Jing Luo of TCM

Jing Luo

INTRODUCTION

"Jing luo", is  issued by ( Huang Di Nei Jing-The Yellow Emperor's Classic of Internal Medicine) in the ancient Chinese medical text, 

1. Jing meridians act as the interior. Those which branch off horizontally are luo meridians
2. Jing means to pass through orpathway and refers to the vertical channels. Luo means network and refers to the networks that branch off from the vertical channels (Jing).
3. Both Jing and Luo mean link or connection, and they are bound closely together to form channels.
4. Jing Luo are the main channels of communication and energy distribution in the body, there is a distribution network for the fundamental substances of Qi , blood , jing , ye (body fluid) throughout the body
5. This distribution network called the Meridian System looks like a giant web, linking different areas of our body together.
6.  Its pathways make up a comprehensive yet complex body map that supplies vital energy to every part of the body.

 Philosophically, the Meridian System explains how we live, and why we become sick., link interior Zang Fu organs with various tissues of superficial areas of the body. In this way they allow for internal adaptation to external change.They connect different superficial areas of the body.The Jing Luo are more external than the Zang Fu Organs. When pathogens penetrate the body from the Exterior, they usually penetrate the superficial channels and then the main channels and finally the Zang Fu Organs. Jing Luo cover the entire body.

CONTENT

Distribution of the Jing Luo ( Meridians)

Merdians(Jing)

• 12 Regular Meridians - Connect with Zang Fu Organs. Carry mainly Ying (Nutritive Qi) and Blood.

• 12 Divergent Meridians - Provide more functional contacts between Yin and Yang channels,Reinforce the circulatory network of 12 Primary Meridians
• 12 Muscular Meridians(sinews regions) - 1st line of defense and adaptation , province of Wei QI energy ,to connect with all the bones and control them to ease flexing and extending of the joints and normal motion of the body
• 12 Cutaneous(skin) Meridains -- the body superficies on which the functions of the 12 Regular Meridians are reflected, and the sites where the Qi of the collaterals spreadsthe most superficial part of the body tissues, they render protection to the organism.
• 8 Extra Vessels - CV, GV and Chong Mai originate in Kidney Organ. The others connect with Principal channels,strengthen association between channels and control, store and regulate Qi and blood of channels (reservoirs). Carry mainly Yuan Qi.
  

Collaterals(Luo)

• 15 Luo Meridians - Link Primary Meridians with surrounding tissues, Link Yin and Yang coupled pairs , it communicate exterior and interior that allows Wei Qi to move in towards the Boold, and the Blood towards the Wei Qi.
• Superficial Collaterals
• Minute Collaterals

The sub-meridian system (superficial channels) has the main functions of maintaining normal function providing for adaptation to changes in the external environment. This adaptation can often occur without the circulation of Qi in the main Meridians being too affected.

There is much disagreement regarding the pathways of the Luo and Tendinomuscular channels. In any case, these channels do not have their own points but share points of the Primary Meridians. The flow of Qi through these channels is affected by needling points on the Principal channels.

Pattern of the Meridian flow direction

The 12 Meridians have lateral and symmetrical distribution on the head, face, trunk and limbs.

• The 6 yin meridians are distributed on the inner side of the limbs and on the chest and abdomen.
• The 6 yang Meridians are distributed on the outer side of the limbs and on the head, face and trunk.

The 12 regular meridians runs in an regular manner: These meridians have their own principles of distribution

1. The 3 Yin Meridians of hand     run from the chest to the hand.
2. The 3 Yang Meridians of hand  run from the hand to the head.
3. The 3 Yang Meridians of Foot  run from the head to the foot.
4. The 3 Yin Meridians of Foot     run from the foot to the abdomen

The order and arrangement of the three yang meridians for both arms and legs are as follows:
a) Yang Ming -- anterior position.
b) Shao Yang -- middle position.
c) Tai Yang -- posterior position.

The order and arrangement of the three yin meridians are as follows:
a) Tai Yin -- anterior position.
b) Jue Yin -- middle position.
c) Shao Yin -- posterior position.


Characteristics of Meridian
 The meridian flow of Qi in the body. The pattern includes exterior towards interior, interior towards exterior, arm towards leg, and leg towards arm, etc.

Exterior towards Interior, Interior towards Exterior. e.g

• The Lung and Large Intestine Meridians are yin and yang organs and have an interior-exterior relationship.

Arm towards Leg, Leg towards Arm.

• The Arm Large Intestine Meridian (Yang Ming) flowing towards the Leg Stomach Meridian (Yang Ming).
  

12 Divergent Meridians

• The 12 Divergent Meridians are the branches which derive from,enter, leave and join the 12 Regular Meridians which, in turn, reach the deeper parts of the body through these branches.

• The Yang Divergent meridians join the Yang regular meridians: the Yin Divergent Meridians connect the interiorly-exteriorly related the Yang Divergent Meridians, thus they are named "Six Confluences".
  

• Strengthen the connections between the Zang and Fu organs by the distribution of branching out from the 12 Regular Meridians.
  
• They bring the 12 Regular Meridians and all parts of the body closer, and extend the scope of indications of the acupoints

The 8 Extra Meridians
The 8 Extra Meridians are the Governor Vessel, Conception Vessel, Thoroughfare Vessel, Belt Vessel, Yin Link Vessel, Yang Link Vessel, Yin Heel Vessel, Yang Heel Vessel. Unlike the 12 Regular Meridians, none of them pertain to the Zang-Fu organs. And they are not exteriorly-interiorly related. Their courses are unique, and hence, they are called extra meridians.

 They contain two main functions.
(1) They can strengthen the relationships among the 12 Regular Meridians. The 8 Extra Meridians communicate with the other meridians which have the related aspects and the similar functions. They assume the responsibility to control, store the Qi and blood of each meridian and regulate Yin and Yang.
(2) The 8 Extra meridians can regulate the Qi and blood of the regular meridians, when the Qi and blood of Zang-Fu organs are vigorous,
 the 8 Extra Meridian can store them; while the body needs them for its activity, they can be supplied by The 8 Extra Meridians.

Acupoints of the Thoroughfare, Belt, Heel and Link Vessels pertain to the Twelve Regular Meridians and the Conception and Governor Vessels. The Conception and the Governor Vessels which have their own acupoints together with the 12 Regular Meridians are called "the Fourteen Meridians". The Fourteen Meridians contain the regular courses, symptoms and their own acupoints, they are main parts of the system of the meridians. They are basic factors for acupuncture treatment and classification of medicinals according to the meridians on which their therapeutic action is manifested.

Application of the Meridian Theory

  The Meridian System is:

1. the process through which our body grows;
2. the explanation how disease continues and develops;
3. the methods by which our body is treated;
4. the place where disease occurs;
5. the concept where philosophy begins,
6. the target where successful outcome should be achieved."

This saying illustrates the importance of the meridian theory in human physiology, pathology, diagnosis and therapeutics in TCM.

Physiological application
"The Meridians move the Qi and Blood. As a result, Yin and Yang get regulated. Tendons and bones get nourished. Joints get facilitated."
Meridians work like a network system, transporting and distributing qi and blood.
They link up organs, limbs, joints, bones, tendons, tissues and skin, and provide communication between the body's interior and exterior.
Through a healthy Meridian System, Qi and Blood successfully warm and nourish different organs and tissues, and maintain normal metabolic activities.
Meridians are essential in supporting the flow of nutritive Qi inside the blood vessels and the flow of protective Qi around them.
Strengthen the body's immunity, protect against external anything evil that causes disease and assist in regulating yin and yang

Pathological application
In Chinese Medicine, the "evils" (pathogenic influences) transform and progress along the meridians to attack the body and cause disease or illness. They are classified in TCM as wind, fire, dampness, dryness, cold and summer heat. Sometimes, the evil travels from one organ to other, but it can proceeds from the exterior to the interior of the body.

Disharmony of one organ can also affect other organs because of their interconnections through the Meridian System. For instance, liver disharmony can influence the stomach, and stomach disharmony can influence the spleen. Moreover, organ disharmony inside the body will show pathological changes along the Meridian channel with which it is associated. For example, liver disharmony can cause lower chest pain, because the liver meridian passes through lower chest region. Kidney disharmony can cause groin pain, because the kidney meridian crosses the groin area. Ulcers on the tip of tongue can suggest heart disharmony since the heart meridian has branches at the tip of tongue.

Diagnostic Application
Because of the special properties of meridians, disharmony and imbalance in the body can be diagnosed according to the meridian and its corresponding organ. Headaches, for example, are classified according to their affected painful spots and the distribution of the meridians in that area. Pain in the forehead indicates a Yang Ming Meridian type headache, while pain in both sides of head indicates a Shao Yang Meridian type headache. Back and neck pain is a Tai Yang Meridian type headache, and pain in the top of head indicates the Jue Yin Meridian type headache. Such specific diagnoses help tailor individual treatment plans allowing for the best outcome for relief of the headache.

Meridian differential diagnosis is essential for both herbal treatment and acupuncture therapy. In TCM, herbal medicines are chosen specifically for treating certain meridians and their corresponding organs. Moreover, some herbs have meridian guiding properties, which help potentiate the therapeutic effects of specific organs and meridians. In this way, meridians allow for an individually tailor-made herbal treatment plan according to a patient's disharmony pattern.

Similarly, understanding meridian selectivity is important for optimal therapeutic outcomes with acupuncture. For example, a headache in the forehead region is diagnosed as Yang Ming Meridian disharmony. Acupuncture points in Arm Yang Ming Meridian such as Hegu (the depression on the dorsum of the hand between the first and second metacarpal bones, at the level of the middle of the second metacarpal bone) can be selected to treat this type of headache. Another common example is a stomach ache (indigestion, dyspepsia). Since the stomach belongs to the Leg Yang Ming Meridian, the corresponding acupuncture point of Zusanli (located: one finger-breadth lateral to the anterior crest of tibia) can be chosen to relieve this pain.

SUMMARY

Jing Luo Function:

• meridians and collaterals belongs to internal organs(Zang-fu) and exteriorly to all the extremities

•  as organic corresponding network between internal organs and body surface.

•  the human body is an organic whole. Meridians and collaterals serve as the route of Qi and blood, Yin and Yang, all of which keep the body in a well-balanced condition.

the Meridian System remains an important and integral part of Traditional Chinese Medicine, and the application of herbal therapies and acupuncture continues to be essential in restoring the balance of health in our bodies.

      1. Observation of Needling Sensation: Acupuncture produces sensation of soreness, numbness, distension or heaviness. This sensation   usually goes to the distal region along a definite pathway.
      2. The Summary of the Therapeutic Effects of Acupoint: The acupoints which have similar clinical effects are regularly lined on the same course.
      3. Reference of the Pathological Phenomenon on the Body Surface: When there appears the disorder in a certain organ, then on the corresponding areas of the body surface appear tenderness, tubercles, skin rash and changes of the skin color, this is also another way of discovering the system of meridians.
      4. Suggestions from knowledge of Anatomy and Physiology:With the help of anatomy. Chinese doctors in ancient times got to know the position, the appearance and some physiological functions of internal organs, and observed the tunnellike and the cordlike structures are distributed over the body and connected with four limbs as well. The phenomenon of the circulation of blood can be seen in same blood vessels.

Knees( both side)and left Elbow joint Pain for 3 years

Case : female 58 ages first visit date :25/09/2009

The patient has suffered from the knees dull pain at both side , left later side elbow for 3 years, she felt very stiffness sensation at night and early morning ,she squat down her leg unsmoothly and pain getting worse when the season change(wind cold) suddenly ,prefer warm massage and 30 minutes light exercise to relieve pain in the morning , left back and waist dull pain ,fixed pain on local area ,she look a pale complexion and difficult to bending of her leg(both) , no swelling , no hot sensation ,she also take 2 tablets of Panadol due to got headache , some prescribe western medicines to treat this syndrome by GP.normal appetite , no chill& fever ,short of breath (a little), sleep time around 6 hours and wake up 1 ~ 2 times during sleep ,yellow urine , defecation is normal , a little bit stress , anxiety from his family , in general , this case diagnosis as Painful Bi syndrome due to some reasons as follows :

• pain of limbs (elbow/knees) is usually caused by invasion of wind , cold , dampness,which occur dull pain , fixed pain due to blood circulation coagulate by pathogenic factor cold and qi and blood stagnation on local area , it fails to nourish the tendons , ligament ,sometime leads to numbness.

• left back and waist dull pain ,fixed pain on local area in relation with yang qi fail to propel and warm up the upper back and waist cause qi and blood stagnation ,

• weak and short of breath (not serious) in movement or exercise pertains to deficiency and cold syndrome
• pale complexion due to decline of qi and blood fail to nourish face
• pale ,thin white coating due to insufficiency of qi and blood fundamental substances
  

My treatment principle aid on disperse wind /cold and promote circulation of qi & blood ,relax and activate tendons ,clear the collaterals to relieve pain, strengthen spleen

Select points & techniques:

• Xiyan : All knee disorders - pain, inflammation
• Heding: knee pain, stiffness, tension.
• Yanglingquan : is the Hui-Meeting Point of the sinews (muscles,ligaments, tendons)
  

• Yinglingquan : he sea & water point of spleen ,to relieve pain in the knee.
• Xuehai : sea of blood to promote circulation of blood ,remove blood stasis
• Lianqiu :xi-cleft point , to treat lateral knee issues.
• Quchi :pain and inflammation, atrophy, tremors - expels wind dampness from the channel.
• Waiguan +Zulingqi : 8 confluent point of Dai mei and Yang-linking channel to promote circulation of qi and blood to stop pain and headache

reinforcing method with TDP

During first treatment she felt some qi movement on local area(both knees) due to apply to TDP (warm and relax tendon ) to alleviate pain , she also have headache but not serious , I do manipulation moderate to strengthen needle sensation at Zulingqi point , she felt electric transmit feeling upward from dorsal of leg, she felt soreness and heaviness of left forearm when needle puncture at Quichi& Waiguan,All apply needles retaining around 40 minutes to promote circulation of qi and blood to relax tendons , collaterals,and channel function ,the patients satisfied with this treatment and also make an appointment after study break , twice per week to my clinical times