JOURNAL OF CHINESE MEDICINE NUMBER 30 MAY 1989
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
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