Friday, September 08, 2006

TCM and Massage 1

Oriental Medical Philosophy in relation to Chinese Massage - Main Aim, Organs, Meridians, Ch'i.


The main aim of any healing discipline or modality - to regenerate the body function as a whole; survival.

Concepts


Twelve Organs


Lungs
Heart
Liver
Spleen/Pancreas
Kidneys
Colon
Small Intestine
Gall Bladder
Stomach
Bladder
Pericardium
Triple Heater


The Pericardium


  • Functional rather than organic
  • protector of the heart
  • messenger of joy
  • roughly anatomically equivalent to the sac enveloping the heart


The Triple Heater


  • 3H1 - Upper Heater - Heart and Lungs (Oxygen)
  • 3H2 - Middle Heater - Liver, Stomach, Intestines (Food)
  • 3H3 - Lower Heater - Kidneys, Testes/Ovaries (Reproduction)


Oxygen and food are processed by 3H1 and 3H2 to produce ch'i, the vital life energy. Ch'i circulates throughout the system, and is also stored in 3H3.


The kidneys govern the sexual function.


If 3H1 or 3H2 are put out of action, death will result. If 3H3 is put out of action, reproduction is impossible, ultimately resulting in death.


Qi


Ch'i, Ki, Prana, Qi - synonyms.


Ch'i flows through meridians, which are channels. There are twelve meridians corresponding to the twelve organs. These twelve meridians are bilateral, i.e. are on both sides of the body.


There are two other meridians which are single (not bilateral):


  • The Conception Vessel, running up the center of the front of the body
  • The Governor Vessel, runs up the center/back of the body and head.


(NB there are other extra meridians as well - but all their points lie on the above main meridians)


Ill health comes when the ch'i flow along the meridians is blocked. Energy normally flows in circles along these meridians.


LAW 1


Man is the microcosm of the macrocosm (i.e. the universe). Therefore he is governed by the same laws which govern nature.


LAW 2


There is nothing between Heaven and Earth except energy and the laws which govern it.


Man is between Heaven and Earth. Therefore he grows through the four seasons. Man's growth and development is cyclic.


The heart is the monarch of the organs.



The left kidney is the water kidney. The right kidney is the "life door" (sex) kidney - with relationship to the Pericardium (circulation/sex).





MeridianPoints of ActionLocation
Lung1-11Arm
Colon1-20Arm - Head
Stomach1-45Head - abdomen - Leg
Spleen/Pancreas1-21Leg - Abdomen
Heart1-9Arm
Small Intestine1-19Arm - head
Bladder1-67Head - Back - Leg
Kidney1-27Leg - Abdomen - Chest
Pericardium1-9Arm
Triple Heater1-23Arm - Head
Gall Bladder1-44Head - Abdomen - Leg
Liver1-14Leg - Abdomen

The six upper meridians are those on the arms - Lung, Colon, Heart, Small Intestine, Pericardium, Triple Heater.



The six lower meridians are those on the legs - Stomach, Spleen/Pancreas, Bladder, Kidney, Gall Bladder, Liver.



Male is right side.
Female is left side.



The movement of energy must follow the cycle of natural flow, heaven to earth and back to heaven again. Rain falls from the clouds (heaven) to earth, then via evaporation water vapour ascends to heaven again.



In the body heaven and earth are defined as forming a polarity between two parts of the body, "top" and "bottom".



Examples:



HeavenEarth
FingersHead
HeadFeet
AbdomenFeet
FingersAbdomen
FingersShoulder

The Meridians of Earth run from Earth to Heaven (flowing "upwards"):



S/P, Liv, Kid, Heart, Lung, Peric.



The Meridians of Heaven run from Heaven to Earth:



Stom, GB, Blad, Colon, SI, 3H.


The three upper meridians of Earth run from earth (body) to heaven (fingers): Heart, Lung, Pericardium.


The three upper meridians of Heaven run from heaven (fingers) to earth (head): Colon, 3H, SI.


The three lower meridians of Earth run from earth (foot) to heaven (body): SP, Liver, Kidney.


The three lower meridians of heavenrun from heaven (body) to earth (foot): Stomach, GB, Bladder.


The heaven and earth relationship also refers to the front and back of the body. The heaven meridians are located on the back of the body and limbs (the tougher, hairy, outer, darker parts of the limbs), the Earth meridians on the front of the body and limbs (the inner, softer, lighter parts of the limbs).


Energy lows continually throughout the body via the twelve meridians in circular flows:


Lung, colon, Stomach, SP, Heart, SI, Bladder, Kidney, Peric, 3H, GB, Liver, back to Lung again.


Meridians must have means of rejoining and redirecting themselves, e.g. when cut during surgery, if a limb is lost, around body piercings, etc.


YIN and YANG


Two antagonistic opposites which complement each other. The Taoist symbol of nature.



YINYANG
PassiveActive
FemaleMale
NightDay
MoonSun
InternalExternal
WaterFire
ColdHot
BottomTop
EarthHeaven
WinterSummer
AutumnSpring
BloodEnergy
FrontBack
ExpansionContraction

Each tendency brings about the search for and production of the opposite tendency to balance.


In winter (cold, yin), we seek heat (yang).


In summer (hot, yang) we seek cold (yin).


Summer (yang) brings growth (yin).


Winter (yin) brings hibernation (contraction, yang).


The human body can be separated into yin and yang. In a situation of
good health, the rate of expansion (yin) matches the rate of contraction
(yang). Health is a balance of yin and yang.


If yang overbalances yin, we get continued contraction. If yin overbalances yang, we get continued expansion.


If the system is unbalanced, we must decrease the deficient aspect. Therefore we require both yin and yang techniques, e.g. techniques to create heat, and techniques to create cold.


Yin and Yang allow us to classify:


  • persons in constitutional type
  • techniques
  • results.


We aim for the TAO - the meeting place at the center.


In the body heaven is Yang, earth is Yin.


ORGANS and MERIDIANS


YinYang
HeartSI
SPStomach
LungColon
KidneyBladder
LiverGB
Peric3H

Yin organs are primary and will affect their yang partners. The converse is not always so.


One can live without yang organs - not without yin organs.



WU HSING


The Five Elements


The five elements are basically a means of categorisation.


The five primary forces of the universe - seasonal influences.


All living things contain the five elements.


In the original texts, earth belongs to all things at the center.


The sun rotates 1 degree per day - 360 days/year (solar days)


The moon rotates 13 degrees per day


72 days per season (includes 72 for earth - 18 days per season during
which energy is nourished)


Natural cyclic patterns in Man and Nature - SHENG and KO cycles.


SHENG CYCLE


  • Mother-son cycle
  • Generating cycle
  • Anabolic cycle
  • Clockwise
  • YANG



Metal - Water - Wood - Fire - Earth - Metal ...


Any blockage of one element will result in a deficiency in the next
(son).


KO CYCLE


  • Grandmother - grandson cycle
  • Checking cycle
  • Catabolic Cycle
  • Clockwise(?)
  • YIN



Metal checks Wood


Wood checks Earth


Earth checks Water


Water checks Fire


Fire checks Metal


If the system is overbalanced in one element it will inhibit the
grandson


e.g. excess of sweet will hurt kidneys;excess of salt will hurt heart


We can use the Ko cycle to reduce an excess of a certain element, e.g. treatment with water will check an excess of fire


Note also that if one element increases its "grandmother" will/may go up to compensate, e.g. if the liver goes up, the lung may go up to compensate.


The five elements correspond to various classes of attributes in the
body and nature:


ATTRIBUTEFIREEARTHMETALWATERWOOD
Yin OrganHeartSPLungKidneyLiver
Yang OrganSIStomachColonBladderGB
SeasonSummerLong SummerAutumnWinterSpring
ColourRedYellowWhiteBlackBlue/Green
EmotionJoySympathyGriefFearAnger
TasteBitterSweetPungent (spicy)SaltSour
Related areaTongueLipsNoseEarsEyes
Disease areaComplexionMusclesSkin/Body HairBonesTendons
FluidsSweatSalivaMucusUrineTears
DirectionSouthCenterWestNorthEast
SeasonSummerLong SummerAutumnWinterSpring
Agric. CycleGrowthMaturityHarvestStorageBirth

Related Areas give indication of organ states.


Disease Areas reflect organ disease.


Directions are for Northern Hemisphere.


Colour refers to primary colours in nature, complexion colours in man.


Agricultural Cycle refers to man also - annually, and to entire life.


Examples: Treat eye problems on liver meridian. Red eyes - too much fire in liver. Treat ear problems in kidney meridian.


MEASUREMENT IN TCM


1 Tsun - 1 anatomical inch.


10 Fen = 1 Tsun


Measurement is based on the patient, and varies between individuals.


The four fingers of one hand, measured across the second knuckles = 3 tsun.


Two fingers across second knuckles = 1.5 tsun.


Each knuckle segment on any finger (length between two knuckles) = 1 tsun.


6 tsun - fingers of two hands


4 tsun - fingers of one hand + 1 knuckle segment


etc.


YU Points


The Yu points are found on the Bladder meridians. They give access to the organ nergy of the 12 organs. The Bladder meridian is the only one which connects to all the organs.


Bladder points are located 1.5 inches laterally from the soft spaces between the vertebrae, e.g. BL13 is between T3 and T4, 1.5 in. bilaterally. Each of the mentioned points has a specific effect on the organ mentioned.


Vertebra (point is below)PointOrgan
T3BL13Lung
T4BL14Pericardium
T5BL15Heart
T7BL17Diaphragm
T9BL18Liver
T10BL19Gall Bladder
T11BL20SP
T12BL21Stomach
L1BL223H
L2BL23Kidneys
L4BL25Colon
S1BL27SI
S2BL28Bladder

7 Cervical Vertebrae (C)

12 Thoracic/Dorsal Vertebrae (T, Th, D)

5 Lumbar Vertebrae (L)

5 Sacral Vertebrae (S)

4 Coccygeal Vertebrae (?)


Bladder points are located 1.5 in bilaterally opposite centre of disc below vertebra, e.g. BL13 is located bilaterally opposite the disk between T3 and T4.


The disk between T7 and T8 is level with the bottom of the scapula.


The disk between L4 and L5 is level with the top of the ilium (iliac crest).


When the neck is rotated, C7 turns, T1 does not.


MU Points


Complementing the Yu points, Yang, on the back of the body, we have the Mu points, Yin, on the front of the body.


Like the Yu points, the Mu points give us access to the organ energy of the twelve organs. They are also called alarm points.


If a certain Mu point is sore when palpitated, it reflects on the organ function. It also gives us a point of action for that organ function.


The Yu points give us access to the organ itself. The Mu points give us access to the organ function.


If the organ is damaged or weak - use Yu.

If the organ function is wrong - use Mu.


The Mu and Yu points affect different parts of the nervous system.


RIBS


We have 7 true ribs (1-7) - attached to spine and sternum.

8,9,10 - joined to spine and rib 7 by cartilage.

11,12 - spine only - floating ribs.



Location of Mu points


StomachCV124 tsun above unbilicus
HeartCV146 tsun above umbilicus
PericardiumCV17between nipples
Chi HoyCV61.5 tsun below umbilicus
3H (general)CV52 tsun below umbilicus
SICV42 tsun below umbilicus
BladderCV32 tsun below umbilicus
Lower HeaterCV71 tsun below umbilicus
Middle HeaterCV12see Stomach
Upper HeaterCV17See Pericardium
KidneyGB25end of 12th rib
SPLiv13end of 11th rib
LiverLiv14between 8/9 rib, directly below nipple
GBGB24between 9/10 rib, directly below nipple
LungLung11.5 tsun below depression at join of collarboneand shoulder
ColonST252 tsun either side of umbilicus

CV12 is meeting point of all Yin meridians


CV6 - Ch'i Hoy, Sea of Ch'i is used to affect chi flow thoughout meridians - can be used to tone system generally.


Examples:


For lung problems can use:


  • Lung1 - Lung Mu point
  • BL13 - Lung Yu point
  • CV17 - 3H1 Mu point
  • CV5 - 3H general Mu point
  • CV6 - ch'i hoy
  • CV12 - 3H2 mu point
  • BL22 - 3H Yu point


For constipation:


  • BL25 - colon Yu
  • ST25 - Colon Mu
  • CV4 - SI Mu
  • CV12 - Stomach, 3H, Yin meridians


with indigestion, CV14 often hurts

Shen - spirit - housed in heart

so indigestion may affect heart point


Learn Mu and Yu points by heart.


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Pressure


Varying pressure can be used both to tonify, sedate, stimulate (activity and nonactivity).


Deep or superficial.


Remember the three levels of energy


HeavenYang
PersonYin/Yang
EarthYin

We treat Yang conditions (Acute, Hot) with Yin techniques.


We treat Yin conditions (Chronic, Cold) with Yang techniques.


It is possible to have a chronic condition which goes acute.


To regulate we use an intermediate technique.


HeavenYangSurfaceExternalTonificationHeatLightPressureShort Duration <= 3 seconds
PersonYin/YangIntermediateIntermediateRegulation5-8 seconds
EarthYinDeepInternalSedationColdDeep PressureLong Duration 10-30 seconds

Disease and the three energy levels


We use the example of the effect of cold on the body.


Heaven - The surface of the body, from wet cold weather, becomes cold. We get a chill.
To treat at this level we can use heat - from a hot bath, warming diet, etc. Massage can be used at this level.


Person - Intermediate. The disease has sunk deeper. We now have a cold.
To treat at this level we can again use heat and massage.


Earth - Deep. The disease has gone internal. We now have pneumonia.
Treatment at this stage involves internal medicines and complete rest. Massage is of no use here.


Note that disease goes from Yang (Heaven) to Yin (Earth). In the example, if the disease process continues it may go back up through the levels until all levels are affected.


If all levels are effected - death will follow.


A chronic condition may be marked by a recurring illness. It is a continuous level of disease which is affected by conditions.


Diagnosis


Knowledge through examination


Diagnosis allows us to make a *Prognosis* - estimation of future aspects of a patient's health.


It also enables us to provide a *treatment* giving a *result*.


Diagnosis involves:


  • Questions and Answers
  • Facial Diagnosis - external manifestations
  • Appearance - walking, sitting, behaviour patterns
  • Palpitation - Mu and Yu points, abdomen, reflex area, tap sound, etc.

We diagnose through the senses:


  • Sight - Appearance, colour of complexion, etc.
  • Hearing - voice tone, breathing, etc.
  • Smell - Aroma
  • Touch - Palpitation
  • Conversation

A prognosis involves knowing


  • Type of condition (yin/yang)
  • Area(s)/Organ(s) affected

A treatment involves


  • Points of Action and procedure to follow
  • Advice (diet, baths, packs, etc.)


Facial Diagnosis



Diagnosis of the internal environment though external manifestation



  1. Horizontal lines across the forehead indicate a great deal of CNS (central nervous system) activity - much thought
  2. Lines on forehead in hapazard directions indicate erratic or disturbed mental activity
  3. Bright red ears indicate excess heat in kidneys, usually due to excess protein or especially too much salt in the diet. Excess salt can hurt the heart (water destroys fire, from the Ko cycle). Salt draws water from the blood, coagulating it. It also hardens the arteries, bring thirst and dehydration, and possible joint problems.
  4. White circle inside pupil - excess salt
  5. Furrows inside corner of eyes - liver problems
    A bubble of fluid between eyes (?) - congested liver
  6. One main line between eyes - SI problems
  7. Darkness in corners of eyes - blue/black - Too much sugar - liver and spleen control sugar digestion or - emotional problems
    spleen -> sympathy -> grief -> thought, contemplation
    can be supressed anger - burning liver
  8. Puffiness under eyes - tired kidneys
    - spleen not transforming water
    - may be accompanied by swollen ankles if severe
  9. Big eyes - yin constitution
    Thin, narrow eyes - yang constitution
  10. Flares (mares) of nose very red - excess heat in lungs - too much calorific heat
  11. Big cleft in end of nose - heart problems
    Large, pitted nose - colon and liver - can be alcohol
  12. Small arterials in cheeks - congestions in arterials in lungs, common in smokers
  13. Very red cheeks - heat in lungs
    Very pale cheeks - cold in lungs
  14. One deep furrow between lips and nose (mostly on women) - urogenital problems, uterus and ovaries
  15. Enlarged top lip - liver
    Enlarged bottom lip - colon
  16. lines at end of mouth - duodenum (ulcers, worry)
  17. Cleft in chin - yang constitution
  18. Small lines off lips all around mouth - reproductive organs no longer being stimulated (3H3?)
    - menopause or sex problems
    - usually in older women

Chinese Clock


0300-0500LUArmYin
0500-0700COArmYang
0700-0900STLegYang
0900-1100SPLegYin
1100-1300HeartArmYin
1300-1500SIArmYang
1500-1700BLLegYang
1700-1900KILegYin
1900-2100PCArmYin
2100-23003HArmYang
2300-0100GBLegYang
0100-0300LILegYin

The above schedule represents meridian flows of nutritive (blood) energy through the twelve meridians. This nutritive energy nourishes meridian and related organs nourishing the whole body over a 24 hour period.


The energy is strongest in the middle of the period (e.g. SI - 1400, Lung - 0400)


Examples


If heart is weak it will improve at midday, and will be worst at midnight.


If heart is overactive (e.g. high blood pressure) it will be worst at midday, and will improve at midnight.


Lower back problems (associated with kidneys) -
if worse in the morning (0500 - 0700) deficient kidneys
if worse in the evening (1700 - 1900) overactive kidneys


Note that the energy flow in an organ is weakest when the nutritive energy is furthest from it (i.e. 12 hours from its nutritive period).


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