An essential diagnostic and treatment tool in acupuncture.
In Chinese medicine, the meridians 经脉 [jīngmài] describe the circulation of qì (energy, for lack of a better translation) and blood in the human body. If the English word of "meridian" is known to all, in Chinese medicine, the meridians of the body are not only lines which segment and define a space but they also fulfill precise physiological functions. They irrigate the body and circulate the qì and the blood, like streams, from top to bottom, from bottom to top, from deep regions to more superficial regions, and vice versa. They protect the yīn and the yáng, lubricate the tendons and the bones, mobilize the joints. They are not an anatomical structure per se but neither are they found anywhere in the body. As specified in chapter 10 of the Língshū (*): "the twelve meridians circulate in the middle of the flesh, in depth, so that they are not visible" (经脉十二者、伏行分肉之间、深而不见). The term flesh should be understood as the space between skin, muscles, tendons, veins and arteries, and bones.
These meridians are mainly organised into two groups, the jīng (经) meridians and the luò (络) meridians. The jīng meridians are the principal meridians, which circulate in depth of the human body, and from which separate secondary meridians, the luò, lying more superficially. The jīng meridians are twelve so-called “regular” meridians. Each of them is directly linked to an organ (or a viscus, singular name for viscera), and works in close, but not exclusive, symbiosis with another meridian among the twelve, itself linked to a viscus (an organ). Thus pairs of meridians are formed: organ meridian with viscus meridian.
Example of such pairs: the lung (organ) forms a pair with the large intestine (viscus), the spleen (organ) with the stomach (viscus), etc. Due to their functional characteristics, the organs are considered to be yīn in nature and the viscera to be yáng in nature. In Chinese medicine, it is said of the organs that they store the essence (yīn) but do not empty, they are filled but are never full; the viscera circulate substances but do not store them, they are full but not filled. For the viscera, it is the movement (yáng) that takes precedence, while for the organs, containing the essence (yīn) is essential. In terms of distribution in space, what is yīn is deeper than what is yáng. So in the human body, the yīn meridians (related to the organs) and the yáng meridians (related to the viscera) create a network where the movement of the substances and the foundation of the essence are allied, where the deep and the superficial connect , creating a whole, communicating essential elements to maintain life.
Without them, there is no life. “If organs and viscera can be considered the material basis of life, meridians are the living expression of all activity and movement,” wrote Dr. Wang Ju Yi. Chapter 10 of the Língshū says that "the meridians decide life or death, they house the hundred diseases, they adjust the vacuum and the full, they must not be blocked" (经脉者、所以能决死生、处百病、调虚实、不可不通). The meridians being the receptacle of all diseases, observing or palpating them should help to better understand the state of the disease and therefore to refine the clinical energetic diagnosis of patients. On this subject, chapter 75 of the Língshū specifies: “before using acupuncture, one must observe whether there is emptiness or fullness in the meridians, one must separate them and follow them, press and pull them [palpation techniques], observe their reactions, then only choose the meridian(s) and the point(s) [to be treated]” (用针者、必先察其经络之实虚、切而循之、按而弹之、视其应动者、乃后取之而下之).
"meridians are the living expression of all activity and movement...decide life or death"
Their observation and palpation is therefore very useful in determining how the body "behaves" in reaction to a disease. If the patient's symptoms related to an organ or viscus are directly reflected on their meridians, then the use of meridians supports the diagnosis. If, on the other hand, observation and palpation reveal more significant changes on other meridians, that these changes can be linked to the same disease and can be explained physiologically, then the use of the meridians brings undeniable added value in the diagnostic and treatment. Again, chapter 10 of the Língshū further mentions the potential of meridians to cure disease. Indeed, after palpation, any treatment that follows then targets with more precision the imbalance created by the disease.
In my practice, the use of meridian palpation as a diagnostic tool is very useful and helps me choose the treatment best suited to the state of the disease in my patients. This method is not taught in Chinese universities and not systematised elsewhere, so there is a tendency to favour diagnosis by the organs with only palpation of the pulse and observation of the tongue. Yet the classical medical texts, such as the Nèijīng, are the source and time-tested foundation of Chinese Medicine. As such, their content and knowledge should be used whenever they can add value to the treatment of a patient. That is why I choose to incorporate this method into my practice with every patient.
(*) Along with the Sùwèn, the Língshū is part of a founding text of Chinese medicine called the Nèijīng (Huángdì Nèijīng or literally the "Inner Canon of the Yellow Emperor"), a group of writings by different authors, dating from the Warring States period (476-221 avant J.C.).