Livro Vertex MACIOCIA

of Body Areas
Giovanni Maciocia
Su Wen Press
www.maciociaonline.com
G iovanni Maciocia is an acupuncturist
and medical herbalist currently resident in
the USA.He has been in practice since 1974.
He studied acupuncture at the International
College of Oriental Medicine in England
and at the Nanjing College of Traditional
Chinese Medicine in China. A respected
author and lecturer, he has skilfully adapted
the traditional disciplines of Chinese medi Su Wen Press
cine and greatly increased its profile in the 956 Calle Cortita
West. Students and patients in Europe and Santa Barbara, CA 93109
America have benefited from his knowledge
and clinical experience. The Three Treasures
is the culmination of his wide research and
Copyright ©2012 by Giovanni Maciocia.
practice.
Giovanni Maciocia is also the author of
seven other books which have contributed
greatly to the diffusion of Traditional All rights reserved, including translation.
Chinese Medicine in the West: No part of this publication may be
reproduced or transmitted by any means,
electronic or mechanical, recording or
• Tongue Diagnosis in Chinese duplication in any information or storage
Medicine (1987), rev. (1995) and retrieval system without permission in
writing from the publishers, and may not
• The Foundations of Chinese Medicine be photocopied or otherwise reproduced
(1989), rev. (2005) even within the terms of any licence issued
by the Copyright Licensing Agency Ltd.
• The Practice of Chinese Medicine
(1994), rev. (2007
• Obstetrics & Gynaecology in Chinese
Medicine (1998)
• Diagnosis in Chinese Medicine (2003)
• The Channels of Acupuncture (2006)
• The Psyche in Chinese Medicine
(2009) ISBN 978-0-9888834-0-6
Table of Contents
Preface ............................................................................... 1
The Vertex ......................................................................... 5
1. Anatomy ....................................................................... 5
2. Channels ...................................................................... 12
3. Symptoms & Signs ...................................................... 25
4. Patterns ......................................................................... 32
5. Diseases ........................................................................ 35
6. Points ............................................................................ 41
7. Herbs ............................................................................. 54
8. End notes ...................................................................... 56

1
Preface
The curriculum of most schools of Chinese medicine is usually broken down into the
following topics concerning the theory of Chinese medicine:
• Physiology of the Internal Organs
• Aetiology
• Diagnosis
• Patterns of disharmony of the Internal Organs
In addition to the above, the acupuncture curriculum is based on the study of the
channels and points. Within each of these topics, various parts of the body are discussed.
For example, when studying diagnosis we break the subject down into interrogation,
observation, palpation and auscultation. Within each of these broad areas, students study
the diagnostic elements of specific areas.
For example, within interrogation, there are sections on the face, chest, abdomen, limbs,
etc. The same is done within observation.
As for channels and points study, when students study the channels, they will typically
study the course of the channel as a whole rather than a section of a channel in a particular
area of the body; the same is done for the acupuncture points, i.e. they usually study the
points for each channel and not the points specific to a certain area.
Figure 1 illustrates this concept. As can be seen in this Figure, we study the face, chest,
abdomen both within the interrogation and the observation; and the same will apply
to palpation. The result is that areas become disjointed and there is nothing to connect
elements of interrogation, observation and palpation relevant to a specific area; moreover,
nothing to connect elements of channels and points relevant to specific areas.
Face Face
INTERROGATION Chest OBSERVATION Chest
Abdomen Abdomen
Fig. 1. Categories of study of interrogation and observation.

2
For example, we study the Kidney and Ren Mai points separately and we explore the
common therapeutic actions of the Kidney points and those of the Ren Mai points
area might have in common, e.g. KI-25 Shencang and Ren-17 Shanzhong.
therapeutic element relevant to that area is discussed together.
Interrogation
Observation
Palpation
VERTEX Channels
Points
Patterns
Diseases
Fig. 2. Layout of present book.
Figure 2 illustrates this principle.
• Vertex
• Face
• Occiput
• Chest
• Abdomen
3
Each of these areas will be the subject of separate books.
For each area I will discuss the following aspects:
1. Anatomy (physical and energetic)

2. Channels
3. Symptoms and signs
4. Patterns
5. Diseases
6. Points
7. Herbs
4
5
The Vertex
By “vertex”, I mean the top of the head including the temporal regions, but excluding the
face/forehead and occiput (which will form topics of separate booklets). See Figure 3
I shall discuss the following aspects of the vertex area:
1. Anatomy (physical and energetic)
2. Channels
3. Symptoms and signs
4. Patterns
5. Diseases
6. Points
7. Herbs
As part of the channels of the vertex area, I will also discuss the Eye System (Mu Xi) which
is in chapter 2, 21 and 80 of the Ling Shu. This is an energetic area consisting in a flow of
Qi from the eyes to the occiput.
Fig. 3
1. Anatomy
There are no muscles on the vertex itself; the temporal muscles are on the temporal
regions. The vertex is the most Yang area of the body where all the Yang channels
converge. On the vertex, superficially there are only Yang channels and for this reason,
the ancient books compared the head to “Heaven” [being at the top and because of the
association between Heaven and Yang]: the clear Qi of the six Yang channels [Tai Yang,
Shao Yang and Yang Ming] and the six Yang organs reach it.
For this reason the head is variously called “the confluence of Yang”, “the Palace of Yang”
or “the Palace of clear Yang”. Thus, energetically, the vertex area is especially prone to
either too much Yang or the opposite, i.e. clear Yang not reaching it.
6
The “Correct Seal of Medical Circles” says: “The head is like Heaven [being at the top]: the
clear Qi of the three Yang channels [Tai Yang, Shao Yang and Yang Ming] and the six Yang
organs as well as the Blood and essence of the three Yin channels [Tai Yin, Shao Yin and Jue
Yin] and the five Yin organs, all reach it. It is affected by the six external pathogenic climates
as well as by internal pathogenic factors.”
As we can see from this quotation, although superficially only the Yang channels reach the
vertex, the Yin channels also influence it and we shall see how.
Divergent channels
Having just observed that superficially only Yang channel reach the head, Yin Qi also
reaches the head, but only internally. Of the Yin channels only the Heart and Liver (deep
pathway) reach the head internally. All the other Yin channels reach the head indirectly
via their Divergent channels as each Yin Divergent channel merges with its related Yang
Divergent channel at the neck area.
The Yang Divergent channels depart from the lower half of the channel, flow upwards,
join with the related Yang and Yin organs, and then join the Main channel in the area of
the neck; the Yin Divergent channels also depart from the lower half of the channel, flow
upward, three of them join the related Yin organ (Heart, Lung and Kidney) and join the
related Yang Divergent channel in the area of the neck (Fig. 4).
Thus, it is through the Yin Divergent channels that Yin Qi reaches the head.
Therefore both the clear Yang from the Yang organs and the pure essences from the Yin
organs reach the head. If Yin Qi did not reach the head, we could not explain certain
pathologies such as chronic headaches from deficient Kidney-Yin or Liver-Blood not
reaching the head.
Fig. 4
7
Fig. 5
Figure 4 illustrates a Yang and a Yin Divergent channel while Figure 5 illustrates the two
channels together.
For example, the couple illustrated in Figure 5 could refer to the Bladder and Kidney
Divergent channels. If we take Figure 5 to represent the Bladder and Kidney Divergent
channels, we can see that the Bladder Divergent channel departs from behind the popliteal
crease, it goes to the bladder, then the kidney, and then merges with the Main Bladder
channel in the neck area. The Kidney Divergent channel also departs from behind the
popliteal crease, it goes to the kidney and then joins the Bladder Divergent channel in the
area of the neck.
Potential of energy
According to the flow of Qi in the 12 channels, the head is the highest part of the body
not only anatomically but also energetically. It is, in fact, the area of maximum potential
of energy in thecirculation of Qi in the channels. The “potential energy” is, as the word
implies, the potential to produce a certain amount of energy due to the location of a given
object. For example, a reservoir of water on top of a hill has the “potential” to produce
electric energy, but this does not happenuntil the gate is open and the water rushes to a
turbine downhill. A drawn bow also has potential energy which is expended when the
arrow is released.
Fig. 6
8
It is exactly the same in the circulation of Qi in the body: when Qi is on the top of the
head, it is like water in a reservoir on top of a hill. As the vertex is the highest point, here
Qi has the maximum potential of energy (Fig. 6).
In fact, Qi circulates in the channels precisely because there is a difference of potential

between the chest and the head: if there were no difference of potential energy between
the head and the chest, Qi would not circulate.
If we consider the first four channels, for example, we see that Qi starts at the chest area in
the Lung channel: this is the area of minimum potential of energy. In order to understand
this we can visualize a certain amount of water at the bottom of a hill, where its potential
of producing energy is minimal. If we slowly transport this water up the hill, gradually its
potential of producing energy will increase, as we know. When the water reaches the top
of the hill, its potential of producing (hydroelectric) energy will be maximum.
In this analogy, the bottom of the hill corresponds to the chest, half-way up the hill
corresponds to the hands (or feet) and the top of the hill corresponds to the head. Thus,
from the Lung channel in the chest, Qi starts to move upwards towards the head. At
the fingertips, Qi changes polarity, i.e. it flows from the Yin Lung channel to the Yang
Large Intestine channel, but it is still flowing towards the head and its potential energy is
increasing. It is important to grasp this concept, i.e. that, although there is a change from
Yin (Lungs) to Yang (Large Intestine), the potential energy is still increasing as it goes
towards the head. When it reaches the head, the potential energy is at its maximum and it
then starts decreasing as it flows towards the feet (Fig. 7).
Fig. 7
At the feet, Qi changes polarity, i.e. it flows from the Yang Stomach channel to the Yin
Spleen channel, but its potential is still decreasing as it flows towards the chest area. When
it reaches the chest the potential energy is minimum (the water has reached the bottom
of the hill again). The Qi from the Spleen channel then connects internally with the Heart
channel and a new 4-channel cycle starts in exactly the same way. Figure 8 illustrates the
9
flow of the potential energy as Qi flows up from the chest to the vertex (via the arms) and
down back to the chest (via the legs).
Fig. 8
Head and Yang energy

For this reason, the vertex is the most Yang area of the body from two points of view. It
is Yang first of all because only Yang channels reach the head superficially (some Yin
chawnnels such as Heart and Liver channels do reach the head but interwnally). Secondly,
it is the most Yang area because it is the area of maximum potential energy: from the
vertex, Qi can only go down when the potential energy is transformed into kinetic energy.
It is because the vertex is the most Yang area of the body (and also because it is at the top)
that it was compared to “Heaven” in ancient Chinese books. It was also sometimes called
the “Confluence of Yang”.
Because the head is the convergence of Yang, it is very much prone to patterns
characterized by rising Qi such as Liver-Yang rising, Liver-Fire and Liver-Wind. However,
precisely because the head is the convergence of Yang, it may also be prone to the opposite,
i.e. clear Yang not rising to the head and leading to excess Yin there, e.g. Dampness or
Phlegm.
Interestingly, the Chinese names of the channels imply three aspects: the polarity of Qi
(Yin or Yang), increasing or decreasing energy potential, and quantity of Qi. While we
in the West will refer to the “Lung channel”, in Chinese, we would say “The Hand Tai Yin
channel”. The term “Hand Tai Yin” defines three aspects of this channel:
- “Hand” refers to increasing energy potential (“Foot” would be decreasing energy
potential)
- “Greater” refers to the amount of Qi, i.e. Lung and Spleen have the largest amount of Yin
Qi
- “Yin” refers to the polarity of the channel
10
Quantity of Qi
Figure 1.7 illustrates the concept of “quantity” of Qi in the channels. The Chinese names
Tai Yin (“greater” Yin), Tai Yang (“greater” Yang), Yang Ming (Yang “brightness”), Shao
Yang (“lesser” Yang), Shao Yin (“lesser” Yin) and Jue Yin (“terminal” Yin) refer to the
quantity of Qi (Yin or Yang) in the channels and this is related to the time of day when
that channel’s Qi is more prominent. As expected, Yang Ming (Stomach and Large
Intestine) and Tai Yang (Small Intestine and Bladder) are active in the daytime while Tai
Yin (Lung and Spleen) and Jue Yin (Liver and Pericardium) are active in the evening or
night.
Thus, the quantity of Qi in the channels during 24 hours has this progression:
3-11am: Tai Yin (maximum Yin) and Yang Ming (average Yang)
11am-7pm: Shao Yin (minimum Yin) and Tai Yang (maximum Yang)
7pm-3am: Shao Yang (minimum Yang) and Jue Yin (average Yin). See Fig. 9.
Fig. 9
This has some clinical relevance because it means that it is easier to tonify Yang in the
daytime and nourish Yin in the evening. The connection between the names and the
quantity of Qi is as follows:
- Tai Yang and Tai Yin = maximum quantity of Qi
- Shao Yang and Shao Yin = minimum quantity of Qi
- Yang Ming and Jue Yin = average quantity of Qi
If we look at the diagram in Figure 9, we can see that the 24-hour day can be divided into
three sections. In the first section, starting with the early morning at 3 am, the Yin is at
its maximum (Tai Yin) and the Yang is average (Yang Ming); in the central section which
corresponds to the middle of the day, naturally Yin is at its minimum (Shao Yin) and Yang
at its maximum (Tai Yang); in the third section which comprises evening and night, Yang
is at its minimum (Shao Yang) and Yin is average (Jue Yin).
The vertex has the Tai Yang channels which appropriately correspond to “maximum
Yang”; this is yet another way in which the head is the “Confluence of Yang” and another
11
reason why the head is so easily prone to excess of Yang and Heat
Sea of Marrow
The Sea of Marrow is discussed in chapter 33 of the “Spiritual Axis” (Ling Shu). This
chapter describes the symptoms of Fullness and Emptiness and the points of the Sea of
Marrow as follows:
Fullness: full of vigour, great physical strength.
Deficiency: dizziness, tinnitus, weak legs, blurred vision, desire to lie down.
Points: Du-20 Baihui (upper Sea of Marrow) and Du-16 Fengfu (lower Sea of Marrow).1
The Sea of Marrow is synonymous with the Brain as it is Marrow that fills up the Brain.
The origin of Marrow is in Kidney-Jing. The symptoms of deficiency are related to the
sense orifices not being nourished by Marrow. As Kidney-Jing is the origin of Marrow,
those symptoms (dizziness, tinnitus, blurred vision, weak legs) are also symptoms of
Kidney deficiency and they are common symptoms in the elderly.
The symptoms of “Fullness” of the Sea of Marrow are to be interpreted more as a

physiological condition of a young person in whom the Sea of Marrow is healthy, rather
than as a pathology.
The Sea of Marrow is related to the Du Mai which flows in the spine and into the Brain:
for this reason, the points of the Sea of Marrow (Du-20 Baihui and Du-16 Fengfu) are on
the Du Mai and, as we shall see, the Du Mai enters the brain at Du-16 Fengfu and exits
at Du-20 Baihui. Indeed, it is through the Du Mai that Kidney-Jing nourishes the Sea of
Marrow and the Brain. In fact, when we say that the Kidneys are the source of Marrow
which nourishes the Brain, how do the Kidneys actually reach the Brain? It is precisely
through the Du Mai that the Kidneys nourish the Brain as the Du Mai originates from the
space between the Kidneys and enters the Brain(Fig. 10).
Fig. 10
12
The description of the Sea of Marrow from chapter 33 of the “Spiritual Axis” should be
read in conjunction with the description of the Kidney’s function in chapter 8 of the
“Simple Questions” (Su Wen) which says: “The Kidneys are the official in charge of power:
skill originates from them.” 2
It is interesting that the “Simple Questions” mentions “power” in connection with the
Kidneys. From a physical point of view, “power” refers to the fact that the Kidneys are the
root of Pre-Natal Qi and house Jing: this determines our innate, constitutional energy or
“power”. This “power” is connected to the “fullness” of the Sea of Marrow which manifests
as “full of vigour, great physical strength”. As we have seen, the physical symptoms of
deficiency of the Sea of Marrow are dizziness, tinnitus, weak legs, blurred vision, and a
desire to lie down.
On a mental-emotional level, “power” of the Kidneys implies mental-emotional resilience:

when the Kidney-Jing and Sea of Marrow are strong and healthy, the person’s Shen is
stable and more resistant to mental-emotional stress. A person with a constitutional
deficiency of the Sea of Marrow will be more prone to emotional stress: his or her Shen
is more vulnerable and the person will lack mental strength and resilience. Under these
conditions, the person is easily prone to depression when subject to emotional stress.
I particularly use Du-20 Baihui to strengthen the Sea of Marrow, nourish the Shen and
strengthen the Kidney’s Will-Power (Zhi). For these reasons, Du-20 Baihui is a very
important point for depression.
Finally, an interesting consequence of the head being the confluence of all Yang channels
is that that might explain why the head does not need to be covered in cold weather as
the rest of the body does (except, of course, in exceptionally cold weather). The “Classic
of Difficulties” (Nan Jing) confirms this in chapter 47: “How come that only the face can
withstand cold? The head is the meeting point of all Yang channels. All Yin channels reach
the neck and chest from where they return [to their origin]. Only the Yang channels reach
the head. For this reason the head can endure cold.” 3
2. Channels
I shall now list the channels reaching the vertex including Main, Muscle, Luo and
Divergent channels. Rather than describing the pathway of each in detail, I will
concentrate mostly on the section of the pathway that concerns the vertex.
Before describing the pathways of the channels on the head, I will briefly describe the
anatomy of the Muscle, Luo and Divergent channels.
13
The Muscle channels (called Jing Jin in Chinese meaning “channel-muscle”) are essentially
the skeletal muscles that run over the Main channels (with a few exceptions). Thus, the
Muscle channels “are muscles” but they are also channels, i.e. they are a conduit for the
circulation of Qi.
There is no direct correspondence between a Muscle channel and specific muscles: each
Muscle channel encompasses many different muscles. The pathology of the Muscle
channels is essentially stiffness and/or pain deriving from external pathogenic factors or
from over-use of the muscles.
The Luo channels are much more directly involved in the circulation of Qi and play a very
important physiological role. When we say “Luo channel”, we actually refer to two distinct
entities. First, from each Luo point (e.g. LU-7 Lieque) a Luo channel starts (in French
acupuncture literature called “longitudinal”) and their pathways were described in the
Ling Shu.
For example, from LU-7 Lieque, the Luo channels runs down the arm and scatters over
the thenar eminence. Secondly, over each Main channel and between this and the skin
there is a Luo “area” where the Luo channels course and where Wei Qi circulates. Thus the
Luo “area” (I prefer to call it thus rather than “Luo channel”) represents the Exterior of the
body where Wei Qicirculates (Fig. 11).
The Divergent channels (called Jing Bie in Chinese) are called thus because from each
Main channel, a separate channel “diverges”. The Divergent channels are deeper than both
the Muscle and the Luo channels.
All Divergent channels “diverge” from the lower part and, directly or indirectly, flow to the
neck area (the Yang Divergent directly and Yin Divergent indirectly).
Fig. 11
14
a) LARGE INTESTINE MUSCLE CHANNEL

The Large Intestine Muscle channel comes up from the side of the neck to the vertex
and crosses over to connect with the mandible on the opposite side, much like a pair
of headphones. It is also for this reason that, when I use it as a distal point for facial
problems, I generally use L.I.-4 Hegu on the opposite side. The Large Intestine Muscle
channel pathway also explains the use of L.I.-4 Hegu for headaches (Fig. 12).
Fig. 12
b) STOMACH MAIN CHANNEL

The Stomach Main channel connects with Du-24 Shenting on the front of the vertex. This
explains the important influence of the Stomach channel on mental-emotional problems
sinceDu-24 Shenting has a major influence on mental-emotional problems (Fig. 13).
Fig. 13
c) STOMACH DIVERGENT CHANNEL

The Stomach Divergent channel goes up to the head and connects with the eye (Fig. 14).
This explains the use of ST-36 Zusanli for eye problems.
Fig. 14
15
d) STOMACH MUSCLE CHANNEL

The Stomach Muscle channel does not reach the vertex itself but only the eye socket and
the area in front of the ear (Fig. 15). This also explains the use of ST-36 Zusanli for eye
problems.
Fig. 15
e) BLADDER MAIN CHANNEL

The Bladder Main channel flows over the vertex (Fig. 16). This explains the occurrence of
headaches from Kidney deficiency (Kidney channel influencing Bladder channel).
Fig. 16
F) BLADDER MUSCLE CHANNEL

The Bladder Muscle channel also flows over the top of the head and down to connect with
eye (Fig. 17). This explains the effect of BL-67 Zhiyin on vertical headaches. Note also that
the Jing-Well points activate the Muscle channel.
Fig. 17
16
G) TRIPLE BURNER MAIN CHANNEL

The Triple Burner Main channel flows over the temporal region of the skull (Fig. 18). This
explains the frequent use of TB-5 Waiguan for temporal headaches.
Fig. 18
H) TRIPLE BURNER DIVERGENT CHANNEL

The Triple Burner Divergent channel separates from the temporal region to go over to the
vertex (Fig. 19). This explains the use of T.B.-5 Waiguan for headaches from Liver-Yang
rising.
Fig. 19
I) TRIPLE BURNER MUSCLE CHANNEL

The Triple Burner Muscle Channel goes over the temporal region (Fig. 20). This also
explains the frequent use of TB-5 Waiguan for temporal headaches.
Fig. 20
17
J) GALL-BLADDER MAIN CHANNEL

The Gall Bladder Main channel flows over the temporal region twice, once more on
the side, once more towards the top (Fig. 21). This explains the use of GB-43 Xiaxi for
temporal headaches.
Fig. 21
K) GALL-BLADDER MUSCLE CHANNEL

The Gall Bladder Muscle channel flows from the temporal region to the vertex (Fig. 22).
This also explains the use of GB-43 Xiaxi for temporal headaches.
Fig. 22
L) LIVER MAIN CHANNEL

The Liver Main channel ascends to the head internally (Fig. 23). This explains the
involvement of the Liver in headache from Liver-Blood deficiency which usually manifests
on the vertex.
Fig. 23
18
M) DU MAI
The Du Mai flows over the vertex: a branch enters the brain at Du-16 Fengfu and exits at
Du-20 Baihui (Fig. 24). Together with the Liver and Bladder channels, the Du Mai is the
one that affects the vertex most closely. The points Du-16 Fengfu and Du-20 Baihui are
points of the Sea of Marrow which has been discussed above. This explains of course the
importance of Du-20 Baihui in vertical headaches.
Fig. 24
N) YANG QIAO MAI

The Yang Qiao Mai ascends over the face to curve around the side of the head towards
the top (Bladder channel) to connect with G.B.-20 Fengchi. In the head, it goes to the
inner corner of the eye where it connects with the Small Intestine, Bladder and Stomach
channels and with the Yin Qiao Mai at BL-1 Jingming. From here, it continues over the
skull, passes behind the ear and enters G.B.-20 Fengchi where it ends (Fig. 25). This
explains the use of BL-62 Shenmai (opening point of the Yang Qiao Mai) for patterns of
Excess Yang in the head.
Fig. 25
O) YIN QIAO MAI

The Yin Qiao Mai ascends over the face to connect with the eye and then enter the brain
(Fig. 26). This explains the use of KI-6 Zhaohai to nourish Yin in the head, e.g. headaches
from Kidney-Yin deficiency.
19
Fig. 26
P) YANG WEI MAI

The Yang Wei Mai ascends over the side of the neck to connect with the Gall-Bladder
channel and flow from G.B.-13 Benshen to G.B.-20 Fengchi (and then to Du-15 Yamen
and Du-16 Fengfu). See Figure 27. This explains the use of T.B.-5 Waiguan (opening point
of the Yang Wei Mai) for temporal headaches.
Fig. 27
Q) YIN AND YANG QIAO MAI AND THE VERTEX/BRAIN

The Yin and Yang Qiao Mai have an important influence on the vertex and the brain. If we
look at their pathways, we note many similarities and primarily these:
- Both flow over the neck
- Both flow to ST-9 Renying
- Both flow to BL-1 Jingming
- Both enter the brain
Chapter 21 of the “Spiritual Axis” (Ling Shu) discusses the pathway of the Yin and Yang
Qiao Mai in the brain and, in this context, it refers to a “crossing” of Yin and Yang Qiao
Mai: “The Bladder channel ...In the brain, it divides into two vessels that become the Yin and
Yang Qiao Mai. The Yin and Yang Qiao Mai cross over each other, the Yang entering the Yin
and the Yin coming out into the Yang, crossing over again at the inner corner of the eye. If
Yang Qi is excessive, the eyes cannot close; if Yin Qi is excessive, the eyes cannot open.” 4
The interpretation of this statement is quite complex as, in my opinion, it refers to two
20
different types of “crossing”. In the brain, the Yin and Yang Qiao Mai cross over vertically,
i.e. the Yang Qiao Mai goes inwards to cross the Yin Qiao Mai and the latter emerges
outwards to cross the former. The text is quite clear on this as it says: “Yang ru Yin, Yin chu
Yang”, i.e. “The 12 Yang enters the Yin and the Yin exits towards the Yang.” 5 In other words,
this “crossing” is a crossing between the superficial and the deep parts of the brain (Fig.
28).
Fig. 28
The second type of “crossing” is horizontal between left and right sides, i.e. in the brain,
each of the two vessels crosses over and reaches the inner corner of the eye of the opposite
side. In other words, this “crossing” is a crossing between sides while the former crossing
is between two different levels (Fig. 29).
Fig. 29
The left-right cross-over of the Yin and Yang Qiao Mai bears a remarkable similarity with
the cross-over of the optic nerve branches in the brain: in fact, at the optic chiasma, the
left side of the optic nerve crosses over and goes to the right eye and vice versa (Fig. 30).
Fig. 30
21
The Yin Qiao Mai is an offshoot of the Kidney channel which flows from the feet up to the
head; the Yang Qiao Mai is an offshoot of the Bladder channel which flows from the head
downto the feet. All the extraordinary vessels flow from the lower part of the body towards
the top: therefore the Yin Qiao Mai flows upwards in the same direction as the Kidney
channel while the Yang Qiao Mai flows upwards against the direction of the Bladder
channel.
With regard to the flow of Yang therefore, there is an apparent contradiction as the Yang
Qiao Mai is an offshoot of the Bladder channel but it flows from the lower part of the body
towards the head, while the Bladder channel flows from the head to the feet (Fig. 31).
Fig. 31
Therefore, although the Yang Qiao Mai ascends towards the head to BL-1 Jingming, the
Bladder channel from which it derives descends from the head and the eyes: this allows the
Yang Qiao Mai and the Bladder channel to bring Yang Qi away from the eyes or up to the
eyes when appropriate.
The flow of Yang to or away from the eyes is also coordinated with the Yin Qiao Mai to
regulate and balance Yin and Yang Qi in the head and eyes. This is an important way in
which the channel system keeps the balance of Yin and Yang in the head. This anomaly
also explains how the Yang Qiao Mai can both carry Yang Qi to the eyes (to keep them
open in daytime) and carry Yang Qi away from the eyes so that they may close at night.
The Yin Qiao Mai brings Yin Qi to the eyes; the Yang Qiao Mai brings Yang Qi to the eyes.
As we shall see, this is essential to regulate sleep at night (when the eyes must receive Yin
Qi) and wakefulness in daytime (whey the eyes must receive Yang Qi).
The functions of the Yin and Yang Qiao Mai are complementary in yet another way: they
absorb Excesses of Yin Qi and of Yang Qi respectively. Both the Yin and the Yang Qiao
Mai enter the brain regulating and balancing Yin and Yang Qi in this organ. As we have
seen, both the Yin and Yang Qiao Mai enter the brain. Indeed, they branch out from the
Bladder channel in the brain (Fig. 32). The connection of the Yin and Yang Qiao Mai with
the brain has two main implications, one mental, the other neurological.
The regulation and balancing of Yin and Yang carried out by the Yin and Yang Qiao Mai
22
has an influence on the mental state: in particular, and Excess of Yang in the Yang Qiao
Mai causes anxiety, agitation, manic behaviour and insomnia.
In neurological conditions, both the Yin and Yang Qiao Mai play a role. In particular, they
are both used to extinguish internal Wind in the treatment of epilepsy: the former when
the attacks occur at night, and the latter when they occur in daytime.
Besides that, the Yang Qiao Mai is used to extinguish internal Wind in Wind-stroke while
the Yin Qiao Mai is used for Atrophy Syndrome (Wei Zheng) which may correspond to
neurological conditions such as multiple sclerosis.
The Yin and Yang Qiao Mai control the left and right side of the body, the former for
the Yin and the latter for the Yang channels: this mean that they can be used to correct
imbalances between the right and left sides of the body, the former in the Yin, medial sides
and the latter inthe Yang, lateral sides. For example, they can be used when a leg is longer
than the other. It is interesting that one of the symptoms of KI-2 Rangu (where the Yin
Qiao Mai starts) is “one foot hot and the other cold.”
Fig. 32
R) THE EYE SYSTEM (Mu Xi)

Chapter 21 of the “Spiritual Axis” (Ling Shu) discusses the pathway of the Yin and Yang
Qiao Mai in the brain and, in this context, it mentions the “Eye System” (Mu Xi): “The
Bladder channel passes through the occiput and enters the brain: the main branch reaches the
root of the eyes and it is called Eye System [Mu Xi]. In fact, in case of headache and eye ache,
one can needle this channel on the occiput between the two tendons.”6 This last sentence
probably refers to the point G.B.-20 Fengchi.
The Eye System is also mentioned in chapters 2 and 80 of the Ling Shu. Chapter 2 says:
“The Bladder channel passes through the occiput and enters the brain: it belongs to the root of
the eyes and it is called Eye System.”
23
The above statement from these three chapters imply that there is a movement of Qi
from the forehead and eyes, into the brain and exiting at the occiput. This is interesting
as it confirms that, besides what I call the “vertical” movement of Qi, there is also a
“horizontal” movement of Qi, in this case a horizontal movement between the eyes and
the occiput.
From a modern perspective, The Eye System is basically the part of the brain that controls
eyesight and the optic nerve. Many points on the head are associated with the Eye System.
These are:
- Yintang
- ST-1 Chengqi
- BL-1 Jingming
- G.B.-20 Fengchi
- G.B.-14 Yangbai
- Du-16 Fengfu.
The Du Mai has four areas of convergence with the Eye System:
1) Du-16 Fengfu: including BL-10 Tianzhu, G.B.- 20 Fengfu and TB-17 Yifeng. The Du
Mai enters the brain from here. The Yang Qiao Mai connects with G.B.-20 from where it
enters the brain and connects with Eye System (Fig. 33).
Fig. 33
2) Du-20 Baihui: including Sishencong, Du-21 Qianding and BL-7 Tongtian. Du-20
Baihui is a point of the Sea of Marrow (Fig. 34).
Chapter 80 says: “The Jing and Qi of the 5 Zang and 6 Fu ascend to the eyes to give vision…
They communicate with many channels constituting an Eye System (Mu Xi) which ascends
to the vertex, enters the brain and then surfaces at the occiput. When pathogenic factors
enter the occiput due to a weak state of the body, they penetrate deeper and, following the
Eye System, they enter the brain. Once in the brain, they cause dizziness, tightness of the
Eye System and blurred vision. When pathogenic factors invade the Essence [Jing].... this is
scattered and double vision will result.” See Fig. 35.
24
Fig. 34 Fig.35
3) Bijiao: including Yintang and Du-24 Shenting. Bijiao is an extra point situated on the
Du Mai, on the bridge of the nose level with the centre of the pupils (Fig. 36).
Fig. 36
4) Du-26 Renzhong and Du-25 Suliao: connect with the brain indirectly through Eye
System (Fig. 37).
The clinical significance of the Eye System is that the above-mentioned points can be
used for eye problems; they also treat the brain and especially the symptom of dizziness.
Reading the passages from chapters 2, 21 and 80 of the Ling Shu, the Eye System may
cause the following symptoms:
- dizziness
- blurred vision
- double vision
- headache
- eye ache
25
Fig. 37
3. Symptoms & Signs
The symptoms and signs which will be discussed for the vertex area are:
a. Headache
b. Dizziness
c. Feeling of heat of the head
d. Feeling of cold of the heade)
e. Feeling of distension of the head
f. Feeling of heaviness of the head
g. Itching of the head
h. Numbness of the head
i. Shaking head
j. Brain noise
k. Premature greying of the hair
l. Hair falling out
m. Alopecia
n. Dry and brittle hair
o. Psoriasis
For each symptom I will give the essential points for that particular symptom. Please note
that these are general points for that symptom in that area, irrespective of pattern. Thus,
the points listed below would help that particular symptom irrespective of pattern. Of
course, these points do need to be combined with the points according to pattern.
For example, the point given below for vertical headache is LIV-3 Taichong because the
Liver channel reaches the top of the head but obviously this needs to be combined with
other points according to pattern.
26
a) Headache
Headache only on the vertex is not common. If it is dull, the most common cause is Liver
Blood deficiency, which would be more common in women; if it is sharp in nature, it is
due to Liver-Yang rising, Liver-Fire or Liver-Wind. If the headache is strong but dull and
associated with a feeling of muzziness (fuzziness), it may be due to Dampness or Phlegm.
In some cases, vertical headache may also be due to a Kidney deficiency (Yin or Yang).
Points for vertical headache: LIV-3 Taichong and Du-20 Baihui.
b) Dizziness
Dizziness is a common symptom in women and in the elderly. Many elderly people seek
treatment specifically for dizziness. As with any symptom, it may be due to a Deficiency or
a Fullness. Full causes of dizziness include (with features in brackets):
- Liver-Yang rising (with headache)
- Liver-Wind (severe dizziness, vertigo)
- Phlegm (with muzziness/fuzziness, feeling of heaviness of the head, poor
concentration).
Phlegm is a very common (Full) cause of dizziness especially in the elderly. In the elderly,
dizziness is also frequently caused by the combination of Phlegm and Liver-Yang rising.
Indeed, several brain symptoms that in the elderly one would instinctively associate with
a Kidney deficiency, e.g. poor memory and dizziness, are often due to Phlegm obstructing
the Brain.
The two most common Deficiency causes of dizziness are Liver-Blood deficiency (more
common in women) and Kidney deficiency (which may be of Yin or of Yang). There are
other, less common causes of dizziness such as Heart and Spleen deficiency or Stomach-
and Spleen-Qi deficiency.
Point for dizziness: G.B.-20 Fengchi.
c) Feeling of heat of the head

A feeling of heat of the head is very common although less so specifically on the vertex. A
feeling of heat of the head may be due to many different organs and the first distinction we
should make is that between Full and Empty Heat.
In order to distinguish Full from Empty Heat, the pulse and tongue are important. In Full
Heat, the pulse is of the Full type and perhaps Rapid (it may not always be so) and the
tongue is red with a coating; in Empty Heat, the pulse is of the Empty type (which may
include Floating- Empty) and the tongue is red without a coating (or partially without
coating).
27
Liver-Fire is a common cause of feeling of heat of the head and also especially of the
vertex.
It would be accompanied by a bitter taste, thirst, propensity to outbursts of anger, a red
tongue with a thick-yellow coating and a Wiry-Rapid pulse. This is more common in men.
Full Heat of other organs may cause a feeling of heat of the head: these are especially
Heart-Heat and Stomach-Heat (the latter especially in children). In small children (under
3), a feeling of heat of the head is often related to Stomach-Heat.
Empty Heat is also a common cause of feeling of heat in the head. If caused by Empty
Heat, the feeling of heat of the head will manifest more in the evenings. One of the most
important distinguishing signs of Empty Heat as compared to Full Heat is the tongue. In
Full Heat, the tongue is red and has a thick-yellow coating; in Empty Heat, it is also red
but it has no coating (or partially without coating).
The most common Empty Heat patterns causing a feeling of heat of the head are Empty
Heat from Kidney-Yin and/or Liver-Yin deficiency and from Heart-Yin deficiency. A
feeling of heat of the head from deficiency of Liver- and Kidney-Yin is very common in
menopausal women.
A special mention should be made of a feeling of heat of the head deriving from Yin Fire.
The concept of Yin Fire was introduced by Li Dong Yuan (1180-1252). According to Dr
Li, Yin Fire develops when the Yuan Qi and the Stomach and Spleen decline. This leads to
a deficiency of the Middle and Lower Burner and to some Heat escaping upwards causing
some feeling of heat of the head. This Heat is neither Full Heat nor Empty Heat from Yin
deficiency: it is “Yin Fire” from a deficiency of the Stomach and Spleen and of the Yuan Qi
(Fig. 38).
Fig. 38
28
A particular feature of Yin Fire that allows us to diagnose it is that, together with a feeling
of heat of the head, there may be symptoms of cold elsewhere and especially in the lower
part of the body such as cold feet or also feeling of cold in general. The pulse and tongue
would also be important to diagnose Yin Fire as the former would be Weak and the latter
may be pale.
Another possible cause of a feeling of heat of the head is Rebellious Qi of the Chong Mai.
Rebellious Qi of the Chong Mai occurs when there is a Kidney deficiency in the Lower
Burner so that the Qi of the Chong Mai escapes upwards causing various symptoms all
over the abdomen and head, from the lower abdomen, to mid-abdomen, chest, breasts
in women, throat, face and head. Again, this pattern is neither Full nor Empty Heat: it
is simply a feeling of heat of the head caused by Qi rushing upwards in the Chong Mai.
In this case too, the feeling of heat of the head may contrast with cold feet. Women are
especially prone to rebellious Qi of the Chong Mai (Fig. 39).
Fig. 39
There is yet another cause of feeling of heat of the head in women and that is a deficien-
cy of Blood, especially of Liver- and/or Heart-Blood. This occurs only in women and it
is a type of “Empty Heat” albeit one that derives from Blood rather than Yin deficiency.
Points for feeling of heat in the head:
L.I.-4 Hegu, HE-6 Yinxi, KI-2 Rangu.
d) Feeling of cold of the head

This includes an actual feeling of cold of the head but also a propensity to wearing a hat
and a strong dislike of wind. A feeling of cold of the head is not a common symptom. It
may be due to Cold and Deficiency of the Du Mai. The accompanying symptoms would be
a feeling of cold of the head and back, cold limbs, feeling cold, sore back, weak knees, pale
complexion.
29
A feeling of cold of the head may also be due to Cold in the Liver channel in which case
the accompanying symptoms would be vertical headache, bluish complexion, cold hands
and feet, and a Deep-Tight pulse.
Points for feeling of cold in the head:
LIV-3 Taichong, Du-20 Baihui with moxa.
e) Feeling of distension of the head

A feeling of distension of the head is usually related to a Liver pathology which is either
Liver- Yang rising or Liver-Fire. Few English-speaking patients would describe this feeling
as “distension” although its Chinese equivalent (zhang) is used frequently by Chinese
patients. Some English-speaking patients might use the term “bursting” when describing
“distension” in relation to the head.
Points for feeling of distension of the head: G.B.-20 Fengchi, Du-20 Baihui, LIV-3
Taichong.
f) Feeling of heaviness of the head

A feeling of heaviness of the head is quite common. It may sometimes be described by
patients as a feeling as if the head were wrapped in a cloth. Both these feelings indicate
either Dampness or Phlegm or both. The feeling of heaviness of the head is often
accompanied by a feeling of muzziness (fuzziness) which itself may be due to Phlegm or
Dampness.
Please note that a feeling of heaviness of the head may indicate either Dampness or
Phlegm but if it is combined with a feeling of dizziness, it indicates Phlegm. To put it
differently, both Dampness and Phlegm may cause a feeling of heaviness and muzziness
(fuzziness) of the head, but Phlegm additionally may cause dizziness which Dampness
does not.
Points for feeling of heaviness of the head: L.I.-4 Hegu, LU-7 Lieque, ST-8 Touwei.
g) Itching of the head

Itching in the vertex is due to Wind in the skin: this may occur either with Blood Heat
(Full cause) or as a consequence of Blood deficiency (Deficiency). Itching of the vertex
occurs frequently with psoriasis of the scalp.
Points for itching of the head: LIV-3 Taichong, HE-7 Shenmen, Du-20 Baihui, G.B.-20
Fengchi.
30
h) Numbness of the head

Numbness of the head on the vertex may indicate three pathological conditions:
- Liver-Blood deficiency
- Phlegm
- Internal Wind
The numbness related to Liver-Blood deficiency is mild; numbness deriving from Phlegm
is accompanied by a feeling of muzziness (fuzziness) together with a feeling of heaviness
and possibly dizziness; the numbness related to internal Wind may be unilateral, i.e. affect
one side of the vertex.
Points for numbness of the head:
ST-8 Touwei, L.I.-4 Hegu, Du-20 Baihui.
i) Shaking head
A shaking head always indicates Liver-Wind which may be Full or Empty. Full Liver-Wind
usually derives from Liver-Yang rising or Liver-Fire; Empty Liver-Wind may derive from
Liver- Blood or Liver-Yin deficiency.
When it is due to Full Liver-Wind, the head shakes vigorously and with large amplitude;
when due to Empty Liver-Wind, the head shakes mildly and with small amplitude.
Points for shaking head: LIV-3 Taichong, G.B.-20 Fengchi, HE-7 Shenmen.
j) Brain noise
“Brain Noise” is similar to the sound of tinnitus in the ears but it is experienced in the
centre of the head. The Chinese name for it is nao ting which means “brain tinnitus” and
its old name was lei tou feng which means “thunder head wind.”
There are two Empty and two Full causes of Brain Noise. The two Empty causes are a
deficiency of the Sea of Marrow and deficiency of Qi and Blood of the Spleen and Heart.
The two Full causes of Brain Noise are Phlegm rising and Liver-Qi stagnation.
In Empty conditions, the brain “noise” will be mild and with low pitch; in Full conditions,
it is loud and of high pitch.
Points for Brain Noise: Du-20 Baihui, KI-3Taixi, BL-23 Shenshu.
k) Premature greying of the hair

The most common causes of premature greying of the hair are rooted in a Deficiency. The
main Empty causes of premature greying of the hair are Liver-Blood and/or Liver-Yin
31
deficiency and a Liver-and Kidney-Yin deficiency (which may be with or without Empty
Heat).
There is another, interesting Full condition of premature greying of the hair in men and
that is stasis of Jing. The pathology of stasis of Jing may seem strange because we are used
to thinking of Jing as the precious essence inherited from the parents and residing in the
Kidneys. However, stasis of Jing occurs only in men and, in this context, jing should be
intended more as “sperm” than as “Essence”. For example, stasis of Jing in men may cause
prostatitis, prostatic hyperplasia or Peyronie’s disease.
The interesting aspect of stasis of Jing is that it may cause symptoms that “look” very much
like a deficiency of Jing (such as premature greying of the hair) but that are actually caused
by the Jing being stagnant rather than deficient.
Points for greying of hair: Du-20 Baihui, KI-3 Taixi, LIV-8 Ququan.
l) Hair falling out

“Hair falling out” consists in hair falling out gradually and uniformly. The deficient causes
of hair falling out are similar to those of premature greying of the hair: it may be caused
by a Liver and Kidney deficiency or by Liver-Blood deficiency. Liver-Fire is a Full cause of
hair falling out: it is due to Liver-Fire, which naturally rises, “burning”the hair on the head.
Points for hair falling out: Du-20 Baihui, KI-3 Taixi.
m) Alopecia
Alopecia consists in the hair falling out rather suddenly and in clumps (Plate 1.1).
Alopecia is usually due to Full causes. These are internal Wind, Blood-Heat from Liver-
Fire or Liver-Blood stasis. Internal Wind causing alopecia may derive from Liver-Fire (Full
Wind) or from Liver-Blood and/or Liver-Yin deficiency (Empty Wind).
Points for alopecia: G.B.-20 Fengchi, LIV-3 Taichong.
n) Dry and brittle hair

When I interview a patient, I always look at the condition of the hair especially in women
as that gives an idea of the state of Liver-Blood. Dry and brittle hair in women is usually
due to Liver- Blood deficiency. However, this is not the only cause as the condition of the
hair depends also on the Kidneys and therefore dry and brittle hair may also be related to
a deficiency of Liver- and Kidney-Yin.
In women, dry and brittle hair may also be due to chronic loss of blood such as that which
occurs with menorrhagia and metrorrhagia.
32
Points for dry and brittle hair: LIV-8 Ququan, SP-6 Sanyinjiao, KI-3 Taixi.
o) Psoriasis
Psoriasis frequently affects the top of the head: this usually happens in chronic cases when
there is Blood deficiency and Dryness which manifest with white scales (Plate 1.2).
Points for psoriasis: G.B.-20 Fengchi, LIV-3 Taichong, KI-3 Taixi, LIV-8 Ququan.
SUMMARY OF CAUSES OF FEELING OF HEAT IN THE HEAD

1. Full Heat
2. Empty Heat
3. Yin Fire
4. Rebellious Qi of the Chong Mai
5. “Empty Heat” from Blood deficiency
4. Patterns
The main patterns affecting the vertex are:

- Liver-Blood deficiency
- Liver-Yang rising
- Liver-Wind
- Kidney deficiency
- Excess of Yang
- Dampness
- Phlegm
For each pattern, I will indicate the main points for that pattern but specifically for
patterns manifesting in that area. Please note that the previous points mentioned were for
symptoms irrespective of patterns: in this section, I suggest points for patterns.
a) Liver-Blood deficiency
The Liver channel reaches the top of the head and for this reason, many Liver patterns
affect the vertex. Liver-Blood affects the vertex in causing dull vertical headaches, i.e.
headaches experienced on the top of the head. Liver-Blood deficiency may also cause
dizziness and blurred vision. Liver-Blood also affects the quality of the hair and may cause
dry and brittle hair.
Points for Liver-Blood and vertex
- LIV-8 Ququan, ST-36 Zusanli, SP-6 Sanyinjiao and Ren-4 Guanyuan reinforced to
nourish Liver-Blood.
33
- LIV-3 Taichong to reach vertex.

b) Liver-Yang rising
The pattern of Liver-Yang rising frequently affects the vertex. Remember that the Liver
channel ascends to the vertex from the eyes. Liver-Yang rising ascending to the vertex
will cause headache and dizziness. The headache from Liver-Yang rising is throbbing
or distending in nature. The dizziness may occur by itself or it may accompany the
headaches.
Points for Liver-Yang rising and vertex
- LIV-3 Taichong and G.B.-20 Fengchi to reach vertex and subdue Qi. As Liver-Yang rises
from a deficiency of the Liver and/or Kidneys, other points will be necessary to nourish
Liver-Blood, Liver-Yin or Kidney-Yin.
c) Liver-Wind
Liver-Wind, like Liver-Yang, also frequently affects the vertex as Wind affects the top part
of the body. The main symptom of Liver-Wind on the vertex is severe dizziness or vertigo,
i.e. dizziness to the point that objects seem to sway with a spinning sensation in the head.
Liver-Wind is more common in the elderly and, frequently, dizziness is the main
presenting symptom of elderly patients.
Points for Liver-Wind and vertex
- LIV-3 Taichong, G.B.-20 Fenchi and Du-16 Fengchi to reach the vertex and extinguish
Wind. Other points will be necessary depending on the pattern underlying Liver-Wind
(Liver-Blood or Liver-Yin deficiency, Kidney-Yin deficiency).
d) Kidney deficiency
The Kidney channel does not reach the head or brain and yet the Kidneys influence the
Brain and the Sea of Marrow. The Kidneys reach the head and brain indirectly through
the Bladder Divergent channel and also through the Du Mai. Indeed, Kidney-Qi must
reach the Brain to nourish it. Both Kidney-Yin and Kidney-Yang influence the vertex. The
Kidneys affect the vertex and Brain only in Deficiency: there is no Full Kidney pattern that
affects the vertex. A deficiency of Kidney-Yin fails to nourish the Sea of Marrow and the
Brain resulting in dizziness and poor memory. A deficiency of Kidney-Yang fails to warm
the Sea of Marrow and it may also result in dizziness and poor memory.
A deficiency of the Kidneys (Yin or Yang) may also cause Deficiency headaches on the
vertex characterized by a dull pain and a mild dizziness.
Points for Kidney deficiency and vertex
- Du Mai (S.I.-3 Houxi with BL-62 Shenmai).
- KI-3 Taixi and BL-23 Shenshu to tonify the Kidneys.
34
- Du-20 Baihui.
e) Excess of Yang
“Excess of Yang” is a general term that may refer to different patterns. For example, the
Liver-Yang rising pattern described above is also an “Excess of Yang” pattern. Other Excess
of Yang patterns concern Heat or Fire rising to the vertex. This is most likely to happen
with Liver-Fire.
Liver-Fire rises (like Liver-Yang) and it may affect the vertex causing severe headaches and
dizziness.
There is another Excess of Yang pathology of the vertex and that is that of Excess of Yang
of the Yang Qiao Mai. The Yang and Yin Qiao Mai are like the first-line “reservoirs”
in absorbing Excess of Yang and of Yin respectively. One of the functions of the Eight
Extraordinary Vessels is that of absorbing Excess of Qi from the main channels. All the
classics use the metaphor of reservoirs and rivers: the main channels are like rivers and the
extraordinary vessels are like reservoirs. Just as in nature when the rivers are overfull from
excess rain they pour the excess water into the reservoirs, in the human body, when the
main channels are overfull, the excess Qi is deviated into the extraordinary vessels.
Of the eight extraordinary vessels, the Yang and Yin Qiao Mai are the first-line reservoirs.
However, these two vessels do not absorb Excess of Yang and Yin in the same areas: the
Yang Qiao Mai absorbs Excess of Yang in the head, while the Yin Qiao Mai absorbs Excess
of Yin in the lower abdomen.
“Excess of Yang” in the Yang Qiao Mai may manifest with severe headaches on the vertex
but it may also manifest on a mental level with anxiety, insomnia or manic behaviour.
Points for excess of Yang in Yang Qiao Mai and vertex
- BL-62 Shenmai and S.I.-3 Houxi to open the Yang Qiao Mai.
- Du-19 Houding.
Points for Liver-Fire and vertex
- LIV-3 Taichong to reach vertex and subdue Qi.
- LIV-2 Xingjian to drain Liver-Fire.
- Du-19 Houding and G.B.-13 Benshen.
f) Dampness
Dampness frequently settles in the head due to the failure of clear Qi to rise and of turbid
Qi to descend. Dampness in the head causes a feeling of heaviness of the head and dull
headaches. Dampness in the head is a frequent consequence of repeated invasions of
Wind, giving rise to residual pathogenic factor.
35
Points for Dampness in the head and vertex

- Du-20 Baihui and ST-8 Touwei to clear the orifices and resolve Dampness from the
head.
- L.I.-4 Hegu and LU-7 to promote the rising of clear Qi and descending of turbid Qi.
- General points to resolve Dampness (Ren-9 Shuifen, Ren-12 Zhongwan, SP-9
Yinlingquan, Ren-5 Shimen, BL-22 Sanjiaoshu).
g) Phlegm
Phlegm is a very common pathogenic factor settling in the head. Like Dampness, it is due
to the failure of clear Qi to rise and of turbid Qi to descend. Phlegm in the head causes
symptoms similar to those caused by Dampness, i.e. a feeling of heaviness of the head and
dull headaches but, in addition, it also causes a feeling of muzziness (fuzziness) of the head
and dizziness.
Points for Phlegm in the head and vertex
- Du-20 Baihui and ST-8 Touwei to clear the orifices and resolve Dampness from the
head.
- L.I.-4 Hegu and LU-7 Lieque to promote the rising of clear Qi and descending of turbid
Qi.
- General points to resolve Phlegm (Ren-9 Shuifen, SP-9 Yinlingquan, ST-40 Fenglong,
Ren-5 Shimen, BL-22 Sanjiaoshu).
5. Diseases
The diseases discussed are:

a) Headaches
b) Psoriasis
c) Brain Noise
a) HEADACHES
Headaches that occur only on the vertex are less common that those occurring on the
temporal regions. Headaches on the vertex may derive from a Full or Empty conditions:
Full-type vertical headaches include those from Liver-Yang rising, Liver-Wind, Liver-Fire,
Dampness or Phlegm. Empty-type vertical headaches include those from Liver-Blood
deficiency or Kidney deficiency.
Before discussing the individual patterns, I will discuss the principles governing the choice
of points for headaches. When I treat headaches, I choose distal and local points and,
36
for each of them, I choose points that treat the patterns and points that treat the channel
(below).
For example, if I am treating a headache from Liver-Yang rising, I select points that treat
the pattern of Liver-Yang rising and points that treat the channel of the area where the
headaches occur: I do this with both distal and local points. The points treating the pattern
will be primarily from the Liver channel while those treating the channel will be primarily
from the Gall-Bladder channel.
Let us say for example that we are treating a headache from Liver-Yang rising deriv-
ing from Liver-Blood deficiency and that the headache is unilateral and occurs on the
corner of the eye and lateral sides of the skull (on the Gall-Bladder channel). The points
I would select would be the following (below).
- Distal points to treat the patterns: LIV-3 Taichong to subdue Liver-Yang, LIV-8 Ququan
and SP-6 Sanyinjiao to nourish Liver-Blood.
- Local or adjacent points that treat the pattern: G.B.-20 Fengchi to subdue Liver-Yang.
- Distal point to treat the channel: G.B.-43 Xiaxi to affect the eye area.
- Local points to treat the channel: G.B.-1 Tongziliao, G.B.-6 Xuanli.
i. Liver-Yang rising
Vertical headaches from Liver-Yang rising are throbbing or distending in character:
they are the most common pattern seen in headaches. Liver-Yang rising always arises
from another pattern which may be Liver-Blood or Liver-Yin deficiency of Kidney-Yin
deficiency or a combination of these.
Bearing in mind what was said above, the treatment of vertical headaches from Liver-
Yang will be based on the following points:
- Distal points for the pattern: LIV-3 Taichong, plus points to nourish the Liver or
Kidneys
37
- Local or adjacent points for the pattern: G.B.-20 Fengchi.

- Distal points for the channel: LIV-3 Taichong (in this case the distal point for the
channel coincides with the distal point for the pattern).
- Local points for the channel: Du-20 Baihui.
As we can see, in this case the point LIV-3 Taichong acts as a distal point both for the
pattern and the channel.
ii. Liver-Fire
Vertical headaches from Liver-Fire are throbbing in character and more intense than those
from Liver-Yang rising. As there is Fire, they will be accompanied by a feeling of heat and
thirst.
The treatment of vertical headaches from Liver-Fire will be based on the following points:
- Distal points for the pattern: LIV-3 Taichong and LIV-2 Xingjian.
- Distal points for the channel: LIV-3 Taichong.
iii. Liver-Wind
Vertical headaches from Liver-Wind are “pulling” in character and accompanied by
dizziness or vertigo. The treatment of vertical headaches from Liver-Wind will be based on
the following points:
- Distal points for the pattern: LIV-3 Taichong.
iv. Dampness
Dampness in the head does not usually affects only the vertex: it usually affects the whole
head and especially the forehead. Headaches from Dampness will be accompanied by a
feeling of heaviness and muzziness (fuzziness) of the head.
The treatment of vertical headaches from Dampness will be based on the following points:
- Distal points for the pattern: SP-3 Taibai plus other points to resolve Dampness (Ren-9
38
Shuifen, Ren-12 Zhongwan, SP-9 Yinlingquan, Ren-5 Shimen, BL-22 Sanjiaoshu).

- Local or adjacent points for the pattern: ST-8 Touwei.
Note how the distal point for the channel is LIV-3 even though Dampness is a pathology
that derives primarily from a Spleen disharmony. I have chosen LIV-3 as a channel point
because the Spleen channel does not go to the vertex.
v. Phlegm
Phlegm in the head does not usually affects only the vertex: it usually affects the whole
head and especially the forehead. Headaches from Phlegm will be accompanied by a
feeling of heaviness of the head, a feeling of muzziness (fuzziness), dizziness and blurred
vision. Remember that Phlegm is more obstructive of the orifices than Dampness is, hence
the feeling of muzziness, dizziness and blurred vision.
The treatment of vertical headaches from Phlegm will be based on the following points:
- Distal points for the pattern: SP-3 Taibai, ST-40 Fenglong plus other points to resolve
Phlegm.
- Local or adjacent points for the pattern: ST-8 Touwei.
Note how the distal point for the channel is LIV-3 even though Phlegm is a pathology
that derives primarily from a Spleen disharmony. I have chosen LIV-3 as a channel point
because the Spleen channel does not go to the vertex.
vi. Liver-Blood deficiency

Vertical headaches from Liver-Blood deficiency are probably the most common
Deficiency vertical headache. The headache will be dull and accompanied by a mild
dizziness and blurred vision.
The treatment of vertical headaches from Liver-Blood deficiency will be based on the
following points:
- Distal points for the pattern: LIV-8 Ququan, ST-36 Zusanli and SP-6 Sanyinjiao to
nourish
Liver-Blood.
- Local or adjacent points for the pattern: Yuyao (extra point in the middle of the
eyebrow).
39
vii. Kidney deficiency

Vertical headaches from Kidney deficiency are also common Deficiency vertical
headaches. The headache will be dull and accompanied by a mild dizziness. The treatment
of vertical headaches from Kidney deficiency will be based on the following points:
- Distal points for the pattern: KI-3 Taixi and SP-6 Sanyinjiao to nourish the Kidneys. BL-
23 Shenshu if there is Kidney-Yang deficiency.
- Local or adjacent points for the pattern: Du-16 Fengfu (point of the Sea of Marrow).
- Distal points for the channel: KI-1 Yongquan.
HEADACHES ON VERTEX
• Liver-Yang rising: throbbing headache, dizziness.
• Liver-Fire: throbbing headache, dizziness, thirst, feeling of
heat.
• Liver-Wind: pulling headache, dizziness, vertigo.
• Dampness: dull headache on vertex and forehead, feeling of
heaviness of the head.
• Phlegm: dull headache, feeling of heaviness and muzziness of
the head, dizziness, blurred vision.
• Liver-Blood deficiency: dull headache, mild dizziness.
• Kidney deficiency: dull headache, poor memory, mild
dizziness.
b) PSORIASIS
Psoriasis often occurs on the vertex and when it does, it indicates the presence of Wind.
The pathology of chronic psoriasis is complex and it may involve Blood deficiency with
dryness, Wind, Blood-Heat and Blood stasis. “Wind” here is neither external nor internal
Wind: it is Wind in the skin which is, however, more akin to external than internal Wind.
With herbs, it is treated in fact with herbs that expel external Wind and those that expel
Wind-Dampness from the joints (in Bi Syndrome).
In the context of psoriasis, the main symptoms of Wind are itching and dryness. It is
interesting that, in skin diseases, dryness may be caused by Wind (rather than Blood or
Yin deficiency) just as, in nature, wind may dry up the land. The location of psoriasis on
the vertex would be a further confirmation of Wind as this pathogenic factor attacks the
top part of the body.
Psoriasis on the vertex occurs usually only in chronic cases and it is accompanied by
scaling. Scaling with white scales itself indicates dryness which may be the result of Blood
deficiency or Wind, or both (Plate 1.2). Plate 1.2 shows a case of severe white scaling: this
40
indicates both Blood deficiency and Wind.
In treatment, I would nourish Liver-Blood, expel Wind and clear Heat and cool Blood
using the following points:
- Nourish Liver-Blood: LIV-8 Ququan, ST-36 Zusanli, SP-6 Sanyinjiao, Ren-4 Guanyuan.
- Expel Wind: T.B.-5 Waiguan, LIV-3 Taichong, G.B.-20 Fengchi, Du-16 Fengfu.
- Clear Heat and cool Blood: L.I.-11 Quchi, SP-10 Xuehai.
c) BRAIN NOISE
“Brain noise” should be distinguished from tinnitus: the former is experienced inside the
headwhilst the latter consists of a ringing in the ears. The three main causes of Brain Noise
are:
1. Deficiency of the Sea of Marrow
2. Deficiency of Blood of the Heart and Spleen
3. Liver-Fire
The brain noise caused by deficiency of the Sea of Marrow is accompanied by dizziness,
poor
memory, and weak back and legs: it is due to the deficient Marrow failing to “fill” the
brain.
The brain noise caused by deficiency of Blood of the Heart and Spleen is accompanied by
dizziness, palpitations, insomnia, poor memory, Pale tongue and Choppy pulse: it is due
to Qi and Blood failing to rise to the head to brighten its orifices. The brain noise due to
Liver-Fire is accompanied by irritability, hypochondrial distension, sighing and a Wiry
pulse: it is due to Liver-Fire rising to the brain.
BRAIN NOISE
• Deficiency of the Sea of Marrow: dizziness, poor
memory, weak back and legs.w
• Heart- and Spleen-Blood deficiency: dizziness,
palpitations, insomnia, poor memory,Pale
tongue, Choppy pulse
• Liver-Fire: irritability, hypochondrial
distension, sighing, Wiry pulse.
41
6. Points
In this section, I shall discuss the points that are situated in the area in question. For each
point,
I will discuss the following:
- Location
- Name
In this section, I shall discuss the points that are situated in the area in question. For each
point, I will discuss the following:
- Location
- Name
- Intersections
- Energetics
- Indications and actions
Under “Energetics” I will discuss the general energetic actions of the point in relation
to the area: these will be indicated as “Action 1”, “Action 2”, etc. The Indications (i.e. the
symptoms and signs from Chinese texts) will be grouped according to actions. This
makes the actions easier to understand and it also highlights how, when indications are
grouped in this way, it becomes apparent how the actions of the point are implied in the
indications.
For example, if we take the point Du-20 Baihui under “Energetics” its first action is
to nourish the Sea of Marrow: this is called “Action 1”. Under the Indications, we find
“dizziness, brain noise, tinnitus, poor memory”: these are clearly related to Du-20’s first
action, i.e. that of nourishing the Sea of Marrow. When the Indications are grouped
according to actions, the therapeutic range of the point is much clearer.
a) DU-20 BAIHUI Hundred Meetings

i. Location
At the vertex, on the midline, in the depression 5 cun posterior to the anterior hairline and
7 cun superior to the posterior hairline.
ii. Name
It is called “Hundred Meetings” because it is a meeting point of all Yang energies (even
though not all Yang channels actually reach this point) and of the Liver channel internally.
The name also refers to the ability of this point to treat “100 diseases.”
42
iii. Intersections
Bladder, Gall-Bladder, Triple Burner and Liver channel.
iv. Energetics
Du-20 Baihui has the following actions:
- it is a point of the Sea of Marrow and therefore it can nourish Sea of Marrow (Action 1)
- it can tonify and raise Yang especially with moxa cones (Action 2)
- it extinguishes Wind and subdues Yang
(Action 3)
- it benefits the sense organs (Action 4).
Thus, if we look at the actions of Du-20 we can see that the energetic effect of this point is
dual: it can raise Qi and Yang or do the opposite i.e. subdue rebellious Yang.
v. Indications and actions

• Action 1: dizziness, brain noise, tinnitus, poor memory.
• Action 2: prolapse of rectum, vagina, bladder, uterus, incontinence of urine.
• Action 3: headache, wind-stroke, opisthotonos, tetany, epilepsy.
• Action 4: nasal obstruction, nasal discharge, nosebleed, blurred vision.
vi. Comments
Du-20 is an important strategic point due to its location at the very top of the skull.
Bearing in mind the concept of potential energy discussed above, Du-20 is situated in
an area of maximum potential. For this reason, it has a powerful, dynamic action: as we
have seen, it can both pull Qi up towards the top or subdue rebellious Qi to make it go
downwards.
I personally use this point more to pull Qi upwards when it is sinking: if we look at Action
2 above, we can see that it lifts Qi since it treats prolapse (of rectum, vagina, bladder or
uterus) and incontinence of urine. When I use this point to lift Qi, I often combine it with
points on the Ren Mai and I will give some examples below. In my experience, Du-20 has
a lifting effect on Qi in the intestines, uterus or bladder.
When Qi sinks in the Intestines, the patient experiences a dull abdominal pain with a
feeling of bearing down: there may also be loose stools. To lift Qi in the Intestines, I use
Du-20 Baihui with Ren-6 Qihai.
When Qi sinks in the Uterus, the woman may suffer from chronic excessive menstrual
bleeding that often does not react to treatment. To lift Qi in the Uterus, I use Du-20 Baihui
with Ren-4 Guanyuan.
43
When Qi sinks in the Bladder, the patient may suffer from frequent urination, a slight
incontinence and a discomfort over the bladder.
To lift Qi in the Bladder, I use Du-20 Baihui with Ren-3 Zhongji (Fig. 40).
Fig. 40
In all these cases, the points may also be combined with the opening points of the Du Mai
i.e. S.I.-3 Houxi and BL-62 Shenmai. In women, I often combine these two points with the
opening points of the Ren Mai crossed over. For example, if I was using the Du Mai in a
woman for urinary problems, I would use the following points (in this order): S.I.-3 Houxi
on the right, BL-62 Shenmai on the left, LU-7 Lieque on the left, KI-6 Zhaohai on the
right, Du-20 Baihui and Ren-3 Zhongji (Fig. 41).
Fig. 41
If I was treating a woman in the same way but for excessive uterine bleeding, all the points
would be the same with the exception of Ren-3 Zhongji which would be replaced by Ren-4
Guanyuan.
44
If I was treating a woman in the same way but for a bearing down sensation in the lower
abdomen, all the points would be the same with the exception of Ren-3 Zhongji which
would be replaced by Ren-6 Qihai.
The lifting effect on Qi of Du-20 is useful not only in the above-mentioned cases of Qi
sinking on a physical level: I use Du-20 also in depression to “lift” mood and the Mind. I
use this point for its lifting mental effect in whatever patterns is underlying the depression.
Du-20 is also a point of the Sea of Marrow and its symptoms of Deficiency (dizziness,
tinnitus, blurred vision, weak legs, desire to lie down) are very common and they aptly
describe the symptoms of the elderly.
The Sea of Marrow is related to the Du Mai which flows in the spine and into the Brain:
for this reason, the points of the Sea of Marrow (Du-20 Baihui and Du-16 Fengfu) are
on the Du Mai. The Du Mai is also the channel through which the Kidneys actually
nourishes the Brain (as the Kidney channel does not go to the brain) and, for this rea-
son, the Du Mai has a deep influence on the nourishing of the brain. In particular, the
Du Mai balances Yin and Yang in the head and brain because it is Yang in nature but it
carries Kidney-Jing which pertains to Yin.
The Sea of Marrow is another reason why Du-20 is a very effective point in depression: it
not only “lifts” mood but it also nourishes the Brain and Sea of Marrow thus alleviating
depression.
Indeed, the symptoms of fullness and emptiness of the Sea of Marrow have mental-
emotional significance and, it is really in the context of mental-emotional problems that
we can understand the symptoms of “fullness” of the Sea of Marrow. The symptoms
of fullness of the Sea of Marrow (“full of vigour, great physical strength”) indicate a
constitutional condition of strength of the individual: this is not only physical vigour but
it also involves mental “vigour” which means that the person will be able to stand up to
emotional stress keeping the integrity of his or her Shen.
To return to the actions of Du-20, I particularly use Du-20 to strengthen the Sea of
Marrow,nourish the Shen and strengthen the Kidney’s Will-Power (Zhi). For all these
reasons, Du-20 is a very important point for depression.
I have often heard some practitioners say that the point Du-20 Baihui is contraindicated if
the patient has high blood pressure. I have never found this to be true in practice. I think
this idea probably derives from seeing Du-20 only as a point that lifts Qi and “therefore”
contraindicated in high-blood pressure. As we have seen, Du-20 has a dual action and it
can subdue rebellious Qi.
45
Moreover, the idea that Du-20 might be contraindicated in high blood pressure because
it lifts Qi belies a misconception about high blood pressure, i.e. that it is always due to
rebellious Qi and especially Liver-Yang rising: this is not so. There are many cases of high
blood pressure that are due to Spleen deficiency and Phlegm and not to any rising of Qi.
b) DU-21 QIANDING In front of the crown

i. Location
At the top of the head on the midline, 1.5 cun directly anterior to Du-20 and 3.4 cun
posterior to the anterior hairline.
ii. Name
The name of this point simply refers to its location in front of the centre of the top of the
skull (the “crown”).
iii. Intersections
None.
iv. Energetics
The point Du-21 is used mostly in Full conditions.
- it extinguishes internal Wind (Action 1);
- it benefits the sense organs and expels external Wind (Action 2).

• Action 1: vertigo, epilepsy, clonic spasm
• Action 2: swelling of the vertex, oedema of face, invasions of Wind, runny nasal
discharge.
Notice the action of Du-21 on the nose (“runny nasal discharge”). It is interesting that
the Du Mai has an action on the nose but specifically runny nasal discharge. A runny
nasal discharge suggests a Yang deficiency and, in my opinion, a Yang deficiency of the
Lungs and Kidneys is at the root of allergic rhinitis (which manifests with a runny nasal
discharge).
The Yang deficiency of the Kidneys also affects the Du Mai which flows through the
nose: this is an additional feature of the pathology of allergic rhinitis, i.e. a deficiency of
the Du Mai. Indeed, several Du Mai points affect the nose, e.g. Du-21 Qianding, Du-24
Shenting and Du-23 Shangxing.
46
vi. Comments
I basically use this point as a reducing point for Full conditions affecting the vertex. I use it
to subdue rebellious Qi not only in headaches from Liver-Yang rising but also in anxiety.
c) DU-19 HOUDING Behind the crown

i. Location
At the back of the head on the midline,1.5 cun directly superior to Du-18 Qiangjian and
1.5 cun posterior to Du-20 Baihui.
ii. Name
The name of this point simply refers to its location behind the top of the skull (the
“crown”).
iii. Intersections
None.
iv. Energetics
Du-19 Houding is used mostly in Full conditions. It differs from Du-21 in so far as it is
more for calming the Mind in Full conditions and not so much for internal Wind. The
actions of Du-19 are as follows:
- it calms the Mind in Full conditions (Action 1);
- it expels external Wind (Action 3).

• Action 1: manic behaviour, insomnia
• Action 2: epilepsy, dizziness
• Action 3: stiffness and pain of the head and neck, vertical headache, aversion to cold.
vi. Comments
Du-19 is a very useful point to calm the Mind in Full conditions. I use it for severe anxiety
and, for this condition, I often combine it with Ren-15 Jiuwei.
d) DU-23 SHANGXING Upper Star

i. Location
At the top of the head on the midline, 1 cun posterior to the anterior hairline and 0.5 cun
posterior to Du-24 Shenting.
47
ii. Name
“Star” refers to the nose because it takes in air from Heaven (where the stars are).
iii. Intersections
None. It is one of Sun Si Miao’s Ghost Points.
iv. Energetics
This point has a downward movement.
- it clears the nose (Action 1);
- it benefits the eyes (Action 2);
- it expels Wind (Action 3).

• Action 1: nasal obstruction/discharge, anosmia, polyps, clear nasal discharge, epistaxis
• Action 2: dizziness, eye pain, short-sighted, redness/swelling face
• Action 3: malaria, febrile disease without sweating.
vi. Comments
This point’s most important action is on the nose. It is an important local point for
problems of the nose which may be pain, swelling, runny nose or allergic rhinitis.
e) DU-24 SHENTING Spirit Courtyard

i. Location
At the top of the head on the midline, 0.5 cun posterior to the anterior hairline and 0.5 cun
anterior to Du-23 Shangxing.
ii. Name
First of all, in this context, I translate Shen as “Spirit” rather than “Mind” because I think
in this instance, Shen refers not only to the Mind of the Heart but also to the Hun of the
Liver, the Po of the Lungs, the Yi of the Spleen and the Zhi of the Kidneys. The reference
to “courtyard” is interesting. This point is situated just inside the hairline at the front of
the brain just as the courtyard of ancient Chinese houses was at the front of the house. The
courtyard was a very important part of the house in ancient China as it was the one that
gave the first impression to visitors. Thus, we could say this point is the “entrance” to the
Spirit just as the courtyard was to the house in ancient China.
This point is on the pre-frontal lobe that is responsible for working memory and James
Ledoux calls it the “gateway to consciousness”: the similarity between the “gateway” of
Ledoux and “courtyard” is interesting.
48
This brain region has been implicated in planning complex cognitive behaviours,
personality expression, and modulating correct social behaviour. The basic activity of this
brain region is considered to be orchestration of thoughts and actions in accordance with
internal goals and social rules.
The most typical neurologic term for functions carried out by the pre-frontal cortex
area is executive function. Executive function relates to abilities to differentiate among
conflicting thoughts, determine good and bad, better and best, same and different, future
consequences of current activities, working toward a defined goal, prediction of outcomes,
expectation based on actions, and social “control” (the ability to suppress urges that, if not
suppressed, could lead to socially-unacceptable outcomes).
The prefrontal cortex is responsible for the ability to plan and execute goal-directed
behaviour. From a Chinese perspective, many of the above-mentioned functions of the
prefrontal cortex arefunctions of the Hun which are carried out in conjunction with
the Shen of the Heart, e.g.executive functions, future consequences of current activities,
working toward a defined goal, prediction of outcomes, expectation based on actions. All
this broadly corresponds to the “planning” of the Hun and to the coordination of the Hun
and Shen. The pre-frontal cortex also influences social “control”: this reflects the control of
the Shen over the Hun.
iii. Intersections
Bladder and Stomach channels.
iv. Energetics
The most important aspect of this point’s energetics is its downward movement: it makes
Qi descend and subdues rebellious Yang. Its actions are:
- it has a profound influence on the Mind and Spirit, both calming and stimulating
(Action 1);
- it affects the nose (Action 3);
- it clears the eyes (Action 4).

• Action 1: manic-depression, depression, anxiety, poor memory, insomnia
• Action 2: opisthotonos, epilepsy, dizziness, vertigo
• Action 3: clear nasal discharge (allergic rhinitis), nasal congestion, nose bleed
• Action 4: lachrymation, blurred vision.
vi. Comments
Du-24 is a very important and powerful point to calm the Mind. I frequently combine it
49
with G.B.-13 Benshen for severe anxiety and fears.
An important feature of this point which makes it particularly useful is that it can both
calm and lift the Mind: therefore it is used not only for anxiety and insomnia but also for
depression and sadness. It is also used in psychiatric practice for schizophrenia and manic
behaviour.
The name of this point refers to its strong influence on the Mind and Spirit. The courtyard
was traditionally considered to be a very important part of the house as it was the one that
gave the first impression to visitors; it is the entrance. Thus, this point could be said to be
the “entrance” to the Mind and Spirit and its being a courtyard, highlights its importance.
Being the “entrance”, it controls our relationships with others and the “extension” of the
Shen of the Heart towards the others. The right part of the Chinese character for Shen is
shen which means “to stretch”, “to extend”.
This point also stimulates memory.
f) BL-7 TONGTIAN Penetrating Heaven

i. Location
1.5 cun posterior to BL-6 Chengguang, 1.5 cun lateral to the midline. (It is 1 cun anterior
and 1.5 cun lateral to Du-20 Baihui).
ii. Name
This point opens the nose and keeps it free. The nose absorbs Qi from Heaven, hence the
name. Another explanation is simply that “Heaven” refers to the top of the head which is
the most Yang part of the body.
iii. Intersections
None.
iv. Energetics
- it clears the nose (Action 1);
- it expels internal Wind and subdues Yang (Action 2)

• Action 1: nasal congestion and discharge, anosmia, nose bleed
• Action 2: headache, dizziness, deviation of mouth, sudden collapse, unconsciousness.
50
vi. Comments
BL-7 is an important local point for vertical headaches: I use as such for whatever pattern
is causing the vertical headaches.
g) BL-8 LUOQUE Retreating Luo Channel

i. Location
1.5 cun posterior to BL-7 Tongtian and 5.5 cun within the anterior hairline. (1.5 cun lateral
and 0.5 cun posterior to Du-20 Baihui).
ii. Name
The Bladder channel has a connection (luo) with the Brain from this point; on the other
hand, the main channel moves from the vertex downwards and also backwards (que)
towards the occiput.
iii. Intersections
None.
iv. Energetics
- it clears the nose and eyes (Action 1);
- it expels internal Wind and subdues Yang 33 (Action 2);
- it calms the Mind (Action 3).

• Action 1: nasal congestion, blurred vision
• Action 2: headache, dizziness, deviation of mouth, epilepsy
• Action 3: manic-depression, disorientation.
vi. Comments
This point has a downward movement as all its actions show. It calms the Mind and I use it
for anxiety and manic behaviour. It connects with the brain and it is effective for nose and
eye problems.
h) G.B.-15 TOULINQI Governing Tears

i. Location
On the forehead, directly above G.B.-14 Yangbai, 0.5 cun within the hairline, midway
between
51
Du-24 Shenting and ST-8 Touwei.

ii. Name
The name refers to the influence of this point on the eyes. It is prefixed by “head” to
distinguish it from G.B.-41 Zulinqi on the foot.
iii. Intersections
Bladder and Yang Wei Mai channels.
iv. Energetics
This point subdues rebellious Qi and has a descending movement.
- it calms the Mind and settles the Hun (Action 1);
- it extinguishes Wind (Action 3).

• Action 1: anxiety, insomnia, excessive dreaming, emotional fluctuation, obsessive
thoughts.
• Action 2: redness and pain of the eyes, lachrymation on exposure to wind, pain on the
outer corner of the eye.
• Action 3: headache, dizziness, epilepsy, Wind-stroke.
vi. Comments
I use this point primarily for its effect on the Mind (Shen) and the Ethereal Soul (Hun). It
primarily calms the Shen and settles the Hun and it treats insomnia, anxiety, and obsessive
thoughts. I use particularly for this last symptom.
i) G.B.-17 ZHENGYING Correct Nutrition (or Correct Nutritive Qi)

i. Location
In the parietal region, on a curved line drawn between G.B.-15 Toulinqi and G.B.-20
Fengchi, following the contour of the cranium, 1.5. cun posterior to G.B.-16 Muchuang.
For reference, (G.B.-15 is 0.5 cun within the hairline, in line with the pupils of the eye,
G.B.-15, G.B.-16, G.B.- 17 and G.B.-18 are 1.5 cun from each other).
ii. Name
“Correct” here indicates the location of the point at the top of the head, while “nutrition”
refers to Nutritive-Qi and the ability of this point to influence Nutritive Qi.
52
iii. Intersections
Yang Wei Mai.
iv. Energetics
This point has primarily a “lifting” action similar to Du-20 Baihui. However, similarly to
Du-20 Baihui, it can also subdue rebellious Qi. It lifts the Mind and Spirit and it calms and
clears the Mind. It stimulates memory and concentration.
- it lifts the Shen in depression (Action 1);
- it subdues Liver-Yang (Action 2).

• Action 1: poor memory, poor concentration, depression
• Action 2: headache, dizziness.
vi. Comments
I use this point primarily for its effect on the Mind and Spirit and particularly in
depression.
j) G.B.-18 CHENGLING Supporting the Spirit

i. Location
In the parietal region, on a curved line drawn between G.B.-15 Toulinqi and G.B.-20
Fengchi, following the contour of the cranium, 1.5. cun posterior to G.B.-17 Zhengying.
(G.B.-15 is 0.5 cun within the hairline, in line with the pupils of the eye, G.B.-15, G.B.-16,
G.B.-17 and G.B.-18 are 1.5 cun from each other).
ii. Name
The name of G.B.-18 clearly refers to its deep action on the Mind and Spirit. It should be
noted here that the word translated as “Spirit” is not “Shen” but “Ling”. “Ling” indicates any
supernatural power or spiritual phenomenon, apart from indicating the soul or spirit. Its
old character is composed of “rain”, “three mouths”, and the character for wu, i.e. shaman
(itself composed of “work” and “two people”).
It therefore derives from the shouting of a shaman to bring on rain, and by extension it
could therefore be translated as “supernatural or transcendentpower”. If this is so, then this
point “supports the Spirit” in the sense of regulating the interaction of Shen and Hun.
iii. Intersections
Yang Wei Mai.
53
iv. Energetics
This point has a calming and descending action.
- it settles the Hun and Po and stops obsessive thoughts (Action 1);
- it stimulates the diffusing and descending of Lung-Qi and opens the nose (Action 2).
• Action 1: obsessive thoughts, insomnia, mania.
• Action 2: nasal discharge, nose bleed, nasal congestion, breathlessness, cough.
vi. Comments
11. G.B.-18 is an important point to open the Mind’s orifices when they are obstructed
(usually by Phlegm). Its use for obsessive thoughts and manic behaviour confirms its effect
in de-obstructing the Mind’s orifices. I therefore use it whenever the Shen is “obstructed”
which is usually by Phlegm. In extreme degrees, obstruction of the Shen causes mental
illness such as schizophrenia and bipolar disease: however, obstruction of the Shen may
exist in may different degrees of severity and it does not necessarily always cause a full-
blown mental illness. In mild degrees, it may cause severe anxiety and especially panic
disorder, obsessive thoughts, mental confusion, or a slight manic behaviour.
k) ST-8 TOUWEI Head’s Safeguard

i. Location
At the corner of the forehead, 4.5 cun lateral to Du-24 Shenting, 0.5 cun within the
hairline.
ii. Name
The name refers to the important action of this point on head diseases and particularly
Phlegm. Hence it safeguards the head from pathogenic factors.
iii. Intersections
Gall-Bladder, Yang Wei Mai.
iv. Energetics
This point makes Qi descend.
- it expels Wind (Action 1);
- it extinguishes internal Wind and subdues Yang (Action 2);
- it resolves Phlegm from the head (Action 4).
54

• Action 1: headache from external Wind
• Action 2: headache, dizziness
• Action 3: decreased vision, eye pain, lachrymation on exposure to wind, twitching
of eyelids
• Action 4: dull headaches from Phlegm, feeling of heaviness and muzziness of the head,
blurred vision.
vi. Comments
ST-8 is an important point on the head to make Qi descend. I use it for headaches on the
forehead and vertex; it also affects the eyes and treats all eye problems. It is a major head
point to resolve Phlegm from the head causing dull headaches, dizziness, a feeling of
muzziness and blurred vision.
7. Herbs
Just as we discussed the channels and points affecting the area in question, I shall now
look at some of the herbs that have a particular affinity towards the head. These herbs are
the equivalent of “local points” in acupuncture and can be added to a custom formula as
“messengers” to reach the top of the head.
Herbs that reach the head include (Fig. 42):

- Jie Geng Radix Platycodi
- Chuan Xiong Rhizoma Chuanxiong
- Bai Zhi Radix Angelicae dahuricae
- Qiang Huo Radix et Rhizoma Notopterygii
- Chai Hu Radix Bupleuri
a) JIE GENG
Jie Geng Radix Platycodi is a herb that has an affinity for the upper part of the body
and the head. Please note that “to have an affinity for the upper part” and “to have an
ascending movement” are two different qualities. Having an affinity for the upper part of
the body, means that Jie Geng will affect the upper part and can be used as a messenger
herb to direct a formula to the upper part of the body and the head but it will not actually
lift Qi.
For example, let us assume that we are treating a patient for sinusitis and we want to
resolve
Phlegm: in such a case, I would add Jie Geng to the formula to make sure it directs the
55
formula to the head.

This is different that having an ascending movement: to have an ascending movement
means that a herb makes Qi rise. This is something we would want to do in prolapse and
depression and something that would be absolutely contra-indicated in Liver-Yang rising.
Chai Hu Radix Bupleuri has an ascending movement.
b) CHUAN XIONG
Chuan Xiong Rhizoma Chuanxiong affects the top of the head and it is therefore
particularly indicated for vertical headaches. Chuan Xiong invigorates Blood and moves
Qi and it is an important herb for most types of headaches. It is said to enter the “Qi
portion of Blood”.
c) BAI ZHI
Bai Zhi Radix Angelicae dahuricae affects specifically the Yang Ming area of the head, i.e.
the forehead and face. It is an important herb for headaches on the forehead.
d) QIANG HUO
Qiang Huo Radix et Rhizoma Notopterygii, by contrast, has an affinity for the back of the
head and occiput. It is an important herb for headaches affecting the back of the skull and
occiput.
e) CHAI HU
Chai Hu Radix Bupleuri enters the Shao Yang area of the head, i.e. the sides and temples.
Shao Yang type of headaches are very common because the headaches from Liver-Yang
usually affect this area. Although Chai Hu makes Qi rise, it is often added in a very small
dose to prescriptions for Liver-Yang rising as a messenger herb to reach the Shao Yang
area. Please note that the use of Chai Hu, which promotes the ascending of Qi, should in
theory be contraindicated in formulae to subdue Liver-Yang but, when it is combined in a
small dose with all the other herbs that subdue Liver-Yang, its use is not contraindicated.
Fig. 42
56
End notes
1. 1981 Spiritual Axis (Ling Shu Jing), People’s Health Publishing House, Beijing. First
published c. 100 BC, p.77.
2. 1979 The Yellow Emperor’s Classic of Internal Medicine-Simple Questions (Huang Ti Nei
Jing Su Wen). People’s Health Publishing House, Beijing, first published c. 100 BC,
p.58.
3. Nanjing College of Traditional Chinese Medicine 1979 A Revised Explanation of the

Classic of Difficulties (Nan Jing Yi Shi), People’s Health Publishing House, Beijing, first
published c.AD 100, p.124.
4. 1981 Spiritual Axis (Ling Shu Jing). People’s Health Publishing House, Beijing, first
published c. 100 BC, p. 56.
5. Yang ru Yin, Yin chu Yang.
6. 1981 Spiritual Axis (Ling Shu Jing). People’s Health Publishing House, Beijing, first
published c. 100 BC, p. 56.
57
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of Body Areas

The Vertex ......................................................................... 5

3. Symptoms & Signs ...................................................... 25

8. End notes ...................................................................... 56

Fig. 1. Categories of study of interrogation and observation.

therapeutic element relevant to that area is discussed together.

Fig. 2. Layout of present book.

Figure 2 illustrates this principle.

Each of these areas will be the subject of separate books.

For each area I will discuss the following aspects:

1. Anatomy (physical and energetic)

In fact, Qi circulates in the channels precisely because there is a difference of potential

Head and Yang energy

The symptoms of “Fullness” of the Sea of Marrow are to be interpreted more as a

On a mental-emotional level, “power” of the Kidneys implies mental-emotional resilience:

a) LARGE INTESTINE MUSCLE CHANNEL

b) STOMACH MAIN CHANNEL

c) STOMACH DIVERGENT CHANNEL

d) STOMACH MUSCLE CHANNEL

e) BLADDER MAIN CHANNEL

F) BLADDER MUSCLE CHANNEL

G) TRIPLE BURNER MAIN CHANNEL

H) TRIPLE BURNER DIVERGENT CHANNEL

I) TRIPLE BURNER MUSCLE CHANNEL

J) GALL-BLADDER MAIN CHANNEL

K) GALL-BLADDER MUSCLE CHANNEL

L) LIVER MAIN CHANNEL

N) YANG QIAO MAI

O) YIN QIAO MAI

P) YANG WEI MAI

Q) YIN AND YANG QIAO MAI AND THE VERTEX/BRAIN

R) THE EYE SYSTEM (Mu Xi)

3. Symptoms & Signs

c) Feeling of heat of the head

d) Feeling of cold of the head

e) Feeling of distension of the head

f) Feeling of heaviness of the head

g) Itching of the head

h) Numbness of the head

k) Premature greying of the hair

l) Hair falling out

n) Dry and brittle hair

SUMMARY OF CAUSES OF FEELING OF HEAT IN THE HEAD

The main patterns affecting the vertex are:

- LIV-3 Taichong to reach vertex.

Points for Dampness in the head and vertex

The diseases discussed are:

- Local or adjacent points for the pattern: G.B.-20 Fengchi.

Shuifen, Ren-12 Zhongwan, SP-9 Yinlingquan, Ren-5 Shimen, BL-22 Sanjiaoshu).

vi. Liver-Blood deficiency

vii. Kidney deficiency

indicates both Blood deficiency and Wind.

a) DU-20 BAIHUI Hundred Meetings

v. Indications and actions

b) DU-21 QIANDING In front of the crown

v. Indications and actions

c) DU-19 HOUDING Behind the crown

v. Indications and actions

d) DU-23 SHANGXING Upper Star