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Extraordinary Vessels - Maciocia (part 2)

Extraordinary Vessels - Maciocia (part 2)

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Published by Shiatsucat
Article Journal of Chinese Medicine, 30 may 1989
Article Journal of Chinese Medicine, 30 may 1989

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 JOURNAL OF CHINESE MEDICINE NUMBER 30 MAY 1989
PART TWO
THE EIGHTEXTRAORDINARY VESSELS
GIOVANNI MACIOCIA
A two-part article on the Extraordinary Vessels by Giovanni Maciocia was originallypublished in Issues 2 and 3 of The Journal of Chinese Medicine (1979/80) and is now out ofprint. Since these articles and indeed the subject of the Extraordinary Vessels have generatedso much interest, we make no apology for publishing another article on the subject byGiovanni Maciocia. This article, also in two parts, is based on the chapter ‘ExtraordinaryVessels’ in his forthcoming book ‘The Foundations of Chinese Medicine’ due to be publishedin June 1989 by Churchill Livingstone. Additional material has been added from the originalarticle. Part One of this new article appeared in The Journal of Chinese Medicine Number 29, January 1989.
PENETRATING VESSEL
Opening point: Gongsun SP-4Coupled point: Neiguan P-6Starting point: Huiyin REN-1Area of body influenced: abdomen, uterus, chest,heart.
The Penetrating Vessel is very complex as it has manydifferent functions at different levels. In a way, it could be considered to be the origin of the other extraordinaryvessels (excluding the Governing and DirectingVessels) as it originates in the Kidneys and spreads itsQi all over the body at the Defensive Qi level. When thisenergy arrives at the relevant starting points, it givesrise to the Yin and Yang Linking Vessels, the Yin andYang Heel Vessels and the Girdle Vessel.The Penetrating Vessel is described as the “Sea of the 5Yin and 6 Yang organs”
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and also as the “Sea of the 12channels”
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. It is described as the Sea of the 5 Yin and 6Yang organs as it is a fundamental vessel whichconnects the Pre-Heaven and Post- Heaven Qi, due to itsconnection with the Kidneys and Stomach. It is con-nected to the Kidneys as it originates in them and itdistributes Essence all over the body. It is connected tothe Stomach as it passes through the point Qichong ST30 which is a point for the Sea of Food. Furthermore, thePenetrating Vessel is connected to the Spleen channelalong which it flows on the inner aspect of the thigh,down to the big toe.It is called the “Sea of the 12 channels” because it branchesout in many small capillary-like vessels that circulateDefensive Qi over the abdomen and chest. The func-tions and clinical use of the Penetrating Vessel can besummarised as follows:1. The Penetrating Vessel is excellent in cases of rebellious Qi
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, and is therefore often used to move Qiand Blood when they stagnate in the abdomen andchest, for such cases as dysmenorrhoea, flatulence, borborygmi, abdominal distention or abdominal masses.In this respect, it is used mostly for Excess patternscharacterised by stagnation and obstruction with acharacteristic feeling of fullness of the chest or epigas-trium. It is effective in Liver-Spleen disharmony whereLiver-Qi invades the Spleen, and for asthma due toStomach-Spleen-Lung disharmony, but not for Kidney-
Fig. 1 The Penetrating Vessel
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 JOURNAL OF CHINESE MEDICINE NUMBER 30 MAY 1989
Case history
A man of 45 suffered from chronicindigestion with a sensation of full-ness of the epigastrium, belchingand nausea. His pulse was Fulland Tight especially in the middleposition, and his tongue had athick white coating. The clinicalmanifestations point to retentionof food in the Middle Burner. Theopening and coupled points of the Penetrating Vessel (GongsunSP-4 and Neiguan P-6) were used,producing a complete recoveryafter several treatments.
Lung disharmony for which the Directing Vessel isindicated.2. The Penetrating Vessel, together with the DirectingVessel, regulates the uterus and menstruation and itnourishes Blood. It can be used for such conditions asdysmenorrhoea, amenorrhoea andmenorrhagia. The main differences between the Penetrating Vessel andthe Directing Vessel in relation tomenstruation is that the formercontrols Qi and can be used to ton-ify and nourish, whereas the lattercontrols Blood and is mostly usedto move Qi and Blood and removeobstructions.3. Since the Penetrating Vesselprovides the link between the Pre-Heaven and Post-Heaven Qi, it can be used in all cases of weak consti-tution with digestive symptomssuch as poor appetite, abdominaldistention and poor assimilation of food.4. The Penetrating Vessel exerts aninfluence on the heart, as it flows through it, and it can be used to move the Blood of the Heart in cases of painin the chest, stuffiness of the chest and palpitations.
Comparison and Differentiation betweenthe Directing and Penetrating Vessels
1. The Directing Vessel corresponds to Qi, thePenetrating Vessel to Blood. The Directing Vessel istherefore used in problems due to deficiency or stagna-tion of Qi, or rebellious Qi, whereas the PenetratingVessel is used more in problems due to stagnation of Blood. This does not mean, however, that the DirectingVessel is not used in Blood problems, since they areoften due to Qi problems.2. As a consequence of the above, the Directing Vesselcorresponds to the Lungs (= Qi) and the PenetratingVessel corresponds to the Heart and Spleen (= Blood).One would therefore use the Directing Vessel more forLung problems and the Penetrating Vessel for Heartand Spleen problems.3. The Directing Vessel is more used in cases of defi-ciency of Qi or rebellious Qi, whereas the PenetratingVessel is more used when there is an actual materialaccumulation (of food or phlegm).4. As a consequence of the above, the Directing Vesselis more used when the pulse is Weak, Short or Fine (allsigns of Qi deficiency), whereas the Penetrating Vesselis more used when the pulse is Slippery and Full or Long(all signs of Excess of some material accumulation).5. The Directing Vessel has more of a circular action onthe median plane of the body, whilst the PenetratingVessel has more of a dispersing action. What is meant by this is that the Directing Vessel is more used in casesof stagnant Qi in the centre line of the body (in any of the three Burners). It thus acts on the central Qi (i.e. theQi of the median line) by stimulating the circulationalong the centre, like a wheel. The Penetrating Vesselis more used in cases of stagnant Qi and/or Blood
GIRDLE VESSEL
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spreading horizontally and creating obstruction in thechest and abdomen.6. To use asthma as an example, both vessels areeffective in this condition. The Directing Vessel is usedwhen the asthma is due to rebellious Qi, while thePenetrating Vessel is more usedwhen the asthma is due to stagna-tion of phlegm (and therefore pres-ents with copious expectoration, aSlippery pulse and a thick tonguecoating).7. The area where the differences between the Directing and Pene-trating Vessels is most blurred isthat of gynaecological problems,particularly menstrual disorders.The choice is made clear if we referto the above points. In particularone would use the Directing Ves-sel when the menstrual problemsare caused by a disorder of Qi, andthe Penetrating Vessel when theyare caused by a disorder of Blood.In the first case the Qi problem isrelated to the Lungs (with its emo-tional implications) i.e. Directing Vessel, and in thelatter case to the Spleen and Liver i.e. Penetrating Vessel.
Opening point: Zulinqi GB-41Coupled point: Waiguan SJ-5Starting point: Daimai GB-26Area of body influenced: genitals, waist, hips.
The Girdle Vessel is the only horizontal vessel of the body. It divides the body into two halves and flowsthrough Zhangmen LIV-13, Daimai GB-26, Wushu GB–27 and Weidao GB–28. It is closely related to the Liverand Gall Bladder and it connects with the Kidneydivergent channel. The functions and clinical use of theGirdle Vessel can be summarised as follows:1. It can be used to harmonise the Liver and GallBladder, particularly in Excess patterns of the Liver,when the Gall- Bladder pulse is Full and Wiry, for suchsymptoms as temporal headaches.2. The Girdle Vessel can be used to disperse damp-heatin the genitals, causing such symptoms as burningand difficult urination.3. The Girdle Vessel encircles the leg channels and itaffects their circulation. Disorders of this channel cantherefore impair the circulation of Qi in the leg chan-nels, resulting in such symptoms as cold legs and feet(“like sitting in cold water”), purple feet or tense outerleg muscles (due to Liver-Blood not moistening thesinews).4. The Girdle Vessel particularly affects the circulationof Qi in the Stomach channel and can cause weakness of the leg muscles, and in severe cases, atrophy. In thesecases the opening and coupled points of the GirdleVessel can be used to ease the vessel and tonify theStomach and Spleen channels.5. The Girdle Vessel flows through the waist and
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 JOURNAL OF CHINESE MEDICINE NUMBER 30 MAY 1989
YIN HEEL VESSEL
Opening point: Zhaohai KID-6Coupled point: Lieque LU-7 Starting point: ZhaohaiKID-6Accumulation point: Jiaoxin KID-8Area of body influenced: inner side of legs, abdo-men, eyes.
The Yin and Yang Heel Vessels are closely related,especially in their relation with the eyes. They both flowup to the eyes, the Yin Heel Vessel bringing Yin energyto them, the Yang Heel Vessel bringing Yang energy tothem. When the Yin Heel Vessel is diseased, the eyescannot stay open and tend to close all the time, i.e. theperson always feels sleepy. When the Yang Heel Vesselis diseased, the eyes cannot close and tend to stay openall the time, i.e. the person cannot sleep
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.The Yin and Yang Heel Vessels also exert an influence onthe tone of the leg muscles. When the Yin Heel Vessel isin excess, the inner leg muscles are tight and the outerleg muscles loose. When the Yang Heel Vessel is inExcess, the inner leg muscles are loose and the outerones tight
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.The Yin Heel Vessel is an offshoot of the Kidney channel,while the Yang Heel Vessel is an offshoot of the Bladderchannel. The clinical uses of the Yin Heel Vessel can besummarised as follows:1. Because of its relation with the eyes, it can be usedin disturbances of sleep, whether insomnia or somno-lence. In this context, it is often used in conjunctionwith the Yang Heel Vessel. In cases of insomnia, the YinHeel Vessel is tonified (by tonifying Zhaohai KID-6)and the Yang Heel Vessel sedated (by reducing Shen-mai BL-62). In cases of somnolence, the Yin Heel Vesselis sedated (by reducing Zhaohai KID-6) and the YangHeel Vessel is tonified (by reinforcing Shenmai BL–62).In both cases, the point Jingming BL-1 can be added toestablish a connection between the Yin and Yang HeelVessels, so that Yin and Yang energy in the eyes can be balanced.2. The Yin Heel Vessel can be used in certain cases of Wei (atrophy) syndrome, when the muscles of the inneraspect of the legs are loose and the foot turns inwards,partly pulled by the tight outer leg muscles. This makeswalking very difficult and a person prone to tripping.The Yin Heel Vessel opening and coupled points can beused to balance the tension of the inner and outer legmuscles.3. The Yin Heel Vessel extends its range of action tothe abdomen, and can be used in Excess patterns of theLower Burner in women, for such symptoms asabdominal distention, abdominal masses, lumps,fibroids, difficult delivery or retention of placenta.4. Finally, the Yin and Yang Heel Vessels can harmoniseleft and right, and can therefore be used in structuralimbalances between the left and right sides of the body.
Case history
A man of 28 suffered from continuous somnolence.This followed a car accident during which hesuffered a fracture of the skull. He came for treat-
influences the hip. It can therefore be used for hip pain,particularly when there is a condition of deficiency of Liver-Blood and excess of Liver-Yang, with Liver-Blooddeficiency leading to malnourishment of sinews and joints.
Case history
A woman of 45 suffered from chronic migraineheadaches characterised by a severe throbbing acheon the temple. Her pulse was wiry and full and hertongue was red with a yellow coating. The head-aches were clearly due to the rising of Liver-Yang,and the Girdle Vessel opening and coupled points(Zulinqi GB-41 and Waiguan SJ-5) were usedseveral times in successive treatments producinga complete cure.
Case history
A woman of 72 suffered from chronic cystitischaracterised by severe burning on urination anddark-scanty urine. She also experienced a severedistending sensation in the hypogastrium. Herpulse was full, rapid and very wiry particularly inthe middle position. Her tongue was deep-red andhad a yellow coating which was thicker on the root.The root of the tongue also had red spots. Thisproblem was caused by the downward infusion of Liver-Fire affecting the Bladder. The opening andcoupled points of the Girdle Vessel were usedseveral times in succession, together with otherpoints to clear Liver and Bladder Heat, producinga nearly complete cure.
Fig. 2 The Girdle Vessel
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