CMAC111 Acupuncture Channel Theory Session 12 Channels & Collaterals of the Gallbladder 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 www.endeavour.edu.au 1
Student Feedback Surveys (SFS) Want to contribute to improving this subject? We re listening! The first 15 minutes of the next class for this subject you will be provided with the opportunity to complete the Student Feedback Survey Please bring your laptop, tablet, or smart phone to your next class so that you can complete the survey in class time Listening1 (Giuliani, 2011). s:// Endeavour College of Natural Health www.endeavour.edu.au 2
The Gallbladder (GB) Foot Shao Yang Channels and Collaterals Deadman, Al-Khafaji & Baker (2007, pp. 415-466) Endeavour College of Natural Health www.endeavour.edu.au 3
The Gallbladder Foot Shao Yang Channel System o The Gallbladder (Foot Shao Yang ) Primary channel o The Gallbladder Divergent channel o The Gallbladder Luo-connecting collateral o The Gallbladder Sinew channel o The Gallbladder Cutaneous region Endeavour College of Natural Health www.endeavour.edu.au 4
The Gallbladder (GB) Foot Shao Yang Primary Channel Regular Points 44 points Connecting Zang Fu Gallbladder Liver Main Channel Connections with other channels Stomach Bladder Pericardium Governor Liver Large Intestine Small Intestine Triple Energizer Endeavour College of Natural Health www.endeavour.edu.au 5
Pathway of the Gallbladder Channel Head: GB-1, 2, 4, 7, 8, 12, 14, 20 Shoulder: GB-21 Ribs: GB-22, 23, 24, 25, Hip: GB-27, 30 Lower leg: GB-34, 35, 36 GB Channel (Deadman et al., 2007, pp. 417-420) Ankle & foot: GB-40, 44 Endeavour College of Natural Health www.endeavour.edu.au 6
Internal Pathways of the Gallbladder Channel There are four branches of the Gallbladder channel that run internally: The major internal branch: o Zigzags over the face, connecting with points on TE, SI and ST channels then o descends from the supraclavicular fossa to connect with internal organs, and the sacrum emerging to the exterior at GB-30. Of the three smaller branches: o One meets runs to meet the GV at GV-14 o One connects the GB channel from ST-12 to GB-22 o The one on the foot runs connects GB & LR channels Deadman, Al-Khafaji & Baker 2007, pp. 417-420 Details of the internal branches follow over the next 5 slides: Only the external pathways of channels will be examined in the practical exam. Endeavour College of Natural Health www.endeavour.edu.au 7
Internal Pathway of the Gallbladder Channel Major internal branch o Separates from the main channel behind the ear o Connects with TE-17 traverses the jaw to the outer canthus of the eye o Descends to the angle of the jaw o Ascends to BL-1 GB Channel (Deadman et al., 2007, pp. 417-420) o Re-joins the channel in the supraclavicular fossa. Endeavour College of Natural Health www.endeavour.edu.au 8
Internal Pathway of the Gallbladder Channel This same branch o Continues to into the chest & crosses the diaphragm o Connects with the liver and gallbladder Sacrum LR & GB Diaphragm o Emerges in the inguinal region GB-30 o Connects with the sacrum o Emerges GB-30. GB Channel (Deadman et al., 2007, pp. 417-420) Endeavour College of Natural Health www.endeavour.edu.au 9
Internal Pathway of the Gallbladder Channel (cont) A further branch o Crosses the top of the shoulder via GB-21 & TE-15 o To meet with the spine at GV-14 o Passes laterally via BL-11 to SI-12 GB Channel (Deadman et al., 2007, pp. 417-420) o Then anteriorly to enter the supraclavicular fossa at ST-12. Endeavour College of Natural Health www.endeavour.edu.au 10
Internal Pathway of the Gallbladder Channel (cont) Another branch o Descends from the supraclavicular fossa GB-22 o To the lateral ribs connecting with the external portion of the main channel at GB-22. o Note that from GB-21 to GB-22 there is no external pathway. GB Channel (Deadman et al., 2007, pp. 417-420) Endeavour College of Natural Health www.endeavour.edu.au 11
Internal Pathway of the Gallbladder Channel (cont) One more branch o Separates from the main channel at GB-41 o Connects with the Liver channel at LR-1. GB-41 LR-1 GB Channel (Deadman et al., 2007, pp. 417-420) Endeavour College of Natural Health www.endeavour.edu.au 12
External Pathway of the Gallbladder Channel Starts lateral to the outer canthus of the eye Crosses the head three times Descends to the shoulder and over the lateral aspect of ribs, flanks, hip, thigh and leg. Ends on the lateral side of the fourth toe. GB Channel Human (Lian, Chen, Hammes, & Kolster, 2005, p.217) Endeavour College of Natural Health www.endeavour.edu.au 13
GB-1 External Pathway of the Gallbladder Channel GB-2 o Originates lateral to the outer canthus of the eye at GB-1 GB-4 o Connects with GB-2 anterior to the ear o And to the corner of the forehead at GB-4 GB Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 14
GB-8 GB-7 External Pathway of the Gallbladder Channel cont d o Descends to the region above the ear o Connects with TE-22 o Curves posteriorly behind the ear to the mastoid process at GB-12, meeting with TE-20 on the way GB-12 GB Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 15
GB-14 External Pathway of the Gallbladder Channel cont d GB-20 o Traverses the scalp to the forehead at GB-14. o Curves posteriorly to the occiput at GB-20 GB Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 16
Pathway of the Gallbladder Channel on the Head GB Channel Human (Lian et al., 2005, p.217) Endeavour College of Natural Health www.endeavour.edu.au 17
GB-21 GB-22 External Pathway of the Gallbladder Channel cont d GB-23 o Descends to the high point of the shoulder at GB-21. GB Channel & Points (Deadman et al., 2007) GB-24 o Passes through GB-22, GB-23 and GB-24 o Crosses the Liver channel at LR-13 Endeavour College of Natural Health www.endeavour.edu.au 18
External Pathway of the Gallbladder Channel cont d GB-25 o Crosses the lateral ribs to the free end of the 12 th rib at GB-25. GB-30 GB-27 o Descends to the anterior superior iliac spine (ASIS) o And hip region at GB-30. GB Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 19
External Pathway of the Gallbladder Channel cont d GB-34 Continues down GB-36 the lateral leg GB-35 GB Channel & Points (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 20
o Traverses the dorsum of the foot o Terminates on the lateral aspect of the fourth toe at GB-44. External Pathway of the Gallbladder Channel cont d GB-40 GB-44 GB 40 & 44 (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 21
External Pathway of the Gallbladder Channel cont d GB Channel Human (Lian et al., 2005, p.217) Endeavour College of Natural Health www.endeavour.edu.au 22
Actions & Indications of the Gallbladder Channel o Chest & hypochondrial pain with inability to rotate at the waist o Grey, lustreless complexion o Headache (especially unilateral) o Spasm of the muscles along the channel. Endeavour College of Natural Health www.endeavour.edu.au 23
Luo-Connecting Channel of the Gallbladder o Separates from the main channel at GB-37 o Connects with the Liver channel o Disperses over the dorsum of the foot. GB Luo (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 24
Indications of the Luo-connecting channel of the Gallbladder o Inability to walk, especially after sitting o Pain in the hypochondrium and sweating on cough o Inability to lift the leg Endeavour College of Natural Health www.endeavour.edu.au 25
Divergent Channel of the Gallbladder Deadman, Al-Khafaji & Baker 2007, pp. 417-420 o From the thigh o Traverses the pubic region o Passes over the ribs o Connects with the Liver and Gallbladder. o Ascends to the lower jaw o Disperses across the face o Rejoins the main channel at the outer canthus of the eye. Endeavour College of Natural Health www.endeavour.edu.au 26
Sinew Channel of the Gallbladder One branch continues to the vertex Passes behind the ear Another branch binds to the side of the nose Binds with the sacrum Ascends over the ribs Connects with the breast Ascends the lateral leg Binds at the lateral knee and thigh GB Sinew (Deadman et al., 2007) Originates at the fourth toe Endeavour College of Natural Health www.endeavour.edu.au 27
Indications of the Sinew Channel of the Gallbladder o Spasm of the outer flank o Inability to bend and stretch the knee o Drawing pain of the thigh and sacrococcygeal region o Stiffness and spasm along the course of the channel Endeavour College of Natural Health www.endeavour.edu.au 28
Cutaneous Regions of the Shao Yang Shaoyang Cutaneous (Deadman et al., 2007) Endeavour College of Natural Health www.endeavour.edu.au 29
Group Discussion Compare (discuss similarities) and contrast (discuss differences) in actions and indications of the Stomach, Bladder and Gallbladder channels. Endeavour College of Natural Health www.endeavour.edu.au 30
Case Studies Three patients present to the student clinic for treatment of acute headache. Each patient had a different channel diagnosis as below. Yang Ming Headache Shao Yang Headache Tai Yang Headache Endeavour College of Natural Health www.endeavour.edu.au 31
Case Studies Which part of the head would be affected in each of these headaches? Endeavour College of Natural Health www.endeavour.edu.au 32
Case Studies How might these headaches present differently? What other signs and symptoms could be present? Endeavour College of Natural Health www.endeavour.edu.au 33
Case Study Shao Yang Headache The student who treated the Shao Yang Headache used: Triple Energizer primary channel Gallbladder primary channel Gallbladder luo-connecting channel Liver main channel Explain why this treatment could be appropriate using channel theory. When would you be likely to include the Liver channel in this treatment? Endeavour College of Natural Health www.endeavour.edu.au 34
Case Study Shao Yang Headache Severe migraines can sometimes induce vomiting. What are two other channels you would use if Janette was vomiting with her headache? Why would these channels be appropriate. Endeavour College of Natural Health www.endeavour.edu.au 35
Group Work Divide into groups of 2 Using a chinagraph pencil or eyeliner, locate the pathway of the Gallbladder channel using main points as landmarks. Locate pathways of Stomach and Bladder channels from knee to toe. Observe where these sit in relation to the Gallbladder channel and each other. Endeavour College of Natural Health www.endeavour.edu.au 36
Preparation for next class To get the most out of your prac time next week it is imperative that you practice the leg channels until you know them. This will give you the opportunity to identify any areas of difficulty and to mark all six channels in class next week in preparation for the prac exam. Endeavour College of Natural Health www.endeavour.edu.au 37
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] 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. Giuliani, S. (2011). Listening1 [Image]. Retrieved February 21, 2017 from https://simonegiuliani.files.wordpress.com/2011/07/listening1.jpg Endeavour College of Natural Health www.endeavour.edu.au 38
Endeavour College of Natural Health www.endeavour.edu.au 39