CMAC111 Acupuncture Channel Theory

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CMAC111 Acupuncture Channel Theory Session 2 Internal, external and secondary channels Lung, Pericardium & Heart Channels & Collateral Chinese Medicine Department All channel diagrams

1 CMAC111 Acupuncture Channel Theory Session 2 Internal, external and secondary channels Lung, Pericardium & Heart Channels & Collateral Chinese Medicine Department All channel diagrams used with permission. Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2 ed.). Hove, East Sussex: Journal of Chinese Medicine Publications.

2 Group Discussion Report back on your conclusions after reading the CMBA Code of Conduct. o Which portions of the code affect your interactions in practical work throughout this subject? o How will you apply these in class? Endeavour College of Natural Health 2

3 OVERVIEW Internal Pathways Secondary Channels Extraordinary Channels Endeavour College of Natural Health endeavour.edu.au 3

4 Channel Network Consists of: o Primary Channel o Secondary channels o Extraordinary channels Endeavour College of Natural Health endeavour.edu.au 4

5 Primary Channels The 12 main channels have an exterior pathway on which acupuncture points are located Interior pathways that connect with the organs and other important structures Key Concept The pathway of a channel, internal and external connections dictate its function and pathology. Endeavour College of Natural Health endeavour.edu.au 5

6 The Eight Extraordinary Vessels o o o o o o Conception (Ren) Governing (Du) Thoroughfare (Chong) Belt (Dai) Yin & Yang Link (Wei) Yin & Yang Motility (Qiao) Note: The 8 extras will be covered in more depth in Sessions 6 & 13 Endeavour College of Natural Health endeavour.edu.au 6

7 Secondary Channels Numerous specialised pathways deviate from the main meridian and connect to the o internal organs o other meridians o Sinews o blood vessels o skin and other parts of the body Endeavour College of Natural Health 7

8 Secondary Channels o o o o o 15 Luo-Connecting 12 Divergent Channels 12 Sinew Channels 12 Cutaneous Regions Minute collaterals Practical exams will concentrate on the external 12 pathway of the main meridians. Final written exam will include all the channels. Endeavour College of Natural Health endeavour.edu.au 8

9 ANATOMICAL POSITION & DIRECTIONAL TERMS Endeavour College of Natural Health endeavour.edu.au 9

10 Accuracy in Locating Channels Anatomical structures and landmarks Key acupuncture points Described using o Anatomical position o Directional terms o Cun measurements Endeavour College of Natural Health 10

11 Anatomical position is used when describing the pathway of channels and location of acupuncture points. Anatomical position: o Standing straight o Legs slightly apart o Eyes looking forward o Head faced forward Anatomical Position o Palms turned forward o Arms held slightly away from the body Anatomical position (Tortora & Derrickson, 2014, p. 13) Endeavour College of Natural Health 11

12 Anatomical Position Anterior Posterior Anatomical position (Tortora & Derrickson, 2014, p. 13) Endeavour College of Natural Health 12

13 Directional Terms Compass (García, 2008) Specific terminology is used to identify the locations of channels and points. o Used throughout your studies o In professional practice Example: The stomach channel runs lateral to the anterior crest of the tibia but medial to the fibula. Endeavour College of Natural Health endeavour.edu.au Endeavour College of Natural Health 13

14 Directional Terms Directional Terms (Tortora & Derrickson, 2014, p. 15) Endeavour College of Natural Health 14

15 Cun Measurements Specific to Acupuncture. Body inch is relative to the individual and specific body area. Used to measure from an acupoint or specific to anatomical landmarks. Proportional measurement is used for accuracy. View the following video in your own time. Arm Cun (Deadman, Al-Khafaji & Baker, 2007) Endeavour College of Natural Health 15

16 CHANNELS & COLLATERALS OF THE ARM YIN Endeavour College of Natural Health endeavour.edu.au 16

17 The Lung (LU) Hand Tai Yin Channels & Collaterals Deadman, Al-Khafaji & Baker (2007, pp ) Endeavour College of Natural Health endeavour.edu.au 17

18 Lung (Hand Tai Yin) Channel System o The Lung (Hand Tai Yin) Primary channel o The Lung Divergent channel o The Lung Luo-connecting collateral o The Lung Sinew channel o The Lung Cutaneous region Endeavour College of Natural Health 18

19 The Lung (LU) Hand Tai Yin Primary Channel Regular Points 11 points Lung Connecting Zang Fu Large Intestine Stomach Main Channel Connections with other channels Nil Endeavour College of Natural Health endeavour.edu.au 19

20 Pathway of the Lung Channel Lu-1 Lu-2 Throat Lu-5 Lu-6 Lu-7 Lu-9 Lu-11 Stomach Lungs Large Intestine Lung Channel a (Deadman, Al-Khafaji & Baker, 2007, p. 73) Endeavour College of Natural Health endeavour.edu.au 20

Internal Pathway of the Lung Channel o Originates from the stomach region (the middle jiao/burner) o Descends and connects with the Large Intestine o Ascends past the stomach and

21 Internal Pathway of the Lung Channel o Originates from the stomach region (the middle jiao/burner) o Descends and connects with the Large Intestine o Ascends past the stomach and diaphragm to enter the lungs o Continues superiorly to the throat o Descends to emerges at LU-1 (Zhongfu) Lung Channel b (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 21

22 Pathway of the Lung Channel Lung Channel Human (Lian, Chen, Hammes & Kolster, 2005, p.80) Endeavour College of Natural Health endeavour.edu.au 22

23 External Pathway of the Lung Channel From LU-1, the channel ascends to LU-2 (Yunmen) located in the hollow of the delto-pectoral triangle Lung points (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 23

24 External Pathway of the Lung Channel Cont d Descends along the anterio-lateral aspect of the upper arm, to LU-5 at the cubital fossa of the elbow Lung points (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 24

25 External Pathway of the Lung Channel Cont d Passes through LU-6 on the antero-lateral aspect of the forearm, towards the styloid process of the radius. Lung points (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 25

26 External Pathway of the Lung Channel Cont d Connects with LU-7; between the tendons of abductor pollicis longus and extensor pollicis brevis, 1.5 cun proximal to the palmar wrist crease (WHO, 2008). LU 7 (WHO, 2008) Endeavour College of Natural Health endeavour.edu.au 26

27 External Pathway of the Lung Channel Cont d oconnects with LU-9 on the lateral border of the radial artery Lung points (Deadman, 2007) o Passes over the thenar eminence o Concludes at the radial aspect of the thumbnail at LU-11 Endeavour College of Natural Health endeavour.edu.au 27

28 Branch of the Main Lung Channel Separates from the main channel at LU-7 Extends to the radial side of the tip of the index finger To the Large Intestine channel at LI-1 Lung Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 28

29 Clinical Uses Key Concept of the Lung Channel Actions and indications of any channel are dictated by the channel pathway and the functions of the organs that the channel connects with internally. Endeavour College of Natural Health 29

30 Group Discussion o Consider the pathway of the Lung Channel and the organs and structures it connects with. o What are some likely clinical uses of the Lung channel? Endeavour College of Natural Health 30

31 Pathologies of the Channels o Channels may be used to treat pathologies or disease states in the body o The channels themselves may also be damaged or become unhealthy. Endeavour College of Natural Health 31

32 Channel Vs Organ Pathologies Which of the following do you think are Lung channel pathologies and which are Lung organ pathologies? Distension of the chest Cough Pain in the infraclavicular fossa Asthma Pain in the shoulder Pain cold or numbness along the channel Endeavour College of Natural Health 32

33 Class discussion o What are some ways that the external Lung channel as distinct from the lung organ might develop a pathology? o How does the Lung channel s pathway explain its ability to treat throat and nasal disorders? Endeavour College of Natural Health 33

34 Luo-Connecting Channel Separates at LU-7 of the Lung Follows the main channel spreads through the thenar eminance Converges with the Large Intestine channel. Lung Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 34

35 Indications of the Luo-connecting channel of the Lung o Sensation of heat in the styloid process, wrist and thenar eminence o Yawning o Incontinence, increased frequency of urination Endeavour College of Natural Health 35

36 Divergent Channel of the Lung ascends across the throat converges with the LI channel Separates from the primary Lung channel at the axilla connects with the Lungs disperses into the Large Intestine Lung Channel (Deadman, 2007) Endeavour College of Natural Health 36

37 Lung Sinew Channel Originates at LU-11 and ascends over the thumb then binds at the thenar eminence Follows the radial artery, then binds at the centre of the elbow Ascends along the antero-lateral aspect of the upper arm Enters the chest below the axilla and emerges at the supraclavicular fossa Travels laterally to bind at the shoulder Descends back to the supraclavicular fossa Descends into the chest and extends over the hypochondrium and diaphragm Starts at LU-11 Lung Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 37

38 Indications of the Sinew Channel of the Lung o Cramping, spasm and pain along the course of the channel. o If severe, accumulation of lumps and pain around the right hypochondrium, and haemoptysis (spitting blood) Endeavour College of Natural Health 38

39 Cutaneous Regions of the Tai Yin Taiyin Cutaneous (Deadman, 2007) Endeavour College of Natural Health 39

40 The Pericardium (PC) Hand Jue Yin Channels and Collaterals Deadman et al., 2007, pp Endeavour College of Natural Health endeavour.edu.au 40

41 Pericardium (Hand Jue Yin) Channel System o The Pericardium (Hand Jue Yin) Primary channel o The Pericardium Divergent channel o The Pericardium Luo-connecting collateral o The Pericardium Sinew channel o The Pericardium Cutaneous region Endeavour College of Natural Health 41

42 The Pericardium (PC) Hand Jue Yin Pericardium Primary Channel Regular Points 9 points Connecting Zang Fu Triple Energizer Main Channel Connections with other channels Nil Endeavour College of Natural Health endeavour.edu.au 42

43 Pathway of the Pericardium Channel PC-1 Pericardium PC-3 PC-6 PC-7 Diaphragm Upper Jiao Middle Jiao Lower Jiao PC-9 Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health 43

o Originates in the chest o Connects with the Pericardium o Descends through the diaphragm o Connects with the upper, middle, and lower jiao to the abdomen o One branch emerges

44 o Originates in the chest o Connects with the Pericardium o Descends through the diaphragm o Connects with the upper, middle, and lower jiao to the abdomen o One branch emerges at the fourth intercostal space, at PC-1 Internal Pathway of the Pericardium Channel Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 44

45 Pathway of the Pericardium Channel Pericardium Channel Human (Lian et al., 2005, p.191) Endeavour College of Natural Health endeavour.edu.au 45

46 External Pathway of the Pericardium Channel From PC-1, in the fourth intercostal space lateral to the nipple, the main channel arcs over the axilla Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health 46

47 External Pathway of the Pericardium Channel cont d Traverses the anterio-medial aspect of the upper arm to PC-3 at the cubital fossa of the elbow Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health 47

48 External Pathway of the Pericardium Channel cont d o Runs between the tendons palmaris longus and flexor carpi radialis, o passing through PC 6, 2 cun proximal to the distal wrist. Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health 48

49 External Pathway of the Pericardium Channel cont d Runs between the Lung and Heart channels, to the wrist PC-7. Terminates at the tip of the middle finger at PC-9. Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health 49

50 Branch of the Main Pericardium Channel Separates from the main channel at PC-8 And follows the radial side of the ring finger to its tip. Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 50

51 Actions & Indications of the Pericardium Channel o Cardiac pain, palpitation, arrhythmias o Pain of the chest o Pain of the lateral costal region o Disorders of the Stomach (vomiting) o Febrile diseases o Disorders of the spirit (Shen) o Swelling and pain in the axilla Endeavour College of Natural Health 51

52 Luo-Connecting Channel of the Pericardium Separates at PC-6 Follows the main channel Converges with the Pericardium and Heart Pericardium Channel (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 52

53 Indications of the Luo-connecting channel of the Pericardium o Cardiac Pain o Restlessness/ Vexation Endeavour College of Natural Health 53

54 Divergent Channel of the Pericardium throat emerges posterior to the ear to unite with the Triple Energizer channel connects to the Triple Energizer Separates from the primary Pericardium channel 3 cun inferior to the axilla PC Divergent (Deadman, 2007) Endeavour College of Natural Health 54

55 Pericardium Sinew Channel Originates at PC-9 Ascends the forearm and binds at the medial elbow Continues along the anteriomedial aspect of the upper arm and binds at the axilla Spreads over the anterior and posterior aspects of the hypochondriac region A branch enters and diffuses at the chest; binding at the diaphragm. Starts at PC-9 PC Sinew (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 55

56 Indications of the Pericardium Sinew Channel o Stiffness and spasm along the course of the channel o Pain in the chest o Xi Ben disorder (dyspnoea with a cup size swelling on the right hypochondriac region) Endeavour College of Natural Health 56

57 Cutaneous Regions of the Jue Yin Jueyin Cutaneous (Deadman, 2007) Endeavour College of Natural Health 57

58 The Heart (HT) Hand Shao Yin Channels & Collaterals Endeavour College of Natural Health endeavour.edu.au 58

59 Heart (Hand Shao Yin) Channel System o The Heart (Hand Shao Yin) Primary channel o The Heart Divergent channel o The Heart Luo-connecting collateral o The Heart Sinew channel o The Heart Cutaneous region Endeavour College of Natural Health 59

60 The Heart (HT) Hand Shao Yin Primary Channel Regular Points 9 points Connecting Zang Fu Heart Lungs Small Intestine Main Channel Connections with other channels Nil Endeavour College of Natural Health endeavour.edu.au 60

61 Pathway of the Heart Channel Tissue surrounding eye HT-1 Lung Oesophagus HT-4 HT-3 Diaphragm Heart HT-7 HT-9 Small Intestine Heart Channel (Deadman, 2007) Endeavour College of Natural Health 61

62 Internal Pathway of the Heart Channel Heart Channel (Deadman, Al-Khafaji & Baker 2007, p. 209) o Originates in the Heart and spreads throughout the network of blood vessels around the Heart o Descends through the diaphragm and connects with the Small Intestine o One branch ascends past the oesophagus to the face, connecting with the surrounding eye tissue o Another branch exits the Heart and travels to the Lungs before emerging at HT-1 at the axilla Endeavour College of Natural Health endeavour.edu.au 62

63 Pathway of the Heart Channel HT Channel Human (Lian et al., 2005, p.99) Endeavour College of Natural Health endeavour.edu.au 63

64 External Pathway of the Heart Channel From HT-1 the channel proceeds medially along the arm to HT-3 at the transverse cubital crease of the elbow HT points (Deadman, 2007) Endeavour College of Natural Health 64

at the pisiform bone of the wrist HT points (Deadman,

65 External Pathway of the Heart Channel Proceeds along the anterio-medial aspect of the forearm through HT-4 to HT-7 at the pisiform bone of the wrist HT points (Deadman, 2007) Endeavour College of Natural Health 65

66 External Pathway of the Heart Channel HT points (Deadman, 2007) Continues along the palm to the radial aspect of the fifth metacarpal to end at HT-9 at radial corner of nail Endeavour College of Natural Health 66

67 Branch of the Main Heart Channel There are no branches from the main channel of the Heart meridian Endeavour College of Natural Health 67

68 Actions & Indications of the Heart Channel o Disorders of the chest/heart o Calm the spirit o Treating tongue and speech disorders o Throat conditions (pain, swelling) o Eye conditions o Disorders along the channel o Various conditions of the complexion Endeavour College of Natural Health 68

69 Luo-Connecting Channel of the Heart Separates at HT-5 Connects with the Small Intestine channel Returns to the Heart meridian Travels to the Heart Zang Links with the root of the tongue and eye HT Luo (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 69

70 Indications of the Luo-connecting channel of the Heart o Fullness or distension of the chest o Aphasia Endeavour College of Natural Health 70

71 Divergent Channel of the Heart Connects with the Small Intestine channel at inner canthus of the eye Enters chest Connects to the Heart Separates from primary Heart channel at the axillary fossa HT Divergent (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 71

72 Originates at HT-9 on the fifth metacarpal and binds at the wrist (pisiform bone) Sinew Channel of the Heart Follows the course of the primary channel and binds at the elbow and axilla Intersects Lung Sinew channel Spreads over the breast region to the centre of chest Travels over the diaphragm to the umbilicus HT Sinew (Deadman, 2007) Endeavour College of Natural Health endeavour.edu.au 72

73 Indications of the Sinew Channel of the Heart o Internal cramping o Spasm and pain along the course of the channel. o Accumulation (lumps) below the chest Endeavour College of Natural Health 73

74 Arm Yin Sinew Channels Try this quick experiment Flex your biceps. What other muscles do you notice that you tense at the same time. How does that relate to the sinew channels of the arm yin? Endeavour College of Natural Health 74

75 Cutaneous Regions of the Shao Yin Shaoyin Cutaneous (Deadman, 2007) Endeavour College of Natural Health 75

76 Three Arm Yin Summary of Indications Portion of Lung Pericardium Heart Channel Chest Chest & lung Heart & chest N/A Hand & Arm Throat, chest,lung Heart, chest, stomach Mental disorders Heat disease Heart, chest Mental disorders Ellis, Wiseman, Boss & Cleaver (2004, pp. 57,88, 172, 276) (Ellis, Wiseman & Boss, 2004) Endeavour College of Natural Health 76

77 Case Study Brad presents with pain in the chest and shortness of breath. When severe the pain sometimes causes vomiting. What is the first question you ask Brad? Heart Pain Cliparts # (Clipart Library, n.d.) Endeavour College of Natural Health 77

78 Case Study cont d Discuss when it would be appropriate to proceed with treatment. Endeavour College of Natural Health 78

79 Case Study Which of the three arm yin channels could be used to treat the chest? If the chest pain is related to coughing- Which would be the channel of choice to treat Belinda? If the chest pain is accompanied by palpitations- Which would be the channel/s of choice to treat Belinda? Which channel/s would you use to address the vomiting? Endeavour College of Natural Health 79

80 Demonstration Lecturer demonstrates tracing external channels (marked in a solid line) on a student model. Lung Pericardium Heart Arm Yin (Deadman, 2007) Endeavour College of Natural Health 80

81 Group Work Divide into groups of 2 and, using a chinagraph pencil, eyeliner or water based marker, trace the pathway of the specified channels on a student partner using main points as landmarks Endeavour College of Natural Health 81

82 References Clipart library. (n.d.). Heart pain cliparts # [Image}. Retrieved January 30, 2018, from Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2 ed.). Hove, East Sussex: Journal of Chinese Medicine Publications. [Available as web app 2013, mobile app 2009 or text 2007] Ellis, A., Wiseman, N., Boss, K. & Cleaver, J. (2004). Fundamentals of Chinese Acupuncture. revised edn, Paradignm Publications, Taos. García, L., (2008). A 18th century azimuthal compass from Spain [Image]. Retrieved June 2, 2015, from Lian, Y., Chen, C., Hammes, M. & Kolster, B. (2005). Pictorial Atlas of Acupuncture, H.G.Ullmann, Marburg. Maciocia, G. (2015). The foundations of Chinese medicine, (3rd ed.). Churchill Livingstone, Edinburgh. World Health Organisation. (2008). WHO standard acupuncture point locations in the Western Pacific Region. Manila, Philippines: World Health Organization. Endeavour College of Natural Health 82

83 Endeavour College of Natural Health 83

CMAC111 Acupuncture Channel Theory

CMAC111 Acupuncture Channel Theory Session 10 Channel Diagnosis - 8 Principles Channels & Collaterals of the Bladder Chinese Medicine Department All channel diagrams used with permission. Deadman, P.,