surface of the leg to the chest or flank. The course of each of the twelve channels comprises an internal and an external pathway. The external pathway is what is normally shown on an acupuncture chart and is relatively superficial. All the acupuncture points of a channel lie on its external pathway. The internal pathways are the deep course of the channel where it enters the body cavities. The superficial pathways of the twelve channels describe three complete circuits of the body

Chest First circuit Second circuit Third circuit Lung Heart Pericardium

Hand Large Intestine Small Intestine Sanjiao

Face Stomach Bladder Gall Bladder

Foot

Chest Spleen Kidney Liver

NAMING OF THE TWELVE PRIMARY CHANNELS

The practice among English-speaking acupuncturists has been to use the same name for each zangfu and its related channel. Thus we talk of the Lung organ and the Lung channel. In practice this may blur the important distinction between the two, and serve to confuse when analysing the different clinical situations of disease of the channel alone, disease of the zangfu alone, or disease of both the zangfu and channel. In Chinese, each has a different name. Thus the Lung zang is known as fei (Lung), whilst

its related channel is known as shou taiyin fei jing (the hand taiyin Lung channel). This naming of each channel consists of three parts: i. The zang or fu to which it belongs. ii. The limb (upper or lower) through which it travels. iii. Its yin or yang identity. The twelve channels are paired with each other in two important ways:

Zangfu Lung Spleen Large Intestine Stomach Heart Kidney

Limb hand foot hand foot hand foot

Yin-yang identity taiyin (supreme yin) taiyin (supreme yin) yangming (yang brightness) yangming (yang brightness) shaoyin (lesser yin) shaoyin (lesser yin)

Zangfu Small Intestine Bladder Pericardium Liver Sanjiao Gall Bladder

Limb hand foot hand foot hand foot

Yin-yang identity taiyang (supreme yang) taiyang (supreme yang) jueyin (absolute yin) jueyin (absolute yin) shaoyang (lesser yang) shaoyang (lesser yang)

i. There is an exterior-interior relationship between the yin and yang channels on the arm, and between the yin and yang channels on the leg, whereby each yang channel of the arm is paired with a yin channel of the arm, and each

yang channel of the leg is paired with a yin channel of the leg. This interior-exterior relationship expresses both an important physiological connection between the paired zang and fu, and an anatomical relationship between the

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channels. For example, when a person stands as described above, the Stomach channel of foot yangming occupies the anterior portion of the outer surface of the leg. It is interiorly-exteriorly related to the Spleen channel of foot taiyin which occupies the anterior portion of the inner surface of the leg. At the same time, the Stomach function

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of rotting and ripening food and drink is closely linked, physiologically, to the Spleen function of transporting and transforming the products of digestion. The interior-exterior relationships of the twelve primary channels are as follows:

Channel Pathway
Lung Large Intestine Pericardium Sanjiao Heart Small Intestine anterior portion of the inside of the arm anterior portion of the outside of the arm middle portion of the inside of the arm middle portion of the outside of the arm posterior portion of the inside of the arm posterior portion of the outside of the arm

Channel Pathway
Spleen Stomach Liver Gall Bladder Kidney Bladder anterior portion of the inside of the leg anterior portion of the outside of the leg middle portion of the inside of the leg middle portion of the outside of the leg posterior portion of the inside of the leg posterior portion of the outside of the leg

ii. The second pairing of the twelve primary channels results from a different perspective on their anatomical relationship, rather than the physiological functions of their related zangfu, although such a relationship often exists. In this pairing, a yang channel is paired with another yang channel, a yin channel with a yin channel. If a person stands normally, with their arms at their sides, the channel that occupies the anterior portion of the outer aspect of the arm is the Large Intestine channel of hand yangming. This is linked to the channel that occupies an anatomically similar position on the leg, i.e. the Stomach channel of foot yangming. The paired connection between these two channels is reflected in the fact that part of their name (yangming) is identical. So important is this paired relationship, that they are often described as the six channels, each pair being referred to as a single channel. For example, yangming

channel as a whole (meaning both Large Intestine and Stomach channels) is described as being abundant in qi and blood. Similarly, the treatment principle for a patient presenting with pain in the lateral costal region as well as temporal headache may be to harmonise shaoyang channel. These two alternative ways of pairing the channels come together in the three main circuits of the flow of qi through the twelve primary channels. The flow of qi in each circuit begins in a yin channel on the chest and passes to the interiorly-exteriorly related yang channel at the hand. It then ascends along the yang channel to the face where it passes into the yang channel's paired yang channel according to six channel theory and descends to the foot where it passes to the interiorly-exteriorly related yin channel and ascends back to the chest before beginning a new circuit.
interiorly-exteriorly related

Lung channel of hand taiyin

six channel pairing

Large Intestine channel of hand yangming Stomach channel of foot yangming Spleen channel of foot taiyin Heart channel of hand shaoyin
interiorly-exteriorly related

six channel pairing

interiorly-exteriorly related

Small Intestine channel of hand taiyang Bladder channel of foot taiyang Kidney channel of foot shaoyin Pericardium channel of hand jueyin
interiorly-exteriorly related

six channel pairing

interiorly-exteriorly related

Sanjiao channel of hand shaoyang Gall Bladder channel of foot shaoyang Liver channel of foot jueyin
interiorly-exteriorly related

back to Lung channel

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THE INTERIOR PATHWAYS OF THE PRIMARY CHANNELS

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resurface at the supraclavicular fossa, neck or face and join their primary yang channel again. The yin divergent channels belonging to the yin primary channels: separate from their yin primary channel on the limbs. sometimes enter their pertaining zang (Kidney, Heart, Lung). converge with their internally-externally related divergent channel. then join the primary yang channel itself.
FUNCTIONS AND CLINICAL SIGNIFICANCE OF THE DIVERGENT CHANNELS

There is a tendency in studying the primary channels to focus on their superficial pathways, since this is where the acupuncture points lie. To understand the actions and indications of the points however, it is essential to know the deep pathways of the primary channels. For example: the Lung channel originates in the middle jiao, in the region of the Stomach, and most of the points of the Lung channel are able to treat disorders such as nausea and vomiting. the Stomach channel ascends to meet with the Governing vessel at points Shenting DU-24 and Renzhong DU-26. Since the Governing vessel enters the brain, this connection helps explain the important action of many Stomach channel points on disorders of the spirit. the affinity of Hegu L.I.-4 for treating pain both at the forehead and the side of the head reflects the fact that the internal pathway of the Large Intestine channel meets with the Gall Bladder channel at Yangbai GB-14, Xuanlu GB-5 and Xuanli GB-6. the internal pathway of the Pericardium channel descends through the middle jiao, enabling points such as Neiguan P-6 to treat nausea and vomiting.

1 The divergent channels strengthen the yin-yang relationship between internally-externally paired channels and zangfu The interiorly-exteriorly related channels and zangfu are already linked by the primary and luo-connecting channels in the following ways: each primary channel precedes or follows its paired channel in the qi circuit, for example the Lung channel precedes the Large Intestine channel, the Spleen channel follows the Stomach channel. each primary channel internally links its own related zang or fu with the zang or fu corresponding to its paired channel, for example the Lung channel penetrates the Lung zang and the Large Intestine fu. the luo-connecting channels link the paired channels Since the yang divergent channels further connect the paired zangfu and since the yin divergent channels intersect first with the yang divergent channels and then with the yang primary channels, the divergent channels are said to strengthen the bonds of paired yin and yang primary channels and the paired zangfu themselves. 2 The divergent channels distribute qi and blood to head and face The six primary yang channels all circulate to the head and face, but of the yin primary channels only the Heart and Liver do so. By their link with the yang divergent and primary channels, the yin divergent channels provide a pathway for the yin channels to circulate qi and blood to the head and face. For example the Lung channel does not ascend higher than the throat region but Lung qi can circulate to the nose by virtue of the connection between the Lung divergent channel and the Large Intestine primary channel.

THE TWELVE DIVERGENT CHANNELS

The twelve divergent channels branch out from the twelve primary channels and have no specific points of their own. It is important, however, to be familiar with the principal features of the divergent channels, since their pathways make internal linkages that may not be made by the primary channels, and therefore serve to explain the actions and indications of many points. Most of the divergent channels belonging to the yang primary channels: separate from their yang primary channel on the limbs e.g. the Bladder channel at the popliteal fossa, the Stomach and Gall Bladder channels on the thigh, the Small Intestine channel at the shoulder, the Large Intestine channel on the hand. enter their related zang or fu as well as their internally-externally related zang or fu, for example the Bladder divergent channel travels to the Bladder fu and then to the Kidney zang; the Stomach divergent channel travels to the Stomach fu then to the Spleen zang etc.

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3 The divergent channels integrate areas of the body not supplied or interconnected by the primary channels For example: great emphasis is placed on the important relationship between the Heart and the Kidneys (fire and water), yet although the primary channel of the Kidney connects with the Heart, the primary channel of the Heart does not connect with the Kidneys. The divergent channel of the Bladder (interiorly-exteriorly related to the Kidneys), however, travels from the Kidneys to the Heart, strengthening this bond. neither the Liver nor the Gall Bladder primary channels travel directly to the Heart, but the pathway of the Gall Bladder divergent channel to the Heart reinforces and helps explain the close physiological relationship between the Heart and the Liver and Gall Bladder. 4 The divergent channels help explain the clinical action of some commonly-used acupuncture points For example: the Bladder divergent channel circulates through the rectal area, helping to explain the action of points such as Chengshan BL-57 and Feiyang BL-58 on the treatment of rectal diseases, especially haemorrhoids. the Stomach divergent channel enters the Heart, helping to explain the use of many Stomach channel points in the treatment of disorders of the spirit. the Bladder divergent channel links with the Heart helping to explain the effect of points of the Bladder channel in the treatment of disharmony of the Heart and spirit, for example Shenmai BL-62 for epilepsy, palpitations, insomnia and mania-depression disorder The pathways of the divergent channels are illustrated in the main body of this text.

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branch off from the trunks of the primary channels, and interlink the primary channels to each other. The pathways of the Conception and Governing vessels are discussed in detail in the main text of this book. The pathways of the remaining six extraordinary channels are given in the following pages.
FUNCTIONS OF THE EXTRAORDINARY VESSELS

1 The extraordinary vessels act as reservoirs The Classic of Difficulties4 compares the extraordinary channels to reservoirs which are able to absorb excessive qi and blood from the primary channels in the same way that reservoirs take excess water from canals and ditches at times of heavy rain. 2 The extraordinary vessels link the twelve primary channels the Governing vessel links all the yang channels at Dazhui DU-14, and is known as the sea of the yang channels, and helps regulate the qi of all the yang channels. the Conception vessel links all the yin channels, and is known as the sea of the yin channels and helps regulate the qi of all the yin channels. the Penetrating vessel links the Stomach and Kidney channels as well as strengthening the link between the Conception and Governing vessels (like both of these vessels it originates in the pelvic cavity and ascends the front of the body as well as the spine). It is known as the sea of blood or the sea of the twelve primary channels. the Girdling vessel encircles the body at the waist, binding the vertical paths of the twelve primary channels in general and the Penetrating and Conception vessels and the Kidney, Liver and Spleen channels in particular. the Yin Motility vessel connects the Kidney and Bladder channels and is said to dominate quietness. the Yang Motility vessel connects the Bladder, Gall Bladder, Small Intestine, Large Intestine and Stomach channels and is said to dominate activity. the Yin Linking vessel connects the Kidney, Spleen and Liver channels and the Conception vessel and is said to dominate the interior of the whole body. the Yang Linking vessel connects the Bladder, Gall Bladder, Sanjiao, Small Intestine and Stomach channels and the Governing vessel, and is said to dominate the exterior of the whole body.

THE EIGHT EXTRAORDINARY VESSELS

The eight extraordinary vessels are the Conception (Ren), the Governing (Du), the Penetrating (Chong), the Girdling (Dai), the Yin Motility (Yin Qiao), the Yang Motility (Yang Qiao), the Yin Linking (Yin Wei) and the Yang Linking (Yang Wei). Of the eight, only the Conception and Governing vessels have points of their own and they are therefore sometimes included with the twelve primary channels in the term the fourteen channels. The remaining six extraordinary vessels have no points of their own, but share points of the fourteen channels (known as the coalescent points). The eight extraordinary channels

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3 The extraordinary vessels protect the body The Conception, Governing and Penetrating vessels circulate defensive qi over the chest, abdomen and back, helping to protect the body from exterior pathogenic factors. Since these three vessels originate in the pelvic cavity and are directly linked with the Kidneys, the storehouse of pre-heaven qi, this function demonstrates the relationship between constitutional vigour and defence against disease.
THE EXTRAORDINARY VESSELS HAVE THEIR OWN CONFLUENT POINTS

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GIRDLING VESSEL

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originates in the region of Zhangmen LIV-13, circles round just below the hypochondriac region, runs obliquely downwards through Daimai GB-26, Wushu GB-27 and Weidai GB-28, encircling the waist like a belt. Coalescent points: Daimai GB-26, Wushu GB-27 and Weidai GB-28. Pathological symptoms of the Girdling vessel Abdominal fullness, a sensation at the waist as though sitting in water, pain around the umbilicus, abdomen, waist and lumbar spine, red and white leucorrhoea, irregular menstruation, infertility, insufficient sperm, shan disorder.
YANG MOTILITY VESSEL

Each of the eight extraordinary channels has a confluent point on the limbs which is considered to have an effect on its extraordinary channel. These are listed and discussed in the Point Categories chapter.

THE PATHWAYS OF THE EIGHT EXTRAORDINARY VESSELS

For illustrations of the extraordinary channels discussed below, see the end of this chapter.
PENETRATING VESSEL

originates inside the lower abdomen (in the uterus in women), emerges at the perineum (Huiyin REN-1), one branch ascends inside the spinal column, another branch emerges at Qichong ST-30, connects with the Kidney channel at Henggu KID-11 and ascends through the Kidney channel to Youmen KID-21, then disperses in the chest, from here, a third branch ascends alongside the throat, curves around the lips and terminates below the eye, a fourth branch emerges at Qichong ST-30, descends the medial aspect of the legs to the popliteal fossa, then descends the medial side of the lower leg, runs posterior to the medial malleolus and terminates on the sole of the foot a fifth branch separates from the leg branch at the heel, crosses the foot and terminates at the big toe. Coalescent points: Huiyin REN-1, Yinjiao REN-7, Qichong ST-30, Henggu KID-11, Dahe KID-12, Qixue KID-13, Siman KID-14, Zhongzhu KID-15, Huangshu KID-16, Shangqu KID-17, Shiguan KID-18, Yindu KID-19, Futonggu KID-20, Youmen KID-21. Pathological symptoms of the Penetrating vessel Counterflow qi, abdominal urgency, dyspnoea, gynaecological disorders, atrophy disorder of the leg.

originates at the lateral side of the heel at Shenmai BL-62, ascends along the lateral malleolus and the posterior border of the fibula, ascends the lateral side of the thigh to the hip (Juliao GB-29) and the postero-lateral costal region to the posterior axillary fold, zig-zags across the top of the shoulder, ascends across the neck to the corner of the mouth, ascends the cheek and alongside the nose to the inner canthus and communicates with the Yin Motility vessel and the Bladder channel at Jingming BL-1, continues upwards to the forehead then curves across the parietal region and descends to meet with Fengchi GB-20 and enters the brain at the occiput between the two tendons. Coalescent points: Shenmai BL-62, Pucan BL-61, Fuyang BL-59, Juliao GB-29, Naoshu SI-10, Jianyu L.I.-15, Jugu L.I.-16, Dicang ST-4, Juliao ST-3, Chengqi ST-1, Jingming BL-1 and Fengchi GB-20. Pathological symptoms of the Yang Motility vessel Daytime epilepsy, eye diseases, loss of consciousness, aversion to wind, hemiplegia, chronic painful obstruction, rigidity of the body, lumbar pain, contracted sinews, flaccidity of the muscles of the medial leg and tightness of the muscles of the lateral leg.

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THE PENETRATING VESSEL

a branch ascends alongside the throat, curves around the lips and terminates below the eye

a branch emerges at Qichong ST-30 and ascends via Yinjiao REN-7 through points Henggu KID-11 to Youmen KID-21 then disperses in the chest

originates in the lower abdomen (in the uterus in women) and descends to emerge at Huiyin REN-1

one branch ascends inside the spinal column

a branch emerges at Qichong ST-30, descends the medial aspect of the legs and terminates on the sole of the foot

a branch separates at the heel and terminates at the big toe.

Coalescent points Huiyin REN-1, Yinjiao REN-7, Qichong ST-30, Henggu KID-11, Dahe KID-12, Qixue KID-13, Siman KID-14, Zhongzhu KID-15, Huangshu KID-16, Shangqu KID-17, Shiguan KID-18, Yindu KID-19, Futonggu KID-20, Youmen KID-21.

Pathological symptoms of the Penetrating vessel Counterflow qi, abdominal urgency, dyspnoea, gynaecological disorders, atrophy disorder of the leg.

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THE GIRDLING VESSEL

originates in the region of Zhangmen LIV-13

encircles the waist like a belt passing through Daimai GB-26, Wushu GB-27 and Weidao GB-28

Coalescent points Daimai GB-26, Wushu GB-27 and Weidao GB-28.

Pathological symptoms of the Girdling vessel Abdominal fullness, a sensation at the waist as though sitting in water, pain around the umbilicus, abdomen, waist and lumbar spine, red and white leucorrhoea, irregular menstruation, infertility, insufficient sperm, shan disorder.

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THE YANG MOTILITY VESSEL

curves across the side of the head to meet with Fengchi GB-20 and enters the brain

ascends along the neck to the face, meeting with Dicang ST-4, Juliao ST-3, Chengqi ST-1and Jingming BL-1where it meets with the Yin Motility vessel

crosses the shoulder, passing through Naoshu SI-10, Jianyu L.I.-15 and Juliao L.I.-16

ascends the lateral side of the thigh to the hip at Juliao GB-29

ascends along the posterior border of the fibula

originates at Shenmai BL-62, descends to Pucan BL-61 and then ascends to Fuyang BL-59

Coalescent points Shenmai BL-62, Pucan BL-61, Fuyang BL-59, Juliao GB-29, Naoshu SI-10, Jianyu L.I.-15, Jugu L.I.-16, Dicang ST-4, Juliao ST-3, Chengqi ST-1, Jingming BL-1 and Fengchi GB-20.

Pathological symptoms of the Yang Motility vessel Daytime epilepsy, eye diseases, loss of consciousness, aversion to wind, hemiplegia, chronic painful obstruction, rigidity of the body, lumbar pain, contracted sinews, flaccidity of the muscles of the medial leg and tightness of the muscles of the lateral leg.

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YIN MOTILITY VESSEL

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YIN LINKING VESSEL

originates below the medial malleolus at Zhaohai KID-6, ascends along the medial malleolus and the posteromedial surface of the lower leg and thigh to the external genitalia, then ascends the abdomen and chest to the supraclavicular fossa, ascends through the throat and emerges anterior to Renying ST-9, ascends beside the mouth and nose to the inner canthus where it meets with the Yang Motility vessel and Bladder channel at Jingming BL-1, then ascends with them to enter the brain. Coalescent points: Zhaohai KID-6, Jiaoxin KID-8 and Jingming BL-1. Pathological symptoms of the Yin Motility vessel Night-time epilepsy, eye diseases, chills and fever, painful obstruction of the skin due to damp-heat, hypogastric pain, internal urgency, pain of the genitals, contracted sinews, shan disorder, uterine bleeding, leucorrhoea, flaccidity of the muscles of the lateral leg and tightness of the muscles of the medial leg.
YANG LINKING VESSEL

originates at the medial side of the leg at Zhubin KID-9 (at the junction of the leg yin channels), ascends along the medial aspect of the leg and thigh to the lower abdomen, ascends the ribs to Qimen LIV-14, ascends to the throat to meet the Conception vessel at Tiantu REN-22 and Lianquan REN-23. Coalescent points: Zhubin KID-9, Chongmen SP-12, Fushe SP-13, Daheng SP-15, Fuai SP-16, Qimen LIV-14, Tiantu REN-22 and Lianquan REN-23. Pathological symptoms of the Yin Linking vessel Heart pain, pain of the chest, fullness and pain of the lateral costal region, lumbar pain.

originates near the heel at Jinmen BL-63 (at the junction of the leg yang channels), ascends along the lateral malleolus and the Gall Bladder channel of the leg to pass through the hip region, ascends along the postero-lateral costal region (posterior to the Yang Motility vessel) to the posterior axillary fold (Naoshu SI-10), crosses the top of the shoulder (Tianliao SJ-15 and Jianjing GB-21) and ascends along the neck and jaw, then passes anterior to the ear as far as the forehead (Benshen GB-13), crosses the parietal region through the points of the Gall Bladder channel as far as Fengchi GB-20, then connects with the Governing vessel at Fengfu DU-16 and Yamen DU-15. Coalescent points: Jinmen BL-63, Yangjiao GB-35, Naoshu SI-10, Tianliao SJ-15, Jianjing GB-21, Touwei ST-8, Benshen GB-13, Yangbai GB-14, Toulinqi GB-15, Muchuang GB-16, Zhengying GB-17, Chengling GB-18, Naokong GB-19, Fengchi GB-20, Fengfu DU-16 and Yamen DU-15. Pathological symptoms of the Yang Linking vessel Visual dizziness, dyspnoea, acute and sudden pain and swelling of the lumbar region, chills and fever, dyspnoea with raised shoulders, fever and chills.

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THE YIN MOTILITY VESSEL

ascends to enter the brain

ascends through the throat and emerges anterior to Renying ST-9

ascends beside the mouth and nose to the inner canthus where it meets with the Yang Motility vessel and the Bladder channel at Jingming BL-1

ascends the abdomen and chest to the supraclavicular fossa

ascends along the postero-medial surface of the lower leg and thigh to the external genitalia

originates at Zhaohai KID-6 and ascends to Jiaoxin KID-8

Coalescent points Zhaohai KID-6, Jiaoxin KID-8 and Jingming BL-1.

Pathological symptoms of the Yin Motility vessel Night-time epilepsy, eye diseases, chills and fever, painful obstruction of the skin due to damp-heat, hypogastric pain, internal urgency, pain of the genitals, contracted sinews, shan disorder, uterine bleeding, leucorrhoea, flaccidity of the muscles of the lateral leg and tightness of the muscles of the medial leg.

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THE YANG LINKING VESSEL

ascends to Touwei ST-8 and crosses the parietal region from points Benshen GB-13 through to Fengchi GB-20 ascends along the neck and jaw and passes anterior to the ear

connects with the Governing vessel at Yamen DU-15 and Fengfu DU-16

ascends to Naoshu SI-10, and crosses the shoulder via Tianliao SJ-15 and Jianjing GB-21

ascends along the lateral aspect of the leg and passes through the hip region

originates at Jinmen BL-63 and ascends through Yangjiao GB-35

Coalescent points Jinmen BL-63, Yangjiao GB-35, Naoshu SI-10, Tianliao SJ-15, Jianjing GB-21, Touwei ST-8, Benshen GB-13, Yangbai GB-14, Toulinqi GB-15, Muchuang GB-16, Zhengying GB-17, Chengling GB-18, Naokong GB-19, Fengchi GB-20, Fengfu DU-16 and Yamen DU-15.

Pathological symptoms of the Yang Linking vessel Visual dizziness, dyspnoea, acute and sudden pain and swelling of the lumbar region, chills and fever, dyspnoea with raised shoulders.

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THE YIN LINKING VESSEL

ascends to the throat to meet the Conception vessel at Tiantu REN-22 and Lianquan REN-23

meets with Chongmen SP-12, Fushe SP-13, Daheng SP-15, Fuai SP-16 and Qimen LIV-14

originates at Zhubin KID-9 and ascends along the medial side of the leg to the abdomen

Coalescent points Zhubin KID-9, Chongmen SP-12, Fushe SP-13, Daheng SP-15, Fuai SP-16, Qimen LIV-14, Tiantu REN-22 and Lianquan REN-23.

Pathological symptoms of the Yin Linking vessel Heart pain, pain of the chest, fullness and pain of the lateral costal region, lumbar pain.

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THE LUO-CONNECTING CHANNELS

There are fifteen principal luo-connecting channels which branch out from the primary channels and the extraordinary vessels and are distributed superficially over the body. The fifteen luo-connecting channels are made up of twelve from the twelve primary channels, one each for the Conception and Governing vessels, and the great luoconnecting channel of the Spleen.
PATHWAYS OF THE LUO-CONNECTING CHANNELS

Spleen great luo-connecting channel: from Dabao SP-21 the luo-connecting channel spreads through the chest and lateral costal region. the Essential Questions5 mentions a sixteenth luo-connecting channel known as the Stomach great luo-connecting channel which connects with the Lung and can be felt and sometimes seen throbbing ceaselessly below the left breast.
FUNCTIONS OF THE LUO-CONNECTING CHANNELS

The luo-connecting channels of the twelve primary channels spread from the luo-connecting point of their own channel to connect with their internally-externally paired channel. After joining with their paired channel they usually continue to follow their own pathways: Lung: from Lieque LU-7 the luo-connecting channel travels to the palm and thenar eminence. Large Intestine: from Pianli L.I.-6 the luo-connecting channel travels to the jaw, teeth and ear. Stomach: from Fenglong ST-40 the luo-connecting channel travels to the nape of the neck, head and throat. Spleen: from Gongsun SP-4 the luo-connecting channel travels to the abdomen, Stomach and intestines. Heart: from Tongli HE-5 the luo-connecting channel follows the Heart channel to the Heart, the base of the tongue and the eye. Small Intestine: from Zhizheng SI-7 the luo-connecting channel travels to the shoulder. Bladder: from Feiyang BL-58 the luo-connecting channel travels to the Kidney channel. Kidney: from Dazhong KID-4 the luo-connecting channel follows the Kidney channel to the perineum and lumbar vertebrae. Pericardium: from Neiguan P-6 the luo-connecting channel travels to the Pericardium and Heart. Sanjiao: from Waiguan SJ-5 the luo-connecting channel travels to meet the Pericardium channel at the chest. Gall-Bladder: from Guangming GB-37 the luo-connecting channel travels to the dorsum of the foot. Liver: from Ligou LIV-5 the luo-connecting channel travels to the genitals. The pathways of the three remaining luo-connecting channels are as follows: Conception vessel: from Jiuwei REN-15 the luo-connecting channel spreads over the abdomen. Governing vessel: from Chengqiang DU-1 the luo-connecting channel travels up the sides of spine to the top of the head; at the shoulder blades it joins with the Bladder channel and threads through the spine.

The luo-connecting channels strengthen the connection between internally-externally paired channels and zangfu. For a full discussion of the actions of the luo-connecting points, please refer to the chapter on Point Categories. The pathways of the luo-connecting channels are illustrated in the main body of this text.

THE TWELVE SINEW CHANNELS

The twelve sinew channels: circulate on the periphery of the body. do not penetrate to the zangfu. are associated with and take their names from the twelve primary channels. all originate at the extremities (unlike the primary channels) and ascend to the head and trunk. broadly follow the course of their associated primary channels but are wider. are more superficial and follow the lines of major muscles and muscle groups, tendons, ligaments etc.
CLINICAL SIGNIFICANCE OF THE SINEW CHANNELS

The sinew channels can either reflect disturbances of the primary channels or can be injured themselves, mainly by traumatic injury or attack by exterior pathogens. There are no specific points which treat the sinew channels but they may be accessed by shallow needle insertions (especially at Ahshi points), and by relatively superficial techniques such as cupping, massage, plum blossom needling, dermal needling and guasha (skin scraping). The pathways of the sinew channels are illustrated in the main body of this text.

THE MINUTE COLLATERALS

Little is said about the minute collaterals in classical texts and it is possible that they derived their identity from observation of small blood vessels at the surface of the

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body. What is evident, however, is that for the qi and blood to reach every part of the body, the larger channels and collaterals need to branch into ever more minute channels, and it is this function that the minute collaterals serve.

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THE TWELVE CUTANEOUS REGIONS

The twelve cutaneous regions are not channels as such, but skin regions overlying the broad network of superficial channels and linked to them. The cutaneous regions provide the theoretical foundation for the idea of invasion by exogenous pathogenic factors through the skin to the deeper layers of the jingluo system. Cutaneous regions also manifest disorders of the deep-lying channels, for example by abnormal skin sensations, skin lesions or discoloration: a blue-green (qing) colour indicates pain a red colour indicates heat a white colour indicates deficiency and cold Finally, the cutaneous regions explain how treatment applied at the level of the skin (for example medicinal ointments, massage, cupping, plum blossom needling, skin scraping and dermal needling) is able to have a deep therapeutic effect. See overleaf for illustrations of the cutaneous regions.

NOTES
1 Silk scrolls describing the pathways of eleven channels and dating back to the 2nd century BCE were discovered during the excavation of tombs at Mawangdui, Hunan Province. 2 Essential Questions Chapter 63. 3 Ahshi points are points of tenderness that may or may not be standard acupuncture points of the fourteen channels. 4 Classic of Difficulties 27th Difficulty. 5 Essential Questions Chapter 18.

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THE CUTANEOUS REGIONS

Taiyang

Shaoyang

Yangming

Taiyin

Shaoyin

Jueyin