extraordinary vessels, with insufficient

information with which to be able to make a

Part II: Classical Chinese jingluo pattern identification. In the early
Acupuncture-Ordinary days, when TCM texts first entered North
America, the Five Element tradition
Skills developed by J.R. Worsley in Leamington
Spa, England, had graduated some of the
earliest trained practitioners of acupuncture
in North America. This tradition was
Reflection Three: Reorganizing brought to the States by Bob Duggan and
Acupuncture Practice: Starting Diane Connelly, who founded the
with the Ling Shu Traditional Acupuncture Institute (TAI) in
affiliation with Worlsey’s institute, based on
THE PROBLEM: that tradition. I became close with Duggan,
and other faculty from TAI as it was known
then (now TAISophia) and was even a
As I have looked closely over the past year or
member of their advisory board at one point.
more at why and how the jingluo filter
I taught frequently at TAI, and Bob Duggan
teachings at the college have been somewhat
and later Jim McCormick, a classmate of
eroded at the college, something I saw in the
Duggan’s from the first Leamington Spa
practice of students in clinic but could not
class, and Lorie Dechar, even later, an early
quite put my finger on, I realized that I had
graduate of TAI, taught at Tri-State (and Jim
followed in the same process articulated by
and Lorie still do).
Maciocia, by allowing the teaching of the
signs and symptoms of the regular meridians
I was struck by the difference in focus of their
to be supplanted by those of the ZangFu.
education, which was highly influenced by
the humanistic psychology movement that
existed in those days and that Duggan and
Early North American Acupuncture Connelly and other TAI faculty were
Practice involved with, as compared to the TCM
based education that was becoming the norm
As I began writing this Reflection, I scoured in California schools. Given that I was the
over the earliest books in English that I used first president of the new council of colleges,
to teach my first students, when textbooks in and intimately involved with establishing the
English were scarce and the main TCM text first national board examinations in
in English was still Outline of Chinese acupuncture through the NCCA (now
Acupuncture. In those early PRC texts, there NCCAOM), I was immersed in debates
were only 14 meridians portrayed, with no about schools of thought and traditions, and
classical signs and symptoms from Chapter Duggan and I were immediate allies and
10 of the Ling Shu and where disorders were fierce defenders of the right to diversity in
presented as more or less biomedical acupuncture education, while some of the
diagnoses with points with no TCM California schools were beginning to demand
differentiation or rationale for the points that the national standard in the United
either, or even a TCM pattern diagnosis in States be the TCM tradition from the PRC.
ZangFu terms. When this PRC text for the
English-speaking world was republished in a I took on the role of mediating this debate,
new edition, in around 1981, it did contain between what was being called the “5
TCM theory, and even a short description Element” versus the “8 Principle”
and pictures of the other secondary and perspectives. In those days I developed a

  1  
simple way of differentiating one style of ZangFu pattern identification, and
practice and practitioner from another by differentiation of Qi, Blood and Fluids to
simply paying attention to which of the main differentiate signs and symptoms of disease.
diagnostic filters each style, or practitioner,
privileged over others that may have been What neither approach contained, which
shortchanged, or even ignored altogether. situated what I was trying to do at the Tri-
What became clear was that practitioners of State College of Acupuncture in yet a third
the “5 element” tradition of Worsley’s used position, was the jingluo filter which taught
the 5 element filter far more frequently than how to regulate Yin and Yang by means of
the YinYang filter (which they resorted to just appropriate use of treatment strategies from
to differentiate between excess and deficiency the regular meridians—where 5 element
conditions, and to perform tonification and strategies were just one option among others,
dispersal needling techniques) whereas “8 as well as from the secondary (especially luo
principle” advocates expanded the YinYang and tendinomuscular meridians) and
filter to include far more detail about signs of extraordinary vessels which these two main
Hot and Cold, Internal and External, and approaches seemed to not make use of at all.
even Yin and Yang patterns. As for the Qi, In this process, I became so involved in these
Blood, Fluids, Shen and Essence filter as it debates, and invited to teach was most
was often referred to in those days (before different about the “French meridian”
Shen disappeared from TCM discussions as a traditions I had studied at other AOM
way of assessing signs and symptoms in a colleges, that I focused most heavily on
diagnostic process), the 5 element teaching the secondary and 8 extraordinary
practitioners talked extensively about Shen, vessels, and allowed the regular meridians,
( given that Worsley reordered the regular and the principal foundation for the jingluo
meridian system to start with the Heart, filter, to slip away and be replaced little by
rather than the Lung which controls Qi and little, by TCM textual explanations. The only
its movement as in all classical and modern solution which it took me over two decades
Chinese and Japanese texts—because the to realize was to return to the Ling Shu, and
Heart “stores the Spirit-Mind”), but gave little especially to Chapter 10 where regular
mention of Blood or Fluids. Conversely, 8 meridian pattern identification, from a
principle practitioners of what soon became jingluo filter perspective, is laid out clearly.
referred to as TCM acupuncture talked far
less about Qi or Shen, and spoke in great
detail about Blood, and of the thin and the Circuit-Needling
thick fluids, phlegm and Fire.
There are three detailed clinical discussions
Finally, what both approaches had in in English of the Ling Shu, by Yitian Ni,
common, much to their surprise, was that Shudo Denmei and Zhao and Jun Wang.
they centered their teaching and practice Giovanni Maciocia’s ambitious The Channels
around ZangFu pattern identification: the 5 of Acupuncture must also be mentioned as an
element practitioners preferring to focus academic resource with useful charts, but the
more on the psychoemotional aspect of the repetitive and at times over indulgent nature
12 “officials” rather than on their visceral of the presentation makes it very difficult as a
functions and disease signs and symptoms, clinical text, which for instance hopelessly
while TCM practitioners of acupuncture confuses any attempt at understanding the
ignored to a greater or lesser extent the luo collateral, muscle channel, Cou Li layer,
emotional side which did appear in the cutaneous regions and minute luo vessels and
classics as we saw in last month’s Reflection, luo regions. Also, owing to an unfortunate
focusing more strictly on the TCM detailed

  2  
dismissal of organ interior symptoms as part and symptoms of channel versus organ
of regular meridian differentiation (in favor disorders, which derive from her vast clinical
of TCM Zang Fu pattern differentiation as experience and other texts listed in her
shared in last month’s Reflection Two), and bibliography.
an alarming misunderstanding about the
critical role of ashi points and palpation for Based on this approach, if one knows the
actual tender points versus favorite textbook basic signs and symptoms of the main or
points for muscle channel problems, I am regular channels, it is easy to then reference
lead to question whether Maciocia practices the list of external, “channel” disorders
the acupuncture that he preaches in this versus internal, associated “organ” disorders,
unwieldy tome. Useful as background and and then move to the clinical application
additional reading for the initiated section where she discusses the use of the
acupuncture educator or practitioner, it is main points from the meridian in question,
misleading and confusing as a foundational, in order of importance, and point
or clinical text for students or neophytes to combinations with other regular, secondary
the jingluo approach. and extraordinary channel points. She even
has an index of symptoms in the back of her
What is clear in studying the Ling Shu in book, taking one to the pages where such
these texts is that they are focused on what point combinations are discussed with
Paul Unschuld refers to as “circuit-needling” specific disorders of the various systems of
with the palpation phase of the four the body.
examinations focused on points, and arterial
pulses, throughout the body as opposed to She does not, however, discuss the point
diagnosis of the meridians via the sole wrist strategies she uses, so a careful study is in
pulses, as advanced for the first time in the order to recognize, for example, that her
Nan-Ching. Unschuld stresses that the interest favorite distal points for the regular Lung
in the Nan-Ching “remained restricted to channel are the Luo point (Lu 7), the Source
theoretical discussions and the practice of point (Lu 9), and the He-Sea point (Lu 5),
pulse diagnosis. Actual clinical practice in and her favorite local points, Lu 1, the Mu
traditional Chinese medicine hardly followed point. A useful exercise for anyone interested
the “conceptual stringency” of this text, and in gaining a deeper appreciation for regular
of the “doctrines of systematic channel pattern identification, and secondary
correspondence” or of pulse diagnosis at the vessel and extraordinary channel
wrist as the sole means of assessment of differentiation would be to take each channel
meridian circulation, Unschuld clarifies, one by one, and analyze the point strategies
concluding on this point: Therapeutic of the points Dr. Navigating lists for recurrent
practice—that is, circuit-needling—continued strategic patterns.
along the lines dictated by experience, not
theory ( NanChing: The Classic of Difficult Regarding the use of local meridian points
Issues translated and annotated by Paul U. Dr. Ni stresses in her introduction that any
Unschuld, University of California Press, local point from a meridian may be used to
1986, pp. 40-41).” treat local symptoms in the area of that
point, a primary principle of “circuit-
In Dr. Yitian Ni’s text, Navigating the needling” and meridian palpation as used
Channels of Traditional Chinese Medicine she extensively in APM.
presents a summary of channel pathology
from Chapter 10 of the LingShu which is
fairly complete, which TCM has left out, and
then detailed lists of disorders and their signs

  3  
 Wang Manuscripts and Chapter 10 from the
A Japanese Meridian Approach LingShu. This presentation seems the closest
to the original that is available in English.
In Shudo Denmei’s text, translated into
English by Stephen Brown as Japanese Shudo begins by citing two phrases from the
Classical Acupuncture-- Introduction to Ling Shu, which were poorly understood until
MERIDIAN THERAPY, there is a detailed the discovery of those earlier documents.
discussion of the symptomology of the twelve These phrases, which appear in Chapter 10
meridians, as this is often termed, as well as of the LingShu are: “ ‘when disturbed, disease
the five Yin organs. Shudo starts this study occurs’ (shi dong ze bing) and ‘when giving rise
with the statement that “symptomology of to disease’ (shuo sheng bing). These two
the yin organs implies pathology of the yin phrases are the way in which regular
aspect. The Li-Zhu school of Chinese meridian symptoms are presented in Ling Shu
medicine holds that the yin always tends Chapter 10: “when disturbed, disease occurs”
toward deficiency, and the yang toward refers to an external disruption in meridian
excess” and regarded the Spleen and Qi (channel symptoms) which can be treated
Stomach, and the middle burner to be the by “treating the meridians involved”; “when
most important focus of middle burner giving rise to disease”, on the other hand,
warming treatment (ibid, p108). refers to internal conditions where channel
Qi disruption “progresses beyond a certain
Shudo adds that the meridian therapy point [and involves the organs]” (Ibid, p. 112,
schools of thought in Japan define this citing Kuwahara, 1976). These concepts are
hypothesis as follows: “the yin organs and discussed in Chapter 22 of the Nanjing
meridians have a tendency to become where “when giving rise to disease”(sousheng)
deficient, and the yang organs and meridians denotes a disorder at the level of Blood, as
to develop excessive conditions (ibid).” clarified in a private communication with
Shudo Sensei continues by presenting the Stephen Brown regarding his translation
signs and symptoms for the “five yin organs” above.
(Pericardium is deleted), from the Su Wen
and the Nan-Ching Japanese translations. In Wang and Wang’s text, there is a careful if
Certain symptoms from the Su Wen are sometimes rigid reading of the Ling Shu
deleted in the Nan-Ching version. Shudo reorganized so as to allow for a clinical
concludes that as for the yang organs, there is approach—“Ling Shu Acupuncture”. In their
much less discussion in the classics, and their presentation, which unfortunately repeatedly
signs and symptoms “resemble those for claims to represent the true and correct
diseases of the same organs in modern acupuncture, with everything that came in
medicine (ibid, p. 110).” For these symptoms, later classics and modern TCM as
he cites Chapter 4 of the LingShu. aberrations, the organization of the
discussion is immediately clinical: Diagnosis
Shudo then lists the symptomology for the by Comparing Renying and Cunkou (carotid
twelve regular meridians. He cites the and radial artery) pulses for regular meridian
discovery of the Ma Wang Tui manuscripts dysfunction; the entire jingluo filter (regular
in 1973, which are thought to be a few meridians and secondary collaterals, finishing
centuries older than the Yellow Emperor’s Inner with 8 extraordinary meridians and the
Classic (Huang Di Nei-Ching) comprised of the relationship between meridians and Zang-Fu
Su Wen and the LingShu. As he presents the organs; the muscle and cutaneous regions;
signs and symptoms for the twelve regular acupoints; acupuncture techniques and
meridians, then, Shudo cites both the Ma contraindications. There are very useful
charts and diagrams throughout, with a

  4  
detailed list in chart form of the regular I will break out these two sets of symptoms,
meridians (pp. 90-92) from Chapter 10 of the for clarity, as well as the last set of symptoms
Ling Shu and translation of the Su Wen that relate to excess and deficiency of Qi. I
Chapter 22 on the ZangFu organs (p. 164). refer the reader to Shudo’s text for the more
They do, however, following PRC/TCM detailed comparison of the Ma Wang Tui
texts, almost completely eliminate the role of manuscript symptoms, compared to those in
the emotions and any discussion of Shen. Chapter 10 of the LingShu (ibid, pp. 113-126.
The reader is also referred to Shudo’s
description of disorders of the sense organs
Regular Meridian Pattern Identification and parts of the body, which are very useful
clinically (ibid, pp. 126-132) and a similar
discussion in Maciocia’s text cited above
Following are the S&S of the Arm Taiyin
(ibid, p. 98) which are commonly learned in
Lung Meridian as an example of Chapter 10,
any acupuncture tradition.
(as cited in Shudo Denmei’s text, pp. 113-
126; see also his detailed and excellent
Let us follow Shudo and the translation he
discussions of each set of signs and
used for the arm Taiyin Lung Meridian:
symptoms. Also see Ni’s text, pp. 17-103 for
her detailed clinical applications).
Arm Taiyin Lung Meridian
Shudo Denmei begins his study of Chapter
M eridian (Exterior) S&S:
10 by shedding light on the terms used to
differentiate between disorders affecting the
“When disturbed, disease occurs”:
meridian only (exterior), and those where the
disorder has moved deeper to include the
Distention and fullness of the lungs, wheezing,
associated organ as above, which bears
coughing, pain in the supraclavicular fossa. When
repeating in Shudo’s own words.
severe, arms folded over the chest (while catching
ones breath) and blurred vision.
This clarification was made possible when
scholars compared the Ling Shu to the earlier
Organ (Interior) S&S:
Ma Wang Tui burial site manuscripts known
as the “Moxibustion Classic”. Based on this
”When giving rise to disease”:
comparison, the meaning of two critical
terms--“When disturbed, disease occurs” (shi
Heat in the face, wheezing, coughing, dry throat,
dong ze bing )” and “When giving rise to
irritability and fullness in the chest, pain along the
disease” ( suo sheng bing ) was elucidated:
channel, depletion, and heat in the palms.
“ ‘When disturbed, disease occurs’ refers to
Excess and Deficiency:
abnormal conditions arising when the
meridian [Qi] is disrupted, and the progress
”When the Qi is excessive”:
of this disturbance can be checked by treating
the meridian involved…’When giving rise to
Pain in shoulders and intrascapular region,
disease’ refers to conditions in which the
sweating from wind-cold, frequent urination and
disruption [of Qi] in the meridian progresses
yawning from wind.
beyond a certain point [and involves the
organs]” (Ibid, p.112, citing Kuwahara,
1976).
”When the Qi is deficient”:

  5  
Pain and coldness in the shoulders and one sees in observing the body surface and
intrascapular region, shortness of breath, inability patient’s structure and bearing.
to take in deep breath, urine color change.
In refining this teaching, which I inherited
from the Quebec Institute of Acupuncture
Internalizing Jingluo Symptomology and especially from its French-Vietnamese
influence via Chamrault and Van Nghi’s
In his always pragmatic fashion, Shudo texts and teachings, I followed these two
Denmei shares the difficulty he experienced French authors in their celebrated
in attempting to just commit to memory such L’energetique humaine where they discussed
symptoms, stating that he “drew in the the jingluo filter in three successive chapters,
location of all the symptoms on a figure of Wei, Ying and Jing, facilitating an
the body, and marked them with a simple understanding and clinical use of these
notation for easy reference (p. 113).” classical treatment strategies:
Another useful tool, he suggests, and then
supplies in his book, is a chart of symptoms • W ei level treatment refers to the
organized by body region. Dr. Ni, on the strategies for the muscle channels
other hand, provides charts that further and cutaneous regions for myofascial
differentiate and list symptoms of the disorders, which I refer to as “surface
Channel as opposed to the Organ. She then energetics”.
lists clinical applications such as exterior • Ying level treatment is the nutritive
syndrome, immuno-deficiency, respiratory Qi level, the level that “promotes
disorders, nose and throat disorders etcetera, Grain Qi”, and refers to the
with her point palette of lung meridian strategies for the regular meridians
points in order of importance in her and their associated organs, which I
experience and based on classical sources. refer to as “functional energetics”.
She concludes with point combination with • Jing level treatment refers to the
points from other channels, and lists an strategies for the 8 extraordinary
index of symptoms in the back of the book vessels, mobilized according to Van
that bring the reader back to these charts. Nghi’s teachings, when the regular
meridians/organs are under assault
Making the effort myself to learn the classical such that two or more
symptoms of the regular meridians, meridians/organs are targeted. This
secondary vessels and extraordinary vessels, is a very modern reading, perhaps
which make up the jingluo filter, as I first influenced by Hans Selye’s theory of
started translating and teaching from Van the stress response, and his General
Nghi, I quickly realized that I could not Adaption Syndrome. In this model,
retain the information unless I combined it the GAS enables a small group of
with palpation of distal and local points from internal functions to mount the
these pathways during the palpation aspect of defensive against unabated external
the four examinations. stressors, in order to protect the
majority of internal organ functions
I found it essential from the beginning to and structures from this onslaught.
resist an overly academic study of the In the French-Vietnamese teachings
meridian system, and to focus instead on perspective influenced by Van Nghi,
internalizing and embodying a tacit feel for it is the role of the extraordinary
each aspect of this system based on what one vessels to become operational in
feels underneath ones fingertips, and what order to protect the 12 regular
meridians/organs. I developed a set

  6  
 of 4 adrenal/stress patterns to map to the neck, chest, or upper back, abdomen
out protocols for using the or mid and lower back, upper legs, lower legs
extraordinary vessels in such chronic and foot to the toe, where it transforms into
stress disorders, as shared in last its foot Yin meridian pair, then flowing back
month’s Reflection, based on these up the inner Yin aspect of the foot, lower leg,
teachings, in my Acupuncture Physical upper leg, front of the torso, making a
Medicine (pp. 85-120) as I shared in descent deep in to the Sea of Blood and Qi
chart form in last month’s again, and then starting all over in this semi-
Reflection. closed loop fashion, carrying Qi and Blood
(oxygenated blood) to all areas of the body,
carrying back deoxygenated blood, renewing
The 12 Regular Meridian Circuits itself with a fresh supply of nutritive Qi with
each circuit loop.
When teaching the 12 regular meridians
(jingmai) it is essential to recognize the way in
which they are comprised of three circuits of
four meridians each that follow a parallel Regular Meridian Symptomology:
almost closed-circuit flow: from deep in the
Sea of Qi and Blood of the interior, and the Below I will present the signs and symptoms
associated yin Organ (Zang), a circuit begins of the 12 regular meridians as three circuits
by exiting on the upper chest, next flowing in this way, as another way of aiding in
down the inner arm (Yin aspect) to the internalizing and embodying this data for
finger; then transforms into its Yang paired ready clinical access, integrating signs and
meridian and flows up a parallel pathway on symptoms from Shudo and Ni’s
the dorsal, outer arm (Yang aspect) to the presentations, based on the Ling Shu.
shoulder, neck, face and head; where it meets
its Lower/Upper connected Yang meridian
of the same name to flow down from the face

  7  
TAIYIN/YANGMING CIRCUIT – Regular Meridian (Jing Mai) Pattern
Differentiation

Hand Taiyin/ Hand Foot Yangming/ Foot

Body Area Signs Lung Yangming/ Stomach Taiyin/Spleen
& Symptoms Large Intestine

Face, Flushing Toothache, Facial pain, ashen Root of tongue

swollen cheeks, complexion, hot rigid, jaundice
Head, yellow eyes, dry face, nose bleed,
mouth, nasal congestion,
Neck nosebleed, cervical neck
swollen pain, skin rashes
Throat Dry throat throat/thirst around mouth, Vertigo
swollen painful
throat,
submandibular
pain
Perspires easily,
Yawning, Violent warm diseases, Whole body
General sweating & pain shivering from whole body heavy
from wind-cold cold, inability to chilled as if
warm up doused by water,
frequent
stretching and
yawning
Cardio- Shortness of No organ S&S Breast pain, heart Chest irritability
Respiratory, breath, irritable pain (ST 18-15),
Chest/Upper breathing, flank pain (SP
Back cough, 21), front of body
wheezing, hot
fullness of chest,
hugs oneself
while shivering,

Gastro- Borborygmus, Nausea from

intestinal, Gastric pain No Organ S&S edema/distention eating, stomach
due to cold, pain, belching,
Abdomen Abdominal passing gas and
discomfort, defecating
constant hunger, brings great
ascites, area hot relief, diarrhea
or cold, pain in with mucous

  8  
 intestines and blood

Genito-urinary,
Gynecological, Frequent No Organ S&S Yellow urine, Scanty urine
Reproductive, urination pain in lower
Lower Back abdomen (ST 26-
30)
Lower abdomen
and extremities
channels Heat in the Heat, swelling Pain along heavy, medial
palms, pain and pain LI 12- channel (ST 32- thigh and knew
along channels, 15; index finger 43), rigidity of swollen, chilling
esp. LU 3-10 dysfunction knee, middle toe and numbness
dysfunction along SP
channel of calf,
big toe
dysfunction
Mental Signs & Obsessions that Mental Aversion to Mental
Symptoms * are future confusion, people and fire, sluggishness,
directed, feels defective rapid heart beat, melancholia,
vulnerable elimination of shuts oneself in obsessive
ideas, when frightened, thoughts of the
stubbornness, prone to mania, past, fixed and
complacency in singing, disrobing rigid ideas,
being wrong, and running sleepwalking,
rigid thinking, about, agitated sleep,
distressed by depression, death nightmares
cold wishes, mentally
overwrought,
mentally slow
LU 7-luo LI 2 –dispersal ST 44-43 ashi for SP 3- source
Point Palette LU 9 source LI 4-source heat/Xu Li SP 2-tonification
LU 6 – cleft LI 6-luo for ST 36, 37, 39- SP 2&3-ying
LU 5-dispersal Toothache lower Sea points and shu
Lu 3-4 window ST 40-luo SP 4- luo
to sky SP 5-dispersal
Lu 1-2/SP 20- ST 25-LI/ST SP 6- three leg
Taiyin union union Yin
ST 18/xu li heart SP 8-cleft
pain/heart burn, SP 9-Sea
Stomach Fire SP 10-Blood
SP 21-Great Luo
SP 20/Lu 1-
Taiyin union

  9  
Associated Local for S&S Local for S&S Local for S&S Local for S&S
channel points Ashi for pain Ashi for pain Ashi for pain Ashi for pain

Points from LI, Points from ST, Points from LI, Points from ST,
ST, SP channels LU, SP channels SP, LU for circuit LI, LU for
for circuit for circuit circuit

(* Cf. Seem, citing Faubert, Acupuncture Imaging pages 27-28. These charts are derived from Shudo Denmei, with
information from Ni, Seem, Faubert.)

We used to see the late Dr. Ki Min Kim, a

Regular Meridian Treatment master Korean constitutional acupuncture
practitioner after whom the Tri-State College
In the Ling Shu Chapter 9, treatment of the of Acupuncture Library is named, do this
regular meridians is presented thus: carotid/radial diagnosis, and root treatment
based on this chapter of the classic text, using
1] If Spleen is deficient, Stomach is excess the Five Phase “4 needle technique”
(carotid pulse four times stronger than radial strategies as the base, followed by careful
pulse): tonify Spleen with one needle; dispersal of local excess, constrained and
disperse ST with 2 needles. If carotid pulse is stagnant points/pathways.
“restless”, disperse Large Intestine (for
circuit).
Regular Meridian Disorders for this
While the actual points are not indicated in Circuit from Dr. Ni
this chapter, chapter One stresses needling
the source point for yin meridians, and a Note:
later chapter suggests needling the ying Any point on a regular meridian may be used
(spring) and shu (stream) points for disorders as a local point for signs and symptoms in
of yin of yin. Dispersal points for Yang that area on that meridian.  
meridians could be dispersal points
themselves, luo points, jing-well points, he-sea A] Hand Taiyin Lung meridian
points, xi-cleft points for acute disorders, or
fire points. So one could tonify Sp 2 or 3, or Exterior syndromes, the cold or flu; allergies
both, and disperse ST 40 and ST 36 for with sneezing and itchy eyes and nose;
example, and disperse LI 2 and LI 5. immuno-deficiency/frequent colds, low
energy, cold hands and feet, CFIDS, chronic
If the reverse is true, with radial pulses diseases; respiratory disorders with cough,
stronger than carotid, this is Yin asthma, breathing difficulties; nose and
meridian/organ excess: throat disorders, rhinitis, sinusitis,
pharyngitis, laryngitis, tonsillitis; edema,
2] If Spleen is excess (radial four times enuresis, retention of urine or urinary
stronger than carotid): disperse Spleen with difficulty; diarrhea, constipation,
one needle (Sp 5 for example); tonify hemorrhoids; GERD; sinus(ST 2-3), temporal
Stomach with 2 needles (ST 38 (ST 7-8), Occipital headaches (all treated by
Fire/Tonification Pt and ST 36). If radial LU 7); sighing, mental distress, weeping,
pulse is “restless”, disperse Lung meridian grief; Bi syndrome along muscle channel.
(Lu 10 or Lu 5 for example for the circuit as
above).

  10  
B] Hand Yangming Large Intestine
meridian: Deficiency or excess digestive disorders as for
stomach; edema, heavy sensation of face,
Toothache; Yangming headache; facial head, whole body; post-prandial fatigue;
paralysis, trigeminal neuralgia and TMJ (ST dampness disorders and s&s; high
5-8); rhinitis, sinusitis (LI 20-ST 2); cholesterol; obesity; atherosclerosis; masses
Nosebleed; sore throat and vocal cord and nodules; Qi & Blood deficiency; Spleen
disorders, thyroid disorders; diarrhea, facial Qi sinking with prolapses, dizziness, vertigo,
edema, sweating/ dry mouth, throat, stool, lightheadedness; constant worry, low spirits,
concentrated urine, dry skin); yang ming difficulty concentrating, poor memory,
febrile disorders; rashes, eczema, boils, depression, palpitations; Bi syndrome along
psoriasis; abdominal pain, epigastric pain, channel; wei syndrome with whole body
nausea, vomiting, belching, cough, asthma, atrophy and flaccidity, especially of lower
chest pain; lassitude, spontaneous sweating, body and extremities.
low immunity; Bi syndrome along muscle
channel. Personality Patterns

For a detailed summary of J.R. Worsley’s

C] Foot Yangming Stomach meridian: depiction of the 5 Element personality types,
and Dr. Yves Requena’s 8 Temperaments,
Excess and deficient digestive disorders with see my Bodymind Energetics, pages 85-107.
excess hunger or poor appetite, burning While character typing is described in the
sensation or cold sensation in the stomach, classic texts, I caution against taking such
and in either case epigastric pain, abdominal depictions of complex human beings too
fullness, distention, diarrhea constipation; literally. With that caution, and with the
yangming headache, sinusitis, rhinitis, stuffy realization that a person may exhibit
nose, nose bleeds; sore, swollen throat, gums, characteristics from more then one
toothache; facial paralysis, trigeminal temperament or type, such information is
neuralgia, TMJ; yangming febrile syndrome; useful in providing practitioners with
general lassitude, sallow complexion, another lens through which to view the
spontaneous sweating, palpitations; stomach people who seek their help. One can also
fire; violent or withdrawn behavior (mania or juxtapose the emotional (shen) signs and
depression); swollen, painful, cystic breasts; symptoms presented in chart form from
Bi syndrome along channel el; wei syndrome chapter 8 of the Ling Shu from last month’s
with whole body weakness and atrophy of the Reflection to further narrow down the
muscles. specific meridian-organ system or systems
involved within a circuit. This applies to the
next two circuits as well.
D] Foot Taiyin Spleen meridian:

  11  
SHAOYIN/TAIYANG CIRCUIT – Regular Meridian (Jing Mai) Pattern
Differentiation

Hand Shaoyin/ Hand Taiyang/ Foot Taiyang/ Foot

Body Area Signs Heart Small Intestine Bladder Shaoyin/Kidney
& Symptoms

Face, Yellow eyes, Yellow eyes, Yellow eyes, eyes Yellow eyes,
hearing loss, tearing, eye pain dizziness,
Head, swollen cheeks, as if popping blurred vision,
submandibular out, vertex jaundice,
Neck swelling, neck headache, flushed face,
pain, sore throat occipital dark comlexion,
Throat Dry throat headache, nape dry tongue, hot
of neck pain, mouth, dry and
nose bleed sore throat,
hoarseness,
Alternating appears as if
No desire to chills and fever, about to be
General drink epilepsy, captured
derangement,

Cardio- Heart pain Intense Thoracic back Wheezing,

Respiratory, posterior pain cough, coughing
Chest/Upper shoulder and up blood, heart
Back, arm pain (SI 8- pain, irritability
14) as if broken,
inability to turn
neck (stiffness at
SI-14-17)

Arm and hand

pain (SI 8-4)
Hand Arm pain (heart
channels 3-7), heat in
palms

  12  
Gastro-
intestinal, Hypochondriac Mid back pain Hunger but no
region pain desire to eat,
Abdomen watery diarrhea

Genito-urinary,
Gynecological, Hemorrhoids,
Reproductive, Lumbar pain,
Lower Back, gluteal area pain

Foot channels Tight popliteal

fossa, hip joint Lumbar spine
pain and pain, inner
inability to thigh pain, Pain
bend, pain in and cold along
calves as if torn, leg channel (Kid
little toe 9-11, pain and
dysfunction heat in the soles

Mental Signs & All shen Poor mental Changeable Anxiety, pain in
Symptoms * disturbances, assimilation, moods, over- the pit of the
insomnia, insecurity, enthusiasm, stomach,
anxiety suspicion, sadness, physical
jealousy, lack of and mental
confidence, fatigue,
lassitude antisocial
tendencies,
laziness

Point Palette HT 8- fire SI 2-water Bl 67- Kid 3-source

HT 7-source SI 3-tonfication tonification Kid 2-fire
HT 7&8-ying SI 4 –source BL 65-dispersal Kid 2&3-ying
and shu SI 5-wrist BL 64-source and shu
HT 5-luo SI 6-cleft BL 58-luo Kid 4-luo
HT 6-cleft SI 7-luo BL 40-Sea Kid 1-dispersal
HT 3 (Sea) SI 8 –Sea Back Shu Points Kid 7-tonify
SI 9-14-ashi Kid 10-Sea
HT 1 and 2 Kid 15.5-
adrenals
Local for S&S Local for S&S Local for S&S Local for S&S
Associated Ashi for pain Ashi for pain Ashi for pain Ashi for pain
channel points
From SI, Kid, Bl From HT, BL, From Kid, SI, From Bl, Ht, SI
for circuit Kid for circuit HT for circuit For circuit

  13  
Treatment of Regular Meridians and costochondritis/non-cardiac chest and
upper back muscle pain.
In Chapter 9 of Ling Shu:

1] If Kidney is deficient, Bladder is excess B] Hand Taiyang Small Intestine meridian:

(carotid pulse three times stronger than
radial pulse): tonify Kidney with one needle Occipital headache, deafness, earache,
(Kid 7 for example); disperse BL with 2 tinnitus; red, swollen, painful inner and
needles (Bl 58 and BL 65 for example). If outer canthi of eyes, blurry vision, excessive
carotid pulse is “restless”, disperse Small tearing, yellow sclera; mouth and tongue
Intestine (SI 1 and SI 6 for example) for the sores and ulcers, toothache; swelling and
circuit. pain of cheeks, lymph glands, parotid glands,
TMJ syndrome; cold and flu, allergies; febrile
2] If Kidney is excess, Bladder is deficient diseases with yellow urine and night sweats;
(radial pulse is three times stronger than edema, retention of urine, painful and yellow
carotid): disperse Kidney (Kid 1 for example) urination; diarrhea, indigestion, stomach
with one needle; tonify BL with 2 needles (Bl pain, abdominal pain and distention,
67 and 60 for example). If radial pulse is constipation; pain of lower lateral abdomen
“restless”, disperse Heart (Ht 9 and 8 for referring to back and testicles, as with
example) for the circuit. inguinal hernia, epididymitis, urethral stones,
ovarian cysts; Bi syndrome, pain along
muscle channel (scapula & posterior
shoulder from SI 14-9, elbow near SI 8,
Regular Meridian Disorders for this forearm near SI 7-6, wrist near SI 5-4 and
Circuit from Dr. Ni little finger dysfunction.

Note:
C] Foot Taiyang Bladder meridian:
Any point on a regular meridian may be used
as a local point for signs and symptoms on
Cold, flu, allergies; occipital headache; eye
that meridian.  
disorders with tearing and pain; rhinitis,
sinusitis, nose bleed; urogenital,
A] Hand Shaoyin Heart meridian:
gynecological and male reproductive
disorders; disorders of any ZangFu especially
Heart and Lung disorders like cardiac pain
when chronic or deficient treated via the
and palpitations, arrhythmia, shortness of
Back-Shu points (combined with Front-Mu
breath, cold extremities, sweating, red, purple
points); mania, depression, epilepsy,
or pale complexion; heat syndromes with
schizophrenia; emotional disorders of any
whole body hot, dry mouth, red face, hot
organ, treated with second line of Bladder
flashes, tongue ulcers, boils; red, painful,
meridian; Bi syndrome and pain affecting
swollen eyes; mania, depression, fainting,
muscles, tendons, ligaments and joints
schizophrenia, anxiety, hysteria, mood
throughout nape of neck, upper, middle,
swings, laughing or crying without apparent
lower back, sacrum and hips, hamstrings,
reason, nervousness, restlessness, insomnia,
posterior calves and heels, little toe
scattered thinking; severe pain or spasm of
dysfunction; acute or traumatic in jury to
internal organs, post-traumatic or post-
neck, back, lumbar region, spine, lower
surgical pain, cancer pain; skin rashes,
extremities
itching, pain; pain along channel (Ht 1-8)

  14  
 D] Foot Shaoyin Kidney meridian: spinal column, degenerative disorders of
bones and joints; wei syndrome with cold,
Kidney deficiency with fatigue, low back pain or heat in the soles.
pain, pain along spinal column, muscular
atrophy; deafness, tinnitus, chronic tooth,
gum and throat disorders; poor memory, Personality Patterns
forgetfulness; hair loss; deficient yin and yang
signs and symptoms; Kidney and Bladder See discussion under the first circuit above.
disorders with edema, facial puffiness,
impotence, infertility; treated for chronic
disorders of the other ZangFu; channel
deficiency and Bi syndrome with pain and
weakness of the lower back, hip and knee,

  15  
JUEYIN/SHAOYANG CIRCUIT – Regular Meridian (Jing Mai) Pattern
Differentiation

Hand Jueyin/ Hand Foot Shaoyang/ Foot Jueyin/

Body Area Signs Pericardium Shaoyang/ Gallbladder Liver
& Symptoms Triple Heater

Face, Yellow eyes, red Hearing loss, Dull, lusterless Dull, lusterless
complexion retro-auricular complexion, complexion, dry
Head, pain, outer headache, outer throat
canthus and canthus pain,
Neck cheek pain, bitter taste,
tinnitus, swollen submandibular
Throat sore throat pain,
supraclavicuar
pain (GB 21)

Constant Sweating Excessive

General laughing sweating, chills
and shivering,
repeated sighing

Cardio- Heart pain, Posterior Maxillary pain, Distention in

Respiratory, severe shoulder pain chest pain, chest and
Chest/Upper palpitations, (TH 15) breast pain, hypochondriac
Back, distention of hypochondriac region
chest, axillary region pain (GB
swelling 22-24), difficulty
moving torso
(GB24-Liv 14
stiffness)

Contraction and Posterior arm,

Hand pain in elbow elbow, wrist,
channels and forearm hand pain (TH
(Per 3-6), heat in 14-3), ring finger
palms dysfunction
Gastro-
intestinal, Distended sub Vomiting
costal region
Abdomen

  16  
Genitor-urinary,
Gynecological, Diarrhea with
Reproductive, undigested food,
Lower Back, inguinal hernia,
scanty or
Foot channels dribbling urine,
Hip, lateral swollen
thigh, knee, scrotum,
ankle, and foot “Shan”, pelvic
pain (GB 30-40), pain, lower back
heat in ankles pain, inability to
and feet, bend forwards
aversion of foot, or backwards,
4th toe Liv 5-6 nodules
dysfunction
Mental Signs & Depression, Emotional upset Bitterness, lack Irritability,
Symptoms * sexual at family/friend of control, anger, difficulty
perversion, breakups, irritability, developing
aversions, depression, unfaithfulness, ideas,
phobias suspicion, lack of courage, depression, lack
anxiety, poor timidity, of energy
elimination of hypochondria
harmful
thoughts
Per 8-fire TH 3- GB 41-dai mai Liv 3-source
Point Palette Per 7-source tonification GB 40-source Liv 2-
Per 7&8-ying TH 4-source GB 38- fire/dispersal
and shu TH 5-luo fire/dispersal Liv 2&3-ying
Per 6-luo TH 7-cleft GB 34- and shu
Per 4-cleft TH 10-dispersal Sea/tonification Liv 5-luo
Per 3-Sea GB 36-cleft Liv 6-cleft
Per 1-2-heart TH 17, 21-23- GB 26-daimai Liv 8-he-sea/
and breast pain ears/tinnitus GB 24-mu tonification

Local for S&S Local for S&S Local for S&S Local for S&S
Ashi for pain Ashi for pain Ashi for pain Ashi for pain
Associated
channel points From TH, Liv, From Per, GB, From Liv, TH, From GB, Per,
GB for circuit Liv for circuit Per for circuit TH for circuit

  17  
 hand and foot spasms; stiffness of the nape
of the neck, chest and hypochondriac
Treatment of Regular Meridians regions.

In Chapter 9 of the Ling Shu:

B] Hand Shaoyang Triple Heater meridian:

1] If Liver is deficient, Gallbladder is excess Fluid disorders, edema, puffiness, enuresis,

(carotid pulse twice as strong as radial pulse): retention of urine, frequent urination; upper
tonify Liver with one needle (Liv 3 or Liv 8 heater disorders like chest pain, palpitations,
for example) disperse GB with 2 needles (GB cough; middle heater disorders like epigastric
38 and GB 34 for example). If the carotid pain, nausea and vomiting; lower heater
pulse is also “restless”, disperse Triple heater disorders like lower abdominal distention,
(TH 1 and TH 10 for example) for the fullness, diarrhea, constipation; endocrine
circuit. and lymphatic disorders like hypo or
hyperthyroidism, diabetes, swollen glands;
2] If Liver is excess, Gallbladder is deficient high lipid levels, fibroids, masses, tumors;
(radial twice as strong as carotid): disperse channel disorders including shaoyang
Liver with one needle (Liv 2 for example); syndrome with chills and fever; channel
tonify Gallbladder with 2 needles (GB 43 disorders affecting the sense organs like
and 40 for example). If radial pulse is migraine headache, ear pain, deafness,
“restless”, disperse Pericardium meridian (Per blocked feeling in ears, tinnitus, cheek and
8 and 9 for example) for the circuit. face pain along course of channel including
TMJ syndrome and toothache, swollen
  glands, sore throat, pain in the mandible and
around the ears, purely channel Bi syndrome
Regular Meridian Disorders for this pain with difficulty laterally flexing the neck
Circuit from Dr. Ni and pain down medial deltoid, upper arm,
elbow and forearm to top of hand, ring
finger dysfunction.
Note:
Any point on a regular meridian may be used
C] Foot Shaoyang Gallbladder meridian:
as a local point for signs and symptoms on
that meridian.  
Gallbladder and Liver disorders with bitter
  taste in the mouth, belching, nausea,
A] Hand Jueyin Pericardium meridian: vomiting, poor appetite, abnormal bowel
movements, dark lusterless complexion,
Heart and blood vessel disorders with abnormal bowel movements, hypochondriac
palpitations, cardiac pain, restlessness, high pain; Urogenital disorders with swelling and
lipid levels; mental and emotional disorders, pain and itching of scrotum, external
delirium, fainting, incessant laughter, genitalia, inguinal hernia, leucorrhea,
depression, mania, anxiety; chest and lung difficulty urinating; emotional disorders with
disorders with stuffiness and restrictions in depression, deep signing, poor judgment,
the chest, cough, restricted breathing, indecision, mood swings, frequent anger,
asthma; stomach disorders, stomach pain, insomnia; shaoyang channel syndrome with
epigastric distention, hiccups, nausea, alternating chills and fever; channel disorders
vomiting, food poisoning; channel disorders affecting the sense organs with temporal
with pain and swelling of the armpit, upper headache, eye pain, pain in the cheek,
arm, elbow, forearm (Per 2-6), hot palms and swollen glands, swelling and pain in the neck,

  18  
mandible, deafnesss, tinnitus; Bi syndrome constrained in the upper heater, whose
affecting the lateral side of the body from primary complaints are lateral migraine
lateral ribcage to lateral hip, ITB, peroneal headache and dizziness with a strong wiry
distribution of lateral knee, lower legs and pulse.
lateral ankle and foot with 4th toe
dysfunction (GB 22, 29-30, 31, 34, 37-39, 40- Observation shows shen to be clearly present,
44). but with a moody disposition bordering on
anger, a tendency to sigh and to breathe very
D] Foot Jueyin Liver meridian: shallowly, even hyperventilating when he
grows animated, with a shouting quality to
Liver Qi and yang disorders with fullness, his voice. He also reports a frequent need to
distention, pain of hypochondriac region, address serious anger issues in his therapy.
dizziness, blurred vision, tinnitus, dry mouth
with bitter taste, flushed face, jaundice; The patient’s secondary complaint is
emotional disorders with depression, mood frequent myofascial pain in the upper traps
swings, nervousness, frequent anger, and lats and generalized muscle tightness.
frustration, plum pit Qi in throat; stomach
and spleen disorders with epigastric pain, From a jing-luo perspective this matches foot
distention, flatulence, belching, eating Jueyin Liver regular meridian symptomology
disorders, vomiting, diarrhea; lung and heart primarily, with additional symptoms of foot
disorders with stuffiness of chest, cough, Shaoyang and hand Shaoyang regular
shallow breathing, deep sighing, palpitations, meridian dysfunction leading to an APM
dream disturbed sleep; abnormal growth diagnosis of Jueyin/Shaoyang Circuit
including cysts, nodules, masses; channel Dysfunction and constrained Liver Qi, as
disorders with spasms of feet and hands, well as foot and hand Shaoyang muscle
headache, low back and lumbar pain channel excess.
extending to scrotum, hernia pain, pain and
swelling of lateral lower abdomen (dai mai), A] Yin-Yang Regulatory Treatment would
spasm and tightness of joints and muscles begin with the source point of the foot jueyin
and pain along course of channel.   meridian, as well as the ying and shu points
  for disorders of yin of yin, Liver 3 (tonified)
  and 2 (dispersed), and the luo point of foot
Personality Patterns Shaoyang, GB 37 along with the Fire point of
  foot Shaoyang, GB 38 both dispersed) to
See discussion under the first circuit above. bring down the rising yang symptoms and
clear the lateral head Shaoyang and upper
trapezius areas of blockage as well as promote
Liver/Gallbladder harmony. Local points CV
10, where tender and where Liver Qi can
Practicing Circuit-Needling become constrained in the middle heater, the
tender area of GB 24 and Liv 14 on the right,
and the tender area near CV 18 would all be
Let’s take the example of a patient who
dispersed to clear the hypochondriac region
presents on palpation with discomfort in the
and ease the breathing.
right hypochondriac region and tenderness
on palpation near GB 24 and Liv 14, as well
as tenderness at CV 10, where Liver Qi can B] Patient-Complaint Treatment would
become constrained in the middle heater, select local points from the yang channels in
and CV 18, where Liver Qi can become this circuit, where local symptoms tend to

  19  
accumulate (yang protects yin) as follows: for
the lateral headache, tender ashi points along
the GB and TH pathways of the lateral scalp,
including GB 8 and points along a line with
it in the temporalis muscle and the Shaoyang
area local lateral headache extra point,
Taiyang, needled with TCM dispersal
technique and never as muscle channel
Trigger Points, with distal Triple Intestine 10
(Kiiko Matsumoto’s TH pathway point level
with LI 10) and LI 4 to complete the 4 gates
and as a powerful headache point; for the
dizziness, GB 20, the extra point anmian (in
the Shaoyang region between the GB 20 and
TH 17 points) and GB 8 (already treated),
with distal TH 3.

If this were a chronic problem, given that

there are three regular meridians and two
ZangFu involved, I would add the
extraordinary vessels as per Van Nghi’s use in
such chronic conditions, using the infinity
combination so suited for Jueyin/Shaoyang
dysfunction: Sp 4/ Per 6 for the constrained
Liver Qi in the ribcage, chest and CV 10
area, and GB 41 and TH 5 for the Shaoyang
symptomology. This would comprise a jing
level supportive treatment to regulate
Jueyin/Shaoyang and relieve the Shaoyang
area symptoms.

In subsequent visits and once the primary

complaint starts to resolve I might add
release of the myofascial constraint areas with
Trigger Point Dry Needling to the upper
trapezius near GB 21, the supraspinatus near
TH 15, and the lats near GB 22. This could
be supplemented at any time with the
influential point for tendons, GB 34.
 

  20