Theory Spleen and Liver

CMAC111
Acupuncture Channel Theory

Session 8
Divergent Channels & Cutaneous Regions

Channels & Collaterals of the Spleen & Liver
Chinese Medicine Department
All channel diagrams used with permission.

Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.).
Hove, East Sussex: Journal of Chinese Medicine Publications.
Endeavour College of Natural Health endeavour.edu.au 1

Focus on the Divergent Channels

Features of the Divergent Channels
Branch out from the twelve primary channels on the
limbs (except TE - branches on head)
Have no specific points of their own.
Make internal linkages that may not be made
by the primary channels
Explain the actions and indications of many points.

Features of the Divergent Channels contd
Yin Channels Yang Channels
Sometimes enter their Most enter their related fu
pertaining zang. as well as their internally-
(Kidney, Heart, Lung) externally related zang.
(TE only enters fu)
Converge with their
internally-externally related Most rejoin the primary
(yang) divergent channel. yang channel at
supraclavicular fossa, neck
Join the primary or face. (Except for SI channel)
(interior/exterior related)
yang channel.

Functions of the Divergent
Channels
Distribute qi
and blood to
Strengthen the head
yin-yang and face Integrate areas
relationship of the body not
between serviced by the
internally- primary
externally paired Explain clinical
channels action
channels and
zangfu of some
commonly used
acupuncture
points

Clinical Use of the Divergent
Channels
Can be used to balance yin & yang
Especially when both yin & yang channels or
organs of an exterior/interior related pair are
affected.
Upper and lower meeting points of the
divergent pairs may be used.
Maciocia (2006, p.345)

Clinical Use of the Divergent
Channels contd
Interior/Exterior Channels Upper Meeting Lower Meeting
Point Point
Lung - Large Intestine LI-18 None
Pericardium- Triple Energizer TE-16 None
Heart - Small Intestine BL-1 Axilla
Spleen-Stomach ST-1 Thigh
Liver - Gallbladder GB-1 CV-2
Kidneys - Bladder BL-10 BL-40
Maciocia (2006, p.345)
Note: Point numbers provided for interest meeting points will not be examinable.

Focus on the Cutaneous Regions

Focus on the Cutaneous Regions
Skin regions overlying the broad network of
superficial channels.
External pathogenic factors may penetrate through
the skin to the deeper layers of the jingluo system.
May manifest disorders of the deep-lying channels
o by abnormal skin sensation
o skin lesions or discoloration

Functions of the Cutaneous
Regions
Regulate sweating
Protect the body from external pathogens

Treating Cutaneous Regions
Treatment affects skin level but can also have a
deep therapeutic effect
Acupuncture
Ointments & liniments
Massage, cupping
Plum blossom needling
Gui Sha (scraping)
Dermal hammer

Leg Yin Channels
Spleen
Liver
Kidney

Leg Yin Channel Pathways
Start at foot
Flow along medial aspect of lower leg
Connect with the Conception Vessel on the
lower abdomen
Meet other yin channels at the chest

Important Anatomical Structures
Metatarsals
Tibia
Medial malleolus
Medial condyle of tibia
Inguinal crease
Upper border of pubic bone
Rectus abdominus
5th intercostal space
Sternum & xyphoid process

Cun Measurements
15 cun
Yinlingquan SP 9 13 cun
Prominence of the medial malleolus

Cun Measurements
Prominence of medial malleolus to SP 9
= 13 cun
Prominence of medial malleolus to popliteal crease =
=15 cun
Anterior midline to lateral border of rectus abdominus
= 4 cun
Anterior midline to nipple
= 4 cun
Anterior midline to acromion
= 8 cun

The Spleen (SP)
Foot Tai Yin
Channels & Collaterals
Deadman et al. (2007, pp. 177-205)
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Spleen (Foot Tai Yin)
Channel System
o The Spleen (Foot Tai Yin) Primary channel
o The Spleen Divergent channel
o The Spleen Luo-connecting collateral
o The Spleen Sinew channel
o The Spleen Cutaneous region

The Spleen (SP) Foot Tai Yin
Primary Channel
Regular Points
21 points
Connecting Zang Fu
Spleen Stomach Heart
Main Channel Connections with other
channels
Lung Gall Bladder
Liver Conception
Pathway of the Spleen Channel
Lower border
of tongue
SP-20
Heart
SP-21 Diaphragm
Stomach
Spleen
SP-16
SP-12
SP-10
SP-9
SP-5 SP-6
SP-1
Spleen Channel (Deadman et al., 2007, p. 177)

Internal Pathway of the Spleen Channel
o Deviates from the main
channel on the abdomen
o Connects with the
stomach and spleen
o Passes through the
diaphragm
o Connects with the lower
border of the tongue
o Connects with the heart

External Pathway of the Spleen Channel
Spleen Channel Human (Lian, Chen, Hammes & Kolster, 2005, p.83)

External Pathway of the Spleen Channel
From SP-1 the channel
traverses the medial aspect of
the foot
Along the boarder of the red
and white skin
Anterior to the medial
malleolus at SP-5
SP 1 & 5 (Deadman et al., 2007, p. 177)


External Pathway of the Spleen Channel contd
Ascends the posterior border
of the tibia
Intersects the Liver channel 8
cun above the medial malleolus
Continues to the medial aspect
of the knee at SP-9
Spleen Channel & Points (Deadman et al., 2007)

External Pathway of the Spleen Channel cont'd
The channel continues up the
anterio-medial aspect of the thigh
On a straight line from SP-10
To SP-12 (lateral to CV-2 on the
inguinal crease)
Spleen Channel (Deadman et al., 2007)

Courses on the lateral aspect
of the rectus abdominal muscle
(4 cun from the midline)
From the inguinal crease to
the margin of the ribs
Spleen Channel & Points (Deadman et al., 2007, p. 177)

Continues 6 cun lateral to the
midline on the chest
To SP-20 in the 2nd intercostal
space
Descends to SP-21 in the 7th
intercostal space below the axilla
Spleen Channel & Points (Deadman et al., 2007, p. 177)

Actions & Indications of the Spleen
Channel
o Transformation and Transportation pathologies
o Digestive disorders
o Conditions of Dampness
o Blood and Qi deficiencies
o Blood stasis (in the lower abdomen)
o Heat in the blood
o Holding blood within the vessels
o Prolapse (Sinking Qi)
o Respiratory disorders/ fullness of the chest
o Disorders of the genitals

Luo-Connecting Channel
of the Spleen
o Separates at SP-4
o Connects with the
Stomach channel
o Ascends to unite with
the intestines and
Stomach

Great Luo-Connecting Channel
of the Spleen
o Separates from the main
channel at SP-21
o Spreads through the chest and
lateral costal region
o Gathers blood of the Luo
channels of the whole body

Indications of the Great
Luo-connecting channel of the
Spleen
o Abdominal pain or distension
o Generalised pain (Great Luo)
o Loose and flaccid joints
o Respiratory distress

Divergent Channel of the Spleen
o Separates from the primary channel
midway up the anterior thigh
o Converges with the Stomach
divergent channel
o Traverses the throat
o Enters the tongue

Sinew Channel of the Spleen
o Originates at SP-1
o Ascends to SP-5 to bind at the

medial malleolus
o Ascends the medial aspect of the

tibia and binds at SP-9
o Continues upwards along the

anterio-medial thigh and binds at
the at the groin
o Connects at the external genitalia

and rises to bind at the umbilicus
o Enters the abdomen and binds at

the ribs before dispersing in the
chest
Indications of the Sinew Channel of
the Spleen
o Pain of the big toe
o Pain and muscular spasm on the medial thigh
o Pain of the external genitalia
o Naval pain
o Hypochondriac pain
o Pain radiating to the chest and spine

Cutaneous Regions of the Tai Yin

The Liver (LR)
Foot Jue Yin
Channels and Collaterals
Deadman et al. (2007, pp. 469-492)

The Liver Foot Jue Yin Channel
System
o The Liver (Foot Jue Yin) Primary channel

o The Liver Divergent channel
o The Liver Luo-connecting collateral
o The Liver Sinew channel
o The Liver Cutaneous region

The Liver (LIV) Foot Jue Yin
Primary Channel
Regular Points
14 points
Connecting Zang Fu
Liver Gall Bladder Lung Stomach
Main Channel Connections with other channels
Spleen Conception Governor Pericardium

Pathway of the Liver Channel
Lung
LR-14
Liver Stomach
Gallbladder LR-13
LR11
LR-8
LR-4
LR-1
Liver Channel (Deadman et al., 2007, p. 469)

Internal Pathway of the Liver Channel
LR13
LR & GB
Diaphragm & Hypochondrium
Lungs & PC-1 Throat &Cheek
Inner Lips GV-20 vertex
Liver Channel (Deadman et al., 2007, p. 469)

Group Discussion
How might Liver channel connections to internal
organs
be involved in
5 element wood disharmonies?

Group Discussion
Liver
Gallbladder Stomach
Lung

External Pathway of the Liver Channel
Lv 11
Liver Channel Human (Lian et al., 2005, p.83)

From LR-1
Traverses the dorsum of the foot
LR-4 on the anterior aspect of the medial
malleolus
Liver Points Channel (Deadman et al., 2007)
LR 1-4 (Lian et al., 2005, p.83)

Intersects with SP-6
Travels anterior to the

Spleen channel passing
through LR-5 5 cun above
the medial malleolus
Liver Points Channel (Deadman et al., 2007)

Travels anterior to the
Spleen channel until 8 cun
above the medial malleolus
Crosses the Spleen

channel LR 8 (Deadman et al., 2007)
Then runs posterior to it

Intersects LR-8 at the
medial knee
Liver Channel (Deadman et al., 2007)

Traverses the
medial thigh
Crosses the groin
via
SP-12 & SP-13 LR 11(Deadman et al., 2007)
Encircles the
external genitals
Liver Channel (Deadman et al., 2007)

Intersects with CV-2, CV-3 & CV-4
on the lower abdomen
LR-14
6th Intercostal space
LR-13
Free end of 11th rib
LR 13 & 14 (Deadman et al., 2007) Liver Channel (Deadman et al., 2007)

Actions & Indications of the Liver Channel
o Stagnation of Liver Qi leading to pain
o Correct movement of Qi in the Stomach, Spleen and Lungs
o Extinguish Liver wind
o Subdue Liver yang
o Benefits the eyes
o Pain and swelling of the external genitalia
o Regulate the menstrual cycle
o Shan disorder (hernias, lower abdominal pain)
o Urinary dysfunction
o Lumbar pain
o Mental-emotional distress

Luo-Connecting Channel
of the Liver
oSeparates from the main
channel at LR-5
oAscends the medial leg
oConverges with the
genitals
Liver Luo (Deadman et al., 2007)

Indications of the Luo-connecting
channel of the Liver
o Sudden onset of hernia

o Itching of genitalia

Divergent Channel
of the Liver
o Separates from the
primary Liver channel on
the dorsum of the foot
o Ascends to the pubic
region
o Connects with the
Gallbladder channel
Liver Divergent (Deadman et al., 2007)

Sinew Channel of
the Liver
o Originates on the
dorsum of the big toe
and binds with the
medial malleolus
o Continues to bind with
the medial tibia and the
genitals where it
connects with other
sinew channels
Liver Sinew (Deadman et al., 2007)

Indications of the Sinew Channel of
the Liver
o Pain of the medial malleolus and spasm of the
toes
o Pain of the medial fibula
o Pain and spasm of the medial thigh
o Dysfunction of the external genitalia
o Impotence
Cutaneous Regions of the Jue Yin
Liver Cutaneous (Deadman et al., 2007)

Case Study
Consider the following case study prior to next
session.
Bring your answers to discuss in class next
week.
Case Study
Jed comes for pain relief
of broken ribs. He fell
heavily whilst snow
skiing. Jed is otherwise
healthy.
Skier carving a turn off piste (Mribel, n.d.)

Case Study Questions
What important information do you need to enable

you to decide what channels could be involved?
How will you obtain that information?

You discover this is the area of
pain.
Make a provisional list of a least

3 channels that could be
involved. Investigate pathways
of leg yang channels as well as
channels already covered.
Which portion/s of the channel

network would likely be
involved?
(E.g. Primary, sinew etc.)
Side view of a male chest from right (Jack nick20, 2014)

What strategies could be used to construct

a clinically effective treatment?
(E.g. Use luo-connecting channels, 6 divisions, primary,
interior-exterior related channels etc.)
Choose the strategy you will use.

Case Study Questions contd
What is the advantage of your strategy?
E.g.. Reduce the number of channels you might
need to use?
Choose two channels you would most like to
treat.
Share your selection and thoughts with the
class.

Essential Reading
Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.). Hove, East
Sussex: Journal of Chinese Medicine Publications. pp. 16, 17, 28,177-181, 331-335 & 469-472.
Qiao, Y. & Stone, A. (2008). Traditional Chinese medicine diagnosis study guide, Eastland Press,
Seattle. pp. 327-330. (Scanned copy provided via LMS session 9.)
Group Work
o Divide into groups of 2 and, using a chinagraph pencil or

eyeliner, locate the pathway of the specified channels using
main points as landmarks
o Be very clear about where Spleen and Liver channels sit in

relation to each other and to the tibia in the lower leg.

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References
Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A manual of acupuncture (2nd ed.). Hove, East Sussex: Journal of Chinese Medicine Publications. [Available
as web app 2013, mobile app 2009 or text 2007]
Jack nick20. (2014). Side view of a male chest from right [Image]. Retrieved February 19, 2016, from
https://upload.wikimedia.org/wikipedia/commons/5/50/Side_view_of_a_male_chest.JPG
Lian, Y., Chen, C., Hammes, M. & Kolster, B. (2005). Pictorial Atlas of Acupuncture, H.H.Ullmann, Marburg.
Maciocia, G. (2015). The foundations of Chinese medicine, (3rd ed.). Churchill Livingstone, Edinburgh.
Maciocia, G. (2006). The Channels of Acupuncture: Clinical Use of the Secondary Channels and Eight Extraordinary Vessels, Churchill Livingstone,
Philadelphia.
Mribel. (n.d.). Skier carving a turn off piste [Image]. Retrieved February 19, 2016, from https://upload.wikimedia.org/wikipedia/commons/0/03/Skier-
carving-a-turn.jpg

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CMAC111

Acupuncture Channel Theory

Divergent Channels & Cutaneous Regions

Chinese Medicine Department

All channel diagrams used with permission.

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Prominence of the medial malleolus

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SP 1 & 5 (Deadman et al., 2007, p. 177)

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Spleen Channel & Points (Deadman et al., 2007)

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Spleen Channel (Deadman et al., 2007)

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Spleen Channel & Points (Deadman et al., 2007, p. 177)

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Spleen Channel & Points (Deadman et al., 2007, p. 177)

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Spleen Channel (Deadman et al., 2007, p. 177)

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Spleen Channel (Deadman et al., 2007, p. 177)

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Spleen Channel (Deadman et al., 2007, p. 177)

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o Ascends to SP-5 to bind at the

o Ascends the medial aspect of the

o Continues upwards along the

o Connects at the external genitalia

o Enters the abdomen and binds at

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Spleen Channel (Deadman et al., 2007, p. 177)

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o The Liver (Foot Jue Yin) Primary channel

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Diaphragm & Hypochondrium

Lungs & PC-1 Throat &Cheek

Inner Lips GV-20 vertex

Liver Channel (Deadman et al., 2007, p. 469)

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