Acupoints A

The 12 Meridians Qi Flow Timeline with Clinical Manifestations

Dr. Bella Tan
May 27, 2021
Lily Forsythe

The 12 meridians are intricate qi highways traveling across our bodies.

Understanding them requires an intimate knowledge of both yin and yang, the zang fu
organs, and the corresponding 24 hour clock through which the qi flows. The following is
a broad overview of each meridian and the different ways meridian qi imbalance can
manifest.
The 12 meridians begin with the Hand Tai Yin meridian, more recognizably
known as the Lung meridian. The qi along this meridian flows from the center of the
chest down the inside of the arm, ending on the radial side of the thumbnail bed. The
fullest of this qi flow happens from 3am-5am. It is a yin meridian; we see its yin
characteristics in the time of day, as the middle of the night reflects the quiet, dark, and
calm of yin. We see it also in the location as it travels on the inside of the arm (soft,
protected, pale), and in the direction it travels, as it moves downwards, and to decrease is
a yin quality. The main clinical indications for the Hand Tai Yin meridian are lung
related. This meridian can be needled to treat exterior lung symptoms such as swelling,
fullness, cough, and chest pain, as well as interior disorders such as cough, panting, thirst,
vexed heart, chest fullness, and pain. I have a particular interest in the Lung meridian
because I relate strongly to the metal element (as well as the water element) personality-
wise and my mother has chronic asthma, which she ties to a long-term sense of grief (the
spirit of the Lung is Po, which has to do with sadness). She also has chronic constipation
– this blew my mind when I learned that the Lung and the Large Intestine were yin yang
paired meridians.
The Hand Yang Ming meridian, otherwise known as the Large Intestine meridian,
travels upwards on the outside of the arm from radial side of the index finger nail bed to
the opposite side of the nostril, on the face. The qi along this meridian flows from 5am-
7am. We now understand the qi in our bodies to have flowed from the heart down to the
hand, then up, to the face, in a time span of four hours. This pattern will continue
throughout the twelve meridians, as the qi flows through each, in two hour increments.
The LI meridian is the yang pair of the Lu meridian, you can see this in the fact that it is
on the outside of the arm and it travels upwards. The Yang qi is beginning to grow as the
sun begins to rise. The clinical indications (exterior pathogens) for Hand Yang Ming are
toothache and neck swelling. Internally problems with this meridian will manifest as
jinye fluid problems such as yellowing eyes, dry mouth, nasal flow/nosebleed, and throat
bi symptoms (heat/stagnation). The pathway of this meridian means that it is able to treat
nose and ear problems locally.
The qi then flows from the face down to the feet. This is the Stomach meridian, or
Foot Yang Ming meridian. It begins just below the eyeball, in the center of the orbital
socket, and flows all the way down to the lateral side of the second toenail. This is a
Yang meridian and covers many symptoms crossing the body. Its qi flow peaks from
7am-9am – this explains why eating breakfast is optimal for digestion. The clinical
indications for this meridian are: cold/shivering, moaning, frequent yawning, dark
complexion, and abdominal distention. Concerning blood disease, when needled this
meridian can treat virulent/toxic febrile pathogens, malaria, and mania. It will treat
head/face excess heat. It will treat breast disorders manifesting red, swollen, and painful
fibrocystic. This meridian is good for treating febrile, “hot” illness because it carries so
much Yang qi. The practitioner can drain the heat through deep reduction needling.
From the feet, the qi flows upwards to the chest. This is the Spleen meridian, or
Foot Tai Yin meridian, with the qi at its fullest from 9am-11am. This meridian travels
from the medial side of the big toenail bed upwards, on the inside of the leg, to the lateral
side of the chest in the sixth intercostal space. It is a Yin meridian treating conditions
regarding the movement and regulation of blood, qi, and fluid. It is the yin pair of the
Stomach. Clinical indications are external pathogens such as stiffening of tongue base,
vomiting, stomach duct aches, abdominal swelling, moaning, and heavy body/limbs.
Needling this meridian can treat internal disorders such as achey tongue base,
immobilization, inappetence, vexed heart, tension/pain below heart, viscous/clotted stool,
insomnia, and inability to lie down.
The qi then flows from the heart to emerge from the internal at the armpit and
down the inside of the arm, ending on the radial side of the pinky finger nailbed. This is
the Heart meridian, or the Hand Shao Yin meridian. It is a yin meridian and it regulates
fire, moves blood, and can clear heat and stasis. It peaks at 11am-1pm. Clinical
indications are exterior pathogens such as dry throat, pain in the heart, and thirst with
desire to drink. Internal causes for treatment manifest as yellow eyes, flank ache, reversal
pain along the channel, and heat/pain in the center of the palms.
The yang pair to the Heart is Small Intestine, or Hand Tai Yang - this is where the
qi flows next. It peaks from 1pm-3pm and flows from the ulnar side of the pinky finger
nailbed up the outside of the arm, zig zagging behind the shoulder, then ending behind
the temple, near the TMJ joint. It helps with nourishment by separating the clear from
turbid, and protects from cold by warming and discharging the exterior. Clinical
indications are external pathogens causing pain in the throat, swollen chin, an inability to
turn head, and pulled up shoulders. Internal indications may be deafness, yellow eyes,
swollen cheeks, aching in head, cervical disorders in ligaments/joints, and pain in
chin/shoulder/elbows.
From 3pm-5pm the qi peaks in the Bladder meridian, or Foot Tai Yang meridian.
This is a yang organ with many points, running primarily on the back. This is a very
“yang” position, as the back bears the brunt of the external world, a very “yang”
characteristic. The meridian begins on the inner canthus of the eye, and runs vertically up
the forehead, over the top of the head, and down the back in two branches. It continues
down the backside of the leg to end on the outside of the nailbed on the pinky toe. Foot
Tai Yang protects from cold by warming and discharging the exterior, it stores fluids and
helps kidneys in maintaining fluid volume, and it secretes and differentiates clear and
turbid Clinical indications of exterior pathogen are headache, bulging eyes, pulling in
nape, spine aching, lower back feels broken, hips cannot bend, knotting in back of knees,
and calves feel split. Interior indications are diseases generated by the sinews, which
manifest as hemorrhoids, malaria, madness, peak-illness (dian-withdrawal/epilepsy),
headache, nape pain, yellow eyes, tearing, nasal flow, nosebleed, and pain along the
channel.
 The yin pair to the Bladder is the Kidney Foot Shao Yin meridian. This channel
peaks from 5pm-7pm. It runs from the sole of the foot up the front of the body, ending
just below the clavicle, lateral to the midline of the body. It governs the pre-heavenly qi
and movement of blood. It also governs bones/marrow, growth and development, ears,
and the ability to persist and follow through (will). The external pathogens on this
meridian manifest as hunger but no desire to eat, cough/spitting blood, shouting loudly
and panting, not wanting to sit, glazed eyes, insufficient qi causing fear, frightened heart.
internal indications manifest as heat in mouth, dry tongue, swollen throat, dry/aching
gullet, vexed/aching heart, diarrhea, back inner thigh ache, somnolence, and hot/achy foot
soles.
From the clavicle, the qi moves from the upper chest (in line with the armpit),
down the inside of the arm to the tip of the inside of the middle finger. This is the
Pericardium Hand Jue Yin meridian. A yin meridian, this channel keeps the heart open
and maintains the peace. It is the protector, wrapping the heart. The qi flow peaks from
7pm-9pm. The external pathogen indications are hot palms, cramped arms/elbows,
swollen armpit, chest/flank fullness, racing heart, red face, yellow eyes, uncontrollable
laughter. Internal disorder may manifest as vexed heart, pain in the heart, or heat in the
palms.
The next meridian, a yang pair to the Pericardium, is the Hand San Jiao Shao
Yang meridian. It runs from the ulnar side of the ring finger nail bed, up the back of the
arm, shoulder, and neck, behind the ear, and ends just lateral to the eyebrow. The qi flow
peaks from 9pm-11pm. This meridian governs and conducts qi and fluid throughout the
body. It essentially makes sure qi and fluid is where it needs from the upper to the lower
jiao, working with the relevant organs in order to do so. External pathogen clinical
indications may be sore throat, pain in the ear, with internal stomach and large intestine
related indications being belching, nausea, bad breath, dark/turbid urination, and smelly
diarrhea.
The next meridian is the Gallbladder Foot Shao Yang meridian. The Qi moves
from a depression near the outer canthus of the eye to trace zig zags along the side of the
skull. It then flows down the side of the body and outside of the leg, eventually ending on
the lateral side of the nail bed of the fourth toe. This is a Yang meridian and peaks from
11pm-1am. The fresh yang for a new day begins to build from this meridian, which is
why it is important to sleep by 11pm in the peak yin time, when yang is low (but
growing). This meridian does more than just transport and transform, like the other yang
organs - it also stores and secretes bile. Clinical indications may be related to poor
decision making (Shen disorders), deafness, tinnitus, toothache, migraine, vertigo,
insomnia, local pain along the meridian, and regurgitation.
The final meridian is the Liver Jue Yin meridian. It runs from the lateral side of
the big toenail bed, along the inside of the leg, circles the groin area, and comes up the
flank to end directly below the nipple in the sixth intercostal space. The qi flow peaks
from 1am-3am. It is a Yin meridian, the yin pair to the Gallbladder, and collects and
directs the Blood, ensuring smooth flow. Clinical indications are headache, irregular
menstruation, dizziness, insomnia, pain in local areas along the meridian, febrile disease,
depression, and hypochondriac pain.
 In sum, the pattern of qi flow, from the chest to the hand, the hand to the head, the
head to the feet, and the feet to the chest, is a beautiful repetitive flow that peaks in two
hour cycles. Understanding the cycle is crucial to analyzing clinical manifestation and
subsequent treatment.

References
Acupoints B powerpoints by Henry Claflin
https://www.sciencedirect.com/topics/medicine-and-dentistry/gallbladder-meridian
https://theory.yinyanghouse.com/
Between Heaven and Earth: A Guide to Chinese Medicine by Harriet Beinfield et al.