In a meridian based approach to pattern identification and treatment emphasis is placed on understanding the relationships between the channels, and how the meridian networks connect to the patient's top three health concerns. The relationships between the channels are determined by the traditional Chinese names for the meridians, the internal-external relationships, and the horary cycle.
To begin to understand these connections between the channels we need to start with the six meridian pairs as classified in the six stages of syndrome differentiation. These are expounded upon in the Shang Han Lun (On Cold Damage) and include the six pairs of tai yang, yang ming, shao yang, tai yin, shao yang, and jue yin. Though the Shang Han Lun discusses these meridians in the context of external cold invasions, this method of pairing the meridians is also based on yin-yang relationships, anatomical location, and physiological functions. Taking the yang ming pair as an example we find that it contains one hand meridian and one foot meridian. Additionally, these meridians are located on the most anterior yang portions of the body, and they share functions in the digestive processes. Similarly, the shao yin pair includes one hand and one foot meridian, and these channels are located on the most posterior yin aspects of the body. In terms of functionality the shao yin governs the most vital fluids of the body, namely the blood and essence.
Another way the meridians may be paired is through what is called the Zang Fu Bei Tong Theory (5 Zang Extra Relationship Theory). This way of pairing meridians is a major component of Tung style acupuncture and is referred to as the system two associations in Dr. Tan's methods. This system takes the tai yang meridians and pairs them with the tai yin, while the shao yang is associated with the shao yin, and the yang ming meridians are paired with the jue yin. It is through this system that the LI and LV meridians form a connection, and this relationship is most commonly recognized in the point combination of LI 4 (He Gu) and LV 3 (Tai Chong).
In addition to the well-known internal-external associations, meridians may also be grouped according to the horary cycle. In this system each of the twelve regular meridians have a designated two hour period of time during a 24-hour day. Meridians that are located opposite the clock of one another may be paired, and examples of this include the relationships between the LV and SI, the ST and PC, and the KI and LI. Additionally, the channels may also be paired when they are located next to each other on the clock and have the same yin-yang designation. This forms relationships between the LV and LU, the SP and HT, and the KI and PC.
The systems that are a fundamental part of meridian systems theory have been described by several classical and traditional sources, including the Nei Jing (Inner Classic), the Shang Han Lun, Master Tung, and Dr. Richard Tan.
Four Meridian Circuits
By joining meridian pairs that share correspondence through these systems, circuits of connection can be formed from four meridians. These are called four meridian (4M) circuits. As an example the yang ming may be connected to the tai yin, and this relationship between the meridians may be represented as:
ST - LI
SP - LU
This image shows how the stomach and large intestine are connected through the yang ming, while the yang ming connects to the tai yin through the internal-external relationships. Taken as a whole we may describe the functions and indications of the yang ming - tai yin circuit.
1. Governs Qi through Respiration and Digestion
2. Benefits the Stomach and Intestines
3. Regulates Bowel Functions
Indications: Weak digestion, bloating, chronic diarrhea, fatigue, PMS, asthma, cough, shortness of breath, bronchitis, colitis, constipation, sinusitis, abdominal pain, deficient stomach acid
The use of this circuit will depend on symptoms that primarily involve the yang ming and tai yin. This is an earth-metal circuit that has broad applications when respiratory and digestive symptoms occur together. This includes food allergies, Candida, asthma, immune deficiency, and external invasions that affect the lungs and digestive system.
This circuit may be used for treating patterns such as spleen qi deficiency, large intestine damp heat, lung qi deficiency, spleen dampness attacking the lungs, spleen and lung qi deficiency, and phlegm obstruction of the lungs.
The Yang Ming - Jue Yin Circuit
According to the Zang Fu Bei Tong Theory, the yang ming also connects to the jue yin meridians of the liver and pericardium. In patterns where the liver is affecting the stomach or large intestine, the use of the meridians in this circuit are usually sufficient to address the numerous symptoms and diseases that can arise from these types of patterns. Notice in this circuit that the LV and LI have a direct connection. The association between these meridians is widely acknowledged in the use of four gates (LI 4 and LV 3). It should also be noted that the ST and PC share a direct connection in this circuit, and this helps to explain the ability of Nei Guan PC 6 to resolve nausea and vomiting. The yang ming - jue yin circuit may be represented as:
ST - LI
PC - LV
1. Regulates Digestive and Bowel Functions
2. Calms the Shen
3. Harmonizes Digestion through Regulating Qi and Blood Circulation
Indications: Stress induced digestive and abdominal conditions, constipation, IBS, loss of appetite, ulcers, colitis, irritability, anger, chest tightness, palpitations, heart disease, headaches, plum pit syndrome, and PMS
This circuit should be used whenever the primary symptoms exist within the yang ming and occur with liver, pericardium, or qi and blood stagnation patterns. Proper circulation of the qi and blood is essential to good digestive health, and when liver patterns present they can easily influence the stomach and large intestine. This can cause symptoms such as acid reflux, ulcers, stomach pain, constipation, and IBS. When the liver is involved in yang ming patterns it is common that the client will also suffer from excessive stress, frustration, and anger. For these reasons PC points are an important addition to the treatment since they have the functions of moving liver qi, calming the mind, and harmonizing the stomach and intestines.
This circuit is useful for treating various patterns including liver qi stagnation, liver qi invading the stomach, qi stagnation of the large intestine, liver heat, and stomach fire.
The Jue Yin - Shao Yang Circuit
The jue yin also connects to the shao yang through their internal-external relationships, and this circuit can be used to treat a variety of patterns including liver yang rising, liver fire, liver qi stagnation, and liver/gallbladder damp heat.
This circuit may be represented as:
LV - PC
GB - SJ
1. Circulates Qi through the Shao Yang and Jue Yin
2. Calms the Shen
3. Controls Circulation of Qi and Blood
4. Resolves Wind
Indications: Temple headaches, neck pain, insomnia, seizures, strokes, anxiety, hyperthyroidism, epilepsy, hip pain, Parkinson's, shen disturbance, tightness in the ribs, constipation, chest tightness, costal pain, stress, PMS, irritability, abdominal pain, palpitations, groin pain.
This circuit is often used when the shao yang meridians are in a state of disharmony and manifest with symptoms in the head, neck, throat, shoulders and hips. Shao yang symptoms will usually occur with jue yin patterns due to the internal-external relationship they share. It is often the case that liver patterns will influence the GB meridian and present with symptoms such as temple headaches, neck tension, eye disorders, and insomnia.
This circuit is also very powerful for clearing internal heat and fire that is located in the shao yang and jue yin meridians. Liver fire will often manifest with GB meridian symptoms, and the SJ is effective for relieving symptoms associated with both the gallbladder and liver. When liver fire is present, needling the SJ helps to clear fire, while the PC meridian clears heat and resolves liver stagnation.
Refining Pattern Identification and Treatment Strategies
The use of the meridian circuits can greatly aid in fine-tuning the process of pattern identification and the corresponding treatments that result. For example, liver qi stagnation can cause a variety of symptoms, and not every patient will manifest all the symptoms that characterize the pattern of liver qi stagnation. Some clients with liver stagnation will experience symptoms such as abdominal pain and constipation. For patients like this the yang ming - jue yin circuit would be the optimum one to use, since it contains meridians that will address the root pattern, as well as treat the organs that have the symptomatic expressions. However, for a client that has liver qi stagnation but experiences symptoms such as temple headaches, neck pain, and shoulder tension, it is best to use the jue yin - shao yang circuit. This is because the shao yang meridians pass through these areas and can easily be affected by imbalances originating in the liver. For this reason the use of the jue yin - shao yang circuit is often a good choice for neck and shoulder conditions, especially when a liver pattern results in symptoms in the gallbladder and/or san jiao meridians.
Meridian Circuit Systems
The use of the 4M circuits constitutes a complete system of pattern identification that is based on the connections between the meridians. When we analyze all the possibilities of 4M circuits that may be formed we find that there are a total of fifteen. By asking the patient about their top three health concerns, and identifying what meridians and organs are expressing symptoms, it is possible to identify which one of the fifteen 4M circuits is most out of balance. By combining this method of pattern identification with more conventional forms like zang-fu and 5-elements, it is possible to arrive at a more accurate diagnosis and have a more complete picture of pathological imbalances that are present. This can greatly help to improve the clinician's selection of meridians and points to be treated, while increasing clinical efficiency with the use of fewer needles.
For more information about the book Meridian Circuit Systems: A Channel Based Approach to Pattern Identification, please visit: http://www.ihsociety.com