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., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.). Hove, East Sussex: Journal of Chinese Medicine Publications. Endeavour College of Natural Health endeavour.edu.au 1
Review Leg Yin Channels Meet paired yang (interior/exterior related) channel at toes. Primary channels flow on medial aspect of leg from toes to abdomen and chest. Meet 6 division paired yin channel in abdomen/chest Sinews merge at groin. Endeavour College of Natural Health endeavour.edu.au 2
8 Principles Interior / Exterior Hot / Cold Full / Empty ( Excess / Deficiency) Yin / Yang Maciocia (2015, p. 452) Endeavour College of Natural Health endeavour.edu.au 3
Channel Diagnosis Interior/Exterior Interior Organs Exterior Channels External pathogens Maciocia (2015, p. 453), Maciocia (2006, p. 97) Endeavour College of Natural Health endeavour.edu.au 4
Channel Diagnosis Full/Empty Full (Excess) Intense pain Stiffness Contractions and cramps Empty (Deficient) Dull ache Weakness or atrophy of the muscles Numbness Maciocia (2006, p. 66, 98) Endeavour College of Natural Health endeavour.edu.au 5
Channel Diagnosis Hot/Cold Hot Red Hot to touch Cold Blue Cold to touch Contraction, stiffness and pain Maciocia (2015, p. 455-458), Maciocia (2006, p. 65-69, 245) Endeavour College of Natural Health endeavour.edu.au 6
Channel Diagnosis Yin/Yang Yang patterns are common in channel disorders. Yin patterns can also occur, but less frequently. How might Yin and Yang present in channel disorders? Endeavour College of Natural Health endeavour.edu.au 7
The Bladder (BL) Foot Tai Yang Channels and Collaterals Deadman, Al-Khafaji & Baker (2007, pp. 249-328) Endeavour College of Natural Health endeavour.edu.au 8
The Bladder Foot Tai Yang Channel System o The Bladder (Foot Tai Yang) Primary channel o The Bladder Divergent channel o The Bladder Luo-connecting collateral o The Bladder Sinew channel o The Bladder Cutaneous region Endeavour College of Natural Health endeavour.edu.au 9
The Bladder (BL) Foot Tai Yang Primary Channel Regular Points 67 points Connecting Zang Fu Kidney Bladder Main Channel Connections with other channels Governor Gall Bladder Large Intestine Small Intestine Endeavour College of Natural Health endeavour.edu.au 10
Pathway of the Bladder Channel BL-3 & 4 BL-10 BL-1 BL-11 &41 BL-30,31,35,36 & 54 BL-39 & 40 BL-57 & 58 BL-61 & 67 Bladder Channel (Deadman et al., 2007, pp. 249-328) Endeavour College of Natural Health endeavour.edu.au 11
Internal Pathway of the Bladder Channel Branches from the main external pathway at BL-23 Enters the Kidneys and Bladder Bladder Channel (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 12
Channel Connections on the Head Another branch travels internally from BL-3 to the vertex and enters the brain Then emerges at GV-17 The bladder channel connects with the following non-bladder channel points on the head GV-20, GV-17 GB-7, GB-8, GB-9, GB-10, GB-11 & GB-12 Bladder Channel (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 13
External Pathway of the Bladder Channel From BL-1 on the inner canthus of the eye The channel traverses the forehead BL-3, 0.75 lateral to the midline One branch moves laterally to BL-4, 1.5 cun lateral to the midline Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 14
External Pathway of the Bladder Channel Bladder Channel Human (Lian, Chen Hammes & Kolster, 2005, p.171) Endeavour College of Natural Health endeavour.edu.au 15
External Pathway of the Bladder Channel cont d The external branch continues over the scalp to connect with BL-10 The channel then splits. The medial branch connects with GV-14 and GV-13 Bladder Channel & BL 10 (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 16
External Pathway of the Bladder Channel cont d Du 17 BL Channel Human Neck (Lian et al., 2005, p.123) Endeavour College of Natural Health endeavour.edu.au 17
External Pathway of the Bladder Channel cont d Medial branch From BL-11 descends 1.5 cun parallel to the midline to BL-30 in the lumbar region Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 18
External Pathway of the Bladder Channel cont d Medial branch cont d Meets with BL-31 and other points in the sacral foramen Then BL-35, 0.5 cun lateral to the tip of the coccyx (WHO, 2008). Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 19
External Pathway of the Bladder Channel cont d Medial branch cont d Descends from BL-35 to the popliteal fossa, running through BL-39 & BL-40 Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 20
External Pathway of the Bladder Channel cont d Lateral branch Descends 3 cun lateral to the midline from BL-41 lateral to T2 to BL-54 crosses the buttock to intersect with GB-30 Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 21
External Pathway of the Bladder Channel cont d The two branches Rejoin at the popliteal fossa at BL-40 Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 22
External Pathway of the Bladder Channel BL Channel Human Back (Lian et al., 2005, p.123) Endeavour College of Natural Health endeavour.edu.au 23
External Pathway of the Bladder Channel Passes through the gastrocnemius muscle to BL-57 & BL-58 Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 24
External Pathway of the Bladder Channel BL Channel Human Leg (Lian et al., 2005, p.123) Endeavour College of Natural Health endeavour.edu.au 25
External Pathway of the Bladder Channel Descends to BL-61 Extends over the fifth metatarsal Terminates on the lateral aspect of the fifth toe Bladder Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 26
External Pathway of the Bladder Channel BL Channel Human Foot (Lian et al., 2005, p.123) Endeavour College of Natural Health endeavour.edu.au 27
Actions & Indications of the Bladder Channel Disorders of the head, neck, eye, nose, back and lumber, febrile diseases and spiritual disorders: o Stiffness and pain of head and neck, fever and aversion to cold, red and sore eyes, yellowish sclera, lacrimation, epistaxis, mania Blockage along the channel regions o headache, pain at the nape, back, lower back, hip, buttocks and posterior aspect of the lower limbs Disorders of Zangfu o Back shu points are indicated for disorders of their corresponding organs and their pertaining organs Endeavour College of Natural Health endeavour.edu.au 28
Luo-Connecting Channel of the Bladder Separating from the main channel at BL-58 Connects with the Kidney channel Deadman, Al-Khafaji & Baker 2007, pp. 249-328 Endeavour College of Natural Health endeavour.edu.au 29
Indications of the Luo-connecting channel of the Bladder o Stuffy nose and pain on the head and back o Clear nasal discharge and epistaxis Endeavour College of Natural Health endeavour.edu.au 30
Divergent Channel of the Bladder o Separates from the primary Bladder channel at the popliteal fossa o Ascends to below the sacrum o Circles the anus o Connects with the bladder & disperses in the kidneys o Ascends the spine o Disperses in the cardiac region o Connects with the Bladder primary channel at the neck Bladder Divergent (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 31
Sinew Channel of the Bladder Binds at the root of the tongue Ascends the laterally to the spine to the neck Binds at the buttock One branch originates at the fifth metatarsal and binds at the lateral malleolus and knee Divides into two over the popliteal fossa Another braches separates below the lateral malleolus, extends along the Achilles tendon Endeavour College of Natural Health endeavour.edu.au 32 Bladder Sinew (Deadman et al., 2007)
Sinew Channel of the Bladder Surrounds the orbit and binds at the cheek bone (B) B A One branch continues superiorly over the scalp and binds at the bridge of the nose (A) Endeavour College of Natural Health endeavour.edu.au 33 Bladder Sinew (Deadman et al., 2007)
Sinew Channel of the Bladder (cont d) Once passes inferior to the axilla to the supraclavicular fossa (B) B C A One connects at the shoulder (C) Bladder Sinew (Deadman et al., 2007) Another branch separates midway on the back and divides into two further branches (A) Endeavour College of Natural Health endeavour.edu.au 34
Sinew Channel of the Bladder (cont d) connecting with the cheek bone (D) D C binds behind the ear at GB-12 (C) B A travels to the supraclavicular fossa (B) The final branch separates from the lateral spine (A) Bladder Sinew (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 35
Indications of the Sinew Channel of the Bladder o Stiffness and spasm along the course of the channel o Inability to raise the shoulder o Pain and strain of the supraclavicular fossa Endeavour College of Natural Health endeavour.edu.au 36
Cutaneous Regions of the Tai Yang Taiyang Cutaneous (Deadman et al., 2007) Endeavour College of Natural Health endeavour.edu.au 37
Bladder Channel Case Study Male back (Godson, 2015) A 40 year old man presents with muscle pain due digging in the garden for two days. What would your 8 principle pattern diagnosis be? Discuss the types of channels that might be affected. Diagnose affected channel sinews. You may wish to view the following link in your own time. http://peterborten.com/wpcontent/uploads/2013/02/sinew-composite2.pdf Endeavour College of Natural Health endeavour.edu.au 38
Group Work Divide into groups of 2 Palpate sinew channels diagnosed in the case study. Note any Ah Shi points. Using a chinagraph pencil or eyeliner, locate the pathway of the Bladder channel using main points as landmarks. Locate upper back section of Small Intestine channel. Observe where these sit in relation to each other. Endeavour College of Natural Health endeavour.edu.au 39
Essential Reading Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.). Hove, East Sussex: Journal of Chinese Medicine Publications. (A scanned copy of pp.11-27 & 26,27 is available on LMS SN02.) Maciocia, G. (2015). The foundations of Chinese medicine, (3rd ed.). Churchill Livingstone, Edinburgh. pp. 795-805. (Scanned copy provided on LMS session 10.) Maciocia, G. (2006). The channels of acupuncture: clinical use of the secondary channels and eight extraordinary vessels, Churchill Livingstone, Edinburgh. pp. 15-31. (Scanned copy provided on LMS session 11.) Endeavour College of Natural Health endeavour.edu.au 40
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References Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.). Hove, East Sussex: Journal of Chinese Medicine Publications. [Available as web app 2013, mobile app 2009 or text 2007] Godson, D. (2015). Male upper back, Endeavour College of Natural Health, Brisbane. Lian, Y., Chen, C., Hammes, M. & Kolster, B. (2005). Pictorial Atlas of Acupuncture, H.H.Ullmann, Marburg. Maciocia, G. (2015). The foundations of Chinese medicine, (3rd ed.). Churchill Livingstone, Edinburgh. Maciocia, G. (2006). The channels of acupuncture: clinical use of the secondary channels and eight extraordinary vessels, Churchill Livingstone, Edinburgh. pp. 15-31. World Health Organisation. (2008). WHO standard acupuncture point locations in the Western Pacific Region. Manila, Philippines: World Health Organization. Endeavour College of Natural Health endeavour.edu.au 42