1. Meridians and collaterals
Lecturer: Qu Hongyan

2. Acupuncture or needling, is a type of therapy that stimulates certain locations or points of the body, by manipulating needles or other similar instrument.

3. Moxibustion refers to a therapy utilizing ignited moxa wool to heat or cauterize the surface of the human body.

4. Cupping is a therapy in which a jar is attached to the skin surface using negative pressure created by introducing a flame into the cup or some other means of suction so as to form a localized congestion or blood stagnation to prevent or treat diseases.

5. Preface
The meridian theory, which is taken as an important component of the theoretical system of traditional Chinese medicine, concentrates on the study of the distributions, physiological functions, pathological changes of the meridians as well as their relationships with the viscera, body constituents, sense organs and orifices, qi, blood and body fluids. It is the core of acupuncture theory.

6. Development of needles
Bian-stone needles
Stainless steel
filiform needles
Bone needles

7. Effects and Clinical application of meridian theories
Twelve regular meridians 1 2
Eight extra meridians 3
Twelve divergent meridians 4
The branch-foundation, tip-root, qi thoroughfare and four seas
Effects and Clinical application of meridian theories 5

8. Jing, meridians, means “go through” or “a path”. They are strong and
trunk
branches
Jing, meridians, means “go through” or “a path”. They are strong and
large. They run longitudinally and interiorly within the body.
Luo, that is collaterals, means “something that connects” or “a net”. They are the
branches of the meridians, thin and small. They run transversely and superficially, and
crisscross and net the whole body.

12. Meridian system Fifteen connecting collaterals Superficial collaterals
Twelve regular meridians
Meridians
Eight extra meridians
Meridian system
Twelve divergent meridians
Fifteen connecting collaterals
Superficial collaterals
Tertiary collaterals
Collaterals

13. Twelve regular meridians

14. Nomenclature
The nomenclature of the twelve regular meridians is based on three factors, which are hand or foot, yin or yang, and zang or fu organs.
e.g. Lung meridian of hand-taiyin
Large intestine meridian of hand-yangming
Gallbladder meridian of foot-shaoyang

15. Nomenclature of the Twelve Regular Meridians
Hand/Foot
Yin/Yang
Three yang/Three yin
The Twelve Meridians
Hand
Yin
Taiyin
Lung Meridian
Shaoyin
Heart Meridian
Jueyin
Pericardium Meridian
Yang
Yangming
Large Intestine Meridian
Shaoyang
Sanjiao Meridian
Taiyang
Small Intestine Meridian
Foot
Spleen Meridian
Kidney Meridian
Liver Meridian
Stomach Meridian
Gall Bladder Meridian
Bladder Meridian

16. Six meridians of hand

17. Six meridians of foot

18. Pathways and flow of qi Hand Foot Head Chest or Abdomen
Three yin meridians of hand
Lung meridian of hand taiyin
Pericardium meridian of hand jueyi
Heart meridian of hand shaoyin
Chest or
Abdomen
Hand
Three yin meridians of foot
Spleen meridian of foot taiyin
Liver meridian of foot jueyi
Kidney meridian of foot shaoyin
Three yang meridians of hand
Large intestine meridian of hand yangming
Triple energizer meridian of hand shaoyang
Small intestine meridian of hand taiyang
Foot
Head
Three yang meridians of foot
Stomach meridian of foot yangming
Gallbladder meridian of foot shaoyang
Bladder meridian of foot taiyang

19. Head three yang meridian three yin meridian Chest Hand of hand
Abdomen of foot
of foot Foot

20. Directions of twelve regular meridians
Three yin meridians of hand run from chest to hand
Three yang meridians of hand run from hand to head
Three yang meridians of foot run from head to foot
Three yin meridians of foot run from foot to abdomen and chest.
If we extend our arms overhead, the yin meridians run upward while yang ones run downward

21. Distribution of the twelve regular meridians
The Twelve Regular Meridians have lateral and symmetrical distribution on the head, face, trunk and limbs.
The six yin meridians are distributed on the medial side of the limbs and on the chest and abdomen.
The six yang meridians are distributed on the lateral side of the limbs and on the head, face and trunk.

22. Distribution in the trunk
Location
The first lateral line
The second lateral line
The third lateral line
Head
1.5cun（ bladder meridian
Waist and back
1.5cun（ bladder meridian ）
3cun（bladder meridian）
Abdomen
0.5cun（kidney meridian）
2cun (stomach meridian）
4cun（spleen meridian）
Chest
2cun（kidney meridian）
4cun (stomach meridian）
6cun（spleen meridian）

23. Chest Tip of index finger Beside the nose Tip of great toe
External canthus
Beside the nose
Chest
Tip of great toe
Tip of ring finger
In the chest
In the chest
Tip of small toe
Tip of small finger
Inner canthus

24. Connections
Yin meridians and yang meridians connect in the hand or the foot.
Two yang meridians with the same name connect in the head or facial region.
Hand yin meridians and foot yin meridians connect in the chest.

25. Exterior-interior relationship
Yin meridians, which are considered relatively inner, belong to zang organs and interact with fu organs.
Yang meridians, which run relatively superficially, belong to fu organs and connect to zang organs.
The heart meridian belongs to the heart and connect to the small intestine
The small intestine meridian belongs to the small intestine and interact with the heart.
i.e.

26. Lung meridian of hand-taiyin

27. Large intestine meridian of hand-yangming

28. Stomach meridian of foot-yangming

29. Spleen meridian of foot-taiyin

30. Heart meridian of hand-shaoyin

31. Small intestine meridian of hand-taiyang

32. Bladder meridian of foot-taiyang

33. Kidney meridian of foot-shaoyin

34. Pericardium meridian of hand-jueyin

35. Triple energizer meridian of hand-shaoyang

36. Gallbladder meridian of foot-shaoyang

37. Liver meridian of foot-jueyin

38. The Eight Extra Meridians
Eight Extra Meridians are the meridians whose courses are different from the twelve regular meridians, eight in all, namely Governor Vessel, Conception Vessel, Thoroughfare Vessel, Belt Vessel, Yin Link Vessel, Yang Link Vessel, Yin Heel Vessel and Yang Heel Vessel.

39. Differences compared with twelve regular meridians
They do not belong to any zang-fu organs directly;
They have no exterior-interior relationship amongst themselves
They travel in an extraordinary way compared to the twelve regular meridians
Apart from GV and CV which have their own points, the other meridians share the points with the twelve regular meridians.

40. Functions of Eight Extra Meridians
They distributed longitudinally and horizontally among the twelve regular meridians, working not only as strengthening the association between the twelve regular meridians, but also as dominating and controlling qi and blood, as well as balancing yin and yang.
They regulate the qi and blood of the regular meridians, such as in storage, drainage of the qi and blood.
If the twelve regular meridians were likened to the rivers and great rivers, the eight extra meridians would be likened to the lakes and reserviors.

41. Physiological functions ：
（1）regulates qi and blood of yang meridians and be named as sea of yang meridians ；
（2）reflects the function of brain, kidney and spinal cord；
（3） governs reproduction
Governor Vessel

42. Physiological functions:
（1）regulates qi and blood of yin meridians and be named as sea of yin meridians；
（2）regulates menstruation and pregnant fetus.
Conception Vessel governs uterus and gestation
Conception Vessel

43. Physiological functions:
（1）regulates qi and blood of twelve regular meridians；
（2） governs reproduction；
“the sea of twelve regular meridians”
“the sea of five zang organs and six fu
organs”
Thoroughfare Vessels

44. Physiological functions:
Restrains the other meridians like a belt
Belt Vessel

45. Twelve divergent meridians
Twelve divergent meridians are branches departing from the twelve regular meridians and traveling deeply into the body cavity.
Twelve divergent meridians have four distribution characteristics, namely “separating”，“entering”，“resurfacing” and “joining”
By the distribution of separating, entering, resurfacing and joining, the divergent meridians strengthening the bonds between the interior and exterior-paired regular meridians as well as with their zang-fu organs.

46. Twelve divergent meridians
The yang divergent meridians then join their own regular meridians again, while yin ones join their internally-externally related yang meridians
Resurfacing usually at neck or the face
Joining
Resurfacing
Yin divergent meridians
Yang meridian
Yang divergent meridians
Yin meridian
Entering
Separating usually at
Popliteal fossa
Yang meridians
Separating

47. The branch-foundation, tip-root, qi thoroughfare, and four seas in the meridian theory

48. Four roots and three tips
Root-tip theory
Root and tip refer to the originating and terminating points of qi in the twelve regular meridians. The word “Gen”, means root or originating, and it refers to the Jing-well point of the individual meridian in the extremities. The word “Jie” means tip or gathering, and it lies on the head, chest and abdomen.
Twelve regular meridians take four extremities as root, the head, chest and abdomen as the tip.
Four roots and three tips

49. Branch-foundation theory
Branch and foundation, or “Biao Ben”in Chinese, refers to the up and down corresponding relationship in the meridians.
Branch upper part of the body
foundation lower part
The limbs are the foundation, trunk, head and face are the branch

50. Qi thoroughfare
Qi thoroughfare is the direct pathway where the meridian qi spreads in the trunk, head and face transversely and obliquely.
Qi thoroughfare theory shows that regions like the head, chest, abdomen and shank are the common pathways for circulation of the meridian qi, and it provides an explanation for the horizontal relationship of various meridians.

51. Four seas
The four seas include the sea of marrow, the sea of blood, the sea of qi and the sea of grain and water.
In Ling Shu, Hai Lun (Spiritual Pivot, Chapter 33), it points out that the stomach is the sea of grain and water, Penetrating is the sea of twelve regular meridians, Danzhong is the sea of qi, brain is the sea of marrow
The four seas generalize the four locations in which the meridian qi generates, distribute and gathers.

52. Physiological functions of meridians
Circulating qi and blood
Linking zang and fu organs and communicating the internal with the external
Resisting evil qi
Inducing and transmitting information
Regulating the balance of the body functions

53. Circulating qi and blood
All zang-fu organs and tissues conduct their normal physiological functions, relying on the nourishment provided by qi and blood, which are transmitted by meridians. As stated in the Ling Shu, Ben Zang (Spiritual Pivot, Chapter 47 ) “the meridians have the function of moving qi and blood, nourishing yin and yang, lubricating joints and tendons.”

54. Linking zang and fu organs and communicating the internal with the external
Human body is a complicated organism consisting of five zang organs and six fu organs, four limbs and bones, five sensory organs and nine orifices, tendons, muscles, etc. Each of them has its own special functions and all of them make the body an organic whole. Such interrelation or coordination between them is accomplished through the communicating function of meridians.

55. Resisting evil qi
In Ling Shu, Ben Zang (Spiritual Pivot, Chapter 47 ) it was recorded that “the meridians have the function of moving qi and blood, nourishing yin and yang, lubricating joints and tendons.” This sentence shows that the meridians and collaterals can ”transport blood and qi to adjust yin and yang”, and since the “nutritive qi flows inside the meridians and defensive qi runs outside the meridians”. The defensive qi is disperse to the skin thereby strengthening the function of defending the surface of the body.

56. Inducing and transmitting information
The phenomenon of arrival of qi, normal sensation felt by the patient treated with acupuncture, is a specified manifestation of inducing and transmitting functions of the meridians.

57. Regulating the balance of the body functions
Meridians function to promote the circulation of qi and blood and harmonize yin and yang, thus maintaining the functional activities of the body in a state of a relative balance.

58. Clinical application of meridian theories
Explaining the pathological changes
Guiding the diagnosis of disease
Guiding the treatment of disease

59. Explaining the pathological changes
Meridians function to transport qi and blood, induce and transmit information. Pathologically, they serve as the passages for transmitting pathogenic qi and manifesting disorders.
pain in hypochondrium
and lower abdomen
Stagnation of
liver qi

60. Guiding the diagnosis of disease
Each meridian runs along certain routes and pertains to one viscus. Under pathological conditions, some morbid phenomena may frequently occur along a meridian and the viscus that it pertains to.
e.g. Frontal headache indicates a disease of yangming meridian
Headache of the temporal region is a disease of shaoyang meridian
pain in the nape and occipital region can be the clue to a disease of taiyang meridian

61. Guiding the treatment of disease
The theory of meridians has been extensively applied to direct the treatment in all clinical specialties, and particularly to the treatment with acupuncture, moxibustion and massage when locating acupoints along the meridians, and to the treatment with drugs when selecting drugs according to meridian tropism.

62. Thank you!