3

MERIDIANS AND QI-POINTS

 

The classical system of meridians and their qi-points was first mapped, and was already well established, more than 2,000 years ago. On these meridians there are more than 360 qi-points where qi can be affected in a way that restores balance and harmony.

 

QI-POINTS

At various intervals along the meridians there are specific points, each with its own unique electrical potential. Acupuncturists call them ‘acupoints’, but in this Tui Na book they are called ‘qi-points’.

In Tui Na, these points can be stimulated by strong pressure, or by needling or cupping. Each qi-point has the potential to affect qi and blood flow in the local tissues but also throughout its meridian, its associated organ and in related meridians. Such is the power of Tui Na that all qi-points are uniquely able to strengthen qi and blood flow as well as remove blockages that cause stagnation.

In the West, the qi-points are all numbered and named according to the meridian on which they are found – for example, Gall Bladder 20 or Large Intestine 4. The standard abbreviations for these are given in the table here. I have chosen qi-points that are particularly powerful and effective in Tui Na, and are most useful for maintaining health, relieving muscle and joint pain and treating many common health problems.

A Tui Na practitioner questions the patient about symptoms and location of pain or discomfort and palpates painful areas to discover which meridian or meridians are primarily affected. From this, and knowledge of meridians and qi-points, the practitioner decides the specific meridians on which to apply Tui Na massage techniques and the specific qi- points on which to focus. For a more comprehensive diagnosis, it would be necessary to identify patterns of disharmony involving the ‘five substances’, the organs and their yin/yang status (see here).

Every qi-point has clearly defined therapeutic functions. Kneading or pressing repetitively on aqi-point will affect qi-flow in a specific way unique to that particular qi-point. The author believes that it’s necessary to knead the chosen points with at least one hundred repetitions where a particular problem has to be resolved, or fifty repetitions for general healthcare.

FINDING QI-POINTS

The positions of qi-points are given with reference to body landmarks. The ‘cun’ (pronounced ‘soon’) is a non-standard unit, used in Chinese medicine to measure the distance of qi-points from body landmarks, such as bones and muscles.

A cun varies from person to person (see diagram opposite). Distances between parts of the body, however, have fixed cun measurements regardless of the size of the body (see Appendix, here). For example, the distance from the lateral knee to the lateral ankle is always 16 cun, while the distance from elbow crease to wrist crease is 12 cun. The meridian illustrations here show the qi-points and describe their positions using this system. Practise finding qi-points, both on yourself and your partner, so that you are familiar with the measuring technique before you start on the whole-body routine in chapter 5.A qi-point that feels particularly tender or even painful to the touch may indicate an underlying energy or musculoskeletal problem in the meridian that needs focused kneading to correct qi-flow.

THE CUN MEASUREMENT A single cun is the width of the top of your own thumb, not the thumb of the therapist. The combined width of the index and middle finger is 1.5 cun; and the four fingers together make 3 cun. As the cun varies from one person to another, you need to use the width of your partner's own fingers to give you their cun measurement in order to locate their qi-points accurately.

USING QI-POINTS AND ASHI POINTS Where qi-points are recommended for healthcare or treatment for common ailments, you should knead them bilaterally – that is, on both sides of the body – to boost qi and blood circulation and remove stagnation. The twelve paired meridians occur symmetrically on either side of the body.

Sometimes during a massage painful points are found that do not lie directly on a meridian. Such points are called ‘ashi points’ or ‘painful points’. When treating a local pain or injury, use the local qi-points on the side affected and nearby ashi points to get the best results.

For clarity, the qi-points are illustrated on only one side of the body, and each point is labelled on the illustration with the meridian abbreviation. Captions give the Western qi-point numbers and their Chinese names (see below), clear instructions for finding the qi-points and a list of conditions that they treat.

CHINESE NAMES The Chinese use specific names and not the Western numbering system to describe the qi-points. The names reflect either the position or the function of the point.

YINXIANG – LI 20 This translates as ‘welcome fragrance’ or ‘meeting of a good smell'. Found in the depression on the outside of the nostril, it is the final point of the large intestine meridian. Massage on LI 20 helps to clear a blocked nose, enabling it to smell fragrant scents again – hence the name ‘welcome fragrance’.

MEASURING CUN

See Appendix, for fixed cun measurements.

image

YUJI – LU 10 The point, meaning ‘fish belly’, is at the base of the thumb, where the skin changes colour and type. The name refers to the large muscle at the base of the thumb, which resembles a fish belly.

TIANZHU – BL 10 The point, which is on the neck, translates as ‘celestial pillar’ or ‘column of heaven’ and represents the pillar that supports the head.

JINGMENG – BL 1 Meaning ‘eye brightness’, this point at the inner corner of the eye is used for treating eye disorders, thus brightening the eyes.

ZUSANLI – ST 36 This point, meaning ‘walk three miles’, is 3 cun (see above) below the lateral knee ‘eye’ and 1 cun outside the crest of the tibia. It strengthens the whole body’s qi and stamina, enabling you to walk with no effort.

PISHU – BL 20 Located 1.5 cun from the spinous process (a bony projection) of the eleventh thoracic vertebra, the point is named ‘pishu’ (‘spleen point’) because it tonifies all the functions of the spleen organ.

LOCAL AND DISTAL QI-POINTS It’s worth having a knowledge of the muscles and joints through which the meridians pass because local qi-points can be used to treat musculoskeletal problems in their immediate vicinity. These can be reinforced with selected distal qi-points on the same meridian. With joint or muscle pain it’s essential to palpate to find the painful qi-points or ashi points and knead them for several minutes. As a beginner, it may be difficult to pinpoint exactly the site of the pain. Identify the meridians that pass through the painful area and use Tui Na techniques to thoroughly massage along them.

Examples of local qi-points

Examples of distal qi-points

Qi-points on the lower limbs are called distal points. These are used for problems in other parts of the body, frequently on the same meridian. Distal qi-points are also useful for treating conditions where local points cannot be used because of skin problems or severe bruising.

When you are familiar with the exact routes of the twelve primary meridians, you can start thinking about their yin and yang relationships, which you can utilize in your treatments. A diagnosis of the patient will indicate which of the organs and fundamental substances need treatment. The focus of the Tui Na massage should be on the meridians and qi-points related to these organs. Qi-points that need specific attention are often the ones that feel tender or painful when palpated.

Tui Na is thus a very precise therapy. The whole-body routine set out in chapter 5 involves working along meridians and kneading qi-points. To give a successful Tui Na massage, you should know the route and direction of every meridian and where it starts and ends. Learning the exact anatomical positions and functions of each qi-point described in this book will ensure that you achieve excellent results. This will enable you to focus specifically on a wide range of conditions.

BACK SHU QI-POINTS

In addition to their specific, therapeutic, local functions, qi-points on the part of the bladder meridian that runs from the neck to the sacrum, down either side of the spine, are called ‘back shu’. They are used to treat local back pain, but each qi-point has a specific link to one of the zang-fu organs after which it’s named. For example, while kneading BL 21, the stomach shu point has a powerful effect on stomach functions. Three of the qi-points – BL 11, BL 12 and BL 17 – on this part of the meridian are not 'shu' points but 'influential points'.

For a quick and effective treatment to maintain good health, a Tui Na massage covering all the back shu points will stimulate all the body’s organs, boosting and balancing qi-flow and removing any blockages. Work through all these points, as described in the back massage section, in Part Three of the whole-body routine in chapter 5.

FRONT MU QI-POINTS

On the chest and abdomen, there are qi-points that have special links with the organs and are known as ‘mu’ qi-points. For example, while kneading R 12, the stomach mu point has a powerful effect on stomach function.

image

The principal functions of each of the organs are described with each meridian in chapter 3, here onwards. The colours refer to the Five Elements described on here. The outer bladder back points are level with the back shu points and have similar functions.

The energetic links between the twelve meridians

The simplest way of classifying meridians is according to their yin/yang relationships (see here). In yin meridians the qi-flow is in the opposite direction to that in their yang partners, forming a continuous qi circuit. These partners connect through branches called collaterals. This energetic connection between the yin and yang meridians means that you could massage the yin meridian and knead qi-points on it to influence functions of the yang meridian, and vice versa. Massaging the meridians will in turn affect the associated organ functions.

LOCATION OF THE HAND AND FOOT MERIDIANS

TCM theory classifies the twelve meridians based on their relative yin-ness and yang-ness. The ancient Chinese tried to explain yin and yang by observing the sun shining on a mountain. The bright side is more yang and the shady side is relatively more yin. The yin meridians are located on the less exposed surfaces, and the yang meridians can be found on the more exposed surfaces.

Each meridian pair is dominated by the energies of one of the Five Elements (see here), and the pages that follow present the meridians according to their ruling element. They describe the functions of the organs and meridians associated with each element, and the qi-points for treating problems that result from their functional imbalance.

These pages are coded using the colours associated with the elements: red for fire, green for wood, and so on. Illustrations of the meridians show all the qi-points used in the treatments in chapters 5 and 6.

image

Qi-flow of the yin/yang hand meridians

The flow of qi through the meridians of the hand link each hand yin meridian (lung, pericardium, heart) energetically with its hand yang meridian partners (large intestine, sanjiao, small intestine). You can trace the flow of qi through the six yin/yang hand meridians.

They are called hand meridians because they either start on the hand or end on the hand. The yin hand meridians start on the chest and end on the hand, whereas the yang hand meridians start on the hand and end on the head.

EXAMPLE: Starting with the lung yin meridian, the energy flows from the chest at LU 1 down to the thumb, and connects via collaterals to the large intestine yang meridian, which starts on the index finger LI 1 and flows up to the face, ending at LI 20.

You can trace the same circuits with the pericardium/ sanjiao and heart/small intestine meridians. When you have learned the Tui Na techniques, you can use them to promote stronger qi-flow through these circuits, which in turn will promote health.

image

EXAMPLES

Qi-flow of the yin/yang foot meridians

The qi-flow through the foot meridians links each foot yin meridian energetically with its foot yang meridian partner. As with the hand meridians, you can trace the flow of qi through the six yin/yang foot meridians. They are called foot meridians because they either start on the foot or end on the foot. The yin foot meridians start on the foot and end on the chest, while the yang foot meridians start on the head and end on the feet.

EXAMPLE: Starting with the spleen yin meridian, the energy flows from the big toe at SP 1 up to the chest, connects via collaterals to the stomach yang meridian, which starts just under the eye at ST 1, and flows down to the foot , ending at ST 45 on the second toe.

image

EXAMPLE:

Eight extraordinary meridians

In addition, there are eight ‘extraordinary’ meridians, only two of which are described here. They are the ren and du meridians, which encircle the head and trunk on the midline. In English, the ren meridian is called the ‘conception vessel’ and du is called the ‘governing vessel’. The ren meridian is relatively more yin than the more yang du meridian. (See also here.)

FUNCTIONS OF THE REN YIN AND DU YANG MERIDIANS

NOTE: Problems on these meridians should be treated with Tui Na massage applied along them, with focused kneading of appropriate qi-points.

THE REN YIN MERIDIAN

This regulates the six hand/foot yin meridians. The three yin meridians of the foot cross at R3 and R4.R 24

Recommended qi-points for treatment

THE DU YANG MERIDIAN

This regulates six hand/foot yang meridians. They cross at DU 14 and DU 20.

Recommended qi-points for treatment

image

The ren meridian starts midway between the anus and the genitals, and the du meridian starts midway between the tip of the coccyx and the anus. They end just below and above the mouth, respectively.