extraordinary vessels, with insufficient

information with which to be able to make a

jingluo pattern identification. In the early
days, when TCM texts first entered North
America, the Five Element tradition
developed by J.R. Worsley in Leamington
Spa, England, had graduated some of the
earliest trained practitioners of acupuncture
in North America. This tradition was
brought to the States by Bob Duggan and
Diane Connelly, who founded the
Traditional Acupuncture Institute (TAI) in
affiliation with Worlseys institute, based on
that tradition. I became close with Duggan,
and other faculty from TAI as it was known
then (now TAISophia) and was even a
member of their advisory board at one point.
I taught frequently at TAI, and Bob Duggan
and later Jim McCormick, a classmate of
Duggans from the first Leamington Spa
class, and Lorie Dechar, even later, an early
graduate of TAI, taught at Tri-State (and Jim
and Lorie still do).

Part II: Classical Chinese

Acupuncture-Ordinary
Skills
Reflection Three: Reorganizing
Acupuncture Practice: Starting
with the Ling Shu
THE PROBLEM:
As I have looked closely over the past year or
more at why and how the jingluo filter
teachings at the college have been somewhat
eroded at the college, something I saw in the
practice of students in clinic but could not
quite put my finger on, I realized that I had
followed in the same process articulated by
Maciocia, by allowing the teaching of the
signs and symptoms of the regular meridians
to be supplanted by those of the ZangFu.

I was struck by the difference in focus of their

education, which was highly influenced by
the humanistic psychology movement that
existed in those days and that Duggan and
Connelly and other TAI faculty were
involved with, as compared to the TCM
based education that was becoming the norm
in California schools. Given that I was the
first president of the new council of colleges,
and intimately involved with establishing the
first national board examinations in
acupuncture through the NCCA (now
NCCAOM), I was immersed in debates
about schools of thought and traditions, and
Duggan and I were immediate allies and
fierce defenders of the right to diversity in
acupuncture education, while some of the
California schools were beginning to demand
that the national standard in the United
States be the TCM tradition from the PRC.

Early North American Acupuncture

Practice
As I began writing this Reflection, I scoured
over the earliest books in English that I used
to teach my first students, when textbooks in
English were scarce and the main TCM text
in English was still Outline of Chinese
Acupuncture. In those early PRC texts, there
were only 14 meridians portrayed, with no
classical signs and symptoms from Chapter
10 of the Ling Shu and where disorders were
presented as more or less biomedical
diagnoses with points with no TCM
differentiation or rationale for the points
either, or even a TCM pattern diagnosis in
ZangFu terms. When this PRC text for the
English-speaking world was republished in a
new edition, in around 1981, it did contain
TCM theory, and even a short description
and pictures of the other secondary and

I took on the role of mediating this debate,

between what was being called the 5
Element versus the 8 Principle
perspectives. In those days I developed a

simple way of differentiating one style of

practice and practitioner from another by
simply paying attention to which of the main
diagnostic filters each style, or practitioner,
privileged over others that may have been
shortchanged, or even ignored altogether.
What became clear was that practitioners of
the 5 element tradition of Worsleys used
the 5 element filter far more frequently than
the YinYang filter (which they resorted to just
to differentiate between excess and deficiency
conditions, and to perform tonification and
dispersal needling techniques) whereas 8
principle advocates expanded the YinYang
filter to include far more detail about signs of
Hot and Cold, Internal and External, and
even Yin and Yang patterns. As for the Qi,
Blood, Fluids, Shen and Essence filter as it
was often referred to in those days (before
Shen disappeared from TCM discussions as a
way of assessing signs and symptoms in a
diagnostic process), the 5 element
practitioners talked extensively about Shen,
( given that Worsley reordered the regular
meridian system to start with the Heart,
rather than the Lung which controls Qi and
its movement as in all classical and modern
Chinese and Japanese textsbecause the
Heart stores the Spirit-Mind), but gave little
mention of Blood or Fluids. Conversely, 8
principle practitioners of what soon became
referred to as TCM acupuncture talked far
less about Qi or Shen, and spoke in great
detail about Blood, and of the thin and the
thick fluids, phlegm and Fire.

ZangFu pattern identification, and

differentiation of Qi, Blood and Fluids to
differentiate signs and symptoms of disease.
What neither approach contained, which
situated what I was trying to do at the TriState College of Acupuncture in yet a third
position, was the jingluo filter which taught
how to regulate Yin and Yang by means of
appropriate use of treatment strategies from
the regular meridianswhere 5 element
strategies were just one option among others,
as well as from the secondary (especially luo
and tendinomuscular meridians) and
extraordinary vessels which these two main
approaches seemed to not make use of at all.
In this process, I became so involved in these
debates, and invited to teach was most
different about the French meridian
traditions I had studied at other AOM
colleges, that I focused most heavily on
teaching the secondary and 8 extraordinary
vessels, and allowed the regular meridians,
and the principal foundation for the jingluo
filter, to slip away and be replaced little by
little, by TCM textual explanations. The only
solution which it took me over two decades
to realize was to return to the Ling Shu, and
especially to Chapter 10 where regular
meridian pattern identification, from a
jingluo filter perspective, is laid out clearly.

Circuit-Needling
There are three detailed clinical discussions
in English of the Ling Shu, by Yitian Ni,
Shudo Denmei and Zhao and Jun Wang.
Giovanni Maciocias ambitious The Channels
of Acupuncture must also be mentioned as an
academic resource with useful charts, but the
repetitive and at times over indulgent nature
of the presentation makes it very difficult as a
clinical text, which for instance hopelessly
confuses any attempt at understanding the
luo collateral, muscle channel, Cou Li layer,
cutaneous regions and minute luo vessels and
luo regions. Also, owing to an unfortunate

Finally, what both approaches had in

common, much to their surprise, was that
they centered their teaching and practice
around ZangFu pattern identification: the 5
element practitioners preferring to focus
more on the psychoemotional aspect of the
12 officials rather than on their visceral
functions and disease signs and symptoms,
while TCM practitioners of acupuncture
ignored to a greater or lesser extent the
emotional side which did appear in the
classics as we saw in last months Reflection,
focusing more strictly on the TCM detailed

dismissal of organ interior symptoms as part

of regular meridian differentiation (in favor
of TCM Zang Fu pattern differentiation as
shared in last months Reflection Two), and
an alarming misunderstanding about the
critical role of ashi points and palpation for
actual tender points versus favorite textbook
points for muscle channel problems, I am
lead to question whether Maciocia practices
the acupuncture that he preaches in this
unwieldy tome. Useful as background and
additional reading for the initiated
acupuncture educator or practitioner, it is
misleading and confusing as a foundational,
or clinical text for students or neophytes to
the jingluo approach.

and symptoms of channel versus organ

disorders, which derive from her vast clinical
experience and other texts listed in her
bibliography.
Based on this approach, if one knows the
basic signs and symptoms of the main or
regular channels, it is easy to then reference
the list of external, channel disorders
versus internal, associated organ disorders,
and then move to the clinical application
section where she discusses the use of the
main points from the meridian in question,
in order of importance, and point
combinations with other regular, secondary
and extraordinary channel points. She even
has an index of symptoms in the back of her
book, taking one to the pages where such
point combinations are discussed with
specific disorders of the various systems of
the body.

What is clear in studying the Ling Shu in

these texts is that they are focused on what
Paul Unschuld refers to as circuit-needling
with the palpation phase of the four
examinations focused on points, and arterial
pulses, throughout the body as opposed to
diagnosis of the meridians via the sole wrist
pulses, as advanced for the first time in the
Nan-Ching. Unschuld stresses that the interest
in the Nan-Ching remained restricted to
theoretical discussions and the practice of
pulse diagnosis. Actual clinical practice in
traditional Chinese medicine hardly followed
the conceptual stringency of this text, and
of the doctrines of systematic
correspondence or of pulse diagnosis at the
wrist as the sole means of assessment of
meridian circulation, Unschuld clarifies,
concluding on this point: Therapeutic
practicethat is, circuit-needlingcontinued
along the lines dictated by experience, not
theory ( NanChing: The Classic of Difficult
Issues translated and annotated by Paul U.
Unschuld, University of California Press,
1986, pp. 40-41).

She does not, however, discuss the point

strategies she uses, so a careful study is in
order to recognize, for example, that her
favorite distal points for the regular Lung
channel are the Luo point (Lu 7), the Source
point (Lu 9), and the He-Sea point (Lu 5),
and her favorite local points, Lu 1, the Mu
point. A useful exercise for anyone interested
in gaining a deeper appreciation for regular
channel pattern identification, and secondary
vessel and extraordinary channel
differentiation would be to take each channel
one by one, and analyze the point strategies
of the points Dr. Navigating lists for recurrent
strategic patterns.
Regarding the use of local meridian points
Dr. Ni stresses in her introduction that any
local point from a meridian may be used to
treat local symptoms in the area of that
point, a primary principle of circuitneedling and meridian palpation as used
extensively in APM.

In Dr. Yitian Nis text, Navigating the

Channels of Traditional Chinese Medicine she
presents a summary of channel pathology
from Chapter 10 of the LingShu which is
fairly complete, which TCM has left out, and
then detailed lists of disorders and their signs

Wang Manuscripts and Chapter 10 from the

LingShu. This presentation seems the closest
to the original that is available in English.

A Japanese Meridian Approach

In Shudo Denmeis text, translated into
English by Stephen Brown as Japanese
Classical Acupuncture-- Introduction to
MERIDIAN THERAPY, there is a detailed
discussion of the symptomology of the twelve
meridians, as this is often termed, as well as
the five Yin organs. Shudo starts this study
with the statement that symptomology of
the yin organs implies pathology of the yin
aspect. The Li-Zhu school of Chinese
medicine holds that the yin always tends
toward deficiency, and the yang toward
excess and regarded the Spleen and
Stomach, and the middle burner to be the
most important focus of middle burner
warming treatment (ibid, p108).

Shudo begins by citing two phrases from the

Ling Shu, which were poorly understood until
the discovery of those earlier documents.
These phrases, which appear in Chapter 10
of the LingShu are: when disturbed, disease
occurs (shi dong ze bing) and when giving rise
to disease (shuo sheng bing). These two
phrases are the way in which regular
meridian symptoms are presented in Ling Shu
Chapter 10: when disturbed, disease occurs
refers to an external disruption in meridian
Qi (channel symptoms) which can be treated
by treating the meridians involved; when
giving rise to disease, on the other hand,
refers to internal conditions where channel
Qi disruption progresses beyond a certain
point [and involves the organs] (Ibid, p. 112,
citing Kuwahara, 1976). These concepts are
discussed in Chapter 22 of the Nanjing
where when giving rise to disease(sousheng)
denotes a disorder at the level of Blood, as
clarified in a private communication with
Stephen Brown regarding his translation
above.

Shudo adds that the meridian therapy

schools of thought in Japan define this
hypothesis as follows: the yin organs and
meridians have a tendency to become
deficient, and the yang organs and meridians
to develop excessive conditions (ibid).
Shudo Sensei continues by presenting the
signs and symptoms for the five yin organs
(Pericardium is deleted), from the Su Wen
and the Nan-Ching Japanese translations.
Certain symptoms from the Su Wen are
deleted in the Nan-Ching version. Shudo
concludes that as for the yang organs, there is
much less discussion in the classics, and their
signs and symptoms resemble those for
diseases of the same organs in modern
medicine (ibid, p. 110). For these symptoms,
he cites Chapter 4 of the LingShu.

In Wang and Wangs text, there is a careful if

sometimes rigid reading of the Ling Shu
reorganized so as to allow for a clinical
approachLing Shu Acupuncture. In their
presentation, which unfortunately repeatedly
claims to represent the true and correct
acupuncture, with everything that came in
later classics and modern TCM as
aberrations, the organization of the
discussion is immediately clinical: Diagnosis
by Comparing Renying and Cunkou (carotid
and radial artery) pulses for regular meridian
dysfunction; the entire jingluo filter (regular
meridians and secondary collaterals, finishing
with 8 extraordinary meridians and the
relationship between meridians and Zang-Fu
organs; the muscle and cutaneous regions;
acupoints; acupuncture techniques and
contraindications. There are very useful
charts and diagrams throughout, with a

Shudo then lists the symptomology for the

twelve regular meridians. He cites the
discovery of the Ma Wang Tui manuscripts
in 1973, which are thought to be a few
centuries older than the Yellow Emperors Inner
Classic (Huang Di Nei-Ching) comprised of the
Su Wen and the LingShu. As he presents the
signs and symptoms for the twelve regular
meridians, then, Shudo cites both the Ma

detailed list in chart form of the regular

meridians (pp. 90-92) from Chapter 10 of the
Ling Shu and translation of the Su Wen
Chapter 22 on the ZangFu organs (p. 164).
They do, however, following PRC/TCM
texts, almost completely eliminate the role of
the emotions and any discussion of Shen.

I will break out these two sets of symptoms,

for clarity, as well as the last set of symptoms
that relate to excess and deficiency of Qi. I
refer the reader to Shudos text for the more
detailed comparison of the Ma Wang Tui
manuscript symptoms, compared to those in
Chapter 10 of the LingShu (ibid, pp. 113-126.
The reader is also referred to Shudos
description of disorders of the sense organs
and parts of the body, which are very useful
clinically (ibid, pp. 126-132) and a similar
discussion in Maciocias text cited above
(ibid, p. 98) which are commonly learned in
any acupuncture tradition.

Regular Meridian Pattern Identification

Following are the S&S of the Arm Taiyin
Lung Meridian as an example of Chapter 10,
(as cited in Shudo Denmeis text, pp. 113126; see also his detailed and excellent
discussions of each set of signs and
symptoms. Also see Nis text, pp. 17-103 for
her detailed clinical applications).

Let us follow Shudo and the translation he

used for the arm Taiyin Lung Meridian:
Arm Taiyin Lung Meridian

Shudo Denmei begins his study of Chapter

10 by shedding light on the terms used to
differentiate between disorders affecting the
meridian only (exterior), and those where the
disorder has moved deeper to include the
associated organ as above, which bears
repeating in Shudos own words.

M eridian (Exterior) S&S:

When disturbed, disease occurs:
Distention and fullness of the lungs, wheezing,
coughing, pain in the supraclavicular fossa. When
severe, arms folded over the chest (while catching
ones breath) and blurred vision.

This clarification was made possible when

scholars compared the Ling Shu to the earlier
Ma Wang Tui burial site manuscripts known
as the Moxibustion Classic. Based on this
comparison, the meaning of two critical
terms--When disturbed, disease occurs (shi
dong ze bing ) and When giving rise to
disease ( suo sheng bing ) was elucidated:

Organ (Interior) S&S:

When giving rise to disease:
Heat in the face, wheezing, coughing, dry throat,
irritability and fullness in the chest, pain along the
channel, depletion, and heat in the palms.

When disturbed, disease occurs refers to

abnormal conditions arising when the
meridian [Qi] is disrupted, and the progress
of this disturbance can be checked by treating
the meridian involvedWhen giving rise to
disease refers to conditions in which the
disruption [of Qi] in the meridian progresses
beyond a certain point [and involves the
organs] (Ibid, p.112, citing Kuwahara,
1976).

Excess and Deficiency:

When the Qi is excessive:
Pain in shoulders and intrascapular region,
sweating from wind-cold, frequent urination and
yawning from wind.

When the Qi is deficient:

Pain and coldness in the shoulders and

intrascapular region, shortness of breath, inability
to take in deep breath, urine color change.

one sees in observing the body surface and

patients structure and bearing.
In refining this teaching, which I inherited
from the Quebec Institute of Acupuncture
and especially from its French-Vietnamese
influence via Chamrault and Van Nghis
texts and teachings, I followed these two
French authors in their celebrated
Lenergetique humaine where they discussed
the jingluo filter in three successive chapters,
Wei, Ying and Jing, facilitating an
understanding and clinical use of these
classical treatment strategies:

Internalizing Jingluo Symptomology

In his always pragmatic fashion, Shudo
Denmei shares the difficulty he experienced
in attempting to just commit to memory such
symptoms, stating that he drew in the
location of all the symptoms on a figure of
the body, and marked them with a simple
notation for easy reference (p. 113).
Another useful tool, he suggests, and then
supplies in his book, is a chart of symptoms
organized by body region. Dr. Ni, on the
other hand, provides charts that further
differentiate and list symptoms of the
Channel as opposed to the Organ. She then
lists clinical applications such as exterior
syndrome, immuno-deficiency, respiratory
disorders, nose and throat disorders etcetera,
with her point palette of lung meridian
points in order of importance in her
experience and based on classical sources.
She concludes with point combination with
points from other channels, and lists an
index of symptoms in the back of the book
that bring the reader back to these charts.

Making the effort myself to learn the classical

symptoms of the regular meridians,
secondary vessels and extraordinary vessels,
which make up the jingluo filter, as I first
started translating and teaching from Van
Nghi, I quickly realized that I could not
retain the information unless I combined it
with palpation of distal and local points from
these pathways during the palpation aspect of
the four examinations.
I found it essential from the beginning to
resist an overly academic study of the
meridian system, and to focus instead on
internalizing and embodying a tacit feel for
each aspect of this system based on what one
feels underneath ones fingertips, and what

W ei level treatment refers to the

strategies for the muscle channels
and cutaneous regions for myofascial
disorders, which I refer to as surface
energetics.
Ying level treatment is the nutritive
Qi level, the level that promotes
Grain Qi, and refers to the
strategies for the regular meridians
and their associated organs, which I
refer to as functional energetics.
Jing level treatment refers to the
strategies for the 8 extraordinary
vessels, mobilized according to Van
Nghis teachings, when the regular
meridians/organs are under assault
such that two or more
meridians/organs are targeted. This
is a very modern reading, perhaps
influenced by Hans Selyes theory of
the stress response, and his General
Adaption Syndrome. In this model,
the GAS enables a small group of
internal functions to mount the
defensive against unabated external
stressors, in order to protect the
majority of internal organ functions
and structures from this onslaught.
In the French-Vietnamese teachings
perspective influenced by Van Nghi,
it is the role of the extraordinary
vessels to become operational in
order to protect the 12 regular
meridians/organs. I developed a set

of 4 adrenal/stress patterns to map

out protocols for using the
extraordinary vessels in such chronic
stress disorders, as shared in last
months Reflection, based on these
teachings, in my Acupuncture Physical
Medicine (pp. 85-120) as I shared in
chart form in last months
Reflection.

to the neck, chest, or upper back, abdomen

or mid and lower back, upper legs, lower legs
and foot to the toe, where it transforms into
its foot Yin meridian pair, then flowing back
up the inner Yin aspect of the foot, lower leg,
upper leg, front of the torso, making a
descent deep in to the Sea of Blood and Qi
again, and then starting all over in this semiclosed loop fashion, carrying Qi and Blood
(oxygenated blood) to all areas of the body,
carrying back deoxygenated blood, renewing
itself with a fresh supply of nutritive Qi with
each circuit loop.

The 12 Regular Meridian Circuits

When teaching the 12 regular meridians
(jingmai) it is essential to recognize the way in
which they are comprised of three circuits of
four meridians each that follow a parallel
almost closed-circuit flow: from deep in the
Sea of Qi and Blood of the interior, and the
associated yin Organ (Zang), a circuit begins
by exiting on the upper chest, next flowing
down the inner arm (Yin aspect) to the
finger; then transforms into its Yang paired
meridian and flows up a parallel pathway on
the dorsal, outer arm (Yang aspect) to the
shoulder, neck, face and head; where it meets
its Lower/Upper connected Yang meridian
of the same name to flow down from the face

Regular Meridian Symptomology:

Below I will present the signs and symptoms
of the 12 regular meridians as three circuits
in this way, as another way of aiding in
internalizing and embodying this data for
ready clinical access, integrating signs and
symptoms from Shudo and Nis
presentations, based on the Ling Shu.

TAIYIN/YANGMING CIRCUIT Regular Meridian (Jing Mai) Pattern

Differentiation

Body Area Signs

& Symptoms

Face,

Hand Taiyin/
Lung

Hand
Yangming/
Large Intestine

Foot Yangming/
Stomach

Foot
Taiyin/Spleen

Flushing

Toothache,
swollen cheeks,
yellow eyes, dry
mouth,
nosebleed,
swollen
throat/thirst

Facial pain, ashen

complexion, hot
face, nose bleed,
nasal congestion,
cervical neck
pain, skin rashes
around mouth,
swollen painful
throat,
submandibular
pain
Perspires easily,
warm diseases,
whole body
chilled as if
doused by water,
frequent
stretching and
yawning
Breast pain, heart
pain (ST 18-15),
flank pain (SP
21), front of body
hot

Root of tongue
rigid, jaundice

Borborygmus,
edema/distention
due to cold,
Abdominal
discomfort,
constant hunger,
ascites, area hot
or cold, pain in

Nausea from
eating, stomach
pain, belching,
passing gas and
defecating
brings great
relief, diarrhea
with mucous

Head,
Neck
Throat

Dry throat

General

Yawning,
sweating & pain
from wind-cold

Violent
shivering from
cold, inability to
warm up

Shortness of
breath, irritable
breathing,
cough,
wheezing,
fullness of chest,
hugs oneself
while shivering,

No organ S&S

Gastric pain

No Organ S&S

CardioRespiratory,
Chest/Upper
Back

Gastrointestinal,
Abdomen

Vertigo

Whole body
heavy

Chest irritability

Genito-urinary,
Gynecological,
Reproductive,
Lower Back

Frequent
urination

No Organ S&S

intestines

and blood

Yellow urine,
pain in lower
abdomen (ST 2630)

Scanty urine

channels

Heat in the
palms, pain
along channels,
esp. LU 3-10

Heat, swelling
and pain LI 1215; index finger
dysfunction

Pain along
channel (ST 3243), rigidity of
knee, middle toe
dysfunction

Mental Signs &

Symptoms *

Obsessions that
are future
directed, feels
vulnerable

Mental
confusion,
defective
elimination of
ideas,
stubbornness,
complacency in
being wrong,
rigid thinking,
distressed by
cold

LU 7-luo
LU 9 source
LU 6 cleft
LU 5-dispersal
Lu 3-4 window
to sky
Lu 1-2/SP 20Taiyin union

LI 2 dispersal
LI 4-source
LI 6-luo for
Toothache

Aversion to
people and fire,
rapid heart beat,
shuts oneself in
when frightened,
prone to mania,
singing, disrobing
and running
about,
depression, death
wishes, mentally
overwrought,
mentally slow
ST 44-43 ashi for
heat/Xu Li
ST 36, 37, 39lower Sea points
ST 40-luo

Point Palette

ST 25-LI/ST
union
ST 18/xu li heart
pain/heart burn,
Stomach Fire

Lower abdomen
and extremities
heavy, medial
thigh and knew
swollen, chilling
and numbness
along SP
channel of calf,
big toe
dysfunction
Mental
sluggishness,
melancholia,
obsessive
thoughts of the
past, fixed and
rigid ideas,
sleepwalking,
agitated sleep,
nightmares

SP 3- source
SP 2-tonification
SP 2&3-ying
and shu
SP 4- luo
SP 5-dispersal
SP 6- three leg
Yin
SP 8-cleft
SP 9-Sea
SP 10-Blood
SP 21-Great Luo
SP 20/Lu 1Taiyin union

Associated
channel points

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Points from LI,

ST, SP channels
for circuit

Points from ST,

LU, SP channels
for circuit

Points from LI,

SP, LU for circuit

Points from ST,

LI, LU for
circuit

(* Cf. Seem, citing Faubert, Acupuncture Imaging pages 27-28. These charts are derived from Shudo Denmei, with
information from Ni, Seem, Faubert.)

We used to see the late Dr. Ki Min Kim, a

master Korean constitutional acupuncture
practitioner after whom the Tri-State College
of Acupuncture Library is named, do this
carotid/radial diagnosis, and root treatment
based on this chapter of the classic text, using
the Five Phase 4 needle technique
strategies as the base, followed by careful
dispersal of local excess, constrained and
stagnant points/pathways.

Regular Meridian Treatment

In the Ling Shu Chapter 9, treatment of the
regular meridians is presented thus:
1] If Spleen is deficient, Stomach is excess
(carotid pulse four times stronger than radial
pulse): tonify Spleen with one needle;
disperse ST with 2 needles. If carotid pulse is
restless, disperse Large Intestine (for
circuit).

Regular Meridian Disorders for this

Circuit from Dr. Ni

While the actual points are not indicated in

this chapter, chapter One stresses needling
the source point for yin meridians, and a
later chapter suggests needling the ying
(spring) and shu (stream) points for disorders
of yin of yin. Dispersal points for Yang
meridians could be dispersal points
themselves, luo points, jing-well points, he-sea
points, xi-cleft points for acute disorders, or
fire points. So one could tonify Sp 2 or 3, or
both, and disperse ST 40 and ST 36 for
example, and disperse LI 2 and LI 5.

Note:
Any point on a regular meridian may be used
as a local point for signs and symptoms in
that area on that meridian.
A] Hand Taiyin Lung meridian
Exterior syndromes, the cold or flu; allergies
with sneezing and itchy eyes and nose;
immuno-deficiency/frequent colds, low
energy, cold hands and feet, CFIDS, chronic
diseases; respiratory disorders with cough,
asthma, breathing difficulties; nose and
throat disorders, rhinitis, sinusitis,
pharyngitis, laryngitis, tonsillitis; edema,
enuresis, retention of urine or urinary
difficulty; diarrhea, constipation,
hemorrhoids; GERD; sinus(ST 2-3), temporal
(ST 7-8), Occipital headaches (all treated by
LU 7); sighing, mental distress, weeping,
grief; Bi syndrome along muscle channel.

If the reverse is true, with radial pulses

stronger than carotid, this is Yin
meridian/organ excess:
2] If Spleen is excess (radial four times
stronger than carotid): disperse Spleen with
one needle (Sp 5 for example); tonify
Stomach with 2 needles (ST 38
Fire/Tonification Pt and ST 36). If radial
pulse is restless, disperse Lung meridian
(Lu 10 or Lu 5 for example for the circuit as
above).

10

B] Hand Yangming Large Intestine

meridian:

Deficiency or excess digestive disorders as for

stomach; edema, heavy sensation of face,
head, whole body; post-prandial fatigue;
dampness disorders and s&s; high
cholesterol; obesity; atherosclerosis; masses
and nodules; Qi & Blood deficiency; Spleen
Qi sinking with prolapses, dizziness, vertigo,
lightheadedness; constant worry, low spirits,
difficulty concentrating, poor memory,
depression, palpitations; Bi syndrome along
channel; wei syndrome with whole body
atrophy and flaccidity, especially of lower
body and extremities.

Toothache; Yangming headache; facial

paralysis, trigeminal neuralgia and TMJ (ST
5-8); rhinitis, sinusitis (LI 20-ST 2);
Nosebleed; sore throat and vocal cord
disorders, thyroid disorders; diarrhea, facial
edema, sweating/ dry mouth, throat, stool,
concentrated urine, dry skin); yang ming
febrile disorders; rashes, eczema, boils,
psoriasis; abdominal pain, epigastric pain,
nausea, vomiting, belching, cough, asthma,
chest pain; lassitude, spontaneous sweating,
low immunity; Bi syndrome along muscle
channel.

Personality Patterns
For a detailed summary of J.R. Worsleys
depiction of the 5 Element personality types,
and Dr. Yves Requenas 8 Temperaments,
see my Bodymind Energetics, pages 85-107.
While character typing is described in the
classic texts, I caution against taking such
depictions of complex human beings too
literally. With that caution, and with the
realization that a person may exhibit
characteristics from more then one
temperament or type, such information is
useful in providing practitioners with
another lens through which to view the
people who seek their help. One can also
juxtapose the emotional (shen) signs and
symptoms presented in chart form from
chapter 8 of the Ling Shu from last months
Reflection to further narrow down the
specific meridian-organ system or systems
involved within a circuit. This applies to the
next two circuits as well.

C] Foot Yangming Stomach meridian:

Excess and deficient digestive disorders with
excess hunger or poor appetite, burning
sensation or cold sensation in the stomach,
and in either case epigastric pain, abdominal
fullness, distention, diarrhea constipation;
yangming headache, sinusitis, rhinitis, stuffy
nose, nose bleeds; sore, swollen throat, gums,
toothache; facial paralysis, trigeminal
neuralgia, TMJ; yangming febrile syndrome;
general lassitude, sallow complexion,
spontaneous sweating, palpitations; stomach
fire; violent or withdrawn behavior (mania or
depression); swollen, painful, cystic breasts;
Bi syndrome along channel el; wei syndrome
with whole body weakness and atrophy of the
muscles.

D] Foot Taiyin Spleen meridian:

11

SHAOYIN/TAIYANG CIRCUIT Regular Meridian (Jing Mai) Pattern

Differentiation

Body Area Signs

& Symptoms

Face,

Hand Shaoyin/
Heart

Hand Taiyang/
Small Intestine

Foot Taiyang/
Bladder

Foot
Shaoyin/Kidney

Yellow eyes,

Yellow eyes,
hearing loss,
swollen cheeks,
submandibular
swelling, neck
pain, sore throat

Yellow eyes, eyes

tearing, eye pain
as if popping
out, vertex
headache,
occipital
headache, nape
of neck pain,
nose bleed

Yellow eyes,
dizziness,
blurred vision,
jaundice,
flushed face,
dark comlexion,
dry tongue, hot
mouth, dry and
sore throat,
hoarseness,
appears as if
about to be
captured

Head,
Neck
Throat

Dry throat

General

No desire to
drink

CardioRespiratory,
Chest/Upper
Back,

Heart pain

Alternating
chills and fever,
epilepsy,
derangement,

Intense
posterior
shoulder and
arm pain (SI 814) as if broken,
inability to turn
neck (stiffness at
SI-14-17)
Arm and hand
pain (SI 8-4)

Hand
channels

Arm pain (heart

3-7), heat in
palms

12

Thoracic back
pain

Wheezing,
cough, coughing
up blood, heart
pain, irritability

Gastrointestinal,

Hypochondriac
region pain

Mid back pain

Abdomen

Genito-urinary,
Gynecological,
Reproductive,
Lower Back,

Hunger but no
desire to eat,
watery diarrhea

Hemorrhoids,
Lumbar pain,
gluteal area pain

Foot channels

Tight popliteal
fossa, hip joint
pain and
inability to
bend, pain in
calves as if torn,
little toe
dysfunction

Lumbar spine
pain, inner
thigh pain, Pain
and cold along
leg channel (Kid
9-11, pain and
heat in the soles

Mental Signs &

Symptoms *

All shen
disturbances,
insomnia,
anxiety

Poor mental
assimilation,
insecurity,

Changeable
moods, overenthusiasm,
suspicion,
jealousy, lack of
confidence,
lassitude

Anxiety, pain in
the pit of the
stomach,
sadness, physical
and mental
fatigue,
antisocial
tendencies,
laziness

Point Palette

HT 8- fire
HT 7-source
HT 7&8-ying
and shu
HT 5-luo
HT 6-cleft
HT 3 (Sea)

SI 2-water
SI 3-tonfication
SI 4 source
SI 5-wrist
SI 6-cleft
SI 7-luo
SI 8 Sea
SI 9-14-ashi

Bl 67tonification
BL 65-dispersal
BL 64-source
BL 58-luo
BL 40-Sea
Back Shu Points

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Kid 3-source
Kid 2-fire
Kid 2&3-ying
and shu
Kid 4-luo
Kid 1-dispersal
Kid 7-tonify
Kid 10-Sea
Kid 15.5adrenals
Local for S&S
Ashi for pain

From SI, Kid, Bl

for circuit

From HT, BL,

Kid for circuit

From Kid, SI,

HT for circuit

From Bl, Ht, SI

For circuit

HT 1 and 2

Associated
channel points

13

Treatment of Regular Meridians

and costochondritis/non-cardiac chest and

upper back muscle pain.

In Chapter 9 of Ling Shu:

B] Hand Taiyang Small Intestine meridian:

1] If Kidney is deficient, Bladder is excess

(carotid pulse three times stronger than
radial pulse): tonify Kidney with one needle
(Kid 7 for example); disperse BL with 2
needles (Bl 58 and BL 65 for example). If
carotid pulse is restless, disperse Small
Intestine (SI 1 and SI 6 for example) for the
circuit.

Occipital headache, deafness, earache,

tinnitus; red, swollen, painful inner and
outer canthi of eyes, blurry vision, excessive
tearing, yellow sclera; mouth and tongue
sores and ulcers, toothache; swelling and
pain of cheeks, lymph glands, parotid glands,
TMJ syndrome; cold and flu, allergies; febrile
diseases with yellow urine and night sweats;
edema, retention of urine, painful and yellow
urination; diarrhea, indigestion, stomach
pain, abdominal pain and distention,
constipation; pain of lower lateral abdomen
referring to back and testicles, as with
inguinal hernia, epididymitis, urethral stones,
ovarian cysts; Bi syndrome, pain along
muscle channel (scapula & posterior
shoulder from SI 14-9, elbow near SI 8,
forearm near SI 7-6, wrist near SI 5-4 and
little finger dysfunction.

2] If Kidney is excess, Bladder is deficient

(radial pulse is three times stronger than
carotid): disperse Kidney (Kid 1 for example)
with one needle; tonify BL with 2 needles (Bl
67 and 60 for example). If radial pulse is
restless, disperse Heart (Ht 9 and 8 for
example) for the circuit.

Regular Meridian Disorders for this

Circuit from Dr. Ni
Note:

C] Foot Taiyang Bladder meridian:

Any point on a regular meridian may be used

as a local point for signs and symptoms on
that meridian.

Cold, flu, allergies; occipital headache; eye

disorders with tearing and pain; rhinitis,
sinusitis, nose bleed; urogenital,
gynecological and male reproductive
disorders; disorders of any ZangFu especially
when chronic or deficient treated via the
Back-Shu points (combined with Front-Mu
points); mania, depression, epilepsy,
schizophrenia; emotional disorders of any
organ, treated with second line of Bladder
meridian; Bi syndrome and pain affecting
muscles, tendons, ligaments and joints
throughout nape of neck, upper, middle,
lower back, sacrum and hips, hamstrings,
posterior calves and heels, little toe
dysfunction; acute or traumatic in jury to
neck, back, lumbar region, spine, lower
extremities

A] Hand Shaoyin Heart meridian:

Heart and Lung disorders like cardiac pain
and palpitations, arrhythmia, shortness of
breath, cold extremities, sweating, red, purple
or pale complexion; heat syndromes with
whole body hot, dry mouth, red face, hot
flashes, tongue ulcers, boils; red, painful,
swollen eyes; mania, depression, fainting,
schizophrenia, anxiety, hysteria, mood
swings, laughing or crying without apparent
reason, nervousness, restlessness, insomnia,
scattered thinking; severe pain or spasm of
internal organs, post-traumatic or postsurgical pain, cancer pain; skin rashes,
itching, pain; pain along channel (Ht 1-8)

14

D] Foot Shaoyin Kidney meridian:

spinal column, degenerative disorders of

bones and joints; wei syndrome with cold,
pain or heat in the soles.

Kidney deficiency with fatigue, low back

pain, pain along spinal column, muscular
atrophy; deafness, tinnitus, chronic tooth,
gum and throat disorders; poor memory,
forgetfulness; hair loss; deficient yin and yang
signs and symptoms; Kidney and Bladder
disorders with edema, facial puffiness,
impotence, infertility; treated for chronic
disorders of the other ZangFu; channel
deficiency and Bi syndrome with pain and
weakness of the lower back, hip and knee,

Personality Patterns
See discussion under the first circuit above.

15

JUEYIN/SHAOYANG CIRCUIT Regular Meridian (Jing Mai) Pattern

Differentiation

Body Area Signs

& Symptoms

Face,

Hand Jueyin/
Pericardium

Hand
Shaoyang/
Triple Heater

Foot Shaoyang/
Gallbladder

Foot Jueyin/
Liver

Yellow eyes, red

complexion

Hearing loss,
retro-auricular
pain, outer
canthus and
cheek pain,
tinnitus, swollen
sore throat

Dull, lusterless
complexion,
headache, outer
canthus pain,
bitter taste,
submandibular
pain,
supraclavicuar
pain (GB 21)

Dull, lusterless
complexion, dry
throat

Constant
laughing

Sweating

Excessive
sweating, chills
and shivering,
repeated sighing

Heart pain,
severe
palpitations,
distention of
chest, axillary
swelling

Posterior
shoulder pain
(TH 15)

Maxillary pain,
chest pain,
breast pain,
hypochondriac
region pain (GB
22-24), difficulty
moving torso
(GB24-Liv 14
stiffness)

Contraction and
pain in elbow
and forearm
(Per 3-6), heat in
palms

Posterior arm,
elbow, wrist,
hand pain (TH
14-3), ring finger
dysfunction

Head,
Neck
Throat

General

CardioRespiratory,
Chest/Upper
Back,

Hand
channels

Gastrointestinal,

Distended sub
costal region

Vomiting

Abdomen

Distention in
chest and
hypochondriac
region

16

Genitor-urinary,
Gynecological,
Reproductive,
Lower Back,
Foot channels

Mental Signs &

Symptoms *

Point Palette

Associated
channel points

Depression,
sexual
perversion,
aversions,
phobias

Per 8-fire
Per 7-source
Per 7&8-ying
and shu
Per 6-luo
Per 4-cleft
Per 3-Sea
Per 1-2-heart
and breast pain

Emotional upset
at family/friend
breakups,
depression,
suspicion,
anxiety, poor
elimination of
harmful
thoughts
TH 3tonification
TH 4-source
TH 5-luo
TH 7-cleft
TH 10-dispersal

Hip, lateral
thigh, knee,
ankle, and foot
pain (GB 30-40),
heat in ankles
and feet,
aversion of foot,
4th toe
dysfunction
Bitterness, lack
of control,
irritability,
unfaithfulness,
lack of courage,
timidity,
hypochondria

Diarrhea with
undigested food,
inguinal hernia,
scanty or
dribbling urine,
swollen
scrotum,
Shan, pelvic
pain, lower back
pain, inability to
bend forwards
or backwards,
Liv 5-6 nodules
Irritability,
anger, difficulty
developing
ideas,
depression, lack
of energy

TH 17, 21-23ears/tinnitus

GB 41-dai mai
GB 40-source
GB 38fire/dispersal
GB 34Sea/tonification
GB 36-cleft
GB 26-daimai
GB 24-mu

Liv 3-source
Liv 2fire/dispersal
Liv 2&3-ying
and shu
Liv 5-luo
Liv 6-cleft
Liv 8-he-sea/
tonification

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

Local for S&S

Ashi for pain

From TH, Liv,

GB for circuit

From Per, GB,

Liv for circuit

From Liv, TH,

Per for circuit

From GB, Per,

TH for circuit

17

hand and foot spasms; stiffness of the nape

of the neck, chest and hypochondriac
regions.

Treatment of Regular Meridians

In Chapter 9 of the Ling Shu:

B] Hand Shaoyang Triple Heater meridian:

Fluid disorders, edema, puffiness, enuresis,
retention of urine, frequent urination; upper
heater disorders like chest pain, palpitations,
cough; middle heater disorders like epigastric
pain, nausea and vomiting; lower heater
disorders like lower abdominal distention,
fullness, diarrhea, constipation; endocrine
and lymphatic disorders like hypo or
hyperthyroidism, diabetes, swollen glands;
high lipid levels, fibroids, masses, tumors;
channel disorders including shaoyang
syndrome with chills and fever; channel
disorders affecting the sense organs like
migraine headache, ear pain, deafness,
blocked feeling in ears, tinnitus, cheek and
face pain along course of channel including
TMJ syndrome and toothache, swollen
glands, sore throat, pain in the mandible and
around the ears, purely channel Bi syndrome
pain with difficulty laterally flexing the neck
and pain down medial deltoid, upper arm,
elbow and forearm to top of hand, ring
finger dysfunction.

1] If Liver is deficient, Gallbladder is excess

(carotid pulse twice as strong as radial pulse):
tonify Liver with one needle (Liv 3 or Liv 8
for example) disperse GB with 2 needles (GB
38 and GB 34 for example). If the carotid
pulse is also restless, disperse Triple heater
(TH 1 and TH 10 for example) for the
circuit.
2] If Liver is excess, Gallbladder is deficient
(radial twice as strong as carotid): disperse
Liver with one needle (Liv 2 for example);
tonify Gallbladder with 2 needles (GB 43
and 40 for example). If radial pulse is
restless, disperse Pericardium meridian (Per
8 and 9 for example) for the circuit.

Regular Meridian Disorders for this
Circuit from Dr. Ni
Note:
Any point on a regular meridian may be used
as a local point for signs and symptoms on
that meridian.

C] Foot Shaoyang Gallbladder meridian:

Gallbladder and Liver disorders with bitter
taste in the mouth, belching, nausea,
vomiting, poor appetite, abnormal bowel
movements, dark lusterless complexion,
abnormal bowel movements, hypochondriac
pain; Urogenital disorders with swelling and
pain and itching of scrotum, external
genitalia, inguinal hernia, leucorrhea,
difficulty urinating; emotional disorders with
depression, deep signing, poor judgment,
indecision, mood swings, frequent anger,
insomnia; shaoyang channel syndrome with
alternating chills and fever; channel disorders
affecting the sense organs with temporal
headache, eye pain, pain in the cheek,
swollen glands, swelling and pain in the neck,

A] Hand Jueyin Pericardium meridian:

Heart and blood vessel disorders with
palpitations, cardiac pain, restlessness, high
lipid levels; mental and emotional disorders,
delirium, fainting, incessant laughter,
depression, mania, anxiety; chest and lung
disorders with stuffiness and restrictions in
the chest, cough, restricted breathing,
asthma; stomach disorders, stomach pain,
epigastric distention, hiccups, nausea,
vomiting, food poisoning; channel disorders
with pain and swelling of the armpit, upper
arm, elbow, forearm (Per 2-6), hot palms and

18

mandible, deafnesss, tinnitus; Bi syndrome

affecting the lateral side of the body from
lateral ribcage to lateral hip, ITB, peroneal
distribution of lateral knee, lower legs and
lateral ankle and foot with 4th toe
dysfunction (GB 22, 29-30, 31, 34, 37-39, 4044).

constrained in the upper heater, whose

primary complaints are lateral migraine
headache and dizziness with a strong wiry
pulse.
Observation shows shen to be clearly present,
but with a moody disposition bordering on
anger, a tendency to sigh and to breathe very
shallowly, even hyperventilating when he
grows animated, with a shouting quality to
his voice. He also reports a frequent need to
address serious anger issues in his therapy.

D] Foot Jueyin Liver meridian:

Liver Qi and yang disorders with fullness,
distention, pain of hypochondriac region,
dizziness, blurred vision, tinnitus, dry mouth
with bitter taste, flushed face, jaundice;
emotional disorders with depression, mood
swings, nervousness, frequent anger,
frustration, plum pit Qi in throat; stomach
and spleen disorders with epigastric pain,
distention, flatulence, belching, eating
disorders, vomiting, diarrhea; lung and heart
disorders with stuffiness of chest, cough,
shallow breathing, deep sighing, palpitations,
dream disturbed sleep; abnormal growth
including cysts, nodules, masses; channel
disorders with spasms of feet and hands,
headache, low back and lumbar pain
extending to scrotum, hernia pain, pain and
swelling of lateral lower abdomen (dai mai),
spasm and tightness of joints and muscles
and pain along course of channel.

The patients secondary complaint is

frequent myofascial pain in the upper traps
and lats and generalized muscle tightness.
From a jing-luo perspective this matches foot
Jueyin Liver regular meridian symptomology
primarily, with additional symptoms of foot
Shaoyang and hand Shaoyang regular
meridian dysfunction leading to an APM
diagnosis of Jueyin/Shaoyang Circuit
Dysfunction and constrained Liver Qi, as
well as foot and hand Shaoyang muscle
channel excess.
A] Yin-Yang Regulatory Treatment would
begin with the source point of the foot jueyin
meridian, as well as the ying and shu points
for disorders of yin of yin, Liver 3 (tonified)
and 2 (dispersed), and the luo point of foot
Shaoyang, GB 37 along with the Fire point of
foot Shaoyang, GB 38 both dispersed) to
bring down the rising yang symptoms and
clear the lateral head Shaoyang and upper
trapezius areas of blockage as well as promote
Liver/Gallbladder harmony. Local points CV
10, where tender and where Liver Qi can
become constrained in the middle heater, the
tender area of GB 24 and Liv 14 on the right,
and the tender area near CV 18 would all be
dispersed to clear the hypochondriac region
and ease the breathing.

Personality Patterns

See discussion under the first circuit above.

Practicing Circuit-Needling
Lets take the example of a patient who
presents on palpation with discomfort in the
right hypochondriac region and tenderness
on palpation near GB 24 and Liv 14, as well
as tenderness at CV 10, where Liver Qi can
become constrained in the middle heater,
and CV 18, where Liver Qi can become

B] Patient-Complaint Treatment would

select local points from the yang channels in
this circuit, where local symptoms tend to

19

accumulate (yang protects yin) as follows: for

the lateral headache, tender ashi points along
the GB and TH pathways of the lateral scalp,
including GB 8 and points along a line with
it in the temporalis muscle and the Shaoyang
area local lateral headache extra point,
Taiyang, needled with TCM dispersal
technique and never as muscle channel
Trigger Points, with distal Triple Intestine 10
(Kiiko Matsumotos TH pathway point level
with LI 10) and LI 4 to complete the 4 gates
and as a powerful headache point; for the
dizziness, GB 20, the extra point anmian (in
the Shaoyang region between the GB 20 and
TH 17 points) and GB 8 (already treated),
with distal TH 3.
If this were a chronic problem, given that
there are three regular meridians and two
ZangFu involved, I would add the
extraordinary vessels as per Van Nghis use in
such chronic conditions, using the infinity
combination so suited for Jueyin/Shaoyang
dysfunction: Sp 4/ Per 6 for the constrained
Liver Qi in the ribcage, chest and CV 10
area, and GB 41 and TH 5 for the Shaoyang
symptomology. This would comprise a jing
level supportive treatment to regulate
Jueyin/Shaoyang and relieve the Shaoyang
area symptoms.
In subsequent visits and once the primary
complaint starts to resolve I might add
release of the myofascial constraint areas with
Trigger Point Dry Needling to the upper
trapezius near GB 21, the supraspinatus near
TH 15, and the lats near GB 22. This could
be supplemented at any time with the
influential point for tendons, GB 34.

20