Oriental Medical Philosophy in relation to Chinese Massage – Main Aim, Organs, Meridians, Ch’i.
The main aim of any healing discipline or modality – to regenerate the body function as a whole; survival.
Concepts
Twelve Organs
Lungs
Heart
Liver
Spleen/Pancreas
Kidneys
Colon
Small Intestine
Gall Bladder
Stomach
Bladder
Pericardium
Triple Heater
The Pericardium
- Functional rather than organic
- protector of the heart
- messenger of joy
- roughly anatomically equivalent to the sac enveloping the heart
The Triple Heater
- 3H1 – Upper Heater – Heart and Lungs (Oxygen)
- 3H2 – Middle Heater – Liver, Stomach, Intestines (Food)
- 3H3 – Lower Heater – Kidneys, Testes/Ovaries (Reproduction)
Oxygen and food are processed by 3H1 and 3H2 to produce ch’i, the vital life energy. Ch’i circulates throughout the system, and is also stored in 3H3.
The kidneys govern the sexual function.
If 3H1 or 3H2 are put out of action, death will result. If 3H3 is put out of action, reproduction is impossible, ultimately resulting in death.
Qi
Ch’i, Ki, Prana, Qi – synonyms.
Ch’i flows through meridians, which are channels. There are twelve meridians corresponding to the twelve organs. These twelve meridians are bilateral, i.e. are on both sides of the body.
There are two other meridians which are single (not bilateral):
- The Conception Vessel, running up the center of the front of the body
- The Governor Vessel, runs up the center/back of the body and head.
(NB there are other extra meridians as well – but all their points lie on the above main meridians)
Ill health comes when the ch’i flow along the meridians is blocked. Energy normally flows in circles along these meridians.
LAW 1
Man is the microcosm of the macrocosm (i.e. the universe). Therefore he is governed by the same laws which govern nature.
LAW 2
There is nothing between Heaven and Earth except energy and the laws which govern it.
Man is between Heaven and Earth. Therefore he grows through the four seasons. Man’s growth and development is cyclic.
The heart is the monarch of the organs.
The left kidney is the water kidney. The right kidney is the “life door” (sex) kidney – with relationship to the Pericardium (circulation/sex).
| Meridian | Points of Action | Location |
| Lung | 1-11 | Arm |
| Colon | 1-20 | Arm – Head |
| Stomach | 1-45 | Head – abdomen – Leg |
| Spleen/Pancreas | 1-21 | Leg – Abdomen |
| Heart | 1-9 | Arm |
| Small Intestine | 1-19 | Arm – head |
| Bladder | 1-67 | Head – Back – Leg |
| Kidney | 1-27 | Leg – Abdomen – Chest |
| Pericardium | 1-9 | Arm |
| Triple Heater | 1-23 | Arm – Head |
| Gall Bladder | 1-44 | Head – Abdomen – Leg |
| Liver | 1-14 | Leg – Abdomen |
The six upper meridians are those on the arms – Lung, Colon, Heart, Small Intestine, Pericardium, Triple Heater.
The six lower meridians are those on the legs – Stomach, Spleen/Pancreas, Bladder, Kidney, Gall Bladder, Liver.
Male is right side.
Female is left side.
The movement of energy must follow the cycle of natural flow, heaven to earth and back to heaven again. Rain falls from the clouds (heaven) to earth, then via evaporation water vapour ascends to heaven again.
In the body heaven and earth are defined as forming a polarity between two parts of the body, “top” and “bottom”.
Examples:
| Heaven | Earth |
| Fingers | Head |
| Head | Feet |
| Abdomen | Feet |
| Fingers | Abdomen |
| Fingers | Shoulder |
The Meridians of Earth run from Earth to Heaven (flowing “upwards”):
S/P, Liv, Kid, Heart, Lung, Peric.
The Meridians of Heaven run from Heaven to Earth:
Stom, GB, Blad, Colon, SI, 3H.
The three upper meridians of Earth run from earth (body) to heaven (fingers): Heart, Lung, Pericardium.
The three upper meridians of Heaven run from heaven (fingers) to earth (head): Colon, 3H, SI.
The three lower meridians of Earth run from earth (foot) to heaven (body): SP, Liver, Kidney.
The three lower meridians of heavenrun from heaven (body) to earth (foot): Stomach, GB, Bladder.
The heaven and earth relationship also refers to the front and back of the body. The heaven meridians are located on the back of the body and limbs (the tougher, hairy, outer, darker parts of the limbs), the Earth meridians on the front of the body and limbs (the inner, softer, lighter parts of the limbs).
Energy lows continually throughout the body via the twelve meridians in circular flows:
Lung, colon, Stomach, SP, Heart, SI, Bladder, Kidney, Peric, 3H, GB, Liver, back to Lung again.
Meridians must have means of rejoining and redirecting themselves, e.g. when cut during surgery, if a limb is lost, around body piercings, etc.
YIN and YANG
Two antagonistic opposites which complement each other. The Taoist symbol of nature.
| YIN | YANG |
| Passive | Active |
| Female | Male |
| Night | Day |
| Moon | Sun |
| Internal | External |
| Water | Fire |
| Cold | Hot |
| Bottom | Top |
| Earth | Heaven |
| Winter | Summer |
| Autumn | Spring |
| Blood | Energy |
| Front | Back |
| Expansion | Contraction |
Each tendency brings about the search for and production of the opposite tendency to balance.
In winter (cold, yin), we seek heat (yang).
In summer (hot, yang) we seek cold (yin).
Summer (yang) brings growth (yin).
Winter (yin) brings hibernation (contraction, yang).
The human body can be separated into yin and yang. In a situation of
good health, the rate of expansion (yin) matches the rate of contraction
(yang). Health is a balance of yin and yang.
If yang overbalances yin, we get continued contraction. If yin overbalances yang, we get continued expansion.
If the system is unbalanced, we must decrease the deficient aspect. Therefore we require both yin and yang techniques, e.g. techniques to create heat, and techniques to create cold.
Yin and Yang allow us to classify:
- persons in constitutional type
- techniques
- results.
We aim for the TAO – the meeting place at the center.
In the body heaven is Yang, earth is Yin.
ORGANS and MERIDIANS
| Yin | Yang |
| Heart | SI |
| SP | Stomach |
| Lung | Colon |
| Kidney | Bladder |
| Liver | GB |
| Peric | 3H |
Yin organs are primary and will affect their yang partners. The converse is not always so.
One can live without yang organs – not without yin organs.
WU HSING
The Five Elements
The five elements are basically a means of categorisation.
The five primary forces of the universe – seasonal influences.
All living things contain the five elements.
In the original texts, earth belongs to all things at the center.
The sun rotates 1 degree per day – 360 days/year (solar days)
The moon rotates 13 degrees per day
72 days per season (includes 72 for earth – 18 days per season during
which energy is nourished)
Natural cyclic patterns in Man and Nature – SHENG and KO cycles.
SHENG CYCLE
- Mother-son cycle
- Generating cycle
- Anabolic cycle
- Clockwise
- YANG
Metal – Water – Wood – Fire – Earth – Metal …
Any blockage of one element will result in a deficiency in the next
(son).
KO CYCLE
- Grandmother – grandson cycle
- Checking cycle
- Catabolic Cycle
- Clockwise(?)
- YIN
Metal checks Wood
Wood checks Earth
Earth checks Water
Water checks Fire
Fire checks Metal
If the system is overbalanced in one element it will inhibit the
grandson
e.g. excess of sweet will hurt kidneys;excess of salt will hurt heart
We can use the Ko cycle to reduce an excess of a certain element, e.g. treatment with water will check an excess of fire
Note also that if one element increases its “grandmother” will/may go up to compensate, e.g. if the liver goes up, the lung may go up to compensate.
The five elements correspond to various classes of attributes in the
body and nature:
| ATTRIBUTE | FIRE | EARTH | METAL | WATER | WOOD |
| Yin Organ | Heart | SP | Lung | Kidney | Liver |
| Yang Organ | SI | Stomach | Colon | Bladder | GB |
| Season | Summer | Long Summer | Autumn | Winter | Spring |
| Colour | Red | Yellow | White | Black | Blue/Green |
| Emotion | Joy | Sympathy | Grief | Fear | Anger |
| Taste | Bitter | Sweet | Pungent (spicy) | Salt | Sour |
| Related area | Tongue | Lips | Nose | Ears | Eyes |
| Disease area | Complexion | Muscles | Skin/Body Hair | Bones | Tendons |
| Fluids | Sweat | Saliva | Mucus | Urine | Tears |
| Direction | South | Center | West | North | East |
| Season | Summer | Long Summer | Autumn | Winter | Spring |
| Agric. Cycle | Growth | Maturity | Harvest | Storage | Birth |
Related Areas give indication of organ states.
Disease Areas reflect organ disease.
Directions are for Northern Hemisphere.
Colour refers to primary colours in nature, complexion colours in man.
Agricultural Cycle refers to man also – annually, and to entire life.
Examples: Treat eye problems on liver meridian. Red eyes – too much fire in liver. Treat ear problems in kidney meridian.
MEASUREMENT IN TCM
1 Tsun – 1 anatomical inch.
10 Fen = 1 Tsun
Measurement is based on the patient, and varies between individuals.
The four fingers of one hand, measured across the second knuckles = 3 tsun.
Two fingers across second knuckles = 1.5 tsun.
Each knuckle segment on any finger (length between two knuckles) = 1 tsun.
6 tsun – fingers of two hands
4 tsun – fingers of one hand + 1 knuckle segment
etc.
YU Points
The Yu points are found on the Bladder meridians. They give access to the organ nergy of the 12 organs. The Bladder meridian is the only one which connects to all the organs.
Bladder points are located 1.5 inches laterally from the soft spaces between the vertebrae, e.g. BL13 is between T3 and T4, 1.5 in. bilaterally. Each of the mentioned points has a specific effect on the organ mentioned.
| Vertebra (point is below) | Point | Organ |
| T3 | BL13 | Lung |
| T4 | BL14 | Pericardium |
| T5 | BL15 | Heart |
| T7 | BL17 | Diaphragm |
| T9 | BL18 | Liver |
| T10 | BL19 | Gall Bladder |
| T11 | BL20 | SP |
| T12 | BL21 | Stomach |
| L1 | BL22 | 3H |
| L2 | BL23 | Kidneys |
| L4 | BL25 | Colon |
| S1 | BL27 | SI |
| S2 | BL28 | Bladder |
7 Cervical Vertebrae (C)
12 Thoracic/Dorsal Vertebrae (T, Th, D)
5 Lumbar Vertebrae (L)
5 Sacral Vertebrae (S)
4 Coccygeal Vertebrae (?)
Bladder points are located 1.5 in bilaterally opposite centre of disc below vertebra, e.g. BL13 is located bilaterally opposite the disk between T3 and T4.
The disk between T7 and T8 is level with the bottom of the scapula.
The disk between L4 and L5 is level with the top of the ilium (iliac crest).
When the neck is rotated, C7 turns, T1 does not.
MU Points
Complementing the Yu points, Yang, on the back of the body, we have the Mu points, Yin, on the front of the body.
Like the Yu points, the Mu points give us access to the organ energy of the twelve organs. They are also called alarm points.
If a certain Mu point is sore when palpitated, it reflects on the organ function. It also gives us a point of action for that organ function.
The Yu points give us access to the organ itself. The Mu points give us access to the organ function.
If the organ is damaged or weak – use Yu.
If the organ function is wrong – use Mu.
The Mu and Yu points affect different parts of the nervous system.
RIBS
We have 7 true ribs (1-7) – attached to spine and sternum.
8,9,10 – joined to spine and rib 7 by cartilage.
11,12 – spine only – floating ribs.
Location of Mu points
| Stomach | CV12 | 4 tsun above unbilicus |
| Heart | CV14 | 6 tsun above umbilicus |
| Pericardium | CV17 | between nipples |
| Chi Hoy | CV6 | 1.5 tsun below umbilicus |
| 3H (general) | CV5 | 2 tsun below umbilicus |
| SI | CV4 | 2 tsun below umbilicus |
| Bladder | CV3 | 2 tsun below umbilicus |
| Lower Heater | CV7 | 1 tsun below umbilicus |
| Middle Heater | CV12 | see Stomach |
| Upper Heater | CV17 | See Pericardium |
| Kidney | GB25 | end of 12th rib |
| SP | Liv13 | end of 11th rib |
| Liver | Liv14 | between 8/9 rib, directly below nipple |
| GB | GB24 | between 9/10 rib, directly below nipple |
| Lung | Lung1 | 1.5 tsun below depression at join of collarboneand shoulder |
| Colon | ST25 | 2 tsun either side of umbilicus |
CV12 is meeting point of all Yin meridians
CV6 – Ch’i Hoy, Sea of Ch’i is used to affect chi flow thoughout meridians – can be used to tone system generally.
Examples:
For lung problems can use:
- Lung1 – Lung Mu point
- BL13 – Lung Yu point
- CV17 – 3H1 Mu point
- CV5 – 3H general Mu point
- CV6 – ch’i hoy
- CV12 – 3H2 mu point
- BL22 – 3H Yu point
For constipation:
- BL25 – colon Yu
- ST25 – Colon Mu
- CV4 – SI Mu
- CV12 – Stomach, 3H, Yin meridians
with indigestion, CV14 often hurts
Shen – spirit – housed in heart
so indigestion may affect heart point
Learn Mu and Yu points by heart.
Pressure
Varying pressure can be used both to tonify, sedate, stimulate (activity and nonactivity).
Deep or superficial.
Remember the three levels of energy
| Heaven | Yang |
| Person | Yin/Yang |
| Earth | Yin |
We treat Yang conditions (Acute, Hot) with Yin techniques.
We treat Yin conditions (Chronic, Cold) with Yang techniques.
It is possible to have a chronic condition which goes acute.
To regulate we use an intermediate technique.
| Heaven | Yang | Surface | External | Tonification | Heat | LightPressure | Short Duration <= 3 seconds |
| Person | Yin/Yang | Intermediate | Intermediate | Regulation | 5-8 seconds | ||
| Earth | Yin | Deep | Internal | Sedation | Cold | Deep Pressure | Long Duration 10-30 seconds |
Disease and the three energy levels
We use the example of the effect of cold on the body.
Heaven – The surface of the body, from wet cold weather, becomes cold. We get a chill.
To treat at this level we can use heat – from a hot bath, warming diet, etc. Massage can be used at this level.
Person – Intermediate. The disease has sunk deeper. We now have a cold.
To treat at this level we can again use heat and massage.
Earth – Deep. The disease has gone internal. We now have pneumonia.
Treatment at this stage involves internal medicines and complete rest. Massage is of no use here.
Note that disease goes from Yang (Heaven) to Yin (Earth). In the example, if the disease process continues it may go back up through the levels until all levels are affected.
If all levels are effected – death will follow.
A chronic condition may be marked by a recurring illness. It is a continuous level of disease which is affected by conditions.
Diagnosis
Knowledge through examination
Diagnosis allows us to make a *Prognosis* – estimation of future aspects of a patient’s health.
It also enables us to provide a *treatment* giving a *result*.
Diagnosis involves:
- Questions and Answers
- Facial Diagnosis – external manifestations
- Appearance – walking, sitting, behaviour patterns
- Palpitation – Mu and Yu points, abdomen, reflex area, tap sound, etc.
We diagnose through the senses:
- Sight – Appearance, colour of complexion, etc.
- Hearing – voice tone, breathing, etc.
- Smell – Aroma
- Touch – Palpitation
- Conversation
A prognosis involves knowing
- Type of condition (yin/yang)
- Area(s)/Organ(s) affected
A treatment involves
- Points of Action and procedure to follow
- Advice (diet, baths, packs, etc.)
Facial Diagnosis
Diagnosis of the internal environment though external manifestation
- Horizontal lines across the forehead indicate a great deal of CNS (central nervous system) activity – much thought
- Lines on forehead in hapazard directions indicate erratic or disturbed mental activity
- Bright red ears indicate excess heat in kidneys, usually due to excess protein or especially too much salt in the diet. Excess salt can hurt the heart (water destroys fire, from the Ko cycle). Salt draws water from the blood, coagulating it. It also hardens the arteries, bring thirst and dehydration, and possible joint problems.
- White circle inside pupil – excess salt
- Furrows inside corner of eyes – liver problems
A bubble of fluid between eyes (?) – congested liver - One main line between eyes – SI problems
- Darkness in corners of eyes – blue/black – Too much sugar – liver and spleen control sugar digestion or – emotional problems
spleen -> sympathy -> grief -> thought, contemplation
can be supressed anger – burning liver - Puffiness under eyes – tired kidneys
– spleen not transforming water
– may be accompanied by swollen ankles if severe - Big eyes – yin constitution
Thin, narrow eyes – yang constitution - Flares (mares) of nose very red – excess heat in lungs – too much calorific heat
- Big cleft in end of nose – heart problems
Large, pitted nose – colon and liver – can be alcohol - Small arterials in cheeks – congestions in arterials in lungs, common in smokers
- Very red cheeks – heat in lungs
Very pale cheeks – cold in lungs - One deep furrow between lips and nose (mostly on women) – urogenital problems, uterus and ovaries
- Enlarged top lip – liver
Enlarged bottom lip – colon - lines at end of mouth – duodenum (ulcers, worry)
- Cleft in chin – yang constitution
- Small lines off lips all around mouth – reproductive organs no longer being stimulated (3H3?)
– menopause or sex problems
– usually in older women
Chinese Clock
| 0300-0500 | LU | Arm | Yin |
| 0500-0700 | CO | Arm | Yang |
| 0700-0900 | ST | Leg | Yang |
| 0900-1100 | SP | Leg | Yin |
| 1100-1300 | Heart | Arm | Yin |
| 1300-1500 | SI | Arm | Yang |
| 1500-1700 | BL | Leg | Yang |
| 1700-1900 | KI | Leg | Yin |
| 1900-2100 | PC | Arm | Yin |
| 2100-2300 | 3H | Arm | Yang |
| 2300-0100 | GB | Leg | Yang |
| 0100-0300 | LI | Leg | Yin |
The above schedule represents meridian flows of nutritive (blood) energy through the twelve meridians. This nutritive energy nourishes meridian and related organs nourishing the whole body over a 24 hour period.
The energy is strongest in the middle of the period (e.g. SI – 1400, Lung – 0400)
Examples
If heart is weak it will improve at midday, and will be worst at midnight.
If heart is overactive (e.g. high blood pressure) it will be worst at midday, and will improve at midnight.
Lower back problems (associated with kidneys) –
if worse in the morning (0500 – 0700) deficient kidneys
if worse in the evening (1700 – 1900) overactive kidneys
Note that the energy flow in an organ is weakest when the nutritive energy is furthest from it (i.e. 12 hours from its nutritive period).