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THE MAIN CHANNELS

6 7 8 9 10 11

Pathways of the main channels 81 Channel symptoms 97 Treatment of main channels 107 The Five Transporting (Shu) points 141 Categories of points 157 The combination of acupuncture points 177

Part 2 of the book deals with the Main channels: their pathways, symptoms and treatment. Besides discussing the Main channels, this part will also discuss the nature and action of the various categories of points. This Part ends with a discussion of the principles governing the combination of points in a treatment.

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PART 2

CHAPTER 6

PATHWAYS OF THE MAIN CHANNELS

LUNG CHANNEL PATHWAY 81 LARGE INTESTINE CHANNEL PATHWAY 82 STOMACH CHANNEL PATHWAY 84 SPLEEN CHANNEL PATHWAY 84 HEART CHANNEL PATHWAY 86 SMALL INTESTINE CHANNEL PATHWAY 87 BLADDER CHANNEL PATHWAY 88 KIDNEY CHANNEL PATHWAY 90 PERICARDIUM CHANNEL PATHWAY 90 TRIPLE BURNER CHANNEL PATHWAY 92 GALL BLADDER CHANNEL PATHWAY 92 LIVER CHANNEL PATHWAY 94

The internal trajectories of the Main channels are described in Chapter 10 of the Spiritual Axis. Modern Chinese books tend to describe the pathways of the channels in an anatomically detailed way that the ancient texts did not have. Acupuncture books in the English language also tend to do the same. For example, the Manual of Acupuncture says that the Lung channel ascends one rib space to Yunmen LU-2 in the centre of the hollow of the delto-pectoral triangle;1 obviously the delto-pectoral triangle is a modern anatomical description and Chapter 10 of the Spiritual Axis describes this part of the Lung channel pathway simply as it descends to the inner side of the shoulder.2 I shall try and follow, as much as possible, the description of the pathways from Chapter 10 of the Spiritual Axis, except in cases where it would be too vague: in such cases, I will integrate the source material from the Spiritual Axis with that from modern Chinese books, putting the text from modern Chinese books in square brackets. The four best English-language sources for the pathways of the channels are the Manual of Acupuncture (Deadman & Al Khafaji 1998),3 Acupuncture a Comprehensive Text (Bensky & OConnor 1981),4

Chinese Acupuncture and Moxibustion (Qiu, 1993)5 and Chinese Acupuncture and Moxibustion (Chen 1987).6 Each channel has two pathways: one supercial and the other deep. The supercial pathway is the section of the channel that flows under the skin and in between muscles and tendons: acupuncture points are located on this part of the channel. The channels deep pathway flows in the interior of the body and into the Internal Organs themselves. Thus, although it is through the supercial part of the pathway that we can affect Qi and Blood, it is only through the deep pathways that we can affect the Internal Organs. For example, the Kidney supercial pathway flows from under the little toe, up the medial side of the leg from the points KI-1 Yongquan to KI-10 Yingu, through the lower abdomen from the points KI-11 Henggu to KI-21 Youmen, and nally to the chest from KI-22 Bulang to KI-27 Shufu. This is the section of the channel where the points are situated and where treatment is applied. By contrast, the deep pathway of the Kidney channel flows internally into the spine, the bladder, the kidneys, the liver and the lungs. It is by virtue of the deep part of the channel that we can affect the Internal Organs. See Figure 6.8. On the gures, the supercial pathways are indicated with a solid line while the deep pathways are indicated with a dotted line.

LUNG CHANNEL PATHWAY

The Lung channel of the arm Greater Yin starts in the Middle Burner It descends to connect with the large intestine

81

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It goes along the mouth [cardiac orice] of the stomach It traverses the diaphragm and enters the lung to which it belongs It emerges from the lung system and goes sideways to the area below the axilla, [it emerges from the lung and rises to the larynx in the throat area then to go downwards sideways to the area below the axilla] Running in front of the Pericardium channel, it enters the elbow Going continuously downward along the anterior border of the bone [radius] on the medial side of the arm, it enters the area of the radial pulse [LU-9 Taiyuan] It goes up to LU-10 Yuji It goes along the edge of LU-10 Yuji It ends at the tip of the thumb [medial side of the thumb]. See Figure 6.1.

CLINICAL NOTE It is interesting to note that the Lung channel starts in the Middle Burner, from the Stomach. Moreover, on its way up, the Lung channel goes through the mouth of the Stomach. This has an important clinical relevance because this connection between the Stomach and the Lung channel confirms the functional relationship between Lungs (Metal) and Stomach (Earth). Earth is the Mother of Metal and, indeed the Stomach and Spleen are frequently reinforced to tonify the Lungs. I personally use Ren-12 Zhongwan very frequently to tonify the Lungs, especially because that is the area from which the Lung channel starts. The pathway of the Lung channel over the larynx confirms the influence of the Lungs on the voice.

LARGE INTESTINE CHANNEL PATHWAY

The Large Intestine channel of the arm Bright Yang starts from the tip of the index nger It then runs along the [radial] side of the index nger to emerge at L.I.-4 Hegu in between two bones [rst and second metacarpals] It goes up dipping in between two tendons [tendons of m. extensor pollicis longus and brevis] It enters the lateral side of the elbow It flows up the lateralanterior aspect of the arm It then reaches the shoulder at the point L.I.-15 Jianyu From L.I.-15, it goes to the 7th cervical vertebra [connects with Du-14 Dazhui] It descends to the supraclavicular fossa to enter the lung It penetrates the diaphragm downwards to reach the large intestine From the supraclavicular fossa a branch ascends along the neck [along the sternocleidomastoid muscle] to the cheek and enters the gums of the lower teeth It then curves around the mouth and crosses Du-26 Renzhong From Du-26 the left channel goes to the right side, and vice versa, to end at the side of the

Fig. 6.1 Lung channel.

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nose [where it links with the Stomach channel]. See Figure 6.2.

CLINICAL NOTE Note that the Large Intestine channel flows to the lower teeth: it is therefore used clinically for problems of teeth and/or gums of the lower jaw; for the upper jaw, the Stomach channel is used.

!
The expression it goes up dipping in between two tendons is interesting as it shows that the channels frequently change depth during their trajectory dipping into joints and other structures or emerging from them. When we draw the channels, we tend to think of them as pathways with a uniform depth throughout but this is not the case.
CLINICAL NOTE Note that the Spiritual Axis says specifically that from Du-26 the left channel goes to the right side, and vice versa, to end at the side of the nose.7 This means that, to treat problems of the face, teeth and gums, the point L.I.-4 Hegu should be used contralaterally, i.e. on the opposite side to the location of the problem.

Fig. 6.2 Large Intestine channel.

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STOMACH CHANNEL PATHWAY

The Stomach channel of leg Bright Yang starts from the lateral side of ala nasi [at L.I.-20 Yingxiang ] It ascends along the nose and meets the Bladder channel [at BL-1 Jingming] It then descends along the outside of the nose and enters the upper teeth It curves around the lips and crosses with Ren-24 Chengjiang It then runs along the posterior side of the cheek reaching ST-5 Daying Winding along the jaw at ST-6 Jiache, it ascends in front of the ear It traverses G.B.-3 Shangguan It follows the anterior hairline and reaches the forehead at Du-24 Shenting From ST-5 Daying a branch goes downward along ST-9 Renying, along the throat and to the supraclavicular fossa It then passes through the diaphragm It enters the stomach, to which it belongs, and connects with the spleen From the supraclavicular fossa, a branch flows down to below the breast and abdomen on the side of the umbilicus to enter ST-30 Qichong Another branch from the orice of the stomach descends inside the abdomen and joins the previous portion of the channel at ST-30 Qichong From this point it runs downwards and traverses ST-31 Biguan and ST-32 Futu It reaches the knee From here it continues downwards along the anterior border of the lateral aspect of the tibia It passes through the dorsum of the foot and reaches the medial side of the middle toe [lateral side of the second toe]8 A branch starting 3 cun below the knee goes down to reach the lateral side of the middle toe Another branch from the dorsum of the foot goes to the big toe [where it links with the Spleen channel]. See Figure 6.3.

CLINICAL NOTE It is interesting to note that the Stomach channel (Bright Yang) meanders all over the face and connects with the Lesser Yang channels at G.B.-3 Shangguan and the Greater Yang channels at BL-1 Jingming. This means that, when treating problems of the face, the Stomach channel is extremely important because through it we can treat all three Yang channels, i.e. Bright Yang, Lesser Yang and Greater Yang.

CLINICAL NOTE Please note that the Spiritual Axis says that the Stomach channel passes through the dorsum of the foot and reaches the medial side of the middle toe. This is interesting: all modern books and charts have the Stomach channel ending at the second toe. Clinically, this discrepancy is not that important as the Stomach channel in fact affects both the second and the third toe.

CLINICAL NOTE Two branches of the Stomach channel flow to the point ST-30 Qichong: one goes from the clavicular fossa down to below the breast and abdomen on the side of the umbilicus to enter ST-30 Qichong; the other goes from the orifice of the stomach down inside the abdomen and joins the previous portion of the channel at ST-30 Qichong. This explains the important and dynamic function of ST-30 Qichong.

SPLEEN CHANNEL PATHWAY

The Spleen channel of the leg Greater Yin starts from the tip of the big toe It runs along the medial aspect of the foot at the border with the white flesh [at the junction of the red and white skin] It ascends in front of the medial malleolus, up the inside [medial aspect] of the leg It follows the back [posterior aspect] of the tibia It crosses and goes in front of the Liver channel

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Fig. 6.3 Stomach channel.

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It goes up the medial aspect of the knee and thigh to enter the abdomen It enters the spleen, to which it belongs, and connects with the stomach From the stomach, it ascends traversing the diaphragm and reaching the oesophagus It reaches the root of the tongue and scatters on the underside of the tongue From the stomach, a branch goes through the diaphragm and links with the heart. See Figure 6.4.

CLINICAL NOTE It is very interesting that the Spleen channel goes to the heart starting from the stomach. This channel connection confirms and further explains the physiological connection between the Stomach and Spleen and the Heart. I personally always use the Stomach and Spleen channels to support the Heart in case of heart pathology such as tachycardia or arrhythmia. Interestingly, if we place the FiveElement diagram with the Earth in the centre and the other four Elements in a cross, the Earth is below Fire.

HEART CHANNEL PATHWAY

The Heart channel of the arm Lesser Yin originates from the heart It emerges through the heart system [the tissues connecting the heart with other Internal Organs] It goes downwards through the diaphragm to connect with the small intestine A branch from the heart system ascends to the throat and eye Another branch from the heart system enters the lung and emerges at the axilla From the axilla, it flows down the inside-back of the arm [posterior border of the medial aspect of the upper arm] medial to the Lung and Pericardium channels down to the cubital fossa and pisiform bone It enters the palm and follows the medial aspect of the little nger to end at the medial side of its tip. See Figure 6.5.
Fig. 6.4 Spleen channel.

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CLINICAL NOTE It is interesting that a branch from the heart system ascends to the eye: this confirms the influence of Heart pathology on eye problems.

CLINICAL NOTE The coursing of the Heart channel to the throat confirms the influence that this channel (and organ) has on the throat. Some throat symptoms (e.g. feeling of constriction of the throat) may be due to Qi stagnation in the Heart channel; this is especially likely when the symptom is caused by emotional stress.

SMALL INTESTINE CHANNEL PATHWAY

The Small Intestine channel of the arm Greater Yang starts at the [ulnar side of the] tip of the little nger Following the outside [ulnar side] of the dorsum of the hand it reaches the wrist It emerges from the wrist bone [styloid process of the ulna] It ascends along the arm below the bone [along the posterior aspect of the forearm] It emerges at the elbow in between two tendons [between the olecranon of the ulna and the medial epicondyle of the humerus] It ascends the back [posterior aspect] of the arm and emerges at the shoulder joint Circling around the scapula, it rises to the shoulder [connects with Du-14 Dazhui] and goes forward to the supraclavicular fossa to connect with the heart From the heart, it descends to the oesophagus It passes through the diaphragm It reaches the stomach and nally enters the small intestine to which it belongs A branch from the supraclavicular fossa ascends to the neck and the cheek It goes through the outer canthus of the eye and then enters the ear From the neck, a branch goes to the infra-orbital region and to the lateral side of the nose

Fig. 6.5 Heart channel.

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It then reaches the inner canthus to link with the Bladder channel and goes sideways to the zygoma. See Figure 6.6.

CLINICAL NOTE It is interesting that a branch of the Small Intestine channel enters the ear: this explains the Small Intestines involvement in some ear pathologies.

BLADDER CHANNEL PATHWAY

The Bladder channel of leg Greater Yang starts at the inner canthus of the eye It ascends the forehead and reaches the vertex [joins the Governing Vessel at the point Du-20 Baihui on the vertex]

From here a branch goes to the area above the ear From the vertex, the channel enters the brain to re-emerge and bifurcate at the nape of the neck From the nape of the neck, it flows down the occiput and all the way down the back running medially to the scapulae and outside the spine From the lumbar area, it enters the backbone It connects with the kidney and reaches the bladder to which it belongs The branch from the lumbar region runs down the gluteus to reach the popliteal fossa The branch from the back of the neck goes straight down along the medial border of the scapulae It passes through the gluteal region It proceeds downwards along the lateral aspect of the thigh where it meets the previous branch [descending from the lumbar region] in the popliteal fossa

Fig. 6.6 Small Intestine channel.

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It runs along the posterior aspect of the leg to the posterior aspect of the external malleolus It then runs along the fth metatarsal bone to end at the lateral aspect of the fth toe where it links with the Kidney channel. See Figure 6.7.

CLINICAL NOTE The Bladder channel enters the brain: this explains the important influence of this channel in the pathology of headaches.

Fig. 6.7 Bladder channel.

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CLINICAL NOTE The Bladder channel flows all along the spine from the occiput to the sacrum and then down to the legs: this explains the important influence of the Bladder channel in back pathologies.

CLINICAL NOTE It is clinically significant that the Kidney channel flows to the liver, lungs, heart and pericardium: influencing so many organs; it confirms the important role of the Kidneys as the foundation of the Yin and the Yang of the other Yin organs.

KIDNEY CHANNEL PATHWAY

The Kidney channel of the leg Lesser Yin starts under the fth toe It runs to the sole of the foot [at KI-1 Yongquan] Running under the [navicular] bone at KI-2 Rangu, it goes behind the medial malleolus It ascends the medial side of the leg up to the inner aspect of the thigh It then goes towards the spine [at Du-1 Changqiang] It ascends along the lumbar spine and enters the kidney and the urinary bladder It then goes forward to enter the liver It passes through the diaphragm and enters the lung From here it ascends to the throat and terminates at the root of the tongue From the lung, a branch joins the heart and flows to the chest [to connect with the Pericardium channel]. See Figure 6.8.

PERICARDIUM CHANNEL PATHWAY

The Pericardium channel of the arm Terminal Yin originates in the centre of the chest emerging from the pericardium to which it belongs It then descends through the diaphragm to the abdomen to communicate with the Upper, Middle and Lower Burner A branch from the centre of the chest emerges laterally from the costal region 3 cun below the axilla It ascends to the axilla and then descends on the inside [medial aspect] of the arm between the Lung and Heart channels It enters the elbow It then descends on the forearm in between two tendons [of m. palmaris longus and m. flexor carpi radialis] It enters the palm and ends at the tip [medial side] of the middle nger A branch from the centre of the palm [P-8 Laogong] runs along the ring nger to its tip [linking with the Triple Burner channel at the point T.B.-1 Guanchong]. See Figure 6.9.

CLINICAL NOTE The channel connection between the Kidney channel and the heart and pericardium is clinically important as it reflects the influence of the Kidneys in Heart pathologies. Moreover, it confirms the importance of the proper communication between Kidney and Heart particularly for the health of the gynaecological and sexual systems. Finally, the communication between Kidneys and Heart is essential also for our mental and emotional health as it is the physical aspect of the communication between the Mind (Shen) of the Heart and the Willpower (Zhi) of the Kidneys.

CLINICAL NOTE It is interesting to note that a branch of the Pericardium channel emerges laterally from the costal region 3 cun below the axilla. This explains the good effect the point P-6 Neiguan has on rib pain; when I use this point to treat rib pain, I usually combine it with ST-40 Fenglong on the opposite side.

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Fig. 6.8 Kidney channel.

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It then descends through the diaphragm to the abdomen to reach the Three Burners, to which it belongs From the chest, a branch goes up to the supraclavicular fossa from where it ascends to the neck, the region behind the ear and to the corner of the anterior hairline It then turns downwards to the cheek and goes to the infra-orbital region From behind the ear, a branch enters the ear It re-emerges in front of the ear It crosses the previous branch in the cheek and reaches the outer canthus to link with the Gall Bladder channel. See Figure 6.10.

CLINICAL NOTE The pathway of the Triple Burner confirms the important influence that this channel has on the ears: in fact, from the chest, a branch goes behind the ear; another a branch enters the ear from behind the ear; it re-emerges in front of the ear.

Fig. 6.9 Pericardium channel.

GALL BLADDER CHANNEL PATHWAY

The Gall Bladder channel of the leg Lesser Yang starts at the outer canthus of the eye It ascends to the corner of the forehead It curves downwards to the region behind the ear [at G.B.-20 Fengchi] From behind the ear, it runs down the neck in front of the Triple Burner channel Turning back, it traverses and passes behind the Triple Burner channel and then down to the supraclavicular fossa A branch from the region behind the ear enters the ear It then comes out in front of the ear and goes to the outer canthus The branch arising from the outer canthus runs down to ST-5 Daying and meets the Triple Burner channel in the infra-orbital region It then descends to the neck and the supraclavicular fossa where it meets the main branch

TRIPLE BURNER CHANNEL PATHWAY

The Triple Burner channel of the arm Lesser Yang starts at the tip of the ring nger It runs up the hand between two ngers [fourth and fth metacarpal bones] It flows to the wrist and up the lateral aspect of the arm between two bones [the radius and ulna] It flows to the elbow and up the outside of the shoulder [passing through the olecranon and along the lateral aspect of the upper arm] where it runs across and passes behind the Gall Bladder channel It winds over to the supraclavicular fossa from where it spreads in the chest to connect with the pericardium

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Fig. 6.10 Triple Burner channel.

From the supraclavicular fossa, it descends to the chest Passing through the diaphragm, it enters the liver and gall bladder to which it belongs It then runs down the hypochondrial region

It comes out from the lateral side of the abdomen and exits at the point Qijie [ST-30 Qichong] From here, it goes to the margin of the pubic hair and then sideways to the hip

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The main portion of the channel from the supraclavicular fossa goes in front of the axilla and the lateral side of the chest to the free ends of the floating ribs It flows to the hip where it meets the previous branch It then descends along the lateral aspect of the thigh and knee It goes further down in front of the bone [along the anterior aspect of the bula] all the way to its lower end It reaches the area in front of the external malleolus It then follows the dorsum of the foot to the lateral side of the tip of the 4th toe A branch separates from the dorsum of the foot [from G.B.-41 Zulinqi], enters the big toe, runs along the inner [medial] side of the bone of the big toe, turns around to pass through the big toe nail and then nally goes to the dorsal hairy surface of the big toe. See Figure 6.11.

LIVER CHANNEL PATHWAY

The Liver channel of the leg Terminal Yin starts on the hairy dorsal surface of the big toe It runs upwards on the dorsum of the foot 1 cun in front of the medial malleolus It rises 8 cun up the medial aspect of the leg where it runs across and behind the Spleen channel It goes further up inside the knee and thigh When it reaches the pubic hair margin, it curves around the genitalia It goes up to the lower abdomen Proceeding further up, it curves around the stomach and enters the liver to which it pertains and links with the Gall Bladder It then continues to ascend, passes through the diaphragm and branches out in the hypochondrial and costal region From here, it ascends behind the throat [through the nasopharynx] to the forehead and reaches the Eye System (Mu Xi) Running further upwards, it goes to the top of the head to meet the Governing Vessel [at Du-20 Baihui] From the eye, a branch goes down to the cheek and curves around the lips. See Figure 6.12.

CLINICAL NOTE A branch of the Gall Bladder channel arising from the outer canthus runs down to ST-5 Daying; this confirms the important role of the Stomach channel on the face because it intersects so many other channels, i.e. Gall Bladder, Bladder and Directing Vessel.

CLINICAL NOTE The Gall Bladder channel descends to the chest from the supraclavicular fossa: this explains the use of G.B.-41 Zulinqi for problems of the breast in women.

CLINICAL NOTE The Liver channel starts on the hairy dorsal surface of the big toe: this is an interesting statement from the Spiritual Axis as most books say that the channel starts on the lateral side of the angle of the big toe nail. The fact that the channel starts on the dorsal surface of the big toe itself, explains the use of this channel for problems of the big toe, e.g. fungal infections.

CLINICAL NOTE The main portion of the Gall Bladder channel from the supraclavicular fossa goes in front of the axilla and the lateral side of the chest to the free ends of the floating ribs: the Gall Bladder channel has a paramount influence on the hypochondrial region and I personally use G.B.-34 Yanglingquan to influence this region.

CLINICAL NOTE The Liver channel curves around the genitalia; this is a very important section of this channels pathway that explains the frequent use of the Liver channel for problems of the genitals (e.g. penis and testicles in men and vulva and vagina in women). For this function, I especially use the point LIV-5 Ligou.

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Fig. 6.11 Gall Bladder channel.

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CLINICAL NOTE The Liver channel curves around the stomach: this is interesting as it explains the important influence of the Liver in epigastric pain and distension (Liver invading the Stomach). To affect this function of the Liver, I tend to use G.B.-34 Yanglingquan in combination with Ren-12 Zhongwan.

CLINICAL NOTE The Liver channel goes to the top of the head to meet the Governing Vessel [at Du-20 Baihui]; this explains the frequent use of Liver points (especially LIV-3 Taichong) to treat headaches.

CLINICAL NOTE From the eye, a branch of the Liver channel goes down to the cheek and curves around the lips: this aspect of the Liver channel has a particular clinical significance in facial diagnosis. In fact, in Liver-Qi stagnation, the area around the lips may be greenish.

NOTES
1. Deadman P, Al-Khafaji M 1998 A Manual of Acupuncture, Journal 2. 1981 Spiritual Axis (Ling Shu Jing 3. 4. 5. 6. 7, 8.
of Chinese Medicine Publications, Hove, England, p. 73. ). Peoples Health Publishing House, Beijing, rst published c. 100 BC, p. 30. A Manual of Acupuncture. Bensky D, OConnor J 1981 Acupuncture, a Comprehensive Text. Eastland, Seattle. Qiu Mao Liang 1993 Chinese Acupuncture and Moxibustion, Churchill Livingstone, Edinburgh. Chen Xin Nong 1987 Chinese Acupuncture and Moxibustion. Foreign Languages Press, Beijing. Spiritual Axis, p. 31. Although all books show the Stomach channel ending at the second toe, Chapter 10 of the Spiritual Axis actually says that it ends at the middle toe, i.e. the third one. It is interesting to note that the Stomach channel affects both the second and third toe.

Fig. 6.12 Liver channel.