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What are Meridians and Points?
By Iona Marsaa Teeguarden, M.A.,
Director, Jin Shin Do® Foundation for Bodymind Acupressure®Homepage
Published in the fall 2006 issue of "Oriental Medicine," a publication of the Pacific College of Oriental Medicine in San Diego, CAThe simplest and most common explanation is that the meridians are a network of channels that transport Qi (energy), and acu-points are places along the meridians where the Qi is accessible-i.e. close to the surface of the skin. (However, there are numerous "extra points" that are found outside of the Meridian network.) Stimulation of acu-points -like with finger pressure, needles or heat- influences the local area and various functions of related Organ Meridian(s). Some modern authors use the word "channel" instead of "meridian." Ted Kaptchuk, in The Web that has no Weaver, explains that the use of the word "Meridian" in English books on Chinese medicine came from a French translation of the Chinese term "jing-luo" [as "meridien"].1 One meaning of Jing is "to go through," and luo means "something that connects or attaches." Kaptchuk thinks channel is a better translation of jing-luo, but says that he uses the word "meridian" to avoid confusion.2 The Chinese word for "acu-point" is "xue" (in the modern Pinyin transliteration). B.C. acupuncturist Arnie Lade says, "The original character for xue contains the image of something precious buried in a small hole in the earth (most likely referring to the placement of the dead in auspiciously positioned burial holes or graves)." The theory of the meridians or channels, and of the traditional associations of the acu-points, summarizes the experience of Chinese healing artists over thousands of years. Its basis is primarily experiential. However, going back to at least 1952, there has been some fascinating scientific research that tends to confirm the existence of meridians and acu-points, and that partially explains the nature of the meridians and acu-points. The theory of the meridians or channels, and of the traditional associations of the acu-points, summarizes the experience of Chinese healing artists over thousands of years.
The Chinese healing arts essentially take an energetic functional approach. In acupuncture and acupressure theory, the emphasis is on energetic function, not on physical form. As is succinctly explained in Acupuncture: a Comprehensive Text, by the Shanghai College of Traditional Medicine: "What happens is considered more important than what something has come to look like."3 From this functional perspective, the Organs are their functions, so explanations of structural and physiological mechanisms are unnecessary.
The word "Organ" is usually capitalized in books on acupuncture and acupressure, to indicate that the reference is to an energetic functional whole. An Organ includes an internal organ, a sense and sense organ, a body fluid, particular body parts, and certain emotions and/or defensive attitudes, all of which are related to a particular season and climatic condition.
Qi is derived from the air that we breathe, the food and liquids that we take in, and other subtle elements that we absorb (like through the skin or senses). The process whereby these elements are transformed into the true body energy (Zhen Qi) is analogous to but different from the digestive process.4
The meridians are a network of channels that transport Qi. An Organ Meridian is a channel that transports Qi to the related internal organ, sense organ, and body parts-including, of course, the tissues along its route. Generally named for the related internal organ, the twelve Organ Meridians are: the Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, Triple Warmer, Gall Bladder, and Liver Meridians.
Each Organ receives Qi (vital energy) through its meridian and its related functions can be influenced by stimulating points along its meridian. As Arnie Lade says, "By influencing the Meridians we affect the Organs, and vice versa also! Acu-points along a Meridian are just gateways to influence the Meridians."
The Shanghai text says, "The Qi and Blood circulate throughout the body via this network of channels," and it is primarily "by means of the channels" that "the intimate relationship between the internal Viscera and the periphery of the body" is maintained. As Arnie Lade points out, this "suggests both a communicative function as well as a defensive capacity of the Meridians." Many modern authors, including Kaptchuk, say the meridians carry Qi and Blood, although it is agreed that the meridians are NOT the blood vessels, and cannot be seen. Arnie explains: "Chinese medicine has a saying: 'Qi is the commander of Blood, and Blood is the mother of Qi.' This means that Qi is the motive force behind Blood while Blood nourishes Qi. Some writers have interpreted this as a kind of anatomical fact, while the opposing opinion says that these descriptions of the relationship between Qi and Blood simply express their energetic function!"
When chronic tension develops in the area of major acu-points, it disrupts the flow of Qi along the meridian and, hence, obstructs the nourishment of the related Organ. Release of tension in the area of an acu-point facilitates the smooth flow of Qi in the meridians that go through that area, and vice versa. Therefore, to more deeply and pleasantly release tension at an acu-point, Jin Shin Do® Acupressurists hold it with one hand while, with the other hand, holding "distal points" along related Organ meridians and Strange Flows (or "Extraordinary" Meridians or "Vessels").
Japanese Research into the Nature of Points and MeridiansIn the seventies, my acupuncture/acupressure teachers emphasized that the meridians distribute Qi (which at that time, in the Wade Giles transliteration, was written as "Chi" or "Ch'i"). For example, in 1971, Dr. Kok Yuen Leung said (in his course, "Chinese Medical Philosophy and Principles of Diagnosis"):"The Meridians are the pathways which distribute the energies of the organs to all parts of the body. These pathways occur externally on the skin and also pass deep inside the body through the organs. They were originally charted in prehistoric times. It is taught that external cosmic energies communicate with the internal man via the meridians and that sickness is an imbalance or disorganization of energy within either a meridian or the organ or both. "Recent research has shown that there is a marked lowering of electrical resistance in the skin along these paths. Japanese acupuncturists in particular make much use of electronic equipment to both trace these meridians and to find 'points of blockage' which show up as minute areas of intense micro-electrical conductivity. These points invariably coincide with the traditional acupuncture points used in therapy."In the summer of 1976, I was fortunate to meet Katsusuke Serizawa, M.D.5 in Japan and to give him an acupressure session. (He was kind enough to say that it was the closest to his approach that he had experienced.) He shared the scientific research done by himself and colleagues in the department of physical therapy and medicine at the University of Tokyo in 1964-1976. Two findings of these Japanese researchers can help us understand the nature of the acu-points, or "keiketsu." One study indicated that the traditional points, which generally exhibit tenderness, normally have a skin temperature 0.1 to 0.6 degrees Celsius higher than the surrounding area.6 Arnie Lade said: "It's interesting to note that the human hand is sensitive to variations of temperature as small as .03 degrees Celsius (according to Dr. J.P. Barral, the developer of modern Visceral Manipulation & author of Thermal Diagnosis)." Another Japanese study concluded that these "electrodermal points or reflex points" are localized skin areas of about 0.5 x 0.5 mm., which have a markedly decreased electrical resistance-about 1/100 of the surrounding area.7 This is the same as saying that the electrical conductivity at these points is 100 times greater than that of the surrounding area! "Electrodermal points or reflex points" are localized skin areas of about 0.5 x 0.5 mm., which have a markedly decreased electrical resistance - about 1/100 of the surrounding area.
Dr. Serizawa also gave me some fascinating research by Dr. Rokuro Fujita on the nature of the meridians. After studies of the electrical reactivity of the points and the appearance of "papules" after moxa (heat) stimulation, in 1952 Dr. Fujita Rokuro Fujita, M.D. concluded that the main cause of meridian phenomena is, basically, muscular movement, or "the transmission of changes based on the serial contraction of systematical muscles connected kinetodyamically." 8
The main cause of meridian phenomena is, basically, muscular movement, or "the transmission of changes based on the serial contraction of systematical muscles connected kinetodyamically."
After a study in 1964, these researchers concluded that "Each meridian in nature consists of interfascial space, wherein exist blood-lymph vessels and nerve trunks at a depth specific to itself," and that these channels (i.e. interfascial spaces) "may be stimulated by muscular movement." Two parts of this interfascial space were defined: one consisting of the "special functional course of impulse" and the other of "the channel for meridian water" or body fluids related to the meridians. Also, "in general, it was found that some meridians have more extravascular connective tissue, and others more extranervous connective tissue." 9
"Each meridian in nature consists of interfascial space..."
To summarize, as I did in The Joy of Feeling: Bodymind Acupressure Acupressure® in 1987:
"Meridians or channels are functionally-related series of points, or pathways along which the vital energy flows... Research in Japan has suggested that the meridians are located in interfascial spaces - spaces between the fibrous membranes which support and separate the muscles...9 "How does the energy, or ch'i, move along these meridians? Japanese researchers have hypothesized that the meridians are stimulated by muscular movement, or by the serial contraction of related muscles.8 Not only physical movement, but also the flow of emotions, causes such contraction of functionally-related muscles. This brings us back to the traditional theory that emotions are the driving energy of the body and the body needs the energy generated by the emotions. In short, both physical and psychological movement stimulates the flow of ch'i, and at the same time, the balance or imbalance of this energy in the meridians influences both the body and the psyche." 10The theory that meridians are located in interfascial spaces may not account for all of the meridian routes. Few theories account for all of anything. However, the theory that the meridians and channels are located in interfascial spaces is still the only theory that makes sense to me - and the more I learn about the fascia, the more sense it makes. Meridians and Myofascial "Tracks"Webster's Dictionary defines fascia as "a thin layer of connective tissue covering, supporting or connecting muscles or inner organs." Taber's Medical Dictionary says fascia is "a fibrous membrane covering, supporting, and separating muscles. It also unites the skin with underlying tissues. Fascia may be superficial, a nearly subcutaneous covering permitting free movement of the skin, or it may be deep, enveloping and binding muscles."11 Registered Jin Shin Do® Acupressurist Evan McCormick of L.A. gives these succinct explanations:12
Fascia is the collagenous network present throughout the body, which enfolds and enmeshes every structure and organ.
Evan offers a fresh perspective on why Jin Shin Do® Acupressure is so effective for tension release: "Many of the basic JSD points correspond to key junctions where bone, muscle and fascia overlap; and the Strange Flows are in the path of myofascial 'tracks.' This helps explain why releasing a JSD point not only relaxes the local tension, but also releases other muscles - those that contribute to the tension through fascial connections. Release of the local point stimulates a spontaneous reorganization along the myofascial 'track.' To use another metaphor, the local point acts like a tuning fork. It is as though all the fascia that relate to that local point organize themselves around its frequency."
B.C. acupuncturist Arnie Lade wrote about the meridians and fascia in Energetic Healing: Embracing the Life Force. He said that, while he perceives "the meridians as being subtle structures in nature," there appears to be "a physical medium through which they operate," which likely is "the body's fascial system." 14
Myofascia is muscle (myo) and fascia combined. The metaphor of myofascial "tracks" helps us visualize the vertical, horizontal and spiral ways fascia runs.13 "Fascia is composed primarily of collagenous and elastic fibers within a colloidal or glue-like ground substance," Arnie explains. "Collagen fibers are highly pliable and tough, and form the bulk of the fascia, while elastic fibers are stretchable, giving fascia greater flexibility. The majority of fascial fibers in the body orient themselves in a longitudinal direction" 14 [as do the majority of the Meridians].Arnie eloquently expands on the idea that the fascia is "the conduit for meridian Qi." He gives two main reasons why the fascial system might be the physical medium through which the meridians operate: 1) The fascia is distributed throughout the body. It is "a single, continuous, mobile sheet of connective tissue wrapping itself around virtually every structure inside the body." 2) "Furthermore, fascia is highly responsive to electrical and magnetic influences. Fascia under the guidance of Qi is a sensitive biological amplifier of subtle external forces" like changes in weather and seasonal changes. "Fascia allows for an amazing amount of responsiveness because of its mobility and elasticity," so that "via the fascia, pain, tension and stress are easily diffused and rapidly communicated throughout the whole body." 14"Although the fascia is a continuous network, three types of fascia are differentiated: superficial, deep, and visceral." Arnie explains that superficial fascia "lies beneath the skin" and helps to maintain body heat and protect against trauma. Deep fascia "covers and holds muscles, tendons and ligaments together, as well as separating them into functional units." Visceral fascia "envelops and supports the internal organs" and stabilizes them structurally, by anchoring them. And, he says, "According to my clinical investigation, the classical routes associated with the meridian system utilize and follow the body's fascia." 14 " . . . the superficial fascia corresponds to the meridian's exterior pathways and the deep and visceral fascial layers to its internal pathways. In this way, the meridians are able to communicate with the organs, nervous system, and interior structures of the body. Specifically, visceral fascia helps the meridians to directly communicate with the organs, while the deep fascia helps the meridians connect with the brain and spinal cord. Indeed, all the fascial linings act as energetic envelopes which protect and maintain any particular structure's integrity." 14 The superficial fascia corresponds to the meridian's exterior pathways and the deep and visceral fascial layers to its internal pathways. In this way, the meridians are able to communicate with the organs, nervous system, and interior structures of the body.
American Research into the Nature of Points and MeridiansFascinating research along these lines has recently been done by Helene M. Langevin, M.D. and colleagues at the University of Vermont. 15 In an article entitled "Relationship of acupuncture points and meridians to connective tissue planes," they start from traditional beliefs that Meridians connect the surface of the body to internal organs and are channels through which Meridian Qi flows. They cite Matsumoto and Birch in saying that "ancient acupuncture texts contain several references to fat, greasy membranes, fasciae and systems of connecting membranes through which qi is believed to flow" 16 - and they have begun to provide experimental evidence supporting the correspondence between the meridians and the fascia! Their hypothesis is: "The network of acupuncture points and meridians can be viewed as a representation of the network formed by interstitial connective tissue." They say that "this hypothesis is supported by ultrasound images showing connective tissue cleavage planes at acupuncture points in normal human subjects." Furthermore, they found an 80% correspondence between the sites of 24 acupuncture points on the human arm and the location of intermuscular or intramuscular connective tissue planes (in postmortem tissue sections).
"The network of acupuncture points and meridians can be viewed as a representation of the network formed by interstitial connective tissue."
They note that the same description fits both "meridians" and "interstitial connective tissue." Both "form a network throughout the body, connecting peripheral tissues to each other and to central viscera." Interstitial connective tissue "constitutes a continuous network enveloping all limb muscles, bones, and tendons, extending into connective tissue planes of pelvic and shoulder girdles, abdominal and chest walls, neck, and head." Therefore, "a form of signaling (mechanical, bioelectrical, and/or biochemical) transmitted through interstitial connective tissue . . . may have potentially powerful integrative functions. . ."
Up until now, there have been no physiological models that satisfactorily explain why stimulation of an acu-point has effects on other body parts. Langevin and colleagues say:
"A mechanism initially involving signal transduction through connective tissue, with secondary involvement of other systems including the nervous system, is potentially closer to traditional Chinese acupuncture theory, yet also compatible with previously proposed neurophysiological mechanisms." "In summary, the anatomical correspondence of acupuncture points and meridians to connective tissue planes in the arm suggests plausible physiological explanations for several important traditional Chinese medicine concepts summarized in Table 1. We propose that acupuncture needle manipulation [particularly at the traditional points] produces cellular changes that propagate along connective tissue planes."Dr. Langevin's Table 1 includes fascinating "proposed anatomical/physiological equivalents" of some of the key concepts of traditional acupuncture/acupressure theory, including:
Meridians: Connective tissue planes.
Points: Convergence of connective tissue planes. Meridian qi: Connective tissue biochemical/bioelectrical signaling. Blockage of qi: Altered connective tissue matrix composition leading to altered signal transduction. The Energetic Functional ApproachThe theory that the Qi travels along the Organ Meridians and Strange Flows via interfascial spaces is fascinating. It is fun to try to understand the theories underlying the ancient arts of acupressure and acupuncture (though knowing that we mortals are unlikely to ever understand all of anything). However, from the energetic functional viewpoint described earlier, it does not matter exactly what the meridians are composed of, or through which structures their routes go, as long as you can find and compassionately hold the points, and can choose appropriate points, based on their traditional associations - which is to say, their energetic functions.FOOTNOTES: 1 French missionaries brought acupuncture back from China, so the French strongly influenced Western acupuncture. NB: the word "meridian" was derived from "meridien." 2 Ted Kaptchuk, O.M.D., The Web that has no Weaver: Understanding Chinese Medicine, 1983, Congdon & Weed, NY, p. 77, 108. 3 Acupuncture, a Comprehensive Text, by the Shanghai College of Traditional Medicine, p. 3, 35; translated and edited by John O'Connor and Dan Bensky, 1981, Eastland Press, Inc., P.O. Box 12689, Seattle, WA 98111. 4 For brief descriptions of the cycle of Qi Transformation, see p. 45 in the Jin Shin Do® Acupressure Handbook 2 (Intermediate), by Iona Marsaa Teeguarden; and p. 81 and 93 in her chapter on "The Zang/Fu and the Twelve Meridians" in A Complete Guide to Acupressure, © 1996, revised 2002; published by Japan Publications, Tokyo. 5 Katsusuke Serizawa, M.D. is author of Massage: the Oriental Method, 1972 and Tsubo: Vital Points for Oriental Therapy, 1976, both published by Japan Publications, Tokyo. 6 "Studies on Clinical Scientific Approach in Acupuncture and Moxibustion Treatment," by Katsusuke Serizawa, M.D.; Dpt. of Physical Therapy & Medicine, School of Medicine, University of Tokyo; and Institute of Physical Therapeutics, Tokyo U. of Education; 1966. 7 "Individual Pattern Changes in the Distribution of Skin Temperature, Electric Resistance, and Potential Difference, by Yoshio Oshima, Kosei Takahashi, Katsusuke Serizawa, Toshimori Fujita, Toshio Kubota, and Kazu Mori; Dpt. Of Physical Therapy and Medicine, School of Medicine, University of Tokyo; and Institute of Physical Therapeutics, Tokyo University of Education; abstract of paper read at the 4th. International Congress of Physical Medicine in Paris, 1964. 8 "Study on Meridians,," 1st. and 2nd. Reports, abstract of paper presented by Rokuro Fujita, M.D., at the Japan Society for Oriental Medicine in Japan, 1952. 9 "Experimental Study on the Main Meridian Line," by Rokuro Fujita, M.D., The Japan Society for Oriental Medicine in Japan, July 14, 1964. 10 The Joy of Feeling: Bodymind Acupressure® p. 36, © 1978, 2004 by the Iona Marsaa Trust, originally published by Japan Publications and now (with new cover!) by JSDF, P.O. Box 416, Idyllwild, CA 92549 – (951) 767-3393 – www.jinshindo.org 11 Taber's Cyclopedica Medical Dictionary, 1981, F.A. Davis Co., Philadelphia, p. 524. 12 "Extraordinary Energy Flows" by Iona M. Teegurden, 2003 Acupressure News, JSDF. 13 See Anatomy Trains, by Thomas W. Myers, 2001, Churchill Livingstone, pp. 51-60. To order: www.AnatomyTrains.net - 1-888-546-3747. 14 Energetic Healing: Embracing the Life Force, by Arnie Lade, ISBN 0-914955-46-2 1998, Lotus Press (P.O. Box 325, Twin Lakes, WI 53181), p. 145-150, (also available in German and Portuguese). Arnie kindly includes exercises (some traditional, some new) to help you experience, and get a body sense of, the life force or Qi. 15 Helene M. Langevin, Jason A. Yandow. "Relationship of acupuncture points and meridians to connective tissue planes": to read this article, go to http://onlinelibrary.wiley.com/doi/10.1002/ar.10185/full. 16 Matsumoto K, Birch S. 1988. Hara diagnosis: Reflections of the sea. Brookline: Paradigm Publications.
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