The Immune System & Chinese Medicine

Modern Immunology

Immunology is a study of about how the body identifies foreign bodies and reacts to them. In essence it is the study about the body's self defense mechanisms. The word "immunology" came from Latin "immunis", which was originally a law concept, and means "not subject to an obligation imposed on others"; e.g. immune from taxation. At first, immunology concentrated on studying anti-infection aspects only, which belonged to a branch of microbiology. In the 1960's, the rapid advancement of immunology expanded to include non-infectious aspects, such as autoimmune, allergy and immunodeficiency, consequently it became an individual science.

According to modern theory, the body depends on the immune system to fight against various infections from bacteria, microbes, viruses, toxins and parasites. It also clears up harmful materials inside our own body. The whole process can be understood as self-discrimination and elimination of foreign bodies in an attempt to create an internal equilibrium and provide physiological protection for the body. Thus, when the immune system is normal, health can be maintained. On the other hand, when the immune system is malfunctioning, disharmony will occur and give rise to illness. The above functions are carried out by an integrated body system, which includes organs (thymus, spleen and lymph nodes), tissues (skin and mucosal layers), cells (lymph cells and macrophages) and cell products (immunoglobulin, antibodies and complement).

To sum it up, the human immune system has three basic functions: defense, surveillance and homeostasis.

The Immune Organs of the Body

Traditional Chinese Medicine Theory and Immunity

The variolation method in ancient times: the patient inhales the vaccine powder through the nose with the aid of a silver tube.

In the history of traditional Chinese medicine (TCM), the documentary records for the Chinese word "immune" was first seen in the 18th century in the book Mian Yi Lei Fang (Formulas for the Immunity from Plague). "Plague" had been a common term used by ancient Chinese to refer to infectious diseases that affected a large population. Although the terminology came later than Western medicine, their concrete context was different. However, TCM already knew about the theory and practice of immunology and infectious diseases from earlier dynasties. In chapter 72 of the Suwen (The Book of Plain Questions), when the Yellow Emperor asked about the seasonal epidemic diseases, his chief advisor Qi Bo answered that in order to defend against those diseases, one should always keep his healthy energy abundant, and the evils will not invade. The dialogue clearly shows that TCM regards "healthy energy" as the general defense mechanism against infectious diseases. Since then, it has abundant experience in various related aspects, with studies concentrating on wenbing, shanghan, liqi (pestilential evils) and measures of variolation (inoculation against smallpox) in the 16th century which was very progressive for the time.

TCM immunology has its own unique characteristics listed below:

The concept of holism is a main characteristic of TCM immunology.

From the beginning, TCM has employed holistic approaches; because, it sees the human body as an organic whole. The correlations between the organs and tissues, as well as the human person and the living environments, are organized according to specific orders, which give rise to mutual balance between each physiological function. This integral stability and harmony is the root of disease defense and health maintenance. Any disturbances in this equilibrium will cause disease. Every part of the body such as qi (vital energy), blood, body fluids, organs and the meridians has its own particular function. They combine to build up the body's defense system and bring out their protective strength mutually. According to TCM concepts, the body's natural resistance against diseases and its repair ability are described as a flow of energy that circulates throughout the body, which is called the healthy energy (zheng qi).

Healthy energy (zheng qi) is the integral manifestation of the human body's immune functions.

Under normal circumstances, the body depends on the immune system to fight against various infections and to clear up harmful materials in order to keep a clean internal environment. When the immune system functions normally, health can be maintained; otherwise disharmony will occur and give rise to illness.

Similar to Western medicine, TCM also holds that the body has its own disease defense ability due to the existence of healthy energy (zheng qi). In chapter 72 of Suwen (The Book of Plain Questions), it states: "When healthy energy is well stored inside the body, no evils can cause interference." In chapter 33 it states: "Whenever the evils are gathered inside, a deficiency of healthy energy must be present." These statements imply that healthy energy is the body's natural resistance against disease, and disease is seen as the result of the disharmonious healthy energy within us. Occasionally, other TCM terms such as primordial qi, genuine qi or protective qi also refer to this kind of resistance. All of these embody the body's comprehensive immune functioning.

Immune modulation effects are an important part of immune functioning.

TCM holds that when healthy energy (zheng qi) is abundant, evil forces cannot prevail. According to the yin yang theory, the body's yin and yang are regulated and adjusted continuously. Keeping yin and yang in equilibrium is an essential factor to carry on normal life activities. Once this equilibrium is disturbed, disease will result.

Resuming yin and yang harmony is the universal treatment goal of TCM. The overall therapeutic strategy is to replenish deficiencies and remove excesses of yin or yang. The approaches are usually focused on holistic regulation and possession of dual modulation effects, which as stated above, are to remove excesses and replenish deficiencies. These characteristics are similar to Western medicine's understanding of our body's immune modulation effects. The dual modulation (or immune modulation) effects of TCM have the following characteristics.

	TCM focuses on mobilizing our own innate healing power; most of its remedies work on the whole being, not just on specific systems. Their healing power is far beyong the physical level; they can also work on the level of qi (vital energy) that empowers us. Even when the body seems healthy and there are no outward symptoms, immune function can be affected with symptoms present internally. Herbal remedies can find and fix these imbalances even when they are not obvious to us.
	To support the balancing process, TCM uses different modulation methods, for example adjusting the body's yin and yang, qi (vital energy), blood or organ functions. They can rehabilitate the body to go from a hyper-functioning state to a normal state or from an under-functioning level back to a normal state. TCM has unique theories about this, categorizing the regulating properties into four actions; "to depress when stimulated", "to rise when collapsed", "to subdue when overwhelming" and "to nourish when deficient."
	In some ways, normal immune functions are enhanced and the internal pathogenic factors are eliminated with dual modulation effects. A complementary relationship is formed that reinforces healthy energy and repels evils.

TCM therapeutic methods are usually focused on holistic regulation and possession of dual modulation effects. The Modulation Effect of Chinese Medicines According to the concept of immunology, no matter if the immune reaction belongs to physiological or pathological factors, all the developing factors are crucial to disease formation. The basic rule for curing immune diseases is to shift the pathological immune reaction to a normal physiological immune reaction. In TCM, it is expressed by regulating the yin and yang balance, by applying holistic approaches to enhance the system's harmony, a method called dual modulation. Certainly, the immune modulation effect of Chinese medicine is extremely complicated, only a preliminary understanding has been revealed at this moment. Below are a few areas of discovery. Modern research shows that the majority of individuals suffer from syndromes of deficiency, various degrees of under-functioning or a disturbance of their immune system. Correspondingly, most of the tonifying herbs applied to these conditions can enhance immune function. For example, herbs like Lingzhi, ginseng, Tang shen, milk vetch root (huang qi), large head artactylodes rhizome (bai zhu), deer antler and Chinese caterpillar fungus, Chinese angelica (dang gui) and Barbary wolfberry fruit (gou qi zi) enhance the engulfing activities of monocytes, promote T- lymph cells' activation, increase the NK cells' activation and specific antibody productions and induce interferon reactions. Tonifying herbs that are blood builders like Barbary wolfberry fruit (qi zi), fleece flower root (shou wu), donkey hide glue, rehmannia root (di huang), Chinese angelica (dang gui) and deer antler enhance blood production in the bone marrow (immune organ) significantly. They can be used as adjuvant therapy in leucopenia (low level of white blood cells) conditions caused by radio or chemotherapies, or some autoimmune blood diseases. Large head artactylodes rhizome (bai zhu) enhances the engulfing activities of monocytes and promotes T- lymph cells' activation. Chinese angelica (dang gui) promotes the NK cells' activation and specific antibody production. Fleece flower root (shou gui) enhances blood production in the bone marrow. In the herbal category for heat clearing, many herbs promote immune function or the body resistance. Meanwhile, they also inhibit certain adverse immune reactions that are harmful to the body. For example, herbs like Baical skullcap root (huang qin), honeysuckle flower (jin yin hua), wormwood (qing hao) and Trichosanthes root (tian hua fen) inhibit hypersensitivity significantly. Some of them also induce the production of interferon or tumor necrosis factor. Enhancement of the pituitary- adrenal cortex can also be done with this category of herbs such as Spreading hydyotis (bai hua she she cao), Ningpo fogwort (xuan shen), Andrographis (chuan xin lian) and Northern ash bark (qin pi). Baical skullcap root (huang qin) inhibits hypersensitivity significantly. Honeysuckle flower (jin yin hua) induces the production of interferon. Spreading hydyotis (bai hua she she cao) enhances the functions of the pituitary- adrenal cortex. Besides the benefit of improving the cardiovascular system and dynamic blood activities, some herbs used for blood and circulation also possess important effects on immune regulation. Herbs like notoginseng, achyranthes (niu xi), Dan shen, Szechuan Lovage (Chuan xiong), peach kernel (tao ren) and Argy wormwood leaf (ai ye) increase T-lymph cells and promote specific antibody production. Some other herbs like notoginseng and madder (qian cao) promote blood production in the bone marrow too. Dan shen increases T-lymph cells. Szechuan Lovage (chuan xiong) promotes specific antibody production. Peach kernel (tao ren) is commonly used for blood and circulation in TCM. Main effect of herbs in the category for expelling wind and relieving syndromes of exterior type, are on the body's immune barriers, such as skin, respiratory mucosa, or localized body fluids and cell immune functioning. For example, some of them enhance the engulfing actions of phagocytes, like Divaricate Saposhnikovia root (fangfeng), cassia twig, Perilla leaf (su ye), fresh ginger and Chinese tororwax root (chai hu). However, some herbs also act directly on the immune organs. Fangfeng enhances the engulfing actions of phagocytes. The main effect of cassia twig is on the body's immune barriers. Chinese tororwax root (chai hu) is commonly used for relieving syndromes of exterior type in TCM. It is well known that Chinese drugs used for rheumatism possess significant immune inhibiting effects. Herbs used to treat this condition include Oriental vine stem (qing feng teng), Tripterygium (lei gong teng) and Northern fangji (Radix Stephaniae Tetrandrae). Other herbs that inhibit multiple hypersensitivity reactions are Paniculate Swallowwort root (xu chang qing), Slenderstyle Acanthopanax bark (wu jia pi) and Largeleaf gentian root (qin jiao). Northern fangji has immune inhibiting effects. Slenderstyle Acanthopanax bark (wu jia pi) inhibits multiple hypersensitivity reactions Largeleaf geatian root (qin jian) is commonly used for rheumatism in TCM. Chinese herbs that possess anti-cancer effects can depress or kill cancer cells by inducing certain immune actions. Such herbs are natural indigo, Java Brucea fruit (ya dan zi), sweet melon pedicel and Chinese fir. Some of these herbs even boost the overall immune functions, such as toad venom, Java Brucea fruit (ya dan zi), blister beetle (ban mao), natural indigo and sweet melon pedicel. Also, some herbs like garlic can help reduce carcinogenic factors. Most Chinese medicines are natural substances that remain in their natural form when used for treatment. After being tested and verified for thousand years by Chinese medicine practitioners, those left behind have proven their effects. Scientists have noted multiple efficacies of these prescriptions which have dual modulation and adaptive capabilities. However, even in the study of immune modulation, projects for Chinese medicine are huge and complex, and the current overall research work has not been systematic. Among those single herbs or formulas, it is necessary to carry out more in depth investigations for further explanation about the mechanism of how these herbal ingredients work.

The Twelve Meridians

1. Arm Tai Yin Lung Meridian

Pathway: The Lung Meridian originates in the middle portion of the body, and runs downwards connecting with the large intestine. It then turns and passes through the diaphragm to connect with the lungs. This meridian branches out from the axilla (armpit) and runs down the medial aspect of the upper arm where it crosses the elbow crease. It continues until it passes above the major artery of the wrist, and emerges at the tip of the thumb. Another branch emerges from the back of the wrist and ends at the radial side of the tip of the index finger to connect with the Large Intestine Meridian.

Symptoms:

Disorders of the Lung Meridian lead to diseases related to TCM lung dysfunction. According to TCM, the lung rules and regulates qi throughout the body and administers respiration (breathing). In addition, the lung moves and adjusts the water channels, so disorders of this meridian may be related to disharmony of lung fluid or "water" and respiratory disorders. Symptoms like chest discomfort with a fullness sensation, dyspnea (shortness of breath), cough, and wheezing indicate Lung Meridian disharmony. This disharmony can also lead to pain along the meridian position. For example, a person may feel pain in the shoulder and back or along the anterior border of the medial aspect of the arm.
Main indications:

Acupuncture points in the Lung Meridian are indicated for throat, chest and lung ailments and for other symptoms that are presented along the meridian's pathway. 

2. Arm Yang Ming Large Intestine Meridian

Pathway: The Large Intestine Meridian starts from the tip of the index finger and runs between the thumb and the index finger. It then proceeds along the lateral side of the forearm and the anterior side of the upper arm, until it reaches the highest point of the shoulder. From there, it has two branches. One goes internally towards the lungs, diaphragm and large intestine. The other travels externally upwards where it passes the neck and cheek, and enters the lower teeth and gums. It then curves around the upper lip and crosses to the opposite side of the nose.

Symptoms:

Disharmony of the Large Intestine Meridian can lead to symptoms of abdominal pain, intestinal cramping, diarrhea, constipation and dysentery. Since it passes through the oral cavity and the nose, symptoms like toothache, a runny nose, nosebleeds, and pain or heat along the meridian pathway can also indicate a disorder in this meridian.

Main indications:

Acupuncture points in this meridian are indicated for diseases affecting the head, face, pharynx (throat), febrile conditions and other symptoms along the meridian pathway. 

3. Leg Yang Ming Stomach Meridian

Pathway: The Stomach Meridian starts from the end of the Large Intestine Meridian at the side of the nose, and passes through the inner corner of the eye to emerge from the lower part of the eye. Going downwards, it enters the upper gum and curves around the lips and lower jaw. It then turns upwards, passing in front of the ear, until it reaches the corner of the forehead where it splits into an internal and external branch. The internal branch emerges from the lower jaw, running downwards until it reaches its pertaining organ, the stomach. The external branch crosses the neck, chest, abdomen and groin where it goes further downward along the front of the thigh and the lower leg, until it reaches the top of the foot. Finally, it terminates at the lateral side of the tip of second toe. Another branch emerges from the top of the foot and ends at the big toe to connect with the Spleen Meridian.

Symptoms:

Stomach Meridian disorders have symptoms of stomachache, rapid digestion, hunger, nausea and vomiting, or thirst. Other symptoms that relate to disorders along the meridian pathway include abdominal distension, ascites (a fluid build up in the abdomen), sore throat, nosebleeds, or pain in the chest or knee.

Main indications:

Acupuncture points in this meridian are indicated for certain gastro enteric diseases, toothaches and mental illnesses. Conditions that affect areas through which the meridian passes such as the head, face, eyes, nose and mouth can also benefit from stimulation of the acupuncture points along this meridian. 


4. Leg Tai Yin Spleen Meridian

Pathway: The Spleen Meridian begins at the big toe and runs along the inside of the foot crossing the inner ankle. It then travels along the inner side of the lower leg and thigh. Once it enters the abdominal cavity, it internally connects with the spleen and continues upward to reach the Heart Meridian. Externally, the Spleen Meridian continues moving toward the chest and branches out to reach the throat and the root of the tongue.

Symptoms:

Disharmony of the Spleen Meridian is related to spleen dysfunction. According to TCM, the spleen is responsible for the transformation and transportation of different substances, and is the foundation of our after-birth existence. Spleen function is essential in maintaining the digestive power of the body and transforming food into qi and blood. If the Spleen Meridian does not function properly, qi cannot be efficiently transported to the spleen. As a result, symptoms like abdominal distention, loose stools, diarrhea, epigastric pain, flatulence and a heavy sensation in the body occur. In addition, symptoms such as pain at the root of the tongue, swelling of the inner side of the lower limb may also indicate disharmony of the Spleen Meridian.

Main indications:

Acupuncture points in this meridian are indicated for peptic, gynecological and genital diseases. They are also indicated for symptoms along the meridian.


5. Arm Shao Yin Heart Meridian

Pathway: The Heart Meridian starts from the heart, and divides into three branches. One goes towards the small intestine. The second runs upwards along the throat towards the eyes, and the third branch emerges under the arm and runs along the inner side of the forearm, elbow and upper arm. It then crosses the inner side of the wrist and palm and ends at the inside tip of the little finger, where it connects with the Small Intestine Meridian.

Symptoms:

Disharmony of the Heart Meridian leads to pain at the heart position (precordial pain or pain at the sternum). In TCM, the heart rules the blood and the pulse. Without sufficient nourishment, an individual may feel thirsty and have a dry throat. Pain in the inner side of the forearm and heat in the palm may also indicate problems in this meridian.

Main indications:

Acupuncture points in this meridian are indicated for heart, chest and mental problems. They are also indicated for symptoms along the meridian.


6. Arm Tai Yang Small Intestine Meridian

Pathway: The Small Intestine Meridian starts from the tip of the little finger and crosses the palm and wrist. It runs upwards along the posterior side of the forearm until it reaches the back of shoulder where it ends at the uppermost part of the back (the bottom of the neck). At this position, it first branches off and moves internally through the heart and stomach to reach the small intestine. The second branch travels externally across the neck and cheek until it reaches the outer corner of the eye and then enters the ear. A short branch in the cheek moves upward to the inner corner of the eye where it connects with the Bladder Meridian.

Symptoms:

Disharmony of the Small Intestine Meridian presents mainly as symptoms along its pathway such as a swollen chin, stiff neck, sore throat, hearing problems, yellow eyes, and pain along the shoulder, upper arm, elbow and forearm.

Main indications:

Acupuncture points in this meridian are indicated for diseases of the head, neck, ear, eyes and pharynx (throat), as well as certain febrile conditions and mental illnesses. These acupuncture points are also recommended for symptoms associated with the meridian's pathway.


7. Leg Tai Yang Bladder Meridian

Pathway: The Bladder Meridian starts at the inner side of the eye and goes across the forehead to reach the top of the head where it branches into the brain. The main channel then goes across the back of the head and divides into two branches. One branch crosses the center of the base of the neck and extends downwards parallel to the spine. Once in the lumbar region (bottom of the spine), it branches out to reach the bladder. The other branch crosses the back of the shoulder and runs downward on the outside, which is adjacent and parallel to the inner branch. It continues down until it reaches the buttocks where two branches run across the back of thigh along different pathways that join at the back of the knee. The joint meridian then continues along the back of the lower leg, circles behind the outer ankle, runs along the outside of the foot and terminates on the lateral side of the tip of the small toe, where it connects with the Kidney Meridian.

Symptoms:

Disharmony of the Bladder Meridian can lead to problems of TCM bladder dysfunction. It is often related to symptoms caused by external pernicious influences (outside influences that cause disease such as cold, wind, fire, dampness, dryness and summer heat). Because the Tai Yang Meridian is considered the most exterior, it is the first meridian to be invaded if there is any external attack. Therefore, its disharmony can cause symptoms such as difficult urination, incontinence, painful eyes, runny nose, nose bleeding and nasal congestion. Pain in the head, neck, back, groin and buttock areas indicate disharmony in the Bladder Meridian pathway.

Main indications:

Acupuncture points in this meridian are indicated for diseases in the head, neck, eyes, back, groin and lower limbs as well as certain and mental illnesses. They are also recommended for symptoms along the meridian pathway.


8. Leg Shao Yin Kidney Meridian

Pathway: The Kidney Meridian starts from the inferior side of the small toe. Crossing the middle of the sole and the arch of the foot, it circles behind the inner ankle and travels along the innermost side of the lower leg and thigh, until it enters the body near the base of the backbone. After connecting with the kidney, it comes out at the pubic bone. Over the abdomen, it runs externally upwards until it reaches the upper part of the chest (the inner side of clavicle). A second branch emerges from the kidney and moves internally upwards and passes through the liver, diaphragm, lungs and throat, finally terminating at the root of the tongue. Another small branch divides from the lung to connect with the heart and the pericardium.

Symptoms:

Disharmony of Kidney Meridian can manifest as wheezing or coughing because the kidneys "grasp the qi". They also are the "mansion of fire and water," and the "residence of yin and yang". If there is insufficient nourishment and warming of the kidney, symptoms like edema (swelling), constipation, and diarrhea can indicate an imbalance in this meridian. Pain in the groin and pharynx (throat), which are located along the meridian's pathway, also can indicate a problem with the Kidney Meridian.

Main indications:

Acupuncture points in this meridian are used for gynecological, genital, kidney, lung, and pharynx (throat) diseases. They are also indicated for symptoms associated with the pathway of the meridian.


9. Arm Jue Yin Pericardium Meridian

Pathway: The Pericardium Meridian starts from the chest, leaves the pericardium organ and runs downwards through the diaphragm to connect with the triple burner. A branch rising from the chest emerges from the lower chest region and travels upwards to the axilla (armpit). From the medial aspect of the upper arm, it makes its way down between the lung and heart channels, until it reaches the elbow crease. It then runs down the forearm and enters the palm ending at the tip of the middle finger. Another short branch splits off from the palm to connect with the Triple Burner Meridian at the end of the ring finger.

Symptoms:

Disharmony of the Pericardium Meridian is related to the imbalance of the TCM heart and blood functions. The manifestation includes heart pain (precordial pain), chest discomfort, palpitations and an oppressed feeling in the chest. Since the Heart stores the "shen" or mental activities, Pericardium Meridian disorders are related to mania. In addition, swelling of the axilla and spasms of the elbow and arm can indicate a problem in this meridian, since it passes through these areas.

Main indications:

Acupuncture points in this meridian are used for heart, chest, and peptic diseases as well as mental illness. They are also indicated for symptoms manifested along the meridian's pathway.

10. Arm Shao Yang Triple Burner Meridian

Pathway: The Triple Burner Meridian begins at the outer tip of the ring finger and goes along the back of the hand, wrist, forearm and upper arm, until it reaches the shoulder region where it branches off. One branch travels internally into the chest and passes through the pericardium and diaphragm uniting the upper, middle and lower burner (triple burner). The other branch runs externally up the side of the neck, circles the ear and face, and finally ends at the outer end of the eyebrow where it connects with the Gall Bladder Meridian.

Symptoms:

Disharmony of the Triple Burner Meridian leads to symptoms like abdominal distention, edema (swelling), urinary incontinence, difficulty urinating, loss of hearing, and ringing in the ears (tinnitus). Pain in the pharynx (throat), eyes, cheek, back of the ear, shoulder and the upper arm can occur as these structures are located along this meridian's pathway.

Main indications:

Acupuncture points in this meridian are recommended for ailments of the ears, eyes, chest, pharynx (throat), and the side of the head as well as certain febrile conditions. They are also indicated for symptoms along this meridian's pathway.

11. Leg Shao Yang Gall Bladder Meridian

Pathway: The Gall Bladder Meridian starts from the outer corner of the eye and divides into two branches. One branch runs externally and weaves back and forth at the lateral side of the head. After curving behind the ear, it reaches the top of the shoulder and crosses the lateral side of rib cage and abdomen, until it ends up at the side of the hip. The other branch enters the cheek and runs internally downward, through the neck and chest to connect with the gall bladder. It continues moving downwards and comes out in the lower abdomen, where it connects with the other branch at the hip. The hip branch then runs toward the lateral side of the thigh and lower leg. After crossing the ankle, it goes over the foot to reach to the tip of the fourth toe. Another small branch leaves the meridian and terminates at the big toe to connect with the Liver Meridian.

Symptoms:

In TCM, the gall bladder is closely related to the liver. Hence, the disharmony of the Gall Bladder Meridian causes symptoms such as a bitter taste in the mouth, dizziness, headache, and pain at the outer angle of the eyelids. Pain along the meridian pathway such as in the axilla (armpit), chest, lower chest, buttocks and the lateral side of the lower limbs can also indicate a disorder of the Gall Bladder Meridian.

Main indications:

Acupuncture points in this meridian are indicated for ailments of the eyes, ears, pharynx (throat), and lateral side of the head in addition to mental illness and fever. They are also recommended for symptoms along the meridian's pathway.

12. Leg Jue Yin Liver Meridian

Pathway: The Liver Meridian starts from the top of the big toe and goes across the top of the foot. After crossing the inner ankle, it continues to go upwards along the inner side of the lower leg and the thigh, until it reaches the pubic region. It then circulates around the external genitalia and enters the lower abdomen. Afterwards, it goes up the abdomen and reaches the lower chest to connect with the liver and gall bladder. The meridian further travels upwards along the throat and connects with the eyes. Finally it emerges from the forehead to reach the vertex of the head. One of its internal branches originates internally from the eye and moves downwards to the cheek where it curves around the inner surface of the lips. Another branch starts from the liver and passes through the diaphragm to reach the lung where it connects with the Lung Meridian and completes the cycle of the twelve meridians.

Symptoms:

Disharmony of the Liver Meridian leads to groin pain, chest fullness, urinary incontinence, difficulty urinating, swelling of the lower abdomen and hernias.

Main indications:

Acupuncture points in this meridian are indicated for liver, gynecological and genital diseases. They are also recommended for symptoms along the meridian's pathway.

Characteristics of Meridian flow

Looking closely at the meridian chart, one can see a beautiful pattern with laws governing the meridian flow of Qi in the body. The pattern includes exterior towards interior, interior towards exterior, arm towards leg, and leg towards arm, etc.

Exterior towards Interior, Interior towards Exterior.

For example, the Lung Meridian (Tai Yin) flows towards the Large Intestine Meridian (Yang Ming). The Lung and Large Intestine Meridians are yin and yang organs and have an interior-exterior relationship. Both of them belong to metal of the five elements. TCM believes the interior belongs to yin and the exterior to yang, because this meridian flow can be considered as: "the internal metal yin running towards the external metal yang." In this way, the flow obeys the yin yang theory and has shown its mobile development and harmonious balance.

Arm towards Leg, Leg towards Arm.

Another example is the Arm Large Intestine Meridian (Yang Ming) flowing towards the Leg Stomach Meridian (Yang Ming). This illustrates the arm and leg relationship.

Pattern of the Meridian flow

The meridian flow chart illustrates an interesting flow pattern which is organized to follow both vertical and horizontal orders. Horizontally, the six meridians on the left side of the chart are all arm meridians, while those on the right side are all leg meridians. Therefore, the meridian flow intrinsically has arm-to-leg and leg-to-arm patterns, which means there is a balance between the upper and lower parts of the body. All meridians communicate with the body in a balanced manner.

Among the six arm meridians, the three on the left-hand are interior meridians while those on the right are exterior meridians. Of the six leg meridians, the three on the left are exterior meridians, while the three on the right are interior. This beautiful symmetry shows meridians go from the interior of the arm towards the exterior of the arm. Then, they proceed from the exterior of the arm towards the exterior of the leg to the interior of the leg and so on.

Meridians in the chart also have a vertical order. All yang meridians follow a downward order: a) Yang Ming; b) Tai Yang; c) Shao Yang. For yin meridians, the order is : a)Tai Yin; b)Shao Yin; c)Jue Yin. For example, Leg Tai Yin Spleen Meridian flows towards Arm Shao Yin Heart Meridian. The Leg Shao Yin Kidney Meridian flows towards the Arm Jue Yin Pericardium Meridian. Generally speaking, the meridian flow follows the order of Tai Yin, Shao Yin and Jue Yin. The yin yang theory governs the flow of meridians and their symmetrical and organized connections throughout the whole body.

Distribution of the twelve meridians in the body

The twelve meridians are named according to their corresponding organs, limb positions and yin and yang properties. They include three arm yin meridians (lung, pericardium, heart), three arm yang meridians (large intestine, triple burner, small intestine), three leg yang meridians (stomach, gall bladder, bladder), and three leg yin meridians (spleen, liver, kidney). The triple burner and the pericardium do not refer to anatomical structures. They are functional units in Traditional Chinese Medicine (TCM). It should also be noted, the organs mentioned here have a much broader meaning in TCM then what is typically thought of their functions in western medicine. Since the twelve meridians make up the majority of the Meridian System, they are known as the regular or principal channels. Name of the twelve Meridians Arm/ Leg Yin/ Yang Three Yang/ Three Yin The Twelve Meridians Arm Yin Tai Yin Lung Meridian Shao Yin Heart Meridian Jue Yin Pericardium Meridian Yang Yang Ming Large Intestine Meridian Tai Yang Small Intestine Meridian Shao Yang Triple Burner Meridian Leg Yin Tai Yin Spleen Meridian Shao Yin Kidney Meridian Jue Yin Liver Meridian Yang Yang Ming Stomach Meridian Tai Yang Bladder Meridian Shao Yang Gall Bladder Meridian

Distribution of the twelve meridians in the body The twelve Meridians have lateral and symmetrical distribution on the head, face, trunk and limbs. The six yin meridians are distributed on the inner side of the limbs and on the chest and abdomen. The six yang Meridians are distributed on the outer side of the limbs and on the head, face and trunk. As shown in the diagram, the order and arrangement of the three yang meridians for both arms and legs are as follows: a) Yang Ming (meaning sunlight yang) has an anterior position. b) Shao Yang (meaning lesser yang) has a middle position. c) Tai Yang (meaning greater yang) has a posterior position. The three names have described the variation of yang qi (pronounced chee). They can also be interpreted as describing the variation of sunlight received. Since most animals' backs receive the greatest amount of sunlight, the back or posterior region is usually named as the Tai Yang position. Similarly, the position of Shao Yang and Yang Ming are located at more anterior regions where less sunlight is received. The order and arrangement of the three yin meridians are as follows: a) Tai Yin (meaning greater yin) has an anterior position. b) Jue Yin (meaning absolute yin) has a middle position. c) Shao Yin (meaning lesser yin) has a posterior position. Again, the three names have described the variation of yin Qi and the degree of darkness at that position. The following figure has illustrated the general distribution of Meridians on the limbs.

The twelve meridians follow specific time schedules and pathways. The Huang Di Nei Jing (The Yellow Emperor's Classic of Internal Medicine) says, " The three yins of the arm go from the organs to the hands. The three yangs of the arm go from the hands to the head. The three yangs of the legs go from the head to the feet. The three yins of the legs go from the feet to the abdomen." Qi is continuously circulating through the meridians in a daily cycle. At certain times, both qi and blood have maximum flow in particular meridians which are outlined below. Meridian Flow Chart (The Daily Qi Current of the 12-hour Division)

Arm Leg Yin/Interior Yang/Exterior   Yang/Exterior Yin/Interior Arm Tai Yin Lung Meridian (3am - 5am) Arm Yang Ming Large Intestine Meridian (5am - 7am ) Leg Yang Ming Stomach Meridian (7am-9am) Leg Tai Yin Spleen Meridian (9am-11am) Arm Shao Yin Heart Meridian (11am-1pm) Arm Tai Yang Small Intestine Meridian (1pm-3pm) Leg Tai Yang Bladder Meridian (3pm-5pm) Leg Shao Yin Kidney Meridian (5pm-7pm) Arm Jue Yin Pericardium Meridian (7pm-9pm) Arm Shao Yang Triple Burner Meridian (9pm-11pm) Leg Shao Yang Gall Bladder Meridian (11pm-1am) Leg Jue Yin Liver Meridian (1am-3am)

As shown in the above chart, qi is more prevalent in different meridians at different times. For example, from 3am to 5am, meridian qi mainly flows through the Lung Meridian and enters the Large Intestine Meridian at 5am-7am, and then the Stomach Meridian from 7am-9am. In this way, the meridian cycle is continuous as the qi flows through the body. Exterior-Interior relationship in the meridian As mentioned before, meridians are classified into yin meridians and yang meridians according to the yin or yang organs with which they are connected. TCM believes the interior belongs to yin and the exterior belongs to yang. Hence, yin organs are thought to have more internal functions and are called interior organs. The yang organs, on the other hand, are believed to have more external functions and are considered exterior organs. TCM analyzes the physiological function of the body based on the harmonious relationships between yin and yang organs. From these relationships, the interior and exterior relationship theory was developed.